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transverse fracture of the patella, to which reference hasbeen made, instead of its being thought probable that noharm would come of it, it was supposed to be a most dan-gerous operation, and hints were thrown out that if any-thing went wrong with the patient I ought to be brought upfor manslaughter. With regard to abscesses, one of our bestprovincial surgeons was at King’s College, and saw some ofthe cases there. He said, " Do you mean to tell me that inthe case of a great psoas abscess connected with disease ofthe vertebrae no pus is formed from the time you squeeze outthe original contents ?" He seemed to think that the thingwas only made out a day or two before, instead of being amatter of practice for years past. Then as regards theorganisation of the blood-clot. I know that this has beensimply discredited, but I will not occupy the time of thisgreat meeting by going into the evidence showing thatthis process really takes place. Nor will I dwell upon theabsorption of dead bone, but I would like to say a wordor two about the catgut ligature. It has been said, " Oh !the organisation of the catgut ligature is all nonsense ; theligature is dissolved." I confess 1 do not understand how itis that some gentlemen are disposed to believe the more un-likely thing rather than the natural and the probable one.Ask any chemist, is it a probable thing that a piece of cat-gut would be dissolved, even if put into pure water, unlessit putrefied ? He would assuredly say that the substanceof the catgut is an insoluble substance. It may remain incold or warm water any length of time without being dis-solved ; still less would it be dissolved in a concentratedmass of albumen. Let anyone try the experiment ; let himput the catgut, as I have done, into putrid serum for anylength of time-it will not be dissolved, however long it isthere. Then let him put it into non-putrid serum, which hemay do by following the method which I have describedin the Path. Trans. (and it is a sort of experiment thatI would recommend my friend, Mr. Holmes, to try, andthen I think he will be convinced that there is something inthe germ theory), and he will find that the catgut will not bedissolved. It is not a matter of dissolution, it is a matteiof absorption by the living tissues. The wandering cellsinfiltrate this dead nutritious material, and the living tissuegrows at its expense. I am sometimes ashamed for mv ownprofessional brethren and their scientific credit. I had re-cently sent me a pamphlet by a young German surgeon,2who has been making experiments to determine whether theabsorption of the dead piece of tissue is performed chieflyby the wandering of leucocytes, or by other tissue elements.He steeped a piece of some organ, such as the liver, in spiritsof wine, so as to make sure that it was dead, and then putit into the abdomen of a rabbit, and after a certaintime he killed the rabbit, and looked at what was goingon. His object was not to demonstrate that the pieceof dead tissue was organised by the substitution of growingtissue for it, but to see which of the living elementswere concerned in the process. Therefore, Sir, I confessit seems to me that statistics are unimportant in re-

ference to the consideration of these great pathologicaltruths, which I believe to be new truths. ProfessorMaas, of Freiburg, lately sent me an introductory lecturewhich he gave to the students, in which he referredto the uselessness of statistics with regard to the anti-septic treatment. But he said he should like anybodywho wants to be convinced of the value of the anti-septic treatment to try the following experiment, whichhas been often performed. In a certain number ofrabbits tie the ureter with a silk thread withoutantiseptic treatment, and in a number of other rabbits tiethe same organ with catgut. Infallibly in those rabbitswhere the silk is tied without antiseptic treatment you havesuppurative pyelitis, and in the others you have simplyhydronephrosis. When at Amsterdam I had evidence ofthe same character from two different and fndependentsources. One was the illustrious Virchow, who told mewhat antiseptic treatment had done for vivisection. " With-out the antiseptic treatment," he said, " if we took awayan organ the inflammation and fever so complicated thematter that we could not judge of the results, but now withthe antiseptic treatment we take away an organ and wecan see uncomplicated the result of its removal." Thatseemed to me, stated in a very simple way, to be a beauti-ful and very important confirmation of antiseptic principles.’Two different ophthalmic surgeons have also told me that

2 Tillmanus: Centralblatt fur Chirurgie, 1879, No. 46. -

in using the antiseptic treatment in extraction of cataract,they found that, instead of it being a question how muchdischarge there was after the operation, there was absolutelynone ; the sclerotic and the conjunctiva were as white as ifthe patient had not been touched. That again seemed tobe a very beautiful confirmation of antiseptic principles.I feel I owe an apology to the meeting for having detainedit so long, and I owe you my thanks for having listened tome so patiently. In such a gathering of medical men as Isee before me I cannot avoid speaking warmly on a matterso near my heart. I have been charged with enthusiasm;but I regard enthusiasm with reference to the avoidance ofdeath, pain, and calamity to our fellow-creatures as a thingnot at all to be ashamed of ; for I feel this to be a matter ofwhich I may say in the words of Horace :-

"Æque pauperibus prodest, locupletibus seque,Xi que neglectum pueris senibusque nocebit."

The meeting, which lasted for upwards of two hours, wasadjourned for a fortnight, on the motion of Mr. JonathanHutchinson, seconded by Mr. Hulke.

HEALTH OF LARGE ENGLISH TOWNS.

FORTY-EIGHTH WEEK OF 1879.THE continuance of unseasonably cold weather caused a

further increase in the rate of mortality last week. In

twenty of the largest towns, containing nearly a third of theentire population of England and Wales, 5160 births and3567 deaths were registered in the week ending last Satur-day. The births were 22 below, while the deaths exceededby 190, the average weekly numbers during 1878. Thedeaths showed a further increase of 79 upon the numbersreturned in recent weeks, and were equal to an annual rateof 25’2 per 1000, against rates increasing steadily from21’9 to 24’7 in the four preceding weeks. During the pastnine weeks of the current quarter the death-rate in thetwenty towns has averaged 22’1 per 1000, against 22’0 and22’9 in the corresponding periods of 1877 and 1878. Thelowest death-rates in these -twenty towns last week were15’4 in Portsmouth, 17’2 in Bradford, 20’S in Sunderland,and 20’6 in Newcastle-upon-Tyne. The rates in the othertowns ranged upwards to 27’1 in Nottingham, 28’2 in Hull,28’6 in Liverpool, and 34’4 in Plymouth.The deaths referred to the seven zymotic diseases in the

twenty towns, which had steadily increased from 442 to 544in the four previous weeks, further rose last week to 551, ofwhich 190 resulted from scarlet fever, 172 from measles,’S3from whooping-cough, and 53 from fever, principally enteric.The annual death-rate from these seven diseases averaged3’9 per 1000 in the twenty towns, and ranged from0’5 and 0’7 in Oldham and Wolverhampton, to 5’5and 5’8 in Leeds and Liverpool, and 7’0 in Plymouth.The 190 fatal cases of scarlet fever corresponded withthe number in the previous week, and were proportion-ally most numerous in Leicester, Nottingham, Bristol, andNewcastle-upon-Tyne. The fatality of measles showed afurther general .increase, the deaths from this disease havingsteadily risen during the past nine weeks from 46 to 172 in.the week ending last Saturday ; the largest fatality ofmeasles last week occurred in Liverpool, Plymouth, and

, Leeds. The mortality from whooping-cough was small- com-pared with that which prevailed at the corresponding period

; of last year. The deaths referred to fever were proportion-ally numerous in Liverpool, Sheffield and Plymouth. Of

the 15 deaths from diphtheria in the twenty towns, 8 weref returned in London and 2 in Birmingham. Small-poxt caused 4 more deaths in London’ and its outer ring of sub-, urban districts (including 2 of unvaccinated children aged- seven years), but not one in any of the nineteen large pro-

vincial towns. The Metropolitan Asylum Hospitals con-3 tained 46 small-pox patients on Saturday last, corresponding

with the number at the end of each of the two previouse weeks.t Considering the low temperature that prevailed through-. out last week, a larger increase of mortality might have been- anticipated, especially from diseases of the respiratory,t organs. The 1802 deaths registered in London during the- week included 576 which were referred to diseases of the

respiratory organs, of which 373 resulted from bronchitis,

855

and 153 from pneumonia ; the deaths from these diseases inthe seven preceding weeks had increased from 190 to 499,and the 576 last week exceeded the corrected average by 89.The annual death-rate from diseases of the respiratory organsand phthisis was equal to 10’9 per 1000 last week in London,against 9’0 in Liverpool.

GLASGOW.

(From our own Correspondent.)

LAST year, in consequence of the gloom that hung overGlasgow through the disastrous bank failure, it was deemedadvisable that the annual dinner of the Faculty of Phy-siciansand Surgeons should not be held. This year, with

reviving trade and confidence, the self-imposed restrictionwas removed, and the Fellows met under the presidency ofDr. Andrew Buchanan, who was supported by the guests ofthe evening, the Presidents of the Colleges of Physiciansand Surgeons of Edinburgh and Dr. P. H. Watson. Thetoast, "Floreat Res Medica," was given by the President witha vigour and eloquence worthy of himself and the occasion.He happily described the sentiment implied by the toast"As being the welfare of the whole human race," and con-trasted the difference with fifty years ago, when, in his ownexperience, the toast would have been received with batedbreath ere wiser legislation and a juster appreciation of thelabours of our art had removed the barriers which opposedits progress. In singularly felicitous terms Dr. P. H. Wat-son replied for "The Extramural Schools of Scotland,"humorously proposed by Professor MacLeod. Appropriatetoasts were also given and replied to by the guests and Drs.Fergus, Yellowlees, Mather, and others.

Obituary.HARRY LEACH, M.R.C.P.

IN our last number we announced with deep regret thedeath of Harry Leach, which took place at his residence inAlbert Mansions on the evening of Wednesday, Nov. 26th.It is now our sad duty, near the close of a year singularlydisastrous to the vanguard of our profession, to devote a por-tion of our columns to the life and labours of one whose losswill widen the gap in the ranks of our representative me-dical men. Mr. Leach might justly be regarded as one

of these, not from any claims on account of clinical or

pathological research, but from the active part he took inthe furtherance of the science of public health the im-portance and influence of which the profession has of lateyears been so widely recognised.

Mr. Leach was horn at Wisbech, Cambridgeshire, in

1836, and belonged to a family long known and esteemed inthat borough. Having completed his early education at St.Albans, he began the study of medicine as a pupil to Dr.

Walker, of Peterborough, a physician who has been pecu-liarly fortunate in the number of honoured and successfulmen trained by him for the profession. Mr. Leach after-wards studied at St. Bartholomew’s Hospital, and in 1858became qualified.After a short service as house-surgeon to the Peterborough

Infirmary, and subsequently a voyage to India, Mr. Leachsettled in London, and was appointed in 1862 resident

physician to the Dreadnought Hospital for Seamen, an

institution with which he was connected, save during a

short interval, up to the time of his death.Soon after he had taken this important step in pro-

fessional life, Mr. Leach showed the bent of his mindwith respect to future duties and endeavours. Thoughexperienced in diagnosis and skilled in treatment, and, ashe proved by his published contributions on the pathologyand treatment of sourvy and dysentery, well qualified to

add to medical knowledge, he soon yielded to a strong*impulse to devote himself to other than strictly medical’studies. He felt himself better adapted for work of anadministrative or official nature, such as influences classesand communities rather than the individual. Though placedin a position apparently unfavourable for such line of action,he forced all difficulties and’ unfavourable conditions to

yield to him, and in course of time, whilst serving his in-stitution most efficiently as resident medical officer, heincreased its influence by suggesting and carrying to a;

successful issue projects of wide utility.The first subject of importance to which Mr. Leach paid

attention was the prevalence of scurvy among sailors.He found that this disease, -whilst it had become-

nearly extinct in the navy, was then a cause of yearly in-creasing suffering and death amongst merchant seamen.Struck by the fact that nearly one hundred cases of seascurvy were admitted annually into the Dreadnought, andaware that these numbers but barely indicated the extent of’

this scourge in the mercantile marine, he endeavoured todiscover the causes of such an evil, and to suggest aneffectual remedy. Having made out that the prevalenceof the disease was mainly due to excessive adulteration

of the recognised antiscorbutic juices and to carelessness

in their administration, Mr. Leach recommended certain

modifications in the supply and storage of lime-juice and.inspection of lime-juice by an authorised officer. He also

insisted very much on the necessity of a strict and full

official inquiry in every case of scurvy occurring on boardship. After a long struggle, carried on with untiringenergy, the good cause having been much assisted throughthe frequent official representations of the Seamen’s Hos-

pital Society, Mr. Leach had the pleasure of seeing a recog-‘ nition, in high quarters, of the necessity of some legislationon this matter. In the autumn of 1868 the Merchant

Shipping Act was amended so as to provide effectuallyfor inspection of antiscorbutics and for such other preeau-tions as had been suggested. Though scurvy still exists in

the merchant service and opportunities are still afforded from‘ time to time of seeing instances of this disease at Greenwich;there can be no doubt that the legislation of 1868 has had, most beneficial results. In the following year the number

of scorbutic patients in the Dreadnought had been reducedby one-half, and three years later by as much as 84 per cent.During the epidemic of cholera in 1866, Mr. Leach’s

duties were much increased through his taking charge ofthe hospital ship Belle Isle, and through organising, in- association with his colleague. Dr. Rooke, a somewhatextensive scheme of ship-to-ship visita,tion on the river;, Thames. After an unsuccessful application to the PrivyCouncil, and with a full knowledge of the difficulties in the

way of the performance of such duties by the riparianhealth officers, the managers of the Dreadnought, actmg onthe suggestions of their medical officers, undertook this

work at their own cost, and carried it out with such

efficiency that for three months every vessel between

London-bridge and Woolwich was visited daily. Mr. Leachtook part in this movement with his usual energy, and inthe course of his work of supervision laid the basis of his

great knowledge of all matters in relation to the Port of

London. Duting his residence on board the Dreadnought,Mr. Leach lost no opportunity of expressing his strongopinion as to the utter unfitness of the old wooden hulk for

r hospital purposes, and the great inconvenience and dangerattending the treatment of sick persons under such con-

ditions. His endeavours in helping Dr. Rooke and hisother colleagues to bring about a change in this respectnever ceased until the long-continued efforts of the layw authorities of the society in this direction had been crownedwith success in the removal of the establishment to a por-tion of Greenwich Hospital in the spring of 1870. The, difficult task of rearranging the medical department underthese altered conditions devolved almost entirely on Mr.Leach, who, after the death of his esteemed friend Dr. Rooke,in September, 1870, was appointed principal medical officer