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PUERPERAL CONVULSIONS WITHOUTALBUMINURIA.

DR. N. VueciNo of Rodosto, writing in the ConstantinopleGazette Medicale d’Orient, gives the case of a lady usuallyenjoying excellent health, except for occasional hystericalattacks, who in the fourth month of her first pregnancy wasseized with a severe frontal hemicrania of quotidian type.At the end of the sixth month she was awakened one nightwith intense pain in the head, followed by a slight con-vulsion affecting the upper extremities. In the morningthe writer found her suffering from general convulsions,consciousness being lost, and a bloody froth issuing fromthe mouth; the pulse was small and hard; but the urinewas then, and continued to be, perfectly normal. Variousmethods of treatment having proved fruitless, it was decidedto bring on the labour, which was done by injecting hotwater (3°). After this had been continued for three hoursand a half, the os uteri became fully dilated, and a dead childwas shortly afterwards expelled. The convulsions ceasedas if by magic, and in twelve days she was able to resumeher household occupations. She afterwards enjoyed goodhealth till the eighth month of her second pregnancy, whenconvulsions reappeared with greater intensity than before.Chloral and chloroform proving inefficacious, the continualhot vaginal douche was again employed. In consequenceof the irregularity of the contractions of the uterus forcepswere required. The convulsions ceased five hours after

delivery, and in seventeen days she was again in hernormal condition. She subsequently became pregnant forthe third time, and during the second month suffered fromsome premonitory convulsive symptoms, which were in-creased by vaginal examination; these came to an end onthe patient aborting. The author considers the case inte-

resting, as showing how convulsions, due, as he believes, toa highly nervous condition of the uterus, may simulate thoseconnected with renal and urinary mischief.

ENGLISH MORTALITY IN 1885.

THE Registrar-General weekly return of mortality in apopulation of nearly nine millions, living in twenty-eightof the largest English towns, beyond serving as a valuablehealth bulletin of these individual urban aggregations,affords a useful and trustworthy indication of the generalstate of the national public health. Experience has shownthat there is a fairly constant relation between the death-rate in the aggregate of the twenty-eight towns andthat in the whole of England and Wales. The meandeath-rate in these large towns in the second quarter ofthis year did not exceed 20’6 per 1000, and was 1’0below the average rate in the corresponding periods of thenine years 1876-84. In the first half of this year the meanrate in these towns was 21’3, against 22’8, 22-7, and 21’0in the corresponding periods of the three years 1882-84.A marked decline in the English death-rate took placein 1881, when it fell to 18’9 ; and the rate was notably con-stant at 19’6, 19’5, and 19’6 in the following three years,1882-84. The available statistics for the first half of this

year afford good ground for the hope that the death-rate for1885 will show a continuance of this remarkable decline.Should this expectation be fulfilled, the mean English death-rate in the first half of the current decennium 1881-90 willshow a decline of nearly 3 per 1000 from the mean nationaldeath-rate in the thirty years 1841-70, which was 22’3. So

important a decline steadily maintained for such a period asfive years appears to contravene all doubt as to the relationbetween this increased longevity of the English people andthe era of active sanitation initiated by the Public HealthActs of 1872 and 1875. The field for still further sanitaryprogress need not be here referred to more particularly than

to point out that during last quarter the annual death-ratein the twenty-eight large English towns ranged from 15’7and 1iJ’8 in Derby and Brighton, to :35’2 in Blackburn, 25’5 inCardiff, 27’0 in 1’resten, I’H’5 in Manchester, and 31’8 inNewcastle-upon-Tyne. --

COCAINE IN HAY FEVER.

THE therapeutical uses of cocaine are so numerous thatthe value of this wonderful remedy seems only beginningto be appreciated. Almost daily we hear of some disease orcombination of symptoms in which it has been tried for thefirst time and has answered beyond expectation. It appearsstrange that so intractable a complaint as hay fever shouldbe amenable to its influence, and yet such is the case. Theaccount given by Mr. Watson, of the Westminster Hospital,of his sufferings and subsequent cure by tabloids of cocaine,is too circumstantial to admit of doubt, even had we notreceived confirmatory evidence from many sources. It hasbeen objected on theoretical grounds that cocaine must ofnecessity be inoperative, or at all events of comparativelylittle use, in those cases in which symptoms of an asthmatictype prevail. Curiously enough, however, it has beenshown that cocaine, when applied to the mucous membraneof the nostrils, has the power of allaying even this spasm.The observation, too, is not new; for many months ago Dr.Bosworth, Professor of Laryngology at Bellevue HospitalMedical College, published a detailed account of a case ofspasmodic asthma completely cured by cocaine. He pointedout at the time that many inveterate cases of asthma are

dependent on, or at all events associated with, nasal dis-orders, the relief of which is promptly followed by an abate-ment of all the distressing symptoms. If this principle ofassociated treatment should be carried on in its integrityit will be difficult to assign the limits of its sphere of action.

CHOLERA AND THE WATER-SUPPLY OFVILLAGES.

WE regret to hear that in many parts of the country,especially in some of the eastern counties, the supply ofspring and well water has fallen very short, indeed in someplaces entirely failed, and that the poorer inhabitants areforced to resort for water to stagnant ponds and ditches. In

these, owing to the drought, the water is scanty and in ahighly concentrated state, being charged with organicmatter in a state of decay. Such a state of things must beregarded as highly dangerous, since the chance introductionof a case of cholera into one of these villages would find allthe conditions requisite for the development of the disease,and form a centre from which the surrounding districtswould be rapidly infected. Nor is the chance of the possibleintroduction of a case of cholera into these villages at allconjectural; since many, which are suffering most fromfailure of the wells, are situated in South Essex, close to thebanks of the Thames and in intimate connexion with the

large docks. In many of these villages the families of menengaged on board the London steamships and vessels reside,and the men on landing-those, at least, who are engaged onboard regular trading-ships, and have not to look out forfresh employment-usually spend a day or so with theirfamilies between the voyages, whilst the vessel is in dock.

Independently, however, of the danger of cholera, the failureof the wells in this district is much to be regretted, as likelyto lead to an increase of malaria, a disease which of lateyears, since the water-supply has been improved by thesinking of wells, has very much diminished among thepopulation. Parkes pointed this out very forcibly in thecontrast he drew between the frequency of ague at TilburyFort, where the garrison used tank-water, and the immunity

from the disease among the rail way servants at Tilbury station

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who drew their drinking-water from a well on the company’spremises. Dysenteric diarrhoea, as a consequence of thedeficicent and impure water-supply, is very likely to beprevalent in these districts, especially among young children.The failure of the wells in the South Essex district isattributed to two causes : first, to the dryness of the lasttwo summers; and, secondly, to the subsoil drainage causedby the deep cuttings in clay by the works for the docks atTilbury, and also acting in a similar way by the increase ofthe brickfields along the banks of the Thames. The

remedy, of course, is to make the existing wells deeper;but this will take time and also be costly, though it must beundertaken sooner or later. For the present every effortshould be employed to improve the drinking-water, such asit is, and to prevent its further contamination. The

villagers should be taught the importance of always boilingpond and ditch water before using it, and the gift of a fewcheap filters, to filter the water after boiling, would prove agreat boon, and do much to prevent the extension of

dysenteric diarrhoea amongst the children. It should,moreover, be the duty of the leading members of the village,the clergyman, the doctor, the squire, and the principalfarmers, to form a sanitary committee among themselves, tovisit the cottages, to see that the cesspools have no con-nexion with the ditches or ponds from which the drinkingsupply is taken, and to direct that any case of choleraicdiarrhoea arising should be at once reported to them, so that itsnature might be inquired into and the case promptly dealtwith. !

THE INTERNATIONAL MEDICAL CONGRESS.

THE Committee of the American Medical Association,appointed to nominate the list of officers and make the

arrangements for the Congress which is to meet in Wash-

ington in 1887, has made a preliminary report. It confirmsthe nomination of Dr. Austin Flint for the post of President.This, we imagine, was never for a moment doubtful, and asthe success of the Congress depends in no small measureupon its President, we are glad to know that this element ofsuccess will not be wanting at the Washington meeting.Among the Vice-Presidents we find the name of Dr. E. OliverWendell Holmes. We trust some arrangement will be madefor him to give an address at the meeting. The Secretary-General is Dr. John Packard of Philadelphia, and ProfessorF. S. Dennis is nominated Chairman of the Finance Com-

mittee ; these also are excellent nominations. The scientificwork of the Congress will be conducted in sixteen sections,one of which will devote attention to the work of Collective

Investigation. -

THE PATHOLOGY OF CHOLERA.

DR. CHARLES S. RoY, Professor of Pathology in the Uni-versity of Cambridge, accompanied by Mr. S. C. Sherrington, ofCaius College, Cambridge ("George Henry Lewes student),and Dr. Graham Brown of Edinburgh, are in Spain, havinggone thither with the special object of investigating thesubject of the pathology of cholera. Grants of money havebeen made by the University of Cambridge, the RoyalSociety, and the Association for the Advancement of Medi-cine by Research. The inquiry has been warmly supportedby the latter Association, and Dr. Roy’s reports will be sentto them.

At the present juncture, when Dr. Koch’s views respectingthe comma bacillus and cholera have been subject to suchstrong criticism, and particularly since the late GovernmentCommission, sent out from this country to India, arrived atso positive a conclusion against the alleged etiological con-nexion between the micro-organism and the disease, theneed of further investigation by a thoroughly independent ’,body of observers is manifest. Professor Roy, during his

tenure of office at the Brown Institution, devoted muchtime to the study of anthrax, epizootic pleuro-pneumonia,and other diseases in which micro-organisms play a part. His

colleagues are also well trained in scientific investigations;and, what is of chief importance, not one of the members ofthis Commission has, so far as we know, committed himselfto any definite opinion upon the subject-matter of theirinquiry. The task before them is no light one ; but we maybe sure that they will perform it with thoroughness andscientific caution. They will necessarily be confronted withthe doctrines and practices of Dr. Ferran; but we imaginethat until they have satisfied themselves of the primaryquestion, they will not pay much heed to them. We hopeto be able to report the progress of this inquiry, and lookfor some substantial gain therefrom towards the elucidationof the most perplexing pathological problem of our time.

NEURALGIC HEADACHE OF WOMEN.

THE increased, and apparently increasing, frequency ofneuralgic headache among women must needs have a cause.There is one of singular simplicity and quite obvious whichhas been overlooked, and to which it is worth while to drawattention. The pain experienced is generally located in oneor more of the branches of the second cervical nerve, verycommonly those terminating in the scalp at the occiput. Asa matter of fact, the nerves of the scalp are irritated by thehair being drawn tightly back and put on the strain, not asa whole, in which case the strain would be spread over alarge area of the surface, but by small bundles of hair whichare pulled back and held in place by hair-pins. Relief is often

consciously experienced as a result of removing the hair-pins, but this has only a temporary and partial effect. The

injury done is lasting, if not permanent, in its consequences.The present style of dressing the hair should be dis-

continued, as it probably, in part at least, accounts for theextreme prevalence of a form of suffering which is bothintractable and distressing. -

SIGNS OF LIVE-BIRTH.

ON July 8th, a woman, aged twenty-three, was triedbefore Mr. Justice Mathew, at the Newcastle Assizes, for themurder of her illegitimate male child at Haltwhistle on

May 8th. The prisoner, a domestic servant, pleaded notguilty to the indictment, but admitted having concealed thebirth. The case may be said to have turned entirely on themedical evidence, and concerning this the judge deliveredhimself in no measured terms. The body of the infant wasfound in a ditch, covered with an apron and some leaves.There were no marks of violence upon it. The throat, thewindpipe throughout its whole length, and the stomachcontained mud. The lungs were of a bright-red colour, andfloated when placed in water. It did not appear that thedeath had taken place from loss of blood-at least this wasthe opinion given by one of the medical witnesses. We donot find that the condition of the lungs was stated in detail,but if the above description as to the colour and degree ofinflation can be accepted with confidence, the presumptionis certainly in favour of live-birth. As regards inflation, ofcourse this might have been effected either by the naturalefforts to breathe or by artificial means; or, again, the lungsmight float from the presence of gases set free by decom-position. It does not appear, however, that the latter pleawas advanced by counsel for the defence. There was some

discrepancy between the evidence of the doctors as towhether or not, or to what extent, the hands were clenched.This point may be dismissed as of little value one way orthe other. For the prisoner, it was contended that an

interval of four hours elapsed between the birth and itsconcealment in the ditch, and, further, that no cry was