NOV. 4, 1922] COUNCIL DINNER. [ TH BRITIs 887 witlh the class which they include, cannot but be a diffi- cult matter, and thle outcome will be watched with some anxiety. Meantime thle prudent slhould make certain that they and their children and dependants are secured against COUNCIL DINNER. tlle infection by immediate vaccination. Why the public vaccinator did not take care that he himself was protected T1HE Britislh Medical Association made a - departure on is the most puzzling thling in the whole outbreak. October 25tlh by the inauguration of a Council dinner, wlhicl it is intended slhall be an annual event. It is designed for recognition of the Past President and any otlher retiring officer at the end of Ills term and to bring together, in converse witlh HUXLEY LECTURE. thle Council, Ministers, tlle heads of learned societies, and OWING to the indisposition of Sir Arthur Keith, F.R.S., tlle otlhers with wlhom thle Association is in touch. Huxley lecture whichl was to have been delivered at Clharing The dinner took place at the Grand Hotel under the clhair- Cross Hospital Medical School on Wednesday next, November manship of Dr. R. A. BOLAM, Clhairman of the Council, wIo 8th, lhas been postponed. explained that, owing to the political crisis, several Ministers (who hiad accepted invitations) and a number of members of Parliament lhad otlher more pressinig engagements and had THE new x-ray department of the Manchester Royal In. sent letters of regret.. filrmary will be formally opened on Friday, November 18th, The following guests of the Association were present: at 2.30 p.m., by Sir Humphry Rolleston, who, with the Professor David Drummond, C.B.E., D.C.L., retirilng President; members of the Electro-Pathological Section of the Royal Right Hon. E. Shortt, K.C., M.P.; Sir Humphry lRollestoni, K.C.B.. Society of Medicine and the Rontgen Society, will be visiting President, Royal College of Physicians of Londoin; Sir Anthony Bowlby, K.C.B., K.C.M.G., President, Royal College of Surg,eons Manchester. of England; Sir William, Hale-White, K.B.E., President, and Six J. Y. W. MacAlister, Secretary, Royal Society of Medicinie; Sur. geon-General W. B. Slaughter, Master of the Apothecaries' Society; Lady Barrett, C.B.E., President, Medical Women's Federation; THE GENERAL ELECTION. Sir Arthur Robinson, K.C.B., Fir6t Secretary, Ministry of Health; Sir George Newman, K.C.B., Chief Medical Officer, Ministry THE position of parties at the approacliing General Election of Healtl; Right Hon. Sir Henry Craik, K.C.B., LL.D., M.P. is confused. The Conservative Party (C.), also spoken of as Sir Philip Magnus, Bt., M.P.; Dr. W. J. Howartlh, Past President, Society of Mledical Officers of Health; Dr. J. G. Fitzgerald, Unionist (U.), and the Labour Party (Lab.) have been before Cbairman of Council, Irish Medical Schools' anid Graduates' the constituencies for a good many years, and their position Association; Dr. C. Hubert- Bond, Commissioner, Board of fairly well defined. In addition there is the Liberal Party, Conitrol; Air Commodore D. Munro, C. [.E., Director, R.A.F.M.S.; is Lieut.-Colonel Nathan Raw, C.M.G., M.P.; Sir S. Squire wllich seems to be divided into two wings, one led by Mr. Sprigge, Editor of the Lanicet; Sir William Gyn-Jones, Secretary, Asquith (L.) and the other by Mr. Lloyd George, wlichl is Pharmaceutical Society. Party (N.L.). known as the National Liberal Sir WILLIAM MACEWPN, Presiden-t of the Association, in The following is a list of medical candidates so far as we giving the toast, " Thie Comninon Healtll," said that wlhen he are at present able to ascertain. We shall be glad to receive wired acceptance of the duty the telegraph clerk interpreted additions and corrections. the words in hiis handwriting as "Thle Common Wealtl." Th'lat man was a philosopher, for wealthl was to a large extent *Dr. C. Addison (L.), Shoreditch a miiatter of health. Many persons very wealthy, in the Dr. R. Ambrose (Ind. Lab.), Whitechapel ortdinary acceptance- of tlhe were not Dr. H. Wausey Bayly (Ind. U.), Sutton, Plymouth term, healtlhy. Gold Dr. H. B. Bates (U.), Newton, Lancs. of ten produced decadenice. He understood thlat the per- Dr. Ethel Bentham (Lab.), lslington East iinanent secretary to the Miniistry of Healtlh would respond Sir George Berry (U.), University of Edinburgh to the toast, and he assurimed that the responsibilities of this Dr. H. B. Brackenbury (L.), Walthamstow East Department embraced everythling. Our old world (whiclh was Dr. W. A. Chapple (L.), Dumfries a kiind wlen it went Sir John Collie (N.L.), Partick of aeroplane), gyrating.through space, *Dr. W. E. Elliot (U.), Lanark p)icked up dust storms that astronomers said were got from *Dr. F. E. Fremantle (U.), St. Albans sanid, and, although these particles were so finely divided Dr. L. Hadeni Guest (Lab.), Southwark North tllat there was not an instrument sufficiently intricate to Mr. Somerville Hastirngs, M.S. (Lab.), Epsom -detect them, yet the Ministry of Healtlh must have prescience - Dr. C.-W.-Hayward (L.), Kensington North Dr. Sidney C. LI.wrence (C.); Combined English Universit es to foretell what would come from tlhem. So also as to those Dr. H. D. Levick (N.L.), Middlesbrough- little canisters containing chemical substances -labelled "wild Sir William Milligan (L.), Salford West duck"; from tlhem they were expected to trace botulism. He *Major J. E. Molson (U.), Gatinsborough did not4 lnow vlere in-vestigatioon was going to stop. They Dr. R' 0. Moon (L.), Wimbledon all ouglht, lhowever, to look to several matters about whiclh Dr. H B. Morgan (Lab.), Camberwell North-West *Dr. D. Murray (L.), Western Isles they lhad common concern. The Association liad especially Sir Sydney Russell-Wells (U.), University of London to consider two very prevalent diseases regarding whicih Dr' V. H. Rutherford (Lab.), Sunderland certain tlleories had been formu'lated and put before tlhe Dr. A. Salter (Lab.), Bermoindsey public, and a very great deal would be done if tlley could Dr. R. W. Simpson (L.), Newcastle-upon-Tyne North be got rid of. One was syplhilis; the other tuberculosis. Dr. George E. Spero (L.), Leicester West Dr. E. H. Stancomb (Ind.), Southampton As to the first named, it it were not stopped, a crime was Dr. D. F. Todd (U.), Chester-le-Street, Durham committed against posterity. The question was sometimes Dr. T. Watts (U.), Withington asked, "Whlere to draw the line?" He drew no line: tlle *Sir William Whitla (UJ.), Queen's University, Belfast disease must be got rid of by whatever means were necessary. Dr. J. H. Williams (Lab.), Llanelly Tuberculosis was not so easily dealt with. But tlle profession Dr. R. M. Wilson (L.), Saffron Walden lhad a great responsibility. If the British Medical Association *Represented the constituency in the last Parliament. withl its 25,000 members made up its mind as to the means it would carry great weiglht. He wondered 'wlether the Among the new candidates Dr. H. B. Brackenbury medical profession lhad not hlitlherto just relied upon polemical (Walthamstow East) and Sir Sydney Russell-Wells (University discussions instead of pushing matters to logical conclusions of London) lhave been approved by the British Medical and then pressing them upon tlle Government and the Association. Among the old members wlho are standing officials who had to carry them out. Much of this disease, it was Universities), Sir said, came from cows through milk, and about 50 per cenit. of again are Sir Henry Craik (Scottish in William Whitla (Queen's University, Belfast), Dr. Walter tlle tuberculosis children was bovine. If so, how did it comuo Albans); from tle cow? Surely it must be through the milk. Tubercle Elliot (Lanarlk), and Dr. F. E. Fremantle (St. was incubated in byres as directly as in an incubating all of them have done yeoman service in the House of chamber. Thle best temperature in which to keep COWs, Commons for the profession, and have frequently given it was said, was 70°F., and in byres were found the thlrce assistance to the British Medical Association in representing other conditions- in which tubercle easily propagated itself- the views of the profession to Parliament. namely, darknless, dirt, and damp. From such places, in such] Nov. I922] THE BRITIga 888 4, COUNCIL DINNER. I MUDICAL JOURNAL = conditions, came milk given to children. Surely, if 25,000 Then came the chemistry and physics people, who might put medical men acted in concert some action might be up a better barrier, and sometimes succeeded. After the next taken to end that form of tuberculous disease. And if obstacle-anatomy-came a greater, physiology. For whereas they got rid of 50 per cent. of tlle disease that way anatomy was a fairly accurate science, and the femoral artery they ought to be able to get rid of a good deal that of to-day was very much wlhere it was a hundred years came by transmission from one person to another. Sir ago, the physiology of to-day was quite a different thing. William Macewen went on to remark that thle British Twenty or thiirty years ago they thought they knew some- were a strange people. They taxed the air they breathed. tlhing about the processes of digestion and the action of Formerly they used to tax tlle liaht whichl came into the the heart and respiration, but it now appeared that they lhouses througIh the Windows. Now, in effect, the cubic did not. So there was reason to pity the poor candidate. capacity of houses was tAxed. God had given every single Having surmounted these obstacles he entered upon the soul that came into thie world as much air as it could breathe, last lap. This used to comprise medicine and surgery and but it was curtailed in this way. Those who got tubercle obstetrics. Now innumerable special subjects were added, from confinement were put into sanatoriums where they so that one might wonder and think how "still the could get just the fresh air God had given. Would it not be wonder grew that one small head could carry all he knew." better to commence the other way and give the children and It was indeed a severe task; yet, in spite of the difficulty of others as much fresh air as they could breathe ? These were seeing the wo'od for the trees, in spite of the fact that a large points which required consideration, and he thought it a good number of young men lnew a great deal about abstract anid tlhing to ventilate them on that occasion. He coupled with special subjects without knowing much about general practice, the toast the name of Sir. Arthur Robinson, First Secretary of in the long run the educated medical man of the present day the Ministry of Health (paying high tribute to the permanent was a strong stand-by and supporter of the public healtlh of civil servant whose work continued while Ministers came and this country. Finally the young man became a full-blown went), and he also associated with it the name of Sir Anthony medical practitioner, and then he sought the advice of those Bowlby, President of the Royal College of- Surgeons, who did in practice. One piece of advice he would give to every young much good service at the front, and wbose methods were a medical man, and that was to join the majority-not in the little more direct. proverbial sense, but to join the majority of the profession, Sir ARTHUR ROBINsoN hoped he would be in order in the British Medical Association. They would tllus get in offering an expression of sympathy with the company. touch with their fellows-an important matter in the medical Instead of the solid substance of a Minister of the Crown profession-and would have assistance and advice when neces- they had to be content with the pale and embarrassed sary from older members. If the newly qualified men went shadow of a permanent civil servant cast for d6somewhat into any of the services, there was still another reason wlhy unwonted task. However, replying to such a toast as the they should join the Association. In recent years the action Common Health was one that should inspire even a silent of the British Medical Association had obtained great benefits civil servant to something rather above than beyond his for the Army and Navy Medical Services, the Indian Medical ordinary performance. Sir William Macewen had said that Service, and the Colonial. In all these departments the it was time that something was done in regard to the milk Association had been of very great assistance to medical supply. Well, the Department had put on the statute book men, and he hoped as in the past, so in the future, a very a measure whicih, though not heroic or final, would be valu- large number of qualified men would become members. able. The underlying principle was to make it worth while Dr. R. WALLACE HENRY gave "The Rtetiring President," and to supply better millk. Provide a man with inducements to said that for many years it had been the custom for tlle supply good milk and it was common sense to suppose that he President to enter upon his term of office in a blaze of glory. would do so. He could say.also as to tuberculosis that there He had given his presidential address surrounded by civic was a policy. It had its limitations, but by reason of it the dignitaries and distinguislhed men of science, clad in garments notifications had gone down and were going down, and the death of many colours. But he had gone out of office so quietly that rate had gone down and was going down. Speaking generally, it might almost be said he was " unwept, unhonoured, and Sir Arthur Robinson said that the Ministry of Health had been unsung." This year the Council had decided that such in existence only a short time and had done a great deal. practice should come to an end, and that each year a dinner Sometlling like 200,000 hiouses had been or were being built, and should be arranged at which one of the principal toasts nothing like that had been done before through a department. slhould be "Thle Past President," and in paying tribute that The Ministry had also made a fair start in dealing with the night to Professor Drumnmond they were making a start with problems of slum areas. Then there was the question of the one whose name would rank hligh amongst tlle eminent men voluntary hospitals. In a period of unexampled difficulty who had held that office. It was many years since he left they had prevailed on the Government to give a sum of half his native land of Ireland, and at a very early period of hlis a million sterling to set going machinery which was gradually professional career Professor Drummond began to make his bringing the voluntary system round, and it had made mark. He had the opportunity at the Meath Hospital at possible the continuance of the voluntary system in fact and Dublin of working under that distinguished heart physician, not merely in name. Broadly, the problem of public health Sir William Stokes, one of whose favourite house-physicians seemed to him one of fitting various parts into a whole. It he was, and what he learned and studied there he took into was a problem of mutual tolerance, of mutual forbearance, his private practice when he went to the north of England. and of working together for one end. Unless they did this He wrote many articles dealing in various aspects with his on the basis of giving each element. in their policy full weight favourite subject (heart disease), one in particular on the policy would be wrong. The Ministry of Health presided aneurysms of the thoracic arch. But his studies were notcon. over the whole public medical health service. It was in fined to the heart. He turned his attention to nervous diseases, close relations with the whole mass of general practitioners and one of his works was a standard book upon diseases of the through the insurance services. There they had a body brain and the spinal cord. His reputation in Newcastle rapidly which dealt with private persons and with public health, grew, and he became physician to the Royal Victoria Hospital. appreciating the different view-points and getting progress His reputation spread abroad. He had received many by unity. He appealed for the co-operation, of the medical distinctions from foreign countries. It was not true in his profession as represented by the British Medical Association. case that the prophet was without honour in his own country, Sir ANTHONY BOWLBY said he represented one of the two for he had been made Principal of the College of Medicine at English Royal Colleges concerned with the education of Durham University as well as Professor of Medicine there, medical men; In this connexion the Colleges did two things and now held the post of Pro-Vice-Chancellor of that Uni- -they examined and they set the pace (the curriculum) for versity. Last of all, within the past two months, appreciation the different medical schools of the United Kingdom. During of his services in Newcastle-on-Tyne had been marked by his the year the two Colleges had spent much time in rearranging being appointed Chairman of the Voluntary Hospitals Com- the curriculum, the main object being to give more time to mitteeof that area. So much in brief for his purely professional the most important subjects-those in the final examination. work. In the British Medical Association he must be one of The task of the present-day student was very difficult. That the oldest members: he had been enrolled forty-four years. individual, he rather thought, looked upon the whole per- As had been the case with a very large number of students at formance fromn the point of view of an obstacle race. The Dublin University and at Queen's College, Belfast, it had been student saw in front of him a long way off-five or six years preached to him and his colleagues that almost as soon as distant-the winning post. In an obstacle race all sorts of they had qualified one of their first duties was to join the things were put in the way of a competitor to delay him. British Medical Association. Would that the same thing The student found the biology examination to begin with. could be done at all the universities in Great Britain also-i IMEDICAL JOARL89 NOV- 4, 1922] SCOTLAND. Professor Drummond had been formerly a member of the Council of the Association, lhad been Secretary of the North of England Branch and at one time President, and it was ,cotItani. partlly duieto his work in connexion with these offices that the Branch-held such a distinguished place in the Association for PARLIAMENTARY REPRESENTATION OF UNIVERSITIES. the splendid work it had done. They would drink his lhealth, IT is thought-improbable tlhat there will be any contest at not merely as a great physician, not merely as Past President this general election for the representation of the Scottislh of the Association, but also as " David Drummond the man." Universities in the House of Commons. There are tlhree They all regarded him with affection and esteem. seats; Sir Henrv Craik and Mr. Cowan are standing agaij, Professor DRUMMOND said it was a great pleasure to hiim and Sir George Berry, consulting ophthalmic surgeon-to the to meet so many distinguished colleagues; and this was Royal Infirmary, Edinburglh, is offering hiimself in the place enhanced by the fact that he was the recipient of their hos- of Sir Watson Cheyne, who decided some time ago not to pitality on the occasion of the inauguration of a function seek re-election. wllich he hoped had come to stay. He went on humorously BOTULINUS ANTITOXIN. -to depreciate the tribute just paid to him by Dr. Henry as In view of the recent outbreak of botulism at Loclh Maree the general compliment of one Irishman to another, and then the Scottish Board of Healtlh has under consideration spoke of the great interest of the period-tlhree years- of arrangements to render available a supply of botulinus anti- hsis official connexion with-the Association as President-elect, toxin in the event of the occurrence of any further cases in -President, and Past President. The-Annual M4eeting formed Scotland. There is no reason at present to expect furtlher a very important part of the proceedings, and their meetings outbreaks, but tlle gravity and mortality of the disease may at Cambridge, Newcastle-on-Tyne, and Glasgow had been be such that it is considered thlat arrangements should be lheld to be as successful as any tlhev had had for many years. made to provide a supply of antitoxin whiclh could be In recalling the gathering at Canibridge he evoked applause obtained more promptly than if the only available supply by referring to the great personality of the great President of were held in London or Edinbugb. It is pointed out that the year (Sir Clifford Allbutt). the only remedy at present kovown for botulism is botulinus The CHAIRMAN submitted the toast of " The Visitors," very antitoxin given by injection, but that it is unlikely to save lhappily referring to their widely representative character and life if the disease lhas progressed to a late stage. It is expressing the hope tllat from year to year tlley would lhave therefore of the greatest importance to give thle antitoxin at present, amongst others, the Ministers with whom they dealt the earliest possible momenit-that is to say, as soon as in otlher circunstances, perhaps not quite with the cordiality symptoms of blurred or double vision, giddiness, ptosis,. with wlhiclh the welcome was given tllat night. He entirely difficulty in speeclh or swallowing, suggest the diagnosis of agreed with Sir Arthur Robinson, that these meetings would. botulism. The effectiveness of treatment by antitoxin for promnote in every way friendship and co-operation, than wlicll this disease is so greatly increased by intravenous injection notlhing was more needful to the country in these years that tllis method of administration slhould always be em- of strain. Coupling the toast with the names of Mr. Shlortt ployed, if possible; otlherwise tlle intramuscular metlhod and Sir Henry Craik, the Clhairman spoke of the sympathy should be used. It may be necessary- to administer sub- which Mr. Shortt had manifested as Eome Secretary for their cutaneously a preliminary inijectioni of a small quantity of work, and expressed gratitude to Sir Henry Craik for wise the antitoxin (0.5 c.cin. of antitoxin, or 8 minims) to test tlle counsel and kindly help in hiis capacities as an experienced reaction of a patient, in order to avoid the risk of serious parliamentarian. symptoms arising in persons hiaghly sensitive to lhorse serumu. Mr. SHORTT, replying in light vein, questioned whether lhe If tlle patient is senisitive the antitoxin must be given witl ougl]t to be there, as the invitation had come to hiim when he caution, and the dose slhould be considerably reduced, the was Home Secretary, but he assured tlle company that he first intravenous injection of 0.5 c.cm. of antitoxin being had greatly enjoyed the evening, and also touched on the diluted witlh 50 c.cm. of saline. Only large doses of anti- satisfaction of being relieved from the cares of office. A Home toxin will save acute cases; the ordinary intravenous dose Secretary wlho tried to do his duty made enemies every day should be from 20 to 50 c.cm. of the antitoxin: it shiould be of his life. Everything he did annoyed somebody, and those previously warmed to body temperature and injected very wlho were pleased with what was done generally took it as slowly. This amount may be repeated daily if necessary. a matter of course. On the ozcurrence of an outbreak of botulism it may be Sir HENRY CRAIK said tllat for seventeen years the medical deemed. necessary by the medical attendant or the public profession had tolerated him as a humble representative in hlealtlh authorities that all persons who have consumed the Parliament of twelve tllousand of tlleir members. -The British suspicious food should be given a proplhylactic dose of anti- Medical Association had conferred upon him the great honour toxin (10 c.cm. intramuscularly) even tlhough they may not of making hirm an honorary member of their society, and present symptoms of the disease. The Board of Health they had further gratified hlim by admittijng hlim to their has accordingly made arrangemuents for a small stock of counsels. He had learned much thereby. IHe recognized tlie antitoxin to be lkept at thle following places, as well as at that the two great objects for wlhich the Association lived the offices of the Board in Edinburglh: the City Hospital, were the maintenance of scientific trutlh in its hiighest form Aberdeen; King's Cross Infectious Diseases Hospital, and the pursuit of research for tlhe good of mankind. He lhad Dundee; City Hospital, Edinburglh; Belvidere Hospital, found also tlhat, according to the scripture plhrase, truth was Glasgow; the medical officer of hlealth, County Buildings, joined with mercy. Thle maintenance of tlle kindliest rela. Dumfries; Mr. Macdonald, Mayor's Drug Store, 31, Higlh Lions between the great medical services and those whom Street, Inverness; and tlle County Hospital, Motherwell, they served was the principle upon which tlley lived, thrived, Lanarklishire. and did their work. THE GRADING OF MILK. Sir JENNER VERRALL submitted the health of the Chairman, Thee Milk and Dairies (Amendmuent) Act, 1922, aulhorized 3peaking in the highest terms of 'his qualities, and the toast the Scottislh Board of Healtlh to make an Order in regard to was received with musical honours. licences for the sale of graded milk. Thle Board has now- Dr. BOLAM, responding, said that this toast was given issued, to producers of higller grade milk and others, a Lgainst his ruling. Service for suclh an Association was a great memorandum shiowing tlle principal conditions under whvicl privilege, and he was lhappy in perforining it. the statutory Order will be made. Before issuinog this the observations of tllose interested were invited. The Milk and Dairies Act, 1922, cont'emplates four grades of milk in THE Loomis Sanatorium, New Yorl, has recently celebrated Scotland-namnely: (1) certified milk; (2) grade A (tuber- its twenty-fifth anniversary, and has published in com- culin tested) milk; (3) grade A milk; (4) pasteurized milk. meemoration a "1 birthday book," giving a description of the It is proposed that the administration in regard to all four foundation, the growth, and the progressive enlargemnent of shall be placed in the lhands of local autlhorities under tlle the institution. A special block has beeii erected at the Public Health Act, 1897. expense of the Standard Oil Company for the treatnment of its (Scotland) enmployees. In formally handing this over to the sanatorium, Certified Milk is milk obtained from tubercle-free cows and the bottled at the farm. vice-president of the company suggestedl that this course Grade A (Tuberculin Tested) Milk is the same as Certified Milk, mnight wvell be followed by the other large commercial houses except that it is not bottled at the farm. of the United States, for not only would the treatment of Grade A Mlilk is milk obtained from herds which have been tuberculosis be better carried out, but the cost would be less examined at least three times a year at the farmer's expense by if borne by private firms than if controlled by the a veterinary surgeon, but the examination will not include O overnment, tuberculin tests.