1804 BERLIN.-COPENHAGEN.

find that the great majority of them have remained cured fortwo or three years after discontinuing the treatment. Theyconclude, therefore, that the sedative application of

electricity has no drawbacks but should take its placeamongst the recognised methods for the treatment of chronicconstipation.

A Protest against Feigned Operations.M. Picqué has brought the matter of feigned operations

before the Chirurgical Society. The patients upon whomone is tempted to practise them fall under three classes :those who complain of real pain, those who complain of amalady which exists only in their own imagination, and thosewho think that they have an animal inside them in the stomachor some other organ. To feign the performance of an opera-tion is, as a rule, harmful to the patient. Its result dependsupon his mental state ; it cannot be beneficial for those whothink they are harbouring something, because their ideaamounts to a delusion and will only be confirmed and

strengthened. Patients suffering from pelvic and abdominalpain may develop an operative mania which may often be"caught " from some other patient, and in these patients apronounced psychosis may result from a feigned operation.M. Picqué considers that simple suggestion is sufficient forthe cure of cases such as these.

Iodide of Potassiitm in the Treatment of Levrosy.It is well known that iodide of potassium usually causes a

febrile reaction and a cutaneous eruption in lepers. At theSociety of Tropical Diseases on June 10th M. Marchoux andM. Bourret made a communication in which they stated thatthis reaction is always accompanied by the destruction of alarge number of Hansen’s bacilli which under the influenceof the drug lose their acid-resisting qualities. They con-sider that this destruction of bacilli sets free a toxic productanalogous to tuberculin in the blood stream, to which thesymptoms of the reaction are due. The iodide producesa variation in the leucocyte count which is modified

according to the source whence the drop of blood is obtained.For instance, blood from a finger and from the neighbour-hood of a suppurating nodule gives a similar count, whilstthere is a considerable difference in the number of leucocytesfound in blood taken from one of the eruptive lesions. June 15th.

________________

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

An Epidemic of Microsporia.AN epidemic of microsporia has recently broken out at

Schoneberg, a suburb of Berlin. A boy, four years old,had been taken to the municipal hospital, suffering from adisease of the scalp, which presented about 10 circular baldspots, partly confluent and covered by adherent, fine grey-white scurf. There was no symptom of inflammation andthe skin on the other parts of the body was healthy. Thehistory of the case proved that the boy had a friend who,together with his brothers and sisters, had the same sym.ptoms. The diagnosis was at first uncertain and was con-sidered to lie between favus and seborrhoea. Microscopicalexamination showed that the hair was covered by a denselayer of small spores. The parasite was by culturesascertained to be a trichophyton of the species microsporon.Dr. Sabouraud, who has made special researches on theseparasites, describes three species-microsporon equi, micro-sporon lanosum, and microsporon Audouini-which give riseto different symptoms and have cultural distinctions. The

microsporon observed in the above case differed from otherspecies in certain points. It is shown not to belong toeither of the first two by the fact that there was no inflam-mation of the scalp and that the disease did not spread toother parts of the body. In cultural appearances, especially inpotatoes, it was very like the third species, the microspcronAudouini. The epidemic has gradually spread and up to thepresent time some 20 children have been admitted to the hos-pital from the same suburb. The epidemic has not yet spreadbeyond its limits and Berlin itself is still exempt. Themunicipal authorities of Schoneberg have taken energeticmeasures against the spread of the disease. A special com-mission has been elected for that purpose, which includes themedical officers of health, the physicians of the hospital,members of the municipal council, and others. ProfessorHis, professor of medicine at the University of Berlin, has

r been invited to take part because he had the opportunity ofr observing a similar epidemic when he resided at Basle. Thef commission has decided to issue popular instruction about the epidemic in order to induce people to consult a medical) man as soon as any suspicious symptoms may appear.

The barbers’ shops are to be put under supervision. Anumber of medical men will be engaged to examine all of

the 8000 pupils of the public and other schools of thesuburb and this examination is to be repeated after a

: certain period. Persons who have caught the disease are

, to be conveyed to the hospital and suspected cases will beexamined and treated free of charge as out patients by thehospital physicians. The class-rooms and lodgings wherethose children have stayed are to be disinfected. As fortreatment, Dr. Plant recommends shaving the scalp andwashing it with soap, then brushing it with a mixture ofepicarin 5 parts, alcohol 80 parts, and ether 20 parts. Herecommends finally the administration of the x rays.

The German Committee on Tuberculosis.The German Central Committee for the Suppression of

Tuberculosis met for the twelfth time at Berlin on May 27th,under the presidency of the Secretary of State for theInterior, Dr. von Bethmann-Hollweg. He said that thecommittee in the preceding year had especially provided for" Fürsorgestellen," institutions such as were planned by Dr.Calmette of Lille for the systematic care of tuberculous andsuspected cases. The number of these Fursorgestellenhas been considerably increased, especially in thecountry, and the advantages of these institutions havebeen systematically preached by the committee. Thegeneral secretary, Professor Nietner, gave a report of thecommittee’s work. It has at present 1539 members and£18,900 have been contributed by the committee for sana-toriums and other institutions. The imperial treasury hassupported the committee by a sum of £3000. There areactually 99 sanatoriums for the poorer classes with10,529 beds, and 36 private sanatoriums for well-to do

people, with 2115 beds. 18 sanatoriums with 827 bedsexist for tuberculous children and 70 with 6843 beds forscrofulous children. Three sanatoriums with 180 beds are incourse of construction. There are, moreover, 175 ’’ Fursorge-stellen " and 82 Walderholungsstätten (daily health resorts).The conveyance of incurable cases into big special sana-toriums has proved a failure because of the resistance of thepatients to these institutions, although the attempt wasmade to accommodate them in small asylums with home-like surroundings. Dr. Kaiserling discussed the presentstate of the law concerning tuberculosis. He hoped thattuberculous children might eventually be isolated in sana-toriums even against the will of the parents. He advocatedan imperial law to deal with tuberculosis which shouldcontain provisions for the institution of local offices whereevery case of tuberculosis should be notified and havingauthorities who could undertake the necessary measures

against the spread of the disease. Professor Neisser spokeon lupus. He said that the disease is actually spreadin the same way as lepra was in former centuries. As thedisease begins as a rule in childhood all the children in theschools ought to be examined regularly. Early treatmentof long duration being necessary to avoid mutilation, herecommended special sanatoriums with the necessary equip-ment, Roentgen ray apparatus, &c. Cured patients shouldbe kept under observation for a certain time. He agreedwith the formation of a committee to deal with lupus whichwould act as a subcommittee of the central tuberculosiscommittee.June 15th.

COPENHAGEN.(FROM OUR OWN CORRESPONDENT.)

A Milk Epidemic in Christiania.AT a recent meeting of the Medical Society of Christiania

Dr. Ustvedt, the sanitary inspector of the city, read a paperon a recent epidemic of febrile angina due to an infectedmilk. which was described at some length in an annotationin THE LANCET of June 13th, p. 1707. In the discussionwhich followed this address the chief medical officer ofChristiania, Dr. G. E. Bentzen, proposed new regulations forthe milk trade which were rather severely criticised. Dr.Malm drew attention to a similar epidemic described in 1897

1805COPENHAGEN.-ITALY.

by Grey-Edwards and Severn, in which anginous affec-tions were likewise caused by milk containing streptococci.To his knowledge there had also been a similar epidemic inStockholm in April this year, where an inflammatory processin the udder of a cow was proved to be the source ofinfection. He had made bacteriological researches on pusfrom a pyarthrosis in one of the patients who died in therecent epidemic and had isolated a streptococcus.

An " After-cure " for Sanatorium Patients.A useful adjunct to the measures directed against tubercu-

losis in Denmark is formed by the so-called "air cureinstitution " of Copenhagen. It is intended for patientsreturning from the Danish sanatoriums, many of whom needan after-cure. The War Office has been good enough to

place a sheltered corner of the old fortifications of Copen-hagen at the disposal of the committee. In this place theusual equipment for the open air rest cure will be providedand entrance will be free to all patients who present acertificate from their medical attendant. Milk in summerand hot dinners in winter will be given free, but otherwisethe patients must cater for themselves. As the whole affairis arranged in the simplest possible manner the spending of afew hundred pounds will enable the committee to let alarge number of patients benefit from this philanthropicscheme.

Artificial Pneumothorax for Pulmonary Tuberculosis.At the last meeting of the Society for Physical Thera-

peutics and Dietetics Professor Saugmann read a paper onForlanini’s pneumothorax treatment of tuberculosis of thelungs. At the Vejlefjord Sanatorium, which was the firstsanatorium in Denmark and erected by subscription amongstthe Danish medical profession, he had tried the treatment in anumber of cases and had been on the whole favourablyimpressed by its results. Dr. Wurtzen said that they hadalso tried the treatment at the Oeresunds Hospital (thetuberculosis hospital of the municipality of Copenhagen)and though he would not commit himself to definite state-ments he thought that the method would prove useful incertain cases.June 15th.

ITALY.(FROM OUR OWN CORRESPONDENT.)

The Divisional S’urgeon and Post-graduate Instruction.IT was a happy inspiration of Luigi Mangiagalli, Porro’s

successor in the obstetric school of Milan, to institute in theLombard capital, the so-called " corsi accelerati di per-fezionamento pei medici condotti (abridged courses ofpost-graduate instruction for the medical officers, divisionalor communal, in town and country). These hard-workedpublic servants have not the time to keep abreast of con-temporary observation and practice, scientific and clinical ;nor, ill paid as they are, have they the means of replenish-ing their libraries with the professional treatises whichsucceed each other with bewildering rapidity. Few and

meagrely furnished, moreover, are the medical journals,weekly or monthly, which suffice of themselves in othercountries to keep the busy practitioner "up to date" in

, knowledge and practice, and so in too many cases the" medico condotto " is inadequately equipped for more thanthe most ordinary routine work. To meet his wants theMilan school (as stated) has instituted a series of ’’ corsiaccelerati " and the numerous and attentive auditories whichthey attract are at once the justification of the step andan appeal to other centres to do likewise. That appealhas just been effectively voiced by the head of the pro-fession in Rome, the Senator Guido Baccelli who, on a specialvisit to Milan, pleaded powerfully before a large audience ofthe profession and the more enlightened of the public forthe multiplication throughout Italy of " corsi accelerati " onsimilar lines to the Milanese and addressed to similarhearers. Prefacing his remarks with a lucid exposition ofthe diagnosis, treatment, and prognosis of cardiac disease asnow understood, practised, and taught in the most advancedmedical schools, he proceeded to urge the claims of the publichealth officer on his more favoured brethren and called uponthe professoriate and clinical staffs of the various academiccentres to spare a few hours from week to week, or

from month to month, for kindly conference with the" medici condotti" of their neighbourhood on the latest

accessions to the healing art in theory and prac-tice. Instancing the success of such "corsi accelerati" "

as those delivered by Professor Belfanti of Milan on thePathology of Infective Maladies-a course to be followedimmediately on not less interesting themes by ProfessorDevote and Professor Bonardi of the same school-he showedthat the great masters of Italian medicine had in times

past been similarly inspired, reaping the reward of theirfraternal intercourse with the rank and file of the great armyof health in the experience at first hand, freely and intelli-gently given, of the men of action " with whom they cameinto touch. In the interests of the public and equally in thoseof medical progress it would be well for the communes toraise a fund so as to facilitate the periodical meeting of their" medici condotti " with their academically placed brethren-a suggestion, it is satisfactory to note, reinforced by the laypress after being heartily endorsed by the 800 medical prac-titioners and consultants addressed at Milan by Baccelli.His Excellency Signor Rava, Minister of Public Instruction,has signalised his sympathy with the movement initiated atMilan, so that before the century is much older we maysee in the response to this " new departure " an earnest ofItaly’s return to the honourable post which she held in thefield of medicine throughout the later decades of the" cinque cento " and the century succeeding.

The Jugge’rnaut of the Streets.According to Mr. Frederic Harrison the twentieth

century omelette requires a great smashing of eggs."Granted ; but is there not excess, or waste, or both in theprocess ? Here in Italy, whose thoroughfares are solitudescompared with those of northern countries, the tale ofkilled or injured from accidents due to motor andcyclist traffic is rising daily in number, and whetheron the high road or in the narrow streets of townsstill mediaeval in character the safety of the pedestrianor even of the passenger in cab or tramcar becomesmore and more precarious. In Great Britain or

France or Germany the claims of business are imperiousenough to make the motor a necessity even more than aluxury, but in Italy, with her petite vie in commerce,industry, and affairs," that vehicle is now in far greaterrequest than her conditions can at all justify. 11 No Italian,"a compatriot has remarked, I I will walk if he can help it "-insomuch that in cities like Florence, whose raison d’êtreis purely artistic and non-commercial, the provision for"vicarious progression" is out of all proportion to thegenuine need for it. Even if she were, like Milan or

Rome or Naples, a seething centre of life and move-

ment, she is less adapted for motor vehicles or high-speedtraffic than the least modern of these cities-her structurebeing still to a great extent what Dr. King Chambers said itwas in THE LANCET half a century ago, I I a series of Han-way passages bordered by Newgate prisons." The last ofa number of accidents, more tragic than the worst of its

predecessors, has, however, roused public indignation to sucha pitch that, if municipal intervention is to count for any-thing, it will mark the close of an all too sanguinary tale.I refer to the horrible death of one of the most valued ofFlorentine residents, the Cavaliere Sebastiano Cecchi, aprominent banker in the city, who yesterday morning,while taking exercise on his motor-cycle in the Cascine,the Hyde Park of Florence, was suddenly encountered byan automobile. Hurled some 50 feet away his death wasinstantaneous.

The "Industria Termale."Of all the interests inspiring the " Association for Promot-

ing the Influx of Foreigners into Italy that of the so-called"thermal industry" or the development of the country’sresources in mineral waters and balneary "cures" " is the mostclamant. At the recent" Congresso d’Idrologia," the ninth ofthe series, held at San Remo, this fact was much in evidence.Discussion, regular and informal, brought out the disquietingtruth that Italy’s wealth in mineral waters remains but verypartially utilised. Such resorts as Montecatini, Salsomag-giore, and Anticoli, second to none in the special virtuesof their waters, are typical specimens of what Italypossesses in abundance, yet of these Salsomaggiorealone, in the opinion of authoritative hydrologists, can

really be called adequate to the x6le they affect in thematter of up-to-date equipment and personal comfort.Enterprise-what Italians call ’° slancio ’ and the French" élan "-has yet to apply itself to the developmentof Italy’s balneary resources, and where private initia-tion is wanting it is suggested that the commune in