67

TaW showing the Number of Students from various Medical Schools whohare obtained 1M Degrees of M.B.. B.Ch, and B.A.O. (equivalent tothe M.D. of the Queen’s) in the years 1889, 1894. and 1899,

Total for1889. 1894. 1899. three

years.

Queen’s College, Belfast ............ 32 21 27 80

Queen’s College, Cork ............... 15 8 11 34

Queen’s College, Galway ............ 2 - 1 3Catholic University Medical School...... 6 5 10 21

School of Physio, Trinity College ...... 5 1 - 6

Royal College of Surgeons in Ireland ... - 1 - 1

London School of Medicine for Women ... - 1 - 1

Durham University .................. - 1 - 1 ,

Mixed returns ..................... 10 - 2 12

70 38 51 159

These statiscs show that all the Queen’s Colleges havebeen impaired in their usefulness by the establishment of theRoyal University of Ireland. The arts faculty in Cork hasbeen ruined and in Galway it has diminished one half, and themedical faculty in Cork is about half what it was, while inGalway it is destroyed. Further, these figures, Dr. McKeowncontends, show that both in arts, and medicine the CatholicUniversity College, Dublin, and Catholic University MedicalSchool, notwithstanding their predominant position and in-fluence, have failed to show the return of graduates whichsurely was expected by the Government in establishing theRoyal University of Ireland. In fact, from that pointof view, the Royal University of Ireland has been a

failure. But, further, these figures demonstrate that in thearts faculty the great majority of students graduating inthe Royal University of Ireland have studied in colleges orschools not associated with the university, or have studiedprivately, for in the three years tabulated no less than 252out of a total of 420 who took the degree of B.A. did notstudy in any of the colleges associated with the university.Many of these colleges and schools have been brought intoexistence or have been given a great impetus by the RoyalUniversity of Ireland, and some have come out most

creditably both in the honour and pass lists. Queen’sCollege, Belfast, has suffered in both the arts andmedical faculty by the establishment of the RoyalUniversity of Ireland. The injury to the arts schoolis not due, as it is in the medical faculty, to the consti-tution of the board of examiners and the unfair influence(in the relative number of examiners) of one Dublinschool, but mainly owing to the opening of the arts degreeto all comers without obligatory attendance on lectures.The students graduating in arts from "private study" andfrom "other colleges and schools" in the Royal Universityof Ireland are one and a half times as numerous as thosefrom all the privileged colleges put together. The Queen’sColleges founded by the Government have been starved by theGovernment. The chairs are not properly endowed, and noprovision is made for assistant professors or for tutors. The

very fact that the colleges are Government institutions andcontrolled far too much in the past by subordinates in Dublinwho delight in religious and political intrigue, have pre-vented the people in their vicinity endowing them asthey would, had they been in the position of the Universityof Edinburgh or the University of Glasgow. Dr. McKeownsuggests another in addition to the many plans pre-

viously put forward to settle this most difficult question.His method may be styled, " Local Government of theQueen’s Colleges." He advises that the governing bodies ofthe Queen’s Colleges should be made as far as possiblerepresentative, and that they should be properly endowed,cut off from Government interference in their manage-ment. and made local. The North of Ireland would have aboard to please itself, the West and South the same. Inthis way the people of the districts in which the colleges arelocated would take a real interest in them. The governingboard might contain representatives of the teachers and ofthe graduates, official representatives of some public bodies,and eminent persons in thorough sympathy with the colleges.Were the colleges in the position in which they ought to be,local, democratic, and endowed, Dr. McKeown thinks thatthen a re-organisation of the Royal University of Ireland, afterthe manner of the University of London, might be seriouslyentertained. Whether Dr. McKeown’s plan will "catch on" "or not, one thing is clear to everyone, that nothing could bemore unsatisfactory than the present condition of college anduniversity education in Ireland. The man who would solvesuch a question would indeed confer a lasting benefit onIreland aue be a true patriot. ’

, Influenza.For -the past few weeks cases of mild influenza have

occurred in Belfast, but since Christmas it has assumed awidespread epidemic form and the type of the disease isdistinctly worse than in the influenza which prevailed lastyear. Pulmonary complications are met with most frequentlyand the death-rate in elderly patients has been very high.The weather, too, has been most trying, days of frost beingimmediately followed by the mildest spring-like weather.

-Death of a Medical Man from Accidental Poisoning.Mr. William J. Belcher, for many years the medical officer

to the Union Hospital, Bandon, co. Cork, was poisoned onDec 30th by a dose of dilute carbolic acid which heaccidentally swallowed in mistake for a draught of fluidmagnesia. Although the accident occurred at 1 o’clock inthe day, and although skilled medical assistance was sum-moned with the utmost possible despatch, death had takenplace before Dr. Reid arrived. It would seem that nowa-

days, and in these countries, carbolic acid is by far the mostfrequent and fatal of poisons.Jan. 2nd.

PARIS.(FROM OUR OWN CORRESPONDENT.)

Operations on Lunatic Paticoats in Asylums.THIS very grave question has been under discussion at the

Society of Legal Medicine, the subject having been intro-duced some six months ago in an important paper by M.Picqu6 and M. Briand. They came to the conclusion that thesurgeon should only interfere in cases of absolute urgency.M. Leredu, a barrister, sent in a report to the society on thequestion formulated as follows :-" Is a surgeon within hisrights in performing a surgical operation upon a lunaticwithout the consent of the patient’s relatives ? " " Heanswered in the negative, except in a case of absolute

urgency. A lunatic is unable to give consent, it is hisrelatives who must give consent to the operation. But therelatives may refuse consent, possibly from fear of an

unsuccessful result, or on the other hand, with the deliberatewish to deprive a person who is a disgrace and expense tothem of a chance of life. Again, the relatives may notchoose to answer, or the lunatic may have no relatives. It is,then, the legislature that must be asked to supply an answerto the question. It would be easy to settle it by an enact-ment drawn in some such terms as these : "When a surgeonis of opinion that surgical interference is called for in thecase of a person who is an inmate of a lunatic asylum heshall obtain leave to operate from the relatives of thepatient. In case the relatives refuse the director of theasylum shall at once inform the Procureur of the Republic.This official shall put the tribunal in possession of the facts,whereupon it may rule the case to be one of urgency andthe proposed operation to be a last resource, making theorder in the Chambre de Conseil, after having referred thematter, should it think fit, to medico-legal experts foran opinion as to the propriety of surgical intervention."M. Picque, in supporting the opinion of M. Leredu, showedhow difficult it was to obtain a really valid consentfrom relatives. In 20 cases where be applied for leavehe received but one answer. The disagreeable conse-

quences (which may arise to a surgeon through operat-ing without consent being taken for granted M. Picquéwould only dispense with such consent in the three

following instances : suffocation, strangulated hernia, andarterial hæmorrhage. There might be others, such as

metrorrhagia and conditions associated with the urinaryorgans, but so long as the matter was not settled, eitherby statute or by a resolution of the society, he would notinterfere, unless he had some authorisation in writing, forfear of incurring both moral and material responsibilitieswhich in France were very grave. If the patient were todie his relatives, who had shown themselves absolutelyindifferent when permission was asked of them, would nothesitate to claim damages and to attack the surgeon in thepublic prints. Even if the operation were successful thesurgeon would not be free from the risk of disagreeable ’consequences. In the discussion which followed without

any conclusion being then arrived at, it was curious tosee the legal members, among whom was M. Jacobi, theAdvocate-General, giving their opinion that it was right forthe surgeon to operate if he- thought it necessary, even

68

against the wishes of the relatives, while the medicalmembers were less bold and demanded some legal prot actionto cover their responsibility. As a matter of fact, despitethe philanthropic and philosophic views of individualmembers of the magistracy, the medical profession knowonly too well how of late these very magistrates have, whensitting in court, shown themselves both severe and unfairtowards medical men and how ready they are to entertaincomplaints from the relatives of patients against theirmedical advisers.

Spitting on the Pavement.The Sixth Committee of the Municipal Council of Paris

has recently had under consideration a proposal laid beforeit by M. Fortin, a member of the council, suggesting that thepopulace of Paris should not spit on the footways. Thepractice is already prohibited in omnibuses, railway-stations,and certain public places. The committee decided, aftersome discussion, to put up enamelled metal notices, suffi-ciently large to be read at some distance, in the chiefstreets and public buildings, bearing the following inscrip-tion : I The public are requested, in their own interests andwith a view to avoid disseminating infectious diseases, toabstain from spitting on the pavement."

.Tan. 3rd.

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

Statistics of the Medical Profession.ACCORDING to Borner’s Medical Directory, edited by

Dr. Schwalbe, the number of medical men in Germany is26,689. The Deutsche Medicinische Tf-oche7tse7trift statesthat since the previous enumeration there has been an

increase of 932-i.e., 3’6 per cent. Of these medical men16,103 reside in Prussia, 2947 in Bavaria, 1968 in Saxony,870 in Wiirtemberg, 1027 in Baden, 661 in Hesse, 766 inAlsace-Lorraine, and the remainder in the other states ofthe confederation. During the last 11 years the medicalprofession has increased 56 per cent., whereas the number ofthe population has increased only 14 per cent. In 1887there was one medical man for 3000 persons, but in1898 there was one for 2197 persons. The mostconsiderable increase during the last 11 years was

in the medical officers to hospitals, clinics, laboratories, &-c.,their number having risen from 581 to 1924, an increase of232 per cent., whilst the general practitioners increased52 per cent. and the army and navy medical officers 21 percent. It is remarkable that in 1887 as many as 57 per cent.of the army and navy medical officers were engaged incivilian practice, but in 1898 only 31 per cent. With regardto the geographical distribution of the profession it is statedthat the eastern districts have far fewer medical men thanthe southern and western districts. Berlin has of course thegreatest number of medical men-viz., 2233 ; Munich, 637 ;Hamburg, 533; Breslau, 510; Leipsic, 411; Dresden, 408 ;Cologne. 332 ; Frankfort, 312 ; Charlottenburg, 298 ; Eonigs-berg, 250 ; Hanover, 234 ; and Strassburg. 234. Of theBerlin medical men two were qualified in 1842, two in 1843,and four in 1844. More than 46 per cent. of the Berlinmembers of the profession became qualified during the lastten years.

-. - d... " . _.

The Institution for Infectious Diseases.Professor Brieger, the head of the clinical department of

the Institution for Infectious Diseases, is resigning this

appointment to become professor of general therapy at theUniversity of Berlin. The chair of General Therapy hasbeen created recently : the Deutsche Medicinische Wochen-

schrift rightly observes that theoretical lectures on therapyare not of great value and that the professor of generaltherapy ought to have wards where he might demon-strate the different methods of treatment. In additionto losing Professor Brieger the staff of the Institutionfor Infectious Diseases will undergo considerable alterations:Dr. Marx is going to Frankfort, where he has received anappointment at the Institution for Experimental Therapyunder Professor Ehrlich ; Professor Pfeiffer, the head of thelaboratory department, has been promoted to be professor ofhygiene at Königsberg. The places of Professor Brieger andProfessor Pfeiffer will be taken by Professor Donitz andProfessor Frosch, the German commissioners for the investi-gation of the plague in Portugal. Professor Koch, who is at

the head of the Institute, is still in the Dutch Indies prose.cuting studies on malaria. -

Actinomnycosis of the Kidney.’ A very rare specimen was recently shown to the BerlinMedical Society by Professor Israel. It was the kidney ofan army officer who in 1892, without any obvious cause, wasseized with haematuria and severe pain in the left lumbarregion. In 1894 a surgeon performed nephrotomy on thesupposition of the presence of a renal calculus. The kidneyproved to be normal, no calculus was detected, but therewere firm adhesions to the surrounding parts so that thekidney had to remain in sit?t and was not brought throughthe wound for inspection. The wound healed without compli.cation, but the urine became opaque and contained blood,the patient had night sweats, and his weight decreased con.siderably. In 1898 a fistula formed and discharged a smallquantity of sero-purulent fluid. In August the fistula wasincised without any improvement resulting. Not long agothe patient came under the care of Professor Israel. He wasvery weak, there were several fistulæ at the old cicatrix dis.charging pus with granules- which proved to be actinomyces,and actinomyces was present in the sediment of the urine. Bycystoscopy the mucous membrane of the bladder was foundto be normal. Nephrectomy was therefore performed. Thelower part of the kidney did not show any alterations; inthe upper part there was a yellow tumour consisting of fatwith actinomyces ; growths of the same kind were alsopresent between the capsule and the kidney. In the pelvisof the kidney there was a calculus consisting of masses ofcalcified actinomyces. This is the first case of operation foractinomycosis of the kidney.

Midwives in. Berlin.The midwives of Berlin are very strictly controlled by the

medical officers to the Berlin police. Not long ago a

qualified midwife was prosecuted and fined because she hadcontradicted a medical man in presence of a parturientwoman, this being regarded as a misdemeanour because thepatient was thereby induced to believe that the medicalman in charge was incompetent. The medical departmentof the Berlin Police has also issued an order to the qualifiedmidwives informing them that it is illegal to recommendindividual medical practitioners to women in their confine-ments, because a law passed in 1725 provides that the

patient must be at full liberty to consult any medical manshe desires. It is especially against the law for midwivesto have an agreement with a medical man and to be paidby him for recommendations to patients.

Jan. 2ad.

ROME.(FROM OUR OWN CORRESPONDENT.)

Hygiene and the Holy Year.IN view of the masses of pilgrims who will be quartered in

Rome at frequent intervals during the Holy Year the Ministerof Foreign Affairs (the Marchese Visconti Venosta) has in-structed the Italian consular service throughout the twohemispheres to supply the Government with full and accuratereports as to the sanitary condition of the several countrieswhence the pilgrimages in question are preparing to start.This is quite a necessary precaution. The central authorityis making every effort to obviate the overcrowding anti-cipated from the influx of so many caravans" " of thefaithful. But even before their accommodation in conven-tual establishments and provisional "baracche" (barracks)becomes a practical question the Government must have satis-factory assurance that they will not import the germs ofinfective maladies from their several places of origin " or" points of departure."

Dr. Mazzoni and the Ceremon?l of the Porta Santa.The solemn inauguration of the Holy Year on Christmas

Eve was not without its amusing episodes, prominent amongthem being that of which Dr. Mazzoni was the hero. Hispresence at the august ceremony was only less de rigiieifthan that of Dr. Lapponi, but owing to argent professionalengagements he was late in presenting himself. Still worse,he had forgotten to come fortified with the indispensable"biglietto d’ingresso" (ticket of admission). Arrived atthe bronze door leading to the Pontifical apartmentshe was met with the inexorable demand, " Biglietto,signore, biglietto." Hardly hearing or attending to the