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actuality above bacteriological suspicion of danger. But,as Dr. Houston remarks, a process which leads to thesolution of the great mass of suspended matters in theraw sewage, which effects a striking reduction in theamount of putrescible matters, which avoids the use ofchemicals and the accumulation of offensive sludge, whichyields an apparently non-putrescible effluent, and which is atthe same time practicable, is one which presents such

singular advantages over chemical treatment, that it wouldbe idle to deny its value or to attempt to minimise its

usefulness simply because it falls snort of a standard ofabsolute perfection. This is perhaps a rosy view, but theseconclusions are based, in our opinion, on one of the bestexperimental investigations that has ever been carried out.We strongly recommend a careful perusal and study of thisexceedingly interesting and valuable report to all concernedin this great question of sewage disposal.

THE PRINCESS OF WALES’S APPEAL.

PERHAPS no one can better appreciate the sore need of I

the families of the poor when the bread-winner is for somereason or other unable to render the aid which is expected ofhim than the medical man, and it is with feelings of thegreatest sympathy that we refer to the appeal which thePrincess of Wales, as President of the Soldiers’and Sailors’ Families Association, has just issued. In

a brief account of the work which the associationis endeavouring to carry out Her Royal Highness states

that since the commencement of the war over

.6510,000 have been directly entrusted to the care of the

association, supplemented by .6190,000 subscribed for wivesand families to the Mansion House Fund, and .650,000received from the Lord Mayor of London’s "Discretionary" "

Fund. The whole of this sum, amounting to .6750,000, distri-buted through the voluntary services of 11,000 ladies andgentlemen, members of the association, is now nearly ex-pended. The last returns show that over 80,000 families havebeen relieved, but the number of, cases do not diminish

to the extent which might be expected owing to the

fact that local funds have become exhausted and havetransferred their cases to the association. At the presenttime not less than .650,000 per month are beinggiven in relief. The aim of the association has been tomaintain the families in the same position as they werewhen their supporters were at home. Assistance has alsobeen given to aged fathers and mothers who relied upontheir sons for support previously to rejoining the colours."Without further funds," says Her Royal Highness, "thesehomes must be broken up and all that we have been doingfor the last 12 months will be undone." The Lord Mayorof London has consented to receive subscriptions sent tothe Mansion House for this object, and the Princess ofWales invites the cooperation of lords lieutenant of

counties, and of lord mayors, provosts, and mayors through-out the kingdom to help her in the same way. Sub-

scriptions will also be received by the local branches ineach county and by the treasurer, Colonel James Gildea, C.B..at 23, Queen Anne’s-gate, Westminster, S.W. Surely theappeal of the Princess will not be in vain.

WE announce with great regret the death of Dr. JohnBaptiste Potter, obstetric physician to the Westminster

Hospital, which occurred on Sunday last, Dec. 30th, 1900.We shall publish shortly a fuller obituary notice.

LORD ROBERTS, who arrived at Cowes on Wednesdaymorning last, was graciously received on the same day atOsborne by Her Majesty the Queen. The whole nation is

gratified by learning that the gallant Field Marshal hasbeen created an earl and has also been appointed a Knightof the Order of the Garter.

" CLUCKS " AND " CLICKS."BY W. AINSLIE HOLLIS, M.A., M.D. CANTAB.,

F.R.C.P. LOND.

As the days of Boer supremacy in South Africa are

numbered, it may be thought not uninteresting to consider,before it is too late, another residual product of the veldtwhose days are also numbered so soon as English boardschools are established in thp Transvaal Colony and the

Orange River Colony. I allude to the lingual "click" ofKaffraria and the surrounding districts. There are evidences,to which I sball hereafter briefly refer, that this suctional

note was at one time widely distributed in speech amongthe nations of mankind. My present purpose, however, is to.consider the physiology of an expressive sound-or, morecorrectly, series of sounds, for there are several modificationsof the "click" still extant-and to draw attention to itsclose relationship to similar notes still in use as calls amongsome of the lower animals.

In general terms the click" may be said to be producedby first pressing the tip, edges, and a part of the dorsum ofthe tongue against the hard palate, exhausting the air fromthe cavity so formed, and then, mainly by the action of themuscles attached to the styloid process and the hyoid bone,forcibly withdrawing the tongue from the position it hasassumed. This operation allows the air to re-enter thepartial vacuum and a 11 click" is the result. As regards the" clicks " at present in use amongst the Ngoni (Zulu), Xosa.Kaffir, and other of the Bantu tribes, European writers, suchas Torrend, Elmslie, and Roberts, agree in dividing theminto three varieties-namely, the dental, the palatal, and thelateral. The two first are chiefly distinguishable from eachother by a reference to the position of the tongue-tip whenthe sound is made. In the former case the tip is placed closeto the roots of the upper incisors ; in the second case the tipis placed considerably farther back. The lateral "click"—which, by the bye, is still to be heard from the mouths ofEnglish drivers-is really a modification of the second formof note wherein the edge of the tongue is first raised for there-admission of air instead of the tip. So we shall find thatthe Zulu " clicks " may be arranged physiologically undertwo headings-the anterior palatal and the posterior palatal,according to the location of the tongue-tip whilst the soundis produced.

If we now pass to the other side of the world, to the homeof the Dakota Indians, we learn through the voluminouswork of the Ethnological Section of the United StatesSurvey of the Rocky Mountains that these tribes also

possess, or until recently possessed, a language in which nofewer than four "clicks" were recognised. Phoneticallythese "clicks differ from those of South Africa, in so far aseach " click" represents a definite out-breathed consonantalsound modified by the suctional manner of its production.Yet, physiologically, the method of uttering these notes is

very similar ; and from what the writers of the dictionarystate we may assume that the p and t 11 clicks of Dakota

, were anterior palatal, and that the c and k "clicks" were.

posterior palatal. In other words, we find in each hemi-sphere of the world tribes of men who have retained in

, their speech these remarkable suctional notes, despite the,

fact that the rest of their language was composed of out-breathed syllables.L

Man, so far as I know, is the only mammal which uses a’ suctional note. Curiously enough, certain lizards of the! South African veldt, the so-called clucking sand lizards"

do, as their name suggests, utter a .. cluck," which in theircase is probably a sex-call. At home, however, in every

1 farmyard there are endless opportunities of observing anavian" cluck." The "clocking" of a broody hen-as oldr John Ray, the seventeenth-century naturalist, called the’ sound whereby the domestic fowl summons its family to a

feast-is familiar to us all. Certain peculiarities touchingthe nature of this avian cluck have led me to conjecture that

yit and the human " click " are both descendants of a commont ancestral "cluck." The peculiarities in question groups

themselves for consideration under various headings-s namely, the kind of sound, its structural cause, and finally

Is its significance as a call. If we compare the "cluck init this manner with the human 11 click the striking affinities

displayed in each instance will, I believe, justify the above

51

surmise. Unfortunately I have been as yet unable to investi-gate the cluck " of the lizard to which I have referred. I

have, in effect, restricted this part of the inquiry to the hen’scluck."To begin with the phonetic nature of the note. If

a clucking hen surrounded by her brood of chickens be

quietly observed three facts may be noted. 1. The sound

produced is a dissyliable, a "culuck" " and not a "cluck."’This observation, as we shall learn subsequently, is of in-terest. 2. The beak is closed when the sound is made..3. The hyoid bone with the larynx ascends at the commence-ment of the note to sink again immediately afterwards. As

regards the structures which bring about these results a fewwords may now be said, and in so doing I must apologise fordescribing the hyoglossal apparatus of the common fowl.From an observation published in one of the most recenttext-books on birds it seems, however, that there is a verygeneral idea abroad that the tongue has nothing to do withthe utterance of all notes emitted by birds, with one possibleexception, the sounds taught to parrots. Against thissweeping statement I must protest, and I feel that I canbest do so by describing briefly the beautiful mechanismin the fowl’s mouth and throat by which the cluck isundoubtedly produced. The somewhat V-shaped os hyoideshas its body prolonged forwards in the form of a spur, whichis embedded in the root of the tongue. At its distal extremitythis spur ends in a hinge-joint about half an inch from thetongue’s tip. A further spicule of cartilage extendingmesially forwards to within an eighth of an inch of the tipand presumably bearing the horny covering of the under-surface of the fore-tongue, completes the joint. The joint isapparently furnished completely with burs, synovialcavity, and so on. By two cylindrical muscles arising fromthe greater cornua and terminating in two long tendons, oneinserted on either side of the under-surface of the fore-tongue,this part of the organ can be bent downwards independentlyof the rest of the tongue. When the hyoid apparatus ismoved upwards the tongue, which usually rests in a cavitybetween the rami of the lower jaw, is also raised, pressingagainst the cleft palate. this movement practically closesthe resonant oral cavity behind. When the hyoid boneis subsequently lowered the back part of the tonguemust immediately descend with it, and in so doing itunseals a part of the palate. Owing, however, to thejoint in the mid-tongue, the fore portion can for awhile.still retain its position in proximity to the palate untilthe further descent of the hyoid occasions its displace-ment also. And so it is apparently brought about that thechicken’s tongue shall leave the roof of the mouth in twodetachments and that their removal shall coincide with thedescent of the hyoid bone and the emission of the dissyllabic" culuck " of a " broody hen."When the precursors of the Indo-Germanic nations

decided to give up the primitive " click " for out-breathedequivalents that note had doubtless already been separatedinto the two great " click " families, the anterior palatal andthe posterior palatal. This sub-division, as we may con-

jecture from the hen’s anatomy, was probably in the firstinstance the direct result of structural necessities. When,after the lapse of geological ages, organic difficulties hadbeen overcome and the mobile human tongue had devisedfresh variations of the suctional note, these varieties, withtheir out-breathed equivalents, still fell naturally under twoheadings, largely dependent upon the distance of thetongue-tip from the upper incisors. Accordingly we reco-gnise in the English "cluck," "click," "clock" and theGerman gluoken an out-breathed equivalent of an ancientfront " click" ; whilst such words as the English " crack,"the German krachen, and the French erique, gripper, hidethe descendants of a post-palatal " click." An investigationof the modern "clicks" and their Indo-Germanic repre-sentatives strengthens this conjecture, as I shall briefly show.It will be noticed also that this inquiry indirectly confirmsthe hypothesis that the avian "cluck" and the humanclick " have had a common origin.Whether the sand lizards "cluck" " whilst they excavate

their burrows is more than I can assert. Every farm-labourer, however, will admit a close association betweenclucking and scratching the soil in the case of the domesticfowl. In the language of Dakota (of which, by the way,a dictionary has been compiled filling a thick quartovolume) precisely six words begin with a c "click," a fewmore begin with the k "click." Amongst that small numberof words, a considerable percentage of which are conjunc-tions or other parts of speech, we nevertheless find

two verbs, ca, ke, signifying " to dig," one, kéga,to scrape," and one derivative again, kes -k6-za"trodden down, smooth"; the final word containingtwo k "clicks." This close association between the

posterior "click" and scraping the soil is not confinedto a nation of Red Indians, the Old English cratch, the OldDutch kratsen, the German 7zratze?z ("to scratch"), theFrench griffer, the German graben, and the English to

" grub," or dig, probably conceal in the initial er, kr. and

gr, the out-breathed equivalent of the suctional note. If we

turn to Zululand this relationship may seem apparentlyabsent. It is traceable, however, although the mentalconnexion between the note produced and its significance isnot the same in the two cases. Whilst in Dakota theoperation of scraping the soil appears to have been upper-most in the mind of the primitive savage whenever heuttered the hinder "click," the ancient Xosa-Kaffir musthave looked rather at the mechanism for producing thisresult-at the hooks and claws arming the limbsof men and animals when they harried the surfaceof the ground. To his simple mind the Aasvogel ofthe veldt (Zulu inqe,l English" griffin," French gnffon),was the embodiment of hooks and eyes, and its name wasconsequently the casket for one "click" or more. (Sometribes, I understand, introduce two "clicks" into this word.)Here again the Indo-Germanic group of tongues assist, forwe find the Old English cryee, the English "crutch,"" crook," and the French croe, represented in the Zuluibaxa, a word containing a lateral " click."

I must not, however, occupy these pages with a philo-logical disquisition. I shall conclude, therefore, with a fewexamples of the anterior "click" and its English equivalents.Such words as I I clip " (Zulu ncotyoha), 11 clasp (Zulu voca)," cloudless (Zulu e7vebile), to be clear" (Zulu çansa), to"close" the eyes, the mouth, the door respectively (Zulucima, cuta, vingca), all have an anterior click whilst theDakota tin-za, I I stife " (as mud), po, "fog," " mist," haverepresentatives in English clay" and "cloud," a furthersupport to the argument that the Indo-Germanic cl is theout-breathed equivalent of a front "click."

REFLECTIONS ON THERAPEUTICS.

BY HARRY CAMPBELL, M.D., B.S., F.R.C.P. LOND.,PHYSICIAN TO THE NORTH-WEST LONDON HOSPITAL AND TO THE WEST

END HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM.

I.

THE VIS MEDICATRIX NATURE ; THE LIMITATIONS OF’ THERAPEUTICS.

ONE of the first lessons the young physician has to learn-too many never learn it at all-is the limitation set byNature upon his therapeutic measures. He has to graspthis primal fact-that she herself is the great physician andthat compared with the vis medicatrix naturas his powers arefeeble and insignificant. The potency of the vis medicatrix,the importance of relying upon it chiefly, allowing it full

scope, and not for ever, by fussy interference, impeding itsbeneficent action, was brought home to me early in mymedical career. It was forced upon me by the followinganalogical argument which, though open to criticism, as

argument by analogy is bound to be, serves the purpose Ihave in view. The argument is briefly this : we may regarddisease as a natural variation, as a variation from thenormal, and just as all natural variations tend to revert tothe normal, so also does disease. This brings the vismedicatrix into line with the phenomena of reversion.Now there are two kinds of reversion. There is, first,

reversion as commonly understood, or developmental rever-sion, that, namely, in which the organism does not developon the ordinary lines, and pf this variety I have nothing tosay here. Secondly, there is that form of reversion in whichthe organism, having partly or completely developed, retro-gresses and thereby displays lost characters belonging topast ancestors ; it is to this second form that I wish todirect attention in this place. One of the most strikinginstances of it is afforded by acromegaly, most of the

1 The Zulu "clicks" are usually rendered by the letters c, q, and x;these letters are merely symbols, and the "clicks" have no sonorouconnexion with them. The q represents the posterior palatal "click."