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BERLIN. (FROM OUR OWN CORRESPONDENT.)

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492 prognosis. The treatment has demonstrated with great regularity the curability of deep angiomas (certain of which were treated in conjunction with Dr. Barbarin), and also the frequent cure of superficial cancer. With regard to deep cancers, radium was used with a purely palliative aim, and its use was in most cases followed by a temporary amelioration. Nevertheless, the result obtained amounted practically to a cure in certain cases of deep cancer of the parotid, the neck, and the uterus, the retro- gression of which from the clinical point of view has per- sisted for three or four years. In spite, however, of the favourable results in some deep malignant tumours, still the authors think that the most advantageous field for the employment of radium is as an accessory to proper operative measures. Feb. 10th. --------------- BERLIN. (FROM OUR OWN CORRESPONDENT.) The Question of Foreign Medical Students in German Universities. FOLLOWING the example set by the medical students of Halle, the Berlin medical students recently held a meeting to protest against the overcrowding of the lecture-rooms and clinics by foreign students. Delegates from Halle were present and gave a report of the state of the anti-foreign movement at other universities. The meeting then passed a resolution to the effect that foreign medical students should be allowed to register only a fortnight after the beginning of the lectures, and that the first three rows in every lecture- room should be reserved for German students. Foreign students should not be allowed to act as dressers and clinical clerks unless no German student was applying for the appointments in question ; they should pay double fees for the lectures, and be admitted only in a certain proportion to the German students. They must have passed the German examen physicum or a similar one in their native country previously to being admitted to the clinics. These demands are obviously far from being reasonable, and are much more severe than the original demands of the students in the University of Halle, who, as has been mentioned in this column, for a time refused to attend lectures in the end of last year, but returned to their studies after the Christmas holidays. The Government has promised to stop to a certain degree the invasion of foreign students, but will certainly not consent to measures which practically amount to a total exclusion of foreigners. Prussian Schools in Rural Districts. At a recent meeting of the Society for School Hygiene Herr Strode read a paper on schools in rural districts in Prussia regarded from a hygienic point of view. Herr Strode, who is a teacher in a school of this description, said that remarkable progress had been made in the construction of school premises since 1895, when new regulations were issued, but that the older premises, which were, of course, in the majority, were unsatisfactory. The rooms were cleaned only twice a week, and that by the children themselves. The rooms were often used for public meetings in the evening, so that the next morning the air was foul with tobacco-smoke and dust. The supply of drinking water was also open to objection, as there were sometimes no wells and the water was kept in a bucket placed in the class-room. The drinking glasses were insufficient in number, so that several children had to use the same glass, a condition which was very favourable for the spread of infectious diseases. It was very undesirable that school children should be engaged in agricultural work. Before going to school in the morning they had often to feed the cattle, and after school to drive the cattle to pasture, and must then learn their home lessons lying on the ground. The results of school training under these circumstances were doubtful, especially as the classes were often over- crowded. Herr Strode strongly recommended the appoint- ment of school medical officers in country places on some- what the same system as exists in England, the district medical officer of health having already too many duties to be able to supervise school hygiene also. He considered that teachers ought also to have some instruction in hygiene, and to inform the parents when the children’s health was unsatisfactory. Dr. Friedmann’s Treatment of Tuberculosis. As already stated in these columns, the success of Dr. Friedmann’s treatment of tuberculosis has been greatly exaggerated in the lay press, especially in foreign countries. The warnings of the medical press, including THE LANCET, have apparently been unheeded. At the beginning of a recent meeting of the Berlin Medical Society Professor Bier made a statement explaining his position in reference to the subject. He said that in consequence of certain foreign newspapers having mentioned his name in connexion with Dr. Friedmann’s treatment he was continually receiving letters, especially from America and Spain, inquiring whether the new treatment was really so efficacious as reported in the journals of those countries. Patients also sometimes came from distant places to be under his care while receiving the treatment, because they believed that he was convinced of its advantages. He wished, therefore, to state as his opinion that he had the impression that Dr. Friedmann’s remedy had a certain action on tuberculosis, but that it was in no way more efficacious than other methods of treatment. He could as a surgeon only speak of external tuberculosis, but he mentioned that Dr. Friedmann had declined to treat severe cases which afterwards showed some improvement under other methods. He regarded it as very undesirable that a system of treatment which was not yet sufficiently tested, and had hitherto been only used by Dr. Friedmann himself, should be lauded in the foreign press as affording a sovereign remedy. If the remedy should eventually turn out to be inefficacious much harm would be done to German medical science and to the Berlin Medical Society by the publishing of uncontradicted statements asserting that the members of the society had expressed themselves in favour of the remedy. He hoped the journals which had reported that he had recommended Dr. Friedmann’s treatment would also insert his present statement. One result of the publicity given to Dr Friedmann’s views has been that the Socialist section of the Berlin town council moved that the mayor and magistrates should take steps to prevent patients in muni- cipal hospitals and inmates of orphanages from being used for therapeutical experiments unless under the special responsibility of the chief physician and with the consent of the patients or their guardians. The supporters of the motion, which after some discussion was, however, with- drawn, took this action in consequence of a statement to the effect that Dr. Friedmann had given injections of living tubercle bacilli to children in one of the municipal orphan asylums. lNlaigratory Impulse in CAildren. Some interesting facts connected with the migratory im- pulse in children were mentioned by Dr. Stier in a paper read at a recent meeting of the Society for Internal Medicine. He said that during the past three years he had seen no fewer than 120 children brought to the out-patients’ depart- ment of the Charité Hospital because they had repeatedly run away from home. The motive which led them to behave in this way was, of course, not always the outcome of a morbid condition, and was frequently nothing more than a spirit of adventure. Whether a given case was a patho- logical one or not could be ascertained only by the history of the child and the circumstances surrounding the act. It was quite useless to ask the children as to their motives. Some writers on the subject alleged that epilepsy was frequently the cause of children running away from home, but in actual fact this condition was seldom found among’ them. In two cases only a post-epileptic feebleness of mind was present ; seven other children had had epileptic fits but a connexion between the fits and the migratory im- pulse was very uncertain. Hysteria was also rare among the children. The majority belonged to the feeble-minded and psychopathic class. Some of them had been so much impressed by some event in the street, such as a procession or a military band passing along, that they simply forgot to return home, and under these circumstances might absent themselves for a considerable time. Some were verv irritable, and in consequence of depressing conditions at home or in school were brought to a state of frenzy which prompted them to run away. Another group were labouring under hallucinations and delusions of fear. Ethical defects were present in a certain number, and it was sometimes difficult to determine whether these children were psychopathic
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prognosis. The treatment has demonstrated with greatregularity the curability of deep angiomas (certainof which were treated in conjunction with Dr. Barbarin),and also the frequent cure of superficial cancer. With

regard to deep cancers, radium was used with a purelypalliative aim, and its use was in most cases followed by atemporary amelioration. Nevertheless, the result obtainedamounted practically to a cure in certain cases of deepcancer of the parotid, the neck, and the uterus, the retro-gression of which from the clinical point of view has per-sisted for three or four years. In spite, however, of thefavourable results in some deep malignant tumours, stillthe authors think that the most advantageous field for theemployment of radium is as an accessory to proper operativemeasures.

Feb. 10th. ---------------

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

The Question of Foreign Medical Students in GermanUniversities.

FOLLOWING the example set by the medical students ofHalle, the Berlin medical students recently held a meetingto protest against the overcrowding of the lecture-rooms andclinics by foreign students. Delegates from Halle werepresent and gave a report of the state of the anti-foreignmovement at other universities. The meeting then passed aresolution to the effect that foreign medical students shouldbe allowed to register only a fortnight after the beginning ofthe lectures, and that the first three rows in every lecture-room should be reserved for German students. Foreignstudents should not be allowed to act as dressers and clinicalclerks unless no German student was applying for the

appointments in question ; they should pay double fees forthe lectures, and be admitted only in a certain proportionto the German students. They must have passed the Germanexamen physicum or a similar one in their native countrypreviously to being admitted to the clinics. These demandsare obviously far from being reasonable, and are much moresevere than the original demands of the students in the

University of Halle, who, as has been mentioned in thiscolumn, for a time refused to attend lectures in the end oflast year, but returned to their studies after the Christmas

holidays. The Government has promised to stop to a certaindegree the invasion of foreign students, but will certainlynot consent to measures which practically amount to a totalexclusion of foreigners.

Prussian Schools in Rural Districts.

At a recent meeting of the Society for School HygieneHerr Strode read a paper on schools in rural districts inPrussia regarded from a hygienic point of view. Herr

Strode, who is a teacher in a school of this description, saidthat remarkable progress had been made in the constructionof school premises since 1895, when new regulations wereissued, but that the older premises, which were, ofcourse, in the majority, were unsatisfactory. The roomswere cleaned only twice a week, and that by thechildren themselves. The rooms were often used for publicmeetings in the evening, so that the next morning theair was foul with tobacco-smoke and dust. The supply ofdrinking water was also open to objection, as there weresometimes no wells and the water was kept in a bucket

placed in the class-room. The drinking glasses were

insufficient in number, so that several children had to use thesame glass, a condition which was very favourable for thespread of infectious diseases. It was very undesirable thatschool children should be engaged in agricultural work.Before going to school in the morning they had often to feedthe cattle, and after school to drive the cattle to pasture,and must then learn their home lessons lying on the ground.The results of school training under these circumstanceswere doubtful, especially as the classes were often over-crowded. Herr Strode strongly recommended the appoint-ment of school medical officers in country places on some-what the same system as exists in England, the districtmedical officer of health having already too many duties tobe able to supervise school hygiene also. He considered thatteachers ought also to have some instruction in hygiene, and

to inform the parents when the children’s health was

unsatisfactory.Dr. Friedmann’s Treatment of Tuberculosis.

As already stated in these columns, the success of Dr.Friedmann’s treatment of tuberculosis has been greatlyexaggerated in the lay press, especially in foreign countries.The warnings of the medical press, including THE LANCET,have apparently been unheeded. At the beginning of arecent meeting of the Berlin Medical Society Professor Biermade a statement explaining his position in reference to thesubject. He said that in consequence of certain foreignnewspapers having mentioned his name in connexion withDr. Friedmann’s treatment he was continually receivingletters, especially from America and Spain, inquiring whetherthe new treatment was really so efficacious as reported in thejournals of those countries. Patients also sometimes camefrom distant places to be under his care while receiving thetreatment, because they believed that he was convinced of itsadvantages. He wished, therefore, to state as his opinionthat he had the impression that Dr. Friedmann’s remedy hada certain action on tuberculosis, but that it was in no waymore efficacious than other methods of treatment. Hecould as a surgeon only speak of external tuberculosis,but he mentioned that Dr. Friedmann had declined to treatsevere cases which afterwards showed some improvementunder other methods. He regarded it as very undesirablethat a system of treatment which was not yet sufficientlytested, and had hitherto been only used by Dr. Friedmannhimself, should be lauded in the foreign press as affording asovereign remedy. If the remedy should eventually turn outto be inefficacious much harm would be done to Germanmedical science and to the Berlin Medical Society by thepublishing of uncontradicted statements asserting that themembers of the society had expressed themselves in favour ofthe remedy. He hoped the journals which had reportedthat he had recommended Dr. Friedmann’s treatment wouldalso insert his present statement. One result of the publicitygiven to Dr Friedmann’s views has been that the Socialistsection of the Berlin town council moved that the mayor and

magistrates should take steps to prevent patients in muni-cipal hospitals and inmates of orphanages from being usedfor therapeutical experiments unless under the specialresponsibility of the chief physician and with the consent ofthe patients or their guardians. The supporters of the

motion, which after some discussion was, however, with-drawn, took this action in consequence of a statement to theeffect that Dr. Friedmann had given injections of livingtubercle bacilli to children in one of the municipal orphanasylums.

lNlaigratory Impulse in CAildren.Some interesting facts connected with the migratory im-

pulse in children were mentioned by Dr. Stier in a paper readat a recent meeting of the Society for Internal Medicine.He said that during the past three years he had seen nofewer than 120 children brought to the out-patients’ depart-ment of the Charité Hospital because they had repeatedlyrun away from home. The motive which led them to behavein this way was, of course, not always the outcome of amorbid condition, and was frequently nothing more than aspirit of adventure. Whether a given case was a patho-logical one or not could be ascertained only by the historyof the child and the circumstances surrounding the act. Itwas quite useless to ask the children as to their motives.Some writers on the subject alleged that epilepsy wasfrequently the cause of children running away from home,but in actual fact this condition was seldom found among’them. In two cases only a post-epileptic feebleness of mindwas present ; seven other children had had epileptic fitsbut a connexion between the fits and the migratory im-pulse was very uncertain. Hysteria was also rare amongthe children. The majority belonged to the feeble-mindedand psychopathic class. Some of them had been so muchimpressed by some event in the street, such as a processionor a military band passing along, that they simply forgot toreturn home, and under these circumstances might absentthemselves for a considerable time. Some were verv irritable,and in consequence of depressing conditions at home or inschool were brought to a state of frenzy which promptedthem to run away. Another group were labouring underhallucinations and delusions of fear. Ethical defects were

present in a certain number, and it was sometimes difficultto determine whether these children were psychopathic

493

or only the victims of neglect. In some the inclina-tion to run away was caused by an irresistible impulsewithout any obvious cause. Dr. Stier said that he had seentwo cases in which the impulse was hereditary throughthree generations, occurring always at the age of 12 years.The prognosis was not unfavourable provided the childrenwere under constant control in an institution of some kind.

A Carrier of Enteric Fever Bacilli.In an outbreak of enteric fever which recently occurred in

the barracks of the regiment of railway pioneers in Hanau,near Frankfort, some of the men at first presented symptomsof bronchitis and atypical fever, but after a few dayssuffered from diarrhoea, and bacteriological examinationshowed the presence of enteric fever bacilli. The disease

spread rapidly over the whole barracks. The cause of the

epidemic was after careful inquiry traced to a woman

employed in the kitchen ; she had suffered from enteric fevera few years ago, and was now found to be still carrying thebacilli of that disease. It was ascertained that the infectionhad been conveyed by potato salad which she had prepared,and she was of course removed from the barracks. The totalnumber of patients infected from this source was 226, ofwhom 14 died.Feb. 10th.

__________________

UNITED STATES OF AMERICA.

(FROM OUR OWN CORRESPONDENTS.)

Committees on Rztral and Urban Sanitation.THE attention of the people, both professional and lay, of

the United States, and particularly of New York Stateand City, is being directed to hygienic and sanitary matters ’’,very much of late, partly through the medium of the medicaland secular press. Committees have been appointed by thenew Governor of the State to study the question of rural andurban sanitation, who are expected as a result of their

investigations to formulate ways and means to remedyexisting evils.

The Port of New York., The attitude of Dr. O’Connell, the port medical officer, in

declaring for a continuance of State control of the port ofNew York rather than for its transference to Federalauthorities, is greatly to be regretted. Statistics disclosethe great importance of New York as the principal port ofentry for imports and immigration not only to the City andState of New York, but to the country at large. Federalcontrol of quarantine has justified itself more and morewhenever it has been tried, while local management hasmiserably failed in many ports because of local prejudices,notably San Francisco during the plague fright some yearssince.

Proposed Sanitary Regulatiot2 of Marriage.A New York State Senator has introduced a Bill providing

that on application for a licence to marry each party to thecontract must present a certificate from a licensed practi-tioner showing freedom from disease due to immorality.This measure has in principle been advocated by medicalassociations, but it is hardly specific enough to have thedesired preventive effect. No such legislation is reallylikely to be of practical good yet, but this measure, to belogical, should be made broader by excluding also conditionsincompatible with the best results of matrimonial alliances.Also recourse should be had to local boards of health so as torelieve the family physician, who would naturally be the onecalled upon, of the temptation to protect the family, and alsowould prevent hasty approvals without careful examinationinto the history, and allow of an examination by those lesslikely to be influenced by association or otherwise.

The Society of Medical Economics. A new society of medical men called The American Society

of Medical Economics has been established to devote itsattention to questions bearing upon the economics of thepractice of medicine. It will seek to protect the publicagainst ignorant, improper, and corrupt legislation, medicalfrauds, substitution, drug store dispensing, the sale ofimpure drugs and foods, as well as all forms of quackery.

Restriction of the Sale of Cocaine in New York.A new Bill is to be presented to the New York Legislature

making the sale or possession of cocaine by an unlicensed

person in New York City a felony, punishable by seven years’imprisonment. The Bill provides that the possession ofcocaine by a licensed pharmacist shall be limited to 5 ouncesat any one time ; that the chemist shall not sell the drug inflakes or crystals, but must dispose of it in a solution or oint-ment of not more than 4 per cent., and keep a record of allsales ; that prescriptions containing cocaine shall not berefilled ; and that no sale of more than 1 ounce shall bemade to any one person by the pharmacist.

A Filthy Practice.The Buffalo (New York) Health Department has been making

investigations concerning the condition of finger bowls inpublic hotels and restaurants. Brass finger bowls are declaredunsanitary, and the assertion has been made that theyspread disease because of the difficulty of properly cleansingthem thoroughly. In public eating-places it has been noticedthat waiters are prone to offer a bowl containing water thathas been previously used. As many persons wash their lips,as well as fingers, in such bowls. the danger is obvious. Itneeds also to be insisted on in public eating-places thatwaiters shall not be allowed to sneeze in such places withoutprotecting their nose and mouth with their handkerchiefs,instead of with the napkins which they are continuallyusing.

Society for the Advancement of Clinical Study.There has recently been organised in New York City the

Society for the Advancement of Clinical Study, which willmaintain a bureau of information where resident and visitingphysicians can obtain definite information regarding theclinical facilities of the hospitals and laboratories of the city.A bulletin board has been installed at the Academy ofMedicine, 19, West Forty-third-street, with a special clerkon duty between 9 A.M. and 6 P.M. to answer telephoneinquiries. On the bulletin board will be posted monthby month the regular clinics, medical and surgical, andalso laboratory demonstrations, all of which are heldat stated hours. Full announcements of daily operationsand demonstrations of cases both medical and surgicalwill, as far as possible, be made on the day preceding theirperformance. Visiting medical men interested in observingparticular operations or the work of particular operators orphysicians will thus attain their object with the least trouble.It is hoped that the unexcelled clinical facilities of New YorkCity will thus be made more generally accessible.

The New York Neurological Society.The following officers have been elected to serve for the

year 1913 :-President : Dr. Smith Ely Jelliffe. First Vice-President : Dr. E. G. Zabriskie. Second Vice-President :Dr. E. W. Scripture. Corresponding Secretary: Dr. J.

Ramsey Hunt. Recording Secretary : Dr. C. E. Atwood.Feb. lst.

HARVEIAN SOCIETY OF LONDON.-On Thursday,Feb. 20th, at Stafford Rooms, Titchborne-street, Edgware-road, W., there will be a discussion on the Diagnosis ofAcute Abdominal Conditions in Children, opened by Mr.E. M. Corner and Dr. E. Cautley, and continued by SirJames Goodhart, Mr. V. Warren Low, Dr. G. F. Still, andothers.

THE ASSOCIATION OF CERTIFIED DISPENSERS.-The annual meeting of this association was held in theCourt Room of the Apothecaries’ Hall, Blackfriars, E.C.,on Feb. 6th, Mr. Montagu G. Smith, of the LewishamInfirmary, presiding. The balance-sheet and annual reportshowed satisfactory progress, but Mr. A. Howell, who

presented the report, stated that the proposed Bill onbehalf of dispensers still waited a suitable opportunity to beput before Parliament. Mr. Howell then gave in his

resignation of the post of honorary secretary, which wasaccepted with regret, and on behalf of the members waspresented with a gold watch by the chairman, who in areminiscent speech alluded to the success of the associationas the result of Mr. Howell’s untiring efforts. Mr. A. MowbrayUpton, clerk to the Society of Apothecaries, spoke to the sameeffect. The committee for 1913 was then elected. Mr.

Montagu Smith and Mr. A. L. Anderson were unani-

mously re-elected chairman and treasurer respectively. Mr.F. E. Trayner, of Hackney Infirmary, Homerton, N.E., wasappointed honorary secretary, to whom all communicationsshould be addressed at 13, Carlton-road, Manor Park, E.


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