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institution, will shortly be opened formally. The wards havefor the past three months been occupied by patients anddorts are being made to raise additional funds on behalf ofthe hospital.

AprU 19th. _________________

PARIS.

(FROM OUR OWN CORRESPONDENT.)

The Number of the Ticbcraulous in the Paris Hospitals.A MEDICAL journal has just carried through an inquiry

into the number of tuberculous patients under treatment inthe Paris hospitals. Of 4117 patients passed under review1685 were tuberculous-namely, 1146 men and 539 females,or a proportion of 40 per cent. A similar inquiry badalready been made by M. Mourier, formerly director of theAssistance Publique, who arrived at the result of 45 per cent.These figures are important at the present time when it hasbeen decided to reserve two or three of the Paris hospitalsexclusively for the use of tuberculous patients.l As a matterof fact, the number of tuberculous persons in Paris is fargreater than is indicated by the above figures. Even whenthe 2000 tuberculous patients who are to be treated in thehospitals are taken away from the general number there willeasily be 2000 others to take their place. Who can tellwhether the patients will go willingly into these "hospitalsof death" where they can be under no illusion as to thenature of their malady ? 7 In hospitals when the plan ofreserving certain wards for tuberculous patients has beentried as soon as those suffering from phthisis saw thatthey were to be in company with their fellow sufferers theyinsisted on leaving.

The Tlte’l’apeutio Uses of the Peroxides.M. Gilbert recently real a paper before the Society of

Biology on the Therapeutic Uses of the Peroxides and as asequel to this paper M. Albert Robin read another before theTherapeutical Society giving his experiences of this drugwhich he has for some time past employed. The peroxidesof calcium and of magnesium give up the whole of theiroxygen when they come in contact with the gastric juice.If, however, they are given in a capsule of keratine so thatthey can pass into the bowel before being decomposed theyhave a powerful antiseptic action. Under their influence theconjugate potassium indoxyl sulphate present in theurine in cases of septic absorption rapidly diminishes.Peroxides diminish the fcetor of the stools and are the bestmeans for overcoming diarrhoea due to a fermentative origin.On this account they may be made to serve as a diagnosticagent, for they have hardly any effect in diarrhoea due toserous, vaso-motor, bilious, nervous, or tuberculous causes.M. Robin quoted two typical cases which were under hiscare at the Beaujon Hospital. One was that of a patientin the third stage of phthisis who had profuse diar-rhoea, probably of tuberculous origin. The stools wereliquid, without marked foetor, very slightly coloured,and neutral or alkaline in reaction. Peroxide of mag-nesium in doses of one and a half grammes perdiem had no effect and reliance had to be placedupon astringents such as tannin, opium, and bismuth.IE these were given up the diarrhoea returned andoxide of zinc had to be given. The other case was

that of a patient suffering from pleurisy who duringconvalescence developed acute diarrhoea with very fcetidstools, giving a markedly acid reaction to litmus paper.This condition seemed to be due to gastric hyperacidity,the existence of which was confirmed by an analysisof the stomach contents and which in its turn was due tofermentation. Peroxide of magnesium was given at first indoses of one gramme per diem so as to act on the stomachcontents and afterwards in a keratine capsule so that it

might act directly on the intestinal contents. Within a fewdays the stools became less frequent and lost their foetor.As, however, they remained acid the stomach contents atthe end of a meal were saturated by a mixture of calciumcarbonate and calcined magnesia, two days after which thestools became absolutely normal. In the belief that oxygenliberated from the peroxides would be absorbed by theblood Hatch, Havald, Mon6, and Munstein have suggestedthat magnesium peroxide should be given in cases in which

1 THE LANCET, April 16th, p. 1085

the direct action of oxygen seemed advisable. Ttiey recom.mend its use in certain cases of ansemia and in certain casesof joint disease.April 19th.

___ ____

SWITZERLAND.(FROM OUR OWN CORRESPONDENT.)

The Midwives’ Petition.A QUESTION of practical importance is at present before

the legislative council of the canton of Ziirich. As the rulesand regulations for admission to the cantonal hospitals, boththose which receive paying patients as well as those whichprovide for the needs of the pauper population, are at presentunder consideration the midwives of the district havepetitioned asking that the fees charged to the paying classof patients should be raised. They plead that the presentcharges at the obstetric clinic should be raised as theinterests of both the ratepayers and the midwives are suffer-ing severely in consequence of the system now in force. Thenumber of women admitted at the obstetric clinic for thepurpose of their confinement has been rapidly increasingfrom year to year ; it has, in fact, more than doubled in tenyears, for there were 1344 admissions in 1902 as comparedwith 540 in 1891. Thus nearly one-fourth of all the confine-ments of the town of Zurich, which has a population of160,000, take place at the clinic and three-fourths are

attended by the midwives and the medical practitioners.I must here mention that the great majority of all the normalconfinements, perhaps over 90 per cent., are conducted bythe midwives and medical aid is only summoned in cases ofabnormal labour, this portion of the work is falling into thehands of the numerous medical specialists, male and female.I must also add that the midwives are well trained for theirduties as they have to spend six months at the clinic instudy in order to obtain a legal diploma. They also have toattend repetition courses at the hospital every three or fouryears as long as they continue in the profession. The rate-payers of the canton of Ziirich are put to considerableexpense owing to the fact that the middle-class patientsare undercharged at the clinic where they get the best ofadvice and attendance for nominal fees. The daily cost atthe clinic is 2s. 5d. per head ; the average amount paid inis only ls. 5d., and the deficit to be covered amounted in1891 to .61700 but has risen in 1902 to .E5100 for the obstetricclinic alone. The midwives argue that if this arrangementextended only to paupers nobody would have reason to com-plain but the middle classes have begun to use, or ratherto abuse, these charitable institutions to the detriment of themidwives who are under a legal obligation to attend normalpauper confinements for the meagre sum of 12s., whereas thepatients who could pay from .61 to E2 for a confinementmake use of the hospital. At present persons declaringtheir incomes at .E80 a year pay only 8d. a day whenin the hospital ; this sum should be increased to ls. 3d. perday. Persons declaring their incomes at amounts up to.E120 should pay 2s. a day instead of ls. as at present. Itmust also 0 be remembered that declared incomes are

notoriously some 20 to 50 per cent. short of the real income,owing to the high rate of income tax-namely, ls. 6d. inthe pound. It seems most necessary that the canton ofZiirich, which is hampered by a deficit now amounting to160.000, should do everything in its power to avoid useless,deficits as in the above case. This petition has caused thescale of charges for admission to the cantonal clinics tobe returned to the authorities for revision.

Ziirich, April 12th. __________________

EGYPT.(FROM OUR OWN CORRESPONDENT.)

Cattle Plague.THIS disease, also called rinderpest or bovine typhus, has

often been introduced into Egypt from Turkey or Syria,where it is endemic as in South Africa and India. One ofthe first duties of the newly formed sanitary department in1884 was to combat it and matters were then impossiblydifficult owing to the complete absence of veterinarysurgeons and all literature on the subject. In fact, theEgyptian Government of that day was 60 averse to in-

creasing the number of English officials that it actually