609

or ventilation. Change from an enervating Mediterraneanclimate to this country is generally necessary and alwaysdesirable during the warm weather in severe or protractedcases, although it may be preferable for certain cases to

remain in the Mediterranean during the winter months inorder to avoid the cold of this country at that season.

THE CROONIAN LECTURER AT THE ROYALSOCIETY.

THE Council of the Royal Society has invited Dr.

Sherrington, F.R.S., Holt Professor of Physiology in Uni-versity College, Liverpool, to deliver its Croonian Lecturethis year. The lecture will be given in April and the subjectwill be the Spinal Cord and Reflex Actions. The official

recognition thus extended to Professor Sherrington’s work isof a particularly complimentary character inasmuch as it isthe custom of the society to invite a foreign savant to

deliver the Croonian Lecture.

STIVEN v. WELSFORD.

WITH reference to our article upon this interesting caseit has been represented to us that we have done the

defendant an injustice by making it appear as though hehad forced the matter into court and had been vindictive inhis method of defence. We do not think that any passagesin our article bear out such constructions, but we are happyto say that we had no intention of making either suggestion.We are informed that Dr. Welsford was from the first willingto refer differences between Dr. Stiven and himself to

medical arbitration, feeling that the issues could be betterdealt with by a scientific tribunal.

AFFECTIONS OF THE CAUDA EQUINA.

IN a recent number of the Archives de Neurologie there isan abstract of an important lecture on this subject by Pro-fessor Raymond. The lecture appeared at length in the

Nouvelle Iconographie de la Scclpetriere. It commences with

a reference to the anatomical relations of the nerves of thecauda and to the muscles and sensory areas which are

supplied by them, and two cases are related in whichthe symptoms briefly were a paralysis, incomplete andlimited to certain regions, a similarly circumscribedcutaneous impairment, and interference with micturitionand defecation. Certain additional phenomena are alsoreferred to, such as trophic disturbances, sexual impairment,modification of the reflexes, and altered electrical reactions.In regard to sensory changes in such cases the pain is usuallysituated in the sacral region, radiating into the lower limbs.It is intermittent as a rule, but has not usually the shootingcharacter of the pains of tabes. The anaesthesia is constant,circumscribed, usually symmetrical, and as a rule involvesthe vesical and rectal mucous membranes and the perinealand pudendal regions, or it may also affect the lower limbs indifferent ways. Its distribution in the limbs gives an indica-tion as to the roots which are implicated in the disease.Various forms of paræsthesiæ are also present. The motor

troubles comprise paralysis and atrophy of certain groupsof muscles in the lower limbs, the distribution of the

paralysis indicating the nerves affected. Incoördination isunusual as a symptom, although slight unsteadiness is notuncommon. Genito-urinary troubles are always present-i.e., incontinence or retention of urine, and also sexual in-competence. The affections of the cauda equina are either’tumours or inflammation. The latter may be of the sub-stance of the conus or nerves or of the meninges, and maybe either idiopathic or the result of traumatism, and thetreatment to be pursued is either medical or surgical. Themedical treatment will be determined by the general con-ditions affecting inflammations of the spinal cord, and if

the diagnosis of tumour can be definitely or even probably- °determined surgical interference may be successful. More-than one case is now on record in which a tumour has been

removed from this region. The lecture forms an excellent

r’ésumé of the symptomatology of this condition, and thetwo cases related are interesting and illustrative.

THE QUEEN’S COMMEMORATION IN BRISTOL.

BRISTOL is setting a good example in the art of fitlycommemorating the notable reign of Her Majesty, At aninfluential meeting on Monday, presided over by the Mayor,Mr. R. H. Symes, it was proposed, on the motion of Mr.Joseph Storrs Fry, seconded by Sir Charles D. Cave, asa fitting expression of thankfulness for the national benefitsaccruing from Her Majesty’s reign, and as a memorial of hergreatness, her worth, and of the services she has rendered tothe Empire, to establish a convalescent home for the benefitof the patients of the Bristol Royal Infirmary, and the BristolGeneral Hospital, at a cost of £50,000, half to be reserved forendowment. A committee was appointed to carry out the-undertaking, and some substantial sums were announcedat the meeting. No purpose could be more in harmonywith the genius of the year. A good convalescent homeis now an essential complement of a good hospital, and,as Mr. Fry said, relieves its funds. It is an economical

way of treating patients that are advanced in recovery.Besides, it gives them an immense impulse in the recoveryof hope and health. The suggestion united men of all

political and religious parties in Bristol, and we hope erelong to report its brilliant success.

THE INFLUENCE OF SMALL-POX HOSPITALS.

THE current number of Pnblic Health contains an interest-

ing abstract by Dr. Meredith Young on the Local Govern-ment Board (Medical Officers’) Report, 1894-5. Dr. Young,in dealing with the question of small-pox, points out thatthough the thesis of the aerial convection of this disease isregarded by the " bulk of authorities " as a settled questionthere are many still unconvinced, and he draws attention tothe experience of Hastings in 1894, where the facts observedform yet another illustration of the danger of placing thesehospitals near to human habitations. It was found in thatinstance that out of thirty-six cases which occurred within500 yards of the Hastings Small-pox Pavilion the percentageof small-pox attacks to population varied as follows :—

Attacks.Within 100 yards circle ...... 4’2 per cent. of population.

" 100 to 200 yards zone ... 2’7 " " "

" 200 300 " " ... 1’9 " " "

" 300 400 " " . 0-9 " " "

" 400 500 " " ... 0’2 " " "

Total within 500 yards circle... 13 3 " " "

Dr. Young adds that the diffusion of small-pox occurredapart altogether from any communication of contagion by

infected persons or things, as a most painstaking inquiryshowed. ___

EUCAINE AS A LOCAL ANÆSTHETIC.

EUCAINE, which is, according to Professor Charteris, a"methyl ester of a benzoylated oxypiperidine, carboogylioacid," possesses some undeniable advantages over cocaine.It is capable of synthetic manufacture and so is cheaper ;and it does not possess the mydriatic effect of cocaine.

Whether, however, it deserves all the encomium lavished

upon it in respect to its greater safety appears open to doubt.Professor Ponchet, in a paper read before the Societe de

Therapeutique on Jan. 27th, asserts that eucaine is a powerfulcardiac depressant, and in some instances produces suddendeath without warning. Injection of 2 milligrammes intoa frog caused slowing and irregular action of the heart,