688 THE C’ASE OF MR R. I3. ANDERSON.

in clinical dental surgery. Other divisions of study hadclaims for considerations, and chairs for these would comein time, but this one had, to his mind, the most urgentclaims and should be the primary object of their efforts inshaping the immediate future of their educational institu-tions. The occupant of such a chair would require to be aman of experience, who would devote much of his time toteaching and superintending the work, and one whose know-ledge and experience would give authority to his instructionand directions. The great want was the lack of money. Heconsidered the possible channels by which they might getmoney. Money out of Imperial funds could not be reliedupon, although he was not without hope that help mightbe given to them some day from that quarter. They hadmainly to look to themselves and to the ever-increasingclass of wealthy persons who were looking for channelsinto which they could direct surplus wealth where itwould be utilised for the amelioration of distress. That

they had so little encouragement in the past from thissource was because they were young. Other and olderinstitutions had claimed attention. Here was something tointerest themselves in, a fresh development to stimulate themto renewed and increased energy, a fresh and additionalplea to place before those who had helped in the past, and astronger and broader claim to urge on those from whom theywould seek assistance in the future.On the motion of Mr. NEALE (Birmingham), seconded in

humorous terms by Dr. CAMPBELL (Dundee), a vote of thankswas very heartily accorded Mr. Macleod for his address.At this stage Principal Sir WILLIAM MuiR entered, and ina few suitable words welcomed the Association to the

University and commented on the importance of the dentalprofession.The TREASURER’S report showed a satisfactory state of the

funds and a considerable sum on hand and on depositreceipt.The SECRETARY’S report dealt with a variety of legal cases.

The object of prosecutions was not so much the expectationof arresting the evil of illegitimate practice, but rather toestablish the meaning of the Act of Parliament and therebyto gather experience and power to grapple with the evil in amore extensive and efficient way at a not distant future.The question of "covering" " was referred to as a fruitfulsource of imposition and injury to the general public.The question of direct representation on the GeneralMedical Council had also received attention, butthe progress had not realised the expectations ofthe more sanguine. Their claim was still before the PrivyCouncil. The committee for the collective investigation ofthe teeth of school children was still at work, and thoughworking in silence it would tend more to forward the Associa-tion’s reputation in public estimation than perhaps any otherinfluence at their disposal.

It was intimated that the next meeting was to be held inLondon in 1896, and that Mr. FREDERICK CANTON, L.R.C.P.Lond., was the President-elect.In the microscopical section Mr. MuMMERY (London)

delivered an address on the Progress of Microscopy in

Dentistry.In the report on school children’s teeth it was stated that

700 children had been reported on during the year, bringingthe total number examined up to 11,422. The investigationsshowed that teeth inevitably decayed as age advanced, andthat the teeth of the children of the wealthy classes seemedmore prone to decay than those of poor charity children.

Dr. FREDERICK HEWITT (London) read a paper in theafternoon entitled, "An Inquiry into the Safety and Sphereof Applicability of Chloroform as an Anaesthetic in DentalSurgery." He had endeavoured to obtain particularsof every fatality which had occurred in the BritishIsles during the past fifteen years. Although deaths fromall general anaesthetics were included, a special analysis wasmade of chloroform fatalities. These constituted a verylarge proportion of the total number, and were so numerousthat it was contended the time had come for the expressionof some authoritative statement as to the proper sphere ofapplicability of chloroform in dental surgery. While ad-mitting the value of chloroform in general surgery, dentaloperations differed widely from major surgical operations inthat the general circumstances under which they took placewere not nearly so favourable so far as the ansesthetic wasconcerned. It was, therefore, clear that there was specialneed in dental surgery for the employment of anaesthetics witha wide margin of safety-a quality with which chloroform

was certainly not endowed. He contended that, with suchan alarming death-rate from chloroform in this branchof practice, this anaesthetic should only be used under veryexceptional circumstances, and that ether-an equally satis-factory agent when properly administered-should be chosenwhen the operation was such that nitrous oxide was in-admissible. He maintained that it was the duty of everyonewho was called upon to administer an anaesthetic for a dentaloperation to employ that one which was least likely todestroy life. For short operations nitrous oxide should beselected, for longer ones ether, and chloroform should onlybe chosen for exceptional cases. The number of deathsduring the period referred to was 37. Of these, 14 occurredin Scotland, 21 in England and Wales, and 2 in London.The discussion of this paper was postponed until the follow.ing day, but it may be referred to here.

Dr. D. WALLACE opened the discussion. He said thatwith regard to the deaths it was to be remembered that theydid not know how often the various anaesthetics had beenused, and he was inclined to think that probably chloroformwas most used. In the Dental Hospital in Edinburgh heunderstood that within recent years probably over 300 caseshad been chloroformed and no accident had occurred. Takenall over it seemed to be granted that ether was safer thanchloroform, also he held that maladministration was much lessprobable with ether than with chloroform, as the former wasgiven by special anaesthetists as a rule, while chloroform wasgiven by all and sundry. He condemned operating during lightanaesthesia. He also considered chloroform more convenientthan ether. As to the causes of accidents from chloroform,he thought that even such discussions as they were engaged intended to engender a feeling of terror about chloroformand they were led into the risk of giving too little. Hefollowed Syme and Simpson in giving it and in attending tothe respiration only. He disapproved of feeling the pulse,as the pulse became feeble if the patient became sick, andsickness was an indication to push the anaesthetic. His twopoints were that the patient should be recumbent, and thatnothing should interfere with free respiration.-Mr. COLYERargued in favour of nitrous oxide gas and said that otheransesthetics were very seldom necessary.-Dr. WILLIAMSON(Aberdeen) pointed out that the medical men recommendedchloroform in Scotland.-Dr. HEWITT, in reply, insisted thatif it were shown that ether was safer than chloroform it wastheir duty to use it, and the medical men ought to beeducated in the administration of it.Mr. BOBBINS (London) read a practical paper on the Use

of Amalgams in Everyday Practice, in which he stronglyadvocated their utility.

Mr. HERN (London) read a paper on Oral Hygiene, in whichhe referred to the care of the teeth.Mr. G. CUNNINGHAM (Cambridge) made a communication

entitled " What the Dentist can do for the State," in whichhe pointed out the importance of attending to the teeth, andhow this point was entirely neglected, and suggested thatthere should be State dental officers.

Various interesting and instructive demonstrations were

given, the most interesting of which was, perhaps, that byMr. FRASER (Inverness) in which he used the electricmallet, and showed the method of adjusting a Logan crownto a front tooth. Methods of taking casts and the uses ofelectricity in dentistry were demonstrated.The scientific part of the meeting was satisfactory and

successful, and the weather was fairly propitious for socialfunctions and sight-seeing. On the evening of the openingday the Lord Provost and magistrates gave a reception. On

Aug. 30th the annual dinner was held, and Mrs. BowmanMacleod gave a successful and pleasant reception in theevening. On Aug. 31st there was an excursion to LochLomond, and the last general meeting was held in theTarbet Hotel.

THE CASE OF MR. R. B. ANDERSON.

THE Civil Rights’ Defence Committee, 3, Mitre-court,Temple, E.C., is making active endeavours to obtain someredress for Mr. Anderson, and in furtherance of this objecta deputation, headed by the Right Hon. the Earl of Stam-ford, had an interview with several members of Parliamenton Aug. 29th in the Conference Room of the House ofCommons. Earl Stamford, after a review of the whole case,

689A VISIT TO PROF. KITASATO’S INSTITUTE FOR INFECTIOUS DISEASES.

.n account of which recently appeared in our colnmns,l,explained that the illegal judgments and orders of thecolonial courts are still in force against Mr. Anderson,.and that he is anxious to appeal to the Privy Council to havethem cancelled, but has hitherto been prevented by lack offunds. General Graham, following Earl Stamford, statedthat the colonial judges, among other illegal acts, incitedand permitted speculative and fraudulent suits to be

brought in formi pauper’is against Mr. Anderson, the plaintiffsnot being paupers, and the affidavits of poverty and of thefacts required by law being systematically dispensed with,’contrary to the provisions of the Bill of Rights. In thesesuits Mr. Anderson was illegally denied his right to give- evidence, he was deprived of his lawful professional charges,.and penal damages were inflicted on him for lawfully exer-cising his right of retiring from a medical case and for lawfullyreobvering possession of his freehold land. To enforce these

judgments he was illegally committed to prison and refusedthe writ of habeas corpus, excessive bail was illegally exacted(B1000 in civil claims of ;&42), and judgment in his appealsagainst these orders was withheld for three and a half monthsin order to keep him under restraint. Finally, having cometo England and gained an action against the colonial judges,he was deprived of damages on the ground that no action could’lie against a judge for acts done in his judicial capacity. Thedeputation urged that if this be the state of the law then it is.essential in the interest of individual rights and liberties thatsome remedy for such abuses and some redress for suchwrongs should be devised.

Messrs. Benjamin L. Cohen, M.P., H. Dalziel, M.P.,W. Jones, M.P., J. Herbert Lewis, M.P., and ReginaldTUcKenna, M.P., having assured the deputation of their

sympathy and their intention to give the matter the utmost’consideration, it was arranged that a second conference.should be held at an early date. Dr. Ward Cousins

’(Soutbsea) then spoke at some length on the bearings of theease in relation to the medical profession, and the pro-ceedings terminated.

A VISIT TO PROFESSOR KITASATO’SINSTITUTE FOR INFECTIOUS

DISEASES.

BY J. M. ATKINSON, M.B. LOND., M.R.C.S.ENG., L.S.A.,COLONIAL SURGEON, HONG-KONG.

’ON July 28th I visited this institution and was shown

tound by Professor Kitasato, Dr. Nakagawa, a Japanesegentleman who is a graduate in medicine of New York

University, acting as interpreter. Professor Kitasato, althoughhaving an intimate knowledge of German, does not speakEnglish. We first proceeded to the laboratory, and I was;shown the following specimens: (1) tubercle bacilli ;’(2) plasmodium malarias ; (3) pneumococcus (Frankel’s); (4)Letter’s bacillus ; (5) tetanus bacillus ; (6) bacillus anthracis ;.(7) plague bacillus ; (8) lepra bacillus ; (9) typhus fever{enteric fever) bacillus ; (10) cholera bacillus ; and (11) gono-coccus. Professor Kitasato’s method of obtaining the plas-modium malarias is first to fix the specimen with a 1 per cent.,solution of corrosive sublimate, afterwards staining with a.saturated solution of eosin in absolute alcohol and then withL6fUer’s solution of methylene blue. With reference to diph-theria I had a long conversation with Professor Kitasato.He has succeeded in obtaining an antitoxin much strongerthan any yet used. To show this 9 c.c. of his serum are allthat he injects to cure a case of diphtheria ; with Roux’sserum, on the other hand, it is necessary to use as much as100 c.c. He can obtain this from the blood of a horse, butprefers that of a sheep. I was shown large pieces of diph-theritic membrane which had been coughed up by patientswho had been injected with this antitoxin. The "tetanusbacillus " was a beautiful specimen and is shaped somewhat likea clove, the head being the spore, and is stained red withcarbolised fuchsine, the body of the bacillus being stainedblue. The sixth specimen showed the spore formation verywell, the spores being, as in the previous case, stained withfuchsine and the bacilli with methylene blue. The plaguebacilli are very distinctive and are exactly similar to thosewhich were obtained this year from the few plague cases

1 THE LANCET, Aug. 31st, 1895

which have occurred in Hong-kong. They are of an oval

shape, presenting two deeply stained poles with a clear non-stained interval between them. The simplest way to obtainthe plague bacilli is to take some of the juice from one of theaffected lymphatic glands, smear it on a cover-glass, and,after fixing, stain with eosin or methyl blue. Bacilli arefound to be present in great numbers ; they are almostidentical in appearance with those of chicken cholera.The bacillus of enteric fever, which was quite new to me,presents a deeply stained body with a number of finefilamentous processes passing off from it ; none of these arebranched. The specimen was from a culture obtained from thefaoces in a typhoid fever case. After this I was taken roundthe menagerie, where there was a large number of animals-guinea-pigs, dogs, rabbits, mice, monkeys, &c.-for the pur-poses of inoculation, investigation, &c., and finally I visitedthe wards. In one room there were two patients convalescentfrom diphtheria who had been injected with ProfessorKitasato’s antitoxin ; in another ward he showed me a caseof leprosy in which the tubercles were disappearing underthe influence of an antitoxin which he is now investigating.In another ward there was a child with traumatic tetanus;this case was also on a fair road to recovery, the seizures

being much less since the injection of a tetanus antitoxinand the temperature having fallen after each injection..There were also some twelve cases of phthisis. Just off thewards there was a Lyons steam disinfector. The laboratorywas furnished with every requisite, and one could not but beconvinced that here, in the middle of Tokio, some excellentscientific research is being carried on by Professor Kitasatoand his assistants.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Bristol Urbart Sanitary A?tt7tority. - The population ofBristol proper was estimated to the middle of 1894 as226,578; it is, however, well to note that the city itself ispractically continuous on two of its sides with other urbandistricts containing an aggregate population of 59,509, so

that in reality the population of which Bristol forms thecentre amounts to nearly 300,000. It is obviously importantto have regard to this consideration in estimating the valueof Bristol’s death-rates &c. The population of Bristol hadup to the time of the result of the 1891 Census been knownto be considerably over-rated, the over-estimation havingbeen in 1891 no less than 10,199. The corrected generaldeath-rate of Bristol for 1894 was 17-92 per 1000, the lowestyet recorded for the city; the infantile mortality for the sameperiod was 148’3 per 1000 births. In commenting upondiphtheria Dr. D. S. Davies observes that the tendency ofthis disease to increase in the large urban districts of Englandand Wales is now unhappily shown in Bristol, although thedeath-rate for this district is found still to compare favour-

ably with that of the thirty-three great towns. With regardto phthisis Dr. Davies considers that hospital isolationas is practised in other infectious diseases is not possible inthis, but he thinks that good results would accrue from itsnotification. Bristol seems to be in a fair way to provideitself with satisfactory isolation accommodation, the urbansanitary authority having procured sites for the separateisolation of small-pox and other infectious diseases. Therelations of Bristol to the surrounding urban sanitary districtsalready referred to would seem to indicate some joint hospitalscheme as the most economical.

Huddersfield Urban Sanitary A1ltllO?’ity.-Dr. J. R. Kayereports that for the third year in succession the generaldeath-rate of Huddersfield has been the lowest on recordsince the incorporation of the borough, the rate for 1894being 15’9 per 1000 of the population. These gratifyingresults are, Dr. Kaye remarks, I largely the reward of wisesanitary work, but corporate action is not limitless andmuch may be ascribed to favourable atmospheric conditions."The birth-rate of the district was for 1894 but 20-25 per1000, there having been a very marked decline in this respectsince 1878, when the birth-rate was 35 per 1000. Among thethirty-three large towns the nearest approach during 1894 tothe birth-rate of Huddersfield was that of Halifax, 23’1