other pollution. Analysis of specimens taken at the time of the inspection proved that it was charged with matter in an active state of putrefaction, and that it was polluted with sewage.

Upon this evidence all issue of milk from the farm was at once suspended.

Such is a brief history of this outbreak to the present time. We have detailed the circumstances of the outbreak simply as they bear upon its past development in July, but there is every reason to believe that scattered cases of enteric fever, which occurred before July in the district of the outbreak, owed their origin to infected milk. A detailed official investigation of the outbreak is now being carried out by the Medical Department of the Local Government Board; and it is understood that this investigation will extend to the conditions of the metropolitan milk supply, with special reference to the modes in which the milk may become infected with the poison of enteric fever.

THE ARTIFICIAL FRUIT ESSENCES.

DR. HENRY K. OLIVER, in a report on the character of substances used for flavouring articles of food and drink, prepared for the State Board of Health of Massachusetts (see Fourth Annual Report of the Board), gives much interesting information respecting the use of artificial fruit essences. The compound ethers which have been found to possess the odour and flavour of certain fruits are several in number.

Butyric Ether. This ether may be prepared by mixing butyric acid with sulphuric acid and alcohol. The former acid may be made by mixing decaying cheese with grape-sugar and chalk, and allowing fermentation to take place. The ether is dissolved in another portion of alcohol, and forms the pineapple essence.

Pelargonic Ether, Oxuanthic Ether, may be prepared by digesting pelargonic acid with alcohol at a gentle heat. The acid is

the result of the action of nitric acid on oil of rue. The ether is dissolved in alcohol, and forms the quince essence.

Acetate of Amylic Ether is prepared by distilling a mixture of fusel oil, acetate of potash, and concentrated sulphuric acid. An alcoholic solution of the ether forms the jargonelle pear

essence.

Valerianate of Amylic Ether may be made by the action of sulphuric acid and valerianic acid upon fusel oil. An alcoholic solution of this ether forms the apple essence.

A mixture of acetate of amylic ether with butyric ether forms the banana essence.

Other mixtures of the ethers, modified by the addition of various agents, as nitrous ether, acetic ether, acetic acid, camphor, tincture of orris, vanilla, the volatile oils, &c., result in imitations of other fruits, the strawberry, raspberry, apricot, currant, &c. &c.

Are these artificial fruit essences deleterious to health? To this question, says Dr. Oliver, a succinct answer cannot properly be given. If taken into the stomach in any considerable quantity and in an undiluted form, the effect would, without doubt, be not simply deleterious, but highly dangerous. But in the form in which they are presented in confectionery, &c., they are more or less diluted; the chance, therefore, of harm following their occasional use is greatly lessened. But when diluted, habitual indulgence in them, according to the opinion of scientific men, cannot fail to be injurious to health; and deleterious results may follow their occasional use, even when in the diluted form this may happen in the case of adults, on account of a peculiar idiosyncrasy. And in all cases, probably, Dr. Oliver thinks, children are more susceptible to their influence than adults. Children are also more likely than adults to partake largely of confectionery, and a free indulgence in articles of this kind, in a season of the year when diseases of the intestinal canal are prevalent, has been known to bring on such disorders, or to augment them where existing. It is, however, sometimes the case that sufficient dilution has not been made, and alarming consequences have attended such carelessness. Dr. Oliver cites the case of two children who were seized, after drinking the liquid contained in a hollow toy-candy-anchor-with

alarming sedative symptoms, requiring active medical treatment. Enough of this liquid was secured to prove that it was flavoured with the artificial pine-apple flavour.

The artificial fruit essences appear to be extensively employed in the United States for flavouring jellies, confectionery of various kinds, and syrups for soda-water. They are also used in the manufacture of factitious wines and other alcoholic liquors. They are found to be less adapted to ices than to the other articles mentioned, and are probably used in them to a very limited extent, and not at all by confectioners of any repute.

The details given by Dr. Oliver of the mode of use of the artificial fruit essences for the above purposes are as amusing as instructive. We may note, à-propos of the recent appearance of sarsaparilla "fountains" in the streets of London, that the syrup from which the sarsaparilla drink is commonly prepared for these fountains in the United States is probably not unfrequently "quite innocent of the famous root." Without exception, the oils of winter-green and sassafras are added to the sarsaparilla syrup to supplement the flavourless preparation of the root. Oil of anise is said to be sometimes used in addition to the two oils mentioned.

When the essences are used in syrups, a small portion of either citric or tartaric acid is used, to give a slightly tart taste. Where also the syrup is to represent the flavour of any of the red fruits, as the strawberry, for instance, colouring matter must be added. This is generally made of cochineal. The sarsaparilla syrup, also, usually receives a little colouring, except when molasses is used, and the colouring substance is caramel.

In respect to jellies, one extensive manufacturer informed Dr. Oliver that he "formerly kept jellies from the pure fruit, but found it didn't pay, and now keeps none at all. Those now kept are made from apples, properly coloured, and flavoured with the artificial essences bought in New York. Pays the highest prices for these essences. The jellies cannot be distinguished by customers from those made of pure fruit; the latter are really no better."

In respect to the use of the essences in the fabrication of factitious wines and other alcoholic liquors, it is sufficient to quote the following extract from the business circular of an

eminent master in the trade :-"Liquors made according to the receipts given" (several of which Dr. Oliver cites) "so closely resemble the genuine that they often cannot be distinguished. They answer for all the same intents and purposes, as the flavours for preparing them are identical with those which are formed naturally during fermentation. Modern chemistry, which has by analysis discovered the existence of these ethers in wines and distilled liquors, has also found other more abundant sources for them, rendering it highly advantageous to employ the latter."

THE PRACTITIONER.

OCTOBER, 1873.

Original Communications.

ON THE PATHOLOGY AND TREATMENT OF SHOCK

AND SYNCOPE.1

BY T. LAUDER BRUNTON, M.D. D.Sc.

Casualty Physician and Lecturer on Materia Medica and Therapeutics at St. Bartholomew's Hospital.

THE assemblage of phenomena which we designate by the term "shock" is so much more frequently met with in surgical than in medical practice that it may almost seem that in writing a paper on this subject I have left the proper domain of the physician, and trespassed on that which the surgeon claims as his own. We shall hereafter see, however, that shock may occur in the course of diseases for which the physician alone is called into consultation, and it is intimately connected with fainting or syncope, a condition which is usually treated of in medical rather than in surgical text-books. So closely, indeed, are syncope and shock connected that they were considered by the celebrated surgeon, Travers,2 to differ in degree rather than in kind, and we shall find it convenient to take a glance at the conditions which we find in syncope, before we proceed to examine those of shock.

1 Read before the Abernethian Society, St. Bartholomew's Hospital. 2 Treatise on Constitutional Irritation, 1826, p. 466. NO. LXIV.

K