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UNSKILLED MIDWIFERY
243 an influence for I allude to the practice of midwifery by uneducated and to know that good in any case in which a choked optic disc accompany d therefore unqualified persons. inI have reason is parturition becoming, meningitis. At all events the experiment is one that both the habit of attending women especially in rural districts, a trade carried on by drugmight be and ought to be attempted. gists and others; and have heard of instances of great peril
cision of the nerve-sbeath might exercise
babes"and still more "hapless" mothers, the entire ignorance on the part of these selfmade obstetricians of all but the most common-place principles of their art. It is hard to say why this branch of our profession should altogether have been left in the cold shade of administrative neglect-i.e., without that legal protection which is accorded to the sister branches, medicine and surgery. Surely it might be said to be of higher importance than either of these to our social polity ; and, as a science, hardly inferior to either in respect of the kind and amount of knowledge-physiological, pathological, and practical-that are required for the competent discharge of its obligations. The corporations belonging to our profession require a competent acquaintance with the principles and practice of midwifery as a condition of receiving their diplomas of to
THE FACTORY AND WORKSHOPS ACTS.
reports of Mr. Redgrave and Mr. Baker, the chief inspectors of factories, are just issued, and are chiefly noteworthy on account of particulars contained therein as to the working of an Act passed last year, which brought under the supervision of these officers workshops as well as THE
The terms of this Act indicate that the owners of these establishments are now only compelled to report accidents which cause loss of life to any persons employed, and those which cause bodily injuries, produced by machinery or by explosion or escape of gas, steam, or metal, and of such a nature as to prevent the person injured from returning to his work in the factory within forty-eight hours after the occurrence of the accident. Mr. Redgrave reports that during the six months ended April 30th, 1872, a total of 3U18 accidents, classed under the above headings, occurred. A great increase in the number of inspectors formerly employed has been made, and the chief trades now thoroughly supervised are straw-plaiting and strawbonnet factories, pillow-lace making, lace clipping, &c., hosiery making, embroidery, horsehair seating, hand-loom weaving, cutlery, artificial flower making, envelope and fancy and paper box making, cabinet and chair making, rope and twine making, dress-making, millinery, tailoring, shirt and collar making, hat, cap, boot and shoe making, and brickmaking. The other chief feature of the Act of 1871 is an authority conferred upon the Secretary of State, when satisfied that any trade is influenced by the state of the weather or the season of the year, to permit extra time to be worked to the extent of one hour and a half per day, not exceeding ninety-six days in the year. The making of bricks, dresses, and straw plaits comes particularly under the above heading, and the inspector records that this, as well as the other general clauses of the Act, have been found to work exceedillgly well, the employers being ready to accept the new regulations, and the parents of the children employed becoming convinced that the law is beneficial. But Mr. Redgrave summarises several conditions in the Factory Acts which require alteration, which even proposed legislation does not touch, but "which really cry aloud for amelioration." Children may still be set to work at eight years of age, boys of thirteen may be employed all night in blast furnaces, or in paper mills, letter-press printing offices, and any factory in which water power only is employed. They are also permitted to work in paper-mills and glass factories between midnight on Sunday to midnight on Saturday for fourteen hours together, and girls of fourteen may be employed in bookbinding until 10 at night. A very decided opinion, is, however, expressed that social and sanitary legislation on these matters is more likely to be successful if attempts are made to define unhealthy occupations more precisely, and to restrict work of children, rather than to settle the exact number of hours of labour.
factories.
Correspondence. "Audi alteram partem."
UNSKILLED To the Editor
MIDWIFERY
of THE LANCET.
SIR,-I trust you will agree with me in thinking that i1 is high time that the attention of our profession shoulc be aroused to an evil which not only exists extensively; but appears to be rapidly on the increase, not perhap., more on account of the injury which it does to a very large and important class of its members, than of the more serious consequences which cannot but thereby accrue in those sec. tions of society in which it is rife.
the 11 hapless
through
licentiateship or membership respectively. Why, then, should the anomaly longer be permitted that others are allowed to practise this art without these tests of qualification for the proper discharge of its duties ? It may be said with regard to female obstetricians that certain women prefer their help in this emergency. I believe that this is only exceptionally the case. The majority prefer men. The other taste can, however, be indulged in, and rightly too. There are women now, highly accomplished, I believe, in this and other branches of our profession, who have entered upon its practice through the legitimate portals ; and others may and are following their examples, and, probably, quite in sufficient numbers to meet the demand. I would, then, that the profession, and especially its governing bodies, take early steps with the view of putting a stop to an evil which, I repeat, is so unjust to its members and perilous to the best interests of society ; and that in future it be demanded of those who practise obstetrically that they shall show the same competence to undertake and discharge its duties as those who practise in the sister branches of our profession. I am, Sir, your obedient servant, JOHN GAY. Finsbury-place South, August 13th, 1872.
ECTROTIC TREATMENT OF SMALL-POX. To the Editor
of THE LANCET. should have to be treated at all in SiR,-That small-pox the British Isles is no less an opprobrium to civilisation than a reflection on our legislation. In efficient vaccination there exists beyond all question or doubt as complete and perfect a preventive of small-pox as anything that can be imagined. I say "’ efficient" advisedly, believing, as I do, that the public want of faith and confidence in vaccination, together with the prejudices and foolish notions of the anti-vaccinators, arise in great part from the inefficient vaccination which is practised; and, again, though in a minor degree, from the improper selection of vaccine lymph, and not from the inutility of the operation itself. The medical profession in this borough have had abundant opportunities for the last twelve months of noticing the preventive influence of vaccination on variola, and nothing has been more common than to meet with persons having three tolerably recent marks on one I contend arm suffering from a severe attack of small-pox. that to stamp out the disease there must be no less than three well-developed vesicles produced on either arm of every child. A less number of marks will not confer a complete immunity, and I am within the mark when I say that the majority of the children in England have not more than half that number of marks on their arms. We must not, therefore, be surprised at the present outbreak of smallpox. When, however, vaccination, properly so called, has been neglected, and we are summoned face to face with H the direst complaint that has ever dogged the path of eivilisation," it behoves us to encounter the difficulty equipped with our best armour. Mr. Furley’s ingenious method is all very well in
theory,
cision of the nerve-sbeath might exercise
babes"and still more "hapless" mothers, the entire ignorance on the part of these selfmade obstetricians of all but the most common-place principles of their art. It is hard to say why this branch of our profession should altogether have been left in the cold shade of administrative neglect-i.e., without that legal protection which is accorded to the sister branches, medicine and surgery. Surely it might be said to be of higher importance than either of these to our social polity ; and, as a science, hardly inferior to either in respect of the kind and amount of knowledge-physiological, pathological, and practical-that are required for the competent discharge of its obligations. The corporations belonging to our profession require a competent acquaintance with the principles and practice of midwifery as a condition of receiving their diplomas of to
THE FACTORY AND WORKSHOPS ACTS.
reports of Mr. Redgrave and Mr. Baker, the chief inspectors of factories, are just issued, and are chiefly noteworthy on account of particulars contained therein as to the working of an Act passed last year, which brought under the supervision of these officers workshops as well as THE
The terms of this Act indicate that the owners of these establishments are now only compelled to report accidents which cause loss of life to any persons employed, and those which cause bodily injuries, produced by machinery or by explosion or escape of gas, steam, or metal, and of such a nature as to prevent the person injured from returning to his work in the factory within forty-eight hours after the occurrence of the accident. Mr. Redgrave reports that during the six months ended April 30th, 1872, a total of 3U18 accidents, classed under the above headings, occurred. A great increase in the number of inspectors formerly employed has been made, and the chief trades now thoroughly supervised are straw-plaiting and strawbonnet factories, pillow-lace making, lace clipping, &c., hosiery making, embroidery, horsehair seating, hand-loom weaving, cutlery, artificial flower making, envelope and fancy and paper box making, cabinet and chair making, rope and twine making, dress-making, millinery, tailoring, shirt and collar making, hat, cap, boot and shoe making, and brickmaking. The other chief feature of the Act of 1871 is an authority conferred upon the Secretary of State, when satisfied that any trade is influenced by the state of the weather or the season of the year, to permit extra time to be worked to the extent of one hour and a half per day, not exceeding ninety-six days in the year. The making of bricks, dresses, and straw plaits comes particularly under the above heading, and the inspector records that this, as well as the other general clauses of the Act, have been found to work exceedillgly well, the employers being ready to accept the new regulations, and the parents of the children employed becoming convinced that the law is beneficial. But Mr. Redgrave summarises several conditions in the Factory Acts which require alteration, which even proposed legislation does not touch, but "which really cry aloud for amelioration." Children may still be set to work at eight years of age, boys of thirteen may be employed all night in blast furnaces, or in paper mills, letter-press printing offices, and any factory in which water power only is employed. They are also permitted to work in paper-mills and glass factories between midnight on Sunday to midnight on Saturday for fourteen hours together, and girls of fourteen may be employed in bookbinding until 10 at night. A very decided opinion, is, however, expressed that social and sanitary legislation on these matters is more likely to be successful if attempts are made to define unhealthy occupations more precisely, and to restrict work of children, rather than to settle the exact number of hours of labour.
factories.
Correspondence. "Audi alteram partem."
UNSKILLED To the Editor
MIDWIFERY
of THE LANCET.
SIR,-I trust you will agree with me in thinking that i1 is high time that the attention of our profession shoulc be aroused to an evil which not only exists extensively; but appears to be rapidly on the increase, not perhap., more on account of the injury which it does to a very large and important class of its members, than of the more serious consequences which cannot but thereby accrue in those sec. tions of society in which it is rife.
the 11 hapless
through
licentiateship or membership respectively. Why, then, should the anomaly longer be permitted that others are allowed to practise this art without these tests of qualification for the proper discharge of its duties ? It may be said with regard to female obstetricians that certain women prefer their help in this emergency. I believe that this is only exceptionally the case. The majority prefer men. The other taste can, however, be indulged in, and rightly too. There are women now, highly accomplished, I believe, in this and other branches of our profession, who have entered upon its practice through the legitimate portals ; and others may and are following their examples, and, probably, quite in sufficient numbers to meet the demand. I would, then, that the profession, and especially its governing bodies, take early steps with the view of putting a stop to an evil which, I repeat, is so unjust to its members and perilous to the best interests of society ; and that in future it be demanded of those who practise obstetrically that they shall show the same competence to undertake and discharge its duties as those who practise in the sister branches of our profession. I am, Sir, your obedient servant, JOHN GAY. Finsbury-place South, August 13th, 1872.
ECTROTIC TREATMENT OF SMALL-POX. To the Editor
of THE LANCET. should have to be treated at all in SiR,-That small-pox the British Isles is no less an opprobrium to civilisation than a reflection on our legislation. In efficient vaccination there exists beyond all question or doubt as complete and perfect a preventive of small-pox as anything that can be imagined. I say "’ efficient" advisedly, believing, as I do, that the public want of faith and confidence in vaccination, together with the prejudices and foolish notions of the anti-vaccinators, arise in great part from the inefficient vaccination which is practised; and, again, though in a minor degree, from the improper selection of vaccine lymph, and not from the inutility of the operation itself. The medical profession in this borough have had abundant opportunities for the last twelve months of noticing the preventive influence of vaccination on variola, and nothing has been more common than to meet with persons having three tolerably recent marks on one I contend arm suffering from a severe attack of small-pox. that to stamp out the disease there must be no less than three well-developed vesicles produced on either arm of every child. A less number of marks will not confer a complete immunity, and I am within the mark when I say that the majority of the children in England have not more than half that number of marks on their arms. We must not, therefore, be surprised at the present outbreak of smallpox. When, however, vaccination, properly so called, has been neglected, and we are summoned face to face with H the direst complaint that has ever dogged the path of eivilisation," it behoves us to encounter the difficulty equipped with our best armour. Mr. Furley’s ingenious method is all very well in
theory,