1050

specialists, he recommends that they should be made topass high examinations in their own subjects, and that theyshould be compelled to practise generally several yearsbefore being admitted as candidates for the specialistdiploma. He appears to have but little faith in the

capacities of medical societies for assisting to raise theposition and emoluments of medical men, remarking thatthey have not been found to exercise much control overtheir own members, and therefore cannot be expected toexercise any at all over outsiders.

AN EXPLORING CANNULA FOR SOLID

TUMOURS.

IN a paper read at a recent meeting of the GynecologicalSociety of Boston, Dr. J. Collins Warren advocated theuse of a little instrument devised by Dr. S. J. Mixter. Itconsists of a fine cannula with a sharp-cutting edge. It is

used as follows. An injection of cocaine is first given; thenwith a tenotome a puncture is made through the skin, andthrough this the cannula is thrust into the tumour to beexplored; it is then withdrawn half an inch, its directionaltered, and a second thrust made. It is afterwards whollywithdrawn, one finger being placed over the outer end. Bythis means a small mass of the tumour is removed, from whichsections can be at once cut on the freezing microtome, or later ion after liardening. Specimens of a tumour an inch or morein length and an eighth of an inch in diameter can beremoved in this way, and they afford ample material formicroscopic investigation. The instrument is designed toassist in the diagnosis of the earliest stages of scirrhus ofthe breast, or of any conditions in which the microscopealone can lead the surgeon to a definite decision as to thenature of a solid mass. Dr. Warren, an accomplishedsurgeon, spoke highly of the instrument, and pointed outthat by it the pathologist could obtain a specimen of thewhole depth of a tumour-not of its central parts merely-and of the surrounding tissues, showing the mode of itsinvasion by the neoplasm.

-

CLINICAL MICRO-BIOLOGY.

UNDER the above title, a course of lectures by Dr. GabrielRoux, chef de clinique to Professor Boudet at Lyons, is

being published in our contemporary La Province Meciicccle.The subject is to be dealt with under the following heads :-1. The clinical bacterioscopical laboratory. 2. Germs, theirpreparation for microscopical examination and cultivation.3. The skin and cavities accessible to air. 4. Sputa. 5. Con-tents of stomach and intestine. 6. Genito-urinary organs;urine. 7. Blood; internal organs. 8. Necropsies from the bac-teriological standpoint. 9. Summary of obviously microbicdiseases. 10. Experimentation on animals. II. Bacterioscopicanalysis of water and air. -

DISHORNING CATTLE DECLARED TO BE

ILLEGAL.

A FEW weeks ago, in an article on the dishorning ofcattle, we mentioned a case in which the legality of thisproceeding had been called in question. Judgment wasrecently delivered in this case by Lord Coleridge andMr. Justice Hawkins. The decision then arrived at is themore important because, while dealing with a particularinstance, it implied a condemnation of this cruel practiceunder the various conditions which have been said toexcuse it. Neither when performed in order to allow ofthe closer packing of cattle, nor when done to preventmutual injury by goring, least of all when intended to

destroy an evidence of age, did the operation commenditself to either judge as useful or necessary. Consequentlyit comes within the scope of the Cruelty to Animals Act,

and is lawfully punishable. This judgment, given aftex

lengthy and careful consideration of the subject, will gofar to bury in disuse a custom already nearly obsolete. Itwill not affect the interests of the great body of stock-

raising farmers who have discarded this practice, but willact as a needed restraint upon the rough-and-ready surgeryapproved by the dishorning minority.

’ RETURNS OF DISEASE FROM NOTIFICATION

j TOWNS.

THE compilation of returns of infectious diseases fromthe English towns having a system of compulsory notifica-tion, which was originally organised under Dr. Tatham’ssupervision, has now for some months past been regularlytransferred to the Local Government Board. From nearlyfifty notification towns, the returns, which were for-

merly despatched to Dr. Tatham, are now forwarded toWhitehall, where they are compiled in a tabular form;and to the medical officer of health of each contributingsanitary authority a complete return of the number of casesnotified from the several diseases in each of the townsconcerned is at once despatched. In this way the notifyingsanitary districts work hand in hand, supplying each otherwith information that is calculated to be of material use inconnexion with the possible importation of disease fromwithout. The names and actual residences of the sicknever formed part of the information supplied, and thereturn was held to be of a confidential nature. This practiceis very properly maintained under the new arrangements.To Dr. Tatham much credit is due for this first instalmentof a public record of infectious sickness.

THE RETINA IN ANaeMIC CONDITIONS.

DR. ARTHUR FRIEDRICHSON, of Dorpat, has publishedas an inaugural dissertation a set of observations madewith the ophthalmoscope on patients with anemia, chlorosis,and other general diseases. He finds that in chlorosis andin anemia consequent on haemorrhage the ophthalmoscopereveals either no morbid change at all, or merely a certainamount of hypersemia of the retinal vessels. The trans-

parency of the retinal vessels appears to depend upon theamount of h2emoglobin contained in the blood, but it is

especially well marked when there is at the same time adiminution in the number of the red corpuscles. When theanaemia is due to haemorrhage, and also in chlorosis, thepulsations of the retinal arteries have the appearance of beingmainly "locomotory" movements, whereas in the anamiaof neurasthenic patients they present very frequently thatof changes in the calibre of the vessels. Dr. Friedrichsonfound the appearance known as Helfreich’s progressivevenous pulse very frequently in valvular disease of the heart.

LIBRARIES AND INFECTION.

THE transference of infectious disease through the mediumof circulating libraries continues to attract attention.

Among the latest suggestions dealing with the subject isone recently brought before the vestry of St. Mary’s parish,Battersea, by Mr. J. J. Joseph, that the Local GovernmentBoard be advised to take such legislative action as willenable it to impose a penalty on any inmate of an infectedhouse who may make use of books in circulation without

notifying the existence of disease to the librarian. The

proposal is worthy of careful consideration, and would, ifadopted, add a suitable corollary to that useful regulationwhich forbids an actual sufferer from infectious disease to

expose himself in any public place. It will be noticed thatit is intended to apply to all public libraries, whether freeor not, and any action on the part of the Board should be

1051

no less extensive. Changes in law, however, are oftentardy in development, and it therefore behoves the managersof libraries in the meantime to impress upon their readersby notice and regulation what is their evident duty in thismatter.

-

QUEEN’S HOSPITAL, BIRMINGHAM

THE resignation of Sir James Sawyer as senior physicianto the Queen’s Hospital will cause some vacancies. It is

rumoured that Dr. Foxwell will be a candidate for this

appointment, and that Dr. Wilson will apply for the postof assistant physician to the General Hospital in the eventof Dr. Foxwell going to the Queen’s. Possibly Dr. Crookemay apply for the appointment of casualty physician to theQueen’s Hospital, and will be ready for any pathologicalvacancy which may occur at the College.

A POLICEMAN in St. Louis having been shot in the abdomenwhile making an arrest, Dr. Bernays, the surgeon whoattended him, at once performed laparotomy, and suturedthe stomach and jejunum, which were injured. The man

recovered, and the municipality of St. Louis has granted asum of$500 to Dr. Bernays for his skilful management ofthe case. Such a graceful act deserves to be recorded, andcommended as a precedent. -

THE Times and Register (New York and Philadelphia,May llth) states that among the names mentioned for thevacancy created by the death of Professor S. W. Gross arethose of Charles Parks of Chicago, C. Wyman of Detroit,Hunter Maguire of Richmond, and Nicholas Senn ofMilwaukee.

___

THE Cavendish Lecture will be delivered by Dr. Andrewat the West London Hospital on Friday, June 7th, at

5.30 P.M. The subject will be "The Relations betweenDisease and the Regulating Nerve Centres."

MR. PROVAXD has given notice to call attention to thefinancial position of the London and other hospitals, and tomove a resolution on the subject.

SIR MORELL MACKENZIE has been elected an HonoraryMember of the Medical Society of the State of New York.

DR. GRAILY HEWITT has been elected a Fellow of the

Royal Society of Edinburgh.

VACCINATION IN JAPAN.By HAMILTON CARTWRIGHT, M.R.C.S. &C.,

EMERITUS PROFESSOR AND HON. FELLOW OF KING’S COLLEGE, LONDON.

IN the face of so many conflicting testimonies and

opinions as to the value of vaccination, from Dr. Creighton’scontribution to the " Encyclopaedia Britannica" to the recentarticle in the TVestminster Review for February, it may be in-structive to those who are interested in the subject to recountthe information which I gained in Japan during a voyageround the world, whence I have just returned. There couldbe no better test country as to the value of vaccination thanJapan, and having visited it twice within the last twentyyears I am enabled to give some personal testimony as towhat the effect of vaccination has been there. Two decadessince, nearly every second person was pock-marked ; whilstnow, as a rule, this is only the case with the old, theyounger children in those districts where vaccination isskilfully performed being unmarked. Whilst at Tokio, Ivisited the native hospitals, under the aegis of Mr. Yamada,the secretary of Dr. Nagayo Sensai, the President of theSanitary Board of the Home Office, to whom I am much

indebted for information on this and other medical matters.My first visit was to the municipal bovine farm under thecare of Dr. Kijuchi, and maintained at the expense of theState. After seeing a calf skilfully vaccinated by thedoctor, he operated upon several patients, and I was surprisedto see that he vaccinated all who came to him, though somehad well-marked cicatrices on both arms of very recent date.He told me that he never refused to revaccinate, howeversuccessful a prior operation had been, as the patients’ returnproved their faith in the operation. In relation to this, hesaid that he considered it had been amply demonstratedin Japan that vaccination, however perfectly performed,only rendered a person far less liable to small-pox ormodified the attack, whilst he thought that it lost much ofits protective power after a lapse of five years, though hesaid that he did not know of a case of death from small-pox in cases in which the operation had been performedwithin five years and was effective in both arms. Inthis institution the operation is most carefully carriedout, five punctures being made in each arm. In Tokiothe people have such belief in the operation that theyfrequently ask to be revaccinated within the year. In thattown, as in Osaca, Kyoto, and Hiogo, great pains are takento secure the efficacy of the operation; but in other placesthere are so few qualified practitioners that it is often im-perfectly performed. Thanks to Dr. Nagayo Sensai I havebeen provided with full statistics with regard to small-poxsince the legal and compulsory institution of vaccination inthe seventh year of Meiji (1874), when the Government insti-tuted a vaccine farm at Tokio for the distribution of calflymph to the different local authorities throughout thecountry in spring and autumn, and whenever small-pox isprevalent.The lymph is preserved in capillary tubes, five boxes

of which constitute a " gu, or set. The distribution wasformerly 3 "gu," or 15 sets per 100,000, now increasedto 6 "gu."

z z In April, 1887, instruction was first given byagents of the Home Department in its use, and the regula-tions for vaccination, and the penalties for non-compliancewith them, enacted in 1874 and 1885, were confirmed.The new regulations oblige not only those unsuccessfullybut also those successfully vaccinated to be revaceinatedwithin a period between five and seven years after thefirst operation, whilst in the event of an epidemic of thedisease all are recommended to be revaceinated, howeverrecent their last vaccination. The breach of theseregulations is punished by fine, or even imprisonment.(See annexed forms of vaccination certificates.) Between

VACCINATION CERTIFICATES.

Form No. 1.

July, 1878, and June, 1879, 2496 persons were attacked bythe disease, and 685 died, from which figures we have a