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The Epidemiology of Diphtheria.Dr. R. Klinger, of the Institute of Hygiene in the Uni-

versity of Zurich, which is under the charge of ProfessorSilberschmidt, in a recently published report, maintains thatbacteriological examinations should be made not only in allcases clinically diagnosed as diphtheria, but also in all

suspicious cases. If diphtheria bacilli are found further exa-mination of other members of the household, school, or

institution are desirable. Carriers of diphtheria bacillishould remain isolated as long as infectious, and specialhospital accommodation should be provided for such cases.In Zurich for the last eight years the State (Canton)pays for all bacteriological examinations, and this ruleshould apply to the whole of Switzerland. Some detailsDr. Klinger publishes are of general interest. Thedecrease in the mortality-rate from diphtheria hasbeen considerable between 1880 and 1910, it havingfallen from 8 to 1 per 10,000. Whereas the mortalityhad reached 3 in 1888, it suddenly increased in thefollowing eight years to 4g and even for one year to 6k ; ithas, however, continued fairly stable at 1 for the last eightyears. Investigations in schools and homes are of the

greatest importance when isolated cases of diphtheria occur.This is evidenced by the following facts. In a school of 49pupils in which 7 cases of diphtheria had occurred 5 childrenwere discovered to be bacilli carriers ; in another class of 428 pupils were infectious. In a home for epileptics, with 264inmates, in which only a few slight cases of diphtheria wereobserved, 23 carriers of bacilli were discovered.

Zurich b’cctcctori2cn for Consumptives.The annual report for 1912 for the Zurich sanatorium for

consumptives contains the following details. Whereas thedeath-rate from tuberculosis in Switzerland has decreasedduring the last nine years from 18-7 to 16’1, the decreasefor the canton of Zurich has been more marked, as it hasfallen from 18-6 6 to 13-9. Doubtless the considerablenumber of annual cures is already beginning to tell on thedeath-rate. A large number of patients, especially thosetreated in the first stage of pulmonary tuberculosis, remainfit for work for quite a number of years. 418 patientswere treated at the sanatorium in 1912, 328 of whomsuffered from pulmonary tuberculosis, 23 from tuberculosisof other organs. The average duration of the stay was158 days. 44 per cent. belonged to the first stage, 23 percent. to the second, 33 per cent. to the third. 80 per cent.derived benefit. Only seven cases were treated withtuberculin.June 12th.

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AUSTRALIA.

(FROM OUR OWN CORRESPONDENT.)

Maternity BOnlt8.IN my last letter I referred to the legal proceedings to be

taken against two nurses on a charge of making falsereturns under the Maternity Bonus Act. On April 19ththe detective police in charge of the matter arrested, inconnexion with the same charge, a middle-aged medicalman who has been known as a city practitioner inMelbourne for some years.

Health of Perth.. The annual reports of the medical officer and his chief

inspector state that typhoid fever showed an increase for1911-12 of 275 cases, as against 161 the previous year. Theyremark that the increase is no doubt due to the. disturbanceof the soil in all directions by the sewerage scheme, and thatin Perth typhoid fever disappears rapidly after heavy rain.

Brisbane Hospital.The annual meeting of supporters of this institution was

presided over by the Governor of Queensland, Sir WilliamMacGregor, who is himself a medical man. During the pastyear 4664 in-patients and 8689 out-patients had receivedtreatment. The committee announced that many improve-ments in building and equipment were needed and that somewere already in hand. It was proposed to spend .614,000,and of this sum E8000 were required to be raised by publicsubscription.

Pharmaoists and Lodges.A movement has lately been made in Victoria by the

members of the Pharmaceutical Society against the lodge dis-.pensaries. The pharmacists complain that these dispensariessell dressings and toilet articles and surgical appliances atrates with which the shops cannot compete, and that thereis no effective control to secure that sales are made only tobond fide members of the Friendly Societies. The societieshave arranged to hold a conference on the subject withrepresentatives of the pharmacists.

Phthisis in Victoria.

Some interesting figures are given by the Victorian Govern-ment statist (Mr. A. M. Laughton) in the Year Book for1911-12 just issued. He states : " The deaths from phthisisin 1911 numbered 1108-598 being of males and 510 offemales-and equalled a rate of 839 per million of the

population, as compared with rates of 830 in the previousyear, 848 in 1909, 955 in 1908, 958 in 1907, and 1134 in1890-2. " Later he writes : ’’ The proportion of the residentsof any large area which is affected by pulmonary tuberculosisrepresents fairly closely the degrees of infection of that centre.Such proportions have been computed for five divisions ofthis State on the experiences of - the two and a half yearsended June, 1911. During that period 1912 residents ofGreater Melbourne, 137 of Ballarat and suburbs, 347 ofBendigo and suburbs, 71 of Geelong and suburbs, and 731 of’ rest of State’ contracted the disease. Comparing thesenumbers with the respective populations it is found that ofevery 10, 000 persons, 13 1 in Greater Melbourne, 11’6 6 inBallarat, 31’6 in Bendigo, 10-2 in Geelong, and 4’9 in’ rest of State ’ contracted tuberculosis of the lungs in eachyear....... Particulars regarding the time which elapsedbetween the beginning of pulmonary tuberculosis andthe date at which a medical practitioner was consultedshow that of the total patients about 1 in every 8 receivedadvice within three months, and slightly less than 1 in 3within six months, while about one-half were medicallyadvised within 12 months from the commencement of thedisease. "

Fairfield Fever Hospital.As a result of the recent inquiry into the conduct of this

institution the Government has decided to have direct

representation on the management.Personal.

Dr. T. W. Sinclair, who has been assistant officer of healthin Sydney for some years, has been appointed health officerof the city of Melbourne, and has taken up the work.-Dr.W. K. Norris, who recently resigned the post of Director-General of Federal Quarantine, has sailed for London, wherehe will enter upon the duties of Commonwealth medicalofficer in charge of the medical inspection bureau to beestablished.

The Northern Territory.An important document, the full text of which is not yet

available, is the report made to the Minister for Home Affairsby Dr. M. J. Holmes, medical officer to the territory, on theclimatic and hygienic outlook in the Northern Territory ofAustralia. Dr. Holmes states that there is an absence of anyof the virulent tropical diseases, and that the most formidablecontagious diseases are those introduced by all civilisations.The climate is equable, and if moderation in living beobserved there is nothing unhealthy in the environment.White women can and do live comfortably, and there is noreason why a male working population should not be accom-panied by their wives and families. The great need at

present is means of communication by which the countrymay be opened up, and once this is assured there is nothingin the climatic conditions to deter white people from livingthere in health and comfort.May 7th.

CENTENARIANS. -John Ryan, residing inMainstone-avenue, Plymouth, celebrated the anniversary ofhis 104th birthday on June 10th. Mrs. Rebecca Clark, ofWood Green, reached the age of 109 years on June 9th.She married 90 years ago, and has brought up nine children.She enjoys good health, and attributes her long life to

retiring early to bed, getting up early, and hard work