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SANITARY INSPECTION IN THE PORT OF LONDON.
417 in Government
(as
clivities, that, said
on
Indeed,
the we
work)
we
as
take
on
his
own
conduct and proto be
it, there is not much
of snubbing or of petty indignities. confidently affirm, having had experi-
score
can
afloat in most quarters of the world, that if the doctor manages well, he can, in the long run, be more comfortable, and hold his own authority in his own sphere more i completely, than any other man in the ship. It is, of course, superlatively unpleasant to be boxed up for several months with a surly, ignorant, or drunken captain, or with officers possessing the same questionable qualities ; but this, as a matter of fact, is quite exceptional. All who elect to serve afloat must expect discomforts of some sort, but we incline to the opinion that a minimum only of them is accorded to the ship’s doctor. ences
____
__
HEAT AND MORTALITY IN NEW YORK. THE remarkable mortality which occurred in New York from sunstroke in the first week of July last, when 212 deaths took place from the direct effect of solar heat," as officially returned, will no doubt lend interest to the following extracts from the meteorological returns of New York and of our own Royal Observatory for the week in question, as well as for the preceding and succeeding weeks.
other statutes in this behalf, do hereby, until the 25th day of March next, assign to the Mayor, Aldermen, and Commons of the City of London, as the sanitary authority of the Port of London, all the powers, duties, capacities, liabilities, and obligations created by or arising out of the Nuisance Removal Acts; that is to say-‘ The Nuisance Removal Act for England, 1855,’ the Act passed in the session of the 23rd and 24th years of her Majesty, intituledAn Act to amend the Acts for the Removal of Nuisances and the Prevention of Diseases,’‘The Nuisances Removal Act for England Amendment Act, 1863,’The Nuisances Removal Act, No.1, 1866,’ and so much ofThe Sanitary Act, 1866; as to the amendment of the Nuisances Removal with all the powers, authorities, and duties contained in the provisions of the last-mentioned Act in regard to ships and waters, and persons engaged therein, in regard to providing hospitals or temporary places for the reception of the sick, so far as those several provisions apply to or affect the local authorities therein men-
relates Acts, together and
tioned.
"And we do further by this order assign to the said sanitary authority the duty of appointing a legally qualified
11
medical practitioner to be the medical officer of health, and also a competent person to be an inspector of nuisances for the said port, to act respectively as such officers during the term aforesaid. " Given under our seal of office, this 7th day of Septem-
ber, 1872.
" JAMES STANSFELD, President. "JAMES "JOHN " JOHN LAMBERT, Secretary." Secretary.’
REGISTERS To the Editor
OF HEALTH. of THE LANCET.
SIR,-Every medical man must have felt the difficulty of obtaining the history of patients, the accounts rendered by themselves being imperfect and unreliable, while, for want of communication between the various medical attendants, the treatment is apt to be uncertain and disconnected. An accurate record, with a view to establish some defined and concerted plan of treatment, would be more advantageous to the patient and more satisfactory to the practitioner. As most cases during a lifetime come under the notice of several doctors, it is very desirable (as reference is rarely possible) that any experience gained by a former treatment should be available in a subsequent and probably similar
such notes, carefully made, would I propose that a valuable medical record. register should be kept by every patient, to commence, if possible, from birth, and contain a concise entry by the medical attendant of each disease or attack as it comes under treatment, with any short note necessary for reference on a future occasion, when the document should be produced. When the patient is the subject of a specific malady, a medical entry would be very suggestive for future treatment. Its perusal would afford more information than , any inquiry could give, while questions of an unpleasant character could often be avoided and much time saved. "The Rpgister of Health" should be inspected in the case of children entering or returning to public or other schools, in applications for life assurance, or other medical examinations, and be, in fact, analogous to the papers of a seaman, but, being only for professional notice, would be of a privileged character. Such a plan could not be carried out without the co-operation of medical men. This, however, would give it a value and enhance its accuracy. I enclose forms (one filled in with my own medical history as exemplifying the plan), which I beg to suggest for the purpose, and which I intend to use in my own practice, and should be glad of your opinion as to the feasibility of carrying out these arrangeor
recurring affection;
become
The registered mortality was at the rate of 17 per 1000 in London and 42 in New York for the week ended 29th June; in the next week it was 19 in London and 87 in New York; and in the last week of the three it was 20 in London and 58 in New York. The excess of mean temperature in New York over London was 15.7° in the first week, 19 4° in the second, and 136° in the third. Notwithstanding, it would appear from the official returns that the sun was hotter at some time almost every day in London than in New York; but there must surely be a difference in the character or position of the thermometers to account for this contradictory appearance. One death from sunstroke occurred in New York on the 29th June, and the deaths therefrom on the succeeding seven days were 7, 34, 68, 43, 44, 12, and 4, respectively ; the fatality from diarrhoeal diseases just doubled itself in that week, which will be a memorable one in the city annals.
SANITARY INSPECTION IN THE PORT OF LONDON.
ments
The
following
document has been issued
by
the Local
Government Board :"To the Mayor, Aldermen, and Commons of the City of! London, the Sanitary Authority of the Port of London, and to all others whom it may concern : " We, the Local Government Board, acting under the
authority ofThe
Public Health
Act, 1872,’ and the several
a
generally.
I am, Sir, yours very truly, FREDERICK H. SMITH, M.D. Lewisham-hill, S.E., August 31st, 1872.
THE foot-and-mouth disease is still very prevalent in Herefordshire, Worcestershire, Kent, Oxfordshire, and
Northamptonshire.
(as
clivities, that, said
on
Indeed,
the we
work)
we
as
take
on
his
own
conduct and proto be
it, there is not much
of snubbing or of petty indignities. confidently affirm, having had experi-
score
can
afloat in most quarters of the world, that if the doctor manages well, he can, in the long run, be more comfortable, and hold his own authority in his own sphere more i completely, than any other man in the ship. It is, of course, superlatively unpleasant to be boxed up for several months with a surly, ignorant, or drunken captain, or with officers possessing the same questionable qualities ; but this, as a matter of fact, is quite exceptional. All who elect to serve afloat must expect discomforts of some sort, but we incline to the opinion that a minimum only of them is accorded to the ship’s doctor. ences
____
__
HEAT AND MORTALITY IN NEW YORK. THE remarkable mortality which occurred in New York from sunstroke in the first week of July last, when 212 deaths took place from the direct effect of solar heat," as officially returned, will no doubt lend interest to the following extracts from the meteorological returns of New York and of our own Royal Observatory for the week in question, as well as for the preceding and succeeding weeks.
other statutes in this behalf, do hereby, until the 25th day of March next, assign to the Mayor, Aldermen, and Commons of the City of London, as the sanitary authority of the Port of London, all the powers, duties, capacities, liabilities, and obligations created by or arising out of the Nuisance Removal Acts; that is to say-‘ The Nuisance Removal Act for England, 1855,’ the Act passed in the session of the 23rd and 24th years of her Majesty, intituledAn Act to amend the Acts for the Removal of Nuisances and the Prevention of Diseases,’‘The Nuisances Removal Act for England Amendment Act, 1863,’The Nuisances Removal Act, No.1, 1866,’ and so much ofThe Sanitary Act, 1866; as to the amendment of the Nuisances Removal with all the powers, authorities, and duties contained in the provisions of the last-mentioned Act in regard to ships and waters, and persons engaged therein, in regard to providing hospitals or temporary places for the reception of the sick, so far as those several provisions apply to or affect the local authorities therein men-
relates Acts, together and
tioned.
"And we do further by this order assign to the said sanitary authority the duty of appointing a legally qualified
11
medical practitioner to be the medical officer of health, and also a competent person to be an inspector of nuisances for the said port, to act respectively as such officers during the term aforesaid. " Given under our seal of office, this 7th day of Septem-
ber, 1872.
" JAMES STANSFELD, President. "JAMES "JOHN " JOHN LAMBERT, Secretary." Secretary.’
REGISTERS To the Editor
OF HEALTH. of THE LANCET.
SIR,-Every medical man must have felt the difficulty of obtaining the history of patients, the accounts rendered by themselves being imperfect and unreliable, while, for want of communication between the various medical attendants, the treatment is apt to be uncertain and disconnected. An accurate record, with a view to establish some defined and concerted plan of treatment, would be more advantageous to the patient and more satisfactory to the practitioner. As most cases during a lifetime come under the notice of several doctors, it is very desirable (as reference is rarely possible) that any experience gained by a former treatment should be available in a subsequent and probably similar
such notes, carefully made, would I propose that a valuable medical record. register should be kept by every patient, to commence, if possible, from birth, and contain a concise entry by the medical attendant of each disease or attack as it comes under treatment, with any short note necessary for reference on a future occasion, when the document should be produced. When the patient is the subject of a specific malady, a medical entry would be very suggestive for future treatment. Its perusal would afford more information than , any inquiry could give, while questions of an unpleasant character could often be avoided and much time saved. "The Rpgister of Health" should be inspected in the case of children entering or returning to public or other schools, in applications for life assurance, or other medical examinations, and be, in fact, analogous to the papers of a seaman, but, being only for professional notice, would be of a privileged character. Such a plan could not be carried out without the co-operation of medical men. This, however, would give it a value and enhance its accuracy. I enclose forms (one filled in with my own medical history as exemplifying the plan), which I beg to suggest for the purpose, and which I intend to use in my own practice, and should be glad of your opinion as to the feasibility of carrying out these arrangeor
recurring affection;
become
The registered mortality was at the rate of 17 per 1000 in London and 42 in New York for the week ended 29th June; in the next week it was 19 in London and 87 in New York; and in the last week of the three it was 20 in London and 58 in New York. The excess of mean temperature in New York over London was 15.7° in the first week, 19 4° in the second, and 136° in the third. Notwithstanding, it would appear from the official returns that the sun was hotter at some time almost every day in London than in New York; but there must surely be a difference in the character or position of the thermometers to account for this contradictory appearance. One death from sunstroke occurred in New York on the 29th June, and the deaths therefrom on the succeeding seven days were 7, 34, 68, 43, 44, 12, and 4, respectively ; the fatality from diarrhoeal diseases just doubled itself in that week, which will be a memorable one in the city annals.
SANITARY INSPECTION IN THE PORT OF LONDON.
ments
The
following
document has been issued
by
the Local
Government Board :"To the Mayor, Aldermen, and Commons of the City of! London, the Sanitary Authority of the Port of London, and to all others whom it may concern : " We, the Local Government Board, acting under the
authority ofThe
Public Health
Act, 1872,’ and the several
a
generally.
I am, Sir, yours very truly, FREDERICK H. SMITH, M.D. Lewisham-hill, S.E., August 31st, 1872.
THE foot-and-mouth disease is still very prevalent in Herefordshire, Worcestershire, Kent, Oxfordshire, and
Northamptonshire.