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He suggested that the proposed Australian Institute should, if possible, be affiliated or federated with the British Institute. If this could be brought about it would add weight and dignity to the institution. With regard to the outbreak of plague in Australia, the

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medical men of Brisbane were unanimous in their opinion that true bubonic plague existed in Brisbane. The epizootic among the rats had been somewhat extensive in Brisbane, and large sums of money had been spent in killing off the rodents. "No rats, no plague," was a truism which supplied a remedy as well as a warning, and while all authorities agreed that the relationship between rat plague and human plague was now a well established fact, there were many factors in the rat question which were as yet very imperfectly understood. The practice of classifying plague under many types of the disease was misleading. Plague was plague, whether of the deadly or benign variety. The term "Pestis minor was misapplied, and should be dropped altogether, except as applying strictly to true plague cases. By far the most promising gain of a of a substantial kind to practical medicine was the improved method of acquaintance with the eausation of disease. A fully equipped laboratory, a hospital for clinical cases, and instruction by competent teachers who had made a special study of tropical diseases, would be one of the best efforts in the direction of medical and scientific progress yet attempted in Australia. In conclusion, Dr. Ham referred to the question of food adulteration and food preservatives. All medical and health authorities seemed agreed that the indiscriminate use of preservatives in food was a practice to be greatly condemned. The noblest aims of sanitary science, it had been well said, was the maintenance of the people in the highest state of efficiency to fit them for the labours of peace and the struggles of war, and the success of the federation of Australia would, in the long run, depend on the quality of its citizens, and good citizens could not be reared under unhealthy conditions.

Dr. KENDALL (Sydney) said Dr. Ham's paper was an important one. He complained of the verbose, longwinded, inefficient character of the Health Acts, especially those of Victoria and Tasmania. They contained involved and confusing sentences in numerous sections. Much of this was, no doubt, due to too close attention having been paid in drafting the bills to the Health Acts of England, without sufficient regard being paid to the different interest and requirements of these States. He commended the South Australian Act as a great improvement, though he did not say it was perfect. The latest Public Health Act was the Queensland one. It was so drastically drawn up that when it was put into practice it fizzled out. He felt with Dr. Ham the necessity for showing the people that scientific hygiene was not a fad, but the outcome of the experience and thought of many men, who had studied the sufferings of mankind throughout the ages.

Dr. MCDOUALL (Sydney) pointed out the reforms that would come with medical officers of health being appointed and paid by a central or State authority, so that he would be independent, both pecuniarily, and with respect to the permanency of his appointment. Such an appointed officer would be able to devote the whole of his time to his duties.

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This was as important as the proposal to establish a federal institute of hygiene.

Dr. KENDALL said the sanitary conditions of many public schools are the worst eye-sores we possess.

Dr. LOVEGROVE (Perth) sympathised with what Dr. Thomson had said. Central Boards of Health overshadowed local boards of health; while they continued to do so the latter showed a tendency to remain quiescent. Another reason why local boards of health were wanting in energy and pushfullness, was because they were in the nature of excrescences on municipal councils, instead of being altogether separate and free bodies.

Dr. Ham, in replying, urged that with an improved public opinion on the subject of public health, reforms would be brought about. He moved "That. in the opinion of this section, the time will shortly arrive when, in the interests both of the sanitary medical service of the various States, and the public of the Commonwealth, the Federal Government, with the assent of the States, should appoint a Minister of Public Health."

In reply to Dr. Thomson, Dr. HAM said that the federal authority could under its constitution take this course, with the consent of the States.

Dr. MACANSH (Victoria) said the feeling was growing that there was altogether too much federation. (Hear, hear.) Instead of interference with the medical officer of health's duties, his experience was that such officers rather got assistance. They were as a rule, carrying out their duties very well, and with much self sacrifice.

Dr. THOMSON was a strong opponent to federal action. As the Commonwealth Government was going on, it seemed as though it was going to ruin us.

Dr. LOVEGROVE felt it would not be wise to turn all such matters over to the Federal Government. The motion was negatived on the voices.

Dr. MACANSH moved :-"That, in the opinion of the Congress, steps should be taken by the States of the Commonwealth and New Zealand to unify the Public. Health Acts throughout Australasia.'

Dr. THOMSON seconded, and the motion was carried Dr. HAM moved :-"That, for the purpose of collecting and imparting information upon all matters connected with the subject of public health, a national society be formed, to be styled The Sanitary Institute of Australasia.'"

Dr. KENDALL seconded, and the motion was agreed to. A further discussion ensued as to insanitary closets, etc., at State schools, and that the elements of hygiene should be part of the State school curriculum.

Dr. MASON said that in New Zealand State school children were taught the principles of hygiene, and a text book had been specially prepared for Maori children in their native language.

On the motion of Dr. THOMSON, seconded by Dr. MCDOUALL, it was resolved :-"That steps should be taken by the Departments of Public Education and other public departments throughout Australasia to make and keep the water supplies, water closets, urinals and other sanitary conveniences of all public buildings, including floor space and ventilation, in such a condition as to be an object lesson to the public. That the elements of hygiene, somewhat after the lines adopted in New Zealand, should form part of the State school curriculum."

Dr. HAM moved :-"That the term 'pestis minor' should not apply to plague cases." Plague was plague, and the term was not desirable.

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Doctors. INVESTIGATIONS have been undertaken at different times, by various observers, into the occurrence and value of the Diazo re-action in the urine of patients suffering from tuberculosis. A communication made to the November issue of the Zeitschrift für Tuberkulose by Blad and Videbeck confirms the results previously recorded by others, and goes to prove that, in a very large proportion of cases, the reaction is negative or inconstant in favourable cases, but positive and well marked in cases which are, from the clinical point of view, had. Should this observation be established by further experience, the test may prove useful, not only as an aid to prognosis, but also as a means of guidance for the selection of cases best suited to the open air method of treatment in Sanatoria.

By the death of Professor Von Ziemssen, which took place on the 20th January, the University of Munich has lost one of its most distinguished teachers, and the profession of medicine one of its most popular and brilliant members. He was born at Greifswald in 1829, and graduated there in 1854. In 1863 he was appointed Professor of Clinical Medicine at the University of Erlangen, and in 1874 was transferred to the University of Munich, where all the rest of his career was spent. There were few subjects connected with clinical medicine on which, throughout his long and busy life, he did not write; but he is probably most widely known, and will be longest remembered, as the editor of two great medical encyclopædias which have been extensively read, not in Germany only, but over the whole medical world.

At a meeting of the Metropolitan Asylums Board, held on the 11th January, some important information was given in reference to the small-pox epidemic. A special interim report concerning the outbreak in the metropolis during the year 1901 was presented by the Statistical Committee. In this report it was pointed out that small-pox had been practically absent from London during the first five months of the year. The first patient was admitted from Islington on the 29th May, and thereafter single cases occurred from time to time in various parts of London up to the 21st August. From this date and onwards the disease obtained a hold in the parishes of St. Marylebone and St. Pancras. Subsequently cases occurred in every one of the thirty-one poor law parishes and unions comprising the Metropolitan Asylums District. The gross mortality for the year was given at 24.28 per cent.; but this death rate is higher than will appear in the final statistics, because many cases are included in this figure which were of recent admission, whereas contemporary cases, which will nearly all ultimately recover, cannot be included until completed by discharge. The percentage of death in vaccinated cases was 14.21; in doubtful cases, 65.08; in unvaccinated cases, 50-52. Looked at in the light of age periods, the statistics bring out the following figures: Under 10, there were 12 vaccinated cases and no deaths; 6 doubtful cases, all of whom died; and 95 unvaccinated cases, of whom 52 died, a percentage of 54.74. Under 20, there were 161 vaccinated cases,

of whom three died, a percentage of 187; 12 doubtful cases, of whom 78 died, a percentage of 58:33, and 151 unvaccinated cases, of whom 79 died, a percentage of 49.07. There seems to be a diminution in the protective power afforded by primary vaccination after the age of 20 years, the death rate rising from 9.85 in vaccinated cases between 20 and 25 years of age to 28.95 in cases between 35 and 40.

Of 2,198 persons employed at the small-pox hospitals between 1884 and 1900 inclusive, in which period 17,900 small-pox cases were received into the hospitals, only 17 persons contracted small-pox, of whom 13 were not revaccinated until after they had joined the ship, and 4 were workmen who had escaped medical observation. During the year there was a large increase of the staff on the ships and at the Gore farm hospital, among whom not one case of small-pox occurred. No member of the staff of the hospital ships has died, or even suffered, from the disease for the past eight years.

These facts confirm the conclusions arrived at by the special committee appointed by the managers to collate statistics after the small-pox epidemic of 1870-1-2. That committee, in their report, dated 11th July, 1872, said:

"The necessity of re-vaccination, when the protective power of the primary vaccination has to a great extent passed away, cannot be too strongly urged. No greater argument to prove the efficacy of this precaution can be adduced than the fact that out of upwards of 14,800 cases received at the hospitals only four well authenti cated cases were treated in which re-vaccination had been properly performed, and these were light attacks. Further conclusive evidence is afforded by the fact that all the nurses and servants of the hospitals, to the number at one time of upwards of 300, who are hourly brought into the most intimate contact with the disease, who constantly breathe its atmosphere, and than whom none can be more exposed to its contagion, have, with but few exceptions, enjoyed complete immunity from its attacks. These exceptions were cases of nurses or servants whose re-vaccination, in the pressure of the epidemic, was overlooked, and who speedily took the disease, and one case was that of a nurse who, having had small-pox previously, was not re-vaccinated, and took the disease a second time."

From the last edition of Churchill's Medical Directory, which was published at the beginning of January, it appears that there is a net increase in the members of the profession for the last year of 434. This is a smaller addition than that recorded for the previous year, when it amounted to 1.98 per cent. on all the names recorded in the Directory, as compared with 1.19 per cent. for 1901. In these days, when the spirit of trades-unionism in the shape of medical aid associations, friendly societies, and other similar organisations, for co-operative pro vision among the working classes to deal with the exigencies of sickness and death, is becoming such a prominent feature in professional life, and when the struggle for an adequate livelihood is greater, perhaps, than it has ever been before, it is remarkable that there should be this progressive increase in numbers to record. It may not be more than what is commensurate with the growing population of the country; but there is some risk that the labourer, though worthy of his hire. may, in medicine, come to be so poorly rewarded for his toil that the profession comes to lose in some measure its attraction for that large class of desirable young men who, however enthusiastic over the scientific and philanthropic interest which attaches to the work of a doctor, must needs live by the "sweat of their brow."

Pursuant to a resolution of the Council, passed on the 28th January. the London County Council have issued the following order :

"The London County Council do hereby resolve and order that Section 55 of the Public Health (London) Act, 1891, with respect to the notification of infectious diseases, shall apply in the administrative county of London, for a period of three calendar months, to the disease known as chicken-pox, and the Council do hereby declare that the case is one of urgency, owing to the prevalence of small-pox in London, and the fact that the failure in many cases to distinguish between chicken-pox and small-pox has led, and is leading, to the spread of the latter disease."

It has been decided by the Medical Councils of Cape Colony and of the Transvaal that foreign subjects will not be allowed to practise medicine in those colonies. unless they belong to a country in which the holders of British medical diplomas are accorded similar privileges. This is a wise and reasonable provision, which will not only save South Africa from an inrush of foreign practitioners, but will also standardise the value of the qualifications to practise up to the level of the mother country.

It is only a few months since Professor Virchow celebrated, with great éclat, his eightieth birthday, the occasion being taken advantage of to pay the veteran scientist all the honour he so well deserved, and to con

gratulate him on having reached such a hale and hearty old age. The echoes of these rejoicings in Berlin have carcely died away when the news comes that Professor Virchow, when alighting the other day from an electric car, fell on the asphalt roadway, and fractured his femur. This unfortunate occurrence has evoked the greatest sympathy among all classes of the German population, as well as among scientific workers all over the world, and it is earnestly to be hoped that the serious consequences which at his advanced age are apt to follow such an accident, may be averted, and that the favourable progress so far recorded may be uninterruptedly continued. According to the Berliner Klinische Wochenschrift, the subcutaneous hæmorrhage is rapidly being absorbed, and callus has begun to develop. The organs of circulation and respiration are also said to be normal, but the patient's rest at night is not so good as is desirable.

The difficulties with which female practitioners of medicine and surgery have to contend are considerable. In the practice of their profession among women and children there is probably little doubt that ultimately they may find an extensive and appropriate sphere of usefulness; but public opinion in this country is not yet ripe for their acceptance as suitable exponents of the medical art in all cases indiscriminately. No one denies the right of women to practise. Having worked for and earned her degree or qualification, she is as much entitled to seek the suffrages of the sick as any mere man; but it will probably be long before public confidence establishes her on anything like the sure basis of her brother practitioner, and circumstances must constantly arise where the question of sex becomes a matter of awkward importance, from the point of view both of convenience and of propriety.

This has been strikingly illustrated quite recently at the Macclesfield Infirmary, where the Governors, no doubt because they considered her the best candidate, appointed a lady as junior house surgeon. The medical staff strongly and unanimously objected to this selection, and when they found that their expression of disapproval was resisted by the governing body, they quite properly threatened to resign en bloc. As they had from the beginning declined to countenance the appointment of a lady, the action of the Governors in

selecting Miss Clark in face of their unanimous disapproval, left the staff no choice but to resign office, both in fairness to themselves and to the best interests of the infirmary. Fortunately this consummation, which would have been a very disastrous one for all the interests concerned, was at the last moment averted by the resignation of the lady whom the Governors had chosen.

It is very obvious that the domestic circumstances of a small hospital are such as to make it highly undesirable to have the two resident medical officers of opposite sex, and it is equally apparent that, in every general hospital, however small, there must always be a certain number of cases unsuitable for the ministrations of a woman. It is all very well to argue that because men doctors treat indiscriminately all the disorders of women, therefore there is no valid reason why women doctors should not similarly be allowed to deal with all the ailments of men. The cases are not parallel, and nothing is more certain than that were such an argument to be put to the test of experience, patients would seriously object, and in most instances refuse to have many of their ailments enquired into and managed by a lady doctor. The inevitable result would be constant friction, and consequent inefficiency in the service of the hospital towards the patients under its roof. If such unseemly wrangles as this at Macclesfield are to be avoided in future, the medical staff of every hospital must be granted as it ought to havea prominent voice in the selection of the resident officers.

Victoria

(FROM OUR OWN CORRESPONDENT.) The Women's Hospital Dispute-The Melbourne Hos pital-Williamstown Lodge Matters - Infant Mortality-Bubonic Plague in Melbourne-Commonwealth Army Medical Service-The A .N.A.— Lodge Abuses.

THE Women's Hospital Committee are now advertising for a Resident Medical Officer, with a salary of £250, to take charge of the midwifery department. So far they have had no response, and Dr. Shields, sen., has been filling the breach in the meantime. There is a great disinclination evinced by any medical men to engage themselves under existing circumstances to the Women's Hospital Committee, and no doubt the junior medical men feel that Drs. Yule and Lewis have a prior claim to any positions that may be vacant, and that they have been badly treated. The general opinion, so far as I can gather from medical men, is that the whole Committee should resign, and a new Committee com. posed of business men and members of the honorary staff should be appointed, and ladies be left out of the management altogether.

There is a good deal of dissatisfaction amongst the students at the Melbourne Hospital at the high fees they have to pay for clinical instruction, and it is to be hoped that a fair reduction will be soon made. There is also a growing feeling that better accommodation should be provided for the Resident Medical Officers at the Hospital, and that they should be paid for their

services.

Payment for medical services is a question that is being discussed in many quarters, and it is felt that our Defence Association might interest itself in bringing to a finality so many honorary positions that should not be honorary. By this I mean appointments to racing clubs, football clubs, bicycle associations, etc., etc. All these amusements should be paid for, and medical attendance should not be gratuitous.

The Williamstown medical men held a meeting on the 12th March, at which it was agreed that the ladies' lodges should be notified that at the end of March their medical fees would be on the same basis as all the other lodges. Dr. Honman intimated that he considered 10s. would be a fair fee to charge the Rechabite lodges for single members, but the proposition was not accepted by the other members, and it was agreed that the rates of pay should remain as they were until complete unanimity was obtained amongst all the medical men. Dr. J. Thomson brought forward the following motion "That the medical officers of the Williamstown Friendly Societies bring under the notice of the Medical Defence Association the paragraphs in the Australasian Medical Gazette of February last, stating that the A.N.A. Board, Sydney, had decided to fix the wage limit for benefit members at £200 per annum, that in their opinion the abuse of medical benefits is most deplorable, and that the Medical Defence Association be requested to take action at once in this matter of wage limit in benefit societies." This was seconded by Dr. Bryant, and carried unanimously.

The infant mortality during the summer months has been very great, and it has been suggested by Coroner Dickson that there should be some public place where infants could be treated in a uniform manner. This is a very wise suggestion, and would be found to answer its purpose admirably, and would be highly appreciated by medical men.

The bubonic plague has at last made its appearance in cur midst, in the person of a man living at Fitzroy. He was removed to Coode Island, and every precaution taken to prevent the spread of the disease. Another supposed case was reported from Yarraville, but did not prove to be plague.

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The Easter camp has been partially postponed, owing to heavy rains; but if the weather clears up part of the programme is to b gone through. Colonel Williams, the P.M.O., met the medical officers of the Victorian military forces at the Victoria Barracks on the 10th March, and gave a of the duties of the medical officers under the Commonwealth regime, and it was felt by all present that in Colonel Williams they had a man who knew his work himself, and would see that everyone else should at least have the opportunity of bringing himself up to a proper standard. It was hoped that in future more consideration would be given to the medical department of the forces, which is woefully behind the times in many ways. Colonel Ryan voiced the opinion of all his officers when he stated that in Colonel Williams we had the most suitable officer to occupy the position of head of the medical department of our Commonwealth.

Dr. Worrall's remarks anent the A.N.A. at the Hobart Congress have caused a great amount of discussion in this State, both amongst medical men and the various branches of the A.N.A., and many motions have been passed by the A.N.A. branches, expressing their indignation at the remarks, and their denial of the charges brought by Dr. Worrall against them.

A lodge abuse that has been quite common lately is as follows:-A young man passes the lodge doctor, and w.thin a week the doctor is called in to attend an invalid mother, and by the lodge laws he must attend this chronic case perhaps for months. It is quite time that lodge matters were brought to a better condition for the general practitioner, whose life at present is most unenviable, what with heavy expenses, small fees. and petty annoyances of all sorts from exacting lodge patients.

ANISOMETROPIA.

(To the Editor of the Australusian Medical Gazette.) SIR,-1 have to thank Feriscopist for his courteous note to my letter. To begin with, I should like to freely acknowledge that on one point, the practice of others, he seems to have proved me partly wrong. When one has recognised what he believes to be a principle, and has put it in practise with success for years, one is apt to assume, as I did without reference, that such names as Periscopist overwhelms me with have recognised and practised it also. I must ask to be acquitted of knowingly suggesting that such men are capable of slipshod work. In this matter, however, I would venture to disagree with part of their practice, and to even prophesy that they will come to change their opinions. The sweeping character of my assertion however, is modified when it is remembered that I referred to anisometropia and not merely to high degrees of anisometropia. Upon his use of this term I hope Periscopist will forgive me for again joining issue with him. Before writing my note I did consult one authority, owing doubtless to a like puzzling thought to that which assailed Periscopist, viz., can my conception, translation or definition of anisometropia be correct? On referring to Landolt (Refraction and Accommodation of the Eye) I found the following definition of anisometropia : "The state in which the refraction of the two eyes is unequal. Slight differences between the eyes in the same person are frequently found, and are certainly commoner than absolute equality of the two. But it is not of such trifling inequalities which deserve no special name that we are about to speak. For our purposes anisɔmetropia begins when the difference of refraction between the two eyes exceeds the value of the minimum interval prescribed by our notation for the different degrees of refraction. In other words anisometropia exists whenever the two eyes demand in order that each shall possess its maximum of visual acuteness, or in order to present to the observer the same clearness in their ophthalmoscopic images two different numbers of spectacle glasses." The italics are mine. Had your periscopic note given any indication that it referred only to high degrees of anisometropia or to exceptional cases my letter had not been witten. But it talked of anisometropia, and I am content to abide by Landolt's definition of this. There can be little doubt that it will also be the definition which would naturally occur to those not engaged in special eye work, and that to such members of the profession the suggestion that the correction of each eye in ordinary cases of anisometropia was unusual would come as a species of shock. Dr. Duane, though using anisometropia somewhat ambiguously, and including in his table "for the most part only such cases as showed a difference of refraction of at least 2 D. between the two eyes," evidently does not restrict the word to high degrees of inequality. In fact his table includes one case in which the following correction was given, viz. :—

R. E.-75 D. qt.
L. E.-1.75 D. oph.

In justice to Periscopist, however, I must acknowledge that some of the text books contain some justification for the restricted use of the term claimed to be usual by him.

The practice of ordering spectacles for constant wear exact for one eye, and knowingly inexact for another eye, capable of sight, seems to me difficult of justifica tion. I find, however, as Periscopist says, that most of the text-books recommend it for high degrees of anisometropia, though not always for the same reason.

My numerous cases, of all of which I have notes, include amongst them, as Periscopist surmises, high degrees of inequality, and my rule has been for the past sixteen years to endeavour to give each eye its correction. I have been so satisfied with the course, which seemed obvious, and with the result, that it would appear to have made me unconscious of the practice being unusual in cases of high degree.

I should, of course, have referred to the different text-books, etc., before speaking so strongly for others, for I admit that my assertion included all but exceptional cases of high as well as those of low degrees of anisometropia. It has occurred to me that my satisfactory results with these cases have been largely due to the fact that I practically never look for immediate comfort, or immediate good distant vision with the glasses I order; expecting sometimes a considerable amount of discomfort and of reduced distant vision (in hypermetropis) until after a few weeks of constant wear. In younger hypermetropis, indeed, immediate comfort with the spectacles ordered means, almost invariably in my experience, under correction of the spherical

error.

I am gratified to learn that Periscopist's practice in general agrees with mine. I have the hope and had the belief that it is not an unusual one amongst my interstate colleagues. I hope that you will not consider the space occupied by this subject has been greater than it deserved.

Yours faithfully,

J. LOCKHARDT GIBSON. [Dr. Gibson's honourable withdrawal from his untenable position leaves me nothing to say beyond that it is a gratifying proof of my estimate of his fairmindedness. I should possibly have made it clearer that Duane's paper referred to cases of considerable difference between the two eyes, but it must be remembered that in the limited space allowed one for these notes one has to eliminate every unnecessary word, and seeing that Dr. Gibson had read Dr. Duane's original paper, I naturally supposed he understood that Duane referred almost entirely to cases of considerable difference in refraction. I should like to know Dr. Gibson's practice in one class of case, viz, in aphakia of one eye, the other eye being healthy. Does he give in these full correction of each eye?-PERISCOPIST.]

piece which will last as long as the apparatus itself, it will not get out of shape, and what is more important it can be thoroughly cleansed after each time it is used, with soap and hot water, or some disinfectant as thought desirable. If you think this suggestion may prove of use, perhaps you will kindly find room for it in the columns of the Gazette. I am, Sir, etc.,

JOHN I. SANGSTER (Senr.) Kooringa, S. Australia, March 19th, 1902.

SANATORIA FOR CONSUMPTIVES.

(To the Editor of the Australasian Medical Gazette.) SIR. I think the Medical Congress is to be congratulated on its rejection of the resolution proposed with regard to the establishment of sanatoria for consumptive patients at distances from all towns and villages with at least an area of 200 acres to each. This well-meant resolution if passed would, I am convinced, have proved most mischievous in retarding the provision of suitable accommodation for phthisical patients. I do not deny that the isolation of these cases on 200-acre blocks at distances from towns and villages would be effectual in the prevention of phthisis, so also would their deportation to an' island in the Pacific. a proposal which is scarcely more impracticable. It should be hardly necessary in writing to a medical journal to repeat such truisms as :-That the consumptive is not necessarily a source of infection, or that the danger of infection in or from an institution in which proper regulations for the disposal of sputum, etc., are carried out is practically nil. I could, if necessary, having recently attended the International Congress for the prevention of Tuberculosis, cite overwhelming authority for these propositions, were it justifiable to fill your space with what must surely be familiar to the majority of your readers. munication of phthisis from the sick to the healthy in private houses, work-shops, hotels, boarding houses, travelling conveyances, etc., is at present owing to the almost universal want of proper precautions in dealing with the sputum, a most serious danger In dealing with it by the provision of sanatoria and hospitals we are hampered mainly-apart from ignorance as to the existence of infection, an ignorance which is gradually disappearing-in the first place by the fear of the

The com

A SUGGESTED IMPROVEMENT IN CLOVER'S expenditure which might be entailed, and secondly by ETHER INHALER.

(To the Editor of the Australasian Medical Gazette.) SIR.-I suppose that most practitioners who have much use for Clover's inhaler, find that after a time the face piece becomes almost unusable, it gets soft, out of shape, and on its inner surface lined with cracks which become receptacles for execretions, often offensive, from the mouth. On application at wholesale houses, I have not been able to get the face piece replaced, so that meant the purchase of a new inhaler. It occurred to me that a metal face piece, capped with the rubber cap, which can always be procured, would answer very wel. The local tinsmith having the old face piece for a pattern made me an excellent substitute, and fixed it to the tubular portion of the inhaler, the edge of the tin face piece needs to be made thicker, by having a rim of wire soldered around it, this prevents the rubber cap from slipping, two bits of adhesive plaster make that doubly sure. The metal tin answers the purpose quite well. perhaps nickel or aluminium would look more finished. The repaired Clover now has a face

the popular prejudice against sanatoria and hospitals for consumption as possible centres of infection. The effect of passing this resolution would have been to have strengthened both these obstacles Proposals for the prevention of tuberculosis on a wide scale to be of use must (1) be of a practical character, utilising as far as possible existing institutions by the addition of suitable accommodation, and (2) must, while pointing out real dangers carefully refrain from encouraging an ignorant fear of sanatoria, for which there is no real foundation. To develop such proposals in detail would, sir, be to trespass too much upon your space. I could hardly do my argument justice within a small compass, and indeed I have already discussed the whole subject recently in an official report, of which I forward you a copy. I have the honour to be, Sir, Your obedient servant,

A. JEFFERIS TURNER, M. D. Lond., D. P. H. Camb. Late Representative of the Queensland Government at the International Congress for the Prevention of Tuberculosis held in London in 1901.

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