contributed by Dr. J. Niven to the Medical News for February, after numerous experiments it was found that no method tried was so successful as rubbing the walls with bread, it being found that the germs adhered to the bread so firmly that, on cultivating them, they were found to grow from it, and did not become readily detached. Disinfecting by means of the spray, washing with carbolic acid solution or solution of corrosive sublimate gave nothing like so good a result. The plan of stripping paper from walls is shown to be very bad, as it only throws the germs about far and wide. Diphtheria Spread by Cats.-In a report on the recent sustained prevalence of diphtheria in Enfield, Dr. Bruce Low, of the Medical Department of the Local Government Board, incidentally states that during the continuance of the epidemic cats were found to suffer in considerable numbers from illness. Though there were no known cases of diphtheria occurring in the practice of the veterinary surgeons at Enfield, yet they found many cases of influenza at this time among animals. The following is an illustration of the possible connection between diphtheria in children and in cats. A cat was seen to lick the vomit on the floor from a boy who was ill with what turned out ultimately to be fatal diphtheria. In a few days the animal was noticed to be ill. During the early part of its illness the cat was let out into the back yard as usual. A few days later the cat of a neighbour was noticed to be ill. This second animal was the pet and play-fellow of four little girls, who nursed it with great care. They all developed diphtheria, their mother being convinced they caught it from the cat; and indeed no other known source of contact with infection could be discovered. This subject has also been brought forward in an official report, also made to the Local Government Board by Dr. George Turner. In January, 1886, Dr. Turner was called to investigate an epidemic of diphtheria at Brent Pelham, Herts. He found that in the cottage in which the first cases occurred a kitten had previously suffered from a throat affection, which was attended by swelling of the neck, foul discharge from the nostrils, and running at the eyes. Other cats at Brent Pelham were found to have suffered in a like way. Similar disease was noticed amongst the cats at Aldershot, in Hants, at Farnham and Yateley, and at Petersfield in Sussex. In the latter town the evidence was very clear, not that the animal had communicated the disease to certain children, but that it had been infected by them. At Moulton, Suffolk, some children were ill of diphtheria, and were, by the direction of the medical man, confined to the upper rooms of their cottage, that the other inmates might escape. No food which had been offered to the sick children was set before the others, the mother always giving it to the cat. The animal subsequently suffered from diphtheritic symptoms. Disinfection of Books in the Sheffield Free Library.—It appears that a new disinfecting apparatus is now in full operation at the Central Free Library in Sheffield. In this invention the best disinfectant known is employed in combination with heat at such a temperature as not to damage the books. The principle upon which the disinfection is based is the vaporisation of carbolic acid by heat-the carbolic acid being thus made more potent and active. The heat used is 150 to 200 degrees Fahrenheit, and the books are subjected to this in conjunction with carbolic fumes for a quarter of an hour. The books have, upon examination by experts, been declared to be uninjured in any way. The books are sweet, look clean, and are said to be in every way improved. Diphtheria.-This disease appears to be on the increase in many parts of the country. In London, last year, the deaths from this cause were 180 in excess of the decennial average, while in each of the last six years the mortality from this cause has been higher than in any year since 1864. At the last meeting of the Managers of the Metropolitan Asylums District the question whether the Board Hospitals should not be available for diphtheria cases was again brought forward. The Medical Wisdom of a Local Board.-The Local Board of Gorton have requested their Medical Officer of Health to exclude from his calculations of deaths from zymotic diseases those caused by measles, whooping cough and croup. The Pan System in Birmingham.-The Health Committee of this Borough have decided not to further extend this system, but, where practicable, to replace the old fashioned privies by waterclosets. Three hundred and seventy-three closets on the plan recommended by Dr. Hill in his annual report for 1886 were introduced during 1887. The Closure of Polluted Wells.-During the past half-year, a case has occurred in Birmingham, where the Magistrates refused to order the closure of a polluted well, because the Public Analyst was unable to say that the water was injurious to the health of the people using it. He stated that it was undoubtedly dangerous and might become injurious at any moment. The question of injury to health is not a matter of opinion, but one of fact, and can only be effectively proved by medical evidence after disease has supervened, so that if the reading of the Act by the Birmingham bench be correct, in future, it will be impossible to prevent the use of sewage polluted water unless ill-health has previously been produced by it. It is satisfactory to note that the matter has been taken up by the Societies of Medical Officers of Health and Public Analysts, with the view of altering (if necessary) the word injurious to dangerous, the meaning evidently intended. Local News. LOCAL COMMISSION.-The London Gazette contains the following:-1st Worcester Volunteer Artillery, Lieutenant J. T. Thomas to be Surgeon; 1st Vol. Bat. Royal Warwickshire Regt., Jordan Lloyd, F.R.C.S., to be Acting Surgeon. SURGEON-GENERAL SIR WILLIAM MOORE, K.C.I.E., who appears in the London Gazette of the 14th inst. as having been appointed Honorary Physician to the Queen, is a son of the late Mr. Edward Moore, J.P., of Halesowen. Sir William Moore was a student at Queen's College in this town, and some years Resident Surgeon at Queen's Hospital, afterwards joining the Indian Army, in which he remained many years. For his services in the East, besides the above distinction, he has also received the honour of knighthood in the Order of the Indian Empire. Mr. MR. BASIL W. HOUSMAN, M. R.C.S., L.R.C.P., has been appointed House Physician to the Queen's Hospital. Housman obtained the Sands Cox prize at Queen's College. THE first examination for the prize in memory of the late Dr. Russell, Senior Physician of the General Hospital, was held on July 21st, at Queen's College. The subject of the examination was "Nervous Diseases," and Dr. Wade acted as examiner. THE first examination for the prize in Pathology given by the Staff of the General Hospital resulted in Messrs. Crump and Sadler being adjudged of equal merit. Prof. Barling and Dr. Crooke were the examiners. New Books, etc., Received. Catalogue of Lewis's Medical and Scientific Library. summer, 1887. London: Lewis. 1888. Revised to Mid Diseases of the Skin. By H. RADCLIFFE CROCKER, M.D. Lond. With 76 Illustrations. London: Lewis. 1888. Nitrous Oxide Anæsthesia. By J. F. W. SILK, M.D. London: Churchills. 1888. A Dialogue against the Fever Pestilence. By WILLIAM BULLEIN. From THE BIRMINGHAM MEDICAL REVIEW. OCTOBER, 1888. ORIGINAL COMMUNICATIONS. PRACTICAL OBSERVATIONS ON CHRONIC HEART DISEASE.* BY ALFRED H. CARTER, M.D. LOND., M.R.C.P., ENORMOUS advance has been made in recent years in our knowledge of the physiology and pathology of the heart; though we are still a long way off finality. There is however far too much routine and rule-of-thumb with regard to the management of cardiac disease. With too many there are but three resources—rest, heart-tonics, and stimulants; and when these fail—well, so much the worse for the patient. And even amongst those who proceed on more thoughtful and enlightened lines, there is a disposition to take too narrow a view of such cases, and thus to lose sight of certain broad relations, the appreciation of which is very necessary to intelligent manage ment. The narrowness of which I complain is, I think, partly due to the disproportionate attention which is devoted in our medical schools to physical examination and minute stethoscopic analysis. of cardiac sounds to the exclusion of important associated clinical features. Thus a student is apt to think that a diagnosis of a case of valvular disease has been completed when a definite * Based upon a clinical lecture delivered at the Queen's Hospital, Feb. 1888. K |