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1261 of science who immolates one life already given up and useless, with the exalted motive of doing good to millions of other human beings has nothing wherewith to reproach his conscience. Such a victim is, he says, one of those unhappy ones who are crushed by the wheels of the car of the new idol, Science. Finally, as considering that the first human life of which he has a right to dispose is his own he inoculates himself. The play has given rise to lively discussions in the reviews owing to the extraordinary skill with which the author has set forth his thesis. As the piece was written and published three years ago it is remark- able that by a pure coincidence the matter should be so widely discussed at the very time when the experiments of Professor Neisser on the injection of syphilitic serum into healthy patients are the subject of such violent denunciation in Germany. The Recent Playue Seare. Some 15 days ago a report spread abroad that plague had broken out in Paris and that three cases had been notified as occurring among the employes of one of the most important linen-drapers in the city. This report was sedulously circu- lated by a paper written for women which is in marked opposition to such large business establishments which employ a large number of women at very low wages. The story was officially denied almost as soon as it began to get about, but public uneasiness was not allayed thereby. Therefore on April 28th M. Leon Colin in the name of the Conseil d’Hygiene made a formal declaration which was published in all the journals (by order of the police) in which it was officially stated that there had been no case of plague either in Paris or elsewhere in France. In order to give your readers first-hand information I myself applied to the Pasteur Institute and inquired at the laboratory there set apart for the study of plague, to which are attached the stables of Villeneuve de l’Etang, where are kept the horses for the preparation of Yersin’s serum. The head of the laboratory, M. Dujardin-Beaumetz, told me in the most categorical fashion that no case of plague had been reported to him. This laboratory would certainly be the first place to be informed of such cases, for it is the only place in Paris which possesses any plague serum. May 3rd. ROME (FROM OUR OWN CORRESPONDENT.) Professor Koch in the Tuscan Maremma. LAST week Professor Koch arrived at Grosseto, in the Tuscan Maremma, to resume the malarial studies initiated last autumn in Italy. Among the coadjutors accompanying him are representatives of the Government in its army, medical, and public health departments, Professor Gosio, Director of the State Hygienic Laboratories, being one of them. The Prefect of the Commune of Grosseto facilitates Professor Koch’s work in every way and the Congregazione di Carità has placed at his service a number of rooms in the local hospital, one of which has been fitted up as a gabinetto scientifico. " Cholera among Poultry." The brief note on this subject contained in THE LANCET of April 22nd, p. 1128, must be supplemented by fuller and more precise details. There is no doubt that in the Alta Italia we are in the presence of a very grave and far-reaching malady, ruinous to poultry-farmers and fraught with risk to the public consumer. The origin of the disease has not been made out. while "cholera" appears to have been a name given to it without scientific sanction. At first it was said that chickens which had died from it might be eaten with impunity as " the cholera germ in poultry is not patho- genic in man." Thereafter deaths from the consumption of chickens so infected were announced, but even in these cases it was not ascertained whether the poultry consumed might not have been unsound from other causes. A typical illustration was thought to have occurred last week when at Settimo Torinese the young father of a family died within four or five days after dining heartily on polli morti di eolera (fowls dead from cholera) with symptoms mainly gastro-intestinal and pulmonary. Two of his children who had also partaken of the poultry recovered from the same illness, but not without difficulty. Bacteriological research on the body of the deceased yielded negative results; nor was it more successful when followed up on me ailing lowis ueionging to uue same oreea ana lot as those which were alleged to have caused the man’s death. Meanwhile in the bacteriological laboratory of the Turinese Ufficio d’Igiene large numbers of the "cholera" infected poultry were minutely examined. Rabbits, guinea-pigs, and healthy fowls and others of the feathered tribe were inoculated, but no "true specific germ could be isolated such as the bacteriologist invariably finds in well-marked colera dei polli. The Turinese School, in fact, confessed itself baffled, when there came from Milan the announce- ment that bacteriology practised there with equal care and thoroughness was not more successful. Then the opinion was hazarded that the malady is not a true colera de-a polli at all but an "epizooia" inducing an infective disease characterised by "pneumonia exsudativa." Research on this hypothesis is now in progress and results are awaited with interest, not to say anxiety. lyte Centenary of Spallanzani. Nature study, up to its most refined developments in clinical observation and research, was largely represented yesterday at Scandiano, where the great naturalist, physio- logist, and scholar, Lazzaro Spallanzani, died 100 years ago. Professor Todaro (Rome), Professor Mosso (Turin), Professor Bertolini (Bologna), Professor Pavesi (Pavia), and many others hardly less distinguished met to do honour to his memory and to inaugurate the gabinetti scientifici erected in the neighbouring Reggio Emilia to continue and commemo- rate his work. The Minister of Public Instruction was represented by Moleschott’s successor in the Roman ’chair of Physiology, Professor Luciani, whose speech at the tomb of the hero of the day was in all respects worthy of his reputa- tion. At the banquet which followed the Senator Giosu& Carducci (" the Tennyson of Italy ") who holds the chair of Italian Literature in the University of Bologna, spoke in the poetic strain of which he is a master, but the occasion evoked no finer discourse than that of Dr. Tamburini, Pro- fessor of Psychiatry in the Modenese School, who in opening the gabinetti scientifici dwelt on Spallanzani’s work as calculated (in the language of Lord Beaconsfield) " not only to commemorate but to inspire." May 1st. CONSTANTINOPLE. (FROM OUR OWN CORRESPONDENTS.) Bubonic Plague in Jeddah. BUBONIC plague still exists in Jeddah, where since its first appearance on Feb. 23rd about 100 or 110 deaths have occurred. It may be said that the number is very small and as a consequence that the illness is of a very mild type, especially if there be taken into consideration the imperfect sanitary condition of Jeddah, the filthiness to which the town is abandoned, and the habits of the pilgrims who are now thronging for the Hedjaz and who have passed through Jeddah to the number of about 30,000. They are badly fed, excessively dirty, and broken down by the long journey and bad accommodation on board ship. Three cases of bubonic plague have occurred in Mecca; of these not one proved fatal. It is not known to what kind of treat- ment such patients are submitted-very probably to none. Besides, the population of Jeddah has been excited against. the sanitary authorities and when the authorities tried to execute the orders given by the sanitary board for checking the spread of the epidemic riots broke out, the pilgrims were ill-treated, many stores and shops were plundered, and the physicians were obliged to hide themselves. They did not forget that last year one of them was grossly ill-treated in similar riots. The most curious thing is that the leaders of the riots were military men and employes of the sheriff. It is therefore conceivable that patients suffering from bubonic plague in Jeddah do not submit themselves to any treatment. The word "patient" does not include women. Up to the present date the sanitary news from the other provinces does not state that any outbreak of bubonic plague has taken place. Public Health, in Constantinople. In Constantinople the death-rate is less than it was a few weeks ago. The number of deaths registered during the week ending April 17th was 283. During the week ending March 13th the number was 354, the highest number being 362 for the week ending Feb. 27th. The most fatal diseases
Transcript
Page 1: CONSTANTINOPLE

1261

of science who immolates one life already given up anduseless, with the exalted motive of doing good to millionsof other human beings has nothing wherewith to reproachhis conscience. Such a victim is, he says, one of those

unhappy ones who are crushed by the wheels of thecar of the new idol, Science. Finally, as considering thatthe first human life of which he has a right to dispose is hisown he inoculates himself. The play has given rise to

lively discussions in the reviews owing to the extraordinaryskill with which the author has set forth his thesis. As the

piece was written and published three years ago it is remark-able that by a pure coincidence the matter should be sowidely discussed at the very time when the experiments ofProfessor Neisser on the injection of syphilitic serum intohealthy patients are the subject of such violent denunciationin Germany.

The Recent Playue Seare.Some 15 days ago a report spread abroad that plague had

broken out in Paris and that three cases had been notified asoccurring among the employes of one of the most importantlinen-drapers in the city. This report was sedulously circu-lated by a paper written for women which is in markedopposition to such large business establishments which employa large number of women at very low wages. The story wasofficially denied almost as soon as it began to get about, butpublic uneasiness was not allayed thereby. Therefore on

April 28th M. Leon Colin in the name of the Conseild’Hygiene made a formal declaration which was publishedin all the journals (by order of the police) in which itwas officially stated that there had been no case of plagueeither in Paris or elsewhere in France. In order to give yourreaders first-hand information I myself applied to thePasteur Institute and inquired at the laboratory there set

apart for the study of plague, to which are attached thestables of Villeneuve de l’Etang, where are kept the horses forthe preparation of Yersin’s serum. The head of the laboratory,M. Dujardin-Beaumetz, told me in the most categoricalfashion that no case of plague had been reported to him.This laboratory would certainly be the first place to beinformed of such cases, for it is the only place in Pariswhich possesses any plague serum.May 3rd.

ROME

(FROM OUR OWN CORRESPONDENT.)

Professor Koch in the Tuscan Maremma.LAST week Professor Koch arrived at Grosseto, in the

Tuscan Maremma, to resume the malarial studies initiatedlast autumn in Italy. Among the coadjutors accompanyinghim are representatives of the Government in its army,medical, and public health departments, Professor Gosio,Director of the State Hygienic Laboratories, being one ofthem. The Prefect of the Commune of Grosseto facilitatesProfessor Koch’s work in every way and the Congregazionedi Carità has placed at his service a number of rooms in thelocal hospital, one of which has been fitted up as a gabinettoscientifico.

" Cholera among Poultry."The brief note on this subject contained in THE LANCET

of April 22nd, p. 1128, must be supplemented by fullerand more precise details. There is no doubt that in the AltaItalia we are in the presence of a very grave and far-reachingmalady, ruinous to poultry-farmers and fraught with risk tothe public consumer. The origin of the disease has not beenmade out. while "cholera" appears to have been a namegiven to it without scientific sanction. At first it was saidthat chickens which had died from it might be eaten withimpunity as " the cholera germ in poultry is not patho-genic in man." Thereafter deaths from the consumptionof chickens so infected were announced, but even inthese cases it was not ascertained whether the poultryconsumed might not have been unsound from other causes.A typical illustration was thought to have occurred lastweek when at Settimo Torinese the young father ofa family died within four or five days after diningheartily on polli morti di eolera (fowls dead from cholera)with symptoms mainly gastro-intestinal and pulmonary.Two of his children who had also partaken of the poultryrecovered from the same illness, but not without difficulty.Bacteriological research on the body of the deceased yieldednegative results; nor was it more successful when followed

up on me ailing lowis ueionging to uue same oreea ana lot asthose which were alleged to have caused the man’s death.Meanwhile in the bacteriological laboratory of the TurineseUfficio d’Igiene large numbers of the "cholera" infectedpoultry were minutely examined. Rabbits, guinea-pigs, andhealthy fowls and others of the feathered tribe were

inoculated, but no "true specific germ could be isolatedsuch as the bacteriologist invariably finds in well-markedcolera dei polli. The Turinese School, in fact, confesseditself baffled, when there came from Milan the announce-ment that bacteriology practised there with equal care andthoroughness was not more successful. Then the opinionwas hazarded that the malady is not a true colera de-a

polli at all but an "epizooia" inducing an infective diseasecharacterised by "pneumonia exsudativa." Research on thishypothesis is now in progress and results are awaited withinterest, not to say anxiety.

lyte Centenary of Spallanzani.Nature study, up to its most refined developments in

clinical observation and research, was largely representedyesterday at Scandiano, where the great naturalist, physio-logist, and scholar, Lazzaro Spallanzani, died 100 years ago.Professor Todaro (Rome), Professor Mosso (Turin), ProfessorBertolini (Bologna), Professor Pavesi (Pavia), and many othershardly less distinguished met to do honour to his memoryand to inaugurate the gabinetti scientifici erected in theneighbouring Reggio Emilia to continue and commemo-rate his work. The Minister of Public Instruction was

represented by Moleschott’s successor in the Roman ’chair ofPhysiology, Professor Luciani, whose speech at the tomb ofthe hero of the day was in all respects worthy of his reputa-tion. At the banquet which followed the Senator Giosu&Carducci (" the Tennyson of Italy ") who holds the chair ofItalian Literature in the University of Bologna, spoke in thepoetic strain of which he is a master, but the occasionevoked no finer discourse than that of Dr. Tamburini, Pro-fessor of Psychiatry in the Modenese School, who in openingthe gabinetti scientifici dwelt on Spallanzani’s work as

calculated (in the language of Lord Beaconsfield) " not onlyto commemorate but to inspire."May 1st.

CONSTANTINOPLE.(FROM OUR OWN CORRESPONDENTS.)

Bubonic Plague in Jeddah.BUBONIC plague still exists in Jeddah, where since its

first appearance on Feb. 23rd about 100 or 110 deaths haveoccurred. It may be said that the number is very smalland as a consequence that the illness is of a very mild type,especially if there be taken into consideration the imperfectsanitary condition of Jeddah, the filthiness to which the townis abandoned, and the habits of the pilgrims who are nowthronging for the Hedjaz and who have passed throughJeddah to the number of about 30,000. They are badly fed,excessively dirty, and broken down by the long journeyand bad accommodation on board ship. Three cases ofbubonic plague have occurred in Mecca; of these not oneproved fatal. It is not known to what kind of treat-ment such patients are submitted-very probably to none.Besides, the population of Jeddah has been excited against.the sanitary authorities and when the authorities tried toexecute the orders given by the sanitary board for checkingthe spread of the epidemic riots broke out, the pilgrimswere ill-treated, many stores and shops were plundered, andthe physicians were obliged to hide themselves. They did notforget that last year one of them was grossly ill-treated insimilar riots. The most curious thing is that the leaders ofthe riots were military men and employes of the sheriff. Itis therefore conceivable that patients suffering from bubonicplague in Jeddah do not submit themselves to any treatment.The word "patient" does not include women. Up to thepresent date the sanitary news from the other provinces doesnot state that any outbreak of bubonic plague has takenplace.

Public Health, in Constantinople.In Constantinople the death-rate is less than it was a

few weeks ago. The number of deaths registered during theweek ending April 17th was 283. During the week endingMarch 13th the number was 354, the highest number being362 for the week ending Feb. 27th. The most fatal diseases

Page 2: CONSTANTINOPLE

1262

were acute inflammation of the lungs, small-pox, and typhoidfever. A few weeks ago H.I.M. the Sultan gave stringentorders to vaccinate and revaccinate the population of thecapital. Unhappily there appears to be no diminution ofthe number of deaths from small-pox since the said orderswere given. During the week ending Nov. 28th last fivedeaths from small-pox were registered. The same numberwas registered for the week ending Jan. 16th ; 10 deathsfrom small-pox were registered during the week endingApril 17th. The largest number of deaths from small-

pox was registered for the week ending Jan. 23rd,1899-namely, 23. Nearly the same number of deaths- occurred from typhoid fever, which presented unusual

hyperpyrexia. Among these there was one very sad case,that of a lady, the wife of one of the high officialsof an Embassy, who in a fit of hyperpyrexia committed.suicide. Always after the rains of March typhoidfever and other zymotic diseases break out, but thisyear such cases are more numerous than usual.This year the municipal authorities have left thetown in a condition of the greatest filthiness. It iswonderful that bubonic plague has not yet broken out.The water-closets of the mosques also are in a very bad con-dition. In order to give employment to certain people thewater-pipes by which water was supplied for the closetshave been intercepted. Those who enter have to pay nowfor the water they need to men who sell it and if sellers donot get enough money they provoke the unhealthy conditionof which I write. There are several cases of diphtheriawhich, however, are of a rather mild character. There are.about 23 deaths registered every week. There is no doubtthat this is owing to the lack of anti-diphtheritic serum which,unhappily, is not regularly provided to the druggists’ shops,whence patients could obtain it easily, not being obliged toapply to the Institut Pasteur which is outside the city.A very interesting discussion on the efficacy of the serum-took place at the last two sittings of the Medical Society ofConstantinople.

Chemical Ancclysis in the Czcstorrz House.The chemical analysis undertaken at the Custom House

of the goods imported into Turkey has provoked the interfer-ence of diplomacy. Several meetings of the dragomans ofthe embassies and legations were held in order to discuss the.affair. Several meetings of the Ambassadors themselves were.also held and it is said that they protested against the saidchemical analysis. The affair has not yet been settled. It is a

very difficult question because not only are the Ambassadors.and Ministers right in complaining of the Ottoman chemistswho have very often declared best quality goods to beharmful to public health, but the Ottoman Government isperfectly right in objecting when, as it states, there has beenseized, for instance, at the Salonica Custom House santoninwhich was a compound of 1 per cent. of santonin and’99 per cent. of crystallised boric acid. Sulphate of quininehas been seized containing more than 30 per cent. of water.as well as other alien substances.

The Medical Selzools of Beyrout.The American Minister has asked the Sublime Porte for a

.special commission to be sent to Beyrout to be present atthe final examinations of the American Medical College inthat town. A similar arrangement has already been madefor the French Medical School of Beyrout at whose final- examinations a commission sent by the Imperial School ofMedicine will be present. This new arrangement will nodoubt put the only two provincial medical schools of the

empire on a firmer and higher footing. So far the Govern-ment has tried to raise difficulties for the licentiates of these.schools. Graduates of the Beyrout schools may come to,Constantinople to have their diplomas authorised or signedin the usual way. They have, however, to work veryhard at the metropolis. They have sometimes towait for years before they can get the necessarypermission to practise medicine in the Turkish empire.I have known Beyrout graduates who had practically to

go through the whole course of the Constantinople medicalschool before obtaining the" official" " diploma. A viva voceexamination has, of course, to be passed by anyone comingfrom abroad, but that is simply nothing compared with thefate of Beyrout men. The viva voce examinations take placeat the Imperial School of Medicine and are as a rule fair.The examiners, however, seem particularly opposed to

Beyrout qualifications and to the American degrees ingeneral. So that if the request of the American Minister

be granted the American Medical College of Beyrout willundoubtedly draw large numbers of students from all partsof the country.

Turkish Delegates to -Jfedi(-al Ccnyresses.Dr. Djelal Mouhtar Bey has been nominated first delegate

of the Imperial Government to the Medical Congress whichis to meet at Brussels in September next. Dr. Mouhtar Beyis I I M6d ecin Attache" to the Imperial Palace, is one of theprofessors at the Medical School, and is chief of the sanitaryservice for the sixth circle of the municipality. The seconddelegate is Dr. Ahmed Fehmi Bey. The Government hasappointed Dr. Feizi Pacha, Professor at the Imperial Schoolof Medicine, and Dr. Djelal Ismail Bey to represent Turkeyat the Medical Congress which is to meet on May 24th inBerlin under the patronage of the German Emperor.

The French Hospital.Dr. Denis has just been nominated head surgeon to the

French Hospital, a post which till lately was occupied by thelate Dr. Larrien, who died from pneumonia. Dr. Denis wasa pupil of the Lyon Faculte. He has for four years actedas an "interne" in the hospitals of that town and wasappointed assistant teacher in pathology to the Faculté,and afterwards "moniteur" of the Obstetrical Clinic. Hebecame assistant surgeon to the Lyon Hospitals in 1898.He brings with him seven years’ hospital and scientific ex-perience and will no doubt be a very useful addition to theFrench Hospital in Constantinople, which was so noted forits surgical department under the great operator, Dr. Lardy.

The British Seamen’s Hospital.Mr. John F. McClean, M.R.C.S. Eng., L.R.C.P. Lond., has

been appointed surgeon superintendent to the British Sea-men’s Hospital, Constantinople, in succession to Dr. JohnPatterson, resigned.April 21st.

_______________

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

Diphtheria Antitoxin Treatment in Chicago.THE Assistant Health Commissioner states that between

Oct. 5th, 1895-the date of the first administration ofantitoxin by the Health Department-and Feb. 28th, 1899, aperiod of nearly three and a half years, a total of 6342reported cases of diphtheria were visited by inspectors; ofthis number 4311 were bacterially verified as diphtheria and4076 were treated by them with antitoxin, the remaining 235either refusing antitoxin treatment or being treated by otherphysicians, results not known ; of the 4076 treated by theDepartment physicians 3795 recovered, 276 died, and fiveremained under treatment at the close of February, 1899.This gives a mortality rate of 6’77 per cent. in 4071 casesof bacterially-verified diphtheria cases treated withantitoxin. During November and December, 1898, andJanuary and February, 1899, there were treated 100 cases inNovember, with 97 recoveries and three deaths, a mortalityrate of 30 per cent.; in December, 119 cases with 115recoveries and four deaths, a mortality rate of 3’36 per cent.;in January, 101 cases, with 94 recoveries and seven deaths,a mortality rate of 7’4 per cent. ; and in February, 103 cases,with 92 recoveries and six deaths, and five remaining undertreatment at the end of the month, a mortality rate of 6’1per cent. of the completed cases in February. The totals forthe four months are 423 cases treated, 398 recoveries, 20deaths and five remaining under treatment on Feb. 28th; theaverage mortality rate was 4’78 per cent. in the 418completed cases. There was no death among 129 cases onthe first and second days of the disease and only three deathsamong 114 on the third day, a mortality of 1’23 per cent. in243 cases. The Commissioner also states that more thanthree years’ experience has demonstrated that in this city atleast the home treatment of diphtheria even in the mostsqualid and insanitary surroundings gives better results thanhospital treatment, as shown by the reports of contagiousdisease hospitals in other large cities. The prime factor ofsuccess in the antitoxin treatment of diphtheria is the earlyinjection of the serum. The delay caused by removal tohospitals by waiting the result of bacterial examination (as isdone in many contagious disease hospitals) and by othermore or less unavoidable routine hospital procedures more


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