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theory, (2) the theory of changes in the glomerules, and(3) the theory of a special constitutional tendency. To this

last view he gives his adhesion, believing that the uric aciddiathesis is the predisposing cause of this condition. With

regard to the views advanced by Dr. Merley and otherwriters respecting the nature and character of these casesof intermitting albuminuria, we are convinced that no onecause can be assigned that will explain the different pheno-mena observed in individual cases, and that, in fact, thistransitory albuminuria can be brought about by a varietyof conditions. In some cases the mere act of rising,even without the influence of the morning meal, willinduce it; in others it is distinctly the ingestion of

food, after the longer abstinence of the night, at break-fast ; in others, the exposure of the body to cold whilstdressing, or the action of the bath. It is this class ofcases more especially, in which the cyclical phenomenaso well described by Dr. Pavy are chiefly observed. In other

forms, again, the albuminuria is paroxysmal rather thancyclical in character, such as those described by Dr. Ralfe,and which are generally accompanied by some dyspeptictrouble and more or less sallowness. In others the albu-minuria is probably of a reflex character, being associated,in young persons especially, with sexual derangements.Vith regard to the peculiar constitutional tendency whichmay bring about this tendency of albumen to pass so readilyinto the urine on slight occasions, we are not inclined tothrow the whole blame on uric acid or gouty diathesis. Wethink it may be fully shared with such dyscrasias as syphilis,malaria, and rheumatism, inherited or otherwise.

HARD TIMES IN THE PROFESSION ABROAD.

COMPLAINTS of the unfair competition of hospitals and.charitable dispensaries with private practitioners are common

1

enough amongst ourselves both in London and in other I

large towns; but the evil, great as it is, and serious as we ]

find it, is nothing compared to the state of things existingin many continental cities. For example, the Prague

I

- conespondent of the Internationale Klinische Rundschaumakes a sad lamentation over the decline of medical

practices in Prague, declaring that a very large number ofBohemian practitioners are now making less than .6100 ayear, with a prospect of a still further diminution of theirincomes in the near future. This is due mainly to two,causes-the abuse of hospitals, and the ever-growingcompetition in the profession from the overcrowding that isgoing on in its ranks. In order to prove the existence ofthe abuse of charitable institutions the writer alluded tohas collected a number of statistics giving the averageannual number of patients relieved in both the Bohemianand German hospitals in Prague-a city which, it should bestated, has only a population of about a quarter of a millioninhabitants. The in-patients averaged about 7000 andthe out-patients about 50,000, most of whom received,in addition to advice, medicine and surgical appliancesgtatis. This would seem to bear out the complaint ofthe practitioners, that as such an enormous number of

patients are treated by public charities scarcely any are leftfor them to attend, and that the profession itself is thusthreatened with starvation, which of course means extinction.Notwithstanding this, professors of Austrian universitiescontinue to pride themselves on the number of their medicalindents. This, it is suggested, they should cease to do, andapply themselves entirely to improving the quality of theusing generation of medical men. Indeed, it is expectedthat the Government will direct its attention to the matter,and will devise means for lessening the terrible competitionwhich is caused by the rush into an already much over-stocked profession.

THE SALE OF POISONS.

THE amount of attention which has recently been devotedto poisons would almost appear to indicate a growing con-viction that poisoning, accidental or otherwise, is on theincrease. No work upon materia medica or therapeuticsseems to satisfy the requirements of the author or thereaders unless it has almost in tabular form a list of poisonsand their antidotes. Special manuals of a few pages onlyare frequently issued upon the same subject, and specialbags have been prepared, fitted up with all essentials for

treating cases of poisoning with the least possible delay.Meanwhile other measures are attracting attention in

America, and in some ways they seem to be in advance ofour own precautions. A new Act has been passed inMassachusetts, widening the previous narrow circle of

officially recognised poisons, which included only four sub-stances-viz., arsenic, strychnine, corrosive sublimate, andprussic acid. Some thirty other preparations are now

hemmed in with cautious restrictions, which entail the

registration of the name and address of the buyer, andthe use of a red label, bearing the name and addressof the seller, together with the word "poison," and in-structions indicating the recognised antidote. The BostonMedical and Surgical Journal, in commenting upon theAct, regrets that nothing is said with regard to thename of the poison being upon the label; but surely this isunnecessary. It should suffice for all but selective purposesto indicate the fact of poison and its mode of treatment ifinadvertently taken. The name of the poison might initself form a temptation to a rash suicidal impulse, whichmight otherwise be resisted if any doubt as to its nature andmode of operation were concealed beneath the red label.From another journal we learn that in New York it is nowunlawful for the manufacturers of proprietary medicines tosell them unless the formula of their ingredients has beenrevealed to the State Board of Health. Legislative inter-ference would seem to be almost inoperative in England;only last week in the course of an inquest it was stated thatthe deceased, a midwife, had for years been in the habit ofinhaling large quantities of chloroform; and it is a well-known fact that most houses in the country have opium,chloroform, or ether for use on supposed emergenciee.

THE DORSET COUNTY HOSPITAL.

No greater misfortune can befall a public charity than thata breach should arise between the lay body responsible forthe management of its affairs and the honorary medicalstaff upon whom rests its reputation as a hospital. Happilysuch differences are of rare occurrence, which speaks wellfor the practice of mutual forbearance on occasions whenquestions arise that are capable of being regarded from thenecessarily differing standpoints of the two bodies con-cerned. An excellent institution, the Dorset County Hos-pital, has just passed through such a crisis, which haskept the county in a state of ferment for some time

past. Without entering into full details, we may say it

appears that the dispute arose from the refusal of twomembers of the medical staff to recognise the claimof the matron to attend operations and ward visits inorder that she might be informed of the instructions ofthe medical men and see that the nurses carried out thoseinstructions. This, at any rate, is all that is ostensible;but we fail to understand how the matter was suffered to

go the length it did, or why the compromise finallyarrived at should have required a prolonged and activedebate in a full court of governors. The resolution adopted,which took the form of an amendment to the motion ofdismissal, was to the effect that the matron (who should bea trained nurse) should have free access to the operating