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wired for by Mrs. X for obstetrics, if he wants vacation leavehe must put it off for obstetrics, his first duty in all cases isobstetrics. "Is it any wonder, then," Major Woodruff asks,I that after watching for 15 years the official d6biit of militarybabies our minds, in accordance with the law, should run tomaternal impressions?"

"

(The subject of the controversy.)Unless he learns all about this matter the writer points outthat he is not competent to fulfil the law, however well hemay be able to perform the duties connected with his chosencalling. The letter, which would occupy about three columnsof THE LANCET, effectively answers the purpose for whichit was wtitten in a spirit of perfect good humour. If all

unkind innuendoes made in the heat of controversy werereplied to in a similar manner we should hope for the dawnof the millennium in the very near future. But we fear thatthe time is not yet-at any rate not in this country, how-ever it may be across the Atlantic.

THE DEFINITION OF WHISKY IN OLDEN TIMES.

WITH reference to the recent discussions on the purity ofmalt whisky and of the adulteration of whisky with patent-still spirit it is of interest to learn the precautions which weretaken by the Scottish Parliaments centuries ago to protectthe purity of Scotch whisky. A correspondent who has beeninvestigating the subject in the British Museum sends us thefollowing excerpts taken from old documents on the subject.In seeking for a definition of whisky or brandy due regard, itseems to us, is bound to be p:1id to the original meaning ofthese words."Accounts of the Lord High Treasurer of Scotland," edited by

Thomas Dickson, 1877.-Vol. I., p. c. c. XIII.

UTMsity or Aqua Vit, date lMJ/,.-5The Exchequer Rolls show a delivery to Friar John Cor of eight bolls

of malt to make aqua vitse. That it was not largely manufactured norin general use at the time is shown from the comparative rareness ofits occurrence, as well as from the manner in which, on the occasionreferred to, it was furnished to the King. It was probably reckonedrather among drugs, than among articles of ordinary consumption.There is a footnote to the above as follows :-

Fratri Johanni Cor, per preceptum compotorum Rotularis, utasserit de mandato Domini regis ad faciendum aquse (sic) vite VIII.boll brassij.The next notice of the use of aqua vitse is to be found inthe index to the Acts of Parliament of Scotland in theBritish Museum, where we note that in 1579 the followinglaw was passed :-No one to make or sell aqua vitse from 1st Dec. to 1st Oct. next

except earls, lords, barons, and gentlemen for their own use.-C. 56,III. 174.

Later the value of the trade seems to have been realised, for iin 1655 we see that ’

The importation of aqua vitae or strong waters was prohibited.- ,VI. II. 828a.

In 1655 the town council of Glasgow issued regulations forpersons who should I - brew, sell and tap aqua vita3," and (

further in the same year : - ‘

An excise of 2d. per gallon English, or quart Scots, imposed on Eaqua vitae or strong waters distilled in Scotland; of 4d. per gallon tEnglish or quart Scots on spirits made of wine imported; of Is. pergallon English or quart Scots on spirits sold instead of aqua vitae orstrong waters.-VI. II. 828a, 828b. t

Already the Scotch had seen the danger of whisky being c

adulterated and at once took steps in the shape of a heavy i

duty to guard against such adulteration. In 1663 they went e

further still, for they then passed a law to the effect :- r

Importation of foreign aqua vitae prohibited.-C. 13, VII. 458. v

In 1672 we find :- - jRatification to Edinburgh of an import on foreign aqua vitse, strong 1]

waters and other foreign spirits distilled. t

These laws show that the Scotch, more than 200 years ago, I

were alive to the danger of the adulteration of whisky with v

foreign spirit and took care by their laws to protect their o

pure malt product. And that whisky was a pure malt 7

product is shown by the next two enactments, as well as by c

the first paragraph of this article, in which it is stated that j<

eight bolls of malt were supplied to Friar John Cor. Wefind then in 1695 :-An excise imposed of 3s. per pint on aqua vitae and strong waters,

not made of malt brewed and sold within the kingdom of 6s. per pinton aqua vitze, brandy, and strong waters (probably foreign); and 13s.per barrel on foreign beer.-IX. 451a.

Again in 1705 :-A tack of the excise on aqua vitae made of malt, set in 1698 for five

years to Sir William Menzies for .640,000 per annum to be paidquarterly.-C. 2. X. 31.

A "tack" in Scotland is a lease. So it seems clear fromthese old laws that whisky was originally a pure all maltspirit and that adulteration by means of foreign spirits waseither entirely prohibited or had to be paid for at a pro-hibitive rate. It is a pity that the Government of the

present day cannot do for us what an enlightened ScotchGovernment did for its people more than 200 years ago.

MEDICAL ARTICLES IN LAY JOURNALS: THEPREVALENCE OF HOOKWORM DISEASE

IN PORTO RICO.

A CORRESPONDENT writes:-

Several of the principal lay papers of the United States haverecently come to an appreciation of the fact that their readers takegreat interest in medical affairs and particularly in matters concerningpublic health. In order to supply news of this character in an accuratemanner some of the journals have initiated the system of procuring asmembers of their staff competent medical men whose duty it is tosupply authentic and re’iable medical literature and to supervise paperswhich come within their especial sphere. With this object in view theNew York Herald has recently sent to Cuba and Porto Rico thefollowing three well-known phvsicians : Dr. Wolfred Nelson, F.R.G.S.,a graduate of McGill University; Dr. P. Jenkins, formerly healthofficer and health commissioner of New York City ; and MajorLouis L. Seaman, U.S.A. Drs. Nelson and Jenkins were despatchedto Cuba in order ’to investigate the reported outbreak ofyellow fever there, while Major Seaman went to Porto Rico.Letters have been received and published in the Herald fromall three of these doctors, that from Major Seaman beingespecially interesting. Dr. Seaman has found that the hookwormdisease prevails to a remarkable extent among the inhabitants of PortoRico, rendering the majority of them unfit for active work. The in-vestigator states that the unsanitary conditions of the island, con-tributing largely to the production of the disease, are the result not ofintentional neglect, but of environment and of inherited habit, forwhich the living generation cannot be held altogether responsible.The writer gives it as his opinion that the uncinari&aelig; gain entrance intothe system through the naked feet of the farm labourers whence theywork their way into the intestines, become encysted, and develop intofull-fledged blood-suckers and gradually undermine the vitality oftheir unconscious host. Remedies recommended are means to ridthe soil of the nematodes, and the application generally of effec-tive sanitary arrangements, and the education of the people as tothe need of thorough personal hygiene. Major Seaman, moreover,makes the suggestion that free clogs should be provided for thelabourers in agricultural districts of Porto Rico in order to protecttheir feet. The example set by the Herald in sending out a com-mission to Cuba and Porto Rico in the interests of public health is onewholly in keeping with the progressive character of that journal, andthe trend of many of the principal newspapers here of supplying theirreaders with authentic medical news and with articles bearing onmedical subjects properly written is a distinct advance in modernjournalism.

The New York Herald has evidently gone to work in theright way to obtain accurate information on certain medicalquestions of national (or rather international) import-ance and by publishing in its columns suitable articles onsuch topics it can, and no doubt will, render the communitya great service. It will be observed that the subjects dealtwith are essentially matters of public hygiene, the remedialtreatment of which can hardly be effective except under twoconditions-namely, when constituted authorities take theinitiative and when the general public loyally support theefforts of the administration. Public opinion, however,requires to be formed and guided-an educational processwhich in America naturally comes within the province of thejournalist. So long as the medical articles in the ordinarynewspapers are confined to general questions of sanita-tion and the prevention of disease much good maybe done, but in the absence of proper editorial super-vision the practice is not unlikely to lead to a varietyof abuses. Newspapers of the standing of the New

York Herald are under no temptation to increase theircirculation by meretricious aids but there are countless

journals of a lower rank which would find discussions on

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the prevention of disease insufficiently attractive and wouldseek to draw attention to themselves by dissertations on anymedical topic which might be exciting the public imagina-tion at the time, whether the pathology of cancer, or thesurgery of the brain, or "bloodless surgery," or hypnotism,or hydrophobia, or the treatment of special diseased con-ditions, and so on, ad infinitum.

COLLAPSE DURING EXAMINATION OF A POST-PHARYNGEAL ABSCESS: RE-ESTABLISHMENTAND MAINTENANCE OF THE CIRCULATION

FOR FOUR HOURS BY MEANS OFMASSAGE OF THE HEART.

IN the Boston Medical and Surgical Journal of Jan. 5thDr. David Cheever has recorded the following remarkablecase in which the circulation was re-established and main-tained for four hours by means of massage of the heart.A girl, aged three years, was taken to hospital complainingof sore throat and dysphagia. There was a history of a

fortnight’s illness, with feverishness and anorexia. The childbecame progressively worse and unable to eat or to talk.

During the last few days respiration became laboured. Onexamination she was pale and ill-nourished, with a pulse of140, respirations 46, and slight cyanosis of the finger tips andthe lips. The respiration was shallow and a few moist raleswere heard at the bases of the lungs. There was a diffusefulness on the right side of the neck which was not tender.A swelling obstructed the oro-pharynx but the strugglesof the child made complete, examination impossible. An

operation was undertaken. As it was impossible to reasonwith, or to gain the confidence of, the child the necessarymanipulations were carried out by force but as gently aspossible. The arms were confined by a blanket and she washeld in the nurse’s lap. No anassthetic was given and shestruggled ceaselessly. The introduction of the gag caused

such choking and cyanosis that it had to be withdrawn-withimmediate relief. At a favourable moment it was againplaced in position and the finger and knife were introducedbut a point of fluctuation could not be felt. Breathingsuddenly ceased and the child was laid on the table andartificial respiration was begun. The pulse could not be feltnor could the heart sounds be heard with the stethoscope.The face and the mucous membranes were moderatelycyanotic, the pupils were dilated and immobile, and thecornea was insensitive. The time was 6.20 P.M. With thechild in the Rose-Trendelenburg position the abscess was

opened and evacuated. As auscultation showed that a satis-

factory amount of air was not entering the lungs a rubbercatheter was introduced through the mouth into the

trachea and the expansion of the chest by manipula-tion was supplemented by insufflation. No improvementensued and the cyanosis was followed by extreme pallor andthere were no signs of action of the heart. Cardiac massagewas begun by rhythmical pressure at the rate of 60 to theminute over the third, fourth, and fifth left costal cartilages.This process with the artificial respiration was continued forfour and a half hours until further efforts were evidentlyuseless. As rapidly as possible brandy and strychnine wereinjected directly into the heart, the legs were bandagedfirmly from the toes to the groins, the abdomen was

manually compressed, and heat and blankets were applied.Directly following the pressure over the heart the colourreturned to the lips and the face and the capillarycirculation could be demonstrated by the blanching andthe return of colour after pressure on the cheeks,the tongue, the lips, and the nails. No heart soundswere heard with the stethoscope at any time but feeblepulsations were detected in the radial and the femoral

arteries, always immediately after the pressure on the heart;they were never felt when the pressure was interrupted for

a moment. The pupils remained dilated and immobile.

Oxygen under considerable pressure was forced into the

lungs through the catheter but the colour of the mucous

membranes at once became worse, therefore insufflation was

again begun. At 8.30 a pint of saline solution was infusedinto the median cephalic vein with transitory improvement ofthe colour and the pulse. There were sluggish oozing from thesubcutaneous tissue and marked haemorrhage from the vein.The blood was slightly darker than normal. Ten minims ofsolution of adrenalin were injected into the pectoral muscleand repeated without noticeable effect. At nine o’clock thetube was accidentally withdrawn from the trachea. Its re-insertion was difficult in consequence of beginning rigidityof the jaw. Tracheotomy was therefore performed and in-sufflation was continued. The wound bled less than the

previous one. The colour failed steadily and the skin becamemottled, although the capillary circulation could still be de-monstrated in the lips. Finally it was determined to injectstimulants into the spinal canal but in turning the body overit was found that rigor mortis was well established in thelegs. Further attempts at resuscitation were thereforeabandoned four and a half hours after they were begun.Death evidently was due to cardiac collapse from the shockof the manipulations performed in attempting to operate onan extremely exhausted patient. In endeavouring to main-tain the circulation artificially Crile and others have shownthat not only must the heart be kept beating but the bloodpressure must be insured by increasing the peripheral resist-ance. Crile does this by injecting adrenalin which causesthe vessels to contract and by the use of his inflated rubbersuit which offers a resistance that can be regulated. In theabove case resistance was produced by bandaging the limbsfirmly and compressing the abdomen. Keen has recentlycollected 27 cases in which massage of the heart was usedfor resuscitation, of which three were successful, and Cohenhas reported a successful case. In some cases the peri-cardium has been opened and the heart rhythmicallycompressed but the circulation has never been more thantemporarily restored. In a case described at the Society ofAnxsthetists by Dr. E. A. Starling the pulse and the respira-tion stopped together during the operation for removal of thevermiform appendix. The surgeon, Mr. W. Arbuthnot Lane,introduced his hand through the abdominal incision, feltthe motionless heart through the diaphragm, gave it a

squeeze or two, and felt it commence to beat. Afterartificial respiration the patient recovered and the opera-tion was completed without more anaesthetic. Good con-valescence followed. In an annotation published soon

afterwards 2 we discussed the whole subject of resuscitationby compression of the heart. Dr. Cheever calls attention tothe fact that his case differs from most of the others recordedin that automatic cardiac pulsation was not re-established.He thinks that the blood was pumped through the vascularsystem by the mechanical pressure on the heart, whichseems to us very doubtful.

THE SALE OF PATENT MEDICINES IN NEWZEALAND.

A RECENT issue of the Nerv Zealand Gazette contained

regulations issued under section 101 of the Public Health

Act, 1900, with effect from June 30th, 1905, notifying that:" All patent medicines imported or sold or offered for sale inthe colony shall be required to have the contents with theirexact proportions legibly set out in English upon a labelaffixed on the bottle, box, or container. In addition to such

information, where such medicines contain one or more ofthe poisons scheduled under ’the Sale of Poisons Act, 1871,’and its amendments, the words This contains poison’ must

1 THE LANCET, Nov. 22nd, 1902, p. 1397.2 THE LANCET, Nov. 29th, 1902, p. 1476.