333

examination and the length of their curriculum. They urgethat the University of London is sufficient for London, andthat the establishment of a second examining body in themetropolis, without any arrangement for University teaching,residence, or discipline, for the purpose of granting a degreeon easier terms, would be objectionable. If this were a

University combining all the Faculties, the objections ofCambridge would be untenable. Moreover, we questionwhether a longer course of medical study is required byall Universities than by the Royal Colleges as licensingcorporations. Oxford, appealing to the interests of literatureand science, has considered the question from a higherstandpoint than the sister University. It is noteworthythat the names of Professors Humphry and Latham aremissing from the Cambridge petition.

THE AGE FOR REVACCINATION.

THE Local Government Board have issued an Order dated

February 3rd, 1888, modifying the one of February 18th,1868, as to revaccination. The old Order limited the per-formance of revaccination by a public vaccinator to thosewho had attained the age of fifteen years and had not pre-viously been revaccinated, except in the face of immediatedanger from small-pox, when the limit might be reduced totwelve years. It has, however, become more and moreevident of late years that even an efficient vaccinationtends to lose much of its protective power before the ageof puberty; and hence, as was foreshadowed by Mr. Ritchiein his recent speech at Sheffield, the age limit is now reduced to twelve years under ordinary circumstances, and to ten years in case there be any immediate danger of

small-pox. The demand for revaccination at the publiccost is not imperative upon the public vaccinator unlesshe is of opinion that the proposed operation is not for

any sufficient medical reason undesirable; and he is furtherempowered to refuse it, provided he is unable to afford

lymph for the purpose without interfering with the per-formance of primary vaccination in his district, the latteroperation very properly taking precedence in point of

importance as a protective against small-pox. The newOrder also extends the meaning of the term public vaccinatorto the medical officer of any workhouse, separate workhouseschool, or workhouse infirmary, provided he performs vac-cination under contract in any such institution. And,further, it also enables the public vaccinator to a workhouseto revaccinate children under his charge at any age belowthe ages specified in the Order, provided he records in hisregister the opinion that he deems their primary vaccinationto have been inadequate.

_

BRITISH NURSES’ ASSOCIATION.

As will be seen by a full report which appears in anothercolumn, a meeting in connexion with the British Nurses’Association was held on the 13th inst. at St. George’s Hall,Langham-place. The large attendance of ladies and ofinfluential members of the medical profession must havebeen sufficient to assure H.R.H. Princess Christian, who,as President of the Association, honoured the gatheringwith her presence, of the great and well-merited success themovement has attained. The draft of the bye-laws appearsto have been well considered, especially No. 9, whichruns as follows: "No scheme or measure shall be carriedinto effect, nor any new bye-law be confirmed, if it shallappear that such scheme, measure, or bye-law, when passedby a General Council meeting, was opposed by two-thirds ofthe medical men present at that meeting." We cannot tooforcibly remind nurses that the active influence of the mem-bers of the medical profession is absolutely necessary, notonly for the foundation, but also for the future well-being, of

the Association. Dependent as nurses are upon medical mennot only for their knowledge and training, but also for theirfuture occupation, it is surely not too much to insist thatin the hands of medical men shall rest a guiding and restrain-ing influence upon the plans and deliberations of the GeneralCouncil of the Association. The wording of the bye-lawmight perhaps be somewhat improved, so that no escapefrom this position would be possible. The presence on the

platform of so many leading surgeons and physicians, andthe warm sympathy expressed by them with the objects ofthe meeting, amply prove that the organisers of the Associa-tion will not lack the counsel and advice of the medical

profession in the future conduct of the Association. In the

proposed bye-law, No. 14, in which power is reserved to theCouncil to erase from the register the name of any associatefor misconduct a wise discretion has been reserved. With

regard to the Charter for which it is proposed to petition thePrivy Council, we trust all details will be fully considered.,and so arranged as to render any dissension between thenurses and the medical representatives in the Council im-

possible. -

IRON IN PURPURA.

A CHEMICAL examination of the blood, bile, pleuriticeffusion, brain, liver, spleen, marrow of the bones, kidney,lungs, and lymphatic glands in a case of purpura has beenmade by Dr. Zaleski, and published in the Russian Military,Medical Gazette, his object being to determine whetherthis disease, which is called by him 11 morblis maculosusWerlhofii," is associated with any increase in the quantityof iron in the body, as some results obtained by Hindenlangand Kunkel appear to indicate. Dr. Zaleski found that, sofar from this being the case, the iron was diminished bysomething like a half. He’found no inorganic iron compoundslike those described by Kunkel, but most of it existed inthe form of an albuminate; some, however, was found inthe pigment spots in very stable compounds similar tohæmoglobin. More iron appeared to exist in the graythan in the white substance of the brain.

BURIAL REFORM.

ALL who have seriously considered the disadvantages attending our present methods of interment will regardwith satisfaction the efforts of the Church of England BurialReform Association. We need only now select three of thespecific reforms which the Society has set itself to accom-plish in order to illustrate the orthodoxy of its views onthis important problem in sanitation. These are (1) timelyinstead of delayed burial, (2) the use of readily perishablecoffins, and (3) selection of a soil appropriate to the purpose-of burial. The first of these desirable changes, we fear, hashitherto been somewhat overshadowed by the prominence indiscussion assigned to the two latter. It is, nevertheless,itself an important matter, and particularly so, for obviousreasons, in cases of death from infectious disease. Thanksto the normal coolness of our climate, its claims to publicnotice have hitherto been less regarded than they wellmight have been. It is never too late for improve ment, how-ever, and we shall feel obliged to the Association if its effortsto encourage the early burial of the dead are instrumentalin altering common usage in this particular. The pressingnecessity for a general disuse of the solid wooden coffin, stillso common, in favour of a light case, which will hardly im-

. pede the carrying out of the sanitary injunction, "earth toearth," we have insisted on in many former issues. On this

point the Society need fear no scientific opposition, but only, the dead weight of ignorant custom. The question of soilis a somewhat large one, connected as it is with those of

: . the inclination of land, the course of streams, relative posi-

334

tion of dwellings, and other matters which are or ought tobe considered in laying out ground for purposes of burial.’The space at our disposal will not allow us to discuss it atlength. We need only now refer to permeability, moderatedryness, and a general slope sufficient to ensure the gradualsubsidence of water due to rainfall, as qualities necessarilyassociated with a suitable soil. We publish in anothercolumn an abstract of a paper on Burial Reform read byMr. Lowndes at Liverpool, in which the urgent need ofchanges in the present method of burial is strongly enforced.

ARMY MEDICAL DEPARTMENT.

IN the memorandum which has just been issued respect-ing the War Office reorganisation, the following is the

paragraph which relates to the Army Medical Service:" The Director-General of the Army Medical Department ischarged with the administration of the medical services,Medical Staff Corps, and medical establishments of the

Army, and the preparation of medical and statistical

returns; with the supply of medical stores to the Army,and with the preparation of estimates for the above ser-vices. He will report on the above questions through theAdjutant-General, Quartermaster-General, or to the MilitarySecretary, according to the nature of the matter submitted."Under this regulation we presume that all questions relatingto the personnel of the Department.-appointments, pro-motions, retirements, rewards, and punishments,-will besubmitted to the Commander-in-Chief through the Adjutant-General, and those relating to the matériel through theQuartermaster-General, on whom also will devolve the dutyto " deal with sanitary questions relating to the Army."The contracts for the supply of medicines and instru-ments will be made by the Director of Contracts onthe requisition of the Director-General, who will have avoice in determining upon the contract to be accepted. Wedo not know that these new rules will make any importantchange in the mode of conducting the service. It maypossibly throw a little more power into the hands of themilitary as contrasted with the civil branch of the War

Office ; but if so, it will transfer with it a greater respon-sibility in the event of any shortcoming such as has beenoften complained of on active service.

SENTENCE OF BANISHMENT ON A DOCTOR.

A ST. PETERSBURG Court of Justice has just passed asentence on a medical man which is sufficient to striketerror into the heart of every hospital medical officer inRussia. The circumstances, according to the St. PetersburgerMedicinisc7ie Wochenschrift, are as follows :-In consequenceof the insufficiency of room in the St. Petersburg hospitalsfor all the sick persons who apply, especially in winter, foradmission, there is frequently great difficulty in obtaining abed, even for an urgent case. In order in some measureto remedy this state of things, an "Information Office" "was established some time ago for the benefit of patients.A medical man is on duty there all day, and he receivesreports from all the hospitals regarding the number ofvacant beds for each sex, and can thus send an applicantto a hospital where he has some chance of being admitted.No beds, washing accommodation, or clothes are providedat the office, but an applicant is allowed to remain theretill nightfall waiting for news of a vacant bed. Afterthat time he must leave. In the case above alluded to,the accused, Dr. Dreipelkher, who held the rank of " CourtCouncillor," was convicted of having sent a patient awayfrom the Information Office, insufficiently clad and in

very cold weather, without giving her any assistance, andso accelerating her death. The patient was an old womanin the last stage of phthisis, who was sent, as indeed she

had been sent on previous occasions, to the InformationOffice by her employers in order that she might be admittedinto a hospital. There was, however, not a single bed for afemale in any of the hospitals. Dr. Dreipelkher sent anattendant with her to a police-station distant only a few

hundred yards, with a request that she might be taken into! a kind of small casual ward attached to the station for thenight. The police, however, would not take her in becauseshe did not belong there." In like manner she was turned

away from two other police stations, no clothing beingprovided for her, although the orders are that the feldsher(dresser) attached to each of the police casual wards shallin very severe weather see that no person is sent awaywithout a warm wrap, a supply of which articles is keptfor the purpose. After 6 o’clock the poor old woman becamealmost comatose, and was admitted to a temporary hos-pital, where she died about an hour afterwards. Inwhat way Dr. Dreipelkher was to blame it would be hardto say. He was entirely without any accommodation forpatients himself, and he seems to have done his bestto provide for the poor creature until the next day,when he hoped he would be in a position to find her a bedin some hospital. He was, however, found guilty by thejury, and was sentenced to the deprivation of personalrights and to banishment for three years to the province ofArchangel! This sentence appears to have been pronouncedin obedience to some statute and against the judge’s in-clination, for he seems to have furthered a petition to theCzar through the Minister of Justice, praying for a com-mutation of the sentence to one month’s imprisonment.

TOBACCO AMBLYOPIA.

THE optic nerve resembles a sensory tract of the spinalcord and consists of two part@, of which the central has aspecial affinity for tobacco, while drugs like quinine leaveit unaffected. Tobacco is the essential agent in causingan axial neuritis which does not generally tend to spread tothe nerve fibres coming from the periphery of the retina. Asa rule, patients apply in the early stage of neuritis, andsimple cessation of smoking is the only treatment required.When recovery is established, moderate smoking is not

injurious. In addition to tobacco, a special condition is

required to bring on an attack, alcohol, diabetes, excessivevenery, starvation, mental shock, or distress being the mostfrequent auxiliaries. In some individuals a special tendencyto degeneration (sclerosis or atrophy) exists hereditarily, andto these tobacco is especially injurious. Such are the con-clusions of, Mr. Edgar A. Browne’s article in the LiverpoolMedico - Chirurgical Aurnal, wherein also a table of casesappears. -

POST-MORTEMS IN UNION INFIRMARIES.

THE Durham guardians are much exercised at the requestof their medical officer for leave to examine the bodies ofthe deceased inmates of the workhouse, whose friends raiseno objection to this procedure. The guardians were

scandalised by such a proposal, and each vied with theother in the use of terms condemnatory of their medicalofficer. Moreover, having discovered that on some pastoccasion a post-mortem examination had been made withouttheir sanction, they resolved to communicate this occurrenceto the Local Government Board. It probably requires aproperly constituted Poor-law mind to recognise this crimeat its full enormity. For our own part, we hold that themedical officer who adds to his pathological knowledgeby taking advantage of the means at his disposal is morelikely to render service to the living than he who is un-willing to incur the trouble of examining the dead. The

guardians of Durham, however, regard this desire to " cutpoor people’s flesh and bones after they are dead," as a