1565

riddled with bullets though he himself was unhurt. Our

heartiest congratulations to Surgeon Maillard. By a

curious coincidence we have to offer the same sort of

congratulations to a French naval surgeon this week.

In virtue of a decree dated Oct. lst, 1898, the Cross

of the Legion of Honour has been conferred upon Dr.

Bartet, a young naval surgeon employed on activeservice in Upper Dahomey. The act of gallantry whichit is designed to recognise is thus briefly described

in the official record : " During the affairs of the 4thand 8th Nov., 1897, while serving with the Borgou columnthis officer, despising death, completed his difficult dutybeside the wounded under a perfect rain of arrows."

GLYCERINATED LYMPH.

THE following minute has been issued by Mr. HenryChaplin, President of the Local Government Board :-

Local Government Board, Nov. 16th, 1898.I desire to place on record an expression of the value

which I attach to the labours and researches of Dr. SydneyMonckton Copeman in connexion with the preparation, bythe aid of an aqueous solution of glycerine, of a vaccinelymph which is free from harmful organisms. An indicationof the value which is attached to Dr. Copeman’s researchesis to be found in the fact that Parliament has decided byStatute that this form of lymph shall for the future be usedin this country. HENRY CHAPLIN.

We are glad to be able to offer our congratulations aswell to Dr. Copeman with regard to his arduous researchesinto the question of glycinerated lymph, though of coursethe idea of using glycerine as a vehicle did not originatewith him. But we think it is fair to say that he

has raised what was formerly a mere hypothesis in this

country into the region of ascertained fact. By theuse of properly prepared and standardised glycerinatedlymph the last shred of objection which any objector otherthan a pig-headed fanatic can possibly put forward to

vaccination has been done away with, and we can only hopethat the "tremendous experiment " upon which the Govern-ment has entered may not be attended with disaster. If an

epidemic of small-pox should come it will fall hardest uponinnocent children who will owe disfigurement and possiblydeath to the mistaken action of those whose first duty itshould have been to guard them against such misfortunes.

MARGATE HOSPITAL.

WE are glad to learn that the Margate Sea-bathing Hos-pital is again open, having been closed by the remodelledcommittee of management to allow of a complete reconstruc-tion of the drainage together with some minor but not un-important building operations, one of the objects of whichhas been a much-needed improvement in the accommodationfor nurses and servants. The opportunity has been takenadvantage of to appropriate two small wards to thetreatment of diseases not "scrofulous" in character but

especially requiring sea air or sea-bathing. For many yearsthe hospital or, as it used to be called, "the infirmary" wasrestricted to " scrofula," but this limitation was no part ofthe original design of the founders, who imposed no furtherlimits to their charity than poverty and the probability ofthe patients deriving benefit from the special influences ofthe place. The establishment of these wards is therefore areversion to the original design and will, it is hoped, bethe means of relieving cases in more rapid successionthan was done when only "scrofula" was received and

that often in very chronic forms. Among other recentimprovements is a new operating theatre which provides Iall the refinements of antiseptic surgery. The hospital is

now being refilled as fast as arrangements can be made,but scarcely rapidly enough to keep pace with the public

demand. The wards are pleasing and sanitary, especiallythose built by the late Sir Erasmus Wilson, and the chapelis no less attractive, while the situation, as close to the

North Sea as it is possible for a building to be placed,ensures that no salubrious influence which sea and shore can

supply will be wanting to the subjects of serious diseasewho go there for the ministry of nature as well as ofart. We are informed that a very considerable proportionof the large sum which has been expended as indicated hasbeen given by a member of the court of directors whois by virtue of his position well acquainted both with thenecessities of the charity and with its utility.

I INVESTIGATIONS AT ROME INTO THE ETIOLOGYI OF MALARIA.

THE Italian observers, Grassi, Bastianelli, and Bignami,who are associated in carrying out a series of investigationsat the Hospital of Santo Spirito, Rome, with the object ofthrowing light upon the etiology of malarial fever, haveagain met with success in their inoculation experiments withmosquitoes. The cont,inuation of Dr. Bignami’s originalpaper dealing with this line of research will be foundat p. 1541 of our present issue. On this occasion onlyone species of these insects was employed in the ex-

periment-namely, Anopheles claviger, captured, as before,in the adult stage in the malarious region about

Maccarese. The subject of the experiment was a

young man who had never suffered from malarial feverand who was received into the Hospital of Santo Spiritofor hysteria about four years ago, during which time hehas been constantly under observation and has had no kindof fever whatever. This man for nineteen days slept in aroom in which were set at liberty from time to time

numerous specimens of Anopheles claviger. On Dec. 2nd

(the eighteenth day) he began to feel unwell and on the 3rdthe blood on examination was found to contain the parasitesof malarial fever exclusively of the common tertian type(the spring tertian of Italian writers). This form of fever

is prevalent at Maccarese. Considerable difficulty is expe-rienced in continuing these experiments on account of manyof the mosquitoes dying and others refusing to feed. This is

probably due to the lateness of the season.

PAUPER ATTENDANTS IN WORKHOUSEINFIRMARIES.

AT an inquest held on Nov. 28th by the coroner forBelfast in the union workhouse the circumstances of thedeath of Henry Savage, a weaver, aged thirty-six years, wereinquired into. The coroner said that he had received in-formation that the death of the deceased had beenaccelerated by improper treatment while he was in theworkhouse. The wife of the deceased said that her husbandsuffered from paralysis and epileptic fits. Dr. MacFaddensaid that he had seen the deceased prior to his admissionand found that lie had several bedsores. He consideredthat the patient should be in an asylum, but on

application being made to the asylum authorities theywould not take him in. John Brennan said that he hadattended deceased as a pauper attendant. He (witness) hadsaid that he believed Savage was starved but he admitted inevidence that he always found plenty of food to give him.Miss Kate Megahy, a Poor-law guardian, said that she hadreceived a letter of complaint signed "John Brennan" con-cerning the deceased. She had visited Savage and found hisbed clean and dry. Dr. Stewart said that he had medical

charge of Savage both by day and night. Savage died fromdegeneration of the brain and should have been in the

asylum. Nurse Wright said that she was in charge of

the ward in which the deceased was. There were 105

patients and she had to look after them all with the

1566

assistance of two probationers and some paupers. The

sheets about the deceased were changed three or fourtimes a day. The jury found that the cause of death was asDr. Stewart had stated and that Savage had received dueand proper care whilst in the workhouse. They also con-sidered that qualified nurses should take the place of pauperattendants. We are glad to be able to think that this patientdid not in any way have his life shortened by want of care,but it is nothing less than a scandal that in any institu-tion for the care of the poor one unfortunate woman shouldhave to look after 105 patients even with the assistance oftwo probationers and pauper attendants in addition. Wehave referred to this question again and again and shallcontinue to do so until the scandal of pauper attendantson the sick poor is done away with. Our English work-houses are not above reproach, nor are those in Scotland;but we cannot call to mind any modern instance of oneunfortunate woman being responsible for the care and

nursing of 105 patients. The Belfast authorities should seethat such an abomination is done away with as soon as

possible. While on the subject of Irish workhouses we

may mention that at the meeting of the Kilrush Board ofGuardians held on Dec. 3rd it was found that the school

master, the clerk, the master of the local workhouse, and allthe heads of the institution had gone off to Cork Assizes.

No responsible person was lef in charge of the inmates whoroamed about as they pleased and one inmate of weak

intellect" ran amuck." Besides this there were other irregu-larities. The guardians described this state of things asscandalous and directed an official to take charge of the

establishment. We may well ask, ycis C1lStodiet custodes?and should be glad to know what course the guardians willtake with their officials. The whole story sounds like a taleby Lever of the days at the beginning of the century,

ROAD-MAKING.

WE have received a letter from a town councillor whichshows how the doctrine of contagium vivum is permeatingthe minds of our local governors. Our correspondent objectsto have any of the old material previously scraped off theroads used for "grout" " when the road is metalled. His

objection is on the ground that this material contains

putrescible organic matter and he asks us whether his" theory " is correct. But road-making is a practicalmatter, and whether or not the material used for makingthe road is foul and offensive can only be answered byan appeal to facts. A heap of road scrapings very soonsweetens and the organic matter is not long in mineralising.Even if the sweepings when used for road-making shouldcontain a small quantity of humus it would be found thatit would dry less quickly than pure mineral matter and wouldhave less tendency to fly about in the form of dust. If our

correspondent’s council are really going to mend their roadswith dung, as he seems to suggest, then they are, of course,wrong. But we hesitate to answer his question categoricallybecause it is of great importance that sanitary authoritiesshould study economy and try as much as possible to utilisethe materials which it is their duty to collect. It is unfor-

tunately not common to find thriftiness in our municipalmanagement and we hesitate to check it without hearingboth sides of the question. It seems to us that road-

making is often carried out in too wholesale a fashionand even country places are not content without a steam-roller. This machine, we must suppose, is capable of

making good roads under certain conditions but those

conditions appear to be rarely met with near London.

The pressure per square inch of a steam-roller is lessthan the pressure of the wheels of a heavily laden

waggon and the result is that the steam-roller-made roadis very liable to

11 pocket." For a few weeks, of course, the

road is smooth enough, but very soon it "gives" for thereason stated and then the cyclist who traverses it goesalong bumping and grunting and perhaps swearing. We

inspected a by-road not long ago which after a neglect ofabout two years had been made up with a steam-roller. Themetal was huge and had been merely chucked " upon thesurface of the road. Then came the steam-roller, jerkingand roaring over it, with the result that it broke two gas-pipes and made a huge depression at one end. This was

filled up and then came, after a lapse of a dayor so, the steam-roller on a second visit. This timeit broke two water-pipes and we only wonder whetherit broke any drain-pipes. Would it not be better to

copy the French and place our by-roads, at least, underthe care of individuals who should work perpetually uponthem-sweeping, watering, and mending. A " stitch in

time " is a good old proverb and it is very doubtful economy

to allow a road to get into a maximum state of disrepair.The man who had charge of a mile or two of by-readflanked by villas would, if he did his work well, be sure ofa Christmas-box, and the work is of a kind which would

keep many an elderly man out of "the house."

DEATH UNDER CHLOROFORM.

A DEATH under chloroform occurred recently in St. Bar-tholomew’s Hospital. The patient, a butcher, aged forty-two years and weighing between 21 st. and 22 st., wasadmitted suffering from an old injury to his thigh. Therewas a large abscess pointing in the upper part of Scarpa’striangle and the thigh was in an erysipelatous condition. Thetemperature was 101’2°F., the heart-sounds were normal, butthe lungs were emphysematous. There was some orthopncea,partly due to the obesity of the patient and partly no doubtto the emphysema. Four hours after admission the anaes-thetic was administered by a house physician. Nitrous oxide

gas followed by ether was given in order to stimulatethe circulation as fatty change in the myocardium wassuspected and the heart’s action was weak. The patient,however, breathed badly and became cyanosed. The induc-tion of anaesthesia being complete the anaesthetic was changedfor chloroform, which was given from lint. To relieve the

diaphragm frcm the pressure of the abdominal viscera theman was turned upon his side and the head lowered. The

breathing became less laboured, being regular and somewhatshallow, but the face remained congested. The patient waskept only lightly under the anaesthetic, slight movementsof the arms and legs being made during the semi-ansesthesia.The operation was completed, a shallow inspiration was thentaken, and subsequently respiration ceased. The tonguewas drawn forwards, a ligature being passed throughit, and ether was injected into the tissues of the cardiacarea. One feeble inspiration was made, but no more.

Artificial respiration was ineffectual in restoring vitality.The pulse stopped and the respiration ceased. The necropsyrevealed advanced fatty degeneration of the heart and otherorgans. Death in this case appears to be due to failure of thediseased heart, possibly owing to shock, as it appears that thepatient was but very slightly under the anaesthetic, and nodoubt it was accelerated by the diseased condition of theman’s lungs, his posture, and the fulness of the venous

system as evidenced by the congested face and labouredbreathing. The case was clearly one of extreme difficultyand even had the operation been performed under a localanaesthetic it is by no means certain that the mentalshock might not have brought about the very resultthat occurred during the administration of the anms-

thetic. The carefully prepared notes (for which we areindebted to Mr. Jameson) do not mention to which sidethe man was turned. Whether the diaphragm is helpedby the lateral decubitus in such cases is, we believe,