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BLOOD-DONORS.
1247 conscious creatures .... experiments of a light-bearing kind, you may rightly undertake in the unreflecting animal in the hope of cure which in man cannot be tried without very long periods of tentative proofs .... but the large view of the matter is that disease pertains to the whole field of life, animal and plant, and that without the comparative
method
no
science has flourished."
Clearly, then, the obvious course seems to be that human and comparative pathological research should be more closely linked together in the future than they have hitherto been in the past. I am, Sir. yours faithfully, W. M.
SCOTT, F.R.C.V.S.
Bridgwater, Dec. 3rd, 1921.
with selected groups of children and young adults have shown the tremendous value of institutional treatment in securing a degree of recovery which affords them the opportunity for useful lives and self support. The results obtained by the Burke Foundation, which has cared for over 2000 selected cases in the past six years, are most convincing. Of 130 boys between 10 and 16 years of age received during the first two years and carefully followed, S5 per cent. have remained steadily at work or at school since leaving the institution. The results obtained in adults and more advanced conditions are less striking, but the economic advantage of rendering a large proportion of these sufferers self-supporting and no longer a financial burden to the community, as well as the humanitarian motive of prolonging life and assuaging suffering, should make an urgent appeal to both our pockets and our sympathies."
In another pamphlet from the same source on Occupation for Cardiacs occur remarks under the To the Editor of THE LANCET. following headings : Danger from Overstrain, Choosa General Housework, Skilled Employments, SIR,-The annotation in your issue of Nov. 26th on ing Job, Employer’s Cooperation, Change of Occupation. the question of blood-donors may tend to bring the With regard to the latter, the important point in into that which is at subject prominence present a selection is that the new job should demand lacking in this country. I am in cordial agreement making The of with the writers in the Guy’s Hospital Gazette and as little physical exertion as possible. are writer but few this concludes: There pamphlet St. Bartholomew’s Hospital Journal and would depredo something to earn a living, cate the use of the medical student’s blood for cardiacs who cannot and of them can earn as good wages as if they many purposes of transfusion. Up to the present one has had no disease whatever." usually depended on some relative of the patient to the subject of heart disease, its prevention provide the necessary blood in an emergency, but andThat treatment-including occupational therapy-is occasions must arise when such will not be available. studied in America medical Last year, in order to meet this difficulty, I examined being systematically The question is, Are and classified the blood of a large number of the literature bears ample proof. Sheffield constables, thinking that they were a healthy we in this country doing our share in the practical of the knowledge we possess ? body of men and easily procurable in a sudden application I am, Sir, yours faithfully, but after classification emergency, unfortunately, the CHARLES W. CHAPMAN. was completed, the Sheffield Watch Committee
BLOOD-DONORS.
"
refused to allow me to utilise the blood of volunteers from their men. I have recently applied to the manager of the tramways for similar facilities, expecting a like answer, as there are obvious objections to the use of men on public duty. I think it would be of advantage if donors could be selected from the general population by some carefully worded advertisement asking for volunteers, each volunteer to receive a small fee for submitting to grouping tests, and, in the event of his blood being used, a fee of at least fiveguineas.-I am, Sir, yours faithfully, E. F. SKINNER. Sheffield, Dec. 1st, 1921.
OCCUPATIONAL THERAPY IN HEART DISEASE. To the Editor of THE LANCET.
SIR,-I
was
much interested in your annotation
on
in the treatment of heart disease in the issue of Nov. 5th ; also in the letter of Dr. I. Harris on the 26th, both referring to my communication of Oct. 22nd. In neither comment, however, was the essential part of my letter discussed, the remarks being confined to the general question of the value of exercises in the treatment of heart disease. The point I desired to emphasise was the humanitarian and economic importance of looking upon the beneficial effects of physical exercises, not as an end in itself, but as means for the acquisition of a capacity for work in a line compatible with the patient’s physical powers, always keeping in view his adaptability to a change of occupation. To achieve this, patients should be carefully graded and training begun at an early period of convalescence ; such training should be specially directed towards preparation for the kind of work appropriate to each case subject to modification where necessary. I have pointed out the unsatisfactory results which follow the return of a patient convalescent from an attack of heart failure to an occupation which had abuncondantly manifested its unsuitability. In this nexion a quotation from a pamphlet, entitled " Sanatoria for Cardiacs," issued by the Association for the Prevention and Relief of Heart Disease, N.Y.:-
physical exercises
" The value of sanatorium treatment of convalescent cardiacs has passed the experimental stage. Experiences
Harley-street, W., Nov. 30th, 1921.
THE SUSSEX PROVIDENT SCHEME : FIRST YEAR’S WORKING. To the Editor of THE LANCET. SIR,-In view of the fact that some doubts have been expressed as to the economic soundness and financial stability of the Sussex Provident Scheme, it may interest some of your readers to hear the results of the first 11 months’ working. It was decided to make the first financial year one of 11months in order
that the associated hospitals might receive what was owing to them before the last quarter day of the current year. The financial arrangement which was agreed to when the scheme was initiated was that, for the first year, the income of the scheme should be divided into 40 parts and that these should be allotted beforehand to the associated hospitals, in a varying proportion based upon the work which each might be expected to do. This was, of course, a purely experimental arrangement and subject to being changed in the light of the first year’s experience, but the results which have been attained will be of value in the future whether the scheme maintains its existence or not. One satisfactory, result is that, although some hospitals have been favoured more than others, they have all been paid in full for the cost of the services which they have rendered to the members of the scheme during the year ; but beyond this 100 per cent., the percentage of payment to the cost of the work done varies very considerably. One hospital which, so far as can be ascertained, has not been called upon for any service to the members of the scheme has been paid one-twentieth of the total income, and of the others the percentage varies from 105 at the Brighton, Hove, and Preston Dispensary, to 307 at the Sussex Throat and Ear Hospital. At the New Sussex Hospital for Women and Children and the Stephen Ralli Memorial Laboratory it reaches 168, while at the Royal Sussex County Hospital it amounts to 117-5. The Dental Hospital has been paid at the rate of 15s. 4d. a visit. The visiting consultants have been paid a fee of £3 3s. for each consultation, while one-eighth of the total income still remains in
method
no
science has flourished."
Clearly, then, the obvious course seems to be that human and comparative pathological research should be more closely linked together in the future than they have hitherto been in the past. I am, Sir. yours faithfully, W. M.
SCOTT, F.R.C.V.S.
Bridgwater, Dec. 3rd, 1921.
with selected groups of children and young adults have shown the tremendous value of institutional treatment in securing a degree of recovery which affords them the opportunity for useful lives and self support. The results obtained by the Burke Foundation, which has cared for over 2000 selected cases in the past six years, are most convincing. Of 130 boys between 10 and 16 years of age received during the first two years and carefully followed, S5 per cent. have remained steadily at work or at school since leaving the institution. The results obtained in adults and more advanced conditions are less striking, but the economic advantage of rendering a large proportion of these sufferers self-supporting and no longer a financial burden to the community, as well as the humanitarian motive of prolonging life and assuaging suffering, should make an urgent appeal to both our pockets and our sympathies."
In another pamphlet from the same source on Occupation for Cardiacs occur remarks under the To the Editor of THE LANCET. following headings : Danger from Overstrain, Choosa General Housework, Skilled Employments, SIR,-The annotation in your issue of Nov. 26th on ing Job, Employer’s Cooperation, Change of Occupation. the question of blood-donors may tend to bring the With regard to the latter, the important point in into that which is at subject prominence present a selection is that the new job should demand lacking in this country. I am in cordial agreement making The of with the writers in the Guy’s Hospital Gazette and as little physical exertion as possible. are writer but few this concludes: There pamphlet St. Bartholomew’s Hospital Journal and would depredo something to earn a living, cate the use of the medical student’s blood for cardiacs who cannot and of them can earn as good wages as if they many purposes of transfusion. Up to the present one has had no disease whatever." usually depended on some relative of the patient to the subject of heart disease, its prevention provide the necessary blood in an emergency, but andThat treatment-including occupational therapy-is occasions must arise when such will not be available. studied in America medical Last year, in order to meet this difficulty, I examined being systematically The question is, Are and classified the blood of a large number of the literature bears ample proof. Sheffield constables, thinking that they were a healthy we in this country doing our share in the practical of the knowledge we possess ? body of men and easily procurable in a sudden application I am, Sir, yours faithfully, but after classification emergency, unfortunately, the CHARLES W. CHAPMAN. was completed, the Sheffield Watch Committee
BLOOD-DONORS.
"
refused to allow me to utilise the blood of volunteers from their men. I have recently applied to the manager of the tramways for similar facilities, expecting a like answer, as there are obvious objections to the use of men on public duty. I think it would be of advantage if donors could be selected from the general population by some carefully worded advertisement asking for volunteers, each volunteer to receive a small fee for submitting to grouping tests, and, in the event of his blood being used, a fee of at least fiveguineas.-I am, Sir, yours faithfully, E. F. SKINNER. Sheffield, Dec. 1st, 1921.
OCCUPATIONAL THERAPY IN HEART DISEASE. To the Editor of THE LANCET.
SIR,-I
was
much interested in your annotation
on
in the treatment of heart disease in the issue of Nov. 5th ; also in the letter of Dr. I. Harris on the 26th, both referring to my communication of Oct. 22nd. In neither comment, however, was the essential part of my letter discussed, the remarks being confined to the general question of the value of exercises in the treatment of heart disease. The point I desired to emphasise was the humanitarian and economic importance of looking upon the beneficial effects of physical exercises, not as an end in itself, but as means for the acquisition of a capacity for work in a line compatible with the patient’s physical powers, always keeping in view his adaptability to a change of occupation. To achieve this, patients should be carefully graded and training begun at an early period of convalescence ; such training should be specially directed towards preparation for the kind of work appropriate to each case subject to modification where necessary. I have pointed out the unsatisfactory results which follow the return of a patient convalescent from an attack of heart failure to an occupation which had abuncondantly manifested its unsuitability. In this nexion a quotation from a pamphlet, entitled " Sanatoria for Cardiacs," issued by the Association for the Prevention and Relief of Heart Disease, N.Y.:-
physical exercises
" The value of sanatorium treatment of convalescent cardiacs has passed the experimental stage. Experiences
Harley-street, W., Nov. 30th, 1921.
THE SUSSEX PROVIDENT SCHEME : FIRST YEAR’S WORKING. To the Editor of THE LANCET. SIR,-In view of the fact that some doubts have been expressed as to the economic soundness and financial stability of the Sussex Provident Scheme, it may interest some of your readers to hear the results of the first 11 months’ working. It was decided to make the first financial year one of 11months in order
that the associated hospitals might receive what was owing to them before the last quarter day of the current year. The financial arrangement which was agreed to when the scheme was initiated was that, for the first year, the income of the scheme should be divided into 40 parts and that these should be allotted beforehand to the associated hospitals, in a varying proportion based upon the work which each might be expected to do. This was, of course, a purely experimental arrangement and subject to being changed in the light of the first year’s experience, but the results which have been attained will be of value in the future whether the scheme maintains its existence or not. One satisfactory, result is that, although some hospitals have been favoured more than others, they have all been paid in full for the cost of the services which they have rendered to the members of the scheme during the year ; but beyond this 100 per cent., the percentage of payment to the cost of the work done varies very considerably. One hospital which, so far as can be ascertained, has not been called upon for any service to the members of the scheme has been paid one-twentieth of the total income, and of the others the percentage varies from 105 at the Brighton, Hove, and Preston Dispensary, to 307 at the Sussex Throat and Ear Hospital. At the New Sussex Hospital for Women and Children and the Stephen Ralli Memorial Laboratory it reaches 168, while at the Royal Sussex County Hospital it amounts to 117-5. The Dental Hospital has been paid at the rate of 15s. 4d. a visit. The visiting consultants have been paid a fee of £3 3s. for each consultation, while one-eighth of the total income still remains in