the feeding of infants

2
740 rule. The sole consolation which the viperous brood of anarchists have upon an occasion such as the present is that their crime sets the various Governments of the civilised world in a ferment as to how to check the pest. The crimes of anarchy are so futile, so stupid, and withal so easy to carry out, that their terror consists in the impossibility of foreseeing when they will happen. Any complacency that the anarchistic leaders may feel in the trouble that they have created will, we hope, be removed by drastic concerted measures against them. The United States will lead the way with peculiar satisfaction, and the European nations may be trusted to assist. America and England have long been known as the two countries where a man undergoes no disabilities for his political opinions, and we do not think that either country is likely to change in this respect. But anarchy is not a political opinion-its preachers, teachers, and active members are simply and solely pests of society and should be remorselessly harried, even as a pack of rabid wolves would be. The whole of Europe and of the various countries of the two Americas will be searching for a remedy for the state of things that makes anarchy possible. We do not deny that in some cases anarchy is bred of poverty and oppression, or that a portion of the remedy for crime is to be found in improving the social condition of workers of every class. But in the meantime the assassins, whether they are the actual perpetrators or the instigators of murder, must be taught that punish- ment swift and terrible awaits them. It is impossible to legislate for the removal of motive in an apparently motive- less crime, and where an assassin is willing to lay down his life to accomplish a crime it is well-nigh impossible to prevent him carrying his design into execution. Whether an attack be successful or not, death, and that carried out in private after a private trial, should inevitably follow. The insensate vanity of the anarchist’s mind revels in the glorifi- cation of a public execution and the world-wide reports of his trial, and these gratifications should be taken away from him. But the head and front of the evil is the propagandist, the man of culture and education who scatters his glib vapourings about property and the rights of man broadcast by means of. the press. Authors and publishers of incendiary and seditious prints should be punished as severely and in as uninteresting a manner as possible ; for though it be the educated brain which conceives inflammatory articles, and the hand which has never done an honest day’s work which writes them, yet the miserable beings who translate these theories , into acts are the poor who are bred in misery and nurtured in hopelessness. Their own misery, and what they can do or cannot do, assume a disproportionate importance in their eyes, and in the vapourings of anarchist writers they see revelations of a Utopia. The remedy is to shut off the stream of violent ideas at the fountain-head. PAIGNTON (DEVON) COTTAGE HOSPITAL.-The garden fete recently held in aid of the funds of this hospital was a decided success. After the payment of .6112 as expenses there remained a sum of .6241 which has been handed over to the institution. Annotations. THE CONDITION OF PRESIDENT McKINLEY. " Ne quid nimis." WE have received the following cable from Dr. M. D. Mann, who, it will be remembered, was the actual operator in the laparotomy performed upon Mr. McKinley. It is dated Sept. 10th and worded as follows :- " President’s condition eminently satisfactory. Barring unexpected complications convalescence is assured." Everyone in these islands will, we are sure, rejoice at the news which tells us that the United States are delivered from the calamity of losing their elected ruler. The dangers in gunshot wounds of the abdomen may be set down as shock, hoemorrhage, and septic peritonitis. From the two first the President may at this juncture be considered quite safe. The injury which the bullet inflicted was to- perforate both walls of the stomach. As, however, that viscus was practically empty at the time of perforation, and as a laparotomy, together with localisation and repair of the perforations, were performed within a very short time after the infliction of the injury, the danger of peritonitis was reduced to a minimum. Although it cannot be definitely asserted until a later date that this com- plication will not arise, yet it may be confidently expected that it will not. The records of the Spanish-American war, and of our present, struggle in South Africa, show that the danger of perforating gunshot wounds of the abdomen is far less to-day than it was some years ago, and although a revolver makes a larger and more lacerated wound than a small-calibre rifle, yet the prompt manner in which the wound was treated gives every hope for expecting a favour- able result. President McKinley’s life has, under Providence, been saved by the excellent surgery of our American con- fmeres, while the ministrations of Dr. Mann, Dr. Parmenter, Dr. Mynter, and the other well-known medical men associated with the care of the case were enormously assisted by the fact that in the grounds of the exhibition there was a perfectly equipped emergency hospital. This was a hospital for use and not for show, and, as a result, within a few minutes of the atrocious outrage the President was receiving every possible assistance that modern surgery could devise. ____ THE FEEDING OF INFANTS. IT is not surprising that at the present time, a season in which more than in any other infantile enteritis with diarrhoeal is apt to be prevalent, the question of milk-supply and milk dieting in infancy should have come into promin- ence. At the last meeting of the British Medical Association at Cheltenham Dr. George Reid, medical officer of health of Staffordshire, added his contribution to this subject in a paper on infant mortality in relation to the employment of married women in factories, in which he insisted on the necessity of a milk diet for infants to the exclusion of sub- stitute foods. It is to be remembered that even milk itself when artificially reconstructed in a laboratory, desiccated, and then prepared with water as a food has proved to be in- sufficient for nutritive purposes and that its use is liable to, be followed by scurvy and other signs of tissue starvation. Nor do we consider that the addition of a fresh food substance to this imperfect diet can be relied upon to obviate the evils which it entails. Experience has shown that the employment of such substitutes for fresh milk, how- ever chemically correct, can at best only serve a temporary purpose. Natural milk must remain the true diet of infancy

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740

rule. The sole consolation which the viperous brood of

anarchists have upon an occasion such as the present is

that their crime sets the various Governments of the civilised

world in a ferment as to how to check the pest. The crimes

of anarchy are so futile, so stupid, and withal so easy to

carry out, that their terror consists in the impossibility of

foreseeing when they will happen. Any complacency thatthe anarchistic leaders may feel in the trouble that theyhave created will, we hope, be removed by drastic concertedmeasures against them. The United States will lead the

way with peculiar satisfaction, and the European nations

may be trusted to assist.

America and England have long been known as the twocountries where a man undergoes no disabilities for his

political opinions, and we do not think that either country is

likely to change in this respect. But anarchy is not a

political opinion-its preachers, teachers, and active membersare simply and solely pests of society and should be

remorselessly harried, even as a pack of rabid wolves wouldbe. The whole of Europe and of the various countries

of the two Americas will be searching for a remedy forthe state of things that makes anarchy possible. We do

not deny that in some cases anarchy is bred of povertyand oppression, or that a portion of the remedy for crimeis to be found in improving the social condition of

workers of every class. But in the meantime the

assassins, whether they are the actual perpetrators or

the instigators of murder, must be taught that punish-ment swift and terrible awaits them. It is impossible to

legislate for the removal of motive in an apparently motive-less crime, and where an assassin is willing to lay down hislife to accomplish a crime it is well-nigh impossible to

prevent him carrying his design into execution. Whether an

attack be successful or not, death, and that carried out in

private after a private trial, should inevitably follow. The

insensate vanity of the anarchist’s mind revels in the glorifi-cation of a public execution and the world-wide reportsof his trial, and these gratifications should be taken

away from him. But the head and front of the evil is the

propagandist, the man of culture and education who

scatters his glib vapourings about property and the

rights of man broadcast by means of. the press.

Authors and publishers of incendiary and seditious printsshould be punished as severely and in as uninteresting amanner as possible ; for though it be the educated brain

which conceives inflammatory articles, and the hand whichhas never done an honest day’s work which writes them,

yet the miserable beings who translate these theories

, into acts are the poor who are bred in misery and

nurtured in hopelessness. Their own misery, and

what they can do or cannot do, assume a disproportionateimportance in their eyes, and in the vapourings of

anarchist writers they see revelations of a Utopia. The

remedy is to shut off the stream of violent ideas at thefountain-head.

PAIGNTON (DEVON) COTTAGE HOSPITAL.-Thegarden fete recently held in aid of the funds of this hospitalwas a decided success. After the payment of .6112 as

expenses there remained a sum of .6241 which has beenhanded over to the institution.

Annotations.

THE CONDITION OF PRESIDENT McKINLEY.

" Ne quid nimis."

WE have received the following cable from Dr. M. D.

Mann, who, it will be remembered, was the actual operatorin the laparotomy performed upon Mr. McKinley. It is dated

Sept. 10th and worded as follows :-

" President’s condition eminently satisfactory. Barringunexpected complications convalescence is assured."

Everyone in these islands will, we are sure, rejoice at thenews which tells us that the United States are deliveredfrom the calamity of losing their elected ruler. The

dangers in gunshot wounds of the abdomen may be setdown as shock, hoemorrhage, and septic peritonitis. From

the two first the President may at this juncture be consideredquite safe. The injury which the bullet inflicted was to-

perforate both walls of the stomach. As, however, thatviscus was practically empty at the time of perforation,and as a laparotomy, together with localisation and

repair of the perforations, were performed within a veryshort time after the infliction of the injury, the danger ofperitonitis was reduced to a minimum. Although it cannotbe definitely asserted until a later date that this com-

plication will not arise, yet it may be confidently expectedthat it will not. The records of the Spanish-American war,and of our present, struggle in South Africa, show that thedanger of perforating gunshot wounds of the abdomen isfar less to-day than it was some years ago, and although arevolver makes a larger and more lacerated wound than asmall-calibre rifle, yet the prompt manner in which thewound was treated gives every hope for expecting a favour-able result. President McKinley’s life has, under Providence,been saved by the excellent surgery of our American con-fmeres, while the ministrations of Dr. Mann, Dr. Parmenter,Dr. Mynter, and the other well-known medical men

associated with the care of the case were enormouslyassisted by the fact that in the grounds of the exhibitionthere was a perfectly equipped emergency hospital. This

was a hospital for use and not for show, and, as a result,within a few minutes of the atrocious outrage the Presidentwas receiving every possible assistance that modern surgerycould devise.

____

THE FEEDING OF INFANTS.

IT is not surprising that at the present time, a season inwhich more than in any other infantile enteritis withdiarrhoeal is apt to be prevalent, the question of milk-supplyand milk dieting in infancy should have come into promin-ence. At the last meeting of the British Medical Associationat Cheltenham Dr. George Reid, medical officer of health ofStaffordshire, added his contribution to this subject in apaper on infant mortality in relation to the employment ofmarried women in factories, in which he insisted on the

necessity of a milk diet for infants to the exclusion of sub-stitute foods. It is to be remembered that even milk itselfwhen artificially reconstructed in a laboratory, desiccated,and then prepared with water as a food has proved to be in-sufficient for nutritive purposes and that its use is liable to,be followed by scurvy and other signs of tissue starvation.Nor do we consider that the addition of a fresh foodsubstance to this imperfect diet can be relied upon to obviatethe evils which it entails. Experience has shown thatthe employment of such substitutes for fresh milk, how-ever chemically correct, can at best only serve a temporarypurpose. Natural milk must remain the true diet of infancy

741

and there is a limit to the extent to which it may be inter-

fered with. In a leading article in THE LANCET of

August 24th we noted the fact that simple boiling or

heating to the degree required for sterilisation does

not appear to influence the nutritive value of milk. Wereferred to the value of this practice as a safeguard againstbacterial contamination. It is necessary, however, to

remember that this part of the question, and, indeed, thewhole subject’ of nutrition, has a domestic as well as a

physiological side. The infective process which results inenteritis arises in all probability as often from want of careat home as from a faulty milk-supply. Mothers and nurses,it is true. are now much more alive to the need of scrupulouscleanliness in regard to everything that relates to the

feeding of infants than they were even a few years ago.Trouble still arises nevertheless and cases of dysentericdiarrhoea, if less common and less frequently fatal thanformerly, are far from unusual. Its prevention ought not tobe a very difficult matter. But the medical man must

remember that no instruction to mothers and nurses can be

too elementary. The commonest lessons of cleanliness

must be taught, and all the influence of the practitionerwill be required, particularly among factory hands and

the poorest classes, to ensure attention to the teaching.

SELF-HELP.

AT Sandgate recently there was opened a new convalescenthome. The lines upon which this and the parent insti-tution at St. Margaret’s Bay, Dover, are being run are suchas would have rejoiced the heart of the late Dr. SamuelSmiles. Eighteen years ago it occurred to a few workingmen, who were endowed with a more than usual share ofadministrative capacity and desire to benefit their fellows,and who were already connected with the Hospital Satur-day Fund, that a home run by a committee of workingmen; and supported principally by small weekly subscrip-tions collected. amongst themselves, would become popularwith craftsmen generally. The result greatly exceeded theirexpectations. Substantial aid was, however, rendered in theearly days by the late Mr. Samuel Morley, after whom thehome at St. Margaret’s Bay was named "Morley House."A liberal supporter was also found in the late Sir Alfred

Bevan and the building just opened at Sandgate bears thename of the "Bevan Memorial Home." Patronised by HisMajesty the King, with the Earl of Aberdeen as president,and with a voluntary committee of men drawn from varioustrades who are elected annually by their fellow mechanics,the supporters of the institution are assured that any moneysubscribed is expended to the best advantage. The com-

mittee visit the home at intervals of three weeks and inspectevery detail, making a tour of the building throughout. In the

evening an hour or two is spent in the recreation-room withthe inmates. Criticism on the conduct of the home is invited

and any suggestions for its improvement are discussed.A liberal dietary is provided, and the food, though plain, isgood. The inmates are not hampered with a number ofirritating rules, the idea being to permit as much individualfreedom as possible. It speaks well for the working ofthe system that out of 12,000 patients who have passedthrough Morley House " only one case of misconduct anddrunkenness has been brought to the notice of the com-mittee. The new home is for the reception of either male 0]female patients, adult or juvenile, who are considered eligiblEby the committee. A number of medical men act as hono-

rary examining officers, and every patient has also to bE

passed by the medical officer to the Home. For a year omore until the last few months the new Home has beeiused as an auxiliary hospital for wounded soldiers returneefrom South Africa. Some of our readers may be glad t(

know of the existence of this home on behalf of thei

humbler patients, though, indeed, there is no lack of

applicants for admission. The purchase of the buildingand the alterations necessary to fit it for the requirementsof the institution have cost between .616,000 and &17.000,and the charitably disposed could not well bestow their

help upon a more deserving object.

ON PATHOLOGICAL DREAMING.

PROFESSOR A. PICK of Prague contributes an interestingarticle on Pathological Dreaming to the July number of theJ01trnal of Mental Science. Students of psychologicalmedicine have long recognised the similarity which dreamsbear to the delusions of the insane or the waking delirium ofthe opium-eater. Dreams may have a pathological significancein certain neuropathic conditions. For example, the dreamsof chronic alcoholism are continued into waking life,thereby influencing conduct, and in certain forms of

hysteria and erotomania day-dreams of a voluptuous naturemay occur occasionally which are hardly distinguishablefrom reality by the patient. For the peculiar perversionof the mental state attending the latter condition HavelockEllis has lately proposed the name auto-erotism.

" Both

Pierre Janet and Nileke state that some degree of cerebral

exhaustion underlies the tendency to abnormal forms ofreverie and day-dreaming, and the latter refers to quitedefinite conditions, such as the fatigue of balls and

weddings, as among the causative agencies. Professor

Pick records three interesting cases, the clinical and

mental symptoms of which he gives at some length. Case 1was that of a man, aged 43 years, a goldsmith. During the10 years of his married life his wife had noticed that the

patient often during the day and night spoke to himself,sometimes softly and sometimes loudly, and as though heimagined himself to be among his fellow-workmen, at thetown council, or before the deputy mayor. ’’ If spoken tohe ceased at once, but gave no explanation, exceptonce when he said that 2tario2as tltoug7tts carne to him

against his 7vill, 1’vlâch he had to speak out althoughhe knero that it mas all 1tntrlle." " Latterly this eon-

dition had grown worse, following upon certain obscure

"seizures -tremblings of the limbs and noddings ofthe head, attended by loss of consciousness-frequentlywitnessed by his wife. The patient had been since a childof a suspicious nature, readily deluding himself with theidea that people wished to poison him. In the other class of

seizures before described, where he gesticulated and talkedwith himself, he retained a certain confused consciousnessand memory of what was happening, and on being ques-tioned he would state that he was experiencing a sort

of dreaming and dream-acting which sometimes felt so

real that he could not distinguish it from actuality. His

physical state showed nothing special and the nervous

system presented no clearly hysterical stigmata. His con-

dition improved a little under treatment and regular work,so that the night-dreaming disappeared and that by daybecame less frequent. Case 2 was that of a law student, aged23 years, who complained of suffering from ’’ phantasies

"

and an excessive proneness to reveries and dream-picturesof masturbation from his eighth to his eighteenth year.

Latterly he developed the idea that people were unfriendlyand disdainful to him and sometimes experienced suicidalpromptings. On one occasion he fancied that he was presentat a duel, but the sensation was so vivid that he " seemedreally to see the people who were present." Optical impressionsplayed the chief part in the dreamings, but he also heardI- voices. " He had various physical indications of neur-

asthenia and degeneracy. Case 3 was that of a clerk, aged18 years, who had manifested peculiar aberrations of conductin the form of petty embezzling and theft, loose living andfastness, and a tendency to fantastic lying (pseudologia