THE BRITISH INSTITUTE OF PUBLIC HEALTH. built at the Northampton County Asylum. The Commissioners express their strong impression of the need of che...

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Northampton County Asylum. The Commissioners express their strong impression of the need of cheap accommodation for the insane who are not paupers, but who cannot afford to pay much for their treatment, and they also desire to advocate the extension of lunatic hospitals on a charitable basis The Annual Report of the Commissioners always contains some unpleasant reading, and as evidence that patient,s are not the only people liable to injury in asylums, may be mentioned the fact that no less than three medical superintendents were the victims of murderous assaults by patients during 1894-viz., Dr. Wigglesworth at Rainhill, The Dr. Deas at Exeter, and Mr, Case at Leavesden. Commissioners urge these facts as an additional argument for the recognition by county councils of the arduous and dangerous duties of those having the care of the insane, and the desirability of the universal establishment of pensions for long service or accident. The number of suicides in county and borough asylums was ten only, but there is a rather long list of fatal casualties during the year, and a , remarkable death is reported-namely, that of a man from shock following gastrostomy, at which operation nearly 1 3/4 lb. of nails, buttons, wire, &c., were removed from the stomach.2 A large part of the remarks about registered hospitals consists of the Commissioners’ report on their special inquiry respecting the death of a patient while in the " dry pack" at the Holloway Sanatorium, and they comment on the fact that their power of control over hospitals for the insane is very limited, and think it ought to be extended by the Legislature. The new regulation on the subject of mechanical restraint, which is found in Appendix P in the Report, is apparently to some extent the outcome of this unfortunate case. The Commissioners report satisfactorily, upon the whole, of the condition of licensed houses throughout the country, though they suggest alterations and improvements in several institutions. The Report closes with the Commissioners’ expression of regret at the death of their colleague, Mr. James Wilkes, who, previously for fourteen years medical superintendent of the Stafford County Asylum, had been a Commissioner since 1855.



For inducing the various to send nearly 300 dclegates to assist in their deliberttions. The council of the Institute were glad to have an opportunity of coming to

greatly indebted to his worship municipalties and county councils


Hull, it being the third port in the United Kingdom and the gateway to the great industrial centres of Yorkshire and the It was worthy of note that the Hull north of England. death-rate for 1894 was only 16-9 per 1000, and that this sueeeeclecl a death-rate of 20’2 per 1000 during the previous decade. The death-rate from zymotic diseases was rather high during 1893, being as much as 4 per 1000, and it was only right that they who came from districts which were not seaports should recognise that for their low mortality from such diseases they were under deep obligations to Hull and other towns similarly circumstanced. The high death-rate in 1893 was, in fact, mainly caused by deaths from cholera, and it was very satisfactory to those who lived in inland places that that great scourge was promptly dealt with at the ports and prevented from spreading in the country. Sir Henry Littlejohn said that the corporation of Edinburgh had expended nearly three-quarters of a million in improving the sanitary state of the city. Sir Charles Cameron expressed his opinion that no better arrangements for preventing the spread of cholera could be made than those which had been carried out at Hull. He thought that the expense of making these preparations should not fall upon Hull and the other seaports, but should be defrayed by the country at large. The work of the four different Sections began on Friday, Aug. 9th, and concluded on the following Tuesday, and among the many interesting subjects introduced to the notice of the meeting may be mentioned Epidemic Cholera (Surgeon-Lieutenant-Colonel Pringle), Public Water-supplies for Rural Districts (Sir James Russell), Municipal Abattoirs and Meat Inspection (Dr. S. Marsden), Cremation (Sir Henry Littlejohn), and Dust and Refuse Disposal (Mr. S. J. Beaman). We print in our issue to-day the address of Dr. J. Spottiswoode Cameron, the medical officer of health for Leeds borough and President of the Section of Preventive Medicine. At the conclusion of the work of the Sections votes of thanks were accorded to the chairman and governors of Hymers College for placing the building at the disposal of the Congress, to various local gentlemen who had entertained the members, and to the office-bearers of the Institute.

THE fourth annual congress of the British Institute of SHENTON v. SMITH: Public Health assembled at Hull on Aug. 8th, and was THE CASE OF MR. HENRY LIONEL SMITH, M.R.C.P. IREL. largely attended not only by members of the Institute but by 11 official delegates from upwards of seventy municipal OUR readers are familiar with this case, but it is of such School authorities, County Councils, Boards, Metropolitan striking interest, not only to medical men, but to all whose Vestries and Boards of Works, &c. duties bring them into contact with things official in our The opening ceremony was the formal reception of the that we consider it right to report from time to time visitors on the afternoon of Aug. 8th at Hymers College by that has taken place in the attempt to secure Alderman Richardson, who is Mayor of Hull and President ofany progress for Mr. Henry Lionel Smith something a little more s the Congress. He said that this visit of the Institute was than sympathy in his admitted wrongs. The story tangible s very gratifying to the people of Hull, especially as this was the first time that such a meeting had been held in a pro- will always bear recapitulation, for the details are a little vincial town. Hitherto the Institute had met in the metro- involved, though the wrongs inflicted are very patent to politan cities of London, Edinburgh, and Dublin, and thee comprehension. In 1887 Mr. Smith received the post of acting medical selection of Hull on the present occasion was very acceptablee to the inhabitants. Their population in the year 18477 officer at Albany. In the following year events happened transfer of the Albany Colonial Hospital to new was only about 70,000, and the death-rate was 31 per during thewhich resulted in the death of a patient suffering buildings in the risen to over r had 1000; 1894, however, population from enteric the immediate cause of death being, as fever, 216,000 and the death-rate had fallen to 16-9 per 1000. was to cold. For this death a coroner’s alleged, exposure A very large sum had been expended in producing this happy y blame to Mr. Smith, and the of three attached persons result, but the money had been well laid out, because an im-jury Government dismissed him; an order being passed on the health of the in resulted in an increased provement people 9th, 1888, informing him that his tenure would cease at capacity for work and for enjoyment of life. Hull was an July ancient as well as a prosperous town ; its charter of incorpora- the end of the year. Mr. Smith proved that he was not tion dated back to 1428, and was the second of the municipal responsible for the mishap, and that the act of the workmen which led to the exposure of the patient to cold was done in charters of the kingdom. The Sheriff of Hull and the Mayors of Huddersfield,’ his absence and without his authority, and the Government an appeal to the Secretary of State, who upheld the Folkestone, and Birkenhead having spoken, Professor W. R. allowed Governor’s Thereupon Mr. Smith-having been Smith, President of the Institute, replied that his first dutyrefused a decision.before the Medical Department in West hearing was to thank the mayor and corporation for inviting the while Sir William Robinson had declined to Australia, Institute to hold its congress this year in Hull. They were arbitrate after the first trial-entered a Petition of Right, with the Colonial Secretary as defendant. In this trial the 2 An account of this case by Dr. J. F. Gemmel, with an engraving of disagreed, eleven being for Mr. Smith and one against, the nails &c. contained in the stomach was published in THE LANCET, but, in a subsequent trial they found for the plaintiff, with vol. ii. 1894, p. 432. m 3




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