Embed Size (px)
that such a charity would interfere with the trained nurse andthe medical men established in the locality. The proposednursing charity was successfully nipped in the bud. Insteadof indiscriminate charity there is at Loughton a MaternityClub. The mothers subscribe some months in advance to thisinstitution and when they are confined they are attendedby one of the local fully-qualified practitioners and theclub pays him a guinea fee. At first the subscriptions paidby the mothers did not suffice and the balance was made upby donations from charitable persons. Now, however, theMaternity Club has ceased to be a charity the memberssubscribe enough not only to pay the guinea fee to themedical attendant, but also to pay a nurse and to get variousthings specially needed at such a time. Thus there are nomidwifery cases attended in Loughton for less than a guineaand one of the local practitioners assured me that duringthe last four years he had had no bad debts and he hadnot even been put to the unpleasantness of having to askfor his money. It is true that the inhabitants of Loughtonare fairly prosperous. They work for the railway, for corn-merchants, and as gardeners for the local residents. Themost improvident belong to the mixed gipsy class. They arenot true gipsies, for when a number of gipsies were turnedout of Epping Forest some of them married East-end womenand thus a sort of half-breed race has grown up. They liveby providing donkeys and various sorts of entertainments forthe holiday folk who visit the forest. These are the onlyclass of people at Loughton likely to give the local practi-tioners some trouble. There is a provident society at Lough-ton which is self-supporting and there are benefit societiesand medical aid associations. These all pay 1d. a week Ifor adults, but for children they pay less. However, as thepopulation is exceptionally healthy and there is very littlesickness these sums represent more than they would in alarge town and I did not hear any complaints. The nursesfrom Plaistow and other and nearer nursing institutions donot come to Loughton. Yet the poor have an efficient nurseto attend to them. This is one of the ’’ Queen’s nurses" andshe costs the community about £100 a year. The money israised by subscription and managed by a committee on whichthe interests of both Church and Chapel are duly represented.The nurse has a cottage to live in, must not accept any fee,and only attends to others than the poor in a case of
emergency. If an accident happens to a well-to-do personand the help of a nurse is required immediately then themedical attendant may send for this nurse, but she mustleave the case as soon as a paid nurse has been broughtdown from London. It is therefore only in cases of emer-gency that the Queen’s nurse can be employed, and on thoseoccasions the person profiting by her services is supposed tocontribute half a guinea towards her maintenance. Such acase, however, is of rare occurrence. The nurse’s time isdevoted to attending the poor, but she must only visit patientsto whom she is sent by one of the medical men of the town.Thus the matter is entirely in the hands of the localpractitioners : the nurse is there to help them and not tocompete against them. The inhabitants of Loughton seemto have realised that it is the business of medical men toattend to the sick and that the best way of helping thosewho are ill is to help medical men to do their work.Efficient nursing is a great help ; the gTievance at Plaistow,East Ham, and elsewhere is not against nurses who help,but against nurses, most of them insufficiently trained, whocompete against fully-trained nurses and against the medicalpractitioners. The fact that such a grievance does not existat Loughton, though it prevails extensively in the immediateneighbourhood, shows what the profession can do when itsmembers are united, and it indicates also that there is a
way out of the difficulty.
NOTES FROM INDIA.(FROM OUR SPECIAL CORRESPONDENT.)
A Third Outbreak of Plague in Bombay.-New Measures andtheir Probable Consequences. --Appointments of DivisionalHealtA Officers.-Plague elsewhere.IT cannot be disguised that Bombay is seeing the com-
mencement of a third outbreak of the plague epidemic. Thedeaths during the past week have risen from 101 to 162, thetype of the disease appears to be extremely virulent, and thecases are occurring in all parts of the city. Considerable
anxiety is being felt and expressed in trade circles withregard to the probability of severe plague regulations being-again enforced. The continuous expenditure on plague-measures is also telling seriously in many quarters, and has.virtually brought the finances of the Bombay Government.to insolvency. The new plague powers and organisations are-much the same as the old, but instead of the Plague.Committee the Municipal Commissioner becomes the-
responsible chief plague authority. As he is interested in,the municipality, and especially in its finances, whatever-plague measures may be enforced will at least be subject to.proper financial control.The denial of the riots of last March being premeditated’
is only an official defence of departmental policy. No one-believes it. I have been given an intimation that if the-former obnoxious measures be reintroduced rioting will be-repeated. The plague regulations being so distasteful the.native leaders seek for means of counteracting them. The’loss of a few lives is nothing to them and is admitted agosuch. They recognise the results of the last riots and almostregret that they were not brought about before, and theyhave the foresight to see that the enforcement of sanitarymeasures which lead to disturbance will assuredly be-condemned and consequently withdrawn. A fight against.disease when the people are against you cannot be conducted’at the point of the bayonet. This, I believe, is the native-opinion and indicates their future policy. If the new powers.placed in the hands of the Commissioner be carried out with’the martial spirit and with the military assistance of the-late Plague Committee the rioting will be repeated. In view’of the developing third outbreak it is to be hoped a more.sympathetic course will be adopted.
In the reorganisation scheme for the Health Department ofBombay city 4 divisional health officers have been appointed.Dr. C. H. Cayley has been given No. 1 division, comprising.the south of the island and the eastern district of the city.Mr. J. Leask has No. 2 division, comprising the westeriband central districts of the city; Mr. W. Venis No. 3!divison, comprising the northern part of the city; Dr. S. C.Hormasjee (a Parsee) No. 4 division, comprising the whole-of the suburbs on the north. As Mr. J. Leask is not amedical man his appointment to such a post is a curious.anomaly. His powers for administrative work are un-
doubted and he has acted as the assistant health officer for-some years. Personally nothing but praise can be said inhis favour, but in principle the appointment is wrong. Some-other post might well have been given to him in order to.secure his services to the corporation.
In other places plague seems more intense than it has ever-been in Bombay. Dharwar district shows a death-rate 0f82 per cent., Thana district of 78 per cent., Satara districtof about 80 per cent., and Belgaum of 77 per cent. Also &
much larger proportion of the population has been attacked.The ridiculous rules made for the English nurses at Calcutta;and previously reported were withdrawn soon after theywere made publicly known by the press.
(FROM OUR OWN CORRESPONDENT.)
Infectious Diseases at Health Resorts.IN his report on the health of Manchester for the second
quarter of this year Dr. Niven draws attention to the-frequency with which children contract scarlet fever andother infectious fevers at " health resorts and to the little-solicitude shown by heads of families that the quarters.selected should present a clean bill of health. He points.out that at most of our health resorts there are powers for-the compulsory notification of infectious disease and thatvisitors may obtain reliable information from the local’medical officers of health. It is to be feared, however, thatthe danger of infection cannot always be met in this way,.for there is no doubt that many children are taken to these"places after suffering from scarlet fever and before desquama--tion is finished and after measles before they are free from.infection. It is clearly the duty of medical practitioners to.do all they can to prevent their patients being moved before-they cease to be dangerous to others.
Poisoning Attributed to Potted Shrimps.Some 40 or more people at St. Anne’s-on-the-Sea have’
’been made violently ill with sickness and diarrhoea from
eating potted shrimps. At all events, that has been the’local belief. The Lancashire coast is famous for its shrimps-and it would be a serious misfortune if they were to lose’their character. The shrimp-nets are plied for some milesalong the coast, where a deep channel divides the foreshorefrom the shallow banks. It is said that the shrimps werecaught, potted, and used the same day. No deaths haveoccurred, though some of the cases were serious. The fisher-men say that the shrimps were caught where there could beno sewage pollution.
An Anti-vaccinator.The first application under the recent Vaccination Act was
made to Mr. Headlam, the stipendiary magistrate, at theManchester city police-court on Sept. 8th. The applicant.said his child was ten months old, and he asked what he.should do under the circumstances, as he had not got allhis papers and was going on a three months’ journey. Themagistrate recommended him to have the child vacci-nated and after some discussion told him to make another- application.
conference on tlte Sewage Question.A meeting of representatives of local authorities in the
Irwell watershed, called by the River Irwell ConservancyCommittee of the Salford Corporation, was held yesterdayat the Salford Town Hall to consider the question of sewagedisposal by land treatment. The chief outcome was a strongprotest against the insistence by the Local GovernmentBoard in every case on land being purchased for-the treatmentof sewage. It still demands " that for every 20,000 of popu-lation ten acres of suitable land should be adopted for landfiltration whether it was possible or impossible to obtainthe land. It was stated that in the Swinton andPendlebury districts preparation had been made for the bacteriological treatment of their sewage and the effluentwas satisfactory to the Mersey and Irwell Joint Committee.;" But the Local Government Board would not give thempower to sewer a certain portion of their district that was atpresent unsewered unless they undertook to buy 125 acres ofland in addition to the 33 acres they had at present." Itwas moved : ’’ That it be recommended that an associationbe formed of the local authorities within the Irwell water-shed to be composed of two representatives of each authorityto fully consider and report upon the following matters-namely : (a) the requirements of the Local GovernmentBoard with respect to filtration of sewage effluent throughland; (b) the rights of manufacturers to turn trade liquidsand refuse into the public sewers; and (e) the standard ofpurity of the effluent required by the Mersey and IrwellJoint Committee, and that each authority be required tocontribute towards the incidental expenses pro rati accord-ing to population."
SCOTLAND.(FROM OUR OWN CORRESPONDENTS.)
Sanitary Association of Scotland.THE twenty-fourth annual congress of this association
has during the past week been in session at Rothesay,receiving a cordial welcome from the inhabitants, who wererepresented by the Marquis of Bute, the honorary President ofthe association. The President for the year is Dr. ArchibaldK. Chalmers, one of the medical officers of health of Glasgow.The subject of the Presidential Address was the VitalStatistics of School Ages. Dr. Chalmers took the yearsbetween the fifth and fifteenth as representing approximatelythe school period and showed by statistics that this periodcontained the healthiest years of life. Comparing the figuresfor 1890-92 with those for 1870-72 it appeared that thedeath-rate for the school age during the former period wasless by 38 per cent. than during the latter. The causes ofdeath during the school period were discussed in detail andfigures were produced to show that the fatal influence ofzymotic and tuberculous diseases had been very considerablyreduced ; also by comparison of the figures for diseases ofthe nervous system it was claimed that no support, but theopposite, was afforded to the contention that over-pressurein schools exercised a prejudicial influence on the nervoussystems of the children. Diseases of the circulationshowed an increase of 7 per cent. 11 art all ages," the increase
being specially marked under five, where it reached 50 percent., whilst during the school age the figures indicated areduction of 10 per cent. The increase in the percentageof deaths from these diseases, Dr. Chalmers remarked, hadbeen going on steadily for many years, and was not to beexplained by the increasing prevalence of rheumaticdisease, a circumstance which he considered suggestedthat greater attention should be given to the supervisionand selection of games and gymnastic exercises. Inthis direction, as in others, children and young peopleneeded guidance and advice. In conclusion the Presidentclaimed that the increased knowledge and improved methodsof the sanitarians were already resulting in saving for thenation a large number of lives which under the conditionsexisting twenty years ago would have been lost. Further, asthe deaths were fewer, the disabled also must be fewer, sothat our school children now left the arena not only ingreater numbers than their predecessors, but the proportionof those among them who were handicapped in the life raceby physical disability had been diminished. Credit for thisin no small measure was due to the efforts of the educationalauthorities to provide for the children the conditions of
healthy existence and vigorous growth. The address was
very cordially received.Faculty of Physicians and Surgeons, Glasgow.
The following gentlemen, having passed the necessaryexaminations, have been admitted Fellows of the Faculty:Hugh Galt, M.B., C.M. Glasg., and Clarence Alfred Wright,L.R.C.P. & S. Edin., L.F.P.S. Glasg.
University of Glasgow.Post-graduate classes in Bacteriology and Practical
Pathology are to be conducted during the vacation byProfessor Joseph Coats, assisted by Dr. L. R. Sutherland andDr. Alexander Ferguson, in the Pathological Institute at theWestern Infirmary.
Sept. 14tli. _______________
(FROM OUR OWN CORRESPONDENTS.)
The Epidemic of Typhoid Fever at Belfast.THE epidemic of typhoid fever still continues at
Belfast and the admissions into the Union FeverHospital were for the week ending Sept. 10th more
in number than in the preceding one. There are
now over 400 cases in that hospital. The type of thedisease is more severe than it was in the beginning andhssmorrhage and other serious complications are more
common. Everyone is waiting for the Public Health Com-mittee to give information as to what they are doing to
remedy the present most serious state of affairs and how
they propose to attack the most difficult question of the
admittedly deplorable sanitary condition of Belfast. It willtake an enormous expenditure of money to remedy thedefects of the town, but we are sure if the Public HealthCommittee will only face these difficulties the citizens willgive them their unanimous support.
Outbreak of Fever at Markethill.At a meeting of the Armagh Board of Guardians held on
Sept. 6th Mr. Marshall reported that in Markethill, of whichhe is medical officer of health, there has been since July anoutbreak of enteric fever and scarlet fever has also affecteda number of persons. Everything is being done by Mr.Marshall to limit the spread of the disease.
Cookstown Sewerage System.The Cookstown Board of Guardians have decided to apply
for a loan of E1370 for the purpose of extending the seweragesystem of Cookstown and a special committee has beenappointed to discuss various matters regarding the sanitationof that town.
Trater Famine at Ctis7tendall.Dr. Fogarty, the sanitary officer of this beautiful health
resort in county Antrim, reported to the Ballycastle Board ofGuardians at their meeting on Sept. 10th that the town waspractically without water. The question of a water-supplywill be fully considered on Sept. 24th.
The Cork Hospital Saturday Collection.The Committee of the Cork Hospital Saturday Collection