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PARIS.(FROM OUR OWN CORRESPONDENT.)

The Sanatorium of Angicourt.IN my last letter I mentioned that this sanatorium after

having taken 14 years to build was just about to be opened.The cost has been enormous owing to the old-fashionednotions of the architects, for instead of building lightlyconstructed edifices of brick and iron in isolated blocksafter the methods approved of by modern hygienic science,they have constructed a veritable barrack in stone whichwill only hold a small number of patients, which has takenan interminable time to build, and which represents manypersons dead from tuberculosis who succumbed while

they were waiting for the finishing of the building wherethey hoped to be treated. Although the sanatorium has atpresent no patients, yet for the last two years it has rejoicedin the possession of a director and this official has recentlysent an appeal to the Hospitals Medical Society praying itsmembers to formulate the conditions of admission to thesanatorium and whether its benefits are to be reserved forquiescent cases of tuberculosis or whether acute cases are tobe admitted. A committee of the society, composed ofM. Faisans, M. Merklen, M. Mosny, M. Rendu, and M.Siredy, have reported on the matter and without enteringinto the question of acute or quiescent cases have drawn upthe following rules. 1. The Angicourt sanatorium shallbe open to indigent inhabitants of Paris afflicted with pulmo-nary tuberculosis, but whose lesions are presumably curable.2. No patient shall be admitted to the sanatorium withouthis furnishing a sanitary record (dossier) drawn up by hismedical attendant showing clearly his family and personalhistory, a history of his tuberculosis, and a complete dailyclinical record extending over at least eight consecutive dayssetting out details of his pulmonary lesions, his rectaltemperatures, his pulse. his respiratory condition, an

analysis of his urine, his weight, and the results of amicroscopical examination of his sputa, including theresults of a search for bacilli carried out in more

than one method. 3. All these dossiers shall beexamined periodically by a medical committee appointedfor that end by the Hospitals Medical Society. The com-mittee further say that records corresponding to the sani-tary dossiers, which shall be drawn up during the stay of thepatient in the sanatorium will allow of the medical directorforming an opinion of the efficacy of the curative propertiesof the sanatorium treatment and consequently of the advisa-bility or the reverse of keeping up the sanatorium. This

report of the committee was carried by the societyunanimously. It is evident that if the authorities succeedin getting drawn up both the sanitary dossiers and therecords illustrative of the patient’s condition while in

hospital there will be a grand opportunity for making anexperimental study of the results of treatment, but it ismuch to be feared that in the case of many of the patientswho will belong to just that very poor class who do not con-sult a medical man with regularity, it will be impossible toobtain sufficiently accurate details of their condition, forthey will not have been under observation for a sufficientlylong time. The Hospitals Medical Society should have gonea step further and arranged for a sort of permanent con-sulting institute at which patients might apply withregularity and so have their dossiers accurately drawn up.

The Alcohol Question in Parliament.The Chamber of Deputies and the Senate have just com-

pleted the draft of a Bill which has been for a long time inpreparation with regard to the trade in alcoholic drinks.The debates on the matter were interminable and showed ina cruel light the pretensions of the trade, who did nothesitate to poison a whole country and to destroy theirfellow-creatures if only they could be assured of a sale fortheir goods. Under such conditions the crusade againstalcohol which certain philanthropists started and whichwas warmly supported by the medical profession presentedalmost insuperable difficulties. How try to diminish theconsumption of alcoholic drinks in France when a greatpart of the population gets its livelihood by making thesame and elects those members who form a majority of theChamber ? How restrict the number of drink-shops when itis by these that the deputies are practically elected ? Howhope to restrain the sale of alcohol by fiscal laws when eventhe new law respects the privilege des boualleurs de cru-i.e.,the right of distilling alcohol without further taxation-

which every proprietor who makes wine or cider from his.own vineyard or orchard possesses ? The fraud to which this.right gives rise is most extensive and it is calculated thatthe revenue loses 400,000,000 francs per annum owingto the frauds which this right brings in its train. Itis quite common to see large landowners distil alcohol.not only from the produce of their own lands but alsofrom wine or cider surreptitiously brought in. Besides, the.inspectors whose duty it is to prevent these frauds are-

generally powerless owing to the amount of electoral cor-ruption which exists. A too zealous agent runs the risk ofbeing recalled by the deputy for his district whose electionis generally in the pocket of the large landowner. Medical,men and hygienists have at least done their part as regards.the thousand-and-one varieties of alcoholic drinks sold underthe name of "amers" and " aperitifs" which play such a.large part in the alcoholic intoxication of France. Many havedemanded that these preparations should be ruinously taxed,but the deputies, with the fear of the drinkshop beforetheir eyes, have not dared to accept the proposals.A Socialist deputy, however, M. Vaillant, had the ingeniousidea of asking that the sale of those alcoholic drinks which.the Academy of Medicine had definitely pronounced to be.harmful to the public health should be interdicted, a demandwhich the deputies dared not refuse, and hence will start a.far-reaching reform if the Minister concerned has only thecourage to carry out the provisions of the Bill. M. Vaillantpersisted in his campaign, for when the Bill after havingpassed the Senate came down to the Chamber of Deputies a.second time for amendment M. Vaillant complained that the.Minister in charge of the Bill had not been sufficiently cate-gorical ; and he succeeded in getting the Chamber to pass aresolution that the Government from henceforth should get.the Academy of Medicine to declare that liqueurs apéritifs.and other alcoholic drinks containing essences were dan--

gerous to the public health, so that their manufacture, cir-Gulation, and sale should be put a stop to.

Deaths of Medical Men in Paris.Last week there occurred the deaths of several well-

known medical men. Dr. Beranger- Feraud, formerlymédecin en ehef to the navy and President of the ConseilSuperieur de la Marine. He left a number of valuable workson the subjects of the pathology of tropical diseases andon pathology from the standpoint of a naval surgeon.-The death is also announced of Dr. de Beauvais, one of the.oldest of the Paris practitioners, who died at the age of-79 years. He left a valuable collection of clinicalnotes on cases and on practical therapeutics and thereputation of a high-minded and courageous man. Hewas formerly President of the Medical Society of Parisand chief surgeon to the prisons. In 1848, when interne-at the ambulance station of St. Lazare, he nearly died fromthe effects of septicaemia contracted during the performanceof an operation. He worked magnificently through thecholera epidemic of 1849 and was at the early age of 28.years made a Chevalier of the Legion of Honour as a rewardfor his conduct. In 1871, while serving as chief medicalofficer at Mazas, he was very nearly being shot by the Com-munists for being too kind to the unfortunate hostages.-The deaths are also announced of Dr. Duclos of Tours, pro-fessor of clinical medicine at the medical school of that city ;of Professor Dubreuil, professor in the Faculty of Medicine.of Montpellier and formerly professeur agrégé in the Paris.Faculty of’ Medicine; and last, and most distinguished ofall, of Professor Potain.Jan. 8th.

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ROME.(FROM OUR OWN CORRESPONDENT.)

Professor Grassi and the Mosquito-Malaria Tlaeory.PROFESSOR GRASSI contributes some " Historical Notes on.

the Recent Discoveries regarding the Transmission ofMalaria " to the Polielinico of Dec. 29th which are evidentlyintended as a reply to Major R. Ross’s recent letter to that.journal on the question of priority in the mosquito-malariatheory.l After enumerating the results obtained by MajorRoss in his experiments with human malaria in 1896-97-98 andstigmatising them as either erroneous, inconclusive, dubious,or positively misleading, he passes to Major Ross’s discovery-which he claims to have himself made with Feletti in 1890—

1 THE LANCET, Dec. 8th, 1900, p. 1684.

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of the evolution of proteosoma in the body of the graymosquito. For this beautiful demonstration, so much admiredby other authors, Professor Grassi has no word of praise, onlyremarking that from a zoological point of view the figures anddescription given by Major Ross are quite incomprehensible.He also refuses to admit that it has more than a doubtfulvalue as a guide to what happens in human malaria, sinceparasites very similar to one another may have totallydifferent life-cycles. As examples, he cites the filariamedinensis which, unlike other niarise, does not propagateitself through the mosquito; the parasite of bovine malariawhich is conveyed through the larv2e of the tick to its newhost ; and one of the two parasites of bird malaria which ithas not been found possible to cultivate in the mosquito.Professor Grassi quotes from a note by Major Ross in theAnnales de t’Institut Pasteur, dated Dec 31st, 1898, with thepurpose of showing that Major Ross himself did not at thattime regard his discovery as settling the question, buton the contrary, considered that much remained to be donebefore a solution could be arrived at. He next proceeds toenumerate the questions in regard to malaria which, in hisview, Major Ros&’s experiments left unsolved: (1) whether thetheory of the propagation of malaria by means of mosquitoeswas borne out by facts; (2) which species of the manyincluded under the name ’mosquito" was capable of pro-pagating human malaria; (3) whether the parasites ofhuman malaria had a life-cycle corresponding to that ofthe parasite of bird malaria ; (4) whether, as appeared,probable, man was only an accidental host of the malarialparasite which reproduced itself indefinitely in the mosquito;(5) whether man became infected only through the bites ofmosquitoes; (6) whether the new experimental data explainedthe empirical knowledge which we possess regardinghuman malaria ; (7) whether other mammals acted as thehosts of the parasite of human malaria; and, lastly (8),how the facts discovered by Major Ross ought to be inter-preted zoologically so as to reconcile them with those alreadyknown about other protozoa. Reverting to his own work andto that done in collaboration with Bignami and Bastianelli,Professor Grassi claims to have settled many of thesequestions, asserting that he was the first to proclaim theintimate relationship between the presence of the anophelesolaviger and the occurrence of malaria ; that to him, alongwith Bignami, is due the credit of experimentally inocu-lating the human subject with malaria by means of mosquitobites ; and that to him also belongs the merit of havingdemonstrated by exhaustive observations and experiments,- condncted with the help of Bignami and Bastianelli, theentire life-history of the human malarial parasite. Headds to these many other points which he claims to haveelucidated in regard to the natural history of the parasite andthe etiology of the disease, and he concludes by reiteratingan assertion that our knowledge of the mode of transmissionof human malaria, which he now regards as complete, at anyrate for Italy, is the result of researches begun by himself,continued with the assistance of Bignami and Bastianelli,and completed by himself alone.

Legislation for the Supply of Quinine.In the light of [recent discoveries it has become evident

that one of the most efficient measures for the prevention ofmalaria must lie in the cure of existing cases of the disease,- since it is chiefly, if not entirely, from these that freshindividuals are infected by the mosquito. Unfortunately, thedifficulty of procuring that sovereign remedy in malaria,-quinine, has hitherto proved a great obstacle in the way ofcarrying out this important method of prophylaxis in manyof the malarious districts of Italy, where there are

often no drug stores, or where, if such exist, the

quinine is often very impure, or is so high priced as

to be beyond the reach of the poor labourers whomost of all require it. Frequent attempts to provideagainst this difficulty by creating a Government monopoly’have been made by Parliament from time to time, buthitherto without success, owing to the determined oppositionof those interested in the sale of quinine. Now that sciencehas been able to show the cure of malaria to be a prophy-lactic measure of the highest public importance everyobstacle has been overcome, and a Bill has been framed whichit is hoped will fully meet the necessities of the case. Bythis law it will become the duty of the Government to

provide for the sale of quinine of the best quality at a verymoderate price throughout the whole country. Wherepharmacies or dispensaries are already established the salewill be confided to these, but where such do not exist

it will be entrusted to the salt and tobacco shops (whichare Government monopolies), or failing these to anysuitable person available. The Superior Sanitary Councilwill determine the form and must approve the quality of thequinine, which it is proposed to supply in three-graintabloids put up in hermetically sealed tubes, each tube tocontain 10 tabloids. The preparations recommended arethe hydrochlorate, the sulphate, and the bisulphate. The

price of the hydrochlorate to the public must not exceed 40centesimi (4d.) per tube, and that of the sulphate and

bisulphate 32 centesimi per tube. No other salts of quininemust be sold except by a chemist, and the prices of thesemust be so regulated as to correspond with the tariff laiddown under this law. Although the price thus fixed is low,it leaves a margin for profit, and the law provides that theresulting fund shall be applied to the purpose of combatingthe causes of malaria. A mixed commission of unpaidmembers selected from both Houses of Parliament and fromthe different governmental departments interested willadminister this fund to the best advantage. The Bill

embodying these provisions passed the Chamber of Deputieson Dec. llth, 1900, and has already gone to the Senate,which it is hoped will approve of the measure as it stands.Jan. 4th.

CONSTANTINOPLE.(FROM OUR OWN CORRESPONDENT.)

The International Sanitary Board.IN my last letter I gave your readers some details of the

difficulties which have arisen in connexion with the Inter-national Sanitary Board owing to the death of Dr. Vitalis,the inspector adjoint. There are at present three personswho have been appointed to fill this post-namely, Dr. DucaBey, who has been appointed by the Superior SanitaryCouncil; a former custom-house official who is not a medicalman, and who has been appointed by the Turkish Govern-ment without salary ; and thirdly, Dr. Eiterer, also appointedby the Turkish Government, to whom a salary will be paidby the Ministry of Finance. The appointment, whoever getsthe post, will have to be confirmed by the Sultan. Owingto the Turkish Government having infringed the rights ofthe Sanitary Council by appointing one who is not a medicalman, the Ambassadors have withdrawn their delegates to theCouncil. The conflict is particularly unfortunate at thepresent time owing to the outbreak of an epidemic atSmyrna, details of which follow.

Alleged Plague in Smyrna.A very fatal disease, the nature of which is not definitely

ascertained, has appeared in the village of Thomaso, nearCordelio, in the vicinity of Smyrna. The first patient was aman who suddenly fell ill in Smyrna during the first week ofDecember, went home to his relatives in Thomaso, and diedeight days after the beginning of the illness. Other casessoon occurred in the village and by Jan. 2nd there had beenin three families 12 attacks with 11 deaths, the patient fromSmyrna not included. In most instances the diagnosis waspneumonia. A long report on the circumstances has beensent to Constantinople by Dr. E. F. Mizzi, médecin sanitaireof Smyrna, pointing out that there have been no symptomsof implication of the lymphatic system, so that in the absenceof bacteriological examination there was nothing to suggestplague, and arguing that the disease was probably infectiouspneumonia due to "grippe maligne." A bacteriologist fromConstantinople arrived in Smyrna on Jan. 2nd, but no exami-nations of the above-mentioned cases could be made, as allthe deceased had been buried. On Jan. 3rd, however, a manwho had been attacked with illness in Smyrna was foundto have an axillary bubo and the plague bacillus was dis-covered on direct microscopic examination.

Poisoning Mischance at a Sch,ool.During the evening classes held at one of the schools at

Beylerbey all the pupils were poisoned by the fumes from acharcoal brazier which had been lighted to heat the class-room. None of the cases, however, was attended with fatalresults.

Assassination of a Medical Man.A few weeks ago Dr. Saltellario, a well-known physician

at Gumendjeh, near Salonica, was called out to see a

patient, and on his way he was shot from behind, thebullet entering under his shoulder and passing through the