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127 increasing from 1889 to 1898 that in Berne, Basle, and Zurich the population has increased by from 50 to 70 per cent. Building activity has been the special reason, many public and private buildings having been erected, but now the influx has greatly decreased owing to an over-production of dwelling-houses and business places, and a healthy reaction is taking place. The increase of population in Zurich, which from 1894 to 1897 was between 10,000 and 11,000 annually, is only 3000 for 1898, bringing the population up to 163,000 for January, 1899. Happily the existing laws for building (I refer especially to Zurich) are such that plenty of room is left for streets and public places. The drainage is perfect and the building laws as regards thickness of walls, proper building material, and the time enforced for drying the newly built houses are strict, so that the public weal cannot suffer. Every effort is made to ensure existing promenades and gardens from being built over and to lay out new ones. We shall also soon have two funicular railways which will take the inhabitants in a quarter of an hour up to the fine fir : woods on the hills round the town. Ziirich, July 2nd. NEW YORK. (FROM OUR OWN CORRESPONDENT.) The Dispenqary Abuses. AFTER three years of agitation the medical profession has succeeded in securing the enactment of a law in the State of New York which places the dispensaries under the control of the State Board of Charities. There are not far from 200 dis- pensaries in the State and they are very rapidly increasing. The special feature of their management which has excited the opposition of medical men is the method of indis- criminate treatment of all applicants without regard to their pecuniary abilities. In the city of New York it is estimated that 50 per cent. of the sick are treated annually in the dis- pensaries. But there are many other features of the manage- ment which are deserving of correction. Many dispensaries are located in drug-stores ; others are in dilapidated and insanitary buildings; all have but a single waiting-room where both sexes congregate ; none has any facilities for separating contagious diseases; and in few is the druggist a qualified graduate of a school of pharmacy. The law empowers the State Board of Charities to make rules and regulations governing the management of these institutions and to grant them a licence to conduct their business. Any violation of these rules may be punished by withdrawing the licence and by fines. The law will come into effect on Oct. 1st. Mean- time the State Board is preparing the form of licence and is also formulating the rules and regulations which are to govern the management of ’all the dispensaries of the State. It is anticipated that this law will prove very beneficial both in limiting the number of dispensaries to the actual wants of the people and by improving the management of those licensed. The Extermination of Yellow Fever. One of the most marked benefits to the United States which is likely to result from the late war with Spain is the possible extermination of yellow fever in its old habitats in Cuba. The thorough cleansing to which Santiago and Havana have been subjected has already given evidence that the yellow fever foci of these hitherto pest-stricken cities have been greatly changed if not altogether destroyed. Though the yellow fever season is well advanced only one or two authentic cases of that disease have been reported. A similar sanitary cleansing is going on in all of the smaller towns and with equally favourable results as regards the improvement of the general health and the absence of cases of yellow fever. Another feature of the sanitary manage- ment of the island is very important in securing not only the protection of the United States from an invasion of yellow fever but also the protection of one Cuban city from the infectious and contagious disease of another. I refer to the introduction of the methods of medical inspection of commerce and travel by officers of the United States Marine Hospital Service, so thoroughly matured in this country. Heretofore every epidemic of yellow fever in this country has been directly traced to the lax and worthless methods of inspection pursued by the local health authorities of the island. Now the local officers are entirely subordinate to the Government at Washington and the most rigid medical inspection is maintained of the shipping as well as of the :r town with a perfect system of notification. It probably y cannot result that no spread of yellow fever will occur during w the present year, so recently has the new ré,r;ime come into n operation, but it is already evident that the extermination n of yellow fever from Cuban cities by enlightened sanitation h is in the near future. The commercial value of such a is reform to the United States may be approximately estimated tr when the fact is recalled that many of the recent epidemics yellow fever imported from Cuba have cost the business r interests of this country from 100 millions to 200 millions e of dollars, beside the widespread desolation caused by the g migration of the people and the large sickness- and death- t rates. - Improvements in the Treatment and Care of the Insane. e The annual meeting of the American Psychological e Association was held recently in the city of New York r and a large number of interesting papers were read illus- trating the progress of psychiatry in this country. There was a manifest tendency toward what is called the State care of the insane in preference to county care. New York is the most conspicuous example of a State which adopted the system of State care, thereby removing all the insane from the counties to the State hospitals. The result has been most favourable to the insane and the question is being widely agitated in other States. Should not the insane be everywhere recognised as wards of the State and come under its sole jurisdiction ? One feature of the meeting was san evening given to the discussion of epilepsy which brought f out the experience of those who have the superintendence of E State institutions for epileptics. These colonies are exciting . a large amount of public and professional interest throughout . the entire country and the effect is to greatly increase their number. The Craig colony for the insane in the State of . New York, embracing upwards of 2000 acres of arable land . and designed to accommodate 2000 inmates, is making a striking success in the treatment of epileptics. It reports . the recovery of some of the most helpless and hopeless . epileptics of the county almshouses. The institutions for epileptics in Ohio, Massachusetts, and Pennsylvania are doing excellent work. The treatment of the insane by the , Scotch system of " boarding-out " was for the first time advocated by a superintendent of a State hospital. The subject of a more effective system of colonising the chronic insane was brought forward in the annual address. Reorganisation of the Army Medical Corps. At the recent meeting of the American Medical Associa- tion it was resolved to recommend to the Government: (1) that the medical corps of the army and navy be enlarged to meet properly all the demands which may be made upon them; (2) that transportation of medical supplies be under the control of the medical department ; (3) that a corps of sani- tary inspectors be created whose duty it shall be to examine into the sanitary condition of camps and bodies of troops in transit and advise in relation thereto ; (4) that the Govern- ment establish permanent camp sites, the selection to be subject to the approval of the surgeon-general, for use in the mobilisation of large masses of troops; (5) that a professor of military hygiene be appointed at West Point to instruct the cadets in the principles of sanitation ; (6) that the medical officers of the National Guard be subject to rigid examina- tion both for admission to the service and for promotion ; (7) that the surgeon-general of the army and navy in time of peace and war be empowered to call into requisition the services of skilled specialists ; and (8) that the President of the United States be respectfully urged to recommend to Congress the appointment of an army medical commission, to be composed of physicians and sanitarians to be taken from military and civil life, including the surgeon-general of the army and navy, whose duty it shall be to prepare a report containing a detailed plan of a modern system to govern the medical departments of the army and navy in peace and war. United States Marine Hospital Service. A board of officers will be convened in New York city on June 27th to examine candidates for admission to the grade of assistant surgeon in the United States Marine Hospital Service. Upon appointment to this service the young officers are, as a rule, first assigned for duty at one of the large marine hospitals, as at Boston, New York, New Orleans, Chicago, or San Francisco. After five years’ service assistant surgeons are entitled to examination for promotion to the
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Page 1: NEW YORK

127

increasing from 1889 to 1898 that in Berne, Basle, andZurich the population has increased by from 50 to 70 percent. Building activity has been the special reason, manypublic and private buildings having been erected, but nowthe influx has greatly decreased owing to an over-productionof dwelling-houses and business places, and a healthy reactionis taking place. The increase of population in Zurich, whichfrom 1894 to 1897 was between 10,000 and 11,000 annually, isonly 3000 for 1898, bringing the population up to 163,000 forJanuary, 1899. Happily the existing laws for building (I referespecially to Zurich) are such that plenty of room is left forstreets and public places. The drainage is perfect and thebuilding laws as regards thickness of walls, proper buildingmaterial, and the time enforced for drying the newly builthouses are strict, so that the public weal cannot suffer.

Every effort is made to ensure existing promenades andgardens from being built over and to lay out new ones. Weshall also soon have two funicular railways which will takethe inhabitants in a quarter of an hour up to the fine fir :

woods on the hills round the town. ’

Ziirich, July 2nd.

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

The Dispenqary Abuses.AFTER three years of agitation the medical profession has

succeeded in securing the enactment of a law in the State ofNew York which places the dispensaries under the control ofthe State Board of Charities. There are not far from 200 dis-pensaries in the State and they are very rapidly increasing.The special feature of their management which has excitedthe opposition of medical men is the method of indis-criminate treatment of all applicants without regard to theirpecuniary abilities. In the city of New York it is estimatedthat 50 per cent. of the sick are treated annually in the dis-pensaries. But there are many other features of the manage-ment which are deserving of correction. Many dispensariesare located in drug-stores ; others are in dilapidated andinsanitary buildings; all have but a single waiting-roomwhere both sexes congregate ; none has any facilities forseparating contagious diseases; and in few is the druggist aqualified graduate of a school of pharmacy. The law empowersthe State Board of Charities to make rules and regulationsgoverning the management of these institutions and to grantthem a licence to conduct their business. Any violation ofthese rules may be punished by withdrawing the licenceand by fines. The law will come into effect on Oct. 1st. Mean-time the State Board is preparing the form of licence andis also formulating the rules and regulations which are togovern the management of ’all the dispensaries of the State.It is anticipated that this law will prove very beneficial bothin limiting the number of dispensaries to the actual wants ofthe people and by improving the management of thoselicensed.

The Extermination of Yellow Fever.One of the most marked benefits to the United States

which is likely to result from the late war with Spain is thepossible extermination of yellow fever in its old habitatsin Cuba. The thorough cleansing to which Santiago andHavana have been subjected has already given evidencethat the yellow fever foci of these hitherto pest-strickencities have been greatly changed if not altogether destroyed.Though the yellow fever season is well advanced only one ortwo authentic cases of that disease have been reported. Asimilar sanitary cleansing is going on in all of the smallertowns and with equally favourable results as regards theimprovement of the general health and the absence of casesof yellow fever. Another feature of the sanitary manage-ment of the island is very important in securing not onlythe protection of the United States from an invasion ofyellow fever but also the protection of one Cuban cityfrom the infectious and contagious disease of another.I refer to the introduction of the methods of medicalinspection of commerce and travel by officers of the UnitedStates Marine Hospital Service, so thoroughly matured inthis country. Heretofore every epidemic of yellow fever inthis country has been directly traced to the lax and worthlessmethods of inspection pursued by the local health authoritiesof the island. Now the local officers are entirely subordinateto the Government at Washington and the most rigid medical

inspection is maintained of the shipping as well as of the:r town with a perfect system of notification. It probablyy cannot result that no spread of yellow fever will occur duringw the present year, so recently has the new ré,r;ime come inton operation, but it is already evident that the exterminationn of yellow fever from Cuban cities by enlightened sanitationh is in the near future. The commercial value of such ais reform to the United States may be approximately estimatedtr when the fact is recalled that many of the recent epidemics

yellow fever imported from Cuba have cost the businessr interests of this country from 100 millions to 200 millionse of dollars, beside the widespread desolation caused by theg migration of the people and the large sickness- and death-t rates.- Improvements in the Treatment and Care of the Insane.

e The annual meeting of the American Psychologicale Association was held recently in the city of New York

r and a large number of interesting papers were read illus-trating the progress of psychiatry in this country. Therewas a manifest tendency toward what is called the Statecare of the insane in preference to county care. NewYork is the most conspicuous example of a Statewhich adopted the system of State care, thereby removing allthe insane from the counties to the State hospitals. The resulthas been most favourable to the insane and the question isbeing widely agitated in other States. Should not the insanebe everywhere recognised as wards of the State and comeunder its sole jurisdiction ? One feature of the meeting was

san evening given to the discussion of epilepsy which broughtf out the experience of those who have the superintendence ofE State institutions for epileptics. These colonies are exciting. a large amount of public and professional interest throughout.

the entire country and the effect is to greatly increase theirnumber. The Craig colony for the insane in the State of. New York, embracing upwards of 2000 acres of arable land. and designed to accommodate 2000 inmates, is making astriking success in the treatment of epileptics. It reports. the recovery of some of the most helpless and hopeless. epileptics of the county almshouses. The institutions for

epileptics in Ohio, Massachusetts, and Pennsylvania are

doing excellent work. The treatment of the insane by the,

Scotch system of " boarding-out " was for the first timeadvocated by a superintendent of a State hospital. The

subject of a more effective system of colonising the chronicinsane was brought forward in the annual address.

Reorganisation of the Army Medical Corps.At the recent meeting of the American Medical Associa-

tion it was resolved to recommend to the Government: (1)that the medical corps of the army and navy be enlarged tomeet properly all the demands which may be made upon them;(2) that transportation of medical supplies be under thecontrol of the medical department ; (3) that a corps of sani-tary inspectors be created whose duty it shall be to examineinto the sanitary condition of camps and bodies of troops intransit and advise in relation thereto ; (4) that the Govern-ment establish permanent camp sites, the selection to besubject to the approval of the surgeon-general, for use in themobilisation of large masses of troops; (5) that a professor ofmilitary hygiene be appointed at West Point to instruct thecadets in the principles of sanitation ; (6) that the medicalofficers of the National Guard be subject to rigid examina-tion both for admission to the service and for promotion ;(7) that the surgeon-general of the army and navy in time ofpeace and war be empowered to call into requisition theservices of skilled specialists ; and (8) that the President ofthe United States be respectfully urged to recommend to

Congress the appointment of an army medical commission,to be composed of physicians and sanitarians to be takenfrom military and civil life, including the surgeon-generalof the army and navy, whose duty it shall be to prepare areport containing a detailed plan of a modern system to

govern the medical departments of the army and navy inpeace and war.

United States Marine Hospital Service.A board of officers will be convened in New York city on

June 27th to examine candidates for admission to the gradeof assistant surgeon in the United States Marine HospitalService. Upon appointment to this service the young officersare, as a rule, first assigned for duty at one of the largemarine hospitals, as at Boston, New York, New Orleans,Chicago, or San Francisco. After five years’ service assistantsurgeons are entitled to examination for promotion to the

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grade of passed assistant surgeon. Promotion to the gradeof surgeon is made according to seniority and after examina-tion as vacancies occur in that grade. Assistant surgeonsreceive$1600 ; passed assistant surgeons,$2000 ; andsurgeons,$2500 per annum. When quarters are not

provided commutation at the rate of$30,$40, and$50 amonth, according to grade, is allowed. All grades abovethat of assistant surgeon receive longevity pay, 10 per cent.,in addition to the regular salary for every five years’service. The tenure of office is permanent.

National Bureau of Public Health.On the recommendation of the Executive Committee the

American Medical Association unanimously adopted resolu-tions endorsing the establishment of a national bureau ofpublic health, with a Cabinet officer at its head, togetherwith instructions to the board of trustees to set aside acertain sum of money for the use of the special committeeappointed in connexion with this matter.June 19th.

Obituary.’

SIR WILLIAM HENRY FLOWER, K.C.B., F.R.S.,F.R.C.S. ENG.

SIR WILLIAM FLOWER, until lately Director of the NaturalHistory Department of the British Museum, died on July lstat his residence, 26, Stanhope-gardens. He had for sometime past been in failing health, and although he had derivedsome benefit from a stay during the winter on the Riviera,yet it was evident on his return to London in May that hishealth was in a very unsatisfactory condition. He was bornat Stratford-on-Avon in the year 1831, his father being thelate Edward Fordham Flower, and he received his educa-tion at University College, London. In 1854 he enteredthe army as assistant surgeon to the 53rd Regimentand accompanied it through the Crimean War, receivingthe Crimean medal with four clasps and the Turkishmedal in addition. On returning to England he took thediploma of F.R.C.S. Eng. in 1857, and from 1859 to 1861he held the post of assistant surgeon to, and demonstratorof anatomy at, the Middlesex Hospital. Subsequently he wasappointed to the conservatorship of the Hunterian Museumof the Royal College of Surgeons and was chosen HunterianProfessor of Comparative Anatomy and Physiology in 1869.In 1884 he succeeded Sir Richard Owen as Director of theNatural History Museum, a post which he held till failinghealth compelled him to resign.

Sir William Flowers’s scientific work for the most parttook the form of gathering up facts and classifying themrather than that of investigation pure and simple ; never-theless by his death science has lost a most valuable worker.As an example of the importance of his work while incharge of the Hunterian Museum it may be mentioned thatin 1884 the collection of materials for studying the physicalcharacteristics of the different races of men consisted of89 skeletons and 1380 skulls (exclusive of the Davis collec-tion), while in 1864 the skeletons numbered 18 only and theskulls 242. A great deficiency was thus supplied and increasedopportunities for the study of osteological variations in manwere afforded, for he never let slip an opportunity ofacquiring small private collections of specimens. The great-ness of the task which he set himself is shown by the factthat his osteological catalogue contained a list of no lessthan 1300 skulls with carefully verified measurements.

So much did he realise the important part which museumsplay in scientific work that he spent nearly the whole of hislife in directing or studying their practical organisation, andboth by precept and example endeavoured to show that a merecollection of unclassified specimens did not constitute amuseum which would further the advancement of scientificknowledge. This he particularly pointed out in his presi-dential address to the British Association at Newcastlesome 10 years ago when he said that museums promoted theadvancement of scientific knowledge by affording facilitiesfor scientific research together with opportunities for popularinstruction, but if they were to be efficient the collec-tions must be arranged with reference to their specialfunctions as collections of classified material. His direc-tion of the Natural History Museum at South Kensington

was no unworthy example of this teaching. A referenceto the catalogue of scientific papers of the Royal Societyconclusively shows the extent to which he enrichedscientific knowledge and amongst his various publicationsare: "An Introduction to the Osteology of Mammalia,""Diagrams of the Nerves of the Human Body," " Introduc-tion to the Study of Mammals, Living and Extinct," "TheHorse: a Study in Natural History," and "Essays on

Museums."To the Encyclopedia Britannica he contributed several

articles-notably one on Mammalia, which showed him tobe a master of the difficult art of accurately expressingoneself in a succinct manner. The memoirs which hepublished on Morphology-notably those on the brain andthe dentition of the Marsupialia-were a great addition toour knowledge on these subjects, as were also his papers onthe characters of the cranium in carnivora and on the evolu-tion of the cetacea.

It was only fitting that a man who worked so laboriouslyin the cause of science should be honoured by the variouslearned bodies of the country. In 1864 he was electeda Fellow of the Royal Society which, moreover, awardedhim a medal in 1882. In 1879 he became presidentof the Zoological Society and he served as president ofthe Anthropological Institute from 1883 to 1885. Hewas appointed president of the section of anatomyof the International Medical Congress which met inLondon in 1881. Oxford and Cambridge both conferredhonorary degrees upon him and so did the Universities ofDurham, Edinburgh, Dublin, and St. Andrews. The In-stitute of France made him one of its CorrespondingMembers, as did also the Royal Swedish Academy ofSciences. He was created a C.B. in 1887 and a K.C.B.in 1892.

Sir William Flower was revered by all who knew him.His genial nature and kindly sympathy endeared him toall who had occasion to consult him and his willingness tohelp those who sought his advice will always be gratefullyremembered.The remains of the late Sir William Flower were cremated

at Woking on Wednesday, July 5th, and the urn containinghis ashes was buried at Stone in Buckinghamshire on thefollowing day. On the day of the cremation a memorialservice was held at St. Luke’s Church, Chelsea, which wasattended by a large number of personal friends and eminentmen of science.

___

HENRY NAUNTON DAVIES, M.R.C.S. ENG.,L.R.C.P. LOND., L.S.A.

THE sudden death of Mr. Henry Naunton Davies of Porth,Rhondda, on July 3rd from apoplexy while staying atCaswell Bay removes from Welsh medical circles one of themost prominent of their members. The tale of the remarkablegrowth of the Rhondda valleys has often been told, but itcan hardly be better appreciated than by stating that at thetime of Mr. Naunton Davies’s birth 70 years ago there was a

population of 500 persons; when he qualified 25 years laterthe population was but 1000 ; while to-day it is close upon130,000. His grandfather and father were medical prac-titioners in the district, and from his earliest days he wasconnected surgically with the collieries of the valley and inthis capacity he was called upon more than once to facedangers not usually met with by those practising outside thecoalfields. In the year 1877 he rendered such conspicuousservice and displayed such unusual presence of mind underthe most trying circumstances connected with a collieryaccident that at the annual meeting of the British MedicalAssociation held in the autumn of that year at Manchesterhe was presented with the gold medal of the Association, anhonour of which he was the first recipient. The cottagehospital at Porth with its 10 beds and the only institutionof the kind in the whole district was established and keptgoing through his energy and his support will be sorelymissed. As a matter of detail he provided for the use of thehospital a most complete set of surgical instruments andhe was constantly adding to the stock such of those morenewly designed which seemed to be of any practical utility.He took his share in the public life of the locality, forsome years being a member of the local board and at thetime of his death he was an alderman of the GlamorganshireCounty Council, to which position he was elected upon thefirst formation of the council. He was also a justice of


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