london and counties medical protection society, limited

1
Council has been misled to take a course so unusual and so nnjnst. The result has been a conviction on my part that yon have been made the victim of some purely personal dislike conceived without any reasonable justification by one or two of the members of the Parish Council in matters entirely unconnected with your professional position....... The case is so flagrant that it has attracted the special attention of the Local Government Board in Edinburgh, which has certain statutory duties to discharge in the matter....... Lord Balfour in his letter [to the chair- man of the Parish Council] has felt called upon to point out that the council has no moral right to dismiss a parochial medical officer on grounds which have nothing whatever to do with his professional duties....... When these facts are known it is very unlikely that any candi- date of high character or honourable feeling will be found willing to take an appointment under such circumstances and under the apparently arbitrary power of such a council....... Should you, on the other hand, determine to appeal to the people among whom you have laboured so long, and who may, as I hope, be completely misrepresented by the present majority of the Parish Council, I shall be glad to continue you in the present small holding of land which you now occupy." --- LONDON AND COUNTIES MEDICAL PROTECTION SOCIETY, LIMITED. IN their report for the year 1897 the Council of the London and Counties Medical Protection Association, Limited, congratulate the members on the fact that a large number of highly important cases have been dealt with successfully. In by far the greater number it was found possible to defend members with complete success against legal proceedings that were commenced against them without incurring the heavier expense that would have fallen upon the society if the cases had gone into court. This desirable result was attained in a great degree by carefully investigating all the circumstances of the caees and’by allowing it to become known that in those cases which were accepted as proper subjects for the society’s intervention the members would be de- fended regardless of expense. Numerous communica- tions were received from members complaining of slan- ders uttered against them in their professional capacity and in many cases ample apologies were exacted, but when inquiry showed that the alleged slanders were 1110 more than the ordinary gossip of which medical practitioners frequently become the subjects the aggrieved persons were advised to disregard them. A considerable number of cases have been dealt with by the society in which members on claiming reasonable fees for their services have been met by threats of actions for damages for neglect or unskilful treatment. Much work has also been done by the society in suppressing unqualified practice and in stopping medical practitioners from assuming titles which they did not really possess. The annual general meeting of the society will be held on March 29th in its office at 12, New Court, Lincoln’s Inn. The treasurer and chairman of the Council is Dr. G. A. Heron. The honorary secre- taries are Dr. Hugh Woods (general) and Mr. A. G. R. Foulerton (financial). All communications with regard to subscriptions, &0., should be addressed to the honorary financial secretary at the office in New Court, as above. "AGGLUTINATION IN TYPHOID FEVER AND ’ANTI-TYPHOID’ VACCINATION." ON Feb. 10th a meeting of the Home Counties Branch of the Incorporated Society of Medical Officers of Health was held at the Holborn Restaurant, when a very interesting paper on the Agglutinative Reaction in Typhoid Fever and "Anti-typhoid" Vaccination was read by Dr. J. S. Tew, medical officer of health of the West Kent combined districts. Dr, Tew gave an account of the technique of the method which he employed and mentioned his results. He had no opportunity of examining cases before the end of the first week, but he "obtained a positive reaction with monotonous regularity in decided cases when the blood was taken during the third or fourth week." In two cases he obtained a positive reaction four and a half years and nine years after an attack of typhoid fever. Four cases giving a negative result, but in which the early symptoms closely resembled those of typhoid fever proved to be rapid phthisis, influenza of a gastric type, alcoholic excess, and gastritis. As regards "vaccination" " against typhoid fever, in the early part of October, 1897, Surgeon-Major Semple offered to personally "vaccinate" " anyone, who wished to be so treated, at the Kent County Lunatic Asylum where typhoid fever had broken out. Al the medical staff and a number of attendants accepted the offer. Not one of those" vaccinated "-84 in number- contracted typhoid fever, while of those "unvaecinated," numbering 120 and living under similar conditions, 16 were attacked. This is a significant fact, although it should in fairness be stated that the water was boiled after a certain date and other precautions were taken, so that the vaccination cannot be said to be altogether responsible for the immunity. Still the figures are striking. Out of 21 cases in which it was sought the agglutinative reaction was obtained in 18. The injection of the culture gave rise to a good deal of constitutional as well as local disturbance in the arm, the site of injection. Most of those treated felt quite well within three days, although the arm remained stiff and painful for longer. Dr. Tew’s paper, which is published in full in the March number of Public Health, should be read by every medical man. His results would certainly seem to show that I I anti-typhoid vaccina- tion " has a most decided prophylactic or immunising effect and the value of this fact in an epidemic like that of Maidstone or Lynn cannot be over estimated. THE ISLINGTON VESTRY AND THE WATER- SUPPLY. MR. A. E. HARRIS, the medical officer of health of Islington, in his latest report to the vestry, says that he would like to see all cisterns for the storage of water for domestic use altogether abolished. He points out that such a course would only be possible if a constant service were supplied by the water companies and if the mains were placed at a sufficient depth below the ground to ensure that the water-supply would not be cut off by frost during severe winters. Mr. Harris further observes that cisterns may become the cause of disease to those who drink water from them and a cause of death to rats, mice, and insects which may have the misfortune to fall into them. He relates a case which came under his own observation in which a putrid mouse was found in a water-cistern in a house at Islington in which a patient had suffered from enteric fever. It is not clear from his report whether Mr. Harris thinks that there was a causal relation between the putrid mouse and the case of enteric fever. Mr. Harris does well to insist on the importance of cleanliness in the case of cisterns which are used for domestic supply. The London water companies are often blamed for sanitary defects which occur in the houses of their customers-a fact which was pointed out many years ago by the late Sir Francis Bolton, the water examiner to the Local Government Board. And the neglect of examining cisterns is, unfortunately, not confined to poor districts like Islington, for the medical officer of health of Kensington has complained that he has very frequently found great negligence displayed by people living in that fashionable quarter. The Parliamentary Committee of the Islington Vestry have issued a report advising that the Royal Commission on the Metropolitan

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Page 1: LONDON AND COUNTIES MEDICAL PROTECTION SOCIETY, LIMITED

Council has been misled to take a course so unusual and sonnjnst. The result has been a conviction on my part thatyon have been made the victim of some purely personaldislike conceived without any reasonable justification by oneor two of the members of the Parish Council in mattersentirely unconnected with your professional position.......The case is so flagrant that it has attracted the specialattention of the Local Government Board in Edinburgh,which has certain statutory duties to discharge in thematter....... Lord Balfour in his letter [to the chair-man of the Parish Council] has felt called upon to

point out that the council has no moral right to dismiss aparochial medical officer on grounds which have nothingwhatever to do with his professional duties....... Whenthese facts are known it is very unlikely that any candi-date of high character or honourable feeling will be foundwilling to take an appointment under such circumstancesand under the apparently arbitrary power of such a

council....... Should you, on the other hand, determine toappeal to the people among whom you have laboured solong, and who may, as I hope, be completely misrepresentedby the present majority of the Parish Council, I shall be gladto continue you in the present small holding of land whichyou now occupy." ---

LONDON AND COUNTIES MEDICAL PROTECTION

SOCIETY, LIMITED.

IN their report for the year 1897 the Council of theLondon and Counties Medical Protection Association,Limited, congratulate the members on the fact that a

large number of highly important cases have been dealtwith successfully. In by far the greater number it wasfound possible to defend members with complete success

against legal proceedings that were commenced against themwithout incurring the heavier expense that would havefallen upon the society if the cases had gone into court.This desirable result was attained in a great degree bycarefully investigating all the circumstances of the caees

and’by allowing it to become known that in thosecases which were accepted as proper subjects forthe society’s intervention the members would be de-fended regardless of expense. Numerous communica-tions were received from members complaining of slan-ders uttered against them in their professional capacityand in many cases ample apologies were exacted,but when inquiry showed that the alleged slanders were1110 more than the ordinary gossip of which medical

practitioners frequently become the subjects the aggrievedpersons were advised to disregard them. A considerable number of cases have been dealt with by the society inwhich members on claiming reasonable fees for theirservices have been met by threats of actions for damages forneglect or unskilful treatment. Much work has also beendone by the society in suppressing unqualified practice andin stopping medical practitioners from assuming titles whichthey did not really possess. The annual general meetingof the society will be held on March 29th in its office at

12, New Court, Lincoln’s Inn. The treasurer and chairmanof the Council is Dr. G. A. Heron. The honorary secre-taries are Dr. Hugh Woods (general) and Mr. A. G. R.Foulerton (financial). All communications with regard tosubscriptions, &0., should be addressed to the honoraryfinancial secretary at the office in New Court, as above.

"AGGLUTINATION IN TYPHOID FEVER AND’ANTI-TYPHOID’ VACCINATION."

ON Feb. 10th a meeting of the Home Counties Branch of the Incorporated Society of Medical Officers of Health washeld at the Holborn Restaurant, when a very interestingpaper on the Agglutinative Reaction in Typhoid Fever and"Anti-typhoid" Vaccination was read by Dr. J. S. Tew,medical officer of health of the West Kent combineddistricts. Dr, Tew gave an account of the technique of the

method which he employed and mentioned his results.He had no opportunity of examining cases before theend of the first week, but he "obtained a positive reactionwith monotonous regularity in decided cases when theblood was taken during the third or fourth week." Intwo cases he obtained a positive reaction four and a

half years and nine years after an attack of typhoid fever.Four cases giving a negative result, but in which the

early symptoms closely resembled those of typhoid feverproved to be rapid phthisis, influenza of a gastric type,alcoholic excess, and gastritis. As regards "vaccination" "

against typhoid fever, in the early part of October, 1897,Surgeon-Major Semple offered to personally "vaccinate" "

anyone, who wished to be so treated, at the Kent CountyLunatic Asylum where typhoid fever had broken out. Althe medical staff and a number of attendants accepted theoffer. Not one of those" vaccinated "-84 in number-contracted typhoid fever, while of those "unvaecinated,"numbering 120 and living under similar conditions, 16 wereattacked. This is a significant fact, although it should infairness be stated that the water was boiled after a certaindate and other precautions were taken, so that thevaccination cannot be said to be altogether responsible

for the immunity. Still the figures are striking. Out of 21cases in which it was sought the agglutinative reactionwas obtained in 18. The injection of the culture gaverise to a good deal of constitutional as well as localdisturbance in the arm, the site of injection. Most ofthose treated felt quite well within three days, although thearm remained stiff and painful for longer. Dr. Tew’s paper,which is published in full in the March number of PublicHealth, should be read by every medical man. His results

would certainly seem to show that I I anti-typhoid vaccina-tion " has a most decided prophylactic or immunising effectand the value of this fact in an epidemic like that ofMaidstone or Lynn cannot be over estimated.

THE ISLINGTON VESTRY AND THE WATER-SUPPLY.

MR. A. E. HARRIS, the medical officer of health of

Islington, in his latest report to the vestry, says that hewould like to see all cisterns for the storage of water fordomestic use altogether abolished. He points out that sucha course would only be possible if a constant service weresupplied by the water companies and if the mains were

placed at a sufficient depth below the ground to ensure thatthe water-supply would not be cut off by frost during severewinters. Mr. Harris further observes that cisterns maybecome the cause of disease to those who drink water fromthem and a cause of death to rats, mice, and insects whichmay have the misfortune to fall into them. He relates a

case which came under his own observation in which a putridmouse was found in a water-cistern in a house at Islington inwhich a patient had suffered from enteric fever. It is not

clear from his report whether Mr. Harris thinks that therewas a causal relation between the putrid mouse and the caseof enteric fever. Mr. Harris does well to insist on the

importance of cleanliness in the case of cisterns which areused for domestic supply. The London water companiesare often blamed for sanitary defects which occur in thehouses of their customers-a fact which was pointed outmany years ago by the late Sir Francis Bolton, the waterexaminer to the Local Government Board. And the neglectof examining cisterns is, unfortunately, not confined to

poor districts like Islington, for the medical officer ofhealth of Kensington has complained that he has veryfrequently found great negligence displayed by peopleliving in that fashionable quarter. The ParliamentaryCommittee of the Islington Vestry have issued a reportadvising that the Royal Commission on the Metropolitan