1177

meant £2652 annually. He suggested that arrangements n,

should be made to reduce pressure on the present asylum by a:

distributing all the harmless lunatics over the different a:

workhouses in the county, and so to obviate the necessity for sl

incurring the enormous expense of building a new asylum. r4

They might easily find room in the Limavady Workhouse for t,100 or 150 of the harmless lunatics at present in the Derry u

Asylum. After some discussion a resolution was passed to gthe effect that, owing to the existing agricultural distress n

and the additional expenditure that it would entail in Cerecting a new asylum, all action in that direction for v

the present be suspended, and that the Limavady board ofguardians offer to give accommodation for 100 to 150 harm-less lunatics in their workhouse. It was suggested that fother unions in county Derry might join with the Limavady guardians with a view to reduce the present pressure onthe Derry Asylum.

Belfast District Lunatic Asylum. From the sixty-sixth annual report of the resident medical 1

superintendent (Dr. Merrick) of the Belfast Asylum I find that during the year the daily average number resident has been 782, an increase of 59 over that of the preceding year.During the year 240 patients were admitted, the highestnumber of annual admissions recorded in connexion withthe asylum. On Dec. 31st, 1895, there were 698 cases in theasylum, while the normal accommodation is 400 ; hence thedifficulty of proper treatment and classification is apparent.It is curious that melancholia figures largely in the admis-sions, there being 78 cases suffering from this condition.Of these, 11 had made suicidal attempts and 53 werenoted in their admission forms as having suicidaltendencies, thus needing special supervision. Eight casesrequired forced alimentation due to voluntary abstinence.There has been a larger proportion on the sick listthan in previous years. Forty males and fifty femaleswere discharged recovered, and forty cases were sent outimproved during the year. There were 44 deaths. The

general health of the patients, excepting delicate cases, wasmost satisfactory, and no case of contagious or infectious- disease occurred. Regarding the great overcrowding ofthe asylum Dr. Merrick urges the completion of eventwo blocks in the County Antrim Asylum, which would

provide accommodation for 200 county patients, andif this were supplemented by the erection of the pro-posed buildings at Purdysburn to accommodate 300chronic patients the present overcrowding would not

only be relieved, but improved classification of the

patients could be adopted, their condition made more com-fortable, and better opportunity afforded for improved treat-ment. The gross expenditure of the asylum for the pastyear was £18,307 10s. 10d., and if £7236 ls. 4d., the amountof the Government grant received, and £1043 18s. 2d., theamount received from miscellaneous sources, paying patients,farm and garden, &c , be deducted, it will give£10,027 lls. 4d. as the net amount chargeable to the rates ofthe district, or !’.12 16s. 5d. per head. The net yearly costper head (including every charge of management) was forthe past year £22 ls. 6d. The inspector of lunatics and com-missioner of control (Mr. G. R. O’Farrell), in his memorandumof inspection on Nov. lst, 1895, says he believes that no

public institution in the United Kingdom is at the presenttime more overcrowded than this asylum ; yet he found everydepartment orderly and clean, while its bill of health wasfavourable and its mortality-rate very low. Certainly, asthe inspector says, "With such perilous surroundings, withdormitories so full that there is scarcely space for beds, theresident medical superintendent deserves the greatest creditfor his good and careful management of the institution.Dr. Merrick is ably assisted by the assistant medical officer,who shows much energy and practical zeal in the dischargeof his duties."

The Mitchelstown Union Hospital: Alleged Ill-treatment ofPatients.

About two months ago a trained nurse was appointed to takEcharge of the Mitchelstown Union Hospital. She had beerthere only a few weeks when she sent in her resignation anealleged that some of the patients had been beaten by one o:

the nurses. The guardians held an investigation, and if thestatements made by some of the inmates be true aver;serious state of affairs must have existed for some time. Atold man eighty years of age told the chairman that be ha<been struck, and that on asking the nurse to allow him tremain in bed she dragged the clothes off him and left hin

naked. It was also stated that the same nurse had struckanother old man when in bed with a poker on the knees andafterwards thrown him down stairs. It was also alleged thatshe had knocked down a patient and kicked him. Theresigning nurse stated she had endeavoured to put an endto such conduct, and as she had found things so generallyunpleasant she had finally decided on leaving. Many of theguardians considered they owed a debt of gratitude to thenurse, and a resolution was passed calling on the LocalGovernment Board to hold a sworn investigation with aview to thoroughly sifting the matter.

’Iriennial Visitation at the Queen’s College, Cork.A triennial visitation will be held at the Queen’s College,

Cork, to-morrow. It is expected that the Presidents of theRoyal Colleges of Physicians and Surgeons will be presentand that Mr. Justice O’Brien will preside. A MedicalStudents’ Association has been recently formed at theCollege, and the association has requested the College councilto make certain alterations in connexion with the medicalschool. It is stated that some of the requests have beengranted and others are still under consideration, but withthe impetuosity characteristic of youth the students thinkthat their views should have been adopted by the council atonce, and accordingly they intend applying to the visitors,who form a court of appeal, to issue a direction to thecouncil with regard to any of the requests which have notbeen acceded to. The students have engaged the services ofa solicitor, and in medical circles the proceedings are lookedforward to with interest.

April 21st. _______________

PARIS.(FROM OUR OWN CORRESPONDENT.)

Castration in Egypt.M. LORTET recently exhibited before the Soci&eacute;t&eacute; de Mede-

cine of Lyons the skeleton of a eunuch of Cairo, whichskeleton measured 1 metre 96 centimetres. The thorax

appears very short as compared with the exceptional lengthof the legs. This phenomenon is quite in accordance withwhat is met with in the lower animals. Thus, while thewings of a capon are no more highly developed than thoseof a cock, the long legs impart to the emasculated fowla peculiar appearance. This same lengthening of the hindlimbs in the ox corrects the sloping of the back-line whichis so characteristic of the bull. M. Lortet furnished someinteresting if not very savoury details concerning the opera-tion of castration as currently practised on Egyptian boysfrom seven to ten years old. One method consists of’theamputation of the penis and scrotum close to the pubisby one sweep of a razor. The poor child is then plunged upto the neck in fine dry sand, the compression thus broughtto bear on the wound contributing to arrest the haemorrhage.At the end of four or five days the patient is removed fromhis sand-bed and the wound is dressed with rags soaked inoil. Another method employed is the application around thespermatic cord and the penis of a very fine, strong ligaturetightly tied. The sufferings of the unfortunate victim caneasily be imagined, but haemorrhage is less to be feared thanby the cutting method. The subsequent burying in sand isin this case dispensed with, the only dressing applied beingthe bark of acacia rich in tannin. But whichever of thetwo barbarous proceedings be adopted it is said that two-thirds of the children succumb. The suppression of sucha cruel practice will in time constitute one of the numerousblessings accruing to this ancient race from the British

occupation of the country.The Sero-therapic Treatment of Puerperal Fever.

Readers of THE LANCET will probably remember that onFeb. 23rd, 1895, M. Marmorek communicated to the Soci&eacute;t&eacute;de Biologie his discovery of an antistreptococcic serum,and that on the same occasion M. Roger and M.Charrin made a similar communication, besides report-ing a case of puerperal fever said to have been cured

, by their serum. M. Roger afterwards reported a second. successful case, and later still the cure of a case of

erysipelas of the new-born and of a case of streptococcictonsillitis by injection of his serum. Then M. Marmorek

announced the successful treatment by his serum of 45 adultcases of erysipelas. M. Charpentierl has collected 40 cases

1 Soci&eacute;t&eacute; Obst&eacute;tricale de France, April 10th.

1178

of puerperal septicaemia, treated by serum in the different

maternity departments of Paris hospitals and in privatepractice. The results were 22 recoveries and 17 deaths, or amortality of 42’5 per cent. Deducting 5 cases treatedin extremis and 1 where the result was vitiated there stillremains a death-rate of 35’29 per cent. Bacteriologicalexamination was conducted in 25 instances, the streptococcusbeing discovered in 16 cases (9 recoveries and 7 deaths),and the streptococcus associated with the staphylococcus orthe bacterium coli in the remaining 9 cases (4 deaths and5 recoveries). The dose, of serum injected varied withinwide limits. In no instance was the serum treatment trustedto exclusively, intra-uterine medication being also employed.Urticaria, erythema, pruritus, and divers symptoms of anervous order were frequently noted as the result of the

injections. M. Gaulard of Lille attributes one death in hispractice to the serum. M. Budin is inclined to deny theutility of the method, and M. Charpentier states thatthe high hopes inspired by the discovery have notbeen fulfilled. M. Bar and M. Tissier have treated19 cases with Marmorek’s serum with 10 deaths and 9 re-coveries. Eliminating 3 cases where the treatment wasinstituted in extremis and 3 in which no bacteriologicalexamination was made, there remain 13 well-studied caseswith 6 deaths. In 6 cases treated by serum prepared byM. Roger and M. Charrin, and eliminating 1 case notexamined bacteriologically, 4 out of 5 died. Four cases of

erysipelas in the new-born died in spite of the employmentof the serum. The serum appears to be too weak to neutralisethe toxines in cases of general infection, although in ordinarycases of adult erysipelas it is efficacious. M. Bar thinksthat the injections are commenced too late in puerperalcases. The strange recommendation of M. Marmorekto refrain from all intra-uterine medication has beendiscarded by all practical gyn&aelig;cologists. M. Bar hasnever seen albuminuria occasioned by the serum, butother symptoms more or less grave have been noticed.Once an abscess formed and, strange to say, largenumbers of streptococci were discovered in the pus. Awoman treated at St. Louis Hospital received about 100 c.c.of serum in twenty days. Four days after the last injectionthe temperature diminished gradually, and debility finallyinduced a fatal result. It is evident that once puerperalfever has made any progress we cannot count uponthe serum any more than we can upon other better-knownmethods of treatment. M. Charpentier wound up the dis-cussion by remarking that when intra-uterine treatment wasapplied at the very commencement a good result invariablyfollowed. All this is disappointing, but it only means thatthe serum, if it is to justify the expectations promised by itsdiscoverers, must be made more active and safer to manage.It may, after all, be the remedy of the future.April 21st.

_______________

BERLIN.

(FROM CUB OWN CORRESPONDENT.)

Alleged Fatal Injection oj Diphtheria Antitoxin.A GREAT sensation has been caused by the recent

announcement in the births, marriages, and deaths columnsof the principal Berlin newspapers that a child, one and ahalf years of age, had died " from inoculation of diphtheriaantitoxin " ; the same subject was moreover continued on thefollowing day by an intimation of the burial of the11 poisoned " child. As the father, who had inserted theseparagraphs, was a very well known medical man, ProfessorLangerhans, prosector to the Moabit Ilospital and a

former assistant to Professor Virchow, the public naturallybecame alarmed, and the lay press discussed the matter indetailed articles, of course before any particulars were known.By order of the legal authorities a post-mortem examinationof the body was made by two medical officers attachedto the law courts, but the cause of the death could not be

clearly defined. As already mentioned in your columns,lthe serum was seized by the authorities, but I learn that itwas ascertained to be of normal quality and that it had beenalready used for other patients without any accident. It isnow stated that the injection was made for prophylacticreasons because a servant of Professor Langerhans had beenattacked with alleged diphtheria and admitted to the Moabit

1 THE LANCET, April 18th, p. 1081.

Hospital. The injection was performed by the father himself, and the child died from asphyxia three minutes afterwards.It is, of course, quite impossible to attribute this suddendeath to the serum, as hardly any poison except hydro.-cyanic acid can destroy life so promptly. The complicationshitherto described as resulting from antitoxin have alwayshappened long after the injection, and no permanent ill-effect from it has hitherto been recorded. The abdomen isstated to have been the site of the injection, and veryprobably death was due either to entry of air into a vein orto thrombosis. The whole proceeding was subsequentlyproved to have been quite unnecessary as the servant’s illnesswas found at the hospital to be simple tonsillitis and notdiphtheria. Professor Eulenburg, the editor of the DeutscheMedicinische Wochenschrift, has given his opinion in mostenergetic terms both in his own journal and in a widely readnon-medical weekly paper. The medical profession isunanimous in blaming Professor Langenhans’s course ofaction, which can only be explained on the ground of hismental anguish.

Medical Courts of Bonour in Prussia.In THE LANCET of June lst, 1895 (p. 1404), an account

was given of a Bill brought before the Saxon Parliamentrelating to ethical misdemeanours committed by medicalmen. Prussia, the greatest of the German States, now has aBill very like that of Saxony, but much more stringent.Its principal feature is that every provincial medical boardshall elect four of its members who, together with a

learned judge, will form the "court of honour." Theywill inquire into alleged contraventions of medical ethicsand will also act as mediators in disputes betweenmedical men. A Government lawyer will act as publicprosecutor, whilst the defendant is entitled to be

legally represented. The court of honour is invested withthe same privileges as an ordinary law court; it may, forinstance, compel the attendance of witnesses, but the pro-ceedings are not public, only the members of the medicalboard being entitled to be present. The penalties are eithersimple warning, reprimand, or a fine not exceeding 3000 marks(&pound;150). A court of appeal is, moreover, to be instituted inBerlin, consisting of the director of the medical departmentof the Home Office as president, three other members of thisdepartment appointed by the Crown, and three representa-tives of the medical boards elected by its members. Thesubject of ethical misdemeanours has for long been ananxiously discussed question at medical gatherings, but

nothing was done, as the Government refused to allow thecourts to have jurisdiction over the medical officers of thearmy and civil service. The invidious exemption of thesemedical officers, which is maintained in the new Bill, togetherwith the introduction of the official element in the shape ofthe public prosecutor and the court of appeal, is lookedupon with distrust, and it is the opinion here that medicalmen should be entitled to settle questions of etiquette andethical misdemeanours among themselves without the inter-vention of Government officials. Some of the sections ofthe Hill will possibly be altered by Parliament, but the

principal points, especially the exemption of the medicalofficers of the services, will certainly become law.

Tlte late Dr. Baum.Dr. William Baum, chief surgeon to the General Hospital

in Dantzic, Western Prussia, died in that town on April 13th.As a military surgeon he took part in the wars of 1864.1866, and 1870-71, and on the conclusion of his militaryservice, in which he distinguished himself by his greatability, he was elected surgeon to the Dantzic Hospital. Henot only conducted a very extensive practice, but wrote onmany subjects, including ovariotomy, cancer of the uterus,resection of the nerves, emphysema, &c. He was universallyesteemed by his fellow-citizens and the profession.April 21st.

ROME.

(FROM OUR OWN CORRESPONDENT.)

Kassala and the Rumoured Prevalence of Malario,.ONM must take with a good many grains of salt the

" I intelligence that appears from French sources as to theAnglo-Egyptian, and more especially the Italian, movementsin the Soudan or in Abyssinia. According to the Italie-French in language and aspiration though published here-