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THE PROPOSED NILE RESERVOIR.
THE PROPOSED NILE HE5E.RVOIR.
50
centrifugal machine. As regarded the was the cause of the outbreak. The small-pox linen was alleged anticipation his lordship did not agree that the process supposed, according to the rules of the establishment, to be mentioned by Dioscorides had anything to do with this case. steeped in a strong disinfectant before being taken to the It was an essentially different thing. The process invented washhouse, and separate days were assigned for washing by the patentee in the present case was not previously known ; the small-pox and scarlet fever linen. Dr. Wilson and he was therefore of the opinion that the patent was good Dr. A. V. Bernays, the medical officer to the hospital, and had been infringed by the defendants, and that accord- after considering all the evidence, are inclined to conclude that-as the washerwoman contracted the disease en ingly the appeal must be dismissed, with costs. when the small-pox linen was first or about the 17Gh, this date is, approximately speaking, and that washed, THE PROPOSED NILE RESERVOIR. by
means
of the
INTELLIGENCE received through Reuter’s Agency states that the commission of hydraulic engineers appointed to consider the question of constructing a Nile reservoir has finished its labours. The commission considered the questions set forth in Mr. Garstin’s note, and all agreed to reject the Wady Ryan scheme owing to its costliness. The members of the commission are unanimous in saying that the condition of the country will not be injuriously affected by a Nile Valley reservoir, agreeing in this respect with Rogers Pasha, the Director-General of the Sanitary Department. The subject is one involving sanitary and other considerations of interest, but we are compelled to postpone any discussion of it this week owing to the pressure on our columns and the lengthy nature of the reports and material bearing upon the question. -
DIFFUSION OF SMALL-POX BY INFECTED STEAM. DR. GEORGE WILSON, medical officer of health of the Mid-Warwickshire districts, has published in the current
-
number of Public Hrczlth an interesting report to the Solihull rural sanitary authority on a simultaneous outburst of five cases of small-pox in the isolation hospital of the district, which both he and the medical officer of that institution consider was probably caused by infected steam wafted to the scarlet fever pavilion from the neighbouring laundry. It seems that the laundry in question is situated between the scarlet fever and small-pox pavilions, being 30 ft. from the former and some 60 ft. from the latter-i e., the scarlet fever and small-pox pavilions are about 90 ft. apart. The history of the outbreak is as follows. On Jan. 23rd and 25th two patients recovered from scarlet fever were discharged from the hospital, and on Jan. 30th and Feb. 3rd returned suffering from small-pox, the latter case having, it appears, developed the disease on Jan. 31st. Two other cases, apparently still in the scarlet fever pavilion, manifested signs of small-pox on Jan. 28th and 29th, while the washerwoman attached to the hospital also fell ill with the disease on the latter date There were thus five persons who contracted the disease in hospital, and who developed it, approximately speaking, at the same time. Independently of these cases there had been admitted on Jan. 10th a patient suffering from malignant small-pox, who died on Jan. 18th and was buried on the 20th Two other cases had been admitted on Jan. 15th, and on the 21st of the same month a severe confluent case. Finally, on Jan. 29th and 31st two more cases were admitted. There were then, as Dr. Wilson points out, six cases of small-pox under treatment at the small-pox pavilion at the end of the month, in addition to those who contracted the disease in hospital. Obviously, however, looking at the fact that the patients who contracted the disease in hospital must have been infected on or about Jan. 17tb, only three of the six above mentioned could have been potent for harm on that date-i. e , the cases admitted on the 10th and 15th. Now, although on took Jan. 17th the first washing of small-pox linen &c. place in the laundry, it seems that the scarlet fever linen, which was washed on the 15th, was not returned to the scarlet fever wards till Jan. 21st-i e., at a date which renders it improbable that any of the small-pox linen which might have been mixed with that of the scarlet fever patients
the one upon which the other cases contracted their attacks-the disinfection of the small-pox linen was insufficient, "and that when the articles were put into the copper the steam developed before the boiling point was reached and wafted with it the infective germs of the disease." In support of this view it is stated that the prevailing winds from the middle to the end of January were from the direction of the small-pox block and laundry. Both Dr. Wilson and Dr. Bernays went carefully into the possibility of personal contagion or contact witb infected articles &:3., but they do not believe that the cause of the outbreak lies in any of these directions," and they think that had the disinfecting apparatus, which is apparently being erected, been ready for use and the linen properly disinfected therein the outbreak would not have occurred. The question which naturally suggests itself, and which id admitted by Dr. Wilson as possible, is whether-assuming, of course, that personal contagion was eliminated-the disease nay not have been conveyed aerially from the small-pox to the scarlet fever pavilion. Whether, it might be asked, is it nore probable that particulate matter, which by analogy we nay assume to be the cause of small-pox, would be wafted across an intervening space in the dry or in the moist c)nlition ? It will be remembered by our readers that Dr. McVail, n the valuable paper which he read recently before the Epidemiological Society on theAerial Convection of Smallog,"1and which was published in full in the columns of thin LANCET, drew attention to the old Haygarth and Naterhouse controversy, in which the former cited, in oppodtion to Waterhouse’s thesis of aerial convection, some ixperiments in which nioist small-pox matter had failed to }e carried atmospherically a distance of eighteen inches. Iaygarth regard this test as conclusive, but as Dr. McVail pointed out, he entirely forgot that only dry matter might be expected to be carried atmospherically.
EXPERIMENTAL TUBERCULOSIS OF THE KIDNEY. IN the February number of the Annales de l’Institnt Paste1lr Dr. A. Borrel gives the results of his investigations into the production of experimental tuberculosis of the kidney, following up his observations on experimental He comes to the conclusion that tubercle of the lung. here also there are two distinct forms of tuberculosis, differing not so much in their structure as in their mode of origin. The first form, which appears to commence immediately after inoculation, appears to be due to a series of changes set up by tubercle bacilli introduced directly into the arterial system, in which there appears to be essentially a taking up of the bacilli by epithelioid cells with large nuclei, but little chromatin and abundant protoplasm, vesicular and firely granular. At the margins of this mass of large cells there are a number of smaller cells with small nuclei rich in chromatin, but with very little protoplasm. These cells are strictly interstitial, the epithelium of the kidneys being absolutely unaffected. The granulations so formed appear to pass through various modifications, but the great point to be noticed is that they are found essentially in the mesoblastic tissues and that any changes in the 1
THE
LANCET, Feb. 3rd, 1894.
50
centrifugal machine. As regarded the was the cause of the outbreak. The small-pox linen was alleged anticipation his lordship did not agree that the process supposed, according to the rules of the establishment, to be mentioned by Dioscorides had anything to do with this case. steeped in a strong disinfectant before being taken to the It was an essentially different thing. The process invented washhouse, and separate days were assigned for washing by the patentee in the present case was not previously known ; the small-pox and scarlet fever linen. Dr. Wilson and he was therefore of the opinion that the patent was good Dr. A. V. Bernays, the medical officer to the hospital, and had been infringed by the defendants, and that accord- after considering all the evidence, are inclined to conclude that-as the washerwoman contracted the disease en ingly the appeal must be dismissed, with costs. when the small-pox linen was first or about the 17Gh, this date is, approximately speaking, and that washed, THE PROPOSED NILE RESERVOIR. by
means
of the
INTELLIGENCE received through Reuter’s Agency states that the commission of hydraulic engineers appointed to consider the question of constructing a Nile reservoir has finished its labours. The commission considered the questions set forth in Mr. Garstin’s note, and all agreed to reject the Wady Ryan scheme owing to its costliness. The members of the commission are unanimous in saying that the condition of the country will not be injuriously affected by a Nile Valley reservoir, agreeing in this respect with Rogers Pasha, the Director-General of the Sanitary Department. The subject is one involving sanitary and other considerations of interest, but we are compelled to postpone any discussion of it this week owing to the pressure on our columns and the lengthy nature of the reports and material bearing upon the question. -
DIFFUSION OF SMALL-POX BY INFECTED STEAM. DR. GEORGE WILSON, medical officer of health of the Mid-Warwickshire districts, has published in the current
-
number of Public Hrczlth an interesting report to the Solihull rural sanitary authority on a simultaneous outburst of five cases of small-pox in the isolation hospital of the district, which both he and the medical officer of that institution consider was probably caused by infected steam wafted to the scarlet fever pavilion from the neighbouring laundry. It seems that the laundry in question is situated between the scarlet fever and small-pox pavilions, being 30 ft. from the former and some 60 ft. from the latter-i e., the scarlet fever and small-pox pavilions are about 90 ft. apart. The history of the outbreak is as follows. On Jan. 23rd and 25th two patients recovered from scarlet fever were discharged from the hospital, and on Jan. 30th and Feb. 3rd returned suffering from small-pox, the latter case having, it appears, developed the disease on Jan. 31st. Two other cases, apparently still in the scarlet fever pavilion, manifested signs of small-pox on Jan. 28th and 29th, while the washerwoman attached to the hospital also fell ill with the disease on the latter date There were thus five persons who contracted the disease in hospital, and who developed it, approximately speaking, at the same time. Independently of these cases there had been admitted on Jan. 10th a patient suffering from malignant small-pox, who died on Jan. 18th and was buried on the 20th Two other cases had been admitted on Jan. 15th, and on the 21st of the same month a severe confluent case. Finally, on Jan. 29th and 31st two more cases were admitted. There were then, as Dr. Wilson points out, six cases of small-pox under treatment at the small-pox pavilion at the end of the month, in addition to those who contracted the disease in hospital. Obviously, however, looking at the fact that the patients who contracted the disease in hospital must have been infected on or about Jan. 17tb, only three of the six above mentioned could have been potent for harm on that date-i. e , the cases admitted on the 10th and 15th. Now, although on took Jan. 17th the first washing of small-pox linen &c. place in the laundry, it seems that the scarlet fever linen, which was washed on the 15th, was not returned to the scarlet fever wards till Jan. 21st-i e., at a date which renders it improbable that any of the small-pox linen which might have been mixed with that of the scarlet fever patients
the one upon which the other cases contracted their attacks-the disinfection of the small-pox linen was insufficient, "and that when the articles were put into the copper the steam developed before the boiling point was reached and wafted with it the infective germs of the disease." In support of this view it is stated that the prevailing winds from the middle to the end of January were from the direction of the small-pox block and laundry. Both Dr. Wilson and Dr. Bernays went carefully into the possibility of personal contagion or contact witb infected articles &:3., but they do not believe that the cause of the outbreak lies in any of these directions," and they think that had the disinfecting apparatus, which is apparently being erected, been ready for use and the linen properly disinfected therein the outbreak would not have occurred. The question which naturally suggests itself, and which id admitted by Dr. Wilson as possible, is whether-assuming, of course, that personal contagion was eliminated-the disease nay not have been conveyed aerially from the small-pox to the scarlet fever pavilion. Whether, it might be asked, is it nore probable that particulate matter, which by analogy we nay assume to be the cause of small-pox, would be wafted across an intervening space in the dry or in the moist c)nlition ? It will be remembered by our readers that Dr. McVail, n the valuable paper which he read recently before the Epidemiological Society on theAerial Convection of Smallog,"1and which was published in full in the columns of thin LANCET, drew attention to the old Haygarth and Naterhouse controversy, in which the former cited, in oppodtion to Waterhouse’s thesis of aerial convection, some ixperiments in which nioist small-pox matter had failed to }e carried atmospherically a distance of eighteen inches. Iaygarth regard this test as conclusive, but as Dr. McVail pointed out, he entirely forgot that only dry matter might be expected to be carried atmospherically.
EXPERIMENTAL TUBERCULOSIS OF THE KIDNEY. IN the February number of the Annales de l’Institnt Paste1lr Dr. A. Borrel gives the results of his investigations into the production of experimental tuberculosis of the kidney, following up his observations on experimental He comes to the conclusion that tubercle of the lung. here also there are two distinct forms of tuberculosis, differing not so much in their structure as in their mode of origin. The first form, which appears to commence immediately after inoculation, appears to be due to a series of changes set up by tubercle bacilli introduced directly into the arterial system, in which there appears to be essentially a taking up of the bacilli by epithelioid cells with large nuclei, but little chromatin and abundant protoplasm, vesicular and firely granular. At the margins of this mass of large cells there are a number of smaller cells with small nuclei rich in chromatin, but with very little protoplasm. These cells are strictly interstitial, the epithelium of the kidneys being absolutely unaffected. The granulations so formed appear to pass through various modifications, but the great point to be noticed is that they are found essentially in the mesoblastic tissues and that any changes in the 1
THE
LANCET, Feb. 3rd, 1894.