1339CANADA.-NOTES FROM INDIA.

a regular nurse or a nurse-helper, and to report at the next annualmeeting of the association.

At present some of the hospitals of the United Stateshave a shorter course and a lower standard of training thanothers, principally in New York. " A Layman’s View ofHospital Work " was the subject of an interesting paper readby Mr. John Ross Robertson, chairman of the trustees of theHospital for Sick Children, Toronto. In the course of hisaddress Mr. Robertson said that during the past 30 yearshundreds of thousands of dollars have been received from

voluntary contributions by the Hospital for Sick Children.A general impression prevails that the money for the supportof the hospital comes from the pockets of the wealthy.An intimate knowledge of the sources which sustaintheir work shows that they receive the dimes of the manyrather than the donations of the few. Of course, there arenoble and notable exceptions, one at least in their historyaided them with a contribution of$10,000, the largest whichthe hospital ever received. A paper entitled ’’ The VisitingCommittee as an Aid to the Safe Conduct of Public

Hospitals," written by Mrs. George Stephenson Bixbyof New York, was read by Mr. B. B. Burritt, secretaryof the New York Hospital Visiting Committee. Ittestified to the value of the work undertaken by the com-mittee. Early in the proceedings of the meeting themembership committee reported that 238 applications, ofwhich 65 were from trustees and members of hospitalboards, had been received during the year. The State ofNew York headed the list with 65 applications. Canada wascredited with 25. The membership is now about 500. Itwas shown that the association had materially widened itsfield of operation and the growth is so remarkable that

present indications were that in a few years hence it willdominate the entire hospital world of America. The trea-surer’s report was very satisfactory. Dr. John A. Hornsbyof the Michael Reese Hospital, Chicago, read an instructivepaper on Some Scientific Aspects of Hospital Management.In introducing Miss M. U. Watson, directress of the HomeEconomic Department of the Macdonald Institute, Guelph,Ontario, Dr. Goldwater, the chairman, said that the interestand stimulation of the proceedings had been enhancedby a number of guests who voluntarily offered to givepapers on various subjects of the utmost importance tothe delegates. Miss Watson gave an interesting talkon "Trained Housekeepers " in which she entered a

strong plea for the systematic instruction of house-

keepers in food values and hygiene and business methods.The work in connexion with children’s dispensaries, the

dispensary work in tuberculosis clinics, the restriction of theabuse of the out-patient department, and the planning andconstruction of the ideal hospital were some of the otherinteresting subjects taken up and fully discussed. Severalpapers treating on the subject of tuberculosis in all its

phases were read. Dr. James Alex. Miller, President of theAssociation of Tuberculosis Clinics, New York, spoke on thecooperation in dispensary work as exemplified by theAssociation of Tuberculosis Clinics of New York. He dealtalmost exclusively with the phase relative to educatingpeople in the home as to the dangers of tuberculosis and itstreatment. This was followed by the introduction of thesubject of the Development of the Work and Restriction ofthe Abuse of the Out-patient Department, the different phasesof which were expounded by Dr. John M. Peters of RhodeIsland Hospital, Providence, R.I., and Mr. John Ross Robert-son of Toronto. Dr. Donald J. Mackintosh of the WesternInfirmary, Glasgow, in speaking on the planning and con-struction of hospitals, smaller cities, and towns, said that hehad gleaned valuable information in America, but he had yetto find a perfect hospital, although he had been in the UnitedStates. He was subsequently elected an honorary member ofthe association. Before an audience of over 200 medicalmen and superintendents of hospitals at the annual banquetof the Association Dr. D. C. Potter, chief of the CharitableInstitution Division, Department of Finance, New York City,said some very scathing things about grafters and hospitalreformers. This was in the course of an address on the subjectof the Private Hospital as a Municipal Agent. Dr. Potter’!experience in New York is such that he has little faith in thEaverage reformer. This class of individual is always or

hand to turn the grafter out and get the job for himself. HE

paid a high tribute to Canadian nurses. In referring to thEcost of maintaining patients in private and municipal institutions, in comparison, he said that while in the privat(

institution it cost from 80 cents to$1.10 per patient perdiem, in the municipal hospital the cost ranged from$1.92 to$10.20 per diem. In discussing the question of the controlof infectious and contagious diseases Mr. John RossRobertson (Toronto) stated that at the Hospital for SickChildren since 1892 it had cost that institution from$15,000to$20.000 through infection brought into the institution bypeople visiting patients. Several of the delegates stated thatthey had had similar experiences in their respective institu-tions. Mr. Ross Robertson was unanimously tendered thepresidency but declined the honour. The officers electedwere : President, Dr. John M. Peters, Rhode Island Hospital,Providence, R.I. ; Vice-Presidents, Dr. Arthur A. Aucker,City and County Hospital, St. Paul, Minn. ; Dr. J. N. E.Brown, Toronto General Hospital; and Miss Emma Blunder-son, New England Baptist Hospital, Boston ; Secretary, Dr.W. L. Babcock, Grace Hospital, Detroit; and Treasurer, Dr.Asa Bacon, Presbyterian Hospital, Chicago. Washington,D.C., was selected as the place of meeting in 1909 on thefollowing dates :-Sept. 22nd to 29th inclusive.

Immigration and Deportation of Defeetizes in Ontario.From a pamphlet which has just been issued by the Legis-

lative Assembly of the Province of Ontario there were onDec. 31st, 1907, exclusive of insane persons in the privateinstitution, the Homewood Sanitarium at Guelph, Ontario,5315 insane persons and 775 idiots and feeble-minded, dividedas follows: males, 2931; and females, 3159. The net increasefor the year was 118. The daily average number of patientsin the provincial hospitals during the year was 6053; thetotal number of admissions, 1162, of which number 262 wereadmitted to the Toronto institution ; the total number of

discharges during the year was 537 ; the total number ofdeaths, 413 ; discharged recovered, 312 ; discharged im-proved, 177; discharged unimproved, 48. By nationalitiesthe population was as follows : Canadians, 4573 ; English,544 ; Irish, 439 ; Scotch, 223 ; United States, 112 ; Germany,

: 71 ; Russia, 13 ; all other countries, 115. 19 persons whohad become a charge on the province were deported as un-desirables in 1906. During the year 1907 the work has beenprosecuted with greater vigour and 87 persons have beendeported, representing a saving to the province in future

, maintainence approximately of$350,000. Referring to theToronto institution alone, the superintendent, Dr. C. K.Clarke, says that of the 262 persons admitted in 1907 less

. than half of these were Canadians, that exactly 134 were

, foreign-born persons.Oct. 20th.

________________

NOTES FROM INDIA.

(FROM OUR OWN CORRESPONDENTS.)

Epidemic of Malaria.AN extraordinary outbreak of malarial fever is reported

among the staff of the North-Western Railway in the Punjab.Europeans and Indians are affected, and as the epidemic haspractically spread all over the line the movement of trafficis being carried out with the greatest difficulty. At Lahorealone during the past week some 60 drivers and 2000 menfrom the workshops were on the sick list, and the stafEelsewhere were contributing their quota. The runningof certain goods trains on some sections has had to becancelled. The railway is doing its utmost to cope with thesituation and is obtaining assistance so far as possible fromneighbouring lines. The epidemic is due to the exceptionally heavy rain in the Punjab during the monsoon period andit is to be feared that the general population will also suffer.The probability of this was indicated some time ago and itwas suggested that quinine should be widely distributedthroughout the province. Special attention will doubt-less be paid to this point by the local government.The committee appointed by the government of Bombayso long ago as 1906 to inquire into the causes ofmalaria and other fevers and to recommend measures

for the improvement of the health of the city has atlast presented its report. The recommendations which itmakes are, briefly, the conversion of the present intermittentwater-supply into a constant one, the adoption of the water-carriage system in place of the present method for the dis-posal of night soil, the removal of the sewage outfall fromLove Grove to a spot where the sewage may be treated before

1340 NOTES FROM INDIA.-AUSTRALIA.

it enters the sea, and the opening out and development of thEdistricts known as Tardeo, Mahalukshimi, and Worli, byencouraging the expansion of the city in this direction andthus relieving the overcrowding which at present exists incertain parts of it.

Ootacund.Two subjects of great interest just now are the health of

the station, which has been bad this season, and the drainagescheme, to which this condition of things is attributed in nosmall measure. Dysentery has been universally prevalentand the official inquiry on the subject, if any, has not beengiven to the public. With regard to the drainage schemethe municipality has held several special meetings to considerthe question but apparently has not yet arrived at a decisionwhether it will take it over from the Department of PublicWorks in an unfinished state or will wait until constructionhas further proceeded to completion and then take it over

-i.e., after it has evidence that it is a workable scheme.

Mayo Native Hospital, Calcutta.At its last meeting the finance special committee of the

Calcutta corporation was to consider a letter received fromthe officiating superintendent and secretary, Mayo NativeHospital, asking the corporation to assist the institution tomeet the expenses incidental to a thorough overhauling ofits drainage and water-supply. The letter is as follows :-

In forwarding herewith the copy of a resolution of the governors ofthe Mayo Native Hospital, dated the 25th May, 1908, I have the honourto request the favour of your kindly helping this charitable institution,which is chiefly dependent on subscriptions and donations, and which istoo poor to meet all the expenses incidental to a thorough overhaulingof its drainage and water-supply. The present drainage and water-supply date from 1874, when this building was constructed, and are nowin a deplorably insanitary condition. Sundry repairs have been donefrom time to time as funds were available, but have proved so unsatis-factory that thorough repairs have now become urgently necessary.Messrs. J. B. Norton and Sons estimate that complete and thoroughrepairs will cost Rs.7624-13-6, which is quite beyond the means of thehospital. The work, however, can be taken up piecemeal, and the mostimportant portion is done now at an estimated cost of Rs.1811-3-6. Itis absolutely necessary that this should be done at once, and if thecorporation can see their way to assist this institution in this matterit will be an act of grace and will be greatly appreciated.

The resolution was as follows :-

The attention of the governors having been drawn to the urgent needof improving the drainage and water-supply of the hospital and to theestimates of Messrs. Norton and Sons for doing the work, it was

resolved that the Calcutta corporation be approached to defray the costof carrying on the work.

Oct. 6th.

AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.)

Eighth Australasian Medical Congress.THE arrangements for the Congress to be held in Melbourne

from Oct. 17th to 24th are now almost complete and thegathering promises to be highly successful both from thescientific and the social aspect. Already 550 members havebeen enrolled, a number which will probably be still further

augmented. The problems of syphilis will form a largefeature of the discussions and are to be dealt with separatelyin various sections and by the Congress as a whole. Theother general discussion will be on hospitals and a series ofmotions will be submitted which it is hoped will form afoundation upon which a reform of existing abuses may beinitiated. The list of papers arranged for the varioussections shows that Australian practice is well abreast of thetimes in modern developments of medicine and surgery. An

important discussion is arranged in the surgical section on" Anæsthesia-General, Local, and Intraspinous." Opsonicwork and treatment by vaccines will be fully dealt with andseveral papers will relate to ionic medication. An interestingpaper in the section of children’s diseases promises to bethat by Dr. Stephens who will tabulate his observations ofthe recent epidemics of infantile paralysis in Melbourne andsuburbs. Tropical diseases as met with in Australia willalso be noticed. A well-equipped museum will be arranged.The social events include a Congress dinner given by the ]Victorian members to visitors ; a ball given by the Victorianofficers of the Australian Army Medical Corps; eveningreceptions by the President of the Congress, Professor H. B. Allen, and by the President of the Legislative Council, Sir H.

e Wrixon ; and numerous garden-parties and other out-doorfixtures.i Bacteriology.

An interesting return of the work done at the bacterio-

logical laboratory of the University of Melbourne for 1907 hasbeen published by Dr. R. J. Bull. The Board of Health

E subsidises the laboratory for examinations of sputum in) regard to tuberculosis and for examinations in relation) to enteric fever and diphtheria. Under this heading

2856 specimens were reported upon. Private practi-Ltioners supplied 3668 specimens for investigation during

the same period. In addition to this clinical work. the laboratory conducts routine examinations for several. Government departments and public bodies. In the agricul-

tural department the interesting discovery has been made. that actinomycosis is prevalent among Victorian dairy cows as. a primary disease of the udder. Purely research work has

been done in actinomycosis, rat leprosy and certain diseasesof fish and poultry, and in various other directions.

Extraordinary Death.At the Melbourne Hospital a patient was admitted

apparently suffering from severe and extensive burns anddied shortly after admission. The burns were evidently theresult of some chemical agent and the man admitted that hehad painted himself with a solution of perchloride of mercury"in order to kill bugs. " He had purchased two ounces of thedrug from a druggist and made a solution himself, the exactstrength not being known.

Cooas2cnaPtaon of Alcohol.Canon Boyce of New South Wales has for the past 25

years worked out the annual drink bill of that State. In1907 he finds that £5,200, 000 were expended by the people ofNew South Wales in alcoholic drinks. This is the highestrecord yet attained, but on a per capita basis it is lower thanin 1900 and 1901. In Victoria the consumption of beer waslarger in 1907 than for many years. It has been demon-strated from figures in Australia that the drink bill fluctuateswith prosperity, being higher in good seasons and lower inbad. The general indications in Australia are that the

people are becoming more and more temperate. Even in theback-block towns the old orgies are becoming very rare.

Milk-Supply.The committee of the Lady Talbot Institute, which was

established for the purpose of encouraging the supply ofspecial clean milk for infants, has formulated a series ofconditions for the production, handling, and storage of suchmilk. Dairymen who comply with these requirements willbe entitled to advertise their milk as having the approval ofthe institute. It is proposed that medical men should beinformed where such milk is obtainable and urged to use itwhere breast-feeding is impracticable. The board hopesshortly to formulate a bacteriological standard for specialmilk. Amongst the conditions are the following:-The milk, on arrival at the cooling room, must at once be strained

through an approved strainer or cleansing centrifuge, and cooled to a tem-perature below 450 F., and so kept until pasteurised or bottled, orotherwise prepared for delivery.

If bottled on the farm, the milk must be bottled in sterilised bottleswithin 15 minutes of being cooled, and, if so required, must then bepasteurised at such a temperature and for such a time as the board mayapprove. Immediately afterwards, or during pasteurisation, the bottlesmust be corked with sterilised stoppers and sealed with the seal of theinstitute, and must be cooled to a temperature below 40° F. within twohours of milking. It may prove practicable to extend somewhat theperiod within which the milk may be bottled and pasteurised, theprimary requirement being that the temperature of the milk shall bemaintained throughout at a temperature below 450 F. The bottled milkmust be available for distribution within such time of milking as theboard may fix, and must, until distributed, be kept at a temperature notexceeding 50° F. The board is prepared to consider methods of packingMid distribution other than in bottles.All persons engaged in any milk-room or place in which special super-

vised milk is handled must wear clean, washable overalls and caps, andnust comply with any prescribed routine for insuring cleanliness ofperson and the protection of the milk from contamination. After milk-ng and milk-handling operations are completed overalls must beemoved, and, if soiled, must be washed and boiled; otherwise theynust be well shaken and put away in a clean cupboard.Utensils must be cleaned and sterilised, and so stored as to exclude

all dust and prevent contamination. For the cleansing of utensils and.ppliances warm soda solution of a strength of 1 pound of washing sodao 20 gallons must be used. After thoroughly cleansing the sterilisa-ion must be effected by means of live steam or by complete immersionn a boiling solution of soda of the above-named strength.When directed by the supervising officer, milkers, after speciallycashing their hands, must milk a sample of milk direct from eachuarter of the udder into sterilised bottles, which will be supplied.’he bottle must be immediately corked with a sterilised rubber