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on the occasion of this meeting, especially as supporters ofvaccination had been directly challenged to reply to thecriticisms on the city’s sanitation, which had been so freelymade. Accordingly, by handbills and pasters, the truefacts as to vaccination and the refutation of the state-ments of its opponents induced some to attend the meetingwho had no sympathy with its objects. Dr. Bond, theenergetic secretary of the Jenner Society, who had beenspecially challenged, appeared on the platform and obtaineda brief hearing whilst he proceeded to demolish the pre-tensions of Dr. Hadwen to speak of the sanitation of a cityin which he was so recent a resident. Another gentlemanwho essayed to defend Gloucester from the imputations castupon it was I I chucked out," only to re-appear, and aftermost disorderly scenes to obtain a brief hearing. But the

proceedings were not suffered to continue, and disorder

reigned supreme, so that the eloquence of Mr. Milnes waslost and the words of wisdom of Dr. Creighton were wasted.We commiserate these two gentlemen on their unfortunateexperience, but we cannot say that we are at all surprised atthe fiasco, which, indeed, was directly provoked by theattitude assumed throughout by the promoters of anti-vaccination in all their references to Gloucester.

THE UNREPORTED DEATH OF A SHIP-SURGEONAT SEA.

MR. S. MASON writes a letter to Fairr-play which tellsa remarkable story of the death of his friend, Dr. W. H.Brendon, on board the steamship "moM. The ship arrivedin London on March 31st, and as Dr. Brendon’s friendsreceived no news from him or information about him theybecame uneasy, and Mr. Mason was asked to inquire for themissing medical man on April 6th. It so happened that thecaptain of the ship was in the office, and on being asked if hetxaid iMtd Dr. Brendon on board he replied "Yes." On beingasked if he was still on board he replied that he was dead,that he had died on March 17th from dysentery, and wasburied at sea on the 18th. On being asked why he or theshipping firm had not communicated the sad fact, he repliedthat they did not wish to alarm the family, and felt sure thatsome of the family would be making inquiries. An equallyshaky basis of excuse was put forward on the ground of nothaving the address ; but Mr. Mason shows by letters to Dr.Brendon that they had knowledge of his address. A brotherhad written to the firm to inquire. He was told that the shiphad arrived, but no hint was given of the death of his brother.Such consideration for the feelings of a family is most

peculiar, and is more honoured in the breach than in theobservance. The facts would appear almost incredible if

they were not vouched for in a published letter. Wecannot imagine that such conduct is common among ship-owners, but we give publicity to these statements so thatthey may, if possible, be contradicted, and, if not, that

they may remain as a unique instance of how not to dealwith news so sad respecting the medical officer or, indeed,the humblest passenger or member of the crew of any ship.

CASTRATION AND VASECTOMY IN HYPERTROPHYOF THE PROSTATE.

DR. J. W. WHITE, who introduced the operation of

castration for hypertrophied prostate, in a lecture recentlydelivered states that as oophorectomy was much abused afew years ago, so is this operation now,’ and that a similarresult in the treatment of appendicitis is threatened. He

never encouraged the idea that his operation was a universalpanacea. If the patient is not very old, retains his sexualpower, has sound kidneys, and only a moderate amount ofresidual urine, the operation is out of the question and only

1 University Medical Magazine, April, 1897.

catheterism is required. If pain is marked and resists smalldoses of bromide, belladonna, phenacetin, &c., that may bean indication for operation. In such cases vasectomy shouldbe selected. If the residual urine reaches twelve ouncesand if it does not diminish under catheterism, the dangersfrom backward pressure on the kidneys, increasing atony ofthe bladder, and cystitis are so great that vasectomy is

again indicated. In patients with larger prostates, witheight or ten ounces of foetid or muco-purulent urine, withfrequent micturition, and pain on the introduction of the

catheter, some operation-vasectomy, castration, or prostat-ectomy-is indicated. The younger the patient, the greaterthe sexual power, the sounder the kidneys, and the betterthe general health, the more the surgeon should inclinetowards prostatectomy. If the patient is somewhat older andthe sexual power is becoming enfeebled vasectomy is to bechosen. Still greater age, with marked renal disease orgreat failure of health, indicates the same operation. If,however, with the greater age and distinctly lessened sexualpower the renal and general conditions are good, castrationpromises the most benefit with the least mortality. In the

worst cases, in which the prostate is enormous, the cystitisexcessive, the bladder dilated and atonied, the retention

absolute, the kidneys inefficient, and catheterism difficultand occasionally impossible, any operation involves risk. Butthis must be taken. Castration in these cases is the best pro-cedure. It will occasionally fail, but often the improve-ment is marvellous.

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A MIDWIFE CAUTIONED.

AN inquest was held at Littlehampton on Friday, the23rd ult., by Mr. F. W. Butler on the body of Clara Dearing,aged thirty-five years, who had died on the morning ofthat day. She had been confined of a dead child on the

preceding Wednesday. The patient had engaged a

midwife to attend her in her confinement. According tothe husband’s evidence the deceased was well up to the

Tuesday evening. It appears that the midwife had seen thedeceased on the Saturday and also on the Tuesday beforethe confinement. Labour apparently began early on theWednesday morning; the midwife attended as soon as shewas summoned, and it seems that when she saw the caseshe advised that a medical practitioner should be sent

for. Mr. Lapthorn attended and gave chloroform, and thepatient was delivered of a dead child. In his evidence hesaid there was a great deal of hemorrhage, but it is not clearwhether this occurred before or after delivery. The patientdied early on the Friday morning. Mr. Lapthorn made apost-mortem examination, and as a result of it gave it as hisopinion that if medical assistance had been obtained on theFriday or Sunday previously to the confinement the patientwould have been saved. The jury found a verdict in accord-ance with the medical evidence, and suggested that the mid-wife should be cautioned as t3 her attendance on such casesin future. Our readers will see that the information givenas to the facts of the case is not sufficient for us to form anyopinion as to its real nature. Perhaps Mr. Lapthorn will tell

us more about it, and especially what the reason was whymedical assistance should have been summoned earlier.

EGYPTIAN PRISONS IN 1896.

MANY references have from time to time been made in ourcolumns to the important reforms introduced into the

Egyptian prison system since Crookshank Pasha became

Inspector-General of Prisons in 1883, and the circumstancethat his retirement from that important position has beenannounced gives additional interest to his official report forthe year 1896. During that year the work of the depart-ment was carried on under unusual difficulties, owing,firstly, to all grants for the improvement of existing

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prisons or the building of new ones being withdrawn

early in the year on account of the Dongola expedi-tion ; secondly, to the want of sufficient accommodation forthe continually increasing number of prisoners ; and, finally,to the outbreak of cholera during the hottest summer monthsin seventeen overcrowded central gaols. There was a total

of 7954 male prisoners confined in twenty-five principalgaols, seventeen of which were invaded by cholera, whileeight remained exempt, and among this large number ofpersons there were only 116 cases of cholera, with 70deaths. Not a single case of the disease occurred among thefemale prisoners, and the Inspector is of opinion that this isdue to the fact that they are fed by the department, whereasat all but two of the prisons for males the prisoners’’food is supplied by their friends and relatives. Whenever

.cholera broke out in a prison relatives were strictlyforbidden either to visit or to bring in food and

clothing for a period varying from one to two months,according to the existence of cholera in the neighbour-hood, and invariably the disease was stamped out

of the prison in a few days. During 1896 there were over47,000 unconvicted and convicted male prisoners admittedinto the central gaols, and during the same period 36,000were discharged. Female prisoners were very much less ’,numerous than male prisoners.

MEDICAL MISSIONS IN CHINA.

ALTHOUGH the unwillingness of the Chinese to receive

instruction from foreign residents only too often shows itselfin outbreaks of murderous violence, it is gratifying to findthat the work of the Medical Missionary Association appearsto be making progress in some of the towns. At the annual

meeting of the Association in Exeter Hall, on May 3rd,Mrs. Bishop, who had been three years in the Far East,stated that at Mukden, the capital of Manchuria and politi-cally the second city of China, the Emperor’s uncle andanother mandarin caused it to be publicly proclaimed thatthey had received medical treatment at the United Presby-terian Hospital, an example of aristocratic preference forforeign over native methods which is likely to be bene-ficial all round. Mrs. Bishop seems not to have been

altogether favourably impressed with the sanitary con-dition of some of the mission hospitals she visited in

China, but allowance must be made for the greatdivergence between Eastern and Western opinion in

regard to such matters and also for the danger that patientsmight be estranged or scared away by too abrupt a departurefrom their accustomed habits. Even in Bombay, where formore than a hundred years the British Government,possessed of absolute power, has had as free a hand as it ispossible to have in dealing with Asiatics, the reports of our-correspondents show that public sanitation is still in a

rudimentary stage. --

DUNLOP TYRES AND PRACTITIONERS’CARRIAGES

OF the comfort of the Dunlop tyre as applied to an

- ordinary carriage there can be no doubt, and the chief.question therefore for those who are anxious to use them is- as to whether they will wear. Of course, they require carein using and are somewhat expensive in the first instance,but against these items on the debit side must be set variouspoints to their credit. We have recently received two veryopposite accounts of the lasting powers of these tyres,which we here lay before our readers. The first is the

experience of a practitioner in Sheffield. He allows that,having procured a set of the tyres in question, he found an.enormous increase of comfort from the absence of vibrationand jolting, and in addition that the body of his carriage, a.light coupe brougham, was saved a proportionate amount of J

wear. But, on the other hand, he found that they fre-

quently burst and, although mended, soon gave way again;that they threw up a quantity of mud, which injuredthe paint of the carriage ; and that the brakes,though efficient, soon wore out. The other experience comesfrom a medical officer of health in a hilly part of Wales. He

had the pneumatic tyres fitted to an ambulance brougham,which in eight months travelled over 750 miles of hilly,rough ground without a puncture and with extreme comfortto the sick transported thereby. The brake blocks wore outin seven and a half months, but the tyres themselves werebut little worn by the brakes, although much cut by theroads. This latter seems a pretty severe test, and we areunable to account for the disastrous experiences of theSheffield practitioner except by assuming that he got a faultytyre, for even with the greatest care anything manufacturedsometimes fails, or else that the tyres were not properlyinflated before use and so got nipped between the road andthe wheel. The increase of comfort is so great that thoughit may not be worth while for a medical man to run the riskof having his carriage laid up for long spaces of time, ashappened to one who tried the tyres, yet in the light ofthe Welsh experience they would seem to be quite worth atrial.

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HERNIA OF THE BLADDER.

ALTHOUGH hernia of the bladder was recognised as longago as 1520, when it was met with by Verdier, yet it hasbeen satisfactorily described only within the last few years.In 1895 fifty-eight cases were collected by Curtis, and inMarch of this year Dr. Gibson published in the NewYork -Ifedical Record a valuable paper on the subject, con-taining particulars of forty-five additional cases. From this

paper we gather that nearly 25 per cent. of these herniaswere of the femoral variety, and that in more than half of thecases the patients were over fifty years of age. The herniatedviscus is often not recognised until it has been opened, andin such cases the mortality is high, for even after deductingthose deaths which could not be attributed to the wound ofthe bladder a fatal result followed in 12t per cent. It is

very probable that the condition is by no means so rare as itis usually thought to be. Dr. Gibson also points out theimportance of recognising that traction on the sac of a

hernia may draw the bladder into the hernial orifice, and soexpose it to the risk of being wounded in an operation.

CHLOROFORM ADMINISTRATION IN WARSAW.

ACCORDING to a paper published in a Russian sur-

gical journal by Dr. Soloveischik chloroform has been

administered in 500 cases in Professor Tauber’s clinicin Warsaw by Junker’s inhaler-Krohne and Sesemann’s

pattern-with very satisfactory results, these being arrangedin somewhat elaborate tabular form. Complete insensibilitywas obtained in male patients in 12’ minutes, and in femalesin 97 minutes, taking the average of all the cases. Infour females the time required was less than five minutes.In thirty females and ten males five minutes was sufficient.No female required more than twenty-five minutes, but threemales required half an hour and one forty minutes. Themaximum quantity used to obtain complete anaesthesia was5 drachms for males and 32 drachms for females. They wereall adults with the exception of seven boys and eleven girlsunder fifteen years of age. The average quantity of chloroformused in producing complete anaesthesia was for males 2’24drachms, and for females 1’64 drachms, calculating thefluid drachm as marked on the bottle as equal to

5-3 grammes, instead of Dr. Soloveischik’s figure, which is

evidently based on the assumption that the marked drachmsare equivalent to Russian drachms by weight. The mean

quantity used per minute during complete ansesthesia.