THE DOCTOR OF THE FUTURE.

511 demonstrations given at, some of the hydropathic centres of the country. Taken in connexion with the work of the British Spa Federation, which includes ’ some of the leading spas complying with a certain standard of efficiency, the lectures are a step towards the organisation of British spas on lines laid down INOCULATION AGAINST MEASLES. by Dr. Fortescue Fox in THE LANCET last year.1 Dr. Arturo Atria, of Santiago de Chile, has writen a These were : (1) the coordination and development of book3 advocating the universal adoption of the practice British waters, under medical authority; (2) postof inoculation against measles. As physician-in-chief graduate lectures in hydrology at the universities ; of the Section of Bacteriology at Santiago and a late (3) facilities at one university for the systematic student of the Pasteur Institute he speaks with a training of hydrologist practitioners. Particulars of certain authority, and he invokes the support of the lectures and demonstrations can be obtained from tradition by giving considerable space to enthusiastic Miss Hilda Fox, care of University Extension Departeulogy of Home, a Scottish physician of the eighteenth ment, University of London, South Kensington, S.W.7. century, who first experimented with inoculation about 1740 on a small scale. Home was certainly an able THE DOCTOR OF THE FUTURE. man, much in advance of his age, but the number of his cases was far too small to admit of any deduction UNDER this title Dr. George E. Vincent, the President being made from the results, and his work is only of of the Rockefeller Foundation, discusses the trend of historical interest. Nor does the amount of work done medical in the United States. At present the since on the same lines come anywhere near to justify- mass of practice the population, " perhaps 75 to 80-per cent., ing the sweeping conclusions arrived at by Dr. Atria. are treated by general practitioners who have limited His attitude may be judged of from the fact that he technical little or no specialisation of skill, speaks of 1150 cases as being a colossal number, and slightappliances, relation to medical services organised in whereas to arrive at any definite judgment we should and clinics." Among the need thousands of cases, carefully observed during a hospitals, dispensaries, forces now at work which will modify the present period of years. No evidence is offered as to how long state of things is the growth of preventive medicine the effects of inoculation last in conferring immunity, which, by reducing sickness, will limit the material nor does the author seem to weigh the very varying for curative practice. The high cost of sickness is degrees of liability in communities and individuals in leading to a demand for insurance. The character of considering such statistics as he has got. Dr. Atria a modern medical education is depleting the rural areas advocates wholesale case-to-case inoculation with the of their physicians. Already four types of doctors blood of individuals at a certain stage in the disease, have emerged from the modern crucible according but he does not face adequately the difficulties and to Dr. who classifies them as follows : dangers of the course that he proposes. Two obvious " (1) the Vincent, doctor who teaches and investiprofessorial ones may be mentioned : (1) As the virus cannot be the specialist ; gates ; (2) (3) the socialised or numbers of cases would from be stored, large required full-time salaried doctor; and (4) the individual, which to inoculate, and there would be a constant risk general practitioner." Can the latter of imparting some other disease, such as syphilis or independent, still the most important numerically, continue type, tubercle. (2) As the constitutional reaction in effecto survive ? he asks, with his increasingly difficult tive cases is presumably more severe than in ordinary While his would be a handicaps. vaccination, very large provision would have to be serious loss, Dr. Vincent disappearance does not look on evidently made for nursing and medical attention if the results it as an impossibility. As conditions of survival he are not to be disastrous. It is a pity that so much in the use of laboratories and time and energy have been expended in advocating postulates cooperation other resources, willingness to take part in insurance can in the state of our what only present knowledge and above all readiness to become a pracThe biblio- schemes, be characterised as wholly premature. titioner of preventive medicine. nor which has neither alphachronological graphy, betical order, shows that a very large number of works has been consulted, but all that is of value in the book THE DIPLOMA IN TROPICAL MEDICINE. might well be compressed into one-tenth of the space IN the Students’ Number of THE LANCET under occupied. this heading it is stated that systematic instruction for these diplomas is given at the London School of BRITISH HYDROLOGY. Tropical Medicine, at 5, Endsleigh-gardens, London, INCREASED attention is being paid to the organisa- N.W. The old London School of Tropical Medicine tion of British spas, which, although differing in now forms the Tropical Division of the London School ranges of altitude and temperature from those abroad, of Hygiene and Tropical Medicine, and the address is do offer in a large number of cases amenities whichi 23, Endsleigh-gardens, Euston-road, N. W. 1, and not only compare favourably with many continental not 5. An account of the activities of the new body spas in the matter of treatment and comfort, but was given in THE LANCET of June 27th, 1925 (p. 1354). also save the expense and inconvenience which foreign travel may mean to many patients. During the war, when continental spas were no longer availSir StClair Thomson has been appointed hon. able to British visitors, and when the indicated consulting laryngologist to the Italian Hospital, treatment for many war victims was that provided London. by baths, the British waters had perforce to be jesorted to, with. the result that a somewhat neglected Dr. T. Vincent Dickinson has been elected Master branch of medical science and practice in this country of the Society of Apothecaries, one of the oldest of received a great impetus. During the past three the City Livery Guilds. years a course of lectures on medical hydrology has been given at the London University, arranged by 1 Vide THE LANCET, 1924, ii., 884, 885. the board to promote the extension of university teaching, and in cooperation with the Committee EXTENSION OF KIDDERMINSTER HOSPITAL.-In for the Study of Medical Hydrology in Great Britain. The fee for the course is ae1, and in the week during commemoration of his silver wedding the Prime Minister which the course is held, usually at the end ofApril has given B5000 towards the .825,000 required for alterations and the beginning of May, visits are made to, and and additions to Kidderminster District General Hospital,

infested countries, since the efficient control of benign tertian malaria is of great importance to British psychiatrists in connexion with the treatment of general paralysis by the Wagner-Jauregg method.I.

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1 THE LANCET, August 22nd, 1925. Profilaxis del Sarampion. By Arturo Atria. La Illustration

Press.

1925.

Pp. 351.

and Mrs. Baldwin recently laid the foundation-stone of the extensions. The scheme embraces an out-patients’

department with consulting room, a dispensary, an operating a new ward for 40 children, and a laundry.

room,