1484 WALES AND WESTERN COUNTIES NOTES.-SCOTLAND.-IRELAND.

The St. Mellons (Mon.) rural district council recently refuseda certificate of occupation for a newly erected house withinits district on the ground apparently that although therewas a well on the premises the medical officer of health (Mr.W, E. James) reported that the water could become pollutedby surface drainage and the supply was not a proper one.The owner of the house thereupon appealed to the justiceswho decided that the house might be occupied.

Typh2cs Fever and Small-pox at Cardiff.Until the past few weeks typhus fever had been absent

from Cardiff for many years. During the second week ofApril a case was reported in the town, and three weeks laterit was found that four more persons were suffering from thedisease. The outbreak has been traced to a man who camefrom Liverpool where 120 cases have occurred during thepresent year. At the beginning of May there was a

recrudescence of the epidemic of small-pox in Cardiff whichhas been attributed to a barber who had been carrying onhis business for nearly a fortnight while suffering from amild attack of the disease. Altogether ten persons wereinfected from this source.

An Honorary Degree for Lord Lister.At the congregation of the University of Wales which will

be held at Cardiff in November next Lord Lister and LordKelvin will have conferred upon them the honorary degreesof doctor in science. The resolution relating to Lord Listerwas unanimously passed at the annual extra collegiatemeeting held on May 14th at Llandrindod and referred to his"long-continued scientific research which, by establishing asystem of antisepsis, has revolutionised the practice of

surgery throughout the world." "

Notification of .I.rIeasles.At the meeting of the Midsomer Norton (Somerset) urban

district council held on May llth it was decided to includemeasles under the diseases which are notifiable under theAct of 1889 for the ensuing five years. A letter was readfrom the Local Government Board stating that the Boardhad the subject of the notification of measles generally underconsideration and that the advantages from the additionof measles to the list of notifiable diseases were largelydependent on the notification, together with the attendantmeasures of prevention, being maintained for a reasonablenumber of years.

Vaccination Grant.Mr. J. Dibble Staple, the public vaccinator for the Ashley

district of the Bristol union, has been awarded the grant forsuccessful vaccination by the Local Government Board forthe third consecutive time.May 19th.

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SCOTLAND.(FROM OUR OWN CORRESPONDENTS.)

The f’isit of the King and the Queen to Glasgo7v.GLASGOW on May 14th was happy in being honoured by

a visit from the King and the Queen and the city, in spiteof the unpropitious weather, showed itself to as greatadvantage as possible. Dense crowds thronged the entire

length of the route which their Majesties took through the Icity and at every point they were received with the greatestenthusiasm and loyalty. The arrangements were perfect andthe whole proceedings passed off without any serious accidentto mar the success of the visit. The King on this occasionwas pleased to lay the memorial stone of the new technicalcollege in George-street. This ceremony took place before alarge and representative gathering of the citizens, there

being invitations issued to over 2500 guests. Glasgow hasalways been acknowledged as the commercial capital ofScotland and it is a matter of extreme satisfaction tothe whole community that the Royal visit has beenassociated with an event so auspicious and one whichmust prove of good augury for the future of technicaleducation in general and of this school in particular. Their

Majesties during their progress through the city visitedthe new art galleries where the scene, in spite of theunfavourable weather, was very brilliant. They visitedalso the University, the foundation-stone of which was laidby themselves (as Prince and Princess of Wales) 35 yearsago. Lord Balfour of Burleigh, the Secretary for Scotland, inthe presence of a large gathering in front of the University,introduced Principal Story who, on behalf of the Universityauthorities, briefly thanked their Majesties for honouring

the University with a visit and presented an address. The

King, in replying, recalled with satisfaction his own share inlaying the foundation-stone of the noble building and re-

cognised it as a true symbol of the greatness of the Universitywhich had adapted itself to the commercial expansion of thecity. In concluding he expressed the earnest desire thatthis university and other universities as schools of higherlearning might grow and prosper and so advance the materialprosperity of his people.

Small-pox in Scotland.On May 18th the Local Government Board of Scotland

intimated that during the period from May 1st to 15thinclusive five cases of small-pox had been notified to itfrom the burgh of Dundee and one from the burgh ofGlasgow.May 19th.

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IRELAND.(FROM OUR OWN CORRESPONDENTS.)

The Irish Medical Association.A MEETING of medical men, chiefly belonging to the Poor-

law medical service of Belfast and surrounding districts,was held in the Medical Institute, Belfast, on May 6th, toconsider the advisability of forming a Belfast and DistrictBranch of the Irish Medical Association. There was alarge attendance and on the motion of Dr. A. Mussen,J P. tGlenavy, co. Antrim), seconded by Dr. D. P.Gaussen (Dunmurry), Professor J. W. Byers was calledto the chair. Dr. A. Gardner Robb (honorary secretarypro tem.) having read several letters of apology frommedical men unable to be present, Professor Byers,after thanking those present for asking him to preside,said that it was of the utmost importance that the

grievances under which the Irish Poor-law medical officerslaboured should be made public in order that they mightbe redressed. He said that these grievances were, in themain, inadequate remuneration, no fixed holidays, andno superannuation. So long as these grievances remainedsuch a state of affairs was bad for the medical men con-cerned, degrading to the Poor-law medical service in Ireland,and injurious to the best interests of the country. An under-

paid and overworked service would in the end be avoided byyoung men of ambition and ability starting life. Hebelieved these grievances could be got rid of in two ways :(1) by the policy at present advised by the Irish MedicalAssociation of the members of the medical profession com-bining and refusing to offer themselves as candidates for

any vacancies that may arise until the authorities in theinterests alike of the people as well as of the professiondecided to improve the conditions of the service ; and (2)by the help of the profession outside the Poor-law medicalservice. It was the bounden duty of every member of theprofession to try to remove the grievances that pressedhard on any member of it and above all to bring con-

tentment and happiness to all those who practised it.

Speaking as one outside the Poor-law medical servicehe could promise that every help would be given to thedispensary medical officers of Ireland by all branchesof the medical profession until their grievances were

redressed. It was then decided to form a Belfast andDistrict Branch of the Irish Medical Association and thefollowing office-bearers were appointed :-President : Pro-fessor Byers. Vice-President : Dr. S. B. Coates. Secretaryand treasurer : Dr. Robb. Members of Council : Dr. W. R.Davison (Ballymena), Dr. J. St.C. Boyd (Belfast), Dr.Mussen, Dr. J. M. Killeo (Larne), Dr. Gaussen, Dr.J. J. Adams, J.P. (Ashville), Mr. J. D. Osborne (Belfast),Dr. J. McLiesh (Belfast), Mr. H. C. Manley (White-house), and Dr. R. J. Munn (Belfast). The president,vice-president, and secretary, with Dr. Adams, Dr. Gaussen,Dr. Davison, and Mr. R. Currie were appointed delegatesfrom the branch to the annual meeting of the association tobe held in Enniskillen in June. The next meeting of thebranch is to be held on June 30th.

Dispensary Contest in the Ardee Union.For several months the position of dispensary officer to the

Drumconrath district of the Ardee Union, co. Louth, hasbeen vacant. The original salary was E120 per annum, with;&30 as medical officer of health..In October, 1902, theguardians advertised the position at the old salary but therewere no applicants. They refused to revise the salary and

1485IRELAND.-PARIS.

postponed making any appointment for several months.

They advertised again at the old salary and on May 5ththere were two applicants-one from Lucan and Mr. W. H.Crean, medical officer at the Ringville Dispensary, Dan-

garvan, co. Waterford, who was elected. Had the salarybeen raised to E200, the minimum suggested by the IrishMedical Association, two local men would have applied, butthey loyally adhered to the resolution of the local branchof the association and did not apply for the position.Although this appointment may in one sense be regarded asa victory over the Irish Medical Association it is satisfactoryto find that 10 of the guardians voted for making no appoint-ment, while those who elected Mr. Crean numbered 16.

Royal "Victoria Hospital, Belfast.At a largely attended meeting of the board of management

and life governors of the Royal Victoria Hospital, Belfast,held on May 6th, Dr. J. S. Morrow was appointed assistantphysician, Mr. J. A. Craig assistant ophthalmologist, andMr. R. J. Johnston assistant physician for diseases ofwomen. Dr. S. Blakely was appointed house surgeon.

The Sanitary Condition of Newry.Dr. C. J. Clibborn (Local Government Board medical

inspector) has reported to the Newry urban council that thesewerage of the Armagh side of the town of Newry is verydefective. If the sewerage of the town were improved, theremoval of refuse through dwelling-houses stopped, and abetter class of privies built Dr. Clibborn thought that thenumber of cases of infectious diseases would be lessened.He also recommended an ambulance for the conveyance of

patients with infectious disease.Pulmonary Tuberculosis in the Belfast Workhouse.

A deputation from the Belfast board of guardians met themembers of the public health committee on May 7th to discussthe steps to be taken to deal with the large number of con-sumptives in the Belfast union workhouse, when it wasdecided to appoint a committee of both boards to go fullyinto the question.

The Poor-law Guardians in Ireland and the MedicalProfession.

The constant friction between the medical profession andthe Poor-law guardians in Ireland continues. Here are thelatest examples. As appears in THE LANCET of May 9th,p. 1340, a meeting was held in the Medical Institute, Belfast,on April 30th, to form a North Down Branch of the IrishMedical Association at which Dr. F. P. MacLaughlin andMr. J. W. Olpherts were present. The attention of the

Downpatrick guardians having been called to this cir-cumstance the clerk was directed to write to ask thesegentlemen for an explanation why they left their districtswithout having first notified the board of guardians or

the relieving officer. Mr. Olpherts replied that duringhis few hours’ absence on April 30th he left the districtin charge of a thoroughly competent medical man and byarrangement ; as to why he left his district it was, hewrote, to attend a meeting in Belfast to form a branchof the Irish Medical Association and to defend professionalinterests. In the other case Dr. E. C. Thompson, M.P.,complains in a letter to the Omagh board of guardiansthat at its last meeting it perpetrated on him a mostunmerited insult and one which he bitterly resents. It

appears that Dr. Hans B. Fleming, who had been ill four

days before the meeting of the board owing to an unfortu-nate accident, nominated Dr. Thompson as his substi-tute at the workhouse (a position he had on many previousoccasions taken for him) and without a word of explana-tion the guardians dispensed with him and appointed anothermedical man in his place. Dr. Thompson says althoughhe had acted on many other occasions for Dr. Fleming with-out fee, yet upon the first occasion on which, in all fairness,the guardians might have been called on to pay for a sub-stitute for Dr. Fleming they turned Dr. Thompson aside andappointed another medical man. Dr. Thompson attributesthis action on the part of the guardians to "excusableignorance and inexperience " in dealing with such mattersand he demands a cheque for Z12 12s. for his four days’attendance at the workhouse, which the board says it couldnot entertain the idea of paying. It is to be hoped that Dr.Thompson will press his claim.

Tuberculosis in Ireland.The committee of the Dublin branch of the National

Association for the Prevention of Tuberculosis has recently

issued a little book entitled " Consumption and its Preven-tion," in which the fact is emphasised that while consump-tion is decreasing in England, Scotland, and Wales there isstill a steady increase in Ireland. It appears that betweenthe ages of 24 and 35 years almost one-half the deaths aredue to consumption which caused an eighth of the entiredeath-rate of the country. The authorities of the NationalEducation Office have undertaken to circulate this pamphletamongst the managers of schools under the board andbetween 10, 000 and 15, 000 copies will soon in that way bedistributed over Ireland.May 19th.

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PARIS.(FROM OUR OWN CORRESPONDENT.)

Alcoholic Cirrhosis and Crypto-tuberc2cZosis.AT the meeting of the Hospitals Medical Society held on

May 1st M. Andr6 Jousset gave the result of some experi-ments which he had made with a view of elucidating therole played by Koch’s bacillus in the production of hyper-trophic alcoholic cirrhosis. He had found that the asciticfluid which accompanies this kind of cirrhosis veryfrequently contains bacilli, while the same thing apparentlyexists with regard to the spleen. In two cases inoculationwith hepatic parenchyma after the blood-vessels of the

glands had been washed out had caused a guinea-pig intowhich it was injected to became tuberculous and the samething happened in another guinea-pig after an injectionof spleen-pulp. M. Jousset laid great stress on the

importance of these researches which he thought explainedin some degree the nature of numerous obscure febrileattacks and also showed that these bacilloemias were curableat least for a time. M. Mosny said that he did notthink that the simple presence of Koch’s bacillus in theeffusions was enough to enable the observer to say that thedisease was really tuberculous. For instance, there werevery many cases where some disease, such as acute pneu-monia or hepatic cirrhosis, lighted up a tuberculosis whichhad hitherto been only smouldering. In these sort of casesthere was a secondary tuberculisation of a diseased con-

dition which was originally of a totally different nature.M. Bezançon agreed with M. Mosny and referred to casesof cancer, of secondary tuberculosis, and of leukaemia

complicated with other kinds of infections. He furtherremarked that it was known to be difficult to differentiateKoch’s bacillus from acid-resisting bacilli. M. Chauffardasked whether these acid-resisting bacilli could not closelyresemble tuberculous bacilli found in the sputum. Thequestion, he thought, was very important.

Physiologioal and Therapeutical Aetiort of Ceeropia.At the meeting of the Biological Society held on May 2nd

Mr. Gilbert and Mr. Carnot described the investigationswhich they had made with regard to the physiological andtherapeutical properties of a foreign plant called cecropia.The alcoholic extract which they employed was of compara-tively low toxicity and could be used in large doses withoutthe production of untoward symptoms. Cecropia, like

digitalis, seems to be cumulative in its action, a pro-perty which explains the persistence of its effects for a

period of several days. It acts on the heart principallyby increasing the energy of contraction of the cardiacmuscle. As shown on sphygmo-manometric tracings,the amplitude of the pulsations is doubled, tripled, or evenincreased to a greater degree and this effect persists for asomewhat long time ; when poisonous doses are given thepulse becomes slow and its tension is reduced. Cecropiaacts on the kidneys as a diuretic and may increase the flowof urine to three or four times the normal amount. In theirclinical trials of cecropia Mr. Gilbert and Mr. Carnot gave thealcoholic extract to patients suffering from heart disease andhaving extreme weakness of the pulse, the usual dose being30 drops every 24 hours continued for four or five days.On and after the third day there was copious diuresis. A

patient who had been passing only 500 cubic centimetres(17t fluid ounces) of urine daily and had taken cecropia forfive days passed 700 cubic centimetres on the second day,2500 on the third, 3100 on the fourth, 2600 on the sixth, and2500 on the seventh. The patient’s general condition im-

proved at the same time, his dyspnoea was less urgent, andhis pulse, which at first could not be counted, became slowerand regular. This very remarkable effect was obtained