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"STERILISATION OF MILK."
1215 certificates, finding their labour thrown away. The new appointments by the Board will, therefore, become sinecures. It will, however, cause constant chagrin and vexation to medical men to find that their efforts to serve children, parents, and schools are so ill appreciated by the Board. After all, the Board should know that medical men are its best friends. All will agree with Mr. Sharp that the school attendance of a child is by no means a "trivial matter," but one of "vital importance, not merely to the future welfare of the child, but also indirectly to the community generally, " especially, I would add, when the child is medically unfit to attend. And of this who are to be thendges ? I am, Sirs, yours faithfully, LEONARD G. GUTHRIE. Upper Berkeley-street, W., May 6th, 1895.
"MEDICAL EVIDENCE AT INQUESTS." To the -Editors of THE LANCET. SIRS,—In THE LANCET of May 4th I notice a communion the above subject. In an editorial note to Mr. Milligan’s explanation you state your opinion "that it would
cation
have been advisable to take the evidence of the medical man who first saw the wound." This seems so obvious that one wonders that it is not the universal practice. I can give a Some time ago I was called to see a man who case in point. had been shot. He lived close to my house, so that I was able to attend within a few minutes of the accident. I found the man lying on the floor, with blood spurting from a wound in the neck. As the patient was rapidly bleeding to death, I placed my finger on the wound, and so stopped the flow of blood. Having sent for the ambulance, the man was conveyed to hospital, when the hasmorrhage was found to have ceased, owing no doubt to the fact that I had kept my finger firmly applied to the wound during the whole time since I first saw him. I may state that the patient made an incriminating statement to me against a youth who had fired the shot, saying that it was done intentionally. The youth was afterwards tried for murder and acquitted, there being no evidence to prove that the occurrence was not purely accidental. After making the statement to me the patient never spoke again. He died a few hours afterwards in hospital. The police whom I sent for carefully took my name and address, and that was the last I heard of the matter. The divisional surgeon, who had never seen the man at all until he saw him in the mortuary, was called at the trial, though what value his evidence could have it would be difficult to say. Had I waited until the police sent for me to attend the man would have been dead, but I should have had a fee. As I attended first and sent for the police myself I saved the patient’s life for the moment, but received no fee. Although I am satisfied that in this case the wounding was accidental, it is not difficult to imagine that there might have been a grave miscarriage of justice. I am, Sirs, yours faithfully, W. A. MALCOLM. 6th, 1895. N., May Holloway-road,
"THE LONDON AND MANCHESTER INDUSTRIAL ASSURANCE COMPANY, LIMITED." To the Editors of THE LANCET. SIRS.—In reference to Mr. Dunlop’s letter in THE LANCET May 4th, it would be as well, perhaps, to remove the impression made by it-viz., that medical men are likely to receive even the utterly inadequate rate of 8½d. for each bottle of medicine supplied by them to club patients-by stating at once that, far from receiving 8½., the most they can expect to receive is 3d. a bottle. I have been myself for many years connected with a club whose of
rate of pay to their medical officers is practically the same as that of the London and Manchester Industrial Assurance Company, and the average amount per bottle received by me over a period of ten years, compiled from accurate statistics kept by my assistant, came to something less than 3d. a bottle. It is true that last year-the year on which Mr. Dunlop’s estimate is based-I too received about 9d. a bottle on an average from my club patients, but that was because (owing to the unusual character of the season) I had, in common with so many medical men in all parts of London, one-third of the usual number of patients requiring attendance-a condition of things not likely to be permanent, and
only
on which, therefore, it would be dangerous on any matter of moment to base calculations for the future. I am, Sirs, yours truly,
JOHN BEATTIE CROZIER, M.B., L.R.C.P.
Elgin-avenue, W., May 8th,
1895.
"IRRIGATION AND CLIMATE." To t7te Editors of THE LANCET. SIRS,-In this week’s issue of THE LANCET thereare some remarks on the effect of irrigation upon the climate of Egypt which raise a question of real interest. Has the climate of’ Lower Egypt become much damper than it used to be? Theanswer must be undoubtedly in the affirmative. I was in , Cairo for the first time in the winter of 1850, and have been there three times since during the last five or six years. At the former period rain was so rare an occurrence that peoplegazed at it as at a remarkable phenomenon. During the latter period boats have been actually used at times in the streets of Cairo at periods of heavy rains. These are the facts, and it is probably not difficult to suggest the causes. I am, Sirs, yours faithfully, W. H. HALLIDAY. Oxford and Cambridge Club, Pall Mall, S.W., May 4th, 1895.
"STERILISATION OF MILK." To the -Editors of THE LANCET. THE LANCET of April 20th Dr. Carter, in an able. SIRS,-In article, calls attention to the vital importance, especially during the summer months, of preparing milk for home consumption which shall agree perfectly with infants and with dyspeptic adults, and which yet shall be neither raw nor boiled. Though he does not say so in so many words, thechief practical advantage of sterilised milk over boiled milk is that it does not cause the constipation usually ccmplained of when mothers are compelled to boil the children’s. food. I may mention that in some Oriental countries mrb:. is regarded as a mild aperient merely because it is the custom of the natives to drink it when no longer fresh. Dr. Carter commends the adoption of a sterilising machine which sounds desirable in many ways. It is apparently a modification of Professor Soxhlet’s sterilising apparatus for milk, which is too little known to English practitioners. This apparatus was brought out in Munich in 1886, and has since then been in constant use in Germany. It has been employed in Egypt for more than three years, and after using it for my own children and for patients I can confidently recommend it as being simple, portable, certain, and inexpensive. (The London agent is Mr. Pearl, 4, Bury-court, St. Mary-axe.) Dr. Carter proposes that the milk-bottles shall be closed with cotton-wool, but the Soxhlet system of providing indiarubber corks, which are sucked into the neck: of the bottle during the heating process, is perhaps better. The milk will then keep sweet for several weeks in the corked bottles. The best kind of cork has been invented by Professor Stutzer, and can be obtained from Messrs. OllendmffWilden of Bonn. In order to preserve milk in larger quantities, as in dairies or hospitals, nothing will be found to act much better than an apparatus originally made for breweries, and introduced some three years ago into the Kasr el Aini Hospital by the medical superintendent, Mr. Milton. Formerly it was impossible to keep milk during the summer nights, but now there are no further complaints, and it i even found that the milk will keep for three days in vessels covered by muslin only, provided that the vessels also are, previously sterilised. By this machine, made by Messrs. Lawrence and Co. of London, Every morning more than 100 pints of hospital milk are rendered innocuous for future consumption in less than fifteen minutes by heating the milk by steam and then rapidly cooling it again. I am, Sirs, yours faithfully, F. M. SANDWITH, F.M. Cairo, May lst, 1895. SANDWITH, M.D.
"THE TITLE OF ’DOCTOR."’ To the Editors
of THE LANCET. SIRS,-Mr. Sewill has hit the Lail on the head. The medical profession require two things most urgently : first,
penal
that the Medical Acts shall be so amended as to make it a. offence for persons to practise any branch of medicine
"MEDICAL EVIDENCE AT INQUESTS." To the -Editors of THE LANCET. SIRS,—In THE LANCET of May 4th I notice a communion the above subject. In an editorial note to Mr. Milligan’s explanation you state your opinion "that it would
cation
have been advisable to take the evidence of the medical man who first saw the wound." This seems so obvious that one wonders that it is not the universal practice. I can give a Some time ago I was called to see a man who case in point. had been shot. He lived close to my house, so that I was able to attend within a few minutes of the accident. I found the man lying on the floor, with blood spurting from a wound in the neck. As the patient was rapidly bleeding to death, I placed my finger on the wound, and so stopped the flow of blood. Having sent for the ambulance, the man was conveyed to hospital, when the hasmorrhage was found to have ceased, owing no doubt to the fact that I had kept my finger firmly applied to the wound during the whole time since I first saw him. I may state that the patient made an incriminating statement to me against a youth who had fired the shot, saying that it was done intentionally. The youth was afterwards tried for murder and acquitted, there being no evidence to prove that the occurrence was not purely accidental. After making the statement to me the patient never spoke again. He died a few hours afterwards in hospital. The police whom I sent for carefully took my name and address, and that was the last I heard of the matter. The divisional surgeon, who had never seen the man at all until he saw him in the mortuary, was called at the trial, though what value his evidence could have it would be difficult to say. Had I waited until the police sent for me to attend the man would have been dead, but I should have had a fee. As I attended first and sent for the police myself I saved the patient’s life for the moment, but received no fee. Although I am satisfied that in this case the wounding was accidental, it is not difficult to imagine that there might have been a grave miscarriage of justice. I am, Sirs, yours faithfully, W. A. MALCOLM. 6th, 1895. N., May Holloway-road,
"THE LONDON AND MANCHESTER INDUSTRIAL ASSURANCE COMPANY, LIMITED." To the Editors of THE LANCET. SIRS.—In reference to Mr. Dunlop’s letter in THE LANCET May 4th, it would be as well, perhaps, to remove the impression made by it-viz., that medical men are likely to receive even the utterly inadequate rate of 8½d. for each bottle of medicine supplied by them to club patients-by stating at once that, far from receiving 8½., the most they can expect to receive is 3d. a bottle. I have been myself for many years connected with a club whose of
rate of pay to their medical officers is practically the same as that of the London and Manchester Industrial Assurance Company, and the average amount per bottle received by me over a period of ten years, compiled from accurate statistics kept by my assistant, came to something less than 3d. a bottle. It is true that last year-the year on which Mr. Dunlop’s estimate is based-I too received about 9d. a bottle on an average from my club patients, but that was because (owing to the unusual character of the season) I had, in common with so many medical men in all parts of London, one-third of the usual number of patients requiring attendance-a condition of things not likely to be permanent, and
only
on which, therefore, it would be dangerous on any matter of moment to base calculations for the future. I am, Sirs, yours truly,
JOHN BEATTIE CROZIER, M.B., L.R.C.P.
Elgin-avenue, W., May 8th,
1895.
"IRRIGATION AND CLIMATE." To t7te Editors of THE LANCET. SIRS,-In this week’s issue of THE LANCET thereare some remarks on the effect of irrigation upon the climate of Egypt which raise a question of real interest. Has the climate of’ Lower Egypt become much damper than it used to be? Theanswer must be undoubtedly in the affirmative. I was in , Cairo for the first time in the winter of 1850, and have been there three times since during the last five or six years. At the former period rain was so rare an occurrence that peoplegazed at it as at a remarkable phenomenon. During the latter period boats have been actually used at times in the streets of Cairo at periods of heavy rains. These are the facts, and it is probably not difficult to suggest the causes. I am, Sirs, yours faithfully, W. H. HALLIDAY. Oxford and Cambridge Club, Pall Mall, S.W., May 4th, 1895.
"STERILISATION OF MILK." To the -Editors of THE LANCET. THE LANCET of April 20th Dr. Carter, in an able. SIRS,-In article, calls attention to the vital importance, especially during the summer months, of preparing milk for home consumption which shall agree perfectly with infants and with dyspeptic adults, and which yet shall be neither raw nor boiled. Though he does not say so in so many words, thechief practical advantage of sterilised milk over boiled milk is that it does not cause the constipation usually ccmplained of when mothers are compelled to boil the children’s. food. I may mention that in some Oriental countries mrb:. is regarded as a mild aperient merely because it is the custom of the natives to drink it when no longer fresh. Dr. Carter commends the adoption of a sterilising machine which sounds desirable in many ways. It is apparently a modification of Professor Soxhlet’s sterilising apparatus for milk, which is too little known to English practitioners. This apparatus was brought out in Munich in 1886, and has since then been in constant use in Germany. It has been employed in Egypt for more than three years, and after using it for my own children and for patients I can confidently recommend it as being simple, portable, certain, and inexpensive. (The London agent is Mr. Pearl, 4, Bury-court, St. Mary-axe.) Dr. Carter proposes that the milk-bottles shall be closed with cotton-wool, but the Soxhlet system of providing indiarubber corks, which are sucked into the neck: of the bottle during the heating process, is perhaps better. The milk will then keep sweet for several weeks in the corked bottles. The best kind of cork has been invented by Professor Stutzer, and can be obtained from Messrs. OllendmffWilden of Bonn. In order to preserve milk in larger quantities, as in dairies or hospitals, nothing will be found to act much better than an apparatus originally made for breweries, and introduced some three years ago into the Kasr el Aini Hospital by the medical superintendent, Mr. Milton. Formerly it was impossible to keep milk during the summer nights, but now there are no further complaints, and it i even found that the milk will keep for three days in vessels covered by muslin only, provided that the vessels also are, previously sterilised. By this machine, made by Messrs. Lawrence and Co. of London, Every morning more than 100 pints of hospital milk are rendered innocuous for future consumption in less than fifteen minutes by heating the milk by steam and then rapidly cooling it again. I am, Sirs, yours faithfully, F. M. SANDWITH, F.M. Cairo, May lst, 1895. SANDWITH, M.D.
"THE TITLE OF ’DOCTOR."’ To the Editors
of THE LANCET. SIRS,-Mr. Sewill has hit the Lail on the head. The medical profession require two things most urgently : first,
penal
that the Medical Acts shall be so amended as to make it a. offence for persons to practise any branch of medicine