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HEREDITY, CRIMINAL AND OTHERWISE.
956 calculated to set it off well in the eyes of the
public. There to have its function considerably impaired. There was truth in the of but not enough no difficulty in swallowing and there seemed to be some some is, course, suggestion, to justify such uncontrolled and unqualified candour. The mental dulness, with slow speech and vague replies to argument was met in the reply of the medical staff with a questions. In discussing the question of an operation dignified challenge to produce "a single case" in support it was thought that the exemption of nerve affection of a charge which could only be justified by cases. The pointed to the growth being distant from the base. There staff argued that to throw open nine beds to sixty or seventy was nothing to indicate one side more than another except practitioners to attend only to their own cases would leave the forced movement to the right (which might mean the responsible care and the internal management unpro- pressure on a cerebellar peduncle on either side) and the vided for and necessitate the appointment of a paid remains of the injury to the occipital bone on the right side. resident. They considered that a hospital in a population So it was determined to operate on the right occiput. Howof 70,000 cannot be compared with a rural hospital with ever, as has been said, accident prevented the operation three or four practitioners around. At the same time from being carried out and the patient gradually sank and the majority of the staff wisely expressed approval of an died about two months after admission. At the necropsy arrangement carried out in the Hampstead Hospital by there was found a tumour on the under surface of the which patients are admitted under the care of their own cerebellum on the right side, lying between the pons and medical men. This ought to be adopted. It seems to us medulla on the one hand, and the right lobe of the cerethat the best of the argument rests here with the staff, and bellum on the other. The growth sprang from the middle that to diffuse the management of nine beds and accidents cerebellar peduncle and the posterior part of it was cystic. among sixty or seventy practitioners would be to divest the The under surface of the right lobe of the cerebellum was appointment of all interest and to invite that state of things excavated and had assumed a cystic character. Undoubtedly where nobody does that for which everybody is responsible. the absence of impairment of the functions of the cranial nerves in this case is very remarkable, and it is also interesting that the forced movements were towards the side of the THE NOTIFICATION OF MEASLES. lesion and not, as in most cases, away from it. Dr. Lloyd WE see from a newspaper report that the Tenterden is of opinion that surgical interference in cases of cerebellar district council resolved at a recent meeting to apply tumour must be largely experimental and is always most to the Local Government Board to allow measles to be hazardous. He thinks that operation in this particular case added to the list of notifiable diseases under the would have been fatal. The difficulty of localisainevitably Infectious Diseases (Notification) Act. The consent of tion must always be great, and the technical difficulties, he the Local Government Board is necessary, for the Act thinks, are such as will frequently baffle the best and most does not mention measles by name, yet measles, being self-possessed surgeon. a disease which kills some 10,000 to 14,000 people every year in England and Wales, is undoubtedly a dangerous HEREDITY, CRIMINAL AND OTHERWISE. infectious disease according to the Public Health Act of PROFESSOR LoMBROSO’s pessimistic theories as to the 1875, and by the Notification Act the local authority is empowered to extend the definition of the dangerous intimate and necessary connexion between degeneracy and infectious diseases mentioned in that Act either temporarily criminality have recently encountered a certain amount of Measles is often added to the list of notifi- hostile criticism in Scotland. Professor W. T. Gairdner of or permanently. able diseases, the Local Government Board assenting, Glasgow University points out, in a letter to the Scotsman provided that the local authorities are willing to main- of Sept. 4th, that the " wild hypotheses and inferences Of of the Italian professor," if carried out to their logical tain the certificate for from three to five years. accommodacourse, the difficulty of providing sufficient conclusion, would absolve criminals from individual respontion for the isolation of measles is almost insuperable, and as sibility and paralyse all wholesome discipline. In support notification without isolation is not of much if any use, this of his opinion that these teachings are unsound he quotes probably is the reason why measles was not scheduled in an instance, remarkable of its kind and capable of the Act. ample verification, which will probably supply Professor and his adherents with some knotty problems. Lombroso CEREBELLAR TUMOUR. As the result of special inquiries, made many years ago, IN a ecent number of the American Journal of tlw Medical Professor Gairdner was informed that the Tasmanians, Sciences Dr. Lloyd of Philadelphia records a case of tumour who are descendants of a British criminal colony, "were of the cerebellum which is particularly interesting from the remarkably free from all such apparentreversions’ of fact that operation was decided upon but for accidental inherited instincts ; and that, whether judged by their reasons was not carried out, and, as was afterwards found, actual criminal record or by the number and quality if it had been carried out as was proposed it would have been of the insane in their asylums, the race now inhabiting unavailing. The patient was a man aged thirty-eight years this oldest and probably worst of our penal settlements with a negative family history. He had had syphilis but was as orderly, as flourishing, and as well-to-do as in denied alcoholism. Seven years before he was seen he had any other colony, and altogether bore most favourable combeen struck on the occiput with a piece of grindstone and parison with any other portion of the British stock either after that had been troubled with violent headaches. Five at home or abroad." In conclusion, he throws out the weeks before his admission to hospital his headaches suggestion "that the case of Tasmania may contain in a became more severe, the pain was shooting in charac- nutshell the whole and sufficient reply of Nature and On civilisation to the extremestigmata’ theory, from which ter, and he noticed that his vision was failing. admission his gait was found to be characteristic of cere- even some of the Lombrosists appear now to recoil." bellar disease. There was forced movement of the head and Students of criminal anthropology and social science will, no trunk to the right side when he attempted to sit up, and doubt, welcome this addition to the data at their disposal this became more marked when he tried to walk. He was for the judging of the question. Professor Gairdner contents almost completely blind and there was intense papillitis himself with calling attention to this conspicuous example with five dioptres of swelling in the left eye and four in of self-regeneration and speedy development of order out of the right. No paralysis of cranial nerves could be dis- chaos ; he does not attempt to trace the phases of the transicovered except that the right auditory nerve seemed tion, neither does he enter on the slippery paths of speculative -
___
957 conjecture. Professor
Lombroso’s
arguments
are,
however,
capable of development in other directions than those selected ’by their author, and the case of Tasmania may even supply - an opportunity of meeting the pessimists with weapons from
and that is that if the district council have, the advice of their health officer, issued the order as to school closure it is no business of the school board to cavil at the grounds on which the order is issued and to make this the basis of a discussion whether they shall obey or not. All that they have to say as to this must be embodied in the appeal to the Education Department, who in such matters seek the advice of the Medical Department of the Local Government Board.
thing is certain, on
their own armoury, for those who admit the existence of an irresistible hereditary bias to crime can hardly deny the possibility of a bias, if not to righteousness, at least to good works. It should not be forgotten that in the transportation days. the island was not occupied exclusively by a -criminal class ; many of the inhabitants were government HOSPITAL ABUSE. officials charged with the maintenance of order, and when these opposing elements became ultimately intermingled the I THE provinces seem to be no better off than the metropolis higher ethical standard of the young generation might be as regards the abuse of hospitals, judging by a letter from a taken as evidence that by the union, for instance, of a layman which appeared in the Sheffield Daily Telegraph of He points out how any day in the outmurderer with the widow or daughter of a gaoler the pre- Sept. 26th. to from the father wickedness inherited was ,disposition patient departments of the various Sheffield hospitals counteracted by the law-abiding bias derived from the people attend as "sick poor"who have paid 2s. for rail.mother. way fare and 3s. for cabs ; that many large firms who ought to pay the local medical man for attending at their THE ENCOURAGEMENT OF BONE-SETTERS. works subscribe instead to the charity and take the "letters" IT is a pity that the press of this country should directly to which they are thereby entitled ; that the usual fee of a ’1end itself to encourage the careers of such men as general practitioner in the neighbourhood is from Is. 6d. to ibone-setters, who pass themselves off as being able to effect 2s. 6d. ; and that even this pittance is not received at once, wonderful cures when all the rest of the world have failed but painfully collected by sixpenny instalments. If this " Observer " writes very temperto do so. The Lancashire .Empress devotes an article to state of things be so-and and with the air of one sure of his facts-it is a crying ately .a bone-setter and joint specialist, in which various wild shame. in We cannot afford to cast stones London, however, statements are made with regard to his skill, as he is said to succeed daily "after the large infirmaries and at our provincial brethren. We wonder in how many hospitals -the most successful surgeons have failed," and all this the same abuse exists. Of our own personal experience we know one hospital to which a patient used to come once a success is attained without blistering, bandages, iodine, - and embrocation such as were used by the old-fashioned month from the other side of Peterborough to be inspected ’bone-setter. We venture to think that it is most and obtain medicine. The return fare (third class) is 12s. 8d., ’unfair to the public to put forth an article such as this which would probably have been a godsend to some village ’unless it is stated that it is an advertisement, for it is practitioner. How abuses of this and kindred sorts are to immediately looked upon as authoritative by a large portion be remedied is doubtless a difficult question, but that they .of the credulous public, who have only to see a thing in print should and must be is a necessity. In another column will to believe it, and are ever ready to reply to any objections be found an article from a correspondent suggesting details ’that-"It said so in the paper at any rate." By this means of a tentative scheme to this end, and in many directions many people are induced to try the various " cures" when no can be seen signs that the profession is making up its mind that it will not be so persistently and cruelly imposed upon. flair advertisement would have drawn them. ___
____
SCHOOL CLOSURE AT SOUTH NORMANTON. ACCORDING to the local press it is stated that the schools - of the South Normanton School Board had been ordered to be closed by the medical officer of health to the Mansfield rural -sanitary authority and that his order had been " set at defiance." The ground of failure to act is stated, amongst other things, to have been that the school board had no ,knowledge of the extent, increase, or otherwise of the ,disease which had led to the order, and that the medical - officer of health had not visited the village. We draw attention to the occurrence because, if it is correctly reported, the case is one of many others in which there is misconception as ,to the duty of the medical officer of health in this matter. In the first place this official has no power to close a school. His duty is that of a health adviser, and when he advises his .district council that a school should be closed or that scholars should be excluded it is the authority, and not he, who issues the necessary order ; and the school board have, under the Education Code, no option but to - comply with the order, although after compliance they can appeal to the Education Department to rescind the order. In the second place a medical officer of health has no duties towards a school board ; his duties are to the district council and through them to the general body of the inhabitants. It may be policy to visit a district and to confer with the school officials before advising the closure of a school or it may not. We are by no means prepared to say that such action may not at times be properly taken on the ,notification returns and without a personal visit ; but one
THE DECUSSATION
OF THE OPTIC
NERVES.
IN the last number of the Neu’I’ologisakes Centralblatt there is an important preliminary communication on this subject from Dr. L. Jacobsohn of Berlin. He refers to the contention of Eolliker at the recent Anatomical Congress at Berlin that in mammals and also in man there is a complete crossing of the optic nerves at the chiasma, a view which Michel formerly advocated against that of Gudden, who held that in mammals a semi-decussation took place at the chiasma. Dr. Jacobsohn used in his researches Marchi’s method, by which a degenerated fibre can be traced clearly from the point of section onwards, and his method of experiment was to extirpate one eye and kill the animal a few weeks later, when the degeneration could be easily traced. As the fibres of the optic nerve run without interruption from the retina to the corpus geniculatum it was obviously easy to trace degenerated fibres both in the chiasma and in the optic tract, and so to determine whether the fibres from the extirpated eye all ran on one side or whether some crossed. Rabbits, guinea-pigs, cats, and monkeys were used for experiment. In the rabbits and guinea-pigs no fibres could be traced through the degenerated All apparently chiasma to the tract of the same side. But in crossed to the tract of the opposite side. cats and monkeys, on the other hand, there was a considerable number of fibres to be traced into the optic tract on the same side as the extirpated eye, clearly showing that in these animals the crossing at the chiasma was only There is, of course, a presumption that an imperfect one.
public. There to have its function considerably impaired. There was truth in the of but not enough no difficulty in swallowing and there seemed to be some some is, course, suggestion, to justify such uncontrolled and unqualified candour. The mental dulness, with slow speech and vague replies to argument was met in the reply of the medical staff with a questions. In discussing the question of an operation dignified challenge to produce "a single case" in support it was thought that the exemption of nerve affection of a charge which could only be justified by cases. The pointed to the growth being distant from the base. There staff argued that to throw open nine beds to sixty or seventy was nothing to indicate one side more than another except practitioners to attend only to their own cases would leave the forced movement to the right (which might mean the responsible care and the internal management unpro- pressure on a cerebellar peduncle on either side) and the vided for and necessitate the appointment of a paid remains of the injury to the occipital bone on the right side. resident. They considered that a hospital in a population So it was determined to operate on the right occiput. Howof 70,000 cannot be compared with a rural hospital with ever, as has been said, accident prevented the operation three or four practitioners around. At the same time from being carried out and the patient gradually sank and the majority of the staff wisely expressed approval of an died about two months after admission. At the necropsy arrangement carried out in the Hampstead Hospital by there was found a tumour on the under surface of the which patients are admitted under the care of their own cerebellum on the right side, lying between the pons and medical men. This ought to be adopted. It seems to us medulla on the one hand, and the right lobe of the cerethat the best of the argument rests here with the staff, and bellum on the other. The growth sprang from the middle that to diffuse the management of nine beds and accidents cerebellar peduncle and the posterior part of it was cystic. among sixty or seventy practitioners would be to divest the The under surface of the right lobe of the cerebellum was appointment of all interest and to invite that state of things excavated and had assumed a cystic character. Undoubtedly where nobody does that for which everybody is responsible. the absence of impairment of the functions of the cranial nerves in this case is very remarkable, and it is also interesting that the forced movements were towards the side of the THE NOTIFICATION OF MEASLES. lesion and not, as in most cases, away from it. Dr. Lloyd WE see from a newspaper report that the Tenterden is of opinion that surgical interference in cases of cerebellar district council resolved at a recent meeting to apply tumour must be largely experimental and is always most to the Local Government Board to allow measles to be hazardous. He thinks that operation in this particular case added to the list of notifiable diseases under the would have been fatal. The difficulty of localisainevitably Infectious Diseases (Notification) Act. The consent of tion must always be great, and the technical difficulties, he the Local Government Board is necessary, for the Act thinks, are such as will frequently baffle the best and most does not mention measles by name, yet measles, being self-possessed surgeon. a disease which kills some 10,000 to 14,000 people every year in England and Wales, is undoubtedly a dangerous HEREDITY, CRIMINAL AND OTHERWISE. infectious disease according to the Public Health Act of PROFESSOR LoMBROSO’s pessimistic theories as to the 1875, and by the Notification Act the local authority is empowered to extend the definition of the dangerous intimate and necessary connexion between degeneracy and infectious diseases mentioned in that Act either temporarily criminality have recently encountered a certain amount of Measles is often added to the list of notifi- hostile criticism in Scotland. Professor W. T. Gairdner of or permanently. able diseases, the Local Government Board assenting, Glasgow University points out, in a letter to the Scotsman provided that the local authorities are willing to main- of Sept. 4th, that the " wild hypotheses and inferences Of of the Italian professor," if carried out to their logical tain the certificate for from three to five years. accommodacourse, the difficulty of providing sufficient conclusion, would absolve criminals from individual respontion for the isolation of measles is almost insuperable, and as sibility and paralyse all wholesome discipline. In support notification without isolation is not of much if any use, this of his opinion that these teachings are unsound he quotes probably is the reason why measles was not scheduled in an instance, remarkable of its kind and capable of the Act. ample verification, which will probably supply Professor and his adherents with some knotty problems. Lombroso CEREBELLAR TUMOUR. As the result of special inquiries, made many years ago, IN a ecent number of the American Journal of tlw Medical Professor Gairdner was informed that the Tasmanians, Sciences Dr. Lloyd of Philadelphia records a case of tumour who are descendants of a British criminal colony, "were of the cerebellum which is particularly interesting from the remarkably free from all such apparentreversions’ of fact that operation was decided upon but for accidental inherited instincts ; and that, whether judged by their reasons was not carried out, and, as was afterwards found, actual criminal record or by the number and quality if it had been carried out as was proposed it would have been of the insane in their asylums, the race now inhabiting unavailing. The patient was a man aged thirty-eight years this oldest and probably worst of our penal settlements with a negative family history. He had had syphilis but was as orderly, as flourishing, and as well-to-do as in denied alcoholism. Seven years before he was seen he had any other colony, and altogether bore most favourable combeen struck on the occiput with a piece of grindstone and parison with any other portion of the British stock either after that had been troubled with violent headaches. Five at home or abroad." In conclusion, he throws out the weeks before his admission to hospital his headaches suggestion "that the case of Tasmania may contain in a became more severe, the pain was shooting in charac- nutshell the whole and sufficient reply of Nature and On civilisation to the extremestigmata’ theory, from which ter, and he noticed that his vision was failing. admission his gait was found to be characteristic of cere- even some of the Lombrosists appear now to recoil." bellar disease. There was forced movement of the head and Students of criminal anthropology and social science will, no trunk to the right side when he attempted to sit up, and doubt, welcome this addition to the data at their disposal this became more marked when he tried to walk. He was for the judging of the question. Professor Gairdner contents almost completely blind and there was intense papillitis himself with calling attention to this conspicuous example with five dioptres of swelling in the left eye and four in of self-regeneration and speedy development of order out of the right. No paralysis of cranial nerves could be dis- chaos ; he does not attempt to trace the phases of the transicovered except that the right auditory nerve seemed tion, neither does he enter on the slippery paths of speculative -
___
957 conjecture. Professor
Lombroso’s
arguments
are,
however,
capable of development in other directions than those selected ’by their author, and the case of Tasmania may even supply - an opportunity of meeting the pessimists with weapons from
and that is that if the district council have, the advice of their health officer, issued the order as to school closure it is no business of the school board to cavil at the grounds on which the order is issued and to make this the basis of a discussion whether they shall obey or not. All that they have to say as to this must be embodied in the appeal to the Education Department, who in such matters seek the advice of the Medical Department of the Local Government Board.
thing is certain, on
their own armoury, for those who admit the existence of an irresistible hereditary bias to crime can hardly deny the possibility of a bias, if not to righteousness, at least to good works. It should not be forgotten that in the transportation days. the island was not occupied exclusively by a -criminal class ; many of the inhabitants were government HOSPITAL ABUSE. officials charged with the maintenance of order, and when these opposing elements became ultimately intermingled the I THE provinces seem to be no better off than the metropolis higher ethical standard of the young generation might be as regards the abuse of hospitals, judging by a letter from a taken as evidence that by the union, for instance, of a layman which appeared in the Sheffield Daily Telegraph of He points out how any day in the outmurderer with the widow or daughter of a gaoler the pre- Sept. 26th. to from the father wickedness inherited was ,disposition patient departments of the various Sheffield hospitals counteracted by the law-abiding bias derived from the people attend as "sick poor"who have paid 2s. for rail.mother. way fare and 3s. for cabs ; that many large firms who ought to pay the local medical man for attending at their THE ENCOURAGEMENT OF BONE-SETTERS. works subscribe instead to the charity and take the "letters" IT is a pity that the press of this country should directly to which they are thereby entitled ; that the usual fee of a ’1end itself to encourage the careers of such men as general practitioner in the neighbourhood is from Is. 6d. to ibone-setters, who pass themselves off as being able to effect 2s. 6d. ; and that even this pittance is not received at once, wonderful cures when all the rest of the world have failed but painfully collected by sixpenny instalments. If this " Observer " writes very temperto do so. The Lancashire .Empress devotes an article to state of things be so-and and with the air of one sure of his facts-it is a crying ately .a bone-setter and joint specialist, in which various wild shame. in We cannot afford to cast stones London, however, statements are made with regard to his skill, as he is said to succeed daily "after the large infirmaries and at our provincial brethren. We wonder in how many hospitals -the most successful surgeons have failed," and all this the same abuse exists. Of our own personal experience we know one hospital to which a patient used to come once a success is attained without blistering, bandages, iodine, - and embrocation such as were used by the old-fashioned month from the other side of Peterborough to be inspected ’bone-setter. We venture to think that it is most and obtain medicine. The return fare (third class) is 12s. 8d., ’unfair to the public to put forth an article such as this which would probably have been a godsend to some village ’unless it is stated that it is an advertisement, for it is practitioner. How abuses of this and kindred sorts are to immediately looked upon as authoritative by a large portion be remedied is doubtless a difficult question, but that they .of the credulous public, who have only to see a thing in print should and must be is a necessity. In another column will to believe it, and are ever ready to reply to any objections be found an article from a correspondent suggesting details ’that-"It said so in the paper at any rate." By this means of a tentative scheme to this end, and in many directions many people are induced to try the various " cures" when no can be seen signs that the profession is making up its mind that it will not be so persistently and cruelly imposed upon. flair advertisement would have drawn them. ___
____
SCHOOL CLOSURE AT SOUTH NORMANTON. ACCORDING to the local press it is stated that the schools - of the South Normanton School Board had been ordered to be closed by the medical officer of health to the Mansfield rural -sanitary authority and that his order had been " set at defiance." The ground of failure to act is stated, amongst other things, to have been that the school board had no ,knowledge of the extent, increase, or otherwise of the ,disease which had led to the order, and that the medical - officer of health had not visited the village. We draw attention to the occurrence because, if it is correctly reported, the case is one of many others in which there is misconception as ,to the duty of the medical officer of health in this matter. In the first place this official has no power to close a school. His duty is that of a health adviser, and when he advises his .district council that a school should be closed or that scholars should be excluded it is the authority, and not he, who issues the necessary order ; and the school board have, under the Education Code, no option but to - comply with the order, although after compliance they can appeal to the Education Department to rescind the order. In the second place a medical officer of health has no duties towards a school board ; his duties are to the district council and through them to the general body of the inhabitants. It may be policy to visit a district and to confer with the school officials before advising the closure of a school or it may not. We are by no means prepared to say that such action may not at times be properly taken on the ,notification returns and without a personal visit ; but one
THE DECUSSATION
OF THE OPTIC
NERVES.
IN the last number of the Neu’I’ologisakes Centralblatt there is an important preliminary communication on this subject from Dr. L. Jacobsohn of Berlin. He refers to the contention of Eolliker at the recent Anatomical Congress at Berlin that in mammals and also in man there is a complete crossing of the optic nerves at the chiasma, a view which Michel formerly advocated against that of Gudden, who held that in mammals a semi-decussation took place at the chiasma. Dr. Jacobsohn used in his researches Marchi’s method, by which a degenerated fibre can be traced clearly from the point of section onwards, and his method of experiment was to extirpate one eye and kill the animal a few weeks later, when the degeneration could be easily traced. As the fibres of the optic nerve run without interruption from the retina to the corpus geniculatum it was obviously easy to trace degenerated fibres both in the chiasma and in the optic tract, and so to determine whether the fibres from the extirpated eye all ran on one side or whether some crossed. Rabbits, guinea-pigs, cats, and monkeys were used for experiment. In the rabbits and guinea-pigs no fibres could be traced through the degenerated All apparently chiasma to the tract of the same side. But in crossed to the tract of the opposite side. cats and monkeys, on the other hand, there was a considerable number of fibres to be traced into the optic tract on the same side as the extirpated eye, clearly showing that in these animals the crossing at the chiasma was only There is, of course, a presumption that an imperfect one.