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IRELAND.(FROM OUR OWN CORRESPONDENTS.)

Housing of the Dublin Poor.AT the last meeting of the Statistical Society of Ireland a

paper was read by Mr. W. Lawson, LL.D., on the subject ofovercrowding in Dublin. There was a large attendance andthe Attorney-General for Ireland presided. Allusion wasmade to the extension of the provisions of the originalPublic Health (Ireland) Act, 1878, by the Dublin CorporationAct of 1890. It was pointed out that Section 20 providesfor the registration of tenement houses by the corporationand imposes penalties for irregularities ; while Section 30enables the corporation to make by-laws regulating thenumber of occupants and provisions of space. The by-lawswhich are in force at the present date were made by thecorporation on August 13th, 1902, and approved by the LocalGovernment Board on Sept. 3rd, 1902. The enforcementof these by-laws is necessarily a matter of difficulty andattended with great expense. A large staff is employedby the corporation, including six women inspectors. Theexcellent results obtained by the labours of the latter havebeen shown by the published account of the managementof the tenement houses in Grenville-street and Summer-hillwhich are owned by the Alexandra Guild Company. The

report of Surgeon-Colonel D. Edgar Flinn, medical inspectorof the Local Government Board (dated Nov. 30th, 1906),specially pointed out that the rate of mortality was highestin the most crowded and poorest districts, while it laid stresson the fact that a fee of £ 1 1s. per annum is now charged toowners of tenement houses for the cleansing of back yardswhich was formerly done without charge, and expressed adoubt as to whether this step in urban economy was really amatter for congratulation, very few owners having paid therequisite amount. The Alexandra Guild (Tenements)Co., Limited, was started by members of that guild with acapital of Z6000 and owns five houses (two in Summer-hilland three in Grenville-street) which contain 52 rooms andaccommodate 47 families, which include about 200 persons.Two families only had two separate rooms, while three othershad each an adjoining closet. The rents were those of the

neighbouring tenement houses, from Is. to 3s. 6d. per week,and a dividend of 2½ per cent. had been paid to the share-holders, leaving a ’’ balance carried forward," showing that the plan could be worked at a moderate profit at least, even whenengineered by volunteers. The Social Service (Tenements)Co., Limited, which was formed in 1900 by members of theDublin University, owned seven houses in Grenville-street. Therents vary from 4s. 6d. to 2s. for a double room, and from3s. to Is. 6d. for a single one. There had been a good dealof loss from bad debts and rooms unlet (from 10 to 13 percent.) which also limited them to a 2 per cent. dividend, andforced them to the conclusion that" until the public healthauthorities put severe pressure on the bad landlords it wouldbe very difficult for those landlords who endeavoured tomaintain their houses in a healthy and well-ordered state toobtain a fair profit." Statistics show that nearly one-thirdof the whole population of Dublin, including the entire

metropolitan registration area, is composed of labourers,hawkers, porters, and so on. In 1907 the death-rate in thisclass was 31 - 9 per 1000. The fact is also before us that 37of every 100 families of the population of this city live each ina single room. With these conditions staring us in the facethe obvious duties of our urban legislators can hardly bemade more clearly demonstrable.

1rish Medical Association.At a meeting of the Fermanagh branch of the Irish

Medical Association on Feb. 6th it was resolved that-

Though large sums of public money are paid to those who instructthe public in agriculture, dairying, fruit culture, the technicalities ofvarious trades, the care of cattle, fowls, bees. &c., &c., and notwithstand-ing that the community is taxed for the maintenance of hospitals andsanatoria for the treatment and cure of disease-much of which is pre-ventible-no public money has hitherto been available for the remunera-tion of those properly qualified to instruct the people in matters ofhygiene and the preservation of their health. Now that the legislaturehas at length recognised public health lectures as a subject of technicaleducation, and as one entitled to share in the local grants, it isno longer necessary to regard the services of the profession inlecturing and instructing the people as a matter of philanthropy.And while we consider such philanthropic societies as the Women’s aNational Health Association are deserving of every sympathyand encouragement, we are of opinion that their existence is the

strongest possible proof and condemnation of the neglect and incapacityof the Government, central and local, in matters of sanitation andpublic health. We are further of opinion that medical men shouldnot lecture under the auspices of such philanthropic societies, or at all,unless adequate remuneration be provided, and we suggest that thesesocieties should cooperate with the county councils for the selectionand remuneration of suitable lecturers. We desire to point out that it £medical men continue to give public health lectures gratuitouslyphilanthropy will bo usurping the functions of the Government andlocal authorities will never be given the opportunity of exercising theirnewly acquired powers of paying for lectures and instruction inhygiene and public health.

Infectious Disease in Ireland.During the four weeks ending Feb. 6th 166 cases of

infectious disease were notified in Dublin (26 being scarletfever, 24 diphtheria, 58 enteric fever, and 46 erysipelas),while in Belfast there were only 78 cases notified (25 beingscarlet fever, 14 diphtheria, 9 enteric fever, and 24erysipelas).

Old Age Pensions Act :Official Visitation.The action of the Government in despatching six officials

from Somerset House to Ireland to inquire into the workingof the Old Age Pensions Act in this country has elicited agood deal of comment from the Nationalist journals. Andmany of us who are not fixedly attached to any politicalprogramme are disposed to regard it as a work of superero-gation in this very ’’ previous " stage. The causes for theexistence of a larger proportion of claimants on thisside of the Channel are surely but too well known. Andit has been pointed out even by English papers that sofar from Ireland receiving more than her fair share ofthe Pensions Fund she is absorbing less than might havebeen expected in a land of proverbial poverty. The almost

I complete absence of other resources than those of landhas promoted the excessive emigration of the youngermembers of the population-that is to say, of the mosthealthy and vigorous members of that important section.This emigration current has continuously drained Irelandever since the middle of the past century and has continuedwithout intermission to increase the relative proportion ofthe aged and infirm and the victims of fragile constitutionsand of tuberculous and other chronic diseases. The DailyTelegraph has recently pointed out the contributory import-ance of our dwindling population in furnishing the apparentexcess in the proportion of Irish claimants to the benefits ofthe new Act.

Obitnary.The news of the death of Dr. Hugh Waddell, which took

place on Dec. 23rd, 1908, at the Arrow district hospital,Arrowtown, Otago, New Zealand, has been received withvery great regret by his many friends in Belfast and Ulster.The deceased, who was only 35 years of age, was

the eldest son of the late Rev. Hugh Waddell, B.A.,a Presbyterian missionary from the North of Ireland, atAzabo, Tokio, Japan, and was educated at the Belfast

Royal Academy and at Queen’s College, Belfast. Evenbefore completing his medical studies he showed signs ofpulmonary tuberculosis, and it was in the hope of regaininghis health that he went to New Zealand. For a time he did

improve and built up a very good practice, but the diseaserecurred and from it he succumbed. Dr. Waddell was amember of a very talented family and was a grand-nephewof Captain Mayne Reid, the novelist.

Feb. l6th. __________________

PARIS.

(FROM OUR OWN CORRESPONDENT.)

Acute Poisoning by Subnit’rate of Biq7nuth.AT a meeting of the Hospitals’ Medical Society held on

Jan. 22nd M. Bensaude and M. Rivet gave an account ofa young woman, aged 22 years, suffering from tuberculousstenosis of the small intestine. She had been in the habitof taking subnitrate of bismuth in doses of from 15 to30 grammes. She developed symptoms much like those ofmethsemoglobinasmia, such as difficulty of the respiration,convulsions, a subnormal temperature, and intense cyanosis.The patient was in a very grave condition for two daysbut nevertheless recovered. These symptoms, which haveoccurred a certain number of times since the extensive useof the subnitrate of bismuth in radioscopy, differ entirelyfrom the aural and intestinal symptoms which have been

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known for a long time and which are due to the impuritiesin the drug. The symptoms under discussion are due to theformation of nitrites and their absorption in the intestine.This happens especially in patients whose intestinal tract isdamaged. This does not mean that they must not be givensubnitrate of bismuth in therapeutic doses but that thecarbonate should be used in their case for radioscopicpurposes.

The Treatment t of Tetanus by Sulphate of Magnesium.At the same meeting M. Netter communicated a note by

M. Dobre upon a child, aged eight years, who died fromtetanus in spite of receiving an early injection of antitetanicserum besides an intraspinal injection twice repeated of twocubic centimetres of a 25 per cent. solution of sulphate ofmagnesium. The case showed, in spite of the unfavourableresult, the sedative effects of the latter procedure, for atemporary improvement plainly followed on the injectionwith no secondary aggravation of the nervous symptoms.It would appear right, then, to regard this remedy as onlysymptomatic, as the improvement is only transitory andaffords no hope of cure. The injection ought to be repeatedafter 24 hours.

The Treatment of Wounds of the Lung.At the Surgical Society on Jan. 20th M. Auvray described

three cases of wounds of the lung. M. Français operatedupon the two first. One was the case of a young woman, 27years of age, who had shot herself with a revolver at thelevel of the first intercostal space. An immediate operationallowed of the suturing of a wound situated near the apex ofthe lung, and in spite of the complication of an empyemathe patient made a good recovery. The second case was thatof a girl, aged 19 years, in whom the bullet had entered in thesecond left intercostal space 5 centimetres from the middleline. The gravity of her condition forced M. Français tooperate without an anaesthetic. He turned back a largethoracic flap and sutured the wound of the lung (which he haddiagnosed), but the patient died on the next day. The thirdcase was that of a man 30 years of age. M. Auvray operatedwithin five hours of the accident, when there was alreadysevere surgical emphysema of the thorax, neck, and head.He cut an osteo-cutaneous flap and sutured a wound in theantero-external surface of the lung. The patient died on thethird day, probably from haemorrhage rather than frominfection, but no necropsy was performed. M. Auvray con-siders that as regards the procedure to be adopted in

operating it is impossible to lay too much stress on the

necessity for a systematic search in every case for thehole of exit of the bullet from the lung on its posterior andthe back part of its interior surfaces. In M. Auvray’s case, inwhich this precaution was omitted because from the shapeof the pulmonary wound it was thought that the bullet hadnot traversed the lung, it is very probable that the patientdied from an undiscovered wound at the back of the lung.The drainage of the pleural cavity is another point of greatimportance in the treatment of wounds of the lung. Drainagefrom below is the best safeguard against the infectivesequelse to retention. It must still be considered thatsurgical intervention should only be employed exceptionallyin dealing with wounds of the lung, and that an expectanttreatment is the most desirable policy.

Suppurative Folliculitis of the Beard Treated by RawCoal 1 ar.

At a meeting of the French Society of Dermatology andSyphilography M. Brocq and M. Fernet showed a patientwho for ten months had been suffering from folliculitis of thebeard. Various methods of treatment having been tried invain a layer of raw coal tar was painted on with the resultof a rapid improvement.Feb. 16th.

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BERLIN.(FROM OUR OWN CORRESPONDENT.)

King Edward’s and Queen Alexandra’s Visit to Berlin.DURING their recent visit to Berlin King Edward and

Queen Alexandra at different occasions came in touch withmedical men and also showed a great interest in medicalinstitutions. At the reception in the town hall ProfessorKoch, who is one of the "Ehrenbürger"-honorary citizens-

of this city, was introduced to, and had an interviewwith, His Majesty. At the special request of the King,Professor von Renvers, the body physician of the late

Empress Frederick, was also present. The Royal couplevisited the Empress Frederick House for post-graduatestudy, an institution which has been described in thesecolumns. This institution was under the patronage, andconstructed after the plans, of the late Empress but sheunfortunately died before it was finished. King Edward hadpreviously shown his interest in the institution which bearsthe name of his deceased sister by sending a special represen-tative to the opening ceremony a few years ago. The Royalparty, including a numerous British and German suite,"was received by the president of the central committee forpost-graduate study, Professor von Renvers, and by thedirector of the Empress Frederick House, ProfessorKutner. They were shown over the premises and visitedthe historical department, which is under the care ofProfessor Hollander, the nursing department, and alsothe lecture rooms, where Professor Kutner delivered ashort lecture and showed lantern slides. The Queen,together with the Empress, visited the Virchow Hospital,one of the largest and finest hospitals of the world, con-structed at an expense of 13,000,000 marks ( £650,000) bythe city of Berlin. Their Majesties were received by themayor of Berlin ; the administrative manager, Dr. Ohlmiiller ;and by Dr. Goldscheider, chief physician, and Dr. Hermes,chief surgeon. Several wards were inspected and the Queenexpressed her satisfaction at the splendid and lavish arrange-ments of the hospital. Unfortunately, His Majesty the Kinghad caught a slight chill owing to the unusually coldweather, so that he was obliged to call in a Berlin laryngo-logist-an interview which was originally not on the pro-gramme of his visit.

Cancer Produced by Roentgen Rays.Dr. Coenen of Breslau, writing in the Berliner Klinische

Wochenschrift, describes the case of a man, 41 years of age,who had been engaged in radiographic work for ten years.He had suffered from dermatitis on the hands for severalyears ; three months ago painful ulcers developed on twofingers. A portion was removed for microscopical examina-tion and it was ascertained that the ulcers showed malignantcharacteristics. Both fingers were accordingly removed andthe wounds healed by primary union. Cases of malignantgrowths caused by Roentgen rays are not unusual, andseveral have been described by German and English authors ;they were nearly all carcinomatous, and Dr. Coenen is of

opinion that they are caused by a chronic irritation of theepithelium produced by the x rays. The genesis of the

"Roentgen cancer " is still inexplicable in view of the factthat by the same kind of rays a cancer may be both producedand cured.

South-West Africa as a Health Resort for the Tuberculous.Some time ago it was proposed to settle tuberculous

patients in German South-West Africa, where the air wassaid to be specially favourable to this class of patients. TheGerman central committee for the fight against tuberculosislately considered this proposal but declined it. It was decidedneither to settle tuberculous people as colonists nor to sendthem to the colony for a temporary stay in sanatoriums. Itwas argued that the efficacy of the climate of South-WestAfrica was not yet sufficiently proved and that the expensesof a trial would be high. It was, however, decided to

support tuberculous people living in South-West Africa by acertain grant of money.

Feb. l6th. __________________

ITALY.

(FROM OUR OWN CORRESPONDENT.)

Small-pox in Parma.PARMA, on the main line of travel from Milan to Florence,

Rome, and Naples, has just witnessed an outbreak of small-pox which, happily, seems to be now circumscribed. Asoldier died at the military hospital from variola which hehad brought with him from a district in the Marches. His

linen, by some unexplained inadvertence, had passed to thelaundress without being disinfected. She took ill of thesame disease, as also did a subordinate of hers. These twowere at once isolated, not, however, in a special locale for