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The Treatment of Elephantiasis by the x Rays. On Feb. 14th M. Mascart showed to the Academy of k

Sciences, on behalf of Dr. Sorel and Professor Soret, ofHavre, a series of photographs of the hand of a patient who had been suffering from the disfiguring affection known as relephantiasis. This patient had got well solely by the use of

1

the x rays. This result had been obtained after three ‘

sittings of a few minutes’ duration. Upon the application of the President the clinical history and notes of the case were iremitted for consideration to the Section of Medicine.

Influenza in Paris. c

The statistics for the week ending Feb. 13th show that there were 50 deaths from influenza out of a total of 1220.In the preceding week the mortality attributed to influenzawas 36. These figures, however, must not be taken asshowing an increase in the epidemic, for the total numberof deaths is almost the same in both weeks-namely, 1114and 1220. The mortality from respiratory affections was220 last week and 260 in the week preceding. A number of medical men are wont nowadays to attribute to influenzadeaths which they would formerly have ascribed to acute ’ bronchitis or pneumonia-a fact which is quite sufficientto explain the rise in influenza mortality. For a justestimate of the value of these figures it is quite sufficientto remember that at the height of the epidemic in 1890-when the total weekly mortality was 2334-the municipalstatistics only gave 22 deaths as due to influenza, so thatjudging by the figures the present epidemic of influenza istwice as serious as that of 1890.

Feb. 16th. _______________

ROME.(FROM OUR OWN CORRESPONDENT.)

A Noble Initiative.FEw contemporary Italians have deserved better at the

hands of nature students than Pietro Blaserna, Professor ofExperimental Physics in the Roman University and author(inter alia) of masterly treatises on the conservation offorce, on the development and duration of induced currents,and on the theory of sound in its relations with music. Hehas just laid the scientific cause in Italy under yet anotherobligation the extent and import of which will be apparentto all who know how that cause languishes for wantof means. Attached to nearly all the Italian universitiesare "istituti" supplementary to the regular "faculties,"and these, naturally enough, are most numerous in the

sphere of inductive research and experimental study. Mostof the " istituti referred to have " gabinetti (cabinets)or " musei" connected with them for illustrative or

practical purposes ; but, like nearly everything educationalin Italy, they are miserably endowed, lamentably short ofmateriel, and quite behindhand in their representation ofcontemporary science. One chief cause of this disastrousstate of things (always excepting the drain on the revenuefor military and naval purposes) is the multitude ofuniversities in the kingdom and the impossibility of

equipping all of them adequately. There are no fewer thannineteen such "seats of learning " in Italy and no

Minister of Public Instruction has yet been influential enoughto reduce their number by half and make the survivors reallyworthy of the name—"almae matres," or nursing mothersof the professions. The truth is the provincial, not to

say parochial, spirit still dominates the peninsula andislands ; still forces the king, for example, to keep on hisfar too heavy civil list the royal, archducal, or simply ducalresidences, many of which he has never seen, and still main-tains universities which have long survived all usefulness butthat of providing for a multitude of local hangers-on. " Inthese circumstances," says Professor Blaserna, "it is idleto hope for a speedy improvement," and -so on his ownaccount he has started a series of lectures from Feb. 16th toApril 6th on his favourite subject (the theory of sound in itsrelations with music) and will devote the fees paid for admis-sion to augmenting the Government pittance vouchsafed forthe "Istituto Fisico" of which he is the director. This

private initiative is quite unprecedented in Italy. Bursariesor scholarships, it is true, are not unfrequently founded byenlightened testators ; but excepting here and there asavant who has bequeathed his private museum or libraryi donatori ad istituti scientinci non sono mai esistiti" (the

endowers of scientific institutes have never existed). It ishoped that the truly philanthropic step taken by ProfessorBlaserna will shame some of Italy’s millionaires into pro.viding adequately for their country’s studious youth; andmeanwhile I hear of more than one attractive holder of alecturership or university chair expressing his willingness oractual intention to give popular or supplementary coursesand from the fees thus earned to reinforce the all too scantyGovernment allowance in aid of his special subject. Italyit is felt has looked too long and too exclusively to theGovernment Hercules to lift her out of the rut and "put heron rails" and ought now to try what can be done in the wayof " ’self-help" on the lines so nobly initiated by ProfessorBlaserna.

The English speaking Practitiener in Italy and theIncome-tax.

Your compatriots in medical practice throughout Italyhave not yet recovered from their astonishment at SignorSantini’s declaration on the 2nd inst. in the Chamber ofDeputies that " non pagano la imposta di ricchezza, mobile "

(they don’t pay income-tax)-the fact being, as stated inmy last letter, that they pay an inordinately heavy income-tax on a total of annual receipts arbitrarily fixed by theRicchtzza Mobile Office, fixed, that is to say, at a figuregenerally far above what the leading Italian consultants inthe kingdom are assessed at. I may incidentally explainthat the said "imposta di ricchezza mobile" (income-tax) is,like well-nigh all Italian institutions, fiscal and other,farmed out, therein perpetuating one of the worst traditionsof the Roman Empire. The’Government receive the moneyfrom the " publicani " to whom they concede its collection,and the" publicani" recoup themselves by what theycan collect over and above the sum estimated bythe Government as approximately due. More lucra-tive returns to the Italian treasury than those yieldedby English-speaking practitioners are not derived from anyother professional class, native or foreign. Yet thisarbitrary fixing of amount of income and the heavy exactionsmade on the strength of it are borne by these practitionerswithout a murmur, which probably explains Signor Santini’sastounding inference that they are not taxed at all! Verydifferent is the conduct of his own compatriots underthe same fiscal regim]e. Let me cite one instance, andthat one an "instantia pimrogativa," as Bacon calls it.Readers of THE LANCET, or indeed the medical world,"ubique gentium," still remember the admirable paper in

your columns on "Cavernous Angioma of the Cheek, itsSurgical Cure." 2 Its author, Professor E. Bottini, lectureron Operative Surgery in the University of Pavia, has longbeen one of the leading consultants in Italy and as suchmarked out as "fair game " by the "publicani " above re-ferred to. Time after time Professor Bottini has protestedagainst the arbitrary estimate formed of his income and thetax correspondingly levied by these exactors. He has evenchanged his residence from one part of the kingdom toanother in order to escape persecution. And now I read inthe public prints the following "dichiarazione" (declara-tion) issued above his signature :-

DICHIARAZIONE.

Colpito da un reddito di ricchezza mobile che reputo esorbitante,e non avendo uiteriore mezzo di difesa dichiaro : di rinunciare intiera.-mente all’esercizio professionale privato.

In fede,Sanremo, 9 febbraio, 1898. Prof. ENRICO BOTTINI.

(Struck by a return for income tax which I held exorbitant, andhaving no farther means of defence, I declare that I renounce entirelythe private exercise of my profession.

In faith.San Remo, 9th Feb., 1898.) Prof. EXRICO BOTTINI.

Professor Bottini dates from the Italo-French frontier-froma health-resort on the Riviera Ponente, where he maycommand a non-Italian elientele, while during the summerhe may continue his clinical prmlections. In this way hemay earn sufficient income, relieved in great part from fiscalexactions, and at the same time keep in touch with his AlmaMater. He will not be the first of Italian consultants whohave had to defeat what they consider an unjust tax. Butthe Ricchezza Mobile Office, amid so much recalcitrancy onthe part of its compatriots, can look, I repeat, with littlefavour on Signor Santini and his Bill, which would excludefrom Italv the English-speaking medical man. who pa’Vs

LANCET, Feb. 12th, 1898, p. 473.THE LANCET, Sept. 20th, 1890, pp. 612-14.

545

without protest a disproportionately heavy income-tax and b,who only asks in return to be allowed to practise his pro- lifession without let or hindrance.

Feb. 13th. ptl

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

Crentation in Austria

ABOUT a year ago the Vienna Medical Society appointed acommittee to consider the question of the introduction of Ecremation into Austria, Professor Hofmann and Professor Gruber being the reporters. At the last meeting of the 1society Professor Hofmann’s report was read by ProfessorMautbner. It was to the effect that inhumation is attended by a great many disadvantages and that crema- tion is to be preferred on hygienic grounds. Decomposi-tion may, however, be accelerated by avoiding metal coffinsand by not making the graves too deep. In selectingplaces for burial grounds the nature of the soil should betaken into consideration. With respect to the aestheticaspect of the subject Professor Hofmann believed thatthere was a disagreeable episode at the onset of a

cremation when the skin gave way and the fat becamestrongly heated. Cremation has the advantage of pre-venting misapplications of dead bodies or portions ofthem, such as the superstitious use of the fat formaking ointments or the turning of the bones to com- mercial account. Proceeding to the medico-legal side f

of the question Professor Hofmann said that exhumation lby order of a magistrate is of infrequent occurrence and 1takes places orly when poisoning is suspected; he denied that poisons are undiscoverable after a short time and he stated that he had succeeded in recognising ,cyanide of potassium four months after death in a body lwhich was very much decomposed. He believed that it iwould be impossible to make cremation compulsory, but he approved of its being made optional.when there was no doubt as to the cause of death or when a pathological or chemical examination of the body had been made. Professor Gruber, the second reporter, said that the treat- 4

ment of bodies in a crematorium is quite unobjectionable.He refuted the bacteriological arguments which have been ]advanced against burial by proving that a great many infec- tious germs perish quickly after bodies have been interred. Professor Mauthner proposed the following resolution, which was unanimously adopted: "There are no objectionable features in the cremation of bodies in a modern crematorium, but inhumation is not attended with such disadvantages that cremation is to be regarded as a necessary hygienic reform. Compulsory cremation would present many difficulties andwould, moreover, be inadvisable for medico-legal reasons,but there can be no reason for opposing optional cremation 1after a careful examination of the body."

Cerebral Pressure.In a pamphlet on the above subject Professor Adamkiewicz

has argued, contrary to the views of Professor von Bergmann and other investigators, that living nerve substance may be compressed without injury to its function and that the normal tension of the cerebro-spinal fluid can neversurpass physiological limits. At least, a pressure actingon the surface of the living brain does not contractthe capillary vessels but causes their dilatation. The source of the cerebro-spinal fluid is the arterial bloodand the source of its pressure must be the pressure inthe capillary vessels where it is secreted. Nothing elsethan obstruction to the return of venous blood fromthe head and general congestion of the venous systemcan increase the tension of the cerebro-spinal fluid. The cir-culation in the veins controls the cerebro-spinal fluid andthere is a free communication between the cavities contain-ing the fluid and the venous blood in the head. The injectionof fluid into the cranial cavity could not increase thepressure in the veins of the neck, even if it had to do withthin-walled veins, for such veins are compressed and closedby external pressure and the result would be that the pressurein the veins of the neck would fall. But if the increasedpressure of the injection was to increase the pressure ofblood in the veins of the head the emissory veins which arenot closed by any external pressure would suffice to carry offthe extra blood. Indeed, it is possible to inject the cranial

bones from the subdural space by means of a colouredliquid. The venous flow in the veins of the bone has asuction action during inspiration on the fluid in the lym-phatic spaces surrounding it. Merely increasing pressure inthe cerebro-spinal fluid cannot have any general effect onthe cerebral pressure.

University Intelligence.By order of the Minister for Public Instruction the winter

half-year, which ought to end in Easter week, was closed onFeb. 7th in consequence of the riots that have taken placeboth in the aula and the class-rooms of the University.When the Government prohibited the display of colouredemblems (the so-called Farbenverbot) at the University ofPrague, in which city there had been many conflictsbetween the German and the Slav population, the Germanstudents in Vienna, following the example of those in Prague,refused to attend any classes.Feb. 14th.

AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.)

Annual Meeting of the Victorian Branch of the Bg-iti8kMedical Association.

AT the annual meeting of the Victorian Branch of theBritish Medical Association the following office-bearers wereelected for the ensuing year :-President: Dr. R. L.McAdam. Vice-President : Dr. A. L. Kenny. Hon.treasurer: Dr. J. R. M. Thomson. Hon. librarian: Dr. F.Meyer. Hon. secretary: Dr. W. Kent Hughes. Editor:Dr. J. W. Springthorpe. Members of council: Dr. A. V. M.Anderson, Dr. F. D. Bird, Mr. F. M. Harricks, Dr. H. F.Lawrence, Dr. M. U. O’Sullivan, Dr. W. Snowball, Dr. R. R.Stawell, Mr. R. A. Stirling, and Dr. G. A. Syme. In hisaddress the retiring President, Dr. R. A. Stirling, commentedon the present conditions in the profession. The subject ofthe hour was serum-therapy, in respect of which Australia waslagging behind other countries. He strongly advocated theestablishment of an institute of preventive medicine inMelbourne which would secure to the profession and theirpatients a proper supply of the various antitoxins and otherantidotes to bacterial disease. To in some degree check thespread of tuberculous disease the localisation of cases byregistration ought to be ensured and the establishment ofspecial hospitals for. all tuberculous ailments must be one ofthe works of the immediate future. Reference was made tothe use of escharotics by quacks for cancer. The operation ofstraightening the deformity of Pott’s disease of the spine,advocated by Dr. Chipault and Dr. Calot, was discussed anda case quoted in which it had been successfully undertakenby the speaker.

Case of Hydatid of the Brain.In the December number of the Inter-colonial Medical

Journal Dr. J. A. Hawkes records an interesting case ofoperation on a hydatid of the brain which unfortunatelyended fatally as most of the cases so far operated on havedone. The patient, a girl aged five years, had complained ofheadache for some months; in April she had vomiting and inMay she had twitching of the face, extending in July to theright hand. She had never had convulsive attacks. Whenseen she had paresis of the right side of the face. The tonguewas pushed to the right. The reflexes were exaggerated andthere was cutaneous hyperseathesia; the pupils were

normal and also the special senses. On moving theright arm or when excited she had large, jerky tremors init. The right leg was rigidly extended. The symptomsvaried a good deal in intensity. The skull was trephined overthe left Rolandic area over the arm centre and the hydatiddiscovered and removed, ten ounces of fluid being evacuated.A small drainage-tube was introduced and the bone replaced.The patient did well for three days when the temperaturesuddenly rose to 104° F. and she died with marked signs ofcerebral irritation. Post mortem it was found that the cavity,in which the cyst had been, opened into the lateral ventricleand there were no evidences of inflammation. Dr. Hawkes

suggests that the sudden relief of the tension affects thecerebral circulation in these cases and that it might be wellnot to drain but to completely close the wound.

Jan. 8th.