636

Dispensary Medical Officers and their Holidays.The quarrel between the guardians and the dispensary

medical officers in Ireland continues. Dr. A. M. Love,medical officer of Drumquin Dispensary, was grantedtwo weeks’ holiday by the Omagh guardians on conditionthat he would procure a substitute at £2 2s. per week.The medical officer wrote saying that he was unableto do this and the guardians replied that on his com-

plying with their conditions he could have his holi-days, to which the Local Government Board (on its atten-tion being drawn to the matter) wrote the guardiansreminding them of the altered state of the law. Recoup-ment can in future be obtained out of the local taxation

(Ireland) account of one-half of the remuneration paid by theguardians, with the sanction of the Local Government Board,to the medical practitioners employed as substitutes for themedical officers of the dispensary districts of the union

during the absence from duty of these officers on vacation.In these circumstances the Omagh guardians were directedto reconsider their former decision. At a specially summonedmeeting the chairman (Mr. G. Murnagham, M.P.), who hasbeen greatly opposed to the claims of the dispensary medicalofficers, said the amount that they would receive would

depend on the amount which they paid in 1902 forsubstitutes. There would not be a recoupment in all caseswhere the guardians gave holidays to their medicalofficers. There had been, he said, a smart trick played inthe House of Commons when the Irish Members were absentby inserting a certain provision into the Act which pre-cluded any union which was not granting its medicalofficer a holiday at the particular time when the Act waspassed from getting any benefit. The chairman eventually(at the meeting of the guardians on August 22nd)was directed to write asking the Local GovernmentBoard if the recoupment could be made without anyrestriction as to the amount paid in 1902. At a

meeting of the Ballymena guardians on August 22nda letter was read from the Local Government Board statingthat the sum of £2 2s. per week proposed by the guar-dians as remuneration for a substitute for the medicalofficer during the latter’s absence on holidays was insufficient,and intimating that unless the guardians could arrange forthe employment of a substitute for Mr. R. Currie at areasonable remuneration, Dr. W. R. Davidson having re-

fused to act at the fee named, the Board would be obligedto use its powers and to direct the guardians to pay a suitablefee. The guardians then granted several applications forholidays on condition that the medical men would arrangefor substitutes at £2 2s. per week. It is hoped that theLocal Government Board will send down a sealed order

compelling the guardians to pay the proper remuneration.Derry Infirmary.

Mr. R. Lee Hogg, a member of the committee of theLondonderry Infirmary, has intimated his intention of subscribing 500 guineas towards the building fund, an adequatesum to be ear-marked for the internal decorations of the oldbuilding. It is given as a token of gratitude to the Kingand Queen for their recent visit to the hospital as well as arecognition of the very real interest that their Majestieshave always shown in hospitals and in their work. Quiterecently Mr. Hogg expended £700 upon the institution onthe occasion of their Majesties’ late visit. Mr. Hogg had theenterprise to do up and to decorate the children’s ward, sothat it will not require any attention for a long time and hehas supplied the house-surgeon with sets of valuable anduseful instruments. At the monthly meeting of the DerryInfirmary committee held on August 18th the best thanksof the committee were tendered to Mr. Hogg for his generousgifts.

Typhus -Fever on Arranmore.I regret to report another serious outbreak of typhus fever

on the island of Arranmore, five miles off the coast of Donegal.The place will be recollected as the scene of the heroic effortsof the late Mr. W. Smyth, medical officer of Burtonport, andDr. B. McCarthy, medical inspector of the Local GovernmentBoard, to convey patients from the island to the feverhospital on the mainland some time ago, when the formercontracted typhus fever and died. At a meeting of theGlenties board of guardians held on August 24th Dr.

McCarthy reported the outbreak, and said further that notonly in the houses in which the fever arose but in thoseupon which he had last year unfavourably reported therehad been no real improvement. There were all the elements

present to breed a preventable disease-unhealthy houses,inadequate windows, clay floors, damp walls, defective roofs,and people huddled and crowded together sleeping in un-healthy beds with deficient covering, supplemented withclothes worn during the day. The island belonged to the con-gested district boards which offered to carry out repairs, butthe occupiers declined to contribute a small assistance. Therewas no pressure of public opinion or pressure from the

sanitary authority, and the people continued to live in housesnot fit for a pig. No medical man and no nurse shouldbe asked to look after typhus fever in such surroundingswith the certainty that they would take the disease and, per-haps, like Mr. Smyth, succumb. Dr. McCarthy implored theguardians to remedy the state of affairs existing on theisland and to have the houses carefully inspected. The

population is about 1300 in 250 houses on the island, with noproper provision for the separation of the sexes, no sanitaryaccommodation, and in many cases cattle and fowl are keptin the dwelling-houses. The guardians decided to instructthe sanitary sub-officer to see if he could get the vacantbarracks or any other house on the island suitable for a

hospital.August 25th.

PARIS.

(FROM OUR OWN CORRESPONDENT. )

The Tsetse Fly and Sleeping Sickness.M. E. BRUMPT of the Bourg de Bozas Mission, recently

made before the Society of Biology some observations whichare worthy of notice, concerning the possible methods ofinoculation of the malady of sleeping sickness. This diseaseis due to a parasite, as is well known, but it is not certainwhether it is a trypanosoma, as Castellani and Bruce consider,or whether it is some other micro-organism. It is certain,however, that the pathogenic agent must be introduced intothe organism by some method or another in the case of

persons affected with sleeping sickness, for it does notexist in them naturally. There are many methods bywhich inoculation can take place, but the most prob-able, in M. Brumpt’s opinion, is inoculation by thetsetse fly which, as is well known, is the agentin the transmission of the disease known as nagana indomestic animals. M. Brumpt further says that there is astriking coincidence between the geographical distributionof sleeping sickness and that of the tsetse fly. The diseaseexists in all territories where the fly is found and whereverthe fly exists the disease can acclimatise itself. Sleepingsickness was formerly only known in the Lower Congo.Nowadays, however, it has reached the Higher Congo andthe country through which the tributaries of this river flow.Here it was formerly unknown, although the tsetse fly existed.On the other hand, if one cannot say that sleeping sicknessexists everywhere that the tsetse fly is found it is at least

possible to state that wherever the fly is absent therealso sleeping sickness is absent. It cannot, at least,arise there, although assuredly patients who have con.

tracted the disease in a tsetse-fly-haunted region may,having travelled away, find themselves in all quarters ofthe globe. One fact which goes to prove the importance ofthe tsetse fly is the following. In a tsetse-infected regionthe flies live chiefly along the borders of the rivers and

sleeping sickness is much more frequent in similar situationsthan in the inland territories. Here is a case which is verysignificant with regard to this point. At Banamia, close toCoquilhaville, there is a mission worked by Belgian Trappists,about 20 minutes’ walk from the bank of the Congo. On thebanks of the river some years ago there used to live some3000 Lolo fishermen. At the present time these fishermennumber about 300, all the rest having succumbed to sleepingsickness. On the other hand, close to the mission buildingsthere was a village of cultivators who very rarely went downto the river and who drank spring water. Among thesecultivators sleeping sickness is extremely rare. The factswhich M. Brumpt cites are well worthy of consideration.If his hypothesis should be verified it is obvious that somemeans should be taken to combat a disease which decimatesthe indigenous population just as much as a disease trans-mitted by the same insect decimates horses and cattle.Enormous obstacles are put in the way of the explorationand civilisation of the widespread territories of the Africancontinent by the tsetse fly.

637

The New Asylums for the Aged in Paris.As is well known the Assistance Pnblique has not

enough beds, more especially as regards making pro-vision for the aged. Those to whom this state ofaffairs seems unsatisfactory have not failed to remarkthat, in the recent scheme of reorganisation of hospitalprovision hospitals only and not asylums are set down asbeing about to increase the number of their beds. M.Mesureur, director of the Assistance Publique, and theConseil de Surveillance have been considering how to fill

up this void and the administration has recently comeinto possession of two large properties which are

intended to become magnificent asylums for the aged.The first is at Aulnay Sous-Bois (Seine) and the second isat St. Firmin-en-Vineuil (Oise). Each asylum is calculatedto hold 150 pensioners. The buildings are already inexistence and only want a certain amount of work expended upon them to fit them for their new functions. At theasylum of St. Firmin the amount of money which will haveto be annually expended by a pensioner will vary from 250to 300 francs. Just at present only 54 beds are in workingorder, but it is hoped that this number will be rapidlyincreased by means of gifts from charitable persons. A thirdsimilar establishment is going to be opened just outside Parisby the Assistance Publique in the month of October next.This will be an asylum for young girls who are convalescingfrom illness or simply run down and ansemic. This asylumwill, in accordance with the desire fit the founder, take thename of St. Joseph. The house stands in a beautiful situa-tion, quite in the open air, at Pontourny in the commune ofBeaumont (Indre et Loire) and 48 young girls will be able tobe received tnere.August 25th.

__________________

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

Cardiac Diseases and the Army.THE military authorities have become aware of a consider-

able increase of cardiac diseases in the army as well as

among the conscripts. Whilst the number of soldiers suffer-ing from cardiac troubles was 1 5 per 1000 during the periodfrom 1881 to 1886, it rose to 3-1 in 1900. Of the con-

scripts in 1894, 9-9 per 1000 ; in 1896, 13 per 1000 ; andin 1898, 17’ 4 per 1000 showed symptoms of cardiac diseasesand were thus considered unfit for service in the army.Cardiac diseases prevail especially in certain districts of theempire, a fact which may be connected with the spread ofinfluenza in these regions. In the army reports the cases ofcardiac disease are classified as pericarditis (35 cases),endocarditis (612 cases), nervous troubles (759 cases), andother diseases of the heart (126 cases). The militaryauthorities being desirous of ascertaining the causes of theincrease of cardiac troubles have asked the scientific councilof the army medical academy to give their opinion ofthe matter. The report of the council, of which Dr.Kraus, professor of clinical medicine, Surgeon-GeneralStricker and Surgeon-General Landgraf are the authors,directs the attention to some social evils to whichyoung men are especially exposed: over-exertion inwork, insufficient time to rest, abuse of spirits and tobacco,extravagances in sport of every kind, and finally thespread of hysteria and neurasthenia must be regardedas the principal causes. Moreover, the prevalence ofinfluenza has undoubtedly contributed to the increaseof cardiac diseases. According to the authors’ opinionconscripts with organic diseases of the heart are totally unfitfor military service, whilst those suffering from functionaltroubles only may eventually be able to serve in certainbranches of the forces, especially in the cavalry. The

report insists on a careful examination of the hearts ofrecruits and conscripts and recommends the use of the ’

radiographic apparatus for that purpose, together with a

special training of the army medical officers in the modernmethods of diagnosis.The Diagnosis of Cholera. !

The German commission for the study of cholera in Egypt,presided over by Professor Kolle of the institution forinfectious diseases, has published a short report in the-Deutsche Medicinische Wochenseltrift. The report mentionsKoch’s method of preliminary cultures in pepton solutions, theprincipal value of this method being the possibility of detect-ing single individuals of the cholera vibrio within a mixture

of other bacilli. It must, however, be remembered that thepepton solution is not a specific soil for the cholera vibrioonly but for other vibrios also. Practically, vibrios whichwere very like Koch’s vibrio were detected in the bowels ina greater number of cases than it was hitherto supposed, butby the agglutination test their non-identity with the genuinevibrio of cholera was ascertained in every instance. Of73 cases examined during the recent epidemic, in 59 Koch’svibrio was detected, in two cases another vibrio verysimilar to the specific cholera bacillus was found to bepresent at the same time, whilst in the remainder of 14cases vibrios of different species were found. Of the lattercases five were apparently not cholera from a clinicalpoint of view; in seven, where the clinical symptomsof cholera had developed, the presence of the pseudo-cholera vibtio was only accidental ; in four cases a

certain diagnosis could not be formed owing to thewant of a trustworthy history. The report further statesthat the serum test by bacteriolysis as well as by agglutina-tion reacted positively in every case of genuine cholera andeven in cultures of no or very little virulence ; on the otherhand, none of the genuine cholera cultures showed a positivereaction in any of the sera obtained from the pseudo-choleracases and none of the 16 pseudo-cholera cultures reactedpositively against the genuine cholera sera; moreover, theindividual species of pseudo-cholera microbes were aggluti-nated only by their own sera and not by any of the others.There were also marked differences in the morphologicalcondition of some of the pseudo-cholera vibrios ; in five casesthe species had several flagella, one species had no powerof moving, and three species when injected into pigeonsproduced general septicaemia and belonged to Metchnikoff’svibrio. The practical result of the investigations carried outby the commission was that by the preliminary pepton-watercultures, by the agar-plate culture, and by the agglutinationtest the diagnosis was ascertained within 16 hours ; thetheoretical result was that the specific action of Koch’svibrio was again proved.

The Degree of M.D.In the winter semester of 1902-03 631 medical men took

the degree of M.D. at the Universities of Germany. Of thisnumber 98 candidates graduated from Leipsic, 65 fromMunich, 62 from Kiel, 45 from Berlin, 41 from Greifswald,38 from Strasburg, 33 from Bonn, 29 from Freiburg, 28 fromKonigsberg. 26 from Halle, 24 from Heidelberg, 20 fromRostock, 19 from Wurzburg, 18 from Marburg, 17 from

Tubingen, 16 from Jena, 15 from Breslau and Giessen

respectively, 14 from Erlangen, and 8 from Gottingen.Three of the candidates were women, of whom two wereRussian and one German. It is remarkable that the numberof graduations at the individual universities is not atall in accordance with the number of matriculatedstudents, as Berlin, which has the greatest number ofmedical students, takes only the fourth place as to gradu-ations, whilst Leipsic being the third as to the numberof medical students has more than double the number ofgraduates in medicine. The cause is that the examinationfor the degree of M.D. is little more than a formality,especially now that the new regulations allow the degree tobe conferred on Germans only when they have previouslypassed the State examination. Therefore, medical men liketo present themselves at any university where the fees arethe most moderate and the examination the easiest to pass,and Leipzic was known long ago to fulfil both conditions. TheBerlin examination is expensive and relatively difficult topass. But for the foreigners who are accustomed to take thedegree at that university where they have performed theircurriculum and are at liberty to present themselves withouthaving passed the State examination, the number of gradua-tions in Berlin would be still smaller, as nearly one-fourth ofthe Berlin doctors of medicine are foreigners.August 23rd.

AUSTRALIA.(FROM OUR OWN CORRESPONDENT.)

Pharmacy Board of New South Wales.THE annual report of the Pharmacy Board has been sub-

mitted to the Legislative Assembly of New South Wales.During the year 60 applications for registration under thePharmacy Act were granted, making the total number of

pharmacists registered 840. Poison licenses had been

granted to 62 pharmacists and annual poison licences to.