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excitement than is usually evoked by political party change, and that the claims of Madeira, long neglected, will now bepressed upon the new Executive in the international interestof the place as a health resort, whose winterless and

perennially vernal climate has now been brought within

three days’ journey of England by the sumptuous liners ofthe Union Castle Company. The overflowing revenue andprosperity of Madeira are truly due to these influences, andthey cannot be too sedulously fostered in the interest of

Portugal. Latterly Madeira has been by no means fre-

quented by health-seekers exclusively, but the island is

becoming more and more the resort of the tired and over- worked-not of the average tourist, but of those to whomcomplete intellectual rest is impossible at home, who desirelight and sunshine, and who seek distraction in fresh interestsand new environment.

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COCOANUT "MILK.’

NOT a few people have wondered what kind of stuff the"milk" of the cocoanut is. The inducement held out to

buy the nuts or " shy " for them is generally that they are"all milky." Recent analyses, however, have dissipated thedelusion that the fluid has anything in common with realmilk. It contains only 4 per cent. of solids, consistingchiefly of sugars 2’ 8 per cent., the balance being made upof mineral matter and tartaric acid. It is interesting torecord that more than half of the sugar present is mannitol,the sweet principle of manna which is sometimes found

also in wine as a product of normal grape sugar. The

question has been discussed as to whether it would be

profitable to extract the cocoanut water for the sake of itscane sugar, but as this amounts to only loth per cent. theprocess would not be commercially successful, in spite of thewater being a waste product. Even if the water con-

tained 5 per cent. of sugar, as some specimens appear tohave shown, the recovery of this amount would be unprofit-able. The juice of the sugar cane yields nearly 20 per cent.of sugar.

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MATERNAL INFLUENCE IN MENTAL DISORDERS.

IN the annual report of the East Sussex County AsylumDr. F. R. P. Taylor, the medical superintendent, records, asa result of inquiries made into the family histories of patientsunder his charge, that in 247 of 277 direct admissions afamily history was obtained, and that heredity was ascer-tained in 28 per cent. of the males and 43 per cent. of thefemales. It would be both of interest and practical import-ance to learn if these figures are similar to those obtain-ing in the statistics of other institutions. It is perhapsnatural to expect that a tendency to insanity in the

mother is more likely -to appear in her offspring thanis a tendency to insanity in the father likely to appearin his. The nervous system of the child is in partelaborated in utero in a period during which the motherherself is peculiarly liable to mental disorder, sometimes

slight, sometimes serious in its manifestations, and in partduring those early years when the maternal influence is

paramount. If that influence, whether within or withoutthe womb, is good it is well with the child, but if, on theother hand, it is for some reason not good the offspring,pari passu, is affected. The life-history of women is boundup to a far greater extent than is that of man with mattersof generation. It is a common observation among physicians,and indeed amongst lay folk as well, that the menstrual flux isvery frequently preceded by, accompanied with, and succeededby peculiarities of mentality, and that therefore in many womenmental equilibrium is scarcely known, and is replaced untilmiddle life by tones of feeling, effectivity, and thought inperpetual see-saw. It is scarcely to be doubted that such

states as these exercise subtle educative influences and mayresult in just those failures in mental balance which maysubsequently dispose the offspring to mental breakdown.

From another point of view it is to be remembered thatcertain affections seem to be transmitted through unaffectedfemale progenitors to male offspring, and it is at least

legitimate to regard it as possible that in other disorders alike tendency exists, while it would be interesting to in-

vestigate the characters of the insanities which appear to beof maternal origin and to compare them with those which

appear to be of paternal origin. There can be no doubt that

within a comparatively few years our generation has seen ametamorphosis of the character of the lives led by women ;such a change indeed as history does not record. It is full

early to pronounce on the effects which are likely to accrue,but it is plainly of vital importance that we should watchthe direction of the drift of those few straws which too oftenare our only guides, and we should regard with satisfactiona further development of Dr. Taylor’s observations.

THE TREATMENT OF TUBERCULOSIS ON THEMEDITERRANEAN COAST: HELIOTHERAPY.

AT a meeting of the Académie de Medecine of Paris onOct. llth M. Debove made a report on a paper by Dr.Revillet of Cannes, entitled "The Treatment of Tuber-culosis in Children on the Mediterranean Coast by Sea andSun." Though the topic may seem trite the results areso remarkable as to demand attention. They are more trust-worthy than the usual excellent results " of therapeutics,for the undue optimism which, however honest, seems in-

separable from writers who are describing the results of

their own methods can be excluded. Here the patientswere Swiss children sent from Geneva to Cannes by aphilanthropic society. Before departing and on returningthey were examined by Professor d’Espine, and the resultsare given in an annual report. It is noteworthy that, in

spite of the proximity of their own renowned mountain sana-toriums, the Swiss should prefer to send these children tothe Mediterranean. Cannes possesses great advantages whichhas led Professor d’Espine to recommend it, but these existalmost equally all along the coast between Hyères andVintmille. It has a sloping sandy beach protected fromcold winds on the north, east, and west by mountains andopen only to the south-an ideal condition for the treatmentof tuberculous children by sea, air, and sun baths. The

band of Swiss children arrives each year in the middle ofOctober and remains until about the middle of June. Anywho show signs of "open " tuberculosis are rejected becauseof the danger of contagion. At the time of arrival the seais warm, having a temperature of about 640 F. As winter

approaches the temperature falls to 46°. The children bathe

daily and do not notice the fall of temperature. The seabath is always short, lasting from one to three minutes atmost. A marked cutaneous reaction always results and therehas never been the least accident. The bathing is continuedthrough the winter even during the coldest month. The

greater part of the day is devoted to heliotherapy ; the

tuberculous part is exposed naked to the rays of thesun. Sunless days are so few in this fortunate clime thatsun bathing is possible for 190 out of the 240 days ofthe children’s sojourn. The reverse holds in mountain

climates ; sunny days are the exception. The effects were

striking. Pale, emaciated children, many of whom were

subjects of severe disease, underwent a veritable resurrection.Appetite, colour, and spirits returned. The average gain in

weight was 4 kilogrammes. For superficial tuberculous

glands insolation proved most efficacious ; it dried up suppura-tion and reduced the keloid-like projections and depressions.Progress was rapid and the surface became covered with a

1436

supple scar which assumed the colour and characters of

normal skin. Old glandular sinuses, which resisted all

previous treatment, rapidly closed. Of 63 children sufferingfrom Pott’s disease 27 were cured, 26 were improved, and 6remained stationary. Four died-three from an intercurrent

disease and one from exhaustion the result of prolongedsuppuration complicated by amyloid kidneys. Of 94 children

suffering from hip disease and white swellings 38 were curedand 50 were improved. Professor d’Espine found that a certainnumber of children suffering from hip disease were com-

pletely cured after treatment for eight months at Cannes-aresult exceptional at other latitudes. The results were not

less brilliant for " white swellings," in the treatment ofwhich immobilisation was avoided. Dr. Revillet considers

that rest treatment is much abused and is the cause of anky-losis and muscular atrophy. In a number of cases " spinaventosa " was rapidly cured by exposure to the sun. In

tuberculous peritonitis effusion and meteorism rapidly dis-appeared ; in 7 cases 3 patients were cured, 3 were

improved, and 1 died from perforation. In 11 cases of

lupus, 8 patients were cured and 3 were improved. The

diseased surface was gradually exposed to the sun until astage was reached when the treatment could be con-

tinued for the greater part of the day. Progress was

rapid ; nodules were effaced, crusts fell, slight desquama-tion was produced, and islets of white skin were formed.Finally, a smooth supple scar, never keloidal, was produced.To sum up, in 888 cases of tuberculosis positive results wereobtained in 93 per cent., and cures in 52 per cent. It is to

be noted that these results are not merely the statement ofDr. Revillet about his own methods, but are vouched for byProfessor d’Espine. What lesson do they teach ? 2 In this

country the open-air treatment of tuberculosis has become acommonplace, but we think that the value of heliotherapy,particularly of exposure of the diseased part to the sun, isnot sufficiently appreciated. Though for this purpose Englandis inferior to the Mediterranean littoral, it should not be for-

gotten-and our frequent meteorological notes prove it-thatwe have many places on our southern shores where the dailyaggregate of sunshine is considerable.

THE HISTOLOGY OF THE SCARLETFEVER RASH.

THE histological characters of the exanthem of scarletfever form the subject of an interesting paper contributed toMedicinische Bldtttr of Oct. 22nd by Professor J. Hlava ofthe Bohemian Pathological Institute of Prague. He states

that the most important previous observations on this subjectare those of Neumann and Unna. Neumann described

swelling of the cells of the rete and the formation of gapsand networks in which wandering cells were enclosed. Unnamaintained that the swelling of the skin resulted from thehyperæmia of the vessels of the corium, and that the changesin the epithelial layer were but slight. Professor Hlava’s

observations were made upon the skin of 18 fatal cases, andalso on small pieces removed ex vivo in seven other cases.He concludes that the chief changes occur not in the hornyor granular layers of the epidermis, but in the cylindricaland prickle layers and in the corium. There is a

hyperasmia associated with oedema. The cedema extendsinto the epithelium and may penetrate through the

granular layer to form small vesicles in the horny stratum.In the epithelium small areas of softening may result fromimbibition or from necrosis. These areas may involve groupsof piickle cells, the disorganisation starting at the peripheryof the cells and extending in towards the nuclei, whichbecome disintegrated. The central cells of these areas of

softening may show the changes to a lesser degree, the pro-toplasm being simply homogeneous and the nuclei pyknotic.

A few polymorphonuclear leucocytes may occur, in andaround these softened areas, but this leucocytic invasion isat most slight. Some dilatation of the lymph channels of thepapillary layer with enlargement of the endothelial cells canbe seen even before the appearance of the rash, and they maycontain some debris of red blood corpuscles. On the first

day of the eruption mononuclear cells with a few polymorpho-nuclears occur around all the blood-vessels of the corium, buteven by the fourth day there is very little proliferationaround these vessels. No changes of any kind are dis-

cernible in the sweat or sebaceous glands. The appearancesin fatal cases are somewhat different. The epithelial cellscontain more pigment; haemorrhages and connective tissuecells containing pigment are much more common in the

corium, and the cell proliferation around the blood-vesselsis more marked. These differences are probably referable tothe hsemorrhagic character of most of the fatal cases. Pro-

fessor Hlava concludes that the hypersmia, the serous

effusion, the leucocytic changes, and the later cell prolifera.tion about the blood-vessels are in favour of the inflammatorynature of the process rather than of the view that it is a

simple toxic oedema. --

THE Lord Mayor has become chairman of a Mansion Housecommittee formed to promote the raising of a fund for theerection of a new building for the Royal Society of Medicine,which already possesses a splendid site.

A POWEUFUL claim has been made by the Society of

Tropical Medicine and Hygiene for the endowment of thestudy and prevention of tropical disease as a memorial to hislate Majesty King Edward VII.

THERE has been praiseworthy activity during the week inthe districts where plague-infected rats have been found, butevidence of a spread of the infection has been forth.

coming. -

WE regret to announce the death of Professor Lancereau,which has just occurred at the age of 80.

ROYAL MICROSCOPICAL SOCIETY.—The next meet.ing of this society will be held on Nov. 16th at 8 P.M.,when there will be an exhibition of specimens of Britishmycetozoa by Mr. A. E. Hilton.

THE NOTIFICATION OF OPHTHALMIA NEONATORUM.-The Midwives Act Committee on Nov. 8th asked theLondon County Council to take action with a view to themore effectual prevention of blindness or impairment of visioncaused by the want of prompt and efficient medical treatmentamong newly born infants, and recommended the compulsorynotification of all cases of ophthalmia neonatorum. So far asthe practice of certified midwives was concerned, the com-mittee stated, a method of notification already existed, asone of the rules of the Central Midwives Board requiredevery certified midwife to advise that medical assistanceshould be obtained in every case of inflammation ofthe eyes, however slight. If the Council made theorder the information obtained would enable the medicalofficers of the sanitary districts to make known to those con-cerned the opportunities available in necessitous cases. Itwould be found of value where the infant was taken to ahospital, where the medical practitioner perhaps would nothave an opportunity of keeping the infant under treatment,and it would serve a useful purpose incidentally in bringingto light cases attended by midwives concerning which theyhad omitted to advise that medical aid was necessary, and toinform the Council accordingly. Notification would rendermore complete the arrangements for securing continuous andefficient treatment of the child. The order would be ad-vertised and a copy sent, as directed by the Public HealthAct, to each qualified medical practitioner residing or

practising in the county. The Council decided to make thecompulsory notification order.