825INTERNATIONAL CONGRESS ON HOUSING. - LOOKING BACK.

The State has an important mission to perform in this pro-vince but it requires the aid of public opinion in the task oftransforming our old towns, for it must also transform habitsand manners."At a brilliant reception which was held on the evening of

Sept. 4th at the Palais Eynard M. P. FAGES, administrativecouncillor and honorary president of the Congress, said :I’ The task before us is arduous. It is necessary to enlightenthe masses, to combat prejudice and habits of routine, todemonstrate that in this matter more than in any other theindividual interest of the richest as well as of the poorest isintimately, even indissolubly, bound up with the general in-terest. It is, moreover, necessary to stir up the inertia of

public authorities, unfortunately absorbed by too muchattention to cares of a less important nature to modify theprivileges of ownership by legislative measures more in

harmony with modern necessities created by the progress ofscience. The municipal authorities of Geneva have no legis-lative prerogative; they cannot exercise any sanitary controlor take preventive measures. They are not, however,ignorant of the improvements necessary in old cities and theobligations which ought to be imposed on new ones. IfGeneva, like all towns traversed by a river or situated on thebank of a lake, is exceptionally healthy it must not slumberin false security. Its sanitary legislation, compelled tostop at the door of each house, is still rudimentary andimperfect. It is necessary for Geneva to complete and tocoordinate, in agreement with private initiative, measuresconcerning the feeding and physical protection of infants ;to generalise the means of disinfection and to enforce theiruse; to create a sanitary record office containing the detaileddescriptive plan of each house, particulars of deaths due toinfectious diseases, the alterations ordered by the sani’jarycommittee, and the results of these orders. It is onlycareful records of this nature which will insure a reallyefficacious intervention of the authority in the transforma-tion of unhealthy dwellings and the construction of newones."A great deal of care and thought was shown in the

arrangement of the different sections under which the subjectwas discussed. There were five main sections dealing with(a) dwelling houses ; (b) lodgings and places of assembly ;(o) moveable or temporary dwellings ; (d) art and decorationof houses; and (e) sanitary administration. Dwellinghouses were discussed separately as houses in towns, work-men’s houses, and rural dwellings. Schools, theatres,factories, hospitals, and military establishments came underthe heading of places of assembly, and railway carriagesand steamboats under that of moveable or temporary dwell-ings. No attempt was made by the organising committeeto get together any kind of public exhibition of models,apparatus, or plans, though facilities were given for the

inspection of some of the public buildings and municipalundertakings in Geneva. Of particular interest to themedical members of the Congress were the latest erectedschool buildings, one feature of which is the bathing roomin the basement, where 20 children can be bathed at once,each in a separate bath. Every scholar is expected to havea bath twice weekly. The cantonal general hospital of 450beds, though an old building, is in many respects a well-equipped institution, and the adjoining maternity hospital,which is approaching completion, is constructed quite uponmodern lines. Mention should also be made of the children’shospital at Pinchdt, which was founded in 1899 by Dr. E. M.Martin, a Genevese practitioner of long standing. The situa-tion of the hospital on an elevated spot permits the com-bination of fresh air and sunshine treatment with that ofmechanical appliances. There is accommodation for 25 ’’

children in two large wards for nine or ten patients, twodouble-bed and two single-bed wards. The surgical dressing-room and operating-room are both designed to accord withthe aseptic views of the present day. There have alreadybeen under treatment in the hospital 275 patients, withseven deaths. Of tuberculous cases requiring surgicaltreatment, there have been 125 instances, of which number50 were suffering from hip-joint disease. The whole of theexpenses of this hospital are defrayed by Dr. Martin, exceptthat when the parents of the children can afford to do sothey pay one franc daily. The daily cost per patient issaid to be two francs.The discussions at the sectional and general meetings were

for the most part well sustained. Where the circumstancesof different localities are so varied there must necessarily bewide difference of opinion upon matters of detail, but there

was general accord upon points of principle. The methodsof inspection by women health visitors met with generalapproval and the opinion was freely txpressed that othercountries might with advantage follow the example of GreatBritain with regard to the administration of the lawsrelating to the housing of the poorer classes.Some of the recommendations adopted were as follows :

1. That a general and sustained effort for the improvementof habitations at the present time should be directed to theprovision of houses for families of small means, if possiblewith gardens, in rural districts. 2. That notification shouldbe compulsory in case of infectious diseases in menand animals and that centres of infection should be com-pulsorily destroyed. 3. That the water necessary for hygienicpurposes and health should be furnished in abundance bypublic bodies. 4. That public bodies should organise them-selves for the struggle against the exodus from ruraldistricts and should facilitate a return to country life bythe construction of hygienic rural houses at a cheaprent. 5. That the principles of rural hygiene should bepopularised and that the sanitary education of the countrypeople should be commenced in the schools by the teachersand be followed up by (a) a thorough administration of thesanitary regulations ; (b) posters, newspaper articles, andlocal publications; (c) meetings of the people in eachdistrict ; (d) agricultural engineers ; (e) medical men andveterinary surgeons ; and (f) midwives. 6. That the dutyshould be imposed by law upon local authorities of protect-ing the public health by preventing all building underinsanitary conditions and by forbidding the occupation of allunhealthy houses. 7. That the examination of plans for newbuildings and the permanent sanitary control of housesshould be intrusted to a commission which should be

competent as much from the medical point of view asfrom the scientific aspects of building. 8. That services fordisinfection should be established in each commune or in agroup of communes. 9. That it is necessary to apply tothe quarters occupied by animals the principles of hygienewhich apply to dwellings for human beings.

Looking Back.FROM

THE LANCET, SATURDAY, Sept. 20th, 1828.

MR. SHELDRAKE ON DISTORTIONS OF THE FEET.

LORD BYRONS CASE.

To the Editor of THE LANCET.

SiB, —It is well known that the late Lord Byron was lamein one of his feet, a circumstance which caused him muchuneasiness in the course of his life ; as the facts of the casehave escaped the notice of all his biographers, this accountof them may not be without some general interest, as well asbe useful in a professional point" of view.

, He was born with one of his feet distorted, like some ofthose which are represented at page 144 of THE LANCET. Ashe was born in Scotland, Lady Byron consulted the mosteminent professional men who, at that time, practised inEdinburgh; as no successful method of treating thesedefects was then known in that country, her Ladyship wastold that her son’s foot was incurable, and she submitted towhat she was told must be his fate.Some years afterwards, the success of my treatment of

these cases becoming known in Scotland, several patientscame to me from that country, and returned home cured;these facts being known to Lady Byron, she determined tosend her son to be under my care in London, as he was thenold enough to be sent to school. She sent him to a privateacademy kept by a Mr. Glenny, at Dulwich, who was orderedto send for me to attend Lord Byron and to cure his foot.A few days afterwards, a gentleman called at my house toask at what school Lord Byron was placed. I had, then, noknowledge of Lord Byron or his residence. The gentlemantold me the state of his foot; that he was sent by his motherto a school near London, with orders to the master to employme to attend him till his foot was quite well: that, as

he was coming to London, Lady Byron requested that hewould call at the school, and see how her son was going onunder my care. He had just arrived in London, and had lost

826 THE ROYAL COMMISSION ON VIVISECTION.-VITAL STATISTICS.

his pocket book, which contained the direction, with otherpapers ; and as he knew his Lordship was to be my patient,he came to me for the address, that he might go to himdirectly ; all this was unknown to me ; there was, evidently,some mistake, which neither of us could explain, and, there-fore, we parted.A few days afterwards, I received a letter from Glenny,

the schoolmaster, who reproved me, in very strong terms, forneglecting Lord Byron, and required me to attend to himproperly. I now saw what the mistake was; that Glennyhad first sent a verbal order to me, which, by mistake, hadpassed into the hands of the person whom Dr. Neale toldCaptain Darley was the wrong Sheldrake, alias Sheldrake thetruss-maker. Finding that his order was not obeyed, Glenny,I suppose, wrote by the post, and directed his letter to theaddress which he had received from Scotland, and, of course,his letter came safe to me. As this was, evidently, the realstate of the case, I wrote to Glenny in explanation ; butnever received an answer to my letter.Many years afterwards, when Lord Byron was at Cam-

bridge, a gentleman told him of the distinction that was tobe made between me and Sheldrake the tr1lss-maker. In con.sequence, he came to London to consult me. He told me allthat passed in Scotland, in the attempts that had there beenmade to cure his foot; of his surprise, when Sheldrake thetruss-maker, was introduced to him, to find that the personof whom he had heard so much, was so stupid and ignorantas the individual who was then introduced to him certainlywas ; that he made no attempt to cure his foot ; made some-thing that he called a leg iron, and when that was done,appeared no more.When Lady Byron was thus disappointed in the great

benefit which it was believed her son would have receivedfrom me, she sought no more for assistance of any kind ;and, in due course of time, his Lordship proceeded to Harrow,and thence to Cambridge.

After I had carefully examined his foot, I was convincedthat, although he was at that time near twenty years of age,it was in such a state, that I could have completely curedhim, if he could have submitted to the seclusion which hemust have borne for so long a time as would have beennecessary to effect a cure.To explain this, it should be told that all the cures which,

at that time, had been performed by me, were effected byusing mechanical contrivances of different constructions, whichwere employed in various directions, and changed, altered,or removed, from time to time, as existing circumstancesrendered necessary ; if this course was followed steadily,the patient was cured ; if it was interrupted, partial relapsetook place ; and, in short, nothing but the most perseveringattention could have ensured success. The instruments thathe must have used were cumbersome to the person, and

disagreeable in appearance,-two circumstances which wouldnecessarily prevent him from going into society, or engagingin those pursuits which suited with his rank, inclinations,and line of life. After having duly considered all thecircumstances, his Lordship made his determination ; heexpressed bitter regret that the vile trick which had beenpractised upon him in early life, had cheated him of thattime which might have been, without inconvenience,employed in effecting a cure, but which he could not nowengage in without the greatest injury to his future pursuits:he was now almost of age, and must, in the nature of things,take his seat in the house of peers, and engage in otherthings that were suited to his rank, and which he could notavoid without injury ; for these reasons he resolved not toattempt a cure, which, it was more than probable, circum-stances would compel him to interrupt, or even renderabortive.The next question was, what could be done to alleviate the

inconveniences he laboured under? I annex two sketchesthat I made from a cast of his foot; one view was looking atthe outside, the other at the inside of his leg ; by these itwill be seen, that when he had no artificial support he Istood upon the outside of his foot, but all the parts of it hadso much flexibility, that by using some exertion with bothmy hands, I could turn the foot about so much as to bringthe sole, and the heel likewise, very near to the ground:the leg was much smaller than the other leg. By makingthe inside of the shoe of a peculiar form, and some otherprecautions, and by placing additional substances upon thesmallest leg, they made it appear equal in size to the other,so that, when he was dressed, his legs and feet appearedto be so equal, that common observers did not perceive

any difference between them in the usual intercourse ofsociety. In this state he continued, from the time that Ifirst saw him, soon after the publication of his " Hoursof Idleness," till he went on his first voyage to Greece;upon that occasion he carried with him as many of thearticles that I had invented for his foot as would serve

till his return, when he continued to use them so long as heremained in England; and when he left England the lasttime, he took a fresh supply, and I saw him no more ; thoughI once received an order from him while he was on theContinent, to send him another set. To execute, eflectuA.lly,the means of concealing the defect in his leg and foot, itwas necessary that his Lordship should be present; ofcourse, after he had left England, it was impossible that itcould be done ; still he was desirous of concealing it asmuch as the circumstances he was in would allow, by hismanner of managing his dress, by keeping his foot under thetable, or by any other artifice that, at the time, he couldpractise to keep it out of sight.l

THE ROYAL COMMISSION ON VIVI-SECTION.

WE are informed that His Majesty the King has beenpleased to appoint a Royal Commission on Vivisection. Themembers of the Commission are as follows :-Chairman, theRight Hon. Viscount Selby ; Colonel the Right Hon.Amelius Richard Mark Lockwood, C.V.O., M.P.; SirWilliam Selby Church, Bart., K.C.B., M.D. ; Sir WilliamJob Collins, M.P., M.D. ; Sir John McFadyean, M.B. ; Mr.Mackenzie Dalzell Chalmers. C.B., C.S.I.; Mr. Abel JohnRam, K.C. ; Dr. Walter Holbrook Gaskell, F.R.S.; Mr.James Tomkinson, M.P. ; and Dr. George Wilson, withCaptain Charles Clive Bigham, C.M.G. (Secretary).The terms of reference are" To inquire into and report

upon the practice of subjecting live animals to experiments,whether by vivisection or otherwise ; and also to inquire intothe law relating to that practice and its administration ; andto report whether any, and if so what, changes are

desirable." "

The Commission will not sit until about the end ofOctober and its offices are to be at Chapel-place, Delahay-street, Westminster, S.W.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8349 births and 6398deaths were registered during the week ending Sept. 15th.The annual rate of mortality in these towns, which hadbeen equal to 18 - 3 and 22 ’ 3 per 1000 in the two precedingweeks, declined last week to 21 ’ 1. During the first 11 weeksof the current quarter the death-rate in these towns averaged15’ 8 per 1000, the rate during the same period in Londonbeing 15’ 3. The lowest death-rates in the 76 towns duringthe week under notice were 4’ 8 in Hornsey, 8’ 6 in Halifax,9’ 3 in Leyton, and 11’ 0 in Plymouth ; the rates in theother towns ranged upwards to 34’ in Preston, 35’4 inHanley and in Warrington, 36’ 0 in Burnley, 36’ inGrimsby, and 39-6 in Merthyr Tydfil. The 6398 deathsin the 76 towns showed a decline of 356 from the highnumber returned in the previous week, but includedno fewer than 2523 which were referred to the principalepidemic diseases, against numbers increasing from 362to 2571 in the nine preceding weeks; of these, so

many as 2311 resulted from diarrhoea, while 66 were

referred to whooping-cough, 52 to diphtheria, 34 tomeasles, 32 to "fever" " (principally enteric), 27 to scarletfever, and one to small-pox. The deaths from theseepidemic diseases were equal to a mean annual rate of8’3 per 1000 in the 76 towns and to 5’ 5 in London.The death-rate from these epidemic diseases did not exceedI - 2 in Hornsey, 1 . 5 in Bournemouth, and 1’9 in Halifax;whereas it ranged upwards in the other large towns to 16’4 4

1 Excerpt from letter, accompanied by two sketches, signed "T.Sheldrake, No. 7, Devonshire-street, Portland-place."