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THE EICHHOLZ CLINIC
848 The transverse fractures should be in put plaster a Cotton position. If Mr. Holzman prefers a Carr’s splint to plaster, has he made sure that his splints have a proper groove cut in the shaft for some two inches or so proximal to the grip crossbar This groove allows pressure to be put by means of a dorsal pad and strapping on the short mobile lower fragment, thus preventing any tendency to backward slip or tilt. Why must these fractures be still subjected to the much vaunted but dangerous early massage and movementsIt has been shown in the large fracture clinics of Mr. Harry Platt and Mr. Watson Jones that in parallel series of cases the movement returns just as well in cases treated entirely by splinting till the fracture be united as where time and money have been spent in early massage. Anyone who has treated a fractured scaphoid of the wrist for three months in plaster will know that good bony union will take place with early return of wrist function. or
massage.
THE EICHHOLZ CLINIC
in
T
am
qir
"U"()llrR
faitiH
G. O. TIPPETT, F.R.C.S.
To the Editor
of
There are sighted medical supervisors and fully qualified sighted sisters and the very complete equipment for electrotherapy has been specially designed for the use of blind operators. Apart from its interest as a useful service to the medical profession, it has claims on all who would like to encourage a body of men and women whose otherwise sombre lives are being brightened by the opportunity of doing really useful work. The clinic is lodged at 204, Great Portland-street,
W.1.
I am,
Sir,
yours
Devonshire-street, W., Oct. 1st. Oct.1st.
THE
UBIQUITOUS COLD
To the Editor
of
THE UREA-CLEARANCE TEST
To the Editor
SIR,-I have read with interest the letter of Dr. Gordon Tippett on this perennial subject. But is there any problem and is not our profession doing and has it not done its best ? We know the nature, the bacteriology, and the prevention of the common cold, but where we fail is in impressing upon that Public which is always clamouring for a panacea and gibing at the doctor because he cannot "curt a cold, that the evil is in itself and not in the physician. One might well paraphrase Cassius and say :"
our
art,
How many members of the public ever think of secluding themselves during the acute stage of a cold and so preventing the infection of others ? They go about in trains, buses, trams, and places of amusement distributing droplet infections with a prodigality worthy of a better cause. They send their children to school heavy with infection to mow down their school-fellows. Even masters will not scruple to infect their classes. Last year, at the request of the headmaster of one of our greatest schools, I gave an address at a parents’ meeting upon colds, and I spoke very plainly. But I seem to have made no impression, for this term sees a large percentage of the boys distributing the mixture (of infection) as before, and when it is remembered that one boy can infect a whole classroom during one period of half an hour, one realises the crass foolishness doctors have to fight. I suppose that a headmaster who dared to issue a notice that any boy sent to school in the acute stage of a cold would be sent home at once would be in the nature of a hero, but he might find himself a martyr. The public must be made to take precautions before anything, and, incidently, the hundreds of nostrums sold by chemists as "sure preventives should be severely dealt with. To those who would argue that my contention that the public is at the root of the evil will not " stop " the original first cold, I would answer that the individual cold may not always be preventable, but we could at least abolish mass-production. I am, Sir, vours faithfullv. MACLEOD YEARSLEY. "
Harley-street, W., Oct. 9th.
faithfully, MOYNIHAN,
Chairman of Medical Advisory Board.
THE LANCET
The fault, dear Public, is not in But in yourselves.
THE LANCET
SiR,—May I beg the hospitality of your columns to invite members of the medical profession to visit the Alfred Eichholz Memorial Clinic which was opened in July by the Prince of Wales It is unique among clinics inasmuch as it is staffed by blind masseurs and masseuses whose very blindness appears to be an aid, rather than a disability, in the development of tactile sensibility.
of THE LANCET estimating kidney function
SiR,-The method of described by Dr. McClure and Mr. Stewart in your issue of Sept. 22nd consists in essence of plotting, in three dimensions, log U, log V, and B, as found by observation on normal individuals under different conditions, thus forming a surface in three dimensions ; the condition of normality is then, that log U, log V, and B as determined on any particular subject should give a point on this normal surface. Actually they project this surface, cut at different levels of B, on the U-V plane, thus obtaining a series of curves on this plane. This method, which does not postulate any particular relationship between U, V, and B, is theoretically perfect, but in practice, I think, it is not so valuable ; for in any particular instance it shows what B the patient would have, were he normal, and this is then contrasted with B as actually found by observation on the patient. This will readily show whether the kidney is normal or subnormal, but if the latter, no numerical expression for the efficiency can be obtained. Van Slyke claims, however, that the figures he obtained for U, V, and B do correspond to a simple relationship, and as a result a numerical expression of efficiency is easily found. I agree with the writers that a graphic method of evaluating the result is simpler than an algebraic, and such a graphic method is elaborated in Peters and Van Slyke : Quantitative Clinical Chemistry, Vol. II. (Methods), p. 566 et seq. I am, Sir, yours faithfully, Glenmore-road, N.W., Oct. 1st.
E. HINDEN.
PUBLIC ASSISTANCE NURSING OF CHRONIC CASES.The Essex public assistance committee has adopted a scheme designed to establish in the committee’s institutions a type of attendant to deal exclusively with chronic cases. Assistant nurses " are to have a two years’ course of training and to be paid E30 for the first and £ 35 for the second year. passing an examination at the end of the course and agreeing to remain in the council’s service for at least a year they will be awarded special certificates and appointed to permanent pensionable posts at a salary of £ 55 rising by increments of f2lox. to E65 a year. They are to be trained by a sister-tutor with a salary of S150, rising by increments of 10 to 180. The scheme has been submitted to the Ministry of Health for approval. "
Upon
massage.
THE EICHHOLZ CLINIC
in
T
am
qir
"U"()llrR
faitiH
G. O. TIPPETT, F.R.C.S.
To the Editor
of
There are sighted medical supervisors and fully qualified sighted sisters and the very complete equipment for electrotherapy has been specially designed for the use of blind operators. Apart from its interest as a useful service to the medical profession, it has claims on all who would like to encourage a body of men and women whose otherwise sombre lives are being brightened by the opportunity of doing really useful work. The clinic is lodged at 204, Great Portland-street,
W.1.
I am,
Sir,
yours
Devonshire-street, W., Oct. 1st. Oct.1st.
THE
UBIQUITOUS COLD
To the Editor
of
THE UREA-CLEARANCE TEST
To the Editor
SIR,-I have read with interest the letter of Dr. Gordon Tippett on this perennial subject. But is there any problem and is not our profession doing and has it not done its best ? We know the nature, the bacteriology, and the prevention of the common cold, but where we fail is in impressing upon that Public which is always clamouring for a panacea and gibing at the doctor because he cannot "curt a cold, that the evil is in itself and not in the physician. One might well paraphrase Cassius and say :"
our
art,
How many members of the public ever think of secluding themselves during the acute stage of a cold and so preventing the infection of others ? They go about in trains, buses, trams, and places of amusement distributing droplet infections with a prodigality worthy of a better cause. They send their children to school heavy with infection to mow down their school-fellows. Even masters will not scruple to infect their classes. Last year, at the request of the headmaster of one of our greatest schools, I gave an address at a parents’ meeting upon colds, and I spoke very plainly. But I seem to have made no impression, for this term sees a large percentage of the boys distributing the mixture (of infection) as before, and when it is remembered that one boy can infect a whole classroom during one period of half an hour, one realises the crass foolishness doctors have to fight. I suppose that a headmaster who dared to issue a notice that any boy sent to school in the acute stage of a cold would be sent home at once would be in the nature of a hero, but he might find himself a martyr. The public must be made to take precautions before anything, and, incidently, the hundreds of nostrums sold by chemists as "sure preventives should be severely dealt with. To those who would argue that my contention that the public is at the root of the evil will not " stop " the original first cold, I would answer that the individual cold may not always be preventable, but we could at least abolish mass-production. I am, Sir, vours faithfullv. MACLEOD YEARSLEY. "
Harley-street, W., Oct. 9th.
faithfully, MOYNIHAN,
Chairman of Medical Advisory Board.
THE LANCET
The fault, dear Public, is not in But in yourselves.
THE LANCET
SiR,—May I beg the hospitality of your columns to invite members of the medical profession to visit the Alfred Eichholz Memorial Clinic which was opened in July by the Prince of Wales It is unique among clinics inasmuch as it is staffed by blind masseurs and masseuses whose very blindness appears to be an aid, rather than a disability, in the development of tactile sensibility.
of THE LANCET estimating kidney function
SiR,-The method of described by Dr. McClure and Mr. Stewart in your issue of Sept. 22nd consists in essence of plotting, in three dimensions, log U, log V, and B, as found by observation on normal individuals under different conditions, thus forming a surface in three dimensions ; the condition of normality is then, that log U, log V, and B as determined on any particular subject should give a point on this normal surface. Actually they project this surface, cut at different levels of B, on the U-V plane, thus obtaining a series of curves on this plane. This method, which does not postulate any particular relationship between U, V, and B, is theoretically perfect, but in practice, I think, it is not so valuable ; for in any particular instance it shows what B the patient would have, were he normal, and this is then contrasted with B as actually found by observation on the patient. This will readily show whether the kidney is normal or subnormal, but if the latter, no numerical expression for the efficiency can be obtained. Van Slyke claims, however, that the figures he obtained for U, V, and B do correspond to a simple relationship, and as a result a numerical expression of efficiency is easily found. I agree with the writers that a graphic method of evaluating the result is simpler than an algebraic, and such a graphic method is elaborated in Peters and Van Slyke : Quantitative Clinical Chemistry, Vol. II. (Methods), p. 566 et seq. I am, Sir, yours faithfully, Glenmore-road, N.W., Oct. 1st.
E. HINDEN.
PUBLIC ASSISTANCE NURSING OF CHRONIC CASES.The Essex public assistance committee has adopted a scheme designed to establish in the committee’s institutions a type of attendant to deal exclusively with chronic cases. Assistant nurses " are to have a two years’ course of training and to be paid E30 for the first and £ 35 for the second year. passing an examination at the end of the course and agreeing to remain in the council’s service for at least a year they will be awarded special certificates and appointed to permanent pensionable posts at a salary of £ 55 rising by increments of f2lox. to E65 a year. They are to be trained by a sister-tutor with a salary of S150, rising by increments of 10 to 180. The scheme has been submitted to the Ministry of Health for approval. "
Upon