MONTREAL.

MONTREAL.

1727 immunised against the "proteine tubercolari." In proporhe increased the number of injections of the Maragliano serum he augmented the immunity a...

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1727 immunised against the "proteine tubercolari."

In proporhe increased the number of injections of the Maragliano serum he augmented the immunity against the action of the tuberculous poison, until after thirty or forty injections the reaction to the same dose of tuberculine was barely appreciable or entirely non-existent. Dr. P. Schivardi, who reports these views of the Neapolitan consultant, adds that in Dr. De Renzi’s opinion there is no remedy for phthisis superior to the Maragliano serum. It seldom fails to relieve, and if applied in time and persevered with under reasonably favourable conditions it almost invariably results in cure. tion

as

Falsification of Wines : a lfarning. The extraordinary rainfall of last summer and autumn has bad effects on wine culture which are simply disastrous. The quality of the grape has been poor beyond precedent and the wines made from it are correspondingly inferior in strength and colour. Spirit of the worst kind has been added by many producers to remedy the former defect, while to make good the latter recourse has been had to colouring matter evolved from catrame (tar). The wine so mani-

pulated

and made noxious is, in

terms

of the law, pro-

bibited from sale, and in Tuscany, last few

particularly within the sanitary inspectors have sequestrated

days, the large quantities. At Florence alone about 1000 flasks have been seized and sent to the municipal laboratory for analysis.

the nature and amount of the noxious adulteration ascertained the producers will be denounced to the legal authorities. So urgent is the danger to the consumer, especially the foreign and experienced, that with commendable promptitude the Enological Commission has been convoked by Signor Guicciardini, Minister of Agriculture, so as to intercept the wine before it is transferred from cask to bottle or fiasco. The Commission a.ppeals for aid to the press to put the public on its guard, well aware that loss of custom is a more powerful deterrent to the adulterator than even the fines imposed by the 11 pretoie or sheriff. As

soon as

are

"

The Health of Milan. Few Italian cities receive more English-speaking guests than the Lombard capital, and few, it is fair to say, are more keenly alive to the hygienic duties such large, if but temporary, additions to their population impose. I have indicated from time to time the increased vigilance of the Milanese sanitary authorities in the prophylaxis of infective disease-notably, in the practical extinction of small-pox through stringent re-vaccination. To-day I can give further confirmation of the effective surveillance maintained over the public health. During October, 1895, the deaths amounted to 9067; but for the corresponding month of the current year they have sunk to 8669, in spite of an accession to the population of nearly 7000 inhabitants. Again, in November last there is a decrease of 100 deaths, as against the November of 1895. The vast draina,ge works now in progress may reasonably be expected to signalise their completion by a still further lowering of the mortality. Honour to Dr. Behring. Our Government have just conferred on the discoverer of the anti-diphtheritic serum the well-merited honour of Grand Cordon of the Crown of Italy.

Professor Durante. The Senator Professor Durante, who holds the chair of Clinical Surgery in our university and is the recognised head of the profession in that department, has sustained a serious accident. Descending the staircase of a house in which he had been visiting a patient he slipped and broke his leg. The fracture was reduced without delay and the apposed surfaces kept in sitit by an apparatus of felt. Within a fortnight he has so far recovered as to look forward to immediately resuming professional work,

on which to place it is he may call at certain druggists’ shops and obtain the paper ; these are attended to by the bacteriologists and a report furnished without charge next day. Dr. Wyatt Johnson and Dr. McTaggart, the experts of the Beard, brought the matter before the last meeting of the Medico-Chirurgical Society and made some reports, also demonstrating the method. Pfeiffer and Vidal have been accorded the priority in urging the method, and now by the dry method, as explained by Dr. Wyatt Johnson, all that is necessary is that a drop of blood be taken from the cleansed finger, placed on the paper and folded up. Two hundred and fifty-seven trials had been made, and in 95 per cent. of the cases suitable for The trial an assured diagnosis was accurately made. clumping or aggregating of the bacilli is easily seen with a one-sixth dry objective. Forty-nine control examinations were made from cases known to be suffering from diseases not typhoid, not one of which gave the reaction. In only one case, which would have been positively pronounced as typhoid from the clinical conditions, was it impossible to get the reaction. As there was no means of verifying this case by section, it does not necessarily detract from the value of the test. The test may be got in two days, but generally not before the fifth, and may be found up to one year or more after convalescence. Eighteen hospital patients who had been discharged well after typhoid were looked up, some of whom had been out for several months; in seventeen the diagnosis of previous typhoid could be made bacteriologically. The difficulties that have been brought out generally consist in neglect of the instructions. Some samples had been literally cooked by too much heating, others had been allowed to gather dust and germs, or too small a quantity had been sent, and so on. Sufficient blood should dry on the paper to make a distinct scale. Dr. Wyatt Johnson demonstrated his method, somewhat dramatically before the American Public Health Society. He undertook to report in one hour on six cases. The specimens were given him without any information, the sources of the bloods being indicated in a sealed envelope to be opened only after the test. His report was definite and accurate in five, and the sixth was reported " doubtful, probably not typhoid ": it was a case of heart disease. In the discussion Dr. Adami, Dr. Finley, and others spoke of the great value of this method, and praised Dr. Wyatt Johnson for popularising it.

taking

the blood and sterilised paper

sent to any

physician desiring it,

Civic

Ht).3pital Mutters. Civic hospital matters have given rise to much comment in the press, lay and professional. Anything done in the province of Quebec under civic or governmental control

It has been in the Civic Infectious Diseases Hospital, Montreal. The building, a rather poorly constructed affair, was divided off and the Protestant portion was officered by medical men and nurses sent by the Montreal General Hospital, which institution was to receive £1500 per annum for the service. Recently, for alleged reasons of economy, the city council decided to dispense with the staff on the Protestant side and put all under the health committee and the medical health officer of the city. At once loud protestations were made from the English side of the community, the medical society, the Ministerial Association, and the English press. The clamour was avowedly based on the supposition that the medical service would not be so satisfactory under civic control as before. The fine results, especially in the treatment of diphtheria with antitoxin, on the Protestant side were referred to, and much pressure was brought to bear on the City Council to reconsider the matter. They, however, have not done so, and the cfficers previously sent by the Montreal General Hospital, who had at first refused to vacate, have been required to give up attendance. must have its Protestant and Catholic sections. so

Dec. 6th.

f

MONTREAL. (FROM OUR OWN CORRESPONDENT.) S’erum THE serum diagnosis of with great Eatisfaction to

Diagnosis. typhoid fever is being carried on the general practitioners by the

Provincial Board of Health.

A

schedule of dirertiors for

or

Sporadic Leprosy. A case of leprosy was discovered post-mortem in Montreal a short time ago. It was in a Chinese resident, of which kind of population we have five hundred. The man was found in a dying state in one of the low-class boarding houses, into which the celestials crowd themselves. No suspicion of leprosy arose until the coroner’s physician, unable to account for a peculiar eruption on the cadaver, tested scrapings bacteriologically, and unmistakeably found the bacilli. A thorough search was made through the Chinese quarter, but no

other

case was

discovered.

1728 British Medical Association. The meeting of the British Medical Association to be held in Montreal is already causing some stir in medical circles. Numerous committees have been appointed and some are now at work. A fine handbook and programme will be issued to the members speedily so that time may be given to make arrangements for a holiday tour by visitors. A comprehensive and elaborate souvenir volume, copiously illustrated with the finest process work, has been contracted for; this will give all the information that the strangers would be- likely to want as to Montreal and Canada. The great honour done our colony in the selection of a Montreal man as the President of the Association has been highly appreciated, and all branches of the profession are unanimous in agreeing that no more worthy and estimable a man among us could be found to bear the honour than Dr. Thomas G. Roddick, M.P. Otir English brethren who come here for the first time will be surprised at the hospitals and institutions we can show them and the advanced state of surgical and pathological work and science teaching. Everything will be done to make the 1897 meeting a great success. The Government has subscribed handsomely, so that with city and individual subscriptions, the sinews of war, so necessary in all large undertakings, are well provided.

PHILADELPHIA. (FROM

OUR OWN

CORRESPONDENT.)

Proposed Munsicipal Home for Phthisis. IT has been proposed by Mr. Lawrence Flick, President of the Society for the Prevention of Tuberculosis in this city, to establish a municipal home for phthisical patients. In the report of the Board of Health of the City of Philadelphia for 1895 appears the following: "It is gratifying to note the steady diminution in the deaths from consumption. There has been a more or less steady decrease in the fatal cases of this disease during the past eight years, and the 2499 deaths during 1895 are actually and proportionately less than for 1894, in which year the number was below that reported for many years. These figures point to a better knowledge of the management of this disease and a greater attention given to prophylactic measures and to the treatment of the disease." Such an institution as the above would doubtless make its influence felt. In 1894 measures were adopted favouring the notification of cases of tuberculosis and steps were taken to secure thorough disinfection of premises where the disease had prevailed. Nothing came of it, however, as notification is not compulsory and it is seldom that permission to disinfect can be obtained from a householder. Hastening the Death of Incurables. The Rev. Dr. Wendte, of Oakland, California, one of the most noted Unitarian ministers of the Pacific slope, has caused a great deal of discussion and not a little adverse criticism by his advocacy of euthanasia in the sense of hastening death, and thus speedily terminating the sufferings of incurables. In a recent sermon printed in the San Francisco Call he said, "But a step beyond establishing hospital wards is needed, and it is one which civilized society is ready to take. I refer to the humane disposal of those who are suffering needless and cruel torture, and whose death is inevitable Why seek, as now, to prolong their agonies ? Why exhaust the resources of medical science to keep them in misery ? Would it not be a more Christian act to put them gently out of pain ? We mercifully end the life of a suffering horse or dog whose restoration is impossible. Shall we be less merciful to our He further human kind than to the brute creation?" advocated the formation of a committee empowered to examine into and pass upon the merits of individual casesthe committee to be composed of four physicians, the district attorney, the chairman of the local board of health, and two citizens of irreproachable character-all to be selected by the Governor of the State in which the person lives. The sufferer must first make an appeal, then the consent of the family is necessary, and ifupon investigation it is

shown that all known treatment is worthless, that the suffering is great, and that the motive is entirely and solely humane, the committee may put an end to the misery. It will be remembered that about eighteen months ago a New York lawyer stoutly contended that it was a common practice among medical men to hasten the death of incurable patients. These statements would scarcely be worthy of notice, but when they have the endorsement of a prominent divine they sink deeper into the minds of the people, and before long are believed. No human agency is capable of prognosticating with absolute certainty the outcome of any illness, a fact not sufficiently appreciated by the laity. The Act to

Regulate

the Practice

of Medicine.

The following resolutions were adopted by the Illinois State Board of Health, Oct. 6th, 1896 :-" Whereas the wiseand progressive enforcement by our predecessors of the Act to Regulate the Practice of Medicine in the State of Illinois, passed July lst, 1877, has resulted in a general but not uniform improvement of the methods of medical education throughout the United States and a material elevation of the standard of professional attainments and ability necessary toobtain the legal right to practise medicine in many States, thereby securing in such States a better equipped, more competent, and more scientific body of medical men, to the great gain and advantage of the people thereof : and, whereas this result has been obtained to the fullest extent in those States where the college diploma is not recognised as final but only as a qualification for examination by a board whose members are not connected with or interested in a college or teaching institution: be it resolved by the present members of the Illinois State Board of Health, with the fullest appreciation of the invaluable work of their predecessors, that medical education and the status of the doctor in medicine have outgrown the limitations of the Medical Practice Act of 1877. Now, therefore, be it resolved that said Act should be so amended as to require, first, that all applicants for the right to practise medicine and surgery or any of their branches in the State of Illinois shall demonstrate their fitness for such practice through an examination by a board of impartial, competent, and practical examiners skillecl in the various branches of medicine and surgery, and no member of which board shall be connected, or affiliated with, or interested in, any diploma-granting college or teaching institution. Secondly, that no applicant shall be eligible to such examination, unless the legal possessor of a diploma of graduation from a medical college in good standing; resolved, that this board earnestly invite the cooperation and assistance of kindred boards throughout the United States to the end that uniformity of practice may ultimately obtain in the recognition of medical practitioners in all parts of the country ; of all reputable medical colleges whose dignity and usefulness will thereby be promoted ; of the medical profession of the State, as represented in the various medical societies, with the view of excluding the incompetent and unworthy from its ranks; and of the members of the forthcoming general assembly in this effort to protect the health and lives of the citizens, of the State."

G’ooatrolling the Practice of Midwifery. The State Board of Health of Illinois have adopted regulations controlling the practice of midwifery. Hereafter no person will be allowed to practise as a midwife unless licensed. Each applicant must obtain a certificate and register with an officer of the board, known as the "inspector of midwifery." She shall attend only normal cases. In complicated labours she must send for a physician. Failing to do this she runs the risk of losing her licence. Where the people are unable to pay a medical man, the nearest district physician employed by the city shall respond. The Act contains nothing relative to the qualifications for practice, but it is safe to assume that the board will demand a certain amount of preliminary training before granting a certificate. The Transportation of Sick People and its Dangers. The members of the State Board of Health of Colorado regard the indiscriminate transportation of sick people as dangerous and a menace to public health, and therefore recommend t iat invalids be required to obtain permits before they catravel in that State.