1342

and is more aperient, due to the presence of Epsom salts.Bocklet, again, near Kissingen, yields a water at 500 F. of440 grains per gallon, part of which is Glauber’s salts ; italso is gaseous. The water at Monsdorff is tepid and non-gaseous and somewhat stronger than the Stirlingshire spring,though it contains practically the same ingredients. Thatwater, however, which bears the closest resemblance to it isthe Eliza well at Kreuznach, a cold spring with no gas tospeak of and of chemical composition very like that of theBridge of Allan water except that it contains traces ofiodine.

It will be seen from the above that this northern water isas worthy of regard as that from some of the most famouscontinental springs. Like them, it is a water to be taken atthe spot and is suited for internal use and externally forbathing, spraying, and douching. Taken internally, the watersare of value in the treatment of subacute and chronic goutand ’rheumatism, their action being greatly enhanced by thesimultaneous use of baths. They are further indicated incatarrhal affections of the stomach and bowels, and throughtheir action as saline aperients they relieve portal congestionand improve hepatic action. The passive venous congestionof chronic cardiac disease is thus relieved and patients Isuffering from constipation and haemorrhoids obtain relief.Neurasthenic cases also benefit by residing at Bridge of Allanand by the use of the waters for drinking combined with theirexternal use. Their richness in calcium chloride has suggestedthat in them may be found a suitable means of prescribingthis salt in cases of hasmophilia and of oozing from mucoussurfaces or under the skin. Externally their great use is inchronic rheumatism where in the form of baths combinedwith massage they prove highly beneficial. In the same waythey are employed in cases of neurasthenia and in con-

valescence after acute illnesses, such as influenza. Skinaffections of the dry type are relieved by their use and theyalso find a place in the treatment of diseases peculiar towomen in the form of hip baths and douches.

Looking Back.FROM

THE LANCET, SATURDAY, Nov. 7th, 1829.

Now fever rarely spreads when brought into an hospital,and Dr. Elliotson did not remember ever having seen aninstance of it ; but the fact that it is not always propagatedby contagion, is no proof that it may not be so communi-cated ; and if positive facts to the contrary are broughtforwards, they are not, on this account, to be denied. It isasserted by some, that hydrophobia is not contagious; nay,some have denied the existence of the disease, and oneindividual does so at present, and declares he has inoculatedhimself with the saliva of a mad dog with impunity; but thisis no argument, for few persons who are bitten becomeaffected, and even a large number of dogs inoculated escape.So it is with small-pox, and even syphilis and gonorrhoea ;many a diseased woman has infected one man, whileanother has visited her, even on the same day, withoutinjury. In France, two students, who denied the contagiousnature even of syphilis, went so far as to inoculate them-selves with matter taken from a syphilitic person ; one ofthese lost part of the axilla from the effects of the disease,and the other was so shocked at finding a bad ulcer form,that he put a period to his existence. Sufficient cases are onrecord of fever occurring from contagion, i.e., from theapproach of persons labouring under the disease (or ofindividuals who had communicated with persons labouringunder it) to others in health, and surrounded by healthypersons, to convince him of the frequent contagious-ness of fever, though he himself never saw a well-markedcase, and this he ascribes to the well-known fact, thatthe contagion of fever is easily dissipated by cleanli-ness and free ventilation, both which are carried tothe utmost pitch in St. Thomas’s, and which he takes care tohave as fully attended to in private practice. Neither is heprepared to say, that fever can be produced by filth only,though certainly it is much more likely to spread whencleanliness is not attended to. It is common amongstthe poor Irish, in London, who are generally thickly Icongregated together, and are extremely dirty in their

habits ; but then they are badly fed, and exposed towet and cold, which are known continually to induce it.The following fact proves the power of filth to aggravate,if not to induce, fever, and looks very much like contagion.There is a court, near Bond-street, where a great numberof poor Irish live, in which there was a large heap of filthbehind the houses, and in one of them, the lower apart-ments being uninhabited, were filled by a large collectionof filth of every kind, dead animals, excrement, and allconoeivable stinking things ! In this place fever occurred,and out of 16, who were attacked by it, ten were from thetwo houses next to each other, one of which contained thelargest mass of filth ; now there is no proof that thesepatients caught it from each other, but some of them werecarried to an infirmary, in which there had been no feverpreviously for a length of time, and shortly afterwards twoof the night nurses, who had been sitting up with, andattending on, these individuals, became ill ; and in proofthat the disease with which the nurses were affected, wasthe same as that of the former patients, it is remarkablethat there was a peculiarity in its form, namely, that aboutthe tenth day there was a relapse in every one of the Irish,and this peculiarity was observed in one of the nurses ; the.other died before the tenth day.

1 Excerpt from Abstract of a Clinical Lecture on Fever by Dr.Elliotson at St. Thomas’s Hospital, London.

MEDICINE AND THE LAW.

Right to Exclude Verminous Children from School..é1. l-ULa’1’LV1V UL cuusluejrnum 1.ut:1"t::s uuuu tu CULlUabIUI1

authorities and the medical profession was raised in a caseheard before the magistrates of the Stourbridge division onOct. 25th at the instance of the Worcestershire educationauthority. The question was whether when a parent sendshis child in such a condition that he or she brings into theschool vermin the school authorities have the right to refuseadmission and to treat the fact that the parent has not sentthe child in a condition fit to be admitted as tantamount to aneglect to cause the child to attend. Several decided caseswere referred to, not exactly covering the question in

dispute but where the principle of law was analogous. InSaunders v. Richardson (7 Q.B.D. 388) it was held that a

parent who, under an order by a court of summary juris.diction that his child should attend a board school, causedthe child to attend the school, but without the school fees,and without having applied to the guardians for pay-ment of such fees or to the school board for a remission ofthem, was liable to be convicted under the ElementaryEducation Act, 1876 (now repealed) for non-compliance withthe order. In Taylor v. Timson (20 Q.B.D. 671) it was heldthat there is no right on the part of a churchwarden forciblyto prevent an inhabitant of a parish or district fromentering the church for the purpose of attending service, eventhough the churchwarden may be of opinion that hecannot be conveniently accommodated. The statute 5 & 6Edw. VI., c. 1, s. 2, having imposed a general duty to go tochurch, which is still binding upon members of the Churchof England, has conferred a correlative general right to goto church on those who are so obliged to go. In Pidgeon v.Legge (21 J.P. 743) the plaintiff, a chimney-sweep, went inhis working dress into the bar of an ale-house where therewere several persons taking refreshment. It was after work-ing hours and the defendant, the landlord, recommendedhim to go and change his clothes and upon his refusal toleave after request the defendant desired two police con-

stables to put him out. The plaintiff offered resistance tothe policemen and when outside the door still struggled andwas thrown down on the street and his leg was broken. Itwas held that if the plaintiff was in his clothes and person inan unfit condition to be in a public-house the defendantwas justified in ordering the policemen to remove him andwas not responsible for the excess of violence which theyused in carrying out his command. In Tomlinson v. Ash-worth (50 J.P. 164) it was held that the workman who isrefused admission through failing to comply with the reason-able regulations of the works absents himself from his work.It was also contended that the Education Act, 1902, s. 17,requires the education authorities to "maintain and keepefficient all public elementary schools " and that unless theyhave power to refuse admission to children who are suffer-ing from vermin they could not maintain and keep the

1343

school efficient. Medical evidence was adduced before themagistrates showing the state of the child when admittancewas refused and that the parent had been twice warned asto the state of the child and required to cleanse her beforesuch admittance was so refused. Further, that the

parent’s neglect to cleanse the child had caused thechild unnecessary suffering and injury to health, and S3 theparent had thus failed in the performance of the dutyimposed by the Cruelty to Children Act, 1904. It was

proved that the vermin would easily pass to other childrenand cause them discomfort, producing inattention to lessonsand possibly their withdrawal from school until their parentscould properly cleanse them. The medical officer also statedthat the absence of the child from school was not due to anunavoidable cause as the vermin could easily have beenremoved in a few days if the parent had exercised propercare. It was proved that the child had been suffering fromvermin for several months. The magistrates held that themanagers were entitled to refuse admission to the child,having regard to her condition, and they fined the parent forneglecting to cause her to attend in such a condition thatshe would be so admitted.

The Black Smoke Nuisance.All who have to do with the administration of the Public

Health Acts in large towns are familiar with some of theproblems which arise when the air is polluted by densesmoke from factory chimneys. By reasonably vigorousenforcement of their powers many sanitary authorities havesucceeded in reducing the smoke nuisance very largely intheir areas. Improved devices for securing complete com-bustion of the hydrocarbons and other volatile products ofcoal have been adopted in numerous factories. In cases

where there have been emissions of smoke as theresult of obvious carelessness convictions have beensecured without difficulty. On the comparatively rare

occasions when prosecutions of this nature have failedthe courts have usually acted on the principle thatcosts should not be given against the sanitary authority,on the ground that its action has been inspired by regardfor the interests of public health. All these things havetended to induce a feeling of confidence on the part ofmedical officers of health in regard to the administration ofthe Public IHealth Acts, and indeed the same considera-tions apply to the enforcement of the Sale of Food andDrugs Acts and other statutes. It is desirable in theinterests of all concerned that such confidence shouldnot result in want of care in the institution orconduct of proceedings. The immediate reason for theseremarks is to be found in the history of the prosecution bythe Chelsea borough council-acting as the local sanitaryauthority-of the Underground Electric Railways Company(of London), Limited, for emitting "black smoke in suchquantity as to be a nuisance " from the chimneys of theirLot’s-road generating station. The evidence for the boroughcouncil showed that residents in the district had from timeto time made complaints as to the nuisance caused byblack smoke from the generating station and that on certaindays during the past summer specially detailed observershad noted the issue of smoke, which seemed to them to beblack, at specified times. These observations were made onthe instructions of the medical officer of health and as aresult a number of summonses were issued. The advisersof the council probably regarded the matter as an ordinarypublic health prosecution which would involve an ex-

penditure of L15 or at the most .620. The case dulycame before Mr. Curtis Bennett at Westminster policecourt. During a hearing which lasted in all seven

days-spread over a period of almost as many months-the defendants produced unimpeachable evidence fromengineers and other men of science showing that the smokeemitted from their chimneys was not " black " as the wordis understood by experts in this connexion, and that thewhole construction of, and method of using, the generatingstation were as perfect as human ingenuity could devise.It was further represented to the magistrate, truly enough,that the conversion of the underground railways from steamtraction to electric traction has conferred inestimable benefitson the inhabitants of London, especially as regards the freedomof the atmosphere from fumes and smoke. The stipendiarymagistrate adopted this view very strongly and in dismissingthe summonses, Mr. Curtis Bennett took the very unusualcourse of awarding the defendants 300 guineas costs against

1 Public Health (London) Act, 1891, Sec. 24 b.

the sanitary authority. The moral is that local authorities andtheir advisers should be just as careful to see that they havea good case when administering the Public Health Acts asany private litigant is in protecting his own interests. It isdifficult enough to enlist public opinion on the side of healthauthorities in the ordinary course. It will be doubly difficultif examples of unsuccessful prosecutions are brought promi-nently before the public by way of the police courts andthe newspapers.

ROYAL COLLEGE OF PHYSICIANSOF LONDON.

A COMITIA was held on Oct. 31st, Sir RICHARD DOUGLASPOWELL, Bart., K.C.V.O., the President, being in the chair.The following gentlemen having passed the required exa-

mination were admitted Members of the College : MauriceAlan Cassidy, M.A., M.B. Cantab., L.R.C,P. Lond.; CharlesWilberforce Daniels, M.B. Cantab.; Samuel Ernest Dore,M.D. Cantab., L.R,C.P. Lond.; John Prescott Hedley, M.A.,M.B. Cantab., L.R C.P. Lond.; Reginald Charles Jewesbury,M.A., M.B. Oxon., L.R.C.P.Lond.; Herbert William GeorgeMacleod, M.D. Edin. ; George Basil Price, M.D. Lond.,L.R.C.P. Lond. ; Robert Frazer Standage, L.R.C.P. Lond. ;and Harold Waterlow Wiltshire, M.A., M.B. Cantab.,L.R.C.P. Lond.

Licences were granted to 91 gentlemen who had passed thenecessary examination.The following communications were received :-1. From

the secretary of the Royal College of Surgeons of Englandreporting the proceedings of its Council on July 25th andOct. 10th. 2. From the Secretary of State for India,forwarding copies of reports by the Indian Government onthe suggestions of the College with regard to plague measuresin India made to Mr. Brodrick in 1905, and of a despatch byMr. Morley to the Government of India of July 26t:b, 1907,on the same subject. The matter was referred to the standingcommittee on plague. 3. From the chairman of the HomeOffice committee on the London ambulance service invitingthe College to appoint a representative to give evidencebefore the committee. Sir William S. Church was nominatedby the PRESIDENT to represent the College.The audited accounts for the year ending Sept. 29th last

were laid before the College and adopted.The quarterly report of the finance committee, dated

Oct. 17th, was received and adopted.The REGISTRAR (Dr. E. LIVEING) moved that the follow-

ing by-law be enacted for the second time-viz.,That Daniel Colquhoun, M.D. Lend., and George Edward Rennie,

M.D. Lend., elected Fellows on April 25th, residing in New Zealand andAustralia respectively, be admitted in absentid, any by-law to thecontrary notwithstanding.The proposal was adopted.The REGISTRAR moved for the second time that alterations

should be made in certain by-laws relating to Licentiates tomake them conformable to the revised regulations of theConjoint Board adopted on April 25th last. The proposalwas adopted.A report was received and adopted from Sir William

Church and Dr. G. A. Heron who represented the Collegeat the International Congress on School Hygiene in Augustlast.A report was received and adopted from Dr. Michael

Grabham who represented the College at the CentenaryCommemoration of the Geological Society in Septemberlast.

Dr. WILLIAM EWART proposed the following motionThat the question be considered of the expediency of securing some

permanent reproduction by photography or otherwise of the mostvaluable among the ancient deeds, documents, and art treasures, theproperty of the College, with a view to their perpetuation in the copyin the event of loss or destruction of the originals.

The matter was referred to the library committee.Dr. F. W. Andrewes was elected a member of the

executive committee of the Imperial Cancer Research Fundin place of the late Sir William Broadbent.A report was received and adopted from the committee of

management dated Oct. 7th, 1907. The committee recom-mended that Mr. Edmund Owen should be appointed visitorto the examinations of the Egyptian School of Medicine forthe examinations to be held in December next.

Griggleswick School, Settle, Yorkshire, was added to thelist of institutions recognised by the Examining Board in