508

have been given the privilege of admission to the Society,and now that the General Medical Council have ceased toregister unqualified practitioners, it seems only logical thatthe British Dental Association should follow suit. Mr.Cunningham’s motion with reference to the advisability ofappointing dental surgeons to the recruiting depots for thenavy gave rise to some controversy. Mr. J. M. Ackland,in a paper on the Higher Dental Diploma Question,expressed his belief that the L.D.S. was second to nodental diploma in the world, and should always be thenecessary qualification. If the student wishes another, itshould be a medical one. This second dental diplomawould, said the author, sever more than ever the dentalfrom the medical; in fact, would be a distinctly retro-grade step. The report of the School Committee,derived from the examination of over 4000 children,mostly in industrial schools, reformatories, and trainingships, showed some startling figures with reference to theprevalence of dental caries. From the nature of the in-vestigations these children belong to the lower class, but acomparatively very small number of cases examined in amiddle-class school gave even worse results. In infants-not the legal definition, for the committee defined them tobe those who had not cut a permanent tooth-the figuresshowed that a considerable number of teeth are decayed asearly as the second or third year, that the number of decayedteeth increases as age advances, and that the proportion ofthose free from caries is about 26 per cent. only. Perfectdentures of permanent teeth, observations of which weretaken between ten and twelve years of age, gave 109 per 1000.Under the heading of retarded eruptions of permanent andundue retention of deciduous teeth there was over 11 percent., and the report adds that this class of cases servesclearly to explain how a large number of irregularitiesof the permanent teeth occur which are obviously ofa preventable nature, and irregularities being a reco-

gnised predisposing cause of decay, the importance ofthis table is considerable. Honeycombed teeth existed inabout 5 per cent., and hereditary syphilitic teeth, thepeg-shaped teeth of Hutchinson, in 0-5 per cent. Oneexcellent and direct effect of the present investigation hasbeen the introduction of tooth-brushes, which in the caseof most schools were formerly conspicuous by their absence." Uneasy lies the head that wears a crown " may be true

of kings, but of humbler mortals, many of whom aspire togolden crowns, it is only during the fitting or adjustment,if at all, that the head lies uneasy. Mr. Claude Rogers andMr. Hern, who gave clinics on this most conservative (usingthe term in its philological sense) and yet most radicaltreatment, showed how, by means of dexterity, skill, and alittle cocaine, this valuable operation may be performed.Messrs. Ackory, Baldwin, Stour, Bennett, Colyer, Brunton,Harding, and Woodhouse demonstrated gold fillings mostlyin combination with other materials. Gold alone is notnow facile prircceps from the dental surgeon’s point of view.Messrs. Cunningham and Rose showed separately methodsof working continuous gum, which is a silicous preparationmade to resemble gum tissue, for artificial teeth, this sub-stance having been heretofore but little used on account ofits high point of fusibility. Mr. Kirby, who has long beenidentified with electrical appliances for use in dental surgery,demonstrated his latest modifications and improvements.Mr. Weiss demonstrated glass inlays, Mr. Gartrell bridge-work, and Mr. Coffin gutta-percha, for taking impressionsof the mouth. The microscopical department, which wasan especial feature of the Congress, and a very popularone, was due to the exertions of Messrs. Campion,Caush, Mummery, Underwood, Charters White, and SimsWoodhead. The following papers were read: Mr. R. Lennoxon Fusible Metal; Mr. Macleod on Dall’s Method of prevent-ing Anterior and Lateral Movements in Artificial Denturesin Edentulous Cases; Mr. Fisher on the Compulsory Atten-tion of the Teeth in School Children and Army and NavyRecruits; Mr. Pedley on Observations on the Teeth ofHospital Children ; Mr. Mummery on Methods of Researchin Bacteriology; Mr. Pearsall on Oblique Rooted Teeth ;Dr. Dudley Buxton on the Choice of Anaesthetics inDental Surgery; Dr. Graves on a Case of Tuberculosis ofthe Palate treated by Koch’s method (patient shown).The Examination Hall of the Royal Colleges of Physiciansand Surgeons, kindly placed at the service of the BritishDental Association, was but the vestibule through whichthe visitors passed to a most cordial reception from theLondon members. Sir John Tomes’ garden party, the

conversazione at South Kensington, the annual dinnerand other festivities, were so well attended as to allow ofno doubt of their appreciation.

IRISH LUNATIC ASYLUMS.

THE fortieth report on the district, criminal, and private-lunatic asylums in Ireland has now been issued. OnJan. lst last there were in Ireland 16,251 persons of un-sound mind under care, being an increase of 225 on thenumber at the commencement of the year 1890. Since1880 the number of the insane in district asylums has in.creased from 8667 to 11,488, and in the workhouses from3513 to 3961, and the total number from 12,982 to 16,251,little or no change having taken place in the numberof inmates of private asylums, or in the criminal asylumat Dundrum. There has been an increase in the insaneunder care from 249 per 100,000 of the population Ein1880 to 346 per 100,000 in 1890. The admissions intodistrict asylums during the past year were 3095, of which2451 were first admissions, and in 644 cases the patientshad been previously under treatment. The larger pro.portion of these admissions take place under the DangerousLunatic Act, 30 and 31 Vict., cap. 118, sec. 10, by whichthe lunatic practically becomes a criminal, for whosedetention no payment can be enforced. Thus for lastyear 2165 persons were committed as dangerous lunaticsout of a total number of 3095, or about 70 per cent., whilein Scotland during 1889 only five persons, or somethingunder 0’2 per cent.,were so admitted. The inspectors recom-mend that in any lunacy law to be introduced for Ireland anew form of procedure for the admission of the insane toasylums, for rich and poor alike, should be introduced,somewhat in accordance with the form under the presentEnglish Lunacy Act. Provision should also be made forthe conveyance of the lunatic to the asylum, and, inthe case of paupers, for the payment of the medical’officer’s fees. There were 1255 patients discharged recoveredfrom district asylums, giving a percentage of 40’5 on the-admissions, while the total number discharged amountedto 594. The deaths in these asylums were last year 936,giving a death-rate of 8’2 on the daily average numberresident. Of the 936 deaths, 237 were due to cerebral andspinal affections, 412 to thoracic diseases (which included255 from phthisis), and 94 to abdominal aneetions; 5"deaths occurred from suicide, and 4 from accidents. Theinspectors regret that post-mortem examinations in asylumsare not made the rule, and urge their importance, as theytend to protect the insane, safeguard the medical staff,and advance our knowledge of brain disease. All the dis-trict asylums throughout Ireland are more or less over.

crowded. The condition of private asylums, with some fewexceptions, is not regarded as altogether satisfactory, andthe inspectors call attention to the great necessity existingin so poor a country as Ireland for a measure enabling publicfunds to be provided for the establishment of accommoda-tion for the insane paying low rates of board, in which no-pecuniary interest would accrue to any private individual ; ;.

and they suggest that, in any future lunacy legislationin connexion with public asylums, provision for the erectionand establishment of separate wards for the reception ofthis class of the insane should be introduced. At present,a number of patients contributing towards their mainten-ance are to be found in the several district asylums, butthey may be said to some extent to occupy space andreceive benefits which were primarily intended only forthe insane poor. It may be added that many of theprovisions of the Irish Private Lunatic Asylums Act areobsolete, and that much more stringent regulations withregard to this class of the insane are desirable. Thepauper lunatics and imbeciles resident in workhousesnumbered 3961, or nearly one-fourth of the total numberunder treatment. In almost all the workhouses there is anabsence of proper supervision, the only attendance pro-vided being that of pauper inmates, often very ignorantand careless, to whom are entrusted in many cases theappliances of mechanical restraint which they oftenuse because the patient is troublesome or noisy, or

because the imperfect nature of the accommodationwill not admit of a better mode of treatment. Further,

509

in some workhouses the insane inmates are foundwithout occupation or amusement, living, eating, andsleeping in the same rooms with no means of artificialheating, and often with flagged floors. The cold anddark "idiot cells have been got rid of in most parts ofIreland, but there are still workhouses where cells areused as accommodation for the insane, places thoroughlyunsuitable for the reception of lunatics. The total ex-penditure in district asylums for the past year amounted to257,031 3s. 5d., or an increase of 21,570 5s. 8d. as com-

pared with the previous year. The average cost per headon the total expenditure was jE22 7s. 8d.

MEDICAL DEFENCE UNION, LIMITED.

FORMATION OF A NORTH OF ENGLAND BRANCH.

FOLLOWING upon the successful proceedings on behalf ofa member in Sunderland, a meeting of the medical pro-fession of the counties of Northumberland, Durham,Cumberland, and Westmoreland was held, by the kindpermission of the Council of the College, in the Council-room of the College of Medicine, Newcastle-upon-Tyne, onAug. 19th. Professor Philipson occupied the chair, andthere was a large influential representative attendance ofmedical men. Letters of apology and cordial approvalwere read from many well-known practitioners in thenorth. The objects, organisation, development, and workingof the Union were explained by Dr. Philipson, Dr. Arnison,and Dr. Leslie Phillips, the general secretary.Resolutions were adopted recognising the necessity for an

organisation having for its object the defence of individualmembers of the profession against unjust charges, expressingthe belief that the Medical Defence Union, Limited, satis-factorily met this want, and establishing a North of EnglandBranch, covering the area of the four northern counties,with Professor Philipson as President, and Mr. G. E.Williamson as Hon. Secretary. A most influential andrepresentative provisional Council was appointed, withpower to add to its number. All information as to member-ship &c. may be obtained from Dr. Leslie Phillips, 22,Newhall-street, Birmingham.

A VISIT TO WEYMOUTH AND PORTLAND.

AMID the arduous labours incumbent upon the assemblingof so many large meetings of medical men during the " dogdays," which have since the time of Esculapius been asso-ciated with the physician’s holiday, a pleasing break wasafforded to those medical men who attended the meetingof the British Medical Association at Bournemouth duringthe earlier part of the present month by a visit to thehealth-restoring town of Weymouth, and the still morebracing island of Portland. An admirably appointedsteamer, conveying 150 passengers, under the imme-diate supervision of Dr. Childs and Dr. Simpson, sailedfrom Bournemouth to what has been well namedthe "Naples of England." The sea breeze, the sun-

shine, the beautiful scenery of this interesting part ofthe South Coast, made the three hours’ sail seem alltoo short. Carriages were provided for the guests so as toafford them an opportunity of visiting the town gardens,to which they were conducted by Dr. Lush Dr. Griffin,Dr. Moorhead, Mr. Wilton, and Mr. Browning. Theparty was then conveyed to the Victoria Jubilee, andhandsomely entertained by the medical men of the town.On proceeding to Portland, the quarries were visited,and the geology of the island was lucidly expoundedby Dr. Moorhead. After mentioning the various forma-tions which constitute the upper oolite of which the islandis composed, he remarked that they afforded indisputableevidence that Portland during past ages had experiencedmore ups and downs than any other island in the world,having been upheaved and submerged at least five timesbefore it attained its present position. Reference wasthen made to the raised beach which is found near theBill at a height of twenty feet above the present sea level. I

A similar beach exists on the south coast of Devon andCornwall, as well as along the shores of the Baltic andthe seaboard of Chili and Peru. The island thus presenteda good illustration of a geological phenomenon of world-wide interest and importance. Dr. Moorhead next exhibitedsome specimens of marine saurians which were found inthe Portland strata. These sea monsters were the "greatwhales " referred to in the first chapter of Genesis as havingbeen created on the fifth day. Thefossil flora was then noticed,including Cycadese and Coniferse, which, from their extra-ordinary luxuriance, had attracted the special attention ofgeologists throughout the world. The stems of the fossilpine trees exhibited the usual concentric rings, indicativeof annual growth. Such rings implied the existence of theseasons, and therefore, as the oolitic period formed part ofthe fifth day of Creation, confirmed so far the accuracyof the account given in the Book of Genesis, whichrecords that the sun and moon on the fourth day wereappointed "for signs and seasons." The trees in thecoal measures exhibit no such rings. The fossil Coniferaefound in the quarries were unrivalled for their heightand size; and when one looked at the remains of themagnificent forest all around, it was not difficult torecall the past, and to think of the grateful shade enjoyedby the island in remote ages, in contrast with its presenttreeless condition. An opportunity was afforded forvisiting a magnificent fossil tree and many otherlarge fossils characteristic of the island. The visitorsthen proceeded to the convict establishment, and by thepermission of the Home Secretary were shown through thePortland Prison. The medical men who looked at the pri-soners in their cells were unanimous in expressing satisfac-tion with their healthy physical condition-a circumstancewhich was rendered more apparent by the fact that theprison hospital contained very few cases of disease whichcould in any way be attributed to prison life. Dr. G. H.Lilley, the medical officer of the prison, who has publisheda most interesting guide to the isle of Portland, spared noefforts to show the visitors all that was to be seen in thatdepartment of the prison. After leaving the prison theparty were driven to the station through the island.Weymouth was reached, and after light refreshments theparty started on the return journey, highly gratified by theexcellent arrangements for their reception made by the localsecretaries, and the untiring courtesy and kindness whichhad been afforded to them.

CANKER OF THE EAR IN DOGS.

MR. A. J. SEWELL, M.R.C.V.S., communicates an in-teresting article to the Kennel Gazette of August entitled"Canker of the Ear." "All those who have had much ex-

perience with dogs," he says, " must have frequently noticedthat they occasionally show signs of great irritation in theear by constantly shaking the head, holding it on one side,and rubbing the side of theface along the ground, and nowand then scratching the back of the ear with the hind foot ;and yet in some cases, on casually examining the ear, thereis nothing much to be seen to account for these symptoms.A little dried brown excretion may be noticed; in fact, theears look just slightly dirty. The conclusion often come tois that if the parts were cleaned the irritation would cease,but such is frequently not the case. If, instead of givinga hurried look into the ear in these cases the parts arewell examined and the canal leading into the ear iscarefully watched, tiny white specks, oval in shape,and about the size of the eye of an ordinary smallsewing needle, will be observed. These are parasites(figured below), and are, in my opinion, the cause ofthat disease called canker of the ear." Mr. Sewelldistinguishes this cause from those others which are

well known and from those others affecting the flap ofthe ear due to eczema. He says : "These parasites,which I have called the psoroptes auricularis canis,’ areextremely active in their movements, and, if the ear be care-fully watched for a few moments, they may be seen runningabout the skin and also along the hairs in the ear at a

i fairly rapid rate, considering their minute size; and thei irritation which they cause is due in a measure, I believe,: to the tickling sensation caused by their movement, and

partly the result of their biting. I have had these parasites