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1170 A table of months in which the accidents occurred is also {given, and it shows that the fewest separate accidents were ’in April and May-17 in each month-and the highest in December-38. The largest number of deaths in any month was in January-viz., 12, and the fewest in November-viz., 1. ’The number of injured was least in March-11-and most in December-31. Advanced State of the Season in the North. The Northern Echo says that a Darlington lady has .already collected sixty different kinds of wild flowers in her neighbourhood this year, and from all accounts received the various fruits and trees are from three to four weeks in advance of what they were last year. Bathing has also pretty ;generally commenced on the coast. Newcastle-on-Tyne, May 10th. IRELAND. (FROM OUR OWN CORRESPONDENT.) The late Professor Macnamara’s Appointments. LAST Thursday the President and Council of the Royal College of Surgeons elected Sir Philip Crampton Smyly as ’’the representative of the College on the General Medical ’Council. The vacancy at the Meath Hospital has been filled by the appointment of Mr. Edward Lennon. At a recent meeting of the Standing Committee of the Meath Hospital the following resolution was passed unani- mously : "That this committee, having heard with the ,deepest regret of the death of Professor Rawdon Macnamara, F.R.C.S., who for a period of thirty-two years as a member - <&f the medical staff acted as surgeon to the hospital, desire to express their sincere sympathy with the sorrowing widow ;and family in their sore bereavement. " The Meath Hospital. The annual distribution of prizes took place last Monday. :Sir George Porter, Bart., D.L., who occupied the chair, .alluded to the loss the hospital had sustained by the recent ’death of his life-long friend and esteemed colleague Rawdon Macnamara, who on a similar occasion two years :since was standing at his side in that theatre, taking part in the distribution of prizes. Mr. Macnamara was a gentleman and a man of honour as well as a most accomplished scholar, -and one whose unswerving friendship he (Sir George Porter) would find it very difficult to replace. The students, he knew, loved him, and he felt that they also mourned the loss - of a kind and genial teacher. The following prizes were "distributed :-First medical prize, William Taylor ; second - medical prize, George P. Moore ; first senior surgical prize, I Watkin ; second senior surgical prize, W. R. Fenton ; first junior surgical prize, Charles E. Hodgson ; second junior surgical prize, P. J. Perkins. Blaekroek and Kingstown Main Drainage. The Blackrock town commissioners have at present before tthe Select Committee of the House of Lords a Bill to provide for the drainage of both townships. Both are situated on the ,coast line, about two miles apart, and it is alleged that Blackrock cannot carry out a main drainage unless asso- ciated with Kingstown, as the sewage from the latter would - pollute Blackrock. The Bill is opposed by the Kingstown rtown commissioners, who are represented by counsel before ’the Committee. By the proposed scheme the sewage of Blackrock and two-thirds of Kingstown would be taken away ’by the ebb tide. There would be a deep-sea outfall and the - outflow pipe would be of such a size that the sewage accumu- !latingfrom the previous high water would be discharged in about two hours some thirty-three feet below the surface and then - carried by the current southwards past the entrance of the Siarbour and towards the Muglins. The cost is estimated at 32,000, or at the rate of 4&frac12;d. in the pound for Blackrock and 1&frac12;d. for Kingstown, the expenses of working being equally divided between the two townships. Cork Water-supply. The Public Health Committee of the corporation have again requested the Local Government Board to take action by insisting on the Macroom guardians providing a proper sewage system, as under the existing state of things a portion of the sewage of Macroom is permitted to flow into the Sullane, which is one of the tributaries of the ’stream from which the water-supply for the Cork Harbour District is taken. The Local Government Board have power to order the guardians to provide a proper sewage system, and if they failed to comply with the order they could be superseded and paid guardians could be appointed in their stead. The Board, however, singular to state, have acted in a very dilatory manner and have not put the necessary pressure on the Macroom guardians, although urgent appeals have been made to them to take action in the matter. The overflow from the sewage tank which receives the Nurserytowll sewage can be seen flowing into the stream ; but chemical and microscopic analyses have hitherto failed to discover any trace of sewage matter in the water-supply, a fact which is explained by the process of filtration which the water undergoes whilst flowing over the gravel bed of the stream from Macroom to Cork. However. not only may this gravel bed at any time become inoperative as a filtering medium, but, in the event of an outbreak of infectious disease, such as cholera, at Macroom, the germs of the infection would not be retained by this natural filter, but would, on the contrary, fructify in the transit from Macroom to Cork, and should such a contingency arise the water-supply to the city, bringing with it germs of the disease, would cause the infection to be widely spread over the district, notwithstanding any precautions that might be taken by the sanitary authorities. A great responsibility now rests on the Local Government Board, and they should without delay put in force the powers legally vested in them. A conference of medical practitioners and other citizens took place last Thursday, when the following resolution was unani- mously adopted: "That, having regard to the alleged pollution of the water-supply of Cork and the apprehension of the cholera visiting the country, this committee requests the Local Government Board to appoint a specialist to inspect the waterworks and to hold an inquiry as to the alleged pollution of the water-supply to Cork and to suggest any improvement in the present system of supply. " Macroom Union. An election for a medical officer to the union to fill the vacancy caused by the resignation of Dr. Warren Crooke took place last week, when Dr. Richard Barrett, medical officer of the Inchigeela district, was elected. The Lord Chancellor has appointed the following gentlemen to the Commission of the Peace : Mr. John Clancy, for county Kerry ; Mr. Andrew C. Flynn, for county Leitrim ; and Mr. Nicholas Furlong, for county Wexford. May 9th. ________________ PARIS. (FROM OUR OWN CORRESPONDENT.) The Diagnostic TTalue of Subclavicular Palpation. DR. HOTTENIER calls attention to the value from a diagnostic point of view of bimanual palpation of the upper part of the chest. A congestive process limited to the apex may not be distinguishable at its commencement by percus- sion and auscultation. In such a case Dr. Hottenier recom- mends the following manoeuvre : Whilst one hand is applied over the subclavicular region and the other is maintained over the corresponding scapula, the to-and-fro respiratory movements are followed by the two hands and a moderate degree of pressure is exercised by the pulp of the fingers in front during inspiration. Should no pain be thus elicited no appreciable lesion of that apex exists. Should the patient, on the contrary, complain of pain it is a proof that congestion is present. A Novel Operationfor Uretero- Vaginal Fistula. M. Chaput reports the following curious case : A young woman underwent the operation of vaginal hyste- rectomy for pyo-salpinx, the proceeding being followed by a left uretero-vaginal fistula situated high up. To remedy this state of things, an incision was made above Poupart’s ligament, the peritoneum displaced upwards, and the dilated ureter exposed as a thick cord after some diffi- culty. This conduit was divided and the upper extremity fixed by a double row of sutures to the colon, whilst the lower portion was obturated by a ligature. Rapid recovery ensued. the patient experiencing no further inconvenience excepting the passage about four times daily of liquid motions. M. Bazy suggests that it might have been preferable to practise supra- 1 Soci&eacute;t&eacute; de M&eacute;decine et de Chirurgie Pratiques, April 27th. 2 Soci&eacute;t&eacute; de Chirurgie, May 3rd.
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1170

A table of months in which the accidents occurred is also{given, and it shows that the fewest separate accidents were’in April and May-17 in each month-and the highest inDecember-38. The largest number of deaths in any monthwas in January-viz., 12, and the fewest in November-viz., 1.’The number of injured was least in March-11-and most inDecember-31.

Advanced State of the Season in the North.The Northern Echo says that a Darlington lady has

.already collected sixty different kinds of wild flowers in herneighbourhood this year, and from all accounts receivedthe various fruits and trees are from three to four weeks inadvance of what they were last year. Bathing has also pretty;generally commenced on the coast.

Newcastle-on-Tyne, May 10th.

IRELAND.(FROM OUR OWN CORRESPONDENT.)

The late Professor Macnamara’s Appointments.LAST Thursday the President and Council of the Royal

College of Surgeons elected Sir Philip Crampton Smyly as’’the representative of the College on the General Medical’Council. The vacancy at the Meath Hospital has been filledby the appointment of Mr. Edward Lennon.

At a recent meeting of the Standing Committee of theMeath Hospital the following resolution was passed unani-mously : "That this committee, having heard with the

,deepest regret of the death of Professor Rawdon Macnamara,F.R.C.S., who for a period of thirty-two years as a member- <&f the medical staff acted as surgeon to the hospital, desireto express their sincere sympathy with the sorrowing widow;and family in their sore bereavement. "

The Meath Hospital.The annual distribution of prizes took place last Monday.

:Sir George Porter, Bart., D.L., who occupied the chair,.alluded to the loss the hospital had sustained by the recent’death of his life-long friend and esteemed colleagueRawdon Macnamara, who on a similar occasion two years:since was standing at his side in that theatre, taking part inthe distribution of prizes. Mr. Macnamara was a gentlemanand a man of honour as well as a most accomplished scholar,-and one whose unswerving friendship he (Sir George Porter)would find it very difficult to replace. The students, heknew, loved him, and he felt that they also mourned the loss- of a kind and genial teacher. The following prizes were"distributed :-First medical prize, William Taylor ; second- medical prize, George P. Moore ; first senior surgical prize,I Watkin ; second senior surgical prize, W. R. Fenton ; first

junior surgical prize, Charles E. Hodgson ; second juniorsurgical prize, P. J. Perkins.

Blaekroek and Kingstown Main Drainage.The Blackrock town commissioners have at present before

tthe Select Committee of the House of Lords a Bill to providefor the drainage of both townships. Both are situated on the,coast line, about two miles apart, and it is alleged thatBlackrock cannot carry out a main drainage unless asso-

ciated with Kingstown, as the sewage from the latter would- pollute Blackrock. The Bill is opposed by the Kingstownrtown commissioners, who are represented by counsel before’the Committee. By the proposed scheme the sewage ofBlackrock and two-thirds of Kingstown would be taken away’by the ebb tide. There would be a deep-sea outfall and the- outflow pipe would be of such a size that the sewage accumu-!latingfrom the previous high water would be discharged in abouttwo hours some thirty-three feet below the surface and then- carried by the current southwards past the entrance of theSiarbour and towards the Muglins. The cost is estimated at32,000, or at the rate of 4&frac12;d. in the pound for Blackrock and1&frac12;d. for Kingstown, the expenses of working being equallydivided between the two townships.

Cork Water-supply.The Public Health Committee of the corporation have

again requested the Local Government Board to take actionby insisting on the Macroom guardians providing a propersewage system, as under the existing state of things a portionof the sewage of Macroom is permitted to flow into the Sullane,which is one of the tributaries of the ’stream from which the

water-supply for the Cork Harbour District is taken. The Local

Government Board have power to order the guardians to

provide a proper sewage system, and if they failed to complywith the order they could be superseded and paid guardianscould be appointed in their stead. The Board, however, singularto state, have acted in a very dilatory manner and have not putthe necessary pressure on the Macroom guardians, althoughurgent appeals have been made to them to take action in thematter. The overflow from the sewage tank which receivesthe Nurserytowll sewage can be seen flowing into thestream ; but chemical and microscopic analyses havehitherto failed to discover any trace of sewage matter in thewater-supply, a fact which is explained by the process offiltration which the water undergoes whilst flowing over thegravel bed of the stream from Macroom to Cork. However.not only may this gravel bed at any time become inoperativeas a filtering medium, but, in the event of an outbreak ofinfectious disease, such as cholera, at Macroom, the germs ofthe infection would not be retained by this natural filter,but would, on the contrary, fructify in the transit fromMacroom to Cork, and should such a contingency arise thewater-supply to the city, bringing with it germs of thedisease, would cause the infection to be widely spread overthe district, notwithstanding any precautions that might betaken by the sanitary authorities. A great responsibilitynow rests on the Local Government Board, and they shouldwithout delay put in force the powers legally vested in them.A conference of medical practitioners and other citizens tookplace last Thursday, when the following resolution was unani-mously adopted: "That, having regard to the alleged pollutionof the water-supply of Cork and the apprehension of thecholera visiting the country, this committee requests the LocalGovernment Board to appoint a specialist to inspect thewaterworks and to hold an inquiry as to the alleged pollutionof the water-supply to Cork and to suggest any improvementin the present system of supply.

"

Macroom Union.An election for a medical officer to the union to fill the

vacancy caused by the resignation of Dr. Warren Crooketook place last week, when Dr. Richard Barrett, medicalofficer of the Inchigeela district, was elected.The Lord Chancellor has appointed the following gentlemen

to the Commission of the Peace : Mr. John Clancy, for countyKerry ; Mr. Andrew C. Flynn, for county Leitrim ; and Mr.Nicholas Furlong, for county Wexford.May 9th.

________________

PARIS.(FROM OUR OWN CORRESPONDENT.)

The Diagnostic TTalue of Subclavicular Palpation.DR. HOTTENIER calls attention to the value from a

diagnostic point of view of bimanual palpation of the upperpart of the chest. A congestive process limited to the apexmay not be distinguishable at its commencement by percus-sion and auscultation. In such a case Dr. Hottenier recom-mends the following manoeuvre : Whilst one hand is appliedover the subclavicular region and the other is maintainedover the corresponding scapula, the to-and-fro respiratorymovements are followed by the two hands and a moderatedegree of pressure is exercised by the pulp of the fingers infront during inspiration. Should no pain be thus elicited noappreciable lesion of that apex exists. Should the patient,on the contrary, complain of pain it is a proof that congestionis present.

A Novel Operationfor Uretero- Vaginal Fistula.M. Chaput reports the following curious case : A

young woman underwent the operation of vaginal hyste-rectomy for pyo-salpinx, the proceeding being followedby a left uretero-vaginal fistula situated high up. To

remedy this state of things, an incision was made abovePoupart’s ligament, the peritoneum displaced upwards, andthe dilated ureter exposed as a thick cord after some diffi-culty. This conduit was divided and the upper extremityfixed by a double row of sutures to the colon, whilst the lowerportion was obturated by a ligature. Rapid recovery ensued.the patient experiencing no further inconvenience exceptingthe passage about four times daily of liquid motions. M. Bazysuggests that it might have been preferable to practise supra-

1 Soci&eacute;t&eacute; de M&eacute;decine et de Chirurgie Pratiques, April 27th.2 Soci&eacute;t&eacute; de Chirurgie, May 3rd.

1171

pubic cystotomy, and find out by catheterism whether thelower end of the ureter was obliterated or not. Should thecanal have been permeable, he would after previous enlarge-ment of the vesical opening have followed it up until the seatof the fistula was reached and then have fixed the supra-fistulous portion to the bladder incision. Should the lower

portion of the ureter be found obliterated all intra-vesicalmethods should be abandoned and the cystotomic incisionclosed; then search should be made above and behind thebladder for the central end of the canal. This having beenfound, it should be sutured to the posterior wall of thebladder. M. Bazy opines that either of these procedures shouldbe preferred to M. Chaput’s method, seeing that the naturalcurrent of urine through the bladder is thus re-establishedand that all danger of ascending nephritis from bacterial con-tamination through the intestinal contents is avoided. Thatsuch a risk is run when the urinary flow is deflected by fistulaor otherwise is proved by an observation of M. Routier. That

surgeon last year practised vaginal hysterectomy on a

young woman for left pyo-salpinx and hoemato-salpinx of theright side. The right kidney was, moreover, movable.After the operation the urine escaped per vaginam. Pressureon the right (movable) kidney determined a flow ofurine by the vagina, proving the existence of a fistulousopening of the corresponding ureter. Autoplastic attemptshaving failed, right nephrectomy was performed. In theremoved kidney there were discovered three infarcts and inthe pelvis a collection of pus.

Proper Pride (!)Ghys, the tramp who enjoys the distinction of having im-

ported typhus fever into Paris, was recently condemned to afortnight’s imprisonment-not for having accomplished thisinsanitary feat, but for having mistaken somebody else’sproperty for his own. The following dialogue between theaccused and the judge is curious reading :-Prisoner Je venais de Lille. J’&eacute;tais tr&egrave;s malade, j’avais besoin d’argentpour me soigner." Judge: "Quelle maladie aviez-vous?"Prisoner (proudly) : "Le typhus ! C’est moi qui 1’ai apporteau Depot a Paris." To what lengths will the rage for dis-tinction lead ?

The Habitat of the Female Itch-mite.The exact situation of the itch burrows is somewhat vaguely

indicated by dermatologists. Most writers state that theyare placed in the illalpighian layer of the epidermis andKaposi gives a figure bearing out the view that the femalesarcoptes hominis lives constantly in this situation. In 1889Torok showed that the burrow and the acarus itself are found inthehornylayer. M. Dubreuilh 3 exhibited preparations confirm-ing this latter statement. Three burrows were, with the upperportion of the dermis, excised and the fragments, fixed byalcohol and coloured en ?7iasse with carmine, were mounted inparaffin and sections made. It was seen that the " run " andthe space occupied by the mite were both contained entirely inthe horny layer, the parasite being separated from the Mal-pighian layer by several series of horny epidermic cells.May 9th.

Obituary.ARNALDO CANTANI.

WE little thought when within the last few weeks we drewattention in our leading columns to the elaborate and instruc-tive treatise, "Pro Silvis," in which a remonstrance was

addressed to the Italian Government in abatement of the

reckless tree-felling that has so changed the peninsula for theworse that its author, Professor Arnaldo Cantani. was so nearthe close of his brilliant and useful career. Yet such wasthen the condition of that great pathologist and consultantthat none of those around him expected or desired for him aprolongation of life. Nephritis of many months’ standing hadworn out his strength and he succumbed on May Day at hishouse at Naples in his fifty-seventh year. He was born onFeb. 15th, 1837, at Hainsbach, in Bohemia, of Neapolitanparentage, his father having emigrated to that provinceof the Austrian empire in the prosecution of com-

mercial enterprise. In 1855 he entered the University.of Prague as a student in medicine and soon attracted

3 Soci&eacute;t&eacute; Fran&ccedil;aise de Dermatologie et de Syphiligraphie, April 8th.

the notice of his teachers by the enthusiasm and the energywith which he devoted himself to work. One of the mosteminent of these-Professor Jacksch-was the first to recog-nise in him the best qualities of the Italian intellect and in1860, shortly after graduation, appointed him his class-assistant in the department of clinical medicine. From thathe became privat-docent in the same subject and not onlydelivered repeated courses of lectures on his own account,but frequently took the place of Professor Jacksch himself’when that eminent consultant was unable to meet his class.About this time Cantani’s fame had reached his compatriots,mainly through his masterly translation into Italian of’Niemeyer’s great treatise on Pathology and Therapeutics,a translation enriched with many original observations.and inductions and so popular in Italy that in spite ofits bulk it ran through three large editions in a few years.In 1864, accordingly, the Minghetti Administration invitedhim to fill the chair of Materia Medica and Toxicology inthe University of Pavia-a post which he left in 1867 to.become "Medico Primario " and Director of the Ospedale-Maggiore at Milan. Here he stayed with brilliant success for a.year, after which he was called, at the instance of the Govern-ment, to the chair of Clinical Medicine in the University ofNaples. From 1868 till his death he devoted the best part of’his powers to the development of that school, leading a life of’tranquil industry in the pathological laboratory and in theclinical wards, which endeared him to colleagues and students.alike. Here it was that his chief work was undertaken and.completed-particularly those monumental studies in malaria,cholera, typhoid fever and the infective maladies in generalwhich have brought him enduring fame not only amongst.his compatriots but in all the greater European and Trans-atlantic schools. His translation of Niemever’s work above.noticed he had already supplemented by his memorable "FirstCase of Floating Liver (1866), his "Observations on Col--lections of Air in Closed Body-cavities" (1867), and by his." Handbook of Pharmacology, " in two volumes, of which asecond edition appeared in 1884-all of these written in the-German language. At Naples, however, his literary activitywas confined to his native Italian, and in 1873-83 appeared his." Diseases of Metabolism," in 1881 his "Progressive Atrophyof the Skin," in 1873 his Lathyrismus," in 1878-79 his.

"IJ;nteroklysma," in 1880 his Different Morbid Aspects of’Individual Infective Disease, " to say nothing of a vast number-of occasional monographs and notes on his favourite themes-of fever, inflammation and infection. For years few meetings,national or international, relating to medicine and surgerywere without his intervention-his presence, especially at the-annual Congresses of Internal Medicine in Italy, beingfruitful of independent thought and trenchant, whilst emi--nently genial, criticism.

" The predominant note in Cantani’s character," writes a.Neapolitan correspondent, "was serenity. No one possesseda calmer, more perfectly balanced judgment ; no one was.further removed from all that savours of flattery or assenta-tion. He had in a rare degree what professional men call the-’ clinical eye ’-a possession all the more remarkable in that-he did not lay himself out so much for consultant practice as.for investigation in the pathological laboratory. The honoursp.of which he had more than his share, came to him unsought,and he never was heard or seen to set store by them. Calledin 1889 to the Senate of the kingdom, his health, never-

robust, kept him from taking part in its deliberations, exceptin rare crises in the State. Outside his professional sphere, andthat was an extensive one, he had but one predilection-he was.passionately fond of music."On his death being announced Professor De Crecchio,

Rector of the University of Naples, caused an eloquent tribnte-to his memory to be affixed to the College gates and the.institutions appertaining to the school, and at the funeral’ceremony which followed every interest in the city and<province-official, academic and civic-was represented.Oraisons,fu.nebres were pronounced over his bier in presence-of a vast audience by Professor de Amicis, who dwelt onCantani as a citizen and man of science ; by the Senator-Gallozzi, who appeared for the Medico-Chirurgical Academyof Naples ; by Professors Cardarelli and De Renzis, who repre-sented the Clinical Department of the Neapolitan School .and, not least touchingly and effectively, by Signor AntoninoAnile, who spoke for his fellow students.

It was characteristic of the man that before death he ex-pressed the desire that his body should be subjected to a post"mortem examination in order that the nature of his malady,which had been the occasion of so much thought and discus-


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