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the bacillus in bone marrow or the pulp of spleen maceratedat a low temperature. It is more resistant to warmth thanto cold and can only be preserved by exclusion of air andlight. Curiously enough, according to M. Chantemesse, itstoxic power is more marked among large than small animals.He is now making inoculation experiments upon horses atthe Institut Pasteur, and we may expect the records of hisresults. At the Société Médicale des Hopitaux M. Ferrandand his assistant gave an account of a singular case of

apparent typhoid fever in which the serum reactions ofM. Widal had been obtained when the patient was in realitynot suffering from typhoid fever, but from septicaemia theresult of an injury to his finger. M. Widal, who was presentat the meeting of the society, criticised the method employedby the experimenters in the case.

Le Service Médical de Nicit.

This service continues to occupy the attention both ofmedical men and the Municipal Council. During ten yearsit has rendered the greatest service to the community, foranyone taken ill during the night was able to obtain from the ’,police station the help of one of the medical men enrolled forthe service. A medical man summoned in this way was paidten francs by the municipal administration, who recovered thesame from the invalid, save in the case of paupers. The

Municipal Council has, as your readers well know,l foundthe strain upon their finances too great. Repayments wereinfrequent, and from economical motives the Councildecided that each medical officer of the service should be

paid a salary of five hundred francs a year, irrespectively ofthe number of visits that he might be called upon to pay.Most of the medical men refused to accept the terms andParis is now without its service medieccl de nuit. Thetrouble has arisen from the fact that the conditions of theservice varied much according to the social status of theresidents in the different districts. In rich districts themedical man would expect to be disturbed say twice amonth, but in poor districts he might have to rise sixtimes in the night, so that to award the same payment allround was to inflict an obvious injustice. Negotiations arestill proceeding between the medical men and the MunicipalCouncil, and the general idea in Paris is that the latter hasmade its economical departure in a maladroit manner andthat the failure of the service has been due to irregularity inthe way in which the Municipal Council has managed itspart of the work. For political reasons and fear of unpopu-larity the Council is said to have taken no pains to see thatthey were repaid the fees they had advanced.A public dinner has been given to Dr. Huchard, a well-

known worker in diseases of the heart, by no less than 233 ofhis fellows, in celebration of his election to the Academy ofMedicine.

Dr. Duroziez, also best known for his researches in cardiacpathology, has recently died in Paris. His work hardly metwith the official or public recognition that it deserved, for histreatise upon diseases of the heart was widely consulted bythe medical profession.

Feb. lst.

ROME.(FROM OUR OWN CORRESPONDENT.)

Professor Salvatore Trinchese.ONE of Italy’s most honoured academic figures has

departed in Dr. Salvatore Trinchese, sometime Rector of theNeapolitan University and Professor of Comparative Anatomyand Comparative Embryology in that seat of learning. A

distinguished alumnus of the same school, he succeededPanceri in 1880 in the anatomical chair, from which he wastransferred to the other professorships above mentioned.During his régime as Rector (an honour he held twice)he took the initiative, since energetically carried out,for the enlargement and re-adjustment of the University’scurricula, himself laying the foundation-stone of the new

buildings. He was a valued as well as voluminous con-

tributor to scientific periodicals, especially to those bearingon nature-study in its anatomical and embryological re-

lations, and he leaves behind him many works of remark-able merit in general biology. His funeral was largely

1 THE LANCET, Jan. 16th, 1897.

attended by the academic and scientific world ; but a&

he was in religion what Italians call a "Calvinista" " (nonconformist), the function was purely civil.

L’Istituto Kinesiterapico.Italy has this week brought herself abreast of a movement

which, begun in Sweden under the auspices of Major Lingand Dr. Gustav Zander, has been vigorously taken up inGermany and Austria-the movement for the mechanicalexercise of the muscles, the joints, and, indeed, of all partsof the system which are apt to get out of gear by sedentaryor self-indulgent habits. The Commendatore Beccaro andDr. Colombo have the credit of this salutary initiative,and in the "Istituto Kinesiterapico " (establishment forthe therapeutics of motion), just opened in thePiazza di Termini, they have given Rome a lead which, it is.to be hoped, will be followed by other great Italian centres,particularly those which, as seats of learning, offer moreinducements to cultivate the mind than the body. In theBritish Isles athletic sports for the young, and such gamesas lawn tennis and golf for the middle-aged and elderly, haveno counterpart in the continental, particularly the Latin,countries. True, these latter have the fencing saloon and thepistol gallery, but such exercises as these imply, generally ina confined atmosphere and calling into play a very limitedproportion of the physical powers, are not for a moment to b&

compared to the games-football, cricket, golf, or boating-which, pursued at fresco, make British youths and men themost finely-developed in the world. Cycling, no doubt, isbeginning to be widely practised abroad ; but it has its dis-advantages—the "kyphosis bicyclistarum," for instance, ofcontinental classification-and needs to be supplemented byother modes of exercise to compensate for the over-pressureof one set of muscles and the comparative inertia of others.Besides, something more systematic than a discipline whichcan be carried out only " when weather permits" isrequired, especially in great cities, to counteract the

degeneration or worse induced by sedentary life. In

spring, in autumn, say the Roman organisers of the"Istituto," the delicious air of the surrounding hills is itselfan attraction to out-door exercise ; while in summer theresort to mountain or seaboard, or this or that Transalpine, oreven Cisalpine " Kur-ort," enables those who can afford it togive the body its due proportion of movement. But inwinter this salutary exertion is suspended, the relapse intosedentary life is inevitable, and with it the no less inevitablereturn of the " degenerations and organised incapa-cities " and " disabilities " which make the professional manor the brain-worker a premature invalid or valetudinarian.In winter, therefore, as, indeed, all the year round, the needsof the sedentary classes are met by the "Istituto," which isconducted on the only sound principle of bodily exercise,that of a gradual evolution of the powers of each organ, theenfeebled or dormant ones first receiving attention till theyare brought level with the more normally developed, and thewhole system finally endowed with that harmonious balancein which excess in one direction is reduced to atone forrestriction in another. To this end accurate measurements aretaken of the degree in which a muscle or limb is defective,and the particular exercise or mechanical apparatus which itscondition indicates are prescribed and brought into play.No movement is allowed to last more than two minutes,sometimes not even so long. Fatigue, cr anything approach-ing to it, is carefully avoided. Again, when muscularforce is so impaired or undeveloped as to be incapable ofexertion, electricity is brought in to restore or evolve the

missing power till this in turn becomes capable of under-going the voluntary movements above referred to. Everyoperation of the professional masseur is indicated bymechanical devices-‘ tapotement," for instance, being effected by a series of little hammers with elastic coveringwhich keep up a beating movement along the course ofa muscle or nerve till a healthy reaction is induced. Toenumerate all the appliances in use at the " Istituto " wouldbe to compile a formidable catalogue-a catalogue, moreover,susceptible of almost limitless extension as experiencesuggests new contrivances. The composition of the assembledpublic at the opening day supplies a measure of the inspira-tion under which the " Istituto " has been started and of thesocial class it is meant to serve. Medicine was repre-sented by its acknowledged heads-academic, clinical, andconsultant ; while the number of lawyers, merchants,bankers, artists, men of letters, and journalists was a

significant indication of the clientz,da in whose interests

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’It has been organised. ’’ Care of the body " is an old tra-dition of the Eternal City. It is an instructive sign of theimes that that tradition is now so effectively resuscitated,with all the scientific improvement and clinical expe-rience that divides the Rome of the nineteenth century from- the Rome of the first.

Kvng Humbert’s Body Physician.Dr. Quirico, sometime physician to the Royal Household,

bas just been nominated "medico particolare" (special pby-sician) to his Majesty King Humbert.

Jan. ,i0th.

VIENNA.(FROM OUR OWN CORRESPONDENT.)

Despatch of a Bubonic Plague commission to Bombay.THE Imperial Royal Academy of Sciences has employed

a portion of the Treitl Fund in sending a commission, com-.posed of Dr. Hermann Muller, Dr. Ghon, Dr. Albrecht, andDr. Poch, to investigate the nature of the bubonic diseasenow prevailing in India. Dr. Miiller is assistant to Professor

Nothnagel and is one of the most distinguished of our youngmedical men. He was born in Gratz in 1860, took theM.D. degree in Vienna at the age of twenty-four years,and was for three years assistant to Professor Ziemssenof Munich. He is at the head of the expedition and isspecially charged with the observation of the clinicalfeatures of the disease; the post mortem examinationswill be performed by Dr. Albrecht, who is at the presentmoment assistant to Professor Weichselbaum. The bacterio-

logical examinations are to be made by Dr. Ghon, who is alsoassistant to Professor Weichselbaum and is well known to themedical world by some publications on bacteriology. Dr.Poch, attached to the clinic of Professor Neusser, is thejunior member of the commission ; he is a very able photo-grapher and will assist his colleagues generally. The fourmedical men will leave Trieste on Feb. 3rd and will remainat Bombay for three or four months. On Jan. 29th theywere received by his Excellency Baron Gautsch, Minister ofPublic Instruction, who complimented them upon their

courage and wished them much success in their inquiries.The Treitl Fund is so called after the late Herr Treitl, aVienna citizen, who bequeathed to the Academy all hisfortune, amounting to about £100,000.

The lMidwives Question.The medical profession in Vienna is at last beginning to

give some attention to the present condition of its materialinterests, and the professional journals, which have untilnow for the most part confined themselves to subjects ofpurely scientific import, are at present filled with articles onthe causes of the decline of medical practice. The medicalassociations have also taken the matter up, and Dr.Stransky has made a contribution to the discussion whichhas caused something of the nature of a sensation amongthe medical profession in Austria. According to him theconditions of medical practice are pitiable ; not only havethe younger members of the profession at the commencementof their career to encounter great difficulties, but he is awareof case in which a well-known and very able man, who hadbeen over thirty years in practice, found the pecuniaryrecompense so inadequate that he abandoned the professionand went into business. If this be so at present it seemsprobable that practitioners will have to face a still more Isombre prospect in the future, for the Government con-

templates a further development of the principle ofInsurance against sickness ; such insurance is at presentobligatory on the working class, and it will in course of timebe extended to employers and tradesmen, so that when thiscomes to pass medical fees will be at the rate of a pennyeach visit. Nevertheless, the number of young men enteringthe profession every year shows no diminution, and theinevitable competition is intensified by the increase ofunqualified practitioners, by the gratuitous treatment of well-to-do patients in the hospitals, and by the encroach-ments of midwives. Not less than a fifth part ofthe practice in the’ outlying portions of Vienna is inthe hands of the midwives. It is the midwife who is firstsent fcr when illness makes its appearance, and it is she whor’ecides whether it is necessary to call in a medical man.Midwives undertake the treatment of cases of abortion andpremature birth, they make examinations, remove retainedportions of the ovum or placenta, and perform irrigations.-ith antiseptic solutions prepared by themselves. When

adherent placenta or atony of the uterus causes hasmor-

rhage they give ergotine, and obtain medical aid onlywhen there is fever. It is not surprising, therefore,that in shoulder presentations turning is not performedin proper time, and that extensive lacerations of the

perineum occur. Midwives also treat children’s diseases,especially scarlet fever, measles, and small-pox, by herbalinfusions and poultices, and they dissuade the parents fromsending for a medical man, saying that if the doctor comeshe will notify the case to the authorities and the house orapartment will have to be disinfected. They treat diseaseof the eyes of new-born children with applications of milkor urine; if eclampsia occurs the sick woman’s weddingveil is put on, and if no improvement follows from the useof this traditional remedy a medical man is called in with aview to avoiding unpleasantness and preventing a post-mortemexamination. How is this state of affairs to be remedied? ?asks Dr. Stransky. The obvious answer would be: By theenforcement of the laws against unqualified practice. Butlaw is uncertain, and if a midwife were punished her practicewould increase, for the public would look on her as a martyrpersecuted by the medical men. Moreover, the midwives areso efficiently organised that a medical man making a com-plaint against one of them would seriously endanger hisposition, and Dr. Stransky mentioned an instance of a manwho lost his obstetric practice in consequence of takingaction against a midwife in connexion with a case ofabortion. Dr. Stransky suggested that the Health Officeshould take energetic steps in the matter, and he stronglycondemned the conduct of some medical men who send outcirculars to midwives soliciting recommendations to patients.Jan. 31st.

EGYPT.

(FROM OUR OWN CORRESPONDENT.)

The Governmzent Lunatic Asylicm.THE total number of lunatics under treatment during the

year 1896 was 910, of whom 182 were discharged recovered,154 relieved, 66 unrelieved, 13 not insane, and 81 died. The

average daily number of resident inmates was 477, havingvaried from 411 to 514. The admissions were 422 andincluded the following: mania, 147 ; puerperal insanity, 2 ;mania from hasheesh, 49 ; intoxication from hasheesh, 17;dementia from hasheesh, 19; mania of persecution fromhasheesh, 3 ; dementia, 54 ; idiots, 3 ; epileptics, 17 ; generalparalysis, 29 ; chronic mania, 11 ; pellagrous melancholia, 8;&c. The 81 deaths during the year were due to-tubercle, 23;general paralysis, 13 ; pellagra, 3 ; ankylostomiasis, 2 ;cholera, 10 ; diseases of the nervous system, 11 ; all other

diseases, 19 The causes of insanity could not be discoveredin 127 patients, though many of them were consumers ofhasheesh ; but the following causes, among others, wereregistered : hasheesh, 88 ; alcohol, 9 ; syphilis, 27 ; pellagra,11 ; epilepsy, 17; sunstroke, 2 ; grief, 30 ; and religiousexcess, 16.

Hasheesh Lunatics.At least a quarter, and probably one-half, of the male

cases are due to an abuse of hasheesh, as has often beenpointed out before. The average residence in the asylum ofdischarged cases was forty days. A few of the patients con-fessed to opium-eating besides the hasheesh habit, and theseven women admitted during the year were all prostitutesor servants in hasheesh dens.

General Paralysis.From Dr. Warnock’s investigation during the last two

years it seems evident thas this disease is commoner in Egyptthan has been supposed. It will be noted from the figuresquoted above that nearly 7 per cent. of the year’s admissions,besides 16 per cent. of the deaths, were due to generalparalysis. The following table is worth quoting as showingthat the Egyptians themselves, as in 1895, furnished thebulk of the cases :-