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BUDAPEST.(FROM OUR OWN CORRESPONDENT.)

Sunstroke and Insuranoe against Accidents.A MAN recently sued a Hungarian accident insurance

company under his policy on the ground that an attack ofsunstroke from which he suffered was of the nature of anaccident. The company, however, resisted the claim,pleading that sunstroke was not an accident but a disease,and that their policy holders were insured only against injuryfrom unforeseen external violence. The word I I accident " inthe policy, from the company’s point of view, was to betaken as employed in its ordinary sense-that is to say, as anoccurrence not according to the usual course of things. It

might certainly be by accident that a person became exposedto conditions leading to sunstroke, but the circumstancesunder which a person might be affected thereby ought to beclassed, in the opinion of the company, among naturalcauses and natural phenomena, and these could not be

correctly called accidents. The court decided in favour ofthe plaintiff, but the medical journals are not quite satisfiedas to the justice of the decision. They say that if it isallowed to stand, then frost-bite, chilblains, and even" catching cold " would have to be placed in the category ofaccidents, and might be made the subject of claims.

The Treatment of ricne Rosaoea by Tonogen.In a recent article in the Orl,osok Lapja Dr. Pór writes that

the administration of digestive tonics and intestinal anti-septics is usually indicated in acne rosacea. In order to bringabout the disappearance of the chronically dilated blood-vessels he has employed tonogen (an extract of the suprarenalgland) both as a topical and also as an internal remedy. The

application of the extract to the affected area of skin for thefirst time determines slight transient hypersemia, which issucceeded by pallor due to the contraction of vessels, but chishyperasmia is not usually observed after subsequent applica-tions. Permanent improvement was observed by Dr. Pórwithin six weeks of the commencement of the treatment.The effects of the external applications were markedlyenhanced by the simultaneous internal administration of theextract in doses commencing with one five-grain tabletthrice daily, gradually raised to six, the dose being reducedin the event of any unpleasant symptoms, such as giddinessor nausea. In cases of moderate severity the combinedtreatment proved very satisfactory, but it was sometimesfound necessary to eradicate the enlarged vessels by theelectro-cautery.Ycur2cations in the 5’usceptibiZatt of Guinea-pigs two diphtheria

Toxin.At a recent meeting of the Medical Society Dr. Schiff, in

speaking of the routine testing of the strength of diphtheriaantitoxin, called attention to the usefulness of the antitoxinunit furnished by the Institute for Experimental Therapyunder the direction of Professor Ehrlich. The one un-

certain element was, he said, the relative resistanceof the guinea-pigs to diphtheria toxin. It was foundthat different dealers furnished guinea-pigs of slightlydifferent susceptibility, and on investigating the matterhe discovered that the different degrees of resistance belongedto certain families or litters and were constant for thosefamilies. For instance, one mother gave birth to youngwhich did not react to what was the usual fatal dose, andfour successive litters possessed the same resistance. As each

guinea-pig could be tested but once the precise degree ofresistance could not be measured, but it appeared probablethat this family could tolerate 40 per cent. more toxin whenmixed with the antitoxic unit than those of average suscep-tibility. Other mothers were traced whose offspring possessedless resistance than the ones described, but could stillneutralise 20 per cent. more toxin, when mixed with theantitoxin unit, than the average. Dr. Schiff said that experi-ments were now being made for the purpose of determiningthe part played by the male in the transmission of toxinresistance. In the case of the most resistant family, thefour litters were the offspring of two males.

Paroxysmal Tachycardia.Dr. Neress has reported an obscure case of heart disease

which terminated fatally. The patient had had his attentioncalled to his heart in boyhood by his medical attendant, andhad always troubled himself about it. Attacks of flattering, I

with changes in disposition, which varied with the characterof the pulse, were the prominent features of the case. Thephysical signs were variable, signs of myocarditis with con-gestion of the liver and oedema of the feet gradually develop-ing. There was no pain, but attacks of apparent anginaoccurred with fair frequency. At the necropsy fibrous myo-carditis, sclerosis of the coronary arteries, and a thrombosisof the left ventricle were found. Many diagnoses had beenmade on this case, and it illustrated the great difficulty ofrecognising myocarditis in the early stage. Dr. Neress

emphasised the importance of causing patients to makemuscular efforts during the examination of the heart; a

murmur which developed under such exercise was suspicious.Oct. 29th.

CONSTANTINOPLE.(FROM OUR OWN CORRESPONDENT.)

The Epidemic of Cliolera.SINCE I wrote last cholera has made its appearance in the

Ottoman metropolis. This was, of course, anticipated, con-sidering the near proximity of Russia and the enormous

difficulties which the medical authorities at Constantinopehaveto contend with in order to take the necessary measures of

prevention. Then again, it is well-nigh impossible to preventan epidemic spreading to Constantinople, a city of greatcommercial importance and of imperfect sanitary conditionsHappily, however, the weather is cool at present. Up to nowthe disease has made little progress, one or two deaths occur.ring daily, seldom more. According to the official reports,since Sept. 13th, when the epidemic seems to have made itsfirst appearance, to Oct. 12th, there were registered 84 cases,of which 46 died. One of the great difficulties which themedical and municipal authorities of the metropolis, as wellas of the provinces, encounter in combating the spread ofthe epidemic is, as in Russia, the incredulity and ignorance ofthe lower classes of the population. A great many ofthem do not believe that there is any cholera in Con-

stantinople, and refuse to take the prescribed measuresof precaution, spreading at the same time the absurdnews that medical men I I invent " cases of cholera in order tobe able to draw money from the Budget assigned to combatthe epidemic. In the provinces the behaviour of the peopleis still worse. In Trebizond, for instance, a medical man wasmobbed for trying to bring help to the cholera-stricken. Asin Russia, so also in some parts of Turkey, the populacefirmly believe that medical men poison the wells of drinking-water, thereby causing disease and death for selfish personalinterests. The Sanitary Commission continues to take rigorousmeasures. All suspicious quarters are visited and sanitaryimprovements are introduced so far as is possible in Constanti-nople, with its dirty and narrow streets, and a drainagesystem so antiquated. All the vendors whose stands are un-clean are being fined or otherwise punished. This is done, forinstance, in quarters like Tatavla, a valley beyond, and to theleft of, Pera, where the sanitary conditions are exceptionallybad. It has also been decided to increase the number of the

municipal medical men so as to enable them to visit thehouses of the poorer quarters. I understand, too, that ithas been thought necessary to issue a proclamation warn-ing the population against throwing any refuse fromdoors and windows-a deplorable practice which is verymuch resorted to at Constantinople. A local paper announcesthat the tohoptchis (refuse gatherers) will henceforward calltwice daily, instead of once, at each house, and that thenumber of street sweepers will be considerably increased.In Bagdad and its neighbourhood cholera is spreading, anda case of the disease is reported from Belgrade. Theadminis-tration of the Oriental Railway Company states that theBulgarian Sanitary Council has decided that all passengers,infected or non-infected, travelling beyond Zaribrod maypass Bulgaria without quarantine, provided that they arekept in a special carriage and do not come in contactwith any person in Bulgaria.

A New Hosp2tal.I understand that the municipality of Constantinople

intends to erect a new hospital in the quarter of ShehirEmin. beyond Ak Serai, in Stamboul. The OsmaniRc1ltrLloyd says that the plans are ready, and that the construc-tion will begin in the month of March. The expense ofconstruction will amount to £T50,000, and will be drawn

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from the city budget. After the completion of the instrtn-

tion the hospital of " Gureba-i-Musselmin " of Yeni Baghtche

Tcbair will be transferred to it. The new hospital willcontain rooms for private patients who are able to pay. The

"Gureba-i-Musselmin," a Moslem hospital, which was muchneglected during the regime of Abdul Hamid, is receiving atpresent adequate attention under the chief medical officer,Dr. Hussein Ihsan Pasha. The wards, the barracks, the

operation room, and the laboratory are being completelyrenewed. It can now accommodate 300 patients.

The Sale of Poison01lS Drugs.The attention of the medical and other authorities is again

drawn to the fact that the public in Turkey have everyfacility for obtaining poisonous drugs without any medicalprescription. In Constantinople, for instance, it is veryeasy to procure corrosive sublimate without prescription atthe different aotars (druggist shops) and at the MissirTcharshi (the so-called Egyptian bazaar). In the provincesit is, of course, still worse, as the lack of control and super-vision there is very great indeed. Often the most poisonousmedicines are taken by ignorant people in incredibly largedoses, with results that can easily be imagined. The otherday a young woman was taken, in a state of completecollapse, into the Jewish hospital at Balat, on the right shoreof the Golden Horn, and soon afterwards died there. In-

vestigation revealed that she had obtained, in the Egyptianbazaar, a large dose of corrosive sublimate and had drunk itin order to procure abortion. She already had seven children,and dreaded a further increase of her family. It is necessary,therefore, that the authorities should take all possiblemeasures and precautions against the indiscriminate sale ofpoisonous drugs.

Earthquakes in the Provinces.In Salour, vtlayet Diarbekir, a violent earthquake has

caused much damage, numerous buildings being injured anda number completely destroyed. Happily, however, therewas no loss of human lives. Also in the vilayets in the neigh-bourhood of Diarbekir, as well as in the province of Erzeroum,violent earthquakes occurred, but details of these are wantingas yet.

Miscellanea.

The Children’s Hospital at Shishli, beyond Pera and Taxim,will receive the services of a special medical attendant witha salary of £T10 monthly, whose duty will be to apply theRoentgen-ray treatment.-The Ministry of War is sendingthis year 20 military medical officers to Germany to completetheir medical studies there.-Under the presidency ofMadame Rifaat Pasha, the wife of the Minister for ForeignAffairs, a Red Cross Society has been formed, which has nowissued its statutes.-The Turks have formed an Ottoman Anti-Alcoholic Union with the purpose of combating the increasingconsumption of alcohol among Moslems.Oct. 13th.

___________________

AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.)

Ethnology in West Australia.Two ethnological expeditions have begun operations in

West Australia. One is organised from Cambridge, underthe direction of Mr. Alfred Brown, and the other is aSwedish undertaking in the charge of Dr. Eric Mjoberg.This latter expedition will cost £1100, the funds being pro-vided by the Stockholm Academy of Sciences. It will proceedto the north-west and operate from Derby up the FitzroyRiver. The Cambridge expedition has a double object ina study of aboriginal features and the collection of botanicalspecimens.

Radium for t7te Poor.In response to the appeal by the Sydney Daily Telegraph

’ for public subscriptions to a radium fund the sum of £2021has been received, including .61400 as the result of a specialiiiutiwge performance and collection by Miss Nellie Stewart.

i Remarkable Record.’ Mr. Justice Chomley of Victoria has been granted a year’s

leave of absence. The judge has been in the public servicefor 57 years, and during the whole of that period has not hada single day’s sick leave.

-Private Hospitals.A new Bill has been introduced in Victoria to regulate the

conduct of private hospitals. The definition is, " Any house,building, tent, or place (other than those excluded) in whichmedical, surgical, or lying-in cases are received or lodged, orin which it is intended that, they shall be received or lodgedfor treatment, attendance, and cure, for which a charge ismade." All private hospitals are to be registered annually.The licence is issued by the Minister for Public Health on theadvice of the Board, but the former has absolute power.Every private hospital must at all times have a residentmanager, and this person must be subject to the approval ofthe Board. Registration books must be kept and officialinspection is provided for. The managers are required to giveinformation respecting certain diseases and in the case ofillegitimate births to notify the neglected children’s depart-ment.

B1lSk Nursing Scheme.The scheme for extension of district nursing to country

areas, which was formulated by Lady Dudley, has practicallybeen abandoned. Meetings were held in Sydney andMelbourne, but it was apparent that financial supportwould not be forthcoming from the general public and thatthe feeling amongst medical men and nurses was that theproposed new order of nursing was not required.

Melbourne Hospital., Dr. W. Moore, the senior surgeon at this institution, hasresigned his position on the staff after a tenure of 25 years.Under the new regulations Dr. Moore might have continuedto hold the position for many years so far as age limit isconcerned, but he has stated that his object in retiring is togive the younger surgeons an opportunity of advancement.Dr. Moore has been one of the leading figures in the surgicalworld in Australia for the past 15 or 20 years. His trainingis entirely Australian and he has not visited any of the oldworld centres. Dr. Moore will continue to hold his seat onthe committee and take an interest in the affairs of thehospital.

Health of Sydney.The annual report issued by Dr. W. G. Armstrong, the

health officer, sets forth that the population of Sydney is now592,000. The birth-rate was 26-11 per 1000 of estimatedmean population, and illegitimate births formed 10 per cent.of total births. The recorded death-rate was 9-83 per 1000,the fully corrected rate, however, being 11-09. Scarlet fever

figures were low, but diphtheria was higher than any yearsince notification became compulsory. 22 persons were knownto be attacked by plague, of whom 7 died. Some of these

belonged to the crew of a visiting steamer. About 68,000rats and 8000 mice were examined, and 136 rats and 11mice were plague infected. The death-rate from tubercu-losis was 0-83 per 1000 living. Infantile mortality rate was81 per 1000 births, which was the lowest yet recorded. ThePure Foods Act came into force on July 1st, 1909, and hasso far been administered by the Board of Health, noadministrative power having been granted to any localauthorities. Generally the amount of food adulterationdisclosed was not significant.

Melbourne Fever Hospital.The Infectious Diseases Hospital at Fairfield, a Melbourne

suburb, has been a fruitful source of complaint and dissatis-faction. The Government called for a report from the Boardof Health, and under this it is probable reforms will beundertaken. The building is quite inadequate, leading toconstant overcrowding. The charges for maintenance areexcessive and it is recommended that they be abolishedaltogether and the hospital supported by Government grantsand direct municipal aid. These reforms will meet the chiefobjections, which have related mainly to such gross over-crowding as placing two children in one bed and to the injusticeof compelling comparatively poor parents to pay 7s. 6d. perdiem for each child treated.

Parkinson Memorial.

To perpetuate the memory of the late Dr. T. C. Parkinson,who died from plague accidentally contracted while engagedin research work for the Indian Plague Commission at Elstree,Herts, the Sydney University has decided to establish aParkinson memorial prize. The prize will be awardedannually, and the subject of examination will be pathology.

Oct. 1st.