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examined eighteen others. In the gorilla the chest was i

planted a vertebra lower than in man. The seventh vertebra (

presented all the characters of the normal sixth, the eighth t

all the characters of the seventh. In man he had seen fthe whole chest a vertebra too high. He had met with three i

cases of a rib more than usual. It was common enough in i

the human body. The cervical rib was more frequently met (

with than a supernumerary rib in the lumbar region. In 1the cases of three out of fourteen gorillas the extra rib was iin the lower part of the chest. The gorilla had one more rib ’than man, but Professor Struthers had never met with the cer- 1vical rib in the gorilla in the upper part of the chest. Thetendency in the human chest was to move upwards ; thetendency in the gorilla’s chest was to move downwards.The use of narcotics in the Nicobar islanders was explainedby Mr. E. H. Man. Among many of the races of Trans-

gangetic India and the Archipelago the habit was commonof taking frequent quids of betel-nut and quicklime through..out the day. So firm a hold had this practice on both sexesthat "betel quid-taking time " was a recognised expression,signifying an interval of some fifteen minutes’ duration.Betel-chewing was commenced at the early age of ten ortwelve, but instances were by no means rare of children whohad acquired the habit before attaining six and even fouryears of age. Professor Macalister gave interesting descrip-tions of skulls from the Upper Congo, of the features of thebrain of an aboriginal Australian, and the facial charactersof ancient Egyptians as illustrated by skulls of undoubtedantiquity.


second NOTICE.]Ix our last issue we gave a brief account of the proceedings

which took place at the meetings on the first two days ofthis Congress. On the third day, in Section A, several paperswere read bearing upon psycho-physical questions, amongthem one by Dr. Verriest on the Physiological Basis of

Rhythmic Speech, and one by M. Binet, who is peculiarlyqualified to speak on such a subject, on the Psychology ofInsects. In Section B, where hypnotism and kindred sub-jects formed the basis for discussion, Professor Delbceufread a paper on the Appreciation of Time by Somnambulists.His observations were carried out on two subjects-young,robust and healthy countrywomen, whose names frequentlycrop up in works on somnambulism. These subjects, he said,were incapable of reducing exactly into hours and minutes anumber of minutes, such as 1000 or even 350, and still lessof calculating at what hour the 1050th minute after,e.g., 6.35 P.M. would fall ; but yet they received suggestionswhich they were to perform after 350, 900, 1600, 1150, 1300and 3000 minutes ! No conclusions were sought to bededuced from these results, but Professor Delboeuf said

they were such as to merit attention and study. Other

papers were read, one by Professor Hitzig on Attacks of

Sleep and Hypnotic Suggestion, and one by Mr. F. W. H.Myers on the Experimental Induction of Hallucina-tions. Professor Janet discussed this paper at some lengthand mentioned some curious experiences. Thus one day ayoung female patient had an attack of somnambulism, duringwhich she had written a letter which she had afterwards tornup and the contents of which she had forgotten. By causingher to gaze upon a shining surface he succeeded in makingher read by hallucination the whole of the letter. Anotherpatient, a young man, was in constant fear without knowingwhy. If he gazed on a shining surface for some time hewould see the flames of a fire, and after listening for sometime to a monotonous sound he would hear the sound of afire-brigade bugle, and in this way was revealed the persistentidea which he had of a fire which he had witnessed sometime previously. To explain such facts different causes wereto be looked for in different cases. Professor Baldwin, in apaper on Suggestion and Will, endeavoured to find out theperiod in childhood at which will commences. He classifiedall responses of the infant in movement as preimitation,imitation and persistent imitation suggestions. In thefirst four weeks of life the infant’s movements are

largely organic and instinctive, but it then begins to

respond to suggestions from others and from its environ-

ments. As soon as the child begins to see the inadequacyof its spontaneous imitations and to make efforts to improvethem, will arises. He also argued that the loss of the mentalfunctions in disease is by stages which form a series thereverse of that required for their acquisition. Some discussionfollowed, and then the president read part of a report of thecensus of hallucinations which since the last meeting in 18891has been actively carried on in England, and to some extentin the United States, France, Germany, Russia and Brazil.To the question " Have you ever, while in good health and?believing yourself to be awake, seen a figure of a person or.’an inanimate object, or heard a voice which in your view was.not referable to any external physical cause " 17, 000 answers,were received in England. It appears that about one in tenof persons taken at random had experienced hallucinations. ofsome kind, the apparitions being mostly those of livingpeople or unrecognised human figures. A remarkable class’was that of collective apparitions, the same hallucinations.being simultaneously perceived by two or more different people,.although in serne of these instances there seemed to be a pos--sibility of verbal suggestion from one to another. But afterall deductions for possible sources of error there was a strongpresumption against chance coincidence, if ordinary accuracy:on the part of informants was to be assumed.On the concluding day of the Congress Dr. Pilchener read.

a paper on Binocular Effects of Monocular Stimulation, and’Dr. H. Donaldson gave in some detail his observations on the’

anatomy of the blind deaf-mute, Laura Dewey Bridgman.Dr. Berillon’s paper on Les Applications de la SuggestionHypnotique à 1’Education, in which it was stated that cases.of nervous insomnia, somnambulism, stammering, inveterate.’idleness &c. had been successfully treated by hypnotism, raised.considerable discussion and some adverse criticism. Dr. VanEeden considered that it was undesirable, for example, too

paralyse a child’s arm by suggestion and that moral sugges-tion alone should be employed, and Dr. Bernheim expressedthe opinion that regular hypnotisation was not often needed’;in young children, the mother being able to inspire the needed.1suggestions at times of special susceptibility. Suggestion, he>

thought, had a rôle in correcting the perversions of moral-Isense, the result of bad companionship, but it could notcreate either an intelligence or a moral sense not born in achild. Dr. Berillon’s reply was to the effect that the resultof treatment alone would show whether the lack of moralsense in a child was due to original defect or to subsequentperversion.

Mrs. Sidgwick read a paper on Thought Transference.Numerous experiments had been made, and the successful3percipients had been seven in number and were generallyhypnotised. One percipient had succeeded in the experi--ments with numbers, when divided from the agent by aclosed door and a distance of about seventeen feet, and the-ideas had reached the percipient, as visual impressionsrecurred with closed eyes, or as hallucinations on a card or-paper, and in other ways. Attention was drawn to the fact;that only some persons are capable of acting as agents or per-cipients, and that there is variation in this peculiar ability tinthe same person on different days, and even at different times.on the same day. Several other papers were read, among them!one by Dr. Wallaschek on the Effect of Natural Selectionon the Development of Music, and with a paper on a Systemof Psychological Interrogation, by M. Marillier, the scientinc.-business of the Congress ended.

It was decided that the next congress should be at Munichin 1896, but a suggestion was made to hold a special meetingin America next year. When the usual votes of thanks hadbeen passed, including one to the President and Council offUniversity College for the use of the rooms, the Congress wasformally dissolved.


THE question of a holiday to a general practitioner is so.inseparably connected with that of securing a satisfactory-locum tenens that in many cases the one may be said entirely to’depend upon the other. Those who are in the habit of going’away annually gain by experience a knowledge of the modus:operandi and are in no need of advice from us. Those, onthe other hand, who have only recently commenced practice,or who have had no experience of what leaving the care of



one’s patients to a stranger implies, may be glad of some fewhints on the subject. If the services of a personal friend canbe obtained, so much the better; if not, resort must be had toadvertisements, medical agents, or perhaps to some friend onthe staff of the practitioner’s old hospital. Answering advertise-ments implies some little delay, for of course references are ]necessary. Too much reliance must never be placed on these, forthough testimonials may be given in perfect good faith they,are generally written immediately the engagement is con-cluded and before any but the most serious causes ofdissatisfaction have come to a principal’s knowledge. Someagents request all principals to whom they have sent a locum’tenens to fill up forms concerning him at the end of the.year, and in this way they manage to purge their lists ,of unsatisfactory men, who, it is only fair to say, formbut a small minority. The lowest terms generally offered- to a locum tenens are three guineas a week, with, ofcourse, board, lodging, and travelling expenses to andfro. The agent charges a small fee, generally 10s. 6d., to-each party. ’

Supposing all arrangements made and the day fixed forgoing away, care should always be taken to secure a sufficiently’long interview with the locum tenens to show him all the:surgery and other arrangements, and to have a good talk with,him over the cases under treatment or likely to be so. Ofall these he should jot down notes unless the principal has.already done so. Many memoranda are required which wouldnot be found in the notes of a hospital clinical clerk-e.g.,whether visits should be paid daily or otherwise and whether:any particular period of the day is unsuitable. Care.should be taken that every bottle in the surgery and,.store cupboard is properly and sufficiently labelled, and,- if private formulas are employed, that they should be easily.accessible. If private abbreviations are used in the day-book, the locum tenens should be told what they mean;’vaccination arrangements also must be explained to him. He- should be shown where all the dressings, splints and instru-ments are, and told what neighbouring practitioners he shouldapply to for assistance, and what to do if drugs or dressingsrun short. The stable arrangements should be shown him, and’it should be clearly settled whether he or the groom is to drive.The night bell, speaking-tube and slate for messages must beshown him, and, if possible, a map of the district left withIhim.

The confinement list will be worthy of a few minutes’ conver-.sation, and he must know how many after-visits are expected’.in a normal case. The scale of fees must be told him and he- must understand whether he has authority to give receipts. It- its often better to let the locum tenens send an acknowledgment- of money received, with a promise that a formal receipt will be. sent by the principal on his return. In case payments have tobe made to the groom or surgery boy or for postage, some’money should be left with the locum tenens. Whereappoint-ments are held the duties should be clearly explained, and’he should be told how to distinguish between club and

private patients who may call at the surgery, otherwise the- day-book may be filled by the names of those who donot pay, while those of private patients are omitted.If possible, a definite date should be given for the prin-cipal’s return, so that the locum tenens may take another- .engagement.

As to household arrangements, a locum tenens should betreated with consideration and his tastes should be as far as

possible consulted. In conclusion, it may be said that thoughdifficulties and unpleasantness do at times occur during the:absence of a principal, the probability of anything takingplace at all seriously damaging to a practice is exceedingly,small if ordinary care be exercised in making the arrangements, and especially if the holiday be limited to three or four"weeks.

DERBYSHIRE ROYAL NURSING INSTITUTION.-The annual meeting of the Derbyshire Roval Nursing andSanitary Institution was held on the 5th inst. at theSt. James’s Hall, Derby. The Mayor (Mr. T. H. Harrison)presided. The twenty-seventh report gave a satisfactoryaccount of the working of the institution with regard to bothits financial condition and the benefit conferred on the poorby means of the Society. Since 1865 (when the Associationwas established) 219 nurses had been supplied to the public.The services of Dr. Ogle as honorary secretary for twenty-seven years were duly acknowledged.



St. Luke’s, Middlesex. —In this metropolitan district thedeath-rate for 1891 reached as high as 30’1 per 1000. Thecorresponding rate for 1886-89 was only some 21 per 1000,and the great increase is found by Dr. Yarrow to be mainlydue to bronchitis and pneumonia brought about by the influ-enza epidemic. The ordinary zymotic diseases were by nomeans exceptionally prevalent and it seems that specialattention is given as regards those which are notified.It has been suggested in St. Luke’s that erysipelas might beeliminated from the list of such diseases, and that measlesshould take its place. To the latter proposal Dr. Yarrowtakes exception. He holds that it is practically of no usehaving notification without means of hospital isolation. Weimagine that anything like hospital isolation of erysipelasdoes not exist; whilst, on the other hand, a number ofmedical officers of health have found that considerableadvantage has accrued as the result of their being able todeal with the spread of measles through the agency of

elementary schools, as they obtain thus early knowledge ofits existence in individual households.

Bollington Urban District. - According to Mr. JamesAllen the death-rate of this district during 1891 was 15’6per1000 living. The unsatisfactory condition of the privies andmidden-privies is maintained, but it is stated that a differentmethod of scavenging has been inaugurated. Another defectlies in the reception of sewage into the bed of a stream whichbecomes dry, the result being an obvious nuisance.



IN thirty-three of the largest English towns 5782 births and3395 deaths were registered during the week ending Aug. 6th.The annual rate of mortality in these towns, which had de-clined in the preceding three weeks from 17’9 to 17’3 per1000, was last week 17’4. In London the rate was 17’2per 1000, while it averaged 17 ’5 in the thirty-two provincialtowns. The lowest rates in these towns were 94 in

Wolverhampton, 10’0 in Gateshead, 10’8in Croydon and 10’9in Burnley; the highest rates were 21’0 in Salford, 21.1 inBirkenhead, 21-4 Cardiff, 23-9 in Sunderland and25’2inLiverpool. The 3395 deaths included 623 which were

referred to the principal zymotic diseases, against 625and 585 in the preceding two weeks; of these, 300 re-

sulted from diarrhoea, 126 from measles, 61 from scarletfever, 57 from diphtheria, 54 from whooping-cough, 25from fever" (principally enteric) and not one from small-pox. These diseases caused the lowest death-rates inHalifax, Brighton, Croydon and Newcastle-upon-Tyne, andthe highest rates in Liverpool, Sheffield, Sunderland, Birken-head and West Ham. The greatest mortality from measlesoccurred in Bristol, Salford, West Ham, Oldham andSunderland ; from scarlet fever in Swansea and Plymouth;from whooping-cough in Preston, Burnley and Birkenhead;from "fever "in Sunderland and from diarrhoea, in Derby,Bolton, Sheffield, Portsmouth, Leicester, West Ham, Liver-pool and Cardiff. The 57 deaths from diphtheria included42 in London, 3 in Birmingham and 2 each in WestHam, Preston and Sheffield. No death from small-pox was registered either in London or in any of thethirty-two provincial towns; 7 cases of this diseasewere under treatment in the Metropolitan Asylum Hos-pitals and 4 in the Highgate Small-pox Hospital onSaturday last. The number of scarlet fever patientsin the Metropolitan Asylum Hospitals and in theLondon Fever Hospital at the end of the week was

2995, against numbers increasing from 1226 to 2864 onthe preceding nineteen Saturdays ; 346 new cases were


admitted during the week, against 382 in each of theprevious two weeks. The deaths referred to diseases of therespiratory organs in London, which had declined from 185

- to 155 in the preceding five weeks, further fell to 143 lastweek and were 47 below the corrected average. The causes