causing a deplorable and death.

The

amount of suffering,

of Small-pox

great prevalence

England throughout

misery, in

the

year points a moral to the decision arrived at by the Royal Commission on Vaccination as anuouuced iu the interim

Report deprecates the impenalties for refusal to conform to the law of having children vaccinated, thus virtually allowing a parent or guardian to evade the law by buying an immunity from further legal proceedings by paying a penalty for a first offence. "We think that the imposition

?11241(4.

Jnitian

JANUARY 1893.

of The early months of 1892 were noticeable of Influenza for a third annual pandemic

which, with its

caused

sequela;,

a

high

death-

victims princes, rate, claiming amongst of men H. R. H. mark. priests, and professional succumbed a week's after Duke op Clarence of followed influenza, by illness to an attack its

H. H. the Kliedive pneumonia a week's illness, which after OF Egypt also died and ended in pneucommenced with influenza But the greatest mormonia and ursemic coma. in those well-stricken occurred amongst and

tality

collapse

;

the Ven'ble Cardinal This disease proved fatal to several well-known in the profession and

example,

years, as, for

Newman. medical men,

to the world at

large, amongst whom

were

Sir

Morell Mackenzie, Professor Sir G. E. Paget of Cambridge, and Professor Yon Brucke of Vienna. Fortunately in Iudia the influenza in

type

and not

moved from

past year was mild widespread. It, however, remidst our great pharmacologist

epidemic our

of the

Dr. William Dymock, of the

Early

in

January

two

This

Report.

of repeated

position

Bombay Army. Berlin investigators

aunounced at Koch's Institute forlnfectious Diseases that they had independently discovered the bacillus of influenza, which appears to have escaped the notice of previous observers. Dr.

Richard PfeifFer fouud it iu great numbers in the sputum of influenza patients, whereas Dr. Canon found the same bacillus in the blood during the pyrexial period. Dr. Koch examined and compared the results of both observers, and pronounced the bacilli to be

mucus and cells of the

practically identical.

first half of the year famine and pestilence,?famine fever, typhus aud cholera,

During the

.devastated many of the provinces of Russia,

repeated penalties

iu

respect

of the

noil-

vaccination of the same child should no longer be possible." * * * *>" We think that they should cease to

be inflicted

at this

conclusion

altogether. We have arrived quite independently of the

whether vaccination should continue compulsorily enforced. " Thus, instead of

question to be

enforcing obedience to the existing law, the recommendation of the Commission tends to protect and favour the law-breakers, who, with perhaps the best?though misguided?intentions,

make themselves and their families a danger to the community and to the State. Iu marked contrast to this is the action of the Bombay Government in their Bill to prohibit the practice of inoculation, and to make the vaccination of children compulsory throughout the

Presidency,

as

well

as

iu

Bombay itself*

where it has been compulsory since 1877. Calf lymph is to be used in every case in which it is asked for; but the Government reserve to themselves the power of enforcing vaccination with human

lymph in au emergency; as, for example, on the outbreak of au epidemic in au out-of-the-way station, where no calf lymph may be available, and when delay might prove dangerous.

the scourge of Cholera Asia and Europe, great Ifc baa been more severely.

During the past year has passed the latter

as a

wave over

suffering epidemic

had its

origin in the Hurdwar

alleged

that the

March,

on the 22nd of closuie the Fair and necessitating the on the 25th March. of the pilgrims

at the

North-West Provinces of India, Fair, where cholera broke out

.dispersion Thus it

along

was

the

carried through the Punjab, and road into Kashmir, where it

new

worked great havoc owing to the extremely insanitary state, of Srinagar and filthy habits of

INDIAN MEDICAL GAZETTE.

20

[Jan.

18931

passed by Afghanistan that its spread was favoured by impure drinkPersia, and Meshed and ing water taken from the sewage-polluted Seine, Teheran suffered severely. By the usual trade by the insanitary conditions of the dwellings routes the cholera was carried into Russia to on the banks of the river, and by the misguided the shores of the Caspian Sea to Baku, across attempts at secrecy on the part of the officials. Caucasia by Tiflis to Batum on the Black Sea Subsequently the disease spread to the provinthe

Thence it

people.

and Turkestan into

coast* In the Caucasus alone

there were 125,000 From the Caspian

and 65,000 deaths. Sea also the disease was conveyed up the Volga and its tributaries, attacking Kazan, Nijninovgorod and Moscow, and finally up to St. Pecases,

tersburg,

where there

1,150 deaths.

The

were

new

railway

Turkestan

Bokhara, through

cases, with

3,300

from

route

and

Northern

Persia to the Caspian Sea, ated the progress of the and northwards.

It also

railway line.

Kazan

ces, and attacked Havre in

months, from the of October, the

there 220,000 deaths from cholera. From St. Petersburg the cholera wave passed to the Baltic ports and ports on the Russia

North

Sea, doing special

finally

mischief at

Hamburg, ripples of the great wave lapped the shores of Great

the last

from east to west

Britain, where an efficient barrier was offered to it by the excellent precautions taken by the

sanitary authorities. lasted about ten

In

weeks,

the

Hamburg

epidemic

in which time there

were

officially reported 17,972 attacks, with 7,610 deaths.

It is

supposed

that

emigrants from

brought the disease to the port of Hamand that cholera germs got access to the burg, water of the Elbe either from the excreta or

Russia

soiled

linen of infected

pothesis earliest ers

and

seems cases

a

This

emigrants.

hy-

from the fact that the

occurred amongst the dock labouraud also from the fact that the of the city is taken from the Elbe

sailors,

water-supply in

probable

practically unpurified condition.

ter of the drinking water may be the following quotation :?" The

The charac-

imagined from sewage may

be said to go out at the basements and in at the roofs of the houses after taking a little tour in the river-and in the waterworks." Previous to, and coincident with, this cholera wave from the East another epidemic existed in France, of which Paris formed the focus. It started early in April in an overcrowded prison It has been at Nanterre close to the Seine.

suggested that this epidemic crudescence of the last cholera

Whether this bp the

case or

was

but the

epidemic

not, it

re-

in Paris.

seems

certain

cholera victims iu France

are

The case of it as formed is the point of Antwerp interesting, confluence in time and place of the two epidemics, i.e., of the general epidemic from the East and the local one from Paris. The disease is stated to have been introduced on the same the 15th from

August, by

Havre,

ships,

two

the St.

and the Nerissen from Ham-

which arrived simultaneously. In India the chiefoutbreak of cholera occurred

burg,

are said to have been over

until

particular. In the six April to the middle

numbered 3,184.

said to have

immensely accelerepidemic westwards day, spread by the Moscow- Paul

Throughout

middle of

16,845 cases with 11,712 deaths reported. Outbreaks also occurred at iu Kulu, Benares and Mian Mir, amongst the troops at Murree where it proved specially disastrous to the medical officers, in Lahore where several deaths occurred amongst the medical students, and at Chitt.agong where the shippiug

Kashmir,

in

where

were

in the

port

and

Europeans of the

station suffered.

past year there have been numerous congresses convened to discuss a variety of mediIn the

cal

subjects.

them all the

was

important

of

the International Conference

on

Perhaps

the most

Sanitary Control

of the Suez Canal, which Venice last January, and again in Owing chiefly to the action of Great

assembled

May.

at

Britain iu opposing the proposals of France, which were agreed to by twelve of the fourteen nationalities represented, a final agreement was not arrived at until June when the delegates of Austria, France and Great Britain assembled at Paris to draw up a protocol?the result of mutual concessions?which has since been accepted by the other Powers which supported the French proposals at Venice. The object of the Venice Conference of 1892 resembled that of the Conference which assembled at Rome in 1885 to discuss what measures should be adopted

prevent

the

imposition

of

spread of cholera from Asia to the Suez Canal route ; .but they difEurope by in the fered fact that most of the Powers, headed by France, at the Rome Congress advocated the

to

stringent quarantine regulations.

Whereas the Venice Congress has aimed

at fram-

Jan.

ing

BENGAL CUSTOMS

1893.] which

measures

little loss

can

be carried

delay efficiency in

with

with

as

to travellers as is

to trade and

compatible

out

DEPARTMENT,

the

prevention

of

importation of cholera into Europe. This recent congress differs also in its decision that

the

vessel is to be

a

if

regarded been

as

"

infected

"

only

cholera board, and not merely because the vessel sailed from an infected port, as obtained previthere

is

has

or

a

of

case

on

ously. of last June, signed by the France and Great Austria, representatives to and by the other Powers, Britain, agreed lays down the sanitary regulations which will in future control the passage of vessels through the Suez Canal. Vessels are classified according as they have a clean bill of health, are suspicious, or are infected. (1) Ships with a clean bill of health may proceed at once after medical inspection. (2) Suspected ships are defined as those The Paris

protocol of

which have

a

leaving port

or

no

fresh

seven

case

days.

case

of cholera

board when

on

during the voyage, but in which has occurred within the previous They are sub-divided into (a) ships

doctor and a disinfecting stove those which have not. The and board, (Z>) former may pass through the Canal in quaran-

which have

a

on

tine ; but a vessel belonging to the latter category is to be detained at the Wells of Moses while the ship and the soiled linen, &c., are dis-

before being allowed to pass through the Canal in quarantine. A "suspect" is a person who has had personal contact with a

infected,

cholera

(3) Infected ships

patient.

are

defined

those which have cholera on board and in which fresh cases have occurred during the pre-

as

vious seven days. They are also sub-divided into (a) those which have a doctor and a disin-

fecting not.

is to be

on board, (b) and those which have ship belonging to the latter sub-division detained and disinfected at the Wells of

stove

A

Moses, the patients

are to be landed and put in and the other to be are .passengers lauded and kept under observation for five daysj after which the ship may proceed in quarantine. But a ship of the foimer sub-division may have the period of five days detention curtailed by sanction ol the sanitary authority if the disinIt is fection is completed. alleged that these

hospital,

regulations

will

facilities when

and will

a

giye "the greatest possible ship has a clean bill of health,"

impose ''effective but

not

vexatious

011

measures

likely

1891-92.

21

all vessels that are infected or In support of this state-

infected."

to be

that, in the five years from 16,491 vessels which passed Suez Caual, only two would have " infected and twenty-eight as as

ment it is shown

1886 to 1890 out of

through

the

been classed "

suspected

"

"

ships.