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"scare" finds less and less encouragement day by day-thanks to the energy and the tactics of the Board of Health,reinforced by the calm and the fortitude of the mass of thepopulation.August 26th.

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VIENNA.

(FROM OUR OWN CORRESPONDENT.)

The Cholera Epidemic.THE recent outbreak of cholera in Russia and Italy, two

countries conterminous with Austria, has caused considerableanxiety among our population, and the most stringentmeasures have been adopted by the Board of Health to

prevent any extension of the disease across our frontier.The danger, however, is great, for intimate relations existbetween the Austrian population in the border districts andtheir Russian or Italian neighbours. Austria being inhabitedby eight different nations, the frontier is, for the most part,a political rather than a national line of separation, and itwill therefore be easily understood that the commercial andsocial intercourse between the residents on both sides of it iscertain to increase the danger of an extension of the disease.Ever since cholera has been reported from the Eastquarantine has been imposed on all travellers arriving fromthat quarter, but now there is a very strict supervision not onlyof all travellers, but also of their luggage and of merchandiseentering this country. Linen and second-hand clothes, inwhich an extensive trade is carried on, are subjected tosuch an ordeal that this class of business is nearly stopped.The danger is much increased by the hostility which thebulk of the population in Russia is manifesting towardsthe sanitary procedures of their respective governments asappears from the rioting which has followed attempts atdisinfection. In Austria, however, the population is wellaware of the necessity of prophylactic measures, and submitsto the unavoidable inconvenience in a spirit of resignation.Leaflets explaining the nature of the epidemic, its danger,and the means of combating it have been freely distributed,and by this means the supervision of many possible sourcesof contamination and importation has been undoubtedlyfacilitated.

Death of Professor Oser.Professor Leopold Oser, chief of the Rothschild Hospital

and of the medical department of the Vienna Poliklinik,died recently, after a prolonged illness, in his seventy-firstyear. Professor Oser had a high reputation as a specialistfor diseases of the stomach and alimentary canal. He con-tributed numerous articles on these questions to the medicaljournals, and his treatise on "Diseases of the Pancreas " isa standard work on the subject. He was the first to pointout the importance of the mechanical forces involved instenosis of the pylorus. The significance of pain in the

diagnosis of duodenal ulcers and peptic ulcers in the stomachwas also one of his early discoveries. As an author he wasso painstaking in his work that his rate of literary produc-tion was rather slow. A twelvemonth ago he reached hisseventieth year, which is the age limit for a professor in anAustrian university, but in consideration of his services hewas granted the prolongation of the so-called honorary year(Ehrenjahr). During this period he died, and his loss is feltkeenly by his numerous friends, pupils, and patients. His

position as Chief President of the Board of Health with thetitle of an Imperial Councillor placed him on practicallythe highest level of distinction attainable by a medicalman in this country.

Infccti01tS Diseases in Austria.A recently issued official report gives some interesting

statistics relative to the prevalence of infectious diseases inthis country during the spring months of 1910. A case of

small-pox which was imported from Russia and terminatedfatally was the means of communicating the disease to a manemployed in the cemetery ; this man in his turn infected hismedical attendant, whose brother and sister also becameill. All were vaccinated and recovered. Another series of6 cases occurred in Galicia, on the Russian frontier. Scarletfever was prevalent in the rural northern districts ; inVienna only 2100 cases were recorded, a proportion of 1 caseper 1000 inhabitants ; in the southern mountainous regionsand in the coast districts only sporadic cases occurred The

mortality was 7’5 per cent. on an average, death being dueto heart failure in 60 per cent. of the cases. Under the headingof diphtheria there were 2733 cases with a mortality of 11-8per cent. ; the majority of these patients were treated withantitoxic serum, except in Galicia and Carinthia, where lessthan 50 per cent. of the patients received serum treatment;the virulence of the disease was said to have been graduallydiminishing for several years. Typhoid fever occurred in3024 cases, of which number more than 60 per cent.

happened in Galicia on the Russian frontier; the causeseemed to be polluted water in nearly all the cases

there ; the mortality was 7-7 per cent.-about the same asfor diphtheria. A few sporadic cases of blackwater feveroccurred in Bohemia, with a mortality of 11 per cent. Only9 cases of dysentery were reported, with 3 deaths. Cerebro-

spinal meningitis was notified in 50 cases, with 11 deaths ;there were 6 cases in Vienna ; the small epidemics in variouscountries of the Empire have had an average mortality of29 per cent. Under the heading of poliomyelitis anterior 59cases were reported, with 5 deaths and 25 recoveries; thewhole of these cases were sporadic and were distributed allover the Empire. Under the heading of pertussis 7316 caseswere notified during the spring, but it must be added that

many cases are not reported ; 2’ 5 per cent. of the patientssuccumbed to the disease. Erysipelas occurred in 558 cases,with a mortality of 5 per cent. There were over 10,000 casesof trachoma, mostly in Galicia, but this number includesmany cases long under observation, only 232 new cases havingbeen reported. Under the heading of anthrax 11 cases werereported, with 2 deaths ; all these patients had been engagedin the leather and hair trade, and the cases were sporadic.August 29th.

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CONSTANTINOPLE.(FROM OUR OWN CORRESPONDENT.)

Ckolera in Russia; Feeling in Turkey.MOST serious accounts of the spread of cholera in Russia

have come to hand. The following official statistics are

published in the Russian papers. Of 57,720 persons attacked,25,554 have died ; that is to say, as many fatal cases havealready occurred as in 1908 and 1909 taken together. The

epidemic has been most severe in the districts of Don,Ekaterinoslav, Kherson, and Kuban. Professor Rein con-

siders the cholera epidemic of this year as being a nationalcalamity and one affecting the whole fabric of the RussianGovernment. He was appointed by the Government toexecute all the necessary measures of prevention. The

greatest danger seems to consist in the fact that the cholerahas infected such territories and out-of-the-way districts ofthe empire where no medical help exists at all. In manyvillages the peasants shut up their houses and fly in maddespair in all directions, thus carrying with them the

germs of the scourge and infecting large tracts of land.In the province of Kyazan four cities and 49 villagesare infected, and hundreds of persons are dying weekly,and a similar state of things exists in the districtsof Yelisawatgrad, Bakhmut, Novotcherkask, Kostroma,and Poltava. In the city of Ekaterinoslav alone2044 persons were infected and many hundreds died. In

Petersburg there were 1268 cases, of which 370 died. Evenin Tzarskoye Seloe, the residence of aristocracy, where thereis excellent drinking water, two cholera cases occurred.What makes the epidemic so specially serious and increasesthe death-rate is the superstitious trend of mind of theRussian lower classes of population. People have beenmutilated, tortured, or killed because they are suspected ofhaving poisoned the wells and other water-supplies. The

police seem to be helpless in dealing with a low,ignorant rabble. In many places the sanitary com-

missioners and medical officers meet with enormous

difficulties in attempting to take the necessary measuresof prevention and cure. A good number sustain heavyinjuries ; some even lose their lives in their attemptsat alleviating the distress. In Constantinople itself alarmis spreading. Great precautions are being taken to preventthe Russian epidemic spreading to Turkey. Milk depots,water-sources, markets, and the like are being visited

by sanitary agents of the municipality and submittedto strict examinations. I learn that ice-cream vendorsare forbidden to traffic in the streets. As if the

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cholera were not mlsfortune enough lor Russia, uuuunlc

plague is reported from Odessa, where it made itsappearance on May 22nd. The authorities, however, keptthe fact secret in order not to cause public alarm. The firsttwo deaths from plague occurred in a baker’s shop. Fromhere the epidemic spread. The exact number of deaths isnot given, as the authorities continue to hide the full extentof the epidemic. Isolated cases of bubonic plague stilloccur. In addition, a cyclone recently devastated thenorthern part of the Crimea, and was accompanied by a briefearthquake shock that was felt over the extent of 200 kilo-metres to the north of the Crimea. All these manifestationsexcite the superstitious feelings of the Russian population,and the feelings of apprehension are spreading to this

country.August 15th.

CHARTHAM ASYLUM, CANTERBURY.——The life-saving apparatus at the East Kent Lunatic Asylum,Chartham, has just been augmented by a new speciallydesigned fire escape of Merryweathers’ "self-supporting"pattern. It has three telescopic ladders extending to a

height of 40 feet, and its properties are such that when fullyextended it can stand entirely self-supported, with a man atthe head of the ladders, without resting against a buildingand without the aid of poles or props. It can thus be usedas a water tower for directing a jet into the upper floors ofburning premises. It is claimed to be the lightest andhandiest self-supporting escape extant.

THE ABERDEEN PARISH COUNCIL AND THE POSTOF VISITING MEDICAL OFFICER TO OLDMILL POORHOUSE -At the present time considerable interest is being taken inmedical circles in Aberdeen over the appointment of a visit-ing medical officer to Oldmill Poorhouse. Prior to the year1908 there were two poorhouses (East and West), bothsituated in the city, and eah with a visiting medical officer.In 1908 a new poorhouse was opened at Oldmill, a distanceof three miles from the city, to take the place of the two thatwere in town. The medical staff at Oldmill was to consistof a visiting medical officer and a resident medical officer.The late Dr. J. J. Y. Dalgarno, from the East Poorhouse, wasappointed visiting medical officer at a salary of E70 perannum, with E5 additional under the Lunacy Acts. This

salary has always been considered totally inadequate for thework to be performed, keeping in view the facts that thepoorhouse is three miles from the town, that there are alwaysover 200 patients in the infirmary alone, and that the dutiesand responsibilities, as laid down by the parish council, areby no means light. Amongst other things, the visitingmedical officer has to visit the poorhouse every alternateday and at any other time should emergency arise, write

quarterly and annual reports to the council and LocalGovernment Board, and generally supervise the dietary,sanitation, and ventilation of the poorhouse. As the poor-house is situated over three miles from the centre of the cityand at a considerable distance from a tramway terminusthe travelling expenses make a serious inroad on the salarygiven ; in fact, calculating moderately, more than half thesalary would be absorbed by driving expenses at ordinaryAberdeen rates. Owing to the lamented death of Dr.

Dalgarno in May last the post of visiting medical officerbecame vacant, and the Local Government Board took thisopportunity to bring pressure to bear on the parish councilto improve the medical administration of the poorhouse andto considerably increase the salary. In spite of this the posthas been advertised by the parish council under the old con-ditions and at the same salary. So strongly did the medicalprofession feel in the matter that a meeting of the localbranch of the British Medical Association was held. After afull and lengthy discussion of all the circumstances and con-ditions, the following resolutions were unanimously agreedto :-(1) That the salary at present offered by the parishcouncil is grossly inadequate ; (2) that no medical practi-tioner should apply for the post under the present conditions ;and (3) that the minimum salary should be il-lS0 per annum.It was further resolved that a circular embodying theseresolutions should be sent to all medical practitioners inand around Aberdeen, and that the parish council and theLocal Government Board for Scotland should be informed ofthe action taken by the local branch of the British MedicalAssociation.

Obituary.SIR COXSTANIINE HOLMAN, M.D. ST. AND.,

M. R. C. 5. ENG., L. S. A.EVERY member of the medical profession will share our

profound regret at the announcement of the death of Sir Con-stantine Holman, which occurred at Ramsgate on August 18th,in his 81st year. His death was unexpected, for althoughduring the last 18 months or so the burden of his years hadbegun to weigh on him, and arterio-sclerosis was telling itstale, he was apparently in his usual health when he leftLondon for Ramsgate to spend an accustomed holiday.Until comparatively recently he had enjoyed robust healthfor so old a man, and it is difficult to associate the idea ofdeath with his fine presence, erect port, well-maintainedmental energy, and unfailing interest in the numerous andimportant affairs in which he had played a leader’s part.But after he had been at Ramsgate a week he sufferedfrom a severe epistaxis, and from this time forward he sank,painlessly and quietly, it being impossible to imagine a morepeaceful ending to a strenuous career.

Sir Constantine Holman was the son of Dr. Henry Holman,a medical practitioner at Hurstpierpoint, Sussex. He wasbornon Oct. 23rd, 189,9, and received his early education at BrightonCollege, whence he proceeded under the old system of pro-fessional training to Reigate, where he was apprenticed in1847 to Messrs. Thomas and Peter Martin, his connexions bymarriage, who had a large practice in that district, and

enjoyed a profes-ional pnsition which made training underthem valuable. From the beginning of his career Holmanwas plunged into medical politics and the organisation ofmedical benevolence, for Mr. Thomas Martin, his immediatechief, was a vigorous worker in these fields. In 1848 Holmanacted as assistant to Mr. Thomas Martin in the secretarialduties connected with a movement for the reform of themedical position under the Poor-law, thus getting an earlyinsight into one of the most interesting medico-politicalproblems of the day. He also acted with Mr. Martin assecretary to the Surrey Medical Benevolent Society, whichfor over 30 years had been active in the county to meetcertain wants of the medical profession. Young Holman,therefore, when he went to Guy’s Hospital in 1849, hadreceived already a liberal preliminary training, havingwatched the conduct of a large country practice for twoyears, and being also singularly well acquainted with thedifficulties of professional life as a whole. At Guy’s Hospitalhe won the Pupils’ Proficiency Prize of the Hospital PhysicalSociety, and secured excellent testimonials from Aston Key,Hughes, and Cook. In 1851 he proceeded to Edinburgh tocomplete his studies, taking in the same year the M.D. degreeof St. Andrews University, and the Membership of the RoyalCollege of Surgeons of England. Then followed the sojournin Paris, which in those days the ambitious young medicalman made if he was so fortunate as to have the chance, andin 1852 he returned to Reigate, and joined his brother-in-law,Mr. Peter Martin, in the work of practice. Here he married

shortly afterwards Marion, daughter of William Street ofNorwood, and here he remained until 1892 a partner, and fora long time the senior partner, in a famous firm of general practi-tioners. The valuable work that he did in the district waswell known, not only to those who directly benefited by it,but to many London consultants who at different times hadbeen summoned by him into the country ; and we may repeathere the regret that we have registered on previous occasionsthat the experiences of those who conduct these great prac-tices can seldom be put on record. The lessons in thera-

peutics of a general sort which they could impart do not lendthemselves to literary shape, while the contents of theircase-books cannot for obvious reasons be used with thefreedom of hospital reports. But the conduct for 40 years ofa great general practice, in the scope of whose workingpersons of all classes suffering from innumerable ills wereincluded, must have given Holman a knowledge not only ofpathology and therapeutics but of men and manners, thefruits of which knowledge we would gladly have shared.

In 1892 he left Reigate, literally tearing himself awayfrom his beautiful home, and settled in London, inGloucester-place, Portman-square, where for some years hecontinued to practise in a somewhat desultory manner, seeingcertain of his old patients as a con’ultant, and being called