7. and with hospitals on a small scale. They will farther possess commodious lazzaretti," while all the ships before entering the Persian Gulf will have to undergo the discipline of the establishment and submit to the regulations prescribed. Such ships, however, as have not been "cleared" from surveillance and which have to re’ascend the Chat-elArab, will be authorised to continue their voyage; but only on condition that they take on board the sanitary warders, who will hold them under surveillance as far as Bassora for the second medical visit and for the prescribed disinfections. Those ships which have to disembark goods or passengers at the Persian ports will have to do so at BenderBushire, when there has been constructed there a suitable hygienic station. Pending this they will have to do it at Ormuz or at Bassora. i However, such ships as have been immunised for ten days will have in each case free course into all the ports of the Persian Gulf, after their state of immunisation has been officially confirmed.
833
iignt, wi3iie powermi l:)oyw extractors win draw the air and damp out through the roof. A screw propeller fan, worked by electricity, supplies hot air to the drying chamber. It is a pity that similar air propellers have " not been placed within the home itself. The care taken to ensure ventilation is more elaborate than scientific. The corridors are warmed by hot-water coils, and apertures above the doors enable the warmed air from the corridors to enter the rooms. On the opposite side, by the outer wall, there is at least one Tobin tube and in the large rooms several such tubes. Every room also has an open-grate fireplace, and above the fireplace an opening, protected by mica valves, which serves to extract the foul air. Thus when both windows and doors are shut there still remains ample means of ventilation ; but this ventilation must of necessity depend on the force and direction of the wind, on the difference of the in-door and out-door temperature-in a word, on varyicg climatic conditions. It will, therefore, be too violent at some moments and insufficient at others. This is inevitable in all buildings excepting those that are provided with motive With power, however, the supply of air can be power. with mathematical precision. It then depends on regulated A NEW AND MODEL CONVALESCENT the velocity of the revolving fans, and not on the force of the wind and the fluctuations of the temperature. At the home HOME FOR WORKMEN. power is employed to pump the fresh and the salt water into THE Rustington Convalescent Home for Working Men will the tanks, to raise the lifts, to work the machinery in the laundry, and even to pump hot air into the drying chamberp be inaugurated to-day (Saturday). This in many respects bat, 1 strange to say, it is not employed for ventilation. is a model institution. It is situated on the beach, close to Hot and cold and salt and fresh water baths are provided Littlehampton, faces the sea, and is well exposed to the Ion every floor. The outer walls are of double thickness with a Built of red brick with a green slate roof two-inch vacant space, or " air blanket"between each wall. sea breezes. The window frames have a weather dip of two and a half and a copper-covered domed clock-tower, it stands out inches and an oak sill. The urinals have a curled lip all the boldly and has a monumental aspect when viewed from the way down both sides. This is Mr. Bostel’s patent, and it Littlehampton sea parade. No expense has been spared. The prevents splashing and keeps the clothes away. Above there instructions to the architect and builder were to err on the is an automatic flush tank, and below an automatic syphon. side of extravagance rather than on the side of parsimony. The soil pipes have inlet and outlet ventilators protected by charcoal, and there is a very elaborate flushing of the closet The principle governing the plans executed is that in the long pans. The fresh-water supply is derived from an artesian well run money will be saved, because the solidity of the materials fifty-five feet deep. This water is softened by Maignen’s employed and the soundness of the workmanship will obviate process and then pumped to the Itop of the building, where the necessity of constant repairs. Though there are no elaborate the fresh-water tanks can hold 3000 gallons. Here there is art decorations, the excellence of the materials and their a very ingenious apparatus for automatically setting the msthetic colours rest and please the eye. For instance, electric pump in motion. As the water level in the tanks glazed bricks are extensively utilised. These are cream white falls the floater acts upon a brass tube balanced on and olive-green, while the wood is so hard that no paint is the wall of the tank loft. When the tube is so required. There are no less than seventeen rooms which pressed down as to reverse the level a steel ball, contain but one bed each. Ten rooms contain two beds which is inside and at the other extremity of the tube, each, and only two rooms hold four beds. This provision runs down, and its weight causes this tubular brass rod to for forty-five patients could be raised to sixty if the rooms: fall with violence, so that it strikes the electric apparatus now allotted to the servants were utilised for the patients. with sufficient and sudden force to establish the current and Every effort will be made two make the patients feel set the electric pump in motion. When the tanks are full thoroughly at home, instead of being treated as if they were pressure on the other side of the tube reverses the action, paupers in receipt of charity who have to be kept well and the tube, swinging back to its original position, stops in hand by the enforcement of stern discipline. On the the pump. Thus. by the automatic see-saw of this brass rod contrary, all the attendants have received instructions to. the tanks are re-filled as soon as they become empty. This treat the patients as if they were guests. The engine-house is; apparatus is known as Bostel’s automatic lever switch, and to be thrown open to inspection, and every information we had the satisfaction of seeing it work very effectively. given that may instruct or interest the inmates of the home. Altogether we were most favourably impressed by our visit There is no knowing to what extent kindness of this descrip- to this new convalescent home, and are convinced that tion may awaken a dormant thirst for higher knowledge,, its future inmates will greatly benefit from their sojourn in and how far, by satisfying the mind and intelligence, atan institution which is so admirably built and situated. The convalescence may be hastened to a happy issue. Thus on1 scheme was originated by Mr. Thomas Noblett, who had the ground-floor there is a large entertainment hall, where3 recognised the great difficulty encountued by workmen and lectures and concerts can be given. Then there are aothers in gaining admission to convalescent homes. A workand bagatelle and otherr man may be ordered to the seaside by his medical attendant, smoking-room and a reading-room, ‘ He games. There is also a quiet room," where patients maybut ofren he has not the means to pay for lodgings, &c. rest undisturbed on sofas, and need not when exhaustedi may then obtain a list of subscribers to existing homes, No answers go to their bedrooms. The grounds comprise about ninee and apply vaguely to ote and the other. Mr. Noblett thereacres, with a sea frontage of 575 feet, and at the backare received, and much time is lost. there is a small pinery, where in summer the shade off fore helped to organise the North-West London Conthese fragrant trees can be fully enjoyed. Numerous seats,i, valescent Home Fund and placed himself in communis some in sheltered positions, and an outhouse for smokers cation with the clergy, the medical men, the missionaries, d and the benefit sick clubs of his district, so that knowafford the means of rest while taking gentle exercise, and this without quitting the premises. In one corner of thee ledge of deserving cases might be obtained and the building, and communicating with the gardens, there aree patients sent to convalescent homes without any loss lavatories and a boot-room, where the patients can put on n of time. From the very first Mr. Noblett obtained I their slippers before entering the main building. generous support from Mr. Henry Harben of HampThe home throughout is lighted by electricity and all the .e stead, and finally Mr. Harben decided to erect at his own services are worked by electric power. A separate building g expense the home we have just described. The cost has contains the boiler, dynamo, and engines, and everything is is exceeded £50,00, and to this Mr. Harben will add an endowin duplicate so that there shall be no breakdown. Above the ment of £20,000. This generous initiative will, it is to be engines there is a model power laundry with all the most hoped, be strengthened by public subscription, a guinea recent machinery. Windows on both sides admit ample le subscription entitling to one letter of recommendation.
apparatus,
ventilation and
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834
Patients, also, unless absolutely destitute, will .to,pay at least 5s. a week.
be
expected
THE MEDICAL DEFENCE UNION.
THE annual general meeting of the Medical Defence Union, was held on Feb. 25th, in the rooms of the Medical Limited, MIDWIVES REGISTRATION BILL. Society, 11, Chandos-street, Mr. Victor Horsley, F.R.S., the in the chair. A MEETING in support of the Midwives Registration Bill President, being The report of the council upon the work of the union ’was held at 73, Chester-square, on March 10th, Lady Balfour during 1896 showed some excellent results ; not only were of Burleigh, president of the Central Association for Pro- the applications made by members for aid, advice, moting Compulsory Registration of Midwives, being in the and assistance increased in number, but the value ,chair. Lady Balfour opened the proceedings with a few of the union is evidently becoming more understood appreciated by remarks, after which Mr. Heywood Johnstone, M.P., by the profession generally and morework themselves. The legal during the in the course of a speech said that a committee of the members past year has been exceedingly heavy and the expenditure
the House of Commons took a considerable amount of ,evidence on this subject in 1892 and 1893, and presented a,n absolutely unanimous report in favour of a measure of this kind. The present Bill does not prevent anyone resorting to the assistance of a friendly neighbour, no matter how unqualified for the special purpose. What it says is that every person who calls in the aid of a midwife shall ’have some security, if she wishes, that she is employing one who is competent to undertake the case. It further provides ’for the creation of a board having a large preponderance of medical practitioners, which board is to draw up certain rules, and among them rules for assigning due limits to the practice of registered midwives ; so there is no reason to ,f ear that the practice of medical men will be encroached upon. Dr. CULLINGWORTH then addressed the meeting, his remarks being substantially as follows:—"An appalling amount of illness is inflicted upon the women of the poorer ’classes in consequence of the attendance given them during their confinements by ill-trained and ignorant persons who assume the title of midwife. A few evenings ago, when ..delivering my inaugural address as President of the Obstetrical Society of London, I had occasion to state that although improvements in obstetric science have largely reduced the mortality among parturient women wherever
has been proportionally higher, notwithstanding the fact that the legal adviser of the union has in many cases succeeded in obtaining payment of the costs from his opponents. In addition to the gratifying amount of success in the law courts, there is good reason for believing that the mere fact of its being known that the union was about to take action greatly facilitated the obtaining of apologies for, and retractations of, various slanders made against individual members. The council is strongly of opinion that nothing short of an amendment to the Medical Act, 1858, making it penal for any person to practise any branch of medicine or surgery for gain without being registered, will succeed in effectually checking unqualified practitioners. When offenders are brought before the law courts it is found that decisions directly opposed to each other are given in cases which appear to be quite similar. In London the council obtained a conviction against an individual who practised under the name of John Ferdinand, M.D. U.S.A., but in another part of the country a prosecution of a like kind was unsuccessful, and on an appeal being made to the High Court the Judges of the appellate Court supported the magistrate who had refused to convict. The council of the union has under its consideration a draft Bill on the subject, and will probably, in conthey are applied, yet the general mortality from puerperal’junction with the British Medical Association, lay it Fever either remains where it was, as is the case in London, before the Government next year in the hope that it or is actually on the increase, as is the case in the may be adopted as a Government measure. The negotiations ,provinces of England and Wales. It prevails most where for amalgamation with the London and Counties Medical there is a scattered and mining population, or where, as in the Protection Society were apparently on the point of being ,mountainous parts of Wales, the attendance of medical men brought to a successful termination when they were broken is rendered extremely difficult, and the care of the mothers off in consequence of a difference of opinion as to the title is in the hands of untrained midwives. In addition to this of the new association. It is stated that the Medical Defence mortality there is also a very large amount of disease among’ Union desired to add to its title the words " with which is women of the working classes wholly due to mismanageamalgamated the London and Counties Medical Protection ment during their confinements. Another very serious Society, Limited," and that this arrangement was refused by matter is that the most usual cause of blindness is infantile, the council of the latter society, who insisted that their ophthalmia, a preventable disease which would not occur proposed name should be adhered to and that the title should in the practice of a conscientious midwife possessed ofbe registered. the most elementary training. The Obstetrical Society The council publishes a list of ninety-seven cases, in which of London has long been of opinion that women who with very few exceptions the result of the action taken by the call themselves midwives should be required to have, union was highly satisfactory. The solicitor also contributes some knowledge of the duties which they undertake, a supplementary report, in which he mentions that the and also that a certain amount of supervision should be year upwards of 150 separate cases had been legally advised - exercised over them. For many years the society urged upon and conducted by him upon the instructions of the upon the Legislature the need for dealing with this question, union. On Dec. 31st the union had 3832 names of members .and in 1872 instituted their examination in midwifery as a on its register, 351 having been added during the year just temporary expedient until a satisfactory measure should be, closed. The offices are at 20, King William-street, Strand, ,passed. I was examiner at the Obstetrical Society for some years, and can bear witness that women who have undergone even three months’ training have been able to attain that kind of elementary practical knowledge which we THE PLAGUE IN INDIA. consider essential. The clause regarding control is one of the most important in the Bill ; it is suggested that in each THE reports from India are, on the whole, more hopeful sanitary district the medical officer of health is the properr person to undertake the duties of local supervision, and1 and promising, those from Bombay city showing a decided in the event of his being unwilling to act the county council improvement. The Plague Committee are working sysmay select some other practitioner for the work. I am and well, and there is on all sides a good deal extremely glad to be here to show that the medical pro- tematically energy displayed in dealing with the disease and in the fession is not, as a whole, opposed to this measure. In my on the ground of interference; hygienic improvement of matters generally. There is no opinion, objections to the Bill with the medical profession are founded upon a fallacy. I concealment or official reticence about the work that is have no desire to see my profession suffer, and I honestly, being done ; on the contrary, everything is open to the inspection of foreign medical missions and visitors from foreign believe that this measure will not have such an effect." Mrs. HEYWOOD JOHNSTONE having read the rules of the countries. The officials afford any information in their West Sussex Association and said that the present meeting!D5, power, and their arrangements can be ascertained by anyone was intended to inauguarate that branch, made a short t who cares to take the trouble. The total plague returns for speech in favour of the Bill, after which the proceedingss Bombay city up to the llth inst. (according to Reuter’s terminated. telegraphic agency) amount to 9032 cases and 7546 deaths. ,
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during
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w.c.
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