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stated elsewhere with reference to his address, that " we have the course of human affairs for thousands of years not only not perceptibly influenced by physical knowledge, but rather influencing it, often most prejudicially, often, too, in a way to suggest the idea of chance or intervention. With this fact before him, on the one hand, no devout member of any religion need hesitate to take up a study hitherto so little able to get the upper hand of human affairs and run away with the world. On the other hand, the most ardent and unflinching materialist may learn to suspect that there is something beyond his philosophy, and that, even if, in his theory, all be matter, there is matter not yet within the reach of his present senses."

PYEMIA AT NORWICH.

ONE of the most interesting papers at the late meeting at Norwich was read in the Public Health Section by Dr. Beverley, Assistant-Surgeon to the Norfolk and Norwich Hospital, on the sanitary condition of that hospital. He began with a quotation from that admirable storehouse of information, Dr. Richardson's "Medical History of England," which appeared in the Medical Times and Gazette during the year 1864. "Certain operations," says Dr. Richardson, "have been performed at the Norwich Hospital with a success that is almost without parallel, and the reason of this is that the great experiment of the treatment after operations by fresh air, and plenty of it, has been going on systematically from the first. The Norwich surgeons not only acknowledge Nature, but take her as the senior partner of the firm. No wonder they can show an admirable balance-sheet in favour of life after capital operations." Dr. Copeman stated that on two occasions forty cases of stone were operated upon without a single death, once by Martineau, and then by Dalrymple, Crosse, and Norgate in succession, forming, as Dr. Richardson observes, "with one exception, the most successful statistics of lithotomy ever presented to the world." After a discussion as to the causes of this great success, he thus sums up-"If neither the selection of cases, nor the skill of the operators, nor the character of the operations-i.e., median or lateral-have given to the profession of Norwich such a magnificent harvest, and thrown around this hospital so bright a flame, what is the directing cause? Good luck !—there is no such thing below the surface of fact. Good luck simply means in all cases, that some inappreciable cause has been at work, doing what has been done; and in the Norfolk and Norwich Hospital there has been no mythical subtlety, but one great and pervading element of success, not good luck-but good air. When Benjamin Gooch absorbed from Dr. Hunter that simple lesson about the necessity of having free ventilation and plenty of cubic space for each patient, he achieved half the success which was to come. When he applied the lesson, he, seconded by his able followers, achieved the rest."

Now, the hospital to which these eulogies were applied was in the simple form of H. But the vicious principle of economy of space had prescribed a multitude of additions, which had clustered around the once unencumbered limbs of the H. A museum, with dead-house and appurtenances, a board-room, chapel, physician's and surgeon's room, besides new wards, had all been crowded round the H, impeding ventilation, and defiling the air.

The ill effects of these encumbrances had been pointed out in 1864, since which the whole drainage had been put into a perfect state, the laundries remodelled, and the kitchen removed. But in spite of this, the number of deaths after operations and accidents was frightful. We must refer to another page for exact particulars and a classification of the deaths, but they seem to include 66 per cent. of amputations

for injury, and 10 per cent. of amputations for disease, and one in 6:58 of lithotomy cases.

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That the mortality is due to the Hospital, and not to the operator, is clear from the evidence of Mr. Cadge, who says:"I have unwillingly and almost tremblingly proceeded to operate in the Hospital, but I have had a happy confidence and a perfect assurance that in all private cases I should avoid any of these disastrous consequences, and I come to the conclusion in my own mind that pyæmia, if it does not find its birthplace, does find its natural home and resting-place in hospitals; and although a hospital may not be the mother of pyæmia, it is its nurse."

That the pyæmia and the general mortality of the patients after wounds and fractures are due to some taint arising from the presence of such patients in an insufficiently ventilated hospital, is clear from the history of this particular hospital, from the general history of surgical and lying-in wards, and especially from that of the obstetric wards in the King's College Hospital, and that of the military hospitals in Paris during the siege. Dr. Beverley seems to us to seize the real point as to prevention. It is of no use to add new wards to an old hospital; they soon become the worst of the whole. Hygienic measures, disinfectants, and antiseptics lessen, but do not cure, the malady in a once tainted hospital. All attempts at architectural features-at making a "noble institution," an ornament to our cathedral city, and monument of the munificence of its citizens," etc.,-must be given up. A set of low buildings, with floors raised from the ground, and no storey, each building capable of containing very few patients, to be emptied of beds and cleaned at short intervals, and disconnected utterly from each other, and from the main building-such is the beau-idéal of a surgical or obstetric hospital.

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But then, exclaims Lady Statistical Philanthropy, what an expense! What is to become of our discipline? We humbly say, We don't know. But the building and maintenance of hospitals is not an imperative duty, and not the only means of relieving the sick; and if we do build and maintain hospitals, they should be such as give patients a fair chance of recovery.

IMPORTANT CASE OF LIFE ASSURANCE.

A CASE of great interest with regard to life assurance was tried at Leeds last week. The plaintiff, a physician, Dr. Jay, of Scarborough, about four years since married a widow lady about forty-five years of age. Under certain terms of the marriage settlement it was arranged that Mrs. Jay's life should be insured for £3000, which was accordingly effected in the Gresham Life Office. Mrs. Jay died in 1873 of what was certified to be "serous apoplexy." The Company, on some information which they had received, declined to pay the sum assured, and left the plaintiff to take his remedy. The lawyers, as usual, managed to involve the question in every possible way, but the simple issue to be tried was whether fraud had been committed by Dr. Jay in his proposal to assure the life of his wife. This consisted in his alleged omission to state that his wife had been attended medically for some considerable period. The second point upon which the Company rested its defence was that Mrs. Jay, for a considerable time before the assurance was effected, and even up to the time of her death, "had been ruining her health by excessive drinking, and that she died of disorders of which that drinking was the real cause." The trial lasted for several days, during which a vast amount of evidence was adduced on both sides. It would be tedious and useless to enter into these details-contradictory, unsatisfactory, and inconclusive. The able summing up of the Judge we give in extenso, as the trial is one of the last importance in reference to life assurance.

Baron Amphlett's address is exhaustive of the law on the subject.

He began by calling the attention of the jury to the extreme importance of the case to both parties and to the public as well. It would be impossible for them to find a verdict for the defendants without convicting the plaintiff both of fraud and perjury; on the other hand, if the verdict was for the plaintiff, a great injury might be done to the defendants should it appear that they had resisted a just claim on grounds which were insufficient. It was also painful to consider that the whole life of the deceased woman was ripped up, and that her character and reputation were at stake. He observed that the burden of proving the untruth of the statements about temperate and sober habits rested on the defendants. He commented upon the law as to the proposal, which was the basis of the policy, amounting to a warranty, so that if the questions were answered untruly, although the untruth was not known to the person answering them, the policy would be vitiated. This, said Baron Amphlett, was a harsh construction, but as the law stood he was bound to lay down that rule. The main points in the case were whether the habits of Mrs. Jay were sober and temperate at the time when the proposal for the policy was sent in, and whether they had been sober and temperate for a reasonable time before. The second question was whether she was in good health at the time when the proposal was sent in, and the answer to that mainly depended on the answer to be given to the former question. The third question was whether Mrs. Jay had ever been subject to any disease tending to shorten life, and a number of diseases were enumerated. This question was not to be taken literally. It must refer only to diseases germane to the present inquiry. There had been evidence of disease of the liver, but there could not have been any serious disease of the liver at the time of the proposal unless the defendants' evidence as to intemperance was true, and, therefore, the answer to this question depended mainly upon the answer to the first. Then came the question whether Mrs. Jay had a medical attendant whose name ought to have been communicated to the defendants. It had been contended by the defendants that Mr. Dale was the usual medical attendant of Mrs. Jay; but, as a matter of fact, upon her marriage Mr. Dale had ceased to be her medical attendant, being superseded by Dr. Jay himself. Therefore the non-disclosure of Mr. Dale's name was not in itself a violation of the terms of the proposal. There was, however, another important point in connexion with this question. If Mr. Dale had attended Mrs. Jay for any serious complaint, and had told Mr. Jay of it, then there would be an omission of a material fact, which ought to have been told to the defendants, and the policy would be vitiated. The learned judge then commented on the evidence of Mrs. Jay's relations, who had given evidence for the defendants. It would be for the jury to consider whether these relations were actuated by such high motives as had characterised the Catos and Brutuses of ancient Rome, or by spite and envy. He then went carefully through the evidence in the case, taking it much in the order in which it was given, but postponing till the end the medical evidence on both sides. In conclusion, the learned judge left four questions to the jury-1. Were Mrs. Jay's habits on the 19th of August, and had they been, sober and temperate; and, if not, was this known to the plaintiff at the time when the proposal was sent in? 2. Was Mrs. Jay in good health on the 19th of August; and, if not, did the plaintiff know of it at the time? 3. Had Mrs. Jay been subject to any disease tending to shorten life and not disclosed to the defendants; and, if so, what was the disease, and did the plaintiff know of it? 4. Was any fact which ought to have been stated to the defendants omitted from the proposal; and, if so, what was the fact, and was it fraudulently omitted? The jury retired at 4.30, and at 10 p.m. found a verdict for the plaintiff on all the issues for £3000.

Under the circumstances, it appears to us the jury could not have returned any other verdict than that which they did. The charge of fraud was withdrawn; and this by itself may be held as good proof that the insurance company had not well considered the position they took up.

VEGETABLE FOOD.

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A PAPER, read by Mr. Cooper before the British Association at Belfast, upholds the nutritive value of farinaceous articles, such as arrowroot and corn-flour. There is no doubt that these matters have fallen into undeserved disgrace for two reasons. First of all, medical men, neglecting the evidence of their daily experience, put implicit trust in the newlydiscovered and fascinating theories of Liebig. According to these, nitrogenous food was the source of force and nutrition; non-nitrogenous food of heat alone. So, beguiled by this theory, our medical brethren began to denounce starch as innutritious, and manufacturers began to wash the starch out of wheat, and to prepare aliments of pure gluten, as ifthough these are valuable in diabetes-they were the best for ordinary nutrition. But then came a reaction: for it was shown by experiment that non-nitrogenous food, by its oxidation, is a source not only of heat, but of muscular movement; and that, although nitrogenous food was necessary for the conservation and repair, and although it might serve for the production, of heat and force, yet that heat and force in vegetable feeders were due to non-nitrogenous elements. Then came the fact that the poorer and cheaper kinds of wheat-flour, as of other vegetables, are the richer in nitrogen and phosphates, whereas the finer and more expensive wheats, which everybody eats who can afford to buy them, are the richest in starch and poorest in nitrogen and phosphates. And next, the experience of every sick-room testified to the value of the old-fashioned cup of arrowroot. Mr. Cooper adds a special instance, showing that during some weeks of sea-sickness he lived on nothing else but arrowroot and water.

Now, all these arguments are conclusive as to the fact that starch has some value as nutriment-value of the same kind as sugar and fat. But one other great reason for the disgrace into which it has fallen is the notion, which seems to be upheld by some of those who have corn-flour to sell, that it alone and by itself is an adequate food for children and sick people. Now, we know that neither muscle nor bone can be made out of starch alone; hence that milk or some other nitrogenous food must be added if the patient is to "make old bones." The truer statement would be that milk plus corn-flour or arrowroot is often more suitable, more digestible and nutritive, than milk without; but then the corn-flour must be looked upon, not as a substitute, but as an improvement to the milk, by adding to its force-creating and muscle-working elements, though it adds not to its muscle- and bone-growing elements. After all, there is truth in the statement of Buckle, much laughed at as it was, that the wealth and power of a nation depend mainly on the abundance of starch.

The misuses of starch food, and the cruel starvation to which infants are condemned who are ignorantly fed upon corn-flour, or sago, and water, fully justify medical practitioners in denouncing such articles as innutritious alone. But if they are to be called innutritious absolutely, and condemned as worthless because they do not take the place of all food, then water, common salt, sugar, butter, and alcohol must also be subjected to the same ridiculous kind of taboo. As Mr. Cooper says, "It would be as idle to complain of the butcher for not selling vegetables as a proper part of the joint, or the baker for not selling butter with his bread, as to raise objections to these starchy foods, which are the most convenient media for conveying by admixture a wholesɔme amount of nitrogenous

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Medical Times and Gazette.

substance, modified according to the requirements of children and invalids, who would otherwise be incapable of assimilating ordinary food."

THE WEEK.

TOPICS OF THE DAY.

AN application was made on Monday to Mr. Justice Archibald, at the Liverpool Assizes, on behalf of Mr. Rigby, a surgeon at Chorley, to stay execution, in order that he may have an opportunity of moving for a new trial. The application was granted. The action against Mr. Rigby was for damages for alleged unskilfulness in the surgical treatment of a fractured arm in a child. As usual, medical evidence was very contradictory, and involved disputed questions of treatment. We believe that Mr. Rigby will succeed in getting a rehearing of the case. He is certainly entitled to it. We reserve comments.

It is proposed to establish a home for temporary rest for over-worked and tired "trained" nurses. It is suggested that Harrow offers special advantages for the undertaking. A lady resident there is ready to be responsible for £80 a year in the first instance, and for the management of the house. A suitable house near one of the churches can be obtained for the home. It is proposed that £200 a year should be at once raised over and above the Lady Manager's contribution, and the work commenced with that amount. We hope the benevolent proposal will meet with public approval. The object is worthy of generous support. It is well known that, from their hard toil and little rest, the ratio of mortality amongst nurses is fearfully high, which might no doubt be considerably reduced were homes of temporary rest provided. The institution, it is intended, shall to a certain extent be a provident one, the nurses subscribing towards its support.

We understand that Mr. Bellamy, of Charing-cross Hospital, is likely to succeed Professor Marshall as Lecturer on Artistic Anatomy in the Government School of Design at South Kensington.

THE ANNUAL STATISTICAL REPORT ON THE HEALTH OF THE ROYAL NAVY FOR THE YEAR 1872. THE annual Blue-book containing the statistical report on the health of the navy for the year 1872 has just been published. From it we learn that, as compared with the preceding year, there was a decrease in the ratio of cases entered on the sicklist equal to 40 per 1000 of force, and an increase in the invaliding rate to the extent of 2-3 per 1000. In the ratio of mortality there was a reduction equal to 0.3 per 1000. The death-rate from disease alone was only 5.6 per 1000, whilst in the year 1871 it was 6.3 per 1000.

On the home station, the training ships for boys furnished, as usual, a number of cases of eruptive fevers; they were not, however, extensively epidemic in any vessel. The only disease which could be said to have prevailed epidemically during the year under notice was mumps, of which a considerable number of cases appeared in three of these ships. There was a slight increase in the ratio of cases of those forms of disease against which the Contagious Diseases Act is directed. On the home station a large proportion of the disease that exists in the protected ports is traceable to importation from unprotected districts, and there appears little doubt that, if these could be reached by legislation strictly enforced, the more destructive forms of disease might be almost stamped out. It is also most satisfactory to learn that, whenever the Contagious Diseases Act is alluded to by naval medical officers, its beneficial influence is always testified to in the highest terms, the only regret expressed in connexion with it being that it is not more extended in its application.

The lowest ratio of sickness during the year 1872 was on

the South-East Coast of America, the highest on the Mediterranean Station. The average sick-rate of the total force was 45.9 per 1000, being an increase compared with the preceding twelve months equal to 0.1 per 1000. A very carefully compiled table shows that in every 100 deaths in the navy during the year in question, 30.90 per cent., or nearly one-third, were from wounds and injuries of various kinds; phthisis pulmonalis contributed 13.76 per cent.; diseases of the circulatory and respiratory systems, each 9.87; and diseases of the digestive system, 7.79; eruptive fevers gave a percentage of 10:38, the greatest mortality, as might be expected, occurring in the two decennial periods from fifteen to twenty-five, and from twenty-five to thirty-five years of age. Another very instructive table shows that out of every 100 cases between the ages of fifteen and twenty-five, 28.11 were due to cases of disease of the cellular tissue and cutaneous system, 21:33 to wounds and injuries of various kinds, 13.12 to diseases of the digestive system, 9:14 to diseases of the respiratory system, 7.82 to diseases of the urinary and generative systems, 4:54 to primary syphilis, 3.57 to rheumatism, 2:41 to continued fevers, and 0.76 to eruptive fevers. In the second decennial period (twenty-five to thirty-five) rheumatism had risen to 6:44, diseases of the respiratory system to 11.82, and diseases of the digestive system to 17:05, while diseases of the cellular tissue and cutaneous system had fallen to 18-12, primary syphilis to 3.50, and eruptive fevers to 0.73. There was, however, a fractional rise in wounds and injuries and continued fevers, compared with the preceding period. In the third decennial period (age from thirty-five to forty-five) there is a progressive increase in rheumatism and diseases of the digestive and respiratory systems, while there is a further decrease in diseases of the cellular tissue and cutaneous system, wounds and injuries, and in continued and eruptive fevers. In the period of age above forty-five years, rheumatism stood at 14-21 per cent., but diseases of the digestive system had fallen about 1 per cent. compared with the preceding period. There was also a progressive decrease in diseases of the cellular tissue and cutaneous system, and in wounds and injuries. As in the previous year (1871), the total percentage shows that the diseases most prevalent in the Royal Navy were those of the cellular tissue and cutaneous system; then wounds and injuries, diseases of the digestive system, of the respiratory system, of the urinary and generative systems, and rheumatism.

The following interesting history of a very severe case of acute rheumatism, occurring in a boy of H.M.S. Cambridge, is given by Staff Surgeon Ahmuty Irwin (an officer very highly spoken of in despatches during the late Ashantee campaign). The boy, aged sixteen, was admitted to the Royal Naval Hospital at Plymouth from the Cambridge, on November 26, 1872, suffering from acute rheumatism affecting the wrists, elbows, knees, hands, and ankle-joints, with high temperature, but without cardiac complication. He was treated, as is customary in this hospital, with a mixture containing bicarbonate, acetate, and nitrate of potassa in effervescence, and an alkaline lotion with opium to the affected joints. He progressed favourably up to December 5, when he became exceedingly restless, and complained of much frontal pain, with anxious expression of countenance. In the evening he was in a state of busy delirium, and symptoms of acute meningitis were conclusively present; at the same time all the articular symptoms disappeared. Enemata were administered, cold to the heart, and blisters, without the smallest relief. He was supported carefully with milk, beef-tea, and a fair allowance of wine. He was very restless, and continually tossing his arms about; pupils dilated, and almost inactive. He continued for about forty-eight hours in the above state, and on the morning of the 7th had been without sleep; pulse 152, and very weak; temperature

102.6°. Draughts containing twenty grains of hydrate of chloral, with syrup of ginger, were ordered, one to be taken immediately, the others at intervals, as required. Soon after taking the first draught the muscular twitchings, or tossing about, ceased, and he fell into a quiet sleep. He passed the day and night tranquilly, taking nourishment at intervals. On the morning of the 8th was quite rational, and comparatively comfortable; but about 2 p.m. there was a return of the unfavourable symptoms, less in degree. Half a chloral draught was given, which quickly composed him, and from that time there was no return of the head symptoms. The rheumatic affection relapsed, both knees becoming swollen and painful to the touch. He steadily improved from the extreme prostration, and was convalescing, but suffered from organic cardiac disease, which will unfit him for further service. He had no recollection of the Cambridge, nor of any circumstance immediately preceding his illness. The case is remarkable—first, for its rarity; secondly, from the fact of the disease being almost invariably fatal; and thirdly, for the good effect produced by the administration of the hydrate of chloral.

THE NEW SYDENHAM SOCIETY.

THE sixteenth annual meeting of the New Sydenham Society was held at Norwich on Thursday, August 12; Dr. Waters, of Chester, being in the chair. The ballot having been taken, the following officers were declared duly elected for the ensuing year (the gentlemen whose names are marked with an asterisk were not in office last year) :-President: Cæsar H. Hawkins, Esq., F.R.S. Vice-Presidents: Alfred Baker, Esq., Birmingham; E. R. Bickersteth, Esq., Liverpool; *J. S. Bristowe, M.D.; *Edward Copeman, M.D., Norwich; J. Matthews Duncan, M.D., Edinburgh; *D. Embleton, M.D., Newcastle; *Edward Long Fox, M.D., Bristol; *Prescott G. Hewett, Esq., F.R.S.; W. D. Husband, Esq., York; T. B. Peacock, M.D.; Sir James Paget, F.R.S., Bart.; George Southam, Esq., Manchester; A. P. Stewart, M.D.; W. Stokes, M.D., F.R.S.; Sir Thomas Watson, M.D., F.R.S. Bart.; C. J. B. Williams, M.D., F.R.S.; Hermann Weber, M.D. Council: James Andrew, M.D.; Warburton Begbie, M.D., Edinburgh; W. H. Broadbent, M.D.; Charles Brooke, Esq., F.R.S.; T. Bryant, Esq.; Thomas Buzzard, M.D.; Robert Ceely, Esq., Aylesbury; W. Cholmeley, M.D.; T. B. Crosby, Esq.; Thomas M. Daldy, M.D.; J. Langdon H. Down, M.D.; Dyce Duckworth, M.D.; Robert Dunn, Esq.; C. Hilton Fagge, M.D.; J. Fayrer, M.D.; *C. J. Hare, M.D.; T. F. Grimsdale, Esq., Liverpool; *John Hamilton, Esq., Dublin; *W. Price Jones, M.D., Surbiton; J. C. Langmore, M.B.; Joseph Lister, F.R.S., Edinburgh; Alfred Meadows, M.D.; G. H. Philipson, M.B., Newcastle; *Henry Power, Esq.; *W. O. Priestley, M.D.; W. Roberts, M.D., Manchester; James Russell, M.D., Birmingham; Leonard W. Sedgwick, M.D.; Septimus W. Sibley, Esq.; *Thomas Sympson, Esq., Lincoln; T. P. Teale, Esq., Leeds; William Turner, M.B., F.R.S.E., Edinburgh. Treasurer: W. Sedgwick Saunders, M.D., 13, Queen-street, Cheapside, E.C. Auditors: E. Clapton, M.D.; S. Fenwick, M.D.; F. M. Corner, Esq. Honorary Secretary: Jonathan Hutchinson, Esq., 4, Finsbury-circus, E.C.

The report shows that the financial condition of the Society is highly satisfactory, there being more than £1000 in hand in addition to a very valuable stock of books. The balance-sheet shows an annual income of £3566, which would appear to represent subscriptions of about 3000 members, augmented by receipts from the sale of surplus back volumes. The principal works which the Society has now in progress are its "Atlas of Skin Diseases," which it is intended to continue for some years longer; its " Retrospect of Medicine and Surgery," which appears biennially; and a new and revised edition of "Mayne's Lexicon," which is in course of preparation. In the preparation of the last of these, the editor-in

chief, Mr. Robert Cooke, will in future be assisted by Drs. Greenhill, Clifford Allbutt, John W. Moore, of Dublin, and Reay Greene, of Belfast. The labour on this volume has been found to be very heavy, and the Council cannot fix any definite time for its probable completion. As a necessary measure of limitation, it has been decided to restrict the work to words having relation to medical pursuits. A translation, with notes by Mr. Hinton, of Van Troeltsch on the "Surgical Diseases of the Ear," with a short monograph by Professor Helmholtz on the "Mechanism of the Internal Ear," is in the binder's hands. A fourth volume of Hebra's work on Skin Diseases," a fourteenth fasciculus of the "Atlas of Skin Diseases," and a second part of the "Descriptive Catalogue of the Atlas" will complete the series of the year.

THE

PHYSIOLOGICAL ACTION OF PROPYLAMINE AND OTHER
DERIVATIVES OF AMMONIUM.

THE Comptes-Rendus de la Société de la Biologie de Paris for 1873 (p. 246) contains an account of some experiments made by M. Laborde on the physiological action of the substances above enumerated, with especial reference to the great use which has lately been made of propylamine and its allies in France in the treatment of acute rheumatism. His results seem, as he himself remarks, to be but little in accordance with empirical views of their properties. The conclusions arrived at are as follows:

1. Propylamine in the crude form, or trimethylamine, both act primarily on the central nervous system, especially its spinal portion, and produce, in physiological doses, excitement and increased functional activity of the cord, so as to react on the respiratory and circulatory systems, and to accelerate the heart's action. In poisonous doses depression follows this excitement, and at this period only (that is, if the doses are excessive) there is a retardation of the pulse and depression of temperature. Death results from cardio-pulmonary asphyxia. If trimethylamine be given to a dog by the stomach, it will be tolerated up to a dose of three grammes without vomiting, but by its local irritation catarrh of the mucous membranes of the stomach and duodenum is produced, accompanied by hyperæmia and superficial ulceration; and if it be injected into the subcutaneous tissues it produces true sloughs. It can also give rise to hæmaturia from congestion of the kidneys.

2. The physiological action of chloride of trimethylamine is substantially the same as that of its base, but it differs from it by its slighter intensity, which scarcely attains that of half a dose of the other. Neither salt should be regarded as acting directly on the muscular tissues or as true cardiac poisons.

3. Trimethylamine and its chloride are in their physiological action on the nervous system rather analogous to the ammoniacal compounds in general, especially the chloride and acetate of ammonium; but while the latter salts even produce tetanic convulsions, trimethylamine and its chloride scarcely do more than produce muscular trembling and an exaggeration of the principal functions of the spinal cord.

Trimethylamine and its chloride (especially the former) are thus general functional excitants, and they rouse and accelerate the circulation more than they depress or calm it, for depression only succeeds large and long-continued doses, which injure the system by irritating the digestive and urinary organs. We cannot therefore look on them as true antipyretics, and they are also much inferior in respect of their exciting and stimu lating action to the chloride and acetate of ammonium, and require to be given in much larger doses than the latter.

The trimethylamine was, in M. Laborde's experiments, injected into the dog's stomach by means of a sound, in doses of one to three grammes dissolved in fifty grammes of water, and the dose was repeated for twenty days.

loride of trimethylamine was injected into the dog's

H

crural vein in five-gramme doses dissolved in fifty grammes of water, and chloride of ammonium was exhibited in the same way in a warm solution of from three to five grammes in forty of water.

HOSPITAL SUNDAY FUND.

THE amount collected by the Hospital Sunday movement this year scarcely exceeds that of last year. It appears to have been distributed amongst the various charities with complete fairness and judgment. It is satisfactory to know that the Committee of Distribution made very searching inquiries into the real position of the institutions to which the various sums were allotted. One of the tests required by them was a balance-sheet of receipts and expenditure during the past three years.

The production of this document was readily furnished in the great majority of instances. It was not forthcoming, however, on the part of certain "hospitals and dispensaries" with high-sounding names and large pretensions. We suppose at least that this was the reason why no grant was made to such charities as the British Hospital for Skin Diseases, Great Marlborough-street; St. Peter's Hospital for Stone; Hospital for Diseases of the Throat; National Hospital for Diseases of the Heart; Royal South London Ophthalmic Hospital; National Dental Hospital; and the Western Ophthalmic Hospital. The St. John's Hospital for Diseases of the Skin did not apply. Now, these "great "hospitals advertise pretty extensively, in fact, some of them almost daily, the sums of money they receive from the public. It is surely due to their contributors and to the public at large, to be informed in what way this money has been spent, and what are the accumulated funds, if any. How many beds, for instance, are contained in each of these "British" and "National" hospitals? Judging from the apparent size of some of them, it would appear difficult to find any beds at all, except those for the housekeepers and servants. At all events, these institutions have no right to expect further support, so long as they refuse to give an account of their stewardship. Amongst the prominent benefits that the Hospital Sunday Fund is likely to confer on the public, is that of testing the real claims of its various applicants to consideration. We have reason to believe that the statements of some of the hospitals, oldestablished, well conducted, and well situated, are unsatisfactory and deplorable: in debt, with failing subscriptions, and in many cases invested capital gradually diminishing. Whatever opposition the private special hospitals may make to disclosing their real pecuniary position, matters but little; the public will draw its inference from their silence-an inference which cannot be a mistaken one.

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INSPECTION OF THE HOUSES OF THE RICH.

HOUSE-TO-HOUSE inspection has hitherto chiefly been limited to the dwellings of the working-classes, but instances are constantly cropping up which reveal a sadly insanitary condition of the residences of the upper and middle classes. The necessity of a like vigilance in the supervision of the houses of the latter classes is gradually forcing itself upon public notice, and it must sooner or later be as regularly and systematically adopted. Scarcely a week passes but some medical officer of health refers to this subject, prompted by the result, probably, of a special inspection of houses occupied by the rich and wellto-do. An Act of Parliament of an important sanitary character on the dwellings of the poor has recently passed the Legislature. It is obvious that fresh legislation is almost as much needed in respect to the vital points of sanitary supervision and construction of the residences of those higher in the social grade. Sanitary administration to be perfect must be universal.

FORTY-SECOND ANNUAL MEETING OF THE BRITISH MEDICAL ASSOCIATION.

THE MEDICAL SECTION.

CASES OF CONVULSIONS FROM ORGANIC BRAIN DISEASE, BY DR. GOWERS-THE LOCALISATION OF FUNCTION IN THE BRAIN, BY DR. FERRIER-DISCUSSION ON APHASIA.

Dr. GOWERS, of London, read a paper on three cases of Convulsion of deliberate march, due to organic cerebral disease, the exact limitation of the lesion being ascertained by postmortem examination. In the first case a series of unilateral convulsions affecting the angle of the mouth, arm, and leg, of one side only, commenced by simultaneous and equal clonic spasm in the two frontal muscles, followed by spasm in the two orbiculares palpebrarum, greater on the side to which, in the rest of the muscles, the convulsion was limited. The lesion found was a clot situated above the lateral ventricle on the opposite side. The distribution of the spasm in this case was compared with that of the paralysis in an ordinary case of hemiplegia, and it was pointed out that the former is explained as consistently as the latter by Dr. Broadbent's hypothesis. The second case was one of a series of convulsions, each beginning unilaterally by a half-coördinated movement of the hand, the forefinger being extended and the hand raised to the head. The spasm then spread to the other muscles of that side, and then to those of the opposite side. The attacks were found to be due to a band of intense congestion and minute extravasation in the frontal lobe of the opposite side, crossing the anterior portion of all three convolutions, and extending from the longitudinal fissure to the anterior limb of the fissure of Sylvius. The congestion was due to thrombosis in a vein. In the third case a small tumour, evidently of long duration, situated in the white substance above the lateral ventricle, was the apparent cause, during several years, of convulsive attacks which began with an aura in the wrist on the same side as that on which the tumour was situated. The aura had, by a blister, been for a time transferred to the opposite arm. It was conjectured that the tumour had probably produced the convulsion by influencing the opposite hemisphere through the commissural fibres of the corpus callosum, in the midst of which it was placed.

Dr. FERRIER, of London, read a paper upon the Localisation of Functions in the Brain, and referred especially to aphasia by way of illustration. He did not wish to make an elaborate statement, but only to point out the bearing of experiment on the pathology and diagnosis of brain disease. The method which he employed was now familiar. The experiments of Fritsch and Hitzig and of himself had been frequently repeated by other observers, and the facts were generally admitted. But the interpretation of these facts was various. Dr. Ferrier then answered certain objections which have lately been raised to his conclusions-for example, that the convolutions are not motor in their function because they do not respond to stimulation when the animal is fully under chloroform; that the movements obtained by galvanising the convolutions are due to excitation of the basal ganglia by conduction, and that similar results may be obtained by exciting the white matter

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