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and the Friendly Societies’ Medical Association. On theother hand, these commercial insurance companies entirelyignore medical ethics. They canvass in all directions,pointing out the advantages of life’ insurance combinedwith medical insurance, praise their own medical menand abuse the other members of the profession. Of course,they have no notion of establishing a wage limit; and,on the contrary, prefer that their members should bewell off as they are more secure in the receipt of thesubscriptions. If one of their medical officers, being dis-satisfied with this state of things, proposes to resign, thecompany will threaten to bring down a new practitioner tocompete against him in his own district. There is also the

Croydon and Surrey Insurance Company at Tunbridge Wells.This is very similar to the Liverpool Victoria Legal Com-pany, but has not so many members.

Fortunately the members of the profession are commencingto make a stand against these abuses. The two consultantswho were formerly attached to the Friendly Societies’Medical Association have resigned; and the questionarises whether all the profession should not boycott thisassociation and refuse to consult with its medical officer.Then, again, one of the local practitioners who had avery large number of members of the Liverpool VictoriaLegal Company on his list has given them all up. This isthe more remarkable as he had absolutely no complaint tomake. He was paid punctually and he thought the terms ofpayment were on the whole fair. The greater part of hispatients were exceedingly poor and it was a charity to helpthem. When, however, he discovered that any of his

patients could afford to pay he struck them off his list andthe Liverpool Victoria Legal Company did not object to this.But though he was thus able on various occasions to preventabuse he could not prevent the canvassing. Several medicalmen in the town wrote to him saying that their patients hadbeen canvassed by the agents of the company whicc

employed him as their medical officer. He found also thaihis own private patients had likewise been canvassed ancthat patients who used to pay him the usual fees now proposed to give him only ld. a week through the intermediarof the Liverpool Victoria Legal Company. At the same timlhe had read several articles on the " Battle of the Clubs’in THE LANCET and these helped to convince him tha

though personally he had no complaint to make, still th

system was bad. He therefore resigned because he waanxious that there should be no stigma attached to his nameThis certainly is a moral triumph. The idea that there isstigma attached to those who sell their professional serviceto a speculating commercial company should be spreabroadcast. This is a weapon held in the hands of th

profession. Good use should be made of it.

THE PLAGUE IN VIENNA.

(BY TELEGRAPH FROM OUR OWN CORRESPONDENT.)

IN January, 1897, the Imperial Academy of Sciences ofVienna sent out a Commission to investigate the epidemicof plague in Bombay. The members of the Commissionwere Dr. Muller, a physician ; Dr. Albrecht, an anatomist;Dr. Ghon, a bacteriologist; and Dr, Poech, physician’sassistant who also has charge of the photographic depart- Iment of the hospital. After a stay of three months

they returned to Vienna and established a plaguelaboratory of their own in Professor Weichselbaum’s pathological and anatomical institute in the General

Hospital. Here they made pathological investigations ofspecimens which they had brought with them, obtained fromfifty-two post-mortem examinations, observing the morpho-logy and biology of the plague bacillus and making experi-ments on animals with a view to ascertaining the nature ofits pathogenic action and the possibility of immunisation.On Oct. 15th a man named Barisch, who looked afterthe animals, suddenly fell ill with high fever andcough without expectoration. Dr. Stejskal, the assistantphysician, diagnosed pneumonia, Dr. Ghon expressed hissuspicion of plague, and the case was isolated in Dr.Nothnagel’s clinic, where Dr. Muller and Dr. Nothnagtldiscountenanced the diagnosis of plague as there was noenlargement of the spleen. On Oct. 17th the patient’ssputum contained blood, the microscope showed poly-morphous bacilli, and a guinea-pig was inoculated withthe sputum. On Oct. 18th the guinea-pig was killed,

ts glands were found to be enlarged, and the microscope *showed plague bacilli. In the afternoon Barisch, whosasymptoms included high fever and copious expectorationcontaining blood, became collapsed and died. A guinea-piginoculated with blood from his heart died in two hours.Sputum collected on Oct. 17th gave plague bacilli on culti-vation, as also did the glands of the guinea-pig. No postmortem examination of Barisch was made on accountof the risk of an extension of the disease, but the

body was buried after Dr. Muller and two nurses had

wrapped it in sheets impregnated with corrosive sublimate ,:they also cleansed the ward. On Oct. 20th Nurse Pecha,,having fallen ill with fever, cough, and expectoration con-taining blood, was transferred to the Infectious Hospitalunder the care of Dr. Muller and the second nurse named

Hochegger. Nurse Pecha’s sputum contained bacilli. Dr.Muller began to feel ill. On Oct. 21st he suffered fromfever accompanied by expectoration, and he found plaguebacilli in his own sputum and also in Nurse Pecha’s, whosetemperature rose to 41° C. (105.8° F.). Dr. Poech undertoolathe treatment of the patients, and was treated prophy.lactically with Paltauf’s serum, but Dr. Muller refused theserum treatment. On Oct. 22nd Dr. Muller showedtypical pneumonia and he died on Oct. 23rd. As inBarisch’s case no post-mortem examination was made.Nurse Pecha was suffering from continuous high fever. OnOct. 24th Dr. Marmorek arrived from Paris with a supply ofDr. Roux’s serum, injections of which were given to NursePecha and prophylactically to Dr. Poech and two nurses.On Oct. 25th Nurse Pecha’s condition showed little change;if any, but on Oct. 26th she was described as moribund. Assoon as the first case of plague was clearly recog-nised the Plague Commission permanently closed ProfessorWeichselbaum’s Institute. All the animals used for experi-ments were killed, and the drains of the Institute were dis-infected ; Dr. Nothnagel’s clinic was cleared and disinfectedand the medical men and nurses belonging to it were

isolated; the public were refused access to the GeneralHospital, all the medical men and the nursing staff werekept indoors, and some supposed febrile cases were trans-ferred from the Institute and Professor Nothnagel’s clinicto the Infectious Hospital. Barisch’s wife and brotherwere also admitted to the Infectious Hospital and receivedprophylactic treatment. No one has been attacked with

plague since Dr. Miiller fell ill, and all the persons in isola-tion have remained free from it up to Oct. 26th, the symptoms

which were regarded as doubtful being only those of sore-: throat. On Oct. 26th Nurse Pecha’s was the only case

officially notified as plague in Vienna, though the symptoms! of a companion nurse are gravely suspicious. She and thosewho had been in communication with her and all the

suspected cases are completely isolated in the InfectiousHospital. Barisch probably received the infection byway of his respiratory organs while feeding the inoculatedguinea-pigs; Dr. Muller and Nurse Pecha were obviouslyinfected by inhaling the germs coughed up by Barisch. Inall three cases the symptoms were exclusively pulmonary;glandular enlargements, which point to infection conveyed

f through the skin, did not occur. Infection never takes placeby way of the alimentary canal. The nursing staff in theInfectious Hospital are provided with " bacteria filters to

, . protect them from inhaling bacteria.

NOTES FROM INDIA.

(FROM OUR SPECIAL CORRESPONDENT.)

Plague and Small-pox.-The Destruction of Rats.--Deat7is of’Medical Officers.-The Progress of the Plague.-A PlagueCommissioot from England.

IT was recently asserted that animals which are susceptibleto plague become immune if they be vaccinated with ordinarycow-pox in four different parts of the body. Whether thisstatement be founded on any experiments is not stated. One

thing, however, is certain, that those persons who have beenvaccinated have no protection from plague. There does notseem to be any antagonism between the toxins of these twodiseases. There is no evidence either that those who havehad small-pox are any safer against contracting plague. Theidea was said to have been current in Constantinople whenplague visited that city, but investigations made in the

, Byculla Jail at Bombay do not give it any support. The?ewas found to be a marked similarity in the proportion of

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.attacks among the primarily vaccinated, amongst the re"

"vaccinated, and amongst those who had had small-pox.There is reason to believe that the extermination of the rat

coopulation in a district bordering on a plague-infected areawould have a preventive effect on the extension of this- disease,. So far the only attempt which has been made in this. direction has been in the destruction of rats by the ordinary’methods. It is now suggested that they should be infected’with some disease. The problem, however, has been to find:a specific infective disease which is pathogenic to ratsbut not to man. It is stated that some progress hasrecently been made in this direction. There is little,doubt that plague primarily affects the rat and that it is,through the rat that the disease spreads amongst men.Wherever an outbreak of plague has occurred amongst human’’beings it has almost invariably been preceded by plague;among the rats. Although plague is not very infectiousfrom one human being to another, except, perhaps, thepneumonic form, there is reason to believe that it is highly’infectious among the rats. If, then, the rats could be- .exterminated in advance of the plague there would be greatprospects of preventing the spread of the epidemic. Theinterval between two epidemics of plague seems to be aboutthe time required to renew the rat population, and althoughthe plague is very fatal and appears to kill off every rat, yet.a few either survive the disease or fail to contract it, and,these few soon regenerate the rat population. The conditionstthen become again favourable for a fresh outbreak and the.cycle of disease incidence is again repeated. Some of the;above facts, although repeatedly observed and recorded,’’have not been taken to heart by the plague authorities andregulations still continue to be issued as if an ordinaryi infectious disease, such as scarlet fever or measles, had tcbe dealt with. It is upon the basis of house contaminationthat the emptying or burning down of houses with thE

encampment of the inhabitants in the open country arounchas alone proved of real value.

- -

I regret to hear that within a fortnight two of the,medical officers of the Maratha Hospital in Bombay have’been attacked with plague and that one has died. Neitherof the officers lived in plague-infected localities, and the pre-- sumption is that they both contracted it at the hospital. The’medical officers of this hospital are native practitioners. As"well-ventilated, well-arranged, and well-conducted hospitalshave hitherto been shown to be extraordinarily safe as

regards contagion and infection of plague some inquiry-should be instituted into this and some of the other’native hospitals. Many of these hospitals are only con-

verted houses and are ill adapted for the purposes in view.’They are, moreover, situated in closed-in and very crowded(localities.

The summary of the progress of plague during the week,Is not satisfactory. In the districts and states of theBombay Presidency the reported number of plague cases

rose from about 4100 to over 5000. It is said that’in Dharwar the disease has become too prevalent for’the staff to cope with, that corpses are being foundin the outskirts of the town and fields with no one to

bury them, and that they are obliged to be left as they areto decompose or to serve as food for the jackals and the’vultures. The southern part of the Presidency is badly’infected, the chief increase occurring in Dharwar, Belgaum,:and the Satara district, and the Kolhapore State. CalcuttaIs apparently free and Karachi had only one death. Thedeath-roll for Bombay city shows a terrible rise, the figures’being 1002 or over 400 above the average. Probably the’whole of this excess is due to plague, although the officialreturns give only 243 deaths from this disease.

It is understood that a Plague Commission will shortly beformed consisting of five members with a secretary. Threeeminent medical men will be sent out from England.

Oct. 7th. _____________

LIVERPOOL. (FROM OUR OWN CORRESPONDENT.)

The Need of a Physical Laboratory in University College,Liverpool.

THE need of a physical laboratory in University Collegehas been felt for a considerable time, as the accommodation- provided for the department of physics has become altogether’(;00 limited owing to its rapid development. To make use of

Professor Lodge’s own words, "it is becoming increasinglydifficult to accommodate the ordinary student and will soonbe impossible." In THE LANCET of Oct. 22nd referencewas made to the munificent donations of Lord Derbyand Mr. Ralph Brocklebank towards the erection ofnew buildings to comprise the departments of anatomy,medicine, and surgery, which are so urgently required.It is much to the credit of Professor Lodge that he will-ingly and approvingly waived his immediate claim toa new physical laboratory, believing that the wants of theabove-mentioned departments were more pressing. In aletter to the local press on the need for a local physicallaboratory Professor Lodge reviews the history of hisdepartment since his appointment as the first professor ofphysics eighteen years ago. The terms of the letterare ; temperate in the extreme, although showing a con

dition of things which cannot be allowed to continuemuch longer. He says that on his appointment he wasintroduced to the temporary accommodation which wasto serve him as a laboratory both for teaching andresearch and which, he was told, was to satisfyhim for twenty years. Professor Lodge truly points outthat physical laboratories in this country and even on thecontinent and in America were not then what they are now.Twenty years makes a wonderful difference in a progressivesubject in the Victorian era, and the whole idea of a work-ing student’s physical laboratory is quite recent, originatingin a large measure with Lord Kelvin at Glasgow, who began

! in a dark hole where now is the old College-street railwaystation. The first practical class (one of 5 students only)

which Professor Lodge had was conducted in an upper roomof a building formerly used as a lunatic asylum, with the

) apparatus mostly on the floor. Gradually, as the otheri professors expanded into new buildings for their respec-

tive departments, the professor says, he also expanded1 by occupying their discarded rooms. He would be loth to

leave them now, having in a manner grown into the place,e but for two serious drawbacks-viz., want of cleanliness ande unhealthiness. He cannot recommend advanced students orr graduates of other universities to come and do research worki- at University College-there is literally no room. He dilates.e on the material scientific advantages to be met with

au Berlin, Duraspurg, Zurich, tiarvara, ana tsaitimore

and at other places far poorer and smaller thanLiverpool. He goes so far as to say that really advancedstudents, even his own, must migrate elsewhere. The

pinch is felt most by the more advanced students.With an average attendance of 26 or 27 students at thepresent time and these likely to increase as the session goeson, and in addition a few teachers only able to come on aSaturday and a large number of evening students on Thurs-days, he wonders how they all get fitted in. And then overand above this number there are 77 first-year students to beput through a beginner’s course of laboratory instruction.These have to be taken in batches ; they cannot be taughtnor can they be examined all at once or in two sets as in Man-chester. At the electro-technical department the pressure is notso severe, but it, too, has to be carefully organised. AltogetherProfessor Lodge makes out a good case for new laboratories,and when that desired object has been attained there will benone more worthy and more pleased to perform the openingceremony than that distinguished man of science, Lord Kelvin,who, on parting at the railway station with his host, ProfessorLodge, on the occasion of his recent visit to Liverpool, madeuse of words to this effect: "When they give you a newlaboratory I will come and open it. Not laying foundations,that’s a dreary ceremony, but the real opening." All wishLord Kelvin health and strength to enable him to fulfil hispromise to Professor Lodge.

Opening of the Albert Infirmary , Winsford : The Duke ofWestminister on vaccination.

The Duke of Westminster performed the opening ceremonyof the Albert Infirmary in Winsford on October 20th. Thenew infirmary is the gift of Mr. W. H. Verdin, D.L., for thebenefit of the inhabitants of Winsford and Middlewich,and the surrounding districts. It was formerly the mansionof the Verdin family; and is a square stone-frontedbuilding. On the ground floor are reception rooms, nurses’rooms, and convalescent rooms, and 2 men’s wards with 8beds. On the first floor are women’s and children’s wardswhich contain 4 beds. The new infirmary will be governed inconjunction with the Victoria Infirmary at Northwich undera board of management of which Sir Joseph Verdin, Bart., is