SMOKE ABATEMENT AT NOTTINGHAM

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1280 disease goes oftener undetected than in men. Per- nicious anaemia again is stated to be more common in males in America; in this country, according to official figures, the death-rate is more than 13 per cent. higher in women than in men. THE FOOD-POISONING INCIDENT AT WEMBLEY. SOME anxiety has been felt in regard to the recent outbreak of acute gastro-enteritis among visitors to the British Empire Exhibition at Wembley, and Major-General S. Guise-Moores, late R.A.M.C., director of medical services at the Exhibition, has been good enough to furnish us with the following notes. " Eighty-seven cases of intestinal disturbance accompanied by vomiting, diarrhoea, abdominal pain, and constitutional symptoms, varying in severity, were admitted to the main ambulance station between the hours of 1 and 8 P.M. on June 9th last. The first symptoms supervened from one to three hours after partaking the mid-day’ meal. The particular causative agent was the veal and ham pie, which was eaten by all the patients without exception. The clinical and symptomatic evidence points to a constitutional disorder due to the absorption of a toxin or toxins present in that food before it was consumed, and was not due to a bacterial infection of the food with subsequent multiplication in the intestine. The majority of the cases admitted to the main ambulance station were sent to their homes by car the same evening. Those that lived at too great a distance from the Exhibition, nine in number, were despatched by motor ambulance to the Willesden General Hospital that night, and discharged the next day. The ’ pies ’ were withdrawn from the restaurants in their entirety very soon after the first cases were seen at the ambulance station. Samples of the pies have been sent for bacteriological investigation and report. Separate investigations are being carried out by the Exhibition authorities, the Ministry of Health, and the caterers concerned. The Ministry of Health has interested itself in the matter and sent Dr. Hancock to interview the D.M.S. of the Exhibition." General Guise-Moores concludes : " It is considered that local conditions played no part in the causation of this outbreak, but that it possibly lies with factors which at present are difficult to control." SMOKE ABATEMENT AT NOTTINGHAM. THE experiment described in the -,Ilu)iicipal .7oKr/M I of June 6th, which is about to be made by the Nottingham Corporation in order to abolish smoke, should prove of great interest. It has been realised for some years that the partial coking of coal at a temperature below that used in ordinary gas-works was one of the means which might help towards the solution of the smoke problem, providing as it does a smokeless fuel suitable for domestic use as well as a rich gas and valuable by-products. The difficulty in the past has been to find a commercially practicable method, since the cost as well as the quality of the fuel produced is one of the governing factors. A market for by-products is also essential for the commercial success of such an undertaking. The industry of lace-making, which is special to Notting- ham, calls for a very clean air, and this doubtless had some influence in deciding the corporation. The conditions under which 1000 tons of coal per day can be treated at a colliery in the vicinity of the city which provides a market for the solid fuel, gas, and by-products produced should give the experiment every chance of success. We must join issue, however, with our contemporary when it is stated, with reference to smoke, that " municipal authorities are unable to accomplish any improvement worth speaking about." Measurements show that in London and Glasgow there has been a great and steady improvement in the direction of smoke reduction of recent years. There are, unfortunately, no measurements of smoke pollution available for Nottingham, which may, therefore, call itself a " clean city " without fear of contradiction. We would urge the corporation to obtain such measurements without delay for comparison with future conditions which will result from their experiment. Such figures would be of real value both to Nottingham and to the country generally as indicating the degree of success attained. NEW MENTAL HOSPITAL ACCOMMODATION. LACK of hospital accommodation for mental disease is acute and almost universal : so long has it prevailed, indeed, that the communal conscience is in danger of becoming hardened. Two bright spots are on the picture. One is the opening, just as we go to press, by the Minister of Health of the West Park Mental Hospital, the fifth institution to be provided by the London County Council on the Horton estate at Epsom. This hospital, when completed, will accommodate 2096 patients (1128 males and 968 females), and includes an admission block, villas for convalescent patients, special wards for the treatment of tuberculosis and dysentery. A chapel, infirmary, and acute wards for female patients will not be ready for occupation until the end of 1925. The other bright spot is the decision of the governing body of the St. Andrew’s Hospital for Mental Diseases at Northampton to erect a special hospital for the recep- tion and treatment of early cases of mental disorder. The foundation-stone is to be laid on June 27th, and judging by the plans contained in a circular accompanying an invitation to this ceremony, a very careful study has been made of arrangements elsewhere for the separation of the recently admitted from the chronic insane. Visits were paid by the subcommittee entrusted with this duty to several psychiatric clinics on the Continent, and to an English spa for the purpose of studying hydrotherapy, which is to be an important feature of the treatment employed in the new hospital. Accommodation will be provided for 16 patients of each sex. The equipment of this hospital will evidently be more varied and extensive than that of any other institution of its size in this country. Ten varieties of hydrotherapy are provided for, bacterio- logical and chemical laboratories, rooms for X-ray and electrical treatment, a dentists’ room, and various other facilities for special treatment. The authorities of the St. Andrew’s Hospital are to be congratulated on tackling with such vigour an urgent problem which is beset with difficulties. Not only will the expense of building this hospital be considerable, but the expense of maintaining it in full working order will probably be equivalent to a capital expenditure many times greater than the cost of building. A numerous staff will be required in order to administer its special departments with due efficiency, although in regard to laboratory investigations it will be open to the hospital to avail itself of the Joint Board of Research for Mental Disease when material can be sent to Holly- moor for investigation. A precis of the year’s research work there appears on p. 1286. We have no informa- tion at present as to the arrangements in view for staff- ing St. Andrew’s Hospital, or as to the proportion of the cost of upkeep which is to be borne by the patients. It is observed that the hospital " can, if necessary, be extended," and one may safely predict that such extension will be found desirable. The facilities for treatment are arranged on such a scale as to be capable of dealing with a much larger number of patients than can be accommodated in the hospital as planned at present. The success of this venture will be watched with keen interest by mental hospital authorities throughout the country. In the millennium of lunacy administration such a reception hospital will be considered a sine qua non by every large institution, and in the meantime it is probable that wherever extended accommodation is required the extension will take some such form as this.

Transcript of SMOKE ABATEMENT AT NOTTINGHAM

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disease goes oftener undetected than in men. Per-nicious anaemia again is stated to be more common inmales in America; in this country, according toofficial figures, the death-rate is more than 13 percent. higher in women than in men.

THE FOOD-POISONING INCIDENT AT WEMBLEY.

SOME anxiety has been felt in regard to the recentoutbreak of acute gastro-enteritis among visitorsto the British Empire Exhibition at Wembley, andMajor-General S. Guise-Moores, late R.A.M.C.,director of medical services at the Exhibition, hasbeen good enough to furnish us with the followingnotes.

" Eighty-seven cases of intestinal disturbanceaccompanied by vomiting, diarrhoea, abdominal pain,and constitutional symptoms, varying in severity,were admitted to the main ambulance station betweenthe hours of 1 and 8 P.M. on June 9th last. Thefirst symptoms supervened from one to three hoursafter partaking the mid-day’ meal. The particularcausative agent was the veal and ham pie, which waseaten by all the patients without exception. Theclinical and symptomatic evidence points to a

constitutional disorder due to the absorption of atoxin or toxins present in that food before it wasconsumed, and was not due to a bacterial infectionof the food with subsequent multiplication in theintestine. The majority of the cases admitted to themain ambulance station were sent to their homesby car the same evening. Those that lived at toogreat a distance from the Exhibition, nine in number,were despatched by motor ambulance to the WillesdenGeneral Hospital that night, and discharged the nextday. The ’ pies ’ were withdrawn from the restaurantsin their entirety very soon after the first cases wereseen at the ambulance station. Samples of the pieshave been sent for bacteriological investigation andreport. Separate investigations are being carriedout by the Exhibition authorities, the Ministry ofHealth, and the caterers concerned. The Ministryof Health has interested itself in the matter andsent Dr. Hancock to interview the D.M.S. of theExhibition."

General Guise-Moores concludes : " It is consideredthat local conditions played no part in the causationof this outbreak, but that it possibly lies with factorswhich at present are difficult to control."

SMOKE ABATEMENT AT NOTTINGHAM.

THE experiment described in the -,Ilu)iicipal .7oKr/M Iof June 6th, which is about to be made by theNottingham Corporation in order to abolish smoke,should prove of great interest. It has been realisedfor some years that the partial coking of coal ata temperature below that used in ordinary gas-workswas one of the means which might help towards thesolution of the smoke problem, providing as it doesa smokeless fuel suitable for domestic use as wellas a rich gas and valuable by-products. The difficultyin the past has been to find a commercially practicablemethod, since the cost as well as the quality of thefuel produced is one of the governing factors. Amarket for by-products is also essential for thecommercial success of such an undertaking. Theindustry of lace-making, which is special to Notting-ham, calls for a very clean air, and this doubtlesshad some influence in deciding the corporation. Theconditions under which 1000 tons of coal per daycan be treated at a colliery in the vicinity of thecity which provides a market for the solid fuel, gas,and by-products produced should give the experimentevery chance of success. We must join issue, however,with our contemporary when it is stated, with referenceto smoke, that " municipal authorities are unable toaccomplish any improvement worth speaking about."Measurements show that in London and Glasgowthere has been a great and steady improvement in

the direction of smoke reduction of recent years.There are, unfortunately, no measurements of smokepollution available for Nottingham, which may,therefore, call itself a

" clean city " without fear ofcontradiction. We would urge the corporationto obtain such measurements without delay for

comparison with future conditions which will resultfrom their experiment. Such figures would be of realvalue both to Nottingham and to the country generallyas indicating the degree of success attained.

NEW MENTAL HOSPITAL ACCOMMODATION.

LACK of hospital accommodation for mental diseaseis acute and almost universal : so long has it prevailed,indeed, that the communal conscience is in danger ofbecoming hardened. Two bright spots are on thepicture. One is the opening, just as we go to press,by the Minister of Health of the West Park MentalHospital, the fifth institution to be provided by theLondon County Council on the Horton estate atEpsom. This hospital, when completed, willaccommodate 2096 patients (1128 males and 968females), and includes an admission block, villas forconvalescent patients, special wards for the treatmentof tuberculosis and dysentery. A chapel, infirmary,and acute wards for female patients will not be readyfor occupation until the end of 1925. The otherbright spot is the decision of the governing bodyof the St. Andrew’s Hospital for Mental Diseases atNorthampton to erect a special hospital for the recep-tion and treatment of early cases of mental disorder.The foundation-stone is to be laid on June 27th,and judging by the plans contained in a circularaccompanying an invitation to this ceremony, a verycareful study has been made of arrangements elsewherefor the separation of the recently admitted from thechronic insane. Visits were paid by the subcommitteeentrusted with this duty to several psychiatric clinicson the Continent, and to an English spa for the purposeof studying hydrotherapy, which is to be an importantfeature of the treatment employed in the new hospital.Accommodation will be provided for 16 patients ofeach sex. The equipment of this hospital willevidently be more varied and extensive than that ofany other institution of its size in this country. Tenvarieties of hydrotherapy are provided for, bacterio-logical and chemical laboratories, rooms for X-rayand electrical treatment, a dentists’ room, and variousother facilities for special treatment. The authoritiesof the St. Andrew’s Hospital are to be congratulatedon tackling with such vigour an urgent problem whichis beset with difficulties. Not only will the expense ofbuilding this hospital be considerable, but the expenseof maintaining it in full working order will probablybe equivalent to a capital expenditure many timesgreater than the cost of building. A numerous staffwill be required in order to administer its specialdepartments with due efficiency, although in regard tolaboratory investigations it will be open to the hospitalto avail itself of the Joint Board of Research forMental Disease when material can be sent to Holly-moor for investigation. A precis of the year’s researchwork there appears on p. 1286. We have no informa-tion at present as to the arrangements in view for staff-ing St. Andrew’s Hospital, or as to the proportion of thecost of upkeep which is to be borne by the patients.It is observed that the hospital " can, if necessary,be extended," and one may safely predict that suchextension will be found desirable. The facilities fortreatment are arranged on such a scale as to be capableof dealing with a much larger number of patients thancan be accommodated in the hospital as planned atpresent. The success of this venture will be watchedwith keen interest by mental hospital authoritiesthroughout the country. In the millennium of lunacyadministration such a reception hospital will beconsidered a sine qua non by every large institution,and in the meantime it is probable that whereverextended accommodation is required the extensionwill take some such form as this.