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OVERCROWDING IN TRAINS.
THE HOSPITAL ISOLATION OF SCARLET FEVER.
1737
danger, kindly to the sick, friendly with colleagues, isolation and reminds us that in THE LANCET of June l3th,. temperate, sober, pitiful, not covetous, not greedy of gain." 1896, p. 1672You will find a letter from me on Isolation and the Public Health. Mr. Cadge was always zealous for the dignity of his proAct," in which I think I anticipated even Mr. Marriott in contending fession and his wide experience of life made him ever lean to that the necessity for public hospitals for infectious diseases (at any the side of mercy. To know to what temptations men rate, scarlet fever and diphtheria) was far from being proved. My mainwere : (1) fever hospitals are not conducive to the speedy succumb is easy ; to know those which they have resisted is propositions recovery of such patients or to the absence of complications; (2) removat of scarlet fever patients does not lessen the prevalence or the spread of difficult. Mr. Cadge was not a surgeon only ; lie had a full the disease; (3) maintenance of non-indigent patients at the public sense of his civic responsibilities and benevolence was with expense is an nn,just burden on the ratepayers ; (4) most cases of scarlet him a habit. Unceasingly did he cultivate the charities of fever arise from infection by slight and unnoticed cases. In your issueof the following week (June 20th. 1896) Mr. W. Berry, medical officer of’ life as citizen and friend, no less than as philanthropist and health of Wigan, wrote a letter in my support, and not long afterwards (in the same year) Mr. Marriott of Nottingham also entered the’ physician. The window was then formally dedicated by the field on the same side. I have always read his letters on the subject Dean. The subject of the window is Our Lord healing the with great interest and I have applauded the energy with which he hascontinued the attack. It is satisfactory to find that there is likely to sick and it was executed by Messrs. Burlison and Grylls. be a public inquiry into the matter, with some prospect of reform. Underneath it are placed two dedicatory tablets. in Dr. Benham when he wrote to us in 1896 in
.
"
was- practising
may be allowed to add to the foregoing that in our issue of Oct. 23rd, 1897, p. 1040, Mr. Arthur Wiglesworth of Liverpool published under theheading of Isolation in Scarlet Fever Unnecessary and Inexpedientalong paper which he said "was read beforethe Liverpool Medical Society nearly four years ago."
Elizabeth-street, London, S.W. We OVERCROWDING IN TRAINS.
DURING a Board of Trade inquiry which was held on Nov. 5th and 21st into the necessity for further workmen’s trains on the London, Tilburv, and Southend Railway and the Whitechapel and Bow Railway some startling evidence was given as to the overcrowding of trains running over these companies’ lines. The inquiry was held on the petition "EKIRI," AN EPIDEMIC FORM OF INFANTILE of the London County Council. Colonel H. A. Yorke, chief DIARRHŒA IN JAPAN. inspecting officer of railways, Board of Trade, conducted VARIOUS views have been expressed by Japanese phythe inquiry for the Board of Trade, while Mr. Dickens, as to the pathogenesis of sicians ekiri," an acute and fatal K.C., and Mr. Corrie Grant appeared for the London diarrhoea. some it has been regarded form of By epidemic County Council. The railway companies were represented of acute as a since the diseaseepidemic meningitis, variety by Mr. W. J. Noble. Observations had been made by with cerebral is associated symptoms, especially in usually the London County Council inspectors many times of it is others regarded as a severe form of the overcrowding’ and the result showed that things were young children; by in and due to the bacillus. childhood In one of the trains it was impossible dysentery occurring now worse than ever. of it has been to count the passengers accurately. The figures for this train Shiga. Recently regarded as acute follicular enteritis. An account of the disease showed that with accommodation for 942 passengers about interesting with records of 1680 passengers were carried. Mr. Dickens argued that by a bacteriological investigations is given by of Fukuoka, Japan, in the Archiv für Dr. Sukehiko Ito rearrangement of the times of the trains it was possible to make additions to the service. There was a crying need for Kinderheilkunde, 1904, Band 39. The inc:ubation period lie improvement. Evidence was given by residents at East estimates at from 12 to 24 hours from a careful study of 21Ham, Manor Park, Plaistow, Canning Town, and Upton cases ; this is followed by a prodromal stage and a fastigium Park, whose evidence all went to show that the overcrowding The characters of the prodromal stage are as follow. A prewas terrible. We understand that Colonel Yorke will make viously healthy child evacuates copious loose offensive stools his report to the Board of Trade in due course and when often admixed with undigested food and sometimes with a that is done we hope to see some practical benefit arise from small quantity of mucus. The general condition of the child the petition of the London County Council which, we are is depressed and the temperature rises to from 38° to 39’ C. glad to see, is awake to the necessities of saving a section of Occasionally abdominal pain and vomiting occur. In the Londoners from sufferings comparable only to those of some fastigium the fever increases and the character of the stools. of the poor wretches who used to be confined under the changes to a watery mucus ; the abdomen has a soft doughy hatches in the Arab slave dhows. We trust the day of feel. Later cerebral symptoms develop, unconsciousness with emancipation may soon dawn and that it will not be said severe general tonic-clonic spasms being not infrequently folthat though a company may not suffocate and squeeze a man lowed by deep coma. The course of the disease is almost invarito death in the daylight on the highway it may do so ably acute and very frequently fatal. Recently an improvement in the recovery rate has occurred, but even now at least onewith impunity when it gets him underground in the dark. third of the children attacked by the disease succumb to it. Dr. Ito has isolated an organism from the stools of patients THE HOSPITAL ISOLATION OF SCARLET FEVER. suffering from the disease which he regards as the pathogenicTHE isolation of scarlet fever patients in special hospitals, agent and to which he has given the name of the ekiri whether such isolation be voluntary on the part of the family bacillus. Its microscopical features are closely similaror enforced against their will, involves a multiplicity of to those of the bacillus coli communis. It is pathogenic debateable questions, some of which have been frequently for mice, guinea-pigs, rabbits, fowls, and pigeons, and it. referred to in THE LANCET. In our issues of August 27th agglutinates with the serum of patients who have recovered and Nov. 5th (p. 624) (p. 1297), 1904, we recapitulated some from the disease and with that of animals immunised to. which have been of recent years urged against the it. It is not found in healthy people but only in cases of arguments did in We not these articles attempt to cover the ekiri. The features of this disease seem to be very similar tosystem. whole ground and did not trace the opposition further back those of the epidemic summer diarrhoea or cholera infantum than a notice of a pamphlet by Mr. E. D. Marriott of of our own large towns and the cerebral symptoms are Nottingham and letters of his published in THE LANCET doubtless analogous to those occurring in that disease, and to. of December, 1900. We have now, however, received a which Marshall Hall applied the name of hydrocephaloid. letter from Dr. F. Lucas Benham of Campden House, The observations are of interest in this connexion, as if the Exeter, South Australia, who, after referrirg to the above- ekiri bacillus prove on further investigation to be the cause mentioned article of August 27th, says that he has for a of this disease in Japan, a,s the Shiga and Flexner bacilli number of years interested himself in this question of have in other cases elsewhere, the differentiation of the: ,.
1737
danger, kindly to the sick, friendly with colleagues, isolation and reminds us that in THE LANCET of June l3th,. temperate, sober, pitiful, not covetous, not greedy of gain." 1896, p. 1672You will find a letter from me on Isolation and the Public Health. Mr. Cadge was always zealous for the dignity of his proAct," in which I think I anticipated even Mr. Marriott in contending fession and his wide experience of life made him ever lean to that the necessity for public hospitals for infectious diseases (at any the side of mercy. To know to what temptations men rate, scarlet fever and diphtheria) was far from being proved. My mainwere : (1) fever hospitals are not conducive to the speedy succumb is easy ; to know those which they have resisted is propositions recovery of such patients or to the absence of complications; (2) removat of scarlet fever patients does not lessen the prevalence or the spread of difficult. Mr. Cadge was not a surgeon only ; lie had a full the disease; (3) maintenance of non-indigent patients at the public sense of his civic responsibilities and benevolence was with expense is an nn,just burden on the ratepayers ; (4) most cases of scarlet him a habit. Unceasingly did he cultivate the charities of fever arise from infection by slight and unnoticed cases. In your issueof the following week (June 20th. 1896) Mr. W. Berry, medical officer of’ life as citizen and friend, no less than as philanthropist and health of Wigan, wrote a letter in my support, and not long afterwards (in the same year) Mr. Marriott of Nottingham also entered the’ physician. The window was then formally dedicated by the field on the same side. I have always read his letters on the subject Dean. The subject of the window is Our Lord healing the with great interest and I have applauded the energy with which he hascontinued the attack. It is satisfactory to find that there is likely to sick and it was executed by Messrs. Burlison and Grylls. be a public inquiry into the matter, with some prospect of reform. Underneath it are placed two dedicatory tablets. in Dr. Benham when he wrote to us in 1896 in
.
"
was- practising
may be allowed to add to the foregoing that in our issue of Oct. 23rd, 1897, p. 1040, Mr. Arthur Wiglesworth of Liverpool published under theheading of Isolation in Scarlet Fever Unnecessary and Inexpedientalong paper which he said "was read beforethe Liverpool Medical Society nearly four years ago."
Elizabeth-street, London, S.W. We OVERCROWDING IN TRAINS.
DURING a Board of Trade inquiry which was held on Nov. 5th and 21st into the necessity for further workmen’s trains on the London, Tilburv, and Southend Railway and the Whitechapel and Bow Railway some startling evidence was given as to the overcrowding of trains running over these companies’ lines. The inquiry was held on the petition "EKIRI," AN EPIDEMIC FORM OF INFANTILE of the London County Council. Colonel H. A. Yorke, chief DIARRHŒA IN JAPAN. inspecting officer of railways, Board of Trade, conducted VARIOUS views have been expressed by Japanese phythe inquiry for the Board of Trade, while Mr. Dickens, as to the pathogenesis of sicians ekiri," an acute and fatal K.C., and Mr. Corrie Grant appeared for the London diarrhoea. some it has been regarded form of By epidemic County Council. The railway companies were represented of acute as a since the diseaseepidemic meningitis, variety by Mr. W. J. Noble. Observations had been made by with cerebral is associated symptoms, especially in usually the London County Council inspectors many times of it is others regarded as a severe form of the overcrowding’ and the result showed that things were young children; by in and due to the bacillus. childhood In one of the trains it was impossible dysentery occurring now worse than ever. of it has been to count the passengers accurately. The figures for this train Shiga. Recently regarded as acute follicular enteritis. An account of the disease showed that with accommodation for 942 passengers about interesting with records of 1680 passengers were carried. Mr. Dickens argued that by a bacteriological investigations is given by of Fukuoka, Japan, in the Archiv für Dr. Sukehiko Ito rearrangement of the times of the trains it was possible to make additions to the service. There was a crying need for Kinderheilkunde, 1904, Band 39. The inc:ubation period lie improvement. Evidence was given by residents at East estimates at from 12 to 24 hours from a careful study of 21Ham, Manor Park, Plaistow, Canning Town, and Upton cases ; this is followed by a prodromal stage and a fastigium Park, whose evidence all went to show that the overcrowding The characters of the prodromal stage are as follow. A prewas terrible. We understand that Colonel Yorke will make viously healthy child evacuates copious loose offensive stools his report to the Board of Trade in due course and when often admixed with undigested food and sometimes with a that is done we hope to see some practical benefit arise from small quantity of mucus. The general condition of the child the petition of the London County Council which, we are is depressed and the temperature rises to from 38° to 39’ C. glad to see, is awake to the necessities of saving a section of Occasionally abdominal pain and vomiting occur. In the Londoners from sufferings comparable only to those of some fastigium the fever increases and the character of the stools. of the poor wretches who used to be confined under the changes to a watery mucus ; the abdomen has a soft doughy hatches in the Arab slave dhows. We trust the day of feel. Later cerebral symptoms develop, unconsciousness with emancipation may soon dawn and that it will not be said severe general tonic-clonic spasms being not infrequently folthat though a company may not suffocate and squeeze a man lowed by deep coma. The course of the disease is almost invarito death in the daylight on the highway it may do so ably acute and very frequently fatal. Recently an improvement in the recovery rate has occurred, but even now at least onewith impunity when it gets him underground in the dark. third of the children attacked by the disease succumb to it. Dr. Ito has isolated an organism from the stools of patients THE HOSPITAL ISOLATION OF SCARLET FEVER. suffering from the disease which he regards as the pathogenicTHE isolation of scarlet fever patients in special hospitals, agent and to which he has given the name of the ekiri whether such isolation be voluntary on the part of the family bacillus. Its microscopical features are closely similaror enforced against their will, involves a multiplicity of to those of the bacillus coli communis. It is pathogenic debateable questions, some of which have been frequently for mice, guinea-pigs, rabbits, fowls, and pigeons, and it. referred to in THE LANCET. In our issues of August 27th agglutinates with the serum of patients who have recovered and Nov. 5th (p. 624) (p. 1297), 1904, we recapitulated some from the disease and with that of animals immunised to. which have been of recent years urged against the it. It is not found in healthy people but only in cases of arguments did in We not these articles attempt to cover the ekiri. The features of this disease seem to be very similar tosystem. whole ground and did not trace the opposition further back those of the epidemic summer diarrhoea or cholera infantum than a notice of a pamphlet by Mr. E. D. Marriott of of our own large towns and the cerebral symptoms are Nottingham and letters of his published in THE LANCET doubtless analogous to those occurring in that disease, and to. of December, 1900. We have now, however, received a which Marshall Hall applied the name of hydrocephaloid. letter from Dr. F. Lucas Benham of Campden House, The observations are of interest in this connexion, as if the Exeter, South Australia, who, after referrirg to the above- ekiri bacillus prove on further investigation to be the cause mentioned article of August 27th, says that he has for a of this disease in Japan, a,s the Shiga and Flexner bacilli number of years interested himself in this question of have in other cases elsewhere, the differentiation of the: ,.