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THE SPANISH-AMERICAN WAR.
436 the antidote.
Prophylactic inoculation is attended by the practical difficulty that we can only get a small proportion of the people to be inoculated. Like vaccination for smallpox it can only prove really successful when performed on a largescale. On the other hand, a curativeserum if successful would rob the disease of its terrors and make the early discovery of fresh cases possible. Hope from this quarter is engendered by the better results from the most recent experiments. If it were possible to reduce the mortality to 20 or even to 30 per cent. plague would be almost disregarded. By these scientific means and by these means alone conquest over the plague seems possible. THE SPANISH-AMERICAN WAR. (FROM A SPECIAL CORRESPONDENT.)
sending 25
I
!
Camp Cuba Libre, Jacksonville, Fla., July 26tli, 1898. MEDICAL officers as well as line officers are all anxious to go to the front. My experience is limited to one army division, but in this one division hospital, the medical wards of which are under my charge, many interesting problems are continuously presenting themselves. The hospital of the Second Division of the Seventh Army Corps is in a pine-grove near the division camp. It consists entirely of tents. A central circular thirtyfoot tent forms a convalescent ward, and radiating from this the floored army hospital tents are arranged in rows of six, the six being broken into groups of twos by arbors which admit air and permit of separation of the patients. There are additional single isolated tents for the treatment of the acute or noisy cases, and for a surgical operatingroom, clinical office, and dispensary. The medical officers’ tents face the hospital at a distance in its front, and the hospital corps nurses and stewards are encamped in the rear. Each hospital tent contains six large and comfortable canvascovered cots. Over each cot, pinned into the seam of the canvas, is a curtain-hook pin on which hangs a printed ’clinical chart bound in pad form. These forms I devised and they were printed for me by the Red Cross Society. The sickness in this command, though not excessive, is already so great as to have increased this hospital beyond its regulation size. We have now about 250 patients, in great part medical-indeed nearly all are fever cases. The fevers are typhoid and malarial, nearly all of the fatal cases being typhoid fever. There were from May 29th to July 22nd 808 patients admitted to the hospital, with 13 deaths, in a command of 13,000 men. The one great favourable feature of this camp is its most excellent water-supply. Artesian water in unlimited quantities is piped to the entire camp. This water is above the suspicion of germ contamination and its properties are of the best. The source of supply is constantly guarded, to prevent poison being added to the water, though the poison which could be used to contaminate such great quantities of water I have found no one able to suggest. This, in brief, is the situation with this army division. We have good water, hot sun, heavy rains and dews, the intemperance usual in armies, and some necessary work. The fesult is much typhoid fever and more of the shorter continued malarial fevers, of which I may write you more. We have had in all three interesting epidemics of typhoid fever. First, nearly all our cases came from the Virginia regiments. The men reported bad water at the Richmond camp. Post-mortem examinations showed the most pronounced lesions. The second epidemic occurred in Company F of the Second Illinois Regiment. On May 30th the members of this company were severely poisoned by the meat served them. Nearly all the men suffered with severe abdominal pains, vomiting, and diarrhma, some even becoming unconscious. Two weeks later webad very many men sent to the hospital from this company with typhoid fever. Three of these patients died, two with perforation, one with meningeal symptoms. Did the beef contain the typhoid bacilli ? Last week our third epidemic began. From the First Wisconsin Regiment we have had 60 admissions, many of which are developing typhoid fever. One unexpected fact is presented by a study of our records. In June, the six Northern regiments in this division sent-172 men to the hospital, while the three Southern regiments sent 216 sick men to us-tlie South thus, with half the number of regiments,
,
per cent. more patients. One would have thought that Southern men could stand the Florida climate better than Northerners. I believe the hospital corps is the hardest worked part of the army, even without any other battle than that with disease germs. We volunteers find the regular army surgeons most pleasant. They overlook our lack of knowledge of military forms and facilitate our work in other respects. All realise the difficulty of hastily meeting the needs of so great a military force at once and attach little importance to hastily made and unjust criticisms of the medical department of the army. But no one should write from the front without giving great credit to the Red Cross Society for the great work it is doing. Without the aid of this society it would have been difficult to care for the sick in this hospital. Each day the Red Cross gives us 50 gallons of milk, 2000 pounds of ice, 30 dozens of eggs. Besides this it has built for us storehouses, floored our tents, given us hundreds of night shirts,I pyjamas, pillows, sheets, buckets, bedpans, and dozens of other articles necessary for the care of the sick. In military channels the stream of supplies flows slowly and with many stops and much formality, but Dr. Kent, who represents the Red Cross here, gives freely and without delay. He has no regulation that prescribes how many bed pans one division must use, but gives all which are needed. This week, with the people of Jacksonville furnishing the motor power, he is going to put electric fans in all the tents.
LIVERPOOL. (FROM OUR OWN CORRESPONDENT.) Prosecution under the ]/actory Act at St. Helens. was instituted at St. Helens Police Court under the Factory Act, 1891, against Rictard H. Twist for a breach of the Act in not providing the workpeople in his factory with suitable overalls and headpieces as a protection against lead-poisoning in the manufacture of china and which have to be earthenware, such as pans, mugs, &c., glazed by means of the use of lead. Mr. Grant, the Government inspector under the Factory Acts, visited the works on July lst and found a man and a woman engaged in the process of preparing the china for dipping. He found that they had no overalls and never had had any. The man had worked there for some years and owing to a serious illness which was pronounced by Dr. Casey to have been due to lead-poisoning was laid up for six months. The defendant controverted the statement that his employe was suffering from lead-poisoning and said that his illness was due to the effects of drink. He stated that he used very little redlead, but mainly lead-ore, and that he did all the mixing himself ; that the girls and men had merely to wash the pails round. He also stated that there were no dust and no brushing. The inspector pointed out to the magistrates that the danger to individuals engaged in these works arose from actual contact with the lead. They got the lead over their hands, and it got under their finger-nails and through the pores of the skin. As the defendant had fairly observed the rest of the rules as regards the manufacture of his special wares the magistrates decided not to convict in this case, but cautioned the defendant against a similar breach of the regulations of the Factory Act in the future. A PROSECUTION
of the Appointment of a Medical Referee under the’ 1Vorkmen’s Compensation Act. The appointment of Mr. J. D. Crawford as one of the medical referees under the Workmen’s Compensation Act to Circuit No. 6, which was notified in THE LANCET of July 16th, has been cancelled by the Home Secretary. Dr. Thomas Clarke, the chairman of the hospitals committee of the Liverpool City Council, has been appointed in Mr. Crawford’s place. Liverpool Consumpt’ion Hospital. Lady Willox, the wife of Sir John Willox, the member for the Everton Division of Liverpool in Parliament, has been the means of raising the sum of .f:.200 towards the new building fund through a bazaar promoted by her ladyship at the hospital. Liverpool Assizes False Charge against a lTTigan Surgeon. Revocation
lhe
grand jury threw
out the bill in the
case
of Mr. James
z
Prophylactic inoculation is attended by the practical difficulty that we can only get a small proportion of the people to be inoculated. Like vaccination for smallpox it can only prove really successful when performed on a largescale. On the other hand, a curativeserum if successful would rob the disease of its terrors and make the early discovery of fresh cases possible. Hope from this quarter is engendered by the better results from the most recent experiments. If it were possible to reduce the mortality to 20 or even to 30 per cent. plague would be almost disregarded. By these scientific means and by these means alone conquest over the plague seems possible. THE SPANISH-AMERICAN WAR. (FROM A SPECIAL CORRESPONDENT.)
sending 25
I
!
Camp Cuba Libre, Jacksonville, Fla., July 26tli, 1898. MEDICAL officers as well as line officers are all anxious to go to the front. My experience is limited to one army division, but in this one division hospital, the medical wards of which are under my charge, many interesting problems are continuously presenting themselves. The hospital of the Second Division of the Seventh Army Corps is in a pine-grove near the division camp. It consists entirely of tents. A central circular thirtyfoot tent forms a convalescent ward, and radiating from this the floored army hospital tents are arranged in rows of six, the six being broken into groups of twos by arbors which admit air and permit of separation of the patients. There are additional single isolated tents for the treatment of the acute or noisy cases, and for a surgical operatingroom, clinical office, and dispensary. The medical officers’ tents face the hospital at a distance in its front, and the hospital corps nurses and stewards are encamped in the rear. Each hospital tent contains six large and comfortable canvascovered cots. Over each cot, pinned into the seam of the canvas, is a curtain-hook pin on which hangs a printed ’clinical chart bound in pad form. These forms I devised and they were printed for me by the Red Cross Society. The sickness in this command, though not excessive, is already so great as to have increased this hospital beyond its regulation size. We have now about 250 patients, in great part medical-indeed nearly all are fever cases. The fevers are typhoid and malarial, nearly all of the fatal cases being typhoid fever. There were from May 29th to July 22nd 808 patients admitted to the hospital, with 13 deaths, in a command of 13,000 men. The one great favourable feature of this camp is its most excellent water-supply. Artesian water in unlimited quantities is piped to the entire camp. This water is above the suspicion of germ contamination and its properties are of the best. The source of supply is constantly guarded, to prevent poison being added to the water, though the poison which could be used to contaminate such great quantities of water I have found no one able to suggest. This, in brief, is the situation with this army division. We have good water, hot sun, heavy rains and dews, the intemperance usual in armies, and some necessary work. The fesult is much typhoid fever and more of the shorter continued malarial fevers, of which I may write you more. We have had in all three interesting epidemics of typhoid fever. First, nearly all our cases came from the Virginia regiments. The men reported bad water at the Richmond camp. Post-mortem examinations showed the most pronounced lesions. The second epidemic occurred in Company F of the Second Illinois Regiment. On May 30th the members of this company were severely poisoned by the meat served them. Nearly all the men suffered with severe abdominal pains, vomiting, and diarrhma, some even becoming unconscious. Two weeks later webad very many men sent to the hospital from this company with typhoid fever. Three of these patients died, two with perforation, one with meningeal symptoms. Did the beef contain the typhoid bacilli ? Last week our third epidemic began. From the First Wisconsin Regiment we have had 60 admissions, many of which are developing typhoid fever. One unexpected fact is presented by a study of our records. In June, the six Northern regiments in this division sent-172 men to the hospital, while the three Southern regiments sent 216 sick men to us-tlie South thus, with half the number of regiments,
,
per cent. more patients. One would have thought that Southern men could stand the Florida climate better than Northerners. I believe the hospital corps is the hardest worked part of the army, even without any other battle than that with disease germs. We volunteers find the regular army surgeons most pleasant. They overlook our lack of knowledge of military forms and facilitate our work in other respects. All realise the difficulty of hastily meeting the needs of so great a military force at once and attach little importance to hastily made and unjust criticisms of the medical department of the army. But no one should write from the front without giving great credit to the Red Cross Society for the great work it is doing. Without the aid of this society it would have been difficult to care for the sick in this hospital. Each day the Red Cross gives us 50 gallons of milk, 2000 pounds of ice, 30 dozens of eggs. Besides this it has built for us storehouses, floored our tents, given us hundreds of night shirts,I pyjamas, pillows, sheets, buckets, bedpans, and dozens of other articles necessary for the care of the sick. In military channels the stream of supplies flows slowly and with many stops and much formality, but Dr. Kent, who represents the Red Cross here, gives freely and without delay. He has no regulation that prescribes how many bed pans one division must use, but gives all which are needed. This week, with the people of Jacksonville furnishing the motor power, he is going to put electric fans in all the tents.
LIVERPOOL. (FROM OUR OWN CORRESPONDENT.) Prosecution under the ]/actory Act at St. Helens. was instituted at St. Helens Police Court under the Factory Act, 1891, against Rictard H. Twist for a breach of the Act in not providing the workpeople in his factory with suitable overalls and headpieces as a protection against lead-poisoning in the manufacture of china and which have to be earthenware, such as pans, mugs, &c., glazed by means of the use of lead. Mr. Grant, the Government inspector under the Factory Acts, visited the works on July lst and found a man and a woman engaged in the process of preparing the china for dipping. He found that they had no overalls and never had had any. The man had worked there for some years and owing to a serious illness which was pronounced by Dr. Casey to have been due to lead-poisoning was laid up for six months. The defendant controverted the statement that his employe was suffering from lead-poisoning and said that his illness was due to the effects of drink. He stated that he used very little redlead, but mainly lead-ore, and that he did all the mixing himself ; that the girls and men had merely to wash the pails round. He also stated that there were no dust and no brushing. The inspector pointed out to the magistrates that the danger to individuals engaged in these works arose from actual contact with the lead. They got the lead over their hands, and it got under their finger-nails and through the pores of the skin. As the defendant had fairly observed the rest of the rules as regards the manufacture of his special wares the magistrates decided not to convict in this case, but cautioned the defendant against a similar breach of the regulations of the Factory Act in the future. A PROSECUTION
of the Appointment of a Medical Referee under the’ 1Vorkmen’s Compensation Act. The appointment of Mr. J. D. Crawford as one of the medical referees under the Workmen’s Compensation Act to Circuit No. 6, which was notified in THE LANCET of July 16th, has been cancelled by the Home Secretary. Dr. Thomas Clarke, the chairman of the hospitals committee of the Liverpool City Council, has been appointed in Mr. Crawford’s place. Liverpool Consumpt’ion Hospital. Lady Willox, the wife of Sir John Willox, the member for the Everton Division of Liverpool in Parliament, has been the means of raising the sum of .f:.200 towards the new building fund through a bazaar promoted by her ladyship at the hospital. Liverpool Assizes False Charge against a lTTigan Surgeon. Revocation
lhe
grand jury threw
out the bill in the
case
of Mr. James
z