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remarked that during the outbreak his experience had beenthat the early cases were always regarded as chicken-pox,and as the season was approaching at which small-poxwas most apt to appear in epidemic form he suggestedthat the committee should recommend the town councilfor the following year to add chicken-pox to the listof diseases which were compulsorily notifiable. He hadnot been able to ascertain where the infection primarily camefrom, but this confirmed his suspicion that the disease wasbeing spread by mild cases which had been missed, probablyregarded as chicken-pox. It was agreed to recommend thatchicken-pox should be made compulsorily notifiable for thenext twelve months.

increase of Tuberculosis in Aberdeen.Dr. Matthew Hay, medical officer of health of Aberdeen,

says that during the quarter 29 tuberculous cases were

admitted to the City Hospital. The pavilion for tuberculouscases has been constantly full, and there has always been alarge number in waiting. The erection of a new shelter inconnexion with the pavilion will provide for an additional 45male cases and for 8 or 10 female cases, increasing theaccommodation for tuberculous cases by one-half.

Inadequate Accommodation at Kingseat Asylum I:lospital.In his report to the asylum committee of Aberdeen

district lunacy board Dr. John Macpherson, Commissionerin Lunacy, says that the hospital accommodation at KingseatAsylum is unfortunately proving too limited and will becomemore so as time goes on. Excluding the isolation wards,’90 of the 93 beds in the building were occupied, and severalpatients who would otherwise have been in hospital werebeing treated in villas. In bringing this question of accom-modation to the consideration of the district board, it wasnecessary to explain that within recent years a perceptiblechange had taken place in the type of patients admitted to.all the asylums in the country. Persons in weakly physicalhealth and those suffering from the infirmities of old agewere now being sent to asylums in proportionately largernumbers than formerly, and the strain upon the hospitalsection of asylums was universally felt. It was evidenttherefore that the district board must sooner or later face the

necessity of erecting hospital accommodation for the institu-tion. The asylum committee also considered the questionof the assistant medical officership at Kingseat, and reportedthat it had before it two applications for the vacant postfrom lady graduates in medicine. The committee resolved

again to advertise the post at a salary of f:120 per annum,with board, as formerly offered, and suggested that in themeantime the medical superintendent should engage a locumtenens.

Typhus Fever in Lewis.At a meeting of the Lewis district committee, held at

Stornawayon August 7tb, the report of Dr. D. Murray, districtmedical officer of health, on the recent outbreak of typhusfever in the township of Borve, was submitted. Eighteencases were notified, occurring in six families, and there werethree deaths. The report states : ’’ There is no cause for

surprise in this epidemic ; the strange element in the situa-tion is that typhus fever should ever be absent from Borve.The village is an exaggerated microcosm of the worst

sanitary features of the Island of Lewis-a congeries of theblackest of black houses, huddled together in a manure-ladenswamp. In many cases the sleeping apartment of one houseis cheek-by-jowl with the byre end of the next, the manurein the latter at a muoh higher level than the bedroom. InBorve-as elsewhere-there is some evidence of progress inthe building of a better class of house ; but the great majorityof the dwellings outrage the most elementary sanitaryprinciples." They are built on sites which are impossible todrain, and are consequently sodden and reeking with theproducts of the byre-a most fertile breeding-ground forfever and other diseases. I I The remedy can be briefly stated.The great majority of the present houses should be con-

demned and a better class built on healthier sites." It

appears that sites for crofters could be got on thecommon grazings, but not for cottars. Typhus fever, how-ever, has no respect for persons, be they crofters, cottars,or squatters, and unless the inhabitants are all removed tohealthier sites-which are plentiful in the neighbourhood-we may be sure, as Dr. Murray says, that outbreaks ofvirulent infectious diseases, perhaps in a more extensiveand aggravated form, will recur from time to time. The

chairman of the Lewis district committee remarked thatsome years ago negotiations for better housing had fallenthrough, owing to the fact that, in addition to the crofters’houses, there were also houses occupied by squatters, whoare not tenants of the estate, and have no legal standing inthe community ; and to provide sites for them would be togive them a recognition which the proprietor, in view of theprovisions of the Crofter’s Act, did not feel justified in givingthem. On the occasion of one of his visits to Lewis, LordPentland visited Borve and saw for himself the sad conditionof affairs there, and on a later occasion he (the chairman)accompanied Mr. Coles, of the Congested Districts Board, toBorve and had a conference with the people. He had nodoubt that if new sites were offered, and a little financialassistance given, there would be no difficulty in getting thepublic to erect new houses. It was agreed to send a copy ofDr. Murray’s report to the Scotch Office and to the LocalGovernment Board, in the hope that they will see their wayto assist the local authority in carrying out some improve-ments.

August 15th. ___________________

IRELAND.

(FROM OUR OWN CORRESPONDENTS. )

Infantile Mortality in Dublin.A FEW months ago a committee was appointed at a public

meeting in the Mansion House, Dublin, to attempt to reducethe high rate of infant mortality in Dublin. It is reportedthat there are now 35 voluntary health visitors work-

ing under the committee, while some 20 more are

being trained for the work. Over 100 nursing mothers arevisited on an average each month. The Countess of Aberdeenhas offered to supply pasteurised milk free in suitable casesto mothers and babies. Diarrhoeal diseases are very pre-valent in Dublin this year, probably as a result of theunusually hot weather. In the three weeks endingAugust 5th the deaths of children under one year of agewere respectively 31, 46, and 53. The Women’s NationalHealth Association has employed eight nurses temporarily toassist the Poor-law medical officers in dealing with disease inchildren.

The Dublin Hospitals and the Insurance Bill.The Board of Superintendence of Dublin Hospitals, a

body which supervises the work of those hospitals in Dublinthat are in receipt of Government grants, in its annual

report presented last week takes occasion to remark on theeffect the Insurance Bill, if passed, may be expected to haveon the finances of the Dublin hospitals :-Hitherto (the report states) the public have looked on the labouring

man disabled for work as a fit object for charity. They have sub-scribed and left legacies to hospitals because it was known that throughthe wards of the hospital and the special dispensaries attached to themlay the smoothest, shortest, and most economical road to recovery. Itis unlikely, should the State arrange for the care of the labour-ing classes when incapacitated by sickness, that the charitably inclinedwill continue to subscribe to the same extent....... It is not too muchto say that a club doctor, responsible for the health of a large numberof workpeople, will, in a great majority of the cases, have to call on thehospitals or their dispensaries for help. On what terms will this begiven ? If the voluntary aid system is abolished, it must mean a suit-able remuneration for all medical service. We are of opinion that asystem on such a foundation would not work as well or as economicallyas does the present one.

Royal Institute oj Public Health.The Congress of the Royal Institute of Public Health was

opened on August 15th in Trinity College, Dublin, when areception was held by the President, Lady Aberdeen.The presidential address followed. There was a fairlylarge attendance. The Congress meets every day untilAugust 21st.

The Lane-ways of Decblin.A potent source of disease in the poorer parts of Dublin is

to be found in lanes and courts. There are some 894streets, alleys, courts, lanes, and roads in the city of Dublin,which are not under the charge of the corporation, and inthese refuse collects in great quantities. The corporationapparently has no power to spend money in removing suchmaterial, though it has power to compel the owners of theseproperties to keep their premises in such condition that theyshould not be a source of disease. The nuisance, however, is

551

by no means confined to lanes not in charge of the corpora-tion, for the public streets in the poorer quarters are littlebetter kept, in spite of the fact that some .650,000 a year isspent in the cleansing of the streets of Dublin.

Appointment oj a City Bacteriologist for Dublin.Matters have come to a deadlock as regards the appoint-

ment of a city bacteriologist for Dublin, as the Local Govern-ment Board persists in its refusal to sanction the appointmentof the gentleman elected by the corporation. At a meeting ofthe corporation a few days ago the town clerk read a letterfrom the Local Government Board stating that they couldhold out no hope that they would alter their decision in

refusing to regard Dr. Russell as a person possessing theproper qualifications for the post of city bacteriologist. Theletter added that the fact that Dr. Russell had passed theexamination for a Diploma in Public Health could not initself be taken as entitling him to be regarded as a bacterio-logist under Section 15 of the Prevention of Tuberculosis(Ireland) Act. In a previous letter the Local GovernmentBoard had given as a reason for refusing its sanction thatDr. Russell, being a dispensary medical officer, had his timealready fully occupied. The corporation has now decided tomake no appointment.

The Apothecaries’ Hall of Ireland.The annual meeting of the members of the Apothecaries’

Hall of Ireland took place on August lst. The Governor,Dr. Caleb J. Powell, occupied the chair. The meeting wasthe largest that has taken place for many years, and thegreatest interest was taken in all matters discussed. Afterthe annual report had been read the following appointmentswere made :—Governor : Dr. Edward Magennis. Deputy-Governor : Dr. J. C. McWalter. Representative on theGeneral Medical Council: Lieutenant-Colonel F. G. Adye-Curran, A.M. S. Registrar: Mr. H.:W. Mason. The follow-ing were elected Directors : Lieutenant-Colonel Adye-Curran,retired. J. D. Crinion, O’C. J. Delahoyde, B. B. Kennedy,T. G. McGrath, R. P. McDonnell, H. W. Mason, J. J.O’Sullivan, C. J. Powell, J. Shaw, G. S. Stritch, J. A.Whelan.

Sanitation of Portadomn.At a meeting of the Portadown town council held on

August 8th a letter was read from the Castleisland LinenCompany, calling the attention of the council to the fact thatit was discharging sewage into the Garvaghy river, whichwas causing the company great loss and was also a serious menace to the health of their workers. The water now comingdown the river Bann at Portadown was practically undilutedsewage, and it was alleged that the council had filled the wharfof the company with sewage matter. The water in the riverwas at present in such a state as to be not only a danger tothe health of the company’s employees, but worse than use-less for business purposes. The medical officer of health (Mr.J. L. Rowlett), who was present, said it was a shame and adisgrace that there should be four deaths of children withinthe week which could have been prevented by proper sani-tary accommodation. The matter was referred to the sanitarycommittee. Portadown has recently and wisely obtaineda good water-supply, but it will need to undertake a

sewerage scheme as well.

Monaghan and Cavan Asylum Board.The question of asylum accommodation in Ireland is rapidly

becoming a serious one. When an institution is common totwo adjacent counties there is apt to be a decided differenceof opinion how to provide for an increasing number oflunatics. In the asylum common to Monaghan and Cavanthere are at present 920 inmates, of whom 505 are charge-able to county Cavan and 415 to county Monaghan. Theboard met on August 10th to decide how additional accom-modation could be provided to relieve the present congestedstate of the asylum. The representatives of county Cavanproposed that steps should be taken at once to supply addi-tional accommodation, provided, however, that if any definiteproposal were brought before the joint committee by theCavan representatives at the September meeting it shouldreceive consideration before proceeding further. The Cavanrepresentatives proposed as an amendment that, in the eventof no guarantee being forthcoming at the September meeting,an inquiry should be held by the inspectors or some other

governing body, who should then proceed to consider theadjourned question of providing such additional accommoda-tion. On a division the seven Cavan members voted for the

- amendment and the eight Monaghan representatives for the motion, which was carried, and a committee was appointed

to make inquiries with regard to the building best suited tothe purpose.

.

Sad Death of a Belfast Practitioner’s Son.Very wide sympathy is felt for Dr. T. K. Wheeler at the

’ drowning, on August 12th, of his eldest son, Mr. T. K.; Wheeler, a medical student of very great promise of the, Queen’s University of Belfast. Mr. Wheeler, who was. spending his holidays at Islandmagee on the county Antrim

coast, was bathing, when his strength gave way and he sank,despite the heroic efforts of Dr. Charles Dickson to save him.Mr. Wheeler was not only an excellent scholar, but a good!

! cricketer and footballer, and he was a member of the Belfast! University contingent of the Officers’ Training Corps.

August 15ht. ___________________

PARIS.(FROM OUR OWN CORRESPONDENT.)

Preventive Measures Against Cholera.THE appearance of cholera in Italy has for some weeks

given rise to fears as to the possibility of its extension inepidemic form to France. As a matter of fact this has notas yet occurred ; most of the cases announced by the press-at Marseilles, at Paris, at Montpellier, at Armentières-areproving to be cases of cholera nostras or cholerine, such asare observed every year about this time. But there are casesof cholera at Marseilles and Montpellier which, it must beadmitted, do resemble true cholera in that they have occurredin subjects coming from Italy, and consequently suspects.Bacteriological examination of the stools has given sus-

picious, though not absolutely conclusive, results. Never-theless, the most careful precautions have been taken ; ;.all the sanitary posts are watchful and the PasteurInstitute has just sent to Marseilles a supply of Dr.Salembeni’s anticholera serum, of which Dr Dopferand Dr. Salemb6ni himself will supervise the applica-tion. The lazaret of Frioul has been got ready to receivetravellers in cases where quarantine is deemed necessary.The system of surveillance adopted by the authorities-bothFrench and Italian-is based on the principle of minimisingthe restraint imposed on travellers. Only actual experiencecan determine whether it is adequate. At Ventimiglia andat Modane the traveller coming from Italy into France isnot subjected to any inquisition ; his name is taken and alsohis destination as shown by his railway tickets. The mayor)f that place is then advised by telegram, and immediatelyon the traveller’s arrival he is visited by the district

physician, who subjects him to a discreet examina-tion, and on the occurrence of the first alarmingsymptom makes a bacteriological examination of thestools. If cholera is officially recognised the subject is atonce isolated, and those of his entourage are placed undersupervision. If experience proves that this procedure isadequate it must be admitted that it is the most humanemethod and the least vexatious one for the public, but itleeds for its perfect execution the goodwill of both travellerand medical man, two human factors upon which it is

impossible always to count. The traveller who may happento resent as unjustifiable and vexatious the supervision to beexercised over him on his arrival at his destination can veryeasily elude it when he has learnt the modus operandi ofthe system, by taking, before reaching the frontier, a

ticket for some place other than his actual destina-.ion, since it is the ticket that gives him away. Fornstance, he can take a ticket for Toulon, and on hisarrival in the station there can immediately book for Paris,vhere there will be no advice of his coming. It is

ssential, therefore, that the surveillance to which the-.raveller will be subjected on his arrival at his destinationshall not be such as to inspire opposition, and that therehall be no fear that he will be exposed to unnecessary andvexatious examinations and to circumstances that will

iubject him to the annoying curiosity and the distrust of thenhabitants. It is to be hoped, then, that no medical man onvhom this duty shall fall, perhaps a simple country general)ractitioner appointed by the mayor, will succumb to theemptation to be over-zealous, which would cause travellerso resent his interference and elude the system by