- Email: [email protected]
DUPLICATED OR REDUPLICATED
493 when doctors and Ministry work together and cease regarding each other as was common between employers and employees until recently that real progress is likely to take place. If Mr. Brown, as the employer, would give heed to the experience of personnel management in industry, I do not think he would find it difficult to win the profession to a less negative attitude, ,,and no service can be satisfactory to the public unless conditions of employment for the doctors are satisfactory too. W. N. LEAK. Wmsford, Cheshire. FEVERS
IN
THE FAR
many women are uniting in demanding better education in child-care, better conditions for mothers, the setting up of nurseries as extensions of the home so that parents can go out together and the mothers need not be on
EAST
SiB,—Ijike others I have read with appreciation Dr. P. B. Wilkinson’s observations (Lancet, 1942, ii, 67 and 1943, i, 210) on smallpox and cholera in Hong-Kong. Now that so many young medical officers are moving east without having seen smallpox, cholera or typhus, they
must be prepared in whatever manner possible. May I stress thisTake care your vaccinations take. In recent years in Hankow I buried four Europeans (a British naval rating, a British consular official, an American naval dental surgeon and an American ex-senator
tourist) who had all been " vaccinated " less than five years before and thought they had protection which they
had not.
Incidentally in China we had no trouble with conscientious objectors to vaccination-they contract the disease, and the question, for them, is settled whatever the outcome. In 1909 I studied my first epidemic of cholera in our hospital in Hankow under Dr. J. A. Thomson, now of Harrogate. He will doubtless recall this, and will pardon me for suggesting that few in the United Kingdom would be better qualified to instruct young MOs in this disease and its treatment. The outbreak, caused by filthy ice, was brought to the European sisters and in the hospital by milk one Sunday morning. full diet suffered severely, and we had hard work with our new saline-infusion apparatus (Cox’s) to pull them through. One naval rating succumbed : he had a renal abscess. Three patients infected on the same day happened to be on a low typhoid diet-and in those days that was milk and nothing else. These were so mildly affected that had we not been looking for signs, we should likely have failed to recognise them. They complained of vague abdominal discomforts, and showed shrivelling of face and fingers, the usual shallow anterior chamber of the eye, and slight blueness. No treatment
patients Those
was
on
required.
°
duty-or tenterhooks-for 24 hours daily for ever. I grateful when the Lancet quoted my views expressed meeting of the London Association of the Medical
was at a
Women’s Federation.
The doctors
were
all
so
fear ; my experience has taught me that they are if proper conditions are given in the nurseries. H. V. ENTHOVEN, Piccadilly, W.1.
full of wrong
Hon. Sec., National Society of Children’s Nurseries.
FEEDING WITH AMINO-ACIDS
S{B,—In his letter of Aug. 28 Professor Brunschwig of Chicago states that, as far as he knows, no-one has ever thought of this method of alimentation as a substitute for the natural one per os. Over twenty years ago I was struck with the dif6.culty of feeding patients by nutrient enema, and I suggested to my teachers of physiology that the obvious thing to do would be to administer intravenously the breakdown products of the protein molecule-namely, the amino-acids. My enthusiasm was dashed by vague replies of possible violent reactions, and I am sorry now that I did not test this method out myself, for I still feel we have here a valuable method of feeding patients who cannot for various reasons be fed by the ordinary route.
E. S. PAGE.
Solihull.
DUPLICATED OR REDUPLICATED SiR,-Writing of accessory heart sounds in your issue of Sept. 25 a correspondent tells us categorically that reduplicated means quadrupled." This statement seems to have been made without verification, and by superficial analogy with such words’ as reconsider, regenerate.and resume. A doctor speaking thus in the sphere of philology is comparable with a patient in the sphere of medicine who should tell us categorically that his disseminated sclerosis had been caused by a heavy fall. The Latin prefix re has some half-dozen meanings which have descended into English. Here are 3 of them :"
1. 2.
Again," which has misled your correspondent. " Duly," "properly" or." as it should be by rights," as
in render, relegate, remit. " 3. The merely intensive meaning of thoroughly" or " and no mistake about it," as in refrigerate, replete and
Men going to work in the east should be provided with reduplicate. Cox’s outfit and taught to use it. Essentially it is a Clearly in usage (3) the prefix’ adds nothing to the small filter-candle which acts as a siphon ; it is boiled/ essential meaning of the main word. The Shorter with the saline to be used for the intravenous infusion. Oxford English Dictionary tells us that reduplicate One outfit can be used for two patients at one time ; the means "makedouble " or "redouble," and that lamp, with automatic regulation of temperature, is not redouble means " double." The words iterate and necessary. The doctor new to this work tends to give reiterate provide an exactly similar instance of the same too little fluid and too much salt : hypertonic saline usage. should not be over a pint. The infusion is often given too W. J. PENMAN. Medical School, London Hospital, E. 1 - ’ fast after the first quart, but should not cease until kidney action is resumed. If the stomach still rejects An inaugural fluids, then fluid per venam should be half-normal A NEw ASSOCIATION OF PHYSICISTS. saline with 5% glucose. Excess of bicarbonate should meeting of the Hospital Physicists Association, held at be avoided. The doctor should use a glass cannula and the British Institute of Radiology on Sept. 24, was attended tie it in ; relapse may set in during the night and it is by 37 physicists drawn from hospitals all over the country. better that a trickle of fluid should continue. It is The aims of the new body are to discuss matters of unwise to remove the vein cannula at night until . mutual interest to those engaged in a branch of scientific work which has grown up largely in the last 30 years. recovery is well established. °
-
A.
Durban, Natal.
H. SKINNER.
is open to physicists attached to hospitals, and medical or biological research departments. The meeting was followed, on Sept. 25, by visits to the Middlesex, Royal Cancer and Westminster Hospitals, and the afternoon session was devoted to papers... Dr. H. T. Flint spoke on technique with the various radium gram units ; Prof. F. L. Hopwood gave an account of the betatron ; Prof. Gilbert Stead discussed teaching for the diplomas and Prof. Sidney Russ dealt with the professional equipment of a hospital physicist.Professor Russ was elected chairman for the first year with Mr. C. W. Wilson, PH D, of Westminster Hospital as honorary secretary. Meetings are to be held thrice yearly at least. Professor Russ reminded his audience that the’first full-time appointment as physicist to the hospital was made 30 years ago. Today between 50 and 60 physicists are engaged in hospital or medical research work.
Membership medical
THE
PROPER
PLACE FOR
CHILDREN
Sin,—Your peripatetic correspondent of Sept. 4 (p. 301) remarked: "It just isn’t true that all small children will thrive in a day nursery." I am afraid many people cannot see round this problem : they are blinded by their own immediate fear or delight over their own successful effort. They do not look at the main facts when they say nurseries for the under-twos are bad or dangerous, that they will break up family life, or that mother loveis everything. Mothers often give up loving because they are too tired and frightened ; ignorance in caring for their children adds to their fears; peace goes from the home, so does respect, and this leads to a general break up, perhaps divorce. I prefer to work to give sound foundations in building home life ;
schools,
IN
THE FAR
many women are uniting in demanding better education in child-care, better conditions for mothers, the setting up of nurseries as extensions of the home so that parents can go out together and the mothers need not be on
EAST
SiB,—Ijike others I have read with appreciation Dr. P. B. Wilkinson’s observations (Lancet, 1942, ii, 67 and 1943, i, 210) on smallpox and cholera in Hong-Kong. Now that so many young medical officers are moving east without having seen smallpox, cholera or typhus, they
must be prepared in whatever manner possible. May I stress thisTake care your vaccinations take. In recent years in Hankow I buried four Europeans (a British naval rating, a British consular official, an American naval dental surgeon and an American ex-senator
tourist) who had all been " vaccinated " less than five years before and thought they had protection which they
had not.
Incidentally in China we had no trouble with conscientious objectors to vaccination-they contract the disease, and the question, for them, is settled whatever the outcome. In 1909 I studied my first epidemic of cholera in our hospital in Hankow under Dr. J. A. Thomson, now of Harrogate. He will doubtless recall this, and will pardon me for suggesting that few in the United Kingdom would be better qualified to instruct young MOs in this disease and its treatment. The outbreak, caused by filthy ice, was brought to the European sisters and in the hospital by milk one Sunday morning. full diet suffered severely, and we had hard work with our new saline-infusion apparatus (Cox’s) to pull them through. One naval rating succumbed : he had a renal abscess. Three patients infected on the same day happened to be on a low typhoid diet-and in those days that was milk and nothing else. These were so mildly affected that had we not been looking for signs, we should likely have failed to recognise them. They complained of vague abdominal discomforts, and showed shrivelling of face and fingers, the usual shallow anterior chamber of the eye, and slight blueness. No treatment
patients Those
was
on
required.
°
duty-or tenterhooks-for 24 hours daily for ever. I grateful when the Lancet quoted my views expressed meeting of the London Association of the Medical
was at a
Women’s Federation.
The doctors
were
all
so
fear ; my experience has taught me that they are if proper conditions are given in the nurseries. H. V. ENTHOVEN, Piccadilly, W.1.
full of wrong
Hon. Sec., National Society of Children’s Nurseries.
FEEDING WITH AMINO-ACIDS
S{B,—In his letter of Aug. 28 Professor Brunschwig of Chicago states that, as far as he knows, no-one has ever thought of this method of alimentation as a substitute for the natural one per os. Over twenty years ago I was struck with the dif6.culty of feeding patients by nutrient enema, and I suggested to my teachers of physiology that the obvious thing to do would be to administer intravenously the breakdown products of the protein molecule-namely, the amino-acids. My enthusiasm was dashed by vague replies of possible violent reactions, and I am sorry now that I did not test this method out myself, for I still feel we have here a valuable method of feeding patients who cannot for various reasons be fed by the ordinary route.
E. S. PAGE.
Solihull.
DUPLICATED OR REDUPLICATED SiR,-Writing of accessory heart sounds in your issue of Sept. 25 a correspondent tells us categorically that reduplicated means quadrupled." This statement seems to have been made without verification, and by superficial analogy with such words’ as reconsider, regenerate.and resume. A doctor speaking thus in the sphere of philology is comparable with a patient in the sphere of medicine who should tell us categorically that his disseminated sclerosis had been caused by a heavy fall. The Latin prefix re has some half-dozen meanings which have descended into English. Here are 3 of them :"
1. 2.
Again," which has misled your correspondent. " Duly," "properly" or." as it should be by rights," as
in render, relegate, remit. " 3. The merely intensive meaning of thoroughly" or " and no mistake about it," as in refrigerate, replete and
Men going to work in the east should be provided with reduplicate. Cox’s outfit and taught to use it. Essentially it is a Clearly in usage (3) the prefix’ adds nothing to the small filter-candle which acts as a siphon ; it is boiled/ essential meaning of the main word. The Shorter with the saline to be used for the intravenous infusion. Oxford English Dictionary tells us that reduplicate One outfit can be used for two patients at one time ; the means "makedouble " or "redouble," and that lamp, with automatic regulation of temperature, is not redouble means " double." The words iterate and necessary. The doctor new to this work tends to give reiterate provide an exactly similar instance of the same too little fluid and too much salt : hypertonic saline usage. should not be over a pint. The infusion is often given too W. J. PENMAN. Medical School, London Hospital, E. 1 - ’ fast after the first quart, but should not cease until kidney action is resumed. If the stomach still rejects An inaugural fluids, then fluid per venam should be half-normal A NEw ASSOCIATION OF PHYSICISTS. saline with 5% glucose. Excess of bicarbonate should meeting of the Hospital Physicists Association, held at be avoided. The doctor should use a glass cannula and the British Institute of Radiology on Sept. 24, was attended tie it in ; relapse may set in during the night and it is by 37 physicists drawn from hospitals all over the country. better that a trickle of fluid should continue. It is The aims of the new body are to discuss matters of unwise to remove the vein cannula at night until . mutual interest to those engaged in a branch of scientific work which has grown up largely in the last 30 years. recovery is well established. °
-
A.
Durban, Natal.
H. SKINNER.
is open to physicists attached to hospitals, and medical or biological research departments. The meeting was followed, on Sept. 25, by visits to the Middlesex, Royal Cancer and Westminster Hospitals, and the afternoon session was devoted to papers... Dr. H. T. Flint spoke on technique with the various radium gram units ; Prof. F. L. Hopwood gave an account of the betatron ; Prof. Gilbert Stead discussed teaching for the diplomas and Prof. Sidney Russ dealt with the professional equipment of a hospital physicist.Professor Russ was elected chairman for the first year with Mr. C. W. Wilson, PH D, of Westminster Hospital as honorary secretary. Meetings are to be held thrice yearly at least. Professor Russ reminded his audience that the’first full-time appointment as physicist to the hospital was made 30 years ago. Today between 50 and 60 physicists are engaged in hospital or medical research work.
Membership medical
THE
PROPER
PLACE FOR
CHILDREN
Sin,—Your peripatetic correspondent of Sept. 4 (p. 301) remarked: "It just isn’t true that all small children will thrive in a day nursery." I am afraid many people cannot see round this problem : they are blinded by their own immediate fear or delight over their own successful effort. They do not look at the main facts when they say nurseries for the under-twos are bad or dangerous, that they will break up family life, or that mother loveis everything. Mothers often give up loving because they are too tired and frightened ; ignorance in caring for their children adds to their fears; peace goes from the home, so does respect, and this leads to a general break up, perhaps divorce. I prefer to work to give sound foundations in building home life ;
schools,