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ASPIRIN SENSITIVITY
1327 This
ejector
nothing, being made entirely from normally consigned to the wastetherefore be replaced instead of being
costs
materials which
are
bin ; and it may
This device may also be used to obtain from vesicles in suspected cases of smallpox. specimens F. BENTHAM Health Public Department,
sterilised.
Medical Officer of Health. Kettering. ASPIRIN SENSITIVITY
SIR,-In your annotation of April 21, you remark that " the dangers of aspirin sensitivity should always be considered when prescribing aspirin for asthmatics and allergic subjects." In this connection I should like to point out that aspirin seems to be a potent drug in checking mild attacks of asthma. During my last 12 years of practice I have used it, alone or with ephedrine, with very good results, to check attacks of asthma, and I have not met any case of aspirin sensitivity." On the contrary, when patients become resistant to ephedrine, necessitating higher doses, the same dose is effective when combined with aspirin. Nocturnal attacks of bronchial asthma may be checked by a dose of aspirin, phenacetin, and caffeine at bed-time ; and this drug can be conveniently taken by patients with high blood-pressure. "
Pandu, Assam,
S. B. DAS GUPTA.
India.
THE WRONG WAY
SIR,—In your leading article last week you
comment
misguided " project to found a new for voluntary hospital Kingston and Malden. Your objections are those which many of us would have
on
our " brave but
advanced in 1948, when the National Health Service was inaugurated and hopes were high. They are not so valid today. In 1948 our area, which like so many others is short of hospital beds, possessed, in addition to the facilities of the Kingston County Hospital, the very excellent 44-bed Victoria Hospital staffed by the local practitioners and a team of consultants who held regular outpatient clinics and operating sessions in collaboration with the local doctors. The hospital was an absolute model of its kind : it worked happily and efficiently for the first three years as part of the National Health Service, and we felt it might well serve as a pattern for the establishment of similar institutions in areas which do not at present have them. There is no need to recapitulate the circumstances of the destruction of all this, under the pretext that the neighbouring large hospital needed our buildings for an additional wing. Nor need I detail our long and patient attempts to negotiate and our unusually stubborn resistance, which did at least serve to draw public attention to the problem, and which prolonged the life and work of the hospital for six months after it was first instructed to close. You reproach us, Sir, for reverting to " the discarded method of charitable support " and suggest that we " seek to remedy defects through the boards and committees within the service." We agree that to finance a hospital by private charity ought not to be necessary in these days, but unfortunately we have found by bitter experience that, in fact, it is. Kingston and Malden have lost their local hospital. The group has lost 44 general beds when general beds are severely short. We believe that the existence of the hospital is a vital link in the health services of the district, and, as plainly there is no hope of its adequate replacement or return under the National Health Service, we are
forced to turn to private charity as the only remedy. As for " boards and committees within the service we have discovered to our cost the futility of appeal to snch. The regional board has power, but is not inclined to take advice. The various committees within the service have no power to do anything but advise, and are pathetically impotent in practice.
We believe that by fighting to the last ditch for our as we have done, and by replacing it as a last resort from outside the service as we are doing, we are rendering a signal service, both to the people of Kingston and Malden, who need the beds we shall provide, and to the people of Britain and the medical profession, whose standards of medicine we shall help to maintain. F. B. LAKE c/o Barclays Bank, Chairman, Kingston and Malden
hospital
Kingston Hill, Surrey.
SIR,—I
Victoria Medical Foundation.
sorry to read your leading article last week the effort of the Kingston general practitioners to start a voluntary hospital outside the N.H.S. If the State hospital service cannot, or will not, provide the type of attention desired by the people, surely it is praiseworthy to try to meet the need by means of was
condemning
voluntary effort ? The Minister of Health himself has paid lip service to the need for preserving G.P. hospitals, and has lately stressed the need for the resurrection of voluntary aid, and the stimulation of local pride in local hospitals. Here is the chance to do both things, and it will be interesting to see if the Kingston G.P.s, by their gallant efforts, succeed in producing a more efficiently run hospital, that may serve as an example and a stimulus to the State-owned hospitals in this country. It is interesting to reflect that in Sweden and Norway, which have had State hospital services for some time, the establishment of privately owned and voluntary hospitals has been stimulated, and appears to be on the increase. Wolverhampton.
VICTOR RUSSELL.
SIR,—Your leading article last week, referring to the effort of the medical staff of the old Kingston Victoria Hospital to found a new general-practitioner hospital, is not only misleading, but unjust and unworthy of your columns. You say that in Kingston the practitioner can, if he wishes, have contact with hospitals, have hospital beds of his own, have access to diagnostic departments and some say on advisory committees. In the Kingston area 150 doctors have been offered 26 beds and cots between them in a hospital which was discarded as a cottage hospital nearly fifteen years ago : it has no diagnostic X-ray department (a portable set is all that has been provided), it has no consultant staff, the operating-theatre can only undertake minor operations and the representatives of the Victoria Hospital have been displaced from the local management committee, so how can they " seek to remedy defects through the boards and committees within the service." The general practitioners in Kingston are fighting for a principle and have raised a banner under which a large number of general practitioners and consultants in the country will fight : your article suggests that you are satisfied with the present National Health Service -if this is so then it shows how little you know of the views of the profession. E. C. WARNER. London, W.l.
* * As we said last week, we have a great deal of sympathy for displaced general practitioners, but we do not feel that those at Kingston have found the right solution to their difficulties. Nor do we feel that they are quite as forlorn as Dr. Warner suggests ; for we are informed that in the Kingston area general practitioners have direct access to Kingston Hospital and the Royal Hospital, Richmond, for pathological investigations, and to Surbiton General Hospital, Thames Ditton Hospital, and Molesey Hospital for radiological examinations. Practitioners formerly on the staff of Kingston Victoria Hospital have also been asked whether they would care to undertake a clinical assistantship in one of the
larger hospitals.-ED.L.
ejector
nothing, being made entirely from normally consigned to the wastetherefore be replaced instead of being
costs
materials which
are
bin ; and it may
This device may also be used to obtain from vesicles in suspected cases of smallpox. specimens F. BENTHAM Health Public Department,
sterilised.
Medical Officer of Health. Kettering. ASPIRIN SENSITIVITY
SIR,-In your annotation of April 21, you remark that " the dangers of aspirin sensitivity should always be considered when prescribing aspirin for asthmatics and allergic subjects." In this connection I should like to point out that aspirin seems to be a potent drug in checking mild attacks of asthma. During my last 12 years of practice I have used it, alone or with ephedrine, with very good results, to check attacks of asthma, and I have not met any case of aspirin sensitivity." On the contrary, when patients become resistant to ephedrine, necessitating higher doses, the same dose is effective when combined with aspirin. Nocturnal attacks of bronchial asthma may be checked by a dose of aspirin, phenacetin, and caffeine at bed-time ; and this drug can be conveniently taken by patients with high blood-pressure. "
Pandu, Assam,
S. B. DAS GUPTA.
India.
THE WRONG WAY
SIR,—In your leading article last week you
comment
misguided " project to found a new for voluntary hospital Kingston and Malden. Your objections are those which many of us would have
on
our " brave but
advanced in 1948, when the National Health Service was inaugurated and hopes were high. They are not so valid today. In 1948 our area, which like so many others is short of hospital beds, possessed, in addition to the facilities of the Kingston County Hospital, the very excellent 44-bed Victoria Hospital staffed by the local practitioners and a team of consultants who held regular outpatient clinics and operating sessions in collaboration with the local doctors. The hospital was an absolute model of its kind : it worked happily and efficiently for the first three years as part of the National Health Service, and we felt it might well serve as a pattern for the establishment of similar institutions in areas which do not at present have them. There is no need to recapitulate the circumstances of the destruction of all this, under the pretext that the neighbouring large hospital needed our buildings for an additional wing. Nor need I detail our long and patient attempts to negotiate and our unusually stubborn resistance, which did at least serve to draw public attention to the problem, and which prolonged the life and work of the hospital for six months after it was first instructed to close. You reproach us, Sir, for reverting to " the discarded method of charitable support " and suggest that we " seek to remedy defects through the boards and committees within the service." We agree that to finance a hospital by private charity ought not to be necessary in these days, but unfortunately we have found by bitter experience that, in fact, it is. Kingston and Malden have lost their local hospital. The group has lost 44 general beds when general beds are severely short. We believe that the existence of the hospital is a vital link in the health services of the district, and, as plainly there is no hope of its adequate replacement or return under the National Health Service, we are
forced to turn to private charity as the only remedy. As for " boards and committees within the service we have discovered to our cost the futility of appeal to snch. The regional board has power, but is not inclined to take advice. The various committees within the service have no power to do anything but advise, and are pathetically impotent in practice.
We believe that by fighting to the last ditch for our as we have done, and by replacing it as a last resort from outside the service as we are doing, we are rendering a signal service, both to the people of Kingston and Malden, who need the beds we shall provide, and to the people of Britain and the medical profession, whose standards of medicine we shall help to maintain. F. B. LAKE c/o Barclays Bank, Chairman, Kingston and Malden
hospital
Kingston Hill, Surrey.
SIR,—I
Victoria Medical Foundation.
sorry to read your leading article last week the effort of the Kingston general practitioners to start a voluntary hospital outside the N.H.S. If the State hospital service cannot, or will not, provide the type of attention desired by the people, surely it is praiseworthy to try to meet the need by means of was
condemning
voluntary effort ? The Minister of Health himself has paid lip service to the need for preserving G.P. hospitals, and has lately stressed the need for the resurrection of voluntary aid, and the stimulation of local pride in local hospitals. Here is the chance to do both things, and it will be interesting to see if the Kingston G.P.s, by their gallant efforts, succeed in producing a more efficiently run hospital, that may serve as an example and a stimulus to the State-owned hospitals in this country. It is interesting to reflect that in Sweden and Norway, which have had State hospital services for some time, the establishment of privately owned and voluntary hospitals has been stimulated, and appears to be on the increase. Wolverhampton.
VICTOR RUSSELL.
SIR,—Your leading article last week, referring to the effort of the medical staff of the old Kingston Victoria Hospital to found a new general-practitioner hospital, is not only misleading, but unjust and unworthy of your columns. You say that in Kingston the practitioner can, if he wishes, have contact with hospitals, have hospital beds of his own, have access to diagnostic departments and some say on advisory committees. In the Kingston area 150 doctors have been offered 26 beds and cots between them in a hospital which was discarded as a cottage hospital nearly fifteen years ago : it has no diagnostic X-ray department (a portable set is all that has been provided), it has no consultant staff, the operating-theatre can only undertake minor operations and the representatives of the Victoria Hospital have been displaced from the local management committee, so how can they " seek to remedy defects through the boards and committees within the service." The general practitioners in Kingston are fighting for a principle and have raised a banner under which a large number of general practitioners and consultants in the country will fight : your article suggests that you are satisfied with the present National Health Service -if this is so then it shows how little you know of the views of the profession. E. C. WARNER. London, W.l.
* * As we said last week, we have a great deal of sympathy for displaced general practitioners, but we do not feel that those at Kingston have found the right solution to their difficulties. Nor do we feel that they are quite as forlorn as Dr. Warner suggests ; for we are informed that in the Kingston area general practitioners have direct access to Kingston Hospital and the Royal Hospital, Richmond, for pathological investigations, and to Surbiton General Hospital, Thames Ditton Hospital, and Molesey Hospital for radiological examinations. Practitioners formerly on the staff of Kingston Victoria Hospital have also been asked whether they would care to undertake a clinical assistantship in one of the
larger hospitals.-ED.L.