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with no fewer than 15,000 cases and 700 in hospital. AtGenoa the municipality has had to order the closing of allprimary and secondary schools. Parma has 14,000 cases inthe city alone and the hospital can admit no fresh ones.At Ferrara there are over 7000 cases, without including thoseof the suburbs or in the provinces, and there again thehospital has no room for more. At Pontedera (Tuscany)not a family has escaped and, as at Parma and Ferrara, theschools are closed from the illness of teachers and pupilsalike. At Piacenza and Bologna the disease is becomingmore extended as well as intensifying in character ; at Turinit is taking a similar turn, and from 20 cases terminatingfatally the proportion has risen to 40, and is still rising.All the public offices are " short of bands" from the illnessof their jfe7’.M?M!,’ not a house indeed is without one or moreof its inmates in bed, and the schools are well-nigh emptythough they are not yet officially closed. Besides Pontederaother centres of population in Tuscany are severely visited-Ponsacco, near Pontedera, for instance, having 700 cases,and Prato numbering so many on the sick list that thescholastic institutions have had to send away teachers andstudents alike on leave of absence. At Florence the diseasehas effected a distinct foothold, though up to last night itscharacter was mainly of the "benignant "form. Even in

Ithe absence of the generally fatal pulmonary com-

plications, however, the neurotic note" which it had"struck" " at its outset is still present - chiefly inthe prostration which attends the general malaise and whichfalls heaviest on the very old or the very infirm. All thisaggravation in the diffusion and intensity of the malady iscoincident with a longer continuance of wintry weather thanItaly has experienced for well-nigh a generation-the snowon the uplands lying deeper than it has been known to dofor thirty years and adding a deadlier chill to the prevailingtramontana.

La nlla Igiea, Palermo.Such is the name given to the sanatorium recently opened

near Palermo for the Cervello treatment of tuberculosis anddesigned as one of the chief attractions to the " GoldenShell" now asserting its claims as a winter-city and specialhealth-resort. THE LANCET of Jan. 13th, pp. 126-127,gave a brief account of the movement started in thissense by leading Palermitans, such as the Com-mendatore Florio and Baron Fassini, and it also referredto the deputation of British medical men who, as theguests of these gentlemen, had gone thither to inspect thesanatorium, its internal equipment and surroundingamenities, with a view to make their impressions knownto the English-speaking world. For four days the membersof the deputation resided at Palermo, mostly at thesanatorium itself, familiarising themselves with the vwduseperandi of the Cervello treatment at the GuadagnaHospital and also at the sanatorium, informing themselvesas to the inception of the latter and, more particularly, as toits appointments, its special therapeutics, and its advantagesas to site and climate. The building, on one of the beautifulslopes of the suburban village of Acquasanta, was begunseven months ago and, thanks to the energy with which the700:workmen were employed, it is now all but complete-risingin a noble park and approached by a fine carriage-drive,from which excursions of the most varied, picturesque, andexhilarating kind can be made in directions not a few.Internally the sanatorium, or I should say the Villa Igiea,is equal in accommodation to the largest hotels of con-tinental capitals and its appointments might be calledluxurious were they not so rigorously hygienic in everydetail, assuring, among other advantages, an antisepsis ofthe most perfect description. Every facility was affordedby the medical staff to their British colleagues for estimatingthe resources of the institution and forming a judgment asto the treatment therein pursued, and the attestation,volunteered by the deputation collectively and signed by itsmembers individually, has, I understand, given much satis-faction to the Palermitan public, professional and lay: "We,"the attestation ran,

.. after a three-days residence in theVilla Igiea have formed the opinion that the sanatorium isadmirably well adapted for the cure of tuberculosis and otherdiseases of the lungs. It would be difflult to imagine as tocilmate and exposure a spot better calculated to attain thisend, more especially in the practice of the open-air cure,’now recognised universally as of fundamental importance inthe treatment of tuberculosis."Jan. 23rd.

NEW YORK.

(FROM OUR OWN CORRESPONDENT.)

-Decision in Kentucky 1vith regard to " Osteopathy."A DECISION has recently been rendered in a circuit court t

in Kentucky which appears to be the most far-reaching ofany yet secured so far as the legal status of "osteopaths"

"

in that State is concerned. An action was brought by aprofessor of the American School of Osteopathy at Kirks-ville, Missouri, against the State Board of Health ofKentucky to enjoin it from prosecuting him for practisinghis system in that State. By a section of the Kentuckystatutes it is provided as follows: "Authority to practisemedicine under this law shall be a certificate from the StateBoard of Health, and the said Board shall, upon application,issue a certificate to any reputable physician who is prac-tising, or who desires to begin the practice of, medicine inthis State who possesses any of the following qualifica-tions : 1. A diploma from a reputable medical collegelegally chartered under the laws of this State. 2. A diplomafrom a reputable and legally chartered medical college ofsome other State or county, endorsed as such by theState Board of Health. 3. Satisfactory evidence fromthe person claiming the same that such person was reputablyand, honourably engaged in the practice of medicine in thisState prior to Feb. 23rd, 1864. 4. Satisfactory evidence fromany person who was reputably and honourably engaged inthe practice of medicine in this State prior to Feb. 23rd,1884, who has passed a satisfactory practical examinationbefore said board." By another section of the statutes it isenacted that there shall be no discrimination against anyinstitution. school. or svstem of ’medicine. The fact wasadmitted that the plaintiff held a diploma from theAmerican School of Osteopathy at Kirksville, Missouri, andthat the said school or college was legally chartered underthe laws of that State. Therefore the question to be decidedwas whether the American School of Osteopathy at Kirks-ville, Missouri, could lay claim to the title of a

"reputable" medical college. In order to determinethis point fairly the Kentucky State Board of Healthsent a committee of three of its most prominentphysicians to investigate fully the Missouri College ofOsteopathy. These medical men, after examining into its

equipment, apparatus, and facilities for teaching ; in fact,after making a full and complete and exhaustive investi-gation, unanimously came to the conclusion that theKirksville School of Osteopathy was not a reputable medicalcollege. In the cross-examination of the witnesses for theprosecution, including several of the professors, the truenature of the said college was thoroughly revealed, and it wasclearly shown that its claim to being a reputable school ofmedicine could not be upheld. Among the witnesses for thedefence were many of the foremost physicians of Kentucky,one of these being Dr. J. Matthews of Louisville, president ofthe American Medical Association. Dr. Matthews testifiedthat he understood the theory and practice of osteopathy andthat osteopathy was not a system for curing diseases, butone which was to be feared for dangerous results which wouldnaturally be caused thereby. He further remarked that the

osteopathy! treatment as a system was very foolish andwould be more likely to kill patients receiving it than tobenefit them. The committee as a whole handed in a

report on the Kirksville College of which the followingis an abstract: "We found a building and appoint-ments adapted to the teaching of anatomy, physiology,normal histology, and chemistry. We found bones anddiagrams, but no dissecting-room or physiological laboratory,and were informed that the students were not accorded the

privilege of dissecting the human body with the necessaryaccruing benefits of such work....... The histological andchemical laboratories were well equipped with chemicals,microscopes, and other apparatus. All this relates to thestudy of the healthy man, there being no pathological labora-tory, pathological specimens, bacterial cultures, charts, ordiagrams available for teaching pathology and morbidanatomy....... Materia medica, which embraces the know-ledge of drugs and medicines, and therapeutics, whichis their application to the cure of disease, are repudiatedby this school, its teaching claiming that in the treatmentof disease the physician has no use for drugs and mediciLes,

since the brain of every human being is a drug-store ready

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to his hand....... Without a dissecting-room, withoutthe privileges of seeing and handling the muscles, vessels,nerves, glands, and viscera of the body the committee cannotunderstand how the graduates of this school can have apractical knowledge of anatomy....... The Hon. SterlingB. Tovey, the judge of the court, after an eloquentsumming up gave judgment for the defendants, theState Board of Health of Kentucky, declaring in thecourse of his speech that it is the policy of Kentucky toexclude charlatanry, and empiricism, and quackery from theState. There are unfortunately several States in Americawhich not only legalise but encourage osteopathy, to thedetriment alike of the general public and of the medicalprofession. It will be remembered that Kentucky has evertaken a firm stand against the practice of osteopathy withinher boundaries, and reference has already been made inTHE LANCET to a decision of a Kentucky judge who, whena member of the ostdopathic brotherhood charged with con-travening the Kentucky Act in regard to the practice ofmedicine excused himself by asserting that he was merelymanipulating with his hands, ruled that" any person whofor compensation professes to apply any science whichrelates to the prevention, cure, or alleviation of the diseasesof the human body, is practising medicine within the mean-ing of the statute." These decisions and the evidence ofprominent medical men should open the eyes of thecommunity at large to the uselessness of the treatmentprovided by professors of osteopathy.Reforms in the Medical Department of the United States

-1 11" -

The American-Spanish war revealed many defects in theconstitution of the medical department of the United States.In the first instance it was demonstrated that the number ofarmy medical officers was inadequate to the needs of theregular army alone. The army at the outbreak of the warnumbered 25,000 men and the medical corps consisted of192 commissioned surgeons. The army was immensely in-creased by volunteers and the dearth of medical men hadto be supplied by physicians taken from civil life. At the

present time there are over 400 civilian surgeons doing dutywith the American army. Until the Philippine campaign isbrought to an end the Government will not decide as to thestrength of the standing army of the United States, but therecan be no doubt that it will be very considerably increased.This, however, is not the extent of the difficulty which facesthe United States authorities. In order to meet any seriousemergency which may arise the standing army will not alonebe depended upon and the same policy will be pursued aswas pursued in the war with Spain-that is, volunteer forceswill be called out. The fact that an army surgeon requiresspecial training to be able to fulfil his duties in an efficientmanner is too palpable to need emphasis. Not only has heto act as physician and surgeon, but at the same time thesanitation and hygiene of camps falls within hissphere of work. Thus a medical man taken fromcivil life is suddenly thrust into a position for whichhe has had no training whatever except in so faras his knowledge of surgery is concerned. The evilresults of following such a course were fully shownin the war with Spain. The Surgeon - General ofthe United States Army is about to present at thepresent session of Congress three Bills with a view ofremedying the existing defective system. The first providesfor an increase in the medical department of the army, thesecond secures regulations in regard to the efficiency of thedepartment, and the third is for the raising of actingassistant surgeons to the rank of captain in thevolunteer service. An increase in the medical departmentof the army is needed at once, for, as the Ne?v YorkMedical Record points out, 11 13 new posts have beenestablished upon the sea-coast in the Department of theEast and 10 have been established in the Departmentof the Columbia, including Alaska. There are now 11independent garrisons in Porto Rico and a large numberof independent commands in Cuba and the Philippines.These independent garrisons and commands require medicalofficers of experience and ability, and in addition all thehigher executive offices of the medical department have tobe filled with men of a rank commensurate with the positionswhich they occupy. It is absolutely impossible to do thiswith the present number of medical of[--’,cers, hence the

1 THE LANCET, Sept. 4th, 1897 (p. 607), and March 19th, 1898 (p. 804).

request of the surgeon-general for legislation as to anincrease of the corps."

Cigarettes in the United States.The analytical report of THE LANCET Sanitary Com-

mission on American Cigarettes has aroused a considerableamount of interest in the United States. The ‘‘ yellow" "

journals of the country have for a long time done theirutmost to prejudice the minds of the general public againstthe cigarette. They have credited it with causing nearlyevery ill which human flesh is heir to. According to theaccounts of some of the most sensational of these papersthe cigarette is responsible for much insanity and is pro-ductive of crimes of all sorts and kinds from murderdownwards. Of course many, or rather the majority, ofthese blood-curdling descriptions exist only in the imagina-tion of the writers or are exaggerated and garbled outof all similitude of truth merely to pander to thelove of the uncanny which has been cultivated in the mindsof American readers of a certain class by the circulation ofthese vividly exciting journals. However, they have servedtheir purpose and cigarette-smoking is regarded in theUnited States with the greatest distrust, and the cigaretteitself is believed by the ordinary individual to be composedof the most pernicious, indeed poisonous, materials. Thematter was taken up in New York some little time ago andvarious brands of cigarettes were tested analytically withthe result that no injurious substances were found eitherin the tobacco or the paper. The finding of THE LANCETAnalytical Sanitary Commission will doubtless go fartowards rehabilitating the cigarette-that is to say, so faras its composition is concerned.Jan. 13th.

_________

Obituary.HENRY HANNOTTE VERNON, MD., F.R.S. EDIN.,

M.R.C.S. ENG., L.M., J.P.,MEDICAL OFFICER OF HEALTH OF SOUTHPORT.

DR. HENRY HANNOTTE VEBNON, medical officer of healthof Southport, died on Jan. 16th after a short illness, at hisresidence, Shipbrook, Cambridge-road, Southport. He had

not been of robust health for a few months, but no anxietyas to his life was felt. He was nearly 68 years of ageand was able to discharge his duties as medical officer ofhealth up to a few days previously to the fatal termination,one of his last acts being to attend a committee meeting inthat connexion.

Dr. Vernon was a well-known, popular, and enthusiasticmedical officer of health, and was appointed to his post inSouthport in 1873, devoting the whole of his time to theduties in 1888. He was born on March 25th, 1831, at Chatburn,near Clitheroe, and was the son of a Church of Englandclergyman-the Rev. William Vernon. After his schooleducation he proceeded to Edinburgh to undergo his medicaleducation, and in 1853 he took the M.D. degree. He

always had the greatest affection for his alma mater.He became i4LR.C.S. Eng. in 1854, and was a Fellowof the Statistical Society and of the Royal Society ofEdinburgh and of the Incorporated Society of MedicalOfficers of Health. He had also been President of theLancashire and Cheshire Branch of the British MedicalAssociation and of the North-Western Branch of theIncorporated Society of Medical Officers of Health, andwas a member of other learned societies. At the com-mencement of his career he practised in London andheld appointments at St. Mary’s Hospital, the GreatNorthern Hospital, and the Bloomsbury Dispensary. Later,however, he removed to Ashton-under-Lyne, where hehad a successful career and became a member of thetown council and a Justice of the Peace. In 1868he’ went to reside in Southport, and after the passingof the Public Health Act of 1872 he was appointedmedical officer of health, a position which he has

worthily and successfully filled. During the whole ofhis official life he was on the best terms with the otherofficials, the members of the Health Committee, and of thecorporation generally. He was a great advocate of the causeof education and was concerned in the establishment of theSouthport Proprietary Schools, and as chairman of the