THE HAMPSTEAD GENERAL HOSPITAL,

1781

responsible, working under the architects, the first connected with the waiting hall and adjoining consulting rooms, while the second deals with the remainder of the buildings. In the first system the air, after being screened, washed, and heated by passing over a steam battery in the basement, is forced by means of two powerful fans, capable of delivering 4,000,000 cubic feet per hour if necessary, into the several rooms the air of which it is possible to change ten times per hour. Whether such a rapid change, even of warm air, can take place without causing an inconvenient draught is a question that experience alone can decide. The colder air in the many passages leading into the large waiting hall would render this problematical. This air is conveyed through a large brick-built glazed duct, having branches to the several points of delivery, all of which are accessible for cleansing with a hose, the main duct being large enough for a man to walk through. The vitiated air is extracted through a similar set of ducts, at the floor and ceiling level, by a large centrifugal fan also fixed in the basement and delivered through an upright shaft above the roof. This double extraction is unquestionably a great advance upon the older system. The second system is in connexion with radiators which are heated on what is known as the "rick"system, in which the circulation is accelerated by the admission of steam into the ascending pipe from the heater. This mixing with the water in a small chamber at the highest point of the system creates such a difference in the specific gravity, between it and the descending column of water, from which the steam has been allowed to escape, that a much smaller pipe can be used to convey the water to the radiators, and resistance caused by any unavoidable depression in the pipe will not materially impede the flow as is the case with the old gravitation system. The water is heated in the first case by a steam coil from the main boiler, which is maintained at a constant pressure of about 5 pounds to the inch by automatic valves. The heaters are in duplicate. Fresh air is drawn in and warmed by passing over the radiators, the amount of which can be regulated in each room by a valve. Large ducts formed in the ceilings of the corridors, which ceilings are at a lower level than the adjoining rooms, are connected at the ceiling level with each room, the air from these can be changed five times in the hour if necessary by means of fans working in connexion. In reviewing the building attention has been chiefly centred upon such points as tend to the maintenance of fresh air and pure water. To comment with any approach to justice upon the various appointments provided in the special and other departments, which generally would seem to be the best of their respective kinds, is not the object of the present article. We can only congratulate the governors of St. Bartholomew’s Hospital on the result of their labours and also on their good fortune in securing such eBxctual support from those who have been intrusted with the execution of their wishes. Looking back to the time when amputations were performed with an axe and the wound was anointed with boiling pitch, say the days of Edward IV., and comparing the provisions made for surgical treatment in the present building the result is certainly gratifying.

result : for the amendment, 59 ; against, 33. On putting this, as a substantive motion an amendment was proposed and seconded that the word "only" should be omitted. On a show of hands a motion for the adjournment of the discus1

sion was carried. The PRESIDENT then dissolved the Comitia.

THE HAMPSTEAD GENERAL HOSPITAL, DURING the present year the position of affairs at theGeneral Hospital has been several times brought before our readers and we dealt at some length with the points at issue in THE LANCET of July 13th, p. 107, and July 20th, p. 182. On this latter occasion we reported an extra-ordinary general meeting of the governors of the hospital to discuss the proposals of its council regarding the question of amalgamation with the North-West London Hospital and the future constitution of its medical staff, and the consequent relations of the hospital with King Edward’s Hospital Fund for London and the local opinion of medical men and other residents in Hampstead. At that meeting a motion supporting the present system of staffing the hospital with local practitioners was withdrawn in favour of a motion to adjourn themeeting and to appoint a committee of six governors to inquire into, and to report on all, the points at issue with power to confer with the various parties concerned. The committee,which appointed Mr. H. A. Harben for its chairman and has been at great pains to collect the available evidence, issued a long report on Nov. 26th and on Dec. 2nd the adjourned meeting of governors was held at the hospital, Mr. Edward Bond being in the chair, and about 83 governors being present besides others interested in the result. The report, after fully rehearsing the negotiations which have passed between King Edward’s Fund and the council of the hospital, and which we have previously put before our readers, proceeds to make the following recommendations :-

Hampstead

1. That the staff of

general practitioners should be replaced by one consulting physicians and surgeons, with a service limit of 15 yearsand an age limit of 60, but that the four senior members of the present staff have a service of 18 years from the date of their appointments or from 1894, whichever be the later, although King Edward’s Fund had’ taken exception to this latter condition. 2. That the amalgamation with the North-West London Hospital in. Kentish Town (which has had to close its wards owing to lack of support for necessary rebuilding and maintenance) under the financiah terms offered bv the King’s Fund is advisable, the out-patient work to of

be confined to the Kentish Town

building except

in

so

far

as

it affects

casualties, diseases of special organs, and observation of discharged inpatients. The King’s Fund guarantees to pay .E1500 a year for five years to the amalgamated hospitals with not more than £150 a year rent for the out-patient department and the cost of adapting the NorthWest London Hospital to this purpose provided the NOIth-West London Hospital hands over its property, less .E600 for compensation, to. the Hampstead Hospital, and that the latter body appoint not less than. three approved members of the medical staff of the North-West London. Hospital to its own staff, and two North-West London Hospital representatives to its own council. The committee reported against this last condition whilst considering that every opportunity should be given to the members of the North-West London Hospital staff to compete for the

The

new

appointments.

report further recommends

:—

3. That three general physicians, two or three general surgeons, aircT "specialists" for the usual special departments be appointed, each with a suitable allotment of beds.

ROYAL COLLEGE OF PHYSICIANS OF LONDON. AN

extraordinary

Comitia

was

held

on

Dec.

12th, Sir R.

DOUGLAS POWELL, Bart., K.C.V.0., the President,

The report was signed by five out of six of the committee, although one signatory recorded her dissent to the proposed change of staff, whilst the committeeman in opposition, Sir George Barham, adds a memorandum disagreeing in toto with. the amalgamation scheme on the ground that it would entirely destroy the local character of the hospital and be of very doubtful financial advantage. At the beginning of the meeting to consider this report the CHAIRMAN read a long letter from King Edward’s Hospital Fund for London, rehearsing the negotiations and setting out the two points still at issue between the King’s Fund and

being in the chair. The petition received at the Comitia, on May 9th last from the London School of Medicine for Women, praying for the admission of women to the examinations of the College, was; then considered. An opinion of the standing counsel to) the College was read to the effect that if women were the council. The Executive Committee of the Fund further admitted to the examination for the Licence they wouldl stated that its only desire was " to facilitate a transaction also be eligible for the examination for the Membership) which it was thought might benefit the public and at the and would then also be eligible for election to the Fellowship) same time be agreeable to the subscribers of the two and as officers of the College. institutions and fair to the medical staffs and officials ....... A motion was proposed and seconded that the petitioni they have throughout regarded their proposal merely as an should be granted. To this an amendment was proposed and1 offer. Should the subscribers feel that the work which their seconded to the effect that such alterations should be made own generosity provides will be better served by declining to the by-laws as will permit of the admission of women tc the offer made by the King’s Fund they may rest assured the examinations for the Licence only. After a prolonged that the King’s Fund fully recognise that the subscribers discussion this was put to the College with the following have an undoubted right to decide as they think best."

1782 After the reading of this letter the matter was keenly debated for two hours, and it was obvious that equallJ decided opinions were held on either side of the controversy A full report of the meeting is not called for but its chiej points were as follows. Mr. HARBEN moved the adoption of the report and Mr. FRANK DEBENHAM seconded the motion. They bott declared that on the evidence before the committee they could not come to any other conclusions than were embodied in the report. Mr. ERNEST COLLINS, chairman of the hospital council, said that he accepted its conclusions. Mr. J. S. BERGHEIM moved that it be referred back to the committee and suggested that three members of the British Medical Association should be added to the committee ; he warmly supported the present staff arrangements. Dr. G. D. PIDCOCK seconded the amendment and complained that no mention had been made in the report of the deputation from the Hampstead branch of the British Medical Association and that the committee had ignored its recommendations. The amendment was put and lost by a large

majority. Mr. HENRY CLARK and Mrs. MEER argued against the of staff and amalgamation. They wanted

proposed change a

Hampstead not a metropolitan hospital.

ROYAL COLLEGE OF SURGEONS OF ENGLAND. MEETING OF THE COUNCIL. AN ordinary meeting of the Council was held on Dec. 12th, Mr. HENRY MORRIS, the President, being in the chair. A report was received from the Board of Examiners in Anatomy and Physiology for the Fellowship stating that at the recent examination 109 candidates presented themselves and of these 39 were approved. The report was adopted. The Court of Examiners reported that 25 out of 63 candidates had been found qualified for the diploma of Fellow. It was resolved to issue diplomas of Fellowship to these. A report was received from the Board of Examiners in Dental Surgery that 44 candidates had been found qualified for the Licence in Dental Surgery. It was resolved to issue licences to these. A report was also received from the same Board to the effect that it had considered the following resolution adopted by the British Dental Association at its annual meeting, viz. :That any regulation prescribing "not less than two years’ instruetion in Mechanical Dentistry" instead of three years, as heretofore, is seriously detrimental to the efficiency of the profession.

Mr. DONALD MACMILLAN, a member of the committee, favour of its report and declared that even if consultants were kept out, yet there was no unanimity amongst Hampstead medical men as to how the staff should be constituted, and he read a resolution passed by their representatives at a meeting on May 24th to the effect that the amalgamation was desirable from a public point of view, To fill the new beds it would be necessary to take patients from Kentish Town which needed the hospital accommodation urgently. Dr. E. COLLINGWOOD ANDREWS, on behalf of the hospital staff,. absolutely refused to accept the report and made common cause with the professional feeling in the neighbourhood against a consultant staff. Mr. HARBEN finally answered several objectors to the report and declared that the council had supported the staff throughout. The meeting, however, rejected the report by 40 votes to 29, whereupon three governors demanded a postal poll of all the subscribers which, as we have announced, resulted in a majority of eight in favour of the report, the figures being This decision has been com195 for and 187 against it. municated to the staff who are taking counsel with the medical profession in the neighbourhood as to the course of action that they should adopt in the circumstances, The council has power under the constitution of the hospital to act on a bare majority of its governors’ votes and we understand that it is prepared to do so. In that case the resignation of the present staff en bloc may quite possibly follow, but we understand that no definite conclusion will be reached until after Christmas.

spoke strongly in

Looking Back. FROM

THE LANCET, SATURDAY, Dec. 19th, 1829. DR. ARMSTRONG-.

under the painful necessity of announcing the sad intelligence, that this excellent man and celebrated physician expired at his house in Russell Square, on Saturday last, December 12th, astat. 46. He has left a beloved wife and excellent mother, and a fine family of seven children, to deplore their irreparable loss, He was a man of most kind disposition, passionately devoted to his family, and seldom or never quitted his home, unless called thence by the duties of his profession. His practice, we believe, amounted to between four and five thousand pounds per annum, and he was decidedly the most successful teacher of the " principles and practice of medicine " in London, his class having consisted, within the last two years, of upwards of two hundred students. We shall give a more extended biographical aketch of the literary and scientific labours of this really great man, as soon as we can obtain those materials which alone can render such a notice valuable. WE

are

The Board saw no reason to alter its recommendation that the period of instruction in mechanical dentistry should be reduced from three to two years. The Board also recommended that the Dental Department of the University of Leeds should be recognised. The report was approved. The following resolution from the minutes of the Museum Committee was received :That the Council be informed that, in the opinion of the Museum Committee, a systematic course of lectures on advanced surgical pathology, illustrated in part by the specimens in the museum, could be established without difficulty; that the lectures might be delivered by the conservator of the museum, if a pathologist, or by the pathological curator; and that the honorarium might be provided from the Erasmus Wilson fund, the Arnott bequest, and other funds at the disposal of the College. It was resolved to postpone the further consideration of this resolution. The Museum Committee suggested certain alterations in the conditions under which the office of conservator should be held. It was decided to advertise the vacant office forthwith and to request candidates to apply before Feb. 1st, 1908. The conditions attached to the post can be learned on application to the Secretary of the College. Mr. T. Clinton Dent was re-elected a member of the Court of Examiners. Mr. J. H. MORGAN stated that the Committee on the Annual Report of the Council proposed to postpone to a future meeting of the Council its report on the annual meeting of the Fellows and Members and the resolutions carried thereat. A letter was read from the President reporting the proceedings of the General Medical Council at its recent The letter was received and entered on the session. minutes. The best thanks of the Council were given to the President for his services as the representative of the College on the General Medical Council. The PRESIDENT reported the delivery of the Bradshaw lecture by Mr. Rickman J. Godlee on Dec. 6th, the subject of the lecture beingThe Prognosis and Treatment of Tuberculous Disease of the Genito-Urinary Organs." The best thanks of the Council were given to Mr. Godlee for his lecture and he was requested to publish it. A letter was read from Mr. Frederick W. Collingwood calling attention to the tables, presented to the General Medical Council, showing the results of the examinations for the Royal Navy Medical Service, the Royal Army Medical Corps, and the Indian Medical Service, and suggesting that these tables are very relevant to the resolution moved by him at the annual meeting of Fellows and Members. It was resolved to thank Mr. Collingwood for his letter. The committee to which was intrusted the consideration of the letter from the deans of the medical faculties of the Universities of Leeds, Liverpool, and Sheffield, suggesting the desirability of holding the primary examinations for the Fellowship at other times of the year than May and November, reported that it proposed to postpone its report with the object of ascertaining the views of the several medical schools upon the proposed change before submitting any recommendation to the Council upon the

subject.