TRAUMATIC EPILEPSY AND OPERATION.

1518 feature in this case is that no evidence was fortllcoming to demonstrate that the oats incriminated were infested with anthrax germs, and their presence in this food was therefore a mere supposition, due to horses having succumbed to the disease after feeding on them, while the same kind of oats had been supplied to feed other horses, but no such fatal consequence had followed. Surely it was possible to give decisive proof of the actual presence of anthrax bacilli in the dust of the grain, and knowing that anthrax infection may occur through drinking contaminated water or consuming hay or grass containing these organisms, and in other ways, it does seem strange that the supposition was accepted as if it had been based on actual demonstration. The decision, at any rate if it is to form a precedent, will have far-reaching consequences when applied to the provision of suspected food to man and animals.

TYPHOID FEVER AT LUTON. SOME weeks ago we drew attention to the epidemic of fever which was existing at Luton, and suggested that a full and independent inquiry into the sanitary condition of the town would be the best means of checking this epidemic and of preventing another in the future. This suggestion was also made by medical men in the neighbourhood, but the authorities have taken no steps towards such inquiry, and the result is that the fever still persists, and seems likely to do so until some more radical measures are taken to find out the source of infection. The cases have mostly occurred in one quarter of the town, and no doubt there will be found various defects to account for it. Among the deaths we regret to have to record that of a nurse named Allan, who died on Nov. 30th, having contracted the disease in the discharge of her duties. According to the Luton papers the inhabitants of the town are now

typhoid

taking the matter up, and will no doubt insist on a proper inspection being made. Typhoid fever is, to a very great extent, a preventable disease, and any failure to take full and adequate measures in dealing with outbreaks entails very grave responsibility on the authorities. DISCOVERY OF UNKNOWN TRIBES IN AFRICA. DR. DOXALDSOX SMITH, who has lately returned to England after exploring in Africa, has discovered no fewer than fifteen tribes. On hearing this news the question may be asked, What good end is reached by these discoveries ? Are the people discovered the gainers-or might it not be better for them to be left in their primitive ignorance ? With the benefits of civilisation will, doubtless, be also imported many of its vices. Probably the solution of the problem lies in the mean, and the evil and the good are fairly evenly balanced. Amongst the newly discovered people was a tribe of dwarfs, none of them exceeding 5 ft. in height. In the accounts published as yet the exact nature of the country is not stated, nor are the physical characteristics of the dwarfs described ; it is therefore idle to speculate as to how near these pigmies are akin to the forest dwarfs found by Stanley, who are mentioned as having large heads and long beards. If, as is not unlikely, it was thick forest where Dr. Donaldson Smith met them there would be a strong presumption that they might be of the same origin, and to carry the speculation further it may be that in many parts of Africa amongst the dense unexplored forests there live tribes of dwarfs of like race, with like customs and In fact, already there have been found by habits. different travellers in Africa more than one tribe of dwarfs, notably the Batwas, 4 ft. 3 in. in height, and the M’Kabbas, near Lake Ngami, reported as averaging but 4 ft. It will be instructive to hear from Dr. Donaldson

Smith a fuller description of the appearance of these diminutive men. How far the origin of the race of dwarfs has been affected by climatic influence is more or less an, open question. Probably the comparative absence of light and air accounts for the forest men, as also for the Laplanders ; but, on the other hand, this argument will not, apply to the Andaman islanders or to the bushmen of£ Australia. When Dr. Donaldson Smith delivers his address. before the Royal Geographical Society he will doubtless enter more fully into details, both with regard to the nature of the country and the appearance and habits of the people.

THE MURDER-MONGER. AT Warwick

Assizes, upon Dec. 10th, Sarah Ann Eden, a. condemned to death for the murder of a woman at Aston, upon whom she procured abortion and who. died in consequence. This was no case of an unmarried ignorant girl in her first pregnancy trying to conceal hershame. For such criminals, wrong as they are, we may have pity, but in the present instance the woman was married and had six children. She first tried, with that indifference to this form of crime which so many women exhibit, to get her medical attendant to perform the opera tion, and when he refused she went to the prisoner. The crime of procuring abortion is far too common, and it cannot be too strongly impressed upon women that she who knowingly gets rid of her unborn child in this way is morally as much a murderess as the operator, and sins of this nature are not confined to the lower orders, but are. only too frequent in the upper strata of society. midwife,

was

TRAUMATIC

EPILEPSY AND OPERATION.

Ix a recent number of the Philadelphia J[càiaal News Dr. John D. Davis relates three cases of unusual interest and importance. The first is that of a man aged thirty a farmer by occupation and without any history in his family of epilepsy, insanity, or other neuroses, who ten years before hecame under observation fell a distance of fifteen feet, striking the back of his head on a piece of wood. Within an hour he was attacked by a severe convulsion, which lasted several minutes. After that he had on an average two convulsions a day, he was seldom free from headache, and had almost constant tinnitus aurium on the left side. He had suffered both in spirits and in appearance, and all the usual remedies had been unsuccessfully tried. The seat of the original injury was over the left occipital region, and it was proposed to trephine in this region in the’ hope that relief might be obtained. Accordingly operation was undertaken, but the membranes appeared healthy and’ there was no indication of a cyst or other morbid condition of the brain ; but on the inner surface of the skull, about three-eighths of an inch from the trephine opening towards. the parietal eminence, it was found that the bone was of almost cheesy consistence All this diseased material was. removed and the wound dressed with the most rigorous antiseptic precautions. Convalescence was rapid and the result;. of the operation most gratifying. There was relief of head ache, the tinnitus ceased, and at the time the paper was. written, two and a half years after the operation, there had been no return of the convulsions. The second case related is that of a man who at the opening of the World’s Fair’ in October, 1892, received a blow with a chair on the right. parietal bone. He was unconscious for several hours and He became’ soon began to suffer from severe headaches. from suffered convulsions,. mentally deranged, epileptiform and lost the use of the left arm and leg. When seen by Dr. Davis about a year after the accident he was suffering from intense paroxysmal headache, frequent convulsions, left hemiplegia, and mental derangement. Nogood effect being

1519 obtained from

was performed over the The dura mater bulged distinctly, andi. right parietal when it was incised about a couple of drachms of thin pus, escaped. The cavity was washed out, and after the operation the patient’s condition was materially better. There; was, however, a return of symptoms ten days later, butb these were relieved by dressing the wound, allowing some; accumulated pus to escape. Since then there had been no) return of the pain or other symptoms, and the left-sicledL weakness was much less and was still diminishing. The; third case was that of a girl aged twenty-two who had had at, fall on the back of her head while skating about sixteeni months before she was seen. She was unconscious for several1 Headache then became incessant hours afte the accident. and was increased by pressure on the back of the head. Her mental condition became very unsatisfactory, herappetite failed, she lost flesh, and suffered from about two) convulsions a day. Operation was performed, and although there was Every indication of very greatly increased intracranial pressure no actual lesion was found. However, three days after the operation the patient ceased to suffer from headache, the mental disturbance disappeared, and she began to gain weight. Eight months after the operation she had remained free from fits. These three cases are certainly remarkable, not only for the success with which they have been treated, but because of the interest which attaches to the different conditions found to be present-in one a softening of the skull at one point, in another an abscess, and in the third increased intra-cranial pressure without obvious cause. Dr. Davis is to be congratulated on the result of his operative, treatment.

drugs, trephining

bone.

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the quarantine station and lazaret of Camaran were opened. and since which date Indian pilgrims have been compulsorily detained there for a period of five to ten days, cholera has actually broken out during the Mecca pilgrimage on eight separate occasions-namely, in 1881, 1882, 1883, 1890, 1891, 1892, 1893, and 1895. Well may our Mahommedan fellow subjects in India begin to demand the abolition of the compulsory detention of hitherto healthy pilgrims at this entrepôt cholérique. That demand is now being raised by those who are primarily concerned ; but, under present circumstances, we fear that some money consideration which shall in some form or other make up for the so-called’ . sanitary dues now imposed on the pilgrims will have to be offered before any such result is likely to be attained. In, the meantime the Turkish possession of Camaran remains the greatest hindrance to the abolition of cholera in connexion with the Mecca pilgrimage.

INFANTILE

MORTALITY AT CARDIFF.

AT the last meeting of the Cardiff Sanitary Committee the medical officer of health (Dr. Walford) was present, and by request read his report upon the alleged excessive He stated that out infantile mortality at Cardiff. of a total number of 608 deaths during the three months of the third quarter of this year 308 were of’ children under one year of age. Eighty of these were from diarrhoea. The deaths took place principally amongst children who were artificially fed. A discussion on the same subject took place at the meeting of the CardifF Burial Board, when a medical man who is a member of this board and also of the Sanitary Committee stated that this excessive mor tality was due to three causes : first, the deplorable lack of CAMARAN: THE CAUSE OF CHOLERA TO knowledge that prevails in all classes concerning the feeding MECCA PILGRIMS. of infants ; secondly, the insanitary conditions in overCOMPLAINTS are gradually accumulatmg as to tne danger crowded districts; and, lastly, infant insurance, with regard of retaining the Island of Camaran as a quarantine station in to which he was of opinion that the Legislature ought to act. the Red Sea. It was shown by Dr. Thorne Thorne during the sittings of the International Sanitary Conference of Paris THE HABITS OF BATS. last year that the detention of intending pilgrims from India A VERY interesting paper on the habits of these curious on that island preliminary to their being allowed to comanimals in captivity appears in the current number of’ mence the land journey to Mecca had again and again been followed by an occurrence of cholera amongst them, although Alatiire Notes from the pen of the artist Mr. J. D. Batten,who has for years kept a number of them as pets. They no suspicion of such disease had prevailed during the long sea voyage from Bombay to the Red Sea ; and the verdict appear to be easily fed on meal-worms, and to be exof a French physician was quoted to the delegates to tremely docile and easily managed, although none of them the effect that Camaran was an entrepôt cholérique. live for more than a few months in captivity. The account Recent experience goes to emphasise and confirm this both of the waking from natural sleep and of hibernation is " view, and reports have shown how utterly unwhole- of great interest. Speaking of sleep Mr. Batten says : Thesome, and even filthy, are the conditions to which bat when thoroughly asleep is dead cold to the touch. If I then the pilgrims are exposed during their enforced deten- took it in my hand...... it would lie quite still. On putting tion on the island. It is quite true that both at Paris it to my ear I could hear a throbbing begin, at first very and elsewhere promises have been made on behalf of slowly and not very regularly, more than a second between the Sultan as to prodigious sums which His Majesty was the beats. Gradually the throbbing became quicker and just going to have spent on removing all sources of com- quicker until it was impossible to count the beats.°,. plaint ; but promises of this sort now only cause an at the same time the warmth of the body was At incredulous smile, and in the meantime it is known that increasing rapidly and the bat quivering visibly. and during the last pilgrimage Camaran remained the entrep6t last the throbbing becomes a continuous whir cholérique it has always been ; soil, air, and water being the body feels hot to the hand. Then rather suddenly the liable to excremental pollutions of the worst sort. The past throbbing quiets down ......, slows somewhat, and becomes history of cholera, in connexion with the Mecca pilgrimage almost inaudible. The bat coughs or sneezes, chatters a little with its teeth, and moves about expecting to be fed." comes aptly to illustrate the mischievous results which this The noises heard must be to a large extent from the volunBetween station has led to. disease-producing quarantine 1817 and 1866 there was an absence of quarantine detentions tary muscles. Some interesting observations are given as to on pilgrims landing on the Arabian shore, and during that the hibernation of bats and their behaviour when roused during cholera out the Mecca broke period only pilgrimage that process. In the case of two bats that died during during on two occasions-namely, 1835 and 1865. Between 1866 hibernation the spleen was found by Dr. F. E. Batten toand 1881 a period of observation lasting twenty-four hours be very large, while in one that died just before that was imposed on arrival in the port of Jeddah, and again stage and in two which died at other times of the yearcholera only appeared during the Mecca pilgrimage on two it was quite small. Much information is wanted as to theoccasions-namely, in 1872 and 1877. But since 1881, when size of the various organs and the chemical constitution of ,

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