1222 THE CHARGES AGAINST LONDON HOSPITALS.

12 per cent. During the year 186 patients escaped fromasylums, and of these all but 20 were captured and broughtback within 28 days from the date of escape. Of 93accidents and casualties which occurred 10 ended fatally,seven of the 10 being due to suicide. During the year80 private patients were placed in single care and 2703pauper lunatics were boarded out in privategdwellings. Thetotal expenditure for pauper lunatics was 309,356, or

£24 2s per head. -

THE CHARGES AGAINST LONDON HOSPITALS.

A CERTAIN section of the lay press has during the

week been attributing ignorance and cruelty of the

crudest sort to those responsible for the management,medical and lay, of certain of the London hospitals.Mistakes unfortunately will occur, but those who denounceour metropolitan hospital system are, we are quite certain,ignorant of the number of sick persons who pass throughthe hands of house physicians and house surgeons and ofthe proportion of error which results. The proportion is

incalculably small, probably less than 1/10000 per cent. It is

unfair as well as grossly stupid to write, as has been donein one or two quarters, as if a certain spirit of inhumanitywere innate in hospital management.

ELECTRIC LIGHTING BOARDS.

A VERY decided advance in the incandescent system of ]

electric lighting has recently been made which will add con- ]

siderably to the convenience and comfort of those using the electric light. By this new method, which is known as ’ he Electric Lighting Board System, an electric lamp maybe attached to any part of the wall, ceiling, or tablewithout the impedimenta of sockets, plugs, holders, anda maze of flexible wiring. To switch on a lampby this system means simply to stick in, so to speak, two pins into a pin-cushion. The electric board may be let into the ceiling or wall or table or floor, and it is only neces- sary to

" prick in " the lamp at any point to obtain the light.The lamps for the purpose terminate in two pin-pricks in place of the usual points of contact which connect the fila- ment with the main wires. Any number of lamps may thus be stuck in the electric board and in any place and the current thus tapped. Instead of plain lamps, standard lamps may also be used with pin-points projecting from beneath the base. The convenience of this system hardly needs pointing out.Everybody is familiar with the difficulty experienced ofgetting the electric lamp always in the right position. Thedifficulty occurs in the operating theatre, but by meansof the electric board the lamps can be placed in what-ever position is required. They can be inserted into theoperating table itself. The same system is adapted to

strips or cables and a lamp may be placed at any given pointand the current drawn off for lighting purposes. Writingtables, again, may be fitted with the electric board and anelectric light may be obtained at any point. Mirrors may havetheir frames fitted with the electric board and lights may beobtained at any point in a similar manner. By means of theelectric board also it is easy to obtain definite designs inelectric lamps. Thus a word may be easily portrayed onan electric board by placing the electric lamps in such away as to form letters. All this may be done without

wires, sockets, or holders. Many other interesting and con-venient applications will occur to different minds, but, in aword, the system may be described as giving the lightexactly where it is wanted without any trouble in regard tomechanical fittings at all. A very interesting demonstra-tion of this new and promising system was given at the showrooms and factory of the Electric Lighting Boards Company,of 18, Dean street, Soho, on Oct. 23rd, when a number of

literary and scientific gentlemen watched the new practicalexperiments with great interest.

THE NATIONAL HOSPITAL FOR THE PARALYSEDAND EPILEPTIC.

THE board of management of this hospital have recentlyhad under their consideration the matters at issue betweenthemselves and the medical staff of the hospital. As a result

they passed on Oct. 17th last the following resolution :-That, in view of allegations in the public press injurious to the

interests of the hospital, it is desirable that an inquiry should be forth-with held into the charges formulated by the medical staff against thedomestic condition and management of the hospital, and that theboard should request some independent legal authority to conductsuch inquiry.

Mr. Burford Rawlings, the secretary-director of the hospital,has written to the Times and in the course of his letterarrives at the conclusion that the system of hospital manage-ment in vogue at St. Bartholomew’s Hospital "in itselfdisposes of the suggestion that the board [of the NationalHospital] have not given full facilities for the cooperation ofthe medical staff in all matters concerning the medical workof the hospital." We cannot follow Mr. Burford Rawlings’sargument, but there can be no doubt of this : if the National

Hospital for the Paralysed and Epileptic is to enjoy thepublic confidence and scientific prestige which it has hithertoenjoyed and to continue its splendid charitable work amonga particularly afflicted class of the poor, the board of manage-ment and the medical staff must work together. The obviousmethod for insuring such cooperation is the placing of seatson the board of management at the disposal of the medicalstaff.

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KOPLIK’S SPOTS IN MEASLES.

IN the October number of the Yale Medical Journal Dr.W. J. Maroney of Springfield, Massachusetts, publishes ashort paper on his experience of Koplik’s spots in an epidemicof measles which occurred in the New York Foundling Hos-pital in March and April. During this period there were140 cases of measles in the hospital. In 53 cases Koplik’sspots were recognised only at the time when the ordinaryeruption commenced, but it must here be explained that thelarge majority of this group of children did not come undermedical observation until after the appearance of the

eruption. In 51 cases Koplik’s spots were recognised 24hours before the appearance of the ordinary eruption ; in

all of the 51 cases the temperature was from 99° to 101° F. ;in 35 of them there were slight coryza and conjunctivitis. In

20 cases Koplik’s spots were recognised 48 hours before theappearance of the ordinary eruption ; at this time the

patients had slight fever but no coryza. In four cases

Koplik’s spots were recognised three days before the appear-ance of the ordinary eruption; these patients had slight feverbut no coryza. In two cases Koplik’s spots were recognisedfour days before the appearance of the ordinary eruption;these patients had slight fever but no coryza. In two cases

Koplik’s spots were observed but there was no eruption ; bothof these children were very delicate ; hyperpyrexia andother symptoms of grave import intervened and deathoccurred in a few days. In eight cases Koplik’s spots werenot observed ; four of these children were marasmic with

very dry mouths ; two had aphthous stomatitis covering themucous membrane. It will thus be seen that in 79 cases

Koplik’s sign was present before any eruption appeared onthe skin. In only two of the 132 cases in which Koplik’sspots were observed did the characteristic eruption ofmeasles fail to appear. Dr. Maroney, therefore, considersthat Koplik’s spots are pathognomonic of measles and enablethe disease to be recognised at an early stage. These spotsoccur on the buccal and labial mucous membranes. Theywere first described by Flindt in 1884. In 1898 Dr. Henry