1046 MOSQUITOES AND YELLOW FEVER IN HAVANA.—THE GROCER’S LICENCE.

the battle against diseases affecting the human species is

shifted from man himself to what is called the intermediaryhost. It has been so with malaria, it has been so in a

measure with plague, and it is so with the several parasiticdiseases which will at once suggest themselves. Of diseases

such as these man has no longer the sole prerogative, theycan no longer be known exclusively as "human diseases."Scientific research has now, in a sense, transferred from

man to the mosquito that veritable scourge of certain

tropical areas, yellow fever. The brilliant and withal

somewhat heroic experimental investigations of our Ameri-can confrèr’es have served to show almost conclu-

sively that personal infection plays an altogether insigni-ficant, if any, rôle in the spread of the disease-that,as with malaria so with yellow fever, it may be a

case of "no infected mosquitoes no disease." Many ofthe researches as to the part played by mosquitoesin diseases common to man have been worked out in

one or another portion of the British Empire which has,

epidemiologically speaking, the fortune to possess within

its limits all the diseases which mankind is liable to inherit

or to acquire ; but unfortunately for scientific patriotismthe workers in the field have often owed allegiance to other

sovereigns than our own. In the matter of yellow fever

the workers have been American, as also has been the soil

upon which the researches have been carried out and the

conclusions applied.As we pointed out in a leading article on June 15th, 1901,

the investigations of Major WALTERREED and his colleagueshave seemed to show that the prevention of yellow fever is

largely bound up with the destruction of the Culex fasciatusor the prevention of its bites, and the military administra-tion of Havana has lost no time in putting this theory to a

practical trial. The result of the destruction of this

mosquito and its potential progeny has been almost dramaticin its thoroughness, and the city of Havana is now pro-

nounced to be practically free from yellow fever. Thus it

<;omes about that the advent of the American administra-

tion at the close of the Cuban war has, according to

the last annual report of Major W. C. GORGAS, surgeon,United States Army, and chief sanitary officer of the

city, been speedily followed by the extirpation of a diseasewhich has been endemic therein for the last 200 years.We are in entire accord with Major GORGAS that this

is a matter of vast importance and that ’’ this fact shouldbe made known to the world as rapidly as possible." If the passage of time sets its seal upon the promise of1901-1902 we are, as Major GORGAS observes, face to facewith a prophylactic measure which is worthy to rank, at

least in so far as the yellow fever areas are concerned,with the discovery of JENNER. We cordially trust that

time may justify the prophecy which has been made in

all good faith and upon apparently trustworthy grounds.But while provisionally accepting the remarkable figuresplaced before us we must be forgiven if we plead for time- before finally acquiescing in the inferences which have

been drawn from them. On looking at the table relatingto the annual deaths from yellow fever in Havana for thelast 45 years we note that the yearly toll ranged from 205E*to 51, this latter figure being exceptional in that there

has been nothing within recent years under 103, the figurefor 1899. Under the anti-mosquito rigime for the first

10 months of the yellow fever year 1901-1902 there have

been but fire deaths and this unprecedented drop is

certainly such as to suggest the operation of some quitenew factor. Unfortunately Major GORGAS does not giveus in the text of his reports many details as regardsthe method of attack adopted, but we gather that

during the period under discussion Havana was a city fullof "non-immunes" and that it was in unrestricted com-

munication by rail with half a dozen infected towns.

Commerce was not interfered with and no restraints were

placed upon the admission into Havana of clothing and

bedding from infected localities. As Major GORGAS terselyexpresses it : "The only infected material from the townslooked after was the sick man, who was carefully soughtout and screened from mosquitoes." This story is full of

interest both for the epidemiologist and the administrator,and the English Government will be lacking in initiative ifit fails to make detailed inquiries at once into all the

circumstances so that, if the facts justify the imitation, themethod adopted in Havana may be applied to the yellowfever areas of our Empire. From the tables in the reportbefore us it appears that there have been very extensive

operations in the direction of the application of petroleum,in intimating to householders the existence of larv&aelig; on their

premises, and in making cisterns mosquito-proof, but precisedetails are lacking.As a matter of curiosity we have been led to examine

the figures as to the prevalence of yellow fever in Vera

Cruz from 1866 to 1900, and from these we find that

the annual figures have ranged from 747 to nil, the

totals on several occasions having been below 10. We

quite accept the obvious criticism that the returns for

Vera Cruz and Havana are not strictly comparable, but

nevertheless the figures show that b large populationswhere yellow fever is endemic it is not unusual for the

returns for any one year to present an absence of the diseasein question. In thus enjoining caution we are anxious toaccord all honour to the American military administration

in Havana the results of which are so graphically portrayedby Major GORGAS himself when he tells us that the

army took charge of the health department of Havana

when deaths were occurring at the rate of 21,252 per year.It gives it up with deaths occurring at the rate of

5720 per year. It took charge with small-pox endemic

for years. It gives it up with not a single case

having occurred in the city for over 18 months. It took’

charge with yellow fever endemic for two centuries-the

relentless foe of every foreigner who came within Havana’s

borders, which he could not escape and from whose attackhe well knew every fourth man must die....... The army has

j stamped out this disease in its greatest stronghold." We

icordially trust that this most pleasing picture is painted. in permanent colours. But the Old World statistician seems

3to hanker after more information as to the rates referred

s to and as to whether the late war in Cuba may have had

any part in accentuating the statistical contrasts.

The Grocer’s Licence.ON Monday last the Home Secretary successfully moved

the second reading of the Licensing Bill which was there-

upon referred to the Standing Committee on Trade. We beg

1047THE GROCER’S LICENCE.

to congratulate him upon the progress which has been madewith this measure. The Licensing Bill may not be a com-

prehensive or drastic piece of temperance legislation-indeed, Mr. RITCHIE has himself disclaimed for his Bill

any such thorough-going character-but it is an honest

attempt to minimise the evils of drinking, and as

such deserves the support of all thinking men and

women, and especially of the medical profession. How

widespread and how complicated the evils of excessive

drinking are is better known to ’Medical practitioners thanto any class of society. The physical ills that are wroughtby intemperance form the daily lessons of our hospitals ; themoral effects of the same baneful habit are seen at their

fullest growth in our lunatic asylums and prisons. It is con-

sequently incumbent upon the medical profession to speakon the absolute necessity of the proper regulation of the

drink traffic, although they are not called upon to vouch forall the sensational propaganda made in the teetotal

interest.

During the debate on the second reading the measure

received from Mr. CAINE, speaking as a representative of thetemperance party of the country, a qualified blessing, but iseveral members, notably Mr. HARWOOD, Mr. TRITTOX, and

Major JAMESON, spoke in condemnatory terms -of some of theclauses. Criticism of the measure centred largely aroundClause 8, that which deals with grocers’ licences. The

present position of grocers’ licences is that any person can

obtain a licence of this kind as a matter of course, if he

fulfils certain obvious conditions. Any tradesman againstwhom nothing serious can be alleged can claim from themagistrates a certificate empowering him or her to purchasea licence at the Inland Revenue Office. The local justicesare not empowered or permitted to entertain the question of

expediency-that is, whether their district stands in need offurther facilities for procuring drink. By the new Bill

the granting of these licences is placed at the free and

unqualified discretion of the magistrates ; no sort of claimcan be made by anyone to the privilege. Mr. HARWOOD,who opened the debate, objected strongly to this alterationof the law, arguing that licences when so granted wouldconfer upon the licensees a vested interest which would add

to the difficulty of compensation-a difficulty which, as allwho have studied the temperance question know, still looms

ahead. Major JAMESON, who believed the Bill to be "as

silly as it was unnecessary," also objected to Clause 8

which he considered to place the off-licence holder in

a most unfair position and the effect of which he did notconsider the Home Secretary to have realised. We expectthat Mr. RITCHIE knows the ins and outs of the matter

as thoroughly as does Major JAMESON. It is obvious that

the new regulation may work unequally. In districts

where the licensed victuallers’ influence is great fewerlicences will be granted to grocers, but we do not

fear that grocers as a class will meet with injusticeany more than we fear that a local feeling against thatmuch-abused citizen, the publican, will anywhere lead

to an attempt to satisfy the drinking requirements of the

community by granting licences to grocers in profusion.Mr. CRIPPS, speaking also on behalf of the off-licence

holder, believed that it was quite untrue to say that

grocers’ licences had led to the increase of intemperance. A

large section of the public appear to share Mr. CRIPPS’S viewthat the conditions under which liquors are sold by off-

licensees are such as conduce to sobriety, while the-

existence of a number" of businesses which have been

legitimately built up under grocers’ licences and about

which no complaints have been made, is an argument againstthe abolition of the existing system which has to be

reckoned with. Why, Mr. CRIPPS asked, should the businessof any of these grocers be placed at the mercy of a benchof magistrates ? The only reply is that the good of the

public calls for the reform even though individual cases of

hardship may occur, while it is our opinion that such caseswill be so infrequent as not to be worth counting.The matter is one upon which the medical profession has

a right to speak somewhat strongly. We believe that we

certainly endorse the views of the majority of our pro-

fession, who have given the question a thought, when

we say that the proposed modification of the manner in

which grocers’ licences for the sale of liquor are to be

obtained is advantageous to the public health and the public.morality. The abolition of grocers’ licences has been

much threatened. A quarter of a century ago we obtainedin this office 900 signatures of medical men to a

petition for this reform, and our movement started

the feeling against off-licences which has remained in

force ever since. At that time we stated that, as far as

we could see, the grocers’ licences were distinctly thingsthat were liable to abuse. By what plea of necessity theissue of unrestricted grocers’ licences could possiblybe excused we were then unable to discover, and

we have not been able to discover since. No valid

reason can be urged on the ground of general utilitywhy the grocer should add to his proper functions a

duty which makes of him virtually a disguised publican.In some country districts, it may be, the provision storemust serve to some extent the purposes of a house of

call, but there is no absolute necessity even here

for the off-licence, while the discretion vested in the

magistrates will meet individual cases. We have no

manner of doubt that the tendency of grocers’ licences its

to encourage secret drinking. The evil influence of

successive little stimulating "nips," taken when the

drinker is not under observation, is well known to be

nearly or quite as hurtful to the health as are the unbridledbut more occasional excesses of the open drunkard. But,

the secret toper, who would resent the imputation of

drunkenness, will avoid a professed drinking bar. The

grocer’s licence is for such men and women-and especiallyfor such women-a special snare. We understand, of

course, that the law cannot restrain an ostensibly sober

person from procuring drink if he or she chooses, but it is

nevertheless quite within the province of the legislature torestrict the opportunities of those predisposed to ruinous

indulgence, especially when its action can in no way interferewith public convenience. On this principle the changeproposed by the new Bill is entirely justified. We

anticipate beneficial results from its operation-not so

much, perhaps, in the case of the chronic inebriate as in

that of many women to whom the ofe-licence affords

a tempting facility of descent. There appears to be

no reason why the holders of grocers’ licences should not

1048 THE GERMS OF THE SEA.

’receive compensation in some form if their present privilegeis withdrawn. Into this part of the question, however, it isBnot necessary for us to enter. We may safely entrust its

Bsettlement to the consideration of the Government.

Annotations.

THE GERMS OF THE SEA.

"Ne quid nimis."

AT no particular spot has the sea been found to -be freeFrom organisms, although those isolated and recognisedhave proved to be harmless, consisting of actively motile’rods and vibrios, cocci being less numerous. As might be

expected, the number of organisms increases immensely as-the shore is approached. Thus about a mile from the shore

something like 4000 germs per cubic centimetre have beenfound, and this influence of the shore extends for four orfive miles. Some hundreds of miles from land the numberdiminishes to 600 and at greater distances to 200 or less. Of

course, the fact that algal vegetation is richest near the shore,,providing a highly nourishing hunting ground for the marineorganism, accounts for the myriads usually found there.

Samples of sea water taken at some depth below the surfaceproved to contain only a few bacteria per cubic centimetre.Thus at half a mile below the surface only from eight to 12bacteria were present. There is little doubt that evenshould pathogenic organisms gain access to the sea, as mustbe the case when sewers discharge raw sewage into it,

’their activity must sooner or later be destroyed. The

sea is remarkable from a bacteriological point of view

-in containing phosphorescent bacteria and it is probablethat some of these are disease-producing so far, at

,.any rate, as regards certain aquatic animals. Thus

- a bacterium has been successfully cultivated from the

body of the luminous talitrus which is both pathogenicand luminous. This bacterium invades the abdominal cavityof this aquatic animal and all its organs with a fatal issue.

During the presence of the disease the victim shines with a. green light which is said to be visible nearly a dozen yards-away and which persists for some hours after the demise ofthe animal. It is not improbable that the luminosity of othermarine animals may be due to the invasion of this light- anddisease-producing organism. The very beautiful phenomenonof the phosphorescence of the sea is caused by photo-bacteria in part as well as by a variety of low forms ofanimal life. The eerie light is in no way connectedwith the element phosphorus as is very commonly supposed.The cause of the phenomenon is respiratory exchange oroxidation, an aerobic function. Sea phosphorescence is

never witnessed in perfectly smooth water, while the

brilliancy of the light when it is observed is always greatestupon the crests of the waves or where the water is in a

’violent state of agitation, as in the wake of a steamer. It<<

occurrence, therefore, is evidence of active oxidation.

Could, again, the sea be sterilised phosphorescence would.cease. The presence of highly combustible matter increasesthe light. A very simple experiment proves this. If the

flesh of a fresh haddock or herring be placed in a 3 per cent.salt solution and kept at a low temperature (from 400 to

50&deg; F.) the liquid will rapidly develop phosphorescence whichbecomes quite brilliant on adding a little glycerine or sugar,or what, in other words, is respirable material. It is curious

’that in marine life disease and death should be associated- ’with luminous phenomena.

EFFECTS OF STRYCHNINE ON RABBITS INWHICH DOUBLE NEPHRECTOMY HAS

BEEN PERFORMED.

IT has been well established that strychnine is eliminated’ from the body mainly through the kidneys. DragendorfEhas shown that all the strychnine leaves the body unchangedand Kratter succeeded even with such a small medicinaldose as two milligrammes in recovering the entire quantityfrom the urine. If the subcutaneous administration be

accomplished very slowly even more than a fatal dose maybe injected without causing any characteristic effect, whichhas been explained on the assumption that in such a caseenough strychnine is eliminated by the kidneys to preventthe accumulation in the blood of an effective dose.

It has been presupposed as a matter that is self-evident that in an animal from which the kidneys havebeen removed subminimum doses will even aggregate withinthe blood to a poisonous dose simply because the eliminatingorgan is removed. This supposition has been proved not to becorrect by Dr. S. J. Meltzer and Dr. W. Salant, who publishthe result of their researches in the Jo.-trnal of ExperimeiitilJct’M, vol. vi., No. 2. The title of their communicationis The Effects of Subminimum Doses of Strychnine in

Nephrectomised Rabbits." " Their investigations bring out

the following points. 1. For a rabbit without its chief

eliminating organs-the kidneys-the minimum toxic

and fatal doses of strychnine are, nevertheless, not smallerthan are those for the normal animals. 2. Even in a rabbitwithout its kidneys a single cumulative toxic dose of

strychnine induces only one attack, or a few attacks, of thecharacteristic spasm and the animal soon recovers and

shows no further effects of the strychnine. Hence a toxic

dose apparently remains within the body, causing a con-

tinual effect. 3. If proper subminimum doses at properintervals are employed "nephrectomised"

" rabbits can

gradually receive thrice the fatal dose of strychnine with-out showing any reaction. Large fatal doses of the poisonare apparently accumulated within the body without causingany effect. Dr. Meltzer and Dr. Salant then proceedto suggest various explanations of these facts, but, as

they admit, these are only hypotheses which require furtherstudy. We consider the most plausible suggestion to be

that after the removal of the kidneys the act of eliminationis carried on by other organs ; for instance, by the gastro-intestinal canal. The above observations are interesting fromseveral points of view but the most practical result is thefollowing consideration. It has been claimed by cliniciansthat in chronic diseases of the kidneys certain drugs, such asstrychnine, should not be administered since, owing to thelessened power of elimination on the part of the kidneys,serious or even fatal accumulative results might follow.

According to the experiments which we have been consider-ing, however, such a theory is incorrect and the animal bodyapparently possesses a mechanism capable of regulating thecumulative capacities of the blood even in the absence of thekidneys. It would be interesting to know the results of

similar investigations with other drugs, such as morphine, forthe fear of cumulative effect in renal’ disease would seem torest at present on theoretical grounds alone.

ON THE RELATIVE PREVALENCE OF DIS-SEMINATED SCLEROSIS.

I Ax important discussion on the relative prevalence of c1i-seminated sclerosis in the United States based upon very z

extensive and exact records collected by leading neurologistsis published in the lIerical ft(!I1:g of New York of March 22ndlast. In opening the discussion Professor C. L. Dana reportedthat he had collected the histories of 3000 private patients

suffering from various forms of nervous disorders and that