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THE POSTPONEMENT OF THE WORKING OF THE DENTISTS ACT.
POSTPONEMENT OF THE WORKING OF THE DENTISTS
there is
no
doubt that from the point of view of
national health and efficiency it would be preferable to the present system of payment wholly in money which is liable to the counter attractions and the leakages which attend the transit of the money from the pay office to the home and its conversion into No doubt this-would involve some change in the law as it stands. But salutary change, the outcome of experience, is always worth while in every field of human enterprise, and the nation cannot afford to risk a serious decline in the health and vigour of its working population. Leicester has in the past been well to the fore in progressive movements, and we are hopeful that the experience gained at Leicester may be of value in encouraging other towns to start schemes of relief work, and thus prevent such of the distress and physical mental and moral deterioration as can be prevented in this national crisis. I am, Sir, yoursfaithfully, C. J. BOND, C.M.G., F.R.C.S., Vice-Chairman, Consultative Committee, Ministry of Health. Leicester, August 4th, 1922.
GRADUATED REST AND EXERCISE IN TUBERCULOSIS. To the Editor of THE LANCET.
SIR,-Through some misunderstanding the procedure at the meetings of the Third International Conference of the International Union against Tuberculosis held at Brussels from July llth to 13th was such that it was possible for several speakers to refer to my views on auto-inoculation in pulmonary tuberculosis and to criticise my writings on this subject without giving me any opportunity, although present, to reply to their criticisms. I therefore ask your kind permission to reply to their statements through your columns.
357
realised that it is by no means an easy treatment,because of the attention to detail which is demanded on the part of the physician-in-charge. Possibly the fact that this personal attention to detail has been lacking has been the cause of the disbelief in the therapeutic value of graduated rest and exercise. T
food, clothing, and rent.
,
ACT.I
a,m.
Sir.
VOl1T’
fa.ithfu11v.
MARCUS PATERSON. Colindale Hospital, N.W., July 26th, 1922.
THE POSTPONEMENT OF THE WORKING OF THE DENTISTS ACT. To the JMi<0 0/ THE LANCET. SiR,-There is reason to think that the postponement of the date on which the Dentists Act, 1921,will come into force from July 28th until Nov. 30th this year has given rise to some misapprehension. I am therefore directed to write and say that any practitioner who has been registered comes within the jurisdiction of the Board, and should pay very careful attention to its warning notice in regard to advertising and canvassing. The extension of the Act does not permit any relaxation in regard to this. It is possible that there are some practitioners whohave been notified that they are eligible for registra-tion who are refraining from completing their applications in order that they may be able to continue the practice of advertising and canvassing. If any such cases were brought to the notice of the Board this matter might have a bearing on the question of good. personal character. There are some practitioners who have in theiremployment assistants who are intending to pass theprescribed examination as soon as they can. TheBoard would be unwilling that these unregistered assistants should be penalised. At the same time the warning notice in regard to " coverins " must be observed, and such assistants should confine their work to mechanical duties or to matters which do not require professional discretion or skill, and should perform them only under the immediate personal supervision of their employers. I have to add that the concession that ex-Service candidates may count work done up to July, 1922, of only to July, 1921, has no bearing upon the eligibility for registration of those who had not attained the age of 23 years on July 28th, 1921. The question of age is one upon which the Act is very definite and the Board has no discretion in regard to, this matter.-I am, Sir, yours faithfully, NORMAN C. KING,
Papers were read on three problems and during the discussion of the third subject-viz., " Work During and After Treatment "-several of the speakers in the arranged discussion stated that they " did not agree with Paterson that work had therapeutic value." These remarks only indicate want of knowledge and experience on the part of the speakers. It is not a question as to whether or not those who spoke agree with me, but whether or not they appreciate facts. Is not the rise of temperature and feeling of ill-health during active tuberculosis due to excessive auto-inoculations, and is not this excessive auto-inoculation controlled by rest for the lung ? Similarly, is not the general symptom of the disease-the malaise, Registrar; Dental Board of the United Kingdom, 44, Hallamassociated with slight fever (often undetected except street, London, W. 1, August 5th, 1922. on close observation)-evidence of auto-inooulation caused by excessive exercise ? To those experienced in the method of treatment CLINIC EXPERIENCE IN CONTRACEPTION. advocated by me, it is well known that when these To the Editor of THE LANCET. auto-inoculations are controlled by rest, the patient the may generally return to the grade of exercise which SiR,-In pages of THE LANCET of July 22nd, caused the fever and continue on this without receiving p. 195, appears a condensed account of the meeting a second auto-inoculation on that grade. This fact, on contraceptive technique, held under the auspices with the additional evidence that not only does the of the Malthusian League, the principal contribution patient commonly feel better after the incident but being that by Dr. Norman Haire, who mentions that that the expectoration becomes less than before, he has had 200 cases, and that all have been successful. surely proves the establishment of some degree of At our Birth Control Clinic, at 61, Marlborough-road, immunity. London, N. 19, which is the first British clinic purely I would also ask if the observations made by Wright for birth control, we have dealt with a thousand cases, and Inman concerning the opsonic index are accepted and we have found that less than 1 per cent. of by the speakers at the Congress as facts, or are they normal women are unable to be fitted with the small also untrue; and finally, how it is possible to explain occlusive cap of the type we use. Of recorded the complement-fixation test unless by auto-inocula- failures after instruction in the cap we have about tions ? The whole question is whether the various 0’5 per cent. of the total number who have been fitted. points to which I have referred are facts or not. If In two or three instances of recorded failure we they are, then auto-inoculations do take place, and suspect that the woman herself has been careless. regulated rest and exercise in skilful hands is an Every practitioner knows that there are: incorrigibly important therapeutic measure. I have never failed careless patients. Where -the cervix is torn, proto convince medical men who have taken the. trouble liferated, seriously injured, or abnormal in any other to go into the matter with me, that treatment by way this type of cap is not feasible, and recourse may auto-inoculation is both possible, -and beneficial in then be had to the inverted or Dutch cap, apparently pulmonary tuberculosis. I think they have also favoured by Dr. Haire for all cases. Against the use of
instead
there is
no
doubt that from the point of view of
national health and efficiency it would be preferable to the present system of payment wholly in money which is liable to the counter attractions and the leakages which attend the transit of the money from the pay office to the home and its conversion into No doubt this-would involve some change in the law as it stands. But salutary change, the outcome of experience, is always worth while in every field of human enterprise, and the nation cannot afford to risk a serious decline in the health and vigour of its working population. Leicester has in the past been well to the fore in progressive movements, and we are hopeful that the experience gained at Leicester may be of value in encouraging other towns to start schemes of relief work, and thus prevent such of the distress and physical mental and moral deterioration as can be prevented in this national crisis. I am, Sir, yoursfaithfully, C. J. BOND, C.M.G., F.R.C.S., Vice-Chairman, Consultative Committee, Ministry of Health. Leicester, August 4th, 1922.
GRADUATED REST AND EXERCISE IN TUBERCULOSIS. To the Editor of THE LANCET.
SIR,-Through some misunderstanding the procedure at the meetings of the Third International Conference of the International Union against Tuberculosis held at Brussels from July llth to 13th was such that it was possible for several speakers to refer to my views on auto-inoculation in pulmonary tuberculosis and to criticise my writings on this subject without giving me any opportunity, although present, to reply to their criticisms. I therefore ask your kind permission to reply to their statements through your columns.
357
realised that it is by no means an easy treatment,because of the attention to detail which is demanded on the part of the physician-in-charge. Possibly the fact that this personal attention to detail has been lacking has been the cause of the disbelief in the therapeutic value of graduated rest and exercise. T
food, clothing, and rent.
,
ACT.I
a,m.
Sir.
VOl1T’
fa.ithfu11v.
MARCUS PATERSON. Colindale Hospital, N.W., July 26th, 1922.
THE POSTPONEMENT OF THE WORKING OF THE DENTISTS ACT. To the JMi<0 0/ THE LANCET. SiR,-There is reason to think that the postponement of the date on which the Dentists Act, 1921,will come into force from July 28th until Nov. 30th this year has given rise to some misapprehension. I am therefore directed to write and say that any practitioner who has been registered comes within the jurisdiction of the Board, and should pay very careful attention to its warning notice in regard to advertising and canvassing. The extension of the Act does not permit any relaxation in regard to this. It is possible that there are some practitioners whohave been notified that they are eligible for registra-tion who are refraining from completing their applications in order that they may be able to continue the practice of advertising and canvassing. If any such cases were brought to the notice of the Board this matter might have a bearing on the question of good. personal character. There are some practitioners who have in theiremployment assistants who are intending to pass theprescribed examination as soon as they can. TheBoard would be unwilling that these unregistered assistants should be penalised. At the same time the warning notice in regard to " coverins " must be observed, and such assistants should confine their work to mechanical duties or to matters which do not require professional discretion or skill, and should perform them only under the immediate personal supervision of their employers. I have to add that the concession that ex-Service candidates may count work done up to July, 1922, of only to July, 1921, has no bearing upon the eligibility for registration of those who had not attained the age of 23 years on July 28th, 1921. The question of age is one upon which the Act is very definite and the Board has no discretion in regard to, this matter.-I am, Sir, yours faithfully, NORMAN C. KING,
Papers were read on three problems and during the discussion of the third subject-viz., " Work During and After Treatment "-several of the speakers in the arranged discussion stated that they " did not agree with Paterson that work had therapeutic value." These remarks only indicate want of knowledge and experience on the part of the speakers. It is not a question as to whether or not those who spoke agree with me, but whether or not they appreciate facts. Is not the rise of temperature and feeling of ill-health during active tuberculosis due to excessive auto-inoculations, and is not this excessive auto-inoculation controlled by rest for the lung ? Similarly, is not the general symptom of the disease-the malaise, Registrar; Dental Board of the United Kingdom, 44, Hallamassociated with slight fever (often undetected except street, London, W. 1, August 5th, 1922. on close observation)-evidence of auto-inooulation caused by excessive exercise ? To those experienced in the method of treatment CLINIC EXPERIENCE IN CONTRACEPTION. advocated by me, it is well known that when these To the Editor of THE LANCET. auto-inoculations are controlled by rest, the patient the may generally return to the grade of exercise which SiR,-In pages of THE LANCET of July 22nd, caused the fever and continue on this without receiving p. 195, appears a condensed account of the meeting a second auto-inoculation on that grade. This fact, on contraceptive technique, held under the auspices with the additional evidence that not only does the of the Malthusian League, the principal contribution patient commonly feel better after the incident but being that by Dr. Norman Haire, who mentions that that the expectoration becomes less than before, he has had 200 cases, and that all have been successful. surely proves the establishment of some degree of At our Birth Control Clinic, at 61, Marlborough-road, immunity. London, N. 19, which is the first British clinic purely I would also ask if the observations made by Wright for birth control, we have dealt with a thousand cases, and Inman concerning the opsonic index are accepted and we have found that less than 1 per cent. of by the speakers at the Congress as facts, or are they normal women are unable to be fitted with the small also untrue; and finally, how it is possible to explain occlusive cap of the type we use. Of recorded the complement-fixation test unless by auto-inocula- failures after instruction in the cap we have about tions ? The whole question is whether the various 0’5 per cent. of the total number who have been fitted. points to which I have referred are facts or not. If In two or three instances of recorded failure we they are, then auto-inoculations do take place, and suspect that the woman herself has been careless. regulated rest and exercise in skilful hands is an Every practitioner knows that there are: incorrigibly important therapeutic measure. I have never failed careless patients. Where -the cervix is torn, proto convince medical men who have taken the. trouble liferated, seriously injured, or abnormal in any other to go into the matter with me, that treatment by way this type of cap is not feasible, and recourse may auto-inoculation is both possible, -and beneficial in then be had to the inverted or Dutch cap, apparently pulmonary tuberculosis. I think they have also favoured by Dr. Haire for all cases. Against the use of
instead