1124 NOTES, SHORT COMMENTS, AND ANSWERS TO CORRESPONDENTS.

Notes, Short Comments, and Answersto Correspondents.

CHOLERA IN ITALY.Mr. M. Carmichael, British Consul at Leghorn, in his annual report to

. the Foreign Office, observes that the public health of Leghorn, as arule, is excellent, and the city enjoys one of the lowest death-rates inItaly. But during 1911, unfortunately, the town was visited, like somany other places in Italy, with a somewhat grave epidemic ofcholera morbus. Two cases occurred on July 6th, followed by twomore cases and one death on July 7th. The epidemic was at its

highest between August llth and 22nd. The greatest number offresh cases in any one day was 67 on August 13th, and the greatestnumber of deaths 28 on August 14th, the average for this period of12 days being 39 cases per day and 17 deaths. The last case occurred

on Sept. 10th. There were two deaths on Sept. 14th, and with thatthe epidemic maybe said to have ceased. The total number of casesbetween July 6th and Sept. 14th was 832, and the total number ofdeaths 428, or about 51 per cent. Sufficient praise cannot be given tothe local authorities and such charitable associations as the Miseri-cordia and the Pubblica Assistenza for the thorough and courageousmanner with which the disease was combated. The families wherecases occurred were immediately removed from their homes andtsolated in one of the lazzaretti for a number of days. Thetown was constantly sprinkled with disinfectants by means

of hand watering-carts, and free disinfectants were distributedto all the poorer classes. The market was rigorously in-

spected every day, and all damaged fruit or suspected provisionsdestroyed. Hygienic rules of self-preservation were printed andcirculated, and every effort made to teach the people their duty inthe trying circumstances. It was impressed upon them that allwater must be boiled and absolutely no uncooked food eaten. Thereis a prejudice in Italy, even among some of the better class, againstdrinking water which has been boiled, while the fuel necessary forthe purpose was a serious tax on the very poor. Fuel was suppliedgratis by the municipality, and water which had been boiled wasdistributed at one or two centres of the town. As regards thecooking of all articles of consumption, this, of course, could not

possibly be controlled, and there is no doubt that raw fruit, cheese,butter, ham, &c., were freely eaten. Even bread is a source of danger,for though baked it passes through various hands before reaching ahouse. The bathing season, on which various classes rely for theextra gain that enables them to tide over the year, was completelyruined by the epidemic. The strangers who had arrived immediatelyleft the town, sacrificing the rent of the villas which they had paid inadvance, and very many of the townspeople likewise departed. The

consequence was severe losses to the poorer classes, while trade andcommerce generally suffered. Subjoined are statistics of previouscholera epidemics in Leghorn : 1835, August 6th to Oct. 9th, 2018cases, 1132 deaths ; 1854, July 15th to Sept. 23rd, 1032 cases, 593

deaths; 1855, May 17th to Nov. 4th, 1783 cases, 987 deaths; 1867,July 14th to Nov. 5th, 1275 cases, 824 deaths ; 1893, Sept. 10th toOct. 30th, 379 cases, 172 deaths.

THE HATPIN DANGER.

THE Tramways Committee of the Manchester acorporation have takenan important step with a view to minimise the risks associated withthe wearing of long hat-pins by ladies using their tramcars. The

following notice has been posted in the Manchester tramcars:-DANGEROUS HATPINS.

The attention of lady passengers is drawn to the danger to otherpassengers and to the servants of the department from the practiceof wearing unprotected hatpins.

A similar procedure will be introduced in Salford, where several nastyaccidents have already occurred. If need be, it may be necessary to

apply for a bye-law making it compulsory to wear hatpin protectors.

THE PUBLIC-HOUSE TRUST.1

THIS little pamphlet contains details of a scheme which bids fair tobring about the settlement of a problem involving the deepestinterests of the population of this land. The evils, both physical andmoral, to which an abuse of the use of alcoholic drinks gives rise areknown to all, and to no section of the community better than tomedical men. Intoxicants in one form or another are a practicallyuniversal form of indulgence all over the world, and although thehuman race may in time deliver itself from the desire for such

indulgence the time is obviously not yet. The Home Counties Trust

1 The Public-House Trust: its Influence upon Temperance andLicensing Problems. By A. F. Part, Managing Director of the HomeCounties Public-house Trust, Limited. To be obtained from the secre-tary, Central P. H. Trust Association, 15, Dean’s’yard, Westminster.Pp. 62. Price 6d.

operates in all parts of the Home Counties, except Surrey andCambridgeshire, which are represented by separate companies, and itsobjects are to convert the present licensed house, which is only toooften a mere drink shop, into an " idealised house of rest, refreshment,and recreation." In other words, the village or other public-houseis to be gradually transformed into a kind of cross between a

club and a restaurant. How this is being done may be read inMr. Part’s account of the movement, and in the preface contributedby Earl Grey, the practical founder of the movement. We cannot

imagine, so far as present circumstances are concerned, a bettersystem for fighting against the evils of drink. Medical men, as a

whole, are not blessed with over much of this world’s goods, but theycan influence their wealthy patients to take an interest in thisadmirable movement. No higher dividend is paid than 5 per cent.;any profits over and above this are put to reserve and administered bythe council for objects of public utility. Any further informationmay be obtained from the Secretary, Dean’s-yard.

THE VISION OF MYOPES.

To the Editor of THE LANCET.SIR,-I have observed some correspondence in your columns lately

with reference to myopia. This has recalled to my mind somereference to the subject in THE LANCET of 1903 and my letter inTHE LANCET of April 30th, 1904, with reference to one or two simpleaids to myopic eyes, or, bluntly speaking, "dodges." Here is another

simple aid which I happen to have discovered, and one or two myopicfriends who have tried it tell me it may be worth recording. Join the

tips of the index fingers of each hand, nails uppermost, in a horizontalline, then join the tips of the thumbs and bring them up till they comein contact with the tips of the index fingers. It will then be seen that a

lozenge- (or diamond-) shaped space or window is produced between thefour tips. Raise the hands while keeping them in the above positionquite close to the right or left eye and look through the lozenge-shapedspace, and the effect will be like that produced when looking through aconcave lens. The lozenge-shaped "window" may be made larger orsmaller, as required for focussing, by pressing together or relaxingslightly the four tips of the fingers and thumbs. If a very small

aperture or "window" is required, remove one of the thumbs and bringthe index finger slightly down, which will leave a small triangularspace between the two index fingers and one thumb.

I am, Sir, yours faithfully,Oct. 8th, 1912. MYOPE.

’NYASALAND PROTECTORATE.

A REPORT on the Blue Book of this Protectorate (which comprises theeastern portion of British Central Africa) for the year 1911-12 hasbeen received at the Colonial Office. It states that the native popu-lation is now estimated at 1,000,659, whilst the European populationis returned as 773 and the Asiatic population as 463. Seven Europeandeaths (including two infants) and three Asiatic deaths were regis-tered during the year. The health of the native community hasbeen satisfactory, and no serious epidemics occurred. Small-poxmade its appearance here and there, but the benefits of the wide-

spread and thorough vaccination of the last few years are now beingfelt, and in no case has the disease spread. The number of cases

diagnosed as sleeping sickness discovered during the year was small;it must, however, be borne in mind that, in spite of the efforts of thelarge medical staff now employed in searching for cases, it is

probable that deaths from this disease are concealed by the natives,in whom confidence is somewhat shaken by the inevitably highproportion of deaths in the sleeping sickness camps. Since 1908,when the first case of sleeping sickness was discovered, 56 cases onlyhave been found after systematic search. All these are dead. The

epidemic appears, as far as present investigations have determined,to be confined to a small area bordering on the lake. The RoyalSociety’s Commission is established and is pursuing its investigationsat Kasu, near the sleeping sickness area.

DRAWINGS OF GUY’S HOSPITAL.

Messrs. W. H. Benyon, fine art publishers, of Hewlett-street,Cheltenham, have forwarded to us a set of eight advance proofsfrom drawings of Guy’s Hospital, by Mr. Hanslip Fletcher. The

plates are collotype reproductions from sketches made this year, andthey give a faithful and artistic representation of the hospital as it isto-day. The subjects of the drawings are "The Gateway andQuadrangle," " Clinical and Medical Wards from the Park," " Clinicaland Dental School," "The Colonnade," " Balcony of Martha Ward andTrees in Springtime," "The Ship and Shovel," "Medical Wards andCollege from Maze Pond," and, finally, the interior of " The Chapel."The artist has, we think, caught the spirit of Guy’s Hospital, andseveral of his sketches, notably those of the front quadrangle and ofthe colonnade, show much artistic skill. The series is well reproducedand mounted, and is sure to prove popular among Guy’s men pastand present. It shows how this famous institution has grown of late

years and yet contrived to preserve its identity. The publishingprice of the set, we are informed, is 31s. 6d.

1125NOTES, SHORT COMMENTS, AND ANSWERS TO CORRESPONDENTS. [OCT. 19, 1912

THE HYGIENIC AND ECONOMIC ASPECTS OF GASHEATING AND LIGHTING.

THAT the question of whether gas is a healthy heating and illumi-nating agent is being vigorously studied clearly appears from twointeresting papers readthis week at the conference of the BritishCommercial Gas Association in Manchester. In one of the papersreferred to, the author, Mr. H. H. Creasey, gives some forcible illus-trations of the difficulty of removing the prejudice against gas firing,which is, reasonably enough, founded on the fact that until fairlyrecently gas stoves have been defective in construction or else

have been fixed by incompetent workpeople. By inaugurating acampaign having for its object the adoption of a system of

control whereby the right stove was supplied and the right people.engaged to attach it to the existing fireplace, Mr. Creasey has effectedmany conversions even on the part of those who resolutely set theirminds against gas heating as a principle which could lay any sort ofelaim to being effective or hygienic. The gas industry now claims;amongst its converts many medical men, who know well enough whenan offence against health is being perpetrated. We have urged all;along that when attention is carefully given to the conditions de-manded by a gas fire for its satisfactory working, which can be doneby handing the installation over to responsible officials, the systemwould soon find favour by reason of its efficiency and economy.In another paper Professor Vivian B. Lewes, F.C.S., F.I.C..discussed the hygienic aspects of gas for heating and lighting in thehome, school, and workshop. His paper bears out what we said inan annotation last week in regard to the character of the seasonalfoga of the metropolis. He concludes, after an able exploration intothe many aspects of the case, that gas as now used in the incan-descent burner and modern gas-fire is by far the most hygienicilluminating and heating agent that we possess for rich and pooralike. (The italics are ours, made with our attention fixed on the greatstrides made in gas appliances since an inquiry on this subject wasconducted by THE LANCET Commission 21 years ago.) Professor

Lewes says that, according to his investigations, the dwelling-house,school, and workshop are all rendered more healthy by the actionof an efficient gas fire, while the change that has taken placein the atmosphere of our large towns during the past ten years-thelessening of smoke, the rarity of bad fogs, and the increase in thehours during which the sky can be seen-bear eloquent testimony,he considers, to the work already done by the partial displacement ofthe coal fire by the gas stove.

HORSE-FLESH AS FOOD.

IN the course of his report on " The Economic Development of Francein 1910-11," Mr. William Gastrell, H.M. Consul-General at Paris,mentions that the first butcn shop for horse-flesh was opened inthat city as long ago as 1866. A few years later, during the siege,horse-flesh was largely consumed. It is chiefly in towns where thereis a large working population that horse-flesh is eaten, and it hasbeen said that it sometimes amounts to 11 per cent. of their total

consumption of meat. In other places it is hardly used at all. Theamount consumed per head has been quoted as four kilos. at Reims,2 kilos, at Lisle, and 1 kilos. at St. Nazaire. In Paris, in 1899, it wasstated to be 2’388 kilos., the number of horses slaughtered havingbeen 17,942. In 1907 there were killed in Paris 49,293 horses, 921

donkeys, and 231 mules. The retail prices of horse-flesh in 1909were officially given as follows by the French Board of Agriculture :-Is. 9d. to 2s. per kilo. (2-2 lb.) for filet Is. 6d. to Is. 8d. per kilo. forfaux-filet; and 6d. to Is. 6d. per kilo. for tranches and cotes.

HEALTH IN THE PHILIPPINE ISLANDS.-

Mr. M. Paske Smith, Acting British Vice-Consul at Manila, writes inhis annual report that at the close of the year 1911 health conditionsin the Philippine Islands were most promising. The death-rate

.among adults compares not unfavourably with that of the UnitedStates and Europe. Efforts are now being made to deal with thegreat infant mortality. Owing to the prevalence of plague in Chinastringent quarantine regulations were made, with the result that thedisease was kept out of the islands. Cholera is non-existent. Small-

pox has found but few victims, and of those the greater number werechildren who had not been vaccinated. The leper colony at Culionhas proved a complete success, and all known cases of leprosy aresegregated there.

Messrs. Aplin and Barrett, &c., Limited, have won a gold medal for thefinest collection of British dairy produce at the London Dairy Show.This, we are informed, is the tenth time that the firm has won thisprize since 1902-a remarkably consistent record.

ERRATUM.—We are requested to stat3 that in the advertisement of theChallenge Rubber Mills in THE LANCET of last week the distancescovered in the tyre test were incorrectly given, and should read:Victor, 5010 miles ; Dunlop, 4767 miles; Continental, 4261 miles,and Michelin, 3799 miles.

COMMUNICATIONS not noticed in our present issue will receive atteutiorin our next.

Medical Diary for the ensuing Week.SOCIETIES.

ROYAL SOCIETY OF MEDICINE, 1, Wimpole-street, W.TUESDAY.

SECTION OF MEDICINE (Hon. Secretaries-Robert Hutchison,’

H. Batty Shaw): at 5.30 P.M.Sir John Broadbent, Bart.: Case of Rupture of an Aneurysm of

the Aorta into the Right Auricle, with Pleural Effusionrequiring Repeated Tapping.

(Members of the Section who can contribute allied cases areinvited to bring them forward and to join in the discussion.)

SECTION OF PSYCHIATRY (Hon. Secretaries-R. H. Cole,Bernard Hart): at 8.30 P.M.

Presidential Address: :Sir George H. Savage, M.D.

WEDNESDAY.SECTION OF OPHTHALMOLOGY (Hon. Secretaries-J. HerbertParsons, Leslie Paton) : at 8.30 P.M.

Inaugural Business Meeting :(1) To Elect Three Vice-Presidents and One Member of.Council.

Nominations for Vice-Presidents:-Mr. George Berry (Edinburgh),Mr. Edgar Browne (Liverpool),Mr. J. B. Story (Dublin).

Nomination for Council :-Dr. Hill Griffith (Manchester).

(2) To approve Draft Regulations for Section.(3) Other Business.The Library and Rooms of the Society will be open for inspec-

tion by new Fellows and Members of the Section who have notyet had an opportunity of seeing them.

FRIDAY.SECTION FOR THE STUDY OF DISEASE IN CHILDREN (Hon.Secretaries-H. S. Clogg, F. Langmead, P. N. Blake-Odgers) :at 4.30 P.M.

Cases .’Dr. Porter Parkinson: Congenital Syphilis with Heematurla.Mr. Philip Turner: Thrombosis of Lateral Sinus followed by

Thrombosis of Facial Vein.Mr. Sydney Stephenson: Ocular Torticollis.Dr. Reginald Miller: Cerebral Maldevelopment.Mr. Maynard Heath: Genu Valgum due to Rarefaction and

Deformity of Femur.Mr. Duncan Fitzwilliams: Extreme Coxa Vara.Dr. F. J. Poynton : Congenital Family Choleemia.Mr. T. H. Kellock : Traumatic Pancreatic Cyst after Operation.Dr. Edmund Cautley : (1) Partial Aphasia; (2) Renal Sarcoma.

Specimen : :Dr. Alexander Morison: Malformation of Heart.

Papers :Dr. E. C. Williams : Notes on a Case of Precocious Development

in a Boy, aged Six Years, with photographs.Dr. Leonard Guthrie: Epidemic Catarrhal Jaundice.

SECTION OF BALNEOLOGY AND CLIMATOLOGY (Hon. Secretaries-A. Manuel, Chas. W. Buckley): at 5.30 P.M.

Presidential Address :Dr. Percy Lewis: Sepsis and Spa Treatment.(The ANNUAL DINNER of the Section will be held at the Cafe

Royal, Regent-street, at 7.45 P.M.)SECTION OF EPIDEMIOLOGY (Hon. Secretaries-G. S. Buchanan,William Butler): at 8.30 P.M.

Presidential Address :Dr. W. H. Hamer: The Influence of Migration upon the

Phthisis Death Rate.

MEDICO-LEGAL SOCIETY, 11, Chandos-street, Cavendish-square, W.TUESDAY.-8.30 P.M., The President (The Right Hon. Earl Russell) :

Annual Address.-Dr. F. G. Crookshank: Delayed Shock.

HUNTERIAN SOCIETY, London Institution, Finsbury-circus, E.C.WEDNESDAY.-9 P.M., The President (Mr. A. H. Tubby): Address.

9.15 P.M., Discussion on Intravenous Anaesthesia:-Mr. E. G.Schlesinger, and Messrs. H. S. Soutar and H. L. C. Noel willdemonstrate Apparatus; Mr. C. M. Page will speak on Intra-venous Hedonal; and Mr. J. F. W. Silk, Mr. H. E. G. Boyle,Mr. W. F. Cross, Mr. F. S. Rood, and Mr. A. Daly will take partin the discussion.

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LECTURES, ADDRESSES, DEMONSTRATIONS. &c.ROYAL COLLEGE OF SURGEONS OF ENGLAND, Lincoln’s Inn

Fields, W.C.MONDAY.-5 P.M., Mr. S. G. Shattock: Specimens illustrating Dis-

eases of the Genito-urinary Organs. (Museum Demonstration.)WEDNESDAY.--5.30 P.M., Mr. J. F. Colyer: John Hunter’s Specimens

illustrating the Formation and Growth of Teeth. (MuseumDemonstration.)

- FRIDAY.—5P.M., Prof. Keith: New Additions to the Collection of theCollege Museum-Specimen illustrating the Result in a Casewhere the Condition of Imperforate Anus was Unrelieved;Specimens illustrating the Comparative Anatomy of theProstate; Sexual Organs of Eunuchs; and UndescendedTesticles. (Museum Demonstration.)