IMPLYING REGISTRATION.

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imagine, however, that the Local Government Board have far too great an appreciation of the value of the notification of infectious diseases and of the services rendered by medical men to the State in this respect to risk the breaking up of the system of notification by encountering the hostility of the whole profession, and we may further assure the councillors that the medical profession will if necessary take steps to prevent any further reduction in notification fees. If the rural councillors who propose the alteration have no idea of the amount of money which has to be expended on the education of a medical man before he can properly diagnose cases of infectious disease, and of the responsibility and strained relationships which notification often entails, we are sorry for the rural district over which these rural councillors preside.

The labour of the colonists requires much supervision from non-epileptic skilled workmen, and supervision is also required for protecting the colonists when attacked by fits and for maintaining order and discipline. It is certain that the erection of the new Home for Women in the neighbourhood of the men’s home will necessitate increased watchfulness and probably a larger staff, proportionally, than is at present adequate. Dr. Buzzard mentioned the i necessity of providing also for a resident medical officer-a need recognised by the Committee in their last report, and he strongly appealed for funds to enable a suitable residence to be erected. No one who has had practical experience of institutions of this kind will question the urgency of this proposal, which becomes doubly necessary now that the committee have decided to admit women as well as men to the same colony. Lord Addington, in responding to a vote THE EPILEPTIC COLONY AT CHALFONT: LAYING of thanks, intimated his intention of specially helping towards the establishment of a residence for a medical THE FOUNDATION-STONE OF A HOME officer, and when next we have occasion to refer to the FOR WOMEN. it is to be hoped that others will also have lent a ON Tuesday last, May 26th, the foundation-stone of a colony hand and that this most necessary addition may have been Home for Women was laid with full Masonic honours by made. Subscriptions are urgently required both for further Lord Addington, Provincial Grand Master of Buckingand for current expenses and should be sent to hamshire, assisted by the Provincial Grand Officers. equipment the secretary, Mr. Gaskell, National Society for the EmployAbout 200 visitors journeyed from London and drove ment of Epileptics, 12, Buckingham-street, Strand. through very picturesque country from Chorley Wood Station. About eighty Freemasons were present, inIMPLYING REGISTRATION. cluding many medical men, and their Masonic garb added WE have submitted the recent decisions in the cases of picturesqueness to the interesting ceremony. Among others v. Frickhart and Reg. v. Bridgewater for his opinion were Mr. Passmore Archdeacon Reg. Edwards, Sinclair, present Dr. Buzzard, Dr. Ferrier, Dr. Shuttleworth, Dr. Fletcher to a legal friend well acquainted with our own profession. Beach, Dr. Aldren Turner, Dr. Colman, Dr. Morton, Dr. He writes as follows :-In these two cases the courts have James Taylor, Dr. Page May, and Mr. George Cowell. held that the mere use of an unregistered foreign diploma. At the close of the ceremony an interesting and eloquent in connexion with medical practice does not constitute such account of the aims and intentions of the Nationali a "wilful and false"pretending to be registered as to ’ Society for the Employment of Epileptics was given by Mr. bring the user within the fortieth section of the Medical Micholls, chairman of the Executive Committee. It appears Act of 1858. The case of Reg. v. Bridgewater (heard by that there are at present thirty-six male colonists, who carry a Divisional Court on the 19th inst.) does not present on chiefly market gardening, carpentering, and shoemaking. any special features beyond the fact that Mr. BridgeThe remarkable generosity of Mr. Passmore Edwards (who water used, in addition to the letters M.D., the explanaThat the law upon this point is not erected the first permanent home for men) has again been tory letters U.S.A. shown in his undertaking the cost of this new Women’s in a perfectly satisfactory position may be taken to be Home, which will accommodate twenty female colonists proved by the observation of Mr. Justice Collins who whom it is proposed to employ mainly in the laundry, at remarked in deciding this case that the law was "in a needlework, and in the dairy. We understand that Mr. fog." The difficulty is that of determining what amounts Edwards also intends to add a Home for Epileptic to a representation that the practitioner is registered. The remarkable progress made by the colony When the statement made is absolutely false or fraudulently Children. in less than two years from its inception indicates misleading the Courts will convict, but when the statement clearly how great a need there must have been for such actually made is true, and the only thing that misleads is the very natural inference that a medical qualification an establishment and that there is a great future in store for it, for it not only gives shelter and protection to a class actually held is registered, the Courts have manifested great of sufferers whose lot is often miserable in the extreme, but, reluctance to press the law against individuals. This feeling by providing them with useful productive occupation under is a very natural one and one of which account should be favourable circumstances, prevents, or at least retards, the taken by those who are responsible for putting the law in dulling of the faculties, which is frequently the saddest motion. There is a tendency both within the medical proaccompaniment of the disease. Those who were present in fession and outside it to look upon the offence of falsely the autumn of 1894, a few months after the colony was pretending to the possession of medical qualifications as an opened, could not fail to have been struck with the differ- encroachment upon the privileges of qualified men, and this, ence in the expression of the faces. Almost all showed to although it is true enough, is not a very instructive view the skilled observer indications of their terrible malady, but of the position. The status of a registered medical practhere was an alertness and a look of independence about many titioner is, in a sense, a privileged one, but the privilege of them which was wanting before, whilst their appearance is not conferred for the benefit of the privileged class but suggested that physically they were in better health than for the benefit of the general public. If ignorant or unmany of the visitors. We were informed that there has been skilful persons are permitted to practise on the public no case of serious illness among the colonists apart from the the public must suffer, and it is for the protection of the immediate results of their fits, a striking tribute to the public against this form of suffering that the Register is healthiness of the site selected by the committee. It was published and protected by penalties against falsification. stated by Dr. Buzzard that the medical staff were fully It is, therefore, a very inadequate view of the statute to look satisfied with the beneficial effect that residence at the! upon it merely as the charter of the medical profession. It colony had had on the epileptic attacks. The work, how- is this only because it is much more ; the protection of the ever, cannot be carried on without considerable expenditure. public is its end and the protection of the profession a means

We

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1508 the seventh and eighth roots. This tumour had given rise to no symptoms, either motor or sensory, and was, indeed, accidentally discovered in the course of a systematic examination. Its character was that of a psammoma. The second case was also that of a female patient, twenty-nine years of age. She had had between 1889 and 1893 several operations for "tumour," but the nature and situation of these could not be discovered. Ever since 1889 she had been troubled with recurring attacks of paralysis and numbness affecting all four extremities. She made a good recovery from several of these, but she was readmitted to the hospital in 1895 with the history of the sudden onset of the state of paralysis in which she was when admitted. There was in all four extremities extensor paralysis with flexor contracture-a condition, indeed, suggesting peripheral neuritis ; but the knee-jerks were active, and there were cystitis and incontinence of urine. She denied ever having been subject to severe pains. The patient died with lung THE HEATH SCHOLARSHIP. symptoms and suppression of urine, and at the necropsy a mass was found on the ventral surface of BY the will of the late George Yeoman Heath, Professor of large quadrilateral the dura mater in the cervical region, involving the first four Surgery in the University of Durham and President of the cervical roots. The dura mater itself was only slightly thickDurham College of Medicine, a sum of f,200 is awarded every ened. The tumour was apparently a degenerated gumma, and second year for a surgical essay. The trustees of the there were considerable changes in the neighbouring vessels scholarship have announced that the second award will be and and descending degenerations in the cord itself. given to the writer of the best essay on "Congenital The ascending writer refers, in conclusion, to a case reported in Brain Deformities, their Pathology and Treatment." All graduates Dr. Michell Clarke, also of spinal tumour without pain, in medicine or in surgery of the University of Durham are by and he is of opinion that the presence or absence of pain, and eligible to compete for this scholarship, and the essay which also the degree of its intensity, may have some relation to must be type-written or printed, should be delivered to the the slowness or rapidity of growth of the tumour. The essay, trustees not later than March 31st, 1898. to that end.

This line of reflection suggests the expeshaping charges of the kind referred to as far as possible in such a way as to bring into strong relief the public mischief which results from any relaxation of the rules regarding registration or the placing of any obstacle in the way of a thorough and efficient working It is, no doubt, possible out of the registration scheme. to show by argument that in this matter the interests of the medical profession and the interests of the public are indistinguishable and that what injures the one injures the other. Hence the wisdom, at any rate until the law has emerged by successive decisions out of the " fog"" and taken shape in clearly defined rules, of submitting to the courts only such instances of encroachment upon the sphere of medical practice as affect in a way too plain for discussion the public interests which it is the object of Medical Acts to protect.

diency of

with any specimens, drawings, casts, microscopical or other means of illustration accompanying it, will become the property of the College, though by permission, the essay may be printed for general circulation by the Heath scholar. This is one of the most valuable surgical prizes in the kingdom, and the competition should be keen.

together

preparations,

" RETURN " CASES OF SCARLET FEVER.

THIS interesting subject seems at irregular intervals to attract the attention of the public and to call for some comments in our columns ; but we are glad to see that the lay press is now approaching the matter in a fair spirit of inquiry and that the occurrence of so-called "returncases is not at once followed by indiscriminate charges of neglect against THE ROYAL INFIRMARY OF NEWCASTLE. The most recent group of cases the hospital authorities. THE prominence and activity of Dr. Philipson in New- which are on thesis of infection being conveyed a explicable castle and its school of medicine-a part of the University from a fever hospital is reported from by discharged patients of Durham-give exceptional interest to the fact of his and there Richmond, certainly appears to have been a very resignation on the score of age. The rule of the infirmary remarkable chronological sequence in some of the cases. requires resignation at sixty years of age-a time of life A patient, after eleven weeks’ isolation in hospital, was when a physician is now often at his best, with the advandischarged presumably free from infection, but five days tages alike of youth and age. The post held for twenty- later a sister was attacked by the same disease and three eight years so honourably by Dr. Philipson is naturally one days after this-i.e., eight days after the first patient’s of the prizes coveted by aspirants to professional fame in discharge-three other children were attacked. All these the city of Newcastle, which has long been noted for men patients were isolated for eleven weeks, but within a week of of strength in the profession. The committee have the their return home the mother of the family was attacked. responsibility of the succession. They will have no excuse It is very strange that this series of cases should occur in for not making a fit appointment. It is understood that the same family, and it would certainly appear probable that Dr. George Redmayne Murray and Dr. Thomas Beattie are some of them were connected with the return of patients candidates for the post. The election will be watched with from the We are not in possession of all the facts hospital. more than local interest. necessary to form a judgment on the merits of this little outbreak, but if the laundryman in whose house the cases PAIN IN CASES OF TUMOUR OF THE SPINAL occurred, and who has doubtless suffered much hardship in CORD. connexion with the outbreak, considers, as apparently PAIN has generally been looked upon as one of the most he does, that he has cause of complaint against the constant symptoms accompanying tumours of the spinal cord. hospital authorities, it will perhaps be better that inquiry In the March number of the Journal of Nervous and Mental should be made as to whether all practicable preDiseases Dr. Pearce Bailey reports two cases which were cautions are taken at the hospital in question, and whether remarkable by reason of the absence of pain which charac- proper disinfection of the house was performed after terised their progress, and while they do not permit any the removal of each case or group of cases-in other general rule to be formulated with reference to this point words, that the question should be investigated from both they are interesting as a valuable contribution to the sides. It would seem improbable that the whole series of symptomatology of an important class of cases. The first cases is to be explained by carelessness on the part of the was that of a woman sixty-five years of age who died from hospital authorities, as after the occurrence of the first nephritis and pneumonia and in whom a tumour was "return"case the authorities would have been especially discovered involving the dorsal region of the cord It is interesting in connexion as to disinfection, &.c. ___

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