HARLEY STREET AND MEDICAL LOCALITIES.

1216 i Pall Mall East, they were bucceedeu by the butchers for. In most parishes the to under the Poor Relief Act of Newgate Market. The English surgeons, after being housed is the adviser of the vestry on health questions, but his only at Barber Surgeons’ Hall in the heart of the City, came responsibility is to make a quarterly report. No definite west, also to the neighbourhood of the great prison. The or systematic inspections or inquiries into sanitary conphysicians established themselves in their present College in ditions are required of him, and his reports are often per- 1825 ; the surgeons were finally located in their first functory. As these appointments for medical relief pur- College in Lincoln’s Inn-fields in 1813. Medicine and poses are in the hands of the vestry, which can relieve the surgery having now established themselves, not in officer of his duties at six months’ notice, he is not in a a corporate capacity but so far as the heads of the position to comment freely on insanitary conditions coming profession are concerned, in Harley-street and its neighunder his observation, as by doing so he is likely to bourhood, the Royal Society of Medicine is about to offend the susceptibilities of his employers, on whose build its new home on the borders of that medical goodwill his tenure of office depends. We may here quarter of London. The student of London fashion may remind our readers that something closely resembling wonder whether, in a very few years, an exodus of the this is not unknown in a number of districts in England general well-to-do residents may not take place from and Wales, where the part-time medical officer of health has Marylebone in the direction of Kensington or Hampstead, frequently to submit to annual reappointment, and if he for there is certainly no finality in these questions of habitat. offend a majority of his council by a display of zeal ’, For ages it has been customary for the west ends of towns he is liable, as a reward, to be superseded in his appoint- to be the resort of leisure, wealth, and fashion. But there ment. Summing up the state of sanitary administration will not be the necessity nowadays that prevailed in the in Barbados Sir Rubert Boyce describes it as " barbaric and eighteenth and most of the nineteenth century to establish primitive" and standing in urgent need of improvement. central buildings where medical men may congregate, nor Accordingly, he recommends the Government to introduce a quite the same inducement for medical men to follow a Bill without delay for the registration of deaths and causes peregrinating public. Enormously increased facilities of of mortality, and for the establishment of a chief medical transit are rapidly making all parts of the metropolis officer of health for the island with local medical officers of accessible to everyone. health under him for each district. These reforms should THE PATHOLOGY OF INFECTIOUS JAUNDICE. prove neither difficult nor costly ; they would, if properly carried out, lift the colony into the first rank, and might AT a meeting of the Societe Médicale des Hôpitaux of make it simultaneously the ideal recuperating ground for the Paris on March 4th, M. P. Abrami, M. Ch. Richet fils, and tired-out and sick ones of Europe and the United States. In M. R. Monod made an important communication on the this connexion we quote Sir Rubert Boyce’s expression of his M. of Abrami. in collaboration with jaundice. pathology impressions of the health-restoring qualities of Barbados : M. Lemierre, has recently put forward the view that infec"Ishall never forget," he says, "the feeling of absolute tious jaundice (ictère infectieux) is usually the result, not of repose, coupled with the stimulating and invigorating effect ascending infection from the intestine, but of descending of the climate and scenery, which I experienced at all hours infection from the blood. Of this the jaundice which someof the day, whether in the early morning, in the noonday times occurs in connexion with typhoid fever is an example. sun, or in the late eventide ; no matter what the hour, every- The systematic examination of the blood in cases of infecthing in life appeared sweet." tious Widal and other French observers has

forthcoming unless specially asked parochial medical officer appointed

jaundice by

The following case is an A 36 woman, aged example. years, was admitted into IN theStrange Case of Dr. Jekyll and Mr. Hyde," hospital with the diagnosis of scarlet fever. Eight days Cavendish-square is referred to by Robert Louis Stevenson as previously she was confined at term. In the last three days "that citadel of medicine,"but the vogue of Harley-street, she presented signs of puerperal fever, and on the previous day Wimpole-street, and the famous square is not, indeed, very generalised erythema and jaundice appeared. On admission ancient. The physicians and surgeons of the earlier part of the temperature was 105’ 60 F., the pulse was 160, the face the nineteenth century had mostly not moved so far west. was sunken, the eyes were surrounded by dark circles, and They lived in Bedford- and Russell-square, or, in the case of the lips were dusky. The patient was fully conscious and several famous surgeons, close to the College in Lincoln’s complained principally of hiccough and difficulty of Inn-fields, while Finsbury-square had not by this time lost its breathing. There were manifest signs of general peritonitis ; attractions. The great medical men of the eighteenth century the abdomen was tympanitic and very tender in the hypogastric had no particular quarter; they lived scattered in fashion- and iliac regions. The respiration was short and rapid able parts of town. Radcliffe lived in Bow-street, and and of the superior costal type ; the diaphragm seemed to John Hunter in Leicester-square, not far from his brother be immoveable. The erythema had all the characters of the William. Mead prided himself upon his spacious library, puerperal scarlatiniform rash ; it affected the whole body 60 feet long, in Great Ormond-street, where he enter- excepting the face and was most marked on the neck, tained Dr. Freind from Albemarle-street and the literary abdomen, and thighs. There was neither angina nor physician Arbuthnot, from Cork-street, Burlington-gardens. scarlatinal stomatitis. The jaundice was well marked ; the This was in the mid-eighteenth century, at which period face and oonjunctivse were of a sulphur-yellow colour. The the City still flourished as the home of wealthy citizens, fseces were decolourised and the urine was dark-coloured among whom were many resident physicians of repute. We and contained bilirubin in abundance. The liver extended get an early glimpse of Harley-street in 1780, when the three finger-breadths below the ribs and the spleen was notorious Lord George Gordon lived there on the confines of enlarged. Death occurred in the evening. A culture made the open country to the north. To a sensible but less obvious from the blood during life yielded in 24 hours a pure growth extent practitioners in medicine and surgery have followed of streptococci, which on inoculation into a rabbit produced their Colleges as well as their patients. The first College of i typical erysipelas. At the necropsy the uterus was found to Physicians in London was in a certain sense the house of be of the size of a fist ; it contained neither clots nor placental Afterwards the physicians remains, but a little opaque inodorous serous fluid. Its Linacre in Knightrider-street. established themselves near Newgate, where, on movingI internal surface was of a violaceous-red colour and its walls

confirmed the view stated.

HARLEY STREET AND MEDICAL LOCALITIES.