the scientific interest, that ought of itself to be sufficient inducement. In addition to the facilities for travelling at reduced rates already announced, the railway authorities of Victoria, New South Wales, and Queensland have agreed to issue return tickets at single fares to members of the Congress and their wives on their way to New Zealand. South Australia also grants this concession to members, but not to their wives. It is most important that members should communicate as soon as possible the titles of papers they propose reading at the Congress, and it is matter for regret that up to the present so few Victorian members have notified any intention of taking part in the scientific work of the Congress. The time is approaching for it, and it is to be sincerely hoped that Victorian representatives will make an effort to maintain their prestige.

CONFERENCE OF MEDICAL STAFFS OF THE

HOSPITALS FOR INSANE.

For some time past, Dr. McCreery, the Inspector of Asylums, has been preparing the way for Annual Meetings of the Medical Staff of the Department, to talk over their work-both administrative and medical. On Tuesday, October 8, the opening meeting was held at the Treasury. The permanent head of the Department (Mr. C. A. Topp, Under-Secretary) was present to meet the various asylum superintendents, and such medical officers as could attend.

After a very able and comprehensive opening address by Dr. McCreery, those present were invited to make any general remarks on the subjects under notice, reserving to themselves the specialising of their views for further conference.

Mr. Topp, in a few well-chosen words, commended the movement, and volunteered the statement that political influence had not, since his appointment, been permitted to interfere with asylum administration, and said he regarded the conference as a distinct move in advance. Three subsequent meetings were held at Kew Asylum to admit of the greatest number being present. The subjects for discussion were :-

(1) The training and examination of attendants and nurses. (2) The revision of the rules for attendants.

(3) The state of medical work in the asylums.

The subject of the appointing of attendants and nurses was dealt with under such headings as physique, general appearance,

education, previous occupation, and the demands of each individual asylum in the filling up of vacancies.

Resolutions were passed on the important subject of transfers of attendants from one asylum to another. It was held that while it would be well for some general rule to be laid down, no hard and fast stipulation for all time would be advisable, and the matter was left with the Inspector and Dr. Watkins to draw up a recommendation for the consideration of the head of the Department.

The subject of grading the work of the attendants was carefully considered. Every Superintendent present held strong views on this matter, to the effect that regrading should be accomplished in such a manner as to admit of those most capable of performing senior duties being promoted to such positions and receiving the pay thereof, and that no mere relative seniority should hold sway as at present. The Inspector moved, and Dr. O'Brien seconded, that it is essential that the work of the attendants be regraded, and that in conjunction with the scheme of teaching now adopted throughout the Department, examinations should be held in writing by the Inspector, and viva voce by him along with the individual Superintendents, and that the results should largely influence promotions of those in the service, and the confirmation of the appointment of those on probation. As the capacity for answering papers was not always commensurate with the ability to most satisfactorily fulfil the duties and vice versa, it was thought that by the arrangement made for each asylum to be graded by itself, and the matter of transfers definitely dealt with, that each group of attendants would receive most consideration, each Superintendent train and largely appoint and retain his own staff, and so have most attention available for his patients, and for the relief of his own anxiety from the old order of everlasting transfers and changes in the staff.

In the matter of medical work, one of the most important points resolved upon was the proper equipment of one of the metropolitan asylums with such apparatus as would be necessary for the prosecution of chemical and pathological research. A pathologist would require to be appointed, and the Inspector of Asylums was asked to urge upon the Government the desirability of following the lead of home asylums in such matters as fully and as early as possible. Various methods were suggested as to the carrying out of this matter, which was eventually left with the Inspector

to deal with. The Inspector also undertook to request the Department to provide funds for a library of reference for the asylums.

After a general discussion on the type of patient at each distinct asylum, the character of admissions, &c., certain general ideas for the method of case-taking were resolved upon and left with the Inspector to arrange.

It was also decided that, as general paralysis of the insane was becoming so increasingly prevalent, it should form the first subject to be dealt with in a series of collective investigations, on lines to be laid down by the Inspector and Dr. Rosenblum.

Rebichos.

The Care of the Baby: A Manual for Mothers and Nurses. By J. P. CROZER GRIFFITH, M.D., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania, &c., &c. Philadelphia: W. B. Saunders, 1895.

Amongst numerous other duties, a medical man is frequently asked to advise a young mother as to the most reliable literature on the subject of infant management, and the want of a really sound book, written up to date with regard to artificial feeding of infants, has long been felt. Dr. Griffith has endeavoured in his book to furnish a reliable guide for mothers anxious to inform themselves with regard to the best way of caring for their children in sickness and in health, and is certainly to be congratulated on the success that he has attained.

He prefaces the care of the baby with a most useful and suggestive chapter of advice to the young wife-mentioning the various disorders of pregnancy, and giving a number of useful hints with regard to exercise, dress, &c.

In the chapter on the baby, useful tables of the pulse and respirations at various ages are given, as well as a somewhat rarer table of the amount of urine passed by babies at different times. In describing the use of the clinical thermometer, the groin is not mentioned as a site for temperature registration.

The development of the child, both mentally and bodily, forms a most interesting subject for the third chapter, but the author might insist a little more strongly on the duty of a mother towards her child with regard to its control over bladder and rectum. Every child can be taught cleanly habits when three months old;

a mother only wants to be told how to do it. Proper stress is laid on the necessity of the constant use of the weighing machine to test the baby's progress, and a most useful table of average heights and weights at various ages is given. Some good advice is given to mothers about the physiological process of dentition, and the care of the teeth after they appear in the mouth is dealt with. The mysteries of baby clothes are laid bare, and improvements are suggested, which all tend towards the comfort of the child and simplicity.

The sixth chapter, entitled feeding the baby, is an excellent one, and is thoroughly up to date. The author says, "regarding the numerous patented foods, it need only be said that some of them are harmful and none of them are necessary or desirable for a child with a healthy digestion." Cow's milk is insisted upon as the proper substitute for mother's milk, and full directions how to prepare it are clearly written down. Some sensible remarks are made upon the wet-nurse, the nursemaid and the trained nurse, and proper attention is drawn to the day and night nurseries and their furniture. The care of the sick baby is treated of in a clear and simple manner, the directions to the mother about how to act in cases of emergency being very good.

A most useful appendix at the end of the book supplies the mother with a detailed account of how to make nearly everything the medical man can order.

Dr. Griffith has succeeded in writing a book that a medical man can safely place in the hands of his patients, for it does not pretend to usurp the place of the medical practitioner, but simply to guide the mother in bringing up her children in a rational manner.

The Surgical Diseases of Children. By D'ARCY POWER, M.A., M.B. Oxon., F.R.C.S. Eng. London: H. K. Lewis, 1895. This work is a recent addition to the admirable series of medical and surgical text-books known as Lewis' Practical Series. The author writes with the authority conferred by his experience as surgeon to the Victoria Hospital for Children at Chelsea, together with the wide pathological knowledge which he is well known to possess; and a perusal of the excellent little manual he has brought out awakens the hope that in the future a more exhaustive work on the same subject may come from his pen.

In the section devoted to Infective Osteitis, which is an unusually clear exposition of our present knowledge of a somewhat

confused and difficult subject, the author objects to the use of the term "epiphysitis," when applied to the infective inflammation which attacks the epiphyseal line of a growing bone; he makes no mention of the drastic measure advised by some continental surgeons of gouging out the whole of the medullary cavity in all cases of acute osteo-myelitis. The articles on Tuberculous Diseases of Bones and Joints are excellent and comprehensive; but many readers will surely be surprised and disappointed to find the weight and extension method accorded a position in the treatment of hipdisease, which they believed to have been almost entirely usurped, with great advantage, by Thomas' splint.

Practical and serviceable accounts are given of the use of the diphtheria antitoxin and of intubation; also of cranio-cerebral topography and surgery, together with a large number of subjects too numerous to mention, all of which are brought well up to date, and contribute to the completion of a very excellent little work, which may be warmly commended to the notice of students and practitioners. R. H. R.

Extracts from Medical Journals.

The Nutrition of Infants Fed upon Raw, Boiled, Pasteurised, and Sterilised Milk.-H. Koplik, after summarising the results of a large number of authorities on infant feeding and nutrition, maintains "that in the nitrogen taken up in the system we have a clear and definite index as to the assimilation of albumenoids ingested into the economy." We can draw certain conclusions from a balance-sheet drawn up to show in a given diet the amount of nitrogen excreted, and the amount ingested—the amount which has been wasted in proportion to that ingested. From original and laborious investigations on these lines, estimating the total amount of nitrogen ingested, the total nitrogen excreted in the fæces in a number of infants each fed successively on a milk diet -boiled, Pasteurised, sterilised, or combined with the breast, he found that the amount of nitrogen excreted, compatible with a condition of perfect health and increase of weight, varies widely, from 1.7 per cent. to 4.3 per cent., and he says it would be unjust to conclude, as some authorities have done, that because the nitrogen excreted in the breast-fed infant is much the same as that in the infant fed upon artificial foods, the latter are equal to the