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THE ALMONER AT THE V.D. CLINIC
145 of the Royal Society and author of the Thesaurus "), and Brodie, on whose recommendation he was appointed medical officer of Pentonville. In 1836 he published " On the Analysis of the Blood and Urine in Health and Disease," one of the
(secretary
famous "
earliest works on biochemistry. In 1838 he demonstrated hyperglycsemia in diabetes, being the first to make a quantitative estimate of blood-sugar. Results of his team-work with Bright on Bright’s disease were published in Guy’s Hospital Reports in 1843, with an appendix by Rees on " Observations on the Blood with reference to its peculiar condition in morbus Brightii." He had previously helped Bright in his work on jaundice. For many years he assisted Swayne Taylor in his toxicological work, giving evidence in the Palmer and other celebrated trials. Rees gave the Goulstonian lectures in 1845, the first Lettsomian lecture at the Medical Society of London in 1850, the Croonian lectures in 1856, and the Harveian oration in 1869, in which he suggested that " nerve force" might be analysed with the help of chemistry (see Lancet, 1869, 2, 26). George Owen Rees died of cerebral hsemorrhage on May 27, 1889. He never married, having devoted his life to science and to the support of his impoverished mother, brother, and sister. THE ALMONER AT THE V.D. CLINIC
THE post of lady almoner to a clinic for venereal diseases is one that calls for exceptional gifts. The patients who attend such a department are in general far from being the moral outcasts and degenerates that the public, and only too many of the medical profession, believe them to be. Usually they are ordinary human beings in serious trouble who are abnormally resentful of prying interference but highly responsive to sympathetic understanding. The almoner’s work, therefore, has many pitfalls and many discouragements, but also many compensations to one endowed with a proper understanding and trained in the right methods of approach. Miss Manchee writes1 from considerable experience at St. Mary’s Hospital, and her book is full of useful information for those who would tread this thorny path. The introductory chapter by the medical director of the clinic at St. Mary’s gives a concise summary of the main facts about the venereal diseases and their treatment which the almoner should know-knowledge which is essential in her work but is ordinarily hard to acquire. Succeeding chapters deal with the general duties of an almoner, and the work of record-keeping, and contain much tabulated information about treatment centres, special hospitals and organisations. Others are devoted to the particular problems of following-up, of maternity patients and of infected children. Miss Manchee’s personal views are sound and instructive, but may be open to criticism on points of detail. She rightly emphasises that the first interview is the most important ; but it may be argued that the patients need not be questioned as to both medical and social circumstances before seeing the medical officer. Many would resent such crossquestioning, although they would be willing to give particulars to the medical officer or later to the nurse who is giving treatment ; after which, if help is needed, they could be referred to the almoner. Then there is the difficult question whether a visit should be the final step in following-up when letters remain 1 Social Service in the Clinic for Venereal Diseases. By Dorothy Manchée. London: Baillière, Tindall and Cox. 1938. Pp. 91. 3s.
unanswered. As Miss Manchee says, "untold harm can be done through thoughtlessness or overzealousness"and many would regard such visits as a serious manifestation of excessive zeal, except perhaps in the occasional case where a child’s health is being jeopardised by parental carelessness or ignorance. In all these situations wise restraint is the first essential, and the almoner who is over-active will do more harm than good. To those who possess the necessary qualities and would attempt this difficult task, the present book is likely to be a substantial
help. A FRIEND OF CHILDHOOD
Miss Clara Andrew, who died last week, had an idea in 1914 and spent the remaining 25 years of her life in working it out. The idea was to give childless couples the opportunity of bringing up children who had no proper homes of their own. It started with her Belgian refugee work but soon broadened in the atmosphere of war-time generosity. She had little difficulty in finding permanent homes for war orphans and then set about protecting not only the adopted children but also the adoptive parents from later interference. The act of 1926 giving both parties legal status is now a commonplace ; it was actually the result of long and patient labour, and Clara Andrew was not content to leave it there. She helped to obtain the appointment of a departmental committee to consider further safeguards and its recommendations are now awaiting royal assent. It has been said that she found homes for more than 6000 children, of whom no more than 30 proved misfits. This was in itself no mean achievement; but she did more than this, for she and her co-workers have almost redeemed the phrase " " baby-farmer from its terrible associations. ERRORS IN THE DIFFERENTIAL BLOOD-COUNT MANY American hsematologists have claimed that accurate differential cell-counts are obtained when the smears are made upon cover-slips than when they are prepared on slides. Boverihas undertaken some comparative studies of accordingly white cells by the two methods. These comprised differential counts on himself on twenty-six days at approximately the same hour of the day. Two films were made on slides, four films (two pairs of films) on cover-slips. On each of the two slide films 600 cells were counted, making 1200 in all, and on each of the four cover-slips 400 cells, making 1600. At the same time as a check the lymphocytes were counted in a Buerker chamber against the remaining types of cells taken together. It was thought that the percentage of lymphocytes obtained in this way more
would represent fairly accurately their percentage in the original drop of blood. The lymphocytecounts obtained from the cover-glass counts and the Buerker-chamber counts agreed closely, the average difference being only 0-5 per cent. The lymphocyte percentages obtained from the slides were constant and higher by approximately 10 per cent. In other words the lymphocyte percentage ranged between 20 and 30 by the counting-chamber and cover-slip technique and between 30 and 40 with the slide method. There was little to choose between the two
methods as far as consistency. For the slides the average difference was 2-15 per cent. and for the cover-glasses 2.2 per cent. The high lymphocytecount is due, Boveri believes, to the tendency of granulocytes and monocytes to congregate near the 1.
Boveri, R. M., Guy’s Hosp. Rep. 1938, 89, 112.
(secretary
famous "
earliest works on biochemistry. In 1838 he demonstrated hyperglycsemia in diabetes, being the first to make a quantitative estimate of blood-sugar. Results of his team-work with Bright on Bright’s disease were published in Guy’s Hospital Reports in 1843, with an appendix by Rees on " Observations on the Blood with reference to its peculiar condition in morbus Brightii." He had previously helped Bright in his work on jaundice. For many years he assisted Swayne Taylor in his toxicological work, giving evidence in the Palmer and other celebrated trials. Rees gave the Goulstonian lectures in 1845, the first Lettsomian lecture at the Medical Society of London in 1850, the Croonian lectures in 1856, and the Harveian oration in 1869, in which he suggested that " nerve force" might be analysed with the help of chemistry (see Lancet, 1869, 2, 26). George Owen Rees died of cerebral hsemorrhage on May 27, 1889. He never married, having devoted his life to science and to the support of his impoverished mother, brother, and sister. THE ALMONER AT THE V.D. CLINIC
THE post of lady almoner to a clinic for venereal diseases is one that calls for exceptional gifts. The patients who attend such a department are in general far from being the moral outcasts and degenerates that the public, and only too many of the medical profession, believe them to be. Usually they are ordinary human beings in serious trouble who are abnormally resentful of prying interference but highly responsive to sympathetic understanding. The almoner’s work, therefore, has many pitfalls and many discouragements, but also many compensations to one endowed with a proper understanding and trained in the right methods of approach. Miss Manchee writes1 from considerable experience at St. Mary’s Hospital, and her book is full of useful information for those who would tread this thorny path. The introductory chapter by the medical director of the clinic at St. Mary’s gives a concise summary of the main facts about the venereal diseases and their treatment which the almoner should know-knowledge which is essential in her work but is ordinarily hard to acquire. Succeeding chapters deal with the general duties of an almoner, and the work of record-keeping, and contain much tabulated information about treatment centres, special hospitals and organisations. Others are devoted to the particular problems of following-up, of maternity patients and of infected children. Miss Manchee’s personal views are sound and instructive, but may be open to criticism on points of detail. She rightly emphasises that the first interview is the most important ; but it may be argued that the patients need not be questioned as to both medical and social circumstances before seeing the medical officer. Many would resent such crossquestioning, although they would be willing to give particulars to the medical officer or later to the nurse who is giving treatment ; after which, if help is needed, they could be referred to the almoner. Then there is the difficult question whether a visit should be the final step in following-up when letters remain 1 Social Service in the Clinic for Venereal Diseases. By Dorothy Manchée. London: Baillière, Tindall and Cox. 1938. Pp. 91. 3s.
unanswered. As Miss Manchee says, "untold harm can be done through thoughtlessness or overzealousness"and many would regard such visits as a serious manifestation of excessive zeal, except perhaps in the occasional case where a child’s health is being jeopardised by parental carelessness or ignorance. In all these situations wise restraint is the first essential, and the almoner who is over-active will do more harm than good. To those who possess the necessary qualities and would attempt this difficult task, the present book is likely to be a substantial
help. A FRIEND OF CHILDHOOD
Miss Clara Andrew, who died last week, had an idea in 1914 and spent the remaining 25 years of her life in working it out. The idea was to give childless couples the opportunity of bringing up children who had no proper homes of their own. It started with her Belgian refugee work but soon broadened in the atmosphere of war-time generosity. She had little difficulty in finding permanent homes for war orphans and then set about protecting not only the adopted children but also the adoptive parents from later interference. The act of 1926 giving both parties legal status is now a commonplace ; it was actually the result of long and patient labour, and Clara Andrew was not content to leave it there. She helped to obtain the appointment of a departmental committee to consider further safeguards and its recommendations are now awaiting royal assent. It has been said that she found homes for more than 6000 children, of whom no more than 30 proved misfits. This was in itself no mean achievement; but she did more than this, for she and her co-workers have almost redeemed the phrase " " baby-farmer from its terrible associations. ERRORS IN THE DIFFERENTIAL BLOOD-COUNT MANY American hsematologists have claimed that accurate differential cell-counts are obtained when the smears are made upon cover-slips than when they are prepared on slides. Boverihas undertaken some comparative studies of accordingly white cells by the two methods. These comprised differential counts on himself on twenty-six days at approximately the same hour of the day. Two films were made on slides, four films (two pairs of films) on cover-slips. On each of the two slide films 600 cells were counted, making 1200 in all, and on each of the four cover-slips 400 cells, making 1600. At the same time as a check the lymphocytes were counted in a Buerker chamber against the remaining types of cells taken together. It was thought that the percentage of lymphocytes obtained in this way more
would represent fairly accurately their percentage in the original drop of blood. The lymphocytecounts obtained from the cover-glass counts and the Buerker-chamber counts agreed closely, the average difference being only 0-5 per cent. The lymphocyte percentages obtained from the slides were constant and higher by approximately 10 per cent. In other words the lymphocyte percentage ranged between 20 and 30 by the counting-chamber and cover-slip technique and between 30 and 40 with the slide method. There was little to choose between the two
methods as far as consistency. For the slides the average difference was 2-15 per cent. and for the cover-glasses 2.2 per cent. The high lymphocytecount is due, Boveri believes, to the tendency of granulocytes and monocytes to congregate near the 1.
Boveri, R. M., Guy’s Hosp. Rep. 1938, 89, 112.