900

corporation, and has suggested that in the case of a patient being too poor to pay a fee the practitioner attending should be paid by the authority. The chairman of the committeeexpressed the opinion that in such circumstances the parishmedical officer should be sent for and it was intimated to thedeputation that the corporation had no power to pay a fee,however willing it might be to do so.

Medical Inspection of Schools in Bristol.At the last meeting of the health committee of the

Bristol corporation a suggestion was made by a memberof the late school board that women health visitorsshould be appointed to visit the houses of workingpeople and to aid by their advice in improving sani-

tary conditions. The chairman of the committee (Mr.Colston Wintle, L.R.C.P.Lond., M.R.C.S. Eng. ), spokein terms of approval of the suggestion but the medicalofficer of health (Dr. D. S. Davies) considered the proposalonly a small part of the very important question of themedical supervision of schools. He thought that domesticteaching should be undertaken by the education committeeand not by the health committee which might, however, withadvantage control the general medical superviion of theschools. Eventually a subcommittee was appointed to con-fer with the education committee on the subject. In his

report for 1902 Dr. Davies dealt at some length with thequestion of medical inspection in public elementary schoolsand detailed the action already taken in this directionin some English towns, notably in Bradford and in Bir-mingham, and he also gave an account of the methodsof medical school inspection adopted in America and inGermany, from which it appears that in New York there are205 medical inspectors of schools, in Chicago 56, and inBoston 50. Each inspector has four or five schools andabout 2000 children under his charge and he visits eachschool daily, examining any child who appears to be ill or inany way needing inspection. In the German towns wheremedical school inspection is in force the inspector as a ruleonly visits each school about once a month, and in addition toinspecting the children he also examines the methods

employed for lighting, warming, and cleansing the classrooms and the system of ventilation. Dr. Davies veryproperly emphasises the desirability of securing at all timessuch systematic inspection of schools as shall lead to thediscovery of the earliest symptoms of illness or of un-

suspected mild cases of infectious disease so as to preventoutbreaks rather than to suppress them and thus to fulfil the

proper function o. preventive medicine.Cheltenham General -Hospital.

The annual meeting of the subscribers to this institutionwas held on March 16th. The report stated that during theyear 771 in-patients had been admitted against 906 in 1902The out-patients numbered 4493 and the patients treated atthe branch dispensary were 3939, being a slight decrease innumbers compared with the previous year. The financialstatement was satisfactory and showed an increase in sub-scriptions and donations, but church collections and the

Hospital Saturday Fund had fallen off. Colonel Croker-King was re-elected president.

The late Curator of Dorset County Museum.Mr. H. J. Moule, curator of Dorset County Museum and

one of the best known antiquarians in the West of England,died at Dorchester on March 13th. He was born at

Gillingham in 1825, being the son of the late Rev. H. Moule,vicar of Fordington, and among his brothers are the Bishopof Durham, Bishop Moule of Mid-China, and ArchdeaconMoule. He was for some years librarian to the late LordWriothesley Russell and the late Earl Fitzwilliam respectivelyand in 1881 was appointed curator of the newly erectedmuseum at Dorchester. There he did excellent work and waswell known as an authority on all matters of antiquarian andhistorical interest. He was a prolific writer, one of his booksbeing Old Dorset."

’

March 22nd. _________________

IRELAND.(FROM OUR OWN CORRESPONDENTS.)

The New Provost of Trinity College.AFTER an unusually long delay the announcement appeared

on March 22nd that the vacant Provostship of Trinity Collegehad been filled by the appointment of Dr. Anthony Traill.Dr. Traill, although he took the degree of M.D. in 1870,

has never had any connexion with the teaching or practice ofmedicine. He is not-like his recent predecessors-a clergy-man but he has for a long period taken a strong and activeinterest in the public affairs of the Church of Ireland. Hehas considerable property in Antrim and is a justice, of thepeace for that county.

Stewart Institution for Imbecile Children.The annual meeting of the council of the Stewart Institu-

tution for Imbecile Children took place at the offices,40, Molesworth-street, Dublin, on March 18th, Dr. WalterG. Smith occupying the chair. In moving the adoption of thereport Dr. Smith delivered an interesting address in whichhe illustrated the progress from a small beginning of theonlv institution in Ireland for the treatment of the imbecilepoor.

The Carmichael Prize Fssay.The Royal College of Surgeons in Ireland announces that

the prize for the Carmichael essay, value £120, will be

adjudged on the first Thursday in November, 1904. Thecontents of this essay, as is well known, are settled by theterms of Mr. Carmichael’s will, which enjoins as its subjectthe state of the medical profession in Great Britain andIreland and of the various hospitals and schools and themodes of examination adopted by the licensing bodies.Essays, which must not exceed 65,000 words in length,should be lodged at the College on or before Julylst, 1904,distinguished only by a device or motto.

Dublin Sanitary Association.The annual meeting of the Dublin Sanitary Association

was held on March 21st in the hall of the Royal DublinSociety, Mr. George R. Price, K.C., the President, occupy-ing the chair. The draft report of the council, which wasread, directed attention to the inadequate fines that hadbeen inflicted for concealment of cases of small-poxduring the recent epidemic, to the dangers in connexion

with the present situation of the isolation hospital at

the Pigeon House, to the disgracefully high infantile mor-tality, and to other matters. It recommended that partof the equivalent grant for education, amounting to

.&185.000, might with advantage be allocated to the improve-ment of the sanitary condition of the national schoolsthroughout Ireland, particularly in the direction of pro-viding sanitary accommodation for the pupils. The Presi-dent of the Royal College of Physicians of Ireland, in

proposing the adoption of the report, said that he was inunison with those who would punish people who attemptedto conceal small-pox but they should follow the Englishsystem and if they locked a man up in an isolation hospitalthey should take care to see that his family did not suffer.He agreed with all that the report stated as regards, theinsanitary condition of the national schools.

Queen’s College, Belfast.The action of the Government, conveyed through Mr.

Wyndham, that it could not see its way to accede to therepresentation seeking State assistance for Queen’s College,Belfast, is unfavourably commented on in Belfast.March 22nd.

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PARIS.

(FROM OUR OWN CORRESPONDENT.)

Hospital lsolation for Cases of Contagious Disease.AT a recent meeting of the Hospitals Medical Society

M. Debove in his own name as a member of the Conseilde Surveillance of the Assistance Publique and also in thename of M. Faisans, a delegate from the society to thiscouncil, asked the opinion of his colleagues on the questionof the isolation of cases of contagious disease in hospitals.M. Debove had recently visited the hospital at Aubervillierswhere he found every necessity for modifying the existingstate of matters. It is needful to isolate two contagiousdiseases-namely, small-pox and scarlet fever. Cases ofthese two diseases should therefore continue to be isolatedin the new hospital which was rising on the site of theold wards at Aubervilliers. The other so-called infectiousdiseases would be treated in the general hospitals, beingnursed by a special staff under the direction of thephysician in charge. M. Debove added that the societyought to deliver an opinion on the matter so that theAssistance Publique could make up its mind at once whatto do. An interesting discussion followed, in the.course of

901

which M. Belin asked that special wards should be reserved r

for doubtful cases. M. Debove answered that he had fore- e

seen this point and also considered that diphtheria should c

be considered as infectious in the same category as scarlet fever. Finally, the society passed a resolution that cases of c

small-pox only should be treated in a special isolation r

hospital and that cases of all other infectious diseases should be treated in isolation wards in general hospitals with a special staff to look after them. t

The Water-supply of Paris. t

At the meeting of the Municipal Council which was held f

on March 9th M. Caplain put a question to the Prefect of the Seine as to the quality of the water-supply. A certain number of cases of typhoid fever has recently been reported and M. Caplain wanted to know whether 1this outbreak had not been brought about by the water authorities having substituted river water for spring water in the public supply. This is done by no means uncommonly,to the great detriment of the population of Paris. ThePrefect of the Seine said that the authorities were alwaysthinking how to improve the sanitary state of Paris and it wasa fact that in 1882 the deaths from typhoid fever were 143 !per 100,000 inhabitants, while to-day the proportion wasonly 10 per 100 000. The present increase in the number ofcases of typhoid fever was much exaggerated and nothinglike an epidemic existed. He allowed that on Feb. 10th theauthorities had been obliged to turn river water into thepublic supply but the water had been filtered and so hadbeen rendered harmless. M. Poirier de Narçay remindedthe meeting that the Municipal Council had already passed aby-law to the effect that the authorities should never sub-stitute river water for spring water without posting a noticeof such substitution. As in the present case this regulationhad been violated M. Poirier de Narçay proposed that avote of censure should be passed on those responsible for theerror. This was accordingly done.

The Prophylaxis of Malaria.In reference to a recently issued report of M. Kermongant

on infections diseases in the colonies M. Laveran gave noticeof the following motion at the meeting of the Academy ofMedicine held on March 8th :-The Academy of Medicine, in view of the excellent results obtained

in diverse countries by the mechanical protection of houses againstmosquitoes, hereby resolves that the military authorities shouldadopt similar precautions, more especially in the French colony ofMadagascar, where mosquitoes which spread malaria abound.

The Dangers of Radio.therapeutic Applications.At the meeting of the Society of Dermatology and Syphilo-

graphy held on March 3rd M. Oudin read a paper in whichhe maintained that in the treatment of large cancerousmasses by radio therapeutics the sittings must not follow eachother at short intervals, and also that each individual sittingmust be short, so that the organism will have plenty of timeto eliminate the reabsorbed products. As a matter of fact,after one or two sittings it is quite common to see signs of atoxæmia, for parallel with a notable diminution in the size ofthe tumour the patients suffer from a raised temperature, lossof appetite, cramps, a drawn expression of the face, scantyand albuminous urine, cough, and vomiting. If the sittingsare then stopped these symptoms pass off after a few days’rest, but if the sittings are continued or if the early oneshave been too long there is a rapid dissemination of the

growth which quickly carries off the patient. In support ofhis opinion M. Oudin related three cases in which an acutecachexia set in during a course of radio-therapeutics. The

patients were suffering from cancer but their general healthhad been excellent at the commencement of the treatment.It is a question whether the disagreeable symptoms are dueto reabsorption of toxins or to the introduction into the

general circulation of cancer cells the vitality and virulenceof which have not been sufficiently attenuated by the raysto render them harmless. M. Oudin rather inclines to thelatter theory.March 22nd.

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EGYPT.(FROM OUR OWN CORRESPONDENT.)

J

EGYPT is enjoying a greater influx of visitors than usual, : partly because some of them are yearning for sunshine after i

the rainy season in Europe and America and partly because :

Qany hesitated to come here last winter on account of thexistence of cholera in the summer of 1902. As usual theihief numbers come from America, England, and Germany.Che hotels filled at an earlier date than is generally the;ase and they are still very full, having occasionally to

equisition tents, corridors, and bath-rooms for a few nights.rhe weather fortunately has been exceptionally pleasant,December being warmer and March being decidedly coolerhan the average, while the general health has been so goodihat both physicians and nurses have been but very littleemployed. A few sporadic cases of influenza have beenmported from Europe but have not spread, and typhoid fevers so scarce that only two cases have occurred, both of thesebeing among the English residents. One child broughtwhooping cough from Italy and by means of a children’sparty succeeded in infecting many of the English colony,out the disease yielded rapidly to a free exposure to sunshine.

The Anglo-American Hospital.This hospital was duly opened in January by the Countess

of Cromer and half of its 26 beds are already occupied. Itis well situated at Ghezireh near the racecourse and issurrounded by the purest of air and fields in which buffaloesgraze on the clover or strawberries are grown for the fruitmarket. The hospital is administered by a house committeeof English and Americans, including a preponderance ofmedical men, and the nursing staff includes a matron andtrained English nurses. Special and private wards are

supplied tor men, women, and children of all nationalities,but preference is given to British subjects and citizensof the United States. Infectious and mental cases are

not admitted. In addition to the paying patients thereare four general wards for those without means and forthe women and children of the army of occupation, in-cluding such midwifery cases as used to be sent to thefemale hospital at the Citadel which has now been closed.The patients in the general wards are attended by an

honorary medical staff of seven practitioners who have volun-teered to take this duty in turn. Any medical practitioner,beirg a British or American subject and practising eitherpermanently or temporarily in Egypt, may treat payingpatients in the hospital and any foreign medical man maybe called in as a consultant. The various rooms have beenmade to look as home like as possible, a well-lighted up-to-date operating theatre has been provided, fireplaces are

placed in all the chief rooms, the electric light has beenlaid on, and a plentiful supply of pure drinking waterhas been obtained by sinking a well. Sir E. Cassel, whooriginally started the subscription list with £5000, has nowpromised to give an equivalent sum to anything subscribedby others, so that every donor of one guinea to the fundis practically obtaining two guineas for the hospital, whichwill be of great value to the whole Anglo-Saxon community.

Sanatorium Al Hayat, Helouan.Under the above heading advertisements can be found in

the leading English medical papers, though this new estab-lishment is more likely to be popular with Germans,Russians, and Swiss than with the British or Americans.The Arabic word Haya" signifies cure and the sanatoriumis admirably placed for obtaining fresh air in the Helouandesert with nothing between it and Suez some 80 miles away.It has been financed by Baron Knoop and his friends andis managed by two German medical men and so far onlytwo nurses. The building, begun in February, 1903, wasopened in December last with 80 beds all facing southin order to obtain as much winter sun as possible.It consists of five storeys, the uppermost three beingbedrooms, while the dining, billiard, and smoking roomsand library are purposely placed at a distance to keep thebedrooms quiet ; they are, however, connected by coveredcorridors. Great care has been taken to construct thebuilding as a modern hospital, with rounded corners to therooms, mosaic cement flooring, an absence of unnecessarycornices, and large plate-glass windows. All are admitted,sick and healthy, and there is no power of enforcing anyrules or regulations, so that the establishment is somethingbetween a hotel and a sanatorium, like many a hydro-pathic establishment in England. It is intended, however,to set apart the top floor for tuberculous patients and todisinfect all the rooms with formalin. The medical men

hope to attract cases of nephritis, gout, rheumatoid arthritis,and tropical complaints on their way home to Europe. Asmall infectious hospital for six beds and a disinfectingstove are now being built, the hospitality of which will be