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Edited by GBORGB B. CRAFT. O.St.J.• F.R.S.A.
VOL. 20. No. 11. THE VALUE OF CONFERENCES
1947.
During the present year there has' been an increasing number of conferences held throughout the country in connection with th e activities of the Order. Mostly, of course, tlJese have been arranged by the Brigade; and th ere can be no doubt that su ch conferences are most important to the organization.
Whether it be a Divisional, Area, County, District, Regional, or National Conference the gathering together of the members is wor th all the tro uble that is taken to arrange the programme. There is definitely a lot of work done bel+ind the scenes by the organizers; work such as arranging the venue, arranging the programme, and obtaining li sts of accommo dation available. It is this work that is often overlooked by those attending conferences; and we do pay tribute to those who und ertake the duties of organizing secretary.
The val u e of the conference li es in th e fact that opportunity is given whereby members can converse with other members, discuss their trials and successes, pass on tips which have stood the test of time, learn how a certain tricky problem has been overcome; and lastly, listen to selected speaker s on work we are asked to perform.
Already the Chief Commissioner has issued a preliminary notice of the Courses he has approved for next year. These will cover all branches of Brigade work; and we feel sure that each and every conference will do much t o foster and extend the usefulness of our members.
H.R.H. THE PRINCESS ELIZABETH
On behalf (if all readers of Th e Gazette, we extend to Her Royal Highness loyal and sincere wishes on her approaching marriage to Lieutenant Philip Mountbatten. Princess Elizabeth was recently invest ed as a Dame Grand Cross of the Order of St. J ohn by the Sovereign H ead, and we welcome this, another link of the Royal Family with our Order.
One card only is available this year for scene in the Chapter House of the Abbey members of the Order, the Association, at the moment when H eracliu s is and Briga,de. appealing to Henry II to save the Holy Om the frollt is the Standard of th.e Land.
Ol'der, and the Order's Badge with the Copies of the card can be obtained from word "Greetings" in gold. The centre- the Stores Department, St. J oh n's Gate, piece is a reproduction. of the painting by London, E.C. 1, price 8d. each, including Mr. Stephen Reid which represents the envelope, plus postage.
369
ml]£ <iranb 'riory in tlJe lSritizlJ nealm of tbe lltntrablt of tbt '1jozpital af . ,it. Jobn Df Jtruzaltm:
His Majesty The King has been graciously pleased to the fellowing Pyometiens in, and Appointments to, The Venerable Order of the of St. John of Jerusalem.
FOR PROMOTION TO THE GRADE OF Colonel North Victor Cecil Dalrymple Hamilton, DAME GRAND CROSS · C.V.O.
The Countess of Cromer.
The Countess of Bessborough. (From Dame.)
FOR PROMOTION TO THE GRADE OF KNIGHT
Major Sir Geerge Aylwem (ifrem C0mmamler).
Sir Romal(\! Wilfre& Matiliews. (Frem Commander.)
FOR ADMISSION IN THE GRADE OF KNIGHT
The Lord WilI0ughby de Broke, M.e., A.F.C .
H.E. Maj0r-General Sir John Noble Kennedy, K.C.V.O., K.B.E., C.B., M.C., Governor of Southern Rhodesia.
Admiral Sir Algel1non Usb orne Willis, G.C.B., K.B.E-, D.S.O.
The Hon. Sir John Patrick Dwyer, K.C.M.G
Lieut.-Celonel Sir Richar& Charles Geers Cottelell, Bt.
FOR ADMISSliON IN THE GRADE OF ASSOCIATE KNIGHT
General A10is Vicherek.
FOR ADMISSION IN THE GRADE OF DAME
Marie Elizabeth, Mrs. Van Zyl.
FOR PROMOTION TO THE GRADE COMMANDER (BROTHER)
William Benton, M.R.C.S., L.R.C.P. ·
Henry Themas Ferrier, M.B.E.
Lieut.-Colenel Will-iam Reed HOl1ntly Steer.
Captain Erie Charles Palmer, M.C. (From Officer.) OF
FOR PROMOTION TO THE OF COMMANDER (SISTER)
Eileen, Mrs. Attfield, M.B.E. (from Serving Sister).
Helen Elizabeth Comfort, Miss Cro0Kshank (fr0m Officer).
Norah Knowles Hardie, Mrs. De la Pryme (from Officer).
FOR ADMISSION IN THE GRADE OF COMMANDER (SISTER)
Catherine, Lady Kennedy.
FOR PR@M0T10N TO THIE @F (EROTHER)
Lieut.-Colonel Angus Gordon Cargill. Francis Henry Edwands, M.B., F.R.C.S.Ed.
Arthur G.ranville Rice.
Thomas Parham Lalonde, M.B., M.R.C.S ., L.R.C.P.
Frederick William Hebblethwaite, M.B.
James Saville.
Major James Percival Critchley.
Louis Yewdall.
Frederick Sarginson.
Harry Harvey.
Thomas Richmond Bailey. Servi.ng
Captain Sydney Harold Gillett, M.C.
Emmanuel Prinski Scott, M.B., M.R.C.S., L.R.C.P., and Desmond Manus MacManus, M.B., M.R.C.S.
L.R.C.P. (on appointment as Personal Esquires to Sir Alfred Webb-Johnson).
Major-General Sir Horace de Courcy Martelli, K.l3.E., C.B., D.S.O.
FOR PROMOTION TO THE GRADE OF OFFICER (SISTER)
Mabel, Mrs Wynne-Jones.
Alice Garrod, Miss Mayhew
Beatrice Elizabeth Katherine, M;-s. Girouard. (From Serving Sister.)
FOR ADMISSION IN THE GRADE OF OFFICER (SISTER)
Flora May, Mrs. Baker, C.B.E.
Dame Audrey Charlotte Georgiana Buller, D.B.E ., R.R.C.
The Ceuntess 0f Brecknock.
The Lady D l nleath. Norah Anne, Lady Clark.
FOR ADMISSION IN THE GRADE OF SERVING BROTHER
Donald Gordon Neish.
George Scott Anderson .
William Robert Trollope.
Albert Charles Gooding.
John Arthur Lockhart.
Alfred Harold Williams.
Percy Walter Paveley.
James Harold W 00dward.
Leslie Richard Pryor.
Percival Goad Doidge.
Arthur Tom Dwelly
Frederick Charles Hutchings.
Edward Charles G00dall.
Richard George Gough.
Arundel Holdsworth.
John William Gomer.
Francis Frederick Gibson.
Victor Reginald J Gnas.
Robert William Smith.
Ernest James Alexander Dougan, L.R.C.P. & S.
William Leslie Ashmore.
Walter William Goddard
Edward Oldham Orme.
Thomas Hamilton McOwat, M.B.
Ernest Ash Coekson.
Captain Alexander Felguson Di€k Jamies0n (tempHi)rary).
Arthur James Piekering. James Carney.
FOR ADMISSION IN THE GRADE OF SERVING SISTER
Eda Stanley, Dr. Curtis
Helen Maud, Mrs. Penny.
Helen Myrtle, MFS. Sutherland. Kathleen Alice, MFS. Beauc};}amp. Christina Hope, Mrs. Irvine.
Emily Kesson Churchouse, Miss McDougall.
Kathleen, Mrs. Ma,rtyn. Melei'!. Marjerie, Mrs. McNeilJil, M.B. MallY, Miss Swi-fit. Elsie, Miss Kirkley.
FOR ADMISSION IN THE GRADE OF Helen Derothy, The Lady ElIen@orough. OFFICER (BROTHER) Marjorie Monteith., Mrs. Warre. Brigadier Hugh Llewelyn Glyn Hughes, C.B.E., Olive Sibley, Miss May, M.R.C.S., L.R.C.P. D.S.C., M.C. Aida, Mrs. Gabe: 370
His Majesty The King, Sovereign Head of the OrdeF, held an at :Buckingham Palace on Octoiber 28, when he invested Bailiffs and Dames Gn"nd Cross. _
First to be invested was H.R.H. The Princess Elizabeth as a Dame Grand CFOSS; after her the were Invested :-
As BAILIFF GRAND CROSS
The Archbishop of Canterbury (Prelate), Colonel Sir Edwin .King (Chancellor), The Earl of Cromer, Field Marshal the Lord Chetwode, Major-General Sir John Duncan.
As DAME GRAND CRO$S
The Countess of Bessbol'ough, The Countess of Cromer, The Countess of Plymouth.
Officials of the Order present at the ceremony included H.R.H. The Duke of Gloucester (Grand Prior), The Earl of Clarendon (Sub-Prior), Brigadier W. B. G. Banle (Secretary-General) and Major-General J. E. T. Younger (Secretary).
The Archbishop of Canterbury read the prayers.
The Grades of Bailiff and Dame Grand Cross are the highest in the of St. John, and both are strictly limited in number. The number of Bailiffs Grand Cross may not exceed eight, whilst those of Dames Grand Cross are limited to six, excluding members of the Royal Family and certain Executive Officers of the Order.
BUCKINGHAMSHIRE At the October meeting reports were receive d of the annual inspection and presentation of Colours; also the very successful Cadet Camp in the Isle of Wight and the su ccess which the Wolverton team gained in the Brigade Finals. County Commissioner Major Dar viI-Smith in his Brigade r eport stated that the County strength had risen from 1,087 in 1938 to 2,088 at December, 1946. A great part of this increase was through Cadet membership. Majm-General J. E. T. Ymmger (Secr€tary of the Order), gave an interesting talk on what othel' Councils were d('ling, commenting on the fact that the Council for Buekingfuamshi!I'e was one of the earliest to be formed.
Lady lVloumt@atilem of Burma, Sup€rinhmdentin-Chief, N D. Brigad€ AtMarne, chatting to p€l'sons during her recent tour in distressed areas in India.
By J. STANDINGFORD
(Ext racts from a taZk give11, to mem bers oj th e Ho spitaZl'ers ' CZub)
(Co ntil1,ue d fr om page 338, OctobelJl , 1947, issue )
The M€mbers of the Order were in vari?us or r an k s. The Grand d th h sel110r officers formed the Master was the supreme controller, an WI IS Chapter-General or governing body .
The principal officers were :- .
Th e Grand Comma].lder, who was r esponsible for the Estates and PropertIes of the Order.
The Mar£ibal or· vVar Mini£ter.
The Ho£pitaller who controlled the Hospita ls and Charities of th e Order.
The Drapier or Quartermaster.
The TrgaShlrer.
When the Order was divid ed into T on gues, and they h ad become. a naval t ore offices wer e created' The Admiral and the TurcopolIer. The power, wo m '. th f th 0 der but Turcopolier was Mast er of the Bowmen m e _pay .0 e r , when the Office was raised to the dlgl11ty of a Grand ClOSS, ItS holder became Commandant of the Coastguard and
These £even senior Knights b ecame r esponsIble each for on e of the new Tongues, anG!. wa£ known as the Pillar of the Tongu e . H e was to attend to the and revi£i(» u for the Knights in hi£ Tongu e. The Tong u e of England was presIded over by the Turcopolier. . . .
The Knights were in tW€) grades. Kl11ghts of JustIce and. Grace.
The Knights of Ju stice were t h ose who h ad theIr n ob IlIty, t a k en their full vows; and fulfill ed all the ob ligations of them.
The Knights of Grace were thos e who had to the Order the influence of Kings and Pop e£ , who often desIred pla ce: m the Ord er for th eIr friends, notwithstanding they were un a ble to comply WIth: th e. of Chapter-General. P erha ps they were married or. had dIfficultIes or failed to pa£s the t est of nobility. These were saId t o b e receI:,ed by of the Grand Master, though it mlil.$t b e said they we r e not gr acIOus ly, and were very much looked down up on b y th:eir brothers of Ju stI ce. .
In addition to the Knights were the Chaplams, the D onats, and the Servmg BrotheF$
The Chaplains were we ll born , but n ot of noble a ncestr y. T.hey the r eligious offices generally, and b efore battle t o the Kmghts and m the Hospital to the patients.
The Donats were p eople who wer e inter est ed in the and. wIllmg to support it, but they we r e not to accept the r elIgIOUS were given the half cross. ThIS dIstmctIOn was also gIven for sp ecIa l ser:'I ces t o the Orci€r as b y eNgineers, and craftsm en engage d on fortIfi cations, h O$ipitals, and other builCi..iID.gs. ..
There wer e also the Serving Brothers who accompamed th e Kmghts and assisted them in v a rious ways. Thgy wer e said to " Not noble, respect.able ."
The division of the Order into Ton g u es was good from the p o mt of VIew of fightil'lg . It introduced competition, and in battle the. Tong u es .vied each other for the honours of Strife, but it was not an unmI xed blessmg for It mtroduced p etty j ealou sy , greed, and other und esirable elem ents , causing mu ch trouble
Promotion in the smaller Tongue s was more rapid than in the larger ones, since ·were fewer to claim an equal numb er OI Gffice£ ; Kn igiht s in t ®e la rge'f Tongue£ were thendlore jealous itfueK rom e [(1])d>M!llabe
Some Knights would be app (1) inted Co mmand ers, and weFe gIVen charge of large E-states of the Order in their own country, to manage them , and to improve them. Capacity-to incr ease the r eve nue£ to the C(1)nvent was considered good gro und :lior 372
further-promotion, and the Commander might become Grand Prior of his country . This gave him a seat in the Councils of th e Order and was a position much coveted. lIt carried w ith it, t OG, a place of est eem and u £efuln es s [n the government of the country, equ a l, as we shouM say to-day, to Cabin et rank. In England the Prior of St. J ohn t ook prece d ence of the Barons and Bishops in the HCiJuse of Lord s , a nd a t Clerkenwell hospitality was extended to Kings and Princes. Command ers and their junior of-fi.cers, while not sharing the excitements of life in the Convent, appear t o have lived the very comfortable life of cOllntry gentlemen, living we ll an d sharing their sport.
The Order ex ist ed for a dual purp ose: to fight for the Church and to serve the p oor and suffer ing. It was thi s dual purpose which ensured its survival when other Orders are but memories. When the n ee d for warriors to fight the battles of r elig ion faded away, there was still left t o them the car e of the sick and poor, and it is thi s work more th an a n y other which has encouraged its sm.-vival to the present day .
It was their first consider ation wherever they went to set up a Hospital. They were pioneers in nursing and ho sp ita l organization, and it should be said in a ll fairness to the Knigh t s tha t no matter h ow they may have enjo yed themse lves, they never neglected their hospital wo rk.
We have a fu ll d escription of the Hospital in Malta, which is of con£iderable interest both as r egards its set-up and the principles guiding its government
In the first place they treat ed friend and foe alike. Ther e was no r eligious or national bar t o patients. The only condition of admittance was their ne ed.
Some of the following points are introduce d in t o hospltal for the TInt time, and strike u s as being so very like what we are accustomed to to-day.
They had separate wards for s urg ical and m edical cases, so that they could b e kept apart. They h ad iso la tion ward s for fev er and d yse ntery ca$€S, and accommodation for convalescents. There was also a ward for the insane. This was a great advance in the care of human unfor tun a t es. Up t o this time the in sane had been looked up on as a danger t o the community, and we re usually confin ed in prisons.
It is generally to the cred it of the Knights that th ey recognized that this was a diseas e, which a lth ough they might not und er stand it, warranted special care.
They introduce d single b eds in their hospital. Up to the ti me pati ents had b een treated t wo-or even three-in a bed and th e cas es were mixed. The single beds of the H osp ita l of St. J ohn h ad a rail at the t op on w hich cOlald be hung a curtain t o give p rivacy t o the p a tient or to act as a mo squito net.
T her e was a high standard of comfort and cleanliness in the hospital. They had a lso a school of anatomy and surgery w ith courses of £tudy of infecti ou s diseases. /
A Knight was detailed each da y t o see tha t the doctors and attendants were at their posts, and that th e food was properly served.
Th ere were three resident physician£ and three £urgeons, each having two ass rustants w h o, we may assume, were student£ in the Medicail Scho o L
The Chaplains ministered t o the so uls of the pati ents, and used their influence to w in th em for Christianity.
E ver y K n ight t ook his turn of duty in the Hospital, usually arranged by Tong u es. Even the Grand Master we nt every Friday to t end the patients.
Ther e was also a District .r urs ing Service. A Knight wen t r ound with t wo women, and h e saw that everything possible was don e for the sick people of the town.
One may wonder w h y the Sisters of the Orde'f did not und ertake this work, but they were cloist ered and n ot a llowed to leave the nunnery. Their duty was t @ pr-ay for t h eir BrotilDll€T£, a[ll.d when, a£ at times , t ihtey reliJeHed, the Grand Mast er wmldd! visit t lb.em Cll!Fl!di a dl!liiBmlisill tililem 'fihe nunneries O[ th e Oydier wer€ fr equ e ntly schools for the ed ucation of young ladies , e.g. that at Martel in the Priory of Toulous e.
Life in the Orcl!er was not all peace and broth€rly love. There w ere' disphltes 373
between the Knights and. their Seniors over matters itiFivic:l, at ethers rt t and yet while their natimils at home were wa:unng one wIth, another, 1mpo an, B . d ' d they meekly offered their dlevotion$ tG the Supreme e mg, an, carne on as usual. Many travel1elis n0ted thi.s, and commented on the mward oneness of the Order despite their differences.
They were a veritable League c:f Nations, and ]ound theHi something transcending human dElffere]l(f:e s and makulg po.ss[?le a umty of purpose and an overriding spirit of loyalty to the Orde r. lIves were based on Sacrifice, Faith, and Service, and these watchwords mIght well be made our own.
It would seem that with all their faults there is much we can learn from them to-day.
The inaugural meeting of the wa.s held in Belfast October 6, when the Gov.ernor, The Earl 0] GJfanvIlle (PresHient .of the Comml:ttee), panied by Her Excellency The Lady Gr.anville (PresIdent of Nursmg Dl.vlslOns in Northern Ireland) was present. HIS Excellency opened the meetmg by referring to the importance of such Committees, welcomed Lord Dunleath as Chairman and wished the Committee every success.
, Lord Dunleath stated that the Committee was greatly honoured that His Excellency had consented to become President and that. Her Excellency was President of the Nursing Divisions. He welcomed J .. E. Younger (Secretary of the Order) who was representing the SIT. BaSIl Brooke (Ptime Minister O:E Northern Ireland), and Mrs. Superintendent-in-Chief), and. then stressed the objects> and responsIbIlItIes of the newly formed Committee.
Dr. R W. M. Strain (Commissioner for Northern Ireland) gave a short account of the workings of the Brigade in Northem Ireland. He was followed by General Young er, who gave an address oN. the Order and its future in Northern Ireland . The proceedings terminated wdh a vote of thanks to General Younger proposed by Sir Basil Brooke and seconded by Brigadier Ian Fraser. a subsequent meeting,' held the same day, Brigadier L. E. Macgregor was appomtea Secre tary and Mr. W. WiltoFl, Hon. Treasurer 'to the Committee. A General Purposes and Finance S1J.b-Committee was also elected and ite ms of general policy discussed.
By the cemrt€sy of the Executive Divisions, replyil'lg to qNestions previOlasly Offic€lrs of the Order the ahove Confe:rence received from delegates. was held at St. John's Gate on October 11, The Countess of Brecknock, Chief Staff attended by $9 representatives from an Offi<i:er to the Supet'intenedent-il'l-Chief, parts of th@ c©untry. then gave a very interesting talk on the Lady Dunbar-Nasmith, Deputy Service Hospitals Welfare work of the Sup erintendent-in-Chief, opened the Con- Joint Committee, and Civilian Relief. ference by read ing a cahle of goo<iil wislwes Miss Miller, S.R.N., S.C.M., County from Lady MountbaHen to which the Con- Nursing Officer for Suffolk, who at the ference sent a r ep ly. She welGomed those request of the County Authorities, has attending and expressed her pleasure at l!!I'D!@!eriJ:ake1!lJ tlJie mga:ii1i.zation of tlre Partseeing so many Officers present, espe<i:ially time Nursing Scheme for East Suffolk as this had entailed overnight travel for gave a very clear and h elpiul acco unt of some and a very eady morning start for the orga!D!izatio'll aned om thie iPartothers. C01f1veying the Chief Gom- - time Nmrsim.g Scheme in her area, where missioner's apologies for absence Lady at present 44 Brigade members are taking Dunbar-Nasmith expressed the <iEisa:p- pa!lft, worlting for 404 hou!lfs a weelK-iJ:ibJe pointment feU by eveFyone that it was molt: equiva[ent of 8 nurses working [ ull-Hme. possible for him to b€ present. Mrs. Girouard, Assistant SuperinThe programme commenced! with Miss ten cl!ent-in- Ohie'fi, expressed the ailPF>!lfeeiaHarrison, Nursim.g Corps aRd t[@!til @f th€ Cenm@rence tlhat, th.e 314
unavoidable absence of Mrs. Warmington, Miss Haipin of tIDe Wo meil'l' s VornuntaFY Services, had kincUy agreed to sJileak on the Hospital Car Service, and referred tc the happy wmking relationship which betweeiIQ t;!we W. V.S. aned St. John throughout the country. Miss Halpin's talk was followed by many questi o ns.
A:fiteF a break for lunch the ConJiereJ.1l!ce reassembled, with Mrs. Girouard taking the Chair. The Seeretary-General of the Oreder, BrigadJi:e!F W. B. G. Bame, gave a most instructive and interesting talk on St. J ohn Councils.
The next session was taken by MF. ]. R. Oldfield, Director of the Joint Committee After-Care Department, who gave a talk on "Emergency Help and After-CaFe" and, in the short time at his disposal, managed to give a gr eat deal of int eresting information about the work of the AfterCare D epartment.
In welcoming Mrs. Raymond, ViceChairman of the Joint Committee Hospital Library Department, Giromard expressed great pleasure that a member of our sister society had kindly come to speak at the Conference. Mrs. Raymond's talk on the work of the Hospital Library D epartment was greatly enjoyed by all present and the r ebound books displayed were much admired , and illu strated the high standard of work achieved.
Lady Dunbar-Nasmith took the Chair for the Open Session when a number of points, including Competition Rules, were discussed.
In summing up Lady Dun.b ar-Nasmith expressed thanks to all those who had contributed to the success of the Conference and all present expressed the hope that a similar Conference would be held next year.
appointed Secretary to the Stourbridge Nl!llismg IDivisioil'l i!0J 1942. In 1943, she was promoted to the rank of Divisional Superintend ent. She worked at the Corbett amcil §t01arbridge F A. Post during the War and since Uil45 had done valuable work in connection with th€ After-Care 0] ServiG:e Persol'll'leL Members of the Brigade were present at the funeral.
Diy. Supt. (R) Mrs. E. Ingham.-When the Sowerby Bridge Nusing Div ision was fermed in 1905 Mrs. Ingham signed the -BF fl; and she becaIPrle Division al Si\.!lperrntendent in 1933. H er work was recogl'lized by the Order in 1934 when she was Admitted a Serving Sister. She was a keen worker, b eth for Ass(;)ciation and the Brigade. Members of the Sowerby Bridge and Halifax Divisions attended the funeral.
Dr. H. W. M. Stroyer, who ' for 25 years was the County Surgeon in Bristol until ill-health caused his retirement m 1946. He joined the Brigade in 1912 and during the 1914-18 War formed the first V.A.D. Hospital in West Hart le]Yool, of whiGh. he was appointed G(;)mmandant. For his services he was made an Officer of the Order of the British Empire . He was a kindly, sympathetic, far man, al'ld did much to further the work of the Brigade. He was an Officer of the Order having been admitted as a Mon. AssoGiate in 1918. Four senior offiGers acted as Pall Bearers and many members attended the funeral.
Supt. William E. who joined the Brigade in June, 1916, and served in the Clifton, Bristol No. 1 Corps, throughout, being mad€ Divisional Superintendent in 1942 The same year he was Admitted a Serving Brother. He was a popular and. haFd-wo!Fkin g officer and his passing will be a great loss to the Brigade. At his funeral, six Divisional Su:perint€lndents., all Serving BrotheFs, acted as Pall Bearers.
We r egret to announce the death of the Supt. W. H. G. Young, who in spite of following :- ill-health carried out his duties until his The Earl of Lytton, K.G., P.C.-Lord el'lcil. MeNlibers of the Mighbrialg€l, Lythm, wib.o died on October 26, was a Blunham, and Di!i>triG:t Division has lost member of Chapter-General and a Bailiff a good friend; al'ld the esteem in which Grand Cross of the Order. He was also he was held was sh®Wl'l at th@ funeral when Pliesident of the Brigade iE, the County e f nearly the whole elf the Divis ion paraded. HertfoFdshire. He was to have been one The Nursing members and Cadets awaited of the six members who were Invested by the cortege in the Church; wlii1st H.M. The King at Bucikingham Palace om. members o[ tlThe C0JU!I'lty Staff and brother 28; but his lamentable death officers from neighbourmg divisions were intervened. present in good number.
'Dr. Wellesley Flood, wfu® was fo[" ma[')JY Mrs. Florence Go'VieF Nicklin, whe> was yea!Fs Corps SurgeoN €Jf the L iverpool a former m@mber and e>fficer of the " B " Corps and Divisional Surgeon of the Chester No. 1 Nursing Division. She B.A.T. Division. He rendered vall.!labl@ 90ine0i the Brrnga@.@ in 1923, being Ambut:0 ]'ldr1rifJ!e!lf Ull.e eause Q)f fil"s;iJ: aid lamGe OfficeI' in 1939. Later she became anciL will be gr€atly missed by th@ Brigade. Superintendent of the Fulford Division. Diy. Supt. Miss W:hittingham.-Sfue She received the Servi<i:e Medal of the j e[1'l!ed the [[OJ! I aililiw \Was OrdeF i.® 1939.
375
By SIR HENAGE OGILVIE, K.B.E., lVI.Cr., F.R.C.S. ·
(Extracts from tall? given at the St. John A mbuZance Brigade SU11geons Conjerenee)
The wallI' wfuich we ilil!a'Ve jmst passe d! accelemted wery grrr:eatly the .]?lace of medical research into cOlDleci:ed with wound treatment .. Pl"omm!1ent these are shock and illlf€ei:ion, the o:fi both of WhlCh has been improved immeasurably as the resu]t Qf. war expenence. The problem .of shock has not been solved--our laboratory fnends wIll never allow that claIm to be made-but it has been greatly simplified.
I that the word Shock without any .in.verted be retained in surgical literature as a name for a chmcal reactIOn wIth whIch all surgeonlB are familiar, and!. which they can treat if they are freed from the aura of doubt which those sto jps imply. Shock to. the " a sbite collapse fo]1owil!1l.g inj tilry , indicated by a depressIOn. of the tWE. and characterized by a [ljeficiel1l!cy in the circulatory volume 111 relatIon to the vascu]ar bed." This simple definition points the road to tre atment and to recovery, but across that road the Red Herring of Research is constantly dragged. Many factors associated with injury can produce a state of collapse and a depression of the circulation distinguished with difficulty from shock. Fracture of the thoracic cage, blast injury of the lungs, or injury of the pulmonary epithelium by the inhalation of flame, fat embolism, ancerobic infection of mmcle, the absorption of toxic substances from damag ed tissu es, p eritonitis, all these will produce a shock-like state. But if they are to be includ e d in shock, the woad ceases to halve any meaning. Again, if shock is allowed to continue, toxic lBuibst<iLnces, diue t @ deikient oxygenation, bacterial growth or tissue autolysis, make their appearan<e€ in the circulation, and accumulate b e cause the ]iver C;:LllIlJot destroy or transform them, or because the kidneys callI)'ot excrete them. These add to the circulatory depression, and wreck th e circulatory mechanism. They can be isolated, and when injected into animals caus e a fall in blood pressure; but they the result, not the cause, of shock.
Many of the experiments whereby shock is produced in the laboratory, and round shock in this context I put large inverted commas of my own, have no possibl@ relationship to the shock of the factory or the battlefield. Tourniquet experiI1lJl€lilts, and those iID. which bssliles or tissue extracts are injected into the cIDrculation OF inserted runto lb® QUy cavities, expeiJiiments used. to support the toxic the my, have hl0 lfese:mlDlan<ee to any accident except a crush injury, and it is dOl!ilbtful whether we are helping progress by putting shock and the crush syndrom.e into the same
Let us then reserve the word shock for a reaction to in jury whose basis is prepondel'atingly volumetric. The other conditions causing a shock-like state should be called pseudo-shock, and later toxic manifestations should be labelled epi-phenomena Even so, CO[ilcussion is a clinical diagnosis indicating a recoverable dilB"ttmoance of cerebral [uncbon, and the disCClvery of organic damage or the app@airance of ep i-phemomeitilCjl. FepIOves a case from the category of conC1!lSS[OFl.
The circulation of the b](0od d.epend!s O[il iti1:l!e action and :fiorce of the hea:rt beat, the v€llume and visc(0sity of the blood, and the peripheral resistance of the arteriol€s. Interference with <wny of these can lead to circulatory failure, and interference with one, two, or all of them may be found in the condition of acute circulatory depression that follows a wound or accident. But traumatic or wound shock is, in the great majority of cases, due to a diminution in the effective volume of the blood. The volume may be ulilchanged but be relatively Inadequate because the bed through which it flows is enlarged, cn the volume may be reduced ?y loss ©f circula6ng fluid. These two tYlPes of ment ar,e fomild pnl1ID.a!l'-Y @ir iil!@it'VOiUS shock a[i}Jd secOll'ld<lliry Git' t n !le sllin.6ck
In shodir there ills di.l!a,tahml <D ill the i]Gel!ipilweiJia lli srowmg of the beat due to stimulation of the vagms, b oth O:E thes e phe11@meiFla beIng reflex responses t(0 a P?Linful Gl,[, emoti0nal ' stimulus. Primary sl;;tock is 376
thel-efor e seen particularly after painful injuries, such as burns, or crushes involving the e xternal genitalia, and it is more likely to occur In nervous or e:lililotiona.l! individuals. Fainting in blood donors is a milt!. and transitoiry example of primary shock, and it is well s1.1ch faints are in 0lmiill ms or imiL eenitres w'li10se jpeirsGliJ1J.ne] mSjp]i]re cOlllfiGi.en!De. P n malfY sifl:0ck IS thus a reflex, and therefme a temporary and l!eceveralD[e state.
Secondary sl'wck, sometimes caned true shock; traumatic sheck or wcmnd shock, is due to actual loss of fluid, and is therefore fully overcome when the volume of fluid has been restored by natural means or by transfusIOn. In vvound shock, the loss is of blood, and the same is usually true of operatIon shock. In the shock which follows crushes or fractures, the loss is of blood and plasma. In burns shock the loss is of plasma only, from the wound surface or into the tissues underlying it.
Primary and secondary shock have this in wmmcm, that the patiemt looks ill, and that the circulation, as judged by, the !lP1J.ls€, IDS deFlressed. Any @me who has worked in the reception room of a hospital receiving cas1l1alties, will SOOl1 learn to recognize shock at sight, and to send the patient without further delay to the resuscitation ward. The experienced observer WIll learn, furthermore, to tell primary from se condary sh?ck.
The app earance of a patIent m pnmary, shock 'suggests that ?e IS from a sudd en fall in blood pressure without actual blood loss. IS or deeply drowsy. He may complain of cold, but hIS IlB warm, and though he is paler than normal, IS not blanc?-ed. HIS pulse IS low tension but full , that is the artery feels ItS nOirmal wildth but the b€at IS feeble; the rate may be raised by excitement, ibut is usua.l1y slOlw. 1'0 sum up, he looks collapsed, but not in danger of death, and a tramed aUendam't would say (( he has fainted" not" he is from shod: ".
The app earance of a patient suffering. from conveys .to the most casual obs erver that he is gravely Ill. He IS not unconscIOUS; he.ls alert and anxiou s , but w e ary. His eyes, with pupils dilated, stare out of a His skin is pale , cold , and clammy, his nose, ears, hands, and fe.el h.k€ Ice (it 'was a saying among the Field Surgical Units, that when a IlB in with cold feet, the surgeon should have cold feet also). Hi: IS usually shallow, but in the WOirst he may the. deep .sIghmg respIrations and extrem e restlessness of a l r hunger. HIS J?w]se IS ira[nd and itJiuea?y, that is it suggests a feeble beat in an arteliy comtracted to SIze. The systolic blood pressure taken with the IS an md€x @f the presence and d e gree of shock, not an entIrely one, :or some extreme comp ensation keep theIr pres :;;;ure up hll near the "\'\ hl1e others show an initial fall and a later nse.
The div ision of four rough grades has a certain practical value if A h ealthy man who loses one pint of blood is not much the 'worse for It ; he loses it as a donor he probably feels better.
One who loses two pints is llwde;rately shocked systolIc .prelBSUiJ,"e willI be firOm 85 mm. to IQ)O lJllm. He win a llimost recoveir If by warmtb and fiil!1idls by and it'ectallliy, ibmt he WIll ;reoover more quickly if l\e is giveill a piil!lt of b]ood! 0'[' p]asma.
One wh0 loses three pints of blood is His systolic pressure will lie between 65 mm. and 85 mm. He IS UilThlIkely to recover 'Nithout the transfusion of plasma or blood. _ One who loses four pints is pirOfoundly shocked a barely. pulse and a systolic pressure. of 65 or un.der. He :wIll dIe unless hIS .volume IS restored early and rapid [y WIth body flUIds,. two pmts at least of i@ e It ca!ll be accepted as a safe woirlnng rule that a man who IS admItte.d a -st ate @[ jjpit'Gf0 1Ll!1illid sheck [iJ!eeds IOU'l.- pints of 10 [Olod a$; soon as ""ve can 'lt lmooit@ . . f 'it; it ".' lit (tall be seemiJ! t !biJJat t1liJJe :Feco-gnition of sifu@el.'f., 0 J. S lla me, whetbeli JPriI11!ary @l! sewitil@a:try, and the of ItS dep€nd OlD clinical ebservation and ©omnilion sense, that IS on klllovvledge the good nurse or 377
orderly can acquixe, and on t.hey should is by reports from the bedside that advances; are InItIated and new discovenes found. The crus;iJiJ. syndrome was discov€3!1."e<.il. by the sturdy of air raid casualties in the wards 0f- LG>!I!ld®!I& HGspita[s, and mat embolism, Gnee tbG'I!1ght t@ he very rare, was shown to b€ a falFly common a@wmpaniment of shGck. When a shocked patient starts to develop moist and bubbly breathing about the second day, and at the same time becomes mentally confused or quarrelsome, fat embolism should be suspected.
(To be concluded)
Berkshire has given a lead in pr<widing a service which may become a very real and ext(tnsive @i1.'le. A smal[ band of has been imio an "Air Unit" mor the purpose of accompanying patients being transported by air. After careful medical, psychologieaJI, and radiological tests, the fittest and most suitable candidates were selected for this special work . All have had air experience and completed a course of flying duti@s for air sickness, etc. They have received instruction in the care and handling of patients in the air induding attemd.ance l!ljp(l)n emergency midwifery eases. !JE:very memiber had a va]icil. :passport and ahead y a stretcher case has been
flown from Switzerland to England under the auspices of the Unit.
On Sunday, October 26, the members 103Jt"acl.ed 1m their smart two-piece unifo;rms at Woodley AiIdlield in Berkshire, where they were inspected by Lady DunbarNasmith (Deputy Superintendent-inChief) who was accompanied by County President Major-General Sir John Duncan, County Vice-President Lady Lorraine, County Commissioner C. A Poole, County Surgeon Buchanan-Barbour, County Supt. The Hon. Mrs. Leslie Gamage, and County Officer Mrs. Miles. The members demonstrated into an aeroplane and many other activities which they might be caned upon to perform.
A stretcher squad of the Berkshire Air Unit loading a stretcher case into an aeroplane.
Lady Dunbar-Nasmith inspecting m emb ers of the newly formed Berkshire Air Unit. County Supt. the Hon. Mrs Leslie Gamage and District Officer (Air) Mrs. Mil es are also present.
with its short wheelbase and forward drive the new AUSTIN 'WELFARER' convertible ambulance is able to thread its way rapidly through the confusion of city buildings or the litter of factory yards, swing round into position, and be on its way again with precious minutes saved in the race against time.
Austin have been making ambulances for forty years, and every detail in the design of the new' Welfarer has been worked out im the light of that experience, by people who understand hospital needs. .The specially hinged rear doors and folding step permit quick, access to the int€rior, whil€ there is a convenient extra door on the near-.sid€. Thermostatically-controlled heating and ventilating ke€p the air fresh and at even temperature.
by Field Marshal Viscount MrJ7'Ltg011'bery of Alamein, ICG., G.C.B., D.S.O.
" We can only regain our wealth and pm;itiol'l in the world by thrift, by savings, and by hard work Shortage of material goods; will not overcome us if we have spiritual reserves; we must mobilise those reserves and create a spirit which will not admit frustration, but which will carry us forward, on a rising tide to Victory in the Battle of Reconstruction: as our spirit did in the late war . . . So I would ask people to save in the same way that they saved in the war years; that is in thankfulness for the victory which has been granted to
us and in the knowledge that the , present Silver ' Lining Campaign will play a vital part in the reconstruction and rebuilding of our country."
No. I (PRINCE OF WALES'S) DISTRICT
T he CGmnliissioner has veceived the foHowing l etter frGm the Stoll Theatres Corporation, Ltd., for services rendered by members at the Empire Th eatre, Chiswick, on September 15. "I should like to place on record the thanks and appreciation of myself and the Company for the excellent assistance rendered by the members of your Brigade present at the Empire Theatre, Chis wick, when some members of the audience were injured by fallin g plaster. The speed ily rendered fir st aid did much to alleviate pain and ga ve confidence to all who were present."
Dr. G. M. Shaw Smith has been app@inted Co unty Surgeon, in place of Lt.-Col. N. M. Hammer, who has accepted an appointment overseas, for the Northern Area.
Haggerston.-The winner of the 1947 Div isional Competition of the Haggerston Nursing Division is A/S. Mrs. Adams, who received the trophy from the donor, Mrs. Milburn, who was for some years Divisional Superintendent of the Division, and also a miniature individual cup given by Vice-President Mrs. Craft.
Hornsey.-On October 23, Miss Francis Pitt, the celebrated British naturalist, again lectured and showed her colour films of birds and beasts at Homsey Town Hall in aid of the Homsey Nursing Divisional Funds. Mr. L. D. Gammans (M.P. for H omsey) acted as Chairman and among those present were Lady DunbarNasmith (Deputy Chief), Co unty President Marie, Marchioness of Willingdon, the Mayor and Mayoress of H omsey, District Supt. Miss Workman, Asst. Commissioner G. P, Hart, Div. President Miss M. M. Dant, to gether with other Area Officers and Div isional Officers. A guard of honour was provided by Cadets from Muswell Hill, H omsey, and H arringay Nursing Divisions This was the fourth occasion Miss Pitt had given a l ecture under the
Battle and supported by members ()f the Ambulance Division , under Supt. L. A. Harris, :presented a demonstratiGn at its hea dquarters. It was staged to t;)nable Lady Div. Supt. Miss Brown, of Vancouver, Brigade Overseas, to witness organization and methods of a division whose ambulance, hospital, and public duties have by no means diminished by the change from war to peace-time conditions. Those present included County Surgeon ]. NewtGn Huds on and Mrs. Hudso n, District Officers the Misses Tuckweils and' Miss N. F. Waters; whilst accompanying Miss Brown were her parents, Mr. and Mrs. Brown, of Sanderstead. The programme covered v arious aspects of Brigade work. FollowirJ.g the demonstrations the Divisions marched to the Green, where a Duty Tent, a gift to the Ambulance Division from an anonymous donor, for use at public duties, was dedicated by The Vicar of Warlingham (The Rev. CanGn W. H. Roseveare).
On October 14, Mr. G. E. Craft (editor of the Gazette) gave members a talk on the history of the Order, the Association, and Brigade, in the home of President Mrs. Wood who is always willing to further the work of the Divisions.
Wimhledon. - Members of the Wimbledon and Merton Division, also representatives of neighbouring divisions and of the B.R.C.S. were recently favoured with an instructive lecture on " Pregnancy and Childbirth ", given by Dr. N. Kramers. Permission had been obtained from the Commissioner for a mixed class to be held; and for over one hour some 80 members enjoyed an interesting and instructive talk. District Officer e. W. Hipkins pres ided and reminded those present that members must bear in mind that· first aiders' duty ends where the doctor 's begins.
aJ uspices of the Homsey N1:msing Division; Mrs. Girouard, Assistant Superinand the audienoe revelled in the tendent-in-Chief, visited N©rthern Ireland pictures shown. During the interval Lady Dis trict fwm October 3 to () in connection Dunbar-Nasmith made an appeal for with the Annual \ iVeekend Residential fund s and recruits; whilst the Mayor of Training Course for officers and members Homsey (Alderman Valette, gave an of Nursing Divisions The Course, under informal party after the lecture at which the direction of Dis trict Supt. Mrs. G. N. Mrs. Plat (Officer-in-Charge) thanked Miss Wallace, was held at Portstewart, County Pitt and the senior officers and presented Londonderry, and was attended by over to Lady DlllDbar-Nasmith and L Chdy 200 officers and members. WiMiJng@'G'lil ClJUimgra.:phed copies of <une Speakers Chi the Course, in addition to Miss Pitt's books. Amb. Officer Mrs. Mrs. Girouard who addressed ttlThe memoe!L"S Richards ilandle£l Miss Pitt a b()uC],net frmTI on Recruiting, included District Surgeon t11e IT'lemoers. MilJlriel Frazer, "'iVork of the BrigaGle in WarIingham.-MemOers of the Nursing Soutb Africa"; District Commissioner Div ision, under Nursing Officer Mrs. E. Dr. R. 'iV. lVI. Strain, (( Some points in the 381
History of Medicine"; Staff Officer Mrs. Shaw (Cadet Headquarters) " Leadership"; and (t@ a combined lectur€ with Girl Guide Commissioners) the Hop. Mrs. Gi@bs " Pl!l blic Relations".
A f€ature of the Course was the Church Parad.e held on Sunday to the Church of Ireland, Portstewart. The parade marched to and from the Church head€d by the local Pip€ Band
Some 150 men, women, aHa cadets paraded at Sandy where for the first time th€ annual inspection ef the North Bedford£hire Divisions was held i!l!l i\he RecT€ation Gnmnd . The Inspecting " Officer was County Commissioner Capt. W. C. Knight who was accomwanied by County Pre£ident Lady Malcolm Stewart. Corp£ Officer G. Parsons was in charge of the parade. Also present was §ir Percy Malcolm Stewart, County Supt. Miss A G. Meyhew, County Secretary E. H. L. Stonebank£, and other Coumty Staff. Dememstrations followed the inspection, and Capt. Knight took the salute at the marcR past. The parade attend€d £ervice in the Parish Church where the Rector, th€ Rev C. G. Hooper, gav€ an in£]Drring addr€ss.
COUNTY OF BERKSHIRE
County Commissioner C. A. Poole, accompanied by County Supt. The HotJ,. Mrs. Le£lie Gamage and other members of the County Staff recently carried emt the annual inspection of the following division£ :-Frnchampstead Nursllig and Nursing Cadet, Brackneli AmbulanGe and Nursing, A£cot Nursrng, AmIDu[anee, amd Nursing Cadet, and Wokingham Ambulance.
Didcot.-The number of transport duties covered by Didcot Ambulance Division during August exce€ded those of any previous month. Eighty-on€ calls were answered and a total of 2,286 miles covered by the two ambulances
Reading.-On OGtob€F 15, County Commissioner C. A. Poole pre£€nted ServiG€ Me@al£ and BaFs t@ GffiCeFS and! members of the Reading Corps.
Windsor.-At the Road Safety Carnival member£ of the Royal Wimd.sor DivisiGn staged a mock accident which was so realistiG that several of the
audience fainted. The demonstration was
tions of "St. John. at Work" were given. County Commissioner C. A. Poole opened the proceedings with an appeal for recruits; and later ]Dresented awards to ;t:iffie NiUrsing and Nursing Cadet members During the interval items were provided by Reading Town "A" Ambulance Cadet Band
The annual competitions of the G.E.C. and Associated Companies were held at Witton on October 4, when six teams competed for the two challenge !,::ups presented by the Hon. Mrs. Leslie Gamage (Cm:mty Supe:rintendent, Berkshire), who was received by President J. J. Gracie. The results were :-AmbuZance.' G.E.C. It B" (Witton Division), 1st, followed by Chamberlain and Hookham Division. Nursing.' G.E.C. (Witton) Division, 1st, followed by G.E.C. (Coventry) Division. Both winners thus retained the cups they gained last year. Teams and friends were entertained· to tea, and a visit was made to the Works' Medical Centre.
The first annual competition for the It Lamberton Cup" and prizes, given by County Commissioner Dr. J. Lamberton, was held at Carlisle on October 11, when seven teams competed. Carlisle It B" team gained first place, with Carlisle It A " team runners-up. Dr. Mark Fraser and .Dr. Wm. Fraser were the adjudicators, with County Officer F. Shelley as Competition Secretary.
COUNTY OF DERBY
Alvaston.-The first competition for the silver cup presented by Dr. S. A. Bower Was organized by the Alvaston and District Division, and attracted 20 teams. Dr. Dinwoodie and Dr. O'Donnell were the judges in the team test and they placed Chesterfield Tube Co. Division first wirth Derby Division as runners-up . J Sursleet (Bentinck Colliery) gained iiirst place in. the individual section, by Supt G. HOFsnaU and Mr. M. Berry, second place going to ]. Shepard (iLangwith Loco). Dr. Bower presented his cup to the winners and also distributed the individual prizes.
OF DORSET watched by some 1,500 people and Supt. Poole.- Under the direction of Corps A. F. L. Simmonds gave a runnimg com- Supt. F. Bryant an interdivisional commentary explaining each st€P of the petition foJ' the H€igham. Cup was he1d on first aid work as it took plaGe. Laterhe October 20 . County Surgeon E. GordGn made an appeal for new Frl:em@€J's Waffi[aJc€, C@FjilS Surgeo[O]j R. J. Whitley.-On OGtobe r 9, at the Com- Honme, DF. Lamia Maule Horpe, and. munity CeHtre, meamQers of th€ Nursing County Officer E. Paddock officiated as Division, under .Supt. M.rs. A. Clalik, The awards were presented by held an open evenmg at WhICh demonstra- SIT Arthur "\V'atson who had just received 382
his warrant as President of the Poole Corps from the hands of Dr. Laura Maule Horne, who also presented Dr. Mackenzie with his wanTaJmt as Divisional Surgeon. POGle gained first place, followed by Parkstone.
Displaced Persons.-An application was received by the County for St. John personnel to attend to Displaced Persons from Europe, arriving at Parkstone Quay. Seventeen Nursing personnel from five Nursing Divisions, accompanied by County Supt. Mrs. Smellie aEld County Cadet Officer Mrs. Howard, carried out the work. Training Course.-A one-day training course for Nursing and Nursing Cadet Officers was held at CGlehester on October 4 when the Rt. Rev. Lord Bishop of Colchester opened the prcceedings. Every Nursing Division was represented; and the lectures included Antibiotics, Pencillin, etc.", by Dr. Penfold, It Activities for Divisional Meetings," by The Countess of Brecknock (Staff Officer to the Superintendent-in-Chief), It Blood Transfusion," by Mr. Alec Blaxill, It Medical Emergencies," by Div. Surgeon McQuarrie, Brigade Orders and Publicity," by County Officer Miss W. K. Argent, and It Seventeen years with the Brigade in India," given by County Officer Mrs. P. Gerrity. County Supt. , Mrs. Smellie, who arranged the course, presided and she was thanked by County Commissioner Col. J. L. Hamilton. Dunmow.-After the annual general meeting Alderman J. Plumbley, :first superintendent of the Division, presented
a silver cigarette box to Dr. S. Allman Hall who had resigned the position of Divi:oional Surgeon owing to health reasons. President W A. Hasler ha:m.ded Amb. Officer G. Patient an electric clock on his resignation of ill-health; whilst an electric kettle was given to Sgt. Arthur Green on the occasion of his marriage.
The annual inspection was carried out by Brigadier F. B. Hurndall (Commissioner for Hampshire); whilst Div Surgeon D. K Gaitskell (Brockenhmst (Hampshilre) Division) critically watched the demGmstrations. The visitors were welcomed . @y Commissioner D;r. J. JR. Hanna, Sir Alexander Coutanche (D€puty Governor) and Lady Coutanche (President No 2 Nursing Division), Brigadier R. M. H. Lewis, Dr. H. J. Shone (President of the Association), and Mr. P. Le Masurier (Secretary of the Association).
Dr. H. J. Shone and County Surgeon Cambridge (Guernsey) adjudiGated at the competition for the Spitfire Trophy Competition for members of the Jersey Division. The team captained by Sgt. T. F. V. Cooke gained first place.
Commissioner Dr. Hanna and Div. Surgeon G. A - Helps judged the It H anna" Individual Trophy competition of the J etsey Division; the winner being LjCpl. H. W. Barnard.
Norwich.-The Lord Mayor of Norwich (Mr. W. O. Copeman) who wa£ panied by the Lady 1Vlayoress, officially opened the new Headquarters on
October 23, and in doing so thanked the officers and members of the Brigade for the which they had nmdered to the citizens of Norwich. He re]erred to the great debt they owed to St . J obn for Fdievrng th.e really acute siho1"[<lJg e @] nurses, and stressed the importance of the b oy and girl Cadets. The buildmg was dedicated by Archdeacon A. C. Moore. County Commissioner Sir Thomas Cook presided at the ceremony and said that although the Brigade had been established in Norwich for many years they had been wanderers without a home.
Those present included the Sheriff and Mrs. P. J. Boddy, County President Lord Albemarle (who proposed a vote of thanks to the Lord Mayor), County PFesident (N.) Lady Cook, County Treasurer Sir Ric!haFdI. Barrett-Lennard, Asst Commissioners Dr. W. E. Rutledge and Dr. W. E. H. Bull, County Supt. Dr. May Rutledge, County Cadet Officers Mrs. G. E. Portal and H. C. Denny, County Secretary Mrs. J. H. Yull, County Organizer Major C. E. V. Sams, and the Chief Constable (Mr. A . F. Plume), who as PresideI'J.t of the Corps expressed thanks to the Archdeacon Moore.
The seventh competition for the Duke of Challenge Cup, arranged by the AshmgtoI'J. and District Collieries Corps, and open to units ofthe Brigade, B.RC.S., and F.A.Ps. in the two counties, attracted ten teams, three of which reached the final round. Div. Surgeon John Brown judged the team test and set a most spe<Gtacular scene. The setting was a comp lete Fep[ica of an underground endless rope hau lage road cOlilnected! to the surface by a
travelling road and drift, provided with double 2 ft. gauge way with tensioner under-tub haulage rope, to which was attacbed a set 0] empty tubs which had becOlne derailed. On the sui"face, at the drift [oo'owth. , was a Hme o[;fllice , e€)lui]l>;pe@ with telephone, first aid equipment, miners' e lectric hand lamp s, etc. The set was in complete darkness; and the test called for full knowledge of the Textbook.
Corps Surgeon H. S. Brown judged the individual tests , wh ilst Dr. A. Roberts (M.O. to the Northern Region of the Ministry of Fue l and Power) adjudicated in the viva voce tests.
Eppleton Colliery" D" team gained first place ]01' the second year in succession, foHowed by Hazelrigg Colliery" A ".
A Novices competition. was a lso h eld for the Ashington Coal Company Cup, and this was won by Backworth Maude Pit
Mr. W. ]. Charlton (Area General Manager for the N.C.B. and President of the Ashington District Collieries Corps) presided over the function , whilst Mr. H. O. R Charlton (Chairman, Northern Division, N.C.:B.) presented the trophies and expressed his keen appreciation of the keen interest shown in first aid. County Commissioner Stanley Embleton proposed a vote of thanks to a ll who had taken part. County Ofncer D. Hind so n was Chairman of the Competition Committee.
HehbuFn.-The new recreation r ooms, the result of months of hard work by members of the Hebburn Ambulance Division, were recently opened by County Commissioner S. Embleton, who said the P ivistiol!l had every reason to be proud of Its achIevement. The rooms include a fully-equipped kitchen and provide s uch
amenities as a full-size billiards table, piano, re-diffusion, table-tennis, and darts
COUNTY OF STAFFORDSHIRE
Tipton.-County Commissioner Capt. F. L. Rich.ard carried out the inspection of the Tipton and District Corps and expressed his pleasure at the turnout. " One is always sure of a good show in Tipton," was one remark he made. Corps Supt. E . Lakin was in charge of th e parade with A/Corps Officer Miss M. M. Byard in char ge of the Nursing personnel.
COUNTY OF SUFFOLK
Ipswich.-The Ipswich Nursing Corps Competitions for the "Hill" Indiv idu a l Officers, and" Last" Individual Members Cup were held on October 13 when Drs. Morrison and Patton judged the work done, assisted by Sisters Pells, Skinner, and Staff Nurse Copeman, of the Borough General Hospital, in the I ursing tests.
The winners were: Miss Mary Groom (Student Division) in the Officers' event; whilst Miss Corbyn (Air Duties), Mrs. Forsgate (Broadwater), and Mrs. Wright (St. Augustines), tied for the Members' Cup. , At the close of the competitions County Supt. Miss A. M. Parker presented Corps Surgeon Dr. Bryne (who had organized the competitions) with photo frames and a cheque from the Ipswich Nursing Corps thanking her for all her assistance in the past and wishing her every su ccess in her work in South China where she hopes to continue Brigade work. Miss Appleton was presented with her warrant as President of the Ipswich Nursing Corps
COUNTY OF SURREY
County Sgt.-Major H. S. Smith, who took for his su bject Drill and Procedure; and Mr. S Channell, operator at the Airscrew Works, who presented films on Blood Transfusion.
Some 150 Officers and N.C.O.s w ere present, including County President The Countess of Lindsay, Asst Commissioner Capt. P. H. Ellis, County Staff Officer Chaplin, Corps Supt. R J. Gristock, and Supt. Miss J. Macey made all local arrangements.
The annual first aid competitions of Rootes Group (Coventry Divisio n) was held on October 11 when "C" team, captained by E. E. Last , gained the President's and Vice-President's Silver Cup, being followed by " B " captained by F. Stiles, who gained the medals. In the Individu a l Sh ield Competition J. Price of " B " team gained first plac e with E. E. Last of " E " team, runner-up and winner of the Medal. County Officer H J. Harris and Corps Secretary Jennings .judged the team test
The annual inspection of the Northern Area was held at Hingley 's Ground, Old Hill, where County Commissioner Dr. F. L. Newton, accompanied by County Supt. Dr. C. Porter, and Co unty Cadet Officer Mrs. Robinson, carried out the inspection. Asst. Commissioner T. C. Lench was in charge and the Commissioner thanked him and County Sgt.-Major E. F. Preece fo r making the arrangements for such a s u ccessful inspection. The Mayor of Rowley Regis, Miss E. C. J eakes, Prestident of the Southern Area Nursing Corps, and A Conferen,ce ,vas held at \ iVeybridge on several Div isional Presidents and ViceOctober 26, when Asst. Commissioner Presidents supported the event. ]. P. Flavin presided in the absence of Hill and Cakemore Nursing Division County Commissioner \lV. G. Pape owing held a Harvest Bring and Buy Sale, the to indisposition. After the luncheon function being opened by the Rev. A. interval County Supt. Mrs. Heald presided. Beaven, Vicar of B lackheath. Supt. The speakers included Dr. K. A. Soutar Miss D ye 'welcomed all friends a nd thanked (Deputy County M.O.H.) who addressed them for their support. the meeting on the National Health Service Rowley Regis Division held a reunion Act an,d Voluliltary Bodies and emphasized s u plPe:r receliltly with President 1. Collins the value and importance of the vo luntary in the chair. After the Loyal Toast the spirit; Miss Ling (Matron, National Chairman sPQke highly of the w01"k of Hospital) who spoke on the Future St. J olm and str essed the need for peaceRelationship of the St. J ohn Ambulance time activ ity. Certificates iss u ed by the Brigade with Medical a nd Nursing Ser- War Organization were presented b y Mrs. v ices , emphasizing the need for qualified Collins; 'whilst Corps Supt . F. G. Price help to augment the regular staffs in presented Service Medals to Amb. Officer Hospitals; COllnro: y S urgeon Surgeo'l1l- ]. T Ashmore , Sgt. E. ]. Yale, Ptes. Capt. G . O. M. Dickenso1il, who gave F. Bill in gham , and M. Ashmore. lVIr. E. S. ulsehll il1!ionlilllation reg2lJrc] rung 'fraining for Joihnson, Vice-Presi:dent dect, presented ; Di v. Srurgeon Dudley th.e ann u al re-examination awards \Nard who spoke of. the dangers of going Po wick antI District Nursing Division beyond the o[ .first aid und eF th e held a socia l evening on October 20, when title" The First Aider is NOT a Doctor"; Supt. Mrs. H. N. Hiscock presided. 385
President Mrs. J. Scott presented Mrs. H. Winn Rowe (late Vice-President) with her War Service award, and then Mrs. Rowe pFeseIilted awards to members of the Division.
Leeds.-At a recent social of the Lower Wortley and Farnley Nursmg Division Supt. Miss G. Renton, on behalf of the members, presented a Biro Pen tel Div. Surgeon T. H. McOwat in recognition of his Admission to the Grad€ of Serving Brother of the Order. She thanked the doctor for his work and his keefl interest in the Divisi©[l Saddlewol'th.-Elevefl teams entered fo1' til€ fi:fith annual €:omp€titions pro-
moted by the Saddleworth Division. Dewsbury West Riding Police gained first place, with Horwick L.M.S. Works Machine Shop second. The Women's test was won by Manchester L.M.S. La01 ies, Himdders:fueld CeIiltral Nurs[ng Division being runners-up. Mr. F. Burton, of Crossfields, ga:ined first place in the Individual test; and Miss Downes, of Manehester, was successful ifl the Individual tests for women.
Pte. A. Blackler (Greenfield) won the Local Cup and also the cup open for competition among Brigade members during the past twelve months. Asst.
Commissioner H. Harrison acted as Chairman; whilst the tr ophies were presented by Mr. H enry Rhodes, M.P. for Ashton.
By FRANK H. EDWARDS, F.R.C.S.(Ed.), O.St.J. (County Commissioner, Shr@pshire)
(Extracts from talk given at the St. J o.hn A m@ulance Brigade Surgeon's Conjer-ence) _
I have be en asked to talk about "Standards of Marking", in conjunction with Dr. Nicol. He has handed the main burden to me, as he has talked on another subject, but I know we are in complete agreement.
I have interpreted the title as meaning not only the proportions of marks that are to be given for the various parts of a Test in a competition, but also the Judge's accuracy in noting what marks have been earned, the Judge's method @f seeing that ' the t eam is allowed to do its best to get those marks, and the . standardization of all three. But first of all-why do we have competitions?
Unofficially the answer may ·be-so that those of us who have First Ai01, Home Nursing, and all that they mean, at heart, can exercise their hobby and meet each other at such events as the Regional and Final Competitions, where we can compare notes and make plans for the b etterment of our own partieular Division.
SOUTHERN AFRICA (CAPE PROVIN CE The head of the Red Cross rang up the DISTRIGT). St. John Lady Divisional Superintendent
The well-known Peninsula Maternity Hospital in Cape Town, which Gares for both Eurcpeans and non-Europeans, is reGeiving a free transport service from the District for discharged mothers and babies.
Owing to the shortage of bed accommodation at the hospital, it is normal for the m©thers to be discharged between the seventh and tenth day, but the district nursing service kept a vigilant eye on all cases for a reasonable pericd thereafter.
A St. J onn member holds the van door open f(')r the hospital staff to assist mothers and babies into the vehicle [@r a speedy and Gomfortable trip home. Few of the patients are ifl a position to affGlrd a taxi when discharged and the Asseciation decided te allocate a 10-seater station van for sitting patients and an ambulance for the more serious cases.
The van is usually driven by Brigad-e members, many of whom are housewives during the day, afld the ambNlail1JJGe cases are moved in the evening when ambulance members are afteF w@rk, as stretcher-bearers. During <l>n€ month alone transpert was arramged foil' 64 mo.thers, :mtJ;t free of charge. ThIS serVIce IS bemg gIven good publicity in the local press
asking her to start a First Aid Post, _ which was done at on€:e. At first this post was in th e fire-station, the only equipment being dressings, band ages, and antiseptic; the members worked from 10 a.m. until 6 p.m.
As things slackened a little, permission was given to move the Post to the Gaiety Theatre building and the refectory was used as the Post while the foyer was utilized as the waiting room: there were 2-hourly shifts during the day and 6-homly dJ uring the night, a doctor, a trained nurse and three St. John members for each shift. Altogether, th e volunteers consisted of ten doctors Sikhs Muslims, including three women: four tramed nurses, three Anglo-Indian, one English, two Red Cross members and thirteen St. John. All the e-quipment' us ed bele>nged to St. John
Escort WCIDS provided to a.ccompany m ernbeFS to and from the First Aid Post and als@ in the ambulamce when patients tr:a-nsfenecl to the R[pcm Hospital. A Jeep IS als@ u£..ed for removing patients.
Two ]3y[tish R.A.M.C. oFdedi.es offered to help and they were asked to undertake night work with a member of an Ambulance Division.
This First Aid Post was well organized; INDIA (No. 10 DISTRI CT). all the cupboards were scrubbed out and the sterilized things were kept in a meat
During the recent troubles in India the safe. Each ease was written up in a bo@k Brigaae Ntlembers of the DeIhl-Simla and. a report givelll to the Police and. to tIle NGl. 2 Nursing Divisiem kave beetrl called! O.C. T !lO@@ps. T !h:ell'e was COitillsta.mt !mJ@);t
UP (\)ll to help. afld kot, sweet tea ready at any
The trG)lflble started in the loeat bazaa.r inme: lliilot water-bottles were a1s0) wHh shootin g, murdering, and looting. vided. 386
Officially-Competitions are held to inspire enthm;iasm among members of the Brigade, to improve the stock, and thereby increase the knowledge of those participating, with the r esult that the public is better served. The aim of a competing t eam should not be to win a Shield or Cup-that should be incidental -but to make itself perfect so that the -individual members will become better fitted to deal with a real injury, should they meet one.
The War naturally stopped all competitions OIl a large scale, and I was more than pl eased when I found what a universal d esire there was ' for them to start again. The more the better-say I.
The old hands at the competition game are getting fewer, and very many ofthe teams now competing in the eliminating rounds-Brigad e, Railway, Police , and other organizations-are made up of young men and women for whom the work is quite new. Their nervousness is stage fright, not sheer excitement, and we Judges must take care of them and handle them carefully.
We must treat them with scrupulous fairness and give them the deal we all appreciated in our own vivas.
Fairness, no bullying, no favouritism, and reasonable assistance to overcome stage fright.
You may wonde r why I mention such things, but I do so b ecause I have' seen Judges act in such a way that Teams have been " put off their stroke" completely, with the result that the marks have had no relationship to the capabilities of the Team.
Needless to say, where I have been in a position to prevent it, those Judges have never been asked to judge again.
I once saw a Judge-while the team was working'-go and sit down to talk to a spectator! J! also heard another ask a T eam leader if she did not wish to take a temperature.
If a team realizes that it .has had a fair deal, i!ll spite of the fact that it has done badly, there is no ill-feeling, and what does more harm to a voluntary organization than ill-feeling ?
To get that s ensation of fairness all t eams must be treated alike. By that I mean that their handling and marking by the Judge must be the same in all stages of a competition, from the preliminary to the final.
The standard of marking and the standard and method of judging should, and could, be the same throughout .
1l0 get diown to mOlfe detail. The proportioning of marks. Here we get two schoolli) -of thought. I have seen tests marked in the" bulk" method-z5 for examin.ati<on., :25 :fl@r treatment, 25 afteif-care, and so on. I know some like llit, but I loatlwe it.
The test is set on the Textbook, and in the Textboe>k, in some place or other, 387
every step is set out. All the points leading up to contact 'with the patient, the relatives, friends, surroundings, all the signs and symptoms. All the details of and after-care. They are all there, together witl1 the application of common sense and the details of what not to do.
I believe that every point should go down on the mark sheet. Complicated, I know, but very wen worth the bouble And how to apportion tihe marks?
I am sure some add up the number of questions, divide into 100, and give the to each one, with no eye to the importance of the question. Two marks for not having' any gral1,ny knots, and two marks for digital pressure on the femoral!
Life saving treatment should have the greatest number of marks-many times more than anything else. The very fact of treating severe hcemorrhage fust shou ld have big marks. I prefer that to deducting marks for not doing so.
Big marks for ef-ticient artificial respiration: treatment of severe shock to my mind, deserves more maFks t11an the tidiest fractured femur that has ever been splinted.
Dovvn at the bottom of the scale come the messages to relatives, the soap and nail brush, and the instructions to the ambulance driver to go carefully over bumps in the road. .
The varieties of Tests, individual and team, with or without Home Nursing, are infinite, but I feel that this method of apportioning marks is applicable in ev@ry case.
And how to award those marks?
Unremitting attention by the Judges, open eyes, and ready ears. I am not in favour of two Judges, but when I am able to do so, I like to have two reliable stewud$ who sit at the sides ot the scene, proviciled with a m;;ufk sheet, and who aGt as extra eyes and ears for me. Many a time I have found them to be very helpful.
If, fm any reason, fewer than the maximum marks are given, I always note the reason on the mark sheet, and I try and add a comment or two of encouragement or advice on the last page. It all helps the team and the spirit of camaraderie.
In other words, every care must be taken to apportion the marks according to importance and to see that credit is given where earned.
And how to get a team to be its natural best. I am using the word" team" throughout, but my rema'fks naturally apply to individual tests in the same way . Here we must go furtiher 1back-to the first eliminating competition.
It is not right that, in a Divisional or a County Competition, the conditions should be totally different from those met in the Regional or Final. The mark sheets and the judging should be the same standard. Scenery cannot beexpense prevents tl;1.at. But some effort should be made towards realismactual telephones, not t oy ones (the G.P.O. will always lend them), real hot water bottles, and registering thermometers.
(To be concluded.)
Thgre is now available a Hamper which contallis spedmen first aid outnts in n1Jlmbgr) an Order Flag, two pennants, and twelve enlarged photographs which depict Brigade personnel at work. The photographs measure 20 in. by 16 in. and are mounted on card with struts for standing up. The hamper will be loaned Jiree of charge to Divisions requiring exhibition material for local events; and applications should be sent to tlm.e Press Officer, St. John'S Gate, London, E.C. 1. 1'1)@se hiring the hamper will be expected to pay the return carriage and to be liesponsible for the contents.
In addition the series of enlarged photographs, size as stated above, are also available for display in sl10p windows, on. stands, etc . These are glazed for protection; and the subjects shown include Pu blic Duty, Hospital Library, Gas and Air Service, Occupational Therapy, Transporting patient from ship to shore, On the Football Field, On the Race C<\)"urse, Rescue from the A von Gorge, etc. These wiJ!] be ioaneo1l free o£ charge; but hirers wi ll iue >tr@ pay il!:iIiil!e lieil!:ilru lrn can-iage and be responsible for the care of them whilst iIil -mse. Applications sh.ou lcJI be made to the Press Officer as above . 388
Headquarters: Priory House, 4 Cathedra! Road. Cardiff.
A second series of spec ial lectures for colliery OFganized by the Frrst AId m Mmes Sub-Committee of the Priory, with the concurrence and s upport of the National Coal B0ard and Ministry Officials, opened at Neath on Saturday, October 18, when Dr. J B. Atkins, Regional Mines Medical Officer gave a highly interesting and informative address on the subject of " Falls of Roof" was keenly appreGiated by an audIence of over 200 first aid men from collieries in the No.1 Area of the South 'Western Division, N.C.B. The Area q-eneral Manager, Mr. D. Douglas, presupported by Members of the First Aid in Mines Committee; who were after'wards entertained to tea by Dr. C. Armstrong, Assistant Commissioner f or Neath County Area.
For the No. 2 Area, a lecture will be given on December 20 at the Bridgend Town Hall by Dr. Naunton Lewis, whose subject will be "Morphia and its use in Trauma, especially in relation to Mining Accidents. Insensibility due to Trauma or due to illness may be met with underground". Mr. Ruscoe Clarke, F.RC.S., Surgeon-in-Charge of the Mobile Operating Theatre, Birmingham Accident Theatre, will be lecturing oil "Modern Trends in Accident Treatment" at the Shelley Hall, Pontypridd, to an audience drawn from the No. 3 Area; and Mr. A. S. Aldis, F.RC.s., will be lecturing Gn a Saturday to be arranged in January at Aberaman for the No.4 Area. Arrangements for Area No.5 have yet to be completed, the Central Hall, Bargoed, having been booked for a Saturday in February; and the series will conclude w ith a lecture by Mr. J. M. Peterson, D.Sc., on " Respiration", to be given at the Great Central Hall, Newport, Mon.
Those attending at the request of the Colliery Manage memts have "td'lew ttra'VeWlFlIg expenses and a tea allowance paid by the National Coal Board. Brigade personnel are afforded an 0ppOl:tunity of being present at their own or Brigade expense; and all who attend receive subsequently a copy of the synopsis of the l€cture and notes of the questions and answers in the ensuing discussion.
when. the a.anual inspectiolQ of the Bromfield Corps was followed by the un veihng and dedication of a memorial tablet to four members of the Wrexham Division who died on Active Service in the Second World War.
Col. Sir Charles Lowther, Bart, Comf0r East Denbighshire, made the ll1SpectlOn, after whkh the Corps formed a square in front of the Wrexham Divisional Headquarters. The Corps Officers steod in the eentre, with. the members of the Division who tend the s ick and injured and man the ambulanees for which the unit is responsible on the right, and the Ambulance Cadets on the left, while forming the fourth side of the square were detachments of the British Red Cross (Denbigh 6 and Denbigh 500).
In the centre of the square sat the relatives and friends of the four men who made the s upreme saermce, namely: FlO. James R Stace, R.A.F., Cpl. James A. Mc-MahoIil, RA.F., A.e. 2 N@rman. Daniels, RA.F., and A.C. 2 Cyril L. Jones, RA.F. From the nearby flag-pole, the Brigade :£lag, at half-mast fluttered in the breeze.
The service, which was conducted by the Vicar of vVrexham, Canon Robert Davies, M.A., Hon. Vice-President of the vVrexham Division, opened with a short address of introduction by the Hon. President, Alderman \i\Tilliam Aston, C.B.E., 'fiollowed by the hymn, "Row these glorious spirits skine!" The lesson was read by the Vicar and members of the public present jGined 'with the Corps in the Lord's Prayer. The memorial tablet fixed on the wall inside the Headquarters was unveiled by Mrs. F. VV. Morris, Hon. President of the Cadet Division, and dedicated by Canon Robert Davies. Royal Air Force bu glers sounded the" Last Post" and. " Reveille" after which the hymn of the St. J ohn Ambl!llance Brigade-" Bioly Father, King Eteffi'[i]!al "- was sung. The serviCi:e eOlilcluded with. prayers and the singing @f the hymn " 0 God our :help in ages past ", followed by the Blessing and tb€ two National Anthems. Music was provided by the 5lalvation Army Band.
The Mayer and Mayoress of Wr€xham (Councillor and Mrs. E. S. Hackett), and the Chief CONstable for Denbiglrshire (Mr. Philip Tomkins) were among the general public present. Corps Superinte:mdemt 1f> iR. Kent was in eil.laJrge (i)f the inspecti®:m am@. due arrangements [@r th€
A eeremGIilY of particular impressiv(mess unveiling and dedication ceremony were took p lace in tihle ooulityard of th€ Cmmty lnade by Ambulanee Officer C. A. Buildings, Wrexham, on September 28, A wreath from the officers and men of the 389
Corps was placed at the foot of the memorial tablet.
Aberavon County Area.-Dr. E. W. M. Hubert Phillips has relinquished th.e office of Assistant Commissioner on app.>ointment as County Surgeon for Glamorgan, the appointment -of Mr. E. A. Howe, as his successor having been approved by the Prior, the Earl of Powis. This appointment can be regarded as a recognition of long and loyal service in the Brigade. Mr. Howe enrolled in the Kenfig Hill Division, of which he became Superintendent iID. 1920, being promoted to Corps Treasurer in 192-3 and Corps Superintendent in 1926. Since 1lil41 he has held tilue ramk of COllmty Officer until h.is new app@iRtment as Assistant Commissioner. He is in possession of the Service Medal and three Bars.
Neath County AI·ea.-The first post-war inspection of Units in the Neath County Area was held at the Neath Football Ground. The inspecting officer was the Commissioner for '\;Vales, the Hon. John H. Bruce, who was accompanied by Mrs. Bruce (Assistant Lady Superilltendent for Vllales), the Mayor of Neath (Councillor Philip Howells), the Commissioner (Mr. D. M. Evans-Bevan), and County Area President (Mrs. Evans-Bevan), Assistant Commissioner Dr. C. Armstrong and Mrs. Armstrong, Theodore Gibbins (Centre Chairman) and Mrs. Gibbins, Mr. A. J. Esmond (Hon. Centre Secretary), Supt. Vi. Doolan, and Mr. and Mrs. T. R. Martin were among those present.
The parade was und er t he charge 01 Corps Surgeon E. P. Coyne, with County Officer John Richards, Corps Officers T. G. Jenkins, and G. D. Williams in attendance.
'Iihe Jinspeding Officer was VC'Fy :p1€ased with the manner in which the men turned out, and was delighted to see so many boy and gil.-l Cadets on parade. He paid tribute to the work of the County Commissioner, particularly in the Neath County Area, which consists of close on 1,000 members, who during the past year rendered first aid in 1,817 cases of accident and sickness. The Mayor of Neath spoke of the excellent work that had been carried out by members of the Brigade in Neath and District and thanked them for their unselfish devotion to duty, and assurecl them of his support.
New Appointment.-Major A. H. G. Field, M.B.E., who has been appointed to the office of Assistant Commissioner, vice Mr. B. E. Maberly, r etired, is well known to all ranks of the Brigade in the Cardiff and District Corps. Possession of the Service Medal and 3 Bars testifies to his record of over thirty years' efficient service, which commenced w ith enrolment in. the Cardiff Emergency Divis ion in 1914. After service overseas in the first World War he resumed Brigade activity, being appointed Corporal in 1921, Ambulance Officer in 1926, and Div is ional Superintendent in 1934. H e was promoted to Corps Superintendent in 1935 and held the rank of County Officer from 1940 until
his recent appointment, which offers Saturday, October 11. Ten teams comample scope for the continued expression peted, with the following result, monetary of his unbounded interest in the work of prizes of £8, £5, and £3 being awarded to the Order. the first three teams :Public Dates.- The personnel on duty PracticaZ. Theory. TotaZ. at the Imteifllational Soccer Match w hich Dufbyn AN'lam 76t sq· 128 was attended by 55,000 spectators at PGchin Colliery . 44t 73 J 17t Ninian Park on Saturday, October 18, Bargoed. 64t 50 114t dealt with 73 cases. Acknowledging the In the Ambulance Cadet competition, in report, the Secretary of the Football which 12 teams entered, the Clee Challenge Association of Wales writes: " The Cup was won by Tredegar Cadets with question I always ask is what would have 147 marks, followed by Trelewis it A II happened if such willing helpers had n ot team with 132, and Bargoed, 127. These been available? " three teams received prizes of £3, £2, and A generous rec ognition of the services £ 1 respectively. rendered by the Brigade in attending all NEWS IN BRIEF matches arranged was recently received from the Cardiff City Association Football Priory Ch.ristmas Greeting Cards i1'l Club, Ltd , in the form of a donation fGur are available dior sale to of £2 5. members of the Order in Wales, Committee Members, Brigade personnel, and BOROUGH OF MERTHYR TYDFIL Association students at 4s. per dozen, CENTRE inclusive of envelopes, plus postage.
The Treharris Divis ion has supplied a Priory ambulances dealt with the rereport of the Comp etition for the Leigh moval of 20,834 cases, involving 363,716 Challenge Cup, which was held on miles during the first nine months of 1947.
Mr. R. A. Newton, Chief Mechanical . Engineer's Dept., Newton Abbot, who was Di v is iona l Ambulance Secretary until he j oine d the Forces in 1943 has again take n over this post. Since 1945 the duties h a ve been ably carried out by Mr. H. J. Potter, Goods D ept., Taunton, who has n ow left the district.
Dr. D. G Tullis, of Hereford, who has for many y ears b een adjudicator in the Divisional Competitions in the Chester, Gloucester, and Worcester Division, had kindly presented a trophy for teams competing in these three Divisions. The trophy will be awarded to the team from either of these Districts gaining the highest number of marks in the semi-final competition.
Cardiff.-Mr. L. Lewis, Class Instructor, presided when Mr. H. H. Swift, Divisional Superintendent, distributed the awards gained by members. Others present induded Dr. Bence (Class Lecturer? and Mrs. Bence, Mr. B. Board (Div. Am.bulance Secretary), and other officers of the Company.
Newton Abbot.-Mr. A. W. H. Christison, Div. Loco. Supt., presid ed at the presentation of awards to the Newton Abbot Class by Mrs Christison. The Chairman' presented a cup to Mr. Sweetland of Taunton, who gained the highest individual marks in the com'JDetitioll of th€) Exeter and Pl YWli@HitiW.
1L.P.T.B. (MET :LINES) Cf.lNl'RlE
awards held at Baker Street on October 9, and the many distinguished visitors. The speaker for the evening was Major-General J. E. T. Younger (Secretary of the Order) who gave a sh0rt talk on the present day activities of the Order, referring to the Priories Overseas and the appointment of liaison officers in Rome, The Hague, and Sweden. Dr. Norman (Chjef M.O.) thanked General Younger for a most interesting and instructive talk.
Mr. J. A. Gravestock then gave his report as Centre Secretary. There were 208 first aid awards to be distributed (an increase of 25 over last year) and 28 Home Nursing awards. In addition there were 276 outstanding awards for 1942-45. Since the formation of the Centre in 1!1)02, over 5,400 :first aid awards had been gained. Twelve Long Service Token Certificates, ranging from 15 to 35 years' service to 'be pFesented and Special Certificates fOF First Ai.d Rendere01 to b>e presented to Mr. H. Allen, Mr. A. Yates, and Mr. H. Steel. The Hally Medal winners were: 1st year, Mr. Ronaid Bird; 2mi year, Mr. Patrick Shallo€.', and 3rd year, Mr. James Vesey. Mr. Geo. Hally, donor of the medals, sent his congratulations to the winners.
Mr. A. H. Grainger (Solicitor to the Board) presented the awards. He congratulated the recipients and thanked them for tfu.e work they were doing. Mr. Webb> (Chairrnam of th€) Centre) expressed thanks to Mr. Gramger. Major A. C. \iVhi.te Knox (Commissioner, Ng. 1
Mr. A. B. B. Valentine (President) presided at the annual presentation of 391 (Continu ed on page 398)
CASE REPORT No. 333.-The Officer-in-Charge of the No. I of Wales's) District, S.J.A.B., reports the efficient of. first aId by. a m.ember of NO·7 (\iVimtledon and Merton) Nunllng DIvISIOn 111 the follow111g Cireum:-
On the afternoon. of August 18, Ambulance Sister D. Cobley (who was 011 holiday in Guernsey, Channel Islands) was having tea with a party of friends at Moulin Bay, when a lady stumbled and fell lileadlong down the rock steps and over into a crevasse. With the help of three men she was lifted out and taken to the tea gardens. She was unconscious and had severe abrasions on hgr head, legs, and arms. Ambulance Sister Cobley, having no equipment with her, used han,dkerchiefs, etc., which she collected :from her friends, and water from the tea rooms for cleansing the abrasions, and for a cold compress to the head. The patient regained consciousness in about ten minuteq. When the ambulance arrived the patient was carried on a stretcher up a very steep hill, and the Sergeant in charge asked A/S Cobley to accompany her to lilospital. The Cllmb wJanee was equipped with radio, whereby contact can be made with doctor and hospital.
COMMENT.-This rep011 t tells a story of good work well done, and w in s for Ambulance Sister D. Cobley cfJ1ldial congratulations.-N. CORBET FLETCHER.
CASE REPORT No. 334.-The Chief Secretary of the Association reports the efficient of first aid by a signal linesman of the Signal and T elegraphic Department, Ramsbottom, in the following circumstances:-
On New Year's Mr. T. Dewhurst (who was off duty cons equent on illness) was walking with his along a road bordering the River Irwell, at Summerseat, when he heard faint groans from the river. By the light of a small pocket torch he saw the body of a woman in the river, and although both banks at this spot are 10 feet above the water level, he immediately climbed down and entered the water, sending his wife to a friend of theirs for assistance, and asking the friend iIEo Dring his motor lorry and to shine the headlights on to the spot.
On reaching the woman, DewhUlfst recognized her as living 50 yards away. She is an eaderly oid ladly of 70 years of age, and very heavy. Actually she was lying unconscious in about 2 feet of wate[', but fortunately her chin was resting on a stone, which kept he[' mouth out of the water.
The first difficulty was to get the old lady out Gf the river, which had to be done by raising her up the 10 bank. It was not possible to do this by ordinary lifting, as she was too heavy. She had to be pulled up a ladder by means of a To.¥le Tound her to get her to the Toad. Once there, Dewhurst and two others carried the old lady, fore and aft, to her home. A rapid examination showed that she had sustained a very deep wound to the head, approximately 9 inches long, an arm fractured both above and below the elbow, and that sJi1e was lfllilCGnS([;[@us.
Artificial respiration resulted in her return to consciousness after a few after which she was undressed, anill wrapped in blankets with hot water bottles, the head wound and the fractured arm sJPlinted, aU this work being perfol'med by, or the leadership of Dewhu['st.
On the arrival of the doctor expressed approval of the work which had bgen done, stitched the head, examined the splinting of the fractur e d arm, and immediately got her off to the hospital in the which had previously been by DewillliiUiFslt.
It very dOlabtful whether old lady would survive; but she is now quite :fit and well again. :Bey@nd s@m@ m[wcmw emlienee ifirom tile fractuTed arm, she appears to be none the worse for lier experience.
COMMEN1l.-M/]!'. T. is eorrlJi(J(;!Jly congratulated on the success wiiich attended his efforts to save the tife of his j>at<iJent for without his aid sn,e would surely have dzed.-N. C. F. 392
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For this reason' Alasil' can be with in all the conditions in which such an agent IS rndlcated, ItS use affords the advantage of greater freedom from the POSSlblhty of unpleasant gastroin testinal sequelae.
• Alasil' is, therefore, an analgesic, antipyretic and which can be prescribed tor patients of all ages. Moreover, It IS so well tolerated that its use can be continued to the desired extent.
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Physical Culture
Beauty Hints
What to Do in Emergencies
Treatment of all Skin Diseases
The Lungs, Pleurisy
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Wounds with Foreign Bedies er Fractures
J. W. (Birl{enhead).-Furlher to your query whieh was pubiis1D.ed under the above heading in the September issue of t ltJie Gazette, I find myself eveTili liflC»1fe perplexed n0W over this c @ID!tlic»verstfal treatment of w cnmdis accompanied by a foreign body or fracture. You say that we must apply direct diigital pressure for competition purposes, but agree that it might be difficult in an actual emergency.
Surely we must not as first aiders be left to make such a decision. Page 25 of the Supplement to Textbook to my mind is conflicting. It states that over a fracture or foreign body bandages and dressings to be applied in such a manner as to prevent direct pressure over the fracture. Yet at the top of the page we are told to apply direct digital pressure with the thumbs. I have trie d to picture the effect of direct pressure ®n a compound fractl!lre of the Ulna and/or Radial Arteries.
Your further ruling with pmlsibly the Revision Committee's ruling will no doubt clear up this difficulty, which many first aiders share; and I thank you for your kind help.
In my p revious answer I was merely underlining the instructions of the Textbook, as you will realize if you turn back to Clause (6) on page 18 of the Textbook under « Essentials of First Aid". There you will find it laid down that you must decide on the character and extent of the treatment to be given. It is, therefore, necessary for you to make a decision in all cases as to the actual tr eatment to be given. I repeat, however, that as far as possible in actual emergencies and certainly in competition work, you should carry (Jut the instructions on p. 25 oIthe Supplem ent to TextbOGk.-N. C. F.
Complicated Fracture of Ribs
J. P. (Hounslow).-(r) May I suggest that on page 80 of the T extbook the instructions « Give ice to suck" should be followed by the words « Only in hcemorrhage fr.om the lungs"? As the t ext stands, having given ice, in conformity with Rule 3, we find this instruction countermanded-exce pt for lung injury-in Rule 4.
(2) Further, for the sake of uniformity of page 80 with page 137 o f the Textbook, the words « c01d 80mpress " should read « ice bag or cold compress". These httle points arose dwring one of our tests, and I pass the m on to you, as I feel sure YOM would Eke the opportunity to consider them.
(I) On pa,ge 80 the Textbook is dealing with injuries to the lungs follo wing fracture of nbs " and th ere could be no point in including the words « in hcemorrhage from the lungs." In Rule 3 on page 137 the Textbook sets out the treatm ent for internal hcemorrhage for all regions. Hence arises the necessity for reference to hcemorrhage from lungs in Rule 3 ...... .
(2) The omission of the icebag in the case of complicated fract 1;we of the ribs appears to be dehberate and to be due to the fact that the weight of the icebag might p rove harmful. .Consequ,ently with this injury the eold compress is prefe rr able. On the other hand, if used 'm the treatm ent oj cases of internal hcemorrhage, the cold compress would los e its eJlicieney within a shotyt time, whe1' eas the icebag would retain its low temperature and the cold would penetrate de eply.-N. C. F.
Humour in First Aid
R. H. (Luton).-Here is another hummous tale which you may like to add to yo ur series, and which actually occurred at Divisional Practice.
The doctor was conducting the annual re-examination, and had asked Qne to name the organs might be involved in a complicated :fracture of the nbs. The member had gIven the correct answeI' except for the one item (to wit the liver), and came to a fun stop.
The doctor a b}t of gUid.ance by saying 'tbat t'llere was one m €ne organ, and that It was somethmg nice to eat. StiU silence from the member. So the doctor said, " Y (l)1,f, p11 eJQabZy like it for breakfa st." - '\iVhen the re was stm 394
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The and antipruritic censtituents in Coal Tar were isolated for the first time when Wright's introdu<;:ed their active @xtract Liquor Carbonis Detergens Qver 8e years ago. This distinctive preparation has secured a prominent place as a medicament in treatment ef skin diseases. It is specified repeatedly by dermatologists and is today, tJl.irough C0nstant research and applicatiem of modern methods of manufacture, better than ever before, both in appearance and antiseptic value. Wright's Coal Tar Soap, soothing to the tenderest skin, derives its healthprotecting powers from this preparation.
COAt
In ancient Greece, when a particularly effective remedy was discovered for any disease, its formula was engraved on the posts of the Temple of lEsculapius, the g0d of healing, who, before his deification, had himself practised as a physician, about the year 1250 B.C. He prescribed natural remedies for disease and, in the absence of efficient analgesics, employed soething charms for the relief of pain and magic songS to increase their effects.
Our m edrical science of t(Hilay, with its X-rays and. its anaesthetics, WQuld have appeared quite incredible to those early practit ioners, whose experIments and progress were based largely on guesswork.
To-day progress is based on knowledge, and one di scovery lea ds to another.
T ake ' Cogene for instance.
Modern science has shown that a smal!l qual11kty of a powerflll drug wm do th.e wod{ ®.f a ll;trge dose if it is ibacked by the vigllt of ®tl1er <Jlrugs in the right propertions.
In ' Cocyene ' minute quantities ef feur separate ili.-ugs (three of them pain_relievers
aNd the f@urth a stimula nt) are scientfiically combined in tablet form. Because each is present in such a small amount there can be noharmfulafter-effects, yet the combination is so effective that' Cogene ' will relieve the most harassing nerve pain in a few minlites. Ask your chemist for it. Supplies are still limited, but he will do his best to see you get your share. P:rice ljltd. a tube.
no am;wer, the doctor said, (( It's best fried with onions." Daylight s u ddenly dawned on the member, a nd h e sho uted in a lo ud vo ice, (( 071, I Tripe."
Good I Next please I I-N. C. F.
Trl"eatronent of Fractured Spime
F. A. (Soutihgate).-May I ask you r ve:ry valuleol opinion in t he follo w ing matters r egarding the Supp lemen.t t o the Textbook, which I think require some enlight enment ?
F irst , I have always ass umed that instructions set o ut in the Textbook sh ould be follo wed in the order in which they are laid dOW11. I think that this assumption is based on common-sense. If that is so, according t o the Textbook, whe n medical aid is not r eadily available, one sho uld place pads between the patient's ankles, knees, and thighs, a nd then app ly bandages in the manner prescribed. Then roll the patient on to back. Would it not bg much simp ler to r o ll the patien t fust on his bade , a nd then apply the pads and ibandages in the manner prescribe d? Surely with the ]patieIil.t ill a ;prone positioIil., probab ly with his legs b ent, it w([)uld be ve ry awkward to apply t he pads and bandages and even then, after they were applied, when turning the patient on t o his back they wou.ld .be apt to slip a nd get out of p osition anyhow.
Your query gives the impression that it is more concerned with the comfort of the first aider than with that of the patient. The latter must, of course, be ,the firs t consideration; and the securing of the lower limbs with pads and bandages ce11tainly results in nducing the risk of displac ing the fragment of the fractu1 1e d spine In these circumstances it is wiser to stand by the instructions contained in the men t trJ T extboon .-N . C. F.
Treatmemt of Burns
F. A (Southgate).-Secondly, does the ruling not t o remove clothing a lways apply even in cases of burns by an a lka li or acid? Supposing that a person tried to r each for a vessel on a shelf containing a so lution o f caustic soda, and that it ina d vertently it slipp e d and the so lution poured dovm his arm, no t only burning his a rm , but satura ting the w h ole sleeve, particularly the inside, wo uld yo u even in tha t case, n ot t ake off the coat? Su rel y if so the so luti on satur ating th e sl eeve wo uld continue to be active and cau se further damage, as far as I can see. Your ver y kind ruling on these points wo uld oblige . Thi $ probZem has caused difficulty to a large number oj firs t aiders; and as a result of qu erie$ received i t has a lr eeuiy been de(J;lt with in this column The l iquid applied on th e dressings is likely to soak thr ough the d()thing and to reach the affected parts; and in the case which you qUQte of a burn resulting from caustic soda it would tend to neutra lize the effects of the injury. Further, uncovering a burn i s always accompanied by risks of sepsis, and is much better done under surgica l conditions in h ospital. I n other words , no case has yet been made out for altering the instructions with reference to burns in the S upplement to Textbook; and you will be wise to - put them into effect when you are called upon to treat thi s injury.-N. C. F
Tl"eatmemt af W0wmds
J. H. (HOFwieh).-Berewi!t h t w® q1ileiFi!es to iweatment olf wOlllThds as n ow in the Suppleme))1t t o TextboCDk.
(r) Refe r en ce p. 25, Rule 7 . When blood soaks thro u gh the first dressing pad and bandage, should we remove t he bandage and apply further dressing and p ad?
(2) R eference p. 27, Rule 9. I s the rubb er bandage t o be applied a bo ve or below the wound in the treatment of venous hcemorrhage? In a recent competition the surgeon exam iner refused to give the (( bleeding contro lled" until th e bandage was applied b elow the wound . Further, I found tha t there js a t end en cy t o treat burst varicose veins as on p. r2 9 of the 'Textbook.
(r) The instructions in the paragraph of the S uppZement which you quote sta te definiteZy that the first ban&age is net t@ be rem(fJved when applying further pads and If you did s@ you relax wntftt pressure h(J{)d app0ied. Also, th l/,s m'bg ht resuU I/,n fu rt h er and severe hf!l3morrhage, especially (j{,S this migh t dusturb bZ ofJd clots w h ic h are in process of formation.
, 396
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IIOlDAT MOENS JUI!.ES, 01 the CoS.T . 8elttu Perc., writ•• :-'" ASPRO ' I• .tlll mr friend anti I ....y. pt .reat r.lI.f from them. am only too ,....ed to re"ommend lhem whenever I can V".""e all looldn, fOl'Ward to lhe time when ,h.1I h Malted on !! mor.. with our _III ..... D 40i !i . Mad. In En&1ancI b, 'talTJd .tV ASPRO LIMITED. SkNap. aaeb. 397
(2) If it is fo ,/tt11,d that hcemorrhage s till cont'imtes afte 'Y the. sec ond dressing pad s (('111d bandage have been applied, it seems clear that the cond t twn cannot be du e to venous hmmorrhage on which direct pressure is always effective. It follo ws , ther efor e, that the h mmorrhag e must be comi ng from some more s eri ous wound tha n a burst varicose vein; and that treatment must be as for a eterial bl eedi 111g. H ence the instruc tion s to apply the tight ligature above the wound.-N. C. F .
RAILWAY NEWS (continued from page 391). District, S.lA.B .) called for new members
to join the Brigade and so assist with The annual comp etitions for the the important duties which the Brigade " Birchenough" Shield and "Downie" will be called upon to do during November Cup were held at Salisbury, the adjudiand at the Olympic Sports m:xt year. cators being Drs. R. W. Fynn, S. G. H. SOUTHERN Gasson, H ]. Riley, K M Rodger, and Eastleigh.-The Town Hall, Eastleigh, E . M. B. West. The individual tests were was paGked to capacity on October 8 held first, followed by the team test, by members of the Eastl€igll and during am actual accident oecurred r(!)unding classes, and many friends, to and some 0f the competitors ·who had hear a talk on " The Supplement to the already competed gave valuable assistance T€xtboGk" and "Competitions ", by Two non-railway teams took part in the Major A. C. White Knox (a member of tests; the results being 1st, Bulawayo the Textbook Revision Committee). The Railway; 2nd, Umtali Railway; 3rd, dOGtor Govered the two subj€cts in an Salisbury City. The winning team will instruGtive and interesting manner and represent Rhodesia in the South African answer€d the many questions put to him Finals for the Selborne Shield. F. West by thos€ present. Only the lateness of the (Bulawayo) gained first place in the inditime pr€vented the meeting <continuing vidlJ.al section, being followed by R. D. Mr. F. A. Trctt (Centre Ambulanc€ Secre- Waldeck (Umtali). These two members tary) presided, and introducing the headed the list last year when the positions speaker referred to th€ fact that the were reversed. number of students on the Southern The" Downie" Cup, awarded to Railway had increased by over 400 this novices with less than three years year. Thanks were expressed to the Brigade Service, was won by H. D. D octe>r by Mr E. S Guppy (Class Secre- Sheasby (Bulawayo) follow ed by M. R. tary) whilst Dr. Lalonde expressed thanks · van Niekerk (Salisbury Railway). to the Southern for allowing membets of The trophies and prizes were presented the St. John Ambulance 13rigade to by the Chief] ustice, the Hon . Sir Robert attend such an instructive talk. Hudson.
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