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remonstrated with said she did not care about the law andshould take or send her child just where she liked. It was

also proved that the child had been sent to shops andallowed to play in the streets with other children, andanother case of scarlet fever had already been reported. Mr.C. F. Gray, M.R.O.S. Eng., one of the magistrates, mostrightly said that the case was a very serious one as thechild would be for some time in an infectious state. A fineof E2 10s. with :E1 8s. 6d. costs was imposed. Unfortu-

nately, since the proceedings had been instituted the parentswith the child had left the town, thus still further runningthe risk of spreading contagion. It is exceedingly difficultto teach such persons as the defendants in the above casethat laws are made not for one but for the many. Isolationof persons suffering from infectious diseases is not designedfor the sole benefit of the patients but for the protection ofthe public. The community must be guarded from the actsof such wilful persons in the same way as from those ofcriminals. It is a crime wilfully to allow a child sufferingfrom scarlet fever to play with other children ; many deathsmay be the result, and the law consequently deals sternlywith such offenders.

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ENTERIC FEVER IN SOUTH AFRICA.

THE lists of casualties which appear daily in the papersdemonstrate only too plainly that we have not yet solved theproblem of protecting large bodies of troops from the ravagesof such diseases as enteric fever and dysentery. Much hasbeen done in prophylactic measures against the former butvery much more remains to be done. One of the greatestdifficulties which confront the medical officers is to inducethe men only to drink water which has been renderedas pure as possible by boiling or filtering. After a

long march the average soldier will run any risk to obtaina draught of water, however bad, and the consequencesof such action were seen after the march to Bloem-fontein when the men partook freely of the water of theModder which was defiled by the dead bodies of men andbeasts. One of the main interests attaching to the medicalaspects of this campaign will be to ascertain the results of theinoculation against enteric fever which was practised uponmany thousands of the officers and men. We have beeninformed that measures have been taken to ensure carefulrecords being kept as to the occurrence of enteric fever

amongst the inoculated and the uninoculated, but it willbe some time before such statistics can be carefullyformulated and the value of such inoculation estimated.

PNEUMOCOCCIC OSTEO-ARTHRITIS.

IT is curious that pneumococcic arthritis which is a

recognised, though rare, affection in France appears neverto have been observed in this country. At the meeting of theSociete Médicale des Hopitaux of Paris on May 18thM. Ch. Fernet and M. Lacapere read notes of a case recentlyunder their observation. A strong man of alcoholic habits,aged 47 years, had an attack of pneumonia which com-menced on Jan. 6th. The crisis occurred on the seventh or

eighth day. He entered hospital on Jan. 13th. Soonafter his admission traces of the pneumonia-bronchialbreathing and sub-crepitant rules in the lower lobe of theleft lung-were found. Two or three days before the patientwas admitted arthritis of the right wrist appeared. It was

characterised by swelling which was rather marked on thedorsal aspect and which was accompanied by slight rednessand pain. On Jan. 24th exploratory puncture gave exit toseveral drops of a liquid as clear as water which was foundon bacteriological examination to contain the pneumococcus.On Feb. 6th the patient had completely recovered from thepulmonary disease, but there were still engorgement of thewrist and slight oedema of the back of the hand. The wrist

was then immobilised on a splint and slight pressure wasapplied by means of wadding. On Feb. 14the the swellinghad diminished, but fluctuation was still evident and

lateral movements of the wrist were accompanied bycrackling. On March 2nd the swelling had furtherdiminished and the pain had disappeared. On March 22ndthe wrist was still swollen and the cellular tissue seemed tobe infiltrated. The axis of the hand was deflected outwardsas if the radius was eroded at its extremity and the jointcrackled on passive movement. Radiography showed on thesound side the bones of the forearm and the carpus clearlyseparated; on the diseased side the wrist was represented bya greyish mass, the ends of the bones of the forearm seemedto be in contact with the carpus, and the extremity of theradius was eroded and enlarged. There were thus evidentlyadhesions between the radius and ulna and the carpus. Thecase was one of pneumococcic periarthritis similar to twocases already reported to the society.l The lesions shown bythe radiograph corresponded to those previously observedat a necropsy in another case of the disease. A similar

rapid course, early erosion of the bones, and formation ofadhesions have been observed in all cases. Ankylosis seemsto be the natural termination. Pneumococcic osteo-arthritisis thus a special type of arthritis which is clearly distinctfrom pneumococcic synovitis.

COUNTY OF DURHAM SOCIETY FOR THE PRE-I VENTION AND CURE OF CONSUMPTION.

THE above society has just opened its new sanatorium.The building is Horne Hall, at Stanhope, which stands intwo and a half acres of garden, and the first instalment of

patients entered on May 15th. At present there is oniyaccommodation for 12 patients, but in the course of thesummer it is intended to increase the number of beds to 20

by adding more bedrooms. The sanatorium will be main-

tained-(1) by ordinary subscriptions which may be allottedfor the benefit of patients from particular districts or

works; (2) by workmen’s subscriptions, each man paying 3d.per quarter, and bodies of workmen subscribing regularlyshall have a first claim on the beds to the full amountof their total subscriptions-e.g., if the total sum of their

I subscriptions amounts to half the cost of maintainence, halfof the beds will be at their disposal without further payment;(3) by weekly payments by or on behalf of patients who donot belong to bodies of regularly subscribing workmen; and(4) by income from investments. There is to be a residentmedical officer, who must be registered according to the

Medical Acts, who shall devote all his time to the welfare ofthe inmates of the sanatorium and shall have his meals withthem. He may have 21 days’ holiday in the course of theyear at times to be approved by the committee, and nothingis said about his getting any salary, although we suppose heis to have one.

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URTICARIA HaeMORRHAGICA.

I IN the Intercolonial Jou’I’nal of A?tstralasia of April 20thMr. C. S. Hawkes has published a case which is of interestboth on account of the rarity of the condition present-hsemorrhagic urticaria-and the medico-legal question whichmight have arisen. A boy, aged 21 months, was let fall byhis nurse. He was supposed to have struck the back of hishead, but the accident appeared to have been a slight oneand no notice was taken of it at the time. Next

morning there was a somewhat tense swelling about twoinches in diameter on the right side of the backof the neck, reaching up to the level of the occiput,with dark bluish discolouratiow in the centre as from abruise. There were also two bluish marks "like bruises"

1 See THE LANCET, Dec. 11th, 1897, p. 1548.