496 THE RADICAL CURE OF HYDROCELE BY EXCISION. have had an order from Heaven on the subject; but that is the dumping ground for the sickness of Bristol. There matters not-he is insane; the desire is the product of a was no small-pox in this district till it was brought from diseased mind, and he is no more responsible for this dis- Bristol to one of the above workhouses, and thence it spread ordered cerebration than is the epileptic who falls down chiefly in the neighbourhood of the hospital, as is shown by convulsed in the street responsible for creating a disturbance a chart which I sent to the Local Government Board. In the and obstructing the thoroughfare. same way the medical officer for St. George’s thinks it arose The "opinion of the judges" still remains the letter of the in his district. Ilorfield, I understand, has only had two law in England; but the spirit of the law, as displayed in cases, and they were clearly traced to Bristol. As to the the utterances of our most liberal-minded and enlightened joint hospital, the matter fell through because the site judges, shows a considerable advance. It may truly be said selected was in the Stapleton district; and I think the ob- that the letter killeth, but the spirit giveth life." jection was reasonable considering we have already two I foci of infection. Our committee are the am, Sirs, yours faithfully, _. - - - sanitary taking S. A. K. STRAHAN, M.D., necessary steps to provide an infectious diseases hospital. ,March 5th, 1888. Barrister-at-Law. It is now six weeks since the last case appeared in this district, and, with the exception of that case, all the others "THE RADICAL CURE OF HYDROCELE who were willing were properly isolated either in their own BY EXCISION." houses or in the hospital of the union, with the guardians of which we for the of To the Editors THE LANCET. arranged reception paying patients. of 1 am, Sirs, yours truly, SiRs,-From the report of the discussion which followed WILLIAM BROWN, "Mr. Henry Morris’s paper on the Radical Cure of Ilydrocele at Fishponds, March 5th, 1888. Medical Officer of Health. the Medico-Chirurgical Society last week it would appear that *** We can quite understand that the facts are as reported the treatment by excision of the tunica vaginalis has not as by Dr. Wm. Brown. For a long time past it has been evident yet become very generally adopted. Having now performed that small-pox was being disseminated by reason of the objec- this in five cases, I should like to a word or two operation say tionable practice of using workhouse buildings as small-pox in favour of it, for in my hands it has been attended the by The of the true facts has .most satisfactory results. Four of the cases have already hospitals. difficulty ascertaining been recorded in THE LANCET (September 10th, 1887), been due to the hospital being connected with a workhouse, along with some remarks on the way in which the opera- and for that reason being subjected to no proper medical - tion should be carried out. At the present time, three of supervision by the central authority.-ED. L. the patients are still free from any evidence of recurrence of the hydrocele, and the fourth also was when last seen some months after the operation. The fifth case under recently LIVERPOOL. my care was one of suppuration of a hydrocele after tapping, when the sac wall was in a very thickened condition. From (From our own Correspondent.) a comparison of the results in these cases with those ob- tained in several others treated and 1 by injection incision, THE WINTER ASSIZBS. have come to the conclusion that in cases of hydrocele, espe- cially when the tumour has been frequently tapped and the MR. JUSTICE GRANTHAM has been presiding in the Crown tunica vaginalis has become somewhat thickened, the ex- Court since the 18th ult. Among other prisoners brought cision method is by far the most certain means of bringing before him was a Greek, a firt:man on board an English vessel, about a radical cure.-I am, Sirs, yours faithfully, stabbing another Greek,who was also one of the F. A. F.R.C S. charged with SOUTHAM, crew. The latter would to have been a to the Manchester Royal appear big, powerful Asst.-Surgeon Infirmary. " Manchester, March 6th, 1888. fellow, and a great bully," the prisoner, a small and com- paratively weak man, being a frequent victim of his THE CHIAN TURPENTINE TREATMENT OF violence. On Jan. 31st, when within six days’ sail of CANCER. Liverpool, the deceased assaulted the prisoner with a back. handed stroke peculiar to Greek sailors. The prisoner, who To the Editors of THE LANCET. was breakfasting at the time, stabbed the deceased on the buttock and front of the as SIRS,—In my letter on the above subject in THE LANCET thigh, selectingtheseregions being least The deceased died from seven of Dec. 17th I mentioned that I had then under treatment dangerous. haemorrhage hours afterwards, and was buried at sea. His clothes were Chian a case of uterine and that in by turpentine cancer, produced, and cuts were visible on the front of the thigh due course I would report the result. I regret to say that and on that part which would cover the buttock. The the issue has been a fatal one. The turpentine treatment knife was also produced, and had stains, apparently of was commenced at the period when the indurated cervix blood, on the blade. The jury acquitted the prisoner. was beginning to break down, and was maintained up to a Another prisoner, a seaman, was tried and sentenced to fortnight before death, when, owing to the great and con- eighteen months’ imprisonent with hard labour for stabbing tinuous nausea produced, it was discontinued. Whilst the the second mate in two places without any provocation. drug had no effect whatever in arresting the progress of the disease, the ulcerative process steadily progressing, A UNIQUE CASE. and converting the cervix into an irregular, excavated Many cases of pregnancy after successful ovariotomy are chasm, it seemed to act beneficially in two respects. The on record, but such a fortunate sequence in a case where, discharge, never at any time great, was lessened; and the before operation, the menopause had apparently been estab- pain, which before taking the turpentine even increasingly lished for years, is not on record. The following is, how- large doses of opiates could not make bearable, was, with ever, such a case. The patient, a lady, gave birth to her - the exception of a short period before death, markedly last child in July, 1882, she being then thirty-five years of diminished. I am, Sirs, yours truly, age. She did not nurse this child. Shortly after, menstrua- Leytonstone, Feb. 27tb, 1888. J. KING KERR, tion became irregular, and finally ceased towards the end of M.D. 1884, when she consulted Dr. Burton, surgeon to the Hospital for Women, who a small ovarian tumour. No SMALL-POX ISOLATION NEAR diagnosed BRISTOL. operation was then recommended, as the tumour was small To the Editors of THE LANCET. and freely movable ; so nothing was done beyond keeping the under observation until when SIRS,—In last issue you make a statement on the patient February, 1887, your the removal of the tumour was considered advisable. The of a member of the Bristol authority Sanitary Authority operation was therefore performed by Dr. Burton on the that small-pox is extending and crossing the border into 18th of that month, when a small tumour, which subsequently Bristol. This is misleading and contrary to the facts. In proved to be a sarcoma of the right ovary, was removed. Stapleton sanitary district there are unfortunately two After this had been done the left ovary was examined. It workhouses to which are attached small-pox hospitals. was found to be small, ivory white, and indurated, and One of these workhouses is solely for Bristol; the other is for no suspicion existed in the minds of those who were pre- the use of 111,264 of the Bristol population, as well as for that sent that it contained any more ova to mature. It was of some neighbouring districts. Practically, then, Stapleton then returned. Exactly a month after the operation-viz" 497

March 10th-the patient menstruated, for the first time for NEEDLES IN A WOMAN’S BODY. three and continued to do so on the nearly years, regularly At intervals the last few 18th of each month until when she ceased, and during months, twenty needles, August, about an inch and a half in have been of soon after made their mostly length, symptoms pregnancy appearance. extracted from the of a woman in tne The was verified about the end of the fifth body Guisborough pregnancy Workhouse. She suffers from month, and has, up to the run a normal (North Yorkshire) epileptic present, perfectly and she states that some she had a severe course, the in most excellent health. fits, years ago patient being and had mustard all over her Liverpool, March 7th. illness, poultices placed body, which were fastened tightly round with needles, and she thinks that a quantity must then have penetrated her body. NORTHERN COUNTIES NOTES. Newcastle-on-Tyne, March 6th. (From our own Correspondent.)

NEWUA8TLE U.HILDREN8 .HU81’ITAL. EDINBURGH. THE annual meeting of the Newcastle Hospital for Sick (From our own Correspondent.) Children was held last week. The Mayor presided, and it was stated that the work done during the past year was of ROYAL MEDICAL SOCIETY. the most useful character, the number of new cases treated THE annual banquet of the Royal Medical Society, mark- being: in-patients, 137; cut-patients, 2311 ; the latter in- ing the close of the 154th year of its existence, was held volving no less than 6173 attendances. The total cost per on March lst, when a large and representative gathering for four the duration of an in- head weeks (this being assembled to do honour to the occasion. The chair was has been £2 9s. This has been an patient’s letter) 8 3/4d. Dr. W. A. Turner, the senior President for the increase on previous years; but as all costs have been occupied by included, the increase is due to necessary building repairs. year, on whose right sat Dr. Lauder Brunton of London, the Allusion was made to the progress of the new building in guest of the evening. After the usual loyal and patriotic the suburbs, named, in reference to the munificence of one toasts, which were warmly responded to, Dr. Brunton pro- of our citizens, the " Fleming Memorial Hospital." posed the toast of the " Royal Medical Society," and stated NEWCASTLE ROYAL INFIRMARY. that precisely twenty-one years ago he had occupied the- The workmen of the firm of Lord Armstrong and Mitchell post so ably filled by the senior President on this occasion. have contributed over X600 during the past year to the This naturally led to an interesting comparison which he funds of the and as each £10 Royal Infirmary, per annum, established between the Edinburgh of a generation ago and the new for one this by rules, qualifies governor, important the Edinburgh of to-day. In speaking of the great firm-indeed, it might be called " arsenal"-will send no less that has occurred in the he re- than governors to the infirmary. It is to development school, sixty-six pleasant to of the teachers and thinkers whose see the best classes of our artisans an ferred several taking intelligent has done much to its interest in an institution from which they have derived so work spread great reputation, much benefit. and specially commented on the work of Keith in ovario- SUNDERLAND. tomy, Lister in surgery, and that of Fraser and Crum Brown in to now to consider the- At a of the Victoria Hall held at regard antipyretics. Turning meeting Calamity Fund, Medical he showed how it was that this in- Sunderland on a was Royal Society, Monday, sub-committee formed to the minds of senior students take to have the statue now in the stitution, influencing ripening steps ready sculptor’s of so a of studio set in the of the Winter Garden. At the medicine, possessed great power implanting up porch of as it also cultivated ease and same the General Committee voted a sum of X50 to originality thought, just meeting clearness of In both he his the Sunderland for the of children exposition. respects expressed Infirmary purpose sending own indebtedness to the He the to convalescent a sum of £825 to the great Society. hoped homes, and, further, men of the school in the would like- Children’s these sums are out of the leading present day Hospital. Although wise in mind their indebtedness to the and interest of this and are voted for this keep Society, fund, year only, they would do their utmost to encroachment on its will in all be continued. prevent any probability useful functions, In responding to the toast, the senior DURHAM. President was able to give a very satisfactory statement of A letter has been received from the Local Government the present condition of the Society. About 100 ordinary Board with reference to the reduction of the salary of the members are on the roll this session, and of these about medical officer of the Durham Rural Sanitary Authority thirty or forty take an active part in the public business of from £150 to £100. The Board request to be furnished with the Society. Financially, the Society is in a flourishing the exact reasons for the reduction, and point out that the condition, and its large library is increasing, and is carefully appointment at the reduced salary was premature, having preserved. A number of other toasts followed, interspersed with and for which Edin- been made on terms not approved by the Board. In reply quasi-medical professional songs, to this the Local Sanitary Authority has agreed to furnish burgh has a deservedly high reputation ; and at the close, res Medica" was the Board with a census of the district, which it is expected when " Floreat duly honoured, according to it was felt that never had will show a decrease of population. Mr. Blackett, who is ancient custom, generally the at present Mayor of Durham, is the medical officer. anniversary dinner been more enjoyable or more distin- guished than on the present occasion. INFECTIOUS DISEASES IN THE NORTH. ROYAL In Newcastle during the past fortnight, only twenty-six EDINBURGH ASYLUM. cases of infectious diseases have been reported by practi- The annual meeting of the subscribers to this institution tioners to the medical officer of health, Mr. H. E. Armstrong was held last week, when, in addition to the usual business,. This gentleman has made an elaborate and exhaustive reporl a very interesting report was submitted by Dr. Clouston,. in reference to the late outbreak of scarlet fever in th physician superintendent of the asylum. During 1887 Jesmond district of the city. The milk supply was fully . 365 patients have been admitted and 282 discharged, in all investigated, but he states that he has been unable t( 1158 having been under treatment during the year. An addition is about to be made to the establishment trace its connexion in any way with the outbreak , important a There has been a rather serious outbreak of measles , in the shape of new department expressly built for high-- at Tynemouth, and some of the schools are closed in i class patients, and to be added to the fine old mansion consequence. The presence of small-pox in some part! house of Craig Hall, once the residence of John Hill Burton,. of Yorkshire and Lancashire has caused no little alarm ic which has been in the hands of the managers for some In his Dr. Clouston shows how marked has adjoining counties, but so far there has been no outbreak , years. report we been the effect of an of and of althougti hear of isolated cases-one at Seaham Ilarboui , improved system nursing co. Durham. The case has evidently been imported frot recent reconstruction of premises and sanitary improve- Spain, as the vessel sailed direct from Bilbao, where th } ments in reducing the death-rate of the institution. The disease is prevalent, and the patient became ill on th report has created great satisfaction amongst those directly, voyage. Another case, which has proved fatal at Carlislt " interested in the welfare of the asylum. has been imported from Manchester. Edinburgh, March 7th.