THE INSPECTION OF PORK IN IRELAND.

THE INSPECTION OF PORK IN IRELAND.

399 the case,

it is your

Your correspondent in arriving at these results your treatment has prejudiced clearly of Swansea taken the total ordinary expendi- duty to report that to the patient’s commanding officer ; ture, .E8214. and divided it by the average number of beds unless, of course, your withers are wrung and conscience tells occupied (114’ 12), with the result (£71 19s )as the cost per you you can do better next time. In this case pocket your bed, but in the case of Cardiff has taken from the total ordinary experience and put it to profit. I am, Sirs, yours faithfully, expenditure, £12,745, a sum of .62606, leaving a balance of R. N. £10, 139, which he has divided by the average number of July 31sat, 1906. beds occupied (157’77) with the result (£64 5s.) as the cost per bed. These results are two totally different costs per INSPECTION OF PORK IN IRELAND. bed, there being no connexion whatever between them, and any comparison must be absurd. When the expenditure of (FROM A CORRESPONDENT.) both hospitals is compared according to the standard laid down by Sir Henry Burdett and adopted almost universally A QUESTION of great importance came before the Belfast by the London and provincial hospitals, and taking into account the out-patients, painting, and bank charges in both corporation on August 3rd-that is, how to deal with the cases, the result would be as follows :carcasses of swine affected with tuberculosis. The market committee carried a motion1 to the effect that when the lesion was strictly confined to the glands of the neck the head and neck should be destroyed and the rest of the carcass returned to the owner, but that where two or more organs were affected the whole of the carcass should be destroyed. The committee followed in its regulation the practice in Glasgow, Dublin, and Edinburgh, and in Germany. but when the matter came up for confirmdtion before the city council it was decided to send back the resolution to the markets committee for further consideration on the ground that the 1898 Royal Commission on Tuberculosis had stated that "in view of the greater tendency to generalisation of tuberculosis in the pig we consider that the presence of tubercular deposit in any degree shall involve seizure of the " This is not time to criticise the standard adopted by Sir whole carcass and of the organs This matter raises several very interesting subjects for Henry Burdett or to question the right of the Cardiff authorities to adopt any standard they may think fit but if discussion. Everyone admits that proper and thorough the expenditures of two hospitals are to be compared it can inspection is necessary, but many believe that the view Commission cannot, with the evidence of the 1898 only be done satisfactorily by adopting a common standard accumulated Royal since it reported, be maintained. First, on for both.-I am, Sirs, yours faithfully, what evidence is it established that there is a " greater W. LLEWN. MORGAN, Lt.-Colonel. tendency to generalisation of tuberculosis in the pig" ?2 In Swansea, August 7th, 190S. Chairman, House Committee. the cae of the very pigs seized recently in Belfast the most careful experiments made microscopically and by injecting the flesh of the animals into guinea-pigs (which are so JUVENILE SMOKING. sensitive to tuberculosis) have totally failed to demonTo the Editors of THE LANCET. strate or to produce the disease, though in these same pigs the glands removed were tuberculous. Among SIRS,-Your annotation in THE LANCET of July 28th, the most complete and authoritative treatises on meat leaves untouched p. 241, on Juvenile Smoking absolutely the point made months ago by the Lord Advocate of inspection is that of Dr. Ostertag, professor in the High School at Berlin, and in the fourth Scotland-viz., that cigarettes can be fetched by the Veterinary his edition of "Handbook of Meat Inspection," bigger boys and secretly sold or given by them to their translated in 1904great Dr. Wilcox, veterinary editor, Experiby in which the or brothers way companions, proposed mental Station Record, younger Washington, with an introduction legislation would be rendered a dead letter. To suggest that this difficulty is insuperable seems absurd. Yet amid all the by Dr. Mohler, chief of the Pathological Division, United writers on the subject not one has told us how to meet the States Bureau of Animal Industry, the whole question is very discussed. It is demonstrated that the experience of point, nor, strange to say, does the Select Committee make fully anatomists shows in the most unambiguous the pathological I am, Sirs, yours faithfully, any suggestion. manner that the meat of tuberculous animals plays only OBSERVER. July 30th, 1906. of human tuberculosis. an role in the

£64 5s. 4d. has in the

case

THE

inconspicuous

TWO POINTS OF MEDICAL ETHICS. To the Editors of THE LANCET. SIRS,-With reference to the letter of "I.M.S."" in THE LANCET of July 28th, p. 258, I submit the following

opinions. 1. As to shameful"diseases your first duty is to your The medical officer is employed by the Crown- , the person who pays the piper calls the tune-and the sick person has joined the service in full understanding of this fact and, of course, the disease must be stated accurately on the returns. No one can expect you to make and sign an incorrect official statement. Take the case of a man unfit for duty from alcoholism. When you are sure of your diagnosis it must be at once officially reported. If not, you probably show a bad example to, and thereby degrade, your subordinates; you prejudice the service ; you very rarely gain anything for your patient, except a putting off of the evil day which will come, and the trouble which follows generally recoils on yourself and serves you right. 2. Officers under treatment by private practitioners. It is most unlikelythat a civil practitioner would see without inquiry an officer who was, « priori, probably the patient of another. In the unlikely case (I am not talking of consultations which I always encouraged, they comfort the patient and often help you) you may deal with the civil practitioner directly and, of course, if the interruption of

employer.

etiology

With reference to the view generally entertained that in undoubted cases of local tuberculosis the meat is harmless, Dr. Ostertag says: " The assumption of the harmlessness of meat in cases of undoubted local tuberculosis will probably remain for all time as an immutable dogma of meat inspection " ; while in reference to the current notion that the generalisation of tuberculosis is always associated with a harmful property of meat Dr. Ostertag says that this can no longer be maintained, for, according to him, "only under certain conditions, and not uniformly, does the generalisation of tuberculosis produce a harmful property in the meat." It is clear that the opinion of the 1898 Royal Commission cannot be regarded as unchallenged, however perfect the counsel conveyed. Secondly, even were such a rigid meat inspection found to be necessary, it is absurd that it should be applied by one local authority and not put in force by another. Why should carcasses be condemned in one place which would pass in another where there is a less rigid inspection, or none at all ? It is common in several of the smaller Irish towns for pigs to be bought and "cured" without any inspection at all, and what is still more meat of these animals is sent into Dublin and Belfast where it is used without being inspected at all in its "cured"state. Many hold that meat inspection should be taken out of the hands of the local authorities. The Government could then adopt one uniform method

ridiculous, the

1

See THE LANCET, August 4th, 1906, p. 327.

400

LIVERPOOL.-WALES AND WESTERN OOUNTIES NOTES.

of meat inspection based upon scientific veterinary and medical knowledge. No one wishes to consume the tuberculous meat of any animal, even though cooking renders it harmless, but, while taking every proper precaution by inspection to get rid of such a risk, it must be

of a tuberculous animal the causation of human tuberculosis. The so-called panacea of meat inspection must not be allowed to draw away attention from other important factors in the causation of consumption.

clearly recollected that the meat plays a comparatively small r6le in

(FROM SINCE the

LIVERPOOL. CORRESPONDENT.)

OUR OWN

Liverpool Infirmary for Children. appeal for £10,000 for this institution first

sums amounting to .c1500 have been subscribed and a further sum of £500 has been promised conditionally on the balance being raised..613,000 are still required to complete the new building, but of this amount C5000 have been voted by the city council provided the balance is raised by the public. Unless the greater portion of £5000 is contributed by the end of September favourable contracts for the unbuilt portions will lapse and the completion of the infirmary will be indefinitely delayed. The committee is earnestly asking for help to complete the work.

appeared

Infantile Mortality in Liverpool. mortality is continuing to be a cause anxiety to the health committee of the city council. Infantile

among

working

women as

to how

an

infant should be fed,

clothed, and managed. August

6th. _________________

WALES AND WESTERN COUNTIES NOTES. (FROM

OUR OWN

CORRESPONDENTS.)

Newport Corporation Bill. ALTHOUGH the Police and Sanitary Committee of the House of Commons did not approve of all the clauses in the Improvement Bill recently promoted by the corporation of Newport, important provisions have been obtained and they will make for more effective public health administration in the borough. The difficulty of fixing the responsibility for negligent drain-laying and similar work upon the proper person has long been felt. As Mr. T. Pridgin Teale said long ago, if a platelayer places rails so that they overlap and in consequence a train is overturned and some person is killed, that platelayer would be put upon his trial for manslaughter:o why cannot the same be done in the case of a drainlayer who lays a line of drains so negligently that a fatal case of typhoid fever is the result? It will in the future be possible to punish such negligence in Newport, for Section 4 of the Corporation Act provides that " if a water-closet or drain is so constructed or repaired as to be a nuisance or injurious to health the person who undertook or executed such construction or repair shall, unless he shows that such construction was not due to any wilful neglect or default, be liable

of great to a penalty not exceeding twenty pounds." A difficulty Allusion which is not confined to Newport has been experienced in was made in THE LANCET of July 28th, p. 260, to the connexion with the repair of drains. Where these are provision of special beds at the Royal Infirmary for the newly laid or are re-constructed there are already sufficient treatment of infantile diarrhoea, at the suggestion of the powers of inspection but in the case of ordinary repairs this health committee. I have now to record that a similar is not so. The clause intended to deal with this difficulty suggestion was received on July 25th by the West Derby was allowed by the committee of the House of Lords guardians from Dr. E. W. Hope (the medical officer of and required that 12 hours’ notice should be given by any health) requesting their asistance in mitigating the effects of person who desired to repair a drain which should be left certain infantile complaints which are causing many deaths open for a period not exceeding 24 hours in order that it amongst young children. The guardians in response have might be inspected. The chairman of the police and sanitary allotted a couple of wards at Belmont-road workhouse for committee, however, considered this to be unreasonable and their reception. the section as it now stands merely requires notice to be given of the intention to repair and gives free access to Death of Dr. Felix B. OFlaherty. officers of the corporatior for inspection purposes. The the death of Dr. F. B. which occurred on O’Flaherty, By under the Act to test drains officers have sanitary August lst from cardiac disease, a promising and compara- (though not by waterpower under pressure) when they have has been removed from our midst. tively young practitioner An reason to suspect that such drains are defective. He was one of several brothers, some of whom fought on the has been made to meet the difficulties which British side in the late Transvaal war, and one of whom lost attempt have arisen owing to the conflicting definitions of a his life. The interment took place on August 3rd at Flaybrick drain in those districts where the Public Health Acts in the of a concourse cemetery, Birkenhead, presence large Amendment Act, 1890, is in force. A drain is defined to of sympathising friends. The deceased was only 45 years include any sewer or drain either already constructed or to of age. be constructed with which two or more houses or premises Infantile Mortality in Cheshire. (whether belonging to the same or different owners) are now Mr. Francis Vacher (the medical officer of health of the or may at any future time be connected The blowing or county of Cheshire) in his annual report for 1905 states that inflating of meat is prohibited. The sections referring to the proportion of infants who died was 9 per 1000 births less tuberculosis in connexion with milk supplies are identical with than in the whole country, and the proportion of infantile those in the Rhondda and other Acts. They include private deaths in the municipal boroughs was 22 per 1000 more than the sale of milk for human consumption provisions prohibiting in the 76 great towns of the kingdom. This is a fair record from cows suffering from tuberculosis of the udder; requiring as regards the whole county but is a decidedly bad record as the isolation of diseased cows and notification to the regards the municipal boroughs. The variation in weather medical officer of health, giving more or less complete conditions and the incidence of epidemics influence the powers of inspection both within and without the district, general death-rate from year to year and as surely increase together with the taking of samples of milk and the The infantile or decrease the mortality among infants. summary stoppage of particular supplies. Other sanitary mortality-rate being high in a particular year might be due provisions have reference to the regulation of the manuto the incidence of sun and rain, the passing of a wave of facture and sale of ice-creams. The corporation is also epidemics, and such recondite causes; but the infantile empowered to make by-laws for preventing the pollution of mortality-rate being high year after year in some special water which it is authorised to take, even though the district, or part of a district, is not to be explained in this contamination of the water may take place in another ready way, so that no one can be made responsible. A high sanitary district. infantile mortality-rate in any district must be due to local The West Wales Sanatorium. insanitary conditions in that district, which it behoves the At a meeting of the building committee of this institulocal authority to discover and to remedy. The main causes of a high rate of infantile mortality may be summed up as tion which was held recently at Alltymynydd it was reported follows: (1) the employment in factories of those about to that the sanatorium was approaching completion. The combecome mothers and those who have been recently confined mittee hopes that the public will make a generous response and should be nourishing their infants; (2) the infants of to the appeal for further funds which was issued not long factory-employed mothers being badly cared for and ill fed ago and anticipates that great assistance will be rendered by during the absence of their mothers at work; (3) the the working classes. environment of the infant being insanitary ; (4) there being Physioal Training. no provision for isolating infectious children or disinfecting The first of the competitions organised by the Glamorganinfectious bedding, &c. ; and (5) the ignorance common shire county council for the physical improvement of the