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LIVERPOOL.
1245 a
greater predisposition
to tuberculosis than those of darker
skin. Dr. NATHAN RAW placed on record the result of an analysis of 232 cases of tuberculosis that had terminated fatally and found that pulmonary tuberculosis was most frequently brought about, first by direct inhalation of the bacillus tuberculosis into the bronchioles ; secondly, by extension from a bronchial gland to the parenchyma of the lung, this being specially associated with or following an attack of some acute infective fever, such as measles, scarlet fever, or diphtheria ; by extension upwards from the abdomen, by the diaphragm to the bronchial glands and then to the lungs ; by extensicn downwards from the glands of the neck directly to the pleura and then to the apex of the lung ; and finally, by a general infection by the circulating blood, as in acute miliary tuberculosis. M. ROBIN believed rather in a tissue or "origan*’" predisposition, though he agreed entirely with the signs of predisposition given by Professor Landouzy. He laid special stress on the marked respiratory changes that occurred not only in
tuberculosis but in other acute diseases. M. RENON, in connexion with these signs or "stigmata," wished to draw attention to the low arterial tension observed in those predisposed to tuberculosis. He also wished to point out that the question of pigmentation was of the greater importance from the fact, as had been pointed out, that in cases where recovery occurred pigmentation was both rapid and complete, whilst in those that succumbed such pigmentation did not occur at all readily. M. PIERY agreed very largely with Professor Calmette that the offspring of tuberculous parents were undoubtedly specially liable to tuberculosis and that the types of the disease in these patients were very varied. He thought, however, that a certain proportion of such offspring were actually immune, and that though immune to a grave tuberculosis they nevertheless were just the types in which the so-called stigmata of hereditary predisposition were present. Moreover, he believed with Professor Calmette, that the patients supposed to have these stigmata of the hereditary susceptibility were already suffering from the disease. There seemed to be, amongst the other speakers, a consensus of opinion that small numbers of non-virulent tubercle bacilli taken into the alimentary canal might in certain cases act as an immunising agent, but that in larger numbers and in virulent forms they might set up typical tuberculous lesions, especially in susceptible animals. In fact, it appeared to be the opinion of some of the speakers that both immunity and predisposition might arise from the same cause, that the bacilli might, in the one case, set up a kind of negative phase or predisposition, in the other a positive phase or immunity, and that until the conditions under which these occurred had been settled it was difficult to determine the part played by heredity. Dr. C. THEODORE WILLIAMS insisted upon the importance of predisposition and on the wisdom of trying to ascertain the conditions of the human system which caused disposition to tubercle and, conversely, those which conferred immunity from tubercle. Analysing 1000 cases of consumption that occurred in the upper classes he found that the age of attack was earlier amongst females than amongst males, and that amongst males affected by hereditary predisposition it was earlier by three years than among those free from hereditary predisposition and in females by six and a half years. Further, on analysing 400 cases of consumption taken from the out-patients of the Brompton Hospital he found that his earlier conclusion as regards the age of attack being hastened on by family predisposition was confirmed, but here the relative influence on the two sexes differed greatly from what was noted in the richer classes. Among the outpatients the age of attack was about the same for males as for females, the males being attacked earlier than among the rich, the females later. The age of attack in those free from family taint was later in both sexes, and the predisposition influence greater in the male than in the female. One or two of the later speakers were of opinion that although the points raised in this discussion were of undoubted interest, and of ccurse of great importance to the individual, it was perhaps inadvisable to lay much stress on this question of predisposition, except in so far as it pointed to the importance of keeping these patients out of the range of the attack of the tubercle bacillus. It was useful, of course, in both prognosis and treatment. The real campaign,
however, must be carried on, and
on
a
large scale, against
the tubercle bacillus and against the conditions under which it did its work most effectively. There seemed to be some danger that the bacillus might be overshadowed in the popular mind, and it appeared to some essential that it be insisted that although the tubercle bacillus does not always set up tuberculosis no tuberculosis is ever set up without the presence of the tubercle bacillus. Were heredity to be put forward too prominently those who are dealing with the question might lose heart. At the same time, should it play any part it should involve a call to the physician to look
after the
and
strengthening of his patient. Other Discussions. The Friday morning sitting was devoted entirely to tuberculosis in the child and in the schools, and the afternoon sitting to women’s work in connexion with tuberculosis. Mrs. NATHAN RAW and Dr. J. WALKER both took part in the discussion and stated the case for England. One of the most interesting contributions made in the afternoon was that by Dr. HERMANN VON SCHROTTER, who spoke of the action of sunlight and high altitudes and their relation to the treatment of tuberculosis. Some of his observations on the pigmentation of the skin seemed to bear out Professor Landouzy’s thesis. Dr. Schrötter believed that the pigment was formed by the cell, that it did not come directly from i the blood, and that the capacity to form pigment under stimulation gave some information as to the activity and stability of the cells. He also spoke of the effect of light, especially of the ultra-violet rays, and of high altitudes upon respiration, circulation, and metabolism. Not only was tuberculosis a disease of obscurity, it was also a disease of concentration of population. Saturday morning was devoted to the nomination of committees and to reports by the delegates from the various countries represented ; from which reports it may be gathered that not only in England, Ireland, and Scotland, but in many continental countries, especially Sweden, tuberculosis was gradually being driven out.
building up
Social Functions. The social functions held during the Conference were almost as interesting as the scientific sederunts. The reception given by the burgomaster and the town council of Brussels in the H6tel de Ville was as interesting from the associations of the place as from the people one met there. The annual dinner was also a great success. Amongst the congratulations and messages sent to the Conference was one from King George, dated from Balmoral Castle : "The Queen joins me in thanking you and the members for your kind telegram. We earnestly pray that successful results may attend your labours, and that a further stimulus may be given to the great international campaign that is being carried out against this terrible disease.—GEORGE, R. et I." Telegrams were also received from the Emperor of Germany, the Queen of Denmark, the Kings of Roumania, Sweden, Spain, and Norway, and from President Taft, all of them expressing keen interest in the work of the Conference. Before and after the regular meetings of the Conference excursions were made to the various Belgian sanatoriums and to other institutions in which measures are being taken to prevent the spread of, or cure cases of, tuberculosis.
LIVERPOOL.
(FROM
OUR
OWN
CORRESPONDENT.)
Strychnine Poisoning in Liverpool. A PROLONGED investigation by the city coroner and a jury took place on Oct. 12th into the circumstances attending the death of a man, aged 58 years, who died at his residence in the city on Sept. 20th, and on whose remains a post-mortem examination, followed by analysis, had taken place. The widow said her husband had long suffered from an affection of the eye, to which he attributed severe pains in the head, but he had thought the pains arose from brain work. The deceased had had medical advice from time to time. Latterly he had been in the habit of going for medicine On the Saturday previous to the shop of a local chemist. to his death the deceased, after complaining of pains in the stomach, obtained a draught from the chemist, and said it gave him relief. He appeared well on the following Monday,
1246 but on returning home about 6.30 P.M. on Tuesday, he said he hadhad a shocking day with his head," and he had called on the chemist who supplied him with a draught. He sat down to tea, but was shortly afterwards heard to scream. His wife inquired what was amiss, and he replied,’’ What " At the deceased’s has come to my head and legs ?" for his son went the chemist, who administered request an emetic, and as the deceased continued to struggle violently he went back to his shop and fetched something in a glass. On the chemist’s advice a qualified medical practitioner was called in, and while he was fetching a stomach pump and an antidote to strychnine the deceased died. The chemist deposed that he had been in business for seven years. The deceased frequently visited his shop to have prescriptions made up, and as he continued of late to complain of pains in the head the witness advised him to again consult a medical man. The deceased, however, seemed satisfied with a weakened and varied form of his own medical man’s prescription made up by the witness, which consisted of a draught containing 1-40th grain of strychnine. He also was supplied with tabloids or pills which contained strychnine. In one form or other the deceased had been taking strychnine regularly for several years. If the deceased died from strychnine poisoning he must have taken more than he obtained at the shop of the witness. The deceased could have his prescriptions, which he retained, made up elsewhere, and he might have taken, in order to relieve his pain, any number of the pills, which ought only to have been administered Mr. W. C. Williams, city and county one at a time. analyst, said that he found strychnine in the stomach and liver, while there were distinct traces of strychnine in the other parts of the body subjected to analysis. The bottle containing the remnant of the draught held less strychnine in solution than the prescription, but as the draught contained an alkali, the strychnine would be precipitated and crystallised, so that it would be impossible to secure the right amount of strychnine in each dose. Hence a prescription thus made up with an alkali was extremely dangerous. The amount of strychnine found in the body Mr. J. E. Stott was consistent with strychnine poisoning. agreed with the analyst, and said that the state of health of the deceased made him an unfit subject for a powerful dose of strychnine. The coroner said there was no doubt that the deceased died from strychnine poisoning, but in all the circumstances it would be well for the jury to confine their verdict to the simple fact of poisoning elicited from the medical man and the analyst. The coroner remarked that it was evidently necessary once more to warn both the public and chemists of the danger of administering potent drugs, save on the advice of a medical man who had diagnosed the individual case. He felt he could not do better than draw public attention to the words of Mr. Justice Kennedy, who had pointed out the tendency of the poor to make the druggist into a doctor, and he warned druggists to be extremely careful, as a public duty was cast on them in
taken in hand, and it was hoped that the committee would not be tied down to any hard-and-fast regulations, but before any serious expenditure was entered into the board would be made aware of it. The project was heartily endorsed by the board. P1lblio Hygiene in St. Helens. At the meeting of the St. Helens health committee held on Oct. 12th the town clerk said that a clause was being put into the new Parliamentary Bill prohibiting spitting in the streets by any person suffering from pulmonary tuberculosis. The corporation had already power to make a by-law to the effect thatNo person shall spit on the floor, side, or wall of any public carriage or of any public hall, public waiting-
yet
or place of public entertainment, whether admission thereto be obtained by payment or not, or in any enclosed or covered market."" It would strengthen the hands of the committee if the clause were put in the Bill. The committee agreed thereto.
room,
Oct. 17th.
WALES. (FROM
New Sehenae. The West Derby board of guardians has decided to embark upon a new scheme for making provision for feebleminded children. At its meeting on Oct. 12th it was reported that a deputation had recently visited Birmingham, and had gained much valuable information from their inspection of institutions provided by the three Poor-law unions of that city for the care of mentally defecThe deputation had been greatly impressed tive children. with the splendid arrangements made by the Birmingham Poor-law authorities for looking after this unfortunate class of people, and in the West Derby Union they had resolved to make a start on similar lines by adapting one of the cottages at the Fazakerley Cottage Homes to this purpose. Later it was hoped to extend the scheme by providing if possible an institution such as the colony they had seen at Birmingham for epileptics and the feeble-minded. This scheme was the most important that the West Derby board of guardians had
CORRESPONDENT.)
Report on Ptomaine Poisoning at W’l’eaeham. THE medical officer of health of the Wrexham urban and rural districts (Mr. D. Llewelyn Williams) has reported upon the cases of food poisoning which occurred in Wrexham and the adjoining district in August last. On the 6th and 7th day of that month about 100 persons were suddenly attacked with acute intestinal symptoms, including abdominal pain, vomiting, and diarrhoea, and in some cases there was collapse. Five of the patients died. It was ascertained that all those attacked had eaten a portion of pork pies purchased at one particular shop. Samples of these pies have been examined in the bacterio. logical laboratory of the Royal Institute of Public Health, and Professor W. R. Smith has reported that there was obtained from them by direct cultivation an organism which both from its varied cultural character. istics and its agglutination results was undoubtedly either the paratyphoid bacillus or the bacillus enteritidis of Gaertner. The same organism was also found in the viscera of one of the patients whose illness terminated fatally, and in the blood of three persons who were in close attendance on this patient and who were attacked with symptoms similar to those in the earlier cases. The organism was also found in the fasces of a man who worked in the shop in which the pies were made. A search for metallic substances in the pies gave negative result..
I
supplying dangerous drugs. Yellow Fever on a Liverpool Liner Two Deaths on Board. Five cases of yellow fever occurred on a Liverpool liner, which arrived in Liverpool last week, between Brazil and Portugal. One passenger and one of the crew died and were buried at sea. One patient nearing convalescence was conveyed to a Liverpool hospital for detention. The Care of Feeble-minded C3tildren West Derby Guardians’
OUR OWN
Cardiff Tibera2closis Dispensary. A scheme for the voluntary notification of phthisis has been in force in Cardiff for some time, and efforts in other directions have been made to lessen the incidence of the disease. On Oct. 2nd there was opened a municipal dispensary for the treatment of tuberculous patients. It is situated in the basement of the City Hall, where there have been set aside a waiting-room, a consulting room, a weighing room, and a dispensing room. Already some 50 patients have attended, most of them being residents in Cardiff, but a few have The institution is come from the adjoining rural districts. open from 6 to 8 on the evenings of Monday, Wednesday, and Friday, and is under the charge of the assistant medical officer of health (Mr. E. Fairfield Thomas), who is assisted by a nurse who acts as dispenser. Every effort will be made to get in touch with the early cases of consumption through the corporation health visitors.
6MM-
in Monnioqtthshire.
in the
Early present year the Monmouthshire education committee erected an open-air school with accommodation for 40 children at Aberbargoed in the Rhymney valley. It is situated on the side of the hill at an elevation of 700 feet above sea level. In the month of March children who were anaemic or debilitated and who were likely to benefit by the change were selected from the lower standards in the neighbouring schools. After attending the school for several I months a marked change has been noticed in them, and the head teacher has reported that they now show an eagerness to
join
in games where hitherto
they had preferred the shelter
greater predisposition
to tuberculosis than those of darker
skin. Dr. NATHAN RAW placed on record the result of an analysis of 232 cases of tuberculosis that had terminated fatally and found that pulmonary tuberculosis was most frequently brought about, first by direct inhalation of the bacillus tuberculosis into the bronchioles ; secondly, by extension from a bronchial gland to the parenchyma of the lung, this being specially associated with or following an attack of some acute infective fever, such as measles, scarlet fever, or diphtheria ; by extension upwards from the abdomen, by the diaphragm to the bronchial glands and then to the lungs ; by extensicn downwards from the glands of the neck directly to the pleura and then to the apex of the lung ; and finally, by a general infection by the circulating blood, as in acute miliary tuberculosis. M. ROBIN believed rather in a tissue or "origan*’" predisposition, though he agreed entirely with the signs of predisposition given by Professor Landouzy. He laid special stress on the marked respiratory changes that occurred not only in
tuberculosis but in other acute diseases. M. RENON, in connexion with these signs or "stigmata," wished to draw attention to the low arterial tension observed in those predisposed to tuberculosis. He also wished to point out that the question of pigmentation was of the greater importance from the fact, as had been pointed out, that in cases where recovery occurred pigmentation was both rapid and complete, whilst in those that succumbed such pigmentation did not occur at all readily. M. PIERY agreed very largely with Professor Calmette that the offspring of tuberculous parents were undoubtedly specially liable to tuberculosis and that the types of the disease in these patients were very varied. He thought, however, that a certain proportion of such offspring were actually immune, and that though immune to a grave tuberculosis they nevertheless were just the types in which the so-called stigmata of hereditary predisposition were present. Moreover, he believed with Professor Calmette, that the patients supposed to have these stigmata of the hereditary susceptibility were already suffering from the disease. There seemed to be, amongst the other speakers, a consensus of opinion that small numbers of non-virulent tubercle bacilli taken into the alimentary canal might in certain cases act as an immunising agent, but that in larger numbers and in virulent forms they might set up typical tuberculous lesions, especially in susceptible animals. In fact, it appeared to be the opinion of some of the speakers that both immunity and predisposition might arise from the same cause, that the bacilli might, in the one case, set up a kind of negative phase or predisposition, in the other a positive phase or immunity, and that until the conditions under which these occurred had been settled it was difficult to determine the part played by heredity. Dr. C. THEODORE WILLIAMS insisted upon the importance of predisposition and on the wisdom of trying to ascertain the conditions of the human system which caused disposition to tubercle and, conversely, those which conferred immunity from tubercle. Analysing 1000 cases of consumption that occurred in the upper classes he found that the age of attack was earlier amongst females than amongst males, and that amongst males affected by hereditary predisposition it was earlier by three years than among those free from hereditary predisposition and in females by six and a half years. Further, on analysing 400 cases of consumption taken from the out-patients of the Brompton Hospital he found that his earlier conclusion as regards the age of attack being hastened on by family predisposition was confirmed, but here the relative influence on the two sexes differed greatly from what was noted in the richer classes. Among the outpatients the age of attack was about the same for males as for females, the males being attacked earlier than among the rich, the females later. The age of attack in those free from family taint was later in both sexes, and the predisposition influence greater in the male than in the female. One or two of the later speakers were of opinion that although the points raised in this discussion were of undoubted interest, and of ccurse of great importance to the individual, it was perhaps inadvisable to lay much stress on this question of predisposition, except in so far as it pointed to the importance of keeping these patients out of the range of the attack of the tubercle bacillus. It was useful, of course, in both prognosis and treatment. The real campaign,
however, must be carried on, and
on
a
large scale, against
the tubercle bacillus and against the conditions under which it did its work most effectively. There seemed to be some danger that the bacillus might be overshadowed in the popular mind, and it appeared to some essential that it be insisted that although the tubercle bacillus does not always set up tuberculosis no tuberculosis is ever set up without the presence of the tubercle bacillus. Were heredity to be put forward too prominently those who are dealing with the question might lose heart. At the same time, should it play any part it should involve a call to the physician to look
after the
and
strengthening of his patient. Other Discussions. The Friday morning sitting was devoted entirely to tuberculosis in the child and in the schools, and the afternoon sitting to women’s work in connexion with tuberculosis. Mrs. NATHAN RAW and Dr. J. WALKER both took part in the discussion and stated the case for England. One of the most interesting contributions made in the afternoon was that by Dr. HERMANN VON SCHROTTER, who spoke of the action of sunlight and high altitudes and their relation to the treatment of tuberculosis. Some of his observations on the pigmentation of the skin seemed to bear out Professor Landouzy’s thesis. Dr. Schrötter believed that the pigment was formed by the cell, that it did not come directly from i the blood, and that the capacity to form pigment under stimulation gave some information as to the activity and stability of the cells. He also spoke of the effect of light, especially of the ultra-violet rays, and of high altitudes upon respiration, circulation, and metabolism. Not only was tuberculosis a disease of obscurity, it was also a disease of concentration of population. Saturday morning was devoted to the nomination of committees and to reports by the delegates from the various countries represented ; from which reports it may be gathered that not only in England, Ireland, and Scotland, but in many continental countries, especially Sweden, tuberculosis was gradually being driven out.
building up
Social Functions. The social functions held during the Conference were almost as interesting as the scientific sederunts. The reception given by the burgomaster and the town council of Brussels in the H6tel de Ville was as interesting from the associations of the place as from the people one met there. The annual dinner was also a great success. Amongst the congratulations and messages sent to the Conference was one from King George, dated from Balmoral Castle : "The Queen joins me in thanking you and the members for your kind telegram. We earnestly pray that successful results may attend your labours, and that a further stimulus may be given to the great international campaign that is being carried out against this terrible disease.—GEORGE, R. et I." Telegrams were also received from the Emperor of Germany, the Queen of Denmark, the Kings of Roumania, Sweden, Spain, and Norway, and from President Taft, all of them expressing keen interest in the work of the Conference. Before and after the regular meetings of the Conference excursions were made to the various Belgian sanatoriums and to other institutions in which measures are being taken to prevent the spread of, or cure cases of, tuberculosis.
LIVERPOOL.
(FROM
OUR
OWN
CORRESPONDENT.)
Strychnine Poisoning in Liverpool. A PROLONGED investigation by the city coroner and a jury took place on Oct. 12th into the circumstances attending the death of a man, aged 58 years, who died at his residence in the city on Sept. 20th, and on whose remains a post-mortem examination, followed by analysis, had taken place. The widow said her husband had long suffered from an affection of the eye, to which he attributed severe pains in the head, but he had thought the pains arose from brain work. The deceased had had medical advice from time to time. Latterly he had been in the habit of going for medicine On the Saturday previous to the shop of a local chemist. to his death the deceased, after complaining of pains in the stomach, obtained a draught from the chemist, and said it gave him relief. He appeared well on the following Monday,
1246 but on returning home about 6.30 P.M. on Tuesday, he said he hadhad a shocking day with his head," and he had called on the chemist who supplied him with a draught. He sat down to tea, but was shortly afterwards heard to scream. His wife inquired what was amiss, and he replied,’’ What " At the deceased’s has come to my head and legs ?" for his son went the chemist, who administered request an emetic, and as the deceased continued to struggle violently he went back to his shop and fetched something in a glass. On the chemist’s advice a qualified medical practitioner was called in, and while he was fetching a stomach pump and an antidote to strychnine the deceased died. The chemist deposed that he had been in business for seven years. The deceased frequently visited his shop to have prescriptions made up, and as he continued of late to complain of pains in the head the witness advised him to again consult a medical man. The deceased, however, seemed satisfied with a weakened and varied form of his own medical man’s prescription made up by the witness, which consisted of a draught containing 1-40th grain of strychnine. He also was supplied with tabloids or pills which contained strychnine. In one form or other the deceased had been taking strychnine regularly for several years. If the deceased died from strychnine poisoning he must have taken more than he obtained at the shop of the witness. The deceased could have his prescriptions, which he retained, made up elsewhere, and he might have taken, in order to relieve his pain, any number of the pills, which ought only to have been administered Mr. W. C. Williams, city and county one at a time. analyst, said that he found strychnine in the stomach and liver, while there were distinct traces of strychnine in the other parts of the body subjected to analysis. The bottle containing the remnant of the draught held less strychnine in solution than the prescription, but as the draught contained an alkali, the strychnine would be precipitated and crystallised, so that it would be impossible to secure the right amount of strychnine in each dose. Hence a prescription thus made up with an alkali was extremely dangerous. The amount of strychnine found in the body Mr. J. E. Stott was consistent with strychnine poisoning. agreed with the analyst, and said that the state of health of the deceased made him an unfit subject for a powerful dose of strychnine. The coroner said there was no doubt that the deceased died from strychnine poisoning, but in all the circumstances it would be well for the jury to confine their verdict to the simple fact of poisoning elicited from the medical man and the analyst. The coroner remarked that it was evidently necessary once more to warn both the public and chemists of the danger of administering potent drugs, save on the advice of a medical man who had diagnosed the individual case. He felt he could not do better than draw public attention to the words of Mr. Justice Kennedy, who had pointed out the tendency of the poor to make the druggist into a doctor, and he warned druggists to be extremely careful, as a public duty was cast on them in
taken in hand, and it was hoped that the committee would not be tied down to any hard-and-fast regulations, but before any serious expenditure was entered into the board would be made aware of it. The project was heartily endorsed by the board. P1lblio Hygiene in St. Helens. At the meeting of the St. Helens health committee held on Oct. 12th the town clerk said that a clause was being put into the new Parliamentary Bill prohibiting spitting in the streets by any person suffering from pulmonary tuberculosis. The corporation had already power to make a by-law to the effect thatNo person shall spit on the floor, side, or wall of any public carriage or of any public hall, public waiting-
yet
or place of public entertainment, whether admission thereto be obtained by payment or not, or in any enclosed or covered market."" It would strengthen the hands of the committee if the clause were put in the Bill. The committee agreed thereto.
room,
Oct. 17th.
WALES. (FROM
New Sehenae. The West Derby board of guardians has decided to embark upon a new scheme for making provision for feebleminded children. At its meeting on Oct. 12th it was reported that a deputation had recently visited Birmingham, and had gained much valuable information from their inspection of institutions provided by the three Poor-law unions of that city for the care of mentally defecThe deputation had been greatly impressed tive children. with the splendid arrangements made by the Birmingham Poor-law authorities for looking after this unfortunate class of people, and in the West Derby Union they had resolved to make a start on similar lines by adapting one of the cottages at the Fazakerley Cottage Homes to this purpose. Later it was hoped to extend the scheme by providing if possible an institution such as the colony they had seen at Birmingham for epileptics and the feeble-minded. This scheme was the most important that the West Derby board of guardians had
CORRESPONDENT.)
Report on Ptomaine Poisoning at W’l’eaeham. THE medical officer of health of the Wrexham urban and rural districts (Mr. D. Llewelyn Williams) has reported upon the cases of food poisoning which occurred in Wrexham and the adjoining district in August last. On the 6th and 7th day of that month about 100 persons were suddenly attacked with acute intestinal symptoms, including abdominal pain, vomiting, and diarrhoea, and in some cases there was collapse. Five of the patients died. It was ascertained that all those attacked had eaten a portion of pork pies purchased at one particular shop. Samples of these pies have been examined in the bacterio. logical laboratory of the Royal Institute of Public Health, and Professor W. R. Smith has reported that there was obtained from them by direct cultivation an organism which both from its varied cultural character. istics and its agglutination results was undoubtedly either the paratyphoid bacillus or the bacillus enteritidis of Gaertner. The same organism was also found in the viscera of one of the patients whose illness terminated fatally, and in the blood of three persons who were in close attendance on this patient and who were attacked with symptoms similar to those in the earlier cases. The organism was also found in the fasces of a man who worked in the shop in which the pies were made. A search for metallic substances in the pies gave negative result..
I
supplying dangerous drugs. Yellow Fever on a Liverpool Liner Two Deaths on Board. Five cases of yellow fever occurred on a Liverpool liner, which arrived in Liverpool last week, between Brazil and Portugal. One passenger and one of the crew died and were buried at sea. One patient nearing convalescence was conveyed to a Liverpool hospital for detention. The Care of Feeble-minded C3tildren West Derby Guardians’
OUR OWN
Cardiff Tibera2closis Dispensary. A scheme for the voluntary notification of phthisis has been in force in Cardiff for some time, and efforts in other directions have been made to lessen the incidence of the disease. On Oct. 2nd there was opened a municipal dispensary for the treatment of tuberculous patients. It is situated in the basement of the City Hall, where there have been set aside a waiting-room, a consulting room, a weighing room, and a dispensing room. Already some 50 patients have attended, most of them being residents in Cardiff, but a few have The institution is come from the adjoining rural districts. open from 6 to 8 on the evenings of Monday, Wednesday, and Friday, and is under the charge of the assistant medical officer of health (Mr. E. Fairfield Thomas), who is assisted by a nurse who acts as dispenser. Every effort will be made to get in touch with the early cases of consumption through the corporation health visitors.
6MM-
in Monnioqtthshire.
in the
Early present year the Monmouthshire education committee erected an open-air school with accommodation for 40 children at Aberbargoed in the Rhymney valley. It is situated on the side of the hill at an elevation of 700 feet above sea level. In the month of March children who were anaemic or debilitated and who were likely to benefit by the change were selected from the lower standards in the neighbouring schools. After attending the school for several I months a marked change has been noticed in them, and the head teacher has reported that they now show an eagerness to
join
in games where hitherto
they had preferred the shelter