1197 Leysin, Montana, Davos, and Arosa. Orthopaedic institu- tions are provided, or are in course of preparation, and there is a large surgical hospital in Lucerne where any major surgery will be performed by first-rate operators. There are already some 9000 Frenchmen interned in Switzerland, a large number of Belgians, more than 3000 Germans, and it is anticipated that more than 500 English invalid prisoners will be released. The British interngs will at present be stationed at Chateau d’Oex, one of the most delightful subalpine spots in the Bernese Ober- land, and at other villager such as G’staad in the same upland valley. Chateau d’Oex is more than 3000 feet above sea-level, and both as health-resort and sport centre has enjoyed some little popularity among British travellers for ten years past. There is still, even during war-time, a small English colony, and the British chaplain, Rev. E. Dudley Lampen, is chairman of the local committee which is to assist in providing comforts and luxuries for the men. The whole system has now been tried with French and German internés for some three months and has worked exceedingly well. A few prisoners have tried to escape, but these were all recaptured before they left Switzerland. Nothing would be gained if they were to reach their native land, because, according to agree- ment, they must then be returned to Switzerland. Most of them are, of course, so gravely invalided that they would be incapable of doing military work for at least twelve months. The threat that if a man behaves badly he will be returned to his prison-camp is used as a simple and effective means of enforcing discipline, but there has been no need as yet of putting it into execution in a single case. Captain F. Schwyzer, of Kastanienbaum, Lucerne, is the officer in charge of the department of British internment; he is a Swiss medical man who has lived in America and is one of the members of the sanitary commission now in this country. Dr. Oscar Bernhard, of St. Moritz, another member of the commission, whose name will be remembered as the pioneer of the open- air and sun treatment of surgical wounds, hopes to be able to introduce insolation treatment for the unhealed wounds of war. At 3000 feet the proportion of ultra-violet rays in the light is naturally much higher than that at sea-level. To avoid needless idleness and its results the internes are encouraged to work at the trades at which they are most competent, and an endeavour is made to find occupation for those who have no trade or skill. Many take up gardening, others engage in shoemaking, tailoring, and laundry-work, or act as barbers. Newspapers and books are usually furnished by some charitable society from home, and wherever there are prisoners there are small libraries springing up. Among a certain group of internés a volun- tary worker is supplying free of charge to them any technical books required for their work, and this might well be done by some public-spirited person for those at Château d’Oex. What has been said about restrictions applies only to private soldiers. Interned officers occupy entirely separate quarters and are practically free to move as they like. At night they are to report at their quarters unless they are living with their own family. ’ On Tuesday, May 30th, the first two trains arrived at Chateau d’Oex, bringing British wounded prisoners of war ’ from German camps. The total for this day was 217 men and 30 officers. A reception had been organised to welcome the soldiers and a crowd of some 5000 witnessed the touching scene. The men are all badly wounded, many were on crutches, many had lost an arm, or a leg, or an eye. The ladies of the ’- British Colony had organised a tea for the soldiers, and speeches of welcome were delivered by the British Minister, 1 Mons. Favrod-Coune, the Deputy, and the Rev. E. Dudley i Lampen, the British chaplain. On Wednesday, May 31st, another contingent of 140 men arrived. We learn from Mr. Lampen that the soldiers have been i put up at the various hotels and pensions under the care of t the Swiss military doctors, that all are doing well in the fine mountain air, and that there are only a few hospital cases. E At the end of June a third contingent of 100 men is expected r at Chateau d’Oex, which will bring the total received in the t valley to some 500 men. - ON June 6th and 7th a war fair on behalf p of the funds of the Wounded Allies Relief, Committee was held at the Caledonian Market, Islington. The fair took the form of a monster rummage sale, and was opened on the first day by the Lord Mayor. The City of London gave the use of the market, and the allied countries and the colonies were represented by special stalls. The attend- ance was good on the first day. A NEW AMBULANCE TRAIN FOR THE NAVY.- During the coming Whitsuntide the Lords Commissioners of the Admiralty have given permission for the exhibition, at Addison-road Railway Station, Kensington, W., of a new naval ambulance train which has just been handed over to them by the London and North-Western Railway. The train will form the latest example of ambulance transport. It is 600 feet long and equipped to meet the special require- ments of the Admiralty. There are 12 coaches serving as wards, where the patients are carried in cots slung as on board ship. This enables a wounded man to be transferred from the ship to the train without being taken out of his cot. A charge of ls. will be made to visitors, and the proceeds will be given to the Dreadnought Hospital for Seamen, Greenwich. BRITISH SPORTSMEN’S AMBULANCE FUND.-This Fund has been organised at the National Sporting Club. At a luncheon at the club on Monday last, presided over by Lord Lonsdale, Mr. James White explained the great need of ambulances at many points on our line and the lines of our Allies in France, and it was decided to attempt to provide a fleet of at least 100 ambulance cars at a cost approximately of £400 each car. All subscriptions should be addressed to the Honorary Treasurer of the Fund at the National Sporting Club, Covent Garden, London, W.C. They will be acknowledged in the press. Medical News. UNIVERSITY OF OXFORD.-The degree of Doctor of Medicine has been conferred upon John Howell Evans. APOTHECARIES’ HALL OF IRELAND.-The next pro- fessional examinations of the Apothecaries’ Hall of Ireland will commence on the following dates: Primary Profes- sional, Monday, July 3rd; Intermediate, Part 1, Monday, July 10th ; Intermediate, Part 2, Monday, July 17th; Final Professional, Monday, July 24th. CHADWICK LECTURES ON MEASLES. - At the second Chadwick lecture on Measles 1 the chairman, Sir James Crichton-Browne, said that he hoped the Compulsory Notification Order would open the eyes of the public to the seriousness of the disease. It was indeed a deadly scourge, accounting for some 11,000 deaths annually, nine-tenths of which were in the first five years of life, and in a host of cases crippling where it did not kill. The death-rate alone gave therefore a wholly inadequate picture of its devastating character. Dr. H. J. Cates opened with the dogmatic state- ment that notification would prove to be the keystone of the arch of any administrative system of control of measles. He dealt with the objections which had been raised to notification, and with regard to the cost he estimated the value of a saved life to the community at JE200 to £300, a sum which would pay for some 4000 notifi- cations at the "war price." He called attention to the gratifying fact that in Birmingham already parents are now notifying almost as many cases as doctors. The remainder of the lecture was occupied with a discussion of various administrative measures for dealing with the disease. The lecturer was entirely in agreement with the late Sir Richard Thorne Thorne, who 20 years ago saw the necessity of com- bining all such measures if any effective control was to be obtained. Each suspected case must be followed up (1) promptly ; (2) by a woman who is a trained nurse of expe- rience or by an instructed health visitor; and (3), most im- portant of all, by one in possession of local knowledge. In case of an extensive epidemic with which the permanent staff was insufficient to deal, temporary workers should be taken on to relieve the staff in their other work and not to visit bhe measles cases. Finally, continuous revisitation was ssential, and it was in this point that some otherwise well- .aid schemes had failed. The instructions for home nursing night be left to the various local associations to formulate ;heir own rules, but a useful model had already been drawn ip by the Central Council for District Nursing in London.2 1 The first lecture was noticed in THE LANCET of June 3rd, 1916, p. 1151. 2 The rules summarised in THE LANCET of March 4th, 1916, p. 525.
Transcript
1197
Leysin, Montana, Davos, and Arosa. Orthopaedic institu-tions are provided, or are in course of preparation,and there is a large surgical hospital in Lucerne where anymajor surgery will be performed by first-rate operators.There are already some 9000 Frenchmen interned in
Switzerland, a large number of Belgians, more than 3000Germans, and it is anticipated that more than 500 Englishinvalid prisoners will be released. The British interngs willat present be stationed at Chateau d’Oex, one of the
most delightful subalpine spots in the Bernese Ober-
land, and at other villager such as G’staad in the same
upland valley. Chateau d’Oex is more than 3000 feet abovesea-level, and both as health-resort and sport centre has
enjoyed some little popularity among British travellers forten years past. There is still, even during war-time, asmall English colony, and the British chaplain, Rev. E.Dudley Lampen, is chairman of the local committee which isto assist in providing comforts and luxuries for the men.The whole system has now been tried with French
and German internés for some three months and hasworked exceedingly well. A few prisoners have triedto escape, but these were all recaptured before theyleft Switzerland. Nothing would be gained if they wereto reach their native land, because, according to agree-ment, they must then be returned to Switzerland. Mostof them are, of course, so gravely invalided that theywould be incapable of doing military work for at leasttwelve months. The threat that if a man behaves badlyhe will be returned to his prison-camp is used as a
simple and effective means of enforcing discipline, but therehas been no need as yet of putting it into execution ina single case. Captain F. Schwyzer, of Kastanienbaum,Lucerne, is the officer in charge of the department of Britishinternment; he is a Swiss medical man who has livedin America and is one of the members of the sanitarycommission now in this country. Dr. Oscar Bernhard, ofSt. Moritz, another member of the commission, whosename will be remembered as the pioneer of the open-air and sun treatment of surgical wounds, hopes to beable to introduce insolation treatment for the unhealedwounds of war. At 3000 feet the proportion of ultra-violetrays in the light is naturally much higher than that atsea-level.To avoid needless idleness and its results the internes are
encouraged to work at the trades at which they are mostcompetent, and an endeavour is made to find occupation forthose who have no trade or skill. Many take up gardening,others engage in shoemaking, tailoring, and laundry-work,or act as barbers. Newspapers and books are usuallyfurnished by some charitable society from home, andwherever there are prisoners there are small libraries
springing up. Among a certain group of internés a volun-tary worker is supplying free of charge to them anytechnical books required for their work, and this mightwell be done by some public-spirited person for those atChâteau d’Oex.What has been said about restrictions applies only to
private soldiers. Interned officers occupy entirely separatequarters and are practically free to move as they like. At
night they are to report at their quarters unless they areliving with their own family. ’
On Tuesday, May 30th, the first two trains arrived atChateau d’Oex, bringing British wounded prisoners of war ’from German camps. The total for this day was 217 menand 30 officers. A reception had been organised to welcome the soldiers and a crowd of some 5000 witnessed the touchingscene. The men are all badly wounded, many were on crutches, many had lost an arm, or a leg, or an eye. The ladies of the ’-British Colony had organised a tea for the soldiers, and speeches of welcome were delivered by the British Minister, 1Mons. Favrod-Coune, the Deputy, and the Rev. E. Dudley iLampen, the British chaplain. On Wednesday, May 31st, another contingent of 140 men arrived. We learn from Mr. Lampen that the soldiers have been i
put up at the various hotels and pensions under the care of tthe Swiss military doctors, that all are doing well in the fine mountain air, and that there are only a few hospital cases. EAt the end of June a third contingent of 100 men is expected rat Chateau d’Oex, which will bring the total received in the tvalley to some 500 men.
-
ON June 6th and 7th a war fair on behalf pof the funds of the Wounded Allies Relief, Committee
was held at the Caledonian Market, Islington. The fairtook the form of a monster rummage sale, and was openedon the first day by the Lord Mayor. The City of Londongave the use of the market, and the allied countries andthe colonies were represented by special stalls. The attend-ance was good on the first day.A NEW AMBULANCE TRAIN FOR THE NAVY.-
During the coming Whitsuntide the Lords Commissioners ofthe Admiralty have given permission for the exhibition, atAddison-road Railway Station, Kensington, W., of a newnaval ambulance train which has just been handed over tothem by the London and North-Western Railway. Thetrain will form the latest example of ambulance transport.It is 600 feet long and equipped to meet the special require-ments of the Admiralty. There are 12 coaches serving aswards, where the patients are carried in cots slung as onboard ship. This enables a wounded man to be transferredfrom the ship to the train without being taken out of hiscot. A charge of ls. will be made to visitors, and theproceeds will be given to the Dreadnought Hospital forSeamen, Greenwich.
BRITISH SPORTSMEN’S AMBULANCE FUND.-ThisFund has been organised at the National Sporting Club.At a luncheon at the club on Monday last, presided over byLord Lonsdale, Mr. James White explained the great needof ambulances at many points on our line and the lines of ourAllies in France, and it was decided to attempt to providea fleet of at least 100 ambulance cars at a cost approximatelyof £400 each car. All subscriptions should be addressed tothe Honorary Treasurer of the Fund at the National
Sporting Club, Covent Garden, London, W.C. They willbe acknowledged in the press.
Medical News.UNIVERSITY OF OXFORD.-The degree of Doctor of
Medicine has been conferred upon John Howell Evans.
APOTHECARIES’ HALL OF IRELAND.-The next pro-fessional examinations of the Apothecaries’ Hall of Irelandwill commence on the following dates: Primary Profes-sional, Monday, July 3rd; Intermediate, Part 1, Monday,July 10th ; Intermediate, Part 2, Monday, July 17th; FinalProfessional, Monday, July 24th.
CHADWICK LECTURES ON MEASLES. - At thesecond Chadwick lecture on Measles 1 the chairman, SirJames Crichton-Browne, said that he hoped the CompulsoryNotification Order would open the eyes of the public to theseriousness of the disease. It was indeed a deadly scourge,accounting for some 11,000 deaths annually, nine-tenths ofwhich were in the first five years of life, and in a host ofcases crippling where it did not kill. The death-rate alonegave therefore a wholly inadequate picture of its devastatingcharacter. Dr. H. J. Cates opened with the dogmatic state-ment that notification would prove to be the keystoneof the arch of any administrative system of control ofmeasles. He dealt with the objections which had beenraised to notification, and with regard to the cost heestimated the value of a saved life to the communityat JE200 to £300, a sum which would pay for some 4000 notifi-cations at the "war price." He called attention to thegratifying fact that in Birmingham already parents are nownotifying almost as many cases as doctors. The remainderof the lecture was occupied with a discussion of variousadministrative measures for dealing with the disease. Thelecturer was entirely in agreement with the late Sir RichardThorne Thorne, who 20 years ago saw the necessity of com-bining all such measures if any effective control was tobe obtained. Each suspected case must be followed up(1) promptly ; (2) by a woman who is a trained nurse of expe-rience or by an instructed health visitor; and (3), most im-portant of all, by one in possession of local knowledge. In caseof an extensive epidemic with which the permanent staff wasinsufficient to deal, temporary workers should be taken onto relieve the staff in their other work and not to visitbhe measles cases. Finally, continuous revisitation wasssential, and it was in this point that some otherwise well-.aid schemes had failed. The instructions for home nursingnight be left to the various local associations to formulate;heir own rules, but a useful model had already been drawnip by the Central Council for District Nursing in London.2
1 The first lecture was noticed in THE LANCET of June 3rd, 1916,p. 1151.
2 The rules summarised in THE LANCET of March 4th, 1916, p. 525.
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Hospital accommodation must be provided at any cost forthose cases too ill to be nursed at home or housed in unsuit-able surroundings. For such cases even in hospital a highmortality must be faced. In the St. Helens epidemic it hadapproached 18 per cent., and the experience of the Metro-politan Asylums Board was to the same effect. In regard tothe control of contacts, adults might be left out of considera-tion. Dr. William Butler’s figures for Willesden had shownthat 97 per cent. of children over 15 years of age had alreadyhad measles and were therefore practically immune. Of
school measures the attempt in recent years to control
infection by closing the school on the ninth day after aninfected child had been introduced for a period of five or sixdays, during which an incubating child would presumablysicken at home, had been favourably reported upon. Itmust, however, never be forgotten that the control ofmeasles was not primarily a school attendance question,because the cases were principally below school age.
PUBLIC HEALTH IN ABERDEEN : REPORT OF MEDI-CAL OFFICER OF HEALTH.-Dr. Matthew Hay, the medicalofficer of health of the city of Aberdeen, has issued hisreport for 1914, and also abbreviated reports for 1915 by themedical officer of health and the sanitary officer. Referringto the popular belief that during or after great wars the pro-portion of males to females born increases, the report saysthat the proportion of boys to girls born in 1915 was 100’5 to100. Only in one year since 1907 were fewer boy babies bornin Aberdeen. As to the outcry about war babies," inAberdeen, a garrison town, the proportion of illegitimatebirths in 1914 was 9’4 per cent. of the total number of births,which was lower than any year since 1908. In 1915 thepercentage was 10-0 of the total births. In fact, illegitimacyhas decreased since war began. In 1915 the percentage ofmarriages was equal to 11’3 per 1000 of the population, byfar the largest rate ever recorded in the city sinceregistration began. Irregular (so-called) marriages havegreatly increased in number, undoubtedly owing to thewar. During 1915 the death-rate was equivalent to18-6 per 1000. This is the highest death-rate in any yearsince 1900. The average age at death was 36’3 years, asagainst an average of 37’9 for the preceding ten years.The excessive mortality during 1915 was mainly due toa considerable increase in deaths from lung diseases(pneumonia and bronchitis), from measles and whooping-cough, from diseases of the digestive system, and fromatrophy and debility. The recorded death-rate from cancerand other malignant diseases was the highest since thecommencement of civil registration. The death-rate frompneumonia was 128 per 100,000. This is also the highestrecorded rate with the exception of the year 1902, when therate was 134 per 100,000. Scarlet fever was more prevalentthan in any year since the commencement of notificationin 1881. The case mortality was 7’7 per cent., or nearly threetimes the average for the three preceding years. Scarletfever may be said to have been continuously epidemicin Aberdeen since 1908, with the exception of a smallrecession in 1910. There were 675 notifications ofdiphtheria in 1915, as against 1627 in 1914 and 2062in 1913. The case mortality was 7’5 per cent., slightlyabove the average for the preceding ten years. Dr.Hay alludes to the suggestion that the extensive use ofgas-cookers for heating apparatus in houses, especiallywhere no provision was made for carrying the fumesof the burned gas into a chimney, might have someconnexion with the excessive prevalence of diphtheriain the last three years. But he says that his inquiriesproved that the proportion of households with gas-cookerswas exactly the same for diphtheria and scarlet fever,and that this fact would seem to point to the con-
clusion that gas-cookers had no predisposing effect fordiphtheria, unless it were assumed that the effect existed,bd was equally strong for both diseases. This, he thinks,is not likely to be the case. The suggested predisposingeffect was merely the possible effect of the combustionproducts of gas, and also of the undue heating of theatmosphere, in rendering the throat more susceptible todiphtheria infection. Against the suggestion there is alsothe fact that gas-cookers are probably as extensively usedin many other large towns as in Aberdeen, and yet in manyof these towns there has been no unusual increase indiphtheria such as Aberdeen has experienced. There were19 cases of epidemic cerebro-spinal meningitis reported, 14 ofwhich ended fatally. The cases included 6 soldiers and1 officer, all of whom except one died.
EMIGRATION FROM IRELAND.-During 1915 thenumber of persons who left Ireland was the lowest recordedsince 1851, when the collection of emigration returns began.The total number of emigrants in 1915-6671 males and 4121females-was 10,792, being 2-4 per 1000 of the estimatedpopulation. It appears that 83’6 per cent. of the personswho left Ireland in 1915 were between the ages of 15 and 35,as compared with 86’6 in 1914. The United States was thedestination of 6681 emigrants in 1915.
Parliamentary Intelligence.NOTES ON CURRENT TOPICS.
The Whitsun Recess.PARLIAMENT has risen for the Whitsun recess. The-
House of Commons resumes on Tuesday, June 20th. So>long as the war continues it seems unlikely that Parliamentwill take a continuously extended holiday.
The Supply of Petrol.A preliminary report has been made by the committee
appointed by the Board of Trade to control the supply anddistribution of petrol. It indicates directions in which theuse of petrol for pleasure purposes may be restricted. It is.hoped that the detailed recommendations will soon be avail-able. The Board of Trade anticipates that action wiltthen immediately be taken.
HOUSE OF COMMONS.
WEDNESDAY, MAY 31ST.Artificial Limbs for Soldiers and Sailors. ,
Mr. BARNES asked the Secretary to the Admiralty whether,,although injury pensions were granted to soldiers andsailors who had lost a limb, or limbs, in the defence of theircountry, they were dependent upon charity for the supply of.the necessary artificial limbs.-Mr. MACNAMARA replied: Allartificial limbs for soldiers and sailors rendered necessary byinjuries received on service are supplied in the first placeand subsequently repairs carried out or replacement whennecessary made at the expense of the Admiralty, War Office,or Greenwich Hospital funds. The particular class of limlrfitted is decided on by skilled orthopaedic surgeons, bearingin mind the man’s probable future employment. No sailorsor soldiers are dependent on charity for such appliances.
British Red Cross Units in Italy.Mr. ELLIS GRIFFITH asked the Under Secretary for War
how many British subjects of military age were engaged inthe British Red Cross units in Italy; and what authoritygranted them exemption from military service.-Mr.TENNANT answered: There is at present no completereturns of the numbers employed in British Red Crossunits in Italy in possession of the Army Council. There isno rule excepting these men from military service, but thosewho are classified in medical categories which are not beingcalled up are not interfered with.
Chief Medical Officers in Dardanelles and Mesopotamia.Mr. SHIRLEY BENN asked the Under Secretary for War
whether he would give the name of the chief medical officerwith the Expeditionary Force at the Dardanelles, and also,the name of the medical officer who had the responsibility inregard to medical provision for the expedition to Mesopotamia.- Mr. TENNANT said, in reply : The Director of Medical Ser-vices of the Expeditionary Force at the Dardanelles was, first,Surgeon-General Birrell, and later, Surgeon-General Bedford.The arrangements for the Mesopotamian Expedition weremade by the Government of India, and Surgeon-GeneralHathaway was the Director of Medical Services of the Force.Surgeon-General Sir W. Babtie was Director of MedicalServices in India at the time.
The National Insurance Act.Mr. CURRIE asked the representative of the National
Insurance Commissioners whether, in view of the emphasislaid by the report of the investigation committee upon thefacts that when the Insurance Act was passed the prospectwas held out to insurers that they would receive a directbenefit from the wisdom of their choice of a society, and’that, in view of the committee, the insurance scheme as awhole cannot possibly be said to satisfy the usual require-ments of a flat-rate system, it was intended to introducefurther legislation.-Mr. CHARLES ROBERTS wrote in reply :.The interim report of the Departmental Committee is nowunder consideration by the Treasury.
THURSDAY, JUNE 1ST.Prisoners of War in Germany.
Major HUNT asked the Secretary for Foreign Affairs.whether his attention had been called to the statements oftotally disabled British soldiers just returned from Germanyto the effect that the food was so bad that rats would not eatit, and that British soldiers with wounds still unhealed werecompelled to dig trenches.-Sir EDWARD GREY replied: TheGovernment Committee on the Treatment by the Enemy ofPrisoners of War will, no doubt, shortly take the evidence ofthe disabled British soldiers recently returned from Germanyand the evidence will receive our careful consideration.
The Production oJ Optical Glass.Major CHAPPLE asked the Minister of Munitions, whether,
before committing himself to any encouragement to the,
