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372 And we have nothing but praise for them, except that we think that the statement about the cold bath is rather too sweeping. However, perhaps even this may be read permissively. Short rules are given as to the dangers of the sputum and the way in which these are to be avoided. Personal and local cleanliness is insisted upon and there is a timely warning to patients not to neglect these rules of hygiene after they return home. COTTAGE BATHS. THERE is some hope that the Manchester Corporation will at length give a favourable response to the oft-repeated prayers for cottage baths in Hulme. The question was considered at a meeting of the Baths Committee on Jan. 16th. Alderman Evans brought forward a resolution from the Ladies’ Health Association "praying the com- mittee to provide cottage baths for the poor people in the Hulme district." A sub-committee was appointed to consider the question ] .and report on the best method of trying the experiment. The idea is to fit up a large cottage with baths where the mothers may take their children and " wash them more frequently and readily than can be done now in many of the houses of the poor." All who are regard- ful of the wants of the poor will wish the scheme every success. PROGNOSIS AND CLASSIFICATION OF HYSTERIA. DR. JOSEPH FRAENKEL of the New York Hospital for Nervous Diseases has published in the New York Medical News of Jan. 5th a concise and interesting article on the prognosis and classification of hysteria in which he deals with the interesting question as to how far the disease may be regarded as fatal, a point which the text-books seem to neglect. Hysterical disorders are divided into three main clinical groups which, he observes, are not sharply demarcated, as many intermediate and complicated types may be met with. The first group comprises the predominantly mental forms-i.e., hysterical psychosis with more or less pronounced somatic symptoms. The -second group includes those with disturbances affecting a lower level of the nervous system-e.g., the cerebro-spiniell forms. The symptoms of this group mainly consist of pheno- mena of paralysis of motor and sensory nerves and phenomena of irradiation. The third group is marked by disturbances which are predominantly splanchnic in their distribution-i.e., visceral and vascular disturbances, and including those of digestion and secretion such as vomiting, constipation, diarrheea, meteorism, ulcerations, oedemata, &c. Around these main groups there cluster the varying kinds of hysterical seizures and crises, grand ou .petit mal hystérique. As regards prognosis he. believes that this is favourable in the first and second groups of cases. In the third or splanchnic group, however, a few cases have been recorded which have ended fatally, and amongst these Dr. Fraenkel enumerates four cases which had been under personal observation, three of which had ended fatally while under observa- tion during the course of two years. Dr. Fraenkel points out that in fatal cases death is believed to be due to paralysis or spasm of the -glottis, or is the result of inanition following persistent hysterical anorexia, or is due to uncontrollable hysterical vomiting. These modes of death do not include the rare cases which end by suicide. The three cases of Dr. Fraenkel are of rare and exceptional interest, and ’the first of these is as follows. A woman, aged 42 years, single, suffered from severe hysteria with anorexia for nine months. There was no attributable cause for the onset of her symptoms, and her family history was good. On admission to hospital the chief symptoms were emaciation, anorexia, vomiting, and obstinate constipation. The pulse and temperature were subnormal. No organic disease could be found by repeated examination. " The patient took only a small amount of nourishment, and after two weeks she died suddenly, - apparently of exhaustion." The necropsy revealed the following con- ditions. There were small haemorrhagio erosions in the stomach and scattered spots of ulceration in the small and large intestines. These ulcerations were dark and parchment-like, and very similar in appearance to trophic ulcerations of the skin. The brain and spinal cord showed no changes to the naked eye, ex- cepting that the meninges were unusually dry. The patient was embalmed prior to the performance of the necropsy, so that the results of microscopical examination (in the form of slight changes in the central nervous system) were not regarded as trustworthy or genuine, inasmuch as the possibility of their being artifacts had to be borne in mind. The sympathetic nervous system was not exami ed. Dr. Fraenkel therefore concludes, and his conclusion is supported by Fournier, that it is reasonable to assume that in hysteria death when it occurs is due to " irritation Or paralysis of splanchnic or vegetative functions and that a case of hysteria with more or less constant and prevailing splanchnic or vegetative symptoms is from a prognostic standpoint to be adjudged very cautiously." Astrion.--1. The question as asked by our correspondent is too vaguely put. The giving of the appuintment would probably vary according to the port of exit and of entry. Our correspondent had better write to the Colonial Office, the Board of Trade, and the Emigrants’ Information Office, the address of which last establishment is 31, Broadway, London, S. W. 2. We do not know the formula of the particular preparation in question. The formula for "grey oil," as given by Dr. E. Lang of Vieuna, who introduced it into practice, is as follows: Lanolini anhydrici, four drachms ; chloroformi, half an ounce. Evaporate in a large mortar with continual stirring down to one ounce. Then add one ounce hydrargyri vivi depur., stir slowly until the chloroform is wholly evaporated and the metallic mercury can be no longer distinguished. This preparation is known as unguentum cinereum laninolatum forte. To prepare an injection of 50 per cent. strength, which is the one most commonly used, take of the above ointment 135 grains and ol. vaselini 45 grains ; add the oil to the ointment very gradually with constant stirring until a smooth oily mixture is obtained. The dose given is usually 0’05 cubic centimetre. Enquirer (2) must, we think, look to his own patient for the fee. He attends the consultation in the plaintiff’s interest, for it would harm his case if he declined to go. W.H.-The objection urged is a possible one. ERRATUM.--In the report of Dr. Churton’s paper on Disease of the Prefrontal Lobes, published in THE LANCET of Jan. 26th, the name " Lichen" at page 251, col. 1, line 9, ought to be Ziehen. The passage at lines 29-32 of the same column ought to be as follows: "...... malingering were included in the first division. As illustrations of disorders characterised by depression of the activity of the prefrontal cells cases were briefly related......." METEOROLGICAL READINGS. (Taken daily at 8.30 a.m. by Steward’s Instruments.) During the week marked copies of the fonowing newspapers have been received : Herts Observer, Stafford Advertiser, Durham Advertiser, Preston Herald, Hereford Times, Hull News, Liverpool Daily Post, Southern Echo, Dunfermline Journal, Plymouth News, East Anglian Times, Sussex News, Leeds Mercury, Worcester Chronicle, Walsall Observer, Swansea Herald, Dundalk Examiner, Chronicle, Walsall Observer, Swansea Herald, Dundalk Examiner, Birmingtzam News, BLyth News, Dover Chronicle, Lancaater Guardian, Norwood Press, Bridge oJ Allan Reporter, Croydon Guardian, Bristol Mercury, Surrey Times, Scotsman, Kettering Guardian, Times of India, Pioneer Mail, Citizen, Wellington Journal, Aldershot N ews, Architect, Builder, Yorkshire Post, Reading Mercury, Mining Journal. Local Government Chronicle, Hertfordshire Mercury, Dorset County Chronicle, City Press, Norfolk Standard, Halifax Evening Courier, Alliance News, Auto motor -Jourilat, Lincoln Echo, Sydney Daily Telegraph, South Africa Review, South Wales Press, Perth Journal, Liverpool Courier, Surrey Advertiser, Local Government Journal, Courrier de la Presse (Paris), Le Journal des Debats, Le Progrès Medical, Le Voltaire, La Politique Coloniale (Paris), La Lanterne (Paris), Le Petit Temps, Australasian Medical Gazette, &c., cGC. Medical Diary for the ensuing Week. OPERATIONS. METROPOLITAN HOSPITALS. MONDAY (4th).-London (2 P.M.), St. BortholomewB (1.30 p.nc.), St. Thomas’s (3.30 P.M.), St. George’s (2 P.M.), St. Mary’s (2.30 P.M.). Middlesex (1.30 P.M.), Westminster (2 P.M.), Chelsea (2 P.M.). Samaritan (Gynaecological, by Physicians, 2 P.M.), Soho-square (2 P.M.), Royal Orthopaedic (2 P.M.), City Orthopsedio (4 P.M.), Gt. Northern Central (2.30 P.M.), West London (2.30 P.M.), London Throat (2 P.M.). TUESDAY (5th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), Guy’s (1.30 P.M.), St. Thomas’s (3.30 P.M.), Middlesex (1.30 p.ac.), West- minater (2 P.M.), West London (2.30 P.M.), University College (2 P.M.), St. George’s (1 P.M.), St. Mary’s (1 P.M.), St. Mark’s (2.30 P.M.), Cancer (2 P.M.), Metropolitan (2.30 P.M.), London Throat (2 P.M. and 6 P.M.), Royal Ear (3 P.M.), Samaritan (9.30 A.M. and 2.30 P. M.). WEDNESDAY (6th).-St. Bartholomew’s (1.30 P.M.), University College (2 P.M.), Royal Free (2 P.M.), Middlesex (1.30 P.M.), Charing-cross ; (3 P.M.), St. Thomas’s (2 P.M.), London (2 P.M.), King’s College (2 P.M.), St. George’s (Ophthalmic 1 P.M.), St. Mary’s (2 P.M.), National Ortho- pædic (10 A.M.), St. Peter’s (2 P.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Gt. Ormond-street (9.30 A.M.), Gt. Northern Central (2.30 P.M.). Westminster (2 p.M Metropolitan (2.30 P.M.), London Throat (2 P.M.), Cancer (2 P.M.)
