486 



NATURE 



[September 17, 1891 



results. Hence it came to be recognized tliat, by preventing the 

 ingress of these germs to the bodies of puerperal patients, com- 

 parative safety, even in lying-in hospitals, was attainable ; and 

 the introduction of the antiseptic and aseptic methods has pro- 

 duced not only a remarkable diminution of mortality, but also of 

 the morbidity or illness incident to the puerperal state. A short 

 sketch was given of the modern methods adopted in several 

 countries to insure the greater safety of patients in maternity 

 hospitals, and of the results obtained in Europe and in the United 

 States. The results were very striking, and were attributable 

 mainly to the introduction of the antiseptic or aseptic modes of 

 treatment, although other improvements are not lost sight of. 

 In concluding he called attention to an interesting table in 

 which were thrown together the statistics of maternal deaths in 

 six lying-in hospitals, situated in various countries, since the 

 introduction of aseptic or antiseptic methods. With these he 

 had contrasted the figures of M. Le Fort before the era of anti- 

 septics, and Mr. Newbatt, the distinguished President of the 

 Statistical Society, had kindly computed for him the difference 

 in the proportion of deaths in the two cases : — 



Mortality in Maternity Hospitals from all Causes in various 

 Countries of Europe {Le Fort). 



Before the Introduction of Antiseptics. 



Deliveries. Deaths. Per looo. 



Total 888,312 ... 30,394 ... 3421 



After the Introduction of Antiseptics. 



Deaths which 

 would have 

 Date. Deliveries. Deaths. occurred on 



basis of Le 

 Fort's figures. 

 15,070 ... 106 ... 516 



5.508 ... 57 .. 188 



76,646 ... 290 ... 2,622 



1,919 ... 15 ... 66 



1,233 .. 27 ... 42 



Vienna 1881-5 . 



Dresden ... ... 1883-7 . 



Russia 1886-9 ■ 



New York ... 1884-6 . 



Boston ... ... 1883-6 . 



General Lying-in 

 Hospital, Lon- 

 don ... .. 1886-9 ... 2,585 ... 16 



Total 



102,961 511^ 



88 

 3.522 



Number of lives saved out of the 102,961 since the introduction 

 of antiseptics — 



Expected deaths on Le Fort's basis 

 Actual deaths 



Saving ... 



3522 

 5" 



3011 



Dr. Priestley said it would be seen that while, according to M. 

 Le Fort, the maternal deaths in European lying-in hospitals 

 were 34 '21 per 1000 under the old regime, the mortality is now 

 reduced to somewhat less than 5 per 1000. This computation, 

 put in another way, indicates that if the former rate of mor- 

 tality had been maintained 3522 maternal deaths might have 

 been expected; the actual deaths were only 511. In other 

 words, 301 1 lives of mothers were saved as the result of new and 

 purely scientific methods of treatment. This, he thought, 

 might fairly be stated to be one of the most striking triumphs 

 of preventive medicine. It was no mean achievement to rescue 

 from death more than 3000 lives of women in the acme of their 

 maturity, and when their lives were most valuable to their 

 families. 



Dr. Graily Hewitt, of London, Mr. F. Fowke, of London, 

 and Dr, Leduc, of Nantes, spoke on the suljject. 



A paper was read by Dr. J. C. van Dooremal, of The Hague, 

 on " La Prevention de la Cecite professionnelle." 



Dr. Sisley, of London, read a paper on "The Prevention of 

 the Spread of Epidemic Influenza." 



Mr. Weaver and Dr. Felkin took part in the discussion. 



Greene Pasha, of Cairo, read a paper on "The Influence of 

 the Nile on Mortality in Egypt." 



Dr. Felkin, of Edinburgh, read a paper entitled "Obser- 

 vations on Malaria and Enteric Fever in Central Africa, and 

 on the possible Antagonism between Malaria and Phthisis." 



' 4*363 per 1000. 



NO. II 42, VOL. 44] 



Inspector- General Lawson and Mr. Weaver spoke on this 

 subject. 



Dr. Lewis Sambon, delegate of the Municipality of Naples, 

 read a paper on "Measures adopted for the Prevention of 

 Infectious Diseases and their Relation to our Knowledge of 

 Epidemics." He first pointed out the similarity, which is most 

 striking, between the mode of development and diff"usion of 

 infectious diseases and some insect pests, such as locusts for 

 instance. Both have likewise their endemic areas, both their 

 seasons of development, both in some years spread more widely, 

 and at long intervals give rise to regular plagues ; both migrate 

 in the same constant direction, and both die away out of their 

 endemic areas, subsiding in the struggle for life. He said that 

 the diff"usion of species by currents and winds will make us 

 understand the peculiarities in the spread of infectious diseases, 

 which had given rise, in all time, to the most strange theories. 

 The influence of atmosphere has been very little studied in con- 

 nection with infectious diseases, and by this he did not mean 

 the registration of the prevailing lower winds during an 

 epidemic, but serious bacteriological researches in the sinking 

 sediment of the atmosphere and in meteoric waters. Instances 

 of animals being carried by regular winds or wind-storms far 

 beyond the limits of their homes are universally known. 

 Insects of all kinds are often caught hundreds of miles from the 

 nearest land, out on the high seas ; North American birds not 

 unfrequently are carried across the Atlantic to Scotland. Far 

 more important is the influence of winds and currents in the 

 distribution of microscopic animals. These minute organisms 

 or their germs, generally adhering to other larger elements 

 of dust, are raised and carried by the wind until they are 

 allowed to sink again to the soil when the air is in stillness. 

 About quarantine Dr. Sambon said that not only our modern 

 investigations proved them useless, but that a long experience 

 has utterly condemned them. England has been accused of 

 being commercially and politically interested in the abolition of 

 quarantine, and this preconception has unfortunately prevented 

 many from valuing the most scientific and liberal ideas which 

 have promoted their opposition to quarantine. No nation can 

 boast of having held public health so high above commercial 

 interest ; and we must also remember that the English, at one 

 time, have been the most sanguine supporters of quarantine. 

 Quarantine was first instituted by the old republic of Venice, 

 whose life and power lay entirely in commerce ; and Dr. 

 Sambon said that, although it had proved so disastrous 

 to finance, so useless to sanitation, and so vexatious to 

 liberty, he was proud that they were a glory of his country. 

 Dr. Sambon concluded that the most important and perhaps 

 the only satisfactory means against infectious diseases was the 

 sanitation of towns and the hygiene of men. In speaking of the 

 sanitation of towns he said how vast areas of the old city of 

 Naples had been recently pulled down and new districts had been 

 built. A large and splendid supply of water has been intro- 

 duced since 1887, and when the drainage is completed, Naples 

 will be one of the healthiest towns of Europe. He spoke of the 

 poor classes of all our large towns, and said how they were the 

 culture grounds of epidemics, and finished by saying that it is 

 not enough to improve the sanitary conditions of a town, but 

 that the principles of hygiene should be impressed on the minds 

 and consciences of people, because there could be no public 

 hygiene where private hygiene was not understood. 



Deputy- Surgeon- General Bostock, C.B., and Sir Vincent 

 Barrington, delegates of the Metropolitan Asylums Board, read 

 ajoint paper on " The Hospital and Ambulance Organization of 

 the Metropolitan Asylums Board for the Removal and Isolation 

 of Infectious Diseases." The paper was illustrated by plans, 

 diagrams, and models. 



Surgeon-General Bostock said that the present accommodation 

 for fever and diphtheria consists of six hospitals : — 



Name. Position. Acreage. No. of beds. -^"erved?" 



1. Eastern Homerton ... 



2. South-Eastern ... Deptford ... 



3. South-Westem ... Stockwell ... 



4. Western Fulham 



5. North-Western... Hampstead 



6. Northern Winchmore Hill . 



2383 



4,211,056 



The first five are in London. The Northern is for convales- 

 cents, and is four miles outside the northern boundary of the 



