1477CONICAL CORNEA.-A QUERY IN EMBRYOLOGY.

suspicion and it was thought to be a case of hysteria. Aboutthis time her arm became very painful and the twitchings inthe limb were so severe that it had to be strapped to herside. In June the left arm was occasionally rigid and it wassometimes " jerked about " ; the patellar reflexes were

exaggerated and clonuses were obtained to a less extentin the left leg. The left angle of the mouth was drawn tothis side more than to the right. Dy September she hadbetter control of her legs and there was but slight if anyrigidity. The movements of the left arm on attemptingany voluntary exercise were increased in violence and theincoordination and rigidity were more marked. The rightarm was about the same. In December, 1887, the sight ofthe right eye was much impaired and as it improved that ofthe left failed. From May to December, 1888, her sightwas considered to be normal. but in this latter month thevision of both eyes began to fail again and she was unableto read or to sew. In February, 1889, the vision of each eyewas -66j, central vision was defective, and the field waslimited. The left optic disc was certainly normal in appear-ance but the right optic disc presented rather small andsomewhat tortuous arteries and it appeared to be whitish.In March she was said to have suddenly lost her sight whenwashing up the breakfast things and she complained at thetime of sudden shooting pains in the eye. In May hermother was confident that she could not see. The leftfundus oculi was then normal. The right optic disc wasof paper whiteness and the arteries were very small andtortuous. She complained of continuous headache and sheblundered into the furniture as she walked. In November,1889, she developed epilepsy. In May, 1890, her knee-jerkswere exaggerated and right ankle clonus was marked.During voluntary movements the right arm became tremu-lous but not otherwise : the hand was pronated andstrongly adducted and the triceps and supinator jerks wereexaggerated. There was no facial paralysis. In June thearteries of the left optic disc were slightly tortuous and thedisc was pale ; vision was defective but she fixed with it.In March, 1891, she was still epileptic and complained ofheadache and giddiness. In October, 1892, she was wet anddirty ; she still had fits and was becoming more dementedand she also had delusions. From then to December, 1895, her retrograde progress was slow but steady. She was thenbedridden and wet and dirty but she had not had any fitsfor four months. In March, 1896, she was much worse, thefits were troublesome, and she died soon afterwards. At thenecropsy lymph a third of an inch in thickness was foundenveloping the whole of the brain. The whole of the leftside of the brain in all its parts was smaller than the right.The convolutions were flattened. The ventricles containedbut very little fluid. The vessels at the base were normal.

I am, Sirs, yours faithfully,Welbeck-street, W. GEORGE CARPENTER.

CONICAL CORNEA.To the Editors of THE LANCET.

SIRS,-I frankly own that the paper published in theBritish Medical Journal of Feb. 23rd, 1889, by Mr. RichardWilliams of Liverpool had escaped my notice or I wouldcertainly have given him the credit of initiating non-

perforation of the cornea. I may, however, remind himthat my paper was published in the Practitioner in1895 and it is only now that he has called my attentionto his own prior communication, thus showing that his

knowledge of the literature of the subject was also some-what wanting. My chief claim to originality lies in thecreation of two distinct zones of varying depths and a smallcentral spot which in the process of healing exercise agraduated pressure and I venture to hope that Mr. Williamswill give this method a trial.

I am, Sirs, yours faithfully,Harley-street, W., May 19th, 1903. ANDERSON CRITCHETT.

A QUERY IN EMBRYOLOGY.To the Editors of THE LANCET.

SIRS,-Without trying to solve the question asked by" Oxon " in THE LANCET of May 16th, p. 1404, as to whetherthe blue she-cac was impregnated by the blue tom" " or by the "black and white tom " or by both, or whether the spermatozoa of the one were destroyed by those of the other,and also without trying to account for the prolongation of l

gestation, if any, the question which he raises (that is,supposing fruitful congress took place between the two blue.cats) resolves itself into a discussion as to the transmissionor non-transmission of acquired characters. But here it hasto be pointed out (for 6 Oxon " asks if it was simply a caseof "maternal impression ") that if anything was acquired bythe she-cat it was a mental impression and not a black andwhite colour. What the kittens evidenced was a black andwhite colour and not, as it would seem from " Oxon’s letter,a mental impression. Surely a specific physical formationcannot be held to be the result or transmission of a specificnervous impression, for what the mother acquired was onething and what the kittens evidenced was quite another and.a thing totally distinct.

I am, Sirs, yours faithfully,Liverpool, May 16th, 1903. CHARLES R. NIVEN.

MEDICAL TESTIMONIALS FOR TRADEPURPOSES.

To the Editors of THE LANCET.

SIRS,-A liberal sample of a new potable spirit is beingsent to members of the profession. This spirit may possessall the merits the proprietors claim for it, but in view ofthe free way in which "the opinion of thousands of themedical profession" and "over 6000 testimonials have beenreceived from medical men" are paraded in advertisementsand pamphlets issued by the vendors of a certain beef, malt,and wine compound, it is to be hoped that the gratitude ofthe receipients of the sample referred to will not in this caseexpress itself in a manner so humiliating. If a medical manis of opinion that a preparation of which he has received a.sample would be of value in his practice, by all means lethim prescribe it in the usual way ; but he should not bebeguiled into giving a written opinion which will in all

probability be used for trade purposes.I am, Sirs, yours faithfully,

Weymouth-street, W., May llth, 1903. C. W. CHAPMAN.

THE ROYAL COLLEGE OF SURGEONSIN IRELAND.

To the Editors of THE LANCET.

SIRS,-In common with many other readers of THE.LANCET I have followed Mr. S. Wesley Wilson’s correspond-ence on the Fellowship of the Royal College of Surgeonsin Ireland with interest. If I recollect aright Mr. Wilsonwas registrar of the Irish Medical Council for manyyears. A more than ordinary responsibility thereforeattaches to his letters. He deliberately states that the"Primary Fellowship " was given without examinationto over 200 practitioners and students at E10 10s. each,that the College violated every contract by which it agreedto examine him, and that out of 40 candidates successivelyexamined for the Fellowship of the Royal College of

Surgeons in Ireland he records the extraordinary fact of 39’successes. Surely the Royal College of Surgeons in Irelandhas some explanation to offer to the medical professionin connexion with these statements. Should its explanationnot be satisfactory, your readers must accept Mr. Wilson’sstatements as facts and agree that his fees should be returnedin full. But have the General Medical Council and theFellows of the College themselves no say in the matter ofirregular examination ?

I am. Sirs, yours faithfully, -,

GEORGE FLEMING, M.B., C.M., M.R.C.P. Edin.Ombersley.

AN EXTRAORDINARY MISADVENTURE.To the Editors of THE LANCET.

SIRS,-The following case is a peculiar one and mustbe somewhat unusual. On May lst I was summoned at

midnight to attend Mrs. -, who was reported by herhusband to have had a premature labour. The case wassome miles out, so in view of possible haemorrhage I gavethe man a tube of hypodermic ergotine citrate grain)and told him to give two of the tabloids by themouth if necessity arose. (I may add that I frequentlygive the hypodermic tabloids per os instead of the ext.

ergotæ liq. on account of the less disagreeable taste ofthe former.) I arrived at the patient’s house at 12.45

1478 THE SECOND INTERNATIONAL CONGRESS OF THE MEDICAL PRESS.

-and found that the child, a six and a half months’ one,had been born two hours, but that the placenta was stillundelivered. This latter was expelled without any difficulty,but on finding the uterus still flaccid I asked for the

ergotine. To my astonishment I discovered that a neighbourin attendance had mistaken the husband’s instructions "to

give two of these at once " and had instead given the tubeitself and wondered where another one was. The patienthad taken it in good faith, thinking it a new form of drugand wondering only why it was so long. Of course therewas nothing to do but to wait. Castor oil was given freelyand on the afternoon of May 5th-four days later-the tubearrived, without any pain and with the cork still in situ. I

may add that the tube was half full of ergotine, so that themany risks of a foreign body in the intestine were muchaugmented by the fact of that body containing a poison.The patient is very well now and able to laugh over her.adventure.-I am, Sirs, yours faithfully,

W. HERBERT GREGORY, M.D.Edin.Beverley, May 16the,1903.

ASPECTS OF LIFE ASSURANCE.

To the Editors of THE LANCET.

SIRS,- With reference to a leading article which appearedin THE LANCET of May 9th, p. 1313, calling attentionto the provision which may be made for the future bythose who insure their lives, I observe that considerablestress is laid upon the certainty attending this formof investment. Indeed, the fact that a sure provisionis made for the survivors of the assured, owing to thefinancial soundness of life assurance companies, is one

always dwelt upon by those who recommend them. Isnot, however, this certainty of provision considerablylessened by the fact that many or most life assurance

societies issue policies which are in express terms madevoid by the suicide of the assured ? 2 It is, of course,contemplated by them that a man might insure his lifeat a high figure, pay a premium or two, and then kill him-self in order to pay his debts or to provide for his wife andfamily. I am, I believe, right in saying that suicide is thusexcepted in the conditions usually made. If I am wrongyou will, no doubt, correct me. My point is that suicide is

very frequently the result of what is substantially disease andas much a cause or form of death to which all are liable astyphoid fever or a railway accident. Speaking from my ownlimited experience I can recall, among others, three personsin particular with whom I was personally acquainted whocommitted suicide. Two were lawyers with moderate pro-fessional incomes and private means ; the third was engagedin commerce and his assets at his death amounted to not farfrom f:lOO,OOO. Of the two former, one became depressed,I do not know why, and before anyone recognised the factthat his brain was affected took his own life ; and the other,as everyone knew, after a severe attack of influenza foundhimself less able to work than before, got worried, andshot himself. Each of these was precisely the sort of manwho might well have insured his life. There was nothing todistinguish him in health from his fellow men ; each had afamily and was earning enough to have been able to havedone so. At all events neither was in embarrassed financialcircumstances, any more than the third, whose brain, Ibelieve, was affected by a succession of hunting accidents.I think, however, that I am right in saying that the majorityof policies which would have held good had these men diedfrom pneumonia or in the hunting-field would have beenrendered void by suicide for which influenza or a huntingaccident was directly responsible. Can life assurance, if itis ineffective in case of a death which (as I contend) is asmuch beyond the power of the assured to avoid as anyresulting directly from disease, be regarded as a certain andsafe provision for a professional man to make ’?

I am, Sirs, yours faithfully,May 18th. 1903. N. M. R.

PRESENTATION TO A MEDICAL PRACTITIONER.-At Orediton (Devon) on May 9th Mr. Leslie Powne,M.R.C.S. Eng., L.S.A., was presented with a pair of goldcuff links by the members of the ladies’ class of the St.John Ambulance Association, in appreciation of his servicesas honorary lecturer.

THE SECOND INTERNATIONAL CONGRESSOF THE MEDICAL PRESS.

(FROM OUR SPECIAL CORRESPONDENT.)

THE OPENING CEREMONY.Madrid, May 6th.

IT seems a long way now to hark back to April 20th whenthe International Congress of the Medical Press held its

inaugural sitting in the great hall of the Central Universitybuildings of Madrid. But this congress, instead of ter-

minating its labours on April 22nd, continued its work up tothe very last minute on April 23rd, giving its members onlyjust time to rush from the closing sitting of the one congressto assist at the opening ceremony of the other. This latter

Congress, the Fourteenth International Congress of Medicine,affording greater general interest than the more specialisedquestions that concern medical journalism as a profes-sion, it seemed to be better to describe the more importantcongress first in spite of the fact that it was held last. The

inauguration of the Medical Press Congress was a ceremonywell worthy of the occasion. Senor Allende Salazar, Ministerof Public Instruction, presided, sitting by the side of Dr.Cortezo, the President of the International Congress of the

Dr. Carlos M. Cortezo. President of the International Congress ofthe Medical Press.

Medical Press, and Dr. Calleja, President of the InternationalMedical Congress. At the presidential table France was

represented by Professor Cornil of Paris, president ofthe International Association of the Medical Press, andEngland by Dr. Frank Pope of Leicester, delegate ofthe Association of the British Medical Press. The rectorsof the Universities of Madrid and of Barcelona were

also in the place of honour at the presidential table.Dr. Larra y Cerezo, as general secretary of the Congress,was first called upon to make a statement and to explain theposition of affairs. As a medical journalist Dr. Larra cannotbe accused of being wanting in enterprise. He had barelyterminated his studies, devoting himself especially to ques-tions of hygiene and therapeutics, when he founded, in 1882,the Therapeutical Review, and not content with this he evenpublished a daily medical paper called the Diario Medico.This was the fruit of youthful enterprise. Dr. Larra was

only 23 years old at the time, nevertheless his daily paperlived ten months, and his review still exists though it wasmerged into La Medicina Militaire Española in 1895. Dr.