789THE PRIORY CHURCH OF ST. BARTHOLOMEW THE GREAT.

quoted that about half of the total deaths occurring in aperiod of eleven years took place in the course of last year,which shows that either the mortality last year has beenexceptionally heavy, or that, as appears to us more probable,the mortality for the preceding ten years has been in someway incorrectly stated. -

THE PRIORY CHURCH OF ST. BARTHOLOMEWTHE GREAT.

ARCHITECTS, artists, ecclesiologists, and medical men,

especially St. Bartholomew’s men, must take an interest inthe well-being of the fine old building which, owing to therapacity and carelessness of those who are dead and gone, isthe sole remaining portion of the beneficent institutionfounded by Rahere which he saw with his own eyes. Much

has been done to heal the wounds inflicted by the creaturesof Henry VIII., but much still remains to be done. The

choir has been restored to something like its former dignity,but some .f:1500 are still urgently needed to liquidate debtsincurred for work already carried out. We would earnestly Iappeal to all medical men and antiquarians for help in thegood work so well begun. In this church the founder of theoldest London hospital lies, and everyone interested in hos-pitals, especially those belonging to that great foundation,ought to respond to the appeal on this account. Subscrip-tions may be sent to the Rector, Sir Borrodaile Savory,12, King - street Chambers, West Smithfield, E.C. SirBorrodaile Savory is the son of the late Sir William Savory.

CRANIOTOMY FOR IDIOCY AND IMBECILITY.

IN the new semi-monthly journal Pediatrics an article

appears on this subject which it is a little difficult to take

seriously-at least, in some of its aspects. It is the work of

Dr. Dana, and after enumerating the results in 81 cases inwhich the operation has been done-viz., 35 improved, 22not improved, and 24 deaths-he endeavours to answer aseries of questions-viz. : 1. What class of cases is thus

benefited ? 2. How much are they benefited and in whatdirection ? 7 3. What is the kind of operation which securesthe benefit ? 4. What are the dangers of the opera-tion ? 5. How does the operation act ? In referenceto the first question Dr. Dana thinks two classesof cases are suitable for operation-viz., congenitalidiots and a class in whom the mental defect isless obvious and who are more correctly described as

imbeciles. Cases in which cerebral diplegia is associatedwith mental defects are not considered suitable cases

Ifor operation. The results are seen in the greater Itractability of the children, and the improvement in

speaking, swallowing, and cleanliness. The best opera-tion he believes to be linear craniotomy with lateral

branches, and the dangers, although the death-rate hashitherto been a heavy one, are now much reduced. But

Dr. Dana’s theory as to the efficacy of the operations,or, rather, as to the reasons for its occasional modified

efficacy, is the part of the paper which it is not easyto take seriously. He believes that the operation, in so faras it is efficacious, is so because of its profoundly disciplinaryeffect upon the idiot. He says : ’’ The operation of cranio-tomy upon children in institutions attracts the attention ofnurses and medical officers, and the children get more careand more stimulating words and help in various directions.I would repeat, therefore, that it is in my opinion largelythrough its pedagogic influence that an improvement inthese cases takes place, and that the operation is allied inits effect to a severe piece of castigation." Surely a strangerplea for an operation has never been brought forward 1 Aswe have said before, it is diffi cult to take the writer of sucha statement seriously. If the operative procedure to whichit refers were not already sufficiently discredited we think it

could hardly survive such advocacy as it has in the paperI under notice. ____

MEDICAL MUNIFICENCE.

, THE hospital at Newport (Mon.) dates from 1867, its

nucleus having been a dispensary which was established in1839. It was enlarged in 1882 and 1887, and now containsfifty beds; but nevertheless it is inadequate to the require-ments of the population, and as further extension of the

premises is impracticable the managers have resolved to

acquire a fresh site and erect a hospital containing at leasteighty beds. The scheme is well supported, for Lord

Tredegar, chairman of the present hospital, has presented asite consisting of three acres of land fronting the Cardiffroad, while Dr. and Mrs. Cxarrod Thomas of Newport havemunificently ofEered to contribute the sum of £5000 on con-dition that £15,000 over and above the value of the siteshall be provided by other donors. At a public meeting heldin Newport townhall, on March llth, the liberality of thesebenefactors was warmly acknowledged, and it was decidedthat the new building should be called the Newport and

Monmouthshire Hospital. -RAILWAY HYGIENE.

IF we are ahead of other countries in the matter of generalsanitation it is perhaps possible that in certain branchesof hygiene other countries are ahead of us, at any ratethe public interest in the subject is far less apathetic.Thirty-four years ago we dealt in an exhaustive manner withthe subject of the influence of railway travelling on health,and the articles when republished were welcomed by a widecircle of the travelling public, inasmuch as they suggestedmany much-needed cautions and substituted facts for the

vague theories which then prevailed. Many neededreforms have since been made, but these do not keep pacewith the ever-increasing railway traffic of the country.At the commencement of the year loud cries were raised

by the public in the press concerning the inadequate light,warmth, and ventilation of the carriages on some of therailway lines, and we then added our protest to that of thepublic. At the last Congress of the American PublicHealth Association no less than four papers dealing withthe matter of Railway Hygiene were read, three of whichfind a place in the journal of the association, and some ofthe points brought out would lead us to suppose that in thisdirection our American cousins are a good way ahead ofourselves. It is rightly pointed out that with regard tocleanliness the condition of the cars is dependent on

those in charge of them, and it is gratifying to learnthat there seems to be an increasing disposition in

America on the part of the railway corporations to

endeavour to see that the employes carry out the workentrusted to them in a proper manner. Of course the con-

ditions of railway travelling in America are very differentfrom our own, but when we remember the slovenly andcareless way in which we have seen carriages cleaned onEnglish lines we wish as much could be said for ourown railway companies. As showing the remarkableadvance that is continuing to be made in this direction,it is stated that the Wagner Car Company have insti-tuted a school of instruction for all their employes inthe prompt and safe handling of passengers and traffic.In a paper on the ventilation of railway coaches is a

. passage which is worth quoting : "Finally," says the writer,

. "it should be remembered that in all ventilating under-. takings but one-half of the requirements are fulfilled wheni the most perfect apparatus conceivable is furnished. Thei excellence of a tool does not ensure the quality of itsL product. Quite as much depends upon the uses as upon thj tool, and not infrequently a superior apparatus is made in