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HEALTH INSURANCE IN THE IRISH FREE STATE.
182 HEALTH INSURANCE IN THE IRISH FREE
by swallowing while STATE. favoured especially, by violent blowing full is
THE text of the National Health Insurance Bill
recently introduced to the Dail was published last week. The only proposal of any importance in the Bill, writes our Dublin correspondent, is that to abolish county insurance committees and to transfer their functions to the county councils, which will be provided with funds to enable them to perform their increased duties. Certain other proposals tend to simplify the working of the Insurance Acts and to
lessen the expense of their administration. The deposit contributors’ fund is to be abolished, and members of this fund are to join approved societies within a specified period. The difficulties which have hitherto existed regarding insurable married women are surmounted by giving an insured female a marriage benefit, and providing that if she desires to work after marriage she will be treated as if she had never been insured. The Bill appears to be based on the recommendations of the Committee of Inquiry on National Health Insurance and the Medical Services, but it only touches on a few of the less important of the reforms suggested by that Committee. AURAL DISEASE AND BATHING. THE holiday season, which has now arrived, will doubtless be accompanied as usual by trouble-some minor and some serious, in the ears of bathers. Mammals such as the seal, which have reverted to an aquatic life, have a mechanism for closing the auditory meatus, and in some cases the nostrils also, when submerged ; but man is not an aquatic animal and does not possess this form of protection. Water can reach the ear and cause damage to it either by way of the external auditory meatus or through the Eustachian tube. When water gets into the external ear it
produces a disagreeable sensation, as every swimmer knows, but it runs out again quickly and does no harm in a healthy meatus. If, however, the ear contains much cerumen this imbibes the water, swells up, and blocks the canal. The sensation of " water in the ear," persisting long enough for advice to be sought, is nearly always due to wax, and can be cured by its removal. People with a tendency to excessive secretion of cerumen should have it removed before going to the seaside. This retention of moisture from the presence of wax readily sets up a dermatitis, and is the usual cause of external otitis in bathers, but apart from this people with a tendency to eczema of the meatus are apt to suffer an exacerbation of their trouble from bathing. Unskilful diving may rupture the drum by compression of the air in the canal, but in general the occasional entry of water into the meatus is harmless, as is evident from the comparative rarity of trouble among innumerable bathers. The most important cause of serious ear disease resulting from bathing is the entrance of water into an old, often quiescent, perforation of the drum ; this event is liable to cause a very severe suppurative otitis with all its attendant complications. Patients with a perforated drum should never bathe without a really efficient means of preventing the entry of water into the ear. Ordinary cotton-wool is useless for the purpose, and, by giving a false sense of security, becomes a danger ; to occlude the meatus a cast of the patient’s concha specially made for each case can be obtained from instrument makers, but a plugging material made of a mixture of wool-fibre and plasticine or wax is very satisfactory and is sold by various chemists ; a rubber bathing cap to cover the ears should be worn over any plug. Patients with a tendency to aural eczema may with advantage put in at night a few drops of mercuric nitrate ointment, 1 drm. to 1 oz. of equal parts of olive-oil and liquid
paraffin. Nevertheless, people with perfectly healthy ears may develop acute otitis media after bathing, and this is caused by the entrance of water into the tympanum through the Eustachian tube. This entrance is
under water and, of the nose, while the of water. It when virulent micropassages are organisms are carried into the tympanum with the water that otitis ensues ; these organisms may be present in the water, and it is obvious that the water of swimming pools and public baths is more likely to be heavily infected than that of rivers and the open sea. Much care has been devoted to the purification of the water of bathing places, but more attention has been paid, as evidence of contamination, to the intestinal flora of the Bacillus coli group, than to the pyogenic organisms which more frequently attack the ears; but it is probable that the swimming bath may play an important part in the spread of streptococcal infections when, for instance in a school, such diseases as tonsillitis or rhinitis are prevalent. Groups of cases, or small epidemics, of infection of the nasal sinuses have occurred under similar circumstances, and probably from the same causation. But microorganisms can be carried with the water into the ear even when the water of the bathing place is perfectly
clean ; this
occurs when the organisms are already in the patient’s own nose or throat, and is liable to result from bathing during an attack of sorethroat or coryza. To sum up: Harmful results from bathing are very rare in proportion to the number of bathers ; it is necessary to plug the ears only when there is an open perforation of the drum or when the canal is readily irritated by the water ; ear complications are unlikely to occur from infection through the Eustachian tube if the bather refrains from swallowing while in the water and particularly from blowing the nose on emerging, and does not bathe at all while suffering from an active cold or sore-throat.
present
THE PROGRESS OF INDUSTRIAL PHARMACY.
IT would be hard to exaggerate the debt which modern medicine owes to the firms who manufacture the drugs and other preparations nowadays necessary for its practice. A century ago most clinicians and experimenters had to mix their own medicines and solutions; nowadays they can draw upon an arsenal of products compounded with the utmost care and standardised with extreme accuracy. If the activities of manufacturing pharmacists could be taken as a measure of the advance of medical science in modern times, that advance can hardly have been surpassed by any other branch of human activity. The annual special issue of the Chemist and Druggist! aims at providing a survey of the industry from all its aspects year by year, and should not be missed by anyone with a sense of the importance of this great auxiliary. Great pains have been taken with the reproduction of the many unique photographs. The chief articles in the industry of to-day deal with the manufacture of cotton-wool and lint at the mills of Messrs. Vernon and Co. ; solid spirituous preparations, and the cultivation and preparation of the soya bean, a seed of ever-increasing value as a source of vegetable oil, and as a foodstuff. The issue also contains three first-class historical essays. Dr. Charles Singer contributes the second part of his " Sketches in the History of English Medicine," in which he describes the Anglo-Norman Period, and the advent of the learning of Salerno and the Arabs. This is illustrated with a large number of excellent contemporary pictures, including two splendid coloured plates. He gives an interesting quotation from the Prologue to Chaucer’s Canterbury Tales; one which perhaps marks the first mention in English of the manufacturing pharmacist: " Full ready had he his apothecaries to send him drugs and his electuaries." Another article describes the pharmacological history of Dublin, where this year’s British Pharmaceutical Conference was held, and the history of druggists’ weights and measures through 1 42, Cannon-street, London, E.C.
2s. 6d.
by swallowing while STATE. favoured especially, by violent blowing full is
THE text of the National Health Insurance Bill
recently introduced to the Dail was published last week. The only proposal of any importance in the Bill, writes our Dublin correspondent, is that to abolish county insurance committees and to transfer their functions to the county councils, which will be provided with funds to enable them to perform their increased duties. Certain other proposals tend to simplify the working of the Insurance Acts and to
lessen the expense of their administration. The deposit contributors’ fund is to be abolished, and members of this fund are to join approved societies within a specified period. The difficulties which have hitherto existed regarding insurable married women are surmounted by giving an insured female a marriage benefit, and providing that if she desires to work after marriage she will be treated as if she had never been insured. The Bill appears to be based on the recommendations of the Committee of Inquiry on National Health Insurance and the Medical Services, but it only touches on a few of the less important of the reforms suggested by that Committee. AURAL DISEASE AND BATHING. THE holiday season, which has now arrived, will doubtless be accompanied as usual by trouble-some minor and some serious, in the ears of bathers. Mammals such as the seal, which have reverted to an aquatic life, have a mechanism for closing the auditory meatus, and in some cases the nostrils also, when submerged ; but man is not an aquatic animal and does not possess this form of protection. Water can reach the ear and cause damage to it either by way of the external auditory meatus or through the Eustachian tube. When water gets into the external ear it
produces a disagreeable sensation, as every swimmer knows, but it runs out again quickly and does no harm in a healthy meatus. If, however, the ear contains much cerumen this imbibes the water, swells up, and blocks the canal. The sensation of " water in the ear," persisting long enough for advice to be sought, is nearly always due to wax, and can be cured by its removal. People with a tendency to excessive secretion of cerumen should have it removed before going to the seaside. This retention of moisture from the presence of wax readily sets up a dermatitis, and is the usual cause of external otitis in bathers, but apart from this people with a tendency to eczema of the meatus are apt to suffer an exacerbation of their trouble from bathing. Unskilful diving may rupture the drum by compression of the air in the canal, but in general the occasional entry of water into the meatus is harmless, as is evident from the comparative rarity of trouble among innumerable bathers. The most important cause of serious ear disease resulting from bathing is the entrance of water into an old, often quiescent, perforation of the drum ; this event is liable to cause a very severe suppurative otitis with all its attendant complications. Patients with a perforated drum should never bathe without a really efficient means of preventing the entry of water into the ear. Ordinary cotton-wool is useless for the purpose, and, by giving a false sense of security, becomes a danger ; to occlude the meatus a cast of the patient’s concha specially made for each case can be obtained from instrument makers, but a plugging material made of a mixture of wool-fibre and plasticine or wax is very satisfactory and is sold by various chemists ; a rubber bathing cap to cover the ears should be worn over any plug. Patients with a tendency to aural eczema may with advantage put in at night a few drops of mercuric nitrate ointment, 1 drm. to 1 oz. of equal parts of olive-oil and liquid
paraffin. Nevertheless, people with perfectly healthy ears may develop acute otitis media after bathing, and this is caused by the entrance of water into the tympanum through the Eustachian tube. This entrance is
under water and, of the nose, while the of water. It when virulent micropassages are organisms are carried into the tympanum with the water that otitis ensues ; these organisms may be present in the water, and it is obvious that the water of swimming pools and public baths is more likely to be heavily infected than that of rivers and the open sea. Much care has been devoted to the purification of the water of bathing places, but more attention has been paid, as evidence of contamination, to the intestinal flora of the Bacillus coli group, than to the pyogenic organisms which more frequently attack the ears; but it is probable that the swimming bath may play an important part in the spread of streptococcal infections when, for instance in a school, such diseases as tonsillitis or rhinitis are prevalent. Groups of cases, or small epidemics, of infection of the nasal sinuses have occurred under similar circumstances, and probably from the same causation. But microorganisms can be carried with the water into the ear even when the water of the bathing place is perfectly
clean ; this
occurs when the organisms are already in the patient’s own nose or throat, and is liable to result from bathing during an attack of sorethroat or coryza. To sum up: Harmful results from bathing are very rare in proportion to the number of bathers ; it is necessary to plug the ears only when there is an open perforation of the drum or when the canal is readily irritated by the water ; ear complications are unlikely to occur from infection through the Eustachian tube if the bather refrains from swallowing while in the water and particularly from blowing the nose on emerging, and does not bathe at all while suffering from an active cold or sore-throat.
present
THE PROGRESS OF INDUSTRIAL PHARMACY.
IT would be hard to exaggerate the debt which modern medicine owes to the firms who manufacture the drugs and other preparations nowadays necessary for its practice. A century ago most clinicians and experimenters had to mix their own medicines and solutions; nowadays they can draw upon an arsenal of products compounded with the utmost care and standardised with extreme accuracy. If the activities of manufacturing pharmacists could be taken as a measure of the advance of medical science in modern times, that advance can hardly have been surpassed by any other branch of human activity. The annual special issue of the Chemist and Druggist! aims at providing a survey of the industry from all its aspects year by year, and should not be missed by anyone with a sense of the importance of this great auxiliary. Great pains have been taken with the reproduction of the many unique photographs. The chief articles in the industry of to-day deal with the manufacture of cotton-wool and lint at the mills of Messrs. Vernon and Co. ; solid spirituous preparations, and the cultivation and preparation of the soya bean, a seed of ever-increasing value as a source of vegetable oil, and as a foodstuff. The issue also contains three first-class historical essays. Dr. Charles Singer contributes the second part of his " Sketches in the History of English Medicine," in which he describes the Anglo-Norman Period, and the advent of the learning of Salerno and the Arabs. This is illustrated with a large number of excellent contemporary pictures, including two splendid coloured plates. He gives an interesting quotation from the Prologue to Chaucer’s Canterbury Tales; one which perhaps marks the first mention in English of the manufacturing pharmacist: " Full ready had he his apothecaries to send him drugs and his electuaries." Another article describes the pharmacological history of Dublin, where this year’s British Pharmaceutical Conference was held, and the history of druggists’ weights and measures through 1 42, Cannon-street, London, E.C.
2s. 6d.