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SCOTTISH NOTES.

(From our own Correspondent.)

A PROPOSAL for the erection of a new asylum for pauperlunatics at Aberdeen is now under consideration by the St.Nicholas Parochial Board. It appears that Elmshill House

has been several times enlarged, that its accommodation isnow overtaxed, and that the Lunacy Board do not considerfurtherextension desirable. In the meantime many of theaber-deen lunatics must be sent to Montrose, Banff, or Elgin, andadditional cost is incurred. It is now decided to adopt thereport by a committee of the board, recommending that aparochial asylum should be built, that accommodationshould be provided for from 250 to 300 patients, and that the costshould be from 12,000 to .615,000. Though it is thus decidedto provide an asylum for the poor of St. Nicholas only, it isthe opinion of many members of the board that a housesufficient for the wants of the district should be built.

Dr. Ogston has now formally received all the support, inhis candidature for the surgery chair at Aberdeen, predictedin the columns of THE LANCET a few weeks ago. Aconsiderable majority of the professors testify in hisfavour, and it is noticeable that the whole of theteachers, who are originally Aberdeen men, favour hisclaims; the staff of the Royal Infirmary are unanimouslyin his favour; a large number of professors and teachersof surgery at home and abroad express their apprecia-tion of his high scientific attainments ; while the pro-fession in the north of Scotland and the present studentsof the Aberdeen school also present memorials. Mr. F. F.M. Moir’s letter of application is published, from whichthe Home Secretary will see that his experience in teachingis considerable, dating back to a period when he was butthirteen years of age. There is not such an array of favour-able testimony on behalf of Mr. Moir as that mentioned infavour of Dr. Ogston ; indeed, so far, a singular reticencehas been shown in publishing any evidence whatever of hisfitness for the responsible position he seeks to fill.What appears to be a rather serious outbreak of scarlet

fever has occurred at Dundee. As typhus, measles, andtyphoid were recently epidemic, and still exist in the town,the fact that the authorities have at length been roused toaction need not be surprising. They have obtained by theirrecent local Act compulsory powers of notification, andalready it is found that this is of little service while theyhave such a meagre amount of hospital accommodation forinfectious diseases. A small-pox hospital was providedsome years ago, and this they propose to utilise ; while it isfurther asserted that the proportion of beds available at theRoyal Infirmary, in the event of an epidemic, is too small.A meeting has been held at which the public authorities andthe infirmary managers discussed the question, and it is notunlikely that a temporary arrangement may be effected,increased ward space being devoted to fever cases.A case of considerable interest has just been settled by the

Sheriff of Midlothian. It appears that the sanitary condi-tion of certain property in the village of Loanhead was sounsatisfactory that the local authority ordered the proprietor,an Edinburgh lawyer, to have the nuisance removed, andthat the defendant denied the title of the pursuers to sue.

His lordship, expressing the opinion that by Section 7 of thePublic Health Act local authorities have power to sue insuch cases, and to appoint committees of their own body totake proceedings, pointed out in detail that the premiseswere in a filthy condition, and that the state of matters wasinjurious to public health and offensive to public decency.The defendant must take steps to remove the nuisance.

PARIS.(From our Special Correspondent,)

A CURSORY mention was made in THE LANCET of

Sept. 23rd of Dr. Felizet’s case of gastrostomy. The patientis now convalescent, and I will now complete the account ofthis case by a description of the operation and the subsequenttieatment. Peter Genisca, for such is the name of this

spoon-swallower, is a young Swiss of nineteen years of age.On the night of Sunday, Sept. 10th, he was amusing the

customers of the café, where he was employed, by introducinga long spoon, such as is used for stirring coffee when servedin glasses, into the oesophagus, pushing it as far down as hecould and then withdrawing it. The performance was

brought to an abrupt ending by the spoon slipping out of hisfingers and disappearing down the alimentary canal. The

following morning he was seen at the hospital by M. Felizet.Palpation revealed the existence of a foreign body, whichprojected in the left hypochondrium. Pressure upon this spotwas painful, and caused a pricking sensation below the liver.The patient complained also of a feeling of constriction inthe epigastrium, of difficulty of breathing, and of a painfulsensation with each movement of the diaphragm. Therewas a constant flow of saliva and mucus from the mouth.Opium and ice were given to allay the pain, but in spite ofthis no sleep could be obtained, and bilious vomiting set in.This symptom, together with the patient’s anxiety andsuffering, decided M. Felizet to operate. In order to lessenthe chance of the escape of any liquids from the stomachinto the peritoneum, and to manipulate the abdominalorgans as little as possible, the following plan was devised :A small india-rubber tube was introduced through one

nostril into the stomach. The outside extremity terminatedin a Y.shaped branch, upon one division of which wasafunnel,whilst the other was in communication by means of a tubewith a recipient containing ether. To begin with, the stomachwas washed out by pouring a solution of bicarbonate of sodainto the funnel, and then depressing the end of the tubebelow the level of that organ, so as to act as a syphon. The

patient was then brought under chloroform and the operationcontinued with antiseptic precautions. An incision wasmade seven centimetres long, parallel to and one and a halfcentimetres below the edge of the false ribs, extending fromthe line of hepatic dulness, three centimetres below andexternal to the xiphoid appendix, to a point on the left sideon a level with the junction of the ninth and tenth costalcartilages. The sheath of the rectus, and some of its fibreswere divided, and the peritoneum exposed. Hæmorrhagehaving been entirely arrested by torsion and ligature,the recipient containing ether was plunged into a

vessel of water at 60° Centigrade, and the stomachat once became distended by the vapour, and the

peritoneum, being divided upon a director, protrudedthrough the wound. Ten sutures in all were then madeto fix the stomach to the abdominal wall, the ether beingallowed to escape, in order to ascertain whether the juxta-position of the surface was complete. One spot appearingdefective the stomach was distended again, and anothersuture inserted. An incision six centimetres in length wasthen made in the axis of the wound. After the vapour hadescaped the stomach was found to be perfectly clean andempty. The spoon was felt, lying transversely across thestomach with one end in the pylorus and the other in thegreater curvature ; it was then extracted without difficulty.After the operation the patient was kept under the influenceof morphia by small hypodermic injections. Tea and rumwere given as a drink, with small pieces of ice. Antisepticdressings were applied. The after effects of the operationwere not serious. There was no fever or tenderness ofthe abdomen. The most distressing symptom was greatthirst, but this was relieved most satisfactorily by enemataof cold water. Notwithstanding the dressings, the liquidsswallowed passed through the wound. On the fourteenthday, a little milk was given, but this oozed through thedressings, and was not renewed. On the fifteenth somemeat was tried, but caused uneasiness. On the first ofOctober, a considerable portion of the wound had healed,and all that remains is a fistulous opening, closed by a pad.The patient eats meat, vegetables, and pastry.

NEW YORK.

(From our Correspondent.)

I ATTENDED the recent meeting of the American Associa-tion for the Advancement of Science, at Montreal, Canada,and offer a few notes of papers read there. ProfessorAlexander Graham Bell explained in detail his methods

employed in constructing an instrument for locating thepresence of metallic substances in the human body. It willbe remembered that such an instrument was twice used upon