1318 METROPOLITAN HOSPITAL SUNDAY FUND.

been so long investigating the subject to suggest a remedy.Dr. Yarrow himself suggests one which seems feasible, andwould, in his opinion, render compulsory clauses nugatory.We fear, however, that he is too sanguine in this respect,unless people generally can be imbued with the strong beliefin the protective value of vaccination which gains in forcethe more the subject is studied.

METROPOLITAN HOSPITAL SUNDAY FUND.

WITH a view to promote the success of the collections tobe made for the Metropolitan Hospital Sunday Fund onJune 9th the Lord Mayor and the Lady Mayoress have issuedinvitations to an evening reception to be held at the MansionHouse on Thursday, June 27th, when illustrations of hospitallife and work in London will be exhibited and described byMr. H. C. Burdett.

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THE LATE PROFESSOR G. J. ROMANES.

PROFESSOR GEORGE J. ROMANES, F.R,S, the friend ofDarwin and the founder of the Romanes Lectures, diedsuddenly at Oxford on Wednesday last, in his forty-sixthyear. His investigations in biological science are well

known, and his ready pen and clear lecturing have donemuch towards making the subject of evolution understandedof the people. Although associated with Oxford, London,and Edinburgh in his various professorships, he was a Cam-bridge man. He had been a Fellow of the Royal Society fornearly twenty years. -

GOITRE IN FINLAND.

ACCORDING to Professor R. Sievers, who has communi-cated the result of his painstaking inquiries to a Finnishmedical journal, goitre has been known in certain parts ofFinland for about fifty years, since which time it may be

said to have been endemic on the north-western shore ofLake Ladoga, the only portion of the country that can beconsidered of an Alpine character. Sporadic cases, too, havefrom time to time occurred on the western shore of Lake

Raijane, and in 1870 there was an epidemic of goitre in agirls’ school at Serdobol, a teacher aged twenty-four andfifteen children being suddenly affected. No one else was

attacked, though there was a boys’ school close by. The

recruiting statistics show that, during the ten years ending1892, of 220,000 young men examined only 144, or 0-06

per cent., were rejected on account of goitre, more than halfof these coming from the province of Vyborg, which includesthe mountainous district already mentioned on the shores ofLake Ladoga. Professor Sievers has been unable to find anyevidence of the existence of cretinism in Finland, and duringthe last year or two goitre appears to have become very rare.

THE MORTALITY OF CÆSAREAN SECTION.

WE published last week a short paper by Dr. Robert P.Harris of Philadelphia-to whose indefatigable industry inregistering international statistics obstetricians must be muchindebted - on the mortality of Cassarean section in GreatBritain during the last eight years ; that is to say, since theimprovements characterising the modern operation were

generally adopted. He has collected a total of sixty opera-tions, the mortality of which was 32 per cent. In the twenty-two operations belonging to London in this list the mortalitywas higher-viz., 40 per cent. Dr. Harris also gives theresults in 100 Cagsarean sections performed in the UnitedStates since 1882. There were thirty-eight deaths in thisseries. During last year there were in America sixteen

operations with four deaths. The results, therefore, bothin America and Great Britain are not dissimilar, and

go to show that in both countries Ca3sarean section is stillan operation attended with considerable danger. Dr. Harris

1 Finska Läkaresällskapets Handlingar, p. 414, Sparr.

further gives the results attending symphysiotomy, from

which it appears that the mortality of Cxsarean sectionin America is more than twice that of symphysiotomy.Inasmuch as modern symphysiotomy is relatively a muchnewer operation than the modern Csesarean section, some ofthe mortality of the former is no doubt due to the want offamiliarity on the part of the operators with the technique ofthe operation. This also appears from the results of the later

symphysiotomies in the United States, which, Dr. Harri&

tells us, show only a mortality of about 7 per cent. for

symphysiotomy. Probably much of the reluctance to under-take this operation that prevails here is due to a fear thatlameness or crippling of the patient may possibly follow. Onthis point it is important to observe that Dr. Harris saysthere has been very little of anything of the kind known to.follow the forty-four symphysiotomies that have been per-formed in the United States. It would be well, however, ifhe would in some future communication state precisely as toeach case what the result in this respect has been.

THE MEDICAL SOCIETY OF LONDON.

THE termination of the 121st session of this society wassignalised, as is customary, by the giving of a conversazioneand by the delivery of the annual oration. Dr. W. M. Ord,who ably filled the post of orator, took for his theme "ADoctor’s Holiday," and he showed how the keen enjoymentof a vacation spent in the midst of country life could beenhanced by the timely application of botanical and geo.logical knowledge. His address (which is published in fu]}in another column) contains not only much that is

scientific, but also much interesting matter gleaned fromold works on herb-lore and early medicine. After the

delivery of the oration the President, Sir William Dalbyrreceived the guests, who were later amused by a varietysketch, and during the evening selections were performed bythe Bijou Orchestra.

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THE DIFFUSION OF SMALL-POX.

THE number of cases of small-pox newly arising in Londonlast week showed a decrease on the figures of the precedingweek, having been 32 against 53. Three deaths were

registered, and there were 200 patients under treatment

n the Metropolitan Asylums Board institutions at the endof the week, in addition to 19 in the Highgate Small-poxHospital, making a total of 219. The admissions in the

week numbered 52, a fall of nearly 20. There were 3 deaths.at West Ham, where 27 fresh attacks were recorded. There

were also 3 deaths in Birmingham, and 38 newly recordedcases, whilst Smethwick had 11 new cases, and Willenhall

very many more. Active measures are in operation in

Hinckley for combating the prevalence of small-pox fromwhich the town has been suffering. Manchester had only 3fresh cases and the same number of small-pox deaths.One death was registered at Oldham, and 7 new cases atBradford. Many other towns had the disease in smaller-amount.

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THE GERMICIDAL POWERS OF BLOOD SERUM.

THE experiments detailed in the paper by Dr. C. B. Ewingwhich appeared in the last issue of THE LANCET, forma distinct contribution to the subject of immunity in.

infectious diseases. These experiments, made with rattle-snake poison, were undertaken to determine the cause-

of the profound blood changes and rapid putrefaction ofthe body that occur after rattlesnake bite. It was arguedthat this might be due to the blood serum losing its bacteri-cidal power, and the experiments were conducted withthe view to test this hypothesis. The results recorded ar&

certainly very startling ; the comparison of the effects ofnormal serum and venom serum showing clearly that the

1319FORTHCOMING EXHIBITION OF HYGIENE AT BOULOGNE,

introduction of the venom speedily affects the germicidalpowers of the blood. This germicidal property of normalserum is, however, itself limited, at least as regards thebacillus coli communis. The experiments with the bacillusanthracis seem to show that after a time the germicidalpower is regained by serum that has been acted on by thevenom. How the venom operates is not shown, but fromthe lucid account given by Dr. Ewing we may infer thatit acts partly by reducing the alkalinity of the blood, an

increase of which is known to raise the germicidal power, andpartly perhaps by the direct influence of the toxic principle.In any case the results seem to confirm the views that normal

healthy blood serum is a powerful protective agency againstthe inroads of bacterial infection, and that toxines act harm-

fully not merely by their direct effect, but equally, if notmore fully, by lowering this resistant power of the bloodagainst secondary infections.

THE DEATH OF DR. TWINING.

THE sad death of Dr. Alfred Hughes Twining of Salcombeonce more illustrates the evil consequences which may attend

practical joking. The deceased gentleman, whilst drivingat night along a country road, was the victim of a foolishlocal custom, which prevails among the inhabitants of thedistrict on May Day, of "ducking " each other with water.Two boys, together with others, were keeping up the custom,when the carriage in which Dr. Twining was returning homehappened to pass, and the boys, it is alleged, threwwater over the horse, causing the animal to bolt, with theresult that the vehicle was overturned and the occupants werethrown violently to the ground. Dr. Twining was taken to theSouth Devon and Cornwall Hospital, where he was found tobe suffering from dislocation of the left ankle and a fracturedleg. On Saturday, May 5th, five days after the accident,it was found necessary to amputate from the thigh, and theoperation was performed on the following day, but the unfor-tunate gentleman never rallied from the shock and died thenext day. It was pleaded on behalf of the boys at theinquest that the water was thrown with no malicious inten-tion and that the practice of " ducking

" was a common one

on May Day. The jury, however, returned a verdict of

"manslaughter" against the two lads, and the coroner ex-pressed the hope that the present case would be the means ofstopping a very dangerous practice in the district.

OPHTHALMIA IN POOR-LAW SCHOOLS.

OPHTHALMIA among the children of our Poor-law schools

is, from whatever point of view it may be regarded, a subjectfor serious consideration. It is a disease that is always moreor less present, and is liable, under certain unhygienic condi-tions of living to which the children of the poor are so

frequently exposed, to develop into outbreaks, with conse-quences to vision that are occasionally disastrous and almostinvariably attended with ocular troubles that are distressingto witness in children and often difficult of cure. The greatthing, of course, to be aimed at from a sanitary point ofview is to prevent the occurrence of epidemic ophthalmiaand to limit the spread of the disease when it does makeits appearance; and, from a curative point of view, to treatthe disease in its initial stage before any real damagehas been done to the eye. An outbreak of ophthalmia oftenoccurs more or less suddenly and provision has at once to bemade for the removal or isolation of the affected childrenand for their accommodation, classification, and treatment.These are matters which cannot be properly accomplishedin a hurry, and they frequently entail a considerable expendi-ture of money in providing temporary buildings, which

may not be needed when the occasion for them has

passed away. The history of the London District Schools

at Hanwell may be cited by way of illustration. Of £that history during the last fifteen or twenty yearsthere is no need to speak, for our readers are already suffi-ciently familiar with it. Mr. Henry John Searle, chairmanof the board of managers of the Central London School

District, has recently put forward a practical proposal fordealing with the ophthalmia in pauper schools. He contendsthat just as the Metropolitan Asylums Board provides forthe proper care and isolation of cases of infectious diseaseso there should be some adequate central establishment inconnexion with the Poor-law school system for thetreatment of children suffering from ophthalmia. He

argues that the advantages of, and the saving by, sucha plan would be very great. Children suffering from

ophthalmia could be at once transferred to an estab-lishment where they would be promptly and efficientlytreated and provided for. In this way the risk of the

spread of the disease and of its epidemic prevalence inschool communities would be removed, and the great expenseincurred at present by the multiplied provision of isolationdepartments at the various schools would be avoided. Whilewe are not at all disposed to underrate the advantages of sucha scheme, as set forth on paper, we think that it presents diffi-culties which will require to be very carefully thought outbefore it is practically adopted. The nature and extent of

accommodation to be provided ; the site of the proposed in-stitution as regards airiness and salubrity and amount ofacreage and its accessibility; the organisation necessaryfor the transfer of the affected children, and the working ofthe system generally, together with the estimated cost of theproposal: all these are matters that must be seriously takeninto account, to say nothing of what might be the possibleeffect of aggregating a large number of children affected withophthalmia in one and the same building.

FORTHCOMING EXHIBITION OF HYGIENE ATBOULOGNE.

AN International Exhibition of Hygiene will be held thissummer at Boulogne-sur-Mer, the popular seaside resort,which has so often been qualified as the most English townout of England. Most of the sanitary reformers whosenames we have had occasion to mention in connexion with

sanitary work in France are assisting in preparing thisexhibition. For instance, we find among these patrons thenames of M. Henri Monod, Councillor of State and Directorof the Sanitary Services of France ; Dr. Brouardel, Dean ofthe Paris Faculty of Medicine; M. Pasteur ; Dr. Proust,Inspector-General of the Sanitary Services ; Dr. Napias.Dr. A. J. Martin ; M. Emile Trelat, the eminent architect andauthority on Ventilation ; M. Bechmann, the engineer; andM. Louis Masson, the Sanitary Inspector of Paris. Dr.

Aigre,l mayor of Boulogne, is the president of the Organising Committee, and he is assisted by the chief medical men,municipal councillors, engineers, and other local notabilities.The exhibition will last from July 15th to Sept. 15th and isto be inaugurated by the Minister of the Interior. From

July 25th to 29th a Medical Hydrotherapic Congresswill meet at Boulogne under the presidency of Professor

Verneuil, of the Institute, and Dr. Bergeron, perpetual £

secretary of the Academy of Medicine. The exhibitionwill be built immediately behind the Casino, on the QuaiGambetta, where the old custom-house used to be. It

will be divided into five groups. The first group, Dcmestic

Hygiene, has three classes. The first class emb,races the

question of the housing of the poor, the supply and sterilisation of water, domestic drainage, the abolition of the smokenuisance, heating and ventilating, &c.; the second class dea1f:with food-supply and storage. The first class of the second

1 See THE LANCET, March 18th, 1893, for an account of Dr. Aigredaction during the cholera epidemic at Portal and Boulogne.