The New Order for Compulsory Notification of Tuberculosis.

113

sociologists,

cannot remain

indifferent ;

their

recognition of subjects him to any restriction, prohibition, or disability affecting himself or his employment, occupation, or means of

its force must at all events impose upon them the duty of seeing

that medical

authority is not rashly given to proposals thatII monogamic system which is the foundation

of Western civilisation.

livelihood on the ground of his suffering from tuberculosis. Outside the county boroughs the medical officer of health is to send weekly to the county officer copies of all the notify

possible prejudice

cations which he has received.

with the

tamper

For this reason, and because of the which it may entail to the interests of the insane, the recommendation that persistent mental disease should constitute a ground of divorce cannot be

with

regulations

by

All forms of tuberculosis

in view of recent events.

Government Board and will take effect solidates the previous Orders of 1908 and

particulars,

con-

of notification to all forms of tuberculosis

limiting it,

tuberculosis.

at

present,

The consolidation of

the sanatorium benefit of

to those

or

suffering only

from

It is to be available also in the

and those who

of which the chief is the

instead

as

from what is termed

pulmonary case

of any

1911, and amends form of tuberculosis for the dependents of insured persons

application of

Apart

ordinary domiciliary treatment,

tuberculosis.

certain

notified,

the National Insurance Act is not intended to be confined to

insured persons

them in

to be

which have led the Local Government Board to take this important step at the present time seem sufficiently obvious

THE Notification and Treatment of Tuberculosis Order 19th, 1912, which has now been issued by the Local

lst,

required

only specified exception being tuberculosis the evidence of which is derived solely from tuberculin tests. The reasons

of Dec.

Feb.

are now

the

The New Order for Compulsory Notification of Tuberculosis. on

are

authority.

the medical profession until it has been discussed in all its bearings and until the objections that lie against it have been conclusively met.

endorsed

the

His expenses in connexion to be defrayed by the local

the

to

the

department

national

pulmonary

previous

are

system

not insured at all.

which is

on

for

organising a develop it by giving obtaining independent

these lines wishes to

local health officers the

Orders

responsible

It is natural that

means

of

concerned, and not procedure simpler and provides for all the principal contingencies leaving them to wait for voluntary applications from those a on uniform plan. Every medical practitioner will entitled to treatment. Much of the non-pulmonary tuberbe to make a primary henceforth notifica- culosis, of course, occurs in children attending schools and required tion of tuberculosis to the medical officer of health of is already brought to official notice in the ordinary course the sanitary district in which the patient lives, in any of school medical inspection. But the circular which accomcase in which he diagnoses tuberculosis and has not any panies the Order recalls the fact that more than half the reasonable grounds for believing that the case has beeni deaths from non-pulmonary tuberculosis are of children under previously notified. The fee of half a crown for each1 5 years of age, and states that it is probable that a much primary notification becomes payable to him by the higher percentage of the total number of persons suffering local authority concerned at the end of the quarter from non-pulmonary tuberculosis are children of this age. It without application being necessary. The medical officers of is hoped therefore that notification of these cases will faciliinstitutions, such as hospitals, asylums, and Poor-law7 tate the investigation of sources of infection and assist in institutions and sanatoriums, are in the same position as! securing improvement in the conditions under which the the private practitioner in regard to primary notifications. children live. The compulsory notification of tuberculosis in England In the case of Poor-law establishments and sanatoriums, to make also and Wales may now be regarded as very completely provided are "secondary" however, they required notifications, on a different scale of fees, of all admissionss for by the new regulations. It is based on the assumption and discharges of in-patients suffering from tuberculosis. that its adoption is in the interests of the tuberculous patients The present system under which the medical officers of, themselves, and to the advantage of preventive medicine and institutions merely notify to the local authority of the’ national statistics ; and on the practical side there is already district in which the institution is situated, leaving itj a large amount of experience which encourages a confident will be

welcomed,

as

the

has

now

information

been made

as

to the individuals

"

’’

’

to the medical officer of health to sort the

distribute the

notifications,

is

superseded ;

cases

andI

the institutionss

will in future send their notifications directly to the medicall The exemptions from notification off officer of health. life for and certain other exceptional1 insurance applicants classes of the population remain, and an addition has beeni

belief that universal notification will mark a new stage in the attack on tuberculosis which will have far-reaching and beneficial results. We refer elsewhere to the steps which are

before, the preparation of

being taken by the Government Departments to encourage provision of institutional treatment of tuberculosis by The organisation to deal with notified local authorities. cases is, of course, still far from being complete. The have as been a settled in governing principles yet only broad outline, in which many gaps’remain to be filled. Time will be required and many different plans will

steps

have to be tried

made which relieves certifying factory surgeons from the3 obligation of notifying. The duties imposed on the medical1 s officer of health in connexion with notified cases include, as a register and taking such and desirable for investigating the3 necessary of infection, for preventing the spread of infection,,

as are

the

by

medical officers of health in order

to learn the ways in which the notifications that they " Even on infection." conditions favourable to receive can be used to the best advantage. removing numerous that side it is obvious adjustments the statistical Nothing in the regulations is, however, to authorise any rand corrections will be necessary as experience is gained. action which renders the person notified liable to penalty or source

and

for

114 The notification

extended will supply to all undertaking useful work in many directions without waiting for the advent of complete

will be on exhibition during the meeting of the congress. Among other sections is one representing the medical deities of savage, barbaric, and other primitive new peoples. Specimens of these have been forwarded from all local organisations which will satisfy all the requirements of the parts globe, but there are still, we learn, many gaps of the tuberculosis problem. to be filled, and those who possess such objects, and would be willing to lend them, should communicate with the secretary of the exhibition, 54A, Wigmore-street, London, W., England. Amulets, talismans, and charms connected with the art of healing will also form another prominent feature, and any loans of this description would be welcomed. In the section " Ne quid nimis." of surgery an endeavour will be made to trace the evolution and development of the chief instruments in use at the RADIATIONS IN ECONOMICS. present day, and it is desired to accumulate specimens of WHEN we consider the many important processes in the instruments used in every part of the world by both savage arts and industries which depend upon the action of and civilised peoples. In pharmacy and in botany special ferments the suggestion that these may be replaced by mere exhibits are projected, which will include models of ancient physical agencies is bound to claim attention. There are pl:armacies, laboratories, and curious relics of the practice of now some observers in the ever-expanding field of electrical alchemy in early times. Specimens of ancient and unusual study who are beginning to assign to the silent electric dis- materia medica from all parts of the world will also be - charge, or to the ultra-violet rays thereby produced, a power exhibited. A complete illustrated syllabus will be forwarded to hydrolyse substances capable of undergoing that process. to anyone interested on application. Starch at any rate after some hours’ exposure to the silent discharge gradually resolves into sugar. It is well known, "QUE DIABLE FAIT IL ..... ?" of course, that acids will do the same thing, and for a long THE aversion of the medical profession from all forms of time sugar has been prepared from starch by boiling it with is well known and of long standing. self-advertisement acids. That was the first step which made the brewing and rooted as it there are signs that twentieth century is, Deeply distilling industries independent if need be of the use of diastase as a converting agent. The mash tun can commercialism is weakening it in some respects, and that The covert publicity is on the increase. Undoubtedly, it is thus be replaced to some extent by the converter. acid used as the hydrolytic agent must, of course, be impossible to draw any hard-and-fast line between what removed, but, if it should prove that by the mere exposure of constitutes a correct and an unprofessional act in this respect. No one would brand as objectionable advertisestarch to the silent electric discharge it can be converted into sugar on a commercial scale, it is possible that both ments the somewhat swollen°paragraphs which some members )f the profession contribute to that very useful and necessary ferment and acid may at some future time be dispensed annual, the Medical Directory. The outlet thus provided with. Further, it is recorded by our Paris correspondent our those who wish to bring their merits adequately this week that, according to M. D. Berthelot, the hydrolytic is not to action of ultra-violet rays confined carbohydrates, before their colleagues serves sometimes a very practical )urpose. Medical men can tell at a glance whether the infor albuminoids have been converted into soluble proteins by ’ormation has been given for the use of professional brethren, the other the action of and to rays, pepsin enzymes exposure being thus imitated. There can be little doubt that the study r for the enlightenment of those members of the public who choose their medical attendants from reference books. Let it of the action of ultra-violet rays, or of the silent discharge, is )e granted, however, that some of our number find sweet which to leading interesting developments may possess great he uses of advertisement-to these we would address a word The of ultra-violet application rays practical importance. ,f warning. Next August the Seventeenth International to the sterilisation of water-supplies furnishes an example, of Medicine is to be held in London, and the leaders although it appears probable that there is still room Jongress f medicine from many lands will attend its deliberations. It for improvements in this application in order to make 7ill appear to some that recognition as a person of mark in the process a completely efficient one. The extension uch company will be useful. A project has been set on of this principle to the preservation of both liquid oot to publish a kind of illustrated album of autobiography and solid foods is also foreshadowed, although here considert the time of the Congress, wherein those who accept able difficulty is encountered owing to the opaqueness of the he proposals of the originators of the scheme will Of exactly in what way the materials to the radiations. nd their careers and their features preserved for the sterilisation is effected we do not appear to have received a dmiration of posterity. Possibly our readers may already satisfying explanation, some attributing it to the action of now of this scheme, for-without any association with ozone and others to a direct killing property of the rays. A ie International Medical Congress-it was floated many of of process preserving perishable foods, independent The name of the publication now projected Lonths ago. the use of chemicals, about the innocence of which there to we are informed, the Medical World, and its be, is doubt, would obviously be a valuable discovery to the a gentleman with a command of fluent and idiomatic litor, community. The continued researches on these questions nglish, together with a strong foreign accent, is already will be looked forward to with the greatest interest. jsy with the preliminary arrangements. To those on whom calls in connexion with the Medical World, Mr. Kunodi, A HISTORICAL MEDICAL MUSEUM. this is his British name, expatiates upon the representaTHE International Medical Congress will meet in London t ve nature of the collection he hopes to form and upon the - -in the coming summer, and in this connexion the exhibition c stinguished British consultants who have commented of rare and curious objects relating to medicine, chemistry, f vourably upon the enterprise. If he were really confining pharmacy, and the allied sciences, which is being organised 1 mself to those leaders of English medicine whose names e household words in medical circles abroad, the project by Mr. Henry S. Wellcome, bids fair to be very successful, The response to the appeal for loans has been encouraging,v )uld be little open to criticism ; but inasmuch as he is with the result that probably one of the most interesting c nvassing many practitioners who know that they are ,collections of historical medical objects ever gathered n t, and can never by any possibility hope to be, leaders,

concerned the

system

means

as now

of

Annotations.

-

a

together