763 obtained when sea-sickness had fully set in, the patients being as a rule too much overcome by their sensations to swallow any medicine at all. It is essential to administer full doses of from two to three grammes a day from the beginning. The use of the drug is not attended with any risk or danger. Dr. Schliep recommends, therefore, that anæsthesin should form part of the stock of medicines carried on board ship. Dentition and Tuberculosis. In a paper read before the Berlin Medical Society Dr. Westenhoeffer gave an account of some experiments on the occurrence of tuberculous infection in early life. He made subcutaneous injections of tuberculous material in the lumbar region of 120 guinea-pigs, 30 rabbits, and three calves The small animals died after two or three months and the calves were killed after that time. At the necropsies caseous changes were found at the site of the injection and in the inguinal, retroperitoneal, and in some cases the mesenteric and perirenal glands. The spleen and the liver were often tuberculous, whilst tuberculosis of the lungs was rather rare. Tuberculous infection might obviously spread through the lymphatic vessels. In 12 cases where the bronchial glands were tuberculous miliary tuberculosis of the lungs was the sequel, an observation in accordance with Professor Behring’s views. Dr. Westenhoeffer found in his researches that sometimes the course of the tuberculous infection was rather irregular, not always going along the lymphatic vessels, so that glands of distant regions were affected whilst intermediate glands were still healthy. Attention was drawn to the fact that tuberculosis was never present in children under three months of age and is rather frequent after the first year. Dr. Westenhoeffer was of opinion that the frequency of glandular tuber- culosis in that period is in connexion with dentition, during which the mucosa of the mouth becomes swollen and somewhat inflamed so that infection may easily occur. Similar conditions exist in the lower animals. Nearly all mammals are either born with teeth or get them within the first fortnight after birth. The only exception is the pig, in which animal the teeth are late in making their appearance. It was remarkable that tuberculosis developed in pigs after dentition and that the lymphatic glands of the neck became swollen first just as in the scrofula of children. Dr. Westenhoeffer said that the frequency of tuberculosis of the lymphatic glands in the poorer classes was principally due to the uncleanly state of their homes. Children during dentition were inclined to put things in their mouths, a practice which is not free from risk in insanitary surroundings. Alluding to Professor Behring’s theory as to the propagation of tuberculous infection through the intestines he said that the alleged permeability of the intestinal mucosa only existed in the first two days of life ; the intestines of children and of adults did not differ as to their liability to tuberculosis. He agreed with Professor Behring that the struggle against tuberculosis must begin in childhood, although the points of view from which they regarded the general question of tuberculous infection were different in some respects. March 7th. SWITZERLAND. (FROM OUR OWN CORRESPONDENT.) The First Succcessful Ovariotomy _performed in Switzerland. THE following details may be of interest to the medical profession in England. In December, 1903, a clergyman’s widow died at Zurich at the ripe age of 83 years, succumb- ing to senile marasmus aggravated by broncho-pneumonia. Nearly 40 years ago she suffered from an abdominal tumour which threatened her life. After various methods employed to prevent the rapid growth of the tumour had all signally failed her medical attendants and Professor Breslau, who at that time occupied the chair of obstetric medicine at the University of Zurich, called in Mr. (afterwards Sir) Spencer Wells of London who performed laparotomy on July 13th, 1865, and removed an ovarian tumour weighing a little over 56 pounds (25 kilogrammes). The patient rapidly recovered and outlived most of her medical attendants. It may be mentioned here that a Dr. Carl Gustav Jung performed the first laparotomy (which, however, was unsuccessful) in Basle as early as 1851. Attendance at Medical Schools in Switzerland. The number of medical students entered at the five Swiss universities during this winter term, 1903-04, amounted to 1654, a slight decrease as compared with 1696 in the corre- sponding period a year ago. The fair sex still preponderates, there being 891 lady students (874 of whom are foreigners) and 763 male students ; of the ladies five are studying at Basle, 151 at Geneva, 177 at Zurich, 181 at Lausanne, and 377 at Berne. The total number of medical students at each of the five universities is as follows : 140 at Basle, 275 at Lausanne, 307 at Geneva, 388 at Ziirich, and 544 at Berne. The establishment of a medical school reserved for lady students is being seriously discussed in the lay and medical press. Fulminant Hemorrhagic Purpura. Dr. A. von Lerber has published an account of a rare case of purpura terminating fatally in 12 hours. The patient was a healthy girl 13 months old, one of a healthy but slightly neurotic family. The child had not been ill except once when she had a slight attack of bronchitis which did not call for medical treatment. During the night of Jan. 5th she became restless and seemed very collapsed at 6 A.M., so that a medical man was called in. At 7 A.M. on the 6:h he found the child quietly taking food. Distributed over the chest, arms, and legs he observed a number of hæmorrhagic spots of a bluish-red colour of about the size of lentils and even larger. The pulse was quick but there was no pyrexia He prescribed a warm bath. Called in again at 9.30 A M. he found numerous similar spots coming out all over the face and body, some as large as a five-shilling piece. At 11 30 A.M. the temperature was 99° F., the respirations were 60 per minute, and the pulse could not be counted. The child became comatose and passed away quietly at 1 P. M. A post-mortem examination was not permitted. Dr. von Lerber remarks that a sister of the patient died four years previously from broncho pneumonia at the age of two years after a skin eruption which may have been either measles or a " similar skin affection," as the mother called it. Ziirich, Feb. 29th. NEW YORK. (FROM OUR OWN CORRESPONDENT.) American Nurses for the Japanese Army. THE United States is to aid in nursing the wounded and sick Japanese soldiers. Dr. Anita Newcomb McGee, who organised a corps of nurses during the Spanish-American war in 1898, first in Cuba and afterwards in the Philippines, , has offered to fit out a nursing staff for service with the . Japanese army. The Japanese Minister in Washington has : accepted the offer on behalf of his Government and Dr. . McGee will leave in the early part of March with several nurses to establish a field hospital in Japan. There are to be , formed committees of women in different parts of the country j to raise funds for the support of the nurses. More nurses will , follow if the subscriptions are large enough to cover expenses. Typhoid Fever and Diphtheria at the University of Minnesota. It is reported from Minneapolis, Minnesota, that somewhat severe epidemics of diphtheria and typhoid fever exist at the State University of Minnesota which will probably close for the balance of the year. President Northrup has publicly warned the students against the city water. A further 1 outbreak of typhoid fever is feared. A faculty health committee has been appointed to fight the contagion. _ Consolidation of the Medical Society of the State of New . York and the New York .’ranch of the American r Medical Association. I The consolidation of the two medical organisations of New , York State is, at the time of writing, practically an accom- t plished fact. For many years there have been more or less a serious differences between these two bodies, but at length r the hatchet has been buried and a satisfactory agreement , has been reached. This result has been mainly due to the r efforts of the American Medical Association, the chairman of i its committee on organisation having appealed to the medical e profession of New York State to endeavour to bring the two e organisations to an agreement. The question upon which e the societies were divided was one of ethics, the Medical Society of the State of New York making a stand against
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obtained when sea-sickness had fully set in, the patientsbeing as a rule too much overcome by their sensations toswallow any medicine at all. It is essential to administerfull doses of from two to three grammes a day from thebeginning. The use of the drug is not attended with anyrisk or danger. Dr. Schliep recommends, therefore, thatanæsthesin should form part of the stock of medicines carriedon board ship.
Dentition and Tuberculosis.In a paper read before the Berlin Medical Society Dr.
Westenhoeffer gave an account of some experiments on theoccurrence of tuberculous infection in early life. He madesubcutaneous injections of tuberculous material in thelumbar region of 120 guinea-pigs, 30 rabbits, and threecalves The small animals died after two or threemonths and the calves were killed after that time. Atthe necropsies caseous changes were found at the siteof the injection and in the inguinal, retroperitoneal,and in some cases the mesenteric and perirenal glands.The spleen and the liver were often tuberculous, whilsttuberculosis of the lungs was rather rare. Tuberculousinfection might obviously spread through the lymphaticvessels. In 12 cases where the bronchial glands weretuberculous miliary tuberculosis of the lungs was the sequel,an observation in accordance with Professor Behring’sviews. Dr. Westenhoeffer found in his researches thatsometimes the course of the tuberculous infection wasrather irregular, not always going along the lymphaticvessels, so that glands of distant regions were affectedwhilst intermediate glands were still healthy. Attentionwas drawn to the fact that tuberculosis was never
present in children under three months of age and israther frequent after the first year. Dr. Westenhoefferwas of opinion that the frequency of glandular tuber-culosis in that period is in connexion with dentition,during which the mucosa of the mouth becomes swollenand somewhat inflamed so that infection may easily occur.Similar conditions exist in the lower animals. Nearly allmammals are either born with teeth or get them withinthe first fortnight after birth. The only exception is thepig, in which animal the teeth are late in making theirappearance. It was remarkable that tuberculosis developed in pigs after dentition and that the lymphatic glandsof the neck became swollen first just as in the scrofulaof children. Dr. Westenhoeffer said that the frequency oftuberculosis of the lymphatic glands in the poorer classeswas principally due to the uncleanly state of their homes.Children during dentition were inclined to put things in theirmouths, a practice which is not free from risk in insanitarysurroundings. Alluding to Professor Behring’s theory as tothe propagation of tuberculous infection through theintestines he said that the alleged permeability of theintestinal mucosa only existed in the first two days of life ;the intestines of children and of adults did not differ as totheir liability to tuberculosis. He agreed with ProfessorBehring that the struggle against tuberculosis must begin inchildhood, although the points of view from which theyregarded the general question of tuberculous infection weredifferent in some respects.March 7th.
SWITZERLAND.(FROM OUR OWN CORRESPONDENT.)
The First Succcessful Ovariotomy _performed in Switzerland.THE following details may be of interest to the medical
profession in England. In December, 1903, a clergyman’swidow died at Zurich at the ripe age of 83 years, succumb-ing to senile marasmus aggravated by broncho-pneumonia.Nearly 40 years ago she suffered from an abdominal tumourwhich threatened her life. After various methods employedto prevent the rapid growth of the tumour had all signallyfailed her medical attendants and Professor Breslau, who atthat time occupied the chair of obstetric medicine at theUniversity of Zurich, called in Mr. (afterwards Sir) SpencerWells of London who performed laparotomy on July 13th,1865, and removed an ovarian tumour weighing a little over56 pounds (25 kilogrammes). The patient rapidly recoveredand outlived most of her medical attendants. It may be mentioned here that a Dr. Carl Gustav Jung performed thefirst laparotomy (which, however, was unsuccessful) in Basleas early as 1851.
Attendance at Medical Schools in Switzerland.The number of medical students entered at the five Swiss
universities during this winter term, 1903-04, amounted to1654, a slight decrease as compared with 1696 in the corre-sponding period a year ago. The fair sex still preponderates,there being 891 lady students (874 of whom are foreigners)and 763 male students ; of the ladies five are studying atBasle, 151 at Geneva, 177 at Zurich, 181 at Lausanne, and377 at Berne. The total number of medical students ateach of the five universities is as follows : 140 at Basle,275 at Lausanne, 307 at Geneva, 388 at Ziirich, and 544at Berne. The establishment of a medical school reservedfor lady students is being seriously discussed in the lay andmedical press.
Fulminant Hemorrhagic Purpura.Dr. A. von Lerber has published an account of a rare case
of purpura terminating fatally in 12 hours. The patient wasa healthy girl 13 months old, one of a healthy but slightlyneurotic family. The child had not been ill except oncewhen she had a slight attack of bronchitis which did notcall for medical treatment. During the night of Jan. 5thshe became restless and seemed very collapsed at 6 A.M.,so that a medical man was called in. At 7 A.M. on the6:h he found the child quietly taking food. Distributedover the chest, arms, and legs he observed a number ofhæmorrhagic spots of a bluish-red colour of about the size oflentils and even larger. The pulse was quick but there wasno pyrexia He prescribed a warm bath. Called in again at9.30 A M. he found numerous similar spots coming out allover the face and body, some as large as a five-shilling piece.At 11 30 A.M. the temperature was 99° F., the respirationswere 60 per minute, and the pulse could not be counted. Thechild became comatose and passed away quietly at 1 P. M. Apost-mortem examination was not permitted. Dr. von
Lerber remarks that a sister of the patient died four yearspreviously from broncho pneumonia at the age of two yearsafter a skin eruption which may have been either measles ora " similar skin affection," as the mother called it.Ziirich, Feb. 29th.
NEW YORK.
(FROM OUR OWN CORRESPONDENT.)
American Nurses for the Japanese Army.THE United States is to aid in nursing the wounded and
sick Japanese soldiers. Dr. Anita Newcomb McGee, whoorganised a corps of nurses during the Spanish-Americanwar in 1898, first in Cuba and afterwards in the Philippines,
, has offered to fit out a nursing staff for service with the
. Japanese army. The Japanese Minister in Washington has: accepted the offer on behalf of his Government and Dr.. McGee will leave in the early part of March with several
nurses to establish a field hospital in Japan. There are to be, formed committees of women in different parts of the countryj to raise funds for the support of the nurses. More nurses will,
follow if the subscriptions are large enough to cover expenses.Typhoid Fever and Diphtheria at the University of
Minnesota.It is reported from Minneapolis, Minnesota, that somewhat
severe epidemics of diphtheria and typhoid fever exist at theState University of Minnesota which will probably close forthe balance of the year. President Northrup has publiclywarned the students against the city water. A further
1 outbreak of typhoid fever is feared. A faculty healthcommittee has been appointed to fight the contagion.
_ Consolidation of the Medical Society of the State of New.
York and the New York .’ranch of the Americanr Medical Association.I The consolidation of the two medical organisations of New, York State is, at the time of writing, practically an accom-t plished fact. For many years there have been more or lessa serious differences between these two bodies, but at lengthr the hatchet has been buried and a satisfactory agreement, has been reached. This result has been mainly due to ther efforts of the American Medical Association, the chairman ofi its committee on organisation having appealed to the medicale profession of New York State to endeavour to bring the twoe organisations to an agreement. The question upon whiche the societies were divided was one of ethics, the Medical
Society of the State of New York making a stand against
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professional sectarianism and declaring against ethicaldifferences of opinion among legally licensed practitionersof other schools. At the annual meeting of the MedicalSociety of the State of New York, held in Albany onJan. 26th, the following motions were unanimouslyadopted :Resolved, that the report of the joint committee of conference be
accepted and that the proposed agreement for the consolidation of theMedical Society of the State of New York and the New York StateMedical Association be and the same is hereby approved, and thepresident of the society is hereby authorised and directed to executethe same in the name and behalf of the society, and the secretary ishereby authorised and directed to affix the corporate seal thereto ; andbe it further resolved that the committee of the society heretoforeappointed for the purpose of bringing about the consolidation-namely,Dr. Henry L. Elsner. Dr. A. Jacobi, Dr. A. Vanderbeer, Dr. GeorgeRyerson Fowler, and Dr. Frank Van Fleet-be and they are hereby con-tinued as such committee with full power and authority to do what-ever may be necessary to carry the agreement into effect.
Action on the adoption of the report of the joint committeeof conference, together with the proposal of motions ratify-ing the action of the State society, will be taken at thestated meeting of the Medical Society of the State of NewYork to be held on Monday, Feb. 29th.
Tenement Children and Tuberculosis.At a recent meeting of the Association for Improving the
Condition of the Poor an appropriation of$15,000 (£3000)was made for the maintenance at the seaside of 50 New Yorktenement children suffering from non-pulmonary forms oftuberculosis. The association wishes to educate the generalpublic to a knowledge of the fact that a large percentage ofchildren known merely as cripples are suffering from tuber-culosis and can be cured. Dr. Hermann Biggs of the NewYork Health Department declares that there are in theNew York tenements alone from 3000 to 4000 children under15 years of age suffering from scrofula and tuberculosis ofthe bones, the joints, and the lymphatic glands. It is, ofcourse, a well-known fact that tuberculosis of the lungsaffects but a relatively small number of children under 15years of age.
Surgeon .7vanted on the Panama Commission.The committee on medical legislation of the American
Medical Association has requested President Roosevelt to
appoint on the Panama Canal Commission a member of themedical profession and has suggested that Colonel William C.Gorgas is well qualified for the position. Colonel Gorgas is asurgeon in the army and is widely known for his researchesin Cuba into the causes of yellow fever. The fact is urgedthat-
Under both the French administrations at the Isthmus the engineer-ing problems themselves, to the chagrin of the medical profession ofthe world, failed of accomplishment largely through the frightful mor-tality among officers and labourers consequent upon lack of authorityon the part of medical officers intrusted with the work of sanitation ;that the same conditions of insalubrity exist now that existed then andthat consequently the sanitary problems are to be recognised as secondin importance, if second at all, only to those connected with theengineering department.
Ne7v York Eye and Ear Infirmary.The board of directors of the New York Eye and Ear
Infirmary has decided to curtail the scope of the work ofthat institution after May lst in the event of sufficient fundsfor its maintenance not being collected. Even after March lstno patients will be received in the part of the hospital knownas Platt Pavilion in which contagious diseases of the eye aretreated. The closing of this wing of the hospital would be amisfortune for many infants living in the very poor districtsof the east side. The infirmary has been in existence for 86years and is considered to be the foremost institution of itskind in the United States.Feb.27th.
________________
AUSTRALIA.
(FROM OUR OWN CORRESPONDENT.)
Quarantine against Small-pox.IN consequence of an outbreak of small-pox in Christ-
church, New Zealand, the various boards of health inAustralia have declared New Zealand to be infected and allvessels from New Zealand ports will be quarantined and nopassengers allowed to land for 15 days unless successfullyvaccinated within the last two years or until pratique is
granted by the health authorities. The necessity of placingquarantine regulations under Federal control as speedily as
possible is again made manifest by the different methods
adopted by the several States in this instance. The firstvessel to arrive from New Zealand at Australian portsafter notification of the outbreak was the Moeraki atHobart. She was allowed to berth and to unship and toship cargo but all passengers were prohibited from land-ing. The Tasmanian passengers were therefore taken onto Melbourne, the next port of call. On arrival at Port
Phillip Heads the Moeraki was boarded by two medicalofficers of the Board of Health. The passengers were
examined and it was found that all who had come fromChristchurch or had passed through that city during the timeof the outbreak of small-pox had been successfully vac.
cinated within the last two years. The names and addressesof all the passengers were taken and on their giving assur.ances to report to the Board of Health in case of illness
they were allowed to land. The 50 passengers for Hobartcan now return there by way of Launceston. The Board ofHealth of New South Wales is quarantining passpngers fromChristchurch only. In Queensland a proclamation has beenissued ordering that all vessels from New Zealand shall bequarantined until granted pmatique by the health authorities.Some uniformity of action is obviously necessary.
Bubonio Plague.Some time ago the Government of West Australia com-
missioned Dr. Anderson to visit India and to inquire into theoccurrence and treatment of bubonic plague. Dr. Andersonhas sent in a report in which he states that plague is not in agreat majority of cases a contagious disease as ordinarilyunderstood and that the discovery of a case in a generalhospital need not necessitate the quarantine of the wholeinstitution. A case of supposed bubonic plague was dis-covered in a coloured seaman on board a steamer at
Williamstown, Melbourne. The steamer was placed inquarantine pending inquiries, the result of which was thatthe case was not plague.
Tuberculosis,The Victorian Year-book for 1902, which has just made its
belated appearance, includes a contribution by Dr. D. AstleyGresswell, chairman of the Board of Public Health, entitled"The Presence of Tuberculosis in Victoria." He mentionsthat from 1863 to 1887 the death-rate from phthisis andother tuberculous diseases remained fairly constant. In thetriennial period commencing at the latter year the averageyearly rate per 100.000 inhabitants for the metropolitandistricts was 283 and for the extra-metropolitan 119 A steadyimprovement then set in and during the triennial period1899-1901 in the metropolitan districts the average yearlydeaths from phthisis were 144 per 100,000 and those fromother tuberculous diseases were 42 per 100,000. Some fewmonths ago, as mentioned at the time, the Board of Healthof Victoria made tuberculosis a notifiable disease under theprovisions of the Health Act. This procedure has been muchopposed by many members of the medical profession. Inhis annual report to the Board of Health, Dr. Wilkinson,health officer of Preston, referred to the subject and observedthat from a long experience in an isolated district witha settled population he was satisfied of the small riskof contagion and had never seen a case of its occurrence,although for over 20 years he had watched the othermembers of households where one had been attacked withtubercle. On the other hand, the reporting and segregatingof such cases would have inflicted great hardship. Dr. D.Turner, who as examining medical officer to the sanatoriumfor consumptives in Victoria has had exceptional oppor-tunities for observation, has forcibly expressed his dissentfrom the action of the Board of Health. He recordsnumerous instances of the hardship inflicted by the opinionsnow promulgated as to the contagiousness of tubercle-opinions which his experience shows to be exaggeratedgreatly. The plans for the new "Eronheimer" wingfor consumptives at the Austin Hospital have been approved.The building will accommodate 30 beds on each floor,making the total number for consumptives 102, The newwing will not be utilised, however, until the question ofits maintenance has been settled. Like the infectiousdiseases hospital the building will lie idle unless the Gùvern-ment comes to the assistance of the committee which atpresent it absolutely declines to do.
Preservatives in Food.As previously stated in this column 1 the manager of a
