Medical Times and Gazette.

On Tuesday evening, the Metropolitan Association of Medical Officers of Health met to hear a paper from Mr. Burge, and to receive a report from a committee which had undertaken the consideration of the subject. This report bore the signature of Dr. R. D. Thomson, one of the most eminent chemists in London. After pointing out that the proposed plan was mainly adopted upon economical grounds, it stated that "the use of perchloride of iron as a disinfectant was originally recommended by Mr. Ellerman in 1847, and reported on by a committee of the vestry of Marylebone, in December of that year, as being somewhat superior to chloride of lime, chloride of zinc, and nitrate of lead, in destroying the odour of night soil and other similar substances. But the committee," so the report goes on, "are not aware that there is a single ascertained fact to warrant the conclusion, that the perchloride of iron absolutely removes any deleterious ingredient from sewage, or that sewage thus merely mingled with solution of perchloride of iron, and discharged into the saline water of the Thames in summer, does not undergo the usual putrefactive decomposition to which the river has been subjected in a greater or less degree for several years. Such deodorisers appear only to act on sewage in its concentrated form. The truth of this position was demonstrated some years ago, when an attempt to deodorise the contents of the main trunk sewers by means of lime ended in failure, because, as soon as the sewage was diluted with the impure river water, the influence of the deodoriser terminated, and a putrefactive action was set up in the body of the stream, which was as energetic as if no disinfecting agent had been employed. The committee are, therefore, under the necessity of coming to the conclusion, that the simple mixture of the perchloride of iron with the sewage will only operate during the brief detention of the sewage in the reservoir, and that its use will be found expensive and fruitless, so far as the removal of the smell from the river is concerned." This report received a full discussion, in which several of the most distinguished of the Health Officers present took part. Mr. Burge asserted, as the result of his own experiments, that the clear liquid of sewage, after addition of the perchloride, ran into putrescence at a temperature of 65° or 70° in the course of a few days. Mr. Liddle, Dr. Aldis, and Mr. Chadwick, quoting from the several reports of Mr. Bazalgette in 1856, 1861, and recently, dwelt much upon the breach of faith which they exhibit in the matter of interception, since, from the first of these reports to the Metropolitan Board, Mr. Bazalgette appeared to drop the deodorising scheme for the western division in consideration of "objections which had been raised to the establishment of deodorising works in the locality mentioned; and no hint has subsequently been given that he and the Metropolitan Board of Works in any way contemplated returning to this idea. The result of the meeting was the passing of the following resolution :

"That the attention of the Association having been called to the plan proposed for the deodorisation of the sewage of the western district of the metropolis, and its subsequent discharge into the Thames, the Association wish to record their opinion that it will be ineffectual in its operation, pernicious in its influence on the river, and entirely subversive of the principles on which the intercepting scheme was originally based."

They passed further resolutions, to the effect that this expression of opinion should be forwarded to all the vestries and district boards of the metropolis, and that a deputation from the Association should wait upon the Metropolitan Board of Works, in the hope that they may be induced to reconsider their determination. Mr. Burge, the Fulham District Board, and the Health Officers of London, have thus done their duty manfully. It remains to be seen what effect these protests will have upon the central authority, which has the power to do a large benefit to the metropolis, or an incalculable damage.

REVIEWS.

Statistical, Sanitary, and Medical Reports for 1860: Army Medical Department. ("Ophthalmic Surgery." By Assistant-Surgeon Dr. P. FRANK.)

Ophthalmia. By Assistant-Surgeon Dr. MARSTON, Royal Artillery. (Reprints of Contributions from "Beale's Archives of Medicine.")

WE have, from time to time, kept our readers au courant with the latest observations of continental writers upon Ophthalmia, in its epidemic or endemic forms. It is not a little remarkable that English authors should have hitherto maintained a perfect silence with regard to the very important pathological changes and appearances in the palpebral conjunctiva, which the eyelids of soldiers and others, living gre gariously, so frequently exhibit. To the Danish, Belgian, and German observers, we have been indebted for all we know upon the subject.

Perhaps no disease is of more importance than Ophthalmia; whether we have regard to the organ attacked, the frequency of its occurrence, the rapidity with which the disease often attains a widely-spread sphere of prevalence in regiments, schools, etc., its contagious properties, and the enormous cost which ophthalmia annually entails upon our Government. In the two works at the head of this article, we have such a large mass of information and observation, that English observers can no longer be said to be left behind in the progress of this part of our science; nor can the facts described be any longer ignored, as if they either did not exist, or had failed to be regarded.

For the present, we refrain from entering any further into the materials of this Medical blue book than into the part bearing upon this subject.

In Dr. Frank's most able Report upon Ophthalmic Surgery," we have a very full and highly interesting account of all the cases of ocular disease admitted into the Surgical Division of Fort Pitt. The paper is too long for analysis here, but we would particularly direct attention to those cases illustrated by capital views of the ophthalmoscopic appearances, and to his observations upon internal lesions of the eye. To say that this Report could only have been written by an exceedingly well read and accomplished Surgeon in this branch of his art, is a small meed of praise; for it contains the result of so much personal experience and original observation, that the best informed will find matters for suggestion and thought, as well as matters of a practical interest in it (a).

Dr. Marston's pamphlet is a reprint of papers originally published in Beale's "Archives"; and it must prove a source of much pleasure to him to find his observations upon conjunctival disease so fully corroborated by Dr. Frank's Report. We shall confine ourselves, for the present, to the subject of that ophthalmia, or conjunctival disease, of which both writers treat.

The specific feature of this affection-and one which contradistinguishes it from ordinary conjunctivitis-is the presence of small deposits in that membrane, as the sole characteristic of its primary stage. Dr. Frank says :-

"The first signs of abnormal nutrition consist in the appearance of small, round, opalescent, sago-grain-like bodies, either isolated, or disposed in clusters or rows, more or less densely crowded over the conjunctival surface, and generally making their first appearance on the lower lid. These so-called vesicular granulations may form and exist for an indefinite period, without the occurrence of any inflammatory symptoms calculated to direct attention to the affected lids."

The histological origin and exact seat of these bodies have been strongly-contested points, as Dr. Frank's references sufficiently indicate. Our limits will not allow us to follow our authors into these; suffice it to say, that the original statement by Van Roosbroeck and Bendz, relative to the presence of closed, solitary follicles in the palpebral conjunctiva, must be conceded as correct. Dr. Marston says:

"It is in the highest degree probable that the vesicular (a) The great merits of this Report remind us that the Army Medical Department can no longer number its writer among its members. The retirement of a man like Assistant-Surgeon Dr. Frank can only be regarded as a great loss to the service. The influence exerted by the presence of an enthusiastic, able, and ingenious man in the junior ranks, upon his fellows, is always great and useful. We should be glad indeed -for the sake of the soldier and the credit of the authorities-to see such men animated by a stronger attachment to the public service, instead of, as now, so frequently quitting its ranks.

looking bodies, sparsely shed in the palpebral conjunctiva, are these follicular organs altered by disease. When, however, the disease has continued for any time, or advanced to any extent, it will be found that these bodies exist in such disproportionately large numbers, and often in such superimposed strata, as it were, as to lead to the conclusion that they cannot all have had their origin in pre-existing follicles. The appearance of follicles is exactly mimicked by the morbid products in the connective tissue; and in diseased lids it is extremely difficult to determine the one from the other."

He adds, therefore, that these bodies may also have their origin in the delicate sub-epithelial stroma; and that, then, there will be a little nest of cell-growth bounded by fibrillatedlooking tissue, in the meshes or interstices of which the new products are seated. So defined, these bodies exactly assimilate to follicles filled with granular and cell contents, nearly identical in appearance and constitution with that vesicularlooking condition which the mucous follicles of the colon assume in incipient dysenteric disease.

Dr. Frank has some very interesting remarks upon the same subject which are very nearly allied to those quoted. What our authors strive to prove-and, to our minds, have succeeded in proving-amounts to this:-These little bodies are among the commonest appearances of diseased conjunctiva in bodies of human beings living as in regiments; and they are very powerful predisposing causes to ophthalmia in general, particularly to that form which results in the "granular" lid, although their presence, per se, may give rise to scarcely any symptoms, and their detection may require careful scrutiny of the eyelids. Thus we read :—

In order to study the typical character of vesicular granulations, they must be sought for in the conjunctivæ of apparently healthy eyes; and this has led to their existence being overlooked and denied by many who are not in the habit of examining the conjunctiva prior to the invasion of inflammatory symptoms. Innocent as these primary lesions may appear, they gain in importance by the predisposition they engender to inflammatory attacks, and by the contagious nature of the secretion, which, under such circumstances, is furnished by the affected conjunctiva."

Dr. Marston says:

"The vesicular bodies appear as the primary lesion, and are the very first products generated by the morbific agency. That these are not the sequelæ of an inflammatory process, but rather the powerful predisposing causes to, and modifying agents of, any inflammatory phenomena that may ensue, appears certain."

In his paper, he attempts to trace the relation of these bodies to the prevalence of ophthalmia, in an epidemic or endemic form, among the military at Malta and Gibraltar, and at the convict establishment at the latter station. Those

scourges of the army-"purulent ophthalmia and " granular lids"-must, in future, always be viewed with reference to the existence or not of a pre-existing stage of vesicular granulation.

The reason these bodies are not found is, that they are not looked for until inflammatory changes have ensued, by which their presence is masked. Dr. Frank says, in a note :

"The influence of a hyperæmic condition in masking vesicular granulations can be easily appreciated by their disappearing, as it were, before the very eyes of the observer, when a lid has been kept everted for a short time, and reappearing again when the congestion has been allowed to subside." Both writers enter into the causes of this singular affectionDr. Marston, by recording the actual results of his own experience and observation; Dr. Frank, by epitomising the views of the latest and best writers upon the subject. They may be referred to two heads:-1. Contagion. 2. An unhygienic mode of life, by which miasmata are generated. The last appears highly probable as a cause of such generation, irrespective of the former, from the observations made, not only upon man, but the lower animals. Of the first, as a cause, there is so little doubt, that many writers consider this as the only means by which the specific agent, or virus, is propagated. Dr. Marston writes:

"So certain do I feel that the prevalence of vesicular disease of the lids is in direct ratio to the amount and degree of defective sanitary arrangements, that I conceive the palpebral conjunctiva offers a delicate test and evidence as to the hygienic condition of a regiment."

Much has been lately said as to the propagation of ophthalmia through the agency of pus cells, floating in the atmosphere of ophthalmic wards. The statement was originally made by Eiselt, and his observations have been corroborated by some recent experiments at Lariboisière Hospital. Professor Parkes, in his interesting "Review of the Progress of Hygiene during the Year 1861," in the present blue book, remarks, that Dr. Frank (by means of an aëroscope, used in the wards of Fort Pitt), had detected, in several instances, unequivocal epithelium cells. Dr. Marston, by means of the same instrument, does not appear to have satisfied himself of the presence of pus globules, in a current of air driven over a vessel containing moist pus, although he could easily determine their presence in air passing over desiccated pieces of lint which had been previously steeped in fluid pus.

The subject should be carefully followed up by investigations in places where cases of purulent ophthalmia are located.

Dr. Frank points out how this apparently trifling and incipient stage may lead to atrophy of the tissues, incurvation of the lids, and disordered vision. If these statements bear even an approach to accuracy, how important are they! To state the presence of "sago-grain-granule in the eyelids of men of a regiment, for instance, is tantamount to saying that ocular disease, or a predisposition to the gravest kind of ophthalmia, is endemic in that regiment. Difficult as these cases are of treatment in their advanced stages, they are easily treated during the earlier. What is far more important, however, is the knowledge that we possess a power over the spread of the disease to healthy individuals.

Dr. Marston's very able paper contains tables, by which the proportion of vesicular to healthy lids, and the proportion of each of these to the more advanced stages of the disease, can be traced. It has many illustrations also, one of which is colored; and, in an appendix, he describes the form and epidemic progress of the ophthalmia lately affect ing the children of the Central London District Schools. In this he embodies also important observations from Mr. Bowman's reports to the Board of Guardians of the school in question.

We cannot do better than conclude, first, by strongly recommending those of our readers likely to be interested in these subjects to read these articles; and secondly, by quoting from Dr. Frank's paper:

"The interest of the affected individuals, and of the community to which they belong, demands most careful attention to these primary conjunctival changes; and it may be presumed that, in regiments to which ophthalmia clings, an explanation of its endemicity may be found in the presence of men affected with this insidious lesion.

“We might regard the presence of foci of this, as well as of all other infectious agencies, with indifference, if we could place implicit reliance on the infallibility of our sanitary arrangements, and their strict and universal observance. In the meantime, measures of isolation should not be despised, and a careful treatment of the disease in its embryotic stage should be thought worthy of attention by military Surgeons as a prophylactic measure of signal importance.

"A due appreciation of the fact, that the conjunctival deposits can exist for an indefinite period without giving rise to any inflammatory symptoms, is, therefore, not only necessary for the efficient prevention and treatment of the disease, but also to enable justice to be done to the claims of the soldier who is disabled by the results of ophthalmia.

"In the abstract of a private, invalided from the 41st Regiment, it was stated that the disease was contracted in St. Lucia, where ophthalmia was not prevalent at the time; the disease was, however, prevalent at head-quarters of the regiment; and not only were the anatomical changes in the conjunctiva the same as are only observed in genuine miasmatic ophthalmia in this and other cases from the 41st Regiment, but the most exquisite vesicular granulations were discovered in the conjunctiva of two other men with eyes apparently healthy, invalided for other causes from the same corps. It was, therefore, justifiable to assume, that the first patient had contracted vesicular granulations before his company was detached from head-quarters, but that the infected lids had remained quiescent till an exciting cause of sufficient intensity to bring on an acute inflammatory attack had acted upon them."

FOREIGN CORRESPONDENCE.

AUSTRIA.

CARLSBAD, December 9.

THE CONGRESS OF GERMAN NATURALISTS AND PHYSICIANS.

SEVERAL important communications were made to the section for Surgery and Ophthalmology of the above Congress, which have not been mentioned in my previous letters. Professor Von Hübbenet, of St. Petersburg, spoke on "Pyæmia," as observed after amputation and disarticulation. His experience in the Hospitals of Sebastopol was decidedly in favour of the latter operation. During the siege of that fortress, he had performed altogether 3345 major operations (amputations, resections, and disarticulations), but had, from want of time and other circumstances, been unable to observe more than 636 cases in their entire course. Amongst these there were 338 operations on the right, and 298 operations on the left side of the former, 63 were successful; of the latter, 74; that is, altogether, 137 (21 per cent.) The most unfavourable cases were those of amputation of the thigh, as out of 264 only 24 (9 per cent.) recovered. The unfavourable results observed in Sebastopol were chiefly due to the crowded state of the Hospitals, and the destructive action of the modern projectiles, but not to any want of proper care, which was, on the contrary, more anxious than it had ever been in times of peace. Another circumstance which had to be taken into consideration, was the low and depressed spirit of the vanquished army, which was especially perceptible in those who had not taken part in the pitched battles, but had always been in the fortress. No importance, however, was to be ascribed to the less considerable force of vitality in the Sclavish nations, upon which Dr. Paul had laid so much stress; for of 33 operations performed upon French prisoners, only three proved successful. In the majority of cases, the amputations were done early and without scrupulous regard to the indications laid down in treatises on Surgery; the excuse for this being, that hygiene and the consideration for other patients required bad contused wounds to be changed into clean incised wounds. Simple dry dressing was used throughout, and the diet and medicines prescribed were made to suit the requirements of each individual case. In the discussion which followed, Dr. Paul mentioned that, in 12,000 cases of amputation and disarticulation he had collected, the rate of mortality was 1 in 4 of the former, and 1 in 5 cases of the latter operation.

Dr. Von Tröltsch, of Würzburg, spoke on the "Diagnosis of the Diseases of the Ear," and condemned, in rather severe terms, the way in which this was generally made. He entered fully into the objective and subjective means of examination, and said that the former, such as speculum, funnel, catheter, rhinoscopic mirror, etc., might serve to lead us to conclusions concerning morbid conditions of the external meatus, the membrana tympani, and the Eustachian tube, but did not help us to distinguish diseases of the cavity of the tympanum and the labyrinth. These latter could only be recognised by subjective signs. The majority of cases of deafness were due to morbid processes about the two fenestræ. Diseases of the labyrinth were rare, and could only be diagnosed after excluding all others. The cavity of the tympanum was chiefly affected by catarrh. There were many peculiar symptoms observed in persons suffering from deafness: some were able to hear the ticking of a watch at a certain distance, but did not hear spoken words; others heard, with one ear, only sounds, and with the other, words; others heard only certain notes of the scale, etc.; but, contrary to the opinion of other aurists, Dr. Von Tröltsch contended, that at present we knew nothing certain with regard to the significance of these peculiar symptoms, nor did we know by what morbid changes they were produced. Dr. Voltolini, of Breslau, quite agreed with the speaker in this particular, but contended, that diseases of the labyrinth were more frequent than Dr. Von Tröltsch was inclined to assume; it was such diseases, and also morbid processes in the acoustic nerve itself, which caused absolute deafness.

Dr. Wuth, of Hanover, exhibited a hypertrophied lachrymal gland which he had removed from a patient who, after the operation, merely complained of impaired motion of the eyelid, dryness of the conjunctiva, and a sensation of burning in the

eye. Professor Arlt, of Vienna, said that he had never observed a case of hypertrophy of the lachrymal gland; this organ could, from its seat and surroundings, only be hypertrophied in a backward direction, and would necessarily cause exophthalmos; it was impossible to excise it without removing, at the same time, a portion of the conjunctiva; and he was inclined to consider the specimen exhibited to be a tumour. Dr. Niemetschek, of Prague, however, remarked, that he had seen a specimen of hypertrophied lachrymal gland in the collection of Professor Adelmann, and which had been microscopically examined by Virchow, who had found that it was true hypertrophy. Professor Patruban then spoke on "Neurectomy for Tic Douloureux;" and Dr. Van der Loe, of Venlo, described a modification of the plaster of Paris splint, which had the advantage that, after the gypsum had become quite hard, it could be easily removed and again put or. Dr. Förster, of Breslau, then read a paper on the "Limits of the Field of Vision," and described a series of experiments he had undertaken on this intricate subject. Professor Von Hübbenet spoke on "Hemeralopia," and said that he had observed annual epidemics of this affection in Russia, during Passion time, and which disappeared spontaneously after that period. There was, in these cases, peripheral limitation of the field of vision, dryness of the conjunctiva and cornea, and fatty degeneration of the epithelial cells. Dr. Förster said that hemeralopia was rare in Silesia, but that he had seen a few epidemics of it. Professor Arlt contended that there were two different forms of this affection: one of them was related to retinitis pigmentosa, was, probably, a hereditary disease, and always accompanied by limitation of the field; the other form was much the same as snow-blindness, which was observed in the Alps, was caused by dazzling, and was, in recent cases, curable by shutting the patients up in a dark room. In this form there was only hyperæmia of the retina, but no other pathological alteration, and no limitation of the field. After Dr. Niémetschek, of Prague, had made some remarks on a "Case of Villous Tumour of the Cornea and Conjunctiva," Dr. Ellinger, of Mergentheim, spoke on the "Treatment of Erectile Tumours by Liquor Ferri Chlorati," which was attended with favourable results. Dr. Streubel declared himself averse to this operation; while Drs. Eulenburg and Paul asserted that it was well worthy of a trial. The statement, that the blood coagulated after the injection, that the tumour became harder and smaller, and could, therefore, more easily be excised, was, no doubt, correct; but the solution used by Dr. Ellinger (viz., one drop of liquor ferri to thirty drops of water) was too weak.

In the section for Gynecology, Dr. Freund, of Breslau, spoke on "Retroflexio Uteri," and its consequences, such as chronic infarctus, diseases of the bladder, indigestion, etc. In this affection the connective tissue was considerably altered at those points where the flexion had taken place; there were adhesions between the fundus and the rectum, owing to peritonitis, and which were frequently incurable. The posterior wall of the flexed womb was filled with masses of connective tissue, the seat and extent of which determined the ease or difficulty of reposition. Hydronephrosis was a frequent concomitant affection, and was caused, either by real stenosis of one or both ureters, or by flexion, owing to dislocation of the womb. After perimetritis the ureter frequently adhered to the lateral wall of the uterus; and this explained the symptoms of hydronephrosis during life, viz., violent lumbar pains, shooting downwards along the ureters, neuralgia in the lower extremities, headache, difficulties of the bladder, and dyspepsia, all of which were formerly incorrectly attributed to hysteria. The condition of the urine resembled that observed in catarrh of the bladder. Pyelitis might often be the consequence. Regarding the treatment, Dr. Freund recommended reposition by mechanical means, more especially by Valleix's sound and medicated enemata.

Professor Hecker, of Munich, spoke on "Congenital Rickets," a subject which he had, together with Professor Buhl, closely studied. He also exhibited some extraordinary specimens of this disease. Dr. Hegar, of Darmstadt, then read a paper on "Abortion in the First Few Months of Pregnancy." This was a very frequent occurrence, as for eight or nine regular births there was one abortion.

In the section for Zoology and Comparative Anatomy, Dr. Von Frauenfeld, of Vienna, gave an account of the scientific collections made by the naturalists of the Austrian ship Novara, during her voyage round the world. A catalogue raisonné of these collections, which will soon be exhibited in

the Viennese Museum, is just being written by the most eminent zoologists of the Austrian capital. The largest number of new species brought by the Novara is of the class of insects. The spiders seem to have been particularly well preserved the following was the method pursued:-They were first placed in weak spirit, and afterwards in strong alcohol; they were then put in small bottles, each one being separated from its neighbour by a piece of cotton-wool. Fishes were wrapped in cotton-wool, and packed up in boxes of sheet-iron; when such a box was full, it was soldered up, so that only a small opening remained; the box was then filled with alcohol, and the last opening also closed. Professor Stein, of Prague, then described several new species of Infusoria he had discovered in the Baltic, during a sojourn at Vismar; and afterwards spoke on the "Paramæcium Coli," an infusorium which had been discovered by M. Malmsten, of Stockholm, in the lower bowel of two men who had fallen ill with choleraic symptoms. Leuckart had already found that this "paramæcium coli" was no paramæcium at all, but was identical with an infusorium very frequently met with in the rectum of the pig, and which he described as a species of Holophrya. Professor Stein has, however, by close observation, been led to the conclusion, that, from the peculiar position of the cilia, the animal appears to be a species of Balantidium. Up to the present time, only one species of this animal was known, viz., the Balantidium entozoon, which is often found in the rectum of the frog: Professor Stein, however, has discovered two new species of it, one of which (B. elongatum) lives in the rectum of the Salamander aquaticus, and the other (B. duodeni) in the upper part of the small intestines of Rana esculenta. Several other communications on newly-discovered animals were made; but as they were only of interest to zoologists, and of no importance to Medicine, I shall not enter into the subject of these papers. The papers read in the section for Physics, Mathematics, and Astronomy were likewise of no general or Medical interest.

In the section for Chemistry and Pharmacy, Professor Böttger, of Frankfort, described the metal "Thallium" which had been discovered by Mr. Crookes, and was distinguished by a peculiar spectral line. It was chiefly met with in the refuse of sulphuric acid manufactories. He showed the thallium line in the spectral apparatus; and Dr. Scheibler, of Prague, showed the lithium lines by burning tobacco leaves. Dr. Jeiseler, of Königsberg, made a linguistic communication on the " Spelling of Sulphur," which, according to him, should be "sulfur," as that was the spelling of the Sanskrit root. Professor Böttger then spoke on the "Most Powerful Means of Oxidation," which, according to him, consists of a mixture of two parts of permanganate of potash and three parts of sulphuric acid. Dr. Ilisch, of St. Petersburg, attacked Liebig's theory of fermentation, and contended that fermentation was impossible without sporules, that albuminous bodies in a state of incipient decomposition were likewise necessary for it, and that compounds of ammonia promoted fermentation. Dr. Scheibler described the effects produced by light upon solutions of sugar, and declared Gerhard's parathionic acid to be a myth. M. Patera showed some compounds of the new spectral metals "Cæsium and Rubidium,” which had been obtained from the Carlsbad sprudel. Professor Strecker spoke on the "Effects of Hydrogen in the Nascent State upon Nitro-benzoic Acid," and described two new bases which were homologous to creatine and creatinine, viz., glycocyamine, obtained by combination of cyanamide and glycocholl, and glyco-cyanamidine, obtained by heating glycocyamine with hydrochloric acid to 300°.

DR. A. DAVIDSON, the Medical missionary sent out by the London Missionary Society, writes from Madagascar thus: "I reached the capital (Antananarivo) after twelve days' jolting in a palanquin. I opened a dispensary the first week I arrived. My patients at present are at the rate of 5000 or 6000 per annum." After describing some of his surgical operations, of which there are many, he says:-" "I have a part of my dispensary set apart for such cases, that they may continue beside me during treatment. The dispensary has been presented by the Prime Minister, who had gout, but is now better. He has suffered nine years, sometimes a month ill at a time. I have been chosen Court Physician, and have received from the King the medal of the Order of Radama for my successful treatment of his son."

GENERAL CORRESPONDENCE.

DR. TWEEDIE'S LECTURES ON FEVER. LETTER FROM DR. MURCHISON.

[To the Editor of the Medical Times and Gazette.] SIR, I trust to your justice, to allow me to reply to a paragraph in the last Number of your journal. You have either been greatly misled, or your information has been derived from one entirely ignorant of the facts. The materials, to which you allude, were not analysed by me for the purpose of illustrating Dr. Tweedie's lectures, but were prepared expressly for the paper published by me in the Med. Chir. Transactions (vol. xli.) I had the permission of the Fever Hospital Committee, and the sanction of both the Physicians, Dr. Southwood Smith and Dr. Tweedie, for making this use of them. My investigations were commenced long before I knew that Dr. Tweedie was going to give any lectures on "Fever"; the paper was presented to the Society on March 30, 1858; and it was finished and submitted to the perusal of Professional friends several weeks before Dr. Tweedie gave his first lecture on March 12, 1858, as I can prove by the testimony of a distinguished Fellow of the College of Physicians who attended Dr. Tweedie's lectures. It is not the case that my investigations were made under Dr. Tweedie's directions, or that he suggested any plan whatever for conducting them. The fact is, that a portion of the tables drawn up by me with great labour, together with a few brief memoranda explaining their object, were lent by me to Dr. Tweedie, for the illustration of his lectures, but it was on the distinct understanding that they had been prepared for my memoir above referred to. A comparison of our respective works is sufficient to show that I was not a mere mechanical drudge in the hands of Dr. Tweedie.

You err, however, in thinking that Dr. Tweedie has been accused of appropriating, without acknowledgment, the statistics of the Fever Hospital tabulated by me; for, in truth, at page 198 of his Lectures, he acknowledges that he is indebted for the tables in question to my paper in the Med. Chir. Transactions. He observes :-"I am bound to acknowledge that for the statistical facts I am indebted to the recentlypublished paper of my colleague, Dr. Murchison, who, availing himself of the ample opportunities the Fever Hospital afforded, has produced a most valuable monograph on the mortality of the different forms of fever, and on the causes which apparently influence their prevalence.-Med. Chir. Transactions, vol. xli." (Dr. Tweedie's Lectures, p. 198).

The complaint is, that Dr. Tweedie has appropriated the conclusions to which I was led by my researches, and, in fact, the ipsissima verba of my published essays, in such a manner that, if I had not noticed the circumstance, I would have rendered myself liable to the imputation, that, in my recentlypublished work, I had borrowed some of my remarks from his lectures, without acknowledgment. Several of the passages in question had no reference to the statistics of the Fever Hospital. The paragraph in my Preface, objected to by Dr. Tweedie, was referred by him nearly four weeks ago to a distinguished Fellow of the College of Physicians, who, after the closest inquiry, and hearing all that both parties had to say, informed Dr. Tweedie, by letter, that he considered my remarks justified, and that silence on my part would have laid me open to serious misconstruction.

That my remarks were called for you must admit, on perusing the paragraphs here appended in parallel columns, They illustrate the use which has been made of my writings; they prove that Dr. Tweedie has been credited with having written a paragraph contained in my previously-published essay; and they show that the very way in which he has introduced my name is calculated to disconnect me from the authorship of the passage. Moreover, the numerical results here given, extending over forty years, and having no reference to the London Fever Hospital, were worked out by me specifically for the memoir referred to.

I shall not trouble you with further details, which will be found in a letter addressed by me to the British Medical Journal. I am, &c.

CHARLES MURCHISON. 79, Wimpole-street, W., December 27.

Out

DR. MURCHISON. (Medical and Chirurgical Transactions, vol xli., 290; communicated March 30, 1858.) "To all of these results the Irish Hos. pitals present a marked antithesis. of 150,939 cases of fever admitted into the Dublin Fever Hospital since the year 1817, only 10,632, or less than 1 in 14, have died; and during the last eighteen years it will be seen from the table that the mortality has only been 1 in 133. Again, in the Cork Fever Hospital, the mortality has been even much less. Since the year 1817, out of 82,293 patients only 3222, or 1 in 254, have died; and during the eighteen years contained in the table the mortality has only been 43 per cent., or 1 in 234. Moreover, the rate of mortality has varied much less in different years than it does in England and Scotland. Thus, in Dublin, in no year during the last forty has it reached 10 per cent.; and in the Cork Hospital in only one year of the last forty has it slightly exceeded 6 per cent. In the year 1838, Dr. Cowan, of Glasgow, drew attention to the striking discrepancy in the mortality from fever between the British and Irish Hospitals; and I find, on referring to Barker and Cheyne's Report of the Irish Epidemic of 1817-19, that out of 100,737 patients in the Hospitals of all Ireland, 4349 died, making a mortality of 4.3 per cent., or of only 1 in 23. No doubt the circumstance, to which I have just called attention, is partly accounted for by the greater facilities afforded to mild cases for entering the Hospitals in Ireland; but whether this be the case or not, it plainly shows that there is a form of fever constantly present in Ireland, which is much milder, and the mortality from which is much less, than is the case with the fever we more generally meet with in this country."

REPORTS OF SOCIETIES.

WESTERN MEDICAL AND SURGICAL

SOCIETY.

FRIDAY, DECEMBER 5.

Mr. JAMES R. LANE, Vice-President, in the Chair. A PAPER, by Dr. CAHILL, was read on

PLUGGING THE NOSE.

In cases of excessive epistaxis, the author had found that the ordinary mode of plugging the nose effectually, both in front and behind, was attended with considerable distress to the patient, and with some inconvenience to the operator, although it might not be attended with much difficulty. The method he had adopted consisted of passing a piece of dry and compressed sponge, about two inches long, and of sufficient size to pass easily, along the floor of the nares. This was secured in the middle by a piece of tape or twine doubled. When the sponge was fairly pushed by a probe, or, what was better, a female catheter, through the posterior nares, the tape was drawn upon; the sponge then took a direction transverse to the nasal cavity, doubling upon itself, and so blocked up, when swelled by the absorption of blood, the posterior nares. The two ends of the tape now passing out of the nostril, being then separated, the anterior cavity was filled with cotton-wool, and the tape then tied across the whole in front of the nose. Removing it was easily managed by pushing the sponge into the pharynx, and so brought out through the mouth. The simplicity of this operation was shown by the author upon the skeleton.

A paper, by Dr. WAY, was read on

STRICTURE OF THE ESOPHAGUS.

The disease had occurred in a woman aged 52, which had commenced ten months previously to her death with the usual symptoms, viz., difficulty of swallowing, vomiting imme

DR. PICKELLS.

(Cork Fever Hospital Report for 1860, read February 21, 1861.)

"To these results, the Irish Hospitals," Dr. Tweedie remarks, "present a marked antithesis. Out of 150,939 cases of fever admitted into the Dublin Fever Hospital since the year 1817, only 10,632, or less than 1 in 14, died; and during the last eighteen years the mortality has been only 1 in 13. Again, in the Cork Fever Hospital the mortality has been much less. Since the year 1817, out of 82,293 patients only 3222, or 1 in 254, have died; and during the eighteen years contained in the table the mortality has been only 4 per cent., or 1 in 234. Moreover, the rate of mortality has varied much less in different years than in England and Scotland. Thus, in Dublin, in no year during the last forty has it reached 10 per cent.; and in the Cork Hospital in only one year of the last forty has it slightly exceeded 6 per cent."

diately after taking food, accompanied with pain. Towards the termination of the disease, shreds of mucous membrane were vomited, with some relief to the symptoms. These shreds of membrane, upon examination, were found to be perfectly healthy. The post-mortem examination showed the upper part of the oesophagus to be dilated, and the stricture to be confined to the lower fourth. The mucous membrane of this part had been removed, exposing the sub-mucous tissue, which was found infiltrated with colloid cancerous disease. There were also some small glands affected in the same manner. The liver was elongated, but no trace of cancer could be discovered. The post-tracheal glands were cancerous. Life had been prolonged by nutrient enemata. The diseased portion of the œsophagus was exhibited. A paper, by Dr. MARTYN, was read on

INDUCTION OF PREMATURE LABOUR.

This proceeding had been recommended, and performed by him in the case of a woman aged 45, who had previously had four children, and whose labours had been more tedious and difficult at each succeeding delivery. Still-born children had been the result of the long-continued pressure and the violent contractions of the uterus. Contraction in the antero. posterior diameter of the pelvis had been made out to be the sufficient cause of the obstruction. At the end of the eighth month, the author, to induce premature labour, injected, by means of a catheter, four ounces of warm water a few inches within the os uteri. Three hours afterwards slight pains came on, but without any further result. The following day, six ounces of water were injected six inches within the uterine cavity. Labour pains set in four hours afterwards. Prolapse of the funis took place, when the liquor amnii was discharged, but the author managed to hook the funis over one of the arms of the child while still in utero, and, leaving the rest to the natural efforts, the child was born eight hours from the commencement of the labour pains. Both mother and child did well.