1790

cases life might have been saved had timely aid in the caseof necessitous children been forthcoming. In some cases

piteous appeals were made by mothers for assistance, butaccording to Professor D. MacEwan " all the agencies of thetown passed them by on the other side because it was

nobody’s business. Professor MacEwan has "no hesita-tion in saying that many children during the last epidemicowed their deaths simply to neglect," and also "therewere a great number of distressing cases neglected as

far as nursing and medical attendance were concerned.""The Sick Poor Nursing Society" has brought the matter tothe notice of the public. Its nurses have had to turn adeaf ear to appeals because the rules are against nursing in-fectious cases. Dr. C. Templeman, medical officer of Dundee,has long urged better provision for such cases, and has saidthat " this lack of accommodation for a certain class ofmeasles cases is perhaps the one black spot in our otherwiseadmirable method of checking infantile mortality; in thismatter of measles we are sadly lacking in facilitiesfor coping with the disease." He regards as thefirst thing to save the lives of the poorest children the

taking them away from homes where recovery is prac-tically impossible, especially with children of that class

suffering from serious complications. The childrenof a home where the mother is at work all day and thereis no one to tend them ought also to be provided withhospital accommodation, but as for the rest of the children,a whole epidemic of measles cannot be provided with accom-modation, only certain classes can be dealt with. Dr.

Templeman remarks that the last epidemic has been of anunusually virulent type, with diphtheria associated with agreat number of the cases ; and he suggests that an isolationblock should be built in the grounds of the hospital similar tothe block which it is proposed to erect for advanced casesof phthisis, and as the accommodation would only be

required for a few months every three or four years, theexpense would not be great. ,

d une kilst.

IRELAND.(FROM OUR OWN CORRESPONDENTS.)

The Midwives Act and Ireland.STEPS are being taken in Dublin to formulate the opinions

of the medical profession on the extension of the MidwivesAct to Ireland. It is expected that a conference will shortlybe held between representatives of the Royal Collegesand of the various medical societies, and it is hopedthat a definite decision may be arrived at whichcan be taken as voicing the opinion of the pro-fession. In the meantime, the governors of the Rotunda

Hospital, who are naturally and properly anxious to removethe disadvantages under which Irish midwives suffer at

present, have circularised the Representative Peers ofIreland in favour of the extension of the Act. The

governors point out that in order to gain the certificate ofthe Central Midwives Board an Irish midwife has to travelto England, while the certificate is already being made com-pulsory for certain Government appointments in IrelandBut the regulations of the Central Midwives Board are con-sidered to be unsuitable in some particulars to the con-ditions of training in the Irish lying-in-hospitals, so thatextension of the Act to Ireland will be attended with someadministrative difficulties.

The Dublin Hospitals’ Tuberculosis Committee.A quarterly meeting of the Hospitals’ Tuberculosis Com-

mittee was held on June 17th, Sir John Moore being in thechair. The honorary secretary, Sir William J. Thompson, reada satisfactory report from the inspector of the Queen VictoriaJubilee Institute for Nurses, showing that the work of thetwo special tuberculosis nurses, supported by the Women’sNational Health Association, continues to be carried on

successfully. The report of Mr. J. T. Daniel of his visitsover a period of three months was also read and approved,as were summaries of the work done by district nurses inDublin and Terenure amongst tuberculosis cases for threemonths. The following resolution was unanimously adopted,and the honorary secretary was directed to send it to thepublic health committee and the cleansing committee ofDublin corporation .’—

That this committee is of opinion that a large proportion of thenumber of chest affections leading to tubercular disease in the city of

Dublin is due to the excessive amount of dust in the streets, theinadequate watering thereof, and the faulty method of sweeping thestreets.The committee note with regret that the plague of dust is especially

prevalent in the poorer quarters where little or no attempt is made tolay it by watering and subsequent removal.

The medical superintendent officer of health of Dublin andthe Local Government medical inspector for the Dublindistrict were elected members of the committee. LadyAberdeen laid before the committee the drawings and pro-posed plans of the P. F. Collier Dispensary for the Preventionof Consumption, which is to be erected forthwith in Charles-street, Upper Ormond Quay, Dublin.

The Tuberculosis Death-rate.In answer to a question in Parliament last week Mr.

Birrell stated that the total number of deaths from all formsof tuberculosis in Ireland had decreased from 11,679 in 1907to 10,594 in 1909. In answer to a supplementary question,however, he seemed to acquiesce in the suggestion that a newmethod of classifying mortality returns might account for someat least of the decrease. This answer naturally gave rise tofear that the improvement announced might after all bequite insignificant. Next day, however, an official statementwas issued to the effect that what the Chief Secretary meantwas that if there had been a change he did not think thiswould account for the decrease which had taken place. Asa matter of fact, no change in the classification has takenplace since 1902, and the figures given for each of the years1907, 1908, and 1909 relate therefore to precisely the sameclassification. The decrease in the number of deaths fromtuberculosis in Ireland, therefore, amounts to 1085 in twoyears. This remarkable result must be encouraging to thoseengaged in fighting the disease.

The Galway Hospital and Medical School.The Bishop of Galway has put forward a scheme for the

reorganisation of the Galway Hospital so as to render it amore efficient centre for clinical instruction. He suggests,among other things, that: 1. The hospital be managed by acommittee, consisting of eight persons nominated by thecounty council, of four selected by the governing body ofUniversity College, Galway, and of three coopted members.2. That the medical staff of the hospital be elected

by the committee from the professors and lecturersof the University College, and that additional appoint-ments may be made to the staff by the managingcommittee subject to the approval of the Local GovernmentBoard. Every appointment on the staff to be for four years,the holder to be eligible for re-election. 3. That the com-mittee of management annually appoint a registrar from themedical staff, whose duty it shall be to supervise the clinicalinstruction. The last recommendation quoted is hardlypracticable, the staff of the hospital being at present com-posed of the medical professors of University College.

Lisburn Fever Hospital.Dr. M. B. Mackenzie, medical officer of Lisburn Fever Hos-

pital, has reported to the board of guardians of Lisburn thatthe present condition of affairs in that institution cannotcontinue, and that, in his opinion, it will be necessary to

provide at least four new wards in addition to those alreadyexisting. As at present arranged, there was neither a wardfor disinfection nor one for observation. When a patientwas brought in suspected of suffering from an infectiousmalady it was necessary to disinfect an empty ward, and ifthat ward was in use, as it often was for other purposes,there was no place whatever available. In reference to dis-infection, they were in a worse position at present, andpatients had to be taken into the nurses’ private apartmentsand disinfected there, a place from every point of view un-suitable. There were only six wards for infectious disease atpresent, one being a large ward divided by wooden parti-tions, and these wards had to accommodate men, women,and children. Dr. Mackenzie asked for two more wards,n addition to ones for observation and dismissal. Thenatter was referred to a committee for consideration.

Health of Belfast.At present Belfast is in the grip of a severe outbreak of

neasles. The medical officer of health reported to a

neeting of the puhlic health committee last week that,under a system of voluntary notification which the committeeiad arranged with district medical officers of health and)thers, during the week ended June llth 362 cases ofneasles were notified, of whom 331 were visited by officers

1791

of the department, and in 280 of these total disinfection wascarried out. If the system of notification was compulsorythere is no doubt it would reveal a much greater number ofcases.

Death of Francis Edwin McCune, B.A., M.D. R. U.I.The death of Dr. F. E. McCune took place on June 12th

in Oban at the residence of his father, Rev. Samuel McCune,formerly minister of the Presbyterian Church, Magherafelt,Co. Derry. Dr. McCune graduated M.B. of the Royal Uni-versity in 1902 and M.D. in 1905, having previously, in 1899,obtained the B.A. in the same University. He entered the

Navy in 1904 and was appointed first to the H.M.S.Excellent and afterwards to H.M.S. Black Prince, stationedin the Mediterranean. He was invalided out of the servicein 19C8, having pulmonary tuberculosis. A very ablestudent and a naval surgeon of great promise, Dr. McCunehas been carried off at the early age of 33 years, to the regretof those who knew him.J une 21st.

PARIS.

(FROM OUR OWN CORRESPONDENT.)

AT a meeting of the Society of Public Medicine held onMay 25th, M. Periss6 introduced a subject of great hygienicimportance-namely, the question of percolation cesspools(puisards absorbants, fosses non gtanches). He said that these

receptacles were everywhere prohibited in France, butnevertheless existed everywhere, because in places wherethere were neither sewers nor a systematic removal ofrefuse it was’ only by soaking into the ground that

slop-water and excreta could be got rid of. Insteadof the indiscriminate prohibition of them there oughtto be compulsory inspection by the municipal authority,followed either by sanction or by an order for discontinuance.The special forms called fosses non etanches were dangerous tohealth in the highest degree, because they filled the subsoil ofhouses with the pathogenic microbes contained in slop-water.In France there were more than 1,000,000 fosses non étanches,which were the principal cause of the contamination of

drinking water. An excellent method of dealing with domestic slop-water was in use at Saint Cloud, where the water from septic pits on the Mouras system was deliveredunder the soil of gardens and cultivated fields by means ofdrain-pipes not far below the surface. All the advantages ofpurification by the action of the earth were thereby obtainedwithout the drawbacks incidental to the superficial distribu-tion of slop-water over irrigation meadows.

Radi2em in the Surgical Treatment of Cancer.The use of radium in the treatment of cancer gave rise to

an animated discussion among several eminent surgeons at

meetings of the Surgical Society held on June 1st and 8th.M. Monod inaugurated this discussion by saying thatM. Wickham in making a communication on the subjecthad mentioned that each of five patients treated in this

way had shown a considerable improvement and a retarda-tion of the appearance of the relapse. In his opinion theapplication of radium wast ndicated when the removal ofthe tumour was impossible ; it might also be resorted toafter complete removal with a view to prevent a relapse. Insome cases radium should be used to supplement a surgicaloperation, not being applied until as much as possible of thetumour had been removed. M. Segond said that several patients under his care had been treated by applications of radium.He had not seen any instance of recovery, but it appeared tohim that the radium had been beneficial to some extent.Under its influence there had been relief of pain andtemporary cicatrisation of the ulcers, but the diseasenevertheless continued to extend subsequently. In cancerof the uterus it seemed to be useless, for the tumourwent on growing behind the cicatrised ulcer, andin one instance produced a recto-vaginal fistula. M.Delbet said that his experience differed from thatof M. Segond, for he had seen good results from theuse of radium in epitheliomata of the uterus. M. Tuffiersaid that he had applied radium before, during, and afteroperations. In some cases of inoperable cancer of the uterusthere was an evident modifying and beneficial action, butthe extension of the disease was not prevented. During

drainage apertures. Some patients relapsed quickly andothers slowly. After the operations the pain ceased and therewas temporary improvement without permanent recovery.M. Lucas-Championniere said that in his experience radiumhad a palliative but not a curative effect. M. Ricard said thathe had observed a very gratifying palliative effect from the useof radium, but not any instance of recovery. M. Nelatonsaid that in a case of epithelioma of the cervix uteriapproaching the limit of operability he employed deepcurettage with subsequent application of 0 - 05 centigrammeof radium, and for the last two months the patient appearedto be quite well. M. Morestin, M. Sieur, M. Walther,M. Routier, and M. Guinard all mentioned cases in whichthe employment of radium was followed by evident improve-ment, which, however, was only temporary.

Acicte Poliomyelitis.Acute infantile paralysis has for a considerable time existed

in Paris in an epidemic form, and at a meeting of the

Academy of Medicine held on May 31st M. Netter, in readinga communication on the subject, said that to his knowledgemore than 100 cases had occurred in the city and the banlieusince the summer of 1909. Last January there was anincreased prevalence of the disease in consequence of thepeculiar climatic conditions. With most of the patients itwas not possible to discover evidence of association withother cases, and instances of family contagion were

observed among the members of only five families, inwhich side by side with typical examples of the diseasethere were abortive forms unaccompanied by paralysis.With regard to the clinical features, he said that somepatients at the outset presented signs of meningitis and weretreated by intraspinal injections. The contagiousness of thisform of poliomyelitis varied with the epidemics, being some-times very marked and sometimes only slight. In conjunc-tion with M. Levaditi, M. Netter had been able to prove thatthe serum of patients who had suffered from infantile

paralysis possessed neutralising properties with respect tothe virus of poliomyelitis. These properties furnishedevidence of the identity of epidemic and sporadic infantileparalysis ; they were found in the blood of patients in whomthe disease assumed the above-mentioned abortive forms.

Antirabic Vaccinations.M. Jules Viala, préparateur in the antirabic department of

the Pasteur Institute, has published the statistics of the anti-rabic vaccinations performed during the year 1909. Amongthe 467 persons who received this treatment there were twodeaths from rabies, one of these patients being a woman inwhom the disease declared itself during the treatment. Thiscase ought obviously to be deducted in computing the mor-tality, which would then work out at the extremely low rateof 0 21 per cent.

June 21st.

VIENNA.(FROM OUR OWN CORRESPONDENT.)

Political Parties and Public Health Legislation.THE Parliamentary Committee for the preliminary con-

sideration of the proposed Infectious Diseases Act (Seuchen-gesetz) was on the point of completing its task when

powerful political influence was suddenly exerted in opposi-tion to some of its most important recommendations, suchas the passing of special laws against tuberculosis andsyphilis and the introduction of a Bill to make vaccinationcompulsory. The objections came from the Clerical party,which has its chief supporters amongst the peasant popula-tion, the members of this party declaring that the subjectwas so important that it must be referred to the populationbefore they could vote either for or against it. There is a

widespread feeling that the hostility of the Clerical party tothe proposed legislation is really prompted by the fear of theexpense which the rural population would incur in conse-quence of it. Country people do not readily understand thatsanitary improvements must cost money. It now remains tobe seen whether the Government will allow the public healthto be endangered by the obstinacy of a political group whichhas little if any knowledge of the question at issue, andwhether the principle of individual liberty will receive moreconsideration in this respect than it does in connexion withmilitary conscription, with the imposition of rates and taxes,and with compulsory education.