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gravel. Finally, the decoction is stated to be a febrifuge, andthe leaves are also employed in the preparation of cata-plasms.

HOPEINE.

The investigations of Dr. Paul appear (PharmaceuticalJoumal) to prove that hopeine is an artificial product, whichhas been manufactured by the admixture of morphine andcocaine. At all events, these two alkaloids were detected inseveral specimens analysed by him. And as the sources ofsuch alkaloids are of widely different botanical origin, theabove conclusion appears probable.

THE FIFTEENTH CONGRESS OF THE GERMANSOCIETY FOR THE ADVANCEMENT OF

SURGERY.

Tms Congress was opened on the 7th inst. at Berlin, in theAula of the University, the attendance of Berlin physiciansand guests being very numerous. Amongst those presentwere noticed Volkmann, Czerny (Heidelberg), Mikuliczfrom Krakow, Schcede from Hamburg, Roser from Marburg,’Gurlt, Eiister, Israel, Bergmann (all four from Berlin),Kœnig from Gottingen, and Thiersch from Leipsic. The

Vice-president, von Volkmann, opened the meeting, ex-

pressing his regret that the President, the highly honouredvon Langenbeck, was prevented by illness from being’present at the Congress. As an acknowledgment of thehigh services of the veteran surgeon on behalf of the

Society, he proposed that they should elect him as honorary,president. The proposal was accepted with acclamation,and the resolution telegraphed to von Langenbeck at

Wiesbaden. Sir James Paget and Sir Joseph Lister inLondon, who at the last Congress were elected honorarymembers, sent communications expressing their sense ofthe honour shown them, and requested that their acknow-ledgments might be communicated to the Society. The

Society has lost several prominent members through death,amongst them being Professor Uhde of Brunswick, Vogt,surgeon at Greifswald, Starke of Berlin, and Burow ofKoenigsberg. All were highly esteemed on account of theirpersonal qualities and extensive knowledge. Five membershave left the Society and seventeen have entered, so thatthe Society now numbers 359 members. Von Volkmannwas elected chairman, von Bergmann vice-chairman, vonGurlt (from Berlin) resident secretary, and von Kusterresident treasurer. Herrn Schœnborn from Koenigsberg,Thiersch, Koenig, Roth from Dresden, and Esmarch of.Kiel complete the committee.The course of addresses was opened by Professor Kraske of

Freiburg with a discussion on the Etiology and Patho-genesis of Acute Osteo-myelitis. Roser, Mikulicz, Fraenzel,and others took part in this discussion.Afterwards Rinne, from Greifswald, spoke on the Drainage

of Abscesses of the Abdomen.The next address was by Professor Rosenbach, from

Gottingen, on the Etiology of Traumatic Tetanus in HumanBeings. Hitherto, the author observed, no satisfactoryexplanation has been forthcoming of this affection. Therelation of the wound to the tetanus could not be direct.Wounds containing foreign bodies, wounds attended withgangrene, and gunshot wounds in the upper and lower thighshow principally an inclination to cause tetanus. The ex-perimentof injecting blood andmatterof tetanised beings intodogs has given negative results, the dog remaining entirelyunaffected ; but results have been obtained with rabbits,.guinea-pigs, and mice. Curiously enough, the inoculation ofthese animals with earth caused tetanus, with symptoms’quite equal to those of traumatic tetanus in man and thehorse, the latter often dying of the disease. From a man who,in consequence of frozen feet, had died of tetanus, the speakerreceived, through repeated inoculation on guinea-pigs andmioe, material for microscopic examination, and discoveredin it those fine bristle-like split fungi which Nicolaierreceived from the cases inoculated with garden earth. Thefungus is a bacillus, and is most likely the cause of tetanusthrough the secretion of a sort of strychnine poison.

After an adjournment for refreshment, an address by Dr.Landerer from Leipsic followed on Transfusion and Infusion.The speaker said that the use of a solution of common salt,

recommended by Kronecker and Sander, had secured a littlebetter result than had attended the employment of blood.Nevertheless this method was also unsatisfactory, becausethe introduced liquid contained scarcely any nutritivematerial, and consequently, after a short revival of thepatient, his death could not be prevented if more than 4½ percent. of the body weight in blood had been lost. He hadtherefore employed a mixture of one part of defibrinatedblood to four parts of the solution of alkaline salt. With thishe had obtained good results, even if more than 6 per cent.of blood had been lost. At the suggestion of ProfessorLudwig, of Leipsic, a solution of alkaline salt mixed with3 per cent. of common cane sugar was then used. Trialson animals showed that this operated well, even with a lossof 6½ per cent. of blood; after a fortnight the loss of bloodparticles was replaced. Various causes were given in

explanation. First, the blood particles keep better in asolution of sugar than in a solution of salt; then, again,sugar draws great quantities of moisture out of the paren-chymatised webs, and procures in this way nutritiouspowers tor the thinned blood; sugar is in itself nutritiousand burns very quickly, therefore quickly brings warmthto the body, increases the pressure of blood, &c.At the meeting on the 8th inst., a discussion resolved on

at last year’s Congress concerning Operations on Stone inthe Bladder was held. In was opened by Koenig from (jot-tingen, and continued by von Bergmann, Trendlenburg, vonVolkmann, Schoede, Furstenheim, Schoenborn, Sonnenburg,Israel, Gussenbauer, Kiister, Lobker, and Petersen.

It was decided to bring forward for discussion at the nextCongress Operations on Obstruction of the Bowels and onPeritonitis and Perforation of the Gut.

UNQUALIFIED ASSISTANTS AND BRANCHDISPENSARIES.

ON Friday, the 16th inst., Mr. George Collier, DeputyCoroner for East Middlesex, held an adjourned inquiry atthe Shoreditch Town Hall relative to the death of HenryHibbard, aged fifty-four, of 45, Bookham-street, Hoxton,who had been in the employ of Messrs. Barron, Harvey,and Co., wholesale druggists, as warehouseman, for a periodof twenty-six years.Mrs. Ellen Hibbard deposed that on Saturday, March 27th,

deceased did not get up, and complained of want of sleep.He sent her to Mr. Money’s surgery for a bottle of composingmixture, he having had one bottle before. She went asdirected, and deceased took the medicine. He got no sleep,and on the Sunday he had another bottle. On the Mondayhe was worse. She then went to the surgery and askedthe doctor to call and visit the patient, -which he did, andtold her to call for the medicine, telling her it would be twodoses, which were to be given in a little stout. She fetchedthe medicine and gave it as directed-one dose when shegot home (about 3.15 in the afternoon), and the other at6 o’clock, as the first did not have the desired effect. Shortlyafter taking the second dose her husband became insensible.She went for the doctor, and Mr. Money himself came. Upto that time. she thought that she had been dealing with aproperly qualified man, but found then that it was theassistant who had been prescribing for her husband. Herhusband died at about 8.15. On Tuesday Mr. Money calledand told her it would be all right; that a mistake had beenmade, as the bottle contained three doses instead of two,and he would have to communicate with the coroner beforegiving the certificate. He took the bottle away with him.The bottle produced (an ordinary six-ounce medicine bottle)was similar. She did not read the label, although she couldread, as she received such plain instructions. She was sureshe was told to give the second dose about two or threehours after the first. The assistant admitted that she hadfollowed his verbal directions.Absalom William Head, 29, East-road, in reply to the

coroner, said he was possessed of no medical qualifications.He had been assistant to Mr. Money for thirteen months, buthe had been connected with the profession twenty-sixyears. He had sole charge of this dispensary. Witnessirst saw the deceased on the 29th ult., when he was delirious.He was quite positive he told Mrs. Hibbard that four hourswere to elapse between the doses. He did not tell her there

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were three doses. He found he had got no two-ouncebottles, so he made three doses, and wrote on the label, " One-third part to be taken every four hours in half a glass ofstout if relief is not procured."Mr. Money gave evidence on the last occasion that the

death was due to narcotic poisoning. He was now recalled.The Coroner: If you had auscultated the case should you

have had any difficulty in arriving at the conclusion thatthe heart was diseased?—Mr. Money: I say emphatically (Iwas present at the post-mortem) that the fatty degenerationof the heart I witnessed was such as could not be deter-mined by the stethoscope.-The Coroner : You concur

generally as to the correctness of the post-mortem ?-TheWitness: Oh, certainly.Mr. Bagster Phillips, divisional surgeon, H Division, 2,

Spital-square, said, in accordance with the request ofthe coroner, he had made a post-mortem examination ofthe deceased. Mr. Money and Mr. Head were present.He made the examination on the 3rd inst. As to thegeneral appearances of the body, he said it was fastdecomposing. It was well nourished. There were no

marks of violence. The coverings of the brain-skin andscalp-were very congested, as was also the substance ofthe skull. The membranes of the brain were loaded withblood and somewhat thickened, and not healthily trans-parent. The substance of the brain was venously congestedand of a fair consistence. The lungs were loaded withblood. The heart was large, flabby, and the degenerationhad taken place somewhat extensively, but was not in a veryadvanced stage as regarded the fibres themselves. The wallswere very thin, especially of the ventricle. The stomachwas very large and almost empty. The whole structure ofit was degenerated, denoting that the deceased was a verydyspeptic subject when alive. The liver did not indicateintemperate habits so much as the stomach. He should givethe opinion, from the condition of the stomach and liver, thatthe man was of intemperate habits, not to say a habitualdrunkard, but a man who indulged in "nips." Spleen,normal; kidneys fairly healthy for a man in such a state ofhealth. Intestines comparatively healthy, but showed theman had not taken much food very recently. His opinionof the cause of death was failure of the breathing power-asphyxia. He should say that death was caused by themedicine acting upon a subject very prone to the action ofsuch medicine in a deleterious way.The Coroner: Supposing you had been called into a case

of this kind, would you have had any difficulty in arrivingat a conclusion that the patient had a weak heart ?-Mr.Phillips: No, 1 think not.-The Coroner: Do you think,under the circumstances, the remedies prescribed wereproper ?—Mr. Phillips replied that this was a very difficultquestion to answer directly. He should prefer to say thathe should have hesitated very much to give such a doseas indicated by the prescription, and there were otherremedies he should have chosen rather than chloral andmorphia, with a knowledge of the state of the heart of thedeceased. He would give it as his opinion that it wasunadvisable to give those remedies in such a state as theman was. Had these not been given, the man would notthen have died.The Coroner summed up the evidence and carefully ex-

plained the law of manslaughter to the jury, and thenobserved : I will leave the case in your hands, merely justcasually remarking, first of all, upon what I must dis-countenance, namely-the prevailing practice (for it prevailsto a large extent in this neighbourhood) of setting up thesedispensaries and putting unqualified assistants in them. Ifthere had been no dispensary of this kind in the neighbour-hood, this man’s death would not have occurred. There isno reason why, if a man’s practice is extending, he shouldnot put up a branch establishment, and attend the poor fora small fee. But I must say these dispensaries are com-menced with a deception on the public. In the first place,the public are attracted by the smallness of the fee they

, have to pay; and, in the second place, they believe they arebeing treated by the qualified practitioner whose nameusually appears upon the door. At the large hospital inthe neighbourhood-the London Hospital-all the house-surgeons are obliged to be qualified. Yet here is a systemby which any man can come forward and engage himself,and practise upon the public just as he likes. Unless some-thing happens, and he brings himself within the criminallaw, he goes on with impunity. Under the circumstances,I think I may call it a most iniquitous system, one that

should be put down, and one I always endeavour to putdown when opportunity offers.The jury retired to consider their verdict, and shortly after-

wards they returned, and the foreman said their verdict was’ Gross negligence against the assistant."-The Coroner:That amounts to a verdict of manslaughter.The assistant was thereupon taken into custody on the

Coroner’s warrant.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN twenty-eight of the largest English towns 6100 birthsand 3535 deaths were registered during the week endingApril 17th. The annual death-rate in these towns, whichhad steadily declined in the preceding four weeks from29-3 to 20-1 per 1000, was last week 20-3. During the thirteenweeks of last quarter the death-rate in these towns

averaged 24-4 per 1000, and corresponded with the meanrate in the first quarters of the ten years 1876-85. Thelowest rates in these towns last week were 14-4 in Wolver-hampton, 14-7 in Sunderland, 15-3 in Birkenhead, and 15’5 inCardiff. The rates in the other towns ranged upwards to25’2 in Plymouth, 25-3 in Portsmouth, 27-1 in Manchester,and 32’3 in Blackburn. The deaths referred to the principalzymotic diseases in the twenty-eight towns, which had been359 and 363 in the preceding two weeks, were 367 last week;they included 140 from whooping-cough, 114 from measles, 43from diarrhoea, 26 from diphtheria, 23 from "fever" (princi-pally enteric), 21 from scarlet fever, and not one from small-pox. The lowest death-rates from these zymotic diseases wererecorded last week in Hull and Leicester, and the highest inBirmingham, Blackburn, and Portsmouth. The greatestmortality from whooping-cough occurred in Plymouth andSalford; and from measles in Oldham, Bolton, Blackburn,Birmingham, and Portsmouth. The 26 deaths from diph-theria in the twenty-eight towns included 17 in Londonand 2 in Liverpool. Small-pox caused but one death amongthe residents of London and its outer ring, and not one inany of the twenty-seven large provincial towns. The numberof small-pox patients in the metropolitan asylum hos-pitals situated in and around London, which had been8, 11, and 13 on the preceding three Saturdays, had furtherincreased to 16 at the end of last week; 6 new cases wereadmitted to these hospitals during the week, against 4and 3 in the previous two weeks. The Highgate Small-pox Hospital contained 3 patients on Saturday last, one casehaving been admitted during the week. The deaths re-ferred to diseases of the respiratory organs in London,which had declined in the preceding four weeks from 917 to348, were last week 362, and were 105 below the correctedweekly average. The causes of 76, or 2-2 per cent., of thedeaths in the twenty-eight towns last week were notcertified either by a registered medical practitioner or

by a coroner. All the causes of death were duly certifiedin Sunderland, Bradford, and Wolverhampton. The largestproportions of uncertified deaths were registered in Halifax,Hull, and Newcastle-upon-Tyne.

HEALTH OF SCOTCH TOWNS.

The annual rate of mortality in the eight Scotch towns,which had steadily declined in the preceding four weeksfrom 27-9 to 21-2, further fell to 20-5 in the week endingApril 17th, but exceeded by 0’2 the mean rate duringthe same week in the twenty-eight English towns, Therates in the Scotch towns last week ranged from 14’6 inGreenock and 16’2 in Aberdeen, to 22-8 in Glasgow and 24.5in Perth. The 507 deaths in the eight towns showed afurther decline of 17 from the numbers returned in the pre-ceding four weeks, and included 10 which were referred towhooping-cough, 9 to diarrhoea, 8 to measles, 4 to "fever"(typhus, enteric, or simple), 2 to diphtheria, 1 to small-pox,and not one to scarlet fever; in all, 34 deaths resulted fromthese principal zymotic diseases, against 62, 46, and 39 in thepreceding three weeks. These 34 deaths were equal to anannual rate of 1-4 per 1000, which was 0-7 below the meanrate from the same diseases in the twenty-eight Englishtowns. The fatal cases of whooping-cough, which had been29, 14, and 11 in the previous three weeks, further declinedlast week to 10, of which 8 occurred in Glasgow and 2