EGYPT.

1160 that purpose by the President of that body. The pro-age Men intrustea witn one or tne most important; cnairs ot The newspapers, moreover, - gramme issued by the committee of organisation includes aclinical medicine in Germany. reception on the evening of Oct. 22nd. The meeting willassert that for nearly 100 years no Austrian has been formally open on the morning of the 23rd, when an addressappointed an ordinary professor in the medical faculty of of welcome will be delivered and a report on the work ofBerlin. The nomination of a German to a chair in Austria the international organisation will be read by the generalis, of course, more frequent ; for instance, Professor ,secretary. Addresses will then be delivered by ProfessorNothnagel, the late Professor Billroth, and the late Professor On behalf of Bruoke, all of Vienna, were called there from German Frankel and Professor Pannwitz of Berlin. It is true that since Professor Nothnagel’s the individual national committees the following gentle- universities. men will speak -Professor Brouardel of Paris, Professorappointment 20 years ago no other German has become von Schrotter of Vienna, Dr. G. A. Heron of London, Pro-an ordinary professor in Vienna and also that at the other fessor Scherwinsky of Moscow, Dr. Linroth of Stockholm, universities of Austria the number of Germans holding Dr. Cozzolino of Naples, Dr. Dewez of Brussels, Dr. Schmid ordinary professorships is relatively small ; as far as I of Berne, Dr. von Lancastre of Lisbon, and Dr. Kaurin of know, Professor Saenger, formerly at Leipsic and since last Molde. Papers will then be read by Dr. Blumenthal of year at Prague, is the only German who has obtained a Moscow, Dr. Obertuschen of Wiesbaden, and Dr. Sersion of professorship in Austria during recent years, for Professor Paris, on methods of rendering the campaign against tuber- Escherich of Graz, Professor Hueppe, and Professor Gad, culosis more popular. At the afternoon meeting the notifi- who are all Germans, have filled their chairs for a comcation of tuberculosis, the question of dispensaries, the paratively long time. As to the German universities other sanitation of workshops, and the disinfection of tuber- than that of Berlin there are only the celebrated surgeons On the 24th Professor von Mikulicz of Breslau and Professor Czerny of culous discharges are to be discussed. the sanatoriums of Berlin and its neighbourhood will Heidelberg who have come from Austria, whilst Professor be visited by the members. On the 25th the forenoon von Eiselsberg, lately at Konigsberg, has returned recently meeting will be devoted to the question of sanatoriums. to Vienna, his native town, to succeed the’late Professor At the afternoon meeting the difference between human Albert. By the appointment of Professor Kraus the and animal tuberculosis and other questions are to be dis- unity of German and Austrian science so emphatically At the final gathering on Sunday, the 26th, only proclaimed at the meeting of the German Association of cussed. matters of organisation are on the order of the day, together Naturalists and Medical Men has proved to be more than with elections to the offices of the international committee a mere after-dinner sentiment. In some circles, however, and some financial questions. The members will certainly there is a feeling of annoyance at the appointment of an have no reason to complain of a paucity of subjects for dis- Austrian to a Berlin professorship and those who would like cussion, the programme being, if anything, rather ample for to re-establish a system of protection against foreign coma two days’ meeting. petition ask whether Germany is in reality so ill-supplied with competent clinical teachers that it is necessary to bring Decisions of the Appeal Court of Honour. one from abroad when a vacancy occurs. The decisions of the appeal courtof honour for Prussia have just been published by the government medical departA German-Russian Medical Jonrnal. ment. This court being the supreme authority in matters It may be of interest to English readers who understand concerning medical etiquette its decisions are in some the German language without having any knowledge of degree equivalent to the provisions f, rmulated in a code of Russian to know that two Russian medical men residing ethics. The appeal court consists of the director of the in Berlin are issuing a monthly journal, called the Bussisr,7ie government medical department as chairman, four members Medicinische Rundschau (Russian Medical Review). The -of the medical chambers, and two medical men appointed new periodical will confine itself exclusively to German by the Crown. Its proceedings are strictly secret ; the translations of important articles published in the Russian system is f-o different from that followed by the British medical journals, its object being to make the work of General Medical Council that not even the decision is Russian medical men more accessible to foreign readers than announced in open court and the names of the inculpated heretofore. The first number contains an article by Dr. individuals are not mentioned in the report which is now Diwawin, of the Moscow Surgical Clinic, (In Operations for issued for the first time since the establishment of the court. Graves’s Disease and reports of Russian medical congresses Some of the decisions are somewhat peculiar and seem to and societies. prove that the members of the court are not thoroughly Oct. 20th. aware of the struggle for existence with which some of the members of the profession are so painfully familiar. For instance, a medical man has been found guilty becau;e EGYPT. he had agitated for the introduction of the free-choice OWN CORRESPONDENT.) (FROM OUR system in a sick club in which another medical man held an fixed with a The observes salary. appointment press rightly Decline of Cholera. that, irrespectively of this particular medical man, the accre- dited representatives of a great combination of the medical As anticipated, the cholera epidemic of this year is rapidly profession agitate openly all the year round in favour of this coming to an end. The daily bulletins from all Egypt are system and that they are all of them liable to be punished now slightly over 100 new cases and once last week fell to dn the same way as the unfortunate individual on whom the a figure below 100. This is a great improvement if it be blow has now fallen. Obviously the free-choice system remembered that early in September there were as many as -cannot be introduced into the working of a sick club without 1600 cases reported daily. Cairo is ,till quite free from the prejudicing the interests of the medical officers who already disease and there is a decided improvement in the reports hold appointments in connexion with it-a fact which was from all the country districts. Precautions, however, are found specially blamable by the court in the above case. not being in any way relaxed and in addition to a large staff of English and native medical men the students of the Professor Gerhardt’s Successor. medical school of the two final years are nearly all still in Professor Friedrich Kraus of Graz in Austria has been the provinces acting as paid sanitary officials. to succeed the late Professor Gerhardt as professor appointed t of clinical medicine at Berlin University and director of Cholera Lessons. the second medical clinic at the Charité Hospital. Professor The Egyptians even of the better classes are indescribably Kraus was born in 1858 at Bodenbach in Bohemia ; he dirty in their houses and their habits and have not yet - studied medicine at Prague and at Vienna, afterwards learnt the rudiments of domestic sanitation, but it is somebecoming an assistant to Professor Kahler in Prague and times disappointing to find Europeans who are taking the - eventually in Vienna,. In 1893 he. was appointed extra- most tremendous pains to avoid the entry of cholera ordinary professor at Vienna University and in 1894 into their houses neglecting some obvious precautions. For He has pub- instance, the kitchens of many good European houses are ordinary professor at Graz University. lished a great many memoirs describing his researches presided over by native male cooks and are extremely dirty, in physiological and pathological chemistry in its rela- unwhitewashed, blackened by smoke, fouled by the greasy tion to clinical medicine, and he has also contributed hands of the servants, swarming with cockroaches, and proto Professor Nothnagel’s "Encyclopaedia" the volume vided with shelves and cupboards which look as if they had The never been washed or painted. This is partly due to the on the Diseases of the Œsophagus and the Throat. appointment of Professor Kraus has given rise to much com1 THE LANCET, Oct. 11th, 1902, p. 1019. ,ment owing to the fact that he has at a comparatively early °

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1161 fact that the mistress of the house, perhaps unable to talk Arabic, is unwilling to cope with the unclean habits of the native servants and therefore seldom enters the kitchen. Moreover, most of the houses are unprovided with a larder, pantry, or scullery, the servants dress and wash in the kitchen, and, worst of all, leading out of many of the kitchens there is an ill-ventilated, untrapped water-closet. In spite of many warnings from typhoid fever the Europeans in Egypt have not yet learned to think of sanitary questions before they take a house or flat, and though there have been two sanitary engineers attached to the Egyptian Government for some years they are seldom invited by anyone except the better class English to give advice as to present or future habitations. It cannot be denied that cholera is extremely valuable in that it draws attention to neglected kitchens, filters, and food-supply. Another forgotten item is the ice box which is, of course, an ab-olute necessity in an Egyptian summer and a valuable luxury even in winter. Few people see that it is ever cleaned out, painted, or disinfected. While tracing the origin of one case in a European house in Alexandria the sanitary inspector found that the patient’s meat had been bought in a butcher’s shop where two assistants had recently contracted cholera. The shop looked quite clean and had been inspected and disinfected, but on closer examination the ice box proved to be swarming with cholera bacilli. Some consternation was felt among the English residents near the Bulkeley station of Ramleh, the popular suburb of Alexandria, by finding that cholera had picked out several victims from their neighbourhood, but it must be remembered that these same residents have in their water-supply and in their conservancy arrangements been neglecting sanitary measures for years. Also, some of them are supplied with milk by the cows of the Bedaween who are under no official inspection. It may be calculated that the present epidemic is more serious than that of 1895-96, but, on the other hand, it has not reached the dimensions of the 1883 outbreak. veterinary Report for 1901. 40 cases of anthrax were reported in Alexandria, 30 in animals coming from abroad, discovered in the quarantine pens, and 10 detected in the slaughter-house. These figures show how careful the inspection ought to be to avoid exposing meat for sale which is infected by anthrax. It is satisfactory to know that no cases were reported from sheep in the interior of Egypt. On the other hand, there were 180 cases of sheep-pox, coming chiefly from three villages in the Delta. 21 cases of rabid dogs and one cat were reported, though only three deaths from hydrophobia occurred among human beings, as compared with 10 during the previous year. Rabies is likely to continue or to increase until the Egyptian Government can be persuaded to take the matter in hand. The pariah dogs of the towns and villages are absolutely useless and should be radically destroyed. An attempt should be made to shoot down the wolves in the neighbourhood of some of the villages. The various European Consuls should also be invited to consent to

prevent people bringing pet quarantine regulations dogs into Egypt from countries where rabies is endemic and private dogs should be registered. 63 cases of glanders and farcy were found, mostly in old worn-out animals in Cairo and Alexandria, and 121 cases of cattle plague were reported as existing in the Soudan during the months of April, May, and June. It must be remembered that cattle plague exists in Abyssinia, Central Africa, and the Italian territory bordering the Soudan. For many years Egypt has been dependent on Europe for veterinary surgeons, but a year ago a veterinary school attached to the sanitary department was opened and 18 students were selected out of 69 applicants. Each student must possess the Government primary certificate and must have a good knowledge of English and the course of study is to extend over three years.

10

were one-eyed, and 20 others had their eyes red, purulent, spotted with leucoma. Savary confirms this by saying that. at that time the University mosque of El Azhar in Cairo contained 8000 blind persons who were kept there. It is known, too, that a century ago this disease was called Egyptian ophthalmia, because both the French and English armies in Egypt suffered so much from it. Larrey tells us that theor

greater number of French soldiers suffered from it and MacGregor, writing in 1804, speaks of 2000 English soldiers whoreturned blind to England. But the country has improved much since those days that it seemed almost ridiculous tothe British troops landing in 1882 with their veils and goggles, and, as a matter of fact, the English army of occupation has hardly suffered from granular ophthalmia, though there have often been a few cases of mild catarrhal ophthalmia among them. According to Dr. Eloui Bey, themost common causes of blindness to-day in Egypt among the natives are granular ophthalmia, glaucoma, purulent ophthalmia, and small-pox. In 1884 he was appointed medical officer of the Government schools ; he then found 8S. per cent. to be affected with granular lids, while now thenumber of students only yields 32 per cent. This great improvement can only be due to gradually increasing reforms. in public and personal hygiene. so

see

The Nile Flood of 1902. happened on several occasions that cholera years in Egypt have coincided with seasons when the Nileflood has been extremely low or later than usual. No. deficiency of the waters of the Nile can, of course, produce cholera, but as the chief method of getting rid of the disease is the granting of an improved water-supply to the inhabitants it is obvious that a late Nile, or a low The two one, can retard the stamping-out of the disease. lowest Niles of the last century were in 1877 and 1899, fortunately neither of them cholera years. This year (1902) is quite as bad as either of them and the flood, moreover, came down 20 days late, but by holding up the new barrage at Assiout and also the old dam below Cairo the Nile has been kept at a high level long enough to prevent there being any great loss. A few thousand acres cannot be cultivated for lack of water and therefore Government will lose the land tax on them for this year, but the deficiency will be much. smaller than in either 1877 or 1899. The barrage (or dam) below Cairo is now much more useful for emergency purposes than it was three years ago, for not only havethe foundations been strengthened but also two new cement weirs have been added below it. At the present time theAssiout dam is holding up half a metre of flood water and> the barrage below Cairo is holding up one metre, thanks to. the skilful resources of the irrigation engineers. Cairo, Oct. 13th. It has

Obituary.

to

The vaccine institute is

one of the most successful branches of the veterinary department and during the past year 220,513 tubes of lymph were issued, yielding results of about 95 per cent. of successes after primary vaccination and about 78 per cent. after revaccinations. A trade is just beginning to spring up in Australian frozen meat, for which there seems a good demand as the prices of fresh meat are continually rising in the markets, and Egypt for her own consumption has to increase her imports of cattle, sheep, goats, and pigs.

Egyptian Ophthalmia. who travelled in Egypt in 1784, said that for every 100 persons he met in the streets of Cairo 20 were blind,

Volney,

DANIEL McDONNELL, M.A., M.D. R.U.I. THE medical profession in Belfast has sustained a heavy loss in the death of Dr. Daniel McDonnell, one of the most brilliant of the younger practitioners in the city. He had been suffering from pulmonary disease for about two years and passed away on Oct. 10th at his residence in Belfast. Dr. McDonnell was descended on his father’s side from theold McDonnells of Antrim, ancient chieftains of Ireland. His father was Dr. McDonnell, J.P., of Randalstown, a man of great general culture and a very skilful physician. YoungDaniel McDonnell received his school training at Castleknock College, co. Dublin, a famous Roman Catholic educational seminary. He subsequently studied at the Roman Catholic Medical School in Dublin and at the Mater MisericordiveHospital, where he gained the First Leonard Prize, and after a brilliant career in the Royal University of Ireland he graduated M.B. with high distinction in 1885, and in 1885 he obtained the M.A. degree of the same university. About 17 years ago he began to practise in Belfast, eventually receiving the appointments of medical officer to the Royal Irish Constabulary of the north district of the city of Belfast and of physician to the Mater Infirmorum Hospital, in both of which positions, by the conscientious and skilful discharge of his duties, heA member of the North of gave the utmost satisfaction.