"They repress the natural exhalations from the skin, and induce an impure condition of the blood." Really this is worthy of an itinerant doctor in a market-place on a Saturday night. All we can say is that we know of no such causes of typhoid fever; and if they exist, the sooner Mr. SIMON knows of them the better. High temperature followed by moisture might induce rheumatism or catarrhs, but not typhoid fever, unless all recent investigation is a delusion. Dr. LETHEBY himself brings the sewer poisons into the tail of his explanations, and at another portion of his letter lets us know that his opinion of the water was that occasionally it might be charged with sewage matter. After these admissions, it is a mere blinding of the eyes of the uninitiated to talk of repressed exhalations and impure blood. We take Dr. LETHEBY's admissions and Mr. HAWKSLEY's statements to be proofs of what we have always believed, that the water-supply in this case was the principal channel by which the cause of the fever was conveyed. We would not exclude the possibility of sewer gases having also a part in the production of the effects; but this theory will not explain the peculiar localisation of the epidemic. If the North Shields people are wise, they will either change their water company, or see that the company changes its watersupply.

Though we take the results of the examination of the water to be all in the direction of showing it to be faulty, and faulty in the very way that produces typhoid, it must be remembered that we do not owe to chemistry our knowledge on this subject or the kindred one of cholera. We know that these are often propagated through water, not by chemists having detected the exact causes of disease in the water, but because common, but close, observation has discovered a connexion between the drinking of certain water and the getting of certain diseases.

AN interesting discussion has been taking place during the last few weeks in the French Imperial Academy of Medicine, in reference to the etiology and treatment of puerperal peritonitis, the leading points of which we shall here briefly note. The argument commenced upon a case reported by M. GUÉRIN, in which, led by certain theoretical as well as practical considerations, he was induced to apply a peculiar mode of treatment; and both his theory and his practice have received sharp criticism from some of the older members of the profession. According to M. GUÉRIN, after labour the uterus usually recedes or retracts into the upper part of the pelvis; its orifice closes; and, as a consequence, the wound formed by the detachment of the placenta is placed in the condition of a subcutaneous wound, and undergoes immediate cicatrisation. Under certain circumstances, however, the uterus does not recede; its orifice

remains more or less patent; and then, the air having access to the wound, it follows the same course as usually occurs with exposed injuries, the surface inflaming and suppurating, whilst the constitutional effects are rendered unusually noxious, owing to the internal, confined, and irregular surface of the organ.

So far, perhaps, most practitioners would be disposed to agree with M. GUÉRIN; but he now explains the supervention of peritonitis on a new and curious theory. He believes

that the sanious and purulent fluids, rapidly undergoing putrefaction, are sucked up by the Fallopian tubes, through the operation of an aspirant force exerted by the abdominal parietes acting at each movement of inspiration on the contents of the uterine cavity. He states that he has unmistakably established the presence of such fluids in the tubes, and he then proceeds to say how easily the lesions occasioned by their presence may propagate themselves by continuity of surface.

Acting on this theory, M. GUÉRIN conceived the idea of applying an instrument which should induce a retrograde or downward movement of the uterine fluids. This consists essentially of a canula of vulcanised india-rubber, which is introduced into the vagina, the passage of which is completely closed by the action of certain ampullæ that can be inflated with air; and with the canula a suction apparatus is connected. M. GUÉRIN had only one case to report upon, but the effects produced were so immediate and beneficial that he thought it worthy of being brought under the notice of the Academy. In this case sharp inflammation succeeded labour, with stoppage of the lochia and great abdominal distension. The application of the instrument was followed by the removal of much purulent and sanious fluids, shreds of lymph &c., and large quantities of air, and all symptoms of peritonitis quickly subsided.

In commenting upon this case, M. DEPAUL expressed some doubts as to whether it was a case of peritonitis at all, and not rather one of metritis; and regarded the suction action of the uterus, as well as the passage of fluids from the uterus to the peritoneal cavity, as anatomically and physiologically impossible, since no fluids could be made to pass in this direction even with the aid of a strong syringe. He further demanded why, after craniotomy, or other operation involving the death of the child, had been performed, and in consequence of putrefaction the uterus had become tensely filled with gas, this did not escape into the peritoneal cavity, though, as is known, rupture of the uterus might even occur from this cause. M. BLOT urged that if the uterus were so flaccid after delivery as not to reascend in the pelvis, it must be obvious that it could exert no aspirant power. M. POISEUILLE, again, whose researches on the physics of the circulation are so well known, expressed himself decisively against the possibility of any suction power being exerted in the mode and direction indicated by M. GUÉRIN.

It appears to us that the act of inspiration, so far from leading to an ascent of the fluids contained in the uterus and Fallopian tubes, would have an opposite effect, since it is produced by the descent of the diaphragm, which must occasion increased pressure on the abdominal organs, as is indicated by the protrusion of the abdominal walls. Again, some influence must surely be attributed to the ciliated epithelium lining the Fallopian tubes, the action of which is well known to be downwards. The reasoning of M. GUÉRIN, therefore, in respect to the mode of origin of this disease, though ingenious, is not quite satisfactory; and whilst the treatment he has suggested deserves further trial, its success can scarcely be explained on the theory he has proposed.

ever, carry the question still further. The medical appointments hitherto made in connexion with the Poor Law have been so unfortunate, that they might almost as well have been legal. A scientific chemist on the one hand, a consulting physician and journalist on the other, must surely have been selected because in them all the special experience which would qualify general practitioners for their offices was conspicuous by its absence. In their hands the profession has been like Paddy, when he was conveyed from place to place in the sedan that had no seat and no bottom. But for the name of the thing, he might as well have walked. We have had the name of a medical element at the Poor-law Board; and we have not only walked, but walked in the mire. We want a medical element that shall be a reality, affording practical knowledge and matured experience of the matters actually at issue. We want men who have lived and laboured among the poor, who have been parish doctors, who understand alike the guardian, the ratepayer, and the pauper, and who know by heart the various social strata with which they would have to deal. Such men could be found in any number amongst the ranks of general practitioners; and it is to general practitioners, and, for provincial districts, to country practitioners, that the Government must look for good and efficient servants-men who will know their business, instead of having to learn it by their blunders. We hear that no decision has as yet been formed at the Poor-law Board upon this question; but we hope that the force of public opinion will render any long hesitation impossible; and we call upon the profession to aid in forming that opinion, and in guiding its action and its demands.

I KILLING NO MURDER.”

THE daily papers have lately contained an account of a case which forcibly illustrates the want of medical supervision of police cells. It appears from the evidence adduced at the inquest, that a woman named Hannah Saunders, aged fifty-five years, and the wife of a cab proprietor, had become much disturbed in mind by some domestic trouble; and that on Saturday night she endeavoured to drown herself in the Regent's Canal. A policeman heard the splash, and, running to the spot, he saw a woman in the water. He managed to draw her out alive, and had her carried to a public-house near. There all her clothing was stripped from her, with the exception of her chemise; that, wet like the rest, was left upon her. A surgeon was called, and when he had pronounced that she might be moved, she was placed on a stretcher, and would have been carried to the police-station without any covering except the chemise, if it had not been for a fruiterer near, whose sense of decency prompted him to throw a sack over her. She was then taken to the station, and placed in the cell in which drunken cases are placed at night. She lay there twenty-four hours, and then died. Attempts were made by her husband to bail her out, and also to obtain a bed for her in the cell; but neither could be done. The police surgeon, who was called in after death, said that he had made a post-mortem examination, and had found that the poor woman had suffered from disease of the heart and liver; the lungs were inflated and distended with water; and that the immediate cause of death was the shock following sudden immersion in the canal. Great care ought to have been taken to prevent a fatal result. Attention and warmth were absolutely necessary; and he did not think the police cell was quite a fit place for the woman to be put into. She ought to have been removed to an hospital; and if he (the surgeon) had been called earlier, he should have ordered her removal.

The Times from Dr. Painter, formerly surgeon to the police at Bow-street, urging that nothing should be left to the discretion of the police in cases of illness or of supposed drunkenness, but that medical aid should always be obtained in order to decide what should be done. Dr. Painter bears testimony to the generally sound discretion exercised by police inspectors, and rests his counsel upon the obvious impropriety of requiring any class of men to determine questions with regard to which they have had no special training. We do not doubt that his favourable testimony is, as a rule, well merited; but we cannot forget that cases of death in police cells every now and then occur, and that to mistake apoplexy for intoxication is by no means uncommon. In this particular case it seems difficult to exaggerate the impropriety of the course that was pursued. The expression of the surgeon, that the police cell was not "quite" the place in which the deceased should have been suffered to remain, seems to us also to call for the most unqualified condemnation; and it is indeed difficult to speak of any part of the subject without using somewhat unparliamentary language. The poor half-crazed old creature, throwing herself into the water in the frenzy of her troubled brain, dragged out again and stripped in the public-house, carried almost naked to the police cell, left there on a bare bench, with only her wet chemise, with no bedding, and, as far as it appears, no food, to linger through the long night and over the Sunday, and then to die of shock and cold and exposure, in the very hands of the officers of the law, and within the hearing of church bells in a Christian country, presents a picture altogether so hideous that we hope it may be long before we are called upon to chronicle such another. If such neglect as that by which this poor woman was suffered to die is not criminal, it is high time that the law should make it so. There could be but two reasons why the divisional surgeon was not summoned during life: one, the trouble of fetching him; the other, the amount of his fee. It is not too much to ask that the life of a wife and a mother should be counted as of greater value than the wear of a policeman's boots or the cost of a doctor's visit. It is said that the police force will shortly be to a great extent reorganised, and we cordially join with Dr. Painter in his demand that this reorganisation should relieve well-meaning constables from medical responsibilities, and should secure the sufferer from apoplexy, or lunacy, or poisoning, against being confounded with and treated as the common criminal or drunkard.

After a long consultation, the jury returned a verdict to the effect that death had resulted from the shock consequent upon the deceased plunging into the water whilst she was in an unsound state of mind; and they censured the police for not having in the first instance sent for the divisional surgeon, and for having left the woman in a cell through the night, instead of taking her to an hospital or to a workhouse infirmary. But the censure of a coroner's jury goes for very little; and in these cases we require intelligent prevention, instead of tardy and unavailing regret.

HAIR RESTORERS.

THE LANCET,]

its original colour in almost less than no time. Has the scalp become denuded for years of its chief ornament?another set offers to clothe it afresh with rich and luxuriant tresses. Is the hair lank and straight and lustreless ?a third class of hair restorers advertises a variety of nostrums for rendering it curly, glossy, "beautiful for ever." The fact that the majority of hair dyes and washes are made up of constituents which not only injure the hair, but are capable, if absorbed, of seriously affecting the health, is pretty widely known; and denunciations of these hair preparations have from time to time appeared in the public press. These denunciations, however, have been for the most part too vague and general to effect much real good. The advertisements go on much as they did before, and the public still continue to be purchasers. In the case of the adulteration of articles of food and drink we found that merely general statements produced little result, but that when the vendor or manufacturer was made personally responsible the deterring effects were rapid and marvellous; and the same remark is equally applicable to the present subject. One of the best known and most extensively advertised preparations for the hair is Mrs. S. A. Allen's World's Hair Restorer. On the label it is affirmed that it is the "best" of all hair restorers; and the reasons given for its being the best are "Because it contains no nitrate of silver, nor any other injurious ingredient. Because it does not dye the hair, but acts directly on the roots, giving them natural nourishment. It contains the specific aliment which is the life of the hair, and in this way the natural colour is restored."

We will now put these statements to the test by reference to the actual composition of the article. We find, then, that it is composed of acetate of lead, sulphur, and glycerine. Now lead, while it is one of the most frequent constituents of hair dyes, is also one of the most if not the most injurious. It will thus be seen how utterly worthless are the statements above quoted, and that the assertion as to the preparation containing "the specific aliment which is the life of the hair" is a mere fiction.

The detection of lead in a hair dye or wash is very simple, and may be readily effected by adding a few drops of a solution of iodide of potassium to a small quantity of the dye, when, if a soluble salt of the metal be present, it will be revealed by the curdy yellow precipitate immediately produced.

OPIUM IN DIABETES.

THERE is nothing novel in the use of opium in diabetes, but there is something new in the mode and results of its exhibition as portrayed by a case which Dr. Pavy brought before the notice of the Clinical Society at its last meeting. The instance was that of a female, aged sixty-eight, who was apparently cured by the narcotic, without restriction as to food. The patient was placed in May upon the ordinary middle diet of the hospital, which included an allowance of bread, potatoes, and beer. She was also ordered four ounces of brandy, and two bottles of sodawater per diem; and this mode of living was continued as long as she remained in the hospital. The opium given was in the form of a pill, three times a day, and the dose was gradually increased. At the outset the quantity of urine was 100 oz., the specific gravity 1040, the quantity of sugar per oz. 32 grains, and the amount of sugar for the twentyfour hours, 3275 grains. Within three weeks the quantity of opium administered was raised to ten grains and a half per diem. It was then suddenly discontinued on account of a greater degree of drowsiness than was desirable being produced; but in a few days it was recommenced, and this time, being more gradually increased, was borne without

[JAN. 9, 1869. 57 producing any sign of disturbance. The sugar disappeared on July 31st, and remained absent as long as she continued in the hospital,—namely, until October 28th. At the time the sugar disappeared, the patient was taking nine grains of opium per diem. It was afterwards still further increased to twelve grains, and then gradually diminished until October 17th, when all was taken off, the patient during the remaining time taking no medicine, and passing no sugar. Dr. Pavy brought some urine, freshly passed, to the Society, and this, upon being tested with the cupropotassic solution, was seen to be free from sugar. Dr. Pavy thought there was still much to be learnt about the extent of the power of opium in different cases. His belief was, from the case which formed the basis of his communication, and other experience that he had had, that it would be found sufficient of itself in many instances, amongst elderly subjects, where the disease was observed to assume its mildest form, to check the elimination of sugar. In young and middle-aged subjects, however, where the disease as a rule assumed a much more severe character, his experience was that, to obtain a similar effect, the restricted diet must be conjoined. The success of the treatment is interesting, and we have thought it deserving of special notice.

THE STRAND DEAD-HOUSE."

THE letter of Dr. Burney Yeo in The Times of Saturday last, referring to the disgraceful manner in which the authorities of St. Mary-le-Strand dispose of the bodies of persons dying suddenly within that parish, will not, we trust, be allowed to pass from public recollection until some steps are taken to remedy a state of things against which every feeling of humanity and decency recoils indignantly. A gentleman who had spent more than thirty out of the sixty-two years of his life in the public service died suddenly of heart disease last week in his room at the Audit Office, Somerset House. Contrary to the suggestion of Dr. Yeo (who was summoned from King's College), that the body should be deposited in some convenient room in the office to await the coroner's order for a post-mortem examination, the Audit-office authorities, having apparently no care for anything but getting rid of what could be of no further use to them, required the parish officials to remove the body, which was, as Dr. Yeo states, "carried down several flights of stairs, out of the office, out of Somerset House, and thrown into the engine-house at the back of St. Mary's Church in the Strand." In this place, described with perfect truth as a mere shed which would afford indifferent accommodation for a pig, Dr. Yeo had to make the post-mortem examination, the only light available being from a sort of trap-door communicating with the churchyard or from the open door giving exit directly on the traffic of the crowded Strand. So straitened was Dr. Yeo for room in executing his task, that he was literally obliged to put the heart, lungs, &c., as he removed them from the body, through the trap-door on to the pavement of the churchyard, where they were in full view of passing drivers, as well as of inquisitive urchins, whose climbing propensities were stimulated by the knowledge that something was going on in the shed. Facts such as these shame our boasted humanity and civilisation, and warrant us in holding up to public execration both the callous officialism which could treat the remains of an old and respected public servant like those of a dog, and the parochial obstinacy which ignores the obvious intention of the Legislature (albeit expressed in permissive language only) that proper places for the reception of dead bodies awaiting post-mortem examination should be provided by local authorities wherever necessary. Are the rooms at the Audit Office so fully occu