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IMPROVED LARYNGEAL FORCEPS.
1286
groups-those of the ventricles alone and those of both auricles and ventricles. Coupled rhythms may occur from various causes and are often due to a regularly recurring extra-systole, most frequently of ventricular origin. The writers of the paper sum up their views in the following sentence : °‘ Whenever an enfeebled heart is unduly irritable in an abnormal site, any excessive rise of intracardiac pressure may produce a regularly recurring premature systole which originates in the irritable area." 8. The Outlook of Sufferers from Exophthalmic Goitre, by W. Hale White. The after-histories of a considerable number of hospital and private cases are given, with a view to throwing light upon the outlook of patients with this disease apart from two
operative
measures.
New Inventions. IMPROVED LARYNGEAL FORCEPS. Messrs. Krohne and Sesemann have recently made this instrument for me, and I have found it very useful for operations
on 1ine
larynx oy
me GlreCu
method. The illustration explains the mechanism. By means of the screw the cutting part of the forceps can be rotated to the required position, and the growths on the cords, arytenoids, or
inter-arytenoid region easily
re-
moved. The cap is hollow and can be opened; this cap catches any pieces removed and prevents them passing into the trachea. The second attachment shown is for removing very small growths-i.e., singers’ nodes from the cord; by means of the same screw its cutting blade can be fixed at any angle, and as the blade fits into a depression on the foot-piece which is under the cord the growths can be removed and the risk of injuring the cord is reduced to a minimum. The attachdifferent .
ments
can
be removed the handle.
easily from GEORGE N.
BIGGS, M.B., B.S. Durh.
POOR-LAW MEDICAL OFFICERS’ ASSOCIATION OF ENGLAND AND WALES. A COUNCIL meeting of this association was held at 34, Copthall-avenue, London, E. C., on Oct. 18th. Mr. D. B.
BALDING was in the chair. A letter was considered from a country member complaining that the guardians in his district had appointed as district medical officer a practitioner who resided seven miles away from his district. This had been sanctioned for one year by the Local Government Board, but recently he had been re-elected by the guardians for a further period of three years. It was unanimously considered by the council that the matter required investigation ; that on the face of it it was a scandal to appoint a district medical officer living seven miles away from his district, having regard to the necessities of the sick poor. A communication was received from a public vaccinator
complaining that because he had resigned his district medical officership on account of inadequate remuneration he was now threatened with the loss of his vaccination office. The local division of the British Medical Association had banned the appointment he had resigned, and so far there had been no applicants, but he felt sure that if no one would take this. post at the old rate the guardians would endeavour to attract. applicants by adding the post of public vaccinator to it. Strong comments were made by those present on the unprotected position of the public vaccinator, and the unscrupulous use made by the guardians of the remuneration from this source to underpay Poor-law appointments. It was regretted by the council that no assistance could be given to their correspondent. Under the present law only a month’s. notice need be given by the guardians to determine any public vaccinator’s office, and this could be done without any reason being given, and it appeared that the Local Government Board had no control in the matter at all. Another correspondent wrote complaining of the refusal of his guardians to allow him the extra fee of £2 for attendance on a long case of phlegmasia dolens on the ground that he had not attended at the confinement of the patient, having only received the order 12 days afterwards. He quoted from Art. 182 of the Gen. Ord. of July, 1847, which lays down that a district medical officer shall be entitled to a fee of R2in any ’’ special case where great difficulty may have occurred in the delivery, or long 8itbseq?zent attendance in ,respect of some puerperal malady, or affection, may have been reyacisate." There was some difference of opinion on this point. It was thought by some that in order to be entitled to this fee the medical officer must have been called to the confinement or very shortly afterwards. But a majority of the council thought that under the article any long-continued attendance on a puerperal case was sufficient, and the honorary secretary was instructed to write and advise the member to push his claim and proffer the assistanceof the association. A delegate from the district medical officers of a metropolitan borough also attended the council meeting to ask for assistance. He stated that the guardians, owing to a recent resignation of one of the district medical officers, were endeavouring to reduce the number of district medical officers from five to four and to force on to two of their number the vacated district under The district medical officers very inequitable conditions. claimed that there should be a re-arrangement of the whole area. That under the present arrangement only one of their number received about the average payment of the district medical officers throughout the metropolitan district-viz., 3s. per order. That all the others were being paid less than 2s. per order. They had sent in a memorial to their board of guardians, and if this were ignored they proposed to carry it to the Local Government Board. The council expressed its. sympathy and promised all the assistance in its power. The honorary secretary read a letter from Mr. Shirley Fussell asking the association to appoint four delegates to meet delegates from the National Poor Law Officers’ Association, the Union and Rural District Clerks’ Association, and the Workhouse Masters’ and Matrons’ Association in a joint conference to consider the recommendations of the Royal Commission on the Poor-laws affecting the interests of Poorlaw officers, and report as to what action (if any) it is necessary or desirable to take now, or in the future, to safeguard the interests of the service. The council appointed Mr. W. Holder (Hull), Mr. A. A. Napper (Cranleigh), Dr. F. S. Toogood (London), and Dr. Major Greenwood (London) to represent the Poor-law Medical Officers’ Association in the proposed conference.
CONTINENTAL ANGLO-AMERICAN MEDICAL SOCIETY. -The annual meeting of this society was held at 81, Boulevard Malesherbes, Paris, on Oct. 15th. The annual dinner was held in the evening at the Carlton Hotel, Paris. The chair was occupied by Sir Frederick Treves, who warmly congratulated the society on its excellent work, laying stress on its usefulness in uniting and in bringing to the notice of the profession at home responsible men to whom patients travelling abroad could be safely entrusted. This very successful gathering was brought to a close by two happy speeches from Professor Tuffier of Paris and Dr. Alexander Lambert of New York, who assuTei the members of the regard of their colleagues in France and in America.
groups-those of the ventricles alone and those of both auricles and ventricles. Coupled rhythms may occur from various causes and are often due to a regularly recurring extra-systole, most frequently of ventricular origin. The writers of the paper sum up their views in the following sentence : °‘ Whenever an enfeebled heart is unduly irritable in an abnormal site, any excessive rise of intracardiac pressure may produce a regularly recurring premature systole which originates in the irritable area." 8. The Outlook of Sufferers from Exophthalmic Goitre, by W. Hale White. The after-histories of a considerable number of hospital and private cases are given, with a view to throwing light upon the outlook of patients with this disease apart from two
operative
measures.
New Inventions. IMPROVED LARYNGEAL FORCEPS. Messrs. Krohne and Sesemann have recently made this instrument for me, and I have found it very useful for operations
on 1ine
larynx oy
me GlreCu
method. The illustration explains the mechanism. By means of the screw the cutting part of the forceps can be rotated to the required position, and the growths on the cords, arytenoids, or
inter-arytenoid region easily
re-
moved. The cap is hollow and can be opened; this cap catches any pieces removed and prevents them passing into the trachea. The second attachment shown is for removing very small growths-i.e., singers’ nodes from the cord; by means of the same screw its cutting blade can be fixed at any angle, and as the blade fits into a depression on the foot-piece which is under the cord the growths can be removed and the risk of injuring the cord is reduced to a minimum. The attachdifferent .
ments
can
be removed the handle.
easily from GEORGE N.
BIGGS, M.B., B.S. Durh.
POOR-LAW MEDICAL OFFICERS’ ASSOCIATION OF ENGLAND AND WALES. A COUNCIL meeting of this association was held at 34, Copthall-avenue, London, E. C., on Oct. 18th. Mr. D. B.
BALDING was in the chair. A letter was considered from a country member complaining that the guardians in his district had appointed as district medical officer a practitioner who resided seven miles away from his district. This had been sanctioned for one year by the Local Government Board, but recently he had been re-elected by the guardians for a further period of three years. It was unanimously considered by the council that the matter required investigation ; that on the face of it it was a scandal to appoint a district medical officer living seven miles away from his district, having regard to the necessities of the sick poor. A communication was received from a public vaccinator
complaining that because he had resigned his district medical officership on account of inadequate remuneration he was now threatened with the loss of his vaccination office. The local division of the British Medical Association had banned the appointment he had resigned, and so far there had been no applicants, but he felt sure that if no one would take this. post at the old rate the guardians would endeavour to attract. applicants by adding the post of public vaccinator to it. Strong comments were made by those present on the unprotected position of the public vaccinator, and the unscrupulous use made by the guardians of the remuneration from this source to underpay Poor-law appointments. It was regretted by the council that no assistance could be given to their correspondent. Under the present law only a month’s. notice need be given by the guardians to determine any public vaccinator’s office, and this could be done without any reason being given, and it appeared that the Local Government Board had no control in the matter at all. Another correspondent wrote complaining of the refusal of his guardians to allow him the extra fee of £2 for attendance on a long case of phlegmasia dolens on the ground that he had not attended at the confinement of the patient, having only received the order 12 days afterwards. He quoted from Art. 182 of the Gen. Ord. of July, 1847, which lays down that a district medical officer shall be entitled to a fee of R2in any ’’ special case where great difficulty may have occurred in the delivery, or long 8itbseq?zent attendance in ,respect of some puerperal malady, or affection, may have been reyacisate." There was some difference of opinion on this point. It was thought by some that in order to be entitled to this fee the medical officer must have been called to the confinement or very shortly afterwards. But a majority of the council thought that under the article any long-continued attendance on a puerperal case was sufficient, and the honorary secretary was instructed to write and advise the member to push his claim and proffer the assistanceof the association. A delegate from the district medical officers of a metropolitan borough also attended the council meeting to ask for assistance. He stated that the guardians, owing to a recent resignation of one of the district medical officers, were endeavouring to reduce the number of district medical officers from five to four and to force on to two of their number the vacated district under The district medical officers very inequitable conditions. claimed that there should be a re-arrangement of the whole area. That under the present arrangement only one of their number received about the average payment of the district medical officers throughout the metropolitan district-viz., 3s. per order. That all the others were being paid less than 2s. per order. They had sent in a memorial to their board of guardians, and if this were ignored they proposed to carry it to the Local Government Board. The council expressed its. sympathy and promised all the assistance in its power. The honorary secretary read a letter from Mr. Shirley Fussell asking the association to appoint four delegates to meet delegates from the National Poor Law Officers’ Association, the Union and Rural District Clerks’ Association, and the Workhouse Masters’ and Matrons’ Association in a joint conference to consider the recommendations of the Royal Commission on the Poor-laws affecting the interests of Poorlaw officers, and report as to what action (if any) it is necessary or desirable to take now, or in the future, to safeguard the interests of the service. The council appointed Mr. W. Holder (Hull), Mr. A. A. Napper (Cranleigh), Dr. F. S. Toogood (London), and Dr. Major Greenwood (London) to represent the Poor-law Medical Officers’ Association in the proposed conference.
CONTINENTAL ANGLO-AMERICAN MEDICAL SOCIETY. -The annual meeting of this society was held at 81, Boulevard Malesherbes, Paris, on Oct. 15th. The annual dinner was held in the evening at the Carlton Hotel, Paris. The chair was occupied by Sir Frederick Treves, who warmly congratulated the society on its excellent work, laying stress on its usefulness in uniting and in bringing to the notice of the profession at home responsible men to whom patients travelling abroad could be safely entrusted. This very successful gathering was brought to a close by two happy speeches from Professor Tuffier of Paris and Dr. Alexander Lambert of New York, who assuTei the members of the regard of their colleagues in France and in America.