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A PROVINCIAL HOSPITAL SURVEY.
774 one district the percentage rising to 95. Similar figures hold good in Egypt. Secondly, where good conditions of hygiene can be established they are eminently successful in preventing the spread of the disease, as was proved by the almost complete immunity enjoyed by our troops stationed in Egypt during the late war. Thirdly, school inspection and hospital treatment exert their good results by controlling the spread of infection among the schoolchildren, by shortening the active infective stages both by medical and surgical measures, and by counteracting the effects of the late or cicatricial stages chiefly with surgical measures. In these respects the Egyptian ophthalmic hospitals founded by the late Sir Ernest Cassel and directed by Mr. MacCallan have done a great work. How large a proportion of it is concerned with the results of trachoma is shown by this fact among others. In 1920, the most recent year for which figures are available, out of 33,609 major operations performed, no less than 27,081were for trichiasis and entropion. Moreover, the treatment given in the early stages of trachoma must have an important effect in diminishing those complications of
in
the disease which lead to corneal nebulae and so to partial or even complete blindness. As a matter of fact in the Egyptian statistics we do not find that trachoma figures at all as a cause of .blindness, though, of course, it is an important cause of defective vision. In Palestine, on the other hand, the report already referred to states that trachoma accounts for most of the blindness and it is well-known that in districts where the disease is allowed to spread entirely without skilled treatment practically complete blindness does often result. This was the case in a rural community of farming folk in South Georgia, where the disease was proceeding unchecked until the advent of an official1 surgeon from the United States Public Health Service. Finally, the reports from Palestine and Egypt agree that to eradicate the disease altogether the only method is to attack the evil at its source by introducing the practice of elementary hygiene into the homes of the people.
it should be noted, was derived from workmen’s contributions and patients’ payments. Sir Napier Burnett wishes to impress on his colleagues that the question of payment of the hospital medical staff is really centred on the provision of beds for patients of moderate means, and he appeals to the medical profession to be willing to act in an advisory capacity to hospital governors and trustees who are seeking for a solution of this problem. He finds the classification of medical institutions based merely on the number of beds to be misleading, any true comparison requiring a consideration of work and efficiency. The work done at hospitals to which medical schools are attached is of a special grade and affects a wider community. These hospitals evidently demand a special group, and the figures relating to their work should be set out separately with a view to any claim for assistance from the Exchequer. Sir Arthur Stanley, in a prefatory note, refers to the increasing appreciation on the part of hospital authorities of these annual summaries, for which the Red Cross undertook to be responsible. Since they began to appear there has been renewed evidence of the desire of all those responsible for the management of voluntary hospitals throughout the country to maintain and increase their standard of efficiency. CELLULAR SELECTION AND CANCER.
SOME years ago Dr. W. J. Penfold showed that the characters of a bacterial growth might be considerably modified by varying the constituents of the culture medium. Among the huge populations which compose an ordinary culture are individuals varving widely from. the average in their several phvsiological capacities. By altering the conditions of life one or other of these variants may be encouraged, either absolutely by furnishing some food of which it ij particularly fond, or relatively by killing off its companions by some poisonous agent which it can withstand. In this way the characters of the majority of the individuals, and hence of the culture as a whole, may come to be very different from those of the A PROVINCIAL HOSPITAL SURVEY. original growth. Dr. Penfold now suggestsl that a similar process of selection may account for the proHospital Flag Day is being celebrated in London duction of cancer by the various irritating substances No doubt the campaign now and incidents which are now as we go to press. recognised, experimentally in progress on behalf of voluntary hospitals would as well as as definite causes of epidemiologically, be rendered vastly more effective if the public tumours. Taking aniline as an example, malignant at large could be made to visualise the extent he points out that it may act by killing off a majority of the work which is being done in them, as well of the cells in its field of action, leaving some peculiarly as the part which they play as centres of health, resistant ones, which are then free to grow without the education, and, therefore. of national progress. From restraint normally exercised by their neighbours. At this point of view Sir Napier Burnett’s report present there are no definite observations in support of deserves close attention, while for everyone con- the idea, but it is a suggestive hypothesis which is cerned with hospital finance and management it is based on a sound appreciation of the biological signipriceless as a fund of information. In little more ficance of variability among large numbers of units. than 100 pages are set out the number of British hospitals, the work done. the sources of income and Sir Frederick Mott will deliver an address on Mental how that income is expended; and the presentment of the case lends great weight to the arguments of Hygiene in Relation to Insanity and its Treatment, those who hold that the voluntary system should and before the Students’ Medical Society, Charing Cross Hoscan be maintained. In 1921, for the first time since pital Medical School, on Tuesday, Oct. 10th, at 5 P.nt. the war, the majority of the hospitals were able to To open the autumn session of the South-West pay their way. Taking Great Britain as a whole, and ’excluding London, details of patients were received London Post-Graduate Association Sir Humphry from 642 voluntary hospitals (88 per cent. of the Rolleston will give an address on the Functions of total number), with 39,973 available beds (95 per the Liver at St. James’s - Hospital, Ouseley-road, - cent. of the total possible) ; in these hospitals Balham, on Wednesday, Oct. llth, at 4.30 P.M. -2,545,055 individual patients were treated during -1921 at a total cost of 25,275,176. Towards this. THE London Medical Exhibition, the thirteenth of expenditure the hospitals received 4,854,661, leaving.its kind, was held at the Central Hall, Westminster, a deficit on the year’s working of 420,515. One from Oct. 2nd to 6th and was visited by a large number third of the total ordinary income of the hospitals, of medical men and women to whom alone admission The exhibition was noteworthy for the was granted. 1 Public Health Reports, issued weekly by the United States successful efforts of British manufacturers to meet the 1922. Health 1st, Service, Sept. Public Some 150 stands 2 Third Annual Report on the Voluntary Hospitals in Great progressive needs of medicine. Britain (excluding London) for the Year 1921. By Sir Napier displayed drugs, chemicals, . medicaL and surgical Burnett, K.B.E., M.D., F.R.C.S., F.R.C.P., Director of Hospital instruments and appliances, furniture, and other Services, Joint Council of the Order of St. John and the British Red Cross Society. With an Introductory Note by the Hon. adjuvants to treatment.. Notice of the more important Sir Arthur Stanley, G.B.E., C.B., M.V.O., Chairman of the exhibits will follow. Joint Council. Published at 19, Berkeley-street, London, W. 1. 1 Medical Journal of Australia, April 29th, 1922. Price 2s. 6d. ____
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,
in
the disease which lead to corneal nebulae and so to partial or even complete blindness. As a matter of fact in the Egyptian statistics we do not find that trachoma figures at all as a cause of .blindness, though, of course, it is an important cause of defective vision. In Palestine, on the other hand, the report already referred to states that trachoma accounts for most of the blindness and it is well-known that in districts where the disease is allowed to spread entirely without skilled treatment practically complete blindness does often result. This was the case in a rural community of farming folk in South Georgia, where the disease was proceeding unchecked until the advent of an official1 surgeon from the United States Public Health Service. Finally, the reports from Palestine and Egypt agree that to eradicate the disease altogether the only method is to attack the evil at its source by introducing the practice of elementary hygiene into the homes of the people.
it should be noted, was derived from workmen’s contributions and patients’ payments. Sir Napier Burnett wishes to impress on his colleagues that the question of payment of the hospital medical staff is really centred on the provision of beds for patients of moderate means, and he appeals to the medical profession to be willing to act in an advisory capacity to hospital governors and trustees who are seeking for a solution of this problem. He finds the classification of medical institutions based merely on the number of beds to be misleading, any true comparison requiring a consideration of work and efficiency. The work done at hospitals to which medical schools are attached is of a special grade and affects a wider community. These hospitals evidently demand a special group, and the figures relating to their work should be set out separately with a view to any claim for assistance from the Exchequer. Sir Arthur Stanley, in a prefatory note, refers to the increasing appreciation on the part of hospital authorities of these annual summaries, for which the Red Cross undertook to be responsible. Since they began to appear there has been renewed evidence of the desire of all those responsible for the management of voluntary hospitals throughout the country to maintain and increase their standard of efficiency. CELLULAR SELECTION AND CANCER.
SOME years ago Dr. W. J. Penfold showed that the characters of a bacterial growth might be considerably modified by varying the constituents of the culture medium. Among the huge populations which compose an ordinary culture are individuals varving widely from. the average in their several phvsiological capacities. By altering the conditions of life one or other of these variants may be encouraged, either absolutely by furnishing some food of which it ij particularly fond, or relatively by killing off its companions by some poisonous agent which it can withstand. In this way the characters of the majority of the individuals, and hence of the culture as a whole, may come to be very different from those of the A PROVINCIAL HOSPITAL SURVEY. original growth. Dr. Penfold now suggestsl that a similar process of selection may account for the proHospital Flag Day is being celebrated in London duction of cancer by the various irritating substances No doubt the campaign now and incidents which are now as we go to press. recognised, experimentally in progress on behalf of voluntary hospitals would as well as as definite causes of epidemiologically, be rendered vastly more effective if the public tumours. Taking aniline as an example, malignant at large could be made to visualise the extent he points out that it may act by killing off a majority of the work which is being done in them, as well of the cells in its field of action, leaving some peculiarly as the part which they play as centres of health, resistant ones, which are then free to grow without the education, and, therefore. of national progress. From restraint normally exercised by their neighbours. At this point of view Sir Napier Burnett’s report present there are no definite observations in support of deserves close attention, while for everyone con- the idea, but it is a suggestive hypothesis which is cerned with hospital finance and management it is based on a sound appreciation of the biological signipriceless as a fund of information. In little more ficance of variability among large numbers of units. than 100 pages are set out the number of British hospitals, the work done. the sources of income and Sir Frederick Mott will deliver an address on Mental how that income is expended; and the presentment of the case lends great weight to the arguments of Hygiene in Relation to Insanity and its Treatment, those who hold that the voluntary system should and before the Students’ Medical Society, Charing Cross Hoscan be maintained. In 1921, for the first time since pital Medical School, on Tuesday, Oct. 10th, at 5 P.nt. the war, the majority of the hospitals were able to To open the autumn session of the South-West pay their way. Taking Great Britain as a whole, and ’excluding London, details of patients were received London Post-Graduate Association Sir Humphry from 642 voluntary hospitals (88 per cent. of the Rolleston will give an address on the Functions of total number), with 39,973 available beds (95 per the Liver at St. James’s - Hospital, Ouseley-road, - cent. of the total possible) ; in these hospitals Balham, on Wednesday, Oct. llth, at 4.30 P.M. -2,545,055 individual patients were treated during -1921 at a total cost of 25,275,176. Towards this. THE London Medical Exhibition, the thirteenth of expenditure the hospitals received 4,854,661, leaving.its kind, was held at the Central Hall, Westminster, a deficit on the year’s working of 420,515. One from Oct. 2nd to 6th and was visited by a large number third of the total ordinary income of the hospitals, of medical men and women to whom alone admission The exhibition was noteworthy for the was granted. 1 Public Health Reports, issued weekly by the United States successful efforts of British manufacturers to meet the 1922. Health 1st, Service, Sept. Public Some 150 stands 2 Third Annual Report on the Voluntary Hospitals in Great progressive needs of medicine. Britain (excluding London) for the Year 1921. By Sir Napier displayed drugs, chemicals, . medicaL and surgical Burnett, K.B.E., M.D., F.R.C.S., F.R.C.P., Director of Hospital instruments and appliances, furniture, and other Services, Joint Council of the Order of St. John and the British Red Cross Society. With an Introductory Note by the Hon. adjuvants to treatment.. Notice of the more important Sir Arthur Stanley, G.B.E., C.B., M.V.O., Chairman of the exhibits will follow. Joint Council. Published at 19, Berkeley-street, London, W. 1. 1 Medical Journal of Australia, April 29th, 1922. Price 2s. 6d. ____
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