sion in the province of Ulster, and to strengthen the surgical reputation of the Belfast Medical ... me to shape my actions so, that having first done my duty to my patients, my next concern would ... Nervous children, instead of being sent to bed ...
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many years to the position of a member of its Council, testifies to the esteem in which you have been held by your colleagues. Your influence and work have done much to advance the interests of the medical profession in the province of Ulster, and to strengthen the surgical reputation of the Belfast Medical School. We congratulate you upon your appointment to the important and re3ponsible office which you now hold, and we wish you and Mrs. Fagan every happiness in the new sphere of life to which you have been called. Signed on behalf of the North of Ireland Branch of the British Medical Association, W. WHITLA, President. JOHN CAMPBELL, Honorary Secretary. Belfast, July 2gth, I897. REPLY. GENTLEMEN,-YOUr kind and sympathetic expressions of regret at my departure from amongst you have made an impression that will not easily be effaced. While I have heard with pardonable pride your reterences to the part I have taken in the inauguration and work of this Society, I have at the same time felt that any effort of mine to further the interests of this Branch was but a humble part in a pleasing work, in which I was ably assisted by willing and distinguished colleagues. My work as a teacher of cltnical surgery in the Belfast Medical School has been a labour of love, and I ask no better reward than your recognition of my devotion to that branch of our profession, and my efforts to give it its proper place in the province of Ulster. All through my professional life it has been a guiding principle with me to shape my actions so, that having first done my duty to my patients, my next concern would be to maintain the dignity and prestige of our common profession, and aid and encourage, more especially my younger colleagues, by word and example. I thank you for your congratulations on obtaining my present office, one that I am happy to say affords me ample field for doing good, and in which I hope to show such results as will justify the kind things said of me by many friends concerned in my appointment. My wife and I are are deeply grateful to you for your good wishes for our future happiness, and will always look back with pleasure to the happy time we spent amongst you in Belfast.-Yours sincerely, JOHN FAGAN.
At a previous dinner given by the Senior Surgeon of the Belfast Royal Hospital (Dr. J. W. Browne) a handsome illuminated address was presented to Mr. Fagan by the members of the medical and physical staff of the hospital.
SPECIAL CORRESPONDENCE, PARIS. Congress of French-speaking Alienists.-Education and Hysteria. The Notification of Infectious Diseases.-Morphinomania and Will-making.-General Nevw8. THE eighth annual congress of French-speaking alienists opened at Toulouse on August 2nd. This city was chosen as being the birthplace of Pinel and Esquirol. Dr. Ritti, in his presidential address, eloquently set forth the glorious work done by these two physicians. Before they studied mental diseases and toiled to improve the treatment of the insane, the latter were treated as something between criminals and wild beasts. Dr. Pinel was appointed physician of the Bic'etre Hospital in 1793. He did away with chains and rivets then in use, and gave the patients the benefit of air and sunshine, which till then had been denied to them, and the preliminary barbarous treatment infl4icted on patients before they were admitted into an asylum was by the persevering efforts of Pinel abolished. Esquirol's famous phrase, " I1 faut aimer les alienes pour ltre digne et capable de les servir," was the mainspring of his work. During forty years all the resources of his knowledge and activity were devoted to improve the condition of the insane. As a private citizen he travelled over all France to inspect lunatic asylums. M. Bezy presented an interesting communication on infantile hysteria, and quoted the following interesting facts publeished by Dr. Pitres, who says: "1 People are born hysterical, and do not become so. Where there is this hereditary constitution three principal factors may provoke the manifestations of hysteria; these are ' education,' 'emotion,' and ' contagion.' Education is a frequent factor. Nervous children, instead of being sent to bed early and kept free from excitement during the day, are by some parents obliged to work too much, or are excited by being taken to pay visits or by being allowed to play at noisy games. Sometimes they are taken to the theatre, or made to play little parts in private theatricals. Telling moving or terrifying stories is a faulty form of education, and especially instrumental in provoking hysterical manifestations in children thus constituted. M. Baralait
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has published a history of six children in one Brittany family who became hysterical after having been told stories about witches and ghosts. Dr. Terrier, in a thesis recently maintained before the Toulouse Medical Faculty, adds to this class of data. The law passed in I892 authorised medical men, in the interests of public health, to disregard professional secrecy and obliged them to notify cases of contagious illnesses met with in their practice. Among these diphtheria is classed. Practitioners are directed by this law to observe certain rules in their notifications. Thus the illness is indicated by a number. In October, I895, a medical man of Arpajon sent to the mayor five notifications, each indicating by its number the illness; all were diphtheria. A municipal councillor stating that he wished to assure himself whether there really was diphtheria at Arpajon and whether the sanitary law was properly observed, asked to be put in possession of the bulletins sent by the medical man to the mayor. The municipal councillor criticised the diagnosis. The medical man complained. The secretary of the mayoralty was proceeded against, and cited to appear before the Tribunal Correctionnel of Corbeil for having revealed secrets of which lie was the official depositary; he was acquitted. The general law court of Paris ratified the judgment, but the Court of Cassation annulled it, and the Rouen law court ratified the judgment of the Court of Cassation. The validity of a will made by a morphinomaniac has been established quite recently by a French civil law court. It was decided that as morphinomania in the penal code is not mentioned as a cause of irresponsibility it can still less be considered as such in a question of civil law. A Committee, of which M. Planchon, director of the Pharmaceutical School, is chairman, has been formed to take steps for the erection of a monument to the memory of the chemists Pelletier and Caventon who, in I820, when organic chemistry was still in its infancy, succeeded in isolating quinine. M. Hervieux is considering the question of the treatment of small-pox in the French colonies so intimately connected with their prosperity, and expresses his belief that compulsory vaccination is the only means of stamping out small-pox. This question will not be discussed at the Academy of Medicine until November.
CORRESPONDENCE. SNAKE VENOMS. [PRoFEssoR T. FRASER, of Edinburgh, asks us to publish the following letter adddressed by him to the Editor of the Nineteenth Century.] [Copyt.] To the Editor, Nineteenth Century. July i6th, I897. SIR,-I have to-day had an opportunity of reading the article on Recent Science, signed "P. Kropotkin," in the July issue of the Nineteenth Centur.y. At page 4I a reference is made to some work which I hiave published on Snake Venoms, and, while I do not admit the accuracy of other parts of this reference, I specially repudiate the latter part of the statement that I " began to immunise a horse, but could not continue, having no snake venom." There does not exist the slightest ground for justifying this remark. The writer gives references to two out of several papers which I have published on the subject, the one in the Proceedings of the Royal Society of Edinburgh of June 3rd, I895, and the other in the BRITISH MEDICAL JOURNAL of June Isth, I895. In neither is it stated that the immunisation of a horse could not be or was not successfully accomplished. On the other hand, in a paper communicated to the Royal Society of Edinburgh on July Isth, I895, I described the results of many experiments made with the blood serum of an immunised horse1; and again, in an address delivered before the Royal Institution of Great Britain on March 20th, I896, published in the Transactions of the Institution and also in Nature and the BRITISH MEDICAL JOURNAL, nearly all the experiments described are distinctly 1 Proceedings, x894-95, pp. 466 and 467
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stated to have been made with antivenene derived from a highly immunised horse. Not only is this the case, but the blood serum of a horse, both in the liquid and dry state, has been sent by me to Africa and India. In the latter country it has been tested, on behalf of the Government, by so experienced and highly competent an observer as Dr. D. D. Cunningham, F.R.S., who has also applied similar tests to three different samples of antivenene prepared at Lyons. In reference to these testings, Dr. Cunningham remarks: "The result of the entire series of experiments with this antivenene" (from Lyons) " was very disappointing and very inferior to that obtained with Professor Fraser's preparations ...... The material, as it reaches this country at all events, would thus appear to be distinctly inferior in potency to Professor Fraser's preparations, and to possess only very feeble antidotal properties."2- am, etc., THOMAS R. FRASER. (Signed) THE GOVERNMENT OF INDIA AND THE PLAGUE. SIR,-Two annotations in the BRITISH MEDICAL JOURNAL have just been brought to my notice: one headed, "The Indian Epidemic Diseases Bill," which appeared in the number for March 6th last; and the other, " Sanitary Guidance of the Government of India," in the succeeding number. In both, you strongly reflect on the advice given by me to the Government of India regarding the measures to be taken in connection with the plague, without having been in possession of the facts, and evidently without having seen all the remarks made by Sir John Woodburn at the discussion which took place at the Council on the introduction of the Epidemic Diseases Bill. The speech containing the remarks to which you refer wvas not the one delivered by the hon. member in introducing the Bill; it merely consisted of explanations in reply to objections raised at the meeting, and the remarks had no reference to me, and were never intended by the speaker to apply to me. On bringing your annotation to the notice of Sir John Woodburn, he immediately sent me a letter, copy of which is enclosed for publication, and I trust that you will give it the same publicity as the articles referred to.-I am, etc., JAMES CLEGHORN, Director-General, Indian Medical Service. Simla, JUlY 31ith. [Copy.]
Simla, July gth, 1897. MY DEAR CLEGHORN,-YOU have brought to my notice an article in the BRITISH MEDICAL JOURNAL, in which reference is made to the remarks of mine in Council on February 4th. I do not need to say to you that I did not refer to you in those remarks. In the earlier stage of the disease the management was in the hands of the Local Government. After your visit to Bombay the opinions you formed were accepted and acted on by the Local Government, as well as the Government of India.-Yours sincerely, J. WOODBURN. (Signed)
*** It is not denied that the Government of India had been misled by the medical advice tendered to it. Surgeon-MajorGeneral Cleghorn is, however, entitled to the full benefit of his protest and Sir John Woodburn's letter. Neither touches the accuracy and justice of our comments, which were founded on well-known facts. Dr. Oleghorn's opinion that .plague i8 not injectious in the ordinary sense is, in the opinion -of the most competent persons here, incomprehensible. Happily, the action ultimately taken was not logically connected with that opinion.
THE COLLEGE OF PHYSICIANS AND HOSPITAL REFORM. SIR,-Although in your leading article in the BRITISH MEDICAL JOURNAL of August 7th and Dr. Garrett Horder's letter in the same issue, this subject has been pretty fully discussed, there yet remain a few words to be said on the subject, for which I hope you may be able to afford me Report on the Result of Experiments on the Action of Various Reputed Antidotes to Snake Venom, conducted during the season z895-96.
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space before the pressure of the reports from Montreal fills up your columns. As one of the signatories to the petition to the College I was considerably surprised to find from your report (see BRITISH MEDICAL JOURNAL, May 22nd) of wlhat took place in the comitia at which our petition was discussed, that we were charged by several eminent Fellows, especially Dr. Dickinson and Dr. Church, with having enormously exaggerated the abuse of the out-patient department, with having put many such exaggerations into the petition, with trades unionism, and by the President himself with a strong animosity towards those connected with hospitals. This last accusation must have been particularly galling to those dozens of hospital physicians and surgeons, both in London and provincial towns, who had signed the petition. We were assured, however, that many of our statements could be controverted, and would be disproved if investigation were made by those conversant with the subject (the very thing for which we had asked), and we waited patiently to see how this could be done. What has happened? After months of consideration "with great care" of the petition by the Council, the only reply given to us is that it is impossible for the College to make the investigation we asked for. Not a word is said as to the charges of exaggeration, trades unionism, or animus so publicly made against those who signed the memorial, not a single fact is brought forward to disprove any one of the plain statements of fact contained in the petition, nor on the other hand is any apology vouchsafed to those Fellows, Members, or Licentiates who had been publicly insulted in their own college. A bare non possumus, is considered by the Council of the College sufficient to settle the question so far as they are concerned. It would be in vain, of course, and might evenbe considered presumptuous, for us to imagine why it was impossible for the College to make such an investigation, seeing that it has not proved impossible for the handful of medical men constituting the Hospital Reform Association to make a similar inquiry into the working of the special hospitals of London, and to present a most valuable report on the subject; nor has it been impossible for the Charity Organisation Society, whose interest in the matter is not a tithe of ours, to investigate very fully the condition of both the voluntary and rateaided hospitals in the metropolis; nor again has it been impossible for the Council of the Hospital Sunday Fund to cause 'investigation to be made into the working of some thirty hospitals where some defective management was alleged to exist. No one knows better than the respected President of the College, how very important it is that our great London hospitals should, if possible, be authoritatively declared to be free from abuse, for he has explained in the Medical Ma azine for January i896, that one reason why the General Medical Council could not interfere with the medical aid associations was that " the Committee saw that the principle of prohibiting men attempting impossible work was very far reaching, even including the assistant physicians and surgeons to outpatients in many London hospitals ;" so that it will be seen that hospital abuse is not only an evil in itself, but is indirectly the cause of the perpetuation of other evils. To come to the question of remedy: I fully agree with Dr. Garrett Horder that pressure should be brought upon the medical staffs of hospitals. For nearly thirty years the BRITISH MEDICAL JOURNAL has consistently advocated hospital reform, while during the last few months the Lancet, with all the zeal of a new convert to the cause, has declared that the medical profession could, if it wished, diminish the amount of abuse to one-half in six months, and in a year practically abolish it. Let us try as an Association what we can do. Let no man be elected to any position of honour either in the Association or its Branches, who is opposed to hospital reform. Let every candidate who is proposed for any office among us, either as a representative on the general or Branch councils, or for president, honorary secretary, etc., be asked to state his views on this important subject and let it depend on his answer whether he shall be opposed or supported. Thus, and thus only, as it appears to me, shall we give effect to the general desire for reform which pervades the whole body of our Association.-I am, etc., H. NELSON HARDY. Dulwich, Aug. I6th.
