the best use of fever beds
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AN ANTHROPOLOGIST ON JOHN BULL.THE first social evening of the session was held
at the Royal Society of Medicine on Monday last,when a very large company of Fellows and guestswere received by Sir JAMES BERRY, the President, andLady BERRY. The speaker of the evening was SirARTHUR KEITH, who entitled his witty and entertainingaddress John Bull: a Study in Anthropology. Hetook as his text the familiar John Bull of BERNARDPARTRIDGE, remarking that not only was the famousPunch artist the son of one anatomist and father ofanother, but also he had drawn John’s features withpeculiar racial and anatomical insight. The artist,he said, could convey with his pencil that John isbluff, honest, kind-hearted, and generous, with a
hearty contempt for everything savouring of pretence,meanness, or dishonesty. The anthropologist withhis craniometer, on the other hand, had as yet foundno precise method of recording or measuring thesecharacteristics. John is dolichocephalic, but hasrather a massive brain. His face shows none of thesharpness and angularity of certain other Britishtypes. TENNIEL’s John Bull was an old, old man,but since then he appeared to have grown graduallyyounger. In the year 1712 the Scotsman, Dr. JOHNARBUTHNOT, in his " History of John Bull," describedthe character he had selected as the essential English-man and to whom he had given this name.
" In the main," he said, "John Bull was an honest,plain-dealing fellow, choleric, bold, and of a very inconstanttemper ; he dreaded not Lewis Baboon (France) either atbacksword, single falchion, or cudgel play ; but then hewas apt to quarrel with his best friends, especially if theypretended to govern him ; if you flattered him, you mightlead him like a child. John’s temper depended very muchupon the air ; his spirits rose and fell with the weather-glass. John was quick and understood his business verywell ; but no man alive was more careless in looking intohis accounts, or more cheated by partners, apprentices, andservants. This was occasioned by being a boon companion,loving his bottle and his diversions, for, to say truth, noman kept a better house than John nor spent his moneymore generously."A second Scotsman, JAMES GILLRAY, an audacious
. and brutal caricaturist, developed John Bull from aloose-j owled, putty-faced farm labourer, as he had drawnhim, into a typical country publican. Although manyof GILLRAY’s drawings showed a very different concep-tion of John Bull from those of ARBUTHNOT andTENNIEL, yet some of them certainly foreshadowedPunch’s John Bull. The lecturer demonstrated withphotographs of English public men how rare in factwas this " typical Englishman," and suggested thathe was met more often in Yorkshire than elsewhere.
Neither in face nor colouring was John Bull, he said,a true Saxon, and to find his prototype it was necessaryto go far back in our island story to certain immigrantsearly in the second millennium B.C. These ancientinvaders appeared to have originated beyond theCaucasus, where big noses and round heads stillabound, and their blood can be traced, said the speaker,chiefly among our landed, professional and businessmen. While the typical John Bull is not uncommon inIreland, he is almost unknown in Scotland and on thecontinent. Hostile French cartoonists gave JohnBull a lantern jaw, loose lips, a rabbit mouth, defectivechin, and sharp nose, and this caricature accuratelyrepresents the anthropological changes which thefaces of the British people are most apt to undergo.German artists in the stress of war picked out theprognathous jaw, ample mouth, shrunken snub nose,and cruel countenance occasionally found amongprosperous and unprincipled city men. Despite theseattempts to crystallise the essentials of Englishcharacter in one symbolic figure, the supply ofindividual types remains inexhaustible, as artistsand novelists reveal every week, and before anthro-pologists lies the tremendous task of reducing thiscomplexity to a scientific unity.Among the interesting exhibits in the library of
the Royal Society of Medicine were a collection ofX ray photographs and engravings of medical men.
Annotations.
THE BEST USE OF FEVER BEDS.
" Ne quid nimis."
AT its meeting last week the Metropolitan AsylumsBoard decided on a change of policy in the allocationof beds in hospitals to the various prevalent infectiousdiseases. Of the total 4185 beds then occupied inM.A.B. hospitals, 2285 contained patients sufferingfrom diphtheria, 1527 from scarlet fever, 194 fromwhooping-cough, 106 from enteric fever, 34 from
measles, 21 from puerperal fever, and 18 from otherdiseases ; the beds allotted in special hospitals toophthalmia, marasmus, small-pox, tuberculosis, post-encephalitic and convalescent cases are not included inthese figures, which, as wil. be seen, bear no relationto the relative fatality of the various infections.Out of every million people living in London duringthe last 15 years, 251 have died annually from measles,and only 42 from scarlet fever, the mortality-rateper cent. in the Board’s hospitals during the sameperiod being 10-6 for measles and 1-5 for scarlet fever.When the Board decided at the beginning of thisperiod-that is, in 1910-to receive measles and
whooping-cough it was with the definite intention ofrestricting their admission to the number of bedsavailable after the prior claims of scarlet fever anddiphtheria had been satisfied. As far as diphtheria isconcerned, the claim remains paramount, but so mildhas been the type of scarlet fever in London duringrecent years that the Board believe the large majorityof these cases would have recovered whatever theconditions under which they were treated. Moreover,the value of isolation in the treatment of scarlet feveris by no means established, although it is possiblethat the more severe complications, such as nephritisand otitis media, may occur less often in hospital thanin patients treated at home. Even under non-epidemicconditions it would be impracticable to isolate allthe cases of scarlet fever, diphtheria, and measles inthe metropolis, and to do so would require enormousexpenditure on new buildings during an epidemic.period, when the number of measles cases may runup to 100,000 in the year ; but the ratepayer mayquite properly inquire whether he is well-served byan expenditure of Is. 4d. per head per annum on thesimple isolation of all cases of scarlet fever, when thecase-mortality of this disease has gone down from10 per cent. in the ’seventies to less than 1 per cent. atthe present time. Having such considerations as this.in view, the Metropolitan Asylums Board, with theapproval of the Ministry of Health and the localauthorities concerned, have decided to modify thepresent scheme of allocation of beds, so as to givemeasles a considerable proportion of the beds nowallocated to scarlet fever. As soon as the one competes.against the other for admission, the borough medicalofficer of health will select cases of either in accordancewith the necessities and home conditions of theindividual case. This decision fulfils a principle,already enunciated in these columns, that while no.sanitary authority should or could undertake the-isolation of all infectious disease in its area, its utilitywould be greatly enhanced if it could undertake todeal with selected cases of all kinds, putting in theforefront those from institutions and from poorhomes, the new cases in a locality and all those ofsevere type. It might be feared that such a re-
allocation would increase the difficulties of preventingcross-infection, but recent experience of bed-isolationat Fazakerley and other places shows that thisproblem may not be as difficult of solution as was oncesupposed.