569 About the year 1900-01 the practice was commenced of distributing at all houses where cases of measles were notified by school teachers instructions as to keeping the windows open and blinds up, and keeping the child clean. To the adoption of these instructions I mainly attribute the fall of mortality. No doubt if more thorough open-air treatment was adopted the mortality might be still further reduced.-I am, Sir, yours faithfully, SIDNEY DAVIES,
Correspondence. "Audi alteram
partem."
THE PROPHYLACTIC TREATMENT OF PUERPERAL INFECTION BY DILUTE SULPHURIC ACID. To the Editor
of THE LANCET.
Medical Officer of Health.
Public Health Department, Woolwich, March 8th, 1915. has afforded us much pleasure to read in your issue of in a letter by Dr. J. L. Moir Jan. 16th of the favourable results he has obtained A GRIEVANCE. by the dilute sulphuric acid treatment in the proTo the Editor of THE LANCET. phylaxis of puerperal infection, because they still SIR,-Most of the Insurance Committees throughfurther afford evidence of the real value of this out England are only paying ls. a head on account in of infections. The subject remedy pyogenic for last quarter owing to the action of the Insurpuerperal infection is such an important one that ance Commissioners in preventing the societies the extension of this mode of treatment as a lists of those members who have joined the sending prophylactic measure should be a valuable step or navy to the committees concerned. This army forward. We now draw special attention to the alteration has resulted in a great many panel doctors being in strength of acid. sulphuric. dil. as the official pre- placed in very awkward financial straits at a time when credit is almost impossible to obtain and paration in the new Pharmacopoeia, 1914, because when many of us who have been called up were the strength has been reduced by 26’7 per cent. It on the money thus held up to pay our counting thus becomes necessary to point out that the dose It is preposterous to suggest that even substitutes. in this treatment must be materially increased to a quarter of the 8d. in addition to the 4d. already be equivalent to the 20-30 minim doses of the acid. withheld will be to balance the removals sulphuric. dil. of the old Pharmacopoeia. The dose from our lists. necessary should now be 25-35 minims. We cannot help Now another grumble at the action of the War feeling that great benefit might be derived by the Office in paying officers with temporary commissions administration of this remedy to the wounded in several shillings a day more than Special Reservists the present European War, as many of the infected Territorials who have taken the trouble to and wounds would, we believe, run a much more favourin times of peace, who, commissions for qualify able course; indeed, it would be better if the treathave established practices and homes to ment were adopted as a routine prophylactic moreover, whereas of the temporaries are many very measure. Sulphuric acid is so inexpensive, and so keep up, I men with no responsibilities whatever. young easily obtained, that even for such an extensive use know it will be said we did it with our open. eyes the question of expense is negligible, and it has the additional advantage of acting as a direct tonic. But we did not bargain for the War Office collaring Dr. Moir also raises an interesting point when he practically three-quarters of the men we were to to fill our places when we were called up speaks of its effect in increasing the resisting power looking and thus making locums so expensive and unobtainof the tissues to infection. This view seems to be able that in my own case I have had to pay JE150 a borne out by expriments already conducted, but the Goodness more than I get as army pay. year as to of the whether diminution alkalinity question I I but feel that do not to wish grumble, of the blood is responsible for the increase of the knows, I am voicing the opinion of practically all Reservist resisting power yet remains to be decided. The and Territorial medical officers. experimental work involved in the investigation of I enclose my card and wish to remain, this subject is necessarily long and tedious and is Yours faithfully, still being conducted. ANONYMR We are, Sir, yours faithfully, J. REYNOLDS. THE SHORTAGE OF LOCUM-TENENTS AND RUSSELL J. REYNOLDS. London, S.W., March 8th, 1915.
SIR,—It
RESIDENT MEDICAL OFFICERS. To the Editor
of THE LANCET. start with SiB,—I may remarking that I have to say against any medical agent or the secrenothing ’ To the Editor of THE LANCET. tary of any hospital. I have dealt once only with each SIR,-With regard to the open-air treatment of of them respectively, and the agent kindly reduced measles and Mr. J. Tertius Clarke’s letter in his fees by one-half on my asking for consideraTHE LANCET of March 6th, I should like to bear tion in special circumstances, and this although The my testimony to the effect of ventilation and light ’, he had my signature to his full terms. in diminishing the mortality of this disease. In ’, secretary to the hospital made my life there as I am a Woolwich the death-rate from measles between comfortable as it possibly could be. 1891 and 1900 was 0’59. During the past four middle-aged practitioner now, and I remember years it has been reduced to 0’19, or about one- both men with gratitude. I would like, however, third of what it formerly was. There is no ques- to make a few remarks on what occurs outside tion here of diminished prevalence, although if the sphere of the agent or hospital secretary. the death-rate was calculated on the number of The main reason for going into a hospital is children living at ages 0 to 5 the fall would not be to be taught. In many cases the staff are too busy The so great as it appears, but even then it would be to teach much, and valuable time is wasted. and at a and men are business quite fairly considerable. agents very
OPEN-AIR TREATMENT OF ACUTE SPECIFIC FEVERS.
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