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to be impressed upon dock authorities. We give in anothercolumn some statistics of fracture and contusions which bythe courtesy of the secretaries we have been able to obtain’from the various metropolitan hospitals-casualties largelyattributable to the causes already mentioned. The marked

prevalence of asthma and bronchitis may also fairly betraced to the same sources. Every practitioner has

lately had occasion to deal with cases of this trying anddangerous malady. What is of especial importance afterits cure, if present, is the prevention as far as possible of’the cause to which both it and the accidental deaths we*have recorded are mainly attributable-the fog. Of latethe press has been fruitful of suggestions respecting thismatter. All of course agree in condemning the ordinarycoal fire, which is a main source of mischief, and itmust be admitted that some of the substitutes proposedin its place bear the mark of practical intelligence.The well known utility of gas for heating and cooking pur-poses requires no commendation where conditions admit ofits employment. Unfortunately, there frequently exists aserious difficulty as to this during frosty weather. Other-wise no better preventive of the fog atmosphere could befound. It is possible, however, even while using coal, touse it in such a form and way as materially to diminishits power of smoke production. For this purpose a non-bituminous coke’or anthracite is clearly preferable, and is.capable of imparting great heat if the grate be furnishedwith firebricks in the manner suggested by Dr. GeorgeWyld. Most of our readers are familiar with the construc-tion of the slow fire which burns from above downwards,the draught from below being stopped by a metal

plate. By the use of either of these methods it is

possible to maintain a fire suitable for all ordinary pur-poses, and possessing an obvious advantage in the factthat it certainly emits a much less than ordinary volumeof smoke. It has been proposed that the duty of smokeconsumption where coal is burnt should not be enforced inthe case of manufactories only, but that the larger kitchensof clubs and hotels should be equally liable. The sugges-tion, if novel, is certainly reasonable enough. It is, indeed,ainquestionably desirable. Whatever the method most

approved, however, it must be allowed that the time hascome when every possible effort should be made to abolishthe fog-tyranny with which we have been in so recent andruinous association.

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TUBERCULIN AT THE BROMPTON HOSPITAL.

A REPORT has been issued from the Hospital for Con-aumpbion and Diseases of the Chest, Brompton, upon theresults of the treatment of cases of phthisis and lupus bytuberculin. The remedy was used systematically for fourmonths from Dec. 6th, 1890, to April 5th, 1891, duringwhich time 30 patients were so treated ; 28 of these werephthisical (18 males and 10 females). The report givesin a succinct manner information of the nature of the

- cases, the condition of lungs and expectoration, themumber of the injections and their results as to reaction,temperature, cough, and expectoration, changes in phy-alcal signs, in general condition, and in body weight.It is stated that 15 improved under the treatment,or 53’6 per cent. ; one was stationary, and 12 grewworse (3 deaths), or 42’S per cent. As to weight, 53.5 per,cent. gained in this respect, 14-2 per cent. were stationary,and 32’1 per cent. lost weight; but this result is qualifiedby the fact that the cases were selected for their being<either early or limited in character and extent. The re-

porters admit that tuberculin speedily causes inflam-

matory changes in and around tubercular lesions, thus pro-moting the formation of cavities, as proved by the appearanceof lung tissue in the sputum and by cavity signs replacing

those of consolidation. It increases the amount of expec-toration, but there is no proof of its diminishing thenumber of bacilli in the sputum; in some cases they appa-rently increased under its use. In many cases the injec-tions were followed by signs of distinct extension ofthe disease. The "reactions" were exhausting, and causedloss of weight and strength. " The treatment is speciallycontraindicated in lung tuberculosis accompanied bypyrexia, as likely to convert intermittent into continuouspyrexia." In two ca’3es there was evidence of fibroid con-traction of cavities accompanying the use of tuberculin.The final judgment is-"That the tuberculin did not

favourably influence the course of the disease in the

majority of cases ; that in some the effects were detri-

mental ; and that even in the stationary and improvedcases it was difficult to ascribe any distinct improvement tothe injections, which might not have been equally attainedunder the treatment ordinarily employed in the hospital."The report is signed by Drs. Theodore Williams andTatham. A report on two cases of lupus treated by tuber-culin is appended by Mr. Godlee. Both cases "showedmarked temporary improvement, followed by a return

towards, if not actually to, the condition preceding thecommencement of the treatment, when the injections werestopped ; and that even before stopping the injections, theretrogression had already set in."

EXPLORATION OF KAFFIRISTAN.

HEROISM has been so connected with deeds of valour inthe battle-field that we are apt to overlook that higherheroism which is the innate result of self-sacrifice under-taken for the advancement of science and for the benefitof mankind. The Indian correspondent of the DailyChronicle records such an instance in the case of the explora-tions in the wilds of Kaffiristan by Mr. G. S. Robertson,Agency Surgeon at Gilgit. "His experience among thathitherto mysterious people will be most interesting andvaluable. At one moment an honoured guest, at anothersurrounded by crowds of frantic savages clamouring forhis blood, he established his supremacy by the calm audacitywhich distinguishes the British race. Armed with no

authority, backed by no escort, but relying solely on hisown determination and coolness, he has been the firstBritish subject to explore that wild country."

SEWERS OR CESSPOOLS FOR CHICHESTER.

THE Corporation of Chichester seems likely to adopt avery retrograde step-namely, one which will tend to per-petuate a system of leaking cesspools, instead of adopt-ing a method of sewerage for the city. One of the

members of the Corporation is alleged to have statedthat with a cesspool the only danger is that 11 occasionallythe air is made to smell a bit," and this in a town where thecentents of 2440 privy-pits and cesspools are allowed to soakaway into the soil on which the place is built, and whereabout 816 houses are dependent for water on wells sunk inthis soil. Then, again, it was advanced that cesspools can bekept out of houses, whereas " sewers had to be laid underthem." Whether house drains pass to cesspools or to sewers,the only difference in this respect lies in the fact that sincethe cesspool must almost always be constructed on thepremises to be drained, whilst the sewer is in the publicthoroughfare, the sewer is, as a rule, farther away. Moreover,the question of drains passing under a house or not dependsentirely on circumstances which are distinct from their out-fall being into sewer or cesspool. Views of the above sortwere applauded by a number of town councillors, and henceit is not astonishing that they elected to try a system forpumping out the cesspools of Chichester by means of ap-