OUR DUTY TO OUR PATIENTS.

697 ake the like precautions, whilst some check should be put. upon the sale of those patent medicines tluO, are known to tct. injuriously in this respect. Any chemist can make the equired addition to an ordinary label, or procure a supply ready printed from a wholesale firm. Whilst looking alter the rest of the body it is our duty not to damage so important an organ as a tooth. It matters not to us that some patients should refuse to carry out an instruction they may regard as irksome and valueless. Great stress is 1’requently laid on the functions of the rectum and the colon, but how much (liscomfort might be saved were due attention given to the care and cleanliness of the teeth and the proper mastication of food? Among the poor one frequently sees long nnsightly teeth thickly contecl with green, fonl-snxcllinl; matter and standing in irritated and receding gums. Their owners are troublecl with an unpleasant taste in the mouth—acidity, flatulence and other attendant evils. Many will not go to the trouble of procuring floss silk, excellent though it be, but they readily make use of a charred match to clear away WILLIAM STANWELL. some, at any rate, of the fermenting material between the Rochdale, Sept. tecth. Perhaps in ordinary practice it might be thought bad taste to supply patients with a few printed simple rules ; but amongst the poor and in unopposed practices it appears "A CASE OF FRACTURE OF THE HUMERUS to me that great good might result, and no liarm be done, FROM DIRECT MUSCULAR ACTION." by the distribution to one’s own patients of leaflets such as that now enclosed. Any required additions or alterations I To the Editors of THE LANCET. can easily be made to suit particular cases, and so long as SIRS,—The following case may be of interest to your no name is printed there seems but small possibility of readers as most uncommon if not unique. On July 22ncl encroaching on one’s neighbour’s practice. I was called to see a gentleman aged thirty, not extremely A large London hospital has kindly given permission for muscular, but well nourished and perfectly healthy in every the reprinting of their hints on the bringing up of babies. respect. He gave me the following history : Whilst trying to The rising generation is greatly damaged by being surfeited "throw the cricket ball,practising’ for some athletic sports, with boile(l bread, biscuits, tea &c.—"just what we have having made his throw he felt his arm suddenly give way— ourselves." A few simple, common-sense rules would help to the ball went about seventy yards-and he heard a report improve the health of those destined for a life of toil for which everyone else in the field hearcl distinctly also. Ile which under present circumstances they are unfitted, and tried to raise his arm and could not. On examination 1 found because, ere the strnggle has begun, their constitution partly a transverse fracture of the right humerus situated at the junchas been impaired. Could vou, Sirs, or one of your tion of the middle and lower thirds. I set it in the usual readers, mention directions for the any similar leaflet manner, took it down on Aug. 19th, and he is now ableto care of those recently confined, I feel sure that many pracresume his occupation. I am, Sirs. yours truly, titioners would be too glacl to procure a supply for Sept. Mth, 1892. J. W. HARRIS, L.R.C.P. LOND., M.R.C.S. distribution, under suitable circumstances, to their patients, and thus many of the evils now looked upon as usual after confinement would be obviated. It frequently happens that a woman, from shortsightedness, gets up prematurely MIDWIVES’ REGISTRATION BILL. from her bed to undertake duties for which she is utterly To the Editors of THE LANCET. unfit, thus rendering herself temporarily or perhaps SIRS,—As one who has read with much interest your account manent y incapacitated for her duties as a mother. The of the proceedings of the Select Committee in the matter of the leaflets cost about 9s. per thousand, so that the expenditure Midwives’ Registration Bill, I believe I am not alone in taking of a single penny might place many families in a position exception to the evidence as given by Dr. James Edmunds of far greater comfort and perhaps of even helping to nation. regarding the high mortality among lying-in, patients attended improve the vital statistics of Tthe am Sirs vrtnrs trnlv as with midwives. To compared by general practitioners SPES. 1892. me it seems he gives the reason for this in his evidence Reading, Sept. 7th, when he says. "If any intercurrent illness occurred she would " turn the patient over to a medical man.’’ Dr. Hugh Woods he cases the answer to this when said usually passed gave LIVERPOOL. into the hands of doctors when death became imminent, and OWN CORRESPONDENT.) OUR (FROM I have long been under the so went to their credit." impression that to get at the true state of affairs some sort of legalised form of death certificate should be in use, The Licensing Sessions. so as to show to the registrar whether a duly qualified person THE annual Licensing Sessions for the city of Liverpool attended during the confinement or not. May I ask, would have just concluded, the result being that there will shortly be it be right for the doctor into whose hands these cases nineteen fewer houses licensed for the sale of intoxicants than now pass to state in the certificate : (a) Parturition ; attended last year, and forty-five less than the year before. It is possible I am, Sirs, yours truly, by a midwife ; (b)? that this number may be slightly lessened on appeal. The JAS. T. T. RAMSAY, L.R.C.P.Edin. &c. magistrates have shown a firm determination to suppress any Blackburn, Sept. loth, 1892. houses which are the resort of prostitutes or the scene of repeatedly disorderly conduct. They have also insisted upon the internal structural arrangements being such as to afford OUR DUTY TO OUR PATIENTS. perfect facilities for the supervision of the police, and that the person named in the licence shall personally conduct the To the Editors of THE LANCET. business and be responsible for whatever occurs on the I notice SIRS,—On p. 374 of THE LANCET of Aug 13th There is every reason to believe that these " an article headed "The Hygiene of the Teeth." Doctors premises. measures will lead to a reduction of intemperance and of are often some of the worst sinners against their patients’ health; for how frequently does one meet with a case the other evils to which it gives rise. of dyspepsia or neuralgia arising from faulty teeth, the City Morals, latter attributed, and in many cases not without good cause, other resolutions brought before the citv council at Among to having taken a large quantity of medicine in some previous its last monthly meeting was one from the Watch Committee illness? Those who are under the unpleasant necessity of proposing that Parliamentary powers should be sought to enable dispensing their own medicines can at least use labels with the police to enter any house suspected to be a brothel and to directions that the mixture is to be taken through a tube or arrest any person of either sex found there. The recent quill. Hospitals might do the same, all practitioners might action of the Watch Committee has led to the prosecution

very offensive evacuations at frequent intervals following jie eating of food, which her husband said at the timewas mfitforuse, was relieved in twelve hours, and entirely rcnoved in two days. Another case with mot ions uf a distinctly ,yphoid fever character, but with no spots, in which I was vatching the temperature, ended in the same favourable way. Children of three or four months old take without any inconenience five grains of the salt every four or five hours ; adults ip to thirty grains every two or three hours. While discussing the therapeutic possibilities of iron, the following, though not entirely connected with its use in the treatment of diarrhoea, The combination of the tincture of seems worthy of note. the perchloride of iron with the solution ’of muriate of morphia yields a green solution, I imagine, with the formaBe this aon of apomorphine or some similar derivative. vhat it may, I have seen from the combination more distinct and rapid relief to the cough and diarrhoea of phthisis than from the administration of the drugs separately. I am, Sirs, yours faithfully,

12th, 1892.

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