686

Effective Reproduction-rate.—The effective reproduction-ratecorresponding to the births in 1949, allowing for continuingimprovement in survivorship conditions, is provisionallyassessed at 1-02, indicating that the births were 2% in excessof those required by a par replacement standard.A report on the survey of sickness in the September

quarter, 1949, is also included in the return.

Smallpox at. SeaSmallpox on Merchant Ships, issued by the Ministry

of Transport (notice no. M342), outlines for ships’surgeons the main clinical features of smallpox, togetherwith notes on precautions and treatment.

Medicine and the Law

Mistake in Morphine InjectionAT a recent inquest upon the death in hospital of

a patient aged 72 there was evidence that he died lessthan four hours after having been given a half-graininjection of morphine and that the injection had beenintended for another patient whose name began with thesame capital letter and was perhaps otherwise slightlysimilar. The assistant nurse who administered the drugadmitted that she had not checked the prescriptionwith the case-sheet. The coroner expressed the opinionthat such checking would have prevented the mistake.The pathologist who carried out the post-mortemexamination stated that death was due to heart-failureand chronic bronchitis and was accelerated by the

morphine. A verdict of death by misadventure wasrecorded.

Hospital practice has hitherto required a qualifiednurse or sister to " check " the dose-to see that theright quantity of the right drug has been drawn into thesyringe. Does the evidence at the recent inquest meanthat it is now left to an unqualified nurse to administerthe actual injection ?

Parliament

QUESTION TIME

Surgeons in Malaya and SingaporeMr. A. J. IpviNE asked the Secretary of State for War

what was the number of British Army surgeons now servingin Malaya- and Singapore ; and whether he was satisfied thatsuch number was sufficient.-Mr. JOHN STRACHEY replied :There are 7 British Army surgeons serving in Malaya andSingapore. They are available to fly to any locality wheretheir services may be needed. This is an addition of 3 RoyalArmy Medical Corps surgeons to the numbers previouslyserving in Malaya and Singapore. I am keeping the require-ment under careful review. There are, in addition, 16 Europeancivilian surgeons in Malaya and Singapore who can be, andare, called on should Army surgeons not be immediatelyavailable.

Tuberculosis in Scotland

Replying to a question, Mr. HECTOR McNEIL stated thatnotifications of respiratory tuberculosis in Scotland in 1939numbered 4657 ; in 1945, 7316 ; in 1947, 7984 ; and in 1948,8204. The provisional figure for 1949 was 8427.

Our Calorie Intake

Dr. BARNETT STRoss asked the Minister of Food whetherhe was aware that the total calorie intake pre-war from grainand potatoes was 34% and in 1946 was 42% ; and whetherhe would now give the figures for 1947, 1948, and 1949.-Mr. MAURICE WEBB replied : The corresponding figures for1947, 1948, and 1949 are 43%, 43%, and 40%. Dr. STROSS :Is the Minister aware that the last figure shows that we areundoubtedly improving the national dietary ?

Mr. HENRY STRAuas : Has the right hon. gentleman everinvited a friend to a calorie intake ?

The Minister of Health has appointed Mr. W. D. Griffiths,M.P. for the Exchange division of Manchester, to be his

parliamentary private secretary.

In England NowA Running Commentary by Peripatetic CorrespondentsOuR life has lately been lightened by the arrival of a

displaced person-a young woman of 30 who is a

Rumanian-born German. She views life in Englandwith a mixture of suspicion, criticism, and admiration,and she is timid of venturing outside the house alone orencountering strangers. Not long ago, just beforerestraints on the sale of eggs were removed, I wanderedout one afternoon to ask for half a dozen eggs from thesmallholding nearby. On the way I met the villagepoliceman who always likes a chat; he has a round andguileless face which invites confidences, and a broadDevon accent. Presently I swung my basket and saidI must be going along, as I wanted some eggs if Mrs.Smith were at home. " She’s at home," said theconstable encouragingly, cos the man from the packingstation’s there. I saw his van as I passed." " Thenit’s no use my going," I said. " All the eggs will begone. I’ll go tomorrow." " You could go and see,"said the policeman. " Look, I can see from here; he’sjust leaving and he’ll be gone in a minute." He wasclearly anxious I should not be disappointed. But Ireturned home, knowing there would be no eggs thatday, and over tea I recounted my meeting. Then athought struck me. " There was I," I exclaimed," doing a little bit of black-marketing and telling thepoliceman all about it. It never occurred to me not to."I happened to glance at Elsa and saw her face a study ofhorror. " Told the police ! " she murmured. Myhusband glanced at her and began to speculate aloud onthe probable length of my sentence. Presently sherealised that he was joking and she relaxed, but remainedpuzzled. These extraordinary English, who expecttheir police to behave like reasonable human beings!

* * *

With a deep sigh he smeared removing-cream over hisface and wiped the grease-paint off with a towel. " I’msorry you struck such a poor evening," he said. "Itwas all right," I replied,

" but what on earth was wrongwith the audience ? I’ve never been in such an apatheticcrowd." " Nurses ; " he sighed again, " from Wednesdaysonward for the rest of the week we are booked out.For months ahead. But Mondays and Tuesdays arethin: I don’t know why. Today the managementpanicked and papered the house with hospital nurses.Tell me, why are they so damnably unresponsive ? Isit because they don’t value anything they don’t haveto pay for ? " I felt it was up to me to stand up forthe girls. " That has got something to do with it,without any doubt," I replied. " I remember when Iwas handed complimentary tickets as a houseman. I

guessed they couldn’t be got rid of in any other way,and my approach to the show tended to be rather...."I hesitated. " Hypercritical ? " he suggested.

" Worsethan that: a sort of ’ Damn-you-you-dragged-me-here-now-amuse-me ’ attitude. Why, I remember once walkingout of a revue before the end when I hadn’t paid for it."" But you weren’t forced to go in the first place, wereyou ? " he asked. " You’re not forced to take thepamphlet a man in the street hands you," I said, " butyou do take it and shove it in your pocket, and perhapsyou glance at it before you throw it away. But youdon’t memorise it, or even file it away. What I meanis that my attitude was very different when I’d plonkeddown five-and-nine for an upper circle or stood mytwo hours for the pit : then I was bent on enjoyingevery moment of the show." I felt I was talking toomuch but as he was merely goggling at me and puttingon his tie I swept on. ’’ Another thing : you get a randomselection by suddenly enlisting nurses who happen tobe having their half-day." "

Half-day ? he asked." In a hospital most of the nurses are on duty till nineo’clock," I explained. " There is only a handful off dutywhen free tickets roll along. And a good proportion ofthese wouldn’t choose a philosophic comedy for theirevening out. Their cup of tea may be musical comedy,ballet, or old Vickery. But they have to take whatevercomes their way." .

"

Well," he said, " I wish theywouldn’t. I’d rather they stayed away." " But if the