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last week Dr. Charles Moore recently addressed an ableletter to the Irish Times directing attention to manymeasures not involving much expense which shouldbe attended to without delay-the removal of dairiesfrom the dirtiest portions of the city, the closureof small slaughter-houses, &c. It is not the first

time that Dr. Moore has written on these subjects, but

nothing seems as’ yet to have been done furtherthan the periodic inspection of such places by theofficers of the Public Health Committee. It is generallystated and believed that the present epidemic of typhoidfever-of which 100 cases were notified during the weekending Sept. 30th-is traceable to infected milk from certaindairies.

Commencement of the Medical Session.

At all the medical schools and clinical hospitals of Dublinlectures were commenced on Oct. 2nd. The inauguraladdresses at those hospitals where such are customary beganat St. Vincent’s Hospital on Oct. 3rd, when Mr. Tobinspoke to a large audience of students and visitors. Dr. JohnWilliam Moore, the President of the Royal College ofPhysicians of Ireland, will formally open the session at theMeath Hospital on Oct. 9th.

Officers of County Infirmaries in Ireland.The Local Government Board have recently announced

that they are advised that no paid officer of the infirmariescan be a member of the governing body thereof.

Medieal Dispensary Officers and their Holidays.A memorial has been sent from the Belfast Board of

Guardians to the Local Government Board asking for arevision of their decision allowing dispensary medical officersfour weeks’ holiday, their substitute to be paid by the

guardians. In the memorial special stress is laid on the factthat "not exceeding twenty-eight days" means that thelocal authority have a discretionary power to grant a shorterperiod.

The Ne7v Hospital for Co. Tyrone.The Ducliess of Abercorn is to open the new hospital in

Omagh on Nov. 13th. It is hoped that there will besufficient money to allow the hospital to be lighted withelectricity and that it shall be begun free from debt.

Belfast Medical School.The winter session will begin on Oct JL7th both at Queen’s

College and at the Royal Hospital. Dr. Calwell has beenelected medical registrar in place of Dr. MeKisack.

The Belfast Union Infirmary.At the usual weekly meeting of the Belfast Guardians on

Oct. 3rd the following were elected visiting medical officers :Dr. James Lynass and Dr. John McLiesh. Both of thesegentlemen have been former resident medical officers in theUnion Workhouse.Oct. 4th.

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PARIS.

(FROM OUR OWN CORRESPONDENT.)

The Academy of Medicine.THE Academy of Medicine recommenced its sittings on

Sept. 19th, the President being Professor Panas. Althoughmany medical men are still away there was a very fairattendance at the first sitting. In the lobbies the chiefsubject of discussion was the new Academy buildings in theRue Bonaparte. The works are being pushed forward withgreat rapidity and it is hoped that the new buildings will beready for opening next year during the Exhibition. Amongthe papers read at the first sitting was a communication fromDr. Moncorvo of Rio de Janeiro, a corresponding member ofthe Academy. It dealt with a new method of differentialdiagnosis between disseminated tuberculosis (granulie) andcommencing intermittent fever in children. The methodconsists in smearing (badigeonnages) the skin with guaiacol,which procedure causes a rapid fall in temperature if thefever be due to tuberculosis, but has no such effect in casesof malaria.

e The New Sanatorium at Hendaye.y A new sanatorium has just been opened at Hendaye for

poor and puny infants of the city of Paris, and M. Lucipia,s the President of the Municipal Council, has recently paide his official visit. This sanatorium, together with those at

Berck-sur-Mer and Angicourt, makes the third of the kind<t erected by the city of Paris. The construction leaver

r nothing to be desired so far as attention to modern prin-eciples of hygiene goes. It is situated a little over two miles.

from Hendaye at the mouth of the Bidassoa in a shelteredIbay and consists of eight isolated blocks, four for girls and

four for boys. Some of the buildings are fitted as studiesfor the children and have large playgrounds looking overthe sea. There is also an observation block for new arrivalswith 26 beds and an infirmary with 17 beds. Altogetherthere is room for 200 children. The Municipal Council

1 has apparently decided to build many other similarestablishments, but unfortunately the work cannot be pushed.on as fast as the buildings could be taken into use

on account of the expense of the buildings and therelatively small number of children that they can contain.

; So already numerous other more economical projects are inthe air. Dr. Dufournier, one of the physicians attached to-the Bureaux de Bienfaisance of Paris, thinks that tuberculouschildren should be boarded out in cottage homes in thecountry in the same way that imbecile children are treated.

, Of course it goes without saying that strict medical super-’

vision would be required and every hygienic precautiontaken so that the children should not be centres of infectionfor their hosts. On the other hand, M. Blondel, a

. member of the Municipal Council, proposed some time

.

ago that the city of Paris should make use of landed

6property situated in the country, which it could obtain at,the lowest possible rates, as sites for colonies of weakly,anaemic children who were prone to become tuberculous, andshould place them under the care of members of its ownstaff who were in need of rest. This method would be a muchless costly one for the city than the building of palatial>sanatoria and the children could be restored to healthwithout interruption to their studies. On the prin-ciple that example is better than precept M. Blondelhas just handed over to the city of Paris a propertybelonging to his family near Nogent-le-Rotrou. Itconsists of six hectares of garden and meadow landwith various farm buildings which can easily be made-into dormitories, dining-rooms, and class-rooms. It hasbeen suggested to build other colonies of this kind inTunisia, and Professor Landouzy, who is the moving spiritin France in favour of sanatoria, has had several communi-cations on the subject with M. Millet, the French Resident-General at Tunis. Such sanatoria for elder children wouldbe at once training schools and centres of colonisation. Un-fortunately the cost of moving the children and the absolute-separation from their families which this plan would necessi-tate put serious obstacles in the way of this method beingadopted. As far as the sanatoria in France are concernedthe railway companies make substantial reductions in the.fares for the children and their parents when the lattermake a visit to the former.

Return of the Pasteur Institute Plague Commission.The commission, the members of which were Dr. Calmette

and Dr. Salembeni, sent out by the Pasteur Institute to-

study and fight against the plague in Oporto returned toParis on Oct. 2nd. The members of the Pasteur Institute-feted Dr. Calmette who has returned delighted with the resultof the commission-such being, in fact, a complete triumphfor the anti-plague serum. The International Commissionappointed to examine the question had come to the.unanimous conclusion that Yersin’s serum was worthyto be extolled as a preparation of value. No doubt.exists of its efficacy as a preventive and after thefirst few days’ excitement and rioting, during which.Dr. Salembeni was injured by being hit on the knee with astone, the inhabitants of Opcrto finally recognised the-benefits of the inoculation and during the last three days.Dr. Calmette inoculated 423 workmen, firemen who carrieddead bodies, and small shopkeepers. The members of the-commission in the first place inoculated themselves. The.

efficacy was, however, less in cases with decided symptoms.Dr. Calmette was successful even in serious cases by in-jecting the serum directly into the veins. Dr. Calmette-thinks that the Portuguese might easily free themselvesfrom plague if they would rigorously carry out the

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measures which have been recommended to them and inparticular if they would carry out inoculation of all theinhabitants of the suspected quarters. The immunity con-ferred by the inoculation lasts 25 days at least, theadvantage of such immunity being capable of indefiniterenewal by re-inoculation. Unfortunately the inhabitants of’Oporto carefully conceal all cases of contagion. Dr.Oalmette quotes a case in which the body of a person deadfrom plague was concealed in his house for three weeks.The only patients brought to the hospital ,were those whohad no family to keep them in hiding ; the greater partwere admitted in a hopeless state. Dr. Calmette frankly,expresses the opinion that it is impossible for the plagueto establish itself in France and to develop there even in theimprobable event of its importation by cases in the stage ofincubation.

Oct. 4th.

ROME.

(FROM OUR OWN CORRESPONDENT.)

A Statesman on Hygiene."SANITAS sanitatum, omnia sanitas," said Mr. Disraeli

on the eve of that General Election in 1874 which returnedhim to power with a sweeping majority. " Sanitas sani-tatum, omnia sanitas," said his Italian counterpart, FrancescoCrispi, when, in 1888, he carried his "Legge per la tuteladell’ igiene e della sanita pubblica." Herein he showedhimself a true statesman-a truer statesman, many will bedisposed to say, than when he helped to organise the TripleAlliance and developed that policy of colonial expansionwhich has not hitherto been favoured by fortune. At therecent Congress of Hygiene held at Como ProfessorBizzozzero of Turin passed in review the sanitary adminis-tration of Italy prior to the Crispian epoch, dwelling par-ticularly on the law of 1868 which fused down into onesystem the enactments hitherto in force throughout theseveral States of the kingdom. That fusion was indispensableas a preliminary, but it had the grave defect of leaving thesafeguard of the public health almost exclusively in thehands of the political and administrative authorities,so that the initiative was withheld from the onlybody capable of taking and directing it aright-to wit,the medical. No regulation suggested by clinical

experience or scientific induction got a fair hearing ;disease, zymotic in origin and epidemic in sway, had freecourse ; action, defensive or precautionary, was inspired byfear ; perfunctory quarantine and sanitary cordons, whilealmost inviting the enemy, wrought serious mischief to thecountry’s commercial and economic interests. All this

Signor Crispi saw-saw, moreover, through eyes stillkeener than his own, those of his friend and fellow

patriot Agostino Bertani, who having sacrificed to-the revolution one of the finest surgical intellects knownto the nineteenth century passed from his Genoese

clinique to Garibaldi’s several expeditions as director-in-chiefof their medico-chirurgical department. The unity of Italyachieved, Bertani lost no time in proclaiming his special con-tribution to the country’s regeneration, a contributionembodied in the memorable words : " In no other way canGovernments more effectively safeguard the less favouredclasses than by protecting them from the manifold assailantsof their health, physical and mental." With such a

counsellor at his elbow Crispi set about his great measureof sanitary reform, and by December, 1888, he had com-pleted it, carried it through Parliament, and made it law.And very thorough the " Codice Sanitario" " was-the jointwork of the Genoese surgeon and the Palermitan jurist.Beginning with the "risanamento" of the soil and the

dwelling-houses erected on it, its next provisions includedthe supply of "acqua potabile" and of unadulterated food.Thereafter was created a school for training the personnelcapable of carrying out its manifold regulations, withlaboratories for hygienic analysis and research and for thepreparation of vaccine and serum in all their varieties,preventive and curative ; while apparatus or methods foundto be useless were replaced by others really effective,until the establishment of sanitary stations, inland and

maritime, vouchsafed the people a rational protectionand with it the confidence which it brings, protectionagainst epidemics, against epizootic disease, against imported

n maladies generally-all this, moreover, without prejudice toe commerce or inconvenience to the travelling world. Tested

by results, Professor Bizzozzero had no difficulty in showinge the salutary working of the Bertani-Crispi law. In 1888e mortality in Italy oscillated between 28 per 1000 and 34 perf 1000. Now it has sunk, by successive, almost annual,’. gradations to 22 per 1000, "with an economy of vitald energy, an appreciable diminution of maladies, and with3. signal advantage to the tranquillity, the decorum, ando the material prosperity of the nation." True, the besetting

evil of Italian political life (its frequent changes of Mini-y stries, and the consequent I solution of continuity" ine administration) has hampered, even hindered, the workinge of the "Codice Sanitario"; but, on the whole, it bids fair.f to have a future worthy of its origin and its inception

and, as shown by such test-cities as that great entrepotof travel, Milan,l justifies its raison d’etre even beforethe outside world. I have been led into these observa-tions by the interesting ceremony to be solemnisedin Palermo on Oct. 4th-the celebration of the eightiethbirthday of Francesco Crispi. Nor am I alone in singlingout for special commendation in his life-work the greatsanitary reform which he effected in concert with Bertani.Not only do Professor Bizzozzero and the Congress just heldat Como indicate that reform as the crowning achievement

li of his career, but nearly all the lay press of Italy join ind the chorus of acclamation.i- Oct. 2nd.

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:0 - ’-

NEW YORK.

(FROM OUR OWN CORRESPONDENT.)

The Relative Cost of Free and Paying Patients.IT appears that during the last fiscal year the number of

pay patients in the Massachusetts General Hospital was 1778;the number making partial payment was 175 ; and those re-ceiving free service was 2854. Those of the first class received5322 weeks’ service and those of the last class 7897 weeks.The value of the work received by the free patients of thehospital amounted to$103,734.64, while the income from thepay patients was$66,774.19. Examination of the returns ofthe McLean Hospital at Waverly, Mass., for the same yearshow that pay patients brought to that hospital$186,769,92;the number treated was 155 and the cost per week percapita was$26.84. Payments from those paying in partamounted to$167,723.16, the total amount from these

patients being $93,735 ; hence the charity dispensed bythe institution was valued at$73,988.16 out of a totalexpenditure of$218,673.60.

Railway Accidents in the United States.The statistician of the Inter-State Commerce Commission

states, in the " Statistics of Railways in the United States,"that more persons were killed or injured by railway accidentsduring the year 1898 than in any year since 1893. But it isan interesting fact that the remark does not apply to

passengers. The increase was confined to employes and isbelieved to be due to the necessity of employing an unusualnumber of inexperienced persons on account of the greatincrease of traffic.

The Quarantine at New -York.The allegation that the outbreak of yellow fever at

Hampton, Virginia, was caused by a case which passed theNew York quarantine has induced the health officer of thisport to explain fully his method of proceeding. He says:"Since May lst every person arriving at this station on

vessels from Cuban ports has been held at quarantine for aperiod of five days from the time of embarkation unless he orshe presents an immune certificate issued by a representativeof the Marine Hospital Service at the point of departure.Not one exception has been made. If the passengers arriveon a United States transport the vessel is detained inquarantine with the passengers aboard, under the constantsupervision of a member of the medical corps of the UnitedStates Army. At the expiration of five days from the timeof embarkation, and after a report from the surgeon incharge that all are well, the passengers are brought to thedeck and personally examined before the vessel is released.

1 The Health of Milan, THE LANCET, Sept. 30th, 1899, p. 902.