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Graduation at the University of Glasgow.The autumn graduation ceremony took place at the Uni-

versity of Glasgow last week and was the occasion of avery rowdy demonstration by the students. 0 11 graduateswho came forward for the degree of M.D. two received it"with honours "and four "with commendation." Severalgraduates, who on account of being referred or for someother reason, were unable to attend the midsummer gradua-tion, received the degree of M.B., Ch.B, Principal DonaldMacAlister presided and, in the absence of the Chancellor ofthe University, conferred the degrees.

Montrose rnfirmary and its Medical Officers.At a meeting of the managers of the Montrose Royal

Infirmary held on Nov. 5th, Provost Foreman presiding, itappeared from the minutes of the house committee that

the medical officers to the hospital had intimated thatin future they intended to charge private patients sent bythem to the infirmary for treatment and that the committeehad by a majority minuted the instruction. Mr. Smith, inmoving the approval of this portion of the minute, statedthat the question of the medical man charging fees was amatter between the medical men themselves and their

patients. The Rev. Mr. Taylor moved as an amendmentthat the board declines to entertain the medical men’s

proposal as being ultra vires alike of the medical officersand of the board. There would, in the event of the

proposal being carried out, be a temptation to the medicalmen to put patients who were able to give fees intothe infirmary. The result would be that the parish Icouncil, the churches, the public works, and individualswould withhold their subscriptions. In his opinion themedical men wished to make a benevolent institution into a

nursing home. The idea of charging people admitted into abenevolent institution was outrageous and he strongly depre-cated employing it in the interests of the well-to-do. TheRev. Mr. Callan seconded the amendment which was carriedby 12 votes to 3.

Outbreak of Enteric Fever at Montrose.An outbreak of enteric fever has taken place at Montrose

and is assuming epidemic proportions. On Nov. 3rd four

patients were removed to the Infectious Diseases Hos-pital at Brookfield, and up to the 7th 12 cases had beennotified. Several of the patients are children and thecases are mostly severe. The outbreak is not confined toany particular part of the town. Dr. M. Connon, the medicalofficer of health, in his report to the public health com-mittee of the town council, stated that so far he had beenunable to discover the cause of the outbreak, and in view ofthe number of cases asked for power to furnish part of thenew administration block for the accommodation of thenurses.

Nov. l2th. _________________

PARIS.

(FROM OUR OWN CORRESPONDENT.)

The Necessity for a Minimum of Visual Acuity in Chauffeurs.MANY of the accidents in connexion with motor-cars may

be put down to a want of visual acuity in the chauffeur, andsince railway men have to undergo a stiff examination in visualacuity it seems only natural to consider that visual acuity isjust as necessary to steer a motor-car as to drive a train. OnOct 8th M. Roche read a paper before the OphthalmologicalSociety in which he stated that there had come under hisnotice a relatively large number of chauffeurs in charge ofpowerful cars whose visual powers were reduced to a

minimum. In one case, for instance, the chauffeur waspractically blind in one eye from a central corneal opacity,while the other eye was so astigmatic that no glass wouldcorrect it. In another case the patient had high myopicastigmatism in both eyes. Only recently this chauffeur, whowas riding a motor-bicycle, had suddenly found himself inthe middle of a flock of sheep which he had taken to be acloud of dust. Some chauffeurs, too, are practicallymonocular and if the healthy eye is momentarily put out ofaction by a cloud of dust, or by a fly getting into it, thechauffeur, for the time, is quite blind. M. Roche con-cluded by asking the society to adopt a motion that no

person should be licensed as a chauffeur unless he had acertificate of at least minimum visual acuity, signed by anophthalmic surgeon. The motion was referred to a com-mittee.

Colloidal Silver in Genito- Urinary Affections.M. Hamonic recently read a paper on this subject at a

meeting of the French Urological Association. Colloidalmetals consist of particles of very small dimensions,suspended or dissolved in a liquid medium. These particlesshow active brownian movements. The colloidal state can bebrought about either by chemical methods or, and this isbetter, by electric discharges. This latter method resultsin the granules being of a definite size and of absolute purity.The method of administration is either by venous injectionor directly into the tissues Metals so prepared have no

toxicity and the particles possess a sort of life of their ownwhich makes them comparable to ferments. They promotemetabolism, increase cellular activity, and raise the phago-cytic power. M. Hamonic has employed silver in this formwith excellent results in cases of tubercle of the bones andglands. The technique of administration is simple : it isonly necessary to inject the drug into the diseased tissue ina quantity varying with the extent of the lesion and thetolerance of the patient. In the case of the testicle thefluid has to be injected very slowly. The prostate may beinjected by placing the patient in the genu-pectoral posi-tion and exposing the site of the gland by a speculum.Sometimes the injection will produce a little reaction butnever one of any moment.

Hearing and Speeeh in Deaf-Mutes.On Oct. 29th Dr. Marage read a paper before the Academy

of Medicine on Some Experiences with Deaf-Mutes. Heconsiders that, whatever be the degree of deafness, thecondition of a deaf-mute can be improved if he is ableto repeat what he understands. Other patients, on thecontrary, who at first sight appear to be very little deaf areabsolutely incurable. A simple examination undertaken byDr. Marage enabled him to class his pupils into threecategories-those who eventually understand and speakalmost as well as anybody else ; those who never get furtherthan simply hearing and understanding music ; and, finally,those, very few in number, who are absolutely incurable.Dr. Marage showed the Academy some deaf-mutes who,beginning in the month of June last, had been takenthrough a six weeks’ course of acoustic exercises with the

sirène à voyelles. These children, who varied in age from 11to 14 years, could not only hear and understand French buttheir voices had gradually lost that very disagreeable qualitywhich when one has once heard it is never forgotten. Thismethod is valuable because the use of the sirene à voyellesdoes not in any way fatigue the teacher.Some Errors in the RadlograpAic Examination of Fractures.At the recent meeting of the French Association of Surgery

held in October M. Lucas-Championniere discussed this sub-ject. A very slight displacement of any part of the apparatusmakes a factitious deformity. Moreover, fractures whichare easily recognised clinically can be missed by radiographyand portions of callus which appear transparent may bereally quite solid. The observer should know how to interprethis radiogram which is by no means, as is commonly sup-posed by magistrates and the public, a true image. The

paper dealt with very important matters from the medico-legal point of view.

A New Chair of Obstetrics.At the sitting of Nov. 5th the Chamber of Deputies

restored a vote of 19,050 francs for the organisation of athird chair of obstetrics (to deal with the clinical teaching ofmidwives) at the Faculty of Medicine, which vote had beenpreviously thrown out by the Treasury officials (Commissiondu Budget) and by the Government. The vote has yet topass the Senate, and, moreover, although the committee ofthe Faculty of Medicine congratulated M. Cazeneuve, towhose effort the passage of the Bill through the lower Houseis mainly due, yet many members of the Faculty are opposedto the creation of the chair.

Nov. l2th. _________________

SWITZERLAND.(FROM OUR OWN CORRESPONDENT.)

The Etiology of Barlow’s Disease.Dr. Bernheim, privat-docettt for children’s diseases at

Ziirich, publishes an interesting paper on the Etiology ofBarlow’s Disease. This affection is so rare in Switzerland thatneither Professor Stoos at Berne nor Professor Hagenbach

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in Basle, who occupy the University chairs for paediatrics,has come across a single case, although sterilised milk is

extensively used in the feeding of infants in this country.Neither had Dr. Bernheim had a case under observation untila year ago. Now he reports on nine not very severe caseswhich easily yielded to treatment and improved on a

change of milk and the prescription of lemon juice. Thesechildren were all fed on sterilised Alpine milk supplied by a first-class firm under medical supervision. However,for the last year the firm had supplied standardised Imilk for infants recommended by German authoritiesas more trustworthy and easier of digestion. Thiscoincidence could not be purely a matter of chance and Dr.Bernheim is of opinion that the standardising is at fault.He concludes that perhaps toxic substances get into themilk during the necessary course of varied manipulations, asanalysis proves that the composition of the milk isunaltered as regards the quantity of mineral substancesand of phosphoric acid. Acting on Dr. Bernheim’sadvice, the firm has given up supplying standardised milk asfood for infants. It appears that in France, where the useof standardised milk (lait fixé) dates further back, Dr.Lecornu and Dr. Comby had in 1902 described quitea series of cases of Barlow’s disease due to this cause.

High Altitude in Cases of Surgical Tuberculosis.In the Revue Médicale de la Suisse Romande Dr. Rollier of

Leysin publishes a report on the treatment of cases ofsurgical tuberculosis of children in high altitudes by insola-tion (sun baths). The well-known good effects of open-airtreatment in cases of pulmonary tuberculosis apply equally tocases of surgical tuberculosis (affections of bones, joints, andglands). In his clinique at Leysin (altitude 4750 feet), abovethe lake of Geneva, Dr. Rollier has so far treated 120 cases,mostly with results far more satisfactory than those obtain-able in the plain, but a stay of many months is obviouslynecessary, as he often has to do with long-standing and com-plicated cases. If the lungs are affected he makes use ofBéraneck’s serum; in cases of cold abscess he injects iodoform ;he also makes use of the Bier treatment in cases of fistulæ.He advocates very conservative treatment and seldom

operates. Operative interference often proves detrimentalowing to extension of infection. Sun-bath treatment

warmly advocated by Dr. Bernhard of Samaden provedbeneficial in many cases. Finsen recommended it in

lupus. Fistulas close very rapidly under the influenceof the rays of the sun, cicatrisation being rapid and often oflasting duration. Dr. Rollier adds details of ten severecases which recovered well.

Ziirich, Nov. 10th. ________________

I

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

A Sanatorium for Medical Menin Marienbad.IN view of the fact that a large number of medical men

visit Marienbad for the benefit of their health the localmedical association is taking steps to organise a sanatoriumfor the use of them and their families only. The intention isto allow each medical man who comes to the watering-placea course of from four to six weeks of rest and a series ofmineral baths and waters free of charge. Until the buildingfor the sanatorium is ready for occupation the medicalvisitors will be received in the houses of the local prac-titioners but will have to provide their own meals. Theother benefits will consist of free admission to all baths, allconcerts, the reading-room, and various entertainments.The theatres and restaurants will also have a reduced scaleof charges for the inmates of the sanatorium. The expensesof the establishment will be defrayed partly by a grant fromthe town council and partly by the local practitioners andother medical men.

The -4 etivity of Voluntary Muscles.At a recent meeting of the Vienna Gesellschaft der Aerzte

Professor Benedikt read a paper on an important subjectwhich has hitherto attracted little attention. He madeexperiments with regard to the activity of voluntary musclesand came to the conclusion that there were two independentsystems of nervous fibres present. One of these controlledthe contraction and the shortening of the contractileelements, while the other controlled the thickening of thediameter. Thus the one controlled the lifting power and the

other the distance of the lifting or "stroke." In restoringthe condition of repose and equilibrium two antitheticsystems of nerves must come into action just as with the

inhibitory nerves of the heart. The feeling of fatigue servedthe purpose of a safety valve against exhaustion. This feelingmight in some patients be excessive, even before action ofthe muscles, and in cases of easily exhausted nerves andmuscles the condition termed neurasthenia might develop.This term was often applied en masse, showing how a wrongdiagnosis might be made if the symptoms were not subjectedto severe analysis. Professor Benedikt thought that thecurrent in the nerves was composed of longitudinal andtransverse waves in different phases. Tabes dorsalis wasexplained by him not as a disturbance of coordination but asan association of independent disturbances in several musclesof a group, as a disturbance of a regulating innervation ofthe elements of the muscle tissue. Through this disturbancethe elements responded less readily to the stimulus and theresulting movement was excessive or " tabetic." Thedoctrine of the correlation between the anaesthesia and thetabetic type of movement was, according to him, entirelywrong and untenable. Syphilis as a causative factor wasrarely present and the syphilitic origin of tabes was nomore than a hypothesis. The use of mercury and iodinein this disease was therefore a grave mistake. ProfessorBenedikt found the best results for some of these cases from

passive stretching of the nerves by laying them bare andpulling at them.

A New Method of Treating Detachment of the Retina.At the same meeting Dr. Sachs showed a woman, 49 years

of age, on whom he had tried successfully a new method ofpreventing a relapse of detachment of the retina, for whichshe had been four times operated upon. Her sclera hadbeen several times punctured for accumulation of sub-retinal fluid. The condition improved after the first twopunctures but the third and fourth times the result was veryunsatisfactory. The punctures had to be resorted tobecause all other methods of treatment, including pressureand injections of solution of chloride of sodium, were un-availing. They were made in the upper external quadrantof the bulbus by means of a small galvano-cautery.Punctures in the other quadrants were also madebut still the disease progressed. Dr. Sachs then re-

solved to bring about permanent adhesion of the retinato the sclera at a point where the retina was easilylifted off its base by a collection of fluid. The anatomicalconditions were as follows. The retina was fixed to its baseonly at the papilla and along the ora serrata, nearly in themiddle between the margin of the cornea and the aequatorbulbi. Then if liquid was accumulating in the subretinalspace it would push away the retina easiest in the middle ofthis distance at the equator. The usual place of puncturewas next to the ora serrata or next to the usual place offixation of the retina ; puncture in this situation, how-ever, did not promote illation in detachment. Dr. Sachs,therefore, on the next occasion punctured behind theequator after dividing the conjunctiva and pulling the eye-ball a little to the inner side. 12 days later, as a slightaccumulation of fluid appeared again and threatened tobreak down the adhesions set up by the last puncture, herepeated the operation, puncturing again behind theequator, this time on the inner side after tempo-rarily detaching the rectus internus muscle. The ophthal-moscopic view was very satisfactory ; white scars were

visible, where the punctures had reached the retina ; therewas some haemorrhage into the vitreous, but the vision of thepatient was excellent and remained so for the six weeks duringwhich she was under observation. After having obtained thisgood result Dr. Sachs operated in the same way behind theequator on three more patients with high myopia and de-tachment of the retina. An improvement was immediatelyvisible but the time that had elapsed since the operations wasinsufficient to show whether the result would be permanentor not. No relapse had, however, occurred as yet, althoughthe patients formerly complained that every few days theirsight failed them. The method was said to be good forrecent cases or for such cases of longer standing as have notyet many folds.The Surplus and the 8,000,000 Kronen for Hospital Wards.The Minister of Finance, in his Budget speech a few days

ago, announced to his astonished audience that the surplusof the year 1906 amounts to 146,000,000 kronen, or more than£6,000,000. The continuous increase of the surplus during