AN UNPLEASANT MISTAKE.

605 of the culture and the same phenomena are pre- was recently held at Grays by the deputy coroner touching Still repeating it, we find the blood of the death of an infant aged five months. Deceased had sented animal has the acquired special properties. It is bled and suffered from "discharge from the head during the few is blood allowed to coagulate in vessels, separating into days previous to its death." the On Feb. 5th the child two parts the red coagulum and a liquid, transparent and was left in bed by the mother apparently asleep. The yellowish, which is the serum wanted. This is a veritable bedclothes were clear of the face. Shortly afterwards it was antitoxin for the plague. Inoculate a few milligrammes of it noticed that something was wrong and Dr. Snell was sent in a rat and then infect the animal with the cultura pesti- for, but before his arrival the child was dead. The report fera." Its health is unimpaired. Infect with the same culture of the inquest relates that Dr. Snell stated in his evidence another rat which previously has not been treated with the that he had not the slightest information as to whether Take a rat already suffering the child died a natural death or the reverse ; and at the serum and it dies invariably. from the plague and inoculate it with the serum and it request of the father he made a post-mortem examination almost invariably recovers. Such, briefly stated, is the and found the cause of death to be asphyxia." When asked practice of Yersin, who in twenty-six subjects ill from the the cause of death Dr. Snell refused to answer on the that the coroner had not issued an order for a postplague has achieved by it twenty-four cures-the two who died having been treated too late. In a disease which mortem examination, and that he should not divulge the numbers 90 per cent. of fatalities the Yersin practice is, secrets obtained by a necropsy privately paid for by the indeed, a boon which Professor Banti and his brethren do well parents. That an inquest was necessary in this case there to bring before the lay public with a view to its being pressed can be no doubt. That a necropsy was desirable seems upon the State. Thanks to the same enlightened action of the probable, but upon the coroner was cast the duty to profession the public are taking a less superstitious view of determine these points. We have frequently asserted that sanitary cordons and such protective measures. In the recent where the cause of death cannot be determined beyond epidemics of cholera, says Professor Banti, those measures reasonable doubt from the general and medical evidence a were useless if not positively harmful. But plague is different post-mortem examination should be made. The coroner, from cholera, as in this connexion he proceeds to show. In acting within his discretion, thought it was not called for and 1815 it appeared at Noia in the Abbruzzi, and a military declined to make an order. In the first place Dr. Snell was cordon was at once drawn around the city and rigorously clearly in the wrong. From his own evidence it is obvious maintained."Il male si spense ove era nato" (The disease that he could not give a certificate of the cause of death, was extinguished where it was born). Again, in 1878-79 the and hence it follows that the body passed into the possession the of in Russia, and of the coroner, and to make a necropsy without an order Astrakhan plague ravaged provinces the same measures, severely enforced, circumscribed was a mistake. The fourth section of the 6 and 7 Will., c. 89, again and choked it. Why so? Because, replies Professor Banti, provides that " no fee or remuneration shall be paid to any the bacilli of plague are extremely delicate bacteria, dying medical practitioner for the performance of any post-mortem easily and easily losing their virulence, not holding out examination which may be instituted without the previous against desiccation-in a word,"they are micro-organisms direction of the coroner." It is obvious that Dr. Snell even more fragile than the vibrios of cholera." Rigidly ’, could not legally claim a fee for what he had done without practised, therefore, such measures can protect the country official authority. Could he then be compelled to state the from the intrusion of plague. Again, even if it has effected result of his examination ? The question is open to argument, but on the whole we are of opinion that, bound by his oath .an entrance, Italy (though in a less degree than France) is not the Italy of " sixty years since"; she has shared in the to give in evidence concerning the death" the truth, the modern movement of hygiene, public and personal, and is whole truth, and nothing but the truth," he could not on pro tanto protected against a malady which, under insanitary the ground of professional secrecy decline to divulge the conditions, reaps its thousands. For plague propagates knowledge he had acquired at the post-mortem examination. itself neither through the air nor the water and the bacteria We are glad to learn that a more conciliatory attitude was which produce it are easily destructible-they can, for assumed towards the close of the inquest and that the instance, be prevented from contaminating the soil, that coroner eventually made the order claimed by Dr. Snell. It indispensable condition for the development of plague. A is not our desire to criticise unduly the procedure adopted by truce, then, to the fumigations, inspired by panic, at frontier coroners, who have frequently a difficult duty to perform, stations. Suspected cases, at once isolated, but not in being exposed to the charge of carelessness and parsimony "lazzaretti," and subjected for a few days to medical on the one hand and to undue prodigality with the ratesurveillance, are excluded from all possibility of diffusing payers’ money on the other. After an impartial consideration the contagion ; and if the malady declares itself in its true of the facts we cannot escape the conclusion that Dr. Snell, colours there is always the " serum anti-pestiferum" to finding he had overstepped the line of prudence in making a combat it. But no time must be lost by the State in pro- post-mortem examination without an order from the coroner, viding the protective measures, on the one hand, and the might have avoided a conflict by timely compromise. antitoxin, in sufficient quantity, on the other. It has had ample warning from medical authority already. All the AN UNPLEASANT MISTAKE. greater must be its responsibility if, in the light of such To fondly nurture an egg which only results in the warning, it adheres to its favourite maxim, "inertia sapientia,"from which Italy has suffered so heavily in the hatching of an ungrateful and venomous reptile is a favourite figure in the pages of fiction and romance, but the figure past. was almost literally realised in the circumstances of a legal action reported this week. A woman ate what she thought CORONER AND MEDICAL MAN. were sweets, when they proved to be those eggs" " which IN THE LANCET of Feb. 20th we had occasion to incubate rapidly into a "Pharaoh’s serpent on applying a comment upon a regrettable incident that occurred at an light. It appears that the plaintiff, a confectioner, purchased inquest, and from the reports before us we considered from the defendants a number of farthing packets, one of that the action of the medical man was consistent with which she sold to a child. The child, however, brought it both the spirit and the letter of the law. It is now our back, as luckily her father had tasted the contents of the duty to draw attention to a conflict between a coroner and packet and wisely expressed the opinion that they were The lady confectioner, however, anxious to show medical man in which other issues were raised. An inquest

quantity

once more.

ground

li

-

nasty.

606 that she sold innocuous things, ate one herself, regarding it as a sweet, with the result that she was taken very ill and was medically attended for several weeks. This was the ground of the action, and very justiUnless the confectioner’s business was fiable ground too. of a mixed kind it is inconceivable that sulpho-cyanide of mercury pills, of which the " eggs " are composed, should be sent to a dealer who sells7sweets. Judge Lushington decided that the negligence was on the part of the defendant and not of the plaintiff, and he gave judgment for the latter for the full amount claimed (£50). Sulpho-cyanide of mercury does not appear to be a very powerful poison, and the quantity in each "egg"is stated to be somewhat over a grain. Its poisonous properties may be referred to the mercury rather than to the cyanogen in its composition. On applying a light, however, the vapours given off are very decidedly mercurial, which fact alone suggests that some measure of restriction should be imposed upon the sale of these apparently innocent ’°eggs."" PROCEDURE UNDER THE SALE OF FOOD DRUGS ACT, 1875.

AND

HOPES have been held out that when a number of matters of greater (?) importance than the health of the people shall have been satisfactorily disposed of, the attention of Parliament will be directed to a revision of the laws dealing with the adulteration of food, which have been practically untouched for over twenty years. The Act of 1875 is in many respects open to amendment, especially as to the inadequacy of the penalties for repeated offences, which, as experience has amply shown, instead of acting as deterrents, too often amount to no more than a small tax on enormous illicit profits, and the difficulties often found in obtaining convictions or in reaching the real offender, while instances of hardship are not altogether unknown. But the most serious defect is undoubtedly in the procedure enjoined for obtaining samples, which is uncertain and haphazard, and, indeed, demoralising to all parties. A consciously fraudulent dealer soon learns to recognise as a suspicious customer an inspector, policeman, or other officer or servant of the sanitary authority, and even a woman or child put forward by the inspector waiting outside. The probability of such person being served with an adulterated article is small, although a large business may be done in such goods under other circumstances, and the subterfuges, or, in plain language, the lies, to which a clever and successful inspector is driven to resort are by no means creditable to the law, while often serving to evoke sympathy with the accused, whom an astute counsel may easily represent as the victim of a mean conspiracy. The procedure, too, is applicable to the retail trade only and cannot be brought to bear on the wholesale dealer or manufacturer, who does not sell his goods in small quantities and to all Customers over the counter ; the only way in which such offenders can be reached being by a further action entered against him by the retailer, and not even then when the latter was a party to the fraud by buying at a price he knew to be incompatible with the purity of the article and of course without a warranty. We would call the attention of those on whom the drafting of a new Bill may devolve to the procedure under the Italian Public Health Act, although we have reason to believe that its provisions are by no means as strictly enforced as they are wisely designed, though this is doubtless the fault of the local authorities and their officials, and not of the able framers of a comprehensive and highly scientific piece of legislation By it the medical officer of health, accompanied, if he

prefer, by the public analyst, is empowered to enter any shop, warehouse, or factory, wholesale or retail, for the preparation or sale of any articles of food or drugs, and at his

leisure to inspect the entire stock, selecting and taking: samples, with prescribed precautions for identification, for examination or analysis. Every element of chance and possibility of evasion is thus precluded, everything is open and fair to all parties, and the opportunity afforded of reaching: the wholesale dealer directly is really a protection to the small tradesman, who is as often deserving of pity as of blame.

"SEAMEN’S HOSPITALS." THE litigation concerning the testamentary intentions of Mr. W. F. Waller of Gravesend, under which a bequest for "Seamen’s hospitals"was made to the acting Lord Mayor,. is now at an end, and the bank shares-the subject of the bequest-have been transferred to his lordship. The will gives the Lord Mayor absolute discretion in deciding what is a "seamen’s hospital," the only condition imposed by thetestator being that the money should be applied "for the benefit of such hospitals or hospital for seamen in some or one of the cities or counties which border on the River Thames in England, as he may think fit." The legacy, after payment of legacy duty, will amount to about £9250. Any hospitals for seamen claiming to come within the words of the bequest should send in particulars of their claim to the City Solicitor. -_--

THE PATHOLOGY AND THERAPEUTICS OF

SCURVY. IN

our

issue of Feb. 13th

we

referred to Dr. Nansen’s

experiences with regard to scurvy. Not a single case. occurred during the whole time that the expedition was. away although the food necessarily consisted very largely of preserved meats. Dr. Torup, Professor of Physiology at the University of Christiania, was of opinion that. if meat was badly preserved certain poisons allied to the ptomaines were produced which caused scurvy and consequently great care was exercised in preparing foodstuffs for Dr. Nansen’s expedition, with the result already stated. Especially interesting in this connexion is the article recently published by Dr. A. E. Wright, Professor of Pathology at the Army Medical School, Netley. He points out that our knowledge of scurvy is incomplete, inasmuch as it does not furnish us with any explanation of the fact that a regimen consisting entirely of preserved meats and cereals, or of either of these separately, induces the symptoms of scurvy. According to Dr. Nansen’s experience, however, this statement

the word "improperly"being before "preserved." Dr. refers to Wright experiments made by Walther under directions. These experimenters had in Schmiedeberg’s view the object of determining the effect of administering mineral acids to animals. The results varied with different animals. In the herbivora there is no special provision for the neutralisation of acids, and consequently rabbits speedily succumb to "acid intoxication" when free acids are administered. This is in conformity with the fact that these animals, so long as they feed exclusively upon herbage, have no need for any such provision, seeing that they are feeding upon alkaline food-stuffs which continually replenish the. blood with alkaline salts. In the carnivora there exists a very effectual provision for neutralising acid by means of the waste ammonia of the body, and consequently a dog, for example, bears up perfectly well against even a considerable acid ingestion. Contrary to what happens in the rabbit, the ingested acid does not in the dog either rob the blood of its alkaline salts or diminish its coagulability. Man occupies with respect to his power of neutralising acid a position which is intermediate between that of the dog and the rabbit. He is, therefore, able to bear up withoutmust

inserted

be

modified,