1309

this should be so if the explanation of the Purkinjephenomenon which I have given be the correct one.

Every acute ohserver knows that as the day progresses andtwilight approaches reds become darker and darker, andgreens, blues, and violets become brighter. This is the

purkinje phenomenon. The answer to the question is thatthe increased sensitiveness of a portion of the retina to thegreen rays cannot be evident until it is stimulated by light.The three black lines do not stimulate it. The portion ofthe retina on which the image of the black disc falls becomesbecause of the altered photo-chemical action more sensitiveto the green. When the top revolves the image of the first

part of the white half of the disc is formed on this portion ofretina and stimulates it, nith the exception of the first three.black lines. These black lines therefore appear red throughcontrast. This effect is only momentary. As the toprevolves the retina becomes more and more sensitive to thered end of the spectrum, and so when the light is suddenlycut off by the three last black lines the portion adjacent tothem becomes blue from contrast, the exact colour depend-ing on the light adaptation produced.

I am. Sir. vours faithfullv.

Hendon, Oct. 23rd, 1909. F. W. EDRIDGE-GREEN.

CHROMIDROSIS.To the Editor of THE LANCET. tiSIR,—On p. 1221 of. the last issue of THE LANCET appears lr

a reprint of an article published in your columns on Oct. 22nd, n1831, in which an account is given of a case of I I The Morbid pTranspiration of Blue Colouring Matter through the Skin." 0The case is a very good example of a very rare cutaneous o

affection, now known as "chromidrosis." " The first case on precord seems to have been one described by Yonge of NPlymouth in the year 1709, and from time to time other ’1similar cases have been recorded. It is probable that two Sdifferent conditions have been confounded under the same bname; in one of these the coloured excretion is undoubtedly 1Bsweat, for it has been seen to be excreted directly under "Bobservation. To this class those cases belong in which the lJcolouration is rapidly formed, but there is another group in (which a powdery greasy deposit forms on the skin. The cal’es (in this latter class are probably examples of a coloured csebaceous secretion, for the pigmentary matter cannot be a

easily removed by means of water, but it is easily got rid of -by ether or spirit, and it is readily proved to be composed 1largely of fatty material. In these cases the excretion is Emore gradual. 1As to its etiology we know little, though here it may be (

mentioned that some cases of pigmentation of the skin are 1

certainly factitious, as in the well-known epidemic at Brest,where the pigment appeared on the superficial surface of alayer of varnish with which the face had been painted. Of 1the genuine cases of chromidrosis it is worthy of note that ithe large majority are women ; in one series 41 cases out of ]49. In most of the cases the patients have been youngunmarried women, though in one instance the patient was57. There seems little doubt that a neurotic temperament is ;a great predisposing cause, and various neurotic manifesta-tions have been described in many of the instances. Thechief concurrent symptom appears to be chronic andobstinate constipation, and it has been recorded that inacme cases the amount of colouration present definitely varied Iwith the degree and duration of the constipation. Some-times it varies at different times of the day, and there- seems some reason to think that some relation exists betweenit and menstruation, for it has been seen to be more well-marked just before a catamenial period, diminishing in

severity after it.As to the exact pathology of the condition, there is

not much to be said, but as in some cases at leastthe pigment has given the chemical reaction of indigo,it is not improbable that the condition is sometimes causedby the absorption of indican from the alimentary canal.Stott has described two cases in one family who sufferedfrom pink perspiration sufficient to stain the clothes ; inthese cases he isolated a yeast, but it is probable that these- cases belong to an entirely separate class. The case reportedin THE LANCET in 1831 was in a girl of 16 years, and thepigmentation was of a beautiful blue colour. Curiously the;account does not mention whether the patient suffered from- constipation or not.

The treatment to be followed in these cases is practicallylimited to relieving any constipation that is present andcorrecting any menstrual irregularity. If there is any founda-tion for the idea that the colouration is due to the absorp-tion of decomposition products from the alimentary canal, itis clear that treatment directed to ameliorating the bacterialcondition of the bowel would be likely to be followed by animprovement in the condition of the skin.

I am, Sir, yours faithfully,

I Oct. 25th, 1909. F.R.C.S.

BIRMINGHAM.(FROM OUR OWN CORRESPONDENT.)

The University.FOLLOWING the example of older universities honorary

degrees have been conferred upon a number of gentlemenand one lady eminent in science, literature, statesmanship,medicine, and other walks of life. The ceremony was to havetaken place when the new buildings were opened by theKing last July, but it was decided that the two functionsshould be separated. The ceremony on Oct. 20th was ofsufficient importance to stand on its own basis. The degreeswere conferred by the Vice- Chancellor, Alderman Beale, inthe absence of the Chancellor, Mr. Chamberlain. The cus-

tomary oration was made by the Principal. Sir Oliver Lodge,in making the various presentations. The six honouredmembers of our profession were: Sir Richard DouglasPowell, Bart., President of the Royal College of Physiciansof London ; Mr. H. T. Butlin, President of the Royal Collegeof Surgeons of England ; Dr. J. S. Haldane, Reader in

Physiology to the University of Oxford; Professor B. C. A.Windle, President of University College, Cork ; Mr. C. S.Tomes, the distinguished dental surgeon; and Dr. ArthurShadwell, the well-known writer on economics. The other

honorary graduates were: The Chancellor (in absentia),Mr. W. N. Atkinson (H.M. Inspector of Mines for SouthWales), the Right Hon. A. J. Balfour, the Bishop of Birming-ham, Professor Bosanquet, Mr. Andrew Carnegie, Sir WilliamCrookes, Mr. Maurice Fitzmaurice, C.M.G., Sir ArchibaldGeikie, the Right Hon. R. B. Haldane, Dr. J Rendel Harris,Sir Charles Holcroft, Bart., Mr. G. J. Johnson, Sir Alex-ander Kennedy, Professor Sir Joseph Larmor, the Right Hon.Walter Long, Professor Gilbert Murray, Sir William Ramsay,Lord Rayleigh, Professor Rutherford, Mrs. Sidgwick, LordStrathcona and Mount Royal, Professor Silvanus Thompson,Professor Tilden, Sir J. J. Thomson, Dr. T. H. Warren(President of Magdalen College, Oxford), and ViscountWolverhampton.

City Atd Society.In the annual report of this society which has just

been issued the question of cooperation with the hospitalshas been considered, especially with regard to the bettermeans for distributing hospital tickets and the methodof dealing with out-patients. In conjunction with repre-sentatives from the chief hospitals the method of advancingthe following principles has been discussed-viz., (1) theelimination of applicants well able to pay for medicalassistance ; (2) discrimination in the number of those whoseailments would be more suitably treated by a providentdispensary, the Poor-law, or some other agency. It was

decided, as a practical start, that, when possible, this society’

should appoint an almoner to attend at one of the hospitals’

and take charge of such cases as may be referred by theI medical staff as being cases which could be attended t..

efficiently at home or by some other institution.I

Oct. 26th. ________________

WALES.

(FROM OUR OWN CORRESPONDENT.)

Additions to the Cardiff Irnfirrrnary.WHEN the Cardiff Infirmary was founded in the year 1837

the population of the town was a little over 10,000. Inthe early days of the institution about 80 in-patients and1000 out-patients were dealt with. By 1880 these numbershad increased to 500 and 7000 respectively and the populationof the town was considerably over 80,000. It was thereforedecided to erect new buildings, and in 1884 the present