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accounted for 37’44 per cent. of the whole, and zymoticdiseases for 10’95 percent. The birth-rate was 27’22 per1000. During the month 453 cases of infectious diseasEwere intimated ; 107 patients were admitted into the CityHospital, 94 were discharged, and six died, and there re-mained at the end of the month 188. The cases atpresent in the hospital include 1 of typhus fever, 24 oienteric fever, and 44 of scarlatina. During the month52,0861b. of unsound meat were seized or delivered up inthe city. The mortality last week was 108, making thedeath-rate 20 per 1000. Diseases of the chest caused 50deaths and zymotic diseases 10, of which 6 were due towhooping-cougb. The intimations for the week were :

typhoid fever, 5 ; scarlatina, 11 ; measles, 74. In Leiththe number of deaths was 27, and the death-rate 20’60per 1000.

Scottish Universities Commission.At the meeting of the Commission on Monday evidence

with regard to instruction in mental diseases was heardfrom Dr. Clouston and Dr. Yellowlees ; and with regard toa proposed chair of Pathology in Glasgow University fromProfessor M’Kendrick and Dr. Joseph Coate.

Hospital Transactions in Edinburgh.There has been some talk of late regarding the starting

of Transactions both at the Royal Infirmary and the RoyalHospital for Sick Children, and it appears there is a pro-spent of this being realised, and that the two hospitals willpublish a conjoint volume. Should this be done, muchvaluable material will be permanently preserved instead of,as at present, being only used for the temporary purposes ofclinical lectures and ward instruction.

The British Association.At a public meeting held in Edinburgh on Monday it was

decided to recommend that the British Association, whichmeets in Edinburgh next year, should meet in the end ofSeptember.

The Infectious Diseases Notification Act. ,

The Police Commissioners of Paisley have unanimouslyresolved to adopt the Notification Act, to come into forceon Aug. lst.

Death of Dr. Smith-Shand.Dr. J. W. F. Smith-Shand, Regius Professor of Practice

of Medicine in Aberdeen University, died on the 12th inst.of apoplexy. He was physician and lecturer on clinicalmedicine at the Royal Infirmary, Aberdeen, and whilst ofa singularly amiable disposition, was possessed of the pro-fessional experience and skill which made his advice muchsought after in the north of Scotland.

Royal Infirmary, Dtcndee.Mr. Thos. Maitland presided at the annual meeting

recently held of the governors of this institution. Thetreasurer reported that the financial position (including anextraordinary expenditure of E1384 13s. 7d.) showed anexcess over revenue of E1486 19s. 10d. The chairman, inmoving the adoption of the report, stated that the work ofthe infirmary during the past year had been the highest onrecord. He at the same time intimated that a considerablesum would annually be required as extraordinary expendi-ture to supply, from time to time, modern and improvedappliances. The report was approved.A scholarship, affording free education at the Edinburgh

School of Medicine for Women and at Leith Hospital, isoffered by a lady to a suitable candidate wishing to devoteherself to work as a medical missionary. Candidates areto send in their names to the secretary of the school, andthe selection will be made by a committee of ladies.June 16th.

________

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

Royal College of Surgeons.ON Thursday, the 18th inst., the Council will elect an

additional Examiner in Ophthalmology and an Examinerfor the diploma in Dentistry. Mr. Theodore Stack will be acandidate for the Vice-Presidency of the College next June.

Regius Professor of Surgery: University of Dublin.The recent meeting of the Academic Council to appoint a

successor to Mr. William Colles has been adjourned to,next Monday.

. Royal University of Irelancl.Her Majesty has appointed The O’Conor Don and Sir

Patrick Keenan members of Senate of this University, inthe room of Sir Robert Kane, M.D., deceased, and Rev. Dr.Woodlock, who has resigned.

Tlzc late Staff Surgeon Piac, R.N.A marble tablet has been placed in Dungarvan Parish

Church in memory of the late William Masters Rae, StaffSurgeon of Her Majesty’s ship Serperat, lost on the coast ofSpain in November last. The deceased gentleman, who’was thirty-six years of age, belonged to Dungarvan.

Rabies.An outbreak of rabies has occurred in Carlow among the

deer at Oak-park, and the animals destroyed exceed 100head. Before the rabid dog attacked the deer it bit threechildren, who have been sent to the Pasteur Institute atParis for treatment at the expense of the Carlow guardians.

Cork North Infirmary.Dr. E. Magner has been elected extern physician in the

vacancy caused by the resignation of Dr. Cremen, and Dr.Richard Dalton has been unanimously appointed assistantphysician to the extern department.Mr. Malone, solicitor, has been elected coroner for the

baronies of Dungannon.Sir Charles Cameron has been elected President of the

Irish Medical Association for the ensuing year.

PARIS.(FROM OUR OWN CORRESPONDENT.)

The Prophylactic Tlalnce of Early Excision of Hccrd Chancres.THE advisability of excising a hard chancre at an early

stage of its development is a moot point, some asserting,with M. Jullien, the utility of the measure as a means ofpreventing further infection of the system; while others-and these certainly form the majority-agree with our ownHutchinson, who maintains that the operation " can rarelybe productive of good." M. Mauriac of the Hopital duMidi believes with the English authority that any hopes ofpreventing the appearance of secondary manifestations ofsyphilis by an early excision of the primary sore are illu-sory. In support of this view of the question, M. Mauriaehas recently given the details of a case in which a threedays’ old Hunterian chancre was excised, there being at that,period no sign of glandular infection. On the morrow afresh preputial chancre, harder even than the original one,appeared at some distance from the site of the latter. It was,in its turn, thoroughly excised twenty-four hours after itsdiscovery. The two wounds healed kindly, but at the baseof the cicatrices a characteristic induration developed, andthe adenopathy, doubtful at the time of the operations,revealed itself in a very unambiguous form. Fifty-threedays from the appearance of the first chancre, the patientwas seized with nocturnal cephalalgia, rheumatic pains inthe intercostal and diaphragmatic regions, together withvesperal fever and night-sweats. These symptoms wereshortly succeeded by the appearance of a generalisedpapular syphilide on the body. An experiment of this.kind being of more value than any amount of theory, Ihave, for that reason, deemed it worthy of record in thepages of THE LANCET.

Hysterical Chorea.MM. Debove, Comby, and Chantemesse have already

called our attention to the existence of the hysterical formof chorea, presenting all the classical characteristics of thetypical ’ choree de Sydenham," as St. Vitus’s dance is

frequently denominated in this country. At a recent meet-ing of the Societe Medicale des Hopitaux (June 12th)M. Laveran-well known as the discoverer of the parasiticmicro-organisms supposed to be peculiar to malarial blood-reported two cases in which the symptoms of hysteria andchorea were so interwoven as to suggest a common origin.The first case is that of a quartermaster-sergeant, who, havingmuch pressing work to do, sat up all one right to get throughit, assisted by copious libations of strong coffee. On thefollowing morning, having discovered an act of disobedience

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on the part of one of his subordinates, he becamefuriously enraged, and was there and then seized with anattack of hysteria, with transitory aphasia. A little laterthere supervened choreic movements of the elbow and arm,these movements subsequently involving the lower limbs.The aphasia gave way to hysterical stammering withgeneralised hyperseatbesia. and hysterical attacks recurredat frequent intervals. This man had never previouslyexhibited signs of hysteria. In the second case, a wine-grower, who had but recently joined his regiment, wasadmitted into the Val de-Gr&ce Hospital with the his-tory of having suffered for the last two or threeyears from occasional involuntary movements of thelimbs. The attack commences with a sensation of con-striction of the chest and neck, and this is fol-iowed, without unconsciousness, by movements of thearms resembling those employed in the act of rowing. These.movements last a few minutes, and are repeated severaltimes during the attack. Hysterical stigmata are presentin the shape of incomplete left hemi-ansesthesia and narrow-ing of the visual field in the left eye. From the study ofthese cases, and a careful analysis of the records of the Val-de-Gf& ;e Hospital archives, M. Laveran arrives at the conclusionthat male hysteria is decidedly on the increase. He statesthat there are at present in his wards at the Val-de-Grâce Hospital three well-marked cases-a large proportion,considering that all his soldier-patients are drawn fromthe ranks of the working- classes. MM. Raymond andBallet, on the other hand, deny the increased fre-

quency of hysteria in the male, opining that the apparentincrease is really due to improved diagnostic methods. M.Ballet tells us that he has in his wards at the presentmoment about fifteen male hysterics. With regard to thenervous origin of chorea, MM. Perret and Devic haverecently published the statistics of 235 cases of the diseasetending to prove that rheumatism is not so common a

starting-point as is generally supposed. They regard choreaas an essentially nervous affection in the majority ofinstances, and they believe that when met with in younggirls, it may be merely a form of hysteria.

The New Medical Bill before the Senate : the State ofMedical Education in France.

This new Bill, already passed by the Chamber, and the’provisions of which I have already transcribed for theinformation of your readers, was duly presented to theUpper House on June 8th. A committee was forthwithappointed to report on it, this body comprising ProfessorCornil (chairman) and eight other senators. The com-mittee proceeded to the discussion of the article dealingwith the abolition of the officiat de santé. Four of their’number pronounced in favour of the maintenance of thesecond-grade diploma, while three others voted for itssuppression. It was ultimately decided, at the suggestionof M. Cornil, to proceed to an inquiry on the subject,the opinion of the County Councils being taken thereon.Apropos of the suppression of the officiat de santé, theAssociation des Professeurs de Ecoles de Medecine deFrance has just signed a petition to the Senate, urgingupon that august body the inexpediency of the proposedmeasure and the necessity of preserving intact and furtherfostering the preparatory schools of medicine scatteredthrough the country. In protesting against the tendencyto further centralisation, these gentlemen contend that attheir schools, free as they are from the overcrowding in-herent to metropolitan hospitals affiliated to faculties ofmedicine, clinical instruction is cheaper and more

complete, and the despised officier de santé emergesfrom his alma mater armed with more practical and usefulknowledge than the generality of "swell" M.D.’s. In theirpetition they draw a melancholy picture of the state ofThings at a large Faculty : of the scarcity of subjects fordissection, the aimless wanderings of the medical tledglingfrom amphitheatre to amphitheatre, the crowd around thepatient at the hospital, those composing its rear guardcraning their necks in their desperate efforts to cullinformation regarding the case, &c., &c. They make astrong point of the general absence of control over thestudies of the aspirant at the Paris and other Faculties,and contrast this indiscipline with the order prevailingat humbler schools, where each student is personallyknown to his teachers. They state that last year noless than 150 foreign doctors were compelled to shakethe dust of Pf ris off their feet and repair to Berlin,

because the defective organisation of the Faculty of Medicinedeprived them of the opportunities for study they had beenled to expect at such a centre of learning. That the accusa-tion formulated by the petitioners is in great part wellfounded is sufficiently proved by the fact that the creationin Paris of a Municipal School of Medicine independent ofthe unwieldy Faculty has for some time past been a subjectmuch discussed. I propose on some future occasion toenlighten your readers on the methods actually in opera-tion of conducting examinations at the Paris Faculty.Reform in this direction is urgently needed, and thearguments I shall adduce will, I doubt not, conquer thesuffrages of those of your subscribers who have, irrespectiveof nationality, the true interests of medical education atheart.Paris, June 16th.

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

Fermentations and Infectious Diseases.A LITTLE treatise on fermentations and infectious diseases,

with special reference to Koch’s treatment of tuberculosis,has recently been published by Dr. Eugen Dreher, formerlyprivate lecturer at the university of Halle. The author,who is not a medical man, but a student and teacher ofnatural science, discusses not only Koch’s method, but alsothe kindred methods of Pasteur, Behring, Kitasato, Brieger,and Karl Fraenkel, and the theory of vaccination. Hetraces the history of the theory of fermentation, stating theviews of Berzelius, Mitscherlich, and Liebig, and dwellingon the important service to this branch of science renderedby Schwann and Pasteur, who discovered and determinedthe part played by organisms in fermentation. After re-ferring to the resemblance between the phenomena of fer-mentation and those of the infectious diseases, he discussesthe various theories of vaccination. As a Darwinite, hefavours the view of Paul Grawitz, according to whom theimmunity conferred by vaccination is due to the victorygained by the cells over the weakened virus, whichvictory strengthens the cells against the virus even

in its unenfeebled form. Dreher accordingly op-poses Koch’s hypothesis of the manner in whichtuberculin acts-namely, by coagulation necrosis. Accord-ing to Darwin, kindred species often have qualities of thesame kind, only stronger in some of them than in others.Dreher therefore suggests that inoculation with kindredbacteria of a less virulent nature might confer immunityagainst the germs of infectious ases. I may add thatthe same author has recently oublished "three psycho-physiological studies," entitled "Darwinism and Archi-gony," "Debility, with reference to Hypnotism," and" Colour-Sensation and Colour-Blindness."

The Bethany Hospital.Dr. Hans von Steinau-Steinruck, one of the ablest of the

younger Berlin practitioners, has been elected to succeedthe late Dr. Goltdammer as chief of the medical departmentin the Bethany Hospital here.

German Death-rates.

The death-rates of the principal German cities in theweek which ended on the 16th ult. were as follows : Aix-la-Chapelle, 23-9; Altona, 17’2; Barmen, 23 ; Berlin,19-9; Bremen, 16-5; Breslau, 28-7; Chemnitz, 28-5;Cologne, 20-3 ; Dantzic, 18-9; Dresden, 24-2; Duaseldorf,23-5; Elberfeld, 18-7; Frankfort-on-the-Maine,21-9; Ham-burg and suburbs, 22-2; Hanover, 17-2; Konigsberg, 24;Krefeld, 19-4; Leipsic, 20-2; Magdeburg, 21-8; Munich,25-4; Niirnberg, 30-4; Stettin, 29; Stuttgart, 18-1. Thedeath-rate of Amsterdam in the same week was 24-9;of Copenhagen, 24.1 ; of Dublin, 25-5; of Liverpool, 29-8 ;of London, 26.1; of Paris, 23-9. Of the Berlin deaths in thesaid week, one was due to scarlet fever, one to influenza, twoto erysipelas, two to quinsy, two to puerperal fever, twoto articular rheumatism, five to poisoning (including onesuicide and two cases of delirium tremens), eleven to gastro-intestinal catarrh, twelve to whooping-cough, sixteen todiarrhoea, twenty to diphtheria, twenty-two to decrepitude,twenty-five to diarrhoea accompanied by vomiting, twenty-five to cerebral apoplexy, forty-two to pneumonia, and 102to pulmonary consumption. Twelve persons committed