1367 and in this country on the effects of histamine in rheumatic conditions, but a more detailed account of the clinical results in the various types of cases treated would have been of value. Only one type of case seems to have shown marked improvement when treated by the hypodermic method-viz., peri-articular arthritis in the hand with circulatory disturbance. They were unable to obtain any clinical evidence of the characteristic histamine effect by ionisation methods and attribute the results to local galvanism, heat, and counter irritation only. They are alone in this finding however, as other observers appear to obtain readily the complete gamut of physiological effects by this method, as by the use of histamine
hypodermically. That the response to histamine varies from patient patient and at different times in the same patient is surely an argument against injection, a,s ionisation can be so regulated that no untoward systemic symptoms need ever arise. Having prescribed over 3000 histamine treatments at the Royal Baths, Harrogate, during the last three seasons, my findings are that good results may be definitely obtained in Identical results are many types of rheumatism. reported by Dr. McKenna and various continental I am, Sir, yours faithfully, writers. A. A. BISSET. June 12th. Harrogate, to
THIOL-HISTAMINE
To the Editor
of THE
LANCET
SIR,-My attention has been drawn to certain articles you have published recently upon preparations of histamine for rheumatism, wherein whatever credit is due for their discovery has been given to German workers. I introduced thiol-histamine in 1917, since when I have used it on a large scale. Frequent references have been made to the preparation in my works on the Nature of Disease, and you were kind enough to publish a letter for me on May 6th, 1933. May I ask you to be so kind as to correct the omission to which I am referring. I am,
Sir, yours faithfully, J. E. R. MCDONAGH. McDoNAGH.
Wimpole-street, W., June 16th. DISTRICT ALMONERS To the Editor of THE LANCET
all these and many other similar cases can be dealt with by an almoner. Convalescence can be arranged, and although the patient at first mention of this may fear the loss of his job by so long an absence, yet it is usual to nnd that an almoner can approach his firm and get over this difficulty, often obtaining a grant partially to cover the cost. Naturally the services of an almoner are not for the well-to-do, but with the assistance of a district almoner practitioners could give better service to their patients, such a large proportion of whom are in varying degrees of domestic or financial difficulties. It would be interesting to hear the views of other practitioners on this subject as it is felt that before further steps can be taken it is necessary to have an idea of the support that can be obtained. I am, Sir, yours faithfully, GEOFFREY HALE. Eccleston-square, S.W., June 16th. CONTINENTAL ANGLO-AMERICAN SOCIETY
To the Editor
LANCET
SIR,-On July 27th at 12.30 P.M. this society will meet for luncheon at the Bournemouth Pavilion on the occasion of the B.M.A. annual meeting. It is hoped that all former members now resident in Great Britain will endeavour to attend on the first such occasion since the war. Any doctors attending the meeting who have patients wintering on the continent will be welcomed at the luncheon. Those who wish to be present should communicate with Dr. E. L. Gros (President) 23 Ave. Maréchal-Foch, Paris, Dr. R. Pryce-Mitchell, Villa Henri, MonteCarlo, or with the undersigned. I am, Sir, yours faithfully, TOM A. WILLIAMS. Royal Societies Club, 63, St. James’s-street, S.W.1, r
June 19th.
BIRMINGHAM HOSPITALS
CENTRE.-The Prince of
Wales will lay the foundation-stone of the Birmingham Hospitals Centre at Edgbaston on Oct. 23rd. On the same day he will cut the first sod on the site of the Birmingham University Medical School, which is an integral part of the hospitals centre project. It is expected that the first portion of the new hospital will be ready for opening in October, 1937.
SIR,-It is
now generally recognised that almoners indispensable in all our hospitals ; and suggestions are being made that there should be district almoners,
of THE
MEDICAL
SCARBOROUGH HospiTAL.-The detailed plans for new hospital, which is to be built at cost of over 100,000, are now available. The
are
Scarborough’s
whose services would be available to all. It is unnecessary to tell those who have worked on the visiting or resident staff of a hospital in recent years what an almoner can do, but there must be many in practice who have never been able to write upon a hospital patient’s card " Will the Lady Almoner please do this or that," and consequently many who do not realise how much an almoner can do to help to get the best results out of treatment. It will interest these to know that the almoner can usually procure all those things for a patient that doctor or nurse cannot procure: abdominal belts, and all other types of surgical appliances, extra nourishment or particular articles of diet, dressings, and special care of any sort for those otherwise unable to obtain them. Patients with advanced cancer ; those with Graves’s disease whose home conditions are unsuitable ; children who have come from a distance for the specialist’s opinion are recommended treatment with rest in bed and may not even have a bed to themselves ;
buildings are to be fireproof, and as far as possible soundproof. Advantage has been taken of a sheltered situation to have large sunny balconies and a solarium for the children. The hospital will have 140 beds, including a number for paying patients, and three operating theatres. The theatres have a ventilating plant which makes it possible to change the air or raise or lower the temperature very rapidly. The X ray therapy and light treatment departments and the massage and orthopaedic rooms are on the ground floor and are connected by two bed lifts with the wards. The out-patients’ department has a large waiting-room where there will be a
a
refreshment counter, and a shelter for prams has also been provided. The dispensary is easily accessible both to the wards and to the out-patients’ department. The kitchen is a self-contained unit and the food will be served from heated trolleys so that appetising and hot dishes may reach the most distant wards. The laundry and boiler room are also self-contained, and a supplementary electrical battery room will be able to provide current for the operating theatres and other parts of the institution if the municipal supply should fail. There are rooms for the visiting and administrative staff in the main building, and a separate home for the sisters and nurses.