395TURVEY TREATMENT, THE LEON SYNDICATE AND THEIR CONNEXION.

incidence of diphtheria attacks at all ages was, as in

previous years, greater on females than on males. Theincidence of deaths at all ages was the same on both sexes,while the case fatality was highest among males. Takingages into account, the greatest incidence of attack was uponmales of three and upon females of four years old ; the

greatest incidence of death in both sexes was upon infants ofone year. The case fatality was highest among male infants11nder nne year and among female infants of one year of age.For several years past enteric fever has been steadily de-

creasing in the metropolis ; in the year 1904 the reportedcases were fewer in proportion to population than in anyyear since 1900. In the county generally the decline in thecase-rate, death-rate, and case fatality has been main-tained, but some London districts suffer practically twiceas severely as others. Sir Shirley Murphy thinks thatthis may in part be due to differences in the food-supply,but that in all probability it is especially dependent onthe habits of the people which induce the spread of infectionfrom person to person. As has been observed in the caseof pulmonary tuberculosis, the districts inhabited exclusivelyby the very poor suffer from enteric fever more heavily thando the districts inhabited by the well-to-do. Efforts toreduce this disease should, therefore, be directed to the

discovery of persons suffering therefrom so slightly that,although infective to others, their own illness escapes re-

cognition and notification. When regard is had to the longperiod during which the enteric fever bacillus persists in theurine of patients affected with that disease the frequency ofthis mode of infection can be appreciated. Not many yearsago enteric fever was held to be non-infectious and cases ofthe disease were treated in general hospitals side by sidewith patients suffering from other diseases. In the presentreport, however, many instances are recorded of the spreadof infection from one person to another. Thus in Bermondseyparticulars are given d nine cases of the disease occurring inthe same house, eight of which were directly infected by thefirst patient, the cause of whose illness was unknown. In

Finsbury, Shoreditch, Wandsworth, Woolwich, St. Pancras,and elsewhere instances of this kind are recorded, in oneof which no fewer than 14 attacks appeared to be dueto infection from a single antecedent case. In severalparts of London various articles of food have come

under condemnation as carriers of enteric fever in-fection. Thus in a single year shell-fish was the

suspected vehicle in nine cases in Finsbury, in eightcases in Bethnal Green, in 12 in Poplar, in 23 in Lambeth,in six in Battersea, in 11 in Wandsworth, and in 13 inGreenwich. In addition to oysters, cockles, and musselsamong so-called shell-fish, other suspected articles of foodwere watercress, fried fish, and ice-cream.As regards the incidence of enteric fever upon the several

ages we learn from the report that although in proportion topopulation the attacks were most frequent in both sexes atages between 10 and 15 years, the deaths occurred mostfrequently in men from 25 to 35 years of age and inwomen 10 years earlier. The case fatality, however, washighest among men from 35 to 45 years old and amongwomen beyond their fifty-fifth year.

(To be continued.)

THE TURVEY TREATMENT, THE LEONSYNDICATE, AND THEIR

CONNEXION.

j

WE have received from Mr. F. S. D. Hogg, the superin- ftendent of the Dalrymple Home for Inebriates at Rickmans. v

worth, the following letter which we publish with a full ]

reply ; for we think it our duty to our readers to give them 1the information, while the circumstances deserve to be ibrought to the attention of the General Medical Council :- j

To the Editors of THE LANCET. ;StRS,&mdash; I have received in common with probably many members of <

the medical profession an invitation from a Mr. R. M. Pooley tosubscribe to the Leon Syndicate. This syndicate has been denouncedby at least one financial paper, but whether it be an honest financial 7venture or a ramp the conduct of a medical man in circularising the (medical profession in behalf of such a scheme seems to me open toprofessional criticism. Please express an opinion on this point.

I am perhaps critical of the circular letter because I believe the (

ll. M. Jfootey who signs it to be the consulting medical omcer to aquack treatment for drink called the Turvey treatment. The sanatoriumin connexion with this treatment is the Eden Hall Sanatorium, Wood-ford, the resident medical officer being a "Dr. Pooley." It seems tome that a member of the medical profession has no business to keep asanatorium where patients are treated upon a quack system and Ishould like your opinion upon this point also.

I am, Sirs, yours faithfully,Rickmansworth. F. S. D. HOGG, L.R.C.P.,&c.

We have received per,onally the letter puffing the LeonSyndicate, and we have also had copies sent to us byother medical men, but we will deal first with the questionof the Turvey treatment for inebriety. In July, 1905,we received a letter from a correspondent informing us thatthe Eden Hall Sanatorium, Woodford, was being run in theinterests of the proprietors of a quack treatment for

inebriety. We made certain inquiries and as a resultrefused to insert the advertisements of the sanatoriumuntil we had learned particulars of the therapeuticmethods adopted. Whereupon there came a letter fromthe Eden Hall Sanatorium signed R. M. Pooley refusingthe particulars but saying that we were "labouring undersome delusion." An appointment was made for an interviewand a gentleman giving the name of R. M. Pooleyappeared at this office prepared, it seemed, to deny, as

resident medical officer of the Eden Hall Sanatorium,any connexion with the Turvey treatment. To this gentle-man there was shown a prospectus of the Eden HallSanatorium and a prospectus of the Turvey British andForeign Institutes, Limited (a company formed for the pur-poses of acquiring proprietary rights in the Turvey treatmentfor inebriety), with the name upon each prospectus of aDr. Pooley. It was pointed out to him that Mr. StuartRobertson, the managing director of Eden Hall, was a

director of the Turvey British and Foreign Institutes ; thatthe Rev. James Stephen Barrass, rector of St. Lawrence Old(sie) Jewry, had the doubtful honour in each case of beingcalled chaplain; that the assistant medical superintendentwas in each case a Dr. Wright; that the London offices andconsulting-rooms of Eden Hall were the offices of theTurvey British and Foreign Institutes, Amberley House,Norfolk-street, Strand ; that one of the telegraphic addressesgiven for Eden Hall was "Turvert, London " ; and lastly,that on the prospectus of the Turvey British and ForeignInstitutes the name of Dr. Pooley was given as medical

superintendent of the Institutes and as residing at EdenHall, Woodford. In these circumstances our visitor wasprobably not surprised when we told him that we consideredthe connexion of Mr. R. M. Pooley, he being the Dr. Pooleyof Eden Hall, with the Turvey treatment of inebriety to beestablished.

It has recently come to our attention that Mr. Pooleyis suggesting that an old-time and unfortunate flirtationwith the Turvey treatment has now been abandoned. Mr.

Hogg sends us a letter dated Jan. 8th in which Mr. GuyElliston, the Secretary of the British Medical Association,says that Mr. Pooley had assured the Ethical Committee ofthe Association that he was no longer connected with theTurvey treatment. Anxious to do justice to Mr. Pooley wecaused inquiries to be made into the matter. On Tuesday,Jan. 23rd, we obtained from Amberley House a prospectusof the Turvey treatment, when we found that the sana-

torium in connexion with that treatment was no longeradvertised by name and that the medical superintendentalso remained anonymous. Clearly Dr. Pooley of EdenHall no longer desired to publish his association withthe Turvey treatment. But a letter to Amberley Housewritten two days later asking if the Turvey treatmentcould be pursued at a sanatorium brought to the writer aprospectus of Eden Hall Sanatorium, "resident medical

superintendent, R. M. Pooley, M.R.C.P., &c.," and a letter

signed J. Stuart Robertson, secretary of the Turvey Treat-ment Company, saying, " I enclose you prospectus of EdenHall where the patient could undergo the Turvey treatmentunder the care of a medical man." Any doubt as to theidentity of the medical man referred to was solved by a letterfrom Mr. Robertson four days later, saying, " I have seenDr. Pooley with reference to the reception of your patientand he could arrange to receive him at once." In face ofsuch letters as these there can be no doubt that Mr. Pooleyis, and has all along been, connected with the Turvev treat-ment of inebriety, and we consider the connexion a highlydiscreditable one.We have been requested by several correspondents, as well

as Mr. Hogg, to state our opinion upon the professional

396 THE MORIEON LECTURES.

.propriety lately exhibited by Mr. Pooley His issuing ia circularinvitation in behalf of the Leon Syndicate, Limited. Thefault here is venial compared to the gross error of parlici-pating in the profits of a quack cure for inebriety, but it isgrave enough. The concern in question is an explorationsyndicate whose (to quote l4lr. Pooley) ’’ work will consistin forming companies and other business undertakingswhich the wide distribution of its one-shilling shares (auseful innovation), and the large working capital, place itin a strong position to do." We procured a prospectusof this company and find that the directors are statedto be Charles Gordon-Lennox Beale, 2, Norfolk-street,Strand, W.C. ; Frank Chetwood Doyle, 3, Verulam-buildings, W.C., and Richard Charles Mason Pooley,M.R.C.P., &c., V.D., Monkhams, Woodford Green. Westrongly recommend our readers to have nothing to do withthe venture which, by the way, has already been unkindlycriticised in at least one financial paper. Mr Pooleyclaimed a sort of disinterested professional feeling in advo-cating the claims of the Leon Syndicate. " It is not

often," he says in his circular letter, " that a medico can

help his professional brethren to make money." "

It is notoften, we think, that a medico has written such a circularletter in support of such a scheme, and those whom beterms his brethren may think as we do, that the letter andprospectus might be laid before the General Medical Councilfor decision as to whether Mr. Pooley’s conduct is ethicallycorrect-as to whether, in fact, Mr. Pooley ought to con-tinue to have the right to address members of an honourableprofession as his brethren. But apart from all professionalquestions, Mr. Pooley seems to us too elusive in his addressand style to be a satisfactory guarantor of a financial scheme.The Richard Charles Mason Pooley, M.R C.P., &c.. V.D., ofMonkhams, Woodford G:een is undoubtedly the Mr. Pooleyof Eden Hall, for in a letter written to one of our

correspondents who had inquired about the Turvey treatmentMr. Pooley replied on paper headed "Monkhams, WoodfordGreen," which he said was the old name of Eden Hall usedby him in his private correspondence. The possession of twoaddresses, which are really one and the same address, doesnot commend itself to u-!, the opportunity thus given for

mystification being obvious, and therefore particularlyunfortunate in a man who is circularising the medical

profession with invitations to part with money uponthe strength of his personal assurance. But granting thatthere are reasons why an inebriate home might well be con-ducted under a private address as well as a professionaladdress, Mr. Pooley’s other varieties of style and locationdisplay a tendency to be confusing and confused. We learnfrom the prospectus of the Leon Syndicate that his nameis Richard Charles Mason Pooley and that he lives at

Monkhams, Woodford Green. We learn from the currentMedical Directory, where, however, the name has an asterisk,and from the Medical Register, that the address of RichardOharles Mason Pooley is 35, Highbury-grove, N., whilethere is no Richard Charles Mason Pooley among the

provincial names. Whatever the intention the significanceof this seems to be that if anyone consults the MedicalDirectory to find out the name of the medical officerof the Turvey Sanatorium at Woodford the name will not befound. Mr. Pooley uses only two initials in signing hisletters and on the various Turvey documents is styled " Dr."Pooley. In the Medic,l Register he is described as

M.R.C.P.I.: in one of his advertisements which we havereceived he figures as M R. C. P. E. and V. D. The assumptionof the medical degree is made by others besides Mr. Pooley-we hasten to admit this-but it is none the less an

assumption and warrants us in asking the date on

which he received his military decoration. We do not

- sa,y that he does not possess it, but we cannot find hisname in the more recent Psts of officers possessing thedecoration. When we recall that Dr. R. M. Pooley, or Mr.R. C. M. Pooley, of Eden Hall, Woodford, or Monkhams,Woodford Green, and also of 35, Highbury-grove, N.,can moreover be addressed at Amberley House, the office ofthe Turvey Treatment Company, we do not yet exhaust thenumber of roofs that shelter him. He is to be seen

"generally here between 3 and 4 o’clock," "here beingthe office of the Leon Syndicate, and the invitation isextended to members of the medical profession desirous ofparticipating in the benefits of that scheme.We commend Mr. Pooley to the attention of the General

Medical Council, at whose disposal are the documents fromwhich this statement is written.

THE MORISON LECTURES.1

THE second of these lectures was delivered in the

hall of the Royal College of Physicians, Edinburgh, on

Jan. 26th. Dr. W. FORD ROBERTSON said that he wishedto deal chiefly with the results of an experimental inquirythat Dr. G. Douglas McRae and he had made into

the action of the living blood and blood serum upon

pure cultures of diphtheroid bacilli isolated from cases

of general paralysis. The bacillus with which they hadworked was one which in respect of its morphologicalcharacters, staining reactions, and p( war to form acid in

glucose broth, closely resembled the Klebs-L&ouml;ffier bacillus.It had been laid down by high authorities that an organismdiffering from the diphtheria bacillus solely in want ofvirulence must be regarded as merely a diphtheria bacillusin an attenuated condition and should be spoken of as such.In previous papers the organism had therefore been pro-visionally regarded as an attenuated form of the Klebs-Lonler bacillus. Whether it was really of this nature or notwas an open question. Their more recent observations

strongly inclined them to the view that it was a specialorganism. Having referred to the remarkable polymorphismof this bacillus, the lecturer considered specially its threadform. The organism had been observed to invade thetissues in this form in several general paralytics ; it hadalso been observed invading in four rats fed or injectedwith cultures of the bacillus. The bacillus when firstisolated often showed a strong tendency to form threads.They had endeavoured to ascertain how the organismcould be made to assume this special character and

they had succeeded in obtaining a filamentous growth bycultivating it for several days at 41&deg; C. upon blood films. Itwas therefore probable that invasion by the thread formoccurred in cases in which there had been a susta’ned hightemperature for several days before death. One of the

points which they had specially studied was the phagocyticaction of the leucocytes upon the bacillus. They had useda technique of their own. Two actions required to be

studied-namely, the power of the leucocytes (in thenatural serum) to take up the bacilli and the power ofthe leucocytes to dissolve the bacilli when engulfed. Noconstant alteration could be detected in the power oftaking up in the general paralytic’s blood. On the otherhand, the power of dissolving the bacilli when takenup bad in most cases been distinctly greater on the part ofthe leucocytes of the general paralytic than on that of theleucocytes of the controls. Within the first three hours ofincubation at least the lysogenic action was entirely intra-corpuscular. Having studied the appearance presented bythe dissolving organisms in the experimental films, theyendeavoured to ascertain if bodies having a similar appear-ance could be found in the fluid and tissues of the generalparalytic. Every case studied with this object had given thesame affirmative answer. Diphtheroid bacilli, more or lessaltered by lysogenic action, were present in great numbersin the catarrhal pneumonic foci that occurred in most generalparalytics dying in congestive attacks. They could also bedetected in the adventitial spaces of the inflamed cerebralvesels and in the meshes of the pia arachnoid. Further, theycould be observed in the films made from the blood of theliving paralytic, especially if the patient was suffering froma congestive attack. They could also be detected in the

centrifuge deposit from the cerebro-spinal fluid obtained bylumbar puncture. Lastly, they were often present in largenumbers in the centrifuge deposit from the urine, especiallyduring a congestive attack. This experimental study hadsuggested to them that failure to obtain cultures from theblood and cerebro spinal fluid depended upon the fact thatmost of the bacilli were dead and that the few living onesthat were occasionally present were killed in consequenceof the continued action of the phagocytic cells. They hadtherefore tried various measures with a view to preventthe continuation of this bactericidal action, the simplest ofwhich was to allow the tube to -stand in the cold for24 hours before incubating them. By adopting this plan,or slight modifications of it, t]2ey had succeeded in gettingpure growths from the blood in four cases (three of the

1 An abstract of the first lecture was published in THE LANCET ofFeb. 3rd, 1906, p. 324.