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and its cessation at night. It is generally limited to theforehead, rarely to the vertex, occiput, or temples. It

generally survives any coincident disorder of the primse visethat may exist, and is distinct from the persistent headacheof neurasthenia, which, however, it resembles in its resistanceto ordinary remedies. M. Galliard claims to have success-fully treated a certain number of these cases by the exhibi-tion at early morning before breakfast of 10 centigrammes ofcalomel for six consecutive days. On the third or fourthday diarrhoea sets in with some colicky pains. The gumsare carefully watched. The headache generally disappears,but should it persist a similar six days course is resumedafter the lapse of a few weeks.

Gynæcology at the Academy of Medicine.Dr. Pozzi, the well-known gynaecologist, has just been

elected a member of the Academy of Medicine. The newacademician has rendered yeoman service in his speciality,which, strange to say, is not officially recognised by thisFaculty, being merged in general surgery. It is certainlysurprising that in the entire programme of lecturesdelivered at the Faculty no mention is made of the diseasesof women. And this with a formidable body of 5000students to teach ! By the foundation of the Hopital Pascal.and his teachings during the last twenty years Dr. Pozzi hasrendered incalculable service to the cause of medical educa-tion in Paris. When the authorities rouse themselves fromtheir torpor we shall doubtless see Dr. Pozzi appointed tothe new chair of gynaecology.March 3rd.

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VIENNA.(FROM OUR OWN CORRESPONDENT.)

The Ireatnient of Uterine Carcinonaa.IN the course of a discussion on the treatment of uterine

carcinoma at a meeting of the Budapest Medical Society, Dr.Backer pointed out that among 11,095 female patients whohad been under his care 705 suffered from this disease, thesecases being 6’35 per cent. of the total. There is no causalrelation between it and delivery, for in 85 per cent. of thecases three years intervened between delivery and the out-break of the disease. Moreover, a carcinomatous uterusshows symptoms of endometritis and the disease is developedin those situations where endometritis commonly occurs. He,therefore, agreed with the opinion of those writers who holdthat endometritis predisposes to uterine carcinoma and advo-cate a radical treatment of the former condition. Extirpa-tion is to be resorted to as soon as the diagnosis is clear.Supra-vaginal amputation, which has been proposed for carci-noma of the vaginal portion, is unsatisfactory becausethe end of the stump becomes strictured and theremay also remain some carcinomatous particles after theoperation. Extirpation by the sacral method is to be per-formed only in those cases where the cervix is already somuch thinned that it breaks down in the course of vaginalextirpation. Vaginal extirpation has been performed in 70cases with a death-rate of 11’6 per cent., and in 33 per cent.there was no relapse during three years. Professor Tauffersaid that the relation between endometritis and uterinecarcinoma had by no means been proved; he recom-

mended Pean-Segond’s method. Professor Elischer believedthat his histological investigations showed endometritis tobe a secondary process. He removed tumours the size of achild’s head per vaginam, but only in the case of a freelymovable uterus. In three cases of radical operation he had obtained gratifying results, one patient having already passed twelve years without a relapse.

" Thyreoiodin."Dr. Toepfer has published some experiments on "thyreo-

jodin," a substance isolated some weeks ago by ProfessorBaumann, who has made the important discovery that iodineis a normal constituent of the thyroid gland in the sheep."Thyreoiodin" contains 9-3 per cent. of iodine, and isprepared by boiling the gland with 10 per cent. of sulphuricacid and extracting with alcohol. It possesses not only thesame physiological effect as thyroid extract, but also asthe whole gland, and it becomes inert when the iodine isremoved from it. In 30 grammes of sheep’s thyroid glandthere was 0’009 gramme of iodine.

Prague General Hospital.’

According to published statements by Dr. Grossmann

overcrowding prevails to a shocking extent in the PragueGeneral Hospital, which at present contains 1418 patients,although there are only 1186 beds, 82 of which are reservedfor infectious diseases. The number of annual admissionshas increased from 9871 in the year 1870 to 13,169 in 1885and to 18,195 in 1895. Patients sometimes have to lie onthe floor in rooms without means of ventilation, the heatingarrangements are inadequate, and the beds are swarmingwith vermin. Eight persons sleep in rooms which are barelylarge enough for four, the work of the nurses is inefficientlyperformed, and the poorer class of patients suffer under theprevalent system of gratuities to officials. The medical staffattend gratuitously for three years ; they are then appointedat a permanent salary of .B35, and have to be on duty fortwenty-four hours every third day. The University of

Prague, which was founded in 1348, numbers among itsprofessors some of the foremost teachers in Austria, and it issurprising that such abuses should have existed so long in ahospital where the medical staff stand high in professionaland general estimation. The Government have instructedHerr Wolf, a sanitary expert, to take measures for themitigation of the present intolerable state of affairs.

Acetonuria and Mental Disorder.

Professor Wagner, Dean of the Vienna School of Medicine,in the course of a paper on Gastro-intestinal Derangementand Mental Disorder read at a meeting of the MedicalSociety, said that acute disease of the brain is not uncommonas a sequel of febrile illnesses, and that a similar relation-ship exists between infectious diseases and polyneuritis, forpolyneuritis may be caused not only by toxic agents, suchas alcohol or lead, but by specific infectious diseases, such asenteric fever or pneumonia, and by impairment of the gastricfunctions. On the supposition, however, that infectious diseasesare not due directly to the specific micro-organisms but to thetoxines elaborated by them, all these causes may be regardedas toxic in their nature. There are also forms of mentaldisorder due to the results of perverted gastro-intestinalaction, the most remarkable of these being acetonuria, whichwas first described by von Jaksch. Acetone, no doubt, origin-ates in abnormalities of the gastro-intestinal function, andacetonuria is a result of perverted metabolism, which maylead to the formation of toxines capable of producing seriousmental disturbance, amentia being the most usual symptom,In these cases Professor Wagner has tried iodoform in dailydoses of one gramme divided into ten parts, each of which,therefore, contains about two grains. Acetonuria is, in hisopinion, due either to micro-organisms or to fermentativeprocesses in the intestine, and as the mental condition of thepatients improves concurrently with the disappearance of theacetonuria he suggested that disinfection of the gastro-intestinal tract would probably be useful in these cases.March lst.

PHILADELPHIA.

(FROM OUR OWN CORRESPONDENT.)

-Report of the Board of Health.

, THE report of the board of health for the year 1895 showsthe health of this city to have been unusually good duringthe year. Based on a population of 1,163,864, the mortalitywas 18’79 per 1000, less than any year for fifteen years except1888, 1889, and 1894. Several factors contributed to thisresult-viz., the introduction of impervious and Belgiumblock paving, the abolishment of cesspools, a more vigorousenforcement of the Notification Act and house-to-houseinspection, supplemented by police surveillance of infectedhouses. Among children under five years of age there were8401 deaths, which is 35’30 per cent. of the total mortality.There were 30,354 births. An interesting fact is noted in thereport of the city bacteriologist, Dr. D. Meade Bolton, and thatis, that peroxide of hydrogen seems to prolong the durationof diphtheria. In 80 cases in the Municipal Hospital, inwhich peroxide was used locally, the average duration of thecases was 35’9 days, while of those cases in the same institu-tion in which no peroxide was employed the average durationwas only 32.3 days. Thirty-two cases occurring in privatepractice and treated with the same drug had an averageduration of 25’8 days, and cases not so treated 23-6 days. In10 cases where bichloride of mercury was used the averageduration was 19-9 days. Dr. Welch, of the Municipal

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Hospital, reports 302 cases of diphtheria treated with anti-toxin with a mortality of 28’14 per cent., while among thosenot receiving the antitoxin the mortality was 25’99 per cent.In the former group the injection was not made until thefourth or fifth day, and very often later in the course of thedisease. This renders the report of little comparative valuetherefore.

The Unemployed.The question, What shall be done with the poor ? is a

serious one indeed. Presidential year is usually depressing tobusiness, an undercurrent of distrust and uneasiness generallyprevailing. This, coupled with the financial depression of thepast two years, has served to swell the army of the unemployed.Mayor Piugree of Detroit some time ago proposed that the poor should be permitted to raise potatoes on vacant cityproperty. The idea was favourably received and successfullyput in operation in Detroit and later in New York, as thefollowing report, issued by the Detroit committee andendorsed by that of New York testifies: "The experimenthas clearly demonstrated that many of the destitute areready and willing to work; that a large number of thesepeople can be supported by utilising vacant land in the out-skirts of the city; that trespassing even upon unfenced landsis not a serious difficulty ; that a small space of ground issufficient to raise enough vegetables to support a familythrough the winter ; that a majority of the citizens who ownthe vacant land would rather allow it to be cultivated by thepoor than pay a large tax for their support ; that the needyare thereby assisted without creating the demoralisation inthe habits of the people that gratuitous aid entails ; andthat much relief and real help may by this plan be affordedwith small expense by charitable persons to taxpayers."The plan has proved so eminently successful that I think itis probably safe to predict it will be in operation in manycities before long.

The William Pep_per Laboratory of Clinical Medicine.The above laboratory recently presented to the University

of Pennsylvania by Dr. Pepper in memory of his father, thelate Dr. William Pepper, is a substantial four-storey building,containing chemical and bacteriological laboratories, rooms foithe pursuit of anthropometrical studies and the study of bloocpressure, respiration, &.c. It offers exceptional facilities foi

original investigation, post-graduates only being accordecthe privileges of the institution.

Feb. 16th. ________________

Obituary.THOMAS WILLIAM THOMPSON, M.R.C.S. ENG.,

L.R.C.P. EDIN., D.P.H.,MEDICAL INSPECTOR OF THE LOCAL GOVERNMENT BOARD.

BY the early and sudden death of Mr. T. W. Thompson theMedical Department of the Local Government Board hassustained a very severe loss. Mr. Thompson was endowedwith intellectual attributes of no mean order ; his mental

processes were of a highly philosophical and deeply reflectivetype, while his modest, sympathetic nature and courteousmanner lent to his handsome, soldierly presence peculiarcharm. To paint a faithful picture of a nature such as hisis no easy task. Mr. Thompson received his professionaleducation at University College Hospital, London, and afterholding residential appointments at other hospitals he joinedthe Army Medical Department and proceeded to the MadrasPresidency, where he served with the Royal Horse Artillery.His sojourn in India was, however, but of short duration, asit severe attack of enteric fever, from which he barelyescaped with his life, rendered his return to England anecessity. On his recovery he was successful in obtainingthe post of surgeon to the 1st Life Guards, which he heldfor some six years, at the end of which time he resigned hisposition in the army and, marrying, entered private practice.During these years Mr. Thompson kept up his medical andscientific reading, while his love of the more speculativephilosophy had already commenced to manifest itself.Although in private practice Mr. Thompson was eminently

successful, not a few of the social duties entailed uponhim by it were somewhat alien to his mental habit ; and,longing for work of a more definitely scientific character, hetook the Diploma of Public Health and obtained the medicalofficership to the Herts and Middlesex combined sanitary

districts. It was very shortly after entering the public healthservice that Mr. Thompson’s great ability, administrativeand scientific, began more especially to manifest itself, andit was not long before the Local Government Board recognisedin him an epidemiologist of no common type, while a

paper upon a scientific subject which he had contributed toTHE LANCET showed that he excelled in clearness of exposi-tion and method of treatment. In the winter of 1890 thelamented death of Dr. David Page of the Local GovernmentBoard created a vacancy in the department, and the Boardwere fortunate enough to obtain in the spring of the sameyear the services of Mr. Thompson..Of his work under the Local Government Board it must

suffice here to remark that everything he did and wrote wasup to the very highest standard of the medical department,and that there pervaded it all that same scientific andtruth-seeking spirit which characterised his life. ProbablyMr. Thompson’s best known work-apart from his valuablereports to the Local Government Board-was the article hecontributed on the" Natural History of Infectious Diseases "to Stevenson and Murphy’s Standard Treatise on Hygieneand Public Health. In the introduction to that article Mr.Thompson established a very high reputation. He dealt inthe most lucid and facile manner with the problems ofinfectious disease as viewed from the standpoint of organicevolution, discussing, on the one hand, the de novo andimmutable stability hypotheses of infectious disease, and onthe other the thesis of relative stability. He pointed outhow in a certain sense at least there might be in some degreereconciliation between these apparently conflicting doctrines.Perhaps we cannot do better than repeat here what was saidin our columns 2 during Mr. Thompson’s lifetime of the articleto which we are referring : " It is no light tribute to Mr.

Thompson’s monograph to say that he has succeeded betterthan any other writer with whose work we are acquaintedin the English language in conveying a faithful picture ofwhat is known of the epidemiology of each of the principaldiseases of which he treats."

In spite of his high intellectual attainments Mr.

Thompson was of the most modest disposition, and it waswith great difficulty that he was prevailed upon to reada paper before the Epidemiological Society of London inNovember last. That paper, Considerations in Respect toI I Return " Cases of Scarlet Fever, was much appreciated bythose who heard it, and we reproduced it in full in ourcolumns in the following week.3 The author during certaininquiries into this subject had been impressed with the factthat, although at times these so-called " return" cases maybe due to maladministration on the part either of the hos-pital or of the sanitary authorities, that neither the one nor theother of these occasional causes suffices to explain all theobserved facts, and that ’’ there are in all probability somemore obscure factors at work, factors perhaps closely boundup with the natural history of scarlet fever." Thus much ofMr. Thompson’s professional life.

Of that form of ambition which tempts some to hustle intheir search for notoriety even their friends and colleagues,Mr. Thompson was absolutely devoid. His one aim seemedto be to do his work to the utmost of his ability, and to beable if possible to keep in touch with modern science andphilosophy. Unfortunately, however, for what he wouldhave termed his intellectual recreation, his official dutieswere a matter of such conscientious concern to him that hiswork in this direction occupied almost his whole energies.It was doubtless for this reason that, although when he diedhe was but forty-four, he was fond of looking forward whenhis official years were over to retirement into absolute

simplicity of life, where, surrounded by his books and, if

possible, within reach of those of his friends who might beleft to him, he could enjoy to the full his well-earnedrepose. Death found Mr. Thompson actually engagedin an important sanitary survey in South Wales. His wife,his constant companion in all his pursuits, was with himat the time when he expired after a few hours’ illness onFeb. 25th. At his funeral, which took place at NorthMimms in Hertfordshire, there were indications from every

; quarter of the deep respect and affection in which he washeld, and amidst the numerous and beautiful wreaths was

. one inscribed, "A token of the affectionate regard and thedeep esteem of his colleagues in the Medical Department ofthe Local Government Board." In conclusion it can only

1 THE LANCET, April 25th, 1885.2 THE LANCET, March 24th, 1894.3 THE LANCET, Nov. 23rd, 1895.