208

THE QUEEN’S SPEECH.

HER MAJESTY has once more opened Parliament in

person, and has thus again made her appearance in publicas the visible Sovereign of these realms. The speech fromthe throne was one of unusual length, not to say prolixity ;and although the Lord Chancellor, who read it, emphasizedthe statement that he was reading her Majesty’s own words,

’

we conclude that this was but a fiction, and that now, as onformer occasions, the Queen simply gave her sanction towhat had been written for her by Ministers. Howeverthis may be, the speech was one of evil omen as far asregards the topics in which our readers take especial in-terest. It would hardly be credited that, notwithstanding theappointment and report of the Royal Sanitary Commission,the Government could venture entirely to omit from theirscheme of legislation any attempt to alter or improvethe chaotic condition of the laws relating to publichealth. For another year at least, as far as Ministerscare or will exert themselves, epidemics may continueto reign; and, independently of the possible casual pre-valence of small-pox or scarlet fever, it is a matter

of certainty that typhoid will claim its fifteen or twentythousand victims. We do not envy the responsibility ofthose by whose supineness not only these deaths, but anadditional untold amount of misery and sickness will, atleast indirectly, be occasioned. We hear much, at varioustimes, of Court influence upon Government ; and, when weremember the loss which the nation suffered in December,1861, by the unchecked diffusion of typhoid poison, it be-comes surprising that a pressure said, now and again, to beexerted about trivial matters, should not make itself felt onthis greatest of all national questions. Even England can-not afford to throw away the lives of her children, or to-permit the unchecked physical deterioration of race by anaccumulation of insanitary influences and conditions.When the main subject of national health has been thus

ignored, no better fate could be expected for that of medicaleducation. The primary education of Scotland received awhole paragraph to itself; but that of the members of theprofession in the three kingdoms was not so much as

mentioned.

THE WAR.

THE COLLAPSE OF THE FRENCH MILITARY SYSTEM.

NOTHING was more extraordinary in the present war thanthe precipitancy of the French nation in commencing it,except their utter state of unpreparedness for sustaining it.From the first almost the French showed a lack of spirit,absence of dash, and want of resource; and spite of allthe warnings they had received from the break-down oftheir medical service, and the melanéholy inefficiency oftheir Intendance system in previous campaigns, no attemptswere made to reorganise either of them. Jealousy, dis-content, and conflicting interests and functions, reigned.supreme where there ought to have been harmonious work-ing and discipline. This stage in the mal-administrationof the Imperial army was soon succeeded apparently by oneof apathy and indifference. We have ascertained from an

eye-witness that the condition of the French hospitals inMetz was bad in the extreme. There was no evidence of

any attention having been bestowed upon the most ele-mentary details of hygiene. Not only were the hospitals,overcrowded, which was probably unavoidable under thecircumstances of a besieged army shut up in Metz, butthey were ill-ventilated, dirty and foul from want of care inremoving the excreta of the patients. The same disregardof organisation was a striking feature in the management

of military, medical, and sanitary matters inside Paris.We hava been assured that the military arrangements forthe removal of the wounded from the field, instead of beingmuch better, were infinitely inferior to those of the aidsocieties and different volunteer ambulances. When theParis 11 bill of mortality comes to be known, the resultswill not be creditable to military surgery and hygiene.

INSIDE PARIS AFTER ITS SURRENDER.

We must refer to the communication from our corre.

spondent in Paris for some interesting details of the effectof the limited food supply on the people. There can be nodoubt that the distress in Paris is at present great, andthat the fears as to its increase were well-founded. Wehave learnt that a military surgeon, who entered Paris

shortly after its surrender with provisions, was much struckwith the aspect of the hungry crowd that gathered roundhim. The urgent nature of the case, and the certaintythat a starving population will soon become a prey toepidemic disease, would, we think, fully justify the Govern.ment, as a matter of national concern and interest, in takingsteps to avert the threatening calamities. That it has

already done something we know, although we do not knowits nature. Meanwhile nearly .850,000 has already beensubscribed to the Mansion-house Fund, for the relief of thedistress in Paris. It is to the credit of the Prussians that

they did all they could towards feeding the people. As aninstance of the energetic exertions being made in this

country we may mention that Messrs. Peek, Frean andCo. despatched last Saturday between ten and elevenmillions of fine navy biscuits, weighing more than 700 tons,and occupying 10,500 packages. A correspondent tells usthat there were about 10,000 wounded in Paris after itssurrender.

THE VALUE OF PORRIDGE.

The venturesome correspondent of the Daily News, whosucceeded in penetrating into Paris, soon after its surrender,on a fine fat charger, the sight of which made many a

hungry Parisian’s mouth water, gives a humorous descrip-tion of his entertainment by Dr. Gordon. Our MilitaryCommissioner was a boarder with one Unthank, who boastedthat the worthy doctor, under his auspices, had lived betterthan any man in Paris. A fowl, for which Unthank had beenoffered 80 francs when it was a feathered biped, was broughtup for dinner, and the correspondent to the Daily News, aScotchman, like Dr. Gordon, shared with him his bicker ofporridge and a tumbler of Scotch whisky. It appears that thediscovery of a store of oatmeal had been made in Paris, andDr. Gordon, being a man to the manner born of porridge, hadbeen sustained better than others who had given themselvesinternal uneasiness by the consumption of stuff that borethe conventional name of bread.

THE PREVALENT DISEASES AMONG THE FRENCH SOLDIERS.

A Surgeon who has had unusual opportunities of seeing alarge number of sick and wounded men in France, thus sum-marised his experience :—A rise in the patient’s temperatureis, of course, indicative of disease; and when it occurs youmay pretty confidently expect small-pox, typhoid fever, orpyasmia, if the soldier be wounded.

THE GENEVA CONVENTION.

Count Bismarck, by way of illustrating the ignoranceand indolence of the French, recently made it a subject ofcomment in one of his official utterances that the French

surgeons showed a perfect ignorance of the terms of theGeneva Convention. If we may believe a tithe of the

charges of barbarity, breaches of faith, and perfidy thatthe belligerents have performed one against the other, anamount of wrong-doing must have been perpetrated undercover of, or in spite of, this Convention which could only be

209

equalled by the crimes that, according to Madame de Stael,had been committed in the name of liberty. It appears

pretty certain that some of the clauses of the Geneva Con-vention will be greatly modified, if not altogether abro-gated ; but we should extremely regret to see the day whenthe spirit of the Convention ceased to rule.

DR. RICHARDSON ON CHLORAL HYDRATE.

BEFORE commencing his lecture on Experimental andPractical Medicine on Tuesday last, Dr. Richardson offeredsome observations on the subject of Hydrate of Chloral, towhich we would call the attention of our readers. He

said :-

My lecture to-day is on Suspended Animation, but I willask you to allow me first to offer a note or two on anothersubject, at this moment of urgent importance. I refer tothe administration of the hydrate of chloral. There haverecently been two assured deaths from the hydrate. Inthe course of the past ten days, I have myself been consultednot fewer than three times on what have been considereddangers attending the administration of the hydrate, andI know generally that doubt and uneasiness prevail in theprofession respecting the abuse as opposed to the use ofthis agent. I think it right, therefore, as I had much todo in introducing hydrate of chloral into medical practicein England, to answer a few of the questions that are mostpressing from this place, where so many demonstrations ofthe action of the hydrate have been carried out.

1. Is the practice of resorting to the use of hydrate of chloral,as a narcotic, in the absence of medical advice and direction,becoming a common practice among the people? The answerto this question is strictly affirmative. The novelty of itsadministration and of proving its effects at an end, thehydrate is not at the present time used so largely by themedical profession as it was a few months ago, when itstrue place in the Materia Medica was less clearly defined.The sale of the hydrate of chloral to medical men is conse-quently considered as declining, while the general sale is,perhaps, increasing. Corresponding with this state of thingswe, in the profession, are becoming conversant with casesof what may not improperly be called " chloral drinking,"and in which serious and singular symptoms are presented.Three classes of people specially resort to hydrate of chloral-viz., alcoholic devotees, who take the substance to Icounteract excess of alcohol and to relieve alcoholic deli- ’’

rium ; sufferers from neuralgia and other painful chronicdiseases, who find in the substance temporary relief frompain; and persons having much mental worry, grief, orcare, who, flying to it at first in order to obtain sleep, con-tinue it until the occasional practice becomes a persistenthabit. As an indication of the quantity of hydrate ofchloral used in this country since its introduction here abouta year and a half ago, I may state, incidentally, on what Ihave every reason to consider reliable authority, that onecommercial house alone has supplied the English drugmarket with ten tons of the substance; three other houseshave, it is supposed, supplied as much; so that fifty tonsweight have been, on this calculation, sent out-an amountwhich, divided into grains, would yield over thirty-sixmillions of narcotic doses to England alone since August1869.

2. What is a dangerous and what is a fatal single dose ofhydrate of chloral ? The largest dose I have known to betaken is one hundred and twenty grains. This dose pro-duced a prolonged and dangerous coma, but recovery ulti-mately followed. I think we may consider a hundred andtwenty grains, as a maximum dose for an adult, dangerous,but not of necessity fatal. Beyond a hundred and twentygrains the danger increases, and a hundred and eightygrains may be considered a dose that would prove, in themajority of cases, positively fatal.

3. What quantity of hydrate of chloral can be given with safetyin divided doses during a stated period of time, say of twenty-four hours? ? Judging from the physiological effects of hy-drate of chloral in relation to dose, and to order of pheno-mena in relation to time, I should infer that the body can-not decompose and throw off the hydrate more rapidly than

at the rate of from five to seven grains per hour. Therewill be difference according to age of person, the tempera-ture to which the body is exposed after the dose has beentaken, and the largeness of the dose, a small dose beingdisposed of quicker in proportion than a large one. But thevariation is not such as to alter materially the rate of actionfrom the estimate given. I should consider, consequently,that a hundred and twenty grains, administered, even individed doses, in twenty-four hours, would be the safe limitof administration. In the treatment of tetanus this pro-portion has been exceeded, but not, I think, to the safetyof the patient; for the fact that the hydrate of chloral over-comes or reduces the spasm is no safeguard against its ownpoisonous effects. From what I know, I conclude that thehydrate of chloral can be given to the extent of overcomingthe severest spasm ; but if the dose be carried too far, withthe determination of removing spasm at all risks, the suc-cess may easily be bought at the expense of a fatal narcotismfrom the remedy.

4. Does the frequent administration of hydrate of chloralessen or increase the danger of the administration ? On thisquestion I am forced to state that the frequent administra-tion of the hydrate of chloral, though it may suggestgreater confidence in it on the part of those who take it,increases the danger from an excessive dose. Hydrate ofchloral differs from opium in this respect. Opium produceschronic symptoms peculiar to itself, but the dose may besteadily increased without any immediate danger from theincrease. Hydrate of chloral cannot be used in this accu-mulative way without danger. In a word, although a personmay become habituated to hydrate of chloral, there is alimitation of the quantity to be taken safely, which limita-tion is not materially modified by persistence in the habitof taking it, but rather the reverse.

After discussing three other questions, relating to thesymptoms and pathological changes incident to the habitualuse of chloral hydrate, to the chemical tests for the hydratein cases where it has caused death, and to the post-mortemdistinctions in instances of chronic poisoning by the hydrateand by chloroform, Dr. Richardson concluded by observingthat, as the world was indebted to the profession of medicinefor the benefits derivable from the hydrate of chloral, itbehoved the members of the profession to use their influ-ence in protecting the public from an agent which, underimproper use, might be turned from its good purpose topositive evil.

ROYAL COLLEGE OF SURGEONS.

PROFESSOR ERASMUS WILSON’S LECTURES ON DERMATOLOGY.

LECTURE II.

1B’IR. WILSON proceeded in his description of the severalvarieties of eczema, and directed attention, in the first

instance, to a variety which had lately been well exemplifiedin a case under his care, and which deserved special re-cognition. It occurred in a man aged thirty-four, andassumed the erythematous form, consisting of puncta andsmall patches, seated chiefly on the body, but also on thelimbs, and a uniform redness of the face, accompanied byitching generally over the body. The man had sufferedfrom bronchitis, and certain liniments of a stimulatingkind had been used, when the eruption broke out suddenlyall over the body, and the neuralgic pains of which he com-plained in the chest subsided. The patches were made upof coalesced puncta, and were some one inch in length andtwo or three lines broad. The patches were abundant onthe back, but slightly raised, uniformly red, some vividlyso, and without desquamation or exudation; in fact, thecase was one of monomorphic eczema. The patches weredirected with their long diameters pointed downwards fromthe spine, then sweeping upwards to the front ; indeed, thepatches were disposed in lines corresponding to the courseof the anterior spinal nerves, like zoster, or the spots of theleopard or tiger. Ten days subsequently the skin desqua-mated, and the disease left behind small circular patches,having the characters of eczema erythematosum orbiculareand circinatum, referred to in the former lecture.Mr. Wilson then described eczema papulatum in its several