970

we need only try to imagine the complications which wouldarise if from stupidity or perversity the nurse refused, insuch a case as that outlined above, to join in the affidavit.Ordinarily, of course, she would simply indorse the medicalattendant’s views, so that her statement would be merelysuperfluous. If the certificate of the medical adviser aloneis considered to be insufficient the rational course is to callin an independent practitioner, as is done when a receptionorder is asked for.

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TURKISH MEDICAL DEGREES FOR FOREIGNERS.

IN our last Students’ Number we inadvertently stated thatforeigners desirous of taking a Turkish diploma were allowedthe use of an interpreter in the course of their examinations.This was an error. Candidates for the Turkish diploma canbe examined in Turkish or in French but in neither case are

they allowed the services of an interpreter.

TREATMENT OF TRIGEMINAL NEURALGIA BYINJECTIONS OF OSMIC ACID.

IN the Journal of the American Medical Association of

August 22nd Dr. J. B. Murphy of Chicago relates a case ofneuralgia successfully treated by the injection of osmic acid,a method recommended by Sir William H. Bennett.l A

man, aged 76 years, had suffered from neuralgia in the

right side of the face for 13 years. Two years before hecame under observation some operation was performed onthe right superior maxilla and was followed by completerelief for four months. The pain then returned and occurredat intervals. It was severe and shooting and began at theright ala nasi and radiated into the cheek. There was also

pain above the right eyebrow which radiated into the temple.The patient was poorly nourished and his arteries were

sclerotic. The supra-orbital and infra-orbital nerves were

slightly tender at the foramina of exit. The problemof treatment was difficult. Neurectomy of the affected

branches would only give temporary relief. Excision of

the nerve trunks external to the cranial foramina or

of the Gasserian ganglion was too formidable an opera-tion in the condition of the patient. Dr. Murphy there-fore determined to adopt the method described by SirWilliam Bennett and exactly followed his technique.Under ether osmic acid was injected into the supra-orbital,infra-orbital, and mental nerves on June llth, 1903. The

operation lasted only 25 minutes and the patient recoveredwell from the anæsthetic. The pain disappeared and up tothe date of the last report, July 21st, there had been norecurrence. Sir William Bennett 2 described ten cases whichwere all treated by injection of osmic acid into the nervewith the most gratifying results. The longest period ofrelief which he could record at the time of publication ofhis paper was two years. Even should the pain recur thismethod is so simple that the operation can easily berepeated. -

THE INCREASE OF PAUPERISM.

A RETURN recently issued by the Local Government Boardshows that pauperism is still on the increase in this country.On Jan. 1st, 1903, there were, excluding lunatics in asylums,19,470 more persons in receipt of indoor or outdoor reliefthan on Jan. lst, 1902. The increase affects chiefly indoorpaupers who show an addition of 3’9 per cent., whilethe outdoor paupers have only increased in number to

the extent of 2 per cent. There has naturally been alsoan increase in the amount expended by boards of guardianswho during the half year ended Lady-day, 1903, had to

find, besides the salaries of officers - and the cost of repairs1 THE LANCET, Nov. 4th, 1899, p. 1220.

2 Loc. cit.

and furnishing, a sum of £ 1,680,332 for indoor main-tenance and £1,438,655 for distribution among the poorwho were allowed to remain in their own homes. Duringthe same period pauper lunatics in asylums cod a furthersum of £1,116,971. As compared with the correspondingperiod last year the average increase for England andWales in the way of indoor relief expenditure was about3 per cent., while for outdoor relief it was 2.8 percent. For London the figures were respectively 0’ 08 percent. and 2-4 per cent., showing an apparent tendencytowards diminished stringency of the requirements of reliefcommittees which at first sight may not appear quite satis-factory. It is to be noted, however, that the expense of

"boarding out" is included under outdoor relief and the ex-tension of this method of dealing with the children of thepoor accounts in part for the figures quoted. No regret needbe felt that the I workhouse test " is not applied to childrenand probably nobody will take exception to an arrangementwhich keeps them in some measure away from the con-

taminating influences of our social failures. The number ofboards of guardians who are awaking to a due sense oftheir responsibilities in the matter of pauper children seemsto be steadily growing throughout the country. No fewerthan 494 now employ the boarding-out system.

THE HOT WELLS, BRISTOL.

IN an annotation entitled "A Provincial Medical Library" we commented upon some researches made into thecontents of the library of the Bristol Medico-ChirurgicalSociety by Mr. L. M. Griffiths, the honorary librarian, andwe expressed a hope that Mr. Griffiths would continue hisresearches. This he has now done and the result is a littletreatise called The Reputation of the Hot Wells (Bristol)as a Health Resort." Mr. Griffiths gives a historical retro-spect of the wells the reputation of which goes back to

the middle of the fifteenth century. The eighteenthcentury, however, saw the hot wells at their zenith offame. For instance, what better advertisement could a healthresort have than the following ? ’’ Mr. TVilliam Gaggs, caseof Bristol Castle Green, a very Fat Man, at his Prime, agedthirty-eight ; he was seized with so violent a Diabeth, thathe made at least three gallons of very sweet Urine with alarge quantity of Oil swimming thereon every night andcould not sleep for either Drinking or Pissing, which in SixDays (his appetite gone) so run off his Fat and Flesh that

he was reduced to helpless Skin and Bones, left off by hisPhysitians (not sparing any money), and given over by hisWife and Friends for a dead Man......." Mr. Gaggs thencast himself resolutely on " God’s Mercy and the Hot WellWater," a fine instance this of faith as exemplified byworks, and paid one visit to the well. The resultwas that he went home, " east a large and savouryMeal, and by drinking the water for some time perfectlyattained his former State of Health, in all Respects." The hot wells became very fashionable and Dr. AndrewCarrick gives a glowing picture of the fascinations of theplace in 1789, when the sublime scenery of the cliffs wasenlivened by the sounds of a band of music." Natural

beauty did not appeal to the beau monde of the eighteenthcentury and no doubt the sweet strains of I I Water Parted"Dr the minuet in Ariadne had as enlivening an effect uponThe fashionable world as they had upon Tony Lumpkin’sDear. Mrs. Lybbe Powys who visited the wells in 1779loes not seem to have appreciated the place, for she

says : " The dismal brown pump room at the hot wells

always fills one with horror. I’m certain its being so dull ame must strike the miserable concourse ot invalids always.ssembled in it with a melancholy not to be erased." 2 In

1 THE LANCET, Sept. 21st, 1901. p. 800.2 THE LANCET, Sept. 16th, 1899, p. 793,