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THE MEDICAL PROFESSION AND THE TRADE-UNION QUESTION.
397
Correspondence. "
Audi alteram partem."
THE MEDICAL PROFESSION AND THE TRADE-UNION QUESTION. To the Editor of THE LANCET.
Parliamentary Committee to form a really active properly representative body for the greatest good of greatest number.-I am, Sir, yours faithfully,
and the
R. FIELDING-OULD, FiaMMNG-OuLD, M.D., M.R.C.P., M.A. William-street, S.W., March 4th, 1919.
CONTACT INFECTION OF CHICKEN-POX. To the Editor of THE LANCET. SIR,-In an article published in THE LANCET of Feb. 12th,
SIR,-It cannot be too widely known, as indicated in your the aerial conveyance of infection of certain . leading article of March lst, that the meeting held in 1916, on I a note on the contact infection of chickenfevers added not of 23rd could stretch Hall on Feb. by any Wigmore work on the aerial conveyance imagination be regarded as representative of the great mass pox. Far reasons stated the but that on the contact
’
infection of medical practitioners. The profession would be gravely of infection was stopped, misled if the decision there recorded went forth to the world of chicken-pox continued, though necessarily slowly, until without some explanation as to the conditions under which the hospital was utilised as an American war hospital. In the note on chicken-pox contact infection 7 cases were that vote was obtained. The meeting was called by the Medico-Political Union-a reported as having passed through the ward without causing case having been placed in the ward on body for some years committed to trades-unionism, and four- infection, the last Since that time 5 more fifths of the audience were already whole-hearted supporters of the eighth day of the eruption. cases have passed through, and as the last marks a definite In article above to the referred deal with the that policy. you arguments put forward by the principal speakers, and mention infecting period there seems to me some reason for recording the fact that they were largely unanswered. This absence of them. The ward chosen for the work was a scarlet fever one of criticism did not mean acquiesence and was mainly due to the fact that while the proposer and seconder of the resolu- 20 beds for small children, and no precautions were taken tion expended one hour in recommending their invitation to avoid infection from the chicken-pox cases introduced. to the whole profession to come under the trade-union The ages of the unprotected children exposed to these five umbrella, opponents, on the other hand, were only allowed cases were : 1 year, 7 ; 2 years, 6 ; 3 years, 9 ; 4 years, 13 ; five minutes to argue their side of the question and were 5 years, 106 years, 6; and 7 years, 2. The five patients then only accorded an impatient hearing with many inter. introduced suffered from both chicken-pox and scarlet fever, ruptions, mostly irrelevant. Any real discussion was there- one being introduced on the eighth day of the chicken-pox fore impossible. It is clear, however, from the three mass eruption, one on the seventh day, one on the sixth day, and meetings recently held in London, that the medical pro- two on the fifth day. Only one case was introduced at a fession is at present politically in a ferment and has shown time, and was kept in the ward until all the scabs had itself to be divided into two main lines of thought. separated or longer, while no patient was discharged from One section still regards the practice of medicine as a voca- the ward until more than 22 days had elapsed after the first tion and not as a trade, and, in a materialistic age, aspires exposure, many being kept much longer. No infection arose from the first four cases (Cases 8, 9, to the twin virtues of service and sacrifice ; the other, and 11), but the fifth (Case 12) infected three children. all 10. the Medico-Political Union, argues represented by 8th Case.-Eighth day of chicken-pox eruption; very questions of medical politics from the standpoint of profit and loss, and takes up a firm trade-union position on a basis numerous scabs and numerous pustules. 19 other patients of hard cash. To the practical medical politician, anxious in ward-11 protected, 8 unprotected. No infection. 9th Case.-Seventh day; numerous scabs and pustules. that his profession should pull its weight in the national 19 other patients in ward-6 protected, 12 unprotected, not to it seems correlate these 1*>at, divergent 1 doubtful. No infection. impossible views and so find some common ground from which to watch 10th Case.-Sixth day; numerous scabs and vesicles; a few the interests of the profession and to promote the public pustules. 19 other patients in ward-8 protected, 10 unproweal. tected, 1 doubtful. No infection. 11th Case.-Fifth day; moderate eruption, scabs and a few Would it not, then, be possible that from these two main bodies of medical opinion two councils be formed, each pustules. 19 other patients in ward-8 protected, 11 unproNo infection. organised on its own lines to suit the special needs of its tected. 12th Case.-Fifth day; very abundant eruption, scabs and and when matters of medical politics some constituents, grave pustules. 19 other patient in wards-7 protected, are discussed they might meet in joint session and so bring 12 unprotected. Infected three children in ward. Of the to bear on the responsible authorities the full weight of their three infected children, one showed the eruption 14 days accumulated knowledge and experience. The Medical after the introduction of the infector to the ward, and the Parliamentary Committee has already among its members other two 16 days after. The infection was apparently by indirect contact, for the infector and the three infected distinguished represent diives of the trade-union doctrine, and were in bed for the first few days of exposure; the infector I venture to suggest that this committee might well be made for the first five days, two of the infected for the first four a rallying ground for all shades of medical opinion and form days, and the other for the first three days. Further, the the nucleus of a general medical Parliament. infected were all in beds at some distance from the infector. It is clear that medical men in contract practice must Altogether 12 cases have passed through this ward, and be treated by Government departments and Insurance Comthe number seem small to some, it is to though missioners differently from what they have been in the past, be remembered that may is a infectious disease. chicken-pox their opinion must be sought, when medical questions are which seldom fails to cause infectionvery in wards occupied by under discussion, and their views not only heard but atten- small children. There is, therefore, some reason to think tion must be paid to them. It is incontrovertible that panel that the contact infection of chicken-pox probably ceases practitioners have been treated infamously on occasion. Dr. about the end of the first week of the eruption or the E. H. M. Stancomb and Dr. J. A. Angus proved this conof the second. Further, that chioken-r’ox may beginning clusively at Wigmore Hall. Furthermore, members of the be infectious by contact on or before the fifth day. profession who are practising as free men, unshackled by certainly I am, Sir, yours faithfully, Government contracts, must be enabled to make their weight FREDERIC THOMSON. felt in the counfita of the nation and wherever their expert North-Eastern Hospital. Tottenham, London, N., Feb. 27th, 1919. knowledge and experience may be of value. In the future, and indeed in the present, no Minister of Health can afford to flout medical opinion, as have Govern"SHOCK" (SO-CALLED). ment Departments in the past, and this must be made clear To the Editor of THE LANCET. in unmi takable terms. Fortunately, we have in the first head of the new Ministry a medical man who is alive to the SIR,-A philosopher has written that " words shoot back value he is likely to gain by ready cooperation wirh his pro- ipon the understanding of the wisest, and mightily entangle fessional confrères. But the trade-union section must not tnd pervert the judgement," and it would be hard to find imitate their less educated brethren by exhibiting the canker ven in theological and metaphysical controversy an instance of unreasoning su-picion. but should take a broad and states- )f greater confusion than has arisen from the misuse of the manlike survey of the situation and unite with the Medical word "shock." According to the dictionaries it denotes
Correspondence. "
Audi alteram partem."
THE MEDICAL PROFESSION AND THE TRADE-UNION QUESTION. To the Editor of THE LANCET.
Parliamentary Committee to form a really active properly representative body for the greatest good of greatest number.-I am, Sir, yours faithfully,
and the
R. FIELDING-OULD, FiaMMNG-OuLD, M.D., M.R.C.P., M.A. William-street, S.W., March 4th, 1919.
CONTACT INFECTION OF CHICKEN-POX. To the Editor of THE LANCET. SIR,-In an article published in THE LANCET of Feb. 12th,
SIR,-It cannot be too widely known, as indicated in your the aerial conveyance of infection of certain . leading article of March lst, that the meeting held in 1916, on I a note on the contact infection of chickenfevers added not of 23rd could stretch Hall on Feb. by any Wigmore work on the aerial conveyance imagination be regarded as representative of the great mass pox. Far reasons stated the but that on the contact
’
infection of medical practitioners. The profession would be gravely of infection was stopped, misled if the decision there recorded went forth to the world of chicken-pox continued, though necessarily slowly, until without some explanation as to the conditions under which the hospital was utilised as an American war hospital. In the note on chicken-pox contact infection 7 cases were that vote was obtained. The meeting was called by the Medico-Political Union-a reported as having passed through the ward without causing case having been placed in the ward on body for some years committed to trades-unionism, and four- infection, the last Since that time 5 more fifths of the audience were already whole-hearted supporters of the eighth day of the eruption. cases have passed through, and as the last marks a definite In article above to the referred deal with the that policy. you arguments put forward by the principal speakers, and mention infecting period there seems to me some reason for recording the fact that they were largely unanswered. This absence of them. The ward chosen for the work was a scarlet fever one of criticism did not mean acquiesence and was mainly due to the fact that while the proposer and seconder of the resolu- 20 beds for small children, and no precautions were taken tion expended one hour in recommending their invitation to avoid infection from the chicken-pox cases introduced. to the whole profession to come under the trade-union The ages of the unprotected children exposed to these five umbrella, opponents, on the other hand, were only allowed cases were : 1 year, 7 ; 2 years, 6 ; 3 years, 9 ; 4 years, 13 ; five minutes to argue their side of the question and were 5 years, 106 years, 6; and 7 years, 2. The five patients then only accorded an impatient hearing with many inter. introduced suffered from both chicken-pox and scarlet fever, ruptions, mostly irrelevant. Any real discussion was there- one being introduced on the eighth day of the chicken-pox fore impossible. It is clear, however, from the three mass eruption, one on the seventh day, one on the sixth day, and meetings recently held in London, that the medical pro- two on the fifth day. Only one case was introduced at a fession is at present politically in a ferment and has shown time, and was kept in the ward until all the scabs had itself to be divided into two main lines of thought. separated or longer, while no patient was discharged from One section still regards the practice of medicine as a voca- the ward until more than 22 days had elapsed after the first tion and not as a trade, and, in a materialistic age, aspires exposure, many being kept much longer. No infection arose from the first four cases (Cases 8, 9, to the twin virtues of service and sacrifice ; the other, and 11), but the fifth (Case 12) infected three children. all 10. the Medico-Political Union, argues represented by 8th Case.-Eighth day of chicken-pox eruption; very questions of medical politics from the standpoint of profit and loss, and takes up a firm trade-union position on a basis numerous scabs and numerous pustules. 19 other patients of hard cash. To the practical medical politician, anxious in ward-11 protected, 8 unprotected. No infection. 9th Case.-Seventh day; numerous scabs and pustules. that his profession should pull its weight in the national 19 other patients in ward-6 protected, 12 unprotected, not to it seems correlate these 1*>at, divergent 1 doubtful. No infection. impossible views and so find some common ground from which to watch 10th Case.-Sixth day; numerous scabs and vesicles; a few the interests of the profession and to promote the public pustules. 19 other patients in ward-8 protected, 10 unproweal. tected, 1 doubtful. No infection. 11th Case.-Fifth day; moderate eruption, scabs and a few Would it not, then, be possible that from these two main bodies of medical opinion two councils be formed, each pustules. 19 other patients in ward-8 protected, 11 unproNo infection. organised on its own lines to suit the special needs of its tected. 12th Case.-Fifth day; very abundant eruption, scabs and and when matters of medical politics some constituents, grave pustules. 19 other patient in wards-7 protected, are discussed they might meet in joint session and so bring 12 unprotected. Infected three children in ward. Of the to bear on the responsible authorities the full weight of their three infected children, one showed the eruption 14 days accumulated knowledge and experience. The Medical after the introduction of the infector to the ward, and the Parliamentary Committee has already among its members other two 16 days after. The infection was apparently by indirect contact, for the infector and the three infected distinguished represent diives of the trade-union doctrine, and were in bed for the first few days of exposure; the infector I venture to suggest that this committee might well be made for the first five days, two of the infected for the first four a rallying ground for all shades of medical opinion and form days, and the other for the first three days. Further, the the nucleus of a general medical Parliament. infected were all in beds at some distance from the infector. It is clear that medical men in contract practice must Altogether 12 cases have passed through this ward, and be treated by Government departments and Insurance Comthe number seem small to some, it is to though missioners differently from what they have been in the past, be remembered that may is a infectious disease. chicken-pox their opinion must be sought, when medical questions are which seldom fails to cause infectionvery in wards occupied by under discussion, and their views not only heard but atten- small children. There is, therefore, some reason to think tion must be paid to them. It is incontrovertible that panel that the contact infection of chicken-pox probably ceases practitioners have been treated infamously on occasion. Dr. about the end of the first week of the eruption or the E. H. M. Stancomb and Dr. J. A. Angus proved this conof the second. Further, that chioken-r’ox may beginning clusively at Wigmore Hall. Furthermore, members of the be infectious by contact on or before the fifth day. profession who are practising as free men, unshackled by certainly I am, Sir, yours faithfully, Government contracts, must be enabled to make their weight FREDERIC THOMSON. felt in the counfita of the nation and wherever their expert North-Eastern Hospital. Tottenham, London, N., Feb. 27th, 1919. knowledge and experience may be of value. In the future, and indeed in the present, no Minister of Health can afford to flout medical opinion, as have Govern"SHOCK" (SO-CALLED). ment Departments in the past, and this must be made clear To the Editor of THE LANCET. in unmi takable terms. Fortunately, we have in the first head of the new Ministry a medical man who is alive to the SIR,-A philosopher has written that " words shoot back value he is likely to gain by ready cooperation wirh his pro- ipon the understanding of the wisest, and mightily entangle fessional confrères. But the trade-union section must not tnd pervert the judgement," and it would be hard to find imitate their less educated brethren by exhibiting the canker ven in theological and metaphysical controversy an instance of unreasoning su-picion. but should take a broad and states- )f greater confusion than has arisen from the misuse of the manlike survey of the situation and unite with the Medical word "shock." According to the dictionaries it denotes