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Editorial.

ANNUAL REPORT OF THE SUPERINTENDENT OF THE WILMINGTON CITY HOSPITAL.

The report of Dr. W. W. Lane, Superintendent of the Wilmington City Hospital shows considerable change and improvement in the condition and management of this useful institution during the past year. After several conferences of the local profession with the Board of Managers, there was created a Board of Regents, consisting of five physicians, to co-operate with the Board of Managers in the management of the institution. Rules were adopted setting forth the duties of the Board of Regents and of each of the employes of the Hospital, and for the governance of the patients and visitors. There has been great need for such a set of rules and their enforcement will work great good to the Hospital. There has been no change. in the personnel of the Hospital staff, except that two physicians of the city are selected each two months by the Board of Re

gents to serve as visiting physicians. This is an important and wise step, inasmuch as the surgeon in charge is thus greatly aided by the counsel of these gentlemen who are required to make the rounds of all the wards daily.

The condition of the hospital has been greatly improved. The colored ward has been brought nearer to the main building to which it is connected by a covered piazza, the whole building renovated and freshly painted, and a new and convenient operating room, with concrete floor, provided. The grounds have also received attention and the shell drives and ornamental flower beds add much to the attractiveness of the place. There is room for still farther improvement in this direction, and at small cost to the city, if the inmates of the city prison were utilized.

There has been done much good work during the past year, neighboring counties for an hundred miles around sending patients to receive the benefits of careful hospital treatment. There were admitted, during the year, 279 patients with 8209 days of relief, a larger number than in any previous year. Of this number sixty were pay patients. The surgical work embraces such operations as laparatomies, excisions of the clavicle, thigh amputations, breast amputations, suprapubic urethrotomies, etc., etc.

The Superintendent appeals to the Board of Managers for several additional improvements, some of which have been sought year after year, and we are surprised to say, in vain. One of these, and it should be supplied at once, is an ambulance. The cost for keeping a horse would be very small, and the present method of conveying sick people to the hospital in an open city cart is neither conducive to the welfare of the sufferer nor becoming the dignity of a well conducted city. We hope that before another year has been added to the history of the hospital, the Board of Managers will have seen fit to supply these real needs that have been asked.

The Kansas Medical Journal says:

"Few men at the present day accept the old theory of the heredity of tuberculosis and yet the majority of examiners for insurance companies and insurance fraternities reject applicants who have a family history of tuberculosis," as though the fact that a man's parents had died of tuberculosis has no influence in estimating the man's life expectation. This rule of the insurance companies was based on the fact that the children of tuberculous parents were more liable to contract the disease than were others. While the "old theory" that the disease itself is hereditary may have been disproved, the fact that the children of tuberculous parents are very liable to contract tuberculosis is as true as it ever was. A fountain cannot rise higher than its source, and we cannot expect feeble parents with depraved vitality to produce children who are strong and hardy. As a child may inherit the features of his parent, a peculiarity in the tone of his voice, a characteristic gait, even a peculiar control over some insignificant muscle, so can he inherit that physicai condition or diathesis which renders him a suitable culture ground for the growth of the tubercule bacillus. This condition might be ignored by the insurance companies if the applicant had never been and would never be exposed to the disease germs but we know that as long as present conditions exist he is constantly exposed to the contagion, for he encounters it in the dust from the streets, in the cushions of the church, in the hangings of the sleeper, in the dust from the floors of the theatre, even in the milk that he drinks and the beef that he eats. He encounters the germs not only in this way, in common with the rest of mankind, but he has the more dangerous misfortune of passing the most critical portion of his life in close contact with his tuberculous parents. Let a person without the inherited disposition be subjected to these exposures and he would probably escape, but let some acute sickness, such as la grippe or pneumonia, enfeeble temporarily his natural resistance against the germs and they would, in all likelihood, effect an entrance and gain such a stand that it would be impossible to throw them off. It is a fact that the children of tuberculous parents are es

pecially liable to tuberculosis, and it is this fact that leads insurance companies to reject them as unfavorable risks, whether it be due to inheritance of the disease, inheritance of diathesis, or continued and close contact with persons suffering with the disease.

Reviews and Book Moices.

The Diseases of infancy and Childhood.-For the use of Students and Practitioners of Medicine. By L. Emmett Holt, A.M., M.D. Professor of Diseases of Children in the New York Polyclinic: attending physicion to the Nursery and Child's and the Babies' Hospitals, New York; etc.; etc. With two hundred and four illustrations including seven colored plates. Cloth, royal octavo; pages 1,118. D. Appleton and Company, New York. 1897.

In presenting this volume to the profession Dr. Holt has drawn very largely from his own experience extending over eleven years of continuous hospital service among young children, but the work of other pediatrists is not unnoticed. Being based so largely upon his own observation the book will be the more valuable as a practical working guide.

Undoubtedly the greatest cause of infant mortality is found in faulty nutrition and diseases of the digestive system. The author recognizing the great importance of this subject, gives to it nearly three hundred pages. The first two sections are, as is usual, devoted to a discussion of the care and development of the newly born and their diseases.

In the section on nutrition there is a most instructive discussion of the constituents of mother's milk and the influence upon it of different diseases aud drugs, also of the composition of the various foods as compared with mother's milk. This chapter could be read with profit by every one who is responsible for the feeding of an infant.

Sections IV. on Diseases of the Respiratory System and V. on Diseases of the Circulatory System are well handled. Continuing the author's arrangement we find Section VI devoted to Diseases of the Uro-Genital System; Section VII. to Diseases of Blood, Lymph Nodes, Bones, etc.; Section IX. to the Spe

cific Infectious Diseases and Section X. to Rheumatism and Diabetes Mellitus. We see no good reason for taking the chapter on Membranous Laryngitis from the Section devoted to Infectious Diseases and placing it in the section on Diseases of the Respiratory system. In fact it would be better to do away with the name Membranous Laryngitis altogether and call it what it is-Diphtheria. Then would the laity, and probably some physicians, recognizing the true nature of the disease, be more strongly impressed with the necessity for isolation and disinfection.

In the surgical tubercular diseases more attention is given to the symptomatology and diagnosis than to treatment. General lines of treatment only are suggested, the reader being referred to works on orthopædic surgery for the details of treatment and description of apparatus. In fact the discussion of questions relating to operative surgery has been omitted, these diseases having been considered only from the standpoint of the physician.

The mechanical work is well up to the usual high standard of the publishers.

Correspondence.

HISTORY OF MEDICINE AND SURGERY IN NORTH CAROLINA.

Editor North Carolina Medical Journal:

Medical histary that has been in making for hundreds of years and has been but imperfectly recorded is hard for even an expert to mold accurately and to dress attractively. A novice. without unstinted help from the elder brethren might then reasonably be expected to relinquish the undertaking. My researches for facts relating to the history of medicine in North Carolina have not been at all extensive, but they have been sufficient to unfold the fact that anything like a creditable article