1030 is bearing fruit in the lessened number of practitioners who hold excellent diplomas, because the work diagnosed in the wards of the hospital. En- that they have done for these diplomas would as easily as couraged by previous success it was determined to possible have obtained for them a university degree had carry on the camp in its entirety during the winter circumstances placed a university curriculum before them. 1902-03 and the same successful results have character- The holder of the diplomas of the English Conjoint Board ised this effort as marked the camp treatment during has passed tests as stringent as those required for medical the summer months. In addition to the two large tents degrees in many of the universities and the only reason why used previously a third large tent was erected on the such a practitioner does not possess a medical degree is that present occasion. This contained no beds but was he was educated in London. He has had the advantage of partitioned by screens into a dining room and a living room attending some famous metropolitan school and of seeing for such patients as were not confined to bed. For it clinical practice in an institution where the wealth of material is unrivalled but not being prepared to give up the was found that only the large tents could successfully withstand the severe weather of the winter months and by this time necessary for the obtaining of the M.D. degree of the new arrangement it was possible to dispense with the small University of London he is without the title of ’’ Doctor." auxiliary tents. Large coal stoves provided ample heating Dr. Leonard recommends that in this plight he should have facilities in severe weather but a high indoor temperature recourse to Brussels and in the present position of affairs
isolation cases
,
,
avoided inasmuch as the cool air had, in this treatment, appeared to exert a decided therapeutic effect of its own. The large living tent was left somewhat cooler than the other tents, so that patients in going in and out of doors passed through it and avoided too sudden changes of temperature. Notwithstanding the constant exposure "not a case of ordinary cold or pneumonia developed during the entire winter" and even when the climatic conditions were unfavourable the patients could securely live a constant outdoor life. A high dry altitude was demonstrated to be essential for the successful treatment of pulmonary tuberculosis. The mortality rate of tuberculous patients during the winter 1902-03 was found to be appreciably lower than that of the previous year. Of 61 patients with slight or moderate tuberculous disease 53 gained weight, seven lost weight, and one remained unchanged. The average gain of weight was 15½ pounds per patient. The general principles of treatment and diet were carried out as in the previous The statistics, add Dr. Wright and Dr. Haviland, season. show a decided improvement over those of the preceding year and encourage the further continuance of the methods of treatment adopted. was
-
THE
M.D.
DEGREE OF BRUSSELS.
ON p. 1037 we publish a communication from Dr. N. Leonard who states very clearly the procedure necessary to obtain the M.D. degree of Brussels and estimates fairly the difficulty of obtaining the degree and the standard of scientific attainment required to cope satisfactorily with the examinations. He concludes his remarks, which will be of value to some of our readers, by saying that the time and trouble spent in the attainment of the degree will be amply repaid in an improvement of social status, and we think that he is right. We also think it particularly unsatisfactory that he should be right, for surely it is an absurd position that the medical man of a country like ours should find it necessary to go to Belgium for a professional hall-mark. We are not intending to open up an endless discussion upon the use of the title of "Doctor." Everyone knows that the title is used in two ways-academically when it implies the medical degree of a recognised university and colloquially when it implies the carrying on of the profession of healing. Everyone also knows that in professional opinion it is wrong for the medical man who does not possess a medical degree to style himself ’’Doctor," but a practitioner cannot help the fact that his patients will habitually style him"Doctor." The double use of the title has produced an ever-annoying situation. Undoubtedly it is a disadvantage in medical practice that it should be possible to" say of any man that he has no right to the title of "Doctor." The public do not understand that only non-possession of a certain university degree is implied, not an inferiority of some sort or other as a practitioner. This mental confusion of the public is particularly hard upon a large number of medical
doubtless there are many who will follow his advice. But may hope that the reconstituted University of London will soon be able to offer to the London student a proper opportunity of obtaining a medical degree. Already the matriculation examination of the University is a fairer introduction to graduation than it used to be and we look forward to the time when a simplification of examination processes, which is not the same thing as a lowering of scientific standards, will lead more London students to try for the medical degree of their own university. we
THE
KING’S SANATORIUM.
IN The Health Resort for October appears a paper entitled The King’s Sanatorium. A Waste of Lives and Money. A Criticism by Ohas. Reinhardt, M.D." After a careful perusal of this article we can only express our regret that it has ever appeared in print. It is founded on views which we feel sure will not be supported by the majority of those who have had extended experience in the sanatorium treatment of pulmonary tuberculosis. The very title of the communication is objectionable and its publication may be productive of harm and much misconception with regard to a most excellent and carefully considered scheme. There are many sentences in Dr. Reinhardt’s paper to which we take strong exception, but space forbids us from mentioning t] them all. Dr. Reinhardt starts with the assumption that a ’‘ costly, substantial, and not altogether appropriate hospital ofpalatial’ character" is to be built. Considering that the o have not yet been made public we entirely fail to p plans understand how Dr. Reinhardt is aware of the detailed u n nature of the building which is to be erected ; consequently t] oft-repeated word "palatial"" is meaningless. It would the h have been in much better taste if such an epithet had been withheld until the plans were known. We feel, morethat from o could be further the comover, nothing mittee’s wishes than that a "° palace" of any kind n sl should be constructed. Dr. Reinhardt’s main contention is t] that the sanatorium should be built on the chalet, instead of on the pavilion, system. He says : "Every phys: sician who has had the opportunity of comparing the results of treatment upon the chalet and room principles will accept o tl following statement: Incipient cases are cured in 25 per the c cent. less time where chalet patients are concerned than is t] the case where patients occupy rooms." We feel sure that s such a statement is not correct and we have derived our information from those who have had practical experience. I is possible that in a suitable climate the chalet or hut It is preferable when only a few patients, say up to s system 2 have to be dealt with. Above this number, however, 20, t] the difficulties in administration and nursing are so great t] that the advantages of the huts are far over-shadowed b by the discomforts inseparable from a large number of chalets scattered over a considerable area of ground, o Dr. Reinhardt attempts a at any rate in this country.