Undoubtedly it is all-important that drains should be in no condition to nourish typhoid germs-they should be well cleansed and well disinfected; there should be no chance of air-borne germs making their way into houses. But all this is secondary; the primary object should be to prevent these germs reaching the places where they can flourish. We most freely admit that this is not easy, and it is not e ndered more easy by constantly calling every malady with elevation of temperature, where no objective signs are to be discovered, typhoid. But, on the other hand, most of us can recall cases where patients suffering under unmistakable typhoid have been going about their business and not feeling very ill until within a few days or hours of their death. These are the cases where we cannot guard against the spread of infection. The only thing we can do is to err on the safe side-to put the patients suspected of having typhoid to bed, and to disinfect all their discharges.

Next, let us try to trace this second epidemic whose history is narrated by Dr. Kelly. As to the accuracy of the narrative we have not the slightest doubt; but there are points of a certain importance which want clearing up. A young man, the son of Y, who lived next door to Z (the dairyman from whose premises the infected milk issued, and whose well was connected with Y's sewage outfall), had been on a visit,absent from Worthing for something more than six weeks. He returned to Worthing on September 16 in good health, but on September 24 this boy fell ill with enteric feverten days after his return home. "The sanitary defects of Y's house were enough to give the boy the fever, and the more so perhaps as for some weeks he had been breathing a purer atmosphere. There is no evidence of any similar cases in the houses at which he had been staying."

The italics are ours, the words are Dr. Kelly's, and they are worthy of all attention, for if we accept the doctrine thus laid down there is no need for excessive rainfall or high tide to explain the former outbreak or any other. Some of the houses in which that made its appearance were described as being damp and dirty, with bad sanitary arrangements. Why should these be inoperative in one case without the additional impetus given by heavy rain and high tide, whilst in another we read that the conditions of the house were enough to give rise to fever. Again Dr. Kelly postulates this, "the more so perhaps as for some weeks he (the patient) had been breathing a purer atmosphere." Surely this is a fresh and new condition of the autogenetic theory of typhoid, that after one has been for weeks subjected to more healthful influences they are to be the more readily attacked by the typhoid poison. If such theories are required to support the "pythogenic" doctrine, had it not better be discarded at once? This doctrine seems to us to require too much of the "confidence" business. And it is not to be forgotten that Dr. Kelly, who thus seems to advocate it, is one of the best men who have turned their attention to sanitation. If, therefore, he requires such assistance to build up a theory as to the autogenetic origin of typhoid, the cause must be in a bad way.

We cannot, however, overlook another portion of Dr. Kelly's report, wherein again he proves rather too much. One of his most alarming conclusions-and his facts seem to bear him out-is that the more milk, when contaminated, you drink, the greater the risk of infection. This is not quite pleasant, as we have formerly said, to milk-drinkers, though it may be quite true. But when he next tells us that if you drink only a small quantity of poisoned milk you may escape typhoid, we are brought face to face with the momentous question, How much bad milk may you drink without getting typhoid? For we can never be sure that we are not drinking bad milk; and apparently, if we drink little, we may escape-let us say, if the cans are only

washed with infected water. But in the very first case which occurred in this epidemic it is said "a lady who had been using Z's milk found that it tasted nasty, and discontinued its use on October 11; her little girl drank much cold milk, and she had the fever on October 16."

Well, if a lady can find milk nasty-and that arising solely from washing out the milk-cans with water thought good by those that habitually used it-we must say that her taste for typhoid germs (which, by the way, do not seem to have troubled her) must have been acute. She wisely apparently discontinued the milk on October 11. On the 14th, Y himself, the father of the first patient, fell ill, presumably from drinking this same water. But if the milk was so nasty as to be discontinued, but not to give fever, on the 11th, and the father of the youth who is supposed to have introduced the epidemic fell ill from drinking the water with which Z's milk-cans were washed on the 14th, the way out of the difficulty is not quite clear. The milk on and before the 11th was nasty; the water was so bad as to give rise to undoubted fever on the 14th-not, be it noted, in a condition to give rise to fever, but actually producing fever, on the 14th. There must be some flaw in the argument.

We have, however, so far exceeded our space that certain of the most interesting details in Dr. Kelly's report cannot be dealt with. That it is valuable in itself we repeat; and not the least value of it lies in the fact that it contains so much sound material for suggestive thought. It is not every man who could have written such an excellent summary of so vast a number of carefully investigated facts.

RICKETS AT THE PATHOLOGICAL SOCIETY. IN continuation of our summaries of the debate on rickets at the Pathological Society, we give here a very brief abstract of the chief points referred to by those who spoke on the third and last evening of the discussion. To bring the debate to a close at the last meeting of the Society the sitting was prolonged to a late hour, so that a full summary of the last evening's debate would occupy more space than is here available. A full report of the proceedings will be found elsewhere.

The President re-opened the adjourned debate with some valuable observations and suggestions. He expressed his regret that the discussion had not elicited more new facts regarding the various problems of rickets. He could not agree for a moment with those who regard the disease as always a result of congenital syphilis. He thought with Sir W. Jenner that the rachitic state is correctly included among the diatheses, rickets being one of the diet-diatheses, or assimilation-diatheses. The speaker also alluded to the possible connexion of rickets with osteo-malacia, intimated his belief that rickets is occasionally congenital, and thought there was nothing improbable in the idea of the hereditary transmission of a constitutional tendency to rickets. Mr. Lucas regarded rickets as distinctly a dietetic disHe made several observations regarding the cranial deformities characteristic of rickets, and he was quite convinced that high intellectual power is very often found in those whose heads show the results of former rickets. Dr. Baxter gave an interesting account of a long series of observations of his own, which had convinced him that rickets is mainly due to the improper feeding of children— the too early exhibition of starchy food being specially recognised as an efficient factor in producing the disease.

ease.

Dr. Barlow and Mr. Shattock read communications showing that fœtuses and infants sometimes present diseased conditions of the bones and cartilages which have been mistaken for rickets, but are totally distinct.. Dr. Longhurst and Mr. Spencer Watson made statements showing how rare

rickets is, both among the children of Europeans and among the natives, in the up-country and mountainous parts of India and other tropical regions. Dr. Goodhart had found, though in a relatively small number of cases, that there was decided enlargement of the spleen in rickety children. He thought, however, that the splenic change was not at all special or peculiar to rickets, being of the nature of chronic congestion. Anæmia was usually a marked feature when the spleen was enlarged. This speaker also alluded to the condition of the blood in rickets, and asked whether the disease was not one which affected the blood before the other characteristic signs and symptoms appeared. No new point of importance was brought forward by Dr. Fagge in his brief reply at the conclusion of the debate.

Next week we hope to review the results of the whole debate.

THE WEEK.

TOPICS OF THE DAY.

In order to deal with the prevailing epidemic of small pox, the managers of the Metropolitan Asylums Board held a special meeting last week, when a return was read showing that the number of small-pox cases in Deptford had increased week by week during the preceding six weeks from 12 to 132, in Homerton from 90 to 110 (after 40 convalescents had been removed to Fulham), at Stockwell from 13 to 87, at Fulham from 3 to 44-being an increase from 115 to 373. The beds still available are 260 in number, but they are most of them remote from the centre of the prevailing epidemic. A report from the Deptford Asylum Committee was considered, which recommended the erection of temporary pavilions to meet the emergency-a course approved by the Local Government Board; but as it was elicited that the cost of permanent buildings would be very slightly in excess of the expense incurred for temporary ones, the report was referred back, in order that the plans of permanent buildings might be drawn. It was also moved that the Local Government Board be informed that if the present resources of the managers prove inadequate, they will not feel themselves justified in incurring fresh responsibility by the acquisition of additional sites, in the face of the Hampstead Hospital case, unless their position be accurately and satisfactorily defined; and it was suggested to ask the President of the central authority to receive in conference the chairman of the Board and the chairmen of the different asylums. Meanwhile, the Local Government Board has thought it necessary to take steps to lessen the spread of the disease, and a circular has been issued to the several vestries and district boards in the metropolis, stating "that, having regard to the present tendency to the increase of smallpox in London, the Board are in communication with the various boards of guardians with a view to exceptional visitation by vaccination officers of houses and tenements in infected neighbourhoods where there may be reason to suspect the presence of unvaccinated children." The cir cular further points out that it would materially conduce to the efficiency of such action by the vaccination officers if each vestry would instruct their sanitary officers to take note, in the course of their daily inspections, of any case of small-pox present in any house or lately removed therefrom, and without delay communicate any information on the subject to the vaccination officers of the district.

A recent report from Odessa states, upon the authority of the Governor-General of Kharkoff, that during 1879 as many as 20,000 inhabitants of that province were attacked with diphtheria, that 7000 of them died in consequence, and that during the ten months of 1880, ending October 31 last, the number of deaths therefrom was 5500. Typhus, which, as

the same report remarks, may be more or less regarded as endemic throughout South Russia, has been on the increase lately in some parts of it, especially in Odessa, where in the town hospital there are at present no fewer than 300 patients under treatment for this malady alone.

The annual meeting of the general body of the Hospital Sunday Fund supporters, consisting of the minister and two lay members of each contributing congregation, was recently held at the Mansion House under the presidency of the Lord Mayor. The report (the principal features of which we have already noticed) was read, and its adoption was moved by the Bishop of London, who, alluding to the doubts which had been felt at the outset, whether the movement was adapted to the metropolis, considered that, as the last collection was larger by £3000 than the first had been, sufficient proof had been given that the scheme had taken root and was steadily prospering. We must say that his Lordship is thankful for small gains. He also expressed his belief that-thanks to the carefully drawn rules-the hospitals and dispensaries were perfectly satisfied with the amounts awarded them. It was proposed and carried that in future two per cent., instead of one, should be set apart from the Fund for the purchase of surgical appliances; and at the instance of the Rev. W. P. Cope it was referred to the Council to consider the expediency of framing a scheme which should enable surgical aid and kindred societies to participate in the benefits of the Fund. Some elections were made to fill vacancies in the Council, and at the suggestion of the Bishop of London, and with the unanimous consent of the meeting, Sunday, June 19 next, was fixed for "Hospital Sunday" of 1881, and the cordial co-operation of all ministers of religion within the metropolitan area was again invited.

A passenger by the Cunard steamship Scythia was recently summoned before the Liverpool magistrate, under Section 120 of the Public Health Act, 1875, for exposing a child suffering from an infectious disease, thereby rendering himself liable to a penalty not exceeding £5. Sanitary inspectors, it appeared, visited the ship on her arrival from New York, and were told by the doctor on board that the defendant's child was suffering from scarlet fever. The defendant was warned that he must not take the child to any house or hotel, or remove it in a cab, and was told that it should be taken to the hospital for infectious diseases in one of the conveyances specially provided by the authorities. Despite this warning, the child was removed in a cab to the North-Western Hotel, the porter of which was not told of the infectious disease from which the child suffered. Subsequently, under pressure of the authorities, the defendant consented to the child's removal to the infectious hospital, and said that he had taken it to the hotel on account of its mother's distress at the idea of having to part from it. The ship's surgeon deposed that the child suffered from scarlet fever seven or eight days before the vessel reached Liverpool, and he telegraphed from Queenstown that there was a case of infectious disease on board. The magistrate said it was a most serious case, and imposed a fine of £5 and costs, making £6 10s. in all.

We sincerely congratulate Dr. Crawford, of Port-Glasgow, on his successful refutation of the charges of unskilful treatment raised against him to evade payment for his professional services. Dr. Crawford was called to attend the cashier of a firm of saw-millers who had met with a severe accident whereby he had sustained a fracture of one of his legs and one of his arms. The attendance lasted from July to November, 1879, and for this only a sum just under £5 was demanded. Payment was, however, refused, and Dr. Crawford sued both the cashier and his employers for the amount.

Each of the defenders raised a counter-claim for £12 against the doctor-the one for unskilful treatment, the others for loss of services. A long trial, in the course of which several eminent medical men gave evidence in proof of the skilfulness of the treatment employed, resulted in a verdict for Dr. Crawford, with expenses.

The evidence collected from all quarters is, and always has been, decidedly adverse to the Artisans' Dwellings Act in its present shape. The Town Council of Brighton, when recently asked to agree to a petition to the Local Government Board for an order confirming an improvement scheme which had been adopted under this Act, resolved, by a very large majority, to allow the matter to remain in abeyance for the present. The arguments used in favour of such a course being pursued were to the effect that the Act as it stood was unworkable, and would have to be amended in the forthcoming session of Parliament.

Dr. Hardwicke, the Coroner for Central Middlesex, has recently issued a report, from which it appears that during the year 1879 he held 1598 inquests, at a cost of £5805, or an average of £3 8s. 11d. for each inquest. No fewer than 228 persons died, as the juries found, from disease of the heart, 168 from diseases of the lungs, 94 from brain-disease and convulsions, and 85 from apoplexy. Deaths of children from suffocation in bed numbered 135, and in all these cases verdicts of "Accidental death" were returned. Forty-six persons died through being run over in the streets, and 43 from the effects of injuries caused by falling down in the streets; 12 deaths resulted from accidental poisoning; 3 persons only were killed by machinery; and 67 succumbed to the results of burns and scalds. Dr. Hardwicke points out the desirability that post-mortem examinations, in cases of paupers and prisoners dying in workhouses and gaols, be made by independent medical men unconnected with those establishments. The report also remarks upon the loose manner in which some registrars grant burial certificates without a written information from a duly qualified medical practitioner detailing the cause of death.

The Lord Lieutenant of Ireland recently laid the foundation-stone of the new buildings for artisans' dwellings about to be erected on the Coombe area, one of the worst districts in Dublin, which has just been cleared by the Corporation under the Public Health Act. The buildings are to be erected by the Artisans' Dwellings Company.

OXFORD.

IT would be hard to find a more notable contrast than one just recorded-we might say within a few days-in the columns of the Times. Two deaths are reported -the one of Herbert Walton, son of Mr. Haynes Walton, aged nineteen -soon, alas! to be followed by that of his sister; the other that of Dr. Bullock Marsham, Warden of Merton, aged ninety-four. Mr. Walton died of diphtheria, caught, so it was said, in an Oxford licensed lodging. His sister nursed him, and she too died of the same complaint. What Dr. Marsham died of we do not know, but he had far exceeded the allotted span of life, which has been the rule since, at least, the time of David. Mr. Haynes Walton was not unnaturally wroth as a man might be who has thus been robbed of his children, and he wrote an angry letter to the Times, complaining of the character of the lodgings assigned to his son, who had not had rooms in college. Many of the complaints made by Mr. Haynes Walton were promptly estopped by the official superintendent of licensed lodgings. So completely was this done that the mode of origin of poor young Walton's fatal illness must remain in doubt; unfortunately, we can have little hesitation in fastening upon the cause of that

which took away his sister. That in all probability was direct contagion. A good many years ago now, we took the opportunity of carefully examining into the sanitary condition of Oxford (though we hardly care to make a parade of the fact), and it would not be easy to describe anything more unsatisfactory as regards certain parts of the town, especially St. Thomas's; but it is plain that the condition of some of the colleges, never provided with the most scientific arrangements, nor built in the most salubrious spots, is not incompatible with long life, nay, with great longevity. We cannot but greatly compassionate Mr. Haynes Walton, but we are not certain that he has hit the right nail on the head when he maintains that the sanitary state of the lodging-house where his son lived was the sole cause of his death.

INTERNATIONAL EXHIBITION OF HYGIENE.

ON Wednesday, December 29, at a meeting of the Committee of the Parkes Museum of Hygiene, Mr. George Godwin, F.R.S., in the chair, a proposal was made to hold an international exhibition in 1881. After a long discussion, in which Dr. G. V. Poore, Professor Corfield, Mr. E. C. Robins, Mr. Rogers Field, Dr. Gowers, and Mr. Mark H. Judge took part, the following resolution was unanimously passed ::-"That her Majesty's Commissioners of 1851 having expressed to the Committee of the Parkes Museum of Hygiene their willingness to provide space at South Kensington for an exhibition of sanitary appliances and the industries connected with medicine, on the occasion of the International Medical Congress in 1881, it is desirable that the Committee should organise such an exhibition, provided that a sufficient guarantee fund be obtained." Those desirous of assisting the Committee in the work they have thus entered upon are requested to send their names to the Treasurer of the Museum, Professor Berkeley Hill.

THE PARIS FACULTY OF MEDICINE.

HAVING served his five years as Dean of the Paris Faculty of Medicine, Prof. Vulpian was about to retire from what he has found a very laborious office, when, at the unanimous request, couched in the most complimentary terms, on the part of his colleagues he has consented to be re-nominated. He takes this occasion in a detailed report to enumerate the changes and improvements which have taken place during the period of his Deanship, 1875-81, and shows that the Paris Faculty is in a state of vigorous efficiency. An elaborate system of correspondence has been organised, by means of which the relatives of the students are apprised at short intervals of the progress they are making. The personnel of the Faculty, including professors and employés of all kinds, has increased from 125 to 252 individuals. New chairs and supplementary chairs have been created, and great extension of practical instruction by means of laboratories préparateurs for the courses of lectures, and extension of the museums and the library. Great additions have been made or are in progress to the buildings of the Faculty. The budget of the Faculty with all these improvements has necessarily been increased, and amounts for the present year to 1,106,167 fr., being an increase of 518,026 fr. over the budget of 1875. The salaries of the professors have been increased from 10,000 fr. to 15,000 fr., and those of the agrégés from 2000 fr. to 4000 fr.. The amount devoted to the library has been increased from 10,500 fr. in 1875 to 35,500 fr. in 1880. In addition to the ordinary budget of the Faculty, supplementary sums have been furnished for the purchase of instruments or for other extraordinary purposes. These amounted, e.g., to 306,886 fr. in 1879. "This," says the Gazette Hebdomadaire, "is the sum of the results obtained since 1875. Within a period of five years the Faculty has seen

its edifices and the services connected with them placed in & proper relation to the necessities of medical teaching as understood at the present time. The number of its professors and agrégés has been increased, and their material situation has been notably improved. Supplementary courses, practical exercises, and special conferences have been instituted. These beneficial reforms, and the prosperous condition of the Faculty, both in a moral and material point of view, are due to the skilful administration of Prof. Vulpian, who should be highly congratulated for having consented to continue his important functions."

SANITARY CONDITION OF ST. MATTHEW'S, BETHNAL-GREEN. IN the annual report on the sanitary condition and vital statistics of the parish of St. Matthew's, Bethnal-green, for the year 1879, Dr. George Paddock Bate, the Medical Officer of Health, shows that the total number of deaths during the period was 3069, against 3040 during the preceding year. The births during the same period were 5246, against 5159 in the previous year; the excess of births over deaths being 22 greater than in 1878. The annual rate of mortality was precisely similar in 1878 and 1879, viz., 23-0 per 1000; the corresponding rates for the whole of London being 23.5 in 1878, and 23-3 in 1879. Dr. Bate remarks that he is not content with this stationary condition of things; "it is only holding our ground when we ought to be diminishing our mortality.", It is not enough that each year shows a result just under the general metropolitan rate, he is anxious to see Bethnal-green something more than an average London parish. He says:-"We have a gravelly soil, wide well-paved streets, good sewers, a fine public park, and few offensive trades carried on in our midst; still the insalubrious condition of many of our houses (and not always the smallest ones) remains a patent fact, and undoubtedly keeps up our death-rate. The drainage arrangements of many houses are as bad as they can well be-leaky and unventilated. What we are endeavouring to abolish as much as possible just now are sinks in washhouses communicating with foul drains, and inside closets badly placed or not thoroughly ventilated. These we get altered as soon as we discover them, but sanitary officers are not ubiquitous, and unless cases of bad drainage and defective sanitary arrangements are reported to us in time, they are frequently not discovered till the mischief is done, and a death from fever in the Registrar's weekly returns draws our attention to the locality. If people would only learn the A B C of sanitary science, keep out drain-air, and open their windows so as to let in fresh air, we should have fewer deaths and a healthier population."

VACCINATION IN BIRMINGHAM.

DR. ALFRED HILL, in his annual report on the health of the 'borough of Birmingham for the year 1879 (which, in passing, it may be remarked, contains the usual amount of interesting information on the sanitary condition of the locality, illustrated by some carefully prepared disease-maps), observes in reference to small-pox that only four cases, and not a single death, have occurred from this disease during the year under notice, while in 1878 the cases numbered twenty-seven, and the deaths five. It is very gratifying to find, he remarks, that in nineteen of the largest towns in England only two deaths occurred from small-pox during the whole year, viz., -one in Nottingham and one in Manchester, though a considerable epidemic existed in London. The fact is gratifying, inasmuch as it proves how much this infectious disease admits of being, and has actually been during the year, held in check by the active employment of vaccination. During the last year for which vaccination returns are

available the public vaccinator of the parish of Birmingham successfully vaccinated 8170 persons, a number not including the operations performed by private practitioners. Of the children registered as born in the parish during the year, 500, or 5.1 per cent., escaped vaccination by removal to places which could not be reached. Out of 5638 children born in that portion of the parish of Aston which is within the borough, 4650 were successfully vaccinated, and 385, or 8 3 per cent., remained unaccounted for; while in that portion of the borough within the parish of Edgbaston, out of 483 registered births, 42, or 7.8 per cent., removed to districts beyond the control of the vaccination officer.

THE PARIS WEEKLY RETURN.

THE number of deaths for the fiftieth week, ending December 15, was 1031, and among them there were from typhoid fever 23, small-pox 21, measles 15, scarlatina 14, pertussis 4, croup and diphtheria 51, erysipelas 1, dysentery 2, acute tubercular meningitis 44, and puerperal infections 9. There were also 42 deaths from acute bronchitis, 69 from pneumonia, and 48 from infantile athrepsia (23 of the infants having been brought up. wholly or in part at the breast), and 7 violent deaths. There was, therefore, a diminution of 20 deaths as compared with the former week. While typhoid fever has diminished from 39 to 23, small-pox from 24 to 21, and pertussis from 11 to 4, the deaths from scarlatina have increased from 6 to 14, and those from diphtheria from 45 to 51. The increase of this last disease has taken place progressively from week to week since the forty-sixth week, when the deaths were 29. Of the 1117 children born during the week, 561 were males (viz., 410 legitimate and 151 illegitimate), and 556 females (viz., 411 legitimate and 145 illegitimate).

CANCER OF THE UTERUS IN THE SEVENTEENTH YEAR OF LIFE.

THAT cancer of the uterus is exceedingly rare in early life everyone knows. A few cases under the age of twenty have been recorded, but none in detail. Those that occur in old authors have, indeed, been rejected by later and more critical writers as instances of mistaken diagnosis; and a case of so rare a kind, mentioned without confirmatory details, must always be open to this suspicion. A case, therefore, that occurred in the clinique of Professor Späth, and is reported by Schauta in the Wiener Medizinische Wochenschrift (Nos. 37 and 38, 1880), is of much interest. The patient was a weak and delicate girl, but no inherited tendency to carcinoma could be made out. She began to menstruate shortly after the completion of her fifteenth year, and the function was regularly performed without pain, but the flow was always abundant. In October, 1878 (the patient having completed her sixteenth year in December, 1877), a sanious watery discharge began to appear, accompanied with pain in the lower abdomen, so severe as to oblige her to keep her bed. In November an attack of profuse hæmorrhage led her to seek medical advice. On examination, a rounded tumour, of the size of a walnut, uneven on the surface, was felt in the vagina. It seemed as if it grew from within the uterus; its pedicle passed through the os uteri. From its consistence, and from its being covered with adherent fibrin, it was at first suspected to be a placental polypus which had followed an early abortion. The uterus could not be made out to be enlarged, and the patient denied all possibility of a miscarriage. An attempt was made to remove the tumour with a Simon's sharp spoon; but the stalk was found too strong to admit this, and it was therefore cut away with curved scissors. It was found to grow from the right half of the vaginal portion of cervix; and on section and on microscopic

=

examination was found to have the characters of malignant disease. The removal of the new growth was completed with a Sims's knife. The patient recovered, and remained well till January, 1879. Then some small nodules, at first of the size of millet-seed, but subsequently getting larger, were discovered in the neighbourhood of the cicatrix. They were removed with the knife; but after this others appeared, which were destroyed with Paquelin's cautery. At the end of March a tumour as large as an egg was felt in the right parametrium: it was rounded, and not connected with the uterus. It grew so fast that at the end of April it reached to the umbilicus and filled both iliac regions. On May 12 bits of tissue microscopically shown to be malignant in character were discharged in the urine, proving that the bladder was now involved. On May 15 the patient died. The autopsy was made by Dr. Chiari. A mass as big as a man's head was found in the pelvis-the lower part of the ileum, the cæcum, lower part of ascending colon, and sigmoid being adherent to the mass. The uterus was small, and pushed to the left. The posterior wall of bladder and right vaginal fornix had been destroyed by the growth. Secondary growths were present in the lumbar lymphatic glands and in the lungs. The growth was very vascular, soft, greyish-red in colour, and exuding a milky juice on section. It was examined microscopically by Prof. Heschl. His report concerning the growth was, that it was a malignant adenoma; that no definite distinction could be drawn between a growth of this kind and a true cancer, and it must be looked upon as a transition form to the latter disease.

PATHOLOGICAL SOCIETY OF Dublin.

At the meeting of this Society, on Saturday, December 18 (Dr. A. W. Foot, President, in the chair), Dr. E. H. Bennett showed the thorax of a man who was killed by being crushed between a railway-carriage and the buttress of a wall. The unfortunate man was rolled along the wall for some distance by the moving carriage. He died in a few hours from respiratory distress. There was no evidence during life of the occurrence of hæmatothorax, but the upper true ribs on the right side fell in and out with every act of respiration. The pelvis was also broken on the right side. There was a fracture of the ramus of the pubes and of the corresponding sacro-iliac articulation. The second, third, and fourth right costal cartilages were broken sheer across about three-quarters of an inch from the sternum. Considerable hæmorrhage had taken place into the anterior mediastinum. The pleura was adherent, and so the non-occurrence of hæmatothorax was explained. Injuries had also taken place on the left side of the chest, where there was luxation of the sternal end of the clavicle, with fracture of the cartilage of the first rib.

THE SANITARY REPORT ON HUDDERSFIELD FOR 1879.

In his annual report on the health of the borough of Huddersfield for the year 1879, Dr. J. Spottiswoode Cameron, the Medical Officer of Health, records that during the thirteen weeks ended March 29 of last year the deaths in the borough were at the rate of 28.1 persons per annum for every 1000 of the estimated population. This mortality was chiefly due to the severe and long-continued cold weather, affections of the chest contributing the largest number of deaths. Moreover, the ill effects of this severe season were not lost till well into the middle of the year, and the rate per annum of mortality for the thirteen weeks ended June 28 was still as much as 24 8 per 1000, the rate of deaths from chest-affections still continuing above the average. The improvement in the health of the town during the latter half of the year, however, reduced the death-rate for the

fifty-three weeks to 22.95 per 1000, as against 22:04 in 1878, and 22.37 in 1877. Notwithstanding vigorous efforts to stamp out scarlet fever in the borough, that disease was very prevalent, especially during the earlier part of the year; and Dr. Cameron bears testimony to the excellent service rendered by the infectious hospital, to which patients were removed so rapidly that the accommodation became insufficient, and measures had to be taken for the erection of a new pavilion to meet the increased demand. The advantages of infectious hospitals are not, Dr. Cameron points out, confined to those neighbourhoods which by their means are cleared of centres of contagion, but they are shared in a far greater degree by the patients, who occupy in them well-ventilated apartments, and receive the attention of trained and skilled

nurses.

SEWAGE AND TYPHOID.

IT would be hard to find a better illustration of the doctrines which we have elsewhere endeavoured to enforce with regard to the origin of typhoid than that afforded by the following extract from the Times of Friday, December 24:"At the Mansion-house, on the 23rd ult., Mr. John Lynn, a refreshment and oyster-shop keeper, of 70, Fleet-street, was summoned before Alderman Sir William Anderson Rose for keeping in his shop a well used for domestic purposes, the water of which was polluted and unfit for use. Mr. Edgar Baylis, solicitor, appeared for the City Commissioners of Sewers, and stated that these proceedings were taken under the Sanitary Law Amendment Act. The well had been the subject of numerous complaints for some time past. As. long ago as the month of June last the defendant had been warned by the authorities, and he then signed an undertaking, in consideration of which the authorities took no further steps against him, that the well-water should for the future not be used for either drinking or cooking purposes, and that the pump should be fastened by a chain and padlock during the hours he was licensed to carry on business. Since then, however, Dr. Sedgwick Saunders, the Medical Officer of Health for the City of London, had visited the premises, and found the pump unchained and in use. The water was analysed, and found to contain sewage-matter, which rendered it totally unfit for use. The object of these proceedings being taken was to get the Court to issue an order for the pump and well to be permanently closed. The defendant stated that his father sank the well in 1826, and it had been in use since he was twenty years old. For the last nine months it had not been used for drinking or cooking purposes, but it was very useful for cleansing the shop. He gave his word that the water had not been drunk since June last, neither had it been used for cooking purposes. Sir William Rose said he was bound to believe the evidence of the medical officer. It did not appear to him that the defendant had any adequate motive for keeping the pump open. He must, therefore, make an order directing the well to be permanently closed up forthwith." It may be well to premise that the account here given, compared with that in certain of the other papers, has been considerably softened down. But, taking the statements as given, we have here a well of the old kind sunk deep enough in Fleet-street to find water in 1826, and in use ever since -up to a recent period, at all events-for all kinds of purposes. The water has come in the course of time to be little else than diluted sewage; yet we have no history of typhoid. Were typhoid begotten of such water alone, we shudder to think of what the consequences might have been. Lynn's is one of the oldest of the oyster-shops in London, and one of the very few which still maintain their pristine character. The clientèle is large and specially select, for it is much patronised by the barristers,