*

Friedelben, who has been largely ("Canstatt Jahresb," for 1861, Band 1, p. 146, 1862) engaged in the analyses of bone, has published a full criticism on the statement made some years ago by Boussingault, that the lime salts taken in water are useful in supplying this earth for the bones. Friedelben has shown that Boussingault's figures are erroneous, and that at present this alleged use of lime salts in water can neither be affirmed nor denied.

A few observations on the propagation of typhoid fever by means of impure water are subsequently related. A good instance has been given in the American War of an outbreak of diarrhoea caused by drinking impure surface water: it ceased when wells of 20 to 30 feet deep were dug.

Dr. Knoch, of St. Petersburg, has published some interesting observations + on the Bothriocephalus Latus. He believes that there is no doubt the embryo (not the egg, or rarely so) is taken with the drinking water into the stomach.

The embryos of the Bothriocephalus Latus develop their ova only after remaining months in fresh water (i.e. rivers and lakes); in river water, as infusorial, ciliated organisms, moving actively about by means of their cilia for several days, and finally becoming transferred in a passive way through the same medium (river water used as drink) to the human system. According to our own observations, there are two species of bothriocephalus common to man, and not a single one only, as hitherto supposed."

With regard to the two kinds or varieties-"The divisions of one are uncommonly broad from the neck to the other extremity in proportion to the length; in the other variety the breadth of the proglottidæ, in proportion to the length, is less marked."

FOOD.

It was expected that the International Exhibition would have been very rich in articles of food, and there were, indeed, almost innumerable specimens of produce of different countries; but there was nothing novel, and, as far as is known, no new kind of food was introduced.

Preserved Food.-For military surgeons the greatest amount of interest attaches to the preservation of food, and to the possibility of obtaining concentrated food which will require little cooking, and which, therefore, would be available for forced marches, secret expeditions, when transportation cannot be got, and other warlike conditions, which will occur to every one.

A paper previously given on "Carniset," a food of this sort prepared in Berlin, and which was sent by the Government to Fort Pitt to be tested, may be referred to as of interest in this direction. In the Exhibition there was nothing at all novel of this kind, but there were examples of two or three rather new plans of preserving food, and the following extract from the Juror's Report will be found to give a good account of them :

"Preserved Meats.

"Very little improvement has been made in this branch of industry since the Exhibition of 1851, notwithstanding the importance of it, and the large increase of its trade. Most of the meat is over-done, and is loaded with fat, and in many cases the food had acquired a metallic flavour from the vessel in which it was preserved.

"As in 1851, the principal mode of preserving the meat is by the exclusion of atmospheric air. This is accomplished by first filling the case with the meat or soup, then soldering down the cover, which has a small aperture in it for the exit of steam. The cases are then stood in a saline bath, or upon a hot plate, until the liquid within them boils freely and expels the contained air. While thus boiling, and steam is freely issuing from the minute orifice in the cover, the hole is stopped with solder, and so the case is hermetically sealed. By this process the meat is generally overdone; it loses its fresh flavour, and becomes sodden and broken up; besides which, on the cooling of the case, the steam within it condenses, and there is a constant vacuum and liability to indent and buckle from atmospheric pressure. A trace, also, of air frequently remains within the case, and thus the oxygen slowly, but surely, sets in putrefactive decomposition. To remedy these defects two improvements have been suggested. One of these was patented by Messrs. John McCall and Co., of

* Petersb. Med. Zeits., 1861; noticed in the Lancet, Jan. 1862; and given in Virchow's Archiv. Band xxiv. p. 453.

Houndsditch, in 1861. It consists in the introduction into the tin of a small quantity of the sulphite of soda. The proportion used is about twelve grains to each pound of meat. The effect of this salt is to absorb from the meat and the air of the case the small proportion of free oxygen which, under the best of circumstances, often remains within it. In order that the sulphite of soda shall be isolated until the air is expelled and the case soldered down, the salt is enclosed in a tin capsule soldered to the inside of the top of the canister. The capsule has two holes in it, plugged with fusible metal, which melts at a few degrees above the temperature of boiling water (about 218°). As soon as the steaming hole is closed, and the temperature raised by the steam pressure within, the fusible metal melts and releases the sulphite of soda within the capsule. It is presumed that the effect of this improvement will be the doing away with the necessity for the prolonged steaming of the food before the cases are soldered down, and thus the prevention of that over-cooking which has hitherto been so objectionable. In the case of soups, the salt is not always enclosed in a cap, but is put into the soup.

"The other improvement is a process of Messrs. Jones and Trevethick, of Botolph Lane. It provides for the preservation of food in the raw state, without the disadvantage which all preceding processes have of maintaining a vacuum within the case. The process is conducted in the following way :-The meat is wrapped up in a piece of cloth, and is enclosed in a tin case; the cover of the case is then soldered down. From the top of the case there projects a short tube, which is brought into connection with the exhausting power of an air-pump: a very ingenious contrivance is adopted, whereby the tin cases are protected from external pressure during exhaustion. This is accomplished by placing the tins in an air-tight vessel filled with water, the elastic property of which supports the sides of the case, and prevents the slightest collapse. When the air has been exhausted from the tins, a charge of pure nitrogen is let into them. This also is exhausted, and then a minute dose of gaseous sulphurous acid is introduced. Finally, another charge of nitrogen is let in, and the vessels are permanently soldered down. The effect of the sulphurous acid is to combine with the minute trace of oxygen which remains in the case, and the nitrogen, by filling the case, prevents collapse from atmospheric pressure. The nitrogen is obtained pure from atmospheric air by a simple chemical process which absorbs the oxygen. Mutton, beef, hams, fish, poultry, and game were exhibited preserved in this way, and the results were remarkably successful and satisfactory. The poultry and game had the appearance of having been but an hour or two from the poulterer's. The ham and bacon were as good after many years' keeping as if they had been just cured; and, although the fresh meat had acquired a rather bright red tint from the action of the gases upon the flesh, yet the flavour was decidedly superior to that of any other kind of preserved meat. The process offers a promise of great economic value."

A process somewhat similar to these has been lately described by Polli.* He has also recalled attention to the very powerful preservative effect of sulphurous acid. The meat is placed in a vessel of convenient size, and suspended over water; sulphur is then burnt in the vessel, which is hermetically closed. The burning of sulphur must be repeated every day at first, and then every two or three days. When the meat is to be used, it must be washed, and then exposed to the air for a short time. The sulphites of the alkalies are less useful, as the meat has to be longer washed, and thus loses some of its salts.

Milk can be preserved in the same way. If it is mixed with one-thirtieth part of its volume of solution of sulphurous acid, it is said to remain fluid for months, and fresh even in summer.

Adulteration of Food.-It would appear that adulteration of food has lessened during the ten years from 1851 to 1861, probably owing to the great attention directed to the point, and to the easy mode of examination given by the microscope. The greatest improvement has taken place in pickles and confectionery.

Pickles are much freer from copper, and the confectionery of the best makers is now tolerably pure. The following extract from the Juror's Report may be interesting: :

"Confectionery and Sweetmeats.

"In a very conspicuous place in the Eastern Annex there is a case of Dr. Hassall's, which represents, as far as confectionery is concerned, the various kinds of adulteration

* Annali Univers de Medic., quoted by Birkmeyer in Canstatt, for 1861. Book vii., p. 52. 1862.

which were practised about the time of the first Exhibition. Every comfit and bonbon contains an amount of impurity which would shut them out from the market at the present time-chalk, plaster of Paris, flour, and poisonous pigments abound in the composition of most of them. A glance, however, at the confectionery which is exhibited in the neighbourhood of this case, will show how great has been the improvement of its manufacture. And not only has there been a large improvement in the quality of the goods, but there has also been a large increase in the quantity of them produced. No longer ago than the year 1855, the total amount of confectionery nade in this country did not exceed 8,000 tons in the year, whereas at the present time the quantity is not less than 25,000 tons per annum. One house alone, as we are informed, is making about two-and-a-half tons of lozenges and comfits per day, besides about fifty tons of marmalade, and sixty of jams, in the course of the year."

c. Diseases produced by Bad Quality of Food.-Circumstances have led to a good deal of discussion during the year, on the effects produced by meat taken from diseased animals, but not actually decomposing. A proposition was made to exclude from the London market the meat of diseased animals, whatever the affection might have been; but it was found that this would have the effect of bearing very hardly on the poor, who obtain at a lower price meat of this description. Before entering on an action of this kind it was felt to be desirable to estimate precisely the nature of the evidence proving the production of disease from this cause. The available evidence was found to be very limited and defective, and the Metropolitan Officers of Health have therefore appointed a Committee to examine the point, and probably the result of their investigation will be available for next year's Report.

Dr. William Budd* has commenced a series of very important papers on a part of this subject, viz., on the production of malignant pustule in men, arising, it is inferred, from inoculation during the use of meat taken from animals who have died of the disease. The general result is to show that malignant pustule in men is not uncommon in this country, and that it is marked by most precise and definite symptoms, symptoms so certain as to identify it beyond a doubt with the "charbon" of cattle, and which are thus detailed by Dr. Budd :

"The commencement of the disease in an affection resembling the bite of a gnat, and at first sight not at all more serious in outward seeming; the importunate itching, or the equally characteristic stinging and burning of the early stage; the formation within a few hours of the well known vesicle; the hardening, blackening, and death (the "mummification," as the French and Germans express it) of the texture immediately around it (hardening so extreme, and death so entire, that in more than one instance the knife of the surgeon creaked in the flesh, inflicted no pain, and gave issue to no blood); the diffuse and erysipelatous swelling of the larger area, the crop of sedentery vesicles, the chains of inflamed lymphatics, the fator of the breath, and, lastly, death amid all the indications of septic poisoning, were incidents common to all. Taken in their whole succession, it may be safely affirmed that there are incidents which are diagnostic of malignant pustule, and belong to no other malady.

There is very little or no pain in the disease, and there is no formation of pus-two negative signs of importance.

The exact similarity of this disease with the charbon of cattle certainly does lead to the idea that it may be derived from animals thus affected, but direct evidence is still rather deficient. In the majority of Dr. Budd's cases the disease was not recognised in time for a proper enquiry to be instituted. In two cases the disease "undoubtedly followed the bite of a fly, and occurred in the seat of the puncture." Dr. Budd believes that insects feeding on the diseased meat may thus carry the poison, and quotes a sentence from Virchow to the effect that flies may, without biting, "implant the poison by their soiled wings and feet."

Certainly there must have been an inoculation of some kind in these cases, though direct evidence of its origin and nature is quite wanting.

Dr. Budd also states that the temperature of boiling water does not destroy these animal poisons.†

British Medical Journal. January and February, 1863.

It may be well to give some of the synonymes of the "malignant pustule;" morbus carbuncularis, anthrax, typhus carbunculosus, pustula maligna, pustula livida, pustula gangrænosa, carbunculus contageosus, milzbrand, karbunkel-krankheit

During the year 1862 the subject of the propagation and changes of the Entozoa, which has been so singularly explained of late years, has received additional illustration.

A great work has been commenced by Leuckardt,* of which the first two parts only have appeared.

The most interesting part of the volume is the description of the Tania mediocanellata, which Leuckardt has shown to be very common, and which he thinks is not derived from the pig, like the Tænia solium, but from the ox. It would seem that the chief tape-worm of Abyssinia is the Tania mediocanellata, and not the Tænia solium, as formerly supposed; and it is very interesting to find that M. Cornbont has, without knowing Leuckardt's observations, stated that the habit of eating raw beef is the cause of the prevalence in Abyssinia.

In last year's Report the singular febrile disease supposed to be produced by the wanderings of the young trichina was mentioned. The last year has seen some remarkable examples of this newly-recognised" trichina disease," which appears to be caused especially by eating pork infested with the trichina spiralis.

A singular outbreak of this affection, affecting 25 to 30 persons, has occurred at Planen, in Saxony. In three patients little portions of the muscle from the upper arm were taken, and under the microscope living and very active trichinæ were seen. The symptoms of the disease were depression for many days, followed then by extraordinary pains in the limbs, swelling of the face, and fever. After two or three weeks the symptoms in the slighter cases gradually disappeared; in the severer cases there was general and painful swelling. Only one case in sixteen died: it was dissected by Zenker, and free and encapsuled trichina were found in abundance.

An extremely remarkable case has also been recorded by Dr. Friedreich, of Heidelberg. The patient was a butcher, who was admitted with a train of symptoms which led Friedreich at once to suspect the nature of the disease. There was considerable fever and diarrhoea, and so far the disease slightly resembled typhoid; but there were singular and excessive muscular pains almost everywhere, especially in the calves of the legs, which were hard and elastic, with a feel almost of India-rubber. So severe were the pains that the patient could not sit up in bed; at a later period there was contraction of one biceps; there was also hoarseness. After continuing for some days without much change, a pustular and furunculoid affection appeared, and swelling of the lower limbs. There was throughout profuse sweating.

The joints were quite free, and this negatived the diagnosis of rheumatic fever.

The patient, who was treated with the picro-nitrate of potash, slowly recovered.

The muscles (calves of the legs) were harpooned several times. The first time was about twenty or twenty-one days after the commencement of the attack; although only a piece of muscle about the size of a hemp-seed was

charbon malin, pustule maligne, puce maligne. Carbunculus hungaricus and pemphigus hungaricus are names, which have been given from its local prevalence. A great number of works have been published abroad on this subject. Virchow, in a short bibliography, gives the titles of 16, the earliest of which was written in 1769, by Fournier, of Dijon. In this country the disease has, till lately, either been infrequent, or has been overlooked. At present it does not appear to be uncommon.

It must be remembered, however, that affections extremely like the malignant pustule can certainly arise in men independent of the diseased meat of animals dying of "charbon;" sometimes these are, owing to other animal poisons, such as pus or fluids from vesicles, and sometimes no cause can be traced. Also, it must be remarked, that Neffell has lately asserted that the Kirghis Tartars cat without injury the flesh of cattle dying of charbon, and that Renault (quoted by Payen) has affirmed that no bad effect can be traced to the use of meat taken from animals with any contagious disease.

*Die Menschlichen Parasiten von Dr. Rudolf Leuckardt. Leipsig, 1862.

+ Observations topographiques et Médicales recueillies dans un voyage a l'isthme de Suez. Paris, 1861.

Schmidt's Jahrb. 1862. No. 7, p. 142.

§ Virchow's Archiv. für path. Anat. 1862. Band xxv. p. 399.

taken out, no less than seven trichinæ were found. Ten days later other harpooning showed no trichinæ ; but seven days after this a living, but not encapsuled, trichina was found; and four days after this an encapsuled worm was discovered. Seventeen days later, when the patient was quite well, the

search for trichina was fruitless.

The muscular fibres were not inflamed, but were fattily degenerating rapidly.

A very extraordinary discovery was that a trichina was found in the pus of one of the boils, so that Friedreich asserts that the furunculoid disease was caused also by a wandering of the worm beyond its usual site.

The patient had been engaged killing pigs the week before his illness, and had often held his bloody knife in his mouth, and had also eaten raw some of the bits intended for sausages.

Another outbreak, apparently of the same kind, has occurred in Magdeburg,* and has prevailed during five summers, but was at first not recognised. The chief symptoms were the fever, the severe pains, and the swelling of the lower limbs, which caused the disease to be called, at first, "scleroma adultorum.” All the circumstances indicated the trichina disease; but the animal was not sought for.

Another instance has been recorded by G. Simon and Herbet, and has been mentioned by Meissner. In a small town of 1,200 persons, 38 persons were attacked (or 3 per cent. of the population), and 8 persons died, with symptoms so striking as to lead to a diagnosis of trichina disease. In one dissection (the only case dissected), the trichina were found in innumerable numbers. It was found that all the inhabitants obtained their meat from one butcher, who, with his wife and daughter, was himself attacked by the disease. Of the 38 persons, no less than 36 were known to have eaten pork-in seven cases raw, in the others lightly cooked. In two cases it was denied that pork had been taken. The symptoms were similar to those already noted; and, looking to all the circumstances of the case, the feeding on the same food, the similarity of the symptoms, the proved existence of the innumerable trichinæ, in one case at least (the only case properly investigated), there can remain no doubt that this was an outbreak of the "trichina disease."

In fact, it seems quite certain that a new febrile disease must be admitted into our nosology, and another slice is taken off from the heterogenous group of "continued fevers."

It seems quite clear that the trichina is not killed by putrefaction of the pork, or by freezing it, or by salting. It does not seem yet certain whether smoking kills the trichina as completely as it does the cysticercus ; certainly many are killed, and, if the process is continued long enough, perhaps all.

SEWERS AND DEODORISATION.

Three important works have been published in 1862, viz., Two Reports of the Committee of the House of Commons (Dr. Brady's)+ appointed to enquire into the question of Sewage; and the Second Report of the Commission,‡ of which Lord Essex is the president, and which is engaged in investigating the subject on a very large scale.

All that is known of the effect of sewage applied to land may be gathered from these books.

Disposal of Sewage.-The Commission have very strongly reported against the practice of discharging sewage into running streams. Not only is there danger of the contamination of the drinking water, but it is found that so great is the deposit that the channels of rivers are becoming clogged. Even the bed of the Mersey is becoming raised. In Glasgow 8,000l. are spent yearly in removing the sewage deposits from the Clyde; at Bath the Avon is becoming clogged; and the streams in Birmingham, where 25,000 tons per annum of solid deposit are now arrested, have permanently silted up their beds some

* Meissner in Schmidt's Jahrb., 1863. No. 1, p. 50 and p. 51. Parl. Paper. Ordered to be printed, April and July, 1862.

Second Report of the Commission appointed to enquire into the best mode of Distributing the Sewage of Towns. Bluebook, 1861.