ireland
TRANSCRIPT
206
immunisation was performed. As it was impossibleto provide a large enough quantity of convalescentserum for this purpose, the serum of the parents wassuccessfully used. By these measures the spread ofthe epidemic was finally stopped.
Birth Control and Population.Dr. Grotjahn, professor of social hygiene at Berlin
University, has been speaking on the problem of birthcontrol from the standpoint of keeping up the popula-tion. He pointed out that on a one-child or two-child system the time when the population will disappearcan be calculated with mathematical certainty. Tomaintain the population every family must bringup at least three children, and as this is impossiblethere must be a number of families with more thanthis in order to cover the deficiency of those marriageswhich are sterile. Twenty births to each thousand ofthe population he regards as necessary. This numberis at present not attained in Germany; in 1927throughout the country registered births amounted to18-3 per thousand, while in the larger towns the figurewas only 14. In France it has been 18-5 for severalyears, whereas in Germany the decrease is pro-gressive. Sixteen living births per thousand wereregistered in 1927 in Paris, as compared with 10-5 inBerlin. In France families with many childrenreceive Government subsidies and for Germany Prof.Grotjahn recommends compulsory insurance forparents to stimulate the will to bring up children.People think that Germany is overcrowded, but thehousing and the unemployment problems cannot besolved by birth control, for the decrease of births willonly have their effect on the labour market after 16or 20 years, whereas unemployment is an actual andpassing problem. On the contrary, there is likely tobe a deficiency of workers within a few years as aresult of the war. In 1928, 1,924,000 youths enteredwork on leaving school, but owing to the decrease ofbirths during the war there will be only 700,000annually in the three following years. If the drop inthe birth rate goes on the German population will bereduced to an extent never previously contemplated.
The Right to Canvass.A medical man, on settling in a Berlin suburb, sent
cards to the neighbouring families to advertise hisarrival. Being prosecuted before the provincial courtof honour he was fined 50 marks, but later the appealcourt of honour in Berlin gave him a verdict of
" Notguilty." The judgment stated that it is not againstthe medical ethics for a medical man to announce hissettlement if this is done in a suitable way. For thispurpose local newspapers are usually employed, butthe recognised rule is that an advertisement shouldnot appear more than once. The cards sent by thedefendant merely announced the fact of his settle-ment, and the court held that no distinction could bemade between an advertisement in a daily paper andcanvassing by cards sent to neighbours.
Tuberculosis of Infants.The Berlin Psediatric Society lately discussed the
infection of infants living in the same houses as tuber-culous patients. Calmette has stated that in Francethe mortality of such children is 24 to 80 per cent.,but according to the figures given to the Society byDr. Peyser, head of the municipal dispensary fortuberculous infants, the number is much smaller inGermany. In Berlin only 5-1 per cent. of infants havedied from tuberculosis in the first year of life, 3-4 percent. in the second year, and 0.5 per cent. in thefollowing years. There is no difference whether thedwelling is in a good hygienic condition or not : theprincipal cause of infection is the mass of bacilli spreadby the parents in the dwelling by couching and there-fore a repression of that nuisance as taught in thesanatoriums is essential. Early and prolonged isola-tion of infants is recommended.
The German Red Cross has 7429 branches andaffiliated organisations with 1,379,843 members. It
has increased in the last year by 66 branches with41,308 members. The Red Cross controls 414 hospi-tals, sanatoriums, maternity hospitals, and homes forconvalescents, children, and the aged, with 17,651 beds.There are, further, 517 advisory offices formothers,and127 tuberculosis dispensaries. The number of nursesbelonging to the Red Cross is 8673. There are 2804ambulance detachments with 101,058 members.A course of practical cooking was lately held in the
Braunlage-Sanatorium in the Harz Mountains underthe patronage of the Balneological Society and theAssociation for post-graduate study. The 97 medicalmen and women who attended were able to learnpractical cooking, especially for dietetic purposes ;.they not only acted as cooks in the kitchen of thesanatorium but also attended lectures delivered byspecialists from Berlin.
IRELAND.
(FROM OUR OWN CORRESPONDENT.)
Public Health in the Free State.
THE annual report of the Department of LocalGovernment and Public Health for 1927-28..recently issued, gives particulars of the public healthwork carried on in the Irish Free State, as well as ofthe other activities of the local authorities. Therehas been some increase in enteric during the year,observable in the rural areas. There has been aslight increase in the number of tuberculous patientstreated under approved schemes. There are 140institutions approved for the treatment of tuber-culosis, and 142 tuberculosis dispensaries. Thedeath-rate associated with childbirth has shown littletendency towards reduction notwithstanding theincreased application of measures for the regulationof midwifery practice. It is noticeable that thematernal mortality of rural districts has a distinctlyworse record, and that the statistics show the largertowns to suffer least heavily from puerperal deaths.The infant death-rate, on the other hand, has under-gone a decided reduction, although the experience ofrecent years indicated that a stationary condition hadbeen reached. In the rural districts it is definitelylow, but the virtual doubling of the rural rate underurban conditions produces a result that can only bedescribed as high. The number of vaccinationdefaulters is diminishing. It is stated that there are26 counties in which county medical officers of healthhave been appointed, or are about to be appointed..The county medical officer of health has jurisdictionover the whole county, and is responsible for all thatrelates to preventive medicine, personal as well as.
environmental. His jurisdiction extends over schoolmedical services and tuberculosis services. InCounty Cork there are, besides the county medicalofficer, three whole-time assistant medical officers.Steps are being taken to train and to appoint whole-time sanitary inspectors. The grants to assist housinghave increased during the year.
Milk in Cork.Dr. J. C. Saunders, medical officer of health for
Cork, draws attention, in a recent report, to theunsatisfactory conditions under which milk is sold inthat city. The vendors of milk from vans and cartshave little notion of cleanliness; vans, vessels, andvendors’ clothes all being dirty. It is little better asregards conditions of sale in shops. The premisesare usually unsuitable ; there is insufficient ventila-tion, and the shops that sell milk commonly deal alsoin such articles as coal, vegetables, dried fish, saltmeat, and paraffin oil. It is an anomaly of theDairies, Cowsheds, and Milkshops Order that whilethe sale of milk in unsuitable premises is an offence- .there is no way of dealing with it except by prosecu-tion ; the local authority has no power to refuse-registration to the vendor.