fire inquests

2
563 NOTES, COMMENTS, AND ABSTRACTS. Nor can he find the slightest justification for th guesses that he died of typhoid fever, of Bright’s disease, or of apoplexy. The late Dr. R. W. Leftwich, in a lecture before the Royal Society of Medicine on March 19th, 1919, considers that an examination of the six undisputed signatures furnishes unimpeachable evidence that Shakespeare suffered from Scrivener’s palsy, as they show every one of the 18 classical symptoms of that disorder. Considering the enormous amount that Shakespeare must have written in the cramped Gothic style which preceded and for some time accompanied the later Italian hand, it might well be that he suffered from writer’s cramp. Incidentally, such a continuous output would result in headache from eyestrain in a period when astigmatism went uncorrected. But people do not die of Scrivener’s palsy. Dr. Leftwich can find no case to be made out for other diseases, and, as a medical man, he must be accounted as a competent witness. Like Dr. Tannenbaum, however, there may be with Dr. Leftwich a strain of the obsession of the expert graphologist. As Nisbet, himself not free from bias, wisely remarks, " Graphology contains no doubt a substratum of truth, though it may not yield results as definite as those its votaries claim for it." Dr. Leftwich states that " it has been surmised that the defects of Shakespeare’s handwriting were due to some constitutional disease such as locomotor ataxy or chronic paralysis, but the preamble to his will, written only a few months before his death, negatives such views." Despite the looseness of this statement one must agree with it, and it may be pointed out in support that in the Elizabethan literature, dramatic and fictional, no allusions are to be found to a disease so prominent in its symptoms as locomotor ataxy, and that the nerve manifestations of syphilis were not the subject of notice before the eighteenth century. From the above short review it is seen that Shakespeare’s death has been attributed to a mis- cellaneous assortment of maladies. Fever, typhus, typhoid, paralysis, epilepsy, apoplexy, arterio-sclerosis, over-smoking, chronic alcoholism, gluttony, sexual excesses, angina pectoris, Bright’s disease, pulmonary congestion, locomotor ataxy ; a sufficiently hetero- geneous list with which to saddle a man ! The hypotheses of medical criticism as to the poet’s death appear to have attributed as many burdens to him as the literary critics have found for his work ! Of the whole list, the most suggestive is that of ambulatory typhoid, but, as in the life, so in the death of Shakespeare nothing is certain. His elusiveness remains. He has not even left us a swan-song. REFERENCES. 1. Routledge, 1930. 2. Shakespeare’s Handwriting, Oxford, 1916. 3. Problems in Shakespeare’s Penmanship, New York, 1927. 4. Shakespeare Jahrbuch, Leipzig, 1925, pp. 89-93. FIRE INQUESTS. A RECENT annual report of the Society for the Protection of Ancient Buildings warns the public of fire dangers to which our fine old country houses are exposed. In this connexion the report mentions a communication from Dr. F. J. Waldo in which the City coroner reiterates the need of technical equip- ment against fire and mentions his unique jurisdiction (under the City of London Fire Inquests Act of 1888) for investigating fires in the City. Dr. Waldo has more than once suggested that what is good enough for the City of London might well be good enough for the rest of the country ; but proposals for the extension of the fire inquest system outside London, though favoured some 20 years ago, are nowadays neglected. Fire inquests could claim an ancient and unbroken pedigree. According to the Mirror of Justices a treatise ascribed to the reign of Edward I., coroners attended on occasions of arson and inquired who put the fire there and how and by what felony, drunkenness or other mischance the fire arose. Modern scholarship is contemptuous of the Mirror of Justices; Pollock and Maitland in their History of English Law decide to ignore its account of the criminal law as full of fables and falsehoods. Coke definitely says that coroners can inquire into no felony except homicide ; Hale and Comyns agree with him. It is nevertheless on record that by local custom mediaeval coroners inquired of other felonies in the turbulent county of Northumberland. In more recent times, according to Jervis on Coroners, inquests on non- fatal fires were held at Rotherham in 1843, at Don- caster in 1853 (on the burning of the parish church), and at Nottingham in 1857, as well as in other towns. Then in 1860 came the case of R. v. Herford wherein Chief Justice Cockburn and his colleagues reaffirmed the dicta of Coke, Hale, and Comyns. William Herford, coroner of Manchester, held an inquest on a fire which had occurred on the premises of a local shop- keeper, and, during an adjournment, the High Court intervened. Statutory confirmation of the limitation on coroners’ jurisdiction was enacted in Section 44 of the Coroners Act of 1887. In the City of London fire inquests had been held from time to time though their legality was contested ; the City of London Fire Inquests Act of 1888 regularised the practice. More than once in the present century the extension of the practice to the whole country has been officially considered. In 1909 the Home Office departmental committee on the law of coroners examined the point at length. Evidence was heard from Dr. Waldo, who said that some 140 or 150 fires were referred to him every year; he made preliminary inquiries in all cases but held inquests in only a small percentage ; he had never committed anyone for trial for arson. Fire inquests duties, he said, were more technical and exacting than body inquests; they took more time and required greater knowledge of the law. He thought the Act had caused a diminu- tion of fires in the City and was useful in showing up neglect of precautions. On the other hand, the chief constable for Manchester deprecated anv extension of the coroner’s power ; the ordinary law was enough ; he claimed that there were fewer fires in Manchester than in the City of London. The com- mittee’s report (Cd. 5004) preferred Dr. Waldo’s view. It declared that the Citv system had worked well and ought to be extended. The Act of 1888 was " preventive and remedial." The committee recommended that a beginning be made with an adoptive Act. County or borough councils might adopt the practice of fire inquests and, if the result was satisfactory, then the Act might be made universal. The recommendation made no more headway than Sir Henry Cotton’s Fire Inquests Bill of 1909. In 1920 the London County Council inserted in a General Powers Bill a clause for the holding of such inquests in the county area (outside the City) on direction from the Council or the Home Secretary. The proposal was withdrawn, pending legislation for the whole of England, owing to disagreements about the coroner’s initiative and remuneration. The position was reviewed by the Royal Commission on Fire Brigades and Fire Prevention. Its report, published in 1923 (Cmd. 1945), remarked on the anomaly that Dr. Waldo should be able to hold fire inquests in the City but not in his adjacent juris- diction of Southwark. The report stated that exam- ination of fire outbreaks whether fatal or non-fatal would be " useful from several points of view." But the Royal Commission accepted an opinion pressed by the London County Council in evidence, that the tribunal should consist not of a coroner whose qualifica- tions are usually medical and legal but of a specialist officer with technical knowledge of building con- struction, engineering, and fire prevention. The analogy of Board of Trade or Ministry of Transport inquiries into boiler explosions or railway accidents was evidentlv attractive. The Commission recom- mended that the Home Office should draw up a panel of persons thus qualified and that the new proposals should apply to Scotland. In Scotland at present the procurator fiscal can obtain an inquiry by the sheriff and a jury into any fatal accident, and in

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Page 1: FIRE INQUESTS

563NOTES, COMMENTS, AND ABSTRACTS.

Nor can he find the slightest justification for thguesses that he died of typhoid fever, of Bright’sdisease, or of apoplexy.The late Dr. R. W. Leftwich, in a lecture before

the Royal Society of Medicine on March 19th, 1919,considers that an examination of the six undisputedsignatures furnishes unimpeachable evidence thatShakespeare suffered from Scrivener’s palsy, as theyshow every one of the 18 classical symptoms of thatdisorder. Considering the enormous amount thatShakespeare must have written in the crampedGothic style which preceded and for some timeaccompanied the later Italian hand, it might wellbe that he suffered from writer’s cramp. Incidentally,such a continuous output would result in headachefrom eyestrain in a period when astigmatism wentuncorrected. But people do not die of Scrivener’spalsy. Dr. Leftwich can find no case to be made outfor other diseases, and, as a medical man, he mustbe accounted as a competent witness. Like Dr.Tannenbaum, however, there may be with Dr.Leftwich a strain of the obsession of the expertgraphologist. As Nisbet, himself not free from bias,wisely remarks, " Graphology contains no doubt asubstratum of truth, though it may not yield resultsas definite as those its votaries claim for it." Dr.Leftwich states that " it has been surmised that thedefects of Shakespeare’s handwriting were due tosome constitutional disease such as locomotor ataxyor chronic paralysis, but the preamble to his will,written only a few months before his death, negativessuch views." Despite the looseness of this statementone must agree with it, and it may be pointed outin support that in the Elizabethan literature, dramaticand fictional, no allusions are to be found to a diseaseso prominent in its symptoms as locomotor ataxy,and that the nerve manifestations of syphilis were notthe subject of notice before the eighteenth century.From the above short review it is seen that

Shakespeare’s death has been attributed to a mis-cellaneous assortment of maladies. Fever, typhus,typhoid, paralysis, epilepsy, apoplexy, arterio-sclerosis,over-smoking, chronic alcoholism, gluttony, sexualexcesses, angina pectoris, Bright’s disease, pulmonarycongestion, locomotor ataxy ; a sufficiently hetero-geneous list with which to saddle a man !The hypotheses of medical criticism as to the

poet’s death appear to have attributed as manyburdens to him as the literary critics have foundfor his work ! Of the whole list, the most suggestiveis that of ambulatory typhoid, but, as in the life,so in the death of Shakespeare nothing is certain.His elusiveness remains. He has not even left us aswan-song.

REFERENCES.

1. Routledge, 1930.2. Shakespeare’s Handwriting, Oxford, 1916.3. Problems in Shakespeare’s Penmanship, New York, 1927.4. Shakespeare Jahrbuch, Leipzig, 1925, pp. 89-93.

FIRE INQUESTS.A RECENT annual report of the Society for the

Protection of Ancient Buildings warns the publicof fire dangers to which our fine old country housesare exposed. In this connexion the report mentionsa communication from Dr. F. J. Waldo in which theCity coroner reiterates the need of technical equip-ment against fire and mentions his unique jurisdiction(under the City of London Fire Inquests Act of 1888)for investigating fires in the City. Dr. Waldo hasmore than once suggested that what is good enoughfor the City of London might well be good enoughfor the rest of the country ; but proposals for theextension of the fire inquest system outside London,though favoured some 20 years ago, are nowadaysneglected. Fire inquests could claim an ancientand unbroken pedigree. According to the Mirror ofJustices a treatise ascribed to the reign of Edward I.,coroners attended on occasions of arson and inquiredwho put the fire there and how and by what felony,drunkenness or other mischance the fire arose. Modernscholarship is contemptuous of the Mirror of Justices;

Pollock and Maitland in their History of EnglishLaw decide to ignore its account of the criminal lawas full of fables and falsehoods. Coke definitely saysthat coroners can inquire into no felony excepthomicide ; Hale and Comyns agree with him. It isnevertheless on record that by local custom mediaevalcoroners inquired of other felonies in the turbulentcounty of Northumberland. In more recent times,according to Jervis on Coroners, inquests on non-fatal fires were held at Rotherham in 1843, at Don-caster in 1853 (on the burning of the parish church),and at Nottingham in 1857, as well as in other towns.Then in 1860 came the case of R. v. Herford whereinChief Justice Cockburn and his colleagues reaffirmedthe dicta of Coke, Hale, and Comyns. William Herford,coroner of Manchester, held an inquest on a firewhich had occurred on the premises of a local shop-keeper, and, during an adjournment, the High Courtintervened. Statutory confirmation of the limitationon coroners’ jurisdiction was enacted in Section 44of the Coroners Act of 1887. In the City of Londonfire inquests had been held from time to time thoughtheir legality was contested ; the City of LondonFire Inquests Act of 1888 regularised the practice.More than once in the present century the extension

of the practice to the whole country has been officiallyconsidered. In 1909 the Home Office departmentalcommittee on the law of coroners examined thepoint at length. Evidence was heard from Dr.Waldo, who said that some 140 or 150 fires werereferred to him every year; he made preliminaryinquiries in all cases but held inquests in only a smallpercentage ; he had never committed anyone fortrial for arson. Fire inquests duties, he said, weremore technical and exacting than body inquests;they took more time and required greater knowledgeof the law. He thought the Act had caused a diminu-tion of fires in the City and was useful in showing upneglect of precautions. On the other hand, thechief constable for Manchester deprecated anv

extension of the coroner’s power ; the ordinary lawwas enough ; he claimed that there were fewer fires inManchester than in the City of London. The com-mittee’s report (Cd. 5004) preferred Dr. Waldo’sview. It declared that the Citv system had workedwell and ought to be extended. The Act of 1888was " preventive and remedial." The committeerecommended that a beginning be made with anadoptive Act. County or borough councils mightadopt the practice of fire inquests and, if the resultwas satisfactory, then the Act might be made universal.The recommendation made no more headway thanSir Henry Cotton’s Fire Inquests Bill of 1909. In1920 the London County Council inserted in a GeneralPowers Bill a clause for the holding of such inquestsin the county area (outside the City) on direction fromthe Council or the Home Secretary. The proposalwas withdrawn, pending legislation for the whole ofEngland, owing to disagreements about the coroner’sinitiative and remuneration.The position was reviewed by the Royal Commission

on Fire Brigades and Fire Prevention. Its report,published in 1923 (Cmd. 1945), remarked on theanomaly that Dr. Waldo should be able to holdfire inquests in the City but not in his adjacent juris-diction of Southwark. The report stated that exam-ination of fire outbreaks whether fatal or non-fatalwould be " useful from several points of view."But the Royal Commission accepted an opinion pressedby the London County Council in evidence, that thetribunal should consist not of a coroner whose qualifica-tions are usually medical and legal but of a specialistofficer with technical knowledge of building con-

struction, engineering, and fire prevention. The

analogy of Board of Trade or Ministry of Transportinquiries into boiler explosions or railway accidentswas evidentlv attractive. The Commission recom-mended that the Home Office should draw up a panelof persons thus qualified and that the new proposalsshould apply to Scotland. In Scotland at presentthe procurator fiscal can obtain an inquiry by thesheriff and a jury into any fatal accident, and in

Page 2: FIRE INQUESTS

564 NOTES, COMMENTS, AND ABSTRACTS.

towns the burgh prosecutor can investigate fireoutbreaks if requested by the town council or onspecial report by the firemaster that wilful fire-raising is suspected. As matters thus stand, the RoyalCommission’s recommendations are an obstacle to theextension of the City of London practice. Indeed theancient usefulness of the coroner as an investigatorof crime is latterly somewhat belittled. Section 20of the Coroners (Amendment) Act of 1926, which putthe coroner out of action when once the examiningjustices have taken in hand proceedings in cases ofsuspected homicide, was a serious break with the past.

BRITISH DERMATOLOGY.To the " Annals of Medical History " (Vol. III.,

New Series, July, 1931), Dr. Haldin-Davis con-

tributes an article of real historic interest settingout the foundations of British dermatology, fromwhich we learn how comparatively modern is anythinglike rational treatment of skin diseases. From thevery dawn of medicine affections of the skin musthave received attention from doctors, for the sufferersfrom skin diseases are more urgent than any classof patients in their demands for relief, while it is alamentable fact that a substantial proportion of themcan only be offered remedial measures of a partial ortemporary character. But there is hopefulness inthe fact that with the general development of path-ology more and more dermatological defaults,following upon the discovery of their origin, are

yielding to intelligent therapeutics. Dr. Haldin-Davis attributes the progress of the last centurymainly to the publication of Robert Willan’s treatisein 1808. This was an attempt at the rational classifica-tion of skin diseases based upon characteristiclesions, and the author completed half of the projectedwork during his life-time. His pupil, Thomas Bate-man, completed the treatise which was publishedunder the heading " A Practical Synopsis of CutaneousDiseases, according to the Arrangement of Dr.Willan." The basis thus introduced into dermato-logical classification has largely remained ; wherepossible the scientific procedure of classifying byaetiology has replaced Willan’s classification byappearances ; but, as Dr. Haldin-Davis points out,our knowledge of the aetiology of skin diseases islamentably deficient at the present day, exceptin the case of a few infective agencies, compellingus largely to classify skin diseases according to theirappearances. Reading this article it becomes clearthat Willan was a very remarkable man, for withoutthe microscopic aid by which so many advances in thisfield of medicine have been made, he devised a systemof classification 130 years ago which to-day is themain medium for intelligent converse between experts.

BLOOD PRESSURE IN THE CAPILLARIES.

RESEARCH which produces important results isof obvious value, but just as useful is the work whichrepeats research in order to confirm or disprove it.This checking of results will often prevent a wholecrop of errors.For a long time attempts have been made to measure

the pressure in the capillaries. Many differentmethods have been applied, but so far no satisfactorysolution of the problem has been found. RecentlyA. Sokolowski and M. Kubiczek 1 have undertakeninvestigations into the method designed by Kylin-a method of compression, which has hitherto beenaccepted as giving the most accurate data. Theyapproached the problem from two aspects, consideringfirst the technical difficulties arising from imperfectionsin the apparatus, and secondly, the results as

interpreted in the light of the anatomy and histologyof the part investigated. The imperfections in theapparatus, they found, made comparative studyimpossible and by certain modifications they triedto overcome them. Then they succeeded in makingseveral interesting observations. For example, theynoted that after the initial compression the capillaryloops continued to contract despite a rapid diminution

1 Ann. de Méd., 1931, xxix., 408.

in the pressure. This suggested. an active contractionon the part of the vessels as a result of irritation ofthe vasomotor nerve-endings in the vessel walls; .consequently, any results obtain with this apparatuswould be influenced in great part by the vasomotornerves. Again, when an attempt was made to getrepeated readings for comparative study-as, forexample, when testing the effects of certain drugs-it was found that after each compression a strongvascular hyperæmia ensued, necessitating a pauseof four to six minutes between each reading.The second half of the work consisted of a careful

examination of the anatomy and minute histologyof the part which had been investigated-namely,the skin just behind the nail bed. Sections of variousthicknesses were taken and stained by severalmethods. Correlating the results, they came to theconclusion that readings obtained by Kylin’s methodof compression, and, in fact, all compression methods,did not give the pressure in the capillaries, but gaveactually the pressure in the afferent arterioles ; inthe area under examination the arteriole was theone described by and named after Spalteholz. Again,the results were influenced by the thickness of the skinof the subject investigated, and by several other factors.The main result from these investigations is to

show the innumerable difficulties in the way of anyattempt to measure capillary pressure, and theinaccuracies of an accepted method.

ANÆMIA IN PREMATURE BABIES.As a further supplement to the work of Dr. Helen

Mackay 1 comes the report of some investigationsby Dr. G. Sanpaolesi,2 of Florence, carried out inProf. Czerny’s clinic in Berlin. He examined theblood of twelve premature babies at approximatelyweekly intervals, beginning from two days to threemonths after birth. He enumerated the total redblood corpuscles present, estimated the amount ofhaemoglobin, and calculated the water content by theindirect method of determining the total solids.All the babies were born normally, ten were onemonth premature and two were two month premature.In one case congenital heart disease was presentand another suffered from a congenital syphiliticinfection. Otherwise the children were normal anddeveloped normally except for slight digestive troubleswhich were without influence on the weight curve.None of the children showed evidence of the so-calledexudative diathesis, held by some authorities to bethe cause of the hydræmia from which they all

appeared to suffer in the third month of life. In thefirst four weeks Sanpaolesi found normal values fortotal solids and water content of the blood but inthe second month began a decrease in the solids andincrease in the water content, associated with aparallel decrease in the number of red blood corpusclesand amount of haemoglobin present. This was notaccompanied by any alteration in the weight curvesand in the child with congenital syphilis the decreasein total solids was more marked than in the normalbabies, while the patient with congenital heartdisease had only a minimum decrease. In two caseswhere vegetable additions to the diet were earlyintroduced the decrease in total solids was very slightand there was a correspondingly quick recovery afterthe third month, although no influence of the diet onthe total red cell count and haemoglobin content couldbe detected. Sanpaolesi thinks that iron deficiencyis not of great importance in the anaemia of thepremature baby which seems to be due rather to adisturbance of the water-regulating mechanism ofthe body. Further observations on the total bloodvolume are necessary to settle this point and theypresent great practical difficulty. For the momenthe merely draws the conclusion that there is certainlya dilution of the blood in the third month of life inpremature babies and that this plays a part inproducing what may be called the physiologicalanaemia of prematurity.

1 See THE LANCET, July 25th, p. 195.2 Jahrb. f. Kinderh., 1931, cxxxii., 277.