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middle ages.

OST readers are familiar with the regions of country. The waters sub

horrors of the plague epidemics sided only to leave the moist, muddy that overspread Europe during the land covered with all kinds of dead

One of these outbreaks animals and decaying vegetation. The is of special interest, as the one so stench and famine gave rise to an epigraphically described by Defoe. The demic of unusual malignancy. This death-rate in these epidemics was very spread westward, and finally overran high. Indeed, it has been known to Europe, destroying more than half the reach the fearful proportions of over population in many districts. ninety per cent of those seized by the This disease follows closely upon disease.

famine, and the neglect of sanitary At Naples, in 1556, as many as 5,000 laws. Large numbers of persons are died daily ; and there were not more huddled together in their filthy dwellthan 50,000 left out of a population of ings. They are compelled to gather 290,000. In 1627, the physician Ales- their grain before it is ripe. It besandro describes the Milan epidemic. comes musty and unhealthy. Fear Under the government of Gonsalva de adds to the ravages of the disease, the Cordova there was great poverty. terrors of superstition. When the Wars had devasted Lombardy for plague is in its earliest stage, timely about a century, and the food of the intervention, so as to avoid overcrowdpeople was reduced to rice and water. ing, filthy conditions of the people and The rice bread became vile through to supply sufficient food, readily conadulterations. The poor became so trols the disease. But when it has benumerous that the authorities lodged come widespread, and large numbers nearly 10,000 persons in a large lazar- of the populace are panic-stricken, it eth. The season was very hot, and is by no means an easy task to stay its symptoms of the plague soon showed progress. With vigourous sanitary itself. The latest great epidemic of and quarantine regulations there is not malignant plague was at Marseilles, in much danger to Europe or the western 1720. The disease has frequently, dur- countries. ing the present century, visited differ- The population of the famine-stricken ent portions of Europe, the latest being regions in India is given at some 90,the Astrakhan, 1878.

000,000. The average annual earnings The fearful visitation known as the of the native labourer is about seven black death was similar to the present shillings, or $1.75. It is easy to see Bombay plague. The black death what must be the fate of such people seems to have started in China after an when overtaken both by famine and earthquake and an inundation of vast disease. The former produces misery 5

(525)

and apathy, while the plague feeds results. He first inoculated rats, and upon these creatures of famine.

then horses ; he then tried the antitoxThe researches of Kitasato, Yersin, ine in a French mission station at Lowson and Aoyama have shown that Amoy. Some who were already comathere is little doubt but that the disease tose when the injections were given, is of germ or bacillary nature. These recovered. He is now in India, where germs have been isolated from those ill the Government intend trying the treatwith the plague, and cultures made. ment in Bombay. These cultures have produced the dis The duty of the British Government ease in animals, especially rats, which is a very delicate one to discharge. It are amenable to the plague infection. is hard to prohibit the Meccan pilgrimThis is certainly a great step in the sci age. This is a religious custom of a entific investigation of the disease, and large number of the inhabitants of will throw much light on its modes of India. On the other hand, the western spread.

countries ought to be protected against Europeans and clean, well-fed natives fearful a scourge as far as it is posare but little susceptible to the infection. sible. While it seems impossible to inIn such cases, prolonged contact is terfere with the religious customs of the often required to produce the disease ; Mohammedans, it might be possible to nurses who are handling the sick, and establish a thorough police, sanitary carrying in their arms afflicted children, and commissariat camp to look after sometimes escaping, or only becoming the pilgrims, both by land and sea. ill after long exposure.

None of the All suspected cases could be taken Chinese students of medicine contract charge of and isolated. The pilgrims ed the disease, although on constant could also be prevented from remainduty for six weeks in the plague hos- ing over and visiting the bazaars. No pital.

pilgrim should be allowed to embark There appear to be two forms of without inspection; and all the pilgrim the disease now prevailing in the East. ships should be under the control of Dr. Cantlie, who has had great oppor competent sanitary experts. tunities of observation, divides plague With our present knowledge of sanicases into two classes-one a very ma tation and the spread of this disease, lignant form and the other a milder there need be little fear of its spread in type. The malignant form is charac the civilized world. The death-rate terized by sudden invasion, chills, great also is much lower among the Europrostration, glandular swellings, high peans. In the present Bombay epifever, weak pulse, vomiting and many

demic it is about eighteen or twenty other severe symptoms. The milder per cent. of those attacked. form, or pestis minor, is not so severe There is in this affliction in India a and comes on more slowly. It may wide field for governmental and private change into the malignant form. This philanthropy. Some 40,000,000 are in is one of the causes of the spread of a state of total want; whereas 50,the disease. These mild, or ambula 000,000 more are in a state of insuffitory, cases may journey to great dis cient and dear food, short of total tance before they become ill. Gener- deprivation.

deprivation. It is estimated to cost ally speaking, the plague spreads the Indian exchequer about $30,000,slowly. It took ten months to spread 000 to afford a mere subsistence to the from Hong Kong to Malao, a distance starving millions. But there must still of thirty miles.

be much left for private benevolence. Dr. Yersin claims to have obtained It is to be hoped that this will not be an antitoxine that has yielded excellent found wanting.

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This sys

IN
N August last I read a paper on “The may be thought of its importance from

Reorganization of the Militia Medi- a military point of view. cal Service” before the members of the “Medical, any more than military, Canadian Medical Association at Mon- organization cannot be evolved in a treal, and pointed out that Canada's perfect state at short notice, when sudMilitia Reserve of 250,000 men would, denly required.” Witness the Northit brought into actual warfare, be un- west campaign! provided with a proper Medical Ser- I will now formulate broadly the vice. The system of medical organi- lines upon which I consider reorganization in Canada is the old “Regi- zation should proceed-after due conmental System,"that is, every regiment sideration of the various systems I takes care of its own sick.

have studied, and due consultation tem was abolished in England in 1873, with those capable of giving advice in but in all its antiquated and discredited these matters, foremost amongst whom features is still retained in Canada. I will name our late P. M. O. in Hali

From the report which I have seen, fax, Surgeon-General Major O'Dwyer, the Militia Department does not dis- lately transferred to England on wellpute the necessity for bearer companies earned promotion, a practical expert on nor medical organization, but it points military organization. out that I have not submitted a definite I should take the present British scheme, and, even if I had done so, it Army Medical Corps system with some would be open to the authorities to ex- modifications adapted to our conditions, plain that as there is at present no or- social, political and financial, as the ganization to enable Canada to place basis of our Canadian Militia Medical or maintain bodies of troops in the service. As the details of constitution, field, it would be premature to organize condition, duties and expenses conmedical arrangements for them. nected therewith, are to be found in the

From this it would appear that with- Queen's regulations, or could be obout such organization the Canadian tained from the Imperial authorities, Militia is useless as a fighting machine, there need be no delay in deciding the and as it is impossible that under pre- question, once it is granted that resent circumstances this state of things organization is desirable. will be allowed to continue, I would Once the government of Canada, as suggest that the military and medical represented by the Minister of Militia reorganization be carried out simul- and Defence, acknowledges the need of taneously, as the perfection of both reorganization of the Medical Departwould be required at the same time, ment, it will be desirable to bring toand the medical certainly appeals very gether a representative of the Canadian forcibly to public sentiment, whatever Militia acquainted with the strength,

organization and distribution of that as fewer officers in the active list would force, and a medical officer of experi be required. ence to discuss the matter.

I would, however, propose in addiThey would have no difficulty in pro tion, that a general Canadian medical viding a scheme for consideration. staff should be formed by volunteers.

A medical officer should remain as They should be an independent body, at present, attached to each military under a medical head (director-general unit.

or surgeon-general) attached to the On active service in the British Army headquarters of the Canadian army, a medical officer is attached to each who would advise and deal with medimilitary unit, but only temporarily; cal affairs, under the orders of the and this is the only provision made for

G.O.C. of the force. He should be a regimental surgical assistance..."first paid and permanent official holding ofaid.” It is a moot question with con

fice for five or seven years. tinental military authorities whether In the new staff or department, this simple regimental arrangeinent rank, titles, terms of service for prowill continue to prevail. In time of motion, etc., should be on the lines of peace in the British service there is no the army medical staff, which, howprovision for a regimental medical ser ever, may be shortly modified by a vice, though trivial cases of illness in new warrant. As I have already sugbarracks are seen to by a medical offi- gested, the present medical officers cer of the military station, and these should remain with their regiments. treated if they are not considered suf It might further popularize the change ficiently serious to be sent to hospital. if medical officers entering the general One proviso should be an integral part service were allowed in ordinary times of any scheme propounded-to meet to be attached to particular regiments, the views of our military aspirants--- with the understanding that they would that is, that the present medical officers be liable to be detached for duty elseshould (if they desire it) be allowed to where--wherever most needed in factremain attached to their respective should the occasion arise. They would

is a question for consider be dealt with by the Government, not ation whether further medical appoint as an integral part of the regiment, ments should not be to the department but as part of a special body tempor(when organized), and not to any spe- arily attached. In time, this scheme

The officers appointed should insure in the service officers of might be gazetted to a general medical different grades. staff, and then be attached to special The number and rank of medical ofregiments when required.

ficers would depend on the number of In fact, I consider it desirable, in the base field hospitals and bearer comcase particularly of juniors coming into panies it was intended to establish. In the service, that they should have an time of active service the reserve list opportunity of studying regimental list of medical officers would be largely life, and of mixing freely with the offi

drawn upon.

In time of peace the cers and men with whom they will have establishment need only be small. to deal.

With regard to bearer companies, When two medical officers belong to which the department thinks desirable, the same corps, as we see now in cer -except in Halifax, where we desire tain of our brigades of artillery and one most and are prepared to aid in battalions of infantry, the senior, by equipping it ourselves—I would propose preference, might be transferred to the that a bearer company and field hosgeneral staff-or, if he so desire it, to pital, with their stores and equipment, the reserve list of medical officers. should be established at the headquart

So far the Government need incur ers of each brigade, presuming that for no expense ; on the contrary, there fighting purposes the Canadian militia would be a distinct saving of money, will be divided into brigades with their

corps; but

cial corps.

headquarters in some special locality- Medical Staff Corps,” “The Field Army Halifax, Montreal, Toronto, London, Establishment," ** The Equipment Reetc., amongst others; but this is a gulations," and the “Store Tables" of matter for future consideration. How the Imperial army. ever, we hope a half bearer company The rank and file of the general medimay be granted to Halifax, where Sur cal service for employment in bearer geon-Major Lees-Hall, of the army companies and field hospitals might medical staff, and Surgeon-Lieut. Car be either specially enlisted or be obleton Jones, of the Garrison Artillery, tained from the various regiments. In have kindly volunteered their services Halifax our C.O.'s of artillery and inas instructors. Both have had exten fantry have generously offered to prosive experience in this line in connec vide the men required to form a half tion with the Army Medical Staff Corps bearer company between them, ten or the St. John's Ambulance Associa

from each corps. tion, in which both are zealous work For many reasons it would be preferers.

able to obtain men—easily got in such Opportunity should be given militia districts where medical schools existmedical officers for special study and by special voluntary enlistment into the training, and inducements might be hospital corps; but the latter system is held out to them as regards promotion, cheaper and is that employed now in etc., for doing so. Courses of teach- England amongst volunteer regiments, ing and training might be established,

where men

are obtained by transfer either in connection with the present from regiments of the brigade to which scheme of instruction or in connection the bearer company is attached. with some of the leading schools of In England no base or field hospitals medicine throughout the country. are required by the volunteer forces. course of military surgery and hygiene These establishments would be supin each medical school might be given plied in time of emergency by the army yearly as a voluntary part of the course, medical staff. In this country on actattendance upon which might be made ive service we should require them, and obligatory upon a surgeon asking ap- require them, perhaps, when we least pointment to the militia medical ser expect to be called upon; and where, I vice. There should also be an exam would like to ask you, will we find ination in these subjects. In England, them? when medical officers of volunteer regi I will only repeat again the words of ments pass the prescribed examination, my friend Surgeon - Major General an additional capitation grant is given O'Dwyer: “Medical any more than

military organization cannot be evolvI do not propose to enter into the ed in a perfect state at short notice, personnel or equipment for field hospi- when suddenly required.” Or is the tals and bearer companies; all informa next campaign to find us as unprepartion required is to be found in “The ed as the last? Regulations for Army Medical Service (1896)," "The Standing Orders for the

II. Tobin, D'y Surg. Genl.

their corps.

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