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THE WATER-SUPPLY OF THE METROPOLIS.
532 be reckoned with in dealing with this question; and that unless the Legislature is prepared to absolutely prohibit all and every kind of unqualified practice midwives will
Annotations.
continue to be an integral part of the social community. At present the midwife is a sort of free-lance, but as a result of all the registration Bills hitherto brought in she would come to be recognised, despite all said to the contrary, as a duly licensed medical practitioner. Although we yield to no one in our desire that puerperal
"Ne quid nimis." THE WATER-SUPPLY OF THE METROPOLIS.
WE begin to-day the report of a Commission which we have instituted to inquire into the water-supply of the metropolis-a subject which bids fair to assume a political women should be protected from the dangers of sepsis importance proportional, if possible, to its importance brought about by the ignorance or carelessness of their when viewed from the aspect of public health. attendants, yet we cannot agree to any scheme which does not lay down a hard-and-fast line between a THE FIGURES OF VACCINATION. midwife and a medical practitioner. The present AT a meeting of the Royal Statistical Society held on Bill in Clause 5 lays all the responsibility of defining the 16th inst. at the Royal United Service Institution a paper the duties of midwives upon the Midwives Board. on "English Vaccination and Small-pox Statistics, with Paragraph f of Section 2 of this clause is as follows : " To special reference to the Report cf the Royal Commission and frame for approval by the General Medical Council rules to recent Small-pox Epidemics," by Mr. Noel A. Humphreys, for regulating, supervising, and restricting within due was read. He arrived at the following conclusions (among limits the practice of midwives." We must confess our- others) based upon the figures discussed: 1. That the mean annual death-rate from small-pox at all ages in selves unable to see how the General Medical Council England and Wales, which was 408 per 1,000,000 in the or any other body is to frame rules which shall lay twelve years for which records exist prior to compulsory down for the guidance of a midwife when her own vaccination, fell to 126 per 1,000,000 in the forty-two attendance shall cease and it becomes necessary for years since vaccination was made compulsory, which her to call in a medical man, for we take it that this is period included the world-wide epidemic of 1871-72. meant by the paragraph under consideration. If the Bill 2. That the main part of this decline of mortality occurred children under the age of ten years, who may be ever reaches the committee stage we consider it absolutely among to have been principally affected by the increase presumed necessary that some clause should be added making it of infant vaccination. 3. That the age-incidence of fatal clear as to what in the opinion of the framers of the small-pox had entirely under the influence of changed Bill a midwive may or may not do ; for as it stands increased infant vaccination ; and that small-pox, from being the measure is very incomplete, and too much seems mainly a disease of childhood, was now proportionately 4. That, judged by the statistics to be left to those who are to arrange the details. more fatal to adults. six principal local small-pox epidemics, the last of All the same it is an honest and carefully-drawn plan to the proportion of deaths of children bore a conattempt to meet a humanitarian want, and if the points stant ratio to the proportion of children officially which we have endeavoured to indicate are dealt with we returned ’’unaccounted for " as regards successful vaccinathink that, as a part of the law of the land, it would in some tion. 5. That efficient infant vaccination conferred a ways diminish pain and suffering. At any rate, to quote practically complete immunity from fatal small-pox during the great master HIPPOCRATES, if it do no good it will at the first ten years of life. 6. That the increase in the proof adult deaths from small-pox must be attributed least do no harm, always provided that it is made perfectly portion the to waning of the protective effect of infant mortality, this clear not only to those who can read the Bill, but also to hypothesis being corroborated by the steady increase in the that class from which the midwife’s patients come, that proportional case-mortality of vaccinated persons in recent even when registered the midwife will be in no way a epidemics at successive age-periods above ten years. 7. That " doctor," but only a nurse. We should like to add that we both the small-pox attack-rate and the case-mortality was see no reason why this question should not be discussed in far lower at all ages among those who had been vaccinated the profession calmly and with politeness. The points are in infancy than among the unvaccinated. 8. That the of disease suffered by small-pox patients was far more all perfectly clear, and the procedure requires formulating, type severe among the unvaccinated than among the vaccinated ; but there is no necessity for ill-tempered recrimination. and that the severity of the type appeared to vary with the number and quality of the vaccination marks. 9. That, PORTSMOUTH AND GOSPORT.-The total funds judged by the statistics of small-pox hospital nurses and successful re-vaccination afforded practically contributed towards the restoration of the Royal Portsmouth attendants, complete protection to adults, even to those brought into Hospital as the memorial of Her Majesty’s long reign hadactual personal contact with the worst forms of disease. We reached on Feb. 13th J?5139. At a meeting at Gosport last recommend these conclusions to the careful consideration of week it was decided to establish a Victoria Nursing Institute. !, those who have been unable to read aright the lessons An amendment was moved by a working man that 100 workmen’s dwellings should be provided instead. Perhaps taught by figures. it is a pity that this was negatived, for workmen’s dwellings THE "LOCAL PRACTITIONER": A PRESS are greatly needed. Parts of the town much need attention, PARODY. to better and long ago the urban council were asked provide is IT a most for decided on the poorer classes. They, however, satisfactory sign of the spirit of our times dwellings Feb. 18th to take no action under the operative sectionL that the interests of hospitals, which have done and are of the Housing of the Working Classes Act, relying on privatei doing so much for the public good and for the reputation of medicine, are well befriended by the daily press. We enterprise and the plea of costliness, _____
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Annotations.
continue to be an integral part of the social community. At present the midwife is a sort of free-lance, but as a result of all the registration Bills hitherto brought in she would come to be recognised, despite all said to the contrary, as a duly licensed medical practitioner. Although we yield to no one in our desire that puerperal
"Ne quid nimis." THE WATER-SUPPLY OF THE METROPOLIS.
WE begin to-day the report of a Commission which we have instituted to inquire into the water-supply of the metropolis-a subject which bids fair to assume a political women should be protected from the dangers of sepsis importance proportional, if possible, to its importance brought about by the ignorance or carelessness of their when viewed from the aspect of public health. attendants, yet we cannot agree to any scheme which does not lay down a hard-and-fast line between a THE FIGURES OF VACCINATION. midwife and a medical practitioner. The present AT a meeting of the Royal Statistical Society held on Bill in Clause 5 lays all the responsibility of defining the 16th inst. at the Royal United Service Institution a paper the duties of midwives upon the Midwives Board. on "English Vaccination and Small-pox Statistics, with Paragraph f of Section 2 of this clause is as follows : " To special reference to the Report cf the Royal Commission and frame for approval by the General Medical Council rules to recent Small-pox Epidemics," by Mr. Noel A. Humphreys, for regulating, supervising, and restricting within due was read. He arrived at the following conclusions (among limits the practice of midwives." We must confess our- others) based upon the figures discussed: 1. That the mean annual death-rate from small-pox at all ages in selves unable to see how the General Medical Council England and Wales, which was 408 per 1,000,000 in the or any other body is to frame rules which shall lay twelve years for which records exist prior to compulsory down for the guidance of a midwife when her own vaccination, fell to 126 per 1,000,000 in the forty-two attendance shall cease and it becomes necessary for years since vaccination was made compulsory, which her to call in a medical man, for we take it that this is period included the world-wide epidemic of 1871-72. meant by the paragraph under consideration. If the Bill 2. That the main part of this decline of mortality occurred children under the age of ten years, who may be ever reaches the committee stage we consider it absolutely among to have been principally affected by the increase presumed necessary that some clause should be added making it of infant vaccination. 3. That the age-incidence of fatal clear as to what in the opinion of the framers of the small-pox had entirely under the influence of changed Bill a midwive may or may not do ; for as it stands increased infant vaccination ; and that small-pox, from being the measure is very incomplete, and too much seems mainly a disease of childhood, was now proportionately 4. That, judged by the statistics to be left to those who are to arrange the details. more fatal to adults. six principal local small-pox epidemics, the last of All the same it is an honest and carefully-drawn plan to the proportion of deaths of children bore a conattempt to meet a humanitarian want, and if the points stant ratio to the proportion of children officially which we have endeavoured to indicate are dealt with we returned ’’unaccounted for " as regards successful vaccinathink that, as a part of the law of the land, it would in some tion. 5. That efficient infant vaccination conferred a ways diminish pain and suffering. At any rate, to quote practically complete immunity from fatal small-pox during the great master HIPPOCRATES, if it do no good it will at the first ten years of life. 6. That the increase in the proof adult deaths from small-pox must be attributed least do no harm, always provided that it is made perfectly portion the to waning of the protective effect of infant mortality, this clear not only to those who can read the Bill, but also to hypothesis being corroborated by the steady increase in the that class from which the midwife’s patients come, that proportional case-mortality of vaccinated persons in recent even when registered the midwife will be in no way a epidemics at successive age-periods above ten years. 7. That " doctor," but only a nurse. We should like to add that we both the small-pox attack-rate and the case-mortality was see no reason why this question should not be discussed in far lower at all ages among those who had been vaccinated the profession calmly and with politeness. The points are in infancy than among the unvaccinated. 8. That the of disease suffered by small-pox patients was far more all perfectly clear, and the procedure requires formulating, type severe among the unvaccinated than among the vaccinated ; but there is no necessity for ill-tempered recrimination. and that the severity of the type appeared to vary with the number and quality of the vaccination marks. 9. That, PORTSMOUTH AND GOSPORT.-The total funds judged by the statistics of small-pox hospital nurses and successful re-vaccination afforded practically contributed towards the restoration of the Royal Portsmouth attendants, complete protection to adults, even to those brought into Hospital as the memorial of Her Majesty’s long reign hadactual personal contact with the worst forms of disease. We reached on Feb. 13th J?5139. At a meeting at Gosport last recommend these conclusions to the careful consideration of week it was decided to establish a Victoria Nursing Institute. !, those who have been unable to read aright the lessons An amendment was moved by a working man that 100 workmen’s dwellings should be provided instead. Perhaps taught by figures. it is a pity that this was negatived, for workmen’s dwellings THE "LOCAL PRACTITIONER": A PRESS are greatly needed. Parts of the town much need attention, PARODY. to better and long ago the urban council were asked provide is IT a most for decided on the poorer classes. They, however, satisfactory sign of the spirit of our times dwellings Feb. 18th to take no action under the operative sectionL that the interests of hospitals, which have done and are of the Housing of the Working Classes Act, relying on privatei doing so much for the public good and for the reputation of medicine, are well befriended by the daily press. We enterprise and the plea of costliness, _____
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