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TRAINING FOR THE PUBLIC HEALTH SERVICE.
1153 and
practical engineering. The
THE
LANCET.
LONDON:SATURDAY, JUNE 1, 1929.
TRAINING FOR THE PUBLIC HEALTH SERVICE. THE London School of Hygiene and Tropical Medicine has issued a pamphlet outlining the course of study to be entered upon in October of this year for the diploma in public health. The appearance of this pamphlet serves as a reminder that this great school of preventive effort, conceived on the lines of the report of the Athlone Committee in 1921, and made possible by the large benefaction of the Trustees of the Rockefeller Foundation, is about to enter upon its full programme of work. We learn, in fact, that the new home of the School in Bloomsbury immediately adjacent to the University site will be opened by the PRINCE OF WALES in July. The incorporation in the new School of the old School of Tropical Medicine in 1924, and the fact that tropical hygiene and research have an arresting and picturesque character, have to some extent obscured the fact that the London School of Hygiene and Tropical Medicine have been slowly building up, concurrently with the growth of the fine structure in Portland stone which is to be their future home, the organisation which is to carry out the first conception of the School as a centre of public health training. On the laboratory side, the subjects of bacteriology, of.chemistry as applied to hygiene, and of parasitology as applied to public health, all contribute to the wholly admirable course of study for the diploma which is set out in the new syllabus, in addition to providing for advanced courses of study and research in the various subjects ; this is true also of the subjects of epidemiology and vital statistics. The laboratory work is clearly designed to take its place as an aid to the solution of the general problems of public health which will confront the prospective medical officers of health, rather than as an end in itself. The course of study as a whole, with the regulations of the General Medical Council in view, extends over a of 12 calendar months divided into three terms of 12 weeks each, and can be fully covered by students prepared to give five afternoons weekly from 2 till 6. This arrangement will be of particular advantage to practitioners who during this period of qualification for the diploma have other calls on their time during the mornings. The whole of the lectures and demonstrations on the theory and practice of public health administration and the principles of sanitary law find their place in that part of the course of study for which the professor of public health is responsible, and the course embraces some 40 visits to places of public health interest. It is an interesting new departure in this scheme of study, and typical of the whole underlying intention to secure the very best results, that the practical work under a medical officer of health, which is an essential part of the period of training, has been arranged in two selected areas as part of the School’s organisation ; the necessary instruction in infectious diseases and hospital management is also provided for, as well as lectures and demonstrations in applied physiology and lectures
period
classes in of
to do
so
sanitary-
study is so designed that those" wishing may proceed to the new academic" in health instituted by the University,., public diploma and it is at the same time clear that those responsible. for the course have in mind the importance of turning out men for the public health service thoroughly well. equipped for the career which is in front of them. This British school stands at the door of opportunity of building up a great international reputation. The excellent work that the University and the Board of Management have done in the appointment of the team of professors and- other scientific and administrative staff promises well for the establishment of: this reputation. In the field of public health, particu-larly, new ground is broken, and a great advance, made on anything previously attempted, and there. is a real promise that men bearing the hall-mark of a University diploma and equipped with a first-rate practical training will carry the good report of the new
course
sanitation and
School to the far
corners
of the earth.
THE SURGERY OF LOW BACK PAIN. THE causation and treatment of what is known as. low back pain has of recent years been much debated especially among surgeons in America. In this, country it has been thought till lately that pain in. the back and hips is seldom due to any anatomical abnormality. Improved means and methods of radiography, however, as well as evidence coming from the United States, have somewhat modified thisopinion. The interest taken in the subject justified the British Orthopaedic Society in selecting Deformities of the Lumbo-sacral Region of the Spine as thesubject for the Robert Jones Gold Medal and Priz;e, in 1927. The essay which gained the prize, written by Dr. JAMES F. BRAILSFORD, of Birmingham, waspublished in the April number of the British Journal of Surgery. His research has been a thorough one based on a study of over three thousand radiograms. and has included clinical examination of thoi3e, patients whose radiograms showed abnormality. Moreover, Dr. BRAILSFORD has investigated, by. dissection and X rays, the lumbo-sacral region of: 40 post-mortem subjects, and has, further, examined. and photographed specimens in the museums-of the Royal College of Surgeons and of the University of; Birmingham. His conclusions are thus founded on, anatomical data and will carry weight with surgeons. and pathologists. In seeking the cause of low back pain with a view ta relieving it by operation or otherwise, it must beremembered, as Dr. BRAILSFORD says, that developmental irregularities may be present and demonstrable, without giving rise to symptoms, and also that even when irregularities and symptoms are present together they are not always in the relation of cause, and effect. The deformity most frequently associated with a developmental defect in these three thousand cases was scoliosis due to asymmetrical sacralisation of the fifth lumbar transverse process. But apart from such curvature this developmental anomaly may lead to narrowing of an intervertebral foramen, and acute neuralgia in the distribution of the nerv in question. The deformities due to developmental irregularities which alter the alignment of the vertebrae tend to become more pronounced with age. He concludes further, that symptoms and deformity following injury to the lumbo-sacral region in which:
practical engineering. The
THE
LANCET.
LONDON:SATURDAY, JUNE 1, 1929.
TRAINING FOR THE PUBLIC HEALTH SERVICE. THE London School of Hygiene and Tropical Medicine has issued a pamphlet outlining the course of study to be entered upon in October of this year for the diploma in public health. The appearance of this pamphlet serves as a reminder that this great school of preventive effort, conceived on the lines of the report of the Athlone Committee in 1921, and made possible by the large benefaction of the Trustees of the Rockefeller Foundation, is about to enter upon its full programme of work. We learn, in fact, that the new home of the School in Bloomsbury immediately adjacent to the University site will be opened by the PRINCE OF WALES in July. The incorporation in the new School of the old School of Tropical Medicine in 1924, and the fact that tropical hygiene and research have an arresting and picturesque character, have to some extent obscured the fact that the London School of Hygiene and Tropical Medicine have been slowly building up, concurrently with the growth of the fine structure in Portland stone which is to be their future home, the organisation which is to carry out the first conception of the School as a centre of public health training. On the laboratory side, the subjects of bacteriology, of.chemistry as applied to hygiene, and of parasitology as applied to public health, all contribute to the wholly admirable course of study for the diploma which is set out in the new syllabus, in addition to providing for advanced courses of study and research in the various subjects ; this is true also of the subjects of epidemiology and vital statistics. The laboratory work is clearly designed to take its place as an aid to the solution of the general problems of public health which will confront the prospective medical officers of health, rather than as an end in itself. The course of study as a whole, with the regulations of the General Medical Council in view, extends over a of 12 calendar months divided into three terms of 12 weeks each, and can be fully covered by students prepared to give five afternoons weekly from 2 till 6. This arrangement will be of particular advantage to practitioners who during this period of qualification for the diploma have other calls on their time during the mornings. The whole of the lectures and demonstrations on the theory and practice of public health administration and the principles of sanitary law find their place in that part of the course of study for which the professor of public health is responsible, and the course embraces some 40 visits to places of public health interest. It is an interesting new departure in this scheme of study, and typical of the whole underlying intention to secure the very best results, that the practical work under a medical officer of health, which is an essential part of the period of training, has been arranged in two selected areas as part of the School’s organisation ; the necessary instruction in infectious diseases and hospital management is also provided for, as well as lectures and demonstrations in applied physiology and lectures
period
classes in of
to do
so
sanitary-
study is so designed that those" wishing may proceed to the new academic" in health instituted by the University,., public diploma and it is at the same time clear that those responsible. for the course have in mind the importance of turning out men for the public health service thoroughly well. equipped for the career which is in front of them. This British school stands at the door of opportunity of building up a great international reputation. The excellent work that the University and the Board of Management have done in the appointment of the team of professors and- other scientific and administrative staff promises well for the establishment of: this reputation. In the field of public health, particu-larly, new ground is broken, and a great advance, made on anything previously attempted, and there. is a real promise that men bearing the hall-mark of a University diploma and equipped with a first-rate practical training will carry the good report of the new
course
sanitation and
School to the far
corners
of the earth.
THE SURGERY OF LOW BACK PAIN. THE causation and treatment of what is known as. low back pain has of recent years been much debated especially among surgeons in America. In this, country it has been thought till lately that pain in. the back and hips is seldom due to any anatomical abnormality. Improved means and methods of radiography, however, as well as evidence coming from the United States, have somewhat modified thisopinion. The interest taken in the subject justified the British Orthopaedic Society in selecting Deformities of the Lumbo-sacral Region of the Spine as thesubject for the Robert Jones Gold Medal and Priz;e, in 1927. The essay which gained the prize, written by Dr. JAMES F. BRAILSFORD, of Birmingham, waspublished in the April number of the British Journal of Surgery. His research has been a thorough one based on a study of over three thousand radiograms. and has included clinical examination of thoi3e, patients whose radiograms showed abnormality. Moreover, Dr. BRAILSFORD has investigated, by. dissection and X rays, the lumbo-sacral region of: 40 post-mortem subjects, and has, further, examined. and photographed specimens in the museums-of the Royal College of Surgeons and of the University of; Birmingham. His conclusions are thus founded on, anatomical data and will carry weight with surgeons. and pathologists. In seeking the cause of low back pain with a view ta relieving it by operation or otherwise, it must beremembered, as Dr. BRAILSFORD says, that developmental irregularities may be present and demonstrable, without giving rise to symptoms, and also that even when irregularities and symptoms are present together they are not always in the relation of cause, and effect. The deformity most frequently associated with a developmental defect in these three thousand cases was scoliosis due to asymmetrical sacralisation of the fifth lumbar transverse process. But apart from such curvature this developmental anomaly may lead to narrowing of an intervertebral foramen, and acute neuralgia in the distribution of the nerv in question. The deformities due to developmental irregularities which alter the alignment of the vertebrae tend to become more pronounced with age. He concludes further, that symptoms and deformity following injury to the lumbo-sacral region in which: