- Email: [email protected]
IRELAND.
1208
BERLIN.—IRELAND.
tendency to habitual luxation of the shoulder are often hereditary. Dr. Maus (Berlin) referred to the familiar occurrence of club-foot. It is not yet ascertained, he said, why this condition is more frequent in males than females. Dr. Brandes spoke on retarded consolidation after osteotomy, which had occurred in 6 per cent. of his 4485 operations, and in his view had local causes. Dr. Simon (Frankfort) said that this retarded consolidation is fairly common in women between the ages of 18 and 25, and is caused Dr. by reduced vitality of the sclerotic bone. Königswieder (Vienna) agreed with this statement, and advised his hearers to abstain as far as possible from cosmetic operations at that age. He believed that endocrine troubles were responsible for the retardation.
Prosecution for Injury by Neglect. Some time ago a medical man and a nurse were found guilty of injury by neglect because the nurse had forgotten to apply the filter in using X rays for curative purposes, the result being a severe burn. The court considered that it was the doctor’s duty to ascertain whether the nurse had applied the filter ; he had, however, left the room after having adjusted the apparatus. On appeal the High Court in Leipzig has cancelled the verdict so far as the medical man is concerned. It regards the application of X rays as a merely technical procedure, including the use of a filter in every case, and holds that the medical man was justified in believing that it had been employed in this particular case as in any other. Administration of X rays may be likened to that of a poisonous drug ; it requires certain precautions, but is, as a rule, entrusted to trained nurses, no medical man being expected to supervise their administration personally if he has assured himself that the nurse is trustworthy. The case has, however, been referred back to the local court, because it had not been made clear whether the nurse was or was not sufficiently experienced to be left in charge by the doctor.
Dental Treatment in Russia. Prof. Dauge, of Moscow, in a paper recently read before the Society of Socialist Medical Men, explained that in Russia dentistry is regarded as a special branch of general medicine like other branches, and that the dentist is expected to be familiar with medical science as a whole. In Leningrad and other places there are stomatological clinics with large staffs where some 9000 dental surgeons have already Whereas in Leningrad therewere, been trained. five years ago, about 500 private dentists, there are Dental treatment is carried out at now only 50. 12 great dispensaries maintained by the State, where the working time of the medical man is only five hours
IRELAND.
(FROM
OUR OWN
CORRESPONDENT.)
- Deep X Ray Treatment in Dublin. improved apparatus for treatment by deep X rays has been installed at the Royal City of Dublin Hospital, and the treatment rooms were publicly opened by the Governor-General last month. AN
The treatment room contains a switch-table which the whole apparatus under the complete control of one operator. Projecting through the wall between the machine and treatment rooms are two large metal cylinders. Each cylinder, which can be raised or lowered by means of a motor mechanism, contains one X ray tube, thus enabling the simultaneous treatment of two patients, who are placed on couches either beneath or over the cylinders, according to the type of treatment being given. The cylinders, which weigh one ton each, are coated with lead a quarter of an inch thick, thus affording complete protection for the operator and enabling the doctor or sister to be in close touch with the patient, heretofore impossible owing to the grave risks run from stray radiation due to imperfectly protected apparatus. The facilities for treatment provided will be available for patients at other hospitals, and also for private patients on the recommendation of their own medical attendants.
places
University College Medical Society. The opening meeting of the University College Medical Society was held at Dublin on Nov. 18th, Dr. D. J. Coffey, President of the College of Physicians, in the chair. The President of the Society for the coming session is Prof. J. M. O’Connor, who delivered an address on the Physiology of Equilibration. He described, with the aid of the lantern, the investigations carried out by the late Prof. Magnus of Utrecht, and laid stress on the fact that in these important experiments no expensive apparatus had been required, but that the cooperation of several workers, including skilled surgeons, had been essential. An interesting discussion followed the address, the speakers being Prof. H. Pringle, Prof. E. P. McLaughlin, Dr. H. Quinlan, and Dr. E. P. Freeman.
The Approved Societies and Medical Benefit. The annual meeting of the Approved Societies Association of Ireland was held in Dublin last week. The annual report was concerned chiefly with the recent report of the Committee of Inquiry on National Health Insurance and the Medical Service. In the opinion of the Association the time has come for a reform of the Poor-law medical comprehensive daily. services. If this cannot be achieved they favour a scheme of medical benefit for insured persons and Insurance against Accidents. their dependents, with an increase if necessary in the statistical to a recent there were report According in 1925 837,695 industrial concerns whose employees weekly contribution, not exceeding 3d. a week, or if this is not feasible, a scheme of medical benefit for were insured against accidents, under the Workmen’s Insurance Act, to the number of 11 millions. There insured persons only, with an additional weekly conwere also 4,601,916 agricultural enterprises with tribution not exceeding 2d., the Association to be 14 millions of workers, and 880,194 employees of the consulted in the preparation of the scheme. The State and municipalities. The total number of report shows that there has been an abnormal increase insured persons was thus about 25 millions, being an in the benefit payments in 1926 and 1927 as compared increase of 1 million compared with the previous with 1925 ; societies were probably not referring their year. Compensation for the first time was secured doubtful cases to the National Health Insurance by 107,517 persons, of whom 53 per cent. were Commission for examination by the medical referee, industrial, 42-6 per cent. agricultural, and 4-4 per which was provided free of cost. The report also cent. employees in public works. The percentage of dealt with the inadequacy of the Sanatorium Benefit compensation payments for each 1000 accidents has Fund, and with the Departmental Committee’s recommuch increased compared with 1924. The rate per mendations on workmen’s compensation with regard 1000 was 5-2 (4-4) among industrial workers, 3-2 to the National Health Insurance Acts. Mr. J. D. Nugent, Secretary of the Ancient Order (2-6) among agricultural workers, and 5-4 (4-2) for State and municipal workers, the figures in parentheses of Hibernians Approved Society, said that the Interbeing those for 1924. The increase is partly due to national Labour Conference in Geneva last June had, legal extension of insurance to the time of transport in its recommendations, to a large extent adopted the to and from work. The accidents were fatal in 7-5 system of health insurance in operation in Great per cent. of cases, and 1-1 per cent. of them caused Britain. Ireland was hampered because she had not such a system. The Geneva report had recommended total incapacity for work.
UNITED STATES OF AMERICA.
1209
compulsory sickness insurance for
all manual and quite clear whether Dr. Dublin accepts the improved’ non-manual workers, and that all insured persons economic condition as a result exclusively of the should be entitled to free medical treatment. The prohibition amendment. From some remarks early scheme as it existed in Ireland did nothing to prevent in his paper, presented to an open forum at the annual or cure disease, but merely provided sickness benefit convention of the American Public Health Associafor members. Doctors were paid for issuing certificates tion, it would appear that he does not. entitling recipients to draw benefits, and the more In connexion with the present prohibition situation in the States attention is being focused on the they issued the greater their income. At the annual dinner held in the evening of the congressional election this month in the city of Denver same day Sir Joseph Glynn, chairman of the National (Colorado). The democratic candidate, Judge White, Health Insurance Commission, replying to the toast has openly declared for a modification of the Volstead of the Health Services, said that the number of insured Act; he is also pledged to a policy "restoring to doctors the right to prescribe liquor in such quantities persons in the Irish Free State was 450,000. for medicinal purposes as in their training and The Milk Commission. experience they find necessary." Judge White’s It is stated that the report of the Milk Commission candidature is strenuously opposed by the Antiappointed by the Government of the Irish Free State Saloon League, the W.C.T.U., and the great majorityin 1926 has been completed and presented to the of the ministers of the Denver churches. Government. It has not yet been published, but Control of Cancer. it is understood to contain, among other recommendations : (1) grading of milk, (2) production under For four years now the Wayne County Medicalhygienic conditions, (3) closer supervision of distribu- Society have carried on an annual campaign of tive agencies, (4) periodic inspection of dairy farms, education for the control of cancer by early diagnosis. (5) veterinary inspection of milch cows, (6) more Each year some 2300 citizens present themselves for stringent regulations regarding licensing of dairies examination during cancer week at the Detroit and distributing centres, and (7) heavier penalties for Hospital ; each year from 15 to 20 per cent. of those breach of regulations. examined are found to have cancer or some precancondition. The following short table of cerous cancer diagnosed in the last two years shows that the UNITED STATES OF AMERICA. amount of latent cancer in the community is apparently constant. fairly AN OCCASIONAL CORRESPONDENT.) (FROM
Prohibition and the Public Health. FROM an analysis of death-rates in the pre-prohibition era of 1900-17 and the prohibition and post-influenzal period of 1921-26, Dr. Louis I. Dublin, of the Metropolitan Life Insurance Company, has attempted to evaluate the broad effect of prohibition on the public health. Taking the death-rate for the whole population (U.S. death registration area) he finds that a downward trend in the first period has not been maintained in the second. " If we had only these It will be observed that the inaccessible growths are " figures," he says, the most favourable interpretation not often diagnosed. Dr. Harry C. Saltzstein, the we could give would be that the prohibition amendsecretary of the Cancer Committee, points out that in ment had come into effect at a time of low and 1925 and 1926 there were 761 recorded deaths from declining mortality, and that the new legislation had carcinoma of the stomach in Detroit; during this no appreciable effect in still further improving the period there were 28 gastric resections for cancer done in all the hospitals of the city, with 15 operative mortality of our people." A somewhat more favourable interpretation is made recoveries. More facilities for diagnosis and treatment possible by dissecting the death-rates according to of cancer are needed, the committee concludes, and. age, sex, and colour distribution. It is then shownmore " follow-up " work of the cases diagnosed. that as regards sex and colour there has been during New Medical Centre in New York. the prohibition period an improvement limited to white females. Among men over the age of 35 there A new medical centre will be formed by the amalga-has, on the other hand, been a definite rise inmation of New York Hospital and Cornell University mortality. Among children and adolescents the pro- in an institution to be called the New York Hospital hibition period coincides with a marked decline Cornell Medical College Association. The building. in mortality. " One might say," ventures Dr. Dublin, will be situated slightly to the north of the Rocke " that the facts are entirely consistent with anfeller Institute for Medical Research, and the cost isassumption that the conditions of life under thelikely to be 15,000,000 dollars (£3,000,000); towards prohibition regime have been favourable to thesethis sum the General Education Board has approgroups ; on the other hand, there is no evidence priated 7,500,000 dollars. There will be about 410. whatever of a favourable influence on adult men." public and 75 private beds, and a large out-patient Examining the death-rates further by causes of department, whose cost is estimated at 11,000,000 death Dr. Dublin finds that at children’s ages the dollars. A distinctive feature of the enterprise is the greatest improvement has occurred in three groups-proposal to relieve the heads of the principal clinicalaccidents, diarrhoeal diseases, and pneumonia. Among; departments from the toil of practice outside the the young women the decline noted above is largely7 institution ; they will be salaried officers giving their_ traceable to a decline in the tuberculosis death-rate.. whole time to patients, teaching and research. Dr. To these ends the campaigns of popular health Robinson, who has been made director of the associaeducation may have contributed, and a rising standardL -tion, is at present director of Vanderbilt University, of living must be held equally responsible. It is; where he organised the medical department in 1920. pretty generally agreed among social service workers; He is a graduate of Johns Hopkins University, and that in the prohibition years there has been a markedl was the first resident physician of the hospital of theimprovement in the economic condition of the poorer Rockefeller Institute for Medical Research. It is classes. " The economic gains," concludes Dr. Dublin,, interesting to recall that New York Hospital is the " help us to understand the condition among women second oldest in the United States, having received and children. The character of the present supply of its charter in 1771. Cornell University Medical liquor helps us to understand the lack of improvement College was established in 1898, and has been affiliated which appears in the mortality of men." It is notwith the hospital since 1912. ,
BERLIN.—IRELAND.
tendency to habitual luxation of the shoulder are often hereditary. Dr. Maus (Berlin) referred to the familiar occurrence of club-foot. It is not yet ascertained, he said, why this condition is more frequent in males than females. Dr. Brandes spoke on retarded consolidation after osteotomy, which had occurred in 6 per cent. of his 4485 operations, and in his view had local causes. Dr. Simon (Frankfort) said that this retarded consolidation is fairly common in women between the ages of 18 and 25, and is caused Dr. by reduced vitality of the sclerotic bone. Königswieder (Vienna) agreed with this statement, and advised his hearers to abstain as far as possible from cosmetic operations at that age. He believed that endocrine troubles were responsible for the retardation.
Prosecution for Injury by Neglect. Some time ago a medical man and a nurse were found guilty of injury by neglect because the nurse had forgotten to apply the filter in using X rays for curative purposes, the result being a severe burn. The court considered that it was the doctor’s duty to ascertain whether the nurse had applied the filter ; he had, however, left the room after having adjusted the apparatus. On appeal the High Court in Leipzig has cancelled the verdict so far as the medical man is concerned. It regards the application of X rays as a merely technical procedure, including the use of a filter in every case, and holds that the medical man was justified in believing that it had been employed in this particular case as in any other. Administration of X rays may be likened to that of a poisonous drug ; it requires certain precautions, but is, as a rule, entrusted to trained nurses, no medical man being expected to supervise their administration personally if he has assured himself that the nurse is trustworthy. The case has, however, been referred back to the local court, because it had not been made clear whether the nurse was or was not sufficiently experienced to be left in charge by the doctor.
Dental Treatment in Russia. Prof. Dauge, of Moscow, in a paper recently read before the Society of Socialist Medical Men, explained that in Russia dentistry is regarded as a special branch of general medicine like other branches, and that the dentist is expected to be familiar with medical science as a whole. In Leningrad and other places there are stomatological clinics with large staffs where some 9000 dental surgeons have already Whereas in Leningrad therewere, been trained. five years ago, about 500 private dentists, there are Dental treatment is carried out at now only 50. 12 great dispensaries maintained by the State, where the working time of the medical man is only five hours
IRELAND.
(FROM
OUR OWN
CORRESPONDENT.)
- Deep X Ray Treatment in Dublin. improved apparatus for treatment by deep X rays has been installed at the Royal City of Dublin Hospital, and the treatment rooms were publicly opened by the Governor-General last month. AN
The treatment room contains a switch-table which the whole apparatus under the complete control of one operator. Projecting through the wall between the machine and treatment rooms are two large metal cylinders. Each cylinder, which can be raised or lowered by means of a motor mechanism, contains one X ray tube, thus enabling the simultaneous treatment of two patients, who are placed on couches either beneath or over the cylinders, according to the type of treatment being given. The cylinders, which weigh one ton each, are coated with lead a quarter of an inch thick, thus affording complete protection for the operator and enabling the doctor or sister to be in close touch with the patient, heretofore impossible owing to the grave risks run from stray radiation due to imperfectly protected apparatus. The facilities for treatment provided will be available for patients at other hospitals, and also for private patients on the recommendation of their own medical attendants.
places
University College Medical Society. The opening meeting of the University College Medical Society was held at Dublin on Nov. 18th, Dr. D. J. Coffey, President of the College of Physicians, in the chair. The President of the Society for the coming session is Prof. J. M. O’Connor, who delivered an address on the Physiology of Equilibration. He described, with the aid of the lantern, the investigations carried out by the late Prof. Magnus of Utrecht, and laid stress on the fact that in these important experiments no expensive apparatus had been required, but that the cooperation of several workers, including skilled surgeons, had been essential. An interesting discussion followed the address, the speakers being Prof. H. Pringle, Prof. E. P. McLaughlin, Dr. H. Quinlan, and Dr. E. P. Freeman.
The Approved Societies and Medical Benefit. The annual meeting of the Approved Societies Association of Ireland was held in Dublin last week. The annual report was concerned chiefly with the recent report of the Committee of Inquiry on National Health Insurance and the Medical Service. In the opinion of the Association the time has come for a reform of the Poor-law medical comprehensive daily. services. If this cannot be achieved they favour a scheme of medical benefit for insured persons and Insurance against Accidents. their dependents, with an increase if necessary in the statistical to a recent there were report According in 1925 837,695 industrial concerns whose employees weekly contribution, not exceeding 3d. a week, or if this is not feasible, a scheme of medical benefit for were insured against accidents, under the Workmen’s Insurance Act, to the number of 11 millions. There insured persons only, with an additional weekly conwere also 4,601,916 agricultural enterprises with tribution not exceeding 2d., the Association to be 14 millions of workers, and 880,194 employees of the consulted in the preparation of the scheme. The State and municipalities. The total number of report shows that there has been an abnormal increase insured persons was thus about 25 millions, being an in the benefit payments in 1926 and 1927 as compared increase of 1 million compared with the previous with 1925 ; societies were probably not referring their year. Compensation for the first time was secured doubtful cases to the National Health Insurance by 107,517 persons, of whom 53 per cent. were Commission for examination by the medical referee, industrial, 42-6 per cent. agricultural, and 4-4 per which was provided free of cost. The report also cent. employees in public works. The percentage of dealt with the inadequacy of the Sanatorium Benefit compensation payments for each 1000 accidents has Fund, and with the Departmental Committee’s recommuch increased compared with 1924. The rate per mendations on workmen’s compensation with regard 1000 was 5-2 (4-4) among industrial workers, 3-2 to the National Health Insurance Acts. Mr. J. D. Nugent, Secretary of the Ancient Order (2-6) among agricultural workers, and 5-4 (4-2) for State and municipal workers, the figures in parentheses of Hibernians Approved Society, said that the Interbeing those for 1924. The increase is partly due to national Labour Conference in Geneva last June had, legal extension of insurance to the time of transport in its recommendations, to a large extent adopted the to and from work. The accidents were fatal in 7-5 system of health insurance in operation in Great per cent. of cases, and 1-1 per cent. of them caused Britain. Ireland was hampered because she had not such a system. The Geneva report had recommended total incapacity for work.
UNITED STATES OF AMERICA.
1209
compulsory sickness insurance for
all manual and quite clear whether Dr. Dublin accepts the improved’ non-manual workers, and that all insured persons economic condition as a result exclusively of the should be entitled to free medical treatment. The prohibition amendment. From some remarks early scheme as it existed in Ireland did nothing to prevent in his paper, presented to an open forum at the annual or cure disease, but merely provided sickness benefit convention of the American Public Health Associafor members. Doctors were paid for issuing certificates tion, it would appear that he does not. entitling recipients to draw benefits, and the more In connexion with the present prohibition situation in the States attention is being focused on the they issued the greater their income. At the annual dinner held in the evening of the congressional election this month in the city of Denver same day Sir Joseph Glynn, chairman of the National (Colorado). The democratic candidate, Judge White, Health Insurance Commission, replying to the toast has openly declared for a modification of the Volstead of the Health Services, said that the number of insured Act; he is also pledged to a policy "restoring to doctors the right to prescribe liquor in such quantities persons in the Irish Free State was 450,000. for medicinal purposes as in their training and The Milk Commission. experience they find necessary." Judge White’s It is stated that the report of the Milk Commission candidature is strenuously opposed by the Antiappointed by the Government of the Irish Free State Saloon League, the W.C.T.U., and the great majorityin 1926 has been completed and presented to the of the ministers of the Denver churches. Government. It has not yet been published, but Control of Cancer. it is understood to contain, among other recommendations : (1) grading of milk, (2) production under For four years now the Wayne County Medicalhygienic conditions, (3) closer supervision of distribu- Society have carried on an annual campaign of tive agencies, (4) periodic inspection of dairy farms, education for the control of cancer by early diagnosis. (5) veterinary inspection of milch cows, (6) more Each year some 2300 citizens present themselves for stringent regulations regarding licensing of dairies examination during cancer week at the Detroit and distributing centres, and (7) heavier penalties for Hospital ; each year from 15 to 20 per cent. of those breach of regulations. examined are found to have cancer or some precancondition. The following short table of cerous cancer diagnosed in the last two years shows that the UNITED STATES OF AMERICA. amount of latent cancer in the community is apparently constant. fairly AN OCCASIONAL CORRESPONDENT.) (FROM
Prohibition and the Public Health. FROM an analysis of death-rates in the pre-prohibition era of 1900-17 and the prohibition and post-influenzal period of 1921-26, Dr. Louis I. Dublin, of the Metropolitan Life Insurance Company, has attempted to evaluate the broad effect of prohibition on the public health. Taking the death-rate for the whole population (U.S. death registration area) he finds that a downward trend in the first period has not been maintained in the second. " If we had only these It will be observed that the inaccessible growths are " figures," he says, the most favourable interpretation not often diagnosed. Dr. Harry C. Saltzstein, the we could give would be that the prohibition amendsecretary of the Cancer Committee, points out that in ment had come into effect at a time of low and 1925 and 1926 there were 761 recorded deaths from declining mortality, and that the new legislation had carcinoma of the stomach in Detroit; during this no appreciable effect in still further improving the period there were 28 gastric resections for cancer done in all the hospitals of the city, with 15 operative mortality of our people." A somewhat more favourable interpretation is made recoveries. More facilities for diagnosis and treatment possible by dissecting the death-rates according to of cancer are needed, the committee concludes, and. age, sex, and colour distribution. It is then shownmore " follow-up " work of the cases diagnosed. that as regards sex and colour there has been during New Medical Centre in New York. the prohibition period an improvement limited to white females. Among men over the age of 35 there A new medical centre will be formed by the amalga-has, on the other hand, been a definite rise inmation of New York Hospital and Cornell University mortality. Among children and adolescents the pro- in an institution to be called the New York Hospital hibition period coincides with a marked decline Cornell Medical College Association. The building. in mortality. " One might say," ventures Dr. Dublin, will be situated slightly to the north of the Rocke " that the facts are entirely consistent with anfeller Institute for Medical Research, and the cost isassumption that the conditions of life under thelikely to be 15,000,000 dollars (£3,000,000); towards prohibition regime have been favourable to thesethis sum the General Education Board has approgroups ; on the other hand, there is no evidence priated 7,500,000 dollars. There will be about 410. whatever of a favourable influence on adult men." public and 75 private beds, and a large out-patient Examining the death-rates further by causes of department, whose cost is estimated at 11,000,000 death Dr. Dublin finds that at children’s ages the dollars. A distinctive feature of the enterprise is the greatest improvement has occurred in three groups-proposal to relieve the heads of the principal clinicalaccidents, diarrhoeal diseases, and pneumonia. Among; departments from the toil of practice outside the the young women the decline noted above is largely7 institution ; they will be salaried officers giving their_ traceable to a decline in the tuberculosis death-rate.. whole time to patients, teaching and research. Dr. To these ends the campaigns of popular health Robinson, who has been made director of the associaeducation may have contributed, and a rising standardL -tion, is at present director of Vanderbilt University, of living must be held equally responsible. It is; where he organised the medical department in 1920. pretty generally agreed among social service workers; He is a graduate of Johns Hopkins University, and that in the prohibition years there has been a markedl was the first resident physician of the hospital of theimprovement in the economic condition of the poorer Rockefeller Institute for Medical Research. It is classes. " The economic gains," concludes Dr. Dublin,, interesting to recall that New York Hospital is the " help us to understand the condition among women second oldest in the United States, having received and children. The character of the present supply of its charter in 1771. Cornell University Medical liquor helps us to understand the lack of improvement College was established in 1898, and has been affiliated which appears in the mortality of men." It is notwith the hospital since 1912. ,