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may produce in the children of gouty parents, without any or-dinary gouty symptoms. I have had two cases lately in mypractice which illustrate his remarks so well that I cannotforbear from quoting them. A Mr. H- came to me

suffering from chronic eczema and psoriasis. He attributedit himself to the great changes of temperature and profuseperspirations incidental to his business. I put him onarsenic and afterwards on iodide of potash, without muchbenefit. He told me that he had never had any goutysymptoms in his life. Shortly afterwards his marrieddaughter, Mrs B-, consulted me on certain intense painsin her eyes, accompanied by temporary congestion andpartial hlindness, which attacked her whenever her digestionwas deranged. Recognising this to be a gouty simptom, andbethinking me of the obscure skin disease which liffiictedthe father, I made somewhat minute inquiries into the pre-vious family history. I then found that the grandfather ofMrs. B- and the father of Mr. H- had been a martyrto gout for many years, and had eventually died of a formof Bright’s disease, which I have no doubt from the descrip-tion was the "contracted granular kidney" so intimatelyassociated with gout.These cases are, I think, interesting as showing the

protean character of the disease, extending over three gene-rations. The grandfather was thoroughly gouty ; the fatherhad skin affections without any other gouty symptom ; thethird generation exhibited eye symptoms and nothing else.I may mention that both cases improved rapidly uponcolchicum and alka)ies.—Yours sincerely,

- - - - --

Southsea, Nov. 24th, 1884. A. CONAN DOYLE, M.B., C.M.

NORTHERN COUNTIES NOTES.(From our own Correspondent.)


OUR mayor has published a letter he has received fromMr. John Hall of this city, in which the latter states thatseeing the sum of d610,000 is likely to be required for theextension of the infirmary, he will with pleasure con-

tribute £ 1000 to the object, and at the same time he makesthe sensible suggestion that the work should be carried outnow, when so many are out of employment and material isso cheap. A statement has been going the round of ourpapers contranting the rate of increase in the legal andmedical professions during the last ten years; and it ispointed out that whereas the ranks of the law haveincreased at the rate of 17 per cent. those ot the medicalprofession have been augmented only at the rate of 3 percent. These figures may hold good in a general way, butscarcely in particular instances. In Newcastle and its vicinity,for instance, there has been a marked increase lately in thenumber of medical practitioners; indeed, it is a generalremark that we are over-stocked, and in this way it may bequestioned if a medical school in a moderate-sized provincialcity is an institution to be desired by the resident practi-tioners as an unmixed blessing.


The Duke of Northumberland has in the most generousmanner made an offer which is little other than a gitt to theNorth Shields Corporation of an important portion of landfor the purpose of forming a public park on the Tynemouth-road. The Duke has at the same time urged that the pre-sent was a most opportune time for laying out the land andgiving employment to a large number of people.


At a special meeting of the Durham Town Council latelyheld in connexion with the small-pox epidemic it was statedthat the town was not nearly so bad as represented, and thatthe disease would soon be stamped out. That the epidemicis bad enough is evident from the fact that there are thirty-four cases in the hospital just opened. It is cettain, also,that small-pox cannot be stamped out by the distribution ofhandbills, however useful in their way. A correspondentpoints out that the police ought to endeavour to repressJuvenile ignorance and temerity in riding behind the car-riage used to convey the small-pox patients to the hospital,that he was distressed to see so many children gatheredtogether at a passage end to see a patient brought out, andon making inquiry he found that there were no fewer than

five cases down the same passage, and he asks, " Can it bewondered at that the disease is spreading ? "


At the usual monthly meeting of the Wallsend LocalBoard last week Dr. Henry Aitchison, the medical officer,reported that the death-rate for the past month was equal toan annual rate of 39 per 1000. Fully one-half of the deathsreported was from scarlet iever of a malignant form, whichwas still epidemic.


I mentioned in a previous communication the success ofthe Rev. Moore Ede, Rector of Gitteahead, with his systemof cheap meals for school children. He has now furtherdeveloped his method so as to provide cheap meals for theworking classes. The foundation of his system is" Nocharity, no pauperisation," therefore nothing is sold undercost price ; nevertheless, he has found that, owing to economyof fuel and labour, as well as to the larger amount ofnutriment extracted by the cooking apparatus employed,he can supply excellent nutritious soup at the price ofordinary soup kitchens-viz., one penny per quart. Thenumber of dinners has increased from half a dozento 100 per day, and the demand for soup and otherarticles for home consumption is daily increasing. The fol.lowing is an example of the bill of fare :-Pea-soup, lentil-soup, potato stew, and raisin pudding. Wholemeal bread issupplied at the rate of fourteen ounces for ld. in fact, agood meal for a working man with a hearty appetite is sup-plied for 2d., including stew or soup and pudding. As tothe economical aspect, Mr. Ede gives his figures, whichshow that since the commencement of the experiment theamount spent on materials was .E24 14s., while the receiptswere E32 13s. 4d., leaving as a balance E7 19s. 4., con-siderably more than was required to pay wages and gas forheating, so that by the end of the year he hopes to have ahandsome balance to hand over to the Distress Relief Fund.Newcastle-on-Tyne, Nov. 26th.


(From our own Correspondent.)


THE opening meeting of the Medical Section took placeon the 21st inst. at the College of Physicians, whenDr. Cruise, President of the College, delivered the inauguraladdress. He principally referred to the conflict which

occasionally took place between law and medicine, anddwelt at considerable length on the loss of time and moneyoccasioned to practitioners for attendance on patients whoseaffairs were relegated to the Court of Chancery. Dr. Cruisegave several typical cases illustrative of the hardship he hadsuffered, and where fees in some instances were altogetherlost or reduced hy the taxing master, and said that for suchtreatment medical men practically had no redress.


The new scheme of education and examination for thediploma in Surgery of this College has now been in operationfor some time, and the longer it exists the more it is dislikedby all who have to do with it. There is a very large sectionnot alone of Fellows but of the Council who now consider itan ill-advised scheme, and one which will require to beamended very matenally before the principal objections to itcan be removed. I am confident a large number of thosewho voted for it formerly would now oppose it if broughtforward, and it is a subject of considerable regret that thescheme as it at present stands was ever introduced. Severalcandidates for the Second Professional Examination havingbeen stopped in October last, they recently petitioned theCouncil for a supplemental examination; and this theCouncil at a meeting held last week have granted. Theexamination will take place in March next, and thecandidates will be allowed credit for the various lecturesand hospital they may take out this session. I may addthat of forty candidates for this examination in October, noless than twenty-two were rejected.


This gentleman, who was resident physician to Cork-streetFever Hospital, Dublin, died last week after a short illness



from malignant scarlatina, aged thirty-five. Dr. Maturinwas formerly surgeon-superintendent of the EmigrationDepartment, New Zealand, and afterwards surgeon to theRtd Cross Society, Rmso-l’urkish War of 1877-78. Skilfuland kind, his untimely death is much regretted by a verylarge circle of friends.


It is rumoured that Sir John Lentaigne, an unpaid mem-ber of the board, has recently sent in a report to the LordLieutenant, in which he suggests a board without the intro.duction into it of a medical member, and contrary to therecommendation of the Royal Commission. On the otherhand, another member, Mr. O’Brien, who does not belongto the medical profession, is of opinion that an independentmedical gentleman should be a member of the Irish PrisonsBoard, and not merely an official under it.


The coroner, Dr. Whyte, recently applied to the Corpora-tion for an increase of salary-viz., from jE500 to j6600 a year,but the application was refused to be entertained. Lastweek, before Mr. Justice Johnson in the Queen’s CourtDivision, Dr. Whyte, through his counsel, applied for theincrease. An objection was lodged that sufficient notice hadnot been given, but ultimately this was waived. Mr. JusticeJohnson said the Act provided that when the Corporationand the coroner could not agree as to the amount of salary,the coroner should refer the matter to the Chief Secretary,and as that had not been done the Court could not interfere.Later in the day it was suggested that the Corporation mightconsider the propriety of granting a sum as salary for a clerk,but as it was too late for the present city presentments, thematter fell through.


The Corporation have adopted a report of the PublicHealth Committee in reference to the nuisance caused bythe discharge of sewage into the Liffey. Pending the carry-ing out of a system of main drainage the committee are ofopinion that the only way of completely abating the nuisanceis the scavenging of the river bed during the summer months, ’,and the more effective employment of disinfectants. Theyrecommend the annual grant for that purpose to be increased


from 200 to 500. The expenditure of 9200 last summerhad no effect in abating the intolerable stench, and it isdoubtful if the larger amount will produce a better result.Dublin, Nov. 25th.



(From our own Correspondent.


THE annual meeting of the subscribers of this deservingcharity was held on Monday, Nov. 17th. From the reportwe gather that during the year 2181 intern patients have


been treated, being an increase of 182 over last year, and con-siderably in excess of the number ever before treated in thehospital. There were also treated 11,765 extern patients,showing an increase of 1201 on last year. The intern andextern cases together number 13,946. Clinical instructionhas been given in the wards to 168 students during the winter,and to 88 during the summer session. Lord Ashley hasbeen elected President of the hospital in place of thelate Marquis of Donegal. During the year the sum of£533 12s. 3d. has been received from sixty-one churches, thissum being 913 8s. 6d. less than the amount contributed theprevious year. There is also a slight falling off in the generalsubscriptions during the year. The donations and bequestshave also decreased, the sum being £899 12s. 6d. less thanthe previous year. The two cheering features in the accountsare the continued increase in the subscriptions of the work-ing classes and the result of the Hospital Saturday movement.Last year the working classes increased their subscriptions bythe sum of £580 16s. 2d. This year there is a further increaseof ;jE680 14s. lld., bringing up the total contribudons of theworking classes to £1692 3s. 7d. From the efforts madeon Hospital Saturday a sum of £529 15s 9d. was raised.The total expenditure on the hospital for the year was£8051 lls. 7d., and notwithstanding all the efforts put forth,there is a deficit of £1791 10s. ld. During the year severalof the wards of the hospital have been refloored and refur-nished, and at present, through the munificence of Mr. Robert

Danville, D.L., several other wards in the centre of the hos-pital are being refurnished, while Mrs. Dunville is most

generously fittiDg up new rooms for the out-patients in con-nexion with the department for the diseases of women., The Grand Bazaar and Fancy Fair in aid of the Royal Hos-pital was opened on Thursday. The main ball was trans-formed into an ambulance encampment, the tmts being used’as stalls for the sale of goods, while in the annexe marqueethere was a great variety of entertainments. In the minorhall the private theatricals were largely attended. There isto be a fancy dress ball on Tuesday, Dec. 2nd, in coii-nexion with the hospital bazaar. It is---hoped that by theefforts put forth at the bazaar a large sum of money will beraised for the hospital, and that the present debt will bemuch more than extinguished.


The want of an institution of this kind for women havingbeen experienced in Belfast, a hospital to supply the needhas been opened in Regent-street, and is now ready for thereception of patients. It is intended for those who are ableand willing to pay for the accommodation, and w4o, if theyso desire it, can be attended by their medical adviser. Allkinds of accidents and diseases except infectious cases will; be received. The careful nursing and diet with the privacyof their own homes are advantages. which will be eagerlysought after, and it is confidently expected that the applicantsfor admission will be very numerous.


The present winter session began in the first -week ofNovember, and the classes at the College and the cliniquesat the hospital are now in regular working order. Theopening meeting of the Queen’s College Literary and Scien.tific Society was held on the 21st inst., and the CollegeMusical Society will shortly give their first concert.


I am sorry to have to announce the death of this mem-ber of the profession, who for a period of sixteen years helda dispensary appointment in Belfast. Dr. Martin was a manhighly respected by his patients, and for his public appoint-.ment a very active canvass is being made.


The first meeting of the above Society for the’present,session was held on Nov. 11th. The retiring president (Dr;Dill) having given a short address, the incoming president(Mr. John Fagan) read a very interesting and practicalpaper. The annual dinner took place on Tuesday evening.


(From our own Correspondent.)


THE cholera epidemic in Paris is decidedly on the declineas shown by the official reports daily published, which Ineed not trouble you with. I may, however, transcribethose for the last three or four days to give your readers anidea of the course of the epidemic :-

These figures comprise the admissions and deaths in townand in the hospitals. On the evening of the 21st therewere 274 (168 males and 106 females) choleraic patientsunder treatment in the hospitals. On the 22ud thenumber was reduced to 221. On the 24th therewere 2 deaths in town and 6 in the hospitals; butthere were no fresh cases reported, as the bulletins haveceased to be published. It has already been brought tonotice that the ill-fed and intemperate were the readiestvictims of the disease. In a report by Dr. Watelet, whowas deputed to inquire into the origin of the cholera m theAsylum for the Aged in the Avenue de Breteuil, this phy-sician declared that he could not trace its origin, but that.the rapid spread and fatality of the disease among itsinmates were probably due to unwholesome food, and as thisconsists of the remnants collected from the different hotelsand restaurants, the possibility of the food thus obtained