supposed outbreak of yellow fever in spain

1
629 has effected an improvement on the traditional system, and last year the 7864 communes having cemeteries of their own bad risen to 8008, while the common charnel pits had sunk from 815 in 1885 to 287 in 1889. Reform, too, has been made in the matter of proximity of interment to habitation, but slowly, the latest returns giving, out of ’8008 cornmuneq, as many as 2066 having cemeteries at less than 200 metres from dwelling-houses. As we write, how- ever, we learn that 346 of these cemeteries are in course of removal to the distance required by law, and are also pro- -viding themselves with a mortuary chapel; but that, on the other hand, of the 287 communes having only charnel pits, not more than 49 are reforming this savage mode of sepulture. Such improvements as have been effected are doubtless due to the sanitary awakening evoked by Bertani’s public health code, and before the century is out Italy may have brought herself to a level with the Teutonic countries of Europe in the matter of decent and properly regulated burial. Till then the less she boasts of her priority in reviving cremation the better SQUALOR AND DISEASE. THOSE whom charity or the duties of their calling bring much in contact with the poor need have no difficulty in understanding how it is that disease is an almost inevitable consequence of helpless poverty. In the case of a family lately relieved by the Shoreditch Board of Guardians this connexion was forcibly suggested and insisted on by one of the witnesses examined. The single apartment which served for a dwelling was an underground kitchen. Beneath the window the floor was rotted away, and rats from the neighbouring sewer ran about the room. For - this wretched stye a weekly rent was charged, and was said to be paid. The owner would do no repairs. It is little wonder, in the circumstances, that the board referred the whole matter to the immediate attention of the sanitary authorities. Less they could not do, and we may now hope ’for such necessary reforms in this neglected den as will at least materially lessen the probability of threatened illness. Such cases as the above are unfortunately only too common in most of our city slums. The neglect of landlords and the squalid poverty and heedlessness of tenants combine to make the "rookery" a mere hotbed of all unwholesomeness, and a, constant menace to the public health. The destruction of such hovels, it has been truly said, is the only true remedy .for their foul condition. We must remember, however, that the cure would only be temporary unless the structures intended to succeed these were built so simply and solidly as to demand no great amount of exertion to keep them in order, and unless their state were periodically examined by a sanitary official. - MEDICAL PRACTICE IN BRITISH COLUMBIA. CONSIDERABLE annoyance has been caused to several gentlemen registered in Great Britain by the uncertainty which has for some time past existed as to the state of the ,law in Btitish Columbia with regard to their admissibility to the register of that colony-that is to say, whether British practitioners could be placed on the colonial register by the simple payment of the moderate fee of 10 dollars, or whether they stood in the same position as, say, Canadian practitioners with Quebec or Toronto diplomas, these having to pass an examination and pay 100 dollars. One British practitioner, whose letter will be found in THE LANCET of Aug. 17tb, 1889, after having passed the examination and paid the larger fee, found that he had been misinformed, and on application secured the return of his money. During the spring of the present year, however, a new Amend- ment Act has been passed, stating that "whereas by au oversight in the classification and consolidation of the statutes of British Columbia intituled the Con- solidated Acts, 1888," the section of an Act of 1870 declaring British practitioners entitled to registration was " therein consolidated and re-enacted as Section 30 of the Medical Act; and whereas it is expedient that such an error and oversight be corrected, therefore Her Majesty, by and with the advice and consent of the Legislative Assembly of the Province of British Columbia, enacts that Section 1 of the Medical Amendment Ordinance, 1870, is hereby declared to have been repealed by the British Columbia Medical Act, 1886, and the Medical Act, chapter 81, of the Consolidated Acts, 1888, shall be read and construed as if the said Section 30 had not been set forth therein." It would therefore appear that British practitioners will now be compelled to pass an examination and pay a large fee before being allowed to practise in British Columbia. ___ SUPPOSED OUTBREAK OF YELLOW FEVER IN SPAIN. IN June last some alarm was caused both in general and in professional circles in Spain by a report that 8imul- taneously with the appearance of cholera in Valencia yellow fever had been seen in Malaga. The circumstances which not unnaturally gave rise to this report are discussed by a naval surgeon, Senor A. F. Caro, in an interesting paper in the Boletin de Nledicina Naval, who was, together with a military surgeon, Señor S. Garcia, deputed by the Government to investigate the case. It appears that a steamship named the Hernccn Cortés, which sailed from Havana on April 28th with a cargo of cotton from New Orleans, after touching at the Canaries and Gibraltar, arrived at Malaga on May 20th, no case of serious disease having occurred during the voyage. On her arrival, accord- ing to some ancient custom, a choir of children from the orphanage of San Bartolome were taken on board to sing to the passengers and to gather contributions for their institution. On the 25th, one of the children who had been on board, a boy thirteen years of age, was attacked by high fever and bilious vomiting, there being a marked change in his appearance, with deeply injected conjunctivae and great prostration. Unfortunately, no further information could be obtained than that death took place in four hours, which was ascribed, on the official certificate of the medical man who attended the case, to "cerebral anaemia." The next case was that of another boy of thirteen, who had formed one of the choir which visited the Hernán Cortés. The death was certi- fied to be due to "pernicious malarial fever." The three other cases presented much the same symptoms. In the more severe of the two the cold stage was very marked, and resembled that of cholera, and this one appears to have been diagnosed as typhoid fever. Apart from the facts that the ship in question had no cases of yellow fever and that the cotton on board came from a port where there was none at the time, and that no cases occurred at the ports where portions of this cotton were landed, the symptoms and course of the cases, though somewhat resembling those of adynamic forms of yellow fever, lacked some of their most essential features. On the whole, therefore, Senores Caro and Garcia are disposed to accept the diagnosis of pernicious malarial fever. PURE WATER AT RAILWAY STATIONS. IT is now generally admitted that water-drinking stands unrivalled as at once the most wholesome and the most effectual means of quenching thirst. It is also with- out doubt the most economical. We may reasonably ask, therefore, why it is that the simplest, most abundant, and most useful of all beverages can often

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Page 1: SUPPOSED OUTBREAK OF YELLOW FEVER IN SPAIN

629

has effected an improvement on the traditional system, andlast year the 7864 communes having cemeteries of their ownbad risen to 8008, while the common charnel pits hadsunk from 815 in 1885 to 287 in 1889. Reform, too,has been made in the matter of proximity of interment tohabitation, but slowly, the latest returns giving, out of’8008 cornmuneq, as many as 2066 having cemeteries at lessthan 200 metres from dwelling-houses. As we write, how-ever, we learn that 346 of these cemeteries are in course ofremoval to the distance required by law, and are also pro--viding themselves with a mortuary chapel; but that, onthe other hand, of the 287 communes having only charnelpits, not more than 49 are reforming this savage mode ofsepulture. Such improvements as have been effected aredoubtless due to the sanitary awakening evoked byBertani’s public health code, and before the century is outItaly may have brought herself to a level with the Teutoniccountries of Europe in the matter of decent and properlyregulated burial. Till then the less she boasts of her

priority in reviving cremation the better

SQUALOR AND DISEASE.THOSE whom charity or the duties of their calling bring

much in contact with the poor need have no difficulty inunderstanding how it is that disease is an almost inevitableconsequence of helpless poverty. In the case of a familylately relieved by the Shoreditch Board of Guardians thisconnexion was forcibly suggested and insisted on by one ofthe witnesses examined. The single apartment whichserved for a dwelling was an underground kitchen.Beneath the window the floor was rotted away, and ratsfrom the neighbouring sewer ran about the room. For- this wretched stye a weekly rent was charged, and wassaid to be paid. The owner would do no repairs. It islittle wonder, in the circumstances, that the board referredthe whole matter to the immediate attention of the sanitaryauthorities. Less they could not do, and we may now hope’for such necessary reforms in this neglected den as will atleast materially lessen the probability of threatened illness.Such cases as the above are unfortunately only too commonin most of our city slums. The neglect of landlords and thesqualid poverty and heedlessness of tenants combine to makethe "rookery" a mere hotbed of all unwholesomeness, anda, constant menace to the public health. The destruction ofsuch hovels, it has been truly said, is the only true remedy.for their foul condition. We must remember, however,that the cure would only be temporary unless the structuresintended to succeed these were built so simply and solidlyas to demand no great amount of exertion to keep them inorder, and unless their state were periodically examined bya sanitary official. -

MEDICAL PRACTICE IN BRITISH COLUMBIA.

CONSIDERABLE annoyance has been caused to several

gentlemen registered in Great Britain by the uncertaintywhich has for some time past existed as to the state of the,law in Btitish Columbia with regard to their admissibilityto the register of that colony-that is to say, whetherBritish practitioners could be placed on the colonial registerby the simple payment of the moderate fee of 10 dollars,or whether they stood in the same position as, say, Canadianpractitioners with Quebec or Toronto diplomas, these havingto pass an examination and pay 100 dollars. One Britishpractitioner, whose letter will be found in THE LANCET ofAug. 17tb, 1889, after having passed the examination andpaid the larger fee, found that he had been misinformed,and on application secured the return of his money. Duringthe spring of the present year, however, a new Amend-ment Act has been passed, stating that "whereas byau oversight in the classification and consolidation of

the statutes of British Columbia intituled the Con-solidated Acts, 1888," the section of an Act of 1870

declaring British practitioners entitled to registration was" therein consolidated and re-enacted as Section 30 of theMedical Act; and whereas it is expedient that such anerror and oversight be corrected, therefore Her Majesty,by and with the advice and consent of the LegislativeAssembly of the Province of British Columbia, enacts thatSection 1 of the Medical Amendment Ordinance, 1870, ishereby declared to have been repealed by the BritishColumbia Medical Act, 1886, and the Medical Act,chapter 81, of the Consolidated Acts, 1888, shall be readand construed as if the said Section 30 had not been setforth therein." It would therefore appear that British

practitioners will now be compelled to pass an examinationand pay a large fee before being allowed to practise inBritish Columbia.

___

SUPPOSED OUTBREAK OF YELLOW FEVERIN SPAIN.

IN June last some alarm was caused both in general andin professional circles in Spain by a report that 8imul-taneously with the appearance of cholera in Valencia

yellow fever had been seen in Malaga. The circumstanceswhich not unnaturally gave rise to this report are discussedby a naval surgeon, Senor A. F. Caro, in an interestingpaper in the Boletin de Nledicina Naval, who was, togetherwith a military surgeon, Señor S. Garcia, deputed by theGovernment to investigate the case. It appears that a

steamship named the Hernccn Cortés, which sailed fromHavana on April 28th with a cargo of cotton from NewOrleans, after touching at the Canaries and Gibraltar,arrived at Malaga on May 20th, no case of serious diseasehaving occurred during the voyage. On her arrival, accord-ing to some ancient custom, a choir of children from theorphanage of San Bartolome were taken on board to singto the passengers and to gather contributions for

their institution. On the 25th, one of the childrenwho had been on board, a boy thirteen years of age, wasattacked by high fever and bilious vomiting, there being amarked change in his appearance, with deeply injectedconjunctivae and great prostration. Unfortunately, no

further information could be obtained than that deathtook place in four hours, which was ascribed, on theofficial certificate of the medical man who attended the

case, to "cerebral anaemia." The next case was that ofanother boy of thirteen, who had formed one of the choirwhich visited the Hernán Cortés. The death was certi-fied to be due to "pernicious malarial fever." Thethree other cases presented much the same symptoms.In the more severe of the two the cold stage was verymarked, and resembled that of cholera, and this one

appears to have been diagnosed as typhoid fever. Apartfrom the facts that the ship in question had no cases ofyellow fever and that the cotton on board came from aport where there was none at the time, and that no casesoccurred at the ports where portions of this cotton werelanded, the symptoms and course of the cases, thoughsomewhat resembling those of adynamic forms of yellowfever, lacked some of their most essential features. Onthe whole, therefore, Senores Caro and Garcia are disposedto accept the diagnosis of pernicious malarial fever.

PURE WATER AT RAILWAY STATIONS.

IT is now generally admitted that water-drinking standsunrivalled as at once the most wholesome and the mosteffectual means of quenching thirst. It is also with-out doubt the most economical. We may reasonablyask, therefore, why it is that the simplest, most

abundant, and most useful of all beverages can often