NEW INFECTIOUS HOSPITALS.
1
8. 789 against at any time, and in view of its frequent occurrence it is no more than ordinary wisdom to dispense with all such wrapping as we have referred to. I THE BELGIAN MEDICAL FEDERATION AND THE NEW BILL ON DISPENSING. A CIRCULAR has been issued by the Belgian Medical Federation, addressed to the presidents of all the medical cercles or branch associations, requesting them to call special meetings of their respective branches to discuss the new Bill by which, as our readers are aware, it is proposed to abolish the right of dispensing their own medicines, which is now enjoyed by a considerable proportion of Belgian practi- tioners. It is hoped that through these branch associations pressure may be brought to bear on members of the Legislature, which will result in a serious modification of the proposed measure, to the general principle of which, however, the Federation, as is pointed out in the circular, assented to both in 1868 and in 1880, when a regular modus vivendi was agreed upon between it and the Pharmaceutical Association. This agreement, however, specially provided that every medical man already enjoying the right to dispense should continue to do so as long as he should remain in the same locality. It is on the question of these vested rights that the proposed Bill is considered so unsatisfactory, for by it they will in no case be respected beyond the period of fifteen years, and in many only for five years, while, in order to be recognised at all, they must have already existed for three years. In discussing the general question of dispensing by medical men, Le Scapel, in answer to the complaints of some pharmacists that medical men having had no proper pharmaceutical training are utterly incompetent to prepare or to estimate the value of drugs, and therefore should not in any case be allowed to exercise what is called the cumul, or combination of the two pro- fessions, points out that it is very misleading and erroneous to talk of the existence of any cumul at all ; that medical men, even though they may be allowed to dispense for their own patients, do not practise pharmacy proper. They do not, and may not, keep an open shop, and they never prepare or com- pound medicines of an elaborate character, their work being almost entirely confined to putting up simple mixtures with preparations which they are obliged to obtain from a pharmacist, and for the quality of which he is responsible, for in Belgium a medical practitioner who dispenses may not purchase his drugs from wholesale houses. There is therefore no great need for him to be acquainted with all the complicated processes for the estimation of samples, and he may surely be trusted to put up mixtures of pre- parations the purity of which is already guaranteed. NEW INFECTIOUS HOSPITALS. A DISTINCT impetus has been given to the provision of isolation hospitals by reason of the recent prevalence of small-pox in various parts of England, and though all the instances in which a determination has been arrived at either to commence such provision or to improve and enlarge the existing accommodation cannot properly be regarded as due to this cause, yet in the majority of the cases which we have from time to time recorded fear of small-pox has been the main stimulus to action. Of this there is, of course, no reason to complain, provided that the sanitary authorities do not let themselves be moved by panic into the construction of buildings which will not secure the imme- diate isolation of first attacks of all such infectious fevers as are likely in future years to arise in their districts. That the provision should be suitably adapted to this principal controlling need should, above all things, be borne in mind. Amongst the recent items of intelligence as to this are the following :-The Nottingham Town Council have decided to erect a new permanent hospital for infectious diseases at a cost of .E33,000; the Grimsby Town Council have decided to erect a brick building to accommodate twenty additional small-pox patients ; the Burton Town Council have, on the advice of their Health Committee, passed a resolution to the effect that it is desirable that a permanent infectious hospital should be established; the Sutton-in-Ashfield Local Board of Health has selected a site of somewhat over 5000 square yards for the erection of a similar building; and the Paisley Abbey Parochial Board have resolved to erect a hospital giving accommodation to 100 patients. It is not clear, however, as regards the latter hospital, how far it will be reserved for any special diseases. HEALTH OF THE EMPEROR OF GERMANY. THE following telegram was received on Thursday morn- ing at THE LANCET office from Charlottenburg :- " During the last week inflammation was noticed in the neighbourhood and below the opening into the trachea, but external to it. On Saturday evening slight shivering took place. On Sunday there was little bronchitis. Pneumonia was anticipated, but did not supervene. It is considered that there is at present peritracheitis with pyasmia." In spite of the cessation of all official bulletins of the Emperor of Germany’s health, it has been abundantly evident that his fell disease has been creeping on apace, and that the Imperial patient was being steadily worsted in the struggle. It was not surprising, therefore, to learn a few days ago that the case had become critical and that the worst fears were entertained. It seems that fever has set in accom- panied with bronchitis. It is well known that in cancer of the larynx, as of any other part in communication with the lungs, septic pneumonia is very likely to supervene, and repeated careful examinations appear to have been made to discover such an affection of the lungs. The latest accounts speak of the absence of all signs of pneumonia and of thelessen- ing of the bronchitis. So that some other explanation of the fever, which still continues, has to be sought. It has been suggested that an abscess has developed in the neighbour- hood of the trachea, and there seems to be only too much reason to fear that this is so. Such abscesses often develop in connexion with cancerous formations in internal parts, and very gravely exaggerate the danger of the primary disease. Blood poisoning from such an abscess often ensues, and, as the above telegram shows, pyasmia has already developed. Whatever the exact complication is, there is no. doubt ground for the gravest anxiety, and for fear that the close of this painful case is not far off. UNWHOLESOME AIR IN SCHOOLS. JJUBJNQ tne past year i7r. tieorge Reia, medical omcer ot health for the rural district of Stafford, has carried out a systematic inspection of the elementary schools within his jurisdiction; and in each case he has made a careful analysis of the school air, the samples being taken as far as possible after the children had been in school for some hours. The various results, and the conditions tending to affect them, are tabulated in the report compiled, and in by far the majority of instances the volume of carbonic acid present per 1000 volumes of air was found to range between 2’039 and 3’708. This must be regarded as excessive, and an atmosphere giving such indications cannot be looked upon as a whole- some one for children to breathe habitually during many hours of the day. The minimum requirement as to air space in elementary schools certainly fails of itself to secure a wholesome atmosphere, and it can only be by making arrangements whereby there shall be a frequent interchange and movement of air without excessive loss of heat that any
Transcript of NEW INFECTIOUS HOSPITALS.
8. 789
against at any time, and in view of its frequent occurrenceit is no more than ordinary wisdom to dispense with allsuch wrapping as we have referred to. ITHE BELGIAN MEDICAL FEDERATION AND THE
NEW BILL ON DISPENSING.
A CIRCULAR has been issued by the Belgian MedicalFederation, addressed to the presidents of all the medicalcercles or branch associations, requesting them to call specialmeetings of their respective branches to discuss the newBill by which, as our readers are aware, it is proposed to abolishthe right of dispensing their own medicines, which is nowenjoyed by a considerable proportion of Belgian practi-tioners. It is hoped that through these branch associationspressure may be brought to bear on members of the Legislature,which will result in a serious modification of the proposedmeasure, to the general principle of which, however, theFederation, as is pointed out in the circular, assented toboth in 1868 and in 1880, when a regular modus vivendi wasagreed upon between it and the Pharmaceutical Association.This agreement, however, specially provided that everymedical man already enjoying the right to dispense shouldcontinue to do so as long as he should remain in the samelocality. It is on the question of these vested rights thatthe proposed Bill is considered so unsatisfactory, for by itthey will in no case be respected beyond the period offifteen years, and in many only for five years, while,in order to be recognised at all, they must have alreadyexisted for three years. In discussing the general questionof dispensing by medical men, Le Scapel, in answer tothe complaints of some pharmacists that medical men
having had no proper pharmaceutical training are utterlyincompetent to prepare or to estimate the value of drugs,and therefore should not in any case be allowed to exercisewhat is called the cumul, or combination of the two pro-fessions, points out that it is very misleading and erroneous totalk of the existence of any cumul at all ; that medical men,even though they may be allowed to dispense for their ownpatients, do not practise pharmacy proper. They do not, andmay not, keep an open shop, and they never prepare or com-pound medicines of an elaborate character, their work beingalmost entirely confined to putting up simple mixtures withpreparations which they are obliged to obtain from a
pharmacist, and for the quality of which he is responsible,for in Belgium a medical practitioner who dispenses maynot purchase his drugs from wholesale houses. There istherefore no great need for him to be acquainted with allthe complicated processes for the estimation of samples,and he may surely be trusted to put up mixtures of pre-parations the purity of which is already guaranteed.
NEW INFECTIOUS HOSPITALS.
A DISTINCT impetus has been given to the provision ofisolation hospitals by reason of the recent prevalence ofsmall-pox in various parts of England, and though all theinstances in which a determination has been arrived ateither to commence such provision or to improve and
enlarge the existing accommodation cannot properly beregarded as due to this cause, yet in the majority of the caseswhich we have from time to time recorded fear of small-poxhas been the main stimulus to action. Of this there is, ofcourse, no reason to complain, provided that the sanitaryauthorities do not let themselves be moved by panic into theconstruction of buildings which will not secure the imme-diate isolation of first attacks of all such infectious feversas are likely in future years to arise in their districts. Thatthe provision should be suitably adapted to this principalcontrolling need should, above all things, be borne in mind.Amongst the recent items of intelligence as to this are the
following :-The Nottingham Town Council have decided toerect a new permanent hospital for infectious diseases at acost of .E33,000; the Grimsby Town Council have decidedto erect a brick building to accommodate twenty additionalsmall-pox patients ; the Burton Town Council have, on theadvice of their Health Committee, passed a resolution to theeffect that it is desirable that a permanent infectious
hospital should be established; the Sutton-in-AshfieldLocal Board of Health has selected a site of somewhat over5000 square yards for the erection of a similar building;and the Paisley Abbey Parochial Board have resolved to
erect a hospital giving accommodation to 100 patients. Itis not clear, however, as regards the latter hospital, how farit will be reserved for any special diseases.
HEALTH OF THE EMPEROR OF GERMANY.
THE following telegram was received on Thursday morn-ing at THE LANCET office from Charlottenburg :-
" During the last week inflammation was noticed in theneighbourhood and below the opening into the trachea, butexternal to it. On Saturday evening slight shivering tookplace. On Sunday there was little bronchitis. Pneumoniawas anticipated, but did not supervene. It is consideredthat there is at present peritracheitis with pyasmia."In spite of the cessation of all official bulletins of the
Emperor of Germany’s health, it has been abundantlyevident that his fell disease has been creeping on apace, andthat the Imperial patient was being steadily worsted in thestruggle. It was not surprising, therefore, to learn a fewdays ago that the case had become critical and that the worstfears were entertained. It seems that fever has set in accom-
panied with bronchitis. It is well known that in cancer ofthe larynx, as of any other part in communication with thelungs, septic pneumonia is very likely to supervene, andrepeated careful examinations appear to have been made todiscover such an affection of the lungs. The latest accounts
speak of the absence of all signs of pneumonia and of thelessen-ing of the bronchitis. So that some other explanation of thefever, which still continues, has to be sought. It has been
suggested that an abscess has developed in the neighbour-hood of the trachea, and there seems to be only too muchreason to fear that this is so. Such abscesses often developin connexion with cancerous formations in internal parts,and very gravely exaggerate the danger of the primarydisease. Blood poisoning from such an abscess often ensues,and, as the above telegram shows, pyasmia has alreadydeveloped. Whatever the exact complication is, there is no.doubt ground for the gravest anxiety, and for fear that theclose of this painful case is not far off.
UNWHOLESOME AIR IN SCHOOLS.
JJUBJNQ tne past year i7r. tieorge Reia, medical omcer othealth for the rural district of Stafford, has carried out asystematic inspection of the elementary schools within hisjurisdiction; and in each case he has made a careful analysisof the school air, the samples being taken as far as possibleafter the children had been in school for some hours. Thevarious results, and the conditions tending to affect them, aretabulated in the report compiled, and in by far the majorityof instances the volume of carbonic acid present per 1000volumes of air was found to range between 2’039 and 3’708.This must be regarded as excessive, and an atmospheregiving such indications cannot be looked upon as a whole-some one for children to breathe habitually during manyhours of the day. The minimum requirement as to air spacein elementary schools certainly fails of itself to secure awholesome atmosphere, and it can only be by makingarrangements whereby there shall be a frequent interchangeand movement of air without excessive loss of heat that any
