- Email: [email protected]
NOTES FROM SOUTH AFRICA.
342 The general tone of the meeting deprecated the hysteria amendment requesting the Government to consider the which has arisen through popular ignorance whenever leprosy advisability of creating a proper health department for South has come up for public discussion in the United States. Dr. Africa under the direct control of a chief medical officer. C. W. Duval, of Tulane University, New Orleans, La., who A long debate ensued in which most of the medical and culture media, several lay members took part. The actions of the Governwas the first to grow the bacillus leprae in described his experiments and what he expected to accom- ment were somewhat freely criticised from all quarters of the plish with serums in producing immunity. He said that House, and eventually the debate was adjourned until the experiments with Japanese mice and other animals showed following week. On the 13th the matter was again raised when the estimates were under discussion, and again there that the disease was certainly infectious by contact. In this the Right Hon. J. X. was a further debate. Unauthorised Necropsies. ex-Prime Minister of Cape Colony, took the Two physicians of Long Island City, a part of the greatEr leading part, and in reply to the Minister for the Interior, city of New York, were recently sued for .B2000 damages for who had expressed doubts as to the value of the work performing an unauthorised necropsy on the body of a widow, done by the late Cape Health Department, he warmly said to have died from gangrenous perityphlitis. The suit was defended this department, emphasising the administrative brought by the children of the deceased and thejury awarded ability and zeal of Dr. A. J. Gregory, its chief medical officer, £1600 damages, the action being undefended. This is the who was now, he stated, in the extraordinary position of being first case of the kind ever tried in the United States. subordinate to his former clerks. Eventually the Minister for the Interior stated that he held very strong views that Abuse of Charity. medical men should not take any part in administration, but According to the findings of the subcommittee on charities he was prepared carefully to reconsider the whole matter, of the Congestion of Population Commission at least one in and in any case he would promise in due course to establish every nine persons resident in New York receives annual a department of public health and to appoint a chief medical assistance from charity. 176 societies furnish food, fuel, officer. While declaring that he was convinced that the larger clothing, and general relief ; there are 92 fresh-air charities, issues of public health should remain under the Union, he 89 societies for the relief of foreigners, 56 for the care of thought that it would be necessary to appoint provincial the sick in their homes, 571 societies for other kinds of home medical officers of health, and possibly to delegate to the relief, 132 to provide relief for destitute or neglected provincial councils the dealing with all smaller and local children, and 69 institutions for the defective adults. The health matters. On this the matter dropped, but the discusobject of charity winds up in the hands of one of 12 burial sion on the adjourned motion was resumed the following evensocieties. All these societies work apart from some 600 ing, when in view of the Minister’s promise the night before the churches, which have their own charitable organisations, amendment proposed by Dr. Neethling was formally agreed to. and none of the numerous hospitals are included in the fore- The department, it is hoped, will be charged with the dealing going list. Most of these societies have property exempt with, inter alia, all infectious and dangerous diseases, port from taxation and distribute their funds without control by health, vital statistics, leper asylums, mines, and the health of the State, the latter confining its inspections to the few State labourers on the mines. It is hoped, also, that it will undertake subsidised organisations. Some 500,000 persons-i.e., as investigation and research into the numerous diseases peculiar already stated, about. one resident in nine-enjoy annually to the country, and administer the bacteriological and the ministrations of these sometimes unwise and over- chemical laboratories, other than those engaged solely in liberal associations. The total amount spent annually, ex- veterinary or agricultural work. It should control district clusive altogether, be it remembered, of what is disbursed surgeons. It might also be conveniently charged with all in strictly medical relief, is over .67,000,000. general medical work, such as the administration of the lunacy laws and the Medical Acts. Some anxiety is felt lest Antivivisection Tactics. a department in name only should be established, with a chief The New York State branch of the Society for the Pre- medical officer without any administrative functions whatvention of Cruelty to Animals is about to urge an investiever, and the profession in South Africa is therefore anxiously gation by the State authorities into the various institutes awaiting developments. The object is to obtain the for pathological research. of and free unannounced entry into the laboratories, The Segregation of Lepers. privilege obviously for the purpose of getting material for absurd A debate of some importance took place on Dec. 13th on and misleading literature." the subject of leprosy, when a motion was moved in the Jan. 24th. House of Assembly praying for the removal of the Robben Island lepers to the mainland. This question is one which has been constantly brought forward in the late Cape NOTES FROM SOUTH AFRICA. Parliament, and has been the subject of a large number of commissions of inquiry and select committees. These have (FROM OUR OWN CORRESPONDENT.) brought in the most divergent reports, but generally to the effect that the advantages of the island as a leper settlement A Health Department for South Africa. considerably outweigh its disadvantages. The result has been DURING the past month in South Africa the value of to lead to chronic unrest amongst the lepers, a condition proper organisation in the profession has been demon- which has apparently been aggravated by lay administration. strated. As indicated in previous communications, for some Dr. D. B. Hewat, member for Woodstock, stated in connexion months past efforts have been made to induce the Govern- with the motion that he had grave doubts whether leprosy, or ment to recognise the importance of public health and the at any rate anæsthetic leprosy, was contagious or infectious at. necessity for having a properly equipped health department all, and he pleaded for a commission of experts to go into thefor South Africa. These efforts, however, did not meet with whole question afresh. A number of other members took success, but the agitation was continued, and at length came part in the discussion and very divergent opinions were to a head in Parliament. On Dec. 7th Dr. J. C. McNeillie, expressed. General Smuts, in reply, stated that the whole member for Boksburg, formally moved in the House of question must be sympathetically treated by the Government. Assembly that the Government be requested to consider the The State had to be very careful to segregate lepers in the advisability of the appointment of a Minister of the Crown interests of the general community. He knew that there with the portfolio of Public Health. In his speech he were matters to complain of at Robben Island. It would b& reviewed the position of the country from a public health impossible to administer a settlement of this sort without standpoint, detailing at length the circumstances leading up complaints. The Transvaal Leper Asylum, with which he wasto the agitation which was being carried on by medical personally acquainted, was, he considered, one of the best men throughout the length and breadth of South Africa. in the world, and yet he had complaints from this asylum. Dr. A. C. Neethling, member for Beaufort West, followed, and He expressed his conviction that even if the patients from stated that as a member of the Government party he con- Robben Island were removed to the mainland, that would not curred in what had been said, but, while he considered that stop agitation for release from segregation by the lepers. eventually a definite portfolio of Public Health would have The line drawn in South Africa was, he considered, a to be created, he thought perhaps that the profession was safe one ; the matter was very largely left in the asking for too much at present, and he therefore moved an hands of their experts. Ifa case was considered by
Merriman,
________
343 for segregation at home, then the NOTES FROM INDIA. under certain conditions to live at home, but, if not, then removal to an asylum was necessary. (FROM OUR OWN CORRESPONDENTS.) He thought that discussions on leprosy in the House could only lead to further agitation amongst the lepers, and he therefore deprecated the matter having been brought The lrreatment of Snake-bite. forward. He thought that the Government should IN July, 1909, the Madras Government requested the vigorously encourage the prosecution of research on surgeon-general in charge of the Civil Medical Department leprosy. The Cape Government had appointed a bacterio- of the presidency to submit proposals for bringing into more logist for leprosy research on the island, and this gentleman general use among the public the treatment of snake-bite was doing good work. The present Government was trying in with Sir Lauder Brunton’s lancets and permanganate of addition to persuade Dr. G. Turner, formerly medical officer In October of the same year the Madras Govern. potash. of health of the Transvaal, and one of the greatest experts ment approved the surgeon-general’s proposal to obtain It on leprosy in the world, to return to South Africa. 12,000 lancets for distribution among its subordinates and was, in his opinion, useless having commissions on others in the presidency. The Hon. Surgeon-General P. H. but he that should endeavour leprosy, quite agreed they in his first annual report on the subject, Benson, 1.M.S., to advance their knowledge of the disease by employissued, describes 15 cases of snake-bite thus treated. recently trained medical men to undertake research work ing He states no definite opinion can be formed as to the efficacy at existing asylums. With this the debate ended. It of the treatment until the total number of cases treated I most medical men think, fully recognised by is, with the lancets is fairly large. The Government, in a that there are drawbacks from a medical point of view to memorandum on the report, considers that the Robben Island as a leper settlement, but these drawbacks are covering information supplied regarding these cases is so incomplete mostly capable of being remedied. Moreover, the leper as to make any deductions from it impossible. It is evident inhabitants on the island are not confined to small areas, but that if any useful information is to be obtained from the are able to roam at will over practically its whole extent. It is further instructions are necessary. Although it has often been represented that Robben Island experiment essential to any useful conclusion that the identity of the is unsuitable, and that its leper inhabitants will never be snake by which the bite was inflicted shall be authoritatively contented until removed to the mainland, it is of interest to determined. Directions have accordingly been issued as to note that when the Government of the Orange River Colony the snakes killed for identification to the superintensending in 1908 or 1909 formed a leper settlement in that colony, and dent of the Madras Museum. arranged for the withdrawal of its lepers from Robben A New Hospital for Aundh State. Island, a large number of these lepers are stated to have The need of good hospitals is nowhere more felt than in strongly objected, on the grounds that they were well aware that they enjoyed greater freedom and lived under happier the native States which are dependent on their own revenues conditions than would be possible if settled inland in their for the erection and maintenance of dispensaries and such. own State. In the Aundh State there are at the like institutions. Memorial to the late King. present time only three dispensaries, situated at long Her Excellency the Viscountess Gladstone is, it is under- distances from one another, and this fact has been early stood, about to make an appeal to the public in South Africa recognised by the present occupant of the gadi, Shrimant for funds to establish a national memorial to his late Bala Saheb, Pant Prathinian, who shortly after his inMajesty King Edward VII. A few weeks ago a number of stallation, towards the close of 1909, sanctioned an influential people were called to Government House, Cape estimate for the building of a hospital in the capital Town, when, after discussing the proposal, the following city, Aundh. At his invitation several European and native gentlemen recently witnessed the ceremony of resolutions were agreed to :the foundation-stone. A small camp has been laid 1. That this meeting resolves that it is advisable to raise a national laying South African fund with the object of establishing a memorial to his out by Mr. Jussuff H. Jaffer of Poona, and the comfort of late Majesty King Edward VII. the guests during their brief stay was well looked after by 2. That a Provisional Committee be formed to consider the question and the State Karbhari, Khan Bahadur Jacob Bapuji. of devoting the fund to the formation of a nursing association or some him, other scheme for the alleviation of human suffering, as to the estimated The ceremony of laying the foundation-stone of the instituscope and requirements of such a project. what funds would appear to tion was performed by Mr. Bonus, I. C. S. , Collector of Satara be needed for the various schemes, holding in view the permanent and Political Agent of the Aundh State, before a large nature of the object, and generally to report. gathering assembled in a decorated shamiana on the building It is believed that Her Excellency’s own proposal is likely to site, and before a large gathering of native officials and be adopted-namely, the establishment of an order of gentlemen of the State. The site selected is an elevated trained nurses on the lines of those which have been piece of ground (about four acres in extent) in the township instituted in India, Canada, and Australia. The nurses of Aundh, and the building when completed is estimated to under such a scheme would be allocated to different districts cost close on Rs. 40,000. It will be a stone structure 150 feet and would be controlled by district committees composed of in length by 30 feet in breadth, of a single storey, and will local representatives under the general supervision of a be in charge of an Indian medical man, and is to be called central committee, the expenses of maintenance being met "The King-Emperor Edward the Seventh Hospital." partly by fees fixed as far as possible within the means of Sanitation in Eas7imip. those requiring the attendance of the nurses, and partly from The cholera a central fund raised by public subscription. The alternaepidemic, which appeared in Srinagar and tive proposal is the establishment of one or more central thence spread to other parts of Kashmir last summer, has sanatoriums for consumptives. There is no doubt of the need again drawn attention to the insanitary condition of that for a scheme for supplying district nurses to outlying otherwise charming country. Municipal scavengers under villages in South Africa. Those of us who have been in proper supervision would work wonders for the sanitation of practice in the smaller towns and villages up country know Srinagar. The provision of a good supply of potable water of the grave disabilities under which work has often to be would involve considerable expenditure, but improvement done, owing to the lack of trained nursing assistance. In in the health of Srinagar largely depends on there being most up-country places medical men do not attend many every year some extension of a water-pipe connexion into midwifery cases except among the wealthier classes, and the areas where at present the people depend for their drinkingmajority of confinements are attended by coloured midwives, supplies on all sorts of contaminated sources. Long years of without training and generally of filthy habits. No wonder, misery and poverty have made the people lazy and indifferent, therefore, that the amount of puerperal fever in this country ready to follow blindly the insanitary practices of their is excessive. If the committee can devise a satisfactory fathers, but every additional hydrant helps to wean a certain scheme for supplying trained nurses and the scheme can be number from their ancient customs and leads them to value given effect to much good will result, not only directly, but the provision of a pure water-supply. As the City of London indirectly, owing to the educative influences which would be was freed from the visitations of plague by the Great Fire, at work with the advent of trained nurses into ignorant which swept away thousands of crowded tenements and insanitary areas, so it is probable a great conflagration households-a truly national memorial to a great king. might not be an unmixed evil in many an eastern town. But Jan. 2nd.
their experts suitable patient was permitted
Merriman,
________
343 for segregation at home, then the NOTES FROM INDIA. under certain conditions to live at home, but, if not, then removal to an asylum was necessary. (FROM OUR OWN CORRESPONDENTS.) He thought that discussions on leprosy in the House could only lead to further agitation amongst the lepers, and he therefore deprecated the matter having been brought The lrreatment of Snake-bite. forward. He thought that the Government should IN July, 1909, the Madras Government requested the vigorously encourage the prosecution of research on surgeon-general in charge of the Civil Medical Department leprosy. The Cape Government had appointed a bacterio- of the presidency to submit proposals for bringing into more logist for leprosy research on the island, and this gentleman general use among the public the treatment of snake-bite was doing good work. The present Government was trying in with Sir Lauder Brunton’s lancets and permanganate of addition to persuade Dr. G. Turner, formerly medical officer In October of the same year the Madras Govern. potash. of health of the Transvaal, and one of the greatest experts ment approved the surgeon-general’s proposal to obtain It on leprosy in the world, to return to South Africa. 12,000 lancets for distribution among its subordinates and was, in his opinion, useless having commissions on others in the presidency. The Hon. Surgeon-General P. H. but he that should endeavour leprosy, quite agreed they in his first annual report on the subject, Benson, 1.M.S., to advance their knowledge of the disease by employissued, describes 15 cases of snake-bite thus treated. recently trained medical men to undertake research work ing He states no definite opinion can be formed as to the efficacy at existing asylums. With this the debate ended. It of the treatment until the total number of cases treated I most medical men think, fully recognised by is, with the lancets is fairly large. The Government, in a that there are drawbacks from a medical point of view to memorandum on the report, considers that the Robben Island as a leper settlement, but these drawbacks are covering information supplied regarding these cases is so incomplete mostly capable of being remedied. Moreover, the leper as to make any deductions from it impossible. It is evident inhabitants on the island are not confined to small areas, but that if any useful information is to be obtained from the are able to roam at will over practically its whole extent. It is further instructions are necessary. Although it has often been represented that Robben Island experiment essential to any useful conclusion that the identity of the is unsuitable, and that its leper inhabitants will never be snake by which the bite was inflicted shall be authoritatively contented until removed to the mainland, it is of interest to determined. Directions have accordingly been issued as to note that when the Government of the Orange River Colony the snakes killed for identification to the superintensending in 1908 or 1909 formed a leper settlement in that colony, and dent of the Madras Museum. arranged for the withdrawal of its lepers from Robben A New Hospital for Aundh State. Island, a large number of these lepers are stated to have The need of good hospitals is nowhere more felt than in strongly objected, on the grounds that they were well aware that they enjoyed greater freedom and lived under happier the native States which are dependent on their own revenues conditions than would be possible if settled inland in their for the erection and maintenance of dispensaries and such. own State. In the Aundh State there are at the like institutions. Memorial to the late King. present time only three dispensaries, situated at long Her Excellency the Viscountess Gladstone is, it is under- distances from one another, and this fact has been early stood, about to make an appeal to the public in South Africa recognised by the present occupant of the gadi, Shrimant for funds to establish a national memorial to his late Bala Saheb, Pant Prathinian, who shortly after his inMajesty King Edward VII. A few weeks ago a number of stallation, towards the close of 1909, sanctioned an influential people were called to Government House, Cape estimate for the building of a hospital in the capital Town, when, after discussing the proposal, the following city, Aundh. At his invitation several European and native gentlemen recently witnessed the ceremony of resolutions were agreed to :the foundation-stone. A small camp has been laid 1. That this meeting resolves that it is advisable to raise a national laying South African fund with the object of establishing a memorial to his out by Mr. Jussuff H. Jaffer of Poona, and the comfort of late Majesty King Edward VII. the guests during their brief stay was well looked after by 2. That a Provisional Committee be formed to consider the question and the State Karbhari, Khan Bahadur Jacob Bapuji. of devoting the fund to the formation of a nursing association or some him, other scheme for the alleviation of human suffering, as to the estimated The ceremony of laying the foundation-stone of the instituscope and requirements of such a project. what funds would appear to tion was performed by Mr. Bonus, I. C. S. , Collector of Satara be needed for the various schemes, holding in view the permanent and Political Agent of the Aundh State, before a large nature of the object, and generally to report. gathering assembled in a decorated shamiana on the building It is believed that Her Excellency’s own proposal is likely to site, and before a large gathering of native officials and be adopted-namely, the establishment of an order of gentlemen of the State. The site selected is an elevated trained nurses on the lines of those which have been piece of ground (about four acres in extent) in the township instituted in India, Canada, and Australia. The nurses of Aundh, and the building when completed is estimated to under such a scheme would be allocated to different districts cost close on Rs. 40,000. It will be a stone structure 150 feet and would be controlled by district committees composed of in length by 30 feet in breadth, of a single storey, and will local representatives under the general supervision of a be in charge of an Indian medical man, and is to be called central committee, the expenses of maintenance being met "The King-Emperor Edward the Seventh Hospital." partly by fees fixed as far as possible within the means of Sanitation in Eas7imip. those requiring the attendance of the nurses, and partly from The cholera a central fund raised by public subscription. The alternaepidemic, which appeared in Srinagar and tive proposal is the establishment of one or more central thence spread to other parts of Kashmir last summer, has sanatoriums for consumptives. There is no doubt of the need again drawn attention to the insanitary condition of that for a scheme for supplying district nurses to outlying otherwise charming country. Municipal scavengers under villages in South Africa. Those of us who have been in proper supervision would work wonders for the sanitation of practice in the smaller towns and villages up country know Srinagar. The provision of a good supply of potable water of the grave disabilities under which work has often to be would involve considerable expenditure, but improvement done, owing to the lack of trained nursing assistance. In in the health of Srinagar largely depends on there being most up-country places medical men do not attend many every year some extension of a water-pipe connexion into midwifery cases except among the wealthier classes, and the areas where at present the people depend for their drinkingmajority of confinements are attended by coloured midwives, supplies on all sorts of contaminated sources. Long years of without training and generally of filthy habits. No wonder, misery and poverty have made the people lazy and indifferent, therefore, that the amount of puerperal fever in this country ready to follow blindly the insanitary practices of their is excessive. If the committee can devise a satisfactory fathers, but every additional hydrant helps to wean a certain scheme for supplying trained nurses and the scheme can be number from their ancient customs and leads them to value given effect to much good will result, not only directly, but the provision of a pure water-supply. As the City of London indirectly, owing to the educative influences which would be was freed from the visitations of plague by the Great Fire, at work with the advent of trained nurses into ignorant which swept away thousands of crowded tenements and insanitary areas, so it is probable a great conflagration households-a truly national memorial to a great king. might not be an unmixed evil in many an eastern town. But Jan. 2nd.
their experts suitable patient was permitted