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Page 1: PARIS


Foreign Medical Intelligence.(FROM OUR SPECIAL CORRESPONDENT.

Ho)ii6eopathy igt Ital y : an extraordinary incident-Small-pox itParis and London- Vital statistics of Madrid- Vesicalcalculus ej)zbec7ded in a, cancerous tumour.

AN extraordinary incident has just occurred in Italy, andis exciting the attention of the medical circles of the

country. One of the provincial municipalities has announceda vacancy amongst its poor-law medical officers, and hasgiven out the astounding news that only a homœopathic- doctor will be entitled to come forward in the competitionfor the post. It seems surprising enough that the munici-pality should take upon itself to decide what ought to bethe doctrine and practice of its medical officers, and force

homoeopathy upon the poor of the locality. But what is

stranger still, and shows how far the wits of the said muni-cipality are disturbed, is the fact that it invites to the postmen who are not duly qualified to practise in the kingdom,since "they must have graduated at a foreign universitywhere homoeopathy is officially taught!" But this is notall. The announcement of the municipality further statesthat the medical man selected must be prepared to providehimself with homoeopathic remedies, and to dispense themamong the poor. Fortunately for common sense, the

- empty-headed municipality have carried their joke too far.The Italian laws are extremely severe in preventing medicalmen from meddling with pharmacy, and the extraordinarypretensions of the now famous town councillors will disap-pear before the general laughter of their countrymen andthe Mom-possMMUM of the laws which they seem so thoroughlyto ignore.

In one of the late numbers of THE LANCET you noticedthe heavy mortality due to small-pox in Paris in comparisonwith the benignity of the disease in London ; and you in-ferred that it might be due to the fact that vaccination wascompulsory in the one city and optional in the other. Pro-fessor Bouchardat, of the Paris School of Medicine, hasrecently given much attention to the subject; and, inorder to explain this difference in the mortality of the twocities, he suggests two causes, which it may be well tonotice. The mortality through small-pox in Paris, he says,is heavier on account of -1. The presence of a greatnumber of workmen who come from the departmentswithout being vaccinated. In France a vaccinationcertificate is necessary before admission into the schools;whilst awaiting a complete reform, the same conditionshould be required for admission into the work-yardsof Paris. 2. The distribution of small-pox sufferers over allthe hospitals of Paris, and their intermingling with patientsfree from the disease. London has its hospital for small-pox ; Paris must have one, and in a locality sufficiently spa-cious for allowing a special convalescent asylum to beannexed, as it is obvious that, with the present notions ofthe mode of propagation of small-pox, variolic patientscannot be sent to the general asylum for convalescents.Such is Professor Bouchardat’s explanation; and as heforesees that the second of his propositions will meet withsome objections, he says that it would bea mistake to supposethat the aggregation in one locality of patients sufferingfrom the same disease would be a serious peril, involvingthe creation of formidable foci of epidemics. On the con-

trary, his experience of the Small-pox Hospital of Londonleads him to think that the mortality there is not heavierthan in town; whilst, on the other hand, disseminationof variolic patients in inhabited centres presents thegreatest inconveniences.We recently published a statistical census of the popula-

tion of Madrid, for the quinquennial period of 1864 to 1868 ;showing how the unhygienic state of the city tells heavilyon its inhabitants. It is a widely known fact that the sanitaryconditions of Madrid are of the very worst. The streets arenarrow and badly kept ; cesspools are abundant ; thesewerage is most imperfect; numerous cemeteries surrounlthe town; whilst, from its situation, Madrid is exposed to themost sudden variations of weather. The statistical accountreferred to mentions that, during the year 1864, there were

11,856 baptisms, and 12,393 burials ; in 1865, 12,937baptisms, and 14,746 burials; in 1866, 11,991 baptisms,and 12,486 burials ; in 1867, 12,796 baptisms, and12,509 burials ; in 1868, 11,994 baptisms, and 13,611burials. The total number is 61,034 on the one hand, and65,748 on the other: the difference is considerable. Thereis need to mention, however, that in 1865 Madrid was visitedby the cholera, and that in the preceding year, as at present,the population was almost decimated by a formidable epidemicof typhus. Yet there can be no doubt that the insalubriousstate of the city, and the unhygienic habits of the popula-tion, explain to a considerable extent this heavy mortality.The vital statistics of last year for the first three quartersshow that the mortality during the whole year will be quiteas large as during 1865.At the last sitting of the Medical Society of the Hospitals

of Paris, an interesting case was related of a large vesicalcalculus embedded in a cancerous tumour.



On account of the changes which I mentioned a fortnightago, the following promotions have taken place in themedical department of the Paris hospitals.M. Desnos has been appointed physician to Lariboisiere

hospital; M. Gombault to St. Antoine; M. Michel Peter toLarochefoucault; M. Bernutz, the well-known gynecologist,to La Charite; Professor Vulpian to La Pitie; M. Luys,the author of several works of merit on diseases of thenervous centres, to La Salpetriere, and M. Blachez toBicetre.Through the renewal of the Board of the Paris Academy

of Sciences, Claude Bernard quits the presidency, and M.Louisville, the vice-president, becomes president. M. Coste,the celebrated embryologist, who is a mediccal man, hasbeen elected to the vice-presidency, and will therefore takethe presidential chair next year.At the same sitting of the Academy Professor Helmholtz

was elected Foreign Associate in the section of NaturalPhilosophy.The board of the Paris Academy of Medicine has also

been renewed. Dr. Blache, who during his presidency lastyear had given proof of such amiable and distinguishedqualities, is succeeded by Professor Denonvilliers, of theParis Faculty.As is usual at this time of the year, the University

of France has conferred several marks of distinction onvarious professors of medicine, on account of the serviceswhich they have rendered by their teaching. ProfessorsCharles Robin, of the Paris Faculty ; Brongniart, of theInstitute; Huguier, Professor of Anatomy at the School ofFine Arts ; Combal, of the Montpellier Faculty ; Goze, ofStrasburg ; Mabit, of Bordeaux, &c. &c., have been ap-pointed officers of public instruction, with correspondingprivileges.

Professors Broca, Lassegue, Verneuil, of the Paris Schoolof Medicine, together with several other provincial profes-sors, have been named officers of the French University.

Italy.Professor Moleschott has been chosen by the Faculty of

edicine of Turin to deliver the inaugural address onthe occasion of the resumption of studies at the TurinUniversity.

After a concours which took place among the laureates ofthe various universities of Italy, Dr. Carlo d’Intino diTerano has succeeded in obtaining the chair 11 for the ad-vancement of clinical medicine " at the Florence University.




IT would be irrelevant to the special character of yourjournal to enter into any details touching the homicide whichtook place at Auteuil, and which is now creating such asensation in France, but a few peculiarities considered froma medico-legal point of view will certainly be of interest toyour readers. The autopsy was performed on the Wednes-day morning at about ten o’clock, by Professor Tarclieu, in

Page 2: PARIS


conjunction with Dr. Bergeron, and under the circumstancesprescribed by the French law. On a superficial examina-tion the bullet could not be discovered ; so the investiga-tion was completed by a formal search into the viscera. Itwas eventually found behind the heart, and in the situationof the diaphragm. M. Tardieu thus explains the course

which it followed :-After having penetrated the clothing,and impaired a rib, it entered the left ventricle of theheart. The bullet was then pushed back by a flow ofblood, and, by its own weight fell out of the heart and foundits way into the situation where it was discovered. M.Tardieu also asserts that, judging from the bullet-marks onthe clothing, the shot was fired, not in close proximity tothe victim, but at a distance of five or six steps. Anotherimportant circumstance from a medico-legal point of view,will be Dr. Pinel’s testimony. Dr. Pinel was called uponimmediately after the fatal event took place to investigatethe condition of the Prince’s face, and see whether a slaphad been received. It is said that he discovered no tracesof a blow on the face, but was shown on the mastoid pro-cess a roundish and well-defined spot which was rapidlyassuming a bluish hue. Dr. Pinel has already attempted tofurnish an explanation of the contusion by raising the fol-lowing hypothesis based on the appearance and character ofthe injury :-1. The contusion may have been caused by astray bullet, which, after rebounding several times, and-losing its strength, eventually struck the Prince behind theear. 2. Fragments of wood and plaster, produced by thepenetration of the two lost balls, may have caused the sameinjury. 3. If the contusion were the result of a slap, itcould be occasioned only by the presence of a ring with a

stone. 4. The stick picked up in the drawing-room of thePrince could only have produced the contusion by itsleaden knob. 5. The door of the drawing-room, facing thebilliard-room, being half open at the time of the event, thePrince may have struck himself against the casing of thedoor which corresponds to the left side of the face, whilstpursuing M. de Foneville. The following circumstancesmay help to throw some light upon the value of these

hypotheses. It was only the Prince who fired, andhe fired three shots. One of the bullets has been discoveredin the dead man’s body; if the other two are found imbeddedin the wainscoting, the first of Dr. Pinel’s hypotheses is dis-proved. Next, M. Victor Noir had no ring on his finger. Itremains to be seen how M. Pinel will support his hypothesesin court, and what deductions he will draw therefrom.Meanwhile it would be out of place, in awaiting the trial, toenter into any other considerations.



One of the medical journals here has started the schemeof a syndicate of the French medical press, and has alreadymet with a certain number of adherents among the editors.The object of this syndicate would be to settle all nicequestions of honour and polemics in the body of the medicalpress, to establish a sort of understanding among its differentorgans, and especially to advocate the interests of themedical press with the Government. Though an institu-tion of this kind would seem, at first sight, to be one ofgreat value and necessity, it may be met by many objec-tions ; and, already, Dr. Dechambre, the able editor ofthe Gazette Hebdon?,aclai)-e, refuses to co-operate in thescheme. If I were called upon to give an opinion, I shouldsay that the project, as the medical press now stands inFrance, involves many inconveniences, with but few ad-vantages. In the first place, the polemics of the medicaljournals here are so extremely mild that one does not seehow there could be delicate questions to settle. With re-

gard to questions of honour and propriety, it is better toleave each editor to judge for himself in regard to thegeneral conduct of his journal and incur the consequencesof his manner of acting, the medical public being the bestjury. In the next place, it has been argued that themedical press, which cannot treat of medico-political andsocial matters without paying a large fiscal due, shouldprotest against this order of things. But this is a generalquestion affecting the political press as well, and inwhich the political journals can better and more effectuallyintervene, as they have been constantly doing, %vith now abetter prospect of success. It could not be fair for themedical press to separate its interests from: those of the general

press, and to ask for the right of treating gratuitously ofpolitical matters when the political press pays such a heavysum for the privilege of doing so. It is, therefore, a measureof general freedom which must be sought, and the in-fluence of the political press is better able to obtain it thanany special syndicate. Lastly, if it is thought necessary tocombine the efforts of all the scientific press in one direc-tion for the promotion of any good cause, professional orscientific, it seems that there are other means of coming toan understanding than by the institution of a syndicate,which, having authority to intervene on every possiblequestion in connexion with the medical press, would notfail to engender much angry feeling, and would soon lose itsauthority through the divisions existing in its own body.DR. LORAIN OX THE PULSE, ITS VARIATIONS AND VARIOUS


I have much pleasure in directing at once the notice ofyour readers to a most important work which is just freshfrom the Parisian press. It is from the pen of my dis-tinguished friend, Dr. Lorain, physician to the Hopital St.Antoine, and deputy-professor at the School of Medicine.About a year ago I mentioned in THE LANCET what valuableresults M. Lorain had obtained by the application of thegraphic method to the investigation of the last choleraicepidemic at St. Antoine. Dr. Lorain had applied all the

physical means of investigation involved in the graphicmethod, to the study of the temperature, the pulse, theweight of body, the quantity and composition of the urine,the muscular strength, and, lastly, the movement of themuscles and circulation of the blood, during the course anddifferent stages of the disease. He thus arranged a seriesof most interesting tableaux, enabling one to take in at a

glance all the striking features of a case. Since then, hehas purposed to resume successively each of these meansof investigation, and apply it to the study of disease.The present volume is devoted to the variations and formsof the pulse. It contains 500 figures due to the sphygmo-graph, and includes five divisions in which the author suc-cessfully describes:-1, the character of the method; 2, ananalysis of contemporary labours on the subject; 3, therules which are indispensable to a practical use of theregistering apparatus of the pulse; 4, his clinical re-searches, especially in connexion with the heart. An im-

portant chapter is devoted to the therapeutical and medico-legal portion of the subject. There is no need to insistfurther on the nature and value of the work.



On descending from the presidential chair at the lastsitting of the Societe de Chirurgie, Professor Verneuil madesome trite and interesting remarks which may serve to showthe general character of the French medical societies."After an existence of twenty years," he said, 11 our society,preserving its strength and vigour, represents faithfullyenough the present condition of French surgery. It maybe blamed perhaps for cultivating facts too exclusivelyand showing too great a neglect of doctrines; for beingrather a clinical panorama than a chirurgical council; forsifting the past and ensuring the present without attempt-ing to sound the future; in a word, for following themovement rather than directing it. These reproaches arejustified to a certain extent, but they may be equally ad-dressed to all learned bodies where matured men, andespecially practitioners, are in a majority. They rarelytake the initiative, and their tendencies are moderativerather than progressive. Leaving to isolated, active, andardent workers the task of enunciating new views, in-

genious hypotheses, and daring innovations, they contentthemselves with judging by experience, and, without alwayslaying themselves open to reproach, they willingly adoptthe melius sistere e grachcna of our prudent aneestors."

Paris, Jan. 18th, 1870.

THE foundation stone of a new hospital and infirmaryfor the Rotherham district was laid on Wednesday withMasonic honours by Earl de Grey and Ripon, who is Deputy-Grand Master of England and Provincial Grand Master ofthe West Riding. This new hospital is to be built on thepavilion principle, which of late years has been so muchapproved.