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Hygiene for Nurses
P U B L I C H E A L T H , October, 1943 became M.P. for the St. Albans Division, the seat he held for the rest of his life. In 1916 he had rather unexpectedly inherited the Bedwell Park estate, near Hatfield, with its fine mansion, pictures and parklands, so he resigned his appointment to become H o n o r a r y Consulting County Medical Officer, and proposed to devote his whole time to parliamentary and other public duties. On entering the House of C o m m o n s he was soon recognised as a spokesman of the medical profession, and the Speaker would call h i m on almost ever'," occasion w h e n health and social matters were the subject of debate. In addition, he rarely failed to attend during the Question Hour, and he became an expert in finding material for a medical or health " supplementary " arising out of the most unlikely questions. He was from 1923 C h a i r m a n of the Parliamentary Medical C o m mittee, which includes m e m b e r s of all parties, and he was also C h a i r m a n till he resigned the office in JanuaD' last of the Health and H o u s i n g Committee of the Conservative Party. Apart f r o m medical interests, he was Chairman of the Select Committee on Publications and H o u s e of C o m m o n s Debates Reports. H e was a m e m b e r of the Industrial Health Research Board in 1930-34, a m e m b e r of the D e p a r t m e n t a l Commission on Rent Restriction Acts in 1928, 1931 and 1937 and on the Midwives Act (1908) and a m e m b e r of the Central H o u s i n g Advisory Committee of the Ministry of Health and of the Interdepartmental Committee on N u r s i n g Service. I n 1920 he was President of the Society of Medical Officers of Health, in 1928 President of the Section of Epidemiology and State Medicine of the Royal Society of Medicine, and he was a Fellow and VicePresident of the Royal Sanitary Institute. H e received the h o n o u r of knighthood in 1932. By his persistence, integrity and high character, Fremantle w o n for himself the affection and respect of m e m b e r s of all parties. But he was held in equal regard by all sorts and conditions of people outside the House engaged in various m o v e m e n t s to promote social betterment. Before the war, when the H o u s e sat till midnight or m u c h later, he would spend hours in the library answering the letters of countless correspondents, often taking infinite pains to help social workers and others who had no immediate claim on his time. F o r his old colleagues in the Public Health Service n o t h i n g was too m u c h trouble, and he often referred with pleasure to his long m e m b e r s h i p of the Council of the Society of Medical Officers of Health. T h e y in their t u r n will long r e m e m b e r Fremantle for his loyalty as a friend and for his untiring devotion to a multitude of good causes. A D e p u t y Lieutenant and Justice of the Peace for Hertfordshire, Fremantle was actively interested in the local affairs of his county. H e was also a frequent correspondent of T h e T i m e s and the a u t h o r of a n u m b e r of books, including " I m p r e s s i o n s of a D o c t o r in Khaki " (1901), " Traveller's Study of Health and E m p i r e " (1911), " T h e H o u s i n g of the Nation " and " Health of the Native " (1927), and " T h e D o c t o r ' s Mandate in Parliament " ~ a Chadwick Lecture (1936). I n 1905 he married D o r o t h y Marion Travers, the only daughter of the late Mr. H e n r y J o s e p h Chinnery, ].p., of Frigford M a n o r , Bicester. T h e i r only son, Lt.-Col. David Fremantle, R.A, is n o w on active service.. M r . SP~NCE, Chief Clerk of the Hertfordshire H e a l t h D e p a r t m e n t , w h o was with Sir Francis from the earliest days of his county appointment, has sent us some interesting notes on the evolution of the work. In 1908, Sir Francis Fremantle inaugurated the scheme of school medical inspection, using as assistant school medical officers the then district medical officers ot health, with the addition of a few general practitioners in more scattered areas. The argument for this was that these men knew their localities, and that they would have a certain variation in the work as compared with assistant school medical officers specially appointed to do nothing more than inspections. This original scheme was in operation up to about 1940-41 without great modifications. In November, 1910, Sir Francis was appointed full-time and later "given an official staff. Motor cars were not in these days in general use, but in spite of being on part-time Sir Francis spent two or three days every week visiting the County and his assistant school medical officers, using train and cycle for his journeys. In 1918 the tuberculosis scheme was started by Sir Francis in conjunction with Dr. Hyslop Thomson, the newly appointed tuberculosis officer for the county, and in the same year the office was transferred to Hertford. Public health in these early days was not taken as seriously ~s it is now, and there was a great deal of cold water thrown on his suggestions, but Sir Francis always took things good naturedly and stuck to his guns. He was a great worker, and spent hours on end in studying the records of school inspections as they were received. He was always full of ideas in connection with his work, and was an active supporter of many health and social organisations, especially in connection with the garden city movement and housing generally. Dr. J. L. DUNLOP, C o u n t y Medical Officer for Hertfordshire, writes : My personal acquaintance with Sir Francis was, of course, limited. As soon as I was chosen for this job, he wrote to me and invited me I~ meet him to discuss the many problems in this County. I called on him soon after I took up duty, and found that he was still intensely interested in the public health problems here. From time to time during the past three years we have had conversations or correspondence on subjects of public health interest and problems peculiar to this County. I always found Sir Francis very willing to consider new ideas without prejudice, and he was always prepared to listen to destructive criticism of ideas on which he held strong views. Sir Franeis'a Annual Report for 1908 gives details of the school medical service he set up in this County in that year. His foundations were well laid, and the
11 services remained pretty well unchanged until the evacuation of sehoolochildrc~ to tiffs County in 1939. In his 1908 Report, he makes a strong case for a combined ap.pointment as Assistant School Medical Officer and Medical Officer of Heahh. "1lie arguments he used then to support his case have more recently been accepted by many other Counties which did not at that time see eye to eye with him. Fremantle had always been a great supporter of the Count~' Nursing Association. In 1910, he wrote a long report warning the Education Committee that they would have to face up to the question of appointing school nurses, and advising them very strongly that the ideal way of doing school nursing was by the employment of district nurses. Friends who worked with him in ttertfbrdshire tell that Sir Francis throughout his career was tremendously enthusiastic about his public health work. He did not always get the support which he bad hoped for, but thi~ did not damp his enthusiasm. G. H. PATTERSON, M'.R.C.S., L.R.C.P., D,PAf, We regret to announce the death of Dr. G. H. Patterson on Septemb e r 12th, within a few days of his 87th birthday. He had retired at the end of 1942 f r o m the post of M . O . H . of the Ulverston Combined Sanitary District, which he had held for nearly 45 years, but he retained that of Medical Officer to the Ulverston Joint Hospital Board u p to the very end. George H e n r y Patterson was born on S e p t e m b e r 14th, 1856, and received his medical education at St. Bartholomew's Hospital, taking the M.R.C.S. and L.R.C.P. in 1879, and the D . P . H . in 1896. After holding various house appointments at St. Bartholomew's and elsewhere he settled in Dalton, where he engaged in general practice. I n January, 1886, he was appointed part-time M . O . H . of D a l t o n U r b a n Sanitary District, and in 1808 he became M . O . H . of the Ulverston C o m b i n e d Sanitary District, comprising the U r b a n and Rural Districts of Ulverston and the U r b a n Districts of Dalton and Grange, with a combined population of some 43,000 and an area of 2 2 0 square miles. D u r i n g his long period of service as M . O . H . he did m u c h to improve the sanitary circumstances of the area u n d e r his control, particularly in relation to improved m e t h o d s of excrement and refuse disposal, and the provision of water supplies. I n the Dalton U r b a n District he waged unceasing war against " that abomination, the privy-midden," and was instrumental in securing the conversion of large n u m b e r s into water closets. T h e conversions w e r e accompanied by progri~ssive decline in the incidence of enteric fever until t h e disease, looked u p o n as endemic w h e n he first assumed office, finally disappeared. In the large rural district Dr. Patterson constantly advocated schemes for the provision of water supplies and s e w e r a g e - - s c h e m e s which, he stated in his last annual report, reflected great credit .~pon successive generations of councillors. T h o u g h m u c h was accomplished in this direction, Dr. Patterson, at the time w h e n he relinquished office, was well aware of the fact that m u c h still remained to be done. In t h e last few years be devoted himself to the immunisation of children against diphtheria, and the results achieved were a g r e a t credit to a m a n of his advanced years. Dr. Patterson was a native of the F u r n e s s area in which he laboured so long and so successfully. In his later years he was affectionately k n o w n to the whole c o m m u n i t y as " O w d D o c t o r . " H e had long since ceased to be regarded as an official and had come to be looked u p o n as a personal friend. Can any higher tribute be paid to the m e m o r y of a Medical Officer of Health ?
BOOK R E V I E W Hygiene for Nurses. By JOHN GUY and J. T. LINKLATER. 6 t h e d i t i o n . E d i n b u r g h : E. & S. L i v i n g s t o n e . 1943. 240 p p . P r i c e 5s. n e t , p o s t a g e 5d. T h i s s m a l l b o o k is w r i t t e n w i t h t h e l a u d a b l e i n t e n t i o n o f i n t e r e s t i n g t h e n u r s e in p r e v e n t i v e m e d i c i n e e a r l y i n h e r c a r e e r . U n f o r t u n a t e l y , t h e c o n c e n t r a t e d p r e s e n t a t i o n o f facts a n d t h e a b s e n c e o f a n y s t r o n g link b e t w e e n t h e v a r i o u s s e c t i o n s h a s n o t r e s u l t e d i n a b o o k w h i c h is v e r y i n t e r e s t i n g to r e a d . T a k e n as a " c r a m b o o k , " h o w e v e r , it is well p r i n t e d a n d easy to c a r r y , a n d its s u c c e s s is s h o w n b y t h e a p p e a r a n c e o f this s i x t h edition. The authors write primarily from the Scottish point of view, w h i c h m a y e x p l a i n s u c h t h i n g s as t h e o m i s s i o n o f a n y a l l u s i o n t o t h e p a s t e u r i s a t i o n o f m i l k in t h e p r e v e n t i o n o f b o v i n e t u b e r c u l o s i s , t h e d e l a y in g i v i n g m i x e d d i e t t o i n f a n t s , a n d t h e presence of that abomination to m o s t p e o p l e - - " milky tea " i n t h e d i e t o f t h e p r e - s c h o o l child. O n t h e o t h e r h a n d , t h e r e is m u c h to b e s a i d f o r t h e a u t h o r s ' r e c o m m e n d a t i o n to t r a i n infants to sleep f r o m 7 p.m. to 6 a.m. ; a n d the inclusion of p o r r i d g e a n d oatcake i n t h e b a b y ' s d i e t b r i n g s b a c k p l e a s a n t m e m o r i e s of Scottish holidays. But w h y do Dr. G u y and D r . L i n k l a t e r tell t h e s e e n e r g e t i c y o u n g p r o b a t i o n e r s s o d o g m a t i c a l l y t h a t " t h e o l d m a n s h o u l d n o t b e a l l o w e d to d o z e a f t e r his m e a l s " ? P e r h a p s t h e y m a y live t o r e g r e t s u c h an emphatic statement.
11 services remained pretty well unchanged until the evacuation of sehoolochildrc~ to tiffs County in 1939. In his 1908 Report, he makes a strong case for a combined ap.pointment as Assistant School Medical Officer and Medical Officer of Heahh. "1lie arguments he used then to support his case have more recently been accepted by many other Counties which did not at that time see eye to eye with him. Fremantle had always been a great supporter of the Count~' Nursing Association. In 1910, he wrote a long report warning the Education Committee that they would have to face up to the question of appointing school nurses, and advising them very strongly that the ideal way of doing school nursing was by the employment of district nurses. Friends who worked with him in ttertfbrdshire tell that Sir Francis throughout his career was tremendously enthusiastic about his public health work. He did not always get the support which he bad hoped for, but thi~ did not damp his enthusiasm. G. H. PATTERSON, M'.R.C.S., L.R.C.P., D,PAf, We regret to announce the death of Dr. G. H. Patterson on Septemb e r 12th, within a few days of his 87th birthday. He had retired at the end of 1942 f r o m the post of M . O . H . of the Ulverston Combined Sanitary District, which he had held for nearly 45 years, but he retained that of Medical Officer to the Ulverston Joint Hospital Board u p to the very end. George H e n r y Patterson was born on S e p t e m b e r 14th, 1856, and received his medical education at St. Bartholomew's Hospital, taking the M.R.C.S. and L.R.C.P. in 1879, and the D . P . H . in 1896. After holding various house appointments at St. Bartholomew's and elsewhere he settled in Dalton, where he engaged in general practice. I n January, 1886, he was appointed part-time M . O . H . of D a l t o n U r b a n Sanitary District, and in 1808 he became M . O . H . of the Ulverston C o m b i n e d Sanitary District, comprising the U r b a n and Rural Districts of Ulverston and the U r b a n Districts of Dalton and Grange, with a combined population of some 43,000 and an area of 2 2 0 square miles. D u r i n g his long period of service as M . O . H . he did m u c h to improve the sanitary circumstances of the area u n d e r his control, particularly in relation to improved m e t h o d s of excrement and refuse disposal, and the provision of water supplies. I n the Dalton U r b a n District he waged unceasing war against " that abomination, the privy-midden," and was instrumental in securing the conversion of large n u m b e r s into water closets. T h e conversions w e r e accompanied by progri~ssive decline in the incidence of enteric fever until t h e disease, looked u p o n as endemic w h e n he first assumed office, finally disappeared. In the large rural district Dr. Patterson constantly advocated schemes for the provision of water supplies and s e w e r a g e - - s c h e m e s which, he stated in his last annual report, reflected great credit .~pon successive generations of councillors. T h o u g h m u c h was accomplished in this direction, Dr. Patterson, at the time w h e n he relinquished office, was well aware of the fact that m u c h still remained to be done. In t h e last few years be devoted himself to the immunisation of children against diphtheria, and the results achieved were a g r e a t credit to a m a n of his advanced years. Dr. Patterson was a native of the F u r n e s s area in which he laboured so long and so successfully. In his later years he was affectionately k n o w n to the whole c o m m u n i t y as " O w d D o c t o r . " H e had long since ceased to be regarded as an official and had come to be looked u p o n as a personal friend. Can any higher tribute be paid to the m e m o r y of a Medical Officer of Health ?
BOOK R E V I E W Hygiene for Nurses. By JOHN GUY and J. T. LINKLATER. 6 t h e d i t i o n . E d i n b u r g h : E. & S. L i v i n g s t o n e . 1943. 240 p p . P r i c e 5s. n e t , p o s t a g e 5d. T h i s s m a l l b o o k is w r i t t e n w i t h t h e l a u d a b l e i n t e n t i o n o f i n t e r e s t i n g t h e n u r s e in p r e v e n t i v e m e d i c i n e e a r l y i n h e r c a r e e r . U n f o r t u n a t e l y , t h e c o n c e n t r a t e d p r e s e n t a t i o n o f facts a n d t h e a b s e n c e o f a n y s t r o n g link b e t w e e n t h e v a r i o u s s e c t i o n s h a s n o t r e s u l t e d i n a b o o k w h i c h is v e r y i n t e r e s t i n g to r e a d . T a k e n as a " c r a m b o o k , " h o w e v e r , it is well p r i n t e d a n d easy to c a r r y , a n d its s u c c e s s is s h o w n b y t h e a p p e a r a n c e o f this s i x t h edition. The authors write primarily from the Scottish point of view, w h i c h m a y e x p l a i n s u c h t h i n g s as t h e o m i s s i o n o f a n y a l l u s i o n t o t h e p a s t e u r i s a t i o n o f m i l k in t h e p r e v e n t i o n o f b o v i n e t u b e r c u l o s i s , t h e d e l a y in g i v i n g m i x e d d i e t t o i n f a n t s , a n d t h e presence of that abomination to m o s t p e o p l e - - " milky tea " i n t h e d i e t o f t h e p r e - s c h o o l child. O n t h e o t h e r h a n d , t h e r e is m u c h to b e s a i d f o r t h e a u t h o r s ' r e c o m m e n d a t i o n to t r a i n infants to sleep f r o m 7 p.m. to 6 a.m. ; a n d the inclusion of p o r r i d g e a n d oatcake i n t h e b a b y ' s d i e t b r i n g s b a c k p l e a s a n t m e m o r i e s of Scottish holidays. But w h y do Dr. G u y and D r . L i n k l a t e r tell t h e s e e n e r g e t i c y o u n g p r o b a t i o n e r s s o d o g m a t i c a l l y t h a t " t h e o l d m a n s h o u l d n o t b e a l l o w e d to d o z e a f t e r his m e a l s " ? P e r h a p s t h e y m a y live t o r e g r e t s u c h an emphatic statement.