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crowding in tenements. The mortality in those districts was ahnost fifty per cent, higher than in private dwell- ings. There was not sufficient air-space for the number of people in the apartments, the plumbing was defective, the people were dirty and ignorant ; they did not realize their danger from infection, and if they did they knew not how to prevent it. Those who were erecting these large tenements cared only for money; they cared not if the people did die, if only the rent was paid. Dr. Janf.way made a few closing remarks. He said that in Berlin the owner of a lot was not allowed to erect a building which covered more than two-thirds of the ground area. The Necessity of Perfect Vision in Cheap Lotrel the Education of the Young. — Dr. Frank Van Fleet read the paper. He though: it was admitted that asthenopia existed only among men, lower animals being free from it, and Discount Lotrel that it was more common among civilized than uncivilized people. The paper was intended to impress upon general practitioners the necessity for correcting weak or imper- fect sight wherever it was possible to do so by glasses. Several cases were related in which neglect to Order Lotrel do this had threatened the future prospects of the subjects, who had found that, for some unknown reason, they were unable to continue their studies, had been considered dull or lazy, and suffered the displeasure of parent and teachers. More than one had said, on receiving glasses, that a new world had been opened to view. Lotrel Mg The paper was Buy Lotrel Online discussed by Drs. Hepburn, Cocks, and Bates. Dr. Hepburn said that horses sometimes suffered from imperfect vision, as he had once proven by experi- ments. Those accustomed to " shy " almost constantly and without apparent reason, had ceased to do so when fitted with glasses. Dr. Anderson presented a small surgical cabinet, in- tended ever to be ready for transporting surgical instru- ments, antiseptic fluids, etc., to the Lotrel Coupon patient's house. AMERICAN PUBLIC HEALTH ASSOCIATION IN CONJUNCTION WITH THE INTERNA- TIONAL CONGRESS OF PUBLIC HEALTH. Tjsjenty first Annual Meeting, Held in Chicago, III., Octo- ber 10, II, 12, ij, and 14, i8gj. First Day, Tuesday, Octoher ioth — Morning Ses- sion. The Congress convened in Hall 7 of the Memorial Art Palace, and was called to order by the President of the World's Congress Auxiliary, the Hon. Charles C. Bon- ney, of Chicago, at 10.30 a.m. Prayer was offered Lotrel 510 by the Rev. Dr. Parsons, after which addresses were delivered by Hon. C. C. Bonney, Mrs. Charles Henrotin, Dr. A. R. Reynolds, Commis- sioner of Health of Chicago, representing the Mayor, Dr. E. Liceaga, of Mexico, and Dr. Sarah H. Stevenson, of Chicago. President's Address. — Mr. Bonney then introduced Dr. S. H. Duruin, of Boston, President of the Ameri- can Public Health Association, as President of the Con- gress, who replied briefly to the several addresses, after which he delivered his Inaugural Address. He dealt with matters pertaining generally to the public health. He said the great trust which the Association took upon it- self twenty one years ago has been worthily held, and the work to which it has addressed itself in the interest of humanity has been diligently pursued. It is fitting, per- haps, at this time, when we may be said to have attained our majority in years, to take a retrospective glance of public sanitation, and to note the possible results of its application in the relief of human distress. The work of the sanitarian is manifold, and deals with the most vital of our personal and social interests. It deals with the air we breathe, the food we eat, the water we drink, and with the general welfare of mankind. It means the inves- tigation of the rise, progress, and Lotrel Price decline Lotrel Coupons of epidemics. and a fostering growth of works and projects designed to prevent and remove the causes of disease. The sanitarian concerns himselfbut little with the cure of disease. The problem which he seeks to solve is how disease can be averted. The pathologist establishes the nature of morbid processes, Lotrel 5 and his investigations sug- gest to us the appropriate remedy. The aim of the sani- tarian is to seek out and remove the cause or causes which produced these processes. It has been said that preven- tive medicine embraces everything which relates to the physical well-being of our fellow-men, so that it has Purchase Lotrel to deal with all physical evils and, incidentally, many of a moral character. Its object is the health, and therefore the happiness and prosperity, of man. In Lotrel 20 Mg the city of Boston our private drainage, like that in most cities, is unsatisfactory, and the cause of an immense amount of inspection, complaint, and annoyance, and un- doubtedly the cause of much ill health. We have statute laws Lotrel Cost and city ordinances which specify the method, mate- rial, and workmanship necessary for the construction of house drainage. Lotrel 10 20 Plans for construction and repairs are submitted to, and the work approved by, the inspector of buildings. The Board of Health is called upon to find defects and to order repairs, and such repairs each year number about four thousand five hundred. For the purpose of ascertaining to what extent defective conditions of plumbing exist, and to what extent traps are supplied, and water-closets substituted for privy vaults, we have taken a large number of blocks of dwellings, both new and old, each season for thirteen years, and made house- to-house inspection. It is a common thing to find on death certificates, in- stead of the morbid process which caused death, such in- definite information Lotrel Online as " disease of bowels," " disease of brain," "disease of skin," "stomach disease," "asci-' tes," "convulsions," "dropsy," "fever," "debility," " teething," "inflammation," "infantile," " heart fail- ure," and other unlikely causes too numerous to men- tion, and which ought never to be used upon the records as causes of death. In his own city, such certificates are rejected, and a competent physician sent to view the re- mains, and consult the family or friends of the deceased for information, with which to make a proper certificatf. It is to be noted, however, that information gathertd in this way cannot be regarded as wholly trustworth) , and often results in the statement of " unknown cause of death." The mention of cholera, like that of smallpox, strikes terror to the people of this country, and while the deaths from these diseases are infinitely small, the fear of them has served the municipal health officers in securing al- most unlimited facilities for their prevention and control, which means may be largely converted to the care of other more common and destructive contagious diseases. Consumption, the most destructive malady to the hu- man race in our country, has received the necessary at tention of the bacteriologist. He has demonstrated to us, satisfactorily, the cause of the disease, the methods ot its transmission, and the means for its prevention. He is sorry to say that, as practical workers in public sanita- tion, we have sadly neglected to apply the means which we believe would prove effectual in largely abating the prevalence of tuberculosis. The isolation of all persons suffering from consumption would be impracticable and perhaps unnecessary, but the use of small sputa cups con- taining a disinfectant, at home, and bits of absorbent napkin used and securely concealed in travelling, to be burned or otherwise disinfected on returning, should at least be urged by public health officers, and popularized as much as possible. Lotrel 10 Mg Turning, in conclusion, from the more onerous every- day duties of the municipal health officer to topics of greater popular interest, we find an increasing growth of public sentiment, in all parts of the country, favoring the municipal provision of large public parks, free public baths, small open spaces, and open-air gymnasiums for ■.I. October 28, 1893] MEDICAL RECORD. 567 the enjoyment and sanitary welfare of the masses of peo- ple whose whole time is spent in the toil of our large towns and cities. The General Committee of the World's Congress Aux- iliary on a Public Health Congress, consisted of Dr. John H. Rauch, Chainiian ; Dr. F. W. Reilly, Vice- Chairman ; Dr. F. W. Brewer and Dr. C. N. Hewitt, Joint Secretaries ; Dr. E. Garrott, Lotrel 5 Mg Dr. J. M. Hall, Dr. [ohn B. Hamilton, Dr. Listen H. Montgomery, Dr. S. J. Jones, Dr. A. R. Reynolds, and Dr. B. J. D. Irwin. After some announcements by Dr. Brewer, the Con- gress adjourned until Wednesday morning. Secoxd D.w, Wednesday, October iith — Morning Session. The Congress was called to order at 10 .a.m. by the President. Sanitary and Medical Service on Emigrant Ships. — The first paper read was by Dr. Albert H. Gihon, Medical Director of the United States Navy, with this title. Report of the Committee on Restriction and Preven- tion of Tuberculosis. — This report was read by the Chair- man of the Committee, Dr. J. N. McCiirm.ack, of Bowl- ing Green, Ky. The Committee offered as its report the following conclusions and recommendations : 1 . Tuberculosis has been conclusively demonstrated to be contagious, by bacteriological experiments, by clini- cal observations, and by a study of the history of the dis- ease. 2. Tuberculosis is a preventable disease. Its preven- tability follows as a logical sequence upon its contagious- Buy Lotrel ness, but has likewise been demonstrated in practical life. 3. The contagium of tuberculosis resides entirely and solely in broken-down tubercular tissue. A person suf- fering from tuberculosis, therefore, does not become a source of danger to others until he begins to give off broken-down tubercular tissue, either in the form of sputa from the throat or lungs, diarrhceal discharges from the bowels, or matter from a tuberculous sore such as lupus, white swelling, cold abscess, scrofula, or tubercular Lotrel 10 in- flammation of a joint. 4. A person suffering from tuberculosis can be made entirely harmless to those about him by thorough sterili- zation of all broken-down tissue immediately upon its being given off. With proper precautions, it is therefore possible to live in the closest relation, and upon the most intimate terms, with consumptives without contracting the disease. 5. Tuberculosis is not hereditary. A predisposition to the disease can be transmitted from parent to off- spring, but this is more true of tuberculosis than it is of all other contagious diseases. 6. A predisposition to tuberculosis can be created anew by malnutrition or by anything which depresses the nervous system. 7. Tuberculosis affects animals as well as man, and is identically the same disease in both. In domestic life human beings and animals mutually infect each other.

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