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Canada Medical Journal.
MONTREAL, FEBRUARY, 1866.
We give below some very interesting details of the prevalence of epidemic cholera in Paris, during the past four months; and however much may be said of the severity of the disease, it does appear that the Parisians have suffered very lightly, when it is recorded that, during the existence of the epidemic, from the 15th September to the 15th January, or 122 days, 6388 deaths only have occurred in the Department of the Seine-this, in a population of over two and a half millions of inhabitants, gives an average of two deaths per day among 100,000 inhabitants. If we take as an average 120,000 inhabitants for our city, and suppose that the epidemic, if it does prevail during the coming summer, should remain four months, it follows that, with a like mortality, we must lose something less than 300 inhabitants by the scourge. This is all too many; but still it is a cheerful prospect, inasmuch as our mortality, taking as an example the experience of former epidemics, was somewhere in the neighbourhood of eight times as many. The corporation of our city have at last decided on the appointment of a health officer, and we do hope that do narrowminded policy will be adopted, either in the appointment to be made, or the work to be done. The services of the very best man should be secured, and his action should be untrammelled; no interference of the Health Committee should for one moment be permitted. The health officer, to be of use to the community, must be a person of sound judg. ment, untiring exertion, and his will should be law in all things appertaining to the department over which he should preside. If the health officer is to be the paid officer of the Health Committee—to be their servant, to do as he is told, go where he is sent, and act in all things under instruction of the Health Committee, then we say his usefulness will be rendered nugatory, and the benefit to the city of no effect. We believe in the necessity of a house-to-house visitation. No man should be
. spared—be he land owner or tenant, city father or employé. Let all be placed under the ban if necessity requires it; and not alone by imposing
a fine, but force on the people the adoption of common cleanliness about their houses and premises. Pigs—we do not mean all animals which come under that designation-we confine our remarks to the porcine tribe-pigs, we say again, should not be permitted to be kept in the city environs. Animals, of whatever kind, if kept, should be in well-ventilated stables, and manure heaps should be removed every three or four days, with the house refuse. Back lanes require to be carefully and rigidly watched, and all accumulations of filth should be speedily removed. The means of flushing our sewers is at hand. With our water-power there should be at least the possibility of cleansing drains. Much might be said about sweeping and cleansing the streets. This is a necessity which our Corporation should strictly attend to; otherwise we would advise the health officer to summon the Mayor and Corporation before the Recorder, and convict them for nuisance. All these things have to be done, and done effectually. To meet the exigency, the city should impose a special tax. Let there be no lack of means or of men to do the work which is before us, when valuable lives are at stake; and if the cholera should come, we will be found in the very best condition to cope with the fell destroyer.
Cholera in Paris.—The return of the Board of Health at the Prefecture of Police, and officially communicated to the Academy of Medicine, gives the following results of the epidemic, from its commencement on 15th September up to the 15th January, when it finally ceased ; no case having appeared from that date to the 27th ultimo: Admission to Civil Hospitals
2,865 Cases occurring in Military Hospitals ...
707 Deaths in the Civil Hospitals........
6,388 During 122 days, from the 15th September to 15th January, there were, in round numbers, 52 deaths daily, from cholera, in the Department of the Seine, or, in other words, there died two persons per day out of every 100,000 inhabitants. On the 14th October was recorded the highest rate of mortality, 230 persons having succumbed to the disease; after that date the epidemic slowly but steadily declined, and rapidly disappeared after the second week in December.
OUR CITY COUNCIL. Organized bodies are proverbially slow to move, and hard to keep in motion, when once started. Hence our astonishment is not great at the perfect state of quiescence in which we still find our City Council, notwithstanding the continual thundering which has sounded in their ears, for several months past, in the journals of this city, from the long editorial of its chief writer down to the hurriedly written, but no less sincere few lines, of its least known correspondent. On our part we have not failed to impress upon those having in charge the sanitary condition of the city, that everything pointed towards a re-visitation from that much-dreaded scourge Cholera, and once again we would raise our voice against the all but criminal apathy in which they seem to be sunk. In a few weeks spring will be upon us, and a March sun pouring down its powerful rays, decomposing the immense quantity of vegetable matter, which careless housekeepers have thrown from their dwellings. If action is to be taken, and there is not a shadow of doubt but that it certainly ought to be taken, not a day should be lost. From actual observation we hesitate not to assert there are portions of this city so filthy, that should the dreaded disease visit us, it will attack such districts with a virulence which only those who remember how previous epidemics visited certain portions of our city, can thoroughly understand. We sincerely trust that at the very first meeting of the new City Council the matter will be brought forward, and pushed to an issue. There must be no more trifling or putting off ; the time for action is at hand, and it must be
If the next two months are lost in inactivity, we do not envy the responsibility which will hang heavy on the shoulders of those whose duty it was to have acted in the matter.
Since the above was written, two meetings of the Council have been held, and at the last one Councillor Devlin, chairman of the Health Committee, moved the appointment of a Health Officer. It was referred to the Finance Committee as it involved a money appropriation, and although no Council meeting has been held since, we have been given to understand that the Finance Committee intend to recommend such an appointment till the first of January next, at a salary of £400. With all due deference to the wisdom of such an important Committee as the Finance, we assure them that their recommendation is considered by those best qualified to judge (the medical profession) as a very foolish one. It is impossible for the city to obtain the services of any gentleman qualified to fill so important a position, for a period of eight months. To obtain a Health Officer of the right sort, the office must be made a permanent one; and we assure the Council there is ample room for the employment of such an official, whether cholera visits us or not. Our
very high mortality, especially among children, is a subject which would engage his attention, and when it is known that a large portion of the mortality of the city is from preventible diseases, the absurdity of appointing a Health Officer, but temporarily, must be seen.
We are informed on the very best authority that there are a large number of cases of small-pox among the Indians at Caughnawaga, and that the practice of inoculation is carried on almost universally by their medicine women-vaccination not being understood, and their prejudices being strongly against its employment. From the proximity of Montreal to the Village of Caughnawaga, and the daily intercourse which occurs between the two places, the presence of the disease to a considerable extent is an important fact; but when we consider that inoculation is performed, the fact becomes so important as to demand the prompt interference of the authorities, to put down a practice which the law prohibits, and against which there is a heavy fine.
We have also heard of other portions of the country where inoculation is performed in preference to vaccination. As this direct violation of a most important statute propagates instead of preventing the disease, we trust that the profession, in places where it is practised, will, in the interest of the public, see that those concerned do not go unpunished. In the meantime we call upon the Government to take prompt action concerning the practice at Caughnawaga.
Dr. Anderson of Quebec has forwarded to us, with a request to publish in the Journal, a very lengthy correspondence which has taken place between himself and the College of Physicians and Surgeons of Lower Canada, on the one hand, and himself and the Royal College of Surgeons, Edinburgh, on the other. While we admit there is considerable of interest in the correspondence, we do not feel there is sufficient to warrant our occupying sixteen pages of our space with it, when its substance may be more briefly stated. The correspondence is opened on the 24th of August, 1865, by Dr. Anderson writing to Dr. Chamberlain, President of the College of Physicians and Surgeons of Lower Canada, drawing his attention to a portion of a report of the late triennial meeting of the College, which appeared in our Journal, stating that a letter had been read from Dr. Sewell of Quebec, complaining that the College had granted a license, without examination, to Dr. Anderson upon his presenting the diploma of the College of Surgeons, Edinburgh-which it has not a right to do-being contrary to the usual practice, and in direct violation of a bye-law of the College. Dr. Sewell, however, it appears, stated in his letter his belief that both from the Imperial Act and the Provincial Act, Dr. Anderson could have compelled the College to give him a license without examination, and that under these circumstances the granting of the license should have been referred to the triennial meeting when the obnoxious bye-law could have been altered. Dr. Anderson then asserts his right to the license without examination, resting his claim upon the Imperial Act, of 1858, which says: that the holder of any qualification recognised by the Act is entitled to practice" in any part of Her Majesty's dominions," which right is recognised by the Provincial statute in the following words, “ But any person who has obtained a Medical degree or diploma in any University or College in Her Majesty's dominions, shall be entitled to such license, without examination as to qualification." The letter concludes by stating that a copy of it, with the report of the triennial meeting, will be forwarded to the Secretary of the Royal College of Surgeons of Edinburgh. On the 28th August, Dr. Chamberlain acknowledges the receipt of the letter, and says, “it will be laid before the College at its next (October) meeting.” Then follows a letter from the Secretary of the College of Surgeons of Edinburgh, stating that Dr. Anderson's letter of the 24th of August was laid before the Council, and that they are unable to take any action in the matter, but
express very decidedly their opinion that when both the Imperial and Provincial Acts are so explicit, it seems difficult to understand why such obstacles should occur. It advises the party aggrieved to institute a suit to test the legality of the bye-law, and the jurisdiction of the College which enacted it. On the 21st of September, 1865, Dr. Anderson again addressed Dr. Chamberlain, with regard to the following portion of Dr. Marsden's report of the proceedings of the College, presented at the triennial meeting. “A strange anomaly (says the report) exists in the law regulating the practice of medicine, surgery and midwifery, that extends through every act regulating the same, and which calls for amendment. By the act of incorporation of this College, the licence of the board of examiners under the bye-law, entitle the bearer to practice physic, surgery and midwifery; whereas the law permits the bearer of a degree or diploma from Universities and Colleges in Her Majesty's dominions to practice physic or surgery or midwifery, and to obtain a license from the board as a general practitioner, which license the board is bound to grant, thus according a higher qualification to the bearer than he possessed in the place where the diploma was granted, and on easier terms and on more slender qualifications than are exacted from Canadian students.” Dr. Anderson denies that a higher qualification is accord d by