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or ailment shall state his Christian and surname in full inthe adverbisement, and shall also place them upon anyhouse or premises to which such advertisement refers, and,if not a medical practitioner, shall also add not registeredunder the Medical 9 ct,1890,’ in such manner as is prescribedby regulations. Any person who shall violate or neglect tocomply with the requirements of this section shall be liablefor every such offence, for every day he is guilty thereof, toa fine not exceeding jE5; and any person, not being theperson whose name appears in any such advertisement, whoshall treat disease, injury, or ailment at any house specifiedin such advertisement, purporting to be the person whosename appears on such house or in such advertisement, shallbe liable to a penalty not exceeding ;e25 for every suchoffence, and the proof of being such person shall lie on the Idefendant."

____ ITHE ROYAL BRITISH NURSES’ ASSOCIATION.

WE publish on another page a letter from H.R.H.Princess Christian respecting this Association and its

work which will attract great attention and awaken nosmall interest throughout the circle of our readers. Themanner in which the endeavours of the founders of this

society to create an orgamsabion which shall consolidate andrepresent the profession of nursing in Great Britain havebeen beset and hampered by an interested opposition on theone hand and official perversity on the other is a very recentstory, upon which we have been compelled from time to timeto speak in terms other and stronger than we shouldhave desired to use. But the. difficulties so created havenot daunted the promoters of the movement, who are

entitled to the credit of having persevered with exemplarydetermination in the task to which they have set them-selves. On the other hand, it cannot be doubted that thevery sharp fire of criticism to which the scheme has beensubjected has enabled its framers to perfect its details, asthey probably could not have done without this assistance,although the tone and manner of the criticism haveabsolved them from any oppressive sense of gratitude totheir critics. The result of this not too genial cooperationis before our readers in the abstract of the Draft Charter,which we publish on another page. From that abstractit will be seen that H.R.H. the President is supported by adistinguished body of corporators, whose eminence cannotfail to satisfy the Privy Council that the scheme commandsthe cordial support of at least a fully representative bodyof medical men and nursing authorities. If it should be

necessary to renew at Whitehall the discussion which hasbeen carried on in the press and elsewhere ever since theinitiation of the movement, we do not doubt that the pro-moters, who have had much the best of the argumentthroughout, will be able to satisfy the committee, whichis at least too familiar with legal procedure to adjudicateupon a claim without hearing in its support those whoadvance it.

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THE MEDICAL MISSIONARY.

THE Edinburgh Medical Missionary Society has justcelebrated its jubilee, and in the speeches delivered on theoccasion the amplest evidence was adduced of the successwith which it has been worked, and of the yet greaterfuture in store for it. History repeats itself, and themedical scholar will note the fact that, while the healingart had its first beginnings under the fostering care of thepriesthood, it has returned, in one important field of itsexercise, to its early alliance with religion. Returned, wesay, but with a difference, for while in ancient India andChina medicine was made the instrument of a degradingsuperstition, it has nowadays become in those very

regions the handmaid of a civilising faith ; the two profes-

sions, that of practitioner and preacher, cooperating dulyeach in its proper sphere, for the rehabilitation of a morallyand intellectually impoverished humanity. In the nrht

quarter of the present century religion and medicine hadno grander representatives than Dr. Chatmers, on the onehand, and Drs. Abercromby and Alison on the other-themen at whose instance the Edinburgh Medical MissionarySociety sprang into life. Every decade that has since

elapsed has witnessed an advance both in the theological andthe medical qualifications of its votaries, till it attracts toits service young men combining in both capacities a pro.fessional efficiency unsurpassed by their home-placed con.temporaries in either. Dr. Martyn Clark was able to drawon his great Indian experience in proof of this posi.tion, insisting as he did on the necessity of exactingfrom the medical missionary a standard of excellence in histwofold activity not inferior to that of his single-handedbrethren of the Motherland. Already, as the literature ofthe profession can testify, the resources of the healing arthave been enriched by medical missionary labour andexperience; while an interesting paper might be written onthe peculiar advantages possessed ia the field of territorial

exploration by pioneers who have combined with thereligious impulse the accomplishments and the spiritof the surgeon and physician. Names like those of

Mungo Park and Livingstone rise at once to the memory;and among German and Italian explorers of more recent dateuhe twofold coincidence receives yet fuller illustration. Atthe meeting in Edinburgh on Monday last Mrs. Bishop,herself a traveller of distinction, pointed out the vast fieldyet to be covered by such societies, whose emissaries areeverywhere " the object of love and trust, everywhere offer.ing in themselves the best interpretation of the Christianlaw of love." Great Britain is the most successful of

colonizing Powers. The rapid development of her medicalmissionary societies is the most effective proof that, in thehighest of all respects that success is merited, and will bemore than maintained.

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FAT EMBOLISM.DR. W. F. WHITNEY contributes a paper on this subject

to the Boston Medical and Surgical Journal, Feb. 18th,1892. He relates the case of a man, aged sixty-two, whosustained a fracture of the right femur by the falling of alifb. Nothing unusual was noticed until the middle of thethird day, when vomiting commenced, and fluid collectedin the abdominal cavity. The patient died on the fourthday. At the necropsy the vessels of the lungs werefound to be extensively plugged with fat ; the head was notopened, and all the other organs were healthy. Dr. Whitneyreviews some of the work which has already been done onthe subject. Majendie, in 1827, was the first to proveexperimentally that oil injected into the veins of an

animal would produce death. But it was not until1862 that Zenker called attention to the presence of fatin the vessels of the lungs in some cases of death afterfracture of the leg, and it then came to be regarded assufficient to account for the fatal issue. "But gradually,as the infective processes with which it was oftenassociated were better understood, the conviction greivthat fat embolism of the lungs alone was not sufficient toproduce death, and that its action on centres more remotemust be considered. By far the most thorough and ex-haustive study was made by Scriba in 1879, and since thenbut little has been added to our knowledge. The problemswhich he proposed were : 1. How much fat is required tokill? 2 In what way does it act? 3. How is it eliminated?In answer to the first question he found that in order tokill an animal by fat embolism a quantity is necessary vary-ing with the force with which it is injected and with thedistance of the point of injection from the heart. Bat in

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no case was it less than three times the amount of fat con-tained in the entire femur of the animal. His conclusionas to the mode of action is that death after aseptic fat embolioccurs only from large numbers of them in the brain andspinal cord, and in consequence of the arterial anaemia, andthe resulting disturbance of nutrition." He further showedthat the oil has no action on the heart, and that in regardto the lungs, five-sixths of the arteries must be tied beforean animal is killed, and that therefore there is never such adegree of embolism of the lung capillaries that death mustresult. On the other hand, it is the fat which has

passed the lungs and reached the central nervous systemthat is the cause of death. In answer to the third

question, his experiments and clinical evidence pointto the kidneys as the organs by which the greaterpart is eliminated. A smaller part is undoubtedlyburned up in the system. Of the symptoms noted, oneof the most striking was the constant fall in temperature.Another symptom was dyspncea, due to the loss of oxida-tion of the blood ; this was often only transitory. Slighthaemoptysis, due to infaretion, has also been noticed. Themost important clinical symptom of fat embolism is the

presence of oil in the urine. Scriba sought this in a numberof patients suffering from fractures, and was able in nearlyall the cases to demonstrate it to a greater or less degree. Thefat could not be recognised as such by the eye alone, butwith the microscope there were seen numerous very small,round drops, which were highly refracting, and had a finedark border. The elimination was not continuous, but in-terrupted. A marked pallor of the skin and mucous mem-branes was noticed in all the animals experimented on.

DEATH OF DR. C. MEYMOTT TIDY.

WE regret to have to announce the death of Dr. CharlesMeymotb Tidy. Dr. Tidy last year suffered from an attackof influenza which left him much impaired in strength,flesh, and colour. He seems never fully to have recovered,and for the last few months he has been much hindered in the

discharge of his multifarious duties. He was Professor of

Chemistry, Medical Jurisprudence, and Public Health at theLondon Hospital, the official analyst to the Home Office, andmedical officer of health for Islington. He wrote many workson legal medicine, and was the author, conjointly withDr. Woodman, of a " Handy Book of Foren8i,- Medicine andToxicology." He had for some time assisted in drawing upthe monthly and annual reports on the quality of the watersupplied to London. He graduated with the highesthonours in Aberdeen University, was a Member of theRoyal College of Surgeons, and a Licentiate of the Societyof Apothecaries. He was also a barrister at law. His

position was due to no accident of birth or education,but was the result of inherent ability and indefatigablework.

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THE NOTIFICATION OF MEASLES.

AT a recent meeting of the Pablic Health Committee ofCork a forcible letter from Mr. Donovan, the superintendentmedical officer of health, was read, arguing the unreasonable-ness of leaving out measles from the list of notifiablediseases under the Notification Act. Mr. Donovan pointedout how much more fatal it is than the diseases whose noti- Ification is specified in the Act. Thus in the three years 1886,1887, and 1888 the deaths from erysipelas, simple fever,and measles were respectively 1, 2, ani 159. From the

comparative abeyance of measles in recent years, except1887-8, he estimates a large number of children to be liableto the disease, which is already showing itself in differentparts of the city. He is strongly of opinion that the earlyno’HbatBon of ca,qes wf1uld tend greatly to prevent an

epidemic. The absence of measles from the notification

list is the more marked as it used to be notified before theAct. These obvious and weighty considerations prevailedwith the committee, which, on the mouion of Mr. Atkins,took steps to have measles included in the Notification Act.We may expect this course to be followed by all sanitaryauthorities who are not penny wise and pound foolish.Some authorities are concerned at the fact of having topay for the notification of measles. At Kidderminster,where the authorities had received nodification of ninety-five cases of measles since Feb. 1st, one gentleman com-plained of the cost as a perfect waste of money. In movingthe adoption of the Health Committee’s report Mr. Parrycomplained that they did not receive from some medicalmen all the help they might expect, and seemed especiallydispleased with one gentleman who very properly apprisedthe Committee of a recent decision-Chisholm .RdcIiS’eLocal Board-that medical men nodding cases were en-titled to the full fee without deduction for postage. It willbe unworthy if the authorities show any illiberaJity towardsmedical men doing their duty. On the contrary, theyshould reward early notification by generous admission ofits utility, if not by extra pay. They should allow, too, forthe dimsulties of notification, arising from difficulties of

diagnosis, which are felt by all but the ignoraot.

THE REPORT ON PERFECT COMBUSTION ANDSMOKE PREVENTION.

WE have received a very lengthy communication fromMr. J. Knapton Thompson, C.E., of Leeds, claiming thata portion of the construction of Leggott and Marsh’s parentfire-range violates an invention and patent of Mr. J.

Knapton Thompson in, as he alleges, two most importantparticulars. It is obvious that we cannot decide betweenthe rights of the respective parties, nor have we room inour columns for such a diecassion. We simply describedthe fire-range as we found it.

A NEW BOMBAY VACCINATION BILL.

THE Ti7nes of India contains a very interesting report ofa meeting of the Council of the Governor of Bombay forthe purpose of hearing the second reading of a Bill toprohibit the practice of inoculation, and to make the vacci-nation of children in certain parts of the Presidency com-pulsory. The meeting was addressed at great length by theHon. Mr. Javerilal W. Yajnik, the Hon. Mr. Rao Bahadoor,Mr. G. Rarade, the Hon. Mr. N. N. Wadia, the Hon. Mr.J. R. Naylor, and others. The second reading was moved bythe Right Hon. Sir Charles Pritchard. Vaccination has been

compulsory in Bombay since 1877. The purpose of the

present Bill is to extend the law to other parts of the

Presidency. The discussion was very creditable to the

intelligence of the Council, not least to its native members.The chief feature of the Bill is that it enjoins compul-sory vaccination with calf lymph whenever the parent orguardian of the child shall so require. Practically all the

speakers recognised the benevolence of this law, and agreedto the principle. The only subject on which any materialdiffeience arose was contained in certain wOlds in Sec-tion 14, giving the Governor in Council power to sanc-tion vaccination with human lymph in cases of emergencyand where delay would be dangerous. His Excel-

lency the Governor heard objections stated at greatlength and certainly with much ability. Bat 6a&t]ythe Bill was read a second time on the ucderstMtdiBg thatthe time for the statement of such objections vva:3 in com-mittee. The objection is based not only on the groundthat disease, such as syphilis or leprosy, might be conveyedthrough vaccination, but that considerations of caate mightb offended by v&c’ir’ation from those of icifeiior caste.Mr. Na.ylor broke with great force in defence of lhe B-ll aa