848 ’ i

been exhausted by farmers ignorant of the first principles ofcorrect farming. The inquiry extends to the sanitary con- dition of the homes of farmers which will prove of greatimportance as these conditions are entirely neglected by thegreat majority of farmers and their wives. Collections ofwaste in and around the home are constant sources of ill-

health but are never recognised by the family. The food of

the farmer is generally rudely prepared and often of objec-tionable quality. It is a common saying that the "farmereats what he cannot sell." It is believed that this Govern-ment inquiry will lead to the issue by the Department ofAgriculture of literature to the farmers relating to the

sanitation of their homes, the best methods of preparing’foods, the sources of preventable diseases of domestic

origin, and other useful information relating to methods ofliving.’ .

Sept. 1st.

NOTES FROM INDIA.

(FROM OUR OWN CORRESPONDENTS.)

The New Principal Medical Officer of India..Surgeon-General F. W. Trevor, C.B., honorary surgeon to

his Excellency the Viceroy and Governor-General of India,bas been appointed, and has taken over the duties of, PrincipalMedical Officer of His Majesty’s Forces in India, vice

Surgeon-General W. L. Gubbins, C.B., M.V.O., V.H.S.,vacated on appointment as Deputy Director General, WarOffice. Surgeon-General Trevor has had a very distinguished.career, having first seen active service in the field in the Afghanwar of 1878-80. He also served in the Soudan expedition of1884-85, and again in the Boer war, in which he wasprincipal medical officer of a division. In 1906, on pro-motion to surgeon-general, he was appointed principal medicalofficer Western Command, India, and received a C.B. in the.birthday honours of June, 1907. Surgeon-General Trevorgraduated at Aberdeen, taking his M. B. degree in 1874.

Conservancy in Indian Municipalities.On many occasions, when inspecting municipalities, the

great waste has been noticed of valuable fertilising materialwhich occurs owing to the prejudice of cultivators againstusing poudrette, or night soil which has undergone destructivechanges after burial in earth to which it has yielded itsnitrogen. Cantonments are generally much in advance ofmunicipalities in this respect and are more alive to thefinancial aspects of the problem. Where no sale for

poudrette is possible it ought to be the endeavour of the

municipal authorities to take up ground and shallow trenchit. No more striking example of the advantages of thesystem and the profit to be made out of it can be quotedthan the case of Bareilly, where for years the cantonmentauthorities have been taking up land and trenching it inshallow trenches 16 feet by 5 feet by 1 foot on the plandevised by Lieutenant-Colonel Thornhill, LA., now Inspectorof Cantonments. Trenches are dug 16 feet long, 5 feetbroad, and 1 foot in depth, with 6 inches interval’between each trench and 6 inches between each line oftrenches and the soil removed is thoroughly pulverised-an.essential point. Two inches of pulverised soil are returnedinto the trench and the contents of one or two night-soil,carts, depending on size, are tipped into the trench to whichthe remaining earth is returned. Where the night soil is

largely mixed with earth or sweepings it is not necessaryto return all the earth. A depth of one foot is necessary,otherwise there will be smell and flies will breed. The land.so trenched, even if of the poorest description, will notrequire remanuring .till the third or fourth year. The land is

usually disposed of by auction and at Bareilly Rs. 30 perbigha rental is paid ; this is got for land that previously letfor Rs. 5. The Indian cultivator takes all the strength whichhe can out of the soil and gives back very little nitrogen.Even allowing for the rotation of crops and elaboration bynitrifying bacteria the land would be much more productivecould the cultivators afford to use nitrates.

The Sullage Farm at Agra.The sullage farm at Agra, which was started in 1903 as a

protection to the Jumna which was being much defiled, hasresulted in a great practical and financial success. Thesullage is run on to the large island below the railway bridge.

Most luxuriant crops have resulted, and the municipalityinstead of spending money on a costly plant and upkeep,now receive lis. 4000 per annum from rental, while thecontractor receives double that sum.

Sanitation in Cities.

Sanitation is largely a matter of money, but the sanitaryofficer has to see that the money is well spent on improve.ments that will bring health, comfort, and well-being to theinhabitants. Sanitation in India is essentially slow in its

progress,but that it is becoming more appreciated by the peopleis undoubted. ’ At first the prejudice and distrust of a filteredwater-supply were great, but now it is very popular andgenerally preferred to the questionable supply taken from themohalla well. It is hoped that in a few years well-drainedand well-ventilated dwellings will largely displace thepresent insanitary ones of the classes. Broad streets, suchas those lately made in Cawnpore and Lucknow, are of

great benefit. They open up congested areas and allow lightand air to enter into badly constructed dwellings. Drainageand paving schemes are of inestimable value. Unsightly andinsanitary cesspools which pollute the air, soil, and water,are abolished, and in the monsoon traffic is easier and,locomotion is possible in comfort. With plague epidemic.in the provinces sanitation has become a, question ofvital importance, and as sanitary problems are solvedthe foothold which it has obtained will be rendered lessand less secure. The fact, however, is that municipalitiescannot bear the expense of twentieth century sanitationwithout grants in aid from the Government. The manycalls upon these bodies and their conservancy chargesare always as much as they can cope with, while in most ofthe large cities there are in addition loans and sinking fundsto be provided for. If these drainage schemes, markets,and other very necessary improvements are to be carried outthere is no other way than the provision of funds from theGovernment, and the Government of India has provided fivelakhs in the provincial budget this year for this purpose.

I’ever in Burma.

Nearly half the total number of deaths recorded in Burmalast year are entered under the head of fevers. This nodoubt includes a large number of deaths due to causes otherthan malaria fever, but it is certain that malaria is,

responsible for a heavy mortality. It is satisfactory,therefore, to learn that there has also been a very largeincrease in the sales of quinine in the province. A machinehas been obtained for the manufacture of compressed tabletsof quinine which are more readily taken by Burmans thanquinine in the form of powder, and it is hoped that by thismeans the distribution of quinine may be much more com-plete than has been the case hitherto. ,

The Order of the Royal Red Cross. Miss E. A. Wildman, who came out to India in 1900 and

has served in Burma, Madras, and latterly in the Punjab, isat present on leave in England, but on her return to Indiashe will take up the appointment of lady superintendent ofthe Military Nursing Service in the Bombay Presidency,Miss Wildman is the latest recipient of the Order of theRoyal Red Cross.

August 13th. _______________

NOTES FROM CHINA.(FROM OUR OWN CORRESPONDENT.)

Child MortaZity.ALTHOUGH the Chinese are a prolific race there is a high

counterbalancing child mortality , rate, and it would beinteresting in these days when the question of race suicide iscoming more and more into prominence at home to considerwhether there are not certain limits in which the now

generally discredited Malthusian doctrine may not have somepoints in its favour in countries such as this, where there isso high a percentage of deaths among the young and wherean easy fecundity is not attended by a due sense of intelligentmaternal responsibility. The mortality is so, great thatburial in coflins (such as adults get) is unknown for infants.As one wanders through the streets one often meets a cartmore or less full of bundles of various sizes, the bodies ofdead children wrapped in old matting. They are taken

849

o&6side the city and. thrown altogether into a large hole.A Chinese "mother does not speak of having buriedher child; she refers to, it as having been thrownout thus: "I have thrown four children." The two chief

causes of death are tuberculosis in all its manifestationsand improper diet with its train of intestinal disorders.Although it is the national custom to suckle a child for twoyears the’second year of its existence is full of rocks andshoals which, if they do not wreck it, cause every child moreor less digestive trouble, as there is no proper system ofinfantile dieting ; and in summer time especially, when fruitis abundant, diarrhoea and dysentery are illnesses from whichalmost every child suffers. A mother will give her fifteen-month old infant a big slice of melon and allow it to gnawthis down to the fibrous rind. Being somewhat struck bythe numbers of children who are brought to hospital inserious condition I recently made a census in the BritishCharitable Hospital, Peking (an institution which treats over10,000 cases per annum), of the numbers of living and deadchildren each mother had had with the following results :1000 mothers had a total of 4723 children, of whom2342 were alive and 2381-more than half-were dead.The average age of the mothers was 39 years and theyhad been married on an average 20 years. Of the sur-

viving children, 1301 were males and 1041 were females,1253 of the dead were males and 1128 were females, so thata larger proportion of the latter than of male children die.These figures are taken from ,the lower middle class andthe poor. Without doubt this represents a mortality whichis largely preventable. There is indeed a wide scope for theefforts of the medical reformer in China, and the work liesamong a people who are not fettered by caste disabilitiessuch as pertain in India and some other parts of the Orient.

, Intestinal Parasites.In continuance of the observations made in a previous

letter on the high prevalence. of intestinal parasitism inChina it will probably surprise helminthologists to hearsome of the results of Dr. J. L. Maxwell’s recent series offascal examinations in Formosa as quoted in the l/ltinaMedical Journal. Of 1000 male cases passing thoughhis hands for all diseases the total infection was 905.Towards the end of the observations the increased practicemade the positive percentage higher than at the beginning,and Dr. Maxwell thinks it no exaggeration to say thatthe whole population is infected with intestinal parasites.No eggs were discovered belonging to any other worm thanthe three common ones-ascaris lumbricoides (found 765times), trichocephalus dispar (491 times), and ankylostomumduodenale (436 times) ; on two occasions oxyuris vermiculariswas found. 70 per cent. of infections occurred amongcoolies working as’farm hands and only 26 per cent. amongthe leisured classes and those engaged in business. Thoughthis difference is ascribed mainly to the fact that the cooliesare constantly engaged in watering the gardens with liquidmanure it, is probable that the careless and less cleanmethods of preparing their food combined with overcrowdingare more potent factors in the spread of infection. Theentire absence of ground-itch in Formosa makes it unlikelythat infection could be due to the passage of the embryothrough the unbroken skin of the feet and legs. With regardto the clinical significance one looks in vain in all thereports to hand from various localities for any note ofinterference with normal health as a result of infection

by ascaris or trichocephalus. Sometimes flatulent colicis complained of by the "hosts" " of the former worm butthe latter appears not to cause any discomfort. Nor is thecase different where the parasite is ankylostomum duodenaleexcept where there is a constant re-infection and theparasites become numerous enough to cause the condition ofankylostomiasis, but this stage is not often reached. Thesmall pathological importance of opisihorchis sint-nsisreferred to in the Journal of Tropical Medicine (February,1908) by Dr. C. M. Heanley of Hong-Kong is also confirmedby Dr. Maxwell who is unable, after an examination of over3000 Cantonese cadavers, to say whether this worm everproduced any disease.

The Suppression of Opium.The present condition of the opium question in China

is this. A great wave has spread over the empire illfavour of suppression and it is now plainly not thefashion to smoke opium. Numbers of anti-opium societies

have been formed among the people,, mostly by youngChinese with reform tendencies. These societies pledgethemselves to do all in their power to discourage the,habit. The Government continues to issue edicts andimperial notes degrading opium-smoking officials and

threatening them with dismissal. It is showing everyevidence of being sincere in its attempts to help the countryto throw off this yoke. The questions for the comingShanghai International Conference are taking definite shape.In fact, theoretically, everything is going on well, but thereis still a vast amount of smoking being indulged in, especiallyby the middle and lower classes. Though opium dens maybe closed the owners manage to carry on their trade

surreptitiously, and in some parts of the empire, as

for instance, at Kueiyangfu in the prefecture ofKueichon, opium is bought and sold openly in thestreets, notwithstanding the official closure of everyopium den in the city. During the past few months.an American (Mr. C. B. Towns) has appeared with-introductory letters from officials at Washington and withvarious testimonials testifying to his ability to cure in threedays all those who have become habituated to the drug.Some mandarins have submitted themselves to him andafter having come successfully through the course of treat-ment have so loudly proclaimed its virtues that the Govern-ment Anti-opium Bureau has taken the vendor under itswing and has helped him to open an institute for thecure of victims. The remedy appears to be one of thoroughsaturation with belladonna; this is continued by two-hourly;doses night as well as day and results in a pronouncedantidotal antipathy to opium. But no observations have,as,yet been maac on tne numoer or cases or recurrent craving,.a common feature in so many opium cures. The difficulties,to be overcome are enormous and more than ever is itnecessary to insist on the importance of giving the Chinese,,and not only them but our colonial authorities at Hong-Kong,freedom from any worry as to further hastening measures.Every month sees a certain amount of progress being made..

Cholera. ’

Cholera has been rife of late at Hankow. During the pastfew weeks three foreigners have died from it as well as a

good number of Chinese. Sporadic cases have also appeared.in Peking. There are also many cases of diarrhoea of a.choleraic type, and this is not to be wondered at when one,sees the innumerable itinerant fruit stalls where over-ripefruit is exposed for sale, as also sliced melon which iskept sprinkled with impure water and is covered with flies.August llth.

_______________ ,

AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.) .

An Australian Medioal School: a Remarkable Record.THE medical school associated with the University of Sydney’

(New South Wales) is just completing its twenty-fifth year ofexistence and the story of its development is an interestingone. When the school was founded in 1882 there was a-

professor of physiology but no medical degree was given,and when the faculty of medicine started there were only four students, of whom at times the attendance of one formedthe whole class. The building available for this littlecoterie consisted of one-half of a four-roomed building,the other half being devoted to the department of biology,and from these small beginnings has arisen almostmushroom-like a school numbering at the present time350 students in medicine who are housed in a palatialGothic building which compares most favourably in

appearance, accommodation, and equipment with mostof the buildings devoted to medicine in Great Britain.The genius of the school and its founder is ProfessorAnderson Stuart. M.D., LL.D., who, after having been goldmedallist at Edinburgh, was chosen in 1882 as professor of-anatomy and physiology, when he was occupying the positionof principal demonstrator and assistant to the late ProfessorRutherford in Edinburgh. Professor Stuart was naturallynot altogether impressed with the dimensions of his class orits home on arrival, but he had a prescient eye and inimagination saw the school he could make of it, with the,result that he set himself to work with a fixed determination