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anaemia, which was associated with cancer of the stomach, washæmatologically of a type intermediate between splenicanaemia and Biermer’s disease. Examination of the blooddisclosed a condition of extreme hypoglobulia with intenseleucopenia and myelæmia. The spleen was enlarged. Thechief interest of the case lay in the histological examinationof the bone marrow which contained cancerous elements

resembling structures that existed in the primary epithelialtumour. The possibility of anaemia being due to cancerousmetastases into the bone marrow was a new idea which mightbe useful in connexion with the etiology of the perniciousanæmias.

The Serum l2eaotion in Bacillary Tuberculosis.M. Salomon and M. Sabareanu have made a lengthy

investigation of the serum reaction in bacillary tuberculosis,and, as mentioned in this column on Sept. llth, theydescribed their general results at the meeting of the FrenchAssociation for the Advancement of Science. Observationsmade on 300 patients have convinced them that in advancedchronic pulmonary tuberculosis the serum reaction was

usually negative, although on the contrary a positive effectwas very frequent not only in pulmonary tuberculosis in thefirst and second stage but also in other forms of tuberculosisin evolution. In acute diseases the serum reaction wasgenerally positive, but it probably ought not to be takeninto consideration unless the diagnosis was confirmed

by other symptoms. In certain diseases which modern

opinion tended to regard as of tuberculous origin, and whichhave been called disguised forms of tuberculosis (tuberculosesia,rv6es), the serum reaction appeared very frequently. It

was, on the contrary, very rare in patients suffering fromnon-febrile diseases and in whom there was no clinical reasonfor presuming the existence of tuberculosis. In patients sus-pected of tuberculosis M. Salomon and M. Sabareanu havenever seen this diagnosis confirmed if the serum reaction hadbeen negative, whilst on the other hand a positive serumreaction was in several cases confirmed by the subsequentcourse of events. The tuberculous serum reaction carried out

according to the method of Arloing and Courmont mighttherefore furnish valuable information and ought to be

regarded as an important diagnostic procedure. Its results,however, were not constant, and it must on no account beconsidered as more than a useful adjuvant to othermethods of clinical investigation. Its absence was notsufficient to remove all suspicion of tuberculosis in a

given case, but every non-febrile person the serum of whoseblood had a marked and constant agglutinating power onhomogeneous cultures of tubercle bacilli ought to be sus-

pected of tuberculosis, especially if obscure symptoms of

impaired general health have also shown themselves.

Scrum Treatment of Epidemia Cerabro-spintcl Meningitis.At the same meeting of the French Association for the

Advancement of Science M. Dopter read a paper in which hereviewed successively the epidemiology, the serum treatment,and the bacteriological diagnosis of epidemic cerebro-spinalmeningitis. He said that fresh light has been thrownon the epidemiology by the bacteriological investiga-tions made in Germany during the epidemic in Silesiain the year 1905, investigations which were continuedand extended in France during the epidemic which

prevailed throughout the early months of 1909. Therewas every reason to believe that the disease was

communicated by the naso-pharyngeal secretions dispersedin all directions by the patient. The favourite habitat of the

meningococcus was the naso-pharynx, where it multipliedabundantly before making its way to the meninges, and whereit occasionally continued to exist for a long time after thepatient had recovered from the meningeal symptoms. Con-valescents were therefore just as much a source of danger tosusceptible individuals as patients in the acute stage were ;it even happened that the meningococcus might be harbouredin the naso-pharynx of healthy persons without causingany lesion beyond catarrh of the mucous membrane ofthat region and without making its way to the meninges.These persons were a danger to the community becausethey distributed the meningococcus wherever they went.M. Dopter has prepared an antimeningococcus serum at thePasteur Institute in Paris on a principle suggested by M.Roux, and much of it was used during the epidemic of 1909in France. To make this serum M. Dopter immunised horses

by means of living cultures only and not by microbial extracts,these cultures being injected at first under the skin andafterwards into the veins. The powerful antimicrobial actionof the serum was proved by the effects produced both onpatients and on the lower animals. This serum reduced themortality, mitigated the symptoms, and restored the cerebro-spinal fluid to its normal condition. It ought to be intro-duced into the spinal canal after the removal of an equalquantity (or even a little more) of the cerebro-spinal fluid by lumbar puncture, so as to avoid the risk of doingharm by compression. The serum must be warmed to380 or 400 C. before being injected. The injection must bemade slowly, and it was an indispensable precaution that thepatient should then be kept for several hours with the pelvishigher than the head in order that the serum might moreeasily find its way to the cerebral meninges. For a child ofat least one year 10 cubic centimetres of serum might beinjected ; for older children, from 10 to 20 cubic centimetres ;and for adults, 20, 30, or 40 cubic centimetres. Dailyrepetitions of the injections were often required until thepyrexia and primary symptoms had disappeared. In theevent of a relapse the treatment must be recommenced.

Complementary Action of the Fallopian Tube and Ovary ofOpposite Sides.

M. Schwartz and Mme. la Doctoresse Boyer have justpublished an interesting case which showed that there mightbe concerted action between a Fallopian tube and the ovaryof the opposite side. The patient, whose menstrual historypresented nothing abnormal, was now 24 years of age andhad been operated on for tubal pregnancy. On the right sidethe ovary was removed, the Fallopian tube not being interferedwith ; on the left side, contrariwise, the Fallopian tube wasremoved, but the ovary was found to be healthy and waspreserved. No approximation of the left ovary and the rightFallopian tube was made, both of them being free in theabdominal cavity. The patient made an uneventful recovery.About six months afterwards she had a normal pregnancy,which unfortunately terminated in a miscarriage at the endof three and a half months.

Sept. 21st. ________________

VIENNA.

(FROM OUR OWN CORRESPONDENT. )

Poisoning by Methylated Gin.A SERIES of cases of poisoning was reported to the health,

authorities recently, and in the subsequent investigations;some unexpected disclosures were made. Within a few daysseven cases of illness, all presenting similar symptoms, wereobserved in a Hungarian mining district and in a Vienna.suburb, about 40 persons being attacked with well-markeddrowsiness, associated with vomiting and violent muscularcramps. In the Vienna cases poisoning by methylated gin,was only ascertained after the source of the fatal cases had,been discovered in Hungary. Altogether about 3700 litres.(900 gallons) of the poisonous gin have been seized and

destroyed, and endeavours are being made to trace the buyers.of other quantities of the liquor. How the methyl alcohol:found its way into the gin could not be ascertained. This is.the first instance in Austria of an alcoholic beverage con-.taining dangerous admixtures having escaped detection by:,the excise and the health officers.

Health of the Labouring Classes.The compulsory insurance against sickness amongst the-

working classes of Austria has led to the formation of enor-mous sick clubs, of which, for instance, in Vienna there isone with 310,000 members. The records and other informa-tion collected by such an organisation naturally afford a verygood insight into the health of the wage-earning part of thepopulation. A report is issued every month, and the onerecently brought out deals with the events of last June.There were then on the sick list 9150 persons, or 3 per cent.Among these patients the number suffering from tuberculosisof the respiratory organs was 1050, being 12 - 5 per cent. ofall cases of disease, or 0-33 per cent. of all members s50 persons suffered from pneumonia, 363 from the bronchialtype of influenza, and 973 from other diseases of the.

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respiratory organs ; altogether over 28 per cent. of all caseswere affected with some disease or other of the air passages.It must be added that the weather was rather inclement and

damp. The alimentary canal was attacked in 750 cases, theorgans of circulation in 366 cases. There were 1869 accidentscausing absence from work for more than three days. Thenumber of deaths was in this month 291, of which 122, or40 per cent., were due to tuberculosis and 32 to otherdiseases of the air passages, whilst 10 injuries proved fatal.In a series of reports the preponderance of affections of theair passages is so distinctly marked that the medical board ofthe Cassa, or sick club, calls the attention of the managingboard to the fact. Increased protection of the workingclasses against the various causes producing these diseases isurgently needed. The constant high morbidity and mortalityfrom tuberculosis form another factor to be considered verycarefully. In this country the tuberculous patient hasnot such numerous facilities for restoration of health as in

Germany, England, France, and the United States ofAmerica. At present there are only a few open-air sana-toriums and these are rather expensive. In the report of themanaging committee it is suggested that the sums spent onsick pay for the tuberculous members of the Cassa would bebetter spent in erecting a tuberculosis hospital and treatingthe patients until they are again fit to work. This end is tobe aimed at rather than keeping the patient away from workwith the confident expectation of his more or less early death,which is what the present system really amounts to. The

high figure of ten fatal injuries out of 1869 accidents callsalso for a better enforcement of the law by the factoryinspectors.

Proposed Restrictions on the Sale of Patent Medioines.

A memorandum drawn up by the medical council ofSilesia has been placed before the Association of AustrianMedical Councils (Oesterreiehiscleer Aerzte Kammern Tag)with a view to suppress the ever-increasing sale of patentmedicines. The memorandum will naturally receive supportfrom the majority of practitioners, but in addition to pre-senting the views of its authors on the subject of patent orproprietary medicines it also puts forward several patrioticand commercial arguments which perhaps are not absolutelyconvincing from a medical standpoint. Anyhow, the motivesare sound. The proposal recommends that in Austria, as inEngland and Japan, a duty should be imposed upon everypatent medicine, but on a much higher scale-namely, from30 to 50 per cent. of the sale price. The income from thissource could be applied in various ways for the benefit of thepublic medical services, such as in providing for the increaseof medical inspection, for the reduction of the rates andtaxes of charitable institutions, and for the remunera-

tion of medical services hitherto rendered to the publicgratuitously by the profession. A second memorandumon the same subject has also been presented to theassociation; this one in opposition to "State help" re-commends I I self-aid "as the best means of suppressing thepatent medicine boom, which not only injures the public andthe medical profession but also lessens the income of theapothecaries. The leading proposal of this memorandumis that each medical council should instruct and bind allits members to abstain from prescribing any remedy themanufacturer of which does not comply with the require-ments of the councils, these requirements being as follows.The medicine must not be accompanied with printedmatter with explanations of the indications for its useor with medical testimonials. This should apply to all

ready-made, bottled or packed substances, also pills, powders,mineral waters, and ointments. Such remedies must notbe advertised except in medical journals and periodicals.Remedies the labels or wrappers of which show anythingmore than their name or which are advertised in ordinarynewspapers should be boycotted by the profession. Thisis easily done by each medical council, as all practi-tioners of each district must belong to some council or

other, and the resolutions of these councils are bindingon all their members. Both schemes have been receivedin a spirit of criticism by a considerable part of the pro-fession. Neither is satisfactory, and the association willprobably have some difficulty in reconciling the needsof the public and the desire of the profession withoutharming anybody. I

Sept. 20th.

CANADA.

(FROM OUR OWN CORRESPONDENT.)

jRy-’CM -MMM< Atecting of the Canadian MedioalAssociation.

THE forty-second annual meeting of the Canadian MedicalAssociation was held in Winnipeg, Manitoba, the half-wayhouse of Canada, on August 23rd, 24th, and 25th, justprior to the meeting of the British Association for theAdvancement of Science. About 350 medical men werein attendance, the largest number in the history of the

organisation. It was the second time that the Associa-tion had met in Winnipeg, and it now did so underthe presidency of Dr. R. J. Blanchard (Winnipeg), one

of the pioneer physicians of the West, Dr. GeorgeElliott (Toronto) acting as general secretary. The generalsecretary’s statement referred to the work which has beendone towards securing a Bureau of Health for Canada, theincorporation of the Association by Act of Parliament, itsre-organisation permitting affiliation of the provincial medicalassociations, Dominion registration, and the work of theMilk Commission. One of the features of the meeting wasthe discussion on interprovincial reciprocity and Dominionregistration. This was introduced, in the absence of Dr.T. G. Roddick, who has fathered this cause, by Dr. R. W.Powell, who, after reviewing the history of the movement andthe connexion of the Canadian Medical Association there.with, proposed the following motion, which was secondedby Dr. R. S. Thornton (Deloraine, Man.) :-That this Canadian Medical Association now in session urge upon Dr.

Roddick the great importance of impressing on the Government andParliament of Canada the desirability of so amending the CanadaMedical Act (the enactment of which had been secured by Dr. Roddickin 1902 and which provided for a Dominion Medical Council) of 1902that when five or more provinces agree to the provisions and pass thenecessary legislation to make it effective, the Bill may become law, andapply to those provinces which have so legislated. That in order to

strengthen Dr. Roddick’s hands a committee be formed of representa-tives from each of the provinces to consult with him on the provisionsof the Bill and as to the amendments necessary or desirable, and finally,that the various colleges of physicians and surgeons or provinciallicensing boards in the Dominion be respectfully invited to nominate atleast one of their own numbers to serve on such committee.

Dt. L. P. Normand (Three Rivers, Quebec), who was presentrepresenting the College of Physicians and Surgeons of theprovince of Quebec, offered an amendment to the effect thatthe Canadian Medical Association shall secure reciprocitybetween the various provinces of the Dominion on the samebasis as with Great Britain. The resolution passed almostunanimously. Representatives were present and spoke for allthe provinces with the single exception of Prince EdwardIsland, all practically favouring the scheme of Dominion regis-tration. As there is a movement at the present in the westernportion of Canada to secure reciprocity amongst the pro-fession in Manitoba, Saskatchewan, Alberta, and BritishColumbia, and another in the Maritime Provinces to securesimilar conditions in Nova Scotia, New Brunswick, andPrince Edward Island, something tangible may result inthe immediate future with regard to this time-honouredquestion.

The presidential address was delivered by Dr. Blanchardand dealt with a wide range of subjects. Referring to

quacks, the President thought these should be dealtwith by an intelligent public outside of the ranks ofthe profession. He argued that the Government makes itillegal to sell diseased meat but does not leave the prosecu-tion of the offender to the honest dealer. It was incon-sistent that the prosecution of the quack should be rele-gated to the medical profession. Speaking of the typhoidepidemics which in the past have run riot over Winnipeg, Dr.Blanchard said that this preventable disease had in the pastthree years cost Winnipeg over$1,000,000. Overcrowdingof the profession was also dealt with at some length and theremedy seemed to him to be a higher educational standardof the profession. The hospital problem was also givenattention, particularly as Winnipeg is at the present timeconsidering increased hospital accommodation.The milk commission of the Association made a report on the

work they had done in the past year, which will go a longway towards improving the entire milk-supply throughoutCanada. Mr. A. McGill, chief analyst for the department ofInland Revenue for Canada, was present by invitation and