926 hDI CORESPONDENCE. [APRIL 10, 19",9
]
JO
PLAGUE IN CALCUTTA.
3nbia. Dr. T. Frederick Pearse, who exercises control over the
special plague establishment in addition to his duties as
(FROM A CORRESPONDENT.] health officer of Calcutta, has submitted a report of the
prevalence of plague in the city during the year ending
ASSOCIATION OF MEDICAL WOMEN IN INDIA. June 30th, 1908. This includes a " quiescent " period,
A NUMBER of medical women were present at the Bombay July-December, 1907, and an "active" period, January-
Medical Congress, the committee having very considerately Jbne, 1908. During the former, 313 deaths were regis-
weserved front seats for them in the Lecture Hall. The tered, and during the latter 1,495, giving a total for the
first general meeting of the Association of Medical Women year of 1,808. This is the smallest aggregate since 1898,
in India was held on February 24th, at the house of the year in which plague was introduced into Calcutta.
Dr. Annette Benson, Physician in Charge of the Cama The epidemic of 1908 was therefore exceptionally mild; it
Hfospital. Forty-two members were present, representing developed more gradually and later, reached a climax
medical aid given to women and children in Government, earlier, and declined more slowly. It is remarkable that
mission, Dufferin, and native State hospitals. Miss the proportion of bubonic cases is higher in the active than
Benson, M.D. (President of the Association) took the in the quiescent period; in 1908 it was not so high as
chair, and opened the proceedinas in the following usual, also the case-mortality was less. The number of
speech: inoculations performed was 1,979, and no attack of plague
occurred among these; 122,069 rats were destroyed, at a
I offer all present a hearty welcome. With this meeting we cost of Rs.16,036. Observations made by Drs. Hossack
inaugurate the Association of Medical Women in India, and it is and Crake, special plague officers, indicate tbat, as in
with the greatest pleasure that I see such a large gathering of Bombay, the " rat-flea season corresponds with the plague
the association which only began to be organized two years season "; but " the comparative absence of fleas in Calcutta
ago. In few words I will describe the first object which we
have before us to-day. Looking at the medical profession in houses, and the practically complete absence of fleas on
India, we see men organized in a service offering worthy careers man," are held to cast doubt on the rat flea being the chief,
to its members, with fair rules of pay, promotion, leave, and or only agent of infection.
pension. We see women a nondescript, scattsred number of
isolated units, at the mercy of chance employment and still
more chance conditions of service, and almost all in subordinate
positions. Yet the majority of better-class women of India have
no one to look to for help in sickness and childbirth but these
same isolated units. For the good of this large factor of the
population, and therefore in the name of the public weal, we
aim so to improve the conditions under which medical women HUNGER PAIN AND DUODENAL ULCER.
work as to make their work efficient and their reward fair.
When you have amended and confirmed the constitution pro- SIR,-Mr. Moynihan evidently remembers the old legal
iposed last August, you shall have laid before you a scheme for adage, " If you have a bad case abuse the plaintiff's
the organization of medical women in India. attorney." Having ventured, in quite temperate language,
The constitution and rules with amendments were then to express the opinion that hunger pain does not always
read. Miss Staley, M.B., described on behalf of the council point to the existence of a duodenal ulcer, I find myself
a scheme for the organization of a women's medical ser- denounced by him as a person whose views are always
vice for India. This scheme was referred to a subcom- "fundamentally inaccurate," who trusts in diagnosis to
mittee to report to the council. what he patronizingly terms " chemistry and- make-
Dr. Baumler spoke on the improvement that had believe," and who is totally unacquainted with that peculiar
,taken place in women's hospitals in the last twenty variety of pathology which he calls " the pathology of the
years, Dr. Brown on the training of dhais, and Dr. living." I venture to think, however, that a little more
-O'Hara against the trainin-a of indigenous dhais as argument and a little less abuse of one who ventures to
now conducted. Letters from various members were differ from him on a scientific question might have
-read. impressed your readers more favourably with the strength
The President mentioned various members of the associa- of his case, for, after all, we are both merely trying to get
'tion who had done good work for it during the year-the at the true meaning of a symptom, although we approach
honorary secretary, the editor, members of council, and its study from different points of view, and I am perfectly
the member who had conducted the information bureau so ready to be convinced by Mr. Moynihan if he can show me
successfully during the past year. that I am wrong.
Perhaps some misapprehension would have been avoided
LADY MINTO'S INDIAN NURSING ASSOCIATION. if, in my first letter, I had defined what I mean by " hunger
This admirable institution, whose object is"to provide pain." Dr. Herschell, for example, evidently distinguishes
-and maintain a regular service of fully trained and experi- between hunger pain and the " pain of hyperchlorhydria."
-enced nurses throughout Northern India and Burmah," Now, I wish to make it quite clear that I, at least,
has been in existence for two years, and the report for 1908 recognize no such distinction, for the pain of hyper-
gives evidence of growing appreciation and increasing chlorhydria corresponds accurately to Mr. Moynihan's
success. The organization consists of a central committee definition of hunger pain, inasmuch as it "comes on
in Calcutta, whose president is the wife of the Viceroy when a patient should be beginning to feel hungry
-ad whose secretary is the Viceroy's surgeon, and nine for his next meal."' Granted this definition of the
,provincial branches. The central committee selects, pays, term, I think Dr. Herschell would agree with me that
distributes, and discharges nurses, and the provincial com- hunger pain does not necessarily imply the existence of
mittees control the employment and upkeep of the nurses an ulcer in the duodenum. I know that this does not
and collect subscriptions and fees. Subscribers pay affect Mr. Moynihan's position one whit, for he evidently
.according to salary, and are entitled to a first claim on the does not believe in the existence of hyperchlorhydria as a
services of the nurses and at lower rates than non-sub- separate disorder at all, but regards it as a figment of the
scribers. Firms and regiments are permitted to join the imagination, a product of " chemistry and make-believe,"
association on special terms. Three lady superintendents and so long as he pooh-poohs all evidence except that
-and forty-four nurses constitute the staff, and 338 cases obtained by operation I do not see how I can hope to con-
were attended during the year, of which 103 were cases of vince him. This only I would say, that if hunger pain
-enteric fever. The income of the year amounted to really be always associated with the presence of an ulcer
Rs. 107,267, of which Rs. 33,172 were fees earned by in the duodenum, then (1) duodenal ulcer is one of the
the nursing sisters. Rs. 43,650 were invested. There is a commonest causes of pain during digestion, (2) it is
home committee which, under the title of the Up- quickly and easily curable by medical treatment, and
-Country and Punjab Nursing Association, used to carry out operation for it is usually unjustifiable (as Dr. Hertz very
-on a more limited scale the same purposes now subserved cogently points out), and (3) the scars of healed duodenal
by Lady Minto's association. The report, which is written ulcers ought to be amongst the commonest phenomena of
by Surgeon.Lieutenant.Colonel W. R. Crooke-Lawless, the post-mortem room. Ten years' experience in the
-C.LE., honorary secretary, and Mrs. E. Davies, chief lady London Hospital out-patient department fails to show me
superintendent, is illustrated by several excellent photo- how these propositions can be denied.
~graphs of the homes. 1 Vide hs article in the Jorr XiL for November 16th, 1907.