622 EGYPT.-NEW YORK.-AUSTRALIA.

arrangements were carried out :-1. The quarters of the

patient were screened with wire netting within two hoursafter the case was reported and a guard was placed over thequarters to see that the one wire door was kept closed,immune persons only being allowed freely to pass. 2.

Arrangements were made to kill all mosquitoes which mighthave become infected before the screening of the patient,both in his own house and in all the neighbouring houses.For this pyrethrum was burned in the room at the rate of1 pound to 1000 cubic feet of space, after which the mos-quitoes were carefully swept up and destroyed. 3. Five days’quarantine was maintained to keep out of the town peoplewho might be suffering from yellow fever or incubating for it.4. Brigades were organised for the destruction of mosquitolarvse in all parts of the city and suburbs. In January, 1901,just before the mosquito brigades were organised, an

inspection of the whole city showed that mosquito larvseexisted in 26,000 different places in the city. A year later asimilar inspection showed less than 300 deposits of larvse inthe same area. The destruction of the mosquito also reducedthe malaria mortality in 1900 from 344 to 151 in 1901. The

fight against yellow fever was begun in February, 1901, andon Sept. 28th of the same year the last case of yellow feveroccurred in Havana. Since that time, now more than a yearago, not a single case had originated in the city, this beingthe first time that the disease had been absent from Havanafor all the years that statistics have been taken. The Medical

Congress passed a vote of condolence with the family of thelate Major Walter Reed who, as readers of THE LANCET areaware, died quite lately in Washington after an operation forappendicitis. He was one of the foremost bacteriologistsand pathologists of the United States and he acted as presi-dent of the board of army medical officers in Havana who

taught the world how to eradicate yellow fever. Dr. Terni

(Messina) also contributed a paper on Yellow Fever whichhe had studied in Brazil and expressed the belief that the°’ bacille icteroide " is the specific cause of that disease.Cairo, Feb. 17th.

___________________

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

Hospital for the Treatmnent of Tuberculosis in Nerv York City.IT is computed that there are in New York 19,000 persons

suffering from tuberculosis. The facilities for taking careof consumptives are very inadequate ; in fact, it has beenshown that New York is far behind London and most of theother large cities in regard to provision for the care ofsufferers from pulmonary tuberculosis. The matter hasbeen taken up recently by the lay and medical journalsand by the medical profession. The New York Heraldhas advocated editorially the establishment of hospitalsand sanatoriums for indigent consumptives. On the even-

ing of Jan. 3rd Dr. Henry P. Loomis spoke in favourof this course. He drew attention to the fact* thatNew York city was actually worse off now than it wasten years ago in the matter of taking care of con-

sumptives, for since tuberculosis has been regarded as acommunicable disease its victims have been barred from thegeneral wards of the city hospitals. The majority of thecases are in the tenement districts where the danger of

infecting healthy people is very great on account of theovercrowding and the ignorance of this class. Dr. Loomistherefore thinks’ that now is the time for the city govern-ment to take practical steps, as has already been donein most of the large cities abroad, to establish a large andthoroughly equipped consumption hospital ; he is furtherof opinion that such a building should be erected onBlackwell’s Island where there is plenty of room andwhere the patients can have the maximum amount of

sunlight and air. In connexion with this main con-

sumption hospital an annexe should be built in the countrynear New York. This annexe should be constructed on the

pavilion plan and should be intended for those hopeful caseswhere the sufferers are in the early stages of the disease.Great interest is being taken in the question of tuberculosis by rich men in this country. Mr. Phipps the other day gavemore than £200,000 to Philadelphia for the purpose of

studying and treating the malady, while Mr. Rockefeller hasgiven to the University of Chicago a much larger sum tobe devoted to research work especially in tuberculosis. Itthus seems probable that New York will soon have thenecessary institutions for its consumptive poor.

Adulteration of Drugs in New York City -- - .

The practice of substituting inferior or impure drugs forthose ordered has been exercising the minds of New Yorkphysicians for some time. So common has this practice onthe part of druggists become that recently many physicians,as well as local medical societies and associations, submitteda large number of samples of different drugs and chemicalagents to the department of public health with the requestthat they should be analysed. Phenacetine is the particulardrug which at present is looked upon with suspicion, and outof a total of 373 specimens purchased from druggists inGreater New York no less than 365 have been found to beadulterated. Many other drugs have been discovered to benot up to the standard of the requirements of the UnitedStates Pharmacopoeia and the health board intends to pursueits investigations on a large scale.

Charyes against Be7levue Hospital.Once again grave charges, reflecting seriously upon the

management of Bellevue Hospital, the large city hospital ofNew York, have been made. Sme two or three years agothe scandals originated by accounts of cruelty which occurredin Bellevue Hospital became so notorious that public opinionwas much agitated and finally a board of trustees investigatedthe matter and made a report. The report stated that manyevils existed in the system of management, and that the

nursing especially was faulty. The board of trustees pre-sented a scheme for reorganisation and among other sug-gestions the recommendation was made that all the old build-ings known as the Bellevue Hospital should be pulled downand that a thoroughly equipped modern hospital should beerected on their site. Similar recommendations were madewit’1 regard to the other city hospitals. Despite these recom-mendations it would appear that few measures of reformhave been introduced, for the charges which have beenrecently brought against the management are in the mainidentical with those preferred many times previously, A

searching investigation is now being undertaken by thedistrict attorney’s office. The Medical Record and otherNew York medical journals insist strongly that the presentsystem of management should be altered and that hospitalsin keeping with the size and wealth of New York should beprovided by the city.Feb. 16th.

__________________

AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.)

Tuberculosis in Victoria.A DEPUTATION from the Victoria Association for the

Prevention and Cure of Tuberculosis recently waited on theMinister of Health and appealed for a Government grant forthe care of practically incurable cases of tuberculosis. TheAustin Hospital was prepared to make provision for thecure and treatment of 60 additional consumptives if theGovernment would bear half the cost. Dr. J. Jamieson,health officer of the city of Melbourne, stated that between1800 and 1900 persons died in Victoria every year fromtuberculous disease and that there were at least from 5000to 6000 sufferers from tuberculosis in the State. Of these

probably 1500 might be regarded as being in a tolerablycurable stage. The only accommodation provided was atthe Macedon and Echuca sanatoriums for 50 cases. The

only provision for the remaining incurable cases was at theAustin Hospital, .to the extent of 80 cases a year, and theMelbourne Hospital, where 150 cases a year were treated.The Minister of Health admitted that a very good case hadbeen made out by the deputation and said that he wouldplace its views sympathetically before the Cabinet, but inthe present state of the finances he could not promise thatthe Government would do anything. He suggested thatthe money should be raised by public subscription.The Financial Position of the Medical Cltaritie8in Victoria.The Government of Victoria in pursuit of its retrenchment

policy has reduced the charities grant by .f.20,000. Owing tothe drought the prices of provisions, and, in fact, of every-thing, are exceptionally high. Consequently the managersof the various hospitals are in a very serious financial diffi-culty. Their expenditure is increased and their income is

, diminished. A deputation of representatives of the various, hospitals recently met the Treasurer to the Government to

discuss the position. The deputation asked that effect might

623AUSTRALIA.- OBITUARY.

be given to the recommendations of the Charities Commission. If some assistance was not forthcoming the various institu-tions must close some of the wards. The Minister, in reply,said that the old-age pensions must have relieved thedemands on organised charities or private individuals bymore than .620,000. He thought also that the charitieswere abused ; by want of closer discipline the benefitsof charity had been given to many who, personally, orthrough relatives, might have paid. The inspector ofcharities in his last report said : "The number of reallydestitute cases was comparatively small ; the hospitals areused by persons not able to pay the ordinary medical fee,yet able to make a small contribution to the institution."

"

Taking the Melbourne Hospital as an illustration only E60were contributed in sums under £1. The people who couldgive small amounts were those who received the benefits ofthe charity. The charitable institutions altogether obtainedfrom private subscriptions, entertainments, and collections65,000 ; from municipal grants, £11,000 ; as interest oninvestments, .Ell, 000; from patients’ contributions, j2!6,000;from out-patients’ fees, 5000 ; from legacies, ;&15,000 ; andfrom the Government, £110,000. He regretted that hecould not see his way to give more aid from the Govern-ment. Speaking as an individual and not as the Treasurerof the State, he would like the charities to have an endow-ment by a tax on sports and the totalisator. It has been

pointed out, however, that the managers of the. charitableinstitutions can do nothing more ; the suggestions of theTreasurer could only be carried out by Parliament. Economyhas been carried to its extreme limits. The debit balanceat the Melbourne Hospital for the year is now £6793. TheQueen Victoria Jubilee Fever Hospital is no nearer a solu-tion of its difficulties. A conference of municipalities in themetropolitan area has been held. A basis for discussionwas presented, providing (1) that half of the cost of main-tenance should be provided by the metropolitan municipalcouncils and half by the Government ; and (2) that all themetropolitan municipalities should contribute in proportionto municipal property assessment. Unfortunately the Premierstated that the Government would not provide half the moneyrequired and so far only eight out of 24 municipalities con-cerned have approved of the scheme, while seven activelydisapprove.New Otct-pcctient Department at the Sydney Hospital for

Sick Children.A new out-patient department has just been opened in

connexion with the Sydney Hospital for Sick Children. It issituated at the corner of Quay-street and Valentine-lane. (It is close to the new central railway station and the George-street trams. The site has been obtained on a 50 years’lease and the estimated cost of the buildings is £3000.There are a large waiting hall to seat 200 persons, with pro-vision for future extension ; an examination-room at the

entrance, with a special room for suspect cases, and four

consulting-rooms ; an adequately fitted operating theatre ; alarge dispensary and attached waiting hall ; and house

surgeons’ and nurses’ ’quarters. Special arrangements aremade for a constant circuit of patients.

Prince Alfred Hospital, Sydney.The enlargement of the Prince Alfred Hospital, Sydney,

from 161 to 236 beds has necessitated changes in the staff.To relieve the medical superintendent of much of the workof directing the non-medical staff it has been decided toextend the functions of the secretary by making him thechief non-medical officer under the medical superintendent.Revision of the rules was also necessitated by the creation ofthe new positions of resident pathologist, registrar, andanxsthetist, clinical assistants to the out-patient depart-ment, and honorary pathologist. The matron will in futurebe known as the matron and superintendent of nursing;the trained staff will consist of sisters, charge nurses,and staff nurses, and the pupil nurses will be graded asfirst, second, and third year pupil nurses. Two new seniorpositions have been created in the matron’s assistant and thehousekeeper, both of which will be generally filled by sisters,the sister acting as housekeeper being changed every sixmonths so that all may receive adequate instruction in thisbranch of hospital management. The directors have alsohad under consideration the question of lightening thenurses’ duties, particularly during their- first year of service.It is held that a certain amount of manual labour, such asscrubbing woodwork, &c., is essential as a test of the physicalcapacity of candidates for the nursing profession to stand

the strain which they must undoubtedly undergo. But ithas been decided that, except during a short probationarytrial, they may be relieved of much of this work and to

permit of this being done wardmaids are for the future to beemployed. These will do the rough works of wards, thusleaving the nurses free to carry out their more distinctiveduties. As the work of the nurses will thus be lightenedto a great extent it is anticipated that the demand for posi-tions upon the nursing staff will be even greater than atpresent. To meet this condition of things it is proposed toraise the status of the nurses by making the position more ofan honorary one than at present and by giving an honorariuminstead of a salary, which will rise by annual increments overa term of three years.

Unirersity Dental Hospital, Sydney.The Senate of the University of Sydney has received a report

from Mr. R. Fairfax Reading, chairman of the UniversityDental School committee, upon the work of the UniversityDental Hospital for the year 1902. The hospital was openedto the public on Jan. 7th and even without making allowancesfor delays and interruptions, due to vacations and the Uni-versity jubilee celebrations, the record of the work was, the

report states, highly satisfactory. The total number ofpatients who had attended at the hospital for treatment inall departments was 3964-a convincing proof of the wisdomof the action cf the Senate in establishing the hospital. Thecommittee had taken every precaution to prevent the hcs-pital being abused by those who could well afford to go to adentist and thereby to assure to the deserving poor the fullenjoyment of its benefits. The committee considered thatthe amount of clinical work done by the second-yearstudents, who only number nine, reflected great credit uponthe students. In March next 11 students at present in theirfirst year would be ready to undertake clinical work and itwould then be necessary to provide at least six more dentalchairs in addition to the 11 with which the hospital is nowsupplied. "The increasing amount and variety of con-

servative dental work which the students are called upon toundertake," the report concludes, "renders the hospitalan important addition to the dental school and will infuture be a guarantee that the dental graduates of the Uni-versity of Sydney will be thoroughly competent to success--

fully undertake any operation incidental to modern con-

servative dental surgery."Preservatives in Food.

The Board of Health of New South Wales has published

amended regulations under the provisions of the Public

Health Act, one of the most important of which is as

follows :-

(a) Any one antiseptic or any one antiseptic preparation may bemixed with any food in proportions not exceeding one one-thousandth’of one grain per pint in the case of liquid foods, and of one one-thousandth of one grain per pound in the case of solid foods ; providedthat the label required by section 86, subsection 2, of the Act to beaffixed to the vessel or parcel containing food mixed with antisepticsor with antiseptic preparations in accordance with this regulation, bein the form given in Schedule L and be printed on a white ground inblack capital letters of the size known as " two-line brevier sans serif,"and contains no other matter. (b) The following substances shall bedeemed to be antiseptics and antiseptic preparations for the purposesof this regulation : Formaldehyde and its preparations, boric acid andits preparations, hydrofluoric acid and its preparations, sulphurous acidand its preparations, benzoic acid and its preparations, salicylic acidand its preparations, and derivatives of coal tar, whether direct orindirect.

The regulation will come into force on Feb. 2nd.Jan. 14th.

___________________

Obituary.EDWARD EUSTACE, M.D. DURH., L.R.C.P.EDix.,

L.R.C.S. IREL.,SURGEON-LIEUTFNANT-COLONEL, A.M.D.

DR. EDWARD EUSTACE died at his residence, Underwood,Cheltenham, on Feb. 16th, in his sixty-second year. Thedeceased obtained the qualifications of L. R. C. S. Irel. andL.R.C.P. Edin. in 1863 and 1864 respectively and graduatedM.D. of Durham University in 1886. Shortly after quali-fying he entered the Army MEdical Department andwhilst in the service was in charge of the Women andChildren’s Hospital at Netley in 1873-74, the European andNative Female Hospitals at Agra in 1881, and the Women’s