1597

had been sent (Charite Hospital, Berlin ; Julius Hospital,Wurzburg; General Hospital, Hamburg; and municipalhospitals in Magdeburg and Krefeld), it was ascertainedthat in no instance had unfavourable symptoms beenobserved. In one of these hospitals a tenfold dose wasadministered to a boy one and a half years of age without any harm resulting ; in another of them a series of children received injections for immunising purposes and remainedquite healthy. The report concludes that from a clinical aswell as from an experimental point of view the serumNo. 216, used in the Langerhans case, must be regarded asa normal one. The death of the child is, therefore, not tobe imputed to the antitoxin.

Hygiene in Printing Offices.A Bill providing for hygienic improvements in printing

offices has been proposed to the Federal Council by theImperial Chancellor. It specifies that the rooms of theoffices must be 4 metres (= 13 feet) in height, and mustcontain at least 15 cubic metres (= 530 cubic feet) of air forevery man employed therein. The floor must be smooth, andthe walls must be painted with oil paint renewed every fiveyears. The type cases must be provided with pedestals toavoid the accumulation of dust beneath them. Stereotypework is to be done in special rooms efficiently ventilated.The type cases are to be cleaned in the open air and by theaid of bellows only. Ample lavatory accommodation is madecompulsory by the Bill, which gives very precise directionsin this matter. One washhand basin at least must befurnished for each five workmen, soap and towels are to besupplied to them free of charge, and a cloakroom separatedfrom the workrooms is to be provided. This Bill, which isviewed very unfavourably by the employers, is on the otherhand declared by competent medical men to be very useful.Dr. Lewin, a Lecturer on Toxicology at the Berlin University,points out that whilst the German insurance laws oblige- employers’ associations to indemnify workmen in case ofaccidents they are entirely unprotected against the chronicinfluence of poisons. As printers are liable to suffer fromthe effects of lead-one of the strongest poisons-he thinksthat preventive measures are necessary, but the Bill ought, inhis opinion, to be extended to other trades where lead isused, and he specially mentions some of the home industrieswhere the workmen’s children inhale dust impregnated withlead. The children of dial-plate painters, for instance, evenif born healthy die in a few months with convulsions. In avillage of Hesse, where pottery is glazed by home workers,71 per cent. of the children were sickly, 50 per cent. diedwithin the first five years, and the survivors suffered fromhydrocephalus or macrocephaly.

Deaths of Medical Men.Dr. Henle, one of the best German anatomists and Pro-

fessor of Anatomy at the University of Tubingen, in

Würtemberg, died in that town on May 23rd. He began hismedical career abroad as an assistant to the great physio-logist Donders of Utrecht, in Holland. He was then

appointed professor at the Universities of Marburg, Rostock,Prague, and Tubingen respectively. The number of hisanatomical publications is very great, his most renownedwork being the " Handbook of Topographical Anatomy."His death will be lamented not only by the membersof the profession but also by lovers of the finearts, because he employed his anatomical knowledgein the interpretation of the problems which presentthemselves to artists. He published an essay on theLaocoon group, another cn the works of Michael Angelocompared with those of the ancient masters, and a series ofarticles which were collected under the title of "Papers onthe Plastic, Mimetic, and Dramatic Art."-Dr. AgathonWernicke, chief medical officer to the Berlin police, died inBerlin on May 26th. He was one of the organisers of theUniversity of Tokio, in Japan, having been summoned theretogether with another German medical man in 1874. Heprincipally occupied himself with epidemiology and medicalgeography, and lectured on these subjects at the Universityof Berlin. He died from diabetic gangrene, and it causedmuch surprise that he allowed himself to be attended by aquack and declined to submit to an amputation which wasrecommended by an able surgeon.

The Apothecaries’ Board.A new board in connexion with the Government Medical

Department is now instituted by a royal order. It has todeal with all matters concerning the pharmaceutical pro-fession and is to be consulted if any alterations or reforms

are intended. It may also advise the Government to alterthe laws and regulations when circumstances require it.The board consists of the Director of the Medical Depart-ment as chairman, three medical members of this depart-ment, four qualified apothecaries (who must be owners ofpharmacies), and four other qualified apothecaries employedin licensed pharmacies. The board is to meet at least oncea year.

ROME.(FROM OUR OWN CORRESPONDENT.)

Infectious Disease in Schools.AT Turin the other day Dr. Angelo Mosso, Professor of

the Institutes of Medicine in the University, delivered beforethe Società Piemontese d’Igiene a lecture on the above

topic. No man can be so "wholesomely practical as thelaboratory worker on due occasions, and Professor Mossoshowed at once the grave importance of school hygiene bydemonstrating that in the dust swept up from betweenthe benches occupied so many hours each day by thescholars any quantity of pathogenic bacilli may be found-among them specimens of the bacillus diphtheriticus.In fact, it was at the instance of Professor Mosso’scolleague, Professor Bizzozero, that the former physiologistprepared the lecture he has just delivered. "Every com-mune," so runs Article 110 of the legislative enactment forthe observance of public hygiene, ’’ must have its schoolsvisited at least twice a month during scholastic hours, andwithout previous intimation by the communal sanitary officeror by medical practitioners specially told off for thepurpose." This precaution, however, Professor Mossoproved by official documents to be quite irregularlyenforced in even the best organised communes, like Turinitself, where there are over sixty schools, urban andsuburban, to say nothing of private ones, and where thesanitary inspection prescribed by Government has to becarried out by only two medical men. Appealing tothe precedent of Great Britain, particularly London,Professor Mosso insisted on the adoption in Italy of asimilar thorough organisation if her large towns are to haveso comparatively clean a bill of health as London, andespecially London schools. Even where the "Commis-sione di Vigilanza," established by the Government quiterecently for the protection of elementary schools, is

fully organised, it is so far defective that the sanitaryofficer is without due authority and is without the means

of effecting the reforms of which he sees the necessity.This is a grave omission, for, according to Professor Mosso,Italian municipalities " sono restii ai progressi dell’igiene" "

(resist hygienic progress), and the want of power to coercethem explains the paralysis of the medical arm and thedisastrous prevalence of infectious disease in young Italy.Meanwhile, urged the lecturer, in the present state of thekingdom (financially and politically incapacitated for thegraver social reforms) the various Society d’lgiene through-out its borders must educate the public mind, show thedangers incurred by tender youth in statu pupillari, and pre-pare for such a methodical and medically inspired regulationof school hygiene as the Government may give effect to at thefirst favourable opportunity. Turning to sanitary details inscholastic life Professor Mosso proved that something morethan ventilation (deficient as that usually is) requires atten-tion. The personale smbalterrzn (the subordinates chargedwith cleaning the school) must be taught hygienic principlesand made to observe them. In the first place thebenches should be only so long as to admit of theireasy displacement for cleansing purposes under andbelow them. The old sweeping methods (with brooms),which simply stir up the dust and diffuse it in theair only to settle down again, must be abandoned.Three or four times a week (better every day) the floorshould be laid with damp sawdust, afterwards diligentlyswept up, while twice a month the walls should be carefullywashed. For such service the personale subalterno shouldbe doubled or trebled. Again, the Società d’lgiene shouldinitiate popular courses of hygienic instruction for school-masters and schoolmistresses, especially as to the origin,nature, and diffusion of infective disease, and should

publish short, practical treatises addressed to the communityso as to ensure intelligent cooperation between school

managers and municipal authorities, between teacher andparent. Such a twofold propaganda can be fraught with

1598

nothing but good for "the Italy that is to be." ProfessorMosso’s recommendations were unanimously adopted by thesociety, which at it3 next sitting will discuss the samephysiologist’s report on "Physical Education in Schools," asubject on which the writer of "The Pathology of Fatigue "

expatiates with peculiar authority.Me Premier on the " IJi’J’ezione di Scznita."

In his great speech on the administrative programme ofthe Government the Prime Minister, the Marchese di Rudini,has just made an important statement as to the "Direzionedi Sanita " (public health department). That departmentlaboured under two constitutional defects which fructifiedin much irregularity and inefficiency. It had a "scuolad’igiene " (a training college of hygiene) all to itself, and ithad "autonomy." The former arrangement, as shown bysuch eminent physicians and surgeons as Baccelli, Tom-masi-Crudeli, and Durante, was vitiated by its detach-ment from the University. A few years’ trial has

proved that solidarity with the academic system ensureda more thorough, more enlightened schooling in sanitationand the cognate sciences on which it depends than could beobtained by a separate teaching staff on which these scienceswere imperfectly represented or not represented at all.Accordingly, the " scuola d’igiene" has ceased to exist andreturns to the University, with all its special laboratories,however, retained. It will, as before, be under the directcognisance of the Ministry of Public Instruction, like everyother branch of medical training and practice. The auto-

nomy," which made the technical department of the scuola"a spending department, was also found to work badly. Expertsin hygiene, as Baccelli showed, are invaluable as counsellorsand assessors, but when it comes to practical administrationanother set of conditions intervenes for which the laboratoryis not the best discipline. They have their place-theirindispensable place-in the " Consiglio Superiore di Sanita,"but according to the Prime Minister they will no longer havethe power of unchecked initiative. Henceforth they willwork in concert and, it is believed, in harmony with theheads appointed by the State. These announcements werereceived by the Chamber of Deputies with loud and well-nigh unanimous expressions of approval.May 30th.

________________

EGYPT.(FROM OUR OWN CORRESPONDENT.)

Oholera in Alexandria.

DURING the past three weeks cholera has been manifestingitself in a much more businesslike way than at any timesince its first appearance last October. The new cases at thebeginning of May could be counted daily upon the fingers ofone hand, but they gradually increased until they reached 40on May 12th. Since then the daily returns have only oncebeen higher than 30, but the total number of new casesduring the three weeks is 521. The chief centre of thedisease seems to have been some outlying hamlets, whencewere brought salad and vegetables for town consumption.Directly the disease was stamped out energetically in thesehamlets by English inspectors the number of cholera casesin Alexandria began to diminish.

Cholera in Gairro.

With the exception of some half a dozen cases reportedduring the winter Cairo remained free from cholera until May9th, when for each of five days there were one or two cases. Thedisease attacked Old Cairo, the southern port of the city, butit is not certain whether it can have arrived from Alexandriaby river or by train. In either case the germs had time toenter the drinking-water of Old Cairo from two men whodied on boats there, and this is sufficient cause for the verylocal distribution of the epidemic so far. Upon May 12ththe sanitary department determined to divide the city intodistricts and to place English medical men temporarily incharge to superintend native medical men and to carry outall necessary prevention work. Old Cairo was allotted toDr. Keatinge, Saida Zenab to Mr. Milton, the citadel toDr. Wilson, Ezbekieh to Dr. Engel, Boulak to Dr. Sand-with, while an extra inspector was also appointed toall other districts. Cholera regulations were put intoforce by the Governor for Cairo on May 16th, andseveral important measures were also taken for the first

time in the history of Cairo. All insanitary bathing-placesin mosques were closed, and power was given at discretionto close all dangerous public baths and drinking fountains.In order to preserve as far as possible from contaminationthe east bank of the Nile above and below the intake of thewater company the river has been by the same decree keptclear of all boats and steamers and all washing and otherpossibilities of pollution. The British soldier is no longerallowed to bathe on that side of the river, and, most im-portant of all, the drainage of the English barracks atKasr el Nil is no longer allowed to foul the riverimmediately above the company’s intake. It is to behoped that this last measure will now be permanentlyadopted, for it has been constantly pressed by sanitaryofficials, and there can be no legitimate excuse forthe negligence of the English military authorities. Aspecial gang of scavengers has been employed to cleansethe river bank, and the whole town is being thoroughly weDcleaned up by a special grant of .61500, placed to the credit ofMr. Perry, the head of the scavenging department of thePublic Works Ministry. But this sum is only for two months’work, as it is assumed by the financial advisers that when theNile has risen and cholera has been washed away no urgentneed for sanitary matters will exist! It is to be hoped at,least that some of the excellent work now being done will beallowed to continue as a permanency. One of the cryingneeds for Cairo is a real sanitary inspector, who must, ofcourse, be an European. The cholera cases in Cairo since

May 9th to May 27th have already numbered 401; nearly allof them so far have been confined to Old Cairo and its neigh-bourhood. Most of the cases in Boulak have been among work-men employed by day in Old Cairo. The maximum numberof cases per day so far has been fifty-three. Dr. Keatinge has astraw hut hospital and a large staff of helpers, includingsome of the senior students of the medical school, and he hasestablished a simple method of improving the water-supplyby running a fire-engine hose out to draw water from abarge far removed from the bank. Yesterday some difficultyarose in consequence of some malcontents objecting to

having their possessions disinfected. Unfortunately somewomen were accidentally sprinkled with acid by a temporaryhelper and had to be admitted to hospital, but with theexception of this regrettable incident the work has beenquite smoothly carried on.

Cholera in other Places.

; Since May 20th there have been 60 cholera cases at Tourat,near Cairo, among a new battalion of recruits and the policeguarding the convict prison and a great village population ofnegresses. Coles Pasha, Mr. Crookshank, Surgeon-ColonelGallwey, and Mr. Littlewood are dealing with this. AtGhizeh, opposite Cairo on the west Nile bank, there have been22 cases, mostly in the prison. The whole number of choleracases since October has now reached 2256 and the deaths1878. This gives the high average of 83 per cent. mortality,but if we assume, as it is only fair to do, that for everyreported case there are at least two unreported the averageof deaths is lowered at once 27’7 per cent. In consideringEgyptian vital statistics it must never be forgotten that thediagnosis is nearly always made by inspection of the deadbody by an ignorant native doctor or midwife. The deathreturns of Cairo are extra high just now, because, in additionto the cholera, there is a fatal epidemic of measles amongchildren under three years of age. The health of the Britishtroops is excellent and the sick-rate at Alexandria, Cairo,and Wady Halfa varies now from 4 to 6 per cent. In spiteof this a case of cholera has to-day been reported from thebarracks at the citadel. The decoration of C.M.G. recentlyand worthily bestowed upon Rogers Pasha is the first officialreward given by England to the Egyptian Sanitary Depart-ment since it came under English control in 1884.

Cairo, May 27th.

NEW YORK.(FROM OUR OWN CORRESPONDENT.)

Regulation of Irnrnigrration.THE immense increase of Italian immigration during the

early months of this year is attracting much attention,and the question of refusing entrance to such largenumbers of undesirable foreigners is agitating the public.It is estimated that the approximate number of Italians whohave arrived in New York between Jan. 1st and April 30th,