THE NATIONAL INSURANCE ACT.
2
1005 about in the medium. When, however, one of these amœbæ is placed in pure water, plus food and plus an auxetic such as tyrosin or creatin in solution, it immediately undergoes cell division of the normal type and will continue to reproduce itself through many generations. The old impression seems to be disproved, therefore, as far as these classes of I cells are concerned. I may add that auxetics or substances which increase their action (augmentors) have been detected in all the industrial commodities which cause cell proliferation or predispose to cancer- namely, soot, tar, tar oils, pitch, certain petroleum fractions, grease, vaseline, aniline dyes, tobacco and its smoke, certain arsenic compounds, manure, briquettes, &c. One must therefore agree with Mr. Mansell Moullin’s most important suggestion that the chemistry of the environment of the cells in the tissues ought to be taken into consideration when investigating the biology of tumours. T a,m. Sir. vonrs faithfully. The John Howard McFadden Research Fund, London, S.W., March 27th, 1914. H. C. ROSS. RIDING ASTRIDE FOR WOMEN. To the Editor ot THE LANCET. ’’ SIR,-Your annotation on the above subject is of interest to me, who as an old horseman of many years’ experience have watched the development of the cross seat for ladies. I have never heard of local evils clearly trace- able to this seat. The main objections are insecurity, which you mention but do not account for. I think not only the lack of the "crutches" but also the conformation of women tends to this ; their thighs, as a rule, being round and fat, cannot grip the saddle like the long flat ones of the average man. The same formation in a man often gives the " washball seat," the opposite of a firm one. The high knee rills used by some ladies only partly remove the insecurity in leaping. " Dragging" is rare, but may happen in a cross saddle to lady or man if the stirrups are too large or too small, the safety bar is stiff, and in certain falls. In side saddle the modern apron habit and detachable stirrup make this risk negligible. Many hunting ladies have reverted to side saddle because of its infinitely greater safety. You do not mention, but may agree in, the very common opinion that a good lady rider looks 80 per cent. better in side saddle than cross, and cross- saddle is really only suitable for young girls and spare females of an age to despise appearances. The only objection to side saddle is for the horse, as while the extra weight is largely compensated by the said weight being further back and less on the forelegs, yet the other trouble of sore backs from careless grooms and bad riders is always clamant and requiring attention and prevention. I am, Sir, yours faithfully, W. STEVENSON, M.R.C.P.Edin., F.R.C.S.Edin. Crieff, N.B., March 26th, 1914. THE LOCAL INCIDENCE OF ENLARGED TONSILS AND ADENOIDS. To the Editor of THE LANCET. SIR,-In your review in THE LANCET of March 28th on my paper on the above subject, published in the annual report of the school medical officer for East Sussex, writing as to the high percentage of cases among children in rural districts, you state that " the probability would seem to be that dirty and carious teeth are commoner in the relatively backward country districts and that enlarged adenoids and tonsils depend frequently upon chronic infection from the mouth." The percentages found for different districts in the county varied from as high as 9 for some rural districts to 2’2 for Portslade, a poor working- class suburb of Hove, the fall in the percentage rate approximately coinciding with the increasingly urban quality of the district. With regard to the explanation offered in your review, I would point out that no more care is bestowed on children’s teeth, either in the matter of dental treatment or in the use of the toothbrush, in the urban than in the rural districts, and also that those who have inspected country children are constantly being struck by the fact that children in " backward " country districts who show signs of neglect and poor nutrition are possessed of remark- ably good teeth. The above-mentioned incidence rates are certainly remarkable, and some of your readers might offer explanations. A possible factor may be the differ- ence in the type of population found in urban and rural districts.-I am, Sir, yours faithfully, Ipswich, March 28th, 1914. GEORGE FINCH. THE ADMINISTRATIVE CONTROL OF SMALL-POX. To the Editor of THE LANCET. SIR,-Referring to the review of my book on this subject in THE LANCET of March 21st, may I be allowed to correct something which I did not say, but which your reviewer implies that I did? He speaks of "the proper authorities" as being the Local Government Board and the county council, thereby limiting, by inference, the applica- tion of my book to this country. That is not the case. No special country is mentioned or intended. The principles indicated are of world-wide application. I am, Sir, yours faithfully, March 26th, 1914. W. MCC. WANKLYN. THE NATIONAL INSURANCE ACT. MEDICAL CERTIFICATES AND SICKNESS BENEFITS. Mr. Runciman, in replying to a deputation from Approved Societies at Dewsbury on the subject of allowing sickness benefit for the first three days of sickness, said that already expenditure under the Act had exceeded what had been estimated by millions. He went on to say that the loose giving of medical certificates had penalised societies and the national scheme, and that the sooner it was put an end to the better, whether by an extended system of medical referees or by the setting up of a State Medical Service. He intimated that exist- ing conditions could not be allowed to continue, and that the Government was watching the matter with grave anxiety. Mr. Runciman is probably aware that the medical profession is also alive to the march of events, and will have to be consulted as to future schemes. ____ LOCAL MEDICAL COMMITTEE FOR LONDON. The Election Committee of the Metropolitan Counties Branch of the British Medical Association, which undertook the arrangements for the election of a Medical Committee for the County of London,
Transcript of THE NATIONAL INSURANCE ACT.
1005
about in the medium. When, however, one of theseamœbæ is placed in pure water, plus food and plusan auxetic such as tyrosin or creatin in solution,it immediately undergoes cell division of the normaltype and will continue to reproduce itself throughmany generations. The old impression seems tobe disproved, therefore, as far as these classes of Icells are concerned.
I may add that auxetics or substances whichincrease their action (augmentors) have beendetected in all the industrial commodities whichcause cell proliferation or predispose to cancer-namely, soot, tar, tar oils, pitch, certain petroleumfractions, grease, vaseline, aniline dyes, tobacco andits smoke, certain arsenic compounds, manure,
briquettes, &c. One must therefore agree with Mr.Mansell Moullin’s most important suggestion thatthe chemistry of the environment of the cells inthe tissues ought to be taken into considerationwhen investigating the biology of tumours.
T a,m. Sir. vonrs faithfully.
The John Howard McFadden Research Fund,London, S.W., March 27th, 1914.
H. C. ROSS.
RIDING ASTRIDE FOR WOMEN.To the Editor ot THE LANCET. ’’
SIR,-Your annotation on the above subjectis of interest to me, who as an old horsemanof many years’ experience have watched the
development of the cross seat for ladies. Ihave never heard of local evils clearly trace-able to this seat. The main objections are
insecurity, which you mention but do notaccount for. I think not only the lack of the"crutches" but also the conformation of womentends to this ; their thighs, as a rule, being roundand fat, cannot grip the saddle like the long flatones of the average man. The same formation in aman often gives the " washball seat," the oppositeof a firm one. The high knee rills used by someladies only partly remove the insecurity in leaping."
Dragging" is rare, but may happen in a cross
saddle to lady or man if the stirrups are too large ortoo small, the safety bar is stiff, and in certain falls.In side saddle the modern apron habit anddetachable stirrup make this risk negligible. Manyhunting ladies have reverted to side saddle becauseof its infinitely greater safety.You do not mention, but may agree in, the very
common opinion that a good lady rider looks 80 percent. better in side saddle than cross, and cross-saddle is really only suitable for young girls andspare females of an age to despise appearances.The only objection to side saddle is for the horse,as while the extra weight is largely compensated bythe said weight being further back and less on theforelegs, yet the other trouble of sore backs fromcareless grooms and bad riders is always clamantand requiring attention and prevention.
I am, Sir, yours faithfully,W. STEVENSON, M.R.C.P.Edin., F.R.C.S.Edin.
Crieff, N.B., March 26th, 1914.
THE LOCAL INCIDENCE OF ENLARGEDTONSILS AND ADENOIDS.
To the Editor of THE LANCET.
SIR,-In your review in THE LANCET of March 28thon my paper on the above subject, published inthe annual report of the school medical officerfor East Sussex, writing as to the high percentageof cases among children in rural districts, youstate that " the probability would seem to be that
dirty and carious teeth are commoner in the
relatively backward country districts and that
enlarged adenoids and tonsils depend frequentlyupon chronic infection from the mouth."The percentages found for different districts in
the county varied from as high as 9 for some
rural districts to 2’2 for Portslade, a poor working-class suburb of Hove, the fall in the percentagerate approximately coinciding with the increasinglyurban quality of the district.With regard to the explanation offered in your
review, I would point out that no more care isbestowed on children’s teeth, either in the matterof dental treatment or in the use of the toothbrush,in the urban than in the rural districts, and alsothat those who have inspected country children areconstantly being struck by the fact that childrenin
" backward " country districts who show signs of
neglect and poor nutrition are possessed of remark-ably good teeth.The above-mentioned incidence rates are certainly
remarkable, and some of your readers might offerexplanations. A possible factor may be the differ-ence in the type of population found in urban andrural districts.-I am, Sir, yours faithfully,Ipswich, March 28th, 1914. GEORGE FINCH.
THE ADMINISTRATIVE CONTROL OFSMALL-POX.
To the Editor of THE LANCET.
SIR,-Referring to the review of my book onthis subject in THE LANCET of March 21st, mayI be allowed to correct something which I did notsay, but which your reviewer implies that I did?He speaks of "the proper authorities" as being
the Local Government Board and the countycouncil, thereby limiting, by inference, the applica-tion of my book to this country. That is not the case.No special country is mentioned or intended. The
principles indicated are of world-wide application.I am, Sir, yours faithfully,
March 26th, 1914. W. MCC. WANKLYN.
THE NATIONAL INSURANCE ACT.
MEDICAL CERTIFICATES AND SICKNESS BENEFITS.
Mr. Runciman, in replying to a deputation fromApproved Societies at Dewsbury on the subject ofallowing sickness benefit for the first three days ofsickness, said that already expenditure under theAct had exceeded what had been estimated bymillions. He went on to say that the loose givingof medical certificates had penalised societies andthe national scheme, and that the sooner it was putan end to the better, whether by an extended
system of medical referees or by the setting up ofa State Medical Service. He intimated that exist-
ing conditions could not be allowed to continue,and that the Government was watching the matterwith grave anxiety. Mr. Runciman is probablyaware that the medical profession is also alive tothe march of events, and will have to be consultedas to future schemes.
____
LOCAL MEDICAL COMMITTEE FOR LONDON.
The Election Committee of the MetropolitanCounties Branch of the British Medical Association,which undertook the arrangements for the electionof a Medical Committee for the County of London,
1006
has declared the subjoined list of names to con- Istitute the committee :- I
Marylebone-C. W. Wirgman.Woolwich, Greenwich, Deptford, Lewisham-No repre-
sentative.Bermondsey, Southwark, Lambeth, Camberwell-No
representative.Wandsworth, Battersea, Fulham, Chelsea-No repre-
seutative.Hammersmith, Kensington, Paddington, Westminster-
W. H. Burnhill and Wilfrid Kingdon.St. Pancras, Islington, Stoke Newington, Hampstead-
No representative.Shoreditch, City of London, Holborn, Finsbury-J. H.
Porter and W. F. Roe.Hackney, Bethnal Green, Stepney, Poplar-A. G. South-
combe, Gilbert Nicholson, and M. C. Corner.Hospital stcc,’representccti2es.-W. McAdam Eccles, T. W.
Eden, James Galloway, V. Warren Low, Fred J. Smith,and G. R. Turner.
Poor-law medical offleers.-H. E. Garrett.Medical officers of health.-No representative.Regastered medical women.-Mina Dobbie.
A meeting of the committee will be held atCaxton Hall, Westminster, on Tuesday next, April 7th,at 3.30 P.M., when it is hoped that as many membersas possible will be present. The business includesthe appointment of a chairman and a secretary.
COMPLAINTS AGAINST LONDON PANEL PRACTITIONERS.
In dealing with a number of complaints byinsured persons against practitioners on the panelthe London Insurance Committee on March 26th.expressed certain views as to the scope of treatmentwhich should be covered by the agreements andother matters concerning the relations of doctorswith persons on their lists, which it may be con-venient briefly to summarise. It was held by thecommittee that the operation of cutting quinsiesand the syringing of ears properly formed part ofmedical benefit ; that a practitioner was " guiltyof a grave indiscretion who examined for men-strual conditions a woman patient not accom-
panied by a friend; that (in regard to the
employment of an assistant) a practitioner wasrequired by the terms of his agreement to provideall treatment for insured persons personally exceptwhen prevented by absence from home or otherreasonable cause. In one case, described as an
unusual one, a practitioner admitted having exer-cised hypnotism upon a patient for the purpose ofinducing sleep; the friends said this was donewithout their being consulted. In respect of apractitioner who resided at a considerable distancefrom the surgery at which he purported to givetreatment and who made no arrangements for the
attendance of his patients when he was ill, thecommittee decided, unless the practitioner haddisposed of his practice by June 30th, to makerepresentations as to the desirability of his removalfrom the panel.
Medical News.EXAMINING BOARD IN ENGLAND BY THE ROYAL
COLLEGES OF PHYSICIANS OF LONDON AND SURGEONS OF
ENGLAND.-At the First Professional Examination of the
Conjoint Board, held on March 24th, 25th, 26th, 27th,and 28th, the following candidates were approved in theunder-mentioned subjects :-
Che,n?.isti-y and Physics.-George Kilpatrick Arthur, St. Bartholo-mew’s Hospital ; Percy George Calvert-Jones, University College,Cardiff ; John Humphrey Thornton Challis and Joseph ClintonCollins, London Hospital; Arthur John Charles Eland, St. Bar-tholomew’s Hospital; Ahclallah Abd El Rahman Galal and GeorgeHenry Johnson, Middlesex Hospital; Abd El Aziz Abul Khair,King’s College; Frank Lawrence, South-Western Polytechnic;John Eric Lewis, University College, Cardiff; John Stuart Lewis,St. Mary’s Hospital ; John Crawford William MacBryan, St. Bar-tholomew’s Hospital ; Guy Meadows, Guy’s Hospital; WilliamGriffith Owen, London Hospital; Christopher Stanley Parker,Charing Cross Hospital and King’s College ; Robert James Saunders,London Hospital ; Walter Manley Savery. Middlesex Hospital;George Augustus Shelmerdine Shacklock and Cecil George DouglasSiggs. Guy’s Hospital; Clement Price Thomas, University College,Cardiff ; and John Henry Tighe, Birmingham University.
CAenM’.<<?’t/.—Yenny Abdel-liassiah, King’s College; Arnold EdgarCollie, M.A. Cantab., Middlesex Hospital ; Louis Dinerstein,London Hospital ; Rupert Vaughan Hudson, Middlesex Hospital;Reginald Edward Jenkins, London Hospital; David JosephHeritage Jones, St. 3lary’s Hospital; Christopher Hugh Macklin,Middlesex Hospital; Alfred Yaphet Massouda. King’s College;Gordon Millar, St. ]3artholomew’s Hospital; Arthur Arnold Osman,Guy’s Hospital; Osbert Lacon Carden Sibley, Middlesex Hospital;Ernest Arthur Leland Sturridge, University College ; FrankAlexander Leslie Sturridge, Middlesex Hospital; Ian MurrayThomson, Guy’s Hospital; and Bertie Moorwood Tonkin, Guy’sHospital.
Physics.-Margarita Sargood Barfield, London School of Medicine forWomen; Thomas Henry Ronald Davies, University College,Cardiff ; Robert Erskine-Gray, Hartley College, Southampton;Malik Girgis, B.A., King’s College; John Stephen Harvey James,Guy’s Hospital; William Anthony Jolliffe, St. Bartholomew’sHospital; John Nesbitt Martin, Guy’s Hospital; Ralph KennethMarwood. University College; George Bertram Monk, D.D.S.Michigan. Michigan and Guy’s Hospital; Edward Hugh FrederickMorris, Guy’s Hospital; Frank Young Pearson. University College,Cardiff ; Charles Farrell Rainer, Charles Cecil Rowland, and JamesAthelstane Stedman, London Hospital; and Frederic FrancisWheeler, St. Mary’s Hospital.
Biology.-Hussein Amin, Cairo and St. Bartholomew’s Hospital;Hector Demetrius Apergis, Guy’s Hospital; George KilpatrickArthur, St. Bartholomew’s Hospital; Ralph William CodringtonBall, University College; Louis Walter Barber, Charing CrossHospital and King’s College ; Margarita Sargood Barfield, LondonSchool of Medicine for Women ; Eric John Swithin Bonnett,St. Thomas’s Hospital; Martin Vincent Boucaud. St. Bartholomew’sHospital; Osmond Hayman Brown, Charing Cross Hospital andKing’s College; Finlay Cameron, M.P.S., King’s College; AndreAlfred Casahs, John Humphrey Thornton Challis, and JosephClinton Collins, London Hospital; Alfred Innes Cox, MiddlesexHospital; Thomas Henry Ronald Davies, University College,Cardiff; Arthur John Charles Eland, St. Bartholomew’s Hospital;Mohamed Abdel Kader El Hennawy, St. Marv’s Hospital; MohamedZaky Aly Emery, Cairo and University College; Frederick KnowlesEscritt, Guy’s Hospital; Herbert Reginald Evans, MiddlesexHospital: Tyrrell George Evans, St. Bartholomew’s Hospital;Donald Charles Farquharson, St. Mary’s Hospital; WyndhamBrookes Farrington, Guy’s Hospital; Francis Malcolm TimothyFlintan and Abdallah Abd El Rahman Galal, Middlesex Hospital;Blanche Sutton Gardner, London School- of Medicine forWomen ; Richard Hilliard, London Hospital; Robert JohnHodgkinson, Guy’s Hospital; Anthony Bancroft Isaacs, St.Thomas’s Hospital; Evelyn Hope Johnson, Manchester Univer-sity ; George Henry Johnson, Middlesex Hospital; WilliamAnthony Jolliffe, St. Bartholomew’s Hospital ; David JosephHeritage Jones, St. Mary’s Hospital; Jeffrey Woodward Jones,B.Sc.Vict., University College, Cardiff; Albert Victor Lopes,St. Bartholomew’s Hospital ; George Bertram Monk, D.D.S.Michigan, Michigan University and Guy’s Hospital; Edward HughFrederick Morris, Guy’s Hospital; Clement Nicory, St. Thomas’sHospital; Hussein Nosrat, University College; Edmund JacobszPapenfus, St. Thomas’s Hospital; Christopher Stanley Parker,Charing Cross Hospital and King’s College ; Eugene ArthurPearsou, London Hospital; Frank Young Pearson, UniversityCollege, Cardiff; Charles Burton Phillips, Durham University;Charles Farrell Rainer and Robert Douglas Finch Robertson,London Hospital; Enoch Sanders, Liverpool University; GeorgeAugustus Shelmerdine Shacklock, Guy’s Hospital; Kenneth EdenShellshear, St. Bartholomew’s Hospital: Stuart Walter Southwood,Birkbeck College; George Ernest Spero and Samuel Leon Szpigner,London Hospital; Clement Price Thomas, University College,’ Cardiff; Graham McKim Thomas, Guy’s Hospital; John HenryTighe, Birmingham University ; Herbert Edward Williams,London Hospital; ltoger Gilbert Wilshere, Guy’s Hospital; VyvianDeane Wyborn, Charing Cross Hospital and King’s College; and
i Claude Young, Middlesex Hospital.
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