1519

dubious utility. A local magistracy would certainly appearto be the best judges in questions as to the rights andrequirements of a community, while the quarter sessions

bench would constitute a court of appeal from their

decisions if required. Everything must, however, dependupon the spirit in which the new Act is administered. It

is much to be hoped that in granting licences under

its provisions regard will be had to the importance of

encouraging temperance among the people.

PUBLIC AMBULANCES.

THE use of ambulances in cases of accident and sudden illness has recently been a subject of discussion in the

columns of the ManeAester Guardian and an importantaddition to the correspondence was made on May 23rd by aletter signed by Mr. R. H. Wolstenholme of Salford,chairman of the Manchester Medical Guild, and by thetwo honorary secretaries of the guild. Briefly stated, the

gaild is in favour of a municipal ambulance and first-aid

system available for the public in general without dis-tinction of class and providing not only for patients whowould probably be treated at one or other of the hos-

pitals but also for those who would prefer to be removeddirectly to their homes. Moreover, the first aid renderedbefore removal by ambulance ought to be far more efficientthan it is at present. Unnecessary haste in removal of

patients is generally to be deprecated. The guild judiciouslyrecommends that the first aid should be as efficient as

the resources of medicine and surgery can possibly make it,that it should therefore be carried out by a properly qualifiedmedical man, and that it should be available at any part ofthe district with the least possible delay. In order to avoidthe expense and complications inseparable from the appoint-ment of special emergency medical officers and the creationof dressing stations the guild suggests that the policeshould be empowered and directed to obtain the attendanceof the nearest available medical practitioner who already hasa surgery fitted up for dealing with emergencies.

ENDOGENOUS PNEUMOCOCCIC INFECTION OFTHE EYE.

MODERN researches have shown that lesions in other partsthan the lungs are frequently produced by pneumococci. In

the eye conjunctivitis and suppurative keratitis may resultfrom infection of external origin. But ocular infection ofinternal origin, the pneumococci being conveyed to the eyeby the circulation, has received little attention. At the

meeting of the Soci6t6 Médicale des H6pitaux de Paris onApril 29th M. P. Le Gendre and M. V. Morax related thefollowing case. A woman, aged 47 years, was admitted tohospital on Jan. 17th in a delirious condition. At the

beginning of the month she took to bed with a feverishillness which her medical attendant attributed to pulmonarycongestion," and on the day before admission she becamedelirious. At the apex of the left lung there were subcrepitantrâles and an expiratory" souffle." " She did not appear to see

clearly but there were no signs of ocular inflammation. Thedelirium continued, the temperature was about 104° F., andauscultation gave rise to a suspicion of infectious endocarditis.On the 19th there were diffuse cloudiness of the right corneaand pus in the anterior chamber. The conjunctiva andepiscleral tissue were moderately injected. In the left eyethe symptoms were less severe ; there were slight iritis andfibrinous exudation in the field of the pupil. On the

following days the condition of the left eye did not altermuch but the pus in the right anterior chamber increasedconsiderably. On the 22nd the right eye was enucleated.Death occurred on the 25th. The necropsy showed in thewhole extent of the left lung extremely thick pleural

adhesions. Apart from slight congestion and oedema noother macroscopic pulmonary lesion was found. There were

vegetative endocarditis of the mitral valve and infarcts in thekidneys and the spleen. Examination of the right eye afterenucleation showed purulent exudation in the retina, theciliary body, and the anterior chamber. Microscopic examina-tion and cultures revealed the pneumococcus in pure culturein the exudation. In the aqueous humour the pneumococciwere as numerous as in a culture. The vegetations on themitral valve were infiltrated with pneumococci. The heart’sblood yielded the pneumococcus in pure culture. Evidentlypulmonary infection preceded the pneumococcic endocarditisand pneumococcic septicaemia to which the patientsuccumbed. The clinical characteristics of the iritis enabledthe pneumococcic nature of the infection to be diagnosedbefore a bacteriological examination was made. In anothercase of pneumococcic iritis of uterine origin with cerebralabscess observed by one of the writers the iritis ended in theproduction of a similar fibrinous exudation in the pupil. In

the pus of the cerebral abscess the pneumococcus was foundin pure culture. Some writers have published cases of

suppurative choroiditis in pneumonia. In 1853 Arlt describedthe case of a child suffering from lobular pneumonia whohad metastatic meningeal abscesses and suppurative choroid-itis. In 1874 Piéchaud observed suppurative choroiditiswith spontaneous perforation of the sclerotic in a woman

who died from pneumonia with empyema. Natanson andEversbusch have reported cases of pneumonia during in-fluenza with irido-choroiditis, unilateral or bilateral. Whenthe part played by the pneumococcus in pneumonia wasdiscovered it became possible to establish more preciselythe connexion between the ocular affection and the pneu-monia. In 1892 Herrnheiser first demonstrated the presenceof the pneumococcus in the ocular pus. The patient was aman, aged 67 years, who was admitted to hospital on

March 25th for pulmonary trouble. On April 2nd therewas suppurative infiltration of both corneas with bypopyon.On the 10th there was left panophthalmitis with perforationof the cornea. In the right eye there were slight infiltra-tion of the cornea, iritis, hypopyon, and yellowish exudationon the posterior surface of the crystalline lens. Death took

place four days later. The necropsy showed fibrinous

pneumonia of the left lung, suppurative meningitis, andacute aortic endocarditis. Pneumococci were found in allthe ocular and other lesions.

THE UNIVERSITY OF WALES AND MEDICAL

DEGREES.

A WELL-INFORMED article in the Cardiff News of May 23rdsets out in much detail a variety of arguments in support ofthe view that the University of Wales should be authorised toconfer degrees in medicine. Of course the chief centre ofinterest in such circumstances would be the Cardiff Medical

School which would naturally bear to the University ofWales the same relation as the Newcastle-on-Tyne MedicalSchool at present has to the University of Durham. The

Cardiff school may be said to date from 1893, when chairs inanatomy and physiology and a lectureship in materia medicaand pharmacy were established, thereby making it

possible for students of medicine to learn the subjectsincluded in the first three years of medical study as

required by all universities and colleges in Great Britain.

Attendance on this portion of the curriculum at Cardiff isrecognised and accepted by all universities and colleges.During last year there were in the Cardiff school 55students of medicine and 20 special students in the publichealth department, making a total of 75. In 1903 there were15 medical students registered at the school, the correspond-ing numbers.being 18 for University College, London, and alsofor the University of Birmingham. As mentioned in our issue

1520

of May 21st, p. 1465, the subject of a supplemental charterconferring various additional powers is already being con-sidered by the University of Wales and the chances of theUniversity obtaining what it seeks seem good.

MODERN PERAMBULATORS.

A CORRESPONDENT who has returned to this country after i

an absence of 20 years is much exercised to find that a new fad has arisen " which may have a most serious effect on the

rising generation. I refer to the baby carriages now ingeneral use in which the unhappy child is propelled ithrough the world backwards." We do not think that our correspondent need distress himself. The modern

perambulator is far superior to the old-fashioned arrange-ment in which the unhappy child was placed on a narrowseat and fastened in with a strap. A weakly child in such circumstances when he fell asleep always fell forwardsand sideways and was mainly supported by the strapwhich pressed on the abdomen while the child’s head lolled over the side. The modern perambulator in whichthe child can lie is far better and it is of no great moment whether the child faces in the direction in which he is <

travelling or no ; in fact, if he faces towards his nurse he can talk to her when he pleases, which, given an intelligent nurse, is a very good thing. There is, however, a form of perambulator, or push-buggy, to give it its name in the

country of its origin, which is most pernicious. It is a (

little mail-cart which runs near the ground and can be folded up at will. The child in one of these is far too near -the ground, the seat is too small, and there is next to nosupport for the feet. It is more than probable that theindiscriminate use of such conveyances may seriously injurea child’s nervous system but the reclining form of perambu-lator is harmless-even though the child does face the oppositeway to which it is going. - l

,

THE SUNSHINE OF ENGLAND AND SWITZER-LAND COMPARED. t

Dr. J. W. Cook, the medical officer of health of the

’Clacton urban district council, sends us a most interest- s

ing table in reference to our remarks upon the relative 1

amounts of sunshine in England and Switzerland which appeared in THE LANCET of May 14th. It will be seen by E

this table that Clacton-on-Sea, even in the dismal years of f

1902 and 1903, had a decided advantage over nearly every other place mentioned in the matter of sunshine.

Comparative Sunshine recorded in the Month of April at the 1

Undermentioned Places in England as per the Meteoro- logical Office Weather -Report for the Three Years 1902, 1903, and 1904.

Dr. Cook says: ’’ Doubtless when Englishmen know thatsuch a large amount of sunshine can be had so near home,rather than going so far for it they will be inclined to keeptheir money in England instead of spending it in Switzer-,land." We rather doubt this, for to get the most advantage

out of a holiday there is nothing like going abroad. A

holiday depends not so much upon sunshine as upon a

complete change of scene, change of surroundings, of food,and even of language. Moreover, a holiday spent abroadas a rule costs much less than in this country. A month

spent in Brittany or Normandy can easily be done for 10francs per diem and the Briton who sighs for the food of hisnative land will now find that French coffee is quite as badas English, only about one-third of the price. But it is still

comforting to know that our much abused climate can

produce as much sunshine as that of countries lying furthersouth.

____

THE DISTRIBUTION OF PLAGUE.

THE medical officer of health of the Cape Colony statesthat for the week ending April 30th only 1 case of plaguewas reported throughout the colony-namely, a Chinesemale at Port Elizabeth. Plague-infected rodents were alsofound in the town. In the Cape Town and Harbour Boardarea 629 rodents were examined but none was affected with

plague. As regards the Transvaal, Lord Milner, telegraphingon May 21st, states that the plague return for the week

ending May 21st was as follows : total number of fresh casesreported since May 14, 7-namely, whites, 2; colouredpersons, 5. Of the cases reported 3 have been found to benot plague-making the present total of suspected and provedcases 140, of which 24 occurred in whites and 116 in colouredpersons. The number of deaths since May 14th is 2, bothwhites.

___

MEDICAL SCIENCE PAPERS AT THE BONNMEETING OF THE GERMAN BUNSEN

GESELLSCHAFT.

THE German Society for the Study of Physical Chemistry,known as the Deutsche Bunsen Gesellschaft, has been

holding its eleventh annual gathering in Bonn and on

May 14th a whole session of its time was devoted to

the reading and discussion of papers of medical interest.

Di. Schroeder of Bonn dealt with the importance of cryo-scopy (or freezing-point determination) in its relation to

health and stated that by such observations upon theblood and the urine valuable light could be thrown upon theactivity of the heart and the state of the circulation. Pro-fessor Dreser of Elberfeld followed with a paper upon thesame subject, while Professor Arrhenius of Stockholm dealtwith the Chemical Mass Action of Toxins and Antitoxins.He has carried out a long series of laboratory investi-

gations on this subject and has arrived at conclusionswhich are opposed to the generally accepted theories of theaction of these bodies upon each other. Professor Arrheniusis convinced that toxins and antitoxins obey the ordinarylaws of chemical action and that they react with one anotherin the animal organism as weak acids react with weakbases in chemical mixtures. Dr. Ehrlich of Frankfort ledthe opposition to the views of Professor Arrhenius andstated that his own experience of the action of poisonsgained in the Institute of Experimental Therapy in

Frankfort, of which he is the head, had convinced himthat the ordinary laws of chemical action would not

explain the interaction of toxins and antitoxins. In the

case of diphtheria his view of the action of the antitoxinwas that it reacted with the toxin produced by the bacteriacharacteristic of the illness, but that such reaction was farmore complex and difficult to follow than was foreshadowedby the theory of Professor Arrhenius. A number ofauthorities and writers on this subject joined in the dis-cussion and striking differences of opinion were manifested.The fourth paper of medical interest was by Professor Nernstof Gottingen and related to the action of the electric currentupon the nervous system. Experiments with high-frequency