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generally of a severe type. There has been much comment iron the exceptionally dry weather which has recently pre- vailed in Dublin and in Ireland generally. The governor of the I

Royal Botanic Gardens, Glasnevin, has reported that during tlthe three months ending July 31st, 1905, the record of rainfall hin the district has been unusually low, the season having o

proved the driest since 1887-the jubilee year. Health of Belfast.

At a. meeting of the city council held on August 1st it was reported that measles is again more or less prevalent in Belfast, 17 deaths having been caused thereby. Between aJune 18th and July 15th there were notified 178 cases of zymotic disease; 65 cases of simple continued fever ; 32 of typhoid fever, 26 of scarlet fever, 24 of erysipelas, esix of diphtheria, four of croup, and one of small- pox. The annual death-rate was 17’1. Diarrhoea is dalso very prevalent, having caused 26 deaths in the clast month. A deputation appeared before the council

c

representing the inhabitants of the Shore-road and the I

North-East district of Belfast to condemn the system of bacteria beds, urging that there should be no more outlayand that a thorough investigation should take place into the proper method to be adopted. Finally they protested against (the discharge of sludge upon the beach in the neighbour- hood. In reply it was stated that the bacteria beds worked (satisfactorily in Belfast and the last bed put down, which (was somewhat of an improvement on the former ones, was (

purifying to the extent of 96 per cent. the sewage passing through it.

Down District Asylum. Down District Asylum. , jThe report for the year ending Dec. 31st, 1904, has just

been published. 179 cases were admitted during the year and there were residing in the institution on Dec. 31st700 inmates-384 males and 316 females-the total casesunder care during the year being 451 males and 391females. There were 84 discharges, the percentage of recoveries on admissions being 41’9. With the possibleexception of dysentery there was no disease due to local con-ditions and this affection is reduced in frequency and inseverity of type. The inspector of lunacy in his report hasexpressed " entire satisfaction " with the institution and hemade no suggestion for improvements which would entailany considerable expense.

Death of Mr. John Auterson, L.R. C.P..Edin.On the night of August 5th as Mr. John Auterson, a well-

known medical practitioner of Cookstown, co. Tyrone, wasreturning home from paying a professional visit in the countryhis horse shied at the reflection of a lamp on the white-washed gable of a house on the road. The animal ran backand the vehicle with Mr. Auterson was precipitated into a bog15 feet below. The road at the place and for many yards istotally unprotected, not even a wire fence or hedge beingprovided at a place where the bog has been gradually cutaway to provide firing by the use of the peat (or turf as it iscalled in Ireland). The accident was fortunately seen andMr. Auterson was removed to an adjacent house where Mr. R.Burgess (Coagh) and Dr. C. H. P. D. Graves, Dr. W. J. R.Knight, and Mr. R. Crossett (all of Cookstown) did every-thing in their power for their injured confrère. On the

evening of the following day Mr. Auterson was removed tohis own house where he died on August 7th. The deceasedgentleman, who was born at Coolsaragh, Desertmartin,became in 1868 L.R.C.P. Edin., and practised at first in

Draperstown but 30 years ago removed to Cookstown, wherehe built up a large practice and was greatly liked by thepublic and his professional colleagues. He was unmarriedand leaves a brother, a medical practitioner, in Magherafelt.August 8th.

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PARIS.(FROM OUR OWN CORRESPONDENT.)

Action of Metallic Ferments on the Blood Cells and on theProduction of Uric Acid and Urea.

IN THE LANCET of Dec. 24th, 1904, p. 1816, an accountwas given of some investigations made by M. Albert Robinshowing that metabolic processes in animals might bemodified by hypodermic injections of fluids containing aminute amount of certain metals in a state of extreme sub-division. The metals in question were palladium, gold,silver, and platinum ; their effects were shown by alterations

in the quantitative composition of the urine and in theamount of carbon dioxide excreted and the name of’’ metallic ferments " was given to the solutions possessingthis property. At a meeting of the Academy of Medicineheld on July 18th M. Robin read a paper describing furtherobservations which he had made on the same subject inconjunction with M. Umile Weil. He said that theyhad examined the effects produced by the metallicferments on three patients suffering from subacute articularrheumatism or cancer of the stomach. The excretion of ureaand uric acid and the assimilation of nitrogen were alwaysincreased with simultaneous production of leucocytosis andintense leucolysis. They had endeavoured to discover theorigin of the uric acid thus produced and eliminated inexcess. It was well known that uric acid was supposed to bederived from nucleins set free and decomposed in the

organism as a result of the destruction of the white

corpuscles of the blood, but in the present cases the

polynuclear neutrophiles must be regarded as the source ofthe uric acid that was eliminated. It was to be remembered,however, that leucolysis and the formation of uric acidwere not uniformly associated and might be broughtabout independently of one another by the use ofcertain drugs. It was obvious therefore that uric acidhad no immediate and invariable connexion with thedestruction of leucocytes but that it might arise from othercauses influencing the hasmopoietic organs. To explain theobserved facts M. Robin and M. Weil have suggested anhypothesis of which the following is an outline. The leuco-cytes are the carriers of the soluble organic ferments ; theseferments when set free by leucolysis exercise a deoxidisingaction in the organism and give the first impulse to the pro-cesses which result in the formation of urea and uric acid.If, however, the ferments do not cause the elimination oEuric acid, as is the case in cancer and cachexial diseases, itis probable that the leucocytes contain no diastase becausedestruction of the leucocytes is not followed by the ordinaryresults of the liberation of diastase. Whatever may be thevalue of this hypothesis the observed facts which itendeavours to explain at least deserve to be recorded.

Neuroses of Childhood and the Education Problem.At the same meeting of the Academy of Medicine

M. Maurice de Fleury described 37 cases of idle, inattentive,mentally depressed, and unruly children who were neuras-thenic, arthritic, hysterical, and mentally deficient, with

. some indications of chorea and diabetes. An improvement

’ followed on the use of appropriate treatment. M. de Fleurysaid that the physical conditions reacted on the moral con-ditions in children as well as in adults, a circumstance

which justified medical treatment even when the disorderwas apparently an intellectual perversion (maladie de

’ l’esprit). Many troublesome school children upon whompunishment had no beneficial effect were found whencarefully examined to be the subjects of either definiteneuroses or nutritional diseases. The results of medicaltreatment showed that the association of these conditions

’

was not a mere coincidence but that they were mutually’ related as cause and effect. The treatment required to be

e

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supplemented by intellectual and moral re-education.

0 Tetanus of Uterine Origin.IAt the July meeting of the Societe d’Obstetrique, deL, Gynécologie, et de Pédiatrie Dr. Ris described a case inn which the patient was a primipara, 18 years of age. Shee was at first attended by a midwife, an elderly woman, but a6 medical man had to be sent for, who found that labour hadd been in progress for 48 hours, that the shoulder was pre-

senting, and that the foetus was dead. Dr. Ris decided to

perform embryotomy by the method of Dubois. The uteruswas in a state of tetanic contraction and rupture of itoccurred as soon as the operation was attempted. Dr. Ris

thereupon immediately performed Porro’s operation. The

patient’s condition was favourable until the evening of thetwelfth day, when her temperature rose slightly and herneck became stiff. The ordinary symptoms of tetanus after-ie wards appeared and she died suddenly. Fluid from the

it cervix contained the bacillus of tetanus in pure culture.

In Wkite Swelling of both Knees.)e At a meeting of the Surgical Society held on July 26tha M. Walther showed a man, 20 years of age, who when in

his tenth year was found to have a white swelling of his left1, knee. Recovery followed after some months but the jointis was ankylosed at a right angle. Last November the young

490

man came under the care of M. Walther with a white

- swelling of the right knee. Orthopaedic resection was

necessary for the left knee, but as a double resection wouldhave condemned the patient to walk with crutches for theremainder of his life M. Walther treated the right knee bythe sclerogenous method (interstitial injection of chloride of- zinc). The joint is now moveable and the man can walkvery well.

The Relative Merits of Rapid and Slow Methods in SurgicalOperations.

At a meeting of the Surgical Society held on July 27thM. Doyen delivered an interesting address on Rapid andSlow Methods of Operating. He said that prolonged opera-tions had come into use since the discovery of the means ofproducing anaesthesia and preventing sepsis. The earliest ofthe prolonged operations were those in which the écraseurof Maisonneuve and Chassaignac was employed. Theinventor of the serre-noeud aimed at the prevention ofpurulent infection. At the present time the rapid andslow methods had each their respective advantages. Most- operations consisted of two distinct stages, the first beingthe removal of the affected part (exerese) and the secondbeing the procedures preliminary to closing the wound(réparation). The first stage ought to be accomplishedin the least time possible so as to avoid loss ofblood and to diminish surgical shock. The second stage,- on the other hand, required both time and care in order thata good result might be secured. It was only by following asimple and definite method that the affected part could beremoved both quickly and well. Skilful management of thefirst stage tended to simplify the second stage. In someinstances the whole of an operation might include no morethan one of the two stages already mentioned ; for instance,the "removal of large naso-pharyngeal polypi consisted onlyof the first stage and operations for fistula only of thesecond stage. Gastro-intestinal operations consisted prin-cipally of the second stage, because the removal of theaffected part required minute precautions and complicatedprocedures. Every surgeon ought to possess manual

dexterity and presence of mind sufficient for the rapid per-formance of such stages of an operation as should not beprolonged ; he would then be able to give the necessary timeto the ligatures, the sutures, and the closing of the wound.The future in surgery would belong to the most skilful and tothose who followed the best methods.

Reflex Pacial Movements.At a meeting of the Medico-Chirurgical Society held on

July 10th M. Maurice Bloch said that it was common enoughto see the features of patients distorted with pain. but oncarefully observing this reflex he had observed that it some-times appeared on the side opposite to the seat of the pain.A man suffering from intestinal pain on the right side hadfacial distortion on the left side. Another man sufferingfrom crural neuritis made spasmodic movements with theorbicularis muscle and the eyelids of the opposite side. Thisfact was an additional proof of the decussation of the sensorynerves and the close connexion of the sensory and motorfibres in the same cerebral hemisphere. This sign might belooked for in various other conditions and might, perhaps, incourse of time become valuable. Care must be taken todistinguish between reflex grimacing and tic.

The Influence of Sea Salt on the Developmcnt of the Ova andLarvæ of Ankylostomum.

At a meeting of the Academy of Medicine held on

-July 25th M. Calmette said that he had found that commonsalt had no action on the ova of ankylostomum. but that, onthe other hand, it affected powerfully the larvae even in asolution of 2 per cent. strength. In salt water the larvas

generally died from two to seven days after coming out ofthe ovum. M. Calmette made experiments with the waterof four ditches at Valenciennes the water in which- contained salt added in proportions varying from 1-16 to3’ 97 per cent. In the solutions of 1’16 per cent. strengththe ova hatched out quite well but the larvae died in 15days. In the solutions of 3’ 97 per cent. strength the ovadid not hatch out, but if after some time they weretransferred to a normal medium hatching then took place,which proved that the salt had no destructive action on theova. Salt water, however, could not be used in coal mines- for the prevention of ankylostomiasis and energetic dis-infection of the infected areas would be necessary.

Poisoning by Unripe Tomatoes.A family consisting of four persons-father, mother, and

two sons-fell ill two and a half hours after one of theirmeals, all complaining of violent colic and profuse diarrhoea,.The father and one of the sons were in a very low conditionand the medical man who was called in was surprised to finddilatation of the pupil in all the patients. The cooking vesselsshowed no particular feature ; meat did not form a part ofthe food ; and the only constituents of it which attractedattention were some tomatoes not fully ripe. The patientssoon recovered after taking ipecacuanha and some teawith rum in it. A few days later the same practitionerwas called to see a young man who presented similar

symptoms one and a half hours after taking food whichconsisted partly of tomatoes. Some of them remained overand were seen to be not quite ripe. These two cases are

interesting, for examples of poisoning by tomatoes havehardly ever been reported.August 7th.

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Obituary.CHRISTOPHER HEATH, F.R.C.S. ENG.,

CONSULTING SURGEON, UNIVERSITY COLLEGE HOSPITAL, ETC.

WE regret to announce the death, which occurred suddenlyon August 8th, at his residence, 36, Cavendish-square, W.,of Mr. Christopher Heath, F.R.C.S. Eng., EmeritusProfessor of Clinical Surgery in University College,London, and a past President of the Royal College ofSurgeons of England. Christopher Heath was born inLondon in 1835, being the grandson of Mr. John Heath,a surgeon in the Royal Navy, who served in the flag-ship under Lord Howe about 100 years ago. He was edu-cated at King’s College School and at King’s College andKing’s College Hospital, London. He served as a surgeonwith the Baltic Fleet during the Crimean war in 1855and in 1856 he became a Member of the Royal College ofSurgeons of England, proceeding to the Fellowship in 1860.In the year 1856 he was appointed demonstrator ofanatomy at Westminster Hospital and six years later hewas made lecturer on anatomy and assistant surgeon at thesame hospital. In 1866 he was appointed assistant surgeonand teacher of operative surgery at University CollegeHospital and in 1875 he became Holme professor ofclinical surgery and full surgeon at the same hospital.It was while he was at Westminster Hospital that he wrotehis well-known ’’ Practical Anatomy," a ninth edition ofwhich was published in 1902, and the year after his

appointment to University College Hospital he was awardedthe Jacksonian prize for his essay upon " The Injuriesand Diseases of the Jaws, including those of the Antrum,with the Treatment by Operation or Otherwise." In1881 he was elected a member of the Council of the

Royal College of Surgeons of England and in 1895 Presi-dent of that body, a post which he held also during theyear 1896.

Christopher Heath was an admirable teacher and theclearness and practical nature of his style are well knownby his clinical lectures on surgical subjects, of which hepublished two series-one in 1895 and the second in 1902.Among his other well-known works were " A Course ofOperative Surgery," the second edition of which appearedin 1884, and the widely-read " Manual of Minor Surgeryand Bandaging," which ran into 12 editions. He wasthe editor of "A Dictionary of Practical Surgery," a

well-known work which appeared in 1886. In 1897,as President of the Royal College of Surgeons ofEngland, it fell to his lot to deliver the HunterianOration, the text of the oration being "John Hunter con-sidered as a Great Surgeon." A very full abstract of thelecture appeared in THE LANCET of Feb. 20th, 1897,and in the same year he had the honour of deliveringthe second course of the Lane Medical Lectures which hadrecently been founded in connexion with the Cooper MedicalCollege in San Francisco. To quote the words of Dr.Cooper Lane, the President of the College, "this coursewas addressed especially to the students of that school butwas also attended by some hundreds of medical men

of the Pacific coast ; the attention of the audience tothe teachings of this eminent English surgeon was markedly