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THE ETIOLOGY OF THE PSORIATIC AND ALLIED CONDITIONS.
486 may be out of the
zone
of fresh
danger.
As
regards
sub-
sequent treatment of the wounded, no fleet of any size, we hope, will be permitted to go into action without an attendant hospital ship in the future. Probably it would be desirable that the hospital ship should receive as her proper charge only the minor cases, capable of returning to duty after .a short treatment, while a regular ambulance service could be organised from among the fast cruisers of the mercantile marine, whose duty it would be to proceed at full speed with the more serious cases to the nearest friendly port, with which communication could be kept up by wireless telegraphy. To each of these hospital transports there should be attached ambulance boats specially fitted for removing the injured from their own ships. In sailing days, when ships often remained at sea for weeks, sometimes months, after an action, it was necessary to provide some space, however inconvenient and unsuitable, for the accommodation of the sick and wounded. Under the altered conditions of the present day removal at the earliest possible time is evidently the urgent indication. The only reason that could possibly be urged against our suggestions would be on the score of expense. If, however, the highest developments of modern science are to be utilised, regardless of cost, for purposes of destruction, but are to be denied to alleviate human suffering, the claim of the present day to any real progress in civilisation breaks ,down. ____
RELIEF
IN WORKHOUSE INFIRMARIES AND THE OLD AGE PENSIONS ACT.
THE local pension committee of the London County Council has dealt with 39,043 claims for old age perisions and has allowed 36,108, involving an annual expenditure of about .B444, 500. Its report presented recently to the Council gives interesting information with regard to the administration of the Act in the metropolis and among other matters contains what must be regarded as an authoritative statement as to the vexed question of disqualification arising out of the recent - treatment of the applicant in a workhouse infirmary. The Act, it will be remembered, declares that a person otherwise qualified shall not be entitled to receive a pension, Section 3 (1) (A), ’’ while he is in receipt of any poor relief (other than relief excepted under this provision), and until the 31st day of December, 1910, unless Parliament otherwise determines, if he has at any time since the 1st day of January, 1908, received, or hereafter receives, any such relief." Three provisos follow defining relief which for the purposes of this sub-section shall not be considered as poor relief, the first one being that ’any medical or surgical assistance (including food or comforts) supplied by or on the recommendation of a medical officer," shall not be so regarded. This exception required no explanation in cases where a medical officer had attended or ordered medicine or food for a patient not received into the workhouse infirmary, but when the patient had been boarded and lodged in an infirmary for the purpose of receiving medical or surgical treatment it seemed to many called upon to administer the Act that the limits of the exception had been exceeded. Careful reading of the words quoted will show that there is something to be said on both sides, and it would be interesting to know what was in the mind of those who are responsible for the wording of the Act. If the draftsman was aware that relief in a workhouse infirmary was not meant to operate as a disqualification by those who were to introduce the Bill, he certainly might have expressed their meaning more clearly. If, on the other hand, the matter was not considered it is to be regretted and perhaps to be wondered at that the point occurred to none of those concerned. ’Two Government offices have enunciated divergent views
upon the subject. According to the report of the London County Council’s committee the Board of Inland Revenue advised that maintenance in a workhouse infirmary rendered the claimant of a pension ineligible, but the committee differed and as a test case granted a pension in the Since then the committee has circumstances indicated. been informed by the Local Government Board that it approves of the decision arrived at, and it has been supplied with a copy of a letter originally addressed to the Morpeth pension subcommittee, in which the Board expressed the opinion that if a person suffering from an illness or an accident were removed to a Poor-law infirmary for cure or treatment he would not be disqualified, such relief as he received other than surgical or medical assistance being merely incidental to such assistance. The opinion of the Local Government Board given above is described as that of the Board ’’ speaking generally," but by the Act the decision of the central pension authority (the Local Govern. ment Board) on any question referred to it (such as the concrete test case laid before it by the London County Council) is final and conclusive.
THE ETIOLOGY OF THE PSORIATIC AND ALLIED CONDITIONS. WE publish in another column an interesting note upon this subject by Mr. M. J. Chevers. The theory advanced in Mr. Chevers’s paper is ingeniously employed to account for many of the phenomena of psoriasis, and it is in great part in accord with the views of many who favour a neuropathic origin of the disease. The tendency to attribute to nervous disturbance signs and symptoms which we cannnot otherwise explain is natural, for we know but little of the cutaneous manifestations of morbid conditions of the nervous system. Mr. Chevers has evidently devoted much attention to the disease. As to the query contained in the final paragraph of his paper, the importance of trauma in inducing the outbreak of psoriasis may indeed be attributable to an action through the nervous system, but it is also possible that the trauma provides a point of entry for a parasite. The occurrence of psoriasis in revaccination is at least suggestive of an infection, for the first psoriatic patch appears at the site of the vaccination.
ENTERIC FEVER
IN
CHESTER-LE-STREET.
the medical officer of health, has issued an outbreak of enteric fever in the rural From the report it district of Chester-le-Street in 1908. that the outbreak in began appears August, reached its maximum in October, fell slightly in November, and had disappeared in December. a
Dr. John Taylor, special report on
Number
The outbreak
was
of Cases.
limited to the
townships of Burnmoor, In considering the
Harraton, Washington, and Usworth.
causes of the outbreak Dr. Taylor arrives at the conclusion that it was due to specifically contaminated water. The rural district of Chester-le-Street has an area of 54 square miles and is supplied with water from various sources, the
zone
of fresh
danger.
As
regards
sub-
sequent treatment of the wounded, no fleet of any size, we hope, will be permitted to go into action without an attendant hospital ship in the future. Probably it would be desirable that the hospital ship should receive as her proper charge only the minor cases, capable of returning to duty after .a short treatment, while a regular ambulance service could be organised from among the fast cruisers of the mercantile marine, whose duty it would be to proceed at full speed with the more serious cases to the nearest friendly port, with which communication could be kept up by wireless telegraphy. To each of these hospital transports there should be attached ambulance boats specially fitted for removing the injured from their own ships. In sailing days, when ships often remained at sea for weeks, sometimes months, after an action, it was necessary to provide some space, however inconvenient and unsuitable, for the accommodation of the sick and wounded. Under the altered conditions of the present day removal at the earliest possible time is evidently the urgent indication. The only reason that could possibly be urged against our suggestions would be on the score of expense. If, however, the highest developments of modern science are to be utilised, regardless of cost, for purposes of destruction, but are to be denied to alleviate human suffering, the claim of the present day to any real progress in civilisation breaks ,down. ____
RELIEF
IN WORKHOUSE INFIRMARIES AND THE OLD AGE PENSIONS ACT.
THE local pension committee of the London County Council has dealt with 39,043 claims for old age perisions and has allowed 36,108, involving an annual expenditure of about .B444, 500. Its report presented recently to the Council gives interesting information with regard to the administration of the Act in the metropolis and among other matters contains what must be regarded as an authoritative statement as to the vexed question of disqualification arising out of the recent - treatment of the applicant in a workhouse infirmary. The Act, it will be remembered, declares that a person otherwise qualified shall not be entitled to receive a pension, Section 3 (1) (A), ’’ while he is in receipt of any poor relief (other than relief excepted under this provision), and until the 31st day of December, 1910, unless Parliament otherwise determines, if he has at any time since the 1st day of January, 1908, received, or hereafter receives, any such relief." Three provisos follow defining relief which for the purposes of this sub-section shall not be considered as poor relief, the first one being that ’any medical or surgical assistance (including food or comforts) supplied by or on the recommendation of a medical officer," shall not be so regarded. This exception required no explanation in cases where a medical officer had attended or ordered medicine or food for a patient not received into the workhouse infirmary, but when the patient had been boarded and lodged in an infirmary for the purpose of receiving medical or surgical treatment it seemed to many called upon to administer the Act that the limits of the exception had been exceeded. Careful reading of the words quoted will show that there is something to be said on both sides, and it would be interesting to know what was in the mind of those who are responsible for the wording of the Act. If the draftsman was aware that relief in a workhouse infirmary was not meant to operate as a disqualification by those who were to introduce the Bill, he certainly might have expressed their meaning more clearly. If, on the other hand, the matter was not considered it is to be regretted and perhaps to be wondered at that the point occurred to none of those concerned. ’Two Government offices have enunciated divergent views
upon the subject. According to the report of the London County Council’s committee the Board of Inland Revenue advised that maintenance in a workhouse infirmary rendered the claimant of a pension ineligible, but the committee differed and as a test case granted a pension in the Since then the committee has circumstances indicated. been informed by the Local Government Board that it approves of the decision arrived at, and it has been supplied with a copy of a letter originally addressed to the Morpeth pension subcommittee, in which the Board expressed the opinion that if a person suffering from an illness or an accident were removed to a Poor-law infirmary for cure or treatment he would not be disqualified, such relief as he received other than surgical or medical assistance being merely incidental to such assistance. The opinion of the Local Government Board given above is described as that of the Board ’’ speaking generally," but by the Act the decision of the central pension authority (the Local Govern. ment Board) on any question referred to it (such as the concrete test case laid before it by the London County Council) is final and conclusive.
THE ETIOLOGY OF THE PSORIATIC AND ALLIED CONDITIONS. WE publish in another column an interesting note upon this subject by Mr. M. J. Chevers. The theory advanced in Mr. Chevers’s paper is ingeniously employed to account for many of the phenomena of psoriasis, and it is in great part in accord with the views of many who favour a neuropathic origin of the disease. The tendency to attribute to nervous disturbance signs and symptoms which we cannnot otherwise explain is natural, for we know but little of the cutaneous manifestations of morbid conditions of the nervous system. Mr. Chevers has evidently devoted much attention to the disease. As to the query contained in the final paragraph of his paper, the importance of trauma in inducing the outbreak of psoriasis may indeed be attributable to an action through the nervous system, but it is also possible that the trauma provides a point of entry for a parasite. The occurrence of psoriasis in revaccination is at least suggestive of an infection, for the first psoriatic patch appears at the site of the vaccination.
ENTERIC FEVER
IN
CHESTER-LE-STREET.
the medical officer of health, has issued an outbreak of enteric fever in the rural From the report it district of Chester-le-Street in 1908. that the outbreak in began appears August, reached its maximum in October, fell slightly in November, and had disappeared in December. a
Dr. John Taylor, special report on
Number
The outbreak
was
of Cases.
limited to the
townships of Burnmoor, In considering the
Harraton, Washington, and Usworth.
causes of the outbreak Dr. Taylor arrives at the conclusion that it was due to specifically contaminated water. The rural district of Chester-le-Street has an area of 54 square miles and is supplied with water from various sources, the