1372 T

slightly above that of the preceding year, was nevertheless w

in defect of the average rate in the ten years 1896-1905. 1

The rate of birth was the lowest on record; it was below s,

the rate of the previous year by 2 per 10,000 living, and was o

below the decennial average rate by 17 per 10,000. The À

death-rate, although higher than that of 1905 by 2 per a

10,000, was nevertheless below the average in the preceding ten years by 14 per 10,000 of the population. Infantile il

mortality, measured by the proportion of deaths under one v

year to registered births, was 133 per 1000, which is 5 per a

1000 above the rate of the preceding year, but as compared vwith the average in the preceding decennium the rate of t

1906 showed a decrease of 14 per 1000 births. ’]

Mediterranean or Malta Fever.DURING the last quarter of a century few if any of the t]

departments of medicine have attained greater triumphs than 0 othat dealing with tropical diseases, for in this period we a

have witnessed discoveries in the etiology of these diseases t;

in which men of science from nearly every country have f:

had their share. We need only mention the famous dresearches of Professor KoCH on cholera and the valuable pand life-saving facts resulting from the discoveries of t

LAVERAN, MANSON, and Ross in malaria. Light has been t

thrown upon the causation of yellow fever by our profes- s

sional brethren in America, while at last the pathology of a

sleeping sickness has been demonstrated by the Schools of tTropical Medicine of London and Liverpool. That curious tdisease, kala-azar, has been the subject of three separate ICommissions appointed by the Government of India and its tetiology seems to have been determined ; and now the s

question of the causation of Mediterranean fever has been tsettled by the researches of a Commission appointed by the s

Royal Society. ,Mediterranean or Malta fever has for a long time been a f

subject of discussion in medical science. The disease was z

first of all described by Dr. WOODWARD; his account was (based on his experience whilst serving in the Federal armyof the Potomac in 1861, and he considered it to be a

hybrid affection-a combination of malaria and typhoid afever. Next BORELLI of Naples and AITKEN of Rome lookedon it as a peculiar form of malarial fever, whilst DURAND- j iFARDEL of China and MOREL of French Guiana considered it tto be only a severe form of malaria. In 1879 Surgeon-Major 1H. R. L. VEALE of the Army Medical Department named the (

disease " febris complicata " and held that it was a definite iaffection-one that is certainly not typhoid fever and as F

certainly not a malarial fever, or any modification of typhoidfever by malaria, or engrafting of the taint of malaria on

i

typhoid fever, for the affection is one not yielding to quininein the slightest degree: the access is insidious and its

c

duration is extremely protracted (being of months ratherthan weeks and having been known to reach a period of twoyears); it is characterised now by deceptive convalescences <

and now by exacerbations, by profuse perspirations whichgive no relief, and by an extraordinary range of complica- 1

tions affecting all the systems of the body, especially thelocomotor apparatus. The importance of this disease to

1

England is evident from the fact that Malta is not only a 3 i

winter resort and an important commercial centre but is also Ia naval station for a large fleet and a half-way house in ’

hich regiments are acclimatised before proceeding to India.t contains a permanent force of over 25,000 soldiers and

ailors and may at any time become the seat of warlike

’perations, when every available man is of vital importance.m these troops must be exposed to this endemic fever

md its lengthened duration causes an enormous yearly.Inancial loss from non-effective pay and invaliding, whilstt may be said to be the most important and, next tovenereal diseases, the most prevalent form of sickness

Meeting our Mediterranean forces. In other parts of theworld the disease has been shown to exist and as affectinge British army we may note its appearance in India.

rhe first step in the true elucidation of the disease was the

liscovery in 1887 of the specific micrococcus Melitensis bycolonel DAVID BRUCE, C.B., R.A.M.C., and now, 20 yearsater, the concluding report (No. VII.) has been issued ofihe Commission which was appointed under the auspices)f the Royal Society and which began its investigationsit the commencement of June, 1904. These investiga-tions have been crowned with success, for at length thefacts regarding the causation of the disease have been

demonstrated and the Commissioners have determined the

paths by which the specific micrococci find their way out ofthe bodies of infected men or of infected animals. Examina-

tion of the breath, saliva, sweat, and scrapings from theskin yielded negative results, the discharges from the bowelare still in the doubtful category, while it was shown that

the main paths are by milk and by the urine, and of thesethe first is the most important. In Malta a very largepercentage of the goats are infected and their milk containsthe specific micro-organism. The chain of arguments pre-sented in the report is conclusive as to the part played bythe Maltese goats in propagating the disease and this is

strikingly confirmed by what has happened in Gibraltar.

While Gibraltar Rock obtained its milk from goats suppliedfrom Malta it was as liable to the fever as that island, but ofrecent years Maltese goats have not been allowed ’to enterGibraltar and the fever is now non-existent in that station.

The Commission concludes its report with a series of valu-able suggestions, and these, of course, will be put in forceas regards our own garrison, but there is no such certaintywith regard to the action of the native Maltese. It is to be

feared that nothing will be done to purify their herds ofthis disease unless the utmost publicity is given to the factthat the ingestion of infected goat’s milk, if not the onlycause, is at any rate the main cause of the infection. We

trust, therefore, that the native inhabitants of Malta willsee the wisdom of setting their house in order in accordancewith the facts led up to by the unremitting work of manycompetent observers and now established by the valuableresearches of the Commission sent out under the auspicesof the Royal Society.

WEST LONDON POST-GRADUATE COLLEGE.-Theannual dinner of the Post-Graduate College and of the pastand present members of the West London Hospital will beheld at the Trocadero Restaurant, Piccadilly-circus, on

Wednesday, June 12th, at 7.30 P.M., Mr. Lloyd Williams inthe chair. Any gentlemen who have worked at the Post-graduate College of the hospital will be welcome and tickets(7s. each) can be obtained on application to the honorarysecretary of the dinner, Mr. L. A. Bidwell, 15, UpperWimpole-street, W.