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given as the cause in from 14½ to 20 per cent. of the cases ;and alcoholic excess is responsible for from 5t to 8 per cent.of all cases, but if male cases alone are considered itmakes the ratio of alcoholic cases amount to a higherfigure-viz., 10 to 14t per cent. Thus one-eighth ofall male admissions to the lunatic asylum are attributedto alcoholic excess. Dr. Evensen points out the mental

inferiority of the habitual drunkard, especially as regardsmorals and self-control. He believes that alcoholic

craving may manifest itself without a hereditary predis-position thereto and without stigmata of degeneracy beingpresent at the same time. In his collection of recordshe finds alcoholic insanity without heredity in 530 males-i.e., in 22 per cent., and alcoholism with heredity in 72 cases.Dipsomania is attributed to periodic states of mental

depression. After referring briefly to the epileptic varietyof alcoholism, which does not necessarily imply insanity,and to delirium tremens, he examines and classifies cases ofalcoholic insanity in the stricter sense. He established Eixclasses of these: (1) the extreme maniacal form ; (2) theexpansive form; (3) the confusional form; (4) the systematicdelusional form ; (5) the demented form; and (6) the pseudo-general paralytic form. Dr. Evensen concludes by pointingat the great importance of the problem of alcoholism froma medico-legal point and in referring to its treatment he

urges the necessity of providing special institutions or

retreats for the treatment of alcoholic subjects.

THE PRESIDENTIAL ADDRESS AT THE AMERICANNEUROLOGICAL ASSOCIATION.

AT the twenty-fifth annual meeting of this Associationheld at Atlantic City, New Jersey, on June 14th last,Dr. James Hendrie Lloyd delivered the Presidential Addressand referred to the future tasks and work of the Associa-tion. In the field of neurology in America it was essential,he said, at the present day that there should exist

an association such as the above to act as an exponentof one of the most important specialties of medicine.

In the United States the tendency was at one time rathertowards provincialism; they had, however, outgrownthat stage and were now realising that greater thingswere to be accomplished. A truly national association wasneeded for neurological science-not national in the pettyand narrow sense that it represented every city or state, butnational in the sense that it included every neurologist inthe country of approved attainments. Most of the genuineoriginal work in neurology done in the United States duringthe past 25 years emanated from those who were members ofthe Association and no national association of specialists inAmerica could by this standard claim to be more trulyrepresentative. Neurology was in a special way a mostdifficult and involved field of practice, and the man whoreaped genuine success in it was willing and anxious to beenrolled in the Neurological Association, for he felt that insuch a place alone could he meet with both the under-standing and the criticism which were at once the rewardand the stimulant of his own work. " The man who worksin nervous diseases," added Dr. Lloyd, "and never seeks togain membership in this Association must either have somesecret misgivings about his own neurology or entertain anindifference towards the very specialty which he professes.Here alone is the arena in which he meets his true confrères ; ;here alone can he hope for the spirit which makes a

symposium of his nocturnal vigils in neurology and createsan atmosphere which is productive of his best thoughts.’It had hitherto been too much the custom to look abroaèfor some of their technique and methods, too frequentlythe case to seek for inspiration and knowledge elsewhereBut a great school of neurological medicine was growing u]at home which ought to bear its own fruit in the immediat

future. In older times neurology was scarcely recognised asa branch of medical science. The old-fashioned professorand practitioner of physic was from force of circumstancesnot proficient in neurology. He was (with few exceptions)unfamiliar with its clinical details, its complex anatomy andphysiology, and its difficult technique. All this, however,was passing away and neurology was assuming its own andproper place in the present-day medical curriculum. Thestudent of neurology had to gather his knowledge, not onlyfrom the lecture-room, but from the bedside and from thelaboratory. The science of neurology presented several

phases which were worthy of note. In the first place ithad grown somewhat lukewarm towards the revelations of

bacteriology as affecting problems arising in its own domain.From a therapeutic standpoint the returns had been comingin rather slowly from the bacteriologists and they were not asyet in a position to offer a reliable serum-treatment for manynervous disorders. In pathology, said the speaker, therewas no occasion for disappointment, for they were standingat the threshold of a new and wide field in neuro-cytologyin which much promise was beginning to unfold itself.But in medicine, as in other sciences, they moved in

"cycles and epicycles," and, like some primitive tribes,they always worshipped the new moon. They were justnow engaged in the cult of Nissl-they were at the hightide, as it were, of methylene-blue. At another time the

neuron-theory had promised much, but more remained to befulfilled. Pathology was the science of disease and theyaccomplished their true aims if, like the archaeologists,they could point out unerringly what had been the normalstructure from a study of its ruins and remains and could dosomething to reconstruct those ruins. In the domain ofthe nervous system this was a fascinating study, for in thenervous system were manifested the highest and noblest

functions of organic matter. Originality and independencein work were of the highest importance. The spirit ofresearch should be cherished and encouraged. They couldnot remain mere copyists or disciples of foreign masters.

Finally, it should not be forgotten that the great lights inmedicine had been the great clinical observers. Clinicaland therapeutical aims should be foremost in their ideals.Without constantly keeping expert in reading the signs ofdisease at the bedside and ministering to the wants of

suffering their medicine would become a dry and barren’ thing.

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THE COMPOUNDING OF PRESCRIPTIONS.

A CASE or great importance to tne meaicai protession ana

druggists was heard recently at the West London Police-court before Mr. Rose. Certain druggists were prosecuted for" selling a compounded drug not comprised of ingredients inaccordance with the demand of the purchaser." Mr. Blanco

White, who attended on behalf of the Fulham Vestry tosupport the summonses, explained that the proceedings weretaken under the 7th section of the Food and Drugs Act.In order to test the accuracy of preparations made np bydruggists, Mr. Jackson, the medical officer of health for

Fulham, wrote out prescriptions and had them made upby the defendants. In the first case heard the sampleof medicine contained, according to the analysis of the

vestry’s analyst, Mr. Cecil H. Cribb, 258 grains of iodide ofpotassium in six ounces of mixture, whereas the prescriptionrequired 240 grains, showing an excess of 18 grains, so thatin each dose there would be an excess of three-quarters of agrain of iodide of potassium. In the interests of thedefendant Professor John Attfield, F.R.S., was called andgave the result of his analysis of a portion of the samemixture which had been submitted to him. He could onlyfind an excess of two grains above the 240 orderedby the prescription. Mr. Blanco White asked that

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the third sample might be submitted to the Govern-

ment Laboratory for a final analysis. Mr. Waddy, who

appeared for the defendant, urged the magistrate to

exercise his discretion in this matter by refusing the

application. Mr. Rose acceded to this and in dismiss-

ing the summons on the facts observed that he had

the greatest doubt whether the Food and Drugs Act wasmeant to be applied to a case of this nature. The Act, he

thought, was intended to deal with frauds and had no rela-tion to a trifling excess of an ingredient in a bottle of

medicine. Moreover, it could not be supposed that the Actwas intended to enforce the absolute exactness of a prescrip-tion. We cannot at all agree with this finding and weconsider the decision a most dangerous one. The 7th sec-tion of the Food and Drugs Act, 1875 (which is still

in force until next year), runs thus : " No person shallsell any compound article of food or compounded drug whichis not composed of ingredients in accordance with thedemand of the purchaser under a penalty not exceeding20." It is of the utmost importance to the general publicthat prescriptions should be made up according to themedical practitioner’s orders, and some law must exist to ’,protect persons from the action of careless druggists. Wefully believe that, as a general rule, the greatest care isexercised by druggists in compounding prescriptions, butexceptions may occur. In the case described above theerror would certainly not have mattered, but for the

magistrate to talk about trifling errors" shows a greatwant of knowledge of drugs. With certain preparationsa "trifling error" might have the most serious results.To utter a decided opinion with all the force it must haveas coming from the Bench in a test case of this kind is toassume a great responsibility. It is not the nature of the

drug in this particular instance that is in question, but thewhole meaning of the Act in regard to the dispensing ofprescriptions. The Act distinctly states that the articlemust be composed of ingredients in accordance with thedemand of the purchaser, and if such be not the case

then a breach of the law has taken place, and a penaltyshould be inflicted. The summons against another ofthe defendants was withdrawn, whilst those against twoothers were postponed. We should like them to be proceededwith, so that the wording of the Act could be furtherinsisted on and its true significance settled. If the learned

magistrate’s decision be correct the sooner a more definitesection be inserted in the Act the better, for we observe thatthe Sale of Food and Drugs Act, 1875 to 1899, which comesinto operation Jan. lst, 1900, contains no reference to thesection quoted above. -

TOKELAU.

ACCORDING to Dr. Tribondeau of the French navy 1 theremarkable skin disease known locally in the Southern iPacific Ocean as " tokelau " has been the subject of numerouspublications, lay as well as medical, for upwards of twocenturies, but it nevertheless still stands in need of an

adequate description. Observers hitherto have been merebirds of passage, for the most part imperfectly equipped, ilacking both time and opportunity to perfect their study of sthe affection and consequently unacquainted with each others’ writings. Hence, no doubt, it is that the disease has ibecome endowed with an exceptionally voluminous nomen- ]

clature, as voluminous probably as can be found throughout the whole range of pathology, but unfortunately among these fmultitudinous designations none are entirely appropriate. ‘Manson and Turner have respectively named the disease "tinea imbricata" and "herpes desquamans," but Dr. Tri- 1

1

bondeau is unable to accept either of these titles. The word

1 Archives de Médecine Navale, July, 1899.

‘° tinea," he maintains, is always used in connexion with thehairy regions of the body, which are precisely those leastand last invaded by the tokelau parasite; and so far frombeing "imbricated" the concentric rosettes which the lattercauses are invariably discrete, never overlapping each otherat their edges. The disease, he thinks, has nothing at all incommon with herpes. He can understand the term "herpescircinata " being thought applicable to a tricophytic eruptionhaving a smooth base, but in tokelau there are no smoothinterspaces, the sufferer’s skin being entirely covered until, ina severe case, he resembles a huge fish. As for the epithet"desquamans," continues Dr. Tribondeau, why exfoliationis such a common phenomenon in skin affections that

really in the present instance something more definite is

required. Tokelau is by no means a perfect name ; still, ithas its merits, and having adopted it definitively himself hetrusts that his example will be generally followed, so thatthe confusion inseparable from a superabundance of

synonyms may be avoided. Dr. Tribondeau spent two

years in and about the Society Islands while employed asmedical officer of the despatch boat Attbe and thus had

ample opportunities for studying the disease. The clinicalnotes which he has collected permit him to give a descriptionof tokelau more complete than any which have preceded " ;and, moreover, in the course of his microscopical researchesinto the intimate structure of the "mushroom" causing themalady he has discovered " forms and organs of reproductionheretofore unknown." The tokelau organism, of which twoadmirable plates 2 are given, is, in Dr. Tribondeau’s opinion,wholly distinct from the trichophytons with which it untilnow has been confounded, and it ought in reality to beclassified as an aspergillus. As no special designationso far exists for the tokelau parasite Dr. Tribondeau

proposes to endow it with the name "lepidophyton" "

(&lgr;∈&pgr;&igr;s-&igr;&dgr;os, fish-scale ; &phgr;UTOV, fungus), a suggestion to

which there would seem to be no objection. Hehas dealt with his subject in five chapters whichare entitled respectively History, Symptoms, Etiology,Diagnosis, and Treatment. He has something interestingto say in each, but we have space for one extract only." In 1889 a native who formed one of a group ofTahitians sent to the Universal Exhibition of Paris, beingcovered with squamous scales wished to take advantageof his sojourn in France by getting rid of his tokelau.

He entered a hospital where they began the essayof a whole series of remedies without producing anypermanent impression on the tenacious parasite. At last anointment of chrysophanic acid brought it to reason. Re-

turned to Tahiti the patient gave the curative formula to anapothecary at Papeete. The ointment in every case actedlike a charm, and if the disease still exists it is because thepeople affected are too lazy to submit to a complete destruc-tion of the lepidophyton. It is, however, permissible to hopethat in a few years tokelau will have become a disease of the

DANGEROUS TRADES.

THE final report of the Departmental Committee on Dan-gerous Trades .has, as we mentioned in THE LANCET of

Sept. 9th, p. 733, been issued as a Blue-book. The report dealswith" millstone building," the manufacture of emery wheels,the preparation of basic slag, the manufacture of the oddly-named silicate of cotton " which is in reality fused slagblown into fine threads, the extraction of salt from brine, andthe use of metallochrome powder. Sundry dyeing processes inwhich salts of lead are in use are considered as well as the

process of dyeing with arseniate of soda. This last process,however, the committee do not think it necessary to label"dangerous." With regard to "label-licking," a process to

2 One representing the newly discovered sporiferous organs