1091

THE BUREAU OF THE PERMANENTCOMMISSION OF THE INTER-NATIONAL CONGRESSES OF

MEDICINE: MEETINGAT THE HAGUE.

THE Bureau of the Permanent Commission of the Inter- c

national Medical Congresses, created at the Congress of c

Budapest, met at The Hague on March 29th and 30th. (The members of this Bureau are : Dr. F. W. Pavy for

Great Britain (President), Professor Waldeyer for Germany,Dr. R. Blondel for France, Professor Miiller for Hungary, (

and Professor Maragliano for Italy (Vice-Presidents), and 1Professor Wenckebach (General Secretary). Dr. J. Lucas-

Championniere, as President of the International Association iof the Medical Press, is also a member of the Bureau. j

The agenda indicated that the Bureau would have to 1

appoint a new general secretary, the holder of that office shaving resigned, and to discuss a certain number of questionsrelating to the definite regulations and constitution of theCommission, together with the principles that should be

applied when organising future congresses, the first of thesebeing the International Congress which is to be held inLondon.The latter items of the agenda were the most important,

and persons had been brought together who possess greatknowledge concerning the preparation of congresses andwhose counsels were likely to prove most useful. As amatter of fact, however, this part of the programme wasalmost entirely suppressed. It had been arranged that thereshould be three business sittings. The first sitting wasdevoted to a speech of welcome, to various formalities, to theintroduction of the new general secretary, Professor Biirger,and, finally, to a long discussion raised by the Hungariandelegate, M. von Grosz. The object of this was to obtain thenomination as honorary members of Professor Wenckebach,who has resigned, and of Professor Waldeyer, who desired toresign. The rules, however, in no wise provide for thenomination of honorary members of the Commission.Then followed a discussion on the rules of the Bureau, but

it did not last long, and the settlement of the question washanded over to a subcommittee. Professor Wenckebach, thesecretary, who was elected at Budapest, explained that hegave up the post because he lived at Groningen and couldnot attend with sufficient regularity to the labours of theBureau which was situated at The Hague. He proposed thatProfessor Burger should take his place, though this gentle-man also does not live at The Hague, but at Amsterdam. Theresidential secretary at The Hague will be M. van den Haer.Professor Wenckebach handed to the members of the Bureaua copy of a pamphlet upon Medical Internationalism whichhad been prepared by Dr. P. J. Eijkman for the Associa-tion for the Promotion of International Relations (BureauPreliminaire de la Fondation pour 1’Internationalisme).At the same time it was announced that the DutchGovernment proposed to give an annual subvention of 4500florins towards the upkeep of the Bureau and its employees,and anticipated in the future the construction of a specialedifice to house the institution. With a view of augmentingthe resources of the Bureau it was decided that if the

organising committees of the International Congresses foundthat there remained a balance in hand after they had settledall their accounts, a portion of this surplus should be devotedto the support of the Bureau.A discussion as to what should be the title of the Bureau

followed. Should it be called the Bureau of the PermanentCommission of the International Congresses of Medicineor the Permanent Bureau of the International Congressesof Medicine ? 2 The first title was ultimately adopted.As for the official language of the Bureau, the Frenchlanguage was unanimously adopted, a fact which on themorrow did not prevent the general secretary from speakingon several occasions in German.The organisation of future congresses was then discussed,

and a request to recognise Spanish as one of the officiallanguages was rejected. Proposals to create a section of pro-fessional medicine to deal with ethical questions and pointsof medical practice, and to admit dentists who were notqualified medical practitioners, were likewise thrown out. In

spite of the very ardent pleading of the general secretary,Dr. Blondel succeeded in securing the adoption of a motionto the effect that, generally speaking, the InternationalCongresses of Medicine would only accept as members suchpersons as possessed a degree of doctor of medicine or suchother diploma as conferred the legal right to practisemedicine in the country where the testamur was issued.

In regard to the next congress (London, 1913) it wasresolved to call the attention of the British organisingcommittee to the fact that the majority preferred that thecongress should meet during the first days of August. TheGerman professors especially are all retained in their uni-versities till the end of the month of July.At the morning sitting held on March 30th the resolution

of the subcommittee appointed to consider the mode of elec-tion of the Bureau and of the Permanent Commission itselfwas adopted. It was decided that the members of theCommission should be elected by their respective nationalcommittees for the duration of the entire period separatingtwo international congresses. At the end of the congress,the members of each committee will hold a meeting and willelect a new delegate or reappoint their former representative.The new Commission thus created will meet at once andelect its bureau. Dr. Blondel proposed that, if possible, thepresident of the Bureau should be the president of theorganisation preparing the next congress, or the delegateof the country where the forthcoming congress is to be held.

By this means the interference of some person who was

foreign to the work of the local organising committee wouldbe avoided. This proposal was adopted.The question of the relations between the Bureau and the

International Association of the Medical Press was the! subject of a long and very animated discussion. Dr. Blondel! spoke on behalf of Dr. Lucas- Championniere, President of the! International Association of the Medical Press, who was

absent, and demanded that the communications from the

. permanent Bureau to the press should be made by the! intermediary of the International Association of the Medical

Press. Dr. Blondel urged forward the proposals formulated) by the British Association of the Medical Press to the! efEect that the Association of the Medical Press should

be entrusted with the organisation of all the relationsbetween the press and the public. Professor Burger

and Professor Wenckebach were opposed to this pro-. position and declared that if it was adopted they would

at once resign. Dr. Blondel in vain sought to modifyhis suggestion by limiting its action to such countries as

possessed an association of the medical press. The General

. Secretary replied that he could not assume the responsibilityof organisation if he was not at liberty to communicatedirectly to newspapers outside of the Medical Press.Dr. Blondel now sought to widen the basis of the discus-sion. He dwelt upon all the difficulties that would arise ifi the new Bureau about to be created was going to awaken- justifiable mistrust. The organising committee in eachi country must be left to freely take what action they might. deem necessary, for on these committees alone rests thei responsibility of success or failure. Obviously the assistance3 of the press in such work is absolutely indispensable. The, Bureau of The Hague should only be the depot for thearchives, the domicile of the general secretary, and the office for correspondence with the members of the Permanent Com-e mission. But the mission of the Bureau, he thought, wouldi prove sterile if it arrogates to itself the right to interfered with and direct the local organising committees or to restrictd in any way their independence. The General Secretary

doubted whether the International Association of the Medicalu Press was capable of taking any really effective action.Lt Finally, Dr. Blondel’s proposals were rejected.e Several other motions were brought forward. Amongis these was a very important report by Professor Waldeyer1. and Professor Posner on the manner in which the nationalh committees were composed. Another motion was intro-Le duced by Dr. Blondel on the limitation of the subjectsg treated in the general reports presented to the con-

gresses. Another proposal was made demanding that means1, should be organised by the Permanent Commission to,1 consult the national committees before the final publication3- of the rules and regulations of the congress. Then there wasts the proposal made by the British Association of the Medical3t Press on the right the Bureau should possess of rejectingfn papers that were not original or of but little value.

1092

All these proposals were set aside upon the statement thatthe General Secretary had not had time to study them.Professor Posner and Dr. Blondel protested that themembers present, with the exception of the GeneralSecretary, who had only been appointed the previous even-ing, were sufficiently experienced in regard to the organisa-tion of congresses to take part at once in what would be avery useful discussion on matters all of which were veryfamiliar to them. In vain it was pleaded that there was

urgent need, in view of the forthcoming congress, to settlesome of the points raised, and that while several competentmen were gathered together good use should be made of theirpresence. It was pointed out that if these men had taken thetrouble to come all the way to The Hague it was solelyfor the purpose of dealing with such questions. Butunder the action of the Dutch and the Hungarians all theseproposals were simply handed in for the General Secretaryto examine and draw up a report upon them which is to besubmitted at a general meeting of the Permanent Com-mission. Thereupon the discussion was at once closed and,further, the sitting which had been announced for the after-noon was not held.

It is probable that the forthcoming meeting of thePermanent Commission will take place during the month ofOctober. Dr. Blondel proposed that it should be held inLondon so as to be more readily able to come to an under-standing with the local committee of organisation of the nextInternational Medical Congress.

MEDICINE AND THE LAW.

Certtficates of tlee Cause of Death and 11’rftwre Lejcislation. IIN connexion with the subject dealt with in our recent Iarticle on the Bogey of Premature Burial we have receiveda letter from a clergyman who points out that the unfoundedrumours as to persons being buried alive might be preventedif medical practitioners were only to give certificates for thepurpose of death registration after having examined the deadbody. The suggestion is by no means a new one but thesituation at present is as follows. The medical certificate

given for the purpose of death registration in obedience tothe law is not, as our c,)rrespondent seems to think, anattestation on the part of the medical man who signs it ofthe fact, but of the cause, of death. The recent Depart-mental Committee appointed to inquire into the law relatingto coroners and coroners’ inquests incidentally inquired intothese two questions of premature burial and of certification ofdeath so far as they might be deemed to come within theterms of its reference. On the first point the committeehad before it evidence of the strongest character from Mr.A. J. Pepper to the effect that the popular scare with regardto premature burial is absolutely baseless. On the second itobserves in its report that the general question of deathcertification is outside the terms of its reference, but pro-ceeds to recommend in connexion with the law of coronersthat a certificate should not be accepted from a medicalpractitioner unless it states that he has satisfied himself ofthe fact of death by personal inspection of the body. Thisrecommendation it makes relevant to the subject of thisinquiry by proceeding to advise that every death as to whicha medical certificate such as it recommends is not givenshould be reported to the coroner. It will thus be seen thatwhenever the law is amended with regard either to coronersor to death registration the certification of the fact of deathby a medical practitioner who has seen the dead body will inall probability be made compulsory. The certificates now

given are regulated by an Act of Parliament passed in 1874,.and are lawfully, if undesirably, given without inspection.

The Preservation of Dead Bodies nith a Vie?v to.7M/MMN’tOM.

At a recent inquest held by Dr. F. J. Waldo as coronerfor the borough of Southwark, it was stated that the body,that of a man found dying in the street from acute alcoholicpoisoning, had not been identified. A description had beengiven by the police, and the jury was informed that this forthe purpose of the identification of human remains was

usually found to be more effective than photographs. At thesame time, attention was called to the desirability of means

1 THE LANCET, March 19th, p. 803.

being provided for the preservation from decomposition ofthe body itself in order to secure as far as possible satis-factory evidence with regard to it. At the conclusion ofthe inquest the jury in a rider to their verdict expressed theopinion that the London County Council should provide anapparatus by which unidentified bodies might be preservedeither chemically or by refrigeration. In this connexion wenote that Dr. Waldo in his annual report to the CommonCouncil upon the work performed by him as coroner for theCity of London speaks of the recent successful installationthere of a Herscher’s apparatus for the preservation ofbodies by formalin, and informs the Common Council thatit has already proved of service in ensuring identification.The first body for which it was used, that ofa man found drowned, remained in it for four months,and at the end of that time was free from appreciable signsof decomposition and easily recognisable. This apparatus,installed by the Common Council, is, we believe, at presentthe only one in use in connexion with a coroner’s court,although Section 93 of the Public Health (London) Act, 1891,enables the London County Council "to provide and fit upone or two suitable buildings " for the purpose in question.The Common Council of the City of London is to be cop-gratulated upon having been a pioneer in this matter, and itis to be hoped that the London County Council may see itsway before long to follow the example set. It expresseditself as unable to make any provision of the kind indicatedas recently as January, 1909, but possibly when the resultssecured in the City are established it will be willing to recon-sider its decision. The usefulness of an apparatus for thepreservation of unidentified remains would be most readilytested in a waterside district, such as Southwark, owing, notonly to the condition of bodies found drowned," but also tothe part which the river plays in crimes of violence, insuicides, and in accidental deaths.

Looking Back.FROM

THE LANCET, SATURDAY, April 14th, 1832.

THE CHOLERA IN PARIS.SINCE the publication of the last number of our journal,

the capital of France has been the scene of such melancholyevents as will form one of the most gloomy pages in thehistory of pestilentietl diseases. Within ten days from itsannouncement in Paris, 7,000 cases of cholera have occurred,of which number 3,600 have terminated fatally. The mailsreceived as we write, give the last daily report at nearly twothozsccnd cases and eight h1lmdred deaths within the twenty-four hours.When it is remembered that this disease and mortality,

enormous as they are, are but the amount of what hasoccurred in the city of Paris alone; and when it is alsoborne in mind that the scourge is raging with equal violencein all the Í1wmediate S16b1Wbs of the town, from which thecases are not reported ; and, lastly, when it is taken intoconsideration, that at least one-third of the cases in Parisare not reported, as is the fact, a just idea may be formedof the overwhelming power of this almost unprecedentedcalamity.

If we ask ourselves,-What is the nature and what the lawswhich govern this anomalous pestilence ?-how strange, howinexplicable are the facts we have to contemplate In Paris,not "five days before the onset of the disorder, M. VILLERME,the well known and gifted statist, in a memoir on epidemics,read before the Aoademie de Medccine, congratulated hisfellow citizens on the probable, nay almost certain immunity,they were to enjoy from the cholera, as well as from all othersimilar visitations. ’6 Paris," he said, exceeded all othercities in the extent of its civilization ; the inhabitants ofthat capital were the strongest in moral courage of any nationin the world,-were unrivalled in physical energy ; " it wassuperintended and controlled by an excellent and indefatigablemedical police ; no nuisances there existed ; knackeries, lay-stalls, dunghills, and all other similar nuisances, were care-fully removed from it beyond the barriers; in short, the

provisions of the "code sanitaire," taken along with thecircumstances of the citizens, were either to defend them