336

&c. Complications: In 39 cases, none. The average timeunder treatment was 5’5 months. Subsequent history:Doing well 15, total abstainers 11, relapsed 9, still undertreatment 7, unknown 7, and dead 1. Of the 50 cases, 23were admitted as private, and 27 under the Act.

THE HOLBORN GUARDIANS AND THEIR MEDICALOFFICERS.

IT is not always an easy question to decide when a patientis too far gone to admit of safe removal to a fever hospital.The Holborn Board of Guardians at a recent meeting ex-pressed strong condemnation of one of their medical officersin regard to a case in which he advised the removal of achild to a hospital who died in the ambulance en route.An unfortunate mistake occurred by which the medical visitwas not paid for twenty-four hours after the delivery of theorder. The order was marked " urgent," but was not delivereddirectly to the medical officer, Mr. Hollis, but was placed onhis desk. It was overlooked until the mother of the childwent again, whereupon Mr. Hollis came and expressed theopinion that the child was not too ill for removal. Such a

question should always be well considered, but infallibilitycannot be expected even of the medical profession. At thesame meeting of the board another medical officer, Mr.Marshall, was asked to-resign because of the prevalence offever among the school children. He was blamed for not

having seen the children oftener. Over fifty cases hadoccurred. Of course the principal duty of the medical officeris to treat those who are ill. No doubt it is also a greatpart of his duty in times of epidemic to take such stepsas shall isolate the sick and guard the well. But we shouldlike to hear Mr. Marshall’s side of the question before

endorsing the action of the guardians.

THE PASTEUR TREATMENT IN BARCELONA.

THE municipal authorities of Barcelona, as we announcedlast year, have established a municipal micro-biologicallaboratory, mainly with the view of enabling persons bittenby rabid animals to obtain the advantages of Pasteur’smethod of treatment. To the post of director of the

laboratory Dr. Jaime Ferran, whose name is well knownas having proposed and carried out a system of anti-cholerainoculations, was appointed, and he has been assisted byDrs. Pauli, Commenge, and Lluch. A report of the workdone from May 10th to Dec. 10th, 1887, has just beenpublished in La Independencia Médica. Altogether eighty-five persons have been subjected to the treatment. Of these,twenty-five had been bitten by animals that were certainlyrabid, fifteen by those which had been pronounced rabid bymedical men or veterinary surgeons, and thirty-seven byanimals which were believed to be rabid, but whose conditioncould not be verified by professional men. The remaining eightpersons had not been bitten at all, but submitted to theprocess in order to prove its harmlessness. The durationof the treatment was more than three months in forty-threeof the cases, more than forty days in sixty-three, and lessthan that in twenty-two cases. Not a single case, either ofthose who had been bitten or of those who had not, provedfatal. The wounds were caused by seventy-two dogs, twocats, and two mules. Two of them were not bites, but dis-section wounds with instruments tainted with the virus ofrabies. At first Dr. Ferran carried out the inoculations ofhis rabbits according to Pasteur’s method-i.e., by trephin-ing. Recently, however, he has adopted a new, and, as hebelieves, an improved, plan-viz., the injection of a singledrop of the emulsion of the medulla containing the virusinto the anterior chamber of the rabbit’s eye. This producesexactly the same effects in about the same time as thetrephining method.

MEMORIAL TO THE LATE SURGEON-MAJORT. R. LEWIS.

THE subscribers to the above memorial will be glad tolearn that the reprinting of Dr. Lewis’s collected scientificworks has now nearly approached completion, much delayhaving been occasioned by the reproduction of numerousmaps and lithographs. The volume, in crown quarto, whencompleted, will contain about 800 pages, illustrated withfive maps, twenty-four copperplate engravings, fifteenchromo-lithographs, and numerous woodcuts, with a portraitof the author in autotype, forming a fitting memorial of onewho devoted his life to scientific medical research. It is

hoped that intending subscribers will give in their namesas soon as possible to the honorary secretaries, care ofMessrs. Holt, Lawrie, and Co., 17, Whitehall-place, S.W., asit is especially wished that the names of all supporters ofthe memorial (each subscriber of .61 receiving a copy of thereprinted works) should appear in the list of subscribers,which will appear as an appendix to the volume.

FORCIBLE DILATATION IN HÆMORRHOIDS.

DR. DMITRIEFF has found that beemorrhoids may some-times be cured by forcible dilatation of the anus. In one

case, where a young man suffered from violent hoemor-

rhage after every stool, and where there were largeexternal hemorrhoids and varicose veins in the insideof the gut, together with constriction at the anus itself,this treatment proved very successful. The patient wasana3sthetised and a Sims’ speculum slowly introducedinto the right side of the anus, then a similar instru-ment was introduced into the left side, lateral dilata-tion being thus produced. Subsequently the two speculawere again introduced into the anterior and posterior halvesof the rectum, dilating the anus in an antero-posteriordirection. Some small fissures of the mucous membranewere produced by the operation. Next day the externalheamorrhoids were found to be smaller and seemed to be

shrivelling up; the internal ones were quiescent. Subse-

quently the former became smaller and smaller, and finallydisappeared. There was no paralysis of the sphincter. In

another case, where there were both internal and external

haemorrhoids, causing slight pain and hfemorrhage, andwhere there was no contraction of the anus, treatmentsimilar to that described above was carried out, but thesuccess obtained was only partial. The hsemorrhoids shrankto half their original size, but did not further decrease.

THE CASE OF MR. McNEILL.

FROM a perusal of Mr. Fletcher’s communication in

another column our readers will be in possession of the factsof the above case complete and in their order of occurrence.Beyond the testimony of the French official doctor that thewounds on the unfortunate deceased were neither self-infiicted nor the consequences of accidental injury, there area number of circumstances which lead to the conclusionthat a murder was committed. The equivocal wording ofMr. McNeill’s telegram with regard to his head having gonewrong has received a satisfactory explanation, so that itcan no longer be supposed that the deceased contemplatedsuicide; and there is abundant evidence to show that hishealth, although not of the best, was not likely to break downin sudden disaster. His having insured his life, made a will,and taken other precautionary steps, must be consideredrather as facts suggested by a prudent foresight than asindications of mental obliquity. His Excellency theFrench Minister for Foreign Affairs, in an official report,adopts the theory of personal violence at the hands ofanother. The vacillating and wholly inefficient way in which