998 MEDICAL JOURALI THE ROYAL COLLEGES. [APRIL 17, 1897.

The Committee have made inquiries of the teachers of the medical ROYAL COLLEGE OF PHYSICIANS. schools, both metropolitan and provincial, and have obtained from them their views on the recommendation of the General Medical Council, in ON Monday, April 12th, in accordance with the Statutes, an regard to practical midwifery. It appears that though, in a certain extraordinary Comitia of the College was held for the elec- number of schools, the teachers are of opinion that the suggested altera- tion of President. Dr. SAMUEL WILKS, President, was in the tion in the certificate is desirable, and can be carried out satisfactorily, in others the teachers consider that the proposed attendance can only be chair. fulfilled in a perfunctory manner; and in a majority of the schools the The PRESIDENT delivered the annual address, in the course teachers are of opinion that it would be impracticable to carry out the of which he took occasion to refer to the matter of profes- proposed arrangements. The Committee, therefore, now report to the two Royal Colleges that in their opinion it is not desirable to adopt the sional secrecy. He expressed an opinion adverse to the alteration in the regulations suggested by the General Medical Council, enactment of any special by-laws or regulations dealing with and they recommend that a reply to this effect be sent to the Registrar of the subject, mentioning among other reasons the impossi- the General Medical Council. bility of drafting any law which would cover every case. The The Committee further recommended that, with regard to sister professions of the Church and of the Law had no such certain alterations in the certificates of practical midwifery written regulations. He enumerated then the Fellows who required for the Final Conjoint Examination, which had had died during the year, and paid a special tribute to Sir been suggested by the General Medical Council, no change in Russell Reynolds, his immediate predecessor in the presi- the present regulations of the Conjoint Board be made, and dency of the College. He spoke next in appreciative terms of that a reply to this effect be sent to the Registrar of the the honesty of purpose and the enthusiasm displayed by Sir General Medical Council. The Committee had made inquiries George Johnson during the course of his long and dis- of the teachers of the metropolitan and provincial medical tinguished career. Dr. Wilks then gave brief biographical schools, and in a majority of the sehools the teachers were of notes of the lives of Dr. Langdon-Down, Dr. George Harley, opinion that it would be impracticable to carry out the Dr. Cholmeley, and Sir B. W. Richardson. Of Dr. Edward proposed arrangements. Ballard's industry, ability, and scientific ardour he spoke in The following report was received from the Laboratories terms of warm praise, and he mentioned briefly Dr. Ralfe, Dr. Committee on the preparation of antitoxic serum, and on the 6Child of Oxford, Dr. Wilson of Florence, Dr. J. F. Parry researches in connection with the grant from the Goldsmiths' McConnell of Calcutta, Sir Thomas Logan, K.C.B. (formerly Company. Director-General A.M.D.), Dr. Charles Blake, R.N. and Dr. I. The TW'ork on Diphtheriafor the MetropoZitan. Asylum.s Board. Since December 4th the Director has supplied 3 OOI doses of antitoxic Fearnside of Bournemouth. under whose will the Royal serum containing 4.000 units each. 125 doses containing 3,o0o units each, Medical Benevolent College would benefit so largely. 350 doses containing 2,000 units each, 300 doses containing 1.500 units each, On the motion of Dr. DICKINSON, Dr. Wilks was requested and 409 doses containing I,ooo units, for the treatment of diplhtheria in to the hospitals of the Metropolitan Asylums Board, and all the demands print his address. have been fully met. During this period T4,028,000 units have been sup- Dr. WILKS then vacated the chair, and the election of plied, against Ic,074,0C0 units last quarter, being an increase of 354,000 President by ballot was held. The Senior Censor, Dr. W. units. S. CHURCH, having counted the votes, declared that as 79 2. Researches in connection with the Grant from the Goldsmiths'Company. The Director has made the following report on the recent work done -out of 87 Fellows present had voted for Dr. Wilks, being more under the Goldsmiths' Research Grant, namely: t-han two-thirds of those present, Dr. Wilks was duly re- "Since my last report on the work done in connection with the Honour- elected. able Goldsmiths' Company Grant, Dr. Wood has continued his investiga- tions on the production of potent diphtheria antitoxins, and has suc- Dr. WILKs having resumed the chair and expressed his ceeded by his new method (already reported) in obtaining large quan- acknowledgments, moved: tities of strong antitoxic serums. That a loyal address of congratulation be presented to the Queen on "The highest of these serums (Soo units c.cm) is much more potent the completion of the sixtieth year of Her Majesty's reign in June next. than any that has yet been placed on the iiarket, even in Germany. where the only one that approaches it in strengtlh is that manufactured This was carried by acclamation, and the officers of the by Professor Behring. which contains 6oo normal units per c.cm. College were requested to prepare such an address. " The strongest of these serums prepared by Dr. Wood has been sup- Dlied to Dr. Sidney Martin at University College Hospital, wlho reported The PRESIDENT stated that Dr. Hale White desired to have to the Lancet, October I7th, 1896, that lie had obtained mnost remarkable permission to deliver his Croonian Lectures on the means by results by its use, In 1894 the percentage death-rate from diphtheria in which the temperature of the body is maintained in health that hospital was m9. In i895, the first year in which antitoxin was used, and disease in the Examination Hall on the Embankment. the death-rate had fallen to 28, and in I896 (September 22nd), when the strong serum was used, to 20.5. This was agreed to. " In Dr. Martin's flgures we have additional evidence of the importance Sir Dyce Duckworth and Dr. Lauder Brunton were ap- of the treatment of diphtheria by antitoxin serum at as early a stage of pointed delegates to the International Medical Congress at the disease as possible. " Dr. Martin also notes that the number of cases of post-diphtheritic Moscow. paralysis was very small-only three in the whole of the cases that re- The PRESIDENT announced that the College had received covered-that not a single case of abscess occurred, and that rashes on from the executors of the late Sir Henry Halford a portrait the skin and pains in the joints wvere of very rare occurrence. of his "He further notes that no cases proved fatal unless they were severe grandfather Sir Henry Halford, G.C.H., President of on admission, and states that the more potent the serum the better will the College I820-44, bequeathed to the College. The portrait, be the results obtained by its use, both as regards immediate effect and as which is a half length, is a fine example of the art of Sir preventing injurious after-effects. Thomas Lawrence. It will be hung in the lower library. "Dr. T. G. Brodie continues his investigations on the separation of antitoxin from the serum in which it is contained, but as yet has nothing further to report. " Whilst these investigations have been in progress I lhave consulted THE ROYAL COLLEGE OF SURGEONS. with the various workers, and have inspected anid controlled many of the A MEETING of the Council was held on April 8th, at the experiments. especially those connected with the determination of the Col- strength of the antitoxin-produced. Along witlh Dr. Wood I have made a lege, Sir WILLIAM MAC CORMAC in the chair. large series of experiments on the standardising of test toxin and anti- The minutes of the ordinary Council on March iith were toxin, which, however, are not as yet completed. In addition I have, read and confirmed. with the help of the laboratory staff and the gentlemen above men- Messrs. and tioned, been able to make numerous improvements in the methods of Bennett Walsham were introduced and admit- injecting the horses. of collecting blood, and separating the active serum; ted members of the Court of Examiners. of keeping it aseptic; of clearing it by sedimentation; of storing it in The Jacksonian Prize was awarded to Mr. Robert Cozens bulk and of decanting and distributing it in convenient form for use. Bailey for his essay on The Pathology, and Concerning these and other improvements in methods and detail I hope Diagnosis, Treat- to give a fuller report at a future date. I cannot speak too highly of the mnent of Diseases of the Prostate Gland. The selection of a fashion in which the investigators under the grant have carried out the subject for the Jacksonian Prize Essay for I898 was post- work assigned to them." poned. In fulfilment of one of the conditions of the grant, anti- On the recommendation of the special Committee the prize toxin has been supplied to various hospitals in London, as founded by the dental profession in honour of the late Sir well as to certain medical practitioners. John Tomes, F.R.S., was awarded to Mr. Charles Lissmore A grant of £0oo was made to the Director of the Laboratories Tomes, F.R.S., Member and Licentiate in Dental Surgery, for for his valuable services in connection with these researches. his original and other scientific work in relation to dental The PRESIDENT stated on behalf of himself and the Vice- surgery, dental anatomy, and histology. Presidents that they recommended the presentation of an A report was received from the Committee of Management, address of congratulation to Her Majesty on the celebration and the following recommendations were adopted: of the 6oth year of her reign. APRIL 17, 1897.] THE PLAGUE. [TH 1 AL. 999 The President of the College for the time being was elected POONA. as a representative of the College on the Council of the British At Poona the epidemic has in all probability attained its Institute of Preventive Medicine. The vacancy was caused maximum. The British soldiers employed in the house-to- by the death of Sir Spencer Wells, Bart. house visitation by their careful search send up the new The President and Mr. Jessop were appointed delegates of cases by leaps and bounds, as will be noticed in the subjoined the College on the International Medical Congress, to be held list, where as many as 64 new cases were found in one day, at Moscoow, in August, 1897. and only io deaths recorded. The honorary medal of the College was presented to Sir James Paget, Bart., and Lord Lister. Mr. W. A. Meredith was elected to the Fellowship of the Mar. 15. Mar. 6 Mar. 17.Mar. I8.Mar.xg. Mar. 20. Mar. 21. Total. College, as a Member of twenty years' standing. New cases 40 38 28 64 59 24 54 307 THE PLAGUE. Deaths ... 29 21 2I3 t0 33 37 30 I73 CHRONICLE OF THE EPIDEMIC. We are glad to be able to state that Surgeon-Major Donnett BOMBAY RETURNS. left the hospital on March 21st quite convalescent. The THERE is more satisfactory news to report from Bombay, soldiers in Poona, it is stated, are carrying out their work for, according to the telegram of the Secretary of State, the without opposition; complete quiet reigns in the city. The death-rate from plague has fallen considerably. For the search made is rigid, and the whitewashing and cleansing week ending April 2nd the deaths as reported in the BRITISH are rigorously carried out. Emigration has now set in from MEDICAL JOURNAL of April ioth, numbered 480, whereas the Poona to Bombay, affording a certain gauge of the state of latest authoritative news gives only 368 on April gth for the the outbreak in these two cities at the present moment; IOl preceding week, or an average of 52.5 per day. The detail of cases were in hospital on March 22nd. From Karachi (Sind) cases in Bombay to week ending March 22nd is as follows: telegraphic reports declare a subsidence, but the latest news- papers to hand are anything but pleasant reading. " Mar. i6. Mar. 17. Mar. I8. Mar. ig. Mar. 20. Mar. 2M)Mar. 22. Total. through the Sirdar one cannot but be struck by its desertedDriving appearance. Block after block of bazaars and houses are almost entirely closed. The bazaar is scrupulously clean, Cases ... 83 69 75 74 43 61 73 473 yet cases occur occasionally. Numbers of beef butchers have left Karachi. The trade in cottons continues, and auch Deaths ... 75 59 73 55 63 6o 59 444 import trade as was arranged for before the outbreak oi plague. Merchants murmur at the veto laid on hides, the THE SCARE SUBSiDiNG IN BOMBAY. hides coolies having enjoyed almost an immunity from In Bombay the scare is over and people are returning in plague." numbers. Even with this influx, however, not only are the HAFFKINE'S TREATMENT. plague returns satisfactory, but the general death-rate from Haffkine's treatment is reported to be verypopular through- all causes is lower than it has been any time this year. The out the entire Presidency. In Bombay city up to April 2nd current belief in Bombay is that the epidemic is over, and 4,769 persons were inoculated; in Poona, 487; Bubar, 273; confidence is returning. The streets are said to be assuming Karachi, I87; Surat, 70; Thana district, 171; Kolaba dis- their usual appearance, although the infected houses are trict, igo. still showing the blue mark which stamps them in- SUKKUR. fected. The fact is that an unfamiliar disease like Sukkur, where plague is reported to be prevalent at present, plague causes a scare out of all proportion to the is the most important town in Upper Sipd, althoagh its number of victims it claims. On March 2nd, only 9,969 population is less than Shikarpoor. According to the census deaths are recorded in Bombay as arising from plague of I89I the population of Sukkur was 28,935; the birth-rate since the commencement of the epidemic in September, i896. was about 40, and the death-rate 26, per i,ooo. Had cholera or small-pox swept off a like number little would The town is situate on the right bank of the Indus, opposite have been heard of the fact, as it only represents a daily Rohri, with the island of Bukkur lying between them. Th death-rate from the epidemic of O.I5. lt is the fact that the low range of limestone on which it is built slopes down to th plague is an unfamiliar disease, something people are not river bank, which on both sides is clothed with luxurian accustomed to deal with. We have heard of small-pox carry- groves of date-palm trees, and forms an exceptionally pic- ing off ioo a day in many Eastern cities, and not even a pro- turesque landscape if viewed from the top of the minaret. cession to the gods being deemed necessary, but small-pox One of the triumphs of modern engineering skill is to be is a daily occurrence and its epidemic recurrence a thing to seen here in the huge iron railway bridge that spans the be expected. Indus through the island fort of Bukkur, a limestone rock PRECAUTIONS IN BOMBAY. interspersed with flint, of an oval shape, 800 yards long and The nature of the work being carried on in Bombay and about 300 yards wide, ceded to us by the Khyrpoor Ameers in other places may be gathered from the following narrative I839. It formed the principal arsenal in Sind during the first published in the Englishman: Afghan campaign. The system of house-to-house inspection lately inaugurated by the Special Committee is being attended with excellent results. Many con- Barracks for a European regiment were constructedrin cealed cases are being discovered, and filthily dirty dwellings are being 1843, but abandoned in I845 when the 78th Highlanders opened, cleansed, and fumigated. This morning the Committee, accom- were decimated by sickness there. panied by several lady doctors, visited many thickly populated streets mainly occupied by Mohammedans in the proximity of the Null Bazaar. Sukkur is now, however, on the whole, one of the Bearing in mind, doubtless, the disorderly scene witnessed in the neigh- healthiest towns in Sind. The intense dazzling glare and bourhood of Grant Road on Sunday, the Committee, in conjunction with great heat reflected from the limestone rocks are very trying, the Commissioner of Police, made arrangements on an extensive scale to but the in the season are deal with any disturbance of the peace should ne(ecsitv arise. One nights hot pleasantly cool when hundred men of the Royal Dublin Fusiliers were conveyed from Colaba to the breeze, which blows up the river, begins about 9 P.m. the Null Bazaar by special tramears, while a large body of police were also and continues till morning, which enables Europeans to on the spot. Happily their services were not required, for although close enj y refreshing sleep in the open air. upon 8,ooo natives assembled to witness the movements of the Committee, no attempt was made to create a disturbance. The Committee spent the To have any idea of tropical heat one should spend a hot best part of three hours inspecting houses, and discovered in one house weather season in Upper Sind, and record his experiences an old woman and a boy suffering from the plague, and ordered their afterwards. Punkas and thermantidotes day and night are removal to hospital. The former died before she could be removed, and the latter was safely conveyed to hospital. Several houses were found to indispensable, and some people have been known to wet be locked. They were opened and seemed to be in a horribly filthy state, their sheets and pillows, and plunge themselves in a tub of and were promptly cleansed and disinfected. Some occupants of houses cold water more than once during the night to procure confessed to have been misled by budmashes as to the object of the Com- sleep. mittee in visiting dwellings. Now they understood it to be for theirgood, and would, if sick, go to the hospitals to which the Sircar might be The water supply is pumped from a well sunk on the pleased to send them bank of the river to a tower on the highest point of the