MEDICAL EDUCATION IN FORMER DAYS
642 similar prohibition should be extended to all these representations, which, though perhaps not having, strictly .speaking, an immoral tendency, certainly have a tendency to suggest and create deeds of violence of the worst description, and that as such they should not be allowed to be publicly exhibited, but should be submitted to the censorship of some responsible person in authority, whose written permission to exhibit theatrical or other scenes should be _previously obtained. I remain,
... tained. I remain, Sirs, your obedient servant, September, 1888. _______________ CORONATOR. POISONOUS MUSSELS. To the Editors of THE LANCET. SIRS,—Mr. Permewan, in his report of a fatal case of mussel poisoning in THE LANCET of Sept. 22nd, states that he could find no reference of any value in the ordinary :text-books on toxicology, and also that the coroner expressed his surprise at the absence of scientific knowledge as to these bivalves. Mr. Permewan is quite right as to the paucity of information in text-books, but, notwithstanding this, the subject has received much attention in Germany, and an extensive literature of quite recent origin will be found in Virchow's Archiv, vols. 102-3-4; Berliner klinische Wochenschrift, 1885-6; Brieger, "Ueber Ptomaine," Part 3; .and elsewhere. Amongst the investigators are Virchow, Salkowski, Max Wolff, Lohmeyer, Brieger, Schmidtmann, and several others whose names I cannot at present remember. The literature in question owes its origin to the occurrence of a wholesale poisoning by mussels which -took place at Wilhelmshaven about three years ago. Dr. Schmidtmann carefully observed and described the -:symptoms, which, together with the results of experiments on animals, showed that the poison was analogous in its action to curare. From a sample of the mussels obtained from the same locality Brieger isolated a ptomaine which he called "mytilotoxine" (from Mytilus edulis, the common mussel), and also, amongst other bases, betaine (oxycholine). There is a difference of opinion amongst authorities as to whether the poisonous mussels are or are not identical with the ordinary edible mussels. Virchow, Schmidtmann, and Lohmeyer contend that the poisonous mussels have lighter-coloured, striped shells, yellowish soft parts, a sweetish, repulsive smell, and that they colour the water in which they are boiled bluish. The non-poisonous mussels have uniformly blacker shells, whiter soft parts, smell of sea-water, and do not colour the water in which they are boiled. Most zoologists, howeveramongst whom are Schulze, v. Martin, and Mobius,—deny the existence of a poisonous variety, and attribute the differences in appearance to the age and surroundings of the bivalves. The older view that the poisonous qualities were the outcome of incipient putrefaction is favoured by the statement of Schmidtmann, that mussels grown in still water are liable to take on poisonous properties. This he proved by placing harmless mussels in the stagnant water of the docks at Wilhelmshaven ; within fourteen days they developed poisonous qualities, but again became harmless on being placed in running water. The dock water was not in itself poisonous. Virchow also admits that some of the poisonous mussels lost their toxic properties after a four-weeks' stay in a seawater aquarium. According to Wolff, the poison first appears in the liver of the mussel, but later on it pervades the whole of the soft parts. It is asserted that placing poisonous mussels for an hour or two in fresh salt water renders them innocuous. Mussels grown in harbours, docks, or basins are dangerous. The subject of poisonous mussels was energetically discussed at several meetings of the Berlin Medical Society, condensed reports of which are contained in the Berliner klirzisclze ffochenschrift for 1886. I am, Sirs, yours very truly, Toxicological Laboratory, Owens College, Sept. 25th, 1888. To the Editors of THE LANCET. SIRS,—In reference to the fatal case of poisoning by eating mussels, stated in last week's LANCET by Mr. Permewan, I was informed by a fishmonger lately that those mussels which are poisonous contain a crab-shaped substance attached to the interior of the shell. Those free of this parasite are quite safe to eat. I may also add that milk is considered an antidote to mussel poisoning, though in the case named, owing to the large quantity consumed, I do not suppose it would have been of any use. I am, Sirs, yours faithfully, Watford, Sept. 25th, 1888. THE CONTAGIOUS DISEASES ACTS. To the Editors of THE LANCET. SIRS,—I am glad to see an indication in the passes of THE LANCET that there are some members of the profession who differ from you in your unqualified laudation of the late Contagious Diseases Acts. I have, since studying the question a few years ago, been of opinion that, although the Acts having for their object the lessening of the spread of venereal diseases were ones that all medical men must commend, yet that the method of their application was based too much upon the assumption that woman was the party who spread the disease, and must be the only one to suffer by law; men being under no penalty, and being allowed to propagate disease as much as they like. You say that it is possible for a woman to spread much more disease than a man. I think this assertion is open to question, for it is certain that a very small proportion of the men who have connexion with diseased women are themselves attacked by disease, whilst, from the physical conditions of the two sexes, it is much more likely for a woman to catch disease from a man than vice versû. As Mr. Benthall points out, the cases of congenital syphilis are mostly due to men infecting virtuous women, for prostitutes do not, as a rule, have any children. Your argument that prostitutes, earning their livelihood by prostitution alone, make themselves a special class quite distinct from the men who make use of them occasionally, is not of much value. It is simply a question of "demand and supply," and the men who create the demand are just as much a special class as the women who supply it. It is a mutual arrangement between certain members of the community, and, if any means are adopted by law to check ill results, both parties should be treated equally. It is the question of the degradation of the female sex by compulsory examination that has raised up nearly all the agitation against the late Acts. Women feel that it is unfair to them, and treats them as the only culprits. If men were liable to be compulsorily examined in the same manner much of the dissatisfaction of the female sex would disappear. It is, of course, a difficult matter to suggest precise methods of carrying into practice the principle that in any State regulation of vice men who support prostitutes should be liable to the same penalties as the prostitutes themselves; yet I feel certain that the British public, which at present looks at the question from a sentimental and not a medical point of view, will tolerate no such unequal laws as the last Acts. I also agree with Mr. Benthall that, if men were examined, it would diminish vice very materially. When prostitution is under State control, in course of years men forget that the primary intention of any such control was to diminish venereal disease, and they come to imagine that the women are provided for their safe gratification ; whereas, if they were liable to a compulsory examination, it would remind them of this fact, and also act as a deterrent to many, for the male sex objects to be examined just as much as the female.-I am. Sirs. vours verv trulv. September, 1888.