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way to earth by the flagstaff, along the roof, throughthe body of Davis, and so to the dressing-room. The

body of Davis was much burned. The accident shows

very well how curiously local are the effects of a lightningdischarge. Dr. C. G. Battiscombe, who has sent us anaccount of the case, mentions that Davis’was quite dry,but it would be interesting to know whether the player Leewas wet. If so he would, or rather his clothes would,conduct better, which might account in part for his escape.The other persons who were struck all suffered from shockand many exhibited "tree markings" of the skin which, however, soon disappeared. They were treated by Dr.

Battiscombe and Mr. T. W. Bailey and some of them werestill under care on April 24th.

CESOPHAGOSCOPY AND GASTROSCOPY.

THE mind of the people has decided that seeing isbelieving," and even in medicine diagnosis is hardly com-plete until the diseased tissues have been seen. Manyendeavours have been made from time to time to investigatethe interior of the oesophagus and the stomach by the aid ofsight, but there are peculiar difficulties in the way. The useof a straight, rigid tube is practically necessary, but sucha tube cannot with safety be introduced. An ingeniousexpedient has been adopted by Dr. Georg Kelling of Dresdento overcome this difficulty. The tube when passed into theoesophagus is flexible, but it is subsequently straightenedand made rigid. In this way, with a minimum of danger tothe patient, a fairly satisfactory view can be obtained of theinterior of the oesophagus and of the stomach. We publish inthis issue of THE LANCET a full account by Dr. Kelling ofthe construction and use of his ingenious instruments, thecesophagoscope and the gastroscope, to which we refer ourreaders. The practical employment of the cesophagoscopeand the gastroscope will probably always be limited to thosewhoaccustom themselves to them by frequent use, and prac-tice on the cadaver.

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THE BIRMINGHAM UNIVERSITY.B

THE new Birmingham University, as was to be expected,is to be concerned largely with commercial and industrialtraining. The report of the Advisory Committee appointed toinquire into the best methods of providing such training hasrecently been issued and deals with a visit of inspection paidto various universities in the United States and Canada. In-

dustrial science as taught at universities in Great Britain wasalso examined, but the committee came to the conclusionthat no teaching upon such points likely to be useful existsin any college of Great Britain. It is proposed to supplementthe teaching already provided in Mason College by chairs ofmining, metallurgy, engineering, and applied chemistry.The deputations appointed to go to the United States and toCanada report that subdivision of subjects and specialismare carried much farther there than with us. It must be

remembered, however, that specialism in commercial andindustrial occupations may easily develop into over-

specialism, and we might almost say has already done soin some instances. It undoubtedly cheapens labour andoutput, but we are not sure that these are invariably advan-tages. For instance, a pair of boots made by one man, hand-made that is to say, is far superior to a pair made in bitspartly by machines and partly by clickers, closers, andfinishers who are severally confined to one branch of thetrade. The craftsman of old days made a thing himself andit bore the stamp of his own individuality; the " hand " ofto day is a mere machine and a very cheap one at that.

However, we wish the new university all success and with-

out doubt the Faculties of metallurgy and of appliedchemistry will have plenty to do. The problem of the

economical and cleanly production of electricity other thanby water power still remains to be solved and if solvedwould add enormously to both the comfort and health of thepopulace. ----

ROYAL ARMY MEDICAL CORPS FUND.

IT will be remembered that in our account of the meetingof the Central Committee of this Fund, which was held at11, Grafton-street, W., on Feb. 5th, we mentioned the

suggested formation of local committees in the provinceswhich should work with the Central Committee. Some weeks

ago a local committee for Birmingham and the neighbouringdistrict was formed to assist the Central Committee inLondon and as a result of the local appeal nearly 9265 havebeen received, the bulk of which has been sent to theLondon committee for distribution, but the sum of 923collected in Lichfield has been sent direct to Surgeon-GeneralWilson in Cape Town. In addition to the money collected,garments of various kinds numbering nearly 4000 in all havebeen sent to the London committee. The Birmingham com.mittee will still remain in existence in case further demandsare made by the prolonged stay of the troops in SouthAfrica.

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DISCHARGE OF CEREBRO-SPINAL FLUID FROMTHE NOSE.

IN the -,Ve7v York Medical Journal of March 31st Dr. W.Freudenthal has published a case of this very rare condition.The patient, a woman, aged 50 years, was seen in June,1899. In October, 1898, she had "fever which left herwith a cough." Since that time her nose had been steadilydripping. A year before the dripping commenced she

began to complain of pain in the forehead above thenose. She suffered from it by night and by day andthought that she would go out of her mind and she becamementally dull. When the dripping began her senses-for

example, hearing-became acuter. When she came underobservation she was using more than 20 pocket-handkerchiefsa day. There was constant dripping of watery fluid from thenose throughout the day and the night. It increased whenshe leaned her head forwards ; when she lay on her back thedischarge ran into the throat. In the morning her pillowsgenerally were saturated. On examination by Killian’s

method with the head bent slightly forward the discharge wasobserved to collect between the middle turbinate bone andthe septum and thence to run down into the vestibule. In

December, 1899, there was an intermission in the escape offluid, which was followed by symptoms of brain pressure. She

became dull and apathetic, though she was generally talka-tive. When the flow began again her condition improved.The fluid was watery, of specific gravity 1007, it contained1’3 per cent. of solids, 0’39 per cent. of salts, a reducingsubstance which calculated as glucose was equal to

0’05 per cent., and a trace of phosphorus. Mucin was

entirely absent. There were " receding neuro-retinitis in theleft eye and a mild degree of papillitis in the right." Thesense of smeH-was completely lost. Polypi were twice removedfrom the nose. Dr. Freudenthal regards the constancy ofthe flow of fluid by day and by night as most important in thediagnosis of this condition from nasal hydrorrhoea. In allthe cases of the latter which he could find recorded the flow

stopped at night, while in all undoubted cases of cerebro-spinal discharge the flow persisted. The pathology of casesof escape of cerebro-spinal fluid is very obscure ; only veryfew necropsies have been made. In one case, according toDr. StClair Thomson, the fluid escaped through a smallhole in the dura mater alongside the crista galli. Inother cases no communication could be found. The forma-tion of polypi is supposed to be due to irritation of the nasalmucous membrane by the discharge. Dr. StClair Thomson

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warns against any attempt to restrain the flow as well as Iagainst intra-nasal medication.

THE STATE CHILDREN’S ASSOCIATION.

ALTHOUGH this society has now entered upon the fourthyear of its existence the aims of its work cannot be too wellknown and we therefore repeat them from the third annualreport which has just been issued. They are :-To obtain the dissolution of large aggregated schools, so that thechildren- may be brought up when possible in families or in small

groups, where they will be in daily touch with the various interests andactivities of social life ; to dissociate the children from all connexionwith the workhouse and the officials who have to deal with a pauperclass; and to obtain for the State further powers of control overneglected children.It is unnecessary to dwell upon the importance of this workwhich must be obvious to everyone, and it is satisfactory toknow that the Poor-law Act which was passed last year wasalmost identical with the Bill which was drafted by theassociation in 1897. This Act gives to boards of guardianscontrol over the children of paupers of the permanent classwhose character or mental deficiency renders them unfit tohave the care of their offspring, and also over children ofhabitual tramps and of the in

" and " out" class, as well asan extended control over orphan children chargeable onthe rates. With a view to facilitate the emigration of

State-supported children the association has called theattention of the Local Government Board to the matterand is now endeavouring to interest boards of guardiansin the subject and urging them to make further use

of the powers which they possess. The report deals withother important work of the association and concludeswith an appeal for still further activity on the part of itsmembers in inducing others to consider children’s needs-" freedom and change, the power to choose and to dare, andthe sense of being loved and wanted." Reason, sentiment,and economy are on the side of its members, says the report,and they are certain to find allies in the heads and heartsof those people who, having themselves been happy children,preserve the memory of a free child-life as a bright spot inthe past. The report can be obtained (price 3d.) from theoffice of the association, 58, Old Broad-street, E.C., or

from Messrs. P. S. King and Son, 2 and 4, Great Smith-street, Westminster.

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EPIDEMICS OF MENINGITIS.

BERDACH 1 records an epidemic of meningitis of exceptionalextent, occurring in Trifail, a town with a population of8500 (February to September, 1898), and involving altogetherabout 72 cases. In addition to these from 26 to 30 abortivecases were met with, producing a total of about 100

patients. 45 cases ended fatally, which is the averagemortality. As regards age and sex it was observedthat the majority of the patients were young, betweenthe ages of 20 and 25 years, and the next largest groupwas composed of children below the age of 10 years. The

youngest patient was a baby three weeks old, and theoldest a man aged 58 years. The majority of the patients-42 out of the 72 severe cases -were workers in a mine.A map appended to the paper shows the distribution ofthe disease and the probable path which it pursued fromhouse to house in the town, sometimes a number ofhouses along the probable route escaping. Infection ofseveral members of a household was occasionally found.The majority of the cases occurred in the spring (March andApril), the epidemic being milder in the summer andautumn. In two fatal cases where death resulted on thethird and fourth days bacteriological examination showed thepresence of the diplococcus meningitidis of Weichselbaumin cultures from the pus on the meninges. Headache was

1 Deutsches Archiv für Klinische Medicin, Feb. 6th, 1900.

lsually observed to affect the occipital region in the milder}ases, and the temperature was moderate and only rising inthe preagonal stage. The pupils were usually widely dilatedand they failed to react to light. Continual vomiting was afeature in one case. Stiffness of the neck was not an earlyfeature. Among the disturbances arising from cerebralirritation and paresis, facial pareses were the most frequent,and among the trophic disturbances herpes was present innearly every case. The abortive form was characterised

clinically by sudden or rapidly developed unconsciousness,and severe headache and nuchal pain, followed by rapidimprovement. The treatment followed was, as usual,symptomatic.

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THE VICISSITUDES OF WEATHER AND OUT-BREAKS OF FIRE.

THERE can be little doubt of the relation existing betweenthe condition of the weather and the occurrence of out-

breaks of fire. Invariably, for example, when a sharp" snap " of cold weather suddenly sets in big fires are *

reported in London, and the relationship is not verydifficult to trace. It may be that fabrics are more easilycombustible in keen dry weather than when the atmosphereis heavily laden with moisture, while accessory to thisis the fact that artificial heat is more resorted to whencold weather sets in and so the risks of the firing ofinflammable material are increased. Similarly it is recordedthat fires. happen with a certain onset of hot weather,but in this case the cause is quite different. Thus duringthe few days which we have recently experienced, whensummer weather suddenly (and temporarily) set in, in factwhen a heat-wave passed over this country, a series ofaccidents happened which were due to the explosion ofcertain chemicals. The chemicals were bisulphide of carbonand ether, which are both volatile and both explosive whenmixed with air. There can be little doubt that the shortand sudden spell of hot weather accounted for theseaccidents. Considerable damage was done and some personalinjury was reported, but happily no loss of life occurred.These incidents only teach how careful a watch must bekept upon exceptional changes of weather, especially whenexplosive substances are concerned, but even in everydaylife the action of weather is undoubtedly a factor whichmust be taken into account as likely to be responsible fordisasters due to the outbreaks of fire. The exceedingly wideand sudden variations of temperature in this country areindisputably responsible for accidents of the kind justdescribed.

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THE PLAGUE IN AUSTRALIA.

LETTERS received from Sydney state that four cases of

plague remained under treatment at the end of the weekended March 16th. During the week ended March 17th thefigures were 12 cases admitted and three deceased, leaving13 remaining under treatment. Up to March 17th the totalcases were 22, with eight deaths. Of the fatal cases threewere discovered only just before or after death, but werereckoned as admissions for convenience. The total " con-tacts " isolated were 117 in number ; there were five cases ofplague among the " contacts." These cases occurred in twofamilies. In one family the second case occurred the dayafter admission. In the other family two attacksoccurred on the day of admission, one on the third, and oneon the fifth day after admission. With the exception of thecases mentioned in THE LANCET of April 14th all the

attacks (17 households) occurred among persons living inthe infected area or working in it and quite unacquaintedwith each other. One case only of the septicasmio formwas met with: it occurred in a girl, aged 14 years, andended within 48 hours. One cervical bubo and two axillar