HOSPITAL v. HOME MORTALITY IN INFECTIOUS DISEASE.

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<ul><li><p>423COAL DUST EXPLOSIONS.COAL DUST EXPLOSIONS.</p><p>character on the 9th, and on the night of the llth thedelirium passed on to coma and Mr. Burrow died. Theblood-poisoning was evidently of a very intense cha-racter, and the virus passed into the circulation withoutgiving rise to a protective inflammation in the lymphaticglands. The septic oedema of the trunk did not appear untilthe fourth day, and to the end there was no formation ofabscesses. It is singular that even in the early stage of theillness the unfortunate sufferer developed a conviction of hisapproaching death, and, while submitting courageously andgratefully to all the measures adopted for his relief, madehis preparations for the end. Cases of this kind are terriblyfrequent, and unnecessarily so. It appears to be very importantthat the habitual use of protective gloves of indiarubbershould be made the rule for all who are actively engaged inpost-mortem examinations, and especially since experiencehas proved that after a little practice the necessary manipula-tions can be performed without difficulty and with almostabsolute safety. The inevitable dangers of our calling arealready too numerous, and it is sad to add to them this seriesof fearful calamities, which may be escaped, or at any rateminimised, by a simple precaution.</p><p>character on the 9th, and on the night of the llth thedelirium passed on to coma and Mr. Burrow died. Theblood-poisoning was evidently of a very intense cha-racter, and the virus passed into the circulation withoutgiving rise to a protective inflammation in the lymphaticglands. The septic oedema of the trunk did not appear untilthe fourth day, and to the end there was no formation ofabscesses. It is singular that even in the early stage of theillness the unfortunate sufferer developed a conviction of hisapproaching death, and, while submitting courageously andgratefully to all the measures adopted for his relief, madehis preparations for the end. Cases of this kind are terriblyfrequent, and unnecessarily so. It appears to be very importantthat the habitual use of protective gloves of indiarubbershould be made the rule for all who are actively engaged inpost-mortem examinations, and especially since experiencehas proved that after a little practice the necessary manipula-tions can be performed without difficulty and with almostabsolute safety. The inevitable dangers of our calling arealready too numerous, and it is sad to add to them this seriesof fearful calamities, which may be escaped, or at any rateminimised, by a simple precaution.</p><p>COAL DUST EXPLOSIONS.ALL doubt that coal dust is the frequent cause of disastrous</p><p>colliery explosions is set at rest by the striking experimentswhich are the subject of a report drawn up by Mr. Henry Hall,one of Her Majestys Inspectors of Mines, by desire of theSecretary of State on behalf of the Royal Commissionappointed to inquire into this subject. Experiments on alaboratory scale, notably those of Professor Thorpe,which have already been described in the columns ofTHE LANCET,1 have demonstrated the extreme probabilityof coal dust igniting with explosive violence when freelymixed with air, as in well-ventilated mines, but the recentexperiments recorded in the report referred to furnishevidence of a practical and conclusive kind since they wereconducted in a main shaft placed at Mr. Halls disposalby the proprietors of the White Moss Colliery, Skelmersdale,in which the working conditions of a mine in active operationwere as nearly as possible realised. It is impossible to dealat any length with the very exhaustive series of experimentscontained in the report, but the conclusions and recommenda-tions which are appended are so important in connexionwith the prevention of loss of life in collieries from theterrible explosions which unfortunately in recent yearshave shown little abatement in their frequency that wegive a brief summary of the results. The flame froma blowing-out gunpowder shot in the presence of drycoal dust is always found to ignite more or less such</p><p>dust and to increase the burning and charring effects ofthe shot. When a large flame such as that of a blowing-outgunpowder shot or the flame from the ignition of a smallquantity of fire-damp traverses an atmosphere containing avery moderate quantity of dry coal dust, the dusty atmospherewill explode with great violence, and the explosion will con-tinue and pass throughout any length of such atmosphere, itsviolence and force increasing as it progresses. The coal dustfrom several seams in certain different districts is almost assensitive to explosion as gunpowder itself, the degree ofsensitiveness increasing in proportion to its high qualityand freedom from impurities. In mines which are brisklyventilated there is a greater probability of explosion,while in such cases it is generally more severe. Oneof the most important results of the experiments madehas been to demonstrate that certain "high explosives" "</p><p>(roburite, ammonite, &amp;c.) are incapable of igniting orexploding coal dust. Mr. Hall, in face of these facts, istherefore led to urge the total abolition of gunpowder from</p><p>ALL doubt that coal dust is the frequent cause of disastrouscolliery explosions is set at rest by the striking experimentswhich are the subject of a report drawn up by Mr. Henry Hall,one of Her Majestys Inspectors of Mines, by desire of theSecretary of State on behalf of the Royal Commissionappointed to inquire into this subject. Experiments on alaboratory scale, notably those of Professor Thorpe,which have already been described in the columns ofTHE LANCET,1 have demonstrated the extreme probabilityof coal dust igniting with explosive violence when freelymixed with air, as in well-ventilated mines, but the recentexperiments recorded in the report referred to furnishevidence of a practical and conclusive kind since they wereconducted in a main shaft placed at Mr. Halls disposalby the proprietors of the White Moss Colliery, Skelmersdale,in which the working conditions of a mine in active operationwere as nearly as possible realised. It is impossible to dealat any length with the very exhaustive series of experimentscontained in the report, but the conclusions and recommenda-tions which are appended are so important in connexionwith the prevention of loss of life in collieries from theterrible explosions which unfortunately in recent yearshave shown little abatement in their frequency that wegive a brief summary of the results. The flame froma blowing-out gunpowder shot in the presence of drycoal dust is always found to ignite more or less such</p><p>dust and to increase the burning and charring effects ofthe shot. When a large flame such as that of a blowing-outgunpowder shot or the flame from the ignition of a smallquantity of fire-damp traverses an atmosphere containing avery moderate quantity of dry coal dust, the dusty atmospherewill explode with great violence, and the explosion will con-tinue and pass throughout any length of such atmosphere, itsviolence and force increasing as it progresses. The coal dustfrom several seams in certain different districts is almost assensitive to explosion as gunpowder itself, the degree ofsensitiveness increasing in proportion to its high qualityand freedom from impurities. In mines which are brisklyventilated there is a greater probability of explosion,while in such cases it is generally more severe. Oneof the most important results of the experiments madehas been to demonstrate that certain "high explosives" "</p><p>(roburite, ammonite, &amp;c.) are incapable of igniting orexploding coal dust. Mr. Hall, in face of these facts, istherefore led to urge the total abolition of gunpowder from</p><p>1 THE LANCET, April 2nd, 1892.</p><p>coal mines for blasting purposes and the substitution of certain,"high explosives " - precautionary measures which manylarge firms have already adopted. Apart from the danger ofusing gunpowder arising from the ease with which it startsa dust explosion, it appears that in mere handling alone 400lives have been sacrificed during the last twenty years, whilethe loss of life from explosions caused by gunpowder duringthe same time has been at least one half of the total loss-</p><p>viz., 4098 persons. With regard to preventive measures everypossible effort, it is recommended, should be made, either bywatering the dry dust or removing it to avoid accumulation, sothat any accidental ignition of fire-damp may be limited in its.effects and prevented from developing into a sweeping ex-plosion through the agency of dust. In view of the factthat the results of these experiments coincide in a remark-able manner with the facts in the previous history of theseams as regards explosion, there can be no doubt at all ofthe great practical value of the report, and the commission)are to be congratulated on having selected Mr. Hall as their-expert in this matter, he having exhibited unquestionable skilland tact in the carrying out of these most important experi-ments. The report is accompanied by some excellent andstriking photographs taken at the time of the experimentalexplosions, and in some cases it is shown that the flame-emerged some sixty feet above the mouth of the shaft when.quantities of from 3 ewt. to 2 cwt. of coal dust were firedat the bottom of the pit by a cannon charged with 12 lbs. ofgunpowder. </p><p>--</p><p>coal mines for blasting purposes and the substitution of certain,"high explosives " - precautionary measures which manylarge firms have already adopted. Apart from the danger ofusing gunpowder arising from the ease with which it startsa dust explosion, it appears that in mere handling alone 400lives have been sacrificed during the last twenty years, whilethe loss of life from explosions caused by gunpowder duringthe same time has been at least one half of the total loss-</p><p>viz., 4098 persons. With regard to preventive measures everypossible effort, it is recommended, should be made, either bywatering the dry dust or removing it to avoid accumulation, sothat any accidental ignition of fire-damp may be limited in its.effects and prevented from developing into a sweeping ex-plosion through the agency of dust. In view of the factthat the results of these experiments coincide in a remark-able manner with the facts in the previous history of theseams as regards explosion, there can be no doubt at all ofthe great practical value of the report, and the commission)are to be congratulated on having selected Mr. Hall as their-expert in this matter, he having exhibited unquestionable skilland tact in the carrying out of these most important experi-ments. The report is accompanied by some excellent andstriking photographs taken at the time of the experimentalexplosions, and in some cases it is shown that the flame-emerged some sixty feet above the mouth of the shaft when.quantities of from 3 ewt. to 2 cwt. of coal dust were firedat the bottom of the pit by a cannon charged with 12 lbs. ofgunpowder. </p><p>--</p><p>HOSPITAL v. HOME MORTALITY IN INFECTIOUSDISEASE.</p><p>WE have received from Dr. Hope of Liverpool a copy of a..pamphlet prepared by him with a view of contrasting themortality amongst patients treated at home with that of thosetreated in hospitals for infectious diseases. The LiverpoolHospitals Committee appear to have been much struck withthe comments which have lately appeared in the lay press asto the alleged excessive mortality amongst fever patients atthe Asylums Board Hospitals, compared with the mortality ofthose treated at their own homes. They have, therefore,.most wisely directed their medical officer to investigate the-whole question with the help of statistics derived not onlyfrom Liverpool infectious hospitals, but also from similarinstitutions in other large manufacturing towns, such as.Manchester, Birmingham, Leeds and Shemeld, and, of course..the metropolis. After obtaining the necessary statistics.from the various hospitals, and comparing them with.similar data from the hospitals of his own city, Dr.Hope properly insists upon the observance of certain well-known precautions before accepting as conclusive the:results of comparison between different groups of statistical facts. In particular, he draws attention to the dis-turbing influence of social conditions on the mortality ofinfectious disease in different localities, and he points out that.in Liverpool, which he states to be " by far the most denselypopulated city in Great Britain," the population is far less.favourably situated (in respect, we suppose, of density))"than London, which has a population to the acre onlyone half as dense." We must here digress for a momentin order to inquire what is the exact meaning that Dr. Hope-attaches to the word " density." If he means that the mean.density of Liverpool is greater than that of London thestatement may not mean more than that London contains.within its area a larger number of open spaces than Liver-pool. What we want to ascertain for the purpose of comparing the two towns is whether in the poorer districts, which,as Dr. Hope shows, furnish the majority of the fever cases,the number of persons living on an acre in the one caseexceeds that in another. Estimated in this way, we fancythat there are parts of London and of other great cities.</p><p>WE have received from Dr. Hope of Liverpool a copy of a..pamphlet prepared by him with a view of contrasting themortality amongst patients treated at home with that of thosetreated in hospitals for infectious diseases. The LiverpoolHospitals Committee appear to have been much struck withthe comments which have lately appeared in the lay press asto the alleged excessive mortality amongst fever patients atthe Asylums Board Hospitals, compared with the mortality ofthose treated at their own homes. They have, therefore,.most wisely directed their medical officer to investigate the-whole question with the help of statistics derived not onlyfrom Liverpool infectious hospitals, but also from similarinstitutions in other large manufacturing towns, such as.Manchester, Birmingham, Leeds and Shemeld, and, of course..the metropolis. After obtaining the necessary statistics.from the various hospitals, and comparing them with.similar data from the hospitals of his own city, Dr.Hope properly insists upon the observance of certain well-known precautions before accepting as conclusive the:results of comparison between different groups of statistical facts. In particular, he draws attention to the dis-turbing influence of social conditions on the mortality ofinfectious disease in different localities, and he points out that.in Liverpool, which he states to be " by far the most denselypopulated city in Great Britain," the population is far less.favourably situated (in respect, we suppose, of density))"than London, which has a population to the acre onlyone half as dense." We must here digress for a momentin order to inquire what is the exact meaning that Dr. Hope-attaches to the word " density." If he means that the mean.density of Liverpo...</p></li></ul>

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