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CHILD MORTALITY AND ALCOHOLISM IN PARIS.
267
DEFERRED DEATH AFTER TRACHE- THE WORKING OF THE NATIONAL INSURANCE ACT IN GREAT YARMOUTH. OTOMY FOR LARYNGEAL DIPHTHERIA. To the Editor vt THE LANCET.
To the Editor of THE LANCET.
SIR,-It is nonsense for Dr. H. Blake, Mr. J. I. SIR,-I must thank Mr. T. Jefferson Faulder for Sankey, and Dr. V. H. Blake, of Yarmouth, to write calling attention in THE LANCET of July 18th to an in THE LANCET of July 18th about " the British apparent inconsistency in my article on the above Medical Association breaking its side of the pledge." subject. The statement in question is that although When Dr. J. R. Ratcliffe, of Birmingham, stated recovery is exceptional once obstruction develops to a degree which makes extraction vital, this
should be postponed until the obstruction becomes immediately dangerous. At first thought it may seem advisable to interfere before the condition is urgent, but clinical experience does not bear this out. It is better to wait, and meanwhile to use steam and the spray, which in themselves
measure
occasionally tide a patient over the critical period. Early extraction, as compared with such treatment, is
no more
certain to avert obstruction and has its
danger. A single extraction in any stage rarely gives permanent relief; forceps have to be used several times as a rule, and it can never be own
last year, at the annual representative meeting at Brighton, that the organisation of the Association had broken down, the chairman of the council very rightly objected to the statement, and said it was. the individual members of the Association who had broken down, and that until they could get members of the Association to be loyal to the organisation nothing could be effected. It is now known that the members of the medical profession cannot be trusted to stand by their words. What can we expect, then, but " trouble trouble," and the saddest part of it all is that many men do not seem to realise what they have I am, Sir, yours faithfully, done. T. CUMING ASKIN.
upon
certain that some irritation and minor traumatic injury to the weakened mucous membrane may not result-conditions which favour a more rapid formation of the plug. Hence I regard extraction as a last THE POSITION OF THE ASSISTANT resource. All that can be claimed for it is that it MEDICAL OFFICERS OF THE will postpone death in many cases, and offers a METROPOLITAN ASYLUMS chance of recovery when a fatal issue is otherwise BOARD. inevitable. Whether any variation of the method would improve the prognosis is an important To the Editor of THE LANCET. question on which limited investigation at Plaistow see from your issue of July 18th that theSIR,-I Hospital throws no light. At best the gain is likely Metropolitan Asylums Board are advertising for to be small, since behind the tracheal obstruction assistant medical officers at a new rate of salary. there is, in the majority of instances, a grave type There has been a good deal of dissatisfaction in of lobular pneumonia. I have no experience of this service for some time past, and lately an the bronchoscope, and cannot foresee its -r6le association of assistant medical officers was formed in this connexion, but as Mr. Faulder has which petitioned the managers for a redress of kindly suggested its use I hope to test -its many grievances, of which the rate of salary was. possibilities in due course. No one. only reply has yet, I understand, been I am, Sir, yours faithfully, received to this petition, and pending such reply JOHN BIERNACKI. the association is precluded from publishing the correspondence. Intending applicants would thereI am sure, be consulting their own interests. fore, THE SCHOOL MEDICAL SERVICE. by finding out from the secretary of the association To the Editor of THE LANCET. (Dr. E. G. Goffe, the North-Eastern Hospital, St. Ann’s-road, Tottenham, N.) what these grievances. still hears the SIR,-One occasionally gibe against school medical officers who are busy forming them- are, and how they have been dealt, with, before: selves into a group for the discussion of their deciding to apply. I am, Sir, yours faithfully, peculiar interests, scientific and sociological (and I JOHN H. TRENCH, M.B. Cantab. daresay it is said of the tuberculosis officers also a who are doing the same thing) that it is only movement of discontented juniors bent on forcing CHILD MORTALITY AND ALCOHOLISM up their own salaries. Now there is no doubt that an increase of salary IN PARIS. has a perennial interest for most of us, but this To the Editor of THE LANCET. does not entirely explain the agitation. The fact is specialised services like the school medical SIR,-May I call attention to the report from service are more and more feeling the need of your Paris correspondent in THE LANCET of being self-contained and self-feeding. We shall July llth of a statement of M. Paul Juillerat and not in future be able to staff the lower ranks with M. A. Filassier, in which they do not hesitate to mere transitional young people on their way toI attribute to alcoholism in the parents this enormous general practice or other departments of the public proportion of children affected with congenital medical service for which, indeed, experience in debility, accounting for 12,342 deaths. This stateschool work very imperfectly fits them. The ideal ment is so contrary to the findings of Professor of the future must be that of a Civil Service, in Karl Pearson, F.R.S., and Miss Ethel M. Elderton which even the lower grades of responsible workers (Galton research scholar)-viz. : " The mean weight must have a living wage, so that if they go no and height of the children of alcoholic parents are higher their lives will not have been a disastrous slightly greater than those of sober parents, but as I am, Sir, yours faithfully, failure. the age of the former children is slightly greater, the correlations when corrected for age are slightly JOHN PRIESTLEY. ,
268 there is slightly greater height and children of the sober. In the case of the father the correlations are not significant, having regard to their probable error; in the case of the mother they may be just significant, but they are so slight as to have no importance."
of fundamental problems connected with insanity and mental deficiency. It was further resolved to inform the Board of Control that the Senate would be pleased to advise them as to the objects towards which investigations thus aided might with most advantage be directed.
study
positive-i.e., weight in the
My practical clinical experience entirely endorses these scientists’ findings. A few years ago I was surprised to find out of a large number of mothers visited in the Hoxton district what strong, welldeveloped infants these mothers had, although I knew that they were addicted to alcohol in excess. This difference between scientists requires more than a passing notice, and I trust that Professor Karl Pearson will reply to M. Juillerat and M. Filassier for the benefit of all impartial medical I am, Sir, yours faithfully, practitioners. THOMAS DUTTON.
UNIVERSITY
OF
CAMBRIDGE.-The
at 3.30 P.M.
MEDICAL MAGISTRATES.-The following Hull practitioners have been made justices of the peace for the city: Dr. Frank Nicholson, senior physician, Hull Royal Infirmary ; Dr. George Gautby, ex-sheriff of Hull ; and Mr. C. H. Milburn.
GLASGOW ROYAL INFIRMARY:
POST-GRADUATE
CLASSEs.-Autumn post-graduate classes in clinical medicine, surgery, and gynascology, and in the various special departments, will be held at the infirmary during the month of September. Full particulars may be obtained from the superintendent, Dr. J. Maxtone Thom.
BRITISH SCIENCE GUILD.-At the last
Medical News. medical
BRISTOL GENERAL HOSPITAL.-The president of the hospital, Mr. George Alfred Wills, will open the new wing and pathological laboratory on Monday next, July 27th,
’,
following
degrees have been conferred :—
M.D.-F. R. Martin. Jtf.C.—W. S. Perrin, Caius. JI.B., B.C.-P. Stocks, King’s ; H. P. Dawson, Trinity; G. Askey, St. John’s ; and T. L. Hardy, Selwyn. H.B.-F. E. W. Rogers, Emmanuel. B.C.-H. Hartridge, King’s; W. B. Gordon, Clare; W. F. B. Smith, Pembroke; J. W. Pigeon, Christ’s; 0. Mackenzie, Emmanuel; and R. A. Thacker, Downing.
UNIVERSITY OF BRISTOL.-At examinations held recently the following candidates were successful :SECOND EXAMINATION FOR THE DEGREES OF M.B., CH.B. Edwin Jennings Ball, Reginald Bertram Britton, Norman Durant, Frederick Viel Jacques, and Ronald Henry Tasker. FINAL EXAMINATION FOR THE DEGREES OF M.B., CH.B. Part I. only.-Oliver Charles Minty Davis. SECOND EXAMINATION FOR THE DEGREE OF B.D.S. William John Langford. DIPLOMA IN PUBLIC HEALTH. William Teulon Torrance. Part II. (completing examination).-John Richard Kay-Mouat. SECOND EXAMINATION FOR THE DIPLOMA IN DENTAL SURGERY. Roy Lugarde O’Sullivan.
meeting
of the executive committee of the guild a special committee, with Sir Norman Lockyer as chairman, was appointed to report upon various matters connected with science and the State and the encouragement of discovery which were referred to by Sir Ronald Ross in his address delivered at the annual meeting of the guild in May last.
THE trustees of the Âme1’ican’ Medicine Gold Medal have awarded the medal for 1914 to Dr. George W. Crile as the American doctor who in their judgment has performed the most conspicuous and noteworthy service in the domain of medicine and surgery during the past year."
ST. GEORGE’S HoSPITAL.-The annual dinner of the St. George’s Hospital Medical School will be held at Prince’s Restaurant, Piccadilly, on Thursday, Oct. 1st, at 6.30 for 7 o’clock, when the Right Hon. Sir Gerard Lowther, joint treasurer of the hospital, will take the chair. The annual introductory address will be delivered on the same day at 3 P.M. in the hospital by Mr. A. E. Shipley, F.R.S., Master of Christ’s College, Cambridge.
DONATIONS AND BEQUESTS.-A further gift of f.10,OOO has been made to Cardiff Medical School by the
anonymous donor who has previously made donations B. equivalent to 90,000.—Mr! Lynn Thomas, on giving COLLEGE, Johnston, M.B., Ch.B. Edin., lecturer on anatomy in the up private practice, has presented to King Edward VII. University of Edinburgh, has been appointed to the newly Hospital, Cardiff, his local private hospital for paying created office of lecturer and demonstrator in anatomy at patients, the value of the gift being estimated at .E4000 University College, London. SOUTH-WEST LONDON MEDICAL SOCIETY.-At UNIVERSITY OF LIVERPOOL.-Mr. John Smyth the annual meeting of this society on July 8th the following Macdonald, professor of physiology in the University of were elected as office-bearers for the 1914-15 session :Sheffield, has been appointed to the Holt chair of Physio- President : Dr. W. D. Murray. Treasurer : Dr. C. J. Martin. : Mr. R. F. Chance and Mr. H. B. A. Pearson. logy in the University of Liverpool, vacated by Professor Secretaries Librarian : Dr. C. J. Martin. Council: Dr. E. H. Brock, C. S. Sherrington. Dr. G. F. Hugill, Dr. G. Ross Laing, Surgeon-Major M. VICTORIA UNIVERSITY OF MANCHESTER.-At Robinson, and Dr. C. M. Young. examinations recently held the following were awarded MEDICAL SICKNESS AND ACCIDENT SOCIETY.certificates in School Hygiene and in Factory Hygiene :G. D. Dawson, M.B., Ch.B., and W. M. MacIlraith, L.R.C.P., The usual monthly meeting of the executive committee of this society was held at 429, Strand, W.C., on July 17th, L. R. C. S. Dr. F. J. Allan being in the chair. The half-yearly IRISH MEDICAL SCHOOLS’ AND GRADUATES’ balance-sheet submitted to this meeting showed that ASSOCIATION.-The summer general meeting and luncheon the society’s reserves continue to expand. The funds of this association will take place at the Grand Hotel, amount to over R260.000, and the income of the society Aberdeen, on Wednesday next, July 29th, at 1.15 for is well over f.35,OOO per annum and shows a steady 1.30 o’clock. rise every year. The grateful letters from members who UNIVERSITY OF LONDON.-A meeting of the attain the age of 65 and receive their bonus are highly Senate was held on July 15th, Sir Wilmot Herringham, satisfactory to those under whose careful management the the Vice-Chancellor, being in the chair. It was resolved in society has prospered sufficiently to enable this bonus to response to a request from the Board of Control to suggest be paid, and the amount actually paid increases every year, the following conditions for the grants allotted to the board and reached Zl500 in 1913. This fact proves that many by the Treasury encouraging scientific research into the attain 65 years, and that insured medical men are, taken as The claim account presented was causes and treatment of mental diseases and mental defect: a whole, good lives. (1) individual grants to be made to a few observers who slightly lower than that of last year and was under the have been thoroughly trained and who are capable of expectation provided for by the tables. The new business carrying out scientific investigations ; (2) no grant under the report was good and shows an increase over that for the scheme to be made merely to maintain or assist pathological same month of the preceding year. A prospectus and all laboratories or to be given to persons for the purpose of information can be obtained from the secretary, 33, Chanceryroutine work ; (3) grants to be given only to advance the lane, London, W. C.
UNIVERSITY
LONDON.-Mr.
T.
DEFERRED DEATH AFTER TRACHE- THE WORKING OF THE NATIONAL INSURANCE ACT IN GREAT YARMOUTH. OTOMY FOR LARYNGEAL DIPHTHERIA. To the Editor vt THE LANCET.
To the Editor of THE LANCET.
SIR,-It is nonsense for Dr. H. Blake, Mr. J. I. SIR,-I must thank Mr. T. Jefferson Faulder for Sankey, and Dr. V. H. Blake, of Yarmouth, to write calling attention in THE LANCET of July 18th to an in THE LANCET of July 18th about " the British apparent inconsistency in my article on the above Medical Association breaking its side of the pledge." subject. The statement in question is that although When Dr. J. R. Ratcliffe, of Birmingham, stated recovery is exceptional once obstruction develops to a degree which makes extraction vital, this
should be postponed until the obstruction becomes immediately dangerous. At first thought it may seem advisable to interfere before the condition is urgent, but clinical experience does not bear this out. It is better to wait, and meanwhile to use steam and the spray, which in themselves
measure
occasionally tide a patient over the critical period. Early extraction, as compared with such treatment, is
no more
certain to avert obstruction and has its
danger. A single extraction in any stage rarely gives permanent relief; forceps have to be used several times as a rule, and it can never be own
last year, at the annual representative meeting at Brighton, that the organisation of the Association had broken down, the chairman of the council very rightly objected to the statement, and said it was. the individual members of the Association who had broken down, and that until they could get members of the Association to be loyal to the organisation nothing could be effected. It is now known that the members of the medical profession cannot be trusted to stand by their words. What can we expect, then, but " trouble trouble," and the saddest part of it all is that many men do not seem to realise what they have I am, Sir, yours faithfully, done. T. CUMING ASKIN.
upon
certain that some irritation and minor traumatic injury to the weakened mucous membrane may not result-conditions which favour a more rapid formation of the plug. Hence I regard extraction as a last THE POSITION OF THE ASSISTANT resource. All that can be claimed for it is that it MEDICAL OFFICERS OF THE will postpone death in many cases, and offers a METROPOLITAN ASYLUMS chance of recovery when a fatal issue is otherwise BOARD. inevitable. Whether any variation of the method would improve the prognosis is an important To the Editor of THE LANCET. question on which limited investigation at Plaistow see from your issue of July 18th that theSIR,-I Hospital throws no light. At best the gain is likely Metropolitan Asylums Board are advertising for to be small, since behind the tracheal obstruction assistant medical officers at a new rate of salary. there is, in the majority of instances, a grave type There has been a good deal of dissatisfaction in of lobular pneumonia. I have no experience of this service for some time past, and lately an the bronchoscope, and cannot foresee its -r6le association of assistant medical officers was formed in this connexion, but as Mr. Faulder has which petitioned the managers for a redress of kindly suggested its use I hope to test -its many grievances, of which the rate of salary was. possibilities in due course. No one. only reply has yet, I understand, been I am, Sir, yours faithfully, received to this petition, and pending such reply JOHN BIERNACKI. the association is precluded from publishing the correspondence. Intending applicants would thereI am sure, be consulting their own interests. fore, THE SCHOOL MEDICAL SERVICE. by finding out from the secretary of the association To the Editor of THE LANCET. (Dr. E. G. Goffe, the North-Eastern Hospital, St. Ann’s-road, Tottenham, N.) what these grievances. still hears the SIR,-One occasionally gibe against school medical officers who are busy forming them- are, and how they have been dealt, with, before: selves into a group for the discussion of their deciding to apply. I am, Sir, yours faithfully, peculiar interests, scientific and sociological (and I JOHN H. TRENCH, M.B. Cantab. daresay it is said of the tuberculosis officers also a who are doing the same thing) that it is only movement of discontented juniors bent on forcing CHILD MORTALITY AND ALCOHOLISM up their own salaries. Now there is no doubt that an increase of salary IN PARIS. has a perennial interest for most of us, but this To the Editor of THE LANCET. does not entirely explain the agitation. The fact is specialised services like the school medical SIR,-May I call attention to the report from service are more and more feeling the need of your Paris correspondent in THE LANCET of being self-contained and self-feeding. We shall July llth of a statement of M. Paul Juillerat and not in future be able to staff the lower ranks with M. A. Filassier, in which they do not hesitate to mere transitional young people on their way toI attribute to alcoholism in the parents this enormous general practice or other departments of the public proportion of children affected with congenital medical service for which, indeed, experience in debility, accounting for 12,342 deaths. This stateschool work very imperfectly fits them. The ideal ment is so contrary to the findings of Professor of the future must be that of a Civil Service, in Karl Pearson, F.R.S., and Miss Ethel M. Elderton which even the lower grades of responsible workers (Galton research scholar)-viz. : " The mean weight must have a living wage, so that if they go no and height of the children of alcoholic parents are higher their lives will not have been a disastrous slightly greater than those of sober parents, but as I am, Sir, yours faithfully, failure. the age of the former children is slightly greater, the correlations when corrected for age are slightly JOHN PRIESTLEY. ,
268 there is slightly greater height and children of the sober. In the case of the father the correlations are not significant, having regard to their probable error; in the case of the mother they may be just significant, but they are so slight as to have no importance."
of fundamental problems connected with insanity and mental deficiency. It was further resolved to inform the Board of Control that the Senate would be pleased to advise them as to the objects towards which investigations thus aided might with most advantage be directed.
study
positive-i.e., weight in the
My practical clinical experience entirely endorses these scientists’ findings. A few years ago I was surprised to find out of a large number of mothers visited in the Hoxton district what strong, welldeveloped infants these mothers had, although I knew that they were addicted to alcohol in excess. This difference between scientists requires more than a passing notice, and I trust that Professor Karl Pearson will reply to M. Juillerat and M. Filassier for the benefit of all impartial medical I am, Sir, yours faithfully, practitioners. THOMAS DUTTON.
UNIVERSITY
OF
CAMBRIDGE.-The
at 3.30 P.M.
MEDICAL MAGISTRATES.-The following Hull practitioners have been made justices of the peace for the city: Dr. Frank Nicholson, senior physician, Hull Royal Infirmary ; Dr. George Gautby, ex-sheriff of Hull ; and Mr. C. H. Milburn.
GLASGOW ROYAL INFIRMARY:
POST-GRADUATE
CLASSEs.-Autumn post-graduate classes in clinical medicine, surgery, and gynascology, and in the various special departments, will be held at the infirmary during the month of September. Full particulars may be obtained from the superintendent, Dr. J. Maxtone Thom.
BRITISH SCIENCE GUILD.-At the last
Medical News. medical
BRISTOL GENERAL HOSPITAL.-The president of the hospital, Mr. George Alfred Wills, will open the new wing and pathological laboratory on Monday next, July 27th,
’,
following
degrees have been conferred :—
M.D.-F. R. Martin. Jtf.C.—W. S. Perrin, Caius. JI.B., B.C.-P. Stocks, King’s ; H. P. Dawson, Trinity; G. Askey, St. John’s ; and T. L. Hardy, Selwyn. H.B.-F. E. W. Rogers, Emmanuel. B.C.-H. Hartridge, King’s; W. B. Gordon, Clare; W. F. B. Smith, Pembroke; J. W. Pigeon, Christ’s; 0. Mackenzie, Emmanuel; and R. A. Thacker, Downing.
UNIVERSITY OF BRISTOL.-At examinations held recently the following candidates were successful :SECOND EXAMINATION FOR THE DEGREES OF M.B., CH.B. Edwin Jennings Ball, Reginald Bertram Britton, Norman Durant, Frederick Viel Jacques, and Ronald Henry Tasker. FINAL EXAMINATION FOR THE DEGREES OF M.B., CH.B. Part I. only.-Oliver Charles Minty Davis. SECOND EXAMINATION FOR THE DEGREE OF B.D.S. William John Langford. DIPLOMA IN PUBLIC HEALTH. William Teulon Torrance. Part II. (completing examination).-John Richard Kay-Mouat. SECOND EXAMINATION FOR THE DIPLOMA IN DENTAL SURGERY. Roy Lugarde O’Sullivan.
meeting
of the executive committee of the guild a special committee, with Sir Norman Lockyer as chairman, was appointed to report upon various matters connected with science and the State and the encouragement of discovery which were referred to by Sir Ronald Ross in his address delivered at the annual meeting of the guild in May last.
THE trustees of the Âme1’ican’ Medicine Gold Medal have awarded the medal for 1914 to Dr. George W. Crile as the American doctor who in their judgment has performed the most conspicuous and noteworthy service in the domain of medicine and surgery during the past year."
ST. GEORGE’S HoSPITAL.-The annual dinner of the St. George’s Hospital Medical School will be held at Prince’s Restaurant, Piccadilly, on Thursday, Oct. 1st, at 6.30 for 7 o’clock, when the Right Hon. Sir Gerard Lowther, joint treasurer of the hospital, will take the chair. The annual introductory address will be delivered on the same day at 3 P.M. in the hospital by Mr. A. E. Shipley, F.R.S., Master of Christ’s College, Cambridge.
DONATIONS AND BEQUESTS.-A further gift of f.10,OOO has been made to Cardiff Medical School by the
anonymous donor who has previously made donations B. equivalent to 90,000.—Mr! Lynn Thomas, on giving COLLEGE, Johnston, M.B., Ch.B. Edin., lecturer on anatomy in the up private practice, has presented to King Edward VII. University of Edinburgh, has been appointed to the newly Hospital, Cardiff, his local private hospital for paying created office of lecturer and demonstrator in anatomy at patients, the value of the gift being estimated at .E4000 University College, London. SOUTH-WEST LONDON MEDICAL SOCIETY.-At UNIVERSITY OF LIVERPOOL.-Mr. John Smyth the annual meeting of this society on July 8th the following Macdonald, professor of physiology in the University of were elected as office-bearers for the 1914-15 session :Sheffield, has been appointed to the Holt chair of Physio- President : Dr. W. D. Murray. Treasurer : Dr. C. J. Martin. : Mr. R. F. Chance and Mr. H. B. A. Pearson. logy in the University of Liverpool, vacated by Professor Secretaries Librarian : Dr. C. J. Martin. Council: Dr. E. H. Brock, C. S. Sherrington. Dr. G. F. Hugill, Dr. G. Ross Laing, Surgeon-Major M. VICTORIA UNIVERSITY OF MANCHESTER.-At Robinson, and Dr. C. M. Young. examinations recently held the following were awarded MEDICAL SICKNESS AND ACCIDENT SOCIETY.certificates in School Hygiene and in Factory Hygiene :G. D. Dawson, M.B., Ch.B., and W. M. MacIlraith, L.R.C.P., The usual monthly meeting of the executive committee of this society was held at 429, Strand, W.C., on July 17th, L. R. C. S. Dr. F. J. Allan being in the chair. The half-yearly IRISH MEDICAL SCHOOLS’ AND GRADUATES’ balance-sheet submitted to this meeting showed that ASSOCIATION.-The summer general meeting and luncheon the society’s reserves continue to expand. The funds of this association will take place at the Grand Hotel, amount to over R260.000, and the income of the society Aberdeen, on Wednesday next, July 29th, at 1.15 for is well over f.35,OOO per annum and shows a steady 1.30 o’clock. rise every year. The grateful letters from members who UNIVERSITY OF LONDON.-A meeting of the attain the age of 65 and receive their bonus are highly Senate was held on July 15th, Sir Wilmot Herringham, satisfactory to those under whose careful management the the Vice-Chancellor, being in the chair. It was resolved in society has prospered sufficiently to enable this bonus to response to a request from the Board of Control to suggest be paid, and the amount actually paid increases every year, the following conditions for the grants allotted to the board and reached Zl500 in 1913. This fact proves that many by the Treasury encouraging scientific research into the attain 65 years, and that insured medical men are, taken as The claim account presented was causes and treatment of mental diseases and mental defect: a whole, good lives. (1) individual grants to be made to a few observers who slightly lower than that of last year and was under the have been thoroughly trained and who are capable of expectation provided for by the tables. The new business carrying out scientific investigations ; (2) no grant under the report was good and shows an increase over that for the scheme to be made merely to maintain or assist pathological same month of the preceding year. A prospectus and all laboratories or to be given to persons for the purpose of information can be obtained from the secretary, 33, Chanceryroutine work ; (3) grants to be given only to advance the lane, London, W. C.
UNIVERSITY
LONDON.-Mr.
T.