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Reports of societies
AND DISEASES O F T H E C H E S T
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or from cases in which the diagnosis was doubtful; i i I of these specimens were positive by the fluorescence method, and an additional 8 9 specimens gave positive cultures. 3. These results are compared with a similar series published by Webster (1943). 4. We find the fluorescence method just as accurate, more sensitive, and more rapid than the Ziehl-Neelsen technique. We recommend the fluorescence technique to any laboratory where large numbers of examinations for tubercle bacilli are done. We wish to thank Mr. P. W. Bliss and Mr. H. K. Bourne of the British Thomson-Houston Co., Ltd., for their co-operation and advice about the "Mazda" lamp. We also wish to thank Mr. W. Goodwin for his keen and accurate technical assistance throughout the investigation. REFERENCES BOURNE,H. K. (I942): PhotographicJourn., 83, i35. GRAHAM,C. F. (I942):Journ. Lab. Clin. IVied., 27, I188. HAGEMANN,P. H. K, (1944): Quoted by Lempert. LEm'ERT, H. (1944): Lancet, 2, 818. LIND, H. E., and SHAUONESSY,H. J. (1942): Journ. Lab. Clin. Med., 27, 53i. WEBSTER,R. (I94I): Brit. Med. Journ., 1, 70; and (I943) Med. Journ. Aust., 2, 6i.
REPORTS OF SOCIETIES JOINT TUBERCULOSIS COUNCIL The principal business at the Joint Tuberculosis Council Meeting on May 18 was the discussion of a report of an interview between representatives of the Ministry of Health and representatives of the Council on the position of the Tuberculosis Service under the National Health Bill. According to a note of the interview made by J.T.C. representatives, the Tuberculosis Service, as it exists at present, will disappear. Tuberculosis Officers will become " Chest Physicians " dealing with all chest conditions. These chest physicians will be in charge of chest clinics in hospitals. T h e y will have no responsibility over non-pulmonary tuberculosis, which will be dealt with by other departments of hospitals. Preventive work, together with home nursing and social service, will remain with the medical officers of health. The chest clinics, however, will come under the new regional hospital authorities. So far as is known, the only integration of these two arms of service will be achieved through conferences presided over by the principal regional medical officers. Whole-time tuberculosis nurses will be exceptional in future, as tuberculosis cases will be included in the proposed new general health visiting and nursing service of local authorities. Rehabilitation, in its clinical aspect, will be controlled regionally by the Ministry of Health, and in its employment aspect by the Ministry of Labour. The Joint Tuberculosis Council regard the Minister's proposals as gravely inadequate and as constituting a danger to the public health. They view with alarm the separation of the social, environmental and epidemiological aspects of tuberculosis from the purely clinical aspect. They hold strongly to the view
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T H E B R I T I S H J O U R N A L OF T U B E R C U L O S I S
that the family and not the patient should be the unit. They reject the Ministry's implied assumption that tuberculosis requires no differentiation from other diseases. No matter how the disease manifests itself in any individual, they say, he requires prolonged special supervision of his mode of life and of his environment. This is essential, not merely for his own safety, but for the safety of the community. This special supervision should be the responsibility of someone with special knowledge of the disease and of each infiividual case. The Council record their emphatic opinion that no attempt should be made by the Government to break down the existing service until a scheme is produced which is at least as well integrated and as satisfactory as the best schemes of the present day. Certainly the existing service should not be altered until the incidence and mortality of tuberculosis have declined to a low level. The Joint Tuberculosis Council assert that the best interests of the tuberculosis patient and of the community would be served if the existing service were transferred intact to the new hospital organisation and retained in that organisation as an entity. The views of the Council are to be communicated to all Members of Parliament, all local authorities, the medical profession generally, and all persons or bodies specially interested in tuberculosis. Some months ago the Minister of Health stated in the House of Commons that tuberculosis patients were entitled to supplementary ration allowances. The Joint Tuberculosis Council took up the statement, and after a protracted correspondence have received a statement to the effect that: i. Tuberculous patients in institutions are entitled to normal civilian rations and points goods. 2. Tuberculosis institutions, along with other institutions, are entitled to priority supplies of goods such as dried eggs, jellies, etc. 3. Tuberculous patients are granted 2 pints of milk per day and 2 ozs. of cooking fat per week instead of the normal civilian' allowances of these foods. In addition,-if the institution concerned possesses a deep fat frier, a special allowance of 2 ozs. per head per week of frying fat Can be obtained. The Council feel that this announcement should receive publicity because the Minister's statement last November was open to misinterpretation.
IN M E M O R I A M GEORGE JESSEL, M.A., M.D., D.P.H. MANY of our readers will have heard with Surprise and regret of the unexpected death o f G e o r g e Jessel. He was one of a dwindling band of the old g u a r d of tuberculosis officers who took office in i9i 3 and grew in stature with the years. Able and ambitious and a ready debater with a clear head, he did good work in the wide field of prevention and treatment of tuberculosis and had scope for his abilities in Lancashire and on many councils and committees. He combined first-rate clinical work with that degree of administrative ability which together make the outstanding tuberculosis officer. In these days of excessive specialisation his varied and successful medical
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or from cases in which the diagnosis was doubtful; i i I of these specimens were positive by the fluorescence method, and an additional 8 9 specimens gave positive cultures. 3. These results are compared with a similar series published by Webster (1943). 4. We find the fluorescence method just as accurate, more sensitive, and more rapid than the Ziehl-Neelsen technique. We recommend the fluorescence technique to any laboratory where large numbers of examinations for tubercle bacilli are done. We wish to thank Mr. P. W. Bliss and Mr. H. K. Bourne of the British Thomson-Houston Co., Ltd., for their co-operation and advice about the "Mazda" lamp. We also wish to thank Mr. W. Goodwin for his keen and accurate technical assistance throughout the investigation. REFERENCES BOURNE,H. K. (I942): PhotographicJourn., 83, i35. GRAHAM,C. F. (I942):Journ. Lab. Clin. IVied., 27, I188. HAGEMANN,P. H. K, (1944): Quoted by Lempert. LEm'ERT, H. (1944): Lancet, 2, 818. LIND, H. E., and SHAUONESSY,H. J. (1942): Journ. Lab. Clin. Med., 27, 53i. WEBSTER,R. (I94I): Brit. Med. Journ., 1, 70; and (I943) Med. Journ. Aust., 2, 6i.
REPORTS OF SOCIETIES JOINT TUBERCULOSIS COUNCIL The principal business at the Joint Tuberculosis Council Meeting on May 18 was the discussion of a report of an interview between representatives of the Ministry of Health and representatives of the Council on the position of the Tuberculosis Service under the National Health Bill. According to a note of the interview made by J.T.C. representatives, the Tuberculosis Service, as it exists at present, will disappear. Tuberculosis Officers will become " Chest Physicians " dealing with all chest conditions. These chest physicians will be in charge of chest clinics in hospitals. T h e y will have no responsibility over non-pulmonary tuberculosis, which will be dealt with by other departments of hospitals. Preventive work, together with home nursing and social service, will remain with the medical officers of health. The chest clinics, however, will come under the new regional hospital authorities. So far as is known, the only integration of these two arms of service will be achieved through conferences presided over by the principal regional medical officers. Whole-time tuberculosis nurses will be exceptional in future, as tuberculosis cases will be included in the proposed new general health visiting and nursing service of local authorities. Rehabilitation, in its clinical aspect, will be controlled regionally by the Ministry of Health, and in its employment aspect by the Ministry of Labour. The Joint Tuberculosis Council regard the Minister's proposals as gravely inadequate and as constituting a danger to the public health. They view with alarm the separation of the social, environmental and epidemiological aspects of tuberculosis from the purely clinical aspect. They hold strongly to the view
m6
T H E B R I T I S H J O U R N A L OF T U B E R C U L O S I S
that the family and not the patient should be the unit. They reject the Ministry's implied assumption that tuberculosis requires no differentiation from other diseases. No matter how the disease manifests itself in any individual, they say, he requires prolonged special supervision of his mode of life and of his environment. This is essential, not merely for his own safety, but for the safety of the community. This special supervision should be the responsibility of someone with special knowledge of the disease and of each infiividual case. The Council record their emphatic opinion that no attempt should be made by the Government to break down the existing service until a scheme is produced which is at least as well integrated and as satisfactory as the best schemes of the present day. Certainly the existing service should not be altered until the incidence and mortality of tuberculosis have declined to a low level. The Joint Tuberculosis Council assert that the best interests of the tuberculosis patient and of the community would be served if the existing service were transferred intact to the new hospital organisation and retained in that organisation as an entity. The views of the Council are to be communicated to all Members of Parliament, all local authorities, the medical profession generally, and all persons or bodies specially interested in tuberculosis. Some months ago the Minister of Health stated in the House of Commons that tuberculosis patients were entitled to supplementary ration allowances. The Joint Tuberculosis Council took up the statement, and after a protracted correspondence have received a statement to the effect that: i. Tuberculous patients in institutions are entitled to normal civilian rations and points goods. 2. Tuberculosis institutions, along with other institutions, are entitled to priority supplies of goods such as dried eggs, jellies, etc. 3. Tuberculous patients are granted 2 pints of milk per day and 2 ozs. of cooking fat per week instead of the normal civilian' allowances of these foods. In addition,-if the institution concerned possesses a deep fat frier, a special allowance of 2 ozs. per head per week of frying fat Can be obtained. The Council feel that this announcement should receive publicity because the Minister's statement last November was open to misinterpretation.
IN M E M O R I A M GEORGE JESSEL, M.A., M.D., D.P.H. MANY of our readers will have heard with Surprise and regret of the unexpected death o f G e o r g e Jessel. He was one of a dwindling band of the old g u a r d of tuberculosis officers who took office in i9i 3 and grew in stature with the years. Able and ambitious and a ready debater with a clear head, he did good work in the wide field of prevention and treatment of tuberculosis and had scope for his abilities in Lancashire and on many councils and committees. He combined first-rate clinical work with that degree of administrative ability which together make the outstanding tuberculosis officer. In these days of excessive specialisation his varied and successful medical