1843

Proposed by Mr. S. B. Coates (Belfast) and seconded by Mr. iJ. W. Olpherts (Downpatrick) :—

That all medical officers in the Poor-law service be entitled to four 1weeks’ annual vacation and that the payment of the locum-tenents beas provided for by Section 5 in the Local Government Amendment Act, i

1902.

Proposed by Dr. T. Donnelly (Dublin) and seconded by Mr.Olpherts :-That the minimum fees for discharge of temporary duty be: Dis-

pensaries, 24 4s. per week; workhouse, 23 3s. both combined, E5 5s.per week; periods less than a week, 21 Is. per day.Proposed by Dr. H. T. A. Warnock (Donegal) and secondedby Mr. Olpherts :-That it be an instruction to the Council to take the necessary steps

to have such alteration of the law as will enable the Treasury to payone-half of the amount of any increase of salary granted by boards ofguardians and sanctioned by the Local Government Board.

A vote of thanks was passed to the President. Luncheonwas served in the Assembly Rooms and Mrs. Kidd enter-tained a large number of members of the profession at

Fermanagh County Infirmary, while the annual dinner whichwas well attended took place in the town hall, the Presidentoccupying the chair.

The New Royal Victoria Hospital, Belfast.In the prospect of the King’s visit on July 27th to open the

new hospital in Belfast work is being rapidly pushed onand it, is expected that everything will be ready at thatdate. The chairman of the construction committee (theRight Hon. W. J. Pirrie, D.L.) and Miss Pirrie have issuedinvitations to the subscribers to an "at-home" " on July 2ndat the hospital to inspect the buildings and the wards. The

hospital is being visited by many American visitors and theyexpress themselves in terms of great admiration of the

originality and thorough efficiency observable in every detailof its construction.

Royal Victoria Hospital, Belfast. IAt a meeting of the corporation of the Royal Victoria IHospital, held on June 22nd, the old by-laws were repealedand in their place the new ones which had been most care-fully considered were passed. The main points of change inreference to the medical staff are that the qualifications areslightly raised and that all members are to retire at the ageof 65 years. The privileges of subscribers are carefullystated and a donor of e500 will have the right of giving aname in perpetuity to a bed, while a donor of qlO,000 willhave the right to name a ward in perpetuity. Already thereare nine donors of 10,000, the last being Lady Harland.

Killarney Lunatic Asylum.At the weekly meeting of the board of the Killarney

Lunatic Asylum, held on June 20th, Mr. L. T. Griffin,resident medical superintendent, submitted his annual

report in which he stated that the daily average numberof patients was 585, an increase of 12 compared with theprevious year. The gross expenditure was 15,130 6s. 3d.,but deducting receipts for paying patients and the amountof repayment of a loan the net cost of each patient was.B2119s. ld., which was less than that of the previous year.The governors of the Richmond Asylum forwarded the

following resolution :-That we promote a conference of representatives of the committees of

district asylums in Ireland to consider the question of the increase ofinsanity, the management of the insane, and the readjustment of theGovernment aid, and that a committee be appointed to draw up ascheme.

It was decided to cooperate with the governors of theRichmond Asylum in the matter.June 23rd.

PARIS.(FROM OUR OWN CORRESPONDENT.)

liuman .OttMOCMM 2n if rance ana other uountmes.DURING the past year 30 cases of actinomycosis in human

beings were reported in France, so that the disease is not sorare as is generally supposed. M. Poncet and M. Trevenothave seen 11 cases of the disease and its localisation wasvery varied, for it showed itself in the rectum, in the

appendix, in the lungs, and in the cervico-facial region. M.Poncet read a paper on the subject at the meeting of theAcademy of Medicine which was held on June 9th. M.Trevenot and himself had noted that within the last fiveyears 86 cases had occurred in France, 101 in Germany, 102

in America, 35 in England, 79 in Austria, and 189 in Russia.For the other European countries the figures were muchlower. In relation to the extent of her territory France hasan average as high as those countries where actinomycosis ismore frequent. The gravity of the complaint varies accord-ing to the place where it shows itself in the body. Thecervico-facial form is the most amenable to treatment.Actinomycosis of the thoracic or abdominal walls is moreserious, visceral affections are still more grave as regardsprognosis, and finally the pulmonary form is often fatal.Actinomycosis is undoubtedly in some cases transmitteddirectly from animals to man but in the majority of casesits origin is from the vegetable kingdom. The more poorlya man lives the more likely is he to be infected. Thedisease is more common in the country than in towns andmore especially in those countries which are given up togrowing cereals and fodder. The most successful treat-ment is iodine in some form, either applied locally or inthe form of iodides, together with scraping and cauterisa-tion. Actinomycosis should always be thought of in cases ofsuppuration and the pus should be histologically examined,for this is the sole method of forming a diagnosis and so ofarriving at a rational method of treatment.

The Pasteur Monument at Chartres.On June 7th the Pasteur monument at Chartres was un-

veiled by a committee, the members of which comprisedrepresentatives of most of the scientific and agriculturalsocieties of the department. The monument consists of abust of Pasteur standing on a pedestal ornamented with asemicircular bas-relief representing experiments on anthraxin sheep, experiments which Pasteur carried out in the

neighbourhood of Chartres. The monument is due to theinitiative of Dr. Paul Richer, a member of the Academy ofMedicine, Professor of Anatomy at the Ecole des BeauxArts, and formerly a pupil and colleague of Charcot. Every

official person in the department of Eure-et-Loir was present,

as also were many medical men and veterinary surgeonsfrom the country round. Various orations were pronouncedand a congratulatory telegram was received from the

Bulgarian Government. The festival closed with a grandbanquet.

m, m . ,,, r

The Treatment of Cancer by the X Rays.At the meeting of the Academy of Medicine held on

June 9th M. Albert Robin communicated a paper by M.Doumer and M. Lemoine of Lille dealing with the abovesubject. The first case was that of a man, aged 64 years,who presented all the signs of cancer of the stomach. Atumour could easily be felt in the region of the greatercurvature. The tumour and all the symptoms disappearedafter five exposures to the x rays. The second case wasthat of a woman suffering from a tumour of the stomach,together with progressive wasting and hsematemesis. Sittingswith exposure to the rays were begun on April 20th and byMay 15th the tumour had disappeared. Similar success

was met with in a third case. In many other cases

only functional amelioration was obtained and in yet othercases the treatment failed completely. It has also beenfound possible to arrest in this way recurrent mammarycancer the diagnosis of which had been histologicallyconfirmed. Although the rapidity of the cure of thesecases of alleged cancer of the stomach makes the diagnosisdoubtful, yet the position of the authors of the paperrenders it impossible to reject the results without the verystrictest inquiries.

Appendicitis as a Complication of Choleoystitis.At the meeting of the Academy of Medicine held on

June 16th M. Dieulafoy related two cases which had comeunder his personal observation in which patients suffered

simultaneously from cholecystitis and appendicitis. The firstcase was that of a woman, aged 78 years, who began her ill-ness with cholecystitis and in whom after a few dayssymptoms of appendicitis supervened. An operation wasperformed and both the gall-bladder and the appendix werefound to contain pus. The patient recovered. The secondcase was that of a man, aged 30 years, who had markedsymptoms of appendicitis. M. Segond, who operated,extended his incision upwards and found the gall-bladderdistended with pus. This patient also recovered. M.Dieulafoy referred further to a case reported by an

American surgeon named Grant, in which suppura-tive cholecystitis was diagnosed and in which withina very short time the patient exhibited signs of acute

appendicitis. From a consideration of this case, (f f

1844

those which he has personally observed, and of 24other cases which he has found recorded, M. Dieulafoy hascome to the following conclusions : Nearly all the patientshad a history of some biliary trouble. Sometimes this factdeceived the medical attendant and made him overlook the

,appendicitis for a certain length of time. It is difficult to

say to what this association of diseases is due. It has but’little to do with calculi, for very often no calculi are foundin the appendix or in the gall-bladder. It is not an ascend-

ing infection, as M, Dieulafoy demonstrated by anatomical,plates, but is most probably a descending infection startingfrom the gall-bladder. But once the appendix is infected"the cholecystitis is masked by the acuteness of the appen-dicitis. Diagnosis must be made quickly, for the doubleoperation necessary admits of no delay.June 23rd.

Obituary.ALFRED HAVILAND, M.R.C.S.ENG.

’ON May 30th there died at his residence, I Ridgemount,"mear Frimley Green, Alfred Haviland, M. R. C. S. Eng., so well<known to the medical profession for his work upon medical.geography. He was in the seventy-eighth year of his age,having been born in Bridgwater in 1825, his father beingMr. James Haviland, M.R.C.S., J.P., a well -known andold-established medical practitioner of that city. Alfred>Haviland was educated at the Hackney Church of EnglandSchool and at University College Hospital and upon qualify-ing in 1845 he became partner in practice with his father.In 1849 he had the charge of his native town at the time ofthe epidemic of Asiatic cholera of that year and during thistime he took meteorological observations day and night andnoted the following coincident facts : (1) Whenever well-established " calms" prevailed over the infected area therewas at once an increase in the number of fresh cases ofcholera; and (2) on the other hand, whenever the air was dis-turbed by equatorial currents from south to west, blowingstrongly, the number of fresh cases from cholera was imme-diately reduced. At the request of his friend the late Mr.’G. J. Symons, F.R.S., he joined the corps of observers formedwhen Schonbein first made known in England his discovery how to detect ozone in the atmosphere by means of white’blotting-paper saturated with a solution of iodide of potas-sium and starch and was much interested in finding thatduring I I calms " the slip of paper indicated that there wasno ozone in the air but that much was present during"windy weather. In 1855, with a view to bring before hisbrother medical practitioners an epitome of the observationsof Hippocrates, he published his first work on " Climate,Weather, and Disease." In 1864 the late Dr. Farr’s firstdecennial supplement to the Registrar-General’s twenty-fifth.annual report formed the basis of the first edition of Mr.Haviland’s work on the "Geographical Distribution ofDisease. " In 1868 he published a pamphlet entitled" Hurried to Death," calling attention to the folly of

hurrying to catch trains and giving the results of his

investigations as to the geographical distribution of heartdisease which he had undertaken to test the soundness ofthe prevailing opinion that the new mode of travelling byrailway was the cause of the supposed increase of that causeof death. On consulting Dr. Farr’s first supplement to the"Registrar General’s twenty-fifth annual report for the ten

years 1851-60, he tabulated the death-rates so as to-enable him to devote a chapter to the geographical dis-tribution of heart disease in England and Wales in whichhe foreshadowed the results which he first published in apaper read before the Medical Society of London. He next

mapped out the 630 registration districts of England andWales in colours, which work was very greatly facilitatedby the kindness of the late Major Graham, the thenRegistrar-General, the late Dr. Farr, and Captain WilliamClode. On Nov. 30th, 1868, Mr. Haviland read his first

paper on the Geographical Distribution of Cancer amongFemales throughout England and Wales during the de-cennial period 1851-60 before the Medical Society of Londonunder the presidency of the late Sir Benjamin WardRichardson. In 1875 the " Geographical Distribution ofHeart Disease and Dropsy, Cancer in Females, andPhthisis in Females in England and Wales, illustrated by,coloured maps of heart disease, cancer, and phthisis,"

by Mr. Haviland was published. In 1879 he read a

paper entitled the "Distribution of Disease PopularlyConsidered before the Society of Arts for which hereceived the society’s silver medal. From 1880 to 1890Mr. Haviland visited Brighton, Scarborough, and the ’Isleof Man and published pamphlets on these places as healthresorts. In 1891 he read a paper on the Influence of

Clays and Limestones on Medical Geography, illustrated

by the Geographical Distribution of Cancer among Femalesin England and Wales, before the Hygienic Congress. Mr.Haviland was led to take up the studies by which his nameis best known owing to an accident in an operation, wherebyhe poisoned his finger and very nearly lost his life. Hehad to resign his practice in Somersetshire and it was duringhis convalescence and inforced inactivity that he made thefirst map of the distribution of rheumatism and heart diseasewith graduated colours of red and blue himself, eventuallyhaving others printed off from it, and very soon followedother maps of "cancer" and "phthisis" " on the same lines.From very early in his life Mr. Haviland made the geographyand causes of disease his study and he read everything con-nected with the subject up to the last, taking the greatestinterest in the work. Before having to give up active profes-sional work he was surgeon on the honorary medical staff ofthe Bridgwater Infirmary, honorary lecturer at St. Thomas’sHospital Medical School on the Geographical Distribution ofDisease, and medical officer of health of the Northamptoncombined districts.

____

HENRY JAMES MOXON, B.A. DuB., L.D.S. R.C.S. ENG.,AND R.C.S.IREL.

THE death on June 3rd, after an operation for appendicitis,of Mr. Henry James Moxon of 11, Buckingham Palace-roadand Brighton, has removed the first dentist appointed to aPoor-law institution-viz., to the North Surrey District

Schools, Anerley-which post he held for 19 years. He alsowas dental surgeon to the following schools-viz., FelthamIndustrial, Anerley, Croydon Union Schools and Infirmary,Poplar Training Schools (Forest Gate), and MayfordUnion (near Woking), and the numbers of childrenunder his care at these schools were respectively 300,980, 200, 900, and 200. He was also formerlydentist to Westminster Union Schools, WandsworthCommon. He had a wide conception of the scope of his

profession in which he took much interest. He was theauthor of "Notes on Dissecting" and the contributor of" Temperature in Health and Disease," published in the

Hospital Gazette, 1876, and of " Lecture on the Teeth " pub-lished in the British Journal of Dental Science, 1887. Thefuneral took place at Abney Park Cemetery on June 8thamong many manifestations of sorrow and sympathy fromhis personal friends, including his brother Freemasons andfrom the institutions with which he was connected. Heleaves a widow, son, and daughter to mourn their loss.

Medical News.ROYAL COLLEGE OF SURGEONS OF ENGLAND.-

The following gentlemen having passed the necessaryexamination and conformed to the by-laws have beenadmitted Fellows of the College in order of seniority asMembers :-

Herbert Willoughby Lyle, M.D. and B.S. Loncl., L.R.C.P. Lond.,King’s College Hospital (Member, July 27th, 1893); Edwin ArthurPeters, M.D., B.C. Camb., L.R.C.P. Lond., Guy’s and St. Bartholo-mew’s Hospitals (Member, Nov. 8th, 1894); Wilfred GeorgeMumford, M.B. Lond., L.R.C.P. Lond., Guy’s Hospital (Member,May 9th, 1895); Francis Edward Freemantle, M.B., B.Ch. Oxon.,L.R,C.P. Lond., Oxford University and Guy’s Hospital (Member,Nov. llth, 1897); Herbert Stanley Jenkins, M.B.Lond., L.R.C.P.Lond., University College, Bristol, King’s College and LondonHospitals (Member, August 2nd. 1898); George AugustusRoberts, L.R.C.P. Lond., King’s College Hospital (Member,August 2nd, 1898); Arthur Martin - Leake, V.C., L.R.C.P.Lond., University College Hospital (Member, Nov. 10th, 1898);Robert Fletcher Moorshead, M.B., B.S, Loud.. L.R.C.P. Lond.,University College, Bristol, and St. Bartholomew’s Hospital(Member, May llth, 1899) ; Burton Alexander Nicol, L.R.C.P. Lond.,D.P.H. Camb., Charing Cross Hospital (Member, May llth, 1899);Ernest Lewis Lilley, M.B., B.S. Lond., L.R.C.P Lond., CharingCross Hospital (Member, July 27th, 1899); Charles Wynn Wirgman,M.B., B.S Lond.. L R.C.P. Lond., University College Hospital(Member, July 27th, 1899); Harold Collinson, M.B., B S. Lond,L.R.C.P. Lond., Yorkshire College and General Infirmary, Leeds