1445

treatment when suffering from accident far more readily fo1than they do for sickness, as in the latter case they still have th

more confidence in the skill of the native barber than in the ci!

methods of European medicine. The subordinate staff of rei

the hospital consists of a native head ward orderly, with pafive trained native orderlies who do the nursing, two cleaners, tu

a cook, a gardener, and a laundry woman, the whole being of

under the charge of an English head attendant and’store- th

keeper; when special nursing is required English nurses st

are obtained from Cairo. The report states that the of

bulk of the cases is formed by "injuries, ophthalmia, ca

dysentery, and diarrhoea., with catarrhal affections of Si

the respiratory system in the winter, and febrile cz

conditions due to the heat in the summer months." The g!

preventive work has been excellently organised; the best CB

water- and food-supplies obtainable have been installed, the w

meat is inspected before and after slaughtering, and there is tra laboratory for the analysis of other articles of diet. There tc

is a plentiful supply of Berkefeld filters in the hospital. A a

system of moveable latrines and sewage trenches is under pthe control of a sanitary inspector and as a result of these o

careful precautions the medical officer is able to state that c:

"the general health of the camp during the period covered by c

the report has been good." In the event of an outbreak of d

infectious disease it is proposed to erect mud shelters fortreating cases, which can be destroyed when no longer Fnøøø I

THE COÖPERATION OF LOCAL SANITARYAUTHORITIES.

ON May 18th a meeting of representatives of certain county ofcouncils and urban sanitary authorities was held at New- tbcastle under the presidency of Alderman H. W. Newton, to

chairman of the sanitary committee of the Newcastle cor- tt

poration. The meeting considered the report of Dr. H. E. p(Armstrong, medical officer of health to the corporation, on w

the problem of tuberculosis, and in the course of a valuable m

address on the urgency of meeting it efficiently the chairman M

brought forward a motion which embodied these proposals :- T

That in the opinion of this meeting it is desirable that a permanent wunion of the sanitary authorities of England and Wales be established SEas a supreme national health authority, with the object of safe-

guarding and promoting the public health interests of the people at w

large against tuberculosis and other dangers to the public health. e;

This motion was unanimously adopted by the meeting tJwhich then constituted itself a committee for the further- hance of this object with power to add to its numbers, and v

the chairman announced that the cooperation of all the 0sanitary authorities in the country would be invited in the cinterests of the scheme. We consider that this movement is 10on the right lines and we welcome its inception; it seems

gdesirable that an organisation of sanitary authorities may tbe formed with a view to winning statutory recognition tand of paving the way to the foundation of such a truly Inational health service as can alone face such gigantic tproblems as those presented by tuberculosis. r

THE ETIOLOGY OF ACUTE PANCREATITIS.

THE etiology of acute pancreatitis is still a moot subject. -y

Dr. A. Egdahl has contributed to the Johns Hoplains Bulletinfor April an important paper consisting of an analysis of thereported cases in which the cause of the disease is stated or’suggested. These amount to 105. The preponderating cause Iassigned is gall-stones which are supposed to act by c

causing obstruction to the flow of bile and its retro-

injection into the pancreatic duct. Gall-stones were the i

assigned cause in 44 cases. The next most common

cause was gastro-intestinal obstruction which was re- i

corded in 32 cases. It is noteworthy that in 17 of these

cases there was gastro-duodenitis due to alcohol or with

a history of alcoholism. In two cases the pancreatitis i

ollowed an attack of appendicitis but the nature ofhe connexion cannot be stated. Two cases were asso-

,iated with typhoid fever. In one a patient who hadecovered from typhoid fever was seized with fatalpancreatitis. In the other case repeated inflammatory dis-urbances of the pancreas followed recovery from an attack)f typhoid fever and typhoid bacilli were demonstrated in,he bile. Pancreatitis is a rare but well-recognised meta-itasis of mumps-one to be expected when the similarity)f the pancreas to the salivary glands is remembered. Of 652;ases of mumps treated at the hospital of Val-de-Grceimonin has reported that pancreatitis occurred in ten. One}ase each of pancreatitis has been attributed to boils, malaria,gastric ulcer, duodenal perforation, syphilis, and tuber-

culosis. Two cases have been attributed to embolism ofwhich one was fatal. Three cases have been ascribed totrauma. The immediate cause of acute pancreatitis appearsto ba infection of the duct of Wirsung. The bacillus coliand other pyogenic organisms have been found in the

pancreas. Mr. A. W. Mayo Robson thinks that in the casesof retro-injection of bile the inflammation is due to organismscarried in that fluid. In cases of injury to the pancreas acondition favourable to bacterial invasion is obviously pro-duced. Infection may also occur through the blood stream.

ROYAL COLLEGE OF SURGEONS OF ENGLAND:THE ORIGINAL NOTES OF JOHN

HUNTER’S LECTURES.

THE recent presentation by Dr. Thomas James Walker ofPeter borough to the Royal College of Surgeons of Englandof the original notes of John Hunter’s lectures, taken bythe latter’s pupil Mr. Hopkinson, is an interesting additionto the College library. In a letter sent to the College withthe volume Dr. Walker explains how the book came into hispossession. He says : " A hundred years ago Mr. Hopkinsonwas carrying on the practice which, with Dr. Kirkwood andmy son, I now conduct. Mr. Hopkinson was succeeded byMr. Whitsed, who in 1819 sold the practice to my father,Thomas Walker. After introducing my father, Mr. Whitsedwent to Edinburgh, took his M.D. degree, and for a timesettled in London; afterwards he moved to Wisbech,where he practised as a physician and died in the

early sixties.’ After his death the book remained inthe hands of his daughter for several years and byher it was given to me." At the commencement of the

volume is an original letter from Mr. Clift, the conservatorof the College, dated Sept. 16th, 1835, to Mr. Whitsed con-cerning the volume, and a cutting from the Englishmannewspaper, dated Nov. 9th, 1836. These additions add

greatly to the interest of the gift and are to be retained inthe volume at the request of Dr. Walker. The cutting fromthe Englishman is a statement concerning John Hunter’spapers and manuscripts and a reputed conversation-" onthe road to Kew "-between Sir Everard Home and Mr. Clift

regarding the manuscripts. As announced in THE LANCETlast week, the presentation was made to the College by Dr.Walker in commemoration of the completion of the fiftiethyear of his Membership of the College.

EPIDEMIC CEREBRO-SPINAL FEVER.

IN the districts where epidemic cerebro-spinal fever is

prevalent the number of cases have shown no great changeduring the last seven or eight days. In Scotland during theweek ended May 18th there were 23 deaths from this causeregistered in Glasgow, 7 in Leith, 5 in Edinburgh, 2 inDundee, and 2 in Paisley. In Glasgow the weekly reportissued on May 17th showed that there were at that time125 cases under treatment. It is announced that in

Edinburgh during the month of April 43 cases were notifiedand 36 deaths occurred. In Belfast during the week ended