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ROYAL UNITED HOSPITAL, BATH.
1078 waters, and of the utilisation of activeprinciples contained in the water.
degrees of luxury. Should not these unconsciously unfortunates have equal advantages with the poorer " 1. That a change of environment exerts an sufferers and havethe opportunity of going into influence is a commonplace ; thus improvement in hostels or nursing homes with all the advantages of health may follow a visit either to a health resort an up-to-date clinic ?P without any special baths or waters, or to a spa ’The Importance of Research 6T’ork. where no real use is made of the special advantages and biochemical laboratories, such as are " Clinical that it possesses. The study of the effects due to such a change comes under the heading of medical attached to the Devonshire Hospital, are essential only for the accurate diagnosis of the diseases climatology, but that climatology and hydrology not should be closely connected is too obvious to require of individual patients but for the maintenance and advance of the science of hydrology and physioargument. A regulated life, supervised diet and These methods of treatment, which are therapy. are no and freedom from doubt worry exercise, so closely allied to the vis medicatrix maturcr, have in more easily ensured at a health resort than at the course of their long existence passed from an home, and in some instances the good effects of a and early semi-religious superstitious period, through visit to a health resort are thus explained ; in the a long empirical phase, into the scientific era which past spas were often used as pleasant places for an began about half a century ago. A good deal of irresponsible holiday after a busy season or life in investigation has been started especially since, and town without any serious attention to the special because of the stimulus of the war, but the science the of individual or to the visitor, requirements hydrology is still in an early stage of development. peculiar properties of the spa treatment. Where of and when this spirit exists and as long as the tide of Of the physiological effects of water internally and fastmon is sumcient to keep the resort full, there externally there is an enormous amount to be learnt, is a danger that the special properties of the waters and the profession naturally looks to its members and the best methods of applying them will be with the opportunities at their hand to take a leading of hydrology. This has been neglected, for the demand controls the supply, and share in the advance British leaders in hydrology, scientific investigation receives no encouragement fully recognised by and their are shown in the young and exertions and less stimulus. The bathing establishments, if there are any, are not kept up to date, and their energetic Archives of Medical Hydrology. The future value and use even as a window-dressing attraction of scientific medical hydrology, and so the lasting will dwindle progressively. Buxton is in no way open and genuine success of spas, depends on research, to any reproach on these scores, and while far from and it is desirable to emphasise the principle that the only real advertisement of a spa is the publication relying on them alone has great natural advantages of good research work into the properties-chemical, from its altitude (1000 ft.) and beautiful surroundings ; it has much historical interest, sharing with Bath the biological, and therapeutical-of the waters and the diseases which can be beneficially treated imprimatur of Roman patronage. These are most into It is to their honour that the thereby. important accessories, for it would be a grave mistake of Buxton have recognised the value ofmunicipality such work to neglect the psychological factor of inspiring a and have to the of the contributed salary analytical helpful joie de vivre among those who come for a chemist attached to the research laboratory of the a and the that search thus obviate boredom to cure, Devonshire Hospital." for health and relief from pain may bring in its " The Prosperity of Buxton " was proposed by the train. Cheerful and attractive surroundings and who said that people talked in Duke of pleasing distractions have their proper place in a these daysDevonshire, about the key industries ; he thought the cure, and it must be admitted that, in the past at key of all industries was health. Buxton, he said, had least, British health resorts have lagged behind many made a real contribution to the subject. In reply to on the continent. But this handicap is rapidly the toast of " The Guests," proposed by Alderman eliminated. being " 2. The second of health resorts is that C. W. Buckley, M.D., Sir W. H. Willcox and Dr. R. A. of
category
of the spas with their medicinal waters and careful medical supervision-two factors inseparable for success. Spas, such as Buxton, Bath, and Harrogate, are, as Dr. Fortescue Fox, our leader in hydrology, has insisted, a national asset. But their value must depend on skilled control of the patients, and circumstances are not always and everywhere favourable to the fulfilment of this necessary condition. Directions as to diet and treatment may be given but not faithfully followed, and it is not surprising that sucha cure ’ brings disappointment. An obvious remedy against dietetic lapses is to remove temptation, so that patients undergoing a cure should find it impossible at their hotels to go outside their prescribed dietary, both as regards quality and perhaps even the more difficult question of quantity. The British spas have their special characters, and the tonic ones, such as Buxton, need fear no rivals in their natural advantages ; but to render these fully available an up-to-date and complete installation, such as is being opened here to-day, is necessary. In addition to the baths and other appliances for hydrological treatment and to all that is included under physiotherapy, such as
department
The guests included the Duke of Devonshire, Lord Hartington, the Lord Mayor of Sheffield, the Mayors of Salford, Bath, Stockport, Derby, Ilkeston, Macclesfield, and Leamington, the Rev. J. Stainer Wilkinson, Sir W. H. Willcox, Dr. G. Newton Pitt, Sir J. W. Moore, Canon Scott-Moncrieff, Sir W. J. Thompson, Dr. H. R. Spencer, Dr. F. J. Poynton, Dr. R. A. Fleming, Dr. R. Fortescue Fox, Sir James Barr, Dr. ur. J. Tyson, Mr. A. R. Courtenay, Dr. J. D. Stanley, Dr. E. P. Poulton, Dr. W. Edgecombe, Dr. Langdon Brown, Dr. C. Wilson, Dr. J. S. Bury, Dr. A. G. Gibson, and Alderman T. H. Cooper. On the following day the guests were entertained to luncheon at the Buxton Hydropathic, and were taken for drives through the picturesque Peak District by the corporation.
ROYAL UNITED OPENING
OF
PRIVATE
HOSPITAL, AND
BATH.
ORTHOPÆDIC
WARDS.
ON May 16th an extension of the Royal United Hospital, Bath, was formally opened by the Duke of important Connaught, who was welcomed by Lieut.-Colonel controlled E. Lewis, deputy chairman of the Royal United
exercises, and electricity, an is that for the diagnosis and treatment of disease ; the poor and those of limited massage,
Fleming responded.
Hospital, acting for Sir Percy Stothert, chairman, be cared for in the mineral-water who was unavoidably absent through illness. The hospitals, such as the Devonshire Hospital here, with Royal United Hospital was formed in 1826 by the its 300 beds and clinical laboratories ; but for the amalgamation of two hospitals, and in 1866 a new wing well-to-do, as is perhaps in keeping with our was added as a memorial to Prince Albert. The characteristics of national individualism and freedom, hospital, which serves the city of Bath and an area of 20 there are only hotels, pensions, and lodgings with miles round, oceupies a site in the city which does not practically complete liberty of action and varying allow of any further extension. A scheme for an means
can
1079 extension on a new site, and provision of paying wards Hospital, and there is a specially trained nursing staff. for persons of moderate means, was placed before the In accordance with the requirements of the Board of managing board in 1920 by certain members of the Education, children while undei-going treatment in FIG. 1.
P,oyal United Hospital, Bath.
General View of the Private Wards.
[Photos by permission of "Bath Herald."
staff of the hospital, the suggested site being the land hospital will be educated by a fully qualified schoolat Combe Park on which the Bath War Hospital mistress. was built in 1915. It is proposed that this shall be the central unit This scheme was subsequently : adopted at a public meeting in the Guildhall, Bath. of an organisation covering the area served by the The site at Combe Park, consisting of about 20 acres, Royal United Hospital in parts of Somerset, Wiltshire, and Gloucestershire, on the lines of the Wingfield was purchased, a portion being retained and the remainder leased to the Pensions Ministry, which and Shropshire Orthopaedic Hospitals, and local On the portion clinics will be established at suitable centres throughhad taken over the war hospital. retained, the private hospital and an orthopædic out the area at which will be carried out outhospital for the treatment of surgical tuberculosis in patient treatment, periodical inspection of all children have been erected. The private hospital is outside cases, the examination and diagnosis of new cases. A specially trained orthopædic after-care a one-storey building with a total accommodation sister from the central hospital will visit them regularly, and members of the surgical staff of the FIG. 2. hospital will attend at stated intervals. These clinics will be controlled by local committees in cooperation with the medical men practising in their
I neighbourhood. On Wednesday, May 28th, a meeting will be held at the hospital by the Bath Division of the British Medical Association, which will be in the nature of an medical opening of the new wards. These will be open for inspection, and Lord Dawson of Penn will an address.
official
deliver
UNITED STATES OF AMERICA. (FROM AN OCCASIONAL CORRESPONDENT.)
Cyanogen Chloride for Fumigation. SINCE the introduction of cyanogen as a fumigating agent on board ships several fatal accidents have been reported from various parts of the world, so a of Ward Interior (1’2 Bcdb). that it became evident that either a very valuable disinfectant-fatal in comparatively low concentration of 72 beds. In the admission of patients preference both to insects and vermin yet comparatively nonwill be given to those from Bath and the area covered injurious to cargo—must either be abandoned or bv the Royal United Hospital, but others will be else improved precautionary measures must be admitted provided there are beds available. All introduced. The United States Public Health Service has been experimenting with the latter object in view patients can be attended by their own doctors. -About 100 yards to the north of the private hospital and during the last year has elaborated a chemical is the orthopædic ward, consisting of one large open- safeguard which has so far given most satisfactory air room about 80 feet long and 30 feet wide. giving results. It consists in combining the cyanogen with accommodation for the reception of 37patients. chlorine so that the poisonous fumes may giveurgent The ward faces due south and is open in its entire warning of their presence. Cyanogen chloride is length, but has a sun balcony in front of it partially said to be produced by a chemical reaction which is covered by a lean-to glass roof. The surgical staff expressed as follows :consists of members of the staff of the Royal United 3 NaCN + NaClO3 + 6 HCl =4 -NaCl + 3 H2O +3 CNCl.
degrees of luxury. Should not these unconsciously unfortunates have equal advantages with the poorer " 1. That a change of environment exerts an sufferers and havethe opportunity of going into influence is a commonplace ; thus improvement in hostels or nursing homes with all the advantages of health may follow a visit either to a health resort an up-to-date clinic ?P without any special baths or waters, or to a spa ’The Importance of Research 6T’ork. where no real use is made of the special advantages and biochemical laboratories, such as are " Clinical that it possesses. The study of the effects due to such a change comes under the heading of medical attached to the Devonshire Hospital, are essential only for the accurate diagnosis of the diseases climatology, but that climatology and hydrology not should be closely connected is too obvious to require of individual patients but for the maintenance and advance of the science of hydrology and physioargument. A regulated life, supervised diet and These methods of treatment, which are therapy. are no and freedom from doubt worry exercise, so closely allied to the vis medicatrix maturcr, have in more easily ensured at a health resort than at the course of their long existence passed from an home, and in some instances the good effects of a and early semi-religious superstitious period, through visit to a health resort are thus explained ; in the a long empirical phase, into the scientific era which past spas were often used as pleasant places for an began about half a century ago. A good deal of irresponsible holiday after a busy season or life in investigation has been started especially since, and town without any serious attention to the special because of the stimulus of the war, but the science the of individual or to the visitor, requirements hydrology is still in an early stage of development. peculiar properties of the spa treatment. Where of and when this spirit exists and as long as the tide of Of the physiological effects of water internally and fastmon is sumcient to keep the resort full, there externally there is an enormous amount to be learnt, is a danger that the special properties of the waters and the profession naturally looks to its members and the best methods of applying them will be with the opportunities at their hand to take a leading of hydrology. This has been neglected, for the demand controls the supply, and share in the advance British leaders in hydrology, scientific investigation receives no encouragement fully recognised by and their are shown in the young and exertions and less stimulus. The bathing establishments, if there are any, are not kept up to date, and their energetic Archives of Medical Hydrology. The future value and use even as a window-dressing attraction of scientific medical hydrology, and so the lasting will dwindle progressively. Buxton is in no way open and genuine success of spas, depends on research, to any reproach on these scores, and while far from and it is desirable to emphasise the principle that the only real advertisement of a spa is the publication relying on them alone has great natural advantages of good research work into the properties-chemical, from its altitude (1000 ft.) and beautiful surroundings ; it has much historical interest, sharing with Bath the biological, and therapeutical-of the waters and the diseases which can be beneficially treated imprimatur of Roman patronage. These are most into It is to their honour that the thereby. important accessories, for it would be a grave mistake of Buxton have recognised the value ofmunicipality such work to neglect the psychological factor of inspiring a and have to the of the contributed salary analytical helpful joie de vivre among those who come for a chemist attached to the research laboratory of the a and the that search thus obviate boredom to cure, Devonshire Hospital." for health and relief from pain may bring in its " The Prosperity of Buxton " was proposed by the train. Cheerful and attractive surroundings and who said that people talked in Duke of pleasing distractions have their proper place in a these daysDevonshire, about the key industries ; he thought the cure, and it must be admitted that, in the past at key of all industries was health. Buxton, he said, had least, British health resorts have lagged behind many made a real contribution to the subject. In reply to on the continent. But this handicap is rapidly the toast of " The Guests," proposed by Alderman eliminated. being " 2. The second of health resorts is that C. W. Buckley, M.D., Sir W. H. Willcox and Dr. R. A. of
category
of the spas with their medicinal waters and careful medical supervision-two factors inseparable for success. Spas, such as Buxton, Bath, and Harrogate, are, as Dr. Fortescue Fox, our leader in hydrology, has insisted, a national asset. But their value must depend on skilled control of the patients, and circumstances are not always and everywhere favourable to the fulfilment of this necessary condition. Directions as to diet and treatment may be given but not faithfully followed, and it is not surprising that sucha cure ’ brings disappointment. An obvious remedy against dietetic lapses is to remove temptation, so that patients undergoing a cure should find it impossible at their hotels to go outside their prescribed dietary, both as regards quality and perhaps even the more difficult question of quantity. The British spas have their special characters, and the tonic ones, such as Buxton, need fear no rivals in their natural advantages ; but to render these fully available an up-to-date and complete installation, such as is being opened here to-day, is necessary. In addition to the baths and other appliances for hydrological treatment and to all that is included under physiotherapy, such as
department
The guests included the Duke of Devonshire, Lord Hartington, the Lord Mayor of Sheffield, the Mayors of Salford, Bath, Stockport, Derby, Ilkeston, Macclesfield, and Leamington, the Rev. J. Stainer Wilkinson, Sir W. H. Willcox, Dr. G. Newton Pitt, Sir J. W. Moore, Canon Scott-Moncrieff, Sir W. J. Thompson, Dr. H. R. Spencer, Dr. F. J. Poynton, Dr. R. A. Fleming, Dr. R. Fortescue Fox, Sir James Barr, Dr. ur. J. Tyson, Mr. A. R. Courtenay, Dr. J. D. Stanley, Dr. E. P. Poulton, Dr. W. Edgecombe, Dr. Langdon Brown, Dr. C. Wilson, Dr. J. S. Bury, Dr. A. G. Gibson, and Alderman T. H. Cooper. On the following day the guests were entertained to luncheon at the Buxton Hydropathic, and were taken for drives through the picturesque Peak District by the corporation.
ROYAL UNITED OPENING
OF
PRIVATE
HOSPITAL, AND
BATH.
ORTHOPÆDIC
WARDS.
ON May 16th an extension of the Royal United Hospital, Bath, was formally opened by the Duke of important Connaught, who was welcomed by Lieut.-Colonel controlled E. Lewis, deputy chairman of the Royal United
exercises, and electricity, an is that for the diagnosis and treatment of disease ; the poor and those of limited massage,
Fleming responded.
Hospital, acting for Sir Percy Stothert, chairman, be cared for in the mineral-water who was unavoidably absent through illness. The hospitals, such as the Devonshire Hospital here, with Royal United Hospital was formed in 1826 by the its 300 beds and clinical laboratories ; but for the amalgamation of two hospitals, and in 1866 a new wing well-to-do, as is perhaps in keeping with our was added as a memorial to Prince Albert. The characteristics of national individualism and freedom, hospital, which serves the city of Bath and an area of 20 there are only hotels, pensions, and lodgings with miles round, oceupies a site in the city which does not practically complete liberty of action and varying allow of any further extension. A scheme for an means
can
1079 extension on a new site, and provision of paying wards Hospital, and there is a specially trained nursing staff. for persons of moderate means, was placed before the In accordance with the requirements of the Board of managing board in 1920 by certain members of the Education, children while undei-going treatment in FIG. 1.
P,oyal United Hospital, Bath.
General View of the Private Wards.
[Photos by permission of "Bath Herald."
staff of the hospital, the suggested site being the land hospital will be educated by a fully qualified schoolat Combe Park on which the Bath War Hospital mistress. was built in 1915. It is proposed that this shall be the central unit This scheme was subsequently : adopted at a public meeting in the Guildhall, Bath. of an organisation covering the area served by the The site at Combe Park, consisting of about 20 acres, Royal United Hospital in parts of Somerset, Wiltshire, and Gloucestershire, on the lines of the Wingfield was purchased, a portion being retained and the remainder leased to the Pensions Ministry, which and Shropshire Orthopaedic Hospitals, and local On the portion clinics will be established at suitable centres throughhad taken over the war hospital. retained, the private hospital and an orthopædic out the area at which will be carried out outhospital for the treatment of surgical tuberculosis in patient treatment, periodical inspection of all children have been erected. The private hospital is outside cases, the examination and diagnosis of new cases. A specially trained orthopædic after-care a one-storey building with a total accommodation sister from the central hospital will visit them regularly, and members of the surgical staff of the FIG. 2. hospital will attend at stated intervals. These clinics will be controlled by local committees in cooperation with the medical men practising in their
I neighbourhood. On Wednesday, May 28th, a meeting will be held at the hospital by the Bath Division of the British Medical Association, which will be in the nature of an medical opening of the new wards. These will be open for inspection, and Lord Dawson of Penn will an address.
official
deliver
UNITED STATES OF AMERICA. (FROM AN OCCASIONAL CORRESPONDENT.)
Cyanogen Chloride for Fumigation. SINCE the introduction of cyanogen as a fumigating agent on board ships several fatal accidents have been reported from various parts of the world, so a of Ward Interior (1’2 Bcdb). that it became evident that either a very valuable disinfectant-fatal in comparatively low concentration of 72 beds. In the admission of patients preference both to insects and vermin yet comparatively nonwill be given to those from Bath and the area covered injurious to cargo—must either be abandoned or bv the Royal United Hospital, but others will be else improved precautionary measures must be admitted provided there are beds available. All introduced. The United States Public Health Service has been experimenting with the latter object in view patients can be attended by their own doctors. -About 100 yards to the north of the private hospital and during the last year has elaborated a chemical is the orthopædic ward, consisting of one large open- safeguard which has so far given most satisfactory air room about 80 feet long and 30 feet wide. giving results. It consists in combining the cyanogen with accommodation for the reception of 37patients. chlorine so that the poisonous fumes may giveurgent The ward faces due south and is open in its entire warning of their presence. Cyanogen chloride is length, but has a sun balcony in front of it partially said to be produced by a chemical reaction which is covered by a lean-to glass roof. The surgical staff expressed as follows :consists of members of the staff of the Royal United 3 NaCN + NaClO3 + 6 HCl =4 -NaCl + 3 H2O +3 CNCl.