534 and, are distributed among eight shafts. Ohiy one, shq,ft: appeared to be infected. Of 1193’ miners examined by.]M.! Brehan extremely few were found to be affected with ankylo- stoma,, but on the other. hand 603 men were found affect(di with trichocephalus and 118 with ascaris.. The, reason for; the rarity, of ankylostoma iri M,. Brehan’s opinion’lies in the’ fact that mines of the North do not show underground wàter-i soakage,or stagnant pools, and finally that the temperatures of f the m,ine is generally below 23°C. In the coal basin of Liège and St. Etienne where ankylostoma is frequently found’ there is water-soakage and.-the. temperature. of the galleries, varies from 25° to 30°C., two facts whicn are very favour-, able to, tb6 hatching of the’eggs of the, parasite. Prophy-; laxis consists in .the ’use of boiled water, a strict medical examination of newcomers, ’and a refusal to employ those coming from a suspected district. Such methods, however,’ are a serious matter’ and microscopic examination of the stools would be more satisfactory than a systematic refusal of miners coming from an infected district. Such examination would be a guarantee of safety and would permit non- infected men to be employed. ’ Feb. 20th. _________________ SWITZERLAND. (FROM OUR OWN CORRESPONDENT.) University Intelligence. THE number of medical students at the five Swiss Uni- versities for the winter term 1904-05 amounts to 1724. There are 958 female students enrolled in the lists and only 766 men. The number of female students goes on increasing rapidly, especially at the universities of Bern and Lausanne. The numbers stand thus :- If the increase of female students goes on at. the same rate in the next five years as in the last five years the medical 1 faculties at Bern and Lausanne will be almost monopolised 1 by the fair sex. : Institute for Physical Therapeutics at the University of ’ which. At a well-attended recent meeting of the Cantonal Medical Society the committee appointed at the previous meeting to consider the question of an institute for physical thera- peutics submitted its report. After a discussion of three hours’ duration the report was agreed to with some funda- mental modifications. The urgent necessity of the institute having its own out-patient department and being independent of the other cliniques was mentioned and obtained favour. The report finally agreed on is to be transmitted to the cantonal authorities, together with the expression of a hope that this institute with a capable director at its head may soon be established and that it may do valuable service both to the public and to science. Wage Limitsfor Club Members at Ziirich. The Krankenpflege " at Ziirich is a very large provident society, having at the present time 6000 members. At a meeting of the medical officers held on Feb. 2nd some motions, proposed by the President, Dr. Haeberlin, caused a lively discussion. The proposal to increase the number of members by admitting persons with incomes of .660, £80, £108, £132, and £160, divided into five classes who were to pay monthly instalments of 10d., Is., Is. 1½d., Is. 3½d., and Is. 6d. per head, met with opposition from several quarters and at last an amendment, proposed by Dr. T. Zangger, was accepted limiting the right of admission to the three first classes and to persons with incomes under £120 per annum. Thus the scheme of municipalisation of medical service in Zurich, described at length in THE LANCET of Oct. 29th, 1904, p. 1246, will for the present still be limited to the working classes. Ziirich, Feb. 20th. 1 THE LANCET, Jan. 28th, p. 266. EGYPT. (FROM OUR OWN CORRESPONDENT.) .. " . ., ’’ Suex Hospital. . ’ ’ ’ ’A NEW hospital, designed ,to meet the varying wants of a, seap6rt,towri, .was.opened by tl?e. Egyptian Government last seaport town, was. opened by the, Egyptian Government last summer. It is well. placed, just outside the town, .being surrounded by miles of desert and provided with a good view of thë,hl)-rbour and adjacent mountains ; ’it is also com- venietitly near’ the Hospital for Infectious Diseases. It is of course provided ’with ; all modern requirements, electric lighting, hot-water ’supply, operating theatre, steriliser, laboratories, an excellent house for the English super’ intendent, and nursing quarters presided over by an English sister. There are separate rooms for private patients and a total’ of 58 beds, of which 40 were occupied at the time of my visit. Most of the patients were suffering from medical diseases, some from the malignant tertian form of malaria, which is commoner in Suez than other parts of Egypt, and there were four natives recovering from appendicitis, though this has usually been considered a rare disease in this country. The old hospital in the town is still utilised for out-patients and for the treatment of prostitutes. Neurasthenia. This complaint is rare among the natives of this country, who are not given to nervous strain, but cases are met with among the Red Sea lighthouse-keepers who are mostly Englishmen. They suffer from sleeplessness, emotional symptoms, tremors, and exaggerated reflexes which the men themselves put down to their lonely life and the monotony of their existence and their food. The tinned food causes dyspepsia and consequent loss of weight but not scurvy. There are always three men in each lighthouse, while the fourth is absent on leave, and they are only visited every three months when they get letters and newspapers. Two men lately committed suicide after leaving Egypt and a third developed delusions. Sleeping Sickness. Captain E. D. W. Greig, I.M.S., was one of those sent by the Royal Society with Colonel Bruce, R.A.M.C., and Dr. D. N. Nabarro, in 1903 to Uganda and as he is now passing through Cairo on his way to London he very kindly consented to deliver a lecture on Sleeping Sickness at the Medical School. About 100 interested people besides the students attended the lecture which was delivered in the Pathological Museum and was illustrated by maps, temperature charts from man and monkey, and beautiful diagrams of the tsetse fly and the trypanosome prepared by Dr. Looss. Only 100 years ago the disease was first described as a separate complaint and until 1901 it was thought to be confined to West Africa between the Congo and the Senegal and its cause was shrouded in mystery. Its introduction into Uganda can be accounted for by the opening up of trade routes from West Africa. The total loss from this cause since 1901 in the Uganda Protectorate is 100,000 anl 1 the monthly death-rate is still at least 1000, so that if sleeping sickness continues unchecked the whole population will shortly cease to exist. The disease is limited almost entirely to the northern shores of the Victoria Nyanza Lake and to the various islands in the lake. Two maps, exhibiting the distribution of the disease and the prevalence of the glossina palpalis, showed the exact co- incidence of the tsetse fly and the endemic. Fortunately imported cases in inland villages do not cause spread from man to man but the disease in the endemic area has already destroyed all the natives of some districts. Captain Greig insists that the name of the disease is misleading, because sleepiness only occurs in the latest stage which may la-t, three or four months ; this may be replaced by mania and morbid elevation of the mental powers. The most important early sign of the disease is enlargement of lymphatic glands, especially those of the cervical region. This has been known for years to the slave dealers who in the old days refused to let a slave with these glands enlarged join the caravan because he was almost certain to die on the journey. Captain Greig has discovered that by puncturing the cervical glands with an ordinary syringe trypanosomes can be seen under the microscope long before the fever and other symptoms occur. He calculates that about 70 per cent. of the general population of areas in which sleeping sickness is endemic are in this early stage which may
Transcript
534and, are distributed among eight shafts. Ohiy one, shq,ft:appeared to be infected. Of 1193’ miners examined by.]M.!Brehan extremely few were found to be affected with ankylo-stoma,, but on the other. hand 603 men were found affect(diwith trichocephalus and 118 with ascaris.. The, reason for;the rarity, of ankylostoma iri M,. Brehan’s opinion’lies in the’fact that mines of the North do not show underground wàter-isoakage,or stagnant pools, and finally that the temperaturesof f the m,ine is generally below 23°C. In the coal basin of
Liège and St. Etienne where ankylostoma is frequently found’there is water-soakageand.-the. temperature. of the galleries,varies from 25° to 30°C., two facts whicn are very favour-,able to, tb6 hatching of the’eggs of the, parasite. Prophy-;laxis consists in .the ’use of boiled water, a strict medicalexamination of newcomers, ’and a refusal to employ thosecoming from a suspected district. Such methods, however,’are a serious matter’ and microscopic examination of thestools would be more satisfactory than a systematic refusal ofminers coming from an infected district. Such examinationwould be a guarantee of safety and would permit non-infected men to be employed.
’
Feb. 20th. _________________
SWITZERLAND.(FROM OUR OWN CORRESPONDENT.)
University Intelligence.THE number of medical students at the five Swiss Uni-
versities for the winter term 1904-05 amounts to 1724. Thereare 958 female students enrolled in the lists and only 766men. The number of female students goes on increasingrapidly, especially at the universities of Bern and Lausanne.The numbers stand thus :-
If the increase of female students goes on at. the same ratein the next five years as in the last five years the medical 1faculties at Bern and Lausanne will be almost monopolised 1
by the fair sex. :
Institute for Physical Therapeutics at the University of ’
which.At a well-attended recent meeting of the Cantonal Medical
Society the committee appointed at the previous meeting toconsider the question of an institute for physical thera-peutics submitted its report. After a discussion of threehours’ duration the report was agreed to with some funda-mental modifications. The urgent necessity of the institutehaving its own out-patient department and being independentof the other cliniques was mentioned and obtained favour.The report finally agreed on is to be transmitted to thecantonal authorities, together with the expression of a hopethat this institute with a capable director at its head maysoon be established and that it may do valuable service bothto the public and to science.
Wage Limitsfor Club Members at Ziirich.The Krankenpflege " at Ziirich is a very large provident
society, having at the present time 6000 members. At a
meeting of the medical officers held on Feb. 2nd some
motions, proposed by the President, Dr. Haeberlin, causeda lively discussion. The proposal to increase the number ofmembers by admitting persons with incomes of .660, £80,£108, £132, and £160, divided into five classes who were to
pay monthly instalments of 10d., Is., Is. 1½d., Is. 3½d., andIs. 6d. per head, met with opposition from several quartersand at last an amendment, proposed by Dr. T. Zangger, wasaccepted limiting the right of admission to the three firstclasses and to persons with incomes under £120 per annum.Thus the scheme of municipalisation of medical service inZurich, described at length in THE LANCET of Oct. 29th,1904, p. 1246, will for the present still be limited to theworking classes.
Ziirich, Feb. 20th.
1 THE LANCET, Jan. 28th, p. 266.
EGYPT.(FROM OUR OWN CORRESPONDENT.)
.. " . ., ’’ Suex Hospital. . ,
’ ’ ’
’A NEW hospital, designed ,to meet the varying wants of a,seap6rt,towri, .was.opened by tl?e. Egyptian Government lastseaport town, was. opened by the, Egyptian Government lastsummer. It is well. placed, just outside the town, .beingsurrounded by miles of desert and provided with a goodview of thë,hl)-rbour and adjacent mountains ; ’it is also com-venietitly near’ the Hospital for Infectious Diseases. It is ofcourse provided ’with ; all modern requirements, electric
lighting, hot-water ’supply, operating theatre, steriliser,laboratories, an excellent house for the English super’intendent, and nursing quarters presided over by an Englishsister. There are separate rooms for private patients and atotal’ of 58 beds, of which 40 were occupied at the time ofmy visit. Most of the patients were suffering from medicaldiseases, some from the malignant tertian form of malaria,which is commoner in Suez than other parts of Egypt, andthere were four natives recovering from appendicitis, thoughthis has usually been considered a rare disease in thiscountry. The old hospital in the town is still utilised forout-patients and for the treatment of prostitutes.
Neurasthenia.This complaint is rare among the natives of this country,
who are not given to nervous strain, but cases are met withamong the Red Sea lighthouse-keepers who are mostlyEnglishmen. They suffer from sleeplessness, emotionalsymptoms, tremors, and exaggerated reflexes which the menthemselves put down to their lonely life and the monotonyof their existence and their food. The tinned food causesdyspepsia and consequent loss of weight but not scurvy.There are always three men in each lighthouse, while thefourth is absent on leave, and they are only visited everythree months when they get letters and newspapers. Twomen lately committed suicide after leaving Egypt and a thirddeveloped delusions.
Sleeping Sickness.Captain E. D. W. Greig, I.M.S., was one of those sent by
the Royal Society with Colonel Bruce, R.A.M.C., and Dr.D. N. Nabarro, in 1903 to Uganda and as he is now passingthrough Cairo on his way to London he very kindly consentedto deliver a lecture on Sleeping Sickness at the MedicalSchool. About 100 interested people besides the studentsattended the lecture which was delivered in the PathologicalMuseum and was illustrated by maps, temperature chartsfrom man and monkey, and beautiful diagrams of the tsetsefly and the trypanosome prepared by Dr. Looss. Only 100years ago the disease was first described as a separatecomplaint and until 1901 it was thought to be confined toWest Africa between the Congo and the Senegal and itscause was shrouded in mystery. Its introduction into
Uganda can be accounted for by the opening up of traderoutes from West Africa. The total loss from this causesince 1901 in the Uganda Protectorate is 100,000 anl 1the monthly death-rate is still at least 1000, so that if
sleeping sickness continues unchecked the whole populationwill shortly cease to exist. The disease is limited almost
entirely to the northern shores of the Victoria NyanzaLake and to the various islands in the lake. Two
maps, exhibiting the distribution of the disease and theprevalence of the glossina palpalis, showed the exact co-incidence of the tsetse fly and the endemic. Fortunatelyimported cases in inland villages do not cause spread fromman to man but the disease in the endemic area has alreadydestroyed all the natives of some districts. Captain Greiginsists that the name of the disease is misleading, becausesleepiness only occurs in the latest stage which may la-t,three or four months ; this may be replaced by mania andmorbid elevation of the mental powers. The most importantearly sign of the disease is enlargement of lymphatic glands,especially those of the cervical region. This has been knownfor years to the slave dealers who in the old days refusedto let a slave with these glands enlarged join the caravanbecause he was almost certain to die on the journey.Captain Greig has discovered that by puncturing thecervical glands with an ordinary syringe trypanosomes canbe seen under the microscope long before the fever andother symptoms occur. He calculates that about 70 percent. of the general population of areas in which sleepingsickness is endemic are in this early stage which may
535
terminate in one of three ways : (1) by extension of the trypanosome to the lymph spaces of the brain and the spinal cord, constituting sleeping sickness proper ; (2) by deathfrom intercurrent disease, of which the most common is pneu-monia ; and (3) by the disease becoming very chronic andpossibly ending in recovery. With regard to this last pointthe lecturer told me that there are several cases of individualsstill alive who certainly had the disease in 1902 and 1903.There is therefore a probability that many of the inhabitantsmay become immune or "salted," as is the case in manydiseases of animals. So long as the trypanosome is confinedto the lymphatic glands the temperature is normal and thereare no obvious symptoms except the glandular swellings.But when the parasite gets into the blood irregular feverbegins, varying from 100° to 103° F., emaciation and nervoustremors are seen, till in the final stage the temperaturegradually sinks till it remains for days as low as 92°, whenthe trypanosome has invaded the brain and the spinal cordand set up a meningo-myelitis. It is now proved that thetrypanosome exists in every case of sleeping sickness and it isa near relation of the parasite which causes surra or naganain cattle. Inoculation of monkeys with the blood and cerebro-spinal fluid of patients suffering from sleeping sickness pro-duces the same disease in these animals. One fact new tomost of the audience is that the glossina palpalis belongs tothe pupipara group of insects which produce one larvainstead of myriads of eggs. The fly by means of its longproboscis can fill its stomach by sucking infected blood forhalf a minute and is then ready charged at any time duringthe next five days to infect any healthy person. Experimentson monkeys lead to the belief that it is not dangerous afterfive days have elapsed. The fly is most active during theday, which is, of course, -the time when the natives are
working in the fly belts. The fly seems to require for its lifeforests of trees granting shade and dense undergrowth inproximity to water. These conditions invariably exist in areaswhere sleeping sickness and glossina palpalis prevail but asone descends the Nile it is found that 30 miles north ofGondokoro the character of the country changes; there arelarge open spaces without much undergrowth and the tsetsefly is absent. It is therefore probable that sleeping sicknesswill not spread to the Sudan and Egypt, though theforest conditions of the Bahr-el-Gazzal are said to be quitefavourable to the habits of this special tsetse fly. Southof the Victoria Nyanza the country again changes to openground and this fly is absent. A synopsis distributed tothe audience enabled them more easily to understand thelecture.
Cairo, Feb. 5th. _________________
AUSTRALIA.
(FROM OUR OWN CORRESPONDENT.)
Bubonic Plague.AN outbreak of bubonic plague has occurred in the Grafton
district, New South Wales. The deaths of five persons arestated to have been due to the disease. Rats have been
dying in large numbers on the farms where the affectedpersons lived but plague was not suspected at first. Thesefarms have now been quarantined and a staff, consisting of amedical officer, a sanitary inspector, and a rat-catcher, hasgone to Grafton. The last previous evidence of plaguewas on Dec. 3rd, 1904, when a plague-infected mouse wasfound in Sydney.
Preservatives in Milk.The question of the use of preservatives in milk continues
to be disputed in the law courts and to occasion differencesof expert evidence. On Dec. 22nd, 1904, the BacchusMarsh Concentrated Milk Company was prosecuted for sell-ing concentrated milk containing 219 grains of boric acid tothe gallon. Dr. W. P. Norris, medical inspector to the Boardof Health of Victoria, said that the amount of boric acidin the sample was unnecessary and harmful and in greatexcess of the amount said to be necessary by the advocatesof the use of preservatives in milk. In his opinion refrigera-tion would keep the milk as long as the Bacchus MarshCompany said its milk should be kept. For the defence Dr.J. W. Springthorpe, lecturer on hygiene at the University ofMelbourne, said that he had used boric acid in doses of 30grains per day in over 300 cases of typhoid fever, also in
epilepsy and other diseases, and had never seen any injuriouseffects. It would be impossible to keep concentrated milk
more than a day without preservatives. He considered thatstale sterilised milk was worse than milk with preservatives.Mr. A. H. Jackson, B.Sc., president of the Institute ofAnalysts, said that preservatives were not injurious whenused in the manner stated in the case in dispute. The benchfined the defendant company and said that the law did notrecognise the use of preservatives.
Treatment of Inebriates in New Smith Wales.Some two years ago the New South Wales Parliament
passed an Inebriates Act under the provisions of which theGovernment sanctioned the erection of two State institu-tions for the treatment of inebriates without means. One ofthese for females, situated on Rabbit Island on the Hawkes-bury river, has been partly erected and will accommodate72 patients. It consists of two pavilions for sleepingaccommodation, dining room, kitchen, laundry, workroom,reception house, officers’ quarters, and matron’s cottage. Anabundant supply of good water has been obtained. Theinstitution was inspected recently by the Minister of Workswho will probably advise the Cabinet to utilise the buildingsearly in the year.
Hospital 7 AffairsHospital Affairs
The Kronheimer wing at the Austin Hospital, Melbourne,still remains unopened owing to the action of the Premier.At a recent meeting of the executive committee of the
Society for the Prevention of Tuberculosis it was decided tobring the matter officially under the notice of the respectivemedical societies with the view of inducing them to takeunited action to secure the withdrawal of the opposition ofthe Premier.-Some feeling has been roused by the refusal ofthe directors of the Sydney Hospital to appoint a womanas resident medical officer. It has been customaryannually to appoint six members of the resident staff ofthe Sydney Hospital and the Royal Prince Alfred Hos-
pital from the best students who have just passed theirfinal examinations at the University of Sydney. Amongthese at the last election was Miss Susie O’Reilly. Theselection is usually made by a conjoint board consistingof the presidents and professional delegates from the hos-pitals concerned. On this occasion, however, the boardselected six men for the Prince Alfred Hospital and fivemen for the Sydney Hospital and left the sixth appointmentan open question for the directors of the latter institution.This body decided not to appoint Miss O’Reilly but a malegraduate.-The fourth annual meeting of the Sydney MedicalMission was held recently. The medical report showed that3216 visits were paid to the homes of 720 patients and thatthe total number of patients treated was 2256.
The Board of Public Health of Victoria.The Government has appointed Dr. William P. Norris to
the position of chairman and chief medical inspector of theBoard of Public Health of Victoria, rendered vacant by thedeath of Dr. D. Astley Gresswell. Dr. Norris is a native ofVictoria and studied medicine at the University of Melbourne,where he was a brilliant student and graduated as M.B. in 1888and M.D. in 1892. After some years in private practice hewent to England and studied sanitary science, obtaining adiploma in public health. Returning to Victoria he obtainedthe appointment of assistant medical inspector to the Boardof Health, which he has since filled very satisfactorily.
The Death-rate of Sydney.The death-rate of the city of Sydney during the first 11
months of 1904 equalled 12 per 1000 of the population,being the lowest experienced in the city during the pastseven years at least. Calculated on the number of birthsthe infantile mortality rate for the first 11 months of 1904was equal to 118 deaths per 1000.
Instrn.et2on in Dentistry at the University of Sydney.The Senate of the University of Sydney at its last monthly
meeting adopted an amended curriculum for the departmentof dental studies leading to the degree of Bachelor of DentalSurgery. The amalgamation of the University Dental Hos-pital and the Sydney Dental Hospital is now satisfactorilycompleted and working well.Jan. 10th.
VACANT CHAIRS AT THE UNIVERSITY OF KAZAN.-There are, says the Meditr. Obosrenie, seven vacant chairsin the University of Kazan: anatomy, operative surgery,psychiatry, diagnosis, special pathology, therapeutics, andforensic medicine and pharmacy.
