- Email: [email protected]
THE POST-GRADUATE CONGRESS AT BUDAPEST.
349 422 cases of true ophthalmia neonatorum. this disease was obscure. From the point of view of vision in both eyes resulted in one case, prognosis and treatment he deemed it proper to in one eye in three cases, whilst in six cases the result discriminate between angina pectoris on the one hand could not be ascertained owing to removal. Sixty- and aorta syphilitica and aorta nervosa on the other. five cases received in-patient treatment at St. As a prophylactic measure he thought it desirable Margaret’s Hospital. As regards beds available in that people who had contracted syphilis not more London for maternity cases, it is estimated that about than 10 or 12 years before should receive specific 37,000 patients could be accommodated, equal to treatment regardless of their condition or the results Since 1915 the of a Wassermann reaction. Prof. Hasenfeld expressed 43 per cent. of thetotal births. undesirable maternity home has disappeared, whilst himself as opposed to surgical treatment because it the standard of efficiency in other homes has improved. excited the patient and might provoke an attack, because it did not affect the fundamental coronary disease, and because pain was the natural warning sent by the heart when it was being given too much THE POST-GRADUATE CONGRESS AT work to do.
there
were
Impaired
BUDAPEST. OUR OWN CORRESPONDENT.) (FROM
Tms year the Hungarian post-graduate medical has been held in the neighbourhood of Ijake Balaton. Vast tracts of flower forests surround the lake which is so large that it is called the Hungarian Sea, and in the July weather it is an ideal place for Those who arranged the course of lectures a holiday. did their best to make the occasion pleasant as well The medical teaching was in the mornings as useful. only and the afternoons could be given over to bathing, fishing, and excursions. An unprecedented number of doctors came to enjoy this happy mixture of relaxation and learning. The first lecture was delivered by Prof. John Bokay, who spoke on his experimental results with the Dick prophylactic inoculations against scarlet He had been, he said, one of the first in fever. Europe to try the method, and experience of more than 6000 cases had led to his complete agreement with the Dicks’ opinions. He saw the closest reaction between the positive result of the cutaneous test and susceptibility towards scarlet fever, and he regarded the Dick test as of great importance from the point of view of prophylaxis. Active immunisation by the injection -of toxins in gradually increasing doses transformed the reaction in 90 per cent. of cases from positive to negative, and it appeared that the immunity thus produced was lasting. His experience also corroborated that of American observers who -could look back three years and who claimed that the immunity lasted at least for this time. The disturbances which might occur during the production of immunity were very mild and were certainly not bad enough to stop the Dick method of inoculation spreading far and wide. Prof. Csiky Jozsef, speaking on the pathology and treatment of headache, said that in his opinion the hereditary nature of neurasthenic headaches could not be contested. Amongst the causes of headache arising outside the skull the greatest importance should be attached to rheumatism, and it was remarkable that so little attention had been paid to this cause in Eastern Europe. The treatment was very simple systematic massage and warm f omentations. Dr. Joseph Tornai gave an address on heart disease and pregnancy, in which he said that two or three decades ago the mortality of childbirth associated with heart disease was 50-60 per cent. ; nowadays it was only 12 per cent. at the most. Methods of - examination, however, as he remarked, are more likely to reveal cardiac disease than they were formerly. Besides the strain which pregnancy threw on the heart there was the fear that endocarditis might recur. In general it could be said that in heart disease of slight degree, so long as the muscular action was strong, the prognosis was fairly good. Aortic disease was generally much more serious than mitral. The law did not allow the doctor enough freedom of judgment in cases where abortion might be required. It was very difficult to say when a patient ought to be advised against marriage, but he thought that a girl and her parents should undoubtedly be told the facts. Prof. Arthur Hasenfeld, in a paper on angina pectoris, pointed out that even yet the etiology of
_______________
UNITED
(FROM
AN
STATES
OF AMERICA.
OCCASIONAL CORRESPONDENT.)
congress
The Cost of Private Nursing. significant facts are emerging in the inquiry now being jointly conducted by the New York State Nurses’ Association and the Committee on the Grading of Nursing Schools. The practice of assigning one nurse on constant duty to attend one patient is now seen to be an anachronism. It dates from some 50 years ago when women’s services were limited in scope, plentiful within their limitations, and consequently inexpensive. To-day the reward paid for private nursing of$5 and$7 a day is not sufficient to draw large numbers to the profession and those who graduate as nurses are attracted in increasingly large numbers to salaried positions in institutions. The daily pay after all is not large. It was found that at a given time, and in the busy season (Feb. 21st28th), only 72 per cent. of 1409 private duty nurses were at work ; 23 per cent. were at home, and 5 per The nurse, cent. were themselves sick in bed. therefore, is not -at work all the year round. And when she is at work her wage is found to average only 49 cents an hour, which is the equivalent of the earning capacity of " charwomen, servants, and unskilled labour." Nor is there prospect of advancement. There are no grades in private nursing and a graduate of ten years’ standing is not supposed to charge any more than a nurse fresh from her training. Another count brought against private nursing is that the long hours of duty are unhealthy and demoralising, while the absence of professional occupation for a large part of the time adds to the demoralisation. It was found that 80 per cent. of the nurses at work were on 12-hour duty and 18 per Two solutions are indicated : cent. on 24-hour duty. the first is to increase the number of hospitals wherein each nurse can give attention to several patients ; the second solution is one which is already finding expression in the growing activity of the Visiting Nurse Associations. Working for these associations the nurse visits several homes each day. It happens sometimes that a patient is so seriously ill that one nurse is assigned for constant duty, but this is a service which is very rarely demanded even though There may have been too much it is available. readiness to relegate to this system of care only those who cannot afford to pay for a full-time nurse. There is no moral or economic justification for any professional worker spending 12 or 24 hours on work that can be done with efficiency in a small part of that time. The Spread of TMM’ee’MCt. The Bureau of Biological Survey has recently issued a warning on th6 prevalence of tularaemia. Cases have been reported they say in 22 States, and in the district of Columbia which indicates in their SOME
that the disease probably occurs throughout United States and that its recognition and occurrence in other States will be only a matter of time, as it was found in nine new States during the past year." The disease may be contracted by contact with the blood or internal organs of infected
opinion "
the
there
were
Impaired
BUDAPEST. OUR OWN CORRESPONDENT.) (FROM
Tms year the Hungarian post-graduate medical has been held in the neighbourhood of Ijake Balaton. Vast tracts of flower forests surround the lake which is so large that it is called the Hungarian Sea, and in the July weather it is an ideal place for Those who arranged the course of lectures a holiday. did their best to make the occasion pleasant as well The medical teaching was in the mornings as useful. only and the afternoons could be given over to bathing, fishing, and excursions. An unprecedented number of doctors came to enjoy this happy mixture of relaxation and learning. The first lecture was delivered by Prof. John Bokay, who spoke on his experimental results with the Dick prophylactic inoculations against scarlet He had been, he said, one of the first in fever. Europe to try the method, and experience of more than 6000 cases had led to his complete agreement with the Dicks’ opinions. He saw the closest reaction between the positive result of the cutaneous test and susceptibility towards scarlet fever, and he regarded the Dick test as of great importance from the point of view of prophylaxis. Active immunisation by the injection -of toxins in gradually increasing doses transformed the reaction in 90 per cent. of cases from positive to negative, and it appeared that the immunity thus produced was lasting. His experience also corroborated that of American observers who -could look back three years and who claimed that the immunity lasted at least for this time. The disturbances which might occur during the production of immunity were very mild and were certainly not bad enough to stop the Dick method of inoculation spreading far and wide. Prof. Csiky Jozsef, speaking on the pathology and treatment of headache, said that in his opinion the hereditary nature of neurasthenic headaches could not be contested. Amongst the causes of headache arising outside the skull the greatest importance should be attached to rheumatism, and it was remarkable that so little attention had been paid to this cause in Eastern Europe. The treatment was very simple systematic massage and warm f omentations. Dr. Joseph Tornai gave an address on heart disease and pregnancy, in which he said that two or three decades ago the mortality of childbirth associated with heart disease was 50-60 per cent. ; nowadays it was only 12 per cent. at the most. Methods of - examination, however, as he remarked, are more likely to reveal cardiac disease than they were formerly. Besides the strain which pregnancy threw on the heart there was the fear that endocarditis might recur. In general it could be said that in heart disease of slight degree, so long as the muscular action was strong, the prognosis was fairly good. Aortic disease was generally much more serious than mitral. The law did not allow the doctor enough freedom of judgment in cases where abortion might be required. It was very difficult to say when a patient ought to be advised against marriage, but he thought that a girl and her parents should undoubtedly be told the facts. Prof. Arthur Hasenfeld, in a paper on angina pectoris, pointed out that even yet the etiology of
_______________
UNITED
(FROM
AN
STATES
OF AMERICA.
OCCASIONAL CORRESPONDENT.)
congress
The Cost of Private Nursing. significant facts are emerging in the inquiry now being jointly conducted by the New York State Nurses’ Association and the Committee on the Grading of Nursing Schools. The practice of assigning one nurse on constant duty to attend one patient is now seen to be an anachronism. It dates from some 50 years ago when women’s services were limited in scope, plentiful within their limitations, and consequently inexpensive. To-day the reward paid for private nursing of$5 and$7 a day is not sufficient to draw large numbers to the profession and those who graduate as nurses are attracted in increasingly large numbers to salaried positions in institutions. The daily pay after all is not large. It was found that at a given time, and in the busy season (Feb. 21st28th), only 72 per cent. of 1409 private duty nurses were at work ; 23 per cent. were at home, and 5 per The nurse, cent. were themselves sick in bed. therefore, is not -at work all the year round. And when she is at work her wage is found to average only 49 cents an hour, which is the equivalent of the earning capacity of " charwomen, servants, and unskilled labour." Nor is there prospect of advancement. There are no grades in private nursing and a graduate of ten years’ standing is not supposed to charge any more than a nurse fresh from her training. Another count brought against private nursing is that the long hours of duty are unhealthy and demoralising, while the absence of professional occupation for a large part of the time adds to the demoralisation. It was found that 80 per cent. of the nurses at work were on 12-hour duty and 18 per Two solutions are indicated : cent. on 24-hour duty. the first is to increase the number of hospitals wherein each nurse can give attention to several patients ; the second solution is one which is already finding expression in the growing activity of the Visiting Nurse Associations. Working for these associations the nurse visits several homes each day. It happens sometimes that a patient is so seriously ill that one nurse is assigned for constant duty, but this is a service which is very rarely demanded even though There may have been too much it is available. readiness to relegate to this system of care only those who cannot afford to pay for a full-time nurse. There is no moral or economic justification for any professional worker spending 12 or 24 hours on work that can be done with efficiency in a small part of that time. The Spread of TMM’ee’MCt. The Bureau of Biological Survey has recently issued a warning on th6 prevalence of tularaemia. Cases have been reported they say in 22 States, and in the district of Columbia which indicates in their SOME
that the disease probably occurs throughout United States and that its recognition and occurrence in other States will be only a matter of time, as it was found in nine new States during the past year." The disease may be contracted by contact with the blood or internal organs of infected
opinion "
the