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’dressing was then entirely removed and massage and elec-tricity were employed. In time the pains were relieved butthey did not disappear in less than six months. Obviouslyan irritation of the plantar nerve had been caused by thestretching of the foot.July 5th.

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ROME.(FROM OUR OWN CORRESPONDENT.)

The late Medico Primario of the Santo Spirito Hospital.THE tragic death of Dr. Enrico Bondi, head of the

cliniques of the Santo Spirito Hospital, has evoked universalsympathy for his widow and young family. His MajestyKing Humbert, besides sending a characteristically touchingmessage of condolence, has interested himself personallyin Madame Bondi’s behalf. The bereaved lady, I under-stand, will receive a pension of 3000 lire (.S120) annually,terminable only in the event of her death or of her secondmarriage, when 1800 lire ( £72) will be assigned yearlyto her son. Meanwhile, on the principle that " there’Is never smoke without fire," a polemic, sufficientlyanimated in its tenour, is now in progress as towhether the conditions to which patients in general, andphthisical patients in particular, are subjected in the SantoSpirito Hospital do not, in some measure, explain the remon-- strances and the vindictive reprisals of the said patientsagainst the management and its personnel. Inquiries as tothe dispozione delle sale" (arrangement of the wards), the

sorvegliadza (surveillance) of the patients, and the food- on which they fare will disclose, it is said, a state of thingsby no means satisfactory, not in the Santo Spirito Hospitalmerely, but in all the other hospitals of Rome.

" Phrenasthenia." The term was coined in 1874 by the great Lombard alienist

Dr. Andrea Verga, but it is now being superseded by othersbased on the practical English distinction between the idiotand the imbecile. That distinction recognises the former-the idiot-as 11 defective in organisation " ; the latter-theimbecile—as "defective in power." Of the two the idiotchild is much the less hopeful in the hands of the medico-psychologist ; the imbecile child, on the contrary, is- educable up to within little short of the normal type. Italy,recognising the distinction in classification, applies thename " tardivi " to the latter group of children andis now, I am happy to say, making vigorous, systematic- efforts to rehabilitate them. Hitherto her record in thisdirection has been worse than discreditable-simply scan-dalous. For her 11 phrenasthenic youth Switzerland has-eight institutions, Austria 12, Sweden 29, Great Britain 39,Germany 40, the United States of America 50, and Italyone I Even this one is private in its initiative and manage-ment, and the circumstances of its inception and com-pletion are interesting. Some 20 years ago Signor AntonioGonnelli-Cioni was an elementary school teacher in Flor-ence ; then he became attached, also as teacher, to a deafand dumb asylum, and his twofold experience was

not thrown away upon him. He had satisfied himself that

many children sent to school are really "phrenasthenic," "

and that there they lose their own time and curtail that oftheir less backward fellows. He had also satisfied himselfthat many so-called deaf mute children are really idiots orimbeciles and ought to be dealt with in special institutions.Still working out his ideas in this direction he visited manyasylums for the idiot and the imbecile abroad, studied theirmethods and estimated their results, and so, full of an

- enlightened solicitude for those "strangely visited" youthin his own country he returned, to found, just 10 years ago, aninstitution for the education of the phrenasthenic " youngat Chiavari. Three years later he transferred theinstitution to Vercurago, a beautifully situated hamleton the borders of the Brescian and Comasque provincesclose to the river Adda, so famed in Manzoni’s greatromance, and there, with the aid of his wife, hisdaughter, and a medically trained specialist (Dr. ZaccariaLucchini), he now educates and trains for entry into civil,wage-earning life as many as 50 " tardivi" varying from fiveto 21 years of age. They come to him unable even to feed or’clothe themselves, with their faculties dwarfed or dormant.They leave his hands so far rehabilitated as to take care ofthemselves, in some cases to be self-supporting, and in every

case fit for social intercourse and cooperation. This, as Ihave said, is the institution referred to as Italy’s one

equivalent for the many which her "sister nationalitiesmaintain. But it will no longer remain in that isolatedposition. In Tuscany on August 1st will be openedan institution on the same lines and for a similarobject at S. Maria a Coverciano with an even fuller equip-ment of teachers and consultants mostly drawn from theFlorentine ’ - Istituto di Studi Superiori" ; and at Turin thetown council will shortly found an institution of its own,also on the lines of that at Vercurago. As usual, it is themedical faculty in all its branches which lends the mosteffective assistance to these local movements for therehabilitation of the neglected, abandoned, or "strangely-visited " young ; and as I write a list of the Turinese’’ Comitativo esecutivo bears out my statement with thedistinguished names of Professor Bizzozzero and ProfessorPagliani.

The Rector Magnijicus of the Roman University.In the recent election to this post medicine has scored

again, as in other seats of learning throughout the kingdom.There were two candidates: Dr. Luigi Luciani, Professor ofPhysiology in the Medico-Chirurgical faculty, and ProfessorValentino; Cerruti, who holds the chair of TheoreticalMechanics in the faculty of Mathematics and Physics. Thelatter had been rector before, but, in spite of his deservedpopularity, the votes recorded in his favour were 25 as

against 28 recorded for his rival. The result, I am assured,has made " ottima impressione " (an excellent impression).July lst.

SWITZERLAND.(FROM OUR OWN CORRESPONDENT.)

Annual Meeting of Swiss Medical Men.THE annual meeting of Swiss medical men which took

place this year at Zurich was attended by over 200 practi-tioners. Professor Eichhorst gpoke on a fatal case of hæmor-rhagic nephritis in a boy aged 12 years due to commonsorrel, a quantity of which had been consumed bythe patient the day before he was taken ill. (I drewattention to this case in THE LANCET of July 1st.)Professor Eichhorst discoursed on the difficulty of thedifferential diagnosis between secondary cancer of theliver and multilocular echinococcus of the liver, a case

of which had just ended fatally at the clinique. Pro-fessor Eichhorst had only seen three cases of echinococcus ofthe liver in 15 years of hospital practice at Zurich out ofa total of 20,000 hospital cases and he had only seen oneother case in private practice ; he therefore could not agreewith the German authors who said that echinococcus occurredvery frequently in Switzerland. He also exhibited cases

of bulbar paralysis, syringomyelia, and Erb’s muscularatrophy. Professor Krönlein exhibited a woman fromwhom he had removed during the third month of pregnancyand without any bad effect on the pregnancy a large tumourof the kidney weighing 19 lb. This proved to bea unique tumour, a fibro-cysto-adenoma. He spoke on

nephrectomy and said that he had lost only eight patients outof 56. The operation was especially successful in the case ofunilateral tuberculous kidney, all of his 12 cases havingrecovered, some of which he exhibited in perfect health.His method of osteoplastic resection to obtain access to theback of the orbit had of late found great favour withophthalmic surgeons. He exhibited a boy, aged 15 years,operated on after this method for angio-sarcoma behindthe globe a year ago. The optic nerve being severedthe boy was blind in one eye, but had kept his eye, andthe cicatrices from the operation disfigured him very little.A case of traumatic ulcer of the stomach which showedgastric symptoms, as vomiting, pain, then haemorrhage, andafterwards cachexia, was successfully operated upon fourmonths after the original injury, which consisted in a

blow from a pitchfork in the pit of the stomach. The ulcer,which was situated near the pylorus, was removed and thepatient made a rapid recovery.

Inerease of Population of Swiss Towns.The influx of inhabitants from the country to the towns

and also from surrounding countries (Germany, Austria, andItaly) to the Swiss commercial centres has been so rapidly

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increasing from 1889 to 1898 that in Berne, Basle, andZurich the population has increased by from 50 to 70 percent. Building activity has been the special reason, manypublic and private buildings having been erected, but nowthe influx has greatly decreased owing to an over-productionof dwelling-houses and business places, and a healthy reactionis taking place. The increase of population in Zurich, whichfrom 1894 to 1897 was between 10,000 and 11,000 annually, isonly 3000 for 1898, bringing the population up to 163,000 forJanuary, 1899. Happily the existing laws for building (I referespecially to Zurich) are such that plenty of room is left forstreets and public places. The drainage is perfect and thebuilding laws as regards thickness of walls, proper buildingmaterial, and the time enforced for drying the newly builthouses are strict, so that the public weal cannot suffer.

Every effort is made to ensure existing promenades andgardens from being built over and to lay out new ones. Weshall also soon have two funicular railways which will takethe inhabitants in a quarter of an hour up to the fine fir :

woods on the hills round the town. ’

Ziirich, July 2nd.

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

The Dispenqary Abuses.AFTER three years of agitation the medical profession has

succeeded in securing the enactment of a law in the State ofNew York which places the dispensaries under the control ofthe State Board of Charities. There are not far from 200 dis-pensaries in the State and they are very rapidly increasing.The special feature of their management which has excitedthe opposition of medical men is the method of indis-criminate treatment of all applicants without regard to theirpecuniary abilities. In the city of New York it is estimatedthat 50 per cent. of the sick are treated annually in the dis-pensaries. But there are many other features of the manage-ment which are deserving of correction. Many dispensariesare located in drug-stores ; others are in dilapidated andinsanitary buildings; all have but a single waiting-roomwhere both sexes congregate ; none has any facilities forseparating contagious diseases; and in few is the druggist aqualified graduate of a school of pharmacy. The law empowersthe State Board of Charities to make rules and regulationsgoverning the management of these institutions and to grantthem a licence to conduct their business. Any violation ofthese rules may be punished by withdrawing the licenceand by fines. The law will come into effect on Oct. 1st. Mean-time the State Board is preparing the form of licence andis also formulating the rules and regulations which are togovern the management of ’all the dispensaries of the State.It is anticipated that this law will prove very beneficial bothin limiting the number of dispensaries to the actual wants ofthe people and by improving the management of thoselicensed.

The Extermination of Yellow Fever.One of the most marked benefits to the United States

which is likely to result from the late war with Spain is thepossible extermination of yellow fever in its old habitatsin Cuba. The thorough cleansing to which Santiago andHavana have been subjected has already given evidencethat the yellow fever foci of these hitherto pest-strickencities have been greatly changed if not altogether destroyed.Though the yellow fever season is well advanced only one ortwo authentic cases of that disease have been reported. Asimilar sanitary cleansing is going on in all of the smallertowns and with equally favourable results as regards theimprovement of the general health and the absence of casesof yellow fever. Another feature of the sanitary manage-ment of the island is very important in securing not onlythe protection of the United States from an invasion ofyellow fever but also the protection of one Cuban cityfrom the infectious and contagious disease of another.I refer to the introduction of the methods of medicalinspection of commerce and travel by officers of the UnitedStates Marine Hospital Service, so thoroughly matured inthis country. Heretofore every epidemic of yellow fever inthis country has been directly traced to the lax and worthlessmethods of inspection pursued by the local health authoritiesof the island. Now the local officers are entirely subordinateto the Government at Washington and the most rigid medical

inspection is maintained of the shipping as well as of the:r town with a perfect system of notification. It probablyy cannot result that no spread of yellow fever will occur duringw the present year, so recently has the new ré,r;ime come inton operation, but it is already evident that the exterminationn of yellow fever from Cuban cities by enlightened sanitationh is in the near future. The commercial value of such ais reform to the United States may be approximately estimatedtr when the fact is recalled that many of the recent epidemics

yellow fever imported from Cuba have cost the businessr interests of this country from 100 millions to 200 millionse of dollars, beside the widespread desolation caused by theg migration of the people and the large sickness- and death-t rates.- Improvements in the Treatment and Care of the Insane.

e The annual meeting of the American Psychologicale Association was held recently in the city of New York

r and a large number of interesting papers were read illus-trating the progress of psychiatry in this country. Therewas a manifest tendency toward what is called the Statecare of the insane in preference to county care. NewYork is the most conspicuous example of a Statewhich adopted the system of State care, thereby removing allthe insane from the counties to the State hospitals. The resulthas been most favourable to the insane and the question isbeing widely agitated in other States. Should not the insanebe everywhere recognised as wards of the State and comeunder its sole jurisdiction ? One feature of the meeting was

san evening given to the discussion of epilepsy which broughtf out the experience of those who have the superintendence ofE State institutions for epileptics. These colonies are exciting. a large amount of public and professional interest throughout.

the entire country and the effect is to greatly increase theirnumber. The Craig colony for the insane in the State of. New York, embracing upwards of 2000 acres of arable land. and designed to accommodate 2000 inmates, is making astriking success in the treatment of epileptics. It reports. the recovery of some of the most helpless and hopeless. epileptics of the county almshouses. The institutions for

epileptics in Ohio, Massachusetts, and Pennsylvania are

doing excellent work. The treatment of the insane by the,

Scotch system of " boarding-out " was for the first timeadvocated by a superintendent of a State hospital. The

subject of a more effective system of colonising the chronicinsane was brought forward in the annual address.

Reorganisation of the Army Medical Corps.At the recent meeting of the American Medical Associa-

tion it was resolved to recommend to the Government: (1)that the medical corps of the army and navy be enlarged tomeet properly all the demands which may be made upon them;(2) that transportation of medical supplies be under thecontrol of the medical department ; (3) that a corps of sani-tary inspectors be created whose duty it shall be to examineinto the sanitary condition of camps and bodies of troops intransit and advise in relation thereto ; (4) that the Govern-ment establish permanent camp sites, the selection to besubject to the approval of the surgeon-general, for use in themobilisation of large masses of troops; (5) that a professor ofmilitary hygiene be appointed at West Point to instruct thecadets in the principles of sanitation ; (6) that the medicalofficers of the National Guard be subject to rigid examina-tion both for admission to the service and for promotion ;(7) that the surgeon-general of the army and navy in time ofpeace and war be empowered to call into requisition theservices of skilled specialists ; and (8) that the President ofthe United States be respectfully urged to recommend to

Congress the appointment of an army medical commission,to be composed of physicians and sanitarians to be takenfrom military and civil life, including the surgeon-generalof the army and navy, whose duty it shall be to prepare areport containing a detailed plan of a modern system to

govern the medical departments of the army and navy inpeace and war.

United States Marine Hospital Service.A board of officers will be convened in New York city on

June 27th to examine candidates for admission to the gradeof assistant surgeon in the United States Marine HospitalService. Upon appointment to this service the young officersare, as a rule, first assigned for duty at one of the largemarine hospitals, as at Boston, New York, New Orleans,Chicago, or San Francisco. After five years’ service assistantsurgeons are entitled to examination for promotion to the