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463 of patients treated during 1904 was 101 and the average . number of days spent by each patient in the sana- torium was 101½. The results of treatment have been distinctly encouraging. At the central offices of the asso- ciation in Leeds applicants for admission are examined by the honorary officers. The number of applicants has been uniformly much in excess of the accommodation at Gateforth and naturally the cases most suitable for sana- torium treatment have been selected. In this way the necessity of instituting a home ..or hospital for the more acute class of cases or for cases in which it was doubtful whether sanatorium treatment would be successful became apparent, and this year the society is able to announce that it has secured Armley House and has fitted it up as a hospital which will accommodate 27 patients of this class and which is admirably adapted for the purpose. Holidays for Poor Children. Following the example of other centres Leeds has started a poor childrens’ holiday camp. The first annual report dealt with the work at Hest Bank, Morecambe. Though the work was not begun till July 130 boys and 130 girls had been kept for various times in the camp. The health of the children had been good. The cost per child of from eight to 14 years of age had been 5s. 3d. per week-3s. lld. for food and Is. 4d. for railway fare. The diet had been generous and in many cases the children ’had gained six pounds in weight. For the next five years the camp is to be held at Silverdale, the rent of the site having been generously promised by Mr. and Mrs. Arthur Briggs, who during Mr. Briggs’s mayoralty did so much for the initiation of the scheme. One of the buildings of the Bradford exhibition has been purchased and erected at a total cost of £374 and it is hoped that the forthcoming season may be started with a few pounds in hand. Feb. 14th. ________ IRELAND. (FROM OUR OWN CORRESPONDENTS.) - i The Irish Medical Association and the Local Government i Board. THE opening stage of the appeal by the Irish Medical Association against the action of the Local Government Board in abolishing a dispensary district in the county of Louth was reported in THE LANCET of Feb. 4th, p. 328. The Lord Chancellor has since delivered the judgment of the Court of Appeal, dismissing with costs the appeal of the Irish Medical Association and upholding the action of the Local Government Board. Royal College of Surgeons in Ireland. It is publicly announced that owing to the illness of His Excellency the Lord Lieutenant the conferring of the Honorary Fellowship of the Royal College of Surgeons in Ireland on the Provost of Trinity College and the College dinner for which invitations were issued for Feb. llth have been postponed until further notice. 2)«MM Sanitary Association. At a meeting of the Dublin Sanitary Association held on Feb. 9th a letter from the secretary of the public health committee of the corporation was read stating that the by- laws to regulate street trading by children in Dublin, under the provisions of the Employment of Children Act, 1903, as approved by His Excellency the Lord Lieutenant, are being printed and that badges are being prepared to be worn by the children licensed to trade in the streets of the city. British Medical Association. The annual meeting of the Leinster (formerly Dublin) branch of the British Medical Association will be held on Saturday, Feb. 25th, at 4.30 P.M., in the hall of the Royal College of Physicians, Kildare-street, when Sir Thomas Myles, president-elect, will deliver the address. The annual dinner of the branch will take place in the College hall at 7.30 P.M. on the same day. Honoecr for Sir Francis Cruise. Sir Francis R. Cruise, M.D. Dub., D.L., Honorary Phy- sician-in-Ordinary to His Majesty in Ireland, has received a brief from the Pope appointing him a Knight of the Order of St. Gregory the Great, together with the star or decoration of that order. Dispensary Medical Officers’ Salaries. A special committee of the Coleraine guardians having conferred with the medical officers of the union as to the scale of salaries recommends the following plan to be adopted. That the minimum, salary of each dispensary . medical ofiicer in the union, as well as that of the workhouse medical officer, be £100 a year, increasing by S10 every five years to a maximum of £150. A statement of the medical officer points out that a penny in the £1 in all Ireland amounts to £62,000 and that the salaries of all the dis- pensary medical officers amount to £88,000, half of which is recouped by the Government. An average ratepayer of R24 valuation pays a little over Is. to the dispensary medical officers, so a halfpenny in the .61 added would give all that the medical officers ask. The matter is to be considered at a future special meeting of the board. The Public Bodies Order. The Local Government Board has issued an Order for the guidance of public bodies in Ireland which is being strongly and adversely criticised on the grounds that it increases clerical work and expense of maintenance without effecting any improvements which might compensate for these disadvantages. For instance, in reference to asylums this Order prescribes new forms relating to the audit of asylum accounts which will necessitate more officials and will interfere with the smooth and economical working of such institutions. The duty of the Local Government Board is clearly to see that local bodies transact their business , honestly and that they fulfil the law but it is absurd to make vexatious regulations which serve no good object but increase the expense of local bodies. At the ordinary meeting of the Belfast asylum committee on Feb. 13th a motion was unanimously carried protesting against the adoption of such an Order on the ground among others that it contains provisions which exceed the statutory powers of the Local Government Board. Other local bodies in Ireland are taking similar action. A Health Lecture for the People. A lecture fully illustrated by limelight views was delivered in the Exhibition Hall, Belfast, on Feb. 14th, by Dr. Henry O’Neill, editor of the Belfast Health Journal, on the Health of Belfast. A collection was made in aid of the Belfast Royal Victoria Hospital. Feb. 14th. _________________ PARIS. (FROM OUR OWN CORRESPONDENT.) Brc:ner’s Yeast in the Treatment of lyphoid Fevep. AT a meeting of the Medico-Chirurgical Society held on Jan. 23rd M. Hirtzmann gave details of three severe cases of typhoid fever occurring in adults. The symptoms included dryness of the tongue, diarrhoea, and other conditions usually found in typhoid fever; the temperature rose to, and remained at, 400 C. (104° F.) for some time. In addition to small amounts of sulphate of quinine he gave to all three patients 60 grammes (two ounces) of brewer’s yeast daily in three doses. This treatment was commenced about the seventh day of the illness. After the taking of the yeast the temperature fell to 38° C., not subsequently rising above 39° ; the gastro-intestinal symptoms improved, the tongue was no longer dry and coated, the diarrhoea dis- appeared, and the pyrexial stage terminated about the twenty-first day. M. Hirtzmann believed that the yeast acted as an antiseptic. He employed either Karcher’s or Grueber’s fresh yeast, the latter being preferable as it was almost liquid. In those cases the typhoid fever was un- questionably water-borne, for the well supplying the house of one of the patients had been evidently contaminated by faecal matter from a house which stood at a higher level and in which there had been some time previously a case of typhoid fever. Respiratory Exercises and Re-education in the l’reatrrent of Convaleseents. At a recent meeting of the Societe Medicale des H6pitaux M. Siredey and M. Rosenthal contributed a paper on Respi- ratory Exercises and Re-eclucation in the Treatment of Con- valescents. They said that respiratory insufficiency was one of the causes of the general debility which showed itself after an acute illness. It was easily recognised by the
Transcript
Page 1: PARIS

463

of patients treated during 1904 was 101 and the average. number of days spent by each patient in the sana-

torium was 101½. The results of treatment have been

distinctly encouraging. At the central offices of the asso-ciation in Leeds applicants for admission are examined

by the honorary officers. The number of applicants hasbeen uniformly much in excess of the accommodation at

Gateforth and naturally the cases most suitable for sana-torium treatment have been selected. In this way the

necessity of instituting a home ..or hospital for the moreacute class of cases or for cases in which it was doubtfulwhether sanatorium treatment would be successful became

apparent, and this year the society is able to announcethat it has secured Armley House and has fitted it up as ahospital which will accommodate 27 patients of this classand which is admirably adapted for the purpose.

Holidays for Poor Children.Following the example of other centres Leeds has started

a poor childrens’ holiday camp. The first annual reportdealt with the work at Hest Bank, Morecambe. Though thework was not begun till July 130 boys and 130 girls had beenkept for various times in the camp. The health of thechildren had been good. The cost per child of from eight to14 years of age had been 5s. 3d. per week-3s. lld. for foodand Is. 4d. for railway fare. The diet had been generousand in many cases the children ’had gained six pounds inweight. For the next five years the camp is to be held atSilverdale, the rent of the site having been generouslypromised by Mr. and Mrs. Arthur Briggs, who duringMr. Briggs’s mayoralty did so much for the initiation ofthe scheme. One of the buildings of the Bradford exhibitionhas been purchased and erected at a total cost of £374 andit is hoped that the forthcoming season may be started witha few pounds in hand.

Feb. 14th. ________

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)-

iThe Irish Medical Association and the Local Government i

Board. THE opening stage of the appeal by the Irish Medical

Association against the action of the Local GovernmentBoard in abolishing a dispensary district in the county ofLouth was reported in THE LANCET of Feb. 4th, p. 328.The Lord Chancellor has since delivered the judgment of theCourt of Appeal, dismissing with costs the appeal of theIrish Medical Association and upholding the action of theLocal Government Board.

Royal College of Surgeons in Ireland.It is publicly announced that owing to the illness of His

Excellency the Lord Lieutenant the conferring of the

Honorary Fellowship of the Royal College of Surgeons inIreland on the Provost of Trinity College and the Collegedinner for which invitations were issued for Feb. llth havebeen postponed until further notice.

2)«MM Sanitary Association.At a meeting of the Dublin Sanitary Association held on

Feb. 9th a letter from the secretary of the public healthcommittee of the corporation was read stating that the by-laws to regulate street trading by children in Dublin, underthe provisions of the Employment of Children Act, 1903, asapproved by His Excellency the Lord Lieutenant, are beingprinted and that badges are being prepared to be worn bythe children licensed to trade in the streets of the city.

British Medical Association.The annual meeting of the Leinster (formerly Dublin)

branch of the British Medical Association will be held on’

Saturday, Feb. 25th, at 4.30 P.M., in the hall of the RoyalCollege of Physicians, Kildare-street, when Sir ThomasMyles, president-elect, will deliver the address. The annualdinner of the branch will take place in the College hall at7.30 P.M. on the same day.

Honoecr for Sir Francis Cruise.Sir Francis R. Cruise, M.D. Dub., D.L., Honorary Phy-

sician-in-Ordinary to His Majesty in Ireland, has received abrief from the Pope appointing him a Knight of the Order ofSt. Gregory the Great, together with the star or decoration ofthat order.

Dispensary Medical Officers’ Salaries.A special committee of the Coleraine guardians having

conferred with the medical officers of the union as to thescale of salaries recommends the following plan to be

adopted. That the minimum, salary of each dispensary. medical ofiicer in the union, as well as that of the workhousemedical officer, be £100 a year, increasing by S10 every fiveyears to a maximum of £150. A statement of the medicalofficer points out that a penny in the £1 in all Irelandamounts to £62,000 and that the salaries of all the dis-

pensary medical officers amount to £88,000, half of which isrecouped by the Government. An average ratepayer of R24valuation pays a little over Is. to the dispensary medicalofficers, so a halfpenny in the .61 added would give all thatthe medical officers ask. The matter is to be considered ata future special meeting of the board.

The Public Bodies Order.The Local Government Board has issued an Order for the

guidance of public bodies in Ireland which is beingstrongly and adversely criticised on the grounds that itincreases clerical work and expense of maintenance withouteffecting any improvements which might compensate forthese disadvantages. For instance, in reference to asylumsthis Order prescribes new forms relating to the audit ofasylum accounts which will necessitate more officials andwill interfere with the smooth and economical working ofsuch institutions. The duty of the Local Government Boardis clearly to see that local bodies transact their business

, honestly and that they fulfil the law but it is absurd to. make vexatious regulations which serve no good object but

increase the expense of local bodies. At the ordinary meetingof the Belfast asylum committee on Feb. 13th a motionwas unanimously carried protesting against the adoption ofsuch an Order on the ground among others that it containsprovisions which exceed the statutory powers of the LocalGovernment Board. Other local bodies in Ireland are takingsimilar action.

A Health Lecture for the People.A lecture fully illustrated by limelight views was delivered

in the Exhibition Hall, Belfast, on Feb. 14th, by Dr. HenryO’Neill, editor of the Belfast Health Journal, on the Healthof Belfast. A collection was made in aid of the BelfastRoyal Victoria Hospital.

Feb. 14th. _________________

PARIS.

(FROM OUR OWN CORRESPONDENT.)

Brc:ner’s Yeast in the Treatment of lyphoid Fevep.AT a meeting of the Medico-Chirurgical Society held on

Jan. 23rd M. Hirtzmann gave details of three severe cases oftyphoid fever occurring in adults. The symptoms includeddryness of the tongue, diarrhoea, and other conditionsusually found in typhoid fever; the temperature rose to,and remained at, 400 C. (104° F.) for some time. In additionto small amounts of sulphate of quinine he gave to allthree patients 60 grammes (two ounces) of brewer’s yeastdaily in three doses. This treatment was commenced aboutthe seventh day of the illness. After the taking of the

yeast the temperature fell to 38° C., not subsequently risingabove 39° ; the gastro-intestinal symptoms improved, thetongue was no longer dry and coated, the diarrhoea dis-

appeared, and the pyrexial stage terminated about the

twenty-first day. M. Hirtzmann believed that the yeastacted as an antiseptic. He employed either Karcher’s orGrueber’s fresh yeast, the latter being preferable as it wasalmost liquid. In those cases the typhoid fever was un-questionably water-borne, for the well supplying the houseof one of the patients had been evidently contaminated byfaecal matter from a house which stood at a higher level andin which there had been some time previously a case oftyphoid fever.

Respiratory Exercises and Re-education in the l’reatrrentof Convaleseents.

At a recent meeting of the Societe Medicale des H6pitauxM. Siredey and M. Rosenthal contributed a paper on Respi-ratory Exercises and Re-eclucation in the Treatment of Con-valescents. They said that respiratory insufficiency was one

’ of the causes of the general debility which showed itself

after an acute illness. It was easily recognised by the

Page 2: PARIS

464

following symptoms which the patient presented-namely,nasal insufficiency, shown by inability to breathe 20 timesthrough both nostrils ; thoracic insufficiency, shown byabsence or impairment of the movements of the thorax;and diaphragmatic insufficiency, shown by immobility or

Tecession of the abdomen during inspiration, a conditionmet with in pseudo-pleurisy of the bases of the lungs.Respiratory re-education under medical supervision was,’in their opinion, the specific treatment for respiratory in-sufficiency. In the case of convalescents it constantly pro-,duced a progressive threefold effect-namely, expansion ofthe thorax, diuresis, and increase of weight. It promotedin a marked degree the recuperation of the vital functionswhich followed acute illnesses and the general health of thepatients improved rapidly. It ought to be combined with- other forms of treatment and the action of the latter wasenhanced by it. Although of great power it did not requirefor its application any special institution or any specialapparatus. The system could be practised anywhere, eitherin a hospital or in the poorest dwelling. It needed nothingmore on the part of the patient than the absence of anymechanical obstacle to the passage of air through the rhino-pharyngeal tract, and nothing more on the part of themedical man than a willing mind and a ’qualification whichwas indispensable though too much neglected-namely, a- knowledge of the fundamental laws of human physiology.

Poisonous Cream Cakes.

, M. Metchnikoff, the deputy director of the Pasteur

Institute, has just been taking part in an interesting inquiry.For some months past he has been receiving almost dailysamples of cream cakes from the same batch as those whichhad given rise to symptoms of poisoning in those personswho had eaten them. M. Girard of the Municipal Labora-tory had also investigated the cakes. The Society of’Confectioners and Bakers was aware of these researchesand its members, when they knew that results had been’obtained, convened a meeting at which Dr. Metchnikoff

gave an interesting discourse. The cause of all the

mischief, he said, was the white of the egg whichcontained microbes. It is not clear why the white ofcertain eggs contains microbes but the fact is certain thatsome hens do lay eggs the whites of which contain microbes.Even freshly laid eggs when cultivated in a cultivator givecultures. This being so the method in which the cream isprepared for the cakes is eminently calculated to developthe microbes. The white of egg slightly warmed is sprinkledwith a " cream " which itself is at a temperature of 80° C.,one far too low to have any destructive effect on the germs.This " cream " being made of gelatin, sugar, and milk offersan ideal culture medium when the mixture is warmed. This,explains why white of egg, even when it does contain germs,gives rise to no symptom of poisoning when it is consumedin the ordinary way without the admixture of "cream."The following method is suggested to avoid future risks.Before sprinkling the white of egg with the "cream itshould be coagulated in boiling sugar which will certainly-destroy the germs.

Feb. 14th. _________________

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

The Prevention of Yellow Fever in Ouba.THE American Public Health Association met in Havana

’on Jan. 10th and the principal feature of the introductoryproceedings was the address of the President, Dr. CarlosFinlay, chief of the Cuban Health Department. He highlyeulogised the labours of American experts to whom, he- said, was due the banishment of yellow fever from Cuba.The American Commission, under the leadership of the lateMajor Reed, had decisively established the true etiology ofyellow fever. Dr. Finlay also praised the work ofMajor Gorgas, chief health officer under General Wood,who, adopting the findings of the commission, succeededwithin seven months in ridding Havana of the in-veterate enemy. Regarding the two cases of yellowfever which occurred in Santiago Province, Dr. Finlaysaid it was presumed that they were transmitted bymosquitoes from a quarantined ship. There can be no doubtthat the American medical men did a great work in riddingCuba of yellow fever and are entitled to all the praise

bestowed upon them by Dr. Finlay. It would, however, seemfrom recent reports that since the Cubans themselves havetaken over the government of the island sanitary affairstherein have decidedly retrograded. It is therefore needfulthat the American Government, for the sake of the in-habitants of Cuba, as well as in the interests of the Americanpeople at large, should strongly advise, and if necessary bringpressure to bear on, the Cuban authorities in order that thesanitary conditions of Cuba should not be allowed to lapseinto their former unsatisfactory state through neglect.

Alleged Swindle by Physicians.Two physicians were arrested in New York recently

charged with engineering a radium cure swindle. The caseagainst them was brought by the New York County MedicalSociety through its attorney, Mr. Champe S. Andrews. Thecomplainant, a carpenter, stated that the physicians hadobtained from him$10,000 ( £ 2000), the amount of his savingsof years. The carpenter had been informed by the medicalexaminers’ of an insurance company that he had a slighttendency to Bright’s disease and went to the defendants fortreatment: He was told by them that he was suffering from ..Bright’s disease in its worst form and that his only chanceof recovery lay in his being treated by means of radium.He was further told that owing to the great cost of radiumthe treatment would be very expensive. Acting upon hisfears the defendants managed to extort from the plaintiffthe sum above mentioned. The New York County MedicalSociety’s agents heard of the matter and initiated an invebti.gation, with the result that some of the so-called radiumwas obtained and subjected to a searching analysis when itwas found that the composition contained no trace whateverof radium, but, as a matter of fact, consisted of gentian, iron,and a few simple drugs ordinarily used in a tonic prepara-tion.

The Adnlterat’ion of WhiskyDr. H. W. Wiley, chief of the United States Bureau of

Chemistry, has recently stated that he believes at least85 per cent. of the whisky sold over the bars in the UnitedStates is not straight" whisky. He states that it is a com-

pound, made of neutral spirit, or alcohol, artificially coloured,often flavoured with artificial essences and sometimes mixedwith more or less " straight whisky to give flavour. Theremarks of Dr. Wiley on the adulteration of food and

whisky have given rise to much heart-searching and theliquor dealers have been endeavouring to minimise as far aspossible the effect of his statements. There can be no doubt,however, that adulteration is conducted on a wholesalescale in the United States and it is not unlikely that theFederal and States Governments may take cognisance ofthe matter and endeavour to check the evil by means oflegislation.

Tuberculosis and Alcohol. -

A controversy has been going on in the lay press of NewYork with regard to the effect of alcohol upon consumptives.Dr. Wiley has recently " stirred a hornet’s nest" by makingpublic his opinion that alcohol is beneficial in consumptionas well as in certain other diseases. Dr. Knopf, the well-known New York authority on tuberculosis, has stoutly com-bated these views and declares that in any stage pr form ofpulmonary tuberculosis large quantities of alcohol are contra-indicated. These views are in direct opposition to thoseheld by Dr. Arthur C. Latham who, writing on the subjectin the Practitioner for January, declares that whensolid food cannot be taken by consumptives alcohol isour sheet anchor and in another part of the same articlesays that " nothing but good results from the administrationof large quantities of alcohol when fever is present so longas the pulse is becoming slower, the appetite better, the skinand tongue moister, and the patient quieter." Opinionsdiverge greatly as to the position of alcohol as a nutritiveagent. In America probably the medical profession isalmost equally divided on the question.

Feb. 6th. __________________

NOTES FROM INDIA.(FROM OUR SPECIAL CORRESPONDENT.)

A Case of I "Sati " in Beltar.

THE desire for the barbaric custom of ’’ Sati" seems tostill linger in the Hindu mind. A recent case in Behar wasattended by an enormous and sympathising crowd and the


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