THE DRAINAGE OF MARGATE.

1155

breathing became rapid, 40 per minute; and there was a frequent short dry cough. Her lungs were examined daily, but no abnormal physical signs were discovered until the day after the commencement of the pericarditis, when SIRS,—Will you permit me, as president and treasurer of fifth I found an area of dulness just below the angle of the left in to ask assistance the Hospital Sunday Fund, your kindly scapula; in this area the breathing was tubular, without reminding the public that on Sunday next, being Hospital accompaniments, and the vocal resonance increased; there. Sunday, collections will be made in the churches and chapels was no rusty sputum, nor did the temperature become further elevated. Until this time the patient had been taking salicin, of London in aid of our hospitals and dispensaries. quinine was now substituted for it, and under this treatHospital Sunday is the one day in the whola year when but ment she gradually improved, being convalescent within a all and ot creeds and denominachildren alike, men, women, after the commencement of the disease. The occurtions, have the privilege and opportunity of helping the month sick poor in their midst. This year the Council have 116 rence of the pneumonic consolidation did not appear to proany effect upon the course of the malady. hospitals seeking relief from the Fund, 18 of which are duce These cases seem to be widely separated from an ordinary for There are also no than convalescents. fewer hospitals 51 dispensaries applying for awards. To cover the pressing exudative pneumonia. 1. They seem to have been invariably needs of all these institutions in respect of their last year’s preceded by pericarditis. 2. The lower lobe of the left lung was affected in each case. 3. There was no rusty sputum work a sum of £100,000 is still urgently required. In our London hospitals and medical charities we have and no cough, except in my case; crepivation was absent or comparatively slight in amount. 4. Theie was very persons of every nationality, and I venture to think that little or no and course of influence on the temperature the thousands of foreigners in London, who are here reapthe disease. The consolidation seems to be passive in itsthe of benefit our and libera,l will Constitution, ing great know how on this day to express their appreciation of, and nature and I am inclined to believe it to be due to pressure of an enlarged pericardium, probably containing fluid, upon gratitude for, the blessings they are here enjoying. I am especially anxious now, on the eve of those annual the pulmonary tissue behind it, this effect being increased lung, collections, to ask everyone in our great City and its suburbs by the sluggish circulation and lessened vitality of the I have to make a determined effort to increase the amount of the and the constant recumbency of the patient. Fund this year to $50,OOO. This would be a practical way observed a similar occurrence in the case of a heart greatly of recognising the debt of gratitude we all owe to these hypertrophied as a result of aortic disease. I may add that charitable institutions, and an effectual means by which the in my case there was no old cardiac lesion; a mitral murmur heard during the time the pneumonia was present, but people of London could give expression to their sympathy was for the sick and suffering poor around them. Like my pre- it disappeared when convalescence was established. I am, Sirs, yours faithfully, decessors, 1 shall be glad to receive at the Mansion House THE METROPOLITAN HOSPITAL FUND. To the Editors of THE LANCET.

the contributions of any who may be absent from London on Hospital Sunday, or who may otherwise be prevented from attending a place of worship and contributing to the Fund through the offertory. Commending this appeal to the liberality and generosity of the inhabitants of the metropolis, I am, Sirs, your obedient servant, P. DE KEYSER, Lord Mayor. Mansion House, June 7th, 1888.

ARTIFICIAL GLYCOSURIA. To the Editors of THE LANCET.

Abergavenny, May loth,

LEO D. GAMBLE, G-AMBLB, M.B., 1I.B., C.M.

1888.

REMOVAL OF DISEASED OVARIES. To the Editors of THE LANCET.

SIRS,— Kindly allow opinion attributed

little space in

explanation of Dr. Bedford Fenwick in his valuable memoir on "Cardiac Degeneration from th& Pressure of Abdominal Tumours" in THE LANCET of June 2nd. He quotes me as saying, " Ovariotomy should not be performed while the tumour is small, nor until the constitution has undergone pome degree of impairment:’’ That was written long ago. For years past I have advo-

an

me a

to

me

by

SIRS,—That glycosuria can be, as pointed out by Mr. F. W. Burton in your issue of June 2nd, so readily developed by cated and early operation. As a general rule, th& salicylic acid in the human subject is of considerable interest sooner a practised diseased ovary is recognised and removed th& from various points of view. Among ochers, it has an better. My conviction of the truth of this rule is strengthenecl important bearing as to the part played by the nervous by the great pathological argument so well illustrated by I am, Sirs, yours faithfully, system in rheumatic fever. In this disorder a patient is Dr. Fenwick. ROBERT BARNES. Harley-street, June, 1888. placed fully under the influence of the salicylates, toxic symptoms are developed, such as deafness, singing in the ears, &c., thetemperature then declines, the rheumatic pains THE DRAINAGE OF MARGATE. are relieved, and, simultaneously with the development of .To the Editors of THE LANCET. in a these toxic symptoms, sugar appears the urine. By curious transposition of a semicolon in Mr. Burton’s paper, SIRS,—With reference to the drainage of Margate, tc’ he is made to say that glycosuria is present before deafness which you referred last week, it may interest you to learn &c. appear; but this is not the case, and the point is that the inhabitants fully determined last autumn to follow important. The sentence in his letter should run as the urgent solicitations of the press and the public. The. follows:" This glycosuria is, however, only present when the patient shows the nervous toxic symptoms of salicysm; difference of opinion that exists in the town refers to the and before deafness, singing in the ears, &c., appear, though action of a certain majority of the Town Council, which perchloride of iron shows the presence of salicyluric acid has invited Mr. Baldwin Latham to send in plans, without, in the urine, I have not found any sugar." Mr. Burton is calling upon any other celebrated engineers to compete with still investigating the subject, and I hope that more light him. The burgesses have petitioned the Council from timehave held several mass meetings, urging th& may be thrown on the pathology of diabetes and rheumatism to time, and to call in other engineers to compete; but up Corporation his by observations.-1 am, Sirs, yours faithfully, P. W. LATHAM. till now they have been ignored by their representatives. Cambridge, June 4th.If88. The feeling among the burgesses is practically unanimous, and the movement is strongly supported by all the RHEUMATIC PNEUMONIA. medical men and the chief inhabitants. It is felt that To the Editors of THE LANCET. it would be difficult for the best-intentioned assessors. SIRS,—In February last I attended a case similar to to condemn the plan of a brother engineer of celebrity, but those described by Dr. Cheadle in his interesting clinical with two or three plans to choose from there could be no. the most appropriate. It will thus lecture in THE LANCET of the 5th inst. The hesitation in selecting

published be seen that the inhabitants are earnestly endeavouring to points of the case are as follows. The patient was secure the best possible advice, and are making laudable a strong healthy girl of eighteen; no history of previous efforts to ensure the selection of the best of the many rheumatism. As a result of severe exposure she developed systems of sewerage in vogue at the present day. I may acute rheumatism with pronounced arthritis and a steady add that perhaps the most important suggestion in Dr. Page’s temperature of 103° F. In a few days pericardial friction report of last year has been energetically carried out, and was observed, and shortly after evidence of effusion; the the town will no longer be supplied with questionable salient

1156 a new well having been sunk in a valley at distance from the borough, which is absolutely free from suspicion of contamination with noxious matters. It is only fair to point out that, in spite of the primitive system of drainage, the health of the inhabitants and visitors during the last twelve months or more has been ’excellent, and the zymotic death-rate compares very favourably with the best of the leading health resorts. I am, Sirs, yours faithfully, A MEDICAL RESIDENT. June, 1888.

drinking water, some

"OSTEO-PLASTIC RESECTION OF THE FOOT BY THE METHOD OF MIKULICZ." jf0the Editors

of THE

LANCET.

SIRS,—Dr. Alfred Swann, in THE LANCET of May 19tb, asks if there can be any sound objection to his operation for the removal of the os calcis and astragalus. May I be permitted to point out that Professor Billroth, in his Lectures on Surgical Pathology and Therapeutici’/ fully discusses the operation in question, and condemns it as an inferior surgical procedure to a Syme’s exarticulation in chronic disease of the tarsus. The passage runs: " We may, therefore, extireven the talus or the calcaneus; but to remove pate both talus and calcaneus, and perhaps also saw off the articular surface of the tibia, would, even if healing took place, leave a rather useless foot, which is of less value than a good amputation stump." The facts on which Professor Billroth founds his opinion then follow, and may be consulted by anyone interested in the matter. On the other hand, it must be confessed that Dr. Swann’s case contains that element of success which is so powerful a factor in every argument.-I am, Sirs, yours obediently. ALEX. G. R. FOULERTON. FOULERTON, M.R.C.S. St. Bartholomew’s Hospital, Chatham, May 23rd, 1888. ......

THE COUNCIL OF THE COLLEGE OF SURGEONS To the Editors of THE LANCET. your issue of June 2nd a statement to the effect that I am likely to seek re-election to the Council of the College of Surgeons. In order to avoid misunderstanding, I ask permission to say through your columns that it is not my intention to do so. I am. Sirs. vours faithfully. JOSEPH LISTER. Park-crescent, June 4th, 1888.

SIRS,—I observe in

ASSOCIATION OF MEMBERS OF THE ROYAL COLLEGE OF SURGEONS. To the Editors of THE LANCET. SIRS,—I enclose copy of a petition signed yesterday afternoon, May 31st, at a meeting of the Central Committee of this Association held at the Charing-cross Hotel. The

petition has

been forwarded this day Lo the Privy Council. I am, Sirs, yours faithfully, WM. AsHTON ELLis, Hon. Sec.

Grosvenor-road, Westminster, June lst, 1888. To Her Most Gracious Majesty the Queen in Council. The hnmbte petition of the undersigned Members of the Royal Collegi Surgeons of England sheweth :-1. That your petitioners are Members of the said Royal College o Surgeons, and of the Association of Members thereof. 2. That on the third day of May, in the year 1887, a petition signe(
of

College. 3. That a deputation of delegates, representing a large proportion o the Members of the said College, including also a large number of th, Members thereof, attended before your Majesty’s Privy Council on th( - eleventh day of November, 1887, in support of the said petition, and con veyed to the Right Honourable the Lord President their request to b, heard by Council in support of their said petition if your Majesty should not otherwise be advised that their claims ought to be per rnitted. 4. Your petitioners are informed and believe that no communicatioI relative to the said petition has since been addressed either to the sai, Association of Members of the Royal College of Surgeons of England o 1

New

Syd. Soc. Transactions, 1878, vol. ii., p. 248.

to the Members of the said

deputation,

or

to the

signatories

of the said

petition. 5. Your petitioners are further informed and believe that, although copy of the statement made on the eleventh day of November, 1887, when the said deputation was received, has been submitted by your Majesty’s Privy Council to the President and Council of the Royal College of Surgeons. no answer to the said statement or to the contentions of the Members of the said College has been made by the President and Council of the College. 6. Your petitioners have heard with surprise that a proposal has nevertheless been made to the President and Council of the said College signifying an intention to grant a Supplementary Charter limited to certain points in which, so far as your petitioners are informed, the aforesaid claims and rights of your petitioners are not recognised in any way; but, on the contrary, the existing elements in the constitution and administration of the said College against which your petitioners and the Members generally protest, will be further strengthened. 7. Your petitioners therefore humbly pray that your Majesty will be graciously pleased to refer the matters in this present petition, together with the said petition, signed by 4665 Members of the said College hereinbefore referred to, and the statement submitted on the eleventh day of November, 1887, for the consideration of your Majesty’s Privy Council or some of the members thereof sitting in judicial capacity, with power to hear all parties interested in the matter of these said petitions, by counsel and otherwise, and to receive evidence thereon ; and humbly to advise your gracious Majesty in the premises as to your Majesty may seem fit. And your petitioners, as in duty bound, will ever pray, &c.

a

BIRMINGHAM.

(From our own Correspondent.) A NEW HOSPITAL.

THE new building of the Birmingham and Midland Skin and Lock Hospital was opened on May 31st by the President, Mr. W. F. Inge. The movement originated with the late Dr. Heslop, whose zeal in the foundation and administration of hospitals was manifested by his untiring advocacy and interest for their promotion. The present hospital is the only one of the kind within eighty miles of the town; and in the midst of a large population there is ample scope for the services of the skilled professional staff whose time is at the command of the institution. The readiness with which such services can be obtained is shown by the circumstance that for the vacancy at present advertised there are seven local candidates of high academic distinction and good standing in the town. THE SWEATING SYSTEM.

Considerable interest has been shown in the able articles which have appeared in THE LANCET in reference to this obnoxious practice in Birmingham. At a meeting of the Town Council held on the 5th inst., the justice of the review was admitted, and its fairness not questioned. Several members of the Council were disposed to take active steps to diminish the evil as far as possible. The difficulty of authority was felt to be a drawback; but a hope was expressed that, by the attention called to the matter, the public would recognise the faults which are embraced by those who are implicated in the continuance of such a pernicious system. POST-GRADUATE LECTURES.

The committee of the Medical Institute have invited the members of theprofession to attend a course of four lectures given by Mr. Bennett May, the subjects being the Hygiene of the Bladder, Inflammation in the Right Iliac Fossa, and two lectures on Diseases of the Rectum. The known ability of the lecturer and the practical nature of the subjects ought to command a good audience. It is to be feared that there has not been a due appreciation of the advantages offered, or the attendance would have been larger than it has been at the lectures already delivered. There is hardly enough excitement in the ordinary acquisition of knowledge to ensure an audience, and in the present day of work and routine the sensation afforded by sound devotion to teaching does not appear to draw sufficiently to command the success deserved. THEFTS AT 1IrASON COLLEGE.

It is a matter of deep regret that a medical student was sentenced to a month’s imprisonment on Monday last for stealing a pair of opera-glasses from the College, the property of the secretary. For some time past various things had been lost, and a detective being employed to watch, the delinquent was caught in the act. The offence was