THE DANGERS OF THE PUBLIC SWIMMING BATH.

779 baths in the previous week, and earache on July 30th, followed by vomiting on the two next days. There were well-marked signs of meningitis when admitted, prejudice confirmed by lumbar puncture. a strepto-bacillus future negotiations and alienate the goodwill of those found in the spinal fluid. Death occurred practitioners whose cooperation is essential to the success being Post-mortem showed pus in on August 5th. early service. the of the left middle ear with unruptured drum and an " Representing, as we do, many distinct branches acute lepto-meningitis. The lad was not accustomed of medical practice and of professions ancillary to to go to the baths and, perhaps, lacked an immunity medicine, we have considered this matter from widely more frequent visitors might possess. before us the of ever needs different angles, keeping a hot summer, like the past, the numbers During the community, to which our individual aspirations of bathers are multiplied many times, and the urgency subordinated. are willingly for frequent change of water and its purification is (Signed) proportionally increased. H. W. BRUCE, BERKELEY MOYNIHAN, I am, Sir, yours faithfully, President. Infirmary Medical SuperinG. W. LLOYD. Oct. 4th, 1921. tendents Society. MALCOLM MORRIS, H. J. CARDALE, of Vice-President and Rept. To the Editor of THE LANCET. ComAssoc. of Panel the National Council for mittees. Combating Venereal SIR,-Acting upon Dr. F. W. Alexander’s suggesF. HERNAMAN-JOHNSON, Diseases. I have turned to the Report of the Royal tion, RadioBritish Assoc. of THOMAS HORDER, logy and Physiotherapy. Sanitary Institute for information regarding the Hon. Treasurer. C. F. RILOT, system employed at the Poplar baths for making J. F. GORDON DILL, British Dental Assoc. and keeping bath-water pure, and I find that the Hon. Treasurer. RONALD RoSS, bacterial content of the water may be kept within CHARLES BUTTAR, British Science Guild. what may be considered to be the limits of safety Hon. Secretary. E. H. STANCOMB, for as long a period as a week or ten days at a cost, JANE WALKER, Medical Southampton Hon. Secretary. in 1912, of, apparently, about one shilling and threeComParliamentary mittee. JOHN ROSE BRADFORD, pence ! Dr. J. Graham Forbes in his interesting E. H. WORTH, London and Counties Med. of the methods of disinfecting the water survey Protection Society. National Medical Union. alludes to the plan as giving good results. Surely, " Postscript.-The signatories of this memorandum then,- if this claim can be substantiated the bathing represent organisations with a combined membership public has the right to ask why this or similar methods exceeding 16,000. In addition, a number of other are not everywhere in use. medical societies represented in the Federation still In my former letter I drew attention to the danger have the matter under consideration and a majority of purulent otitis media as a result of bathing in conof the professional bodies representative of pharmacy, taminated water. But my indictment does not stop all at the ear. Since writing that letter I have seen a nursing, midwifery, massage, radiography, &c., of whom are members of the Federation and intimately case of- suppuration of the maxillary aritrum in a concerned with the matter, have expressed a wish schoolboy, which the parents ascribed to the same to subscribe to the memorandum, which, accordingly, cause, and this case reminds me that some years ago has been submitted to their executives. These further Mr. C. W. M. Hope1 brought before the Laryngonames in support of those given will be forwarded logical Section of the Royal Society of Medicine at an early date as a supplementary list." several cases of nasal sinus suppuration which he I am, Sir, yours faithfully, attributed to infection received during bathing. N. HOWARD MUMMERY, While, however, it is but common sense to insist General Secretary. that the water people bathe in should be made as The Federation of Medical and Allied Societies (Inc.), clean as possible, the alternative hypothesis of self12, Stratford-place, W. 1, Oct. 4th, 1921. infection must not be lost sight of. And in this connexion Dr. Arnold Renshaw, of Manchester, has THE MARRIAGE BAR. pointed out to me that the chilling effect upon the To the Editor of THE LANCET. bather of too prolonged a stay in the water must SIR,-In an interesting report in your issue of operate powerfully in favouring auto-infection-and this week you draw attention to the action of the extraneous infection also for that matter. Is it too Borough Council of St. Pancras in requesting one of much to ask that a rule should be laid down limiting its medical officers to send in her resignation because the period of stay in a public bath ? As most of the she has recently married. Allow me to point out cases one sees of ear and nose troubles due to this that the Sex Disqualification (Removal) Act, 1919, cause occur in children, the rule might be confined enacts that: " A person shall not be disqualified by to bathers below a certain age. I am, Sir, yours faithfully, sex or marriage from the exercise of any public DAN MCKENZIE. function or from being appointed to or holding any Wimpole-street, W., Oct. 3rd, 1921. civil or judicial office or post, or from entering or assuming or carrying on any civil profession or THE NEGLECT OF SURGICAL ANATOMY. vocation, or for admission to any incorporated To the Editor of THE LANCET. society .... and a person shall not be exempted by sex or marriage from the liability to serve as a SIR,-In his interesting and very important paper in your last issue on a form of injury in the region juror." One or two qualifying provisions follow which of the ankle-joint, Sir W. Arbuthnot Lane lets the have no bearing on the St. Pancras case. fault-of improper comprehension and inefficient I am, Sir, yours faithfully, treatment-rest, " not with the surgeon, but with MARY D. STURGE, the teacher." The teacher to whom he refers in this Oct. lst, 1921. President of the Medical Women’s disparagement is, of course, the teacher of surgical Federation. anatomy, and the context"leaves the impression that his inefficiency is in some way the fault of the teachers THE DANGERS OF THE PUBLIC SWIMMING of anatomy. This would not appear to be quite just, from the point of view of the anatomists, who BATH. might very well argue that it is their function to To the Editor of THE LANCET. teach anatomy, while it is that of the surgeon to SIR,-In the last three years we have had several teach the surgical application of anatomy. So far cases of otitis media in Camberwell Infirmary, as the mechanics of the skeleton are concerned, this following visits to public swimming baths. On comes in, naturally, in ordinary teaching in the August 2nd of the present year, M. S., aged 19, 1 was admitted with a history of three visits to the Hope, C. W. M., Journ. of Laryng., vol. xxix., 1914, p. 507.

(4) A reduction of the present capitation fee medical practitioners is reported to be imminent. such reduction made before full inquiry has been past results and future requirements, would tend to

of panel But, any held into

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