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no way done harm to either the Metropolitan Hospital SundayFund or the Hospital Saturday Fund, but, on the contrary,by more widely calling attention to the needs of hospitalshad benefited both those older funds. In the course of the

proceedings the Lord Mayor announced a legacy of .f:l090 bythe late Mr. Thomas King of Tisbury. The fact that the

meeting lasted little more than half an hour was evidence, asthe Lord Mayor pointed ont, of the business-like methods ofthe Fund.

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STREET NUISANCES.

ON Dec. 12th the Local Government and Taxation Com-mittee of the London County Council laid before that bodysome proposed by-laws dealing with window cleaning and"flash light advertisements. Owing to the pressure of

business the passing or rejection of the by-laws was deferreduntil the next meeting of the council on Dec. 19th. We

earnestly hope that the by-laws will pass, for they dealstringently with the dangers incident to both matters. ITHE APOTHECARIES’ HALL OF IRELAND AND

THE GENERAL MEDICAL COUNCIL.

AT a special meeting or me Apotnecanes naii or ireianaheld on Dec. 8th, 1899, it was proposed by Dr. Adye-Cnrran and seconded by Dr. Evans :-"That the observations with reference to this body made by

Dr. Atthill at the General Medical Council in London beconsidered most unprofessional, totally uncalled for, and

highly discreditable to the Representative of the RoyalCollege of Physicians of Ireland."The motion was passed unanimously.

POISONING BY MERCURIAL INJECTIONS.

THOUGH numerous authorities recommend mercurial injec-tions in the treatment of syphilis and though the practicehas now become extensive any advantages over establishedmethods still remain to be proved. Successful results havebeen recorded on all sides, but in what more successful thanwith other methods of treatment is a question scarcely con-sidered. Indeed, the same holds true of most of the newdrugs and new methods which deluge therapeutics. Further-

more, mercurial injections have a distinct disadvantage overordinary methods of treatment. An element of danger isintroduced and in several cases fatal results have ensued.This fact is not so well known as it should be, possiblybecause most of the cases have occurred on the continent.At the meeting of the Société M6dicale des Hbpitaux ofParis on Nov. 17th MM. Gaucher and J. Noel read notesof the following case in which death followed injections ofcalomel. A man, aged 50 years, had paraplegic symptomsapparently of alcoholic origin, but which were treated

by a practitioner as syphilitic. Iodide of potassiumwas given and Vigier’s preparation of calomel (whichcontains five centigrammes to the cubic centi-

metre) was injected. The first injection was given on

June 26th, the second on July lst, and the third on

July 6th. In all 15 centigrammes of calomel were in-

jected, No improvement resulted. In the middle of

September the patient was able to move about on crutches.About Oct. 15th he began to complain of digestive troubles.On the 20th he had severe itching all over the body andseveral red patches like those of urticaria appeared on theforehead. The liver was painful and extended three fingers’breadth below the ribs. On the 21st the face was coveredwith a rubeoliform eruption and there were sanguineousdiarrhoea and vomiting. The eruption appeared over thewhole body. There were hebetude, scarcely perceptiblepulse, incessant vomiting, ptyalism, foetid breath, andswollen tongue and gums. He died on the 29th. MM.Gaucher and Noel insisted that no other diagnosis than

mercurial poisoning was possible. They explained the long-interval-nearly four months-between the injections andthe production of symptoms by the fact that insolublemercurial salts remain for a time encysted in the tissuesand inert and then suddenly become dissolved. This is pre--cisely the danger of calomel injections. Injections of solublesalts were recommended instead because the effects could be

easily watched. In the discussion which followed M.Merklen and others pointed out that an interval of three orfour weeks had been observed between the injection ofcalomel and the production of symptoms ("stomatiteme’J’c1l’J’ielle tILTCL22G "). That a dose so small as 15 centi-

grammes (two and a quarter grains) should prove fatal wasexplained by the ill-health of the patient.

UNIVERSITY OF CAMBRIDGE: LONG VACATIONCOURSE.

THIS year the classes in pathology and bacteriology will,be carried on as usual, but will be supplemented by instruc-tion in methods of diagnosis used in the ward and in the-out-patient departments. We are informed that the classes-are announced early this year, as the last long vacationcourse was somewhat interfered with by a statement thatfound currency that it would not be held. Altogether thearrangements will be much more complete, and the workwill cover considerably more ground than was possibleduring the last course. -

THE WORKMEN’S COMPENSATION ACT.

1N THE LANCET of Sept. 30th we published an importantarticle by Mr. Albert Benthall dealing with some points inthe working of the above Act. From the point of view of themedical profession the salient point of the paper was thatdealing with the question of medical referees. "The Act,’9’said Mr. Benthall, " with a great originality, contemplatedthat in all cases of dispute as to the medical points of aclaim any committee, arbitrator, or judge should have theservices of a State-appointed medical referee to report on.any matter that seemed material to the question......."Unfortunately, continued Mr. Benthall, the use of the word," may " instead of " shall " in the clause has rendered

the whole machinery of the Act with regard to medicalreferees practically a dead letter. Mr. Benthall concluded

by suggesting that the medical referees should be called" assessors and should sit with the arbitrator or judge to.advise him on the medical points of the case, as do theassessors with the judge in the Wreck Commissioner’s Court.A correspondent writing to us apropos of Mr. Benthall’s paper-and who, we may say, is not a referee under the Act-tellsus the following story. Recently after giving evidence in a..

county court case he came back to town in company with thecounsel for both defendant and plaintiff, to each of whom hewas known. These legal gentlemen pointed out that in theiropinion the profession would not be satisfied with the

judgments of the present medical referees, for they aregenerally in practice in the neighbourhood, not as consult-ants, but as general practitioners in opposition to those onwhose opinions they have to give judgment. Our correspon-dent adds that he has heard from various medical men thata professional opponent has made capital out of the fact thathe is a medical reteree and, moreover, that many medicalmen who are referees under the Act, finding no par-ticular work under the Act, are acting for solicitorswhose practice lies in taking up workmen’s claims. Thesemedical men may override the opinions of other practi-tioners in the district on the strength of being medicalreferees. To return to the opinions of the barristersalluded to above, they con-tiered that medical assessors.should be appointed who should be consultants, that a,medical certificate should be sent with notice of claim,.

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and that such certificate should be paid for, not by theclaimant, but by the Home Office. The whole matter is oneof considerable difficulty, and we shall recur to it.

SANITARY PRECAUTIONS IN POPLAR.

MR. F. W. ALEXANDER, the energetic medical officer of’health of Poplar, has issued a notice to the medical practi-tioners of Poplar and its immediate neighbourhood pointingout that it is most desirable that special attention should bepaid to all persons arriving from Portuguese ports who maybe brought under their attention in any stages of illness, butespecially in early stages. Directions accompany thiscircular for obtaining and sending material for bacterio-

logical examination and a reminder is added that cases ofplague will be received into the Metropolitan Asylums Boardhospitals upon the forwarding of a certificate, as are otherinfectious diseases. Plague will be made a notifiable disease’from the commencement of the year 1900. Mr. Alexanderhas also caused to be distributed among lodging-housekeepers postcards to be filled up and sent to him givingnotice of any lodger from suspicious ships. We are glad tosee that the Poplar Board of Works have, upon the re-

commendation of the medical officer of health, passed thefollowing resolution :-

"That the various sanitary authorities in London be askedto point out to importers and wholesale dealers in condensedmilk in their districts the desirability of having bad con-densed milk destroyed or removed by the local authority astrade refuse to prevent the possibility of its being sold forthe purposes of human food."

’If the importers and wholesale dealers honestly carried outthese recommendations-and we think that in most cases, if.not all, that they would-the business of scoundrels like

Daley and others upon whose conduct we have commentedwould rightfully suffer.

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THE ROYAL BERKSHIRE HOSPITAL.

THIS eminently useful institution having reached the-sixtieth year of its age has unfortunately fallen upon eviltimes as regards its finances. The annual expendi-ture exceeded the income by some 1500 and henceit was felt that a special effort must be made.The Chairman, Lord Wantage, had the pleasure of Iraising .66000 by a personal appeal which he made to

Berkshire and the surrounding counties, but more

remained to be done, so a festival banquet was organised byMajor Thoyts, the senior vice-president of the hospital. The

=banquet took place upon Dec. 5th under the presidency ofH.R.H. Prince Criristian. About 150 persons sat down. The

President, in proposing the toast of " The Queen," announcedthat Her Majesty had given .f:25 as a special donation tothe funds of the hospital. Sir A. D. Hayter, in proposing’’ The Navy, Army, and Reserve Forces," made a feelingreference to the presence of the son of the President at the

front, and then Mayor Thoyts referred to the financial

position of the hospital. They required, he said, an

additional .S1500 a year to put them on a sound financialbasis. Mr. E. H. Simmons then announced that Lord

Wantage’s appeal had raised .f:6000 in donations and .f:270in increased annual subscriptions, while the proceedsof the dinner amounted to S6144 18s. 6d. in donations andnew or increased subscriptions to the amount of 450 6s.,being a grand total of about .612,865. This, we think, is a

very generous response and the stewards and Lord Wantageare to be greatly congratulated. A county hospital is an

institution which if well conducted is of inestimable

value, and the Royal Berkshire Hospital does excel-lent work. In this connexion we may mention thatwe have just received the report for 1898-1899 of the

Reading Pathological Society, which dates from 1841. The

resident medical officers of the hospital for the time beingare ex. offic’io members of the society. Meetings are held everymonth with the exception of August, and at the annual

meeting an oration is delivered by some leader of the pro-fession. This year the orator was Dr. J. F. Goodhart whochose for his subject Uric Acid.

TABES DORSALIS.

C. L. DANA 1 considers that tabes dorsalis is a primaryatrophy or disease of the neuron, and not the resultof a spinal meningitis. As a fact meningitis is not

always present, and even when present it cannot bemade to explain such phenomena as the Argyll-Robertsonpupil. He maintains that acquired syphilis is the chiefmorbid factor in the production of tabes, and that

among the accessory causes are neuropathic heredity andoverstrain of the spinal cord by indulgence in excessivemuscular exercise, &c. After referring to the usual

symptoms of the pupil, knee-jerk, &c., he discusses the lessusual methods of onset, which occur in 10 per cent. of cases,and among these he mentions such phenomena as rectal,neuralgic, laryngeal, and gastric crises, optic atrophy andarthropathies, and manifestations of secondary syphilis whichgradually merge into tabes. Among early symptoms of import-ance are areas of anaesthesia and analgesia, the latter beingamong the earliest. Such areas of anaesthesia are found oncareful examination, and their position and distribution havealready been minutely studied and recorded by Muskens.The symptom of Biernacki, or cubital analgesia,2 a pheno-menon which is of frequent occurrence in general paralysisof the insane, is also met with in tabes dorsalis. There is alsoa lack of sensitiveness to pressure on the popliteal nerves.The abdominal reflexes are present when the knee-jerk isabsent, and the existence of ataxia revealed by extremetests-e.g., standing on the toes-is another early featureof note. For treatment Dana recommends mercury andiodide of potassium in cases with a syphilitic history, alternat-ing with tonics in the form of iron and phospates and strych-nine. A more strictly tonic treatment is recommended in

non-syphilitic cases. Dana has also obtained good results bythe use of Fraenkel’s method of treatment. He thinks thattabes dorsalis is distinctly amenable to treatment and that

, it is sometimes arrested and very often relieved.

OUTBREAKS OF FIRE IN COLD WEATHER.

A VERT remarkable succession of destructive fires

occurred in the metropolis at the latter end of last weekand in the early days of this week. Close on midnighton Friday, Dec. 8th, the printing and other machinery ofTHE LANCET, which had not yet completed the week’sissue, was involved and considerable damage was done,a large portion of the issue being destroyed. This

fire, near the Strand, was of serious magnitude andwas followed on Saturday by an enormous conflagrationnear King’s-cross in which several large timber-yardswere destroyed. Further fires hardly less in magnitudeoccurred on the following Sunday and Monday andat one time the whole force of the Metropolitan Fire

Brigade was in action. It surely is remarkable thatthese fires should have occurred within a few hours ofeach other, the first having started at a time exactlycoincident with the onset of a " snap " of very cold weatherwhen dry, keen easterly winds and frost commenced.At the time of going to press we learn that over

80 alarms occurred in London in four days. Webelieve that this is not the first time that this curiousrelation of cold weather to the outbreak of an epidemic

1 Medical Record, Nov. 1st, 1899.2 THE LANCET, March 18th, 1899, p. 783.