In cases of chronic renal disease-cases in which there is great diminution of the amount of hæmoglobin, and a profound degree of anæmia-I have found repeated evidence of prolongation of the systole, indicating that the balance between the hypertrophy of the ventricle and the thickened arterioles is no longer maintained, owing to the impaired quality of the blood supplied to the cardiac muscular tissue. I pass on to a consideration of the action of the ventricle in cases of primary or idiopathic fever. It is an established fact that one great danger to be feared in severe cases of fever-e.g., typhoid fever-is the onset of a condition of acute myocarditis, but it is to milder cases that I wish to direct your attention. In the words of the late Dr. Anstie, (c) "The persistence of the febrile state at a high standard for a certain number of days involves large tissue-destruction, and this destructive process almost invariably involves to a large extent the muscular and other nitrogenised tissues of the body." The amount of this destruction can be ascertained by determination of the excretion of urea, and that the muscular tissue of the heart is involved in the destructive process, there is very little doubt. Dr. Anstie expressed great hopes of the utility of the sphygmograph in the prognosis of fevers, (d) employing, as the element in esta blishing a prognosis, the form of the pulse-wave, whether of the full dicrotous, hyper-dicrotous, or monocrotous type. In a case of typhus fever, the tracings of which I have published, (e) I have seen the pulse-curve pass within seventy-two hours from the hyper-dicrotous form, through various phases, to regain its normal character.

It is not, however, to the character of the pulse-tracing that I wish to call your attention, but to the position which the aortic notch holds relatively to the whole beat in comparison with its normal position; and I take, as my example, the case of C. C., aged twenty, male; first seen on the eleventh day of the disease (typhoid fever). Temperature 104.6°. Sixteen motions, and a trace of blood in the stools. Slightly delirious. The delirium persisted until the fifteenth day, by which date the temperature had fallen to 103°, and he was sweating profusely. Eight motions daily, with no further passage of blood. By the eighteenth day the tongue was, instead of being black, covered with a thin white fur, and the temperature had fallen to 99.6°; seven motions daily. On the nineteenth day he suffered a relapse, having been allowed to talk to his friends for a long time. By evening his temperature had risen to 102-4°, and he was once more delirious, the tongue covered with a black fur. The delirium persisted for forty-eight hours, after which the temperature fell to 99.8° by the twenty-third day. He was then perfectly conscious, and passing a few slight motions daily. There was a trace of albumen in the urine. From that time his symptoms gradually subsided, and on the forty-ninth day he left the hospital, quite convalescent.

I have here (Fig. 3) a chart indicating the day of the disease and the state of the bowels, the horizontal line representing the normal temperature and normal length of systole. The temperature record is indicated by the continuous black lines, and the prolongation of the systole in twentieths of a beat by the dotted lines. Following the chart (which is to be read from right to left), you notice that the greatest degree of prolongation of the systole coincides with the highest degrees of temperature on the eleventh and twelfth days, and gradually approaches the normal length, with a slight remission on the fifteenth day up to the nineteenth day, when, coincidently with the relapse, an extreme degree of prolongation ensued, the systolic portion continuing, however, from the following day to return progressively and uninterruptedly to its normal length, which was regained about the thirty-fifth day, keeping pace with the decline of temperature and improved condition of the patient. The coincidence of the greatest prolongation of the systole with the acme of hyperpyrexia, the simultaneous return of temperature and the aortic notch towards the normal standard, the aggravation of the prolongation coincidently with the relapse,-these facts, I think, all point to an intimate relation between the heart's action and the body-temperature; a relation which would serve as an argument in favour of those who support the antipyretic treatment of fevers by hydrotherapy or other methods. Let me add, in conclusion, that the most severe degree of

(c) Anstie, Practitioner, vol xii., page 192.

(d) Vide Lancet, vol. ii. 1867, pages 35, 63, 123, 189, 385.
(e) Medical Examiner, June 14, 1877.

systolic prolongation which I have encountered was in the case of a girl suffering from a severe attack of typhoid fever, in addition to old-standing disease of the aortic valve, the ventricular action being already chronically impaired by the aortic disease, and to a still further degree acutely impaired by the excessive hyper-pyrexia. In other words, in a complicated case, the prolongation of the systole is equal to the sum of the prolongations of the constituent disorders. I have to-night studiously avoided all details of figures and mathematical calculations, putting the question in its most simple aspect, by comparing together actual tracings of health with those of disease with similar pulse-rate, and drawing therefrom certain conclusions. If the aortic notch does not represent the termination of the systole, these conclusions are absolutely worthless; but, believing, as I do, strongly, that the termination of the systole is represented by the aortic notch, I have brought the facts, which I have collected, before your notice, in the hope that I may enlist the services of some worker in the same field of research.

TORBAY HOSPITAL.-On Tuesday last a testimonial was presented to the Senior House-Surgeon of this Hospital, Mr. G. W. Hamilton Cumming, on the occasion of his leaving Torbay to practise near Bath. The inscription on the testimonial runs thus:-" Presented to Mr. G. W. Hamilton Cumming, on his resignation of the office of House-Surgeon, by the Weekly Board, medical staff, nurses, and friends connected with the Torbay Hospital, as a mark of their high appreciation of service rendered at a critical period." In making the presentation, the Vice-Chairman of the Weekly Board (Col. Bainbridge) said Mr. Cumming had come among them at a time of great difficulty, when the credit of the Hospital was at its lowest, and by his tact and judgment, and his courtesy and attention to his duties, he had helped them and the other officials to raise the institution to its present efficient state, and to dispel the unfortunate feeling which had existed out-of-doors.

PRESCRIBING IN ENGLISH.-A Bill is now before the State of Pennsylvania with the following preamble:"Whereas, grievous errors and mistakes have been made by druggists and others in the compounding of the prescriptions of physicians by reason of the same being heretofore written in the Latin language and in abbreviations thereof, as well as the quantities or proportions of the drugs or medicines being designated therein by figures or symbols in a mode not readily understood by the bulk of the people, whereby undue advantage and a mystification of the patients may be taken by unscrupulous doctors, druggists, and persons who prescribe or compound medicines for the sick and poor, and, it being desirable to simplify the practice of medicine and to enable the public generally to better comprehend the names and nature of such drugs." All physicians and others prescribing, therefore, are, under a penalty of $20, to be compelled to write the names and quantities in English, without abbreviations; and a copy of such prescription is to be affixed to the bottle or packet containing the medicine in question. All druggists, under a penalty of $10, are to be compelled to conspicuously label, in unabbreviated English, everything they sell.-Philadelphia Med. Times, February 26.

(Continued from page 457.)

(Under the care of Mr. R. CLEMENT LUCAS.)

[For the following reports we are indebted to Mr. W. R. ETCHES.] Case 2.-Linear Fracture of the Left Side of the Occipital Bone, extending to the Foramen Magnum-Extensive Bruising of the Opposite Side of the Brain-Trephining for Meningitis-Temporary Relief of Symptoms-Coma-Death. W. P., aged fifty-three, was kicked on the head by a horse, while in an intoxicated condition, and run over, after which he remained in a semi-conscious state for thirty hours, and was then brought to Guy's Hospital on October 12, 1880.

On admission the patient is still in a semi-comatose condition. There is a wound about one inch above the occipital protuberance in the median line. There is some facial paralysis; he does not close his right eye so tightly as the left; the right naso-labial fold is obliterated, and he moves his tongue slightly to the right. Sensation is unimpaired on the face. There has been no bleeding from the ears, but he cannot hear so well on the right side. There is loss of power in the right arm, and considerable bruising of the left thigh. He can raise both his knees equally. He was placed on low diet, and an ice-bag was applied to his head.

October 14.-The facial paralysis is less marked. The patient passes his motions and urine involuntarily. Temperature 93.4°.

15th.-At 5 a.m. the patient was clear and collected in mind. About a quarter of an hour after this he was attacked by a fit; his eyes were opened, and his head turned to the left side; his pupils became dilated and the eyeballs turned to the left. The face was congested, and his left arm tightly drawn up, his right only slightly so. After the fit the pulse was 125; respirations 13; temperature 98 6'. The patient experienced fourteen attacks of this kind between 5 a.m. and 11 a.m.; they followed each other at intervals of about fifteen minutes. In the afternoon the patient was put under chloroform, and Mr. Clement Lucas trephined over the seat of injury, a little to the left of the median line. A linear fracture was found. There was no blood under the bone; but the dura mater appeared to bulge a little into the hole. The wound was dressed antiseptically. In the evening, after recovering from chloroform, the patient appeared quite rational, and answered questions intelligently. Evening temperature 98 6°.

16th.-During the night the patient has been attacked with the same fits, though not so severely. The facial paralysis still continues. He is more conscious this morning. Temperature: Morning, 100°; evening, 102.8°.

17th. The patient is in a comatose state, and passes his evacuations under him. Temperature: Morning, 100 7°; evening, 101.2°.

18th-The conjunctiva of the right eye is congested, and some secretion has collected about the lid. The facial paralysis is more marked, especially at the lower part of the face. He has more power in the right arm to-day than yesterday. The patient swallows better and seems less comatose than yesterday. Morning temperature 991°. At 6 p.m. temperature rose to 103°, and at 8.30 p.m. to 105-4°. 19th. In the night the patient's breathing became stertorous. He could not swallow fluid, and perspired freely. He died early this morning.

Post-mortem Examination.-A fracture was discovered starting from the left side of the occipital protuberance, and running down the vertical crest to the foramen magnum, where it ended. There was no fracture of the right temporal bone; the right frontal lobe was deeply bruised, and the temporo-sphenoidal lobe was lacerated, the laceration extending nearly to the lateral ventricle. Over the right hemisphere there was a good deal of blood both on the arachnoid and beneath it. On the left side there was some arachnitis, chiefly about the vertex, and the dura mater on this side was much thickened and rough on its inner surface. No communication was traced directly between this menin

gitis and the trephine opening, nor with the lacerated brain on the right side. There was distinctly no bruise on the left side. The skull was unusually thick, there being hardly any trace of the inter-parietal or parieto-frontal sutures. Some bronchial pneumonia was present.

Remarks (by Mr. Lucas).-This case was one which excited considerable interest at the time, owing to the nurse employed in the surgery having sent the man away when he was first brought to the hospital soon after the accident, without calling the dresser or house-surgeon. I have little doubt that had either of these gentlemen seen the patient he would have been admitted at once, because it is always the rule to take in every doubtful case of head-injury; but I am equally certain that it would have been impossible for them to have detected the linear fracture present through the wound, for at the time of the operation, with the bone fully exposed, I was in doubt as to the fracture, and asked a colleague to assist me with his opinion. The history of the manner in which the injury was received should have determined his admission, as a scalp-wound when a man has been knocked down and run over, and remains confused in intellect, is of very much more serious import than a more extensive wound inflicted by a light instrument. Further, a careful examination would have brought to light severe bruising of the right thigh and scrotum, a wheel having apparently passed over Scarpa's triangle. When I first saw him there was confusion of intellect and a drowsy state, such as is common after concussion, but at the same time it was noticed that there was incomplete paralysis of the right side of his face and some weakness in the right arm. On the fourth day after the accident he was seized with convul. sions, and these were found to affect the left side more than the right. They recurred at frequent intervals, and appeared to call for some interference. He was accordingly taken into the operating theatre for the purpose of being trephined. I then explained to the students that, had the symptoms present come on within the first twenty-four hours after the accident, they would almost certainly have indicated blood-pressure, but that coming on after three or four days they probably indicated meningitis of the left hemisphere. Trephining might save the patient's life if there was blood extravasated between the dura mater and bone, and even with meningitis it might give relief. When the bone had been exposed by a crucial incision, a linear fracture was detected to the left of the occipital protuberance. I trephined to the extreme left of this so as to be near the posterior branch of the middle meningeal artery, and also because all the symptoms pointed to injury of the left side of the brain. No blood was found, but the dura mater was thought to bulge somewhat through the aperture in the bone. After the operation the patient appeared much benefited; the convulsions ceased for twelve hours, and he answered questions rationally. The temperature, however, gradually rose, the fits returned, and he died three days after the operation and seven days from the time of the accident. The post-mortem examination confirmed the diagnosis I had given before operating-viz., that there was meningitis over the left hemisphere. In addition to this, extensive bruising by contrecoup was found at the anterior part of the right hemisphere, with meningeal hæmorrhage, but no inflammation.

POISONING BY INADVERTENCE. - Dr. Jules Lefort brought a case of this before the Académie de Médecine (Bulletin, April 12), in order to see whether anything could be suggested to prevent accidents of this kind. A druggist, having to prepare five powders, each containing two centigrammes of calomel and two of santonine, substituted strychnine by accident, causing the deaths of two children. In this particular case the accident was the more distressing because it was only by excess of precaution that the santonine was placed in the poison cupboard at all, as it is not directed to be so by law. However, there it stood, next in alphabetical order to the strychnine which was mistaken for it. Dr. Lefort observes that if the compound labelled santonine was officinally designated by its proper chemical name, santonic acid, the accident would also probably have been prevented, as the names santonine and strychnine are too similar. Moreover, as the former is chemically incorrect, he suggests that it should be abolished from all prescriptions and materia medicas.

THE GENERAL MEDICAL COUNCIL.

THE General Council of Medical Education and Registration met for its thirty-second session on Tuesday, the 26th inst., and our readers will learn from the opening address delivered by the President, which is published elsewhere in our columns, what was the business for which it was deemed necessary to summon the Council at this time of the year. As in February last it was necessary that the Council should, in order to put a new, and highly convenient, interpretation on parts of the Dentists Act, and "make legal the issue of a correct Dentists' Register," so now, the President says, it has appeared "of urgency to consider without delay certain questions affecting the education and examinations of schools and colleges throughout the country." The President of the Council always speaks of the acts of that body in the most courteous language possible, and never fails to show the tenderest regard for their feelings; but without incurring any risk of being reproached for harshness or severity, he might have ventured to use the word "reconsider," instead of "consider," in the sentence above quoted. The words would then have expressed the real character of the chief business before the Council much more exactly, and with as much clearness as could be expected. For, of course, no President could have bluntly said, The resolutions respecting general education and preliminary examination so hastily considered and passed last session-after only six days of discussion—are impracticable, and unless there is to be a dead-lock as regards preliminary examinations, you must reconsider and in some way modify them. That is, however, the real reason why the Council had to meet. We have more than once felt obliged to observe that the Council possess very little clear and definite knowledge respecting the teaching in the great majority of our secondary schools of general education-that is, in the schools to which the mass of lads meant for our profession have possible access,-and Sir William Gull pertinently remarked, on the seventh day of the session of Council in July

last, that "the whole of the last few days' work ought to have been referred to a committee of those persons who were engaged in the education of boys under sixteen." It would have been more to the purpose if Sir William had said "boys under seventeen," but the meaning of his remarks, as of ours, was that the Council had not the knowledge of what is usually taught in our general schools, to boys up to seventeen, that they ought to have before deciding on the subjects of the examination in general education which students are to be required to pass before they can become medical students. And, further, before finally settling the subjects of that examination, they ought to have had also a clear and exact knowledge of the character and range of the examinations that are held by the great educational bodies, or, at least, by those examining boards in the United Kingdom whose examinations in general education they had agreed to recognise. But it appears that when revising, last year, their recommendations on general education and preliminary examinations, the Council never gave any consideration to the practicability of the alterations they made, or to the effect of them in connexion with their resolution, so strongly insisted on, that "the superintendence of the general education of the medical profession should be left to the great national educational bodies, meaning thereby the universities of the United Kingdom." Without due consideration of this kind, the Council made their alterations, and issued, last year, a notice embodying their then conclusions as to the subjects which should be compulsory in any Arts examination for medical students; and pointed out to the Arts examining boards the subjects they desired to be comprised in the preliminary education of medical men, and without a knowledge of which students should not be allowed, after the end of the present year, to enter on medical study. The result is, that if the new regulations with regard to preliminary examinations passed during the last year's session of the Council be strictly enforced, none of the examinations by the University of Cambridge, or of those conducted by the University of Oxford, will fulfil the required conditions.

The Oxford and Cambridge Schools Examination Board informs the Council that its certificate would not exactly comprise all the subjects specified in their notice, and adds, "If exact compliance with the terms of the notice is required in all cases, the Previous Examination at Cambridge will not fulfil the conditions of the Council, nor will any one examination (nor all the examinations together) for a degree in Arts fulfil those conditions." The Cambridge University Local Examinations Board say, "In the list of examinations accepted in lieu of your own preliminary, we find the Previous Examination here ('Little Go '), and the Degree Examination. Neither of these contains any dictation, or composition, or reading, or writing, as a subject on which passing depends, or dynamics, or English history, or modern geography, or, except in a few cases, English literature. Are we to take it that your new regulation excludes these examinations? With respect to the Local Examinations, our juniors (under sixteen) have no dynamics, and our seniors (under eighteen) have no dictation; and our juniors have no longer any set piece of composition, we having struck it out from their course after years of experience of its uselessness." And Dr. Paget, writing as chairman of the Board of Medical Studies of the University of Cambridge, says that if the changes made by the General Medical Council are carried into effect, "no one of the examinations in Cambridge, nor any one of the several examinations conducted elsewhere by the University (such as the Local Examinations, the Higher Local Examinations, and the Oxford and Cambridge Schools Board Examinations), will fulfil the conditions of the Council." These examinations, he says, in the subjects of general education by the University have been arranged, after large

experience and much deliberation, by persons who may be judged to be well conversant with the subject of general education and examination; and he observes that they could not be altered to fulfil the conditions of the Council without much difficulty, and that "it may certainly be questioned whether such alteration would, on the whole, conduce to their improvement." It must be remembered that all of this information ought to have been known to the Council last year, as they had accepted the certificates of these examining bodies; or at any rate it might have been obtained by them. The difficulty the Council are now placed in is greatly aggravated by the fact that the Council of the Royal College of Surgeons of England have decided, in compliance with the desire of the Medical Council, to give up after this year the Preliminary Examination conducted under their superintendence by the College of Preceptors; and this examination was passed, in 1880, by nearly four hundred students; further, the examination was especially convenient to students, because it was held in March and in September; and after the present year, we are told, the "Registration Examination for medical students" by the University of Durham, and the" Examination in Arts" by the Apothecaries' Society of London, will be the only examinations in England which take place in those months. The College of Preceptors has proposed to establish “a special examination" to replace that of the College of Surgeons, but modified and extended to meet all the latest requirements of the Medical Council; it would be held at such periods of the year as experience has shown to be best suited to the convenience of students, and it is suggested that, by means of local centres, it might be rendered capable of indefinite extension to other localities than London. The Council of the College inquire whether the Medical Council will sanction this scheme by placing it on their list of recognised examinations. It would undoubtedly be a very convenient examination, and would meet, in a way, the difficulty created by the new regulations, but it would not be an examination by one of "the universities of the United Kingdom." In the Medical Council it has been objected to, and much denounced because it is called "a special examination," and a good deal was said against specialism in general education, and of the great desire the Council have that the general education of the would-be medical student should be simply the general education of middleclass English youths. We believe, however, that the College mean nothing more by the phrase, "a special examination" in Arts, than an examination comprising all the requirements of the Council, and held at a time most convenient to candidates for the medical profession; and, as to the "specialism," it may be asked why the Council, if they desired proof of only ordinary general education, did not apply their new regulations only to special Arts examinations conducted by medical bodies, and not to all Arts examinations?

And,

What the Council had to decide at this meeting was how to meet the difficulty in which they had placed themselves. As the President says in his address, "the arrangements for examination now existing throughout the country are extensive and elaborate, and cannot at once be altered, even if it should be considered desirable that they should be altered. Nor can the Council compel alterations. further, it is to be admitted that there are various ways of forming a true and firm character in a youth, and of training him to habits of observation and accuracy." The Executive Committee, in their report to the General Council on the communications from the Universities of Oxford and Cambridge and the College of Preceptors, have recommended that the Council should delegate to them "to make arrangements with bodies willing to institute preliminary

examinations suitable for medical students." In coming to a decision, the Council had the help of the advice given by the President, though it came rather late, and of the wise and sound advice offered by Dr. Paget in his letter. As a former, and most excellent, President of the Council he was especially well qualified to advise them in this matter; and he says, "The Medical Council has repeatedly expressed the desire that the preliminary examination of medical students should be left more and more to the national educational bodies.' This desire must in no small degree be frustrated if the 'changes in the regulations' are enforced in the case of the examinations conducted by the English universities. It will be best attained by showing a practical confidence in the character of these examinations, and by leaving the details more largely to the judgment of the persons who are appointed by the universities to determine the subjects and the manner of conducting the examinations."

After a very creditably small amount of discussion, considering how especially provocative of talk the subject of education always has been, the Council resolved—” That the Executive Committee be requested to communicate with the universities of the United Kingdom, and with the College of Preceptors, with a view to promote that such of their examinations as most nearly correspond to the minimum requirements of the Medical Council in respect of preliminary education, and are open to all classes of candidates, should be held, or in part held, at times which may be generally convenient to medical students intending to enter on their professional curriculum in the winter or summer session "; and further, that the examinations in general education conducted by the universities be accepted as heretofore, but that if any of them do not include the elementary mechanics of solids and fluids, a knowledge of these subjects shall be required at a subsequent examination.

WHAT IS HOMEOPATHY? AND WHY IS IT HATEFUL ?

RECENT events, to which no farther reference need be made, have brought up again the often-recurring question of What is homœopathy? and we may very well add to it the additional query, Why is it so unpleasant to the orthodox practitioner ? A discussion in the Times, ready to the memory of us all, has called fresh attention to the subject, but this discussion betrays on its very surface such an amount of ignorance and ill-feeling, that, for our own part, we could hardly, with patience, wade through it.

Briefly, we shall try to indicate our position in the matter. Of homœopathy we may well say, as of other things, that it is made up of what is good, bad, and indifferent. Of the good, we may say again that on the principle of careful physiological investigation of the action of remedies we are quite at one with our homeopathic brethren, or cousins, or whatever they may be ; but we would not include phantasms and fancies among the results of so-called "provings." Neither would we include the results of slight bodily variations among these; and, above all, we would have nothing to do with fanciful doses.

But it is when we come to homoeopathic practice that we are brought face to face with what has chiefly roused the ire of our profession. It is impossible for men of common sense to avoid a suspicion of imposition, wilful or involuntary, on the part of those who deal with quantities of remedies intangible, not to be detected, hardly computable; and to account for the effect of these "high potencies" by the mystery of what is called "dynamisation," which practically means that the more you dilute the stronger becomes the

Medical Times and Gazette.

remedy, all through the shaking required to effect the dilutions!

Neither is it possible for us to accept the notion that disease is but a bundle of symptoms, and that all that has to be done is to select some substance which will produce a group of symptoms as nearly as possible alike to the original complaint to secure a successful result. But herein again lies one of the pieces of nonsense involved in the system founded by Hahnemann, for, according to this, the more nearly akin the symptoms produced by the drug are to those of the actual disease, the greater the success is likely to be; but the moment they become identical it is, say they, but adding fuel to fire. The treatment must be by similars, not by

identicals.

Were it not for absurdities like these, there could be no great harm in a man selecting a remedy according to what he might be pleased to call the law of similars, were he likewise to rely on experience of success. We have always held firmly to the doctrine that we are justified in using-nay, bound to employ all manner of means for the relief of our patients. From our point of view there are no such things as homœopathic remedies. As the proof of the pudding is in the eating thereof, so are the value and uses of a drug to be obtained by experience alone. One man may fancy, and may even say, that the effects of the remedy are similar to those of the malady; that concerns us not, though to him who fixes his faith on a dogma it may much. The only real knowledge of drug-action is to be obtained by experiment on animals, by experiment in health, and by what we see in disease. All else in the

meantime is moonshine.

be

It is hardly worth while at the present time of day to enter into a discussion of the character of Hahnemann. To one set of men he is still apparently an ignorant charlatan; others have the audacity, not to say irreverence, to speak of him as the 66 Messiah of Medicine." As usual, neither extreme is right. Hahnemann was certainly not ignorant, and assuredly the introduction of his system has not been equivalent to even the dawn of the Messianic period in medicine. Probably the truth is, that as Hahnemann had no very good scientific or medical training-such, indeed, was not then to be had-he was the more easily led astray, seeking after vain shadows, eager to found a system for which not even the foundations were laid. Witness his doctrine that all disease is psora, i.e., suppressed itch! Once gone wrong, he was forced farther in the same direction, both by public treatment and mental disposition. Hahnemann was neither a very great genius nor a very great rascal; he was simply a clever man gone wrong; but those who are best acquainted with the state of medicine in his day will be the last to cast a stone at him. It was a day of dreams of systems, and not of realities.

COLOUR-BLINDNESS.

IT has long been felt desirable that legislative measures should be taken to protect the public from the dangers to which they are exposed by the employment of the colourblind in positions in which safety is dependent on colour-perception. Statistics have been industriously collected by our Continental and Transatlantic confrères as to the prevalence of colour-blindness, but it is obviously necessary that our legislative bodies should be supplied by trustworthy, accurate data as to the frequency of colour-blindness amongst our own population before they can be urged to frame laws for the public safety. The Ophthalmological Society has, therefore, done good service in instituting an inquiry into the prevalence of colour-blindness in the United Kingdom. The Report of the Committee appointed to inquire into defects

of sight in relation to the public safety was read at a meeting of the Society held on the 7th inst., by Dr. Brailey, from whose lucid and able statement we gather the following particulars.

The inquiry extended over five months, and the examinations were conducted by gentlemen of experience. The material was collected from various sources, consisting of public institutions, schools (public and private), the Metropolitan Police, and the Coldstream Guards. The number examined (18,088) was sufficiently large to justify deductions from the observations. The examinations were made by the matching of coloured wools, following, in the main, the method of Holmgren. Certain cases were also tested by coloured lights, as exhibited in the instrument of Donders, and also by means of a lamp designed by Mr. Nettleship, in which is employed the actual coloured glass used in railway signals.

Colour-blindness was taken as an inability to distinguish from each other two or more colours; but persons who had simply confused blue with violet, or green with blue, had not been ranked with the colour-blind. It was clearly distinguishable from a defective knowledge of the names of colours, and from defects of vision in other respects. Those were recorded as slightly colour-blind who had failed to distinguish from each other the pale shades only of different colours-mistaking, for example, grey or buff for green, and even mauve, yellow, or pink. Those who, besides failing as above, could not recognise the difference between red and green, matching either scarlet with green, or rose colour with green, grey, or violet, were considered pronounced colour-blind. Three cases only were discovered where there was a total failure of the recognition of all colours, these being only distinguished as shades. In the vast majority deficient recognition of two colours only was conspicuous. These associated colours were either red and green, or blue and yellow. Failure to recognise blue and yellow was rare, and from its little practical importance these cases were included as slight cases of colour-blindness. In every one of the pronounced cases of colour-blindness (617 in number) there was blindness to red and green.

All persons with pronounced blindness to red and green were found utterly incapable of naming with certainty a red or green light when exhibited singly. All failed, also, when the distance and intensity of illumination of the coloured light were unknown. The pronounced colour-blind were divided, as far as practicable, into two groups, in accordance with the definitions of Continental authorities, Those matching rose-coloured wools with dark-blues or violets, and scarlet with dark-greens or browns, were called red-blind; while those matching the rose with greys or greens, and scarlet with light-browns or greens, were called green-blind. Notwithstanding that many colour-blinds stood, as regards the wools, in a position intermediate between the two groups, this division still appeared to the examiners to have a practical value, as the red-blinds failed to appreciate at all, even as a light, except at a much shorter distance than normal, a light viewed through glass of the purest red obtainable; whereas the green-blind appreciated it at the full, or nearly the full, normal distance. Red-blindness appeared to be, in the United Kingdom, a little more common than green-blindness.

Coming now to the numerical results, we find that of the 18,088 persons examined, 16,431 were males and 1657 were females. Deducting from the males certain groups of cases specially selected in the expectation of finding peculiarities, there remained 14,846 with an average of colour-defects of 4-76; whilst amongst females, making similar deductions, there remained 489, with a percentage of only ·4. Moreover, in addition to the striking difference in the prevalence of