50

in coffee plantations and tea-gardens, but a Highlandquarryman is very unlike an East Indian coolie, and if hestrongly approves of the status in quo he is not likely to befar wrong. The " distant granite quarry," which is said to

Btake Dr. Grant too far from the slate quarry, is, we under-stand, about four and a half miles from his house, from Iwhich it is reached by a good road. It employs about 60or 70 men, and, considering the sparseness of the popula-tion, it is obvious that the men at the two quarries must beacquaintances. The distance between the places would notbe reckoned great in that part of the country, and for thedirectors seriously to’ put this forward as their reason for

dismissing the medical officer would almost lead us to

imagine that they were influenced by some other motivewhich they were unwilling to disclose.

ILLNESS FROM THE PATIENT’S POINT OF VIEW.

OUR profession is, perhaps, accustomed to look at diseasesomewhat too exclusively from the point of view of the

medical man. We are apt to forget that from the patient’sside many symptoms wear a very different aspect. Thereare many small contrivances which a patient learns only byexperience and which yet serve to mitigate greatly the painand discomfort of the invalid. It would be of interest to

gather the experience of medical men on the nursing andgeneral management of illnesses from which they havethemselves suffered, for medical men, alas, have no

prerogative of immunity from disease. In the presentnumber of THE LAXCET (see page 455) we publish somesuggestions made by a member of our own profession whohas suffered for 24 years, and we cannot but think that theymay prove helpful to his fellow-practitioners.

THE PRESIDENTIAL ADDRESS AT THEAMERICAN NEUROLOGICAL ASSO-

CIATION.

IN his presidential address delivered at the recent annualmeeting of the American Neurological Association and pub-lished in the Jo2crnal of Nervous and Mental E’lsease for

July last Professor Joseph Collins gives a concise epitomeof the most important work that has been done in neurologyduring the year past. Although no epoch-making con-

tribution has appeared there was no dearth of effort to solvethe many problems in the anatomy and pathology of thenervous system with which we are confronted. The neuron

theory which to-day stands as the basis of all neurology andneuro-pathology, in spite of criticisms and of the most Ielaborate histological investigations, has become more firmly

I

established than ever. Recent researches, notably those of ’,Apathy and Bethe, were, explains Professor Collins, uot inreality in antagonism to the neuron theory. All investiga-tion tended to show that "ontogeneticallythe neurons (ornerve elements) became more intimately united in series

and that such intimacy was structually heightened byuse." " There were, however, many obscurities still sur-

rounding the question of the growth of axis-cylindersin relation to their cell bodies or trophic centres which

required to be cleared up. There also remained forsolution the question whether in the human cerebralcortex the presence of the dendritic cell-processes and theneuroglia sufficed to account for the relative large separationof the nerve cell-bodies, or whether a certain amount of

intercellular substance remained which accounted for the

appearance in question. In the field of cortical localisationthe results of Horsley and Beevor as obtained by the methodsof local electric stimulation of the cortex in the higheranthropoid apes had been corroborated and expanded bySherrington and Grunbaum. Flechsig in the latest of hiswonderful researches on the association-centres of the human

brain was able to show that from 30 to 40 "areas" or centrescould be mapped out on the brain in accordance with theirtimes and rates of development. Important confirmation ofthe same had come from the researches of Schafrer of Buda-pest and Storch of Breslau on general paralysis. 1vÍucbattention had been devoted to the study of tendon reflexes.the most important and valuable discovery in this directionbeing the so-called Babinski reflex, which is now acceptedas a definite indication of degeneration of the pyramidaltract. The subjects of "toxaamia" and of internal secre-tion were receiving more attention, and further investiga-tions in these directions were needed to elucidate the patho-logy of exophthalmic goitre, acromegaly, and allied dis-orders. Quite recently Professor Mills of Philadelphia hadshown that the Roentgen rays were of use in determining thesite and occurrence of certain kinds of cerebral tumours.Dr. Henry Head had published a suggestive report uponvisceral disease and the mental changes accompanying them,and there was still great room for the further investigationof such neuroses as hysteria neurasthenia and hypochon-driasis in which mental disorders co-existed. On the whole,concludes Professor Collins, there has been more than usualactivity in the realms of neurology and questions of thevastest importance were still awaiting solution.

THE RECEPTION OF DEAD BODIES ATHOSPITALS.

I AN inquest was recently held at the London Hospital byMr. yVynne E. Baxter on the body of a female child, agedabout 14 days, of unknown parentage. It was stated inevidence that the child was brought in after death had takersplace by a woman who stated that the child had beentreated at the hospital on the previous day. The cause ofdeath was found to be bronchitis. The woman gave a nameand address but the information was found to be false.

Some of the members of the jury made remarks which weconsider not only uncalled for but showing ignorance of the-responsibilities which the resident medical officers should orshould not take upon themselves. Dead bodies are fre.

quently brought to the hospitals and the medical officer onduty having obtained the name and address of the deceasedand of those bringing the body, and having made inquiries,as to the nature of the illness or accident which was

supposed to have caused death, has discharged his dutiessatisfactorily. It would be on very rare occasions that hewould be justified in detaining persons who had brought inthe dead body and calling the police. The position of themedical officer is strictly that of a medical man and not

that of a detective. --

THE RESULTS OF A VOLCANIC ERUPTION.

AT a recent meeting of the French Academy of MedicineM. Kermorgant gave some details taken from reports of thecolonial medical officers of the condition in which thevictims of the St. Pierre catastrophe were found. In the

centre of the town there had apparently been the mostviolent explosion. Bodies were found shattered to pieces orwith several fractures in the arms and legs. In many cases.

the skulls were broken to pieces and empty. Further awayfrom the centre of the town bodies were found lying exactlyas they had fallen at the moment of death and these were ingreat part carbonised. Death appears to have occurred eitherfrom the inhalation of gases at an extremely high tempera-ture which had brought about sudden coagulatior. of the

blood or from electric shock. Those persons who hadnot been killed instantaneously must have had terrible

difficulty in breathing. The nose was generally full of dustand fragments of pumice. The pharynx and the larynxshowed traces of burning as low down as the bronchi. In

some instances portions of mucous membrane had sloughed,

451

These details are full of interest and appear to justify what ’

we wrote in our issue of May 17tb, that "it is, however, some I

consolation to reflect that the wholesale destruction of i

human life by rivers of molten lava deluging a town or by 1

the incessant hail of hot sulphurous cinders filling the airdoes not necessarily imply an agonising death. On the 1

contrary, it is probable that, in some instances at any rate, I

there is no struggle-the vapours of lava would quickly over-power and render the victims senseless and in this state they iwould probably be overcome by asphyxiation and die." In 1

the same article we remarked that it was reported that manymf the bodies presented the appearance of having been struckby lightning.

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:

,CHOLERA IN EGYPT.

THE following figures show the distribution of cholera

throughout Egypt for the week ending August 4th. The

total number of cases was 346, of which 185 were new cases.The total number of deaths was 278, of recoveries 13, and109 cases remained under treatment. The Director-Generalof the Sanitary Department reports that he is glad to beable to state that the diminution in the number of cases

reported from Cairo last week continues, and it is to be

hoped that the epidemic in this city will take no further

very serious proportions. The disease is spreading some-what in the vicinity of Assiout. The report continues :During the week Abou Tig, Beirout, Mellawi, Beni-Masoud, and

Beba have declared cases but in none of the towns up to the presenthas the disease shown any tendency ’to spread in an alarming manner.It is much to be hoped that we have succeeded in finding the firstoases early and so shall be able by vigorous measures to prevent thespread of the disease in these towns, but I fear it must be expected forsome time to come that we shall hear of fresh towns becoming infectedfrom time to time. A marked improvement has taken place at Mouchaduring the last few days. The Sanitary Commission of Cairo hasrecommended the permanent closure of all wells in Cairo the water ofwhich is considered contaminated by leakage from cesspools, &c. Thismeasure, which is, in my opinion, of the greatest importance not onlyfor the prevention of the spread of cholera during the present epidemic<but also for the prevention of so much enteric fever in the town, whichno doubt is due in a great measure to the consumption of water frompolluted wells, will be taken in hand at once. In all towns infectedspecial hospitals have been established for the reception of patients andall possible measures taken to prevent the spread of the disease.

SYNTHETIC SILK.

SYNTHETICS loom large even now, although it is true thatattention has chiefly been turned to the synthesis of drugs.But there is no reason why equal success should not attendthe efforts of the chemist to build up articles of food, drink,and clothing from their elements in the same way as merechemical compounds have been constructed. It is only aquestion of the growth of knowledge of the constitutionof matter. Already the synthesis of many articlesof common daily occurrence has been effected. The

aniline colouring matters are practically synthetics ; indigoand madder are common products of the laboratory ; andsugar and alcohol may be prepared from the elementswhich compose them. The latest achievement of the build-

ing chemist appears to be the artificial production of at anyrate the most important constituent of silk. Chemists have

long known that the chief constituent of silk-insects’cocoons and spiders’ threads-is an insoluble proteid,behaving very much in the same way as proteids in general ofwhich the albumins are types. Mulberry silk in particularconsists of over 70 per cent. of a proteid substance termedfibroin associated with 22 per cent. of a yellowishtransparent substance resembling gelatin in compositionand character and known as sericin. These two albuminoussubstances occur in silk with about 3 per cent. of

wax and 1 per cent. of mineral matter. It is sericin,however, or rather its derivative by hydrolysis, serine,which has been successfully synthesised, and inasmuch assilk owes its peculiar and delightful character largely tothis substance there is no doubt that an important steptowards the artificial manufacture of silk has been made.

Day by day synthetics are forcing themselves upon our

notice and are threatening to take a place somewhere orother in man’s ordinary routine. The question has still to

be settled whether a synthetically or artificially preparedsubstance-that is, one which is identical as far as can

be judged with the natural product-gives precisely thesame satisfactory results. Most people, we are sure,

will confess so far to a sneaking preference for the

thing which nature takes time to elaborate rather than forthe product conjured up, so to speak, in a few hours in thelaboratory. But already it is getting difficult in some direc-tions to obtain the natural article. It is so, at any rate, with

indigo ; and it is just possible that in the near future it will beno uncommon experience to hear in the shops a customerprecise in his demand for either the synthetic or naturalarticle in accordance with his choice. It is to be feared.

however, that as synthetic successes are scored so fresh roomfor fraud will be opened and this fact is quite sufficient toraise a prejudice in the meantime.

A NEW PATHOLOGICAL SCHOLARSHIP.

IT was mentioned at the meeting of the British MedicalAssociation recently held at Manchester that Mr. J. FrancisMason of Freeland Lodge, Woodstock, Oxfordshire, had,through Dr. T. F. S. Caverhill of Edinburgh, offered a

scholarship of .f.200 a year with extension to two or

three years if the work seems to promise good results,for the purpose of carrying on investigation into the

physiology and pathology of the thymus gland, includingif necessary collateral investigations on the other ductlessglands. The founder of the scholarship has associated withhimself Dr. Caverhill and Professor G. Sims Woodhead

to act as a small committee for the purpose of select-

ing a suitable candidate. In filling up the scholarshippreference will be given to those who have already made astudy of the thymus or other ductless glands, or have givensome evidence of their fitness to carry on this or similar

work, and who will devote the whole of their time duringtheir tenure of the scholarship to the special research men-tioned. Every facility for carrying on this work in the

Pathological Laboratories, Cambridge, will be placed at thedisposal of the scholar, and further particulars will be foundin our advertisement columns.

HYPOPLASIA OF THE AORTA.

IT more than occasionally happens that morbid con-

ditions of rare occurrence are shown to exist more

frequently than was previously imagined. This maybe explained partly by improved methods of examina-tion (e.g., actinomycosis) or because, attention havingbeen drawn to one or two instances, certain observers

keep close watch on all cases likely to prove of the samenature. In a communication which we published inTHE LANCET of August 9th, p. 358, Dr. W. LeeDickinson records four cases of hypoplasia of theaorta-a condition which has not been generally re-

cognisable on account of its rarity. As Dr. Dickinson

points out, the cases he records having occurred within10 years in the experience of a single hospital suggestthat the association of aortic hypoplasia and aneurysmshould be worth looking for in the future, especially,perhaps, in those cases of aneurysm which are least

susceptible of explanation by ordinary causes, such as

aneurysms in women and young children. Women are

notoriously more liable to hypoplasia than men and the

suggestion presents itself that some degree of hypoplasia,not necessarily to be seen unless searched for, maybe the reason for the more untoward course of their

aneurysms. Dr. Dickinson further mentions the con-

nexion alleged to exist between arterial hypoplasia and