1596

selling milk containing an unusual proportion-say 20 percent.-of cream 1) Four cases of this kind occurred recentlyart Birmingham. In two of the cases tincture of iodine wassold containing 150 per cent. of iodine and 50 per cent. of.potassic iodide in excess of the quantities set forth by theBritish Pharmacopoeia; in the other two cases samples pur-porting to be tincture of aloes contained 40 per cent. of solidingredients and 50 per cent. spirit in excess of the formula.With the exception 0 one case-viz., that of aloes, in whichit appeared the inspector purchasing the samples had enteredit as "compound tincture "-fines were inflicted and costsimposed. It is not probable in these particular instancesthat any harm would have resulted despite the greatexcess of ingredients found on analysis by Dr. Alfred

Hill, the medical officer of health ; but if the same

laxity had been extended to other drugs the results might.obviously have been very serious indeed. The majority ofthese offences are probably committed when a purchaserbuys drugs on his own responsibility, and not when he isunder the direction of a medical adviser. On the whole the

record of offences of this sort, on the part at any rate ofrespectable chemists and druggists, is a very satisfactoryone; theirs is a business which requires constant care, and no- one better than themselves know it and realise it. Still,the cases which do occur from time to time should not

escape the notice of the medical profession, who should,therefore, keep a constant watch and some sort of check onthe medicines which druggists make up for them.

A CASE OF TRICHINOSIS.

A CASE of trichinosis is reported by Dr. Edgar Garceau of 1Boston in the Boston Medical and Surgical Journal ofNov. 21st of this year. Apart from the rarity of the diseasethe case presents several points of interest. The patient wasa German thirty years of age. About the end of March he ,te some smoked ham. Many of his friends who also atesome of the same ham were taken violently ill the day afterwith severe vomiting and purging, but they all eventuallyrecovered. He himself was not taken ill at once, which facthe thought was accounted for because he ate only a verysmall piece. For two weeks, however, he felt ill, com-

plaining chiefly of backache and pain in the limbs. Whenseen on April 12th the muscles of the calves of his legs andof the arms and back were sore. The bowels had

been regular, and there had been no symptoms of intestinalirritation. On examination a few red spots were seen onthe abdomen, which disappeared on pressure. The spleenwas of normal size. The temperature was 103.5°F. The facewas red, the eyes bulging in the sockets, and the conjunctivaered and swollen and raised above the level of the corneae.

The next day he was worse, and he passed three very loosestools, watery, and of pea-soup consistency. The following daythere was vomiting, the temperature was 1040, and the voicehusky. He gradually grew weaker and died on April 17th. Onlya partial necropsy was allowed, but no difficulty was experi-enced in demonstrating the characteristic trichinae. At the

early stage of the case the diagnosis and the resemblance toenteric fever was remarkable. The prodromata of malaise,backache, and pain in the limbs, the gradually rising tempera-ture. the characteristic typhoid stools, and the rose-colouredspots all suggested enteric fever as the probable diagnosis.The pains in the limbs, however, became so severe that

morphia had to be administered for their relief, and then thediagnosis of trichinosis was more assured. We have, there-fore, the history of the case and the period of incubation(two weeks) during which time the trichinae were migratingfrom the intestines to the muscles. If the patient had eatena good deal of the ham it is probable that he would haveescaped, as the others did, by the violent vomiting andpurging. Dr. Garceau suggests that a cathartic should be

given in future doubtful cases to clear out the parasites. In

this patient’s case all the trichinae swallowed had a chanceto propagate, and the number so propagated may be inferredwhen it is said that a single female trichina may producemore than a thousand embryos. The ocular symptomswere suggestive ; the nedem:), of the conjunctivae was verymarked, and was the first symptom which aroused suspicionas to the nature of the case. The implication of the

laryngeal muscles, as evidenced by the husky voice, was alsocharacteristic.

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THE "SUN" AND CHARGES AGAINST AMEDICAL MAN.

ON Thursday, Dec. 12th, the case of Ady v. Cadett camebefore Mr, Vaughan. Mr. Cadett is a journalist, who, itwas alleged, had published a defamatory libel in the columnsof the Sum upon one J. C. Ady, a medical man. Mr. Adyhaving been cross-examined, Mr. Vaughan stopped the caseand dismissed the summons. As we believe further pro-ceedings are pending we refrain from any comment.

MUSCULAR ATROPHY AND GENERAL PARALYSIS.

Ix a recent number of the Miinchener Medicinische Wochen-

schrift Dr. Riebeth publishes a case of which an abstractappears in the Neurologisches Centralblatt. The patient hadgonorrhcea in 1884, but had not apparently had syphilis.His nervous symptoms began in 1893, and consisted of

weakness, giddiness, noises in the ears, and inability to

work. There were also considerable excitability occasionallyverging on violence, an indifferent manner and emotionaltendency. He was found to have unequal pupils, loss of

reaction to light, absent knee-jerk, articulatory disturbance,and impairment of intelligence. After his discharge therewere increase in his psychical symptoms, diminution in

his appreciation of pain, and other disturbances of sensi-

bility. In March, 1894, the triceps and trapezius on eachside were found to be wasted, and this wasting graduallyincreased, so that at the end of May, 1894, there was muchatrophy of the right trapezius and latissimus dorsi, and ofthe pectorals and triceps on both sides. There was slighteratrophy of the left trapezius and of the serratus, rhomboid,deltoid, and infra-spinatus on the right side; while in theleft latissimus, the flexors of both forearms, the rotators ofthe upper arm on the right side, the right supra-spinatus, andthe abdominal muscles the atrophy was very slight, butdistinct. In these muscles there was diminished responseboth to faradaism and voltaism. It is evident that in thiscase there was first affection of the posterior columns with adisturbed cerebral state, while the condition underlying themuscular atrophy developed later. The condition somewhatresembled that in the juvenile form of muscular dystrophy,but here the muscular atrophy probably depended uponchanges in the spinal cord.

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HUNTINGTON’S AND CONGENITAL CHOREA.

AT the recent meeting of the Vienna Tereinfitr Psychiatric1/ond Neurologie Dr. von Solder showed a case of Hunting-ton’s chorea. The patient was a woman fifty-two years ofage who became affected with chorea seven years previously,but her intelligence was still good. The eye muscles,contrary to the usual rule, took part in the contractions.

Speech was much interfered with, and there was but littlevoluntary control of the choreic movements. These, how-ever, ceased during sleep. There was considerable muscular

weakness, and the reflexes were distinctly increased. The

patient was the granddaughter of a woman who becamechoreic at the age of fifty and died in her fifty-thirdyear. Of her seven sons, all (including the father of

1 Neurologisches Centralblatt, 1895, p. 1149.

1597the patient shown), except the eldest, suffered fromchorea about the fiftieth year. The patient had four

sisters, and of these one suffered from chorea at the ageof forty-nine, while two others were mentally affected. A

son of the patient was healthy. Another case was also

shown, one of so-called chronic congenital chorea " in agirl aged sixteen. The contractions were noticed immedi-

ately after birth, and the patient did not begin to walkuntil she was four years old, and it was only at the ageof eight that she could walk alone. She was also late in

speaking. She used her hands with difficulty, but her

condition showed a slow but gradual improvement. Volun-

tary movement increased the contractions. The knee-jerkwas slightly increased, but with the exception of a smalldegree of weak-mindedness the general condition was

fairly good. The case, according to Dr. von Solder, is

really one of cerebral diplegia, and, as was recently pointedout in our columns, this is almost invariably the actualcondition in cases of so-called congenital chorea ; so that

the term is probably a misnomer, and the movements

would be more correctly described as those of athetosis.

DR. RENTOUL explains in a circular that his opposition tofive successive Bills since 1890 has cost him, " out of his ownprivate means," ;E321 15s. 9d. Dr. Hugh Woods establisheda fund to repay Dr. Rentoul, and succeeded to the amount of.E50. Mr. Colin Campbell succeeded in the same way to theamount of £30. In 1894 the branch committee of theLancashire and Cheshire Branch refunded him E37 17s. 2d.These sums amount in all to E117 13s. 21/2d., leaving him still.8204 2s. 6d. out of pocket.

THE death, on the 17th inst., is announced of Mr. DanielAmbrose, M.D., Q.U.I., L.R.C.S.I., &c. Dr. Ambrose was

member of Parliament for South Louth. He belonged tothe anti-Parnellite party, and at the last General Electiondefeated another medical man, Mr. J. G. Fitzgerald.

WE regret to hear of the death of Dr. Fauvel, of Paris,whose reputation as a laryngologist is of world-wide fame.

His work on Tumours of the Larynx is one of the standardworks on thf subject.

THE ASHANTI EXPEDITION.

VERY great activity has been displayed on the Gold Coastin disembarking stores and in preparing for the advance ofthe troops on Kumasi. One of the main difficulties in the

present expedition, as on the last occasion, has been thetransport. There is no animal or vehicular transport in thecountry, and everything has to be carried by native bearers.Great care has been taken in providing and organising asnfficient force of these, and the transport work went on verysatisfactorily as far as Mansu, but owing to the difficulty inprocuring food in the country beyond, and the desertion of anumber of the native carriers, a block occurred from theaccumulation of stores at that station. This will, however,soon be overcome. As in our Indian warfare, and followingthe course adopted in the last Ashanti campaign, rest

camps have been provided along the line of route. Eightof these have been constructed, and a field telegraph will becompleted between Cape Coast Castle, which is the base, andPrahsu. The postal service which has been organised betweenthese stations is working well. The distance, it may bementioned, of Prahsn from the base is about eighty miles.A pontoon bridge is being constructed over the Prah, but thework is temporarily delayed pending the arrival of requisitematerials, and cannot be completed for many days. Threecanoes, each capable of carrying thirty men, have been con-structed for the passage of the river.Meanwhile a hospital for the troops is being provided at

Connor’s Hill, which will afford accommodation for fiveofficers and seventy-five men, and a bearer company of 600

men has been organised for the transport of the sick. Weare-not told, by the way, what the means of transport of thesick and wounded will be, whether stretchers or canvas cotsor hammocks from the naval ships, or all of these. Surgeon-Captain Eckersley has started to provide for the establish-ment of a hospital, at Prahsn for the troops on the march. Inaddition to the land hospitals at the base there will, ofcourse, be the large amount of accommodation afforded bythe floating hospital, the Coromandel, which has been spe-cially fitted up for the purpose ; and with the steam trans-ports and other communications between the Gold Coast andthis country there should be no difficulty in arranging for

the transit of invalids., Whilst preparations are being made for the advance of theforce along the line of route from Cape Coast Castle acrossthe Prah to Kumasi, a movement is also to be made con-

temporaneously with that of the expeditionary force fromthe coast, from the north, by a large force of constabularyand a detachment of Houssas and two Maxim guns. Thislatter force will, it is understood, proceed to the Nkoranzacountry, and thence threaten, and advance if necessary,on the Ashanti capital.The subordinate chiefs in the interior of the colony are-

understood to be very favourable to the expedition, and haveproffered their services and large detachments of bearers.

Samory, the Mahommedan chief of a large warlike tribe inthe vicinity of Ashanti, who has a powerful army, is under-stood to be also favourable to the British enterprise.The belief entertained on the Gold Coast is that the chiefs

of the Ashantis are determined on fighting. It is rumouredthat Prempeh will be deposed and replaced by his mother, awoman of fortitude and masculine character, who is stronglyinimical to the whites. Be this as it may, the expeditionmay have to encounter some unforeseen difficulties and hardfighting before the troops succeed in capturing the Ashanticapital. The topographical difficulties and dense bush forobvious reasons offer very favourable conditions for Ashantiwarfare. The country is well adapted for raids and surprisesand sudden attacks from numerous small and concealedbodies of men.The health of the troops on the Gold Coast is reported to

be excellent. The present season is favourable in this respectfor the expedition, which cannot, however, it is believed,start for Kumasi for some time. We hope that when it doesstart the march to the Prah may not be protracted by anydefective arrangements or other obstacles, for the countryand bush are very malarious, and that when the expeditionhas accomplished its work by penetrating to the capital andsecuring its political objects the force may effect its returnmarch before the rains set in. In that case there is no reasonto suppose that the risks to health and life should prove-greater than on the occasion of our last war with Ashanti.Everything depends upon the exercise of forethought in

providing for the requirements of the force and in safe-guarding their health, as far as practicable, by good sanitaryarrangements. The previous experience of those who haveto conduct the arrangements in these respects affords thebest guarantee that we can have of their being properlycarried out.

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ROYAL COLLEGE OF SURGEONS OFENGLAND.

AN ordinary meeting of the Council was held on the12th inst., the President, Mr. Christopher Heath, being inthe chair.A further report dated Nov. 15th was presented from the

Board of Examiners in Dental Surgery. The chief recom-mendation was that an examination in mechanical dentistry,chemistry, physics, and metallurgy should form the first

examination for the licence. The report was referred to acommittee of the Council.

Dr. Arthur P. Luff was appointed an Examiner for Part I.of the Examination in Public Health.Two cases of alleged misconduct on the part of Members

were considered.The President stated that the Deputation Committee, at a

meeting held on the 2nd inst., had determined to furtherpostpone their report to the Council, as one of the subjectsreferred to their consideration had been selected by the