THE SCHOOL BOARD FOR LONDON AND LECTURES ON HEALTH.

770 but it does not contain psoricum, but white pepper, Sicilian saffron, myrrh, amidon, opium, and Judean balm ; perhaps he extended this recipe as a substitute for diapsoricum. Capitaine Esperandieu in his essays upon oculist seals has fully discussed the question of psoricum, concluding that it consisted of cupric oxide and was especially used as a" remedy for a condition termed "scabrites oculorum." It is also recommended for 6’ claritas"(clearing the vision) and for defective vision. It will be noted that the difficulties of the subject are not diminished by the Rugles seal, because it places diapsoricum among the various delacrimatoria which appear to have possessed a double virtue, in some cases being used to provoke tears, and in others to stanch them, these latter being cases of epiphora or lacrimatio. As to whether, on the Rugles seal, diapsoricum was

collyrium

or to diminish, lacrimatio, we know not. the first time that it has been found suggested for such purpose instead of the usually recommended myrrh or balm.

to It

produce, is

THE

PROGRESS

OF LUNACY IN

ENGLAND

AND WALES. IN the fifty-seventh report of the Commissioners in Lunacy it is stated that there were in England and Wales on Jan. 1st, 1903, 113,964 notified lunatics, being 3251 in This excess of the number on the same day in 1902. increase for 1902 contrasts with one of 2769 for 1901 and 1333 for 1900. The average annual increase in the number of lunatics under official cognisance for the five years ending Dec. 31st, 1902, was 2398. Thus the increase in the year 1902 exceeded the annual average increase in the preceding five years by 853. The last returns show an increase in the county and borough asylums of 3749 patients over the number for Jan. lst, 1902, in registered hospitals of 27, in Broadmoor Asylum of 73, in the metropolitan district " asylums of 62, and an increase of 22 patients in ’’ single care. On the other hand, the returns show a diminution of 291 in those detained in the metropolitan licensed houses, of 177 in the provincial licensed houses, of 24 in naval and military hospitals, of 140 in ordinary workhouses, and of 50 in the number of outdoor paupers. The pauper patients males and have increased in the 56,692 females) (47,102 in and county borough asylums by 3628, registered hospitals by 3, and in the metropolitan district asylums by 62 ; but against these must be set a decrease of 388 in metropolitan and provincial licensed houses, 140 in ordinary workhouses, and of 50 among outdoor paupers. The decrease in the number of these patients in licensed houses was mainly due to the opening of the London County Asylum at Horton and the transfer to it of patients from those houses. As regards the ratio of the insane to the population the Commissioners point out that the aggregate of lunatics under official cognisance on Jan. lst, 1903, gives a ratio of one to every 293 persons of the general population of England and Wales. The rate of increase of the insane in proportion to the general population is shown in Table II. of the report. Thus in 1879 the ratio of lunatics to the general population was 1 to 363, in 1889 it was 1 to 337, and in 1899 it was 1 to 303. The proportion has continued to increase steadily ever since and it now amounts to 1 in 293. Excluding from consideration the idiot establishments, which show but little variation in admissions, recoveries, and deathrates, it is found that in all other institutions the admissions during the past decade have risen from 17,823 in the year 1893 to 22,851 in the year 1902. The total number of patients discharged as’’ recovered"were 10 2 per cent. of the average number resident in 1893 and 9’03 per The deaths, which in 1893 amounted to cent. in 1902. 6609, or 9’ 86 per cent. of the average number resident, rose

1902, or 10’55 per cent. of the average number resident. At any period and in any year of the series the recovery rate has been higher among females than among male patients, while per contra the death-rate of females The has been invariably higher than that of males. disorder are in the of mental factors production etiological often complex and difficult to classify and the figures given " have only a relative value. 11 Previous attacks of insanity of males and were stated to have occurred in 16’ 2 per cent. five years of females the admitted cent. 23’1per during 1897 to 1901, whilst "heredity"was ascertained in 18’8per cent. of males and 24’6per cent. of females. Alcoholic intemperance was assigned as the cause of insanity in 23’11 per cent. of males and 9’ 6 per cent. of females. There are about 12 per cent. of the inmates of asylums suffering from epilepsy, this being the average met with in the visits of the Commissioners. The proportion of male epileptics exceeds that of females to a marked extentabout 30 per cent. The male general paralytics admitted, however, outnumber the females in the proportion of about Thus during the five years 1897 to 1901 one to four or five. the average annual number of general paralytics admitted to all institutions was 1307, comprising 1069 males and 238 females. Of the total number of persons admitted to institutions for the insane"nearly 25 per cent. are," says the report,"known to be suicidally disposed....... This large proportion of suicidal patients contrasts with the comparatively small number of deaths from suicide of patients under care, and the contrast is a striking commentary upon the necessity of supervision and the admirable manner in which it is universally carried out." The weighty statistics collected by the Commissioners serve to illustrate several points of importance. The falling recovery rate during the past quarter of a century, the slightly enhanced deathrate, and the steady growth and increase of the insane at a rate faster than the growth of the general population are matters which must engage the thoughtful attention of the medical profession, of legislators, and of public authorities. to 9266 in

THE

SCHOOL BOARD FOR LONDON AND LECTURES ON HEALTH.

WE have from time to time expressed our views that the School Board for London was in the habit of teaching a great many more subjects than could reasonably be included under the heading of elementary education, but for what must be among the last official acts of the Board we have nothing but praise. The evening continuation schools committee has sanctioned the opening by Dr. R. J. Collie of 20 experimental classes on health. Dr. Collie has been for some years medical superintendent of the ambulance and home-nursing classes of the Board and he has been struck with the importance of teaching the poorer section of the population such things as the value of fresh air, the importance of a cheap and nutritious diet, and the gain of living in "physiological righteousness." The classes are to be held in different districts of London and the lecturers will be recognised medical men. From the syllabus of the lectures which Dr. Collie has forwarded to us we see with pleasure that the lectures are to be made as practical as possible and are to be illustrated by experiments. The subjects will be the hygiene of the house, air and ventilation, clothing, the prevention of consumption, exercise of

personal hygiene, food and water, the prevention of the spread of infection, the care of infancy, ill-health and dress in women, and cooking. No one who has not worked among the poor can form any idea of the excessive ignorance which exists among them regarding the feeding of infants and children, the cooking of food, and the necessity for ventilation. The wife of the average working man has no idea of cooking food as a rule. She simply "does it." She does not

771 I

know how to prevent the spread of infectious disease and in such a common complaint as measles she considers that her child is perfectly able to go out as soon as the rash has disappeared, a proceeding which of course in many cases leads to pneumonia. We are quite aware that it is exceedingly difficult for those living in the heart of a great city to obtain adequate house room for facilities for practising hygiene, but even those who live under the worst possible conditions could do something more than they do in practice to live a less unhealthy life thai5;.is the custom. We therefore hope that Dr. Collie’s lectures will meet with

practical

success. --

AN

EDEN.

ADAMLESS

female deaths in The bulletin of the health department for the week ended August 22nd, which has just been issued by Dr. Arthur R. Reynolds, commissioner of health of the city, shows that there were 483 deaths reported, which is exactly the same number as for the previous week. Of these, 291 were males and 192 were females, an excess of 50 per cent. of male deaths. " In 1901 this excess was 23’4 per cent. ; in 1902 it was 29’5 5 per cent. ; during the first six months this year it was 37’4 per cent., and now 50 per cent. more males than females are dying. In another 20 years-Place aux dames!" These are Dr. Reynolds’s words and undoubtedly they will seem to be justified if the present position is maintained or aggravated in subsequent bills of mortality. THE

increasing

excess

Chicago is becoming

THE

a

of male

matter of

DISTRIBUTION

over

some

OF

importance.

weeks before the date appointed for the opening of the congress. At the meetings the authors of the papers will be requested by the president to state the conclusion of their respective papers in a few words and the discussion will then commence. Members present who are interested in the subject of the paper will, of course, have had the opportunity of reading the paper before the opening of the The discussions will be printed and published congress. at the close of the congress and possibly papers received too late to be printed before the opening of the congress will also be discussed and printed with the discussions. Only one subject will be officially discussed by the congress-namely, the Question of Indemnity as Regards the Value of an Eye Lost or Injured. Upon this matter Professor Axenfeld of Freiburg, Dr. Sulzer of Paris, and Dr. Wurdemann of Milwaukee have been requested to draw up a report. The afternoons of the congress sittings will be devoted to practical demonstrations. The congress will be held on Sept. 19th, 20th, and 21st, 1904. The president is Professor Dufour, the vice-president Professor Pfliiger, the secretary and treasurer Professor Mellinger, and the honorary president Professor Snellen of Utrecht, who was president Another honorary president is Dr. of the last congress. Deucher, the President of the Swiss Confederation. Further information can be obtained from the correspondents for the United Kingdom : Mr. W. H. H. Jessop, 73, Harley-street, London; Dr. George Mackay, 20, Drumsbeugh-gardens, Edinburgh ; and Mr. H. R. Swanzy, 23, Merrion-square, Dublin. ____

ON TOBACCO-ALCOHOL AMBLYOPIA.

PLAGUE.

IN recent years the pathogenesis of the toxic amblyopias in and particularly the alterations which are produced in the ganglion cells of the retina by the action of methyl alcohol, quinine, and filix mas have attracted much attention. Accounts of some of these researches have been from time to time published in these columns during the past two years.1 In the American Journal of the Medical Sciences for August Professor G. E. de Schweinitz and Dr. D. L. Edsall, both of Philadelphia, contribute an interesting account of seven cases of toxic amblyopia which were studied with the special object of determining the nature of the toxic changes directly or indirectly set up by alcohol, tobacco, or other toxic agent. Writing in 1900, Professor Schweinitz said : " It is quite possible that nicotine, or one or more of the many principles present in tobacco smoke, liberates some toxic influence in the system which must be held accountable for the disease, which, in other words, " depends upon a species of auto-intoxication." Sachs maintained that even in pure cases of tobacco amblyopia certain chemical derangements occur first in the stomach with a resulting transformation of the normal gastric acids into acids of the fatty series. These acids having combined with the nicotine and other injurious substances of tobacco, the product acted far more deleteriously than the simple tobacco derivatives (bases) themselves, constituting in themselves the toxins which produced amblyopia. In order to ascertain the presence or otherwise of such toxins in patients the urines of seven persons sufEering from tobacco-alcohol amblyopia were submitted to thorough analysis for varying periods of time. The results obtained indicated that alcohol and tobacco acted not merely in a direct fashion on the retina but that they also produced gastric changes whence arise secondary toxic products, the action of which The following two cases are was still more deleterious. cited as typical ones. The first patient was a male, aged 46 years, by occupation a negative retoucher. He applied for

report of the medical officer of health of Cape Colony for the week ending August 15th states that no case of plague was discovered throughout the colony during the week in question. Dead rats, however, were found at East London and at Queenstown. As regards the Mauritius, a telegram from the Governor received at the Colonial Office on Sept. 4th states that for the week ending Sept. 3rd there were 28 cases of bubonic plague and 25 deaths from the disease. With regard to Australia, our correspondent states that no cases of plague have been reported from any of the States during July. The Brisbane Board of Health has declared the ports of Brisbane and Fremantle free from plague from August 8th. In Sydney occasional rats caught are found to be plague-infected and the work of rat destruction is conducted vigorously. Our correspondent in Constantinople reports that limited outbreaks of plague have occurred near the Turco-Persian frontier and in the Lebanon. THE

general,

____

THE

INTERNATIONAL CONGRESS OF OPHTHALMOLOGY.

THE International Congress of Ophthalmology, which is held every five years, is to meet in 1904 in Lucerne. From an official circular which we have received the authorities of the congress appear to have taken a new departure in their arrangements and to have decided upon a course of action which seems to us to be worthy of imitation at other Nopapers are to be congresses of a like nature. read, for, as the committee very rightly says, papers are much more easily understood by being read in the scientific journals and the multiplicity of papers which are sent in to a congress almost entirely precludes discussion. Any member, therefore, who wishes to contribute a paper is requested to send it with the admittance fee before May lst, 1904, to Professor Mellinger of Basle. The paper must be written in one of the four official languages, French, German, or Italian. The papers will be printed and grouped according to their subjects and this printed report will be sent to each member with his admission card at least

English,

l 1901, p. 93),

I

two

1 Blindness due to Drinking and Production of

March 29th, 1902,

p. 911).

Bay Rum (THE LANCET, July 13th, Amblyopia by Alcohol (THE LANCET,