"MEDICAL ORIGINALS."

466

regard to scurvy, a malady which has hitherto been usually own interests. As regards the other medical fees, such as Dr. Nansen ventured those for midwifery and major operations, we think there occur in Arctic explorations. that disease by can be but little doubt-less doubt than in the case of it was to avoid that to [declare very easy and he proceeded to relate his vaccination fees-that these must be held to be included taking proper precautions, among the " emolumentsfor purposes of superannuation, experience :" Dr. Torup, Professor of Physiology at the University of for they are "fees applicable to the office" of medical Christiania, had come to the conclusion, after examining the officer, and as yet no doubt has been thrown upon the fact subject, that scurvy must arise from poisoning, caused, in that a district medical officer is an officer of the guardians. particular, by badly preserved meat and fish. He thought We understand, as a matter of fact, that percentage" that in the decomposition which takes place in the meat from been deducted from these fees in the various bad preserving-in salt meat, for instance-there was have already in view of their forming a basis for superannuation. poisonous matter allied to the so-called ptomaines, which, unions, when constantly partaken of, engendered the malady we In reference to the lunacy fees which some district and call scurvy. Particular attention was paid to this at the resident medical officers receive when called upon by the time of their equipment, and from their experience and the lunacy justices to examine and certify lunatics, these fees investigations he had the opportunity of making during the cannot well be included within the scope of the Act, because journey, he could entirely subscribe to Torup’s opinion in this matter. It was to be hoped that in a near future there they are paid to the practitioner, not by virtue of his office would be scientific elucidation of this important point; and as a medical officer, but by order of the justices in his it was equally to be hoped that certain means for avoiding capacity as an ordinary medical man. No special clause has this hitherto so fateful sickness be shown."

found to

might been inserted to cover this difficulty as in the case of superWhether this supplies a key to the explanation of all the out intendent-registrars, and nothing short of fresh legislation breaks of scurvy that have occurred it would be premature can alter matters as regards lunacy fees. But in the case of to declare ; but it marks a new departure and is well worthy vaccination fees we are of opinion that the grounds in of further investigation. Meanwhile, we think it may favour of their being included are sufficiently strong to state account for some of the outbreaks about which difference of opinion existed as to whether they were to be entirely explained by the absence of fresh vegetables.

for the interpretation of the Act upon this of the High Courts.

possibly

a case

a

one

point

in

-

"MEDICAL ORIGINALS." THE

NEW

POOR-LAW SUPERANNUATION AND MEDICAL FEES.

heading a writer in a Russian periodical interesting details regarding the mode of life

UNDER this

ACT

supplies of

some

eccentric member of the medical

whose

profession, "YES," remarked an eminent politician to us the other was well known in the streets of St. Petersburg appearance day, "you doctors never look after your interests as a class ; some half a century since. Having in the course of a your work is so exacting that you have not the time, and somewhat a concareer succeeded in an

amassing lengthened the interests of your class are in siderable fortune, the physician in question, whose name is question you go to the wall." Medical officers in the Poor- not given, decided on retiring from practice in order to pass law service are much exercised just now as to whether the the remainder of his days with dignity in the enjoyment of extra fees which they receive for midwifery, amputations, leisure. It however, that his brain, so long vaccinations, &c., can be allowed to count as a basis for accustomed tohappened, active exercise, proved unable to withstand their future superannuation allowances as well as their fixed the enervating effects of idleness. While the stimulus salary. The Act provides that the superannuation allowance afforded by his daily ministrations to his sick and suffering to which an officer is entitled shall be based upon the average continued in operation his faculties remained townspeople of his "annual salary and emoluments" during the five years but no sooner was this withdrawn than at once unclouded, prior to the date when he ceases to hold office, and the of mental deterioration began to show themquestion raised is whether these fees form part of the emolu- symptoms destitute of family ties he lived entirely selves. Being ments" of a medical man’s office. We have already referred save for an antiquated crone, who was nominally alone, to this subject,l and on grounds already stated we have his cook, although apparently she had but little whereupon maintained that where a medical officer is also a vaccination to exercise her culinary talents. In addition to avarice the officer the vaccination fees form part of the emoluments of chief form of derangement with which the old gentleman his office, and should therefore be included as a basis for was afflicted was dread of robbery. Formerly conspicuous calculation. The Local Government Board, however, has for his gaiety he now became morose and suspicious to the expressed the opinion that as a vaccination officer only holds last degree, fearing to leave his treasure for a moment, and that office under a contract terminable on either side at a unable either to sleep or to eat. According to the ancient month’s notice these fees. cannot be included. As the matter dame he would assuredly have put an end to his misery by now stands, therefore, the only way to get a final decision on if he could only have prevailed on himself to go to the question of the vaccination fees would be to take the hanging the expense of a rope. The means this aged monomaniac matter before one of the High Courts of Justice and get an i to protect his beloved gold from thieves was authoritative interpretation of the Act on this point. Clerks adopted remarkable. truly Having been medical attendant to the to guardians, who are generally superintendent-registrars of he contrived to procure the skeletons gaol births and deaths, stand in precisely the same position as principal of a number of malefactors who had been executed, regards their registration fees, but these gentlemen took good and these he disposed around his premises in a care in the framing of the Act that a special clause (Clause 19) way that unquestionably was calculated to strike terror should be inserted to the effect that " for the purposes of into the heart of the boldest of burglars. In the first this Act superintendent-registrars and registrars of births with his own hand he blackened the walls of the place, and deaths are deemed to be in the service of the guardians various rooms and and thus passages, having prepared the of the union in which their districts are situated," and therehe next the background arranged lugubrious relics in a fore the registration fees can be counted for superannuation. of attitudes all more or less startling. In the variety This precedent, it seems to us, is a very important one in vestibule, for instance, he placed by way of a cloak-rack the considering the case of vaccination fees ; but it also forms a skeleton of a woman who had cut the throats of her very apt illustration of the advantage of looking after one’s children. In the middle of the adjoining room stood the 1 THE and minatory osseous remains of a Grenadier, who LANCET, Nov. 7th and 28th, 1896. thus when it

happens that

gigantic

467 had suffered the extreme penalty for murder. In lieu of a sideboard the dining-room contained a grim-looking erection fashioned out of human bones, plates and dishes resting on the pelves, and knives, forks, and spoons between the ribs, while the dome of a skull served as a sugar-basin and a child’s ossicles as sugar-tongs. The appliances thus forbiddingly stored were, however, more for show than use, since their owner never by any chance entertained a guest and towards the end abstained almost altogether from eating. His death is ascribed to fear and hunger combined. A few moments before he expired he is said to have raised himself up in bed with great difficulty in order to blow out a candle ; but whether he was actuated by a desire for economy or dreaded to afford illumination for the longexpected robber it is impossible to determine.

OYSTERS AND TYPHOID FEVER. ACTING on the instructions of the Sanitary Committee, the medical officer of health of Brighton, Dr. Newsholme, has written to the medical officers of the thirty-three great towns of England and Wales, drawing attention to the danger of the spread of cholera and typhoid fever from sewage-contaminated oysters and other molluscs, and asking whether they would support a petition to the Local Government Board for legislation giving powers to local authorities to prevent the consumption of molluscs so polluted similar to the powers already in force for dealing with milk, or to take proceedings before the magistrate of the district in which the oysterlayings are situated, for the purpose of obtaining an nrder prohibiting their use until rendered fit for the purpose. Twenty.two answers had been received, nearly all in hearty support of the proposals. A petition on behalf of local authorities generally is to be prepared.

TUBERCULOSIS

OF

THE LUNGS LIFE.

PULMONARY tuberculosis

when

IN

developed

ADVANCED at

a

fairly

motile bacillus which could not be recognised,’, known form. In the remaining seven cases the above. any described forms of saprophytes were found in six and in. the other case only the pathogenic bacilli were found. No definite relationship could be discovered either between,’, the presence of the ’ streptococci and the height of the fever or between the former and the existence of cavities and the course of the disease. In those.

third

as a

as

over sixty years of age streptococci were never found. With the exception of two cases in which the animals died, in two cases of blood-poisoning (streptococcic in fection), the sputum and contents of the cavities when. inoculated were not virulent. The tubercle bacilli, howcaused to death in from four six weeks. Dr. Luzzatto. ever, that concludes, therefore, although, of course, pulmonary tuberculosis in old people has the same specific originnamely, the tubercle bacillus-yet mixed infection is not nearly so common as in younger life, it being present in only4 about half the cases. Further, the micro-organisms which are found show only a slight degree of virulence and are not very tenacious of life; in short, we have to deal with ap attenuated infection, and this explains to some extent thelong and mild course which pulmonary tuberculosis usually exhibits in advanced life.

patients

A DANGEROUS DELAY. AT a meeting of the Uckfield (Sussex) rural council last week one of the sanitary inspectors made a statement which, if it be true, reveals an extraordinary condition of affairs. At one of the railway stations in his district, this office. declared, small-pox had broken out in the house of thestation-master. Six children suffered from it, and at thetime of the inspector’s visit the station-master, not been relieved by the company, could not leave hisAt the time one of the children, in the desquamating post. was stage, actually running about the platform, and it was’ the only upon inspector telegraphing to the authorities that’ the man was relieved. This state of affairs, with passengers through the place daily, was bad enough, but to make matters worse the man was also sub-postmaster! So that by rail and by letter this centre was capable of spreadin6" the disease. It was proposed that the man should be prosecuted, but eventually an amendment to caution him was carried. It seems a case in which, surely, something should’ be said to the railway management-provided, of course, that. the facts are as stated.

having

advanced age, fifty years and upwards, often runs a very chronic course, and the acute form is but seldom met with In the Centralblatt fiir Bakterioloqie, at this time of life. Parasitenkunde und InfektionshrankA6it6n, Jan. 20th, 1897, is The presence a paper on this subject by Dr. A. M. Luzzatto. of other micro-organisms, in addition to those pathognomonic of tubercle, is known to have a marked influence on the febrile phenomena and destruction of lung tissue, and Dr. Luzzatto’s investigations were directed to the isolation of SCARBOROUGH’S SHAME. such bacteria. Fifteen cases were chosen, the patients being all over fifty years of age. In four cases scrapings were A SERIES of admirable articles upon sanitary reform have obtained from pulmonary cavities and the tissue of the recently been appearing in the Scarboro’ Post which reveal. lungs, and in eleven cases the sputum was examined, having a state of matters by no means creditable to the surely, been washed by Kitasato’s method. In each case cover- ironically styled" health committee" of that well-known glass preparations were made, cultivations were made on watering place. From these articles it appears that the agar plates, and rabbits or guinea-pigs were inoculated. The death-rate for the three years 1893-95 was as follows :. following results were obtained. In eight cases colonies of England and Wales, 18-2; Birmingham, 19’9; Hastings, streptococci were obtained on agar plates which always ex- 14-2; Bournemouth, 13-2; Eastbourne, 12-6; Southport, hibited the same characteristics ; the cocci were fairly large, 16’5 ; and Scarborough, 18’2. Of course part of this mornot motile, stained well by Gram’s method, and formed tality is due to deaths of visitors registered in the borough long chains, especially in broth cultures. The colonies were but the same remark holds good with regard to Eastbourne,. small, but often raised considerably above the surface ; in Hastings, and especially Bournemouth. One great cause is only three instances could a broth culture be obtained, not far to seek, but is contained in the following simple stateand sub-cultures were made with difficulty. The virulence ment : Scarborough, 8900 houses-6500 privies. Some of. of the fresh broth cultures was tried on two rabbits; these privies are actually inside the houses, and although the in the first animal there was a slight local reaction ; soil is removed weekly it still has to be carried through the in the second no result followed. The streptococci houses. Several cases of this kind are alleged to exist within. were in two of the cases found to correspond with the a few yards of the Town Hall ; this being so it might urge: staphylococcus pyogenes (aureus, citreus, and albus), and in the members of the health committee who talk about all the cases with three forms of saprophytes ; one was " sanitary fads"to action if the night soil were carried recognised as the micrococcus candicans (Flugge), the through the Town Hall when the said committee were sitting> second as the bacillus fungoides (Tschistowitsch), and the Another crying want is an isolation hospital, the need for ___