THE PLAGUE IN HONG-KONG.-HOSPITAL ABUSE AT BRIGHTON. I 131 all forms of incontinence and bestiality-and as long But in trichinosis this may be slig...

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all forms of incontinence and bestiality-and as long But in trichinosis this may be slight and not attract In a severe case the swelling and hardness of as such establishments as those of Wilson exist they will attention. the authorities are now But the of the muscles, the extreme tenderness, and the position of eyes open happen again. that of the so we as well as those may fairly hope flexion without redness or swelling of the joints are almost public, to a blot on will cease constitute that massage houses pathognomonic. Early in typhoid fever these are never to of the seen. But later there may be swelling and tenderness and a the innocent London civilisation danger of the muscles. Dr. Oslerl has described such cases. (Edema .community. which in its most characteristic form is seen in the eyelids THE PLAGUE IN HONG-KONG. and over the eyebrows is of great value because of its early A CORRESPONDENT writing on April 8th reports that for appearance. It was characteristic in four cases. In the the week ending April lst seven cases of plague had been hands and feet it is more commonly seen late in the notified in Hong-Kong, all of which died. No. 9 health disease. (Edema with slight erythema above the swollen district was declared to be infected with plague on April 5th tender muscles is very characteristic. Leucocytosis and so that house-to-house visitation and cleansing might be eosinophilia are important features. It is only recently that the state of the blood has received attention. Dr. T. R. is with. said to be in Formosa Plague proceeded spreading both in town and country. The Japanese have the same Brown2 has found leucocytosis and great relative increase difficulty about securing reports of cases as we have. Their in the number of eosinophile cells. In all cases this medical men and nurses are said to be devoted in their was observed and in some it suggested the diagnosis. The question remains whether in other forms of "infectious struggle with the epidemic. myositis the eosinophiles are greatly increased. But such cases are extremely rare and if eosinophilia does occur the THE YARROW CONVALESCENT HOME. diagnosis can be made by examining a portion of the THE Yarrow Convalescent Home at Broadstairs was estabaffected muscle. lished for the accommodation of- children of middle-class people in reduced circumstances. It can receive 50 girls HOSPITAL ABUSE AT BRIGHTON. and 50 boys who must not have recently suffered from WE have on previous occasions called attention to the preany infectious or contagious disease, and must be between of hospital abuse at Brighton. Therefore we are valence the ages of four and 16 years for girls and four and 14 years to see that by the printed report of the Brighton Comfor boys. The report for 1898, which has just been issued, glad shows that there has been a steady increase in the admissions mittee of the Hospital Reform Association the evil comof children each year since the opening of the home in plained of is gradually lessening. The report in question, August, 1895, the numbers being 661 for the 17 months after referring to the remarks of our Special Commissioner ending December, 1896, rising to 601 for the 12 months and saying that his report shows a state of affairs which ending December, 1897, and 947 for the 12 months ending should demand the immediate attention of all those who are December, 1898. From May to August, 1898, there were in earnest in wishing to ameliorate the condition of our only a few unoccupied places. The report of the medical poorer neighbours and instil into their minds habits of officer, Mr. Frank Brightman, states that 929 children were independence and frugality," points out that in the year discharged during 1898, of whom 647 were then quite well, 1894 the medical staff of the West-street Lying-in Institution - 69 were greatly benefited, and 193 were improved. The attended 1240 cases, being over one-third of the total number average length of stay of each child was 27 days. The of births in Brighton and Hove for that year. In 1897, howLondon offices of the home are at 73A, Queen Victoria- ever, the figures had fallen to 955 and are still decreasing. The reports for 1898 of the various hospitals and of the disstreet, E.C. pensary have also been published and all show a decrease in the number of extern cases. The local committee of the THE DIAGNOSIS OF SPORADIC TRICHINOSIS. Reform Association urge upon the local charities to IN the American Jo2trnal of the Medical Sciences for March Hospital take up the work of reform and they state their opinion that Dr. Osler has drawn attention to the difficulty of diaif this were done the subscriptions received would be quite gnosis in sporadic trichinosis. The symptoms may not be for the requirements of the institutions and the poorer enough at all distinctive ; a large proportion of the cases are no classes would be really benefited. The association seems to doubt overlooked. The hog is more frequently infected with have met with some success and we can only hope that owing trichinse in America than in Germany, but disease is less to its efforts the evils exposed by our Commissioner will soon common because few persons eat raw or partially cooked pork. be things of the past. During 20 years’ hospital practice Dr. Osler has observed only five cases, and these in the last two and a half years. THE LIVERPOOL SCHOOL OF TROPICAL In all gastro-intestinal symptoms were not marked at the DISEASES. onset and in only one were they at all severe. All at the Lord ON 22nd Lister April (as reported in THE LANCET onset complained of irregular pains in the muscles, joints, -and back. Fever is the symptom most apt to lead to of April 29th) formally opened a special ward of 12 beds (to be called the Samuel Henry Thompson Ward) at erroneous diagnosis. It is accompanied by headache, stupor, the Royal Southern Hospital at Liverpool, when it was -and general symptoms of serious illness. The diagnosis of typhoid fever is therefore suggested. It is strengthened by pointed out that cases of tropical disease had been treated the diarrhoea,. In one case the temperature was very sug- at that hospital ever since it had been founded. The gestive of typhoid fever. Shortly after admission it reached arrangements for teaching tropical diseases at Liverpool are 104° F., and the diurnal variations for three days were now complete. Major Ross has been engaged as special not more than 2° in spite of the spongings carried out under lecturer, Dr. Annett as demonstrator, and Professor Boyce, this belief. Epistaxis was noted in two cases, and enlarge- the professor of pathology at University College, Liverpool, It will be remembered that Lord Lister ment of the spleen in three. Ehrlich’s diazo-reaction was well as pathologist. The citizens of in October last. the laboratories marked on admission in three cases. In one case there were opened must on be the businesswarmly congratulated two suspicious rose spots. There are in trichinosis three Liverpool the like in school has manner which been and founded features of great value in diagnosis. While in typhoid fever -




aching of the back and limbs special complaint of pain in the



no means

muscles is





Studies in Typhoid Fever, vol. ii., pp. 399-401. 2 THE LANCET, August 13th, 1898, p. 419.