773 intentions in the world from time to time, especially when cases, even although comtant familiarity with such risks epidemics are prevailing, he may be brought into contact and long immunity from an accident may tend to lessen his with various infectious diseases. We may therefore sense of the danger of infection to which his patients in discussing this case start with the assumption that it is inevitably must be subjected from time to time. quite impossible for the ordinary general practitioner in the course of his daily work to avoid coming in contact with BARMAIDS IN BURMA. infectious diseases of different kinds. Allowing this to be with the leading article on Barmaids IN connexion The obvious so, what is his duty to his other patients ? which appeared in THE LANCET of Jan. 27eh, p. 239, answer to such a question must be that he is bound to we received from a correspondent at Rangoon an have take every possible precaution to avoid carrying infection account of the successive steps by which the interesting As Mr. Justice Lawrence from one patient to another. of women in drinking-bars has been prohibited employment to the in out his in the jury pointed up During the last few years the proprietors in question, the mere fact that a medical man in Burma. case of in Rangoon had imported and employed such bars has by accident carried infection to one of his women for the purpose of attracting customers patients does not render him liable so long as it English and of increasing the consumption of liquor, and the is not due to any want of care on his part. If such evils and scandals incidental to, or consequent upon, the an unfortunate circumstance does occur the question to be answered is, Were the precautions taken those practice became so manifest to the respectable portion which a reasonably skilful medical man would take ? In of the British community as to lead them to take active steps in the direction of reform. The organisers of the answer to this question the jury agreed that Dr. Carrie had taken the usual precautions and found a verdict therefore movement determined to refrain from resting it upon the for the defendants. It is impossible and inexpedient to religious or temperance aspects of the question and took to attempt lay down strict rules as to the nature of the pre- their stand solely upon grounds of humanity, hygiene, and cautions to be adopted in any given case. The medical public policy. A petition was addressed to the Financial Commissioner of Burma asking for a total prohibition of the men who gave evidence upon this point were far from unanimous in their opinions. Our own view is that it is employment of women in drinking-bars and the Commisbetter to err on the side of safety and to endeavour to take sioner, after proper investigation, issued the necessary order. The bar proprietors appealed to the law and the every conceivable precaution rather than to run any undue risks. Even if the puerperal woman is not specially order of the Commissioner was declared to be in excess of his powers, but in December, 19J3, a Bill to amend the prone to develop scarlet fever, yet in the circumstances she undoubtedly is predisposed to almost any kind of Burmese excise law was introduced by his successor and was infection if only from the fact that she is not in her passed by the Council in January, 1934. Under its prousual health, and in view of the close personal contact visions rules absolutely prohibiting the employment of which must exist between the medical man and his patient women in public drinking-bars will come into force in during a confinement the precautions to be taken to avoid Burma in the now approaching month of April. The infection can hardly be too stringent. Whenever possible it law in Bengal has been strengthened in the same is undoubtedly best for the medical man for the time being direction and the employment of women in the manner It is to give up attendance on cases of midwifery. In the event indicated has already been forbidden in Calcutta. manifest that the of women English possible degradation of the practitioner working single-handed this may prove impracticable but where there is an assistant or a partner before Orientals would for many reasons be specially such a solution of the difficulty should not be beyond objectionable, but in all essentials the conditions are alike It may be urged that patients do not like in all countries, and we cannot but congratulate the Governattainment. changing their medical attendants, especially in the ments of Burma and of Bengal on having set examples event of their expecting confinement, but if the which, we trust, will eventually be followed both at home reason for such a change is pointed out to them and in the colonies. such any objections should be easily overcome. Naturally, INDECENT PUBLICITY AND THE FEEBLEit must frequently happen that such a course of action MINDED. is not feasible. In these circumstances the practia AT recent of the tioner must endeavour to protect his patient from any sitting Rjyal Commission on the Care risk of infection to the utmost of his ability. The safest and Control of the Feeble-Minded Dr. Henry Maudsley, who and therefore the best kind of safeguard is undoubtedly a gave evidence, called attention to the need for improvement complete change of clothing and a bath with the free use in the machinery by which action has now tj be taken when of antiseptic. In busy general practice so complete a it is desired to protect the persons and the property of disinfection often must prove quite beyond realisation. feeble-minded persons. He pointed out with regard to this Such simple precautions, however, as the wearing of an that in order to prove such a person incapable of taking care apron, to be obtained in almost every household, during the of himself and of his aff Airs an inquiry may have to be conduct of a confinement and the wearing of a light water- instituted, not before a Master in Lunacy only but, when proof overall when visiting infectious cases such as scarlet a jury is demanded by the person sought to be controlled, fever, in addition to the most thorough cleansing of the before a Master and ajury. This course entails the employhands, should not be beyond the powers of even the most ment, almost necessarily, of solicitors and counsel upon busy general practitioner. The knowledge that he has taken both sides and all the great expense of a protracted the utmost precautions cannot fail to prove a comfort to the hearing, with the additional drawback that there is no medical practitioner who sees infection spreading from one certainty that the result will be a decision in accordance of his patients to another, while the haunting dread that he with the weight of evidence or to the benefit of the alleged himself may be the source of infection cannot but increase feeble-minded person, but, on the contrary, a risk lest a the many mental anxieties inseperable from the life of the jury consisting of laymen may misunderstand or disregard overworked and harassed medical man. The further proof the testimony of experts under the influence of prejudice which such a trial as this affords,.that even a medical man may and sympathy. They may, in short, be led to a conclusion be put to the expense and annoyance of defending his actions disastrous to the feeble-minded person by the belief that he in a court of law, will render him less likely to relax any one is defending himself against an attempt to deprive him of The of the rule3 which he has laid down for his conduct in these his property and to incarcerate him as a lunatic.
summing
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