1597

and of bringing the sugar below 50 grammes in the twenty-four hours. In March last he again came into hospital andwas found to be passing about 2 litres of urine containingfrom 40 to 84 grammes of urea and from 29 to 47 grammes ofsugar, there being a distinct parallelism between the ureaand the sugar, even when as a test 100 grammes of glucosewere given, this not increasing the quantity excreted to anygreat extent, so that the case was pretty certainly one notdepending on mere consumption of sugar, but on somethingconnected with the azoturia. Though the man was verystout--weighing 200 kilogrammes-tbe ferment had a

marked effect, reducing the average sugar from 41 to 11grammes and the percentage of sugar in terms of theurea from 64 to 30. Further, after the treatmentwas stopped the sugar only rose to 14 grammes, andthe percentage of it in terms of the urea to 39. Pro-fessor Lupine remarked that the effect of the fermentwas less after it had been taken for some days ; also thatattempts to obviate this by increasing the dose were notsuccessful, so that whatever the action of the ferment mightbe in the chemical laboratory it could by no means be saidthat in the system of a diabetic patient the effects were at allproportional to the quantity. Not only, however, were thepatients made to pass less sugar by a very small quantity ofthe ferment, the daily dose being 1 litre of liquid containing3 grammes of ferment, but at the same time there was amarked improvement in their general condition. It isworthy of remark that no diuresis was produced and nounpleasant effect whatever, so that the remedy is one whichmay be tried without any misgiving on the part ofmedical men. The difficulty is to obtain the ferment,which does not keep more than a few hours, andwhich must be used immediately it is neutralised. If.however, the directions given in Professor L6pine’s originalpaper are closely followed there will be no serious difficulty.

GALEGA AND OTHER GALACTOGOGUES.

Galactogogues are a somewhat unsatisfactory class of

drugs, and any light that can be thrown upon them iswelcome. Dr. Griniewitch, who has been making a series ofexperiments upon them, has found that there are a fewvegetable drugs which really increase the quantity of milksecreted without in any way acting detrimentally uponit, the specific gravity not being altered and the fat

being even somewhat increased. The most efficient ofall is a plant which, though it is said to have sudorificproperties, is practically unknown in medicine, thecommon goat’s rue (galega ojJicinalis). An extract is pre-pared, and from this a tincture is made containing6 5 per cent. of the extract. The dose of this tincture isfrom 50 to 100 drops repeated five times a day. If preferred,the extract may be prescribed in 4-grain pills, which may betaken from one to four times a day. A syrup may also bemade containing 5 per cent. of the extract. The next drugin the scale is the common stinging nettle-urtica 1trens;a tincture containing 20 per cent. of the extract is pre-scribed in divided doses amounting to from 250 to 500 dropsduring the day, or a syrup may be employed. Camin, anise,and fennel are also in the category, and these can be pre-scribed in powder-15 grains from once to five times daily.

THE ANNUAL REPORT OF THE MEDICALOFFICER OF HEALTH FOR THE

ADMINISTRATIVE COUNTYOF LONDON.

I.

EARLY in the autumn of last year Mr. Shirley Murphypresented to the Lendon County Council 1is first annual

report as medical officer of health for the administrative

county of London-namely, that for the year 1892, In

noticing that report shortly after publication, we tookoccasion to congratulate its author on the eminentlysuccessful manner in which the several branches of science

ancillary to what is included under the term "sanitation " have

1 Archives de Médecine Expérimentale, ler Mars, 1895.

been applied by him to the eucidation of the many complexproblems which still encumbbi the path of sanitary progress.We therefore hailed the appearance of Mr. Shirley Murphy’sinaugural report as of the happiest omen for the future ofpublic health administration in Greater London. We haverecently received the second of Mr. Shirley Murphy’s annualreports, which deals with the events of the 3ear 1893.As regards its general scope, and the arrangement of its

subject matter, this report closely resembles its pre-decessor, and in common therewith bears abundantevidence of the patience, diligence, and skill with whichit has been prepared. The tables, charts, and other illus-trative devices are so arranged as to be really helpful to thosereaders, whether sanitarily expert or not, who seek instructtion respecting the important details which are to be foundon every page of the text. It is, further, encouraging tonotice, as showing his special fitness for the task of con-

serving the health of the metropolis, that Mr. Shirley Murphyhas throughout appreciated and kept steadily in view the two-fold purpose which reports of this kind should always bemade to serve. The prevailing notion, which is probablyalso that of sanitary authorities generally, would seem to bethat the object for which such reports were designed bythe Legislature is mainly that of placing on record theuseful and praiseworthy official acts of the administrative

sanitary authority. But for us, as a profession, it is

far more important to remember, and to act uponthe knowledge, that in providing for the systematicpublication of these periodical reports, and prescribingtheir general character, it was obviously the paramountintention of the Legislature to secure that the medical officerof health should be encouraged and required to utilise to theuttermost the opportunities thus periodically afforded himof formally and publicly advising his authority, and of

imbuing them with scientifically correct notions ccncerningthe direction which sanitary progress should take.We may truthfully repeat with regard to this report what

we said of its predecessor last year-namely, that it appearsto us in every way excellent and worthy of the importantsubjects of which it treats. In accounting for the somewhatlate appearance of this second report, Mr. Shirley Murphypertinently remarks that "the time at which his own annualreport can be prepared depends on the date at which theseveral district reports are received by the Council." It

appears that in several instances these necessary contributionsare but tardily sent in, and, as a consequence, the appearanceof the chief medical officer’s report is correspondirgly delayed.We therefore agree with Mr. Shirley Murphy in expressing thehope that in future yeara the earlier receipt by him of thereports of district medical cfficers of health will enable a reportfor the entire aiea of London to be presented with less delay.We are glad to note that the County Council have seen fit toplace on sale both these valuable contributions to sanitaryliterature. The successive health reports may, therefore, be

’ studied with both pleasure and profit by all who take aninterest in the health and consequently the prosperity andgeneral well-being of the vast and rapidly increasing popula-tion of the English metropolis. In our review of Mr. ShirleyMurphy’s first report we published in these columns certainextracts and tables from that document with the object ofgiving some idea of its scope and general character.

1 As we have before remarked, the general plan of the firstreport has been adhered to in the second ; we shall not,

therefore, again discuss those points which are common to

both reports, and which were dealt with at length in ourprevious notice. There are, however, certain features in the

report for 1893 which appear there for the first time, and

; which for many reasons are deservirg of special corsidera.tion. We shall accordingly proceed to notice briefly themore important of these features in ensuing issues.