285CHOLERA AND QUARANTINE IN THE UNITED STATES.

that unless more care is taken to guard the too longoverlooked interests of medical men, such institutions

will not have the sympathy of the profession.

THE published report of the proceedings of the annualmeeting of the Illinois State Board of Health gives someaccount of the action adopted in certain parts of the UnitedStates with regard both to maritime and land quarantine.The steamship Alesia arrived at New York on Sept. 23rd,1887, having cases of cholera amongst her complement of550 immigrants from Italy; and she was sent to the

quarantine station at Hoffman Island for so-called observa-tion. Dr. RANCH, secretary to the Illinois State Board

being anxious to protect the district under his supervision,sought repeated information from the New York healthofficer, and from this we learn that there were eight casesin hospital on Sept. 24th, that by Oct. 10th twenty-six ofthe detained immigrants had contracted the disease, andthat on the 19th another case occurred. 11 The quarantinesystem of the port of New York is now on trial," signifi-cantly added the New York health officer, and this apparentlybefore the issue of the report of the committee appointed bythe College of Physicians and Surgeons of Philadelphia,commenting severely on the condition of the New Yorkquarantine station. As regards immigrants intending toenter the State of Illinois, an effort was made to prevent anyperson who had been detained at Hoffman Island from even

travelling by rail unless provided with a certificate settingforth that he was not suffering from cholera or choleraicsymptoms; but one company felt they could only act thusprovided concerted measures were taken by all the com-panies in this direction. But much greater stringency thaneven this prolonged detention of the healthy together withthe sick seems to be asked for by the Illinois Board, for onthe arrival of 614 other immigrants from Palermo on boarda vessel as to which the port medical officer states thatthere was "positively no evidence unfavourable" " to her, theIllinois Board would, on the ground that she had come froma cholera-infected district in Italy, have had her detainedfor " observation during the necessary " incubation " period,’and this although the journey from Palermo must havEexceeded anything which the most stringent quarantinisthas ventured to regard as a cholera-incubation period.The attitude thus taken up by this inland State is

altogether different from that adopted in this country; butit is held to be justified on the ground that the circum-stances are in no way parallel, on account of the vast

hordes of immigrants that are continually crossing thE

Atlantic, and this in vessels the officers of which cannot bErelied on for trustworthy reports as to the occurrences ojthe voyage. And as to a certain number of infectioul

diseases, it is very truly held that the length of the voyagis just about long enough to increase the susceptibility t(contagia brought on board by steerage passengers. It i:

also rightly maintained that whatever is done by way oprevention should be done at the expense of the nation as whole, and not at the cost of those States which happen t(contain the ports, or the great centres from which immi

grants distribute themselves over the country at large.The report admits that, although at New Orleans ther

is the most thorough and vigorous system of sanitar,

quarantine which has ever been enforced for the protectionof a port, it will not suffice to exclude such a capriciousdisease as cholera, and it goes on to say that there is

absolutely no safety for the United States so long as choleraexists anywhere on the continent of Europe unless vesselsare immediately taken charge of by the quarantine autho-rities, cleansed and disinfected, and also subjected to adetention long enough to cover the recognised period ofincubation after arrival. The remedy is heroic, judged ofby proceedings taken in this country, and we doubt whetherthe States, as a whole, will ever agree to it; and this themore since during the long continuance of cholera in

Europe in 1885-87, and under the present system, which isheld to be insufficient, it is admitted that 11 as yet no casesof cholera" have developed "among or from immigrantsallowed to land and travel into the interior" from the

various vessels. Reading between the lines, we can wellregard the extension of disease which took place at

Hoffman Island in September and October last as

largely brought about by those conditions under whichthe hitherto healthy people were compulsorily detained,and which were so "severely" commented on by the

leading medical authorities of Philadelphia.

Annotations.

ROYAL UNIVERSITY OF IRELAND.

" Ne quid nimis."

THE following changes in the regulations for the medicalexaminations in the University have been fixed by the Senate,and only await the sanction of the Crown to be put intooperation. 1. Students passing the examination now appointedfor the M.B. degree will be entitled to receive the threeprimary degrees of M.B., B.Ch., and B.A,O. without anyadditional fee beyond what is already prescribed in theCalendar for admission to the M.B. degree. 2. Candidates

may be admitted to the examinations for the higher medicaldegrees of M.D., M.Ch., and M.A.O. after the lapse of threeacademical years from the time of obtaining the primarymedical degree. Provided always that every person whobefore the 1st day of January, 1888, had passed the exami-nation for the degree of M.B. shall be entitled at any timeduring the three years then next ensuing to proceed to thedegrees of il2.Ch. and M.A.O., according to the courses andregulations in force in October, 1887. Provided also that all

persons who in the year 1888 shall pass the examination forthe primary medical degrees shall be entitled to proceed tothe degrees of M.Ch. and M.A.O. at any shorter interval, uponpassing the prescribed examinations. After next year certainadditional certificates of hospital work will be required ofcandidates at medical examinations. The regulations re-garding exhibitions, scholarships, &c., have also undergonemodification, the nature of which will be published in duecourse.

___

THE BRITISH NURSES’ ASSOCIATION.

WE are glad to know that the organisation of the BritishNurses’ Association may now be considered an accomplishedfact. The key-note of the movement is that nursing is anessential factor in the modern treatment of disease. Thenumber of highly educated gentlewomen now engaged innursing has raised the social status of nurses immeasurablywithin the last decade. The founders of the new Associationclearly saw that the time had come to unite nurses in themembership of a legally constituted profession, They also

286

knew that the control of this profession must be kept solelyin the hands of medical men and nurses, and that it wouldbe simply disastious to allow nurses to be organised andcontrolled by any unprofessional and therefore irresponsiblepersons, a danger which certainly would have arisen but forthe prompt action which has been taken. But the new Asso-ciation utterly disclaims any antagonism to any other

body. It merely claims for medical men and nurses thebare right to manage the nursing profession without theinterference of any of the lay public, however well-intentioned. The Association therefore is fighting for

the indisputable rights of the medical profession, and,as we have pointed out, deserves the support of

every medical man who respects his calling. Meet-

ings of leading medical men were called together toformulate the bye-laws. These have now been elabo-

rated, and provide for the whole control of the nursingprofession of the future being in the hands of a GeneralCouncil, to be composed of an equal number of medicalmen, matrons of hospitals or infirmarieo, and sistersor nurses. The Council will annually elect an ExecutiveCommittee containing twelve medical men among its

members, the President of which will be H.R.H. PrincessChristian. Membership of the Association will be open onlyto medical men, matrons of hospitals or infirmaries, and nurseswho have been trained for three years. A general meeting is tobe held on Feb. 13th, at 4 P.M., when Mr. Savory will take thechair. H.R.H. Princess Christian has announced her inten-tion to be present, and we hear that leading members of themedical profession will attend and speak. We sincerely hopethat many of our readers will make a point of being presentand of joining the new Association at once, to show notonly their interest in the welfare of nurses generally, butalso their appreciation of the large share allotted to medicalmen in the organisation and government of the Association.We understand that any further information or tickets forthe meeting can be obtained on application to the hon.secretary, 20, Upper Wimpole-street, W.

SUMMER HOMES FOR NURSING SISTERS IN INDIA.WE are glad to learn from the Indian papers that Lady

Roberts’s philanthropic scheme for the establishment of

summer homes for nursing sisters is making satisfactoryprogress. A house has been purchased at Murree, and isnow being properly fitted and farnished, and at Kasauli oneis being built. At both of these institutions sick quartersfor officers are to be provided, an arrangement which cannotfail to be productive of great benefit to those for whom it isintended. The introduction of skilled European nurses intothe hospitals in India is a movement which must commenditself to all who have friends in that country, and who takean interest in the welfare of those on whom devolve its

government and its defence ; but to send out nurses withthe prospect of continuous work in hospitals in the plainswould be an act of great inhumanity to them, and would toa large extent counteract the advantages expected fromtheir services by the almost inevitable break-down in healthfrom unintermitting residence and work in these malariousdistricts. If, therefore, we are to have efficient nursing,it seems imperative that provision should be made to Irelieve the nurses for a season from the cares and

responsibility necessarily connected with their woik, andto afford them an opportunity of regaining strength andenergy when their health is beginning to suffèr from

long-continued expomre to heat and to the pbysical i

deterioration inseparable from hospital work. A con-

siderable success, from a financial point of view, hasattended Lidy Roberts’s labours, 53,000 rupees having been Iraised in India, and about 1600 in England ; but this

is much below what it ought to have been. It has en-

abled a commencement of the good work to be made inBengal and the North-West Provinces, but the schemeshould be extended to Madras, Bombay, and Burmah. Webelieve that the very moderate amount of help fromEngland has been in a great measure a result of the non-appreciation of the necessity for these "homes of rest" andignorance of the movement now for the first time under-taken to provide them. We cannot but think that if the

imperative need of them, in the interests alike of the nursesand of our sick countrymen, in whose service their health isbeing sacrificed, were better known, there would be noscarcity of funds to provide all that may be deemed requisite.The establishment of sick quarters for officers at thesesummer homes, where they will receive that care andattention which are so invaluable to invalids, will furnishan additional claim upon those who have friends in India,and who will be naturally anxious to promote a schemewhich promises to add so materially to the comfort andwell-being of those in whose interest it has been organised.The wotking of such an institution will be attended with

many difficulties, but we trust that, under the judiciousmanagement of a thoroughly practical committee and thesuperintendence of carefully selected matrons for each ofthe homes, these may be overcome, and an important elementof success in the treatment of their cases may be securedto the medical officers of hospitals by the provision of

efficient skilled nursing. __GERMAN MEASLES IN THE PORT OF PLYMOUTH.

OWING to the existence of four cases of German measles onboard the Peninsular and Oriental steamer Ravenna on her ’arrival in Plymouth Sound on the 7th inst., the actingexamining officer of Customs ordered the return of the steamtender, with officials on board, to Melbay until after aninspection by Dr. Fox, the port medical officer. When hevisited the ship, he found two boys, sons of a British officer,and two Lascars .suffering from the disease, and it is statedthat a difficulty then arose as to dealing with them and themother of the lads, because there was small-pox on boardthe port hospital ship. As a matter of fact, there is no

power of removal in such cases except under a magistrate’sorder, and Dr. Fox, having telegraphed to the Local Govern-ment Board for instructions, received an answer authorisinghim to exercise his discretion under the circumstances ofthe case. In conformity with this view he allowed thevessel and all the passengers to proceed to Gravesend—a,course which was obviously the right one, for the patientsare stated to have been carefully isolated on board, and it ishardly likely that in these circumstances any magistratewould have ordered them into a small-pox hospital.

OVERHEAD WIRES.

THE educational action of circumstances has necessarilyeverything to do with the appreciation of danger and thedevelopment of a habit of caution. It is a natural cunse-

quence of our experience that we are always inclined to

examine our surroundings and the ground on which we treadfor it is in connexion with thesa that we may expect tofind most of lift’s risks and troubles. How seldom do we look

I upwards unless it happen that some elemental disturbanceforces us to respect our interests in that quarter. We are

likely, however, to become ere long as careful of the stateand contents of our upper atmosphere as of any other part ofour environment. The possible means of injury acting fromabove have certainly increased as a direct consequence ofrecent scientific discoveries. A dozen years ago one had, in-deed, a potent, though very rarely effective, source of dangerin the overhead telegraph wires of our large cities. Nowthere are in some towns not only this but two other kindredpowers at work in the telephone and the electric lightingcom-