american public health association
TRANSCRIPT
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Board of Health, said that in the last full year thenumber under treatment in the two hospitals was345, and that in the past 25 years more than 35,000cases had been admitted. Sir Harold J. Stiles moveda vote of thanks to the managers. Referring to theLiberton Hospital, he said that when he saw theoutside huts he realised how it was that some of thecases of tuberculous diseases of the spine which weresent into the hospital incurable had gone out cured.
Medico-Chirurgical Society of Edinburgh.The opening meeting of this Society took place on
Nov. 5th. The meeting opened. with the election ofnew office-bearers who, together with those already inoffice, are :-President : Sir David Wallace. Vice-Presidents : Dr. George Mackay, Dr. Robert Thin, Dr.William Guy. Councillors: Sir Robert Philip, Dr.Chalmers Watson, Dr. John Orr, Dr. J. A. H. Duncan,Dr. A. H. H. Sinclair, Dr. W. T. Ritchie, Dr. J. S. Fraser,Mr. J. M. Graham. Treasurer: Dr. W. Macrae Taylor.Secretaries : Mr. W. J. Stewart, Dr. John Eason. Editorof Transactions : Dr. Fergus Hewart. The followingnew members were elected : Dr. H. R. Dodson, Dr.J. Donald Gunn, Dr. James Irvine, Dr. AlexandraLothian, Prof. T. J. Mackie, Dr. W. N. Boog Watson,and Dr. A. R. Wightman. During the session eightordinary meetings are arranged, commencing at8 P.M. The dates of the remaining seven are : Dec. 3rd,Jan. 21st, Feb. 4th, March 4th, May 6th, June 3rd,July 1st. In addition there will be two clinicalmeetings in the Medical Out-patient Department ofthe Royal Infirmary on Nov. 19th and May 13that 5 P.M.
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IRELAND.
(FROM OUR OWN CORRESPONDENT.)
Prosecution for Soliciting a Bribe.AN important prosecution took place in the Central
Criminal Court, Dublin, last week, when two membersof the late Co. Roscommon Board of Health, recentlydissolved, were found guilty of soliciting fees or
rewards to induce them to vote for the election of aparticular candidate as medical officer of a dispensarydistrict in the county, as I wrote in my letter ofOct. 18th. Prosecuting in the first case, that ofJohn Corrigan, Mr. Carrigan, K.C., said that thecase was an important one, involving a charge ofattempted corruption to secure the vote of a memberof the Board. The prosecution was brought under thePublic Bodies Corrupt Practices Act. The offence wasa misdemeanour, and one consequence of convictionwould be to deprive the man convicted of the rightto vote for seven years. It was not necessary thatany money should pass. The offence was in corruptlysoliciting for himself or another a fee or reward tobring about such an election. Evidence was givenby friends of Dr. T. P. McDonnell that when theyasked Corrigan to vote for Dr. McDonnell he replied,that " none of the candidates was a brother of his, andhe would vote for the man who paid him most." Inthe other case, Dr. McDonnell swore that ThomasMoran had told him he could have his vote for £50,or that for £400 or £500 he could secure enough votesto make sure of the election. In both cases, after averdict of guilty, the prisoners were put back forsentence. For years past rumours have been currentthat elections by local authorities are influenced notmerely by undue family and political connexions, butare subject to bribery and corruption. This is thefirst occasion on which anyone has been prosecutedon such a charge. Immediately after the electionDr. McDonnell objected to it on the ground of briberyand demanded a sworn inquiry by the Ministry ofLocal Government and Public Health. The inquirywas promptly held, and enough evidence was forth- coming to justify the criminal prosecution, whichhas now been brought to a successful issue. Theactivity of the Ministry of Local Government in
investigating the charge and of the criminal authoritiesin ordering a prosecution is highly satisfactory. Suchaction will, it is hoped, teach a lesson to rogues inother parts of the country who may be prostitutingthe interests of the public and of the sick poor to theirown profit.
Physical Training in Schools.
On the invitation of the Co. Dublin Branch of theNational Athletic and Cycling Association of Ireland,a conference was held last week in the Royal College ofSurgeons to discuss the steps that should be taken tointroduce a system of physical training into theschools of Ireland. Mr. P. Lynch, K.C., presided,and the conference was attended by representativesof the Irish Medical Association and a number ofpersons interested in health and education. It wasstated that there was already a fair system of physicaltraining in the secondary schools, but none in theprimary schools. The importance of physical trainingto improve the health and physique of the race wasemphasised. It was pointed out, also, that the timewas opportune to press the matter, as a system ofmedical inspection of school-children was about to beput in force, and the two reforms should go together.After an informative discussion a small committeewas elected to study the systems in vogue in othercountries, and to press its views on the Ministry ofEducation.
AMERICAN PUBLIC HEALTH
ASSOCIATION.
FIFTY-THIRD ANNUAL MEETING.
(FROM OUR OWN CORRESPONDENT.)
MEMBERS of the American Public Health Association,drawn from all parts of the United States and fromCanada, met in Detroit for their Fifty-third AnnualConvention from Oct. 20th to 23rd. On the first day,when the addresses of welcome were delivered, over600 had registered their presence. The President ofthe Association, Dr. W. H. Park, is recovering froman attack of pleurisy and was not able to be present.His place was taken by Dr. J. W. S. McCullough, ofToronto. After welcoming addresses had been givenby the Mayor and Health Commissioner of Detroit,Dr. Thorvald Madsen, Chairman of the HealthSection of the League of Nations, described the workof that body. Many members of the large audiencewere not able to hear Dr. Madsen, who speaks withmore of an English than an American accent, and onthis account, coupled with the political distrust ofthe League which is still found amongst Americans,the very careful and wise analysis of the work of theHealth Section did not excite the interest which itdeserved. Dr. Victor C. Vaughan followed with alively impromptu address largely in praise of Michigan.He told the audience, among other historic achieve-ments of his fellow citizens, that a member of thehealth department had discovered in the ’eighties amethod of artificial respiration which had been widelytaught and practised as the Michigan method. When’Sir E. S. Schafer came to Detroit and described hisprone pressure method it was found that the two werepractically identical. Dr. Vaughan maintains thatwe should not be satisfied with raising the expectationof life while neglecting the quality of the lives weprolong. It does not profit us to increase the numberof youthful degenerates and senile dements. Dr.Vaughan proposes to devote the rest of his life to theimprovement of the human stock. These speecheswere followed by an informal reception and dancing.The main work of the conference was divided betweenthe various sections which sat more or less con-
temporaneously-an indication that even the field ofpublic health in this country is not kept free from thevice of specialisation.
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PUBLIC HEALTH ADMINISTRATION.In the Public Health Administration section the
Dick tests and immunity results in scarlet fever cameunder review. Among other subjects discussed, Dr.Adam H. Wright, of the Toronto Department ofHealth, considered the cause or causes of cancer. Hewas not hopeful that a specific cause of cancer wouldbe discovered nor that we should be greatly helpedby its discovery. The discovery of the tuberclebacillus had not helped greatly in the treatment ofconsumption.An impressive study was that reported by Dr.
Haven Emerson on
Hospital Morbidity Statistics.Five years’ experience with scarlet fever, diphtheria,and measles covering 16,435 hospital admissions hadbeen analysed to determine if possible a basis forjudging of the value of hospital care for these diseases,and to formulate principles of hospital practice whichwould contribute to (a) a lower mortality from theoriginal or primary infection ; (b) a reduction in theincidence of secondary infections ; (c) fewer complicat-ing lesions; (d) a shorter period of hospital care. Itappeared to be true that periods of crowding andshortage in nursing personnel were always accompaniedby higher case mortality-rates, together with higherincidence of secondary and complicating infections,this experience suggesting the propriety of establishingminimum floor space per patient and maximumpatient ratio per nurse expressed in hours ofnurse service per patient per day or week. Thedeath-rate among children under 2 was so high,especially in measles, that it was believed inadvisableto admit such patients to hospital care even when thehome conditions were unfavourable, if by visitingnurse service passable conditions could be provided.He said that the frequency with which deaths occurredwithin the first 48 hours after admission, especiallyfrom diphtheria and from pneumonia in measles,indicated the necessity of renewing the education ofphysicians in the early and adequate use of diphtheriaantitoxin in suspicious cases and of declining to permittransfers from other institutions in cases of measleswhere complicating pneumonia had already set in.
Dr. R. G. Leland, Chief, Division of Hygiene, OhioDepartment of Health, Columbus, Ohio, laid downcertain essentials in the
Administration of a Public Health Nursing Service.Public health nursing had, he said, come to occupya foremost position in combating preventable causes ofdisease and death. It had shown a marvellous growthboth in volume of work and breadth of application ;it should be almost entirely educational in character.He held that whatever the community problem andnumber and type of local groups interested in publichealth, the nursing service should be directed by theadministrator of the official health agency. Com-pensation for health nursing should be consistent withthe type and dignity of the service. The value of aservice that prevents sickness and prolongs life is toooften unfairly estimated.The question of generalised versus specialised
nursing was taken up again at a public health forum,and gave rise to a lively discussion. Dr. HavenEmerson and Miss Elizabeth Fox declared forgeneralisation under supervision of specialists, theformer laying down the standard of one nurse for every2000 population as a minimum.
SECTION OF LABORATORIES.In the Laboratory Section the influence of intensive
work on diphtheria carriers upon the diphtheriamorbidity was discussed by Dr. W. Royal Stokes,Dr. John F. Hogan, and Mr. C. Leroy Ewing, of theBureaux of Bacteriology and Communicable Diseasesof the Baltimore Health Department.
After reviewing the literature to show the relativeprevalence of diphtheria carriers and positive virulencetests in convalescents, non-contacts in the generalpopulation, and contacts with cases of diphtheria,
the speakers stated that practically all cultures fromconvalescents were virulent, whereas in a generalmixed population, excluding schools and other institu-tions, 0 -09 per cent. show virulent diphtheria cultures.The spaakers referred to their study of a largenumber of initial contacts in Baltimore where theyfound that about 1 in every 100 harboured virulentdiphtheria bacilli as against about 1 in 1000 in thegeneral community. The statistical evidence presentedwas not very conclusive. They then described themethods pursued in Baltimore and 17 other com-parable cities in detecting and isolating initial contactcarriers, and in finding additional release carrierswhen the house was reported for the release ofquarantine.
INDUSTRIAL HYGIENE.
The meetings of the Section of Industrial Hygienewere not well attended, and although those who werepresent showed a lively interest in the proceedingsthere was evident a sense of dissatisfaction with thepresent control of occupational disease.
Prof. H. Field Smyth spoke of anthrax as a
" continuing and probably increasing hazard " ofAmerican industry. Although satisfactory methodswere available for the disinfection of hair and woolthey were not being carried out properly in the smallerplants where the necessary expert supervision was notavailable. Speakers representing private organisationsor workers’ unions gave interesting accounts of theirwork. It was particularly gratifying to hear of a NewYork Union that had actually declared a strike toenforce the decisions of its sanitary board. But thisrepresented an unusual development of the healthconscience. On the whole, much remains to be donein the way of educating both employers and workers.As regards the former it must be realised that theappeal to self interest has a limit. There comes a pointat which the expense of improving sanitary conditions,wages, &c., is greater than the return from increasedefficiency. It would be unfortunate to set the limitsof industrial hygiene at this point.Most apparent, and in marked contrast with English
conditions, is the need for better Governmentalsupervision of occupational diseases. Prof. E.Hayhurst, of Ohio State University, laid this needvery eloquently before an open session of theconvention.
REPORTS.Some of the committee reports were inconclusive,
the reporters evidently fearing that they might makea painstaking survey without its leading to any directresults.The Committee on Nomenclature had a number
of useful definitions to suggest, among them thefollowing :-
Health in the absolute sense.-That quality of lifein which the body is sound, the various organs functionnaturally, and the whole organism responds adequatelyto its environment (the definition in a relative senseis similar). Hygiene is the science and art of theprotection and promotion of health.The Committee on Social Hygiene reports no proof
of the rumoured decrease in venereal disease. Theyfind the attitude of the public improved and recom-mend attempts to control procuration and to enforcequarantine of diseased individuals. The Committee onCancer suggests that health officers attempt to securethe reporting of cancer morbidity. Free pathologicalexaminations should be available. The periodichealth examination is waimly endorsed.
Dr. Henry Vaughan was elected President of theAssociation for the coming year, and it was decided tohold the 1925 convention at St. Louis.
DONATIONS AND BEQUESTS.—Miss Rosalie AnneLe Geyt, Jersey, left £1050 to the Royal Hospital forIncurables, Putney, and £1000 to the Royal United KingdomBeneficent Institution.-Miss Clara Walker, of Bideford,Devon, left £1000 to the Bideford and District Hospital.-Mr. Thomas Henry McCormick, of Lancaster, left £500 toAncoats Hospital, Manchester.