THE MEDICAL DEFENCE UNION.

1048 -realisation of the object which they all desired-the entire e elimination of tuberculous meat and milk from the supply. r. Finally, he discussed the question of the open-air treatment and said he believed that for the cure of phthisis they y required plenty of fresh air and so far as they couldd h secure it protection from dust and winds, together with as much sunshine as possible. Every large centre off population should have close at hand or within easyy reach some place where the open-air treatment of phthisis could be carried out, and he thought that muni-icipalities would come to recognise that it was cheaper too send their phthisical patients to a place where theree would be a chance of recoverv than simply to housee them in infirmaries until they died. At the conclusionn of Sir William Broadbent’s address, on the motion off the Marquis of Dufferin, seconded by the President of thee North of Ireland ‘Branch of the British Medical Association (Dr. Henry O’Neill), it was decided to approve of thee constitution of a branch of the National Association for thee Prevention of Consumption and other Forms of Tuberculosis,’ and that those present should form themselves into such. Office-bearers of the branch having been appointed, thee meeting concluded with votes of thanks to Sir William Broadbent and the Lord Mayor (who presided). After thee meeting was over the Lord Mayor entertained at luncheon -in one of the committee-rooms of the Town Hall Sir William - Broadbent and other friends who had been present. ,

.

in the

dwelling-houses ; memorialising the Home Secretary increasing the minimum cubic space for persons in workshops; obtaining power to prohibit the opening in future of underground workshops; obtaining power to increase the amount of open area required for all new houses, and the establishment of a public slaughter-house. Regarding the last-mentioned question-viz., that of a public abattoir-Dr. Hay regrets that when the proposal was recently before the Town Council it met with a discouraging result. The memorandum will be considered at as early a date as possible by the Public Health Committee, the as

to

understood to be desirous of somedone in Aberdeen in helping on the The convener (or "new crusade" against tuberculosis. chairman) of the committee is Mr. John Robertson, L.R.C.P. & S. Edin. BRISTOL. Meetings have been held in Bristol in connexion with the National Association for the Prevention of Consumption and Other Forms of Tuberculosis, and a provisional committee of medical men has been formed, with Dr. E. Long Fox as chairman, Dr. D. S. Davies as vice-chairman, Dr. P. Watson Williams as honorary treasurer, and Dr. Michell members of which

Clarke

Hay,

the medical officer of health of

as

honorary secretary.

KANTHACK MEMORIAL FUND.

ABERDEEN. Dr. Matthew

are

thing practical being

THE

is

list of the

which have

following subscriptions Aberdeen, has, in accordance with instructions to that been received for the Kanthack Memorial Fund, concern- effect, just submitted to the Public Health Committee written in THE LANCET. Dr. which we have a

already of the Town Council of that city suggestions for the ing prevention and control of tuberculous disease. The J. H. Drysdale, 25. Welbeck-street, W., is acting as honorary - report points out that tuberculous disease destroys in secretary. We understand that the Fund will shortly be Aberdeen about 350 persons every year and is accountable closed, so that intending subscribers should make no delay .for one out of every seven deaths, or, taking into account in their contributions. sending .the deaths of children registered as due to ill-defined causes, -9 s. d. L s. d. Dr. Hay believes ’’that tubercle, directly or indirectly, deter5 00 Dr. H. J. Bumsted ... Amount already acmines nearly one-fifth of all the deaths within the city." Mr. D. H. F. Cowin ... 0 10 0 knowledged in After referring to the wide dissemination of tuberculous 1 00 THE LANCET 267 11 0 Dr. J. G. Forbes ...... 1 10 Mr. Albert Norman ... 5 50 disease and its curability the report states that efforts to Dr. H. P. Cholmeley 2 20 5 5 0 Dr. A. M. Mitchell Dr. J. S. Edkins prevent tubercle must be largely directed against the Mr. W. E. Sargant 5 50 1 1 0 Dr. H. H. Tooth...... transmission of the tuberculous infection or germs from Mr. T. R. Smith 2 20 Dr. A. Lyndon 2 2 0 1 10 2 2 0 Dr. J. L. Maxwell R. C. Ackland already infected human beings or from infected animals. It Mr. Dr. R. A. Yeld 0 100 Dr. W. Osler, F.R.S. to that reforms and an is remarked owing general sanitary 5 00 (Baltimore)......... 10 10 0 Mr. T. G. A. Burns ... 1 1 0 0 Dr. A. G. Penny...... 10 10 improved standard of living the mortality from tuber- Lord Lister 0 10 6 10 10 0 Mr. E. C. Frend ...... culous diseases, especially from phthisis, has declined Mr. Alfred Willett Dr. A. L. Ormerod 1 1 0 Sir Richard Thorne, fallen in the the case within 40 years, having past greatly 2 2 0 Dr. E. W. Ormerod ... 1 10 K.C.B ............. of phthisis in Aberdeen to nearly one-half of that which Mr. Stephen Paget ... 5 5 0 1 1 0 Dr. A. F. Stabb 2 20 1 1 E. W. Brewerton ... it formerly was, but that there is still large scope for Dr. John Faweett...... 0 Mr. Mabyn 1 1 0 Read ...... Mr. C. H. Cosens....., improvement. Numerous suggestions are then made for the Dr. 1 1 0 Dr. M. L. Hepburn ... 1 10 J. R. Leeson...... more effective control and prevention of the spread of Dr. J. Calvert 1 1 0 5 5 0 Dr. R. Farrar ......... tuberculous disease within the city. These relate (1) to the Dr. G. C. Garratt...... W. J. Horne ...... 3 3 2 2 0 0 1 1 0 2 2 0 Mr. G. J. Briggs...... Mr. R. A. Walter..... -purity of air in the atmosphere, in dwelling-houses, in Dr. 1 10 2 2 0 Dr. T. H. Molesworth... D. Rawlings schools, and in workshops, and under this branch a stricter Dr. J. 1 1 0 Dr. P. Horton-Smith 2 20 W. Black Jones ... ......

...

...

...... ...

......

......

...

...

......

.........

...

...

5 5 0 Dr.

......

......

Dr.i

...

enforcement of the enactments for the abatement of smoke - from the chimneys of workshops and manufactories in .Aberdeen is recommended ; (2) to proper feeding ; (3) to -proper clothing ; and (4) to physical exercise. Then follow detailed precautions applicable to the community and to -persons suffering from tuberculous disease respectively, and suggestions for the prevention of the spread of tuberculous - infection from the lower animals. Dr. Hay’s chief suggestions are-the direction of the attention of keepers of hotels, restaurants, and eating-houses to the necessity for great care in the cleansing of eating-utensils; the preparation under Section 65 of the Public Health (Scotland) Act of suitable ’by-laws for regulating the cleansing and sanitary condition generally of public conveyances ; the consideration of the question of a sanatorium (in the country) for phthisical -patients, and of the associated out-door or dispensary arrangements ; the consideration of a scheme for the inspec-tion of cows in all dairies supplying milk to the city, with a view to preventing the sale of tubercle-infected milk; and the consideration of the question of providing a public steri’lising station for milk. Dr. Hay also makes recommendations -to the Town Council as to the cleansing of foot pavements, fi.c.; -the systematic securing of open spaces for recreation; the provision of public gymnasia with, if possible, public baths .attached; the formation or encouragement of cottage areas and the discouragement of the tenement system of housing ; -the hastening of the demolition of slum dwellings ; obtaining power to raise the minimum cubic space for each person

...

Mr. J. Ackery Dr. Arthur Latham Mrs. Unwin Dr. A. B. Green

......

...

......... ......

Dr.&.WaIker ..... Mr. H. S. Well come

...

Dr. C. F. Marshall Dr. E. Clifford Beale ... Dr T. P. Legg Dr. A. B. Rendel......

...

......

Anonymous

.........

Mr. J. H. Churchill ... Mr. Claud Worth...... Mr. Ernest Clarke ...

3 3 0 10 10 0 5 0 0 5 0 0 1 0 0 5 50 1 1 0 3 3 0 1 0 0 5 5 0 1 1 0 1 1 0 1 1 0, 2 20

Dr. F. W. Robertson Mr. F. Belben Dr. C. Balfour Stewart Dr. C. Neill Dr. C. Addison Dr. E. F. Trevelyan Dr. W. B. Addison Mr. A. Cuddon-Fletcher Dr. G. H. Sowry...... Dr. R. Sevestre ...

......

.........

......

...

...

......

Dr.J.Hohday Total

......

.........

1 0 2 0 5 50 10 100 2 2 0 3 30 1 1 0 1 1 0 1 1 0 2 ’20 1 1 0 1 2

£459 2 6

THE MEDICAL DEFENCE UNION. I

ANNUAL GENERAL MEETING. general meeting of the Medical Defence Union was held on April 6th at St. Martin’s Town Hall. The President, Dr. W. S. A. GRIFFITH, was in the chair. After the minutes of last year’s annual meeting had been confirmed and signed, the report and statement of accounts for the year 1898 were presented. The report, of which we gave a resume last week, dealt exhaustively with the aims of the society and its work during the past year and laid special stress on the fact that THE annual

1049 the chief duty ot the Union is the defence of its members not the benefit of the profession as a whole, which is

and

more properly the work of the General Medical Council and the British Medical Association. It suggested that much might be done to increase the numbers of the Union if the members, especially those who had received the full benefits of the society, would make more generally known the great advantages attached to membership. The Council regretted having bad to take strong measures to secure more prompt payment of subscriptions which were allowed to fall in The report further stated that owing to the able arrear. way in which the Union carried on its work, the British Medical Association had considered it unnecessary to take up the work of medical defence. The solicitor’s report stated that though there had been fewer cases than in the previous year more important decisions had been involved and that this reduction in number was a healthy indication of the growing influence of the Union’s weight. The chief cases considered by the Council were enumerated and they served to show the vast amount of good work done by the Union on behalf of its members and of the whole profession. The CHAIRMAN, in moving the adoption of the report, said that it was a matter of doubt to the Council whether members read the report which was sent to them and whether they had any idea of the amount of work done. The work was increasing yearly as shown by the report and it involved a considerable sacrifice of time. The meetings of the Council had now to be as frequent as two a month and many had to be adjourned. The success of the Union was largely dependent on the zeal of the secretary and the solicitor, and this year it was specially indebted to the additional work done by the treasurer during the secretary’s illness and he thought that this additional ’work should be recognised in some suitable way. He had no special statement to make with regard to the policy of the Union. The solution of many important questions now agitating the profession might be thought a part of their duties, but owing to the great difference of opinion prevailing among medical men who make no real attempt to meet each other half-way the settlement of such vital questions could not be expected yet. On one point the Union was unanimous and that was that its duty was to defend every member of the Union who is attacked unfairly to the utmost of its power, and therefore it is inclined to take the work which lies before it rather than to deal with matters which the profession is not prepared to accept. The question of the qualification of members was a matter which had been referred to the Executive Committee to report upon. Mr. STAMFORD FELCE, in seconding the motion, congratulated the President, who had succeeded Mr. Victor Horsley, on the ability with which he had discharged his duties. Mr. E. C. BOUSFIELD objected to the Council not having drawn up a schedule of cases, as, in his opinion, if such a schedule were forwarded to each member of the profession it would have a great deal of effect as an actual statement of the work done and might be a means of increasing the

Dr. W. P. HERRINGHAM, who seconded the motion, remarked that this was one of the most important things now before the profession and that there was nothing more important than to have its legal position more nrmly established. Dr. LOVELL DRAGE, coroner for Hertfordshire, said that, in the small experience which he had had, evidence was. frequently given by unqualified and unregistered people who< were sometimes supported by certificates issued by registered practitioners; this appeared to him to be a matter which. the Union could remedy without going to Parliament. The CHAIRMAN said that whatever assistance ought to be. given by the Union would be given, but it was neither just nor right to expend the money subscribed by 4000 members. of the profession for the benefit of the whole. The motion was then unanimously adopted and the;

meeting

terminated.

VITAL STATISTICS. HEALTH OF ENGLISH TOWNS.

largest English towns 6481 births and 4755 deaths were registered during the week ending April 8th. The annual rate of mortality in these towns which had been 23 1 per 1000 in each of the two preceding weeks declined last week to 21-7. In London the rate was 20’8 per 1000, while it averaged 22-4 in the 32 provincial towns. Thelowest death-rates in these towns were 11-8 in Cardiff, 16’1 in Bolton, 16’3 in West Ham, and 16’6 in Gateshead ; the highest rates were 26 7 in Halifax, 27’5 in Brighton, 28’1 in Burnley, and 39’9 in Wolverhampton. The 4755 deaths in these towns included 379 which were referred to the principal’ zymotic diseases, against 397 and 401 in the two preceding weeks ; of these, 125 resulted from whooping-cough, 85 from measles, 75 from diphtheria, 39 from ’’fever"(principallyenteric), 33 from diarrhoea, and 22 from scarlet fever. The lowest death-rates from these diseases were recorded in Bolton, Croydon, Bradford, and Bristol; and the highest i rates in West Ham, Manchester, Burnley, and Huddersfield. The greatest mortality from measles occurred in Manchester I, and in Gateshead; from whooping-cough in Birkenhead, Burnley, Preston, Halifax, Hull, and Sunderland; and from "fever" in Wolverhampton, Derby, and Salford.. The mortality from scarlet fever showed no marked excess in any of the large towns. The 75 deaths from diphtheria included 34 in London, seven in Sheffield, four in Ports-mouth, four in Liverpool, four in Leeds, three in Swansea, three in Birmingham, and three in Leicester. No fatal case of small-pox was registered last week in any of the 33’ large towns, and only one small-pox patient was under treat ment in the Metropolitan Asylums Hospitals on Saturday last, April 8th. The number of scarlet fever patients in these hospitals and in the London Fever Hospital at the end of last week was 2234, against numbers declining from 2584 to 2322 on the five preceding Saturdays ; 150 new cases were admitted> membership. The motion for the adoption of the report was then during the week, against 224, 177, and 167 in the three preceding weeks. The deaths referred to diseases of the respicarried unanimously. organs in London, which had been 604 and 505 in theratory Dr. W. S. A. Griffith, Dr. A. H. Jones, and Mr. T. Garrett two preceding weeks, further declined last week to 470, but the members of the were re-elected. Horder, Council, retiring Dr. J. A. MASTERS, in proposing that the accounts as were 93 above the corrected average. The causes of 69, or audited by Mr. Lewis Hardy be received, adopted, and 1’5 per cent., of the deaths in the 33 towns were not certified-: entered on the minutes, said that no mention had been made either by a registered medical practitioner or by a coroner. of the work done by the honorary secretary, Dr. H. Campbell All the causes of death were duly certified in Leicester, NotSalford, Bradford, and in eight other smaller towns;: Pope, in the absence of the general secretary. He was glad tingham, to say that the financial position of the Union was very the largest proportions of uncertified deaths were registered in West Ham, Liverpool, Blackburn, and Preston. gratifying. Mr. Lewis Hardy was elected auditor for the ensuing HEALTH OF SCOTCH TOWNS. year. A sum not to exceed E100 was allotted pro ratâ to the The annual rate of mortality in the eight Scotch townS’ members of the as Council or provincial payment part payment of their railway fares whilst attending Council and which had increased in the three preceding weeks from 21-0 to 23’3 per 1000 declined again to 21’8 during the week Executive Committee meetings. ending April 8th, and slightly exceeded the mean rate during Dr. DANFORD THOMAS then moved:the same period in the 33 large English towns. The rates in That this meeting of members of the Medical Defence Union, the eight Scotch towns ranged from 17’7 in Edinburgh and’ believing that no effectual legal action can be successfully taken and other and against quacks unqualified persons prac- 17’9 in Greenock to 25’7 in Dundee and 27’3 in Aberdeen. unregistered tising medicine for gain under the provisions of the present Medical The 665 deaths in these towns included 23 which were referred’ Acts, does consider that the time has arrived for the promotion of a to whooping-cough, 22 to measles, 20 to diarrhoea, nine to. Bill in Parliament for the amendment of the same and that this the Council of this Union should in conjunction with other associations take such measures as may be deemed advisable in assisting and supporting such amended legislation as may effectually protect the interests ùf the medical profession as well as those of the public

meeting would further suggest that take such action in the matter, or

generally.

IN 33 of the

to scarlet fever, and two to " fever." In all, 79 deaths resulted from these principal zymotic diseases, against 67 and 97 in the two preceding weeks. These 79 deaths were equal to an annual rate of 2’6 per 1000 which was 0’S’ above the mean rate last week from the same diseases in the

diphtheria, three