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1084 SIR ANDREW CLARK MEMORIAL. reuralgic attacks and pains in the tendons, indisposition to exertion, irritability of temper, depression of spirits, frequent and severe attacks of vertigo and migraine, sleep- lessness, and drowsiness during the day. The main factor in treatment is regulation of the diet. The food ought to be mainly vegetable. Green vegetables (especially asparagus), fresh fruits, stale or toasted bread, with the white meat of poultry and fish, should constitute the chief items. An excess of carbohydrates, especially sugar, should be avoided. The only drink to be allowed is water, and sufficient quantities should be taken to flush the kidneys. Mineral waters may be ordered to accomplish the same purpose. Alcohol should be positively excluded. Exercise in the open air is also an important part of the treatment. But little drug treatment is required. Saline laxatives are very useful. A combination of lithium carbonate (2 gr.) with extract of nux vomica 1/6 gr.) given after meals is of special value. In attacks of lithæmic migraine a few doses of a mineral acid, it is claimed, will often cause the symptoms to disappear. - CAWNPORE WATERWORKS. SANITARY progress of a practical kind is being made in India. Waterworks are being started from time to time in various cities and towns of that country. The Cawnpore waterworks, which were opened the other day, are only part of a scheme of sanitation which includes drainage. The two should go hand-in-hand, and no more water should come into a place than can be disposed of. Indian experience has shown that a good water-supply has only a temporary influ- ence in reducing mortality unless accompanied by a good system of drainage. Cawnpore has now got a daily supply of four millions of gallons of filtered water distributed by pipes and a plentiful supply of stand-pipes. Let us hope that we shall have evidence of the good that has been effected by a diminished prevalence of and mortality from cholera. What is now required for Cawnpore, as the Government is opposed to the discharge of sewers into rivers, is a sewage farm, and the utilisation of its water-supply, after use, in driving the sewage on to land for agricultural purposes instead of directly into the River Ganges. Sewage farming in Madras appears to answer very well. MANCHESTER AND SALFORD SANITARY ASSOCIATION. THE annual report of this society includes also the reports of the societies which are affiliated with it. These comprise the Ladies’ Health Society, the Noxious Vapours Abatement Asso- ciation, and the Open Spaces and Children’s Holiday Fund Committees. The work of the parent society dates back to 1852, and it has had no small influence on the sanitary welfare of Manchester and Salford. It was, in fact, mainly owing to the efforts of this society that the first medical officer of health for Manchester was appointed, and it will probably be remembered that recently, on Dr. Tatham retiring, the society presented a memorial to the city council pointing out the great progress in the public health of Manchester which had taken place under Dr. Tatham, and advocating that, in order that this progress should be maintained in the future, the status of the new medical officer of health should be assured by offering a salary in some degree commensurate with the duties and responsibility of the office. Among the subjects taken up by the society during 1893 were : the condition of the Irwell, the certification of deaths, eye accidents in factories, sanitary requirements in elementary schools, and the notification of measles--which, by-the-bye, the society strongly advocates. Lectures were also delivered in several parts of the city under the auspices of the society. Judging from a statistical table compiled by Dr. Tatham, the Ladies’ Health Society has performed some valuable work during the year. The Noxious Vapours Abate- ment Association have organised a committee to test and report upon the most efficient smoke-preventing appliances. When the report is published it is apparently proposed to make application for the appointment of a Parliamentary Committee "to inquire into the practicability of suppressing the smoke nuisance without injury to manufacturing in- dustries." An attempt was also made by the same associa. tion to raise a fund for the periodical testing and publishing of the quality and illuminating powers of the Manchester and Salford gas. It is to be regretted that the necessary funds were not forthcoming, since some tests that were made seem to indicate need for improvement in the illumination. The two other affiliated societies have done good work during the year, but space will not permit of our noticing them in detail. SIR ANDREW CLARK MEMORIAL. A public meeting to advocate the memorial to the late Sir Andrew Clark will be held at Prince’s Hall, Picoadilly, on Thursday, May 3rd, at 4 P.M. H.R.H. the Duke of Cam- bridge will preside, and amongst the speakers will be the Right Hon. W. E. Gladstone, the Right Hon. T. H. Huxley, His Eminence Cardinal Vaughan, Canon Wilberforce, Sir James Paget, and Mr. Hutchinson. It has been decided that the memorial shall take the form of a small wing to be added to the London Hospital, to be called "The Sir Andrew Clark Wing," containing isolation wards for the temporary care and treatment of cases of an infective character, and the much-needed rebuilding of the pathological department. These are objects of great practical utility, and would appropriately perpetuate Sir Andrew Clark’s long and active connexion with his hospital. HOSPITAL LIFE AND HOSPITAL ABUSE. ONE of our contemporaries-which has its crotchets and even serious ones, but yet gives a hearing to both sides-is airing the question of hospital life with regard to several of its aspects. We are glad to see in the letters published the prevalence of common sense. One letter on hospital abuse, giving an account of an old gentleman E200 a year of whose income arises from perpetual rent charges, which he is dis- posed to leave benevolently, is well worthy of study. The writer of the letter sees nothing unsatisfactory in such a gentleman walking simply and firmly into a hospital meant for poor folk, and supported by many people whose subscrip- tions require them to pinch themselves, and he wonders that such a person should be interrogated as to his means. He clinches what is meant to be a severe letter by stating that this action on the part of the hospital authorities is likely to cost the hospital E20 a year-that, apparently, being the penalty devised against the hospital authorities for doing their simple duty. All honour to the hospital authori- ties. This simple narrative confirms the accounts we have heard before of an honest attempt to eliminate unfit cases. They mayfeel assured that, if they lose this gentleman’s , f:20, they would lose much more if they did not reserve the hospital accommodation for those who cannot pay a private practitioner. They deserve to receive £ 200 a year additional for faithfulness in their attempts to stop hospital abuse, which is the only serious explanation of the financial embarrassment of hospitals. Once restrict hospitals to fit cases and the argument for them is irre- sistible. The chief other question discussed in these letters in our contemporary is what we may call the ameni- ties of hospital life, chiefly that of consideration-con- sideration for poverty, for sex, for individual feeling in the motley groups that crowd the hospitals We have not much to say in repression of such a discussion. A nurse or a student, a physician or a surgeon, without such feelings does not deserve association with the medical profession and its

SIR ANDREW CLARK MEMORIAL

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1084 SIR ANDREW CLARK MEMORIAL.

reuralgic attacks and pains in the tendons, indispositionto exertion, irritability of temper, depression of spirits,frequent and severe attacks of vertigo and migraine, sleep-lessness, and drowsiness during the day. The main factorin treatment is regulation of the diet. The food oughtto be mainly vegetable. Green vegetables (especiallyasparagus), fresh fruits, stale or toasted bread, with thewhite meat of poultry and fish, should constitute the chiefitems. An excess of carbohydrates, especially sugar, shouldbe avoided. The only drink to be allowed is water, andsufficient quantities should be taken to flush the kidneys.Mineral waters may be ordered to accomplish the same

purpose. Alcohol should be positively excluded. Exercisein the open air is also an important part of the treatment.But little drug treatment is required. Saline laxatives are

very useful. A combination of lithium carbonate (2 gr.)with extract of nux vomica 1/6 gr.) given after meals is ofspecial value. In attacks of lithæmic migraine a few dosesof a mineral acid, it is claimed, will often cause the symptomsto disappear. -

CAWNPORE WATERWORKS.

SANITARY progress of a practical kind is being made inIndia. Waterworks are being started from time to time invarious cities and towns of that country. The Cawnporewaterworks, which were opened the other day, are only partof a scheme of sanitation which includes drainage. The two

should go hand-in-hand, and no more water should come intoa place than can be disposed of. Indian experience hasshown that a good water-supply has only a temporary influ-ence in reducing mortality unless accompanied by a goodsystem of drainage. Cawnpore has now got a daily supplyof four millions of gallons of filtered water distributed bypipes and a plentiful supply of stand-pipes. Let us hopethat we shall have evidence of the good that has beeneffected by a diminished prevalence of and mortality fromcholera. What is now required for Cawnpore, as the

Government is opposed to the discharge of sewers into rivers,is a sewage farm, and the utilisation of its water-supply, afteruse, in driving the sewage on to land for agricultural purposesinstead of directly into the River Ganges. Sewage farmingin Madras appears to answer very well.

MANCHESTER AND SALFORD SANITARYASSOCIATION.

THE annual report of this society includes also the reports ofthe societies which are affiliated with it. These comprise theLadies’ Health Society, the Noxious Vapours Abatement Asso-ciation, and the Open Spaces and Children’s Holiday FundCommittees. The work of the parent society dates back to1852, and it has had no small influence on the sanitary welfareof Manchester and Salford. It was, in fact, mainly owing tothe efforts of this society that the first medical officer ofhealth for Manchester was appointed, and it will probably beremembered that recently, on Dr. Tatham retiring, the

society presented a memorial to the city council pointing outthe great progress in the public health of Manchester whichhad taken place under Dr. Tatham, and advocating that,in order that this progress should be maintained in the

future, the status of the new medical officer of healthshould be assured by offering a salary in some degreecommensurate with the duties and responsibility of the office.Among the subjects taken up by the society during1893 were : the condition of the Irwell, the certification ofdeaths, eye accidents in factories, sanitary requirements inelementary schools, and the notification of measles--which,by-the-bye, the society strongly advocates. Lectures werealso delivered in several parts of the city under the auspicesof the society. Judging from a statistical table compiled byDr. Tatham, the Ladies’ Health Society has performed some

valuable work during the year. The Noxious Vapours Abate-ment Association have organised a committee to test andreport upon the most efficient smoke-preventing appliances.When the report is published it is apparently proposed tomake application for the appointment of a ParliamentaryCommittee "to inquire into the practicability of suppressingthe smoke nuisance without injury to manufacturing in-dustries." An attempt was also made by the same associa.tion to raise a fund for the periodical testing and publishingof the quality and illuminating powers of the Manchester andSalford gas. It is to be regretted that the necessary fundswere not forthcoming, since some tests that were made seemto indicate need for improvement in the illumination. Thetwo other affiliated societies have done good work during theyear, but space will not permit of our noticing them in detail.

SIR ANDREW CLARK MEMORIAL.

A public meeting to advocate the memorial to the late SirAndrew Clark will be held at Prince’s Hall, Picoadilly, onThursday, May 3rd, at 4 P.M. H.R.H. the Duke of Cam-

bridge will preside, and amongst the speakers will be theRight Hon. W. E. Gladstone, the Right Hon. T. H. Huxley, HisEminence Cardinal Vaughan, Canon Wilberforce, Sir James

Paget, and Mr. Hutchinson. It has been decided that thememorial shall take the form of a small wing to be added tothe London Hospital, to be called "The Sir Andrew ClarkWing," containing isolation wards for the temporary care

and treatment of cases of an infective character, and themuch-needed rebuilding of the pathological department.These are objects of great practical utility, and would

appropriately perpetuate Sir Andrew Clark’s long and activeconnexion with his hospital.

HOSPITAL LIFE AND HOSPITAL ABUSE.

ONE of our contemporaries-which has its crotchets andeven serious ones, but yet gives a hearing to both sides-isairing the question of hospital life with regard to several ofits aspects. We are glad to see in the letters published theprevalence of common sense. One letter on hospital abuse,giving an account of an old gentleman E200 a year of whoseincome arises from perpetual rent charges, which he is dis-posed to leave benevolently, is well worthy of study. Thewriter of the letter sees nothing unsatisfactory in such agentleman walking simply and firmly into a hospital meantfor poor folk, and supported by many people whose subscrip-tions require them to pinch themselves, and he wondersthat such a person should be interrogated as to his means.He clinches what is meant to be a severe letter by statingthat this action on the part of the hospital authoritiesis likely to cost the hospital E20 a year-that, apparently,being the penalty devised against the hospital authorities fordoing their simple duty. All honour to the hospital authori-ties. This simple narrative confirms the accounts we haveheard before of an honest attempt to eliminate unfit cases.

They mayfeel assured that, if they lose this gentleman’s, f:20, they would lose much more if they did not reservethe hospital accommodation for those who cannot paya private practitioner. They deserve to receive £ 200 a

year additional for faithfulness in their attempts to stophospital abuse, which is the only serious explanation of

the financial embarrassment of hospitals. Once restrict

hospitals to fit cases and the argument for them is irre-sistible. The chief other question discussed in theseletters in our contemporary is what we may call the ameni-ties of hospital life, chiefly that of consideration-con-

sideration for poverty, for sex, for individual feeling in themotley groups that crowd the hospitals We have not much

to say in repression of such a discussion. A nurse or a

student, a physician or a surgeon, without such feelings doesnot deserve association with the medical profession and its