the profession, therefore it must be altered. The prac-

titioners of England have had to learn that they cannotuse unqualified assistants. The lesson has been a hard

one, involving removal of not a few from the Medical

Register. The Council has insisted on this reform in

England in spite of the obvious hardships inflicted by itupon the whole class of unqualified assistants and uponnot a few practitioners. It must not hesitate to requirein the same way that medical practitioners in Scotland,or elsewhere, shall not lend their professional name andstatus to cover a use of unqualified assistants in an

open shop. Such a proceeding is quite different from

that of dispensing the private prescriptions of a medicalman under his immediate supervision in his private dis-

pensary. Medical practitioners are at liberty to adaptthemselves and their terms to their environment and to the

modest means of those who need medical advice, but theyare not at liberty to use their professional status to defeatActs of Parliament, and to bring enormous risks at the sametime within reach of the public whose health is presumed tobe their care.

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Annotations."Ne quid nimis.

THE NEW YEAR HONOURS.

THE new year’s list of honours is remarkable in one way-namely, that no peerage has been conferred. Of those who

belong to, or are connected with, our own profession we haveto note the names of Thomas Barlow, M.D., F.R.C.P. Lond.,and William Selby Church, M.D.Oxon., F.R.C.P. Lond.,who have both been honoured by a baronetcy being con-ferred upon them. Dr. Barlow is a physician extraordinaryto Her Majesty the Queen and is also physician to the House-hold. Dr. W. S. Church is President of the Royal Collegeof Physicians of London and his baronetcy may be regardedas much a tribute to his official position as to his recentservices on the Hospital Commission. In this connexion itshould be noted that in the Order of the Bath Lord JusticeRomer has been made Grand Cross. Lord Justice Romer, itwill be remembered, was chosen to preside over the commis-sion of inquiry into the management of the hospitals andother medical matters in South Africa. Among the KnightCommanders of the same order is the name of Sir William

Turner, M.B.Lond., F.R.C.S. Eng. & Edin., the Presidentof the General Medical Council. In the Order of St.Michael and St. George, Maximilian Frank Simon, M.D.St. Andrews, late principal civil medical officer of the

Straits Settlements, has been made a Companion upon hisretirement from office. In the Order of the Indian EmpireMajor John Crimmin, V.C., I.M.S., has been made a Com-panion. Among those who have received the honour of

knighthood is Hugh Adcock, C.M.G., L.R.C.P. Edin.,M.R.C.S. Eng., who is physician to H.LM. the Shah of

Persia, while Colonel James Sutherland Wilkins, I.M.S.,and Arthur Neve, F.R.C.S., L.R.C.P. Edin., have beendecorated with the Kaisar-i-Hind medal for 11 publicservice in India." Mr. Neve is a medical man workingat Srinagar, Kashmir, under the Church Missionary Society.Lord Justice Romer’s name is not the only non-medicalname that deserves mention in THE LANCET. Among the ’new knights are Mr. Edward Henry Busk, Chairman of ’,Convocation in the University of London, and Mr. Alfred ilCooper (of Surbiton) whose philanthropy is known to our i

readers. Mr. William Jameson Soulsby, C.B., the secretaryto so many Lord Mayors of London and secretary to theMansion House Indian Famine Relief Funds in 1877, 1897,and 1900, has been made a Companion of the Order of thaIndian Empire. To all these gentlemen we offer our bestcongratulations upon their well-earned distinctions.

THE LONDON WATER-SUPPLY OF A HUNDREDYEARS AGO.

VERY great changes have taken place in the water-supplyof London during the last 100 years. At the commencementof the nineteenth century a large number of the peopleobtained the whole of their water from wells. Many houses-had private wells, but in addition to these there were a greatnumber of public wells in the streets. These were filled with.surface water, and their depth below the ground level was.not great. At the present time we are not aware

of the existence of any private surface wells fromwhich the water is used for drinking, but there.are a fair number of deep wells which pass throughthe London clay into the chalk and from theseexcellent supplies are still obtained. One public pump stillexists in Kensington Gardens, and there is one in Aldgate,but for many years the latter has been supplied with filteredwater. At the beginning of the century it was quite acommon thing for the inhabitants who lived near a publicpump to send there for the supply which they required fordrinking and for household purposes. Many of the wells-became contaminated and towards the middle of the centurythe incidence of cholera in the neighbourhood of the pumpin Broad-street, Soho, led Dr. Snow to make those careful,researches which led to his discovery of the chief method bywhich cholera was spread in London. The oldest organisedsystem of water-supply which existed in the metropolitanarea was probably that of Westminster, for in the year 1800..and, indeed, till the middle of the century, the Abbeyprecincts obtained their water from Hyde Park. Some

parts of Westminster were at that time supplied by theChelsea Company, whose reservoirs were then situatedin Hyde Park and in the Green Park. The site of the

former is still plainly to be seen near Park-lane, not,

very far from the Duke of Westminster’s house. Ithas been converted into a sunk garden. The Green Parkreservoir was not far from Piccadilly, nearly opposite HalfMoon-street, but the exact site is not at the present time-marked by any visible trace. Other parts of Westminsterwere supplied by the New River Company, and by the YorkBuildings Company which pumped water directly from the.Thames. The works of the latter company were near the

Adelphi Buildings, and their tower is a prominent feature inall the contemporary drawings of that part of the north,bank of the Thames. The company’s customers were chieflythe residents in the Strand and in the adjoining streets. At.this time (1800) much building was going on in Marylebone,which was not well supplied by the New River Company,.and during the next few years two companies, the WestMiddlesex and the Grand Junction, were started to supplythis important new residential area. Holloway and parts of-Tottenham Court-road derived their water from Hampstead.In the City of London the New River Company had nomonopoly and the London Bridge Waterworks Company stillhad a considerable number of customers whom they lost afew years later because they were unable to supply water ata pressure sufficient to reach the upper storeys of the houses,a condition which had become necessary in consequence of the

exigencies of more modern sanitation. The East end ofLondon in the year 1800 was supplied by waterworks situatedat Shadwell and at Hackney. The New River Companydeclined to supply the latter place unless a certain minimum,annual water rent was guaranteed to them. The source of

46

supply of the Shadwell Company was the Thames, and thatof the Hackney Company, the Lee. The residents of South’London bought much of their water from merchants whotook it round in carts. The London Bridge Waterworkspumped some water to Southwark and there were other worksnear the church of St. Mary Overie. The Lambeth Companywas started about the year 1795 and soon promised to

do a roaring trade. It was energetically worked, the pro-.prietors taking an active part in the extension of thebusiness. At one time pipes could not be obtained quicklyenough to satisfy the impatience of those desirous to be

customers. The pipes then in general use were made ofwood, usually of elm, and the lumen of the tube was formedby boring out the centre of a tree. The pipes fitted into oneanother and were fastened together by a band of iron. Such

pipes are frequently dug up when the streets of London areegcavated, and attention was lately called to one found inthe City of London by a gentleman who happened to be

passing when it was unearthed, and who promptly wrote tothe Times concerning a portion of Roman drainage whichhe had lately discovered. A few specimens of these

pipes have been preserved and two of them may be

-seen any day opposite a house situated on the south

side of Jermyn-street, not far from St. James’s Church.Wooden pipes were not very satisfactory, considerable

leakage often took place at the joints, and it was

computed that something like a fifth of the amount

of water sent from the works was lost during’its transit tothe houses of the customers. It would be a mistake to

- suppose that wooden pipes were the only ones in use at thebeginning of the century. Some of the mains and some ofthe smaller pipes also were made of lead. Wooden pipes,however, were in general use. Attempts were made at a laterdate to replace them by a substance called "artificial

stone," but this material proved eminently unsatisfactory.ron pipes were then introduced, and although the initial

expense of these was considerable they led to a great savingin the amount of water wasted, and were capable of standing’high pressure without any untoward results. Very littlewas done at the beginning of the century in the way of water.purification. Most of the companies pumped their suppliesdirectly from the Thames and contented themselves by keep-ing out the grosser impurities by the use of a sort of sieve.The Chelsea Company’s water was allowed to settle for aabort time in their reservoirs, their customers not beingsufficiently numerous to necessitate pumping every day.,Of the public supplies that of the New River must havebeen by far the best. Some of the water came from a

beautifully pure spring at Chadwell and that derived fromthe upper Lee was much superior to the Thames water. TheNew River itself was carefully guarded by stately officialswho are represented in pictures as wearers of top hats andwho had bound themselves by an oath to do their duty.Magistrates then took a severe view of the culprits whoventured to bathe in the river, and the offence was in the eyesof the law not a light one. The proprietors of the companyand their friends made an annual survey of their propertyto see that everything was right ; the survey occasionallyoocupied two days and the proprietors were wont to go downthe river in a barge. It must have been a charmingexcursion 100 years ago. For the New River, in spite of thecomplete transformation of much of its landscape, is notdevoid of beauty to-day. -

THE AFTER-CARE ASSOCIATION.

THE work of the After-Care Association in helping poorpersons discharged after recovery from asylums for theinsane is deserving of greater support than it usuallyobtains. A home for convalescents from mental diseaseis a necessity, as was pointed out long ago and often by

the great Earl of Shaftesbury during his prolonged officeas chairman of the Lunacy Commissioners. Yet among the240 convalescent homes on the register of the CharityOrganisation Society not one appears to be speciallydesigned and available for such inmates. The After-Care Association, by obtaining for these people, whenneedful, an interval of change of scene and air, by givingthem grants of money and clothing, and by assistingthem to obtain suitable employment, endeavours to filla hiatus which ought not to exist. The work needs

extending greatly, but this cannot be done until the neces-sary funds are forthcoming. The annual meeting of theassociation will be held in the library of Lambeth Palace onJan. 29th, at 2.30 P.M., when the Archbishop of Canterburywill preside. All communications should be made to the

secretary, Mr. H. Thornhill Roxby, Church House, Dean’s

Yard, Westminster, S.W., by whom contributions will be

thankfully received, or they may be paid into the account ofthe "After-Care Association," Union Bank of London

(Regent-street branch), Argyll-place, London, W. Any ofour readers in search of an object for their practicalbenevolence can be certain that in this association theyhave a most worthy object, and as such it may be con-

fidently recommended by them to laymen.

NIGHT-TERRORS IN INFANTS.

DR. ALFRED BEYRAND contributes in a recent Thèse deParis (1900) an interesting clinical and psychologicalaccount of the night-terrors of children. This form ofcerebral disturbance had been long recognised and in 1867Dr. Sydney Ringer stated that there was a close analogybetween night-terrors and nightmare. He adduced as

common causes of both troubles bad food, excessive feedingat night, intestinal worms, and difficult dentition. Steiner

(1876), however, showed from a large number of observationsthat an idiopathic cerebral irritation, associated probablywith a transitory cerebral bypersemia, lay at the root of thismorbid psychical and sensorial disturbance. Debacker

(Tleese de Paris, 1881) showed conclusively that vividhallucinations of sight and of bodily feeling enter into

the pathology of night-terrors and more recently Braun(1891) and Kamenski (1893) have proposed to classifythis ailment in the group of neuroses which includes

hysteria and neurasthenia, the actual attacks of pavornocturnus being indications of a profound morbid nervoustaint in the child. Soltmann has also shown in the " Hand-buch der Kinderkrankheiten" (edited by Gerhardt, 1898) thatthe children who suffer from night-terrors are anasmic andpresent a distinct neuropathic predisposition, and that theyare the offspring of families in which neuroses are found toprevail. In the present thesis Dr. Beyrand quotes a numberof cases observed personally, in which it appeared that

hallucinations, mainly visual, played an important partin deteimining the attacks. It is pointed out that in severeattacks the child screams and cries with terror, and is com-

, pletely oblivious of surroundings or of the presence of, parents until the terror has subsided, that the end of the

I crisis is generally marked by the emission of clear urine and

. a falling-off to sleep, and that on waking the child pre-serves no recollection of the horror experienced. There is

: no stupidity or intellectual torpor such as characterises theJ

post-epileptic state, nor is there any convulsion or

biting of the tongue. The attack is also different fromsomnambulism and from the nightmare following an

alcoholic debauch. After passing in review the excitingr causes which may provoke an attack, such as gastro-: intestinal irritation from ill-digested food, or worms,

, teething, and infections fevers (e.g., pneumonia and typhoids fever), Dr. Beyrand shows that the habit in France of

, allowing the child to sip small quantities of wine along with