1091THE KING AND THE TOURING CLUB OF FRANCE.

admirable address which is published at p. 1057 of our presentissue. There can be but little doubt that with greater

artificiality in the preservation of the species, undoubtedlyconcomitant with advancing civilisation, there must arise

inquiry into the less instinctive and more artificial methodsfor its healthy continuance. Herein lies the demand for

eugenic knowledge, while from such work as that of Dr.

MOTT we learn the immense way we have to go before we can

even hope to see daylight.

Annotations.

THE KING AND THE TOURING CLUB OF FRANCE.

II Ne quid nlmIB." "

IN response to a suggestion made by Sir Francis Bertie,the British Ambassador in Paris, His Majesty King George V.has graciously accepted an honorary membership of the

Touring Club of France. At almost the same time His

Majesty King Albert I. of Belgium accepted the same mem-bership. Those who are acquainted with the excellent workaccomplished by the Touring Club of France will rejoice atthe well-merited compliments thus conferred on it. It is

not as tourists but as sanitary reformers that we welcomethe action of their Majesties, for that is the side of the

club’s work in which we are interested. The first attemptmade by the Touring Club of France in health directions

was to insist on the sanitary reform of the hotels that

tourists were likely to frequent. Hotels that put in a propersystem of drainage and furnished their rooms in a wholesomemanner were allowed to call themselves Touring Club hotels.Here the thick carpets spread over the whole room and

permanently fastened down, the heavy window drapings,and voluminous bed-hangings were all abolished. The paperin a Touring Club hotel is stripped off the walls and

washable paint or distemper is employed instead. The

floors are wood blocks polished with beeswax, or are laidwith tiles. A small rug or two that can be lifted

away and shaken alone is allowed on the floor. The

numerous culture grounds for infective material provided bythe old-fashioned manner of furnishing hotel rooms are thusdone away with. Plenty of light and every facility for

cleaning are provided, and in some cases now the anglesbetween the walls and the floor and ceiling are being roundedoff, so that these havens of dust will soon exist no more.The members of the Touring Club are provided with regularforms, so that they can send complaints to the central officeif any hotel fails to keep the rules laid down. These rulesrelate not only to sanitation but also to the charges. Ifa traveller is overcharged he need not incur the un-

pleasantness of a dispute with the landlord. He need

only insist on a detailed receipt for the payment whichhe has made. This he sends to the central office, andif he has been overcharged he will not have to wait longbefore the unjust surplus is returned to him. Agreementshave been signed between the Touring Club of France withmore than 3000 hotels, not only in France but in many othercountries. Here the tourist will find the best sanitary con-ditions available, and will not have to pay more than theTouring Club tariff. Of late, in regard to this control

exercised over hotels, a new and very interesting departurehas been made. The gastronomic tourist has gaineda hearing. With the increasing facilities of travelthere is an unfortunate tendency to build hotelsall over Europe on almost identically the same model.The menus of the meals are always in the same

style, and local characteristics are being effaced bythe general European assimilation. British and American

travellers, by reason of their ignorance of the gastronomicarts, are largely responsible for the deterioration of the

cooking, especially in the first-class hotels. The TouringClub is making investigations and offering prizes to thosehotels which maintain the local traditions, which persist incooking the dishes for which the town or province is

renowned, even if a foreigner cannot appreciate them. Whenthe best and most artistic samples of culinary art are

looked upon with suspicion by the ignorant, or refused by thedyspeptic, the native chef is apt to lose heart, and so clearlyhad this become the case that the best traditions of French

cooking were in danger. Now the Touring Club is trying tosave the situation, and the connoisseur may still expect to finddishes capable of satisfying an experienced palate. After

thus seeking to improve the hotels, the Touring Club exercisesits great influence to maintain the roads by which all thebeautiful parts of the country can be reached. It sees to

it that there shall be a popular outcry raised if a

natural or artistic beauty-spot is likely to be destroyedor spoilt in any way. But more than that, it watches

over the forests that they shall not be uselessly cut

down, that likely spots shall be planted with trees, that thebeauty of sites shall be improved by suitable verdure ortimber, and that the climate shall not suffer for want of

sufficient woodland. All this is done by the exercise of

personal influence and persuasion, by publications, by thedistribution of prizes, and by the aid of subventions.

Altogether the Touring Clab of France has spent more thanR100,000 in this public service, a service which does so

much to facilitate that form of travelling called touring.This, we take it, is holiday travelling, and the holidayis essentially a health institution. The work of the TouringClub is the work of preventive medicine, for it facilitatesthe relaxation on which health so much depends ; and,by the sanitary control of hotels, it seeks to dissipatethose dangers that used to be associated with travellingand hotel life.

____

"THE FATE OF ICARUS."’’ BYRON’S ’ Mountain Spirit’ (writes an Italian correspon-

dent) might be credited with a sombre acquiescence’in the fate of poor Chavez were it to act as a deterrent toall future aviators in daring to molest her ancient, solitaryreign.’ But that grim satisfaction will be denied her.

Other attempts will follow till the flight over the Alps willin turn be surpassed, and Chavez’s feat (who knows ?) beeclipsed by another, and less tragic, flight over the Andes ofhis native Peru. Meanwhile, the company of competingaviators at Milan were well inspired to suspend operations outof respect to their young rival’s memory, for a more patheticextinction of a career bright with promise has rarely beenput on record. To have out-soared all competitors of allnationalities, to have earned the enthusiastic applause of theworld, and the Rabelaisian title of ’Astrophil,’ with themotto ’ Quo non aseendam ?’ to have reached an altitude of2680 metres, and to have succumbed to a fall of barely 20,surely this must have induced a moral revulsion, a ’ heartfailure,’ which explains the nervous collapse which frustratedall the skill and care of the numerous consultants gatheredround his bed. True, the surgical lesions were grave ; notmore so, however, if not indeed less, than those from

which many a victim of a railway accident has recovered.But the experienced head of the medical clinique at

Turin, the Senator Professor Bozzolo, entertained from thefirst a prognosis more than doubtful, remarking to a

colleague as he left the patient’s private room in the hos-

pital at Domodossolo, ’ I fear the diffused nervous shock iscausing the ominous prostration. Neither the consultants inimmediate charge of the case nor I myself have been able tolocalise any seat of disturbance.’ Later, Professor Bozzolo

1092

dictated the following bulletin : ’ Considerable generaldepression, with tendency to drowsiness consequent on arestless night and increased since yesterday. Pulse at a

high rate of frequency, 134; respiration, 34 ; temperature,370 C. Pr(J{jnostieo asscci riservato (prognosis very reserved.)’ IEvery eilort was expended towards saving the brave

young soul, whose ’ will to live’ (the analogue in the

physical, of the ’ will to believe’ in the spiritual, sphere) wasa distinct clinical asset ; but Dis aliter is1(m. Revivingfor a time, under the inhalation of oxygen, of which 600

litres were consumed from first to last, he met each visit witha smile and seemed more concerned with the trouble he was

giving than with his own sufferings. At last delirium super-

vened, in the course of which he was heard to murmur

incoherently, the only expressions to be distinctly made outbeing, Ah! ...... la montagne...... la montagne I’ And so,

having already received the last consolations of the Churchat the hands of the good canonico Colcati, he glided away,.in the words of John Tyndall, like a streak of morning- cloud, into the infinite azure of the past.’

"

INTESTINAL OBSTRUCTION DUE TO A FOREIGNBODY IN THE ABDOMEN, PRESUMABLYINTRODUCED THROUGH A PERFORA-

TION IN THE UTERUS.

IN the -,A’et, ’or7 Medical Junrnal of Sept. 17th Dr. HenryRoth has reported a case of intestinal obstruction due to anextraordinary cause-a foreign body in the peritoneal cavitywhich was apparently introduced through a perforation madein the uterus in the induction of abortion. A single woman,aged 24 years, was admitted into hospital with the followinghistory on May llth, 1908. Three weeks previously she hadan attack of abdominal cramps and vomiting which lastedabout eight hours. She remained well for a week, and thena similar attack occurred which lasted 24 hours. She againremained well until May 10th, the day before admission,when, whilst walking in the street, she was seized withsevere abdominal pain and vomiting. The pain was moresevere than before, and compelled her to take to her bed. At

first the pain was all over the abdomen, but gradually it

became most marked in the right lower quadrant. She

vomited repeatedly, and on the following day suffered

intensely from thirst, and was unable to retain even smallquantities of water. In spite of the repeated administra-tion of cathartics and enemata the bowels did not act.On examination the abdomen was found moderatelydistended ; rigidity was most marked in the right lowerquadrant. There was considerable tenderness over thelower part of the abdomen, and this was most,marked on the right of the umbilicus. No mass was

palpable. The temperature was 1010 F., the pulse was 80,and the respirations were 16. The pain was observed to beparoxysmal, coming on about every ten minutes. In view of

the history of two similar attacks in three weeks and thesigns, acute appendicitis was diagnosed, but in consequenceof the paroxysmal cramp-like pains the possibility ofintestinal obstruction was not negatived. Laparotomy wasat once performed, about 36 hours after the onset of the

pain. The incision was made on the right side and on

opening the peritoneum much clear serum escaped. Digitalexploration revealed a cord-like structure running from theright side downwards towards the median line and attachedto a mass of intestine which it constricted. The structure

proved to be omentum and on separating it and withdrawingit from the abdomen a body about 2 inches long and inchwide was brought out. This proved to be a pledget of

absorbent cotton discoloured by blood. Further examina-

tion revealed two loops of ileum adherent at the mesentericborders. The adhesions were broad and firm and required

ligation before division. In the midst of these adhesionsmore cotton was found and removed. Part of the omentumand the vermiform appendix were removed. The questionarose, How did the cotton reach the peritoneal cavity?As laparotomy had not previously been performed, per.foration of the uterus in the production of abortion was

suspected. The pelvic organs were therefore carefullyexamined. All that could be found was a small induratedarea in the lower part of the posterior wall of theuterus. The abdominal incision was closed without drainageand recovery was uneventful. After the operation the

patient admitted that she had had several abortions induced,the first about two years previously and the last on

March 28th, 1908, when she was about two months pregnant,about six weeks before the onset of the present illness. No

unusual pain or other symptoms followed the abortion. The

last menstruation occurred about two weeks before admission.In most cases in which foreign bodies have been foundin the peritoneal cavity they have been left there

accidentally in the course of operations. In this case

the cotton was probably introduced on a uterine soundor forceps which perforated the uterus. A. P. Heineck,by an exhaustive search of medical literature from 1895 to1907, collected 160 cases of perforation of the uterus duringintra-uterine instrumentation. In 26 the object was to

induce abortion. He found that perforation could occurwith startling ease even in the hands of clever operators.He disagreed with those who believed that the accident wasnot followed by alarming symptoms. Shock, hemorrhage,injury of viscera, infection, prolapse of omentum or intes-tine, with or without strangulation, were the immediatecauses of danger. Several cases have been recorded in

which bougies were introduced into the abdomen through aperforation in the uterus in the induction of abortion andwere later found when laparotomy became necessary andremoved.

____

THE RIGHT TO EFFICIENT VENTILATIONAT SEA.

A VERY important decision has been given by JudgeRentoul in the City of London Court. Returning from SouthAfrica, two passengers complained that their cabin hadno ventilation and paid .f.1j. 12s. 2d. to occupy another

cabin, contending that "a cabin without a fan was quiteintolerable." On the other hand, the Union Castle Mail

Steamship Co. in their booklet state that "a completesystem of ventilation had been adopted, and that electricitywas brought to bear on the cabins, saloons, &c., by theadoption of a large number of electric fans." JudgeRentoul said that anybody reading the booklet would thinkall the cabins had electric fans in them, and as the discardedcabin had no fan he gave the verdict in favour of the pas-senger, and ordered that the money paid to ensure a change ofcabins should be restored. So far so good, and it is somethingto know that the law can be invoked to secure the execution of

promises made in regard to the ventilation of the cabins

passengers have to occupy on board ships. But unfortunatelyignorance in regard to ventilation is so profound that

it is not difficult to satisfy the public with a sham andcheap pretence of its benefits. Whether the ship in ques’tion, has or has not "a complete system of ventilation" is amatter on which we could not possibly express an opinionwithout first very carefully inspecting the ship herself. If she

has, then she differs from most other ships afloat. Aluch asthe question of ventilation has been neglected on shore, it is

still more behind the exigencies of modern scientific require-ments at sea. All the talk of fans in the case just tried isevidence of the prevailing ignorance. There seems to have

been an impression that a fan has something to do with