the eighth international congress of hygiene and demography

2
661 another instance of a member of the medical profession sacrificing his life in the performance of duty. He was a most genial, courageous man, and he will be sadly missed by all with whom he has been associated b3th professionally and from a social point of view. He was considerate towards others, but careless of himself. The manner of hi9 death shows this only too clearly; although shivering with infiuenz 1, be did his town and country work as usual, but, an attack of pneumonia ensuing, it proved fatal. Dr. Innes (who was at one time in the Army Medical Service) was singularly successful in his treatment of little chitdren, who, attracted by his genial manner, seemed at once to look upon him more as a friend than as a physician. What higher compliment could be paid him by his little patients? 7 He not only had good ability, a clear head, and a large stock of common sense, but, in a rare degree, he was earnest in the pursuit of whatever he undertook. Often far from well, he was always cheerful and hopeful. Such a man could not fail to meet with approval and to make many friends. He always showed scrupulous regard for the rights and feelings of his ,,2onfrres, and he will be missed by many, both rich as well as poor." - DEATHS OF FOREIGN MEDICAL ME.-The deaths of the following members of the medical profession abroad are announced :—Dr. A. Finkelstein, Assistant Medical Officer in the Moabit Hospital, Berlin, from septic infection, at the age ,af thirty-one.-Dr. Adolf Messner, a well-known Munich surgeon.—Dr. Leo Warnots, Professor of Operative Surgery in the University of Brussels, at Wiesbaden, aged thirty- eight.—Dr. Stolnikoff, Professor of Special Pathology and Therapeutics in Warsaw.-Dr. Danielssen, of Bergen.- Dr. A. B. Miles, Professor of Surgery in the Tulane Univer- sity, New Ocleans. THE EIGHTH INTERNATIONAL CONGRESS OF HYGIENE AND DEMOGRAPHY. THE Congress, which opened with a considerable measure of practical promise, has hardly fulfilled its auguries. Some of the minor arrangements for delegates were good, though it must be confessed that this commendation does not cover the accommodation made for the foreign press ; but whether the Congress as a whole is going to prove of any practical ’7alne is a different matter, and in many respects the organi- sation left much to seek. "To me," writes a valued correspondent, "it seems undoubted that very great reforms will be necessary in the organisation of future Congresses. Experience proves that twenty-six Sections are not workable. This means so great a subdivision of Sections and of subjects that many delegates found themselves called upon to be in ’three or four different Sections at one and the same time; whilst others, who had no particular business, gravitated towards the Section where the most notable personages were to speak or the subject of the greatest general interest was to be discussed. The members who, discarding these attractions, went to] their special Sections as often as not found that many of the papers announced were not to be read. When the authors were called upon they either were not at the Congress at all or else were reading some other paper in some other Section or had been utterly unable to find their way to the proper place at the proper time. The organising committee ingeniously con- trived to mark with numbers and huge letters the various blocks of buildings in which the different Sections were located. But there were not only the twenty-six Sections, there were also six different localities occupied by the - exhibition and the numerous offices. To learn the topography of such vast installations was no easy matter; and the distances, even when the right road was ascertained, from one Section to another were considerable. Thus much Gime was lost in wandering about from place to place. As a consequence some of the most important Sections were very badly attended." - On Wednesday morning, Sept. 5Gh, only twenty persons were found in the Section devoted to State Hygiene, while the Section dealing with Sport was shut up, no one having put in an appearance. At 10.30 A.M. the Section of Tropical Diseases was already closed, and in the Section dealing with the Hygiene of Railways and Navigation there were only eighteen members present. On Saturday morning, when the Sections should have been thronged by eager attendants anxious to complete their programme before the closure of the Congress, many Sections were closed. Some of the rooms were even locked, and an attendant was placed on guard to inform inquirers that there was no meeting to be held. In other instances the door was open, but the room void. Thus the Railways and Navigation Section did not meet, nor the Section of Sports. At the Hygiene of Towns Section there were but twelve persons, and at the Prophy- laxis Section twenty-one. In the Hygiene of Schools Section, a number of ladies being present, the total amounted to an attendance of forty persons. Thia, however, was quite ex- ceptional. Even an interesting debate on the Contagious Diseases Act and kindred subjects did not draw more than thirty-six persons to the State Hygiene Section. But the worst disappointment of all was the small attend- ance at the plenary meeting held in the Town Council Chamber at three o’clock on Saturday afternoon. Professor Fodor was in the chair, and he explained that without dis- cussion he would seek to ascertain whether there was a majority of those present in favour of the resolutions carried in the different Sections. Most of these were printed in four languages, but others were written only, and these gave great trouble. - The first resolution was proposed by Dr. A. J. Martin, Sanitary Inspector-General of Paris, and seconded by Mr. Adolpbe Smith of London, and was to the effect that, as the law controlled the manufacture of boilers, to see that explosions did not take place, there should be a State control and a State mark placed on disinfecting stoves. It was as necessary that stoves should disinfect as that boilers should not burst. This resolution, carried in the Section, was unanimously confirmed by the plenary meeting. Then a long resolution cn diphtheria was read and ultimately adopted. It proposed obligatory declaration, isolation, and complete disinfection of premises, of linen during the pro- gress of disease, and of the carriage used for the transport of the sick ; that children related to a sick child should be kept from school, and if the disease broke out in a school then all the children should be placed under medical supervision ; and, finally, that bacteriological experiments should be made to diagnose the disease. A very lengthy resolution on cholera, submitted by Dr. Kuborn of Liege, was referred back as too complicated, and later a resolution approving the decisions of the Dresden International Sanitary Conference was carried. Miss Florence Nightingale’s resolution, as carried in the Section of Tropical Diseases, was confirmed by acclamation. "The Tropical Section of the Congress," it ran, "having had under consideration a paper by Miss Nightingale on Village Sanitation in India, are of opinion that the subject is a very important one, affecting as it does the health and prosperity of so many millions of industrious and law-abiding people. They appreciate the efforts that have been made in the dif- ferent provinces by the Government of India to promote this work; and, looking to the special conditions of the village com- munities of India, they think that the best results will be obtained through the cooperation of the people themselves if they are instructed in the primary rules of health. The

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Page 1: THE EIGHTH INTERNATIONAL CONGRESS OF HYGIENE AND DEMOGRAPHY

661

another instance of a member of the medical professionsacrificing his life in the performance of duty. He was amost genial, courageous man, and he will be sadly missedby all with whom he has been associated b3th professionallyand from a social point of view. He was considerate towardsothers, but careless of himself. The manner of hi9 deathshows this only too clearly; although shivering with infiuenz 1,be did his town and country work as usual, but, an attack ofpneumonia ensuing, it proved fatal. Dr. Innes (who was atone time in the Army Medical Service) was singularlysuccessful in his treatment of little chitdren, who, attractedby his genial manner, seemed at once to look upon him moreas a friend than as a physician. What higher complimentcould be paid him by his little patients? 7 He not only hadgood ability, a clear head, and a large stock of commonsense, but, in a rare degree, he was earnest in the pursuitof whatever he undertook. Often far from well, he was

always cheerful and hopeful. Such a man could not fail tomeet with approval and to make many friends. He alwaysshowed scrupulous regard for the rights and feelings of his,,2onfrres, and he will be missed by many, both rich as wellas poor."

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DEATHS OF FOREIGN MEDICAL ME.-The deaths of thefollowing members of the medical profession abroad are

announced :—Dr. A. Finkelstein, Assistant Medical Officer inthe Moabit Hospital, Berlin, from septic infection, at the age,af thirty-one.-Dr. Adolf Messner, a well-known Munichsurgeon.—Dr. Leo Warnots, Professor of Operative Surgeryin the University of Brussels, at Wiesbaden, aged thirty-eight.—Dr. Stolnikoff, Professor of Special Pathology andTherapeutics in Warsaw.-Dr. Danielssen, of Bergen.-Dr. A. B. Miles, Professor of Surgery in the Tulane Univer-sity, New Ocleans.

THE EIGHTH INTERNATIONAL CONGRESSOF HYGIENE AND DEMOGRAPHY.

THE Congress, which opened with a considerable measure ofpractical promise, has hardly fulfilled its auguries. Some ofthe minor arrangements for delegates were good, though itmust be confessed that this commendation does not coverthe accommodation made for the foreign press ; but whetherthe Congress as a whole is going to prove of any practical’7alne is a different matter, and in many respects the organi-sation left much to seek.

____

"To me," writes a valued correspondent, "it seems

undoubted that very great reforms will be necessary in theorganisation of future Congresses. Experience proves thattwenty-six Sections are not workable. This means so

great a subdivision of Sections and of subjects that

many delegates found themselves called upon to be in’three or four different Sections at one and the same time;whilst others, who had no particular business, gravitatedtowards the Section where the most notable personages wereto speak or the subject of the greatest general interestwas to be discussed. The members who, discardingthese attractions, went to] their special Sections as

often as not found that many of the papers announcedwere not to be read. When the authors were called uponthey either were not at the Congress at all or else were

reading some other paper in some other Section or had beenutterly unable to find their way to the proper place at theproper time. The organising committee ingeniously con-trived to mark with numbers and huge letters the variousblocks of buildings in which the different Sections werelocated. But there were not only the twenty-six Sections,there were also six different localities occupied by the- exhibition and the numerous offices. To learn the

topography of such vast installations was no easy matter;and the distances, even when the right road was ascertained,from one Section to another were considerable. Thus muchGime was lost in wandering about from place to place. As a

consequence some of the most important Sections were verybadly attended." -

On Wednesday morning, Sept. 5Gh, only twenty personswere found in the Section devoted to State Hygiene, whilethe Section dealing with Sport was shut up, no one havingput in an appearance. At 10.30 A.M. the Section of TropicalDiseases was already closed, and in the Section dealing withthe Hygiene of Railways and Navigation there were onlyeighteen members present. On Saturday morning, when theSections should have been thronged by eager attendantsanxious to complete their programme before the closure ofthe Congress, many Sections were closed. Some of the roomswere even locked, and an attendant was placed on guard toinform inquirers that there was no meeting to be held. Inother instances the door was open, but the room void.Thus the Railways and Navigation Section did not meet,nor the Section of Sports. At the Hygiene of TownsSection there were but twelve persons, and at the Prophy-laxis Section twenty-one. In the Hygiene of Schools Section,a number of ladies being present, the total amounted to anattendance of forty persons. Thia, however, was quite ex-ceptional. Even an interesting debate on the ContagiousDiseases Act and kindred subjects did not draw more thanthirty-six persons to the State Hygiene Section.

But the worst disappointment of all was the small attend-ance at the plenary meeting held in the Town CouncilChamber at three o’clock on Saturday afternoon. ProfessorFodor was in the chair, and he explained that without dis-cussion he would seek to ascertain whether there was a

majority of those present in favour of the resolutions carriedin the different Sections. Most of these were printed in fourlanguages, but others were written only, and these gavegreat trouble.

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The first resolution was proposed by Dr. A. J. Martin,Sanitary Inspector-General of Paris, and seconded by Mr.Adolpbe Smith of London, and was to the effect that, as thelaw controlled the manufacture of boilers, to see that

explosions did not take place, there should be a Statecontrol and a State mark placed on disinfecting stoves. It

was as necessary that stoves should disinfect as that boilersshould not burst. This resolution, carried in the Section,was unanimously confirmed by the plenary meeting.Then a long resolution cn diphtheria was read and ultimatelyadopted. It proposed obligatory declaration, isolation, andcomplete disinfection of premises, of linen during the pro-gress of disease, and of the carriage used for the transport ofthe sick ; that children related to a sick child should be keptfrom school, and if the disease broke out in a school then allthe children should be placed under medical supervision ; and,finally, that bacteriological experiments should be made todiagnose the disease. A very lengthy resolution on cholera,submitted by Dr. Kuborn of Liege, was referred back as toocomplicated, and later a resolution approving the decisions ofthe Dresden International Sanitary Conference was carried.

Miss Florence Nightingale’s resolution, as carried in theSection of Tropical Diseases, was confirmed by acclamation."The Tropical Section of the Congress," it ran, "having hadunder consideration a paper by Miss Nightingale on VillageSanitation in India, are of opinion that the subject is a veryimportant one, affecting as it does the health and prosperityof so many millions of industrious and law-abiding people.They appreciate the efforts that have been made in the dif-ferent provinces by the Government of India to promote thiswork; and, looking to the special conditions of the village com-munities of India, they think that the best results will beobtained through the cooperation of the people themselvesif they are instructed in the primary rules of health. The

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662

most pressing needs appear to be a wholesome water-supplyand the removal of refuse and other insanitary matter fromthe neighbourhood of dwelling-houses."

In the Section of Industrial and Agricultural Hygiene Dr.Axmann’s resolution was : " Considering that 60 per cent. ofthe accidents happening in factories and workplaces arecaused by the use of alcoholic drinks, the attention of theGovernment ought to be called to this fact." Dr. Axmann

proposed that the price of drinks, such as beer, which areless harmful, should be lowered as far as possible, whilstthat of strong intoxicants should be raised high enough torender their consumption more difficult." Dr. Kraft pro-posed : ’’ That the Governments are requested to devotemore attention to the condition of the workmen engaged insmall industries." Both resolutions were confirmed by thegeneral assembly. -

In the Section of School Hygiene a resolution to the

following effect was put to the meeting :-- " Considering thatthe international comparison of infant mortality is renderedvery difficult, and sometimes absolutely impossible, in con-

sequence of the different statistical methods employed, theSection consider it desirable that at least the main data ofinfant mortality should be published by all the States in auniform manner. For this purpose the Section proposethat the Congress in plenary assembly nominate a com-mittee of six physicians for children and six demo-

graphists to prepare reports and resolutions for the next

Congress. As members of this committee they recom-mend the following medical men : Mr. H. Abbott, M.A.,F.R.C.S., of Leeds ; Professor Dr. A. Epstein of Prague ;Dr. Julius Eross, Lecturer, of Budapest ; Alfons Monteuscfoof Naples; and Dr. L. Pfeiffer of Weimar." The resolu- ’!

tion was carried, and also Professor Huppe’s resolutionsthat: "1. In order to promote scientific researches and theteaching of hygiene all high schools should be providedwith properly endowed professorships of hygiene, should

have sufficiently endowed institutes and laboratories, andthat hygiene should be an obligatory subject in examina-tions for medical degrees. 2. That for the propagation ofhygienic knowledge in all branches of instruction it is

necessary to create medical officers for schools, and thatthese medical officers should be required to give instructionin hygiene."

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Resolutions in favour of teaching hygiene in trainingcolleges, one advocating the State monopoly of alcohol,among others, were declared carried, though in the confusionand absence of translations it was at times not possible toascertain what they were about. The plenary sitting, at firstattended by only 120 persons, gradually dwindled away. The

facts that the resolutions could not be discussed and thatsome important meetings and excursions were taking placeelsewhere robbed this general assembly of much of its

importance. The whole question of plenary meetings andtheir duty towards the resolutions sent up to them by thevarious Sections will have to be carefully considered in thefuture. It seems preposterous that out of 2500 membersbarely more than 100 were present to confirm, approve,or reject the work of the Sections. Surgeon-General Billingsmade a vigorous protest against the wholesale adoption byan unrepresentative assembly of imperfectly understood

resolutions, and his action was generally approved.

M. Treille, Inspector-General in the French SanitaryServices and Chief Sanitary Adviser to the French ColonialMinister, announced to the Section of Bacteriology thatDr. Yersin, of the Sanitary Service, had been recently sent toHong-Kong to study the outbreak of bubonic plague there

and to make special research into its possible bacteriologicalcause. Dr. Yersin, said M. Treille, had succeeded in isolatinga bacillus which, upon cultivation, yielded abundant colonies;and he passed round among the members of the Sectionphotographs of the results of bacteriological work on thesubject undertaken at the laboratory of the Pasteur Institute.He claimed that this bacteriological work had confirmed theaccuracy of Dr. Yersin’s researches.

The committee appointed by the Congress of 1891 to frame-a report on 50, 000 children seen in schools as to their physical’and mental condition found that the methods employed inobservation and description of children now make it possible-to supply much new and valuable information bearing oneducation and the care of boys and girls. The scientific

principles, which rendered it possible to use physical signs.to indicate mental conditions, may also be employed forthe improvement of the theory and practice of education,especially in cases of those feebly gifted mentally. The:committee urged that such inquiries should be conducted inother countries than Great Britain, and they offer assistance-in organising such investigation.

Dr. Francis Warner gave a demonstration before the Con-

gress of his methods of observing the physical conditions.and the expression of nervous states in school children, whichattracted much attention. A number of school children beingpresent, Dr. Warner looked at each child in turn ; holding acoin before the child, he told him to look at it, and thusfixed the child’s head and prevented him from looking at the,observer. A full profile and full-face view of the child wasthus obtained. The points as to bodily condition observedwere: the head as to size, form, and proportions, the externalears and their parts, the eye openings, the nose, the mouthand jaw, and lastly the palate. As indications of nerve

irregularities in some children, in the forehead horizontalcreases caused by overaction of the frontal muscles andvertical creases caused by corrugator muscles are signs.common in imbeciles. Other children showed the orbiculari&oculi muscles to be relaxed, leading to fulness and swellingunder the eyes, indicating fatigue. The hands when heldout in front of the child were in some cases drooped at thewrist, with fingers bent, indicating weakness, or drooped atthe wrist, with all the digits over-extended at the metacarpo-phalangeal joints, indicating a nervous or choreic condition.When the hands were held out in front, in the weak childrenthe spine bent forwards in the lumbar region (lordosis), the-upper part being thrown back. In his remarks Dr. Warner

explained that the hands in the normal child are held on alevel with the shoulder, the arms being parallel, and all

parts of the hand being in the same plane. A pub)ished list,of 103 signs seen in this inquiry was presented to the-

Congress. -

The Hungarian members of the Congress manifested mucbinterest in the school inquiry and did Dr. Warner and Dr.Shuttleworth-whose paper upon the educational care offeeble-minded children will be found in this issue under theSection of the Hygiene of Schools-the honour of electingthem vice-presidents of the Section.

THE CLOSING OF THE CONGRESS.

(FROM A SPECIAL CORRESPONDENT.)Budapest, Sept. 9th.

THE proceedings of the International Congress of Hygieneand Demography were brought to a close this (Sunday)morning in the great hall of the Redoubt, where the openingceremony had taken place. There were, of course, not so

many delegates present, and the gorgeous gala uniformswere not so plentiful. Herr Charles HieronyBH, Minister