the position of the medical profession

1
821 Revenue would indorse the age of matured spirit by means of certificates attached to the labels. The authorities must know from the books of the distillers that the whisky is of the age that it is represented to be. Such a system of control need not be feared by the grain spirit industry, since they are confident in their view that grain spirit or a blend of whisky and grain spirit is preferred by the public or is held by them to be more wholesome than an all-malt spirit. Oddly enough, however, the dealer in grain spirit trembles at the idea of such an innovation, judging from the views expressed by writers in the trade journals. We can never understand why vendors have such an objection to describe their goods accurately when they hold at the same time that they supply these goods in accord- ance with the demands or the preference of the consumer. In the same way, however, margarine is often maintained to be a better food than butter and yet the temptation cannot be resisted at times to label it butter. We still maintain that the consumer should have some guarantee of the nature, substance, and quality of the beverage which he is drinking as well as of the food which he is eating ; and in accordance with this principle, the morality of which nobody can honestly gainsay, some plan is called for which shall help him to gain the genuine article. Surely it is not too much to maintain that the Government should take the lofty view in this manner and encourage honest dealing. Honest dealing is open to everybody and therefore it is absurd to say that by adopting a system of Government guarantee an unfair monopoly would be created. BACTERIAL LIGHT. A TELEGRAM through Reuter’s Agency was published in the daily papers on March 16th announcing the discovery by a professor in Prague of a lamp lighted by means of bacteria. We suppose that the discovery amounts to an im- proved method of feeding photogenic bacteria, the existence of which has been known for some years. In THE LANCET of Oct. 13th, 1900, p. 1087, for example, we published par- ticulars which would enable anyone to demonstrate for him- self the properties of phosphorescent bacteria. The experi- ment is quite simple and easily succeeds. All that is necessary is to place the flesh of fresh haddocks or herrings in a 2 or 3 per cent. solution of common salt, keeping the mixture at a temperature of about 70 C. above freezing point. After a few days it will be found that not merely the flesh of the fish but also the whole of the liquid in which it is immersed gives off a pale greenish light which becomes much more brilliant if a little sugar is added. We remarked at the time of writing these particulars that " it is not possible to say whether the culture will ever be carried to such a pitch that the vessel containing it may be used with advantage as a street lamp or a lamp upon our tables, or as a Chinese lantern at our garden parties." Doubtless by paying attention to the needs of these specific bacteria-by employing, for example, highly stimulating food -more intense light than was hitherto the case has been obtained. It is even suggested that the bacterial light might afford a safety lamp for the miner. THE POSITION OF THE MEDICAL PROFESSION. A WRITER in Baily’s Maga--ine of Sports and Pastimes-an unexpected quarter, by the bye, for serious treatment of a professional question-discourses in the February number upon the position of the medical profession in this country and the modes of entering it." As to the latter portion of this subject the writer merely details, as might be expected, the various universities and examining bodies, giving some additional information as to length of curriculum and such matters in the various instances. In his estimation of the position of our profession, however, this writer lays himself open to controversy, although in the main we agree with his conclusions. No one can deny that, politically speaking, the medical profession in Great Britain is non-existent. The few individual Members of Parliament who are also medical men combine the qualities by mere coincidence. As medical men their position in Parliament is no different from that of any other Member. As a political force, in fact, the medical profession does not count. Medicine has no Minister and the medical profession as a profession is unrepresented in the councils of the State. Compare this state of matters with that which obtains in the professions of the ecclesiastic and the lawyer. Practically ever since there was a Parliament in England the Archbishop of Canterbury and the Lord Chancellor have sat in that Parliament. Moreover, besides the Lord Chancellor there are other law officers of the Crown. But as to social position we do not agree with the idea of the writer. In our opinion the social position of the medical profession is not, <*6?’M various, as a rule, lower than that of members of either of bhe other two learned professions. With the suggestions Eor the raising of the status of the profession which 9.re laid down in the article before us we cannot alto- gether concur. The one-portal system-i.e., an examination in addition to the examinations held by the universities ind other bodies and analogous to the State examina- tion " of foreign countries-may come-some day. It would solve many practical and professional difficulties and is the reform for which all interested in British medicine should work. There is certainly room for greater State encourage- ment of scientific research, but we cannot understand how :t practitioner is to be debarred from dispensing his own medicines or restricted in his midwifery practice. DRAINAGE OF THE PERICARDIUM. THE first suggestion to evacuate the fluid in a case of pericardial effusion was made more than 250 years ago, for Riolan in 1648 in his Eucheiridium Anatomicum " advo- ated tapping the pericardium through a trephine opening in jhe sternum. The recommendation was repeated 100 years .ater by Senac, though he advised that the opening should :)e made to the left of the sternum where the left pleura .eaves a vacant space. In spite of repeated suggestions that aracentesis or incision of the pericardium should be made .n cases of serous or purulent effusion it does not appear jhat any surgeon ventured to put into practice any of ;he procedures advised until, in 1798, Desault endeavoured o incise the pericardium in a case which had been dia- gnosed as pericarditis with effusion, but unfortunately it proved to be a localised pleurisy situated in front of the pericardium. The first successful incision of the pericardium appears to have been performed by Romero of Barcelona in L819. He made an incision between the fifth and sixth ribs m the left side opposite the junction of the ribs and cartilage, but as he does not seem to have wounded the pleura some have doubted whether the effusion was really pericardial. For serious effusion the use of a trocar or ispirator is usually sufficient and this operation has now 3een performed a large number of times. Incision is seldom -esorted to now unless the fluid is purulent or it is desired o drain the pericardial sac. A very important case of irainage of the pericardium was recorded by Dr. Samuel West in 1883. In this case over 80 ounces of pus escaped i,nd recovery ensued. At the present time there is a lack )f unanimity as to the best route by which to approach he pericardium. Usually the fourth or fifth space is hosen for the incision and a portion of the fifth rib may or may not be resected. In the present number of rHE LANCET a case is reported from St. George’s Hospital which was under the care of Dr. Arthur Latham and Mr. H. S. Pendlebury in which the pericardial cavity was greatly

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Page 1: THE POSITION OF THE MEDICAL PROFESSION

821

Revenue would indorse the age of matured spirit by meansof certificates attached to the labels. The authorities mustknow from the books of the distillers that the whisky is ofthe age that it is represented to be. Such a system of controlneed not be feared by the grain spirit industry, since theyare confident in their view that grain spirit or a blend

of whisky and grain spirit is preferred by the public or

is held by them to be more wholesome than an all-malt

spirit. Oddly enough, however, the dealer in grain spirittrembles at the idea of such an innovation, judging fromthe views expressed by writers in the trade journals.We can never understand why vendors have such an

objection to describe their goods accurately when they holdat the same time that they supply these goods in accord-ance with the demands or the preference of the consumer.In the same way, however, margarine is often maintained

to be a better food than butter and yet the temptationcannot be resisted at times to label it butter. We still

maintain that the consumer should have some guarantee ofthe nature, substance, and quality of the beverage which heis drinking as well as of the food which he is eating ; andin accordance with this principle, the morality of which

nobody can honestly gainsay, some plan is called for whichshall help him to gain the genuine article. Surely it is nottoo much to maintain that the Government should take the

lofty view in this manner and encourage honest dealing.Honest dealing is open to everybody and therefore it is

absurd to say that by adopting a system of Government

guarantee an unfair monopoly would be created.

BACTERIAL LIGHT.

A TELEGRAM through Reuter’s Agency was published inthe daily papers on March 16th announcing the discoveryby a professor in Prague of a lamp lighted by means of

bacteria. We suppose that the discovery amounts to an im-proved method of feeding photogenic bacteria, the existenceof which has been known for some years. In THE LANCETof Oct. 13th, 1900, p. 1087, for example, we published par-ticulars which would enable anyone to demonstrate for him-self the properties of phosphorescent bacteria. The experi-ment is quite simple and easily succeeds. All that is

necessary is to place the flesh of fresh haddocks or herringsin a 2 or 3 per cent. solution of common salt, keepingthe mixture at a temperature of about 70 C. above

freezing point. After a few days it will be found that notmerely the flesh of the fish but also the whole of the liquidin which it is immersed gives off a pale greenish light whichbecomes much more brilliant if a little sugar is added.We remarked at the time of writing these particulars that" it is not possible to say whether the culture will ever becarried to such a pitch that the vessel containing it may beused with advantage as a street lamp or a lamp uponour tables, or as a Chinese lantern at our garden parties."Doubtless by paying attention to the needs of these specificbacteria-by employing, for example, highly stimulating food-more intense light than was hitherto the case has beenobtained. It is even suggested that the bacterial light mightafford a safety lamp for the miner.

THE POSITION OF THE MEDICAL PROFESSION.

A WRITER in Baily’s Maga--ine of Sports and Pastimes-anunexpected quarter, by the bye, for serious treatment of aprofessional question-discourses in the February numberupon the position of the medical profession in this countryand the modes of entering it." As to the latter portion of

this subject the writer merely details, as might be expected,the various universities and examining bodies, giving someadditional information as to length of curriculum and suchmatters in the various instances. In his estimation of the

position of our profession, however, this writer lays himself

open to controversy, although in the main we agree with hisconclusions. No one can deny that, politically speaking, themedical profession in Great Britain is non-existent. The few

individual Members of Parliament who are also medical mencombine the qualities by mere coincidence. As medicalmen their position in Parliament is no different from thatof any other Member. As a political force, in fact, the

medical profession does not count. Medicine has no

Minister and the medical profession as a professionis unrepresented in the councils of the State. Comparethis state of matters with that which obtains in the

professions of the ecclesiastic and the lawyer. Practicallyever since there was a Parliament in England the Archbishopof Canterbury and the Lord Chancellor have sat in that

Parliament. Moreover, besides the Lord Chancellor there areother law officers of the Crown. But as to social position wedo not agree with the idea of the writer. In our opinion thesocial position of the medical profession is not, <*6?’M

various, as a rule, lower than that of members of either ofbhe other two learned professions. With the suggestionsEor the raising of the status of the profession which9.re laid down in the article before us we cannot alto-

gether concur. The one-portal system-i.e., an examinationin addition to the examinations held by the universitiesind other bodies and analogous to the State examina-tion " of foreign countries-may come-some day. It wouldsolve many practical and professional difficulties and is thereform for which all interested in British medicine should

work. There is certainly room for greater State encourage-ment of scientific research, but we cannot understand how:t practitioner is to be debarred from dispensing his ownmedicines or restricted in his midwifery practice.

DRAINAGE OF THE PERICARDIUM.

THE first suggestion to evacuate the fluid in a case of

pericardial effusion was made more than 250 years ago, forRiolan in 1648 in his Eucheiridium Anatomicum " advo-ated tapping the pericardium through a trephine opening injhe sternum. The recommendation was repeated 100 years.ater by Senac, though he advised that the opening should:)e made to the left of the sternum where the left pleura.eaves a vacant space. In spite of repeated suggestions thataracentesis or incision of the pericardium should be made.n cases of serous or purulent effusion it does not appearjhat any surgeon ventured to put into practice any of;he procedures advised until, in 1798, Desault endeavouredo incise the pericardium in a case which had been dia-gnosed as pericarditis with effusion, but unfortunately it

proved to be a localised pleurisy situated in front of thepericardium. The first successful incision of the pericardiumappears to have been performed by Romero of Barcelona inL819. He made an incision between the fifth and sixth ribsm the left side opposite the junction of the ribs and

cartilage, but as he does not seem to have wounded thepleura some have doubted whether the effusion was reallypericardial. For serious effusion the use of a trocar or

ispirator is usually sufficient and this operation has now3een performed a large number of times. Incision is seldom

-esorted to now unless the fluid is purulent or it is desiredo drain the pericardial sac. A very important case of

irainage of the pericardium was recorded by Dr. SamuelWest in 1883. In this case over 80 ounces of pus escapedi,nd recovery ensued. At the present time there is a lack)f unanimity as to the best route by which to approachhe pericardium. Usually the fourth or fifth space is

hosen for the incision and a portion of the fifth rib

may or may not be resected. In the present number ofrHE LANCET a case is reported from St. George’s Hospitalwhich was under the care of Dr. Arthur Latham and Mr.H. S. Pendlebury in which the pericardial cavity was greatly