FEVER AND CONVULSIONS DUE TO ASCARIDES.

1119 After all but a the London degree altogether. without the aid of any optical contrivance was partially to abandoned t close the eyelids. A patient some years ago taught me a ten years of practice I can conscientiously say that on no s method that was new to me and of which I have not yet single occasion I can recall would such knowledge of inA boy, aged 17 years, with myopia of one corganic chemistry as the University requires have been of seen an account. t slightest use to me. I am. Sirs. vours faithfullv. and a half dioptres, showed me that he could greatly improve the F.R.C.S. ENG. his distant vision by putting his finger on the external canthus Oct. llth, 1903. of one eye and drawing the eyelids outwards. This observation I have confirmed on myself and others. If a + 2 D. spherical FEVER AND CONVULSIONS DUE TO glass be put before an emmetropic eye so as to render it ASCARIDES. it will found of be that the letters Sneilen’s myopic, large To the Editors of THE LANCET. types can be read at five metres much better by drawing out the upper eyelid by the finger than by approximating the SIRS,-IN regard to your recent annotation upon the above eyelids in the ordinary way by the action of the orbicularis.subject and the subsequent correspondence thereon, may I The difference between the two methods is considerable ; by point out that, owing to the almost universal presence of the one vision equal to can barely be reached, by the these parasites amongst the natives of India, this is a matter other one can succeed after a little management in getting which has already received the careful attention of officers vision up to 5/12 or even higher. When making this observa- of the Indian Medical Service. One of the commonest tion one can easily see that the horizontal strokes of the causes of slight attacks of fever in that country is the letters became more distinct when approximating the eyelids, presence of ascarides and, further, the most extraordinary and that both horizontal and vertical strokes, especially the and misleading symptoms are undoubtedly due to the prelatter, became plainer when the upper eyelid was stretched sence in excessive numbers of this worm or to the wonderful by the finger. This result was to me quite unexpected. journeys undertaken by this enterprising animal. If your One might perhaps have thought that the circles of diffusion readers will consult the writings of the late Norman Chevers could be cut off as well by one method as the other. A or the files of the Indian Annals of Medicine, Madras little experiment will, however, show at once the superiority Quarterly Journal of Medical Science, Indian Medieal of the method of drawing out the upper eyelid by the finger. Gazette, &c., as well as the Transactions of the S. I. I am, Sirs, yours faithfully, Branch of the British Medical Association they will find E. DONALDSON, B.A. T.C.D., L.R.C.S. Irel. how thoroughly the matter has been investigated in that Londonderry, Oct. 10th, 1903. country. I myself believe that there is no room for doubt that this parasite is capable, by continued pressure, of forcing Per contra, I do not a passage through various tissues. PUBLIC VACCINATORS IN RURAL believe in the "toxin" theory, which, by the way, is much DISTRICTS. older than the article by Dr. Wettendorff referred to in the original note. To the Editors of THE LANCET. The foregoing affords another instance of what is an unSIRS,—Aa I am appointed to give evidence before the doubted fact-viz., that a large number of what are still departmental commission of the Local Government Board on as being moot or as being fresh points, especially behalf of the public vaccinators in rural districts of England regarded in "tropical" medicine, have long ago been investigated, and Wales I should be glad to receive from those gentlemen discussed, and settled in India, as a careful study of the information giving instances of excessive distances and any medical literature of that country, including many scarce accurate statistics of the proportion of visits paid to the and made clear to me some unattractive-looking reports," number of vaccinations effected. In all cases the various years ago. So, also, as regards treatment, one too often Corre- sees methods or medicines recommended as fees allowed to each vaccinator should be given. original which spondence may be addressed to me direct and must reach me have years before been tried and adopted or rejected in within the next two weeks. I had collected many examples of this kind of India. I am, Sirs, yours faithfully, error with a view to ultimate publication, but for A. MAUDE. several reasons, of which ill health is perhaps the most Winterton House, Westerham, Kent, Oct. 12th, 1903. effective, I cannot expect to accomplish that which I had planned. Fcrtunately there is no lack of men in the Indian Medical Service well able to undertake and to complete THE M.D. DEGREE OF BRUSSELS. the task and I have great hopes that some officer of that To the. Editors of THE LANCET. service will devote himself to the printed records of medical SIRS,-IN THE LANCETof Oct. 10th Dr. N. Leonard work in India with a view to demonstrating the hidden a clear account of the general requirements of the M.D. wealth that is contained therein. Brux. examination hut has surely omitted to state a fact which I am writing to the editor of the Indian Medical Gazette to is generally not known and which detracts considerably from suggest the publication of a special I I Intestinal Parasites"" the value and status of the degree. That fact is that the number; which would, I feel certain, furnih most interesting M.D. Brux. confers no right to practise in Belgium, as it is reading and afford a means by which many of the accounts not a ’’ State University " examination and that it is therefore’ of the ascaris lumbticoides and the symptoms to which its The presence give rise contained in British text-books could be practically valueless from a legal point of view. Belgians themselves take the State degree," which is quite both amplified and made more correct. another matter.-I am. Sirs. vours faithfullv. I am. Sirs- vours faithfnllv. P A. NIGHTINGALE, M.D. Edin. A. E GRANT, Ludgate-hill, B.C., Oct. 10th, 1903. Ennore, Boscombe, Oct. llth, 1903. Major, Indian Medical Service. .

IB

gives

To the Editors of THE LANCET.

MEDICAL ACTS AMENDMENT BILL.

SIRS,-I have read with interest your annotation on the I have thought for many years M.D. degree of Brussels.

that those who have received their medical education in London have a m(lst distinct grievance against the University of London. May I quote my own case. Before the age of 17 I matriculated at the University and within a month or two of j pining a London medical school I passed the preliminary scientific examination. I then found that to pass the interme(liate examination I should have to acquire an intimate hn wledge of inorganic chemistry, a subject of which I knew littor nothing and for which I had no

particular aptitude. I found, moreover, that the time I should necessarily have spend in acquiring this special knowledge would lose me my position among my cor-temporaries and my right to compete for certain prizes. In the circumstances I

to

1

THE

LANCET,

Oct.

10th, 1903, p. 1030.

To the Editors

of THE LANCET.

requested by the council of the Association and Surgeons of the Society of Apothecaries, Limited, to draw your attention to the following resolutions on the above-mentioned subject :SIRS,-I

of

am

Physicians

At the September meeting of the council of the Association of Physicians and Surgeons of the Societv of Apothecaries Limited, it was resolved that in the opinion of this Association no Medical Acts Amendment Bill can be considered satisfactory which does not include the

following provisions

:—

registered under the Medical Act of 1858 in to qualifications to practise medicine shall henceforth be described as physicians and all persons registered in respect of qualifications to practise surgery shall henceforth be described as surgeons. 2. That all persons registered under the amending Act and under the Medical Act of 1886 shall be described as physicians and surgeons. 1. That all persons

respect

1 THE

LANCET, Sept. 26th, 1903,

p. 898.

’