576 .THE RELATION OF .THE PHARMACIST TO THE PHYSICIAN.i

welcome the health visitors ,and do their best to carry out I,the instructions given to them. The total death-rate for the- districts was 12’ 48 per 1000 as contrasted with 13’ 5 and--12 - 87 in the two previous years. In the urban districts

Erdington had the lowest >death-rate, 8 78 per 1000, and,&bgr;ulkington the highest, 20’7. The zymotic death-rate was0’ 84, the lowest yet recorded in the county, a distinct

improvement upon the 1’ 49 of the previous year, due very. largely to the diminution of diarrhoea.

THE RELATION OF THE PHARMACIST TO THE

PHYSICIAN.

IN the July 131ÛleÜn. vf the Amerwan PharmaceuticalAssociation Dr. C. S. N. Hallberg deals in an interestingmanner with the relation of the pharmacist to the physician.Dealing first .with the prescription he points out that many

I physicians have ceased to write prescriptions, partly owingIto the common practice among patients of handing their..prescriptions to their friends. A prescription is designedonly for a particular person for a particular period and

--should not be. regarded as a common recipe. Accordingto a declaration formulated by a joint committee of

physicians and pharmacists at Chicago a prescription is

;t.a.n ’utterance of the prescriber who alone should directand control its employment. It should, whenever prac-ticable, bear the name of the patient, the age, if a minor,and the date when written. It should be retained by’the pharmacist as a record for not less than five years,nor the protection of the prescriber, the pharmacist, and thepattient. It should not be dispensed more than once if the,prescriber signifies that it is not to be repeated ("N. rep."),

1 if it contains narcotic or habit-forming drugs, or if

.asked for by any other person than the ’original patient.f These requirements are exceedingly reasonable and have been. -approved by several medical societies. The recommendation’of medicines by the .pharmacist furnishes a fruitful source oftrouble between ’him and the physician. Theoretically thepharmacist should not recommend any medicines but shouldsuggest that’his patrons should seek the advice of a physician..The pharmacist has no right to ’diagnose, and herein lies a

B valuable guiding principle which admits of general applica-tion. Dr. Hallberg suggests that the pharmacist should neverrecommend patent medicines or display them, but whether’ ’he should refuse to supply them on demand must be left to individual judgment. His refusal would be rendered more

easily possible if physicians’ through their societies wouldresolve to give preference to those pharmacists who do notkeep patent medicines at all. ’To meet the popular demandfor domestic medicines ’ it has been suggested that a

list of official articles should be selected by the jointmedical and pharmaceutical societies, such articles tobe supplied with suitable labels. Dr. Hallberg’s observationsare largely applicable to all countries where the Englishtongue is used. In many continental countries the pharmacist; its bound to observe a rigid code of ethics and in some of I

these countries care: is taken to regulate the number opharmacies, so that it- is possible for the rules to be carried’out and at the same’ time the pharmacist is able to conductthe business with profit.

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FOOD POISONING AT ST. ANNE’S-ON-THE-SEA.

WE have received from Mr. ’Edward Sergeant, the medicalomcer of health of the’ eounty palatine’ of Lancaster, a copyof his report on the outbreak of food poisoning whichoccurred early’ in July last in the urban’district of St.

Anne’s.on-the-Sea. Investigation showed that altogether’there were 76 cases of poisoning, aild without exception

the cause of illness was attributable to either potted beefor pork pies. 34 cases of illness due to the potted meatcame under observation- and 42 attacks were traceableto pork pies. Three deaths occurred, two of which wereattributed to potted meat and one to pork pie. The fatalcases exhibited the following symptoms. The food wasconsumed about 8 or 9 in the evening. The patientsoommenced to be ill with pain in the stomach, vomiting,and diarrhoea about 1 o’clock next morning. Death from

syncope took place six days after- the meat was eaten.There could be little doubt, that both the potted meatand the pork pie had established some kind of bacterialpoisoning-a conclusion, at all events, which was borne outby the bacteriological investigations made by Professor S.Delepine. The bacillus obtained from the pie when mixedwith the food of a guinea-pig caused the infection anddeath of that animal..Inoculation with cultures of thebacillus obtained from one fatal case and also from the

’potted meat produced infection and death in two or

three days. The blood of other patients gave the

characteristic reaction indicating that they had beeninfected by the same bacillus. The outbreak appears,therefore, to have been due to a bacitllus which had most ofthe characters of the bacillus enteritidis of Gaertner, whichis similar to the organisms which have been found in foodcausing analogous poisonous symptoms in previous outbreaks.’There was evidence also that the blood of some of thebakehouse employees had been similarly infected. The

insanitary surroundings in which the bakehouse was foundfurther suggests that the fons et origo rnali was the intestinalorganism. There can be little doubt that am efficientsanitary condition in places where food is prepared andcooked is of the utmost importance to the health of the

public, especially as ’it has been -shown that even in the

process of cooking some pathogenic organisms may surviveowing to the temperature not having completely penetratedthe mass.

___

WE regret to announce the death of Sir Charles GageBrown, E.C.M.G., M.D., which took place on Thursday,August 13th, at Wreningham Rectory, Norwich. Sir Charles

Gage Brown, who was for many years physician andmedical. adviser to the Colonial Office and to the Crown

.Agents for the Colonies, and who on occasions gavecounsel also to the Foreign Office and Audit O:ffi.oe, hadreached the age of 82 years.

Dr. Lucas-Championniere, consulting surgeon to the

Hotel-Dieu, Paris, and senior surgeon at the Beacon.Hospital, attended at the Royal College of Surgeons of

England on Tuesday last and signed the roll of HonoraryFellows in pursuance of his election by the Council..

Dr. W. H. Willcox, assistant physician to St. Mary’sHospital, has been appointed to the post of Senior SeientificAnalyst to the Home Office in succession to the late SirThomas Stevenson.

READING PATHOLOGICAL SOCIETY.-At a recentmeeting of this-society the following were elected officersfor the new-i.e., the seventy-eighth-session: President,Dr.1 Jamieson B. Hurry;’ honorary librarian, Dr. Francis HHawkins ; honorary curator, Dr. H. M. Clarke ; andhonorary secretaries, Mr. N. B. Clowes and Dr. W. B.Secretan. For many years it has been the custom of thesociety to inaugurate the session by an oration, which Willon’ this occasion be delivered by Dr. F. W. Andrewes,pathologist to St. Bartholomew’s Hospital, subject, "TheTreatment-of Infectious Conditions by Vaccines." After theoration the, annual dinner of the society will be held.

577MOTORING NOTES.

MOTORING NOTES.BY C. T. W. HIRSCH, M.R.C.S. ENG., L.R.C.P. LOND.

A LARGE number of the profession are, from the manyletters I receive, I know anxious to find a small car, a two-seater, with which they can do their work, and one thatwithout much trouble they can look after themselves. Theywish to use it as well for holiday jaunts in the summer whenthe .visiting list is not heavy and the desire arises to refreshthe soul and purify the mind by trips to picturesque old-world villages and places where nature sits beside the hiddenstream. With a little car this can be done without much

expense. Quite recently I noticed in the Royal A2ctomzobileClub Journal a letter from a country parson stating that .613had covered the whole expenses of a low powered two-seaterfor a year, during which he had done over 1500 miles ; and Iknow of a good many medical men who have covered a muchlarger mileage, and including 5 for interest on capitalinvested, R5 for insurance, .B10 for tyres, and .B15 for repairs,petrol, lubricating oil, and paraffin and carbide for lamps, thewhole excluding cleaning-that is, wage of lad for washingthe car-they have done this for three years at a cost notexceeding on an average 935 a year, and this includes newtyres, and for the first year it was much less. And some menI know have done all the cleaning themselves, while others,though doing all the adjustments, have had the car-washingdone by their surgery boy.One of the most popular cars that come under this

category is the 6 h.-p. Rover, a car manufactured by theRover Company of Meteor Works, Coventry, which can beseen at the London depôt, 59-61, New Oxford-street, W.The car has made many recent public performances, whichinclude the winning of the Yorkshire Automobile Club hillclimb, the first place at the New Forest hill climb atBeaulieu, the silver medal for the 12 hours’ reliability test,the Gaillon hill climb in France, &c., and all this has madeit one frequently thought of by medical men in search oftheir first mechanical mount, so it was with great pleasurethat I accepted the offer of their London manager tomake use of their standard 100-guinea car for a morn-

ing’s round and to see for myself how it could climb.The length over all is 92 feet, while the width is 4 feet8 inches, which makes the car most easy to handle and turnabout-important points in a carriage for a practitioner whomay have to go up narrow lanes and ;byways. The body Tsroomy and has two seats, nicely upholstered. In the 100-guineatype wire wheels are fitted but artillery wheels are suppliedwith the more expensive model. The car sent to me -was

especially made for the profession and had an excellent Cape-cart hood and screen, and as the actuating levers are all onthe steering pillar, though the weather was most un-

propitious, I was able to drive without getting in any waywet, and stepped out of the car at my patient’s house in aspresentable a condition as if I had been driven there in a

brougham, the only difference being that I was taken thereat about three times the speed of a horse-drawn vehicle. The

springing is excellent and though the length is small I wasunable to detect any vibration, weighty matter for a carriagein which one may have to spend from six to eight hoursevery day of one’s life. The springs, too, act as radius rods,a very simple attachment permitting of a slight movement.The engine has a bore of 97 mm. and a stroke of 110 mm.,the crank shaft is solid, and the inlet and exhaust valves areboth operated off cams. A cross-piece, held by a single nuton a central stud, keeps the inlet and exhaust pipes incontact with the side of the combustion head, copper andasbestos washers making the joints gas-proof. The sparking-plug is in an excellent position right over the inlet valve,and there is a cap over the exhaust valve which can betapped to take an extra sparking-plug, should magneto-ignition be fitted as a stand-by, which I strongly recommend.The piston has four rings, two in a groove, and the connect-ing-rod is attached to it by a tapered gudgeon-pin held inbosses formed in the casting on the interior, and small screwsprevent any possible lateral movement of the pin, which isalso, of course, a "drive fit." A plate over the cylindercasting, which is held in position by nuts, can be removedfor the purpose of cleaning the water-jacket. This Iknow to be a great boon. On cars I have bad thecylinder and water jacket have been cast in one, and as

in my early days I did not use distilled water incrustationswould form, and they were a trouble to clear out ; with thisremoveable cover it can be done at once, while if distilledwater only be employed deposits cannot form. ’The commu-tator is of the external wipe kind and by means of spur gear-ing it is brought up to a level with the crank case, which iscertainly an advantage, as it makes it easy to get at. This

way of firing the mixture answers exceedingly well, only, asin all motor matters, it needs occasional adjustment ; if aridge or groove wears on the fibre, in front of the metalcontact, when the engine is running quickly, it may missfire ; this can be avoided by seeing that the wheel is true,and it may require spinning in the lathe. It is also a

good plan to carry a spare wipe; the ends are hardened ; ystill flats do form and cause poor contact; it is impossibleto file them true on the road ; with a grindstone itis even a bother, and as they only cost a few penceI strongly commend the inclusion of one in the tool kit.Unlike most cars the coil is not carried on the dash ; it isnot an ornament there, so I rather approve the Rover planof putting the coil in the accumulator box on the step. The

objection is the added length to the high tension wire, but itis well insulated and not in a position likely to chafe, so thefear of " shorts " may be, I think, dismissed. The clutch is ametal to metal one of the disc variety and runs in oil; it is

certainly very smooth, and even on a hill when let in ratherhurriedly there was not a trace of a jerk. Three forward

gears and a reverse are fitted ; they are of the Panhard "

type, but the first motion shaft is in two, and on top gear adog clutch makes the two solid and the drive is direct to thelive axle. The gear box and crank case are in one castingand there is one universal joint between the gear box andback axle ; the casing of the cardan shaft acts as a torquerod. Neither mechanical nor pressure lubricators are used ;the usual drips on the dash are conspicuous by their

absence ; in their place there is a well near thecrank case, whence the engine, clutch, and gears are

automatically lubricated by gravity, the fly-wheel returningto the reservoir any excess of oil. The carburettor is one ofthe strong points of this car, which by means of a floatingpiston with ports allows more air to pass as the speed of theengine increases, or the throttle is opened up; and the controlworks in conjunction with the contact maker and is actuatedby one lever on the steering column. The jet can be easilytaken out for cleaning, but this should seldom be needful asa gauze strainer washer is fitted in the petrol supply pipe.Of course, the strainer has its disadvantages, for it maybecome choked by dust; still it is but a moment’s work toremove and to clean it, and though on the Rover the jet caneasily be reached on some cars it is a fiddling back-achingjob. The cooling is by radiators with a fan, driven off theengine shaft at the back, and a centrifugal pump maintainsthe water in circulation. The brakes consist of two; one,worked when the clutch pedal is pushed right forward, actson a drum fixed to the cardan shaft, the other acts on drumson the back wheels and is operated by a foot pedal, whichby a pawl can be fixed to a small ratchet, which for theuse of the medical profession seems an improvement on thoseworked by a side lever.

I made use of the car for an ordinary round and especiallynoted the behaviour of the engine, clutch, gears, and the

springing. As the fly-wheel is an especially heavy one, Ifound that the engine ran slowly and quietly when standingidle, and retarded; on letting in the clutch she drew well, andon a .bad hill she started off without any jerk on the secondspeed, and climbed an ascent of one in six, which wasapproached by a back turn and so could not be rushed, onthe low gear without any trouble; there was no knocking or nogroaning, and she went up quite easily. So many cars in theearlier days were guaranteed to mount such roads, and ’tis.true they did, but oh, it was a slow moaning triumph; not so"this little Rover-she really ran up without any grumbling. Ialso tried her on the flat, and when the engine was acceleratedI do not think that she was far off 30 miles an hour. Thecontrol is really delightful: from a crawl, in a few lengths’the car, without a jerk, could do a good 20 miles, and theclutch when slipped picked up smoothly, and still whenhome had a good hold. The steering, too, at all speeds was.easy and steady. The brakes, both the one on the gearshaft and those on the wheel drums, separately held the car,in both directions, on a hill of 1 in 6, and that is a goodtest. As a result of my test I am of opinion that the