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affected. Raja Alang Iskander of Perak tells me

that long ago in an isolated house there lived a Malaywith his wife and children. One night when the husbandwas absent at a distant village the woman went out of thehouse to draw a little water from the well. She didnot return, and her children, too frightened to go outin search of her, were terrified by the roar of a tigerin the compound. At dawn the husband returned with somefriends and a strange sight met their eyes. In the littlebrinjal patch at the back of the house the Malay woman anda large tiger were prowling round each other growling.Occasionally the tiger would make a little spring towardsthe woman and the woman would spring towards the tiger.Then she would jump back and the tiger would jump backtoo. Both the woman and the tiger were latah 1

In being contagious by imitation latah resembles those epi-demics of hysteria which sometimes take place in small and ,,

predisposed societies such as schools, nunneries, remote andsuperstitious villages, and the phenomena are such as appealstrikingly to the imagination, such as religious ecstasies,strange forms of fits, saltatory spasms and laryngeal noisessuch as bellowings, barkings, or mewings."2 As Manson

points out these latter outbreaks occur in epidemics, whilstlatah is an endemic psychosis. The former, he says, arediseases of the emotions, the latter of the intellectualreflexes. With regard to the somnambulistic stage of latah,"Janet considers somnambulism closely allied to hysteriaand hysterical fits as virtually instances of somnambulism." "

It is especially in connexion with this somnambulistic stageof latah that the important question of volition arises.With regard to volition in the hypnotic stage Dr. J. Milne

Bramwe113 says: "I have never seen a hypnotic suggestioncarried out which involved anything opposed to the patient’sprejudices, feelings, or moral sense. Bernheim and othersbase the possibility of hypnotic crime on the fact that

hypnotic subjects will sometimes execute imaginary ones,e.g., put a lump of sugar into a friend’s teacup whentold it is arsenic ; questioning in subsequent hypnosis,however, always reveals the fact that the subject knewexactly what he was doing and fully recognised the

experimental nature of the transaction." In the som-

nambulism of latah this is certainly not the case. Thereis at the present time a Malay woman in the General

Hospital, Kuala Lumpur, whom I have seen constrained bysuggestion to run her fingers repeatedly through her hair,ruffle it up, and pull it over her face just after she had com-pleted her toilet and carefully arranged her hair. Soonafterwards when the poor woman had " done " her hair againthe suggestion was repeated with the same result. This

was, I am sure, " opposed to the patient’s prejudices andfeelings." It is a well-known fact that latah folk will stripoff their clothing at the suggestion conveyed in a gesture.This is strongly opposed to their feelings. No Malays, noteven the men, will ever bathe naked.

Mr. Wilkinson, secretary to the Resident for the State ofPerak, tells me of a case which is interesting from a forensicpoint of view with regard to crime committed owing to alatah impulse but without the involvement of a criminalsuggestion. It occurred some years ago in Malacca. Two

men, who may be called Kassim and Amat, were walkingtogether through the jungle, each carrying his parang, orheavy chopping knife, when a dead twig, breaking off froma tree overhanging the path, fell to the ground. Kassim,being startled by its fall, in imitation thereof flung himselfdown on to the path. His companion, Amat, in his turnbeing startled by seeing his friend fall to the ground andovercome by the imitative impulse, threw himself down onthe track by the side of Kassim and in so doing swunground his arm and parang. The heavy parang struck Kassimon the wrist and completely severed his hand from thearm. Amat was arrested, in due course appeared beforethe magistrate, and was sent to gaol for six months.Kassim, the injured man, stated that he felt sure that theaffair was an accident ; he had lived for years in the samekampong with Amat ; they were both latah and he entirelyaccepted Amat’s explanation. The court, however, probablyfelt that it was impossible to admit the excuse of latah.The disease is so common that were such a precedentcreated any Malay on his trial for a deed of violence wouldplead latah as an excuse. A similar case is that of a Sikh who

2 J. A. Ormerod, Clifford Allbutt’s System of Medicine, vol. viii.3 Encyclopædia Medica.

was squatting down beneath a small bush by the side of ajungle path when a latah Malay happened to walk by. Atthe moment the latter was passing the Sikh rose up from theground and his head appearing suddenly through the leaves-of the bush so startled the Malay that he at once becamelatah, and thinking that the saw a wild beast before him splitthe head of the unfortunate Sikh with his parang. In boththese cases grievous bodily hurt was inflicted owing to anuncontrolled impulse in a latah subject who had beenstartled by a sudden shock. The question now arises as towhether an individual who is latah will carry out a criminalaction which is altogether due to the influence of a suggestionmade by a second party and which would be repugnant tothe individual when in a normal state. Most authorities on

hypnotism deny the possibility of ’’ hypnotic crime."In order to investigate the question of "volition " with

regard to crime in a person subject to pronounced latah thefollowing experiment was carried out. A woman namedJ- was admitted to the General Hospital, Kuala Lumpur,suffering from sarcoma of the breast. She was very latahand said that she had been so since the death of one of herchildren which had taken place rather suddenly a few yearsago and was a great shock to her. J- was in a smallroom with two other Malays. This room communicated by ashort passage with a ward in which there was a largenumber of Tamil patients. She could not see the ward fromher bed in the little room. On the particular day on whichthe experiment was carried out there was a drizzling rain,and, as is their custom in such weather, the Tamil patientswere curled up on their beds entirely covered by theirblankets. One of these patients was aroused and sent outinto the verandah. The outline of the body was then repro-duced under the blanket by means of a pillow and a foldedraincoat. The appearance was indistinguishable fromthat presented by the real patients as hidden undertheir blankets in the beds near. J- was then sum-

moned from her room and told that there was a rich Tamilwoman covered with jewellery asleep on one of the beds.The bed with the raincoat was then pointed out to her.Suddenly a large amputating knife was thrust into her handsand a command was shouted at her, I I Kill that woman andsteal her jewellery." J- rushed at the bed and withgreat force drove the knife into the blanket and the raincoatunderneath. Hardly had she struck before she uttered a cryof remorse and threw herself back with a look of horror onher face. The command kill (potong)" " was shouted ather and again she fell to hacking the raincoat with herknife.

Latah crime is certainly a possibility and may be either :(1) a criminal act resulting from an imperfectly controlledcoordinate reaction to a sudden stimulus, as in the case ofAmat and of the Malay and Sikh ("a disorder of the intel-lectual reflexes," as Manson points out) ; or (2) a criminal actresulting from suppression of volition in the somnambulisticform of latah, the determining cause of which act is acriminal suggestion made by a second party.

THE FIRST REPORT ON RESEARCH WORKBY THE DIRECTOR OF WATER EXA-

MINATIONS, METROPOLITANWATER BOARD.

Dr. A. C. Houston has issued a report upon the vitalityof the typhoid bacillus in artificially infected samples of rawThames, Lea, and New River water, with special referenceto the question of storage. The report is of great interest,as the 18 series of experiments carried out with unfilteredwaters artificially infected with large numbers of typhoidbacilli, numbers much larger than can be imagined to occurin nature, prove that with no other treatment than simplestorage an enormous reduction in the living bacilli occurs." In practically all the experiments the reduction was over99’ 9 per cent. Although from a public health point ofview the actual number remaining may be of far greaterimportance than the percentage reduction, these results

show the enormous advantage (in a relative sense, and

assuming the possible presence of the typhoid bacillus)

256

obtained by storing raw river water even for a short time."The following typical results may be quoted from the tablein which the experiments are summarised :-

In none of the 18 experiments could the bacillus beisolated from one cubic centimetre of water by the methodemployed after the lapse of five weeks, and in 10 ex-

periments it could not be isolated three weeks after theinfection of the water. Dr. Houston points out that itis undoubtedly possible by simple tests to show that under

storage a "change" has occurred associated with relative,and perhaps even absolute, "safety" so far as the typhoidbacillus is concerned. Such a simple test is afforded by thedisappearance of excremental bacteria which are constantlypresent in raw river water, for if these cannot be isolated theabsence of living typhoid organisms may be safely assumed.Appendices to the report contain a description of the condi-tions and methods of the experiments, tables showing theresults in detail, a note on "the necessarily artificialcharacter of the experiments," and another on the older workof Professor E. 0. Jordan, Professor H. L. Russell, and Pro-fessor F. R. Zeit on the longevity of the typhoid bacillusinclosed in permeable sacs of celloidin and parchment andplaced in flowing river water. Dr. Houston summarises hisconclusions under the following heads :-

(a) It is most desirable that the question of storage should be lookedat from a general standpoint so as to render the length of time duringwhich water is stored more uniform throughout the different districts ;hence the policy of intercommunication already being applied to thefiltered water should be extended to the stored water, as far as this ispracticable.

(b) The advantages accruing from even a few days’storage may be somaterial that, exceptional cases apart, the use of raw unstored riverwater for filtration purposes should strongly be deprecated.

(c) Although as a counsel of perfection a water should possibly bestored for one to two months, storage for four weeks may perhaps, inthe present state of our knowledge, be regarded as affording a sufficientmargin of safety.

(d) It is possible to determine, with reasonable accuracy, whether thewater being used for filtration purposes has been stored antecedentlyfor such a length of time as to give relative (if not absolute) assurancethat any harmful properties it may originally have possessed have beendestroyed in the process of storage.

(e) It is not impossible that the additional "safety" conferred byadequate storage may come to be regarded as a reasonable pretext forfiltration through mechanical filters. at speciallv rapid rates, therebyeffecting considerable economies in the cost of filtration, as ordinarilypractised; but any departure from old-established filtration-customshould not be entertained in the absence of convincing experimentalproof of the reliability of the new process.

(f) The question of storage is one both of quality and quantity and,strictly speaking. the number of days it is desirable to store water toimprove its quality should be added to the minimum number of daysof storage which it is necessary to provide in guarding against thepossibility of a shortage of water; nevertheless, during a considerablepart of each year, there is an abundance of water of relatively goodquality in the Thames and Lea. and the existing storage reservoirs aresufficiently large, M the aggregate, to improve enormously the waterderived from these rivers.

(g) How far it is possible to unify the existing system of storage andto effect radical alterations in the present regulations governing theabstraction of water from the rivers in question are matters which mayseem to lie outside the province of this report, but they have so largean influence on the provision of a uniformly safe and wholesomewater-supply for London, at a reasonable cost, that it is necessary tomention them.

(h) The advantages accruing from adequate storage of water are of ageneral character and are not limited to the elimination of danger fromtyphoid fever.

THE Fourth International Congress of Thalasso-Therapeutics will be held at Abbazia from Sept. 28thto 30th. The subjects to be discussed include Indicationsand Contra-indications of Seaside Treatment of Chlorosisand Anaemia and of Diseases of Women ; and Analyses andClimates of Different Seaside Resorts.

POOR-LAW MEDICAL OFFICERS’ASSOCIATION.

AT a meeting of the Poor-law Medical Officers’ Associa-tion of England and Wales held at the Town-hall, Hull,on July 15th, Surgeon-General G. J. H. EvATT, C.B., A.M.S.(retired), the President, being in the chair, the followingmotions were carried :-

-

Dr.Proposed by Mr. W. HOLDER (Hull) and seconded byDr.MAJOR GREENWOOD (London) :

1. That in the opinion of this meeting the present system of re-

muneration of district medical officers in England and Wales urgentlyrequires revision; that only by such revision can the present inadequateand inequitable salaries met with in many unions be redressed and auniform scale be introduced by which Poor-law medical officers shallreceive a remuneration in some measure commensurate with the dutiesthey are called upon to perform.

2. That in the opinion of this meeting the scale of remuneration laiddown in Art. 177 of the General Order of July, 1847, for special servicesis unsatisfactory; that the above scale was adopted more than half a .century ago, since which time owing to the advances of medicine andsurgery much more operative assistance has become necessary to meetthe fair requirements of the sick poor.

3. That in the opinion of this meeting much unnecessary suffering isincurred by the sick poor owing to the difficulty often experienced inprocuring a qualified anaesthetÜ,t in operative cases ; that some specialregulation in reference to such administrations should no longer bedelayed, so that it should be within the power of Poor-law medicalofficers to obtain when necessary such assistance.

4. That in the opinion of this meeting every district medical officerwhen called upon in his official capacity to attend upon a lying-in caseamong the poor of his district should be guaranteed the fee laid downin the Poor-law Orders ; that it should be the duty of the guardians torecover this fee from the husband of the patient where the circum-stances of the latter do not warrant the expense thereby incurred beingcast upon the ratepayers. They note with approval that this systemhas for some time been practically in operation in this city of Hull.

5. That in the opinion of this meeting the too frequent practice ofsome boards of guardians of utilising the emoluments of publicvaccinators to supplement the inadequate remuneration of districtmedical officers is much to be condemned, as the post of publicvaccinator is by law altogether distinct from any Poor-law office andshould be treated as such ; that the attention of the Local GovernmentBoard be specially directed to the recent action of the guardians of theDriffield union in determining their vaccination contract with Dr. A. T.Brand solely in consequence of his resignation of his office of districtmedical officer; that T. R. Ferens, Esq., M.P. for E. Hull, be requestedto put a question to the President of the Local Government Board onthe aforesaid matter.

VOYAGES D’ETUDES MEDICALES.

ABOUT 80 members of the association of French medical

practitioners known as the Voyages d’]tudes Medicales wereon July 16th entertained at a complimentary banquet givenat the Hotel Cecil in their honour by members of themedical profession in London, Dr. GEORGE OGILVIE being inthe chair. After the toast of ’’ The King had been dulyhonoured the health of the President of the French Republicwas drunk with enthusiasm.The CHAIRMAN then proposed the toast of Nos Invit6s."

Speaking in French, he referred to the Franco-BritishExhibition as a new proof of the firmness and sincerity ofthe bonds of friendship uniting the people of France to thepeople of England. His comments on the tercentenary fetesin Quebec were greeted with loud cheers from the audience,which were renewed when he declared that" Personne n’aoublie que c’est à Quebec que deux heros, un heros Franoaiset un heros Anglais, Montcalm et Wolfe, reposent dans Iememe tombeau. Ils ont lutte tous deux sur le meme champde bataille, ils ont donne leur vie pour leur pays, maintenantils dorment cote cote de leur dernier sommeil, egalementhonores par la France et par l’Angleterre. S’il m’est permigd’exprimer un vosu, ce serait qu’on ajoutdt sur le socle dumonument qui leur a ete eleve--La France et l’Angleterreunies pour le progres et pour la paix.

" This toast was

replied to by M. le Professeur A. PITRES who in an eloquentspeech voiced the thanks of his compatriots for the splendidhospitality which had been accorded to them and for thegenerous sympathy with which they had been received.The next toast was submitted by Dr. LEONARD P. MARK

and was described on the programme as that of the EntenteCordiale." " Speaking in French, he remarked that thegreater number of the visitors came from the most distantparts’ of France, from towns situated on the frontiers or on thecoasts, many of them from the shores of the Mediterranean,