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549 doubtless, that a man does not suddenly become insane in the brief interval between murdering his family and committing suicide. In other words, one of His Majesty’s judges has inclined towards the medical rather than the legal view. PARIS. (FROM OUR OWN CORRESPONDENT.) WHEN SHOULD ANTI-TETANUS SERUM BE GIVEN ? NOT long ago a doctor omitted to give a prophy- I lactic injection of anti-tetanus serum to a person who died of tetanus. The price paid for this omission was a big sum in damages awarded against the doctor who, had he been wiser or more cynical, would have reasoned that an injection of anti-tetanus serum may be prophylactic in more senses than one. The problem, to inject or not to inject anti-tetanus serum as a precautionary measure, would seem to be quite insoluble if all parties concerned are to be satisfied. The doctor who argues that in any given case the chances of his patient developing tetanus are infinitesimal, and who accordingly holds his hand, may one day be obliged to pay terrific damages to the cost of which none of the hundreds of patients whom he has saved from the discomforts of anti- tetanus serum will contribute a single sou. On the other hand, the doctor in whose mind the above- mentioned damages loom heavily, and who gives prophylactic injections of anti-tetanus serum as a matter of routine whenever a patient comes to him with a scratch, is liable, sooner or later, to be accused by individuals and insurance companies of exploiting this measure to his own profit. Que faire ? ? Is every doctor to be a law unto himself and decide every case on its own merits to the best of his judgment ? ’? Or should some corporate body lay down certain general rules behind which the practitioner may shelter, both from the claims of the relatives of the patient who has died for want of an injection, and from the aspersions of those who regard wholesale preventive inoculations as a device for increasing the doctor’s income and the insured worker’s leisure ’? These questions are not merely of local interest ; they are common to every country where tetanus exists. In France the problem has become so burning that the Academy of Medicine, on the initiative of Prof. Hartmann, has appointed a commission composed of Profs. Hartmann, Balthazard, Auvray, Mauclaire, Gosset, Roux, J. L. Faure, Vaillard, Vallee, Bazy, and Walther to study it and to frame rules of conduct for the guidance and protection of practitioners. Such guidance is of course already to be found in text-books. But the protection an authoritative statement by the Academy of Medicine can give in this matter should prove effective, from whichever side the practitioner may be threatened. THE SUMMER HOLIDAYS. Another knotty problem which the Academy has lately been asked to unravel concerns the French school-child in the latter half of July. Is he or is he not to languish at his desk or face his examiners during a fortnight which is almost always hot and sultry The overburdening of the school curriculum in France has lately attracted general attention, and the critical fortnight is only part of a bigger question. In pre- senting his report to the Academy on behalf of the Commission on the overloaded educational curriculum, Dr. Le Gendre pointed out that for years schools have broken up on or before August 1st, and that virtually the summer holidays already begin with the national fete of July 14th, only prizemen or examiners con- tinuing to attend school. France having such a wide range of temperatures and climates, it might not, he thought, be fair to impose on the school-child grilling in Marseilles in July the same curriculum that might be bearable in Briançon, fanned by mountain breezes. Hence his suggestion to give education committees in different parts of the country a certain latitude in choosing the hours of work and rest for their scholars. The Commission has recommended the Academy ta declare that the excessive temperature often experi- enced in the second fortnight in July, but sometimes occurring earlier, may hamper mental work and injure the health of the less resistant. The Academy is also invited to recommend a change in the scholastic time-table in excessively hot weather so that intellec- tual work is not done between 11 A.M. and 4 P.M. The daily application of cold water in some form or other is recommended. BIRDS AS CARRIERS OF BRUCELLA. On Feb. lOth a report was presented to the Academy by Dr. H. Violle who, in conjunction with Dr. Montus, has infected various species of birds with Brucella abortus. They were led to suspect birds as carriers of this germ by the observation that undulant fever sometimes occurs in human beings in areas where infection by the hitherto known sources can be definitely excluded. Intramuscular injections of brucella into three pigeons were followed by the death of one of them in three davs. The two survivors were well when killed seven days after the injections, but the germ was recovered from the blood, heart, spleen, and liver of one of them. Of two chaffinches similarly inoculated, one died 48 hours later, its blood and spleen yielding a pure culture of brucella. The other, which was in good health, was killed a week after the inoculation, when its organs still contained brucella. Similar results were obtained with thrushes. The fact that birds, including migrants, may harbour brucella is the more significant as they are immune to quarantine regulations and sanitary cordons which sheep and goats may be forced to respect. Dr. Violle drew a rather alarming picture of the pigeon living in contact with manure infected with the urine of diseased sheep, goats, and cattle, and transmitting the infection to human beings either by direct contact with their soiled feet, or in the process of preparation for human food. NOTES FROM INDIA. (FROM OUR OWN CORRESPONDENT.) IIEALTFI IX JAIL. THE report on the prison administration of Burma for 1929 records health statistics " even less favourable than those of the previous year," thus drawing attention to the fact that Burmese prisons occupy an unenviable eminence in this respect. There are often unavoidable reasons for heavy morbidity- and mortality-rates in jails in particular areas. It would not be fair for instance to compare, without qualifica- tion, some fever-stricken districts in Bengal with the healthier parts of the Deccan, and epidemics or famine may account for an exceptional increase any- where, but a comparison with most Indian provinces. certainly shows the Burmese prisons in an unfavour- able light. Mortality in Indian jails during 1929 varied between 8-1 per mille for the United Provinces,

NOTES FROM INDIA

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doubtless, that a man does not suddenly becomeinsane in the brief interval between murdering hisfamily and committing suicide. In other words, oneof His Majesty’s judges has inclined towards themedical rather than the legal view.

PARIS.

(FROM OUR OWN CORRESPONDENT.)

WHEN SHOULD ANTI-TETANUS SERUM BE GIVEN ?

NOT long ago a doctor omitted to give a prophy- Ilactic injection of anti-tetanus serum to a personwho died of tetanus. The price paid for this omissionwas a big sum in damages awarded against the doctorwho, had he been wiser or more cynical, would havereasoned that an injection of anti-tetanus serum maybe prophylactic in more senses than one. The

problem, to inject or not to inject anti-tetanusserum as a precautionary measure, would seem to bequite insoluble if all parties concerned are to besatisfied. The doctor who argues that in any givencase the chances of his patient developing tetanusare infinitesimal, and who accordingly holds his hand,may one day be obliged to pay terrific damages tothe cost of which none of the hundreds of patientswhom he has saved from the discomforts of anti-tetanus serum will contribute a single sou. On theother hand, the doctor in whose mind the above-mentioned damages loom heavily, and who givesprophylactic injections of anti-tetanus serum as a

matter of routine whenever a patient comes to himwith a scratch, is liable, sooner or later, to be accusedby individuals and insurance companies of exploitingthis measure to his own profit. Que faire ? ? Is everydoctor to be a law unto himself and decide every caseon its own merits to the best of his judgment ? ’? Orshould some corporate body lay down certain generalrules behind which the practitioner may shelter, bothfrom the claims of the relatives of the patient who hasdied for want of an injection, and from the aspersionsof those who regard wholesale preventive inoculationsas a device for increasing the doctor’s income and theinsured worker’s leisure ’? These questions are notmerely of local interest ; they are common to everycountry where tetanus exists. In France the problemhas become so burning that the Academy of Medicine,on the initiative of Prof. Hartmann, has appointed acommission composed of Profs. Hartmann, Balthazard,Auvray, Mauclaire, Gosset, Roux, J. L. Faure, Vaillard,Vallee, Bazy, and Walther to study it and to framerules of conduct for the guidance and protection ofpractitioners. Such guidance is of course already tobe found in text-books. But the protection an

authoritative statement by the Academy of Medicinecan give in this matter should prove effective, fromwhichever side the practitioner may be threatened.

THE SUMMER HOLIDAYS.

Another knotty problem which the Academy haslately been asked to unravel concerns the Frenchschool-child in the latter half of July. Is he or is henot to languish at his desk or face his examiners duringa fortnight which is almost always hot and sultry The overburdening of the school curriculum in Francehas lately attracted general attention, and the criticalfortnight is only part of a bigger question. In pre-senting his report to the Academy on behalf of theCommission on the overloaded educational curriculum,Dr. Le Gendre pointed out that for years schools havebroken up on or before August 1st, and that virtually

the summer holidays already begin with the nationalfete of July 14th, only prizemen or examiners con-tinuing to attend school. France having such a widerange of temperatures and climates, it might not, hethought, be fair to impose on the school-child grillingin Marseilles in July the same curriculum that mightbe bearable in Briançon, fanned by mountain breezes.Hence his suggestion to give education committeesin different parts of the country a certain latitude inchoosing the hours of work and rest for their scholars.The Commission has recommended the Academy tadeclare that the excessive temperature often experi-enced in the second fortnight in July, but sometimesoccurring earlier, may hamper mental work and injurethe health of the less resistant. The Academy is alsoinvited to recommend a change in the scholastictime-table in excessively hot weather so that intellec-tual work is not done between 11 A.M. and 4 P.M.The daily application of cold water in some form orother is recommended.

BIRDS AS CARRIERS OF BRUCELLA.

On Feb. lOth a report was presented to the Academyby Dr. H. Violle who, in conjunction with Dr.Montus, has infected various species of birds withBrucella abortus. They were led to suspect birds ascarriers of this germ by the observation that undulantfever sometimes occurs in human beings in areas whereinfection by the hitherto known sources can be

definitely excluded. Intramuscular injections ofbrucella into three pigeons were followed by the deathof one of them in three davs. The two survivorswere well when killed seven days after the injections,but the germ was recovered from the blood, heart,spleen, and liver of one of them. Of two chaffinchessimilarly inoculated, one died 48 hours later, its bloodand spleen yielding a pure culture of brucella. The

other, which was in good health, was killed a weekafter the inoculation, when its organs still containedbrucella. Similar results were obtained with thrushes.The fact that birds, including migrants, may harbourbrucella is the more significant as they are immune toquarantine regulations and sanitary cordons whichsheep and goats may be forced to respect. Dr. Violledrew a rather alarming picture of the pigeon living incontact with manure infected with the urine ofdiseased sheep, goats, and cattle, and transmittingthe infection to human beings either by direct contactwith their soiled feet, or in the process of preparationfor human food.

NOTES FROM INDIA.

(FROM OUR OWN CORRESPONDENT.)

IIEALTFI IX JAIL.

THE report on the prison administration of Burma _

for 1929 records health statistics " even less favourablethan those of the previous year," thus drawingattention to the fact that Burmese prisons occupyan unenviable eminence in this respect. There areoften unavoidable reasons for heavy morbidity- andmortality-rates in jails in particular areas. It wouldnot be fair for instance to compare, without qualifica-tion, some fever-stricken districts in Bengal with thehealthier parts of the Deccan, and epidemics or

famine may account for an exceptional increase any-where, but a comparison with most Indian provinces.certainly shows the Burmese prisons in an unfavour-able light. Mortality in Indian jails during 1929varied between 8-1 per mille for the United Provinces,

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and 17 for Assam, as compared with 27-4 for Burma.The figure for Madras and Bombay is a little over 10per mille, Bengal and the North-West FrontierProvince in the neighbourhood of 12, the CentralProvinces and Punjab between 13 and 14, and Biharand Orissa 15-9. A disquieting feature is that theBurmese figures are not exceptional, judging by therecord of the last five years. A frequent cause ofuneasiness to superintendents of prisons is over-

- crowding, and it is obvious that the recent political,disturbances must have thrown a great strain onthe accommodation available in many areas. Burma,however, has been less affected than India proper bypolitical disturbances, and although it is mentionedthat a number of jails were not free from overcrowd-ing during part of the year, additional accommodationfor 1302 prisoners was provided, and the Inspector-General states that at the end of the period over-crowding had ceased to exist. That diet on the wholewas sufficient and good in quality may be taken forgranted, and the fact is confirmed by a reasonableaverage increase in weight of the prisoners. Water-

supply is evidently a difficulty in certain of the prisons,and in some cases resort was had to chlorination.Conservancy, as in the great majority of up-countryIndian prisons, is generally of the dry-earth type,:and soakage pits for urine are in general use.

THE BURMESE JAIL POPULATION.

The daily average strength was 19,956. Of the546 prisoners who died, 215 were admitted to jail ingood health. Amongst causes of death dysenterycomes first, with 1106 admissions and 145 deaths.Tuberculous diseases were responsible for 248 admis-sions and 134 deaths. Thus these two diseases.accounted for more than half the total mortality.It was not a bad cholera year, and malaria, thoughthere were a considerable number of admissions, wasnot a large cause of death (0-59 per mille). Burma,:as a rice-eating country, is subject to beri-beri, butthere were only 28 admissions for this disease, withone death. Some of the prisoners contracted beri-beriwhile detained in local lock-ups under trial. Thisshows the necessity of keeping a careful check ondieting under such conditions. There were 3440admissions for ankylostoma infection, and seven

deaths were attributed to this cause. It is recordedthat 6-70 of the convict population were opium con-sumers. The prison at Bhamo returned the almostincredible percentage of 87-85 of opium addicts ; butthis habit is notoriously one of local prevalence. Itis interesting to note that punishments show a largedecrease for the year, and that the Borstal system,.and other modern means of dealing with juvenile.offenders, are receiving attention. The Salvation

Army has made itself responsible for some juvenileadult criminals, and a prisoners’ aid society is in

.operation in Rangoon.

BOMBAY JAIL MORTALITY.

The Bombay mortality iigure 01 10.3 per milie e

admits of little criticism from a sanitary or hygienicpoint of view ; but even this figure is above that ofthe previous two years, for each of which the ratewas only 8-6. The increase was due to the prevalenceof influenza in part of the Deccan, and malaria follow-ing exceptional floods in sind. The principal causes ofdeath were pneumonia (33), pulmonary tuberculosis(17), dysentery (9), out of a total of 136 deaths for theyear. The daily average strength was 13,204. Therewas no serious overcrowding. Prisoners’ aid societies"have been formed, and religious and moral instruction

is given in many centres. An experiment with theboy scout movement has been started at a juvenilejail.

THE FIGURES IN ASSAM JAILS.

Although still high, the figures for Assam are

considerably lower than in most of the last ten years.With a daily average of 2470 there were 42 deaths(17 per mille). Leaving out 1921, in which the

mortality amounted to 35-4 per mille, and one ortwo other exceptionally bad years, there has been analmost continuous improvement. Here again the

principal causes of death were dysentery (13) andtuberculosis (13). When special attention was directedto the water-supply at Sylhet it was found that themunicipal arrangements for chlorination were defec-tive ; efficient chlorination in the jail resulted in arapid diminution of cases. All Assam jails have nowbeen ordered to chlorinate their water-supplies.Many of the tuberculosis cases were suffering fromthe disease on admission. Malaria only accounts for113 admissions and one death, ankylostomiasisfor 14 admissions. There is no prisoners’ aid societyin the province, and no mention is made of a Borstalinstitute, or other special provision for juveniles.

SUGGESTIONS FOR IMPROVEMENT.

No one can study reports of the average Indianjails without being impressed with the solid good workwhich has been put into these institutions, and thefact that from nearly every material point of viewmost of them continue to improve. It would be

interesting however to observe the effect of a uniformchlorination of water-supplies. Water-borne disease

still seems to bulk too largely in many mortalityreturns. As regards social and moral uplift there isperhaps more room for comment. Subject to themaintenance of discipline, nothing but good couldresult from the sort of amenities which have beenintroduced into some American and British prisons;such civilising privileges as books, music, lectures,and even plays might well be utilised to a greaterextent than at present. The Indian prisoner is

responsive to influences of this kind.

IRELAND.

(FROM OUR OWN CORRESPONDENT.)

THE CENSORSHIP BOARD AND SCIENTIFIC BOOKS.

UNTIL recently the Censorship Board of the IrishFree State, in its relations with books as distinctfrom periodicals, had dealt mainly with two classes ofbook-namely, modern fiction and works which

advocate the unnatural prevention of conception.The latter class is prohibited specifically by the Act,and the Board has no duty except to decide that acertain work does as a matter of fact advocate suchprocedure, and the work is ipso facto prohibited onthe report reaching the Minister. In regard toother works the prohibition of which they recommendthe Censors must form the judgment that the workis obscene or indecent, and in coming to such judg-ment they must take into consideration the generaltendency of the work. Opinions will differ about thepropriety of their judgment in regard to many ofthe works condemned, such as, for example, Mr.Aldous Huxley’s "Point Counterpoint,’’ Mr. SinclairLewis’s " Elmer Gantry," and Mr. A. P. Herbert’s" Water Gypsies.’’ But in the last list of books, the