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Council Meeting
~6o
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PUBLIC H E A L T H .
become markedly" less, physical signs have improved, and the patient's life has been made more comfortable. H o w much of this is due to sanatorium principles, and how" much to Coltosol Calcium, it is of course difficult to say.
(c) Mixed Cases comprise two with Laryngeal involvement, and one with extensive cervical gtands. One of the Laryngeal cases (with positive sputum) did particularly well, the other (with negative sputum) appeared to suffer severe reactions after her injections, the throat becoming dry and painful. She was accordingly treated with Collosol Calcium by mouth, and she herself declares that she has benefited greatly thereby. The case with cervical glands has also done very well--the sputum, which was positive, is now quite dried up and the glands have improved considerably. This patient has suffered frequently from severe headaches after his injections, and severe local reactions. (d) Febrile Cases were ten in number (6 positive, 4 negative) ; they were eases of acute illness or of advanced disease with febrile temperatures. I cannot say that these cases have been benefited in the slightest degree by the administration of Collosol Calcium, either by mouth or by subcutaneous injections. I have failed to influence the temperature in the least, and I am not prepared to say that night sweats were influenced either. G.W., a female, with abundant positive sputum, had been in the sanatorium for seven months, there was extensive disease in both lungs, and there had been several attacks of hmmoptysis. On April 18th, 1922, I commenced treatment with Collosol Calcium, the initial dose being 0.3 e.c., and in all 20 injections were given, spread over a period of four and a half months. After the fifth injection (0.5 c.c.) the temperature shot up to t03 degrees F., she complained of pains in her chest, the cough became more troublesome, and there was a slight hmmoptysis. The dose was reduced, but the temperature did not come down for six weeks. No higher dose than 0.6 c.c. was given at any time. The temperature remained fairly stationery for ten weeks, when it again shot up. The iniections were discontinued; three weeks later the patient died. Did the iniections of CollosoI Calcium cause the exacerbation of temperature after the fifth injection, or did it arise in the natural course of the disease? I leave the question unanswered. Of the remainder, all are dead with the exception of one, and he is gradually going down hill. HI.--Glands.--In addition to these cases treated in the sanatorium, I have treated six cases of Cervical Gland disease in children
attending the Dispensary~-all appear to have done well, the glands have decreased in size, and so far, three to six months later, all have remained well. To sum up, I have treated 72 cases in the sanatorium. Children.--16 cases, 2 positive sputum, 14, negative. All the negative cases have done well and kept well. Adults.--56 cases. 23 Early cases, 4 positive, 19 negative sputa. With the exception of one, all have done well. 19 Chronic cases. :7 positive, 12 negative. 14: Cases have done well. 10 Febrile cases: 6 positive, 4 negative. All have done badly. 3 Mixed cases: 2 positive, 1 negative. Two have done well, the other has shown little change. A total of 21 positive and bl negative, and from observations upon these I would draw the following conclusions : - t . - - I n acute or advanced cases the admlnistration of Coltosol Calcium has, in my hands, been of no value. It.---The occurrence or recurrence of h~emoptysis in patients undergoing a course of treatment is not prevented by its administration. I I I . - - C h i l d r e n appear to derive real benefit. I V . - - A d u l t s with early disease and certain chronic cases also appear to benefit. In short the cases which respond best to the administration of Collosol Calcium, are those cases with good powers of resistance, the type of case that responds most readily to Sanatorium treatment. V.--In glandular tuberculosis, Collosol Calcium is of real value. I have given you details of some of nay failures. They were cases which, had the drug been a specific, one might reasonably have expected, woul~l have responded to its administration. It is on this point that I seek further enlightenment this afternoon.
SOCIETY
OF
MEDICAL HEALTH.
OFFICERS
OF
COUNCIL M E E T I N G . A meeting of the Council was held at the house of the Society on Friday, May l l t h , 1928. Dr. T. Eustaee Hill (President) was in the chair, and there were present :--Professors H. R. Kenwood and H. Kerr, Drs. G, F. Buehan, Charles Porter, Horne,
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Pearce, Rees-Jones, Joseph, Evans, Garstang, Snell, J. T. C. Nash, Peyton, Gibbons Ward, Stirk, Stocks, Jolly and Lyster. The minutes of the last meeting having been approved and signed, messages of apology were received from Dr. A. B. MeMaster, Dr. R. J. Ewart, Dr. R. Veitch Clark and Lt.-Col. Herbert Jones. The Executive Secretary was directed to convey the ,the sympathy of the Council to Col. Jones o n'~ accident which kept him in bed, and to wish him a speedy recovery.
Correspondence.--(1) From the Ministry of Health, suggesting that the Society's Scale of Salaries should be submitted to the Associations representative of Local Anthorities before its adoption by the British Medical Association. The Executive Secretary was directed to reply that this course of action had been jointly agreed by the Society and the B.M.A. (2) From the Ministry of Health stating that the request of the Society for the earlier issue of the Department's Circular as to M.O.H. Annual Reports had been noted and would be borne in mind when the revision of the current circular is undertaken. (3) From the Board of Education stating that in conformity with the request of the Society they would arrange to send copies of documents relating to the School Medical Service to the School Medical Officers " as well as to the chief officer representative of the Local Educative Authority." (4) From the British Medical Association, sending the draft of the letter addressed to the Associations representative of Local Authorities, explanatory of the Society's Scale of Salaries shortly to be considered by the A.R.M. of the Association. The draft was approved subject to minor amendments which had been suggested to the B.M.A., and the Executive Secretary was directed to inform the Associaticn that the Society would urge the adoption of the Scale at the Portsmouth A.R.M. regardless Of any negotiations that might be proceeding or pending with the bodies representing Local Authorities, as such adoption would in no way prejudice a successful issue of such negotiations. Election of President.--The following were nominated for election as President of the Society for the session 1928-24 : ~ B y the Metropolitan, Northern, North-V(estern and Yorkshire Branches-Dr. T. W. Naylor Bartow, O.B.E. ; by the Midland Branch--Dr. T. Ridley- Bailey; by the Southern Branch--Dr. R. A. Lyster. Dr. Lyster having expressed his wish not to stand on the present occasion, a ballot was taken, Dr. Barlow receiving 15 votes and Dr. Ridley Bailey 10. It was agreed to nominate Dr. Barlow for election by the Society. Election of ~3"ce-Presidents.--The voting for VicePresidents for the session 1923-24 was as follows : ~
26I
Lt.-Col. F. E. Fremantle, O.B.E., M.P., 18 ; Dr. W. J. Howarth, C.B.E., 172; Dr. T. W. H. Garstang, 17; Lt.-Col. Herbert Jones, 16. The first three were declared elected.
Election of Treasurer and Editor.--Dr. G. F. Buchan and Dr. R. A. Lyster were re-elected Treasurer and Editor respectively for the session 1923-~4.
Revision of Articles" of Association.--Professor Kenwood, chairman of the committee appointed to revise the Society's Articles of Association, reported that the draft revision as published with the April issue of " Public Health " had been referred to all the Branches and Groups of the Society. Certain minor amendments had been suggested to the Committee and adopted by them. After a prolonged disc-assion the Council adopted further amendments and approved the final revision for circulation to all members of the Society with the formal notice of the requisite Statutory Meetings. The late Sir Shirley Murphy.--On the motion of the President, the Executive Secretary was directed to convey to Lady Murply the sincere sympathy of the Society on the death of her husband, thrice President of the Society mad for several years Editor of " Public Health." The resolution was adopted in silence, the members upstanding. Owing to the late hour, consideration of reports from the Maternity and Child Welfare Group was deferred until the next meeting of the Council. The Council then adjourned. M E T R O P O L I T A N BRANCH. A meeting of this Branch took place at the Society's House in London, on Friday, 4th May, 1923, the President (Sir Wqllian-a H. Hamer) occupying the chair. Nineteen other members were present. News of the death of Sir Shirley Forster Murphy, K.B.E., late M.O.H., London County Council, was received with great regret, and many members paid tribute t o his work in the Public Health Service. Many references were made to the assistance he had rendered to the Society and the Metropolitan Branch in particular, with which he had been intimately associated for so many years. Directions were given for the sincere sympathy of the Branch to be conveyed to Lady Murphy. Dr. T. YV. N. Barlow, O.B.E., M.O.H., VVallasey, was nominatecl for tile Presidency of the Society for the Session 1923-1924. Dr. W. J. Howarth and Dr. Charles Porter tendered their resignations as representatives of the Society on the Panel Committee for the
juNs,
PUBLIC H E A L T H .
become markedly" less, physical signs have improved, and the patient's life has been made more comfortable. H o w much of this is due to sanatorium principles, and how" much to Coltosol Calcium, it is of course difficult to say.
(c) Mixed Cases comprise two with Laryngeal involvement, and one with extensive cervical gtands. One of the Laryngeal cases (with positive sputum) did particularly well, the other (with negative sputum) appeared to suffer severe reactions after her injections, the throat becoming dry and painful. She was accordingly treated with Collosol Calcium by mouth, and she herself declares that she has benefited greatly thereby. The case with cervical glands has also done very well--the sputum, which was positive, is now quite dried up and the glands have improved considerably. This patient has suffered frequently from severe headaches after his injections, and severe local reactions. (d) Febrile Cases were ten in number (6 positive, 4 negative) ; they were eases of acute illness or of advanced disease with febrile temperatures. I cannot say that these cases have been benefited in the slightest degree by the administration of Collosol Calcium, either by mouth or by subcutaneous injections. I have failed to influence the temperature in the least, and I am not prepared to say that night sweats were influenced either. G.W., a female, with abundant positive sputum, had been in the sanatorium for seven months, there was extensive disease in both lungs, and there had been several attacks of hmmoptysis. On April 18th, 1922, I commenced treatment with Collosol Calcium, the initial dose being 0.3 e.c., and in all 20 injections were given, spread over a period of four and a half months. After the fifth injection (0.5 c.c.) the temperature shot up to t03 degrees F., she complained of pains in her chest, the cough became more troublesome, and there was a slight hmmoptysis. The dose was reduced, but the temperature did not come down for six weeks. No higher dose than 0.6 c.c. was given at any time. The temperature remained fairly stationery for ten weeks, when it again shot up. The iniections were discontinued; three weeks later the patient died. Did the iniections of CollosoI Calcium cause the exacerbation of temperature after the fifth injection, or did it arise in the natural course of the disease? I leave the question unanswered. Of the remainder, all are dead with the exception of one, and he is gradually going down hill. HI.--Glands.--In addition to these cases treated in the sanatorium, I have treated six cases of Cervical Gland disease in children
attending the Dispensary~-all appear to have done well, the glands have decreased in size, and so far, three to six months later, all have remained well. To sum up, I have treated 72 cases in the sanatorium. Children.--16 cases, 2 positive sputum, 14, negative. All the negative cases have done well and kept well. Adults.--56 cases. 23 Early cases, 4 positive, 19 negative sputa. With the exception of one, all have done well. 19 Chronic cases. :7 positive, 12 negative. 14: Cases have done well. 10 Febrile cases: 6 positive, 4 negative. All have done badly. 3 Mixed cases: 2 positive, 1 negative. Two have done well, the other has shown little change. A total of 21 positive and bl negative, and from observations upon these I would draw the following conclusions : - t . - - I n acute or advanced cases the admlnistration of Coltosol Calcium has, in my hands, been of no value. It.---The occurrence or recurrence of h~emoptysis in patients undergoing a course of treatment is not prevented by its administration. I I I . - - C h i l d r e n appear to derive real benefit. I V . - - A d u l t s with early disease and certain chronic cases also appear to benefit. In short the cases which respond best to the administration of Collosol Calcium, are those cases with good powers of resistance, the type of case that responds most readily to Sanatorium treatment. V.--In glandular tuberculosis, Collosol Calcium is of real value. I have given you details of some of nay failures. They were cases which, had the drug been a specific, one might reasonably have expected, woul~l have responded to its administration. It is on this point that I seek further enlightenment this afternoon.
SOCIETY
OF
MEDICAL HEALTH.
OFFICERS
OF
COUNCIL M E E T I N G . A meeting of the Council was held at the house of the Society on Friday, May l l t h , 1928. Dr. T. Eustaee Hill (President) was in the chair, and there were present :--Professors H. R. Kenwood and H. Kerr, Drs. G, F. Buehan, Charles Porter, Horne,
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PUBLfC H E A L T H .
Pearce, Rees-Jones, Joseph, Evans, Garstang, Snell, J. T. C. Nash, Peyton, Gibbons Ward, Stirk, Stocks, Jolly and Lyster. The minutes of the last meeting having been approved and signed, messages of apology were received from Dr. A. B. MeMaster, Dr. R. J. Ewart, Dr. R. Veitch Clark and Lt.-Col. Herbert Jones. The Executive Secretary was directed to convey the ,the sympathy of the Council to Col. Jones o n'~ accident which kept him in bed, and to wish him a speedy recovery.
Correspondence.--(1) From the Ministry of Health, suggesting that the Society's Scale of Salaries should be submitted to the Associations representative of Local Anthorities before its adoption by the British Medical Association. The Executive Secretary was directed to reply that this course of action had been jointly agreed by the Society and the B.M.A. (2) From the Ministry of Health stating that the request of the Society for the earlier issue of the Department's Circular as to M.O.H. Annual Reports had been noted and would be borne in mind when the revision of the current circular is undertaken. (3) From the Board of Education stating that in conformity with the request of the Society they would arrange to send copies of documents relating to the School Medical Service to the School Medical Officers " as well as to the chief officer representative of the Local Educative Authority." (4) From the British Medical Association, sending the draft of the letter addressed to the Associations representative of Local Authorities, explanatory of the Society's Scale of Salaries shortly to be considered by the A.R.M. of the Association. The draft was approved subject to minor amendments which had been suggested to the B.M.A., and the Executive Secretary was directed to inform the Associaticn that the Society would urge the adoption of the Scale at the Portsmouth A.R.M. regardless Of any negotiations that might be proceeding or pending with the bodies representing Local Authorities, as such adoption would in no way prejudice a successful issue of such negotiations. Election of President.--The following were nominated for election as President of the Society for the session 1928-24 : ~ B y the Metropolitan, Northern, North-V(estern and Yorkshire Branches-Dr. T. W. Naylor Bartow, O.B.E. ; by the Midland Branch--Dr. T. Ridley- Bailey; by the Southern Branch--Dr. R. A. Lyster. Dr. Lyster having expressed his wish not to stand on the present occasion, a ballot was taken, Dr. Barlow receiving 15 votes and Dr. Ridley Bailey 10. It was agreed to nominate Dr. Barlow for election by the Society. Election of ~3"ce-Presidents.--The voting for VicePresidents for the session 1923-24 was as follows : ~
26I
Lt.-Col. F. E. Fremantle, O.B.E., M.P., 18 ; Dr. W. J. Howarth, C.B.E., 172; Dr. T. W. H. Garstang, 17; Lt.-Col. Herbert Jones, 16. The first three were declared elected.
Election of Treasurer and Editor.--Dr. G. F. Buchan and Dr. R. A. Lyster were re-elected Treasurer and Editor respectively for the session 1923-~4.
Revision of Articles" of Association.--Professor Kenwood, chairman of the committee appointed to revise the Society's Articles of Association, reported that the draft revision as published with the April issue of " Public Health " had been referred to all the Branches and Groups of the Society. Certain minor amendments had been suggested to the Committee and adopted by them. After a prolonged disc-assion the Council adopted further amendments and approved the final revision for circulation to all members of the Society with the formal notice of the requisite Statutory Meetings. The late Sir Shirley Murphy.--On the motion of the President, the Executive Secretary was directed to convey to Lady Murply the sincere sympathy of the Society on the death of her husband, thrice President of the Society mad for several years Editor of " Public Health." The resolution was adopted in silence, the members upstanding. Owing to the late hour, consideration of reports from the Maternity and Child Welfare Group was deferred until the next meeting of the Council. The Council then adjourned. M E T R O P O L I T A N BRANCH. A meeting of this Branch took place at the Society's House in London, on Friday, 4th May, 1923, the President (Sir Wqllian-a H. Hamer) occupying the chair. Nineteen other members were present. News of the death of Sir Shirley Forster Murphy, K.B.E., late M.O.H., London County Council, was received with great regret, and many members paid tribute t o his work in the Public Health Service. Many references were made to the assistance he had rendered to the Society and the Metropolitan Branch in particular, with which he had been intimately associated for so many years. Directions were given for the sincere sympathy of the Branch to be conveyed to Lady Murphy. Dr. T. YV. N. Barlow, O.B.E., M.O.H., VVallasey, was nominatecl for tile Presidency of the Society for the Session 1923-1924. Dr. W. J. Howarth and Dr. Charles Porter tendered their resignations as representatives of the Society on the Panel Committee for the