800

patients under treatment, with 121 discharges and 94 deaths.The admissions show a decrease of 55 as compared with thtprevious year, the diminution being due to a falling-off in thecases transferred from the Belfast workhouse (the numbersfrom that institution being fewer by 59), while, on the otherhand, the number of admissions directly from the patients’homes remains at the same ratio to the population as in

previous years. In a very interesting and suggestivereport Dr. Graham quotes from the inspectors oflunatics in their special report (on the alleged increaseof insanity for 1906) a statement to the effect thatthey believe that " the Irish branch of the Celtic race

is specially predisposed to mental breakdown, and thereforethe great increase in the number of registered insane all overthe civilised world is for this as well as for other reasonsvery marked in Ireland " ; and they think that probably"the innutritious dietary and other deprivations of themajority of the population of Ireland must, when acting overmany generations, have led to impaired nutrition of thenervous system, and in this way have developed in the racethose neuropathic and psychopathic tendencies which are theprecursors of insanity." Further, statistics prove-as statedin Dr. Graham’s report-that the proportion of the insaneamong the Irish in America is greater than that ofany other nationality. It is curious that Armenian andother emigrants to the United States from the Turkishdominions do not evince the same proneness to mental break-down. Further, the refugees from Poland and fromsome parts of the Russian empire (whose state athome has been as unhappy as the Irish emigrant) do notshow the same tendency to mental breakdown. Dr. Grahamsuggests, as an explanation of this curious fact, that it isdue to two reasons. First, that many Irish emigrants aredriven by poverty to the United States who are ill-fitted forthe new conditions of life, the crowded tenements of big cities,and the abnormally keen competition for a livelihood-ina word, all that is implied in a sudden change from a quietagricultural existence in Ireland to the bustle and excite-ment of New York or Chicago; and secondly, that theintellect of the Irishman is finer and that he is morecivilised than the Russian or Hungarian. Owing tothe fact that the Irish race, as a race, is of finerpsychical structure, therefore, adverse conditions tell on

him more strongly than on the others. This brightness,to quote from Dr. Graham’s report, this keen susceptibilityto joy and sorrow, make him more liable to mental break-down than would be the case among duller peoples. The

gross expenditure for the financial year ended March 31st,1907, amounted to .625,483, which, after deductingreceipts from paying patients and miscellaneous sources,gives the low net capitation cost of .E21 ls. 8d. per annum.Special reference is made to the great loss which theinstitution-and, I may add, the medical profession-has sustained in the death, on Feb. 13th, 1907, of Dr.R. A. L. Graham who had been an assistant medical officerfor eight years. Dr. A. S. Merrick, who for 22 years wasmedical superintendent (he resigned in 1897), died at theclose of last year.

Queen’s College, Belfast.The report of the President of Queen’s College, Belfast

(Rev. Dr. Hamilton), just issued for the academic year,1906-07, indicates that the College continues to prose-cute its work with vigour and success. Special refer-ence is made to the splendid achievement accomplishedby the equipment fund. 20 years ago there was butone laboratory; now there are eight. Owing to theTreasury giving .E5400 for new buildings on conditionthat a corresponding sum of C5400 was contributedby the better equipment fund, there are now the"Donald Currie Laboratories" " devoted to chemistry,the "Musgrave Laboratories" devoted to research and

teaching in pathology and bacteriology, the "JaffeLaboratories" for physiology, the" Harland Laboratories"

"

for natural philosophy and engineering, as well as

biological, pharmaceutical, and anatomical laboratories. Ofthe students there was an increase in the Faculty of Artsand as usual the medical students were numerous. Anathletic field will be available next session, and all thestudents’ college societies appear to have had very usefuland successful sessions during the academic year 1906-07.Among the honours to old students Professor J. W. Byerswas knighted, Serjeant Dodd, K.C., was appointed one ofHis Majesty’s judges in Ireland, and Mr. J. 0. Wylie, K.C.,

was selected as the judicial head of the Irish LandCommission.

Women’s National Health Association of Ireland.Her Excellency the Countess of Aberdeen is to be present

and to take part in a meeting which will be held onOct. 29th in the City Hall, Belfast (the Lord Mayor, theEarl of Shaftesbury, presiding), to establish a Belfast branchof the Women’s National Health Association of Ireland.

Lunacy in Ireland.The following deplorable statistics were mentioned at a.

meeting of the Belfast Asylum Committee on Sept. 9th. In1851 the registered number of insane in Ireland was 9980 ;in 1901 they totalled 25,050, or 1 to every 179 of thepopulation. In 1851 the entire insane for Belfast, countyAntrim, county Down, and Carrickfergus was 330. The lastreturns showed-Belfast, 1150 ; County Down, about 600 ;.and County Antrim, about 550; a total of 2300, or an increaseof 1970. While the population of Ireland in 1841 was

8,175,124, it was in 19014,458,775, a decrease of 3,716,349.(In 1906 the Registrar-General estimates the population as-in the middle of the year-4,388,006, while in 1906 therewere 35,344 emigrants.) Comparing the number of lunaticsper 10,000 of population, the result was :-

England and Wales. Scotland. Ireland.

1871 ......... 30.4 4 ...... 34-0 ...... 30-51881 ......... 32-5 ...... 38-5 ...... 35-61891 ......... 33-6 6 ...... 38-4 ...... 45’01901 ......... 40-8 .8 ...... 45-0 ...... 56-2

Such startling figures surely demand the attention of states-men and patriots.

Cerebro-spinal Fever.On Sept. 9th a boy, six years of age, who first exhibited

signs of cerebro-spinal meningitis on Sept. 6tb, died atHarryville, Ballymena, county Antrim.Sept.10th.

_________________

PARIS.

(FROM OUR OWN CORRESPONDENT.)

The Purification of Water in Hocels.THE French Touring Club is organising a competition the

object of which is to discover the best means of insuring thepurity of water supplied in hotels. The programme has.been arranged by a committee of which M. J. Lucas-

Championniere is the president, and proposals are invitedfor methods of sterilisation which will be satisfactory aliketo the Faculty of Medicine, to hotel-keepers, and totravellers. Any inventor may compete. The method or

apparatus which is adjudged the best will be recommendedto all hotel-keepers and to all the members of the French,Touring Club.

Tracaination in Paris.

Dr. Roux has presented to the council of public health ofthe department of the Seine a report on his inspections ofvaccination stations (établissements vaccinogenes) in 1906.He remarks that he carnot conclude his report without call-ing attention to the fact that more than three years have-elapsed since vaccination and revaccination were madeobligatory, but that the law has not been systematicallyenforced either in Paris or in the department of the Seine.Lists of persons who were required to conform to the regula-tions were not prepared, hours of attendance (seances) werenot arranged, and the results were not recorded.

The School of Medicine in Indo-China.In the School of Medicine at Saigon in Indo-China a,

military department has been established for the purpose oftraining ten native medical assistants each year. Thestudents will be selected by competition among the nativesoldiers in course of training. The period of study will befour years.

Treatment of Ankylosis of the Knee joint with Malposition.At the congress of the French Association for the Advance-

ment of Science M. Lardennois read a paper on the treat-ment of the cases in which a child’s knee-joint had becomeankylosed in a faulty position. He said that ankylosis ofthe knee-joint in the position of flexion was not uncommonin childrt n, and the proper treatment was a difficult problembecause the same operative measures could not be used as in

801

the case of adults. An immediate correction might no doubtbe obtained by partial resection of the tibial epiphysis, butthe ultimate results would be disastrous, for this cartilagewas necessary for the natural growth of the bone andinterference with it would lead to a shortening of sixor eight inches in the patient’s lower limb when adultlife was reached. Moreover, when the ankylosis was

divided in the usual way two flattened surfaces were pro-duced which could not be brought into satisfactory ap-position when the limb was straightened. M. Lardennoisavoided this difficulty by making a curved incision withSéglie’s wire saw ; the opposing curved surfaces obtained inthis way presented a considerable area of contact and firmunion might be expected.

Wounds of the Eye Caused by tlae Bursting of Bottles.At the same congress M. A. Bourgeois read a paper

on the treatment of wounds of the eye caused by the burst-ing of bottles. He said that on account of the thickness ofchampagne bottles the fragments produced by their burstingwere usually of considerable size, and the wounds whichthey caused were proportionately extensive and serious ; thebruising effect of the flying glass caused the edges of thewounds to be irregular but no glass was left in them. Hehad found that suture of the cornea or of the cornea andsclerotic gave excellent results when performed soon afterthe infliction of the injury. Seriously wounded eyes wereinvariably enucleated 20 years ago but the improved methodsand instruments of modern surgeons frequently avoided thenecessity for enucleation, to the advantage of the patient’sappearance and in some cases a certain amount of visualpower was retained.

l!’rench Ambulances Work in Morocco.Dr. Henri de Rothschild has just started for Tangier to

organise there an ambulance service for the wounded fromCasablanca. With him have gone two other medical menand two nurses (surveillantes). The Red Cross Society(Societe de Secours aux Blesses) has also organised anambulance with the authority of the Minister of War. The

general secretary of the society has started for Tangierwhere he will confer with the French Minister to Morocco.The ambulance will consist of 100 beds and the staff of18 nurses, eight male and ten female.

A Gift of 4,000,000 Francs.The Red Cross Society has just received an anonymous gift

consisting of the estate of Mont des Oiseaux at Hyeres. Theestate includes a park of 80 hectares, terraces, gardens, ahouse containing 120 rooms and five villas scattered throughthe grounds, the whole being valued at 4,000,000 francs.The society is going to make it a convalescent home for sickand wounded officers. The anonymous donor has also givena sum of 100,000 francs for upkeep.Sept. 10th.

________________

ITALY.

(FROM OUR OWN CORRESPONDENT.)

Hospital Accommodation in Rome.THE Administrative Board of the Roman Hospitals has

this year been confronted with the problem of hospitalaccommodation in an acute form, for which a prompt remedyhas become an absolute necessity. The overcrowding whichfor many years has prevailed in the wards of all the hos-pitals has lately been greatly aggravated through the.demolition of part of the Hospital of Sant’ Antonio on theEsquiline Hill to make room for the new Via Napoleone III. ;by the removal of a wing of the Hospital of Santo Spiritoto allow of the systematisation of the adjoining partof the Tiber near the Bridge of St. Angelo; and,finally, by the increase of the population of the city, whichaugments the number of patients seeking admission tothe hospitals by about 400 every year. Whilst in Londonthere is an outcry over the cost of maintaining empty beds,here in Rome the complaint is very different, as will beunderstood by a glimpse at any of the wards of such hos-pitals as Santo Spirito or San Giovanni. In the latter, forexample, one of the wards on the ground floor contains 150beds arranged in four rows with scant room between andevery bed with its occupant. And for each bed that becomesvacant there are always dozens of applicants. With such astate of affairs already existing and the certainty in view that

with the advent of winter the number of patients demandingadmission will be greater still, no time was to be lost in pro-viding additional accommodation. To meet the most pressingneeds the board has ordered the immediate erection on asite contiguous to the hospital of San Giovanni of ten of thetransportable hospitals known as the Docker," many ofwhich are used by the Red Cross Societies in Germany andelsewhere, and of which there are already two in Rome at theLazaretto of Santa Prisca. These "Docker’s barracks" area Swedish invention, and are 22 metres long by six metreswide ; they consist of a single storey and have a double wallof wood lined with enamelled" cloth, and a waterproofroof made of wood and cloth, or cardboard and cloth. Eachcontains 22 beds. It is hoped that they will all be erected bythe end of the year. Their cost will be 120,000 lire (£4800).At the same time the foundations are being laid, on a sitebetween San Giovanni and the Via Merulana, of six new

permanent hospital pavilions of two storeys each, with alarge ward on each floor capable of taking 30 patients.When these are all completed some 600 additional beds willbe available for the reception of patients, a provision whichwill give at least temporary relief to the present congestedstate of the other hospitals.

Outbreak of Tetanus at Bologna.The surgical clinic of the University of Bologna has been

closed on account of the numerous cases of tetanus whichhave appeared amongst the patients there.

The Moderate Use of Wine.The controversy as to the use of alcoholic beverages has

diffused itself over the continent, the Latin countries in par-ticular. In Italy it, still shows animation, though the GiornaleVinicolo (Wine-growers’ Journal) is not perhaps the bestmedium through which the arguments pro et contra mightbe addressed to the public. These, however, are all fromclinical teachers or consultants whose impartiality is beyondquestion, and there could hardly be a better " autho-rity " to open the discussion than the Senator GiulioBizzozero, whose loss to science is deplored far beyondthe subalpine schools of which he was an ornament.

Insisting on the wine in daily use being the genuine juice ofthe grape with which the " manufacturer " has as little as

possible to do, he sees only good to be derived from it iftaken in moderation-that is, in quantities adjusted to thephysical and mental wants of the consumer. So used he

’ has found it to brace the mind for its regular work, giving asense of confidence as well as support to the faculties. Next

. comes the all-accomplished professor of physiology in thesame school, Dr. Angelo Mosso, who is convinced that wine,

. within the limits laid down by Bizzozero, is a nutrient to’ the system, slowing or diminishing waste. Having placed

this fact in physiological evidence, he cites the experi-ence of the Prussian army which in the severe campaignof 1870-71 maintained its health in augmented proportion asit was quartered in ever greater force in a wine-growingcountry. Those in its ranks who belonged to total abstinencesocieties were found less able to stand the fatigues andprivations of the march or the trenches than their comradeswho drank in moderation the bottled sunshine of theLoire. Dr. Augusto Murri, professor of clinical medicinein the University of Bologna (whose contributions toTHE LANCET on cerebral pathology are still referred to byworkers in that field), is of opinion that the graduated useof wine is not hurtful; on the contrary, by reason ofits adjustment to the individual’s needs, it is distinctlywholesome. His long and varied clinical experiencewarrants him in saying that men who have usedwine freely in their work, professional or other, main-tain a high degree of vigour even in old age andthat it would be more in accordance with true science toassert the value of wine, moderately used, than to condemnit simpliciter. Dr. Bonaventura Graziadei, who holds thechair of medical diagnosis in the University of Turin, isas clear as any of his colleagues on the subject. "Alcohol,"he says, "is a necessity for man. All races possess theirstimulating beverages. Of these wine is the prototype and Iam convinced that its moderate use is beneficial." To thesame effect may be cited the opinion of the Senator AchilleDe Giovanni, professor of clinical medicine in theUniversity of Padua, while Dr. Alessandro Lustig, whooccupies the chair of general pathology in theIstituto di Studi Superiori at Florence, says he finds" a glass of sound wine not only agreeable to the

palate but useful to the organism." Dr. Cesare Lombroso