- Email: [email protected]
NEW YORK.
1637 incidents of the commemoration will be an international has inspected the Gourisba hospital of the metropolis and congress and an international exhibition of hygiene. The found it in a most deplorable condition. Complaints of the congress and exhibition alike will be inaugurated on May 25th bad management of this institution have been very loud for a at Buenos Ayres, and the exhibition will remain open till long time past. A special commission has been formed, conNov. 25th of the same year. Under 14 different heads it will sisting of the surgeon Djemil Bey, Mustafa Bey, the Director comprise specimens of every object, appliance, and practical of the Faculty of Medicine, and Dr. Nizameddine Bey, to method known to sanitation in its widest sense, and already investigate the matter. This commission has now submitted more than one of the continental powers are taking steps to a report which completely condemns the administration of be represented in the various sections. Exhibits will be the hospital. Goureba is one of the most important national accepted up to March 31st and will be exempt from all charitable institutions of Constantinople, containing as it import dues whatever, except in the case of their finding does 300 beds. The management seems to have been utterly purchasers at the close of the exhibition. The navigation neglected. Typhoid fever cases were confined in one room companies will (it is understood) concede transport of goods in very large numbers. Disinfection was hardly ever underas well as of passengers at reduced rates, precise particulars taken, and when undertaken it was done in a superficial, ’as to which will in due course be ascertained at thecasual manner. The most primitive hygienic measures were ’Consulates and Vice-Consulates of the Argentine domiciled in neglected. An idea of the great mortality that prevailed at Italy. Meanwhile, information as to terms of admission andGoureba can be formed from the large sum spent for shroudother details of interest to intending exhibitors can now beclothes. It has been proposed that the direction of the had on application at No. 15, Via Monte della Pietà, Milan,hospital should be intrusted to Dr. Nedjmeddin Arif Bey, the seat of the Commissione Esecutiva del Comitato per le who has studied in Paris and Berlin, and who lived in exile Esposizioni all’ Estero. during the old rcg6me. Nov. 14th.
Nov. 18th. _________________ ________________
CONSTANTINOPLE. (FROM
OUR OWN
CORRESPONDENT.)
NEW YORK. (FROM OUR OWN CORRESPONDENT.)
Pellagra Board of Investigation. THE increasing prevalence of pellagra in the Southern IN come of the local newspapers reports have appeared of ’the outbreak of the epidemic of typhoid fever in different States has led the Government to appoint a board of investito its cause and the preventive measures necessary quarters of the metropolis. The cause is attributed to bad gation asarrest. This board is empowered to visit the for its water. I seen in the the have course of drinking myself localities the disease is most prevalent, to make such where last few months quite an unusually large proportion of and as may be found necessary, and inquiries investigations two fever cases on at Haskeuy and Balat, districts typhoid the Golden Horn. Numerous people in Constantinople to confer and cooperate with local health authorities in the measures found to be essential to the :firmly believe that all the sources of water-supply here are instituting contaminated and absolutely dangerous to be used for extermination of the disease. The board consists of medical of the Public Health Service of large experience in drinking purposes. Even the famous Sultan scMyoM (Sultan’s officers of pestilential diseases, and experts in the investigation water) got from the street fountains, which has, up to work. laboratory experimental the of has now, enjoyed reputation being perfectly pure, now been condemned by a large section of the population as Accidents from Automobiles. ’being also polluted. Although many of the popular fears are The National Highways Protective Society has published groundless, there can be no doubt that many of the water a list of the killed and injured in New York during the ’sources of the capital are anything but pure. This is the month of October by automobiles. The total number of the Commission that was some special appointed opinion 22 killed was and the traffic lines, 33. Within injured time ago to examine them. The so-called Derkos water which where the police are stationed at intervals, there are no of the and a section which use city, many supplies large accidents, but in the suburbs, where there is no such prounboiled and unfiltered, is certainly impure. tection, the accidents chiefly occur. The society states that MalarW Fever. the average rate of speed in the streets is 20 per cent. higher Another epidemic-namely, that of malarial fever-is than it was and is steadily increasing; the trouble is with raging in the vilayet of Houdavendighiar. It is especially the drivers. Any man who sends$2 to the Secretary of State severe in Nicæa, where (so says the Osmanischtr Lloyd) there and asserts that he has had a certain amount of experience Typhoid Fever.
is no house without a sufferer from the disease, and where may have a licence to drive ; the result is that even ex,the medical man himself is laid up. Since there is no convicts, whose photographs are in the Rogues’ Gallery, are druggist or chemist in that place people are forced to buy driving some of the taxicabs. The society has decided to quinine from the bacal (grocer). It has been found that this endeavour to secure legislation creating a Highway Comdrug is not of the necessary quality, with the result that the mission with power to issue licences to chauffeurs and to disease still continues its ravages. The medical man says regulate the operation of automobiles in cities and villages. that he has already several times asked the municipality of The Rockefeller Commission for the Eradication of the Hookthe town to take the necessary measures of prevention, but in worm Disease of the Southern States. vain. He was always answered that for the successful comThe creation of this Commission and its endowment with of the the sum be of would f.500 bating epidemic required, which was not available. In Nicæa as many as 60 persons $1,000,000 is an interesting if not a unique instance of a have died from malaria in the course of the last few weeks. great work of public beneficence by private wealth. Mr. The opinion is expressed that the cause of the epidemic J. D. Rockefeller, recently organised a Commission of expert lies in the swamps of the district. The canal of Ghemlik, medical scientists, of which Professor Welch of Johns Hopkins which unites the Lake of Nicsea with the Marmora Sea, University is the president, and addressed to it a communicahas not been for a long time past in good working tion, saying : "For many months my representatives have order, and the accumulations in the swamps have con- been inquiring into the nature and prevalence of hook-wormI disease and considering plans for mitigating its evils. sequently not found the necessary exit. A large part have of the population of Nicasa have expressed the wish delayed action in the matter only until the facts to undertake the work of clearing the canal and as to the extent of the disease could be verified and the the swamps. The inhabitants of Ghemlik, however, ener- effectiveness of its cure and prevention demonstrated. If deem it wise to undertake the Commission I shall getically object to this undertaking, as they fear that the you glad to be permitted to work with you to that end, clearing of the place will result in an inundation. The be dilemma is rather a difficult one, and the authorities are and you may call upon me from time to time for such sums as may be needed during the next five years for carrying undecided what to do. on an aggressive campaign, up to a total$1,000,000." In The Hospital of Gouréba. of the Commission the members accepting Hamada Pasha, the Minister of Evkaf (religious property) replied as membership follows: ’’Your generous offer ...... has our ,
1638 heartiest approbation and we accept your invitation to administer this trust with a keen appreciation of the opportunity that you give us to do a great public good. The hookworm parasites often so lower the vitality of those who are affected as to retard their physical and mental development, render them more susceptible to other diseases, make labour less efficient, and in the sections where the malady is most prevalent greatly increase the death-rate from consumption, pneumonia, typhoid fever, and malaria....... The disease can be easily recognised, readily and effectively treated and by simple and proper sanitary precautions successfully prevented." It may be interesting to notice in this connexionL that there has long been a class of inhabitants of the Southern States which has been known as the "poor whites."’ They have been characterised by their listless habits and, extreme poverty and apparent want of interest in business of every kind. In 1902 Dr. Charles W. Stiles, chief of the: division of zoology in the hygienic laboratory, announced that, the "poor whites" were not wilful degenerates but helpless invalids, and that the cause of their condition was the uncinaria or hookworm," an intestinal parasite probably brought from Africa by slaves many generations ago. Dr. Stiles’s investigations showed that this disease was extremely common among the poorer and unhygienic classes, and he was led to estimate the number of victims of this parasite at 2,000,000 at least, and probably a far greater number of sufferers actually exist. The discovery of this disease and its cause excited no other public comment than that it was a remarkable explanation of the peculiar habits of laziness of a class of people in which no one was especially interested. A Southern newspaper says : " The ridicule which Dr. Stiles’s discoveries received at the outset now The idea of a germ of laziness could seems itself ridiculous. not at first be assimilated by the public mind. The hookworm was soon a subject of popular jest, and its finder became the butt of many dull jokes. But public disbelief and contempt only spurred Dr. Stiles to repeat his experiments and to stand on his discoveries....... When William H. ,
.
.
Welch and Simon Flexner, America’s greatest pathologists, lend their support to a campaign against hookworm popular support must follow. Their approval is the seal of scientific
authority." Vital Statistics in the United States in 1908.
The chief statistician of the Bureau of Vital Statistics, Dr. L. Wilbur, states that the civilised world has reached an era of low mortality. The death-rate in the registration area in 1908 was 15- 3 per 1000 population. This rate is the lowest that ever occurred in the United States. In the rural portion of the registration States the death-rate is even lower, being only 14 per 1000, while that of the urban population was 16.5 per 1000, the latter including all cities having a population of over 8000 in 1900. The year 1908 must be considered as one of extremely low mortality throughout the United States, but while it was marked by a general absence of severe epidemics there was unusual mortality from other
Cressy
causes.
Importa-nce cf
Government Controt of the Sale of Vtzecine Virus.
The sale of vaccine virus by private pharmaceutical firms a Federal licence. Recently the Public Health Service discovered that a firm which makes vaccine virus one of its products had prepared a large amount of virus which was demonstrated to be contaminated. On reporting this fact to the Government office, the license of the firm was suspended until it had withdrawn all of the contaminated virus from the market. The company then withdrew the condemned product from the market and destroyed it, the value of the amount destroyed being estimated at more than $14,000. The firm then presented a bill to the Government for the amount of loss, which was refused.
requires
Concentration of Offices of Physicians.
NOTES FROM INDIA. (FROM
OUR OWN
CORRESPONDENTS.)
P ccoyooa.
plague ending Oct. 2nd showed with in the week preceding. 2595 compared Bombay Presidency reports 911, Madras 141, Bengal 31, the United Provinces 236, the Punjab 193, Burma 30, Central Provinces 1063, Mysore State 248, Central India 305, and Rajputana 274. For the week ending Oct. 16th the returns show 4175 deaths, compared with 4123 in the week preceding. Bombay Presidency reports 924, Madras 74, Bengal 61, the United Provinces 367, the Punjab 321, Burma 25, the Central Provinces 1304, Mysore State 216, Central India 430, and Rajputana 421. Stringent sanitary measures and inoculation against plague are reported in progress in Mysore city in view of the large gathering of people expected there for the Dusserah festivities this month, which include the holding of the annual agricultural and industrial exhibition, and also in view of the Viceroy’s visit to the city towards the end of next month. The health of Mysore is not satisfactory as plague is epidemic, and about 10,000 persons in the vicinity In Bangalore the of the palaces have been inoculated. plague inoculations commenced just two years ago, and as a result of house-to-house inoculation the aggregate to-day THE
returns for the week
3460 deaths,
reaches 70.000 inoculated and re-inoculated out of a population of 90,000. The resulting immunity has been very marked, in that only about 1 person per 1000 has been attacked by plague. Vaccination in Benyal. A series of interesting experiments have been carried out during the past year in various districts of Bengal Presidency, chiefly with glycerinated lymph manufactured in the Central Animal Vaccination Depot, Calcutta. The results achieved appear so satisfactory that the civil surgeons of Howrah, Gya, and Midnapore have recommended the substitution of this lymph for the lanoline vaccination paste at present being used. The chief drawback to its use, however, appears to be that it is liable to deteriorate through heat and does not retain its efficiency so long as does the lanoline paste. It also requires careful handling by the vaccinators. The Sanitary Commissioner intends to give this lymph a further trial exclusively in two or three selected districts, and if successful the question of its general introduction will be considered. A satisfactory feature during the year has been the appointment of a special inspector of vaccination at Orissa. It has given considerable impetus to vaccination in the districts of Puri and Cuttack. This specially trained officer by tact and energy succeeded in overcoming the opposition to vaccination generally shown by villagers, and induced the natives of tracts affected with small-pox and other districts where vaccination had always been resisted to come up for vaccination. By these means an epidemic was cut short at Puri and the mortality greatly reduced. Another result attributed to the same agency was the marked increase in the number of infants vaccinated in Cuttack and Puri districts, especially in the latter. The appointment of special inspectors with local knowledge and status seems to be fully justified, and no doubt the Government of India will in time make these appointments more
general. Instruction art Bacteriology for I. M.S. Officers. In and after January, 1910, a course of training in clinical bacteriology and laboratory technique is to be made available for officers belonging to the Indian Medical Service at the Central Research Institute, Kasauli. Officers detailed for the course will be permitted to be absent from their stations for four weeks in addition to the actual time occupied by the journey to and from Kasauli, and one day for preparation for each journey. The classes of instruction will assemble in the months of January, March, May, July, September, and November each year. It is to be hoped that the Government of India will see its way to extend the same privileges to the other branches of the medical services in India.
For several years the profession of New York has had a central building devoted exclusively to the offices of medical men and called "The Sydenham." The movement was at first received with marked disfavour, but has now become Compulsory Quinine. decidedly popular. In Philadelphia the profession is about The Punjab Government has just issued a circular letter to erect a building for this purpose at a cost of$500,000 and to all heads of departments and deputy-commissioners in the with facilities for 200 offices. Punjab recommending anti-malarial measures and expressing Nov. 6th.
Nov. 18th. _________________ ________________
CONSTANTINOPLE. (FROM
OUR OWN
CORRESPONDENT.)
NEW YORK. (FROM OUR OWN CORRESPONDENT.)
Pellagra Board of Investigation. THE increasing prevalence of pellagra in the Southern IN come of the local newspapers reports have appeared of ’the outbreak of the epidemic of typhoid fever in different States has led the Government to appoint a board of investito its cause and the preventive measures necessary quarters of the metropolis. The cause is attributed to bad gation asarrest. This board is empowered to visit the for its water. I seen in the the have course of drinking myself localities the disease is most prevalent, to make such where last few months quite an unusually large proportion of and as may be found necessary, and inquiries investigations two fever cases on at Haskeuy and Balat, districts typhoid the Golden Horn. Numerous people in Constantinople to confer and cooperate with local health authorities in the measures found to be essential to the :firmly believe that all the sources of water-supply here are instituting contaminated and absolutely dangerous to be used for extermination of the disease. The board consists of medical of the Public Health Service of large experience in drinking purposes. Even the famous Sultan scMyoM (Sultan’s officers of pestilential diseases, and experts in the investigation water) got from the street fountains, which has, up to work. laboratory experimental the of has now, enjoyed reputation being perfectly pure, now been condemned by a large section of the population as Accidents from Automobiles. ’being also polluted. Although many of the popular fears are The National Highways Protective Society has published groundless, there can be no doubt that many of the water a list of the killed and injured in New York during the ’sources of the capital are anything but pure. This is the month of October by automobiles. The total number of the Commission that was some special appointed opinion 22 killed was and the traffic lines, 33. Within injured time ago to examine them. The so-called Derkos water which where the police are stationed at intervals, there are no of the and a section which use city, many supplies large accidents, but in the suburbs, where there is no such prounboiled and unfiltered, is certainly impure. tection, the accidents chiefly occur. The society states that MalarW Fever. the average rate of speed in the streets is 20 per cent. higher Another epidemic-namely, that of malarial fever-is than it was and is steadily increasing; the trouble is with raging in the vilayet of Houdavendighiar. It is especially the drivers. Any man who sends$2 to the Secretary of State severe in Nicæa, where (so says the Osmanischtr Lloyd) there and asserts that he has had a certain amount of experience Typhoid Fever.
is no house without a sufferer from the disease, and where may have a licence to drive ; the result is that even ex,the medical man himself is laid up. Since there is no convicts, whose photographs are in the Rogues’ Gallery, are druggist or chemist in that place people are forced to buy driving some of the taxicabs. The society has decided to quinine from the bacal (grocer). It has been found that this endeavour to secure legislation creating a Highway Comdrug is not of the necessary quality, with the result that the mission with power to issue licences to chauffeurs and to disease still continues its ravages. The medical man says regulate the operation of automobiles in cities and villages. that he has already several times asked the municipality of The Rockefeller Commission for the Eradication of the Hookthe town to take the necessary measures of prevention, but in worm Disease of the Southern States. vain. He was always answered that for the successful comThe creation of this Commission and its endowment with of the the sum be of would f.500 bating epidemic required, which was not available. In Nicæa as many as 60 persons $1,000,000 is an interesting if not a unique instance of a have died from malaria in the course of the last few weeks. great work of public beneficence by private wealth. Mr. The opinion is expressed that the cause of the epidemic J. D. Rockefeller, recently organised a Commission of expert lies in the swamps of the district. The canal of Ghemlik, medical scientists, of which Professor Welch of Johns Hopkins which unites the Lake of Nicsea with the Marmora Sea, University is the president, and addressed to it a communicahas not been for a long time past in good working tion, saying : "For many months my representatives have order, and the accumulations in the swamps have con- been inquiring into the nature and prevalence of hook-wormI disease and considering plans for mitigating its evils. sequently not found the necessary exit. A large part have of the population of Nicasa have expressed the wish delayed action in the matter only until the facts to undertake the work of clearing the canal and as to the extent of the disease could be verified and the the swamps. The inhabitants of Ghemlik, however, ener- effectiveness of its cure and prevention demonstrated. If deem it wise to undertake the Commission I shall getically object to this undertaking, as they fear that the you glad to be permitted to work with you to that end, clearing of the place will result in an inundation. The be dilemma is rather a difficult one, and the authorities are and you may call upon me from time to time for such sums as may be needed during the next five years for carrying undecided what to do. on an aggressive campaign, up to a total$1,000,000." In The Hospital of Gouréba. of the Commission the members accepting Hamada Pasha, the Minister of Evkaf (religious property) replied as membership follows: ’’Your generous offer ...... has our ,
1638 heartiest approbation and we accept your invitation to administer this trust with a keen appreciation of the opportunity that you give us to do a great public good. The hookworm parasites often so lower the vitality of those who are affected as to retard their physical and mental development, render them more susceptible to other diseases, make labour less efficient, and in the sections where the malady is most prevalent greatly increase the death-rate from consumption, pneumonia, typhoid fever, and malaria....... The disease can be easily recognised, readily and effectively treated and by simple and proper sanitary precautions successfully prevented." It may be interesting to notice in this connexionL that there has long been a class of inhabitants of the Southern States which has been known as the "poor whites."’ They have been characterised by their listless habits and, extreme poverty and apparent want of interest in business of every kind. In 1902 Dr. Charles W. Stiles, chief of the: division of zoology in the hygienic laboratory, announced that, the "poor whites" were not wilful degenerates but helpless invalids, and that the cause of their condition was the uncinaria or hookworm," an intestinal parasite probably brought from Africa by slaves many generations ago. Dr. Stiles’s investigations showed that this disease was extremely common among the poorer and unhygienic classes, and he was led to estimate the number of victims of this parasite at 2,000,000 at least, and probably a far greater number of sufferers actually exist. The discovery of this disease and its cause excited no other public comment than that it was a remarkable explanation of the peculiar habits of laziness of a class of people in which no one was especially interested. A Southern newspaper says : " The ridicule which Dr. Stiles’s discoveries received at the outset now The idea of a germ of laziness could seems itself ridiculous. not at first be assimilated by the public mind. The hookworm was soon a subject of popular jest, and its finder became the butt of many dull jokes. But public disbelief and contempt only spurred Dr. Stiles to repeat his experiments and to stand on his discoveries....... When William H. ,
.
.
Welch and Simon Flexner, America’s greatest pathologists, lend their support to a campaign against hookworm popular support must follow. Their approval is the seal of scientific
authority." Vital Statistics in the United States in 1908.
The chief statistician of the Bureau of Vital Statistics, Dr. L. Wilbur, states that the civilised world has reached an era of low mortality. The death-rate in the registration area in 1908 was 15- 3 per 1000 population. This rate is the lowest that ever occurred in the United States. In the rural portion of the registration States the death-rate is even lower, being only 14 per 1000, while that of the urban population was 16.5 per 1000, the latter including all cities having a population of over 8000 in 1900. The year 1908 must be considered as one of extremely low mortality throughout the United States, but while it was marked by a general absence of severe epidemics there was unusual mortality from other
Cressy
causes.
Importa-nce cf
Government Controt of the Sale of Vtzecine Virus.
The sale of vaccine virus by private pharmaceutical firms a Federal licence. Recently the Public Health Service discovered that a firm which makes vaccine virus one of its products had prepared a large amount of virus which was demonstrated to be contaminated. On reporting this fact to the Government office, the license of the firm was suspended until it had withdrawn all of the contaminated virus from the market. The company then withdrew the condemned product from the market and destroyed it, the value of the amount destroyed being estimated at more than $14,000. The firm then presented a bill to the Government for the amount of loss, which was refused.
requires
Concentration of Offices of Physicians.
NOTES FROM INDIA. (FROM
OUR OWN
CORRESPONDENTS.)
P ccoyooa.
plague ending Oct. 2nd showed with in the week preceding. 2595 compared Bombay Presidency reports 911, Madras 141, Bengal 31, the United Provinces 236, the Punjab 193, Burma 30, Central Provinces 1063, Mysore State 248, Central India 305, and Rajputana 274. For the week ending Oct. 16th the returns show 4175 deaths, compared with 4123 in the week preceding. Bombay Presidency reports 924, Madras 74, Bengal 61, the United Provinces 367, the Punjab 321, Burma 25, the Central Provinces 1304, Mysore State 216, Central India 430, and Rajputana 421. Stringent sanitary measures and inoculation against plague are reported in progress in Mysore city in view of the large gathering of people expected there for the Dusserah festivities this month, which include the holding of the annual agricultural and industrial exhibition, and also in view of the Viceroy’s visit to the city towards the end of next month. The health of Mysore is not satisfactory as plague is epidemic, and about 10,000 persons in the vicinity In Bangalore the of the palaces have been inoculated. plague inoculations commenced just two years ago, and as a result of house-to-house inoculation the aggregate to-day THE
returns for the week
3460 deaths,
reaches 70.000 inoculated and re-inoculated out of a population of 90,000. The resulting immunity has been very marked, in that only about 1 person per 1000 has been attacked by plague. Vaccination in Benyal. A series of interesting experiments have been carried out during the past year in various districts of Bengal Presidency, chiefly with glycerinated lymph manufactured in the Central Animal Vaccination Depot, Calcutta. The results achieved appear so satisfactory that the civil surgeons of Howrah, Gya, and Midnapore have recommended the substitution of this lymph for the lanoline vaccination paste at present being used. The chief drawback to its use, however, appears to be that it is liable to deteriorate through heat and does not retain its efficiency so long as does the lanoline paste. It also requires careful handling by the vaccinators. The Sanitary Commissioner intends to give this lymph a further trial exclusively in two or three selected districts, and if successful the question of its general introduction will be considered. A satisfactory feature during the year has been the appointment of a special inspector of vaccination at Orissa. It has given considerable impetus to vaccination in the districts of Puri and Cuttack. This specially trained officer by tact and energy succeeded in overcoming the opposition to vaccination generally shown by villagers, and induced the natives of tracts affected with small-pox and other districts where vaccination had always been resisted to come up for vaccination. By these means an epidemic was cut short at Puri and the mortality greatly reduced. Another result attributed to the same agency was the marked increase in the number of infants vaccinated in Cuttack and Puri districts, especially in the latter. The appointment of special inspectors with local knowledge and status seems to be fully justified, and no doubt the Government of India will in time make these appointments more
general. Instruction art Bacteriology for I. M.S. Officers. In and after January, 1910, a course of training in clinical bacteriology and laboratory technique is to be made available for officers belonging to the Indian Medical Service at the Central Research Institute, Kasauli. Officers detailed for the course will be permitted to be absent from their stations for four weeks in addition to the actual time occupied by the journey to and from Kasauli, and one day for preparation for each journey. The classes of instruction will assemble in the months of January, March, May, July, September, and November each year. It is to be hoped that the Government of India will see its way to extend the same privileges to the other branches of the medical services in India.
For several years the profession of New York has had a central building devoted exclusively to the offices of medical men and called "The Sydenham." The movement was at first received with marked disfavour, but has now become Compulsory Quinine. decidedly popular. In Philadelphia the profession is about The Punjab Government has just issued a circular letter to erect a building for this purpose at a cost of$500,000 and to all heads of departments and deputy-commissioners in the with facilities for 200 offices. Punjab recommending anti-malarial measures and expressing Nov. 6th.