748
’Such desire, unless safeguarded by some definite religious- organisation, always leads to the wildest and most foolishsuperstitions. We cannot wonder at uneducated personsbelieving in portents, in the malign influence supposed tobe exercised by a comet, in ill luck and similar superstitions,when we find persons of education and men of the world
apparently seriously guiding their life’s course of action
by means of warnings given through the medium of a piece-of wood, a penny lead pencil, two pantograph wheels, and apiece of paper. -
THE SANITARY INSTITUTE.
THE twenty-first congress of the Sanitary Institute will
be held at Bradford on July 7th to llth, 1903, the Earl ofStamford being President. The section of Sanitary Scienceand Preventive Medicine will be presided over by Professor T.Clifford Allbutt ; the section of Engineering and Architecturewill be presided over by Mr. Maurice Fitzmaurice, C.M.G.,M. Inst. C.E. ; and the section of Physics, Chemistry, andBiology will be presided over by Professor C. HunterStewart. The usual popular lecture will be given byMr. J. Slater, B.A., F.R.I.B.A. Eight technical con-
ferences will also be held in connexion with the congress,presided over by Mr. W. C. Lupton, Professor Thomas
<Oliver, Dr. J. Spottiswoode Cameron, medical officer of
health of Leeds, Mr. T. H. Yabbicom, M. Inst.C.E., Mr. C.Drabble, M.R.C.V.S., Mrs. Moser, Dr. James Kerr, medicalofficer to the London School Board, and Mr. Isaac Young.
WORKHOUSE MEDICAL OFFICERS ANDREFRACTORY PAUPERS.
A CORRESPONDENT addresses us as follows :-
I shall be greatly obliged if you could give me advice on thefollowing. A is medical officer for the workhouse and district, butnot police surgeon. B is a pauper in the union, a rowdy fellow witha bad heart, who is periodically handed over to the police for assault,.&c., in the house. One night lately he was arrested there andtaken to the police-station. After a time the officer on duty thoughthim ill and sent to the union to have the medical officer ofthe workhouse sent to see B in the cells. A constable accompaniedthe messenger from the union to A’s house. As A has had somedifficulty before with the police staff over similar matters he repliedthat B having been arrested and taken to the cells he was now outof his (A’s) care as a pauper, and that either they must send for thepolice surgeon or send him (A) a proper request from the police station,not under cover of the workhouse. A sat up till 1 Å.lIf. (the messagecame at 11 but no further communication came till yesterday,when A got a letter from his board of guardians asking him to explainhis refusal to attend " unless the police paid him," and enclosing along letter to the guardians from the superintendent of police makingthe above accusation and asking for payment of 8s. 6d., the policesurgeon’s fees for attending the case.Was A justified in his line of action ? or was he still responsible for
the treatment of B ? If so, is he liable to be sent for to attend everydrunken rowdy in charge who may be a pauper even without a relievingofficer’s note ?
If the circumstances mentioned in the above letter include.all the facts bearing on the incident and neither correc-
tion nor amplification be required, then it appears to us
that our correspondent was legally justified in his lineof action. Two offices are held by him-one at the
workhouse, the other in the district. Article 207 of the
general consolidated order deals with the former of these
appointments and states that the duty of the medical
officer is "to attend at the 1vorklwuse at the periods fixed bythe guardians and also when sent for by the master or
matron." " Clause 2 of the same article states that the
medical officer shall ’’ attend duly and punctually upon allpoor persons in tAe workhouse requiring medical attend-
ance." " (The italics are ours.) There is no clause
in the article quoted, nor can we find one elsewhere,which would enable the guardians or the master to call
upon the medical officer of the workhouse to visit and toattend a person who had left the workhouse. In connexionwith this point it may be mentioned that it is within our
knowledge that stipendiary magistrates on many occasionswhen refractory paupers were charged before them haveasked the respective workhouse medical officers to
examine the prisoners in the cells and that in each
instance, so far as can be ascertained, a fee of
10s. 6d. was awarded. Evidently the magistrates were
convinced that workhouse medical officers were entitled
to remuneration for examining paupers at police-courts.The obligations affecting the holder of the post of districtmedical officer may be read in Article 206 of the same
consolidated order. Briefly they are: "To attend duly andpunctually upon all poor persons requiring medical attend-ance within the district assigned to him whenever he maybe lawfully required to furnish such attendance by a writtenor printed order of the guardians, of a relieving officer, or ofan overseer." The two extracts from the consolidated orderdefine the position clearly enough. The police have no legalbasis upon which they can demand the attendance of theparish medical officer, as parish medical officer, upon a
pauper in their custody. There is a person expresslyappointed for the purpose-namely, the police surgeon. Our
correspondent must remember that it will be his duty underArticle 205 to give to the guardians all the informationthat he is able to supply respecting the case. Whether itwill be wise for him always to adopt the line of actionlegally justified is a matter for his consideration.
SUTURE OF THE PATELLA.
M. QUENU of Paris (as reported by our correspondent) hasrecently been making some researches into the strength ofthe union effected by suturing a fractured patella. He has
shown in the dead body that if a patella is united by awire suture by any method a comparatively small weightcan cause some separation of the fragments. We should
think that the separation was probably due to stretching ofthe wire or to partial untwisting of the "knot." That
weights of 100 and 150 pounds could give rise to an intervalof a quarter of an inch between the fragments does notaffect at all the question of the value of suturing fracturedpatella?. The object of the wire is not to hold the frag-ments together while a force of 100 pounds or
more is applied, but it is intended to resist the
pull of the quadriceps muscle and to maintain the
fragments in the best position for the formation of
osseous union. On no account should the suture be reliedon to withstand voluntary movements of the limb. Thus .
M. Quenu’s experimental results, though of interest, are ofbut little practical importance, for no surgeon trusts to wirefor permanently holding the fragments together. The full
time for bony union should be allowed to elapse before thepatient is permitted to bear any of his weight on the affectedlimb. Used in this way suturing is probably the besttreatment for a fractured patella, but even without operationgood results may be obtained if sufficient care be taken to
bring the fractured surfaces into apposition. In the presentissue of THE LANCET Mr. G. T. Mockett of Burslem describesa method he employs which is ingenious. The chief point inhis method is the employment of a sheet of lead with a holein it just large enough to contain the patella. This is appliedover the knee and thus the fractured surfaces are maintainedin contact, strapping and bandages being also employed tofix the fragments.
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THE CLIMATE OF CAIRO.
IN a footnote on p. 182 of his "Thousand Nights and aNight " (Library Edition) the late Sir Richard Burton gives itas his opinion that of late years the climate of Cairo hasdeteriorated. "Even as late as 1852," he says, "when Ifirst saw Cairo, the city was girt by waste lands and theclimate was excellent. Now cultivation comes up to thehouse wall;;, while the Mahmudiyah Canal, the planting thestreets with avenues, and over-watering have seriouslyinjured it ; those who want the air of former Cairo must go
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