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The literature of preventive medicine
1929.
The THE
PUBLIC
Literature
HEALTH.
of Preventive
DERMATERGOSES OR OCCUPATIONAL AFFECTIONS OF THE SKIN. By R. PROSSER WHITE, M.D.,' C.M., Ed., M . R . C . S . , Lond., President, Certifying Factory Surgeons' Association, etc., etc. L o n d o n : H. K. Lewis and Co., Ltd., 1928. pp. 734, illustrated. Price 35s. net.
Dr. Prosser White is tile outstanding authority on affections o.f the skin associated with occupation, and this is, of course, the standard work on the subject. The first edition was published in 1915, and since then, in addition to a second English edition, there have been editions in other countries and other languages, Russian particularly. In this, the third edition, considerable revision has been carried out and new matter introduced. As a result its value and usefulness have been increased and it will, as it deserves, be consulted and quoted more widely than ever.
MATERNITY AND CHILD WELFARE. By ETHEL CASSIE, M.D., Ch.B., D.P.H. (Edin.), Assistant Medical Officer of Health for Maternity and Child Welfare, and Medical Superintendent of the Carnegie Infant Welfare Institute, Birmingham. London : H. K. Lewis & Co., Ltd., 1929. pp. 228, illustrated. Price: 8s. 6d. net. It is easy to accept the statement in the preface t h a t the author has been asked, by medical officers of health and medical officers engaged in child welfare work, to write a book dealing with maternity and child welfare for the use of public health workers by a maternity and child ,welfare worker in the public health Service. Such a book has long been: ~anted. At once it may be said that Dr. Cassie w a s just the per§on with .the qualifications for providing ~what was~r6quired, ~/nd tl~at"~[ie~tihs, in fact, provided it., Books innumerable almost, have been poured, out for some time, all with some reference to child welfare in their title or their contents. Some good, some not so good, none has given exactly what was wanted in the way *3f practical information that the person on the job or preparing for the job wanted. Dr. Cassie appears to have found the right line at once, a n d the embryo as well as the fully-fledged health visitor (it is suspected that
243
Medicine.
Dr. Cassie would.like to call her the " public health nurse " - - a n expression with which she disfigures her, preface) will quickly learn that this is her book. It deals with extraordinary completeness with all the activities in which the health visitor is concerned; from home visiting to conduct of clinics of all kinds. It discusses the subject of health talks, food and food values, child management, and so on. It gives excellently clear and simple instruction on infectious diseases, the skin and its affections, heliotherapy, and numbers of other medical subjects, it is all extremely well done. Pleasantly and readably written, authoritative and practical, the book is welcomed heartily and recommended strongly.
OUR BABY. By MRS. J. LANGTON HEWER, State Registered Nurse, Certified Midwife, etc. Bristol : John Wright & Sons, Ltd., 1929. p p . 186, illustrated. Price 2s. 6d. net. THE BABY OF TO-DAY. By the same author and publisher, pp. 32. Price fourpence net. The first of these books was originally published in 1891, and was written " for those mothers and nurses who know that there must be a right way of bringing up a child, and who are anxious to ascertain what that way is." That it has appealed to those for whom it was intended may be accepted, since this is the nineteenth edition in which is completed a total issue of 180,000 copies. The " Baby of To-day," the second from the author's pen, is intended for persons undergoing t rainiag as nurses, and appears to be on the way.to ,attain as great a popularity as the larger volume, as it is now in its third 'edition.
HERITAGE OF ILLS. By ETHEL BROWNING, M.D. London : William Heinemann (Medical Books), L t d . , 1928. pp. 132. Price 3s. 6d. net. The intention of this short volume is to attack some of the commonest and most troublesome of human illnesses from the preventive point of view. It states briefly the extent to which heredity may be said to play a part in
2 1,t
PUBLIC HEALTH.
such things as rheumatism and tuberculosis; emphasizes the general importance of all that is included in the term " environment " in the causation of most complaints, and explains the elements of psychological reactions of various kinds and their starting of certain neuroses. The book is extremely well written and should prove helpful to a considerable public.
In the Annual Reports. AN OUTBREAK OF DYSENTERY.--During the yea r under review it will be noted that there" were five cases of dysentery. My attention was drawn by a medical practitioner to three children who were ill in a family, and at his request they were seen by me. At tlm salne time I had the question of the food p a r t a k e n gone into and the drains inspected. The drain age was found to be defective. At the time of my visit there was also another chitd isolated in an anteroom. I was of opinion that the three children were suffering from dysentery, and with the concurrence of the medical a t t e n d a n t they were removed to hospital the next day. The other child and the mother subsequently developed the disease. Meanwhile the stools were e xa mi ne d and the " Flexner " bacillus of dysentery found, confirming the diagnosis. The bacteriological history is in'teresting. The cli'nical diagnosis was confirmed in all cases of this family sent to hospital, by serological or bacteriological means. An organism of the " Flexner " type of the bacillus dysenterim was isolated from the mother, a daughter and a son, whilst another daughter and son gave serological evidence of suffering from the same infection. The o rg anism in one case gave reactions of a " W " strain of Flexner, while in another case reactions of the " X , " " V " or " W " type were given. The subsequent history of these cases as mentioned is interesting as showing that in a small house such cases cannot be adequately attended to. F i r s t of all we had the three cases, then another child taken ill a few days afterwards, and then a week afterwards the mother, but we t h i n k the mother may have been ill a day or two before she admitted it. There remained at home the father, who kept well all through, although he
Islinglon.
'l'l-Ili BIG AND "rile LI:rTLE TRADER.--lt is nay opinion that very few c o t t a g e l l o u s e s are suitable for the m a k i n g of ice cream and it is not advisable the trade should be carried on under such conditions, and here I may repeat w h a t was said in r egard to the m i l k business, viz., the more it is in the hands of large companies with capital and scientific advice at their disposal, the safer for the general public. T wo out-of-town firms established depots during the s u m m e r for the storage and distribution of ice cream under strict hygienic conditions, and I t h i n k such people
APRIL,
19:79.
should be encuuraged if we wish to l i mi t the chance of infection a.s nmch as possible. It wuuld be advisable if, at some future date, the ice cream trade could be put on the same footing as the mi l k business as regards registration. At present any person can s t a rt ice cream m a k i n g , whatever be the condition of his premises, and it is only by coming across his b a r r o w in the street or seeing a card in the w i ndow of his shop that we become a w a re of w ha t is t a k i n g pl a c e .--D r. Stephen Rowland,
Northampton.
TIlE DIAGNOSIS OF I)OUBTFUL CASES OF TUBERCULOSIS.-Of all the tests the subcutaneous O.T. test is the only reliable one in absolute diagnosis. If one gets a positive s put um or a focal reaction the diagnosis is certain. This test has been relegated to oblivion by the majority of workers because of its supposed da nge r in re a c t i vatin g a latent lesion. I t h i n k it is dangerous if it is used in the way some people have used i~, but I have seen no single case ha rme d by its use when the test is done w i t h the most careful precautions. There is no absolutely reliable single test of an active early case, laying stress on the words single and active, and in the end one often has to rely upon one's clinical instinct by a ge ne ra l impression of the result of every enquiry and especially on the presence or absence of symptoms that need t r e a t m e n t . - - D r . W. M.
Ash, Derbyshire County Council.
DISINFECTION "o EARLY DIaGNOSIS.--.Disinfection of premises and clothing is still practised in the case of the most infectious notifiable diseases. F r o m experience one would say, however, t ha t far too much importance is attached by the general public to disinfection and that too little consideration is given to w h a t is regarded as a slight indisposition. It is obvious t ha t in the spread of disease the detection of the mild case is a factor of gr eater importance than disinfection as now p r a c t i s e d . - - D r . H.
Gordon Smith, Lincoln.
" SUMMER TIME " MAKES HEALTHY WORKERs.--The general he a l t h of t h e workers, p a r t i c u ! a r l y t h e y o u n g e r ones, has, I believe, i m p r o v e d d u r i n g t he past few years. T h e factors w h i c h have c o n t r i b u t e d to this i m p r o v e m e n t are m a n y , a nd not t h e least, I consider, is " s u m m e r t i m e , " w h i c h enables the w orke rs to take a d v a n t a g e of th~ recrefitional facilities n o w p r o v i d e d by m a n y employers~ A n increase Of s uc h facilities, w h e t h e r b y indi',fidual firms or by m u n i c i p a l i t i e s , will, in the f u t u r e , be J:eflected in the i m p r o v e d heaIth of t h e worker~: T h e r e can be n o : d o u b t t h a t t he a r r a n g e m e n t s for welfare now m a d e b y m a n y firms, benefit t h e h e a l t h of t h e i r e mpl oye e s . Progress has been m a d e f r o m year to year in t hi s m o v e m e n t , b u t there is still a t e n d e n c y to l i m i t t he a p p l i c a t i o n of welfare to female employees. Of p a r t i c u l a r i m p o r t a n c e are those projects w h i c h ha ve for t h e i r object r e c r e a t i o n o u t s i d e w o r k i n g h o u r s for j u v e n i l e employees. T h e s e , i f well organised, cannot fail to c ount e ra c t t he pot e nt i a l ill effects of nnonotony a n d t e d i u m c o n s e q u e n t u p o n t h e m a n y m e c h a n i c a l a n d r e p e t i t i v e oc c upa t i ons u n a v o i d a b l e in m o d e r n i n d u s t r y . - - D r , ffohn C. Bridge, Senior Medical
Inspector, Factory Department, Home Office.
The THE
PUBLIC
Literature
HEALTH.
of Preventive
DERMATERGOSES OR OCCUPATIONAL AFFECTIONS OF THE SKIN. By R. PROSSER WHITE, M.D.,' C.M., Ed., M . R . C . S . , Lond., President, Certifying Factory Surgeons' Association, etc., etc. L o n d o n : H. K. Lewis and Co., Ltd., 1928. pp. 734, illustrated. Price 35s. net.
Dr. Prosser White is tile outstanding authority on affections o.f the skin associated with occupation, and this is, of course, the standard work on the subject. The first edition was published in 1915, and since then, in addition to a second English edition, there have been editions in other countries and other languages, Russian particularly. In this, the third edition, considerable revision has been carried out and new matter introduced. As a result its value and usefulness have been increased and it will, as it deserves, be consulted and quoted more widely than ever.
MATERNITY AND CHILD WELFARE. By ETHEL CASSIE, M.D., Ch.B., D.P.H. (Edin.), Assistant Medical Officer of Health for Maternity and Child Welfare, and Medical Superintendent of the Carnegie Infant Welfare Institute, Birmingham. London : H. K. Lewis & Co., Ltd., 1929. pp. 228, illustrated. Price: 8s. 6d. net. It is easy to accept the statement in the preface t h a t the author has been asked, by medical officers of health and medical officers engaged in child welfare work, to write a book dealing with maternity and child welfare for the use of public health workers by a maternity and child ,welfare worker in the public health Service. Such a book has long been: ~anted. At once it may be said that Dr. Cassie w a s just the per§on with .the qualifications for providing ~what was~r6quired, ~/nd tl~at"~[ie~tihs, in fact, provided it., Books innumerable almost, have been poured, out for some time, all with some reference to child welfare in their title or their contents. Some good, some not so good, none has given exactly what was wanted in the way *3f practical information that the person on the job or preparing for the job wanted. Dr. Cassie appears to have found the right line at once, a n d the embryo as well as the fully-fledged health visitor (it is suspected that
243
Medicine.
Dr. Cassie would.like to call her the " public health nurse " - - a n expression with which she disfigures her, preface) will quickly learn that this is her book. It deals with extraordinary completeness with all the activities in which the health visitor is concerned; from home visiting to conduct of clinics of all kinds. It discusses the subject of health talks, food and food values, child management, and so on. It gives excellently clear and simple instruction on infectious diseases, the skin and its affections, heliotherapy, and numbers of other medical subjects, it is all extremely well done. Pleasantly and readably written, authoritative and practical, the book is welcomed heartily and recommended strongly.
OUR BABY. By MRS. J. LANGTON HEWER, State Registered Nurse, Certified Midwife, etc. Bristol : John Wright & Sons, Ltd., 1929. p p . 186, illustrated. Price 2s. 6d. net. THE BABY OF TO-DAY. By the same author and publisher, pp. 32. Price fourpence net. The first of these books was originally published in 1891, and was written " for those mothers and nurses who know that there must be a right way of bringing up a child, and who are anxious to ascertain what that way is." That it has appealed to those for whom it was intended may be accepted, since this is the nineteenth edition in which is completed a total issue of 180,000 copies. The " Baby of To-day," the second from the author's pen, is intended for persons undergoing t rainiag as nurses, and appears to be on the way.to ,attain as great a popularity as the larger volume, as it is now in its third 'edition.
HERITAGE OF ILLS. By ETHEL BROWNING, M.D. London : William Heinemann (Medical Books), L t d . , 1928. pp. 132. Price 3s. 6d. net. The intention of this short volume is to attack some of the commonest and most troublesome of human illnesses from the preventive point of view. It states briefly the extent to which heredity may be said to play a part in
2 1,t
PUBLIC HEALTH.
such things as rheumatism and tuberculosis; emphasizes the general importance of all that is included in the term " environment " in the causation of most complaints, and explains the elements of psychological reactions of various kinds and their starting of certain neuroses. The book is extremely well written and should prove helpful to a considerable public.
In the Annual Reports. AN OUTBREAK OF DYSENTERY.--During the yea r under review it will be noted that there" were five cases of dysentery. My attention was drawn by a medical practitioner to three children who were ill in a family, and at his request they were seen by me. At tlm salne time I had the question of the food p a r t a k e n gone into and the drains inspected. The drain age was found to be defective. At the time of my visit there was also another chitd isolated in an anteroom. I was of opinion that the three children were suffering from dysentery, and with the concurrence of the medical a t t e n d a n t they were removed to hospital the next day. The other child and the mother subsequently developed the disease. Meanwhile the stools were e xa mi ne d and the " Flexner " bacillus of dysentery found, confirming the diagnosis. The bacteriological history is in'teresting. The cli'nical diagnosis was confirmed in all cases of this family sent to hospital, by serological or bacteriological means. An organism of the " Flexner " type of the bacillus dysenterim was isolated from the mother, a daughter and a son, whilst another daughter and son gave serological evidence of suffering from the same infection. The o rg anism in one case gave reactions of a " W " strain of Flexner, while in another case reactions of the " X , " " V " or " W " type were given. The subsequent history of these cases as mentioned is interesting as showing that in a small house such cases cannot be adequately attended to. F i r s t of all we had the three cases, then another child taken ill a few days afterwards, and then a week afterwards the mother, but we t h i n k the mother may have been ill a day or two before she admitted it. There remained at home the father, who kept well all through, although he
Islinglon.
'l'l-Ili BIG AND "rile LI:rTLE TRADER.--lt is nay opinion that very few c o t t a g e l l o u s e s are suitable for the m a k i n g of ice cream and it is not advisable the trade should be carried on under such conditions, and here I may repeat w h a t was said in r egard to the m i l k business, viz., the more it is in the hands of large companies with capital and scientific advice at their disposal, the safer for the general public. T wo out-of-town firms established depots during the s u m m e r for the storage and distribution of ice cream under strict hygienic conditions, and I t h i n k such people
APRIL,
19:79.
should be encuuraged if we wish to l i mi t the chance of infection a.s nmch as possible. It wuuld be advisable if, at some future date, the ice cream trade could be put on the same footing as the mi l k business as regards registration. At present any person can s t a rt ice cream m a k i n g , whatever be the condition of his premises, and it is only by coming across his b a r r o w in the street or seeing a card in the w i ndow of his shop that we become a w a re of w ha t is t a k i n g pl a c e .--D r. Stephen Rowland,
Northampton.
TIlE DIAGNOSIS OF I)OUBTFUL CASES OF TUBERCULOSIS.-Of all the tests the subcutaneous O.T. test is the only reliable one in absolute diagnosis. If one gets a positive s put um or a focal reaction the diagnosis is certain. This test has been relegated to oblivion by the majority of workers because of its supposed da nge r in re a c t i vatin g a latent lesion. I t h i n k it is dangerous if it is used in the way some people have used i~, but I have seen no single case ha rme d by its use when the test is done w i t h the most careful precautions. There is no absolutely reliable single test of an active early case, laying stress on the words single and active, and in the end one often has to rely upon one's clinical instinct by a ge ne ra l impression of the result of every enquiry and especially on the presence or absence of symptoms that need t r e a t m e n t . - - D r . W. M.
Ash, Derbyshire County Council.
DISINFECTION "o EARLY DIaGNOSIS.--.Disinfection of premises and clothing is still practised in the case of the most infectious notifiable diseases. F r o m experience one would say, however, t ha t far too much importance is attached by the general public to disinfection and that too little consideration is given to w h a t is regarded as a slight indisposition. It is obvious t ha t in the spread of disease the detection of the mild case is a factor of gr eater importance than disinfection as now p r a c t i s e d . - - D r . H.
Gordon Smith, Lincoln.
" SUMMER TIME " MAKES HEALTHY WORKERs.--The general he a l t h of t h e workers, p a r t i c u ! a r l y t h e y o u n g e r ones, has, I believe, i m p r o v e d d u r i n g t he past few years. T h e factors w h i c h have c o n t r i b u t e d to this i m p r o v e m e n t are m a n y , a nd not t h e least, I consider, is " s u m m e r t i m e , " w h i c h enables the w orke rs to take a d v a n t a g e of th~ recrefitional facilities n o w p r o v i d e d by m a n y employers~ A n increase Of s uc h facilities, w h e t h e r b y indi',fidual firms or by m u n i c i p a l i t i e s , will, in the f u t u r e , be J:eflected in the i m p r o v e d heaIth of t h e worker~: T h e r e can be n o : d o u b t t h a t t he a r r a n g e m e n t s for welfare now m a d e b y m a n y firms, benefit t h e h e a l t h of t h e i r e mpl oye e s . Progress has been m a d e f r o m year to year in t hi s m o v e m e n t , b u t there is still a t e n d e n c y to l i m i t t he a p p l i c a t i o n of welfare to female employees. Of p a r t i c u l a r i m p o r t a n c e are those projects w h i c h ha ve for t h e i r object r e c r e a t i o n o u t s i d e w o r k i n g h o u r s for j u v e n i l e employees. T h e s e , i f well organised, cannot fail to c ount e ra c t t he pot e nt i a l ill effects of nnonotony a n d t e d i u m c o n s e q u e n t u p o n t h e m a n y m e c h a n i c a l a n d r e p e t i t i v e oc c upa t i ons u n a v o i d a b l e in m o d e r n i n d u s t r y . - - D r , ffohn C. Bridge, Senior Medical
Inspector, Factory Department, Home Office.