THE LANCET

902

THE LANCET.

LONDON: SATURDAY, DECEMBER 26, 1874.

THE ANNUS MEDICUS 1874.

THE history of any given year, from a medical point ofview, admits of very different representation, according tothe specialty and even the temperament of the writer. It

might be shown to be a good year or a poor year, perfectlyunhistorical or really eventful, according to the writer’sview of what constitutes medical progress. A man of

gloomy temperament, after trying to sum up the historyof 1874, might say we have made no progress. We have nonew medicines and no new method. Cancer and pyaemia,despite attempts at definition, in the best style of scientificeloquence, by our greatest authorities, are still in nubibus.Typhoid and scarlatina must still take their course as re-gards individual cases, and, even in their relation to theState, have still very much their own, way in the com-

munity. But, for all that, we should be prepared to differfrom our gloomy historian, and would be content to rely onthe last number of THE LANCET, or on any other number ofthe year, to prove to all practical minds that Medicine isnot only a year older since our last summary, but a yearwiser and a year more effective in its knowledge of diseaseand of methods for controlling it.The first month of the year had not been completed when

Mr. GLADSTONE suddenly advised Her Majesty to dissolveParliament, and in so doing threw the country, for the spaceof a month or two, into a state of high political excitement,which ended in a complete reversal of the strength of poli-tical parties and the instalment of Mr. DisRABLi as Premier.To the medical profession this change involved at least oneblessing-the removal of Mr. STANSFELD from the LocalGovernment Board. The profession viewed the changewith the more interest, not only because of its somewhatConservative tendencies, but because of the high place

I

which an expression of Mr. DISRAELI, some short time ’,before this, led the public to expect he would give to sani- itary questions in the Legislature. At the Mansion House, in IJuly, Mr. DISRAELI again very eloquently insisted that the Icondition of the people ought to be the first consideration Iof statesmen, and pleaded as his only excuse for not re-deeming old promises of legislation in this direction the

fact of his unexpectedly sudden accession to office. Mr.

DISRAELI’S health, of late, has not been so good as his mostdetermined opponents wish it to be. But it is now much

better; and we venture to hope that, instead of wastingthe powers of his party and risking the stability of hisGovernment by legislation on impracticable questions intheology, he will, at an early date, set a lesson to the nationsof consideration for the physical condition of the people.In Physiology, one of the principal works that have

been published since the close of last year is Dr. KLEIN’Smemoir on the Lymphatic System, in which the distribu-tion of the lymphatics as well as the arrangement of theepithelium on the serous membranes is very fully con-

sidered; the general result arrived at being that the serousmembranes are to be regarded as unraveled lymphaticglands, and, as such, play an important part in the forma-tion of the white corpuscles of the blood. Drs. FOSTER and

BALFOUR have just published a work that has long beenneeded-" The Elements of Embryology,"-in which theprocess of development is described, in a singularly lucidand intelligible manner, from the’ earliest period in thefowl, and which constitutes the first part of a larger work.On the same subject, embracing the history of developmentin other animals, Dr. BALFOUR has also done a good pieceof work in following the development of the dog-fish andits allies. Mr. PARKER has continued his elaborate account

of the development of the skull in his lectures delivered atthe Royal College of Surgeons. ARNOLD, GASSER, RAUBER,MIHALKOVICS, SERNOFF, von TÖROK, MERKEL, and manyothers, have devoted themselves to the elucidation of the

process of development of various special parts or organs,as the eye, ear, pituitary body, testis, &c. Mr. ST. GEORGE

M1VART has published a brief but useful account of theAnatomy of the Frog. Quite recently Mr. BARKER haspublished a valuable translation of FREY’S Histology. A

very interesting little work has been issued in the Inter-national Scientific Series, by M. MAREY, on "Animal

Mechanism and Aerial Locomotion," in which great in-

genuity is displayed in the application of recording appa-ratus to the registration of the movements of animals, bothin aerial and in terrestrial locomotion. To the same series

Dr. DRAPER, of New York, has contributed a volume thatwill be read with interest, on the "History of the Conflictbetween Religion and Science," in which the learned author,who is well known for his excellent treatise on Human Phy-siology, has endeavoured to present a clear and impartialstatement of the views and acts of the two contendingparties. There is also a third, consisting of a trans-

lation of OSCAR SCHMIDT’S Doctrine of descent and Dar-

winism. A popular physiology is contained in HINTON’S

"Physiology for Practical Use." A complete account of

the Physiology of Food and Dietetics has been written byDr. PAVY. Dr. CARPENTER has developed two or three

chapters on Mental Physiology contained in the earlier

editions of his Physiology, which have been excluded fromthe later ones for want of space, into a goodly volume,written with his usual clearness and intelligence. Amongstforeign works may be mentioned the "History of Creation"and the " Development of Man," by HAECKEL, the formerof which has been translated into English by LANKESTER,and the latter into French. HERRMAN has published afifth edition of his excellent work on Physiology, which is

now, we believe, in course of translation into English. Dr.

GUSTAVE LE BoN, in a large volume entitled 11 La Vie,"remarkably well illustrated, and M. COYTEUX, in another,the 11 Etudes sur la Physiologie," have both treated fully ofhuman physiology. HITzIG has collected his observations

and inquiries into the functions of the brain into one

volume, which is worthy of careful perusal. Though,perhaps, scarcely capable of being included under the headof Anatomy and Physiology, we must not omit to chroniclethe first International Congress of Orientalists, which washeld at the Royal Institution in London, in September,

903THE ANNUS MEDICUS 1874.

and which, under the presidentship of Dr. BiRCH, wasthe occasion of several excellent addresses, amongstwhich those of MAX MuLLER, the President, and Professor

OwEN, deserve special mention. Professor RUTHERFORD

has been appointed to the Edinburgh Chair of Physiology,and carries with him the good wishes of his late

colleagues in King’s College, and of his friends in

London. We trust still increasing numbers of studentsin attendance upon his classes will testify to the abilitywith which he conducts them. A large number of sepa-rate contributions have been made by individual observers,amongst which it is difficult to select any of pre-eminentvalue. BRAUN has repeated HITZIG’s experiments on theexcitability of the surface of the cerebrum by weak elec-trical currents, and whilst generally confirming his experi-ments, and those of FERRIER, adds this novel point, thatthere are several cases in which there appear to be two

centres on the surface of the hemispheres for the same setof muscles, as, for instance, those of the neck. He also

finds that, after shaving off the grey matter from a givenspot, the same groups of muscles can be made to contractif the current be applied to the cut surface of the whitesubstance as before, showing that the nerve-fibres reallyarise from the grey matter, whilst, if the white substancebe divided, all manifestation of nervous excitation ceases.

BURDON SANDERSON has also made experiments upon thispoint, and has shown that there are points in the corpusstriatum of the same side which correspond to those of thesame hemisphere. Dr. FERRIER considers that in Dr.

SANDERSON’s experiments only a medullary correspondingto the cortical centre is removed. NOTHNAGEL, from ex-

periments on the thalami optici, has come to the conclusionthat they have no relation to voluntary muscular movements,nor to the general sensibility of the skin, but that they are

immediately connected with the muscular sense. It is

pleasant and encouraging, in connexion with the subject ofPhysiology, to call to mind the meeting of the RussianAssociation for the Advancement of Natural Science, heldat Kasan, a flourishing city in the very centre of EuropeanRusqia, on the Volg", which possesses a good university.Physiological subjects figured largely in the discussions. Wemay mention especially Dr. A. SCHAKOWSKY’S paper on theAmount of Fat in Human Milk, averaging 3 per cent., andthe striking reduction in the amount produced by a strictlyvegetable diet, till it fell to 08 per cent. ; Professor ROWA-

LEWSEY’s paper on the Mechanics of the Movement of the

Bile ; and the paper of Dr. A. TROITZKY, of Kasan, on amethod of estimating the rapidity with which a stimulus ispropagated under different temperatures, and with variousstrength of exciting currents. The maximum rapidity ofpropagation of stimulus is between 68° and 50° F.

There is not much to note in the history of the College ofPhysicians during the year. Sir GEORGE BuRRows was re-

elected for the fourth time, and had the still higher honourto receive a baronetcy at the hands of Her Majesty. Sir

- GEORGE delivered a lucid address on being re-elected. Byfar the most important thing done by the College was thepresentation to the Premier of a memorial setting forththe evil of overcrowding, which we hope will bear fruit inthe coming session. The lectures of the College were of,

perhaps, more than average interest-to wit, the GulstonianLectures, by J. F. PAYNE, M.B., on the Origin and Relation ofNew Growths; the Croonian Lectures, by Dr. MURCHISON, onFunctional Derangements of the Liver; and the LumleianLectures on the Influence of Bright’s Disease-(l) on theHeart and Arteries, and (2) on the Production of Inflam-mation.

The attitude of the Royal College of Surgeons, or ratherof its Council, has throughout the year been one of passiveresistance to the scheme for a Conjoint Examination andlicence to practise. At the annual election to the Council

Mr. HILTON was elected, and is now the senior member; andMr. BAKER, of Birmingham, was returned to represent theprovincial interests. Mr. MARSHALL, who, as Mr. CHARLESHAWKINS’S representative, had to stand a re-election, wasreturned as a matter of course. Early in the year ProfessorHUMPHRY put in a plea for the admission to the Fellowshipon easy terms of the young surgeons of provincial hospitals,but a letter from Mr. BRUDENELL CARTER, which appeared inthese columns, showed the desirability of increasing ratherthan diminishing the tests for the Fellowship if that order wasto maintain its professional reputation; and we are glad tonote a tendency on the part of some of the College examinersto make the examination a real test, of surgical acquire-ments.

The action of the Universities is increasingly interestingto the profession. The London University had a livelydebate on the subject of vivisection. Alarge majority votedagainst too vague a motion against vivisection. The Uni-

versity of Glasgow has instituted two clinical chairs. The

mode of institution seemed to us open to considerable ob-

jection, which we made. But the actual Professors appointedwere an acquisition to the University. In Dublin the CatholicUniversity has had troubles in trying to maintain at once itsefficiency and its sectarianism. The University of Edin-burgh a few days ago invaded London, and, under theauspices of the Duke of EDINBURGH, at Willis’s Rooms,

pleaded for English help to extend her buildings, and madegood, her plea.The experience of the year has shown that EsMARCH’s

plan of preventing haemorrhage is capable of general appli-cation with advantage, and it has been almost universallyadopted. The same cannot be said for DITTEL’S elastic

ligature, which seems to have dropped into oblivion. Its

application to the treatment of fistula in ano has been

lately highly praised by Mr. ALLINGHAM, who has treateda number of cases with it satisfactorily. An interestingcorrespondence took place in our columns in January as tothe credit of priority in the use of the elastic bandage andof the elastic ligature. According to our correspondent, Dr.GESUALDO CLEMENTI of Naples, Dr. GRANDESSO SILVESTRIof Vicenza used the elastic ligature in 1862; and he andProf. VANZETTI of Padua together used and described theelastic bandage very much in the same way as EsMABCH. Thesubject of bloodless surgery, by means of the galvanic cautery,has been discussed at length by Mr. BRYANT, and the intro-duction of a new constant battery with carbon and bi-

chromate of potash for its elements seems to remove one ofthe difficulties hitherto in the way of the general adoptionof the plan. In connexion with the subject of Pysemia, we

904 THE ANNUS MEDICUS 1874.

may refer to Mr. LISTER’S practice, as reported upon by Mr.GAMGEE, which serves to illustrate the proverbially diverseeffect produced by the same series of phenomena in differentminds. The treatment of Syphilis was the subject of anaddress to the Hunterian Society by Mr. JONATHAN

HUTCHINSON, who proved, we imagine, to the satisfaction ofall candid inquirers, that mercury is the remedy for thatloathsome disorder. The subcutaneous injection of mercurywas the subject of an interesting communication by Mr.CULLINGWORTH, but the method is one which has hithertofound little favour in this country. Sir WM. FEEQUSSON has

introduced a modification of the method of operating oncleft hard palate, which seems to promise well ; and thesame eminent surgeon was able to relieve public and privateanxiety as to the identity of LIVINGSTONE’s remains by therecognition of the ununited fracture of the humerus. Mr.

TEALE has called attention to the operation of ovariotomy inexceptional cases; Mr. JOHN WOOD has contributed to theliterature of thoracentesis, and Mr. REGINALD HARRISON tothat of puncture of the bladder by the aspirator. The recent

lecture on American Surgery by Mr. ERICHSEN has set

before us many points of interest in connexion with thesurgery and hospitals of the United States; and Dr.

BucHANAN’s introductory address served to illustrate theactivity of our northern brethren. Amongst the feats ofsurgery for the year, we may mention BILLROTH’S total ex-

tirpation of the larynx and epiglottis for carcinoma-thesecond operation of the kind which he has performed; also hissecond complete removal of the thyroid gland, and the extir-pation of a fibro-cystic tumour of the uterus, weighing 16 lb.,with the uterus and its appendages, followed by recovery, byDr. E. H. TRENHOLME, of Montreal. THE LANCET of July 25thsets forth that Dr. HENRY HARLAND, of Wadhurst, Sussex,had extracted a Waterloo bullet from the hand of JAMES

JENNER, aged eighty-three. The said bullet had been in

the veteran’s hand fifty-nine years, and had become incon-venient to him at his work as a gardener ! Our pages have

contained many illustrations of the happy use of the aspi-rator in tapping the pericardium and other cavities, and Dr.MACLEAN speaks of the pus let out of livers at Netley bythis instrument in a summer as measuring hundretls ofounces.

The Medical Societies have continued their work duringthe year with unflagging energy, and many valuable caseshave been brought forward and papers read and discussed.Two discussions in particular must be mentioned, importantboth on account of the subjects considered and the numberand ability of the speakers: we refer to that on Pyaemia atthe Clinical Society, and that on Cancer at the Pathological.The former was opened by a valuable paper by the Pre-sident, Mr. PRESCOTT HEWETT, in which he gave the resultsof his experience of pyasmia in private practice; and in thediscussion which followed, extending over four meetings,a number of the most distinguished hospital surgeons, ob-stetric physicians, and pathologists gave their views on thesubject. The debate on cancer was opened by Mr. DEMORGAN, and the discussion, which lasted during fourmeetings, was notable for the ability and experience whichwere arrayed on both sides of the question, which turnedchiefly upon the constitutional or local origin of cancer.

The speeches of Sir JAMES PAGET, Mr. SIMON, and Sir

WILLIAHi JENNER will be especially remembered in con-, nexion with this discussion. It is to be regretted that in

both these debates the exact meaning of the terms employedwas not more clearly defined, as the results would thenhave had far greater scientific value. The other meetingsof the Pathological Society have not been marked by any-thing to call for special mention, although cases of interesthave been constantly brought forward. The work done at theClinical Society has been generally good and the discussionswell maintained. Amongst others, we may mention one onthe use of the Elastic Bandage in Surgical Operationsopened with a paper by Professor EsArcH. Of papers of

importance at the Medico-Chirurgical Society, those by Dr.CuNiNSHAM on Recent Experience of Cholera in India,and by Surgeon A. HALL on the use of Chloral subcuta-neously injected in that disease; by Mr. MAHOMED on thePrealbuminuric Stage of Bright’s Disease; by Dr. GEORGEJOHNSON on the Laryngeal Symptoms produced by Pressureon the Vagus and Recurrent Nerves,-may be noted. Muchvaluable matter has been brought forward at the MedicalSociety, which shows no signs of decay; and we must notomit to mention the able Lettsomian lectures delivered

before the Society by Dr. BROADBENT, on the subject ofSyphilitic Affections of the Nervous System. The most

important papers at the Obstetrical Society have been thoseon Puerperal Thrombosis, by Dr. PLAYFAIR, and on theRelations of Flexion and Congestion of the Uterus, by Dr.JOHN WILLIAMS. We may note also a discussion at a specialmeeting on the admission of ladies as members of the So-ciety, which resulted in a decision adverse to the proposal.The summer months brought the usual pleasant gather-

ings of scientific societies, in which not a few of our brethrenseem to find their holiday. The meeting of the British

Medical Association at Norwich was large and successful.The addresses were of a high character, and the society ofthe old city was full of worthy hospitality. Amongst thedistinguished foreigners was M. MAGNAN, who essayed toillustrate on dogs the different action of alcohol and absinthe,and in so doing involved some of the spectators in a criminal

prosecution, at the instigation of the Society for the Pre-vention of Cruelty to Animals. The Poor-law Medical

Officers’ Association has not been inactive. It has held

various meetings, and at one on the 16th of July agreedto certain important propositions which, we hope, may formthe basis of future and not remote legislation. There

is yet much that is lax in the administration of the

Poor Law, both as regards the nursing of the sick and themanagement of pauper children. A very bad case of mis-

management of a dying pauper in the Holborn Union calledfor our strictures. The boarding-out system has of latebeen much advocated in consequence of the poor strumous

health and bad after-history of pauper children. The Bri-

tish Pharmaceutical Conference generally meets at the sameplace as the British Association, but such is the touchy -condition of pharmaceutical questions in Ireland just now,that it was deemed more conducive to peace and goodwillto meet in London. The meeting was a very successful one.The Association numbers now between 2000 and 3000. The

meeting of the British Association at Belfast was presided


over by Professor TYNDALL, who lauded matter in such termsas to offend the sensitive religious mind of the Irish. He

indicated that he saw in matter the promise and the po-tency of all things. It is only fair to add that he has

since confessed that when he looks abroad on the beauty ofthe universe, he cannot resist the feeling that there mustbe some Being superior to it and more familiar with it thanhe himself. And so we think. We have great regard forProfessor TYNDALL and his colleagues of the British Asso-ciation ; but we trust that there is a Being somewhere inthe wide universe to whom even the knowledge of our

wisest sovans appears very elementary. Professor HUXLEY’S

address in Physiology on the Hypothesis that Animalsare Automata, and Dr. HooEBB’s on the Carnivorous Habitsof Plants, Professor REDFERN’s paper on the Effects of £

Ozone on the Animal Economy, Professor CLELAND’S on the

Morphology of the Brain and the Function of Hearing, SirDUNCAN GI]BB’S case of an old woman of 111, and other com-

munications will be remembered by our readers as full of

scientific or human interest. The Social Science Congressmet in Glasgow. One of the best features of the meetingwas a very able address from the chair of the Public Healthsection by Dr. L?ON PLAYFAIR. During the sitting of theBritish Association, congratulation and friendly sentimentswere exchanged with the French Association for theAdvance-ment of Science which met at Lille. The Medical section

of the French meeting was well attended, and the scientificwork of it was good. The Public Analysts are now be-coming an important power in the community. They helda meeting at Cannon-street Hotel on Friday, August 7tb,and in several resolutions expressed their mind on questionsinvolved in the working of the Adulteration Act.The General Medical Council had a long and important

sitting in the very hot days of July, from the 9th to the18th. The business was opened by a very perfect addressfrom Dr. PAGET, the retiring President, who, however, wasre-elected for the sitting of the Council. The chief busi-

ness of the Council was to receive the reports of the visitorsof the Examining Bodies, who had been appointed theprevious year to visit the px ,minations of the Society ofApothecaries; of the Royal College of Physicians and Sur-geons, Edinburgh; of the Royal College of Physicians,Edinburgh, and the Faculty of Glasgow; of the Facultyof Physicians and Surgeons, Glasgow; of the University ofGlasgow; of the Royal College of Surgeons in Ireland; of

the Qaeen’s University, Ireland. The pith of the reportof the visitors in the case of the above bodies may be found

in THE LANCET of July 18th. Suffice it to say generallythat the visitors report a terrible defect in preliminaryeducation. They recommended that teaching and examina-tion should not be in the same hands, and that in every

subject, especially in anatomy, they should be as practicalas possible. They considered that in most examinationsinsufficient time was allowecl to candidates. The reportsled to important debates and resolutions. We may specifythe proposal of Dr. HUMPHRY, seconded by Dr. PARKES,that the certificates of students should include certificates

of attendance at examinations from time to time held

on the subject of study to which the certificate re-

lates; and the motion of Dr. ANDREW] WooD, se-

conded by Dr. BEGBIE, limiting the area of examination

in zoology, botany, chemistry, and materia medica. The

question of Conjoint Schemes of course, for very decency’ssake, had to be noticed by the Council. But the question" seemed asleep or dead." In the preceding twelve monthsthe prospects of a Conjoint Scheme in Ireland had becomemore and more hazy. The Fellows of the Royal College of

Surgeons had met once or twice, and, on one ground orother, displayed strong objection to any scheme, and to theactual scheme in particular. Scotland had boldly given up-the question. Even in England the scheme seemed un-accountably to 11 stick " somewhere. We know now prettywell where. And the Council were reluctant to express

complacency with the state of the question. But Dr.

BENNETT begged hard for a little encouragement forhimself and his co-operateurs, and a vague resolution on the

subject was passed. At the end of the year the scheme is

still not completed, and he must be a sanguine man whoexpects to see it in operation. Meantime, the Council

grows very rich, and out of its accumulating wealth last

year allowed the liberal sum of a pound and threepence to-wards the expenses of a prosecution for an offence againstthe Medical Act. At the end of the meeting of the Council,to the regret of all its members, Dr. PAGET persisted in hisdetermination to retire from the chair, and Dr. ACLAND waselected to fill it.

In the " Mirror of Hospital Practice" we have duringthe past year reported an unusually large number of in-

teresting cases drawn from medical and surgical practice,

as well as from the special departments. We have, more-

over, endeavoured to increase the value of the reports bypublishing, whenever possible, a series of cases illustratingimportant points in the diagnosis of disease, and showingthe effects of treatment. Where the cases have been fatal we

have appended careful records of the post-mortem conditions.

The Mirror will therefore be found a good and useful com-pendium of morbid anatomy, as well as a safe and sure guideto clinical medicine and surgery. Great care has been alwaystaken to ensure accuracy and conciseness of the reports,and everything has been done to make this part of the

journal valuable as well as interesting. And here we must

not forget to express our indebtedness to the physicians andsurgeons of the various metropolitan and provincial hospi-tals, who have always given us their hearty,co-operation,andhave often furnished us with clinical remarks. Nor must we

neglect the numerous medical and surgical registrars, clerks,and dressers, who have always shown their willingness andreadiness to supply us with the details of the cases. We have,attempted to make each case more instructive by prefixingshort running comments, in which we have not only drawnattention to the salient points of each case, but explainedtheir significance and bearing by reference to other cases ofa similar nature. In a few instances we have ventured to

caution the reader against hasty generalisations from ex-ceptional cases; and, while giving rare instances of disease,we have not lost sight of what is the general rule. It is

difficult in the short space at our disposal to call attentionto all the facts which have been recorded in the Mirror, or to

particularise all the clinical and pathological knowledgethat may be gained by a careful study of the cases reported


therein. Every department has been well represented, andalmost every mode of practice exemplified. We have, forinstance, frequently called attention to the employment ofESMARCH’s bandage for the exsanguination of limbs beforeamputation, excision, ligature of vessels, or the opening ofaneurisms. Early in the year we reported the details ofan operation performed by Sir HENRY THOMPSON at Uni-versity College Hospital for the removal of a mammarytumour by means of gradual strangulation with an elasticligature, after the plan recommended by Professor DITTEL,of Vienna. Later in the year Mr. LAwsoN TAIT recorded

some cases in the Mirror affording further illustration

of this method of operating as applied to the removal ofvaricocele and the opening up of perineal nstulse. Duringthe year we have published a large number of interestingcases of aneurism in various parts of the body treated onthe most approved methods-by digital or instrumental

compression, by flexion, by ligature of vessels, or by openingthe sac. One of the reported cases was an instance of

traumatic femoral aneurism, under the care of Mr. DARKE,of Salisbury, and was cured in ninety minutes by digital com-pression. From Guy’s Hospital we have lately published aninteresting series of cases illustrating the surgery of arteries,and especially the value of torsion; also an instructive seriesof cases of colotomy, one of which showed very strongly theimportance of keeping the rectum clear of faeces after the per-formance of colotomy, especially where there is much ulcera-tion of the bowel or many fistulae. From St. Bartholomew’s

I

we reported a series of cases of compound fractures success-fully treated on the plan recommended by Mr. CALLENDER,of which plan we at the time gave a special report. Several

interesting cases of compound dislocations have been re-corded ; but one by Mr. JEREMIAH M’CARTHY is worthyof special notice. There was compound dislocation of theelbow-joint and rupture of the brachial artery; but the casewas successfully treated by simple dressings and by rest.We published also the notes of the dissections made by thesame gentleman in two cases of dislocation of the femur.From the Ardwick and Ancoats Hospital, Manchester, werecorded a case, under the care of Mr. LEGGE PEARSE, ofsimultaneous dislocation of both humeri at the shoulder-

joint ; and from the London Hospital the particulars of anoperation performed by Mr. MAUNDER, in which exostosis ofthe femur was successfully broken subcutaneously. From

St. Thomas’s Hospital and from the Wilts County Asylumwe published interesting cases of caries of the atlo-axoid

articulation, in which the lesion was not recognised till afterdeath. The various methods of treating stricture of the

urethra and of retention of urine have been frequentlyillustrated; and several cases have been reported of thesuccessful employment of the pneumatic aspirator in dis-tension of the bladder. The use of the aspirator fortapping of hernial protrusions, for the removal of fluidfrom the chest and from the pericardium, has also beenillustrated by cases. From King’s College Hospital wereported a series of cases showing the great value of

Sir W. FERGUSSON’s new operation for the closure of theclefts in the hard palate. Although this operation was ori-ginally proposed by DIEFFENBACH, to Sir WILLIAM reallybelongs the credit of its independent application and its

introduction to modern surgical practice. An interestingcase of facial anthrax with plugging of the facial and oph-thalmic vein, followed by recovery, was reported from theHopital St. Louis, Paris. The open treatment of wounds

was well shown in the records of some cases under the care

of Mr. DE MORGAN at Middlesex Hospital. From the same

hospital an unusual case of gunshot injury of the head wasreported. In this case the patient attempted suicide byloading a piece of gas-piping with powder and bullet andfiring it with one end against the wall and the other end atthe forehead. Mr. GEORGE LAwsoN trephined the skull, re-moved many fragments of bone and of bullet, and the

patient eventually made a good recovery. A few months

ago we published, with illustrations, the notes of two casesof lithotomy performed by Mr. TEALE, of Leeds. In one

case the stone weighed four grains and a half, and inthe other case eight ounces and twenty grains. About

three weeks ago we reported a case in which a plum-stone, lodged in the left bronchus, was removed byMr. MARCUS BECK by tracheotomy at University CollegeHospital. Among the medical cases we may mention a caseof enteric fever with typhoid symptoms prolonged into aperiod of normal temperature under the care of Dr. HENRYTHOMPSON, and a case of pyaemia with hepatic abscesssupervening on typoid fever from Dr. G. F. BURDER, ofBristol. Several cases of rheumatic fever have been pub-lished, in which almost every conceivable remedy has beengiven with varying success. The acid treatment and the

alkaline treatment, quinine, iron, and propylamin have allbeen shown to be valuable, or at least not hurtful, in somecases of acute articular rheumatism. In the first half of the

year we published a valuable series of cases of tubercular

meningitis from St. Thomas’s Hospital. For the excellent

notes of these cases we were indebted to Dr. GREENFIELD, themedical registrar. We have also supplied our readers with

many valuable contributions to the pathology of NervousDiseases. Chief among these were some interestingcases and valuable remarks by Dr. HUGHLINGS JACKSON,Dr. RAMSKILL, and Dr. JOHN OGLE, and a case by Dr.FERRIER. The association of granular disease of the kidneysand haemorrhages from the mucous membranes was veryclearly shown by Dr. HENRY THOMPSON, and more recentlyby Dr. ARTHUR Ems in the reports of some cases of menor-

rhagia. A large number of cases of ovariotomy have beenreported from the metropolitan and provincial hospitals;and an interesting example of puerperal mania with pplvichsematocele, followed by death, was reported from the WestRiding Asylum by Dr. CRICHTON BROWNE. The value, in

epilepsy, of bromide of potassium in large doses frequentlyrepeated, was illustrated in a patient under the care of Dr.RANSOME, of the Nottingham General Hospital. From

Charing-cross Hospital we published a case showing thuvalue of chloroform in chorea, and from the Royal UnitedHospital, Bath, another showing the value of chloral hydratein the same affection. Ophthalmology has been representedby the report of a case of perineuritis with total blindnessfrom the Birmingham and Midland Eye Hospital, andone of embolism of the central artery of the retina fromthe Leeds Infirmary. Lastly, we lately recorded a case fromUniversity College Hospital in which a child was shown to


have suffered from an acne-like skin eruption, shrewdly shows at once the Protean effects of this intestinal guest,traced by Dr. TILBURY Fox to taking milk from its mother, and the efficacy of discriminate treatment. He evidentlywho was under the influence of bromide of potassium. revels in the possession of nineteen tapeworm heads fromIn Therapeutics, interest still centres to a very large eighteen patients, not only as the guarantee of complete

extent in substances which, as a matter of fact, affect the cure, but as a rich accession to his cabinet specimens.nervous system, such as alcohol, chloral, belladonna, phy- Although the closing year is not likely to be rememberedsostigma, phosphorus, &c. The value of alcohol as a thera- as one in which crime was less in amount than usual, there

peutic agent is still a much contested point. But we have has, nevertheless, been an absence of crime of a sensational

lately had to remark on the great care and moderation with order. Public attention has not been roused by anywhich it is prescribed by the present leaders of medical villanous or subtle atrocity, and medical jurists have not

practice. The care with which a spirit ration was served been called upon to unravel any startling mysteries. The

- out, and its effects watched, in the Ashantee war, made the great question of identity involved in the TICHBORNE

subject of a very interesting communication to our own Trial has been settled, and perhaps we may go so far as tocolumns. To say the least, the teetotalers sustained in that say that the Lord Chief Justice has originated a newwarfare a creditable amount of health, and in sickness principle of identification by his axiom that however closelyshowed a creditable amount of recuperative power. The two persons may resemble each other anatomically, yetGold Coast campaign may be held to have proved, in the "no two persons ever were alike within." Certain it is

words of Dr. PARKES, that the rum-ration should not be that his masterly dissection of the inward ORTON, and his

given in greater quantities than two ounces and a half per comparison of it with the inward TicHBOBNB, served to

man daily, and that the time for giving it is not before or carry conviction when scars, thumbs, ears, twitchings,during, but after a march. We may hope that in future brown marks, and peculiarities had merely tended to makethe spirit-ration will be, as it was here, an extra to be given confusion worse confounded. One of the most importantwhen deemed expedient by those best able to judge of cir- advances in forensic medicine has been made by Dr.cumstances and the wants of men. That remarkable me- RiCHARDSON, of Philadelphia, who, by employing a mi-dicine physostigma stands credited in our first number, on crometer and the higher powers of the microscope, hasthe testimony of Dr. CRICHTON BROWNE at the Medical shown that a distinctly recognisable difference exists in theSociety of London, with having cured two cases of general size of the blood-cells of man and the other mammalia.

paralysis. Supposing there to have been no error of dia- Recent legislation has made it compulsory upon medicalgnosis, and no misconstruction of the relation of events in men to furnish, when applied to by authorised persons,these cases, we should say that this is the most remarkable certificates of the cause of death of their patients, and the

therapeutical achievement recorded in the year-much more Registrar-General has recently issued a new form of cer-remarkable than the several cases of tetanus apparently cured tificate, admittedly superior in every way to the old one.by chloral. The applications of the curative powers of this The science of toxicology is threatened with a severe

latter medicine become multiplied. Unfortunately the use of check from an unexpected source. The practice of cre-

the drug as a tippling agent also increases. Several cases of mation has been strongly advocated, and should it comepoisoning by it have occurred. Amongst the purposes for into vogue there will be, of course, an end to rc exhumationwhich it is recommended, with some show of reason, is as by order of the coroner." Civil cases involving medicalan anaesthetic in labour, and as a remedy, hypodermically questions have not been numerous. Payment of a life

injected, in cholera. In two or three cases of exophthalmic policy has been refused on the ground that material in-

goitre, under the care of Dr. R. T. SMITH, very great formation as to the habits of the assured was withheld,relief and advantage were obtained by the employment and although a verdict was originally obtained for theof belladonna. The question of the use of the cold bath plaintiff, the insurance company obtained a rule for a

in typhoid fever has been raised by an amateur thera- new trial. The case of SIMPSON V. DAVEY was one of a

peutist -in The Times; but there has been no important peculiarly painful and distressing nature, and has rousedaddition to our knowledge of its value. In the serious the sympathy of the whole profession. Dr. DAVEY has had

epidemic of typhoid at Lyons it was used extensively, but to pay .8500 damages (besides law expenses) because, havingwith rather injurious results in the production of con- unfortunately contracted syphilis at a midwifery case, andgestion, &c., and a correspondingly high rate of mortality. having infected with it another patient (Mrs. SIMPSON),The bath used seemed to be at too low a temperature- and, further, having undertaken to treat Mrs. SIMPSON freenamely, 68° F., and the use of it was not sufficiently re- of charge till she was well, he failed to fulfil his contract.

stricted to cases of hyperpyrexia. In November, Df. We would particularly remind our readers that Dr. DAVEYCLIFFORD ALLBUTT, of Leeds, discussed in our columns the has suffered, not on the ground of having infected a pa-mode of death in the early days of scarlatina, and gave tient, but merely on the ordinary ground of non-fulfilmentproof-first, of the frequency of hyperpyrexia as a cause of of a contract. There have been the usual number of

death ; secondly, of the efficiency of cool bathing in averting " railway cases" in 1874. A medical coroner has been

the tendency to death. The use of ipecacuanha in the form elected for Central Middlesex. In spite of the cruel attacksof spray for cases of winter cough and bronchitic asthma so repeatedly made on the late Dr. LANKESTER the free-is considered by Dr. RINGER in THE LANCET of Sept. 5th. holders showed, when that lamented gentleman died, "thatDr. SPENCEr., COBBOLD has just finished an account of cases they preferred efficiency to penny-wise economy," and

illustrative of the treatment of tapeworm, in which he elected Dr. HARDWICKE as his successor by a large majority.


The question of the, relation of crime to insanity has re- away of the epidemic in 1868 to a limited outbreak in the-ceived a good deal of attention, and although Mr. RUSSELL province of Kiev, South Russia, was followed, as is now

GuBNBY’s Bill for the codification of the law as regards well known, by the reappearance of the disease in an

homicide did not become law, there can be little doubt that actively diffusive form in the city of Kiev in 1869, and itsthe " talk " of this year will, ere long, assume a tangible subsequent spread over a large portion of the Continentform. Several of our professional brethren have been and continued prevalence in one place or another until thecruelly gibbeted-in the press and before the magistrates- present year. The causes of this active reawakening offor performing, or participating in the performance of, cholera at Kiev in 1869 have not been clearly ascertained,physiological experiments on live animals. and have formed the subject of an official correspondence ofThe year will be remarkable in epidemiological annals, great interest between the English and Russian Govern-

first, for the reappearance of plague in no less than three ments. The results of this correspondence, forming an im-different localities of Asia and Africa; and, next (we may portant series of papers on the scientific issues involved inmore reasonably hope), for the cessation of the long-con- the question, were published by the Local Governmenttinued prevalence of cholera in Europe. Early in the Board in the course of the year. While we write, the hopepresent year plague broke out in Mesopotamia, on the lower we had formed of some rest to this country and to EuropeEuphrates; somewhat later it appeared in the Regency of from alarm of cholera is disturbed by the news of a seriousTripoli, district of Bengazi, North Africa; and still a little prevalence of the disease in the Dutch Indian settlements.later in Western Arabia. The scene of the outbreak in These settlements contribute many pilgrims to the MeccaMesopotamia is memorable in ancient history as being within pilgrimage, and the Ottoman Government deems the chancesthe confines of Babylonia, not far distant from the ruins of of conveyance of cholera to Mecca by these pilgrims in thethe great city. Here, among the Afij Arabs, who occupy the approaching pilgrimage so serious that it has commissionedfirst of the great marshes which exist on the east bank of the Vice-President of the Constantinople Board of Health,.the river, and of which a series extends to the junction of Dr. ARIF BEY, to proceed to the sacred city to make pre-the Euphrates with the Tigris, the disease appeared. cautionary arrangements. At the same time Dr. C. MIL-

Spreading from the marshes, it extended along both banks LINGEN, of Constantinople, has been commissioned to visitof the river, attacking the different towns and villages as the Assyr district in Yemen to investigate the outbreak of

high as Hiliah. Travelling westwards also, it passed the plague there.marshes of Hindieh, on the west bank of the river, the A summary of the more important Sanitary Acts passedscene of the outbreak of plague in 1867, and attacked the during the last session of Parliament will best indicate thetwo cities, sacred to the Shiite Mahomedans, of Meshed Ali public health work of the Legislature during the year.

(Nedjef) and Meshed Hussein (Kerbela) on the border of First may be named the Sanitary Laws Amendment Act (37the great Arabian desert. It is estimated that this out- and 38 Vie., cap. 89), an Act of fifty-nine clauses, devoted,break carried off 4000 persons out of a population of 90,000. with more or less success, to the stopping of various gapsThe outbreak of plague in North Africa was first recognised in existing Acts, and which has, let us hope, a prospectiveat Merdj, a village twenty hours distant from Bengazi. It interest in being, if not the last, at least almost the lastis stated to have appeared first among a Bedouin tribe en- legislative straw under which the public health statutorycamped near the village, then to have extended to the camel must break down. Next is the Registration of Births,village, and to have subsequently spread among the tribes and Deaths Act (37 and 38 Vic., cap. 88), the fifty-fourinhabiting the district. Here the outbreak was preceded by sections of which amend much that was imperfect in theand occurred at a time of famine, and when the country previous Acts, and which at length secures the cardinalabout Merdj had been. converted’into a vast marsh by points of making the registration of births and deaths and

protracted rain. A French physician, Dr. LAVAL, un- medical certification of the cause of death (where a medi-fortunately contracted plague in investigating this re- cal man has been in attendance) compulsory. The amendedcurrence, and died from the disease. The outbreak Alkali Act (37 and 38 Vie., cap. 43) and a Vaccination Actis now reported to have ceased, but the loss of life it of two sections (37 and 38 Vic., cap. 75) need but this briefhas caused is not yet known. The district of Bengazi reference. An Act to regulate and otherwise deal with

was affected with plague in 1851. The scene of the Slaughterhouses and certain other Businesses in the Metro-outbreak of plague in Western Arabia is in the moun- polis (37 and 38 Vic., cap. 67), while enabling the local

tainous Assyr district, North Yemen. Here also, it is stated authorities to make bye-laws for the governance of existingin a recent report, that the disease is at an end. This out- businesses coming within its scope, absolutely forbids theirbreak would seem, so far as is yet known, to have been very establishment anew within the bounds of the metropolis.circumscribed, but of its nature no doubt appears to be en- A Public Health Act for Ireland (37 and 38 Vie., cap. 93),tertained. Plague, it is said, had not been known in Yemen laid down upon the same lines as the English Act of 1872,since 1816 until this appearance. although apparently less open to the vexations which haveThe probable cessation of cholera on the Continent re- accompanied the working of that Act, has, in reality, proved

lieves Europe from an incubus which has been weighing sufficiently flexible to be a source of peculiar vexations,heavily upon it for ten years. The disease has been un- under which our brethren across St. George’s Channel areinterruptedly present in Europe ever since its extension now groaning. Finally, we have to name a Working Man’sfrom Egypt to the southern coast of the Continent Dwelling Act (37 and 38 Vic., cap. 59), which enables muni-in 1865. The apparent cessation and actual dwindling cipalities to convert lands they may possess into sites for


each dwellings; and a Factories (Health of Women) Act,which limits and defines in a certain fashion the hours of

continuous employment of children, young persons, andwomen. The question of providing suitable dwellings forthe poor of London has occupied some of the time of Par-liament, and there can be little doubt that the MetropolitanBoard of Works will next session be provided with powerto acquire suitable sites within the metropolitan area forthe erection of industrial dwellings. Those who care to

know how the poor live will find many interesting detailsin the report of the special Commissioners whom we ap-pointed to investigate this important matter. Of sani-

tary administration in the past year there is little that

needs to be said. The Local Government Board, underthe presidency of Mr. ScLATER-BOOTH, has not added

to the muddle of administration created by Mr. STANS-FELD. This is a great deal to say, considering the difficult

position in which Mr. SCLATER-BoOTH must have been

placed by his predecessor’s administrative vagaries, and ityields some hope of a better future in the sanitary work ofthe Board.

Port Sanitary Authorities are increasing in number andimportance, and their influence in checking the importation-and perpetuation of epidemic diseases is being acknowledgedand appreciated. More than fifty such authorities havebeen constituted under Section 20 of the Public Health Act,and London continues to take the lead in organising a work-able system of surveillance of a kind necessarily novel andof some difficulty. The systematic inspection of vessels im-mediately after arrival, the removal and isolation of thesick, the examination of the drinking water, the closet

accommodation and state of bilges, the disinfection of

clothing, the inspection of foul cargoes, and other mis-

cellaneous duties, are found to be within the scope of work- of a port medical officer. At the beginning of the currentmonth a large party of Russian and German emigrants im-ported small-pox into the Thames, and, although the sickand suspected were at once separated from the healthy, thelatter proved to be infected, and took the disease to Liver-pool, where, however, it was successfully circumvented by thelocal authorities. The half-yearly reports issued by theCorporation of London, as sanitary authority of the port,show the large amount of sanitary work that has to be doneon this as on other rivers. Scurvy has exhibited a slighttendency to increase in our mercantile marine. Seven

official inquiries have been held by the medical officer of theBoard of Trade during the year on account of outbreaks ofthis disease; and in one of these the master of the shipwas prosecuted and fined for non-compliance with the sani-

tary clauses of the Merchant Shipping Act of 1867. Some

progress has been made in the ventilation of ships of allclasses; and much attention has been directed to this im-

portant subject, chiefly with reference to ironclads and toschool ships.Our Sanitary Commission during the year has issued

twenty-one reports-viz., four on the causes of certain out-breaks of fever, six on the drainage and general sanitarycondition of important towns and districts, and eleven on

sanitary matters of general interest, such as inquiries intothe condition of the dwellings of the poor, and the influence

of chemical manufactures on health, &c. The outbreak of

typhoid fever at Cambridge was the subject of our firstreport. The disease appeared late in the autumn of last

year, and, after slowly making its way along a certain lineof drainage, culminated in a severe outbreak in the new

buildings of Caius College. We attributed the spread ofdisease to the abominable condition of the town drains and

to the percolation of sewage matter into the wells ; and

suggested that the cause of the outbreak at Caius Collegewould be found in some defect in the main drain, by whichcontaminated excretory matter or sewer gas had found

access to the College buildings. Dr. BUCHANAN some weeks

later found that a portion of faecal matter -had been sucked

up from this drain, and had contaminated the water-supplyof that part of the College where the cases occurred. The

sanitary authority charged our Commission with exaggera-tion, and in order to colour this accusation they published areport purporting to contain extracts from ours, and whichthey evidenced as instances of exaggeration; these extractswere entirely imaginary, and had never formed part of ourreport at all. Towards the end of January fever againappeared in the town, and on our drawing attention to thefact they sent a notice to the daily press, stating that themedical men of the town had declared that only two casesof typhoid had occurred in the town during the month,suppressing the important statement of one of the hospitalphysicians that there were eight recent cases in Adden-brooke’s Hospital, two of which had been fatal. Retribution

speedily followed, and a committee was appointed to inquireinto the matter. The high death-rate at Newcastle, andthe prevalence of scarlet fever in that town, formed the next

subject of our inquiry. Newcastle of late years has under-

gone great improvements, but still much remains to be

done. We found the sanitary authority intelligent andanxious to do its duty. The chief factors in producingthe high death-rate of the town were-the injuriousinfluence of certain trades and manufactures, the

overcrowding of the poor, and the intemperancealmost universally prevalent. Whilst at Newcastle our

Commissioners directed their attention to the influence of

chemical manufactures on the health of the operatives, andvisited several chemical works and examined into the health

of the men employed; they also for the same purpose visitedseveral manufactories in Lancashire. The evidence theyobtained with respect to the health of the men employed atthe alkali works was somewhat negative. In the manu-

facture of bleaching-powder, for instance, they found thatif a man were originally healthy, kept sober, and employedthe usual precautions, he suffered but little, if at all. On

the other hand, if his chest were weak, or he were in-

temperate, or neglected the ordinary precautions, the worksoon proved fatal to him. The same held true of other

manufactures. Our Commissioners were able, however, tomake some important suggestions for the better protectionof the workmen from the noxious vapours and fumes presentin the chambers when at work. The Condition of the

Dwellings of the Poor was the subject of three reports.Notbing can be more distressing than the state of thingsrevealed by our Commissioners. The efforts of philan-thropists barely reach the evil, and strong measures are


required from the Legislature to compel landlords to furnish works are not yet completed, and the temporary outfall forat least a sufficient water-supply and decent privy-accom- the sewage is not sufficient. Consequently, the sewers aremodation for the occupants of their houses, even if they can- becoming choked, and a most abominable stench is the result.not materially diminish the overcrowding. The report on the The water-supply of the town is disgraceful, and the condi-outbreak of small-pox at Newmarket in August illustrates tion of the low-lying suburbs deplorable in the extreme. Twothe origin and progress of epidemic disease in a rural as deaths from typhoid fever have since occurred among thewell as an in urban district, and shows the kind of control undergraduates. Our Commissioners were able to make somethat can be exercised by the sanitary authority under the suggestions to remedy the present state of things, and in con-present system of working the Public Health Act. Our sequence of their representations some action is to be takeninquiry into the health and management of the children at in the matter. The correspondence in The Tintes during thethe Brentford Union Workhouse led us to the conclusion early part of November on the sanitary state of Winchesterthat the state of our workhouses is rapidly reverting to the led us to report on that town. Nothing could be more dis-status quo ante bellum 1866, and served to increase a growing graceful; there is no drainage, and the most primitive sani.feeling in favour of boarding-out pauper children. The new tary arrangements are everywhere present throughout thedrainage-works at Brighton were the subject of a lengthy town. The sanitary authorities are anxious to do something,.report. Whilst congratulating the authorities, and more and have certain schemes "under consideration"; the one

especially the visitors, on the sea being no longer a bath most likely to find favour is the ingenious system of

of dilute sewage, we do not think the scheme perfect. Captain LIERNUR. Early in the present month we re-Undoubtedly it will improve the health of the town, but ported on the outbreak of diphtheria in the married

considerably more pumping and flushing power will be re- men’s quarters at Woolwich, from which, out of nineteen

quired to carry off the excreta thoroughly. At all events, the children seized, fifteen have died. The localisation and

sewer is constructed, and the sanitary authorities must do fatality of the outbreak was no doubt due to the

the best they can with it. The neighbourhood of Ascot has dampness and extreme overcrowding of the huts in whichlately been growing in repute as a health resort. Our Com- these children were housed. It is distressing to find

missioners report most favourably of it as one of the most that Government has permitted such an intolerable

beautiful and the healthiest in the island. The water- sanitary nuisance to exist in spite of repeated remonstrancessupply is good and abundant. The town of Eton has earned and of the fact that during the last ten years the infantthe credit of being the first riparian town to take its name mortality has averaged sixty per thousand. How is it pos-off the list of Thames polluters. It has adopted the sible that sanitary measures can be enforced on negligentseparate system of drainage-that is, it returns its storm town authorities when Government sets the country such anand surface water to the river, whilst its sewage is disposed example ? A strong remonstrance has already been sent toof by irrigation. Towards the end of October the country the War Office on the subject, and, if the public presswas shocked by the terrible catastrophe at Over Darwen, continue to agitate the question, we hope by this timeand the disgraceful revelations made with respect to the next year to report that these hovels have been sweptsanitary condition of the place. Our Commissioners did not away, that comfortable spacious quarters have been pro-visit the town because the origin and the spread of the disease vided for our married soldiers, and that children are nowere so manifest, and the sanitary authority apparently so longer herded with their parents in the common sleepingapathetic, that they could have done but little good. They apartment. Our last report was on the subject of the

directed their attention, however, to the smaller town of Proposed Fever Hospital at Hampstead, ’which has been,Lewes, where an outbreak proportionately as severe had and is still, exciting so much public interest. We arrived

occurred about the same time. The conditions here were at the conclusion that most of the supposed dangers doexactly the reverse of those at Over Darwen. The town had not exist, and that such as are really to be feared may bea reputation for healthfulness, the sanitary authority were obviated by proper precautions. Our Commissioners sug-

active, there were no glaring sanitary defects, and the water- gested several measures which, if adopted, would avoid

supply was good. The cause of the outbreak in this case was many risks and remove many grounds of objection.eventually traced to some children opening avalve which shut At the close of the past year we were in the midst of oneout the water of the river from the water of the reservoir of of those "little wars" in which it is the misfortune of

the town water-works, so that contaminated water found this country to be from time to time engaged. The brief

its way to the inhabitants. The subsequent spread of the but brilliant campaign which ended with the capture offever was due to the sucking up of contaminated faecal Coomassie was undertaken in the teeth of great publicmatter and sewer-gas into the water-pipes of houses pro- opposition and amid gloomy forebodings and prophesiesvided with closets, caused by the varying atmospheric pres- that were wellnigh universal. At the beginning of thesure produced by the intermittent water-supply. An in- year we were recording the medical and sanitary arrange-vestigation into the sanitary condition of Epping led to the ments for the march to Coomassie; and now that this

most unpleasant revelations. Typhoid fever was extremely " doctors’ and engineers’ war" has ceased to possess

prevalent, and the water-supply is derived from wells uni- much more interest than an old almanac we recall the

versally polluted with sewage matter. So bad is the time when we ventured to dissent from the opinion sowater-supply that one gentleman pays .81 a week to obtain strongly and generally expressed that the Ashantee campaignpure water for his household. At the request of some inhabit- must have a disastrous ending. With the spring of 1874ants of Oxford we visited that town. The extensive drainage the sands of Sir GALBRAITH LOGAN’S official hour-glass


had run out, and Sir WILLIAM MUIR was appointed his presidencies have been too numerous to mention. Amongsuccessor in the direction of the Army Medical Department. the scientific contributions from officers of the British

Whoever is at the helm, it seems to be no easy matter for a Medical Service we would especially direct attention to theDirector-General to steer his craft amid the rocks and shal- prize essays by Mr. WELCH, of the Netley School, and bylows of official waters. The service has fallen on troublous Surgeon ALCOCK, on the Nature and Varieties of Destructivetimes; and the War Minister of the present Government Lung Diseases witnessed among Soldiers, both of which

has inherited a difficult task from his predecessor in office. are exceedingly well worth reading; the articles in THEThere is no concealing the fact that the late Government LANCET, embodying the results of the observations of

left the affairs of the Department in a disorganised and the various medical officers on the issue of a spirit-ration tovery unsatisfactory state, and that very great discontent soldiers on the march to Coomassie, drawn up, analysed,exists at the present time. The medical profession, and and commented on by Dr. PARKES; the papers by Surgeon-especially the medical officers, are looking forward withhope- Major Dr. LEITH ADAMS, F.R.S., on the Abnormalities andful expectation to Mr. GATHORNE HARDY to redress their Morbid Conditions met with in Recruits, containing, amonggrievances. So long as they remain unremedied, the service other things, some points having a bearing upon thecan only grow more and more unpopular. The medical Darwinianhypothesis; a good practical matter-of- fact report,profession in the public services generally have many and by Surgeon-Major SLAUGHTER, on the late outbreak of

just causes of complaint; and if their interests were, even Dengue; and a remarkable case of heart-disease, recorded

imperfectly, represented in Parliament, it would not be pos- by Surgeon LONGHURST, in which there was found an opensible for any Government to do the things that are now septum ovale, the inferior vena cava emptying itself intodone. Could anything, for example, be more illogical and the left ventricle, and in which there was no cyanosis presentunjust to members of the Indian Medical Service than Sir during life.JOHN STRACHEY’S appointment of a young civilian as Sani- Little need be said of the Naval Medical Service save that

tary Commissioner of the N.W. provinces of Bengal? It its ranks are daily becoming thinner through retirement,is tantamount to saying that sanitary science is a pretence, resignation, or dismissal of its members. In the early partfor it is a pretence if a man without knowledge or experi- of the year Sir DOMINIC CORRIGAN endeavoured to show

ence can discharge its highest duties. that young naval surgeons were suffering hardship fromAlthough we have no such important contribution to being compelled to serve against their will; and though, as

chronicle this year as that of Surgeon LEWIS’S very re- we pointed out at the time, if the authorities had no con-markable discovery of the presence of filaria circulating in trol over their officers the public service would come to a dead-the human blood, the members of the Indian and British lock, the disagreeables of a sea-life seem to have been

medical services have contributed their quota to the too much for many of the younger surgeons, who have in

scientific work of the year. The Ninth Annual Report of some cases submitted to a court-martial rather than con-

the Sanitary Commissioner with the Government of India tinue to serve. It has been announced, and, we believe, oncontains a remarkable paper, illustrated by some fifty-nine good authority, that the First Lord of the Admiralty hascoloured drawings, on the floating bodies in the air of that taken the matter in hand, and is uow engaged in perfectingcountry, by Dr. D. D. CuNNINGHAM, of the Indian Medical a warrant which will give satisfaction to both seniors andService, who has been employed under Government, in con- juniors in the matter of pay and retirement. We trust this

junction with Dr. LEwis, of the British army, in the in- may be so, and we believe that if Mr. WARD HUNT be wise

vestigation of cholera in India. Dr. CUNNINGHAM has also, he will endeavour to conciliate the seniors of the service, and

in addition, made many miscellaneous aeroscopic observa- enable them to retire at a comparatively early age on a pen-tions in connexion with the piesence, development, and sion, and that this will prove the most attractive bait to

influence of bacteroid and other bodies found in the air those about to enter on the struggle of a civilian medicalof certain localities, and in that of sewers, from which he life. The Ashantee War gave several naval medical officers

draws many interesting conclusions, one of which is that no opportunities of distinguishing themselves, and these re-

connexion can be traced between the number of bacteria, ceived their reward in early and well-deserved promotion.spores, &c., present in the air, and the occurrence of dis- Adverting for a moment to the biblicgraphy of the pastease, nor between the presence or abundance of any special year, we should say that a reference to our columns will

form or forms of cells, and the prevalence of diarrhoea, show that this is a writing age ; books and publicationsdysentery, cholera, ague, &c. Dr. VANDYKE CARTER has pro- accumulate so rapidly that it is next to impossible to keepsecuted and published his researches into the affection known pace with them. Still, we have striven to keep our readersas mycetoma, or fungus-disease of India. A Commission au courant with the science and literature of the day, and

composed of the leading medical authorities at Calcutta we have devoted a larger amount of space than usual to ahave instituted an exhaustive series of experiments into notice of continental works, which are not always acces-

the nature and effects of Indian snake-poison, as compared sible to all. To go over a list of works that have been re-

with that of Australian snakes-the Australian tiger-snake, viewed in our columns would prove tedious and useless ; butfor example,-which have established the correctness of the we would briefly advert to the three works on " Continuedresults previously arrived at by Dr. FAYRER, and proved Fevers," by Drs. MURCHISON, BUDD, and STOKES. The

the inefficacy of the ammonia treatment of snake-bite. The new edition of the first is, to our mind, an admirable bookcontributions in the shape of medical, sanitary, and sta- in every way, broad and philosophical in its grasp of prin-tistical reports from the medical officers serving in the three ciples, full and practical in its details. Of the second, Dr.


BUDD’S work, there is no need to say anything, beyond re- loss of Dr. PETER ALLEN. Another death, too soon for science,iterating our opinion of its great merits, and especially of but not too soon for the bequest of a bright example and anthe logical force of its author’s reasoning, conveyed in a honoured name, was that of Dr. JOHN JONES PHILLIPS of

style so perspicuous as to make it a model in’ its way. If Guy’s. Within a few days of each other passed away threewe do not agree with the doctrines advanced by Dr. STOKES, men eminently "representative," and not easily replaced-there is no gainsaying the fact that his lectures are rich in two of them typical specimens of that combined solidity andclinical observations; and his book serves to complete the re- force which sends so many Scotsmen to the front. Dr. NEIL

presentation of the views held by the most eminent phy- ARNOTT was not carried to the rear till after seventy years’sicians of our time and country on the subject of Fever. active service in the cause of humanity-a cause which heIn Surgery we have to note the issue of a third edition of benefited not only by his personal labour, but by his writtenDr. PIRRIE’S book, and a work embodying the observations publications and his munificent bequests to education. Aand lectures of Mr. CAESAR HAWKINS. We must not just thinker, a severe and penetrating student of symptom-omit to mention with satisfaction the papers in THE atology, and a pointed and occasionally eloquent expositor,LANCET on Hospital Construction, by Dr. SUTHERLAND retired from the field in Dr. ALEXANDER KILGOUR, whoseand Captain DOUGLAS GALTON. Our tribute to the merit green old age was closed in peaceful seclusion on his well-of Dr. BARNES’S work on the Clinical History of the earned property near Aberdeen; while Dr. FORBES WINLSOWMedical and Surgical Diseases of Women has been fully had not quite survived his vigorous and devoted energies inendorsed by the profession. A new edition of MEIGS’ and medico-psychology when he too was summoned to "thePEPPER’S Diseases of Children, and Dr. WEST’S well-known majority." Medical physics owes much to the first of thesework on the same subject, deserve a passing word. We physicians, medical diagnosis to the second, and the limita-reviewed at much length a number of works on the Anatomy tion of criminal responsibility in courts of law to the third.and Diseases of the Ear, by POLITZER, HINTON, TURNBULL, The Bombay army boasts of few abler medical officers than

ALLEN, and others. A new edition of DUNGLISON’S Dic- Dr. JOHN MACLENNAN, who discharged with equal prompti-tionary of Medical Science, large and valuable as it un- tude and effect duties apparently diametrically opposed; but

doubtedly is, would still be benefited by careful revision. a yet severer loss than his was that of CRUVEILHIER, the greatIn Mental Physiology Dr. CARPENTER’S 11 Principles " deserves anatomist, physiologist, and surgeon, a worthy disciple ofto be named as an important contribution to that subject. DUpuYTREN, and long one of the brightest ornaments of the

In Sanitary Science and Army Hygiene we have had many great Parisian school. 11 literary labour," says his com-

works in connexion with the late Franco-Prussian war, patriot and eulogist, M. BARDINET (himself just numberedLEx’s and ROTH’S contributions, and Dr. Guy’s Lectures on with the dead), "hospital practice, patients at home

the Sanitary Aspects of War. PETTIGREW on Animal Locomo- and abroad, faculty engagements, lecturing, and so on,

tion has excited some controversy. The notices of works in absorbed eighteen or nineteen of the twenty-four hours,

physical science, chemistry, on literary subjects generally, and this herculean work was carried on for many years.

on education, and those of biography and travel, in our Rarely has a man of science been so thoroughly kind

,pages have been very numerous, and served to vary those and considerate to his patients; rarely have the latter

subjects which more specially come within the province of more warmly reciprocated a welcome so sympathising."the medical journalist.

-

Truly "his works do fellow him," for few anatomists of

The Hospital Sunday movement grows and extends every- the century continue to fill a greater or a more honoured

where. In London, auspiciously begun in 1873, it expanded place on the bookshelves of the learned. About the same

in the present year, both as regards the sum raised and time England-and, indeed, the whole civilised world-

the number of contributing congregations. A separate began reluctantly to persuade themselves that the mightiestHospital Saturday movement, led by Captain MERCIER, has missionary explorer since LAS CASAS or XAVIER had died inbeen such a costly and unsuccessful enterprise that its DAVID LIVINGSTONE-died indomitable to the last, after a

promoters seem fain to disconnect themselves from it. life which more than any other realised ARNAULD’s noble

When they are quite satisfied of the wisdom of keeping rejoinder when entreated to rest-‘° Rest! we shall rest

Hospital Sunday and Hospital Saturday together, doubtless through eternity The arrival of his mortal part on our

the Mansion-house Committee will be glad to resume its shores enabled Sir WILLIAM FERCiUS90N to identify it by the

thought for the cause of Hospital Saturday. In the pro- recognition of the false joint which LIVINGSTONE had asked

vinces, notably in Liverpool, Birmingham, Newcastle, &c., Sir WILLIAM to examine in London some seventeen years

Hospital Sunday is increasingly popular. The universal before. The honour of a tomb in England’s Walhalla,

acceptance of this idea makes it increasingly obligatory on Westminster Abbey, was accorded to him; but his monu-

the committees to devise sound and liberal principles of ment- " sere perennins

distribution. Regalique situ Pyramidum altius,"—The roll-call reveals many gaps in the professional ranks.

Early in the year Mr. WORMALD, senior member of St. will be that disenshrouded Africa with its slavery sup-Bartholomew’s surgical staff, died at a ripe age; and Mr. pressed and its moral and religious darkness replaced byTHOMPSON DICKSON closed prematurely a promising career Christian science. From the same region continued toat Guy’s. A versatile hnd valued practitioner was lost to us come news of kindred though less irretrieva,ble loss-

in Dr. GEORGE BEAMAN-a connecting link between the old Surgeons MACARTHY and BALE, victims to the insidiousorder and the new; while aural surgery will long deplore the fever-blight of the Gold Coast, and poor DILLON, who died

913THE PROPOSED HAMPSTEAD FEVER HOSPITAL.

in delirious suicide in tracking the malaria-stricken routeof LIVINGSTONE. At home, the death of TAMPLIN caused a

blank, unique of its kind, in orthopaedic surgery; while inmedicine proper, CHARLTON, of Newcastle, has left an

honoured name for high professional skill and for versatileaccomplishment in walks remote from the physician’s beat.Drs. C. J. Fox, VESALIUS PETTIGREW, WM. LYON, andROBERT COWIE, were all notable in their way-PETTIaREWfor the part he bore in medical teaching, and LvoN forhis contributions to obstetric surgery. In the latter half

of the year we have lost, amongst others, Dr. JOHN

FITZGERALD CHARLTON, R.N.; J. H. SIMPSON, M.B. ; Mr.ALEXANDER CRAIG GIBSON ; ; JOHN BURFORD CARLILL,M.D. Lond. ; Dr. JOHN WILSON, of Devonport ; Mr. CHAS.WRIGHT SMERDON, of Clifton; Dr. CHARLES CHRISTOPHER

HAYMAN, of Eastbourne; FRANCIS EDMUND ANSTIE, M.f). ; zMr. EDWARD CUTLER, F.R.C.S.; Mr. W. BRANSBY FRANCIS,of Norwich; SAMUEL SOMERVILLE, M.D. ; Dr. WILLIAM

BATES, of Manchester; Mr. JOSEPH SWAN, F.R.S.; EDWINLANKESTER, M.D., F.R.S. ; Deputy Surgeon-General ALEX.BARCLAY, M.D. ; EDWARD SMITH, M.D., F.R.S. ; Dr. JAMESD. HENWOOD; EDWARD WILSON DUFFIN, M.D., F.R.C.S.; ;Sir JAMES RANALD MARTIN, C.B., F.R.S.; WM. HARGRAVE,M.B., F.R.C.S.I. ; JOHN FRANCIS M’EvERs, M.D. Glasg. ;Inspector-General CHAMBERS, M.D. ; Mr. JOHN B. FOSTER ;and WM. THOS. WILSON, M.D., R.N. Some of these died

full of years and honours, and thus ended honourable androunded lives. Others died in their prime, or before their

prime, like ANSTIE and FOSTER. Dr. ANSTIE’S death was

the cause to us of almost domestic grief, and threw ourpages, which he had so much enriched, into mourning. Weneed not recount again his virtues,-

" Since Heaven, what praise we offer to his name,Hath rendered too authentic by its choice."

We must here leave our attempt to exhaust the historyof medical labour. We can only, as busy men, snatch frag-ments from the accumulating pile of the stately building ofmedical science and art. We should especially like to have Iattempted to do some justice to our foreign brethren and toour American-we were going to say-fellow-countrymen;but we will content ourselves by referring to our constantattempt to represent in our columns the points of all

their scientific and practical work. Witness the ForeignGleanings, the letters of our Paris Correspondent, and ourfrequent leaders on physiological or pathological questions.As regards our American friends, what English surgeon didnot feel proud as he read Mr. ERICHSEN’s address, windingup with that accomplishment of Dr. SAYRE, the removal ofthe head of the femur fifty-two times, bearing the samerelation to Mr. STME’s excision of the elbow that the Reform

Bill of 1867 bore to that of 1832. We should like, too,

by a selection of the titles of the papers by which ourcolumns have been adorned during the last year, to show

. that we have not been unmindful of any of the many-sidedquestions of medicine. But we must deal with ourselves as

we have dealt with labourers abroad-refer to our own

pages. Medicine is becoming more and more an affair of

public interest. "Internationalism" has no dread to suggestwhen it represents the discussion of sanitary questions atVienna or physiological questions at Kasan. Be it ours in

the future not only to hold high the domestic and socialinterests of the profession, but also to recognise medicallabours everywhere, whether applied to minute and im-

palpable questions in pathology, or to those great questionswhich affect the health and the happiness of communities.Our pages shall be open, as they have always been, to thebusiest country practitioner as well as the leader of practiceand the hospital surgeon in town, so long as they have any-thing to say that will enhance the sum of human knowledgeor abate the sum of human misery.

Medical Annotations."Ne quid nimis."

THE HAMPSTEAD FEVER HOSPITAL.

WE had hoped that for the present at least our duty inreference to this question was exhausted, and that we hadplaced before the public both the facts of the case and ourown views upon them with sufficient succinctness to give aclear idea of our opinion of the subject. But at the meetingof the Asylums Board last week certain statements weremade by Dr. Cortis, which, if correctly reported in TheTimes, we cannot allow to pass unchallenged. Dr. Cortis,:,who is well known as one of the most active and influentialmembers of that body, is reported to have said that" THE LANCET, which at first supported the removal of thehospital, had sent a Commissioner, who had reported thatthe supposed dangers did not exist." The obvious corollaryis that our opinion as to the advisability of the removal ofthe hospital had been altered. Now we do not think that

any candid and intelligent reader who has taken thetrouble to read carefully the comments we have madefrom time to time on this subject, and the report ofour Sanitary Commission published in this journal last

week, could by any possibility be led to make sucha statement as to the facts or the conclusions to bedrawn from them. The view taken by THE LANCET uponthis subject has been consistent throughout, and our pre-dictions as to the probable issue have been almost exactlyverified, whilst the independent report of our SanitaryCommission merely served to complete the information uponthe subject, and to point out certain evils and the mode of

i remeding" them. On November 21st, in some remarks

upon the hospital, we said that the hospital when usedfor contagious diseases must damage, and that it has

damaged seriously, neighbouring property, hardly admits ofquestion; but to rest any serious action for its removal

upon such arguments as those advanced by Mr. Alford issimply to court failure,"-a prediction abundantly verifiedby the result. And we added, " the hospital ought neverto have been placed where it is,"-a position to which westill adhere. Again, on Nov. 28th, we remarked that whilst"the risk of spreading infection among the community inthe neighbourhood of such hospitals is apt to be much

exaggerated, the unanimous feeling of the inhabitants inthis respect should unquestionably receive full attention.The deterioration of one of the most lovely London suburbsis the reason on which the opposition is mainly to begrounded." In an article on Dec. 12th we again urged thesame view of the subject, and, in addition, we pointed out

certain dangers which seemed to us to require consideration.And, finally, the report of our Sanitary Commission, which,it must be remembered, had to deal solely with one side ofthe question, fully confirmed the statements which we hadpreviously made on more general grounds, and also pointed

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