ROYAL INSTITUTE OF PUBLIC HEALTH ; THE BERLIN CONGRESS.

1420 T It appears to reduce the output of sugar, diminish the signs of acidosis, and prolong the life of the patient. Two of the most important points dealt with in Dr. Strouse’s review are the selection of cases and the proper It is apparently inadvisable method of using the cure. to employ it in mild cases, which respond well to the ordinary dietetic restrictions. Such cases appear in some instances to have been harmed rather than benefited by it. The oatmeal cure seems to produce the most striking effects in those cases in which the ordinary limitations of carbohydrate intake either fail to cause the desired diminution of the sugar in the urine or tend to produce acidosis. The method of preparing the gruel is to add 250 or 300 grammes of washed butter to 250 grammes of cooked American oats, the two being thoroughly mixed while hot, and then divided into three or four portions, to be taken during the day. At each feed one or two eggs may be added to the gruel, but the general tendency now is to limit the day’s food to the oats and butter. It is usual to allow as much water as the patient wants, and in Germany a little light wine is permitted. No other food is given on the oatmeal days, and the addition of meat or of In other carbohydrates renders the treatment valueless. order to prepare the patient it appears to be best to get him as nearly sugar-free as possible. The directions given by Falta, who has devoted special attention to the subject, are that after reducing the patient to as low a carbohydrate allowance as he can take without danger, he is given nothing but vegetables of low carbohydrate content for two days, then the gruel for three or four days, then two more days of vegetables, and, in some instances, another course of oatmeal. Von Noorden and others classify the cases treated in four groups according to the results obtained. The first comprises those who are not relieved by ordinary treatment, but in whom the oatmeal cure produces not only marked lowering of the acidosis but also an increased tolerance of sugar. In the second group the results are similar but temporary ; in the third the glycosuria persists but the acidosis is diminished, and after the oatmeal days the patient has a more or less decided increase in his tolerance for carbohydrates. The fourth group, which according to most reports is a small one, is made up of cases showing no reaction to the treatment. In patients with diabetes on whom surgical procedures are necessary a course of oatmeal diet after the operation may prevent the onset of coma. The explanation of the beneficial effects of oatmeal in diabetes is still a matter of speculation. Various theories have been advanced by von Noorden, Naunvn, Falta, Lampe, Luethje, and Klotz, but none of them has yet brought forward convincing proofs in support. Dr. Strouse refers briefly to these theories and discusses them. His interesting review is a valuable summary of an important matter and is worthy of careful consideration.

Allbutt), Bacteriology and Comparative Pathology (President, Professor G. Sims Woodhead), Child-Study and School Hygiene (President, Sir James Crichton-Browne),. Naval, Military, and Colonial (President, Major Sir Ronald Ross), and Municipal Engineering, Architecture, and Town Planning (President, Mr. P. C. Cowan, D.Sc., Chief Engineer of the Local Government Board). A number of prominent medical men have indicated their intention of reading papers The President of the or of taking part in the discussions. Earl is Beauchamp. Very complete arrangements for Congress travelling and hotel accommodation have been made;and opportunities will be given for visiting the various public

measures.

ROYAL

INSTITUTE OF PUBLIC HEALTH ; BERLIN CONGRESS.

THE

FROM Thursday, July 25th, to Sunday, July 28th, the Royal Institute of Public Health, of which His Majesty King George V. is patron, will hold a congress at Berlin. The preliminary programme, which has just been issued, affords

indication of the importance of the proceedings both a scientific point of view and also from that of a Sir T. Vezey common friendship between the two countries. Strong is the chairman of the English Organisation Committee. The reception room and offices of the Congress will be in the Herren Haus (Imperial House of Lords), where the whole of the meetings in connexion with the Congress will also be held. The proceedings will be divided into five sections-namely, State Medicine (President, Sir T. Clifford some

from

health and educational institutions in Berlin in connexion with the Imperial Board of Health, the Imperial Board of Education, the Municipality, the University, and so forth, Full details can be obtained on application at the cces of the Royal Institute of Pablic Health, 37, Russell- square, London. The honorary secretary of the Berlin Organisation Committee is Oberstabsarzt Niehues, M.D,, Medizinal Abteilung des Kriegsministerium, Wilhelmstrasse, 86-87, Berlin, W. 66. --

EPIDEMIC DYSENTERY IN THE

,

FIJI

ISLANDS.

FOR some time past annual epidemics of dysentery havebeen occurring in the Fiji Islands, and the outbreak of 1910 having proved more extensive than any in recent years the London School of Tropical Medicine instructed Dr. P. H. Bahr, who was visiting the colony on other business, to make an investigation into circumstances associated with the prevalence of the disease. From Dr. Bahr’s report, which has lately been published as Supplement No. 2 of the .7oitrnal of the London School of Tropical Medicine, we learn that although both the amoebic and the bacillary forms of dysentery are met with in Fiji, it is the latter variety which gives rise to the annual epidemics. These yearly outbreaks coincide with the hot season and the period of greatest rainfall, those conditions being accompanied by the appearance of enormous, swarms of flies which Dr. Bhr regards as being intimately concerned in the spread of the disease. In the course of the inquiry organisms were isolated from human fæces, and from material in the post-mortem room, morphologically and, culturally identical with Shiga’s and Flexner’s bacilli ; other micro-organisms morphologically similar, but gi7ing an atypical reaction with various sugars, were also found. Seven types of dysentery bacilli, according to their fermentative reactions, were isolated ;y but no special strains were shown to be peculiar to any distinctive clinical types of the disease, nor were any of them peculiar to a particular race. Clinically three types of the disease were recognised-the mild or catarrhal, the ac;:;te or ulcerative, and the toxic or fulminant. As regards treatment, the best results appear to have been obtained by intravenous injection of polyvalent anti-dysenteric serum. In the town of Suva, the capital of the colony, dysentery was found to be largely an institutional disease, the majority of the cases occurring in the two jails. The natives of FijI are illadapted for agricultural pursuits, and consequently it has been found necessary to import large numbers of coolies from India, and in less amount from the Solomon Islands, to carry on the work in the numerous sugar, cocoanut, and banana plantations. Of 159 consecutive cases which were specially studied in detail by Dr. Bahr, 79- were Indians, 54 Fijians, 20 Solomon Islanders, 4 Europeans, and 2 half-castes. The Indians constitute the bulk of the criminal classes in Fiji, and many of them are expert malingerers. It is interesting to mention some instances in which these Indian prisoners tried to exploit thedysentery epidemic of 1910 for their own purposes, in order to obtain the coveted rest and idleness of the-