No. 2920. VOL. 103 (4TH SERIES VOL. 49).]

The Official Organ of British Pharmacy

(Established 1841).

Editorial Offices: 17, Bloomsbury Square, London, W.C. 1.

The Pharmaceutical Journal and Pharmacist is the official organ of the Pharmaceutical Society, the leading organ of pharmacy and the drug trade in Great Britain, and the oldest weekly newspaper for Pharmacists. It has the

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EDITOR'S ADDRESS: 17, BLOOMSBURY SQUARE, LONDON, W.C. 1. ADVERTISEMENT OFFICE; 150, HOLBORN, LONDON, E.C. 1.

[LONDON, SATURDAY, OCTOBER 4, 1919.

EDITORIAL ARTICLES.

THE RAILWAY STRIKE AND THE SOCIETY'S
AFFAIRS.

ALTHOUGH, contrary to the expectation of the strikers, what was at first an almost total cessation of the railway passenger and goods services all over the country did not entirely paralyse the industrial and business functions of the nation-it did inevitably create widespread derangement of these functions, and in common with other sections of the community the practice of pharmacy and the business of the Pharmaceutical Society have suffered serious interruption. As far as supplies of goods are concerned, as will be seen from the reports collected under "The Railway Strike" (p. 313), thanks to the resourcefulness of the leading London drug houses, only a few of which are named, these have been fully maintained within a radius of fifty miles of the centre of London, and we have no doubt the area of distribution has been similarly extended by wholesalers in the chief provincial centres. Nevertheless, there is bound to be some difficulty of distribution to outlying parts of the country until the strike is over, and this can best be met, both on the part of medical men and pharmacists, by a judicious recourse to "alternative preparations," and a rigorous husbanding of staple drugs and medicines. As regards the business of the Society at headquarters, while this has been considerably hampered, it is being carried on in all essential respects much as usual. Fortunately, as the President was detained in town over the week-end because of his attendance at the first stage of the Qualifying Examination, which closed on Saturday afternoon, and the Vice-President succeeded in "getting through " from Exeter, it was found practicable with the assistance of the London members who were in town (Mr. Skinner is held up in Scotland) to form a quorum for the meeting of the Council, at which all the routine and urgent essential non-contentious business was transacted. Notwithstanding this limitation the meeting proved quite an interesting and valuable one in respect of two circumstances, namely, the discussion on the recommendation of the Benevolent Fund Committee that as there seems no need for it, no new annuitants should be elected this year, from which emerged the suggestion by Miss Buchanan that, lest this may create the impression that the Benevolent Fund will be so much richer by this saving, it ought to be made clear that as the existing annuities and grants must be increased to provide for the. higher cost of living, contributions to the Fund will have to be it. upon multiplied and augmented if it is to meet future claims The other important item was the report by Miss Buchanan of her visit, along with Miss Braithwaite, to the Red Cross Society in connection with its scholarships for the training in pharmacy of Red Cross women dispensers. The particulars of this scheme are given in the report of Miss Buchanan's speech on page 302, from which it will appear that the Red Cross Society has commendably liberal, if not exactly well-informed

B

views on the subject of pharmaceutical education and training, which, now that they have been corrected and directed by the two women representatives of the Council, are certain to yield satisfactory results. For the first few days after the strike began there was hardly any correspondence from the provinces for the General Office or the Editorial Department; but there has been an appreciable improvement in the deliveries since the middle of the week. The Secretary (Sir W. S. Glyn-Jones), who went to Wales to fulfil an engagement at Rhyl with the North Wales pharmacists, was, until Wednesday, "strike-stayed" in the Principality, but returned to town on Thursday, and the London members of the Office, Editorial, and School Staffs, most of whom live miles away from Bloomsbury Square, have had in many instances to walk to and from business, and it is to their credit that all of them, from the oldest members of the Staff to the youngest, have contrived to keep office hours and carry on as usual. Indeed, some of them actually profess to be better in health for the walking exercise. It is of good omen that they and the British people are taking this disruptive development in so sane and cheerful a spirit. There is some hope for a nation that thus comports itself under conditions that might readily rouse the worst passions of human nature.

A PUBLIC MEDICAL SERVICE.

IN the discussions about, and the proposals for, a State or Public Medical Service there has been SO much cry and so little wool, as the Devil said when he clipped the sow, that it is an agreeable surprise to come upon the exposition of a scheme which, whatever else it may lack, is well found in point of data and definiteness. The statement in question is the joint production of David McKail, M.D. (Glasgow), D.P.H. (Camb.), and William Jones, Clerk and Treasurer, Glasgow Burgh Insurance Committee, and is published in booklet form by the Fabian Society under the title of A Public Medical Service.' In a closing paragraph that might more appropriately have been a prefatory note, the authors state: "So far discussion has been along general lines. In the foregoing pages an effort has been made to give a concrete illustration of the organisation and probable cost of a Public Health Service," and we are bound to admit that, as far as facts and figures can prove anything on paper, the authors can claim some measure of success for their undertaking. We say this in no spirit of depreciation, for we have every respect for the industry and skill with which Mr. William Jones, a recognised authority on vital and other statistics, has constructed his case; but we do venture to doubt whether in his actuarial survey he and his collaborator fail to make adequate allowance for certain sociological and economic factors which militate considerably against their thesis. The scheme which they present owes its origin to an experiment in the organisation of district dispensaries, which was tried in Glasgow during the war, to compensate for the shortage of panel practitioners, due to the absence of so many of the normal complement on Active Service. Great pains were taken to give this experiment every chance of success, and it was set up in two districts under what the authors describe as apparently ideal conditions." Nevertheless, "the scheme was discontinued in the Townhead district after six weeks' trial for reasons which were mainly of a personal nature and are now of no interest.' At the same time the other centre and its sub-centre were also closed. But as careful records were kept at all three centres it is claimed that the experience gained was not without value, both from the administrative and financial points of view. On the strength

of the data derived from this and other sources the authors conclude that 100,000 is a convenient unit of population in an urban area for which to provide a comprehensive scheme, and they then proceed to an analysis and synthesis of the problem as applied to an area of the City of Glasgow, and by means of factors of vital statistics and volume of sickness estimate that for such a population the primary number of dispensary medical officers required for consultations and attendances would be twenty-seven; but if there were added maternity medical service and special services (diseases of the eye, ear, throat, and nose, skin diseases, venereal diseases, etc.) there would be required a total medical staff of 45, at a total cost to the community or the State of 6s. 5.47d. per head, calculating on a pre-war standard of sickness and expenditure" (the italics our ours). Put otherwise, a general medical service provided through the dispensary costs less than 2s. 9d. per head per annum, compared with the 7s. to 7s. 6d. which is the capitation fee paid to panel practitioners. Treating of drugs, medicines, and appliances, the authors contend that "in no other department of a unified or public service can centralisation be more readily achieved and substantial economies effected." It is stated that analysis of a very large number of prescription forms in Scotland has shown tnat of every 20s. charged to the Drug Fund for drugs, medicines, and appliances, 10s.. represents the wholesale price of the ingredients, 5s. is establishment charges and profit, and the remaining 5s. dispensing fees. "Under a dispensary scheme purchases would be made in bulk, so that prime costs would be at the lowest possible rates. Profit would be entirely eliminated and salaries to dispensers would be substituted for dispensing. fees." Whereas under the existing system, of the 1s. 6d. primarily available for drugs, etc., the prime cost of drugsis 9d.; 30 per cent. would probably be saved by purchasing in large quantities, thus reducing the cost to, say, 6d., and' the 3d. thus saved could be used to pay for additional appliances. As regards the dispensing, taking the ratio of prescriptions to panel patients as 0.6 to service rendered, the number of prescriptions per annum for a population of 100,000 would be 186,543 and if the number of prescriptions dispensed per hour were six (Mr. J. Rutherford Hill's evidence before the Departmental Committee on the Drug Tariff), with a 33-hour working week, the pharmaceutical dispensing staff required would be normally 18-5 persons, or, adding the usual 25 per cent. for emergencies, 23, made up of the chief dispenser (qualified), salary £250 to £350; four assistant dispensers (qualified), £130 to £180; eighteen assistant dispensers (unqualified), £80 to £100; and the porter at £80. "In a population of 100,000 persons this equals 6.29d. per annum, adding to which 9d. already allowed for drugs, medicines, and appliances, the total cost of the drug service would' be 1s. 3.29d. per head." The salaries suggested are, of course, at the pre-war rate, to which we cannot return for generations, if, indeed, ever. However, as this factor is common to both the present and the proposed system, there is no need to discuss it. But what are we to say to eighteen unqualified assistants to five qualified dispensers? This is. surely out of all proportion to the balance that ought to be adjusted between these grades and to the quality of the service that the population have a right to demand. And if profit is to be eliminated, what pays for housing, heating, lighting, cleaning, plant, and replacement of plant, or depreciation? Confessedly the scheme under review is adapted! only to a population of a high degree of density or having special facilities of rapid transport, such as、 exist in Glasgow. It is quite inapplicable to areas, urban or rural, in which the population is spread out or much scattered, consequently it would be

impossible to pitch the site of a dispensary so that it would be a geographical centre for the district. At present, except in some remote parts in the North of England, Wales, and Scotland, there is a panel chemist's shop within reasonable reach of insured persons, who have the additional advantage of the personal services of a thoroughly competent and trustworthy pharmacist, whose duty and interest it is to do the best that he can for his customers. It may be demonstrable actuarially that the Public Medical Service which our authors honestly commend would be cheaper than the present Insurance Service; but cheapness may be purchased too dearly. And while we are not so obstructive or obscurantist as to insist that there is no possibly better system than that under which we live, or that it should stand fast for ever, we are not at all convinced that the people of these islands are going to be so much better served and so much more benefited by an unlimited extension of collective action on the part of local authorities or of the State. If changes must come, let them come slowly, lest they do not, in removing one deficiency or disorder, create others still more hurtful to the common weal.

THE OPENING OF THE SCHOOL OF PHARMACY. NOTWITHSTANDING the tumult in the industrial world, the School of Pharmacy opens its Seventy-eighth Session under unprecedentedly auspicious circumstances, alike as to the number of students and the personnel of the teaching staff; and in spite of the difficulties as to transport the inaugural meeting was remarkably well attended, although somewhat more subdued than usual. As Mr. Woolcock rather ruefully avowed, he is never so much at home when reading a paper as when he can expatiate at ease extemporaneously; but he reads well, and his pleasing delivery and the interest of the subject matter of his address on "The Evolution of the Pharmacist," closely held the attention of his audience from start to finish. The sympathetic personal note on which the address opened at once placed him en rapport with his hearers, who felt that he was talking familiarly with and not down to them as is the fashion of certain orators on such occasions. His address was also agreeably remarkable for its studious avoidance of that conventional moralising and commonplace which the healthy minded student rightly resents and discounts. Mr. Woolcock was happy in his choice of a subject, and most successful in his treatment of it. His rapid but illuminating survey of the development, chiefly under the influence of the National Health Insurance Acts, of the professional status and functions of the pharmacist, of the value of pharmacy and of the pharmacist during the war, as illustrated by the assiduity and fidelity with which panel chemists maintained the Insurance Service and the manifold services rendered to the State by the Society,, and his forecast, in prudently guarded terms, of pharmacy and the pharmacist in the future, all conspired to create in the minds of his student auditors an adequate sense of the dignity, usefulness, and possibilities of the calling upon which they are entering. We have rarely listened to a speech which afforded us livelier pleasure than that given by Mr. Woolcock's old apprentice master, Mr. H. H. Pollard, in moving the vote of thanks to his former pupil. instinct with true eloquence and genial humour, and was vastly relished by the meeting. Mr. White's very friendly word of counsel and admonition to the new students was well received, and will doubtless be taken to heart. The meeting on the whole was an. exceptionally pleasant and profitable one, and will always be remembered as an outstanding event by all who had the privilege of being present at it.

It was

ANALECTA PHARMACEUTICA ET

MISCELLANEA.

Mrs. Sweeney's Fatalism. "Mrs. Sweeney was sitting on a rough kind of settle between the other window and the door of another room. She was a short, comfortable woman, about forty, with red hair, quick blue eyes that roved round the cabin and silenced with a glance the whisperings that rose from the children. And how's the one that had the bad cough?' asked Willie, pursuing his conversation with her with his invariable ease and dexterity. 'Nora's her name, isn't it?' 'See how well he remembers," replied Mrs. Sweeney. Indeed, she's there back in the room lyin' there three days. Faith, I think it's like the decline she be's havin'. Masther Willie.' 'Did you get the doctor to her,' said Willie. 'I'll give you a ticket if you haven't one.' 'Oh, indeed, Docther Kelly afther givin' her a bottle; but, shure, I wouldn't let her put it in her mouth at all. God knows what'd be in it. Wasn't I afther throwin' a taste of it on the fire to thry what'd do, and phitz says it, and up with it up the chimney! Faith, I'd be in dread to give it to the child. Shure, if it done that in the fire, what'd it do in her inside?' you're a greater fool than I thought you were,' said Willie, politely. Maybe I am, faith,' replied Mrs. Sweeney, with a loud laugh of enjoyment, but if she's dyin', the crayture, she'll die aisier without thim thrash of medicines; an' if she's for livin', 'tisn't trustin' to them she'll be. Shure, God is good; God is good.' 'Divil a betther,' interjected (deaf) old Sweeney. It was the first time he had spoken, and, having delivered himself of this trenchant observation, he relapsed into silence and the smacking of his lips."-("An Irish Cousin," by Martin and Somerville.)

The Magical Powers of Foxglove.

Well,

"So Fox, purtendin' to be fixin' his shoes be the book (stream), pulled two lusmores (foxgloves) an' put them on under his heels, for thim were the fairies' own flowers, that woorks all soort ov inchantmint, an' he, of coorse, knew all about it, for he got the wrinkle from an ould lenaan (fairy guardian) named Cleena, that nursed him when he was a little stand-aloney." (From Maccowhail and the Princess," from "The Shamrock," by J. McCall.)

Harry Siplars."

"She comes to me (the wise woman_loquitur), and she ses, 'Mary,' she ses, can you cure me, for I am heart-sick o' thim doctors at the dispensary, an' they're not doin' me won pack o' good.' Ses I to her, ses I, What did they give ye?' ses I. O! the dear knows,' ses she. 'I haven't buk anythin' they said, for I didn't belave they would do me no good.' An' I had pity on the cratur', for her face was the size of a muckle pot, an lek nuthin' undher the sun. Ses I to her, 'I can cure you, my good woman, but ye'll have to do what yer tould,' ses I, an' I'll mek no sayent about it.' Says I, It's cow's dung an' flour mixed, an' ye'll put it on your face, and lave it there for a fortnight,' ses I, an' whin ye'll wash it off ye'll have no Harry Siplars (erysipelas), an' nayther she had.' This wise woman's amamentarium consisted of lodulom (laudanum), hickery pickery (hiera picra), gum-go-whackum (gum guaiacum), assy fettidy (asafetida), and red perspitherate (red oxideof mercury)."-From "A Boy in the Country," by John Stevenson.)

The Overworked Leeches.

A drunken Scottish doctor attending the daughter of Sir R. Bethell, promised to send out leeches from the nearest town. Just before midnight a small boy appeared empty-handed, but with the message: "The doctor was sair fashed (annoyed) that he couldna' send the leeches; they were sae worn out they could dae nae mair suckin'."-(Arthur H. Engelbach, "Anecdotes of Bench and Bar.")

PRACTICAL NOTE.

Labelling Bottles Stored in Damp Places. Many chemists whose store cellar is damp have experienced inconvenience from the labels of bottles stored there becoming illegible and often detached by moisture from their containers. The British Journal of Photography gives a hint worth adopting in such circumstances. A few drops of a saturated solution of potassium bichromate (sufficient to impart an orange tint) are added to very thick gum, and this mixture is used for attaching labels, of good paper, to the bottle. When dry the labels should be coated with celluloid varnish, carried beyond the label-edge. Labels so affixed are stated to remain in position for years, although constantly exposed to damp, and will even stand occa sional washing. The mixture of gum and bichromate must be freshly made as required.