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351 accidents, operations, and illnesses with the name of the doctor to whom reference may be made." I couldn’t resist the temptation of putting the list in reverse order the second time, but I hope I didn’t upset the filing system. Will Johnny’s mother have greater confidence in me when I increase his feeds to 6 scoops of N.D.M. if my Pott’s preceded my piles ? Will Dr. R.I.P. object to being dis- turbed to write a report on the state of my fundi at his last consultation, so that I can do four hours work for our local authority ? This was the hardest paper I had yet endured. In retrospect, how pleasant those Membership ones were -three hours to write as much as you liked on unlimited paper answering five questions. But a bargain’s a bargain, so I faithfully plodded on to the last question, fearful lest I should let Osbert down. This morning’s post brought my reward in duplicate. My services have been accepted as " part-time home help at 2s. per hour." Next time I’ll pay my locum in hard cash-it’s easier than i.Q. examinations for scrubbing floors. * * * It is now generally realised that even vertebrae have feelings and sometimes get tired. Thus to a small unit in the backbone of our profession after a few dozen 150-hour weeks a holiday in Scotland is something worth writing about. Papers did not come till midday. Letters were delivered by the local bus, and the wireless was seldom heard. The chief topics of conversation were the weather and the size of the trout daily retrieved from the nearby loch. Our only approach to medicine was the bismuth bottle in which we carried the milk for our picnic teas. We saw deer run and salmon leap. We climbed hills and hit golf balls. We ate porridge and fried trout. We spent our nights in bed and forgot Bevan. Finally three tired doctors began to change from dry bones to live humanity. Too soon my 2200 units called me home and now the drying process has started again. It isn’t pleasant at first, but one gets used to it. After all I suppose it is something to be a spicule of bone or even the tip of a coccyx in the backbone of the N.H.S. weeK as -une many posuponements wmcn our commit- ments had caused were delaying the whole club tourna- ment. We therefore decided to play the match on the following Wednesday and if either of us was unable to turn up then the other would be considered the winner. I worked hard all Wednesday morning and completed my visiting by one o’clock. I enjoyed an unhurried lunch and reached the club in plenty of time. I was disappointed to see Dr. Putter arrive exactly on time as I was just beginning to contemplate a suitable celebration for my win. At the tenth hole I was four up when we saw the club steward running towards us. By pretending not to notice him we played another hole which I won ; but the steward was waiting for us on the twelfth tee and told me I was wanted on the phone. Anxious but still hopeful I went back to the club-house and found that I was needed urgently on the other side of the town. I had no alternative but to drive over to the patient’s address. The door was opened to me by the patient’s wife who very sweetly said, " Ah, doctor, I am so sorry to have troubled you, but our doctor, Dr. Putter, is out on an urgent case and your wife said you were only playing golf." I have since heard that Dr. Putter has been recommended for an honorary degree in gamesmanship. * * * " Old piles projecting from the bottom often prove a nuisance, and operators are called on to cut them off. If large, sawing them will be found very difficult, and the proper method of doing the job is to run through a series of auger holes close together and cut away the remainder with a chisel." A Ministry of Health memo ? No; instructions to deep- sea divers. Notes and News THE SCIENTIST’S SALARY WHATEVER may be said against salary-scales, they do at least enable the earner to measure his prospects. In a report on the economic position of (non-medical) scientists, the Association of Scientific Workers vigorously attacks indus- trial concerns for refusing to accept negotiated scales-a refusal which is the cause of " an outstanding grievance of the scientific and technical staffs." "It is certain," the report observes, " that the scientific and technical workers of graduate standing in industry are the lowest-paid of qualified staffs." That qualified scientists in industry are not richly rewarded is suggested by the association’s estimate of salaries in 1948. It was found that at 35-40 years of age chemists were earning on average £933 per annum, physicists $870, and engineers and metallurgists £ 700 ; and these figures include Civil Servants and others whose salary-scales are above the average. Elsewhere some progress has been made ; scientists in the universities, in medical research, and in the Civil Service, though still, in the association’s view, at a disadvantage vis-a-vis doctors, dentists, and opticians, now receive salaries which bear some relation to those of their medical colleagues. Thus in the University of London the scale for full-time non-medical readers is £1050-£1450 and for lecturers £600-£1150 ; while for posts in the preclinical medical schools the corresponding figures are £1200-£1800 and £800-£1100. Similarly, the Civil Service offers to graduate scientists a career in which, at the top of the principal scientific officer grade, they will be earning £1220 a year in London or £1180 in the provinces. The main theme of the report is that examination, " especially among scientific and technical workers in industry and the research associations, will reveal that these professional workers are poorly paid- relatively worse paid in fact than they were before the war- and that a wide gulf separates them from the salary levels considered appropriate for professional workers in the National Health Service." ’ EPIDEMIC DISEASE IN HOSPITAL IN the light of this year’s outbreak of smallpox in the west of Scotland,2 the Ministry of Health has reviewed the arrangements for cooperation between hospitals and medical officers of health in the control of epidemic diseases, and for the protection of hospital staffs who are liable to be exposed. A memorandum to hospital authorities (R.H.B. [50] 75) urges that the M.O.H. should have the earliest possible information about actual or suspected cases of such diseases as smallpox and enteric fever in any hospital. " Boards should now examine the existing arrangements for cooperation between hospitals and medical officers of health to ensure that they are comprehensive, fully worked out, and generally understood." The standing arrangements should also provide for : (1) consultation with the M.o.H. on preventive measures within the hospital, and (2) transmission by the M.o.H. to the hospital authorities of information on the incidence of epidemic disease. As regards smallpox vaccination, all nurses and others -liable to infection should be protected. In all hospitals the staff records should contain accurate information about the vaccinal state. In hospitals where the staff are especially at risk all recruits should be offered vaccination unless there is clear evidence that this has recently been done. The staff in post should be offered vaccination or revaccination at least once every three years. If a case of smallpox or a contact arrives at the hospital or is likely to be admitted, steps should immediately be taken to offer vaccination to all the staff, and their vaccinal state should be carefully checked. " The medical superintendent or other responsible medical officer should interview any members of the staff who refuse vaccination, to explain their position. He will also be responsible for any necessary arrangements for such members ceasing to work... where a special risk of infection exists." In hospitals designated for the reception of smallpox cases, all members of the staff should be protected at all times by periodic revaccination ; and they should also, if possible, be revaccinated before the first case is admitted. The vaccination procedure recommended in the memorandum 1. The Economic Position of the Scientific Worker. Published by the Association of Scientific Workers, 15, Half Moon Street, London, W.1. Pp. 23. 6d 2. See Lancet, 1950, i, 1094.
