INFECTIOUS DISEASE IN THE OUT-PATIENT ROOM.

992 was stated by Mr. Crawford and by Captain Yule, who visited the coast of Ava later, to be almost edentulous. Recently Maphoon, now about seventy years of age, has been on exhibition at Washington, and having some trouble with the mouth, was seen by a dentist (Dr. Daly) of that city. He removed fifteen teeth, showing that the deficiency in number was not so great as was thought to be the case; but that teeth and hair are correlated to some extent was shown by two pairs of teeth being " geminated," two upper molars being joined together by their roots, and a lower second molar and wisdom tooth united by both crown and roots. One son of Maphoon is also on exhibition, but his mouth was not examined. The hairy Burmese family were on exhibition in London last year, but we do not know whether any examination was then made of the dental organs.

EFFECT OF ANÆMIA ON THE GASEOUS CHEMICAL CHANGE. IN order to determine the effect of acute aneemia on the gaseous chemical change, or gaseous metabolism as he calls it, Dr. M. F. Kandaratski, of St. Petersburg, has experimented on a number of dogs by abstracting a portion of the blood, thus producing a condition analogous to that of acute ansemia, and estimating the gaseous change before and after the operation. His idea was to discover whether the intravenous injections of defibrinated blood, saline solutions, &c., in acute anaemia act in a chemical manner by restoring the gaseous metabolism which may be supposed to be lessened by the diminution of the red corpuscles. The observations made showed that, whether a small quantity of blood equivalent to 29 per cent. of the whole, or a large amount equal to 62 per cent., or in one case to 73 per cent. of the whole, was abstracted, no alteration was caused in the gaseous chemical change. His experiments were conducted with great care, each observation lasting for three days, and the mean of two observations being taken. He was also careful to eliminate any error that might arise from food. -

SPRING RISKS. THE recurrence of spring surroundings revives the need for the usual spring warnings. Bright sunshine is apt to prove a delusion if trusted too implicitly. Warm clothing is but too readily discarded in favour of light airy garments, which seem more seasonable. Whole habits of life, with their customary precautions, are liable to be set aside hastily, in deference to the appearance of bright weather. The range of light occupation widens, and the younger members of the community seek the river or the cricket field and tennis lawn, and at the same time they discard warm clothing as unsuitable for the brisker movements, and revert to the garments of the preceding summer. This is reasonable enough if the sites of the lighter enjoyments of their youth are within close access of their homes, allowing of a rapid change to warmer clothing as the cool of the evening approaches, and the waning light warns them to cease from their labours of pleasure. It should not be forgotten, however, that the conditions of space in London render it rarely possible for this rapid change to be effected. A journey by rail must mostly be encountered on the return home, and with its draughts and delays constitutes a serious risk if precautions have not been adopted to prevent rapid and harmful evaporation from a perspiring skin. The interests of the game mostly increase as the day declines; the players put forth more vigour to make the most of the remaining light; the rowers pull a faster stroke as time runs short and they are still some distance from the station. It may be regarded as inevitable that sunset should find all these votaries of pleasure flushed

with their exercise and offering a ready prey to the cooling breezes which so often follow. Fortunate, indeed, are those who escape with merely a nasal catarrh or a mild laryngitis, after braving such perils with the carelessness of youth. Though medical men may incur the false charge of being alarmists, they should not weary of proclaiming that the brightest spring morning may yet be followed by a chill wintry evening, full of danger to those who are forgetful of this fact. ___

INFECTIOUS

DISEASE IN THE OUT-PATIENT ROOM.

THE effects of a hospital for good or ill have during the present week been the subject of inquiry in a court of law, and a point mentioned in evidence deserves consideration by those who have the management of these institutions. There is often some laxity in making proper provision for the isolation of cases of infectious disease applying for relief at the out-patient room. Persons suffering from this class of malady and ignorant of the nature of their disease are frequently to be found in the waiting room, and it is incumbent on the hospital authorities that every care should be taken to prevent the spread of their disease to others with whom they may come in contact, both in the hospital and afterwards in the public street. The Metropolitan Asylums Board lose no time in removing to their hospitals all cases of fever and small-pox thus discovered; but it is necessary that such patients should be promptly isolated pending their removal, and there should be in connexion with every out-patient department a room specially set apart for this purpose, and so placed that the infectious persons may be conveyed to the ambulance without necessitating that they should again pass through the often crowded waiting-room. Further, each hospital should bear in mind its responsibility with regard to those cases of infectious disease which are not admissible into the Metropolitan Asylums Board’s hospitals, and should itself undertake the removal, either to their home or to the London Fever Hospital, of all persons suffering from measles or diphtheria, unless it is prepared to treat these diseases within its own walls. Hospitals are necessary for the treatment of the sick poor and for the study of disease, but every possible care should be taken to reduce to a minimum any risk which may result from the occasional but inevitable association of

infectious with non-infectious persons. INTERMITTENT ALBUMINURIA. A

interesting contribution to the gradually literature with respect to those anomalous forms increasing of albuminuria which occur in persons apparently healthy has just been made by Dr. Merley (Kdpitaux de Sainte Etienne) in a work in which he ably reviews the investigations of previous observers, and adds numerous observations of his own. He confirms the original statements of Dr. Pavy in this country and Dr. Teissier in France as to the cyclical character of the intermittency in many of these forms. He also states that the urine in these cases contains an excess of colouring matter, a considerable quantity of albumen, an exaggerated elimination of urates, and a marked increase in the elimination of urea, in this point confirming the observation of Dr. Ralfe (THE LANCET, Aug. 23rd, 1886), who accounted for this condition by referring it to increased hsemolytic action of the liver, which, causing a too rapid destruction of blood-corpuscles, increased the amount of urea and colouring matter in urine on the one hand, and led to albuminuria on the other. Dr. Merley investigates very closely the various hypotheses which have been advanced to account for the phenomena of cyclical and intermittent albuminuria, and which he divides into (1) the mechanical VERT