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rather than wait till the Whitsun holidays were actually athand, the public were to commence their summer purchasesin January and February, it would greatly relieve the con-gestion and subsequent stagnation of the trade. More steadyemployment and better wages would result. The sweatersprofit by irregularities and gluts, as these force work out ofthe factories and into their hands.

GASKELL’S RESEARCHES.

THE most able judges will pronounce Dr. Gaskell’stheories to be bold but reasonable, wide but well supported.His facts cannot be questioned, and his explanations cannotbe substituted by any better hypotheses. In his lecture,recently delivered before the Royal Medical and ChirurgicalSociety on his receiving the Marshall Hall prize, Dr. Gaakellgave an elaborate and lucid historical sketch of the rise and

progress of his researches on the relations between the

function, structure, origin, and distribution of the nervefibres which compose the spinal and cranial nerves. The

place of birth of these remarkable investigations was thevagus nerve of the lowly frog. In this nerve it was inferred,as the result of certain experiments, that there existed twokinds of nerve fibres, having very opposite functions andvery different histological structures. Stimulation of theone caused, or tended to cause, a slowing of the heart’srhythm and a weakening of its contractions, whilststimulation of the other increased the force and thefrequency of the cardiac contractions.

In the paper published in the Phil. Trans., 1882, part 3,Dr. Gaskell suggested that the vagus is the trophic nerve ofboth the muscular tissue and the motor ganglia, meaningthereby that it increases the activity of the various forma-tive processes going on in both these kinds of tissue, andproduces all its effects by virtue of this quality. This state-ment was made after a study of the heart of a frog andtoad. Subsequent investigations on the hearts of tortoisesthrew a new light upon the cause of the sequence of theventricular upon the auricular beat. Other experimentsrender it probable that the action of the vagus on warm-blooded is similar to its action on the cold-blooded animal.The action of the vagus upon the muscular tissue of theheart is characterised by two different sets of effects, andthe one increasing the contractile force is exerted throughthe mediation of the fibres derived from the sympatht ticplexus, but going to the heart along with the vagus, fibreswhich are characterised by being non-medullated and veryfine, whereas the vagal inhibitory fibres are large andmedullated. A distinction is thus drawn and contrastedby great differences between what may be called anabolic(vagal) and catabolic (accelerating). The first namedleads to the construction of explosive material, to con-

servation ; the second to destructive metabolism, to break-ing down of the explosive substance or protoplasm.The vagus increases the activity of the formative processgoing on in the muscle, and it will produce therefore aug-mentation of the force of the contractions alone, a diminutionfollowed by augmentation, or even standstill, followed byaugmentation, according as that activity is more or lessequally distributed over the different stages of the process,the ultimate end of which is the formation of the finalcontractile substance. In the paper published in theJournal of Physiology, vol. iv., the innervation of the heartis considered in special reference to the heart of the tortoise,and in relation to the subject of the lecture the most im-portant conclusion was drawn that the vagus of the tortoisewas like that of the frog in possessing depressor and aug-mentor functions. In the crocodile, suggested as an animalfor study by Sir Joseph Fayrer, the same conclusion wasfound to hold good. Following the historical development,we come next to the important communications publishedin the Transactions of the International Congress held in i

Copenhagen in 1884, and this treated of inhibitory actionsand inhibitory nerves in general. The following conclusionswere arrived at by Dr. Gaskell:—That direct stimulationcauses inhibition, chiefly because the terminations of theinhibitory nerves are stimulated. Inhibitory nerves havean existence separate from motor or excitor nerves. The

process of inhibition is not destructive or neutral, but con-structive in its nature,

,

In the Journal of Physiology, vol. vii., we are led stillfurther into the special subject which occupied the MarshallHall lecturer. The structure and distribution of the nerveswhich innervate the visceral and vascular systems receiveattention. We are told that the white rami communicantesare formed by an outflow of medullated nerves from bothanterior and posterior roots of the spinal nerves betweenthe second thoracic and second lumbar inclusive, whichmedullated nerves pass not only into their metameriasympathetic (lateral) ganglia, but also form three mainstreams upwards into the cervical ganglia, downwards into.the lumbar and sacral ganglia, and outwards into thecollateral ganglia. The white rami communicantes alona

. constitute the rami viscerales of the physiologist. The; outflow of visceral nerves from the central nervous system

into the so-called sympathetic system takes place by thesemeans alone, and is therefore limited in the thoracic region

.

to that part of the spinal cord which is included between. the origins of the second lumbar and second thoracic, nerves inclusive. It was next demonstrated that the

outflow of visceral nerves could be recognised not merely by the presence of the white rami communicantes,s

but also by the smallness of the calibre of the visceralnerve fibres. The distribution of visceral nerves occurstherefore in definite sacral, thoracic, and cervico-cranial

, regions; from these regions they pass out into the ganglia.of the visceral system ; from the sacral region they pass out

’ in a single stream to the ganglia of the collateral chain; fromthe thoracic region they pass out in a double stream, one to,the ganglia of the lateral chain, the other to the ganglia of the

; collateral chain; from the upper cervical region they pass out.in a single stream to the ganglia on the main stems of thevagus and glosso-pharyngeal nerves. Later on it was found

’. that vaso-motornerves for all parts of the body can be tracedas bundles of the finest medullated fibres in the anterior

: roots of all the spinal nerves between the second thoracic. and second lumbar inclusive, along the corresponding ramus

visceralis to the ganglia of the lateral chain (main sympa-. thetic chain), where they become non-medullated, and arel thence distributt d to their destination either directly or

after communication with other ganglia. The next impor-tant conclusion is to the eff t ct that the viscero-motor nervesupon which the peristal tic contraction of the thoracic portion

. of the oesophagus, stomach, and intestines depends, leave

. the central nervous system in the outflow (of nnemedu)Iate4visceral nerves) which occurs in the upper part of the cervicalregion, and pass by way of the rami viscerales of the acces-sory and vagus nerves to the ganglion trunci vagi, where

: they become non-medullated. The cells of Clarke’s columnin the spinal cord are confined to those regions of the central

I nervous system which give origin to the rami viscerales.1 Evidence has been adduced to Ebow that these cells are the1 real source of the visceral nerves. Further, though these fibres.: pass out from the cord as fine medullated structures, they1 lose their medullary sheath after passing through the- sympathetic ganglia. But the conclusions of Dr. Gaskell- are so suggestive and so important that we must reserve. their further consideration.

METROPOLITAN HOSPITAL SUNDAY FUND.

IN view of the approaching Metropolitan Hospital SundayFund collection, which will take place on Sunday week, the-10th inst.,we would draw particular attention to certain of thalaws of constitution, of which we subjoin an abstract sufficientto enable those ministers who make appeals on behalf of the,fund to take the opportunity of reminding their coidgrega-tions of its perfect organisation for the distribution ofthe various offertories entrusted to it. Law 1 is to the effectthat the congregations which have forwarded contributionsto the fund during two successive years shall be entitled to avoice in the management of the fund during the year followingthe last of such contributions, the minister and two laymenfrom each congregation forming the constituents of thefund. Law 2 provides that the Council shall consist of notmore than fifty clerical and fifty lay members, includingmany physicians and surgeons. Rules 3, 4, and 5 providerespectively that the Committee of Distrihution shall consistof the Lord Mayor, as President ex officio, and of nine othermembers ; that those hospitals and dispensaries only which-produce theirprinted reports, with balance-sheetsduly audited

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for the last three years, shall be allowed to participate inthe Fund; and that the awards to hospitals &e. shall be

primarily based on the average total expenditure of eachinstitution for the last three years. We would especiallynote Law 8, which refers to the supply of in-patient and out-patient letters, and which reads as follows :-" The Councilshall be authorised to recommend, through their secretary,on the application of the contributing ministers and

others, in-patients and out-patients to the several hos-

pitals and dispensaries sharing the Hospital Sundaycollection; but their recommendations shall be equal tohalf the number only of what might be claimed by annual,subscribers, whose contributions in the aggregate shouldrepresent a sum equal to the award made out of the HospitalSunday Fund to the respective hospital or dispensary."Thus a member of a contributing congregation can obtainfrom his minister a letter of recommendation to any one ofthe participating hospitals. Rule 12 gives the Committeeof Distribution power to set aside 4 per cent. of the totalamount of collections for the purchase of surgical appliances.

ROYAL COLLEGE OF SURGEONS IN IRELAND.

AT the annual meeting, to be held to-day (Saturday), cthe following resolution will be moved by Mr. Thomson :— (°It is hereby resolved that the declaration of the Fellows

1

that a President of the College may hold office for two sue-cessive years be reaffirmed; that this rule shall take effect 9from June, 1890; that the Fellow who may be selected aspresident at the annual election in that year may so hold (

his office for two years; and that it be a recommendation tothe Council to take such steps as may be necessary to giveeffect to this resolution."

During the past year twenty-seven candidates were ad- mitted to the Fellowship, eighty-five received the Letters Testimonial, four licentiates received the diploma in Mid- wifery, and four practising dentists obtained the licence in Dentistry. 1The new regulations for the Fellowship Examination will

eome into force in November next, and candidates will be 1divided into two grades-viz., (1) licentiates or graduates in ,Surgery of less than ten years’ standing, and (2) those of amore than ten years’ standing. For Grade 1 the examina- i

tion will be as follows :-First day: Six hours for papers. iAnatomy-five questions by each of two examiners ; Phy- siology—three questions by each of two examiners; Surgery- 1

three questions by each of three examiners. Second day {oral): Surgery—three examiners, half an hour each ; iSurgical Pathology-two examiners, a quarter of an hour i- each. Third day: Clinical Surgery—two examiners, one hour; Histology-two examiners, one hour; Dissections- two examiners, a quarter of an hour each; Anatomy-two examiners, half an hour each; Physiology-two examiners, ]

a quarter of an hour each. Fourth day: Operative Surgery- 1

two examiners, half an hour each.-Grade 2: First day :Papers. Five questions in Surgical Anatomy, and three inSurgery. Second day (oral) : Surgery-three-quarters of anhour; Morbid Anatomy, Clinical Surgery-one hour. Third day: Operative Surgery, Surgical Anatomy-half an hour.The fees for either grade will be 25 guineas for licentiatesof the College, and 40 guineas for licentiates in Surgery ofother licensing bodies. In either case 10 guineas will beretained by the College in case of rejection, and will not beallowed in the fees of the re-examination. Candidates for theFellowship may divide the examinations under Grade 1 intotwo parts-Primary and Final. The subjects of the PrimaryExamination will be Anatomy, Dissections, and Histology ;and the Final Examination will include all other subjects:required for Grade 1.

CENTENARIANS. —The death is announced of Mr.Norman Macdonald of Big Bras Dor, Cape Breton, at thereputed age of 110 years. It is stated that he was a sur-vivor from Waterloo, and that he was thirty-seven years ofage at the time of the battle. He was a man of greatactivity and endurance, and up to about two years ago wasable to work on his farm.-The widow of Mr. AldermanArmstrong, of Huntingdon, has died at the reputed age of100 years.

OSTEO-PLASTIC RESECTION OF THE FOOT.

(From a Correspondent.)

ON May 5th Sir William Mac Cormac published in THELANCET an account of a case in which he performed anoperation first prominently brought under the notice ofthe profession by biikulicz. It is an operation designedto replace Syme’s or Pirogoff’s amputation at the ankle,and consists in the removal of the ankle joint, astragalus,os calcic, and a part of the scaphoid and cuboid, while theanterior part of the foot is preserved and is brought intoline with the leg, and the patient subsequently walks uponthe hyper-extended toes and the heads of the metatarsalbones, as in the condition of marked pes equinus. The detailsof the operation and the after-result are well shown inthe diagrams illustrating Sir William Mac Cormac’s paper.The indications for the procedure are chiefly met within cases of injury to the tarsus and ankle joint,in which the anterior part of the foot is not seriouslyaffected. Sir William Mac Cormac’s patient was the sub-ject of extensive caries. And it is evident that suchcases are not so well adapted for the operation, and thaton two grounds: first, because in very many cases a lessformidable method is quite sufficient, and the entire footcan be preserved; and secondly, because in many cases ofmore extensive carions disease the anterior part of the footis either at the time affected or liable to become so.But the real question raised in connexion with this

operation is, How far, if at all, is Mikulicz’s methodsuperior to amputation at the ankle by the method ofSyme, Roux, or Pirogoff ? The answer must depend inthe main upon two considerations-the relative severity ofthe operations and the comparative results. On the firstpoint Sir William Mac Cormac’s narrative is somewhatdeficient in detail. The date of the boy’s admission tohospital (January 29th) is given, and the approximate dateof his return to the hospital to have a boot fitted (December) ;but it is difficult to gather from the published accountof the case how long the boy was in the hospital afterthe operation, or the exact time that elapsed between itsperformance and the fitting on of the appropriate boot toallow of ordinary progression. We are therefore left in un-certainty on these important points so far as this par-ticular case is concerned; but it is quite obvious that theoperation is a more severe one than simple amputation ofthe foot, and that when everything goes well convalescencemust be more prolonged. But does not the final result ofthe resection compensate for the additional difficulty, danger,and tediousness of the operation ? The advantages claimedare a broader basis of support and a certain slight amount ofelasticity in the stump. The result in Sir Wm. Mac Cormac’scase was very good, the patient being able to stand and walkfirmly and easily. So far as the comparative length of thetwo limbs goes there is no essential difference. A Syme’sstump is a little shorter than the sound limb, and afterMikulicz’s operation the foot is longer than the sound limb.Judging from Sir William Mac Cormac’s drawing of thestump in his case, there is very little advantage in thebreadth of the stump. The lower ends of the tibia and fibulaare a much better basis of support than the heads of themetatarsal bones; and even when seen from the inner (best)side, the antero-posterior diameter of the stump is very littlemore than that of the leg just above the resulting scar.This procedure cannot therefore be looked upon as an im-portant advance in the surgery of the foot, or as effectingany great improvement upon a Syme’s amputation. SirWilliam Mac Cormac has shown English surgeons that it ispossible to obtain an excellent result from it, but it is

highly probable that its application will be limited to thesmall minority of cases in which patients or their parentshave an insuperable aversion to anything known as an" amputation."In THE LANCET of July 1st, 1888, an operation very closely

resembling Mikulicz’s is recorded, having been performedthe previous year at the Royal Free Hospital. The patientrecovered with an useful foot. It was then spoken of as"the new foot-operation," and this leads one to observethat a good name for the operation is wanted. " Osteo-plastic resection of the foot" is a very bad name for it.First of all, it is not osteoplastic" ; and secondly,