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The treatment of deafness
96
PUBLIC
Correspondence. The Editor does not accept fesponsibility /or the opinions of correspondents. QUEEN CHARLOTTE'S HOSPITAL AND RESEARCH INTO PUERPERAL FEVER. T o the Editor of PUBLIC HEALTH. SIl¢,~All teachers of Obstetrics will feel deeply grateful to you for the admirable note, published in your issue of last month, under the abo;ee heading. There is a certain aspect of the question of liability to puerperal infection which deserves to be made known to the public. Cases of puerperal fever not infrequently arise after a labour so rapid and easy that the b a b y was born before the arrival of the doctor. T h e y also occur sometimes in lying-in hospitals, when the patient has had the advantages of hospital management all through her labour, and in which the whole birth-process is " normal," i.e., no assistance has to be rendered to the mother. Cases of this kind have been a source of the greatest anxiety to Obstetric Teachers, but within recent years certain facts have come to light which may explain them. It has been established that an apparently healthy pregnant woman may carry, in some part of the birth canal, organisms which are capable of setting up blood-poisoning when introduced into a wound. No natural birth can take place without the formation of an internal wound, and accordingly after labour these organisms may get their chance, and the result will then be blood-poisoning. On October 6th, I had the honour of presiding at a meeting held at Seaford House, Belgrave Square, in aid of the Mother-Saving Campaign of Queen Charlotte's Hospital. I then pointed out the necessity of organised research into this aspect o f - t h e causation of puerperal f e v e r . W e do not know what proportion of pregnant women are actually carriers, nor do w e know what proportion of women who have fallen victims to puerperal fever were actually carriers during the antenatal period. Such points as these can only be resolved by" prolonged and extensive research, yet it is obvious that they have a very direct bearing upon the question o f prevention. W e must undoubtedly improve the training of doctors and nurses; we must undoubtedly provide hospital accommodation for every
HEALTH.
DECEMBER,1997.
mother who needs it; we must watch over and educate the expectant mother, but this wilt not of itself suffice to rid the community of puerperal fever. W e must also study such problems as that presented by the carrier, and this can only be done b y close collaboration between the bedside physician or surgeon and the laboratory worker. In other words, the hospitals must take up the problem, and this they cannot do unless they are enab'led to maintain the necessary institution for research. It is difficult to think of any other department of preventive medicine in which private beneficence might be more usefully exercised than this. I am, Yours faithfully, T. WATTS EDEN, M.D., F . R . C . P . , F . R . C . S . 26, Queen Anne Street, London, W . ! . November 4th, 1927. THE
TREATMENT OF DEAFNESS. T o the Editor of PUBLIC H~ALTH. SIR,--I was interested to read, in the October number of the journal, the review of Mr. Macleod Yearsley's book on the ZiindBurguet method of treating chronic deafness, because so tong ago as 1913 or 1914, Dr. George Cathcart treated a friend of mine with this apparatus with beneficial results, and I had the instrument and its mode of application explained to me. As Mr. Yearstey seems to have used the method for little over a year he does not appear to be entitled to the title of pioneer given him by your reviewer. Nor is his book the only book in English on the subject, as Dr. Cathcart published a book in 1926, e m b o d y i n g the results of his fifteen years experience of the Electrophonoid method of Ztind-Burguet. I am, Y o u r s faithfully, F. J. AI,LAN. T e d d i n g t 0 n , Middlesex. October 22nd, 1927. THE Royal Free Hospital, London, is being presented by Mr. George Eastman, of the K o d a k Company, Rochester, New y o r k , with a building and equipment upon a n adjoining site for providing dental treatment for children of school age and other l Patients, including nursing and expectant mothers. Plans are now under consideration, and it i s expected that building operations will be commenced shortly.
PUBLIC
Correspondence. The Editor does not accept fesponsibility /or the opinions of correspondents. QUEEN CHARLOTTE'S HOSPITAL AND RESEARCH INTO PUERPERAL FEVER. T o the Editor of PUBLIC HEALTH. SIl¢,~All teachers of Obstetrics will feel deeply grateful to you for the admirable note, published in your issue of last month, under the abo;ee heading. There is a certain aspect of the question of liability to puerperal infection which deserves to be made known to the public. Cases of puerperal fever not infrequently arise after a labour so rapid and easy that the b a b y was born before the arrival of the doctor. T h e y also occur sometimes in lying-in hospitals, when the patient has had the advantages of hospital management all through her labour, and in which the whole birth-process is " normal," i.e., no assistance has to be rendered to the mother. Cases of this kind have been a source of the greatest anxiety to Obstetric Teachers, but within recent years certain facts have come to light which may explain them. It has been established that an apparently healthy pregnant woman may carry, in some part of the birth canal, organisms which are capable of setting up blood-poisoning when introduced into a wound. No natural birth can take place without the formation of an internal wound, and accordingly after labour these organisms may get their chance, and the result will then be blood-poisoning. On October 6th, I had the honour of presiding at a meeting held at Seaford House, Belgrave Square, in aid of the Mother-Saving Campaign of Queen Charlotte's Hospital. I then pointed out the necessity of organised research into this aspect o f - t h e causation of puerperal f e v e r . W e do not know what proportion of pregnant women are actually carriers, nor do w e know what proportion of women who have fallen victims to puerperal fever were actually carriers during the antenatal period. Such points as these can only be resolved by" prolonged and extensive research, yet it is obvious that they have a very direct bearing upon the question o f prevention. W e must undoubtedly improve the training of doctors and nurses; we must undoubtedly provide hospital accommodation for every
HEALTH.
DECEMBER,1997.
mother who needs it; we must watch over and educate the expectant mother, but this wilt not of itself suffice to rid the community of puerperal fever. W e must also study such problems as that presented by the carrier, and this can only be done b y close collaboration between the bedside physician or surgeon and the laboratory worker. In other words, the hospitals must take up the problem, and this they cannot do unless they are enab'led to maintain the necessary institution for research. It is difficult to think of any other department of preventive medicine in which private beneficence might be more usefully exercised than this. I am, Yours faithfully, T. WATTS EDEN, M.D., F . R . C . P . , F . R . C . S . 26, Queen Anne Street, London, W . ! . November 4th, 1927. THE
TREATMENT OF DEAFNESS. T o the Editor of PUBLIC H~ALTH. SIR,--I was interested to read, in the October number of the journal, the review of Mr. Macleod Yearsley's book on the ZiindBurguet method of treating chronic deafness, because so tong ago as 1913 or 1914, Dr. George Cathcart treated a friend of mine with this apparatus with beneficial results, and I had the instrument and its mode of application explained to me. As Mr. Yearstey seems to have used the method for little over a year he does not appear to be entitled to the title of pioneer given him by your reviewer. Nor is his book the only book in English on the subject, as Dr. Cathcart published a book in 1926, e m b o d y i n g the results of his fifteen years experience of the Electrophonoid method of Ztind-Burguet. I am, Y o u r s faithfully, F. J. AI,LAN. T e d d i n g t 0 n , Middlesex. October 22nd, 1927. THE Royal Free Hospital, London, is being presented by Mr. George Eastman, of the K o d a k Company, Rochester, New y o r k , with a building and equipment upon a n adjoining site for providing dental treatment for children of school age and other l Patients, including nursing and expectant mothers. Plans are now under consideration, and it i s expected that building operations will be commenced shortly.