608 THE ACETYLENE LIGHT IN OMNIBUSES.-SMALL-POX IN LONDON.

and it would have been wise for this to have been testedin like manner, as well as the garments which had been near

the vaccinated spot. There is, further, the improbability that.

the plaster which was placed over the whole was so com-pletely secured as to be impervious to dust, and the stockingworn over the leg is also a conceivable source of the bacilli.In these mysterious cases no stone should be left unturnedin the attempt to discover the origin of the disease.

Nothing can be dismissed as impossible, and no amountof improbability should be allowed to hinder a thoroughinvestigation. Our knowledge of the nature of thevirus points out clearly the lines of the inquiry, but

we still know little of the channels by which access is

gained to receptive surfaces. Moreover, the fact that theexact nature of the cases of tetanus supposed to be

idiopathic is still obscure is an additional reason for takingthe fullest advantage of every opportunity of learning moreof the part which may be played by dust in the productionof the disease. The free growth of the organisms in earthis well known, and so also is the great frequency with whichthe organisms are certainly inoculated where earth obtainsaccess to a wounded surface. But little is known regardingthe actual frequency with which the tetanus bacilli exist inthe common dust of houses, dust which is inevitablyabundant in all the houses of large towns. However strict

may be the effort to maintain a high degree of cleanliness,there is probably no house in which sufficient dust does notaccumulate in some places to constitute a source of these

bacilli ; and a thorough examination, however troublesome,should be neglected in no case in which the occurrence ofthe disease points to the possibility that the search mayyield definite results.

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THE ACETYLENE LIGHT IN OMNIBUSES.

IT is not many weeks since the acetylene lamp was madeto replace the dirty time-honoured oil lamp in most of theLondon omnibuses, and very general appreciation was

expressed of the great improvement in the interior lightingof the vehicle which is thereby gained. The acetylenelamp undoubtedly gives a powerful white light and theconsumption of gas for this brilliant effect is compara-

tively small. Unfortunately, the acetylene’ generated fromcarbide of calcium possesses a very disagreeable odour,suggesting at the same time garlic and the fumes fromthe moistened tip of a phosphorus match. The least

escape of gas is thus instantly detected by the nose,

and omnibus passengers have raised strong complaintsabout it, while the drivers themselves confess that

it has sickened many of their number. It is doubtful

whether pure acetylene is poisonous, and it is cer-

tainly only faintly odorous, but the gas from carbide

of calcium is very impure and contains usually a veryperceptible proportion of phosphoretted hydrogen and

sulphuretted hydrogen to which is due its smell. The

former gas is, of course, intensely poisonous, and may easilygive rise to symptoms of poisoning, having an exciting actionupon the respiratory tissues and an irritating action uponthe skin. Sulphuretted hydrogen is also poisonous,but not to the same degree. Acetylene prepared from

commercial carbide of calcium may therefore easilyprove injurious to health, and there seems to be little doubtthat some bad effects are being experienced by the

drivers of the acetylene-lighted omnibuses. Health, how-ever, must not be sacrificed for the sake of increased lightand something should be done to remove this reproach fromthe acetylene lamp. The complaints which have been madepretty freely point, of course, to escape of gas, perhaps bydraughts, which surely can be remedied, but, failing this,cannot carbide of calcium be purified from sulphur andphosphorus compounds which form highly poisonous gases

during the generation of acetylene’! " Phossy jaw " amongstomnibus drivers and travellers would be a startling sequelto the installation of acetylene lamps in London omnibuses,

SMALL-POX IN LONDON.

THE returns of small-pox for the past week show thefollowing figures. On Saturday, Feb. 22nd, there were 44fresh cases notified and removed ;’ on Sunday, the 23rd,there were 25 fresh cases ; on Monday, the 24th, there were58 fresh cases ; on Tuesday, the 25th, there were 63 fresh

cases ; and on Wednesday, the 26th, there were 44 freshcases. Within the county of Essex 378 cases have been

reported from Jan. lst to Feb. 22nd. Dr. J. C. Thresh,the medical officer of health of the county, reports underthe date of Feb. 24th that there is grave reason to suspectthat the disease is being spread by tramps. The medica)officer of health of the metropolitan borough of Woolwich,Dr. Sidney Davies, has distributed two leaflets to every housein the borough. The one deals with small-pox and the

truth about vaccination, giving plain simple statementswhich should convince anyone inclined to doubt the efficacyof vaccination, while the other leaflet contains simplehygienic precepts, the precautions to be taken againstmeasles and consumption, and 14 simple rules for feedingbaby." The London County Council has issued a circular tomedical practitioners within the county stating that theCouncil has made an arrangement with 37 medical menwho are willing to act as consultants to facilitate the

diagnosis of doubtful cases of small-pox. The fees ofthese gentlemen will be paid by the Council. This is a

most important departure, and we believe that our readerswill see in the action of the London County Council a realintent to be helpful to them in an arduous time. The diffi-

culty of diagnosing small-pox is great, seeing that the majorityof the medical profession in London, fortunately for the Londonpublic, have not any familiarity with the disease. It was

not an easy task for the London County Council to select themedical men who would be able to assist in the diagnosis ofdoubtful cases of small-pox, and the list of names has notgone uncriticised. London medical men may, however, becertain that no pains were spared to choose practitioners, toact in an advisory capacity, who had had actual experienceof the disease.

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FELLOWS’ DINNER OF THE ROYAL MEDICALAND CHIRURGICAL SOCIETY.

A MOST successful dinner of the Fellows of the RoyalMedical and Chirurgical Society was held in the WhitehallRooms on the evening of Feb. 26th, and was attended bysome 120 Fellows and their guests. The Vice-President, Dr.C. Theodore Williams, in the absence of the President, Dr.F. W. Pavy, took the chair. The guests of the society wereProfessor A. W. Rucker, F. R. S. (President of the University ofLondon), Dr. A. Conan Doyle, Sir Walter Sendall, G.C.M.G.,Surgeon-General W. Taylor, C.B. (Director-General of theArmy Medical Service), Mr. Henry G. Howse (President of the-Royal College of Surgeons of England), Sir William Turner,K.C.B., F. R. S. (President of the General Medical Council),Mr. Howard Marsh (President of the Clinical Society ofLondon), Mr. W. Watson Cheyne, C.B., F.R.S. (Presidentof the Pathological Society of London and of theHarveian Society of London), Dr. Peter Horrocks (Pre-sident of the Obstetrical Society of London), Dr. UrbanPritchard (President of the -Otological Society of theUnited Kingdom), and Mr. J. Y. W. MacAlister (theresident librarian of the society). Dr. Theodore Williams

proposed the toast of "Our Patron" His Majesty the

King, the third sovereign who had been graciouslypleased to be patron of the society. After the toast of

609INTRA-CEREBRAL INJECTION OF ANTITETANIN IN THE HORSE.

"Her Majesty the Queen, the Prince and Princess of Wales,and the other members of the Royal Family," the Chair-man proposed "The Royal Medical and Chirurgical Society."

"

He said that the society had its foundation in 1805 whenowing to dissensions in the old Medical Society the

new society was formed. Since that date it had steadilyadvanced in prosperity, meeting at first in the Freemasons’

Tavern, afterwards in Berners-street, and in 1890 moving toits present quarters in Hanover-square. The financial con-dition of the society was most satisfactory. Mr. Alfred

Willett (the President Elect) proposed the health of the

guests. The toast was responded to by Sir Walter Sendalland by Dr. Conan Doyle—the latter of whom said that he feltlike a deserter dining with his own regiment and as a fullprivate dining at the officers’ mess. The study of medicinewas one of the best trainings that a man could go through,and though he was far from wishing to people England withamateur doctors, he thought that the study of physiology,medicine, and surgery for a few years gave a man the truestbasis for life and thought. He held in the highest esteemthe parish practitioner, who without hope of fame, withouthope of riches, was yet content with duty done. Dr.

George Ogilvie, in a humorous speech, showed how theinvasion of England by the Scot dated from the

Saurian period and had continued to the present day.England had benefited much by the invasion of the Scot, forhe had brought with him several excellent things, amongwhich was the game ’of golf which had introduced anexcellent vocabulary into the English language. The Scothas also brought with him a song "Auld Lang Syne,"which had done more to bring about the federation of theEmpire than had Mr. Chamberlain. Sir William TumeI

regretted the absence of the President and expressechis deep sympathy with him in his family affliction. Ht

proposed the health of the chairman of the evening. Dr,

Theodore Williams replied, and the guests separated after amost enjoyable evening.

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INTRA-CEREBRAL INJECTION OF ANTITETANIN

IN THE HORSE.

Ix the February number of the Journal of ComparativePathology and Therapeutics there is a very interestingarticle by Mr. Sydney Villar, F.R.C.V.S., illustrating thevalue of the intra-cerebral injection of antitetanin in the treat-ment of tetanus in veterinary practice. The patient in thefirst case was a small pony showing visible signs of tetanuswhen admitted to Mr. Villar’s infirmary on June 9th. It

had walked a distance of three miles and was somewhat

distressed on arrival. I he initial treatment consisted in

keeping the patient quiet in a loose box and administeringa little belladonna in the drinking water. As trismusbecame very much more marked, on June 18th intra-cerebral injections of antitetanin were resorted to. LTnder

antiseptic precautions and cocaine anaesthesia a small

circular hole was made through the right parietal bone withan Archimedean drill, and by means of an ordinaryhypodermic syringe three cubic centimetres of antitetanin

were injected right into the substance of the cerebral

hemisphere. The wound was dressed with iodoform andcotton-wool. 24 hours later there was a marked abatementof the tetanic symptoms which gradually disappeared withinthe next 10 days, the pony making an excellent recovery.On August 7th there was only a small scar to indicatethe seat of operation. The animal was a trick ponybelonging to a travelling circus, and it had not forgotten itsperformance, showing that its mental capacity was not

affected in any way, and at no time was there any signof ill effect from the injection into the brain substance.

The second case was that of a hunter which had received a

punctured wound in the heel on Nov. 2nd. Tetanus

supervened on the 23rd, and by the 26th (trismus.was very marked, the spasms being very severe. On this.date eight cubic centimetres of antitetanin were injecteddirectly into the cranium to a depth of two inches. Imme-

diately after the withdrawal of the needle the horse becamevery violent and appeared as though it were in an] epilepticfit. These symptoms passed off in about five minutes, but.it was impossible to dress the wound on the forehead.

thoroughly. The next day the symptoms had considerably-lessened and on Dec. 8th the horse was able to go to walking -exercise. As a general rule, if recovery takes place, the-horse is at least a month or six weeks before being able toleave the infirmary. In both the above cases the durationwas scarcely three weeks. These are the first cases which,have been recored in veterinary practice in England.Although a definite opinion can scarcely be formed from two.cases, the results are sufficiently encouraging to show thatthis treatment is worthy of an extended trial.

THE LIVERPOOL SCHOOL OF TROPICALMEDICINE: DEPARTURE OF MAJORRONALD ROSS FOR WEST AFRICA.

MAJOR RONALD Ross, F. R. S., late I. M.S., sailed from’

Liverpool on Feb. 22nd to join the expedition which is now- engaged in sanitary work on the West Coast of Africa under,he auspices of the Liverpool School of Tropical Medicine.Major Ross has gone out to make an examination of the-

drainage operations now being carried out in Sierra Leone,and he intends also to prepare statistics as to how the workis progressing. He also purposes to inquire carefully whether-any change for the better has taken place in the health of the;natives. Among other places he will proceed to the Gambia.to examine the drainage there. Sir George Denton, the

Governor of the Gambia, and his staff have been engaged-for some time in carrying out drainage operations in thatcolony. Dr. Logan Taylor has been in Sierra Leone for the

past eight months and fortunately he has not suffered frommalaria-a fact which points to the success of the drainage-operations carried out under his directions. Major Rossintends to return to Liverpool at the end of April. Prior tohis departure for West Africa he expressed the opinion that ifthe Government continued the work of drainage and pushedforward other improvements the health of the natives would’be considerably improved and the health of the resident

Europeans in West Africa would also be safeguarded. Major-Ross was seen off by Mr. William Adamson (vice-chairman,of the school), by Professor R. W. Boyce of UniversityCollege, Liverpool, by several students of the school, and bya-number of gentlemen who have taken an interest in the work.of the expedition. -

INTRACRANIAL PRESSURE AND CEPHALALGIA INBRIGHT’S DISEASE, WITH REFERENCE

TO TREATMENT.

DR. G. SCHERB in the Revue Neurologique of Jan. lst last:refers to the intense and agonising headache and cerebral toxæmia of Bright’s disease and deals with the method ofitreatment by lumbar puncture which he believes to give-almost complete relief. He refers to the recent observations.of Dr. Marie and Dr. Guillain of Paris who in the case of at

patient suffering from intense cephalalgia of the kind alludedto above obtained great relief after lumbar puncture, and he-cites a second case, confirmatory of the same, published byLegendre. Dr. Marie has since then collected five other-cases similarly and successfully treated for intense cephalalgia.in Bright’s disease and Dr. Scherb adds another rare and.

interesting case illustrating the method and results of treat-ment. The patient was a man, aged 49 years, who suffered’from Bright’s disease with intense headache and pain in theoccipital region of the head which utterly prostrated him