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1490 T acquisition of the sanatorium by the town and then asking them to cancel an honourable agreement. He also added that he was willing to make good any deficit (not exceeding £300) which might arise on the working of the sanatorium on its present lines from May lst to Dec. 31st of this year. Presentation to an, Inverness Practitioner. On May llth Dr. G. W. England Kerr of Inverness was, on the occasion of his wedding, presented with a beautiful motor car and with a purse of sovereigns, while his wife also received a gift. Mr. James Ross, rector of the Mackenzie School, made the presentations on behalf of the subscribers, who numbered over 1800. Keith Town Omtncil and Pulmonary Tuberculosis. At a meeting of the Keith town council, held on May 10th, it was decided to include pulmonary tuberculosis among notifiable diseases. May 18th, IRELAND. (FROM OUR OWN CORRESPONDENTS.) Mortality in Irish Towns. THE second week of the present month showed a more favourable death-rate record than any of its predecessors for a number of years. The rate fell from 23 per 1000 of the population in the previous week to 18’ 75. The average of the four preceding weeks had been 23 - 5. The highest death- rate of the second week of May which occurred in Ireland was that of Kilkenny, which reached 39 3. No deaths occurred in Clonmel, another favourable contrast from the 36 per 1000 of the week preceding. In three other town districts only was the rate below 10 per 1000 : Drogheda (8 - 2), Sligo (4’ 75), and Galway (4). The death-rate of Queenstown reached 33. The total number of deaths which occurred in Dublin was 133, the number of births being 301. During the 18 weeks which ended with the second week of this month the average death- rate of Dublin was 26-5 per 1000-being 1-5 below the average for the corresponding periods of the past ten years. The deaths from whooping-cough fell to four, as against 13 of the previous week. Those from tuberculous disease fell from 33 to 29, which included 23 from pulmonary consump- tion. There were no fresh cases of whooping-cough reported in the city area, but 14 cases were reported from the Pem- broke township. Four cases of scarlet fever occurred in Rathmines. There were seven cases of diphtheria reported in the city and one in Rathmines; the other townships remained free. The Medical 0"yceer of Health of BeVa8t. In reply to a letter of the public health committee asking the Local Government Board to reconsider its decision regarding the proposal of the Belfast Corporation to increase the salary of the medical officer of health, the Local Government Board has written that it was unable to vary its decision and that it saw no reason for departing in this case from its usual practice of requiring a period of five years’ service before sanctioning increase in an officer’s salary. The health committee has expressed its regret at this decision which is final. Ballykelly Dispensary. Dr. J. R. Ross has just been obliged, owing to the state of his health and his age (69), to tender his resignation of the office of medical officer of Ballykelly Dispensary, a position which he has held for 42 years. At a meeting of the Limavady board of guardians held on May 17th the resignation was accepted and a resolution was unanimously passed acknow. ledging Dr. Ross’s faithful services, particularly to the poor. The Queen’s University Commission. This Commission began further sittings on May 17th a1 Queen’s College, Belfast. The selection of the new pro. lessors and lecturers was considered ; and deputations were received from the Technical Institute in reference tc coordinating university and technical education, and fron the other institutions in regard to recognition as a teaching institution, May 18th. PARIS. (FROM OUR OWN CORRESPONDENT.) Isotonic Sugar Solutionsfor Injection. AT a recent meeting of the French Society of Military, Medicine M. J. Labougle and M. Boutin communicated, a paper in which they called to mind the undesirable results, which sometimes occur from injections of saline solutions, even when they were isotonic, and they proposed the replace- ment of the sodium chloride by sugar. A solution composed of 10’ 30 grammes of sugar in distilled water is, they state, perfectly isotonic, is cryoscopic in the same degree as the blood serum, is non-toxic, and has been employed with the greatest success in various cases of serious illness, such as typhoid fever, malaria, and septicaemia. These sugar injec. tions have the same good effects as those of artificial serum, without giving rise to the disagreeable effects which the latter sometimes produce, and they can be used without risk even in patients suffering from acute albuminuria. Moreover, they produce abundant diuresis. The only, contra-indication to their use is diabetes. Ophthalmia in the Newly Born. At a meeting of the Academy of Medicine held on May 4th M. Motais read a paper in which he advocated the use of protargol instead of nitrate of silver in the treatment of ophthalmia of the new-born infant. The eyelids are everted and gently washed with a solution of potassium permanganate of a strength of 1 in 400. Then two drops of a solution of protargol, one gramme to five grammes of distilled water, are dropped into the eye every three hours, day and night, for two or three days, until the secretion becomes less in quantity and of thin consistency. When this happens the instillation is only made every six hours. After five or six days of this treatment there is hardly any secretion and the swelling of the lids has practically disappeared. The treatment is continued with a solution of half the strength until complete cure is obtained. If ulceration of the cornea has commenced before the treat- ment is begun the protargol arrests the destructive process, and cicatrisation of the ulcer commences almost at once. Midwives are at present authorised to use preventive treat- ment by instilling into the eyes of a new-born child a solu- tion of nitrate of silver of a strength of 2 per cent., and it is. to be feared that as they have this solution at their disposal they will continue to use it. M. Motais considers that it would be more prudent to allow them to use nothing but a one in five solution of protargol, which is quite harmless although very active. The Prevention of Blindness in Iforkers. At the same meeting of the same society M. Motais , discussed a most interesting and important question-namely, ’ the measures to be taken for preserving the sight in workers . who by their tasks are exposed to the risk of losing it. He said that great importance was rightly attached to ocular hygiene in schools, but that no one took any heed of ocular hygiene in workshops, offices, and shops. The children in secondary schools throughout France numbered about , 250,000. The number of workers of both sexes, such a& L dressmakers and embroiderers especially, and in other trades, those who are exposed to dust, to either too intense or not enough light, to injuries by pieces of steel, or stone, or coal, exceeds 3,000,000. Every year thousands, of dressmakers, clerks, cashiers, and accountants lose their sight, not so much from excess of work as from defective lighting and a deplorably faulty position during their work. Each year, too, thousands of workers become sblind from irritating dust, fragments of iron, coal, glass, - wood, or stone shot into the cornea, or from exposure to, , intense lights. To remedy this state of things M. Motais proposed the appointment of an inspector of factories who should look after the cleanliness of the windows, which are t too often encumbered with dust or spiders’ webs or over- -shadowed by trees. Arrangements for day lighting should be- e based on those at present in use in schools; for artificial olighting a special committee should be appointed. The use protective spectacles should be made obligatory on all’ . workers whose eyes are exposed to the possible impact of foreign bodies, and advice should be given to workers as to the importance of there being good light for their work.
Transcript

1490 T

acquisition of the sanatorium by the town and then askingthem to cancel an honourable agreement. He also addedthat he was willing to make good any deficit (not exceeding£300) which might arise on the working of the sanatorium onits present lines from May lst to Dec. 31st of this year.

Presentation to an, Inverness Practitioner.On May llth Dr. G. W. England Kerr of Inverness was,

on the occasion of his wedding, presented with a beautifulmotor car and with a purse of sovereigns, while his wife alsoreceived a gift. Mr. James Ross, rector of the MackenzieSchool, made the presentations on behalf of the subscribers,who numbered over 1800.

Keith Town Omtncil and Pulmonary Tuberculosis.At a meeting of the Keith town council, held on May 10th,

it was decided to include pulmonary tuberculosis amongnotifiable diseases.May 18th,

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

Mortality in Irish Towns.THE second week of the present month showed a more

favourable death-rate record than any of its predecessors fora number of years. The rate fell from 23 per 1000 of thepopulation in the previous week to 18’ 75. The average ofthe four preceding weeks had been 23 - 5. The highest death-rate of the second week of May which occurred in Irelandwas that of Kilkenny, which reached 39 3. No deathsoccurred in Clonmel, another favourable contrast from the36 per 1000 of the week preceding. In three othertown districts only was the rate below 10 per 1000 :Drogheda (8 - 2), Sligo (4’ 75), and Galway (4). Thedeath-rate of Queenstown reached 33. The total numberof deaths which occurred in Dublin was 133, thenumber of births being 301. During the 18 weeks whichended with the second week of this month the average death-rate of Dublin was 26-5 per 1000-being 1-5 below the

average for the corresponding periods of the past ten years.The deaths from whooping-cough fell to four, as against 13of the previous week. Those from tuberculous disease fellfrom 33 to 29, which included 23 from pulmonary consump-tion. There were no fresh cases of whooping-cough reportedin the city area, but 14 cases were reported from the Pem-broke township. Four cases of scarlet fever occurred inRathmines. There were seven cases of diphtheria reportedin the city and one in Rathmines; the other townshipsremained free.

The Medical 0"yceer of Health of BeVa8t.In reply to a letter of the public health committee asking

the Local Government Board to reconsider its decisionregarding the proposal of the Belfast Corporation to increasethe salary of the medical officer of health, the LocalGovernment Board has written that it was unable to varyits decision and that it saw no reason for departing inthis case from its usual practice of requiring a period offive years’ service before sanctioning increase in an officer’ssalary. The health committee has expressed its regret atthis decision which is final.

Ballykelly Dispensary.Dr. J. R. Ross has just been obliged, owing to the state of

his health and his age (69), to tender his resignation of theoffice of medical officer of Ballykelly Dispensary, a positionwhich he has held for 42 years. At a meeting of the Limavadyboard of guardians held on May 17th the resignation wasaccepted and a resolution was unanimously passed acknow.ledging Dr. Ross’s faithful services, particularly to the poor.

The Queen’s University Commission.This Commission began further sittings on May 17th a1

Queen’s College, Belfast. The selection of the new pro.lessors and lecturers was considered ; and deputations werereceived from the Technical Institute in reference tc

coordinating university and technical education, and fronthe other institutions in regard to recognition as a teachinginstitution,May 18th.

PARIS.(FROM OUR OWN CORRESPONDENT.)

Isotonic Sugar Solutionsfor Injection.AT a recent meeting of the French Society of Military,

Medicine M. J. Labougle and M. Boutin communicated, apaper in which they called to mind the undesirable results,which sometimes occur from injections of saline solutions,even when they were isotonic, and they proposed the replace-ment of the sodium chloride by sugar. A solution composedof 10’ 30 grammes of sugar in distilled water is, they state,perfectly isotonic, is cryoscopic in the same degree as theblood serum, is non-toxic, and has been employed with thegreatest success in various cases of serious illness, such astyphoid fever, malaria, and septicaemia. These sugar injec.tions have the same good effects as those of artificial serum,without giving rise to the disagreeable effects which thelatter sometimes produce, and they can be used withoutrisk even in patients suffering from acute albuminuria.Moreover, they produce abundant diuresis. The only,contra-indication to their use is diabetes.

Ophthalmia in the Newly Born.At a meeting of the Academy of Medicine held on

May 4th M. Motais read a paper in which he advocated theuse of protargol instead of nitrate of silver in the treatmentof ophthalmia of the new-born infant. The eyelids are

everted and gently washed with a solution of potassiumpermanganate of a strength of 1 in 400. Then two drops ofa solution of protargol, one gramme to five grammes ofdistilled water, are dropped into the eye every three hours,day and night, for two or three days, until the secretionbecomes less in quantity and of thin consistency. Whenthis happens the instillation is only made every sixhours. After five or six days of this treatment thereis hardly any secretion and the swelling of the lids has

practically disappeared. The treatment is continued with asolution of half the strength until complete cure is obtained.If ulceration of the cornea has commenced before the treat-ment is begun the protargol arrests the destructive process,and cicatrisation of the ulcer commences almost at once.Midwives are at present authorised to use preventive treat-ment by instilling into the eyes of a new-born child a solu-tion of nitrate of silver of a strength of 2 per cent., and it is.to be feared that as they have this solution at their disposalthey will continue to use it. M. Motais considers that itwould be more prudent to allow them to use nothing but aone in five solution of protargol, which is quite harmless

although very active.The Prevention of Blindness in Iforkers.

At the same meeting of the same society M. Motais, discussed a most interesting and important question-namely,’ the measures to be taken for preserving the sight in workers. who by their tasks are exposed to the risk of losing it. Hesaid that great importance was rightly attached to ocularhygiene in schools, but that no one took any heed of ocularhygiene in workshops, offices, and shops. The children in

secondary schools throughout France numbered about, 250,000. The number of workers of both sexes, such a&

L dressmakers and embroiderers especially, and in othertrades, those who are exposed to dust, to either too intenseor not enough light, to injuries by pieces of steel, or

stone, or coal, exceeds 3,000,000. Every year thousands,of dressmakers, clerks, cashiers, and accountants losetheir sight, not so much from excess of work as fromdefective lighting and a deplorably faulty position duringtheir work. Each year, too, thousands of workers become

sblind from irritating dust, fragments of iron, coal, glass,- wood, or stone shot into the cornea, or from exposure to,

, intense lights. To remedy this state of things M. Motaisproposed the appointment of an inspector of factories whoshould look after the cleanliness of the windows, which are

t too often encumbered with dust or spiders’ webs or over--shadowed by trees. Arrangements for day lighting should be-e based on those at present in use in schools; for artificialolighting a special committee should be appointed. The use

protective spectacles should be made obligatory on all’. workers whose eyes are exposed to the possible impact of

foreign bodies, and advice should be given to workers as tothe importance of there being good light for their work.

1491

Sero-therapy in Diphtheritic Paralysis.At a meeting of the Hospitals Medical Society held on

April 30th M. Mery, M. Weill-HaII6,.and M. Parturier.recom-mended the following method of administration of anti-

diphtheritic serum for the prevention and cure of diphtheritic,paralysis. The serum must be injected subcutaneously dayby day both during and after the affection of the throatwithout waiting for the first manifestations of paralysis.Big doses must be used, from 40 to 60 cubic centimetres a

day during the acute period, and after this from 10 to 20.cubic centimetres every two days. Also, according toM. Hutinel’s advice, 10 centigrammes of powdered supra-Tenal body must be given every day. M. Netter has alsoused large doses of serum together with adrenalin. Thecombination of these two therapeutic measures will cure acertain number of severe diphtherias without complications.But as grave cases of diphtheria do not always declare them-selves as such at the beginning of the disease the intensivetreatment should be begun and continued in every case ofdiphtheria. The ,large doses of serum injected do not

appear to bring about any anaphylaxis or any toxic effects,.and M. Sicard stated that in one case of diphtheriticparalysis he had injected over 600 cubic centimetres of serumwithout any ill-effect.May 18th.

____________________

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

A Novelty in Open-air Treatment.. ON the recommendation of -several medical men in Vienna,the municipality last year opened .an institution called hereby the popular name of "Gäuschäufel." It is simply an-open-air sanatorium for healthy persons. The old idea that

,sunlight, air, and water are the main restoratives at our"disposal was long ago taken up by a non-medical philan-thropist, who opened an establishment of the most primitivekind on the banks of the Danube on the outskirts of Vienna.The results obtained by him have prompted the municipalityto enlarge the establishment and conduct it on modernprinciples. An immense area covered with fine sand,deposited from the Danube, which used to flow’there in ancient times, a long river bank with shallow,-rapidly-flowing, cold water, and the absence of anyshade-giving trees are the three principal health-givingfactors relied on. Special care has been taken to enablesehools to make use of the facilities offered there ; 4000persons can undress at the same time, and free ticketshave been granted to schools and workshops, so that on somedays last summer 10,000 persons weye seen there, goingabout in the open air nearly naked. It must be admittedthat the institution has done much to convince the lower- classes of the good influence of a natural mode of life. Noless than 200,000 persons have availed themselves of the"opportunity offered them and for this year an increased areahas been thrown open for the air cure." There is a specialmedical attendant present, for cases of sunstroke have beennoticed now and then, but, generally speaking, no seriousmishap has occurred. As the inhabitants of Vienna, unlikethose of London, have no sea coast within easy reach, thissubstitute has been welcomed by.the population.

The Prevention of Yenereal Disease among St2cdents.The increase of venereal disease amongst the better classes

- 6f the population, as well as the fact that young studentsfresh from school or country are very liable to succumb to-sexual temptation, has prompted the senates of the univer-sities not only in Austria but also in Germany to issue aprinted warning to all students on matriculation, cautioningthem against the dangers of venereal disease. In this leafletthe widely-diffused idea that sexual intercourse is absolutelynecessary for the developing body is refuted, and the anti-quated notion that I a little gonorrhoea " is nothing to beashamed of is shown to be a serious and dangerous fallacy.The students are reminded that such superstitions result interrible suffering on the part of innocent wives infected by-their husbands, for gonorrhoea may completely undermine awoman’s health, causing sterility and domestic unhappiness.It is added that in more than 50 per cent. of sterilemarriages the first link in -the chain of events has been

gonorrhoea contracted by the husband. After recom-

mending an immediate visit to a competent practitionerwhen once disease has been acquired and cautioning against’secret remedies and quacks who make great promises, theleaflet goes on to say that sexual intercourse whilst a man isstill affected with disease is an infamous act. It is signed bysome very well-known men, including Dr. Gruber, Dr. von"Esmarch, Dr. Fischer, Dr. Flugge, Dr. Hueppe, Dr. Neisser,and Dr. Pfeiffer. In order to enable students to obtain com-

petent help and advice in cases of disease special friendlysocieties (Erankeneassen) have been formed for students of alluniversities and all branches in Austria. The medical menattached to them have mostly been at one time members of aCassa themselves, and the students in this way have at a verysmall cost sufficient medical care and attention. It must bementioned that in this country numerous students come frompoor families, so that the expense of treatment would be avery heavy burden to them but for these Krankeneassen.

Horse Serum in the Treatment of Hœmophilia.At a recent meeting of the Gesellschaft der Aerzte Dr.

Mautner showed a boy, four and -a half years old, who wassuffering from haemophilia and had once already been in hos-pital for dangerous haemorrhage which was controlled withdifficulty. This time the child was admitted in a nearlymoribund condition, three days after the extraction of alower molar tooth. He had been losing blood continuallyand the styptics applied locally were absolutely useless. Dr.Mautner thereupon injected 20 cubic centimetres of normalhorse serum, acting on a suggestion made by Dr. Wirth andmentioned by me in THE LANCET of Feb. 13th, p. 508. Aftera few minutes the oozing became less and the bleeding soonstopped but reappeared the next day. Another injection ofthe same strength had a permanent effect. Whilst a bloodcount on admission showed only 1,700,000 erythrocytesper cubic millimetre their number rose to 2,700,000 fivedays after the first injection and the general conditionof the patient improved rapidly. A remarkable featureof this ease was an atypical serum disease appearing 28days after injection, manifesting itself by a rise of tempera-ture, swelling of the glands, pain in the joints, and leuco-penia (4000 leucocytes per cubic millimetre). There alsoappeared at the same time a general erythema of the natureof erythema multiforme. A similar belated occurrence of aserum exanthem has been noticed several times in verydebilitated persons. A point worth mentioning was the factthat the experiments on anaphylaxis showed that in additionto other changes the injection of serum caused also a loss ofcoagulability of the blood after two or three weeks. This,-however, was only in certain animals which had receivedlarge amounts of serum intravenously, and especially indogs. In human patients the amount of serum used wasrelatively much smaller and its absorption was muchslower, otherwise there might be reason to fear that hsemo-philic patients treated with horse serum would be in greatdanger if fresh bleeding should occur from 20 to 25 daysafter the injection. That this did not happen has beenproved already.May 17th.

___________________

CONSTANTINOPLE.

(FROM OUR OWN CORRESPONDENT.)

Public L’xee2ct2vns.

MARTIAL law and court-martial have commenced thework of retribution with a stern and resolute hand. Theinstigators and the leaders of the last mutiny, soldiers andofficers, civilians and priests, are being publicly executed onopen places of the metropolis which are most crowded andexposed, such as the Stamboul end of the Galata bridge, thewide space near Saint-Sophia, and the thoroughfare of themosque of Sultan Bayezid. The executed men were exposedon their gibbets’to the crowds for several hours, and withfeverish eagerness great masses of people streamed out to seethem suffer. The scenes were repulsive in the highest degree.A female patient of mine who saw the hangings was soaffected by the horrible sight that she is bedridden at presentin a febrile delirious condition and probably many more shareher punishment for their morbid curiosity.


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