case which did not involve the larynx. The only muscles paralyzed were those of the soft palate.

Dr. Ray: I reported a case, which I saw in consultation with Dr. Cottell, the second in which I used antitoxin, and which also required intubation. The child recovered, and presented three weeks later paralysis of one external rectus muscle. JOHN L. HOWARD, Secretary.

Foreign Correspondence.

LONDON LETTER.

[FROM OUR SPECIAL CORRESPONDENT.]

Prize Distribution at Guy's; Memorial to Professor Huxley; Grace on Cricket; A Public Mortuary; Work on Diphtheria; Indian Oculist's Instruments; New Masonic Lodge; A Nurses' Society; Treatment of Syphilis, etc.

The distribution of prizes and medals to the students of Guy's Hospital was this year discharged by the Master of the Salters' Company. Want of funds, the chronic condition in these times of depression of so many charities, constituted the prevailing feature of the speeches. Guy's is one of the two great hospitals which have to minister to the necessities of all the poor of South London, with its 1,600,000 inhabitants. The hospital shows a deficit of £19,000 this year.

A memorial is to be established in connection with Charing Cross Hospital Medical School to the late Professor Huxley. At present it is proposed that the memorial take the form of an annual lecture and a science scholarship and medal. The late Right Hon. Thomas H. Huxley was destined for the medical profession by his father, and attended lectures at the medical school of Charing Cross Hospital, taking his degree of Bachelor of Medicine at London University when twenty years of age. He showed a brilliant knowledge of physiology at the examination. In 1846 he was appointed to the medical staff at the naval hospital at Haslar, a year later going to sea as assistant surgeon of the Rattlesnake on the Australian station. For three years he had the opportunity of prosecuting his favorite studies in natural history in the then little explored waters of the antipodes. Early recognition of his scientific acquirements was accorded him in the shape of the election to a Fellowship of the Royal Society in 1851, and the award of one of the Society's medals in the following year. had only reached the age of thirty when appointed Examiner in Physiology

and Comparative Anatomy to the University of London. Sir Joseph Fayrer, an old friend and fellow-student, is chairman of the committee which has been formed to carry out the idea of a fitting memorial.

There is no member of the medical profession so popular as Dr. W. G. Grace, the well-known cricketer. Dr. Grace in a recent article says cricket is a good exercise for girls, but they must be young ones. He strongly disapproves of it for adult women. His own daughter, he mentions, is an excellent but smart field, and in fact a good all-round player. "But," says the doctor, "she will soon have to relinquish it." The tribute which is being prepared for Dr. Grace will not be begrudged by all sorts and conditions of men, and it has been suggested that a knighthood would not be out of place.

A mortuary for the poor is about to be opened in the crypt of the Norman Priory Church of St. Bartholomew the Great, which stands just outside the walls of St. Bartholomew's Hospital. The dead may be placed there while awaiting interment. It is hoped that the innovation will meet with the appreciation of those who inhabit the crowded tenements of the neighborhood; but so conservative are the majority of the poorer classes that it is felt the use of the public mortuary will be viewed with suspicion and dislike, and will be slowly taken advantage of, and the fact that the mortuary in the past has been associated in their minds with murder and suicide may not be without prejudicial effect.

Mr. Lennox Brown has published a new work, "Diphtheria and its Associates." He traces the history of the malady from a period long antecedent to the Christian era. The present essay is based mainly on experience gained in one of the fever hospitals of the Metropolitan Asylums In the appendix the author explains the antitoxin method and analyzes the many claims that have been put forward as to the advantages of the new treatment over ordinary methods. He concludes that until the efficacy of antitoxin be proved the spread of diphtheria may be best prevented by improved sanitation, prophylactive surgery, and effectual isolation and disinfection.

The members of the Ophthalmological Society had recently an opportunity of viewing a complete set of Indian oculist's instruments, which had been presented to the Society by a military surgeon. There is great difficulty in obtaining these instruments, as they are handed down from father to son for generations. When operating there is no attempt at asepsis or cleanliness, the lower lid is everted, and incision made in the ciliary region with a lancet, and the lens couched by passing an instrument through the incision. Less than ten per cent of the cases are successful, most eyes being lost by panophthalmitis or secondary glaucoma.

The new masonic lodge, Rahere, which has been founded for the convenience of members of the medical profession on the medical staff of St. Bartholomew's Hospital, promises to be a great success. At the consecration the Prince of Wales arrived at five o'clock, accompanied by the Crown

Prince of Denmark, and General W. Lawrie, Past Grand Master of Nova Scotia. The Dean of Gloucester delivered an oration, exhorting the brethren to be true to masonry, keeping up as best they could to the high masonic ideal of self-sacrifice for others, loyalty to their Queen and patriotism to their country. The Prince of Wales was unanimously elected the first honorary member of the lodge.

At the first annual meeting of the Registered Nurses' Society it was explained that the Society was formed in order to enable the public to obtain the services of registered nurses, it being necessary that before a nurse was put on the list that she must have worked for at least three years in hospitals and must possess the highest personal character. The nurses receive their entire earnings, minus 71⁄2 per cent, which is deducted to cover the expenses of management. The sixteen senior nurses have received on the average £11 125. for an average of fifty-one weeks' work. There have been more applications for nurses than the Society could supply.

The appointment of Sir Philip Smyly to the Surgeoncy to her Majesty in Ireland has given great satisfaction in Irish medical circles. Sir Philip is Surgeon to the Meath Hospital and representative of the Royal College of Surgeons in Ireland in the General Medical Council.

The testimonial to Sir Joseph Lister will be presented to him at King's College Hospital on July 30th. Sir J. Eric Erichsen will make the presentation.

Dr. Alexander has for some years been studying the Aix la Chapelle treatment of syphilis. He thinks the success of this watering place, which is yearly crowded by people of every nationality, is due to the fearless use of mercurial ointment, the daily use of the hot bath, the thoroughness with which the inunction is carried out, good dietary, and the absence of spirituous liquors. Dr. Alexander has come to the conclusion that there is not much advantage in the drinking of the waters peculiar to Aix la Chapelle, and that the treatment could be carried out with the same results anywhere. For five years he has carried out the routine treatment in a hospital under his supervision with the most satisfactory results, summer and winter, and he sees no reason why many well-situated resorts should not be utilized for successfully carrying out the treatment.

The first fatality under ether recorded for 1895 is reported from a provincial college hospital. A woman, aged sixty-three, was suffering from umbilical hernia of some years' standing; at the first inhalation of ether she vomited, the bowel immediately gave way and death ensued in a few minutes. At the inquiry held after the death it was proved that although a fatal result occurred it was not due to the ether.

LONDON, July, 1895.

sure.

Abstracts and Selections.

PUNCTURE OF THE SPINAL MENINGES.-Fürbringer (Berl. klin. Woch.) has punctured the membranes more than one hundred times in eighty-six cases. The procedure is quite easy. The author recommends that the patient should sit up, at the same time bending well forward, and that the needle be introduced on a level with the under surface or exact extremity of the spinous process. An anesthetic is unnecessary. Sometimes the aspiration of the fluid was found to cause pain in the neck, back, or head, so that the author uses the Pravaz syringe almost exclusively. The amount of fluid withdrawn varied from a few drops to 110 cubic centimeters. The amount evacuated does not always correspond to the amount present or to the pressure. Very occasionally a bloody or blood-stained fluid was withdrawn. Once, owing to pain in the legs, it was thought that a nerve root had been pierced. In four fifths of thirty-seven cases of tuberculous meningitis the diagnosis was established with certainty by the presence of the tubercle bacillus. Improvement is so rare that any curative action can hardly be thought of. In the author's opinion the symptom-complex of this disease is not in any great measure the direct result of increased presIn two cases with meningeal symptoms in which no tubercle bacilli were found the after-examination showed a serous meningitis. In one case of chronic hydrocephalus the fits lessened after the puncture; the necropsy eventually showed the hydrocephalus to be due to a tuberculous nodule in the cerebellum. In one case pus was withdrawn. In three cases of cerebral tumor there was slight improvement in the headache in one case. There was but slight change in a second case, which subsequently recovered under antisyphilitic treatment. In a third case sudden death occurred on the day after the puncture. In a fourth case, much improved by trephining, lumbar puncture was practiced owing to a relapse. The symptoms improved slightly, but death occurred twenty-four hours later. It can not be said whether the puncture had any thing to do with the sudden deaths. In two uremic cases ninety and fifty cubic centimeters of fluid were withdrawn without result. In one case of cerebral hemorrhage with rupture into the ventricles blood was withdrawn, as well as in a case of hemorrhage into the cerebellum rupturing into the fourth ventricle. For diagnostic purposes spinal puncture is most valuable in tuberculous meningitis and when pus is withdrawn. In hemorrhages into the ventricles or subarachnoid space it may also be of service. Therapeutic results (at all permanent in character) are either absent or only rarely to be seen. Whether there is any danger in spinal puncture is neither proved nor disproved. British Medical Journal.

THE SURGICAL TREATMENT OF EMPYEMA OF THE ANTRUM.-Dr. S. Lloyd, of New York, read a paper in which he said that this condition might result from disease of the nose or from carious teeth. If the teeth were removed while dental periostitis was present, the diseased condition under consideration might result. Various methods existed of forming a diagnosis of antral empyema; for example, percussion, a stick being held in the mouth against the diseased part, also transillumination by means of an electric light in the mouth. It was important to determine that pus actually flowed form an opening in the antrum, and this was sometimes difficult. Most of the methods of treatment in use were defective. Schmidt's exploratory puncture, a hole being drilled between the two bicuspids, was very useful as a means of diagnosis. It was not always easy to get the pus out, even when its presence had been determined, especially if it was contained in compartments. The principle of draining from the most dependent point should be observed. The disadvantages of making a hole into the antrum through the alveolar process were, that a healthy tooth might be sacrificed in making the hole, the food might make its way through, and, if decomposition or caries was present, it was not easy to remove the offending material through such an opening. Désault's operation, by which a flap as large as a shilling was turned back from the gum, and a hole then chiseled into the antrum, gave plenty of room both for inspection and for removal of diseased and offending material. The objection to it was that infection might be carried to the mouth. The operation and the instruments recommended by Mikulicz were considered the best means of attacking the disease.

Dr. W. C. Phillips, of New York, thought that disease of the antrum was often overlooked, especially when it also involved the frontal and ethmoidal sinuses. Suppurative disease of the antrum was, however, relatively infrequent. He approved of transillumination as a means of diagnosis. Peroxide of hydrogen as an application he did not approve of, as it made a clot within the cavity which was difficult of removal. Spontaneous cure of the disease sometimes resulted; hence surgical operations were not always indicated. Especially was this the case if sound teeth were to be sacrificed. A polypoid condition of the antrum often co-existed with empyema, and Myles had devised instruments for its curettage. For drainage the use of tubes was objectionable; gauze was better and was less likely to prolong the infectious process. Cleansing and alterative fluids should be used in the irrigation of the cavity.-New York Medical Journal.

SERUM TREATMENT OF CARCINOMA.-Emmerich and Scholl (Deut. med. Woch.) relate their clinical experience of the treatment of carcinoma with erysipelas serum. They first refer to Coley's researches into the treatment of inoperable tumors, both carcinoma and sarcoma, with bouillon cultures of the erysipelas coccus inoculated with B. prodigiosus. In addition to the favorable results obtained by Coley, there were some unpleasant by-effects. The authors inoculate sheep with erysipelas cultures and free the blood