1
448 THE NATIONAL SPIRIT OF THE MEDICAL AND TEACHING PROFESSIONS. the neglect of genito-urinary work at our large London general hospitals, the teaching on such subjects as syphilis and gonorrhoea having been lamentable, and the opportunities of students for obtaining first-hand knowledge meagre in the extreme. Consider seriously this advice given to a patient of mine, an officer under treatment in one of our largest naval hospitals, " Massage your own prostate daily " - surely a feat within the compass only of the domestic cat. I am, Sir, yours faithfully, Grafton-street, W., March 13th, 1918. ROLF CREASY. ROLF GREASY. THE LIBRARY OF THE ROYAL SOCIETY OF MEDICINE. 10 the Editor of THE LANCET. SIR,-I notice in your article on Medical Libraries in last week’s issue that you refer to this library as having so many duplicates, that some readers have misunderstood it as depreciating the net value of our stock, and I would ask your kind permission to refer to the matter. I have consulted our librarian, Mr. Hewitt, and he states that while it is true we have a considerable number of duplicates, we have not, as would appear to be suggested, triplicates and quadruplicates, and most of the duplicates we do possess are of books over 20 years old. On the suggestion of Dr. Arthur Latham, honorary secretary of the Amalgamation Committee, who did so much to achieve the amalgamation, we have been trying to form a reference, as well as a circulat- ing, library, and we try to get duplicates of all important books, and these are specially labelled and reserved ’’ for reference only." Of important new books, I am glad to say, we have often in circulation as many as half-a-dozen copies, but we only buy one and hire the others, and exchange these for others as soon as the demand falls off ; but of duplicates in our permanent stock I doubt if we have 2000. I am, Sir, yours faithfully, J. Y. W. MACALISTER. 1, Wimpole-street, London, W., March 18th, 1918. * ** Our annotation was certainly not intended to convey that the admirable library of the Royal Society of Medicine was encumbered with duplicates.-ED. L. J. Y. W. MACALISTER. THE NATIONAL SPIRIT OF THE MEDICAL AND TEACHING PROFESSIONS. To the Editor of THE LANCET. SIR,-Mr. Bonar Law, speaking in the House of Commons on March 7th, said he did not believe the spirit of this country was weakening in the war and that if the question could be put, ° ° Are you prepared to go on with the war until the results you set out to achieve have been attained, or are you not ?" the response would be astonishing alike to our enemies and ourselves. Mr. Bonar Law’s question was a challenge to a certain attitude of mind amongst Parliamentarians which is dis- turbing to many people in these critical times. Debates in the House do not convey the idea of a solidly united nation. Carping criticism, undercurrents of party feeling, and intrigue find expression. Certain Members of Parliament forget their representative character, so long is it since they faced an election. We want to tell them that the nation is determined to see this thing through. In a sense everyone is war-weary, but the aims of the Allies have been put in almost identical terms by the Government, the Labour party, and President Wilson, and we only need the endorsement of the whole people. It has occurred to us that the medical and teaching pro- a fessions are in an exceptionally good position to initiate a response to Mr. Law’s question. Neither of these professions can be described as capitalist. Their members are seldom keen party politicians and their international interests have long been such as to make a narrow nationalism impossible to them. Plans for reconstruction after the war also demand atten- tion. Unless there is a satisfactory peace these plans will be brought to naught, and we shall have to prepare for the next war, which German writers are already discussing. The members of both our professions, being brought into contact with all sorts and conditions of men and homes, are well able to realise the great need there is for these schemes of reconstruction. The cry for reforms is in the air, but there is also the chance that even after a satisfactory peace we may settle down as before without tackling the crying evils in our midst, hence the need for a declaration of policy on this point. We suggest that these two professions should take steps to arrange for meetings to be held throughout the country on Empire Day, to be presided over by the Lord Mayor, mayors, and chairmen of county councils, for the purpose of giving the Government an answer to the question of the Chancellor of the Exchequer and, further, tor the purpose of pledging the nation to the execution of such reforms as are needed to bring abut that better country which shall be a noble and lasting memorial of those of our countrymen who have laid down their lives for what we believe to be the most sacred cause which ever sent a nation to war. Practically our suggestions are these :- 1. That the members of the medical and teaching pro. fessions in every county and county borough should approach the elected head of their local government area and request him to call a public meeting. 2. That at this public meeting two resolutions should be submitted. The first would express the determination of the country to secure a satisfactory peace ; the second would pledge the country to far-reaching schemes of reconstruction after peace is declared. We are. Sir- vnurs faithfullv. JOSEPH BATEY, Head Master, Carter Knowle Council School. ISABEL CLEGHORN, Past President of the National Union of Teachers. CHARLES W. COWEN, Hon. Secretary, Sheffield Branch of the National Union of Teachers. A. W. FORREST, Hon. Secretary, Local Medical War Committee. J. A. GREEN, Professor of Education ; Dean of the Faculty of Arts. J. H. HICHENS, Head Master, King Edward VII. School. O. H. HUDSON, Chairman, Sheffield Branch, British Medical Association. JOHN W. ILIFFE, Principal, Central Secondary Schools. J. B. LEATHES, Dean of the Faculty of Medicine. A. C. P. LUNN, Head Mistress, High School for Girls. R. J. PYE-SMITH, Emeritus Professor of Surgery. HAROLD SCURFIELD. Professor of Public Health, SOPHIA WITTS, Hon. Secretary, Sheffield Branch, British Medical Association. Sheffield, March 18th, 1918. URBAN VITAL STATISTICS. (Week ended March 16th, 1918.) English and Welsh Towns.-In the 96 English and Welsh towns, with an aggregate civil population estimated at nearly 17.000.000 persons, the annual rate of mortality was 16’6, against 15’7 and 16’7 per 1000 in the two preceding weeks. In London, with a population exceeding 4,000,000 persons, the death-rate was 17’8, or 0’3 per 1000 above that recorded in the previous week; among the remaining towns the rates ranged from 6-7 in Smethwick, 7’0 in Southend- on-Sea, and 7’2 in Ilford to 23-6 in Norwich and in Bath, 24’9 in Swindon, and 39’2 in Barnsley. The principal epidemic diseases caused 614 deaths, which corresponded to an annual rate of 1’9 per 1000, and included 244 from measles, 231 from whooping cough, 68 from diphtheria, 55 from infantile diarrhoea, 9 from scarlet fever, and 7 from enteric fever. Measles caused a death- rate of 4’0 in Stoke-on-Trent, 4’3 in Swansea, 5’5 in Great Yarmouth, 7-4 in Norwich, and 17’0 in Barnsley; whooping-cough of 2’3 in Middlesbrough, 2’5 in West Hartlepool, 2’7 in York, and 5’2 in Carlisle ; and diphtheria of 2’3 in St. Helens. The 936 cases of scarlet fever and 1616 of diphtheria under treatment in the Metropolitan Asylums Hospitals and the London Fever Hospital were 3 and 28 below the respective numbers remaining at the end of the previous week; there were also 25 cases of small-pox under treatment on Saturday last, including 15 new cases admitted during the week. Of the total deaths in the 96 towns 213 resulted from violence. The causes of 38 deaths were uncertified, of which 6 were registered in Liverpool and 4 in Birmingham. Scotch Towns.-In the 16 largest Scotch towns, with an aggregate population estimated at nearly 2,500,000 persons, the annual rate of mortality was 13’9, against 14.0 and 14’6 per 1000 in the two pre- ceding weeks. The 320 deaths in Glasgow corresponded to an annual rate of 15’0 per 1000, and included 7 from measles, 5 from whooping- cough, 4 from infantile diarrhoea, and 1 each from enteric fever and diphtheria. The 73 deaths in Edinburgh were equal to a rate of 11.4 per 1000, and included a fatal case of scarlet fever. Irish Towns.-The 168 deaths in Dublin corresponded to an annual rate of 22’0, or 2’3 per 1000 below that recorded in the previous week, and included 6 from whooping-cough and 1 each from measles and scarlet fever. The 190 deaths in Belfast were equal to a rate of 25’2 per 1000, and included 19 from whooping-cough, 6 from measles, 2 from infantile diarrhcea, and 1 from diphtheria. HOSPITAL SUNDAY FUND AT BRISTOL.-The Hos. pital Sunday collections in Bristol for 1918 amounted to £3634, which is X473 higher than any previous year. There are a few collections still to be reported.

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448 THE NATIONAL SPIRIT OF THE MEDICAL AND TEACHING PROFESSIONS.

the neglect of genito-urinary work at our large Londongeneral hospitals, the teaching on such subjects as syphilisand gonorrhoea having been lamentable, and the opportunitiesof students for obtaining first-hand knowledge meagre inthe extreme. Consider seriously this advice given to a

patient of mine, an officer under treatment in one of ourlargest naval hospitals, " Massage your own prostate daily "

- surely a feat within the compass only of the domestic cat.I am, Sir, yours faithfully,

Grafton-street, W., March 13th, 1918. ROLF CREASY.ROLF GREASY.

THE LIBRARY OF THE ROYAL SOCIETYOF MEDICINE.

10 the Editor of THE LANCET.SIR,-I notice in your article on Medical Libraries in last

week’s issue that you refer to this library as having so manyduplicates, that some readers have misunderstood it as

depreciating the net value of our stock, and I would ask

your kind permission to refer to the matter. I have consultedour librarian, Mr. Hewitt, and he states that while it istrue we have a considerable number of duplicates, we havenot, as would appear to be suggested, triplicates and

quadruplicates, and most of the duplicates we do possessare of books over 20 years old. On the suggestion of Dr.Arthur Latham, honorary secretary of the AmalgamationCommittee, who did so much to achieve the amalgamation,we have been trying to form a reference, as well as a circulat-ing, library, and we try to get duplicates of all importantbooks, and these are specially labelled and reserved ’’ forreference only." Of important new books, I am glad to say,we have often in circulation as many as half-a-dozen copies,but we only buy one and hire the others, and exchange thesefor others as soon as the demand falls off ; but of duplicatesin our permanent stock I doubt if we have 2000.

I am, Sir, yours faithfully,J. Y. W. MACALISTER.

1, Wimpole-street, London, W., March 18th, 1918.

* ** Our annotation was certainly not intended to conveythat the admirable library of the Royal Society of Medicinewas encumbered with duplicates.-ED. L.

J. Y. W. MACALISTER.

THE NATIONAL SPIRIT OF THE MEDICALAND TEACHING PROFESSIONS.

To the Editor of THE LANCET.SIR,-Mr. Bonar Law, speaking in the House of Commons

on March 7th, said he did not believe the spirit of thiscountry was weakening in the war and that if the questioncould be put, ° ° Are you prepared to go on with the war untilthe results you set out to achieve have been attained, or areyou not ?" the response would be astonishing alike to ourenemies and ourselves.

Mr. Bonar Law’s question was a challenge to a certainattitude of mind amongst Parliamentarians which is dis-

turbing to many people in these critical times. Debates inthe House do not convey the idea of a solidly united nation.Carping criticism, undercurrents of party feeling, and

intrigue find expression. Certain Members of Parliamentforget their representative character, so long is it since theyfaced an election. We want to tell them that the nation isdetermined to see this thing through. In a sense everyoneis war-weary, but the aims of the Allies have been put inalmost identical terms by the Government, the Labour party,and President Wilson, and we only need the endorsement ofthe whole people.

It has occurred to us that the medical and teaching pro-a

fessions are in an exceptionally good position to initiate aresponse to Mr. Law’s question. Neither of these professionscan be described as capitalist. Their members are seldomkeen party politicians and their international interests havelong been such as to make a narrow nationalism impossibleto them.

Plans for reconstruction after the war also demand atten-tion. Unless there is a satisfactory peace these plans willbe brought to naught, and we shall have to prepare for thenext war, which German writers are already discussing.The members of both our professions, being brought intocontact with all sorts and conditions of men and homes, arewell able to realise the great need there is for these schemesof reconstruction. The cry for reforms is in the air, but

there is also the chance that even after a satisfactory peacewe may settle down as before without tackling the cryingevils in our midst, hence the need for a declaration of policyon this point.We suggest that these two professions should take steps to

arrange for meetings to be held throughout the country onEmpire Day, to be presided over by the Lord Mayor, mayors,and chairmen of county councils, for the purpose of givingthe Government an answer to the question of the Chancellorof the Exchequer and, further, tor the purpose of pledgingthe nation to the execution of such reforms as are neededto bring abut that better country which shall be a nobleand lasting memorial of those of our countrymen who havelaid down their lives for what we believe to be the mostsacred cause which ever sent a nation to war.

Practically our suggestions are these :-1. That the members of the medical and teaching pro.

fessions in every county and county borough should approachthe elected head of their local government area and requesthim to call a public meeting.

2. That at this public meeting two resolutions should besubmitted. The first would express the determination ofthe country to secure a satisfactory peace ; the second wouldpledge the country to far-reaching schemes of reconstructionafter peace is declared.

We are. Sir- vnurs faithfullv.JOSEPH BATEY,

Head Master, Carter KnowleCouncil School.

ISABEL CLEGHORN,Past President of the National

Union of Teachers.CHARLES W. COWEN,

Hon. Secretary, SheffieldBranch of the National

Union of Teachers.A. W. FORREST,

Hon. Secretary, Local MedicalWar Committee.

J. A. GREEN,Professor of Education ; Dean

of the Faculty of Arts.J. H. HICHENS,

Head Master, King EdwardVII. School.

O. H. HUDSON,Chairman, Sheffield Branch,British Medical Association.

JOHN W. ILIFFE,Principal, Central Secondary

Schools.J. B. LEATHES,

Dean of the Faculty ofMedicine.

A. C. P. LUNN,Head Mistress, High School

for Girls.R. J. PYE-SMITH,

Emeritus Professor of Surgery.HAROLD SCURFIELD.

Professor of Public Health,SOPHIA WITTS,

Hon. Secretary, SheffieldBranch, British Medical

Association.Sheffield, March 18th, 1918.

URBAN VITAL STATISTICS.(Week ended March 16th, 1918.)

English and Welsh Towns.-In the 96 English and Welsh towns, withan aggregate civil population estimated at nearly 17.000.000 persons,the annual rate of mortality was 16’6, against 15’7 and 16’7 per1000 in the two preceding weeks. In London, with a populationexceeding 4,000,000 persons, the death-rate was 17’8, or 0’3 per 1000above that recorded in the previous week; among the remainingtowns the rates ranged from 6-7 in Smethwick, 7’0 in Southend-on-Sea, and 7’2 in Ilford to 23-6 in Norwich and in Bath, 24’9 inSwindon, and 39’2 in Barnsley. The principal epidemic diseasescaused 614 deaths, which corresponded to an annual rate of1’9 per 1000, and included 244 from measles, 231 from whoopingcough, 68 from diphtheria, 55 from infantile diarrhoea, 9 fromscarlet fever, and 7 from enteric fever. Measles caused a death-rate of 4’0 in Stoke-on-Trent, 4’3 in Swansea, 5’5 in Great Yarmouth,7-4 in Norwich, and 17’0 in Barnsley; whooping-cough of 2’3 in

Middlesbrough, 2’5 in West Hartlepool, 2’7 in York, and 5’2 in Carlisle ;and diphtheria of 2’3 in St. Helens. The 936 cases of scarlet fever and1616 of diphtheria under treatment in the Metropolitan AsylumsHospitals and the London Fever Hospital were 3 and 28 below therespective numbers remaining at the end of the previous week; therewere also 25 cases of small-pox under treatment on Saturday last,including 15 new cases admitted during the week. Of the total deathsin the 96 towns 213 resulted from violence. The causes of 38 deathswere uncertified, of which 6 were registered in Liverpool and 4 inBirmingham.Scotch Towns.-In the 16 largest Scotch towns, with an aggregate

population estimated at nearly 2,500,000 persons, the annual rate ofmortality was 13’9, against 14.0 and 14’6 per 1000 in the two pre-ceding weeks. The 320 deaths in Glasgow corresponded to an annualrate of 15’0 per 1000, and included 7 from measles, 5 from whooping-cough, 4 from infantile diarrhoea, and 1 each from enteric fever anddiphtheria. The 73 deaths in Edinburgh were equal to a rate of 11.4per 1000, and included a fatal case of scarlet fever.

Irish Towns.-The 168 deaths in Dublin corresponded to an annualrate of 22’0, or 2’3 per 1000 below that recorded in the previous week,and included 6 from whooping-cough and 1 each from measles andscarlet fever. The 190 deaths in Belfast were equal to a rate of 25’2per 1000, and included 19 from whooping-cough, 6 from measles, 2 frominfantile diarrhcea, and 1 from diphtheria.

HOSPITAL SUNDAY FUND AT BRISTOL.-The Hos.pital Sunday collections in Bristol for 1918 amounted to£3634, which is X473 higher than any previous year. Thereare a few collections still to be reported.