518and the amorphous veratridine. The question has not beensettled whether pure veratrine might with advantage besubstituted for this mixture of potent alkaloids. Apo-morphine presents an interesting problem. It is wellknown that solutions of this alkaloid become coloured

on keeping but it is uncertain whether such solutionsretain their potency. Of potent drugs that are largelyused in medicine, although we have no definite knowredgeas to the strength of the preparations made from them,Cannabis indica, jaborandi, and ergot may be mentioned.Ergot is a drug possessing several constituents of differentphysiological value. Thus, ergotinic acid is soluble in waterbut insoluble in alcohol and produces paralysis of the spinalcord. Another principle of ergot, sphaceliuic acid, on thecontrary, is insoluble in water but soluble in hot alcoholand produces contraction of the blood-vessels. A third

substance, ergotinine or cornutine, is probably the most

important ; it causes contraction of the uterus. It would

appear to be particularly necessary to possess means of

determining the strength of preparations of ergot, at leastin terms of ergotinine. The botanical origin of several well-known drugs is still doubtful and requires investigation, thedrugs of doubtful origin including the varieties of asafoetidaasd galbanum, the gum-resin opoponax. and the varieties ofcopaiba that are met with in commerce. Many of the

problems referred to will demand for their solution the

collaboration of pharmacologists and pharmacists.

THE TREATMENT OF EPITHELIOMA BYRADIUM.

THE Clinique Ophtalmologique of July 25th contains an

article by Dr. A. Darier on the Treatment of Epithelioma(Superficial) by Radium. In one case the disease commencedas a hard nodule on the ala of the nose eight years beforebeing seen by Dr. Darier. It was originally treated by theapplication of tincture of iodine. Two years subseqnentlyit was completely removed by the knife but it reappearedand continued to extend, presenting the characters of a

typical epithelioma and affecting the side of the nose, theinner angle of the eyelid, and the outer surface of the lowerlid. Dr. Darier applied the galvano-cautery to various

points of the edges of the ulcer, then touched them withchromic acid, and finally powdered the surface with methylblue. The results seemed to be satisfactory and the patientwent home. After the lapse of a few months she returnedwith a trilobate tumour affecting the upper lid and declinedto undergo any further operative treatment. Dr. Darierthen suggested the employment of radium, which was

accepted, and he proceeded to apply to each of thethree lobes of the tumour five milligrammes of sulphateof radium of 500,000 units activity attached with enamelvarnish to a plate of copper one inch square. The applica-tion lasted 90 minutes (30 minutes to each lobe) ; three daysafterwards the exposure was repeated. In the course of

eight or ten days the tumour had melted away and only asmall ulcer remained. The applications of radium were cr n-tinued every eighth day and in a month’s time a complete curewas effected. There only remained a slight depression andredness of the adjoining skin. Dr. Darier prefers the radiumemanations to the x rays on account of their being far moreeasily managed. The best means of ascertaining the activityof the substance that is about to be used consists in placingit in contact with the skin of the forearm for a period offrom five to 20 minutes and noting the number of days thatelapse before the redness characteristic of radium is pro-duced. If the radium be pure and separated from theskin by a layer of varnish only the burn may appear imme-diately. Inclosed in a glass tube it may, if the glass be thick,lose as much as 90 per cent. of its activity. Mica, celluloid,and caoutchouc absorb a much smaller proportion. Dr.

Darier uses the sulphate suspended in a varnish which isapplied to a metal and strongly heated. This in different

strengths he uses for the treatment of epithelioma,chalazion, warts, naevus, trachoma, conjunctival tuber-

culosis, Parinaud’s conjunctivitis, spring catarrh, and certainforms of parenchymatous keratitis. The little apparatus isapplied for 20 or 30 minutes every second, third, or even

eighth day. -

A SANATORIUM FOR CONSUMPTIVE CHILDREN.

MOST of the existing sanatoriums for tuberculous patientsreceive only adults, but children are, nevertheless, quite asliable to suffer from tuberculous disease and, in fact, have aspecial predisposition to some forms of it. In the interestsof these helpless little sufferers an appeal is being made onbehalf of a proposed sanatorium for consumptive childrenwhich it is proposed to erect on a site in Norfolk betweenHolt and Cromer. The list of patrons and the general com-mittee include many well-known and influential names, about

half the number being ladies. The intention is to commencewith a small building capable of accommodating about 25children and the necessary staff but so planned as to allowextensions being made when opportunity offers. A sum ofE8000 is required at the outset. Donations and subscrip-tions may be paid to the " Children’s Sanatorium Account"at Messrs. Hoare’s Bank, 37, Fleet-street, London, E.C., ormay be sent to Mr. Thomas H. Wyatt, M.V.O., the honorarysecretary, at the temporary address, The Rectory, 42, GreatOrmond-street, London, W.C.

"FONDATION OPHTALMOLOGIQUE ADOLPHE DEROTHSCHILD."

IN a pamphlet of 32 pages Dr. A. Trousseau gives anaccount of an ophthalmic institute which has been built atParis at the cost of the late Baron Adolphe de Rothschildwho left a large sum for its construction and endowment.It has received the name of " Fondation OphtalmologiqueAdolphe de Rothschild" and Dr. Trousseau was named inthe will to be the first director. The building was intrustedto two architects who have spared no pains to adapt it in

every way to the purpose for which it was designed. A

reproduction of a photograph is appended to the pamphletwhich shows the facade of a handsome edifice of four storeyswith attics. It is situated at the angle of the junctionof the Rue Manin and of the Rue Priestley, is in close

relation with numerous tramways, and by the metropolitanrailway is in connexion with the heart of Paris. It is

well lighted, as Dr. Trousseau, who seems to have been

consulted largely, is not a believer in darkness in the

ordinary treatment of ophthalmic affections. It is 250 feetabove the level of the sea and has an area of about

20,000 feet. Behind it is a large garden for the exercise andthe recreation of the patients. The hospital looks to thenorth-east over the park of Buttes-Chaumontand the pleasureground is therefore to the south-west. The operating theatrefaces the north. The drainage and the ventilation have beencarefully considered. The floors are of iron covered withcement. An agreeable temperature is maintained by a

steam engine working at low pressure. The whole buildingis freely illuminated by electricity generated on the spotand there are all kinds of electrical apparatus capable ofbeing utilised in the treatment of disease such as is

required for galvano-cautery, photophores, and exploratorylamps. Corners and ledges that might harbour dust havebeen avoided as far as possible. There are a laundry,a disinfecting room, and a destructor for burning alldressings. Radiography can be practised. Every arrange-ment is made for the sterilisation of instruments, dressings,and for personal cleanliness. The hospital contains 36 beds,There are to be no paying patients. The benefits which it

549

affords are to be open gratuitously to all. A novel and goodfeature of the service of the hospital is that consultationsare to be held three times daily, in the morning from 9 to 12,in the afternoon from 1 to 3, and in the evening for workingmen who have no other available time, from 7 to 8. Theestablishment as a whole is worthy of the liberality of thelate Baron A. de Rothschild and of the care and attentionwhich have been bestowed upon it by Dr. Trousseau.

THE DISTRIBUTION OF CARBONIC ACID.

To what an extent the health and comfort of human

beings depend upon the proportion of carbonic acid gas in theair which they breathe is known to all students of hygiene.In the life of other organisms, also, the substance plays animportant part ; thus, Brown and Escombe have shown thatthe living leaf assimilates carbonic acid according to the

pressure of the gas in the surrounding atmosphere, whileLoeb has demonstrated the influence which the gas exercises

upon the occurrence of parthenogenesis. Normally there isprescnt in the air about 0’04 per cent. of carbonicacid and when local interference-e.g., the absence ofefficient ventilation-is eliminated this ratio exhibits littlevariation. All the more curious, therefore, are certainobservations upon the composition of the air in the vicinityof the inland of Disko which are recorded in No. 26 ofMeddelelser om Grogiland. The island is situated near the

west coast of Greenland in a region where there are noartificial conditions likely to introduce atmospheric modifica- ,,

tions, yet a Danish man of science, M. A. Krogh, found thatat different seasons the proportion of carbonic acid in the airvaried from 0’025 to 0’07 per cent., the highest amountsbeing present when the wind was blowing from the north andwest and the lowest occurring in conjunction with southerlyand easterly winds. He concludes that the island of Dibkomust be near the margin of an area in which carbonicacid gas is liberated and as to the source of the supply heoffers an ingenious explanation suggested by a circumstancewhich at first sight appears to have not the remotest con-nexion with the subject-viz., the thickness of the shells ofcertain molluscs. Jensen had observed that the calcareous

portion of molluscan shells taken from deep water was thinand sometimes eroded as if by the action of some chemicalagent and it has also been noted that the shells of dead

molluscs falling into deep water are speedily dissolved.These effects it is thought can only be satisfactorilyexplained by assuming that in the depths of the sea thereis much carbonic acid in solution and Krogh has supposedthat in Baffin Bay there is an upwardly directed stream ofwater loaded with carbonic acid, which gas is liberated whenthe water containing it reaches the surface.

THE STERILISATION OF SO-CALLEDDEGENERATES.

WE have received from Dr. R. Rentoul a long communica-tion in reference to our annotation of July 29th entitled "TheSterilisation of So-called Degenerates." On several occasionswe have alluded to Dr. Rentoul’s views on this topic and asthe statement of them which has just been forwarded to uspresents no novel features we are unable to find space formore than a brief notice of it. The familiar statistics fromthe reports of the Commissioners in Lunacy and from othersources are set forth and are made the basis of unconvincingarguments but there is no attempt to formulate a prac-tical scheme for the application of the principle ofsterilisation to existing social conditions. There is, on

the contrary, a want of clearness as to the matters

really at issue which detracts from the value of the

suggestions offered. "At present," says Dr. Rentoul, "theovaries, tutes, and uterus are removed when persons suffer

from diseases of those organs," and after mentioning rathersuperfluously some instances he proceeds: "No one objectsto this sterilisation and if we so agree why can we

not agree to extend its beneficial action to the pre-vention of mental diseases?" " The cases are obviously notparallel, for in the one the persons operated upon areagreed as to the advisability of the operations, whilein the other the agreement, so far as it goes, is merelyon the part of those who may be called in to operate. Dr.

Rentoul appears to be under the impression that becausethe provisions of the Lunacy Act, 1890, do not meet the

difficulties connected with the segregation of the unfit

nothing more can be accomplished in this direction by legis-lation. For ourselves we are content to wait in order to seewhat the deliberations of the Royal Commission on the

Care of the Feeble-minded may bring forth.

THE RELATIVE VALUE OF BACTERIOLOGICALAND CLINICAL SYMPTOMATOLOGY.

THE quarantine camp at Tor, a village on the coast of thepeninsula of Sinai and not far from Suez, is an importantplace in connexion with the annual pilgrimage to Mecca.As the risk of the dissemination of epidemic disease by thepilgrims on returning to their homes is recognised even inMahometan countries, a careful supervision over these

travellers is exercised at various points and an outline ofthe routine work of the camp at Tor last March and Aprilis given in two pamphlets published by the Conseil SanitaireMaritime et Quarantenaire d’Egypte. One of them is byDr. Zachariadis Bey, < irector of the camp in question. On

account of the presence of plague in Egypt all the Egyptianpilgrims as well as foreigners passing through Egypt hadto undergo quarantine at Tor but no case of the diseasewas discovered. The prevailing diseases this year were

pneumonia and dysentery. The general health of the

pilgrims was not so good as last year when there

were 79 deaths among 29,964 pilgrims, whereas this

3ear there were 161 deaths among 33,036 pilgrims.Dr. Zachariadis speaks highly of the services rendered bythe medical staff which included at least one femaleprac-titioner (doctoresse). Three bacteriologists were engaged atthe camp, one of whom (Dr. Felix Gotschlich) had thespecial duty of searching for the cholera vibrio and was theauthor of one of the two pamphlets to which we havereferred. The decision as to whether epidemic diseaseexisted among the pilgrims rested with Dr. Zachariadis asbeing director of the camp and this year, not for the first

time, he decided that the presence or absence of clinical

symptoms among the pilgrims was of far more diagnosticimportance than the bacteriological results, whether positiveor negative, obtained in the laboratory. For instance, hestates that in 1895 he declared the camp infected withcholera and took measures accordingly some time before thebacteriologists succeeded in finding the cholera bacillus ;eventually, however, the bacillus was found. On the other

hand, in 1897 he declared the camp healthy although thebacteriologists had found the cholera bacillus ; there

were then 6000 pilgrims in the camp, none of whom

presented symptoms of cholera, and there were no

outbreaks of the disease in the places to which

they returned in their own countries. During the pilgrimageof the present year a similar conflict of opinion arose. In

six fatal cases which after necropsy were officially describedas either colitis or dysentery Dr. Gotschlich found a bacilluswhich in his opinion was beyond all doubt that of cholera

1 The words of Dr. Gotschlich are as follows, the italics being hisown : "En r&eacute;sum&eacute; il r&eacute;sulte de notre examen approfondi des six culturesen question, d’apr&egrave;s les m&eacute;thodes les plus vari&eacute;es, tant de la s&eacute;ro-r&eacute;action que de l’examen des caract&egrave;res morphologiques, biologiques,et cultureux, que ces vibrions appartiennent tous &agrave; une m&ecirc;me et uniqueesp&egrave;ce et sont tous identities avec le vrai vibrion de chol&eacute;ra de Kock."