1503

Notes, Short Comments, and Answersto Correspondents.

HEALTH AND HOSPITALS IN BRITISH GUIANA.

A REPORT on the Blue-book of British Guiana for the year 1911-12 hasbeen prepared by Mr. G. D. Bayley, Assistant Government Secretary.From this it appears that the estimated population of the colony is295,784-153,441 males and 142,373 females. The birth-rate per 1000 ofeach of the different races representing the community was in 1911 :Europeans other than Portuguese, 10’7 ; Portuguese, 25’9; East

Indians, 26-0; Chinese, 32-5; Aborigines, 67-7; Blacks, 294; mixedraces, 32’9. With the exceptions of Europeans, Chinese, and Blacks,which show decreases, an increase has been noted in respect of eachrace on the figures for 1910. Of the births registered, 3303, or 38-7per cent., were legitimate, and 5227, or 61’3 per cent., illegitimate. Thedeath-rate was 31’7 per 1000 of the estimated population. The mean Irate for the previous five years was 32’2. The mortality amongstchildren under one year continues to be high-229 per 1000 births. Thefive principal causes of death throughout the colony during the pasttive years have been: malaria, 19’ per cent.; pneumonia andbronchitis, 13’3; diarrhoeal diseases, 12’9 ; kidney diseases. 7’5; andphthisis and other forms of tuberculosis, e’ 2 per cent. There was no

epidemic last year of any dangerous, infectious, or contagious disease,though the existence of plague in neighbouring places gave rise toconsiderable anxiety.Anti-malarial and anti-mosquito measures are being generally and

gradually enforced with visible signs of success. In 1906-07, 33,748cases of malarial fever were treated in the sugar estates’ hospitals; atthe end of 1911-12 the numbers had fallen to 15,164. For the year underreview there were 5235 fewer cases treated than in the previous year.Quinine has been for some years sold at all post offices to the generalpublic at cost prices; it is also distributed by the sugar estates freeto their labourers. Prisoners, members of the police force, the inmatesof the industrial school and the orphan asylum, and attendants at thepublic institutions are also supplied by the colony with free quinine.Ankylostomiasis, which has engaged the attention of the Medical

Department for several years, has considerably decreased on the sugarestates ; this is due to improved sanitary measures and the erectionof latrines. A mosquito census for the city of Georgetown was takenby the Government bacteriologists ; this census showed the enormousnumber of mosquito breeding grounds and the necessity for a morevigorous campaign against the mosquito. The total rainfall for the

calendar year 1911 at the Botanic Gardens, Georgetown, was 87’89inches. The average maximum temperature in the shade was 85’4° F.,and the average minimum 74’6°. There are five public hospitals in the

. principal centres of population, and the outlying districts are served.

by dispensary hospitals and dispensaries. The immigration law alsorequires the maintenance of hospitals on every plantation on whichthere are indentured East Indian labourers, and those institutions areavailable for the treatment of emergency and pauper cases from the

general community. There were 758 patients in the public hospitalsat the beginning of the year, and 17,185 were admitted during theyear. The daily average was 697. There were 1952 deaths. Outdoortreatment was given to 83,009 persons. At the leper asylum therewere 422 patients (299 males and 123 females) when the year began,and during the year 139 were admitted.

THE GERMAN ANTI-ALCOHOL ASSOCIATION.

To the Editor of THE LANCET.

SIR,-May I point out that the report of your Berlin Correspondent(May 10th, p. 1351) would be more interesting if the extravagant state-ments of the members of the above association had defined the quantitiesof alcohol that caused the commission of offences stated. In mystudies of alcohol I have never found that strictly moderate con-sumption daily ever had any tendency to " aesthetic and sentimental- contemplation of the world instead of a moral and practical one." ,

The report also states that 30,000 people were sent to the asylum foralcoholism. As junior medical officer at a large asylum I studiedthis cause and found that in most of the cases so sent the lesions of thetrain were the cause of the alcoholism, not the alcoholism the cause ofthe insanity. The statistics were therefore erroneous.

I am, Sir, yours faithfully,New Cavendish-street, W., May 14th, 1913. THOMAS DUTTON.

ST. LUKE’S HOSPITAL, CHEMULPO, KOREA.As was stated in THE LANCET of April 26th (p. 1213) missionary

hospitals may be in a sense the outposts of medical science. Thereport of St. Luke’s Hospital, Chemulpo, for 1912, is interestingreading, but is lacking in details of the professional work. Amedical report dealing with local diseases and the variations of

disease under an environment totally dissimilar from thatin the West would be useful. The Koreans, it is stated

in the present report, have long been ready to go to foreignmedical men in surgical cases, but not for diseases requiringmedical treatment, for which they still cling to the old-

style native practitioner. The itinerant nostrum vendor is

becoming a curse in the country. Appendicitis and heart diseaseseem to be on the increase-though ;far less common than at home,acute rheumatism being also very rare. Abdominal emergencies areinfreqent. Fevers of various kinds are met with, but the ordinaryones of childhood are usually only heard of, not seen. Naturally,with only one medical man as house physician, house surgeon, andvisiting staff, the hospital system has to be very elastic. TheOriental deliberation, like the Spanish " rnaiiana " in Latin America,creates much difficulty. One of the opportunities afforded by missionhospitals - that of trying to discover more about the hitherto,undescribed fevers-is recognised in the report, but seems to beimpossible for lack of assistance, for financial conditions donot permit otherwise. Expenses are increasing, while the changingeconomic conditions under the new régime in the country are makingthe poor poorer. Though there is a small balance on the year’sworking, subscriptions and grants are urgently needed. The hospitalcontains two male wards of 13 beds and 12 beds respectively, afemale ward of eight beds, two small private one-bed rooms, andthree cots. Besides the medical officer, Dr. H. H. Weir, the’

European staff consists of Mrs. Weir, lady superintendent and nurse,a lady nurse, and a lady dispenser, while the Korean staff of helpersnumbers nine. The total number of in-patients during 1912 was 368,of out-patients 6848. The operations numbered 132. Grants are made

by the Society for the Propagation of the Gospel and the HospitalNaval Committee. Subscriptions and donations may be sent to theRev. S. J. Childs Clarke, 5, Amen-court, London, E.C., marked "St.Luke’s Hospital," or to Captain J. H. Corfe, R.N., Junior UnitedService Club, S.W., for the Hospital Naval Fund.

DIFFUSED ARTIFICIAL LIGHT.

UNDER the heading of "Light Run Amok" in an annotation inour issue of March lst, 1913, we commented upon the objectionto most modern systems of artificial lighting that they are

usually " direct " instead of " indirect," whereas the actualsource of light should be invisible to the eye, and only theeffects of its reflection seen upon the objects in the diffused

light stream. The matter is of considerable importance in con-

nexion with the use of artificial light and the question of eye-strain and other eye troubles. This view has received endorsement

by the Electrical Engineering and Equipment Company, Limited, ofBank Buildings, 109-111, New Oxford-street, London, W.C., whohave introduced the " Indra system of lighting adapted chieflyto illuminating by means of electric lamps. In this system theactual source of light is not seen, yet the bulk of the light is reflecteddirectly through clear glass. In their ow n words, " a simple fittingconsists of a combination of specially designed, upper reflector andlower distributor. The upper reflector is preferably of opal glass,but in some cases, where the whole of the light is required in a.

downward direction, an aluminium reflector is supplied. The lower

plate is provided with alternating rings of clear and etched glass.The etched glass rings are at right angles t o the direct rays from thelamp, and are of translucent or etched glass, while the clear glassrings are arranged in such a manner that the rays of lightreflected from the top reflector pass straight through." It happensthat most of the rays from the metal filament lamp emanate at rightangles to the filament. These rays strike the reflector and aredirected through the clear glass rings of the distributor. As to the

rays which strike directly on the distributor, they are diffused throughthe translucent or etched surface glass rings, producing an efficientillumination which is agreeably diffused, the eye being saved fromthe strain caused by light issuing direct from the filament. Wehave made practical trials with the " Indra" shades in domesticrooms, and have found that they give the agreeable effects ofillumination which are claimed for them. In four words, there is

no glare.AN ULTRA-VIOLET RAYS OUTFIT.

l’HE action and effects of the ultra-violet rays are attracting suchinterest at the present time that experimentalists in this field willbe glad to learn of a silica lamp laboratory outfit which has been putupon the market by the Westinghouse. Cooper, Hewitt Co., Limited,of 80, York-road, King’s Cross, London, N. We have examined aspecimen lamp in our laboratory, and find that it is not only aneflicient producer of the ultra-violet rays, but that it is quite easyto "rig up" and manageable to run. It consists of a quartztube containing mercury hung upon a special frame provided.A resistance coil is supplied which enables the voltage to be

adapted to the particular requirements of the lamp. Anumber of very interesting experiments can be made with this

lamp, as, for example, the examination of fluorescent sub-stances (which in many instances give a gorgeous response), thedetermination of the bleaching effect on colours, the investigationof the sterilising power of the ultra-violet rays, and so forth. Other

practical studies suggest themselves in which the use of a silica lamp

1504

laboratory outfit would obviously be of service. It is well to point outthat when operating with this lamp the eyes and akin should be pro-tected from the rays. This can be done by screening the lamp with asheet of ordinary glass. It will be remembered that the efficiency ofthe silica lamp is due to the fact that quartz is transparent to the rays,whereas glass is opaque, and therefore glass tubes are not availablefor the purpose. The light is very intense.

Dr. D.-It is not easy to reply to this question. Much depends on thenature of the bills paid and the circumstances attendant thereon.Any correspondence on the subject past or present, with the bills andparticulars as above, should be put before our correspondent’s legaladviser for his opinion.

COMMUMCATIONS not noticed in our present issue will receive attentionin our next.

Medical Diary for the ensuing Week.SOCIETIES.

ROYAL SOCIETY, Burlington House, London, W.THURSDAY.-Prof. A. B. Macallum : Acineta Tuberosa: a Study on

the Action of Surface Tension in Determining the Distributionof Salts in Living Matter.-Surgeon-General Sir David Bruce,Major D. Harvey, Major A. E. Hamerton, and Lady Bruce:Morphology of Various Strains of the Trypanosome causingDisease in Man in Nyasaland. IV., The Mzimba Strain.-HelenL. M. Pixell : Notes on Plasma Gondii (communicated by Prof.E. A. Minchin).-Mr. J. C. F. Fryer: An Investigation byPedigree Breeding into the Polymorphism of Papilio Polytes.Linn. (Communicated by Prof. J. S. Gardiner.)-Dr. S. Russand Dr. Helen Chambers : On the Action of Radium Rays uponthe Cells of Jensen’s Rat Sarcoma (communicated by Mr. H. G.Plimmer). _____

ROYAL SOCIETY OF MEDICINE, 1, Wimpole-street. W.MONDAY.

SECTION OF ODONTOLOGY (Hon. Secretaries-Stanley P.Mummery, Robert McKay): at 8 P.M.

Annual General Meeting.-Election of Officers and Council forSession 1913-1914.

Cus1tal Communications : Mr. W. W. Gabell: Abnormal Extension of the Antrum

(Unilateral).Mr. L. A. Harwood : Odontome (?) in Premaxilla.Mr. G. C. Birt ; Fusion of Maxillary Molars.

Paper :Mr. A. Hopewell-Smith : The Structure of the Dental Pulp in

Ovarian Teratomata.DiscussionOn Mr. W. W. James’s Paper on the Cure of Mouth Breathing.

(Adjourned from the last Meeting.)Preliminary note for June Meeting :-This Meeting will be

held on Monday, June 23rd, at the Royal College of Surgeons,when the Curator of the Odontological Museum, Mr. J. F.Colyer, will give a Demonstration on the Recent Additions to theMuseum, after which the Museum will be open for inspection.

TUESDAY.SECTION OF MEDICINE (Hon. Secretaries-Robert Hutchison,H. Batty Shaw): at 5.30 P.M.

Annual General Meeting.-Election of Officers and Council forSession 1913-1914.

Paper: :Dr. H. A. Lediard : Cases of Chyliform Effusion.To be followed by a discussion on the Chemistry of these

Effusions, opened by Dr. Mackenzie Wallis.

SECTION OF PSYCHIATRY (Hon. Secretaries-R. H. Cole,Bernard Hart): at 6 P.M.

Annual General Meeting.-Election of Officers and Council forSession 1913-1914.

WEDNESDAY.SECTION OF THE HISTORY OF MEDICINE (Hon. Secretaries-Raymond Crawfurd, D’Arcy Power): at 5 P.M.

Annual General Meeting.-Election of Officers and Council forSession 1913-1914.

Dr. Chowry Muthu : The Ancient Systems of Indian Medicine.Dr. Galloway: The Priory of Ronceval at Charing, Middlesex

(illustrated by lantern slides).Dr. Nixon: Further Notes on Thomas Dover.Mr. Macleod Yearsley: (1) Two Relics of John Avery,

F.R.C.S. Eng., sometime Surgeon to Charing Cross Hos-pital ; (2) Elegant Medical Prescriptions for Various Dis-orders by Dr. Hugh Smith, 1796.

SATURDAY.SECTION OF BALNEOLOGY AND CLIMATOLOGY (Hon. Secretary-Charles Buckley).

Provincial Meeting at Bournemouth.Annual General Meeting.-Election of Officers and Council for

Session 1913-1914. _____

MEDICAL SOCIETY OF LONDON, 11, Chandos-street, Cavendish-square, W.

MONDAY.—8.30 P.M., Annual Conversazione. 9 P.M., Oration :-SirWm. Whitla, M.D.: The Trend of Thought in Recent Pharma-cological Research.

AL SOCIETY OF ARTS, John-street, Adelphi, W.C.THURSDAY.-4.30 P.M., Sir John Benton, IC.C.LE.: Irrigation Works

in India.

LECTURES, ADDRESSES, DEMONSTRATIONS, &c.MEDICAL GRADUATES’ COLLEGE AND POLYCLINIC, 22,Ohenies-street. W.C.MONDAY.-4 P.M., Dr. J. M. H. MacLeod: Clinique (Skin). 5.15 P.M.,

i Lecture :-Dr. A. J. Jex-Blake : Influenza, Bronchitis, andTuberculosis of the Lungs.

TUESDAY.-4 P.M., Dr. G. N. Pitt: Clinique (Medical). 5.15 P.M.,Lecture :-Dr. R. A. Young: The Diagnosis of Basic LungConditions.

WEDNESDAY.—4 P.M., Mr. T. P. Legg: Clinique (Surgical). 5.15 P.M.,Lecture:-Dr. T. W. Eden: Some Clinical Forms of AcutePelvic Inflammation.

THURSDAY.-4 P.M., Mr. A.,Carless : Clinique (Surgical). 5.15 P.M.,Lecture:-Mr. J. J. Clarke: Open Operations in SimpleFractures.

FRIDAY.-4 P.M., Mr. E. A. Peters: Clinique (Ear, Nose, andThroat). 5.15 P.M., Lecture :-Dr. W. Wingrave : Polypi.

POST-GRADUATE COLLEGE, West London Hospital, Hammersmith.road, W.MONDAY.-10 A.M., Dr. Simson: Diseases of Women. 10.30 A.M.,

Medical Registrar: Demonstration of Cases in Wards. 12 noon,Dr. Bernstein : Pathological Demonstration. 2 P.M., Medical andSurgical Clinics. X Rays. Mr. Armour: Operations. Mr. Dunn:Diseases of the Eye. 5 P.M., Lecture:-Mr. Baldwin: CommonDiseases of the Rectum.

TUESDAY.-10 A.M., Dr. Robinson : Gynaecological Operations.10.30 A.M., Surgical Registrar: Demonstration of Cases in Wards.12 noon, Mr. T. Gray: Demonstration of Fractures. 2 P.M.,Medical and Surgical Clinics. X Rays. Mr. Baldwin: Operations.Dr. Davis: Diseases of the Throat, Nose, and Ear. Diseasesof the Skin. 5 P.M., Lecture :—Mr. Baldwin : Common Diseasesof the Rectum.

WEDNESDAY.-10 A.M., Dr. Saunders: Diseases of Children. Dr.Davis: Operations of the Throat, Nose, and Ear. 11 A.M.,Mr. Souttar: Demonstration of Minor Operations. 12 noon,Mr. Souttar: Abdominal Diagnosis. 2 P.M., Medical and SurgicalClinics. X Rays. Mr. Pardoe: Operations. Mr. B. Harman:Diseases of the Eye. Dr. Simson : Diseases of Women. 5 P.M.,Lecture :-Mr. Baldwin: Common Diseases of the Rectum.

THURSDAY.-10.30 A.M., Dr. Simson: Gynaecological Demonstration.12.15 P.M., Lecture :-Dr. G. Stewart: Neurological Cases.2 P.M., Medical and Surgical Clinics. X Rays. Mr. Armour:Operations. Mr. Dunn: Diseases of the Eye. 5 P.M., Lecture:-Mr. Baldwin: Common Diseases of the Rectum.

FRIDAY.-10 A.M., Dr. Robinson: Gynaecological Operations.10.30 A.M., Lecture :-Dr. Owen: Practical Medicine. 12.15 P.M.,Lecture :-Dr. Bernstein: Clinical Pathology. 2 P.M., Medicaland Surgical Clinics. X Rays. Mr. Baldwin : Operations.Dr. Davis: Diseases of the Throat, Nose, and Ear. Diseasesof the Skin. 5 P.M., Lecture :-Mr. Baldwin : Common Diseasesof the Rectum.

SATURDAY.-10 A.M., Dr. Saunders: Diseases of Children. Dr. Davis:Operations of the Throat, Nose, and Ear. Mr. B. Harman:Diseases of the Eye. 10.30 A.M., Surgical Registrar: Demonstra-tion of Cases in Wards- 12 noon, Mr. Souttar: Surgical Anatomyof the Abdomen. 2 P.M., Medical and Surgical Clinics. Mr.Pardoe: Operations.

LONDON SCHOOL OF CLINICAL MEDICINE, DreadnoughtHospital, Greenwich.MONDAY.-Out-patient Demonstrations :-10 A.M. Dr. Singer:

Medical. Mr. H. Curtis: Surgical. 12 noon, Mr. G. N. Biggs:Throat, Nose, and Ear.-2.15 P.M., Mr. W. Turner: Surgery,

°

3 P.M., Mr. W. Turner : Operations. 3.15 P.M., Sir DyceDuckworth: Medicine. 4.15 P.M., Mr. R. Lake: Ear and Throat.

TUESDAY.-Out-patient Demonstrations:-10 A.M., Dr. G. Holmes:Medical. Mr. Cole : Surgical. 12 noon, Dr. H.MacCormac:Skin.-2 P.M., Mr. L. McGavin: Operations. 2.15 P.M., Mr.R. Carling: Surgery. 3.15 P.M., Dr. G. Rankin: Medicine.4.15 P.M., Sir Malcolm Morris : Skin.

WEDNESDAY.-Out-patient Demonstrations : 10 A.M., Dr. F. Lang-mead : Medical. Surgical. 11 A.M., Mr. R. E. Bickerton : Eye.

-2 P.M., Mr. L. V. Cargill or Mr. Choyce: Operations.Dr. A. Davies : Pathological Demonstration. 2.15 P.M., Dr. F.Taylor : Medicine. 3.15 P.M., Mr. Cargill: Eye Clinique.4.30 P.M., Mr. C. C. Choyce: Surgery. 3.15 P.M., SpecialLecture:-Mr. L. V. Cargill: The Treatment of Ocular Injuries.

THURSDAY.-Out-patient Demonstrations:-10 A.M., Dr. Singer:Medical. Mr. H. Curtis: Surgical. 12 noon, Mr. G. N. Biggs:Throat, Nose, and Ear.-2 P.M., Mr. R. Carling or Mr. W.Turner: Operations. 3.15 P.M., Dr. R. Wells: Medicine.4.30 P.M., Special Lecture:-Dr. R. 0. Moon: FunctionalDisorders of the Heart.

FRIDAY.-Out-patient Demonstrations;-10 A.M., Dr. G. Holmes:Medical. Mr. Cole: Surgical. 12 noon, Dr. H. MacCormac :Skin.-2 P.M., Mr. L. McGavin : Operations. 2.15 P.M., SirJohn Rose Bradford : Medicine 3.15 P.M.. Mr. L. McGavin:Surgery. 2.15 P.M., Lecture :-Sir John R. Bradford, K.C.M.G.:Ascites.

SATURDAY.-Out-patient Demonstrations: 10 A.M., Dr. F. Langmead :Medical. Surgical. 11 A.M., Mr. R. E. Bickerton: Eye.-10 A.M., Radiography.

NORTH-EAST LONDON POST-GRADUATE COLLEGE, Prince ofWales’s General Hospital, Tottenham, N.MONDAY.-Clinics :-10.30 A.M., Surgical Out-patient (Mr. E.

Gillespie). 2.30 P.M., Medical Out-patient (Dr. T. R. Whipham) ;Nose, Throat, and Ear (Mr. H. D. Gillies). 3 P.M., ClinicalPathology and Pathological Demonstration (Dr. W. H. Duncan).

TUESDAY.-Clinic; 2.30 P.M., Operations. Clinics :-Medical Out-patient (Dr. A. G. Auld) ; Surgical (Mr. Howell Evans);Gynaecological (Dr. A. E. Giles). 3.30 P.M., Medical In-patient(Dr. A. J. Whiting).

WEDNESDAY.-Clinics:-2 P.M., Throat Operations (Mr. Gillies).2.30 P.M., Children’s Out-patient (Dr. T. R. Whipham); Sldn(Dr. G. N. Meachen) ; Eye (Mr. R. P. Brooks). 3 P.M., X Rays(Mr. W. Steuart) ; Clinical Pathology and Pathological Demon-stration (Dr. W. H. Duncan). 5.30 P.M., Eye Operations (Mr.Brooks).