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From Dr. Florence E. Barrett
r924.
PUBLIC
heart a n d faintness. That the toss at confinement and during the following night had been severe, and that the lochia were free and offensive. A copy of this letter was put in and admitted on Nurse's behalf. In cross examination he stated that there was no albumen in the urine previous to the confinement. Later he was recalled, and stated that previous to the confinement on his visits, he had found patient with a good colour, and in no way anaemic, and he had expected a normal confinement. The House Physician at the Infirmary stated, in evidence, that on admission, pulse was 140, lochia very foul. Patient died four hours after admission. He entirely agreed with the previous medical witness's opinion. At the post mortem the organs were found to be i n a high degree anaemic, the spleen was three times its normal size, a portion of placenta twice the size of a hen's egg was found; it was not microscopically examined. He stated that placenta could be readily distinguished from blood clot, that the portion of placenta was adherent to the body of the uterus near the fundus, and there was no possible doubt that it was in fact placenta. The defence was that this was a case of toxaemia of pregnancy. It was admitted that in face of the evidence it could not be denied that a portion of placenta had been left behind. The Board dismissed charges (1) and (2), and convicted on charges (8), (4) and (5), and gently censured the Midwife. Comments.
The Board appear to have completely ignored the evidence of two doctors, and a report from a pathologist of the post mortem findings with regard to the retained placenta. (Charge 1). With respect to Charge (9), excessive bleeding was admitted i n the Midwife's letter produced at the enquiry. The Public Health Committee reported to the County Council on this case. " While the result amply justifies the acNon taken in reporting the case to the Board, the Committee feel bound to record their dissatisfaction with the findings of the Board, nor can they regard the ' c a u t i o n ' administered to the Nurse as an adequate way of dealing with such grave neglect in a case where the life of the patient was at stake." I am, Yours faithfully, "
COUNTY~IEDICAL OFFICER."
WOMEN IN MEDICINE. From Dr. FLORENCE E. BARRETT. DEAR S I R , - - M y attention has been called to an editorial article in your Journal of PUBLICHEALTH,
I8]
HEALTH.
in reply to which it is only fair to the public to say that the cost of medical training for women in the London (R. F . H . ) School of Medicine for Women (with which alone I am acquainted) has proved by no means an unsatisfactory 6r unremunerative investment. The whole profession, both as regards men and women, is somewhat overcrowded at the moment, owing to the very large entry of students at the end of the War. That entry, however, has rapidly declined, and it w o u l d b e an entire delusion to found any judgment on the needs of t h e profession by the numbers qualifying within the last year or two. It would be very interesting to see what kind of women write the letters suggested in your editorial. I can only say that of all our students who have started in practice none of them have had the experiences you describe, and I have never, in my whole experience, heard one medical woman declare " that the continual grind and petty annoyances of practice are unendurable for women, and that they are on the verge of a breakdown in health." I am surprised that, in spite of your view that business is a more desirable employment than the medical profession, you do not utter one word of guidance to the parents of men students, whichmight deter them from sending their sons into the profession. It seems to be a singularly unfortunate time for an article of this kind to appear in your paper, when medical women have been working loyally to prevent the acceptance of under-paid posts. Such an editorial as yours will only encourage public bodies to offer lower salaries to women, and thereby damage the profession as a whole. Yours very truly,
FLORENCE E. BARRETT. P . S . - - I have just made careful enquiry as to the actual figures affecting the present time for the women of our oWi~ School. There are 0nly six women who will be requiring poStS immediately, and three or four of these are not yet out of the posts they are now in. Sixty women h~ave obtained Hospital appointments within six months, and of those who have started in general practice, all are succeeding beyond their expectations.
" THE
SOAP A N D W A T E R S C H O O L OF DISINFECTION."
From Prof. H. K E N W 0 0 D . SIR,--A careful perusal of our paper will supply our answer to most of the points which Dr. K. Simpson raises in his letter which appeared in your last issue.
PUBLIC
heart a n d faintness. That the toss at confinement and during the following night had been severe, and that the lochia were free and offensive. A copy of this letter was put in and admitted on Nurse's behalf. In cross examination he stated that there was no albumen in the urine previous to the confinement. Later he was recalled, and stated that previous to the confinement on his visits, he had found patient with a good colour, and in no way anaemic, and he had expected a normal confinement. The House Physician at the Infirmary stated, in evidence, that on admission, pulse was 140, lochia very foul. Patient died four hours after admission. He entirely agreed with the previous medical witness's opinion. At the post mortem the organs were found to be i n a high degree anaemic, the spleen was three times its normal size, a portion of placenta twice the size of a hen's egg was found; it was not microscopically examined. He stated that placenta could be readily distinguished from blood clot, that the portion of placenta was adherent to the body of the uterus near the fundus, and there was no possible doubt that it was in fact placenta. The defence was that this was a case of toxaemia of pregnancy. It was admitted that in face of the evidence it could not be denied that a portion of placenta had been left behind. The Board dismissed charges (1) and (2), and convicted on charges (8), (4) and (5), and gently censured the Midwife. Comments.
The Board appear to have completely ignored the evidence of two doctors, and a report from a pathologist of the post mortem findings with regard to the retained placenta. (Charge 1). With respect to Charge (9), excessive bleeding was admitted i n the Midwife's letter produced at the enquiry. The Public Health Committee reported to the County Council on this case. " While the result amply justifies the acNon taken in reporting the case to the Board, the Committee feel bound to record their dissatisfaction with the findings of the Board, nor can they regard the ' c a u t i o n ' administered to the Nurse as an adequate way of dealing with such grave neglect in a case where the life of the patient was at stake." I am, Yours faithfully, "
COUNTY~IEDICAL OFFICER."
WOMEN IN MEDICINE. From Dr. FLORENCE E. BARRETT. DEAR S I R , - - M y attention has been called to an editorial article in your Journal of PUBLICHEALTH,
I8]
HEALTH.
in reply to which it is only fair to the public to say that the cost of medical training for women in the London (R. F . H . ) School of Medicine for Women (with which alone I am acquainted) has proved by no means an unsatisfactory 6r unremunerative investment. The whole profession, both as regards men and women, is somewhat overcrowded at the moment, owing to the very large entry of students at the end of the War. That entry, however, has rapidly declined, and it w o u l d b e an entire delusion to found any judgment on the needs of t h e profession by the numbers qualifying within the last year or two. It would be very interesting to see what kind of women write the letters suggested in your editorial. I can only say that of all our students who have started in practice none of them have had the experiences you describe, and I have never, in my whole experience, heard one medical woman declare " that the continual grind and petty annoyances of practice are unendurable for women, and that they are on the verge of a breakdown in health." I am surprised that, in spite of your view that business is a more desirable employment than the medical profession, you do not utter one word of guidance to the parents of men students, whichmight deter them from sending their sons into the profession. It seems to be a singularly unfortunate time for an article of this kind to appear in your paper, when medical women have been working loyally to prevent the acceptance of under-paid posts. Such an editorial as yours will only encourage public bodies to offer lower salaries to women, and thereby damage the profession as a whole. Yours very truly,
FLORENCE E. BARRETT. P . S . - - I have just made careful enquiry as to the actual figures affecting the present time for the women of our oWi~ School. There are 0nly six women who will be requiring poStS immediately, and three or four of these are not yet out of the posts they are now in. Sixty women h~ave obtained Hospital appointments within six months, and of those who have started in general practice, all are succeeding beyond their expectations.
" THE
SOAP A N D W A T E R S C H O O L OF DISINFECTION."
From Prof. H. K E N W 0 0 D . SIR,--A careful perusal of our paper will supply our answer to most of the points which Dr. K. Simpson raises in his letter which appeared in your last issue.