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SCOTLAND.(FROM OUR OWN CORRESPONDENTS.)

Hospital Treatment of Mental Affections.Mr. John Carswell, who is certifying medical officer in

lunacy cases for the Glasgow parish council, has been

pointing out that with respect to applications made to theinspector of poor on behalf of persons supposed to be insanea sorting-out process is necessary in the interests both of thepublic and of the patients. This can only be done by twomethods: first, by a careful medical examination cf eachcase ; and, secondly, by provision of a special hospital forthe care of the early and transient mental cases. Theremust necessarily be a considerable proportion of cases

presenting mental symptoms which do not require asylumcare. He strongly objects to the term "observation wards" as applied to mental hospitals. It leads to the idea that

patients are sent there for the purpose of diagnosis,which is not the case. The diagnosis has to be made, if

possible, before the patient arrives there. In the GlasgowHospital the period of residence is limited to six weeks, atthe end of which time the patient must be discharged or becertified for the asylum, boarded out, or otherwise disposedof under the lunacy statutes. The patient has perfectfreedom of action and there is no power of detention. Thehospital is in the midst of a busy district but that causes nodifficulty as regards the efficient care and medical treatmentof the patients and a certain amount of open-air exercisecan be secured. Moreover, the wards are well ventilatedand have abundance of light. The average periodof residence is about four weeks. Out of 1027 cases

reported to the inspector of poor as lunatics 449 werecertified insane and were removed directly to the asylum.Of those treated in the mental hospital there were after-wards certified insane and removed to an asylum 134.There were treated in the hospital in addition to thoseenumerated as having been transferred to the asylum338. Of these, 213 were discharged recovered, 95 were dis-charged relieved-i.e., sufficiently well to be sent home orso far recovered from the mental condition as to be cared forin the ordinary wards of a hospital-and 30 had died. Therewere otherwise disposed of as not certifiable, treated athome, &c., 76. The general result is that of 1027 cases 583were removed to asylums and 414 were disposed of withoutrecourse to asylum care. The figures seem to justify thegeneral proposition that in a population such as that ofGlasgow there is a considerable number of patients who aresuitable for treatment in a mental hospital and who couldtherefore be spared the stigma of being sent to an asylum.

Munificent Gift to Glasgow.Glasgow has profited much by the gifts of many of her

public-spirited citizens and the last possession which she hasacquired in that way is by no means her least valuable one.Mr. A. Cameron Corbett, M.P., has notified the Lord Provostthat he has agreed to purchase a part of Ardkingloss estatewith a view to handing it over to the corporation ot Glasgow.The extent of the land in question is 9000 acres and theestate is most exquisitely situated between Loch Long andLoch Goil. As Mr. Corbett says in his letter, his objectis "to preserve a grand and rugged region for the best useof those who love the freedom of the mountains and wildnatural beauty." In the deed of conveyance a clause is in-serted prohibiting the sale of alcoholic liquor and Mr. Corbettsuggests that nothing should be done which would mar thenaturalness of such scenery. Such a gift is unique andit seems almost unnecessary to descant upon the generositywhich prompted it. The corporation has not yet seriouslyapproached the problem of what to do with its newestate but the suggestions put forward by correspondentsin the newspapers are legion. Glasgow has hitherto donewell in its efforts to provide facilities for those of its citizenswho suffer from pulmonary tuberculosis. The work carriedon at Bellefield Sanatorium has been largely successfulbut unfortunately the accommodation there is limitedand many patients suitable for treatment are constantlywaiting for admission. That this should be so is distinctlyunfortunate in the case of a disease in which it is

recognised that to obtain the most successful results treat-ment should be commenced as soon as the disease makesitself manifest. It has been suggested for some time that itwould be an advantage to establish a subsidiary sanatoriumin the form of a consumptive camp, but one of the difficulties

has been to secuie a suitable site for such an enterprise.Surely in this large tract of land so generously placed in thehands of the corporation a nook will be found suitable forthe establishment of such an institution in a situation whereits presence will not interfere with any other plans whichmay be carried out in order to enable the citizens to take thebest advantage of their new possession." Tuberculosis and a S’imple Life " : Leeture by Sir James

Grant.

Sir James Grant, M.D., ex-President of the CanadianAssociation for the Prevention of Tuberculosis, delivered avery interesting lecture in the Young Men’s Christian Associa-tion Hall, Aberdeen, on August 10th on Tuberculosis and aSimple Life. Dr. J. C. Ogilvie Will presided over a largeattendance. Sir James Grant said he was not there as aforeigner but as a Scotchman born and educated in thatcountry. He had merely come from Canada, endorsed byLord Strathcona, to offer a few observations upon tuber-culosis and a simple life, to compare notes with the lead-ing authorities in this country, and to see what could beaccomplished by exchange of ideas on those p,ints. Afterreferring to the work of the Canadian Association for thePrevention of Tuberculosis, he said that in mastering orcontrolling this disease it was absolutely necessary that thereshould be thorough organisation. Three specific objectswere : first, educational ; second, preventive ; and third,curative. In an educational way a great work was beingdone by lectures. Then the dissemination of literature was

giving people information. With regard to preventivemeasures, a by-law had been recently passed in Ottawa

making it an act for which an individual would be punished-in fact he might be put in prison-if found expectorating inthe streets, or on the railways, or in the churches. As

regarded curative measures, he said if there was any subjectthat concerned the welfare of the community it was thismatter of the treatment of tuberculosis. They knew per-fectly well that sanatoriums were being discussed and erectedalmost all over the world at the present time. He did notapprove of large sanatoriums. Was it to be supposed for onemoment that a large number of people huddled together hadthe same prospect of recovery as by the modern treatmentwhich was going on to-day in the tent and the home ? 2 Ifanyone in the country developed this disease all he had todo was to put up a small tent, fit it up with a bed, a stove,and culinary apparatus, and get the fresh air and. modernattention. The house where a consumptive case had beenought to be purified thoroughly and when there was a con-sumptive patient in the house the health authorities shouldbe notified. He thought a proprietor should be fined if heallowed a second inmate into a house where a consumptivehad resided until it was purified thoroughly. The reason

why so many took the disease was that their vitality waslowered. If the simpler life was not followed there wasdanger of a lowered vitality and there would be promoted veryreadily that condition of the system which would enable thebacillus to settle down and generate tuberculosis. He believedthat all schools should be examined by medical experts.The whole question of the treatment of this disease requiredto be taken into serious consideration by the authorities.Dealing with the question of food and alcohol, he said asregarded food that there was no substance in the whole listof articles of diet that could surpass oatmeal. With refer-ence to the drink problem he was pleased to know that atthe present time a marvellous change had been comingover the minds of the people of the world in regard tothis extremely important subject. The subject had beencarefully, sol:dly, and substantially investigated. Everyday it was growing more popular not to use alcoholic liquors.The lecturer then referred to an interesting visit which hepaid to Balmoral and said that he had been thoroughly im-pressed with the remarkable evidence in all the surroundingsof Balmoral of a simple life that contributed in no smalldegree to lengthen the years which enabled Her Majesty thelate Queen Victoria, as woman and sovereign, to influencefor good all movements of her time, as if by a uniquemagnetic power, transmitted to all parts of her empire,throughout which " she made herself understood, beloved,and revered." Dr. Ogilvie Will moved a vote of thanksto Sir James Grant for his excellent address. The subjectwas one of extreme interest to everyone, to the highestas well as to the lowest in the land. King Edwardhimself had initiated a home for the treatment of con-

sumption. A great deal had been said as to the estab-lishment of homes for the treatment of tuberculosis amongst

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the working people. He had always had his doubts as tothe expediency of this being carried out on account ofthe great expense and the impossibility of treating any largenumber. He did not think that it had been yet provedthat sanatorium treatment was the best possible methodand he was not sure that Sir James Grant was not

advocating the right thing when he suggested treatment ofa simple character. He had had reason to raise his voice

against that disgusting habit of spitting which went on solargely in Aberdeen. One point was known as the "spittingcorner "-beside the Queen’s statue-where the loafersseemed to have nothing else to do but to amuse themselvesby expectorating. He was glad to see that in the tramwaycars there were notices requesting people not to indulge inthis filthy habit. He was sorry to say, however, that the rulewas not always observed and when on several occasions hefound fault with people they seemed to think that he wastaking a great liberty indeed.August 15th.

IRELAND.(FROM OUR OWN CORRESPONDENTS.)

The Death of Mr. John Auterson, L.R.C.P. Edin.AT an inquest held on August 8th in Cookstown in

reference to the sad death by accident of Mr. JohnAuterson, who had for many years been a practitionerin that town, evidence was given as to the unprotected con-dition of the road over which he with his vehicle and horse were projected 15 feet. One witness said that the road lwas unprotected for a long distance in both county Tyroneand in county Derry and was very dangerous. Severalaccidents have occurred in a similar way on the road, someof them, as a witness testified, resulting fatally. Mr. R.Burgess, J.P., who attended the deceased, said that theroad was a disgrace to modern civilisation. The juryreturned a verdict in accordance with the medical evidence

(shock to the sympathetic system followed by peritonitis),adding a rider in which they drew attention to the

dangerous state of this road -which is the leading highwayfrom Coagh to Cookstown and on which there is great traffic.The coroner is sending copies of the verdict and rider to thecounty officials of Derry and Tyrone and to the rural andcounty councillors concerned. The coroner, the medical wit-ness, and the jury having expressed their sincere sympathywith the friends of the late Mr. Auterson, a brother-in-lawof the deceased feelingly replied.

Typhus Fever in Donegal.An alarming outbreak of typhus fever has occurred in

Innishowen, a district of co. Donegal. It is believed that thecontagion was brought into the country in second-handclothes, packed in Glasgow and sold at local fairs. Ninefamilies in Effeshmore, a mountainous district in Clonmanyparish, have been attacked and already there has been onedeath. Dr. B. MacCarthy (medical inspector of the LocalGovernment Board) and the district medical officers aremaking every effort to stamp out the epidemic. The"contacts" have all been isolated.

A Medical Officer’s Boliday.A curious situation has arisen in Lurgan. It appears

that Mr. Hugh Reid, dispensary medical officer of LurganNo. 2 district, had been granted by the guardians a

month’s leave of absence on the condition that his substitutewould accept 3 guineas weekly, but as he has been unable tofind any local locum-tenent who will act at this figure, thechairman announced that if Mr. Reid could find no medicalman to act for him at 3 guineas per week he must dowithout his holiday.

Smiley Cottage Hospital, Larne.At the second annual meeting of the trustees and con-

sultative committee of this hospital held in Larne on

August llth it was reported that 54 in-patients (and a fewout-patients) had been treated. Of the interne cases 30 weremedical and 24 were surgical; there were 15 operations.Admirable work is being done in this most useful institu-tion for which the people of Larne and neighbourhood haveto thank Sir Hugh Smiley and his generous wife.

Royal Victoria Hospital, Belfast.Through the kindness of the board of management of

the Royal Victoria Hospital the superintendents of the

Hospital Saturday collection were entertained on August 12thand were given an opportunity of inspecting the hospital andits working which was much appreciated by the numerousguests who were very hospitably treated.

Belfast District Lunatic Asylum.At a meeting of the asylum committee held on August 14th

it was reported that there were at present on the asylumregister a total of 1108 inmates-504 males and 604 females.During the five years ending December, 1904, there were 509cases received into the asylum from the workhouse and sofar this year there had been 53 admissions. Some improvedprovision will have to be made for the idiots and imbeciles,as neither the workhouse nor the asylum is the proper placefor such cases.August 15th.

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PARIS.(FROM OUR OWN CORRESPONDENT.)

The Relations between Albuminuria and Diabetes.AT a meeting of the Academy of Medicine held on

July 25th M. Lancereaux said that in his opinion it was anerror to suppose that the passage of sugar through thekidney was the cause of the albuminuria which was foundin diabetes, because albuminuria was unusual in pancreaticdiabetes in which the amount of sugar varied between 500and 1100 grammes in 24 hours, whereas it was relativelyfrequent in fatty or arthritic diabetes in which the amountof sugar seldom exceeded 100 grammes. There were threepathogenic conditions which might give rise to albu-minuria in diabetes. One was an intercurrent disease,especially tuberculosis. The urine was in that case high-coloured, turbid, and scanty ; its specific gravity wasincreased and it was loaded with flocculent albuminand tube casts ; the kidney lesion was epithelial nephritis,quite independent of the diabetes and connected with thegeneral disease. The second of the three conditions abovementioned was arterio-sclerosis with consecutive atrophy ofthe kidneys. The urine was of low specific gravity, trans-parent, pale, and abundant ; the albuminous precipitatewas small in quantity; the kidney lesion was arterial

nephritis, which, as well as the diabetes, was of arthriticorigin ; ureamia was of frequent occurrence. In the last ofthe three conditions there was neither any intercurrentdisease nor arterio-sclerosis. The urine was almost normal in

quantity, specific gravity, and colour, and it contained neithertube casts nor leucocytes; the albuminuria was generallyabundant and was increased by mental excitement and over-work, but the patient’s general health was fairly good andanaemia was rare. This third form deserved to be calledalbuminous diabetes on account of its constant associationwith glycosuria, and in accordance with the celebratedexperiment of Claude Bernard it ought to be attributed to adisorder of the bulbar innervation.

Præcordial Massage in Heart Disease.At the same meeting of the Academy of Medicine

M. Cautru read an interesting paper on the Utility of Massageof the Cardiac Region in Heart Disease. Such massage hada decided effect on the arterial tension, on the pulse, and onthe cardiac dulness. In exaggerated tension he used massageto reduce it and in low tension he used massage to increaseit ; massage was, in fact, capable of regulating arterialtension. The desired result was generally obtained in fromfive to ten minutes and at first it lasted for several hours butafter successive applications of the treatment, varying fromten to 20 repetitions, the effect became permanent. The

particular kind of massage to be used was determined by theblood pressure. In patients with diminished blood pressureand quick pulse massage reduced the frequency of the pulseand increased its amplitude, as was shown by sphygmographtracings. Furthermore, under the influence of massage thearea of cardiac dulness was notably diminished-both theabsolute dulness corresponding to the portion of the heartwhich was in contact with the thoracic wall and the relativedulness due to the interposition of the margin of the lungs.When, however, the pericardium was adherent the absolutedulness remained invariable, a sign which might be useful inthe diagnosis of such cases.

Operations for Cancer of the Stomach.At the same meeting of the Academy of Medicine