SEATS AND DESKS. In which direction do they face? seat above the floor? How high is the top of the desk above the floor? How high is the What is the distance from the back of one Desk to the front of another? What is the width of the Seat? If your room is not in the form of a Parallelogram, will you please give an outline sketch of its shape? REMARKS. They succeeded in collecting statistics from 116 schools. The two reports already presented were discussed: first, the amount of floor space, and secondly, the amount of cubical space needed. These reports are to be followed by others on ventilation, lighting, and school furniture. After examining the opinion of various authorities, the committee assumed as a standard, one square metre for the floor space and four cubical metres for the cubical space for each scholar in the school. They then calculated the actual space given to each scholar in the 116 schools; making the calculation, both for the average attendance and for the total seating room of the school. They found out of the 116 schools, 39 were provided with too many seats, while 16 were overcrowded; some of them very much so. These reports were published in full in the secular papers, so that the people at large might benefit from the results. Dr. TRAILL GREEN gives the following account of the Epidemic of Influenza which prevailed during the winter of 1878–79 and spring of 1879. The Epidemic of Influenza which visited us during the past winter, cases of which are still occurring, is worthy of notice. Diseases of the respiratory organs became quite common in January last, and have continued to increase during the three months of the opening year as will be seen by referring to the following tabular statement for the corresponding months of 1878 and 1879. From the 1st to the 15th of April I had fifteen patients who were adults and ten children, showing a remarkable decrease in the disease. It will be seen that the number of cases had largely increased in February, 1879, above the number of cases of a catarrhal character which occurred in the previous month, or the corresponding month. of 1878. What seemed to be ordinary bronchitis at the commencement in many cases were soon found to be attacks of influenza, accompanied by great debility, unusual discharges from the nostrils, and a copious flow of tears, and obstinate cough. A very marked symptom in this epidemic was this great debility; adults usually remarked that they never felt so much prostrated by what is usually called "a cold," so that it would be said by robust persons, "I cannot possibly live through this attack." It was remarked that the temperature, even in the worst cases, did not run high; two or three degrees increase was found in the afternoon or evening. This made the prognosis in this epidemic favorable. Wunderlich says, "In influenza and bronchitis considerable or high febrile temperatures are always very suspicious, and the more so if they occur in the morning or later on in the course of the disease. They indicate with great probability an extension to the finer bronchi, or the supervention of pneumonia; but they also sometimes occur in cases in which the bronchitis simply masks the deposit of acute (gray or miliary) tubercle." Sometimes no increase of temperature could be detected by the thermometer, and yet there was much suffering from the coryza and other symptoms of the disease. Inflammation of the fauces was common, attended by great pain and heat. Sometimes a small spot of inflammation intensely red on the velum palate, or farther forward on the roof of the mouth, caused great suffering and yielded very slowly to the usual remedies. Slight swelling of the tonsils occurred in many cases. Percussion did not reveal severe local disease at any time, and the disturbance of the general system was much greater than the local symptoms of this mild character usually produces; such as the great debility, as already stated, and the general malaise. The expectoration was not free, hence auscultation failed to detect the usual signs of bronchial disease. In the early stage of the disease it was usually clear frothy mucus, which became thicker and yellow as the disease advanced, and even then was usually very small. In several cases a sputum of pure blood was occasionally discharged, but I did not meet with a case in which there was rusty expectoration, pathognomonic of pneumonia. In most epidemics the disease runs its course in a few days; in this the attacks were protracted for several weeks. It seemed that the treatment arrested the attack, but slight exposure renewed it 1 Medical Thermometry, p. 222. The question arises, did not the epidemic influence continue all these months? for new cases are still occurring in April with all the symptoms which were present in the cases met with in January. So relapses were common, as those of intermittent fever in malarial districts, the patients wondering why they are not permanently cured. The speculations hitherto made with reference to the cause of influenza have not brought us to a clear knowledge of its etiology. It was noticed in this epidemic that perspiration occurred during the twenty-four hours of the day without marked chills or exacerbation of heat. In one case pain occurred on one side of the nose with free discharge from the nostril and great flow of tears, regularly at ten o'clock A. M. These symptoms were entirely relieved by full doses of quinine. These periodic symptoms occurring in inflammatory affections would seem to indicate the agency of a miasmatic cause in the production of them. I have seen a perspiration occur daily in dysentery, in which the symptoms of inflammatory disease were present, yield to the administration of quinia-the tormina, tenesmus, and bloody and slimy stools disappearing without the use of any other remedies, such as opium, laxatives, or astringents. Quinine was useful in the early stages of the disease, and was called for to the close. It was needed as freely as in intermittent fever, the great nervous prostration and feebleness of the heart's action requiring this medicine in full doses, as well as alcoholic stimulants. Opiates were useful to quiet the system and to compose the patient at night; morphia and Dover's powders acted pleasantly, and the ordinary expectorants used in the treatment of bronchitis were needed throughout the disease. The number of cases of influenza and bronchitis, including the mildest cases of catarrh, treated from January 1, 1879, to April 15th, were three hundred and two-none died-showing that while the patients suffered much the disease was not of a serious character. The epidemic of influenza of the winter of 1831-2, we believe was not so mild, while that of 1843, which prevailed later in the season, running into the month of July, was more like the epidemic now prevailing. REPORT OF THE PHILADELPHIA COUNTY MEDICAL SOCIETY ON METEOROLOGY AND EPIDEMICS, FOR THE YEAR 1878. THE health of Philadelphia during the past year has been unusually good, if we may judge from the diminished annual death-rate reported by our Board of Health. This rate as deduced from Dr. Wm. H. Ford's admirable tables amounts to only 17.97 per thousand inhabitants, and the favorable character of this exhibit will be at once appreciated when we consider that according to the most recent bulletin of Gen. J. B. Hamilton, M.D., from the late lamented Surgeon-General J. M. Woodworth's office, the death-rate in London was 30, in Manchester 31, in Paris 29, and in Berlin 24 per 1000 inhabitants. Of course the proportion of deaths is only an approximative guide to the actual number of cases of illness in our limits, but since it is impossible as yet to procure exact statistics in regard to non-fatal attacks of sickness, we must for the present at least be satisfied with the information thus obtained. Satisfactory as this decrease in the death-register is, as compared with previous years, it should nevertheless furnish a powerful incentive to every medical practitioner, and indeed to every philanthropist, to urge by all the means in his power those sanitary precautions which will bring about a still further amelioration in this respect. In order to show what may be accomplished towards this desirable object, I cannot do better than epitomize some remarks of my friend, Mr. Edwin Chadwick, C. B., respecting actually achieved success in sanitary work. This Nestor of English sanitarians at the meeting of the British Social Science Association (Aberdeen, Sept. 19, 1877) pointed out in an address before the Health Section the present position of Sanitary Science, and the advance it has made since the time when, in 1842, he first took an active part in awakening interest concerning public hygiene in England. From his own experience as a government official, and from the published records of various institutions, he gathered the satisfactory assurance that practical sanitation was not a delusion, but was capable of tangible and beneficent results. The saving of human life attained as the result of applying intelligently the recognized principles of hygiene in infant asylums, in jails, and in the army and navy, indicated what is possible for the entire race, and pointed to the "normas" of sanitation for the people at large. The following is his summary of conclusions as deduced from practical experience: 1. That we have gained the power of reducing the sickness and death-rates in most old cities by at least one-third, or, as a rule, to sixteen or seventeen in one thousand annually. 2. That in new districts, or sites apart from old urban sites, we may with a complete arterial system of water supply and surface cleansing, including measures for the prevention of overcrowding, insure a reduction of death-rates to less than one-half, or to a mean rate of ten in one thousand annually, and the sickness in like proportion. 3. That in well-provided and well-regulated institutions for children from three to fifteen years of age, we may secure them an immunity from the common children's epidemics, and reduce the death-rates to the mean of about three in one thousand, or to less than two-thirds the death-rates prevalent among children of those ages in the general population. 4. That in prisons and places under effective sanitary supervision the death-rates from disease have been reduced, among persons from the school ages and upwards, to about three in one thousand, or to one-third the death-rates prevalent among the population of the same ages. 5. That to the persons in such institutions an immunity may be given against all ordinary epidemics, typhus, and the eruptive diseases, diarrhoea, and dysentery which ravage the general population. 6. That among the general population, a reduction by full onehalf of the diseases of the respiratory organs, may be effected by general public sanitation. 7. That complete habits of skin cleanliness, alone or apart from general structural alterations, or alterations of habits in other respects, constitute a factor of about one-third the power of "sanitation." 8. That by a proper selection and due sanitation of sites in tropical climates, and sanitary care of the population, the birth-rates among Europeans may be made to exceed the death-rates. 9. That by the increased health and strength imparted by improved physical training, under sanitary conditions, on the halfschool time principle, in the infantile and juvenile stages, the efficiency of three for productive occupations may be imparted to every two of the most depressed classes of the population. |