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A PRESIDENTIAL ADDRESS.
157 in the watershed and represented on the watershed board should have opposed the Bill. He then stated that twenty-nine authorities had sewage works in operation, but that they varied in effectiveness. Some required alteration. In twenty-three places there were no schemes in operation and on twenty of these twenty-three authorities notices had been served. The two months’ notice had now expired and he thought it desirable that further action should be taken against them at the next meeting. The figures he had submitted dealt only with urban authorities-the rural had in nearly every case taken some action. Mr. Armitage gave notice that at the next meeting he would move that action be taken against those authorities which had not adopted any scheme.
thority
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ELECTRICITY ASTRAY. AN accident to an electric lighting main in Walbrook, E. C., appears to have recently occasioned some merriment to the dwellers in those parts. We cordially congratulate them on having escaped any more serious consequences than those which provoked their mirth. It seems that through some unexplained failure of the insulator of an electric-lighting main a metal shop front became charged with wandering electricity and passers-by discovered that by touching it with their hands they could experience the delightful inconvenience of an electric shock. The circumstance this is in the minds that of most people, and luxury particularly of most street urchins, associated with festival occasions and penny fees no doubt invested the unpriced supply in Walbrook with an added charm. Happily, the amount of current obtainable seems to have been inconsiderably small; but seeing that a metal shop front in connexion with an electric-lighting main might easily become a greater source of peril to unwary passers-by than an uncaged tiger, the story of this mishap is calculated to give the reader of a serious turn more food for reflection than is altogether pleasant. Fortunately, it is not possible that such an accident should happen without serious fault on somebody’s part, and although the London public seem to have taken the matter with a light heart, we hope that those whom it most nearly concerns will make a point of exacting the full penalty for a flagrant default, be it whose it may—p* enOOI(fJ’ager les aittres.
tear their hair and creamHai, hai, wai, wai’ if anyone is badly attacked....... For a time there seems to be no ’ purdah’ and no class is specially inaccessible. In fact the well-to-do Hindus seem quite as willing to receive me In many cases one can do little; in others as any others. one can turn the scale. But although a few lives here and there have been saved I think the moral effect of our work is more important. The people well know the apathetic selfishness of their co-religionists and they see the missionaries and ladies as well as others going about trying to relieve " suffering." Mr. Neve’s assistant succumbed to the disease, though after transfusion he rallied for a short time. The Indian Government have deputed Surgeon-Colonel Harvey to make a searching inquiry into the epidemic and he has taken up his quarters in the mission house with Dr. Ernest Neve, who has returned, Mr. Arthur Neve going out into the villages where the cholera, after having abated in the city, was becoming
rife. ___
ENTERIC FEVER AT NORTHALLERTON. ENTERIO FEVER still prevails at Northallerton, but, as we anticipated, the Local Government Board do not see any reason for sending a medical inspector to investigate its causes, those causes being known in advance to the local authority. Mr. Lumley again tells the local board that the further incidence of the disease goes to confirm his view that it is due to polluted water. Unfortunately the of account the proceedings of the local board does not contain any statement as to what is being done ; indeed, the only action recorded is a proposal that the board should form itself into a committee to further consider the outbreak and the means which should be adopted to stop the spread of the disease. It is, however, to be hoped that all suspicious watersupplies have been stopped and that a wholesome supply is being delivered day by day, by water-cart or otherwise, at all houses where the local supply is liable to contamination.
A PRESIDENTIAL ADDRESS. THERE lies before
us a copy of an important and highly which should be available for every document interesting member of the profession, for it deals with topics of more than local interest. It is the address of the President of the Royal College of Physicians delivered to the assembled THE CHOLERA IN KASHMIR. Fellows on the occasion of the close of his year of office. We SOME further particulars of the cholera in Kashmir are toare unfortunately restrained from discussing its contents and hand in the form of a letter from Mr. A. Neve, the seniorIespecially its exhaustive treatment of the movement for a medical missionary, who when the epidemic commencenew i or reformed University in London by the superscription " was working single-handed, as his brother, Dr. Ernest Neve,on the title-page private and confidential. Is this also one had gone with a party of Moravian missionaries to Ladak.of the secreta Colle-ii? Surely it cannot be so intended. He had, however, a valuable native helper. As soonIncidentally we may remark that the secreta" have of recent as the epidemic became at all pronounced the Britishyears been unusually numerous, and we cannot help speculating resident and all the European visitors took flight to whether the bond of union that has obtained between this Gulmarg, a hill sanatorium some thirty miles from College and the sister institution in Lincoln’s-inn-fields may Srinagar. Mr. Neve and his assistant carried out ashave had a tendency to deprive the proceedings of the College systematic a visitation in the city as was possible, but little of Physicians of a publicity which in these days ought to be could be done either in the way of sanitation or of medication, the rule and not the exception. Apart from the general as the cases were rarely seen dmring the first few hours, when question, however, it does seem foolish and unworthy of the drugs are really valuable. The hospital was as far as possible College to require its President to restrict the circulation o cleared out, the patients being sent away to their villages lest his address to a small circle, and whilst we are dealing with in their weak state they should contract the disease. " I get this specific instance we may perhaps express a natural regret up very early," continues Mr. Neve, "and ride to the that the previous addresses of the present occupant of the bazaar. The head man of each district then comes and presidential chair and those of his much-revered predecessor escorts me to the new patients in the neighbourhood. Many have never been published. They are of permanent value of the houses are two- or three-storeyed and one has to climb and should not be suffered to lie neglected in the College up and down the most tortuous stairs, usually very steep and vaults. For without doubt they contain words of wisdom and the ceilings very low, so that my thick sola topi has been the teachings of ripe experience which might exert the best almost smashed to pieces. The people all crowd round the possible influence upon the profession, not only in the present unfortunate patient. A well-known man will have twenty or day but in years to come. The London College of Physicians thirty neighbours sitting round him and the women do not occupies such an eminent position among the medical institureserve their wails for the dead, but beat their breasts and tions of the empire that it is its bounden duty to lose no
158
opportunity of inculcating the principles it represents and authorities in India have had great experience of what occathe ethical standard it maintains. It could not better pro- sionally happens at Hurdwar and other large religious mote these aims than by publishing the annual addresses of gatherings and of the arrangements that have to be made to the leaders of the profession whom it places at the head of prevent an outbreak of cholera or limit its spread. A great deal of forethought and labour are expended in the way of its affairs. organisation and preparation on such occasions, and arrangements are also made for the sudden breaking up of the religious SMALL-POX IN YORKSHIRE. fairs and dispersal of the pilgrims in case of need. When SMALL-POX still hangs about some of the Yorkshire towns any epidemic is actually present or impending there must and villages. During the month of June Liversedge and the be great risk attending the assemblage of a large obviously Doncaster rural district and some localities in the neighbour___
hood of Halifax were somewhat seriously affected. borough is still suffering from the disease.
THE SCARLET FEVER EPIDEMIC IN
Mex-
LONDON.
A STATEMENT made at the last meeting of the managers of the Metropolitan Asylums Board is entirely in the direction of the caution which we uttered in our leading article of last week as to the extent to which scarlet fever is prevailing in the metropolis. The chairman explained that the incidence of the 2247 cases under isolation in the Managers’ hospitals amounted only to one case per 2000 of the 4,250,000 people in London. And even if we assume the total number of to be double that in hospital, the rate of attacks patients would only be 1 per 1000. The death-rate, as we intimated, is by no means alarming at the present moment.
THE MEDICAL MAGAZINE. A
literary adventure in the medical
world deserves a in the case of the hearty welcome, when, monthly journal appearing under the above name, it is issued with the laudable desire to restrict the growing tendency on the part of lay periodicals to insert contributions on medical subjects This magazine, which is produced in in their pages. commendable style, has doubtless a mission to fulfil, and the contents of the first number are varied as well There is a faithful and just tribute to as interesting. the work and character of the late Dr. H. G. Sutton, one of the most remarkable physicians of our day from the pen of Dr. Donkin ; an interesting sketch of the health conditions of Chester from mediseval times to the last century by Dr. Creighton ; and some strong advocacy of the value of periodical medical literature in advancing medicine by Dr. Saundby. Dr. Maudsley writes on Suicide in Simple Melancholy, in which he conveys the impression that suicide is not out of the natural order of things, as we are disposed to regard it. Mr. G. H. De’Ath, the medical officer of health for Buckingham, does good service by drawing specific attention to facts of rural sanitation (or rather insanitation) which have come to his notice. Dr. Francis Warner contributes a brief paper on Mental Physiology; and there is an anonymous (presumably editorial) article on the Medical Profession and Practical Politics-an appeal to members of the profession, especially those retired from active practice, to share in NEW
as
political and municipal affairs. CHOLERA AND CROWDS. ’rH11 Russians are evidently greatly disquieted by the fear of the threatened epidemic of cholera and are taking the most active measures to prevent the spread of that Cholera is advancing disease along the lines of railroad. be no doubt appathat there can Of the up Volga. a becomes serious and it question as to what steps rently, have been taken in regard to the approaching fair which, we are told, is to be held at Nijni Novgorod. The latest accounts would indicate that the official authorities in Russia have been very active in this direction of late, but whether the sanitary arrangements are of an adequate kind and commensurate with the occasion we do not know. The
of people. Even if some of them did not bring the with disease them, the heat, fatigue, overcrowding, defective sanitary arrangements and difficulties connected with watersupply, are all adverse factors that have to be encountered. A commercial fair like that at Nijni Novgorod is, of course, on quite a miniature scale compared with one of the vast Hindu religious gatherings in India, but all such assemblages require great preparatory care in the way of sanitary organisation and arrangements. The truth is there is no short and ready way, no royal road to the prevention of the spread of cholera in a country by quarantine and cordons. The scale on which the attempt has to be made is altogether too large and the difficulties too great for it to be practicable to apply such methods. Sanitation on a large scale, a pure and good water-supply, efficient sewerage, cleanliness and wholesome dwellings are the only reliable safeguards against cholera. There is the seed and the muckheap to be dealt with, and if the former cannot be destroyed the muck-heap necessary for its growth and development can be removed. An increased knowledge and experience have only confirmed the truth and given precision to the late Lord Palmerston’s sagacious remarks on the subject. concourse
RIGOR MORTIS IN ITS RELATION TO DEATH FROM POISON. THE Wiener 1J.Ieilicinische Presse publishes a paper read by Professor A. Paltauf before the Association of German physicians at Prague on some experiments he had made to show the causal connexion between rigor mortis and deaths from poison. For the purpose of these experiments such poisons were used as were known to exert a certain influence on the muscular system, either by directly acting on the muscular substance or indirectly by affecting the nervous system. Amongst the poisons belonging to the first series curare always considerably delays the occurrence of rigor mortis. Amongst those acting on the central nervous system, strychnine, picrotoxine, camphor, and the salts of ammonium accelerate the occurrence of rigor mortis. This acceleration is still more increased by artificially prolonging the stimulation of the muscular system, but is again arrested on the occurrence of paralysis. Veratrine and physostigmine cause only a slight acceleration of the rigor mortis, but with caffeine and its chemical the rhodan salts this acceleration becomes derivatives considerable. To study the influence of the nervous system at the time of occurrence of the rigor mortis, Professor Paltauf divided the nerves and the spinal cord, with the result that the more a muscle had been stimulated by the poison the sooner was the rigor mortis observed, independently of its connexion with the spine, if such connexion existed. The reaction of the rigid muscles was in the case of many poisons, Other poisons, howas has been generally believed, acid. ever (such as camphor, ethyl-theobromine and the rhodan salts), gave, contrary to the general assumption, an alkaline reaction. This alkaline reaction affected, however, only the anterior portion of an animal in which after the poisoning the cord had been divided. The posterior part of the animal, in which the rigor mortis was delayed, showed the usual acid reaction until the alkaline reaction of putrescence took place. Where the reaction of the anterior portion of the animal was -
-
thority
-
ELECTRICITY ASTRAY. AN accident to an electric lighting main in Walbrook, E. C., appears to have recently occasioned some merriment to the dwellers in those parts. We cordially congratulate them on having escaped any more serious consequences than those which provoked their mirth. It seems that through some unexplained failure of the insulator of an electric-lighting main a metal shop front became charged with wandering electricity and passers-by discovered that by touching it with their hands they could experience the delightful inconvenience of an electric shock. The circumstance this is in the minds that of most people, and luxury particularly of most street urchins, associated with festival occasions and penny fees no doubt invested the unpriced supply in Walbrook with an added charm. Happily, the amount of current obtainable seems to have been inconsiderably small; but seeing that a metal shop front in connexion with an electric-lighting main might easily become a greater source of peril to unwary passers-by than an uncaged tiger, the story of this mishap is calculated to give the reader of a serious turn more food for reflection than is altogether pleasant. Fortunately, it is not possible that such an accident should happen without serious fault on somebody’s part, and although the London public seem to have taken the matter with a light heart, we hope that those whom it most nearly concerns will make a point of exacting the full penalty for a flagrant default, be it whose it may—p* enOOI(fJ’ager les aittres.
tear their hair and creamHai, hai, wai, wai’ if anyone is badly attacked....... For a time there seems to be no ’ purdah’ and no class is specially inaccessible. In fact the well-to-do Hindus seem quite as willing to receive me In many cases one can do little; in others as any others. one can turn the scale. But although a few lives here and there have been saved I think the moral effect of our work is more important. The people well know the apathetic selfishness of their co-religionists and they see the missionaries and ladies as well as others going about trying to relieve " suffering." Mr. Neve’s assistant succumbed to the disease, though after transfusion he rallied for a short time. The Indian Government have deputed Surgeon-Colonel Harvey to make a searching inquiry into the epidemic and he has taken up his quarters in the mission house with Dr. Ernest Neve, who has returned, Mr. Arthur Neve going out into the villages where the cholera, after having abated in the city, was becoming
rife. ___
ENTERIC FEVER AT NORTHALLERTON. ENTERIO FEVER still prevails at Northallerton, but, as we anticipated, the Local Government Board do not see any reason for sending a medical inspector to investigate its causes, those causes being known in advance to the local authority. Mr. Lumley again tells the local board that the further incidence of the disease goes to confirm his view that it is due to polluted water. Unfortunately the of account the proceedings of the local board does not contain any statement as to what is being done ; indeed, the only action recorded is a proposal that the board should form itself into a committee to further consider the outbreak and the means which should be adopted to stop the spread of the disease. It is, however, to be hoped that all suspicious watersupplies have been stopped and that a wholesome supply is being delivered day by day, by water-cart or otherwise, at all houses where the local supply is liable to contamination.
A PRESIDENTIAL ADDRESS. THERE lies before
us a copy of an important and highly which should be available for every document interesting member of the profession, for it deals with topics of more than local interest. It is the address of the President of the Royal College of Physicians delivered to the assembled THE CHOLERA IN KASHMIR. Fellows on the occasion of the close of his year of office. We SOME further particulars of the cholera in Kashmir are toare unfortunately restrained from discussing its contents and hand in the form of a letter from Mr. A. Neve, the seniorIespecially its exhaustive treatment of the movement for a medical missionary, who when the epidemic commencenew i or reformed University in London by the superscription " was working single-handed, as his brother, Dr. Ernest Neve,on the title-page private and confidential. Is this also one had gone with a party of Moravian missionaries to Ladak.of the secreta Colle-ii? Surely it cannot be so intended. He had, however, a valuable native helper. As soonIncidentally we may remark that the secreta" have of recent as the epidemic became at all pronounced the Britishyears been unusually numerous, and we cannot help speculating resident and all the European visitors took flight to whether the bond of union that has obtained between this Gulmarg, a hill sanatorium some thirty miles from College and the sister institution in Lincoln’s-inn-fields may Srinagar. Mr. Neve and his assistant carried out ashave had a tendency to deprive the proceedings of the College systematic a visitation in the city as was possible, but little of Physicians of a publicity which in these days ought to be could be done either in the way of sanitation or of medication, the rule and not the exception. Apart from the general as the cases were rarely seen dmring the first few hours, when question, however, it does seem foolish and unworthy of the drugs are really valuable. The hospital was as far as possible College to require its President to restrict the circulation o cleared out, the patients being sent away to their villages lest his address to a small circle, and whilst we are dealing with in their weak state they should contract the disease. " I get this specific instance we may perhaps express a natural regret up very early," continues Mr. Neve, "and ride to the that the previous addresses of the present occupant of the bazaar. The head man of each district then comes and presidential chair and those of his much-revered predecessor escorts me to the new patients in the neighbourhood. Many have never been published. They are of permanent value of the houses are two- or three-storeyed and one has to climb and should not be suffered to lie neglected in the College up and down the most tortuous stairs, usually very steep and vaults. For without doubt they contain words of wisdom and the ceilings very low, so that my thick sola topi has been the teachings of ripe experience which might exert the best almost smashed to pieces. The people all crowd round the possible influence upon the profession, not only in the present unfortunate patient. A well-known man will have twenty or day but in years to come. The London College of Physicians thirty neighbours sitting round him and the women do not occupies such an eminent position among the medical institureserve their wails for the dead, but beat their breasts and tions of the empire that it is its bounden duty to lose no
158
opportunity of inculcating the principles it represents and authorities in India have had great experience of what occathe ethical standard it maintains. It could not better pro- sionally happens at Hurdwar and other large religious mote these aims than by publishing the annual addresses of gatherings and of the arrangements that have to be made to the leaders of the profession whom it places at the head of prevent an outbreak of cholera or limit its spread. A great deal of forethought and labour are expended in the way of its affairs. organisation and preparation on such occasions, and arrangements are also made for the sudden breaking up of the religious SMALL-POX IN YORKSHIRE. fairs and dispersal of the pilgrims in case of need. When SMALL-POX still hangs about some of the Yorkshire towns any epidemic is actually present or impending there must and villages. During the month of June Liversedge and the be great risk attending the assemblage of a large obviously Doncaster rural district and some localities in the neighbour___
hood of Halifax were somewhat seriously affected. borough is still suffering from the disease.
THE SCARLET FEVER EPIDEMIC IN
Mex-
LONDON.
A STATEMENT made at the last meeting of the managers of the Metropolitan Asylums Board is entirely in the direction of the caution which we uttered in our leading article of last week as to the extent to which scarlet fever is prevailing in the metropolis. The chairman explained that the incidence of the 2247 cases under isolation in the Managers’ hospitals amounted only to one case per 2000 of the 4,250,000 people in London. And even if we assume the total number of to be double that in hospital, the rate of attacks patients would only be 1 per 1000. The death-rate, as we intimated, is by no means alarming at the present moment.
THE MEDICAL MAGAZINE. A
literary adventure in the medical
world deserves a in the case of the hearty welcome, when, monthly journal appearing under the above name, it is issued with the laudable desire to restrict the growing tendency on the part of lay periodicals to insert contributions on medical subjects This magazine, which is produced in in their pages. commendable style, has doubtless a mission to fulfil, and the contents of the first number are varied as well There is a faithful and just tribute to as interesting. the work and character of the late Dr. H. G. Sutton, one of the most remarkable physicians of our day from the pen of Dr. Donkin ; an interesting sketch of the health conditions of Chester from mediseval times to the last century by Dr. Creighton ; and some strong advocacy of the value of periodical medical literature in advancing medicine by Dr. Saundby. Dr. Maudsley writes on Suicide in Simple Melancholy, in which he conveys the impression that suicide is not out of the natural order of things, as we are disposed to regard it. Mr. G. H. De’Ath, the medical officer of health for Buckingham, does good service by drawing specific attention to facts of rural sanitation (or rather insanitation) which have come to his notice. Dr. Francis Warner contributes a brief paper on Mental Physiology; and there is an anonymous (presumably editorial) article on the Medical Profession and Practical Politics-an appeal to members of the profession, especially those retired from active practice, to share in NEW
as
political and municipal affairs. CHOLERA AND CROWDS. ’rH11 Russians are evidently greatly disquieted by the fear of the threatened epidemic of cholera and are taking the most active measures to prevent the spread of that Cholera is advancing disease along the lines of railroad. be no doubt appathat there can Of the up Volga. a becomes serious and it question as to what steps rently, have been taken in regard to the approaching fair which, we are told, is to be held at Nijni Novgorod. The latest accounts would indicate that the official authorities in Russia have been very active in this direction of late, but whether the sanitary arrangements are of an adequate kind and commensurate with the occasion we do not know. The
of people. Even if some of them did not bring the with disease them, the heat, fatigue, overcrowding, defective sanitary arrangements and difficulties connected with watersupply, are all adverse factors that have to be encountered. A commercial fair like that at Nijni Novgorod is, of course, on quite a miniature scale compared with one of the vast Hindu religious gatherings in India, but all such assemblages require great preparatory care in the way of sanitary organisation and arrangements. The truth is there is no short and ready way, no royal road to the prevention of the spread of cholera in a country by quarantine and cordons. The scale on which the attempt has to be made is altogether too large and the difficulties too great for it to be practicable to apply such methods. Sanitation on a large scale, a pure and good water-supply, efficient sewerage, cleanliness and wholesome dwellings are the only reliable safeguards against cholera. There is the seed and the muckheap to be dealt with, and if the former cannot be destroyed the muck-heap necessary for its growth and development can be removed. An increased knowledge and experience have only confirmed the truth and given precision to the late Lord Palmerston’s sagacious remarks on the subject. concourse
RIGOR MORTIS IN ITS RELATION TO DEATH FROM POISON. THE Wiener 1J.Ieilicinische Presse publishes a paper read by Professor A. Paltauf before the Association of German physicians at Prague on some experiments he had made to show the causal connexion between rigor mortis and deaths from poison. For the purpose of these experiments such poisons were used as were known to exert a certain influence on the muscular system, either by directly acting on the muscular substance or indirectly by affecting the nervous system. Amongst the poisons belonging to the first series curare always considerably delays the occurrence of rigor mortis. Amongst those acting on the central nervous system, strychnine, picrotoxine, camphor, and the salts of ammonium accelerate the occurrence of rigor mortis. This acceleration is still more increased by artificially prolonging the stimulation of the muscular system, but is again arrested on the occurrence of paralysis. Veratrine and physostigmine cause only a slight acceleration of the rigor mortis, but with caffeine and its chemical the rhodan salts this acceleration becomes derivatives considerable. To study the influence of the nervous system at the time of occurrence of the rigor mortis, Professor Paltauf divided the nerves and the spinal cord, with the result that the more a muscle had been stimulated by the poison the sooner was the rigor mortis observed, independently of its connexion with the spine, if such connexion existed. The reaction of the rigid muscles was in the case of many poisons, Other poisons, howas has been generally believed, acid. ever (such as camphor, ethyl-theobromine and the rhodan salts), gave, contrary to the general assumption, an alkaline reaction. This alkaline reaction affected, however, only the anterior portion of an animal in which after the poisoning the cord had been divided. The posterior part of the animal, in which the rigor mortis was delayed, showed the usual acid reaction until the alkaline reaction of putrescence took place. Where the reaction of the anterior portion of the animal was -
-