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which M. Belin asked that special wards should be reserved r

for doubtful cases. M. Debove answered that he had fore- e

seen this point and also considered that diphtheria should c

be considered as infectious in the same category as scarlet fever. Finally, the society passed a resolution that cases of c

small-pox only should be treated in a special isolation r

hospital and that cases of all other infectious diseases should be treated in isolation wards in general hospitals with a special staff to look after them. t

The Water-supply of Paris. t

At the meeting of the Municipal Council which was held f

on March 9th M. Caplain put a question to the Prefect of the Seine as to the quality of the water-supply. A certain number of cases of typhoid fever has recently been reported and M. Caplain wanted to know whether 1this outbreak had not been brought about by the water authorities having substituted river water for spring water in the public supply. This is done by no means uncommonly,to the great detriment of the population of Paris. ThePrefect of the Seine said that the authorities were alwaysthinking how to improve the sanitary state of Paris and it wasa fact that in 1882 the deaths from typhoid fever were 143 !per 100,000 inhabitants, while to-day the proportion wasonly 10 per 100 000. The present increase in the number ofcases of typhoid fever was much exaggerated and nothinglike an epidemic existed. He allowed that on Feb. 10th theauthorities had been obliged to turn river water into thepublic supply but the water had been filtered and so hadbeen rendered harmless. M. Poirier de Narçay remindedthe meeting that the Municipal Council had already passed aby-law to the effect that the authorities should never sub-stitute river water for spring water without posting a noticeof such substitution. As in the present case this regulationhad been violated M. Poirier de Narçay proposed that avote of censure should be passed on those responsible for theerror. This was accordingly done.

The Prophylaxis of Malaria.In reference to a recently issued report of M. Kermongant

on infections diseases in the colonies M. Laveran gave noticeof the following motion at the meeting of the Academy ofMedicine held on March 8th :-The Academy of Medicine, in view of the excellent results obtained

in diverse countries by the mechanical protection of houses againstmosquitoes, hereby resolves that the military authorities shouldadopt similar precautions, more especially in the French colony ofMadagascar, where mosquitoes which spread malaria abound.

The Dangers of Radio.therapeutic Applications.At the meeting of the Society of Dermatology and Syphilo-

graphy held on March 3rd M. Oudin read a paper in whichhe maintained that in the treatment of large cancerousmasses by radio therapeutics the sittings must not follow eachother at short intervals, and also that each individual sittingmust be short, so that the organism will have plenty of timeto eliminate the reabsorbed products. As a matter of fact,after one or two sittings it is quite common to see signs of atoxæmia, for parallel with a notable diminution in the size ofthe tumour the patients suffer from a raised temperature, lossof appetite, cramps, a drawn expression of the face, scantyand albuminous urine, cough, and vomiting. If the sittingsare then stopped these symptoms pass off after a few days’rest, but if the sittings are continued or if the early oneshave been too long there is a rapid dissemination of the

growth which quickly carries off the patient. In support ofhis opinion M. Oudin related three cases in which an acutecachexia set in during a course of radio-therapeutics. The

patients were suffering from cancer but their general healthhad been excellent at the commencement of the treatment.It is a question whether the disagreeable symptoms are dueto reabsorption of toxins or to the introduction into the

general circulation of cancer cells the vitality and virulenceof which have not been sufficiently attenuated by the raysto render them harmless. M. Oudin rather inclines to thelatter theory.March 22nd.

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EGYPT.(FROM OUR OWN CORRESPONDENT.)

J

EGYPT is enjoying a greater influx of visitors than usual, : partly because some of them are yearning for sunshine after i

the rainy season in Europe and America and partly because :

Qany hesitated to come here last winter on account of thexistence of cholera in the summer of 1902. As usual theihief numbers come from America, England, and Germany.Che hotels filled at an earlier date than is generally the;ase and they are still very full, having occasionally to

equisition tents, corridors, and bath-rooms for a few nights.rhe weather fortunately has been exceptionally pleasant,December being warmer and March being decidedly coolerhan the average, while the general health has been so goodihat both physicians and nurses have been but very littleemployed. A few sporadic cases of influenza have beenmported from Europe but have not spread, and typhoid fevers so scarce that only two cases have occurred, both of thesebeing among the English residents. One child broughtwhooping cough from Italy and by means of a children’sparty succeeded in infecting many of the English colony,out the disease yielded rapidly to a free exposure to sunshine.

The Anglo-American Hospital.This hospital was duly opened in January by the Countess

of Cromer and half of its 26 beds are already occupied. Itis well situated at Ghezireh near the racecourse and issurrounded by the purest of air and fields in which buffaloesgraze on the clover or strawberries are grown for the fruitmarket. The hospital is administered by a house committeeof English and Americans, including a preponderance ofmedical men, and the nursing staff includes a matron andtrained English nurses. Special and private wards are

supplied tor men, women, and children of all nationalities,but preference is given to British subjects and citizensof the United States. Infectious and mental cases are

not admitted. In addition to the paying patients thereare four general wards for those without means and forthe women and children of the army of occupation, in-cluding such midwifery cases as used to be sent to thefemale hospital at the Citadel which has now been closed.The patients in the general wards are attended by an

honorary medical staff of seven practitioners who have volun-teered to take this duty in turn. Any medical practitioner,beirg a British or American subject and practising eitherpermanently or temporarily in Egypt, may treat payingpatients in the hospital and any foreign medical man maybe called in as a consultant. The various rooms have beenmade to look as home like as possible, a well-lighted up-to-date operating theatre has been provided, fireplaces are

placed in all the chief rooms, the electric light has beenlaid on, and a plentiful supply of pure drinking waterhas been obtained by sinking a well. Sir E. Cassel, whooriginally started the subscription list with £5000, has nowpromised to give an equivalent sum to anything subscribedby others, so that every donor of one guinea to the fundis practically obtaining two guineas for the hospital, whichwill be of great value to the whole Anglo-Saxon community.

Sanatorium Al Hayat, Helouan.Under the above heading advertisements can be found in

the leading English medical papers, though this new estab-lishment is more likely to be popular with Germans,Russians, and Swiss than with the British or Americans.The Arabic word Haya" signifies cure and the sanatoriumis admirably placed for obtaining fresh air in the Helouandesert with nothing between it and Suez some 80 miles away.It has been financed by Baron Knoop and his friends andis managed by two German medical men and so far onlytwo nurses. The building, begun in February, 1903, wasopened in December last with 80 beds all facing southin order to obtain as much winter sun as possible.It consists of five storeys, the uppermost three beingbedrooms, while the dining, billiard, and smoking roomsand library are purposely placed at a distance to keep thebedrooms quiet ; they are, however, connected by coveredcorridors. Great care has been taken to construct thebuilding as a modern hospital, with rounded corners to therooms, mosaic cement flooring, an absence of unnecessarycornices, and large plate-glass windows. All are admitted,sick and healthy, and there is no power of enforcing anyrules or regulations, so that the establishment is somethingbetween a hotel and a sanatorium, like many a hydro-pathic establishment in England. It is intended, however,to set apart the top floor for tuberculous patients and todisinfect all the rooms with formalin. The medical men

hope to attract cases of nephritis, gout, rheumatoid arthritis,and tropical complaints on their way home to Europe. Asmall infectious hospital for six beds and a disinfectingstove are now being built, the hospitality of which will be

902

offered to the town of Helouan which has at present nobuilding for receiving infectious patients. German medicalmen practising in Cairo and Helouan are specially excludedfrom treating their patients in the sanatorium except inconsultation with the resident physicians, but in specialcircumstances non German patients may be treated bymedical men of their own nationality. This is to preventany linguistic difficulties but it is only fair to say that oneof the resident medical officers speaks English extremely well.

Cairo, March 16th. ______________

CANADA.

(FROM OUR OWN CORRESPONDENT.)

Montreal Medico.Chirurgical Society.Dr. Harvey Cushing of Baltimore, Maryland, U.S.A., read

a paper before the Montreal Medico Chirurgical Society atits regular meeting of Feb. 5th, the subject being on theremoval of the Gasserian ganglion for tic douloureux. Bythe direct or sphenoidal zygomatic route Dr. Cushing hasoperated on 25 cases with but one death and he stated thathe knew of 50 more cases with a general mortality of 5 percent. The average age of his patients was 60 years and sevenware over 70 years. 15 out of 20 cases were men and theright side was affec’ed in four out of five cases. Drainagewas used in only six cases. In every case the ganglion was-examined by neurological experts but not in one could anypathological lesions be detected.

Montreal General Hospital.3066 patients passed through the wards of the Montreal

General Hospital during 1903 and the outdoor patientsnumbered almost 36,000. The excess of expenditure overordinary income amounted to nearly$14,000, which wasabout$4000 more than last year. On Dec. 3lst, 1902, theendowment fund amounted to$43.500, to which have sincebeen added during the year$7,000. Dr. D. A. Shirres waselected neurologist to the hospital.

Annual Meeting of the Ontario Bard of Health.At the annual meeting of the Ontario Board of Health

held in Toronto during February the secretary presented theannual report. It showed that during the year 1903 therewas a marked decrease in small-pox and scarlet fever.

Diphtheria, however had prevailed extensively but was by- no means of such deadly effect as formerly because of the in-telligent use of antitoxin. The greatest prevalence of thisdisease was in the last quarter of the year, when the death-rate was 13’47 per cent. of the cases, which is slightly in-excess of the yearly rate. The deaths from tuberculosis

during the year amounted to 2072. The death-rate in the

province for 1903 was given as 12’6 per 1000. March wasthe most fatal month, when the death-rate rose to 14’7.The splendid work of the retiring secretary, Dr. Peter H.Bryce, was marked by the presentation to him of a grand-father’s clock.

Conference on School Hygiene.During the month of February there was held in Toronto a

conference of educationists and medical men on the subjectof school hygiene, called together at the instance of theHon. Minister of Education. Dr. Charles Sheard, medicalhealth officer, Toronto, read a paper on How to Prevent Oat-breaks of Infectious Diseases among School Children andto Suppress them when Present. Dr. Bryce dealt with theGreat Relative Prevalence of Preventable Diseases in’Children of School Age as revealed by the Ontario Statistics.He called attention to the fact that the death-rate from theseinfectious diseases had been reduced in Ontario by one-third.Dr. Charles A. Hodgetts discussed the question of CompulsoryDrill for School Boys..A Trial of Marmorek’s Antituberculous Serum in Montreal.Two or three weeks ago Dr. Lemieux returned to Montreal

from Paris, bringing with him a sufficient quantity ofMarmorek’s antituberculous serum for 15 injections. Underhis direction it was given a trial at the Nôtre DameHospital, two cases being experimented upon, one case

being surgical tuberculosis of the knee-joint and the,other tuberculosis of the lungs. In the former neither

good nor bad effects were noticed. In the case oftuberculosis of the lungs the results are reported as

follows. In all this patient received nine injections ; the

temperature remained the same but the pulse-rate increased ;

the sputa were weighed every day during the period ofinjections and daily showed an increase up to two ounces onthe ninth day. on which day the injections were stopped atthe request of the patient himself. When the injactionswere first commenced the patient weighed 118 pounds ; afterthe ninth injection a loss of three pounds was recorded.The cough also increased and was more troublesome Inthis hospital during the month of January there were treatedin the outdoor departments 1262 patients and 171 patientsin the wards.

Typhoid -Fever Epidemic.Montreal has recently passed through an epidemic of

typhoid fever, there having been in its suburbs a number

approaching 1000 cases and the hospitals have all beencalled into requisition to care for those afflicted with thedisease. Of course, the drinking water of the suburbs inquestion came in for criticism and the provincial board ofhealth ordered an analysis with the result that the waterwas found to be contaminated with sewage but no typhoidbacilli were found. The Montreal Medical Journal publishesa statement from the civic engineer which is remarkable.This gentleman, who has been investigating the cause of theepidemic, states that there was formed a wall of ice 67 feethigh, so strong as completely to divert the current of theSt. Lawrence river, so that the main stream made its wayover and through locks and canals, and then crossing thebed of the Ottawa river the current struck the head ofthe island of Montreal, so that for the first time in thememory of the oldest inhabitant of the metropolis of Canadathe waters of the St. Lawrence river passed, not merely alongthe southern shore of the island but also flowed down theback river, so that while Montreal was enjoying the purestdraughts from the St. Lawrence its suburbs were partakingof the filth and the slime of sewage contamination.

Raising the Standard of Medical Matriculation.The standard of entrance into the medical profession is

being steadily raised in Canada. Lately Queen’s Universityat Kingston, Ontario, has decided to make the matriculationthe same as in Arts, with the exception of modern languages.10 per cent. of Queen’s students are usually Arts graduatesand 75 per cent. more generally pass the Arts matriculationbefore beginning the study of medicine. It is only theother 15 per cent. who would find the new regulations morestringent and it will do them no harm to comply with them.

Addition to the Mc Gill University Medical Faculty.The Dental Association of the province of Quebec has

decided to cast in its lot with McGill University and withLaval University. This means that the present Dental

College of the province of Quebec will be abolished, McGillUniversity furnishing the dental course for English-speakingstudents and Laval University that for the French language.McGill University, however, declines to grant the degree ofdoctor of dental surgery upon graduation as is done by thepresent college. Instead it will grant a degree of master ofdental surgery followed by one of doctor of dental surgerythree years later upon the applicant writing an originaltechnical essay. Laval University will grant the degree ofdoctor of dental surgery upon graduation. So far as the

department is concerned in McGill University it will beunder that of the medical faculty, of which Df. ThomasG. Roddick, M.P., will be Dean.March 14th.

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Obituary.THOMAS HUNTER HUGHES, M,R.C.S. ENG., L.S.A.,

CORONER FOR SOUTH CARNARVONSHlRE.

Mr. Thomas Hunter Hughes died on March 17th at his

residence, 11 Penmaen," Pwllheli, Carnarvonshire. The

deceased, who was 67 years of age, received his medicaleducation at St. Bartholomew’s Hospital and took the quali-fications of M. R. C. S. Eng. and L.S.A. in 1858. Mr. Hugheshad been for the past 24 years coroner for South Carnarvon-shire. The coronership has now been in the family for overa hundred years, Mr. Hughes’s father and grandfather-bothmembers of the medical profession-having preceded him inthe appointment. The deceased was highly esteemed by themembers of the profession in North Wales and had filled the