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PUBLIC HEALTH IN CAPE TOWN.
150 W. P. Cooney, in his report as to the work of the male V.D. centre, emphasises the need for education of the public, and points out that suitably trained coloured and native lecturers would do an immenseamount of good in this direction. As examples of the prevalence of venereal disease in Cape Town, he mentions one household where three servants out of five were suffering from syphilis, one being in an infeetious state, and a public institution in which four members of the staff were sufferers, two of whom, one infectious, were concerned with food preparation. The want of proper homes, lack of education, and the almost complete absence of moral sense in a number of patients attending the clinic are some of the difficulties. One of the greatest dangers is supplied by the large floating population of the casual type who sleep in the open and cannot be induced to attend for regular "treatment. In spite of these difficulties only one case of accidentally acquired " syphilis was noted during the past year. One definite case of reinfection of syphilis was also noted. In her account of the female V.D. clinic, Dr. Mary van Ingen shows that 64 pregnant women were treated, and that of these 32 gave birth to healthy infants, 20 ceased to attend with results unknown, one infant was born with spina bifida and died at 17 days old, while the remaining five whose treatment was insufficient had stillbirths or infants who developed syphilis. Three of the last-mentioned five only came up for treatment during the last month of pregnancy. New regulations for protecting the milk-supply were i-ntroduced in October, 1922, and follow lines which are familiar in this country. Attention is given to the protection of meat while on sale by the provision of fly- and dust-proof screens, and improvements have been made in the type of carts and wagons used in the conveyance of meat. During the summer months two men are constantly employed in dealing with the mosquito and fly nuisance. Two deaths of Europeans from malaria were recorded during the year—on eat the ageperiod 1 to 5, and the other at the age-period 35 to 45. A large amount of work has been done in repairing and improving insanitary property, but owing to the scarcity of houses the council has been holding its hand with regard to closing of houses.
PUBLIC HEALTH IN CAPE TOWN. WE have received from Dr. T. Shadick Higgins the annual health report of Cape Town for the year ended June 30th, 1923. Dr. Higgins only took over the duties on June 18th, 1923, so that the period dealt with shows the health position
at the beginning of his term of office. It may therefore be of mterest to give a table showing some of the principal health statistics for the European and non-European populations respectively, for comparison with English districts.
It will be noted that the statistics of the European population of Cape Town do not differ appreciably from those of a clean-aired English town, while the non-European population has a very high birth-rate and an excessive death-rate from all causes, tuberculosis and respiratory diseases, the deathrate from cancer being low and the maternity mortality from childbirth being equal to that of the Europeans. Dr. Higgins, in presenting the report, pays a tribute to the good work of his predecessor, Dr. A. Jasper Anderson, the first whole-time medical officer of health for the city, who gave up his appointment on March 31st, 1923, after over 21 years’ service. A study of the report makes it obvious that public health JUNKET POWDER. problems in Cape Town are not essentially different from Messrs. Edward Birks and Son, 88, Castle-street, Reading, those iD the old country. Thus, among the admissions to the City Hospital for Infectious Diseases, the only unusual have submitted to us a sample of junket powder which ailments are one fatal case of anthrax, and one case of consists of active rennet in a desiccated form. Our tests Malta fever which recovered. Enteric fever heads the list have shown that junket made by its use possesses all the while the dry numerically, as might have happened in an English hospital qualities of that made with liquid rennet, its qualities unimpaired and has the additional during the ’eighties of last century. In the table giving the powder keeps causes of death, the most striking features are the prominence advantage of being easily portable. Birks’s junket powder of enteric feveramong both races, and of diarrhoea, disease is sold in bottles from 4d. to 3s. 6d., and a small wooden of the stomach, enteritis, syphilis, bronchitis, and pneu- measure is supplied with each bottle. monia amongst the non-European population. During the year seven cases of leprosy were notified, one European ARE WHITE CATS WITH BLUE EYES DEAF? female and three each of non-European males and females. To the Editor of THE LANCET. There were no deaths from leprosy recorded. An outbreak of influenza occurred during June, 1922, and continued into SIR,-There is an interesting article in the Quarterly the year under review, and was accountable for seven Journal of Medicine, April, 1924, by Dr. Stobie, on the European and five non-European deaths. As in many parts association of blue sclerotics with brittle bones and progresof England, a small-pox hospital serves the purpose of many sive deafness. I was not aware of the associated deafness till surrounding districts. The report of the maternity and child I read this recently. Long ago I read the statement-I welfare work, submitted by Dr. Mary van Ingen, shows that ’I, rather think in one of Darwin’s works-that white cats with this department is administered on similar lines to those at blue eyes are always deaf. I have once or twice been able home. There are ten sanitary inspectresses and a chief. The to verify this, though not recently, but I would suggest that notification of every child born after the completion of the the coincidence is sufficiently striking to make it worth while sixth month of pregnancy, whether alive or dead, is required to follow up this interesting problem in comparative pathowithin 24 hours. Of 7088 births notified during the year, logy to see whether the resemblance is more than superficial. 6337 were notified by midwives and nurses, 740 by parents I feel fairly sure that in one case the same features appeared and others, and 11 by doctors. Five bureaus for infant in some of the kittens, but I did not look closely at the sclera are in operation, and their work continues to or do more than satisfy myself as to the deafness. increase. Voluntary workers give their help. Minor ailments I, I am, Sir, yours faithfully, are treated at the bureaus, dried mild is supplied to infants EDMUND HOBHOUSE. who cannot be breast-fed, and free dinners are provided at Brechin-place, S.W., July 10th, 1924. two centres for poor nursing mothers. A sanatorium is needed for tuberculosis, as the accommodation in the CLERGYMEN AND HOUSEMAID’S KNEE. infectious diseases hospital is inadequate. Last year 100 cases were admitted to the last-named hospital. IN the recent Conjoint Examination a candidate, who had Dr. already given evidence of common sense as well as surgical acumen, was asked by one of the examining surgeons why clergymen did not suffer from housemaid’s knee. The IMPROVED METHOD FOR ARTIFICIAL RESPIRATION: answer desired was that housemaids habitually strain to scrub REFERENCES. or dust more ground when kneeling on one spot than they can conveniently reach, and therefore poise themselves on A. Keith : THE LANCET, March 13th, 20th, 27th, 1909, pp. 745, &c. the patella with their heels in the air ; whereas clergymen Meltzer : Jour. A.M.A., May 10th, 1913, lx., 1407. Committee Jour. A.M.A. : Sept. 26th, 1914. kneel decorously on the tuberosity of the tibia, almost Kuhn : Zentralblatt für Chirurgie, 1908, p. 788. on their heels. This is an ingenious suggestion which sitting Meltzer : Intra-tracheal Insufflation, Medical Record, New York, well form a subject of instruction for domestic workers. March 19th, 1910, p. 477; Jour. A.M.A., August 12th, 1911, might p. 521 ; Jour. Experimental Medicine, 1909, p. 622. Harrison : Detroit Medical Journal, 1916, p. 269 ; The Use of Bellows in Artificial Respiration, A.D. 1530 to 1830, Medical Portable Radiographs.-The telephonic address of this firm Record, New York, 1917, xc. 11, 1 to 10. at 1, Woodstock-road, Bedford Park, London, W. 4, on whose Hewer : Brit. Med. Jour., Feb. 12th, 1921. work we commented in last week’s issue of THE LANCET, O’Dwyer: New York Medical Record, Sept. 16th, 1911. is Chiswick 2162. Technical Paper No. 77, Gov. Printing Office, Washington, D.C.
’,
I
consultations
PUBLIC HEALTH IN CAPE TOWN. WE have received from Dr. T. Shadick Higgins the annual health report of Cape Town for the year ended June 30th, 1923. Dr. Higgins only took over the duties on June 18th, 1923, so that the period dealt with shows the health position
at the beginning of his term of office. It may therefore be of mterest to give a table showing some of the principal health statistics for the European and non-European populations respectively, for comparison with English districts.
It will be noted that the statistics of the European population of Cape Town do not differ appreciably from those of a clean-aired English town, while the non-European population has a very high birth-rate and an excessive death-rate from all causes, tuberculosis and respiratory diseases, the deathrate from cancer being low and the maternity mortality from childbirth being equal to that of the Europeans. Dr. Higgins, in presenting the report, pays a tribute to the good work of his predecessor, Dr. A. Jasper Anderson, the first whole-time medical officer of health for the city, who gave up his appointment on March 31st, 1923, after over 21 years’ service. A study of the report makes it obvious that public health JUNKET POWDER. problems in Cape Town are not essentially different from Messrs. Edward Birks and Son, 88, Castle-street, Reading, those iD the old country. Thus, among the admissions to the City Hospital for Infectious Diseases, the only unusual have submitted to us a sample of junket powder which ailments are one fatal case of anthrax, and one case of consists of active rennet in a desiccated form. Our tests Malta fever which recovered. Enteric fever heads the list have shown that junket made by its use possesses all the while the dry numerically, as might have happened in an English hospital qualities of that made with liquid rennet, its qualities unimpaired and has the additional during the ’eighties of last century. In the table giving the powder keeps causes of death, the most striking features are the prominence advantage of being easily portable. Birks’s junket powder of enteric feveramong both races, and of diarrhoea, disease is sold in bottles from 4d. to 3s. 6d., and a small wooden of the stomach, enteritis, syphilis, bronchitis, and pneu- measure is supplied with each bottle. monia amongst the non-European population. During the year seven cases of leprosy were notified, one European ARE WHITE CATS WITH BLUE EYES DEAF? female and three each of non-European males and females. To the Editor of THE LANCET. There were no deaths from leprosy recorded. An outbreak of influenza occurred during June, 1922, and continued into SIR,-There is an interesting article in the Quarterly the year under review, and was accountable for seven Journal of Medicine, April, 1924, by Dr. Stobie, on the European and five non-European deaths. As in many parts association of blue sclerotics with brittle bones and progresof England, a small-pox hospital serves the purpose of many sive deafness. I was not aware of the associated deafness till surrounding districts. The report of the maternity and child I read this recently. Long ago I read the statement-I welfare work, submitted by Dr. Mary van Ingen, shows that ’I, rather think in one of Darwin’s works-that white cats with this department is administered on similar lines to those at blue eyes are always deaf. I have once or twice been able home. There are ten sanitary inspectresses and a chief. The to verify this, though not recently, but I would suggest that notification of every child born after the completion of the the coincidence is sufficiently striking to make it worth while sixth month of pregnancy, whether alive or dead, is required to follow up this interesting problem in comparative pathowithin 24 hours. Of 7088 births notified during the year, logy to see whether the resemblance is more than superficial. 6337 were notified by midwives and nurses, 740 by parents I feel fairly sure that in one case the same features appeared and others, and 11 by doctors. Five bureaus for infant in some of the kittens, but I did not look closely at the sclera are in operation, and their work continues to or do more than satisfy myself as to the deafness. increase. Voluntary workers give their help. Minor ailments I, I am, Sir, yours faithfully, are treated at the bureaus, dried mild is supplied to infants EDMUND HOBHOUSE. who cannot be breast-fed, and free dinners are provided at Brechin-place, S.W., July 10th, 1924. two centres for poor nursing mothers. A sanatorium is needed for tuberculosis, as the accommodation in the CLERGYMEN AND HOUSEMAID’S KNEE. infectious diseases hospital is inadequate. Last year 100 cases were admitted to the last-named hospital. IN the recent Conjoint Examination a candidate, who had Dr. already given evidence of common sense as well as surgical acumen, was asked by one of the examining surgeons why clergymen did not suffer from housemaid’s knee. The IMPROVED METHOD FOR ARTIFICIAL RESPIRATION: answer desired was that housemaids habitually strain to scrub REFERENCES. or dust more ground when kneeling on one spot than they can conveniently reach, and therefore poise themselves on A. Keith : THE LANCET, March 13th, 20th, 27th, 1909, pp. 745, &c. the patella with their heels in the air ; whereas clergymen Meltzer : Jour. A.M.A., May 10th, 1913, lx., 1407. Committee Jour. A.M.A. : Sept. 26th, 1914. kneel decorously on the tuberosity of the tibia, almost Kuhn : Zentralblatt für Chirurgie, 1908, p. 788. on their heels. This is an ingenious suggestion which sitting Meltzer : Intra-tracheal Insufflation, Medical Record, New York, well form a subject of instruction for domestic workers. March 19th, 1910, p. 477; Jour. A.M.A., August 12th, 1911, might p. 521 ; Jour. Experimental Medicine, 1909, p. 622. Harrison : Detroit Medical Journal, 1916, p. 269 ; The Use of Bellows in Artificial Respiration, A.D. 1530 to 1830, Medical Portable Radiographs.-The telephonic address of this firm Record, New York, 1917, xc. 11, 1 to 10. at 1, Woodstock-road, Bedford Park, London, W. 4, on whose Hewer : Brit. Med. Jour., Feb. 12th, 1921. work we commented in last week’s issue of THE LANCET, O’Dwyer: New York Medical Record, Sept. 16th, 1911. is Chiswick 2162. Technical Paper No. 77, Gov. Printing Office, Washington, D.C.
’,
I
consultations