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THE BATTERSEA BOROUGH COUNCIL AND ITS MEDICAL OFFICER OF HEALTH.
THE HAMPSTEAD GENERAL HOSPITAL "vacca"process, an account of which I remember to have read in your valuable journal. The great drawback to milk treated by the Budde process is that it only remains sweet for a period of from eight to 14 days, whilst your report, coupled with that of Dr. Klein, of the " vacca " milk in your issue of March 8th, 1902, which I have before me, states that the latter will keep indefinitely in bottle-in fact, some of the samples on which you report you state to be quite a month old. The " vacca" milk is, in fact, absolutely sterile and yet neither heat in the ordinary way nor preservatives are employed. The Budde process, on the contrary, according to Professor Hewlett, does not kill spores. From Professor Hewlett’s account of the Budde process I cannot help thinking that the results must prove to be rather uncertain. The effect of this method must be largely dependent upon the quantity of "catalase"which is present in the fresh milk. This quantity varies in fresh milk and decreases as the milk gets older, from the time it has been drawn from the cow. This must necessarily cause In any case it an element of uncertainty in the process. must be admitted that in the Budde process a preservative is added to the milk in the shape of peroxide of hydrogen, which may or may not be harmless. In Germany, at any rate, the addition of peroxide of hydrogen to fluids or food is prohibited. By treating milk by the Budde process there is not always the certainty that the peroxide of hydrogen has decomposed because the same quantity of catalase is not always present and it is impossible to find this out each time in a practical methodical way. I am pleased to note that Professor Hewlett admits this himself where he says that it may prove necessary to add yeast enzymes artificially to the milk. Having made the preservation of milk the object of many years’ study I was naturally interested in this article and I trust you will allow me to point out what I consider to be its scientific imperfections. However ingenious the idea may appear it is not on a level, in my opinion, with the vacca process which you have previously described, which, while completely preserving the milk, adds nothing to it or disturbs its nourishing qualities, as is the case by the ordinary methods of sterilising milk. I am, Sirs, yours faithfully, Dr. F. BASENAU. Amsterdam, March 14th, 1906.
863
small privileged staff is unfair to the patients of other practitioners, as, indeed, it is to the practitioners themselves (though the staff, by all reports, do their work in a very satisfactory manner) ; and that the appointment of a staff of consultants, which is rumoured as a possibility, in place of the existing general practitioner staff is opposed both to the original objects of the founder and to the needs of the I am, Sirs, yours faithfully, locality. F. R. HUMPHREYS, Chairman, Hampstead Division, British Medical Association.
Fellows-road, N.W., March 20th, 1906.
THE ADMINISTRATION OF ADRENALIN IN CASES OF FAILURE OF THE
CIRCULATION.
of THE LANCET. P. Lockhart J. SIRS,-Mr. Mummery’s comments on the case I published in THE LANCET of March 3rd did me the service of calling my attention to his extremely valuable articles in the issues of March 18th and April lst, 1905. I quite see that theoretically the ideal method of administering the drug is intravenously. He, however, states that even " in cases of failing circulation...... adrenalin if injected under the skin will have a very poor chance of reaching the peripheral circulation." In my case, however, the pulse at the wrist was not to be felt and yet the recovery of the patient proves that it did reach the circulation. Of course, it may be said that the hypodermic needle pierced a fair Mze vein, but the same almost immediate effect (about 20 seconds elapsing before a change was noticed) occurred after each injection. The point I wish to emphasise is that in suitable cases an injection of adrenalin hypodermically may be of the utmost service. As a general practitioner I have constantly come across cases in which I now see that its use might have been of the greatest value. In many of these, circumstances would not have permitted intravenous infusion. It consequently seems to me that if some manufacturer would place on the market sealed capsules containing suitable doses capable of being carried in the hypodermic pocket-case he would be fulfilling a want. Mr. Mummery also finds the action of adrenalin very transitory. In my case, however, weakening of the pulse began quite 15 minutes after the first injection THE HAMPSTEAD GENERAL and was not marked enough to call for a second injection till 30 minutes after it. It is true that I gave 10 minims To tkc Editors of THE LANCET. orally, but Mr. Mummery says this can have had no effect. SIRS,-The management of the Hampstead General Hos- The remaining injections were given at about two-hour has been the of much criticism the local subject pital by intervals according as the pulse required it; that is to say medical profession for some time past and the matter has the effect appeared to last about that length of time. One been coming to a head gradually in the course of the past small point more: do the words vaso-motor stimulant" or The was founded a local two. year originally by hospital imply a nervous action ? It happened that I knew the general practitioner as a home hospital, where individual action of adrenalin was direct, and unless these words imply local practitioners could themselves continue, in more action through a nerve, which it does not seem to me they do, the treatment commenced in the satisfactory circumstances, it is not right to say that "adrenalin can in no sense patients’ homes. The hospital was in considerable diffi- surely be called a vaso-motor stimulant." culties for some years ; finally it was only by the united I am, Sirs, yours faithfully, efforts of the local profession that it was kept open. H. O. 0. BUTLER. March 1906. Chiswick, 19th, W., From a home hospital this institution has advanced, or into a with a out"general hospital," degenerated, large patient department, a limited staff of general practitioners, THE DANGERS OF THE FLUTE-KEY a few (pay) beds for the patients of practitioners not on the FLASK FOR ADMINISTRATION OF staff, and a management on which the outside profession is ETHYL CHLORIDE. This the and divorce between management unrepresented. the local profession is greatly to be deprecated on every To the Editors of THE LANCET. ground. The hospital has recently become possessed of a to thank you for inserting my letter in SIRS,—I that it is and is rumoured about to beg donation it very large receive another. It has been transferred to a new specially THE LANCET of March 17th on the dangers of the flute-key erected building quite recently (and objections might be flask. I regret that I have made an error. Instead of Sumner’s measure," it should be "Messrs. easily made to the choice of site). The lines upon which "(3) Messrs. I should be glad if the hospital authorities have been recent,ly developing that Reynolds and Branson’s Antivolat.’" institution indicate further alterations in the near future you would correct this.-I am, Sirs, yours faithfully, THOMAS Y. SIMPSON. and, indeed, there are rumours, apparently well founded, Royal Albert Hospital, Devonport, March 19th, 190r). which foreshadow further drastic changes. This letter is not for the purpose of opening a discussion in your columns, Sirs, but in order to request the general THE BATTERSEA BOROUGH COUNCIL practitioners of Hampstead and its neighbourhood to keep AND ITS MEDICAL OFFICER OF an open mind upon the subject in view of the proposal to call a meeting of the local profession in the course of the HEALTH. next few weeks to consider the whole matter. I will, thereTo the Editors of THE LANCET. fore, merely ooserve that there appears to be a consensus of medical opinion that an out-patient department in this SIRS,—I observe in the list of duties proposed by the neighbourhood is neither necessary nor desirable ; that if Battersea borough council for the medical officer of health To the Editors
HOSPITAL.
"
any hospital be required in Hampstead it should be one of the nature of a home hospital ; that the appointment of a
to be
them that this officer must " issue all communications to sanitary inspectors
appointed by
instructions
and
THE FIFTEENTH INTERNATIONAL CONGRESS OF MEDICINE.
864
(male and female) through
the chief sanitary inspector." As medical officer of health who has direct supervision of the work of both male and female inspectors may I draw attention to the serious difficulties which will almost certainly arise if this duty as to instructions and communications be literally carried out and particularly in the case of the female inspectors ?‘! Their work will consist, one presumes, in, for example, visiting the mothers of newly born children and advising as to feeding and the general management of infancy, inquiring into circumstances attending deaths from diarrhoea or cases of puerperal fever, advising as to the management of cases of measles, whooping-cough, and the like, visiting midwives and seeing that the regulations of the Central Midwives Board are carried out, and so on. Yet all instructions and communications " in reference to these and the other duties of female inspectors must be transmitted through the chief sanitary a
"
inspector.
This transference of the practical administration of importance of which has been brought to light solely by medical men to one who, however well qualified he may be otherwise, possesses no medical knowledge, almost amounts to the putting of an indignity upon the profession. Moreover, the constant reference from one official to another cannot but seriously hamper important work, and work which is often of an urgent character. My opinion is shared, I know, by the medical officers of health of many other provincial large towns. Intending candidates for this position will also do well to compare the original duties of the office issued in February, 1906, with the ones issued within the past week or so ; the relations of the medical officer of health and chief sanitary inspector have been materially altered by the recent issue and most medical officers of health will think considerably to the detriment of the I am, Sirs, yours faithfully, former. NOT AN APPLICANT FOR THE POST. March 19th, 1906. matters the
THE FIFTEENTH INTERNATIONAL CONGRESS OF MEDICINE. THE OVERLAND ROUTE TO LISBON.
(FROM
OUR
SPECIAL
COMMISSIONER.)
UNDOUBTEDLY for those who can afford the time the sea to Lisbon is most It is the cheapest route and nothing can be more healthy and more restful than a few days’ quietude on the ocean. If, however, the traveller is not a good sailor then the overland route is preferable. Consequently, to avoid sea-sickness and to save time it is probable that the greater part of the members of the International Congress of Medicine will elect to travel by land. In that case, the British contingent must pass through Paris and must stop there for the night if travelling by the Sud express. This, of course, is the dearest of all routes and it allows of no sightseeing and only of such rest as can be obtained in a sleeping-car. From Paris it is the quickest route but the train only runs three days a week and does not correspond with any English mail. The Sud express leaves Paris at 12 18 P.M. The London and Calais mail reaches Paris at 5.50 A.M., and to be homeless in Paris for more than six hours after a night journey is no pleasant prospect. By the Dieppe route the same difficulty occurs, only Paris is reached a little later-namely, at 7.5 A.M. The Southampton route should correspond but it will not suit those whose object it is to avoid the sea. By Calais or Dieppe it is not possible to sleep properly as the sea journey is too short ; but on the luxurious and large Southampton boats there are a clear seven hours and good berths. Should, however, the wind and tide be unfavourable there is a chance of missing the 8 A.M. express at Havre and then the connexion with the Sud express would be lost. Even if the journey is performed under normal conditions Paris is not reached before 11 o’clock, so there is only just the necessary time to clear the luggage and to drive the short distance that separates the Gare St. Lazare and the new Orleans railway station on the Quai d’Orsay. Therefore, so far as the journey from England is concerned, there is no saving of time secured by the Sud express, for it is necessary to start the day before and to spend a night at Paris. Those who are indifferent to fatigue and wish to save
journey
attractive.
the
extra cost of the Sud express will take the
ordinary
leave London on April 16th (Monday morning) by any one of the three routes-Calais, Boulogne, or Dieppe. The trains arrive at Paris in time to, allow for dinner with all ease and comfort. Coffee and cigars may follow, for the express does not leave the Quai d’Orsay before 10.23 P.M. Bordeaux is reached in time for coffee next (Tuesday) morning, and lunch may be had at midday on the Spanish frontier at Irun. The main Madrid line is left at Medina at 1.48 in the night, Salamanca is reached at 5.45 on Wednesday morning, and Lisbon at 10.25 on Wednesday evening, and the Congress begins on the next day. It would, however, be a thousand pities to undertake so long and wearisome a journey without, stopping on the road. If the traveller must go straight through, then he had better take the Sud express. He would leave London on Sunday morning, the 15th ; sleep at, Paris ; and, starting on Monday at 12.18 P.M., reach Lisbon There will a little before midnight on Tuesday, the 17th. then be the whole of Wednesday for sightseeing before the Congress begins. On the other hand, it would be very awkward to arrive at Lisbon at about midnight if rooms. The ordinary express had not been secured beforehand. is due at Lisbon at 10.25 P.M., and that allows an hour or two more to find quarters ; also this train runs every day instead of only three times a week. If time permits the difference of fare between the Sud express and the ordinary express will just about cover the cost of some extremely pleasant and interesting sightseeing. Tastes and interests differ so widely that it is not possible to make suggestions likely to prove valuable to everyone. Personally, I have always preferred to make my first run from Paris to Bayonne, that is from 10.23 P.M. to 10.59 A.M., but others prefer to leave the train at 7.3 A.M., when it reaches Bordeaux. There is also a good train leaving Paris at 8.7 P.M. and arriving at Bayonne at 7.37 A.M. but this is not a through train to Lisbon. If the through train is to be caught again the next morning it means leaving too early if the stop is made at Bordeaux. Also, for a short stay and a rest and as regards the character of the buildings and surroundings generally I much prefer Bayonne. This town is reached just in time for the French déjeuner and the afternoon may be spent on the sands or rocks of the beach at Biarritz. Doubtless many would select to sleep there at one of the numerous cosmopolitan hotels. For my part, I am more interested in the quaint historic town of Bayonne with its narrow, shady streets and cool arcades leading up to its magnificent Gothic cathedral, the whole being surrounded by ancient walls, moats, and bastions that give it a picturesque appearance. Here the Basque native population is not obliterated by tourists and pleasure-seekers who throng from all parts of the world to so fashionable a resort as Biarritz. In any case, with 24 hours’ stay, it is possible to obtain not only a good sleep-this time not in the train but in a real bed-but to see both Biarritz and Bayonne. Indeed, those who know Paris well might travel from London to Bayonne, stopping only at Paris for dinner as indicated above. Or to go even more quickly, the 2.20 P.M. London train viti Folkestone could be taken, the traveller dining in the train after leaving Boulogne, and reaching Paris at 9.15 P.M. in time to drive from the northern station to the Quai d’Orsay for the 10.23 P.M. express to Bordeaux and express.
In that
cae
they
can
Bayonne. From the latter town, leaving comfortably a little after 11 in the morning, Burgos could be reached on the same evening and there one or two days may well be spent. The next stage would naturally be Salamanca and thus two of the most interesting towns in Spain could be visited and it would scarcely be too much to devote a couple of days to each of them. From Salamanca, after crossing the Portuguese frontier at Villa Formosa, the journey might be broken again at Pampilhosa, the junction for Coimbra and Then, again, some of these towns might be visited on the outward journey and others on the return journey. In any case, it is a very long route to travel without stopping and it is also a pity to pass through so many historical and interesting cities without seeing anything of them. But, on the other hand, travelling is not easy as it is in England. Often there is but one really good train per day and it does not always start at a convenient hour. There are many charms and advantages to be enjoyed when away from the rush and hustle of great modern centres of business and civilisation, but there are also disadvantages, notably the lack of frequent and rapid trains.
Bussaco.
863
small privileged staff is unfair to the patients of other practitioners, as, indeed, it is to the practitioners themselves (though the staff, by all reports, do their work in a very satisfactory manner) ; and that the appointment of a staff of consultants, which is rumoured as a possibility, in place of the existing general practitioner staff is opposed both to the original objects of the founder and to the needs of the I am, Sirs, yours faithfully, locality. F. R. HUMPHREYS, Chairman, Hampstead Division, British Medical Association.
Fellows-road, N.W., March 20th, 1906.
THE ADMINISTRATION OF ADRENALIN IN CASES OF FAILURE OF THE
CIRCULATION.
of THE LANCET. P. Lockhart J. SIRS,-Mr. Mummery’s comments on the case I published in THE LANCET of March 3rd did me the service of calling my attention to his extremely valuable articles in the issues of March 18th and April lst, 1905. I quite see that theoretically the ideal method of administering the drug is intravenously. He, however, states that even " in cases of failing circulation...... adrenalin if injected under the skin will have a very poor chance of reaching the peripheral circulation." In my case, however, the pulse at the wrist was not to be felt and yet the recovery of the patient proves that it did reach the circulation. Of course, it may be said that the hypodermic needle pierced a fair Mze vein, but the same almost immediate effect (about 20 seconds elapsing before a change was noticed) occurred after each injection. The point I wish to emphasise is that in suitable cases an injection of adrenalin hypodermically may be of the utmost service. As a general practitioner I have constantly come across cases in which I now see that its use might have been of the greatest value. In many of these, circumstances would not have permitted intravenous infusion. It consequently seems to me that if some manufacturer would place on the market sealed capsules containing suitable doses capable of being carried in the hypodermic pocket-case he would be fulfilling a want. Mr. Mummery also finds the action of adrenalin very transitory. In my case, however, weakening of the pulse began quite 15 minutes after the first injection THE HAMPSTEAD GENERAL and was not marked enough to call for a second injection till 30 minutes after it. It is true that I gave 10 minims To tkc Editors of THE LANCET. orally, but Mr. Mummery says this can have had no effect. SIRS,-The management of the Hampstead General Hos- The remaining injections were given at about two-hour has been the of much criticism the local subject pital by intervals according as the pulse required it; that is to say medical profession for some time past and the matter has the effect appeared to last about that length of time. One been coming to a head gradually in the course of the past small point more: do the words vaso-motor stimulant" or The was founded a local two. year originally by hospital imply a nervous action ? It happened that I knew the general practitioner as a home hospital, where individual action of adrenalin was direct, and unless these words imply local practitioners could themselves continue, in more action through a nerve, which it does not seem to me they do, the treatment commenced in the satisfactory circumstances, it is not right to say that "adrenalin can in no sense patients’ homes. The hospital was in considerable diffi- surely be called a vaso-motor stimulant." culties for some years ; finally it was only by the united I am, Sirs, yours faithfully, efforts of the local profession that it was kept open. H. O. 0. BUTLER. March 1906. Chiswick, 19th, W., From a home hospital this institution has advanced, or into a with a out"general hospital," degenerated, large patient department, a limited staff of general practitioners, THE DANGERS OF THE FLUTE-KEY a few (pay) beds for the patients of practitioners not on the FLASK FOR ADMINISTRATION OF staff, and a management on which the outside profession is ETHYL CHLORIDE. This the and divorce between management unrepresented. the local profession is greatly to be deprecated on every To the Editors of THE LANCET. ground. The hospital has recently become possessed of a to thank you for inserting my letter in SIRS,—I that it is and is rumoured about to beg donation it very large receive another. It has been transferred to a new specially THE LANCET of March 17th on the dangers of the flute-key erected building quite recently (and objections might be flask. I regret that I have made an error. Instead of Sumner’s measure," it should be "Messrs. easily made to the choice of site). The lines upon which "(3) Messrs. I should be glad if the hospital authorities have been recent,ly developing that Reynolds and Branson’s Antivolat.’" institution indicate further alterations in the near future you would correct this.-I am, Sirs, yours faithfully, THOMAS Y. SIMPSON. and, indeed, there are rumours, apparently well founded, Royal Albert Hospital, Devonport, March 19th, 190r). which foreshadow further drastic changes. This letter is not for the purpose of opening a discussion in your columns, Sirs, but in order to request the general THE BATTERSEA BOROUGH COUNCIL practitioners of Hampstead and its neighbourhood to keep AND ITS MEDICAL OFFICER OF an open mind upon the subject in view of the proposal to call a meeting of the local profession in the course of the HEALTH. next few weeks to consider the whole matter. I will, thereTo the Editors of THE LANCET. fore, merely ooserve that there appears to be a consensus of medical opinion that an out-patient department in this SIRS,—I observe in the list of duties proposed by the neighbourhood is neither necessary nor desirable ; that if Battersea borough council for the medical officer of health To the Editors
HOSPITAL.
"
any hospital be required in Hampstead it should be one of the nature of a home hospital ; that the appointment of a
to be
them that this officer must " issue all communications to sanitary inspectors
appointed by
instructions
and
THE FIFTEENTH INTERNATIONAL CONGRESS OF MEDICINE.
864
(male and female) through
the chief sanitary inspector." As medical officer of health who has direct supervision of the work of both male and female inspectors may I draw attention to the serious difficulties which will almost certainly arise if this duty as to instructions and communications be literally carried out and particularly in the case of the female inspectors ?‘! Their work will consist, one presumes, in, for example, visiting the mothers of newly born children and advising as to feeding and the general management of infancy, inquiring into circumstances attending deaths from diarrhoea or cases of puerperal fever, advising as to the management of cases of measles, whooping-cough, and the like, visiting midwives and seeing that the regulations of the Central Midwives Board are carried out, and so on. Yet all instructions and communications " in reference to these and the other duties of female inspectors must be transmitted through the chief sanitary a
"
inspector.
This transference of the practical administration of importance of which has been brought to light solely by medical men to one who, however well qualified he may be otherwise, possesses no medical knowledge, almost amounts to the putting of an indignity upon the profession. Moreover, the constant reference from one official to another cannot but seriously hamper important work, and work which is often of an urgent character. My opinion is shared, I know, by the medical officers of health of many other provincial large towns. Intending candidates for this position will also do well to compare the original duties of the office issued in February, 1906, with the ones issued within the past week or so ; the relations of the medical officer of health and chief sanitary inspector have been materially altered by the recent issue and most medical officers of health will think considerably to the detriment of the I am, Sirs, yours faithfully, former. NOT AN APPLICANT FOR THE POST. March 19th, 1906. matters the
THE FIFTEENTH INTERNATIONAL CONGRESS OF MEDICINE. THE OVERLAND ROUTE TO LISBON.
(FROM
OUR
SPECIAL
COMMISSIONER.)
UNDOUBTEDLY for those who can afford the time the sea to Lisbon is most It is the cheapest route and nothing can be more healthy and more restful than a few days’ quietude on the ocean. If, however, the traveller is not a good sailor then the overland route is preferable. Consequently, to avoid sea-sickness and to save time it is probable that the greater part of the members of the International Congress of Medicine will elect to travel by land. In that case, the British contingent must pass through Paris and must stop there for the night if travelling by the Sud express. This, of course, is the dearest of all routes and it allows of no sightseeing and only of such rest as can be obtained in a sleeping-car. From Paris it is the quickest route but the train only runs three days a week and does not correspond with any English mail. The Sud express leaves Paris at 12 18 P.M. The London and Calais mail reaches Paris at 5.50 A.M., and to be homeless in Paris for more than six hours after a night journey is no pleasant prospect. By the Dieppe route the same difficulty occurs, only Paris is reached a little later-namely, at 7.5 A.M. The Southampton route should correspond but it will not suit those whose object it is to avoid the sea. By Calais or Dieppe it is not possible to sleep properly as the sea journey is too short ; but on the luxurious and large Southampton boats there are a clear seven hours and good berths. Should, however, the wind and tide be unfavourable there is a chance of missing the 8 A.M. express at Havre and then the connexion with the Sud express would be lost. Even if the journey is performed under normal conditions Paris is not reached before 11 o’clock, so there is only just the necessary time to clear the luggage and to drive the short distance that separates the Gare St. Lazare and the new Orleans railway station on the Quai d’Orsay. Therefore, so far as the journey from England is concerned, there is no saving of time secured by the Sud express, for it is necessary to start the day before and to spend a night at Paris. Those who are indifferent to fatigue and wish to save
journey
attractive.
the
extra cost of the Sud express will take the
ordinary
leave London on April 16th (Monday morning) by any one of the three routes-Calais, Boulogne, or Dieppe. The trains arrive at Paris in time to, allow for dinner with all ease and comfort. Coffee and cigars may follow, for the express does not leave the Quai d’Orsay before 10.23 P.M. Bordeaux is reached in time for coffee next (Tuesday) morning, and lunch may be had at midday on the Spanish frontier at Irun. The main Madrid line is left at Medina at 1.48 in the night, Salamanca is reached at 5.45 on Wednesday morning, and Lisbon at 10.25 on Wednesday evening, and the Congress begins on the next day. It would, however, be a thousand pities to undertake so long and wearisome a journey without, stopping on the road. If the traveller must go straight through, then he had better take the Sud express. He would leave London on Sunday morning, the 15th ; sleep at, Paris ; and, starting on Monday at 12.18 P.M., reach Lisbon There will a little before midnight on Tuesday, the 17th. then be the whole of Wednesday for sightseeing before the Congress begins. On the other hand, it would be very awkward to arrive at Lisbon at about midnight if rooms. The ordinary express had not been secured beforehand. is due at Lisbon at 10.25 P.M., and that allows an hour or two more to find quarters ; also this train runs every day instead of only three times a week. If time permits the difference of fare between the Sud express and the ordinary express will just about cover the cost of some extremely pleasant and interesting sightseeing. Tastes and interests differ so widely that it is not possible to make suggestions likely to prove valuable to everyone. Personally, I have always preferred to make my first run from Paris to Bayonne, that is from 10.23 P.M. to 10.59 A.M., but others prefer to leave the train at 7.3 A.M., when it reaches Bordeaux. There is also a good train leaving Paris at 8.7 P.M. and arriving at Bayonne at 7.37 A.M. but this is not a through train to Lisbon. If the through train is to be caught again the next morning it means leaving too early if the stop is made at Bordeaux. Also, for a short stay and a rest and as regards the character of the buildings and surroundings generally I much prefer Bayonne. This town is reached just in time for the French déjeuner and the afternoon may be spent on the sands or rocks of the beach at Biarritz. Doubtless many would select to sleep there at one of the numerous cosmopolitan hotels. For my part, I am more interested in the quaint historic town of Bayonne with its narrow, shady streets and cool arcades leading up to its magnificent Gothic cathedral, the whole being surrounded by ancient walls, moats, and bastions that give it a picturesque appearance. Here the Basque native population is not obliterated by tourists and pleasure-seekers who throng from all parts of the world to so fashionable a resort as Biarritz. In any case, with 24 hours’ stay, it is possible to obtain not only a good sleep-this time not in the train but in a real bed-but to see both Biarritz and Bayonne. Indeed, those who know Paris well might travel from London to Bayonne, stopping only at Paris for dinner as indicated above. Or to go even more quickly, the 2.20 P.M. London train viti Folkestone could be taken, the traveller dining in the train after leaving Boulogne, and reaching Paris at 9.15 P.M. in time to drive from the northern station to the Quai d’Orsay for the 10.23 P.M. express to Bordeaux and express.
In that
cae
they
can
Bayonne. From the latter town, leaving comfortably a little after 11 in the morning, Burgos could be reached on the same evening and there one or two days may well be spent. The next stage would naturally be Salamanca and thus two of the most interesting towns in Spain could be visited and it would scarcely be too much to devote a couple of days to each of them. From Salamanca, after crossing the Portuguese frontier at Villa Formosa, the journey might be broken again at Pampilhosa, the junction for Coimbra and Then, again, some of these towns might be visited on the outward journey and others on the return journey. In any case, it is a very long route to travel without stopping and it is also a pity to pass through so many historical and interesting cities without seeing anything of them. But, on the other hand, travelling is not easy as it is in England. Often there is but one really good train per day and it does not always start at a convenient hour. There are many charms and advantages to be enjoyed when away from the rush and hustle of great modern centres of business and civilisation, but there are also disadvantages, notably the lack of frequent and rapid trains.
Bussaco.