The Vaccination Act is the vehicle of many changes. First it abolishes arm-to-arm vaccination at a public station, substituting vaccination by means of glycerinated calf-lymph at the residence of the children; next it extends the age from three months to six, and finally it puts an end to repeated penalties where parents conscientiously object to vaccination.

A new hospital for soldiers' wives and children was recently opened at Aldershot; it is named the Louise Margaret Hospital, after the Duchess of Connaught. There are altogether fifty-three beds, twenty-eight in the maternity block and twenty-five in the general block. The wards are of various sizes, and named after different members of the Royal family and those connected with the camp.

Professor Virchow, of Berlin, has consented to deliver the forthcoming Huxley lecture at the Charing Cross Hospital on October 3d. This lectureship was founded at the death of the late Professor Huxley out of the sum raised by the medical school and its friends to commemorate the fact that Huxley received the whole of his medical education at that hospital. The lecture is a biennial one, and the subject of that to be delivered by Professor Virchow is "Recent Advances in Science and their Bearing on Medicine and Surgery." The first Huxley lecture was delivered by Professor Michael Foster in October, 1896, and Professor Virchow's lecture on October 3d will be the second.

A medical man who has had great experience in diving operations has related a recent case of a diver one hundred and sixty-two feet down who was jammed against a beam by the slipping of a piece of machinery and his supply of air partially cut off. After five minutes he suffered from nausea, giddiness, pains and noises in the head, flashes in the eyes, accompanied by loss of sensation in the legs and arms, but never lost consciousness. He was eventually brought to the surface, but for many weeks did not recover. The doctor says below one hundred and sixty feet every fathom of depth becomes more dangerous, especially for old divers.

Surgeon-General Korting, of the First German Army Corps, has vindicated the employment of the Dum Dum bullet. He points out that the Italians in their Abyssinian campaign found the ordinary small bore bullet almost useless. Abyssinians when wounded in several places would go on fighting, and in war the great law is to disable the enemy, but not to inflict unnecessary suffering. The Dum Dum bullet, he says, certainly does not transgress this principle.

London is now provided with two mortuaries where by means of a glass partition a coroner's jury may view the subject of their inquiry without incurring the risk of distressing and infectious exhalations.

In a recent annual report of a benevolent society the following delightful sentence occurs: "Notwithstanding the large amount paid by the society for medical attendance and medicine, very few deaths occurred during the year."

LONDON, August, 1898.

Abstracts and Selections.

THE TREATMENT OF ANEMIA BY MOUNTAIN AIR.-Lepine (Sem. Med., March 16, 1898) gives a summary of what is known as to the effect of altitudes on anemia. Paul Bert first drew attention to this subject in 1882 by finding that a given volume of a mountain animal's blood absorbs more oxygen under similar conditions than an equal quantity from an animal of the plain. More detailed experiments have confirmed this. Thus Müntz. found that seven years after importing rabbits from the plain to the Pic du Midi (2,877 meters) the blood of their descendants differed greatly from that of those which had remained below. If the fixed matters, the metallic iron of the blood, and the oxygen absorbed be each represented by 100 for the plain animals, the corresponding numbers for the mountain animals are 139, 174, and 180. Still more striking were his results with sheep which had lived on the Pic only six weeks. It is probable that several climatic factors are involved in this increase of hemoglobin, but Regnard has shown that barometric depression alone is sufficient, for he obtained the same results by keeping guinea-pigs under a bell jar for a month under a constant atmospheric pressure corresponding to an elevation of 3,000 meters. Mercier again found that while counting the corpuscles of men and rabbits returned from the mountains to the plains, the daily decrease ceased on the barometer falling 13 mm., and in two rabbits there was even an increase of corpuscles. Whether on a mountain or under a bell jar, the most noticeable alteration in the blood is an increase of the red corpuscles, which appears earlier and is more rapid than the increase of hemoglobin. Egger has had the same results in man at an elevation of 1,890 meters; the average increase of red corpuscles after fifteen days was sixteen per cent. Mercier confirms this. Those observers (Loewy, Kohlbrugge) who have failed to note this property of mountain air were not careful to exclude vitiating conditions from their experiments. All the most reliable evidence goes to show that the increase of red corpuscles is real and has nothing to do with a supposed concentration of the serum through evaporation. Viault and others have remarked the great number of small discs in blood received on elevated places, which are probably developing erythrocytes. This explains the fact that the hemoglobin does not increase so rapidly as the corpuscles, since the young globules do not contain their full amount. Finally, Schauman and Rosenquist have observed nucleated red corpuscles in the blood of dogs and rabbits living for some weeks under a bell jar under a depression of 45 to 48 cm. of mercury. Suter and Jaquet found that in rabbits which had lived at Davos for four weeks not only was their blood one sixth richer in hemoglobin than that of those left behind at Basle, but

the quantity was more per kilogramme of body weight (about one tenth). The mechanism of the increase of red corpuscles is still not properly understood. It is certain that in healthy persons this increase is not permanent, but disappears on a return to the plains as rapidly as it came. However, the most important fact is that anemic people retain more red corpuscles than they had before their mountain sojourn for long after their return.— British Medical Journal.

OSTEOSARCOMA OF THE LUNG AND THE ROENTGEN RAYS.-Leo (Berl. klin. Woch., April 18, 1898,) relates a case in which the Roentgen rays revealed the presence of growths in the lungs. A boy, aged ten, had his leg amputated for sarcoma. Six or seven weeks afterward he had a dry cough, and sixteen days later pain in the left side and back, besides a slight systolic murmur. No abnormal physical signs could then be made out. He had an alarming attack of dyspnea six weeks later. Eventually a circumscribed patch of dullness was found at the angle of the left scapula, which extended. Impaired percussion also appeared below the right clavicle. Bronchial breathing was present over the dull area. The patient died of increasing dyspnea. Five tumors were found in the peripheral portions of the left lung immediately beneath the pleura. In the right lung there was a mass as big as the fist, besides smaller nodules. With the exception of parts presenting bony hardness the growths were composed of soft tissue. The diagnosis of organic lung disease was possible at an early date, and owing to the previous history metastases in the lungs appeared most probable. Two days before death a Roentgen photograph was taken. There was a distinct shadow to be seen between the ribs abutting on the cardiac shadow, and with an irregular limit above and below. On the right side the shadow was deeper, of an oval shape, and as large as the adult fist. The size of the shadow was very striking, as it was much larger than the physical examination would lead one to expect. The Roentgen rays proved with certainty that the greater part of both lungs was involved. The necropsy showed that the new growth was an osteosarcoma, but it must remain undetermined whether the marked shadow was due to the bony tissue or not. Here photography was of greater service than the physical signs, although the diagnosis was previously certain. It can not be doubted that the Roentgen rays may enable a diagnosis of lung tumor to be made at a time when percussion can detect no abnormality.—Ibid.

CONSTIPATION of muscular origin in women, resulting from pregnancy and implicating the abdominal and perineal muscles, should not be treated by purgative. Symmetrical massage and gymnastic exercises are called for. The diagnosis is made by observing the feeble abdominal constriction. -Pineus.

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PROFESSIONAL SECRECY.

The very severe punishment administered by an English court to Dr. Playfair, who not many months since unwisely told his wife a professional secret involving the good name of a kinswoman, has proved a profitable study in ethics to the medical men of the whole civilized world, and will doubtless keep the doctors of Great Britain at least in prudent silence as to such matters for generations to come.

In America, however, where each State has its own peculiar laws, and where ignorance of law is a common failing among doctors, enough on this score has not yet been said. For now and then a case in which the good name of a dying girl is at stake is painfully paraded in the public prints and before the courts of justice, through the meddlesome interference or ethical leakage of some young M. D. whose taste for notoriety outweighs his sense of justice and professional duty. The divulgence of such professional secrets should be condemned, if for no other reason, because of the notable fact that in the large majority of such cases the guilty parties go unwhipped of justice, while the only visible result is the disgrace of a family and the frailty of one poor woman more brought to light.

One would suppose that self-interest, with a philanthropic sense of right and justice, would be sufficient for all, as it is for most, of the

profession; but that these considerations are insufficient is now and then only too painfully manifest.

While the laws should be and are in most countries so framed as to protect patients against injury through the possible divulgence of the secrets which their medical advisers must know, the tables are sometimes turned, as when the doctor is called to act as a witness in court, where the lawyers, if permitted, would draw from him testimony prejudicial to his patient.

At common law the information obtained by a doctor in his professional relation is not privileged; that is, he can be compelled to testify thereto; but by the statutes of some of the States the physician can not testify unless the patient expressly consent to his so doing. We note with approval the law indicated by the following French decision, and hope that every State in the Union may soon, by statute, protect the confidential relation of patient and physician, and forbid the physician to testify as to any information so obtained, except with the express consent of his patient:

The Echo medical du Nord for July 3d records a legal decision in the French court of appeal which is of great interest professionally. According to Article 378 of the French penal code, a physician is forbidden to reveal any secrets confided to him, or of which he becomes cognizant in the exercise of his profession. A married woman, applying for a divorce from her husband, sought permission to introduce in evidence certain letters addressed to her by Dr. Cordonnier, who had attended her husband, to show the nature of his malady. The court commenced by laying down that the physician does not exceed the limits of his rights when he informs by letter the wife of a man whose husband he is attending of the causes and nature of his disease. But it adds that these letters must not be divulged, even by agreement between the sender and the recipient; as the obligation to professional secrecy imposed by the law does not permit of his consenting to their publication, This rule permits of no exception, and must be applied even when the applicant for divorce wishes to put them in evidence as proof of her wrongs; for confidences which the interest of the patient can alone justify, must not, under any pretext, be used against him.