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OUT-PATIENT REFORM AT THE LONDON HOSPITAL.
957 modity this singular arrangement. A the discussion which followed Dr. Poore said that it was a common belief in the country that the spores of the disease parasites concludes the portion of the volume lived in the soil, which might therefore be the agent of inthis is and treated in to devoted general pathology, subject fection. He also spoke of some experiments he had made fuller detail than usual in a pathological text-book; but, in in England with a variety of Diosenrea, but had found that view of the growing proof of the ubiquity of parasitic theyield of this yam was very deficient. A member of the disease, this is not to be wondered at. Of course the audience asked whether excess of manure predisposed to the bacterial organisms are fully described, and with much disease. Sir Joseph Fayrer inquired whence and when the disease was imported, also whether there was more than lucidity. one of the potato. Mr. Murray, in reply, thought The rest of the volume deals in turn with the lesions of therescourge be some foundation for the belief that the soil might the various organs and systems of the body, and is decidedly acted as a source of infection. Manure had no influence on exhaustive. To discuss it adequately is hardly possible the disease. Most probably the disease originated from the here, but we may in general terms state that the descriptions home of the potato, but in 1845 it seemed to be clearly traced When he in its spread from Belgium to the Isle of Wight, thence to are for the most part clear and sufficient. England, Scotland, and Ireland. Another fungus (Fasiapproaches subjects which have afforded especial ground for sporium solani) had been described in connexion with the contention he speaks definitely and decidedly : as, for potato plant, but probably this was always a sequel to the example, when, in dealing with phthisis, he affirms his Phvtophthora infestanr. On Thursday next, December 6th, the evening lecture belief in the revived doctrine of Laennec as to its being will be given by Dr. Poore, who takes for his subject a local pulmonary tuberculosis, complicated with chronic " Coffee and Tea." Sir Henry Thompson will preside on the inflammatory changes ; or when, again, in treating of Bright’s occasion. The lecture commences at 8 r.M., and the public disease, he employs a division into glomerulo - nephritis, are admitted for a nominal charge of sixpence. parenchymatous and interstitial nephritis, the granular contracted kidney being the type of the latter. It should also be mentioned as a feature of the work that it OUT-PATIENT REFORM AT THE LONDON contains a fairly full account of diseases of the nervous HOSPITAL. system, preceded by an anatomical and physiological study of the nervous centres, which is almost essential ON many occasions the Committee of the London Hospital to the comprehension of the significance of the localised have attempted to reform the oat-p1tient department of this affections of the brain and spinal cord. Diseases of Hospital, but as Mr. Nixon, the House Governor, declares bones and joints, and of the skin and its appendages, in his report of the 30th ult., sent to us by the courtesy of form the concluding chapters of a work which we can the "all previous schemes have failed." At a authorities, heartily commend. It should be stated that in arrange- special general court held in Jane last the Governors determent, type, &c., it is admirable; and that the author mined to make one more attempt, and approved certain has not overloaded it with references to memoirs, nor added recommendations of the House Committee etre-ting changes a bibliography, doubtless on the principle that such addiin the out-patient system of this hospital which it has been tions are unnecessary in a student’s text-book. The illus- decided shall come into operation on and after the lst of trations are numerous, many being original, and many It 1884. is January, gratifying to find that several of thes; culled from Virchow’s work on Tumours and from other as will be seen, embody the reforms we urged the changes, In point of execution, however, the original Committee to sources. in adopt an article published in THE LANCET figures do not come up to those which are so marked a on April 21st, 1883. The scheme embraces the followirg feature of the text-book of Professor Ziegler. important changes :-1. The appointment of an inspector to investigate doubtful may think fit to
chapter
on
a view to elimination-first, of th03e found to "well to do" that they are unfit objects of medical charity ; and, secondly, of persons in receipt of parish relief, who are to unions, and should be treated at THE address delivered by Mr. George Murray at the Poor-law chargeable The intending ]J:1tients 1-n ing, in dispensaries. Parkes Museum last week was a decided success. After both cases, once treated by the bospitd btsdr’, anrl being alsu giving a lucid description of the anatomy of the potato plant in both cases freed from social inquiry altogether, if the the lecturer proceeded to delineate the structure of the medical or surgical oiticer on duty shall decide that they are ill as to render delay of treatment injurious, or so fungus (Phytophthora infestans) which is the cause of the thatseriously are, for professional reasons, singularly suited to they potato disease. The mode of growth and the methods of be hospital patients. reproduction were passed in review. With a view to the 2. The lessening of numbers under treatment-that is to prevention of the disease there was nothing to compare with say, practically, the eventual lessening of the daily crowd of the thorough burning of the refuse of diseased potato fields. out-patients, by the direct action of the out-patient staff, ill distinct ways : first, by refusing to prescribe more than Many suggestions were made before the Potato Crop Com- two once for any case found to be too trivial to require conmittee of the House of Commons by different observers with tinuous ; and, secondly, by refusing, at any period the object of exterminating the disease. Of these propo- whatevertreatment of a patient’s attendance, to continue treatment sitions the lecturer advocated the introduction of a new beyond the current visit. species of potato, for the fungus can thrive only on certain 3. The withdrawal of free access to the departments for species. The notion of earthing up the potatoes by fine sand Diseases of the Eye, Ear, and Skin, &c., and the requirement of a Governor’s ticket as a passport to first treatment, was not recommended for two reasons, the first being that; the filaments of the fungus were utterly incapable of pene- thus ensuring a preliminary check on improper applicants the necessity for a ticket conveying a valuable privilege, trating the layers of cork cells forming the cuticle, and, by and on arrival, which is acknowledged to be secondly, the spores were so minute that they might findl morean inspection necessary for special hospital cases than for any other their way without much difficulty between the crevices of thej relatively large particles of sand. Prof. Baldwin had proposedl class of applicants. to stamp out the disease by an Act of Parliament whichl 4. The reference, whenever possible, to approved Provi. should prevent the potatoes from the last year’s crop beingdent Medical Institutions, of all professionally certified used at all for the next year. Fresh seed would, on this; trivial cases, deemed suitable, in a social sene, for treatview, have to be obtained from some other country where ment at such institutions. the disease was unknown. Mr. Munay ventured to think: Such is the substance of the House Committee’s scheme, that such a course was an impossibility. Moreover, the and it will no doubt excite a good deal of attention and same mildew flourished on other species of solanum. Int interest.
cases, with
be
THE PARKES MUSEUM.
’
.
,
so
chapter
on
a view to elimination-first, of th03e found to "well to do" that they are unfit objects of medical charity ; and, secondly, of persons in receipt of parish relief, who are to unions, and should be treated at THE address delivered by Mr. George Murray at the Poor-law chargeable The intending ]J:1tients 1-n ing, in dispensaries. Parkes Museum last week was a decided success. After both cases, once treated by the bospitd btsdr’, anrl being alsu giving a lucid description of the anatomy of the potato plant in both cases freed from social inquiry altogether, if the the lecturer proceeded to delineate the structure of the medical or surgical oiticer on duty shall decide that they are ill as to render delay of treatment injurious, or so fungus (Phytophthora infestans) which is the cause of the thatseriously are, for professional reasons, singularly suited to they potato disease. The mode of growth and the methods of be hospital patients. reproduction were passed in review. With a view to the 2. The lessening of numbers under treatment-that is to prevention of the disease there was nothing to compare with say, practically, the eventual lessening of the daily crowd of the thorough burning of the refuse of diseased potato fields. out-patients, by the direct action of the out-patient staff, ill distinct ways : first, by refusing to prescribe more than Many suggestions were made before the Potato Crop Com- two once for any case found to be too trivial to require conmittee of the House of Commons by different observers with tinuous ; and, secondly, by refusing, at any period the object of exterminating the disease. Of these propo- whatevertreatment of a patient’s attendance, to continue treatment sitions the lecturer advocated the introduction of a new beyond the current visit. species of potato, for the fungus can thrive only on certain 3. The withdrawal of free access to the departments for species. The notion of earthing up the potatoes by fine sand Diseases of the Eye, Ear, and Skin, &c., and the requirement of a Governor’s ticket as a passport to first treatment, was not recommended for two reasons, the first being that; the filaments of the fungus were utterly incapable of pene- thus ensuring a preliminary check on improper applicants the necessity for a ticket conveying a valuable privilege, trating the layers of cork cells forming the cuticle, and, by and on arrival, which is acknowledged to be secondly, the spores were so minute that they might findl morean inspection necessary for special hospital cases than for any other their way without much difficulty between the crevices of thej relatively large particles of sand. Prof. Baldwin had proposedl class of applicants. to stamp out the disease by an Act of Parliament whichl 4. The reference, whenever possible, to approved Provi. should prevent the potatoes from the last year’s crop beingdent Medical Institutions, of all professionally certified used at all for the next year. Fresh seed would, on this; trivial cases, deemed suitable, in a social sene, for treatview, have to be obtained from some other country where ment at such institutions. the disease was unknown. Mr. Munay ventured to think: Such is the substance of the House Committee’s scheme, that such a course was an impossibility. Moreover, the and it will no doubt excite a good deal of attention and same mildew flourished on other species of solanum. Int interest.
cases, with
be
THE PARKES MUSEUM.
’
.
,
so