1194 the occasion for the above finding, was contained principally in the evidence of a druggist, who stated that for several years he had supplied the deceased with bottles of medicine in extraordinary quantities, for which frequently she used to send her children or the children of neighbours. A great deal of z, this medicine was ostensibly under a prescription. The prescription provided for 2 drachms of morphia, but the druggist, recognising the craving of his customer for this drug, reduced the morphia to 112 drachms, and finally, when she asked that the medicine should be supplied in larger quantities and in greater strength, gave her no morphia in two out of the three bottlesful that she was consuming daily. At a later period she was having three bottles a week of the medicine containing morphia, her purchases being made up to three bottles a day with tonics and purgatives. Among the tonics she used was one containing strychnine, of the danger of which he warned her, but there was no warning written on the bottle last sold to her before her death. Medical evidence based upon the post-mortem examination was given to the effect that death was due to strychnine and not to morphia. The law does not forbid unlimited repetition in the making up of a prescription, and probably such a limit in all cases would be resented by the public, however desirable it may appear to the medical profession. It would be easier to impose and to enforce limits to the use of any prescription containing certain specified drugs. Probably nothing, except, possibly, the efforts of relatives, would have hindered the woman in this case from drugging herself. AN ERROR IN DISPENSING. An action of an unusual character was tried recently by Lord Darling and a special jury. The plaintiffs were Mr. R. R. Boyd and his young son, Geoffrey R. Boyd, and the defendants, Messrs. Savory and Moore, Limited, were sued on the ground of their alleged negligence in dispensing a prescription for the use of the son. In defence they denied negligence, and pleaded that they had acted reasonably in reading the prescription in question, and further that the plaintiff, Geoffrey Boyd, had suffered no damage through their act. Geoffrey Boyd, 22 years of age, was from the age of 11 years subject to epileptic fits, and in 1922 Dr. Henry Head gave for his use a prescription for medicine to contain 1 t gr. of luminal sodium. The defendants made up this prescription at various dates from May, 1922, to March, 1923, and misreading the amount of luminal sodium ordered, always compounded it with half a grain, instead of a grain and a half. The plaintiffs alleged that through this error the youth’s recovery was delayed at a time when he was expecting to go into his father’s business, and damages were claimed accordingly. Dr. Head, called on behalf of the plaintiffs, described luminal sodium as a " tricky drug," and in answer to a question from Lord Darling said that it was impossible to tell whether a grain and a half would have had any influence in the patient’s favour. He explained the circumstance in which he had prescribed it, and in reply to Mr. Eastham, K.C., counsel for the defendants, stated that he was unable to say that the omission of a grain of luminal sodium every night for ten months, the period of the prescription, had had any material effect on the course or progress of the epilepsy. As far as he could say the omission had done no harm. After reference by Mr. Eastham to the " rather misleading " character of the writing of the pre- scription, Dr. C. Hinds Howell gave evidence in support of the view that the absence of a grain of luminal sodium had made no difference to the epilepsy, and said that half a grain was a common amount to prescribe. Sir William Willcox agreed, and added that he had first dealt with luminal sodium as a hypnotic in lectures in 1913. It was first used for epilepsy at some time during the war, but was very often ineffective with regard to epilepsy in any dose. In reply to questions raised by the jury, Sir William Willcox said that there was no recognised cure for epilepsy, and that continued use in large doses of such a drug as luminal sodium might cause mental degeneration. He should not attribute an increase in the plaintiff’s fits to the diminution in the luminal sodium administered to him. The jury were unable to arrive at an agreement as to their verdict and were discharged. Mr. Justice Darling gave judgment for the defendants with costs; on the ground that there had been no evidence to go before the jury of any damage resulting from the alleged negligence, even if there had been negligence. A stay of execution was granted in view of a possible appeal. ROYAL SOCIETY OF MEDICINE. THE ANNUAL DINNER. THTR annual dinner of the Royal Society of Medicine was held on Nov. 26th at the Hotel Victoria, London, Sir StClair Thomson, the President, presiding over an assembly of some 400 persons. Since their election to the Society women have, of course, been present at the annual dinner, but necessarily only in small numbers. The innovation on this occasion was the permission to members to bring guests of either sex, and the result was to make of the gathering a large series of small dinners flanked by one long, high table. After the loyal toasts, Sir Auckland Geddes proposed the Prosperity of the Royal Society of Medicine, laying stress on the tact that the great work of the Society, though done directly for the profession, resulted in enormous benefit to the public. The general facilities of the Society, and especially the library, enabled a large mass of doctors to keep abreast, either by the work of the sections or b v the consultation of references, with their science. In speaking of the Transactions of the Society, he pointed out, that, while there were 4000 members on the roll, their com- munications to the proceedings were included in 2000 pages. He raised considerable laughter by wondering when the House of Commons would have rules whereby the average in " Hansard " was only half a page per M.P. Sir StClair Thomson, replying for the toast, pointed out that the motto of the Society was " Life is not worth living if it is not lived well," and commenced his speech by a versicle regretting that speeches had to be made, for, he said :- " I like the talk that comes between The pottage and the peaches ; But hail with a dejected mien The speeches." After a criticism of the inarticulateness of Englishmen he paid an eloquent tribute to the prevision of the late Sir Andrew Clark and the devoted service of Sir John AlacAlister who, he said, was absent upon his doctor’s strict directions. " The ideal," he said, " to which we have attained was foreshadowed by Sir Andrew Clark when he held in 1892-93 the position of President. His wise imagination bodied forth the objects of our existence in the words : ’A Royal Academy of Medicine is calculated to bring together for their common help all the investigators in the various departments of medicine.’ Sir Andraw Clark died a few months after, but 15 years had to pass before what he had imagined attained a local habitation and a name. And thereby hangs a regret. For he, who wielded the English language so gracefully, had suggested the title of ’Academy ’ for our body, just as Mr. James Berry at this table in 1922, when speaking as President of the Medical Society, said that, being a collection of societies, the title of ’ Academy ’ was much more appropriate. That may come yet. But it is only a family matter whether we call ourselves a society or an academy. This amalgamation, shadowed
Transcript
1194
the occasion for the above finding, was containedprincipally in the evidence of a druggist, who statedthat for several years he had supplied the deceasedwith bottles of medicine in extraordinary quantities,for which frequently she used to send her childrenor the children of neighbours. A great deal of z,this medicine was ostensibly under a prescription.The prescription provided for 2 drachms of morphia,but the druggist, recognising the craving of hiscustomer for this drug, reduced the morphia to112 drachms, and finally, when she asked that themedicine should be supplied in larger quantities andin greater strength, gave her no morphia in two outof the three bottlesful that she was consuming daily.At a later period she was having three bottles a weekof the medicine containing morphia, her purchasesbeing made up to three bottles a day with tonics andpurgatives. Among the tonics she used was onecontaining strychnine, of the danger of which hewarned her, but there was no warning written on thebottle last sold to her before her death. Medicalevidence based upon the post-mortem examinationwas given to the effect that death was due tostrychnine and not to morphia.
The law does not forbid unlimited repetition in themaking up of a prescription, and probably such a limitin all cases would be resented by the public, howeverdesirable it may appear to the medical profession.It would be easier to impose and to enforce limitsto the use of any prescription containing certainspecified drugs. Probably nothing, except, possibly,the efforts of relatives, would have hindered thewoman in this case from drugging herself.
AN ERROR IN DISPENSING.
An action of an unusual character was triedrecently by Lord Darling and a special jury. Theplaintiffs were Mr. R. R. Boyd and his young son,Geoffrey R. Boyd, and the defendants, Messrs. Savoryand Moore, Limited, were sued on the ground of theiralleged negligence in dispensing a prescription forthe use of the son. In defence they denied negligence,and pleaded that they had acted reasonably in readingthe prescription in question, and further that theplaintiff, Geoffrey Boyd, had suffered no damagethrough their act. Geoffrey Boyd, 22 years of age,was from the age of 11 years subject to epileptic fits,and in 1922 Dr. Henry Head gave for his use aprescription for medicine to contain 1 t gr. of luminalsodium. The defendants made up this prescriptionat various dates from May, 1922, to March, 1923,and misreading the amount of luminal sodiumordered, always compounded it with half a grain,instead of a grain and a half. The plaintiffs allegedthat through this error the youth’s recovery wasdelayed at a time when he was expecting to go intohis father’s business, and damages were claimedaccordingly. Dr. Head, called on behalf of theplaintiffs, described luminal sodium as a " trickydrug," and in answer to a question from Lord Darlingsaid that it was impossible to tell whether a grainand a half would have had any influence in thepatient’s favour. He explained the circumstance inwhich he had prescribed it, and in reply to Mr.Eastham, K.C., counsel for the defendants, statedthat he was unable to say that the omission of agrain of luminal sodium every night for ten months,the period of the prescription, had had any materialeffect on the course or progress of the epilepsy.As far as he could say the omission had done noharm.
After reference by Mr. Eastham to the " rathermisleading " character of the writing of the pre-scription, Dr. C. Hinds Howell gave evidence in supportof the view that the absence of a grain of luminalsodium had made no difference to the epilepsy, andsaid that half a grain was a common amount toprescribe. Sir William Willcox agreed, and addedthat he had first dealt with luminal sodium as ahypnotic in lectures in 1913. It was first used forepilepsy at some time during the war, but was veryoften ineffective with regard to epilepsy in any dose.
In reply to questions raised by the jury, Sir WilliamWillcox said that there was no recognised cure forepilepsy, and that continued use in large doses ofsuch a drug as luminal sodium might cause mentaldegeneration. He should not attribute an increasein the plaintiff’s fits to the diminution in the luminalsodium administered to him.
The jury were unable to arrive at an agreementas to their verdict and were discharged. Mr. JusticeDarling gave judgment for the defendants with costs;on the ground that there had been no evidence to gobefore the jury of any damage resulting from thealleged negligence, even if there had been negligence.A stay of execution was granted in view of a possibleappeal.
ROYAL SOCIETY OF MEDICINE.
THE ANNUAL DINNER.
THTR annual dinner of the Royal Society of Medicinewas held on Nov. 26th at the Hotel Victoria, London,Sir StClair Thomson, the President, presiding overan assembly of some 400 persons. Since their electionto the Society women have, of course, been presentat the annual dinner, but necessarily only in smallnumbers. The innovation on this occasion was thepermission to members to bring guests of either sex,and the result was to make of the gathering a
large series of small dinners flanked by one long,high table.
After the loyal toasts, Sir Auckland Geddes proposedthe Prosperity of the Royal Society of Medicine,laying stress on the tact that the great work of theSociety, though done directly for the profession,resulted in enormous benefit to the public. Thegeneral facilities of the Society, and especially thelibrary, enabled a large mass of doctors to keep abreast,either by the work of the sections or b v the consultationof references, with their science. In speaking of theTransactions of the Society, he pointed out, that, whilethere were 4000 members on the roll, their com-munications to the proceedings were included in2000 pages. He raised considerable laughter bywondering when the House of Commons would haverules whereby the average in " Hansard " was onlyhalf a page per M.P.
Sir StClair Thomson, replying for the toast, pointedout that the motto of the Society was " Life is notworth living if it is not lived well," and commenced hisspeech by a versicle regretting that speeches had tobe made, for, he said :-
" I like the talk that comes betweenThe pottage and the peaches ;
But hail with a dejected mienThe speeches."
After a criticism of the inarticulateness of Englishmenhe paid an eloquent tribute to the prevision of thelate Sir Andrew Clark and the devoted service of SirJohn AlacAlister who, he said, was absent upon hisdoctor’s strict directions. " The ideal," he said, " towhich we have attained was foreshadowed by SirAndrew Clark when he held in 1892-93 the positionof President. His wise imagination bodied forth theobjects of our existence in the words : ’A RoyalAcademy of Medicine is calculated to bring togetherfor their common help all the investigators in thevarious departments of medicine.’ Sir Andraw Clarkdied a few months after, but 15 years had to passbefore what he had imagined attained a local habitationand a name. And thereby hangs a regret. For he,who wielded the English language so gracefully, hadsuggested the title of ’Academy ’ for our body, justas Mr. James Berry at this table in 1922, when speakingas President of the Medical Society, said that, beinga collection of societies, the title of ’ Academy ’ wasmuch more appropriate. That may come yet. Butit is only a family matter whether we call ourselves asociety or an academy. This amalgamation, shadowed
1195
forth by Sir Andrew Clark, was the endorsement of ascheme at which another man had toiled for years ;not a medical man, mark you, but one who loved us as ’’a brother and in return we all wear him in our heart’score, aye, in our heart of hearts. He had worked ’!at it for more than five years before Sir Andrew died ;he toiled on it for 15 more years before it was accom-plished ; he has continued another 17 years to betterwhat he had already bettered. He has served thisSociety for 37 years. It has been his life’s work, andhe has given his life to it. It is only his doctor’sstrict orders which prevent our perpetual secretary,Sir John MacAlister, from being with us to-night."The President then acknowledged the valuable I
services of the hon. librarians, Mr. Walter Spencer andSir Humphry Rolleston, and the hon. treasurers, Mr.C. H. Fagge and Dr. Farquhar Buzzard, addingthat a great debt was due to Dr. Arnold Chaplin forundertaking to catalogue, mount, and index theSociety’s fine collection of over 4000 prints. Inthanking Sir Auckland Geddes for the terms in whichthe toast of the evening had been given, Sir,StClairThomson said : " You, Sir, in coming here to-nightand in proposing the health of our Society, have. Iassure you, added to your large troops of friends in thetwo hemispheres. You need not have taken thechairmanship of the Food Inquiry to gain the shortestway to our hearts. We all know and are proud of yourrecord. We have not forgotten that you went throughthe South African War as a lieutenant in the HighlandLight Infantry ; that as recently as 1908 you tookyour M.D. with the gold medal at Edinburgh, and thatlittle more than 10 years ago you were makingmodels in the dissecting room of McGill University inMontreal. Then came your last crowded ten years ofglorious devotion to your country-Member ofParliament, Director of Recruiting, Minister of NationalService, Minister of Reconstruction, President of theLocal Government Board, President of the Board ofTrade, Brigadier-General, gassed in France, Principalof McGill University, and His Britannic Majesty’sAmbassador to the United States. And you are notyet 46 1 In France the highest honour that can begiven a man is to put on record that he has deservedwell of his country. Anyone who visits the H6tel deVille in Paris will see that in the last ten years onlytwo names have been added to the lists on the walls-those of Clemenceau and Poincaré. Underneath themare written the simple and thrilling words, ’ Ils ontbien mérité de la patrie.’ You have deserved well ofyour country ; your profession is proud of you ; thissociety is most deeply grateful to you."
Sir George Blacker proposed the Health of the Guestsin a deliberately light vein, and referring to the posses-sion by women of the Parliamentary franchise, saidthat Sir Douglas Hogg’s electoral campaign had led tothe unheard-of situation in Harley-street and Wimpole-street that doctors were seen abroad with their wives.Until that occasion it seemed that the medical inhabit-ants of those streets could never appear with theirwives, some of the men being too busy, and theothers being engaged in pretending that they weretoo busy.
Sir Douglas Hogg, the Attorney-General, replied,and pointed out that his profession and that ofmedicine were the two strictest trade-unions in thecountry, and had this in common, that their unionismwas non-political, while the difference in status wasindicated by the fact that doctors, it seemed, could be Iproceeded against for lapses of conduct, when lawyers *enjoyed an immunity owing to the fact that they had Itaken care to make the laws. Speaking as Member for IMarylebone," a most important medical constituency,"
Ihe viewed with admiration the amount of gratuitouswork which was done by the medical profession, andhe wished that the poorer people of the country couldreceive the same service from lawyers, inasmuch as,during his tenure of office as Attorney-General, hehad seen many cases in which free legal assistance wasneeded almost as badly as free medical assistance.
SCOTLAND.
(FROM OUR OWN CORRESPONDENT.)
lJleasles and TFhoopirar-cozch in Edinburgh.OWING to an outbreak of measles and whooping-
cough in Edinburgh a letter was circulated to localpractitioners by the medical officer of health. Inthis notification is invited of first cases occurringin any family and payment of notification has beenapproved by the town council. The letter pointsout that the object of the notification is to informthe public health department of the existence ofcases of measles or whooping-cough, so that home
visitation by qualified fever nurses may be carriedout. If, however, a practitioner does not considerit necessary or desirable for visits to be paid by anurse, a statement to this effect is to be added to thenotification form. Where home environment isfound to be faulty or likely to be prejudicial to thehealth of those affected, removal to hospital will beundertaken. The letter terminates with an appealfor cooperation in order to reduce the death-ratefrom these diseases, especially among children under5 years of age. Since the adoption of this schemeof notification, 405 cases of measles and 113 cases ofwhooping-cough have come under notice. As long asthe epidemic was confined to the Leith area, whereapparently it had origin, one nurse was able to over-take the necessary visits, but with the extension ofthe diseases to Edinburgh, it was essential for a secondnurse to be employed. Up to the present the resultsfrom home visiting have not been very encouraging,and in cases where removal to hospital has beenconsidered advisable a certain amount of oppositionfrom parents has been encountered. In cases ofscarlet fever or diphtheria no protests have beenoffered to the removal of children to hospital, but inthe case of measles and whooping-cough, parents,not realising the dangers of these conditions, are
often reluctant to allow a child to go to hospital,considering home treatment quite sufficient. Anendeavour has been made to surmount this difficultyby means of propaganda. A statement is made tothe press by the medical officer of health in whichhe points out that measles and whooping-cough inyoung children cause a greater number of deaths thandiphtheria and scarlet fever, though the two latterare looked upon as much more serious maladies.
Edinburgh Royal Infirmary.I
Some interesting details with regard to the financial
position of the Edinburgh Royal Infirmary weregiven on Nov. 26th at the sixth annual meeting ofthe League of Subscribers, which was held at theOddfellows’ Hall, Forrest-road, under the presidencyof Mr. James Campbell. A report submitted by Mr.Russell Paton, the organising secretary, showed thatthe revenue obtained by systematic collections at
public works and places of business in the city andcountry"districts amounted to 220,904, or an increaseof nearly 2560 over subscriptionsobtained last yearfrom similar sources. From reliable estimates itwould seem that the individual membership of theLeague is now about 73,300 for Greater Edinburghand 23,200 for country districts. an increase of some2500 over last year’s figures. During the year 152new groups have been added to the League. Theworkers’ contributions from all sources have beenestimated at job40,000 per year, which shows how wellthe work of the institution is appreciated by theworking classes. The total expenditure of theinfirmary for the past year, it was stated, amounted toz127,500, or an increase of .S7700 compared with theprevious year. Against this, however, must beplaced .678,900 in legacies. An interesting item in thereport was the fact that the salaries of the seniornurses had been substantially increased. Referencewas made to the offer of ;B;30,000 by the RockefellerTrust for the erection of a clinical laboratory in theinfirmary grounds. It has been decided to accept the
