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THE DUNSTABLE TOWN COUNCIL AND THEIR MEDICAL OFFICER OF HEALTH.
249 doubt be only too glad to have their services, for they fully acknowledge the capital work which Mr. Hankin has done in India. It is quite right, of course, that all the moderni methods of scientific research practised in Europe should be, adopted and systematically applied in India, and we have frequently urged that this should be done. But this is not; everything-it is only a means to an end; and we, shall regard it as a distinctly retrograde step and a great injury to the progress of practical hygiene iff India be deprived of its staff of sanitary commissioners. There is, as everybody knows, a great deal of practicalL sanitary work to be done in that country; questions bearing upon public health are constantly arising, and have to be dealt with in a prompt and practical manner ; inspections have to be made, and cannot be dispensed with if even the elementary details of sanitation are to be; attended to and pressed upon the notice of the local government authorities ; and how are these matters to be carried out except by a body of men selected for the purpose ?? ,
,
and Constantinople was a seat of the disease during the last three months of the past year. It is not easy, on the information thus far available, to decide precisely what was the source of the infection in this case, but the persistent continuance of the disease and the large proportion of persons attacked tends rather in the direction of the theory of water pollution ; so, also, does the commencement of the outbreak within a few days after filling up the water tanks at so suspicious a place as Constantinople. Happily, our cholera organisation was instantly on the alert, and all that was necessary was carried out without resort to vexatious
restrictions.
A STUDY OF CHILDHOOD.
EVERY ONE who has read Professor Sully’s" Studies of Childhood " must acknowledge the American child to be a subject worthy of study. But the following delicious production which we received from the medical man to whom it was sent shows, we think, that the child mind in this country is equally interesting. The letter is written upon small pink paper, ornamented with a picture of a pony, THE CHITRAL CAMPAIGN. and we transcribe it verbatim, omitting only names and THE wars and rumours of wars and the rapid succession addresses :of incidents that have occurred of late of a more or less " Dear Dr. -,-I would be very pleased if you would exciting and unexpected character have tended to diminish, let me have a Baby for one guinea. We want it on The 4th but not to obliterate, the impression which the dramatic series of Febry for Mother’s birthday. We would like it fat and of exploits connected with the Chitral campaign made upon Bonny, with blue eyes and fair hair. We Children are going the public mind. It was, altogether, an expedition in which to give it to her ourselves please answer at once.-Yours the European and native armies of India did excellent and sincerely, ARCHIE -." P.S.-Which would be the cheaper a Boy or a Girl? " brilliant service and dispiayed a spirit of pluck and fortitude of which any nation might feel proud. The nature and We commend this to the notice of Professor Sully. The variety of the incidents and the difficulties that were so P.S. is delightful, and who is there shall answer the manfully encountered and overcome in the siege and relief !, momentous question? The age of the writer-the eldest of Chitral were well calculated to excite the imagination, child-we may add, is seven ; and the letter, except for and their history makes up a fine page in the military certain paternal instructions as to spelling, given without records of India. We are glad to say that the medical seeing the letter, is the unaided composition of "we service took a worthy and important part in that campaign, children." We are honoured with the acquaintance of and we sincerely congratulate those of its members whose a young lady aged five who one day remarked, "Father, services have been recognised by Her Majesty and whose dear, why is our baby such an unpleasant, common little thing?" but this only shows from what different names appear in the list of honours and rewards published in the London Gazette. Surgeon-Major-General Thomas points of view children may look at the same thing. We Maunsell of the Army Medical Staff and Surgeon-Colonel fear that these children have not been instructed by George Thomson of the Indian Medical Service are made "Baby Buds," or they would know that babies are not procurable by the mercenary method suggested by their Companions of the Bath in the Military Division. letter, but it shows that the real child is still with us.
CHOLERA-INFECTED VESSEL AT HOLYHEAD. THE steamship Garlands came into Holyhead on the 15th instant under stress of weather with the yellow flag flying. It then transpired that she came from the Black Sea with a crew of twenty-three men, and took -in water at Constantinople. Four days after leaving Constantinople sickness set in, and by Jan. llth there had been about ten cases of so-called severe diarrhoea, besides three of undoubted cholera, two of which had terminated fatally. The last death took place on Jan. llth. Directly information as to the arrival of the vessel reached the Local Government Board, Dr. Theodore Thomson of the medical department was instructed to travel down by night mail; and on his arrival he, in cooperation with the medical officer of health and the deputy health officer and sanitary officials, advised as to additional measures of precaution and of disinfection. Several days having elapsed without any recurrence of illness amongst the crew, and no one being desirous of landing, the vessel was then, under the orders of the Local Government Board, free to continue her voyage to her destination-namely, Barrow-in-Furness. This incident shows that we are by no means free from the risk of a re-importation of cholera into this country. Russia is still somewhat widely affected by the disease, Asia Minor and the Levant are infected, Egypt is not yet clear of infection,
THE
DUNSTABLE TOWN COUNCIL AND THEIR MEDICAL OFFICER OF HEALTH.
SOME members of the town council of Dunstable have odd notions as to the post of medical officer of health. When the late health officer’s term of one year for which he had been elected came to an end, the town council met to fill up the vacancy, and then some curious views were enunciated. One councillor said that as there were several medical practitioners in the town "the office ought to be shared all round "-in other words, it ought first to be bestowed on one and then on another. This view received support even from one who had reached the responsible position of an alderman. This gentleman did not care whether the appointment was made for one year or for five, but he did hold that the office should be 11 fairy shared in rotation." It is hardly conceivable that those who are presumably men of business and experience, and who are acquainted with the public matters with which they have to deal, can enunciate such a doctrine as this. Do these their or those who, in other gentlemen change managers have of their once interests capacities, charge every year or every five years, so as to give every other suitable person in the town a turn ? Do they by any chance turn out their legal adviser every year ? It is, indeed, the first time
250 we ever heard such views expressed, and we are certain that if e:Eect were given to them the damage done to those great interests which are involved in public health questions would be irretrievable. But the alderman announced that the post of medical officer of health was a sinecure, and this is, we expect, the secret of the curious views which are held by If this post is ever a some of the notabilities of Dunstable. sinecure we must blame the miserable salary which is intended to serve as a hint that no work is expected or wanted, or the fact that the medical officer of health never receives the support of his council when he advises as to action that should be taken. What the precise cause of the alleged nuisance is in Dunstable we do not know, and, since the Mayor and Mr. Councillor Perkins did their best to save the reputation of the council, we need not inquire whether the statement is correct or the reverse. The former urged the reappointment of the present officer, and the latter pertinently asked whether people usually discharged their servants just as they became accustomed to their work, and in the end the council were unanimous in re-electing Mr. Morcom for one year only.
of these invalid settlers was only what might have beeo expected under their greatly improved vital conditions. Their efficiency as cultivators afforded the most gratifying proof of this improvement, and the fact that the attainment of these desirable ends was found to be compatible with a noteworthy economy in expenditure ought to reassure any who may still be disposed to doubt the wisdom of aiding with their means this new departure in the treatment of disease. We feel confident, therefore, in supporting th: appeal issued a few days ago on behalf of our national colony by the chairman of the executive committee. A sum of Z1200 received up to the date of that request has been found altogether inadequate to the purposes which the committee have in view. It certainly seems exceedingly meagre compared with the annual subsidy of .630,000 allotted to Bielefeld in a much less wealthy country than our own. We feel assured that the present difficulty need only be mentioned in connexion with a work so deserving and so fruitful of good as we have shown this to be in order to open more widely the justly-generous purse of the British public. BOILER EXPLOSIONS.
THE LONDON POST-GRADUATE COURSE.
OUR remarks upon the Board of Trade report on boiler DURING the spring term, which will commence on issued about this time last year, apply with-fresh, explosions, Monday, Feb. 3rd, there will be classes at Moorfields (Eye), and even greater, force to the report just recently issued. In Blackfriars (Skin), Bethlem (Mind), Great Portland-street the report issued in 1895 the total number of boiler explosions (Throat, Nose, and Ear), King’s College (Bacteriology), was 104, of which 21 occurred in the case of Cleveland-street (General Medicine and Surgery), Parkes investigated domestic heating apparatus. In the report now before us the Museum (Public Health and Hygiene), and at the Institute of total number of explosions investigated was 114, of which 27
Preventive Medicine (Urine Testing). The hours at which the lectures are to be given will all be in the afternoon and evening, so that the practitioner can attend. The fees are payable for single courses, and are from 1 to 3 guineas each. Early entries are desirable so that the classes may be formed. During 1895 nearly 200 practitioners attended. They came from all parts of the Empire and from the most distant countries of the world. A central building, which would naturally aid in the organisation and multiplication of the classes and extension of the work, has become a necessity and is in contemplation. Entries will be received by Dr. Fletcher Little, secretary, 32, Harley-street, W. OUR EPILEPTIC COLONY.
COMMONLY the accepted gauge of success in colonising is the measure of commercial profit. There is, however, one exception to this rule. It is the case in which the colonists Establishments like those of Bielefeld, Chalare epileptic. the American and font, colony in Tennessee must be judged In them the return from land, or standard. another by even from work, is not calculated in money alone..This form of advantage, indeed, is not forgotten, but it is not The farm is before the one or even the first consideration. all things a training school designed and administered It is a hospital planted out in on sanitary principles. cottage fashion, partly self-supporting, but mainly dependent, as it needs must be, upon public or private charity. It is chiefly as a therapeutic enterprise that it now claims our attention. Viewed in this light it possesses a great and peculiar interest. Furthermore it is only necessary to examine the reports published from time to time respecting the German institution which forms the prototype of its class in order to prove success by the results of wise and careful treatment. The respectful flattery of imitation has not been wanting to it, and the work done for thirty years in a Westphalian village has been reproduced on a varying scale not only in Germany itself, but in Great Britain, America, Holland, and Switzerland. In THE LANCET of Nov. 17th, 1894, we published a detailed account of the epileptic colony recently founded at Chalfont, in Buckinghamshire. The marked improvement in the health
due to domestic heating appliances ; so that the number of cases inquired into shows a small increase upon the number recorded in the preceding year, while the number of persons killed and injured is larger than in any year since the Boiler Explosions Act came into force. This increase, however, was due to some exceptionally serious accidents at industrial works, and an unusual number of domestic boiler explosions consequent upon a prolonged period of severe frost. The latter accidents were, in the main, the result of undue pressure in the boiler arising from the freezing of the water in some part of the apparatus. The lesson is taught afresh, therefore, of the need of measures to prevent such occurrences. We believe this would be amply met by the use of a safety-valve placed in a convenient and accessible recess so as to permit of inspection and testing from time to time. So far the present winter has, happily, not been very severe, and should it continue without a " cold snapsuch as we experienced in the previous season we may hope to find a complete absence of accidents and disasters in the next Board of Trade report. But then, such a satisfactory result ought to serve as a lesson of equal force as when disaster happens, and it must be borne in mind that the foretelling of weather is not at present an exact science.
were
THE SMALL-POX EPIDEMIC AT GLOUCESTER. THE Gloucester Board of Guardians, who do not enforce the Vaccination Acts, discussed at their meeting last weeka minute of a special meeting of the sanitary committee of the City Council, which stated that the number of cases of small-pox in the Infectious Diseases Hospital was thirty-six, that others had been notified, and urged that vaccination should be enforced as the only means of staying the epidemic. After a long discussion the board passed a resolution recommending parents to have their unvaccinated children immediately operated upon, and stating where this vaccination and the revaccination of adults would be performed. The action of the sanitary committee was influenced in an effective manner by the resolutions passed at a meeting of the members of the medical profession of Gloucester held on the 16th inst., on the invitation of the committee to advice
,
and Constantinople was a seat of the disease during the last three months of the past year. It is not easy, on the information thus far available, to decide precisely what was the source of the infection in this case, but the persistent continuance of the disease and the large proportion of persons attacked tends rather in the direction of the theory of water pollution ; so, also, does the commencement of the outbreak within a few days after filling up the water tanks at so suspicious a place as Constantinople. Happily, our cholera organisation was instantly on the alert, and all that was necessary was carried out without resort to vexatious
restrictions.
A STUDY OF CHILDHOOD.
EVERY ONE who has read Professor Sully’s" Studies of Childhood " must acknowledge the American child to be a subject worthy of study. But the following delicious production which we received from the medical man to whom it was sent shows, we think, that the child mind in this country is equally interesting. The letter is written upon small pink paper, ornamented with a picture of a pony, THE CHITRAL CAMPAIGN. and we transcribe it verbatim, omitting only names and THE wars and rumours of wars and the rapid succession addresses :of incidents that have occurred of late of a more or less " Dear Dr. -,-I would be very pleased if you would exciting and unexpected character have tended to diminish, let me have a Baby for one guinea. We want it on The 4th but not to obliterate, the impression which the dramatic series of Febry for Mother’s birthday. We would like it fat and of exploits connected with the Chitral campaign made upon Bonny, with blue eyes and fair hair. We Children are going the public mind. It was, altogether, an expedition in which to give it to her ourselves please answer at once.-Yours the European and native armies of India did excellent and sincerely, ARCHIE -." P.S.-Which would be the cheaper a Boy or a Girl? " brilliant service and dispiayed a spirit of pluck and fortitude of which any nation might feel proud. The nature and We commend this to the notice of Professor Sully. The variety of the incidents and the difficulties that were so P.S. is delightful, and who is there shall answer the manfully encountered and overcome in the siege and relief !, momentous question? The age of the writer-the eldest of Chitral were well calculated to excite the imagination, child-we may add, is seven ; and the letter, except for and their history makes up a fine page in the military certain paternal instructions as to spelling, given without records of India. We are glad to say that the medical seeing the letter, is the unaided composition of "we service took a worthy and important part in that campaign, children." We are honoured with the acquaintance of and we sincerely congratulate those of its members whose a young lady aged five who one day remarked, "Father, services have been recognised by Her Majesty and whose dear, why is our baby such an unpleasant, common little thing?" but this only shows from what different names appear in the list of honours and rewards published in the London Gazette. Surgeon-Major-General Thomas points of view children may look at the same thing. We Maunsell of the Army Medical Staff and Surgeon-Colonel fear that these children have not been instructed by George Thomson of the Indian Medical Service are made "Baby Buds," or they would know that babies are not procurable by the mercenary method suggested by their Companions of the Bath in the Military Division. letter, but it shows that the real child is still with us.
CHOLERA-INFECTED VESSEL AT HOLYHEAD. THE steamship Garlands came into Holyhead on the 15th instant under stress of weather with the yellow flag flying. It then transpired that she came from the Black Sea with a crew of twenty-three men, and took -in water at Constantinople. Four days after leaving Constantinople sickness set in, and by Jan. llth there had been about ten cases of so-called severe diarrhoea, besides three of undoubted cholera, two of which had terminated fatally. The last death took place on Jan. llth. Directly information as to the arrival of the vessel reached the Local Government Board, Dr. Theodore Thomson of the medical department was instructed to travel down by night mail; and on his arrival he, in cooperation with the medical officer of health and the deputy health officer and sanitary officials, advised as to additional measures of precaution and of disinfection. Several days having elapsed without any recurrence of illness amongst the crew, and no one being desirous of landing, the vessel was then, under the orders of the Local Government Board, free to continue her voyage to her destination-namely, Barrow-in-Furness. This incident shows that we are by no means free from the risk of a re-importation of cholera into this country. Russia is still somewhat widely affected by the disease, Asia Minor and the Levant are infected, Egypt is not yet clear of infection,
THE
DUNSTABLE TOWN COUNCIL AND THEIR MEDICAL OFFICER OF HEALTH.
SOME members of the town council of Dunstable have odd notions as to the post of medical officer of health. When the late health officer’s term of one year for which he had been elected came to an end, the town council met to fill up the vacancy, and then some curious views were enunciated. One councillor said that as there were several medical practitioners in the town "the office ought to be shared all round "-in other words, it ought first to be bestowed on one and then on another. This view received support even from one who had reached the responsible position of an alderman. This gentleman did not care whether the appointment was made for one year or for five, but he did hold that the office should be 11 fairy shared in rotation." It is hardly conceivable that those who are presumably men of business and experience, and who are acquainted with the public matters with which they have to deal, can enunciate such a doctrine as this. Do these their or those who, in other gentlemen change managers have of their once interests capacities, charge every year or every five years, so as to give every other suitable person in the town a turn ? Do they by any chance turn out their legal adviser every year ? It is, indeed, the first time
250 we ever heard such views expressed, and we are certain that if e:Eect were given to them the damage done to those great interests which are involved in public health questions would be irretrievable. But the alderman announced that the post of medical officer of health was a sinecure, and this is, we expect, the secret of the curious views which are held by If this post is ever a some of the notabilities of Dunstable. sinecure we must blame the miserable salary which is intended to serve as a hint that no work is expected or wanted, or the fact that the medical officer of health never receives the support of his council when he advises as to action that should be taken. What the precise cause of the alleged nuisance is in Dunstable we do not know, and, since the Mayor and Mr. Councillor Perkins did their best to save the reputation of the council, we need not inquire whether the statement is correct or the reverse. The former urged the reappointment of the present officer, and the latter pertinently asked whether people usually discharged their servants just as they became accustomed to their work, and in the end the council were unanimous in re-electing Mr. Morcom for one year only.
of these invalid settlers was only what might have beeo expected under their greatly improved vital conditions. Their efficiency as cultivators afforded the most gratifying proof of this improvement, and the fact that the attainment of these desirable ends was found to be compatible with a noteworthy economy in expenditure ought to reassure any who may still be disposed to doubt the wisdom of aiding with their means this new departure in the treatment of disease. We feel confident, therefore, in supporting th: appeal issued a few days ago on behalf of our national colony by the chairman of the executive committee. A sum of Z1200 received up to the date of that request has been found altogether inadequate to the purposes which the committee have in view. It certainly seems exceedingly meagre compared with the annual subsidy of .630,000 allotted to Bielefeld in a much less wealthy country than our own. We feel assured that the present difficulty need only be mentioned in connexion with a work so deserving and so fruitful of good as we have shown this to be in order to open more widely the justly-generous purse of the British public. BOILER EXPLOSIONS.
THE LONDON POST-GRADUATE COURSE.
OUR remarks upon the Board of Trade report on boiler DURING the spring term, which will commence on issued about this time last year, apply with-fresh, explosions, Monday, Feb. 3rd, there will be classes at Moorfields (Eye), and even greater, force to the report just recently issued. In Blackfriars (Skin), Bethlem (Mind), Great Portland-street the report issued in 1895 the total number of boiler explosions (Throat, Nose, and Ear), King’s College (Bacteriology), was 104, of which 21 occurred in the case of Cleveland-street (General Medicine and Surgery), Parkes investigated domestic heating apparatus. In the report now before us the Museum (Public Health and Hygiene), and at the Institute of total number of explosions investigated was 114, of which 27
Preventive Medicine (Urine Testing). The hours at which the lectures are to be given will all be in the afternoon and evening, so that the practitioner can attend. The fees are payable for single courses, and are from 1 to 3 guineas each. Early entries are desirable so that the classes may be formed. During 1895 nearly 200 practitioners attended. They came from all parts of the Empire and from the most distant countries of the world. A central building, which would naturally aid in the organisation and multiplication of the classes and extension of the work, has become a necessity and is in contemplation. Entries will be received by Dr. Fletcher Little, secretary, 32, Harley-street, W. OUR EPILEPTIC COLONY.
COMMONLY the accepted gauge of success in colonising is the measure of commercial profit. There is, however, one exception to this rule. It is the case in which the colonists Establishments like those of Bielefeld, Chalare epileptic. the American and font, colony in Tennessee must be judged In them the return from land, or standard. another by even from work, is not calculated in money alone..This form of advantage, indeed, is not forgotten, but it is not The farm is before the one or even the first consideration. all things a training school designed and administered It is a hospital planted out in on sanitary principles. cottage fashion, partly self-supporting, but mainly dependent, as it needs must be, upon public or private charity. It is chiefly as a therapeutic enterprise that it now claims our attention. Viewed in this light it possesses a great and peculiar interest. Furthermore it is only necessary to examine the reports published from time to time respecting the German institution which forms the prototype of its class in order to prove success by the results of wise and careful treatment. The respectful flattery of imitation has not been wanting to it, and the work done for thirty years in a Westphalian village has been reproduced on a varying scale not only in Germany itself, but in Great Britain, America, Holland, and Switzerland. In THE LANCET of Nov. 17th, 1894, we published a detailed account of the epileptic colony recently founded at Chalfont, in Buckinghamshire. The marked improvement in the health
due to domestic heating appliances ; so that the number of cases inquired into shows a small increase upon the number recorded in the preceding year, while the number of persons killed and injured is larger than in any year since the Boiler Explosions Act came into force. This increase, however, was due to some exceptionally serious accidents at industrial works, and an unusual number of domestic boiler explosions consequent upon a prolonged period of severe frost. The latter accidents were, in the main, the result of undue pressure in the boiler arising from the freezing of the water in some part of the apparatus. The lesson is taught afresh, therefore, of the need of measures to prevent such occurrences. We believe this would be amply met by the use of a safety-valve placed in a convenient and accessible recess so as to permit of inspection and testing from time to time. So far the present winter has, happily, not been very severe, and should it continue without a " cold snapsuch as we experienced in the previous season we may hope to find a complete absence of accidents and disasters in the next Board of Trade report. But then, such a satisfactory result ought to serve as a lesson of equal force as when disaster happens, and it must be borne in mind that the foretelling of weather is not at present an exact science.
were
THE SMALL-POX EPIDEMIC AT GLOUCESTER. THE Gloucester Board of Guardians, who do not enforce the Vaccination Acts, discussed at their meeting last weeka minute of a special meeting of the sanitary committee of the City Council, which stated that the number of cases of small-pox in the Infectious Diseases Hospital was thirty-six, that others had been notified, and urged that vaccination should be enforced as the only means of staying the epidemic. After a long discussion the board passed a resolution recommending parents to have their unvaccinated children immediately operated upon, and stating where this vaccination and the revaccination of adults would be performed. The action of the sanitary committee was influenced in an effective manner by the resolutions passed at a meeting of the members of the medical profession of Gloucester held on the 16th inst., on the invitation of the committee to advice