745

or else relegated to the small hours of the morningor at a time when the ordinary traffic practically ceases.We should like to know what the effect of this heavy steamtraffic is likely to be upon the various mains in the streets.The consequences that may arise from the crushing of thesemains are really alarming, considering the close proximity

Iof the water mains, gas mains, and the high-pressure Ielectric mains. As long as the streets are to be permittedfor the use of engines and wagons on the same scale as

railroads we may well shudder at the awful possibilities ofturning electric currents astray and of letting loose gasand water at the same time.

CANCER "CURES.’

IN the Pall Mall Gazette of Feb. 27th a short article

appeared which was called "A Triumph of Electricity." It

concerned itself with the cure of cancer by "high frequency" "

electricity and the gist of it was that a "doctor" who livesI I in a handsome house not a hundred miles from Hyde Park "

and is "one of the first and foremost private medical menin this line" and one who may in all truth be said to

have advanced even a step or two further than any other "

has discovered that "high frequency" is the cure forcancer. Reference is also made to the opening of a

hospital for the application of his treatment. There are

also in circulation just now a printed leaflet and a letterabout the same matters and in these appears the nameof Mr. E. A. Cloete Smith. He has a hospital not far fromHyde Park. The letter recommends the high frequencytreatment of cancer as against the use of the Roentgen raysand mentions Mr. Smith as the skilled operator. Con-

sidering the nature of cancer and the slow and laboriouswork which is being done in many quarters to try to

solve the problem of finding a successful treatment for

it-considering, too, the slight encouragement which is

leading investigators forward into the x ray and other

electrical methods in spite of many disappointments-itcertainly seems that Mr. Smith and his friends are doingmuch harm and little or no good by announcing thatthe disease can be cured, and that by high frequencyelectricity. The facts about high frequency and cancer arethat whereas some relief of pain and some temporarydecrease of size in the tumour may be obtained by highfrequency we are nevertheless baffled in the attempt to obtainanything which may be called a cure. Much more pains-taking work has to be done before arriving at the goal andit is uncertain whether the desired result will be reached

at all or not. Certainly it is not by proceedings like thoseof Mr. Smith that success is to be found. The evidence in

favour of the efficacy of the x rays is considerably strongerthan any which can be adduced as yet for high frequency.A few cases which have been reported of high frequency" cures " have proved to be fallacious and some at least ofthe patients reported as "cured" have died from a recur-rence of their disease.

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A QUESTION OF REMUNERATION UNDER THEPOOR-LAW.

A CORRESPONDENT who is medical officer to a workhouse,having received a letter from his board of guardians request-ing him to attend at an early hour every day to examinethe tramps in the casual wards before they leave, in orderthat cases of small-pox may be detected in the earliest stage,asks us to give our opinion as to the amount of remunerationthat he would be entitled to claim for the performance of soinconvenient, so constant, and, in this case of a gentlemanengaged in general practice, so objectionable a duty. It

is somewhat beyond the limits of possibility to define theexact value of medical services and especially when they are

Iof such a nature as those here indicated. A knowledge of the I

appointments held under the board of guardians and of the-class of the patients in the practice conducted by the-

surgeon concerned would be necessary for the making ofa correct appraisement. The most important factor inthe position will be found in the terms of the contract

between our correspondent and his guardians. At his

appointment as medical officer were the casual wards put inhis care ? In other words, has he visited sick casuals as partof his duty at the workhouse ? If the answers to thes&

questions be in the affirmative then it will appear that

the guardians, under the powers given by Article 207of the general consolidated order, can call upon him

to visit the wards at the hours which they may fix andwithout payment other than the salary otherwise given. On

the contrary, if the duty of visiting the patients in the

casual wards has been added to the duties of the workhousemedical officer, or if the number of such visits was agreedupon originally and has now been increased, then our

correspondent will have a right to claim further remunera-tion. To enable him to estimate the value of the extra.

services demanded from him it may be mentioned that manyof the metropolitan workhouse medical officers have had toundertake an additional duty recently-namely, to visit onceor twice a week, or when required, the new receiving homesfor children, and that the salary added for these visits hasbeen about .640 per annum._

HASHEESH AS A CAUSE OF INSANITY AND

CRIME.

I Dr. John Warnock, medical director of the EgyptianHospital for the Insane, Cairo, records in the Jozcrnal ofMental Seience for January last the results of his observa-tions on "hasheesh," or cannabis indica, as an agency inthe production of insanity and crime, drawn irom an

experience which is exceptionally large in this field of

medicine. It is pointed out that Ibn Beitar, an Arabianphysician, was the first to recognise an insanity from theuse of hasheesh, A.D. 1235, but the drug had then been inuse probably for many centuries. At present the drug is

largely consumed in Egypt, adds Dr. Warnock, although itsimportation is prohibited by law. The fact that about 16tons of hasheesh were confiscated in Egypt during the year1901 will give some indication of the extent of its use.

"Most of the drug is consumed by smoking in the gozeh[an Egyptian pipe] and in cigarettes, but a considerableamount is eaten in pill form and in sweetmeats, magoon,&c." " The usual reason given by patients for using hasheeshis that it induces a general feeling of pleasure and

content. When eaten in pills and sweetmeats it seems

to be taken chiefly as an aphrodisiac. Insanity fromhasheesh belongs to the "toxic" group which includesinsanities due to alcohol, opium, and cocaine. Dr. Warnockclassifies the insanities from hasheesh under the follow-

ing types. First there is the temporary intoxication fromhasheesh which is attended with pleasurable exhilara-tion. Pleasant, half-waking dreams, not unlike those of theopium-eater, occupy the mind, but active excitement, as inalcoholic intoxication, is uncommon. Secondly there is a

delirium from hasheesh, which is associated with hallucina-tions of sight, hearing, taste, and smell. Great exaltation,restlessness, and sleeplessness are marked features, but thereis an absence of the tremors and physical exhaustion of

alcoholic delirium tremens. The third variety is a more

acute form of excitement attended with hallucinations,incoherence, destructiveness, indecency, and impulses to-

wards violence. Delusions of poisoning or of persecutionare common in this affection. States of depression andterror may be intermingled with excitement. Thesecases tend to pass into a chronic condition which con-

stitutes the fourth class. Eventually there succeeds a