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open to doubt, and there is always the danger of still furtherhampering respiration and circulation by compressing one orother lung in that posture when the patient is very heavy,especially when emphysema is present. The initial use of

gas and ether in this case may be adversely criticised

by some but it certainly possessed the advantage-animportant one in the present instance-of avoiding the stageof excitement so common when chloroform is used in the

induction of anaesthesia. Probably had the development ofcyanosis been foreseen the brief operation would have beenconducted under nitrous oxide gas mixed with oxygen,which answers well in short cases, although it must beadmitted that it is not an ideal anaesthetic for such personsas the patient is described to have been in the case in

question. -

LARGE FAMILIES AMONG THE POOR.

AT an inquest held on Dec. 2nd by Dr. Wynn Westcottat Bethnal-green on the body of an infant found dead in bedthe mother of the deceased mentioned that she had fifteenchildren. The coroner remarked that he could not under-stand how it was that the poor managed to keep such

large families, whereupon a juror remarked : "One

or two don’t make no difference. Some grow up and

help to keep the others." After all, there may be

more sound sense in this argument than might at first

sight be supposed. Everyone who has any experience of workamong poor people knows how kind the poor are in taking inan extra child for nothing very often, and sometimes for asmall weekly payment. We do not, of course, refer to babyfarmers, but as a matter of fact the charity of the poor toone another is above all praise, and so perhaps the largefamily may not be so undesirable after all. The greatdifficulty in connexion with such is not so much clothing orfeeding but proper house-room, and to find this with theexorbitant rents which are being daily demanded in Londonis almost impossible.

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THE ANNUAL REPORT OF THE ARMY VETERINARY

DEPARTMENT.

THE usual annual report of the Army Veterinary Depart-ment has recently been completed by the Director-General,Veterinary-Colonel Duck, C.B., F.R.C.V.S. It consists of a

general summary of the diseases met with amongst the armyhorses and transport animals at home and abroad. In the

Home Department the number of patients amounted to

65-12 per cent. of the average strength, being greatest inthe Army Service Corps which has the Young Horse Depotattached to it and lowest in the Military Police. It was

noticed, as has been the case before, that the percentage ofadmissions to treatment was higher in horses about four orfive years of age than in those of more mature years. It is

a matter of great congratulation to know that glanders is

still absent. One suspicious case occurred amongst theanimals at Shorncliffe in November, 1897, but a careful

post-mortem examination and the use of the mallein test

amongst the in-contact horses demonstrated beyond dis-

pute that the disease was not glanders. In Egypt,from which country the report is made by the senior

veterinary officer, Veterinary Captain Blenkinsop, the absenceof glanders is also noted, although 69 cases of this diseasewere reported by the Egyptian civil authorities. TheGovernment stables, however, had a narrow escape frombecoming a centre of contagion, as a private pony standingin one of them showed suspicious symptoms and after re-acting to mallein was destroyed, the necropsy confirmingthe existence of the disease. All the animals in the same

stable were promptly tested, but none reacted and thedisease has not again reappeared. Veterinary - CaptainBlenkinsop suggests that as remount horses and mules

are largely obtained from Syria, where glanders exists tosome cor.s’d( rable extent, all animals should be tested beforebeing admitted to the troop stable. In South’Africa out.breaks of glanders occurred at Etchowe or Pietermaritzburg.Mallein was employed and all animals which reacted

were destroyed. Every precaution was adopted andthe disease appears by the last reports to be stamped out.Mortality from horse sickness " was very heavy and an un-usually large number (no less than 119) of animals died fromcolic due to the ingestion of large quantities of sand. Thelatter cases occurred at Ladysmith, where the animals werepicketted out in the open on a sandy soil which they con-tinually licked, the sand accumulating in the intestine andcausing complete obstruction. In the Army VeterinarySchool the usual classes were held for officers and farriers,examinations being held and certificates granted to thosewho were successful. From the Vaccine Institute lymph wasissued for 71,103 people, the average yield from each calfbeing sufficient for 4345’25 persons, the total expenses forthe year, including cost of calves, instruments, &c., beingonly .891 9s. 3d. Lymph is now supplied from here to thenavy as well as to the army, a request to that effect havingbeen received from the Admiralty.

BILATERAL ACUTE LABYRINTHITIS.

IN the Intercolonial Medical Journal of A1tstralasia ofOct. 20th Dr. Percy Webster relates a case of this very raredisease. A healthy lad, aged ten years, one day looked paleand ill. He vomited, became delirious and complained ofpain in the head ; he had to be held down in the bed. Theacute delirium lasted 11 hours, after which he was quiet butlay muttering. He called out with pain when touched;moving the limbs seemed to cause great suffering. At timeshe would lie with his back arched and his head retracted. Hewas ill for about two months and became very thin. He had

giddiness and after his recovery staggered at times especiallyin the dark. Deafness was noticed before he recoveredfrom the delirium and remained permanent ; it was totalboth for bone and aerial conduction. He complained of painand constant buzzing in his ears. The fundi were normal,the knee-jerks were active, and there was neither ankleclonus nor paralysis. As the history was only obtained fromhis friends it was impossible to say whether the labyrinthitiswas primary, or associated with meningitis, pneumonia,typhoid fever, or one of the exanthems, or whether it wassecondary to otitis media.

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THE PURPURA OF CHILDHOOD,

AT the recent Congress on Gynaecology, Obstetrics, andDiseases of Children, held in Marseilles, Dr. Leon Perrin

discussed the pathological significance of purpura inchildren. This term, he reminds us, no longer stands forthe name of a disease but of a symptom. The condition ofblood-stasis which it denotes, whether merely an intensecongestion with capillaries unruptured or a true extravasa"tion, is in the great majority of cases due to an infectiveprocess-a toxaemia. Even the rheumatic variety, he main-tains, ought to be relegated to the same series as those ofobviously septic origin as being also toxic, though by meansof a different toxin. Purpuras associated with syphilis, withthe eruptive and other infectious fevers, with septic pleurisiesand pneumonias, are necessarily of this character. In thesame connexion a reference to two cases in which the pre-sence of staphylococci was demonstrated in the bloodis interesting. Dr. Perrin also quotes the observa-

tions of de Boeck-Renher, Hutinel, Le Gendre, and othersto prove the frequency with which the tonsil serves as thechief point of entrance for the germs of disease. But

whether this gland, or the skin, or the gastro-intestinalcanal provides ^ the nidus, the later action of toxic products