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case the hakim takes the credit and the fee, which latter isoften in kind. As an instance of this, one European medicalman of our acquaintance after restoring to health a patientseriously ill with some sort of toxic fever, by means of15 grains of calomel, was rewarded by a pair of socks. If

the patient dies the hakim says that it is God’s will.

Surgery is in as crude a condition as medicine ; fracturesare treated by splints made of paper stiffened withwhite of egg but the limb is frequently bandaged sotightly that gangrene sets in. In Northern Persia,at any rate, syphilis is extremely frequent and the

medical man whom we have previously mentioned

frequently saw villages of which nearly the whole populationshowed syphilis in one form or another. Diseases of the

eye, as throughout the East, are very common, more

especially ophthalmia, the liability to which is increased

by the dust and the glare. With trained medical menPersia might become a health resort of great value. Thereare many mineral springs, and in Northern Persia the districtround the lake of Urmi possesses most valuable thermalwaters. The lake of Urmi itself could be used for the sameaffections as those for which the waters of Droitwich areused in this country for it is a saturated solution of salt.

A man bathing in it is quite unable to swim, for all that hecan do is to lie on his back on the top of the water or to sitin it with his arms round his knees. A marsh surrounds

the lake made up of sulphurous mud and at intervals

are hot sulphur springs which have a great reputationamong the natives for rheumatism and affections of the skin.In parts of Persia Armenian physicians are to be foundwho have had a European training but as a rule Westernmedicine is only to be found at the various missions. TheAmerican Presbyterian mission does excellent medical workat Urmi and the French Roman Catholic mission keeps upa hospital where the nursing is done by the sisters ofSt. Vincent de Paul, but, so far as we know, no medical manis attached to this mission. The Church Missionary SocietyalsQ does useful work from a medical point of viewat Julfa, near Ispahan (not the Julfa on the Araxes whichis little more than a telegraph station), but on the wholemedical science in Persia as it affects the natives is but

little touched by Western ideas and as a rule the Persianhakim of to-day is the same as he is depicted in Morier’simmortal work, "Hadji Baba." "

THE POWER OF PRISONERS TO INJURETHEMSELVES.

, A SOMEWHAT mysterious case was recently inquired intoby Mr. Garrett at the South-Western police court withoutany definite conclusion being arrived at. A woman who

undoubtedly had been put into a cell overnight very drunkwas brought before the magistrate with marks upon her faceand neck which, according to medical evidence, were con-sistent with her having been burnt with carbolic acid. A

bottle which contained, or which had contained, carbolicacid was admitted by the police to have been found in hercell and its presence was unaccounted for, the policestating that the woman had been searched when she wasput in the cell. The woman stoutly maintained that thebuns had been caused by a member of the police at thestation who had deliberately thrown the acid over her, butshe declined to identify any particular man saying that asher glasses had been taken away she had been unable to seehis features. In the circumstances Mr. Garrett ordered thatthe defendant should pay the fee of the medical man sum-moned to attend her and requested the police to investigatethe matter. Upon such evidence no one would willinglyimpute to a constable the dastardly outrage charged bythe woman, but the matter is certainly one which rc-

ires considerable attention on the part of the autho-rities. That a drunken woman should he able to conceal

a bottle,- whether of carbolic acid or of anything else,when locked up for the night is scarcely creditable to thevigilance of those who search prisoners at police stations.Concealment upon such occasions has led sometimes toserious results, and the cases of Whitaker Wright andanother convicted prisoner at the Old Bailey, both of whomcommitted suicide, are of recent occurrence. These two

prisoners took their own lives in order to avoid long termsof penal servitude, but suicides in police-cells are by nomeans uncommon and the inebriate or the person of ill-balanced mind charged with a minor offence is at least as

likely to try to make away with himself as the malefactorwho has deliberately committed a more serious breach ofthe law.

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THE DISTRIBUTION OF PLAGUE.

As regards the Transvaal, Lord Milner, in a telegram tothe Colonial Office received on May 28th, states that theplague return for the week ending on that date was asfollows. Total number of fresh cases reported since

May 21st, 5, all coloured persons. Of previous cases 5have been found not to be plague, making the presenttotal of suspected and proved <$I,ses 140-viz., 24 white and116 coloured persons. The total number of deaths reportedsince May 21st is 3, all coloured persons. As regards Hong-Kong, a telegram from the Acting Governor received at theColonial Office on May 31st states that for the week endingMay 28th there were 27 cases of plague and 27 deaths fromthe disease. A telegram from the Acting Governor of theMauritius received at the Colonial Office on May 27th saysthat for the week ending on that date there were threedeaths from plague.

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PRIMARY CEREBRAL ACTINOMYCOSIS DIAGNOSEDBY LUMBAR PUNCTURE.

AT the meeting of the Soci&eacute;t&eacute; M6dicale des H&Ocirc;pitaux ofParis on May 13th M. Enriquez and M. Sicard described thefollowing case of actinomycosis which is remarkable not onlyon account of the rarity of the disease in the brain but alsobecause of the establishment of the diagnosis by lumbar

puncture. A groom, aged 43 years, was admitted to hospitalin July, 1898, with all the signs of cerebral tumour in thecortex of the left hemisphere. There were attacks ofJacksonian epilepsy, headache, visual troubles, and vertigo.Although he denied having had syphilis mercury and iodidewere given energetically but without result. The symptomsincreased in severity, walking became more and more

difficult, and double optic neuritis developed. Trephiningwithout incision of the dura mater was performed. As inalmost all their cases of cerebral tumour M. Enriquez andM. Sicard found that the operation produced ameliora-tion of the symptoms-vertigo, headache, and nausea,and above all of the stasis of the optic discs. But threeweeks later the patient relapsed and lumbar puncture wastentatively performed in order to diminish the hydrocephalictension. Cloudy fluid was obtained. At this time cytologicalexamination of fluids was unknown. Microscopic examina-tion of the deposit obtained after allowing the fluid to standrevealed actinomycetes. The patient was in the habit of

chewing straw, but neither in the mouth nor elsewhere

could the portal of entry of the fungus be discovered.A meningocele formed in the cranial wound and at its

summit suppuration took place. In the pus characteristic

granules with central mycelium and peripheral club-shapedbodies formed. Increasing doses of iodide of potassiumwere given but the patient died at the end of a fortnightfrom diffuse staphylococcic meningitis. The duration of thedisease was less than eight months. ’In the fluid obtained

by a second lumbar puncture two days before death the

fungus was not found but only staphylococei. The necropsyshowed general cerebro-spinal meningitis. In the left fronto-

parietal region of the brain was a soft tumour, purulent at the

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periphery. It communicated by a narrow opening with theleft lateral ventricle. Neither in the tumour nor in the puscould actinomycetes be found, only staphylococci. The otherviscera were normal. The absence of actinomycetes from thetissues examined after death is easily explained. M. Poncet

has shown that after secondary infection with pyogenicmicrobes the fungus disappears from the affected parts. M.

Enriquez and M. Sicard could find on record only one othercase of primary cerebral tumour due to actinomycetes. In itthe actinomycosis was recognised only at the necropsy. Thetumour was situated in the position of the third ventricle.The portal of entry was in this case also impossible to find.The patient died comatose without secondary infection abouta year after the onset of symptoms. On the other hand,secondary cerebral actinomycosis is well recognised. Out of19 cases referred to in the classical treatise of Poncet andB6rard cranio-cerebral actinomycosis was due to extensionfrom a cervico-facial lesion in eight and due to metastasis,almost always from pleuro-pulmonary lesions, in 11. Thiscase again shows the value of lumbar puncture in diagnosis-a subject to which we have referred recently. The

setting free of the fungus in the cerebro-spinal fluid was

probably due to penetration into the dilated lateral ventriclefrom the tumour. M. Poncet finds that actinomycosis of thenervous system is invariably fatal. The largest doses ofiodide are powerless to arrest the disease and the patients donot live beyond some months.

THE FIFTEENTH INTERNATIONAL CONGRESSOF MEDICINE.

A MEETING of the National Committee for Great Britainand Ireland was recently held, Dr. F. W. Pavy being in

the chair, and Sir William S. Church, Sir Dyce Duckworth,Mr. Reginald Harrison, and others being present. It was

resolved, in view of the confusion and disorder attending thelast assemblage of the Congress-attributable, it is con-

sidered, to the deviation from former procedure in admittingas members of the Congress others than medical andscientific men-that the attention of those intrustedwith the organisation of the forthcoming Congress at

Lisbon should be called to the matter. This resolutionwas forwarded to the President and Secretary-Generalof the fifteenth Congre3s which will meet at Lisbonin April, 1906, and the rules just issued show that thequalifications of members are as strictly limited as theywere at Paris in 1900. The recommendations of thesubcommittee as to the future constitution of the NationalCommittee were approved and it was decided that thecommittee should consist of a president and two secre-

taries who should invite the cooperation of (1) His

Majesty’s chief medical advisers in the Navy, the Army, theIndian Army, and the Lunacy and the Local GovernmentBoards ; (2) the Presidents for the time being of eachmedical corporation in the United Kingdom; (3) the Pre-sident of the General Medical Council ; (4) a professor ofthe faculty of medicine from each University; (5) thePresident for the time being of the Royal Medical and

Chirurgical Society of London, of the Royal Academy ofMedicine in Ireland, and of the Medico-Chirurgical Societyof Edinburgh; (6) the President for the time being of theIncorporated Society of Medic1.1 Officers of Health ; (7) arepresentative of the National Medical Press Association ;(8) eight persons practising medicine and surgery in

England (including Wales), four general practitioners fromScotland, and four general practitioners from Ireland ; and(9) such other persons as it may be found desirable fromtime to time to invite to the National Committee. Dr. Pavywas asked to continue in the office of President and Mr.

D’Arcy Power as secretary. Dr. Horton-Smith regrettedthat he was unable to continue to act as secretary. Dr.

Clive Riviere was nominated to act in his place and a cordialvote of thanks was tendered to Dr. Horton-Smith for thevaluable services he had rendered to the National Committee

during his tenure of office. It was proposed by Dr. J. F.. rSutherland that, in order to allay the feelings of irrita-tion and disappointment rankling in the minds of thosewho attended the Madrid Congress, and to reassure theseand others who may contemplate attending the Lisbon

Congress, the honorary secretaries should be instructed tosend a note to THE LANCET and the BritiR7" Medioal Journalto the effect that the British National Committee intendsto supervise the comfort and convenience of congressists:The committee hopes to prevent or to reduce to a minimumat the Lisbon meeting the annoyance, discomfort, and dis-appointment experienced in Madrid in regard to travel-

ling facilities, lodging accommodation, and so on, andto attain this end it is desirable to have a local Britishcommittee to keep in touch with the executive of the Lisboncommittee. The proceedings terminated with a vote ofthanks to the Medical Society for its kindness in puttingthe society’s rooms at the disposal of the British NationalCommittee.

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THE INFANT ORPHAN ASYLUM AT WANSTEAD.

IN another column of our present issue we publish twoimportant letters relative to precautions against the occur-rence of infection among the children in the Infant

Orphan Asylum at Wanstead. We think that manyfriends of that long-established institution will regret,that the committee has adopted a course so incompatiblewith the expressed opinions of the medical staff. In viewof the universal liability of young children to scarlet

fever, measles, and whooping-cough and the havoc that,

has often been worked by outbreaks of contagious eyedisease among children in Poor-law institutions, no-

effort should be spared in the early detection andisolation of such cases. A number of schools, both publicand private, recognise this fact and make provision accord-ingly but the committee of the Orphan Asylum, where manyof the children are of tender years, not only declines toprovide an isolation building but has dismissed the staff ofitrained nurses.

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THE FORD-PALLISER DRINKING TANK.

UNDER the heading of " The Services " in THE LANCET ofMay 21st, p. 1458, we briefly referred to some inventions ofmedical interest which were shown at Bisley on May 17th,one of them being a water cart with appliances for rapidlyboiling water in large quantities, thus minimising the risksof infection with enteric fever. The essential feature of this.

water-cart, which has been called by its designers the Ford-Palliser (Anti-enteric) drinking tank, is a tubular boiler-tankheated by ordinary paraffin oil. In this apparatus 50 gallonsof water can be boiled in an hour while the cart is in motion,the tank being kept level by means of a gimballed arrange-ment. A second tank with interior cells containing a solutionof saltpetre is connected with the boiler and is used for-

cooling purposes. Water which has been exposed to anykind of microbic or organic contamination is well knownto be improved immensely for drinking purposes by mereboiling. If therefore it is found practicable under the con-ditions of a campaign to boil water rapidly whilst the cartis in motion and to distribute this water by the ordinarywater carts to the troops in the field, a great advance willalmost certainly have been made in protecting the men fromenteric fever. Among those who witnessed the exhibition atBisley were Lieutenant-Colonel A. M. Davies, from the

Army Medical Headquarters staff, Major T. C. McCulloch,R. A.M. C., Colonel Robinson, officer commanding the RoyalArmy Medical Corps Depot, Aldershot, Lieutenant-Colonel