THE CORONER'S JURY.

1169 of the College previously to Harvey’s day--Thomas Linacre, simple, and very rarely have any surplus funds available for Thus did outside purposes. Despite this great disadvantage, however, the founder of the College, and John Caius. he happily turn the thoughts of his hearers to those it will be found that several have been doing good work in who are not only foremost in establishing and main- this direction for years. The honour of being the first in taining one of our cherished institutions, but whose learn- this country to adopt this system belongs to the Northern ing and medical knowledge were doubtless responsible Hospital, Liverpool which, thirteen years ago, purchased a for fashioning the thoughts of their great successor, whose horse ambulance and has had one in daily use ever since. fame has overshadowed theirs. With admirable skill, During 1895 it was called out on no less than 954 occasions. showing a perfect mastery of the conditions then obtaining, This is an enormous number when we remember that the the orator sketched the course of mediaeval medicine and hospital has only 155 beds. The horse is hired, but the pointed out how the teachings of Galen had obtained driver is permanently employed by the hospital. The so large a share of influence through the revival of Royal Southern and the Bootle Hospital possess horse same the Greek medical classics, to the study of which both ambulances, which are worked in much the In Birmingham the only Linacre and Caius were devoted. He showed, too, that manner as the original one. the Hippocratic revival, which gave so great an impetus to one is at the General Hospital, and this appears to clinical study and is associated with the name of Sydenham, be used chiefly to take patients to the semi-convalescent had together with Harvey’s great discovery laid the founda- home and not to be always in readiness for emertions of modern medicine ; but he added that if it had not gencies. There is a similar arrangement at the North been for Aristotle and Galen that discovery might never Staffordshire Infirmary. In Sheffield and Bradford there is have been made. The main burden of his discussion an excellent service conducted by the fire brigades, but this contention and having no connexion with the hospitals the ambulances do was to demonstrate the truth of to show that Galen, in spite of errors unavoidable not carry a surgeon. Possibly the best equipped in England from the manner and limitations of his observations, is is the Leeds Infirmary, which in 1887 was presented with deserving of a niche in the Temple of Fame second only to two horse-ambulances-one carrying two and the other four Each is, of that of Aristotle, whose physiological theories he in some stretchers-by the working-men of the town. points correctly traversed. Dr. Payne has done no more course, provided with the usual splint-locker, bandages, than justice to Galen, whose errors have been magnified, but dressings, and medicines, being carried in a bag. The managewhose methods of work were those of the true scientific ment is equally satisfactory. The ambulances are kept about investigator who knew of no authority but that of 100 yards away, at the headquarters of the fire brigade, who direct personal observation and whose industry was supply men and horses; one ring on the electric bell remarkable. Most excellent and needful in these days summons the smaller, two the larger. The time elapsing of somewhat arbitrary science were the passages in the between the receipt of the alarm and the despatch of the early part of the oration in which the speaker con- van with surgeon is from one to two minutes. The dresser tended that error has its place in progress as well as truth ; of the week goes during the day and the house surgeon of how often, indeed, the truth is only revealed through error the week during the night. In the year 1895 490 calls were So prompt are the firemen that there is and few of us can avoid the inference that perchance many answered. of the conclusions which are now believed to be without flaw generally a race between the dresser and the ambulance as may, as knowledge widens, prove in time to come to to which shall be ready first. It is certainly desirable that be as faulty and as fanciful as some of the theories of all work of this kind should be done from a hospital, as the the ancients which to us sound strange and singular. requisite surgical aid can there be provided at any time to The above does not profess It is only such great central facts as that which Harvey accompany the ambulance. brought to light-although many who preceded him came to be a complete list of ambulance-using hospitals. If very near to his discovery-that are and must be immutable inquiries were made doubtless many other examples would and perennial. But physiology abounds in data that are be discovered and probably will reveal themselves now that less firmly rooted than this, which, accepted as truths the subject has been broached. Enough, however, has by one generation, may perchance be dismissed to the probably been said to show that we are not so utterly limbo of errorby another. This much is certain, that ignorant or neglectful as the writer referred to seems to think. no labour, however vain, is lost; and just as from the errors of an Aristotle or Galen sprang the truths of a Harvey, so in due time may further insight be gained into THE CORONER’S JURY. the wonderful economy of the animal body at the cost of the THE often unsatisfactory nature of the verdicts given by sacrifice of cherished convictions through the illuminating coroner’s juries and the unwillingness with which the jurors genius of another Harvey. themselves perform their duties is arousing a large amount of attention. Our own columns constantly record instances HORSE AMBULANCES. of what we may for shortness call mal-praxis at inquests, Irr the Nineteenth Century for the present month there using the word to signify a useless verdict or unseemly We are appears a most interesting article on the subject of Hone wrangles between witness, jury, and coroner. Ambulances. The writer gives a history of their origin at glad to see that the lay press has taken the matter the 13th ult., in a leading the Belle Vue Hospital in New York and of their develop- up, for the Times of ment in the United States, and also mentions their use in article, refers to this subject. The writer recalls Lord Vienna and Paris. Unfortunately, he takes no note of any Herschell’s remarks on the matter in 1876. His lordship in this country, and, apparently assuming that there are then proposed the abolition of the coroner’s jury and the none, blames us for having neglected so long an example appointment of a medical officer to be attached to the set us by far younger cities than our own." For the coroner’s court, " whose duty it would be to make, without purpose of correcting the wrong impression thus given loss of time, a report into every death calling for inquiry." it may be well to refer very briefly to what has been The Times thinks no one would object to this change, done in this direction in some of the more important but suggests that in the meantime coroners themEnglish towns. Granting at once that we are far behind selves might do something to raise the character of their the Americans in this respect it may be urged in mitigation tribunals by, for instance, procuring a better class of jurors. that our hospitals, unlike theirs, are all charities pure and As we remarked in a recent issue, no inquest should be held ____

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at least, ithe fat ingested with the food escaped undigested from the proper build- bowels in the fseces. Subsequent experiments, especially ing attached in which the coroner’s court could be held. As those of Lawes and Gilbert, on the herbivora clearly demonit is we are rated for sundry silly and useless fads, butistrated that one, at least, of the sources of fat is the In the meanwhile various most likely no one would object to a rate for the provisionfarinaceous material ingested. some for circumstances had led of a decent mortuary and coroner’s court investigators to adopt the view every parish. that the or the moment its albuminoid THE LANCET from almost of nitrogenous constituents of the inception fought Much has court. in the generation of fat. Thus food might play a part against the degradation of the coroner’s been done in the way of improvement, but more remains to it was found that animals fattened best when their food, be done. if chiefly farinaceous, was mingled with some albuminous compounds ; whilst Pettenkofer and Voit demonMEDICAL JOURNALISM IN CUBA. strated that in a dog freely supplied with fiesh the WE learn that our Cuban contemporary, La Revista de whole of the nitrogen thus introduced into the economy was Ciencias Medicas, founded eleven years ago, has now recoverable from the urine and fasces, whilst the carbon ceased to appear. The final number contains, among remained in the economy and hence, probably, formed or The observations of an - other matter, account of two successful cases of aided in the formation of fat. Kemmerich on nursing bitches, of Subbotin on feeding and one of abdominal vaginal hysterectomy hysterectomy performed by Dr. Enrique Nunez, one in 1895 and the others dogs with palm oil and meat, of Hofmann on larvas fed on ,during the present year. As medical journalists, we cannot defibrinated blood containing a known quantity of fat, all but admire the tenacity of purpose which has enabled our pointed in the same direction and led Voit to maintain, first, colleagues in Cuba to carry on their work as long as they that the fat of animals is exclusively formed from the proteid have done amid the scenes of anarchy and bloodshed which aliments, and, secondly, that hydroc3,rboraceous compounds are not converted into fat in the animal organism, but simply afflict that unhappy island. preserve the fat formed from the proteids from oxidation. The most recent researches on this point, however, are not ORIGIN OF FAT IN THE BODY. in accordance with Voit’s views. M. Kaufmann quite THE subject of the origin of fat has once more been taken arrives at the conclusions. The proteids, in following up by the experimentalist, and M. Kaufmann contributes a common with the ternary compounds of the food, conpaper giving the results of his researches to the Arc.hives de tribute to the formation of fat, but, contrary to Voit’s Physiologie for October. Many years have now elapsed since statement, they are not the exclusive origin of it. When the well-known French chemists, MM. Dumas and Boussinduring digestion a large quantity of proteids is absorbed gault, as the outcome of their researches, maintained that it rapidly undergoes disintegration and forms fat. This animals, whether herbivorous or carnivorous, were supplied fat has, speaking generally, three applications. One with all their proximate principles by the vegetable kingpart oxidises and passing through the phase of glycose dom-the former class directly, the latter indirectly through supplies the requisite energy for the general physiological the herbivora on which they preyed. Animals, according to work of the organism; another part undergoes incomplete these observers, did not make fat, sugar, or albumin, but oxidation and is transformed into carbohydrate which is derived each and all of these substances from plants. This stored up in reserve as glycogen; whilst the third part position was contested by Liebig, who contended in regard to remains intact and is deposited as fat. The proportion of fat that this was not altogether obtained by animals fat which is fixed during the digestion period varies with the from the fat of their food. On the contrary, they were abundance of the repast and the richness of the organism in able to make it with either sugar or starch. He pointed glycogen. If the animal is poor in glycogen it may happen out, as Huber had done before him, that bees fed on that the whole of the non-oxidised fat may be converted sugar or honey alone were capable of forming fat in the into glycogen. Calorimetric investigations demonstrate that form of wax, but Huber had omitted to weigh the if the anaerobic decomposition of albumin really occurs the bees before dieting them, and Dumas and Boussingault process is not attended with any disengagement of heat. Ingeniously argued that the wax formed on a diet of pure farina or sugar was originally stored up in the THE PLAGUE IN INDIA. bodies of the bees and utilised by them in the SINCE writing last week to the effect that there did not construction of their combs. Liebig therefore still seem to be much doubt as to the natureof the disease at the view that the of Huber and held supported greater part of the fat which is deposited in the animal body and that Bombay and that it had the distinctive features of bubonic which is found in the milk of nursing mothers is formed in plague intelligence has been received that M. Haffkine, the body and almost exclusively from the hydrocarbonaceous who had been sent to Bombay to report upon the nature of compounds of the food. The albuminoids, he thought, the outbreak, had pronounced the disease to be plague. A played quite a subordinate rôle from this point of view, as, recent number of the Times of India gives a long account of indeed, seemed probable when it was considered that the the outbreak in question derived from inquiries among medical food of the herbivora which store up much fat is chiefly practitioners in Bombay. We gather that the disease was in .composed of carbohydrates, whilst the bodies of the the first instance confined to the Mandvi district, but that oarnivora, whose food is chiefly albuminous, contain little some cases had subsequently appeared in other districts of or no fat. Moreover, he experimented on a goose, the city. The disorder in some of the cases seems to have which from a lean condition was fattened to such been quite typical in its clinical and bacteriological features. - an extent that three pounds of fat were obtained The malady is of a virulent kind, attended by high feverfrom it, although the maize with which it had been 104° to 105° F.-rapid pulse and respiration, with glandular ’fed did not contain anything like that quantity of fat. enlargement of the groin, axilla, or neck, and attended with Dumas and Boussingault returned to the charge by great prostration. These symptoms are accompanied or making a careful analysis of the food given to a cow for a followed by delirium and a drowsy unconsciousness, and the year and determining the quantity of fat which the animal attack is commonly fatal in two or three days. Bacilli resemyielded in the milk. They found the fat introduced with the bling those found by Professor Kipasato at Hong Kong have efood to be considerably in excess of that eliminated by the been discovered in the blood and other fluids of those attacked. milk, but Liebig scored a point by observing that nearly all As was the case at Hong Kong, it has been noticed that the a

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