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INQUIRIES ABOUT HOSPITAL PATIENTS
783 no effect, and he appeared to be a lost After reading Cook and Ogden’s article, we decided to try cardiazol after the method of Meduna, the patient’s heart, blood-pressure, and urine showing no contra-indication. After the first convulsion the patient, who formerly disturbed everybody with his stereotyped delusions, became quiet; after five convulsions he began to clear up ; and now, after twelve convulsions, he is absolutely clear, smiles, shaves himself, takes interest in his dress, and has resumed his former activities.
tried with case.
It appears therefore that cardiazol offers a cure for involutional melancholia even in a patient at such an age and after so many years of illness. This thera. peutic effect further emphasises the fact that the border between the depressions and involutional melancholia is not distinct.
We are, Sir,
yours
faithfully, HANS HOFF,
Royal Hospital, Baghdad, Feb. 28.
J. A. SHABY.
COLOUR OF VENOUS BLOOD IN RHEUMATISM ago when carrying out the sedimentation-rate test on venous blood by ordinary Westergren’s method, I noticed that in almost all severe cases of rheumatoid arthritis the blood was a curious pale red colour, very like Chinese lacquer. The colour is seen most easily in bright sunlight or electric light. At first I attributed this colour to the fact that arthritic patients cannot take much exercise, but against this I found that it was also seen in early cases of arthritis and in young athletic people who had suddenly developed rheumatism and who had been taking active exercise up to the time of the blood test. Again, the red colour is present in hunting men who have been seized with lumbago and in early and chronic osteo-arthritis. If the blood is kept in a Westergren’s tube for 24 hours it slowly turns to a dark mahogany colour which is normal for healthy venous blood. I should be interested to know if any others have observed this almost constant
SiR,-Some years
phenomenon. I am,
Sir, yours faithfully, VERNON HETHERINGTON.
Weymouth Street, W.1, March 17.
SALE OF PATENT MEDICINES
SiR,-A fortnight ago there was broadcast in the National programme a discussion on "patent " medicine. The impression I had when listening was that one of the trio who engaged in it said that poor people had a perfect right to do what they liked with their money. I find on reading the report in the Listener that I was not wrongly impressed. Before pursuing this point let me quote something else the same speaker said : "between the manufacturer and the public there is always the chemist. Practically the whole of this trade passes through the chemist’s hands a highly trained man with great of the knowledge goods that he sells, and the strongest sense of the dignity and importance of his job." Now, first, I dispute the right of a manufacturer to persuade the poor to spend money on medicines which would be better spent on bread ; second, as a chemist, I resent the compliment that I have a great knowledge " of the goods which the secret-medicine manufacturer makes. I have not the slightest knowledge on the subject and I regard it as an impertinence that the " knowledge of the chemist" should be utilised to bolster up a traffic which offends practically the whole of the craft. But there is another ...
"
point. There are in this country some 15,000 chemists’ shops; there are also 135,000 shops whose owners are licensed to sell " patent " medicine by virtue of the payment of a yearly fee of 5s., and I am told on the best authority that the fees for the licences of a very large number of these shopkeepers are paid by manufacturers of patent medicines. Digressing for a moment, may I add that the fees are sometimes paid, through the shopkeepers, in kind and not in cash ; that is to say, five-shillings-worth of goods are given free to the shopkeeper, who instead of paying the five shillings to the supplier, pays five shillings for the licence. Question : Does the generosity of the manufacturer cost him in some cases more than nvepence ? If my old friend the late Colonel E. F. Harrison was right it often costs less "
"
than that. How can the statement that " practically the whole of this trade passes through the chemist’s hands " be reconciled with the fact that of the 150,000 people who sell " patent " medicines only 15,000 are chemists*? It is common knowledge that most of the holders of patent-medicine licences are owners of little shops patronised by the very poor. I am, Sir, yours faithfully, F. C. GOODALL. Whiteball Place, S.W.I. MI1,J’cb 24.
INQUIRIES ABOUT HOSPITAL PATIENTS SiR,—II was interested to read Dr. Lockhart’s letter
about
hospital patients by their difficulty occurs in this locality. As a rule the staff of the local hospital are most courteous in replying to questions, both from relatives and from doctors ; but I have had many complaints that relatives, and doctors, on telephoning to inquire, have had appalling delay in establishing contact with on
inquiries
relatives, for the
same
the person concerned. When one realises that most calls by relatives are from a call-box, possibly from a distance, where " three minutes " is the extent of the call, and that the ordinary working man cannot afford to repeat his three minutes up to fifteen minutes, at 6d. a call, one feels that the first essential in good staff management of a general hospital is a thoroughly efficient porters’ and house-telephone service. I do not want to bring on my head the wrath of our otherwise excellent hospital telephonists, else my time spent waiting with my ear to the receiver would extend to infinity ! Therefore I sign myself Bath, March 2 7.
Yours faithfully, " THREE MINUTES PLEASE."
ROYAL SUSSEX COUNTY
HOSPITAL, BRIGHTON.-
March 15 Dr. Donald Hall, chairman of the governors of this hospital, protested against the heavy burden laid on hospitals by the rates. Dr. Hall said : " As we extend our services to the public, so in proportion are we penalised by the municipal authorities." He was referring to the new Latilla department for the treatment of the deformed, the crippled, and the injured which has resulted in an increase of £ l58 per annum in the rates payable by the hospital. Dr. Hall welcomed the statement that had recently been made by the Mayor of Hove that the time had come for closer cooperation between the voluntary hospitals of the twin towns, and he reminded his hearers that another step towards this cooperation was likely to be taken soon. He said he felt sure they would succeed, and that eventually all would come together in one corporate body. Once that was done it would be the aim of the governors to go further and to see the voluntary and public hospitals working hand in hand.
Speaking
at
a
meeting
on
tried with case.
It appears therefore that cardiazol offers a cure for involutional melancholia even in a patient at such an age and after so many years of illness. This thera. peutic effect further emphasises the fact that the border between the depressions and involutional melancholia is not distinct.
We are, Sir,
yours
faithfully, HANS HOFF,
Royal Hospital, Baghdad, Feb. 28.
J. A. SHABY.
COLOUR OF VENOUS BLOOD IN RHEUMATISM ago when carrying out the sedimentation-rate test on venous blood by ordinary Westergren’s method, I noticed that in almost all severe cases of rheumatoid arthritis the blood was a curious pale red colour, very like Chinese lacquer. The colour is seen most easily in bright sunlight or electric light. At first I attributed this colour to the fact that arthritic patients cannot take much exercise, but against this I found that it was also seen in early cases of arthritis and in young athletic people who had suddenly developed rheumatism and who had been taking active exercise up to the time of the blood test. Again, the red colour is present in hunting men who have been seized with lumbago and in early and chronic osteo-arthritis. If the blood is kept in a Westergren’s tube for 24 hours it slowly turns to a dark mahogany colour which is normal for healthy venous blood. I should be interested to know if any others have observed this almost constant
SiR,-Some years
phenomenon. I am,
Sir, yours faithfully, VERNON HETHERINGTON.
Weymouth Street, W.1, March 17.
SALE OF PATENT MEDICINES
SiR,-A fortnight ago there was broadcast in the National programme a discussion on "patent " medicine. The impression I had when listening was that one of the trio who engaged in it said that poor people had a perfect right to do what they liked with their money. I find on reading the report in the Listener that I was not wrongly impressed. Before pursuing this point let me quote something else the same speaker said : "between the manufacturer and the public there is always the chemist. Practically the whole of this trade passes through the chemist’s hands a highly trained man with great of the knowledge goods that he sells, and the strongest sense of the dignity and importance of his job." Now, first, I dispute the right of a manufacturer to persuade the poor to spend money on medicines which would be better spent on bread ; second, as a chemist, I resent the compliment that I have a great knowledge " of the goods which the secret-medicine manufacturer makes. I have not the slightest knowledge on the subject and I regard it as an impertinence that the " knowledge of the chemist" should be utilised to bolster up a traffic which offends practically the whole of the craft. But there is another ...
"
point. There are in this country some 15,000 chemists’ shops; there are also 135,000 shops whose owners are licensed to sell " patent " medicine by virtue of the payment of a yearly fee of 5s., and I am told on the best authority that the fees for the licences of a very large number of these shopkeepers are paid by manufacturers of patent medicines. Digressing for a moment, may I add that the fees are sometimes paid, through the shopkeepers, in kind and not in cash ; that is to say, five-shillings-worth of goods are given free to the shopkeeper, who instead of paying the five shillings to the supplier, pays five shillings for the licence. Question : Does the generosity of the manufacturer cost him in some cases more than nvepence ? If my old friend the late Colonel E. F. Harrison was right it often costs less "
"
than that. How can the statement that " practically the whole of this trade passes through the chemist’s hands " be reconciled with the fact that of the 150,000 people who sell " patent " medicines only 15,000 are chemists*? It is common knowledge that most of the holders of patent-medicine licences are owners of little shops patronised by the very poor. I am, Sir, yours faithfully, F. C. GOODALL. Whiteball Place, S.W.I. MI1,J’cb 24.
INQUIRIES ABOUT HOSPITAL PATIENTS SiR,—II was interested to read Dr. Lockhart’s letter
about
hospital patients by their difficulty occurs in this locality. As a rule the staff of the local hospital are most courteous in replying to questions, both from relatives and from doctors ; but I have had many complaints that relatives, and doctors, on telephoning to inquire, have had appalling delay in establishing contact with on
inquiries
relatives, for the
same
the person concerned. When one realises that most calls by relatives are from a call-box, possibly from a distance, where " three minutes " is the extent of the call, and that the ordinary working man cannot afford to repeat his three minutes up to fifteen minutes, at 6d. a call, one feels that the first essential in good staff management of a general hospital is a thoroughly efficient porters’ and house-telephone service. I do not want to bring on my head the wrath of our otherwise excellent hospital telephonists, else my time spent waiting with my ear to the receiver would extend to infinity ! Therefore I sign myself Bath, March 2 7.
Yours faithfully, " THREE MINUTES PLEASE."
ROYAL SUSSEX COUNTY
HOSPITAL, BRIGHTON.-
March 15 Dr. Donald Hall, chairman of the governors of this hospital, protested against the heavy burden laid on hospitals by the rates. Dr. Hall said : " As we extend our services to the public, so in proportion are we penalised by the municipal authorities." He was referring to the new Latilla department for the treatment of the deformed, the crippled, and the injured which has resulted in an increase of £ l58 per annum in the rates payable by the hospital. Dr. Hall welcomed the statement that had recently been made by the Mayor of Hove that the time had come for closer cooperation between the voluntary hospitals of the twin towns, and he reminded his hearers that another step towards this cooperation was likely to be taken soon. He said he felt sure they would succeed, and that eventually all would come together in one corporate body. Once that was done it would be the aim of the governors to go further and to see the voluntary and public hospitals working hand in hand.
Speaking
at
a
meeting
on