APEiIL8 , -' MRMORMDA.

this obliquity must be allowed for, and the only question is,whether the correction is to. be-applied in the joints of therider's limbs, or in the structure of the bicycle; in otherwords, whether the body is to be adapted to the-machine or.the machine to the body. Medical men, at least, shouldhave only one answer.

I may point out that in the motor bicycle the separation ofthe feet is greater, and their inversion on ordinary pealstherefore more marked, than on the common "safety"bicycle. Though the feet are less used for prpulsion, I haveno doubt that here also the comnfortof a more natural positionwill readily be recognized.

I am not the first to suggest: this form of pedal. In thecourse.of my inquiries, I have found that one of what the lateProfessor Tait used to call those " worst of plagiarists, whoadopt-our ideas long before we have' thought of them our-selves," devised and patented precisely the same thing in theUnited States sixteen years ago (Fig. 4). I have not been ableto trace William E. Smith, of Washington, nor do I know thathis patent has been worked; but our common contention,that sloping pedals are the most natural and comfortable, isstrongly enforced' by the fact that we have arrived at it byquite different paths. He has found, as I have, that lateralslipping of the foot is avoided; but he knows nothing ofcycling corns. His dissatisfaction with the ordinary pedalseems to have arisen from discomfort in the ankle and thetarsal joints; forhesays.that it-compels the foot to play in a very tiresome manner upon the ankle-joints. . . By my construction this difficulty Is overcome and therider enabled to propel the machine with less exertion than heretofore.

I think we may go further and say that not only the footbut the whole limb is put in a constrained position whenworking an ordinary pedal; and that this constraint isgreatly lessened by a proper inclination of the tread. Severalfriends have reported to me that with a sloping tread they"find pedalling easier." Dr. Watteville, Kingussie, writes(after six months' trial):

In addition to the lessening of friction, I find that the slopingpedals give me more power, and fatigue is thus lessened. I am derivingmuch comfort from- them.Increase of power and of comfort are advantages that

should claim the attention of. all bicyclists. To the minoritywho suffer from cycling corns the hope of getting rid of them,as I have done, will make an additional and a still strongerappeal. In the hope that- some medical men may be inducedto adopt and to recommend an improvement devised onanatomical instead of- purely mechanical principles, I desireto bring it under the notice of the profession.

E MEMORANDA:MEDICAL, SURGICAL, OBSTETRICALi, THERA-

PEUTICAL, PATHOLOGICAL, ETO.THE LOWERING OF THE BODY TEMPERATURE IN

HYPERPYREXIA. BY MEANS OF RAPIDEVAPORATION OF WATER.

THE application of cold water has now become so well recog-nized as a part of the treatment of typhoid fever that mostpublic hospitals are equipped with arrangements for itsroutine administration. Many difficiulties,- however, still faceits adoption, while a fairly large staff of nurses is requisite forits systematic use. Again, where ice is utilized the supplyoften gives out, and in the hot zones of Australia, India, orAfrica the difficulties associated with this special method oftreatment can be better imagined than described. Thescheme which I have improvised for the lowering of bodytemperature is as follows:The patient's bed is covered with some waterproof, over

which is placed a sheet of towelling. This towelling, thesides of which are cut in a slant, is braided with jaconet.The patient reclines on the sheet, and has, if necessary, awarm bottle to his feet. Over the whole of his trunk anotherpiece of towelling is now placed in one or two layers, hemmedand bound along its sides with jaconet. A cradle is nowplaced over the bed, to the dome of which is attached a smallelectric revolving fanx surrounded by a wire cage. Affixed tothe cradle is a small rose, through which water slowly spraysin fine driplets on to the towelling covering the patient. Thefan, revolving with more or less rapidity, affects the evapora-tion of water so that the degree of cold can be regulated to anicety. All the nurse has to do after taking the temperature

of the-paient ia to switch-on the eleetrieinstalsatinwbenit will be,o1und-that-a rapid,evaporationef Wmatuve-owezsthe, temperatare. Should there -be any surpls of. water itwill ran down the -jeonet -draias inta.a receivenst the foot ofthe be.d..A few large fans in the ward. would keep the air pure and

cool the -atmosphere. This, of course, requires electricinstallation, but bhe initial eost cannot. be considecablewbenthe set-off;in. the eeeaay- both in labour and material4s-tken-Ito aceount.

Louis HzNRi, M.D.,Honorary Assistant Physician, Alfred Hospital, Melbourne, Victoria.

PROTECTIVE POWER. OF VACCINATION.THE following case supplements that published by Dr. Angusin the BRITISHMuDrok J;JURNAL, October I5th, 1904:Mrs. S. D., aged -37, was admitted. to the Basford- Sana-

torium, Nottinghm auffering from small-pox *n June 13th,1903. Her seven months old baby, which she was suckling,and which had been successfully vaccinated fourteen dayspreviously, was- admitted with- her. The bs,byFwasgntwsaed

A..

but was nursed by its mother throughout her illnesis (con-fluent small pox) and was handled daily by the other patients,about fifty in number, in various stages of small-pox. Thebaby left in perfect health. The vaccination marks. on thebaby's- arm can be made -out in the photograph by means ofamagnifying glass.Bulwell, Nottingham. H. J. NEIILSON, M.D.

A RARE FORM OF DISLOCATION OF THlE ANKLE.A MAN, aged 56, was descending some stone steps when hemissed his footing; his left foot got fixed in a corner, and hefell, twisting it outwards under him. He was taken to hos-pital in an ambulance, and I saw him about three-quarters ofan hour after the accident. He was in great pain, and lyingflat on his back. The patella of each knee looked straightupwards, but whilst the right foot pointed straight upwards,the left was lying transverse and flat on its outer.side, dis-located at the ankle joint by being rotated exactly a rightangle outwards on its vertical axis. It was neither too farforwards or backwards, but simply rotated. The tibia wasunbroken, and. the internal malleolus projected consiJerably,stretching the iskin over it. But the anterior face of thelower end of the tibia, was still m'ore prominent, and stoodout very remarkably. The fibula was broken by anoblique fracture extending ,,downwards and inwards in its

77° T I HOSPITAL REPORTS. i[APRL. % 1905.

middle third. The external malleolus was twisted outwardsand backwards with the outer side of the astragalus towhich it was still attached in its normal relation-ship, so that the two malleoli were only separatedbehind by about a quarter of a circle, and by three-quarters of a circle in front. The astragalus was still in con-tact with the articular surface of the tibia, but at a right angleto its normal position. The tendo Achillis and the heel lookedpractically normal, the foot not being noticeably shortened orlengthened. The inner side of the tibia was very prominent,and the skin was tightly stretched over its lower end, andtwisted like a corkscrew. The two things that were moststriking on first seeing the case were the peculiar transverseposition of the foot, and the strange appearance of the anteriorface of the lower end of the tibia. The foot was not at alleverted or inverted on its longitudinal axis, but rotated aquarter of a circle on its vertical axis. -Under an anaestheticthe foot was replaced with very slight extension and internalrotation, and it went into its normal position with a snap.The case was seen also by my colleague, Mr. Llnington, andthe House-Surgeon, Mr. Bradbury. I have given thislengthyaccount of the case as I can find no record of anything of thekind.

THOMAS EASTES,Honorary Medical Officer, Victoria Hospital, Folkestone.

PEMPHIGUS NEONATORUM.IN May last I received a telephone message from the Women'sHospital asking me to see some little babies there which weresuffering from cutaneous disease. I immediately went, andwas greatly rewarded by seeing an interesting clinical entity-to wit, pemphigus neonatorum. At the time there was abad case of syphilitic eruption in the hospital, and it wasthought that it might be due to this; but the rapidity withwhich the disease progressed precluded this. Evidently thiswas an epidemic of cutaneous disease. At the time therewas quite a number of newly-born babies in the hospital, andone and all became affected with the disease. It was abullous-like eruption, commencing In the fingers and hands,and spreading on the face, buttocks, and other parts. Itbecame pustular and confluent in a sort of semicircle. Thesewould form bullae, especially on the face, which becameswollen. It rapidly effloresced. The eyes were swollen andejected. At first I thought it might be impetigo contagiosa.It bore somewhat of this character. The etiological characterof pemphigus neonatorum is still a moot point. Most moderndermatologists consider it allied to, if not identical with,impetigo contagiosa or bullous varicella. I ordered anointment of I0 gr. of ammoniated mercury in vaseline. Itimproved rapidly under this. The hospital was in a soundsanitary condition, no bad sewers or drains.Two types of this disease are known-mild and severe.

Sometimes it results in high fever and death. An epidemichas been reported in a lying-in hospital, due to the careless-ness and uncleanliness of the midwife. As these cases ofpemphigus neonatorum are not extremely common, it seemedto me that a report of a case might not prove uninteresting.

J. LESLIE FOLEY, M.D., L.R.C.P.Lond.,Physician to the Skin Department of the Western Hospital,

Montreal.

GONORRHOEAL ENDOCARDITIS.HAVING read Dr. Hunter's interesting paper on a case ofgonorrhoeal endocarditis,l and having leamed that few casesof this condition are upon record, I submit the followingnotes of one which occurred recently in my practice.On November i ith, I904, at 9 p.m., I was called in to see J. A.,

aged 24. He was stated to be gasping for breath and dying.On examination, I found temperature 1050, pulse 140, ortho-pnoea, acute pain in precordial region, heart sounds unrecog-nizable, great distress in breathing, lividity of face and ex-tremities, great anxiety, and delirium. He had been at hiswork the previous day, and there was no history of rheu-matism and no affection of the joints. I injected liq. strych.ntij hypodermically, prescribed sinapism to precordial region,emptied the bowel, and put him on a mixture of tr. digitalisand liq. strych.Next day he was still very ill, had not slept, and was

vomiting. Temperature 1040, and pulse 130. I stopped themixture and put him on pil. digitalin, renewed the sinapism,and gave him. liq. morph. "ix, aq. chlorof. Ass, and rectalinjection of beef-tea.. 1 saw him again in the evening:the pulse was slowi9r-I20-and the breathing easier. The

1 BRiTISl iMED1CAL JUUtNAI., March xith, P. 525.

temperature was IO3°, and the delirium was gone. Nextmorning the improvement still continued, but the endo-carditis was still present. Both the mitral and the aortievalves were affected. On inquiry, I ascertained that threeweeks previously he had developed an acute gonorrhoea, andhad been under treatment by a local chemist. though no dis-charge was present when I examined him. He continued toimprove under rest, strict dieting, morphine, and digitalis,until November 25th, when I was called late at night to seehim. He had lost the use of his left arm, but was otherwisefeeling better. &I had the arm elevated and wrapped in cottonrwool, and prescribed liq. feri phosphThe paresis continued till December gth, when it disap-

peared as suddenly as it had come. His convalescence wasuninterrupted. The gonorrhoeal discharge reappeared onDecember 15th, during convalescence, but yielded easily to afew protargol bougies. The man is a carter, and is now backat his work and in good health, save for a mitral regurgitantmurmur.

I have not previously had a case of this complaint, but to(my thinking the interesting features are (i) the rapid onsetof the endocarditis, (2) the high temperature, (3) the em-bolism, and (4) the quiet disappearance of the embolus. 1quite agree with Dr. Hunter when he says that the "gonor-rhoeal bacillus must be regarded as capable . . . of settingup widespread disease in the body."

W. M. HAMILTON, M.D.,Surgeon, Eccles and Patricroft Hospital.

REP ORTSON

MEDICAL AND SURGICAL PRACTICE IN THEHOSPITALS AND ASYLUMS OF THE

BRITISH EMPIRE.

WARRJNGTON INFIRMARY.A CASE OF SPONTANEOUS SUBLUXATION OF THE WRIST.(Under the care of E. J. Fox, B.Sc., F.R.C.S.Eng.)

[Reported by A. HODGKINSON, MI.SC., M.B.Vict., Senior HouseSurgeon.]

SPONTANEOUS subluxation of the wrist is a condition of suffi-cient rarity to render the following case worthy of record.

IIistory.-X., a domestic servant, aged 17, was admitted to theinfirmary on November soth, 1902, under Mr. Fox, with the followinghistory. She was employed in a public-house, her time being prin-cipally occupied in dusting, washing, and scrubbing. Her tathersuffered from phthisls. Her mother, one brother, and two sisters wereall healthy; five other children -died in infancy. She herself states shehad always had good health. There was no history of syphilis orinfantile rickets. In June, 1902, she noticed that her left wrist becamepainful while using it. She al3o observed that it was becoming deformed.By degrees the pain and deformity increased until even at night whenthe limb was at rest the pain was of such a severe character as to keepher awake. Complete loss of power in the wrist followed, and then shecame to the infirmary.

State oni Examination.-She was a well-built, robust girl. The bonysystem was well developed, and there were no signs of disease with theexception of the lesion about to be described. On examination of thewrist by palpation, the inferior extremity of the ulna was found to bedisplaced posterior]y, and very prominent. The carpus was sepa-rated from the ulna, lying in a plane anterior to that bone. The radiuehad a slight anterior curve, its inferior extremity being separated fromthe ulna by a space wider than usual, and lying in a plane anterior tothat of the ulna. The carpus in relation to the radius was subluxedslightly anteriorly. The hand was carried forward by the carpus.There was no wasting of the thenar or hypothenar eminences, and nocapparent wasting of the interossei; on the other hand, the muscles ofthe forearm were slightly wasted.The following comparative measurements show the difference in the

two forearms:At the level of styloid process: Left. Right.

Circumference... ... ... ... 6 in. 6 in.Autero-posterior diameter ... ... I,,Transverse diameter ... ... . 2- ,, 2-

At a level 2 in. below olecranon process:Circumference... ... ... .8,, 9

The movements of abduction and extension on the left side were notso complete as on the right side.A study of various skiagraphs verified the facts obtained by palpa-

tion. Besides the anterior flexion of the radius there was a slight lateralcurvature with its convexity external. There was no enlargement ofthe inferior extremity of either the radius or ulna.

Operation and Treatment.-The patient while in the infirmary wasanaesthetized, and an incision Ii in. in length was made over theposterior surface of the inferior extremity of the radius. Another, z in.

7tSc6 TM.l 5IOl,I MEDIGAL NSWS. ['APRIL -8, igo;90.

MEDICAL NEWS.PROFESSOR J. SYMINGTON of Belfast has been appointed an

examiner in applied anatomy and physiology for theentrance examination to the Indian Medical Service.

THE first cremation at the recently-erected crematorium atthe City of London Cemetery, Little Ilford, was carried outsuccessfully on March i8th. Complete incineration waseffected in sixty minutes.

THE annual public meeting of the Metropolitan HospitalSaturday Fund will take place at the Mansion House onApril 29th, on which occasion Dr. Latham will deliver anaddress on Sanatoriums for Workers.

THE festival dinner of the National Hospital for the Para-lysed and Epileptic. Queen Square, London, which was tohave been held on Thursday next, has been postponed owingto the continued absence of Lord Stratheona in Canada.

A PROVINCIAL sessional meeting of the Royal Sanitary Insti-tute will be held-at the University of Liverpool on Saturday,April 15th, at, ii a.m., when a discussion on recent methodsof rehousing tenants dispossessed from insanitary propertywill be opened by Mr. Fletcher T. Turton, Deputy Surveyorof the Corporation of Liverpool.

THE dinner at which the medical profession of Croydonand district have decided to entertain Dr. Owen Fowler willtake place at the Greyhound Hotel, Croydon, on May 4th, atS p.m. It will be remembered that Dr. Fowler was theco-respondent in the recent action of Miller v. Miller andFowler, and when the case against him was dismissed thejudge said that Dr. Fowler had absolutely cleared himself,and left the court without a stain upon his character.Tickets, exclusive of wine, se. each, can be obtained ofDr. C. M. Fegen, Town Hall, Croydon.Miss J. BLOWER, late matron of the Ardwick and District

Nurses' Home, Manchester, has been presented by the medicalmen with whom she has been associated in the work amongst-the sick poor for the past nineteen years with an illuminatedaddress, accompanied by a cheque, in recognition of their.apreciation of her valuable services. Dr. Vipont Brownpresided at the meeting on April 4th, when the presentationwas made by Dr. F. W. Saberton on behalf of over sixtymedical men whose names were appended to the address.

THE wounded officer and men of the Russian warshipVaryag, which was sunk by the Japanese at Chemulpo in thefirst stages of the war, had the benefit subsequently of theprofessional care and attention of Dr. Atkinson, PrincipalCivil Medical Officer, and Dr. J. Bell, Superintendent of theGovernment Civil Hospital. The Czar recently sent for eachof the gentlemen a cigarette case of solid gold, with theImperial coat of arms set in diamonds. These souvenirs werepresented to Drs. Atkinson and Bell recently by the Governorof Hong Kong.

THEI EPIDEMIC OF TYPHOID FEVER IN LINCOLN.-The totalnumber of notifications during the week ending Friday,March 31St, was 38, the totals of the four previous weekshaving been 37, 46, 46, and 32 respectively.

ANTI-C0GAREFrTE LEGISLATION IN AMIERICA.-A Bill whichmakes unlawful the sale, gift, or importation into the Stateof cigarettes or cigarette materials passed the WisconsinSenate on March 17th. It had previously been passed bythe Assembly.

BEQUESTS TO MEDICAL CHARITIES.-Under the will of thelate Miss Amelia Jane Bathurst of Eastbourne, which hasnowbeen proved, the West London Hospital, the Princess AliceMemorial Hospital, Eastbourne, and the All Saints' Convales-cent Hospital in the same town, each receive the sum of£200.GERMAN SURGICAL CONGRESS. The German Surgical

Society will hold its thirty-fourth annual Congress in Easterweek, April 26th to 29th. The following questions are pro-posed for discussion: The operative treatment of appendi-citis; renal diagnosis and extirpation of the kidneys; post.operative pneumonia; the treatment of fracture of the patella.Members will have an opportunity of seeing Bier's method ofartificial hyperaemia practised in a number of cases of acuteinflainmatory conditionsby Dr. Bier himself.

THEc SPITING NUIsANOE.-Printed notices to the numberof 2,700,000 have been prepared sand will be placed in allschool textbooks in New York City, warning pupils againstspitting on street- pavements aand the floors of . public placeasAt a recent meeting-f the <Maryland Society for the Pre-vention of Tabereulosie held in' Baltimore, Dr. John S. Fultonpresented cards which he had prepared for distribution amongthe public. The object is to collect "sputisties " regardingexpectoration in public places. Those interested in the sup-pression of this filthy nuisance were urged to fill up thecards with records of their observations and forward them tothe Secretary of the Society.METROPOLITN HOSPITAL SATURIDAY FUND -The report of

the Council of this fund, which was adopted at the thirty-firstannual general meeting on April ist, showed that in Januarylast the Board of Delegates divided £22,196 among I98 hos-pitals, dispensaries, and convalescent homes, this amountbeing over £-,ooo greater than in any previous year. Thereceipts from the colleetiens made in-nworkshops and plaees ofbusiness also showed satisfactory increase, and had reached£24,344. The Surgical Appliances Committee provided duringthe year 4 644 appliances, to the cost of which the recipientscontributed £2,289. Jn addition, arrangements had beenmade for the transport of a good many patients to or from thehospitals. The Boar.d recommended the grant of a sum of£500 to the National Committee for the establishment ofsanatoriums forworkers to assist in the erection of the proposedsanatorium at Benenden in Kent, and thereby secure fifteenbeds in this institution for the use of supporters of the fund.DINNER TO MR. W. JOHNSON SMITH.-A complimentary

dinner was given to Mr. W. Johnson Smith by his friendsand colleagues on the occasion of his retirement from thepost of principal medical officer to the Seamen's HospitalSociety (Dreadnwught), Greenwicb. The dinner was given atthe Trocadero on April 5tb, with Sir Patrick Manson in thechair. In front of the Chairman were placed an ancientsilver porringer and a chest containing a silver service, forpresentation to Mr..Johnson.Smith, whilst in the middle ofthe room was a large model of the old Dreadnought. Afterthe toast of "The King" had been duly honoured, SirPatrick Manson, in proposing the toast of the guest of theevening, "Mr. Jobnson Smith," said that they were met to wishMr. Johnson Smith prosperity and long life, and to give them-selves the satisifaction of expressing their appreciation of theservices he had rendered to the Seamen's Hospital. Mr.Johnson Smith had not only deserved success but he hadattained it. Sir Patrick Manson went on to describe howmuch had changed in the medical profeesion since Mr.Johnson Smith joined it in I862, and pointed out that thewhole atmosphere and style of surgical science had undergonea complete alteration. When Mr. Johnson Smith joined theprofession microscopes were practically unknown in hospitalsand the only anaesthetic in use was chloroform. There mustbe stored up in the mind of Mr. Johnson Smith a mine ofmemories of the preantiseptic days, but he had kept pacewith the advances made in his profession, and his work, TheShipmaster's Medical and Surgical Help and First Aid waswidely used. The friends and colleagues of their guest wereanxious that he should not forget them, and to emphasizethat they had materialized their feel.ings, of goodwill towardshim by asking him to accept a chest of plate and a porringer.Sir Patrick Manson then presented Mr. Johnson Smith withthe plate and porringer, and expressed the hope that theywould remind him of his old friends and colleagues.Mr. Johnson Smith, in replying, spovke of the happy dayshe had passed on board the Dreadnought. He referredto the connexion of the Seamen's Hospital with Sir PatrickManson, and observed how proud they all were of his cele-brated researches into the question of malaria. He describedhow the patients in the Dreadnought were nursed when hefirst joined it. There were a few oldwomen, but the majorityof the nurses were old men, and their chief qualification forthe post was that they had been fishermen. They certainlyenjoyed the full confidence of their patients, and were anobject of concern to politicians, as they lived on shore intenements and therefore had votes. Mr. Johnson Smith con-eluded his speech by declaring that it was some comfort tohim to know that he had tried to do his best. Sir HenryBardett, in proposing the toast of "The Seamen's HospitalSociety," eulogized the work done by that charity. AfterMr. Nairne and Professor Hewlett had replied to thistoast,Mr. William Turner gave the toast of "The Chairman," whichwas suitably acknowledged.

I=

APRIL 8, 1905.] SPECIAL CORRESPONDENCE. [1 *A 797

ERNEST HART RESEARCHI SCHOLARSHIP.The Council of the British Medical Association is also

prepared to receive applications for the Ernest Hart MemorialScholarship of the value of £2oo per annum, tenable for oneyear, but subject to renewal by the Council for another year.The Scholarship is for the study of some subject in thedepartment of State Medicine.Applications for all Scholarships must be made on forms to

be had of the General Secretary, an(i returned on or beforeMay 3Ist.

429, Strand, March, I9o5. GuY ELLISTON, General Secretary.

THE GRIFFITHS TESTIMONIAL FUND.DR. A. P. FIDDIAN (23, The Walk, Cardiff), Treasurer of thisFund, has received the following further subscriptions:

£ s.d.Amount previously acknowledged ... ... ... 70 14 6Dr. W. C. Griffiths ... ... ... ... o zo 6Dr. J. Shaw Lyttle ... ... ... ... ... ... o IO 6

The object and particulars of the fund were stated In ourcolumns of January 218t, I905, P. I6o.

CONTRACT MEDICAL PRACTICE.NOTICE AS TO ]DISTRIaTS IN WHICH DISPUTES EXIST.

A notioe as to places in which diputes exist betwee membere ofthe medical profession and various organizations for providingcontract practice will be found among the advertisements, andmedical men who may be thinking of applying for appointments inconnexion with clubs or other forns of contract practice are requested to refer to the advertisement o page 95.

SPECIAL CORRESPONDENCE,BERLIN.

Alcoholism among the Workhig Classes.-New Wing of theChildren's Hospital.-The Discoverer of Morphine.

THEa Berlin Municipal Hospital-" Friedrichahain "-which issituated in the east end of the city, makes its report for thisyear the vehicle for some serious reflections on the drinkinghabit and its ravages among the working population of Berlin.No less than 208 cases of delirium tremens were taken induring the year, and this figure is far from expressing the realnumber, for in many cases delirium tremens supervened as acomplication of other diseases. The Friedrichshain patientsare recruited chiefly from the working classes, and the registersshow how widespread the drinking habit is among them.Almost a third of all sickness among the men is broughtabout by excessive spirit drinking.A new wing is to be added to the Kaiser and Kaiserin

Friedrich Children's Hospital. Building has been begun, andit is hoped that the wing will be ready for use before the endof z9o6. The number of beds, which at present is Igo, willthen be almost doubled.A hundred years have passed since Dr. Seeturner, an

apothecary in Hamelu (EHanover), discovered morphine, andthe German Society of Apothecaries has marked the date byaffixing a commemorative tablet to the house in whichDr. Seetirner lived.

LIVERPOOL.The Ladies' Charity and Lying-in Hospital.-District Nursing

Association.THE annual meeting of the Ladies' Charity and Lying-inHospital took place recently at the Town Hall, the LordMayor presiding. The report showed that the operations ofthe charity for the past year had been the largest in severalrespects since 1896. The outdoor cases were i,goo, against1,790 in the previous year. The usual relief in the form offood, special nourishment, and coal, was furnished to verypoor patients, and clothing and bedding were lent or given;281 patients were admitted to the hospital, against 250 in theprevious year. Sixty-eight pupil midwives were trainedduring the year, 5o receiving certificates, showing a consider-able increase which was attributed to the passing of the Mid-wives Act of i9o2. Ten medical students took out their

midwifery practice with the charity during the year, inaccordance with the arrangements made with the University.The annual report of the Queen Victoria District Nursing

Association shows that the work done by this very excellentinstitution continues to increase, and that the Association isnow equal to the largest individual District Nursing Associa-tion in the country. There are 47 nurses and 5 matrons onthe staff. During the year 7,496 separate cases were attendedand 185022 visits were paid. Besides these the nurses goingto the elementary schools for the purpose of attending to theminor ailments of the children had made 46,695 dressings.The Liverpool Education Committee are at present consider-ing the question of officially recognizing and assisting thispart of district nursing.

LEEDS.The Feeding of School Children: The Childref's Relief Fund:Dr. Hall's Investigations: Efects ofExtra Meals on Weight ofChildren.

THERE can be no doubt that one of the most important factorsin influencing the physique of a nation must be the possi-bility of the children obtaining an adequate supply of suitablefood. The Education Committee have made an inquirythrough their School Attendance Subcommittee into thenumber of underfed children attending the elementary schoolsin the city. According to their report the numb&r amountsto 3,245. The number of parents known to be out of work was802, of whom 1og belongecd to the less deserving class. At thebeginning of the winter the number of underfed children wasstated to be 6,720. It was resolved to recommend the LordMayor to convene a meeting of voluntary workers with a viewto considering the question of providing meals for underfedschool children at three or four centres; that the cost of suchmeals be defrayed by voluntary contribution, and that inquirybe made by the school attendance officers into all the cases toprevent abuse.This, of course, is very far from representing the beginning

of the work in Leeds in the direction of feeding necessitouschildren. Early in the winter the Leeds Children's ReliefFund began its work, and an interim report issued on January20th showed that 175000 dinners had been provided at a costof I Iyd. per head. In the first week, 29,797 children were fed,and in the fifth 26,coo. This work, however, came to an endsome weeks ago, and it mav be remembered that attentionwas called to this in the House of Commons by Mr. KeirIlardie.Not only is the feeding of children during the school-going age

of the utmost importance, but there ranks with it the feedingof the younger children and infants, and of the mothers duringpregnancy and lactation. The work of Dr. William Hall, oneof the senior members of the medical profession of Leeds,who lately retired from practice, and has employed his leisuIein extending his investigations in this connexion, is of theutmost interest and importance. As already explained in theBRITISH MEDICAL JOUIRNAL, Dr. Hall has, with every precau-tion to ensure a fair comparison, investigated the physicalcondition of groups of Jewish and Gentile children of the sameage, and living under the same conditions as to locality, andas to poverty. After the examination of a great manychildren, some 3,000 in all, Dr. Hall stated that the poor Jewwas 3 lb. heavier and 2 in. taller than the poor Gentile at theage of 8; at io years of age he was 6T lb. heavier and 21 in.taller; and that at 12 he was 7 lb. heavier and iI in. taller.The teeth of all the children were examined and the con-

dition of the osseous system investigated as far as possible,and Dr. Hall's report is that from 6 to 13 years of age thepoor Jew is much less rickety and has much better teeth.A great many of the Gentile children were mouth-breathers,but in his examination of the Jewish children Dr. Hall was1struck by the size of the nasal chamber and with thebreadth and flatness of the roof of the mouth, and by theabsence of mouth-breathing. Without in any way denyingthe injurious influences of overcrowding, hereditary predis-position, damp, cold, and impure atmosphere, Dr. Hall claimsthat the favourable and unfavourable position of the Jew andthe Gentile children respectively in the above comparison isdue in great measure to the character of the nourishmentsupplied to them before and after birth. Among theclass he has investigated the pregnant Jewess is betterfed, and after delivery sbe usually nurses her child, being ableto do so in a greater percentage of cases than her Ggentilesister. After the period of lactation he has found that the

APRIL 8, Ig.] MEDICO-LEGAL D M - 803

Queries. He joined the C.E.T.S. in 1875, and became a totalabstainer, and the temperance cause became thenceforth veryaiear his heart. He published some valuable contributionsto the literature of the subject ; one of these, on Alcohol inArctic Exploration. attracted much notice, and was translatedinto Dutch. Another paper on the mortality referable to*alcohol led to the appointment of the Committee of theHarveian Society, which presented a valuable report on thesame subject. He worked hard for the Committee anddrafted the renort. He was also chairman of a small Com-mittee of the British Medical Association, which presented areport upon the consumption of alcohol then and twenty-five3years previouisly.

Dr. Morton was Chairman and Consulting Medical Officerto the Kilburn Provident Medical Iastitute, which owed itsinception to his efforts and initiative thirty years ago (i84),when a scheme was drawn up for its management for whichhe was mainly responsible. He was a Vice-President andmnember of the Council of the Society for the Study ofInebriety; and acted as secretary of an important committeewhich investigated the question of alcoholism and its hereditytransmission two years ago; and he had been on the Counciland Treasurer of the British Medical Temperance Associationeince 1884.

Of late years Dr. Morton had taken a deep and increasinginterest in the subject of heredity and the transmission ofSpredispositions and tendencies in the mental and psychicalsphere, his thoughts being led in this direction largely by hisobservations during his professional life upon the morbid-effect of parental and especially maternal intemperance uponthe children. He also published various other papers, chieflyuapon the subject of intemperance. He was a Vice-Presidentof the Metropolitan Counties Branch of the British MediealAssociation, and a President of the Harveian Society. Heconstantly attended the annual meeting of Fellows andMembers of the Royal College of Surgeons at the College, andoften proposed resolutions haVing for their object the repre-eentation of the Members on the Council.

Altogetherhe was a man of-wide sympathies, great industry,and energy, and was the object of respect and esteem of a'large circie of patients and friends. He was a man withoutguile, always crediting others with the same transparentlyhonest motives as those which actuated himself. His wifeand sons and a daughter survive; his son, Dr. J. L. Morton,hiad been his partner for some years.

THE death is announced from New Zealand of Mr. JAMES1PAYNE BAKER, of Tauranga, Auckland. He was originallya student at Edinburgh, and became L.R.C.P.and S. in I876,and a Fellow of the College of Surgeons of Edinburgh in 1879.After a certsin amount of work in England he went out toNew Zealand, and there gained a distinct if not very promi-nent position as a medical man earnest in all he undertookand sincere in all his ways. He took a great interest inChurch matters, and for long acted as a lay reader, and con-ducted services in places which regular clergymen could butrarely visit. He was a member of the New Zealand Branch ofthe British Medical Association, and a Mason of standing inthe craft.

WE regret to have to record the death on April 2nd ofDr. JAMES ALEXANDBR, of Paignton, President of the South-Western Branch of the British Medical Association. Wehaope to publish a biographical notice in a subsequent issue.

DEATHS IN THE PaOFESSION ABROAD.-Among the membersof the medical profession in foreign countries who have re-cently died are Dr. Lombard, Director of the Medical Schoolof Caen; Dr. Parinaud, a well-known Paris ophthalmologist,author of works on eye diseases, aged 6o; Dr. Collinot,representative of the Yonne Department in the FrenchSenate; Dr. W. H. McPheeters, the oldest physician of St.Louis, formerly professor of clinical medicine in the St.Louis Medical College and associate editor of the Medical andSurgical Journal of that city, aged 89 ; Dr. Bobroff, Professorof 8urgery in the University of Moscow, President of theRussian Surgical Society and author of numerous contribu-tions to surgical literature, aged 55 Dr. G. Piotrowski,.Privatdocent of Physiology in the University of Lemberg; Dr.Andreas Chodin, of Kieff, a leading Russian ophthalmologist,author of monographs on the simulation of blindlness anddefective vision, on practical ophthalmology, on ophthalm-o1scopy, and on opera! ions on the eye, founder, and for many

years sole editor, of the Russian We8tnik Oftalmologii (Journalof Ophthalmology), aged 58; Dr. Theodor Bornbaupt, some-time Professor of Surgery in the University of Kieff, aged 63;and Dr. Alfred Frantzen, a well-known gynaecologist of St.Petersburg, aged 42.

MEDICO-LEGAL AND MEDICO-ETHICAL.MEDICAL MEN AND TILE LAY PRESS.

THz gentleman, whose interview with a reporter we referred to in theBRITISH MEDICAL JOURNAL Of March 25th, writes to say that the inter-view was "almost necessitated by a most blood-curdling and exa.gger-ated article iu the Daily ExpresJ the previous day," but that much ofwhat was put into his mouth was "the creation of the reporter whowas doubtless anxious to undo the mischief he had done."*** While we are glad to give publicity to this explanation it only

serves to emphasize the objection to giving such interviews.

CIRCULARI3ING TEIl PROFESSION.WITH regard to the post card iLsued by a resident medical practitioner tothe profession in the Manchester district, referred to in the BRITISHMBDiCAL JOURNAL of March s25h. we learn that there are special circum-stance3 which entitle him to sympathy. We should regard it asmost unfortunate to allow a precedent of this nature to be established bywhat is undoubtedly a hard case. There is a well-known legal maximthat "HHard cases make bad laws."

SECRET COMMISSIONS.A CORRESPONDENT sends the following advertisement cut from theScotsman of March 22nd:Medical.-Chemist wishes to meetwith doctor desirous of creatinga practice in country town; good distriet; commission given.

He adds, " Apparently Mr Justice Fry's remarks on secret commissionare true in fact, when it is thus openly advertised."*** We have never denied that offers of secret commission have been

and are made to medical practitioners. What we have denied is SirEdward Fry's assertion that it was the practice of the medical profes-sion in this country to accept them. We can only trust that we areright in supposing that such an offer will not meet with any response.

"MESUAGES RECEIVED."Ir has been repeatedly pointed out that, as a general rule, a notice in ashop window that messages are received for a medical practitioner is anunjustiflable advertisement. only permissible in very scattered countrydistricts. In the present instance, if this excuse does not exist, thematter should be referred to the Division to which the member ofwhom complaint is made belongs.

ROYAL NAVY AND ARMY MEDICAL SERVICES.INDIAN M13DICAL SERVICE.

PROMOTION To LIJSUIENANT-COLONEL.IT has been decided that promotion to the higher grade of Lieutenant-Colonal in the Indian Medical tiervice, in place of an officer transferredto temporary half-pay, is to be permanent, the officer so promotedbecoming supernumerary in the event of the officer transferred beingrestored to the effective list.

MEDAL FOR NORTHIERN NIGERIA, x9o3.THE King has been pleased to approve of the Africa general servicemedal with clasp. inscribed "N. Nigeria, 1903," being granted to thoseofficers and others of the Imperial and Colonial forces engaged in theSokoto-Burmi, Northern Nigeria, military operations between April 15thand July 27th, 1903, both dates inclusive, who have not received themedal and clasp under Army Order 171 of 1903. Those who are alreadyin possession of the Africa geueral service medal, but have been awardedthe clasp 'N. Nigeria, x903," will receive the clasp only.

INCREASED PAY TO INDIAN MEDICAL SERVICE.Txz Pioneer (an Indian newspaper) announces that the Socretary of Statehas agreed to the proposals of the (iovernment of India to increase thepay of civil surgeons, with retrospective effect from April Ist, x9o4. Theincrease to officers of the Indiaa Medical Service in military employmenthas effect from the middle of August, I903.

PUBLIC HEALTHAD

POOR-LAW MEDICAL SERVICESMILKBORNE SC&RLET FEVER.

DR STUART PETnICK, the Moedical Officer of Little Woolton in Lancashire,has furnished an interesting report ou a recent outbreak of scarlet levertraceable to milkborne infection. The population is r,o9r, and at the endof March and beginning of ApI il last year tttere was a sudden occurrenceof scarlet fever (30 cases) from which the district had been free. Twenty-eight of the patients received iheir milk supplyfrom the same dairy farm,and the remaining two probably draLuk the implicated milk on more thanone occasion. Households were atta'redu in proportion to the amount ofmilk consumed, those consuming most being most attacked, the incidence

804 K.TIw=l UNIVERSITIES AND COLLEGES. [APRIL 8,_IO5*being greatest among children. The infection in the milk was continuousfor some ten days, but its exact source was not detetrmined. The sanitaryconditions of the farm and the methods of dairying were good. Nopersons in the farmer's family or aImoDg the milkmeu or their familiesnad recently suffered from scarlet fever or any disease simulating it. Thecows were also healthy and well kept, with the exceptlon of one whichappeared to be suffering from nephr-itis. Bacteriological examination ofthe milk fromn this cow revealed no pathological condition. The circum-stances of the outbreak poiut definitely in the dtrection of milkborneinfection, but the exact way in which the milk became infected remainsobscure.

CARE AND CONrROL OF IDIOTS AND EPILEPTICS.THE Royal Cammlission on the Care and Control of thc Feeble-mindedsat again otn April 3rd.Dr. HERB14'. 'tAJ.LLEY, Medical Inspeotor of H.M. Prisons in England

and Wales, havinug described the methods in use for dealing with weak-minded inhabitants of local prisons and convict establishments, ex-pressed the view that it was not desirablc that such persons should beconsigned to gaol.Dr. G. B. GkIFFITHSs, Deputy Medical Officer and Deputy Governor of

Holloway Gaol, saict he regarded the practice of giving feeble-mindedoffenders repeated short sentences of imprisonmeut as unscientific inprinciple and unsatisfactory in result. fhese persons tlhus becamehabitual criminals, who preyed on the public when at large and lived onthe taxpayer when iu prison. There should be special institutions towhich the court wlhich tried feeble-minded persons could send them ifconvicted. Their treatment should be injdividual and on medical lines,and their cla-'sification should be exact; they should be detained forprolonged periods in pleasant, healthy surroundings and taught somemanual occupation.Dr. A. EscuffoLz, H.M. Inspector of Schools for the Blind, Deaf, and

Defecttve, indicated the need for new legislation in the way of securingthe compulsory attendance at sui!able schools of all feeble-minded andepileptic children, and the detention, permanent and temporary, of allpersons 'morally unable to helo themselves. In view of the successfulworking of the Blind and Deaf Education Act, which was compulsory, hethought a new Act of the kind describcd would be successful also. Muehcould be done indirectly to arrest the serious evil of feeble4nindednessby attackinD the much more extensive evil of physical degeneracy fromwhich it sprang.

THE ADMINISTRATION OF THE MIDWIVES ACT, 19o2.DR. R. R. RhNTOUL (Liverpool) writes: The Liverpool City Council hasappointed its Health Committee to act, as " the Local SupervisingAuthority" under the above Act, and the latter body has passed thefollowing resolution: "That in cases of urgency in which mnedicalpractitioners have been called in by certificated midwives as corLtem-plated by Rule I7 of the Rules issued by the Central Midwives Board,pursuant to Section III, Subsection I, of the Midwives Act, 1902, a feenot exceeding I guinea be paid, on the certificate of the medical officerof health, to each such medical practitioner, inthe eventof hisfailingtoobtain pavmeut of his fee from the patient or from the Poor-lawauthority." This resolution is somewhat ambiguous. For iustance, thefee is not I guinea, and therefore afee of 5s. may be paid; and, again, themedical practitioner must prove to the medical officer of health thatneither the patient nor the Poor-law authority will' pay the fee. Also,the fee is to entirely cover any difficult obstetric operation, or merelyone visit. I would suggest that a fee varyitig from as. to 449. be paid bythe local supervisinig authority for an obstetric operation, and a 5s. dayand a I0s. night visit for an ordinary visit. One must ask, if the"agents" of the local supervising authority advise that a medicalpractitioner be called in. is their agent or authority responsible forpayment of the fee? I do not think either the agent or the authorityis, because Rule 17 of the Rules of the Midwives Board states only thatin certain cases "amidwife must decline to attend alone, and mustadvise that a registered medical practitioner be sent fot." Again, inRule Ig (b) nothing is said regarding payment! It simply states that awoman " requires medical assistance at once on account of -.Signed , Midwife." In fact it is careful to avoid making anyrequest for the practitioner to attend, or promise to pay. I think everypractitioner should carefully study these official Rules. A copy can beobtained trom Spottiswoode and Co., New Street Square, London, for7d., and the Midwives Act for 2d.

BACTERIAL DIAGNOSIS OF DIPHTHERIA.LOEFFLER'S BACILLUS. -In those districts in wvhich bacteriological exami-nations are systematically carried out in cases of suspected diphtheriait is the custom to ask the practitioner in attendance upon the patientto procure the material for cultivation, but where the clinical signs arewell marked and the medical attendant d)es not consider it necessaryto call in the aid of bacteriology it would be most undesirable for themedical officer of health to himself swab the patient's throat. To do sowould be to break the most important rule of conduct of a medicalofflcer of health-namely, never to see the patient of another practi-tioner except with the latter's consent or in consultation w:ith hiin.

UNIVERSITIES AND COLLEGES,UNIVERSITY OF EDINBURGH.

Tlhe Lord Rect'rship.THE Right Honourable R. B. Haldane, K.C., LL.D., M.P., has accepted tbeinvitation of the Executive of the University Liberal Association to standas their candidate at the next Rectorial election in November. Mr.Haldane is a graduate ofthe University.

First Professio7al Examination.The following candidates have been approved in the subjects indi-

cated:Physics.-D. C. Adam, F. Armstrong, Janet Armstrong, Alice E. M.

Babington, T. Hi. Balfour, G. L. Batra,. A. E. C. Beausoleil, B. J. W.Bennetts, J. G. Boal, T. C Borthwick, A. M. Bose, E. 0. Bowen, T. S.Bradburn, G. E K. Branch. W. G Brand. S. W. Brackenridge, J. A.Browne, W. F. Buist, 0. S. Bullock, W. L. Burgess, A. D. Campbell, J.A. Campbell, &. B..aOh lain J. 2...Charnock, A. D. Child, W. F.

Christie, H. A. Cookson, N. A. Coward, J. S. Crichton, Lucy E. Davle5Jemima B. Dickie, J. K. K. Dickie. I. D. Dickson. Adelaide A.Dreaper, F. A. Duffield, W. Dunlop, A. H. Ilmslie, H. G_Feliham, G. F. Fismer, C. C. Foster, F. B. Fraser, W. T.Gardiner, Mary M. Gardner, H. L. de F. Garland, G. H.Garnett, A. W. (Gill, W. E Goss, W. T. Graham, D. M.Grant, W. B. Grant, R. W. Greatorex, F. W. Greaves, W. p.Grieve, A. (G. Hamilton, R H. Hamilton, R. C. Harkness, EHenderson, G. X. Inoglis, Flora R. Iunes, A. B. Jamieson, W. CJardine, J. M. Jones, R. R. Kerr, G. E King, Lina Kurz, J. M. Lal,JanetLeiper, L. Leslie, L A Lewis, H Lipetz, W. R. Logan, W. H.Lowe, H. F. Lumsden, D. C. Macaskill, J. C. MacL;altum, A. J.M'Connell, P. A. M'Cool, W. Macdonald, T. M'Fetridge, R. BMaefie, Mary E. V. MIiwaine, J. Mackil, G. E. G. Mackay, A.Mackenzie, A. D. MIKenzie. W. M,Kle, A. c. M'Kil]op, D. M Phail,.R. C. Ma(Queen. A J. MaeVie, W. Messer, E. L. Middleton, G. M.Miller. R WV Miller, A. M. alinford. L. M. V. Mitchell, J. B. de!W. Molony, Flora Morrison, J. A Mortimer, R. M. Nicholson, W. H.Pallett, H. Paterson, R J. E. Paterson, Ella F. Pringle, S. P. P.Proctor, J. Rendwick, D. G. Robertson, J. Rooertson, W. S. Robert-son, W. H. Robinson, D. Ross, W. Ross, R. P. Rosser, Jessie A.Scott, J. M. Scott, S. C. Sen-Gupta, K. R. G. Shah, W. K. Sim, K_Simpson, G. H. Sinclair, W. Skirrow, T. W. Smart, H. F. Smitti,J. G. Smyth, J. J. Stevenson, W. Stewart, R. K. S. Sutherland, JSwan, L. W. C. Taylor, Ri. W. Teague, J. A. Thampson,.-A. B. Todd,J. Ware, A. Watson, T. Welsh, J. P. Whetter, H. Whittaker, E. W.Wilbourne, S. Williams, D. W. Woodruff, Margaret C. Young.Zoology.-D. C. Adam, J. R. Adam, D). Aiken. H. J. Allsopp, Janet Arm-strong, Annie C. Austin, G. L. Batra, W. M. Biden, T. C. Borthwick,A. M. Bose, A. M. Britton, F. A. J. Brodziak, B. b. Browne, J. E.Brydon, A W Burton, H G. Carter. J. A. H. Carter, L. L. Cassidy,J. Cathcart, W. D Chambers, P. Chisholin, Gladys H. Cook, J. S_Crichton, J. Crocket, J. K. M. Dickie, J. W. C. Drever, F. A. DuffieldW. J. Duncan, J. M. Elliot, A. M. Elliot, C. F. Fismer, Helen Forbes'W. C;. Fragoso, E. L. Galletly, F. P. Gibson, EI. R. B. Gibson, V. ],Gordon, D. M. Grant, W; B. Graut, J. A. W. Hackett, E. S. B-Hamilton, R. H. Hamilton, G. de C. Hugo, G. L. W. Iredale, H. iJohnson, J. H. Jones, J. Langwill, J. H. Lawrs, L. A. Lewis, H--Lipetz, H. A. V. Loots, P. C. Lornie, J. C. Lorraine, J. R. M'Gregor,Mary E. B. MacIlwaine, J. M. M'Keand, A. G. MacLeod, R. D. M.Macpherson, A. C. Maliace, T. H. R. Mathewson, Li. B. Maunsell,Flora Morrison, N. S Neill, E. F. W. Nixey, H. 0 O'Neill, J. J. Pace,W. H. Pallett, H. F. Panton, A. R. Price, K. A. Raeman, Di. Ross, R.P. Rosser, J. M. Scott, A. Sinclair-Loutit, W. Skirrow, T. F. MSmart, R. 0 Spencer, C. P. A. Stranaghan, G. F. Taylor, T. R. S.Thompson. W. S. lhomson, R. Thorp, P. Wheeler, J. Wilson, D. W,Woodruff, R. C. Wupperman, R. B. M. Yates.

UNIVER8ITY OF GL&SGOW.First Profeissional Examination.

TaE following candidates have been approved in the subjects indicatecB(B., Botany; Z., Zoology: P., Physics; u., Chemistry):D. R. Adams (Z.), J. Allen (B., Z.. P., C.), A. C. Anderson (Z. C.), J. G.Anderson (Z., C.), W. Anderson tZ., C.), W. H. S. Armstrong (P., C),J. C. Auchencloss (C), D. Barbour (Z., C.), A. M. Bayne (Z), h A. C.Beard (B., Z.), C. S. Black (Z), J. Blakely (B., P., C.), D. M. Borland(Z.), C. Brash (B., P), M. W. Broudy (B., Z., P., C.), A. H. Brown, (B.,Z., C.), C. J. B. Buchheim (B., Z), J. A. G. Burton (Z., P., C.), J. A.M. Cameron (Z., P.), A. t. Clark (Z, C), J. L. Cochrane (Z.), J. C_Coalburn (B., Z.), R. Cramb (P.), D. l)ownle (B, Z.), C. Duiguld (Z. C.",D. Fisher (Z., C.). T. S. Fleming (Z), G. Fletcher, M.A. (Z., C.), R. D.B. Frew (P., C.). J. B. Galbraith (B., P.), R. Gale (Z), W. E. Gemmel)(Z.). D. Gibson (P.), A. G. Gilchrist (Z., C.) R. D. (Soldie (Z., C.), G. S.Gordon (Z.), E. O'D. Graham (Z.), J. Graham (B., Z., P., C.), J..Granger (Z., C.), K. C. G. Gray (Z., C.). A. W. Gregorson (B.),G. Haddow (Z., P), J. M'L. Hendry (P., C.), B. M. Hunter (Z., C.),J. W. Jones (Z., C), 5. P. Kinloch (Z, P.), T. J. Kirk (B., C.), D. N.Knox (Z, C.), J. Lang (C.), A. Leishman (Z., C.), W. T. Lindsay(Z., C.), G. S Livingston (C.), W. M'Adam, M.A. (Z., C.), J Macallan(B., Z., P.), W. C. Macartney (Z., P.), F. C Macaulay (C ). R. M'Carli(Z., C.), W. M'Connell (Z., C.), D. M'Dougall (C), Di. M'Intyre (B.),SC. B. F. M'Kail (Z.. C), W. M. M'Kie (B., P. C.). R. H. M'Killop (B.),A. M'Kinnon (Z.). D. Mackinnon (B, P., C.), J. J. Mackintosh (P. C.),M. H. M'Leod (B., Z.), J. W. M'Nee (Z., C.), J. H. M-Nicol (Z., C.),M. MacPhail (P), A. M*Pherson (B., C.). M. M'K. MacRae (B., P.),T. Marlin (Z, U.), J. P. Mathie (C ), A Mitclhell (B), H. B. W. Mtorgan:(Z. C.), J. M'1 Morgan (B ), J Mowat (P., C.), J. Muir (B ), F. Murchie-(B.), C. S. M'K. Murison (P.), F. L Napier (Z), W. Niccnl (Z., C.)*R. C. Robertson (Z.), H. G. Robinson (Z, C.). A. Roemmele (Z., C.),W. W. Rorke (Z., C.), W. Rutherford (Z. C.), N. C. Scott (B., Z. P.,C.),WVW. Scott (P., C.), J. J. sinelair (Z., P., C.), J. S. Somervillo(Z., P.), R. Steel (Z), A. Stewart (Z., P), A. F. Stewart (Z, C.), I)Stewart (P., C), W, B. Stewart (B), R. W. Sutherland (Z., C.), D. C.Suttie (Z., C.), R. Sweet (Z.), A. Taylor (Z., C.), D. M. Taylor (Z.),W. Telfer (B, Z.), A. G. W. Thomson (Z.), J. L. Ure (Z., P.), C. H.Wagner (B., Z, P.), W. S. Waterhouse (C.), T. P. Watson (P.), J. B.Whitfield (Z, C.), W. C. Whittingham (Z., C.), J. A. Wilson (Z.. C,),W. M. T. Wilson (C.), J. Y. Wood (Z., U.), D. Yellowlees (Z., C.), D,Young (Z., C.).

Women.-C. Barrowman (P., C.), M. B. S. Darroch (C.), M. C. Mitchell(C.), M. Muir (C.), J. D. Rankin (P.), M.JE. Robertson (P., C.), 0.Robertson (P.), M. E. Rutherfurd (C.).

Second Professional Examination.The following candidates have been approved in the subjects indicated(A., Anatomy; P., Physiology M., Materia Medica and Therapeutics):W. 'W. Adamson (A., P.), A. Anderson (A., P.), A. H. Arnott (A.), D.Arthur (A., P.), H. Bertram (A., P., M.), R. I. Binning (A., P.), W.Brown, M.A., (A., P.), M. Buchanan (A.), J. Cairneross (A., P.), T. H.Campbell (A., P., M.), J. P. ('armichael (A.), J. H. J. V. Coats (A., P.),A. J. Couper (A., P.), J. R. Craig (A., P., M.), J. C. Crawford (A.).C. A. Critchlow (A., P., U.), J. A. Doctor (A., P.), R. J. Driscoll (.),J. Dunbar (M.), D. Duncan (A., P., M ), W. H. Duncan (P., M.),A. Dunsmuir (A., P.), L. J. Dunstone (A, P., M), W. M.

Elliott (A., P., M.), A. Fairley (A., P ), W. M. Fairlie (M.T. Forsyth (P., M.), G. M. Fraser (P., M.). S. N. Galbraith (A., P.),B. Gale (A., P., M.), H. M. Granger (A., P., M.), J. V. Grant (P., M.),- T. P. Grant (A.. P.), J. D. Gray (P., M.), W. C; Gunn (A., P., M.), T.

ARIL 8, 5.] HOSPITAL AND DISPENSARY MANAGEMENT. '4 3o

Harkin (P., M:), J. M. lenderson (P.), A. Hogg (A., P., M.), A. J.Hutton (A., P.. M.), P. J. Kelly tP), W. H. Kiep (A., P.), J. T. Kirk-land (P., M.), W. Leitch (A.. P.). G. Lisertwood (MI.), E. B. Macaulay(P.. M.). T. M'Crirlck, hd A.. B SC. (M.), C. Macdonald (A., P.), J.M'Donald (A., P.), J. R. M'Gilvray (P., M.), R. (M'Inroy A., P., M.),W. A. M'Kellar (M), M. D. Mackenzie (M.), T. C. Mackenzie (M.),A. D. MacLachlan (A.. P.), D. C. MacLachlan (P., M.), A. N. R.M'NeiU (A., P., M.), J. M'Vittie (A., P., M.). Isa C. Marshall (A, P.),J. H. Martin (&.. P.), W. S. Melville (A., P.), A. F. Miller(P., M.), J. W. Miller (A., P.), R. S. Miller (M.), W. Miller<N.), H. Morton (A., P.), R. C. MUtir (P., M.), P. O'Brien (A., P., M),J. Oswald (M.), I. Papiermetster (A.. P.. M.). D. Renton (A., P., M.),M. M. Rodger (NI.), A. Scott (A., P., M.), G. W. Scott (A., P., M.),J. Smitb, M.A., (A., M.), J. M. Smith (A.), J. Steedman (A., P., M.),C. K. Stevenson (A., P.). W. Stevenson (M.). J. Stewart, M.A (P., M.),J. T. W. Stewart (M.), M. J. Stewart (A., P., M.), L. Storey (A., P.),*3. A. Struthers (A., P., M.), J. M. Taylor (P.), R. S. Taylor (A.. P.)'f. J. Thomsnn (A., P.), R. Todd (W.), K. Turnbull (M.), J. M. Walker(P.. M.). G. Wallace (P), H. tF. Watson ('U.). W. B. Watson (A., P., M.),T. M. Watt (A., P.), F. R. Wilson (A. M.), H. M. Wilson A., P. M.),S. Wilson, M.A. (A., P., M.), T. Winning, M.A. (A., M.), G. Y.Yardumian (A., P., M.), M. Young (A., P.).-

Women: M. M. Buchan (P.), E. S. Hill, M.A. (P.), A. R. Bird (A., M.),J. A. Macvea (M.), F. Mann (A., P.), V. D. Reis (A.), J. I. Robertson,M.A. (A., P).

T. R. A. A. e. Crawford (under the old regulations).

Tlhird Professional Examination.The following candidates have been approved in the subjects indicated

(?., Pathology; M., Medical Jurisprudence and Public Health):J. M. Anderson (P.. M.), T. Barbour. B.Sc. (P., M.), C. Burns (MI.), W. R.

Cammock (P., M.), W. A. Campbell (P., M.), J). L. Carmichael (P.),'K. R. Christie (P.), J. S. Clark, M.A. (P.), T. G. Copestake (P., M.),J. Coutts (P., M.). A. D. Cowan (P., M), T. L. Craig (P., 1N), A. M.Crawford (P.), W. B. Cunningham (P.), H. W. Dempster (P.), A. C.Douglas (P., M), J. R. Drever. M.A. (P., M.), E. M. Eaton (P.),J. Ferguson (P.), E. J. Fitzgerald (P.), T. H. Forrest (P.), W. GilbertP.), W. Gilfillan (P., NI.), A. H. Gray (P., M.), R. N. Guthrie (P. M.), J.Hfammond (M.), W. T. Hardie (NM), 8. H. Harris (M.), R. M'C. Hill (P.),L. Hislop (Nt), J. Keys (P.. M.), A. M'Call (P.. M.), J. M'Farlane(P., M.), W. F. Mackenzie (P.), W. Macleod (P.), A. A. C. M'Neill<P., M.). C. J. C. MacquLrie (P), W. H. Manson. M.A. (P.. M.); R.Msarshall (P., M.), J. Miller (P., M.), P. Mitchell, M.A. (P.), H. W.Moir (P., KI.), P. J. O'Hare (P.), J. H. Paul (P., M.), A. G. Paxton(P., M.), 3. Reid (NI). F. G. Robertson (P., D{.), W. 3. Rutherfurd(P., M',)J. Samson (P.), A. C. Sharp (P., M.), J. C. D. Simpson (P.),B. A. Slater (P., M.), W. Smellie (P , M.), T. B. Smith (P.), J. Steven-son (P., M.), J. Stevenson (P., M.), A. A. Stewart (P.). D. L. Tate(P. M.). C. S. Thomson (P.) J. K. Welsh (P., M.),D. J. Williams (P.),G. H. Wilson (P., N.), M. Youdelevitz (P.).

Women.-R. I. Hudson (A.), E. Oversby (P.. M.), A. Picken, M.A.(P.. M.), M. B. Taylor (M.), C. G. Thomlinson (P.).

B. S. M'Kim,M.A. (under old regulations).

The following candidates passed with distinction in the subjectsindicated:

First Examination.-In Botany, Zoology, Physics, and Chemistry-J. Allan. In Zoology and Physics-J. A. M. Cameron. J. L. Ure.In Zoology and Chem'stry-W. M'Adam, M.A. In Zoology-C.Duguid, J. W. M'Nee, W. W. Rorke, R. Sweet, D. Young. InPhysics-Jessie D. Rankin, Margaret E. Robertson, N. C. Scott,W. W. Scott, J. J. Sinclair, J. S. Somerville, A. Stewart. InChemistry-M. W. Broudy, D. N. Knox, J. P. Mathie.

Second Examination.-In Anatomy and Physiology-W. H. Kiep, M.Young. In Physiology and in Materia Medica and Therapeutics-M. J. Stewart. In Anatomy-J. H. Martin. In Physiology-W. W. Adamson, L. J. Dunstone, W. C. GuDn, A. J. Hutton,H. Morton, J. Stewart M.A., H. J. Thomson. W. B. Watson. InMateria Medica and Therapeutics-T. H. Campbell, J. R. Craig.

.hird Examination.-Tn Pathology and in Medical Jurisprudence andPublic Health-W. Gilfillan, A. C. Sharp. In Pathology-W. R.Cammock, P. Mitchell, M.A., T. B. Smith. In Medical Juris-prudence and Public Health- C. Burns, R. Marshall, AgnesPicken, M.A..

in the Third ProfessionalExamination for M.B., C.M. (old regulations),R. S. M'Kim, M.A., passed with distinction in Pathology.

CONJOINT BOARD IN SCOTLAND.THE following candidates were approved at the quarterly examinationsdndicated:

First Examination, Four Years' Course.-J. S. Lamech.First Examination. Five Years' Cour8e.-J. A. S. Phillips (with distinc-

tion), H. W Howatson. I. C. Pratt, T. S. Reddy, F. J. de Souza, T.Walsh, F. R. Watson, Mary Imre-Macaulay, J. Blackburne.

Second Examination, Four Years' Course.-A. D. Roberts.&econd Examination, Five Years' Course -S. A. Friar, W. F. McKenna,

J. S. J. Stenhoupe, G. E. Anderson (with distinction), M. J. Hayes,J. W. R. Rockwood.

Third Examination, Five Years' Course.-E. H. G. Duncan, L. N. Ghosh,J. W. N. Roberts, W. L. Watson, G. Heatbeote, J. 5. R. Weir, T. W.Faulkner, H. M. Sturrock, D. L. G. Radford, T. A. Gregg.

Final Examination.-W. A. Graham, J. Walsh, Sybil L. Lewis, A. H.Singleton. J. B. Mears, A. McKendrick, Elizabeth M. E. Kerr-Harris, F. W. Green, S. 8. Antia, W. L. Robertson, D. S. Steele-Perkins, G. W. Craig, W. M. Johnston, A. Oyejola, H. J. D. David-son, E. H. Knowles, A. T. Munroe. E. R. Frankish, C. H. K.Scharengulvel, S. S. Sperber, M. K. N. S. Culeria, G. H. van Zyl,A. C. Dhondy, H. E. Bolton.

UNTVERSITY OF LEEDS.First Degrees Conferred.

AT a congregation of the University held on March 3ist, In the Library ofthe Medical School, tbe degrees of Bachelor of Medicine and Bachelor ofSurgery were conferred on the following, who had satisfied the examinersin the receDt examinations: F. Bailey, C. 1S. Smith, A. B. S. Todd,M' G. L. Walker. Before conferring the degrees the Vice-Chaurcbllor(Dr. Bodlngton) remarked that, t was in every wayVp0ropriate;that t'he

first degrees to be conferred in Leeds, other than honorary degrees,should be degrees in medicine, as the School of Medicine was the oldestof the departments of the University. In this respect Leeds had followedthe precedent set by most of the European Universities, in which theearliest subjects to be studied and taught were those bearing uponmedicine.

A.B. Examinations.The result of the other examination i are as follows:Second M.B. and Ch.B.-W. L Dibb aDd W. D. Hamilton.Final I.B. and Ch.B.: Part I.-E. R. Flint, F. E. Kendall, W. 0. McKane.

UNIVERSITY OF LIVERPOOL.DEGBEES IN MEDICINE: ADDRESS BY THB VICB-CHANCELLOR,

THE spring examinations for the M. B., Ch.B. degrees have juga beencompleted. Twelve candidates presented themselves, and nine passed,all being students of the Royal Infirmary.The graduation ceremony took place on April ist, the candidates being

preseuted by the Dean, Professor Benjamin Moore, and the degrees beingconferred by Vice-Chancellor Dale. The Vice-Chancellor, having con-ferred the degrees, delivered an address, in which he appealed to the newgraduates to remember the Univera4ty to which they owed so much, andto preserve unbroken the ties that bound them to it. He reminded themof the Old Students' Association, and of the invaluable services which ithad rendered to their corporate life, and said he hoped it would bepossible for some, if not all, of thean, by active servioe in that Associa-tion, to increase the work that others had begun. The reputation of theUniversity lay in their hands, and he trusted they would do their best toenlarge and extend the traditions laid down by their predecessors. Normust they forget tIhat graduation was the beginning, and not the end, ofstudy, and that they were now passing out of the school of medicine intothe greater school of the world. They must remember that the acience towhich they had devoted themselves was a science that was perpetuallyadvancing. Above all, he exhorted the graduates in their future careerto place service first and success second. In the recognition of, andobedience to, this principle, he believed, was to be found the true secretof all success, all lhappiness, and.all strength.

TRINITY COLLEGE, DUBLIN.THE following candidates were approved at the Hilary Examination inthe subjects indicated:Diploma in Public Health.-Part : R. J. Fleming, D. S. B. Thomson.

Part II: T. F. Griffdn, D. S. B. Thomson.

ROYAL COLLEGE OF SURGEONS IN IRELAND.THE following is a list of the prize winners for the winter session:Descriptive Anatomny.-Junior: ist, G. C. Sneyd; 2nd, R. Adams. Senior:

ist, FE. W. White; snd, J. Murray.Practical Anatomy.-First year: ist, Miss- I. M. Clarke; 2nd, C. Greer.

Second year: Ist, G. S. Levis; 2nd, G. W. Stanley.Practice of Medicine..-ist, J. Lucas; 2nd, J. Prendiville.Sgurgerv.-ist, L. Lucas; 2nd. C. H. Wilson.Aftdwiferv.-ist, J. Prendiville; 2nd, G. M. Loughnan.Physiology.-ist, A. E. 8. Martin; 2nd, G. S. Levis.Chemistry.-ist, R. H. F. Taaffe; 2nd, R. Adams and Miss I. M. Clarke

(equal).Pathology.-ist. G. F. Shepherd; 2nd, C. J. Hare.Physics-1st, R. Adams; 2nd, Misfy I. M. Clarke.Tlhe lectures and practical courses of the summer session commenced

on Monday, April 3rd.

HOSPITAL AND DISPENSARY MANAGEMENT.BARNWOOD HOUSE HOSPITAL FOR THE INSANE,

GLOUCESTER.THE forty-fifth annual report of this important privateasylum for the year I904 shows that on January ist, I904,there were 141 patients under care, and on December 3I8t143, an increase of 2 on the previous year, but a slightdecrease from any of the preceding sixteen years. Duringthe year 38 patients were admitted, which is higher than theaverage for the preceding five years-namely, 33, and 5 ofthese were readmissions. The Medical Superintendent, Dr.J. Grieg Soutar, says that the admissions contained a fairproportion of acute cases, so that 9 had already been dis-charged as recovered at the time of writing, and in 12 morethere was a good prospect of early recovery. Dr. Soutar saysthat there has been of reczent years from some unexplainedreason a marked diminution in the number of cases of acutemania, and a corresponding increase of cases of acute melan-cholia, entailing greatly-increased watchfulness and care onthe part of the management. The statistical tables showthat i8 of the 38 admissions were cases of acute melancholia,and 2 more cases of chronic melancholia, whilst there wereonly 5 cases of acute mania and 8 of other maniacal states.There were also 4 cases of dementia and i case of generalparalysis of the ineane. Dr. Soutar admits the diffi-culty-he might have said the impossibility-of ascer-taining with any degree of certainty the causes whichinduced the mental attack, but shows that hereditarypredisposition was ascertained in at least 55 per cent. of theadmissions. Intemperance in drink is meintioned as cause intwo cases, "moral'" causes in 6, venereal disease in 2, bodilydiseases in iI, and'previous attacks in.4. During the year: 8ywvre-diseborged as mecavereigiving a percentageteatiery-.