142 to swear him as an expert. 2. If the Court refuse to do so, and if the physician be nevertheless compelled to _ive his opinion as an expert, he shall complain to the com- petent authority. 3. If a physician be called upon to give his opinion as an expert on the basis of statements which the physician who treated the case in question has made as .an expert witness, he must conscientiously ask himself whether he is able to give a pertinent opinion on the basis of these statements ; and if his conscience tell him that he cannot, he must make the giving of his opinion dependent "on co-operation with the physician who treated the case, and who must be called as an expert witness. 4. The supreme legal authorities shall be requested urgently to recommend the courts always, even when one of the parties objects, to appoint the physician who has treated the case, as, if not the sole expert, yet one of the experts in conjunction wit h other physicians in cases in which the said physician has been examined as an expert witness, and an expert medical opinion is to be heard on the basis of his statements." The Congress further resolved to express its opinion that ’drunkenness should be recognised as a reason for placing a person under trustees; also that the obligatory period of medical study, including the term of military service, should be fixed at not less than five years. The Typhus Epidemic in Berlin in 1889. At the last sitting of the Medical Society, Professor Fiirbringer, of the City Hospital in Friedrichshain, reported on’the typhus epidemic which raged in Berlin at the beginning of this year. The epidemic, lie said, was the first we had had in Berlin for fourteen years. It began in the third week of January, and lasted seventy-five days; 15 typhus patients were taken to Friedrichshain in the second half of January, 90 in February, and 50 in March. During these seventy-five days four-fifths as many typhus patients were taken to the hospital as are usually received during a whole year. Of the 155 patients, 67 were men, 75 women, and 13 children under twelve. Sixteen died--i.e., 10’3 per cent., a much -smaller percentage than that of the former epidemics, which was over 17. Of the men 12, of the women 8, and of the .children 15 ’5 per cent. died. The greater mortality among the men than among the women was attributed to the greater prevalence of excessive drinking in the former class. In accordance with former experience, the typhus patients were not strictly isolated, a course which the lecturer de- clared to be without danger, provided that the removal of the "excrements was strictly enforced. None of the other patients were infected, but four sisters of mercy and one attendant were, all of whom recovered. Forty-two of the convalescents were sent to the convalescent hospitals at Heimersdorf and M31ankenburg, with excellent effect in all cases. A New Hospital in Berlin. The trustees of the Paul Gerhardt Fund opened a new ,hospital in the North of Berlin on July lst. One of its purposes is the training of sisters of mercy to assist the labouring population in tending their sick. More than 100 sisters are now supported by the fund. The medical superin- tendent of the new hospital is Dr. Schlange, who has been assistant to Professor von Bergmann for several years. Statistics of Cremation. A paper bearing the significant name of " Flamme " 4FIame) gives the following statistics. At the end of last month there existed 39 crematoria: 23 in Italy, 10 in America, 1 in Germany, 1 in England, 1 in France, 1 in Switzerland, 1 in Denmark, and 1 in Sweden. Two corpses were burned in Italy in 1876, 15 in 1877, 16 in 1878, and 226 in 1888. Since 1876, 1177 corpses have been burned in Italy, and 1269 in the other countries. The number burned last month was 55. The Consumption Hospital at Falkenstein. The Empress Frederick visited the Hospital for Diseases of the Lungs at Falkenstein, in the Taunus Mountains, on the 5th inst. Dr. Dettweiler accompanied Her Majesty through all the important rooms and through the grounds, where the patients reclined in their easy chairs. The Empress addressed kind words to several of the patients. Honours to German Scientists. The Medical and Surgical Academy of Perugia has appointed Du Bois-Reymond, P. Guttmann, R. Koch, Leyden, Senator, and ’Virchow honorary members, and von Bergmann, Ewald, Gerhardt, Martin, Mendel, and Salkowski corresponding members. Dr. Bernhard Fischer. Dr. Bernhard Fischer, who was lately appointed director of the Office for the Examination of Articles of Nourishment in Breslau, was for five years assistant to Professor Liebreich in the Pharmacological Institute of Berlin University. His special task there was the instruction of apothecaries in chemistry. He has made a special study of organic pigments, and has published a handbook of chemistry for apothecaries, and a list of the more recently introduced medicines, which is much used by physicians and apothecaries. Dr. Weber-Liel. Dr. Weber-Liel, formerly Professor of Auricular Thera- peutics at Jena, who was compelled by illness to give up his professorship and his practice four years ago, isnowrecovered, and has resumed practice at Bonn. Before being called to Jena, lie practised for many years as an aurist in Berlin. He is the originator of the operation of cutting the sinew of the tensor tympani. A dva7iced Medical Instruction in Jena. For years past the professors and private lecturers of the medical faculty in the University of Jena have delivered courses of lectures every summer to practitioners on medical subjects, especially the more recent discoveries and methods. These courses will begin this year on July 22nd and last till Aug. 3rd. They will probably be largely attended. Professor von Nageli has resigned his Professorship of the University of Munich. He has held it for thirty-two years, and the great majority of the younger German botanists were pupils of his. Under-Secretary Lydow, President of the Scientific Depu- tation for Medical Affairs in Prussia, will resign on Oct. 1st. Sandstone statues of the geologist Leopold von Buch and the physiologist Johannes Miller have been erected above the portal of the new Museum for Natural Science in the Invaliden Strasse in Berlin. In and near the village of Cotta, near Dresden, it is stated that about 120 persons fell seriously ill some weeks ago after eating beef taken from a diseased cow. Several of them died after great suffering. Berlin, July 8th. Obituary. CHARLES ELAM, M.D., F.R.C.P. IN May, 1824, Charles Elam was born at Birstall, near Leeds. His father was a Wesleyan minister, who coupled with his clerical duties those of a schoolmaster. Amongst his pupils was his son Charles, who soon showed evidence that his abilities were of a high order. Young Elam’s medical education was conducted at the Leeds School of Medicine, where he and the late Dr. Radcliffe, whose death we noticed in a recent number of THE LANCET, shared rooms together and became close friends. This friendship remained close and true until it was ended by the death of Dr. Radcliffe. Young Elam was a distinguished student, and he crowned that period of his career with the remark- able results of the brilliant examination for honours which he passed when lie took the M. B. degree of the University of London in 1846. He entered for honours in Physiology and Comparative Anatomy, in Surgery, in Medicine, and in Midwifery. In the last-named subject his is the only name mentioned in the honours list. In all the other subjects Elam came out first, securing the scholarship and gold medal in Physiology and Comparative Anatomy, and in Surgery, and the gold medal in Medicine. The only subject in which Elam did not enter for honours at his University was Structural and Physiological Botany. He used to say that he "could not learn botany." So great was the difficulty he experienced in "getting up " botany that he used to write out what he thought sufficient of the subject for examination purposes, and commit what he had written to memory. It is obvious that Dr. Elam was a man who, as a student, was possessed of exceptional powers of a high order for mastering the study of any subject in the medical curriculum of his day. That is a fact which makes very curious the statement concerning his inability to study botany in the same way in which he worked at other sub-
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to swear him as an expert. 2. If the Court refuse todo so, and if the physician be nevertheless compelled to_ive his opinion as an expert, he shall complain to the com-petent authority. 3. If a physician be called upon to givehis opinion as an expert on the basis of statements whichthe physician who treated the case in question has made as.an expert witness, he must conscientiously ask himselfwhether he is able to give a pertinent opinion on the basisof these statements ; and if his conscience tell him that hecannot, he must make the giving of his opinion dependent"on co-operation with the physician who treated the case,and who must be called as an expert witness. 4. Thesupreme legal authorities shall be requested urgently torecommend the courts always, even when one of the partiesobjects, to appoint the physician who has treated the case,as, if not the sole expert, yet one of the experts in conjunctionwit h other physicians in cases in which the said physicianhas been examined as an expert witness, and an expertmedical opinion is to be heard on the basis of his statements."The Congress further resolved to express its opinion that’drunkenness should be recognised as a reason for placing aperson under trustees; also that the obligatory period ofmedical study, including the term of military service, shouldbe fixed at not less than five years.
The Typhus Epidemic in Berlin in 1889.At the last sitting of the Medical Society, Professor
Fiirbringer, of the City Hospital in Friedrichshain, reportedon’the typhus epidemic which raged in Berlin at the beginningof this year. The epidemic, lie said, was the first we had hadin Berlin for fourteen years. It began in the third week ofJanuary, and lasted seventy-five days; 15 typhus patientswere taken to Friedrichshain in the second half of January,90 in February, and 50 in March. During these seventy-fivedays four-fifths as many typhus patients were taken tothe hospital as are usually received during a whole year.Of the 155 patients, 67 were men, 75 women, and 13 childrenunder twelve. Sixteen died--i.e., 10’3 per cent., a much-smaller percentage than that of the former epidemics, whichwas over 17. Of the men 12, of the women 8, and of the.children 15 ’5 per cent. died. The greater mortality amongthe men than among the women was attributed to thegreater prevalence of excessive drinking in the former class.In accordance with former experience, the typhus patientswere not strictly isolated, a course which the lecturer de-clared to be without danger, provided that the removal of the"excrements was strictly enforced. None of the other patientswere infected, but four sisters of mercy and one attendantwere, all of whom recovered. Forty-two of the convalescentswere sent to the convalescent hospitals at Heimersdorf andM31ankenburg, with excellent effect in all cases.
A New Hospital in Berlin.The trustees of the Paul Gerhardt Fund opened a new
,hospital in the North of Berlin on July lst. One of itspurposes is the training of sisters of mercy to assist thelabouring population in tending their sick. More than 100sisters are now supported by the fund. The medical superin-tendent of the new hospital is Dr. Schlange, who has beenassistant to Professor von Bergmann for several years.
Statistics of Cremation.A paper bearing the significant name of " Flamme "
4FIame) gives the following statistics. At the end of lastmonth there existed 39 crematoria: 23 in Italy, 10 inAmerica, 1 in Germany, 1 in England, 1 in France, 1 inSwitzerland, 1 in Denmark, and 1 in Sweden. Two corpseswere burned in Italy in 1876, 15 in 1877, 16 in 1878, and 226in 1888. Since 1876, 1177 corpses have been burned in Italy,and 1269 in the other countries. The number burned lastmonth was 55.
The Consumption Hospital at Falkenstein.The Empress Frederick visited the Hospital for Diseases
of the Lungs at Falkenstein, in the Taunus Mountains, onthe 5th inst. Dr. Dettweiler accompanied Her Majestythrough all the important rooms and through the grounds,where the patients reclined in their easy chairs. TheEmpress addressed kind words to several of the patients.
Honours to German Scientists.The Medical and Surgical Academy of Perugia has
appointed Du Bois-Reymond, P. Guttmann, R. Koch,Leyden, Senator, and ’Virchow honorary members, andvon Bergmann, Ewald, Gerhardt, Martin, Mendel, andSalkowski corresponding members.
Dr. Bernhard Fischer.Dr. Bernhard Fischer, who was lately appointed director
of the Office for the Examination of Articles of Nourishmentin Breslau, was for five years assistant to Professor Liebreichin the Pharmacological Institute of Berlin University. His
special task there was the instruction of apothecaries inchemistry. He has made a special study of organic pigments,and has published a handbook of chemistry for apothecaries,and a list of the more recently introduced medicines, whichis much used by physicians and apothecaries.
Dr. Weber-Liel.Dr. Weber-Liel, formerly Professor of Auricular Thera-
peutics at Jena, who was compelled by illness to give up hisprofessorship and his practice four years ago, isnowrecovered,and has resumed practice at Bonn. Before being called toJena, lie practised for many years as an aurist in Berlin.He is the originator of the operation of cutting the sinew ofthe tensor tympani.
A dva7iced Medical Instruction in Jena.For years past the professors and private lecturers of the
medical faculty in the University of Jena have deliveredcourses of lectures every summer to practitioners on medicalsubjects, especially the more recent discoveries and methods.These courses will begin this year on July 22nd and last tillAug. 3rd. They will probably be largely attended.
Professor von Nageli has resigned his Professorship of theUniversity of Munich. He has held it for thirty-two years,and the great majority of the younger German botanistswere pupils of his.
Under-Secretary Lydow, President of the Scientific Depu-tation for Medical Affairs in Prussia, will resign on Oct. 1st.Sandstone statues of the geologist Leopold von Buch and
the physiologist Johannes Miller have been erected abovethe portal of the new Museum for Natural Science in theInvaliden Strasse in Berlin.
In and near the village of Cotta, near Dresden, it isstated that about 120 persons fell seriously ill some
weeks ago after eating beef taken from a diseased cow.Several of them died after great suffering.Berlin, July 8th.
Obituary.CHARLES ELAM, M.D., F.R.C.P.
IN May, 1824, Charles Elam was born at Birstall, nearLeeds. His father was a Wesleyan minister, who coupledwith his clerical duties those of a schoolmaster. Amongsthis pupils was his son Charles, who soon showed evidencethat his abilities were of a high order. Young Elam’smedical education was conducted at the Leeds School of
Medicine, where he and the late Dr. Radcliffe, whose deathwe noticed in a recent number of THE LANCET, sharedrooms together and became close friends. This friendshipremained close and true until it was ended by the death ofDr. Radcliffe. Young Elam was a distinguished student,and he crowned that period of his career with the remark-able results of the brilliant examination for honours whichhe passed when lie took the M. B. degree of the Universityof London in 1846. He entered for honours in Physiologyand Comparative Anatomy, in Surgery, in Medicine, and inMidwifery. In the last-named subject his is the only namementioned in the honours list. In all the other subjectsElam came out first, securing the scholarship and gold medalin Physiology and Comparative Anatomy, and in Surgery,and the gold medal in Medicine. The only subject in whichElam did not enter for honours at his University wasStructural and Physiological Botany. He used to say thathe "could not learn botany." So great was the difficultyhe experienced in "getting up " botany that he used towrite out what he thought sufficient of the subject forexamination purposes, and commit what he had written tomemory. It is obvious that Dr. Elam was a man who,as a student, was possessed of exceptional powers of a highorder for mastering the study of any subject in the medicalcurriculum of his day. That is a fact which makes verycurious the statement concerning his inability to studybotany in the same way in which he worked at other sub-
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jects. About the accuracy of that statement there can,however, be no doubt, for we have it upon authority whichis perfectly reliable.
After his brilliant success at the University of London,Dr. Elam returned to Leeds, and received the appoint-ment of house surgeon to the infirmary there. In1848 he went to Sheffield, where, for twenty years, he
practised his profession. That his abilities were clearlyrecognised in Sheffield is shown by the fact that hewas appointed lecturer on Medicine and Physiologyat the School of Medicine there, and also, in 1856,physician to the Sheffield Infirmary. He had previously-1854-been appointed one of the physicians to the SheffieldDispensary, but he resigned that oflice when he becamephysician to the infirmary. In 1868 Dr. Elam leftSheffield and came to London. For many years it hadbeen his desire to practise as a consultant in the metro-polis, in order that he might have the leisure withoutwhich he felt he could not, with justice to himself, prosecutesuccessfully his studies, and certain literary work on theaccomplishment of which his heart was set. When he leftSheffield he was in large practice. To Dr. Elam’s greatannoyance, it was said that he had come to London becausehe wished to retire from professional work, so far as see-ing patients goes. That was never his wish. He felt that hecould not both see large numbers of patients, as he had todo in Sheffield, and carry on the studies and the work towhich allusion has already been made. With those viewsand desires he came to London, and he always felt that therumour that he wished to retire from practice materially in-jured his chance of success in consulting work in the metro-polis. While in practice in Sheffield Dr. Elam had enjoyedhigh repute as a physician greatly skilled in the managementof diseases of the nervous system and of the kidneys. Thisreputation, together with his brilliant record as a student,gained him the post of physician to out-patients at theNational Hospital for the Paralysed and Epileptic in Queen’s-square. That appointment he held for only two or threeyears, when he retired altogether from hospital practice,retaining only his honorary physiciancy to the SheffieldInfirmary.
Dr. Elam’s pen was a busy one. He published eleven of hiswritings in book form, besides contributing largely to severaldaily, weekly, and monthly periodicals. His most note-worthy books are-" A Physician’s Problems"; "On Cerebriaand other Diseases of the Brain"; " Winds of Doctrine, orAutomatism and Evolution "; and " The Gospel of Evolu-tion." " To the Journal of Psychological Medicine he contributedessays on Epilepsy, Monomania, and Puerperal Insanity.Dr. Elam took up a position of antagonism to the theorieswhich touch the question of evolution as they were putforth by Darwin and the men who thought with him. The
keynote of Dr. Elam’s view, in that connexion may be fairlywell indicated by one of his own statements. It is this:" There can be no position which is true in exact scienceandfalse in ethics. If man be merely an automaton, andpart of an inevitable series of cosmical causes and effects,then religion, virtue, and responsibility are only unmeaningand foolish forms of words ; legislation and education onlyabsurd and mischievous forms of muscular activity. Untiltrue science has said its last word on the subject, we refuseto accept so grotesque a conclusion." Professor Huxley, thelate Professor Clifford, and Mr. Herbert Spencer, amongstothers, attacked Dr. Elam’s views. It need hardly berecorded here that the controversy ended, as most con-
troversies do end, by everyone concerned in it being, ifpossible, more convinced than ever of the truth of hisown views, and of the blindness to obvious truths of hisopponents.
Dr. Elam obviously wrote, as a rule, for general readers,rather than for professional or scientific circles only; and itis plainly evident that many of his opinions were acceptableto a large number of general readers, and that his criticismsof the questions of the day which he examined were in con-sonance with popular rather than with scientific opinion.His cast of mind may be to some extent appreciated onreading the following anecdote of him, which we know tobe true. One night, while walking with a friend, a well-known physician, he suddenly stopped in the light of alamp-post, and made a pencil note upon a piece of paperwhich he took from his pocket. Rejoining his friend, heremarked, " No doubt you wonder why I should have
stopped in our walk and talk to write a few words on a bitof paper. Well, an idea struck me suddenly for the first
time, and I noted it down lest I should forget it. I lookupon an idea coming like that just as you look upon theresult of an experiment worked out in the laboratory." Itis very diflicult for men who do not accept Dr. Elam’s esti-mate of the worth of a laboratory experiment, as it is hereexpressed, to look at ideas and things as he looked at them,and to judge fairly and dispassionately of men like him,and of their methods of searching after truth.In his " Cerebria and other Diseases of the Brain,"’
Dr. Elam advocates the recognition of "a spontaneous,acute, general inflammation of the substance of the brain,uncomplicated with meningitis." This condition he calls"cerebria." Those who wish to study the reasons whichhe brings forward in support of the acceptance of his,views, in connexion with this subject, should read the bookitself. It is sufficient for our present purpose to statethat more recent research in the field of diseases of thebrain do not, so far as we know, support Dr. Elam’s views.He, however, quotes several cases which occurred in hisown experience, and which he submitted to post-mortemexamination, with the result of establishing, to his owissatisfaction, the not infrequent occurrence of "cerebria" ashe defines it in the words we have quoted above.
It is not the purpose of a notice of this kind to give any-thing like a full review of the literary work of the manwhose life it sketches in very incomplete outline. Enoughhas, we think, already been given to enable the reader toform some notion of what manner of man Dr. Elam was,in so far as his life is of interest to his professionalbrethren in general. In its social aspect, his nature wasmarkedly genial, when he found himself in the society ofthose he knew well. He was fond of conversation, of music,of chess, and of whist; and he was, we believe, a true andconstant friend. When he removed to London, he left inthe north many warm friends who have given testimony tothe kindly interest which they always felt in him and inhis fortunes. In Sheffield his attainments were fully appre-ciated, and he was for some time the President of theLiterary and Philosophical Society there. It should havebeen mentioned that Dr. Elam took the Membership of theCollege of Physicians of London in 1860, and that in 1870 hewas elected to the Fellowship of that College.
Last November Dr. Elam had an attack of gout. InFebruary phlebitis, of the so-called gouty character, beganto show itself in the veins of the legs and thighs, andafterwards in the arms and neck. This was accom-
panied with much local swelling and pain. Seven weeks.ago right hemiplegia came on, and from that time pain!ceased to be a troublesome feature of the case. The plug-ging of veins was distinctly periodic in character, comingon regularly once a fortnight. So marked and regular wasthe recurrence of symptoms due to vein-plugging that itwas expected to happen at those regular intervals both byDr. Elam and by his medical attendants. He died at hi&residence in Harley-street on July 9th.
Medical News.ROYAL UNIVERSITY OF IRELAND.-The following
candidates have passed the First Examination in Medicineof this University :-Upper Pass Division.—Thos. J. Connolly, Mina Dobtie, Willes Donnan,Hugh Fisher, Alexander Jameson, John Johnson, Alex. McMustry,Robert Parkhill, William Roundtree, John Cowan, Wm. J. Woods.
Passed.-J. Ahern, M. Aicken, M. Atkins, E. Bell, C. Blue, J. Clements"J. Colville, J. Dick, V. Fielden, T. Fitzpatrick, J. Flynn, A. Fulton,T. McKendry, J. McMullen, J. Mathewson, W. Norcott, A. Peel,,H. Reid, J. Reid, L. Rowan, W. Scott, J. Shine, A. Stewart.
PHARMACEUTICAL SOCIETY OF IRELAND.—Thefollowing gentlemen have obtained the licence of the Society: o-
was destroyed by fire on the afternoon of the 12th inst. The-building was a wooden structure and the property of the-Grantham corporation.MEDICAL MAGISTRATE.-The Lord Chancellor has
placed the name of J. E. Brooks, M.R.C.S., L.R.C.P., onthe Commission of the Peace for Ludlow, Shropshire. Mr.Brooks was mayor of the borough for the two years 1885and 1886.
