68 NOTES FROM CHINA.

Three editions of Eustachius—Amsterdam, 1722; Rome, 1728 ;Leyden, 1761-were there, as also the first editions of ColumbusRealdus, Bartholin, Barthelemy Cabrol, Malpighi, Vesalius,and many others too numerous to mention. In addition tothe books was a collection of medical portraits, includingmany fine engravings, old diplomas, seals, medallions, busts,surgical instruments and appliances, &c. The entire collectionwas furnished by the members of the club, with the aid of theSt. Louis Medical Library and the Washington, St. Louis, andMissouri State universities. The association, through itsHouse of Delegates, supported the principle of the OwenBill to create a national department of public health, witha secretary having a seat in the Cabinet. Of late years therehas developed considerable opposition among members ofthe American Medical Association to an alleged dominatingI ring," which is said to control the politics of the association,and through it of the profession at large in the United States.This opposition has given rise to a great many personalities.At the present session Dr. Simmons placed his resignation assecretary before the House, which was accepted. At theelection of officers, however, he was unanimously re-elected tothe post by a rising vote, not a single delegate refraining fromvoting or voting adversely. For the presidency Dr. AbrahamJacobi of New York and Dr. J. B. Murphy of Chicago werenominated, Dr. Murphy being elected. The association adopteda, resolution in favour of the passage of State laws abolishingthe office of coroner and dividing the medical from the legalfunctions, allotting the former to a medical examiner and thelatter to the district attorney, according to the plan that hasfor some years been in successful operation in Massachusetts.Another resolution attributed the alarming increase in suicidesin part to the publication by the lay press of details thereof,,and urged legislation denying the use of the mails to news-papers that published such details. A gold medal was awardedto Dr Claude A. Smith of Atlanta, Ga., for his researches onhookworm. It was resolved to create a Section on Genito-Urinary Diseases.Other organisations that held their annual session in

St. Louis during the meeting of the American MedicalAssociation were the National Committee on OphthalmiaNeonatorum, the Academy of Medicine, the American Uro-logical Association, the American Medical Editors’ Associa-tion (at which both the retiring and the present presidents ofthe American Medical Association spoke), the NationalFederation of State Licensing and Examining Boards, theAmerican Association of Medical Examiners (before whichDr. Liston H. Montgomery of Chicago read a paper onLongevity, in which he expressed the opinion that the

average length of human life might be lengthened to 120years by careful attention to the following points : the elimi-nation of quacks and unprincipled physicians, the abolitionof poorly equipped hospitals and medical schools, the enforce-ment of the Pure Food and Drug Acts, cold storage regulation,Government inspection of all dairies and abattoirs, municipalsanitation under Government inspection, publicity and educa-tion of the public through literature especially in relationto venereal diseases, the electrification of all railways andthe abolition of the smoke nuisance, and closer inspection ofall immigrants), the American Association of Medical MilkCommissions, the Medical Library Association, the Baltimoreand Ohio Association of Railway Surgical Surgeons, theAmerican Proctologic Association, and the American Gastro-Enterological Association. The following distinguishedforeigners were present as guests of the association : Dr.

Holger Hygind of Copenhagen, Dr. Paul Fleischmann ofBerlin, Mr. J. Herbert Parsons, Dr. A. Primrose of Toronto,and Dr. Alfred Saenger of Hamburg.June 21st.

NOTES FROM CHINA.

(FROM OUR OWN CORRESPONDENT.)

C’rccniccl Sarcoma.A CHINAMAN came to hospital asking for removal of a

cranial growth (see illustration). His history was that thetumour had first appeared three years ago. When about thesize of a turkey’s egg, two years later, he had asked a foreignmedical man to remove it, but operation was refused. Onreturning to his village a native " doctor " had acupuncturedit in three places. This was done about six months ago andhad resulted in a steady acceleration of the growth. Theskin was hairless but intact; there was eggshell crackling as

of bony trabecular structure over its whole extent. The

growth itself was painless, but latterly he had headache whentired from the weight of it." " The upper right eyelidshowed pressure oedema. The tumour on palpation was not hardnor was there any pulsation ; it was of the same consistency allover, summit as well as base. As he was beyond operativehelp he left the hospital, taking with him some phenacetin andcaffein citrate powders which gave him great relief whenheadaches came on. It would be impossible to say whetherthis was a growth of the pericranium or diploe. There wereno symptoms pointing to encroachment on the intracranialcavity; he was bright mentally, and both optic fundi were

normal. There was no involvement of lymphatic glands.The case is interesting owing to the element of traumaticsarcoma introduced by the village charlatan’s needlingoperation. The increase in size was almost imperceptibletill the acupuncture, after which it " began to grow one daybigger than another," to use the patient’s words.

Health of Shanghai.The annual report of this, the largest European settlement

in the Far East, shows that the public health during 1909has been satisfactory. There has been continued immunityfrom human plague ; the reason for this immunity, saysDr. A. Stanley, the medical officer of health, is notobvious in view of the constant communication by shippingbetween Shanghai and infected ports. Vigorous sanitaryprecautions have been kept up. During the year 92,000rats were trapped and burnt, and 17,634 rats were founddead and taken to the laboratory; of these latter 187were plague-infected. People have been encouraged to

keep cats, and the building of ratproof houses (steel andconcrete) has been advocated whenever possible. A noteis made of the absence of any marked degree of opposi-tion from the Chinese, who have cooperated to a greaterextent than was expected. The incidence of small-poxhas been exceptionally small. Only one case was notifiedamong the foreign resident community. Among the Chinesethere were 19 deaths, as compared with 143 and 863during the preceding two years. Vaccination is done freefor all Chinese and indigent foreigners applying at the HealthOffice. Vaccine is also supplied free to the Chinese hospitals inShanghai. Although there has been an increase in the numberof cases of choleraic diarrhœa the diagnosis of Asiatic choleracaused by the cholera bacillus has not been confirmed bythe laboratory, where over 50 cases, foreign and native, wereexamined. These cases were therefore not held to be truecholera, though the clinical picture and post-mortem signsof both diseases are identical. Typhoid fever remains an

important factor, causing a case mortality of 18’9 per cent.Scarlet fever appears to have come to Shanghai to stay. Itwas practically unknown there prior to 1900, when it wasprobably introduced by foreign immigrants. As would be

expected with a recently introduced disease, against which

69OBITUARY.

evolution has afforded no natural immunity, scarlet feverhas been of a virulent type among the Chinese. It is

probable that the passage of the disease through the sus-ceptible Chinese has led to an intensification of the virus sothat it is more fatal to foreigners also. The prevalence oftuberculosis remains at the same high level. There havebeen no deaths registered from Malta fever. Quite a numberof cases of malarial fever, mostly of the benign tertian type,are contracted in and around Shanghai. As regards beri-beri, the incidence of this disease has increased, deaths fromit having occurred in the Municipal Gaol. Dr. Stanley, afterclose observation of the causes, thinks that the evidence sofar preponderates in favour of beri-beri being an infectivedisease having no direct relation to food, and infective

through body vermin. Recommendations regarding the admis-sion of municipal prisoners have been adopted which willsettle the latter point. Relapsing fever again made its

appearance among the prisoners ; it is evidently common inShanghai among Chinese and to some extent among foreigners.The death-rate per 1000 for the year among foreigners was16-7 and among Chinese 15-1.

Presentation to Dr. W. J. Milles, M.D. Brux., F.R. C.S. Eng.Dr. W. J. Milles, who is severing his connexion with

Shanghai and returning home after having been for 27 yearsone of the leading and most successful members of themedical faculty in Shanghai, has been made the recipient ofa very cordial leave-taking on the part of his professionalcolleagues, with whom, as with all Shanghai, he has beenvery popular. The meeting took place at the house of Dr.W. J. Jackson, and Dr. C. J. Davenport, on behalf of all his

colleagues, presented Dr. Milles with a massive Japanese bronze vase. Dr. Milles, in replying, said that when he Icame to Shanghai there were only eight medical men, whileat present they numbered 40. After some interestingreminiscences, Dr. Milles concluded by wishing all presentas felicitous a termination to a long and happy professionalcareer as he had himself enjoyed in Shanghai.Peking, May 25th.

_________________

Obituary.CLAUD MUIRHEAD, M.D. EDiN., F.R.C.P. EDIN., :

CONSULTINU PHYSICIAN TO THE ROYAL INFIRMARY, EDINBURGH, ETC.

WE regret to record the death of Dr. Claud Muirhead,one of the senior members of the medical professionin Edinburgh. He had done his usual medical visits andgone to his insurance office on Tuesday, June 21st.Next morning he was found dead in bed, lying calm andpeaceful. He had but recently attended, in his last illness,his old friend, Dr. John Smith, whose death he feltkeenly. He was in his seventy-fifth year, and by his deaththe medical profession in Edinburgh loses one of its mosteminent and esteemed members. His father was ClaudMuirhead, proprietor of the Edinburgh Advertise’r, a respectedcitizen of his day. After his school education he entered onthe study of divinity under the Edinburgh Presbytery of theChurch of Scotland, and completed one year’s study. On

applying for admission to the divinity classes at the

beginning of the second year he was unfortunate enough tofall into the hands of a parson who was known as the bearand bully of the Presbytery of Edinburgh. Muirhead wasthen, as always, a shy, retiring, reserved man, and annoyedat the rude treatment he had received at the hands of thiscleric he abandoned divinity and took to the studyof medicine in the University of Edinburgh. He

graduated M.D. in 1862. In 1864 he became a Memberof the Royal College of Physicians and in 1865 a Fellow.After graduation he studied at Berlin, Vienna, and Paris.He was house physician to Warburton Begbie in the Edin-burgh Royal Infirmary in 1864-65. Along with Dr.

(now Sir) T. R. Fraser he was in 1869 appointed assistantphysician to that institution, chiefly to take the chargeof the fever wards. In 1870 he published in the EdinburghMedical Journal an account of Relapsing Fever in Edin-burgh, which attracted considerable attention because of therarity of the disease. In 1876 he was appointed full ordinaryphysician to the Royal Infirmary. From 1867 for several

years he assisted Dr. (afterwards Sir) Douglas McLaganin his private practice. He attended his former "chief,"Warburton Begbie, in his last illness and was one

of his executors. He taught and lectured on clinicalmedicine during all the 15 years he was physician to theRoyal Infirmary, and he was specially strong on thera-

peutics. As a " chief " in the Royal Infirmary he was greatlybeloved by his resident house physicians. After leavingthat institution he was appointed physician to Chalmers

Hospital and consulting physician to the EdinburghRoyal Infirmary, to Leith Hospital, and the ChalmersHospital. For two periods of five years each hewas a manager of the Royal Infirmary and acted as

convener of the committee of medical managers, where hedid excellent work in framing the new regulations. He wasmedical officer to the Scottish Equitable Insurance Companyfor a few years, which he left to become chief medical officerof the Scottish Widows Fund, which he continued to be tillhis death. In this latter capacity he published a valuable-monograph on "The Causes of Death among the Assured,1874-1894." In the Edinburgh Medical ,Tozcrnal in 1887 hepublished a paper on the Treatment of Acute Bronchitis, andin the Edinburgh Hospital Reports a paper on the Treatmentof Enteric Fever. He was a member and an ex-President ofthe Edinburgh Royal Medical Society.

in the old innrmary days he had to deal witn several

epidemics of small-pox, typhus fever, and enteric fever,and the experience he then gained he turned to excel-lent use when later he became consulting or visiting-physician to the City Fever Hospital, after it was

separated from the Royal Infirmary but housed in theold infirmary buildings. He devoted himself entirelyto his professional duties. He appeared little at themedical societies or the social functions for which Edin-burgh has always been notable. He was too shy andretiring. Like Professor J. Wyllie and Dr. J. 0. Affleck,.he would not consent to act as President of the RoyalCollege of Physicians when he was chosen in rotation for thathonourable position. He was greatly beloved by his patients-both in the medical profession and among the general public.He was very genial and very inspiring. His encouragingvisit was often better than medicine to the patient. The

great sorrow of his life was the death of his wife and onlychild. He never married again. Latterly he and his brotherlived together in Charlotte-square. He was a member of St.

Stephen’s Church, but he did not take any prominent part in,the management of its affairs, though working much privatelyfor the poor of the congregation.

HUBERT ROTHWELL GREENE PASHA, L.R.C.S. IREL.,L.R.C.P. EDix.

Hubert Rothwell Greene, whose death, in his seventieth.year, occurred at Dunstable on June 4th, had a distinguishedmilitary and official career. He was the youngest son of thelate Samuel Greene of Kilmanahan Castle, Co. Waterford.He was educated at Trinity College, Dublin, and studied,medicine at the Royal College of Surgeons in Ireland. In1862 he obtained the L.R.C.S. Irel., and in the following-year, after taking the L.R.C.P. of Edinburgh, he entered theArmy Medical Service.

During the Afghan war of 1878-80 he acted as secretary toSir Benjamin Simpson, the Principal Medical Officer, and atits termination was commissioned with the organisation of-the medical service in the new Quetta district. In 1884 heserved in the Suakim campaign under Sir Gerald Graham,and was especially mentioned in despatches. He was alsoa member of the Nile expedition party for the relief ofKhartoum.

In 1885 he was appointed sub-director of the EgyptianSanitary Department, and in the following year he retiredfrom the army with the rank of brigade-surgeon. In 1887’he became Director of the Egyptian Sanitary Departmentand was created Pasha by His Highness the Khedive, beinggranted the Second-class Order of the Medjidieh. Sanitaryreform in Egypt at the time of Greene’s administration wascrippled by want of money, by the capitulations under whichall foreigners were amenable to their own consuls, and by the-bondholders. The task which he had before him was there-fore no easy one, but he performed it with conscientiouszeal and ability, as may be judged from the excerpt whichfollows from a letter written to Greene in 1890 by the late-Sir Gerald Portal, then officiating Agent and Consul-Generalfor Egypt :-In forwarding to the Foreign Office the Statistical Reports of the

Sanitary Department. I have given myself the pleasure of explaining atsome length the very great progress made during late years by this