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and the terrible wear and tear, the stress and turmoil of

competition, make deep inroads on the public health. It

must be counted to the city’s good that the awful fact of

suffering is voluntarily met by the best surgical and medicalknowledge and by nursing accommodation which men, women,and children may promptly claim. To those who take their

corporate responsibility seriously these are grateful facts.£ 50,000 a year : it is at once a large and a small sum. It is

about the income of the weekly cost of the war and aboutone-fortieth part of the sum compulsorily paid in rates to theSchool Board. But it is not much for London to find, and

yet should London be asked to find it all ? A great propor-tion of the patients at a London hospital come from thecountry; many of them are genuine cases of illness and

some are not. We remember one patient who made

fortnightly trips to a London hospital from Peterboroughfor a pint of cod-liver oil. But a London hospitalis really a national institution and we think that the

appeal might be made to a wider area than that of the

metropolis alone. To intending donors we would pointout that the fund is admirably administered and that a verysmall portion of the money subscribed goes in expenses orsalaries.

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THE PRESERVATION OF DEAD BODIES BY

FORMIC ALDEHYDE.

THE preservation of dead bodies by some method whiclwill not affect the colour or the pliability of the tissues i:

a thing much to be desired in the interests both of teacher:and students of anatomy as well as of forensic medicine.Such a method has, we think, been found in the vapour offormic aldehyde, and an ingenious apparatus for its applica-tion has been devised by Dr. G. de Rechter, a member ofthe Sanitary Board of the city of Brussels, and his brother,1B1. F. de Rechter, who is an engineer. The apparatus,which we have had the pleasure of inspecting at the

Examination Hall on the Thames Embankment, consists

of two compartments, one the disinfecting chamber, andtl.e other which is divided into two for the productionof formic aldehyde vapour in the one and of ammonia

vapour in the other. The use of this last is to neutralise

the formic aldehyde if required. Above each one of the

compartments. which are really containers for evapora-tion over a large surface, is fixed on the outside a

sprinkling-receiver containing liquid corresponding for theone part with formalin and for the other with ammonia.

These sprinkling-receivers are made in imitation of ordi-

nary oiling apparatus with a visible drop such as those

employed in the lubrication of engines. They are air-

tight and are provided with an air-tube plunging into theliquid in such a manner as to work at a constant level,and, by means of a screw, the requisite number of dropsto be given out per hour can be regulated. From thereceiver the sterilising or neutralising liquid falls into a

collector, which distributes the liquid uniformly on a numberof wicks of plaited cotton, hung vertically so as to spreadthe substance over the largest possible surface, and with aview of ensuring complete draining. In order to producethe circulation of the air throughout the whole apparatusand to ensure progressive saturation in the sterilisingchamber a small electric fan should be placed in the passageconveying the vapours. It goes without saying that duringthe period of disinfection the air circulates exclusively in thedisinfecting and formic aldehyde chambers. The ammoniais only used on the withdrawal of the body or other matterwhich is being treated. On Nov. 4th we ’’assisted" inthe French sense at a post-mortem examination on the body of a man which had been in the chamber since Oct. 12th.The body had not been touched in any way before beingplaced in’ the chamber. The limbs and skin were soft and

pliable except on the face, scalp.. and the fingers and toes,where the skin was leathery. The brain was somewhat soft

but had no disagreeable smell. The intestines, however, andthe abdominal muscles showed slight signs of putrefaction,although the smell was slight ; the liver, though soft, wasof a perfectly normal colour. It must be remembered,however, that this body had been treated by one unaccus-tomed to the apparatus and had not been kept at a tem-perature of 12° C. for the first week or so as recommended

by MM. de Rechter. The process will be found, we shouldsay, to be of great value both for anatomical and medico-legal purposes, and with regard to the latter point wemay mention that experiments have been made with thebodies of animals which had been poisoned by morphine"atropinc, strychnine, and arsenic. In no one of these didthe formalin in any way prevent the detection of the

poisons, but we think that it would be of interest to try anexperiment on an animal poisoned with cyanide of potassiumor phosphorus. One other use of the apparatus would be in

keeping condemned meat for a magistrate’s inspection. If

put into the apparatus on seizure the meat would undergono further change. We may add that the agents for theapparatus in Great Britain are Messrs. Thomas Christy andCo., 4, Old Swah-Iane, London, E.C.

THE REMOVAL OF PATIENTS SUFFERING FROM

ENTERIC FEVER.

AT the Kettering Police-court on Oct. 16th Mr. WilliamMackenzie, the medical officer of health of Raunds, was

summoned for a breach of the Public Health Act by aidingand abetting one Frederick Allen unlawfully to expose him-self whilst suffering from enteric fever at Kettering. Theevidence given was rather conflicting in some respects.It appeared that Mr. Mackenzie was called in to see a mannamed Allen-one of his club patients. When Mr.Mackenzie arrived at the house he found Allen up and

dressed, but as his temperature was 100.2° F. and his sym-ptoms suggested enteric fever, and as there had been severalcases in the neighbourhood, he came to the conclusion thatthe patient was suffering from that disease. Mr. Mackenzieasked if there was a hospital for infectious diseases

in the neighbourhood and was assured that the patientwould be admitted ; he consequently said that if the

patient could be taken into the hospital it would

be a good thing." It was in this respect that the

evidence varied, the witnesses for the prosecution statingthat Mr. Mackenzie advised the patient to go, Mr. Mackenziehimself stating that he merely suggested such a course andsaid that if the patient did go it was to be "on his ownresponsibility.’’

-, Allen consequently went in a cab to the

hospital but was refused a.dmission as he did not belongto the district. The prosecution maintained that Mr.

Mackenzie ought to have made further inquiries before

giving his consent to the patient’s removal and that

by using a cab Allen had made himself a source of

public danger. When Allen returned home Mr. Prettysaw him and five days afterwards he was removed to

the hospital. For some reason Mr. Pretty was not called as

a witness. We consider that he should have been, for

whether the removal of a patient in a cab was a source ofpublic danger largely depended upon the stage of the

disease. From Mr. Mackenzie’s evidence the patient wasapparently in the very early days of enteric fever, probablynot later than the third, and as it has been shown that thepathogenic bacilli do not appear in the stools until the ninthday, and as infection by the breath is of the veryrarest occurrence, we cannot consider that there was anydanger of infection to the public by Allen’s removal inthe cab, but Mr. Mackenzie took the further precaution of

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having the cab disinfected and could not therefore, accord-ing to the evidence given, be said to be guilty of the chargefor which he was summoned. After consideration the bench

dismissed the case against Allen, but considered that " DrMackenzie acted very injudiciously in sending the man toKettering without first communicating with the medicalofficer there." But on the evidence they did not feel

justified in convicting. We think this is rather hard on Mr.Mackenzie. He was certainly acquitted of the breach of thePublic Health Act, and the evidence with regard to thereasons why the man went to the hospital for infectiousdiseases was, as we have already said, most conflicting.

THE LAY TREATMENT OF ALCOHOLISM.

A CORRESPONDENT has sent us a little four-page leaflet,dated from "The Lodge, Carnoustie, N.B." We learn fromthis that Mr. and Mrs. William Mathie who have had

large experience in the treatment of alcoholism have openedthe above home, where special attention will be given tothose suffering from such a condition....... The dura-tion of treatment is three weeks, not less, and no

restriction as to stimulants is put upon the patienton entering, for as the medicine takes effect the

desire for stimulants progressively lessens. The medicineacts directly on the nervous system......." An extract

from the Dundee Evening Telegraph of May 27th, 1901, is

given by which we learn that " it is indeed worthy of notethat some medical experts have recommended the sendingof anasmic young women to the matron for treatment similarto that meted out to other visitors." This statement maymean a great deal more than meets the eye, and we do notbelieve that any medical expert would send a simple case ofanæmia to be treated by a secret remedy. We must confessthat we should like to know more about Mr. and Mrs.Mathie and their manager, Mr. Donald F. Cameron.

THE PHYSIOLOGICAL EFFECTS OF COCAINISA-TION OF THE SPINAL CORD.

Professor A. Pitres and Dr. Jean Abadie of Bordeauxhave published in the Archives de Neurologie for October avaluable paper based on an extensive series of experimentsand observations made by them to determine the physio-logical and clinical effects of cocainisation of the spinal cordby the method of lumbar puncture. 50 cases were thus

studied, the cocaine injection used being a 2 per cent. sterilesolution. The following are the chief conclusions reached :1. The analgesia which follows spinal cocainisation is dueto the action of the cocaine not on the spinal cord, but onits posterior roots the conductibility of which is diminished.The analgesic action is, however, somewhat irregular, hencesometimes the anaesthesia begins in the perineo-scrotalregion, sometimes in the thighs or feet-i. e., in detached

patches which gradually extend and coalesce. The same

fact has been observed by M. Tuffier and M. Hallion.2. The analgesia is thus progressive and after the operationthe restoration of sensibility to pain is similarly not uniform.3. Cutaneous sensibility to pain (pinching or pricking) is thefirst to disappear, and later the sensibility to heat or cold.Touch may be erroneously localised at this stage (allo-cheiria). The sense of contact and pressure on the skin isthe last to disappear. 4. The touch of clothing, the hand,or metal on the legs or body may be perceived for a

long time, and ether falling on the skin and evaporatinggives rise to a sensation of warmth, whereas chloroformsimilarly applied to the skin gives rise to no sensation.

5. Tickling of the soles of the feet is long perceivedby the subject but the usual reflex is not provoked.6. Cutaneous sensibility to touch is the first to re-

appear, next the sensibility to pressure, next the thermal

sense, and lastly, the sensibility to tickling and to pain.7. In four patients the electric sensibility of the skin (notedbefore the experiment) was abolished after the injection.8. Deep sensibility of the muscles, bones, and joints is

abolished in proportion to the degree of cutaneous analgesia,and when the latter is complete so is the former. 9. Con-

sciousness of position of the limb is generally preservedduring the analgesia, the only exception in the 50 casesbeing a patient who was tabetic. 10. Deep visceral sensi-bility (testicular and peritoneal) is never totally abolished,though it may be considerably diminished. 11. The

knee-jerks and the tendo Achillis reflexes are alwaysmodified by the lumbar injection. In normal subjectsthey are at first exaggerated and then diminished until thenormal degree of reaction is re-attained. 12. Sphinctertroubles in the form of paralysis of the bladder or rectumare never produced with the moderate doses of cocaine

employed. In a considerable minority of cases erections ofthe penis were noticed to occur. 13. Vaso-constrictionoccurs in the analgesic areas and the skin becomes pale andcomparatively bloodless, scarcely bleeding when pricked.14. The skin of the lower limbs and lower part of the trunkremains cold and dry, while the face, upper limbs, and

upper part of the body sweat freely after the injection. Pro-fessor Pitres and Dr. Abadie further state that after simplelumbar puncture they had never observed epileptoid trem-blings, contractures, or fibrillary tremors of the muscles,and that nausea and vomiting were rare sequelæ, but thatheaadche was common and was probably due to the toxiceffect of the cocaine.

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THE DISTRIBUTION OF PLAGUE.

A TELEGRAM from the Governor of the Cape of Good Hopereceived at the Colonial Office on Oct. 30th states that forthe week ending Oct. 26th the cases of plague in the CapePeninsula numbered 2, both Europeans. The cases at Port

Elizabeth numbered 4-namely, 1 Malay and 3 natives. For

all other places the cases numbered 0. The deaths from

plague were as follows : Cape Peninsula, 1, a European;Port Elizabeth, 1, a European ; all other places, 0. The

area of infection remains unchanged. The cases of plagueamong persons under naval and military control numbered2-namely, a private of the 3rd Lancaster Regiment,Greenpoint Camp, and a private of the 3rd Battalion of theBuffs, Simonstown. As regards the Mauritius a telegramfrom the Governor received at the Colonial Office on Nov. 4thstates that for the week ending Oct. 31st there were 77

cases of plague and 47 deaths.

THE EAST SUSSEX MEDICO-CHIRURGICALSOCIETY.

THIS society celebrated the jubilee of its existence bya dinner held on Oct. 31st at the Eversfield Hotel,St. Leonards-on-Sea. The President (Dr. J. W. Batterham)took the chair and a large number of members and guestswere present. Among the latter were the President of theRoyal College of Surgeons of England (Mr. H. G. Howse),Mr. W. Allingham. Mr. Howard Marsh, Mr. Edmund

Owen, Colonel Brookfield (M. P. for the Rye Division of

Sussex), the Mayor of Hastings, and Canon H. B. Foyster.After the usual loyal and patriotic toasts Mr. Howse gavethe toast of "The Society and its President." He drew

attention to the fact that their society was one of the oldestmedical societies in the kingdom and complimented them uponthe excellence of their rules and regulations, more especiallywith regard to those which dealt with ethical relations. Dr.

Batterham, in reply, said that their society was founded byDr. Greenhill and a few others in 1851. There were at first11 members, now there were 50. Their original library con-sisted of 57 books, now they had one of between 2000 and