799

of the cord by means of Quincke’s lumbar puncture. By theemployment in this way of from five to 10 milligrammes ofcocaine hydrochlorate Dr. Bier succeeded in producing anaes-thesia of the lower limbs and was able to perform pain-lessly such operations as resection of the knee-joint andankle-joint, sequestrotomy of the tibia, resection of the

ischium, treatment of a case of osteomyelitis of the femur,and resection in a case of complicated fracture of the femur.The only drawbacks resulting from this mode of adminis-

tering the drug were severe headache, nausea, and vomiting,which some of the patients suffered from for several daysafter the operation. It was then decided that exact experi-ments should be made to determine more precisely the

effects and for this purpose both Dr. Bier and his colleagueDr. Hildebrand submitted themselves to the action ofcocaine injected into the spinal subdural space in themanner alluded to before. It was found that anaesthesiaof the whole of the lower extremities supervened in fromfive to eight minutes after the injection and a dose of fivemilligrammes of the cocaine was sufficient to make this con-dition of anaesthesia last for about 45 minutes, after whichnormal sensibility slowly and gradually returned. Theafter-effects were, however, not always pleasant and werelike those found in the surgical cases referred to above. Dr.Bier was even obliged to’remain in bed for some days. Itwas therefore decided that further experiments should bemade on animals, so that the effects might be more fullystudied with a view to obviate the disagreeable effects pro-duced by the drug and to enhance its undoubted usefulness.

ON Sept. 13th Mr. Justice Cozens Hardy granted anapplication of the Jenner Institute of Preventive Medicineto enable them to alter their Memorandum of Association soas to profit by the gift from Lord Iveagh of .6250,000.

WITH reference to medical men willing to serve on l

plague duty in India the authorities of the India Office 1

inform us that no more are required at present, but that a <

list is kept at the India Office of those who are ready to go 1if required. - f

ITHE Colonial Office has received a telegram from the

Governor of Mauritius stating that for the week ending fSept. 7th 62 cases of plague occurred, of which 51 proved t

fatal. -

bA TELEGRAM from the Governor of Hong-Kong (Sir H. A. p

Blake) received at the Colonial Office on Sept. llth reports y13 cases of plague with 12 deaths for the last week. f

___

LI

THE nineteenth report of the Inspector of Retreats under v

the Inebriates Acts, 1879 and 1888, has just been issued. 14 s

retreats are dealt with. ___

o-

C

THE British Association have made a grant of towards the expenses of the National Antarctic Expedition. a,

P.

ANNUAL REPORT OF THE SANITARYCOMMISSIONER, BENGAL, 1898.

THIS report was due on May lst, but the delay in itsissue has been occasioned by the Sanitary Commissionerhaving necessarily to devote so much of his time to the

supervision of plague measures. The Inspector-General ofCivil Hospitals has appended to it a valuable note in which hereviews the salient points in the sanitary history of the year.The number of births which were registered in 1898 was2,540,701, against 2,625,844 in the previous year, the ratio

per mille of population being 35’79 as against 36’94 in1897. The decrease in the birth-rate was anticipated bythe Sanitary Commissioner in his last report and is nowconsidered by him as due to the low vitality of the peoplein the preceding year caused by the effect of famine andhigh prices. He points out that the number of births waseverywhere considerably higher during the last five monthsof the year than during the earlier months, and that thiswas particularly noticeable in those parts of the provincewhich were most severely affected by famine. This explana-tion, however, does not seem to be sufficient because thedecreased birth-rate does not correspond with the districtswhere famine prevailed, and some districts which wereclassed as famine districts actually record a higher rate.It seems to be the normal state of things for an increasednumber of births to occur in the later months of the year.Other causes were therefore probably at work. Considerablygreater accuracy in registration must be attained beforethe vital statistics of the province can be considered as abasis on which definite and satisfactory conclusions can befounded.

Calcutta is as usual at the bottom of the list with a birth-rate of 13’98 per mille, the departure of women from fear ofplague having doubtless caused the large decrease since lastyear. It must be remembered, however, that the proportionof males to females in Calcutta is more than 2 to 1. Thenumber of deaths registered in 1898 was 1,888,468, giving aratio of 26-57 per mille as against 2,341,632 and 32-94 in theprevious year. The mortality from fever and cholera wasparticularly low. Owing to the general absence of epidemicsthe death-rate of the towns fell to the remarkably low figureof 27’50, as against 35’09 last year. The death-rate amongmales was 28’75 per mille against the average of 30.87for the past 10 years. Among females it was 24’40 permille, against 2668, the average of the preceding 10years. Registration in the case of females is more

defective. The mortality among Mussulmans is givenas 29’53 per mille, as against 25’51 among Hindus.This difference is unexplained and does not occur everyyear. No less than 1935 persons were convicted forfailure to register and Rs. 3052 were imposed in fines.

Registration is probably defective to the extent of 13 pernille in the case of deaths and 11 per mille in the case ofbirths. These are the deficiencies which are discovered bythe vaccination staff. The influence of the meteorologicalconditions on the prevalence of fever and cholera is a

perennial subject of discussion. In the present year thenortality from fever has been lower than usual and that’rom cholera has been the lowest ever recorded in the

There appears to be no satisfactory explanation of thesefacts. Inoculation against cholera has been carried onthroughout the year at the Purulia coolie dep&ocirc;t and whileno information is available from Assam as to its results thework is obviously a necessary one and is reported to havebeen well and carefully conducted. The deaths from small-

pox numbered 14,269 as against 19,655 during the previousyear. There was a large falling off in the number of deathsfrom dysentery. Expenditure on conservancy increasedlargely in many places apparently from fear of the plague.In many towns nothing has been spent on original sanitaryworks and the want of proper drains is a deficiency con-stantly noticed. Until outside pressure is brought to bearon some of the municipalities nothing is done. The pre-cautions against plague consisted in the working of fourlarge observation camps at Chausa. Chakradharpore, Mairwa,and Khurda Road. At Chausa 636,819 persons were inspectedand 24,776 were detained. There were five deaths from

plague. At Mairwa 177,501 persons were inspected and4757 were detained, and at Khurda Road 110,083 personswere examined and 3478 were detained. An importantexperiment in sewage disposal was inaugurated. The sani-

tary engineer was placed on special duty in England forthe purpose of inquiring into the subject and his proposalto carry out experiments on the septic tank principle hasbeen adopted by Government. The precautionary measurestaken against the plague have indirectly drawn increasedattention on the part of local bodies to sanitation generallyand to conservancy in particular. " Should it prove to havethoroughly and permanently awakened the local authoritiesto the supreme importance of an efficient system of sanitationthe plague will have done the people of Bengal a servicewhich will go far to counterbalance the trouble and anxietywhich it has caused.’