377 Week. METEOROLOGICAL READINGS. Medical Diary for the ensuing (Taken daily at 5.30 a.m. by Stezaard’s Instruntents.) Monday, March 6. THE LANCET OFFICE, March 2nd, 1882. ROYAL WESTMINSTER OPHTHALMIC HOSPITAL.—Operations, 1½ P.M. each day, and at the same hour. ROYAL COLLEGE OF SURGEONS OF ENGLAND.—4 P.M. Professor Flower, " Anatomy, Physiology, and Zoology of the Edentata." ROYAL INSTITUTION.-5 P.M. General Monthly Meeting. MEDICAL SOCIETY OF LONDON.-8 P.M General Meeting.—Ballot for Officers and Council.-Dr. Hughtings-Jackson, " On a Case of Cortical Tumour of the Brain, with convulsive seizures beginning in the right foot."-Dr. Sansom, " On a Case of Hodgkin’s Disease." Tuesday, March 7. ChrY’s HOSPITAL.-Operations, 1½ P.M., and on Friday at the same horn WESTMINSTER HOSPITAL.-Operations, 2 P.M. WEST LONDON HOSPITAL.-Operations. 3 P.M. ROYAL INSTITUTION.—3 P.M. Professor John G. M’Kendrick. "On the Mechanism of the Senses." - PATHOLOGICAL SOCIETY OF LoNDON.-8.30 P.M. The following specimens will be shown :-Anomalous Nerve-disorder in Infancy (living spe- cimen) ; Multiple Osteochondromata (living specimen); Congenital Notes, comments, and Answers to Dislocation of the Hip ; Spinal Caries in early stage ; Fracture of Short Condyle of Femur (card) ; Radically cured Inguinal Hernia; Congenital Hypertrophy of Toes (card) ; Sarcoma of Epididymis ; Double Displacement of Tibia (living specimen); Sequ-strum in Correspondents. Head of Femur; Intestinal Obstruction in a Marmoset; Carcino- matous Stricture of Œsophagus (card); Case of Alopecia ; Three Cases of Alopecia areata in one family ; Microscopical Preparations Ct is that local events of Alopecia areata. especially requested early intelligence of a medical or which it is desirable to March 8. having interest, bring Wednesday, under the notice the be sent direct to MIDDLESEX HOSPITAL.-Operations, 1 P.M. of profession, may ST. BARTHOLOMEW’S HOSPITAL. - Operations, 1½ P.M., and on Saturday this Office. at the same hour. Letters, whether intended publication or ST. THOMAS’S HOSPITAL. - and on Saturday at tht for private informa- Operations, 1½ P.M., must be authenticated names same hour. tion, by the and addresses of ST. MARY’S HOSPITAL.—Operations, 1½ P.M. their writers, not necessarily for puhlication. J.oNDON HOSPITAL.—Operations, 2 P.M., and on Thursday and Saturday We cannot prescribe, or recommend at the same hour. practitioners. GREAT NORTHERN HOSPITAL.-Operations, 2 P.M. Local papers containing reports or nems-parag’raphs should UNIVERSITY COLLEGE HOSPITAL. —Operations. 2 p.M.. and on Saturday be marked. at the same hour.-Skin and on at Department.-1.45 P.M., Saturday and should be writtea on 9.15 A.M. Lectures, original articles, reports ROYAL COLLEGE OF SURGEONS OF ENGLAND. -4 P.M. Professor one side only of the paper. Flower, "Anatomy, Physiology, and Zoology of the Edentata." All correrrmunieations relating to the editorial business of the ROYAL COLLEGE OF PHYSICIANS OF LONDON.-5 P.M. Gulstonian rnust be addressed " To the Editor." Lectures: Mr. W. Ewart, ’,On Pulmonary Cavities-their Origin, journal Growth, and Repair." Letters relating to the publication, sale, and advertising HUNTERIAN SOCIETY.-7.30 P.M. Council Meeting.-8 P.M. Dr. Bedford depxrtments of THE LANCET to be addressed " To the Fenwick, "On Venesection in Cardiac Disease." Publisher." ROYAL MICROSCOPICAL SOCIETY.-8 P.M. General Meeting. - March 9. Thursday, SANITARY STAT E OF DAVOS PLATZ. ST. GEORGE’S HOSPITAL.—Operations, 1 P.M. ST. BARTHOLOMEW’S HOSPITAL.-1; P.M. Surgloat Consultations. WE have received from Dr. Beeli, of Davos, a communication, too long CHARING-CROSS HOSPITAL.-Operations, 2 P.M. for insertion entire, in which he controverts the statements put forth NORTH-WEST LONDON HOSPITAL.-Operations, 2! P.M. Mr. on the detects of this famous ROYAL INSTITUTION.-3 P.M. Dr. P. L. Sclater, "On Geographical Dis- by Symonds sanitary health-resort, tribution of Animals." and commented on in an annotation which appeared in our issue of OPHTHALMOLOGICAL SOCIETY OF THE UNITED KINGDOM.—8½ P.M. January 21st last. Dr. Beeli says :- Dr. Walter Edmunas, "On a Case of Suppurative Ophthalmicis " " Since fourteen houses have in and after Ligature of Common Carotid."—Mr. Lawturd, On an Unusual 1877 only been built Davos-Platz Case of Gunshot Injury of the Eye."—Mr. Waren Tay : (1) " Oa a its vicinity. Eleven of them are small villas and private houses ; one is Case of Optic Neuritis after Concussion of the Brain;" (2) "On a the parish school and two are hotels, containing about thirty-five- Case showing Condition three years after Optic Neuritis from rooms each. In process of construction are two small private houses, to the Head."-Dr. "On a Case of Injury Sidney C.)upland, Optic a deaconess’ house for the reception of very weakly patients and a Neuritis Contusion of the Brain."-Mr. " On a following McHardy, villa for Mr. himself. Besides the Case of Extensive Retinitis following Injury to the Head."—Mr. Symonds buildings above mentioned, we must not an of the but it consists Fitzgerald (Duolin), " On a Case of Detective Vision ina Seaman."- forget enlargement kurhaus; Dr. Brailey—microscopical specimens: (1) From a Case of R-tinal entirely of well-ventilated public-rooms, no addition with a view to ac- Detachment simulating Sarcoma of Choroid; (2) (For Mr. Mason, commodating more visitors having entered into the plan. Many house- of Bath) From a Case of Sclero.comeal Tumour.—Mr. Snell holders have increased the number of their balconies and widened their " On a Case of in (SheB&eId), Sympathetic Ophthalmitis setting terraces and verandahs.... The piece of high way that serves the after Excision."-8 P.M. Mr. "On a Cdse of Nettleship, Atrophy of visitors as a and which in in Optic Disc after Orbital Erysipelas (living specimen). promenade, consequence (particularly ABERNETHIAN SOCIETY (St. Bartholomew’s Hospital).—Mr. Griffith, winter) is kept in first-rate order by the so-called ’kurverein, is at least " On the Diagnosis of Syphilis." two and a half kilometres (roughly speaking, one and three-quarters in Ou tha side of this stretch of road four March 10. English miles) length. sunny Friday, houses only have been built since 1877, a length of seventy ST. GEORGE’S P.M. representing HOSPITAL.—Ophthalmic uperations, 1¼ metres-about English yards. As the cloud of smoke, ST. THOMAS’S HOSPITAL.—Ophthalmic Operations, 2 P.M. eighty regards now over the facts are as KING’S COLLEGE HOSPITAL -Ooaratinna. 12 P.M. supposed to hover constantly the valley, ROYAL COLLEGE OF SURGEONS OF ENGLAND. -4 P.M. Professor follows. On cold, calm days the smoke (proceeding almost exclusively Flower, "Anatomy, Physiology, and Zoology of the Edentata." from wood fires) is retained by the freezing air at a certain height ROYAL COLLEGE OF PHYSICIANS OF LONDON.-5 P.M. Gulstonian above the roofs of the houses and disperses slowly after the lapse of Lectures: Mr. W. "On Cavities." Efart, Pulmonary several hours. This was, however, the case in 1877 as it is to-day, and ROYAL INSTITUTION.-8 P.M. Mr. J. W. Swan. "On Electric Lighting." the phenomenon is due to the remarkable stillness of the air, one of CLINICAL SOCIETY OF LONDON.—Mr. G. Lawson, "On a Case of Chimney Sweep’s Cancer of the Axilla treated by Excision of the the chief factors of our climate. The snow supplies us with a proof of Growth, Ligature of Axillary Artery, and Amputation at Shoulder- the purity of the air, for when weeks elapse without the recurrence of joint."-Mr. H. Marsh, " On a C"se of Aneurism of Axillary Artery, any fresh fall, it might be expectad to lose something of its pristine Ligature of Subclavian, Rupture of the Sac, Amputation at Shoulder- whiteness, but Mr. Symonds himself declares that " the snow-dress of the to be -Dr. " On a Case joint ; recovery " (patient shown) Mahomed, valley glitters with pure crystals." ... The sanitary arrangements of under treatment" to be Myxcedema improving (patient shown).- are good in all the hotels of Divos-PIatz. A general system of drainage Mr. Howard, " On a Case of Removal of the Hyper- Warrington for the whole of Davos and a complete canalisation of the Landwasser trophied Spleen."—The following living specimens will be ex- hibited:-A Case of Radical Cure of Congenital Hernia in the Adult, are already determined upon, and the work will be commenced as by Mr. C. H. Golding Bird; a Case of Cured Spina Bifida, by Mr. soon as the subvention, to which the Federal Government is pledged, Pearce Gould; Two Casesof Universal Ichthyosisin Adult Females, has been granted. As regards the social gatherings in Davos, most by Dr. B. 0. Connor. visitors complain of their paucity. Social entertainments cannot be Saturday, March 11 entirely dispensed with, because many healthy persons come to Davos ROYAL FREE HOSPITAL.—Operations. 2 p.t as companions to the invalids and rebel against medical discipline. ROYAL INSTITUTION.-3 P.M. Mr. W. Watkiss Lloyd, "On the Iliad Doctors and hotel proprietors have always exerted themselves to and Odyssey." prevent the invalids from taking part in the amusements." 378

AN UNUSUAL CASE OF STONE. DEATH UNDER CHLOROFORM. MR. W. H. MACDONALD, member of the resident staff of the Toronto To the -Editor of THE LANCET. General Hospital, reports in the Canadian Journal of Medical Science SIR,-On Jan. 24th a man about fifty years of age came to me suffering a rare case of calculus under the care of Mr. to the McFarlane, surgeon from a subcoracoid dislocation at the shoulder-joint of about twenty- hospital. The patient, a lad aged nineteen, went into hospital in a four hours’ standing. Failing to reduce this by the ordinary methods, I low, emaciated condition, the only history obtainable being that he suggested that he should take chloroform, and to this he assented. He had been suffering for six or seven years. A hard, brawny, red and had inhaled about two drachms, and I had taken the handkerchief away from his his while tumid condition of the perineum was found ; and a little to the left of face in order to place a rug beneath feet ; doing this he raised his black in the and died. I the median line, about an inch in front of the anus, a small urinary suddenly body, got face, kept up artificial respiration for about an hour, but it was of no avail. On post. fistula was seen to open. Catheterism was impracticable. An incision mortem examination the heart was found in a state of fatty degenera. was made the centre of the and the knife struck through swelling, tion, and the other organs extensively diseased. The jury attached no a stone. it was found a upon On introducing the finger, that large blame to the medical man, but several of them were of opinion that the calcareous mass occupied the whole space between the pubic arch and custom adopted by medical men of giving chloroform alone was to be the rectum. In view of its size and the low condition of the patient, deprecated. Whether the medical profession will adopt this advice is no attempt was then made to remove it. Per rectum a stony mass questionable. If medical men were to take their advice chloroform would seldom be used in and children in convulsions would withm the bladder could be detected. Urine dribbled away freely midwifery, continue convulsed until a second medical man could come and be a enough, and no urasmic nervous symptoms were presented; but the looker on. I am, yours, &c., succumbed to diarrhoea and asthenia. At the Sir, boy shortly necropsy Gloucester Hause, Malvern, Wells, PERCY HAYNES. the left kidney was found to be represented by a small mass of fat and Feb. 7th, 1882. fibrous connective tissue, reniform in outline, but devoid of kidney structure, with a shrunken and impervious ureter. The right kidney Q. G.-The practitioner in the circumstances of B. is under a very strong was a large purulent sac, with little renal structure remaining. The obligation to refuse to take charge of A.’s patients. We are not bladder was thickened and contracted, closely enveloping a phosphatic prepared to say that there are no considerations which would justify stone, half an ounce in weight. The lower bladder wall was defective, B. in allowing his refusal to be overcome; but they would have so that the calculus it contained articulated by a facetted surface with to be of unusual force and of rare occurrence. The freedom of the the extra-vesical calcareous mass which occupied all the space beneath patient has of course to be considered, but between well-regulated the arch of the pubes, measuring two by two and a half by one and a practitioners a misunderstanding in such circumstances as those half inches, and weighing two ounces and a half. The urethra seemed detailed will be very uncommon and of short duration. to be obliterated at its pubic end, as nothing could be passed along it, Dr. Heywood Smith.—The paper has been received, and will appear in no connexion traced and between it and the bladder. an early number. is at most of the EFFECTS OF THE INGESTION OF CAMPHOR. Expectans.—Instruction given metropolitan hospitals -e.g., St. Bartholomew’s, University College, Guy’s, and King’s To the Editor of THE LANCET. College. SIR,—It is desirable to bring before your notice a case of some interest, rarity, and therapeutic importance. TREATMENT OF PLEURO-PNEUMONIA. S. L-, an omnibus conductor, felt extreme giddiness, became To the Editor of THE LANCET. unconscious, and fell off his’bus in Holloway, on Sunday, Feb. 26th, 1882. He recovered after a few hours, save his bruises. He is a SIR,-Whilst your communications from hospital and other physicians teetotaler, and never had a fit before, but for a cold he had eaten are usually exceedingly interesting and instructive so far as the dia- 80 to 100 grains or more (" two lumps each the size of the third of a gnosis and pathology of diseases are concerned, they are too often dis. finger") of camphor a short time previously to this occurrence. appointing as to the treatment followed or suggested. The interesting Most works on materia medica state that in doses of one drachm or case given by Dr. Sturges in your number of Feb. 18th is an illustra. more camphor has produced giddiness, sickness, muscular weakness, tion. It occupies over four columns, but a single line only is given to the coldness of extremities, loss of consciousness, and even death. It is a treatment. Are we to understand that a case of acute pleuro-pneumonia matter of surprise that these cases are so seldom known to occur, so severe as to produce complete consolidation of half a lung, with a camphor being in nearly every household. " bulky effusion of lymph and some ounces of fluid, complicated aftera I am, Sir, your obedient servant, few days with typhoid fever, was treated, especially during the six days Holloway, Feb. 27th, 1882. PHILIP COWEN, M.R.C.S. previous to the commencement of typhoid, simply by the " liberal administration of strong beef-tea and other nutrients" ? This is the TOLERANCE BY THE BRONCHUS OF NITRATE OF SILVER. natural inference from the context, but I have little doubt it would be it of his if To the Editor of THE LANCET. incorrect, and would add much to the value communication Dr. Sturges would kindly supplement it by the treatment actually Gibson’s recommendation of inhala- SIR,-Dr. (Newcastle-on-Tyne) adopted. I am, Sir, yours, &c., tions of nitrate of silver in the treatment of certain bronchial affections, WILLIAM S. CORTIS, M.D. me of some reminds experiments performed by Dr. Horace Green Kennington-park-road, S.E., Feb. 25th, 1882. (American Medical Monthly, Feb. 1860), with the view of testing the endurance of the bronchial mucous membrane. means of a catheter By Mr. R. Hickman.—The sentence can only be inserted as an advertise- he introduced into the bronchus of a half an ounce of a solution of dog ment. nitrate of silver of the strength of fifteen grains to the ounce of water. ’The dog did not appear to suffer from the operation, and continued well Mess1’s. -E. Chapman and Co.-The letter has not been preserved. The of one ounce next day. injection, however, of a solution of the same Iota.-It is not usual for Fellows of the College of Surgeons to put their salt, containing thirty grains to the ounce, killed the animal, but not at titles on their door-plate, or to hang their diplomas framed in the once. The first experiment shows that the bronchial mucous membrane Such a title is not a to be ashamed is not so delicate or sensitive as is usually supposed. This fact may yet consulting-room. certainly thing prove of service in practical therapeutics. of, but we admire the modesty which leaves it to be learnt from the I am, Sir, yours, &c., Medical Register or the Medical Directory. Feb. 1882. G. HUNTER M.D. Edinburgh, 27th, MACKENZIE, Cor. S.-We do not prescribe. The ordinary medical attendant should °‘ Beer in Workhouses."-We are not in the least degree surprised to find be consulted. a spirit of criticism-some of it a little uncourteous-called forth by our declaration in favour of the supply of beer to the aged and infirm in TOBACCO SMOKING: AN APPEAL. workhouses. We have nothing to add to our expressed opinions on To the Editor of THE LANCET. this The of our is a mature conviction subject. key-note judgment SIR,—I am a hard-worked lawyer, nearly sixty years of age, and till is to that wise moderation in the use of stimulants preferable absti- about two years ago have for many years previously been comforted by nence. We recognise the physiological need of stimulants (taken in resort to moderate smoking. But during the last two years this solace small quantities with food) in the case of debilitated subjects. has been denied to me, for if ever I smoke now (even a cigarette) it produces a few hours afterwards a complete disturbance of the liver, .E. W. has not enclosed his card. with all the attendant consequences of a bilious attack, and, as a result, Dr. B. Foster.-Next week. I am practically prohibited from availing myself of the enjoyment of "the fragrant weed," and am thereby deprived of an immense solace to Dr. J. W. Hunt.-In an number. early a worn and weary brain. Medical friends to whom I have applied afford Marsupial.—Apply to Silver and Co., Cornhill. me no practical help, and I have therefore determined to ask your per- mission to submit my difficulty to unknown friends (especially smokers) Medicus is thanked for his communication. It would be of little use to through the medium of your journal, and inquire whether I can take or such bare which are not novel. ’ publish particulars, altogether Apart do anything, and what, to render a quiet pipe innocuous. from some history of the epidemic and of the individual cases, the I am, Sir, yours, &c., value of the treatment could not be judged Feb. 25th, 1882. G. 379

SPLEXECTOMY. "SWISS EYAIIINATIONS." To the Editor of THE LANCET. To the Editor of THE LANCET. SIR,-—Mr. Herbert Collier’s article in your issue of February llth is a SIR,-There is in your last number a letter on the Swiss examinations valuable summary of the results of this operation, but I think that which I cannot allow to pass without a word of protestation, because be induced surgeons who carefully study his tables will find good reasons for people unacquainted with the real state of things might to believe that the on the most would declining-in the present immature state of our knowledge and expe- description is, whole, true, though I struck several evident Dr. Wise considers rience on the subject—to entirely agree with his assertion that the be, think, by exaggerations. that the standard of the Federal diploma is tolerably high ; the fact is operation is a "useless and deadly experiment." that there is perhaps no other country where so much has been done The early history of all great operations has always been a discourag- within the last few years to improve the rules on medical examinations, ing one, and more especially in the various branches of abdominal and we have now arrived at a point very nearly satisfactory to all except surgery, but the many and great difficulties have in all cases in (except those who present themselves as candidates without being sufficiently gastrostomy and splenectomy) been surmounted. May it not be possible, prepared. The examination lasts about six weeks, and consists of two a of even and by proper selection leucocythæmic cases, by the adoption parts-the first written and practical, the second oral. For the first of procedures, to render removal of the not improved surgical spleen part we are examined on pathological anatomy, medicine, surgery (in- but also at and for merely justifiable, satisfactory ? I, least, hope so, cluding bandaging), and obstetrics. We are also required to perform a the reasons. following post-mortem examination, two operations on the dead body, and to 1. Mr. Collier’s table of the leucooytheemic cases shows that fourteen report on a case of medical jurisprudence. The second (vivâ voce) of the sixteen patients operated on were in an advanced stage of the examination comprises topographical and pathological anatomy, de- disease, and were from thirty-seven to forty-nine years of age. If scription of surgical operations, materia medica and therapeutics, younger subjects in an early stage of the disease were selected the opera- hygiene, medical jurisprudence, medicine (including mental diseases tion would have a better chance of success. It is true that the probably and diseases of children), surgery, obstetrics, and ophthalmology. A two cases, also fatal, were young in a remaining subjects comparatively viva voce examination on diseases of the ear has, I believe, been added of the but is it to condemn an early stage malady; right operation which, since I took my Federal diploma in 1879. Most candidates in 1881 were with and offer the increasing knowledge improved methods, may only twenty-four to twenty-eight years old, and twenty-six per cent. failed to chance for these unfùnunate on the evidence of these two people, In that same obtained Federal cases ? pass. year thirty foreigners diplomas (medical and pharmaceutical). Formerly, possessors of foreign diplomas 2. The or rather that leucocy- physiological, pathological, argument were admitted to practise in Switzerland after a simple colloquium, the thaemia is a blood and that of the will be use- disease, extirpation spleen being an invasion of foreign quacks. Now must has to be and if there be truth in the view that the consequence foreigners less, yet proved, any submit to the general rules, but this change was only effected in order to is a of and a spleen great manufacturer white corpuscles, is, moreover, an and " check obvious dangerous abuse. foreigner who conforms sort of second heart its Every propeller-a (Dr. Roy)-driving " Brummagem to the general rules and possesses the necessary amount of is the diseased the liver to reach the heart- knowledge products (in state) through admitted without any difficulty, and due indulgence is shown to those which be as its of distribution-then, I say, there may regarded agent who speak the language imperfectly. In answer to the fourth paragraph is all the more reason means can be found to do for,its removal, provided of Dr. Wise’s letter, I will certainly not say that frauds are impossible so with some of success. Cancer was not since held to be a hope long in our examinations; on the contrary, I am quite willing to admit that blood but did not continue to and with a fair disease, surgeons operate, they are possible, and that they unhappily occur here and there, but amount of in cases taken And now the wind has veered success, early? they occur wherever examinations are passed, and not only in Switzer- round and the modern doctrine is that carcinoma is of local Will origin. land. They reflect discredit on those who practise them, and not on the the weathercock with reference to leu- " pathological similarly change examination. To say that they are more frequent or more winked at" cocytheemia ? in Switzerland than elsewhere is a pure misrepresentation, and my 3. The danger which appears to be special to the operation is h2emor- experience of examinations in Switzerland, Germany, and England does and this likens it in this to but it remains rhage, particular haemophilia; not tend to alter my conviction. to be shown that this is insurmountable. In some of the cases in danger I remain, Sir, yours obediently, the leucocythæmic table there is no mention of haemorrhage during the J. KAESER, M.D. Bale, M.R.C.S. Eng. operation, though this may have occurred; and in others the bleeding Queen Anne-stre et, W., Feb. 25th, 1882. was due to the slipping of a ligature. I can readily believe that adhe- sions may give trouble, as in ovariotomy, but I trust that the future will C. F. P.-The question should be addressed to the Secretary, Local show that if suitable cases be operated on adhesions will either not give Government Board, Whitehall, S.W. unconquerable trouble, or may even not exist. My personal as well as Jff. S. Palmer to the National Vaccine my indirect experience in ovarian, uterine, and other abdominal tumours W. (Camberwell).—Apply has convinced me that peritonitis, and therefore adhesions, almost never Establishment, Local Government Board, Whitehall, S.W. occur in small tumours which have not been to nor caused subjected Mr. A. More.—No. The hairs will grow unless their follicles are or irritation on therefore it is a most pressure neighbouring parts, likely destroyed. consequence that if these leuoocythaemio spleen tumours be operated on early, we need apprehend little inconvenience from adhesions. A would-be Student.-We cannot advise in the matter. At present there is a young Jew, aged twenty-four, in the London M. Guyot.-Thanks, our arrangements are in of the under the care of Dr. Mackenzie and At complete respect Hospital joint Stephen myself. matter. the proper time Dr. Mackenzie will doubtless give a complete medical history of the case; I wish, however, to state that I consider the case a Dr. Julius Althaus.—The paper is marked for insertion. fairly favourable one for the operation, because the disease is far from Mr. J. T. intended as a extreme, the patient is young, and because he will surely die if nothing Markley’s verses, protest against ordinary pigeon be done. Dr. Mackenzie and I have put the true state of the case shooting, and " addressed, in the interests of the Royal Society for the thoroughly before the patient and his relatives, and they all prefer to Prevention of Cruelty to Animals, to the fashionable ladies who elect that the operation be done. Should it be performed, I assume the patronise the heartless cruelty at Hendon, Hurlingham, and Monaco," and now comes Am I in responsibility, the grave question, justified are forcible and opportune, but scarcely suitable for our columns. committing the patient’s surgical suicide? The answer in casuistry seems to me to be and it is this. The desires the plain, patient operation SMALL-POX : HOW IT IS SPREAD. on the remote chance of recovering ; I operate on the equally remote chance (judging by present statistics, the actual value of which I have To the Editor of THE LANCET. endeavoured to gauge) of his pulling through. SIR,-In the Halifax Borough Hospital at present I have under treat- I have pondered out the steps of the operation, and have forethoughted ment and surveillance a family-father, mother, and four children. The should the I possible complications, and operation take place, sincerely history of this may prove useful, now that leave has been obtained for the that the methods used be successful. family trust, patient’s sake, may to in a Bill for the of One child was I bring propagation small-pox. am, Sir, yours truly, where had all Grosvenor-street, W., Feb. 14th, 1882. H. A. REEVES. removed from a common lodging-house, they been living together, suffering from confluent small-pox (a bad case, child unvacci- nated). The corporation sanitary authority took active steps to limit "HEALTH OF CANNES." the disease. Another child was attacked with confluent small-pox (child To the Editor of THE LANCET. unvaccinated). The mother was also taken ill. She had been vacci. but in her in of confluent there were SIR,—With reference to the letter of Dr. Menzies, that appeared in nated, case, place small-pox, about or well-marked vesicles. The a THE LANCET of Feb. 4th, in which it is stated that the carts that sixty eighty father, boy aged eleven, and a baby aged ten months had been exposed to the contagion. convey the offensive drainage from the cesspools are emptied only at have been in There has not been a of the I have to state that instead of this the case the of They quarantine. symptom night, being process had all been vaccinated. The authorities emptying took place during the whole of the afternoon of Feb. llth last, disease; they corporation destroyed the bedding. The guardians, acting on my advice, permitted creating so offensive a smell in the harbour as to compel the yacht destruction of all the clothing belonging to the supplying a com- Chazalie to leave at a moment’s notice, and this had been going on for family, plete outfit of new clean articles of for the lot. This was true the two days the yacht was lying there. But whether the emptying, clothing economy on their part, and they deserve credit for their liberality. which takes place under a shed on the mole, occurs by night or by day, it makes it equally dangerous for yachts to lie in the harbour. I hope There has not been another case in the town. The family will soon be and move of his may be a sufficient warning for all yachts to beware of Cannes. discharged, may to another town without fear carrying con- I am, Sir, yours faithfully tagion with them in their clothes.-I remain, Sir, yours, &c., Feb. 16th, 1882 L. G. Horton House, Halifax, Feb. 14th, 1882. TH. M. DOLAN 380

A CORRECTION COMMUNICATIONS, LETTERS, &c., have been received from-Professor Professor llr. T. To the Editor of THE LANCET. Marshall, London ; Brown-Séquard, Paris ; Holmes, Lmdon; Dr. Cobbold, London; Dr. Walter Whitehead, Manchester; I wrote the letter which in issue of SIR.—When appeared your Dr. Wickham Legg, London; Dr. Kent Spender, Bath; Dr. 0liver, Jan. Ir. W. B. to furnish and 21st, calling upon Hemming you your Newcastle-upon-Tyne ; Dir. Metcalfe Johnson, Lancaster ; Dr. Capon, readers with "a statement of the evidence on which he plain grounds London; Dr. Danford Thomas; Dr. L. Louis; Mr. Ctrrington Sykas, the assertions in the second and of his letter concluding paragraphs Barnsley; Dr. Kesteven, London; Dr. Ewart, London; Mr. Adams, of Jan. I did not would his 14th," anticipate that you accompany Maidstone ; Dr. Gramshaw, Gravesend; Dr. MacCormac, Belfast; in next issue with the intimation that could not "rejoinder’’ your " you Mr. Cullins, Paignton ; Dr. Lttham, Cambridge ; Mr. Royes Bell, insert more letters on the What I would have done then any subject." London ; Dr. Vincent Jackson, Wolverhampton; Dr. W. C. James, had I so I must ask to me in to do anticipated you permit simple justice London; Mr. Martindale, London; Mr. J. T. Markley, Eastbourne; to before and readers the late Mr. W. D. now—namely, lay you your Mr. Pugin Ttlornton, London; Mr. Cresswell, London; Dr. Magens, own as indicated in the last letter I received Hemming’s evidence, very St. Thomas, D., W.I.; Mr. P. Swain, Plymouth ; Dr. C. E. Saunders, from him on the of Pulitzar’s as to the relations" subject book, " precise London ; Mr. L. Kemp, London; Dr. Redmond, Dublin ; Mr. Cowen, which existed deceased between the gentleman and myself with regard London; Mr. Cole, Holywell ; Dr. Boyd; Dr. Hunter Mackenzie, to that work. Edinburgh ; Mr. G. D. Sutherland, Richmond ; Mr. Francis Mason, " My Dear Dr. Cassells,—I beg to acknowledge the receipt of my London; Dr. Evatt; Dr. Althaus; Dr. Sliman, London; Mr. Barton; MSS. and your card. I am very sorry that you cannot see your way’ Dr. Hunt, Dalston ; Dr. Boulton, London; Mr. Bellamy, London ; to bringing out a joint translation of Politzer’s book, in which I take Dr. Latham, Cambridge ; Dr. Lamb, London; Mr. Hardman, Black- much interest. Anyhow, I hope a translation of it will appear shortly pool ; Dr. Collie, London; Dr. Zinkeisen, Cork ; Mr. B. Bell, Edinburgh ; from as it would be a that the work should be lost your pen, great pity Mr. Palmer, London; Mr. Barraud, London; Mr. Infute, London ; to English readers, or that its publication in should be English long Mr. Benham, Barons-court; Dr. R. Smith, Cheltenham ; Dr. Davy, - delayed, as owing to your being so much engaged, must, I fear, be inevit- Exeter; Mr. More, Dublin; Mr. Barwell, London; --Nlr. Lightfoot, able. When you do bring it out I trust it may prove a success, though I Dr. Davos Dr. London; Dr. must repeat my regret that you will not allow me to share the work with Brighton; Beeli, Platz ; Kaeser, Reginald Dr. Mr. 0. you. I will send your MSS. on shortly. I shall be gls,d to hear what Thompson, London; Cortis, London; Hehner, London; Mr. Dr. J. A. Dr. answer you received from Dr. Carpenter.* With kind regards, yours Hope, Netherfield ; Campbell, Glasgow; Clouston, very faithfully, "(Signed) W. DOUGLAS HEMMING.. Edinburgh; Mr. Moreland, London; Dr. More, Rothwell ; Dr. Squire, "Glenalmond, Bournemouth, April 10th, 1880." London; Messrs. Christy and Co., Sheffield; Mr. Williams, Exeter; * J. S. Miss Mr. This last sentence refers to my application to Dr. Carpenter to get Mr. Turner, London; Tuke, Carnforth; Weakley, Mr. W. -D. Hemming made joint secretary with me in the otological sec- Birmingham; Dr. Macartney, Lahore; Mr. Double, Birmingham; tion at the British Medical Association in Cambridge, and which was Dr. Barton, Lifford ; Mr. Rainer, Ipswich ; Dr. Newman, Bowness ; granted. Messrs. Shaw and Son, King’s Lynn; Mr. W. R. Buchan, Glasgow; Mr. Dr. M. This letter will be found on careful reading to be so inconsistent with Hickman, Newbury; Padley, Swansea ; Guyot, Paris; the claims put forward in the paragraphs above referred to as to render Mr. Young, Chilton Polden; Mr. Leveson, London; Mr. Bellamy, comment by me all but unnecessary. That I shared with him neither London ; Surgeon; Universitatis; Baffled ; Expectans; Orthodox; the honour nor the labour of translation is there made abundantly B. C., London; Q. G. ; Medicus; Iota; W. ; A. D M.; Nonensis; evident, and not less evident is the entire absence of any indication that C. D. ; &c., &e. he regarded my refusal so to share as the non-fulfilment of any agree- LETTERS. each with enclosure, are also acknowledged from-Dr. Beust, ment." The only ever made between us on the subject of agreement" Edinburgh ; Dr. Hayes. London ; Messrs. Boulton and Paul, Norwich ; Politzer’s work was the one arranged in Cork, to which reference has Mr. Whipple, Kew; Mr. Mr. been made. By it he to write a clean copy of my translation King, Leeds; Maycock, Leamington; engaged Mr. Mr. Miss for the printer, to correct proofs, and to make out an index, for which Jaekman, Coggeshall ; Barney, Tiverton; Thompson, Mr. Mr. work he was to be paid. That " agreement," however, had to be Oldham ; Stewart, Gringley-on-the-Hill; Williams, Oxford ; departed from because of his insisting to have added to these duties Mr. Cornish, Manchester; Messrs. Vezey and Co., Bath; Mr. D’Orsey, those of joint translator. The book therefore has not only not the London; Mr. Newland, Hammersmith; Dr. Roberts, May Fair; merit-whatever that may be-of containing a single line of Mr. Mr. Holloway, Kidderminster; Dr. Plnder, Bow; Mr. E. A. White, Hemming’s translation, but is without the advantage of having been Malmesbury ; Dr. Maxwell, Gainsboro’; Mr. Young, Bridgwater; otherwise in any way forwarded for publication by his labours. On the Mr. Garden, East Harding; Mr. Birdwood; Mr. Heely, Kennington; appearance, therefore, of the most unwarrantable claim put forward in Dr. M’Naughton, Blackpool; Mr. Calligan, Chester; Mr. Jordan, your obituary notice, I had no alternative, in justice not mprplv to Birmingham; Dr. Clark, Liverpool; Messrs. Brady and Martin, myself, but to those to whom I really have been indebted for ssistanc3, Newcastle-on-Tyne; Mr. Bernard, Hemel Hempstead; Mr. Banks, than to make the correction which I did. I may say, in conclusion, that Boaz; Lambda; ; M.R.C.P.; the late Mr. and I failed to to in Wolverhampton; Surgeon, Horncastle; although Hemming agree co-operate A. this matter, our relations continued to be none the less cordial in our Postmaster, Abingdon ; M.D., Newcastle-on-Tyne; K., Sheffield ; subsequent intercourse; and I shall be very greatly surprised indeed if Chemicus, Guy’s Hospital; Home; E. J. J., New Ferry ; P. C. ; H. E., Mr. W. B. Hemming is able to produce evidence-which he has not yet Atherdtone; A. B. C.; Beta, London ; Medicus, Norwich; Alpha, attempted to do-that his son ever expressed himself so as to warrant Edinburgh ; Principal, Seaford ; Medieus, Bishopsgate ; V. J. C.; the unfounded assertions which are now advanced as on his authority. H. B. R. I shall now let the matter rest. X. Y. Z. ; T. R. F. ; Omicron ; Medea ; H., Derby; A., I am, Sir, yours very truly, London; M. A. R. ; P.O.M. ; Alpha, Worcester; Surgeon ; H. R., Glasgow, Jan. 31st, 1882. JAS. PATTERSON CASSELLS. Mile-end; &c., &e. *** We publish the above letter at the particular request of Dr. Cassells. House and Home, English Lakes Visitor, Glasgow Evening Times, West As the question in dispute is of little professional importance, we Middlesex Advertzser, Montgomeryshire Express, Scotsgna?t, Alliance must decline to insert any further communications on the subject.- News, West Cumberland Times, Temperance Record, Bolton Daily ED. L. Chronicle, &c., have been received.

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