1902

lysol for 24 hours before it is taken to the laundry to bewashed.Two interesting cases of relapse in typhoid fever have

occurred. In the first case the patient’s temperaturerose about 10 or 11 days after his first attack and hehad all the usual symptoms of a slight relapse, suchas headache, malaise, pains in the limbs, slight abdo-minal distension, and enlargement of the spleen. The

evening temperature remained up for seven days, witha normal temperature each morning after the first three

days, during which time it rose to 102° F. On the eighthday the patient seemed quite well again; his temperaturewas normal and it remained so for five days. On thefourteenth day he was seized with pain in the abdomen andhis temperature suddenly ran up to 105° without any pre-

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ceding condition of collapse being noticed. His abdomenwas rigid and did not move well with respiration. Therewas dulness of the lower part of the abdomen, especially onthe right side, sickness began, and the pulse became morerapid and weaker. Dr. Washbourn, in connexion with Dr.Richmond, diagnosed a perforation of a typhoid ulcer, andlaparotomy was performed by Mr. Raymond Johnson. A smallperforation was soon discovered in the centre of a typhoidulcer in the ileum of about the size of a shilling. The wallsof the gut were too soft to allow of the ulcer being stitchedup and so it was sewn into the wound and the peritoneumwas washed out with boric acid lotion and the pelvis drained.The patient unfortunately sank a few hours after the opera-tion. At the post-mortem examination it was found thatthis was the only ulcer present, although there were evidencesof recent typhoid ulcers. It is thus clear that a singletyphoid ulcer can give rise to a relapse, and that althoughsuch relapse may have a very short period of pyrexia it isof the utmo 4 nportance to treat such attacks with as muchcare as in llJ...c primary attack. In this instance the patient twas kept on a strict diet of plain milk from the second dayon which his temperature rose nntil his decease. In thesecond case a relapse occurred with all the usual symptomsand with enlargement of the spleen and with spots fiveweeks after the patient’s temperature had been normal.Deelfontein, May 14th.

ASSOCIATION OF BRITISH POSTALMEDICAL OFFICERS.

ANNUAL DINNER.

THE annual dinner of the Association of British PostalMedical Officers was held under the chairmanship of thePresident, Dr. W. DOUGAN, on June 21st, at the White-hall Rooms, Hotel M6’iropole. The usual loyal toasts

having been honoured, Sir JAMES CRICHTON BROWNE

proposed ’’ The Imperial Forces" in an eloquent speechand the toast was replied to by Sir JOSEPH FAYRERwho said that he had endeavoured to record in thebook which he had just written and published the

history of his life’s work and he had honestly done hisbest for those Services for which he was responding. Forthe rest of his life, which in the nature of things couldnot be very prolonged, he felt that he had the approba-tion of his confrcres in the profession and of his brotherofficers in the Service, which he thought was the bestreward a man could have. "The Houses of Parlia-ment" was next proposed by Mr. EDMUND OWEN in abrilliant and witty speech, and was replied to by Mr. J.WALTON, M.P., who said that he had always entertained theidea that the House of Lords was a body of men independentof, and uninfluenced by, the voice of clamour, but that ideaof his a short time ago received a shock when the peerssurrendered on the vaccination question. Mr. EUGEXEWASON, M.P., proposed, and Sir ROBERT HUNTER repliedto, the toast of " The Postmaster-General, the Secretary, andother Executive Officers of the Post Office." 11 The Board ofEducation and other State Departments" was proposed byDr. F. DE HAVILLAND HALL, and was responded to by SirGEORGE KEKEWICH, Secretary to the Board of Education. IDr. J. F. W. TATHAM. Superintendent of Statistics to theRegistrar-General’s Office, also acknowledged the toast,and said that he wished to extend the usefulness of thestatistics issued by his office. He had to thank themembers of his own profession for the hearty supportextended to him in the performance of his duties. Thetoast of " Preventive Medicine" was proposed by Dr. WOOD

(Dulwich) and was replied to by Professor W. H. COBFIEU),who said that such was the excellence of the carry-ing out of the vaccination regulations in Germanythat since 1874 no epidemic of small-pox had occurred

throughout that empire, and as a result when a case of

small-pox occurred in the extreme outlying parts adjacent.to countries where the vaccination laws were carelesslyenforced the first German medical officer seeing the case

generally mistook it for chicken-pox. He himself couldremember three hospitals in London where scarlet fevercases in times past were mixed up with the general patients.For his efforts to stop that he had received the severest

possible censure from the chief physician of one of thehospitals concerned who was also medical officer of health ;.that alone showed how preventive medicine had advanced.-Dr. A. WHITELEGGE (Chief Factory Inspector), in givingthe toast of "The General Medical Council," saidthat it was realised that the Council was endeavouringto make the profession more select by elimination ofundesirable members and by increasing the stringency ofthe qualifying examinations.-Dr. J. G. GLOVER, in respond-ing to the toast, said that it would be well for the medicatprofession if all gentlemen spoke of the General MedicalCouncil with the generosity which characterised the remarksof Dr. Whitelegge. He (Dr. Glover) did not wish tcsave the Council from criticism for it was the better for

it, but any fair student of its proceedings would concludethat with the limited powers it had it did the best itcould. Nothing would do the Council more good than theencouragement of the profession. As a slight proof of theright of the Council to feel that it had done something forthe profession he would refer to the question of infectiousdiseases. He himself had taken an active,part in trying to

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increase the education of students in the matter. He was amember of the deputation sent to ask Mr. Ritchie to openthe Metropolitan Asylums Board hospitals to students. Itwas possible for a man to be a most distinguished studentand yet never see a case of small-pox and possibly measles.When the deputation went to Mr. Ritchie Sir Samuel Wilksrelated how Guy’s Hospital had been asked to send amedical man to one of the important public schools, andthe best man the hospital had was sent. There arose in theschool a mysterious complaint which this gentleman hadnever seen before. He was so puzzled that he went to theoldest medical practitioner in the district and detailed thesymptoms and was duly informed that he had to deal withan outbreak of measles. This defect in medical educationthe Council was trying to remedy. The unity of the pro-fession would be best served and promoted by giving all

encouragement to the General Medical Council, for it was themost representative body in the profession: it represented themedical schools in the United Kingdom, the Universities,the medical corporations, and the great body of the medicalprofession, though, of course, it must be admitted thatdirect representation was not as adequate as it might be. Ifthey used the amount of direct representation which theyhad in the right way it would be increased, but they mightso abuse it as to secure not extension but extinction.He (Dr. Glover) could say as one of the Direct Representa-tives that the other members of that Council representingthe Crown and other interests paid great respect to theviews of the Direct Representatives.-Dr. R. PARAMORE pro-posed 11 The Medical Press," which toast was suitablyresponded to.-The Rev. HENRY BELCHER proposed "TheAssociation of the British Postal Medical Officers," andthis having been replied to by the PRESIDENT, Dr. H.FITZGIBBON proposed " The Guests," which receiveddue acknowledgment from Sir THOMAS ROE and Mr. P. J.

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FREYER.-A very cordial vote of thanks to the honorarygeneral secretary, Dr. R. Ritchie Giddings, concluded theproceedings. The enjoyment of the evening was muchenhanced by the excellent singing of Miss Lilian Corner andMr. George Schneider and by a well-selected programme omusic executed by the Imperial Orchestra.

THE NEW INFIRMARY AT NEWCASTLE.

THE foundation-stone of the Royal Victoria Infirmary waslaid by the Prince of Wales on Wednesday, June 20th. Thenew building, which is to commemorate the Diamond Jubileeof Her Majesty the Queen, will occupy a site upon Castle

Leazes and will take the place of the old infirmary which, by