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surgeon responsible for pain and to blame him for applying ithe most approved treatment, as Dr. Thorne did here, evenin the opinion of witnesses for the defence ; and when toimpatience and peevishness he adds slander which becomessown broadcast, it is high time to appeal to the law forredress. Dr. Thorne’s action, both in its surgical and ethicalaspects, will commend itself to all members of the professionand, indeed, to all reasonable persons.

DEMENTIA AND INCOÖRDINATION IN CHILDREN.

VR..J:)ûUCHAUD records in the ltevue lYeurotogique twocuriously interesting cases. The patients were brother andsister, one aged six and the other aged seven at the com-mencement of the illness. This began with a certain amountof intellectual weakness and incoördination in all four limbs.The gait was like a combination of the tabetic and cerebellar,but no paralytic symptoms were present and no nystagmus.The knee-jerk was absent in one patient and much diminishedin the other, but the superficial reflexes were retained, thespeech was slow but the articulation good, and the ex-

pression was always bright. The symptoms, both physicaland psychical, became gradually worse, the speech unin-telligible, and difficulty in chewing and swallowing wassuperadded. The sphincters became affected, and muscularrigidity became marked. The muscles wasted, but therewas no fibrillary twitching. Scoliosis gradually developed,and bedsores were the final stage of the illness. In the boymeningeal symptoms were present before death, but the girldied from marasmus and influenza. An examination of thecords revealed in one case sclerosis in both lateral columns,while in the brain there was an absence of medullated fibres.In the other case there was a similar condition in the cord.Otherwise the nervous structures showed no abnormality,although the anterior horn cells were perhaps reduced innumber.

THE DIFFUSION OF SMALL-POX.

WE give the facts as to small-pox in London in anothercolumn. The malady seems to have subsided completely inWest Ham. At Walsall there were last week but 2 cases,and 17 at Birmingham, with 4 deaths, and the sanitaryauthority now hope that the disease will shortly die out, atany rate for the present. Much space has been occupied in z,some of the Midland newspapers concerning the death of a ’,man in Coventry, who is held by the health officer to havebeen unvaccinated, but who is, on the other hand, stated by Ithe anti-vaccination party to have been primarily vaccinated.The latter party appear to be catching at straws. Stockportis not yet free from small-pox, cases having been recordedagain last week. There were 22 fresh attacks at Man-

chester, and 1 death ; whilst several other towns in Lan-cashire and many in Yorkshire had experience of the

disease, Middlesbrough having half a dozen cases. At Leith

the end of the first week of July found 49 cases in hospital,and this number decreased to 28 a fortnight later. The Coal-hill Hospital has been closed, only 10 new cases having cometo light in the fortnight. Over 7000 persons have been vac-inated at the public expense at a cost of some ;&600. Two Icases of small-pox were reported and isolated in Dublin lastweek.

OVARIOTOMY DURING PREGNANCY.

IN the re7aize de Tocologie et de Gynecologie 1 there is

an article by Dr. R. Condamin on the treatment of ovariantumours complicating pregnancy, with an account of twocases of the kind which had come under his notice. The

question discussed is at what period should ovariotomy beundertaken : should the operation be undertaken during preg-nancy as soon as the tumour has been detected, or not until

1 Vol. xxi., part 4,

after the confinement 2 Dr. Condamin’s two cases point tothe advantage of operating as soon as the tumour has beendiscovered. In one of them ovariotomy was not performedtill about three months after the confinement, and in thatcase the patient had become very ill before the opera-tion was undertaken, with great pain and high temperature.When the abdomen was opened the pedicle of the tumourwas found to be twisted six or eight times, and the appear-ance of the cyst wall here and there suggested that gangrenewas about to supervene. The patient recovered, but fromthe account given it is evident that her condition was duringpart of the time such as to cause anxiety. Dr. Condaminbelieves that the lax condition of the abdominal walls

naturally resulting after labour is an important factor infacilitating twisting of the pedicle when there happens tohave been an ovarian tumour complicating the pregnancy.In the other case related ovariotomy was undertaken atthe fifth month of pregnancy ; the operation was per-fectly simple and the after history uneventful. It is not.

however, expressly mentioned whether or not the patientwent her full time. Dr. Condamin refers also to the seriesof post-partum ovariotomies published by Dr. Aust Lawrencelast year, and he considers that an examination of the detailsof these cases strongly supports the conclusion to which hehas himself arrived-namely, that when an ovarian tumouris discovered during pregnancy there are no advantages-but,on the contrary, many serious disadvantages-in delay, andthat ovariotomy should be performed as soon as possible.We may add that this accords with the opinion generallyheld in England.

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SHAM NURSES.

IT is reported that fashion, late but for once true in

taste, has begun by occasional ventures to appropriate theseemly nursing costume as part of her system of decoration.We need not be surprised at the preference thus expressed.Cleanly, simple, neat, but undemonstrative as it usually is,the dress of female attendants on the sick was not likely toescape entirely from the flattery of imitation. Neverthelesswe consider its exhibition at all times and places, and espe,cially its use by those who have no professional title to its use,to be an error and a folly. The nurse’s apron, cloak, andbonnet are as much her distinctive regimentals as militaryscarlet is the national guarantee of a soldier’s position.Wearing it we know exactly who and what she is, we cansomewhat gauge her character by her attire, and we cantrust her service ; but if any and every admirer of her comelydress may ignore its distinctive character we lose much morethan can be gained by a usurping fashion. The meaning isentirely gone. The casual wearer may be anyone-no merelyinnocent masquerader, not even the glorified jackdaw of thefable, a nameless attraction only, a person void of per-sonality, perhaps not insignificant, but certainly, in the indi-cations of her clothing, unreliable. It is to be hoped, forthe credit and continued usefulness of a class representativeof the highest womanhood and not less for our common

security against a mischievous deception, that every meanswhich public sense can employ will be used to baffle thisnew strategem of thoughtless or unscrupulous fancy.

THE TREATMENT OF INFANTILE TUBERCULOSISAND RACHITIS IN FRANCE.

AT the Congres de Bains de Mer, lately held at Boulogne,a note on the proceedings at which will be found in

another column of our present issue, an interesting accountwas given of the treatment of rachitis at the children’s

hospitals at Berck, at Arcachon, and at Banyuls-sur-Mer.The hospital at Berck is supported by the municipality ofParis, with payments for patients from other places ; and theother institutions exist by subscriptions, by payments from