WHITE BILE IN BILIARY STASIS.

864 of the difficulties and dangers of theories are put into practice. LONDON R.F.H. SCHOOL OF MEDICINE It may be recalled that a welfare department was FOR WOMEN. found necessary to the Ministry of Munitions when the INTERESTING LUNCHEON. AN safety of the nation appeared to depend on the greatest standard of efficiency among shell-makers and fillers. The Blue-book, issued as a result of the experience ON Tuesday afternoon, at Fishmongers’ Hall, a then gained is full of valuable data on the conditions luncheon was given by 100 representative women to the welfare and of the for proper efficiency necessary a projected men in support of workers. Is not such work as important to the life of 100 representative and its associated the nation in peace time, and is it not an essential appeal for the Royal Free Hospital school, the London School of Medicine for part of the industrial medicine which is to form an medical The function commemorated the near Women. of work in future? the professional integral part of the jubilee of the Royal Free Hospital, approach it that Now does appear the miners are making a distinct effort in the direction of securing the " welfare " and marked the fact that more than 50 years had of their workers; if this be true it is important that elapsed since women first found a place in the medical Sir ALAN GARRETT ANDERSON, honorary there should not be interference with a provident profession. scheme. For many years past arrangements have treasurer of the London R.F.H. School of Medicine for existed in some colliery practices whereby the whole Women, and son of the late Dr. Elizabeth Garrett presided. Princess Louise Duchess of Argyll organisation, financial and otherwise, rests in the hands Anderson, was present, and among the hostesses and guests were of a combined committee of owners, miners, and doctors, a true Whitley council, and in these circum- the following :HOSTESSES. stances the best of good feeling has, we learn, existed. Miss Aldrich-Blake, M.S., M.D. (Dean of the London School of On the other hand, should the committee responsible for Medicine for Women); Lady Ampthill; Miss Adelaide Anderson; the whole of the medical arrangements in an area Miss Louisa Garrett Anderson, M.D.; Miss Lena Ashwell; Mrs. consist entirely of subscribers, without representation Ayrton. Miss Lilian Barker ; Lady Barrett, M.S., M.D.; Miss Billington; of employers and professional men, then there would Lady Bland-Sutton; Miss Marjorie Bowen; Miss Lilian Braithbe danger of arbitrary dealing, to use no stronger term. waite ; Miss Brodie-Hall; Miss A. M. Browne, L.S.A.; Miss Margaret Professional men should be independent in professional Buchanan; Viscountess Burnham; Dame Clara Butt. Miss Chadburn, M.D.; Miss Clough ; Miss. Constance Coehrane; matters, but for a successful service, in the sense of Miss Cox-Davies (Matron of the Royal Free Hospital); the close for the needs of the Marchioness of Crewe; Professor Winifred Cullis ; Countess adequate provision public, of Kedleston. Curzon cooperation is the desirable condition. If worked Mrs. Despard; Miss Durham. under joint committees such local schemes could The Lady Emmott; Miss Lloyd Evans. be made satisfactory to everyone concerned, and Mrs. Fawcett; Mrs. Bedford Fenwick; Lady Firth. Miss A. Garrett; Mrs. Ogilvie Gordon; the Countess of Gosford; where the scheme includes cooperative surgeries and " Alice Gregory. primary centres " with proper hospital provision the Miss Lady Hall (King Edward’s Hospital Fund) ; Mrs. Handley-Read, development is surely along accepted lines. Presumably M.R.C.S., L.R.C.P. ; Lady St. Helier; Miss Hopwood; Mrs. Hoster ; the management of the scheme will ultimately be taken Lady Hulton. Mrs. H. B. Irving ; Miss Frances Ivens, M.S. over by local authorities, to form an integral part of a The Dowager Countess of Jersey; Miss H. Jex-Blake; Miss K. L. The of a service. salaried service Johnston. complete question Mrs. Lucas Keene, M.D. ; Mrs. Mark Kerr; Mrs. Laura Knight. a knotty one, and its as against free choice is The Hon. Lady Lawley; the Hon. M. A. Lawrence; Dame Lloydsolution largely depends upon the view taken of incenGeorge ; Miss Lloyd-Still. tive. The questions arise: Is the professional man Mrs. Lyon Massey ; Miss Mary Macarthur; Miss Lillah Macarthy; Miss Rose Macaulay; Mrs. MacLean, D.Sc.; Lady Marling; Miss now giving-his most efficient service under the stimulus Martindale, M.D.; Lady Meyer; the Countess of Minto; of a steadily increasing practice ? Are the conditions Louisa the Hon. Mrs. E. Montagu; Miss Flora Murray, M.D. under which his work is now done the best possible Miss Olga Nethersole; Viscountess Northcliffe ; the Lady guarantees for a high standard? Do financial con- Northcote. Miss Rosalind Paget; Mrs. Peel; Mrs. Theodore Pennell, M.D.; siderations induce him to undertake the expenditure Lady Perley ; Mrs. Perrin; Mrs. Picton. Turbervill. for the of his maintenance On Mine. Teresa Del Riego; Viscountess Rhondda; Miss Lucy necessary efficiency? the answer to these questions depends the future Robinson; Mrs. Scoresby Routledge. Mrs. Vaughan Sawyer, M.D.; Mrs. Scharlieb (President of the of medical practice in colliery districts. London School of Medicine for Women); Dr. C. Henrietta Shearer; Dr. Amy Sheppard; Miss;MaySinclair; Miss Beadsmore Smith; Mrs. Stanley; Miss Florence Stoney; Lady Strachey ; the Duchess of Sutherland. WHITE BILE IN BILIARY STASIS. Mrs. Tata : Miss May Thorne, M.D.; Miss Jane Turnbull, M.D. Miss Jane Walker, M.D. (Medical Women’s Federation). LIGATION experiments in dogs, cats, and monkeys show that under conditions of stasis the gall-bladder GUESTS. and bile-ducts act very differently. The gall-bladder, Sir Alan Garrett Anderson, K.B.E. (Hon. Treas.. London (R.F.H.) continuing to exercise normal functions, effects a great School of Medicine for Women); H.R.H. Princess Louise Duchess concentration of the stasis bile, and adds mucus thereto of Argyll; Right Hon. Christopher Addison, M.D., M.P. (Minister Health); Right Hon. F. D. Acland, M.P. (Chairman, London in quantity. As a result, if an obstruction is produced of (R.F.H.) School of Medicine for Women. below the entrance of the cystic duct, all of the extra Sir Francis Layland Barratt, Bt. (Hon. Treasurer, Royal lobular biliary channels come at length to be filled with Free Hospital); Sir William Beveridge (Director, School of Sir John Bland-Sutton (President of the Royal Society The ducts, on the other Economics); a thick greenish-black fluid. of Medicine); Sydney Boulton (Chairman of Lloyd’s); Sir Anthony have no and their hand, concentrating faculty, lining Bowlby (President, Royal College of Surgeons); Sir Napier Burnett secretes but little mucus. In an obstructed duct system (Director of Hospital Services, Joint Council of Red Cross and St. John) ; Viscount Burnham; Sir E. Busk (Chairman of Convocablocked off from the gall-bladder, or connected with one tion, University of London). Dr. Harry Campbell; Sir Francis Champneys (Chairman of so changed as to be incapable of functioning, there Midwives Board); George Clausen, R.A.; Right Hon. regularly accumulates a limpid watery fluid devoid ofCentral J. E. Clynes, M.P. (President, National Union of General Workers); pigment and bile-salts, even when the animal is heavilySir Frank Colyer; Right Hon. Sir E. E. Cooper (the Lord Mayor); L. Courtney, LL.D. ; Philip Franklin, F.R.C.S. (Honorary jaundiced-the " white bile " of the surgeon. TheiW. American Hospital in London). passages soon become so distended with it that trueSecretary, Right Hon. Sir Eric Geddes (Minister of Transport); Sir John bile ceases to enter them. These facts are recorded hyi3-oodwin (Director-General of A.M.S.); H. A. Gwynne. P. Rous and P. D. McMaster, of the Rockefeller InstiProfessor F. J. C. Hearnshaw ; Sir H. Frank Heath; Sir Wi1mo fferringham (Chairman of the Universities Grants Committee ot tute, and seem to point to cholecystectomy as a E.M. Treasury) ; Brigadier-General Horwood (Commissioner of measure in gall-stone cases, especially when the ]Police of the Metropolis); Sir Robert Hudson (Chairman of the bladder is but little damaged. For an abnormal concen- wise3ritish Red Cross Society and the Order of St. John). Admiral Mark Kerr. tration and thickening of the bile, such as the gallLangton (Chairman, Royal Free Hospital); Sir John bladder can effect, must act both to promote the Alfred A.R.A.; Dr. R. T. Leiper; Earl of Lytton. La/very, formation of stones and to render obstruction by them Sir Nevil Macready; Sir Alfred Mond (Office of Works). Newman (Chief Medical Officer. Board of Education more complete. Sir George The frequent rapid increase of stones Ministry of Health). partially obstructing the common duct is attributable to amd Sir Cooper Perry (Principal, London University). the concentration of stasis bile by the gall-Madder. Lord Riddell; Sir Ronald Ross.

experience they yield arising when the best

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