1210 -’"
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Tarn Severin. It is a lapidary inscription which, " with obtain a legal remedy for the neglect of the Liverpool all reserve," may be approximately translated thus: "To authorities to carry out their statutory obligations. the divine shades Marcus Valerius Longinus (son of Marcus), Complaints were made to the corporation and the physician of the VII. Claudian Legion, adorned with the town clerk promised that steps would be taken to give Senatorial ornaments of the illustrious order of the Hadrian a sufficient supply of water and the corporation pumped water to the high-level tank during the night as well as municipality of Drubetis, lived 23 years." during the day, so that a certain amount of water was supplied to the club cistern during the night. During the THE PREVALENCE OF GERMAN MEASLES. daytime, however, when water was taken in any quantity in IT is well to remember that there is a good deal of this the lower part of the town the amount of water obtainable disease abroad. Sometimes it is taken for a second attack at the club was insufficient for domestic use. In support of measles. We have seen lately the rapid succession of the of this statement the secretary, the manager, and the two complaints within six weeks’ time. In such instances chairman of the club gave evidence and the presiding the disease is more likely to be narrowly examined and a magistrate, after hearing witnesses for the defence, said mistake in diagnosis to be avoided. In other cases the that the bench were satisfied that the supply of water diagnosis is not quite so easy. At one time the exist- was insufficient. On behalf of the Liverpool corporation ence of scarlet fever is apt to be assumed and the it was pleaded in the course of the ttial that, in the patient possibly is sent to a hospital as so affected. first place, the conviction was not good because the water In doubtful cases a little time and care will be well rent had not been paid at the date from which the fine was spent before deciding on the non-existence of true measles imposed. In the second place, it was pleaded that the LiverAfter all, the differentiation can pool corporation could not with their present woiks and or of scarlet fever. be made, though we have in exceptional cases to apparatus supply water at sufficient pressure and that they generally wait for the evidence of the more decided desquamation could not increase their works without Parliamentary of scarlet fever. The absence of severe coryza and of authority. It was urged, moreover, that if the contentions of high temperature, plus the different nature of the rash the club were correct the corporation would be compelled to and the enlarged glands behind [the sterno-mastoid, will erect new works from time to time to supply high buildings it generally guide the physician aright as between German such were erected. On the application of the counsel for the and ordinary measles, as the absence of serious sore-throat Liverpool corporation the magistrates agreed to state a case The for the higher courts. The matter, therefore, which is of and pyrexia will help him to exclude scarlet fever. incubation stage seems longer than that of measles and of some importance, has not been finally settled, and we awai course much longer than that of scarlet fever. According the result with interest. to the report of the committee of the Clinical Society of London the interval between the exposure to infection and TRAUMATIC RUPTURE OF THE INTESTINES. the appearance of the rash is generally nearly three weeks. THE number of cases of traumatic rupture of the intestine unassociated with wound of the abdominal parieteswhich THE LIVERPOOL CORPORATION AND THEIR have been submitted to operation with a successful result-is WATER CUSTOMERS. very small. The difficulties which surround the formation AN interesting appeal case was heard at the Liverpool of a diagnosis are many and varied. As, however, the County Quarter Sessions last week with regard to the patients invariably die when the rupture is not sutured Liverpool water-supply. The Liverpool corporation supplyand the abdomen properly cleansed it is of the utmost water not only to the city but to certain districts around and importance i that the profession should recognise the possiunder a section of the Corporation Act of 1866 they are bility of a rupture having resulted from an injury and bound to supply water at constant service at such a pressure take measures to obviate the fatal result which must otheras to reach the top storey of any house situated within the wise follow. We hope to give our readers fuller details of district supplied by them unless the service is inter- three cases in a future number of THE LANCET, merely rupted by drought or by frost. Some time ago an stating now their bare outlines. It is interesting to note inhabitant of Prescot, which is in the district supplied that the three cases were all subjected to operation at by the corporation, commenced an action at the Prescot one of our hospitals, St. Thomas’s, where the fi.at police-court to compel the corporation to carry out their successful intestinal suture in London for similar injury statutory duties. The case was taken to the Divisional was performed by Mr. John Croft. About two months ago Court in London and was decided in favour of the com- Mr. Makins was called to see a man who had been run plainant. After this decision the members of the Conserva- over a few hours before. At the operation an oblique tear tive Club of Prescot were encouraged to bring an action to of the ascending colon was found. This was sutured, the compel the Liverpool corporation to give their premises a peritoneum was cleansed, and the man made a good recovery. constant supply of water which had previously been with- The second case was that of a man, aged twenty-seven years, held. From the report before us it appears that the club who had been run over when intoxicated and had been refused was supplied from a high-level tank and until nearly the end admission to another hospital. This patient was operated of last year water was only obtained at the club on by Mr. Battle twenty-one hours after the injury. A between six o’clock in the morning and six o’clock in the tear in the small intestine twelve inches from the ileoevening. At a previous period the water was supplied by cæcal valve was sutured and the peritoneum was cleansed, gravitation from the reservoirs and the pressure was but with some difficulty. The patient’s condition was only sufficient to supply the first and second floors of the very serious. We are pleased, however, to learn that club during the day. The deficient water-supply caused con- there is a good prospect of recovery. The operation was siderable inconvenience, because the bar, lavatory, and baths performed on April 5th. Only last Sunday, April 24th, had not a constant supply. In the year 1896 two cisterns Mr. Pitts was called to see a man who had received a kick had been placed in the upper storey for the storage of water. in the abdomen from a horse. He operated and sutured an These cisterns were not supplied during the night. The opening which was found high up in the small intestine. members of the club had suffered from this state of things The patient has progressed extremely well. There can be for a considerable time but the decision in the case which no doubt that early operation is indicated in ’these cases, has just been referred to determined them to try toÞ for the sooner the opening in the bowel is closed the less ___
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1211 extensive will be the infection of the peritoneum and the less will be the risk of septic peritonitis which is so enuch to be dreaded. -
THE HEALTH OF MR. GLADSTONE.
resignation
I
of the omoes he held at King’s College and The date is fixed for Jane 4th and Lord Lister will preside. Dr. John Phillips is acting
King’s College Hospital. as
secretary.
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THE British Institute of Preventive Medicine has now WE are sorry to learn on good authority that Mr. Gladnotified a change of address. After May lst, 1898, formally stone is manifestly weaker, though this is not due so much to communications should be made to Grosvenor-road, London, any obvious progress of disease as from a general failure of instead of to 101, Great Russell-street, London, W.C. S.W., power. He retains, however, a fair amount of strength, while the appetite is satisfactory, and the pulse, though variable, is at times good. We are very glad to state that though the illustrious patient is not free from intermittent REPORT OF THE ROYAL COMMISSION ON dashes of pain, these do not now appear to be of a very TUBERCULOSIS. severe character. -
IRISH OPPOSITION TO THE LONDON UNIVERSITY BILL.
I
I.-MILK. FEw subjects have been more considered by Royal ComOPPOSITION to the London University Bill is brewing frommissions and other committees than that of bovine tubera somewhat unexpected quarter. The Daily Nation (Dublin) Iculosis. In 1888 the subject had already attracted so on Tuesday last devoted its first leading article to a]much attention that it was added to the work of the passionate appeal to Irish representatives to unite in Departmental Committee appointed to inquire into pleurostrenuously opposing the passage of the University ofpneumonia. The contagious nature of the disease was not London Commission Bill " until and unless adequateInearly so clearly recognised at that time as it is to-day and measures are forthcoming that the Government will takealthough the recommendations of the committee were strong steps to remedy the gross inequality of treatment between no decided action followed them, as there was not sufficient the two kingdoms." It is averred that the measure in evidence to prove that such action would be acceptable to question is to be pressed forward by the Government as stock-owners. During the next year or two, owing to the soon as the Irish Local Government Bill has passed stringency of some medical officers of health in condemning through Committee; and that if passed it "will give to for the purpose of food animals which after slaughter England an additional university almost precisely similar in showed traces of the disease, the butchers, on whom the loss character to that for which Catholic Ireland has appealed from these seizures fell, agitated for the appointment of a un vain." Now we do not complain of Ireland’s desire to Royal Commission to consider the question. This Royal have a Roman Catholic teaching university established in a Commission was appointed in 1890 to inquire into the effect country where so much of the higher education is carried of food derived from tuberculous animals on human health, the report, delayed in consequence of the necessity on by Roman Catholics, but surely it is rather absurd to and out experiments to gain accurate informaof speak of the reconstitution of the University of London as a tioncarrying The conclusion on the point, was presented in 1895. measure which runs parallel to the foundation of a Roman of that report, shortly, was that an appreciable part of the Catholic university for Ireland. We fear that our Irish tuberculosis which affects man is obtained through his food, friends are not well posted in the history of the movement chiefly from milk containing tuberculous matter. At the to secure a teaching university for London, of which the same time the Commissioners stated that "provided every tuberculous matter be avoided and present Bill is the outcome ; and we trust that they will part that is thea seat of deal of meat from animals affected destroyed ...... great think twice before quoting this reform in the facilities for with tuberculosis may be eaten without risk to the !higher education in the metropolis as another "injustice to consumer." Very valuable as that report was it did not Ireland." Indeed, if the views expressed by the Daily touch on the administrative procedures available for reducing .Nation are accepted then the fact of the passage of this Bill the amount of tuberculous material in the food supplied by should prove a powerful argument in support of their par- animals to man, and as that was the point with regard to which the butchers were most interested the matter was not ticailar demand. allowed to rest. During the time that the Royal Commission had been sitting knowledge of the disease had been greatly SIR WILLIAM BROADBENT is announced to take the chair extended. The stringent measures with regard to the at,the annual meeting of the Medical Mission (Auxiliary to seizure of tuberculous carcasses in countries such ai the Church Missionary Society), which will be held at Germany, France, and Belgium had been greatly relaxed, Exeter Hall on Thursday next, May 5th, at 7.30 P.M. Among and through the discovery of the value of tuberculin as a the speakers will be Mr. A. Neve, medical missionary in means for diagnosing the disease in cattle it was thought that an important agent for eliminating the disease lay ready to Kashmir; Dr. Herbert Lankester, physician to the Church hand. The time was therefore ripe for the reconsideration Missionary Society; and the Rev. J. C. Hoare, M.A., of the subject and in July, 1896, the present Commission missionary in China. There are a few reserved seats, which has just reported was appointed to inquire into the tickets ls. each, but other tickets are free on application administrative procedures for controlling danger to man to the secretary, Medical Committee, Church Missionary through the use as food of the meat and milk of tuberculous animals. All the seven members of the Commission sign the House, Salisbury-square, E.C. report, but a memorandum on the subject of compensation to owners of condemned carcasses is added by three of t’1em, THE annual dinner of the Indian Medical Service will take including the chairman, Sir Herbert Maxwell. We think that the conclusions at which the Commissioners place at the Cafe Monico on Thursday, June 9th, at 7.45 P.M. have arrived will commend themselves to the medical proSurgeon-General Sir Joseph Fayrer, Bart., K.C.S.L, F.R S., fession and the general public. The members have evidently M.D., will preside. It is particularly requested that officers availed themselves of the powers allowed to Royal Comintending to be present will intimate their intention at the missions to gain first hand information on the subject of their earliest possible date to the honorary secretary, Mr. P. J. inquiry by visiting Belgium, Germany and Denmark, where ’ the administrative measures have been worked out much Freyer, 46, Harley-street, W. more fully than has been the case in this country. In addition to the 55 witnesses whom they summoned before SOME of the friends and colleagues of Dr. W. S. Play fair them, consisting principally of medical officers of health, h&ve arranged to give him a complimentary dinner on his sanitary inspectors, butchers, and dairy farmers, they visited -