Concerning the ambulance system: The city owns two ambulances, stationed at the Isolation Hospital, besides six at various police stations; and in addition, the covered police patrol wagons (over two dozen), are ambulances for all practical purposes. Some seven or eight ambulances are owned by as many hospitals, and there are one or two belonging to private corporations. The city's vehicles are well scattered over the city geographically.

The great defect of the ambulance service is the lack of trained surgical assistants to accompany the vehicles. It sometimes happens that a physician in the vicinity of the police station or a senior medical student can be obtained; as a rule, however, no assistance of this character is at hand. In Berlin this is overcome by training the police to ambulance work. A "Samaritan" is always present at each police station and nearly two thousand men have been trained. There are "Samaritans" in the fire brigades also.

In Chicago there is no such competition for accident cases as that in New York, where we read in the Medical Record:

"The competition for accident cases has become so active among ambulance surgeons that it has become necessary to establish rules of precedence at fires. These rules provide that whenever a general ambulance call is made for a disaster, explosion, collapse of building or a fire of unusual proportions, the surgeon first reaching an injured person shall be considered in charge of the case. If surgeons from different hospitals reach the case at the same time the one from the nearest hospital shall take it.”

It is needless to point out the many lines of usefulness of ambulance surgeons, e. g., in controlling hemorrhage, in administering antidotes in poisoning cases, in cases of insolation, etc. Another direction in which the ambulance surgeons may give useful service is in correcting the police

The problem of how to deal with cases of diphtheria, scarlet fever, measles and the like in charity cases- -a serious question a few years ago-has been partially solved by setting apart a ward in the pavilion recently erected at the County Hospital for the reception of these patients. These accommodations being limited it seems wise to use for this purpose the new Isolation Hospital belonging to the city, and which has a capacity of 50 beds. This has been done during the past winter, and since the prospect is that smallpox will not assume any alarming proportions, with vaccination thoroughly carried out as it now is, the plant may well be used for the reception of cases of the other contagious diseases instead of allowing it to remain idle.

In the way of special hospitals there is urgent and growing need for a public lying-in hospital. It is little short of criminal to receive parturient women under the same roof with all classes of patients, many of them pus cases. Yet this practice exists in several hospitals in the city, and while the obstetrical ward is isolated, yet the practice is to be decried. In the spasms of economy with which the Board of County Commissioners is periodically afflicted, it is proposed to do away with the obstetrical ward of the County Hospital entirely. This would necessitate the majority of charity patients being sent to the "poor-house" at Dunning, to have their children born within its walls-something to be regretted from a sociologic standpoint. A small beginning toward a Public Maternity Hospital has been made under private auspices, and it is to be hoped will prove the nucleus of a large institution worthy the city and age.

It would seem as if a "lock" hospital or some other provision for venereal cases should be made. Let us take cases of inguinal adenitis; these are exceedingly painful and nearly inhibit locomotion. Individuals suffering from this and other forms of venereal disease need hospital treatment

h

diagnosis of "drunk or stupid." For some inscrutable reason all persons found on the street comatose, either with or without the smell of alcohol on their breath, are judged by the police to be drunk, and locked up as such. In a few hours they are often found dead, when post-mortem examination reveals a fractured skull and cerebral hemorrhage. For example: J. M., 31 years old; locked up for alcoholism, found dead in cell. On post-mortem a depressed area in skull, five square inches, with large extra-dural clots, was found. The writer has noticed similar cases frequently during his service as Coroner's Physician.

When, if ever, the ambulances are provided with medicine chests and materials for "first aid," and manned with surgeons, the control of the public ambulance system should be vested in the DEPARTMENT OF HEALTH. In New York City the Commissioners of Charities and Corrections control the ambulances connected with the public and municipal hospitals; the Police Department merely allot the cases from which private hospitals may receive charity cases.

Report of the Municipal Laboratory: 1895-6.

ADOLPH GEHRMANN, M. D., DIRECTOR AND BACTERIOLOGIST. CASS L. KENNICOTT, F. C. S., CHEMIST.

THE Laboratory of the DEPARTMENT had its origin under an ordinance creating a Bureau of Milk Inspection, passed November 21, 1892. This ordinance was enacted owing to a popular agitation of the subject of pure milk brought about by a series of analyses that were made, and by a number of newspaper articles showing to the public that adulterations and sophistications of milk had existed in the city. During December of that year, PROF. E. B. STUART was appointed by MAYOR WASHBURNE as Deputy Commissioner of Health in charge of the Bureau, and he immediately began its organization. MR. CASS L. KENNICOTT and PROF. J. H. SALISBURY were selected as chemists and DR. ADOLPH GEHRMANN as microscopist. These persons were his scientific assistants, and seven inspectors were selected by examination to fill the positions of sample collectors. A definite plan of procedure was decided upon and the collection of samples was begun. The first series of analyses that were made showed that but five to ten per cent. of the samples so obtained were in accordance with the requirements of the ordinance as passed. The chief faults were found to be insufficient fat in the milk, owing to extreme skimming, and the addition of coloring matter.

During January, 1893, PROF. STUART and DR. GEHRMANN visited Boston, New York and other eastern cities to obtain additional information for the collection of samples and for the prosecution of offenders. The analytical laboratory at