1686

and that such certificate should be paid for, not by theclaimant, but by the Home Office. The whole matter is oneof considerable difficulty, and we shall recur to it.

SANITARY PRECAUTIONS IN POPLAR.

MR. F. W. ALEXANDER, the energetic medical officer of’health of Poplar, has issued a notice to the medical practi-tioners of Poplar and its immediate neighbourhood pointingout that it is most desirable that special attention should bepaid to all persons arriving from Portuguese ports who maybe brought under their attention in any stages of illness, butespecially in early stages. Directions accompany thiscircular for obtaining and sending material for bacterio-

logical examination and a reminder is added that cases ofplague will be received into the Metropolitan Asylums Boardhospitals upon the forwarding of a certificate, as are otherinfectious diseases. Plague will be made a notifiable disease’from the commencement of the year 1900. Mr. Alexanderhas also caused to be distributed among lodging-housekeepers postcards to be filled up and sent to him givingnotice of any lodger from suspicious ships. We are glad tosee that the Poplar Board of Works have, upon the re-

commendation of the medical officer of health, passed thefollowing resolution :-

"That the various sanitary authorities in London be askedto point out to importers and wholesale dealers in condensedmilk in their districts the desirability of having bad con-densed milk destroyed or removed by the local authority astrade refuse to prevent the possibility of its being sold forthe purposes of human food."

’If the importers and wholesale dealers honestly carried outthese recommendations-and we think that in most cases, if.not all, that they would-the business of scoundrels like

Daley and others upon whose conduct we have commentedwould rightfully suffer.

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THE ROYAL BERKSHIRE HOSPITAL.

THIS eminently useful institution having reached the-sixtieth year of its age has unfortunately fallen upon eviltimes as regards its finances. The annual expendi-ture exceeded the income by some 1500 and henceit was felt that a special effort must be made.The Chairman, Lord Wantage, had the pleasure of Iraising .66000 by a personal appeal which he made to

Berkshire and the surrounding counties, but more

remained to be done, so a festival banquet was organised byMajor Thoyts, the senior vice-president of the hospital. The

=banquet took place upon Dec. 5th under the presidency ofH.R.H. Prince Criristian. About 150 persons sat down. The

President, in proposing the toast of " The Queen," announcedthat Her Majesty had given .f:25 as a special donation tothe funds of the hospital. Sir A. D. Hayter, in proposing’’ The Navy, Army, and Reserve Forces," made a feelingreference to the presence of the son of the President at the

front, and then Mayor Thoyts referred to the financial

position of the hospital. They required, he said, an

additional .S1500 a year to put them on a sound financialbasis. Mr. E. H. Simmons then announced that Lord

Wantage’s appeal had raised .f:6000 in donations and .f:270in increased annual subscriptions, while the proceedsof the dinner amounted to S6144 18s. 6d. in donations andnew or increased subscriptions to the amount of 450 6s.,being a grand total of about .612,865. This, we think, is a

very generous response and the stewards and Lord Wantageare to be greatly congratulated. A county hospital is an

institution which if well conducted is of inestimable

value, and the Royal Berkshire Hospital does excel-lent work. In this connexion we may mention thatwe have just received the report for 1898-1899 of the

Reading Pathological Society, which dates from 1841. The

resident medical officers of the hospital for the time beingare ex. offic’io members of the society. Meetings are held everymonth with the exception of August, and at the annual

meeting an oration is delivered by some leader of the pro-fession. This year the orator was Dr. J. F. Goodhart whochose for his subject Uric Acid.

TABES DORSALIS.

C. L. DANA 1 considers that tabes dorsalis is a primaryatrophy or disease of the neuron, and not the resultof a spinal meningitis. As a fact meningitis is not

always present, and even when present it cannot bemade to explain such phenomena as the Argyll-Robertsonpupil. He maintains that acquired syphilis is the chiefmorbid factor in the production of tabes, and that

among the accessory causes are neuropathic heredity andoverstrain of the spinal cord by indulgence in excessivemuscular exercise, &c. After referring to the usual

symptoms of the pupil, knee-jerk, &c., he discusses the lessusual methods of onset, which occur in 10 per cent. of cases,and among these he mentions such phenomena as rectal,neuralgic, laryngeal, and gastric crises, optic atrophy andarthropathies, and manifestations of secondary syphilis whichgradually merge into tabes. Among early symptoms of import-ance are areas of anaesthesia and analgesia, the latter beingamong the earliest. Such areas of anaesthesia are found oncareful examination, and their position and distribution havealready been minutely studied and recorded by Muskens.The symptom of Biernacki, or cubital analgesia,2 a pheno-menon which is of frequent occurrence in general paralysisof the insane, is also met with in tabes dorsalis. There is alsoa lack of sensitiveness to pressure on the popliteal nerves.The abdominal reflexes are present when the knee-jerk isabsent, and the existence of ataxia revealed by extremetests-e.g., standing on the toes-is another early featureof note. For treatment Dana recommends mercury andiodide of potassium in cases with a syphilitic history, alternat-ing with tonics in the form of iron and phospates and strych-nine. A more strictly tonic treatment is recommended in

non-syphilitic cases. Dana has also obtained good results bythe use of Fraenkel’s method of treatment. He thinks thattabes dorsalis is distinctly amenable to treatment and that

, it is sometimes arrested and very often relieved.

OUTBREAKS OF FIRE IN COLD WEATHER.

A VERT remarkable succession of destructive fires

occurred in the metropolis at the latter end of last weekand in the early days of this week. Close on midnighton Friday, Dec. 8th, the printing and other machinery ofTHE LANCET, which had not yet completed the week’sissue, was involved and considerable damage was done,a large portion of the issue being destroyed. This

fire, near the Strand, was of serious magnitude andwas followed on Saturday by an enormous conflagrationnear King’s-cross in which several large timber-yardswere destroyed. Further fires hardly less in magnitudeoccurred on the following Sunday and Monday andat one time the whole force of the Metropolitan Fire

Brigade was in action. It surely is remarkable thatthese fires should have occurred within a few hours ofeach other, the first having started at a time exactlycoincident with the onset of a " snap " of very cold weatherwhen dry, keen easterly winds and frost commenced.At the time of going to press we learn that over

80 alarms occurred in London in four days. Webelieve that this is not the first time that this curiousrelation of cold weather to the outbreak of an epidemic

1 Medical Record, Nov. 1st, 1899.2 THE LANCET, March 18th, 1899, p. 783.