970

symptoms of poisoning by mushrooms simulate some-

times those generally following on the administration of

a narcotic, such as drowsiness, giddiness, and dimnessof sight, and at other times of an irritant when vomitingand purging are characteristic. The remedy is usually toadminister an emetic, while strong tea or a solution oftannin in most cases serves as an effective domestic antidote.The physiological antidote, which, however, should of"course only be prescribed by a medical man, is belladonna.

MEDICAL ARRANGEMENTS FOR THETRANSVAAL

WE understand that the scheme of medical arrangements,9n the event of war in South Africa was prepared in all its.details some three months ago. But as the War Officeauthorities have not considered it advisable to make knowncto the public any particulars regarding the composition of.the army corps (which would doubtless be mobilised) weare unable to publish the professional information which

would be so interesting to our readers.

LOCALISED TUBERCULOSIS OF THE INTESTINE.

WE have called attention to a paper by Dr. N. Senn onthis subject. In the New Tork Medical Journal of August’19th’Dr. W. G. Mayo has published an important communica-tion. He finds that in St. Mary’s Hospital, Rochester,Minnesota, 1003 abdominal operations were performed in thelast six years of which 64 were for tuberculosis. The latterare classified thus : peritonitis 30, encapsulated collectionsforming an abdominal tumour three, ovaries and tubes 11,appendix seven, kidneys seven, and intestine six. The intes-tinal tuberculosis in all these cases appeared to be primary.in adults there is a tendency for the disease to remainlocal. The most common seat of primary tuberculosis isthe ileo-caecal coil ; the sigmoid flexure and lower ileumare also often affected. Dr. Senn has described two formsf disease, one fibrous with great hypertrophy resemblingcarcinoma, the other ulcerative and more apt to cause

stricture. But the two forms often co-exist. The diagnosisis difficult ; in only two out of seven cases reported by Dr.Mayo was the disease recognised. A tuberculous familyhistory was present in only two. The general appearance ofpatients who developed obstruction was good up to the timeof the stoppage. In three in whom the ulceration was of

the largest extent there was some evening pyrexia. In the

majority of the cases alternating constipation and diarrhoeawere observed, and in the cases of stricture serious symptomsof obstipation appeared several times before the attack ofobstruction rendered relief imperative. In only one casewas diarrhoea marked, and here the caecum and ascendingcolon were extensively involved. Diarrhoea is in favour of a

qarge extent of ulcerated surface and is common in the

secondary disease. The constant symptoms in all cases werecolicky pains. A well-marked tumour was present in thecsecal region in three cases. The following case is an

example. A woman, aged 37 years, had not been well

since the birth of her youngest child three years previously.Tor six months she had constant pain in the right side andcramps in the bowels. Constipation alternated with diarrhoeaand there was occasionally a slimy discharge. Per vaginama thickening was felt in the right broad ligament. In the

Tight side of the abdomen was an enlargement occupying theposition of the cascum and extending upwards to the lowerfiibs. Operation showed the csecum to be enlarged, adherent,and marked with board-like scars. The appendix was

involved and lay in the pocket under the ileo ccecal junction.The right ovary and tube were also involved in the caseatingmass. The neighbouring lymphatic glands were enlarged

1 THE LANCET, July 30th, 1898, p. 274.

and cheesy. A portion of the cseoum, the appendix, theovary, and tube were excised. Recovery ensued. Six monthslater intestinal obstruction necessitated a second operation.The i!eo-ca3cal coil was involved in a tuberculous process andadherent to the bladder. The ileum was divided eightinches above the ileo-caecal valve, the distal portion was

emptied, and the cut end was turned in and sutured. Anasto-mosis of the proximal end with the transverse colon was

produced by means of the Murphy but,ton. Recoveryagain followed.

-

THE WATER-SUPPLIES OF DERBYSHIRE.

THE fact that water schemes are everywhere to the frontshows how the community is waking up to the knowledgethat an adequate supply of pure and wholesome water is thefirst sanitary requirement. It cannot be said that the

county of Derby possesses a satisfactory supply, althoughthere is an abundant supply of pure and whole-some water in the county which only needs careful

engineering in order to render it available for publicuse. A very interesting and comprehensive report uponthis subject has recently been presented to the membersof the Public Health Committee of the Derbyshire CountyCouncil by Dr. Sidney Barwise, the county medical officer,and Mr. John Somes Story, M.I.C.E., the county surveyor.It would appear that in Derbyshire there is a popu-lation of over 10,000 without any water-supply within a

reasonable distance except rain-water stored in tubs. Some

130,000 are dependent upon shallow wells which are

liable to pollution, while the public supplies whichexist are so insufficient or of such suspicious originthat additional supplies are required for another 130,000.Many available sources of supply have been considered, butpeculiar difficulties have been met with owing to thefact that most of the springs in Derbyshire are highlymineralised. At length a scheme was prepared for

bringing down the pure waters of the upper reaches ofthe Derwent, and the scheme known as the Derwent

Valley scheme has, under the title of the Derwent ValleyWater -Act, only just received the Royal assent. Bythis scheme the joint water board have power to constructsix impounding reservoirs in the upper Derwent Valley.The total capacity of these reservoirs will be nearly10,000,000,000 gallons. Provision has been made for com-

pensation water, after which the county of Derby is to havea prior right of 5,000,000 gallons per diem, that is, to havealways a fixed quantity reserved for the use of the county,instead of a percentage of the water, so that in time of

drought the county of Derby will still be entitled to this

quantity. The remainder of the water is to be divided in the

following proportions: the Derby Corporation 25 per cent.,the Leicester Corporation 35 72 per cent., the NottinghamCorporation 14 28 per cent., and the Sheffield Corporation25 per cent. The cost of the scheme contemplated by thejoint board is given at f.5,500,000, while additional works tobe carried out by the different authorities will involve an

outlay of 1,145,000, to be borne jointly by the corpora-tions respectively of Derby, Leicester, and Sheffield. Itis pointed out that this allocation of water to an

administrative county has never been made in any Actof Parliament before, and even where authorities haveobtained the right to take water, by paying 4 per cent. or4t per cent. upon the proportion of the capital which theirshare of the water has necessitated being expended, as inthe Birmingham and Manchester Acts, the corporation carry-ing out the scheme has always reserved to itself the rightto take the whole of the water if at any time in the futureit should require it. In regard to quality the Derwentwater is in marked contrast to the water from othersources. It is very soft though it is without action on lead,

971

having no appreciable acidity like the moorland waters oi

Derbyshire, except that which is due to carbonic acid,

We are surprised to find that no mention is made in the

report of goitre or 11 Derbyshire neck," the prevalenceof which has been notorious in the county and ascribed

to the fact of the highly mineralised state of the

waters derived from the coal measures. Since Derwent

water is so pure and soft we should have thought that thispoint would have been urged with some emphasis in favourof the Derwent Valley scheme.

DIARRHŒA OR GASTRO-ENTERITIS.

THE large number of deaths from infantile diarrhoea whichhave occurred in all parts of the country during the past fewweeks once more emphasises the importance of a uniformnomenclature of diseases. The Registrar-General includesunder the heading of 11 diarrhoea" only such deaths as are dueto that disease, although it is well known that when a praeti-tioner records the cause of death as "gastro-enteritis"he is only expressing in different terms the meaning of hisneighbour who prefers to write on the death certificate

merely 11 diarrhoea." As diarrhoea is included among theseven principal zymotic diseases it is evident that for

comparative purposes the zymotic death-rates during thesummer months as given by the Registrar-General are

absolutely valueless, for the district in which it is thecustom to certify the cause of death as "gastro-enteritis"

"

will apparently have a much lower rate than one wherethe same disease is called "diarrhoea." That such is

actually the case is well shown from the August returnsrelating to three large towns in South Wales havingan aggregate population of nearly 250,000. Merthyr,with a population of 72,000, had a I I diarrhoea death-rateamong children under five years of age equal to 5’5 per 1000persons living per annum ; Pontypridd, with a population of38,000, had a rate equal to 7 0 per 1000; and Rhondda, witha population of 124,000, one equal to 11-6 per 1000. Butthe death-rate at the same age-period in these towns duringAugust from diarrhoea plus gastro-enteritis-that is to say,the real diarrhoea death-rate-was in Pontypridd equal to18 per 1000 yearly and in Merthyr and Rhondda equal to22 per 1000. If we adopt the nomenclature of the Registrar-General the diarrhoea rate in Rhondda is double that of

Merthyr though in reality it is exactly the same ; his figuresagain would place the Pontypridd rate at 1’5 per 1000 abovethe rate for Merthyr, whereas the true rate is 4 0 per 1000below. That the Registrar-General is aware of, and appre-ciates, these discrepancies is evident from the fact that inthe more recent weekly returns of births and deaths he drawsattention in the paragraph which treats of diarrhoea inLondon to the number of deaths from gastro-enteritis amongchildren under five years of age.

STATE AID IN SCIENTIFIC RESEARCH.

AN instractive comparison appears in an article in theTimes of Sept. 30th of the advances made in scientificresearch in England and in Germany, and it is shown thatin spite of State assistance in the latter country still

England records greater results of progress. This

important place in the present progress of scientific

knowledge which England proudly occupies is due, accord-ing to Dr. Siemens, to the work of rich independentmen of science. "Without these dilettante,’ " he

remarks, "she would be nowhere." As an instance he

quotes the work that was performed in England in privatelaboratories which was devoted to the determination of theexact value of the units of electrical measurement. In

Germany State assistance to the progress of science waslimited to providing instruction in physical science, and thus

real research after all was left to private effort. There wasno support provided for original work. On whose side, then,is the reproach 7 Until recent years no State assistance was

offered in this country for the pursuit of original investiga-tion, so that practically all the splendid discoveries withwhich English scientific men are justly accredited are theoutcome of private research actuated by a desire to seek thetruth for the truth’s sake. In the application of these dis-coveries Germany has certainly not been behindhand in adapt-ing them for the improvement of the arts and industries ;England, on the contrary, has, oddly enough, been slowto recognise the value of the application of her own dis-coveries to technical occupation. But public opinion haslargely been drawn to this fact and there is promise now ofa movement being organised which will give not only apowerful stimulus to original research but also to the

application to manufacture of the fresh knowledgegained by these inquiries. Mention need only be made ofthe scheme for the enlargement of the Government PhysicalLaboratory at Kew, where researches in theoretical and

applied science are to be carried out, and of the research

laboratory presented to the nation by Dr. LudwigMond. As the Times points out it is interesting to

note that while Government aid has been necessary to

bring about the initiation of the Kew scheme,.private effortin a similar scheme was sufficient in the case of Germany rand only at a later stage did the German Government takethe financial responsibility of their research laboratories,thus affording a striking example of a reversal of the usua

procedure in the two countries.

SERIOUS ILLNESS OF GIOSUE CARDUCCI.

AT Bologna, in the university of which he holds the chairof Italian Literature with a supplementary lectureship on theliterature of the Romance languages, Giosue Carducci, Italy’sgreatest poet since Alessandro Manzoni, is lying dangerouslyill-so ill, in fact, as to plunge his compatriots into some-thing like the solicitude and anxiety universal nine monthsago throughout the English-speaking world at the life-and-death struggle fought out by Rudyard Kipling. 14 years agoSignor Carducci suffered from cerebral thrombosis with slightdifficulty in moving the tongue and right arm. Happilysurmounted with no apparent sinister sequoias the,lesion reappeared on the morning of Sept. 25th withdistinct aggravation of the old symptoms. Though feeling" not very well" he yet attempted to go out as usual but hadvery shortly to return in "considerable nervous perturbation,"’and immediately thereafter was seen by his distinguishedcolleague Dr. Antonio Murri, professor of clinical medi-cine. Rest, absolute and continuous rest, is what Dr. Murri

prescribes, all the more that he traces the reappearance ofthe malady to the severe mental strain which Signor Carduccihas been imposing upon himself in preparing an edition ofMuratori’s monumental work, the " Rerum Italicarum Scrip-tores." He had, it seems, been prosecuting his editoriallabours all the summer even in his favourite villeggiatura atMadesimo on the Italian slope of the Splugen Pass andwas already far advanced in a learned critical prefacewhen he returned to Bologna for the winter session very littleable for its duties. Struck down on Sept. 25th, as stated,he is now being vigilantly tended until the expected im-provement so far sets in as to admit of his being conveyedto some quiet resort, presumably in his native Tuscany,sheltered from adverse winds yet open to the restorativesea-breeze. That improvement, indeed, is well-nigh alreadyvisible, and he was able not only to be informed of thenumerous inquiries received daily by telegraph as to his

condition, but even to dictate a brief reply to the affectionatedispatch which reached him on Sept. 29th from QueenMargherite. The author of the "Odi Barbare" which