VARICOSE EPIGASTRIC VEINS FOLLOWING PHLEBITIS.

1093 1 themselves for examination with a view to diagnosis and the waste of infant life due to ignorant and neglectful treattreatment. In placing patients under hospital treatment thement ] in London than in the aggregate of the 75 provincial assistance of the police was required in the case of five men towns. Due allowance being made for the meteorological and six women. On 44 occasions the aid of the police was conditions of the past summer, the mortality statistics requisitioned when the sources of infection were to be sought. relating to the largest English towns afford evidence, howIn accordance with the law that punishes with imprisonment ever, of generally improving sanitary conditions, both as for not more than three years those who, conscious of or regards infant mortality and the preventable fatality of diarrhcea. suspicious of venereal disease in themselves, infect or expose to infection others by cohabitation or improper intercourse, EPIGASTRIC VEINS FOLLOWING eight men and 13 women were prosecuted ; of these two men and six women were convicted and sentenced. In acknowPHLEBITIS. that from of fact children the hereditary ledgment suffering IN the Yale Medical Journal for July Dr. J. E. Lane has syphilis are themselves a great source of infection, efforts reported a case in which phlebitis had an unusual sequelhave been made of late years to educate mothers and foster- varicose epigastric veins. An Italian shophand, aged 17 mothers as to the true nature of the disease, and to prevent years, complained of a sore on the left leg and severe pain in as far as possible such children being adopted by families’ both legs when standing or walking. Seven or eight years This movement has been largely before he suffered from enteric fever and was confined to bed with healthy offspring. helped by a recent law which enacts that ’’he who conscious; for six months. During most of the time both legs were of or suspicious of infectious syphilitic disease in a child, and painful. For about a month there was auditory employs a nurse for such a child, or puts it out to nurse, is and motor aphasia which disappeared gradually. In the past liable to fine or imprisonment not exceeding six months." two years there had been at different times sores on the legs Owing to the difficulty experienced in finding suitable homes, ,which healed under treatment. Examination showed on the these children have often to spend years in hospital, whereasfront and outer surface of the right leg just above the ankle in Sweden Professor Welander’s nursing home provides for .the scars of two varicose ulcers. On the inner surface of the just such cases. just above the ankle was a clean ulcer about an inch in diameter. The legs were oedematous up to the knees and ENGLISH URBAN MORTALITY DURING THE the superficial veins of this region were much enlarged. PAST SUMMER. On the left side of the trunk two dilated veins stood THE annual rate of mortality during the three months out prommently. une, tne supernClal tnoracico-epigastnc, - ending with September in .London and in the 75 other largest started in the groin and ran up the trunk to the axilla English towns dealt with .in the Registrar-General’s weekly connecting the femoral vein with the axillary. The other returns, having an aggregate population of more than ran nearer the middle line from the groin to the lower end 16,000,000, did not exceed 13-4 per 1000, notwithstanding of the sternum. It began as the superficial epigastric and a marked increase during August. This rate exceeded the above the umbilicus anastomosed with the superficial median unprecedentedly low rate in the corresponding period of xiphoid vein which empties into the transverse anastomotic last year by 1-2per 1000, but was 1-9 below the or pre-xiphoid. This last vein connects the two internal mean rate in the same towns in the third quarters of The two dilated veins on the trunk were veins. mammary the four years 1904-07. The deaths registered in these tortuous, especially in their lowest part, and the current of ’76 towns during last quarter exceeded the low number blood in them was from below up. Palpation revealed returned in the corresponding quarter of 1907 by nothing abnormal in the saphenous or femoral vein. 5311, of which excess 4601 were due to increase in the Evidently the attack of enteric fever was complicated with number of deaths resulting from diarrhoea. The exception- extensive phlebitis, involving the veins of both legs. The - J..l_.... --a 1fB(BrJ ally low death-rate during the summer quarter of 1907, more hrombosis must have left an obstruction, partial or,complete, ’especially the low rate due to diarrhoea, was the result of n the femoral or external iliac vein, compelling the blood to the remarkably low temperature that prevailed during those ,ake the circuitous route described. The history of the three months. In the third quarter of last year only 510 aphasia is of interest on account of the rarity of cerebral deaths were referred ;to diarrhoea in London, equal to an embolism or thrombosis in enteric fever. annual rate of but 0 - 46 per 1000, whereas during the same period of this year the number rose to 1645, equal to a rate THE Hunterian Society’s first lecture of the new session of 1’ 37 per 1000 ; in the corresponding quarters of the ten will be delivered at the London Institution, Finsbury-circus years 1897-1906, however, ,the mean annual rate from on Wednesday, Oct. 14th, at 8.30 P.M., by Dr. James The this disease was equal to 2’ 72 per 1000. Mackenzie on the Bearing of Hunter’s Work on Recent of mortality in the summer quarter is undoubtedly Advances in the Study of Heart Affections. All members of governed mainly by meteorological conditions, through the medical profession are invited.

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the varying fatality of diarrhoea, almost entirely infantile. Infant mortality in the 76 large English towns during last quarter was equal to 146 per 1000 registered births, exceeding by 37 per 1000 the mean rate during the cool summer quarter of last year ; it was, however, considerably below the rate that prevailed in these towns in the corresponding quarters of 1905 and 1906, when it was 186 and 209 per 1000 respectively. In London the rate of infant mortality last quarter did not exceed 132 per 1000, while the mean rate during the quarter in the 75 provincial towns was equal to 151 per 1000. Infant mortality last quarter in London was 14-3 per cent. below the mean rate in the three preceding corresponding quarters, whereas in the 75 provincial towns the rate was not more than 12.77 per cent. below the 13ame average. These figures imply more progress in checking

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His Majesty the King has been pleased to grant permission to Dr. T. Vincent Dickinson to accept and to wear the order of Chevalier of the Crown of Italy, conferred on him by the King of Italy in recognition of his services as physician to the Italian Hospital.

ROYAL SOCIETY OF MEDICINE.-The Odontological Section of the Royal Society of Medicine is prepared to receive applications for grants in aid of the furtherance Parof scientific research in connexion with dentistry. ticulars and forms of application will be supplied by the Honorary Secretary, Scientific Research Committee, Odontological Section, Royal Society of Medicine, 20, Hanoversquare, W.