- Email: [email protected]
OPHTHALMIC QUACKERY.
497 has done useful work in collecting and publishing the of internists, pa’diatrists, and surgeons. Many remedies for tuberculosis possess the negative virtue of harmlessness, but even this faint praise is ,denied Friedmann’s vaccine, which has been credited with decided aggravation of symptoms in certain .cases. According to Prof. B. Heymann and Dr. M. Koike,1 two similar preparations have been put on the market in Germany; one is " Dr. Piorkowski’s " Chelonin," the other Dr. Baum’s K.T.B. Vaccine." i Both profess to contain turtle tubercle bacilli, and both enjoy a considerable vogue. Imitation being the sincerest form of flattery, Friedmann’s denunciation of these preparations as plagiarisms of his own seems ungrateful. Heymann and Koike have examined numerous samples of all three preparations, and their report on all of them is unflattering. One of Friedmann’s ampoules contained cocci, the proportion of living to dead germs was very variable, and the total number of germs also varied greatly. Four of 24 of Baum’s ampoules contained cocci and Gram-negative " Chelonin " ampoules only three rods, and of 22 contained living turtle bacilli. It did not mend matters that one of the ampoules containing no living turtle bacilli proved to be contaminated with live cocci .and spore-forming rods. The reaction which has set in against Friedmann’s vaccine is evidenced by a notice,2 according to which the 800,000 marks allocated by the Ministry for Science, Art, and Education in its budget for 1921 to the investigation of this vaccine has been diverted to the study of tuberculosis in general. It is hardly necessary to advert to the methods of publicity which have done so much to discredit Friedmann’s remedy with the bulk of the medical profession in Germany, except to discourage similar adventures elsewhere.
experiences
____
OPHTHALMIC QUACKERY. IN his presidential address at the opening of the last session of the Bristol Medico-Chirurgical Society Mr. Cyril Walker made some interesting remarks on this subject, which appear substantially in the Bristol 34edico-Chirurgical Journal. For centuries those afflicted with eye disease have been peculiarly In England liable to fall into the hands of quacks. in the Middle Ages, as in India to-day, couching for cataract was commonly carried out by itinerant quacks. The immediate result was often strikingly good, but ultimately the last state of the eye was ’, almost always worse than the first. In the eighteenth century the Chevalier Taylor, a qualified surgeon and oculist to many kings, practised as an itinerant quack on a large scale ; he travelled about from town to town in great state and inviting the gentry to witness his cures. In recent times quack sellers of eye-drops have continued to do a flourishing trade. It is not quite easy. said Mr. Walker, to define quackery, for it includes dishonest practice by qualified men no less than a pretension to skill which they do not possess the part of the unqualified. Indeed, qualification on is no guarantee of skill unless we know the nature of the qualification. The best definition of quackery would appear to be dishonesty in practice, a definition which might apply to qualified men who in their dealings with patients put the interests of their own pockets before those of their patients; and also to those who, whether qualified or not, undertake tasks for which they know they have not the requisite training or skill. As Mr. Walker remarks, a good deal of quackery, both in England and America, is associated with the prescribing of spectacles by opticians. Glaring instances in which purchasers have been fleeced often come to the notice of ophthalmic surgeons, who are subsequently called upon to revise the optician’s prescription. And yet, as Mr. Walker says, most opticians are competent and honest, and on the whole the public have benefited by the improved knowledge of those of them who have passed the examinations set by the Spectacle Makers’ Company "
2
"
1 Zeitschr. f. Tuberk., 1921, xxxv., 161. Deutsche medizinische Wochenschrift, Jan. 19th.
and other bodies. Whether or not these examinations ought to include sight-testing is a moot point on which the opticians, represented by their journal, The Optician, take up a definite position and the bulk of surgeons another, diametrically opposed A committee of the Council of British Ophthalmologists is considering the subject and we await its
ophthalmic to it.
report with interest. Meantime there are two points on which the public should be informed. One is that the optician cannot be so well equipped for the prescription of glasses in children and in difficult cases of adults as the ophthalmic surgeon, as the former is precluded from the use of mydriatics. Secondly, a certain proportion of those with defective sight owe their disabilities to disease, either of the eye or the general system, and with these the optician is
necessarily incapable
of
dealing.
MEDICAL INSPECTION OF SCHOOL-CHILDREN. SOME arresting figures are contained in a report just issued by the Education Committee of the L.C.C. on the extent to which medical inspection of schoolchildren is carried out under the- L.C.C. system. During the year 1921 no less than 294,552 children were examined in detail at elementary schools, when 113,732, or 38-6 per cent., were noted as requiring treatment for one or more defects. Teeth, vision, and nose and throat complaints accounted for most of these cases. In addition to elementary school examinations, 2255 children were examined at special schools, of whom 40-6 per cent. were found to need treatment for defects other than the disability which rendered attendance at a special school necessary, 73,470 children were seen during the year as urgent cases, and 26,425 of these were found to require treatment. The figures under the head of "
re-inspection"
are
possibly
even more
illuminating
to the effect on the health of the community of the Council’s activities. During 1921, 175,096 cases came up for review. At the first re-inspection there were 112,776 cases, of which 45-2 per cent. were recorded by the school doctors as discharged. At the second re-inspection 62,320 cases were examined, and of these, 60-3 per cent., or 32 per cent. of the original number, were reported as having received treatment, or being no longer in need of it. Combining the results of the first and second re-inspections, 77-2 per cent. of the children had been dealt with. The results of the year 1921 are the best since the Council undertook the inspection and treatment of children. Out of every 100 cases reported to have received treatment. 73 obtained it under the Council’s scheme ; the remaining 27 went to private practitioners or dentists, or to hospitals not under the scheme. as
WE
regret to
announce
the
death from heart
following influenza of Dr. Benjamin Moore, recently Whitley professor of biochemistry in the University of Oxford, and for the period of the war failure
active and fertile member of the medical research staff under the National Health Insurance scheme. an
THE report of the proceedings of the conference, convened on Jan. 19th and 20th under Sir Frederick Willis, to consider in what directions lunacy administration and the treatment of persons suffering from mental disease may be improved, is now obtainable from H.M. Stationery Office for 2s. 6d.
CENTRAL MIDWIVES BOARD.-At the examinations February last the number of candidates examined was 669, of whom 526 passed, the percentage of failures being 21-4. WEST KENT MEDICO-CHIRURGICAL SOCIETY.-A meeting will be held in the Board Room of the Miller General Hospital, Greenwich, to-day, Friday, March 10th, at 8.45 P.M. The President, Dr. C. T. T. Comber, O.B.E., will occupy the chair. Mr. Ernest B. Dowsett, L.D.S., will give a lecture on Pyorrhoea Alveolaris, illustrated by lantern slides. held in
experiences
____
OPHTHALMIC QUACKERY. IN his presidential address at the opening of the last session of the Bristol Medico-Chirurgical Society Mr. Cyril Walker made some interesting remarks on this subject, which appear substantially in the Bristol 34edico-Chirurgical Journal. For centuries those afflicted with eye disease have been peculiarly In England liable to fall into the hands of quacks. in the Middle Ages, as in India to-day, couching for cataract was commonly carried out by itinerant quacks. The immediate result was often strikingly good, but ultimately the last state of the eye was ’, almost always worse than the first. In the eighteenth century the Chevalier Taylor, a qualified surgeon and oculist to many kings, practised as an itinerant quack on a large scale ; he travelled about from town to town in great state and inviting the gentry to witness his cures. In recent times quack sellers of eye-drops have continued to do a flourishing trade. It is not quite easy. said Mr. Walker, to define quackery, for it includes dishonest practice by qualified men no less than a pretension to skill which they do not possess the part of the unqualified. Indeed, qualification on is no guarantee of skill unless we know the nature of the qualification. The best definition of quackery would appear to be dishonesty in practice, a definition which might apply to qualified men who in their dealings with patients put the interests of their own pockets before those of their patients; and also to those who, whether qualified or not, undertake tasks for which they know they have not the requisite training or skill. As Mr. Walker remarks, a good deal of quackery, both in England and America, is associated with the prescribing of spectacles by opticians. Glaring instances in which purchasers have been fleeced often come to the notice of ophthalmic surgeons, who are subsequently called upon to revise the optician’s prescription. And yet, as Mr. Walker says, most opticians are competent and honest, and on the whole the public have benefited by the improved knowledge of those of them who have passed the examinations set by the Spectacle Makers’ Company "
2
"
1 Zeitschr. f. Tuberk., 1921, xxxv., 161. Deutsche medizinische Wochenschrift, Jan. 19th.
and other bodies. Whether or not these examinations ought to include sight-testing is a moot point on which the opticians, represented by their journal, The Optician, take up a definite position and the bulk of surgeons another, diametrically opposed A committee of the Council of British Ophthalmologists is considering the subject and we await its
ophthalmic to it.
report with interest. Meantime there are two points on which the public should be informed. One is that the optician cannot be so well equipped for the prescription of glasses in children and in difficult cases of adults as the ophthalmic surgeon, as the former is precluded from the use of mydriatics. Secondly, a certain proportion of those with defective sight owe their disabilities to disease, either of the eye or the general system, and with these the optician is
necessarily incapable
of
dealing.
MEDICAL INSPECTION OF SCHOOL-CHILDREN. SOME arresting figures are contained in a report just issued by the Education Committee of the L.C.C. on the extent to which medical inspection of schoolchildren is carried out under the- L.C.C. system. During the year 1921 no less than 294,552 children were examined in detail at elementary schools, when 113,732, or 38-6 per cent., were noted as requiring treatment for one or more defects. Teeth, vision, and nose and throat complaints accounted for most of these cases. In addition to elementary school examinations, 2255 children were examined at special schools, of whom 40-6 per cent. were found to need treatment for defects other than the disability which rendered attendance at a special school necessary, 73,470 children were seen during the year as urgent cases, and 26,425 of these were found to require treatment. The figures under the head of "
re-inspection"
are
possibly
even more
illuminating
to the effect on the health of the community of the Council’s activities. During 1921, 175,096 cases came up for review. At the first re-inspection there were 112,776 cases, of which 45-2 per cent. were recorded by the school doctors as discharged. At the second re-inspection 62,320 cases were examined, and of these, 60-3 per cent., or 32 per cent. of the original number, were reported as having received treatment, or being no longer in need of it. Combining the results of the first and second re-inspections, 77-2 per cent. of the children had been dealt with. The results of the year 1921 are the best since the Council undertook the inspection and treatment of children. Out of every 100 cases reported to have received treatment. 73 obtained it under the Council’s scheme ; the remaining 27 went to private practitioners or dentists, or to hospitals not under the scheme. as
WE
regret to
announce
the
death from heart
following influenza of Dr. Benjamin Moore, recently Whitley professor of biochemistry in the University of Oxford, and for the period of the war failure
active and fertile member of the medical research staff under the National Health Insurance scheme. an
THE report of the proceedings of the conference, convened on Jan. 19th and 20th under Sir Frederick Willis, to consider in what directions lunacy administration and the treatment of persons suffering from mental disease may be improved, is now obtainable from H.M. Stationery Office for 2s. 6d.
CENTRAL MIDWIVES BOARD.-At the examinations February last the number of candidates examined was 669, of whom 526 passed, the percentage of failures being 21-4. WEST KENT MEDICO-CHIRURGICAL SOCIETY.-A meeting will be held in the Board Room of the Miller General Hospital, Greenwich, to-day, Friday, March 10th, at 8.45 P.M. The President, Dr. C. T. T. Comber, O.B.E., will occupy the chair. Mr. Ernest B. Dowsett, L.D.S., will give a lecture on Pyorrhoea Alveolaris, illustrated by lantern slides. held in