1743NOTES, SHORT COMMENTS, AND ANSWERS TO CORRESPONDENTS.

Notes, Short Comments, and Answersto Correspondents.

THE CARE OF THE FEEBLE-MINDED AND THE FUTUREOF THE RACE.

THE secretary of the Incorporated Lancashire and Cheshire Society forthe Care of the Feeble-minded writes to us to inform us that

although, as mentioned by our Manchester correspondent in his noteon the society which appeared in his letter published in THE LANCETof Nov. 18th, the balance at the end of September was nearly ;M20,according to the accountant’s statement, yet that this balanceincludes cows, pigs. and sheep which are not available as cash. The

cash balance at the time of the meeting was £10 and this has nowbecome an adverse balance of £100 The society therefore is muchin want of funds. The secretary says that the society has a numberof boys working on the farm who have reached the age of

16 years and accordingly no further grants are available forthem. She adds: "We have the satisfaction of knowingthat they are not unemployed, nor paupers, nor criminals;nor-which would be worse than all-fathers of families." We maymention in reference to this remark that we have received a com-munication from a correspondent founded upon a statement whichhe attributes to Professor Karl Pearson : "The one safeguard againstthe multiplication of the unfit lies in a selective death-rate. Wehave provided unlimited medical comforts and housing for the

physically unfit and for the rogue." Our correspondent goes on toillustrate his argument by three hypothetical newspaper reports ofthe future. The first deals with a member of the Peculiar Peoplewho is charged with administering medicines with the wilful intentof prolonging the life of his child, he himself and the child belongingto "the unfit." The second describes how a celebrated surgeon was

charged with prolonging the life of a patient suffering from appendi-citis, not caused by accident, and the third deals with a publicanwho is summoned for not serving the Jane Cakebread of the timewith drink when she was already drunk.Of course the point raised by Professor Pearson and elaborated by

our correspondent is not new and it is perfectly true to argue thatthe race would be far stronger physically, and possibly mentally, ifthe unfit were to be eliminated, either by allowing disease to runrampant or by the ancient custom of exposure of unhealthy infants.But civilisation, to say nothing of Christianity, has decreed that theweaklings should be preserved. And if every weakly child had beenkilled at birth, or allowed to die from disease without any care beingexpended upon it, how great would have been the loss to the worldof art in general, and in a few cases at least, at any rate as concernsour own country, from an Imperial point of view. The name ofWolfe will occur to everyone, and Wellington was, when at Etcn,"of a rather weakly constitution." That the diseased and the weak-minded should be prevented, as far as possible, from reproducingtheir like may be desirable, but at present it does not seem to be"within the bounds of practical politics."

GARBAGE.

AT Worship-street police court on Dec. 5th Messrs. Lipton, Limited,were summoned for having on their premises carcasses of pigs whichwere unsound and unfit for human food. The dealer who sold the

pigs the carcasses of which were seized said that he paid top pricesfor them. Mr. Cluer is reported as saying that this was certainly acase where the employer must suffer for the fault of his servant,and he imposed the full penalty of B50 and 20 guineas costs.

A QUESTION OF PRECEDENCE.To the Editors of THE LANCET.

SIRS,-I am more than half ashamed to air a grievance on the subjectof dignity and I am pusillanimous to the degree of requesting to beveiled in the cloak of anonymity; for my grievance is against thataugust body, the Royal College of Physicians of London, and I :standin awe of their dread Censors who hold fate in each hand. Whyshould their Licentiate Diploma in official communications take prideof place over the Membership of the College of Surgeons ?Nearly a quarter of a century ago my heart swelled with wholesome

pride that I had been able to achieve the honour of Membershipof the College of Surgeons, but my pride was partly neutralisedwhen it was necessary to couple with this honour the lessglorious title of Licentiate and it has always been a sneakinggrievance that the minor sounding permissive title of "Licentiate"should take precedence of " Member," which to the ordinaryintelligence suggests a position of more responsibility and dignity.It is, of course, true that there are three grades of titles associated withthe College of Physicians and it was convenient to give the lowestgrade the title of Licentiate. In ancient days the physician was agreat and important personage and the chirurgeon was a mere shedderof blood and setter of bones, a humble servant of the learned physician.In these days, however, there are men bold enough to claim some

, measure of equality for the surgeon and in a few more yearswho shall say that there will be any occupation for the poor

I physician, for most of the organs will be excised by the surgeon

before he is called upon the scene. Under these circumstances,caused by increased knowledge and increased responsibilityrequired by men practising surgery, is it not time that some

change should take place in the relative position of the two greatbranches of the profession ? As a small indication of this, might it notbe possible for those who possess the two ordinary qualifications ofM.R.C.S. Eng. and L.R.C.P. Lond. to have these titles expressed in theorder of apparent relative importance ? There may be others like

myself who are specially associated with surgical work and for variousreasons have not been able to take the Fellowship who would feel

gratified if the surgical diploma could be placed first in officialdocuments. This is, perhaps, not a very serious matter but it may beworthy of consideration. I am, Sirs, yours faithfully,Nov. 27th, 1905. L.R.C.P. LOND., M.R.C.S. ENG.

THE LONDON TEMPERANCE HOSPITAL AND TEMPERANCESTATISTICS.

To the Editors of THE LANCET.

SIRS,-The " paucity of argument " which Dr. A. H. Copeman ascribesto my last letter is easily explained. One cannot argue against ground-less vituperation, and I could only expose the disingenuous misrepre-sentations contained in Dr. Copeman’s letter. I am sorry to observethat instead of apologising for his misconduct he repeats it in his latestcommunication, in which he represents the board and medical staff ofthe London Temperance Hospital as glorying in their superiority to theboards and medical staffs of other hospitals. They have done nothingof the kind, but have honestly endeavoured on one particular methodof treatment to show a more excellent way than is commonly pursued.The charge involved in Dr. Copeman’s statement is one always ad-vanced against those who diverge from traditional routine. The fewwho are the pioneers of all reforms are invariably charged withpretending to be wiser than their predecessors.Dr. Copeman evidently wishes to convey the impression that the

board and medical staff of this hospital are banded together to carryout an idea at whatever cost to the patients. This is a monstrouscaricature of the situation. The board have in all cases selected theirmedical officers on professional considerations, trusting to their honourto conform to the rules of the institution Personal abstinence, thoughvalued, is not made a condition of appointment and at the present timeI am not aware that more than one member of our medical staff is atotal abstainer.Dr. Copeman concludes his letter by a question which is as reason-

able, or unreasonable, as if we were to ask whether the medical staffof University College Hospital had ever administered alcohol to anypatient when its use would have been beneficially dispensed with.

If Dr. Copeman is really desirous of obtaining correct informationconcerning the course of treatment pursued in the London Temper-ance Hospital he can procure it from any member of our visiting staffif he should propose his inquiries in the spirit and language of a

gentleman. I am, Sirs, yours faithfully,DAWSON BURNS,

Honorary Secretary, London Temperance Hospital.Hampstead-road, N.W., Nov. 28th, 191

A POINT OF DIAGNOSIS.

To the Editors of THE LANCET.

SIRS,-I have received a letter requesting information from a formerpatient of mine who now lives in a remote part of California. She wasa hospital nurse and therefore the details in the following statementcan be trusted. She writes as follows : " My sister, aged 49 years, has acondition of the gums that is most serious and no one seems able torelieve her. She has worn false teeth for 15 years and lately has hadgold plates to see whether they would be less irritating but with nobetter result. Small ulcers first form, then the gums become very red,a little swollen, very tense, and shiny looking, with tremendous

inflammation and great pain. This condition will last about four or fivedays and then get better gradually. She cannot use her teeth for abouta week. After some improvement in one night this dreadful conditionappears again."

I should be grateful if any of your readers can suggest a diagnosisand treatment. Is the condition one allied to herpes or is it due tosome parasitic inflammation? ? I am, Sirs, yours faithfully,Dec. 4th, 1905.

-,

ETONENSIS.

" SCARLET FEVER " IN CHILDREN AFTER BURNSAND SCALDS.

AT the Hackney coroner’s court on Dec. 2nd Dr. W. Wynn Westcottheld an inquest upon the body of a little girl, aged two and a halfyears, who had died three days previously in the Eastern Fever Hos-pital at Homerton. It appeared that a fortnight before her deaththe child had been left alone in a room where an unguarded fire wasburning; the mother, hearing screams, rushed to her aid and foundthat the velvet sleeve covering the child’s left arm wa3 ablaze; shewas stated to have been a left-handed child ; a flannelette petticoatwhich she was wearing at the time was not burnt. Shewas forthwith admitted into the North-Eastern Hospital forChildren and four days later, owing to a great rise in hertemperature and the development of a red rash upon her body,she was diagnosed as suffering from scarlet fever and was dealt withaccordingly. The skin of the left arm sloughed and bhe died onNov. 29th, said Dr. E. W. Goodall, from septieaemia and collapse, bothconsequent upon the burning. The coroner, in commenting on the

1744 NOTES, SHORT COMMENTS, AND ANSWERS TO CORRESPONDENTS.

improbability of infection by scarlet fever in this case, stated that hehad under his consideration a very similar case ten days previously,and that during the past ten years a score at least of these caseshad come before his courts; there was no blame to be attachedto the local medical practitioners for the wrong notifications, as

it was their duty to protect the public ii there occurred in a

patient signs and symptoms which indicated that there was even aslight chance of infection; nevertheless, expense and annoyancefollowed from their precautionary action, for the local sanitaryauthority had to disinfect the suspected children’s homes and theschool attendance officer had to prohibit any children in the affectedhouse from going to school.

THE TREATMENT OF CONVULSIONS IN INFANTS.

To the Editors of THE LANCET.

SIRS,-The usual treatment advocated and practised in convulsionsin infanta, which I have been in the habit of following myself. is toplace the infant in a warm bath, apply cold water or ice to the head,and administer bromides. This is no doubt effective in a certainnumber of cases; but very frequently it has appeared to me that itproduced very little immediate effect in the way of either relieving thecondition or preventing the recurrence of seizures. A considerablenumber of these cases are associated with, and I think produced by, ahigh temperature occurring at the onset or during the course of thespecific fevers, lung affections, or merely digestive disturbances. In

fact, in many infants any affection which produces a considerableelevation of temperature seems to fling them into a succession of con-vulsive seizures. A plan of dealing with these cases which seems to mea more rational proceeding is to place them in a tepid bath or, havinglaid them on a blanket over a mackintosh, to lavetbem freely with water,not too cold but with the chill just taken off, followed by a small doseof phenacetin, two or three grains. In a few cases in which I havetried this treatment recently it reduced the temperature and caused amore rapid disappearance of the nervous condition than I have seentake place after the more usual treatment of the warm bath, &c. Thismethod of dealing with such cases is no doubt known to many practi-tioners, but as there may be others who have not given it a trial, andas these cases occasionally terminate fatally, I have thought it worthwhile to draw attention to it.

I am, Sirs, yours faithfully,Nov. 28th, 1905. EDGAR R. IvATi’s, M.R.C.S. Eng., L.R.C.P. Lond. I

’

THE TREATMENT OF URTICARIA.

IN answer to a letter under the above heading which appeared inTHE LANCET of Sept. 30th last, in which " Puzzled Practitioner"asks for advice as to the best treatment for an intractable case ofurticaria with nocturnal pruritus which has resisted all the usualmethods of treatment, " R writes from New York: "For therelief of nocturnal pruritus in urticaria give, when going to bed,pilocarpin (dose, one-eighth of a grain to one-quarter of a grain).Pilocarpin is satisfactory in the pruritus occurring in jaundice andpresumably may be serviceable in pruritus from any cause."

DEFRAUDING THE BENEVOLENT IN THE NAME OF AHOSPITAL.

A WELL-DRESSED woman, 28 years of age, was sentenced to fourmonths’ imprisonment recently at the North London police court forobtaining money by pretending that she was a collector solicitingcontributions to hospitals. It w as stated that the secretaries of severalLondon hospitals had given information which had led to inquiriesand to her arrest. Her credentials appear to have consisted in her

plausible story and a book in which she entered the amount receivedin the presence of her dupe, a method very often adopted by personsof this class, who are usually able to show those who hesitate to givethat some neighbour has already contributed. The only peculiarityof the prisoner’s methods in this instance was a preference for personswith Jewish names, which led Mr. Fordham to observe, thereby con-firming the experience of many hospital treasurers, that the better-class Jew is proverbial for his benevolence.

NON-INFLAMMABLE FLANNELETTE.Mr. Charles Henry Whipp of 10, Aytown-street, Manchester, hassent us a specimen of " non-flam" flannelette which he claimsis practically non-inflammable and that, further, the substance

used in rendering it so is not washed out in the ordinarycourse of washing the material. We boiled the material in

water and in soap and water for several hours and at the endof the experiment we found no evidence of the metallic salt used

being dissolved out. Nor was the non-innammablo quality of thefabric diminished. On boiling with dilute hydrochloric acid tracesof metallic salt appeared in the liquid. This, however, is not thekind of ordeal that the material is likely to be submitted to in prac.tice. The contention is that the salt used actually combines with thefabric, and this would appear to be the case according to our experi-ments. The material is, of course, inflammable, but not with thatenergy and suddenness which make ordinary flannelette so dangerousan article of apparel.

THE SALE OF MEDICAL LITERATURE.

WE have received one or two replies to "Medico’s" letter, whichappeared in our issue of Nov. 25th, asking us for further information.Has " Medico " any catalogue of his library ?

M.B. is thanked for sending us an interesting extract from a local

newspaper. We cannot publish the article in our columns as it hasbeen published elsewhere, nor do we think that the error is one thatis likely to occur.

COMMUNICATIONS not noticed in our present issue will receive attentionin our next.

Medical Diary for the ensuing Week.OPERATIONS.

METROPOLITAN HOSPITALS.MONDAY (llth).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St.

Thomas’s (3.30 P.M.), St. George’s (2 P.M.), St. Mary’s (2.30 P.M.),Middlesex (1.30 P.M.), Westminster (2 P.M.), Chelsea (2 P.M.),Samaritan (Gynaecological, by Physicians, 2 P.M.), Soho-square(2 P.M.), City Orthopaedic (4 P.M.), Gt. Northern Central (2.30 P.M.),West London (2.30 P.M.), London Throat (9.30 A.M.), Roval Free(2 P.M.), Guy’s (1.30 P.M.), Royal Bar (2 P.M.), Children, Gt. Ormond-street (3 P.M.).

TUESDAY (12th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St,Thomas’s (3.30 P.M.). Guy’s (1.30 P.M.), Middlesex (1.30 P.M.), West-minster (2 P.M.), West London (2.30 P.M.), University College(2 P.M.), St. George’s (1 P.M.), St. Mary’s (1 P.M.), St. Mark’s(2.30 P.M.), Cancer (2 P.M.), Metropolitan (2.30 P.M.), London Throat(9.30 A.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat, Golden-square (9.30 A.M.), Soho-square (2 P.M.). Chelsea (2 P.M.), CentralLondon Throat and Bar (2 P.M.), Children, Gt. Ormond-street(2 P.M., Ophthalmic, 2.15 P.M.).

WEDNESDAY (13th).-St. Bartholomew’s (1.30 P.M.), University College

(2 P.M.), Royal Free (2 P.M.), Middlesex (1.30 P.M.), Charing Cross(3 P.M.), St. Thomas’s (2 P.M.), London (2 P.M.), King’s College(2 P.M.), St. George’s (Ophthalmic, 1 P.M.), St. Mary’s (2 P.M.),National Orthopaedic (10 A.M.), St. Peter’s (2 P.M.), Samaritan(9.30 A.M. and 2.30 P.M.), Gt. Northern Central (2.30 P.M.), Westminster (2 P.M.), Metropolitan (2.30 P.M.), London Throat (9.30 A.M.),Cancer (2 P.M.), Throat, Golden-square (9.30 A.M.), Guy’s (1.30 P.M.),Royal Ear (2 P.M.), Royal Orthopaedic (3 P.M.), Children, Gt,Ormond-street (9.30 A.M., Dental, 2 P.M.).

THURSDAY (14th).-St. Bartholomew’s (1.30 P.M.), St. Thomas’s(3.30 P.M.), University College (2 P.M.), Charing Cross (3 P.M.), St.George’s (1 P.M.), London (2 P.M.), King’s College (2 P.M.), Middlesex ,

(1.30 P.M.), St. Mary’s (2.30 P.M.), Soho-square (2 P.M.), North-WestLondon (2 P.M.), Gt. Northern Central (Gynaecological, 2.30 P.M.),Metropolitan (2.30 P.M.), London Throat (9.30 A.M.), St. Mark’s(2 P.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat, Golden-square(9.30 A.M.), Guy’s (1.30 P.M.). Royal Orthopaedic (9 A.M.), Royal Ear(2 P.M.), Children, Gt. Ormond street (2.30 P.M.).

FRIDAY (15th).-London (2 P.M.), St. Bartholomew’s-(1.30 P.M.), St’Thomas’s (3.30 P.M.), Guy’s (1.30 P.M.), Middlesex (1.30 P.M.), CharingCross (3 P.M.), St. George’s (1 P.M.), King’s College (2 P.M.), St. Mary’s(2 P.M.), Ophthalmic (10 A.M.), Cancer (2 P.M.), Chelsea (2 P.M.), Gt.Northern Central (2.30 P.M.), West London (2.30 P.M.), LondonThroat (9.30 A.M.), Samaritan (9.30 A.M. and 2.30 P.M.). Throat,Golden-square (9.30 A.M.), City Orthopaedic (2.30 P.M.). Soho-square(2 P.M.), Central London Throat and Ear (2 P.M.), Children, Gt.Ormond-street (9 A.M., Aural, 2 P.M.).

SATURDAY (16th).-Royal Free (9 A.M.), London (2 P.M.), Middlesex(1.30 P.M.), St. Thomas’s (2 P.M.), University College (8.15 A.M.),Charing Cross (2 P.M.), St. George’s (1 P.M.), St Mary’s (10 P.M.),Throat, Golden-square (9.30 A.M.), Guy’s (1.30 P.M.), Children, &t.Ormond street (9.30 A.M.).

At the Royal Eye Hospital (2 P.M.), the Royal Londcn Ophthalmic(10 A.M.), the Royal Westminster Ophthalmic (1.30 P.M.), and theCentral London Ophthalmic Hospitals’operations are performed daily.

SOCIETIES.MONDAY (11th).-MEDICAL SOCITITY OF LONDON (11, Chandos-street,

Cavendish-square, W.).-8.30 P.M. Discussion on the ModernMethods of Diagnosis in Kiduey Disease (introduced by Mr. H.Fenwick).

TUESDAY (12th).-RoyaL MEDICAL AND CHIRURGICAL SOCIETY (20,Hanover-square, W.).-8.30 P.M. The Special Discussion on

the following Papers will be resumed :-Dr. A. E. Wright:The General Principles of Therapeutic Inoculation by BacterialVaccines as applied to the Treatment of Tubercular Infection.-Dr. D. Lawson and Dr. I. S. Stew art: A Study of some Points inRelation to the Administration of Tuberculin (T.R.) controlled byObservations of the Opsonic Index in Pulmonary Tuberculosis.—Dr. W. Bulloch: The Treatment of Tuberculosis by Tuberculin.-Mr. J. Pardoe: The Treatment of Tuberculosis of the UrinarySystem by Tuberculin (T.R.). A number of Patients will be

i exhibited at the meeting, MEDICO-LEGAL SOCIETY (22, Albemarle-street, W.).-8.15 P.M. Exhi.

bition of Specimens. Paper:-Dr. F. J. Smith: Post-mortemExaminations which do not reveal the Cause of Death.

PHARMACEUTICAL SOCIETY or GREAT BRITAIN (17, Bloomsbury-! square, W.C.).-8 P.M. Papers :-Mr. H. Rodwe 1: The Preparation- of Compressed Tablets -Mr. J. C. Umney and Mr. C T. Bennett:, False Oil of Savin.—Mr. M. M. Holmes : Notes on Indian Aconite, Hoot,, Zedoary Itoot, Dragon’s Blood, and other Recent Donations

to the Museum.

WEDNESDAY (13th).-HUNTERIAN SOCIETY (London Institution,Finsbury-circus).-8.30 P.M. Papers :-Mr. H. Lett: SurgicalAspects of the Colon.—Mr. J. T. Fox: Considerations on the

r Management of the Large Intestine.. DERMATOLOGICAL SOCIETY OF LONDON (ll,Chanoos-street, Cavendish-

square, W.).-5.15 P.M. Meeting.