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Scotland Deaconesses, for whom there is a home in Edin-burgh where, on payment of a certain sum per annum, theyare trained for mission work as teachers and evangelists. Acertain number of them wish to have some training as nurses,but it is not sought to give them a, complete and qualifyingcourse of hospital instruction. For some time they werereceived into the Royal Infirmary, but the authorities therewere so dissatisfied with the arrangement that they had todecline to receive them. The result of this was that thoseresponsible for the Deaconesses’ Home determined to get ahospital of their own where nurses could be trained formission work, and the outcome has been this hospital. Thehospital deserves nothing but praise, and those responsible forit may be congratulated on having secured Dr. G. A. Gibsonand Mr. Alexis Thomson as, respectively, honorary physicianand honorary surgeon to it. At the same time, it mustbe said that the multiplication of medical charities in analready over-burdened community does not commend itself.

Antitoxin at the City Hospital, Aberdeen.In his last report Dr. Matthew Hay, medical officer of

health, says : "It is of interest to mention that the newtreatment of diphtheria by antitoxin, regarding which so

much is being written at present as an almost perfect cure,is being tried in the hospital, and that, so far, encouragingresults have been obtained. A little child sixteen monthsold was admitted with pronounced diphtheritic throat, andon the following day the disease was progressing so rapidlythat the breathing was being seriously impeded and the caseappeared to be hopeless. From the time of the injection ofthe antitoxin the child began to improve, and the breathingafter one or two days became quite natural. As far as Icould judge, the child’s life was saved bythe antitoxin."

Health of Aberdeen.Last week 42 cases of zymotic disease were reported.

Measles, scarlet fever, and whooping-cough are on the

increase ; diphtheria is on the decrease. For September thedeath-rate was 12’85 per 1000. In the preceding month itwas 15’56, and in September of last year it was 17-66 per1000. As regards the mortality at different age periodsDr. Hay’s report says there is a remarkable fall at theinfant period, the death-rate being only 28, as against anaverage of 42 for the corresponding month in the precedingfive years.

The University of Aberdeen. The winter session both at King’s College and Marischal

College opened to-day. A large number of students havealready put in an appearance. The new university buildingsare being rapidly pushed forward, and already the Mitchelltower is an imposing feature of the city. On the motionof the Lord Provost the town council have decided to conferthe freedom of the city on Dr. Mitchell.

The Pathological and Clinical Society of Glasgow.At the first meeting of the present session of this Society

the following cases were shown :-Dr. R. M. Buchanan, anAortic Aneurysm which had burst into the (Esophagus ;Dr. D. Fraser, an Osseous Tumour of the Brain ; Mr. H. E.Clark, a Kidney removed by Lumbar Nephrectomy ; Dr. D.Newman, the Bacillus of Diphtheria-the Antitoxin used intreating the disease, reference being also made to some cases;Dr T. K. Monro, a Ruptured Bladder; Mr. Maylard, anEncysted Hydrocele of the Cord.

Public Health of Glasgow.During the past week the Glasgow death-rate was 15 per

1000, which must be regarded as satisfactory, consideringthat scarlet fever is again so prevalent, there being 672 casesin hospital.

How to Spread Scarlet Fever.Horv to AS’pread Scarlet Fever.During the past summer some scarlet fever patients were

allowed to travel from Saltcoats (on the Ayrshire coast) toGlasgow while still capable of distributing infection. Thesecases were discovered in Glasgow, the sanitary officials of whichcity took energetic action, leading to a somewhat acrimoniouscorrespondence and a reference to the Board of Supervisionconcerning alleged laxity on the part of the Saltcoats localauthority. Dr. Littlejohn has investgated the matter andpublished his report, in which he seems to Mame the twomedical attendants concerned and to exonerate the local

authority. In the first case the disease was so mild thatthe medical attendant’s services were dispensed with at hissecond visit and his bill paid, his connexion with the casethen ceasing ; the other case also was so mild that after

the second visit the medical attendant, unfortunately, at theurgent request of the parents, gave his consent to the removalof the patient to town after certain sanitary precautionshad been taken. Of course it is the duty of medical mento maintain a rigid attitude on questions such as this, andto withhold their professional sanction from all proposedbreaches of sanitary law ; on the other hand, it is impossibleto follow Dr. Littlejohn in his exoneration of the localauthority. It is, surely, dangerous doctrine to say inan official report that "it is impossible for any local

authority to keep a watch over the movements of certifiedcases of infectious disease." In a place so small as Saltcoatssuch surveillance should not only be possible but easy,and surely the watching of cases of infectious diseaseand the prevention of improper removal come well withinthe recognised duty of sanitary authorities, particularly incircumstances like those alluded to, where the medicalattendant is only allowed to make a few visits and is thendismissed. One would have expected that the due certifica.tion of such cases threw the whole onus of watching on thelocal authority. This is no light matter, as Glasgow suffersgrievously in this way, not an autumn season passing withoutthe wholesale importation of scarlet fever, enteric fever, &c.,from insanitary towns and villages on the coast in thecountry. It is to be hoped that Dr. Littlejohn’s report willnot make country local authorities even more lax than theynow are.

Oct. 13th.

IRELAND.(FROM OUR OWN CORRESPONDENT.)

Richmond Lunatic Asylunm.AT the close of the past week there were about 150 lunatic

inmates suffering from beri-beri in this asylum. The over-crowding of the asylum has been known to exist for the pastthree years, but little has been accomplished to remedy theevil. Pending the completion of the auxiliary asylum atPortrane, it has been suggested to locate the infected inmatesin empty workhouses ; but the authorities appear to regardthis as ineligible, and three years since the inspectors oflunatic asylums, in their yearly report, stated that it wouldbe cheaper to erect buildings than to utilise disused work-houses. They might, however, be suitable enough ts

accommodate the infected inmates alone. The site forthe Portrane Asylum was selected by the Board of Controlmore than two years ago, and, it is said, is absolutelywithout any natural water-supply whatever, except a

small well which every summer fails to supply water. It

is stated that the board, in order to obtain water, proposeto bring it from the Broad Meadow River, five miles dis-tant, which will cause considerable expense in the forma-tion of pumping stations and reservoirs, and may cost

£40,000, to be added to the cost of the Portrane Asylum. Theresident medical superintendent has on several occasionspointed out to the governors of the Richmond Asylum thatit was questionable as to whether it would not be well to giveup the asylum altogether, as the site could probably never bemade a healthy one for an institution of the kind, and he hasdrawn attention to the constant existence of dysentery, appa-rently similar to the malarial dysentery of the tropics, which i&endemic among the inmates. A male patient named DenisKinsella died on the 27th ult. from coma due to fracture ofseveral ribs of both sides and rupture of the liver. It is con-sidered that these injuries were inflicted by some of thewarders, and after investigation one attendant was suspended,

and a second dismissed. As the matter is in the hands ofthe police I can add nothing more at present.

Catholic University Medical School.A report upon the working of the school for the past two

years under the new constitution was last week presentedby the Rector of the Catholic University to the RomanCatholic Archbishop of Armagh and the other Roman Catholicarchbishops and bishops of Ireland. I learn that of latethe medical school has shown a considerable increase in thenumber of students attending lectures. Last year it wasabout 120, but this year it is stated to be beyond 200. It isnot stated whether these 200 were for the anatomical classes;. y.in the case of the latter, the returns are not obtainable untilNov. 25th, so it is probable that they do not represent theseentries. The Rector states that on an average 40 percent,of the students go through the curriculum of the Royal

947

University of Ireland. He claims that a public endowment isnecessary and could be usefully applied.

Dublin Orthopædic Hospital.The inmates of this institution, through the kindness of

the Countess of Mayo, were enabled to spend the summermonths in a furnished house at Johnstown, and in recognition’of her kindness the Countess has been elected a life governor- of the hospital.

Attack on a boy by a Rabid Cat.A boy sixteen years old, while walking at Clonlyon, King’s

-county, on Saturday last, was attacked by a cat, whichsprang upon him and bit him in the thigh and the little6nger of the left hand. The cat was flung to the

ground, but again attacked the boy and bit the left handseverely until it was choked. A veterinary surgeon who- examined the carcase pronounced the cat to have been

suffering from rabies. The patient will be sent to thePasteur Institute, Paris, for treatment.

,Oct. 16th. ____

PARIS.

(FROM OUR OWN CORRESPONDENT.)

Chloroform Inhalation and its Action on the Heart.AMONGST the most interesting papers read at the Eighth

Congress of French Surgeons (which for the first time wasthis year held outside Paris-viz., at Lyons) was one byM. Alphonse Guerin of Paris on the Rationale of Heart-failure during Chloroformisation. That authority (whosename will be familiar to students of surgical progress as

he originator of the cotton-wool or germ filtration method of dressing wounds) maintains that chloroform vapour doesnot act directly on the heart muscle, but that when this failsto contract it does so by virtue of a reflex paralysing influencethrough the medium of (a) the nasal nerves and (b) thepneumogastric nerve. M. Laborde some time ago demon-strated the lethal effects of chloroform on a rabbitwhich is made to inspire it by the nose. He thoughtthat the reflex path was by way of the nasal nervesand the superior laryngeal nerve. At M. Guerin’s sugges-tion, M. Laborde’s experiment was modified as follows.Tracheotomy is performed, and chloroform administeredthrough the trachea, with the result that the heart continuesto beat normally ; but when in this same animal the inhala-tion was in its turn practised through the nose the heart-beats ceased immediately. M. Guerin asserts that deathfrom this cause will become a matter of history if, in

administering this ansesthetic, care be taken to prevent theintroduction of the vapour into the nasal fosssæ by compress-ing the nose between two fingers of the hand holding theinhaler or the compress (the latter is almost universallyemployed in France). Anaesthetists and the public generallywill, I am sure, rejoice should M. Guerin’s prediction proveto be correct.

Suggestion as a Remedy against Delirium in the Insane.Dr. Voisin of the Salpetriere Hospital calls attention to the

curiously rapid and satisfactory action of hypnotic sug-gestion in dispelling delirium and hallucinations in theinsane. Directly suggestion is completed calmness succeeds’to the previous agitation. Very frequently, however, byp-raosis seems to be an impossibility in the insane. Dr. Voisinsurmounts the difficulty by previously inducing partialanaesthesia by small doses of chloroform. Another usefulpreliminary proceeding is the administration of a verystrong galvanic shock. The object of these preparatorymeasures (anaesthesia and electric shock) is to render the

patient momentarily insensible to his mental preoccupations.The opporunity is then seized to hypnotise him in the usualmanner.

The Contagion of Cancer.Any information capable of shedding a new light on the

nature of that mysterious disease, cancer, is eagerly welcomedby the profession. Some facts in this connexion broughtforward by Dr. Guelliot of Reims at the Lyons SurgicalCongress on Oct. 9th will accordingly be found interesting andinstructive by the readers of THE LANCET. The experimentsof Hanau and those of Morau recently reported in theArchives de Médecine Experimentale prove that cancer

can be grafted on to animals of the same species. Experi-mental hetero-inoculation is thus an established fact ;spontaneous or accidental hetero-inoculation is, therefore,possible. It is to clinical observation that inquirers musthave recourse in order to clear up the question, and falsedeductions are more easily avoided when these observationsare made in country districts where the pathological ante-cedents and mode of life of the population are well known.The very unequal distribution of the disease is an extremelystriking phenomenon. Thus 100,000 persons in Paris or

Rheims supply 100 victims, the corresponding figures for avillage in the Ardennes and a district of the Aisne respec-tively being 266 and 1400. Instances have again been knownof the inhabitants of a particular district of a town or agroup of houses being especially visited by the disease. Nay,habitations that may fitly be designated as cancer houses havebeen known to exist, where three or four denizens have beensuccessively victims of cancer. Dr. Guelliot has collectedfifteen such examples, yielding fifty victims. It would seemthat nothing short of contagion could explain the foregoing.More instructive still are examples of cancerous affectionsappearing successively in two persons living constantly underthe same roof (cancer a. deux). Dr. Guelliot cites 103 suchinstances, 42 of these having been noted by himself. Of these103 examples 14 had reference to co-lodgers, relatives, andmasters and servants, and 89 (or more than four-fifths) tohusband and wife. The transmission may be direct (throughpenis and uterus), but more frequently it is effected indirectlythrough wearing apparel or table ucensils. Twic&eacute; inoculationoccurred through a tobacco pipe. In more than one-half of64 cases of cancer &agrave; deux the interval separating the appear-ance of tumours in the two persons was under two year<.In 26 instances the cancer was homotopic (affecting thesame organ) ; in 97 heterotopic. Dr. Guelliot opines thatthe influence of heredity is exaggerated. At most only12’5 per cent. come under this heading, and if account betaken of persons who, born of cancerous parents, reach extremeold age the proportion is reduced to 5 or 6 per cent. (fromthe statistics of fifty old men ranging from seventy to ninetyyears of age). He knows of nine examples of practitionersattending special cases of cancer who contracted the disease.Dr. Guelliot concluded his powerful argument in favour ofthe contagious nature of cancerous tumours by remarkingthat, although the appreciation of the danger incurred byindividuals brought into contact with patients of this classmay frighten the public, it is always preferable to look facts,especially disagreeable ones, in the face, and counteractrisks of the kind by precautions based on the dictates ofcommon sense.

The new Treatment of Diphtheria.The subscriptions now being received by the Figaro for the

foundation of an antitoxin department at the InstitutPasteur, whose business it will be to supply the vaccine tothe practitioners of France, reach to-day the total of255,539 fr. 70 c. The Budget Commission has, on the

proposition of M. Rouvier, voted 100, 000 fr. as a subventionto the Assistance Publique for the same purpose. It remainsfor the Chamber to confirm this vote. The MunicipalCouncil has instructed its Special Commission to arrange withDr. Roux for the distribution, at the Council’s expense, ofserum to different depots to be created in Paris. TheComit6Consultatif d’Hygi&egrave;ne Pablique de France, at its meetingyesterday at the Ministry of the Interior, resolved to addressa congratulatory letter to Dr. Roux and his illustrious master,M. Pasteur, and als to ask of the Government an annual creditto facilitate the diffusion of the antitoxin. The enthusiasmshown in favour of the movement is extraordinary. For

example, a livery- stable keeper offers a horse to the PasteurInstitute to serve for the preparation of the serum. A vote of10 000 fr. will be proposed at the next meeting of the ConseilGeneral de la Seine. Numerous prefects of departmentshaving addressed inquiries to the President of the Council, whois also Minister of the Interior, on the value of anti-diphthericseropathy, the Minister referred the question to the Academyof Medicine, which body named a Commission to study thematter. The Commission, composed of MM. Bergeron, Proust,Cadet de Gassicourt, and Strauss (reporter), to-day deliveredits conclusions, which I transcribe verbatinz :"Votre com-mission vous propose done d’&eacute;mettre un avis favorable sur1’emploi du serum antidiphtherique et de formuler, en outre,les v&oelig;ux que l’Institut Pasteur soit mis en mesure de faireface aux demandes qui pourront lui etre faites, soit par lesmedecins, soit par les pouvoirs publics."

Oct. l6th.