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THE TROOPS IN CYPRUS.
776 or to the fact that it is an affection of this pai ticular organ ? We think that facts point rather to th latter conclusion. The influence of sex is one such fact whilst another of still greater weight is that the irritation o the urethra by the simple passage of a catheter is sometime sufficient to cause quite similar joint trouble, withou lighting up urethritis. The belief in the specific nature of gonorrhoea is fast losing ground, if it has not already entirely disappeared in England; and we believe tha gonorrhceal rheumatism will ere long be known as urethra rheumatism, and be no more adduced as proof of the specifil or constitutional nature of what is usually a simple an( local disease. Notes on Rheumatism. By JULIUS POLLOCK, M.D Second Edition. J. & A. Churchill. 1879.-The secon( edition of this little work differs from the first mainly ii the addition of a chapter on the chemistry and mode o action of salicin, salicylic acid, and salicylate of soda, witl an appendix of illustrative cases. The merits of the bool are in inverse proportion to its size, and it may be especially commended to practitioners. Ozone in relation to Health and Disease, By H. DAY M.D. London : Churchills. The chief facts concerninl ozone have been carefully studied and lucidly arranged by Dr Day, so as to make this pamphlet very pleasant and profit able reading. To those who wish to learn something con cerning ozone, especially in its relation to health and disease but who have not time to devote to the systematic study o the subject, we commend the perusal of this brochure. It: twenty-four pages abound with solid and useful information Essentials of Chemistry, Inorganic and Organic, for th, Use of Students in Medicine. By R. A. WITTHAUS, A.M. M.D., Professor of Chemistry in the Medical Department New York : William Wooc University of Vermont, &c. and Co. 1879.-A small catechism on the plan formerl5 It appears fairly accurate, but w< so popular in schools. fail to see any special merit that it possesses.
We may briefly summarise the information on these points as follows :-The 101st Regiment served in the island 78 days ; its average strength was 813 men, who furnished 841 admissions into hospital and 5 deaths. The 42nd Regiment served 119 days; its strength was 727 men; admission: 1258, deaths 12. The 71st Regiment was 146 days on. the island, and had an average strength of 724 men, with
urethra,
-
THE TROOPS IN CYPRUS. Two papers have recently been presented to Parliament relative to the health of the troops in Cyprus. The first is a return, giving the strength of each description of force
employed, and the numbers sick in them on every Friday from the date of occupation till the 10th of January last; and the second, a copy of a report of the Principal Medical Officer on the health of the troops. We had anticipated that the latter, furnished by the officer who for several years was head of the Statistical Branch of the Army Medisal Department, would have given such numerical details as would have thrown considerable light on the extent and nature of the sickness from which the troops suffered so severely ; but in this we have been disappointed. The military force employed consisted partly of British and partly of native Indian troops. Of the latter no information, or at least scarcely any, is given. As Sir A. D. Home was principal medical officer of the whole force, he must, of course, have received weekly returns from the Indian contingent ; and we are quite unable to understand upon what principle all the details relative to it have been omitted. But even as regards the British troops no tabular statement has been furnished of the admissions into hospital and deaths by the different classes of diseases, and the report does not contain the slightest reference to the Royal Artillery beyond the statement that the F Battery, 2nd Brigade, came to Cyprus from India. As regards the Royal Engineers also, although allusion is made to the sickly condition of some of the detachments, no information is given as to the sickness and mortality of the whole.
1083 admissions and 5 deaths. The annual ratio of admissions and deaths per 1000 of mean strength is stated in the report to have been as follows :42nd Regiment, 4264 admissions, 40-68 deaths per 1000 3242 14’97 71st " " " 101st 4082 24’27 " " " .
The report does not furnish data from which to calculate the sickness and mortality of the Royal Artillery, Royal Engineers, or the total force. The report is also remarkable for the absence of all reference to the number non-effective from sickness-a most important subject from a military point of view. This information is, however, given in the return above alluded to. From it we learn that the average strength of British troops from July 26th to January 10th was 1886 ; of Indian troops from July 19th to October llth 1336; of marines, from July 12th to December 27th, 145; and of sailors for the same period 904. The average proportion constantly non-effective from sickness per 1000 of strength was 97’4 English soldiers, 62’7 Indian soldiers, 32’3 marines, and 474 sailors. We have no information as to how or where the marines and sailors were quartered, or whether they were frequently relieved from the ships, so that noaccurate comparison can be instituted between them and the troops. We merely direct attention to their marked relative exemption from sickness, in the hope that it may call forth. some explanation from those who are acquainted with the details. The return shows that on the average of the period included in it one-tenth of the European soldiers were constantly non-effective from sickness, but this does not correctly represent the extent to which the force was thus dis. abled. In the week ending August 16th the inefficiency from sickness amounted to one-fifth of the English soldiers, and during the four weeks ending Sept. 13tb, 20th, and 27th, and Oct. 4th, it was one-eighth. The principal cause of this high proportion of sickness was fever, in the early period of the remittent type, giving place to the intermittent as thehot season passed away. As we have already pointed out, no numerical statement is furnished of the admissions and deaths by the various classes of disease.in The Principal Medical Officer states his report that the troops landed on the evening of July 22nd, and were encamped on " a plain near the sea at Cheflik Pasha, about five miles south-west of Larnaca. From a military point of view it was very suitable for the purpose... Nor, regarded from a sanitary point of view, could the ground selected be regarded at first sight as ineligible." Thit opinion is scarcely borne out by a statement which follows: " The sea was nearly two miles off, but there was a large. salt-water lagoon between it and the east border of the camp." And again: "About half-way between Larnaca. and Cheflik there was an extensive salt-water lagoon; and nearer the camp, the water escaping from the aqueduct at one point found its way to the sea through sodden rush. covered ground." About ten days after the troops landed the admissions into hospital became very numerous, the 101st and 42nd Regiments furnishing a considerably larger number of cases than the 71st; the comparative exemption of the latter was supposed to be due to the somewhat higher ground occupied by it, and its greater distance from the low land near the salt marsh, but it was maintained throughout the whole period of service in the island. In consequence of the great sickness the troops were moved to other camps, and these again were changed when the men became sickly in them. It is unnecessary to detail the various changes, which have been fully recorded in the report before us. It may be sufficient to state that the removal seemed to be beneficial at first in every instance, but this was very soon succeeded by a large increase of sickness. It was not till the last week of October that a decided improvement took place; "it marked the turning-point between the healthy and unhealthy season, between the excessive and moderate prevalence of the endemic illness." The 101st Regiment left Cyprus on Oct. 8th, the 42nd Regiment on Nov. 18th, and the 7lst on Dec. 15th. The lst Batt. 20th Regiment, which relieved the latter, enjoyed excellent health, the average constantly sick having been only 33 per 1000.
777 The sickly condition of the troops throughout the sumniei and autumn appears to have been caused by malaria cornbined with great solar heat, cold nights, excessive moisture manifested bv heavy dew at night and dense mist in the morning. "There was often a difference of 40° between the highest day and lowest night temperatures." To these may probably be added, though not specified in the report, the emanations arising from turning up the soil in the roadmaking and in the formation of the various camps. It is certainly remarkable that all the changes of locality appeal in the first instance to have been attended with a reduction in the amount of sickness, to be followed in a few days by a marked increase. The tents were mostly of the ordinary bell. shape, quite unsuited to shelter the men from the great solai heat, the temperature in them rising to 113° in the hottesi part of the day. In addition to these causes, there were the very indifferent quality of the meat and the inadequate We cannot be surprised at the sickly means of cooking. condition of the troops under such unfavourable circum. stances. The military and medical authorities appear tc have exerted themselves to ameliorate the condition of th( men, but with very indifferent success. The sickness diè not abate till the cool weather set in and the troops were with adequate shelter in huts. The Principa’ provided Medical Officer is of opinion that if sent out between thE middle of November and the middle of February, anè then properly lodged, fed, and clothed, "under these easily satisfied conditions" troops might be stationed at a selectecin the hills of Cyprus with every prospect of their being healthy and efficient. If this be so, what must w{ say as to the responsibility of those who sent them out last summer without any one of these conditions being fulfilled’ We regret that we have been compelled to speak in term: of depreciation of the report before us. It does not come ul, at all to what we should have expected from Sir A. Home and we can only hope that he has prepared for the head o his department one which will give in full detail all th( information that can be desired relative to the extent ancc character of the sickness which prevailed among the troops generally and the individual constituent portions of th( force, the causes of this sickness, the means ’employed t( avert it, and the degree of success or failure which attendeè these. We have yet to wait for a satisfactory medica history of the military occupation of Cyprus, and we trusi that such may in due time be forthcoming from the Arm3 Medical Department.
place
REPORTS OF MEDICAL OFFICERS OF HEALTH. THE reports of the medical officer of health, for the yea] 1878, of the Craven combined sanitary district in Yorkshire, Dr. Fred. W. Barry, are remarkable for the evidence the3 afford of thorough work. Including the general report, anc one special report, they are ten in number. Each of th( several sanitary districts (eight) entering into the combinec district is reported upon separately, while the general statE of the district is discussed in an independent report. Thf special report refers to the sanitary condition of a separatE village, which is dealt with in detail, and we understand that this is to be the model upon which Dr. Barry proposes tc report upon the villages and towns of his district. ObvionslJ Dr. Barry has unbounded confidence in his capacity fo] work, and is determined not to rest until every particulai agency harmful to the health of the population of his distric1 is brought into the fullest light. Craven, with such2 worker, should become as distinguished for its sanitar) condition as for its natural beauties. Dr. Anningson, the medical officer of health for Cam bridge, in his annual report for 1878, expresses himself af dissatisfied with a death-rate of 19’66 per 1000 for the year, the birth-rate declining. There is room, he thinks, for thE
borough,
accurately, "improvement district," t( have a still lower mortality, and he congratulates the loca board on the activity they are displaying in lessening ac knowledged sanitary evils. or, more
The medical officer of health for Bradford, Y orkshin in his report for 1878, states that thE death-rate of the borough-22’5 per 1000 population-wai
(Mr. Butterfield),
lower in that year than in the two previous years. The report contains much of interest relating to the detailed sanitary work of the borough. The annual report for 1878 of the medical officer of health to the Epping rural sanitary authority (Mr. Trevor Fowler) shows a death-rate of 15’4 and a birth-rate of 27per 1000 population for the year. The average annual death-rate of the district for the five years 1874-78 was 15’8, and the birth-rate 28’7. The annual report (the first) of the medical officer of the Thingoe rural sanitary district (Suffolk) for 1878 (Mr. Charles Scott Kilner) shows a death-rate of 12’5 and a birthrate of 28’2 during the year. Even the low death-rate here recorded cannot, according to the information in the report, be regarded as indicating the whole health capacity of the district. It is, in fact, a higher rate than need be in this district, and, if Mr. Kilner’s excellent advice be given heed to, Thingoe may presently return a still lower rate of mortality. The annual report of the medical officer of health of Dundee for 1878 (Dr. Pirrie), recently issued, presents little for special observation. Uneventful years do not lend themselves to the preparation of interesting reports ; and, happily for Dundee, 1878 appears to have been an uneventful year in the health-history of that burgh. The death-rate of the burgh for the year was 21-56 per 1000, a slight increase over the death-rate of 1877 ; and the birth-rate was 33’56 per 1000, a decrease as compared with that of the previous year-a result, Dr. Pirrie observes, due to a diminution of the population, and to the commercial depression which persisted throughout the year. The death-rate, with the exception of that of Greenock, was the lowest observed during the year among the principal towns of Scotland. The slight excess of mortality in the burgh appears to have been occasioned by a somewhat larger prevalence of diseases of the zymotic class than had taken place in 1877. The annual report of the sanitary inspector, Mr. Kinnear, is published in conjunction with that of Dr. Pirrie, and gives evidence of the care with which the sanitary details of the
burgh are considered.
Dr. Whitmore makes a curious complaint in his last It relates to the unreasonable calls made upon the time of the sanitary officers of the parish by wellto-do householders wishful to have the health-condition of their houses examined. The time which has to be thus given to the requirements of persons presumably quite able to secure competent help at their own cost affects detrimentally the work of the sanitary officers as relates to the houses occupied by parishioners who are unable to obtain such help, and which Dr. Whitmore thinks havea primary claim on the sanitary authority. The question thus raised is not without difficulty, and we hope it may be discussed by the Marylebone vestry.
monthly report.
ARSENICAL POISONING FROM WALLPAPERS, ETC. THE following is a copy of the queries issued to the members of the profession by Mr. Malcolm Morris (of 63, Montague-square, W.), hon. secretary to the committee recently appointed by the Medical Society of London to investigate the subject of arsenical poisoning by means of wall-papers, paint, articles of furniture, and wearing
apparel :1. Have you had under your observation, during the last five years, any cases clearly traceable to arsenical poisoning, produced by wall-papers, paint, articles of furniture, or wearing apparel, &c. ? 2. Any cases previous to that time ? 3. What were the first symptoms that led you to suspect this form of poisoning ? 4. State briefly the prominent characteristics of each case.
5. Were there any external symptoms of irritation.? 6. How long was it in each case before the patient recovered health and strength ? 7. Were any cases fatal? 8. What article contained the poison? What tests were employed to detect its presence ? 9. How many cases occurred in men? How many in women ? How many in children ?
We may briefly summarise the information on these points as follows :-The 101st Regiment served in the island 78 days ; its average strength was 813 men, who furnished 841 admissions into hospital and 5 deaths. The 42nd Regiment served 119 days; its strength was 727 men; admission: 1258, deaths 12. The 71st Regiment was 146 days on. the island, and had an average strength of 724 men, with
urethra,
-
THE TROOPS IN CYPRUS. Two papers have recently been presented to Parliament relative to the health of the troops in Cyprus. The first is a return, giving the strength of each description of force
employed, and the numbers sick in them on every Friday from the date of occupation till the 10th of January last; and the second, a copy of a report of the Principal Medical Officer on the health of the troops. We had anticipated that the latter, furnished by the officer who for several years was head of the Statistical Branch of the Army Medisal Department, would have given such numerical details as would have thrown considerable light on the extent and nature of the sickness from which the troops suffered so severely ; but in this we have been disappointed. The military force employed consisted partly of British and partly of native Indian troops. Of the latter no information, or at least scarcely any, is given. As Sir A. D. Home was principal medical officer of the whole force, he must, of course, have received weekly returns from the Indian contingent ; and we are quite unable to understand upon what principle all the details relative to it have been omitted. But even as regards the British troops no tabular statement has been furnished of the admissions into hospital and deaths by the different classes of diseases, and the report does not contain the slightest reference to the Royal Artillery beyond the statement that the F Battery, 2nd Brigade, came to Cyprus from India. As regards the Royal Engineers also, although allusion is made to the sickly condition of some of the detachments, no information is given as to the sickness and mortality of the whole.
1083 admissions and 5 deaths. The annual ratio of admissions and deaths per 1000 of mean strength is stated in the report to have been as follows :42nd Regiment, 4264 admissions, 40-68 deaths per 1000 3242 14’97 71st " " " 101st 4082 24’27 " " " .
The report does not furnish data from which to calculate the sickness and mortality of the Royal Artillery, Royal Engineers, or the total force. The report is also remarkable for the absence of all reference to the number non-effective from sickness-a most important subject from a military point of view. This information is, however, given in the return above alluded to. From it we learn that the average strength of British troops from July 26th to January 10th was 1886 ; of Indian troops from July 19th to October llth 1336; of marines, from July 12th to December 27th, 145; and of sailors for the same period 904. The average proportion constantly non-effective from sickness per 1000 of strength was 97’4 English soldiers, 62’7 Indian soldiers, 32’3 marines, and 474 sailors. We have no information as to how or where the marines and sailors were quartered, or whether they were frequently relieved from the ships, so that noaccurate comparison can be instituted between them and the troops. We merely direct attention to their marked relative exemption from sickness, in the hope that it may call forth. some explanation from those who are acquainted with the details. The return shows that on the average of the period included in it one-tenth of the European soldiers were constantly non-effective from sickness, but this does not correctly represent the extent to which the force was thus dis. abled. In the week ending August 16th the inefficiency from sickness amounted to one-fifth of the English soldiers, and during the four weeks ending Sept. 13tb, 20th, and 27th, and Oct. 4th, it was one-eighth. The principal cause of this high proportion of sickness was fever, in the early period of the remittent type, giving place to the intermittent as thehot season passed away. As we have already pointed out, no numerical statement is furnished of the admissions and deaths by the various classes of disease.in The Principal Medical Officer states his report that the troops landed on the evening of July 22nd, and were encamped on " a plain near the sea at Cheflik Pasha, about five miles south-west of Larnaca. From a military point of view it was very suitable for the purpose... Nor, regarded from a sanitary point of view, could the ground selected be regarded at first sight as ineligible." Thit opinion is scarcely borne out by a statement which follows: " The sea was nearly two miles off, but there was a large. salt-water lagoon between it and the east border of the camp." And again: "About half-way between Larnaca. and Cheflik there was an extensive salt-water lagoon; and nearer the camp, the water escaping from the aqueduct at one point found its way to the sea through sodden rush. covered ground." About ten days after the troops landed the admissions into hospital became very numerous, the 101st and 42nd Regiments furnishing a considerably larger number of cases than the 71st; the comparative exemption of the latter was supposed to be due to the somewhat higher ground occupied by it, and its greater distance from the low land near the salt marsh, but it was maintained throughout the whole period of service in the island. In consequence of the great sickness the troops were moved to other camps, and these again were changed when the men became sickly in them. It is unnecessary to detail the various changes, which have been fully recorded in the report before us. It may be sufficient to state that the removal seemed to be beneficial at first in every instance, but this was very soon succeeded by a large increase of sickness. It was not till the last week of October that a decided improvement took place; "it marked the turning-point between the healthy and unhealthy season, between the excessive and moderate prevalence of the endemic illness." The 101st Regiment left Cyprus on Oct. 8th, the 42nd Regiment on Nov. 18th, and the 7lst on Dec. 15th. The lst Batt. 20th Regiment, which relieved the latter, enjoyed excellent health, the average constantly sick having been only 33 per 1000.
777 The sickly condition of the troops throughout the sumniei and autumn appears to have been caused by malaria cornbined with great solar heat, cold nights, excessive moisture manifested bv heavy dew at night and dense mist in the morning. "There was often a difference of 40° between the highest day and lowest night temperatures." To these may probably be added, though not specified in the report, the emanations arising from turning up the soil in the roadmaking and in the formation of the various camps. It is certainly remarkable that all the changes of locality appeal in the first instance to have been attended with a reduction in the amount of sickness, to be followed in a few days by a marked increase. The tents were mostly of the ordinary bell. shape, quite unsuited to shelter the men from the great solai heat, the temperature in them rising to 113° in the hottesi part of the day. In addition to these causes, there were the very indifferent quality of the meat and the inadequate We cannot be surprised at the sickly means of cooking. condition of the troops under such unfavourable circum. stances. The military and medical authorities appear tc have exerted themselves to ameliorate the condition of th( men, but with very indifferent success. The sickness diè not abate till the cool weather set in and the troops were with adequate shelter in huts. The Principa’ provided Medical Officer is of opinion that if sent out between thE middle of November and the middle of February, anè then properly lodged, fed, and clothed, "under these easily satisfied conditions" troops might be stationed at a selectecin the hills of Cyprus with every prospect of their being healthy and efficient. If this be so, what must w{ say as to the responsibility of those who sent them out last summer without any one of these conditions being fulfilled’ We regret that we have been compelled to speak in term: of depreciation of the report before us. It does not come ul, at all to what we should have expected from Sir A. Home and we can only hope that he has prepared for the head o his department one which will give in full detail all th( information that can be desired relative to the extent ancc character of the sickness which prevailed among the troops generally and the individual constituent portions of th( force, the causes of this sickness, the means ’employed t( avert it, and the degree of success or failure which attendeè these. We have yet to wait for a satisfactory medica history of the military occupation of Cyprus, and we trusi that such may in due time be forthcoming from the Arm3 Medical Department.
place
REPORTS OF MEDICAL OFFICERS OF HEALTH. THE reports of the medical officer of health, for the yea] 1878, of the Craven combined sanitary district in Yorkshire, Dr. Fred. W. Barry, are remarkable for the evidence the3 afford of thorough work. Including the general report, anc one special report, they are ten in number. Each of th( several sanitary districts (eight) entering into the combinec district is reported upon separately, while the general statE of the district is discussed in an independent report. Thf special report refers to the sanitary condition of a separatE village, which is dealt with in detail, and we understand that this is to be the model upon which Dr. Barry proposes tc report upon the villages and towns of his district. ObvionslJ Dr. Barry has unbounded confidence in his capacity fo] work, and is determined not to rest until every particulai agency harmful to the health of the population of his distric1 is brought into the fullest light. Craven, with such2 worker, should become as distinguished for its sanitar) condition as for its natural beauties. Dr. Anningson, the medical officer of health for Cam bridge, in his annual report for 1878, expresses himself af dissatisfied with a death-rate of 19’66 per 1000 for the year, the birth-rate declining. There is room, he thinks, for thE
borough,
accurately, "improvement district," t( have a still lower mortality, and he congratulates the loca board on the activity they are displaying in lessening ac knowledged sanitary evils. or, more
The medical officer of health for Bradford, Y orkshin in his report for 1878, states that thE death-rate of the borough-22’5 per 1000 population-wai
(Mr. Butterfield),
lower in that year than in the two previous years. The report contains much of interest relating to the detailed sanitary work of the borough. The annual report for 1878 of the medical officer of health to the Epping rural sanitary authority (Mr. Trevor Fowler) shows a death-rate of 15’4 and a birth-rate of 27per 1000 population for the year. The average annual death-rate of the district for the five years 1874-78 was 15’8, and the birth-rate 28’7. The annual report (the first) of the medical officer of the Thingoe rural sanitary district (Suffolk) for 1878 (Mr. Charles Scott Kilner) shows a death-rate of 12’5 and a birthrate of 28’2 during the year. Even the low death-rate here recorded cannot, according to the information in the report, be regarded as indicating the whole health capacity of the district. It is, in fact, a higher rate than need be in this district, and, if Mr. Kilner’s excellent advice be given heed to, Thingoe may presently return a still lower rate of mortality. The annual report of the medical officer of health of Dundee for 1878 (Dr. Pirrie), recently issued, presents little for special observation. Uneventful years do not lend themselves to the preparation of interesting reports ; and, happily for Dundee, 1878 appears to have been an uneventful year in the health-history of that burgh. The death-rate of the burgh for the year was 21-56 per 1000, a slight increase over the death-rate of 1877 ; and the birth-rate was 33’56 per 1000, a decrease as compared with that of the previous year-a result, Dr. Pirrie observes, due to a diminution of the population, and to the commercial depression which persisted throughout the year. The death-rate, with the exception of that of Greenock, was the lowest observed during the year among the principal towns of Scotland. The slight excess of mortality in the burgh appears to have been occasioned by a somewhat larger prevalence of diseases of the zymotic class than had taken place in 1877. The annual report of the sanitary inspector, Mr. Kinnear, is published in conjunction with that of Dr. Pirrie, and gives evidence of the care with which the sanitary details of the
burgh are considered.
Dr. Whitmore makes a curious complaint in his last It relates to the unreasonable calls made upon the time of the sanitary officers of the parish by wellto-do householders wishful to have the health-condition of their houses examined. The time which has to be thus given to the requirements of persons presumably quite able to secure competent help at their own cost affects detrimentally the work of the sanitary officers as relates to the houses occupied by parishioners who are unable to obtain such help, and which Dr. Whitmore thinks havea primary claim on the sanitary authority. The question thus raised is not without difficulty, and we hope it may be discussed by the Marylebone vestry.
monthly report.
ARSENICAL POISONING FROM WALLPAPERS, ETC. THE following is a copy of the queries issued to the members of the profession by Mr. Malcolm Morris (of 63, Montague-square, W.), hon. secretary to the committee recently appointed by the Medical Society of London to investigate the subject of arsenical poisoning by means of wall-papers, paint, articles of furniture, and wearing
apparel :1. Have you had under your observation, during the last five years, any cases clearly traceable to arsenical poisoning, produced by wall-papers, paint, articles of furniture, or wearing apparel, &c. ? 2. Any cases previous to that time ? 3. What were the first symptoms that led you to suspect this form of poisoning ? 4. State briefly the prominent characteristics of each case.
5. Were there any external symptoms of irritation.? 6. How long was it in each case before the patient recovered health and strength ? 7. Were any cases fatal? 8. What article contained the poison? What tests were employed to detect its presence ? 9. How many cases occurred in men? How many in women ? How many in children ?