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ITALY.
1640 I are less known. schools in Ireland that it was positively cruel to expect faculties Lyons is the most important prochildren to go to, and he certainly thought they ought not tovincial centre and has at its mixed faculty 242 students. ’ be compelled to go. The Montpellier Faculty of Medicine has the greatest number of female medical students-namely, 98-of whom The Belfast Hospital for Diseases of the Nervo2cs System. 78 are foreigners, and Montpellier, moreover, has the largest At the annual meeting of the supporters of this institutionnumber of male foreign students-namely, 137-of whom 98 held in Belfast on May 19th it was reported that there wereare Russians and 13 are Bulgarians. French female medical 70 patients admitted during the past year and 523 externistudents go chiefly to Bordeaux, where there are 45 to only The total receipts were Z643 10s. ld. (of which sumi6 cases. foreign ; and to Lille, where there are 32 and only 2 318 6s. 8d. were contributed by patients themselves), while foreigners. Russians form by far the largest group of the total expenditure was E625 15s. 10d., and there is a foreign students, for besides the 98 at Montpellier there are balance in hand of £ 104 5s. 4d. The building debt has been 30 at Nancy. At Nancy, too, there are 25 Bulgarian reduced by R100. ,students in medicine. Deccth of Dr. Sccmzcel llTceazlcc, M.D. Q. U.I. Sick Soldiers and their Families. I On April 22nd Dr. Samuel Macaulay died at his residence, The Under-Secretary of State at the Ministry for War has Bloomfield, Belfast, in his fifty-third year. A native of recently ordered that in future military patients are to be co. Armagh, the son of the late Rev. James Macaulay,asked on entering hospital whether they wish one or more Drumhillery, Dr. Samuel Macaulay studied in Queen’s persons to be made acquainted with their illness, and for the College, Belfast, and graduated M.D., M.Ch. of the Queen’s exact address of such persons. In cases where the patient is University in 1881. He practised for a time in England, but unable to express any wish on this point news of his progress since his mother’s death two years ago has resided in Belfast. is to be sent regularly to his family through the municipal Dr. Macaulay was unmarried. authorities concerned.
E...4.. Kirkwood, L.R. P. y S. Edin., L,F.P.S. Glasg. Mr. Kirkwood, a well-known practitioner in the North End of Belfast, died at his residence, Crumlin-road, after a severe illness, on May 23rd. A son of a Belfast man, Mr. Kirkwood was a student of the medical school in that city, and after attending Queen’s College in 1897 obtained the L.R.C.P. & S. of Edinburgh. Mr. Kirkwood was honorary physician to the North Belfast Day Nurseries and medical examiner to the Amalgamated Society of Engineers. He was also a prominent member of the Masonic order. He leaves a widow, but no family.
DeatA
‘
of Mr.
June lst.
(FROM
OUR
PARIS. OWN CORRESPONDENT.)
Fight against Infectioqis Disease in ]i’rance, Sweden, and Norrvay. AT a meeting of the Academy of Medicine held on May 18th, M. Ferdinand Widal read, on behalf of M. Jules The
Courmont,
a
paper
on
the results obtained in Sweden and
Norway in the fight against infections disease. In Sweden the mortality has decreased from 17 ’ 7 per 1000 in 1881 to 14-3 per 1000 in 1906, and the infantile mortality from 112 .7 per 1000 in 1881 to 83 per 1000 in 1904. The population has increased from 4,572,245 in 1881 to 5,537,055 in 1906. The mean mortality in France is 20 per 1000 ; at the rate which obtains in Sweden, France would gain nearly 250,000 lives per annum. At Stockholm the mean mortality from typhoid fever is 0 - 02 per 1000 inhabitants, while in France it is; in towns of over 20,000 inhabitants, 0’24. In Norway, since the law of 1900, every obvious case of tuberculosis has been notified, and disinfection is always obligatory after death. The Pú3lation At read
recent a paper called in to a
of Peritonitis to Erysipelas. meeting of the Society of Surgery, M. Vallas on this subject. One day last year he was see a woman who showed signs of gastro-
intestinal trouble, which were, however, indefinite and did not appear to call for operation. She got slightly better, but then a relapse occurred, the temperature ran up, the abdominal pains reappeared in a more acute form than before, and meteorism became marked. On a laparotomy being performed nothing wrong was found with either the appendix or the cascum, but a loop of small intestine showed thinned patches covered with a greyish exudation. Recovery was uneventful, and the cause of the peritonitis remained a mystery until some days after the operation M. Vallas learned that the daughter of the patient had facial erysipelas. M. Vallas added that he had found two other cases in which peritonitis appeared to be attributable to a streptococcal infection. foreign Medical Stt(,dents in 1’race. Statistics as to foreign students of medicine in Paris have often been published, but those dealing with the provincial
June Ist. __
(FROM
OUR
ITALY. CORRESPONDENT.)
OWN
The Second National Congress on Professional .J[aladies. THE centre of hygienic interest was last week the Tuscan capital, where a National Congress, the second of the series, has been held in the Hall of the Duecento in the Palazzo Vecchio, on what is rather ambiguously styled "Malattie Professionali." By these maladies the reader is to understand the lesions, surgical and medical, incident not to the liberal callings but to the labourer and the artisan, the lesions, in fact, which have come under the purview of the great International Congress held during the present week in Rome. This premised, the above congress enlisted the support and presence of an influential body of the profession, mainly reinforced from Florence, its seat, and under the presidency of Dr. Gaetano Pieraccini, in medical pathology at the Florentine Istituto di Studi Superiori Pratici e di Perfezionamento."In a brilliant introductory address Dr. Pieraccini dwelt on the maladies to be considered and discussed by the Congress, demonstrating the increase both in number and intensity of these the lower we descend in the social scale-the tendency to contract them being greatest in the proletariat, as shown by the statistics not only of mortality but of one of their He was followed by the commonest sequelae, crime. veteran hygienic reformer, the Senator De Cristoforis of " Milan, who warmly seconded Dr. Pieraccini’s "augurio" the Government would in future show that greater energy and zeal in mitigating the hardships, physicial and social, of On its passing to the agenda of the the toiling masses. programme the Congress heard with due interest and attention a masterly paper by Dr. Eugenio Tanzi, professor of psychiatry at the Istituto,"on the Malattie Mentali di Lavoro " (mental disease as occasioned and conditioned by labour). An animated discussion followed, in which the medical schools of Milan, Naples, and Venice joined in amicable controversy with that of Florence, on whose part Professor Tanzi made an effective reply. Pellagra was another theme which evoked a conflict of views, Professor Devoto of Milan, who was the primary spokesman, eliciting approval, none the less cordial for being somewhat distasteful to national amour propre, by the contrast he drew between the Austrian modes operandi in combating the disease and that still practised in Italy. Fas est et ab hoste doaeri,. and a fortiori it is still more lawful to take a leaf from the book of an "ally I" Next in order and importance was Dr. Glibert’s elaborate paper on the "Defence against Professional [Industrial] Maladies "-a luminous exposition drawn mainly from Belgian experience, and made still more telling by a series of "projections"" taken from the Belgian Department of Labour. This was followed by a visit to the Arcispedale di Santa Maria Nuovo, where, guided by Professor Pieraccini, with the effective assistance of Dr. Giglioli, the congressisti were shown a number of typical cases of the maladies in question. Among the subsequent
privat-doeent
1641 papers special notice is due to that of Dr. Giglioli on the lesions occasioned by mercury, particularly in the mining districts-a paper followed by interesting, mainly confirmatory, comments, resulting in an"order of the day"to impress upon Government the urgent need of inspection, with a view to amelioration of the conditions under which the mines of Monte Amiata and Abbazia San Salvatore are worked. On similar lines two papers on Avvelenamento Cronico da Fosforo (Chronic Poisoning by Phosphorus) evoked fruitful discussion, Dr. Tria and Dr. Furno (their authors) leading up to another ordina del giorno,"urging, in the match-making industry, the replacement of the actively poisonous white phosphorus by the comparatively innocuous red phosphorus-an order of the day carried nemine conOther papers, hardly less interesting and tradicente. ably handled, were those on " Quininic Prophylaxis in Theory and in Practice" ; on the "Evils, Moral, Economico-political, and Hygienico-sanitary, of the Emigration from Southern Italy " ; and an exceptionally brilliant communication by Dr. Tito Gualdi of the hygienic department of the Roman School, entitled The Ten Years’ Conflict against Malaria." This latter, which attracted to the auditory not a few members of Parliament and notabilities, male and female, of the general public, was illustrated with projections which put in vivid relief the successes gained in that conflict by the combined forces of medicine and legislation. The " Atti" or official report of the Congress, I mayadd, will be read with profit far beyond the circle originally addressed-forming as they do an effective awcnt-cozcre2cr of the proceedings which have taken place on still more extensive lines at the International Congress in Rome. May 28th.
VIENNA. (FROM
OUR OWN
CORRESPONDENT.)
Remarkable Powers of Memory
Manifested in an Idiot. recent meeting of the Society for Psychiatry and Neurology Dr. Witzmann showed a man, aged 20 years, who possessed an extraordinary memory for certain of the data recorded in calendars. This individual, who, moreover, was an inmate of an asylum for idiots, could with the utmost readiness tell what day of the week it had been or would be on any given day of the month in any year during the long period from the year 1000 of the Christian era until the year 2000. Although he has devoted much attention to the case, Dr. Witzmann has not yet succeeded in finding out by what means the young man has acquired this faculty, at once so marvellous and so rare. He believed that the patient had found out for himself some kind of code by which he worked, for he was capable of answering a question as to a given date and the corresponding day of the week in an instant, but his arithmetic was faulty when he was made to set down the figures of a computation based on the ordinary tables appended to some of the calendars. The results stated by him off-hand were always correct ; for instance, some of the test questions put to him were as follows. Question : What was the day of the week on Oct. 3rd, 1907 ? Answer : Thursday. Question : What was the day of the week on June 14th, 1808 ? Answer : 1808 was a leap year ; June 14th was a Tuesday. Question : How long will,the carnival last in 1924 ? Answer : 58 days. (This was easily found from the calendars used in Roman Catholic countries.) The personal history of the patient showed no reason for his idiotic condition and the family history gave no assistance. He could read and write only tolerably well, was backward at arithmetic, and had no aptitude whatever for manual work ; he could, therefore, be employed only as an errand boy or in some similar capacity. It was a remarkable fact that his knowledge of the calendar did not extend beyond the year 2000. His powers stopped suddenly at this point, and yet by using tables and following the established rules the results desired could be obtained with equal facility whether the dates were earlier or later than the year 2000. An explanation was furnished by the fact that all calendars at present accessible to the man extended only to the year 2000. It would seem that he had learned by heart the date of Easter of each of the 1000 If, therefore, he has at his disyears from 1000 to 2000. posal something of the nature of the tables appended to the AT
a
read off, as it were,
the proper answers to the questions proIn addition to knowing the day of the week for each day of the month, he knew also the patron saint of each day Such persons have several times been of the month. observed by neurologists. Idiots have been found to possess a special faculty of storing in their brains and reproducing at will masses of figures, like railway time-tables, Budget statistics, and entries in bank-books. The after-history of most of these mentally affiicted "brain athletes," as they have been called, showed that they had a tendency to either complete amentia or complete paralysis. The patient under consideration was already at times experiencing hallucinations.
posed.
’
improved Conditions in the Army Medical Service. important new conditions have lately been introduced in the arrangements necessary to bring up the officers of the Army Medical Corps to the required number. The recent preparations that were made in expectation of war showed that in spite of universal compulsory service ’
Some
the number of medical officers available would be insufficient for the requirements of a modern army. The Minister of War has therefore announced that medical men not over 30 years of age will, on making application, receive a grant not exceeding £ 250, in repayment of the cost of their professional education, on condition that they undertake to enter the service and remain with the colours for at least six years. Medical students on binding themselves to the same conditions will receive a monthly grant of 5 guineas, and on taking their degree the remainder of the sum at once, till the E250 have been paid them ; they will also, when called upon for service, receive an extra .63 per month. They will have facilities for continuing their studies after graduation, for at least a year in clinics, at the expense of the Ministry of War. The applicants must satisfy the Board of Studies of the Ministry as to their bodily and mental fitness for military service. The openings thus offered to students are tolerably good, for within six years after obtaining the degree of M.D. they may attain the rank of regimental surgeon ; on the other hand, men who have served already their term with the army, on entering now are entitled to have this service considered in their promotion. The facilities for study are also good, as the Government keeps in every clinic a number of posts open for its surgeons, and if the surgeon retires after only ten years’ service, he becomes entitled to a pension of about .8100 a year.
Pellagra in A16stria. Pellagra has existed in the eastern part of the Austrian Empire for many years, and in 1905 a vigorous attempt was made by the Government to check the disease. When it was proved that pellagra was caused by eating damaged maize, good flour was distributed by public officials, and means were taken to inform the population how to avoid the danger. In various districts the Government established bakeries where bread could be obtained at a nominal cost, and a good result was obtained in diminishing both the prevalence and the severity of the disease. Successive bad harvests have, however, impoverished the people, and thereby to some extent neutralised the good work that has been done; while on the other hand, the more careful examination of hitherto unsuspected districts has also caused an increase In 1901 there were 251 in the number of cases reported. cases reported in the affected district (Bukowina), which has an area of about 5000 square miles with a population of over 1,500,000. In 1906 there were 1575 patients, in 1907 the number was 2387, and in 1908 it was 2952. The cases of pellagra in the hospitals are also more numerous than formerly. In 1901 only five patients were admitted, whereas last year there were 85. There were 34 districts in which the public authorities last year instituted preventive measures at a cost of .63500. In the result 76 per cent. of the patients were reported as improved, 22 per cent. were not improved, 1per cent. became worse, and 1 per cent. died. The treatment consisted, as mentioned before, in free distribution of maize, healthy food, administration of iron and quininefree of charge, and, if necessary, in surgical interference. This year a sum of .610,000 has been granted by the Government in order that the prophylactic and therapeutic measures directed against pellagra may be extended to all affected districts. j May 26th.
E...4.. Kirkwood, L.R. P. y S. Edin., L,F.P.S. Glasg. Mr. Kirkwood, a well-known practitioner in the North End of Belfast, died at his residence, Crumlin-road, after a severe illness, on May 23rd. A son of a Belfast man, Mr. Kirkwood was a student of the medical school in that city, and after attending Queen’s College in 1897 obtained the L.R.C.P. & S. of Edinburgh. Mr. Kirkwood was honorary physician to the North Belfast Day Nurseries and medical examiner to the Amalgamated Society of Engineers. He was also a prominent member of the Masonic order. He leaves a widow, but no family.
DeatA
‘
of Mr.
June lst.
(FROM
OUR
PARIS. OWN CORRESPONDENT.)
Fight against Infectioqis Disease in ]i’rance, Sweden, and Norrvay. AT a meeting of the Academy of Medicine held on May 18th, M. Ferdinand Widal read, on behalf of M. Jules The
Courmont,
a
paper
on
the results obtained in Sweden and
Norway in the fight against infections disease. In Sweden the mortality has decreased from 17 ’ 7 per 1000 in 1881 to 14-3 per 1000 in 1906, and the infantile mortality from 112 .7 per 1000 in 1881 to 83 per 1000 in 1904. The population has increased from 4,572,245 in 1881 to 5,537,055 in 1906. The mean mortality in France is 20 per 1000 ; at the rate which obtains in Sweden, France would gain nearly 250,000 lives per annum. At Stockholm the mean mortality from typhoid fever is 0 - 02 per 1000 inhabitants, while in France it is; in towns of over 20,000 inhabitants, 0’24. In Norway, since the law of 1900, every obvious case of tuberculosis has been notified, and disinfection is always obligatory after death. The Pú3lation At read
recent a paper called in to a
of Peritonitis to Erysipelas. meeting of the Society of Surgery, M. Vallas on this subject. One day last year he was see a woman who showed signs of gastro-
intestinal trouble, which were, however, indefinite and did not appear to call for operation. She got slightly better, but then a relapse occurred, the temperature ran up, the abdominal pains reappeared in a more acute form than before, and meteorism became marked. On a laparotomy being performed nothing wrong was found with either the appendix or the cascum, but a loop of small intestine showed thinned patches covered with a greyish exudation. Recovery was uneventful, and the cause of the peritonitis remained a mystery until some days after the operation M. Vallas learned that the daughter of the patient had facial erysipelas. M. Vallas added that he had found two other cases in which peritonitis appeared to be attributable to a streptococcal infection. foreign Medical Stt(,dents in 1’race. Statistics as to foreign students of medicine in Paris have often been published, but those dealing with the provincial
June Ist. __
(FROM
OUR
ITALY. CORRESPONDENT.)
OWN
The Second National Congress on Professional .J[aladies. THE centre of hygienic interest was last week the Tuscan capital, where a National Congress, the second of the series, has been held in the Hall of the Duecento in the Palazzo Vecchio, on what is rather ambiguously styled "Malattie Professionali." By these maladies the reader is to understand the lesions, surgical and medical, incident not to the liberal callings but to the labourer and the artisan, the lesions, in fact, which have come under the purview of the great International Congress held during the present week in Rome. This premised, the above congress enlisted the support and presence of an influential body of the profession, mainly reinforced from Florence, its seat, and under the presidency of Dr. Gaetano Pieraccini, in medical pathology at the Florentine Istituto di Studi Superiori Pratici e di Perfezionamento."In a brilliant introductory address Dr. Pieraccini dwelt on the maladies to be considered and discussed by the Congress, demonstrating the increase both in number and intensity of these the lower we descend in the social scale-the tendency to contract them being greatest in the proletariat, as shown by the statistics not only of mortality but of one of their He was followed by the commonest sequelae, crime. veteran hygienic reformer, the Senator De Cristoforis of " Milan, who warmly seconded Dr. Pieraccini’s "augurio" the Government would in future show that greater energy and zeal in mitigating the hardships, physicial and social, of On its passing to the agenda of the the toiling masses. programme the Congress heard with due interest and attention a masterly paper by Dr. Eugenio Tanzi, professor of psychiatry at the Istituto,"on the Malattie Mentali di Lavoro " (mental disease as occasioned and conditioned by labour). An animated discussion followed, in which the medical schools of Milan, Naples, and Venice joined in amicable controversy with that of Florence, on whose part Professor Tanzi made an effective reply. Pellagra was another theme which evoked a conflict of views, Professor Devoto of Milan, who was the primary spokesman, eliciting approval, none the less cordial for being somewhat distasteful to national amour propre, by the contrast he drew between the Austrian modes operandi in combating the disease and that still practised in Italy. Fas est et ab hoste doaeri,. and a fortiori it is still more lawful to take a leaf from the book of an "ally I" Next in order and importance was Dr. Glibert’s elaborate paper on the "Defence against Professional [Industrial] Maladies "-a luminous exposition drawn mainly from Belgian experience, and made still more telling by a series of "projections"" taken from the Belgian Department of Labour. This was followed by a visit to the Arcispedale di Santa Maria Nuovo, where, guided by Professor Pieraccini, with the effective assistance of Dr. Giglioli, the congressisti were shown a number of typical cases of the maladies in question. Among the subsequent
privat-doeent
1641 papers special notice is due to that of Dr. Giglioli on the lesions occasioned by mercury, particularly in the mining districts-a paper followed by interesting, mainly confirmatory, comments, resulting in an"order of the day"to impress upon Government the urgent need of inspection, with a view to amelioration of the conditions under which the mines of Monte Amiata and Abbazia San Salvatore are worked. On similar lines two papers on Avvelenamento Cronico da Fosforo (Chronic Poisoning by Phosphorus) evoked fruitful discussion, Dr. Tria and Dr. Furno (their authors) leading up to another ordina del giorno,"urging, in the match-making industry, the replacement of the actively poisonous white phosphorus by the comparatively innocuous red phosphorus-an order of the day carried nemine conOther papers, hardly less interesting and tradicente. ably handled, were those on " Quininic Prophylaxis in Theory and in Practice" ; on the "Evils, Moral, Economico-political, and Hygienico-sanitary, of the Emigration from Southern Italy " ; and an exceptionally brilliant communication by Dr. Tito Gualdi of the hygienic department of the Roman School, entitled The Ten Years’ Conflict against Malaria." This latter, which attracted to the auditory not a few members of Parliament and notabilities, male and female, of the general public, was illustrated with projections which put in vivid relief the successes gained in that conflict by the combined forces of medicine and legislation. The " Atti" or official report of the Congress, I mayadd, will be read with profit far beyond the circle originally addressed-forming as they do an effective awcnt-cozcre2cr of the proceedings which have taken place on still more extensive lines at the International Congress in Rome. May 28th.
VIENNA. (FROM
OUR OWN
CORRESPONDENT.)
Remarkable Powers of Memory
Manifested in an Idiot. recent meeting of the Society for Psychiatry and Neurology Dr. Witzmann showed a man, aged 20 years, who possessed an extraordinary memory for certain of the data recorded in calendars. This individual, who, moreover, was an inmate of an asylum for idiots, could with the utmost readiness tell what day of the week it had been or would be on any given day of the month in any year during the long period from the year 1000 of the Christian era until the year 2000. Although he has devoted much attention to the case, Dr. Witzmann has not yet succeeded in finding out by what means the young man has acquired this faculty, at once so marvellous and so rare. He believed that the patient had found out for himself some kind of code by which he worked, for he was capable of answering a question as to a given date and the corresponding day of the week in an instant, but his arithmetic was faulty when he was made to set down the figures of a computation based on the ordinary tables appended to some of the calendars. The results stated by him off-hand were always correct ; for instance, some of the test questions put to him were as follows. Question : What was the day of the week on Oct. 3rd, 1907 ? Answer : Thursday. Question : What was the day of the week on June 14th, 1808 ? Answer : 1808 was a leap year ; June 14th was a Tuesday. Question : How long will,the carnival last in 1924 ? Answer : 58 days. (This was easily found from the calendars used in Roman Catholic countries.) The personal history of the patient showed no reason for his idiotic condition and the family history gave no assistance. He could read and write only tolerably well, was backward at arithmetic, and had no aptitude whatever for manual work ; he could, therefore, be employed only as an errand boy or in some similar capacity. It was a remarkable fact that his knowledge of the calendar did not extend beyond the year 2000. His powers stopped suddenly at this point, and yet by using tables and following the established rules the results desired could be obtained with equal facility whether the dates were earlier or later than the year 2000. An explanation was furnished by the fact that all calendars at present accessible to the man extended only to the year 2000. It would seem that he had learned by heart the date of Easter of each of the 1000 If, therefore, he has at his disyears from 1000 to 2000. posal something of the nature of the tables appended to the AT
a
read off, as it were,
the proper answers to the questions proIn addition to knowing the day of the week for each day of the month, he knew also the patron saint of each day Such persons have several times been of the month. observed by neurologists. Idiots have been found to possess a special faculty of storing in their brains and reproducing at will masses of figures, like railway time-tables, Budget statistics, and entries in bank-books. The after-history of most of these mentally affiicted "brain athletes," as they have been called, showed that they had a tendency to either complete amentia or complete paralysis. The patient under consideration was already at times experiencing hallucinations.
posed.
’
improved Conditions in the Army Medical Service. important new conditions have lately been introduced in the arrangements necessary to bring up the officers of the Army Medical Corps to the required number. The recent preparations that were made in expectation of war showed that in spite of universal compulsory service ’
Some
the number of medical officers available would be insufficient for the requirements of a modern army. The Minister of War has therefore announced that medical men not over 30 years of age will, on making application, receive a grant not exceeding £ 250, in repayment of the cost of their professional education, on condition that they undertake to enter the service and remain with the colours for at least six years. Medical students on binding themselves to the same conditions will receive a monthly grant of 5 guineas, and on taking their degree the remainder of the sum at once, till the E250 have been paid them ; they will also, when called upon for service, receive an extra .63 per month. They will have facilities for continuing their studies after graduation, for at least a year in clinics, at the expense of the Ministry of War. The applicants must satisfy the Board of Studies of the Ministry as to their bodily and mental fitness for military service. The openings thus offered to students are tolerably good, for within six years after obtaining the degree of M.D. they may attain the rank of regimental surgeon ; on the other hand, men who have served already their term with the army, on entering now are entitled to have this service considered in their promotion. The facilities for study are also good, as the Government keeps in every clinic a number of posts open for its surgeons, and if the surgeon retires after only ten years’ service, he becomes entitled to a pension of about .8100 a year.
Pellagra in A16stria. Pellagra has existed in the eastern part of the Austrian Empire for many years, and in 1905 a vigorous attempt was made by the Government to check the disease. When it was proved that pellagra was caused by eating damaged maize, good flour was distributed by public officials, and means were taken to inform the population how to avoid the danger. In various districts the Government established bakeries where bread could be obtained at a nominal cost, and a good result was obtained in diminishing both the prevalence and the severity of the disease. Successive bad harvests have, however, impoverished the people, and thereby to some extent neutralised the good work that has been done; while on the other hand, the more careful examination of hitherto unsuspected districts has also caused an increase In 1901 there were 251 in the number of cases reported. cases reported in the affected district (Bukowina), which has an area of about 5000 square miles with a population of over 1,500,000. In 1906 there were 1575 patients, in 1907 the number was 2387, and in 1908 it was 2952. The cases of pellagra in the hospitals are also more numerous than formerly. In 1901 only five patients were admitted, whereas last year there were 85. There were 34 districts in which the public authorities last year instituted preventive measures at a cost of .63500. In the result 76 per cent. of the patients were reported as improved, 22 per cent. were not improved, 1per cent. became worse, and 1 per cent. died. The treatment consisted, as mentioned before, in free distribution of maize, healthy food, administration of iron and quininefree of charge, and, if necessary, in surgical interference. This year a sum of .610,000 has been granted by the Government in order that the prophylactic and therapeutic measures directed against pellagra may be extended to all affected districts. j May 26th.