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varying explanations offered in reference to the movements ’,of the eyelids, and he himself evidently leans to the last-mentioned theory-viz., an affection of the oculo-motor ’,nucleus and a consequent paresis of the upper facial

group of muscles. But it might be objected to such an ’,explanation that if, as is stated, this group of muscles is ’almost constantly weak, the movements of the lids should ,also be constant, and, as is well known, this is by nomeans the case, so that perhaps a satisfactory explanationfor all cases is not yet forthcoming.

HOSPITALS FOR SOUTH LONDON.

ONE practical remedy for the want of hospital accommo-dation in South London is to get rid of hospital abuse andreserve St. Thomas’s Hospital and Guy’s Hospital severelyfor the really poor and for fit cases, instead of catering forthe well-to-do. The proposals to transfer hospitals on thenorth side to the south side of the river sound slightlyimpracticable. The managers of all our hospitals are

gratuitously undertaking the impossible task of catering forhuge classes who can well take care of themselves and forwhom the charitable public will not much longer feel it theirduty to provide.

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A NEW METHOD OF STUDYING THE PATHOLOGY OF THE VERMIFORM APPENDIX.

THOUGH the number of cases in which the appendixvermiformis has been removed is undoubtedly very large,but little work has been done in investigating the exactconditions present in the appendix. Dr. R Abbe, of NewYork, published a paper in the Medical Record of July 10th,in which he showed that, by distending the appendix with95 per cent. alcohol and then immeising the organ in alcoholof the same strength, the pathology could be investigatedmuch more satisfactorily than by the ordinary methods.The illustrations which accompany the paper show the chief

types which are met with, and the differences, which ategreat, must be of importance in the pathology. The method

is obviously of great value, and the results obtained should rbe of practical value in treatment.

ANOTHER DEATH FROM ANTHRAX.

AT an inquiry held at Bradford on Aug. llth, regard-ing the death of a woman who had been engagedin wool-sorting, some interesting facts were broughtto light concerning the way in which the new wool-

sorting regulations are carried out, or rather set on

one ide. The medical officer of health of the district isof opinion that the case was one of anthrax, and, takinginto consideration the circumstances under which thedeath occurred and the fact that a microscopical examina-tion of the blood was made, there appears to be little doubtas regards the diagnosis. Although the infection was

probably through the respiratory passages it seems thatthis woman was allowed to go to work whilst wearing band-ages rendered necessary by the infliction of a wound on thearm. The dust from the dust chambers removed once

a week should by the regulations laid down be burnt,but it is alleged that it was given away for the purposeof being transformed into an artificial fertiliser or

manure. It seems incredible that people should thinkof using such a material for land. It was urged that

disinfectants were sprinkled over the floors of the rooms inwhich the wool-sorters were working. It seems absurd withour present knowledge of the resisting power of anthrax

spores to play with them in this fashion. Nothing but themost careful disinfection can be of the slightest value, andthe mere sprinkling of disinfectants simply leads to a falsesense of security and to the neglect of real precautions.

What with the minimising of the draught, the contractingof the flues, the irregularities as regards openingbales in rooms not specially set apart for the purpose.and similar breaches of regulations, the astonishing thing-is that fallen Persian wool, even when greasy, does not give-rise to more cases of anthrax than are at present attributedto it. The manufacturers may complain that the restrictionsput upon their trade interfere with the rapidity of work andtherefore with their chance of competing in the open market;but as the various questions bearing on wool-sorter’s diseaseare now no longer debatable it is surely time that an effortshould be made to compel compliance with the new regula-tions, which, good as they are, in many respects might stil’1with advantage be made more strict. Until, however, anefEort is made to enforce even the present regulations wemust expect from time to time a recurrence of these sadcases of death from anthrax.

UNQUALIFIED PRACTITIONERS AND DEATHCERTIFICATES.

WE publish in another column the account of an inquest.held on Aug. 5th at Rosedale Abbey, Pickering, Yorkshire.As will be seen by the evidence the deceased, a woman agedfifty-six years, was under the treatment of an unqualifiedpractitioner. The latter gave a certificate that death wasdue to 11 inflammation of the bladder and peritonitis." The

registrar refused to accept the certificate on the grounds.,that it was not signed by a legally qualified medical manand that the death was sudden. On the case being reportedto the coroner he decided to hold an inquest, and issuedan order for a post-mortem examination. The necropsyrevealed acute inflammation of the kidneys. The bladderwas empty and contracted and free from disease. Therewas no peritonitis. What was in reality suppressionof urine had been regarded as retention. It seems strangeon the diagnosis that a catheter was not passed. What,

symptoms there could have been to suggest cystitis we are ata loss to understand. Even qualified medical men are liable,to err, since medicine is not an exact science, but with the.facts before them it is astonishing to a degree that the juryshould for one moment have unfavourably criticised the.

registrar’s action in refusing to register the death. It mighthave been thought that they would have expressed andrecorded their approval of the course he took, instead of

condemning both him and the coroner in the rider to theirverdict that " the post-mortem examination and the inquestwere unnecessary." We consider the case was eminently onetfor the fullest inquiry.

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MATERNITY CHARITIES AND UNMARRIEDWOMEN.

AN attempt to define the normal relation between child-birth and the work of charitable relief might at first sightappear to be superiluous. Yet the fact remains that such adefinition is still unknown, or if it does exist is too imperfectlyunderstood to command general approval. Where the-

antecedents to matrimony have been quite regular there isof course no difficulty save that of the expense incurred.The case of illegitimate childbirth on the other hand is quite-different. Questions of moral responsibility have enteredin here, and the consequence is that public institutionswhich freely accept as inmates poor and deserving marriedwomen have no offer of help for a maiden mother. While weare willing to spare by every due consideration the feelings.of the former class with regard to social surroundings, wecannot but think that the distinction in treatment ao

favourable to them is unduly neglectful of their erringsisters. 16 cannot be defended on the ground of chariry,unless we accept the much wider proposition that every

mischance of illness which is the direct outcome of a vicigus-

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practice is outside the province of the charitable healer. I

The close connexion between illegitimacy, conceal-

ment of birth, and infanticide needs no explanation.Snch preventive measures as have hitherto been employed todestroy this mischievous and criminal combination have notbeen highly successful. The question remains whether theyshould not be supplemented by such public and charitableaid as is plainly needful to secure the safety of mother andchild at the time of birth. We would answer this question inthe affirmative. Mr. Frederick Lowndes, in a paper recentlyreprinted, advocates a similar view. He proposes that mid-wives attached to maternity hospitals should be eligible forattendance on cases of labour without distinction outside thewalls of these hospitals, and that provision should be madefor the reception of a certain number of necessitous caseswithin the wards also. We believe that the adoption ofthese or similar suggestions would neither, in a well-

regulated institution, tend to lower our present standard ofmorality nor act upon the recipients of charity as an

encouragement to do evil. A judicious selection of Gasesfor admission would of course be imperative, and a pre-ference, though not wholly exclusive, would naturally begiven to married women. Defended by such needful safe-guards, the arrangement suggested should, we consider,work well and should prove in the end to be both a humaneand a politic measure.

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THE OPERATIVE TREATMENT OF SPINAL

CURVATURE.

AT the French Academy of Medicine M. Chipault hasfrom the commencement of his researches on the reductionor correction of spinal deviations maintained that thecorrection will not be permanent unless the vertebral columnis kept in its new position by direct fixation of the spinousprocesses ; this applies both to scolioses and to the results ofPott’s disease. All the authorities on the subject now agreewith him. M. Regnault has, in the first place, demonstratedbefore the Anatomical Society thit Pott’s disease and spinalcurvatures (scolioses) if left to themselves tend to recoveryby ankylosis of the posterior portions of the vertebrm, andthat metallic fixation of the processes consequently does no

I

more than anticipate in a most logical way the natural pro-cess of recovery. In the next place, M. M6nard has

exhibited to the Academy and to the Surgical Society aseries of anatomical preparations which proves the harmless-ness of the operation for reduction. S3 far as the spinal cordand the parts surrounding the vertebral column are concerned,the correction of these deviations sometimes produces a

remarkable change in the configuration and dimensions ofthe space lying in front of the vertebral column, and theseanatomical preparations show that for the purpose of render-ing the improvement permanent it is necessary that the

spine shall be fixed in the new position. Many cases ofrecent occurrence in which distortion returned when fixa-tion was neglected after correction of the deformity provethe absolute necessity for fixation of the processes.The attention of surgeons in many different places seems atthe present time to be directed to this subject, andM. Chipault has now given an account of the improvementswhich he has during the last few months made in the opera-tion originally devised by him. It consisted, as will be

remembered, in tying the processes with stout silver wire, amethod which is satisfactory and will continue to be

employed under certain circumstances, but is neverthelesssometimes difficult of application on account of thestiffness of the wire. In place of the wire he there-fore now uses hooks of four different forms, twofor lateral deviations and two for antero - posteriordeviations ; each form of hook is made in two qualities, onebeing rigid, for use when it has been possible to correct the

distortion completely, and the other being pliable, so as tobe available when the correction of the deviation is onlypartial. The hooks can be applied with the utmost ease.They cause no local disturbance and do not interfere withthe development of the portion of the spine to which theyare applied.

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A PATIENT FINED FOR LEAVING A HOSPITAL.

A PATIENT has lately been fined for leaving a fever

hospital while suffering from typhoid fever. He hadbeen an inmate for some time and had apparentlybeen very ill, but during his convalescence he thoughthe was well enough to go and so walked out one

day without saying anything to anyone. Patients in

general hospitals not infrequently practise this modeof departure, which probably does little harm to any-one except the patient himself; but in the case ofinfectious hospitals things are different, for unless the

patient and his clothes are properly disinfected disease maybe spread to any extent. It is thus right that patientsshould understand that although they may risk doing harmto themselves by leaving hospitals against advice, they mustnot be allowed to convey infectious diseases to other peoplewho are unfortunate enough to come in contact withthem.

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THE FAMINE IN INDIA.

THE news from the famine districts of India has been so

uniformly good for some weeks that we hope we are nowwithin a measurable distance of the ending of the acutestage. But before the famine passes out of men’s minds or

is crowded out by the more exciting news of frontier

wars, it may be well to recall the chief causes of the scarcityof food in the famine-stricken districts. No rain, no food

for cattle, then starvation of the earth and its dwellers.Cattle are fed during the year for three months correspond-ing to the rainy season upon green grass, and then for the

next four months they are fed upon hay made from thissame grass; but at the end of seven months the supply isexhausted, and for five months the animals get only milletstalks as their staple food. It must be rememberedthat beans, barley, and oats grow only in Upper India.When the supply of rain is abnormally diminished the grassand hay are deficient, and the cattle die for want of food.The dearth of cattle puts an end to all bullock traffic, to thecarting of grain for human needs, to ploughing, and to allagricultural work. Ploughing in India is done twice a yearand is impossible except after the rains, because the groundat other times is too hard and fissured. In the old days thenatives used to buiy grain for years, and so in famine timesthere was a hidden store of food for men and cattle, butto-day the grain is all exported by rail to Bombay, andthence out of India. This is a necessary sequeme of themodern extension of railways throughout country districts.

POLYNEURITIS.

AT the recent meeting at Baden Baden of the South-westGerman Society of Neurologists and Alienists 1 Professor

Strumpell directed attention to some points in the sym-

ptomatology of this disease. He mentioned in particularthe occurrence of double facial palsy in alcoholic neuritisas a result of an affection of both facial nerves. Thiscondition he had observed on two occasions. He alsoreferred to a hitherto undescribed affection of the

auditory nerves which had been described by Professor

Kiesselbach-viz., true nerve deafness on each side-

passing off in three weeks, and being replaced by noises

1 Neurologisches Centralblatt, p. 610.