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THE PUBLIC TELEPHONE CALL OFFICE AS A FACTOR IN THE SPREAD OF DISEASE.
240
by each medical man to’his successor in a practice, but where there is no such succession-what then2 As a rule, At the Middlesex Hospital trypsin has been tried; in when a learned man dies, unsympathetic legatees regard his books and papers with scant favour. Sometimes, on the part the first two cases there was no improvement in the of a practical widow and her daughters, there occurs a great patients nor was the progress of the growth influenced by burning of "dear papa’s old rubbish," but at other times the injections; but it may be objected that in these cases there is a scattering to the four winds of heaven of docuthe preparation of trypsin may not have been potent, so ments that it would have been best to burn. This scattering later a fresh supply of the drug was obtained and each is not necessarily rapid ; it may last years and its final may be that the most private memoranda have become ampoule of injection was tested for digestive power. The result matter of public comment by the literary pickers-up of injections were used on nine cases ; in three of these unconsidered trifles. Medical men should, of course, make treatment was employed for little more than three weeks a point of leaving their case-books and other memoranda in and therefore they may perhaps be put aside. In the safe hands, and this can be done either by will or on retireremaining six cases the treatment lasted from 66 days to ment from practice. Sir Astley Cooper’s elaborate accounts 118 days. Of the six, two succumbed, one was sinking fast of cases are now in a special or reserved collection in the at the time of the last note, and three were still living. In library of the Royal College of Surgeons of England. This is as it should be. As the great surgeon always mentioned two of those still living at the time of the report the weight the names of patients and as those names are still mostly had decreased ; in the third it was stationary. The evidence well known in England to-day, it is alarming to reflect what of improvement in the six cases was as follows : in one there would have happened had his very circumstantial records of was distinctly less pain, in one there was a diminution of the ancestral complaints fallen into the hands of nervous But this might have, and has in other stenosis of the rectum, and in one the disease was stationary. moderns to-day.
have not sufficient data to be certain of the correctness of the diagnosis.
The treatment did not
showing
a
progressive
prevent loss of
from
cases
and except in one We have no wish
THE
most of the
weight
on
patients
perhaps sometimes, happened.
PUBLIC TELEPHONE CALL OFFICE AS A FACTOR IN THE SPREAD OF DISEASE. we have heard to IT would be interesting to know the bacteriology of the of cases where improvement appeared to have resulted air of public telephone call offices. The suggestion should from the trypsin injections. We have heard also of cases stimulate the curiosity of the scientific staff of the London where no benefit occurred. When the treatment has been County Council, many of the inquiries of which have the insanitary conditions of many places in tested systematically both on mice and men it seems to proved the light of bacteriological research. The public telehave failed completely, and it is only by a thorough trial phone call office appears to be singularly well designed that we can come to a correct conclusion as to its value. for the capture and growth of pathogenic organisms. No one will rejoice more than we shall should the treat- These little stations are usually carefully closed, are padded, ment eventually prove of value, but hitherto we have seen and kept almost air tight ; sunshine and fresh air seldom can reach the interior, while of course no attempt is made to no certain evidence of that value. keep them aired or ventilated, because any provision for securing ventilation is calculated to make difficult the hearing of the message. External sounds must be kept out, the box must be sealed against them, and when this plan succeeds it must succeed also in excluding The with equal efficacy external purifying agencies. "Ne quid nimis." in call station be described, fact, as may telephone THE NEW COURT APPOINTMENTS. a bacteriological box in which pathogenic and other THE King has been pleased to appoint Sir Richard Douglas organisms are carefully nursed. Infection of the imprisoned Powell to be one of the physicians-in-ordinary to His Majesty air must at all events be constantly taking place and this in the room of Sir William Broadbent, deceased. Dr. only too readily spreads whenever the opportunity arises. Bertrand Dawson, physician to the London Hospital, has Caller after caller thus either may infect or receive infecbeen appointed one of the physicians extraordinary. tion so long as no steps are taken to purify the The King has also been pleased to appoint Sir Thomas air within the station. It is a common experience McCall Anderson to be one of His Majesty’s honorary of those who have occasion to use these call offices physicians in Scotland in the room of Sir William that unless the padded door which when closed is Gairdner, deceased. In the notice of these Court appoint- tight-fitting is left wide open (a plan which is not ments, as it appeared in the tvazette on Friday last, encouraged) the air within is frowsy, stale, and often July 19th, the name of Sir Thomas Fraser, also one of His has an offensive odour. Common sense appeals against this Majesty’s honorary physicians in Scotland, was substituted state of things and it would be safe to predict that the for that of Sir William Gairdner, with the result that many bacteriological examination of this air would tell an appallquestions were directed to us as to how and when and where ing story. Surely it would be simple enough to attach a the well-known professor of clinical medicine in the Univer- system of ventilation to these call boxes which would not sity of Edinburgh had met his death. We were happy to interfere with the articulation of the transmitting disc or be able to assure inquirers that he was, in his own words, prevent the message from being heard. The interior should be air-swept regularly or automatically and disinfected. We " very much alive." have heard of the septic condition of the receiver or tube THE DESTINY OF CASE-BOOKS. into which the operator delivers his message and we know THE destiny of old case-books and notes of cases is one that it has been clearly demonstrated by scientific experiwhich concerns medical men and the public alike. What, ment that in the act of speaking materies morbi may be as a rule, becomes of a medical man’s written records of his projected from the speaker’s mouth for a considerable patient’s ailments ? Generally speaking, these highly distance. With reasonable care such a risk of infecinteresting and often compromising documents are handed tion can be minimised, but the polluted air of the
local improvement occurred. condemn the trypsin treatment ;
case no
Annotations.
I
--
241
telephone box can scarcely be avoided. Many persons digestibility but it is questionable whether the advantage using the telephone speak needlessly near to the re- is worth the extra cost. "Breakfast foods"are usually ceiver. The message at the other end is no clearer for sold in packages of varying weight, a fact which renders this and is often unintelligible in these circumstances. A a strict comparison of prices impossible, but the price of message well delivered with words properly and concisely these foods appears to vary from 5 to 23 cents per pound, pronounced is faithfully recorded, even though it is spoken whereas oatmeal or wheaten flour is retailed in Canada quite away from the receiver. The contamination of the at from 3 to 4 cents per pound. In conclusion, reference receiver when it exists may therefore be avoided to a very may be made to the extravagant phraseology of the claims great extent, but the air of the telephone call box is difficult made for many of these foods. The language is similar to to avoid and yet it must contain a whole menagerie of that employed by the manufacturers of quack medicine. organisms, some of them without doubt pathogenic, and it We quote a few instances in illustration of this: ’’ The should be the duty of the telephone authorities to protect natural food for creating power " ; Concentrated malted their customers from the possibility of contracting disease in food ; ready to eat. Pure, predigested, thoroughly cooked" ; this way by providing for a constant renewal of the air and "A food for brain and nerve centres " ; "Grain combined by keeping the station bacteriologically clean by the use of an with vegetable or plant iron"; and The natural food for efficient disinfectant. creating power, repairing waste, maintaining energy." "
____
BREAKFAST FOODS.
CATS AS A PREVENTIVE OF PLAGUE. THE recent work of Professor Robert Harcourt on the food SINCE Lieutenant-Colonel A. Buchanan, I.M.S., wrote in values of advertised "breakfast foods," which formed the last drawing attention to the value of the domestic cat subject of an annotation in our issue of May 4th, p. 1240, May as a preventive against plague and insisting on the fact that has been amply corroborated by the publication of the results as the animal enjoys the unique distinction of being held of the analysis of 99 samples of various breakfast foods " Hindus and Mahomedans alike it would be diffisacred by Mr. J. G. A. Valin, in the laboratory of the Inland cult forbyeven native suspicion to suggest sinister motives Revenue Department, Ottawa, Canada. Mr. Thomas Macto Government in encouraging its breeding and maintenfarlane, the chief chemist of that department, in issuing the there have been several communications to the same report defines a "breakfast foodas consisting of a cereal ance, effect in the Indian press the writers of which were appawhich has been subjected to a certain amount of preparation rently unaware that the subject had already been broached by or cooking, with or without the addition of some other food Lieutenant-Colonel Buchanan. Writing to the Pioneer from material. Determinations were made of the proteids, moisCherat on June 4th Major 0. R. A. Julian, R.A.M.C., after ture, and fat. In a previous bulletin (No. 127) it was shown the want of success which has attended upon all deploring that rolled oats which have had no previous cooking never efforts to deal with plague on scientific grounds, proposes that yield more than 3 per cent. of dextrin. Of the foods healthy cats should be brought in small consignments examined, only Beaver oats, Quaker oats, Saxon oats, and good and protected while breeding until they were sufficiently Pilson’s oats appear to be made from oats, as judged by the numerous for distribution. Then to encourage the natives percentage of fat present. The figures obtained by the in should be offered each village, one for the finest analysis of rolled oats and of porridge made from the same prizes and another for the best cat ratter. ’’II venture to think," afford a useful guide to the values of these foods. The "that the sporting or gambling continues Julian, Major figures are calculated on the dry substance :instinct of the native would be appealed to and that he Sugars would probably turn up not only with his cat but with a bag and Total Dextrin. Starch. Dextrin Fat. St of rats for the contest, and the extermination of rats would proteids. 5-19 4-13 2-32 Boiled oats 13-76 71-21 be an event of the near future and with them the without made salt 0-55 0-34 7-62 18-72 67’41 Porridge plague." On June 15th Assistant-Surgeon S. M. Pavri 6-69 with 13’97 17-60 ... l7 53-98 wrote as follows to the Times " of India: "The rat-fleaIf the analyses of the four advertised varieties of preparedL man theory being scientifically established, the desirability oats above mentioned are calculated on their dry substance that every house should be without a rat is the burning the resulting figures show that they contain less than half, question of the day. But so many and so varied are the the amount of dextrin present in porridge prepared by thei religious superstitions and social prejudices among the old-fashioned way. The figures here recorded show that the peoples of India against this destruction of rats, and so method of cooking oatmeal without salt is a very ineffectivei wonderfully prolific is the rat itself, that how to achieve way of predigesting the starch which it contains. Porridgei this end on the line of least resistance does, and I am afraid cooked with salt contains twice as much soluble dextrin as, will, remain a moot point....... Under these circumstances porridge cooked without salt. Another fact which is broughtii may I venture to suggest a remedy which does not seem to out by these tests is that the fat seems to disappear during the: have attracted the attention it deserves? I mean a ratcooking. It is possible that it may enter into some sort ofE killing campaign by cats." Assistant-Surgeon Pavri then combination with the proteids so as to render it incapable} proceeds to argue that the getting rid of rats by means of of removal by the usual solvents. It has been shown byr their natural enemies is not calculated to arouse opposition Dr. Chamberlain of Washington that the fat of wheateni or discontent on the part of ’’ the sensible masses flour undergoes such a change in the process of baking who will not reject the bargain when it is a quesbread. It is important to note that, calculating on the} tion of life and death to them and their families." dry substance, bread contains from 13 to 16’ 76 perr Under the head of "Notes and News"in the Journal cent. of substances soluble in water after extractioni of Tropical Medicine and Hygiene dated July lst it by alcohol, representing an amount of dextrin far greaterr’ is stated that "Lieutenant-Colonel Buchanan took a cat than that contained in most of the "breakfast foods" census of certain villages that enjoyed exceptional immunity examined. It follows from this investigation that the claimss from plague and of others that had been severely handled by as to "predigestion" made for advertised foods are ofteni the disease." The result showed that the immune comexaggerated. Porridge made with a suitable quantity of saltt munities harboured large numbers of cats, whereas in those is vastly superior to most of them in this respect. As regardss that suffered the animals were scarce. Our contemporary is the processes of "rolling "and "flaking"the grains it is quitea of opinion that " the expedient is one that is certainly possible that the thinning out of the material increases thea worthy of attention, though it is difficult to see how the , .
, .
soluble
proteids.
............
...
...
"
11
...
...
...
...
...
...
...
...
...
by each medical man to’his successor in a practice, but where there is no such succession-what then2 As a rule, At the Middlesex Hospital trypsin has been tried; in when a learned man dies, unsympathetic legatees regard his books and papers with scant favour. Sometimes, on the part the first two cases there was no improvement in the of a practical widow and her daughters, there occurs a great patients nor was the progress of the growth influenced by burning of "dear papa’s old rubbish," but at other times the injections; but it may be objected that in these cases there is a scattering to the four winds of heaven of docuthe preparation of trypsin may not have been potent, so ments that it would have been best to burn. This scattering later a fresh supply of the drug was obtained and each is not necessarily rapid ; it may last years and its final may be that the most private memoranda have become ampoule of injection was tested for digestive power. The result matter of public comment by the literary pickers-up of injections were used on nine cases ; in three of these unconsidered trifles. Medical men should, of course, make treatment was employed for little more than three weeks a point of leaving their case-books and other memoranda in and therefore they may perhaps be put aside. In the safe hands, and this can be done either by will or on retireremaining six cases the treatment lasted from 66 days to ment from practice. Sir Astley Cooper’s elaborate accounts 118 days. Of the six, two succumbed, one was sinking fast of cases are now in a special or reserved collection in the at the time of the last note, and three were still living. In library of the Royal College of Surgeons of England. This is as it should be. As the great surgeon always mentioned two of those still living at the time of the report the weight the names of patients and as those names are still mostly had decreased ; in the third it was stationary. The evidence well known in England to-day, it is alarming to reflect what of improvement in the six cases was as follows : in one there would have happened had his very circumstantial records of was distinctly less pain, in one there was a diminution of the ancestral complaints fallen into the hands of nervous But this might have, and has in other stenosis of the rectum, and in one the disease was stationary. moderns to-day.
have not sufficient data to be certain of the correctness of the diagnosis.
The treatment did not
showing
a
progressive
prevent loss of
from
cases
and except in one We have no wish
THE
most of the
weight
on
patients
perhaps sometimes, happened.
PUBLIC TELEPHONE CALL OFFICE AS A FACTOR IN THE SPREAD OF DISEASE. we have heard to IT would be interesting to know the bacteriology of the of cases where improvement appeared to have resulted air of public telephone call offices. The suggestion should from the trypsin injections. We have heard also of cases stimulate the curiosity of the scientific staff of the London where no benefit occurred. When the treatment has been County Council, many of the inquiries of which have the insanitary conditions of many places in tested systematically both on mice and men it seems to proved the light of bacteriological research. The public telehave failed completely, and it is only by a thorough trial phone call office appears to be singularly well designed that we can come to a correct conclusion as to its value. for the capture and growth of pathogenic organisms. No one will rejoice more than we shall should the treat- These little stations are usually carefully closed, are padded, ment eventually prove of value, but hitherto we have seen and kept almost air tight ; sunshine and fresh air seldom can reach the interior, while of course no attempt is made to no certain evidence of that value. keep them aired or ventilated, because any provision for securing ventilation is calculated to make difficult the hearing of the message. External sounds must be kept out, the box must be sealed against them, and when this plan succeeds it must succeed also in excluding The with equal efficacy external purifying agencies. "Ne quid nimis." in call station be described, fact, as may telephone THE NEW COURT APPOINTMENTS. a bacteriological box in which pathogenic and other THE King has been pleased to appoint Sir Richard Douglas organisms are carefully nursed. Infection of the imprisoned Powell to be one of the physicians-in-ordinary to His Majesty air must at all events be constantly taking place and this in the room of Sir William Broadbent, deceased. Dr. only too readily spreads whenever the opportunity arises. Bertrand Dawson, physician to the London Hospital, has Caller after caller thus either may infect or receive infecbeen appointed one of the physicians extraordinary. tion so long as no steps are taken to purify the The King has also been pleased to appoint Sir Thomas air within the station. It is a common experience McCall Anderson to be one of His Majesty’s honorary of those who have occasion to use these call offices physicians in Scotland in the room of Sir William that unless the padded door which when closed is Gairdner, deceased. In the notice of these Court appoint- tight-fitting is left wide open (a plan which is not ments, as it appeared in the tvazette on Friday last, encouraged) the air within is frowsy, stale, and often July 19th, the name of Sir Thomas Fraser, also one of His has an offensive odour. Common sense appeals against this Majesty’s honorary physicians in Scotland, was substituted state of things and it would be safe to predict that the for that of Sir William Gairdner, with the result that many bacteriological examination of this air would tell an appallquestions were directed to us as to how and when and where ing story. Surely it would be simple enough to attach a the well-known professor of clinical medicine in the Univer- system of ventilation to these call boxes which would not sity of Edinburgh had met his death. We were happy to interfere with the articulation of the transmitting disc or be able to assure inquirers that he was, in his own words, prevent the message from being heard. The interior should be air-swept regularly or automatically and disinfected. We " very much alive." have heard of the septic condition of the receiver or tube THE DESTINY OF CASE-BOOKS. into which the operator delivers his message and we know THE destiny of old case-books and notes of cases is one that it has been clearly demonstrated by scientific experiwhich concerns medical men and the public alike. What, ment that in the act of speaking materies morbi may be as a rule, becomes of a medical man’s written records of his projected from the speaker’s mouth for a considerable patient’s ailments ? Generally speaking, these highly distance. With reasonable care such a risk of infecinteresting and often compromising documents are handed tion can be minimised, but the polluted air of the
local improvement occurred. condemn the trypsin treatment ;
case no
Annotations.
I
--
241
telephone box can scarcely be avoided. Many persons digestibility but it is questionable whether the advantage using the telephone speak needlessly near to the re- is worth the extra cost. "Breakfast foods"are usually ceiver. The message at the other end is no clearer for sold in packages of varying weight, a fact which renders this and is often unintelligible in these circumstances. A a strict comparison of prices impossible, but the price of message well delivered with words properly and concisely these foods appears to vary from 5 to 23 cents per pound, pronounced is faithfully recorded, even though it is spoken whereas oatmeal or wheaten flour is retailed in Canada quite away from the receiver. The contamination of the at from 3 to 4 cents per pound. In conclusion, reference receiver when it exists may therefore be avoided to a very may be made to the extravagant phraseology of the claims great extent, but the air of the telephone call box is difficult made for many of these foods. The language is similar to to avoid and yet it must contain a whole menagerie of that employed by the manufacturers of quack medicine. organisms, some of them without doubt pathogenic, and it We quote a few instances in illustration of this: ’’ The should be the duty of the telephone authorities to protect natural food for creating power " ; Concentrated malted their customers from the possibility of contracting disease in food ; ready to eat. Pure, predigested, thoroughly cooked" ; this way by providing for a constant renewal of the air and "A food for brain and nerve centres " ; "Grain combined by keeping the station bacteriologically clean by the use of an with vegetable or plant iron"; and The natural food for efficient disinfectant. creating power, repairing waste, maintaining energy." "
____
BREAKFAST FOODS.
CATS AS A PREVENTIVE OF PLAGUE. THE recent work of Professor Robert Harcourt on the food SINCE Lieutenant-Colonel A. Buchanan, I.M.S., wrote in values of advertised "breakfast foods," which formed the last drawing attention to the value of the domestic cat subject of an annotation in our issue of May 4th, p. 1240, May as a preventive against plague and insisting on the fact that has been amply corroborated by the publication of the results as the animal enjoys the unique distinction of being held of the analysis of 99 samples of various breakfast foods " Hindus and Mahomedans alike it would be diffisacred by Mr. J. G. A. Valin, in the laboratory of the Inland cult forbyeven native suspicion to suggest sinister motives Revenue Department, Ottawa, Canada. Mr. Thomas Macto Government in encouraging its breeding and maintenfarlane, the chief chemist of that department, in issuing the there have been several communications to the same report defines a "breakfast foodas consisting of a cereal ance, effect in the Indian press the writers of which were appawhich has been subjected to a certain amount of preparation rently unaware that the subject had already been broached by or cooking, with or without the addition of some other food Lieutenant-Colonel Buchanan. Writing to the Pioneer from material. Determinations were made of the proteids, moisCherat on June 4th Major 0. R. A. Julian, R.A.M.C., after ture, and fat. In a previous bulletin (No. 127) it was shown the want of success which has attended upon all deploring that rolled oats which have had no previous cooking never efforts to deal with plague on scientific grounds, proposes that yield more than 3 per cent. of dextrin. Of the foods healthy cats should be brought in small consignments examined, only Beaver oats, Quaker oats, Saxon oats, and good and protected while breeding until they were sufficiently Pilson’s oats appear to be made from oats, as judged by the numerous for distribution. Then to encourage the natives percentage of fat present. The figures obtained by the in should be offered each village, one for the finest analysis of rolled oats and of porridge made from the same prizes and another for the best cat ratter. ’’II venture to think," afford a useful guide to the values of these foods. The "that the sporting or gambling continues Julian, Major figures are calculated on the dry substance :instinct of the native would be appealed to and that he Sugars would probably turn up not only with his cat but with a bag and Total Dextrin. Starch. Dextrin Fat. St of rats for the contest, and the extermination of rats would proteids. 5-19 4-13 2-32 Boiled oats 13-76 71-21 be an event of the near future and with them the without made salt 0-55 0-34 7-62 18-72 67’41 Porridge plague." On June 15th Assistant-Surgeon S. M. Pavri 6-69 with 13’97 17-60 ... l7 53-98 wrote as follows to the Times " of India: "The rat-fleaIf the analyses of the four advertised varieties of preparedL man theory being scientifically established, the desirability oats above mentioned are calculated on their dry substance that every house should be without a rat is the burning the resulting figures show that they contain less than half, question of the day. But so many and so varied are the the amount of dextrin present in porridge prepared by thei religious superstitions and social prejudices among the old-fashioned way. The figures here recorded show that the peoples of India against this destruction of rats, and so method of cooking oatmeal without salt is a very ineffectivei wonderfully prolific is the rat itself, that how to achieve way of predigesting the starch which it contains. Porridgei this end on the line of least resistance does, and I am afraid cooked with salt contains twice as much soluble dextrin as, will, remain a moot point....... Under these circumstances porridge cooked without salt. Another fact which is broughtii may I venture to suggest a remedy which does not seem to out by these tests is that the fat seems to disappear during the: have attracted the attention it deserves? I mean a ratcooking. It is possible that it may enter into some sort ofE killing campaign by cats." Assistant-Surgeon Pavri then combination with the proteids so as to render it incapable} proceeds to argue that the getting rid of rats by means of of removal by the usual solvents. It has been shown byr their natural enemies is not calculated to arouse opposition Dr. Chamberlain of Washington that the fat of wheateni or discontent on the part of ’’ the sensible masses flour undergoes such a change in the process of baking who will not reject the bargain when it is a quesbread. It is important to note that, calculating on the} tion of life and death to them and their families." dry substance, bread contains from 13 to 16’ 76 perr Under the head of "Notes and News"in the Journal cent. of substances soluble in water after extractioni of Tropical Medicine and Hygiene dated July lst it by alcohol, representing an amount of dextrin far greaterr’ is stated that "Lieutenant-Colonel Buchanan took a cat than that contained in most of the "breakfast foods" census of certain villages that enjoyed exceptional immunity examined. It follows from this investigation that the claimss from plague and of others that had been severely handled by as to "predigestion" made for advertised foods are ofteni the disease." The result showed that the immune comexaggerated. Porridge made with a suitable quantity of saltt munities harboured large numbers of cats, whereas in those is vastly superior to most of them in this respect. As regardss that suffered the animals were scarce. Our contemporary is the processes of "rolling "and "flaking"the grains it is quitea of opinion that " the expedient is one that is certainly possible that the thinning out of the material increases thea worthy of attention, though it is difficult to see how the , .
, .
soluble
proteids.
............
...
...
"
11
...
...
...
...
...
...
...
...
...