to time; yet, since their arrival in February last, but one of those Spaniards thus brought over to work on the canal has died of disease, and he of typhoid fever. Two others were killed-one in a railroad accident, and one by a dynamite explosion. There has been for the last six months a well nigh steady decline in the death rate for the population of the zone, this being largely due to the decrease in deaths from pneumonia which has been the most fatal disease on the isthmus. In October there were ninety-nine deaths of every kind among the employes of the isthmus. There were then on the rolls 5,500 whites, seveneighths of them being Americans. Of these whites but two died of disease, and as it happened neither man was an American.. Of the 6,000 white Americans, including some 1,200 women and children, not a single death has occurred in the last three months, whereas in an average city in the United States the number of deaths for a similar number of people in that time would have been about thirty from disease. This very remarkable showing cannot, of course, permanently obtain, .but it certainly goes to prove that if good care is taken the isthmus is not a particularly unhealthy place. In October, of the 19,000 Negroes on the roll, eighty-six died from disease, pneumonia being the most destructive disease and malarial fever coming second. The difficulty of exercising a thorough supervision over the colored laborers is of course greater than is the case among the whites, and they are also less competent to take care of themselves, which accounts for the fact that their death rate is so much higher than that of the whites, in spite of the fact that they have been used to similar climatic conditions. Even among the colored employes it will be seen that the death rate is not high.

DIMINUTION OF MOSQUITOES.

In Panama and Colon the death rate has also been greatly reduced, this being directly due to the vigorous work of the special brigade of employes who have been inspecting houses where the stegomyia mosquito is to be found, and destroying its larvæ and breeding places, and doing similar work in exterminating the malarial mosquitoes-in short, performing all kinds of hygienic labor. A little over a year ago all kinds of mosquitoes, including the two fatal species, were numerous about the Culebra cut. In this cut during last October every room of every house was carefully examined, and only two mosquitoes, neither of them of the two fatal species, were found. Unfaltering energy in inspection and in disinfecting and in the work of draining and of clearing brush are responsible for the change. I append Dr. Gorgas's report on the health conditions; also a letter from Surgeon General Rixey to Dr. Gorgas. The Surgeon General reported to me that the hygienic conditions on the isthmus were about as good as, for instance, those in the Norfolk Navy Yard.

Corozal, some four miles from La Boca, was formerly one of the most unsanitary places on the isthmus, probably the most un

Dr.

sanitary. There was a marsh with a pond in the middle. Gorgas had both the marsh and pond drained and the brush cleared off, so that now, when I went over the ground, it appeared like a smooth meadow, intersected by drainage ditches. The breeding places and sheltering spots of the dangerous mosquitoes had been completely destroyed. The result is that Corozal for the last six months (like La Boca, which formerly also had a very unsanitary record), shows one of the best sick rates in the zone, having less than 1 per cent. a week admitted to the hospital. At Corozal there is a big hotel filled with employes of the Isthmian Canal Commission, some of them with their wives and families. Yet this healthy and attractive spot was stigmatised as a "hog wallow" by one of the least scrupulous and most foolish of the professional scandal mongers who from time to time have written about the commission's work.

CORRESPONDENCE.

Professor Herbert E. Smith, Dean of the Faculty of Medicine of Yale University, States the Requirements for Admission to the Yale Medical School, beginning September, 1909. He thinks Two Years of Collegiate Work an Adequate Preparation for Professional Study.

EDITOR BUFFALO MEDICAL JOURNAL.

SIR: Believing that you are interested in every effort to improve the grade of students entering our medical schools, I am sending you a statement of the requirements for admission to the Yale Medical School which have just been announced by the corporation of Yale University as applying to the ninety-seventh annual session beginning in September, 1909.

The essential points of the requirements are that the minimum entrance qualification will be two years' work of college grade, and that the preparation must include inorganic chemistry, physics and general biology. In view of the fact that a student in Yale College may by a proper choice of subjects secure both the B.A. and M.D. in six years, the effect of these regulations will be doubtless that the great majority of those receiving the degree of M.D. at this University will receive it as a second degree. We expect this to be the case, and we hope that many will pursue more than the minimum of two years of college work. We believe, however, that the preparation involved in the college entrance requirements, and two years of collegiate work is an adequate preparation for professional study, and we do not think it desirable to make it impossible for a student to proceed to the degree with this minimum requirement in case, for any reason, he elects to do so.

The requirements as they will apply to college graduates, and to non-graduates are as follows:

I. Candidates who have received degrees in arts or science from approved universities or colleges, will be admitted on presenting their diplomas or other satisfactory testimonials.

II. Other candidates must present evidence that they have complied with the entrance requirements of some collegiate institution of good standing, or have passed equivalent examinations before some recognized examination board such as the College Entrance Examination Board. They must also present evidence that they have performed, with credit, the equivalent of at least two full years of work of collegiate grade of fifteen hours per week. Such evidence may be furnished by certificate from an institution of good standing. Candidates who have not attended institutions able to give this certificate but who have otherwise fitted themselves for the study of medicine by work of corresponding grade, may qualify by examination in this University on payment of a fee of $10.00.

All candidates for admission must furnish evidence that they have a satisfactory preparation in physics, general inorganic chemistry, and general biology.

HERBERT E. SMITH,

Dean of the Faculty of Medicine.

YALE UNIVERSITY, MEDICAL DEPARTMENT,

NEW HAVEN, DECEMBER 1, 1906.

PRURITUS ANI.-T. Chittenden Hill says that by far the most

important causes of pruritus ani are superficial ulcerations or abrasions of the anal canal. This lesion is very constant and should always be looked for. The writer then discusses various other conditions associated frequently with this affection, among which are catarrhal diseases, hemorrhoids, and polyps. Appropriate treatment must be applied to the unnatural skin before much amelioration of the itching can be expected. After defecation the patient should cleanse thoroughly the anal region, preferably with absorbent cotton which has been wrung dry of some antiseptic solution. An anal pad held in place by a T bandage will protect the parts from friction and irritation of the discharge. Nitrate of silver and citrine ointment are excellent applications in most cases. For delicate skins the following ointment may be substituted for the citrine: red oxide of mercury three drachms, Venice turpentine one ounce, lanolin three ounces.-Medical Record, December 22, 1906.

BUFFALO MEDICAL JOURNAL.

A Monthly Review of Medicine and Surgery.

EDITOR:

WILLIAM WARREN POTTER, M. D.

All communications, whether of a literary or business nature, books for review and exchanges, should be addressed to the editor 284 FRANKLIN ST., BUFFALO, N. Y.

VOL. LXII.

JANUARY, 1907.

No. 6

SE

Improved Municipal Sanitation.

EVERAL questions formerly irrelevant to the problems of municipal sanitation are now becoming paramount. Great progress has been made in the control of communicable and preventable diseases and the annual death rate has been greatly reduced through the efficiency of the health officers in this respect, not only in Buffalo but also in many other large cities.

Else

The time seems to be appropriate to take up collateral questions relating to the health and comfort of our citizens. where, in this issue, we publish an important communication from Dr. Dewitt C. Greene, entitled, "The Air we Breathe," which deals intelligently with the smoke nuisance.—an ever increasing detriment to the health and comfort of this community. In New York it is unlawful to burn soft coal in factories, hotels, homes or apartment houses, and Dr. Darlington, the health commissioner, has instituted prosecutions with determined vigor against violators of the law and has obtained in each case a conviction that has served to prevent further infraction. It would be well if the health commissioner of Buffalo were given similar powers.

Another important factor causing distress and perhaps danger to the sick, which seems timely for the health department to deal with is the unnecessary noises incident to the traffic and pleasure of large cities. This problem has already been handled successfully in many cities but as yet Buffalo has not outgrown its swaddling clothes in this respect and perhaps in some others; at all events, it behaves very much like an overgrown village with reference to many problems relating to the preservation of health, and the prevention of disease, as well as those relating to the increase of its business facilities.

In New York, again, we find an example worth heeding. A crusade has been organised by a new society for the suppression of unnecessary noises, led by Mrs. Isaac L. Rice. This philanthropic, high minded and progressive woman already has successfully conducted a crusade against whistling tugs in the harbor. The hideous whistles have been put out of commission. In a recent interview Mrs. Rice outlined her plans and hopes, indicating that she has begun a long-needed crusade against the noises which make life a hideous bedlam for those confined in

the hospitals and public institutions. She said in part:

I have long felt that there has been an urgent need for such a society, but as nobody else appeared willing to take the initiative in the matter I have finally had to do so myself. The noise question grows more important every year in this city, and it has become more aggravated of late than some people imagine. It is an evil which in most cases is entirely unnecessary and therefore the more objectionable. This is not an anti-noise society, but is only against unnecessary noises.

One of the things that the new society will ask the city administration's aid in, will be the detailing of a policeman on each hospital beat to prevent the various unpleasant sounds that are at present made by the small boys of the surrounding neighborhood. One of their customs is to get on their little gocarts at the top of a street on a certain hospital block, then ride down close to the fence and scrape a stick along the railing, producing an ear splitting noise which is especially annoying to the sick.

As an instance of how it would be possible to quell the various needless noises about the hospitals, Mrs. Rice mentioned the fact that St. Vincent's Hospital, in Seventh avenue, between 11th and 12th streets, which had been erected before he tracks of the street railway were laid in that avenue, had entered into an agreement with the railway authorities at that time never to ring their bells when passing the institution. rule has been rigidly adhered to.

This

The milk wagon nuisance was touched on by Mrs. Rice. "Our society will endeavor to have an ordinance passed which will make it compulsory for all business vehicles, such as milk and bakers' wagons, which have to be on the streets before the hour of 6 in the morning, to be equipped with rubber tires, and to fix the milk cans in such a manner that the noise created by the shaking of the wagon will be done away with," said Mrs. Rice. "I for one will refuse to trade with a dealer who does not comply with this rule."

Factory whistles and sirens on river craft on the North and East rivers will also be made objects of crusade.

There is no possible argument that can logically prevail against the proposition that unnecessary noises prolong ill health,