four were doubtful, and 10 were normal. Thus of 84 general paralytics at various stages 44 showed "cubital analgesia,' eight were doubtful, and 32 were normal. Of the other lunatics who exhibited the symptom the ratios were: dements, 87 per cent.; idiots, 85 per cent.; degenerates, 40 per cent.; melancholiacs, 32 per cent.; chronic delusional cases, 30 per cent.; maniacs, 19 per cent.; alcoholics, 10 per cent.; while epileptics showed normal feeling in all the cases-20 in number were examined. It will thus be seen among lunatics that excluding the cases of idiots and dements-i.e., all cases of profound arrest of growth or degeneration of the brain-the greatest percentage of patients who exhibit this sign is composed of general paralytics, of whom 52 per cent. have cubital or ulnar analgesia. This symptom must therefore, the writers think, take rank next only to the already known physical signs-viz., inequality of the pupils with loss of reaction to light and tremors of the tongue and lips, with indistinctness or hesitancy of articulation which characterise general paralysis of the insane even in its early stages. the chigoe, but Dr. Emily never met with a case of craw-craw| 36 at an advanced stage 22 showed "cubital analgesia,” among the blacks of the Lower Congo. The wounds made by the insect pests and enlarged by scratching may serve as ports of entry to the specific germs, but apparently the latter do not reside in the irritant liquid which is injected beneath the epidermis. Craw-craw ulcers are invariably multiple and may occur all over the body. Dr. Spire of Ubangi has met with them on the penis where they simulated chancres, the resemblance being accentuated by inguinal adenopathy. The treatment of craw-craw has hitherto been most unsatisfactory, apparent cure after lengthened medication being almost always followed by relapse. So inveterate, indeed, did Dr. Emily find the complaint that in spite of all his efforts several members of the mission who had acquired craw-craw in Western Africa were still suffering therefrom on arrival in the Nile basin. At length it occurred to him | to make a trial of boric acid and as far as he has gone the results have been well-nigh magical. But the drug must be given a fair chance of coping with the germs at close quarters in the following manner. All hair in the vicinity of the ulcer having been removed the next procedure consists in an energetic washing with soap, brush, and a corrosive sublimate solution. This portion of the toilet over, the craw-craw itself is next cleansed by means of a similar solution and tepid boiled water. The base of the ulcer thus exposed will be found to be granular, tortuous, and purulent. Dr. Emily then proceeds to swab out the cavity with wellsqueezed plugs of lint, nor is he content until the pus is replaced by sanguineous oozing. As may be supposed this stage of the process is a painful one, but it does not last very long and is absolutely essential. Pure pulverised boric acid applied freely, boricated vaseline, and antiseptic bandaging complete the operation. The pain quickly disappears, being followed by a sensation of great comfort and when after five or six days the appliances are removed the craw-craw will be found to be completely cicatrised. Dr. Emily gives the details of four cases which were treated in this way with the utmost success. "CUBITAL ANALGESIA" IN THE INSANE: A VALUABLE DIAGNOSTIC SIGN. FIVE years ago an Italian observer (Biernacki, in NeuroZogisches Centralblatt, 1894) noted that the peculiar painful feeling with tingling felt along the course of the ulnar nerve and the slight muscular contraction in the little finger and hypothenar eminence, following upon pressing and nipping the ulnar nerve-trunk at the back of the elbow, were absent in a considerable number of patients suffering from locomotor ataxy. In the following year Cramer noted that this "cubital analgesia" was very common among general paralytics in lunatic asylums, reaching as high as 75 per cent. The attention of alienists being thus directed to the subject, various observations were made on the frequency of this sign in lunatics other than general paralytics to establish its value, if any, in differential diagnosis. Mündel stated' that from his observations at the Berlin Polyclinic on tabes, general paralysis, and other neuroses he considered that this sign was of great importance. In the present year Dr. P. Keraval, superintendent of the asylum at Armentières in France, has published the results of a systematic examination of 626 asylum patients-viz., 84 general paralytics and 542 other lunatics (melancholiacs, dements, imbeciles and degenerates, idiots, maniacs, alcoholics, &c.)—carried out by himself and his assistant, Dr. Laurent, with the following results :-Of 18 general paralytics at an early stage 10 showed "cubital analgesia," two were doubtful, and six were normal; of 30 at a medium stage 12 showed "cubital analgesia," two were doubtful, and 16 were normal; and of 1 Psychiatric Congress at Berlin, 1895. 2 Archives de Neurologie, vol. vii. No. 38 February, 1899. 2 MYELOPATHIC ALBUMOSURIA. AT the meeting of the Royal Medical and Chirurgical Society on March 14th Dr. Bradshaw and Dr. Warrington of Liverpool made a most interesting communication on a rare case which clinically was at first characterised by the persistent occurrence of albumose in the urine which was present till death. Shortly before death indications of softenit was found that the softening of bones was due to multiple ing of the ribs and the sternum appeared and at the necropsy myelomata. The association of albumosuria and multiple tumours of bone has been recorded previously, the first case being by the late Dr. Bence Jones in 1847, but in all of Bradshaw and Dr. Warrington's case appears to be the first these the bone lesions were only discovered after death. Dr. in which the diagnosis was made during life. The name of 'myelopathic albumosuria" which they propose to give to the condition is an appropriate and convenient one and will distinguish it from other forms of albumosuria which are often associated with granular contracted kidney and with diseases attended by much formation of pus such as empyema. THE CONSERVANCY OF THE RIVER LEE. THE Condition of the River Lee, as our readers are aware, has for a long time past been in a most unsatisfactory state. In the articles which we published on the metropolitan water-supply we called attention to the condition of the intercepting drain which belongs to the East London Waterworks Company and was made for the purpose of lessening the impurity of the river at the intakes of the company. We pointed out that the effluents which passed into the drain from the sewage farms of two of the local authorities were in a disgraceful state. The Conservators have certainly not exercised proper vigilance in this matter. The barge owners who use the Lee Navigation have also just cause for complaint as to the condition into which the waterway has been allowed to pass. When a public body neglects its duties it is sometimes best radically to change its constitution. This idea was strongly held by the London County Council who in a Bill which they introduced into Parliament this year proposed to entirely alter the constitution of the present Lee Conservancy Board. The proposition of the London County Council was that the board should consist of 14 members, of whom seven should be appointed by themselves, and that the counties of Bedfordshire, Hertfordshire, and Essex, the corporations of West Ham and of London, the council of the administrative county of Middlesex, and the water companies should elect one representative each. The 1774, the year after its foundation, which led to the proposition that the London County Council should have the resignation of the President and the secretaries, and of the appointment of seven members and that the county of Hert- way in which Lettsom smoothed over the difficulties and lea fordshire should have only one member seems on the face of to the return to the society of the revolted members. it absurd, and possibly the London County Council made this Lettsom cemented this reunion by regaling the Fellows quaint proposition simply with a view of showing that "some- in 1775 on a turtle which had been presented to him. thing should be done.” This effect at any rate has been pro- The ancients believed that the earth rested on the back of a. duced. The London County Council Bill came up for second tortoise and Mr. Owen believed that the prosperity of the reading in the House of Commons on Thursday, March 9th, society was "based on the carapace of that turtle." Followwhen Mr. Cecil, member for the Hertford division of Hert- ing the toast of the evening came the presentation of the fordshire, announced that the Lee Conservancy Board had Fothergillian Gold Medal to Dr. S. Monckton Copeman passed a resolution to the effect that "if the clauses relating for his researches on glycerinated calf lymph which had to the Lee Conservancy be withdrawn from the present led to such excellent results. Dr. Copeman was very Bill the Lee Conservancy Board will themselves pro- loudly cheered. Dr. West proposed proposed the toast of1 mote a Bill in the next or following session of Parlia- the visitors to which Sir Samuel Wilks, Bart., and ment for the reconstitution of the Board in such Sir William of the Board in such Sir William Mac Cormac, Bart., K.C.V.O., responded. manner as to make it representative of all the interests The health of the President was proposed by Dr. Orď of the river Lee." Mr. Cecil announced that the Hertford- who referred not only to Mr. Owen's fulfilment of his office shire and Bedfordshire members of Parliament had come to as President, but to his personal qualities which would have. the decision that it would be well for the Lee Conservancy ensured him distinction whatever profession he had adopted. Board to promote a Bill on the lines indicated and that they The toast was received with musical honours and Mr. Owen would be ready to do so if the London County Council replied. An excellent musical programme was arranged by dropped that part of their Bill referring to the Conservancy Dr. Robert Maguire which added greatly to the enjoyment of of the Lee. Mr. James Stuart, member for Shoreditch, the evening and included pianoforte solos by Mr. Plimmer, a who was responsible for the Bill, withdrew the clause violoncello solo by Mr. Ronald Carter, and two songs by Mr. which had reference to the Lee on the understanding Foster Ferguson which were loudly encored. that a Bill will shortly be promoted by the Lee Conservancy Board. The purity of the Lee water and the navigation of the river are of very great importance and we are of opinion that they should be dealt with by the Government. The enormous amount of good which has been effected by the Thames Conservators during the last few years has shown what can be done in the way of river We are of opinion that the best solution for purification. the present difficulties concerning the Lee would be to place it under the care of the existing Thames Conservancy Board. The present Conservators and their had considerable experience as to the methods by which improvements can be brought about in the Thames and its chief tributaries, and it would be a great advantage that the duty of conserving the Lee should be placed in strong and experienced hands. We do not think that any exception could reasonably be taken to placing the Lee under the Thames Conservators if a small number of members representing the interests of the counties concerned were added to the Thames Conservancy Board. It would be a great mistake to increase the numbers of the Board so as to make it an unwieldy body, but we think that all interests would be properly represented by a very small addition to the existing Board. officers have now an since. .. SUGAR "AS A MILITARY ALIMENT." DR. JOSEPH DE PIETRA SANTA has recently published of interesting paper in the Journal d'Ilygiène,1 which he is editor, on the merits of sugar as a military It was long believed, he says, that sugar aliment." heating," an caused constipation and was moreover ill-defined term greatly in vogue a generation or two In the opinion of many distinguished members. of the medical profession sugar became unwholesome when it was consumed in anything but small quantities, causing ulcers in the mouth with softening of the gums and also predisposing to scurvy. Requiring a large amount of gastric juice for its proper solution it consequently soon fatigued the stomach, while at the same time it favoured worms and weakened the chest. By degrees, however, more enlightened views began to prevail. Physicians in variouscountries became converted and in France the celebrated hygienist, Michel Lévy, constituted himself the champion of the maligned product, preaching the doctrine that Nature her self taught us to make use of sugar inasmuch as she combined with it many tasteless or acid substances which other Cruveilhier likewise wise would remain unpalatable. supported sugar from the coign of vantage of his professorial ANNIVERSARY DINNER OF THE MEDICAL SOCIETY chair, declaring that its evil reputation was a libel, while OF LONDON. THE 126th anniversary of the founding of the Medical Society of London was celebrated on March 8th by the Fellows and their guests dining at the Hotel Métropole, the President, Mr. Edmund Owen, being in the chair. There was a record attendance, 168 sitting down to dinner, and the well-known hospitality of the society on these occasions had been exercised to an unusual extent. Among the guests were Sir Samuel Wilks, Sir William Mac Cormac, Sir Henry F. Norbury, and the Presidents of practically all the medical societies meeting in London. After the usual loyal toasts had been duly honoured, Mr. Owen proposed the toast of "The Medical Society of London" in an eloquent and humorous speech and in welcoming the guests informed them that social relaxation in the past had played an important part in the history of the society. He gave a graphic account1 of a quarrel and schism in the society in 1 Vide THE LANCET, March 11th, p. 719. Proudhon was responsible for the aphorism that "sugar con- the change being in a great measure due to the 1 No. 1169, Feb. 16th, 1899. 20 mer having been selected from each company of a regiment, necropsies disclosed the lesion which was diagnosed during all of them resembling each other as much as possible in physique, general health, &c., an extra ration of 100 grammes of sugar was issued to half of the whole number. The results are said to have been conclusively in favour of the sugar eaters. They increased in weight while their comrades did not, they enjoyed much better health, and they were also able to support the hard work with much less distress. The use of a lump or two of sugar is described as acting like a charm not only against fatigue but also in quenching thirst; and none of the men who consumed the extra ration felt in the least surfeited by it. The French soldier, it seems, only gets two and a half grammes of sugar daily, whereas his English congener's allowance is 37 grammes. "How far we are behind this practical people !" exclaims Dr. de Pietra Santa. THE CHAIR OF PHYSIOLOGY IN EDINBURGH UNIVERSITY. As announced in our advertising columns last week, the preliminary steps are being taken with a view to filling the chair of physiology left vacant by the lamented death of Professor Rutherford. On account of the important interests involved it is essential that both the patrons who decide the appointment and also the intending candidates should have ample time in which to complete their arrangements. Applications are now invited and are to be sent not later than Saturday, May 20th next, to the secretary to the curators of patronage, Mr. R. Herbert Johnston, W.S., 66, Frederick-street, Edinburgh. Each candidate must send eight copies of his application, one of which should be signed, and must also send eight copies of any testimonials which he may desire to submit. GENERAL PARALYSIS OF THE INSANE IN THIS rare condition has been very rarely recorded, and a recent interesting case (with results of the post-mortem examination) published by Dr. Oscar Müller in the Allgeeneine Zeitschrift für Psychiatrie, June, 1898) calls for special motice. The mother, a woman aged 45 years, had had syphilis and had given birth to two children, one of whom died from infantile convulsions. This child showed evidences of congenital infantile syphilis. The other child grew up upparently in good bodily health and as regards her mind she was an average and even promising child. At the age of 10 years, however, she began to exhibit loss of intelligence, could not keep pace with her schoolmates, and soon became quite dull and stupid. From being a clever skater she soon became an incapable one, while her handwriting also rapidly failed and grew confused and illegible. Her increasing mental dulness passed into a profound apathetic dementia; she was reduced to an idiotic and helpless condition, in which state she died. The mother shortly before this began to show signs of mental and moral deterioration and probably the onset of the climacteric period tended to hasten the dénouement. She developed extreme conjugal jealousy and then she became careless and neglectful of her own appearance and took to drink. At this time a slight defect of articulation developed; this became marked and finally there was actual paresis of the muscles of articulation, with tremors of the tongue and lips. Her mind now rapidly and steadily lapsed into dementia and she died shortly afterwards. A necropsy showed her brain to be affected with the typical vascular and meningeal lesions of general paralysis. The child was also examined post mortem and the brain lesions were found to conform to those of the mother. The interest of the case lies not only in its rarity, but also in the fact that the life. Further interest attaches to the fact that the case of the daughter was one of that rare type of disease known as “juvenile general paralysis." It may be mentioned that cases of such similar heredity are quite rare, and when they do occur there has generally been associated with them a history either of personal or congenital syphilis. The latter is a factor of such predominating frequency that it leaves no doubt as to the fact that the chief cause of juvenile general paralysis is congenital syphilis. The larger question, however, as regards the agency of acquired syphilis in determining the appearance of general paralysis in adults is unfortunately not settled by the evidence of cases such as the above, though the weight of evidence inclines to view syphilis as an accessory and contributory factor with others, such as general excess and intemperance. BLACKWATER FEVER. Mr. THE paper which is to be read before the Epidemiological Society of London to-night (Friday) on this interesting but imperfectly understood condition is probably looked forward to with much interest by epidemiologists. W. H. Crosse, the reader of the paper, was for some years Principal Medical Officer to the Royal Niger Company and in this capacity he had unusual opportunities for studying the manifestations of this condition and its relations to malarial fever, to paroxysmal hæmoglobinuria, and to quinine poisoning. As to the distribution of this abnormal state we have yet much to learn, and it must be said that having regard to the large number of our countrymen who spend most of their existence in those of our colonies where malaria obtains it is of great importance that our knowledge on the subject should be extended. THE MEDICAL FACTOR IN IMPERIAL EXPANSION. THE "white man's burden" is a complex as well as a weighty one and its medical constituent is as important as any. This was admirably put by Professor McKendrick at the mass meeting held last week in Glasgow on the subject of medical missions. No other nationality has combined, as has the British, colonial development with civilisation— civilisation of which the inferior races sooner or later feel the benefit and from which they take "a new departure" in their evolution. True, in the sixteenth and seventeenth centuries Francis Xavier and his followers, mainly belonging to the Society of Jesus, did splendid work in East Africa and in South America, but that work was too closely identified with religious proselytism to be thoroughly healthy or lasting. Their successors in practice have admitted as much. The Capuchin monk Massaia (afterwards promoted to be cardinal) took a leaf out of English-speaking missionary effort when he made Bible instruction to come after, not precede, physical and moral rehabilitation. In the Galla country 50 years ago he taught the savage population the arts of peace (mainly agricultural industry) before translating for them and interpreting the Sermon on the Mount. But his most effective resource was of a medical nature and he owed his wonderful command of native sympathy and allegiance more to his having stamped out small-pox by vaccination than to any other of his benefactions. Among all the incidents brought to light by the Fashoda difficulty, none was more significant than the friendly reception accorded to Major Marchand by the natives from the mistaken notion that he was English, so universal is the native impression that of all the "white men who invade Equatorial Africa, those of British nationality are the least to be dreaded or rather the most to be welcomed. Professor McKendrick and the able speakers who followed him put the superiority of English-speaking expansion over that of its other European competitors in the strongest light-a superiority due to the civilising energies and aptitudes of the race, using as a main instrument the medical missionary. Scotland has an honourable record in this field of enterprise, from Mungo Park to David Livingstone and the noble band of volunteers to whom the regions round the Equatorial lakes are already so deeply indebted. The faculty which he represented in Glasgow University took, said Professor McKendrick, "the deepest interest in medical missionary work." Long may it continue to do so, thus making medicine the handmaid of physical and moral evolution and promoting spiritual reclamation with a success which religion, single-handed, has never known. "ANTI-VIVISECTION.” AN institution that desires to be known as the National Anti-Vivisection Hospital is advertising for funds. A noble lord and a lady whose name is not given have promised sums of £50 and £10 respectively if a given number of persons will also oblige with donations of equal value. The programme which the promoters of this foundation lay down for it is brief and is as follows: "No vivisectors on its staff; no vivisection in its schools; no experiments on patients." There is here an obvious omission and one which no doubt the intending donors of £50 and £10 will desire to see supplied before drawing their cheques. A fourth rule should run to this effect: "No operation will be performed and no drug will be administered in this hospital the effect of which has been discovered or verified in any degree by means or with the aid of experiments on living animals," all such experiments being presumably included in the word "Vivisection" as used in the advertisement. The precise meaning of the expression "experiments on patients" needs further definition. Either the surgeons in this institution are to profit by operations successfully performed for the first time elsewhere by other surgeons, but are not to be trusted to take steps without precedents to follow, or a wider principle is suggested for universal guidance similar to that enjoined by the fond but Hibernian parent who forbids a child to enter the water until he has learnt to swim. In whatever way it may be regarded every deviation, however slight, from established practice is necessarily an experiment the first time it is made, aye and until the deviation has itself become recognised as necessary when occasion demands. But now we are beginning to pay the faddist the useless compliment of reasoning with him, whereas he will not even gracefully reply by submitting to us a schedule of the operations and drugs that he would permit under the limitations which we have suggested and which are the logical complement to those already propounded. RIVER POLLUTION: THE MERSEY AND IRWELL began its work. It was satisfactory to know, too, that the committee had not interfered with trade. No single instance had occurred in which a manufacturer had to leave the district by reason of the action of the committee. The returns were of considerable interest. They had hitherto not been able to state definitely what the condition of the rivers was. He had the results of a very complete. system of analyses of the waters of the ship canal and of the rivers in the watershed. 63 samples had been taken from the Ship Canal and analysed and they had obtained a fair idea of the condition of the water generally. It had been said that the composition of the water in the canal was worse than the effluent from the local authorities. This was proved by analyses not to be the case. 69 samples had been taken from the streams. It was found in all cases that the condition of the water deteriorated the further they went from the source. Although they could not tell exactly the improvement which had taken place in the condition of the streams during the last few years there was no doubt that some improvement had taken place. The samples related to the Irk, the Medlock, the Mersey, the Irwell, the Roach, and the Beal. The Irk was by far the worst of the streams; the Mersey and Irwell were not nearly so bad. The reason for this will no doubt be the subject of investigation. CONVERSAZIONE AT THE MIDDLESEX HOSPITAL. A CONVERSAZIONE was held on Wednesday, March 15th, success Davidson's apparatus for localisation in skiagraphy, and especially neat was a portable form of the apparatus intended for use by army surgeons in the field. Mr. Mackenzie Davidson also showed stereoscopic skiagrams by means of Wheatstone's stereoscope. In the bacteriological research laboratory was an interesting series of specimens preAr a meeting of the Mersey and Irwell Joint Committee pared by Mr. A. G. R. Foulerton illustrating the successive held on March 6th Sir Henry Roscoe presented a return of a steps in the complete bacteriological diagnosis of pulmonary series of analyses of sewage effluents and of the waters of tuberculosis. In the museum Dr. Voelcker and Dr. Campbel the Ship Canal and of the rivers in the district. Of 36 Thomson showed many recent additions to the museum samples of effluent taken 26 were either good or fair, the un- prepared by the Kaiserling method which so satisfactory effluents mainly coming from tanks. The tables | fully retains the normal appearance of the tissues. Dr. concerning the effluents showed that the difficulty of dealing Voelcker also kindly lent for exhibition | with the sewage was mostly felt in the large towns. Since valuable collection of archaic medical works. In the committee began its work, however, their knowledge had the chemical theatre were to be seen the spectra of the been much extended and he felt that even in large towns latest additions to the list of elements-namely, 'neon, the difficulties which presented themselves could be overcome. krypton, and xenon; these were exhibited by Professor There was no doubt of considerable progress having been W. Ramsay and Dr. Travers. In the anatomy lecturer's. made and this progress was especially noticeable in the con- room was an exhibition by Messrs. Schall of electrical dition of the rivers themselves. Many cases had come before apparatus adapted to medical purposes. In the pathological them in which water could be used for manufacturing and bacteriological laboratories were many microscopical purposes which could not be so used before the committee preparations of morbid histology and some original paintings a fine and and drawings by Sir Charles Bell; there were some very interesting microscopic sections of yeast tumours and some showing mycosis of the lung. Two species of filaria-namely, perstans and nocturna-were also shown. Messrs. Swift and Messrs. Swift and Son showed many microscopes and microscopic preparations, and surgical and scientific instruments were exhibited in the dissecting-room by Messrs. Allen and Hanbury, Mr. O. Baker, Messrs. Curry and Paxton, Messrs. Krohne and Messrs. Krohne and Sesemann, and Messrs. Maw, Son, and Thompson. In the physiological laboratory Mr. Somerville Hastings gave a demonstration of the action of the auriculo-ventricular valves in the heart of the ox, and Dr. J. J. Pringle exhibited many striking water-colour drawings of rare skin diseases. In the entrance hall were to be seen the skeletons of the originals of Landseer's "Dignity and Impudence." The band of the Royal Artillery performed a charming selection of music in the museum during the evening. THE PETROLEUM BILL. THIS Bill, in which Mr. Harold J. Reckitt sought to raise the flash-point of oil for lighting purposes from 73° to 100° F., was rejected on a division on the second reading in the House of Commons last Wednesday by a majority of 85, the figures being 159 for and 244 against. We have throughout entertained doubt whether the Government would be led, in view of the recommendation in favour of raising the lash-point being being sustained by so narrow a majority of the Petroleum Committee, to legislate in this direction. Interest will now turn on the proposals which the Government will make in their Bill which Mr. Jesse Collings has promised to introduce shortly. We are entirely with those who are studying the question solely from the point of view of public protection, and trust that whatever measure may be proposed it will be one calculated to protect Life and limb. DR. THOMAS BARLOW has been appointed to fill the vacancy in the body of the University of London Commissioners caused by the resignation of Sir William Roberts, M.D. Lond. WE regret sincerely to learn of the death of Major James W. Evans, I.M.S., Professor of Pathology in Calcutta Medical College, from plague. THE LAW IN REGARD TO THE PROFESSIONAL SECRECY OF MEDICAL PRACTITIONERS. THE following is the memorandum on this subject prepared by Mr. Muir Mackenzie at the request of the President of the General Medical Council with the concurrence of the Executive Committee for transmission through the Home Secretary to the Russian Ambassador who had asked for information for the use of his Government. MEMORANDUM ON THE LAW OF THE OBLIGATION OF MEDICAL PRACTITIONERS WITH REGARD TO PROFESSIONAL SECRECY. There are two aspects of the question of professional secrecy of medical practitioners-namely, first, whether a medical man can be made to divulge professional confidences in a court of law and, secondly, whether he may under any circumstances be permitted to divulge professional confidences in the intercourse of daily life. (1) As regards the first question it is settled law that a medical man cannot claim the privilege, to which lawyers have been held to be entitled, of refusing to disclose matters communicated to them professionally. fessionally. "A surgeon has no privilege where it is a material question in a civil or criminal cause to know whether parties were married or whether a child was born to say that his introduction to the parties was in the course of his profession and in that way he came to the knowledge of it. knowledge of it. If a surgeon was voluntarily to reveal these secrets to be sure he would be guilty of a breach of honour and of great indiscretion; but to give that information in a court of justice, which by the law of the land he is bound to do, will never be imputed to him as any indiscretion whatever " -per Lord Mansfield in the Duchess of Kingston's case, 20 S.T. p. 573. The 4 T.R. p. 760, where he says; "There are cases to which it is same position is recognised by Buller, J., in Wilson ". Rastall, much to be lamented that the law of privilege is not extended; those in which medical persons are obliged to disclose the information which they acquire by attending in their professional characters"; and similarly in a later case Lord Chancellor Brougham, after referring to a lawyer's right of privilege, continues as follows: "The foundation of this rule is not difficult to discover; it is not (as has sometimes been said) on account of any particular importance which the law attributes to the business of legal professors or any particular disposition to afford them protection, though certainly it may not be very easy to discover why a like privilege has been refused to others, especially to medical advisers."-Greenhough v. Gaskell, 1 M. & K., p. 103. In Rex. v. Gibbons, 1 C.P. 97, where the prisoner was indicted for made to him, Park, J., overruled the objection that the witness was at the murder of her child and a surgeon was called to prove confessions the time attending the prisoner in his capacity of surgeon, adding: "That is no sufficient reason to prevent a disclosure for the purpose of justice"; and the same rule, "that there is no privilege of this description in the case of a medical man," was repeated by Best, C.J., in Broad v. Pitt 3 O.P. 518. From these cases it is clear that a medical man not only may, but must, if necessary, violate professional confidences when answering questions material to an issue in a court of law. of 2. Upon the second question there have been, not unnaturally, very few expressions of judicial opinion. It is admitted as a general principle that a medical man should not disclose communications made to him in his professional capacity, and in the Scotch Court of Session it has been judicially decided that "secrecy is an essential condition of the contract between a medical man and his employers, and breach of secrecy affords a relevant ground for an action of damages." A.B. v. C.D., 14 Dunlop, second series, 177. But upon this rule of the general' inviolability of professional confidences (outside a court of law) the custom of the medical profession has engrafted two exceptions, (1) in cases of criminal communications; (2) "where violation of sucrecy is considered necessary for the protection of wife or children (to which may be added a third exception, suggested by the court in A.B. v. Ö.D., cited above-viz., instances conducive to the ends of science, though concealment individuals should in such cases be secured). These two exceptions were the subject of testimony given by eminent medical witnesses in the case of Kitson v. Playfair in 1896 as being generally recognised among medical men, but they are not judicially recognised as invariable exceptions, as is shown by the suniming-up of Sir H. Hawkins in that case, The defendant pleaded privilege on the ground of the second of the above exceptions, and though the point was not decided owing to the jury finding that the defendant had been influenced by an indirect motive the following passages are relevant to the matter of the obligation of secrecy among medical men. On medical evidence as to professional privilege being given Sir H. Hawkins said: "The question of privilege is for me to decide, and, so far as it concerns that question, I shall not be influenced by this evidence."---Times, March 26th, 1896. The following passage occurs in the report of the judge's summingup: "The medical profession might, no doubt, discuss among themselves rules for their own guidance; but they had not power to impose |