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Current public health literature
CURRENT PUBLIC HEALTH which no allusion is made in the report, Dr. Chalmers is fully entitled to claim that the rate of decrease in these diseases is greater in districts which have a concurrent decrease in room density. The report of Dr. Niven, of Manchester, upon the cow-sheds of his city, is prefaced by a short resumg of the dangers to which cows, improperly kept, give rise and to the importance which this will have upon the prevalence of tubercular disease, especially in children, the bulk of whose food is milk. The greater liability of town-kept cows to contract tubercle is pointed out and the necessity for weeding out doubtfut cases urged. No one now doubts the infectivity of tuberculous milk, and there are but few who would voluntarily eat the flesh of a tuberculous beast, but the difficulty of clearing them out is very great. T h e sources of infection are clearly set out, and it is suggested that udders may become inoculated without there being any marked tubercular changes in the lung. The laboratory statistics of Dr. Sims Woodhead are quoted, showing the great preponderance of intestinal and mesenterie lesions in children dying of tubercle, and is in contrast to the figures of Dr. Chalmers above quoted. The main proposition which Dr. Niven lays down is that the infectivity of the milk depends rather upon the udder being infected than upon the extent of tuberculous lesions elsewhere, as shown by the results obtained in the laboratory of Prof. Del~pine, of Owen's College, and set out in the appendix to the report. The report also contains the replies of other towns to Dr. Niven's queries, and appendices showing the systematic and valuable work being done in Manchester in respect to the proper housing of milch cows. CURRENT PUBLIC HEALTH LITERATURE. PUBLIC BATHS. cCR.EPORTS ON PUBLIC BATHS AT NiSRNBERG, AT STUTTGART, by Guttstadt, AND AT ]~ERLIN by
Ad. Bajinsky," in Z-/.A'. vi. THE latter report is of importance~ as it contains an account of the symptoms of a form of blood poisoning, observed by Bajinsky in his own son, aged eight years, in two sons of Prof. Schleringer, and other schoolboys taking swimming lessons in two old and ill-arranged baths, public, though not under municipal control. Hot water and soap were provided for a preliminary ablution. In warm weather the water in the bath was foul and illsmelling and swarming with bacteria. It appeared that it was renewed only at long intervals. The symptoms began variously with nasopharyngeal catarrh, otitis, or conjunctivitisj followed by gastrointestinal irritation, emaciation, prostration, and cardiac disturbances. The pulse was slow, weak~
LITERATURE.
339
irregular and dicrotic, with tendency to syncope. There was febrile disturbance followed by subnormal temperature and threatened collapse. Bajinsky ascribes the symptoms to a septic poison first attacking the mucous surface exposed to the water, next the alimentary tract, through some of the water being swallowed, and lastly, and indirectly, the nerve centres. ~ RABIES AND HYDROPHOBIA IN PARIS IN
I894-5." C. •. Cons. Salnt. Seine ii., p. 279. In I894 one inhabitant of the Department of the Seine and five strangers under treatment at the Pasteur Institute died of hydrophobia. In i895 the numbers were one and three, the first not having undergone treatment. The number of persons bitten in 1894 was i,o54, including 975 by dogs, 15 by eats, 67 by horses, i by a zebra, and i by a monkey; while 435 dogs and 47 cats were killed in consequence of having been bitten by rabid animals. In 1895 there were reported I,z85 cases of persons bitten, i,~o8 by dogs, 3i by cats, 14o by horses, I by an ass, and i by a monkey. In I894- 5 there were 499 ascertained cases of rabies among animals. The number of persons bitten by them was 143, of whom 94 were in Paris and 49 in the extra-urban districts of the Department. ACTINOMYCOSIS ON THE BRAIN. Dr. Job, Thbse de .Lyozz, I896. Dr. Job, a pupil of Profi Poncet, describes a number of cases of this rare and always secondary form of actinomycosis which is sometimes circumscribed, resembling in appearance and symptoms a neoplasm, or tumour, of the brain, or far more rarely is diffused, when it simulates meningitis or encephalitis, being a widely-spread inflammatory lesion. SMALL-POX, "VACCINATION AND TUBERCULOSIS,
Revue de 3[[dicine. 2lzn. X VI_I. No. 4. AiOril, I897Dr. Lop, in an exhaustive report on the recent epidemic of small-pox at Marseilles, raises, among other questions that have been discussed ad nauseam, several of a novel character, and gives some observations worth noticing. Eleven women were attacked at various periods of pregnancy from the fourth month to full term. In all, the disease was severe, coherent, confluent, or h~emorrhagic. Four died without, and one after, aborting. Five recovered after delivery (two at the eighth month and three at full term), and one without interruption of pregnancy (this was that in the fourth month). Four infants were born alive and vaccinated within twenty-four hours and one on the sixth day. In only one was the operation successful, and it was attacked with small-pox on the fourth or fifth day, or that following the appearance of the vaccinal papules (bontons). It died on the eighth day. Two of those vaccinated un-
340
CURRENT PUBLIC HEALTH
successfully were revaccinated on the sixth and twentieth days respectively, but equally without result. In none of the three was there a trace of small-pox though they were kept under observation for a month. They were evidently immunised, while the first mentioned was infected in utero. ffalse VacdnaNon.--In twenty-four successful vaccinations, the vesicles and scabs were apparently normal, but the incubation was only from twentyfour to thirty-six hours. This phenomenon had been noticed by Cadet de Garrieourt, Trousseau, and Flervill (Bull de l'Acad. I893), and ascribed to an attenuation of the vaccine analogous to that of small-pox in "varioloid." In seventeen of the twenty-four, re-vaccination was attempted, at various intervals of from ten to fifteen days, but without success, though Dr. Lop doubts the permanence of the protection conferred by this "false" or attenuated vaccinia. H e observed one case of generalised vaccinal eruption, in a female infant of fourteen months suffering from impetigo, vesicles appearing amid the other eruption on the face, arms, and thighs, accompanied by severe febrile disturbance, convulsions, and alarming pulmonary congestion ; she also nearly lost two of her fingers from suppuration. Midwives and school teachers encouraged the popular prejudice against vaccination during the epidemic as likely to induce small-pox. Dr. Lop quotes largely from Landowzy, who at the Congress on Tuberculosis (see 2~ev. d'f-lygi~ne, t. x. No. 9, 1888) maintained that an attack of small-pox, whether discrete, coherent, or confluent, and in the vaccinated and unvaccinated alike, predisposed to tuberculosis. Of 300 patients of his-mostly in hospital, but some in private practice m more or less marked by previous attacks of smallpox, all but 3 % were tuberculous in some way. Among his private patients all such, except a general officer of fifty years, were between the ages of sixteen and thirty-nine. In many the tubercle had supervened within a short period of the variola, and several were members of families otherwise wholly free from a tuberculous history, they alone having suffered from small-pox. He considered that persons having recovered from small-pox should remove to the open country, and avoid all risks of exposure to tubercular infection. COMMUNICABILITY OF FOOT AND MOUTH DISEASE TO OTHER DOMESTIC ANIMALS.
IVochensc~ f Thierhei/k. N'o. 23, 1896. Albrecht failed in numerous attempts to infect a single horse, dog, cat, sheep, lamb, kid, or fowl, with the saliva of various severe cases of the disease in cattle, rubbing it in their mouths, etc., and was equally unsuccessful, except in a single lamb, in endeavours to inoculate with the saliva or the exudation from the scabs by rubbing them between the animal's toes. [Yet, long ago, Prof.
LITERATURE.
Johne, in Eulenburg's ttandbueh f 6ff Gesund. stated that by drinking the unboiled milk of affected cows the disease is easily communicated to man in the form of an eczematous eruption on the face, hands, and feet, with febrile disturbance and quasi --poeumonia.--Rep.] SPEEDY PRODUCTION OF DIPHTHERIA TOXIN.
W. H. Park and A. W. Williams. Jaurn. of 2~xi~. Med., VoL I., _A7o.i, Jan., 1896 , N.Y. Behring, Roux and Yersin required twenty days, Sprinck and Tourenhout thirteen, and Aronson eight days for the incubation of the toxin, but these investigators by their method have obtained in twenty-four hours a culture of which o'o25 c.cms, kill a guinea pig of 4o0 grms. in three anda-half days, and after four to seven days a dose of o'oo 5 killed one of 5oo grms. in ihree days. The reaction of the bouillon was of great importance. The best results were obtained with a bouillon, to Which, after neutralization, were added 7 c.cm. p. litr. of normal soda solution, though too great alkalinity was a disadvantage. Strong toxins were produced with I-iO p.o. of pepton, but 2-4 p.o. was the best proportion. When the stage ofalkalinity had set in the production gradually sank to nil. The presence of glucose tended to favour acidity and thus to check the formation of toxin. IMMUNISATION AGAINST DIPHTHERIA.
17. G. Morrill. Boslon Med. Surg. Jaurn., Vol. cxxxiv., p. 512. (H.R. ~ii. II). For four months all children admitted to Boston Children's Hospital underwent two preventive inoculations 24 hours apart, being quarantined meanwhile and transferred to the general ward only when examinations for B. Diphtheri~e gave negative results ; the inoculations being repeated every four weeks. If bacilli were detected, but no membrane, the child was isolated, and inoculated at once if more than ten days had elapsed since the last operation. Bacilli were found in 75 per cent. of the two hundred and ninety children admitted during the four months. One only developed clinical diphtheria, and in this case, the injection had been neglected for thirty-six days. Dr. Morrill considers that the induced immunity lasts for four weeks and then rapidly falls off. In one case, where bacilli were not found till the third examination, they persisted for three months. THE
COMPOSITION OF EXPIRED AIR AND ITS EFFECTS UPON A N I M A L LIFE.
J. S. Billings,S. Weir Mitchell and D. H. Bergey. Smilhsonfan Conlributians,Vol. xxix., No. 989 . (/-LR. vii., IX). After an enumeration and examination of all recent observations, the majority of which tend to discredit the theory of Brown-S6quard and D'Arsonville that expired air contains a toxic organic body or bodies, which, rather than the
CURRENT PUBLIC HEALTH LITERATURE. CO2 or the want of O, or the two conditions combined, are the cause of the depression and death resulting from the non-renewal of the air in a closed or overcrowded chamber, the writers give their own analysis of the expired air from the lungs of a healthy, a tracheotomised and a tuberculous man, the free ammonia and albumenoid ammonia being in each liter of the condensed vapour, o'o19, 0"00046, 0'003 and 0'08,, 0"00036 , 0"0034 grams and the oxygen required for the oxidation of the total organic matters lO' 7z, 9"68 and i9"34 rags. These varied in the healthy man from 3"86 rags., halt an hour after a meal to x i "98 four hours after, but if the mouth were well washed out, the latter amount was reduced to 2"49. Allattemptsat detecting organic alkaloids failed. Numerous experiments on animals seemed to point to no other cause than deficiency of oxygen and excess of CO 2. Death was hastened by low and delayed by high temperatures. The effects of gradually accustoming an animal to breath foul air as recorded by Brown S4quard were confirmed. ]V[EDICAL INSPECTION OF SCHOOLS.
Boston Meal. Surg. fourn, cxxxiv. 15. Dr. S. H. Durgin gives the result of a year's medical inspection of schools in 5o districts, each having on an average 4 schools with 14o scholars, and a medical inspector who visits each school daily, receiving an honorarium of 200 dollars (.£4o). Among r4,666 children 9,i88 were found suffering in some way or other, and 1,745 sent home. There were 7° eases of diphtheria, 26 of scarlatina, i i o of measles, of whooping cough 28, mumps 43, pediculosis 66, scabies 42, etc. Throat affections numbered 5,053 ; and while the school inspector reports all infectious cases to the Board of Health, he receives daily from the office a list of eases notified in the town, that he may satisfy himself as to possibility of isolation and the protection of children in the house.
Ztscri. f Scriulgesundheitspf ix. lZ. In France, this duty, which had in some form been recognised in Paris since I877, has within the the last few years been throughout the country committed to the poor law medical officer, though extending to public elementary schools only. Dr. Mangenct, himself a medical inspector of schools in Paris, sends an able report of the organisation and methods followed in the French capital to a German publication in recognition of the attention long given to the subject in that country. Dr, T. H. Homburger. Inauz. Tries. tfeidelburg, Ifarlsrurie 1895 , 8vo. N A T U R A L ILLUMINATION OF SCHOOLS.
PP. 55. An able discussion of the relative and absolute intensity of daylight in all seasons and circum-
34 r
stances, and the influence of the angle of incidence, ratio of window to floor space, and of every other optical and structural condition. PHYSICAL EDUCATION. Albert Hoffa. [Vurzburg, 1894. 8vo. 29 pp. A masterly yet popular exposition, remarkably condensed, of the influence of methods of instruction, mental and physical, on health, and the maintenance of a balance between them. He would allow 4 hours in winter and 5 in summer to lessons, and follow these by -~ hours passed in exercises, pre[erably in thc open air. SEPARATION 'OF O Z O N E FRO_~[ H Y D R O G E N PEROXIDE) AND EVII)ENCE OF OZONE IN THE
ATMOSPHERE. C. Engler and W. Wild.
Bet. d. deutsch, dzem. Gese[[. /~'d. xxix., No. *2. Chromic acid, whether in the solid form or in solution, decomposes even the most dilute peroxide ofhydrogen, while it has no action on ozone, and the amount of H 2 02 determined by titration of the iodine liberated from potassium iodide before and after exposing the air to the action of chromic acid is very constant in successive observations at the same time and place. But these authors find that the best test for ozone is the chloride ot manganese, which is not only extremely delicate as a test, but in consequence of its hygroscopic character it keeps the paper at the requisite moisture. Ozone turns such paper brown by the formation of manganese dioxide. Hydrogen-peroxide and nitrous acid have no such effect, but since ammonia and its carbonate turn these papers brown, the colour should be tested by moistening with tincture of guaiacum, when, if the paper have been acted on by ozone, a blue colour will be developed even before the brown has had time to appear. No blue is yielded by a browning due to ammonia. CHOLERA
13IMUNISATION.
A resum6 of all that is as yet known, and a bibliography well up-to-date, are given by Sovernhelm (1t. R. _No. 4, 5, 6, 7 alzd 9, 1897). Pfeiffer and Proskaner (C. tL .~akt, etc.,/bt. I. Bd. XIX., Nos. 6 and 7) find that the antitoxin of immunised animals, recognised by its solvent action on the vibrios, is combined with certain constituents of the serum, which is equally active whether fresh or dried. When dialysed the separated globulin and albumen acted feebly, but the residual liquid energetically, as it also did when the albumens were destroyed by pepsin and pancreatin, and the peptones removed by dialysis. The characteristic reaction of an enzyme, the blue colour with tinct. guiaci and peroxide of hydrogen, was obtained when all the globulin and most of the other albumens had been removed by dialysis. They compare its action to that of pepsin and trypsin, and its combination to that of the enzyme in yeast cells. See also on Cholera and Typhoid by Pfeiffer (l.c. Nos. 16 and 17).
342
A N A L Y T I C A L NOTES.
GENERALISED
INFECTION BY FRAENKELJS PNEUMOCOCCUS.
(C.B. 2. Bakt. Abt. i., Bd. xix,, No. 25. ) Schabad reports case of man, aged 45, dying in Obuchow Hospital, St. Petersburg, of general pneumococcosis--pneumonia of both lungs, abscesses in right hip and left knee joints, and purulent effusions with pneumococci in peritoneum, spleen, etc. ~ T H E INFLUENCE OF POLLUTED WELL V~tATERS IN
THE
EPIDEMIC
OF C H O L E R A
AT IV[ARSEILLES,
1894." (Dr. t 9. G. Lop, idem.) Surgeon-Major Dr. Martig continues (idem) his exhaustive inquiry into the physical developments of men in various occupations. c* DISINFECTION BY FORMOL. ~'
(Bosc and Bataill~. B u l l MJL z6 August, i896), and by Formaldehyde (Vaillard and Lemoine. Ann. _PasL x. 48I. SepL I896 ).
the flocculent precipitate not subside rapidly an additional o"5 c.c. of the alum solution is used, since a slight excess (up to x c.c.) does not affect the result. The precipitate (which in the case of cow's, goat's, pig's, and ass's milk is in mediumsized flakes, but in woman's milk in small flakes), is allowed to stand for some minutes, and then filtered. After having been well washed with water, the filter and its contents are extracted with ether in a Soxhlet apparatus, the nitrogen determined by Kjeldahl's methods, and the amount calculated into casein, r o the clear filtrate from the casein Io c.c. of tannin solution are added, the voluminous precipitate filtered off, washed three times with water, and the nitrogen it contains determined, and expressed as that of the soluble albuminoids (albumin and globulin). The separation of the casein in human milk may be accelerated by the addition of a little sodium chloride during the warming, and the filtration by the addition of a little calcium phosphate, which mechanically prevents the fine casein flakes from passing through the filter.
~$ DETERMINATION OF SULPHUR COMPOUNDS IN
C O A L GAS."
(Collan, Zeitsch.f Anal. Chem. xxxiv.)and (Dennstedt, and Ahrens, .H: R. V. 944). " EFFECTS ON H E A L T H OF I~AD[ANT I-~EAT FRO-~I TERRESTRIAL SOURCES OF LIGHT. ''
(M. Rubner Arch. f. Hyg. xxiii.) ~ ARTIFICIAL ILLUMINATION FROM THE HYGIENIC STANDPOINT."
(Schiitt. Vierteljal,rsch.fl Gerfcht. Med. xii. i62. /u/y, I896 ), ANALYTICAL NOTES. Rapid Metkod of Ana/ysi, zg Gzdaeol and Creosotes. L. Adrian.--This method is based on the colour reaction which nitrous acid gives with pure guiacol. From 5 to 6 grammes of the drug are shaken in a 2oo e.c. flask with water (exact quantity immaterial) for two minutes, and the liquid filtered. The filtrate is diluted with water, and to i c.c. are added 2 drops of a solution of sodium nitrite (io per cent.) and i drop of nitric acid. Pure guiacol gives an orange colour, whilst samples containing less than 5 ° per cent. give a distinct yellow colour. By preparing standard mixtures of pure guiacol and creosote, and comparing the colours given by these with that yielded by the sample, it is possible in a few minutes to judge of the approximate purity of the drug.
The Determination of Albumizoids iz Milk. ,4. Schlossmaan.--Ten c.c. of the milk are warmed to 4 °0 C., with 3 to 5 parts of water, and I c.c. of a concentrated solution of alum added. Should
Quick method for Detectin~ Margarine in Cheese. B. ftefeImann.--Twenty to fifty grammes of the cheese are either grated or rubbed down with little sand, according as it may be hard or soft, and placed in a test-tube with 20 to 25 e.e. hydrochloric acid of specific gravity i"i 9. The tube is then immersed in a bath of boiling water, and heated for about half-an-hour, with repeated shaking. The casein dissolves to a brown or violet-red fluid, while the butter-fat separates as a clear layer, floating upon the acid solution. A drop of the fat is then removed by means of a dropping-tube, and examined by the butter refractometer of Wollny. Should the proportion of fat be too small to separate in this way, the contents of the tube may be cooled to 3°0 C., and x5 c.c. of petroleum ether (boiling below 70? C.) added, the whole shaken, and the petroleum ether with the fat in solution transferred to a beaker and evaporated, and the residual fat examined by the refraetometer. On continued heating, the refraction of the lower fatty acids gradually increases, until in some cases it ultimately reaches the lowest observed value for margarine. Further, in certain cases the fat of poor cheeses may show refractometer numbers up to 2"5 above the doubtful point. Tke Determination of Aloin in Aloes. G. L. Schafer.--The method is based on the fact that aloin in ammoniacal solution forms compounds with the alkaline earths, which are but little soluble, and from which the aloin can 'be recovered on treatment with an acid. Fifty grammes of aloes are treated with 300 e.e. of boiling water containing a few drops of hydrochloric acid, and when cold the solution is separated from the resin. Fifty c.c. of
Ad. Bajinsky," in Z-/.A'. vi. THE latter report is of importance~ as it contains an account of the symptoms of a form of blood poisoning, observed by Bajinsky in his own son, aged eight years, in two sons of Prof. Schleringer, and other schoolboys taking swimming lessons in two old and ill-arranged baths, public, though not under municipal control. Hot water and soap were provided for a preliminary ablution. In warm weather the water in the bath was foul and illsmelling and swarming with bacteria. It appeared that it was renewed only at long intervals. The symptoms began variously with nasopharyngeal catarrh, otitis, or conjunctivitisj followed by gastrointestinal irritation, emaciation, prostration, and cardiac disturbances. The pulse was slow, weak~
LITERATURE.
339
irregular and dicrotic, with tendency to syncope. There was febrile disturbance followed by subnormal temperature and threatened collapse. Bajinsky ascribes the symptoms to a septic poison first attacking the mucous surface exposed to the water, next the alimentary tract, through some of the water being swallowed, and lastly, and indirectly, the nerve centres. ~ RABIES AND HYDROPHOBIA IN PARIS IN
I894-5." C. •. Cons. Salnt. Seine ii., p. 279. In I894 one inhabitant of the Department of the Seine and five strangers under treatment at the Pasteur Institute died of hydrophobia. In i895 the numbers were one and three, the first not having undergone treatment. The number of persons bitten in 1894 was i,o54, including 975 by dogs, 15 by eats, 67 by horses, i by a zebra, and i by a monkey; while 435 dogs and 47 cats were killed in consequence of having been bitten by rabid animals. In 1895 there were reported I,z85 cases of persons bitten, i,~o8 by dogs, 3i by cats, 14o by horses, I by an ass, and i by a monkey. In I894- 5 there were 499 ascertained cases of rabies among animals. The number of persons bitten by them was 143, of whom 94 were in Paris and 49 in the extra-urban districts of the Department. ACTINOMYCOSIS ON THE BRAIN. Dr. Job, Thbse de .Lyozz, I896. Dr. Job, a pupil of Profi Poncet, describes a number of cases of this rare and always secondary form of actinomycosis which is sometimes circumscribed, resembling in appearance and symptoms a neoplasm, or tumour, of the brain, or far more rarely is diffused, when it simulates meningitis or encephalitis, being a widely-spread inflammatory lesion. SMALL-POX, "VACCINATION AND TUBERCULOSIS,
Revue de 3[[dicine. 2lzn. X VI_I. No. 4. AiOril, I897Dr. Lop, in an exhaustive report on the recent epidemic of small-pox at Marseilles, raises, among other questions that have been discussed ad nauseam, several of a novel character, and gives some observations worth noticing. Eleven women were attacked at various periods of pregnancy from the fourth month to full term. In all, the disease was severe, coherent, confluent, or h~emorrhagic. Four died without, and one after, aborting. Five recovered after delivery (two at the eighth month and three at full term), and one without interruption of pregnancy (this was that in the fourth month). Four infants were born alive and vaccinated within twenty-four hours and one on the sixth day. In only one was the operation successful, and it was attacked with small-pox on the fourth or fifth day, or that following the appearance of the vaccinal papules (bontons). It died on the eighth day. Two of those vaccinated un-
340
CURRENT PUBLIC HEALTH
successfully were revaccinated on the sixth and twentieth days respectively, but equally without result. In none of the three was there a trace of small-pox though they were kept under observation for a month. They were evidently immunised, while the first mentioned was infected in utero. ffalse VacdnaNon.--In twenty-four successful vaccinations, the vesicles and scabs were apparently normal, but the incubation was only from twentyfour to thirty-six hours. This phenomenon had been noticed by Cadet de Garrieourt, Trousseau, and Flervill (Bull de l'Acad. I893), and ascribed to an attenuation of the vaccine analogous to that of small-pox in "varioloid." In seventeen of the twenty-four, re-vaccination was attempted, at various intervals of from ten to fifteen days, but without success, though Dr. Lop doubts the permanence of the protection conferred by this "false" or attenuated vaccinia. H e observed one case of generalised vaccinal eruption, in a female infant of fourteen months suffering from impetigo, vesicles appearing amid the other eruption on the face, arms, and thighs, accompanied by severe febrile disturbance, convulsions, and alarming pulmonary congestion ; she also nearly lost two of her fingers from suppuration. Midwives and school teachers encouraged the popular prejudice against vaccination during the epidemic as likely to induce small-pox. Dr. Lop quotes largely from Landowzy, who at the Congress on Tuberculosis (see 2~ev. d'f-lygi~ne, t. x. No. 9, 1888) maintained that an attack of small-pox, whether discrete, coherent, or confluent, and in the vaccinated and unvaccinated alike, predisposed to tuberculosis. Of 300 patients of his-mostly in hospital, but some in private practice m more or less marked by previous attacks of smallpox, all but 3 % were tuberculous in some way. Among his private patients all such, except a general officer of fifty years, were between the ages of sixteen and thirty-nine. In many the tubercle had supervened within a short period of the variola, and several were members of families otherwise wholly free from a tuberculous history, they alone having suffered from small-pox. He considered that persons having recovered from small-pox should remove to the open country, and avoid all risks of exposure to tubercular infection. COMMUNICABILITY OF FOOT AND MOUTH DISEASE TO OTHER DOMESTIC ANIMALS.
IVochensc~ f Thierhei/k. N'o. 23, 1896. Albrecht failed in numerous attempts to infect a single horse, dog, cat, sheep, lamb, kid, or fowl, with the saliva of various severe cases of the disease in cattle, rubbing it in their mouths, etc., and was equally unsuccessful, except in a single lamb, in endeavours to inoculate with the saliva or the exudation from the scabs by rubbing them between the animal's toes. [Yet, long ago, Prof.
LITERATURE.
Johne, in Eulenburg's ttandbueh f 6ff Gesund. stated that by drinking the unboiled milk of affected cows the disease is easily communicated to man in the form of an eczematous eruption on the face, hands, and feet, with febrile disturbance and quasi --poeumonia.--Rep.] SPEEDY PRODUCTION OF DIPHTHERIA TOXIN.
W. H. Park and A. W. Williams. Jaurn. of 2~xi~. Med., VoL I., _A7o.i, Jan., 1896 , N.Y. Behring, Roux and Yersin required twenty days, Sprinck and Tourenhout thirteen, and Aronson eight days for the incubation of the toxin, but these investigators by their method have obtained in twenty-four hours a culture of which o'o25 c.cms, kill a guinea pig of 4o0 grms. in three anda-half days, and after four to seven days a dose of o'oo 5 killed one of 5oo grms. in ihree days. The reaction of the bouillon was of great importance. The best results were obtained with a bouillon, to Which, after neutralization, were added 7 c.cm. p. litr. of normal soda solution, though too great alkalinity was a disadvantage. Strong toxins were produced with I-iO p.o. of pepton, but 2-4 p.o. was the best proportion. When the stage ofalkalinity had set in the production gradually sank to nil. The presence of glucose tended to favour acidity and thus to check the formation of toxin. IMMUNISATION AGAINST DIPHTHERIA.
17. G. Morrill. Boslon Med. Surg. Jaurn., Vol. cxxxiv., p. 512. (H.R. ~ii. II). For four months all children admitted to Boston Children's Hospital underwent two preventive inoculations 24 hours apart, being quarantined meanwhile and transferred to the general ward only when examinations for B. Diphtheri~e gave negative results ; the inoculations being repeated every four weeks. If bacilli were detected, but no membrane, the child was isolated, and inoculated at once if more than ten days had elapsed since the last operation. Bacilli were found in 75 per cent. of the two hundred and ninety children admitted during the four months. One only developed clinical diphtheria, and in this case, the injection had been neglected for thirty-six days. Dr. Morrill considers that the induced immunity lasts for four weeks and then rapidly falls off. In one case, where bacilli were not found till the third examination, they persisted for three months. THE
COMPOSITION OF EXPIRED AIR AND ITS EFFECTS UPON A N I M A L LIFE.
J. S. Billings,S. Weir Mitchell and D. H. Bergey. Smilhsonfan Conlributians,Vol. xxix., No. 989 . (/-LR. vii., IX). After an enumeration and examination of all recent observations, the majority of which tend to discredit the theory of Brown-S6quard and D'Arsonville that expired air contains a toxic organic body or bodies, which, rather than the
CURRENT PUBLIC HEALTH LITERATURE. CO2 or the want of O, or the two conditions combined, are the cause of the depression and death resulting from the non-renewal of the air in a closed or overcrowded chamber, the writers give their own analysis of the expired air from the lungs of a healthy, a tracheotomised and a tuberculous man, the free ammonia and albumenoid ammonia being in each liter of the condensed vapour, o'o19, 0"00046, 0'003 and 0'08,, 0"00036 , 0"0034 grams and the oxygen required for the oxidation of the total organic matters lO' 7z, 9"68 and i9"34 rags. These varied in the healthy man from 3"86 rags., halt an hour after a meal to x i "98 four hours after, but if the mouth were well washed out, the latter amount was reduced to 2"49. Allattemptsat detecting organic alkaloids failed. Numerous experiments on animals seemed to point to no other cause than deficiency of oxygen and excess of CO 2. Death was hastened by low and delayed by high temperatures. The effects of gradually accustoming an animal to breath foul air as recorded by Brown S4quard were confirmed. ]V[EDICAL INSPECTION OF SCHOOLS.
Boston Meal. Surg. fourn, cxxxiv. 15. Dr. S. H. Durgin gives the result of a year's medical inspection of schools in 5o districts, each having on an average 4 schools with 14o scholars, and a medical inspector who visits each school daily, receiving an honorarium of 200 dollars (.£4o). Among r4,666 children 9,i88 were found suffering in some way or other, and 1,745 sent home. There were 7° eases of diphtheria, 26 of scarlatina, i i o of measles, of whooping cough 28, mumps 43, pediculosis 66, scabies 42, etc. Throat affections numbered 5,053 ; and while the school inspector reports all infectious cases to the Board of Health, he receives daily from the office a list of eases notified in the town, that he may satisfy himself as to possibility of isolation and the protection of children in the house.
Ztscri. f Scriulgesundheitspf ix. lZ. In France, this duty, which had in some form been recognised in Paris since I877, has within the the last few years been throughout the country committed to the poor law medical officer, though extending to public elementary schools only. Dr. Mangenct, himself a medical inspector of schools in Paris, sends an able report of the organisation and methods followed in the French capital to a German publication in recognition of the attention long given to the subject in that country. Dr, T. H. Homburger. Inauz. Tries. tfeidelburg, Ifarlsrurie 1895 , 8vo. N A T U R A L ILLUMINATION OF SCHOOLS.
PP. 55. An able discussion of the relative and absolute intensity of daylight in all seasons and circum-
34 r
stances, and the influence of the angle of incidence, ratio of window to floor space, and of every other optical and structural condition. PHYSICAL EDUCATION. Albert Hoffa. [Vurzburg, 1894. 8vo. 29 pp. A masterly yet popular exposition, remarkably condensed, of the influence of methods of instruction, mental and physical, on health, and the maintenance of a balance between them. He would allow 4 hours in winter and 5 in summer to lessons, and follow these by -~ hours passed in exercises, pre[erably in thc open air. SEPARATION 'OF O Z O N E FRO_~[ H Y D R O G E N PEROXIDE) AND EVII)ENCE OF OZONE IN THE
ATMOSPHERE. C. Engler and W. Wild.
Bet. d. deutsch, dzem. Gese[[. /~'d. xxix., No. *2. Chromic acid, whether in the solid form or in solution, decomposes even the most dilute peroxide ofhydrogen, while it has no action on ozone, and the amount of H 2 02 determined by titration of the iodine liberated from potassium iodide before and after exposing the air to the action of chromic acid is very constant in successive observations at the same time and place. But these authors find that the best test for ozone is the chloride ot manganese, which is not only extremely delicate as a test, but in consequence of its hygroscopic character it keeps the paper at the requisite moisture. Ozone turns such paper brown by the formation of manganese dioxide. Hydrogen-peroxide and nitrous acid have no such effect, but since ammonia and its carbonate turn these papers brown, the colour should be tested by moistening with tincture of guaiacum, when, if the paper have been acted on by ozone, a blue colour will be developed even before the brown has had time to appear. No blue is yielded by a browning due to ammonia. CHOLERA
13IMUNISATION.
A resum6 of all that is as yet known, and a bibliography well up-to-date, are given by Sovernhelm (1t. R. _No. 4, 5, 6, 7 alzd 9, 1897). Pfeiffer and Proskaner (C. tL .~akt, etc.,/bt. I. Bd. XIX., Nos. 6 and 7) find that the antitoxin of immunised animals, recognised by its solvent action on the vibrios, is combined with certain constituents of the serum, which is equally active whether fresh or dried. When dialysed the separated globulin and albumen acted feebly, but the residual liquid energetically, as it also did when the albumens were destroyed by pepsin and pancreatin, and the peptones removed by dialysis. The characteristic reaction of an enzyme, the blue colour with tinct. guiaci and peroxide of hydrogen, was obtained when all the globulin and most of the other albumens had been removed by dialysis. They compare its action to that of pepsin and trypsin, and its combination to that of the enzyme in yeast cells. See also on Cholera and Typhoid by Pfeiffer (l.c. Nos. 16 and 17).
342
A N A L Y T I C A L NOTES.
GENERALISED
INFECTION BY FRAENKELJS PNEUMOCOCCUS.
(C.B. 2. Bakt. Abt. i., Bd. xix,, No. 25. ) Schabad reports case of man, aged 45, dying in Obuchow Hospital, St. Petersburg, of general pneumococcosis--pneumonia of both lungs, abscesses in right hip and left knee joints, and purulent effusions with pneumococci in peritoneum, spleen, etc. ~ T H E INFLUENCE OF POLLUTED WELL V~tATERS IN
THE
EPIDEMIC
OF C H O L E R A
AT IV[ARSEILLES,
1894." (Dr. t 9. G. Lop, idem.) Surgeon-Major Dr. Martig continues (idem) his exhaustive inquiry into the physical developments of men in various occupations. c* DISINFECTION BY FORMOL. ~'
(Bosc and Bataill~. B u l l MJL z6 August, i896), and by Formaldehyde (Vaillard and Lemoine. Ann. _PasL x. 48I. SepL I896 ).
the flocculent precipitate not subside rapidly an additional o"5 c.c. of the alum solution is used, since a slight excess (up to x c.c.) does not affect the result. The precipitate (which in the case of cow's, goat's, pig's, and ass's milk is in mediumsized flakes, but in woman's milk in small flakes), is allowed to stand for some minutes, and then filtered. After having been well washed with water, the filter and its contents are extracted with ether in a Soxhlet apparatus, the nitrogen determined by Kjeldahl's methods, and the amount calculated into casein, r o the clear filtrate from the casein Io c.c. of tannin solution are added, the voluminous precipitate filtered off, washed three times with water, and the nitrogen it contains determined, and expressed as that of the soluble albuminoids (albumin and globulin). The separation of the casein in human milk may be accelerated by the addition of a little sodium chloride during the warming, and the filtration by the addition of a little calcium phosphate, which mechanically prevents the fine casein flakes from passing through the filter.
~$ DETERMINATION OF SULPHUR COMPOUNDS IN
C O A L GAS."
(Collan, Zeitsch.f Anal. Chem. xxxiv.)and (Dennstedt, and Ahrens, .H: R. V. 944). " EFFECTS ON H E A L T H OF I~AD[ANT I-~EAT FRO-~I TERRESTRIAL SOURCES OF LIGHT. ''
(M. Rubner Arch. f. Hyg. xxiii.) ~ ARTIFICIAL ILLUMINATION FROM THE HYGIENIC STANDPOINT."
(Schiitt. Vierteljal,rsch.fl Gerfcht. Med. xii. i62. /u/y, I896 ), ANALYTICAL NOTES. Rapid Metkod of Ana/ysi, zg Gzdaeol and Creosotes. L. Adrian.--This method is based on the colour reaction which nitrous acid gives with pure guiacol. From 5 to 6 grammes of the drug are shaken in a 2oo e.c. flask with water (exact quantity immaterial) for two minutes, and the liquid filtered. The filtrate is diluted with water, and to i c.c. are added 2 drops of a solution of sodium nitrite (io per cent.) and i drop of nitric acid. Pure guiacol gives an orange colour, whilst samples containing less than 5 ° per cent. give a distinct yellow colour. By preparing standard mixtures of pure guiacol and creosote, and comparing the colours given by these with that yielded by the sample, it is possible in a few minutes to judge of the approximate purity of the drug.
The Determination of Albumizoids iz Milk. ,4. Schlossmaan.--Ten c.c. of the milk are warmed to 4 °0 C., with 3 to 5 parts of water, and I c.c. of a concentrated solution of alum added. Should
Quick method for Detectin~ Margarine in Cheese. B. ftefeImann.--Twenty to fifty grammes of the cheese are either grated or rubbed down with little sand, according as it may be hard or soft, and placed in a test-tube with 20 to 25 e.e. hydrochloric acid of specific gravity i"i 9. The tube is then immersed in a bath of boiling water, and heated for about half-an-hour, with repeated shaking. The casein dissolves to a brown or violet-red fluid, while the butter-fat separates as a clear layer, floating upon the acid solution. A drop of the fat is then removed by means of a dropping-tube, and examined by the butter refractometer of Wollny. Should the proportion of fat be too small to separate in this way, the contents of the tube may be cooled to 3°0 C., and x5 c.c. of petroleum ether (boiling below 70? C.) added, the whole shaken, and the petroleum ether with the fat in solution transferred to a beaker and evaporated, and the residual fat examined by the refraetometer. On continued heating, the refraction of the lower fatty acids gradually increases, until in some cases it ultimately reaches the lowest observed value for margarine. Further, in certain cases the fat of poor cheeses may show refractometer numbers up to 2"5 above the doubtful point. Tke Determination of Aloin in Aloes. G. L. Schafer.--The method is based on the fact that aloin in ammoniacal solution forms compounds with the alkaline earths, which are but little soluble, and from which the aloin can 'be recovered on treatment with an acid. Fifty grammes of aloes are treated with 300 e.e. of boiling water containing a few drops of hydrochloric acid, and when cold the solution is separated from the resin. Fifty c.c. of