QUALIFIED PRACTICE IN PHYSICAL TREATMENT
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1340 it passes through the lovely Hertfordshire scenery are eloquently set out, with ample literary references, and its tributaries receive similar notice. We con- gratulate Sir Alexander Houston on his successful blend of science and letters. QUALIFIED PRACTICE IN PHYSICAL TREATMENT. THE advantages to be derived from physical treatment are becoming better known not only to the medical profession but to their patients. To give only one example, the public are nowadays prepared to pay a reasonable price for massage after fractures and are likely to demand prescription of this treat- ment if it is not spontaneously suggested to them. Unfortunately, a large number of unqualified people, by specious advertisement and otherwise, are attracting to themselves much of this work, to the disadvantage of the patient and to the cause of physical treatment generally. The publication of the recent Register of Members of the Chartered Society of Massage and Medical Gymnastics 1 shows that there are now 6570 men and women who are qualified, by training and examination, to carry out physical treatment. It will be seen from the place index which forms part of the Register that there are few, if any, districts where none of its members is available. It is easy to distinguish between the qualified and unqualified, since under the Charter members of this Society alone are entitled to style themselves " Chartered Masseurs " and " Chartered Masseuses." Before registration each candidate for membership has to sign an undertaking not to treat any case except under the direction of a registered medical practitioner; not to advertise except in recognised medical and nursing papers ; not to sell goods to patients in a professional capacity, and not to accept secret commissions on the sale of goods. It is seldom that these undertakings are not faithfully respected, and it would seem only fair that members of an ancillary profession which is so loyal to medical practitioners, should receive corresponding support. There is good reason to believe that this is not always forthcoming, possibly because the activities of the Society are not sufficiently well known, though attention has frequently been drawn to them in these columns. One of the duties of this Society is to inspect all the schools in which candidates for the Society’s examinations are being trained. This inspection is carried out in the most searching manner, and every attempt is being made to bring those schools which lag behind up to a proper state of efficiency. The progress made since the Charter was granted in 1920 is remarkable, and if the Society receives the support which it deserves, the standard of physical treatment in this country should reach a high level. HYDROCYANIC ACID AS AN INSECTICIDE AND RATICIDE. Hydrocyanic acid is much used as a means of killing rats, bugs, and other vermin, more especially on ships. About its efficacy there can be little difference of opinion, but it is very poisonous, and elaborate precautions have to be taken to ensure the safety of human beings and domestic animals exposed to risk. It appears that in France this -deadly substance has been used for "disinfecting" houses, and as accidents have been reported the Paris police have now forbidden its employment in any form for disinfection or for the destruction of harmful animals in habitations. It certainly seems undesirable that this or any other poison gas should be used in any place which cannot, like a ship, be effectively isolated from surrounding dwellings-. Such isolation is impos- sible in any house which is not detached from other 1 Printed for the Society by the Campfield Press, St. Albans. Pp. 266. 4s. buildings and distant from public highways. Detached houses standing in their own grounds are not usually overrun with bugs. but cockroaches only too often abound in old country houses which have been fitted with central heating. Those who are tempted to use so efficacious a means of killing these vermin should remember the Paris edict. Information about the way the gas is used will be found in a pamphlet 1 recently issued by the Ministry of Health. The particulars it gives will enable any ordinarily intelli- gent person to generate, use, and dispose of the residues left after use of HCN, and it includes valuable information on gas masks and on first aid for persons overcome by the gas. As was announced last week, subscribers to the Dawson Williams Memorial Fund will meet at the Royal Society of Medicine, 1, Wimpole-street, London, W., on Tuesday, July 10th, at 5.30 P.M., to receive the statement of Sir StClair Thomson, the hon. treasurer, and to decide upon the form of the memorial. The organising committee recommend that the memorial should take the form of a " Prize to be awarded every two years, or at longer intervals, for the best work which has appeared on pediatrics since the previous award." The list of subscribers will remain open until July 10th, and contributors should send their cheques to Sir StClair Thomson before that date. At present the net amount to be invested will be somewhat over £800. The meeting will also be asked to make arrangements as to the trusteeship of the Fund. Modern Technique in Treatment. A Series of Special Articles, contributed by invitation, on the Treatment of Medical and Surgical Conditions. CCLXXXII. THE TREATMENT OF ONYCHIA. THE term " onychia " is usually defined as an inflammation of the matrix of the nail, but in practice it is used rather more loosely to include inflammations of the nail bed and also of the nail folds, though for the latter the term perionychia is often used. It is however often difficult, clinically, to separate inflammations of the nail matrix and bed, and hence the term onychia is often employed to cover inflammations of all these structures. Inflammations of the nail may result from physical or chemical injury, from local infection by bacteria or fungi, or may be a part of some general inflamma- tory eruption, such as syphilis, eczema, or psoriasis. With this last group we are not concerned in this article. Physical injuries to the nail may be traumatic- crushing, bruising, and the like ; due to heat or cold- burns and frostbite ; or to harmful radiations, as in X ray and radium dermatitis. Chemical injury to the nails is frequently seen in industrial workers ; it is almost invariably secondary to dermatitis of the fingers, but not infrequently this inflammation spreads over the nail folds and involves the matrix, usually producing a chronic type of onychia with mal-growth of the nail, so that this latter becomes rough, thickened, and furrowed. The treatment consists of removing the cause and dealing with the associated dermatitis with soothing and protective applications, the nails requiring no special treatment. It is, however, to the infective types of onychia that our attention is specially directed ; of these there are two groups: pyogenic onychia and mycotic onychia. Pyogenic Onychia. Pyogenic onychia is a common affection, and may be due to infection either with streptococci or 1 Memorandum on the Fumigation of Ships with Hydrogen Cyanide. H.M. Stationery Office. 1928. 1d.
Transcript of QUALIFIED PRACTICE IN PHYSICAL TREATMENT
1340
it passes through the lovely Hertfordshire sceneryare eloquently set out, with ample literary references,and its tributaries receive similar notice. We con-gratulate Sir Alexander Houston on his successfulblend of science and letters.
QUALIFIED PRACTICE IN PHYSICAL
TREATMENT.
THE advantages to be derived from physicaltreatment are becoming better known not only to themedical profession but to their patients. To giveonly one example, the public are nowadays preparedto pay a reasonable price for massage after fracturesand are likely to demand prescription of this treat-ment if it is not spontaneously suggested to them.Unfortunately, a large number of unqualified people,by specious advertisement and otherwise, are
attracting to themselves much of this work, to thedisadvantage of the patient and to the cause ofphysical treatment generally. The publication ofthe recent Register of Members of the CharteredSociety of Massage and Medical Gymnastics 1 showsthat there are now 6570 men and women who arequalified, by training and examination, to carry outphysical treatment. It will be seen from the placeindex which forms part of the Register that thereare few, if any, districts where none of its membersis available. It is easy to distinguish between thequalified and unqualified, since under the Chartermembers of this Society alone are entitled to stylethemselves " Chartered Masseurs " and " CharteredMasseuses." Before registration each candidate formembership has to sign an undertaking not to treatany case except under the direction of a registeredmedical practitioner; not to advertise except in
recognised medical and nursing papers ; not to sellgoods to patients in a professional capacity, and notto accept secret commissions on the sale of goods. Itis seldom that these undertakings are not faithfullyrespected, and it would seem only fair that membersof an ancillary profession which is so loyal tomedical practitioners, should receive correspondingsupport. There is good reason to believe that thisis not always forthcoming, possibly because theactivities of the Society are not sufficiently wellknown, though attention has frequently been drawnto them in these columns.One of the duties of this Society is to inspect all
the schools in which candidates for the Society’sexaminations are being trained. This inspection iscarried out in the most searching manner, and everyattempt is being made to bring those schools whichlag behind up to a proper state of efficiency. Theprogress made since the Charter was granted in 1920is remarkable, and if the Society receives the supportwhich it deserves, the standard of physical treatmentin this country should reach a high level.
HYDROCYANIC ACID AS AN INSECTICIDEAND RATICIDE.
Hydrocyanic acid is much used as a means ofkilling rats, bugs, and other vermin, more especiallyon ships. About its efficacy there can be littledifference of opinion, but it is very poisonous, andelaborate precautions have to be taken to ensure thesafety of human beings and domestic animals exposedto risk. It appears that in France this -deadlysubstance has been used for "disinfecting" houses,and as accidents have been reported the Paris policehave now forbidden its employment in any form fordisinfection or for the destruction of harmful animalsin habitations. It certainly seems undesirable thatthis or any other poison gas should be used in anyplace which cannot, like a ship, be effectively isolatedfrom surrounding dwellings-. Such isolation is impos-sible in any house which is not detached from other
1 Printed for the Society by the Campfield Press, St. Albans.Pp. 266. 4s.
buildings and distant from public highways. Detachedhouses standing in their own grounds are not usuallyoverrun with bugs. but cockroaches only too oftenabound in old country houses which have been fittedwith central heating. Those who are tempted to useso efficacious a means of killing these vermin shouldremember the Paris edict. Information about theway the gas is used will be found in a pamphlet 1recently issued by the Ministry of Health. Theparticulars it gives will enable any ordinarily intelli-gent person to generate, use, and dispose of theresidues left after use of HCN, and it includes valuableinformation on gas masks and on first aid for personsovercome by the gas. ____
As was announced last week, subscribers to theDawson Williams Memorial Fund will meet at theRoyal Society of Medicine, 1, Wimpole-street, London,W., on Tuesday, July 10th, at 5.30 P.M., to receive thestatement of Sir StClair Thomson, the hon. treasurer,and to decide upon the form of the memorial. Theorganising committee recommend that the memorialshould take the form of a " Prize to be awarded everytwo years, or at longer intervals, for the best workwhich has appeared on pediatrics since the previousaward." The list of subscribers will remain open untilJuly 10th, and contributors should send their chequesto Sir StClair Thomson before that date. At presentthe net amount to be invested will be somewhatover £800. The meeting will also be asked to makearrangements as to the trusteeship of the Fund.
Modern Technique in Treatment.A Series of Special Articles, contributed by invitation,on the Treatment of Medical and Surgical Conditions.
CCLXXXII.
THE TREATMENT OF ONYCHIA.
THE term " onychia " is usually defined as an
inflammation of the matrix of the nail, but inpractice it is used rather more loosely to includeinflammations of the nail bed and also of the nailfolds, though for the latter the term perionychia isoften used. It is however often difficult, clinically,to separate inflammations of the nail matrix andbed, and hence the term onychia is often employedto cover inflammations of all these structures.
Inflammations of the nail may result from physicalor chemical injury, from local infection by bacteriaor fungi, or may be a part of some general inflamma-tory eruption, such as syphilis, eczema, or psoriasis.With this last group we are not concerned in thisarticle.
Physical injuries to the nail may be traumatic-crushing, bruising, and the like ; due to heat or cold-burns and frostbite ; or to harmful radiations, as inX ray and radium dermatitis.
Chemical injury to the nails is frequently seen inindustrial workers ; it is almost invariably secondaryto dermatitis of the fingers, but not infrequentlythis inflammation spreads over the nail folds andinvolves the matrix, usually producing a chronic typeof onychia with mal-growth of the nail, so that thislatter becomes rough, thickened, and furrowed.The treatment consists of removing the cause anddealing with the associated dermatitis with soothingand protective applications, the nails requiring nospecial treatment.
It is, however, to the infective types of onychiathat our attention is specially directed ; of these thereare two groups: pyogenic onychia and mycoticonychia.
Pyogenic Onychia.Pyogenic onychia is a common affection, and may
be due to infection either with streptococci or
1 Memorandum on the Fumigation of Ships with HydrogenCyanide. H.M. Stationery Office. 1928. 1d.
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