1684 PARIS.-ROME.

,them with a flat denial and the engineers proclaim for thefuture their pretence of insuring the water-supply of the

city without paying the slightest attention to the views ofthe Academy of Medicine or to those of the professionalhygienic authorities. This is how the matter came to ahead. The " water lords " (administration des eaux),-instead of finding new springs, found it much simplerto construct, near Paris, filtering beds into which waterfrom the Seine should be led. This water after passingthrough beds of sand and gravel passes into reservoirsfrom which it is distributed to people as drinking-waterat times such as when the spring water-supply fails.This, of course, is during very dry weather and it is

precisely then that the Seine is lowest and consequentlymost befouled and its water most difficult to render fit fordrinking by any filtration process. In my letter publishedin THE LANCET of Nov. 24th, p. 1538, I gave yourreaders an account of how this custom was criticised

by the Council of Hygiene and of the confessionwhich the chief engineer had to make how during.a period of three weeks during this summer Seinewater was mixed with spring water and that the period-of admixture coincided with a recrudescence of typhoidfever. The Academy of Medicine in its turn has sent aresolution to the Prefect of the Seine setting forth that thenecessary measures ought to be undertaken without delayfor insuring a complete separation between spring waterand filtered river water, and moreover that the water ofthe Seine should be supplied at such a pressure thatit could be used by the inhabitants of Paris for suchpurposes as lifts, washing, and watering. Owing to thelow pressure at which the river water is suppliedspring water has to be used for these purposes. ThePrefect’s reply is simply amazing. According to him

spring water and filtered river water have been for a longtime delivered by quite separate services. He refuses to usethe filtered Seine water as the Academy demands forindustrial purposes and this for a most remarkable reason-namely, because the filtration necessitates a series ofdelicate and difficult operations which would, if thewater were used for industrial purposes, simply result-in a loss. He might just as well argue that the"water lords," having already made a grave mistakein adopting this gross method of filtration in face ofthe protests of the Academy and the Council of Hygiene,- suggest that the water should be used so that the expense towhich they have been put for purification should not bewasted. The defence of the water from an alimentary point ofview is undertaken as follows. The filtered water, says thePrefect, has been certified as being perfectly wholesome in- numerous analyses made by the chemists of the officiallaboratories, and contains, as a matter of fact, fewerbacteria and less organic matter than does spring water.The whole of suburban Paris and many large cities, notablyLondon and Berlin, are supplied with filtered river water"for drinking and the public health does not therebysuffer. In fact, adds the Prefect, the mortality incities so supplied is no higher than in cities supplied withspring water. As for supplying river water at high pressurethe Prefect ignores this question entirely on the ground that’it is concerned with technical -and administrative detailswith which the Academy of Medicine has nothing to do.The Academy naturally protests vehemently against this high-handed way of treating its resolutions, and M. Henriot hasagain lifted up his voice against the assumption of theengineers that Seine water is fit for drinking. In the presentstate of bacteriology a bacteriological examination is not

enough to affirm the purity of a water, and nothing-is more dangerous than to rely on laboratory researches,however numerous they may be. Typhoid fever possessesan organism which reacts much more delicately to itthan any organism known in the laboratory-namely, thehuman body-and the people of Paris would have been

spared the sad experience of the last two years if the pre-fectoral administration had seen fit to forbid absolutely theadmixture of river water and spring water. M. Henriotconcluded by deploring the pig-headedness of the engineers,by sticking to their system, in compromising the interest!of public health and rendering of no effect the enormoussacrifices which the city of Paris has made to keep itselffree from typhoid fever. M. Brouardel agreed with him,The debate concluded by the appointment of a committeEcharged to lay before the Prefect of the Seine the reso-

’lutions of the Academy in a yet more urgent form.

Pcnetrating Gunshot Wounds of the Cranium.The Society of Surgery has again had this subject under

consideration. Opinions were much divided. With refer-ence to the use of the x rays for diagnostic purposes M.Tuffier considered that these rays should not be used directlyafter the infliction of the injury. M. Reynier, on the otherhand, thought that they could be used with safety withoutdelay, and that by the use of M. Contremoulin’s arrangementthe position of projectiles could be easily located. As for treat-ment there were two main currents of opinion-one in thedirection of simply enlarging the wound of entry, removingfragments and making the trail of the bullet aseptic,but not searching for it unless there were grave cerebralsymptoms ; the other view looked upon the bullet itself as

a septic body and that it should be removed, if possible, aslong as it lay within easy reach.

Dec. 4th. ______________

ROME.(FROM OUR OWN CORRESPONDENT.)

The Question of Priority in the Mosquito-Malaria Theory.THE Policlinico of Nov. lst, in publishing a letter from Major

R. Ross, I.M.S., on this subject, says by way of preface that" scientific discoveries do not usually gush forth ready-madefrom the mind of genius, but are the fruits of the activity ofmany energies which unite the elements more or less directlyserviceable to attain the desired end. Whether the greatestcredit is due to him who initiates the work, or to him whoprosecutes it most successfully, or to him who synthesisesand presents it in the best form, is always a subject ofdiscussion in regard to everything new. No wonder, then,that such a dispute should arise around a doctrine so impor-tant both in its scientific bearings and its immediate practicalapplication as that which aims directly at the reclamationfrom malaria and utilisation of immense tracts of territoryhitherto waste. The Policlinico is glad to open its columnsto such questions and to men of such worth. No precon-ceived scientific opinions, neither personal considerations,nor a blind patriotism, nor servility towards foreigners willhinder it from keeping the controversy to the region offacts." It is indeed no more than fair that the Italianscientific world, which has hitherto heard only one side ofthis question, should now get the opportunity of hearing theother and so be in a better position to apportion merit tothose who deserve it. Major Ross has many complaintsagainst Professor Grassi, who, he says, in his recent work," Studi di un Zoologo sulla Malaria," seeks to discreditthe former’s researches on malaria in order to gain unmeritedcredit for himself. Major Ross thinks that many persons inItaly who are not acquainted with the true facts maybe misled by these plausible. statements of ProfessorGrassi which he characterises as a tissue of dis-ingenuous fallacies and a contortion of the facts withomissions of dates and attacks upon his (Major Ross’s)veracity. He then recalls the different steps in his workdating from May, 1895, his first unsuccessful attemptsto cultivate the parasite in culex, followed in August andSeptember, 1897, by his success with semilunar bodies in

anopheles ; the interruption of his experiments at this

point and their resumption a year later when he successfullydemonstrated the extra-corporeal life-cycle of hæmosporidiaof birds in mosquitoes and infected healthy birds experi-mentally by means of the bites of these insects ; and finally,after a second interruption of his labours, the publication ofhis results by Manson and himself on June 18th, 1898-adate a month in advance of the time at which ProfessorGrassi, by his own account, commenced his work on therelation between malaria and mosquitoes, and fully fourmonths before he and his colleagues could show any result.And this success they only obtained by following MajorRoss’s methods and profiting by his observations, previouslyto which Professor Grassi and his friends had been lost in amaze of error. Even Professor Grassi’s pretence that MajorRoss had not indicated the anopheles as the definitive hostof the parasite falls to the ground, for he himself hadevidently recognised it from Major Ross’s description of his" dapple-winged mosquito," as appears from several circum-stances, but more especially from a letter dated Nov. 25th,1898, written to Major Ross by Dr. Charles of Rome, inwhich the latter states that he had found Professor Grassi inhis laboratory intently reading Major Ross’s letter to the

1685ROME.-CANADA.

British Medical Journal of Dec. 18th, 1897, and thatGrassi appeared to be convinced that the description of themosquito therein given referred to the anopheles claviger.Indeed, a few hours afterwards, according to Dr. Charles’Professor Grassi found some of the zygotes derived fromsemilunar bodies in the anopheles claviger. It is absurd,then, Major Ross contends, for Professor Grassi to arrogateto himself the merit of the original discovery simplybecause he had confirmed it. In conclusion, Major Rossappeals to the recognition accorded to him in the matter ofpriority by such authorities as Laveran and Blanchard inFrance, by Koch in Germany, by Manson and Nutall inEngland, by Celli in Italy, and by the Indian MedicalGazette in India.

Medullary Anasthesia.At the second sitting of the Italian Surgical Society a

discussion was opened by Dr. Fummi on Bier’s method ofcocainising the spinal cord, by a reference to 40 casesoperated on under Professor Montenovesi’s direction at theSanto Spirito Hospital. The point he wished to dwell uponwas the attempts to extend the anaesthesia to the higherparts of the trunk and to the upper extremities. Byexperiments on dogs and on the cadaver it was soughtto determine why a liquid of the specific gravity of 1014(which is nearly that of the ordinary 1 per cent. solutionof cocaine) cannot ascend to the upper portion of the spinalcord even when the body is placed in a strongly inclinedattitude head downwards. It appeared that the reason liesin the difference of specific gravity between the cocainesolution and the cerebro-spinal fluid. By using a solution ofcocaine in glycerine the alkaloid was found to reach the

highest point of the cerebro-spinal canal, being detected bythe very delicate method of Grefel even in the cerebralventricles. This was still better seen with solutions ofmethyl blue in glycerine. The first application of this

glycerine solution of cocaine to the human subject wasfollowed by distinct anaesthesia of the thorax, neck, andupper limbs. Immediately after the injection the patientwas placed in the inclined position and he soon began toexperience a sensation of formication and heat advancingfrom the abdomen to the thorax and thence to the neckand arms. Further observations will be reported later ;meanwhile, the trials are being continued in ProfessorMontenovesi’s wards. Bastianelli and Fioretti related their

experience of this method of anaesthesia, the former from atotal of 35 cases, the latter from 25 cases. Bastianelli gaveas cases suitable for its employment operations on the lowerextremities, laparotomies, and uncomplicated hernias ; andas contra-indications, the need for full muscular relaxation,nervousness, the age of infancy, extensive abdominalopera-tions (on account of the sensitiveness retained by the peri-toneum), states of collapse, &c. On the whole, thediscussion showed that the method is taking up a recognisedplace here, and that the variety of surgical procedures inwhich it may be employed is rapidly increasing.

Dec. lst. _______________

CANADA.(FROM OUR OWN CORRESPONDENT.)

Politics and the Profession.A GOOD many members of the medical profession have

been returned to Parliament in the recent general electionsheld on Nov. 7(.h, and some notable ones have fallen in thefight. Amongst these is the venerable and virile leader ofthe Conservative party, Sir Charles Tupper, who has sinceannounced his retirement from public life. At the age of 34years, Sir Charles, then Dr., Tupper forsook a lucrative andgrowing practice in his native province of Nova Scotia forpolitics, and rapidly attained a commanding position in thecouncils of his country. At Confederation in 1867 he tooka prominent part in the formation of the Canadian MedicalAssociation and was unanimously elected its first president,which office he successfully filled for the two succeedingyears. At the age of 80 years he has exhibited inthe recent campaign a wonderful vitality, and his losswill be a keen one to the Conservative party as well as tothe country. In many public works, this Canadian prac-titioner has left his lasting mark. The profession throughoutthe Dominion is congratulating itself that Dr. T. G. Roddick,the promoter of the Dominion Medical Council Bill, has beenable to retain his seat in Parliament by a narrow majority.

Speaking recently at a banquet tendered in his honourLord Strathcona paid a high and deserving tribute to Dr.Roddick for the good he was seeking to accomplish in

bringing about this Dominion registration, stating that thepublic were beginning to take an interest in the measure, asit would be another means of knitting the provinces togetherin closer bonds of union. The medical profession can nowlook forward confidently to important progress being made inthis direction at the next meeting of the Dominion Parliament.

T’ital Statistics in Ontario.

By the returns last year from the Registrar-General’soffice for the province of Ontario the birth-rate was shownto have decreased considerably as compared with the previousyear. At that time it was thought that the apparent decreasemight be due to defective returns, so an extra effort was putforward to remedy this laxity on the part of parents, butthe returns for 1899 exhibit a still further decrease. Thebirths in Ontario last year (1899) numbered 44,705 as com-pared with 46,599 in 1898, a decrease of 1894. On the otherhand, the marriages exceeded those of the previous year by1139, the figures being 16,514 as compared with 15,375 in1898. The deaths for 1899 number 28,607, as against 26,370in the preceding 12 months, or an increase for the formerperiod of 2237. The birth-rate was 19-4 per 1000 in 1899, ascompared with 20 4 in 1898 ; the death-rate was 12’4 per 1000,as against 11’5; and the marriage-rate was 7’1 per 1000,compared with 6 70.

Toronto General Hospital Training School for Nurses.The annual graduating exercises of this institution were

held on Nov. 9th, when 13 graduates received their diplomas.This institution was established in 1881 with 16 pupilnurses, and since that time 317 have graduated, 223 ofwhom are still actively engaged in the practice of theirprofession, many of these being employed in the neighbouringRepublic, as Canadian nurses are much sought after by thehospitals of the United States. A new and handsomeresidence has just been completed for the nurses, of whomthere are now eight probationers and 59 pupil nurses, at acost of 4000 ($20,000) which is the finest of its kind inthe Dominion. The lady superintendent stated that duringthe past year she had received 650 applications, of which only25 were granted. The course of training in the school lastsfor three years and during that time a pupil nurse receives$4$5. and$6 per month respectively, board and washing beingalso supplied. a

Home for Incurable Children, Toronto.This deserving institution was started in September, 1899

when Senator Cox presented the lady philanthropists whowere undertaking the work with a fine house in a residentialquarter of the city for a home. In December last this wasformally opened with the reception of two little patients. Atthe first annual meeting held a few weeks ago the secre--

tary’s report showed that during the past year 13 children.had been admitted, and of this number 10 now remain, twohaving died and one having been transferred to the OrilliaAsylum for Idiots.

The Consumption Sanitarium for Toronto.Toronto is making an earnest effort to establish a sani-

tarium for her consumptives. The medical health officer,Dr. Sheard, has just reported on the subject to the effectthat as soon as the Anti-Consumptive League of Ontario orthe National Sanitarium Association, which controls theMuskoka Cottage Sanitarium, provides a fund of $50,000,the city should submit a by-law to the ratepayers forauthority to contribute a like sum. Dr. Sheard further stipu-lates for the city that the institution must be located within30 miles of the city and that the grounds surrounding thesame must not be less than 50 acres in extent. Mr. Gage,the treasurer of the national organisation, who was-

instrumental in founding the Muskoka Sanitarium, hasnow come forward with an offer to construct and to equipthe hospital at the expense of the National SanitariumAssociation without any civic assistance. The offer of Mr.Gage is for a hospital of 50 beds, and it is altogether likely,cow that conditions are in such good shape, that the cityof Toronto will soon have its consumptives properly lookedafter.

The Victorian Order of Nurses.A meeting of the board of management of the Victorian

Order of Nurses was recently held in Montreal and amongstothers present were Lord Strathcona, who has given consider-able monetary assistance to the Order, and Dr. Craik, Dr.