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Reed’s experiments have not conclusively shown that theremay not be some other means than the mosquito by whichyellow fever is transmitted. But when these experimentsare considered in connexion with the results of our practicalexperience it is clearly evident that this disease is not con-tracted by personal contagion or through the medium ofclothing, bedding, cargoes of vessels, &c. Therefore Ibelieve we are justified in changing our quarantine regula-tions to conform to these views, and that such a proceedingis safe and reasonable, particularly as we now have at hand amethod which if properly and scientifically carried out, canbe ?depended upon to limit the extension of yellow fever.If the future shows that there are other means of infectionit will then be time enough to add whatever restrictions arenecessary for the protection of the public health."

Mosquitoes and Dengue.- The New York Medical Record of Feb. 8th contained anarticle on Dengue by Dr. Harris Graham, professor of

pathology in the American College, Beyrout, Syria. Thisarticle was referred to in THE LANCET of March 22nd atpage 855. Dr. Graham made a careful study of, andinvestigations into, the mode of propagation and the patho-logy of the disease, and as a result of these researches he- claimed that it was caused by a protozoal parasite, and statedthat his experiments had convinced him that dengue wasconveyed to man by means of a mosquito, apparently of the- culex species, which, as in malaria, acted as the inter-

mediary host. The Bureau of the United States Marine

Hospital Service having had its attention drawn to Dr.’Graham’s article has determined to make investigations withthe object of testing the value of his conclusions, and hasrequested that health officers in all parts of the UnitedStates will furnish the Surgeon-General of the Marine HospitalService with early information as to the appearance of denguein epidemic form in their respective localities, in order thatinvestigators may be early dispatched to the seats of suchepidemics.May 6th, 1902.

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AUSTRALIA.(FROM OUR OWN CORRESPONDENT.)

The Plague. In

THE bubonic plague has recurred in Australia, with a atvarying virulence in the different States. In Sydney it has St

’been very severe, over 80 cases having occurred, with about grthe average mortality of the previous epidemic-viz., one in df’three. Two popular actresses were among those who died, inand this fact led to Her Majesty’s Theatre being closed Gfor a time and quarantined. In Melbourne only one case, cl

non-fatal, has occurred so far. In Brisbane several cases have been notified. A supposed case was isolated at aiAdelaide but the diagnosis proved to be erroneous. No tr.cases have been reported from West Australia. As regards st

Sydney the fresh outbreak began gradually. For 15 months Rthe disease was quiescent and it reappeared on Nov. 14th, d’

. 1901. Up to Feb. 20th, 1902, 22 cases occurred at varying tl

intervals, from 36 days to one day, and in six different rEareas. In some areas the nature and source of infection - could not be traced ; in others a definite local infection fromrats was fairly clear. Four produce stores were implicated a

in the outbreak. The cases afterwards increased in number Pwith few and short intervals. One infected area was largely 2

occupied by Chinese and was highly insanitary. The destruc- ntion of rats and cleansing operations are being vigorously ri

prosecuted in all the States. It is difficult to conceive, how- 1- ever, how indifferent the various municipal authorities are to I

sanitary matters.. In Melbourne, for instance, the garbage e

and refuse are still disposed of in "tips" which are most nobnoxious. The corporation imported a destructor which (could deal with only about one-fifth of the refuse, but it is f

not used, it is said, because of the cost. In Sydney recent tinspections showed that parts of the city which had been Edemolished during the first outbreak of plague had been Irebuilt in exactly the same insanitary manner and under the - very eyes of the municipal authorities.

1The Health of Sydney.

The medical adviser to the Metropolitan Board of Water-supply and Sewerage, Sydney (Mr. T. M. Kendall), has furnished his annual report. It stated that the board 1

supplied water to 511,382 persons, of whom only 364,775were accommodated with a sewerage system. The mor-

tality from general causes exceeded that for 1900. The

mortality from diarrhoea and typhoid fever was lower andthat from diphtheria and phthisis was higher. An investiga-tion of 874 cases of typhoid fever reported showed that31 ’2 per cent. came from districts unprovided with sewerage,28’6 per cent. from dwellings unconnected with sewers, 24’3per cent. from dwellings in which the sanitary fittings weredefective, and 15 per cent. from dwellings in which theboard’s regulations had been complied with. The installa-tion of the sewerage system had undoubtedly diminished theprevalence of typhoid fever. The mortality from this diseasebefore and after the laying down of the sewers had been asfollows in the districts named : city of Sydney, before 5’07,after 1’07 ; Glebe, before 2’5, after 1-8 ; Darlington, before4’0, after 0’3 ; Newtown, before 6’6, after 1-8 ; Redfern,before 3-6, after 1-0 ; Waterloo, before 1-2, after 0-9 ;Paddington, before 2-7, after 0’9; Woollahra, before 2-1,after 0-8.

Hospital Affairs.The difficulty at the Women’s Hospital, Melbourne, to

which reference has been previously made, remains un-

settled. The resident staff was dismissed and when

applications for the positions were invited the two lateresidents were the only applicants. The committee refusedto re-appoint them and Dr. Andrew Shields, formerlyGovernment medical officer, offered his services temporarilyand was appointed. The committee now invites applicationsfrom men who have been three years at least in practiceand offers a salary of 250 per annum.-The report readat the annual meeting of the supporters of the SydneyWomen’s Hospital showed that 299 in-patients and 1493out-door patients had been treated. The financial positionwas satisfactory. The directors intimated that as soon as thenew maternity hospital in course of erection was completedthe Women’s Hospital would be amalgamated with it.-Thetwenty-second annual report of the Sydney Hospital for SickChildren stated that 536 in-patients had been treated. Ofthis number 314 were discharged cured, 72 were relieved, 46were discharged unrelieved, 60 died, and on Dec. 31st therewere 44 remaining in the hospital. In the diphtheria cottagethere had been admitted 197, making, with five remainingfrom the previous year, a total of 202 patients undertreatment. Of these 155 were discharged cured, 36 died,and on Dec. 31st there were 11 remaining in the wards.In moving the adoption of the report the Premier drewattention to the very large amount of money spent by theState in assisting hospitals. Last year the Government

, grant to various hospitals amounted to £227,000, and he.

deemed that the community did more than any other countryin the world in supporting charitable institutions. TheGovernment had also granted a very fine site for a newchildren’s hospital and had undertaken to drain it. It

; overlooked Centennial Park, Moore Park, and Botany Bay and could not be built out. -The annual report of

) the Prince Alfred Hospital, Sydney, stated that the

; statistics of the first year’s work were as follows :-

; Remaining in hospital on Dec. 31st, 1900, 223 ; admitted

during the year 1901, 3216 ; total under treatment, 3439. Of, these 1848 patients were cured, 725 were relieved, 268 were un-t relieved, 360 died, and 238 remained in hospital on Dec. 31st,1 1901. The rate of mortality per cent. (deducting 61 deaths1 which occurred within 24 hours of admission) was 9’29.-TheI annual report of the Sydney Hospital showed that the

r patients remaining in hospital on Dec. 31st, 1900, numberedcr 286 ; patients admitted during 1901, 3951. Total under treat-

,- ment, 4237. Discharged cured, 2467 ; relieved, 873; un-

yrelieved, 165 ; died, 428 ; remaining in hospital on Dec. 31st,1901, 304 ; percentage of mortality on admissions, 10’9.

o Improvements had been effected in the buildings by thee erection of the Nightingale wing and operating theatre-it now equal to anything in the southern hemisphere. Theh Government had voted an additional sum of E2500is for further improvements, including the furnishing of

the Nightingale ward and a new casualty room. Kefer-n ence was made to the danger of admitting phthisicaln patients to the general wards and the efforts made to estab-

lisli a separate institution for their treatment. The patho-logical department of the hospital had proved of great use as ahelp to the diagnosis of cases in the wards. The laboratory ofpathological chemistry was now equipped with apparatus

r- which rendered it possible to make use of the more moderndiscoveries in physiological and pathological chemistry in

d their application to the improvement of diagnosis, prognosis,75 and treatment in many cases of disease which were before snr-

rounded by almost impregnable difficulties and fallacies. It1e was the distinction of the Sydney Hospital to be able to report

1433

that to it belonged the honour of being the pioneer hospital ofAustralia, perhaps of the southern hemisphere, in introduc-ing modern chemical methods in diseases of the stomach andmetabolism generally. In the skiagraphic department alarge number of cases had been treated, 263 cases havingbeen submitted to the Roentgen rays.-A new hospital hasbeen established in Sydney called the King Edward Hospital.It is situated at Miller’s Point and is specially for seamen.It has been started very quietly and many doubt the need forit seeing that the Prince Alfred Hospital and other hospitalsare being enlarged.-The committee of the Melbourne Hos-pital has appointed delegates to confer with delegates fromother hospitals to fix a standard of efficiency for trainednurses and if possible to appoint a conjoint board ofexaminers and to decide on a recognised system of examina-tion. The committee also decided in future to import allthe drugs required direct.

.

The Profession and the Friendly Societies in Neiv SouthWales.

As has been previously mentioned, friction has existed forsome time between the friendly societies in New South Walesand their medical officers, or more strictly the New SouthWales Branch of the British Medical Association. Mattersare rapidly reaching a crisis. At the annual meeting of theFriendly Societies’Association held on March 12th the matterwas referred to. The annual report stated :-During the year under review the attention of this association has

been directed by an affiliated society to the action of the British MedicalAssociation in practically boycotting the society referred to. Themajority of societies for several years past have enjoyed an uninter-rupted career of mutual understanding between the members and thesurgeon, but if this new issue, the wage-limit question, is pressed itcannot conduce to the maintenance of the harmony that has hithertoexisted. The following notice of motion was referred to a committeeto report: " That it is desirable to place before all candidates for Stateelection the question if they favoured the introduction of a measurewhereby medical practitioners would be compelled to meet in consulta-tion any duly qualified medical man and regulate fees for attendanceand consultations." The committee met and took a quantity of evidencebut the State elections being then in full swing it was too late to makeany recommendations dealing with the above notice of motion.The President said further :-Unless they could make some compromise with the British Medical

Association he could not help saying that he foresaw trouble looming inthe distance. The question of the wage-earning limit was a seriousmatter and could not be regarded too lightly by this association. Theaction of the doctors in his opinion would be to destroy a cosmopolitancharacter of our societies. They considered no man’s financial positionany barrier to their membership. That a man with his income ofthousands was equally entitled to membership in their orders as a manwhose earnings amounts to £200 or less, that being the limit fixed byour worthv friends " the doctors" to admit as financial members of asociety. The medical fraternity were doing their utmost to keep outan element which was conducive to the well-being of the societv. Verymany of the moneyed members, while paying their contributions hadnot joined for any benefits that they may be entitled to, andthe same will apply to the doctors. Very few of such membershave enlisted the services of the lodge doctor and he chal-

lenged the profession to say otherwise. Their societies were

not open to distinction or class. The admission of the rich and the

poor was essential to their success, both financially and intellectually.Roughly estimated there were about 70,000 or 80,000 members of variousorriers in New South Wales and if a central medical board was formedsufficient funds could be raised annually to pav salaries to doctors anddistribute them in all parts of the State. Other difficulties such asmeeting in consultation could easily be overcome by legislation, buthe should be very loth to interfere in the harmony now existing, butwould be forced to do so if this wage-earning limit were peristed in.

The matter was discussed by the meeting and it was agreedthat the action of the British Medical Association in boy-cotting the Australian Natives’ Association was inimical tothe interests of friendly societies and that this resolutionshould be forwarded to the secretary of the Britih MedicalAssociation. It was also decided that a special meetingshould be held this month to consider the question raisedby the doctors. The New South Wales Branch of theBritish Medical Association also discussed the subject at itslast meeting and carried a motion-That the resolution of August 31st, 1900, declaring the Australian

Natives’ Association to be a society inimical to the interests of themedical profession, be adhered to. !The Australian Natives’ Association is determined to make Ithe question a public one and, according to its secretary,"will fight it to a finish." He observes that at the inceptionof the Australian Natives’ Association the British MedicalAssociation demanded that a wage-limit of 200 per annumshould be fixed. After some consideration the wage-limitwas conceded and still the British Medical Associationboycotted the Australian Natives’ Association. At its in-ception the Australian Natives’ Association had only onebranch with 32 members ; now it had 35 branches and 2700members. Out of nearly 1200 medical practitioners regis-tered in the State of New South Wales only 300 are members Iof the British Medical Association.

Obituary.Dr. George Goode of Camden, New South Wales, died

recently. He was born in Ireland in 1843 and took his M.A.and M.D. degrees at Dublin University. He was for some

years in the New Zealand Investigation Service and went to-.Camden in 1875. After residing there for 10 years heremoved to Orange, but after a few years resumed practice-at Camden. He was a brother of fDr. J. Goode, of

Macquarie-street, Sydney, and was well known and popular-with the profession.April 7th.

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Medical News.UNIVERSITY OF CAMBRIDGE. --- The following

medical and surgical degrees were conferred on May 8th :-Bachelor of Medicine.-H. P. Bradley and B. L. Thurlow, Gonville-and Caius ; and J. M. Brydone, Jesus.

Bachelor of Surgery.-J. P. Hedley, King’s; G. R. Wilson, Trinity;.A. S. Bradley, G. L. Crimp, G. P. D. Hawker, J. E. B. Snell. andB. L. Thurlow, Gonville and Caius ; J. M. Brydone, Jesus ; F. E.Shipway, Christ’s ; H. C. Brown, A. F. Elliott, and H. J. Shone,Emmanuel; and C. H. Sedgwick, Sidney Sussex.

The Registrary calls the attention of candidates for medicaland surgical degrees to the new regulations for the Third.Examination for the degree of M.B. which will come intoforce next term and points out that all such candidates,with the following exceptions, are now subject to those-

regulations :-1. Students who have already passed one part of the Third Examina-

tion. Students who have passed in surgery and midwifery (old III.M.B., Part I.) are required to satisfy the examiners in section (3) onlyof the new Part II. (physic). Students who have passed in physic (oldIII. M.B.. Part II.) are required to satisfy the examiners insections (1).and (2) only of the new Part II. (surgery and midwifery).

2. Students who shall have passed both parts of the Second Exa-mination before October next. These students are still permitted topresent the same certificates on admission to Part I. of the ThirdExamination as would have been required from them on admission toPart 1. under the old regulations, and to present the same certificateson admission to any section or sections of Part II. as would havebeen required from them on admission to Part II. under the old

regulations.Students who have been admitted to. but have not passed, either partof the Third Examination must, either before, after, or together with-Part II.. pass the new Part I. (pharmacology and general pathology),but they require no new certificates for admission either to this partor to the section or sections of the new Part II. corresponding to thepart of the old Third Examination to which they have already beenadmitted. A special examination in pharmacology and general patho-logy will be held on June 9th, 1902; the ordinary examination forPart I. will he held in December, 1902, and in June and December offuture years.

UNIVERSITY OF DURHAM.--At the convocationheld on April 26th, the following degrees and diploma were-conferred :-

Doctor in Medicine.--Laurence James Blanclford. M.B., B.S. Durh.;Leopold Stanley Davison, M.B., B.S. Durh. ; Richard Henry Dix,M.B., B.S. Durh.; Henry Adamson Fielden, M.D., B.S. Durh. ;John Reginald Fuller. M.B., B.S. Durh. ; Edward Walter Joscelyne,M.B. Durh. ; Eliot Swainston, M.B., B.S. Durh.; and DavidHenderson Weir, M.B., B.S. Durh.

Doctor in Medicine J’or Practitioners of 15 years’ standing.--EdwardHarris Armitage, M.R.C.S., L.R.C.P., D.P.H.; Charles WilliamJoseeline Bell, M.lt.C.S., L.R.C.P. ; Albert Bothay, M.R.C.S.,L.R.C.P., L.S.A., D.P.H.; Edward Joseph Day. M.R.C.S., L.S.A.;.Ambrose William Fairles, M.R.C.S. ; Thomas Frederick Gardner,M.R.C.S., M.R.C.P., L.S.A.; Frederick Charles Goodwin. M.R.C.S.,L.R.C.P.. DP.H.; William Gosse, M.R.C.S., L.R C.P.; RobertRankin Hunter. M.B.. VT.S. Glasg., M R.C.S.; Richard JohnMorris, M.R.C.S., L.R.C.P., L.S.A.; John Latimer Parke,L.K.Q.C.P. Irel., L.F.P.S. Glasg., L.S.H., D.P.H.: James William-son Patrick, L.R.C.P. & S ; George Frederick Pollard, M.R.C.S.,L.S A. ; Alfred Tom Rimell, M R.C.S.. L.R.C.P.; and JohnRogerson. L.R.C P. & S. Edin., L.F.P.S. Gla,5g.

Master in Surgery.--Joseph William Leech, M.D., B.S.. F.R.C.S.,and William Hunter Richards, M.B., B.S.

Bachelor in Medicine (M.B.).-Erziest Bertram Appleby, WilliamRobert Davidson Dagbsh Mary Evelyn De Rusett, Henry WallaceFurnivall, James Alfred Giles, and James Herries Graham, Collegeof Medicine, Newcastle-upon-Tyne ; Ivon Henry Skipwith Hawes,St. George’s Hospital; Kenred Manson, College of Medicine, New-castle-upon-Tyne; Lucy Selina Molony, London School of Medicinefor Women ; Robert William Nevin, Henry Reah, Ralph StuartRenton, Hermann Heinrich Ruffmann. and Alfred Henry Proctor,College of Medicine, NewcastIe-upon-Tyne : Godfrey De Bee Turtle,King’s College; Ralph Thomas Vaux. College of Medicine, Newcastle upon-Tyne; Marmaduke Cordeux Wetherell, Guy’s Hos-pital ; and Hugh Widdas and Thomas Wilson, College of Medicine,Newcastle-upon-Tyne.

Bachelor in Surgery (B.S.).--Ernest Bertram Appleby, William.Robert Davidson Daglish. Mary Evelyn De Rusett, Henry WallaceFurnivall, James Alfred Giles, and James Herries Graham, College-of Medicme, Newcastle-upon-Tyne : Ivon Henry Skipworth Hawes,St. George’s Hospital; Kenred Manson, College of Medicine.Newcastle-upon-Tyne; Lucy Selina Molony, London School ofMedicine for Women; Robert William Nevin, Alfred Henry Proctor,