royal college of surgeons of england

2
in commenting upon this interesting occasion and cere- mony we may join in the congratulations which de- servedly fell to the corporation upon the success that is attending the progressive policy of its various committees. We do so more particularly because this progress seems to us to prove that the qualifications of a watering place are not necessarily dependent upon a continental name or reputation. Our country, as a matter of fact, is just as favourably endowed with a variety of natural medicinal waters as are most countries abroad, but even where the qualities of the waters at home are not only equal, but superior, to those abroad of an analogous description, little, if any, attention has been given to making treatment a serious systematic matter. There has not been the regime insisted upon as is the case on the continent, where not only is a regular course of baths or of drinking required, but where at the same time a control over general and dietetic habits is demanded. Such strict routine is only ensured by medical supervision, and requires relief in the shape of social amusements and an environment of healthy air and attractive scenery. For- tunately, the English watering places are-invariably situated in beautiful country, and for the most part they are swept by a pure and invigorating air. Their armamen- tarium, in short, is good from the point of view of Nature’s aids, but it is desirable that the benefits of these aids should be secured by methods of scientific administration and the routine made tolerable by social attractions and recreation. Watering-places have gained their growth and reputation, of course, from the fact of possessing a source of natural water endowed with thermal or chemical properties. Nowa- days, however, it is considered that no spa is com- plete without the many supplementary methods of treat- ment which are not hydropathic at all, yet which are known to be of the greatest value. Hence, in addition to the variations in the methods of applying the natural water, as in mud baths, sprays, irrigations, internal administration, and so forth, relief is often obtained by the use of electrical, thermal, and mechanical appliances, as adjuncts to treat- ment. The recent extension of such departments at Harrogate is particularly noteworthy. The appliances, for example, for electrotherapeutics at Harrogate are very complete, though the authorities have kept to those well-estab- lished methods of application which are most useful in conjunction with the treatments peculiar to the waters, and have not installed a lot of unnecessary apparatus. The hydro-electric bath is very complete, and every possible precaution is taken to make accident impossible. It has an independent electrical supply, which is quite detached from the town main, but to make doubly sure the baths are insulated so thoroughly as to give a resistance to earth practically amounting to infinity. Every form of current is readily available and under perfect control. Static electricity is supplied by a high-speed ebonite plate ’’, machine which appears to give satisfactory results. High- frequency electricity is obtained from about half a dozen sets of apparatus in various parts of the establishment. It is used through vacuum electrodes for a variety of con- ditions, for the production of ozone, and for what is called bipolar massage-a form of treatment that has given good results at Harrogate. The newer form of this current, known as diathermy, has been recently provided for and is gaining favourable opinions. By no other method can the tempera- ture of the subcutaneous tissues be raised appreciably above the normal, and while this is not its only feature, this alone was almost certain to give it a high value in therapeutics. Another recent addition to the electro- therapeutic installation is the apparatus for the treat- ment of obesity as suggested by Bergonie. The current used is of the faradic variety, and by means of several electrodes distributed over the body according to a definite scheme the principal muscles are made to go through a series of rhythmic contractions against a load that is adjustable by the use of sandbags. The result is exercise without fatigue-there is a loss of weight from the beginning as well as an improvement in the general health. In addition to the above, there are a number of light cabinets of various kinds, coils for the production of dry heat, and other valuable appliances in which electricity plays a subsidiary part. Equally complete are the installations, including the treatment, the sulphur and needle the - bieres bath and douche, Vichy massage douche, the liver pack, the oxygen bath, the Schwalbach bath, the brine bath, inhalation systems, throat sprays, nasal douche, radiant heat and light treatment, cataphoresis, massage, and, in fact, all the accessories which are now recognised as forming part of the scientific equipment of an establishment claiming to be progressive in all branches of balneo-therapeutics. With the recent additions of a new pump room and the extension of the Victoria baths Harrogate has, in fact, set its houses of treatment in order, and when we couple this with the fact that side by side with these up-to-date methods of treatment abundant provision has been made for social amuse- ments and recreation, the reproach that "they always do- these things better at spas abroad" can no longer be advanced. By their commendable spirit and enterprise the authorities at Harrogate should help to remove the prejudice which has for too long existed in the minds of the British public as to the inadequacies and deficiencies of home health resorts. And what Harrogate has done other watering-places in the country might do. METROPOLITAN HOSPITAL SUNDAY FUND. THE following are among the amounts received at the’ Mansion House up to June 6th. Total to date about £33,000. £ s. d. St. Paul’s, Onslow-square ............ 203 0 0 St. Simon Zelotes, Upper Chelsea............... 156 0 0 Holy Trinity, Tulse Hill .................. 143 0 0 Aldenham Parish Church .................. 129 0 0 Emmanuel, Wimbledon .................. 100 0 0 Greek Church, Bayswater .................. 88 0 0 St. Thomas’s, Portman-square ............... 85 0 0 St. Stephen’s, South Kensington ............... 80 0 0 St. Philip’s, Kensington .................. 73 0 0 St. Nicholas’s, Chislehurst .................. 72 0 0 Immanuel, Streatham .................. 70 0 0 Christ Church, Lee Park .................. 53 0 0 St. Matthew’s, Bayswater .................. 52 0 0 Holy Trinity, St. Marylebone ............... 52 0 0 St. Saviour’s, Paddington .................. 47 0 0 St. James’s, Clapham Park .................. 46 0 0 Christ Church, Beckenham .................. 46 0 0 Chapel Royal, Hampton Court ............... 45 0 0 St. Anne’s, Soho ..................... 43 0 0 Hornchurch Parish Church .................. 40 0 0 St. Mary’s, Wandsworth Common............... 35 0 0. St. Saviour’s, Denmark Hill .................. 34 0 0 St. Paul’s, Wimbledon Park............ 34 0 0 Parish Church with St. Mary-le-Park, Battersea ...... 32 0 0 St. Clement’s, Notting Hill .................. 29 0 0 St. Alban’s, Streatham .................. 28 0 0 St. Bartholomew-the-Great, E.C..............., 27 0 0 Acton Parish Church with St. Andrew’s Mission ...... 27 0 0 St. Mary Magdalene. Munster-square ............ 26 0 0 Mr. H. Dent 13rocklehurst .................. 25 0 0 St. Mary’s, Hornsey Rise .................. 25 0 0 All Saints’, West Dulwich .................. 22 0 0 Waltham Abbey Parish Church ............... 22 0 0 St. Luke’s, Eltham ..................... 22 0 0 Westminster Cathedral ............... 21 0 0 Holy Trinity, Stroud Green............ :..... 21 0 0 St. George’s, Tufnell Park.................. 20 0 0 ROYAL COLLEGE OF SURGEONS OF ENGLAND. ELECTION TO THE COUNCIL. ON Thursday, July 3rd, the Fellows of the College will elect four members of Council, as was stated in THE LANCET of May 31st, where were also set out the names of the present. members of the Council. On the day of the election the ballot will also be open from 3 to 5 o’clock P.3i. for those, Fellows who may wish to record their votes by personal attendance at the College. RECEPTION AT THE COLLEGE. By permission of the Council of the Royal College of Surgeons of England Sir Rickman and Lady Godlee held a reception at the College on June 5th from 9 till 12 P.M. An exhibition of specimens of Prehistoric Man, by Professor A. Keith, who also demonstrated on some microscopical specimens, took place in the Museum, where Mr. Shattock also had an exhibition of pathological specimens, and Mr.

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in commenting upon this interesting occasion and cere-mony we may join in the congratulations which de-

servedly fell to the corporation upon the success that is

attending the progressive policy of its various committees.We do so more particularly because this progress seems to usto prove that the qualifications of a watering place are notnecessarily dependent upon a continental name or reputation.Our country, as a matter of fact, is just as favourablyendowed with a variety of natural medicinal waters as are mostcountries abroad, but even where the qualities of the watersat home are not only equal, but superior, to those abroadof an analogous description, little, if any, attention has beengiven to making treatment a serious systematic matter.There has not been the regime insisted upon as is the caseon the continent, where not only is a regular course

of baths or of drinking required, but where at thesame time a control over general and dietetic habits isdemanded.Such strict routine is only ensured by medical supervision,

and requires relief in the shape of social amusements and anenvironment of healthy air and attractive scenery. For-

tunately, the English watering places are-invariably situatedin beautiful country, and for the most part they are

swept by a pure and invigorating air. Their armamen-tarium, in short, is good from the point of view of Nature’saids, but it is desirable that the benefits of these aids shouldbe secured by methods of scientific administration and theroutine made tolerable by social attractions and recreation.Watering-places have gained their growth and reputation, ofcourse, from the fact of possessing a source of natural waterendowed with thermal or chemical properties. Nowa-

days, however, it is considered that no spa is com-

plete without the many supplementary methods of treat-ment which are not hydropathic at all, yet which are

known to be of the greatest value. Hence, in addition tothe variations in the methods of applying the natural water,as in mud baths, sprays, irrigations, internal administration,and so forth, relief is often obtained by the use of electrical,thermal, and mechanical appliances, as adjuncts to treat-ment.The recent extension of such departments at Harrogate

is particularly noteworthy. The appliances, for example,for electrotherapeutics at Harrogate are very complete,though the authorities have kept to those well-estab-lished methods of application which are most useful in

conjunction with the treatments peculiar to the waters,and have not installed a lot of unnecessary apparatus.The hydro-electric bath is very complete, and everypossible precaution is taken to make accident impossible.It has an independent electrical supply, which is quitedetached from the town main, but to make doubly sure thebaths are insulated so thoroughly as to give a resistance toearth practically amounting to infinity. Every form ofcurrent is readily available and under perfect control.Static electricity is supplied by a high-speed ebonite plate ’’,machine which appears to give satisfactory results. High-frequency electricity is obtained from about half a dozensets of apparatus in various parts of the establishment. Itis used through vacuum electrodes for a variety of con-

ditions, for the production of ozone, and for what is calledbipolar massage-a form of treatment that has given goodresults at Harrogate. The newer form of this current, knownas diathermy, has been recently provided for and is gainingfavourable opinions. By no other method can the tempera-ture of the subcutaneous tissues be raised appreciably abovethe normal, and while this is not its only feature, thisalone was almost certain to give it a high valuein therapeutics. Another recent addition to the electro-therapeutic installation is the apparatus for the treat-ment of obesity as suggested by Bergonie. Thecurrent used is of the faradic variety, and by means ofseveral electrodes distributed over the body according to adefinite scheme the principal muscles are made to go througha series of rhythmic contractions against a load that is

adjustable by the use of sandbags. The result is exercisewithout fatigue-there is a loss of weight from the beginningas well as an improvement in the general health. In additionto the above, there are a number of light cabinets of variouskinds, coils for the production of dry heat, and othervaluable appliances in which electricity plays a subsidiarypart.

Equally complete are the installations, including the

treatment, the sulphur and needle the -

bieres bath and douche, Vichy massage douche, the liverpack, the oxygen bath, the Schwalbach bath, the brine bath,inhalation systems, throat sprays, nasal douche, radiant heatand light treatment, cataphoresis, massage, and, in fact, allthe accessories which are now recognised as forming part ofthe scientific equipment of an establishment claiming to beprogressive in all branches of balneo-therapeutics.With the recent additions of a new pump room and the

extension of the Victoria baths Harrogate has, in fact, setits houses of treatment in order, and when we couple thiswith the fact that side by side with these up-to-date methods oftreatment abundant provision has been made for social amuse-ments and recreation, the reproach that "they always do-these things better at spas abroad" can no longer beadvanced. By their commendable spirit and enterprise theauthorities at Harrogate should help to remove the prejudicewhich has for too long existed in the minds of the Britishpublic as to the inadequacies and deficiencies of homehealth resorts. And what Harrogate has done other

watering-places in the country might do.

METROPOLITAN HOSPITAL SUNDAYFUND.

THE following are among the amounts received at the’Mansion House up to June 6th. Total to date about £33,000.

£ s. d.St. Paul’s, Onslow-square ............ 203 0 0St. Simon Zelotes, Upper Chelsea............... 156 0 0Holy Trinity, Tulse Hill .................. 143 0 0Aldenham Parish Church .................. 129 0 0Emmanuel, Wimbledon .................. 100 0 0Greek Church, Bayswater .................. 88 0 0St. Thomas’s, Portman-square ............... 85 0 0St. Stephen’s, South Kensington ............... 80 0 0St. Philip’s, Kensington .................. 73 0 0St. Nicholas’s, Chislehurst .................. 72 0 0Immanuel, Streatham .................. 70 0 0Christ Church, Lee Park .................. 53 0 0St. Matthew’s, Bayswater .................. 52 0 0

Holy Trinity, St. Marylebone ............... 52 0 0St. Saviour’s, Paddington .................. 47 0 0St. James’s, Clapham Park .................. 46 0 0Christ Church, Beckenham .................. 46 0 0Chapel Royal, Hampton Court ............... 45 0 0

St. Anne’s, Soho ..................... 43 0 0Hornchurch Parish Church .................. 40 0 0St. Mary’s, Wandsworth Common............... 35 0 0.St. Saviour’s, Denmark Hill .................. 34 0 0St. Paul’s, Wimbledon Park............ 34 0 0Parish Church with St. Mary-le-Park, Battersea ...... 32 0 0

St. Clement’s, Notting Hill .................. 29 0 0St. Alban’s, Streatham .................. 28 0 0St. Bartholomew-the-Great, E.C..............., 27 0 0Acton Parish Church with St. Andrew’s Mission ...... 27 0 0St. Mary Magdalene. Munster-square ............ 26 0 0Mr. H. Dent 13rocklehurst .................. 25 0 0St. Mary’s, Hornsey Rise .................. 25 0 0All Saints’, West Dulwich .................. 22 0 0Waltham Abbey Parish Church ............... 22 0 0St. Luke’s, Eltham ..................... 22 0 0Westminster Cathedral ............... 21 0 0Holy Trinity, Stroud Green............ :..... 21 0 0St. George’s, Tufnell Park.................. 20 0 0

ROYAL COLLEGE OF SURGEONS OFENGLAND.

ELECTION TO THE COUNCIL.

ON Thursday, July 3rd, the Fellows of the College willelect four members of Council, as was stated in THE LANCETof May 31st, where were also set out the names of the present.members of the Council. On the day of the election theballot will also be open from 3 to 5 o’clock P.3i. for those,Fellows who may wish to record their votes by personalattendance at the College.

RECEPTION AT THE COLLEGE.

By permission of the Council of the Royal College ofSurgeons of England Sir Rickman and Lady Godlee held areception at the College on June 5th from 9 till 12 P.M.An exhibition of specimens of Prehistoric Man, by ProfessorA. Keith, who also demonstrated on some microscopicalspecimens, took place in the Museum, where Mr. Shattockalso had an exhibition of pathological specimens, and Mr.

Burne a number of natural history specimens. In theCouncil Room some Hunterian manuscripts, books, andhistorical specimens were on view, and in the Museum,which was specially lit for the occasion, a ladies’orchestra played during the evening. Mr. Kearton’smoving pictures were shown by him in the theatre.

INDIAN MEDICAL SERVICE.

The nn2cal Dinner.THE annual dinner of the Indian Medical Service was held

at the Hotel Cecil, London, on June 10th, under thechairmanship of Surgeon-General the Hon. Sir C. P. Lukis,K.C.S.I., Director-General, I. M. S. The following guestswere present : The Marquis of Crewe, Secretary of State forIndia ; Sir Thomas Holderness, Permanent Under Secretary ;Sir Francis Champneys, Bart., President of the RoyalSociety of Medicine; Sir William Watson Cheyne, Bart.,President of the Medical Society of London ; the Editorof THE LANCET ; and the Editor of the British Medical.To2ernal. General Sir Beauchamp Duff, G. C. B. ; Sir ThomasBarlow, Bart., President of the Royal College of Physiciansof London ; Sir Rickman J. Godlee, Bart., President of theRoyal College of Surgeons of England ; and Mr. Austin Lowhad been invited, but were unable to be present.The following members of the Service dined :-Surgeon-

Generals : Sir A. M. Branfoot, K.C.I.E., Sir R. HavelockCharles, G.C.V.O., J. Cleghorn, C.S.I., J. P. Greany, G.Hay, and Sir L. D. Spencer, K.C.B. Colonels : C. W.

Carr-Calthrop, G. W. P. Dennys, D. ffrench-Mullen, B. B.Grayfoot, G. F. A. Harris, P. Hehir, D. E. Hughes, C. C.

Little, M. D. Moriarty, R. D. Murray, A. Porter, and P. A.Weir. Lieutenant-Colonels : W. Alpin, J. Anderson, R. J.Baker, R. H. Castor, W. H. Cadge, J. T. Calvert, D. G.Crawford, P. J. Freyer, C. R. M. Green, H. Greany, E. A. W.Hall, J. Jackson, E. Jennings, E. R. Johnson, D. F. Keegan,M. A. Ker, D. P. MacDonald, W. Molesworth, J. Moorhead,T. R. Mulroney, W. H. Ogilvie, K. Prasad, W. G. Pridmore,J. J. Pratt, W. H. B. Robinson, W. H. Thornhill, D.Warliker, H. R. Woolbert, and H. G. L. Wortabet. Majors :W. R. Battye, R. Bonstead, P. F. Chapman, S. R.

Christophers, de V. Condon, A. T. Gage, A. A. Gibbs,C. M. Goodbody, E. Hutcheson, F. H. G. Hutchinson, J. H.Hugo, W. Lethbridge, E. A. C. Matthews, J. H. MacDonald,F. 0. N. Mell, O. St. John Moses, C. R. Pearce, E. L. Perry,Sir Ronald Ross, K.C.B., F.R.S., S. A. Ruzzak, R. F.Standage, J. W. Watson, and J. M. Woolley. Captains :C. H. Barber, F. Powell Connor, W. T. Finlayson, C. A.

Gill, D. P. Goll, D. L. Graham, J. B. D. Hunter, H. H. G.Knapp, J. L. Lunham, G. E. Malcolmson, E. Selby Phipson,R. D. Saigol, H. B. Steen, J. Taylor, and W. P. Williams.

After the loyal toasts had been honoured the CHAIRMANaddressed the company. He said that, speaking after fouryears’ experience as Director-General, the position andprospects of the Indian Medical Service were never brighterthan at the present time. Steady progress had been made,and in many respects the conditions of service had beengreatly improved. Annual increments of pension after17 years’ service had been granted, the fee rules had beensatisfactorily modified, brevets had been awarded for distin-guished service other than in the field, large grants hadbeen made towards research and for the establishment of aschool of tropical medicine in connexion with the CalcuttaMedical College, and the King George Medical College hadbeen opened at Lucknow. At no time in the history of theService had honours and rewards been so freely bestowedupon its members. It was incorrect to say that the mennow entering the Service were not up to the former stan-dard. Taking the Service as a whole, 71 per cent. of theofficers possessed higher qualifications, whilst the averagefor lieutenants alone was 73-5 per cent. So far from therebeing a falling off in the standard, they were getting bettermen than ever before. The Indian Medical Service stilloffered a magnificent career to men of the right stamp.Changed conditions would arise and competition would bekeener ; but remembering the medical needs of that vastcountry he believed that ample room would be found in Indiafor themselves, for the sister service, and for the independentmedical practitioner. Sir Pardey Lukis concluded with anacknowledgment of the deep debt owed by them all to Lord

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affecting the general welfare of the Service and the personalinterests of individual officers.Lord CREWE, in acknowledging the toast of his health,

which was received with acclamation, spoke of the interestin medical progress and the admiration for the medicalprofession which he had always felt. As Secretary of State,formerly for the Colonies and now for India, he had beenbrought much in contact with medical and sanitary matters.He recognised that many difficult problems lay before theIndian Medical Service, but he wished to associate himselfwith the hopeful view expressed by their chairman.There were no other speeches and the remainder of the

evening was spent informally. The attendance at thedinner was the largest on record, and the honorary secretary,Lieutenant-Colonel P. J. Freyer, is again to be congratulatedon a very successful entertainment.

Public Health.ANNUAL REPORTS OF MEDICAL OFFICERS OF HEALTH.

. Port of 1lIaneleester.-This port, which is formed by the

Manchester Ship Canal, was used by 1400 vessels comingfrom "foreign" " and by 4732 ships arriving" coastwise ’.’

during 1912. It has become one of the principal food--

importing ports in the United Kingdom, and Mr. W. F.Dearden gives a number of interesting particulars of recentresults that have followed the inspection of foodstuSswhich has been organised under his direction. One of theprincipal causes of the contamination by lead and tin whichis sometimes found in canned goods, particularly tomatoesand other acid fruits, is the action of their liquid contentsupon solder. The examinations of canned foods made at..Manchester and other ports have largely contributed to the.greater use of then solderless

" tin, which has not only beeneffective in minimising metallic contamination, but also hasproved a commercial success. Mr. Dearden states that.canners of American fruits are the latest converts to solder-less methods. Nutmegs, which are not usually suspect,were imported during the year in an unsound condition,being found crumbly and practically useless in the interior,The cause was their attack by two species of beetles, one ofwhich, Arascerus co:Kea3, is well known in its destructiveeffect on coffee beans. The beetle lays its eggs on the seeds,and when the grubs, which are whitish-brown in colour,wrinkled, and furnished with biting jaws, hatch out, theyproceed to feed on the seed. The Malay Peninsula is thegreat native habitat of this species, but it may now be

regarded as cosmopolitan, having been distributed all overthe world in the seeds in which it has been feeding.Separation of the unsound nutmegs was effected by puttingthe consignment in brine of strength just sufficient to allowthe sound nutmeg to sink. Some rather mystifying allusions-in the report to imported hog’s fat " suggest that, notwith-standing the efforts which have been made to exclude fromBritish ports the products made from carcasses that havebeen condemned at American packing-houses, a considerableamount of this material goes from America to Dutch ports,whence it is either shipped to England after the removal oftell-tale labels, or is refined and sent to us as lard. Mr.,Dearden considers the only remedy to be that the LocalGovernment Board should insist on a certificate of satis-

factory origin being attached to each package of the refinedand the unrefined variety. A contrast between the con-dition of American and Irish cattle brought for slaughterto the foreign animals’ wharf is decidedly in favourof the former in regard to absence of tuberculosis.Mr. Dearden also draws attention to the dangers ofthe Irish dead meat trade which was rapidly developedlast year during the prohibition of importation of livecattle from Ireland on account of outbreaks of foot andmouth disease in that country. It is evident that much ofthis meat was not systematically inspected in Ireland, andthere is at present no guarantee of its entry into England atports where it will be strictly examined before going intoconsumption, as the places of importation of meat fromIreland are not necessarily those where arrangementsfor inspection have already been made on account ofthe importation of foreign meat. Now that inspection