BRITISH INSTITUTE OF PREVENTIVE MEDICINE.

46 to remind members that the agreement of Oct. 7th, 1896-" I hereby undertake after Jan. 1st, 1897, not to enter into any new club or contract >engagement for less than 4s, per year per member "-applies to juvenile as well as to adult members. Reports were made to the last meeting of the Council of flagrant instances in which patients of members bad been canvassed by agents ,of one of the medical aid associations, and it is suggested that the promises made a little more than a year ago have not been kept; but -the Council have not seen their way to advise any more active policy as regards the medical aid associations this year than last and for the ’same reason; active opposition cannot be successfully pursued until we have complete unanimity and present an unbroken front. A few months ago there was a conference in London between representatives of the British Medical Association and some of the friendly societies. It was very amicable and the representatives of the friendly societies seemed anxious to look at all sides of the question and to - consider a revision of scales. By quiet work it will gradually be made >plain that the club rates must be revised sooner or later. The question of hospital abuse has not been forgotten. There have been several meetings of the committee involving a great deal of work. A joint meeting with a committee of the monthly board of the General ’Hospital has been held. Work of this kind is very slow but it has been continuous. The treasurer reports that the funds of the union are in a satisfactory estate. -

THE A;CIE1T ORDER OF FORESTERS AT EVESHAM. Court No. 4648, Vale of Evesham of the above friendly society is in a parlous condition as regards medical aid. On June 7th a specially summoned meeting of the court was held to consider a proposal to reduce the salaries of the medical ,officers, Mr. A. H. Martin and Mr. J. S. Slater, who have held the appointment for the last twenty-five years, from .5s. per member per annum to 4s. The only notice given had been by means of the agenda paper which was dropped into ’, Mr. Martin’s letter-box about a week previously to the meeting. Under the rules of the society the surgeons only hold .ûffice " according to the pleasure of the court." Mr. Martin attended the meeting on June 7th and before the resolution was put explained that if it were carried he and his partner would immediately resign. It was ,carried and both medical officers at once sent in their resignations,which were accepted by the court, which thereupon carried a resolution that they should advertise for another medical officer at the rate of 4r. per member per .annum. All the other medical men residing in Evesham have been applied to but all refuse to have anything to do with the society at the reduced rates. The club is therefore now without any recognised medical man and the secretary has instructed any members who are ill to go to what medical man they like and then send in the bills to him. ’The committee of the court have refused to pay Mr. Martin and Mr. Slater the salary due to them on June 7th-i.e., one quarter’s salary-and these gentlemen have therefore issued a county-court summons to obtain their due. So matters stand at present and we congratulate the medical men of Evesham upon their firm stand. We will only add that if Mr. G. Carrick, the secretary of the court, likes to send us his official account of what has happened and what is going to happen we shall be happy to comment fully on, or possibly print, it. -

held as soon as possible and as often as desired 1>y members. The date of the next council meeting was fixed for

Thursday, July 14th. The headquarters of the society are at the West Ham Hospital, Stratford, E., and the hon. secretary is Mr. Murtaugh Houghton. The society is only in its youth, but there can be no doubt of the necessity for its existence, and the fact of thirty new members joining at the first statutory meeting is of good augury for its prosperity.

BRITISH INSTITUTE OF PREVENTIVE MEDICINE. THE annual general meeting of the British Institute of Preventive Medicine was held on June 24th at Chelsea, among those present being the Duke of Westminster, the Earl of Feversham, Lord Lister, Dr. Pye-Smith, Dr. Thomas Bridgwater, and others. The chairman submitted the annual report of the council, which was adopted. The report stated that during the year the work of the Institute has been marked by progression and expansion. The internal fittings of the new building are in an advanced state, some departments are already in full working order, and it is confidently anticipated that all will be fully equipped in the early autumn. The Institute has published during the year a volume of Transactions, which has been favourably received. The demand for diphtheria and serum has increased and there has also been an increased demand for mallein and tuberculin. The Institute has rentedd laboratory accommodation to the Local Government Board for the purpose of preparing glycerinated calf lymph. It was also stated that the Institute would require a considerable addition to its funds to enable it to carry out adequately the objects for which it was founded. The report of the hon. treasurer, Six Henry E. Roscoe, containing the balance-sheet and statement of accounts duly audited, was submitted to the meeting and adopted. The directors’ report and the reports of the scientific staff were also adopted and it was directed that these should be circulated amongst the members of the institute. Dr. Horace Brown, F.R.S.. was elected a member of council in place of the late Surgeon-General W. R. Cornish. The volume of published by Messrs. Macmillan and Co. on behalf of the Institute, contained nine original contributions by members of the staff. A review of this volume appeared in THE LANCET of Jan. 8th, 1898. p. 106. A number of fresh investigations have been conducted and completed during the year, some of which are published and others are on the eve of publication. There are also other investigations in progress and the laboratories continue to attract research workers. The courses of instruction given by the staff have also been well attended. About 2000 reports were sent out by the Institute during the year. The Institute has endeavoured to encourage the periodical examination of water and water-supplies and several local authorities have requested the Institute to undertake this systematic examination on their behalf. Bacteriological work has also been undertaken for several additional sanitaryy authorities. In the new building every facility is being provided for the furtherance of bacteriological research and the antitoxin department at Sudbury continues to do useful work in the field of serum therapeutics. At the close of the meeting the members inspected the fittings of the new laboratories which will be formally opened in the autumn.

streptococcic

Transactiuns,

EAST SUBURBAN MEDICAL PROTECTION AND MEDICOETHICAL SOCIETY, LIMITED, WEST HAM HOSPITAL, E. The first statutory meeting of the above society was held .at the West Ham Hospital on June 23rd, 1898. There was a, large and widely representative gathering of practitioners from the neighbouring districts, including some lady practitioners. Over thirty new members were elected at the meeting. The Executive Council was elected for the ensuing year. The President, Dr. F. J. Smith, delivered his address These were pracon the Aims and Objects of the Society. tically explained at the inaugural meeting of the society, a full report of which was published in THE LANCET of Feb. 12th, 1898, p. 459. The secretary, in answer to inquiries, explained that the scheme for the formation of local branches was under consideration ; it was certainly THE ROYAL EYE HOSPITAL, SOUTHWARK-A - desirable to have local representatives who should be elected The secretary also festival dinner of this institution was held at the Hotel as far as practicable by the local men. said that a scheme for keeping a black list had been Métropole on June 17th. The chairman said the hospital prepared for consideration by the council, that arrangements ministered to the needs of a population of nearly a million and had been made to commence the debt-collecting at an early three-quarters and last year had relieved 15,400 out-patienis date and that the views of individual members would be and over 400 in-patients, 30 per cent. of whom were under represented by the fact that the whole council was elected twenty years of age and about 16 per cent. under thirteen annually. years of age. A large number of the community were thus It was resolved that a general meeting should be held saved from blindness and a life of comparative inutility. In the course of the evening a record sum of £2170 was quarterly to receive report of work done by the council. It was stated that clinical and social meetings would be announced by the secretary as the result of the dinner.

47

METROPOLITAN HOSPITAL

SUNDAY FUND.

WE continue below our record of some of the principal - amounts received at the Mansion House. At the time of ,our going to press on Thursday the total amount received was

£32,000.

-

Public Health and Poor

Law.

LOCAL GOVERNMENT DEPARTMENT.

-

REPORTS OF INSPECTORS OF THE MEDICAL DEPARTMENT T OF THE LOCAL GOVERNMENT BOARD.

Ozv an o?itbreaz, of entirie fever iw the Urban District nf Camborne and in portions of the tzt7 ,joini2ig Rural Distr-,-’ctx of Redruth and Helston, hy Dr. R. BRUCE Low.1-A sudden outbreak of enteric fever appeared in December, 1897, at Camborne, in Cornwall, a town with some 14,000 inhabitants. Simultaneously excessive prevalence of enteric fever was manifest in two rural parishes which adjoin Camborne. Altogether 165 cases. 12 of which proved fatal, were notified from these places in the course of six weeks. No doubt, Dr. Bruce Low points out, a considerable number of other cases occurred which did not come to the knowledge of the sanitary authorities concerned. The facts which Dr. Low records leave no room for doubt that the cause of this epidemic was a specifically infected public water-supply. In Camborne and its neighbourhood there are, it is true, numerous insanitary dwellings and nuisances arising from accumulation of excrement and refuse abound in certain localities. But there had been no exceptional incidence of enteric fever upon the occupants of such unhealthy dwellings and localities. And, as Dr. Low shows, the outbreak by its suddenness differed totally. from what might have been expected had the epidemic been produced by excremental contamination of soil. The (luestion of infected milk could at once be set aside. But as regards water the case was otherwise. The Camborne Waterworks Company supplies with water the greater number of houses in Camborne and also a few small areas in the adjoining rural parishes of Illogan and Crowan. Dr. Bruce Low gives the following table showing the incidence of the disease upon houses supplied and upon houses not supplied by this public service :— ‘

supplied by Houses the Camborne ! Localities invaded by enteric fever during

December, 1897, an

January, 1898.

Company.

!

by the ’

i

.’ .

2

...

,

Camborne Urban

District...

2365

Illogan parish

.........

810

parish .........

158

Crowan

Houses not supCamborne Company.

plied

1064.5

i

26 ; 3’2 ! 7 4-4 i

762 1297

427

552

2 22

i ’ 0’7 ’

0’2

0.5

,

Total ............

I

3333

139

4-22486 ,

9

0.4

Persons attacked in the 9 dwellings not included in the area of public supply had in several instances consumed the Camborne Company’s water shortly antecedently to illness. Indeed, of the total of 165 cases there were practically only 2 attacks in which there was doubt as to the persons having had opportunities of drinking water from the incriminated supply. The conditions under which water was obtained1 by the Camborne Water Company can hardly be consideredd other than scandalous. Two grounds contribute to their supply. Water from the first at Cargenwyn is commonly used ill the summer months only. Itr had been cut off four weeks or more antecedent to the beginning of the epidemic and could not therefore be considered to have had to do with the causation of the outbreak. Incidentally, however, we note that part of this Cargenwyn supply was found by Dr. Low to consist of the natural drainage of fields, upon several of which human excrement was scattered. This is hardly to be wondered at when we learn that of 19 dwellings upon this gathering ground 13 had no privy or closet accommodation

gathering

1

London : Eyre and Spottiswoode, East Handing-street, E.C.; EdinJohn Menzies and Co. ; Dublin: Hodges, Figgis, and Co.

burgh :

1898. Price 7d.