286 LIVERPOOL.-SCOTLAND.

" 3. That apart from first aid, and urgent cases, regulationsshould be framed by the hospitals to exclude trivial casesand cases where the patients are in a position to pay for suchtreatment as they may require.

"4. That facilities should be given for cases so excludedbeing dealt with by dispensaries or provident associations.

"5. That any person recommended by an approvedprovident association, or by a qualified medical practitionershould, as a rule, be admitted to the out-patient departmentsof the hospitals without further formality."Though these recommendations may be open to criticism,

and might be enlarged, they constitute for all practicalpurposes a good working basis. A programme may be moreor less good ; that is a matter of secondary importance; thewhole question rests on the activity shown in realising theprogramme. An imperfect programme applied is better thana perfect scheme which is merely set down on paper. Thereal point is not what the Committee and the medicalprofession said, but what they did. In this respect it isdifficult, while keeping within the bounds of courtesy, todescribe and qualify what followed the publication of theReport of the Hospital Reform Inquiry Committee. Neverwas a reform movement on this subject launched underbetter and more influential auspices, and yet never did amovement so utterly collapse. The report when publishedwas universally approved and with equal unanimity univer-sally neglected.

This extraordinary collapse is explained in variousways. It is urged that the local press never reallytook the matter up. A principal lay manager ofthe General Hospital was opposed to reforms. Asthis is the largest hospital, it is difficult for the otherhospitals to move without the approval of the GeneralHospital, and it cannot be said that the committee of thishospital has shown any .very particular deference to theopinions of its medical staff. The managers of hospitals areto a great extent recruited from among the successfulmerchant class. Outward and visible success is their aim,and so long as the hospital they patronise has the largestnumber of beds and of patients they think the end isattained. Hence a spirit of competition was introduced whichblocked the attempt at reform. Though the medical staff ofthe General Hospital had largely contributed to bring aboutthe inquiry, when that hospital was invited to join in form-ing the proposed general council it failed to send any reply.Month after month passed by, and it was only whenthe agitation had simmered down and lost all its

impetus that the General Hospital at last sent an

answer. The impression seems to be that it was the

delay on the part of this, the most important medical

charity in Birmingham, that killed the movement. It hasbeen urged that the Ethical Section of the British MedicalAssociation should have pursued the matter; but in answerit is stated that they are only a consultative body andcannot take the initiative in any question. If so, it is hightime that some organisation should be constituted which cantake the initiative. An influential committee is appointed,an exhaustive report is issued, the whole of the professionagrees with its conclusions, and yet seven years are allowedto elapse without anything whatever being done. Itsuffices that a few laymen, members of hospital committees,should disapprove or fail to understand the necessity of theproposed reforms, and the whole of the medical professionis scattered like chaff in all directions, loses what littlecohesion it had acquired, and quiescently allows thegrievances it had proved and denounced to go from bad toworse.

(To be continued.)

LIVERPOOL.

(FROM OUR OWN CORRESPONDENT.)

The Netherfield-road Hospital for Infectious Diseases.THE formal opening of the extension of the City Hospital

North, Netherfield-road, took place on the 22nd inst. in thepresence of the Lord Mayor. This hospital up to the year1886 was carried on as a charitable institution for the treat-ment of infectious diseases. By the passing of the LiverpoolImprovement Act, 1886, the corporation had vested in themthe control of the Netherland-road Hospital. Several addi-tions and alterations were subsequently made, comprising

the erection of a new administrative block, laundry,mortuary, and boundary walls ; a complete systemof drainage was also introduced, together with new

roadways, at a total cost of £13,640. By these means pro-vision was made for ninety-six beds. In the year 1895further improvements were made at a cost of £1000. Thepresent extension comprises two new pavilions, having twowards in each pavilion, with ten beds in each ward, making atotal of forty beds ; also an isolation block, containing fourwards with ten beds, additional accommodation being thusprovided for fifty patients; by means of this enlargementthe total accommodation is brought up to 146 beds. The

laundry buildings have also been extended and provided’with new machinery and fittings ; these are to be used’exclusively for cleansing patients’ clothing, the old appliances.being reserved for the use of the staff. A new lodge hasbeen erected containing dis charging- rooms, waiting-rooms,&c. The administrative block has also been enlarged,.giving additional bedrooms for ten nurses and eight servants,the total staff now consisting of one resident medical officer,matron, twenty-five nurses, five porters, and twenty-two.servants, total fifty-four, as against thirty-two prior to theextension. A new approach of easier gradient has also beenmade. The total cost of this scheme, including the cost ofproperty purchased, furnishing, electric lighting, drainage,and laundry machinery, amounted to £26,000, while thearea of the recent extension is 5500 square yards, thusenlarging the area of the hospital to 15,140 square yards.Each patient has 144 feet of floor space, and there are 12lineal feet between each bed. At present there are sixty-fourpatients in the hospital, and it is gratifying to know thatthere is not one case of small-pox in any of the city hospitals.

The New Professorship at University College, Liverpool.The conversion of the lecturership on hygiene at University

College, Liverpool, into a Professorship of Public Health,alluded to in THE LANCET of July 24th, follows on thescheme matured by the College authorities for developingwithin the College a school of sanitary science, a full descrip-tion of which was given in a former number of THE LANCET.Dr. Hope, who has been promoted to the new professorship,was appointed Lecturer on Hygiene in the year 1886, and inthe following year became examiner in Public Health at theVictoria University. By reason of becoming a member ofthe professorial staff Dr. Hope will in future have a seat inthe Senate of the College..Distribution of the Hospital Sunday and Saturday Funds.The joint committee of the Hospital Sunday and Satuiday

Funds have distributed £11,400 among the various Liverpoolcharities, being an increase of £400 on the previous year.There was a falling off in the Hospital Sunday Fund, but,on the other hand, the Hospital Saturday Fund shows anincrease of £500 as compared with last year. The amountreceived by the Hospital Sunday Fund was L6028 and by theHospital Saturday Fund £5726. ’

July 27th. _______________

!

SCOTLAND.’, (FROM OUR OWN CORRESPONDENTS.)

Post- Gradutate Classes in Edinburgla.ARRANGEMENTS have been made at Surgeons’ Hall for a

series of courses in the following subjects, to commence

simultaneously on or about Sept. 27th :-Anatomy (Medicaland Surgical), Bacteriology, Central Nervous System(Anatomy and Pathology of), Dermatology, Diseases of theChest, Children, Ear, Throat, and Nose, Demonstration ofModern Gastric Methods, Electricity in Medicine, Gynæco-logy, Infectious Diseases, Ophthalmology, Ophthalmo-scopy, Pathology, Practical Sanitation, Surgery (Clinical,Practical, and Operative), and Minor Surgery in Children.

The Hospital Difficulty at Aboyne, Aberdeenshire.Sir W. Cunliffe Brooks, Bart., of Glen Tana, Aboyne,

having, as stated in THE LANCET of July 17th, offeredto pay £1000 if the fever hospital at present being erectedabout half a mile east from the village of Aboyne weretransferred to a more isolated site, the Deeside DistrictCommittee have re-considered the question. While agree-ing to take all steps to defend their action in view of an-appeal by ratepayers to the county council, the districtcommittee remitted to a sub-committee powers to meet

287IRELAND.-PARIS.

with the objectors and to make an arrangement with them.’The Marquis of Huntly, from whom the present site wasacquired, suggested a new site about half a mile farther- east, and Dr. Watt, county medical officer, and Mr. G. G.Jenkins, the architect, are to report as to its suitability.

Women Strdents of Medicine at Aberdeen.The graduation list of the University of Aberdeen on this

-occasion shows that one woman student has passed the first,professional, while three others have passed the first portion.of the same examination.July 26th.

______________

!

IRELAND.(FROM OUR OWN CORRESPONDENTS.)

Royal College of Surgeons in Ireland.THE Prince of Wales, on behalf of the Queen, recently

received a deputation from the Royal College of Surgeons in’Ireland, consisting of Mr. William Thomson, President; Mr.R. L. Swan, Vice-President; Sir Charles Cameron, Secretaryof Council; Mr. A. H. Jacob, Mr. F. T. Heuston, and Mr.L, H. Ormsby, Members of the Council.

The Outbreak of Beri-beri at the Richmond Asylum,Dublin.

There have been 124 cases of beri-beri in the RichmondAsylum since the new outbreak-a fact the significance ofwhich needs no comment.

The Royal Academy of Medicine in Ireland.The deputation from the Royal Academy of Medicine in

’Ireland, which was recently received by H.R.H. the Princeof Wales at St. James’s Palace, consisted of Dr. James Little,President; Mr. John B. Story, Secretary; Mr. WilliamThomson, Dr. George F. Duffey, Dr. John W. Moore, andMr. F. T. Heuston.

Medical Superintendent ships of Irish Lunatic Asylums.The Moderator of the Irish Presbyterian Church (Rev.

Professor Leitch, D.Lit.) interviewed Mr. Gerald Balfour(Chief Secretary for Ireland) on July 21st to urge the claimsof Presbyterian medical men to a larger share in the medicalsuperintendentships of lunatic asylums in Ireland. Hepointed out that of twenty-three of these appointmentsseventeen were held by members of the Church of Ireland,while Presbyterians, though almost equal in numbers as acreligious body, only held one. Mr. Balfour replied that hewould give the matter his best attention, and expressed his.surprise at the figures quoted, and said that Presbyterianism-should disqualify no one whilo he was in office.

2he Royal Victoria Hospital, Belfast.At a meeting of the City Council of Belfast, held on

July 22nd (the Lord Mayor presiding), a very large andinfluential deputation from the promoters of the Royal’Victoria Hospital attended to apply for a portion of thegrounds of the present lunatic asylum in Grosvenor-streetas a site for the new hospital. The Sites’ Committeeof the hospital and the medical staff, after most careful- consideration, have come to the conclusion that this isthe best place, and the deputation asked the corpora-tion to grant them ten acres, or to recommend theBoard of Control of Asylums to agree to the introduction.of a Parliamentary measure authorising the transfer of,say, five acres now, or as soon as possible, and an

-additional five acres when the same might become avail-able. The deputation having retired, the Council passed aresolution recommending the Board of Control to agree tothe allocation of six acres as a site, and, if feasible, anadditional four if hereafter required, the Board of Control topromote the necessary measure. The proposed site is anelevated one with two frontages (one opposite the Dunville.Park), and it will in every way be most suitable. Themedical staff of the hospital were unanimous in recom.

mending it.

Professorship of Zoology in the M’ Gill University, Canada.I have pleasure in announcing that Mr. Ernest W. McBride,

M.A., B.Sc. (London University), Fellow of St. John’:College, Cambridge, and Demonstrator of Animal MorphologJin the Biological Laboratory of that university, has beerappointed to the chair of Natural Science in the M’GilUniversity, Montreal, Canada. Mr. McBride, who is thi

son of a highly respected Belfast merchant (Mr. S. McBride),was a distinguished student of Queen’s College, Belfast,-where he held the Senior Scholarship in Natural History insession 1887-88. At Cambridge, in addition to a most brilliantacademic career, Mr. McBride was President of the Univer-sity Union, and he has done some most valuable originalwork contributed to the Royal Society. He is also agraduate of the London University.July 27th.

PARIS.

(FROM OUB OWN CORRESPONDENT.)

Normal Thromboses in the Placenta.AT the Academy of Medicine M. Delore mentioned that he

had frequently met with thromboses under the chorion in theplacentas of women who had shown no signs of illness. Hehad made some bacteriological researches and was able tostate that all placentm contain microbes and thromboses invarying quantities. The microbes in nearly all cases arefound in the thrombi. He cited two illustrative cases, thefirst, that of a woman in good health, a primipara, who bada perfectly natural labour lasting three hours. The placentawas placed in an aseptic box and the chorionic facewas found covered with thrombi, and out of eightcultivations made from these seven gave positive results,micrococci, diplococci, and streptococci being found. The

puerperium was,. however, absolutely free from any com-plications. In the second case the woman was ill during herpregnancy, and had previously suffered from endometritis.Only a few thrombi were found, but many microbes. Thereare then normally found in the placenta microbes both livingand virulent, and the researches of Desaubry and Bordierhave shown that in the dog, after the assimilation of fat,there is found in the lymphatic and venous systems anabundance of microbes. It is probable that the same resultfollows in the pregnant woman after a heavy meal. As itis necessary that these microbes should not enter the foetusthe decolourised thrombi would seem to be a means ofresistance and of protection for the fcetus employed by theorganism against them.

The Antitoxin Treatment of Tetanus.M. Nocard has brought forward a somewhat encouraging

communication on the Treatment of Tetanus by Antitoxin.Experiments alone can solve this question, and those ofM. Nocard were carried out with a toxin prepared at thePasteur Institute in the form of powder and so virulent that6 mgs. are enough to produce a fatal tetanus in the horse.If the immunising powers of the two anti-tetanus serumsprepared by Hoechst and by the Institute are compared it

will be found that they are not quite identical. An

intravenous injection of either has no power to arrest, the progress of tetanus once declared. Fairly satis-

t factory results obtain if the injection is made twenty-; four hours before the appearance of the first tetanic

symptoms, but the dose must be considerable. If

injected forty-eight hours previously to the appearance of the tetanic symptoms the serum is almost always effectual,but the dose must be large and injected straight into theveins. Finally, if the serum be injected within twelve hours

after the toxin has been injected the animal resists to awonderful degree. If these conditions are adhered to the

- serum treatment would seem very effectual.

EL Stealing Inoculated Rabbits.0

Parisians have been greatly alarmed by learning throughthe daily press that a robbery had taken place at the Auber-villiers Hospital, which is specially devoted to contagiousdiseases. A quantity of rabbits inoculated for some researchesof M. Roger have been stolen, and they had been inoculatedwith diphtheria, tetanus, typhus, cholera, &c. As it is

probable that the thieves sold the rabbits to dealers, everyonewho supped off rabbit that evening is consumed with ahorrible fear of having caught some infection. Interviews

;, have been published with Dr. Roux and other authorities,’s and instructions have been given to the octroi officials toy stop the entry of such rabbits, their carcases being easilyn recognisable by having been shaved for the purpose of inocu-11 lation. In case they come in skinned, instructions have been

given for a very prolonged cooking, which, according to