HOP-PICKERS AND SMALL-POX.

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for a playful headline. "Arma virusuc cano he began, graft human tubercle in cattle would not be uniformly and explained that he was talking of arms and the vaccina- successful, and experiments which did not entail the direct tion markI Among educated people, then, it may fairly be insertion of the virus into the tissues might fail entirely. taken that vaccination is so generally accepted and familiar Another instance which proved that the different nature of that even its inconveniences are a laughing matter. After the soil must always be taken into account was the There was the possibility that the present augmented activity in vaccination we may hope variolation of cattle. tuberculous virus can be grafted on the in as human Great Britain to whom its inasmuch that there will be few persons of invasion of the human be instances and whom its will there also defects not be cow benefits are not obvious may by but Professor Crookshank was with bovine of tissues treated in this same spirit bacilli, pleasant contempt. that such an with Professor Koch in quite agreement could be occurrence quite exceptional. If it were only ANNUAL MEDICAL SERVICE AT ST. PAUL’S of the rule the inhabitants CATHEDRAL. every country in the world in which bovine tuberculosis was prevalent must have THE annual medical service at St. Paul’s Cathedral been decimated by tuberculous disease owing to the organised by the Guild of St. Luke will take place this year frequency with which tubercle bacilli occur in milk, cream, on Thursday, Oct. 17th, the Eve of St. Luke, at 7.30 P.M. and cheese, and the quantity of meat derived from As in past years many members of the medical profession butter, tuberculous animals. Professor Crookshank then made some have signified their intention of attending in academical remarks on meat inspection and maintained that a carcass robes. The arrangements of the service this year have been should be condemned when the disease was but considerably modified with a view to making it simpler and if the carcass was well nourished and the generalised ; meat healthy in brighter. The sermon will be preached by the Rev. Canon the existence of small local deposits of tubercle appearance Gore, and the music will be rendered by the London Choir was not a sufficient reason for condemning the in the Association, the choir being conducted by Dr. H. Walford flesh asorgans unfit for food. Davies, organist of the Temple Church. Admission to the spaces under the dome will be by tickets only. HOP-PICKERS AND SMALL-POX. *

ON Saturday last, Sept. 28th, Dr. G. Newman, medical officer of health of Finsbury, informed the medical officer THE introductory address to the students beginning their of health of the County of London that certain cases professional studies at this College was delivered by Pro- of small-pox had been found among hop-pickers whose fessor E. M. Crookshank, the chair being taken by Mr. Albert London home was in Finsbury and who had returned to Brassey, M. P. Professor Crookshank spoke very highly of London from Bodiam in Sussex. It was also stated the teaching and equipment of the college, of the advantages that other persons at the farm where they had been of the veterinary profession as a career, and of the value in employed had had eruptions similar to those found upon He urged the persons who had returned, and that all of the hopmany occupations of a veterinary training. the necessity of the importance of original research in pickers employed on the farm would return on that veterinary work, and as an illustration of the great need day. Prompt measures were taken for medical men to for further investigation he instanced the subject of meet the trains by which these people might arrive, the tuberculosis. He reminded his hearers that at the recent medical officers of the London County Council and of Congress on Tuberculosis the relation of the bovine to Finsbury and the chairman of the Sanitary Committee of the human malady was prominently brought forward in Finsbury, Mr. Evan Jones, M. R. C. S. Eng., taking part in the It was instructive work. All the hop-pickers arriving during the afternoon and an address given by Professor Koch. and encouraging to the veterinary profession that some of evening at New Cross, London-bridge, Waterloo, Cannonthe researches which created so much interest at the street, and Charing-cross stations were, as far as was congress were those undertaken in different veterinary practicable, examined, and the addresses of persons coming colleges. Professor Koch’s experiments had been carried from the farm were taken. Five persons actually sufferout during the past two years with the cooperation of Pro- ing from small-pox were detained by Mr. Evan Jones (who fessor Schutz at the Veterinary College of Berlin. Professor undertook to watch at Cannon-street station) and were sent As a piece of prompt action, Crookshank then referred at some length to Professor Koch’s to the hospital ships. experiments which led to the conclusion that human tubercu-I rendered possible by the cooperation of the county and losis differed from bovine and could not be transmitted to borough oflicers, we may speak with much satisfaction of cattle, and Professor Koch further announced that whether the procedure adopted ; and the fact that actual cases of man was susceptible to bovine tuberculosis at all was not yet small-pox were found among the travellers will justify to absolutely decided. Professor Crookshank agreed fully with the most critical every step that was taken. The incident, Professor Koch that if infection to human beings occurred at however, serves to show how little anyone can reckon upon all it was very rare, but he could not accept the statement not being exposed to small-pox and how the only actual that human tubercle could not be experimentally inoculated safeguard is to render each individual insusceptible to attack. in bovines. He also felt very strongly that Professor Koch’s Small-pox was not known to exist at Bodiam and the dictum that preventive measures were not advisable was a fellow travellers of the sufferers were certainly unconscious singularly unfortunate one. It conveyed the impression, as that their companions were suffering from this disease. Dr. Hueppe had pointed out, that Professor Koch would It will be interesting to observe what effect the return of the concede to dairymen and milk-sellers the right of selling hop-pickers to London has on the prevalence of the disease. tuberculous milk. Professor Crookshank felt justified in It is too much to expect that no proportion of the people at disagreeing with Professor Koch in these points because in Bodiam who were associated with the sufferers on the farm, the course of an inquiry in 1888 which he had conducted on and who travelled with them in crowded carriages to London behalf of the Board of Agriculture lie made an experiment are incubating small-pox. As far as it has been possible which proved that a healthy calf could be successfully inocu- to do so the addresses of people coming from this farm have lated with human tuberculous sputum. Other investigators in been ascertained, and where this has been done they will no England and America had confirmcd this result. Professor doubt be kept under observation ; but small-pox in the metroCrookshank was of opinion that human and bovine tuber- polis will in all probability receive some increment from this culosis were distinct varieties of the same disease. Man was source and there is a chance that the disease will be carried not the natural soil of bovine tuberculosis, and the attempts into homes where the risk of spread will be especially

ROYAL VETERINARY COLLEGE.

CHARACTERISTIC HEADACHE IN TUMOUR OF THE

CEREBELLUM.

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result is there will be the satisfaction five days. Then he began to have pain in the trephined that every step was taken to limit the mischief as far as this area. On March 3rd union of the wound was complete, but could be done. Among the factors conducing to the spread in the position of the cicatrix was a fluctuating swelling of of small-pox at the present time is the difficulty of dis- the size of an egg. This enlarged and became distended tinguishing it from chicken-pox. It is stated that the disease until some liquid flowed away from it. Puncture gave exit to among the hop-pickers on the Bodiam farm was regarded 250 grammes of clear fluid and the patient was relieved, but on the next day it was again distended and the vomiting as chicken-pox and hence the circumstances of which we have given account. We note with satisfaction that the and pain reappeared. On April 16th puncture gave exit to Borough Council of St. Pancras are proposing to require the 500 grammes of cerebro-spinal fluid. From this date puncThe patient wasted notification of cases of chicken-pox, and the adoption of this ture was performed every other day. .course will, no doubt, go far in that district to meet the and always complained of pains in the temporal region and in the trephined area. On June 23rd he became comatose difficulty which we mention. and died. The necropsy showed a tuberculous tumour of the size of a mandarin orange in the left lobe ’of the CHARACTERISTIC HEADACHE IN TUMOUR OF cerebellum. The swelling at the trephine opening was THE CEREBELLUM. formed by a hernia of the dilated left lateral ventricle, the AT the meeting of the Societe Medicale des Hopitaux of wall of which was very thin. M. Merklen, who insisted on Paris on June 14th M. Pierre Merklen pointed out that the the importance of céphalée d’e.ffort avee raideur due la nuque headache of cerebellar tumour may be characteristic. He as a sign of cerebellar tumour, referred to another case finds that the pain is principally occipital, but may be also in which this sign proved diagnostic He saw in consultafrontal or occupy the whole head. At first it is intermittent, tion a man who for several months after a carriage accident then it becomes continuous, but exacerbations, which may be suffered from vertigo and heada he and who at last became excruciating, occur on exertion. Further, the headache is somnolent. M. Merklen ascertained that the headache accompanied by rigidity of the neck and retraction of the appeared on, and was intensified by, exertion and was head-an attitude which is assumed because every movement accompanied by a rigidity of the neck. Operation showed a intensifies the pain. Finally, the headache is little influenced serous cyst of the cerebellum, the evacuation of which proved by drugs, but, curiously, is subject to temporary remissions a radical cure. under the influence of "suggestions "-of any new treatment, for example, or of isolation or any exercise of AN INGENIOUS ADULTERATION. medical authority. The cause of the headache is intraANYONE may adulterate butter, whether it be for his own cranial tension from hydrocephalus of the ventricles. The tumour lying under the tentorium cerebelli compresses consumption or for that of his neighbours, but if he deals in the veins of Galen and causes dropsy of the ventricles. Move- the adulterated article he must follow in so doing the conments and efforts increase the intracranial tension and there- ditions laid down in the Margarine Act-he must not sell it fore the headache. The only treatment is removal of the as butter and he must not, a fortiori, sell it as "pure tumour or palliative trephining. The following case con- butter.The firm of Pearks, Gunston, and Tee, Limited, who firms the preceding description and explanation. At the claim to have a very large number of places at which they beginning of September, 1894, a man, aged 28 years, in good sell their goods, were summoned in July last under the Sale health, was suddenly seized for some minutes with pain in of Food and Drugs Act for selling that which was the forehead and nape of the neck. The pain returned every not of the nature, substance, and quality of the article morning and was always provoked by exertion. In October demanded by their customers ; that is to say, for the spleen was found to be enlarged and the meningeal streakselling as butter a substance containing more than could easily be produced. Meningeal tuberculosis was sus- the 16 per cent. of moisture which is recognised as a lawful pected, although there was no pyrexia or other symptom offactor in the butter of honest commerce. They were further the disease. In November there were violent paroxysms ofcharged in other summonses under the Merchandise Marks headache on exertion and the patient held his head retracted. Act with applying a false trade description to their goods. The idea of intracranial tumour was suggested by M. In July the full hearing of these summonses was adjourned Brissaud, M. Raymond, and M. Rendu who saw the patientowing to the defendants desiring to await and abide by in consultation with M. Merklen, but the absence of otheran appeal then pending which has now apparently been symptoms did not allow a definite diagnosis. One day thedecided adversely to them, for they have appeared patient complained of violent pains in the abdomen. As heagain at the police-court and have been duly fined. had become hysterical this symptom was thought to confirmL The nature of the appeal we need not discuss, for the the diagnosis of neurosis. Accordingly he was isolated in aL facts of the case against Messrs. Pearks, Gunston, and hydropathic establishment. Great improvement took place inl Tee, Limited, hardly seem to us capable of raising the first week, though the stiffness of the neck persisted. legal discussion ; their methods, however, as described in Then the paroxysms of pain recurred and were accompaniedL July, were sufficiently ingenious to be worth recalling. It by vomiting. In January, 1895, they became more frequentb was their practice to purchase large quantities of colonial and he would scarcely leave his bed. Apart from theand foreign butter which, owing to the method of its paroxysms he complained of continuous occipital and frontal1 preparation and the exigencies of its market, contains conpain. At times his gait was like that of a drunken man. siderably less moisture than ordinary English butter, and There were no ocular signs. He improved for a few days3 into this they used to force milk by softening the butter and and returned to his home ; then all the symptoms becameblending the two together in huge churns, adding a little It was aggravated and he threatened to commit suicide. Anodynes,, borax in compensation as a preservative. including morphine, were useless and only inhalation off stated before Mr. Curtis Bennett that by this process ether gave relief. On Feb. 23rd M. Terrier made ai as much as 10 quarts of milk could be added to a horse-shoe incision from the left ear to the occiput and1 hundredweight of butter, and a moment’s calculation trephined the skull. When the dura mater was openedi by those familiar with the weight of liquids will show that by a crucial incision the brain bulged out. It was punctured; this means the increase of a hundredweight of butter by with a needle, but no fluid escaped. The skin and peri-more than 20 pounds avoirdupois, with an addition of profit osteum were sutured, but the dura mater was not. Improve-!- to the vendor equal to the difference between the price of ment was immediate and the patient was free from pain forr the added milk and the price of a quantity of butter of ____

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