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had been observed by others before, that the blood so

drawn was dark and that it clotted very freely and rapidly,especially when drawn after fits. Control experimentswere made with the serum of three healthy persons and itwas found that from five to seven cubic centimetres per kilo-

gramme of body-weight injected into rabbits produced nolethal effect. It was found (a) that in epileptics in the

period between attacks (five experiments) the toxicitywas but slightly raised above that of normal blood in twocases and was about normal in the other three cases;

(b) that the blood immediately preceding convulsive

attacks was (two experiments) decidedly more toxic thanin group a, or than in health ; and (e) that the blood

immediately after attacks (six experiments) showed in-

creased toxicity if drawn within a few minutes of the

fits and that it produced convulsions and death readilyin rabbits. In from one to two hours after, this toxicityslightly diminished. In discussing the results Dr. Cololianpoints out the analogies of the toxaemia of epilepsywith that of puerperal eclampsia and notes that theoccurrence of albuminuria following epileptic fits has beennoted in half of the number of cases investigated byMM. Voisin and Peron.4 As regards the exact nature ofthe toxic substance present in the blood of epilepticsnothing further is as yet known, since it has not

been chemically separated or analysed. It is believed,however, that it is produced periodically in the bodyowing to "anomalies of nutritive exchanges" and thatfrom its resultant effects it must be analogous to con-

vulsive agents like absinthe. As contributory causes a renalincompetency with insufficient elimination of the poisonand a cerebral predisposition (hereditary or acquired) to

respond with undue facility and in the form of convulsionsto the toxasmic condition are also indicated. On the whole,the facts ascertained bear out the more recent views

regarding treatment for eclampsia and the status epi-lepticus-viz., limitation of nitrogenous diet, aperients, andin the grave cases venesection and an equivalent injection ofsterilised normal saline solution to the extent of from one totwo pints or even more.

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THE ABUSE OF MEDICAL CERTIFICATES.

MEDICAL men cannot be too careful in giving certificatesto hospital patients and persons belonging to the lower

classes of life. They are often used for illegal purposes inseveral ways and especially as a cloak for begging by idleand unprincipled persons. It is not sufficient to write acrossthe top of a certificate "Not to be used for begging purposes,"as the incident about to be mentioned shows. A week or two

ago several of the residents at Croydon received a call froma person who stated that he had been in the service of the

corporation for 20 years in the capacity of driver of awater-cart but was unable to continue his work on

account of varicose veins. In proof of this he displayeda certificate from a well-known medical man practisingin the neighbourhood. With this certificate he hadbeen from house to house collecting money for elastic

stockings to enable him, he said, to resume his occupation.Fortunately, an intelligent police constable, seeing him comefrom a house, asked him the purport of his visit, to whichthe prisoner replied : " To get a piece of rag to tie up myfinger." But on inquiry the householder stated that he hadcome to ask for money. On his way to the police-stationhe attempted to destroy a pocket-book containing a list ofthe generous donors who on the strength of the medical

practitioner’s certificate had given him various sums

amounting in the aggregate to 18s. The practitioner wassummoned to the police-court and he stated that the prisoner

4 Archives de Neurologie, No. 69, 1890.

came to him and told him that he was a driver of a water"cart for the corporation ; and that, believing his statement,witness had given him a certificate stating that he was,

suffering from varicose veins and that he was in want of anelastic stocking. He did so because prisoner told him that ifhe had a certificate he could get a letter for the Surgical,Aid Society. Witness wrote across the top, ’’ Not to be.used for begging purposes," but this and the date hadbeen torn off. A lady on whom the prisoner had calledand to whom he had shown this certificate had replied to.his request for money that it was " a surgical letter" hewanted, but prisoner said, "No, no ; look at this," andshowed her a list of the names of other residents who hadcontribnted. A foreman from the corporation gave evidence.that the man had never been in the employment of the’

corporation in any capacity. If it had not been for the.astuteness of the constable there is practically no limitto the depredations which this impostor might have carriedon, starting each day with a fresh list and working a freshdistrict. In hospital practice nothing is commoner thanfor patients to ask for a certificate either to enable them taget sick-pay from a club, a convalescent-home letter, or

some surgical apparatus. Grave abuse may arise in any ofthese directions but in nothing more than in that of sick-pay.Perhaps the patient may be suffering only from dyspepsia,and by slightly magnifying his symptoms he can, in the,rush of out-patient work, induce the physician to sign a.

certificate week after week. Great care should be exercised,for not only is grave injury done to the patient by incul-cating habits of idleness, but it is also a duty which the.

profession owes to the charitable public, who rely so

absolutely upon "the doctor’s certificate" as a guaranteenot only as to the medical aspect of the case but even as,to its genuineness in other respects.

THE DRAINAGE OF HAVANT.

THE Local Government Board have notified to the Ports-

mouth Corporation, the Portsmouth Water Company, and theHavant Urban District Council that as a result of the

inquiry held at Havant in December last they have decided.to issue an Order requiring the Havant Urban DistrictCouncil to provide efficient sewers for their district. Our

readers will remember that the exciting cause of the.

inquiry was a report issued by Dr. Theodore Thomson.and Mr. Whitaker on the surroundings of the Ports-mouth Water Company’s springs, in which attention wasdirected to the risk of pollution from the insanitary stateof Havant.l On receipt of this report the company comeplained to the Local Government Board (under Section 299,Public Health Act, 1875) that the Havant Urban SanitaryAuthority had made default in providing their district,with sufficient sewers, and petitioned the Local GovernmentBoard to limit a time for the performance by that authorityof their duty in that respect. The inquiry was conducted)by Dr. Bulstrode and Mr. F. H. Tulloch, C.E., and in face of’the evidence of the insanitary state of Havant then elicited,strengthened as it was by the previous report of Dr.

Thomson, it is difficult to come to any other conclusionsthan has been arrived at by the Local Government Board.The time limit given by the Board is six months, and to.

those acquainted with the ingenious methods of pro--crastination often adopted by sanitary authorities forcedto act against their inclination this period will seem

by no means too short. The inclusive cost of pro--viding an efficient system of sewerage for Havantwas stated by Mr. Baldwin Latham at the inquiry to-

be about 10,000, of which sum, by the way, the watercompany’s share as ratepayers is about <E2000. The water

1 THE LANCET, Jan. 28th, 1899, p. 244.

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company may be congratulated on the successful result oftheir action and it must also be a source of gratification tothe more enlightened of the inhabitants of Havant that their Ihealth and the good name of their town are, at any rate sofar as they depend on modern drainage, no longer to be leftto the mercy of such incapable sanitarians as the HavantDistrict Councillors have proved themse!ves to be.

SIR WILLIAM TURNER, D.Sc.

THE following were the words of the Public Orator, Dr.Sandys of St. John’s College, in presenting Sir WilliamTurner for the honorary degree of Doctor of Science at

Cambridge on Thursday, April 27th:-Virum regni totius medicorum concilio praepositum, virum

bonoribus academicis plurimis cumulatum, etiam noster.8enatus titulo suo decorare anno proximo decrevit. InterLancastrienses natus, inter Londinienses educatus, interEdinenses. medicinae in schola celeberrima, quam tot’coloniae Britannicae studiorum medicorum quasi p:fJTp6rro^L"venerantur, anatomiae scientiam per annos plus quam trigintapraeclare professus, non modo Universitati suae aedificiisjiovis instruendae operam insignem dedit, sed etiam studiorumsuorum actis per seriem edendis iamdudum maxima cumlaude praefuit. Idem, rerum naturae spoliis olim inBritanniam feliciter reportatis, Australasiae praesertimanthropologiam opere in magno accuratissime expositamluculenter illustravit. Nuper societatis Britannicae scien-tiarum finibus proferendis praeses in annum proximumdesignatus, ab eadem disputationibus de anthropologiaescientia etiam inter Canadenses habendis haud ita pridempraepositus, hominum omnium plausus propterea praesertimmeritus est, quod simiarum superbiam recentem repressit etgeneris humani dignitatem veterem denuo vindicavit.Duco ad vos generis humani vindicem, equitem insignem,

anatomiae professorem illustrem, WILLELMUM TURNER.Dr. Sandys’s introductory speeches are always conspicuousnot only for elegant Latinity but also for the happy wayin which the Public Orator seizes on the salient points in thecareer of him whom the University delights to honour.Such honour was never better or more worthily bestowedthan in the case of Sir William Turner the " vindex humani

generis," and we may hope the bearer of this proud titlein his capacity of President of the General Medical Councilwill continue his" vindication" as regards the rights andliberties of that portion of the race which practises or wishesto practise the noble art and science of medicine.

AN&AElig;STHETIC LEPROSY: CHANGES IN THENERVES AND SPINAL CORD:

NECROPSY.

ONLY a few histological investigations of anaesthetic

leprosy have been recorded in literature and examinationuf the spinal cord and ganglia has been still rarer. In a

case described by Samgin 1 this disease began with chronicrhinitis and was soon followed by pain and then byanaes-thesia in the arms and legs. The body also became almostentirely anaesthetic. The form of the anesthesia in the

affected areas was as follows. There were complete analgesiaand thermo-ansesthesia, but tactile sensibility was retainedthough in diminished degree. The disease pursued the.usual course with smooth desquamative skin changes andwith atrophic patches which in the anaesthetic areas becameconnuent and finally underwent destruction and cicatrisa-tion. The facial nerve was paralysed on both sides in itsupper part, but there were no bulbar symptoms. Claw-.hand was present on both sides. The peroneal nerves wereparalysed. The ulnar nerves felt thickened and hardened.The symptoms pointed on the whole to anaesthetic leprosyand excluded syringomyelia. The necropsy revealed a

variety of instructive conditions.. In the affected patchesof skin lepra bacilli were present and they were also

1 Deutsche Medicinische Wochenschrift, No. 30,1898, p. 475.

found in the peripheral nerves, but not in the spinalcord, posterior root ganglia, or brain cortex. Thenerves examined (ulnar and peroneal) showed inter-stitial neuritis, with an almost entire disappearanceof the myelin. In the spinal cord there was found

secondary degeneration of the posterior roots and of thecolumns of Goll (sensory tract). Degenerated nerve fibreswere also found within the ganglia of the posterior rootsand these were apparently continuous with those occurringin the peripheral nerves. The cells of the grey matter ofthe cord in the anterior cornua were not degenerated.Samgin believes that the degenerative process began in theperipheral ends of the sensory nerves of the skin and passedupwards into the spinal cord vii the posterior roots, consti-tuting thus a degeneration of the entire sensory neuron. The

changes seem to be analogous to those occurring in theperipheral neuritis of alcoholism and they suggest the actionof a toxic agent elaborated by the bacilli during their growthin the cutaneous and subcutaneous tissues and in the nerve-trunks.

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TRADE-STAMPS AND DEFECTIVE SANITARYFITTINGS.

IN a recent letter addressed by a correspondent to our con-temporary the P1lblic Health Engineer headed Trade-Marks " attention is called to the desirability of stamping bysome properly constituted authority the various fittings andmaterials used in plumbers’ work. The idea is excellentbut not by any means new. At the Congress ofPlumbers and others interested in sanitary matters held inLondon in 1884 the question after considerable discussion

formed the subject of a resolution. It was proposed thatthe ancient practice of marking lead and solder formerlyexercised by the Worshipful Company of Plumbers should berevived. Since then many by-laws have been passed byvarious local authorities regulating to some extent the natureand quality of material to be used in such work, but verymuch still remains to be done. Many if not all the watercompanies stamp or restrict the use of the fittings relatingto the water-supply; this does not in all cases tend to

the improvement of the sanitary condition of a building butmerely to the prevention of waste of water and for thisreason is not of much value from a sanitary standpoint.The whole question deserves very serious attention, but fromits gigantic proportions it is far from being one easy of solu-tion. Even supposing that such a body as the Plumbers’Company undertook to mark as efficient all sanitaryappliances or materials voluntarily submitted to them theywould require depots for the purpose throughout the

kingdom, whilst the difficulty of making any such arrange-ment one of compulsion would be enormous. Apparentlythe best plan would be some increased development of localby-laws.

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’THE DEVELOPMENT OF DENTINE.

THE Transactions of the Odontological Society of GreatBritain for March contain a paper by Professor F. T. Paulwhich throws a good deal of fresh light upon the develop-ment of hard unvascular dentine. To a great extent theconclusions arrived at confirm the view held by Mr. J. H.Mummery-namely, that the development of dentine is

practically similar to the formation of bone in mem-

brane. Several interesting points were, however, demon-strated by Professor Paul. Chief amongst these was the

fact that the young pulp contains a complete fibrousbasis composed of delicate wavy fibres interlacing in

every direction. These fibres are found to be directlyderived from the cells and are of a gelatin-yieldingcharacter. He also showed that the first layer of cellsformed on the surface of the pulp beneath the ameloblasts