THE CONTROL OF PULMONARY TUBERCULOSIS.

31 the diagnosis of arsenical poisoning, arsenic was ance of the members of the medical and surgical staff, and found in more than 30 per cent. in quantities varying the proceedings throughout were characterised by great from a trace to upwards of 0’05 milligramme to the cordiality and enthusiasm. The dean, Mr. Pearce Gould, litre. About half the patients were private and half read his annual report alluding to the distinctions gained by hospital, and, of the latter, several were selected as pupils of the school, and stating that during the year 129 showing no arsenical symptoms. The conclusions which students had joined the school, bringing the total number up Dr. Putnam draws from these facts are firstly, that to 360. Earl Spencer gave a short address after the distributhe community is exposed to arsenical contamination on a tion, in which he commented on the great services rendered to very large scale, and that the occasional occurrence of the community by members of the medical profession, and accidental poisoning, due perhaps to special susceptibility, particularly instanced the improvements in sanitation and unusual exposure, failure of elimination, &c., need occasion dwellings which are so largely owing to them. He referred no surprise; and, secondly, that the mere finding of arsenic also to the great improvements seen of late in the adminisin the urine in a doubtful case does not prove the symptoms tration of hospitals, the care of the sick in workhouses, and He conto be caused by arsenic. Arsenical paralysis is now well the enormous advances made in sick nursing. cluded that schools would continue the medical by hoping recognised as due to a neuritis, and such cases as Dr. Putnam points out are not uncommonly the result of the medicinal to work on independent lines, and that great success would administration of arsenic. It has also been pointed out that crown their efforts. On the motion of Mr. Hulke, F.R.S,, such a condition may be due to arsenic absorbed uncon- senior surgeon, seconded by Dr. Cayley, senior physician, sciously under " domestic" conditions. One case is recorded a vote of thanks to Earl Spencer for presiding was carried by the author himself in which severe symptoms of arsenical by acclamation. We publish elsewhere a list of the prizepoisoning, accompanied by motor and sensory disturbances, winners. evidently the results of neuritis, persisted for months, but afterwards passed away. The symptoms came on soon after THE CONTROL OF PULMONARY TUBERCULOSIS. the patient had occupied some rooms, which were found to IN a final official report on the use of Koch’s lymph in be papered with a highly arsenical paper, and improvement cases of tuberculosis of the lung, Dr. H. D. Geddings, of commenced after the patient’s removal from them. The the United States Marine Hospital Bureau, states as follows: facts adduced are of the greatest importance, and it is to be 1. That tuberculin, or Koch’s remedy for tuberculosis, is hoped that fresh attention will be directed to a danger of a potent remedy, and one which should be administered which, we fear, the full extent is not yet adequately with caution and under close and careful observation. It is a recognised. remedy which should only be used in institutions where its effects can be closely and constantly watched. 2. That in the AN APPEAL FOR MEDICAL MISSIONARIES. limited number of cases which come under observation in the AN urgent appeal to medical students to consider the incipient stages of the disease it is beneficial, provided that needs of heathen countries, where educated medical men the disease is not excessive, that softening and breaking are either totally wanting or few and far between, has just down of the tissue has not taken place, or the patient’s been issued by some of the medical missionaries connected vital forces are not exhausted by long-continued hectic or by with the Church Missionary Society, which, like most other disturbances of digestion and the alimentary canal. 3. That societies of the kind, seems to be finding medical missionaries its results in tubercle of the larynx are very variable, and so valuable-so indispensable, indeed, that it is desirous of its use liable to produce the most distressing and alarming augmenting the number, if only suitable men come forward. symptoms. 4. That, in cases where softening has taken There is little doubt that, from the professional point place, or the patient is exhausted by any or all of the causes of view alone, missionary work presents great attrac- named above, a fatal issue is hastened more or less rapidly tions. The late Dr. Elmslie used to say when talking to by the exhibition of the remedy. 5. That in the hsemorstudents during his furlough : "My dear fellow, work at rhagic cases the use of tuberculin is prejudicial, and cerhome is merenibbling at practice’ compared to what you tainly productive of harm, and that most rapidly and get abroad"; and if he could say so twenty years ago when violently. And, having regard to these conclusions, he he was surrounded by political and other difficulties, when holds that the remedy is of limited applicability, and that he had no hospital, and when patients coming to see him while the future may have for it an important sphere within had sometimes to do so by stealth or brave the risk of the limits formulated, its general results must be regarded being fined or imprisoned for their temerity, how much more as disappointing to physician and patient. forcibly might the same expression be used by those who have now the charge of the Kashmir station, Messrs. A. and THE EXHUMATION CASE AT LIVERPOOL. E. Neve. These gentlemen, as was mentioned in a recent ON June 19th Dr. Stevenson of Guy’s Hospital and issue of THE LANCET, performed between them last year Mr. George Stoker arrived in Liverpool for the purpose of over 3000 operations, 759 of which were of a serious character. At the present time the Society referred to, whose head- exhuming and examining the body of Mr. James McHenry, who died at his late residence, Hope Lodge, Kensington, on quarters are in Salisbury-square, Fleet-street, is anxious to find medical missionaries for the Indian frontier, for Kafiristan May 26th, aged seventy-three, and whose body was interred and Chinese Turkestan, for Arabia, Persia, Palestine, the in St. James’s Cemetery, Liverpool, on June 1st. With of Mr. Lowndes, surgeon to the Liverpool Niger, East Africa, and for both Central and Southern China. the assistance police, Mr. Irvine, an experienced member of the local detective police, and the clerk of the cemetery, arrangeEARL SPENCER AT THE MIDDLESEX HOSPITAL. ments were made that day for the exhumation of the coffin THE annual distribution of prizes at the Middlesex in that evening, and its deposit in a part of the cemetery Hospital Medical School (which has hitherto been held suitable for its opening and the examination of the body at the opening of the winter session) took place on next morning. The coffin was opened at an early hour on Tuesday, the 30th ult. The prizes were distributed June 20th. This took upwards of half an hour, the body by Earl Spencer, K.G., who was accompanied by the being enclosed in a triple coffin of shell, lead, and oak, Countess Spencer, and by Lord Sandhurst, the chairman of the lead being very strongly adherent to the lid of the shell. the weekly board of the hospital. There was a full attend- The body was identified by Mr. Stoker, a personal friend

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