1885

which they keep their food are very strict." " He had foundalso that in Hungary the infantile mortality was lowest

among the Jews. These remarks were followed a dayor two after by an interesting article in the Manchester(}1lardian by "A Jewess." She speaks of it as a fact

brought out by several investigations that Jewish childrenare superior to non-Jewish children in stamina and phy-sique and would with Dr. Rhodes attribute it primarilyto the fact that Jewish mothers do not go to the factoryto work. It is considered a disgrace for a man to let"the mother of his children go to the factory, workingabove her strength and depriving the children even beforebirth and after it of that care which is their right."She is surprised, however, that Dr. Rhodes should considerthat the Jewish mothers keep the vessels from which theinfant is fed cleaner than their neighbours’. Her experiencehas not led her to look for great cleanliness among the

poorer Jews, many of whom come from the ghettos ofRussia and Poland. Most certainly the appearance of thelower class Jews to be seen in Strangeways and the neigh-bouring streets would indicate that cleanliness was not

considered a virtue. But she says that they give theirchildren good milk and she considers that the Jewish dietmakes for health. All forms of pig’s flesh, all shell-fish, andall tinned meats are excluded " because they have not

been killed and examined in accordance with the law."All game, too, is forbidden. Beef, mutton, poultry, andmost kinds of fish are allowed if fresh and free from

disease, and care is taken that such meats only are offeredin the shops where Jews purchase. There is also verylittle alcoholic excess. Few Jews are teetotalers but as a

rule they only take wine, beer, or spirits on festive occasionsand practically there is no excess. No doubt somethingmay be learned from the aliens who are rapidly transferringthe ghettos of Russia and Poland to certain quarters of ourlarge towns.

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COLLATERAL PARALYSIS IN CEREBRALLESIONS.

IN the Scottish 1’tledicccl and Surgical Journal for NovemberMr. J. H. Pringle has published a valuable paper on

"collateral paralysis" in lesions of the brain. The termcollateral is. applied to rare cases of paralysis in which thecerebral lesion is apparently on the same side. The conditionis of great importance to the operating surgeon. Mr. Pringlerelates the following case. A man, aged 58 years, was takento hospital in a comatose condition. He went to work as usualat 5 A.M. on that morning but after one and a half hours hereturned home in a tramcar because he did not feel well. On

arrival he had a dazed look and soon became unconscious.On admission respiration was slow and stertorous with puffingof the cheeks. The arteries were very atheromatous. The

right limbs were very rigid, but the left were not. On beingpinched he moved the left limbs but never the right.The right pupil was small and its reaction was

doubtful. The left eyeball was shrunken from an old

injury. Mr. Pringle diagnosed cerebral hasmorrhage onthe left side. The patient never recovered consciousnessand died on the following day. No history of any injurycould be obtained. The necropsy showed a fissured fractureof the skull which commenced anterior to the right parietaleminence and ran downwards and forwards, dividing into

two limbs of which one ended in the middle fossa at the

sphenoidal fissure and the other in the orbital roof. In the

brain the only lesion found was an extensive laceration ofthe right frontal and temporo-sphenoidal lobes with a largeeffusion of blood in the right middle and anterior fosssewhich extended upwards over the right hemisphere. Exa-

mination of the medulla did not show any abnormalityof decussation. Mr. Mansell Moullin has recorded the case

of a stevedore, aged 43 years, who received a blow on the

right side of the head. He continued working for threehours and then became comatose. He was admitted to the

London Hospital with right hemiplegia. The coma became

deeper on the eighth day and he was trephined on the leftside without any lesion being found. He died on the

following day. The necropsy showed a subarachnoidclot covering the. right hemisphere and no other lesion.lProfessor Ledderhose has published an important paperon collateral paralysis 2 of which he collected 42 cases.

25 were due to spontaneous haemorrhage, six to abscess,eight to tumours, and three to recent traumatic hoemor-

rhage. In a case of injury of the head under his own

care with complete right hemiplegia he trephined onthe left side but found nothing abnormal. Deathoccurred 24 hours later and the necropsy showed a

large subdural clot on the right side. In a case

related by Dr. Lauenstein of Hamburg there was left

hemiplegia after a fall. Trephining was performed on theright side with negative result. The patient died and thenecropsy showed on the left side an extradural clot measur-

ing eight by eleven by one and a half centimetres. The

explanation of such cases is difficult. Morgagni suggestedthat they might be due to absence of the usual decussation ofthe pyramidal tracts and some support to this view has beengiven by Fleschig who showed that the number of fibreswhich decussate is very variable, but according to SirWilliam Gowers "there ’is strong reason to believe thatwhere the paths do not decussate in the medulla theycross lower down in the spinal cord." In the dis-cussion which followed the reading of the description ofthe only other case in which the haemorrhage was extra-

dural,3 Cruveilhier suggested that blood effused on one

side of the brain might cause so much pressure on the

opposite hemisphere against the skull as to produce para-lysis. But, as Mr. Pringle remarks, no doubt paralysismight be so produced but probably both hemispheres wouldsuffer and the paralysis would be bilateral, not collateral.Professor Ledderhose refers to the experiments of Goltz ondogs, which show that, while all the muscles of the bodyare represented in each hemisphere, the paths to the

muscles of the opposite side are easier than those to the

muscles on the same side and suggests that in some personsthe motor path on the same side may be easier than theone on the opposite side, so that a cerebral lesion would

produce collateral paralysis. Whatever be the explanationthe patient generally dies unless the effused blood is

removed by operation. Mr. Pringle therefore thinks thatif, on trephining the side indicated by the paralysis thesurgeon finds no lesion to account for the hemiplegia, heshould explore the opposite side of the brain.

WE regret to announce the death, which occurred onDec. 23rd, of Dr. Francis Henry Blaxall, formerly a fleet-surgeon in the navy and for many years a medical inspectorof the Local Government Board.

1 THE LANCET, Nov. 18th, 1893, p. 1251.2 Archiv für Klinische Chirurgie, vol. ii., p. 316.

3 Bauchet: Bulletins de la Société Anatomique de Paris, 1852, p. 452.

THE GERMAN MEDICAL MISSION AT URFA INASIA MINOR.-Dr. Andreas Vischer, assistant in the surgicalclinic of the University of Basle, will go out to Urfa asmedical missionary in charge of the hospital there.DONATIONS AND BECuESTS. - Mr. Herbert

William Allingham, F.R.C.S. Eng., by his will bequeathed;E2000 or the residue of his estate, if less than that sum, toSt. George’s Hospital, to found a surgical scholarship to benamed the "Herbert Allingham Surgical Scholarship," thesum to be invested separately, in permanent funds, and10 guineas out of the income are to be paid to the examinerfor the scholarship annually and the residue of the incomein such way as the governors of the hospital may direct.