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and should continue thirty years longer, begins to fail at forty-five; and while at thirty a man can earn 45 shillings a week, at forty-five, strive as he may, he cannot earn over 38 shillings, and at fifty-five his earnings fall to 24 shillings a week, owing to premature decay from overwork. In Sheffield he found that makers of penknives aged thirty years, who, in order to make a comfortable living, must strike 28,000 blows a day with a hammer, at forty years find their celerity and skill so at fault from this continuous overstrain that their wages decline to nearly one-half.

and higher schools, that is, the so-called memoriter method of instruction, which seems to be a necessity so long as the rank in scholarship continues to be de termined by per cent. of a pupil's cor rect answers in examinations. Thi abuse of memory fatigues the brain and lowers the powers of the mind. Physi cians protest against this method o teaching because it distresses the brain impairs free thought and the construc tive power of the intellect. Lesson are memorized and not acquired efforts of the understanding, hence they are not well retained, and furnish

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Not only this, but the emotional condi tions so often encountered, and the startling phenomena of hypnotism, ar in many cases superinduced by thi cramming method.

There are no fortuitous condition that concur for the production of the best moral and political circumstance of society; the whole is purposive in telligence existing in the individual and combined for the exigencies of the family and the State.

Wherever the highest developmen of physical health exists, there will b found the surest basis for developmen of the mental faculties. These are no abstract questions of philosophy, but are the most practical questions of ou day.

Physicians are held to be the guar-poor basis for wide intellectual culture dians of the organs that concur for the maintenance of the body; but it is not so generally understood that the great brain is just as much an organ of their conservative regard: it is not so well understood that a healthy brain is necessary to free will. This is a momentous question, and it concerns the happiness and prosperity of the social and political state. The injury which pupils suffer, more especially in the primary and intermediate grades of public schools, by the bad hygiene in overcrowded, illlighted and ill-ventilated rooms, has become so serious as to bring about state interference. In Germany medical supervision has been authorized in the construction of school buildings so as to overcome these evils. The sense of sight has been particularly impaired; but the organic life of the brain has been lowered by the same evils, and the intellectual processes affected. In the technological schools of France the use of tobacco by students is forbidden because it had been ascertained that this intoxicant deteriorated the higher mental faculties. Researches have been diligently made by medical specialists in our country, and gross evils in the hygienic conditions of school-houses ascertained, and the injury of general and special organs pointed out, and the American Medical Association has steadily promoted these investigations; but these reports have not seriously awakened the attention of city or state governments.

Another very serious evil exists in almost the whole range of our common

and

A Secretary of Public Health would represent the medical consciousness of the Nation, and become one to whom we could look for the exploitation of measures that will direct continuous scientific and collective investigation in regard to endemic, contagious other diseases; the enlightenment of the people in sanitary ways of living; the dissemination of information respecting the most favorable places of residence for those afflicted with such chronic diseases as asthma, rheumatism, neuralgia and consumption; the examination of food and drinks; medicinal springs; the collection and tabulation of vital statistics at large and in various localities, such as the congested areas of our great cities and amongst various races. He would be able to cooperate with State Boards of Health, the Signal

32D

Ist Session.

S. 302.

IN THE SENATE OF THE UNITED STATES.

Service, the medical departments of the
Army, Navy and Marine Service, unify
and utilize their work, and thus make
the Department of Public Health the
repository of the most important facts
that concern the comfort of the people; MR.
and his duties will grow broader and
stronger in adaptability to public needs.
Moreover, the creation of this depart-
ment will be a declaration by Congress
that the promotion of the health of the
people is a supreme law, and that in
the future progress of civilization medi-
cine shall have its true rank with the
other offices of the State.

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TO ESTABLISH A DEPARTMENT OF

PUBLIC HEALTH.

Be it enacted by the Senate and House of Representatives of the United

All of which is respectfully sub- States of America in Congress Assem

mitted.

C. G. COMEGYS, Chairman.

N. S. DAVIS.

T. G. RICHARDSON.

J. F. HIBBERD.

W. B. ATKINSON.

CHARLES Lindsley.
C. A. HUGhes.
W. T. BRIGGS.
CHARLES DENISON.
THOS. P. EVANS.
ALEX. I. STONE.

W. I. SCHENCK..
P. O. HOOPer.
H. J. SWEARINGEN.
THOS. F. WOOD.
J. N. MCCORMACK.
J. J. REED.

J. C. CULBERtson.
H. O. WALKER.
LANDON B. EDWARDS.
A. N. BLODGETT.

NOTE.-I have not appended the names of

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a number of the Committee because I have not heard from them. I hope to get them all, that they can be added in the committee-room of Congress. Physicians who favor this movement will please send to me, without delay, by postal or letter, their names and addresses, saying: "I favor the movement to create a Department of Public Health and a Medical Secretary of Public Health." I will forward their names to Washington.

If all of the profession who favor it will write to their Senators and Representatives it will greatly aid the movement. A distinguished Senator writes to me, saying: "I appreciate the great importance of the subject, and will give any aid I can to promote its adoption." Respectfully,

C. G. COMEGYS,
266 Elm St., Cincinnati, O.

bled, That there shall be established a Department of Public Health. There shall be appointed from civil life by the President, by and with the advice and consent of the Senate, a Medical Secretary of Public Health, who shall be intrusted with the management of the Department herein established. shall be paid an annual salary of He shall, with the approval of the President, provide suitable offices for the Department and shall employ such assistants and clerks as may be necessary.

He

SEC. 2. It shall be the duty of the Department of State to obtain from consular officers at foreign ports and places all available information in regard to sanitary conditions of such ports and places and transmit the same to the Department of Public Health; and the Secretary of Public Health shall also obtain, through all sources accessible, including State and municipal authorities throughout the United States, weekly reports of the sanitary condition of ports and places within the United States and shall prepare, publish and transmit to the medical officers of the Marine Hospital Service, to collectors of customs, and to State and municipal health officers and authorities, weekly abstracts of the consular sanitary reports and other pertinent information received by said Department.

The said Department also shall, as far as it may be able, by means of the voluntary co-operation of State and municipal authorities, of various general and special hospitals and sanitariums,

of public associations, and of private persons, procure and tabulate statistics relating to marriages, births, deaths, the existence of epidemic, endemic, and other diseases, especially those of a degenerative character, such as malignant growths and affections of the circulatory, respiratory, secretory, and reproductive organs, and data concerning the fruit of consanguineous marriage and transmissibility of insane, alcoholic, syphilitic, nervous, and malignant types of constitution. He shall also procure information relating to climatic and other conditions affecting public health, especially in reference to the most favorable regions in the United States for the cure or relief of the chronic diseases of the several organs of the body, especially of consumption. He shall also obtain information in a sanitary point of view of the health and comfort of the laboring classes. He shall seek through the State boards of health information in regard to the healthiness and comfort in public-school houses. He shall, so far as he can, further collective investigations in regard to the common diseases of an inflammatory and febrile character that prevail among the people. He shall co operate with State boards of health, the Signal Service, the medical departmeuts of the Army, Navy and Marine Service, unify and utilize their work so as to make the Department of Public Health a repository of the most important sanitary facts that concern the public comfort.

Besides the reports of the state of public health, which he shall report from time to time, the Secretary of Public Health shall make an annual report to Congress, with such recommendations as he may deem important to the public interests; and said report, ordered printed by Congress, shall be done under the direction of the Depart

ment.

The necessary printing of the Department shall be done at the Government Printing Office, upon the requisition of the Secretary of Public Health, in the same manner and subject to the same provisions as that of other public printing for the several departments of the Government,

SEC. 3. That the Medical Secretary of Public Health shall frame rules, under the direction of the President, which shall serve for the instruction of consular officers of the United States and of the medical officers serving at any foreign port. In compliance with these rules every master of a vessel destined for a port of the United States shall be furnished with a certificate containing a detailed statement of the inspection of the vessel, cargo, crew, and passengers, and of the sanitary measures carried out at the expense of the vessel; or, if such measures are not carried out, instant warning shall be transmitted to the Medical Secretary of Public Health, who shall immediately notify the quarantine authorities of the port of destination.

SEC. 4. That the Medical Secretary of Public Health shall make investigation, both in the United States, and, if necessary, in foreign countries, into the nature, origin, and prevention of contagious and epidemic diseases, as well as the causes and conditions of particular outbreaks of disease in the United States, and shall publish and distribute documents relating to the prevention of disease.

SEC. 5. That the President is authorized, when requested by the Medical Secretary of Public Health and when the same can be done without prejudice to the public service, to detail officers from the several Departments of the Government for temporary duty, to act under the said Department of Public Health to carry out the provisions of this act, and such officers shall receive no additional compensation, except for actual and necessary expenses incurred in the performances of such duties.

When a detail of suitable officers can not be made, the Medical Secretary of Public Health, approved by the Presi dent, may employ such experts, and for such time and in such manner as the funds at the disposal of the Department may warrant.

SEC. 6. That to defray the expenses incurred in carrying out the provisions of this act the sum of dollars, or so much thereof as may be necessary, is hereby appropriated to be

disbursed, with the approval of the

President, under the direction of the said Secretary of the Department. That

Selections.

this act shall take effect sixty days after FROM CURRENT MEDICAL LITits passage, within which time the Medical Secretary of Public Health shall be appointed.

SEC. 7. That an act entitled "An act to prevent the introduction of contagious and infective diseases into the United States and to establish a National Board of Health," approved March third, eighteen hundred and seventy-nine, and all other acts and parts of acts conflicting with the provisions of this act are hereby repealed.

EDITORIAL NOTES.

We have the pleasure of calling attention to the Medical Fortnightly, a new journal with headquarters at St. Louis. The first number is very good, and from it we prophesy a successful career to our new neighbor.

THE agitation of the Medical Practice Act is being carried briskly forward. Cleveland has fallen in line, and is working for the success of the measure. The following is taken from the Cleveland Medical Gazette:

We hope that all the readers of the Gazette will take every opportunity to influence members of the Legislature

to vote for the Medical Practice Bill which will be presented this winter.

Have you done what you could for the success of the measure?

IT seems that there will be an

attempt made in the Legislature this winter to apply some "ripper" legislation to the Cincinnati Hospital. The Hospital is not perfect, but making it a political institution will not be in the line of improvement.

BINDING.-Preserve your files of the LANCET-CLINIC and make a convenient library of reference by sending your unbound volumes to to this office. Any style of binding desired, at uniformly low prices.

ERATURE.

FRAENKEL'S PNEUMOCOCCUS IN SUPPURATION PROCESSES.

Dr. Nannotti's observations (Il Morgagni) go far to prove that the pneumococcus can give rise to true abscess in connective tissue, either before, during, or after the evolution of a pneumonia. The author relates four instances: one of abscess of the submaxillary region, one of the mastoid region, one of the tissue surrounding a tooth, and one of the perineum. The pus was carefully collected and found to contain only diplococci, and cultures showed the only micro-oganism present to be that of Fraenkel. Experiments on guinea-pigs showed all the special changes caused by the pneumococcus, of which the encapsulated appearance was typical.-N. Y. Med. Record.

MANAGEMENT OF THE PAROX

YSMAL INEBRIATE.

The assertion so confidently made by some to the effect that paroxysmal inebriety can be "radically cured," seems to me open to serious question. I have

cured" cases relapse. There is little seen altogether too many doubt, however, that under proper management the duration of the paroxysms can be materially shortened, and the intervals between them prolonged to such a degree that, in the majority of cases, the disease need no more interfere with a man's business than a gouty

diathesis with occasional acute exacercondition must be treated as one of disease pure and simple, and the family and friends of the patient must heartily coöperate with the physicians in enforcing the necessary discipline. If the patient will himself coöperate, so much the better.

bations. But to attain this result the

The plan of treatment which has proven most effective in my own hands is as follows: The patient is put to bed

and kept there for three or four days under the constant care of a nurse; if the patient be allowed to go about he does not recover physical tone as soon, and if he be let alone any length of time the fits of mental depression into which he is certain to fall greatly retard his recovery. Alcoholic liquor in every form is withheld from the first. Hot broth is given every hour, and hot milk at the usual meal times. Strychnia (1/80 to 1/120 grain of the sulphate) is given every hour, and in case the heart acts feebly or the kidneys are sluggish it is combined with 1/480 grain of digitalin. At night a sedative is given subcutaneously. Terchloride of gold and sodium (1/20 grain in thirty minims of water) has seemed to act kindly-more so than preparations of opium, either alone or combined with atropia or hyoscyamia, or those mixtures containing chloral or bromides. Coffee, hot; and without milk or sugar, is allowed if the patient cares for it. Irregularities of the stomach and sluggish action of the chylopoietic system are corrected with small doses of calomel (1/10 grain three to six times a day), combined with ipecac and soda.

which in his case seem to determine the attack, and of coming to the physician when the prodromata (most prominent among which are indigestion and insomnia) first appear.

By taking these precautions, patients often go two years, and even longer, without a relapse. To make a long story short, dipsomania is one of the graver manifestations of nervous exhaustion. The principles that underlie its successful treatment are the same that underlie the treatment of other extreme forms of neurasthenia, viz., rest, forced feeding, and tonics, with proper care after recovery to forestall_a recurrence of the attack.-Dr. L. B. TUCKERMAN in Medical Record.

GERM THEORY OF DIPHTHERIA
FROM THE THERAPEUTIC

POINT OF VIEW.

According to the Bulletin Général de Thérapeutique, October 30, 1891, Dr. Jacques, of Marseilles, promulgates the following doctrine: While diphtheria is due to a specific germ from which emanates toxic properties, causing various disorders in their journey through the economy, the germ itself exists only in false membranes, and does not penetrate the blood or organs. The mouth and false membranes contain other micro-organisms beside the specific diphtheritic germ. Gargles are recommended every hour, first of perchloride of iron in solution, followed by washing the throat with warm water containing three parts of boracic acid to every hundred parts of water; and the alternate hour, a gargle of carbolic solution, 1: 100, without washing the throat afterward. For very young children powders may take the place of gargles.

After the third day the patient is allowed to sit up, and easily digested food, such as rare beefsteak, etc., is added to his diet. From the fifth to the eighth day the nurse can usually be dismissed, and the patient returns to his business free from the craving for liquor for the time being. I add the qualification advisedly, for over-work, or over-worry, or prolonged privation of sleep, or any other cause which lowers the reserve of nerve-force below a given point, will occasion a return of the craving, and with this craving comes the delusion of dipsomania, viz., that, since he is cured, he can take one-N. Y. Med. Record. glass and then stop. He takes it, but he doesn't stop. As a precaution, after the patient has returned to his usual avocation, it is just as well to have him come to the office first daily, then every other day for a week or so, for his hypodermic of terchloride of gold. Every pains should be taken to impress both the patient and his family with the necessity of avoiding those causes

THE TREATMENT OF DYSEN

TERY.

At a meeting of the Medical Society of London, held October 19, 1891 (Medical Press), Professor Bahadurji, of Bombay, read a paper on the treatment of dysentery, which he said was not a contagious or infectious disease,

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