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CHANGES IN THE PUPIL IN THE INSANE

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1249 and under the supervision of an officer, and twenty-four hours’ notice is required when any such operation is in- tended and the ingredients necessary for such operation must be previously submitted for approval. Wines thus rendered sparkling and bottled in bond are regarded as sparkling wines and liable to the same duty as imported sparkling wines. The bottles containing this wine must each bear a label with the name or the description of the wine as well as the words, " Made sparkling in the United Kingdom," and the corks must be branded with a similarly plain intimation. This last provision is an excellent one, and obviously intended to prevent the public from being imposed upon with sparkling wines that are not naturally so. It is possible that there are differences of some importance from the dietetic point of view in sparkling wines in which, on the one hand, the gas is generated in the liquid by the action of the yeast plant, and those, on the other hand, into which gas obtained chemically is subsequently forced, but we are not aware that any definite evidence has been obtained on this point. It is satisfactory, however, to find that our Revenue regulations are fairly stringent in this matter, as otherwise the introduction of cheap, nasty, and unnatural champagnes and other sparkling wines would probably go on to an appalling and, likely enough, detri- mental extent. ____ THE SUN YAT SEN INCIDENT. THE satisfactory conclusion of the so-called Chinese kid- napping case by the release of Sun Yat Sen following the prompt and decided action of the Marquis of Salisbury terminates a strange incident. There is no need to enter into any detailed history of a subject which occupied the attention of so many people last week, for the facts have been already fully set forth in the daily press. It was a very fortunate coincidence for Sun Yat Sen that he happened to have studied from 1887 until he qualified at the College of Medicine at Hong-Kong, of which Mr. James Cantlie was the dean and a professor, and that at the time of Sun Yat Sen’s visit to London Mr. Cantlie happened to have been in this country, otherwise his late Chinese pupil might have now been on his way to China with a very disagreeable prospect in front of him. Mr. Cantlie having received information that Sun was a prisoner at the Chinese Legation, and that he was in a few days to be sent to China, where he would certainly lose his head, at once took such steps as showed, by his adroit management of the matter, that he (Mr. Cantlie) had not "lost his head" ,. on receipt of the strange news. Aided by the advice of Dr. Manson, who had been previously a Dean of the Medical College at Hong-Kong, Mr. Cantlie set to work with cha- racteristic energy and skill to make himself personally acquainted with all the facts, and it reflects great credit on him and Dr. Manson that the subject was soon carried to a successful issue. Apart from all contentious matter as to whether Sun had been begged, borrowed, or stolen, or how he had obtained admission into the Chinese Legation, there he was, forcibly detained as a prisoner on the assumption that he was a Chinese, that the Legation was theoretically Chinese soil, that Sun was wanted in China, and that the Legation had a right to do what it liked with its own. When the readers of the lobe, which was instrumental in first bringing the strange story to light, learned that Sun Yat Sen had been kidnapped and was imprisoned at the Chinese Legation, they were probably somewhat amused and incredulous ; but it was no amusing matter for the unfortunate Sun. Moreover, all sorts of abstract legal questions were started, but Lord Salisbury’s action soon solved the Chinese puzzle by a peremptory demand to the Chinese Minister, and the embassy captive was forthwith released. Sir Halliday Macartney, Councillor of the Chinese Legation, was once Dr. Macartney and an army medical officer, and the actors playing prominent parts in the story are all, as it happens, members of the medical profession; but the political principle involved was a big one, affecting international law, the Foreign Office, and the protection of the rights of people while on British soil. We can only suppose that the Government at Pekip, had issued peremptory orders to Sir Halliday Macartney in the matter. THE HEALTH OF SIR WILLIAM MACCORMAC. SIR WILLIAM MACCoEMAC’s condition during the past week has not shown so much improvement as might be expected after the favourable report of last week. Strength is returning very slowly, the remaining pulmonary trouble subsides very gradually, and the temperature has not yet become quite normal. Considering, however, the severity and nature of the illness we cannot feel surprised that recovery should be tardy, and are satisfied to know that some real progress is being made. THE SALE OF POISONS. AN important case was tried at Bow County-court upon Oct. 27th before Judge French. Robert Potton, a seaman, was summoned by the Council of the Pharmaceutical Society for that he, not being a registered chemist, did sell a packet of " Hammond’s remedy for killing vermin." It was mentioned by Mr. Grey, who prosecuted, that the vermin- killer on being analysed was found to contain arsenic enough to poison 150 people. A number of children had been poisoned lately in the neighbourhocd by rat poison con- taining arsenic, and it was difficult to find where it came from. The following conversation then ensued :- Judge French (to defendant) : What do you say—re you a chemist ? —Defendant: I ain’t no chemist. I’m a working man. I am the branch secretary of the union. Mr. Gibbs, who makes this rat cake, used to have offices at the union building. A lot of letters came for him and I gave them to him to oblige. One day a gentleman 1i thought was the manager of large works called. He said he wanted 2;i. worth of the poison. I asked Mr. Gibbs for it. He called again,. gave me 2s., and 1 gave up the money to Mr. Gibbs. Judge French: Did you have any of the 2s. —Defendant: Not a. penny. Judge French: How do you make him liable?-lflr. Grey: The Act says we must go for the person who actually sells it. Judge French : Why not go for the man Gibbs ? He is really the guilty person. If you had made proper inquiries, surely you would not have gone against this poor man ?-Mr. Grey : The Act does not allow us. Judge French : Then it is a bad Act. It is your own Act; the sooner you get it amended the better. Judge French finally made an order for the full penalty, .E5, to be paid at the rate of Is. per month. Of course, Mr. Potton had no right to sell the poison, but neither, we imagine, has Mr. Gibbs, and the incident is only one more argument for the alteration of the Act. At any oil- shop vermin- and weed-killers containing arsenic, strych- nine, and phosphorus can be easily obtained, to say nothing of the fact that carbolic acid, the corrosive mineral acids, and other deleterious preparations can be also procured without let or hindrance. If the Act is to have any real use it must be made far more stringent. If not it is useless for the Pharmaceutical Society to institute such prosecutions. The keeping of a poisons book by registered druggists is a good rule, but even that is easily evaded. CHANGES IN THE PUPIL IN THE INSANE. AT the recent meeting of German alienists at Heidelberg Dr. Soemerling contributed an important paper on this subject. He attaches little importance to a difference in the size of the pupils, as the pupils are not uncommonly unequal in those who are in perfect health. The loss of reaction to light, on the other hand, he regards as of the utmost importance and significance, and of all conditions of the pupil in the insane it is the most frequent and the most important. In 3010 cases of progressive paralysis it was found to be present in 68 per cent., and it forms an early symptom in this disease, and may exist as an isolated one for so long as
Transcript

1249

and under the supervision of an officer, and twenty-fourhours’ notice is required when any such operation is in-

tended and the ingredients necessary for such operationmust be previously submitted for approval. Wines thusrendered sparkling and bottled in bond are regarded assparkling wines and liable to the same duty as importedsparkling wines. The bottles containing this wine must

each bear a label with the name or the descriptionof the wine as well as the words, " Made sparkling inthe United Kingdom," and the corks must be branded

with a similarly plain intimation. This last provision is anexcellent one, and obviously intended to prevent the publicfrom being imposed upon with sparkling wines that are notnaturally so. It is possible that there are differences of someimportance from the dietetic point of view in sparkling winesin which, on the one hand, the gas is generated in the liquidby the action of the yeast plant, and those, on the otherhand, into which gas obtained chemically is subsequentlyforced, but we are not aware that any definite evidence hasbeen obtained on this point. It is satisfactory, however, tofind that our Revenue regulations are fairly stringent in thismatter, as otherwise the introduction of cheap, nasty, andunnatural champagnes and other sparkling wines wouldprobably go on to an appalling and, likely enough, detri-

mental extent. ____

THE SUN YAT SEN INCIDENT.

THE satisfactory conclusion of the so-called Chinese kid-napping case by the release of Sun Yat Sen following theprompt and decided action of the Marquis of Salisburyterminates a strange incident. There is no need to enterinto any detailed history of a subject which occupiedthe attention of so many people last week, for the

facts have been already fully set forth in the daily press.It was a very fortunate coincidence for Sun Yat Sen that he

happened to have studied from 1887 until he qualified atthe College of Medicine at Hong-Kong, of which Mr. JamesCantlie was the dean and a professor, and that at thetime of Sun Yat Sen’s visit to London Mr. Cantlie

happened to have been in this country, otherwise his lateChinese pupil might have now been on his way to Chinawith a very disagreeable prospect in front of him. Mr.Cantlie having received information that Sun was a prisonerat the Chinese Legation, and that he was in a few days to besent to China, where he would certainly lose his head, atonce took such steps as showed, by his adroit management ofthe matter, that he (Mr. Cantlie) had not "lost his head"

,.

on receipt of the strange news. Aided by the advice ofDr. Manson, who had been previously a Dean of the MedicalCollege at Hong-Kong, Mr. Cantlie set to work with cha-racteristic energy and skill to make himself personallyacquainted with all the facts, and it reflects great credit onhim and Dr. Manson that the subject was soon carried to asuccessful issue. Apart from all contentious matter as to

whether Sun had been begged, borrowed, or stolen, or

how he had obtained admission into the Chinese

Legation, there he was, forcibly detained as a prisoner onthe assumption that he was a Chinese, that the Legation wastheoretically Chinese soil, that Sun was wanted in China,and that the Legation had a right to do what it likedwith its own. When the readers of the lobe, which wasinstrumental in first bringing the strange story to light,learned that Sun Yat Sen had been kidnapped and wasimprisoned at the Chinese Legation, they were probablysomewhat amused and incredulous ; but it was no amusingmatter for the unfortunate Sun. Moreover, all sorts ofabstract legal questions were started, but Lord Salisbury’saction soon solved the Chinese puzzle by a peremptorydemand to the Chinese Minister, and the embassy captivewas forthwith released. Sir Halliday Macartney, Councillorof the Chinese Legation, was once Dr. Macartney and an

army medical officer, and the actors playing prominentparts in the story are all, as it happens, members of themedical profession; but the political principle involved wasa big one, affecting international law, the Foreign Office,and the protection of the rights of people while on Britishsoil. We can only suppose that the Government at Pekip,had issued peremptory orders to Sir Halliday Macartney inthe matter.

THE HEALTH OF SIR WILLIAM MACCORMAC.

SIR WILLIAM MACCoEMAC’s condition during the pastweek has not shown so much improvement as might beexpected after the favourable report of last week. Strengthis returning very slowly, the remaining pulmonary troublesubsides very gradually, and the temperature has not yetbecome quite normal. Considering, however, the severityand nature of the illness we cannot feel surprised thatrecovery should be tardy, and are satisfied to know that somereal progress is being made.

THE SALE OF POISONS.

AN important case was tried at Bow County-court uponOct. 27th before Judge French. Robert Potton, a seaman,was summoned by the Council of the Pharmaceutical Societyfor that he, not being a registered chemist, did sell a packetof " Hammond’s remedy for killing vermin." It was

mentioned by Mr. Grey, who prosecuted, that the vermin-killer on being analysed was found to contain arsenic enoughto poison 150 people. A number of children had been

poisoned lately in the neighbourhocd by rat poison con-taining arsenic, and it was difficult to find where it camefrom. The following conversation then ensued :-Judge French (to defendant) : What do you say—re you a chemist ?

—Defendant: I ain’t no chemist. I’m a working man. I am thebranch secretary of the union. Mr. Gibbs, who makes this rat cake,used to have offices at the union building. A lot of letters camefor him and I gave them to him to oblige. One day a gentleman 1ithought was the manager of large works called. He said he wanted2;i. worth of the poison. I asked Mr. Gibbs for it. He called again,.gave me 2s., and 1 gave up the money to Mr. Gibbs.Judge French: Did you have any of the 2s. —Defendant: Not a.

penny.Judge French: How do you make him liable?-lflr. Grey: The Act

says we must go for the person who actually sells it.Judge French : Why not go for the man Gibbs ? He is really the guilty

person. If you had made proper inquiries, surely you would not havegone against this poor man ?-Mr. Grey : The Act does not allow us.Judge French : Then it is a bad Act. It is your own Act; the sooner

you get it amended the better.

Judge French finally made an order for the full penalty, .E5,to be paid at the rate of Is. per month. Of course, Mr.Potton had no right to sell the poison, but neither, weimagine, has Mr. Gibbs, and the incident is only one moreargument for the alteration of the Act. At any oil-

shop vermin- and weed-killers containing arsenic, strych-nine, and phosphorus can be easily obtained, to say nothingof the fact that carbolic acid, the corrosive mineral acids, andother deleterious preparations can be also procured withoutlet or hindrance. If the Act is to have any real use itmust be made far more stringent. If not it is useless forthe Pharmaceutical Society to institute such prosecutions.The keeping of a poisons book by registered druggists is agood rule, but even that is easily evaded.

CHANGES IN THE PUPIL IN THE INSANE.

AT the recent meeting of German alienists at HeidelbergDr. Soemerling contributed an important paper on this

subject. He attaches little importance to a difference in thesize of the pupils, as the pupils are not uncommonly unequalin those who are in perfect health. The loss of reactionto light, on the other hand, he regards as of the utmostimportance and significance, and of all conditions of the pupilin the insane it is the most frequent and the most important.In 3010 cases of progressive paralysis it was found to be

present in 68 per cent., and it forms an early symptom inthis disease, and may exist as an isolated one for so long as

1250

ten years without having other symptoms added to it.

It is nearly always bilateral, although the two pupils ate notalways equally affected and the shape of the pupil may beround, oval, or irregular. The sudden and quick dilatationof the pupils is sometimes present in general paralysis, butthis occurs also in the healthy and is probably without muchsignificance. Hippus is rare in paralysis. Except in generalparalysis the loss of light reflex in the pupil is uncommon.Among 9160 insane this symptom was present in 1639 cases,and of these 1524, or 92 per cent., were cases of general para-lysis. In syphilis also this condition of the pupil is some-times found without evidence of any other morbid condition.Its occurrence after injuries to the head alone is very doubtful,and it probably does not occur in simple and uncomplicatedhysteria. In short, he regards the loss of light reflex as asymptom of weighty import and grave significance. If it isnot a precursor of tabes dorsalis or general paralysis it at leastindicates a profound disturbance of the nervous system, andit may be present long before any other morbid phenomenonmanifests itself. A few other unimportant variations in thepupil in connexion with epileptic and other attacks are

referred to, and, in conclusion, the question is raised as tothe position of the central mechanism on which the pupillaryreaction to light depends. No definite group of cells can as

yet be indicated as the centre for this reflex.

AT a meeting of the managers of the Metropolitan AsylumsBoard held on Oct. 24th it was moved by Dr. WilliamR. Smith, seconded by Mr. R. M. Hensley, chairman of theGeneral Purposes Committee, and resolved : " That it bereferred to the General Purposes Committee to considerwhether arrangements can be made by which any surplusantitoxic serum from time to time in the hands of theLaboratories Committee of the Royal Colleges of Physiciansand Surgeons may be supplied through the managers to themedical officers of health for the use of the medicalattendant in the treatment of such cases of diphtheria asmay desire it and as cannot be taken immediately into thehospitals of the Board, and that the General Purposes Com-mittee be empowered to take such action in the matter asthey may consider expedient."

A COMMITTEE of friends, old fellow-students, and former

pupils of Sir W. MacCormac has been formed, under the- chairmanship of the Marquis of Dufferin, to have Sir WilliamMacCormac’s portrait painted for presentation to Queen’sCollege, Belfast, where he was educated. The honorarysecretary is Mr. J. Andrew Strahan, 3, Brick-court, Temple.

H.R.H. TAE PmrrcESS oF WALES has sent a donation of IH.R.H. THE PRINCESS OF WALES has sent a donation ofJ:.20 in aid of the extension and improvement fund of QueenCharlotte’s Lying-in Hospital, l4Tarylebone-road, of whichshe is a vice-patron. -

WE regret to inform our readers that Dr. George Harley,F.R.S., died suddenly on Tuesday last. An extended obituarynotice will be published in our columns.

THE council of King’s College, London, have appointedDr. Crawford Hayes Professor of Practical Obstetrics.

LITERARY INTELLIGENCE.—Messrs. ArchibaldConstable and Co. have secured the entire copyright in theEnglish language of Dr. Nansen’s forthcoming work on hisexpedition to the North Pole. Tue same firm announces the

appearance of " Problems of Modern Democracy," essays byTdavin Lawrence Godkin, editor of The Nation, the leadingliterary and political paper of America.

THE REPORT OF THE ROYAL COM-MISSION ON VACCINATION.

(Continued from p. 1019.)

THE PROPOSALS OF DR. 117. J. COLLINS ANDMB. J. A. PICTON.

CoitTlNUlNCt our discussion of the legislative and adminis-trative aspects of the subject it seems convenient now torefer to the proposals of Dr. Collins and Mr. Picton.We wcre about to add that these two members of the Com-

mission might be looked on as representatives of anti-

vaccination, but it is necessary to be careful of phrases here,as it is held by the anti-vaccination party that they had norepresentatives on the Commission. Confining ourselves

strictly to historical fact, therefore, it will suffice to say thatDr. Collins was, previously to his appointment on the Com-mission, a Vice-President of the London Society for theAbolition of Compulsory Vaccination, and that Mr. Picton,who was M.P. for Leicester. gave notice of a resolution inthe House of Commons in 1887 for repeal of the compulsoryclauses of the Vaccination Acts, while as to vaccinationitself he wrote in the Contemporary Revie7v, in January, 1889,that he was rapidly approaching the conclusion" that" vaccination is of no use."

Section 273 of the "Statement by Dr. Collins and Mr.Picton of the Grounds of their Dissent from the Com-mission’s Report " is as follows : " In accordance with thesub-head No. 2 of the reference to the Commission we wouldsuggest the following as the means other than vaccinationwhich should be employed for protection of a communityfrom small-pox. 1. Prompt notification of any illness sus-pected to be small-pox. Improved instruction in thediagnosis of small-pox. 2. A hospital suitably isolated ofadequate accommodation in permanent readiness and capableof extension if required. No other disease to be treated atthe same time in the same place. 3. A vigilant sanitary staffready to deal promptly with first cases and if necessaryto make a house-to-house inspection. The medical officer ofhealth to receive such remuneration as to render him inde-pendent of private practice. 4. Prompt removal to hospitalby special ambulance of all cases which cannot be properlyisolated at home. Telephonic communication between healthoffice and hospital. 5. Destruction of infected clothing andbedding, and thorough disinfection of room or house imme-diately after removal of the patient. 6. Daily observation(including, where possible, taking the temperature andinspection for rash) of all persons who have been in closecontact with the patient during his illness ; such supervisionto be carried out either in quarantine stations (away fromthe hospital) or at their own homes. 7. Closure of schoolson the occasion of the occurrence of small-pox among thescholars or teachers. 8. Hospitals and quarantine stationsto be comfortable and attractive, and so administered as tosecure the confidence of the public. Hospital treatmentto be free to all classes and compensation to be paidto those detained or otherwise inconvenienced in the

public interest at the public expense. 9. Tramps enteringcasual wards to be medically inspected, their clothing to bedisinfected, and bath provided. The measures for detectionand isolation of small-pox in common lodging-houses sug-gested in section 507 of the Report to be carried out.10. International notification of the presence of small-pox,and special vigilance at seaports in communication withinfected places, after the plan adopted in the case of cholera.11. Attention to general sanitation, prevention of overcrowd-ing, abundant water-supply, and frequent removal of refuse."

Needless to say, medical men everywhere are agreed thatthere is great value in diagnostic skill, in prompt notificationof small-pox, in proper hospital accommodation, in adequacyand efficiency of a sanitary staff, in prompt removal tohospital, in disinfection or destruction of infected articles,and so on all through these recommendations. The Com-mission itself makes similar recommendations as to hospitalprovision, and the details set forth by Dr. Collins and hiscolleague as to disinfection, &c., belong to the very alpha-bet of public health administration. They are not onlytrue ; they are truistic. In some respects it is anything buteasy to ascertain exactly the position of the two dissentientson important points. They nowhere state in so many wordsthat they advocate compulsion in removal to hospital. In


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