1282 THE RISKS OF KOCH’S TREATMENT.

no means to be an indiscriminate one. They should be (

prepared to show some real work and profib of work besidesgiving evidences of character. The dangers of unprincipled and ignorant midwives, not only as regards mothers, butchildren, is a subject that has not had siiflicient considera- ,tion.

Certificates of still-birth are already given somewhatominously. A correspondent lately showed that in his

village the midwife gave one in every case where the childdid not live more than five hours. In Liverpool, in 1889, in eight cemeteries there were 483 children buried as " still-born." Such figures show the necessity of having evidenceof character, as well as of training, in midwives, and of

looking closely at these certificates of still-birth. The

critics and opponents of this legislation will do much goodif they will devote their energies to procuring amendmentsin this sense. They cannot permanently avert, but theymay powerfully control legislation.

Annotations.

THE COLLEGE OF SURGEONS AND THEUNIVERSITY OF LONDON.

11 Ne quid nimis."

A WELL-ATTENDED meeting of the committee of theAssociation of Fellows, specially convened for the purposeof considering the negotiations between the Senate of theUniversity of London and the Council of the College ofSurgeons, was held on Tuesday, the 9th inst., at 5 P.M.Mr. Lawson Tait’s letter, published in THE LANCET lastweek, was read, and, after discussion, the following resolu-tion was unanimously adopted: "That the committee ofthe Association of Fellows desires to record its emphaticprotest against any final settlement between the Councilof the College and the Senate of the University of Londonin the matter of the reconstitution of the University with-out the Council of the College having consulted either theFellows of the College, or, if they cannot be convenedseparately, a general meeting of Fellows and Members."A memorial to the Senate was drawn up and adopted, andit was resolved that it should be sent to the Senate ofthe University without delay, copies being forwarded tothe Lord President of the Privy Council, Lord Selborne asChairman of the recent University Commission, and theCouncil of the College. This memorial we publishin another column. It was also determined by thecommittee that a general meeting of the Associationshould be summoned by advertisement to meet at the roomsof the Royal Medical and Chirurgical Society on Saturday,20th inst., at 4 P.M. At this meeting the committee willsubmit the action, which the urgency of the occasion hascompelled it to adopt, to the judgment of the Association;and, in view of the great importance of the proposedamended scheme and its vital interest to the Fellows of th(

College, will invite all Fellows of the College who like t(attend to take part in the discussion. Apart from thebearing of the scheme upon the position and prospects o:the metropolitan and provincial schools, and on medicaeducation and examination generally, it is evident that thenegotiations between the Senate of the University and thECouncil of the College, which at any moment may bbrought to a final settlement behind the backs of theFellows and Members of the College, raise once againthe broad constitutional question whether’ any importan

change in the constitution and external relations of the

College ought to be effected by a body of twenty-fourFellows without any reference to the Fellows and Memberswho constitute the body corporate. By taking its standagainst the exercise of autocratic authority by the Councilof the College, and endeavouring to raise the position ofthe Fellows of the College of Surgeons and give them aninfluential voice in its affairs, the Committee of theAssociation is lighting the battle of the Fellows as a body,and, if properly supported, would be able to obtain con-cessions from the Council of the College which would adddignity and influence to the Fellowship, and materiallypromote the welfare of a great public institution.

THE RISKS OF KOCH’S TREATMENT.

IN the very interesting communication from our SpecialCommissioner at Berlin reference is made to the dangeroussymptoms which may attend the use of injections with Pro.fessor Koch’s liquid ; and although he explains the fatalityin some of the fatal cases to be due to the ordinary courseof the disease under treatment, there can be little doubtthat in a few regrettable instances there has been evidenceof disastrous results. The fact is the profession have beenplaced in possession of a most powerful poison, and that asyet experience of its effects-which, like all poisons, vary inindividuals according to their special idiosyncrasies-is sosmall as to necessitate the most cautious employment of it;this, too, quite apart from cases of pulmonary and laryngealtubercle, where the local reaction set up by it may of itselfproduce alarming and dangerous symptoms. Therefore weendorse fully our correspondent’s view as to this being anagent (and it is still to be proved that its action is curative)which should not be employed in general practice, but onlyunder circumstances admitting of the strictest continuousmedical surveillance. A like conclusion is stated in theexcellent report drawn up by Drs. Saundby, Simon, andBarling (Birmingham Medical Review, December), who urgethe greatest circumspection in dosage and conditions of ad-ministration. We believe, for example, that it is rash tocommence the treatment of lupus with as much as 0’01 grin,as recommended by Professor Koch, the severity of the localand general reaction being in many cases so extreme.

THE INDECENT ADVERTISEMENTS ACT.

SOME correspondence has recently passed between thesecretary of the Medical Defence Union and Mr. Lock.

wood, Q C., M.P., on the subject of extending the pro-visions of this Act so as to catch advertisements of thecharacter aimed at by the statute which are at presentexempted by its terms. A very flagrant violation of thespirit of the Act is the exhibition of bills of the pro-hibited character upon sandwich-boards. It would seemthat the ingenuity of the draughtsman has failed to

comprehend this particular form of advertisement inthe language of the section which should apply to

it, and consequently the same bill which, if affixedto a wall, would render its exhibitor liable to the

penalties of the statute, may be legally displayed upon asandwichman’s board. Advantage has been promptlytaken of this singular omission in the Act by the quacks ofBirmingham, and the inhabitants of that town are con-

sequently subjected by reason of the Act to an aggravatedform of the very annoyance against which the Act waspassed as a protection. Such an anomaly cannot be allowedto continue, and we have no doubt that the promoters ofthe original Bill will easily obtain from the Legislaturesuch a supplementary enactment as will avail to suppressthis impudent evasion of the statute. A more serious

difficulty is presented by the problem of dealing with