1701

mild cases of fever accompanied by glandular enlarge-ments and those severe outbreaks of the disease which

have at times devastated whole communities. Their aim

is to establish the pathological affinity or identity of the

mild with the fatal form of the disease and to show that this

relationship had not escaped the observation of either theolder authorities or of those of our own time who had

furnished reports and descriptions of the more recent out-breaks of the plague in North Africa, Mesopotamia, theLevant, Astrakhan, and elsewhere. The writers of the articleon Pestis Ambulans state that their attention having beendrawn to the fact that cases of glandular sickness with feverhad occurred in Howrah, Calcutta, and Chinsurah, they hadinstituted an inquiry and made an examination of several ofthese cases, of which they furnish detailed accounts. In Isome of them they found on examination of the blood adiplo-bacterium essentially similar to the bacterium dis-

covered by Kitasato and Yersin in the Hong-Kong outbreakof 1894. As regards the origin of the disease in Bombayseveral explanatory theories have been adduced, such as

importation from Hong-Kong or from the Persian Gulf andthe use of diseased grain, as well as overcrowding, baddrainage, and insanitary causes generally.

SIDE-LIGHTS ON THE PLAGUE OF LONDON.

THERE is no quarter from which the historian may not t,draw materials-a fact of which none are more cognisant t’than workers in the history of medicine. The Plague of tLondon has been described with a fulness of detail denied Ito other visitations hardly less memorable, but still it seems tthere is fresh light to be thrown upon it. The Scottish s

Review for the current quarter contains a highly interestingand ably written article on the "Coronation of James I. ofEngland," and its writer, Mr. Guy le Strange, has availedhimself of the despatches of the Venetian Envoy sent

chome week by week to the Serene Republic by Mr. Secretary k

c

Scaramelli. These " dispacci," as giving us " a vivid picture rof the time," are, says Mr. le Strange, "unriv&lled," but

r

their number is so considerable that only a " very small part 1 (:

has as yet been copied, translated, or even calendared." Those ‘

of 1603 (hitherto unpublished) are what Mr. le Strange has 1

been deciphering, and besides a singularly animated and 1

curious account of King James’s Coronation they give, *

as we have said, side-lights on the plague, which

are not only interesting in themselves, but suggest J

to us what yet may be derived for the elucidation of

the same subject from other contemporary reports addressedby accredited eye-witnesses to their respective Governments.Like most epidemics of the kind the "Plague of London" Ihad several stages, all within a few years of each

I

other, till they culminated in the " Great Plague" pay,excellence of 1665. It is with that of 1603 thatScaramelli has to do, and certainly his details regard-ing it are ghastly enough. To his despatch dated

June 14th (May 25th, Old Style) he adds a postscript that"during this last week 22 have died of plague in 13 parishes,"while in the following week he announces 32 deaths from 15infected districts. The plague steadily gains ground, 30 deadare recorded within the seven days ending June 19th (NewStyle), and "the Court removes to Windsor, where the Kingremains and awaits the arrival of the Queen," and so on ; butthe warnings it signalled were so little taken to heart thatsucceeding visitations found the authorities as unprepared formitigating or combating it as before. Overcrowding, if notits provoking, was certainly its aggravating cause, and yet weread that "the Queen arrives to-day at Windsor with 250coaches and more than 5000 horsemen, for these during thewhole length of her journey kept increasing in numbers, beingintent on escorting her." They were equally escorting theplague; but while we read of this great accession to an

already overcrowded quarter the only countervailing measure-we are told of is that " an order had been issued for all dogsto be killed." Halt the expenditure lavished on the cere-monial so vividly placed before us by Scaramelli would, ifapplied to the relief of the congested lanes and alleys, havebeen more to the purpose than this hecatomb of dogs. Butthe laws of health had yet to be discovered and framed,and State medicine formed no part of King James’s "kingcraft," any more than of the Government of the Serene-

Republic to which its envoy addressed the despatches so-

vividly brought to our notice by Mr. le Strange.

TYPHUS FEVER AND INFLUENZA.

I THE Vienna correspondent of the Standard telegraphs that.an epidemic of typhus fever and influenza has broken out atPola, where there are 500 cases of typhus fever in the NavalHospital and 250 in the municipal ward. Nearly everyhouse is said to have its sufferer from one or other disease.The Berlin correspondent of the same journal also records aserious recrudescence of influenza in that city.

BEATTY v. CULLINGWORTH.

WE publish to-day a further list of subscriptions to thefund which is being raised to indemnify Dr. Cullingworthagainst pecuniary loss on account of having done his dutyto the best of his ability. We note with great pleasure.the generous way in which the profession has respondedto the appeal made to it, for if anything can atone to.Dr. Cullingworth for all the anxiety and trouble he has gonethrough it is the knowledge that his action has the unanimous.support and approval of his professional brethren.

AUTOTOXIS AND INSANITY.

DR. ALLAN McLANE HAMILTON has in recent papers dis-cussed with care and clearness an apparent relationship.between "Intestinal Autotoxis and Insanity." 1 As theresult of observation in fifty cases assisted by experimentsperformed on rabbits he finds himself unable to recognise!any specific or noso-toxicity in the urine of the insane, andin particular he has not been able to discover that any suchproperty is markedly associated with the retention of uric-acid by the blood. Where this product is apparently activehe regards it rather as possibly indicative of the destructivemetabolism of the nuclein of leucocytes and as related to a.primary intestinal disorder. The absorption of leucomaineswhich he administered to rabbits in food in the form of

hypoxanthin was attended with a distinct but not a,

very markedly disturbing effect on the nervous system.On the other hand, a clinical investigation into the changesoccurring in the contents of the intestinal canal and theireffects upon mental states and upon the condition of theurine shows results which are at least suggestive. Brieflystated, these are such as go to prove constant association withsome forms of mental disorder of putrefactive changes in thelower bowel. An equally constant result of this process is theexcretion by the kidneys of large amounts of indican (indoxyl-sulphuric acid) and of combined sulphates, evidently derived from toxic absorption at the seat of intestinal putre-faction. Certain forms of insanity are, in Dr. Hamilton’s.

experience, generally related to this autotoxic condition,while others do not in this respect agree withthem. The former include acute insanities with rapidlydeveloping symptoms, post-febrile, traumatic (after opera-tion, &c.,) and alcoholic forms of the disease, cases dueto drugs, and cases of transient hallucination connected withinsomnia and gastro-intestinal disorders. Into the other andnon-toxic category come the stuporous and chronic in-

sanities. The treatment advised for the toxic series consists.

1 New York Medical Journal, Oct. 31st and Nov. 14th, 1896.