MARYLEBONE WORKHOUSE. - The report of the experienced and able master of the Marylebone Workhouse, Mr. G. E. Douglas, for 1882, has just been issued. The average daily number in the house was 1,577. While deploring the frequency with which some weak paupers returned on their day of leave, drunk enough to be quarrelsome, but not so intoxicated as to be refused admission, the indefatigable master speaks most favourably of the conduct of the inmates generally, especially of the old people. All this excellence of conduct, and good discipline, though, as Mr. Douglas states, "during the year not a single ounce of ale, porter, wine, brandy, gin, or whisky had been ordered by the medical officer, and, except on Christmas Day, there had been no fermented or spirituous liquors consumed in the workhouse by the inmates"

HUDDERSFIELD WORKHOUSE.-At a recent meeting of the Huddersfield Board of Guardians it was stated that a letter had been received from Dr. Scougal, medical officer of Fulstone, as to the adoption of the non-alcoholic principle in the treatment of paupers. After his appointment Dr. Scougal, who is a total abstainer, asked if it was absolutely necessary for him to order brandy, spirits, or wine along with beef-tea or other articles of extra food for sick patients; and he suggested that instead of wines and spirits farinaceous food and maltine should be substituted. Acting upon instructions, Dr. Scougal tried the system for six months, and in writing to the Board he said that patients improved more rapidly on the use of malt extract, Lloyd's food, and such things, than they did when they had brandy or wine. Several patients had recovered far more rapidly under a non-alcoholic treatment than under the other treatment; and he expressed the opinion that the non-alcoholic treatment had the merit of economy. After a short discussion, it was decided not to make any

change, but to leave it to the medical officer.

CHATHAM WORKHOUSE.-At a meeting of the Medway Board of Guardians Dr. W. Buchanan (the house surgeon), reported that since he had stopped the supply of wines, spirits, and beer, the working of the building had been much more satisfactory. There had been no disturbances and quarrels as formerly, and all were satisfied with the new arrangements. The lunatics are much better now than when they had liquors allowed to them. The whole of the hospital was better now than previously, although the number of cases brought in had been larger. A question had been raised as to whether the withdrawing of the wines, spirits, and beer, tended to prolong the stay of invalids in the hospital; but his experience was that it had the opposite effect, as there were now no inducements for them to stop. Then there was the point as to mortality; this he had carefully gone into and found that although the cases of sickness had been more numerous the number of deaths during the past six months had been six less than in the corresponding period of the previous year. The Clerk said that whilst going through the accounts he had been struck by the fact that the entire cost of wine, spirits, and beer-including the beer allowed to the officers and servants-was, for the last year, under £100. In the hospital it had not been more than £3. He had known it to have been as high as £800 or £900.

HEREFORD ASYLUM.-In the 11th annual report of the Committee of Visitors of the Hereford County and City Lunatic Asylum for the year 1882 the following significant statement appears :-"Milk is now the general beverage, and only two or three patients complained to us of its substitution for beer." The medical superintendent reports that at dinner skim milk is given instead of beer, and at lunch cocoa is provided. He adds::-"The change has been in no

lead to a wider one, and that it would be conducted under the auspices of the British Medical Association. Possibly they might also recommend a method by which certificates might better define the cause of death than now.

Surgeon-Major FRANCIS spoke of the connection between beer-drinking and rheumatism, and related the case of a man who was cured of this soon after he abstained from that beverage. It was beyond question that a large percentage of liver disease was due to alcohol; but some people suffered in this way who never drank alcohol at all. This report did not touch that very large class who became incapacitated for the duties of life mentally and bodily by reason of drink. He thought this was one of the most valuable inquiries they had had for some time.

Dr. FAIRLESS pointed out that alco. hol in many cases of death might be the chief factor, but was disguised under some other cause. Now, they could never arrive at proper results unless the true factors were given. The real cause of death was often veiled.

Dr. MORTON said that the experience of Dr. Drysdale was that of a physician and not of an ordinary medical practitioner, which might account for the difference of his observation. He (the speaker) believed that heart disease was largely caused by alcohol, particularly what had here been described as structural disease of the walls of the heart. In the deaths

recorded in a large asylum not one was put down to alcohol, and to look at 'suicide one would suppose that it had nothing to do with drink. Therefore the figures of the Harveian report erred probably in underestimating the deaths due to alcohol. He thought grocers' licenses had much to answer for respecting female intemperance, and the law should be altered.

Dr. NORMAN KERR (who, in the absence of Dr. Richardson, the President, had occupied the chair), in proposing a cordial vote of thanks to Dr. Morton, said that this was a subject of national importance, and should command the attention of the Legislature if it desired to attend to the health of the people. The medical profession, without entering into party politics, should make representations to the Government, so that laws might be passed to increase the life and health of the community. Dr. Kerr proceeded to show the great difficulty of arriving at the exact facts in an inquiry like this, and concluded by endorsing the suggestion of Dr. Ridge that this matter should be dealt with on an extended scale by the British Medical Association.

On the motion of Dr. Drysdale, seconded by Dr. GRAY, a resolution was passed condemning grocers' licenses, as detrimental to the health of the community, and urging that they should be discontinued.

The proceedings then closed.

148

UNION.

NURSES' TEMPERANCE We are glad to report the formation of a Temperance Society for Nurses throughout the United Kingdom. The members "promise, by God's help, to abstain from all intoxicating drink, and to use all means in my power to alter the habits and customs by which drinking is encouraged." The honorary secretary is Miss A. T. Bristow, The Park, Dunmurry, Co. Antrim, or Nurses' Home, Belfast.

THE DALRYMPLE HOME.-At the first annual meeting of the Dalrymple Inebriate Home Association it was reported by the Honorary Secretary, Dr. Norman Kerr, that upwards of forty sites had been inspected, but one had not yet been secured for the proposed Home, although it was expected that an offer now under consideration would be accepted There was £600 in the bank, and £1,100 more was promised. A member of the committee has also offered £500 if nine other sums of an equal amount were raised. A very influential list of vicepresidents has been published.

REMARKABLE LONGEVITY. - In a letter to the Medical Press and Circular (March 7) Dr. O'Flanagan, of Houghton-le-Spring, Durham, gives an account from La Presse of February 7 of "a Russian peasant, named James Zygelof, who had just died at Odessa, at the age of 147. Of the rest of the family, his son is still alive, at the age of 115 years, his grandson at 85 years, and his great-great-grandson at 40 years. More wonderful still, Zygelof never smoked nor drank any alcoholic liquors in his time. And the history ends by saying that this is a good point for the temperance societies.'

MILK V. ALCCHOL IN THE TREAT. MENT

OF INSANITY.-"The greater my experience becomes," writes Dr. Clouston, in the Annual Report of the Royal Edinburgh Asylum for the Insane, "I tend more to substitute milk for stimulants. I do not undervalue

the latter in suitable cases; but in very acute cases, both of depression and maniacal exaltation, where the disordered working of the brain tends rapidly to exhaust the strength, I rely more and more on milk and eggs made into liquid custards. One such case this year got eight pints of milk and sixteen eggs every day for three months, and under this treatment he recovered. I question whether he would have done so under any other. All acute mental diseases, like most nervous diseases, tend to thinness of body; and therefore all foods, and all medicines, and all treatments that fatten, are good. To my assistants, and nurses, and patients, I preach the gospel of fatness as the great antidote to the exhausting tendencies of the disease we have to treat; and it would be well if all the people of nervous constitution would obey this gospel."

PROGRESS OF MEDICAL OPINION.Dr. H. Nankivell, speaking at Bourne. mouth, said he thought the medical profession had during the past twenty years fairly boxed the compass on the temperance question. When he was a student in the London hospitals it was a practice whenever a fever case came in to order at once three ounces of brandy; whatever the condi ion of the patient might be this was a matter of routine, and if the house surgeon had neglected to order that prescription he would probably have found himself taken to task by the physician when he came round next day. He was thankful to say, as they were an advancing and progressive profession, they had found out tha was wrong, and had not been ashamed to acknowledge it and to alter their practice. He did not think there was a hospital in the country now where brandy was ordered in that way to fever patients; and in private practice he believed the cases in which medical men found they were obliged to order stimulants would grow less and less.