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141 stand the true import of the remarkable decline in the numbers of the resident population of the City in recent intercensal periods, the result of the day census may be useful in affording evidence of the still increasing activity of this beehive of the commercial world; and presuming that the system adopted for taking the recent day census is practically identical with that adopted in 1881, the results are not without a certain statistical interest, although their practical utility is somewhat doubtful. It is stated the cost of this day census which falls upon the City has already exceeded fl200, and it may be interesting to note that if the national census had been equally expensive in proportion to population its cost of collection would have exceeded 900,000, instead of little more than a tenth of that sum. The City day census is evidently an expensive undertaking. - BAD EXCUSES FOR HOSPITAL ABUSE. "A LADY who doesn’t know better" writes to the St. Jamcs’s Gazettc, protesting against the fuss made about people who can pay going to hospitals. We must not take the letter too seriously, for it has not a very serious look. Most humorous is the first idea, that medical men have an interest in keeping the lady "dangling as long as possible." The second is perhaps not quite so funny, but it is equally wide of the truth : "London doctors are so ridiculously dear," as if there ever was a time when medical charges were so ridiculously cheap. Competition has sometimes made even graduates of the best universities forget the cost of their education and the dignity of their calling. We must keep asserting the great evil of hospital abuse, and make those who are guilty of it understand that they are acting without self-respect, and disrespectfully towards a great and learned profession, which has made itself too cheap in the past. - THE ASSOCIATION FOR THE ADVANCEMENI- OF MEDICINE BY RESEARCH. WE would direct attention to the letter in another column urging the claims of the above useful Association. It has done much good work in the past, and is altogether an essential body in affording a guarantee of the character and quality of experimental observations, which have for their sole object the advancement of the science and art of medicine. The Association has, moreover, taken an active part in the furtherance of these objects in appointing a I commission upon cholera and in sending a delegate to I Berlin to study Professor Koch’s method of treatment of tuberculosis. We trust, therefore, that the Association will receive abundant support from those who can appreciate and value the work it is doing. FOREIGN UNIVERSITY INTELLIGENCE. - Be/’’M.—Dr. M. Rubner, Professor of Hygiene in the University of Marburg, has been offered the Directorship of the Hygienic Institute, vacated by Professor Koch. Giessen.-Dr. Ferdinand Fuhr has been promoted to an Extraordinary Professorship of Surgery. Jcraa.-Dr. F. Skutsch has been promoted to an Extra- ordinary Professorship of Gynaecology. Pruguc (Bohemian University).-Professor Maydl of Vienna has been selected for the chair of Surgery, vacant by the death of Professor Weiss. AT the next meeting of the Council of the Royal College of Surgeons, on the 30th inst., a member of the Court of Examiners in Surgery will be elected to fill the vacancy caused by the retirement of Mr. Berkeley Hill. Candidates must send in their applications before the 23rd inst. H. CROOKSHANK PACHA, Inspector General of Prisons, Cairo, F.R.C.S. Edin., has received the assistance of the- Khedive in his efforts to establish an asylum for criminals under fifteen years. On the occasion of his setting out for New York, where he is to be married on the 5th of next month, his Highness presented to Crookshank Pacha a. magnificent "collier de scarcabees," mounted in gold, as a. wedding present for his fiancée. THE Ospedale Maggiore at Milan has just received from, the Duchessa Eugenia Litta Bolognini, who recently lost her husband and her second son, a donation of 500, COO’ francs-the proceeds of the sale of her jewels. The special department of the hospital thus munificently endowed is. that of the Children’s " Clinico-Chirurgico," or ward for the, surgical lesions of children, and is intended as a memorial: to the young Duca Litta Bolognini, prematurely deceased. I - IT is stated by a Dalziel telegram, dated the 15th inst.p. that Professor Bergmann and Dr. Hahn have been ordered’ to answer within twenty-four hours the charges of having; inoculated pauper patients with cancerous matter. DR. A. TUCKER WISE (Swiss Federal diploma) has re- ceived permission from the Sanitatorath (Medical Council)) of the Grisons to practise in Davos. Pharmacology and Therapeutics. NAPHTHALINE AS A VERMIFUGE. According to Dr. Mirovich of Bielsk, naphthaline is aID admirable remedy not only for ascarides, but for tapeworm- He considers it much more certain and far less poisonous:’ than most of the other vermifuges. For grown-up people he prescribes a fifteen- grain powder, to be followed imme- diately by two ounces of castor oil. For two days before this dose the patient is directed to live on salt, acid and; highly seasoned food, then the naphthaline is given fasting; early the following morning. In the case of children naphthaline may be mixed with castor oil, flavoured> with a drop or two of bergamot. In all the cases in which this plan was carried out, including some in which more,. ordinary means had failed, the whole tænia was expelled with its head after the first dose. MERCURIAL OINTMENT IN GLANDERS. Dr. Gold of Severinovka, near Odessa, has been fortunatæ enough to cure cwo cases of glanders occurring in peasants by means of rubbing in strong mercurial ointment. In both cases there was bronchial trouble, pyrexia, and a considerable-- number of indurated nodules, as well as soft, fluctuating, and even phlegmonous swellings all about the body. The ex- amination of the purulent and serous contents of these at the Odessa bacteriological station showed the presence of the virus of glanders, as animals inoculated from cultures suc- cumbed to a disease typically resembling glanders. Half a, drachm of very strong mercurial ointment was rubbed in twice a day in each case for about a month, when the cure was complete. The effect on the mouth was combated with chlorate of potash gargles, and the suppurating spots were treated by poulticing, incisions, washing out with solutions of perchloride of mercury, and dressed with iodoform gauze. The first of these two cases was treated in 1888 : the patient is still alive and in the best of health. Dr. Gold has had some thirty cases of glanders in his practice, all of which have proved fatal except these two. The idea of using mer- cury was suggested to him by the fact that in some respects. there is a similarity between glanders and syphilis, and by the active microbicidal properties of mercury. ARISTOL IN BURNS AND SCALDS. Dr. Heinrich Stern, of New York, having used aristol in two cases of burns and scalds, speaks highly of its influence- in promoting early and rapid recovery. In the first case
Transcript
Page 1: Pharmacology and Therapeutics.

141

stand the true import of the remarkable decline in thenumbers of the resident population of the City in recentintercensal periods, the result of the day census may beuseful in affording evidence of the still increasing activity ofthis beehive of the commercial world; and presuming thatthe system adopted for taking the recent day census is

practically identical with that adopted in 1881, the resultsare not without a certain statistical interest, although theirpractical utility is somewhat doubtful. It is stated thecost of this day census which falls upon the City hasalready exceeded fl200, and it may be interesting to notethat if the national census had been equally expensive inproportion to population its cost of collection would haveexceeded 900,000, instead of little more than a tenth ofthat sum. The City day census is evidently an expensiveundertaking.

-

BAD EXCUSES FOR HOSPITAL ABUSE.

"A LADY who doesn’t know better" writes to theSt. Jamcs’s Gazettc, protesting against the fuss made aboutpeople who can pay going to hospitals. We must not takethe letter too seriously, for it has not a very serious look.Most humorous is the first idea, that medical men have aninterest in keeping the lady "dangling as long as possible."The second is perhaps not quite so funny, but it is equallywide of the truth : "London doctors are so ridiculouslydear," as if there ever was a time when medical chargeswere so ridiculously cheap. Competition has sometimesmade even graduates of the best universities forget thecost of their education and the dignity of their calling.We must keep asserting the great evil of hospital abuse,and make those who are guilty of it understand that theyare acting without self-respect, and disrespectfully towardsa great and learned profession, which has made itself toocheap in the past.

-

THE ASSOCIATION FOR THE ADVANCEMENI-OF MEDICINE BY RESEARCH.

WE would direct attention to the letter in anothercolumn urging the claims of the above useful Association.It has done much good work in the past, and is altogetheran essential body in affording a guarantee of the characterand quality of experimental observations, which have fortheir sole object the advancement of the science and art ofmedicine. The Association has, moreover, taken an activepart in the furtherance of these objects in appointing a Icommission upon cholera and in sending a delegate to

I

Berlin to study Professor Koch’s method of treatment oftuberculosis. We trust, therefore, that the Association willreceive abundant support from those who can appreciateand value the work it is doing.

FOREIGN UNIVERSITY INTELLIGENCE.- Be/’’M.—Dr. M. Rubner, Professor of Hygiene in the

University of Marburg, has been offered the Directorship ofthe Hygienic Institute, vacated by Professor Koch.Giessen.-Dr. Ferdinand Fuhr has been promoted to an

Extraordinary Professorship of Surgery.Jcraa.-Dr. F. Skutsch has been promoted to an Extra-

ordinary Professorship of Gynaecology.Pruguc (Bohemian University).-Professor Maydl of

Vienna has been selected for the chair of Surgery, vacantby the death of Professor Weiss.

AT the next meeting of the Council of the Royal Collegeof Surgeons, on the 30th inst., a member of the Court ofExaminers in Surgery will be elected to fill the vacancycaused by the retirement of Mr. Berkeley Hill. Candidatesmust send in their applications before the 23rd inst.

H. CROOKSHANK PACHA, Inspector General of Prisons,Cairo, F.R.C.S. Edin., has received the assistance of the-Khedive in his efforts to establish an asylum for criminalsunder fifteen years. On the occasion of his setting outfor New York, where he is to be married on the 5th of nextmonth, his Highness presented to Crookshank Pacha a.

magnificent "collier de scarcabees," mounted in gold, as a.wedding present for his fiancée.

THE Ospedale Maggiore at Milan has just received from,the Duchessa Eugenia Litta Bolognini, who recently losther husband and her second son, a donation of 500, COO’francs-the proceeds of the sale of her jewels. The specialdepartment of the hospital thus munificently endowed is.that of the Children’s " Clinico-Chirurgico," or ward for the,surgical lesions of children, and is intended as a memorial:to the young Duca Litta Bolognini, prematurely deceased.

I -

IT is stated by a Dalziel telegram, dated the 15th inst.p.that Professor Bergmann and Dr. Hahn have been ordered’to answer within twenty-four hours the charges of having;inoculated pauper patients with cancerous matter.

DR. A. TUCKER WISE (Swiss Federal diploma) has re-ceived permission from the Sanitatorath (Medical Council))of the Grisons to practise in Davos.

Pharmacology and Therapeutics.NAPHTHALINE AS A VERMIFUGE.

According to Dr. Mirovich of Bielsk, naphthaline is aIDadmirable remedy not only for ascarides, but for tapeworm-He considers it much more certain and far less poisonous:’than most of the other vermifuges. For grown-up peoplehe prescribes a fifteen- grain powder, to be followed imme-diately by two ounces of castor oil. For two days beforethis dose the patient is directed to live on salt, acid and;highly seasoned food, then the naphthaline is given fasting;early the following morning. In the case of childrennaphthaline may be mixed with castor oil, flavoured>with a drop or two of bergamot. In all the cases in whichthis plan was carried out, including some in which more,.ordinary means had failed, the whole tænia was expelledwith its head after the first dose.

MERCURIAL OINTMENT IN GLANDERS.

Dr. Gold of Severinovka, near Odessa, has been fortunatæenough to cure cwo cases of glanders occurring in peasantsby means of rubbing in strong mercurial ointment. In bothcases there was bronchial trouble, pyrexia, and a considerable--number of indurated nodules, as well as soft, fluctuating,and even phlegmonous swellings all about the body. The ex-amination of the purulent and serous contents of these at theOdessa bacteriological station showed the presence of thevirus of glanders, as animals inoculated from cultures suc-cumbed to a disease typically resembling glanders. Half a,drachm of very strong mercurial ointment was rubbed intwice a day in each case for about a month, when the curewas complete. The effect on the mouth was combated withchlorate of potash gargles, and the suppurating spots weretreated by poulticing, incisions, washing out with solutionsof perchloride of mercury, and dressed with iodoform gauze.The first of these two cases was treated in 1888 : the patientis still alive and in the best of health. Dr. Gold has hadsome thirty cases of glanders in his practice, all of whichhave proved fatal except these two. The idea of using mer-cury was suggested to him by the fact that in some respects.there is a similarity between glanders and syphilis, and bythe active microbicidal properties of mercury.

ARISTOL IN BURNS AND SCALDS.

Dr. Heinrich Stern, of New York, having used aristol intwo cases of burns and scalds, speaks highly of its influence-in promoting early and rapid recovery. In the first case

Page 2: Pharmacology and Therapeutics.

142

the injury was a burn of the forearm of the "fourth- degree"; the skin and subcutaneous tissues had been de.stroyed, the parts turned hard, dry, and eschar like, thesurrounding skin became contracted and folded. Aristoland vaseline in the proportion of one to ten were at onceapplied. The eschar separated completely by the fourthday, and under the continuous use of the ointment suppura-tion was limited, and granulation and repair were com-pleted in less than a month. In the second case, a child offour years old fell in a bath of hot water, and blisteringresulted nearly all over the body. The largest blisters’were punctured, and aristol and vaseline in the above-men-tioned proportions were applied, and recovery was complete.in the course of about two weeks.

REPORT OF THE LANCET

Special Sanitary CommissionON THE

REHOUSING OF THE POOR AT MANCHESTER.

THE position of Manchester in respect to sanitary reform,with regard more especially to the rehousing of the poor, isparticularly interesting at the present moment. Manchesterand Liverpool are, after London, the two moat importanttowns in Great Britain. The population in each town isabout the same, the last census giving the population of

Liverpool as 518,000 and that of Manchester as 505,300;but during the last ten years the population of Liverpoolhas decreased to the extent of 6’2 per cent., while that ofManchester has increased 9’3 per cent. The death-rate inboth towns is exceptionally high, and the condition of thehousing of the poor particularly unsatisfactory. Taking themedical officer of health’s return for the first quarter of the.current year, we find that during each of the first quartersof the last four years the rate of mortality in Manchesteraveraged 30’5 per 1000 per annum, but that the death-rateof this year’s first quarter was below the mean to the extentof 9 per cent., as it amounted to 27’8 per 1000. Even at thisreduced rate the mortality of Manchester was 4’8 per1000 higher than that of the twenty-eight great towns,though they contain an aggregate population of more than10,000,000 people. The death-rate of the twenty-eightgreat towns amounted to only 23 per 1000. Of course,many causes contribute to bring about this result.The high death-rate is not due exclusively to over-

crowding and defective sanitation. The fact that so

many women work in mills and workshops, and conse-quently grossly neglect their children, is one of the veryevident causes of the mortality. But the bad housing ofthe working and labouring classes is undoubtedly alsoanother among the principal reasons of this high death-rate. This is very generally acknowledged. The Man-chester and Salford Sanitary Association, which is oneof the oldest organisations ever started to agitate infavour of sanitary reform, has by many years of per-sistent work brought this fact home to the minds ofthe inhabitants of Manchester. A very loud outcry hasbeen raised. The corporation governing the city of Man-chester was fairly besieged on all sides. Something had tobe done to satisfy the public clamour, and the first act wasthat of appointing Dr. John Tatham as medical officer of’health for Manchester. Dr. Tatham had distinguishedhimself, when medical officer for Salford, by the couragewith which he struggled against those members of the localauthority who were opposed to measures of sanitary reform.He was therefore carried into office on the crest of the waveof sanitary reform; but this appointment did not suffice toallay the outcry for reform, and a scheme of improvementwas promptly prepared which gave the greatest promise ofuseful results.An area in the centre of the town was selected. The pro-

perty most certainly deserved condemnation. This fact wasadmitted by the corporation so far back as the autumn of1889, when it was decided to lodge a petition with the Local’Government Board, asking for a local inquiry. In Novemberof the same year a Bill was prepared for Parliament, entitledthe Manchester Dwellings’ Scheme, 1890, by which the cor-

poration were to have the right of expropriating the ownersof the condemned property, and of erecting in its steadsuitable dwellings or lodging-houses for persons of the

working class. Four different areas were included in thisscheme. The first, that already mentioned, measured19,271 square yards, and had 1250 inhabitants ; the second,4233 yards, with 400 inhabitants; the third, 863 squareyards, with 120 inhabitants ; and the fourth, 956 squareyards, with 100 inhabitants. The cost of the land and im-provements was set down at ;E103,000. The interest of thisscheme rests not so much with the size of the areas involved,but on the far-reaching plan of action on which it is based.The corporation intended on the first and largest area tobuild a model common lodging-house, similar to thosealready built by the city of Glasgow and fully described inthese columns. This common lodging-house, like those ofGlasgow, was to remain the property of the town. On theremaining land model tenement dwellings or artisans’cottages were to be built, and let out directly by themunicipality to the occupier. This being accomplished,the municipal property was destined to serve as a

model and a menace to all property owners. Havingset the example, the authorities of the town were totreat all owners of insanitary and degraded propertywith unprecedented severity. They were to be told that ifthey did not make their houses as good in every respect asthe houses, &c., owned by the municipality, they would, intheir turn, be expropriated, and the town would undertaketo build proper dwellings. In a word, the corporation wasabout to compete with private owners, and compel thelatter to vastly improve their property, or to sell out.

This seemed a bold scheme, and at first sight gave everypromise of success. Unfortunately we have to deal with anumber of details that combine together to thwart thescheme. A very important change has taken place in Man-chester during the last thirty years, and it very disadvan-tageously affects the powers for doing good the municipalitywould otherwise possess. Formerly most of the owners ofthe property tenanted by the poor of Manchester were fairlyrespectable people. They had of necessity, however, toemploy a very harsh class of men as rent collectors, or pro-perty agents. These agents were often rough, hard, un-educated men, the very last class of person likely to appre-ciate the broad interests of humanity involved in the causeof sanitary reform. Yet these property agents have nowbecome to a very large extent property owners. The formerowners, sometimes gentlemen of broad and generous views,were also often spendthrifts. They therefore too readily con-sented to accept loans of money from their rent collectors,and tbf latter thus gradually became owners of the propertyfor which they had been but the agents. Soon a numerousclass of people commenced seeking by every means to be-come the owners of poor cottages and of bad property. Bythe operations of building societies also a good many houseshave passed into the hands of this class of person.The mischief this has wrought will be easily under-

stood. As a class these owners are opposed to sanitaryreform. It is the bad, overcrowded, degraded, and in-

sanitary property that, in proportion to the capital invested,brings in by far the largest profit. The tenants for themost part pay their rent once a week, and are very often afew weeks in arrears. They stand therefore in terrorof the collectors, who at any moment may throw themout into the street. As most of these tenants occupy,not lodgings, but cottages, they have votes for theelection of the Town Council, but they generally vote forthe nominee of their landlords. Thus this new class ofproperty owners, which has sprung into existence withinthe last few years, influences both the poor and the membersof the Town Council. Yet, and in spite of this undoubtedlystrong and hostile influence, the very bold scheme of sani-tary reform we have described above was adopted by thetown and received the sanction of Parliament.

If we look a little below the surface, it will be seen thatthose who receive their income from the poor may stillhope to enjoy for some time to come a very large measureof immunity. It will soon be discovered that, after all, theHousing of the Working Classes Act of 1890 works to theadvantage of the landlord. With the exception of the10 per cent. extra compensation for compulsory sale, it is inthe main a repetition of the Land Clauses Act. The sum ofcompensation which the sanitary authority must give toowners of condemned property has to be fixed by an arbi-trator, and this arbitrator can, if he chooses, take into


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