CEREBRAL TUMOUR AND MENTAL DISTURBANCE.

897 which these waters made their way unperceived red and white marrow, and the muscles, all retained fresh and natural appearance. If this process should prove into the sea to obtain ample, almost inexhaustible, supplies of the purest waters on the Kentish, no less than on a permanent one it will add very greatly to the value of our the Sussex coasts, in quantities probably sufficient to museum specimens. supersede the use of the Thames and -Lea, and without prejudice to the supplies of the seaside towns or THE NURSING OF THE INSANE. detriment to the agricultural interests. These views have MOST of our readers are no doubt aware that certificates received a striking confirmation in the recent diecovery of in nursing and attending on the insane may be obtained Mr. Easton of Westminster, the engineer to the Dover from the Medico-Psychological Association of Great Britain Undercliff Reclamation Scheme, who calculates that at one and Ireland. It is now announced that the next examinaspot alone 5,000,000 or 6,000,000 gallons of water are daily tion will be held on Monday, Nov. 2nd, and that Monday, running to waste in the sea-a quantity sufficient to give Oct. 5th, will on this occasion be the last day for the entry thirty-three gallons per head to a population of 150,000 to of candidates’ names. Schedules may be had from the 180,000 and five or six times as much as is supplied to Registrar, Dr. Spence, Burntwood Asylum, near Lichfield. Dover at present. The water issues from a fissure in the cliffs upon which he came almost by accident. He had DEATH OF SIR JOHN ERIC ERICHSEN. been sinking headings with but little result until the llth inst., when after having gene but a few feet IT is with deep regret that we record the death of Sir John the water burst in upon them with such force and Eric Erichsen, which occurred at Folkestone on Wednesday, in such enormous volume that the men in escaping from Sept. 23rd. Sir John Erichsen had been for some the shaft had not time even to save their tools. Repeated months suffering from angina pectoris and his condition failures followed by the sudden disclosure of a supply in bad caused considerable anxiety to his friends and medical excess of all possible demands marked the construction of attendants. He had occasional, though very temporary, loss the present water-works at Brighton, and if these explora- of control of some of the muscles of his right leg and arm and tory sinkings were carried out at intervals along the whole of had also not infrequently great difficulty of articulation. the Sussex and Kentish shores it is by no means improbable But despite these manifestations of serious breakdown, that the vexed problem of the water-supply of the metropolis he was on Wednesday, the 16th, a week before his might receive a solution less costly and less precarious than death, in fairly good health and hopeful about himself. But on Thursday morning, Sept. 17th, he was found that of the proposed aqueduct from Wales. by his servant in the morning in a state of insensibility. He soon recovered consciousness, but remained aphasic PRESERVATION OF COLOUR IN MUSEUM and hemiplegic. On Tuesday last the condition changed SPECIMENS. for the worse, the temperature began to rise, and dulCURATORS of pathological museums have made numerous ness developed at the base of the right lung, with rales. attempts to obtain a preservative fluid which will enable the This was the immediate beginning of the end, the lungs -the original colour to be retained by the specimens, but soon becoming engorged, and on the following afterhitherto only indifferent success has rewarded their efforts. noon he died. Sir John Erichsen was attended assiduously Especially has this been the case with the lungs and brain. through his last illness by Dr. Percy Lewis, and was seen In the Berliner Blinisclae 11-ockenschrift of Aug. 31st a in consultation by Dr. Barlow and Dr. Ringer. We shall paper is published by Dr. C. Kaiserling describing a process publish an extended obituary notice in our next issue in he has introduced, and with very encouraging results. The which we shall attempt to do justice to Sir John Erichsen’s organ to be preserved is first placed in a solution of the distinguished career. It is sufficient here to say that in following composition : Formalin, 750 c.cm. ; distilled water, the deceased surgeon we have lost the most able literary 1000 c.cm. ; nitrate of potash, 10 grammes ; acetate of exponent of his science that this generation has seen. potash, 30 grammes. The organ is disposed in such a position as to preserve its form as far as possible, and the fluid CEREBRAL TUMOUR AND MENTAL should be large in proportion to the size of the specimen. DISTURBANCE. This solution does not abstiact any colour, but remains Ix the State Hospitals Bulletin for the State of New York - quite clear, and can be used for a large number of An immersion of the in hours recently published Dr. Mellen reports a case of interest, twenty-four specimens. Ruid is sufficient for any tissue, but double this period will especially to alienists. A female patient aged sixty-six years The organ is then allowed to lie was admitted from an almshouse, of which she had been an not do any harm. for twelve hours in 80 per cent. alcohol and then for inmate for three years, on account of mental disturbance two hours in 95 per cent., and is subsequently preserved and delusions of persecution. She declared that her legs in equal parts of water and glycerine, with the addition had been amputated, she talked incessantly, and there was of thirty parts of acetate of potash. Very delicate tissues, much mental confusion and impairment of memory. She .such as intestine, are best kept in equal quantities of was also violent and destructive and refused her food. glycerine and water after the addition of absolute There was a distinct musical murmur both at the apex and .alcohol in the proportion of one part of alcohol to base and there was strabismus of the left eye, this being ten of the mixture. By this method Dr. Kaiserling deviated upwards and inwards. She became irritable and has succeeded in retaining the natural colour of blood quarrelsome and complained of headache, she declared that and the transparency of her husband had had his legs cut off in a railway accident, (congestion, infarcts, &c.), nearly all organs. The substance of the brain is par- and she frequently expressed a feeling of"being so stupid." ticularly well preserved, areas of softening, haemorrhages, Her health gradually failed, but one night she was found and pus in the pia mater being very well demonstrated. struggling with another patient, and after being put to bed Excellent specimens were also obtained of lung, liver, and she had a convulsion which lasted about five minutes. She kidneys. Nodules of tubercle with central caseation ex- fell out of bed and cut her face and had an attack of hibited both zones clearly delineated. Cysts in the kidney erysipelas. During a recrudescence of this attack fhe was remained unaltered, retaining the colour of their contents, found early one morning apparently in a sound slumber, Her pulse was rapid and areas of fatty metamorphosis were seen of a yellow but she could not be roused. oelour. Intestinal ulceration, tubercles in the pleura, and feeble, her respiration frequent, her temperature

-through

a

-

’

I

898 105° F.,

and she was unconscious and unable to swallow food. In the course of an hour and a half she died. The immediate cause of death was apparently the erysipelas and the cardiac condition, but on removing the brain a tumour of considerable size was found lying against the right side of the pons and pressing upon that and the temporo-sphenoidal lobe. This was attached to the dura mater for two inches on the posterior border of the lesser wing of the sphenoid bone, which was eroded and roughened. The tumour weighed one and a quarter ounces ; it was two inches long, one inch and three-quarters wide, and one inch thick. It was separate from the brain, merely pressing on it, and the third and sixth nerves were involved in the pressure. Histologically it was a fibro-sarcoma. The presence of a tumour was not suspected during life, and it is an interesting question what was the relation, if any, between the tumour and the disordered mental condition ? It is scarcely likely that the one was dependent on the other in any very close relation, but it is instructive as indicating the care necessary in the investigation of every so-called mental case. No doubt mental disturbance, usually transitory, is often a feature in the course of. cases of cerebral tumour, especially those which are basal and frontal ; but the presence of a tumour in this particular case seems merely to have coincided with the occurrence of mental disturbance. ____

to be regretted. Moreover, under such circumstances difficulties in the working of the hospital were certain to arise, for, as our Australian correspondent showed in our issue of July llth, "it was obviously impossible that the newly appointed pair of officers could do all the work of a metropolitan hospital of over 300 beds and give adequate clinical instruction as well." A conference was held between the board of management of the hospital and the university authorities in the hopes of finding some way out of the difficulty with regard to the provision of clinical instruction. Certain proposals were made, but we are not

think, much

satisfactory arrangement was finally arrived According to a telegram from Adelaide affairs at thehospital would seem to have reached a fresh crisis, it being announced that"four house surgeons have resigned" and that the " hospital is disorganised." For the details of the aware

that any

at.

trouble which has arisen the mail.

new

we

must await the arrival of

____

THE EASTBOURNE WATER-SUPPLY. IN the British llledical Jo2arnal of Sept. 19th we notice a, communication from a correspondent headed "The Water Question at Eastbourne," in which the following passage occurs: A declaration has somehow been obtained from a medical paper that the water ispalatable and wholesome.’ It can hardly be that the water ispalatable,’ unless it be to people who find sea water a pleasant drink." We presume the correspondent refers to an article which appeared in our issue of Aug. 29th, in which the words "palatable and wholesome"occur. But they do not refer to the saline water, but to the new water-supply from the chalk delivered by stand-pipes. This is obvious, for at the beginning of the article we expressly said, " water containing 16 5 per 1000 of sodium chloride and calcium chloride cannot be very palatable or wholesome." ......

THE PURE BEER COMMITTEE. THIS inquiry promises to be interesting, and matters are far advanced that Mr. Cuthbert Quilter, M.P., has already received a copy of the Treasury minute appointing the committee, which will consist of the following members :-The Earl of Pembroke and Montgomery (chairman), Dr. James Bell, C.B., F.R.S., late Principal of the Inland Revenue Laboratory ; Sir J. H. Gilbert, F.R.S., Dr. Odling, F.R.S., Mr. H. W. Primrose, C.B., C.S.I., chairman of the Board of Customs ; Mr. Clare Sewell Read, and Mr. W. The Blain of the Treasury, who will act as secretary. committee is thus composed of representatives of agricultural science, analytical chemistry (especially in regard to food), pure chemistry, inland revenue affairs, and matters connected with the duties on imported products. The duty of the committee is "to inquire into and report upon the questions whether legislation is required to prevent the use of deleterious substances in the manufacture of beer, and whether the materials of which beer may be composed can be defined by aw without undue interference with the liberty of brewers to use any wholesome materials in brewing." This definition of the scope of the inquiry is, we think, perfectly fair to all those concerned. It is certainly less sweeping than the proposals which were originally made. For our part we welcome any definite legislative endeavours to place articles of general consumption, be it beer or other commodity, upon a high level of quality or purity. This is doubtless the aim of the Pure Beer Bill, but if a definition of what beer should be is eventually forthcoming the word " pure" will obviously be superfluous. so

THE ADELAIDE

HOSPITAL.

IT will be remembered by our readers that as a result of a the Government the honorary medical staff of the Adelaide Hospital resigned in a body, and that, so united and firm were members of the profession in the colony, the Government were forced to import two gentlemen from Great Britain to occupy the posts respectively of resident surgeon and resident physician. The action of these gentlemen in endeavouring, by their acceptance of these appointments, to fill the gaps created by the resignations of the honcrary medical staff was, we

dispute with

SMALL-POX AT MARSEILLES. ALTHOUGH vaccination is not obligatory in France as it is in Germany, the operation is usually so efficiently performed in the former country that cases of small-pox are now seldom to be met with. The malady, however, still exists in certain towns, and of late years Marseilles has maintained an unenviable notoriety amongst them, no fewer than 9000 deaths from small-pox having taken place there since 1872. The mayor of the celebrated seaport-the capital of Southern France, as it is often styled-is a medical man of distinguished professional attainments, but no radical measures for stamping-cut the disorder have so far been adopted by the municipality of which he is the head. It is alleged’ that the infection is constantly renewed by low-class immigrants from Italy and elsewhere who have never been vaccinated, and that consequently it is impossible to extinguish the disease ; but-as several critics have pointed out-a great deal might be accomplished by a more stringent system of inspection combined with the rigid isolation of all new arrivals who present suspicious symptoms. Moreover, small-pox could not createsuch ravages, says a writer in a Parisian contemporary, no matter how many cases were imported, if the regular inhabitants were properly vaccinated and re-vaccinated. Failing the possibility of putting in force a fundamental system of repression similar to that which has yielded such magnificent results in Germany, the Marseilles municipality should not lose a single minute in attacking as best they may the enemy which has effected a lodgment in their midst. When good will directs the means are always to be found. Should they persist in maintaining this present attitude the rest of France will be obliged to put their city in quarantine just as though it were being decimated by cholera. Marseilles