DR. BACCELLI-THE NEW MINISTER OF PUBLIC INSTRUCTION IN ITALY.

THE ATTITUDE OF ENGLAND AS TO CHOLERA. of May, 1892, this country consented to sign the Venice Convention of the previous January. That Convention dealt essentially with the traffic from the Far East up the Red Sea, through the Suez Canal, and into the basin of the Mediterranean. The importance of an understanding as to this was vital to this country’s interests, especially in view of the necessarily constant intercourse between our home and our Indian ports. Some of these latter ports were nearly always "infected," according to European notions ; but we absolutely and firmly declined to allow healthy people to be subjected to quarantine in the miserable establishments-or mockeries of establishments-provided for that purpose in the Red Sea. This persistent attitude on the part of our delegates led to the breakdown of the Rome Conference of 1885 ; but in the end the purposes we have all along had in view have been attained, and the old-fashioned practice of deeming people so dangerous, that they must be locked up merely because they happen either to have come from an infected port, or to have travelled in a vessel which at some antecedent date, more or less remote, has been an infected vessel, is, so far as England is concerned, practically at an end. Vessels really infected will only be dealt with as such before entering the Suez Canal, and no one sailing under the British flag need ever be landed on the shores of the Red Sea so long as the medical officer of the vessel is prepared to say that he is not suffering from cholera. The second stage of the difficulty was happily overcome at Dresden. Here the delegates dealt with cholera in Europe, including the Mediterranean. Once again, whilst consenting willingly to all needed measures of disinfection and of dealing with the actual sick, and also whilst in no way interfering with the discretion of Continental Powers in controlling land or river traffic across their frontiers, the British delegates were firm in refusing the control of shipping which involved the detention of healthy persons in quarantine in our ports merely because such people were looked upon with suspicion. For certain classes of vessels a "period of observation" was decided on at Dresden as regards the healthy passengers arriving in infected or even suspected vessels. The British delegates willingly assented to the principle of "observation," but they refused to accept the Continental interpretation of it. Our Cholera Regulations require that persons landing from infected vessels shall give the addresses of the destinations to which they are travelling in order that the local inland authorities may, by keeping them under observation for a few days, learn at the earliest moment if they should sicken of cholera ; but other Governments intended to use the power conferred on them to confine these travellers in port quarantine establishments. Hence the reserve made at Dresden when assenting to the principle, and hence the formal reserve made in the Protocol to the Convention by our delegates with the authority of the British Government. Here, again, we see that England has for been many years firmly resolved not to accede to the pressure of foreign Governments in the matter of quarantine, and though we have had long to wait, we have only waited just so long as was necessary to bring the other contracting Powers into line with the position which England decided on finally about 1872, and to which she has firmly adhered without wavering ever since. But there remains a third stage which effects this country

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mainly in

connexion with her Eastern possessions. It is the control of pilgrims attending Mecca and Medina, in such way that those travelling under the auspices of the British Government can be held free from the suspicion of having conveyed cholera into a mass of humanity so circumstanced that the disease must of necessity spread and cause a havoc which probably has no parallel in any other part of the world. If the matter were thoroughly inquired into it that our Indian Government does than it receives credit for, and that much of the cholera which is, in ignorance, put down to arrivals by ship from Indian ports is really carried overland by the many thousands who travel in that way and who enter Arabia from the East. We should also learn how utterly futile and miserable are the arrangements made by the Turkish Govern-

would much

probably transpire

more

deal with any

ment to

disease ;

but

in order to

accidentally imported case of the promised a further international gathering where the difficulty as to this pilgrim traffic

we are

see

lies, what is the truth about it, and how far it may be remedied.

sense-will and whilst

England-using that term in the widest Imperial again be only too glad to lend a helping hand ; she will again refuse to sacrifice sound principles

public health, she will spare no reasonable trouble expense to prevent any importation of cholera by means pilgrims travelling from British or Indian ports to ports of

the Arabian shore of the Red Sea.

token of future

Our

success

hitherto is

or

of on

a

in

coping with so fatal a malady ; and at the moment we have only to congratulate ourselves on another step towards the prevention of cholera, which has success

been achieved in connexion with the Dresden Conference.

Annotations. as

DR.

Ne

quid nimin.11

BACCELLI-THE NEW MINISTER INSTRUCTION IN ITALY.

OF

PUBLIC

FROM the Parliamentary throes in which she has for the last few weeks been struggling Italy emerges with a new Cabinet, stronger and more viable than the most promising of its recent predecessors. It combines elements drawn from the Right, the Left, and the Centre, and will doubtless be supported by a sufficient following in all parts of the Chamber to ensure despatch and efficiency in its legislative and administrative work. By universal admission one of its most able members is the Professor of Clinical Medicine and President of the Accademia Medica in Rome-Dr. Guido Baccelli. His portfolio is that of Public Instruction, which he held in a previous Administration with much skill and tact. Short as it was, his tenure of office is still remembered for the salutary reforms effected in intermediate, and, above all, in professional education, for the impulse given to scientific research, and for the treasure-trove with which archseology enriched her museums. The recognised head of a calling whose watchword is "Upwards and onwards," Dr. Baccelli, in a recent address to his constituents, gave a clear and impres sive outline of the task of statesmanship in Italy. To the furtherance of this he is now, in the zenith of his powers and with the experience he has already acquired, called upon to contribute, and the many and much-demanded innovations expected of him are a measure of the confidence he inspires in the most enlightened of his compatriots. One undertaking, dear to every professional Italian, will certainly profit by his

’THE

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QUEEN OF ENGLAND TN FLORENCE.""

elevation to office-the speedy and satisfactory completion of the " Policlinico " whose claims have been so fruitlessly urged upon preceding Ministries. With the accelerated progress that noble " shrine of illinera Medica " may at length count on making, all doubt as to a fitting locale in which the Eleventh International Congress of Medicine and Surgery An additional can hold its sittings is at an end. guarantee for the success of the mighty gathering is indeed afforded by the fact that its president is also the new Minister of Public Instruction, whose goodwill and solicitude for the best interests of its members only required official opportunities and powers for translation into deeds. Thus the Congress, opened by the King and presided over by one of the wisest and most popular of his Ministers, has unusual and unexpected prospects of happy results, not the least of which will be the profitable account to which its lessons, practical and theoretical, will be turned by a President who has so deeply at heart the professional advancement of his country. -

"THE QUEEN OF ENGLAND IN FLORENCE." THE leading journals of Central Italy announce, from official information received in Florence, that Her Majesty Queen Victoria will certainly visit the Tuscan capital next This intention on the part of the Queen has, for some time, been known to our readers. "When at Windsor last summer," says the 1,-azione of the llth inst., "Prince Corsini took leave of Her Majesty, the Queen replied, ’A rivederci a Marzo’ ("till wa meet again in March "). "Various i,n.teraicnez2 of the Royal household," continues the Florentine journal, "have already in the course of the autumn been inspecting more than one of the villas in our environs, and indeed, we know that Colonel Biggs, who accompanied Her Majesty on the Queen’s last visit, is in treaty with the proprietor of the Villa Fabbricotti at Montughi for Her Majesty’s vernal villeggiatura." For the present the project of a ten days’ subsequent residence in the Royal villa at Capo di Monte, seems abandoned in favour of a short visit to King Humbert’s Lombard Castle at Monza. This modification of programme has much to recommend it-the advantages of the Neapolitan villeggiatura being more than balanced by those available at Mocxa, with its proximity to the North Italian lakes, and to the noble mediseval cities of the Lombardo- Venetian territory.

bacillus which was not present in the healthy intestine, but which, in his view, might have been concerned with the malady. Here again we are face to face with the exceedingly difficult problem as to whether there is any etiological relation between our English cholera and our autumnal fatal diarrhoea on the one hand and Asiatic or true cholera on the other hand. The point will never be cleared up at coroners’ inquests, and we trust that no attempt will be made to supersede skilled bacteriological investigation with recent materials, by a process of the heretofore clumsy methods involving delay which have been customary at some of our inquests. The investigator must be almost on the spot to secure such material as he needs, and if he has to wait the pleasure of public officers appealing to the Home Office or other bodies he may just as well drop his work altogether. On the other hand, there need be no difficulty in his receiving six to eight inches of the small intestine without in any way interfering with any such work as devolves upon a coroner and a jury, who are incapable of understanding the etiological points at issue ; and it seems to us a pity that, with such abundant material as was available in the case of the eleven bodies of those who died of the Greenwich disease, any cavilling about bacteriological and etiological research should have been heard. ___

spring.

THE NATURE OF THE RECENT EPIDEMIC AT GREENWICH. THE Greenwich epidemic is still involved in a good deal of obscurity. At the adjourned inquest which was held on the 12th inst. both Dr. Bulstrode of the Local Government Board and Dr. Klein, F.R S., were present as witnesses. Dr. Bulstrode announced the conclusion at which he had arrived as the result of the investigations-etiological, bacteriological, and chemical-which had been carried out ; and the terms in which he did so had evidently been carefully thought out. He stated that the disease, which had been fatal to old people in the workhouse, and which had also prevailed in some parts of the town of Greenwich, was an infectious form of diarrhoea which was shown bacteriologically not to have been Asiatic cholera, but which, having regard to its distribution in Greenwich and its seasonal incidence, was probably related to those forms of diarihoeal sickness that especially tend to prevail in seasons when cholera is prevalent in Europe. For the precise significance of this differentiation of the Greenwich diarrhoeal disease from true cholera we would refer our readers to our comments on " Cholera in England : its Bacteriological Interpretation," in our issue of Nov. 25th last. Dr. Klein, in giving evidence, decided that bacteriologically the disease was not Asiatic cholera; but in all the fatal cases which he had examined he had found a definite

THE

DIFFUSION OF SMALL-POX.

IN some of the towns where small-pox was most rife a diminution in the intensity of the prevalence is observable. Thus, the fresh attacks last week in Bradford were reduced to 30, and in Walsall to 37, the number of patients under treatment in the hospital at the latter place being also on the decline. On the other hand, the disease in Birmingham shows but little abatement. There were 63 fresh attacks last week, some 240 patients are in hospital, and the authority have decided to erect a permanent small-pox hospital in a very sparsely-peopled part of the borough, and to allot more than twenty acres to that purpose. In Bristol an increase is noted, the fresh attacks amounting to 25 ; and in other places the numbers were as follows : West Ham, 14; Wakefield, 12 ; Aston Manor, 9 Liverpool, 5 ; Bath, 3 ; Middlesbrough, 3 ; Handswortb, 2 ; and Leicester, 2. There were also small-pox occurrences in Batley, Bolton, Croydon, Wimbledon, Willesden, West Bromwich, Rowley Regia, Smethwick, Derby, Chadderton, Oldham, Huddersleld, Halifax, Dewsbury, Hnll. In the metropolis there were 20 Aberavon, Wilienhall &c. new cases last week, one epidemic area being Bow-commonlane ; and there were on the llth inst. 114 cases under treatment at Long Reach and the Gore convalescent establish. ments.

THE SOCIETY OF ANÆSTHETISTS. Ix another column we publish a report of the first meeting of this Society. So much importance has of late been attached to all matters connected with anaesthetics that there is no doubt a raison d’etre for such a society. While many surgeons and physicians have undertaken special work in connexion with the elucidation of both the physiology and practical bearings of ana3-ithesia, there has up to the present time been no society where such work could be sure of being intelligently criticised and discussed by those experienced in the subject. Now, however, if anesthetists fail to get their results duly ventilated it will be their own fault. THE LANCET has always been so impressed with the immense importance of careful and accurate study of ansesthesia that since 1848, when Mr. Wakley published his observations on chloroform in these columns, we have uniformly accorded to the subject the space its importance deserves, and have 1 A Record of One Hundred Experiments on Animals with Ether and Chloroform performed by Thomas Wakley, F.R.C.S., Surgeon to the Royal Free Hospital, THE LANCET, Jan, 1st, 1848.