2
1057 PARIS. (FROM OUR OWN CORRESPONDENT.) Tobacco Angina. M. Fiessinger discussed before the Academy of Medicine on April lst the part played by tobacco in the serious effects of angina pectoris. Certain anginal neuralgias are induced by tobacco, but they are benign in character and disappear with the removal of the toxic agent. In fatal cases syphilis must be held responsible. M. Fiessinger related three cases in which a positive Wassermann reaction led to mercurial treatment, which was followed by immediate improvement, after all other remedial measures had failed. The diagnosis of serious tobacco angina-angine scléro-tabagique, as Huchard called it-cannot be admitted unless syphilis has been previously excluded. Biology and the Kinematograph. At the Société de Physique M. Guillaume recently dis- cussed the application of the kinematograph by Dr. Comandon, not merely for recording the movements of large organs, such as the heart, but also for following the life process up to its ultimate manifestations. By its means, he reminded his hearers, the circulation and the intimate mechanism of respiration can be demonstrated ; the life phases of bacteria can be followed step by step, their mode of locomotion fathomed, and their struggle with the organism witnessed. By a retarded movement of the kinematograph, taking only one picture every minute, and then causing the film to rotate at the ordinary speed, the development of a seed, the growth of a flower, the meta- morphoses of a larva, can be followed. The prospect is captivating, and the retarded kinematograph is undoubtedly ,a most useful means of instruction. Finally, a particular experiment in animal physiology can be made once for all, and where this can be done by means of the kinematograph .the experiment can be repeatedly demonstrated to students. Surgical Intervention in Tuberezc.losis Peritonitis. M. Kirmisson considers surgical intervention indicated in .certain cases of tuberculous peritonitis, in support of which view he cited many examples before the Societe de Chirurgie on April 2nd. While performing a laparotomy in a case of intestinal occlusion he found, besides an intestine perforated by tuberculous nodules, two bands of adhesion which kept ’the intestine kinked. He divided them and kept the patient, who was cured, under observation for a year. This happened also in another case. At other times it was not bands but .an agglutinated mass which caused the occlusion, and in such a case operation is ineffective, as he had found by trial. M. Lejara said that he had occasion to operate in a certain number of cases. In one case that presented all the signs of occlusion apparently connected with a tuberculous peritonitis, on opening the belly he found ascites with tuberculous vegeta- tions and bands, which last he divided. The patient was .cured. M. Lejars then recalled that there are in some forms .of peritonitis pseudo-occlusions often simulating appendicitis. Merely opening the abdomen suffices to overcome such con- ditions, which are due only to acute localised peritonitis. Finally, M. Quenu added the testimony of cases from his own practice in support of surgical intervention. Vaccination against Anthrax. M. Roux has brought before the Académie des Sciences the results of the work of M. Declainche and M. Vall6e, who for 12 years have been pursuing systematically the study of vaccination against anthrax, with the result that they have been able progressively to improve on the technique of their first operation. They have now made public a process that enables them to produce really attenuated strains of the bacillus anthracis, strains that it has hitherto been impossible to obtain. Vaccines prepared therefrom ensure, with a single vaccination and without any risk, the perfect immunisation of animals exposed to infection. As 345,000 .cattle have been vaccinated by this method with complete success in the past three years, the authors consider the problem of vaccination against symptomatic anthrax definitively settled. Impure Salt. M. Andouard has been studying salt, which the bacterio- logists consid-er a veritable hotbed of microbes of all kinds and a possible source of more or less severe infections. M. Andouard first showed that sea water near the shore, and consequently in the immediate vicinity of the salt-beds, contains considerable quantities of bacteria, of which the preliminary clarification beds favour the multiplication. This naturally is augmented by the raking of the beds with unclean instruments and the feet of the waders. The grey salt used for cooking and baking is of this kind. The fine salt is less rich in harmful germs, though not entirely exempt. In spite of the re-dissolving and clarification of the fresh liquid and the action of heat to induce a recrystallisation, there still remain about 2400 microbic colonies to the gramme of white salt. On a ham cured in salt liquor, M. Van Ermengem found the bacillus botulinus, a cause of very grave intoxications. M. Andouard concludes from his observations that sal t is a substance more or less impure from both the chemical and the bacteriological points of view, and that serious measures are called for refining, sterilisation, and clean packing-to put an end to the disorders that may be caused by this product. April 7th. ________________ NOTES FROM INDIA. (FROM OUR OWN CORRESPONDENTS.) The Calcutta Swamp. THE state of the Calcutta streets during rain recalls the fact that the city was built upon a swamp, and is con- sequently condemned to suffer whenever a few inches of rain fall. In the monsoon the subsoil water is but a few inches from the surface, and the only means of remedy- ing the effect of the excess of water from below and above would be an unusually extensive drainage scheme. The chief engineer has shown in the course of a lengthy note how the existing drainage of Calcutta has become too small for the work forced upon it by the growth of the city. The remedy is obvious, but the means of carrying it out by no means springs so readily to the eye. Physique pf Educated -1-ndians. An article appears in the February Wednesday Reciew from the pen of the Hon. Dr. T. N. Nair on the Physical Degeneration of the Educated Indian. Dr. Nair attributes this degeneration to early marriage, malnutrition, injurious environment, and overstudy, and advocates medical inspec- tion and feeding by the State of all school children. The Supply of Hospital Nurses in India. The report of the Lady Minto Nursing Association, which shows that the association is continuing and gradually extending its sphere of usefulness, has just been issued. During the year the nursing sisters throughout India attended some 514 cases, 309 of which were medical, 68 being cases of enteric fever, 96 maternity cases, and 40 infectious cases. 138 applications for nurses had to be refused owing to no nurse being available. The highest number of cases attended in any previous year was 477 in 1910. During 1912 the number of non-subscribers’ cases attended was 184, and the fees realised from these cases amounted to Rs.17,166. The total subscriptions received during the year amounted to Rs. 38,730, and the total fees to Rs.48,104, there being in all 1608 subscribers. During the year 10 nurses were sent out to India, all except 2 of them having received their training at London hospitals. Dr. T. F. Pearse, late Medical Officer of Calcutta. Dr. Pearse, having retired from his post as medical officer of health of Calcutta, is leaving here and will arrive home probably about the end of May. At a special meeting of the Calcutta Corporation, held at the Central Office on March 5th, a resolution was passed placing on record its high appreciation of the services which Dr. Pearse had rendered to the city and expressing its regret that reasons of health had rendered his resignation necessary. Dr. Pearse, who has been connected with the Calcutta Corpora- tion for 15 years, has been its health officer for six years, and has done excellent work during his term of office. King George V. Anti-Tuberculosis League, Bombay. This League, which, under the presidency of Lord Syden ham, the Governor of Bombay, and a distinguished committee, was formed to commemorate the Coronation Durbar and the

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Page 1: NOTES FROM INDIA

1057

PARIS.

(FROM OUR OWN CORRESPONDENT.)

Tobacco Angina.M. Fiessinger discussed before the Academy of Medicine

on April lst the part played by tobacco in the serious effectsof angina pectoris. Certain anginal neuralgias are inducedby tobacco, but they are benign in character and disappearwith the removal of the toxic agent. In fatal cases syphilismust be held responsible. M. Fiessinger related three casesin which a positive Wassermann reaction led to mercurialtreatment, which was followed by immediate improvement,after all other remedial measures had failed. The diagnosisof serious tobacco angina-angine scléro-tabagique, as Huchardcalled it-cannot be admitted unless syphilis has beenpreviously excluded.

Biology and the Kinematograph.At the Société de Physique M. Guillaume recently dis-

cussed the application of the kinematograph by Dr.Comandon, not merely for recording the movements of largeorgans, such as the heart, but also for following the lifeprocess up to its ultimate manifestations. By its means, hereminded his hearers, the circulation and the intimatemechanism of respiration can be demonstrated ; the life

phases of bacteria can be followed step by step, theirmode of locomotion fathomed, and their struggle withthe organism witnessed. By a retarded movement of the

kinematograph, taking only one picture every minute, andthen causing the film to rotate at the ordinary speed, thedevelopment of a seed, the growth of a flower, the meta-morphoses of a larva, can be followed. The prospect is

captivating, and the retarded kinematograph is undoubtedly,a most useful means of instruction. Finally, a particularexperiment in animal physiology can be made once for all,and where this can be done by means of the kinematograph.the experiment can be repeatedly demonstrated to students.

Surgical Intervention in Tuberezc.losis Peritonitis.M. Kirmisson considers surgical intervention indicated in

.certain cases of tuberculous peritonitis, in support of whichview he cited many examples before the Societe de Chirurgieon April 2nd. While performing a laparotomy in a case ofintestinal occlusion he found, besides an intestine perforatedby tuberculous nodules, two bands of adhesion which kept’the intestine kinked. He divided them and kept the patient,who was cured, under observation for a year. This happenedalso in another case. At other times it was not bands but.an agglutinated mass which caused the occlusion, and insuch a case operation is ineffective, as he had found by trial.M. Lejara said that he had occasion to operate in a certainnumber of cases. In one case that presented all the signs ofocclusion apparently connected with a tuberculous peritonitis,on opening the belly he found ascites with tuberculous vegeta-tions and bands, which last he divided. The patient was.cured. M. Lejars then recalled that there are in some forms.of peritonitis pseudo-occlusions often simulating appendicitis.Merely opening the abdomen suffices to overcome such con-ditions, which are due only to acute localised peritonitis.Finally, M. Quenu added the testimony of cases from hisown practice in support of surgical intervention.

Vaccination against Anthrax.M. Roux has brought before the Académie des Sciences theresults of the work of M. Declainche and M. Vall6e, whofor 12 years have been pursuing systematically the study ofvaccination against anthrax, with the result that they havebeen able progressively to improve on the technique of theirfirst operation. They have now made public a process thatenables them to produce really attenuated strains of thebacillus anthracis, strains that it has hitherto been impossibleto obtain. Vaccines prepared therefrom ensure, with a

single vaccination and without any risk, the perfectimmunisation of animals exposed to infection. As 345,000.cattle have been vaccinated by this method with completesuccess in the past three years, the authors consider theproblem of vaccination against symptomatic anthraxdefinitively settled.

Impure Salt.M. Andouard has been studying salt, which the bacterio-

logists consid-er a veritable hotbed of microbes of all kinds

and a possible source of more or less severe infections.M. Andouard first showed that sea water near the shore, andconsequently in the immediate vicinity of the salt-beds,contains considerable quantities of bacteria, of which thepreliminary clarification beds favour the multiplication.This naturally is augmented by the raking of the bedswith unclean instruments and the feet of the waders.The grey salt used for cooking and baking is of this kind.The fine salt is less rich in harmful germs, though not entirelyexempt. In spite of the re-dissolving and clarification of thefresh liquid and the action of heat to induce a recrystallisation,there still remain about 2400 microbic colonies to the grammeof white salt. On a ham cured in salt liquor, M. VanErmengem found the bacillus botulinus, a cause of verygrave intoxications. M. Andouard concludes from hisobservations that sal t is a substance more or less impurefrom both the chemical and the bacteriological points ofview, and that serious measures are called for refining,sterilisation, and clean packing-to put an end to thedisorders that may be caused by this product.April 7th.

________________

NOTES FROM INDIA.

(FROM OUR OWN CORRESPONDENTS.)

The Calcutta Swamp.THE state of the Calcutta streets during rain recalls the

fact that the city was built upon a swamp, and is con-

sequently condemned to suffer whenever a few inches ofrain fall. In the monsoon the subsoil water is but afew inches from the surface, and the only means of remedy-ing the effect of the excess of water from below and abovewould be an unusually extensive drainage scheme. Thechief engineer has shown in the course of a lengthy notehow the existing drainage of Calcutta has become too smallfor the work forced upon it by the growth of the city. The

remedy is obvious, but the means of carrying it out by nomeans springs so readily to the eye.

Physique pf Educated -1-ndians.An article appears in the February Wednesday Reciew

from the pen of the Hon. Dr. T. N. Nair on the PhysicalDegeneration of the Educated Indian. Dr. Nair attributesthis degeneration to early marriage, malnutrition, injuriousenvironment, and overstudy, and advocates medical inspec-tion and feeding by the State of all school children.

The Supply of Hospital Nurses in India.The report of the Lady Minto Nursing Association, which

shows that the association is continuing and graduallyextending its sphere of usefulness, has just been issued.During the year the nursing sisters throughout Indiaattended some 514 cases, 309 of which were medical, 68being cases of enteric fever, 96 maternity cases, and 40infectious cases. 138 applications for nurses had to berefused owing to no nurse being available. The highestnumber of cases attended in any previous year was 477 in1910. During 1912 the number of non-subscribers’ casesattended was 184, and the fees realised from these casesamounted to Rs.17,166. The total subscriptions receivedduring the year amounted to Rs. 38,730, and the total feesto Rs.48,104, there being in all 1608 subscribers. Duringthe year 10 nurses were sent out to India, all except 2 ofthem having received their training at London hospitals.

Dr. T. F. Pearse, late Medical Officer of Calcutta.Dr. Pearse, having retired from his post as medical

officer of health of Calcutta, is leaving here and will arrivehome probably about the end of May. At a special meetingof the Calcutta Corporation, held at the Central Office onMarch 5th, a resolution was passed placing on record its

high appreciation of the services which Dr. Pearse hadrendered to the city and expressing its regret that reasonsof health had rendered his resignation necessary. Dr.Pearse, who has been connected with the Calcutta Corpora-tion for 15 years, has been its health officer for six years, andhas done excellent work during his term of office.

King George V. Anti-Tuberculosis League, Bombay.This League, which, under the presidency of Lord Syden

ham, the Governor of Bombay, and a distinguished committee,was formed to commemorate the Coronation Durbar and the

Page 2: NOTES FROM INDIA

1058

visit of their Imperial Majesties, the King Emperor and QueenEmpress, to this country, has issued a plan of campaign andmade an earnest appeal for contributions. The plan ofcampaign includes the notification of the disease, theestablishment of tuberculosis dispensaries, the education ofthe people, the medical inspection of school children, thesupervision of milk and food supplies, and the general reliefof distress caused by the bread-winner of a family developingconsumption. The scheme is therefore a very comprehensiveone and if it can live up to its programme should materiallybenefit the province, especially as it is the intention of the

league t-o emphasise the importance of the establishmentof hospitals for advanced cases, of sanatoriums and farm

colonies, of open-air schools and homes for cripples, andthe segregation of infected purdah women in suitable institu-tions, these institutions being provided for and maintainedby municipal bodies or outside philanthropic agencies withor without Government aid. Towards the general schemeMr. Ratan Tate has promised to contribute Rs. 1,50,000, theGovernment of Bombay an annual donation of Rs. 19,000for three years, and the municipal corporation of Bombayhas sanctioned a similar amount for the same period, whileseveral commercial firms have promised assistance. It has Ialso been arranged that there should be an enrolled list ofannual members and life members paying a subscription ofRs. 5 and Rs. 100 respectively. Dr. J. A. Turner and Dr.N. H. Choksy are the honorary secretaries.

King Edward VII. Memorial Sanatorium at Lotni, Bhawali,Naini Tal Distraet.

Major A. W. Cochrane, I.M.S., the superintendent of thesanatorium which was raised as a memorial to the late Kingby the people of the United Provinces, has issued his reportfor 1912. Up to Dec. 31st 54 patients were admitted,comprising 45 males and 9 females, the percentage of thosegiving a history of tuberculous lung disease in near relativesbeing 55 per cent. Of 36 patients who left the sanatoriumduring the year the average stated length of illness beforeadmission was 388 days. The average stay of the patientsin the sanatorium was 81.44, the maximum being 183 andthe minimum 17 days. The result of the treatment, not including 6 cases which stayed less than 1 month, was asfollows : in the first and second stages (11 cases) no deaths,1 not improved, 1 improved, 2 much improved, and 7 diseasearrested. In stage three (19 cases) 1 died, 5 not improved,4 improved, 5 much improved, and 4 disease arrested. This

gives 63’63 per cent. of cases of arrested disease in stages1 and 2 and 21 - 05 per cent. in stage 3.

The Viceregal Lodge Fund for the Turkish Army.A sum of Rs. 21,842-7-3 was sent to Constantinople

on behalf of Her Excellency Lady Hardinge’s Fund forthe relief of the women and children of Turkish killedand wounded. This sum has now reached its destina-

tion, and, with the permission of Her Excellency, hasbeen added to Lady Lowther’s Fund, which deals with theabsolutely destitute women and children who have lost theirall owing to the war. There are at present 15,000 refugeesentirely dependent on Lady Lowther’s Fund, of whom 6000are the families of the Turkish soldiers-dead, wounded, orlost-and it is for the maintenance of these that LadyHardinge’s Fund has been utilised. The Turkish Govern-ment has in most cases been able to provide housing forthem, but they are entirely dependent on charity, I under-stand, for all the other necessaries of life. They are nowbeing supplied from the Fund with bread, charcoal, bedding,and garments, and in some cases with milk, rice, medicine,and beans.

The Ghent Exhibition.

Surgeon-General Sir A. M. Branfoot will represent theGovernment of India at the Ghent International Exhibitionof Tropical Diseases, which has been fixed for the spring.Exhibits relating to malaria, kala-azar, cholera, and small-pox are being collected for inclusion in the British collectionfor the Exhibition.

Bangalore Improvements: As a result of the inspection late last year by Major J. C.

Robertson, I.M.S., of the sanitary requirements of the civiland military station of Bangalore, the Government of Indiahave now sanctioned a special grant of four lakhs of rupees(£25,000 sterling) to be expended exclusively on sanitation.This will include further relief of congestion in the general

bazaar by the demolition of insanitary dwellings, compensa-tion for road opening, and new tenement extensions.

, Plague at alzetum,.

Plague has broken out in the city of Jhelum. During thelast few days about half a dozen men were taken ill, and allof them succumbed to the disease. At first the diseaseremained confined to the upper part of the city, but now itis spreading to the other parts. The first case took place inthe sweepers’ huts, but now it has extended further. Deadrats are being thrown into the streets by the people, apractice that should be stopped at once. In consequence ofthis outbreak the Jhelum cantonment is placed out ofbounds.

The Dangers of Petrol.An unfortunate accident illustrating the danger of using

petrol for cleaning purposes occurred in Lahore recently. A

lady had cleaned a pair of gloves with petrol early one morn-ing, and after doing so hung the gloves up in the verandah. Inthe afternoon when going out she put on the gloves, and wasjust leaving her drawing-room when she noticed that the fireneeded attention. She picked up the poker and stirred thefire, when her gloves suddenly burst into flames. She hadthe presence of mind to thrust her hands under a heavy rugwhich was handy, but both hands being burnt she wasunable to press the rug down on them. It was some timebefore the flames were extinguished, and the lady’s armswere severely burned. It is worth while to call attention tothis case because there is a very general impression thatthe small amount of petrol used for glove-cleaning, &c.,evaporates rapidly, and that a very brief time is sufficientto prevent all possibility of danger. In this case the gloveshad been hanging for several hours in the open air beforethey were used, but enough petrol remained in them tocause a serious accident.

The Madras Water-supply.The Government of India has submitted for sanction’ to

the Secretary of State a project for a reservoir connectedwith the Madras water-supply which is estimated to cost

20 lakhs of rupees.Karachi’s Water-supply.

In a recent report the chief engineer of the Karachi

municipality shows that for an expenditure of about 6 lakhsof rupees he can provide for all the reasonable requirementsof Karachi for the next ten years. For the more distantfuture there is a project for damming the river Malir about29 miles away, which will guarantee a practically unlimitedand inexhaustive supply. It remains for the municipality todeal with the financial aspects of the situation.March 14th.

___________________

AUSTRALIA.(FROM OUR OWN CORRESPONDENT.)

Health of t7ze Australian Naty.THE report for last year states the strength of the

navy at 14 vessels, carrying 3450 men. The number of casesof disease and injury entered on the sick list was 2691, whichwas an increase of nearly 50 per cent. on the average for theprevious five years. The invalidings numbered 56. Therewere 13 deaths. The average number of daily sick was 80’ 7.The increase in the sick list was due to minor ailments, andthe venereal statistics were said to be satisfactory.

Maternity Bonus.The Commonwealth maternity bonus has now become very

generally claimed, and it is estimated that the first year’spayments will total over .E.600,000. The first prosecutionfor making a false return was heard in Victoria, and theaccused woman was fined :&10 and ordered to return theamount of the bonus. The mother had obtained it byforging the nurse’s signature.

New South Wales Public Health Department.Dr. J. Ashburton Thompson has retired from the position

of principal Government medical officer and President of theBoard of Health. Dr. Thompson has done good work duringhis occupancy, and is recognised as a leading authority onleprosy and bubonic plague. It was owing to his work inSydney that bubonic plague became definitely recognised asa disease of rats, and probably conveyed to man by means