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Published on the 15th of each month. Address all Communications and make all Cheques, Post Office Orders and Postal Notes payable to the Publisher, George Elliott, 203 Beverley St., Toronto, Canada
TORONTO, JUNE, 1908.
COMMENT FROM MONTH TO MONTH.
The Tuberculous Immigrant.--In our May issue we published an address on the above subject, which was delivered by Dr. Peter II. Bryce, Chief Medical Officer for the Department of the Interior, at Ottawa, before the annual meeting of the Canadian Association for the Prevention of Tuberculosis. When the country is fighting strenuously the situation as it presents itself to-day, there is every need on the part of the medical health officers, examining immigrants at ports of entry, to do it with the utmost care. According to Dr. Bryce's address, we fully believe this has been done as carefully as it could be done, when we consider that only one in every 14,000 examined was admitted tuberculized. Dr. Bryce makes a strong point when he states money can be got for any and every scheme, but not for fighting the great white plague. Governmental and municipal grants are small, and almost given grudgingly; private contributions are practically nil. Probably the proper scheme has not yet been devised to secure the financial ammunition. If medical health officers were as zealous in combating tuberculosis as they are in attacking smallpox or diphtheria epidemics, better advance would be made. Probably it would be well to have compulsory notification on the part of physicians, not necessarily for red, blue or yellow placards, to
the passer-by away, but in order to place the onus of responsibility upon the medical health officer, to deal with these cases as with
smallpox, etc. We will then see in the estimates of health officers such an item as this: "For dealing with cases of consumption, $10,000." The money would be forthcoming in every municipality, and scarcely a taxpayer would raise an objection to the fraction of a mill so levied on his assessment.
The Wasserman Reaction for the Diagnosis of Syphilis.Some two years ago Wasserman introduced a new method for the diagnosis of syphilis, whether in acute or tertiary form, the reaction being based on the use of the serum of apes artificially infected. The method, however, is so elaborate in its technique that it cannot be carried out except in a properly equipped laboratory. Wasserman employed an extract of the liver of a child which had died of congenital syphilis. An immune serum was obtained by treating monkeys with this extract. But he later found that, in a patient suffering from syphilis, serum could be got which took the place of the immune serum from the monkey. In other words, the specific immune body for syphilis is contained in the serum of such syphilized individuals. It is valuable only from a diagnostic standpoint, and it would appear from observations, in confirmation of Wasserman's findings, that it is a specific reaction, and is found only in those who have or have had the disease. It has been positive in hemiplegia, negative in simple apoplexy; also in cases of paralysis and tabo-paralysis. One observer and experimenter, Schutze, says: (1) The longer the syphilis virus has remained in the body, and the more frequently it has produced symptoms, the greater is the amount of “antibody” in the serum, and therefore the more regularly does the reaction show a positive result; (2) the earlier that mercury has been employed in the treatment of the disease, and the longer that treatment has been carried out, and the more frequently it has been applied, the smaller will be the amount of “antibody” contained in the serum, and the more often will the test be negative.
The Strength of Tetanus Antitoxin can now be measured by four methods: There is the German method of Behring; that of Roux, of France; the Italian-Tizzoni; the American method. The European, being complicated and difficult to carry out, not accurate, admitteilly unsatisfactory, brings into prominence the American-simple, direct and accurate. It is the result of six years' careful work in the National Ilygienic Laboratory. Since the estab
lishment and promulgation of the American standard, the unit strength of tetanus serums on this market have decidedly greater antitoxic value. The American unit is thus defined: “The immunity unit for measuring the strength of tetanus antitoxin shall be ten times the least quantity of antitetanic serum necessary to save the life of a 350-gram guinea pig for ninety-six hours against the official test dose of a standard toxin furnished by the Hygienic Laboratory of the Public Ilealth and Marine Hospital Service." The toxine is given out to licensed manufacturers to prepare the antitoxin.
Tetanus in man is not a widespread disease as compared with other plagues. Ilippocrates in his writings, described it and told of its diagnosis and prognosis. Aretaeus, of Kappadoza, has given us a description of lockjaw, which holds to the present day. He described an opisthotonus, an emphrothotonus and a tetanus, as the muscles of the back, abdomen or of the body generally were involved. Later pleurothotonus was added, when the muscles of one side were especially affected. Through the Middle Ages there was no advance made in the knowledge of tetanus. About 1860 IIerberg and Rose, and Billroth and Spencer Wells, believed it a zymotic disease, and that the spasms were caused by a poison in the blood, like strychnine. In 1876 Strumpell declared tetanus to be due to an infection. In 1881 Carle and Radirie first successfully showed that the disease was transmissible. In studying the micro-organisms of soil or ground tetanus, Nicolaier, in 1884, always found a slender bacillus in the pus. Rosenbach, in 1886, found a similar bacillus, with a round terminal spore, in a case complicating frost gangrene in man. Kitasato, for the first time in 1889, grew the bacillus in pure culture, and successfully proved this bacillus was the real cause of tetanus. From further experiments and observations, he concluded we were dealing with an intoxication and not an infection. In 1890 Behring and Kitasato laid the foundation of serum therapy when they published their great work on the tetanus toxin and the tetanus antitoxin.
Canadian Medical Association.—Once again we desire to draw the attention of our readers to the forty-first annual meeting of the above Association in Ottawa on the 9th, 10th and 11th June. Complete railway and steamboat arrangements are secured, and the Standard Certificate Plan prevails in every Province. The provisional programme has been sent out to members, to those on the programme and to the medical press.
It is the best provisional programme ever issued from the office of the General Secretary in the past seven years. From it it will appear that the idea of meeting in different sections, as set out in the new constitution, and as adopted now for the first time, will quite evidently prove a popular one. There are also many who have never before had the opportunity to visit the Capital while Parliament was in session, and the opportunity presents itself now for the first time. The men in Ottawa have spared no pains to look well to the social side, and there promises to be a very fine meeting socially, as it will sure to be scientifically. Can you, reader, afford to miss this meeting?
DR. II. L. COLLINS, of Kinloss, has gone to Edmonton.
DR. CHARLES A. IIEBBERT, of IIawkestone, Simcoe County, has been appointed an associate coroner for Nipissing District.
DR. JOHN R. AND MRS. PARRY and daughter, of Ilamilton, are guests of Mr. and Mrs. R. A. Harrison. Dr. Parry will leave for Europe next week.
DR. W. RUSSELL, house surgeon at Victoria IIospital, London, has resigned and left for Highgate to practise there. Dr. John McGillicuddy has also handed in his resignation.
DR. W. C. GILDAY, Toronto, who left last September to take up a special course in London, England, has passed his conjoined examination, and received the degrees of M.R.C.S. and L.R.C.P.
DR. A. A. JACKSON, formerly of Everett, has purchased the practice of Dr. Lepper at Bolton. Dr. Jackson has just returned from London, England, and Dublin, Ireland, where he took postgraduate courses.
DR. G. V. ILARCOURT, who has built up a large practice in Powassan during the past few years, has disposed of it to Dr. Carveth, of Toronto, who has already assumed his new duties and made many friends.
DR. JOHN M. ADAMS, chief house surgeon at Victoria Hospital, London, has handed in his resignation, to take effect on May 1. Dr. Adams has been on the staff of the hospital for one year. After a holiday he intends to go to Seattle to commence practice there.
DR. AUSTIN HUYCKE, who has been taking a post-graduate course in Bellevue Hospital, New York, was in Warkworth this week, and is visiting his brothers in that vicinity. Dr. Huycke
, intends leaving shortly for Vancouver, where he will take up his practice.
BRANTFORD will erect a consumption hospital this year. A promise of liberal support from the Government has been secured, augmented by handsome private subscriptions. Medical men of the city have the project in hand, and state that it is in such a condition as to warrant definite announcement concerning the prospects.
Muskoka Sanatoria Medical Staff.-W. B. Kendall, M.D., C.M., L.R.C.S., L.R.C.P., Physician-in-Chief of the Muskoka Cottage Sanatorium, has been appointed Physician-in-Chief of both the Cottage Sanatorium and the Muskoka Free Hospital for Consumptives; and C. D. Parfitt, M.D., M.R.C.S., L.R.C.P., Physician-inChief of the Free Hospital since its opening in 1902, becomes Resident Consultant of the two Sanatoria, each giving his entire time and effort to these institutions. The medical staff will also include a trained resident pathologist and two assistant doctors, together with a staff of specially trained nurses.