394 makes the establishment of long-stay annexes difficult ; but the Central Middlesex Hospital annexe at Stanmore is an experiment of the kind, and King Edward’s Hospital Fund for London has set aside 250,000 to provide homes under the regional hospital boards, the teaching hospitals, or the British Red Cross Society, where residents will remain in the care of the hospitals to which they were admitted in the first instance. The N.C.C.O.P. is also anxious to help voluntary societies to provide this kind of home. Some hospitals are cooperating with the general practitioner and district nurse by providing hospital equipment for the care of the patient at home, and transport to bring him to and from hospital for physiotherapy and other treatment. Employers, too, are changing their attitude to the older workers, and quite a large number are nowadays keeping them on in jobs appropriate to their skill and strength. ’All these advances, and many others which he names, Lord Amulree finds good ; but they are not yet widespread enough. Voluntary and statutory bodies can combine splendidly in the work, and are doing so in The underlying principles are clear many places. enough. The old need to be housed as well as the young ; but, as he points out, their needs are smaller. They should not be segregated, but should live in the midst of the community with as much freedom and independence as possible ; and this means that in every area they need all the ancillary services he has described, as well as access to hospital when they are sick, and the opportunity to go on working if they wish. " The principle that continuance at work should be a disqualification for a contributory pension," he says, " seems to be a bad
one." THE INSIDIOUS POISON
NOT only are we eating more and more tinned and processed foods nowadays, but the rapid growth of the chemical industry has enabled the manufacturer to add more and more extraneous substances to his goods so that they may look nicer, taste nicer, or keep longer. Scarce materials are also often replaced by new chemical substances. The possible harmful effects of these substances absorbed in small doses over a long period of time are unknown. Although the risk to lifeand health from their use is probably small, it is good news that the Advisory Council on Scientific Policy has been considering the problem. The council recognises the existence of this risk, which its recommendations are designed to reduce to a minimum. The effects of acute poisoning which shortly follow exposure to a particular agent are more easily detected and assessed than are those of chronic poisoning. The addition of potentially toxic substances to food is likely to cause chronic rather than acute poisoning, and toxic effects may not be noticed until a substance has been absorbed in repeated small amounts for months or years. Though the Food and Drugs Act, 1938, requires manufacturers and distributors to guarantee that the food they offer the public is fit for consumption, the true cause of an illness due to chronic poisoning by an added substance may not be recognised. The extent of the danger must remain uncertain until research yields more information. The’ council recommends that the situation should be kept under review, and that research in toxicology should remain the responsibility of the Medical Research Council. But if Government departments are to protect the public they must know what substances are being used in the production, manufacture, and processing of foods. To do this they should have facilities for discussing problems and: for coordinating scientific knowledge on ,these, problems. This information could be collected and correlated in a central organisaCouncil on Scientific Policy; 4th annual report. section ix. H.M. Stationery Office. 1951. Pp. 17. 9d.
tion to which Government departments would turn for advice, and from which knowledge of toxic substances could be exchanged with authorities in other countries. The report acknowledges that much of the responsibility must remain with manufacturers, who should be told that they are expected to take reasonable care that no new substances are offered for sale if toxic effects are suspected. Many small firms have no facilities for testing new substances, and the council suggests that a central toxicological laboratory should be set up and paid for by
industry. ADMISSION OF ABORTION CASES TO HOSPITAL MANY hospitals are reluctant to admit cases of abortion, perhaps partly owing to fear that they may introduce sepsis into a gynaecological ward, and partly to their liability to have legal complications distracting the medical staff from hospital work. In a report to the North-West Metropolitan Regional Hospital Board, Dr. Avery Jones and his colleaguesremark that the voluntary hospitals commonly used to exercise a bias against such patients, who went mainly to the old local-authority hospitals ; these had a statutory obligation to admit all patients needing hospital treatment. Under the National Health Service this obligation no longer exists, and the report suggests that patients with abortion may have suffered particularly by its absence. Figures supplied by the Emergency Bed Service go a long way to support this suggestion. The E.B.S. finds that the problem of gaining admission for these cases is second only to that of the chronic sick ; on average every sixth call by the service secures admission for an abortion case, whereas every fourth call secures admission for other cases. Inquiry by Dr. Avery Jones and his associates has shown, moreover, that the London teaching hospitals, except for the Postgraduate Medical School, Hammersmith, are admitting far fewer of these cases than non-teaching hospitals of comparable size. The report observes that few resident medical officers can have had the experience needed to deal with this condition; and there is undoubtedly a reluctance to call out the visiting gynaecologist to treat it. The report goes on to propose that each hospital management committee area should have special gynaecological centres to which abortions could be sent, instead of to the smaller hospitals. " The objection that more beds would be needed at such hospitals might be overcome if a routine with the local practitioners could be worked out, enabling patients to be sent home more quickly, when home conditions were suitable." Furthermore, this concentration of cases in selected regional hospitals would enable teaching hospitals, by liaison, to make better arrangements for training in this field. Dr. G. ROCHE LYNCH has been elected master of the Society of Apothecaries, Sir WILSON JAMESON senior warden, and Brigadier E. M. TOWNSEND junior warden.
Sir ARCHIBALD GRAY will deliver the Harveian oration to the Royal College of Physicians of London, on St. Luke’s day, Thursday, Oct. 18, at 3 P.M.. He is to speak on the Development of Dermatology from the Time of
Harvey. Dr. G. L. BROWN, F.R.s., Jodrell professor of physiology in the University of London, and Sir JAMES LBARMONTB, regius professor of clinical surgery and professor of surgery in the University of Edinburgh, have been appointed members of the Medical Research Council from Oct. 1, 1951. Memorandum on 1. Jones, F. A., Bigby, M. A. M., White, B. the Admission of Abortions, submitted to the North-West Metropolitan Regional Hospital Board at its meeting on Aug. 13, 1951, as an appendix to the report of the medical committee.