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PARIS.(FROM OUR OWN CORRESPONDENT.)

Ponudos or Pseudo-leprosy.WHILE on a visit from Guatemala, where he is

stationed, Dr. Roblès has described to the Academyof Medicine a disease frequent enough in Guatemala,but which has never yet been classified. The lesionsare chronic, resembling elephantiasis of the feet,the onset being insidious with successive remissionand advance. The first sign is an erythematouspatch accompanied by transient enlargement of theinguinal glands and high fever, followed by chronicoedema with thickening and pitting of the toe-nailsand dorsal surface of the feet. The lesions onlyaffect the soft parts, the skiagram showing the bonesto remain unaffected. Dr. Robles proposes the nameof pseudo-leprosy for this affection, inasmuch as ithas been frequently confused with true leprosy,although readily distinguished bv the absence oflepra bacilli and of any alteration of sensation.On the other hand, it is distinguished from otherkinds of elephantiasis by the absence from theblood and tissues of any recognisable parasites.

The Medico-legal Aspect of General Paralysis.The favourable results of treatment by arsenical

and bismuth salts, by shock therapy, and especiallyby malarial infection, in cases suspected of meningo-encephalitis or even at an early stage of generalparesis, have materially altered the outlook for thepatient. Figures show that the proportion of casesin which long remission is obtained varies from 30to 40 per cent. Prof. Henri Claude, who has dealtwith 143 cases at the clinic for mental diseases,gives a percentage of 40’5 of complete remission ascompared with 10 to 12 per cent. of partial remissionoccurring spontaneously. This alteration in outlookhas necessitated the revision of the legal measurestaken for the protection of these patients. It is, ofcourse, necessary to take account of the importanceof their responsibilities and of the nature of theirwork, and in any case it is desirable in the patient’sown interest for him to avoid overwork and remainan indefinite time under medical supervision. Prof.Claude counsels reserve even in the cases of mostfavourable aspect, when the question of civil capacityand the possibility of relapse has to be decided.Yet he admits that in a number of patients whowere allowed to return to their occupation, progresshas been continuous and satisfactory. It is thereforepossible that medico-legal decisions in general paralysismay in the future not be couched in the stringentform of the past. The appointment of a provisionaladministrator may avoid the necessity of makingany final decision and allow of watching the evolutionof the disease when submitted to energetic treatment.On the other hand, in view of the unbalanced mentalityof these patients, it would obviously not be judiciousto allow them too rapidly to recover control of theiraffairs. Cases of complete restoration are still theexception, but in view of the increasing numberof recoveries, Prof. Claude is right in insisting oncaution in taking medico-legal decisions as to civilcapacity.

Leprosy in Paris.The Paris Municipal Council is considering measures

for the control of leprosy, its action being urgedbecause there is a tendency on the part of lepersfrom various countries to seek the treatment affordedby the Hopital St. Louis and other Paris hospitals.The new measures contemplate isolation of the casesin a special ward at the Hopital St. Louis, obligatorydeclaration, domiciliary control by therapeutic andbacteriological methods, exclusion of lepers fromoccupations such as hair-dressing, laundries, and thecooking and sale of foods, and the creation ofleprosariums and the elaboration of arrangementswith foreign countries with a view to restriction ofthe immigration of lepers into France.

VIENNA.

(FROM OUR OWN CORRESPONDENT).

Deaths in the Profession.BY the death a few days ago of Prof. Rudolf

Kaufmann, the cardiologist, Vienna loses an investi-gator of great ability. Whilst still a young man hecommanded the attention of Nothnagel and Maunabergby his work on the pathology of the intestinal canal,and when, at the beginning of this century, modernmethods of research on the heart were made known,he threw himself with zeal and ardour into the newstudy ; a long series of papers on the size of the heart,the cardiac muscle and its rhythm, stenocardia,pulmonary oedema, parasystole, allorhythmia, andthe circulation in the coronary vessels show to whatwide understanding he attained. Together with Prof.H. Mayer he experimented on the pharmacologicalside of his subject, and during the late war heorganised a huge " heart hospital," in which theeffects of shock, over-exertion, infectious disease, andneurasthenia on the normal and diseased heart werestudied. Many soldiers regained their cardiac healthin this hospital, and after the war Kaufmannsucceeded in perpetuating its service for the benefit ofthe general public. His death at the age of 56 camequite unexpectedly.The second severe loss to the medical faculty is

caused by the death of Prof. Luithlen, the derma-tologist, in his fifty-eighth year. He, too, had beenclosely associated with the work of Prof. Mayer andhad investigated the pharmacology of the skin,publishing numerous papers, also, on pemphigus,scleroderma, and elephantiasis. At one time he wasassistant to the famous Kaposi.

Lactation.At the last meeting of the Gynaecological Society of

Vienna Prof. Kraul read a paper in which he dealt withthe physiology of lactation. This condition, he said,brings about a regular alteration of the blood picture;there is leucocy-tosis, eosinophilia, and lymphocytosis.The vasomotor centres react in a different way in thelactating woman to adrenalin and caffeine, and thelactating mother is less prone to glycosuria than thenon-lactating. There is also increased tone in thevagus. In 75 per cent. of all lactating women thetypical amenorrhoea of lactation is found. This iscaused not by an absence of ovarian function, but bycystic degeneration and over-rapid maturation of thefollicles ; at the same time there is hypofunction ofthe hypophysis. The vegetative nervous system acts(so to say) as an intermediary between metabolismand ovary on the one hand and the rest of the glandsof internal secretion on the other. Most investigatorsare not of this opinion, believing that the mammaryglands produce their secretion because they are notstopped by the ovary. In abnormally protractedlactation loss of ovarian function is certainly found; butas there are wet-nurses who are regular in theirmonthly periods although they are producing largequantities of milk, Prof. Kraul does not accept thetheory that the ovary controls the breast. It isnoticeable that the appearance and condition of womenoften greatly improves after childbirth, which suggeststhat lactation has a considerable influence upon thegeneral health and disposition.

BUCHAREST.

(FROM OUR OWN CORRESPONDENT.)

Seaside S’arzutoriurrz for Surgical Tuberculosis.THE Ministry of Public Welfare has long been

considering the establishment of a seaside sanatoriumfor the cure of surgical tuberculosis in children. TheGovernment, however, has been unable to set asidethe necessary funds, although convinced that such an