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Employment for tuberculous persons
April, 1921]
LETTERS
publio health services of all the countries concerned, and the acceptance of the League of the OlIice International 6S the basis of its health orga.nisation secured this consultation not only froOl countries which were members of the League, but from other important countries signatory to the Rome Convention .
NORTH WESTERN TUBERCULOSIS SOCIETY. At a special meet ing of the above Society, held in Manchester, on February ~4 , l\ letter was read from the Seereta.ry of the North Western Branch of the Society of Medical Officers of Health , This letter suggested that the North-Western Tuberculosis Society should become a subgro':!p of the Tuberculosis Group within that SOClety. Dr. George Jessel, in introducing the diseusaion, gave a brief outline of the history of the ~orth Western Tuberculosis Society. Formed In 1919, by the tuberculosis officers of Lancashire as the Lanes and Westmor. land Society, it soon assumed a wider scope und.er its present .t itle. . The object of the Society was the discussion of subjects concerrnng the control and eradication of tuber. culoais, No political Issues had been dealt with throughout. The point at issue was whether the Society should sink its individuali ty in the Society of Medical Officers of Health or not. Dr. James Niven, in l\ very understanding and sympa.thetic way. lent support to the amalgamation of the two Societies, in order
331
that union might be achieved in this essentially 'p ublio health subject. In any ca se and at all costs we must. be prepared to sink personal interests for the common and public good. The best man should come to the top and this could only be done by union. Dr. J. H. Peyton said that the need for both clinical and political discussion was urgent. Tbis Society should be clinical and there was room for a society for status interests. It wa s not possible for provincial members to a.tteod in London, so there should be some method of influencing the policy of the Society of Medical Officers of Health from the provinces. Dr. Leigh considered that the sub-group of the :M.O.H. Society would be formed in any case . The question arose as to the relationship of the two societ ies . lIe thought any member should be a.llowed to use his own discretion whether he joined the Group or not. Dr. F. S. Tinker thought that Manchester a~d.di8trlct.iustifiedthe existence of a purely clinical society, and urged the mai ntenance of the, Socie~y . It was delightful to hea.r that l\ ~ocle~y eXI~ted I~ tubercle wh ich did not spend its tima dISCUSSlD/t sa.laries. He suggested a representation from the Society upon the Group to .w~tch the i.nterel
LETTERS. INT£RNATIOlUL UNIOli AGAINST TUBERCULOSIS. Conference in [,olu1on-".uly 1921, under t1/6 auspices of the Nationa! Association jor the Prevention of Tuberculosis. DEAR EDITOR-Tha next International Conference will be held in London from Tuesday July 26 to Thursday, July 28, inclusive. ' The Conference will be open to members of the International Union against tuberculosis and to delegates from countries within the League of Nations and from the United States of America. The President of the Interna.tional Union for the current year is lIIonsieur Leon Bourgeois, President of the French Senate who will be succeeded on tbe occasion of th~ Conference in London by Professor Sir Hobert Ph iliJ', of the University of Edinburgh. It IS hoped ~hat the. opening address of the Conference WIll be given by Monsieur Leon Bourgeois. The arrangements for the Conference are under the charge of the Executive Committee
of. the Internati?no.l Union, in correspondence WIth the Oouncil of the National Associat ion for the Prevention of Tuberculosis. The subjects proposed for di scu ssion include the following :_ (1) "The Modes of Diffusion of Tuberculosis throughout the Races of the World," to be opened by Professor Calmette. (2) "The role of the Medical Profession in the Prevention of Tuberculosis." In the name of th e Internationa.l Union LEON BERNARD: Secretarg; E~rPLoYMENT FOR TUBERCULOUS PERSONS.
Dlu.a EOITOR--\Vith reference to my note on . "Employment for Tuberculous Persons" whl~h appeared in your February issue, I have received the following comment.s on the suggested scheme, written by a layman with practical knowledge of this work. .. I doubt if the scheme can be seH-supporting, let alone proflt-maklng, for the
332
'tUBERCLE
[April, 1921
waste, supervision, runninR charges, &:c., and simple reason thAt the out-turn of unhealthy, l.e ., inelficicnt, labour could not hope to is directly ailected by qua.nt.i ty and qualit.y of the finished ..rticle. t'rofit, of course, comes compete 0.11 regards prices, qUAlity or quantity, with that of healthy labour. I assume, 01 in commercially; but in this ease, all it is probably not Bought, ueed not be considered, course, in thi s statement tha.t mechanical skill It is proposed to pay T. U. rates. Waste. is equal, or at Icast comparable, in both cases, 1 think, Is certain to be bigh owing to physical I f it is not, I do net see how the scheme can possibly be run except as Ilo drain on some dlsability ; supervision is also likely to be expensive owing to the necessarily non aU:liliary fund. Prices 1 will refer to later. Consider quality. continuous nature of the labour (I mean mertality will be higher than with ordinary It is len.!\onab\e to suppose that the hea.lthy mind, depending largely on a hcalthy body, labour, and men will have to be trained in Will produce 1\ better article than the diseased tae shop to replace others at much more bod)" directed by a mind which must feel tho frequent intervals). Running charge- depend lull handicap of such disease. I am certain, largely, of course, on the skill with which the from my own personal experience, thll.t there shop is organised. is no doubt that quality of out-turn, otber I think the T.U. rate of wlI~e would be thinp;lI being equal , is 1\ direct function of entirely uneconomical in regard to the out. health. turn which could be expected, and therefore Quaat ity. H tbe tuberculous worker can this Iactor must increase the selling price 3S ml\inta.in an even output over four hours and compared with that of the article produced that output eorrespoud to tho four bours by healthy labour. period of II. hcalthy man, quantity will, of 1 fear that the aggreg\l.te of these items course, be safe-but can he? postulates an almost impossible solling price. Suffering as he does I think that his first Incidents.lly, electrical componenta are menbour'a out- turn will be the only one which tioned. Some of those produced in England could hope to compare as regards quantity at present are priced at 3G8. a dozen-Germa.ny with any period of a healthy man's shift. lands a better article in this country for 6s. At the cnd of the first hour the tub erculous Hence our so-called healthy labour requires person will begin to feel fatigue, which will protection. What would our unhealthy Increase in IJ, h igh proportion in the succeeding workers require to pay their war?" hours in relation to his own first hour and reach a maximum at the end of the fourtb These comments are of very great interest. hour. and show how difficult is this question of I also think fatigue will increase immeasuremployment. It appears to me, however, ably faster in tbe sick man than in the healthy many of them would be equally true if one, even though we compare a total four hour applied to other forms of suggested employbhilt with all eight hour one. ment for tbe tuberculous, While recognising Wha.t r mean is tbat the out-tum (quantity) the truth of many of these comments, I see in the fourth hour of 0. sick man is likely to no reason to doubt that an experimental work. be much less than tbat of the eighth hour of shop carried out 011 the lines 1 suggested in 1\ healthy one . Lack of quantity and, still my note would yield the mo~t valuable informore, lack of quality runs up the price of mation , and even if run at some loss would producti.on which has to compete i.n the open compare favourably from nll points of view market.. with the more exp ensive settlements and T1·ai,~ill!J . r have no doubt th at anyone can colonies. be trained in very much leAS than l\ fortn ight Faithfully yours, to fllt a rod into an auto-machine and take it FRKDERICK J. I.J. BLACKMORI£. out .. rain at the right time. Small Indian 39, Woodland Terrace, boys, 14 to 18 years of age, do it regularlyand Old Charlton, S.E.7. successfully; but they are not auto-machinists. February 28. 1921. An auto-machinist should be able to change cams on bis machine I\nd have sufficient mechanical knowledge to recognise when his tools are out of order, i.e., to remove a blunt, THE DUGNOSIS OF PULnrONARy'rUBERCULOSIS. damaged or broken tool. I doubt if this could To the Editor of .. Tubercle." bo learned under several months. DEU\ 811\,-1 llhould like, it I tna.y \;0 If the men are to work under the conditions in wbich our Indian boys do, skilled super- comment on the important article by 'Dr Bardswell in the U arch number of TUllERCLll:' vislon would be essential, otherwise tbe phmt would be broken up in a short time. Buch a It appears to point out clearly the practica.i supervisor could command 1Io wage of £7 or £8 va.lue of observation beds in hospital, by a week, and would if ho were non -tubercular showing that only 15 pel' cent. of the 158 want more to cover his risks in such a shop cases observed were recommended for trea\;. l\S the one suggested. ment. No doubt this was the reason for its The tra.ining of a ma.chinist can only be publication. But it implies sometbinR more short. when a. \a;rge i1,killed sUllerv\sor y IItllo
LETTERS
publio health services of all the countries concerned, and the acceptance of the League of the OlIice International 6S the basis of its health orga.nisation secured this consultation not only froOl countries which were members of the League, but from other important countries signatory to the Rome Convention .
NORTH WESTERN TUBERCULOSIS SOCIETY. At a special meet ing of the above Society, held in Manchester, on February ~4 , l\ letter was read from the Seereta.ry of the North Western Branch of the Society of Medical Officers of Health , This letter suggested that the North-Western Tuberculosis Society should become a subgro':!p of the Tuberculosis Group within that SOClety. Dr. George Jessel, in introducing the diseusaion, gave a brief outline of the history of the ~orth Western Tuberculosis Society. Formed In 1919, by the tuberculosis officers of Lancashire as the Lanes and Westmor. land Society, it soon assumed a wider scope und.er its present .t itle. . The object of the Society was the discussion of subjects concerrnng the control and eradication of tuber. culoais, No political Issues had been dealt with throughout. The point at issue was whether the Society should sink its individuali ty in the Society of Medical Officers of Health or not. Dr. James Niven, in l\ very understanding and sympa.thetic way. lent support to the amalgamation of the two Societies, in order
331
that union might be achieved in this essentially 'p ublio health subject. In any ca se and at all costs we must. be prepared to sink personal interests for the common and public good. The best man should come to the top and this could only be done by union. Dr. J. H. Peyton said that the need for both clinical and political discussion was urgent. Tbis Society should be clinical and there was room for a society for status interests. It wa s not possible for provincial members to a.tteod in London, so there should be some method of influencing the policy of the Society of Medical Officers of Health from the provinces. Dr. Leigh considered that the sub-group of the :M.O.H. Society would be formed in any case . The question arose as to the relationship of the two societ ies . lIe thought any member should be a.llowed to use his own discretion whether he joined the Group or not. Dr. F. S. Tinker thought that Manchester a~d.di8trlct.iustifiedthe existence of a purely clinical society, and urged the mai ntenance of the, Socie~y . It was delightful to hea.r that l\ ~ocle~y eXI~ted I~ tubercle wh ich did not spend its tima dISCUSSlD/t sa.laries. He suggested a representation from the Society upon the Group to .w~tch the i.nterel
LETTERS. INT£RNATIOlUL UNIOli AGAINST TUBERCULOSIS. Conference in [,olu1on-".uly 1921, under t1/6 auspices of the Nationa! Association jor the Prevention of Tuberculosis. DEAR EDITOR-Tha next International Conference will be held in London from Tuesday July 26 to Thursday, July 28, inclusive. ' The Conference will be open to members of the International Union against tuberculosis and to delegates from countries within the League of Nations and from the United States of America. The President of the Interna.tional Union for the current year is lIIonsieur Leon Bourgeois, President of the French Senate who will be succeeded on tbe occasion of th~ Conference in London by Professor Sir Hobert Ph iliJ', of the University of Edinburgh. It IS hoped ~hat the. opening address of the Conference WIll be given by Monsieur Leon Bourgeois. The arrangements for the Conference are under the charge of the Executive Committee
of. the Internati?no.l Union, in correspondence WIth the Oouncil of the National Associat ion for the Prevention of Tuberculosis. The subjects proposed for di scu ssion include the following :_ (1) "The Modes of Diffusion of Tuberculosis throughout the Races of the World," to be opened by Professor Calmette. (2) "The role of the Medical Profession in the Prevention of Tuberculosis." In the name of th e Internationa.l Union LEON BERNARD: Secretarg; E~rPLoYMENT FOR TUBERCULOUS PERSONS.
Dlu.a EOITOR--\Vith reference to my note on . "Employment for Tuberculous Persons" whl~h appeared in your February issue, I have received the following comment.s on the suggested scheme, written by a layman with practical knowledge of this work. .. I doubt if the scheme can be seH-supporting, let alone proflt-maklng, for the
332
'tUBERCLE
[April, 1921
waste, supervision, runninR charges, &:c., and simple reason thAt the out-turn of unhealthy, l.e ., inelficicnt, labour could not hope to is directly ailected by qua.nt.i ty and qualit.y of the finished ..rticle. t'rofit, of course, comes compete 0.11 regards prices, qUAlity or quantity, with that of healthy labour. I assume, 01 in commercially; but in this ease, all it is probably not Bought, ueed not be considered, course, in thi s statement tha.t mechanical skill It is proposed to pay T. U. rates. Waste. is equal, or at Icast comparable, in both cases, 1 think, Is certain to be bigh owing to physical I f it is not, I do net see how the scheme can possibly be run except as Ilo drain on some dlsability ; supervision is also likely to be expensive owing to the necessarily non aU:liliary fund. Prices 1 will refer to later. Consider quality. continuous nature of the labour (I mean mertality will be higher than with ordinary It is len.!\onab\e to suppose that the hea.lthy mind, depending largely on a hcalthy body, labour, and men will have to be trained in Will produce 1\ better article than the diseased tae shop to replace others at much more bod)" directed by a mind which must feel tho frequent intervals). Running charge- depend lull handicap of such disease. I am certain, largely, of course, on the skill with which the from my own personal experience, thll.t there shop is organised. is no doubt that quality of out-turn, otber I think the T.U. rate of wlI~e would be thinp;lI being equal , is 1\ direct function of entirely uneconomical in regard to the out. health. turn which could be expected, and therefore Quaat ity. H tbe tuberculous worker can this Iactor must increase the selling price 3S ml\inta.in an even output over four hours and compared with that of the article produced that output eorrespoud to tho four bours by healthy labour. period of II. hcalthy man, quantity will, of 1 fear that the aggreg\l.te of these items course, be safe-but can he? postulates an almost impossible solling price. Suffering as he does I think that his first Incidents.lly, electrical componenta are menbour'a out- turn will be the only one which tioned. Some of those produced in England could hope to compare as regards quantity at present are priced at 3G8. a dozen-Germa.ny with any period of a healthy man's shift. lands a better article in this country for 6s. At the cnd of the first hour the tub erculous Hence our so-called healthy labour requires person will begin to feel fatigue, which will protection. What would our unhealthy Increase in IJ, h igh proportion in the succeeding workers require to pay their war?" hours in relation to his own first hour and reach a maximum at the end of the fourtb These comments are of very great interest. hour. and show how difficult is this question of I also think fatigue will increase immeasuremployment. It appears to me, however, ably faster in tbe sick man than in the healthy many of them would be equally true if one, even though we compare a total four hour applied to other forms of suggested employbhilt with all eight hour one. ment for tbe tuberculous, While recognising Wha.t r mean is tbat the out-tum (quantity) the truth of many of these comments, I see in the fourth hour of 0. sick man is likely to no reason to doubt that an experimental work. be much less than tbat of the eighth hour of shop carried out 011 the lines 1 suggested in 1\ healthy one . Lack of quantity and, still my note would yield the mo~t valuable informore, lack of quality runs up the price of mation , and even if run at some loss would producti.on which has to compete i.n the open compare favourably from nll points of view market.. with the more exp ensive settlements and T1·ai,~ill!J . r have no doubt th at anyone can colonies. be trained in very much leAS than l\ fortn ight Faithfully yours, to fllt a rod into an auto-machine and take it FRKDERICK J. I.J. BLACKMORI£. out .. rain at the right time. Small Indian 39, Woodland Terrace, boys, 14 to 18 years of age, do it regularlyand Old Charlton, S.E.7. successfully; but they are not auto-machinists. February 28. 1921. An auto-machinist should be able to change cams on bis machine I\nd have sufficient mechanical knowledge to recognise when his tools are out of order, i.e., to remove a blunt, THE DUGNOSIS OF PULnrONARy'rUBERCULOSIS. damaged or broken tool. I doubt if this could To the Editor of .. Tubercle." bo learned under several months. DEU\ 811\,-1 llhould like, it I tna.y \;0 If the men are to work under the conditions in wbich our Indian boys do, skilled super- comment on the important article by 'Dr Bardswell in the U arch number of TUllERCLll:' vislon would be essential, otherwise tbe phmt would be broken up in a short time. Buch a It appears to point out clearly the practica.i supervisor could command 1Io wage of £7 or £8 va.lue of observation beds in hospital, by a week, and would if ho were non -tubercular showing that only 15 pel' cent. of the 158 want more to cover his risks in such a shop cases observed were recommended for trea\;. l\S the one suggested. ment. No doubt this was the reason for its The tra.ining of a ma.chinist can only be publication. But it implies sometbinR more short. when a. \a;rge i1,killed sUllerv\sor y IItllo