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recent knowledge on the transmissibility of yellow fever, was reported adversely by the Executive Committee; the report was accepted by a very close vote. It was vehemently opposed by most of those who unqualifiedly accept the mosquito transmissibility exclusively. But Dr. Guiteras, who so believes, nevertheless advocated, and was chiefly instrumental in, the adoption of the Executive Committee's report.-A memorial resolution of the late Dr. H. B. Horlbeck, ex-president, was adopted.-Motion was made that the president appoint delegates to the American Congress on Tuberculosis, to meet in St. Louis, 1904: adopted.

Committees for 1903 were announced as follows:

Purification of Public Water Supplies-G. W. Fuller, New York City, chairman.

Disposal of Industrial Wastes-Dr. G. T. Swarts, Providence, R. I., chairman.

Purification and Disposal of Sewage-George H. Benzenburg, chairman.

Disposal of Garbage-Rudolph Herring, New York City, chair

man.

Animal Diseases and Food-D. E. Salmon, Washington, D. C., chairman.

Car Sanitation-Dr. G. P. Conn, Concord, N. H., chairman. Steamboats and Steamships-Dr. Peter H. Bryce, Toronto, Can., chairman.

Etiology of Yellow Fever-Dr. John W. Ross, U. S. Navy, chairman.

Plague-Dr. Alvah H. Doty, New York City, chairman. Demography and Statistics: Their Sanitary Relation-Dr. Wm. A. King, Washington, D. C., chairman.

Cause and Prevention of Infectious Diseases-Dr. A. R. Reynolds, Chicago, Ill., chairman.

Disinfectants and Disinfection-Dr. Hibbert Hill, Boston, Mass., chairman.

Production and Free Distribution of Vaccine-Dr. H. P. Walcutt, Cambridge, Mass., chairman.

The Teaching of Hygiene and Granting Diplomas of Public Health-Dr. Benjamin Lee, Philadelphia, Pa., chairman.

Standing Aid Societies-Dr. Geo. W. Goler, Rochester, N. Y., chairman.

Publication-Dr. Josiah Hartzell, Canton, chairman.

Dr. Fred J. Mayer, of Scott, La., offered a resolution regarding Sanitary Education, that the Association promulgate a campaign

of education to enable persons of all classes of society to combat with sanitary measures the incipiency of all infectious diseases: referred to Executive Committee.

At the afternoon session the subjects of discussion were: Committee report, Dr. Chas. A. Lindsley, of New Haven, Conn., on "The Canteen System of the U. S. Army"; "Sanitary Aid Societies," committee report, Henry Lomb, Rochester, N. Y., chairman; "Dirt Diseases and the Public Health," by Dr. C. V. Chapin, Providence, R. I.; "Oculists and Opticians," by Dr. Augustin Chacon, of Mexico; "The Water Supply of New Orleans and Its Improvement," by Robert Spur Weston, of Boston, Mass.; "The Ways in Which Typhoid Fever May be Transmitted," by Dr. Wm. T. Sedgwick, of Boston, Mass. Discussion on these papers was mostly upon channels of infection in contagious diseases and the prime importance of pure water, centering chiefly on typhoid fever. Dr. Sedgwick arranged his evidence as follows: 1. The water supply in a number of American cities has been made approximately good. 2. In cities having a pure water supply and yet suffering from typhoid fever, the prevalence of the fever follows closely the warm weather. 3. Many cities, in spite of the purity of their pure water supply, still pay a heavy tax in typhoid fever. The conclusion he deduced from this evidence was that the fever was contracted through the presence of undisinfected excreta of patients. Dr. Woodward, of Washington, said that he believed that the fact that typhoid fever is most malignant during warm weather does not prove conclusively that the infection. is conveyed through typhoid excreta. If there is any chance for contraction of the disease by water, it is in the summer, when many of the streams, especially brooks and creeks from which water is used, are low and clear. In the floods of the spring and winter the disease and other germs that are swept into the water have not the chance of concentration that is possible during a season when the water is more or less at a standstill. Much typhoid might be contracted from the use of such water, which is liable to be overlooked as a source of infection. He forced the proposition that the water is often more dangerous when it is pleasant and appears most attractive. Dr. McGehee thought that while the conclusion that undisinfected excreta was a principal source of typhoid fever infection may be correct, nevertheless there were many other ways by which the typhoid germs could be transferred to water from such excreta as had not been disinfected. He

thought it the part of wisdom to preclude the use of water at hotels and other public places unless it was first boiled.

The canteen question came in for part of the discussion. But the report of the committee was confessedly inadequate; the only member of the committee who had access to the records in Washington was not present, hence, the chairman said, "to make any additional report over the last was impracticable. But he might say the committee had taken a different stand from those persons who seem unable to make any distinction between total abstinence and temperance. The general attitude of the committee was in accordance with Scriptural injunction, Be temperate in all things.'"-On motion, the committee was continued.-Dr. Hurty, of Indianapolis, who read the report of the Committee on Sanitary Aid, said that lectures had been delivered before schools and churches, to school children, their mothers and other persons. Frequent application had been made for such lectures. In fact, forty-seven had been delivered in one season. A variety of phases of principal topics had been treated, including directions for hygienic measures during small-pox and other diseases. The lectures were given with lantern slides preferably. Another feature had been the distribution of publications of the boards of health in different places. There had also been inspections of houses in infected districts, and efforts made to stop the spread of consumption and other diseases. Trained nurses had been furnished in various instances, co-operation of effort effected and urged, so that, all in all, information had been disseminated in many ways. Discussing the paper on "Dirt Diseases," the author said that to fight infection the important thing is to get at its source-to prevent its spread from the infected person to healthy persons. Dr. Kohnke, of New Orleans, said that while he appreciated the paper on "Dirt Diseases" in its pointed features, it was well to remember that cleanliness should be enforced every way. If all cleanliness were made a point, then the dangerous kinds of uncleanliness would be sure to be covered by steps to procure municipal cleanliness, which was, in a degree, correlative with personal cleanliness.-The special and important part of the paper on “Oculists and Opticians" was the common incompetency of the latter and the need of physiological knowledge as well as of pathological conditions. Prescribing by them should be wholly prohibited. Oculists should have thorough clinical training, and upon them should devolve the responsibility of prescribing.

The paper on "The Water Supply of New Orleans and Its Improvement" was both particular and comprehensive of the peculiarities of the locality with relation to the river and other circumstances and external conditions, rainfall and sources of impurity; the past with regard to cisterns and wells; the present undertaking for the supply and systems of purification, with the conclusion "that the present water supply of New Orleans is neither satisfactory nor abundant, and that sufficient data have been collected during the investigation to allow a system of water purification to be designed which will efficiently and economically purify the Mississippi River at New Orleans. Furthermore, the available evidence shows that the American system of purification is best adapted to local conditions, on account of its low first cost, coupled with adequate efficiency."

Fourth and last day's session was almost wholly devoted to the routine of winding up business and the election of officers for the ensuing year. An animated discussion arose in regard to bubonic plague in San Francisco, but without any practical remedy. Resolutions were adopted favoring a sanitary exhibit at the exposition to take place in St. Louis in 1904; asking that control of illuminating gas be placed in the hands of municipal authorities; asking that railroad and steamship companies be compelled to furnish pure drinking water, and several memorial resolutions.

Officers elected for 1903 were as follows:

President-Walter Wyman, Surgeon-General of the United States Public Health and Marine Hospital Service, Washington, D. C.

First Vice-President-Dr. C. P. Wilkinson, of New Orleans.
Second Vice-President-Dr. John L. Leal, of Paterson, N. J.
Treasurer-Dr. W. F. Wright, of New Haven, Conn.
Secretary-Dr. C. O. Probst, of Columbus, Ohio.

To Fill Vacancies on Executive Committee-Dr. John S. Fulton, of Baltimore, Md.; Dr. John A. Amyot, of Toronto, Can.; Dr. Jose Ramirez, of Mexico.

Place of Meeting in 1903-Washington, D. C.

DISINFECTION OF THE URINE IN TYPHOID FEVER.

If a physician were to neglect disinfection by some simple, recognized method of the stools in typhoid fever, he would be held blamable, and justly so. If he were to omit cautioning the con

sumptive in regard to the dangerously infectious character of the sputum, he would be regarded as careless and negligent. Again, if the physician were to permit his scarlet fever patients to run about in the neighborhood before desquamation is completed, it would spread consternation through the community and the general condemnation of such action would not be slow in making itself effectively heard.

Numerous other instances could be mentioned of equally glaring sins of omission and commission in the preventive treatment of infectious diseases against which the general professional conscience would protest. How is it in the case of the urine in typhoid fever? It is demonstrated beyond doubt that in a considerable percentage of the patients suffering with typhoid fever, typhoid bacilli occur in that urine in large quantities, frequently so numerously that the urine is rendered turbid on that account alone. It is furthermore known that typhoid bacilli- may persist in the urine for months and even years after an attack of typhoid fever, such persons being in reality perambulating disseminators of bacilli, which are deposited wherever urine falls. In this way, unless precautions are taken, the cause of typhoid fever may be perpetuated locally and new foci of disease started as the bacillophorous urine finds its way into the sources of water supply. With the springing up of brisk endemics of typhoid here and there the question arises, are physicians using proper precautions in regard to the urine of their typhoid patients? Has the proper care of the urine become a matter of definite routine as is the case with the stools? Probably much more ought to be done than is being done. Certainly a convalescent typhoid patient should not be allowed to leave the hospital or be discharged from supervision before the condition of the urine as to the absence or presence of typhoid bacilli has been established. This would require a bacteriological examination of the urine, at least in many cases, and this the vast majority of private practitioners are unable to do as thoroughly as modern sanitary ideas require. In the case of hospitals, however, such examination ought to be a matter of routine. We are in need of further reports concerning the presence and persistence of typhoid bacilli in urine after attacks of typhoid fever. Careful observations should be made with the view to the establishment of easily practicable methods by means of which the practitioner can determine for himself the condition of the urine of his typhoid patients. In the meantime, it is our

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