1323UNPACKING AT THE PARIS UNIVERSAL EXHIBITION.

UNPACKING AT THE PARIS UNIVERSALEXHIBITION.

THE INTERNATIONAL MEDICAL PRESS CONGRESS.

(FROM OUR SPECIAL CORRESPONDENT.)

THOUGH a number of interesting objects are now unpackedand actually placed in the glass cases ready for view, it notunfrequently happens that the exhibitors have found it moreprudent to cover these over with sheets of white paper orcalico. The fact is that a peculiar and most penetratingwhite dust pervades the whole Exhibition. It seems to be

composed mainly of pulverised plaster, and people, on

leaving the Exhibition, appear as if they had been

visiting a flour mill. In the surgical and medicalsection the cloud of white dust is especially thick,for the ornamentation of the outer walls and small buildingsnear the entrances are not yet finished, and it is the stone-masons and the plasterers who produce much of this dust.Then the crowds raise and stir up this dust. Withtheir feet they pulverise the larger particles so that itmore easily tloats about in an impalpable form. Exhibitors

despondently stand watching and wondering when these whitednst-clouds will subside and they do not feel inclined tounpack their treasures in its midst. Still some among themseem to grasp the fact that if everyone is going to waittill everyone else is ready then no one will ever be ready.Now that a few exhibitors, in spite of the white dust, havetheir stalls ready their neighbours and rivals will feelcompelled to follow suit. Surgery and medicine are com-prised within Group III., which is devoted to sciences andarts, and they constitute Class 16, so that anatomical speci-mens, for instance, are not far from musical instruments orfrom the exhibits of the various universities, &c.Thus among the first to unpack were the Publishers’

Association of Great Britain and the Oxford UniversityPress, with the Kay Scheerer Company, surgical instrumentand furniture makers of New York, as close neighbours.The British Publishers’ Association has a very rich andartistic collection of printing and also display the title-pagesof a great number of British periodical publications, includ-ing, of course, THE LANCET ; while the Oxford UniversityPress distinguishes itself especially by the rich and artisticcharacter of its bookbinding. Now it is just by the side ofthese publications that will be found the only exhibit ofAmerican hospital furniture and surgical instruments. It istrue that this is in itself a very large and representativeexhibit. Everything is aseptic, only metal and glass is

employed. For instance, there is a washstand for hospitalase made of thick glass. A cup-shaped basin of largercircumference than the hole under which it is placed is socontrived that it is not likely to be touched by the hands.From above hot or cold water is made to descend by press-ing a pedal with the feet, thus the surgeon and nurse washtheir hands without touching the sides of the basin or thetap. In the water-tanks above steam can be dischargedso as to sterilise the water. Close by there is a new

model operating-table devised] by Dr. Clement Cleveland ofNew York. It is divided transversely into three moveableparts and also lengthways down the centre, thus sixmoveable pieces of glass fitting to a metallic frame-workconstitute the bed. Handles attached to crank wheelsfacilitate a great variety of movement and there are

shoulder-straps to keep the patient from slipping. Anothertable, also of glass but with different mechanical con-

trivances for moving its various parts, is shown by Dr,H. J. Boldt of New York. There is further a veryingenious bath that can be wheeled up to a patient’sbedside. A thin enamelled metallic slab is passed underthe patient as he lies in bed and he is thus lifted withoutbeing disturbed and placed on a sort of cradle that issuspended above the water from two short poles or mastsat each end of the bath. Then by a pulley arrangement thepatient is slowly lowered into the water. In the samemanner he is lifted out of the water and placed backinto the bed, and throughout he has not been disturbed,but has continued to remain in a reclining position. Amongthe surgical instruments Dr. Ernest Laplace of Philadelphiashows a set of anastomosis forceps which seem new andingenious, and Dr. Howard A. Kelly of Baltimore a completeset of endoscopic instruments.

These are on the ground floor, and for some reason orother difficult to explain it is necessary to go up tothe gallery above to find similar exhibits from Frenchmanufacturers. It is true that according to the mapClass 16 should be in the gallery at the extreme end ofthe westerly wing of the main building close to the EiffelTower. But then, why is the American hospital furniture&c., on the ground floor 7 Among the French exhibitors thewell-known firm of Dupont, rue Hautefeuille, alone hasventured to unpack. Others will follow suit shortly. Thechief feature of these exhibits is the ingenuity with whichwhat appears to be an ordinary and handsome piece offnrniture-an armchair or a sofa-can promptly be con-

verted into an operating-table. The back of the armchair,for instance, falls over the seat and becomes a table orbed on which the body of the patient can be placed,while from the sides arms protrude to hold the feet, andfrom underneath there are steps that can be pulledout for the patient to ascend. Then there is also a

great show of moveable chairs for invalids, some beingarranged with longitudinal divisions so that each leg maybe placed at a different inclination, or one division canbe removed altogether, leaving a leg quite free, whilethe other is bolstered up. The wheels are now surroundedwith pneumatic tyres so that the patient is moved along withgreat comfort. Near at hand there are some very fineanatomical wax models. But, as already observed, theseexhibits are very much mixed, thus the next things are somebeautiful photographs of the moon, &c., taken at the ParisObservatory, which, though interesting, are a very differentmatter. Then a little further on it will be seen thatnationalities as well as subjects are mixed up, forthere is here an extensive display of the maps of the

geological survey of the United Kingdom and specimencharts of the London Meteorological Council. Underneaththe mural exhibits and in cases, are the scientific instru-ments used at the Inland Revenue Department of SomersetHouse and exhibited by Professor T. E. Thorpe, F.R.S.,the electrical pyrometer by Mr. Robert Austin and photo-meters for testing the illuminating power of gas. Then a stepfurther there is a large compartment where German opticalinstruments are being unpacked, and next to it is anotherlarge compartment which in time will be full of Germansurgical instruments. By way of contrast and just onthe other side of the passage, Japan displays charts to showhow much the use of the telegraph, the telephone, postagestamps, postal orders, &c., have increased in that countryduring the last few years. From Japanese postal communi-cation a step further brings the visitor to a little room,so arranged as to be built within a larger room, for thetreatment of small-pox with red light. The walls are ofcourse wooden partitions roofed over with red transparentcanvas, and the window is covered with red material. Theinfluence of red light tends to prevent, it is maintained, thepitting produced by small-pox. By the side of this is theexhibit of the Finsen Medical Institute, of Denmark. Withprisms and a sort of telescope Dr. Finsen-decomposes the direct.rays of sunlight in such a manner as to exclude the red.Photographs show how, in the garden of this institute, thenurses throw the ray of light from which the red has beenexcluded on to the face of patients suffering from lupus. On.the walls are suspended life-size photographs of a number ofpatients taken before and after this treatment, and, to judge-from these photographs, the results were certainly veryfavourable. After contemplating these cases of lupus fromDenmark there come the veterinary schools of France-thoseof Alford, Lyons, Rheims, and others-with very fine waxanatomical models of the diseases of horses and other animals.Thus there is no lack of variety in this part of the exhibition ;indeed, the difficulty is to keep to one subject for more thanfive minutes at a time.The extremity of the opposite, or easterly, %ing of the

main building on the Champs de Mars is more advanced ;more exhibits are unpacked, though it must be confessedthat they are not likely to be spoiled by the dust,and this may account for the difference. Here are theexhibits comprised in Group XI.-namely, mines and metal-lurgy.To illustrate how public health questions turn up in all

directions the exhibits of the great Anzin Coal-mining Com-pany are well worth a visit. Apart from what relates to thegetting of coal, carboniferous geological formations, &c.,there is a chemical department where the method of analysingthe atmosphere within the mines is shown. Then, on another

1324 UNPACKING AT THE PARIS UNIVERSAL EXHIBITION.

table, a small cube of coal two centimetres in dimensions isshown. Next to it there is a round glass ball about fourinches in diameter, and this indicates the volume of choke-damp which the libtle piece of coal could produce. A secondand much larger glass globe shows the amount of air neededfor combustion in proportion to the piece of coal. Finally,a third glass globe very much larger represents the actualamount of air pumped into the Anzin mines. Thesemodels are in the same ratio to each other as thequantities occurring in actual practice. Then we havethe written explanation that a cubic metre of coalat Anzin can produce 47’5 cubic metres of choke-damp, but that 11,833 cubic metres of air are suppliedto dilute the poison. Thus in 1897 the output of coal atAnzin was equal to 255,388 tons, which could have produced10,091,520 cubic metres of choke-damp weighing 7246 tons.The company sent down into the mines during that year2,522,880,000 cubic metres of air, weighing 3,027,456 tons.Thus to get one ton of coal up it is necessary to pump downfrom 15 to 16 tons of air. Fortunately it is easier to moveair than coal. Further, it is calculated that if the choke-damp could be utilised the amount mentioned above for theyear 1897 at Anzin would have sufficed to feed continuously28,000 Auer burners or to melt and to bring to boilingpoint 15,000 kilogrammes of glass per hour. These figureseloquently demonstrate the close connexion between indus-trial and public health problems.THE INTERNATIONAL CONGRESS OF THE MEDICAL PRESS.

The proposal to hold an international congress at whichthe editors, contributors, and proprietors of mèdicalperiodical publications should be represented has attracteda good deal of attention on the continent and has metwith a large measure of support. Perhaps it is that the

position of the medical press in England is very differentfrom that which prevails in other countries; in any case

England is the only important country which has takenno step whatever in order that its medical press may beproperly represented on this occasion. The idea ofholding this Congress was first brought forward by Dr.Marcel Baudouin and Professor C. Posner of Berlinat the International Medical Congress held at Rome in1894. Some of the medical journalists present atRome had conceived the idea of an internationalassociation of the medical press, which, among other

things, would seek to facilitate the work of medicaljournalists at medical congresses. Then Dr. Dobrzychiproposed at the Congress at Rome that there should be aspecial medical press section at the general internationalmedical congresses. A committee was constituted to studythe matter, consisting of representatives of l’Associationde la Presse Medicale Franchise and of the Freier Verein derDeutschen Medicinischen Fachpresse, which was to have metin Brussels in 1896. This meeting, however, was postponedtill the close of the assembly of the General Medical

Congress at Moscow in 1897. The distractions were then sonumerous and complicated and the members of the presswere so scattered in different directions and had so muchprofessional work to do that they had to content themselveswith postponing the whole business to the Paris Exhibitionof 1900. Consequently in November, 1897, the Associationof the French Medical Press decided to convoke an inter-national congress of the medical press to be held just beforethe general International Medical Congress.

Since the Medical Congress at Rome the original idea hassomewhat developed. It is no longer merely a question oforganising for the successful reporting of the proceedings ofmedical congresses. Following the example given byjournalists belonging to the political press, it seemed that aninternational agreement would tend to protect and promotethe moral and material advantages of medical journalism.Literary scientific property could be better protected by theholding of periodical congresses. The Congress which it isnow proposed to convoke will be the first effort of thesort, and subjects will be discussed internationally for thefirst time. Therefore the agenda, it was felt, should bereduced to the simplest expression, leaving the field open forfurther developments as necessity might arise. Thus thereare only two subjects on the agenda: (1) the advisability offounding an international association of the medical pressand the conditions on which such an association shouldexist; and (2) the application of the principle of the pro-tection of literary property to medical literature.On the first question reports will be presented by Dr.

Laborde of Paris, Dr. C. Posner of Berlin, and Dr. Rubino ofNaples. These reports will be published before the meetingof the Congress and distributed to all the members. Dr. deMaurans, of La Sentaiiie McLicccLe; M. Hochet, Advocate atthe Court of Appeal and legal adviser of the Association ofthe French Medical Press ; and M. Pouillet of the Order ofAdvocates, will report on the second question and their

reports will also be published in advance.Other questions have also been suggested for discussion,

such as the unification of medical technical terms ; theextension to members of the medical press of certain

privileges accorded to members of the political press; a

better understanding as to what constitutes a legitimatequotation ; the principle which should govern exchanges ofpapers ; the representation of medical papers in foreigncountries ; and the part of the medical press in the organisa-tion and preparation of medical congresses. Such is thegeneral programme. The organising committee has for itsPresident Professor Cornil, Member of the Senate ; for Vice-Presidents Dr. Lucas-Championniere and Dr. Laborde. Dr.Cezilly is Treasurer and Dr. R. Blondel, 8, rue Castellane,Paris, is the General Secretary.The Congress will meet on July 26th and will last for three

days. All proprietors, editors, sub-editors, and membersof the staffs of all medical periodical publications, togetherwith the legal advisers attached to such publications, areadmitted as members of the Congress on the payment ofan entrance fee of .61. The families of such members andmedical men and medical students may also attend asspectators on payment of an entrance fee of 8s. Theywill participate in all the fetes and receptions but notin the discussions and votes of the Congress. Speechesmay be delivered in German, French, or Italian, and therewill be meetings in the morning and in the afternoon.More than 50 French medical publications have appointedmembers of their staffs as members of the Commission ofOrganisation for this Congress. Committees of organisationfor the Congress have also been formed in Germany, Italy,Spain, and the United States of America. Professor Virchowis the honorary president of the German committee, whichseems to comprise Austria as well, for the names of Dr. Adlerof Vienna and Dr. Herrnheiser of Prague are included inthe list. For Italy Professor Baccelli is honorary president,and Professor L. M. Bossi of Genoa acting president. Dr.Valldor is the president for Spain. The Association ofAmerican Medical Editors has nominated 10 of itsmembers to form the American committee, together withfive members of the American Medical Publishers’ Associa-tion and five members of the Medical Press Club of the

Mississippi Valley.More important than the formal programme of the Inter-

national Congress of the Medical Press is the social concourseof so many persons of different nationalities concerned withthis phase of journalism. For 10 years or more the desirethat such a meeting should take place has been expressed,and now there is a good opportunity to realise this wish.As matters now stand it is proposed to receive the membersof the Congress in an official manner at the Pavilion of thePress on the Exhibition grounds, A lunch will follow. Thisis to take place on Thursday, July 26th. On the morningsand afternoons of the following Friday and Saturday theCongress will meet at the Ecole de Medecine. The eveningsof Thursday and Friday are to be given over to privatehospitality, but on the Saturday there will be a banquet ofthe entire Congress to be followed by a grand receptiongiven by the Paris Municipality at the Hotel de Ville. Theintervals between the meetings of the Congress andthese entertainments are to be employed in visits to the

Bibliographical Medical Institute of M. Marcel Baudouinand the special folding and colour printing machinesemployed by La Semaine Médicale, and other installationsthat are of technical interest to medical journalists.

It is, however, difficult to understand why a most in-appropriate date has been selected for the meeting of thisCongress. The journalists who attend the InternationalCongress of Deontology or Medical Ethics will be busy withthat congress up to July 28th. Those who are to attendthe International Medical Congress which is to meet onAugust 2nd will not have arrived in Paris on July 28th.Why run the Medical Press Congress during the lastthree days of the Deontological Congress when there are

four clear days vacant after the Deontological Congresshas terminated and before the International MedicalCongress begins-namely, July 29th, 30th, and 31st, and

1325GERMAN CONGRESS OF INTERNAL MEDICINE.

August 1st? The medical journalists wish to organise.Well and good, but so do the medical practitioners. Whyshould the medical journalists hold their congress just at adate when it will injure the efforts of the medical practi-tioners 2 If they meet during three out of the four followingdays they will not clash with any other congress and it willbe more convenient for those who are going to attend theInternational Medical Congress. Indeed, it would thus bepossible to be present at all the four most important con-gresses-namely, Medical Ethics or Deontology from

July 23rd to the 28th ; the Congress of the Medical Pressfrom, say, July 30th to August lst ; the InternationalMedical Congress from August 2nd to the 9th; and the

Congress of Hygiene from August 10th to the 17th. Thisseems so simple and easy a solution of the difficultythat it is to be hoped that the organisers of the Congressof the Medical Press will see their way to alter their date ofmeeting from July 26th to the 29th or 30th.

THE FATAL ACCIDENTS.

Though the fatal accident which occurred close to theExhibition on Sunday has elicited the most varied, and insome cases] the most abusive, complaints and criticisms noone has suggested that the ambulance service was in any waydeficient. A sort of field hospital was very promptlyorganised in an adjacent building and ambulance wagonswere on the spot in good time to remove the nine injuredpersons to the hospitals or to their private homes after theirwounds had been dressed. The same may be said withregard to the second and more blameworthy accident whichoccurred on Monday. Four workmen were decorating theceiling of the Hall of Festivals in the great MachineGallery. This was inside and not, as in the other case,outside the Exhibition, and yet it would appear that the

plank of the scaffolding on which these four men stood wasof bad or rotten wood; it snapped, the four men fell, andtwo of them were killed on the spot. The third victim diedsubsequently and the fourth is under treatment. The chiefof the medical service of the Exhibition, Dr. Gilles de laTourette, was at once called and arrived in time to be ablehimself to dress the wounds. While deploring such accidentsit is in any case some satisfaction to know that promptsurgical assistance was at hand.To facilitate communications there are so many small

bridges for pedestrians in and about the Exhibition thatfears of another collapse may very naturally be enter-tained. Yet, on looking more closely into the matter, itwill be seen that this is not at all likely to occur. Thebridge in question was not in use. There was no one onit. It was meant to connect a big side show called theCelestial Globe with the Exhibition which is on theother side of the broad Avenue de Suffren. This showwill not be completed before June 15th, and therewere boards on both sides to prevent access to the

bridge. It is against the law to allow anyone on a bridgebefore its security has been officially tested. Evidently thesupports of the bridge had been removed before the cementwas sufficiently dry or bad materials had been employed.In any case there was no one on the bridge, it collapsed ofits own accord. Only as it was a fine holiday afternoonthere were many persons passing underneath at the timeand nine were injured and eight killed. The test for bridgesin France is that they shall bear an overcharge or load of400 kilogrammes per square metre of surface. But as greatcrowds are expected at the Exhibition this test has simplybeen doubled. It is calculated that, however great thecrush, it is simply impossible for more than from six to sevenpersons to stand within one square metre. Even if theseseven persons each weighed 70 kilogrammes this would onlyamount to 490 kilogrammes per square yard, and no bridge Iis open to the public at the Exhibition which has not beentested for 800 kilogrammes per square metre of its surface.There is consequently no need to fear that these bridges willgive way under the crowds that are likely to pass over them.

Paris, May lst.

THE MEDICAL GOLF TOURNAMENT. - This Stournament will be played on May 10th at Wembley bykind permission of the Wembley Club. The condition willbe one medal round of 18 holes. There will be senior andjunior classes. Entries, with 5.., should be sent to Mr.Creasy, Windlesham, Surrey, by May 7th.

GERMAN CONGRESS OF INTERNALMEDICINE.

(FROM OUR BERLIN CORRESPONDENT.)

THE Congress of Internal Medicine was opened inWiesbaden on April 18th by the President, Professor VONJAKSCH of Prague.

-

T’l’eatrnent of Pneumonica.Professor KORANYI (Budapest) read the first paper, his

subject being the Treatment of Pneumonia. He said thatthe differences in the symptoms of pneumonia were notcaused by differences in the pathogenic germs producing thedisease but by the varying conditions of age, con-

stitution, &c., presented by the patients. The serum

treatment of pneumonia had no undesirable sequelas,but at the same time it was of no specific action.Medicines were not able to shorten the duration of

the illness, but some of the substances given with thisobject in view might have an injurious effect on the red cor-puscles of the blood. Professor Koranyi has ascertained byrecent researches that in pneumonia the amount of sodiumchloride in the blood decreases and that its point of congela-tion becomes higher. By the influence of oxygen the bloodis rendered normal again. He therefore recommended in-halations of oxygen and said that venesection was indicatedin certain cases.

Professor PEL (Amsterdam) said that the prognosis of thedisease depended not so much on the pathological alterationsin the lungs as on the constitution of the patient. A robust

patient often recovered from pneumonia in its severest form,whilst a person weakened by alcoholism, syphilis, or someother constitutional disease would die from a pneumonicprocess of limited extent. Professor Pel then reviewed allthe drugs recommended for the treatment of pneumoniaand concluded with the statement that they were all uselessand of no specific action. The physician, however, can dovery much for the patient by providing suitable nourishmentand proper nursing and by relieving pain. It is a greatmistake to allow patients to get up too soon ; they should bekept in bed a week after the crisis. Rest in bed, whichweakened healthy persons, was strengthening for con-

valescents. With regard to the use of alcohol he said thatit might be administered in small doses as a tonic; largedoses must be avoided. It must be the aim of the physicianto guard against cardiac failure. This was the essentialpoint in the treatment of pneumonia.

Dr. MÜLLER, of the Army Medical Corps, gave statisticsof the disease in the German army. He said that thenumber of cases had decreased during the past 20 years,but that the mortality was still rather high. Every soldierconvalescent from pneumonia had a furlough of four weeks.

Professor NOTHNAGEL (Vienna) and Professor SENATOR(Berlin) strongly recommended systematic hydropathic treat-ment of the disease.’ Endocarditis.

’, Professor LITTEN (Berlin) said that Endocarditis wasalmost always a sequel of infectious diseases and withthe exception of the atheromatous form was caused by micro-organisms. From a clinical point of view a benign and amalignant form were to be distinguished. With regard to itsetiology there existed first a benign form of rheumatic,choreic, gonorrhoeal, scarlatinal, diphtheritic, pneumonic,and traumatic endocarditis ; in the second place a malig-nant, rheumatic, choreic, and gonorrhoeal endocarditis ;and finally a septico-pyæmic endocarditis caused by a com-bination of one of the two first species with pyogenicgerms. The benign and the malignant form ofgonorrhoeal and rheumatic endocarditis were caused by thesame species of micro-organisms of different virulence.Malignant endocarditis often produced metastases. Thesewere simple infarcts if caused by emboli detached from theendocarditic deposits or from coagula in the right ventricle,but suppurative if the emboli contained streptococci. The

septico-pyasmic form was only a symptom of general septicpyaemia. Traumatic endocarditis might either be benignand end in recovery or it might produce chronic disease ofthe heart, or if combined with pyogenic germs might turninto the septic form.

Dr. LENHARTZ (Hamburg) denied that the suppurativeand the non-suppurative forms of malignant endocarditis