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100 CONSECUTIVE CASES OF MEASLES WITHOUT CHRONIC MIDDLE-EAR DISEASE.
THE RECTAL INJECTION OF ANrISTREPTOCOCCIC SERUM.
1280
at all until, perhaps, it gets so bad that it matters little to him or to his patient whether he does notify or not. No, Sirs, it will be time enough’ to enforce notification when the necessary sanatoriums all over the country are ready -and that is a very big job-and not sooner. Long before any kind of compulsory notification was heard of for fevers. there were fever wards and fever hospitals in most populous places. The public has to be educated, and this step in the path, as I readily allow, of genuine sanitary progress must come, as everything natural and proper comes, by the laws of evolution and needs much time and much consideration for its complete development. I am, Sirs, yours faithfully, W. BRUCE, Medical Officer of Health of Ross and Cromarty. April 30th, 1906. case
THE
RECTAL INJECTION OF ANTISTREPTOCOCCIC SERUM. To the Editors of THE LAN C E T. SIRS,-It was with great interest that I read Dr. Nathan Raw’s paper on the value of rectal injections of antistreptococcic serum in ulcerative endocarditisas this week a paper was read by Dr. W. Soltau Fenwick and myself before the Royal Medical and Chirurgical Society on the rectal injection of the same serum in gonorrboeal infections and some cases of purpura haemorrhagica.2 The administration of various sera by rectal injection has been practised by us at the London Temperance Hospital during the past six years and two years ago you were good enough to publish a short letter by me on its use. Serum appears to have precisely the same effect when introduced per rectum as if injected subcutaneously, and its action seems equally rapid, while the danger of spreading inflammations and local abscesses at the site of injection is removed and the patient does not look upon the injection in the light of an I am, Sirs, yours faithfully, operation. J. PORTER PARKINSON.
’BVimr ole-street, W., April 28th, 1906.
IN
PRAISE OF RUM AND MILK. To the Editors of THE LANCET.
SiRS,—I was very pleased to read Dr. Francis T. Bond’s letter on the above subject. I have prescribed rum and milk in pulmonary complaints with very gratifying results for about 25 years. I have always found good sound rum better assimilated than any other spirit and it seems to combine well with milk, especially separated milk. I am,
Sirs, yours faithfully,
Manchester-square, W., April 28th, ]906.
THOMAS DUTTON.
PASTEURISED MILK AND INFANT FEEDING. To the Editors of THE LANCET. SIRS,-It may not be known to many of your readers that several of the large dairy companies in London are supplying pasteur ised milk to all their cu.-toraers without any indication that the milk has been so treated. This fact was brought to my knowledge in the following manner : At a children’s hospital in London the medical staff decided to use pure fresh milk, unchanged by heat, preservatives, or otherwise, for the in-patients. Extra precautions were taken so as to maintain the purity and freshness of the milk which was to be supplied in sealed and sterilised bottles, and was to be kept on ice. A large dairy company undertook to supply such milk, and did so for about 18 mrnths. At the end of that time it was accidentally discovered that the milk for about 12 months had been pasteurised at the dairy. The company when taxed with this breach of contract, expressed regret but said that it had acted on high medical authority and that pasteurised milk was really safer for infants than milk not so treated. Into this question the medical staff did not enter but proceeded to secure untreated milk from another source. This action on the part of the dairy companies is one of In the first place, the considerable public importance. pasteurising of the milk is not undertaken by them for the 1
THE LANCET, April 21st, 1906, p. 1103. 2 THE LANCET, May 5th, p. 1244.
benefit of the infant population but for the purpose of prothemselves from spreading typhoid fever or otherdisease through contaminated milk, with subi-equent legal proceedings and heavy damages. They may or they may not be justified in taking this precaution, but their customers areat least entitled to know the fact that the milk has been pasteurised. Whdt is cows’ milk ? This is a difficult question to answer, but it is certainly inadvisable to allow the dairy companies to plead in the future " the custom of the trade " in selling pasteurised milk when If pasteurised milk is to fresh cows’ milk is ordered. continue to be sold it ought to be labelled as such, just as " condensed and " humanised milks are. the the health of children may be seriously affected Again, by this action of the dairy companies. At present, and largely owing to medical teaching, it is the custom in many households to boil the milk on delivery. If the milk is first pasteurised by the seller and then boiled by the purchaser, it will be a poor, devttalised sort of food which eventually reaches the infant, and ansemia and scurvy may be expected to follow. These are the results which one would anticipateevidence is forthon theoretical grounds, and practical coming as follows: Dr. W. S. Colmanrelates that a short time ago there was an epidemic of infantile scurvy among children in Berlin supplied with pasteurised milk from an institution, but it was found to be confined to children whose parents, as an additional precaution, boiled thepasteurised milk for some time, after it was delivered to the house. More recently Dr. J. A. Couttshas recorded three cases of scurvy at the East London Hospital for which the patients were ordered fresh cows’ milk and were further treated in the usual way with raw meat juice, scraped potato, and lemon-juice. In none of the cases did the usual speedy resolution of the subperiosteal clot take place. "That three: consecutive cases of scurvy should take this extraordinary course led to an inquiry and it was discovered that for several months the dairy company to the hospital had been supplying pasteurised instead of fresh milk, without thehospital authorities being adequately informed of the change. On the substitution of fresh for pasteurised milk each infant began to improve." These facts speak for themselves and would seem to justify the anticipation that injury to the health of the children and aggravation of their diseases will result if this action of the dairy companies is allowed to continue. More especially will the danger be present if the public and the profession are kept in ignorance of the factthat the milk is being pasteurised. I am, Sirs, yours faithfully, G. A. SUTHERLAND. April 30th, 1906.
tecting
’
100 CONSECUTIVE CASES OF MEASLES WITHOUT CHRONIC MIDDLE-EAR DISEASE. To the Editors of THE LANCET. PiRS,—Within the last 12 months I kept notes of the first. 100 cases of measles which I attended during an epidemicand amongst this number I had not a single case of chronic middle-ear disease. At the most I bad one or two cases of earache which soon got well without discharge of any kind. Although I have no actual figures to prove my contention E feel sure that 20 years ago it would not have been possible to attend 100 consecutive cases of measles without at the When same time having several cases of "running ears." I began practice 14 years ago it was common to find on asking the cause of deafness or of purulent ear disease to be told in an off-hand manner, as if it was a matter of course, that the mischief had existed since the patient had had measles. Within recent years I have found that measles. is not so of en given as a cause of this troublesome affection but in order to prove or disprove the correctness of my impressions I made the observations now recorded. That the epidemic was not particularly mild is shown by the facts as follows. The deaths numbered four, two being due to broncho pneumonia ; one was helped by the teething process and one by whooping-cough, and all occurred in children under 18 months. Other notable points are: two out of the 100 were adults, and they had not had the disease before, six had had measles previously, and one " or two had had more than one attack. "Pronounced" 1 The Practitioner, October, 1905, 2 West London Medical Journal, April,
p. 536. 1906, p. 82.
BIRMINGHAM. was the commonest complication. Three had well-marked laryngitis-one of these began with laryngitis as the first symptom of the disease and one had subsequent laryngeal paralysis (a girl, aged six years). The majority of the patients were under five years of age and belonged to the working-class section of the community. One may well ask, what is the reason of this great improvement in results as regards the miduleear? I believe it is due (1) to a rise in the standard of general cleanliness amongst the great body of the people ; and (2) to a better appreciation of the laws of hygiene as therapeutic agents amongst the members of the medical profession. These laws I have tried to interpret and to practise as follows : 1. To keep the rooms comfortably cool and as fresh as possible, as opposed to the sweltering heat of former days. 2. By attention to the patient’s skin ; frequent sponging down. Changing the patient’s dress as often as necessary. Wrdpping the child in a sheet with a blanket outside instead of the sweat-laden bltnket in which the 3. Bj poor patient used to be invariably wrapped. allowing the patient plenty of cold water, soda water, lemonade, or other cool fluid of a similar kind in the early days of the disease. The food to be diluted milk. Not forcing solid food against the wish of the patient. By adopting this line the pharynx and naso-pharynx are kept sweet and hence the chances of mischief extending along the Eustachian tube to the middle ear are greatly reduced. Tact is necessary often to get these orders carried out, especially if there is a grandmother in the question. Medically I give one-twentieth of a grain of tartrated antimony along with half a fluid drachm of solution of ammonia and the same of simple syrup three or four times a day to still further keep the skin and kidneys active. When the cough is particularly troublesome I add to the foregoing one or two minims of tincture of opium according to age. Ordinarily I leave the cough to take care of itself. I do not believe measles has lost its virulence and if patients, generally speaking, were placed under the foul - conditions of farmer days chronic affections of the middle ear would be as frequently met with as of yore. I am, Sirs, yours faithfully, GORDON SHARP. Leede, April 26th, 1906.
broncho- pneumonia
1281
of the action, amounting to fully As a misinterpretation of the note accompanying the report is apparently checking the flow of subscriptions to the Carswell and Gilchrist Fund the union desires by publishing this explanation to second the efforts of the special committee in soliciting contributions, which should be sent to Dr. W. G. to pay the entire costs
.&bgr;900.
Dun, 15, Royal crescent, Glasgow, W. We are, Sirs, yours faithfully, ROBERT W. FoRREST, M.D. Glasg., Chairman. Chair.nan. WILLIAM YOUNG, YouLNc, Secretary. 108, West George-street, Glasgow, April, 1906.
FORREST, M.D. Glasg.,
BIRMINGHAM. (FROM CORRESPONDENT.) OUR OWN
The University. THE summer term commenced on April 23rd and the students seem to have settled down to steady hard work at This is perhaps due to the fact that the summer once. term is short and that many of the University examinations take place during the latter half of June. The Principal, Sir Oliver Lodge, has returned after his long rest. His holiday appears to have had very beneficial effects, for he looks strong and well. It is pleasant to see his big form and cheery, purposeful face about the place again, for he seems to diffuse encouragement and energy into everything which is under his charge.-It is becoming the custom in the Medical School for one or more members of the staff to deliver during this session short courses of lectures to which practitioners in the city and surrounding district and the students of the University are invited. The lectures are delivered on Thursday afternoons at 4 P.M. in the medical theatre, as has been already announced in THE LANCET. They were commenced on April 26th by Professor J. T. J. Morrison who is delivering a course of three lectures on the Legal and Social Relations of E glish Medicine, Past and Present, and they will be continued by Professor Robert Saundby who, on June 7th, commences a course of three lectures on Medical Ethics. On May 17th and May 24th Dr. C. E. Purslow, who is Ingleby lecturer for the year, will lecture on the Management of a case of Labour. The THE BRITISH DENTAL ASSOCIATION. Ingleby lectures are also open both to practitioners and students. Professor Morrison’s lectures have been extremely To the Editors of THE LANCET. interesting, for by examining old records and ancient books SIRS,-Will you kindly permit me through your columns he has been able to place before his audience in a most to apply for the loan of specimens—microscopical sections, attractive manner an account of the history of the practice photographs, or skiagrams-of odontomes and such tumours of medicine and surgery in this country, tracing it from its as may be included when this term is used in its widest sense ? first beginnings in the hands of the priesthood to its transferThe loan of specimens from so many collections, both public ence to the laity and showing how gradually, at various times, and private, has been promised us that we are endeavouring the have attempted to consolidate their powers practitioners to make tLi, collection as complete as possible, and by the and Those of us who have but little time for privileges. aid of medical men who have been fortunate enough to into old records are deeply grateful to Professor looking obtain specimens of these tumours we hope we may add to Morrison for the glimpse he has given us of many -our museum. The museum is to be held in connexion with past events associated with the history of the growth the annual meeting of the British Dental Association which of our profession.-The new pathological department was takes place in London at the Examination Hall of the Royal not in a sufficiently advanced state to be opened at the Co’lege of Surgeons on May 17th, 18th, and 19th next. Will beginning of the session and I understand that there will be those who possess specimens be good enough to communicate no formal opening ceremony. Work will probably be comwith me at the address given below ? the new buildings in about three weeks or a menced in I am, Sirs, yours faithfully, In future the pathological department will do much month. W. W. JAMES, more work for the health department of the city than it has Honorary Secretary, Museum Committee. hitherto undertaken. This increase of work will necessitate 22, Wimpole-stree’, W., April ZOth, 1306. the appointment of an additional assistant who will have to devote himself chiefly to public health work.
MEDICAL AND DENTAL DEFENCE UNION The Wo7nen’s Hospital. OF SCOTLAND, LIMITED: PURVES There is much cause for congratulation and a v. CARSWELL AND GILCHRIST. regret in association with the annual report of the Hospital. The statistics for the year show that 0 tlw Editors of THE LANCET. number of
the annual report of the union to nonmembers a note was inclosed stating that the defence in the above actions was conducted by this union. In view of the vital importance of the issue to the medical profession generally the council, after due consideration, decided to give the defenders the use of the name and organisation of the union, but unfortunately a misconception seems to have arisen as regards the liability of this union for the costs. Mr. John Carswell and Dr. Marion Gilchrist not being members of the union when the matter occurred out of which the action arose, were therefore excluded from the privileges of membership in respect of that matter and have
SIRS,—In sending
little for Women’s the total 993 less than the
cases treated was 17,656, or year, the diminution in number being accourt -d ior by the fact that the out-patient department was closed 1" s’j August for alterations and additions. The number of inpatients treated was 492, an increase of 13 on the previous year. The most satisfactory parts of the report are those dealing with the new hospital which was opened in September last and the account of the mortality-rate after abdominal section. The new buildings and equipment have added greatly to the efficiency of the arrangements of the hospital and the death-rate in 275 cases of abdominal section was only 2 1 per cent. In the previous year the death-rate was 2’ 3 per cent., and the average rate since the founding
previous
1280
at all until, perhaps, it gets so bad that it matters little to him or to his patient whether he does notify or not. No, Sirs, it will be time enough’ to enforce notification when the necessary sanatoriums all over the country are ready -and that is a very big job-and not sooner. Long before any kind of compulsory notification was heard of for fevers. there were fever wards and fever hospitals in most populous places. The public has to be educated, and this step in the path, as I readily allow, of genuine sanitary progress must come, as everything natural and proper comes, by the laws of evolution and needs much time and much consideration for its complete development. I am, Sirs, yours faithfully, W. BRUCE, Medical Officer of Health of Ross and Cromarty. April 30th, 1906. case
THE
RECTAL INJECTION OF ANTISTREPTOCOCCIC SERUM. To the Editors of THE LAN C E T. SIRS,-It was with great interest that I read Dr. Nathan Raw’s paper on the value of rectal injections of antistreptococcic serum in ulcerative endocarditisas this week a paper was read by Dr. W. Soltau Fenwick and myself before the Royal Medical and Chirurgical Society on the rectal injection of the same serum in gonorrboeal infections and some cases of purpura haemorrhagica.2 The administration of various sera by rectal injection has been practised by us at the London Temperance Hospital during the past six years and two years ago you were good enough to publish a short letter by me on its use. Serum appears to have precisely the same effect when introduced per rectum as if injected subcutaneously, and its action seems equally rapid, while the danger of spreading inflammations and local abscesses at the site of injection is removed and the patient does not look upon the injection in the light of an I am, Sirs, yours faithfully, operation. J. PORTER PARKINSON.
’BVimr ole-street, W., April 28th, 1906.
IN
PRAISE OF RUM AND MILK. To the Editors of THE LANCET.
SiRS,—I was very pleased to read Dr. Francis T. Bond’s letter on the above subject. I have prescribed rum and milk in pulmonary complaints with very gratifying results for about 25 years. I have always found good sound rum better assimilated than any other spirit and it seems to combine well with milk, especially separated milk. I am,
Sirs, yours faithfully,
Manchester-square, W., April 28th, ]906.
THOMAS DUTTON.
PASTEURISED MILK AND INFANT FEEDING. To the Editors of THE LANCET. SIRS,-It may not be known to many of your readers that several of the large dairy companies in London are supplying pasteur ised milk to all their cu.-toraers without any indication that the milk has been so treated. This fact was brought to my knowledge in the following manner : At a children’s hospital in London the medical staff decided to use pure fresh milk, unchanged by heat, preservatives, or otherwise, for the in-patients. Extra precautions were taken so as to maintain the purity and freshness of the milk which was to be supplied in sealed and sterilised bottles, and was to be kept on ice. A large dairy company undertook to supply such milk, and did so for about 18 mrnths. At the end of that time it was accidentally discovered that the milk for about 12 months had been pasteurised at the dairy. The company when taxed with this breach of contract, expressed regret but said that it had acted on high medical authority and that pasteurised milk was really safer for infants than milk not so treated. Into this question the medical staff did not enter but proceeded to secure untreated milk from another source. This action on the part of the dairy companies is one of In the first place, the considerable public importance. pasteurising of the milk is not undertaken by them for the 1
THE LANCET, April 21st, 1906, p. 1103. 2 THE LANCET, May 5th, p. 1244.
benefit of the infant population but for the purpose of prothemselves from spreading typhoid fever or otherdisease through contaminated milk, with subi-equent legal proceedings and heavy damages. They may or they may not be justified in taking this precaution, but their customers areat least entitled to know the fact that the milk has been pasteurised. Whdt is cows’ milk ? This is a difficult question to answer, but it is certainly inadvisable to allow the dairy companies to plead in the future " the custom of the trade " in selling pasteurised milk when If pasteurised milk is to fresh cows’ milk is ordered. continue to be sold it ought to be labelled as such, just as " condensed and " humanised milks are. the the health of children may be seriously affected Again, by this action of the dairy companies. At present, and largely owing to medical teaching, it is the custom in many households to boil the milk on delivery. If the milk is first pasteurised by the seller and then boiled by the purchaser, it will be a poor, devttalised sort of food which eventually reaches the infant, and ansemia and scurvy may be expected to follow. These are the results which one would anticipateevidence is forthon theoretical grounds, and practical coming as follows: Dr. W. S. Colmanrelates that a short time ago there was an epidemic of infantile scurvy among children in Berlin supplied with pasteurised milk from an institution, but it was found to be confined to children whose parents, as an additional precaution, boiled thepasteurised milk for some time, after it was delivered to the house. More recently Dr. J. A. Couttshas recorded three cases of scurvy at the East London Hospital for which the patients were ordered fresh cows’ milk and were further treated in the usual way with raw meat juice, scraped potato, and lemon-juice. In none of the cases did the usual speedy resolution of the subperiosteal clot take place. "That three: consecutive cases of scurvy should take this extraordinary course led to an inquiry and it was discovered that for several months the dairy company to the hospital had been supplying pasteurised instead of fresh milk, without thehospital authorities being adequately informed of the change. On the substitution of fresh for pasteurised milk each infant began to improve." These facts speak for themselves and would seem to justify the anticipation that injury to the health of the children and aggravation of their diseases will result if this action of the dairy companies is allowed to continue. More especially will the danger be present if the public and the profession are kept in ignorance of the factthat the milk is being pasteurised. I am, Sirs, yours faithfully, G. A. SUTHERLAND. April 30th, 1906.
tecting
’
100 CONSECUTIVE CASES OF MEASLES WITHOUT CHRONIC MIDDLE-EAR DISEASE. To the Editors of THE LANCET. PiRS,—Within the last 12 months I kept notes of the first. 100 cases of measles which I attended during an epidemicand amongst this number I had not a single case of chronic middle-ear disease. At the most I bad one or two cases of earache which soon got well without discharge of any kind. Although I have no actual figures to prove my contention E feel sure that 20 years ago it would not have been possible to attend 100 consecutive cases of measles without at the When same time having several cases of "running ears." I began practice 14 years ago it was common to find on asking the cause of deafness or of purulent ear disease to be told in an off-hand manner, as if it was a matter of course, that the mischief had existed since the patient had had measles. Within recent years I have found that measles. is not so of en given as a cause of this troublesome affection but in order to prove or disprove the correctness of my impressions I made the observations now recorded. That the epidemic was not particularly mild is shown by the facts as follows. The deaths numbered four, two being due to broncho pneumonia ; one was helped by the teething process and one by whooping-cough, and all occurred in children under 18 months. Other notable points are: two out of the 100 were adults, and they had not had the disease before, six had had measles previously, and one " or two had had more than one attack. "Pronounced" 1 The Practitioner, October, 1905, 2 West London Medical Journal, April,
p. 536. 1906, p. 82.
BIRMINGHAM. was the commonest complication. Three had well-marked laryngitis-one of these began with laryngitis as the first symptom of the disease and one had subsequent laryngeal paralysis (a girl, aged six years). The majority of the patients were under five years of age and belonged to the working-class section of the community. One may well ask, what is the reason of this great improvement in results as regards the miduleear? I believe it is due (1) to a rise in the standard of general cleanliness amongst the great body of the people ; and (2) to a better appreciation of the laws of hygiene as therapeutic agents amongst the members of the medical profession. These laws I have tried to interpret and to practise as follows : 1. To keep the rooms comfortably cool and as fresh as possible, as opposed to the sweltering heat of former days. 2. By attention to the patient’s skin ; frequent sponging down. Changing the patient’s dress as often as necessary. Wrdpping the child in a sheet with a blanket outside instead of the sweat-laden bltnket in which the 3. Bj poor patient used to be invariably wrapped. allowing the patient plenty of cold water, soda water, lemonade, or other cool fluid of a similar kind in the early days of the disease. The food to be diluted milk. Not forcing solid food against the wish of the patient. By adopting this line the pharynx and naso-pharynx are kept sweet and hence the chances of mischief extending along the Eustachian tube to the middle ear are greatly reduced. Tact is necessary often to get these orders carried out, especially if there is a grandmother in the question. Medically I give one-twentieth of a grain of tartrated antimony along with half a fluid drachm of solution of ammonia and the same of simple syrup three or four times a day to still further keep the skin and kidneys active. When the cough is particularly troublesome I add to the foregoing one or two minims of tincture of opium according to age. Ordinarily I leave the cough to take care of itself. I do not believe measles has lost its virulence and if patients, generally speaking, were placed under the foul - conditions of farmer days chronic affections of the middle ear would be as frequently met with as of yore. I am, Sirs, yours faithfully, GORDON SHARP. Leede, April 26th, 1906.
broncho- pneumonia
1281
of the action, amounting to fully As a misinterpretation of the note accompanying the report is apparently checking the flow of subscriptions to the Carswell and Gilchrist Fund the union desires by publishing this explanation to second the efforts of the special committee in soliciting contributions, which should be sent to Dr. W. G. to pay the entire costs
.&bgr;900.
Dun, 15, Royal crescent, Glasgow, W. We are, Sirs, yours faithfully, ROBERT W. FoRREST, M.D. Glasg., Chairman. Chair.nan. WILLIAM YOUNG, YouLNc, Secretary. 108, West George-street, Glasgow, April, 1906.
FORREST, M.D. Glasg.,
BIRMINGHAM. (FROM CORRESPONDENT.) OUR OWN
The University. THE summer term commenced on April 23rd and the students seem to have settled down to steady hard work at This is perhaps due to the fact that the summer once. term is short and that many of the University examinations take place during the latter half of June. The Principal, Sir Oliver Lodge, has returned after his long rest. His holiday appears to have had very beneficial effects, for he looks strong and well. It is pleasant to see his big form and cheery, purposeful face about the place again, for he seems to diffuse encouragement and energy into everything which is under his charge.-It is becoming the custom in the Medical School for one or more members of the staff to deliver during this session short courses of lectures to which practitioners in the city and surrounding district and the students of the University are invited. The lectures are delivered on Thursday afternoons at 4 P.M. in the medical theatre, as has been already announced in THE LANCET. They were commenced on April 26th by Professor J. T. J. Morrison who is delivering a course of three lectures on the Legal and Social Relations of E glish Medicine, Past and Present, and they will be continued by Professor Robert Saundby who, on June 7th, commences a course of three lectures on Medical Ethics. On May 17th and May 24th Dr. C. E. Purslow, who is Ingleby lecturer for the year, will lecture on the Management of a case of Labour. The THE BRITISH DENTAL ASSOCIATION. Ingleby lectures are also open both to practitioners and students. Professor Morrison’s lectures have been extremely To the Editors of THE LANCET. interesting, for by examining old records and ancient books SIRS,-Will you kindly permit me through your columns he has been able to place before his audience in a most to apply for the loan of specimens—microscopical sections, attractive manner an account of the history of the practice photographs, or skiagrams-of odontomes and such tumours of medicine and surgery in this country, tracing it from its as may be included when this term is used in its widest sense ? first beginnings in the hands of the priesthood to its transferThe loan of specimens from so many collections, both public ence to the laity and showing how gradually, at various times, and private, has been promised us that we are endeavouring the have attempted to consolidate their powers practitioners to make tLi, collection as complete as possible, and by the and Those of us who have but little time for privileges. aid of medical men who have been fortunate enough to into old records are deeply grateful to Professor looking obtain specimens of these tumours we hope we may add to Morrison for the glimpse he has given us of many -our museum. The museum is to be held in connexion with past events associated with the history of the growth the annual meeting of the British Dental Association which of our profession.-The new pathological department was takes place in London at the Examination Hall of the Royal not in a sufficiently advanced state to be opened at the Co’lege of Surgeons on May 17th, 18th, and 19th next. Will beginning of the session and I understand that there will be those who possess specimens be good enough to communicate no formal opening ceremony. Work will probably be comwith me at the address given below ? the new buildings in about three weeks or a menced in I am, Sirs, yours faithfully, In future the pathological department will do much month. W. W. JAMES, more work for the health department of the city than it has Honorary Secretary, Museum Committee. hitherto undertaken. This increase of work will necessitate 22, Wimpole-stree’, W., April ZOth, 1306. the appointment of an additional assistant who will have to devote himself chiefly to public health work.
MEDICAL AND DENTAL DEFENCE UNION The Wo7nen’s Hospital. OF SCOTLAND, LIMITED: PURVES There is much cause for congratulation and a v. CARSWELL AND GILCHRIST. regret in association with the annual report of the Hospital. The statistics for the year show that 0 tlw Editors of THE LANCET. number of
the annual report of the union to nonmembers a note was inclosed stating that the defence in the above actions was conducted by this union. In view of the vital importance of the issue to the medical profession generally the council, after due consideration, decided to give the defenders the use of the name and organisation of the union, but unfortunately a misconception seems to have arisen as regards the liability of this union for the costs. Mr. John Carswell and Dr. Marion Gilchrist not being members of the union when the matter occurred out of which the action arose, were therefore excluded from the privileges of membership in respect of that matter and have
SIRS,—In sending
little for Women’s the total 993 less than the
cases treated was 17,656, or year, the diminution in number being accourt -d ior by the fact that the out-patient department was closed 1" s’j August for alterations and additions. The number of inpatients treated was 492, an increase of 13 on the previous year. The most satisfactory parts of the report are those dealing with the new hospital which was opened in September last and the account of the mortality-rate after abdominal section. The new buildings and equipment have added greatly to the efficiency of the arrangements of the hospital and the death-rate in 275 cases of abdominal section was only 2 1 per cent. In the previous year the death-rate was 2’ 3 per cent., and the average rate since the founding
previous