Clinical Infectious Diseases & The Journal of Infectious Diseases
FACILITIES FOR CLINICAL INSTRUCTION IN INFECTIOUS DISEASE AFFORDED BY THE HOSPITALS OF THE...
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512 MEDICAL TEACHERS.-THE SERVICES. or in the case of a foreign ship in the country to which that ship belongs ; and (b) his name has been notified to the emigration officer at the port of clearance, and has not been objected to by him; and (e) he is provided with proper surgical instruments to the satisfaction of that officer. If any person proceeds or attempts to proceed as medical prac- titioner in any emigrant ship without being duly authorised, he shall be liable to a fine not exceeding £100. Surgeons in charge of passenger ships should keep a record of any sickness that occurs on the voyage, whether among saloon passengers, emigrants, or crew, and they are requested to report the same to the emigration officer at the end of the voyage. The remuneration for these appointments is extremely variable, ranging from a free passage to the port of destination to a salary of £10 a month during continuance in the service. The appointments are of course made by the various firms of shipowners and the applicants are some- times numerous. FACILITIES FOR CLINICAL INSTRUCTION IN INFECTIOUS DISEASE AFFORDED BY THE HOSPITALS OF THE METRO- POLITAN ASYLUMS BOARD. THE study of infectious disease is a very necessary part of the student’s curriculum, but it is only within recent years that proper facilities have been afforded for taking advantage of the valuable material to be found in the fever hospitals of the Metropolitan Asylums Board. In former years the - student had but’few opportunities of becoming familiar with the natural history of this branch of medicine, and it was by no means an unheard-of event for a student to complete his career without having seen half a dozen cases of infec- tious disease. That there is still evidence of the state of affairs which formerly obtained may be gathered from the fact that during 1895 no fewer than 1277 patients, or a per- centage on the total admission into the Metropolitan Fever Hos- pitals of 7’6, were, after admission, found not to be suffering from the diseases mentioned in the medical certificates upon which they were removed to hospital, the percentage of mistakes at the Eastern Hospital at Homerton being 11’0 of the total admissions. At the present time five of the admirable hospitals of the Asylums Board-viz., the Eastern at Homerton, the Western at Fulham, the South-Eastern at Deptford, the South-Western at Stockwell, and the North- Western at Hampstead, are open under certain conditions to ,students and medical practitioners, while instruction in small-pox is also afforded at the small-pox ships in the Long Reach, near Dartford. A student desirous of taking a - course at one of the Board’s hospitals, must have completed his third year and have held the office of clinical clerk and dresser; he must then obtain the sanction of the Medical School to which he belongs and pay a fee of °hree guineas for the first three months, and one guinea ..or each subsequent month to the clerk of the board, from whom he receives a card indicating the hospital to which he is to be attached. At this hospital he must attend at stated times for at least two days in the week for a minimum period of two months, and on the completion of his attendance he receives a certificate from the medical - superintendent whose lectures and classes he has attended. While in the hospital the student places himself under the control of the medical superintendent, and is bound to observe the regulations in force for the prevention of spread of infection. These rales comprise the wearing while within the hospital wards of brown holland overalls, consistng of ’coat, trousers, and cap, which are provided by the board, .and the use of what may be termed a discharge block, which consists of an infected room where the overalls are left, a lavatory, and a theoretically uninfected room. The students .are further required to keep their hair short and to be .efficiently protected against small-pox. A duly qualified medical practitioner has equally to conform to these regu- lations and obtain the consent of the medical superintendent of the hospital at which he elects to attend. The student who attends these courses will obtain a fair knowledge of infectious disease, which will stand him in good stead in years to come, while he will also get an insight into the management of fever hospitals and the methods of dis- infection practised therein. The provisions with regard to instruction in small-pox differ somewhat from the above, as it is necessary for the student to reside for from two to four weeks on the small-pox ships, where he is provided with rations, apartments, and washing at the extremely moderate sum of 12s. per week. The student has to travel to and from the hospital ships on the ambulance steamer and to furnish himself with a suit to which he does not attach much value, in order that it may be disinfected or destroyed at the termination of the period. If the student can take this course during the summer we can promise him, as the result of a personal experience, a most enjoyable and instructive little holiday. MEDICAL TEACHERS. Ms. R. C. B. KERIN, B.A. London, first in First Class Honours in Classics, assisted by a staff of B.A. and B.Sc. Honour Graduates, pre. pares candidates in class and by private Tuition for Medical Prelimin- aries, London Matriculation, Preliminary Scientific Inter. Science, Hospital Scholarships, First Conjoint, First M.B. Oxon. and Camb., &c. Chemical and Physical Laboratories. For last four years 91 London University Successes and 3 Hospital Science Scholarships, &c.- Carlyon College, 55 and 56, Chancery-lane, W.C. The University Examination Postal Institution prepares candidates through the post or personally for all medical examinations. The four medical tutois have the M.D. or M.S. degree, three being medalists, Preparation also by the other tutors for the Preliminary Arts or Science Examinations. Bacteriological Laboratory for D.P.H. candi. dates. Numerous recent successes.-Apply to the Manager, Mr. E. S. Weymouth, M.A. Lond., Office, 27, Southampton. street, Strand, London, W.C. M.D., B.S. Lond., prepares for all the Professional Exams. Small classes are held for the Final College of Surgeons and Physicians, the Hall, the M.D.’s of Brussels, Durham (fifteen years’ standing), Tuition by correspondence. -Address, M.D., 23, Wimpole-street, Cavendish. square, W. Special preparation, in class, privately, and by correspondence, for the Triple Qualification, Edinburgh. Also for Fellowship Examinations of Royal College of Surgeons, Edinburgh, and M.D.Brussels. Resident pupils received.-Address, Class Rooms, 7, Chambers-street, Edinburgh. Coaching for Examination (University of Brussels). Also Corre- spondence Course for Provincial Practitioners, with practical and viva voce work in London before going to Brussels.-Cantab., TRJI LANCET Office, 423, Strand, W.C. INSTRUCTORS IN ELOCUTION, &C. Professor ALTSCHUL, Ph.D., has made Stammering, Stuttering, Lisping, Falsetto, recent or of long standing, due to nervousness, &c., irrespectively of age or sex (without any mechanical appliances), his special life-long study. The voice greatly developed and strengthened. - 9, Old Bond-street, W. (Attends at Brighton.) Mr. WILLIAM VAN PRAAGH, the public introducer of the Pure Oral System of Teaching Deaf Mutes, has made the subject of Lip-reading, and the cure of all Defects of Speech, both acquired and congenital, his special study. Papers on the various subjects can be had at 11 Fitzroy-square, W. Mrs. EMIL BEHNKE gives instruction in Voice Training and treats Stammering and other Defects of Speech at 18, Earl’s-court-square,S.W. Miss BOULTBEE, 37, Gloucester-place, Portman-square, W., gives Lessons in Lip-reading to persons wholly or partially Deaf. THE SERVICES. WE are frequently asked for copies of the examination papers set at the competitive examinations of Her Majesty’s Army and Indian Medical Services, and the following papers set at a recent examination may be of service to our readers. We omit the questions in Natural Science, which are more or less elementary. Three hours are allowed for each paper. MEDICINE AND PATHOLOGY (PROFESSOR McCALL ANDERSON). 1. State fully what the symptoms in the following case imply, giving the grounds for your diagnosis; and what anatomical lesions would you expect to find in the event of a fatal issue :- A baker, aged twenty-six, whose family and personal history in early life were good, was admitted into hospital on Jan. 1st, 1897. Six years before, after a chill, he was seized with fever, profuse sweating, and pain and swelling in many joints, large and small. The joint affection was erratic-flitting about from joint to joint- but when he recovered their shape and mobility were in no way impaired. Three years thereafter-having in the internal apparently enjoyed excellent health-he began to suffer in an increasing degree from breathlessness and palpitation on exertion, sometimes accompanied by praecordial pain. On examining the heart the apex beat was found to be displaced con- ! siderably downwards and to the left of the nipple line, with a corresponding increase of the cardiac dulness, and there was a murmur at the apex accompanying the first sound, with accentua- tion of the second pulmonary sound at the base. Three months , before admission be became suddenly paralysed on the right side, without loss of consciousness. The palsy of the arm and leg was nearly complete, that of the face partial, and mostly of it) lower segment. At the same time he entirely lost the power
Transcript of FACILITIES FOR CLINICAL INSTRUCTION IN INFECTIOUS DISEASE AFFORDED BY THE HOSPITALS OF THE...
512 MEDICAL TEACHERS.-THE SERVICES.
or in the case of a foreign ship in the country to which thatship belongs ; and (b) his name has been notified to theemigration officer at the port of clearance, and has not beenobjected to by him; and (e) he is provided with propersurgical instruments to the satisfaction of that officer. Ifany person proceeds or attempts to proceed as medical prac-titioner in any emigrant ship without being duly authorised,he shall be liable to a fine not exceeding £100. Surgeonsin charge of passenger ships should keep a record of anysickness that occurs on the voyage, whether among saloonpassengers, emigrants, or crew, and they are requested toreport the same to the emigration officer at the end ofthe voyage. The remuneration for these appointments is
extremely variable, ranging from a free passage to the portof destination to a salary of £10 a month during continuancein the service. The appointments are of course made by thevarious firms of shipowners and the applicants are some-times numerous.
FACILITIES FOR CLINICAL INSTRUCTIONIN INFECTIOUS DISEASE AFFORDEDBY THE HOSPITALS OF THE METRO-
POLITAN ASYLUMS BOARD.
THE study of infectious disease is a very necessary part ofthe student’s curriculum, but it is only within recent yearsthat proper facilities have been afforded for taking advantageof the valuable material to be found in the fever hospitalsof the Metropolitan Asylums Board. In former years the- student had but’few opportunities of becoming familiar withthe natural history of this branch of medicine, and it wasby no means an unheard-of event for a student to completehis career without having seen half a dozen cases of infec-tious disease. That there is still evidence of the state ofaffairs which formerly obtained may be gathered from thefact that during 1895 no fewer than 1277 patients, or a per-centage on the total admission into the Metropolitan Fever Hos-pitals of 7’6, were, after admission, found not to be sufferingfrom the diseases mentioned in the medical certificates uponwhich they were removed to hospital, the percentage ofmistakes at the Eastern Hospital at Homerton being 11’0of the total admissions. At the present time five of theadmirable hospitals of the Asylums Board-viz., the Easternat Homerton, the Western at Fulham, the South-Eastern atDeptford, the South-Western at Stockwell, and the North-Western at Hampstead, are open under certain conditions to,students and medical practitioners, while instruction in
small-pox is also afforded at the small-pox ships in the LongReach, near Dartford. A student desirous of taking a- course at one of the Board’s hospitals, must have completedhis third year and have held the office of clinical clerkand dresser; he must then obtain the sanction of theMedical School to which he belongs and pay a fee of°hree guineas for the first three months, and one guinea..or each subsequent month to the clerk of the board,from whom he receives a card indicating the hospital towhich he is to be attached. At this hospital he must attendat stated times for at least two days in the week for aminimum period of two months, and on the completion ofhis attendance he receives a certificate from the medical- superintendent whose lectures and classes he has attended.While in the hospital the student places himself under thecontrol of the medical superintendent, and is bound toobserve the regulations in force for the prevention of spreadof infection. These rales comprise the wearing while withinthe hospital wards of brown holland overalls, consistng of’coat, trousers, and cap, which are provided by the board,.and the use of what may be termed a discharge block, whichconsists of an infected room where the overalls are left, alavatory, and a theoretically uninfected room. The students.are further required to keep their hair short and to be.efficiently protected against small-pox. A duly qualifiedmedical practitioner has equally to conform to these regu-lations and obtain the consent of the medical superintendentof the hospital at which he elects to attend. The studentwho attends these courses will obtain a fair knowledge ofinfectious disease, which will stand him in good stead inyears to come, while he will also get an insight into themanagement of fever hospitals and the methods of dis-infection practised therein.The provisions with regard to instruction in small-pox
differ somewhat from the above, as it is necessary for thestudent to reside for from two to four weeks on the small-poxships, where he is provided with rations, apartments, andwashing at the extremely moderate sum of 12s. per week.The student has to travel to and from the hospital ships onthe ambulance steamer and to furnish himself with a suitto which he does not attach much value, in order that itmay be disinfected or destroyed at the termination of theperiod. If the student can take this course during thesummer we can promise him, as the result of a personalexperience, a most enjoyable and instructive little holiday.
MEDICAL TEACHERS.
Ms. R. C. B. KERIN, B.A. London, first in First Class Honours inClassics, assisted by a staff of B.A. and B.Sc. Honour Graduates, pre.pares candidates in class and by private Tuition for Medical Prelimin-aries, London Matriculation, Preliminary Scientific Inter. Science,Hospital Scholarships, First Conjoint, First M.B. Oxon. and Camb.,&c. Chemical and Physical Laboratories. For last four years 91London University Successes and 3 Hospital Science Scholarships, &c.-Carlyon College, 55 and 56, Chancery-lane, W.C.The University Examination Postal Institution prepares candidates
through the post or personally for all medical examinations. The fourmedical tutois have the M.D. or M.S. degree, three being medalists,Preparation also by the other tutors for the Preliminary Arts or
Science Examinations. Bacteriological Laboratory for D.P.H. candi.dates. Numerous recent successes.-Apply to the Manager, Mr. E. S.Weymouth, M.A. Lond., Office, 27, Southampton. street, Strand,London, W.C.M.D., B.S. Lond., prepares for all the Professional Exams. Small
classes are held for the Final College of Surgeons and Physicians, theHall, the M.D.’s of Brussels, Durham (fifteen years’ standing), Tuitionby correspondence. -Address, M.D., 23, Wimpole-street, Cavendish.square, W.
Special preparation, in class, privately, and by correspondence, forthe Triple Qualification, Edinburgh. Also for Fellowship Examinationsof Royal College of Surgeons, Edinburgh, and M.D.Brussels. Residentpupils received.-Address, Class Rooms, 7, Chambers-street, Edinburgh.Coaching for Examination (University of Brussels). Also Corre-
spondence Course for Provincial Practitioners, with practical andviva voce work in London before going to Brussels.-Cantab., TRJILANCET Office, 423, Strand, W.C.
INSTRUCTORS IN ELOCUTION, &C.Professor ALTSCHUL, Ph.D., has made Stammering, Stuttering,
Lisping, Falsetto, recent or of long standing, due to nervousness, &c.,irrespectively of age or sex (without any mechanical appliances), hisspecial life-long study. The voice greatly developed and strengthened.- 9, Old Bond-street, W. (Attends at Brighton.)Mr. WILLIAM VAN PRAAGH, the public introducer of the Pure Oral
System of Teaching Deaf Mutes, has made the subject of Lip-reading,and the cure of all Defects of Speech, both acquired and congenital, hisspecial study. Papers on the various subjects can be had at 11
Fitzroy-square, W.Mrs. EMIL BEHNKE gives instruction in Voice Training and treats
Stammering and other Defects of Speech at 18, Earl’s-court-square,S.W.Miss BOULTBEE, 37, Gloucester-place, Portman-square, W., gives
Lessons in Lip-reading to persons wholly or partially Deaf.
THE SERVICES.
WE are frequently asked for copies of the examinationpapers set at the competitive examinations of Her Majesty’sArmy and Indian Medical Services, and the following papersset at a recent examination may be of service to our readers.We omit the questions in Natural Science, which are more orless elementary. Three hours are allowed for each paper.MEDICINE AND PATHOLOGY (PROFESSOR McCALL ANDERSON).1. State fully what the symptoms in the following case imply, giving
the grounds for your diagnosis; and what anatomical lesions would youexpect to find in the event of a fatal issue :-
A baker, aged twenty-six, whose family and personal history in earlylife were good, was admitted into hospital on Jan. 1st, 1897. Sixyears before, after a chill, he was seized with fever, profusesweating, and pain and swelling in many joints, large and small.The joint affection was erratic-flitting about from joint to joint-but when he recovered their shape and mobility were in no wayimpaired. Three years thereafter-having in the internalapparently enjoyed excellent health-he began to suffer in anincreasing degree from breathlessness and palpitation on
exertion, sometimes accompanied by praecordial pain. Onexamining the heart the apex beat was found to be displaced con-
! siderably downwards and to the left of the nipple line, with acorresponding increase of the cardiac dulness, and there was amurmur at the apex accompanying the first sound, with accentua-tion of the second pulmonary sound at the base. Three months
, before admission be became suddenly paralysed on the right side,without loss of consciousness. The palsy of the arm and leg wasnearly complete, that of the face partial, and mostly of it)
lower segment. At the same time he entirely lost the power
