501 The former post, to which Dr. J. Douglas Stanley was appointed, carries an honorarium of .E100 per annum and entails a large amount of work, for it will be necessary that the consulting physician should examine a large number of patients, not only when the hospital is opened but whenever a vacancy occurs, in order that the cases most likely to benefit may be selected. Dr. Stanley is physician both to the Queen’s and the Children’s Hospitals and no one who knows his keenness and energy will doubt that he will carry out the new work thrown upon him with conscientious ability and with an eye to securing the best results from the sanatorium treatment. Dr. Paul Mathews, who has held the post of resident medical officer in the Newcastle-upon-Tyne Sanatorium, was appointed medical superintendent at
Salterley Grange. Infectaaics Ihsease in the Yaq’dley Rural District. There is evidently need for increased hospital accommodation for infectious diseases in the Yardley district, for a somewhat sudden rise in the number of scarlet fever cases has made it necessary to admit only special cases to the beds at the disposal of the authorities, so that many cases have had to be refused admission and provided with home treatment. Fortunately this state of affairs has not so far proved a serious menace to the public health, for apparently only two fresh cases have occurred in houses from which patients could not be removed. The district council cannot count, however, on a continuance or repetition of such good luck, and it would be wise to accept the warning that the hospital accommodation it has provided is not sufficient ’ for the very possible needs of the district. 26 Cost of King’s NO’l’ton Lunatics. The enormous strain which the maintenance of the insane throws upon any public community was illustrated at a recent meeting of the King’s Norton board of guardians, when Mr. Garret, the chairman of the finance committee, drew attention to the fact that within a period of two or three years the cost, so far as King’s Norton was concerned, had risen from 10,000 to .E12,000 per year, exceeding the total cost of maintaining the inmates of the workhouse, the old people in the infirmary, and the children in the cottage homes. If the people generally could be got to realise the strain which is thrown upon them by insanity it is possible that useful laws aimed at its reduction might be obtained. The present system of trying to obtain as many so-called cures as possible simply serves to increase the calamity, and it appears strange that there is no outcry against it. The Annual Report of the Medical Officer of Health of
TF(t’C7’A
NEWCASTLE-UPON-TYNE. (FROM Statistics
OUR OWN
CORRESPONDENT.)
the
Royal TTactoria Infirmary, 1907. THE year 1907 was an eventful one in the history of this institution in view of the fact that the magnificent new buildings on the Moor Edge were completed and opened by H. M. the King in July. The old infirmary buildings on the Forth banks alongside the Central Railway station were formally surrendered to the corporation of Newcastle-uponTyne in August. The new infirmary is much more extensive and affords much greater accommodation for the reception and treatment of patients than the original institution. The number of beds for patients has increased from 293 on Jan. lst, 1907, to 411 on Dec. 31st, 1907. The number of patients admitted during the year was 6445, an increase of 1546 over 1906. The average daily number in the wards was 3354 against 251’8in the previous year, while the highest number in the wards on any one day was 407, against 291 in 1906. The average length of stay was slightly greaterviz., 18 - 9 days in 1907 and 18 - 7 in 1906. The number of out-patients was 35,445, an increase of 3001 over the number for 1906, while the casuals receiving treatment numbered 18,274, as against 17,808 in 1906. The total attendances in the out-patient department (indoor and outdoor) showed a decrease of 366993,244 in 1907 and 96,913 in 1906. The total ordinary income in 1907 was .622,869, an increase of .66342 over the income for 1906. The total ordinary expenditure amounted to .627,267, which exceeds the expenditure for 1906 by .66806. The excess of ordinary expenditure over ordinary income amounts for the year to .64397, while in 1906 the excess of expenditure over income totalled That is to say, that for every .6100 of income the <&bgr;3932. infirmary authorities spent in 1907 about 119 and in 1906 about 123. The cost per in-patient, calculated upon the total ordinary expenditure less the cost of out-patient and casuals, was .64 Os. 5-kd., the average stay being 189 days. The cost per occupied bed was L77 5s. 10d. In 1906, calculated upon a similar basis, the cost per in-patient was .63 18&. (average stay 18 ’7 days), and the cost per occupied bed 975 17s. 7. It is to be noted that nearly one-half (.&bgr;I0,877) of the total ordinary income for 1907 (<&bgr;22,869) was made up of workmen’s subscriptions. This amount of .,10,877 IP exceeds the amount received from the same source during 1906 by .63658. of
Dr. H. Malet’s report on the health of Wolverhampton disAnntbal Report of the 1lTedieal Officer of Health of closes a comparatively satisfactory condition of affairs in Newaastlefo1’ 1907. that town during 1907, the total death-rate for the year being to the annual report of the medical officer of According 14 5 per 1000, or 32 per 1000 less than during the previous health (Dr. H. E. Armstrong) the population of the city in year. This is no doubt due partly to absence of infantile the middle of 1907 was estimated to be 272,969. There diarrhoea and partly to a lowered birth-rate, but some part of were 1251 cases of infectious disease notified during the the diminution must be ascribed to gradually improving con- year, including 614 cases of scarlet fever, 383 of diphtheria, ditions, and it is probable that the appointment of a lady and 66 of enteric fever. The death-rate from all causes was inspector of midwives who is to supervise the midwives and 16 -8per 1000 of the population and the death-rate from the give advice to mothers will help to reduce the high infantile seven" chief zymotic diseases "1-4 per 1000 of the populamortality-rate which is so largely due to the ignorance tion. Scarlet fever was responsible for 22 deaths, giving a regarding the proper treatment of babies which exists mortality per cent. to cases notified of 3’6. Diphtheria amongst the working classes. caused 52 deaths and the rate of mortality to cases was 13’6 The Walsall and -District Hospital. per cent., as against 18.1in the previous year. There was an Enteric The financial position of the Walsall District Hospital is increase of 19 cases over, the number in 1906. fever caused 11 deaths ; the rate of mortality to cases a subject of serious concern to the committee, and at a The number of deaths from recent meeting of the general committee the chairman, Mr. notified was 16’7 per cent. F. J. Cotterell, stated that although it had been suggested diarrhoea was only 46 during the year, as compared with a that the hospital had not been as economically managed as return of 257 for the year 1906. A large part of the report of a reprint of a previous report submitted by the possible he was unable, after going carefully through all consists the details, to hold out any hope that it would be possible to medical officer of health to the sanitary committee on Tuberdiminish the expenditure to any degree except by the closure culosis, its Casualties, Causes, and Control. After reviewing of a certain number of beds. It was estimated that the the range and fatality of human tuberculosis Dr. Armstrong to consider the causes of the disease and the media expenditure for the present year would be E1100 in excess proceeds of the income and the adverse balance would thus be raised by which the bacillus gains entrance into the bodies of preto .E2000. In these circumstances the committee felt that, viously healthy human beings. These he enumerates in the much as they regretted the step, some of the beds must following order: (a) the milk and milk products of tuberbe closed. In the meantime, however, efforts to increase culous cows consumed as focd; (b) the milk of a tuberculous the income were being continued and appeals were being human mother; (a) the flesh of tuberculous animals consumed matters and other infectious made to secure support from surrounding districts which as food ; (d) dried expectorated inhaled or swallowed as of consumptive persons discharges derive benefit from the hospital. and
August llth.
atmospheric dust, &:c. ;
;
(e) heredity ;
(f) marriage
502 of the tuberculous, &c. Each of these causes is considered in detail and under the head of the prevalence of tuberculosis among dairy cows Dr. Armstrong estimates that there are 560,000 tuberculous milch cows in England alone and nearly one and a quarter millions in the United Kingdom. ’’ The bare idea of the amount of possible human tuberculosis from the milk of so immense a number of diseased cows is appalling." The question of extinction of tuberculosis is then sketched and in reply to the query, Is the control of the disease so far as it relates to the two chief articles of diet, meat and milk, worth while trying ?Dr. Armstrong’s answer is : "To this the reply is undoubtedly Yes ! for although the cost of exterminating tuberculosis in food-yielding animals must of necessity be great, and is likely to be opposed by persons whose private interests may be touched and by party politicians, yet the prospect of the benefit in view to the State and suffering humanity and the hope of obtaining it are greater still."
Professor 1. OlivcT. Dr. Thomas Oliver, professor of physiology in the University of Durham, who was president of the section of industrial diseases at the recent annual meeting of the British Medical Association, is to be congratulated upon the honorary degree of doctor of science recently conferred upon him by the University of Sheffield as a mark of recognition of the value of his work in industrial hygiene. August,10th.
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WALES AND WESTERN COUNTIES NOTES. (FROM OUR OWN CORRESPONDENT.) Medical Inspection in the Rhondda Valleys. THE Rhondda urban district council has not yet decided how the medical inspection of the school children in the district shall be carried on, but a proposal has been made by a committee that an assistant medical officer of health shall be appointed who shall reside at the isolation hospital and devote part of his or her time to the medical inspection of school children. As the population of the district is considerably over 130,000 it is obvious that the whole of the medical inspections cannot be done by one officer in addition to the duties attached to the hospital, where there are now 36 beds and will very shortly be 52, a number all too few for the size and industrial character of the district. Three years ago the district council obtained special clauses in a private Bill enabling the medical officer of health to enter the public elementary schools in the district and to examine the scholars in attendance, excluding from school any he conA further provision sidered likely to spread infection. requires the head teacher of a school to inform the medical officer of health of the name and address of any child in the school who is suffering from an infectious disease and upon request the teacher must furnish a list of the scholars attending the school, payment being made at the rate of 6d. for every 25 names.
The ffealt7t of Bristol. The death-rate in Bristol for 1907 was 13’3, compared with 147 in 1906 and the ten years’ average of 16 -1. This. death-rate is the lowest on record for Bristol. The birthrate was 24’ 2, which also is the lowest on record. The. infantile rate was 100 per 1000 births, which is the lowest infantile rate ever recorded in the city. New Cottage Hospital for Torrington (De2on). For many years the need of a hospital for Torrington has. been felt and on August 5th, in the presence of a large gathering, Mrs. Scott Browne, in the unavoidable absence of Lady Gertrude Rolle, laid the memorial stone of a cottage hospital. The memorial stone has an inscription statingthat the institution is "in memory of William Glubb, who endowed it, of the Honourable Mark Rolle, who gave the site, and of William Vaughan, who originated the scheme." The hospital will be completed in a few months at a cost of .&1190, the whole of which sum has been raised. The greater portion of the maintenance is provided for by a bequest from the late Mr. Glubb which produces 230 per annum. The Sanitary Condition of Monmouthshire. At the last meeting of the Monmouth county council attention was drawn in a report of the medical officer of health (Dr. D. T. Rocyn-Jones) to the two urban districts of Abertillery and Rhymney. In each locality there appears to, be a great lack of suitable dwellings for the colliers who are employed there. In Abertillery it is the general custom to take in lodgers whether there is a spare room or not, for in some instances the same beds are occupied by different persons both day and night. The district council is advised to provide a public slaughter-house and in this connexion it is of interest to note that the same recommendation has been made by the Abertillery medical officer of health (Dr. D. C. Muir) for at least ten years. Another suggestion made in the report to the county council is the erection of a refuse destructor, and this again is but the echo of a strong recommendation of Dr. Muir in 1903, in which year, according to the review of the sanitary condition of the county issued by the sanitary committee of the county council, it was decided to erect a destructor in connexion with -an electrical installation. The medical officer of health of Rhymney (Dr. T. H. Redwood) has for years reported unfavourably upon the back-to-back and back-to-earth houses in his district, and the attention of the county council is once more drawn to this objectionable type of house, and it is to be hoped that that body will now insist upon their closure or conversion into dwellings with a through ventilation. August 10th. _________________
SCOTLAND. (FROM
OUR OWN
CORRESPONDENTS.)
Clyde Pollution. IT is expected that in a very short time, when the various Bristol Water-supply. sewage works now completed or in process of completion The water-supply of Bristol is not in the hands of the city are in full working order, Glasgow will cease to be an corporation but is controlled by a private company who offender in the matter of river pollution. In connexion obtain supplies from springs on the sides of the Mendip Hills with this matter a circular has been issued to ’local shipowners and to the masters of all vessels visited by the some 16 miles from the city, and from wells and springs about 12 miles distant. The supply is constant and good. Sand sanitary inspectors to the effect that all water-closets for filtration is resorted to before delivery into the mains and the seamen and firemen on board ships of all nations must be kept closed while the vessels are in harbour. The port analytical results recorded in the annual report of the authorities have now provided latrines ashore for these medical officer of health (Mr. D. S. Davies) show that the water is quite above suspicion of pollution. Before filtra- classes, special provision having been made for the Lascar tion there were found 240 colonies per cubic centimetre on and Chinese crews. Now that the city of Glasgow has set its nutrient gelatin at 22° C., a number which was reduced to own house in order communications have been addressed to the 36 colonies by filtration. The amount of chlorine was low, local authorities in the upper and lower reaches of the river for 1.6 parts per 100,000, but of albuminoid ammonia rather the prevention of the pollution of the river there. The Lanarkshire county council has given satisfactory assurances that high-namely, before filtration 0’03 per 100,000 and after it is dealing with the matter, but there are still one or two filtration 0 - 008 per 100, 000. neighbouring burghs which continue dumping their sewage into the Clyde and show no indication of altering their Hospital Sunday Fund in Bristol. The total amount contributed to the Hospital Sunday Fund methods. As soon, however, as the new sewage scheme for at Bristol for 1908 was .61859, being Z104 more than in 1907. Glasgow is completed-and this will be very shortly-the Of this sum Z1776 have been divided amongst the various city will no doubt take proceedings for the enforcement of medical charities of the city, the final distribution being the provisions of the Rivers Pollution Acts, and in that way made by the committee of the Fund at its meeting on compel the recalcitrant burghs to fall into line with the July 31st. majority.
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