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THE BURDEN NEUROLOGICAL INSTITUTE
763
PUBLIC HEALTH
THE BURDEN NEUROLOGICAL INSTITUTE
SiR,-In view of the difficulty that
must be extreatment for cases perienced obtaining inpatient of nervous and early mental disease occurring in evacuation areas I should be glad if you could bring
in
the services offered by the Burden Neurological Institute to the notice of your readers. The institute would be prepared to receive a number of cases of early mental disease for a course of shock therapy, and cases of organic nervous disease including cerebral tumours for investigation and if necessary operation. The institute which was endowed by the late Mrs. Burden is fully equipped both for neurosurgery, shock treatment and :endocrinologic31 in-
vestigation. I am,
Sir, yours faithfully,
authority, the salary scales being based on those of Emergency Hospital Medical Service. Wholetime obstetric specialists (non-resident) will be paid n300 a year, the salary of a group officer. Parttime specialists will be paid a proportion of that salary. Obstetric officers who act as residents either at the hospital unit for complicated maternity cases or at an improvised maternity home will be paid ;tõ50 a year, the salary of a medical officer under the emergency hospital scheme. In some cases two or more authorities may combine and make a joint appointthe
the officer’s time may be divided between The appointments will be for six months in the first instance. A number of them have already been made.
ment,
or
surgical and obstetrical work.
Hospital
F. GOLLA.
Treatment for Non-Casualties
The Minister of Health has taken further steps to generally known amongst the hospitals that patients whose medical condition necessitates inpatient treatment should be immediately admitted. This " reflux " into the normal hospital accommodation was always provided for in the Ministry’s scheme. To meet it, new beds are continually being added, so that on balance the number held in reserve for casualties will not be seriously diminished. The figures received by the Ministry each day from the regional hospital officers show that this is in fact make it
LONDON
VOLUNTARY HOSPITALS GENCY BED SERVICE
EMER-
SiR,-On the outbreak of war, by a prearranged plan the whole staff of this service was taken over by the Ministry of Health as part of the Ministry’s emergency medical service to assist in running the sector casualty bureaus. In consequence, the emergency bed service was closed down. A new staff has now been recruited and the service will reopen forthwith and will endeavour to assist doctors to obtain admission for their acute or emergency patients. In the first instance it will only be possible to run a daytime service (9 A.M. to 10 P.M.), but it is hoped to restart the full 24-hour service as soon as the staff are sufficiently trained. I am, Sir, yours faithfully, R. E. PEERS, Secretary, Joint Committee of the King’s Fund and the Voluntary Hospitals Committee.
PUBLIC HEALTH Obstetric
Appointments
in
Receiving
Areas
IN a letter addressed to medical officers of health in the receiving areas on Aug. 25, Sir Arthur MacNalty made it clear that the arrangements for the care of expectant mothers evacuated to their areas were the responsibility of the local supervising, authorities. The maternity work involved, he said, should be under the clinical supervision of an obstetric specialist or specialists, who should be in charge of the maternity unit for complicated cases. These specialists should also act as consultants for antenatal cases of doubt or difficulty, in the treatment of women suffering from serious illnesses of pregnancy, in complicated confinements and in the treatment of puerperal sepsis. He suggested, too, that one or more medical officers with sound obstetric experience might be needed to act
as
residents in the
larger improvised maternity
homes and to assist the specialist in other directions.
The local emergency committees of the British were to be consulted on the
Medical Association matter of
and if obstetric consultants of standing already employed by the authority, their services should be utilised for this work. Local authorities have had time to consider their needs, and the Minister has now asked for their
suitable
personnel,
were
proposals. The officers will be
appointed
and
paid by
the local
taking place.
Outpatient departments are continuing are being reopened at a number of hospitals where they had been temporarily closed. to function and
EPSOM .SALTS MANY observers have studied the cathartic action of MgS04 on the bowel, but several of its features have remained obscure. Clearly the salt, whether in dilute or concentrated solution, induces hypermotility of the gastro-intestinal tract, ’and it is also known that it but it is not certain whether causes secretion ; secretion alone is responsible for the increased bulk or whether transudation also plays a part. In experiments on cats, Lium and Florey noted1 that a single dose of magnesium sulphate, even in isotonic solution, might cause not only one watery motion but a continuance of such motions for some days and after the magnesium has been excreted. A similar effect in man has also been noticed, and is attributed to a slowing of the absorptive capacity of the bowel. Another possibility, that the prolonged action is due to irritation of the intestinal mucosa, was explored histologically by Lium and Florey, but they found no more evidence of irritation with magnesium sulphate than with sodium chloride, although the appearances were consistent with secretory activity. They also tried to determine the action of the magnesium and ordinary salts on defaecation in cats. Magnesiumsulphate solution, in quantity comparable to that which causes purgation when given orally, was injected into the colon through an appendicostomy opening, and the result was a defaecation attributed to the mechanical action of the increased bulk of the intestinal contents. Sodium chloride had no such effect. It was observed also that isotonic magnesium sulphate slowed the absorption of isotonic sodium chloride from the intestine, but did not influence the absorption of glucose solution. The poisonous effect of magnesium sulphate is described by F. E. Byron, who reports2 five cases in which Tamil children, aged 2,’Eto 5 years, died within two hours of single doses of this drug. 1. Lium, R., and Florey, H. W., Quart. J. exp. Physiol. August, 1939, p. 303. 2. Byron, F. E., J. Malaya Branch, Brit. med. Ass. June, 1939, p. 100.
PUBLIC HEALTH
THE BURDEN NEUROLOGICAL INSTITUTE
SiR,-In view of the difficulty that
must be extreatment for cases perienced obtaining inpatient of nervous and early mental disease occurring in evacuation areas I should be glad if you could bring
in
the services offered by the Burden Neurological Institute to the notice of your readers. The institute would be prepared to receive a number of cases of early mental disease for a course of shock therapy, and cases of organic nervous disease including cerebral tumours for investigation and if necessary operation. The institute which was endowed by the late Mrs. Burden is fully equipped both for neurosurgery, shock treatment and :endocrinologic31 in-
vestigation. I am,
Sir, yours faithfully,
authority, the salary scales being based on those of Emergency Hospital Medical Service. Wholetime obstetric specialists (non-resident) will be paid n300 a year, the salary of a group officer. Parttime specialists will be paid a proportion of that salary. Obstetric officers who act as residents either at the hospital unit for complicated maternity cases or at an improvised maternity home will be paid ;tõ50 a year, the salary of a medical officer under the emergency hospital scheme. In some cases two or more authorities may combine and make a joint appointthe
the officer’s time may be divided between The appointments will be for six months in the first instance. A number of them have already been made.
ment,
or
surgical and obstetrical work.
Hospital
F. GOLLA.
Treatment for Non-Casualties
The Minister of Health has taken further steps to generally known amongst the hospitals that patients whose medical condition necessitates inpatient treatment should be immediately admitted. This " reflux " into the normal hospital accommodation was always provided for in the Ministry’s scheme. To meet it, new beds are continually being added, so that on balance the number held in reserve for casualties will not be seriously diminished. The figures received by the Ministry each day from the regional hospital officers show that this is in fact make it
LONDON
VOLUNTARY HOSPITALS GENCY BED SERVICE
EMER-
SiR,-On the outbreak of war, by a prearranged plan the whole staff of this service was taken over by the Ministry of Health as part of the Ministry’s emergency medical service to assist in running the sector casualty bureaus. In consequence, the emergency bed service was closed down. A new staff has now been recruited and the service will reopen forthwith and will endeavour to assist doctors to obtain admission for their acute or emergency patients. In the first instance it will only be possible to run a daytime service (9 A.M. to 10 P.M.), but it is hoped to restart the full 24-hour service as soon as the staff are sufficiently trained. I am, Sir, yours faithfully, R. E. PEERS, Secretary, Joint Committee of the King’s Fund and the Voluntary Hospitals Committee.
PUBLIC HEALTH Obstetric
Appointments
in
Receiving
Areas
IN a letter addressed to medical officers of health in the receiving areas on Aug. 25, Sir Arthur MacNalty made it clear that the arrangements for the care of expectant mothers evacuated to their areas were the responsibility of the local supervising, authorities. The maternity work involved, he said, should be under the clinical supervision of an obstetric specialist or specialists, who should be in charge of the maternity unit for complicated cases. These specialists should also act as consultants for antenatal cases of doubt or difficulty, in the treatment of women suffering from serious illnesses of pregnancy, in complicated confinements and in the treatment of puerperal sepsis. He suggested, too, that one or more medical officers with sound obstetric experience might be needed to act
as
residents in the
larger improvised maternity
homes and to assist the specialist in other directions.
The local emergency committees of the British were to be consulted on the
Medical Association matter of
and if obstetric consultants of standing already employed by the authority, their services should be utilised for this work. Local authorities have had time to consider their needs, and the Minister has now asked for their
suitable
personnel,
were
proposals. The officers will be
appointed
and
paid by
the local
taking place.
Outpatient departments are continuing are being reopened at a number of hospitals where they had been temporarily closed. to function and
EPSOM .SALTS MANY observers have studied the cathartic action of MgS04 on the bowel, but several of its features have remained obscure. Clearly the salt, whether in dilute or concentrated solution, induces hypermotility of the gastro-intestinal tract, ’and it is also known that it but it is not certain whether causes secretion ; secretion alone is responsible for the increased bulk or whether transudation also plays a part. In experiments on cats, Lium and Florey noted1 that a single dose of magnesium sulphate, even in isotonic solution, might cause not only one watery motion but a continuance of such motions for some days and after the magnesium has been excreted. A similar effect in man has also been noticed, and is attributed to a slowing of the absorptive capacity of the bowel. Another possibility, that the prolonged action is due to irritation of the intestinal mucosa, was explored histologically by Lium and Florey, but they found no more evidence of irritation with magnesium sulphate than with sodium chloride, although the appearances were consistent with secretory activity. They also tried to determine the action of the magnesium and ordinary salts on defaecation in cats. Magnesiumsulphate solution, in quantity comparable to that which causes purgation when given orally, was injected into the colon through an appendicostomy opening, and the result was a defaecation attributed to the mechanical action of the increased bulk of the intestinal contents. Sodium chloride had no such effect. It was observed also that isotonic magnesium sulphate slowed the absorption of isotonic sodium chloride from the intestine, but did not influence the absorption of glucose solution. The poisonous effect of magnesium sulphate is described by F. E. Byron, who reports2 five cases in which Tamil children, aged 2,’Eto 5 years, died within two hours of single doses of this drug. 1. Lium, R., and Florey, H. W., Quart. J. exp. Physiol. August, 1939, p. 303. 2. Byron, F. E., J. Malaya Branch, Brit. med. Ass. June, 1939, p. 100.