The St John Ambulance Gazette (1940)

THE JOURNAL OF THE VENERABLE ORDER OF THE

BSON& SONS

ST. J OHN AMBULAN C E G AZETTE is published en the 15 th oj each month. T he annual subSCription is F. 6d., post free; single copie s 3d Brigade Reports and P hotograph s should be addressed t o the Editor, at 32, Shoe L ane , E.C.4. R ep orts and photographs should reach him as early in the month as p ossible.

SubSCriptions and Advertisements should be forwarded to the publishers: Messrs. British Periodicals, Ltd., 19, 19a Cur-sitor Street, L ondon , E.C.4.

C ONTEN T S PAGE Editorial 3 Air Raid Precautions. 4 Reviews 5 Overseas News 6 Obituary 8 Railway News 8 Promorions and Appointments 9

and Answers 12

fo r Wales 15

Transfusio n Service 18 Persistent Poison Gases I9 Red Cross and St. J ohn War O rganisation. zo

CHANCER Y OF THE ORDER, S T J OHN'S GATE, CLERKENWELL, L ONDON , E .e r.

L o rd Cromer' s M es sa g e

We are now faced with a New Year, and what it may have in store for us as active workers u nder the Red Cross an d St. J ohn \'\'ar Organi sation no one can forete l l.

Up to th e p r esent we h ave no t b een pu t to the tes t to t he deg r ee ori g in ally a nti ci p ated. O ur o r ganisatio n i s no t a lone in this r es pe ct. I realise th at an y pe r iod of wait ing u p on eve nt s whic h we cannot

in fl uence or control is necessarily tedious and uninspiring.

This must not be allowed to discourage us, lessen our keenness or blunt our energies. At any time a call may come that will require of us to make every effort of which we are capable. To meet this as we should all wish, our Organisation must remain stc:adfast and prepared for any emergency.

My message for 1940, in one sentence, is " Remain patient and ready to answer D uty'S call."

CROl1ER, Chairman, Executive Committee, R ed Cross and St. John War Organisation

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Indi a n

Joi n t

War Committee

The Joint War Committee of the Indian Red Cross Society and the St. John Ambulance Association (Indian Council) announce that, with the approval of His Excellency the Viceroy, an appeal will be issued for a \Var Fund to provi d e money for the many services which it is the business of the Red Cross Society to render to the sick and wounded and to the troops in general in time of war. The Joint War Committee are responsible for Red Cross care of all troops in India and for troops that have gone overseas from India, except in places where British Red Cross Society take or share responsibility by mufual agreement.

* * *

League of Red Cross Societies

On account of the war the headquarters of the League of Red Cross Societies has been transferred from Paris to Geneva, says a circular issued by the League. The circular points out that the Leao-ue will 0 contlnue to carryon its normal activities in the fields of r elief, nursing, health problems and the Junior Red Cross, in co-operation with the International Red Cross Committee as usual.

Air Raid

GOVERNMENT

SIIORT

COURSE

IN - FIRST AID

(See Home Office Circular, 26 January, 1939, Ref. 7°3191/1).

By W. C. BENTALL, o.n.E., F.R.C.S., F.R.G.S., Assistant Surgeon-in- C hie!

Precautions

Third Lecture

Continuing our short course of four lectures from the last month's, I will deal with the third lecture this month, and refer to :-

I. Asphyxia.

II. Wounds and Burns.

I. ASPHYXIA

Asphyxia means insufficient oxygen too m,!ch carbon dioxide. It is caused by anythIng which interferes with 'r espiration. Therefore the actual causes are :-

I. Choking-example: swallowing. false

2. Suffocation-example: in a burrung bwlding.

;. Hanging.

4. Drowning-not caused by swallowIng water, but b y asphyxia.

5. Poisonous gases-example: oven or, in war, phosgene gas. .

All these things cause death by keepIng oxygen from going to the lungs, and preventIr:g dioxide from coming out of the lungs-that zs asphyxta. Treatment.

(I) Remove the cause, and don't forget to do that before No.2, or you may kill the patient_

(2) Artificial respiration-except for phosgene, when never do artificial respiration or you may kill the patient. two methods: (a) Schafer's- patient chest down; (b) Silvester's-patient chest up. If you do Silvester you need a helper to hold the tongue out; but not with Schafer's.

II. WOUNDS

Don't try to learn how to 'dress a prick, a cut, a leg torn off, or blown off with a high but grasp the principle underlying the dressIng of all and every wound.

The body is protected by skin. We are entirely surrounded by poisonous germs which cannot enter the body through the skin. Prick, cut, or damage the skin (which makes a wound) and you let these poisonous germs in, and the wound does not heal well. It festers or suppurates-p us may form, or even blood poisoning and death follow.

This was the great discovery of Pasteur and' Lister in I874-75 and led to the success of modern surgery. The boiling of instrumen,ts, the sterilising of gowns 4

and all the paraphernalia of tpe operating room IS to prevent these germs getting into the wound.

But in first aid we can do it, too - kill the germs. How?

(I) Boiling kills them .

(2) Many antiseptics also, but doz:,'t think ot things you have to go and buy, but think of thIngs you have with you. Why run and buy Lysol, Dettol, Jeyes' fluid, etc., when you have just as good an antiseptic or germ-killer nearb y, such as methylated spirit, turpentine and p etrol.

You can boil rags for dressin g, or scissors, etc., if you like, or you can soak them in the just mentioned. You can wash your own hands WIth the methylated spirit, etc., also the wound of the be it a thorn prick or a ghastly wound, and you will kill the invading poison and the wound will heal.

III. B URNS

Dry heat causes a burn. Moist heat causes a scald. The result for treatment is the same.

Do not break the blister, for (as in wounds above ) you will let poisonous germs into a wound the pricked skin. Cover the burn .or scald. WIth a clean handkerchief, or towel, or serVIette, which you put first into a teapot good strong .tea This. is actually a 2 per cent. solution of tannIC aCId whIch the books talk about, and the water in the teapot has boiled and is therefore germ-free or aseptic. The dressing also excludes the air, which lessens the pain. Cover the tea rag with a good pad of cotton wool and a lightly tied bandage. Next month the fourth lecture will deal with C( Unconsciousness.))

A.R.P. Questions and Answers

1. a.-\Vould you advise a drop of oil in the eye aft?r washing for mustard contamination?

A. -After liquid-yes, but under knowledgeable supervision.

2. Q. - What is the relative size of a liquid patch , compared with blister that would form?

A.-Dependent on number and nature of garmentf>

before it reached the skin, and if on bare skin dependent on fatty nature under the skin.

3. Q.-Would you approve of clothing being added as a fourth means o! protective treatment, in addition to the three you gIve?

A.-N ot for ge neral public to whom I referred.

4. a.-How about airbricks, sink-pipes, etc.; will they ;now gas to enter the refuge room?

A.-Airbricks will, and we teach that they should be covered on the outside with a small piece of b oard. Sink-pipes are genera lly trapped to prevent sewer o-as travelling back and so need no further treatment. b

5. Q.-In protecting a room, when blankets are used shoul d they be wet or dry?

A. - They are better wet. Oil is more effective than water.

6. Q. - Observing Officer at. top of tall .factory chimney during gas attack, conSIdered gas .might be drawn up the chimney in heavy concentrat1On.

A.-Yes, if the concentration was heavy enough, and the height of the factory chimney sufficient to allow for its sufficient dilution.

7. a.-What do women ambulance drivers wear?

A.-I suggest asking a female

8. a.-When the eye has been contaminated by liquidmustard, what is the time limit for treatment, and what is the treatment?

A.-See special chapter on Handbook No. 3 for Doctors.

9. Q.- Will you please state the composition of mustard gas

A.-(CH 2 ClCH z )2 S., or Dichlor-diethyl-sulphide, quite unnecessary to know.

10. a.-What is the effect of swallowing per cent. sclution of mustard in water.

A. - I do not know, and if I did I should never know the exact percentage of the mustard gas in water.

I. Q.- What is "Union Cloth" for protecting doors and windows?

A.-A trade term for any material made of a mixture of cotton and wool.

12. Q.-I have filled lots of old stockings with sand for putting along the bottom of doors and wi?dows ; would they be effective?

A.-Yes, if not laddered too much.

13. Q.-Is it a fact that olltsid.e air will find its. way into a room despite the sealing of every likely entrance?

A.- No, the reverse is the most likely to occm as the pressure of air in an occupied rOom would probably be greater than outside pressure.

REVIEWS

J. F. Sutherland's First Aid to Injured and Edited by Halliday Sutherland,. M.D. Edinburgh: E. and S. Livingstone. Price 6d. net; post fr:c 7d First published in 1887 and now in its 41St editIon, this wonderfully concise and compact ambula?-ce Vade -Mecum continues its successful task of educatmg students in the science of first aid. No less than 4.6 diagrams are included and increase t he value. of thi s instruction which is based on the o.f Instruction of the St. Andrews Ambulance ASSOClation. No attempt is made to divide conten.ts into. chapters; and the various items are discussed ill sect10ns under distinctive headings. Throughout its caree.r the booklet has been of a size which just fits the waIstcoat pocket; and it is kept up to by the preser:t editor who is the son of the ongInal It IS curious that father and son err in theu spelling of the name "Silvester." Once again we commer:d the booklet to readers of THE GAZETTE who wlll find it both interesting and instructive.

Iflustrations of Bandaging and First Compiled by Lois Oakes, S.R.N., D.N. Edinburgh: E. and S. Livingstone. Price 6s. net. In the absence of a demonstrator, students would like to have the help of reliable. ar:d well-chosen photographs. they can o.btaln ill the published Illtlstratzons if Bandagmg, the aIm which is to enable students of first aid and nurs1ilg, b y means of pictures, quickly to rr:aster tJ:e art bandagino- and the science of renderIng effiCIent asslstance in treatment of fractures and Well printed on excellent pal?er, the book 290 admirable photographs which make t?e as natural and as near to actual results 1n as is possible. The book covers all t?e recogrused treatments which may be accomplished by the triangular, roller and many-tailed bandages; and, accompanying all the there explanatory descriptions, which are correct and .tr:crease the practical value of the books. In these CHcumstances we anticipate a very successful career for the book; and we know that readers of THE G AZET TE will find it most useful when, apart from the. supervision of their demonstrations, they practise the various forms of bandaging.

St. John: "Best Seller"

Authors of " b est -sellers" may well be envious of the sales of The St. John Manual. Prom September, 193 8, to September, 1939, 1,I25,000 copies we:e soleL The Home Nursing Manual sold 200,000 dunng the same period. ,

One thousand eio-ht hundred exarrunauons were held and 260,000 issued. Pifty tons of stores were sent abroad.

It is expected that even these amazing figures will be exceeded in the current year.

SIMLA

OVERSEAS NEWS II

INDIA

A.R.P. DEMONSTRATION

On September 22 part of the gardens of Viceregal Lodge in Simla was made the stage for a mock aerial attack, when members of the Delhi-Simla Nursing Division organised an A.R.P. demonstration, the first of its kind to be held at Simla. His Excellency the Viceroy was among the spectators. The Lady Joan Hope took part in the demonstration.

The scene depicted was a city park with school children and others passing to and fro" and preparation for air raid emergencies was represented by a Gas Shelter, a First Aid Post and Decontamination Centre.

The demonstration started with a warning siren which brought out the Air Raid Warden with her rattle to disperse the passers-by to shelter. Three Blenheim bombers of the R.A.F. from Ambala delivered a series of mock attacks and synchronising with their dives, smoke bombs and high explosive bombs were exploded to give a further touch of realism. A number of school children who had run into an area contaminated by the gas bombs were led to safety, when A.R.P. squads appeared on the scene equipped with anti-gas suits and masks. The Air Raid detected mustard gas, gave orders to our squad to remove the affected persons to the Decontamination Centre, while another squad got busy demarcating the contaminated zone. A third squad was sent out to warn people off the area, while patrol squads moved about, followed by stretcher parties, searching for possible casualties. The All Clear Signal was given after a time, when the stretcher cases having received emergency treatment were sent off to hospital and the shelters were vacated.

The demonstration, which was successfully and efficiently carried out, was the of training undertaken by a large number of women in Simla during the summer. Lectures and prac;tical training had been given and examinations held with the assistance, amongst others, of expert medi-cal officers of Army Headquarters.

Prior to the Air Raid demonstration, the Chief Commissioner for the Empire of India, Sir Ernest Burdon, inspected the Delhi-Simla Nursing Division and the St. Thomas' School Cadet Division. Lady Joan Hope, representing Her Excellency the Marchioness of Linlithgow, in addition to her "First Aid" duties, presided over the afternoon's proceedings and presented their certificates to the successful candidates.

Following is the text of the Chief Commissioner's speech :-

Lady Joan Hope, Ladies and Gentlemen,

"In the circumstances in which we now stand

it requires no eloquent speech from me to explain . the significance of this afternoon's function. We are all acutely conscious of the supreme value of kind of preparation for war service and of the urgent need for all of us to continue with all our might whatever we are able to do. You have heard from Mrs. Mason a report of what has been done in this way in the past year by the Dellu-Simla Nursing Division supplemented by the efforts of Mrs. Bourne and others who, though resident in Simla, do not actually belong to the Delhi-Simla Division. I may safely say that the results achieved are the best that Delhi and Simla have ever shown. That is not surprising, for, Erst the threat of war, and now the outbreak of war, have given a new impulse to all public-spirited people. At the same time, the results are none the less gratifying, and I wish, as Chief Commissioner of the St. John Ambulance Brigade in India, to thank very cordially and very sincerely the large number of ladies and children also who have answered the call to service so wHlingly, and also to congratulate them. I am sure, too, it must give themselves a great feeling of satisfaction that they have qualified, or have helped others to qualify, for essential public duty, and I wish to thank them for this also that they have set a good example to others, which I am sure will be followed increasingly so long as the war lasts.

« I do not propose to go over all the ground which Mrs. Mason has covered in her very clear report. There are, however, one or two points in the report which I wish to stress. In the Erst place, Mrs. Mason, mentioning some of the factors which have contributed to the success of the year's work, has referred to the visit of the Honourable Mrs. Copland-Griffiths, Lady Superintendent-In-Chief of the St. John Ambulance Brigade Overseas, and the which Mrs. Copland-Griffiths has given to the work of Nmsing Divisions in India, and particularly to Indian women.

I hope very much that more will come of this latter development, and I hope that the Delhi Provincial Council of Women in the coming cold weather will help the St. John Ambulance Brigade still more in recruiting Indian ladies for First Aid and Home Nursing classes and for the practical work of Nursing Divisions. I will mention one other step which has been taken to advance the work of the Order of St. John in Delhi, and that is the constitution of the Delhi Province into a separate and independent District of the St. John Ambulance Brigade, with the Chief Medical Officer, Major Ebden, as Assistant Commissioner in charge. I have had a letter from Major Ebden expressing his great regret that official duty has prevented him from making, as he had intended, a special visit to Simla to be present at this afternoon's inspection and demonstration. Major-

Ebden, however, has plans in hand already f<;)[ new intensive work to be undertaken in Delhi dunng the cold weather. And this means that when we go down to Delhi we will find a complete Brigade organisation which will enable more people to be instructed and to receive practical training an ord:red system and with all the proper machmery proVIded by the St. John Ambulance Association. and And here I should like to tell you that In recogrutlOn of her long service, practical experience and devotion to the work of the Order Mrs. Mason has just been appointed Lady District Superintendent of the Delhi District. Mrs. Bourne, whom I have already mentioned, who has been working this summer in Simla and has helped notably with the for the demonstration has similarly been appOInted Lady District of the newly-formed District comprising the province of the PunFb.

will be possible to secu.re opportunities members of the Nursing Division to be tramed In actual hospital work. The existing members of the Division are already aware of the for Vol.u.ntary Aid Service of nurses regarding whIch detaIled orders have recently been issued. I am g lad. t o sa y that I have already received a number of appli cation s for enrolment in the Voluntary .Aid Service from members of Nursing Divisions of the St. John Ambulance Brigade, some of whom are prese?t here to-day. The Voluntar y Aid Servi.ce of IS to be recruited entirely from the NurS111g DlvislOns of the St. John Ambulance Brigade, and this imposes on u s all a dut y which we must try to fulfil to the v er y utmost.

"Mrs. Mason has told you of the many people who have helped her in the work of the rear. I. know that those who have benefited by the lnstructIrm ate

" 1t is, I think, hardly necessary for me to emphasise - you all know it very well-that the of the Order does not end when classes of lnstructlOn and examinations have been surmounted. Knowledge must be kept up to date by continued study, and, above all things, by further practical training and practical experience. That why so glad that the Delhi-Simla Nurslng DrnslOn, with the encouragement and inspiration of Joan Hope and the help of many others, has orgamsed the practical demonstration which is to take place to-day.

As you will realise when you see the demonstration this has entailed a great deal of thought and preparation of a material kind also, and I am sure you will find it interestin a and instructing. You must be b .' prepared for an institution of bombwg practlce which has been devised by Major Lawrence Archer. 1 hope that more practical. work this and kinds will be undertaken In Delhi, and I hope it

very grateful to them and on my part as Chief Commissioner of the Bngade I WIsh to offer them my most hearty thanks; I wish to thank in particular Colonel Thompson, whose expert knowledge of Air Raid Precautions has been quite invaluable and who has aiven much time and taken infinite trouble b in preparing and giving lectures. I have he ar d on all hands how very interesting his lectures have ?een and how greatly his sacri?ces have ?een apprecIated by the ladies of Simla. Flnally, I WIsh to Her Excellency Lady Linlithgow for her encouraaement and for the help she has g Iven by b V. allowing to-day's proceedings to take place at lceregal Lodge, and to thank also Lady Joan Hope , who has not only taken part in the season's work but als.o has very kindly represented Her Excellency this afternoon as hostess, has presided over our proceedings, and will now take part in the demonstration of A.R.P."

Obituary

The Chief Commissioner regrets to announce the death of Dr. James Cairns, C.LE., O.B.E., at Lahore on December 16, 1939. Dr. Cairns, who was a Commander of the Order and a holder of the Service Medal, had been officer in charge of the No. I District, India, since 1927, and during his period of office performed invaluable work for the Brio-ade Overseas b in India. Dr. Cairns has also performed much valuable work for the Association and his loss will be o-reatl"b } felt by both organisations in India

We regret to announce the death of Lad'Y Ambulance Officer Miss Howe, Northampton Headquarters Nursing Division, which occurred ron October 23.

Miss Howe joined the Division in 1909 and durin g the Great War served in Leeds Military Hospital and - No. 8 General Hospital, France.

On the formation of the Cadet Nursino- Di v ision b 1922 ':Miss Howe was appointed Cadet Superlntendent, a position she held until her death.

The funeral service was held at the Church of the Holy Sepulchre. Officers and members of the Nursinob and Cadet Divisions under Lady Superintendent Miss Cowley and officers and men of the Ambulance D ivision, under Corps Superintendent W. E. Edwards, lined the pathway to the church. Th e Castilian, Spencer, and Reeve's Nursing Divisions were also represented.

Members of Headquarters Ambulance Division acted as bearers.

Among the many attendants at the church was Mr. G. Philpot, one of the oldest members of the Brigade.

A Message from H.M. the IGng

I am desired by the King to express the interest of His Majesty in the report that a Penn y-a- Week Fund in scope,.is to be organised with the hel; ot E mployers and Trade Unions in aid of the Red Cross and St. John's Fund.

His Majesty, as Patron both of the British R ed Cross Society and St. John's Ambulance Association welcomes the scheme. '

Yours truly,

ULICK ALEXANDER, Keepet· of the Privy Purse.

RAILWAY NEWS

Southern Railway

(CONTRIBUTED BY E. UZZELL)

The District Sh.ield, presented b y Sir Herbert Walker, and known as the "Walker Challenge Trophy," is awarded annually to the District showing the greatest increase in members in proportion to the number of staff employed in that district.

The shield, won this year by No. IB District (London Suburban Area) was presented at Waterloo Station recently, by Mr. W. Geo. Pape (Chairman of Centre) in the unavoidable absence of Mr. E. J. Mlssenden (General Manager). The presentation was made in the presence of Mr. E Uzzell (Welfare Officer), Miss Grindley and the Class Secretaries.

Ir.: .handing over the trophy, Mr. Pape gave an lnSPUlng message from the General Manager, who regretted his inability to do so personally, and SaId they had done remarkably well to obtain so many recruits to enable them to win with such a large percentage of marks. He stressed the fact that i t was more necessary than ever that the whole of the staff should have a knowledge of first aid "I know," he said, "I can rely on all those present to give whatever assistance lies in their power."

Mr. Prew, in thanking Mr. Pap e for presenting the shield, also thanked his Class Secretaries for the successful fruition of their work, and expressed determination to further the work of the Centre and the St. John Ambulance Association.

The Chairman of the Centre then handed over a of the shield to last year's winners (No. lA Dlstnct), and Mr. E. Boorman, representing Mr. W. Hagell ( District Secretary) suitably replied.

RAM SGATE

<?wing to the nationa l emergency, the concert which was arranged for the presentation of awards in cOllilection with the Southern Railway Ambulance Centre (Rams gate class) had to be cancelled.

The awards were presented b y Dr. N. Gordon and Dr. R. J. Archi bald.

Dr. Gordon, in his remarks, said how pleased he was to see t h at the sma ll service which he was able to render had been a bi g help to the members, as out of 48, 47 were successful in passing the examination.

Dr. Archibald ex pr esse d his pleasure at being with the members once again, as he thought it was his 34th year that he had been with the class. He thanked all the memb ers for giving up their valuable time In training for such a national service.

London Midland and Scottish Railway (CONTR IBUTED BY GILBERT S. HILL)

A substantial increase in th e total number of staff examinatio-?-s during the year ended June 30, 1939, is recorded in the General Ambulance Secre-

tary's report. It is urged that this interest should be maintained.

The number of entries in the District Competitions was 489. 59 of these teams took part in the Preliminary Competition. The first three teams qualified to compete in the Finals were: Warrington, Crewe Machine Shop and Camden Goods "A." In the Final Ambulance Competition Crewe Works (Machine Shop) and Camden Goods tied for first place. In accordance with Competition rules the higher place was awarded to Crewe as a result of their obtaining the greater number of marks in the Individual Sections. Crewe Works (Machine Shop ) were also successful in winning the International Ambulance Competition.

There have been many instances of first aid of an exceptional nature rendered by the staff. These have been considered on their merits, with the result that the award of the Meritorious First Aid Certificate has been made to Mr. H. H. Clerk, Goods Depar tment, Manchester.

The genero us assistance provided b y the Railway Company in connection with the general organisation, the gifts of prizes for competitions, long service medals and bars and the additional free tickets, etc., have been greatly appreciated by all concerned.

In concluding his report the General Am bulance Secretary said that he would again pay tribute to the courtesy shown, and assistance given, b y the officials of the St. John Am bulance Association and the Priory for Wales.

London and North-Eastern Railway

The Special Ambulance Committee's annual report of the ambulance activities on the London and North-Eastern Rail way during the year ended September 30, 1939, is a record of further steady progress.

The number of Am bulance classes increased from 361 in 1938 to 418 in 1939 and there was a corresponding rise in the number of members enrolling.

The total staff employed by the Company in 1939 was 170,271 and of these 8,023 gained ambulance awards. This compares with a staff of 177,236 and 7,2.25 awards in 1938.

180 go ld medals and 107 gold bars were earned by railway ambulance men, making a total of 1,5 89 gold medals and 1,200 go ld bars since the inception of these awards.

were again an important feature of railway ambulance work and during the past year 182 teams entered competitions held under the auspices of the Railway Company.

The Special Ambulance Committee appreciate the fact that railwaymen trained in first aid work have rendered valuable assistance in providing trained personnel for the Company's A.R.P. schemes, and in view of the urgent importance of such knowledge under present conditions, it is desirable that a progressingly increasing number of ,the staff should identify themselves with the ambulance movement.

Promotions and Appointments

His Majesty the King has been graciously pleased to sanction the following Promotions in, and Appointments I to, the Venerable Order of the

VICTORIA FOR ADMISSION IN THE GRADE OF SERVING BROTHER

Captain Alexander Christie, M.B.E.

Major James Austin Chapman, O.B.E.

SOUTH AUSTRALIA FOR ADMISSION IN THE GRADE OF SERVING BROTHER Lieut.-Colonel Albert Ray Sou hwood, M.D., M.R.C.F.·

Eugene Thomas Cornish.

Eric Lindsay Symons, M.B. FOR ADMISSION IN THE GRADE OF SERVING SISTER

Mrs. Gertrude Mary Dawkins.

T AN GA !\'Y I KA FOR ADlIHSSION IN THE GRADE OF SERVING BROTHER

Henry Joseph O'Donnell Burke·Gaffney, C.M.G., M.B.

THE GRAND PRIORY CHURCH OF THE VENERABLE ORDER OF ST. JOHN OF JERUSALEM

Owing to the war no services will be held in the church until further notice.

The Chief Commissioner regrets to announce that he has been advised by the Medical Department of the Navy that the fonowing Reservists of the Royal Naval Auxiliary Sick Berth Reserve were among the missing from the A.M.e. Rawalpindi when that ship was lost on November 25 last:Crompton Division.

1920. S.B.P.O. Ernest Schofield. Bristol Corps.

X7579 P.S.B.,A. Kenneth Parker.

The St. John Ambulance Brigade News

No. 3 (EASTERN) DISTRICT

The marked interest in the war work of the St. John Ambulance Brigade which H.R.H. the Duchess of Gloucester has displayed in recent months by visiting and inspecting many of the Northamptonshire corps has infused new life into the movement locally. The following letter, signed by Dr. Leslie W. Dryland, County Commissioner, and the Marchioness of Exeter, County President of Nursing Divisions, has therefore been forwarded to Her Royal Highness's Lady-in- Waiting :-

"On behalf of the members of the St. John Ambulance Brigade in Northamptonshire, will you kindly convey their very grateful thanks to Her Royal Highness for the great interest she has taken in their war work in this county.

"Her Royal Highness's recent tours to the first aid posts have been an inspiration to all those who have had the privilege of meeting her. We can assure Her Royal Highness that the result of her visits will be reflected in the increased efficiency and enthusiasm of the Brigade personnel who man these important posts. We may add that the members were especially delighted to see Her Royal Highness wearing on each occasion the uniform of Deputy Commandant-in-Chief of Nursing Corps and Divisions.

Yours sincerely, LESLIE W. DRYLAND, County Commissioner.

MYRA EXETER, County President of Nursing Divisions."

LUTON

When the Vauxhall Division of the St. John Ambulance Brigade was formed in December, 193 8 , its strength was 38. The total strength to-day is 2 I!.

It is hoped that within the next few weeks the Commissioner will have given his consent to the official establishment of a Nursing Division.

The latest development in this Division is a register of volunteers to attend club events for carrying out any first aid that may be necessary, and also to function as "stand-by" men in the event of an air raid.

Sixty have volunteered already. The alternate Monday night practices are well attended. On no occasion has the total number on parade been less than 120 often it has been around 15 0

During the whole of 1939 there were 48 occasions on which the drill and practice register was marked up (Ambulance Officer McEvoy was present every

time, and Private Parrott next with 37 attendances).

The average number present at each drill was 20.

During the last four months of the year (1939) the Division's four ambulances covered a mileage averaging 105 each week.

No. 4 (LANCASHIRE) DISTRICT BLACKBURN

Dr. P. M. Herbert, Bishop of Blackburn, who is a chaplain of the Order of St. John, recently presented long service and other awards to members of the

be involved in service overseas, in ways they had never expected they would be called upon to follow, and said it was part of the offer of self-sacrifice and the training they had undergone that they were ready to go they were needed. Theirs was service of which the whole country might be justly proud.

Assistant Commissioner Dr. Clegg presented a book of the story of the Order to the Bishop, and suggested that the Brigade should start a fund with the object of having a part of the new Cathedral dedicated to the Order of St. John.

Blackburn Corps. The Mayor of Blackburn (Councillor E. Porter, J.P.) presided.

Speaking of the work of the Brigade, the Bishop said though no doubt the community took it largely for granted, it still appreciated the service and help the Brigade represented To him it was remarkable that there could never be a great gathering, whether at a football match, a Royal Jubilee or a Coronation, or a big function in the town's life without, quite naturally and as a matter of course, members of the Brigade being on duty, . often seeing little of the spectacle themselves, but quite content.

He pointed out that members of the Brigade would

Replying, the Bishop said he was anxious that when completed the Cathedral would be a home for all good causes that liked to connect themselves to the Church. It had always his dream that various portions of the Cathedral should be specially associated with different sides of common life that wanted to keep in touch with the Cathedral. He gladly welcomed Dr. Clegg's suggestion.

In his report Corps Superintendent J. W. Walmsley stated that intensified activity started about the crisis in September, 1938, and since then the Corps hld

(Contintled on page 14)

II

Interesting Case Reports II

CASE REpORT No. 159.-The Officer-in-Charge of North Lincolnshire Area S.J.A.B. reports the efficient performance of first aid by a member of the Scunthorpe Corps in the following circumstances :-

On October 2.6 this member, who is employed by the Railway, was working in a signal box when four platelayers were knocked down by a locomotive engaged in propelling some wagons. No. man was run over and sustained severe injuries of both legs; No.2 man had severe head injuries; NO.3 man received injuries to chest and head; and NO.4 was found to be suffering from profound shock. Having no equipment, this Brigade member exercised his resourcefulness in the use of towels which he obtained from the signal box, improvising tourniquets where indicated and dressings to cover the wounds. With the assistance of bystanders he was able to have the patients removed by ambulance in twenty minutes, having done all that was possible with the material to hand. Unfortunately, the man with the leg injuries died some eight hours later.

COMMENT.-Improvisation is the very essence of first azd and nothing tests the efficiency of a first-aider more than the need to use whatever is at hand. To this unnamed member of the Scuntho rpe Corps, the?'efore, go our cordial congratulations on good work well done.-N. C. F.

LENGTH AND FREQUENCY of PRACTICE CLASSES

J. W. (Chingford).-At our place of business we have recently formed a first aid -party. Intensive training has been given and the members of the party hold their certificates. The question has now arisen as to the amount of time per week that should be devoted to practice. My view is that at least one hour per week should be given, especially as our members have had no real experience.

It might help if I inform you that there are about 200 employees in the building, which situated in the . danger zone.

I should be obliged if you would kindly give me your opinion as to whether one hour per week for practice is sufficient, or what is the minimum amount of time that should be given to keep the party at the level of efficiency?

_ First aid is based on a little knowledge, much commonsense and as much practice as is possible. In these circumstances it is dijjicult to lqy down hard and fast rules which will fit the circumstances ofyour place of business. Ambulance Divisions of the Brigade often meet once a week for practice lasting two hours,. and I know one firm whose certificated first aiders do likewise after ojjice hours with the object of maintaining and increasing their efficienry.

IncidentallY, it was the realisation of this med Jor prflctice and the fear of forgetting their recentlY acquired knowledge, which in the pioneer dqys ofl877 to 1887 caused certificated p , tlpils of the Association to combine together for practice as Corps and which in 1887 caused the Order of St.John to recognise the Brigade.-N. C. F.

ACTION OF HEART

D. B. (New Ollerton).-If I may be allowed to say so, I have thought for some years that the circulation of the blood as described in the Textbook (p. 86) is misleading. The various problems I would like you to solve for me are :-

(r) The heart being divided into four parts, two Auricles and two Ventricles, can I take this as a four-valve pump ? If so, are two portions force sections and tw.o suction sections, and, if so, which are which?

(2) If I place m y hand upon my heart, which sectlOn do I feel, the auricle or the ventricle?

(3) Can an artery be termed a valve? If so (or otherwise), why does the Textbook not state this?

(4) Arteries convey blood from the heart; and at every contraction we can place a finger on any superficial artery and .count 72 per minute. Is this a forcing rate or a suction rate? I would like to know also if the systemic circulation and the pulmonary are acting at the same time, as the left ven t r icle sends bri ght red blood to the arteries which cause the pulsation.

(5) Again, how does the arterial blood get into the veins and, changing its colour, become venous?

You may think that I am asking a funny lot of questions, but the Editor tells us, "If you want to know, ask!" I shall await with interest your opinion and thank you in anticipation.

I cannot agree with you that the Textbook is misleading in this connection,. and I note that you are e1JidentIY mechanicallY minded and that you are trying to thi1zk of the actir;n of the heart in terms of the double-action pump. This is not correct.

You should rather think of the heart as a four-roomed house, two rooms upstairs and two down. First the lower chambers empty by the squeezing together of their walls. ImmediatelY after, the upper chambers empty by the same kind of pressure and pass the blood down through a trap door into the lower chambers. Where the word " valve" is mentioned in connection with the heart it refers to a trap-door arrangement which opem one wqy onlY, thus allowing the blood to flow one wqy onlY. Another comparison is that the valves act like the lock gates in a canal.

The answers 10 your va1'ious questions are :-

( I) All four chambers are force sections.

(2) You feel the action of the left ventricle.

(3) An artery is merelY a pipe which conveys pU?'e blood awqy from the heart.

(4) The systemic and pulmonary circulations are going on at the same time.

(5) The change in colour occurs in the capillaries,. and you will find a description of this on p. lor of the Textbook.

The word" suction 1) at top of p. 103 merelY means that after the auricles send the blood down into the ventricles there is a suction effect by the opening out of these chambers because of their elastic wal/s.-N. C. F.

STRETCHER DRILL

F. B. (New Kent Road).-An argument has cropped up at our Stretcher Party Depot with reference to stretcher drill. The Textbook (p. 206) tells us that Bearer No. 1 proceeds to the right of the patient. My colleagues affirm that this Bearer should place himself on the more injured side of the patient, particularly when loading the stretcher. My opinion, however, is that Bearer No. should go to and remain on the ri ght of the patient. I would be glad to have your ruling.

1 agree with you.-N. C. F.

TREATMENT OF HEAD INJURIE S

J. J. (Crouch End).-Our instructor states that a patient who has severe head injuries with injuries to mouth and face should be carried on a s tretcher with his face downwards, head hanging over the end of stretcher.

Would this not increase the bleeding and make it impossible to observe patient's features during transport should compression come on?

Your observation on these points will be welcomed.

Your statement is so vague that comment is dijjicult. If, how ever, you include bleeding wounds tinder your term "injuries," then, of course, the first step in the treatment of wounds (Textbook Rule I, p. 106) js to stop the bleeding and not to lornr the head which, as you state, would increase the bleeding.

Should, howeve r, there be pressing danger of the patient's tongue falling backwards and choking him, then it will be 2'}Jise to foll02'}J the instructions of A.R.P. Handbook No. 10 (pp. 20 and 2r) and tf) remove the patient with his face d02'}Jn1'}Jards and l'vith his head hanging over the end of the stretcher.-N, C F.

PULMO ARY BLOOD VESSELS

F. B . (Muswell Hill).-In the revised edition of the Black Book, Fig. 58 and the wording on p. 102 give the impression that the pulmonary artery leads to the heart and the pulmonary vein aJ'}Ja), from it, containing respectively arterial and venous blood. I welcome your views on the subject.

Yotlr dijjiculty on this point is entirelY one of your own making. YOpl cannot take out of its contexts a portion of the description of the pulmonary circulation and then claim that the Textbook is giving false impressions. In other words, Fig. 58 and its explanation on p. 102 must be read in cOf!junction with the remainder the description page I03.-N. C. F.

REMOVAL OF FRACTURED PEL VIS

F. B. (Muswell Hill).- With fractured pelvis the patient should be removed by means of poles and looped bandages. The Black Book, howe ver, does not give this instruction and apparently considers that the normal method of removal is adequate. A.R.P. Handbook No. 10 confirms my contention, in that instructions are given on p. 5 to remove cases of fractured pelvis as described for fractured spine. Further, I would prefer a simila:r method of removal for all cases of fractured base of skull because here again it is difficult to avoid slight movement when lifting patients on to the knees of the Bearers.

The Textbook is written for ordinary civilian emergencies, whereas A.R.P. Handbook No. 10 is designed expresslY to meet war conditions in which the if!Juries would probablY be far more serious and complicated. In atry case the poles and looped bandages are not to be used, as you state, for the removal of the patient but simplY to lift him off the ground while the stretcher is placed in position.

PersonallY I see no advantage in the use of poles and looped bandages for fractures of pelvis and base of skull in civilian emergencies,. and on this point I agree with the Textbook. When, however , you are instructing Stretcher Bearer Parties for war emergencies you must stand by the methods taught in the A.R.P. Handbook.-N. C. F.

TREATMEN T OF CRUSHED HAND

F. B. (Muswell Hill).-There are certain differences between the instructions of the old and the revised editions of the Black Book about which I would ask yo ur opinion.

In the case of a crushed hand, should the thumb be bound inside the bandage and not left outside as in the previous edition? Of course a certain latitude is allowed for the actual seat of the fracture.

Fig. 46 on p. 86 settles yotlr problem because the thumb is not visible as it is in Fig. 45. ClearlY then the thumb is now to be left in contact with the fingers in the treatment of crushed hand.-N. C. F.

THOMAS SPLINT

E. B. (Hull).-I very much appreciate your page in THE GAZETTE and your answers to queries which I have found most helpful; and I would now ask your kind help with regard to the Thomas Splint. On p. 255 of the Textbook Rule reads: "With its horizontal part one hand's breadth IN FRONT of the foot" (referring to the suspension bar), In the two illustrations on pp. 249 and 250, however, the suspension bar appears to me to be behind the foot . Please state which is correct.

The word" front" on p. 250 is used in relation to the illustrations on pp. 249 and 250, and 110t in its strictlY anatomical position. Further, the measurement "hand's breadth" emphasises the need to avoid placing the suspension bar too close to the sole of the patient's foot.N. C. F.

Relnember

thaI

Ovaltine Sleep is Nerve-restoring Sleep

YOUR are doing double duty these days. They need the nourishment and the sleep which the special properties of Ovaltine • assure.

Although entirely free from drugs, 'Ovaltine' is of outstanding value for inducing sleep quickly and surely. And while you sleep it repairs the nervous system, energy and refreshes the tired brain and body.

The exceptional properties of 'Ovaltine' are derived from the eggs liberally used in its manufacture. No tonic food beverage would be complete without eggs.

Remember that' Ovaltine • is a complete and perfect food. There is all the difference in the world between 'Ovaltine' and imitations made to look the same.

Ovaltine does not contain any Household Sugar. Furthermore, it does not contain Starch. Nor does it contain a large percentage of Cocoa.

Moreover, the high quality of ' Ovaltine • and its concentrated goodness make it most economical in use.

iJrink delicious

-and note the difference in !lour

andOullook./

Brigade New8-(Continued from page II)

been responsible for the training of I,323 and women in first aid, home nursing, and air raid precautions, apart from the instruction given to members of the Corps.

At the end of August the personnel of the Corps numbered 158, many of whom had responded to the country's call. During the year a new division, the Blackburn Post Office Division, was registered.

No.

5 DISTRICT

WETHERBY

The Wetherby Nursing Division recently held a special meeting at their headquarters.

Lady District Officer Mrs. E. H. Lodge opened the meeting with a sympathetic reference to the death of Miss M. E. Herdman, of Ripon, a former Lady District Officer for the area, and gave an appreciation of the work which Miss Herdman had done for the Brigade.

Mrs. Lodge announced her resignation from the position of Lady Divisional Superintendent with regret, owing to her promotion to Lady District Officer. She retained, however, the Commandantship of V.A.D. 84.

Miss E. M. Johnson, Assistant CO!ll!llil.ndant of V.A.D. 84, was appointed as the new Lady Divisional Superintendent.

The formation of a new Section, at East Keswick, under the leadership of Miss E. A. Wilkinson, was also announced.

Arrangements were made for the sending of a Christmas parcel to members both of the Nursing and Ambulance who were on active service with H.M. Forces, and a " Wool Fund" was announced to provide material for knitting for members of the Forces. An invitation had been received to join with the local branch of Sea Rangers to adopt and knit for members of the crew of the minesweeper Selkirk. This was readily accepted.

Plans were made for carrying on the work of the Division in the New Year, even under the difficulty of black-out conditions, and restricted travelling facilities in a rural area. In the meantime members are helping at the Wetherby First Aid Post by padding splints, assembling equipment, etc., so that no time is lost between the end of one series of lectures and the beginning of another.

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

FIRST AID ON PUBLIC SERVICE VEHICLES

At a meeting of the Welsh National Road Transport Competition Committee held at Priory House on November 23, it was decided to suspend the annual competition for the duration of the war. Some useful discussion, however, had the result of submitting a suggestion to the Secretary-General of the Order that perhaps the time had come to re-open the question of safety measures on the road in connection with public conveyances. A condition of "black-out" in war-time is responsible for an increased number of fatalities and accidents upon the roads; and apart from this, there is evidence that at least one Omnibus company, viz., Western Welsh, Ltd., is concerned by the rising rate of such occurrences in peace time, for a memorandum dated October 25, 1939, was circulated to the staff at various depots in the following terms :-

" The attention of all staff is drawn to the alarming increase in the number of accidents during the first nine months of 1939 compared with the corresponding period of 1938. The increase for the nine months is no less than 299 .... Accidents to passengers have increased by 9 only, but the total figure stands at 12 4

" Area Managers could assist materially by issuing a general warning to all road staff that accidents are on the increase and that staff should exercise every effort to reduce them to more reasonable limits."

Meetings of the above Committee have provided periodic opportunities for testing the views of both the management and staff of road transport companies in South Wales. Pressure is always brought to bear upon the Priory to make representation in the right quarter with a view to the adoption of ameliorative measures, which fall into two categories, viz., (I) training in first aid for drivers and conductors of passenger transport vehicles; and (2) equipment with first aid boxes of not merely long distance and contract, but also stage coaches. The anomaly has long existed, on the one hand, of drivers and conductors of the former class of vehicle lacking knowledge to make practical application of the contents of the first aid box; and on the other hand, of drivers and conductors versed in first aid lacking the equipment with which to render aid in case of accidents to passengers on stage coaches. It is uncrerstood

that the policy of the Ministry of Transport has been to trust to the good will and keenness of employers and employees alike to remedy these d efi ciencies of training and equipment in the light of experience. The Priory has reason to know that combines of employers are reluctant to impose a financial obligation upon smaller constituent concerns by enforcing uniformity in regard to the provision of boxes; and that employees, even if they have the desire, find difficulty in attending first aid classes owing to the variation of hours and chances of location imposed b y their work. On the other hand, there is evidence that one of the biggest companies in the Midlands have made the possession of a first aid certificate, or its acquisition within a given time, a pre-requisite to employment.

Committee members hold a view that A. R,P . arrangements in connection with first aid classes have largely removed the disability from which passenger transport employees have suffered in the past, because there are now many more classes held in out-of-the-way places.

The attention of the Priory has also been called to the fact that manufacturers of motor coaches of all descriptions now provide for the carrying of a first aid box, which is included on delivery, in order that the vehicle shall be properly equipped for long distance travelling and contract engagements; but that such equipment is immediately dispensed with by the company accepting delivery while the coach is running stage journeys, and only replaced for the more occasional uses of long distance conveyance. If the company is put to the expense of purchasing a first aid box in the first instance, it would appear a waste of money and unfair to the public to have the box lying idle, when it could be carried perfor all purposes. But, the two objectives the Committee have in mind are interlocked, as it is unreasonable to carq a box which neither driver nor attendant can handle; and stage coaches invariably travel considerable distances in the country where the services of neither docto r nor nurse are immediately available, nor first aid cupboards to hand. The circumstances of "b lack-out" should surely reinforce these arguments, when the death and accident figures are increasing to an alarming extent and the public conscience is fully alive to the gravity of the situation. Information from the members of the Committee goes to suggest that employers and employees alike are ready to acquiesce

in a measure of compulsion in both respects, viz., provision of boxes for coaches used on all types of journey, and the training in first aid of the operating staff. Peaceful persuasion by the light of example is a slow process; and the public interest would appear to require more dr astic measures than hitherto.

CENTRE REPORTS

A NGLESEY CENTRE

Tribute to the work which the St. John Nursing Members are carrying out in war and peace time was paid by Sir Henry Mulleneux Grayson, Bart., K.B.E., Corrimissioner for A nglese y on December I4, when at his residence, Ravenspoint, Trearddur Ba y, he inspected the Hol yhead Nursing Division o f

Sir Henry, a joint committee of the Order of St. John and the Red Cross Society had been formed in Anglesey to co-ordinate work during the war and to reproduce in miniature, the London activities of the two Societies, which had amalg amated for the duration. " I am sure," he added, "that when the time unfortunately arrives, which calls for all you r skill and all your gentle kind n ess, and when all the hard training you have under g one has been put to practical Us€, you all work together in carryin g out your duties for the benefit of humanit y ." Th e Division had every reason to be proud that in peace time they had willingl y and ch eerfull y g i ven up thei r spare time to this g reat cause, and that the y w ere n0 'o/ full y qualified t o do such important nati onal wo r k . In co ncludin

Tu rne r , in o r g arusill g and staffin g the Bargoed Fi r st Aid Post, o f which Dr. S. B. Turner (A.R.P. Staff Officer fo r Wal es) i s M e dical Officer, in the capaci t y o f Ho n orary Co m m and ant , Te sting time came o n Sunday, D ecember 17 , whe n throu g hout the Gellyga er Ur b an Di strict A .R.P. t rainin g exer c.ises were carried out. Th e d em ons tr ation s we re org am se d by th e P o lic e i n con ju n ct ion w ith the A. R P Committee o f th e Ge llygaer Ur b an Co u nci l.

A m o ck air-r ai d at Bargoe d was w itn esse d b y crowds of p eop le. A" gas b om b " d ro p pe d in Trafa lgar Sq uare and "ince n diary bo rr: bs" fe ll o ? bui ldings whic h became" ablaze." W hIl st an Offin1bus was approaching a terminus the driver "lost control" as a result of t h e "bomb," and th e b us crashed into a shop . This caused "casualties," who were removed by a first aid party to first aid posts for treatme n t . T he fire brigade, incl u di ng a strong muster of auxiliary men, came into" acti on," and a specta cular incident was provided b y a fireman who climbed a lad der and rescued a boy from one of the upper rooms of a shop. A decontamination party arrived to clear away the "poisonous gas." The police diverted traffic at various centres.

The demonstrations were watched with keen interest by Mr. Joseph Jones (Chief Constable for Glamorgan) and many representatives of the County Authority. All the work reflected time and energies well spent by the various sections of A.R P. workers and not least by the vo luntary personnel ·of the Fi rst Aid Post.

...\10NMOUTHSHlRE CENTRE

the Brigade Sir Hen ry deplored the absence of the Commissioner for Wales, whose engagements had made attendance i mpossible, and of Dr. G. P. W illiams, Holyhead, who had been called away to South Wales, fo r the y all knew the great interest w hich he took in the work of the Brigade. " It will g ive me great pleasure, " continued Sir Henry, "to report to the Priory what excellent work will hav e been done since the last inspection, and how smart and efficient y ou are I congratulate you all. Although, mercifully, your services have not so far been r equired for war casualties, the work of your Brigade goes on in peace or war, and no great public gathering ever takes place in Britain without the presence of those well-known volunteers in their black and white uniforms, carrying on their work of me r cy." As the y w ere p r obably aware, continued I6

a message of encouragement from the Priory in which the Commissioner for Wales had stated that a testing time lay ahead which none co uld foresee . The Pric:ry y.ras proud t o possess a Brigade t r ained for . servIce ill peace and wa r . History was bein g wntten and a new era opening. Thei r motto would be " Hold fast, work hard and pull together."

In presenting certificates to successful mem b er s, Mrs R. H Prothero, wife of the Chief Const a bl e and Assistant Commissioner of Anglesey, congratulated them on their success, and wished them continued progress in the work

GLAi\fORGAN CENTRE

CaerphillY County Area.-Since the outbreak of war, practically full-time duties have been imposed upon the Lady County Superintendent, Mrs. S. B.

Nw Headquarters opened at Ynysddu -The Principal Secretary (the Hon. John H . Bruce, J.P., D. L.) had (he pleasure of performing the opening ceremony of the Ynyssddu Ambulance Hall on Saturday, December I6. A particularly pleasing feature of the occasion was the fact that the building which had cost £3 50, was opened free of debt, a sum .of £ 2 having been transferred from a local Medical .Aid Fund, while a 50 per cent . gran t had been receIved from the Commissioner for the Special Areas; and a free issue of furniture was made b y the South Wales and Mo n mo uthshire Co m mittee, Miners' Welfare Fund. Thus, the Y nysd d u Ambu lance Division, which has made o-ood progress during its eight years' existence, es t abl is h ed a Ca d et Unit in I934, em barks u pon a n ew era w it h all t h e advantages 6f a ho m e of its own in which to devcIop its important activities, n ot th e least im por tant of wh ich is th e provisio n al forma ti on of a N u rsing D ivi si on. The prospect of such ad eq ua t e a cc ommo d ation the Y n vs d d u D ivisio n amo n g th e m an y Uni t s WhICh benefi t ed in 19 3 8 by a sp ecia l ar eas grant for Medi cal Comforts Dep o ts ; and alrea d y I 2 0 articles h ave been issu e d. Th e Dep o t w as open ed with £50 wort h of m edical requisit es and sick-ro o m comfor ts, w hich lor e lent at normal char ge s , w hi le in necessitous cas e s n o hire fee is imposed.

Mr. Richard Th o mas presi d ed ov er th e proceeding s; and the occasi o n w as m ark ed b y the pres ent ation o f a cloc k t o Div isi onal Supe r intenden t A. W illiams, whose sevi ces to amb ul ance w or k ext end bac k t o 191

< F amilY T radition M aintained.-T he recent award of th e Se rv ice Me d a l o f th e O r der to Ca d et Superint en den t , Miss E. A. Mogford, Pontypool, b r ings her i n to line wi th her two b roth ers, ex-Corps Secretary S. H. Mogfor d, S. B and D ivis i on al Superinten d ent W. H. Mogfor d . For nine years Miss Mogford was Se cretary of th e Po n typool Nu r sing Division, and for the past seven yea r s has held the rank of Cadet Su perint endent.

A.R P. Tests .-Blaenavon and Caerleon, both of which are part of the Monmouthshire No. I area for A.R P. purposes, had tests on Sunday, December 3, and in b oth cases it was shown that the personnel fully prepared to deal with emergencies which may anse

All the services were brought into operation a Blaenavon and the test was the more difficult because it was arranged that all the " occurrences" should be located at Forge Side. There was a fire, which had the prompt attention of Blaenavon fire engine and trai ler p u mp , and "casualties" had to be attended on the spot and taken to the ambulance depot at St. Paul's Church in Blaenavon, where they were " treated" by the first aid party drawn from the Brigade, and about 30 women who have taken ambulance instruction u nder Dr J. J. Crowe, Blaenavon, and Mr. S. White, Ambulance Officer .

Capt. S. T. Beard, O.B.E., Commissioner for Monmouthshire, was among those who watched the exercise.

There was a similar experience at CaerleoD, where th e test was worked in co-operation with the area main control station. An Ambulance and a first aid party wen t from Pontypool to deal with emergency " casualties" at Ponthir Here, too, the test was h ighly satisfactory.

Pfu\1BROKESHlRE CENTRE

The Daniel Daniel Ambulance League Cup.-During the summer, eliminating competitions for the Daniel D aniel Am b ulance League Cup were held at various cen tres in the county with the object of fostering greater interest in ambulance work, the centres being Haverfordwest, Milford Haven, Pembroke Dock, Tenb y an d Nar b erth. These competitions proved b oth in tere sting an d educative an d the standard of th e work sh owe d that a ll competing teams had made th e b e st o f their t raining It mu st h ave been a source o f satisfa ctio n t o all th e teams that the same ju d ge, D r. H Mi ddl eton, IvLC., Haverfordwes t , officiated at a ll the eli min ating contes t s, an d the Ce n tre feels o- reatl y ind e b te d to the D octor fo r giving his services gratuit o usl y on so man y oc casi ons. The teams fi gu r in g in the comp etitio n s we r e the Mi lford Haven

Ambulance Division Team and Police Teams of Haverfordwest, Goodwick, Milford Haven and Pembroke Dock, the teams entering the final competition being the Milford Haven Ambulance Division Team and the Milford Haven Police Tea. This event took place at the Petty Sessions Room, Milford Haven, on August 29, 1939, and the Daniel Daniel Ambulance League Cup was won by the Milford Haven Ambulance Division Team for the first time, the judge being Dr. Colin McGeoch, Haverfordwest, whose services are placed very freely at the disposal of the ambulance movement in the county.

The cup was presented to the captain of the winning team by Mr. L. J. Me yler, J.P., Chairman of the Milford Haven Justices.

Elliott Alves Cup.- The competition for the Cup, between the Milford Haven Police Team and the Goodwick Police Team, was held at the Police Recreation Room at Haverfordwest Castle, on October 25,1939, the judge being Dr. D. H. Pennant, D.S.O., Saundersfoot. In his adjudication, Dr. pennant stated that the standard of both teams was very high and that, in the aggregate marks, there was very little difference between the teams. He gave to the teams some very useful hints on competition work in general. Capt. A. T. N. Evans, the Chief Constable, who is Assistant Commissioner for the County, warmly thanked Dr. Pennant for his services.

The Centre is to be commended on continuing competition work, particularly in view of the suspension of all the national ambulance competitions. It has been observed that eliminating competitions serve a very useful purpose as a good percentage of the spectators consist of first-year students in first aid, who undoubtedly gain much knowledge by watching the practical part of the competitions. The practice of holding the competitions at different centres is to be recommended, as it brings the work to the notice of a wider circle of spectators.

Obituary.-The Centre reports with regret the death of :Mr. R. W. Coen, Divisional Superintendent of the Milford Haven Ambulance Division, who had been f0r many years a staunch supporter of the ambulance movement.

The Division is fortunate in having secured Capt. Norman V. Robinson, M.e., Penbryn, to succeed Mr. Coen as Superintendent. Having ably captained the Milford Haven team, his services are well known throughout the county.

Annual Inspection.- The Pembroke Dock Ambulance and Nursing Divisions turned out at practically full strength on Monday, December 18 for annual inspection by the Commissioner for Pembrokeshire, Mr. Daniel Damel. Both Divisions acquitted themselves with credit.

CITY OF CARDIFF CENTRE

The Brigade was represented at the funeral by the Commissioner Assistant Commissioner (Capt. F. P. Robathan, M.e.) and a contingent of members in uniform.

NEWS IN BRIEF

Nursing Members enrolled in the Civil Nursing Reserve are reminded that in order to qualify for the 5s. Uniform Grant in lieu of overall and cap, they musr complete the Hospital Attendance Register obtainable on application to Priory Headquarters.

Blood Transfusion Service

The Brigade in many parts of the country has extended its humanitarian work b y including a Blood Transfusion Service. Recently the names of ten members of the Winchester Ambulance Division were brought to the notice of the Chief Commissioner as donors of blood at the Royal County Hospital, Winchester. To such donors the Chief Commissioner issues a certificate to the following effect:-

" It has been brought to my notice that you have given your blood to save a patient b y transfusion.

"No one could give a nobler gift, and in giving it you have acted most fully up to the motto of the Order of St. John, which is For the good of humanity.'

" To save life you could not have done more than to give your own blood, ' and in doing so you have not only performed a noble and gallant act but you have also brought cre:iit to the St. John Ambulance Brigade.

"I am proud to have you as a member."

In expressing appreciation of the humane action of the Winchester Ambulance Division for their most excellent and effective Blood Transfusion Service, the Chief Commissioner has remarked that by their generous action they have ·indeed put into practice the motto of the Order, « For the good of humanity "

The Commissioner, Dr. Edgar Llewellyn, records with deepest regret the loss the Brigade at Cardiff IS has sustained by the death of Mr. James \Villiam Barnes, Superintendent of the Cardiff Dowlais Works Division. Mr. Barnes enrolled jn the Cardiff City Division in 1926 and was transferred to the Works Division on its formation in I927. His marked efficiency and devotion won him well-merited promotion through succeeding offices, until he became Divisional Superintendent in 1938. His energies were not confined to his own Unit. As a e.A.G.S. Instructor he was at all times ready to lecture and examine other A.R.P. classes in Cardiff and District.

PERSISTENT POISON GASES

By MAJOR HUMPHREYS, T.D., M.R.e.S., ETC.

A warfare gas is delivered either in a liquid or in a gaseous state Such a gas is kept in tacIes, and when liberated from the restralnt It eIther tunIS at once into a gas and mixes with the air, or it flows out as a liquid which more or less slowly evaporates. Some vapours such as Chlorine or Phosgene hang about for a time, upon the wind, the temperature of the alt, the actlOn of rain, etc. The" persistent" or liquid gas has to be dealt with by the town organisation. " Mustard Gas" is an example of this. In the Field, as on the West Front in the last war, it was neutralised with the help of Chloride of Lime. This chemical is a powerful antiseptic and was largely used in the Boer War. It has now been displaced, cresol and similar coal tar products bein g in use. It is sti ll used for making Eusol, a wound dressing, or for bleachlil g purposes. It will keep good in metal or other suitable receptacles; in cardboard boxes it rapidly deteriorates.

In usin a it for destroying "Mustard Gas," the chemical indicate that the amount required is equal to about that of the substance to be treated.

In using Chloride of Lime, it must always be mixed with water, for if put on in the dry it will cause the evolution of considerable heat, and this will evaporate the gas rapidly into the air and add to the danger

One of the great differences b etween military in the Field and civil life lies in the drainage systems to be found in towns. The principle in dealing with persistent gases lies in washing the liquid into the surface drains witbout delay. In towns, the surface drains run into the main sewers, which have a tremendous flow of warm water constantly passing through them.

In old towns the surface drains deliver their contents in many different ways in adjacent quarters. In country towns the surface water is run off to neighbouring brooks, or even roadside ditches. It not pass to the sewage farms; it water-logs them 1f it does.

These exits for the surface drainage have to be very carefull y guarded during a gas attack. The neutralising chemical must b e applied there in quar:-city. Probably it is best to dig a deep soak-p1t at the point of exit; this will fi ll with water and the liquid aas bein a heavier than water will sink to the b b bottom, and the antidote will have an of dealina with it. The local District Surveyor WIll have the;e exits marked on his plan of the district, and provision will have been made at these points--as well as in other places-for neutralisation.

What

is the best antiseptic?

In the course of a recent lister Memorial lectu re an eminent surgeon declared that" the best antiseptics are not those which, in vitro, have the greatest germicidal power, but those that have a powerful proteolytic action, such as Dakin's fluid, which rapidly destroys dead or dying tissues

Milton is of the same chemical nature as CarrellDakin solution, that great life-saver of the last war.

The Dakin solution must always be mixed afresh to ensure strength: MILTON IS STABLE. With Dakin solution there is a tendency to causticity : MILTON IS NON-CAUSTIC. Milton has not only full germicidal power but that destructive action on pus and dead tissue that leaves a wound surgically clean

Which is the least . expensive antiseptic?

Milton unquestionably-consistent with achiev ing proper conditions of antisepsis Its great germicidal power makes possible effecti\r e dilution of as little as I in 100, or three tablespoons to a gallon of water.

Red Cross and St. John War ' Organisation

(Continued from page 346 D ecember issue)

CANADIAN RED CROSS

Recent visitors to Headquarters have been Mr. R. B. ' Bennett, Chairman of the London Advisory Committee of the Canadian Red Cross, and Dr. Fred W. R o utle y, the National Commissioner. Both visitors explained that it was the wish of the Canadian Red Cro ss to work in close co-operation with the War Organisation: and they desired to make it clear that the resources of the Canadian Red Cross would always be available for the common cause. Dr. Routley is arranging for the reception and storing of quantities of garments, comforts and hospital supplies now ready for despatch from Canada. The y are int ended for British as well as Canadian sick and w o unded soldiers. In addition" he is engaged in es tablishing a Canadian Red Cross Hospital on Lord A sto r s estate' at Cliveden.

AMERICAN RED CROSS

Other visitors were Mr. J. E. Swift, the ViceChairman of the A merican Red Cross Society, and Mr. Wayne Taylor, the liaison officer in Europe of the Society. Discussions with them were of great as sistance to the War Organisation in laying the foundations of an understanding respecting the coordination of offers of assistance from the United States. Mr. Swift took with him a detailed , list of Cross requirements.

SCOTLAND JOINS IN

T he Lord Mayor'S Red Cross Fund, organisedin response to the appeal made by H.R.H. The Duke o f Gloucester, now embraces the whole of Great Britain, as the Scottish Branch of the British Red Cross Society have agreed to associate themselves with the Mansion House Appeal. All the various schemes which have been inaugurated by the Lord M ayor's Committee will now be extended to Scotland as well as to England and Wales This course will prevent unnecessary .overlapping and should be g r eatly to the benefit of the Fund. All moneys rais ed in Scotland will be credited to the Scottish Branch. In the case of the Penny-a- Week Workers' contributions, the St. Andrew's Ambulance Association is to benefit with the Scottish Branch of the British Red Cross in regard to contributions from Sc otland.

AID FOR SHIPWRECKED

The War Organisation has been in touch with the Shipwrecked Fishermen and Mariners Royal Benevolent Society to ascertain what action it can appropriately take in the way of relief to persons shipwrecked by enemy action. As the outcome, British Red Cross Society County Directors, Commissioners and Assistant Commissioners of the St. John Arn-

2.0

bulance Brigade concerned, and units of the Brigade in coastal towns have been advised that Detachments of the Society and Divisions of the Order should get into touch with the local representatives of the Shipwrecked Fishermen and Mariners Royal Benevolent Society. with a view to securing the fullest possible co-operation.

Captain Neil McEacharn, who owns a g arden on the shores of Lake Mag g ior e, has presented to the Red Cross 20,000 tulip bulbs to be used for beautifying hospital gardens and convalescent homes in France.

PLEASE P A IR THEM

When one bu ys socks and stocking s in shops they are stitched or stapled to g ether in pairs- sometimes much to the inconvenience of the purchasers Perhaps this is the reason why socks, stockin g s, mittens and gloves received from individual knitters and knitting parties by the Red Cross Hospital Supply Service are arriving unstitched. It mean s additional work in sorting articles into pairs.

S T O RE S

The demand on the Stores Department for supplies both at home and abroad has develop ed considerably A consignment of good s, including ov er 30,000 garments of all kinds, beddin g , ward accessories, surgical equipment, and games and comforts are in transit to the Base Stores in France.

Urgent demands have also be e n received from naval hospitals in the North of England and from several hospital ships. All were immediately met.

In addition, considerable demands have come from military hospitals at home. The y have been supplied with a wide rang e of articles from surgical requisites and garments to wireles s sets, g ramophone s and games of all kinds. Special arrang ements have been made with the authorities to meet requests from small military hospitals in this country.

In view of the substantially increased activity it has been found necessary materially to augment the packing and other staff and to occupy additional accommodation.

Approved grants for the purchase of stores now reach in round figures £100,000.

Close collaboration continues with the Central Hospital Supply Service. Further arrangements are being made to facilitate the associated activities of the two Departments.

The qUt:stion of co-operation with the Stores Department of the Canadian Red Cross in this country has been discussed with Dr. Routley, the National Commissioner. He has been assured that

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the Stores Department of the War Organisation will co-operate with him in every way in order to facilitate the work of the Canadian Red Cross.

With Lord Wigram as Chairman and Mr. S. F. Rouse as Honorary Secretary, the Sports section of the Lord Mayor's Appeal has already raised or been instrumental in raising approximately £15,000. Of this, Mr. Henry Cotton on the golf links has accounted for £ 5,000. In every field of sport there is enthusiasm for the cause, and plans have been made for the next six weeks which will produce much money for the Fund.

BOXING HELPS FUND

At a meeting of the Executive Committee at the Mansion House a few days ago, Lord Wigram was able to make a most satisfactory statement. The Amateur Boxing Association has arranged a Boxing Tournament at Wembley in co-operation with the Army Boxing Association and the Wembley Stadium, Ltd., for February next.

Some £2,000 will reach the Lord Mayor as the result of an effort of the British Boxing Board of Control. In co-operation with the Marquis of Queensberry -and the National Sporting Club, a tournament was held at the Empress HaU, Earls Court, and the above-mentioned £2,000 is the result. The British Board of Control has other arrangements in prospect.

BILLIARDS CONTRIBUTE

A programme has been arranged by. the Billiards Association for professional and amateur billiards players, while several hundred Billiards Halls have agreed to Red Cross collecting boxes being placed in prominent positions. An interesting feature of the efforts of the Association and the Control Council is in connection with Sunday opening. The Home Secretary is being asked to penult such opening on the understanding that the whole of the takings less overhead expenses shall accrue to the Fund. Already Mr. joe Davis and other professionals have raised £500 at two exhibitions in London clubs.

GOLF AND FOOTBALL

Allusion has already been made to Mr. Henry Cotton's effort. The 29 clubs of the English Golf Union by weekly and monthly tournaments have sent in £293, and there is more to come. The Football Association has already produced about £8,000 as the result of matches and donations. The expenses of matches are being borne jointly by the Football Association and the clubs, so that the whole of the proceeds are given to the Fund. Lord Wig-ram pointed out that Rugger is also arranging matches.

T ABLE TENNIS TOURNAMENTS

THE ROYAL NAVY

A very special appeal is made for the men of the Royal Navy. Warm comforts of every kind are needed. Knitted scarves, mittens, socks, all warm things in navy-blue are wanted, and special helmets which allow their wearers to use telephones unhampered. Directions for knitting these may be obtained price 3d., post free, from the Depot for Knitted Garments for the Royal Navy, I la, West Halkin Street, London, S. W. I. To this address all gifts should also be sent.

THE ROYAL AIR FORCE

The great demand is again for knitted comforts.

A special oversock is much needed, to be worn over ordinary socks under gum boots. These oversocks should be made of very strong, coarse wool, in natural or any dark shade. They are an enlargement of the ordinary sock, with length of foot from lIt in. to l2 in., the leg carried up to reach just below the knee and finished with 4 in. of ribbing done on finer needles than those used for the rest of the sock, to afford a good grip. Scarves in double wool and plain knitting are much needed. They should be in Air Force blue if possible, and measure from 52 in. to 56 in. long and II in. to 12 in. (not more) w.ide. Mittens and short helmets are also much needed. Knitters are asked to tack the mittens together in pairs.

Gifts should be sent to Ro yal Air Force Comforts, Berkeley Square House, Berkele y Square, London, W.I.

THE AR...Y.IY

The special request is for mufflers (without mittens in khaki wool, and so cks, preferably grey. Gjfts should be sent to the Officer in Command, Army Comforts, I la, St. Mary Butts, Reading.

TRA I NE D NURSES

H.R.H. The Princess Royal visited the Department receptly and was very interested in and appreciative of all that she saw. She paid particular attention to the Record of Nurses enrolled under the War Organisation.

Courses of Intensive Training for Auxiliary Nurses are being held under the auspices of Mrs. BeckwithSmith, who has issued a very satisfactory report of the first course. The Matron-in-Chief has been asked to serve on a Committee to organise additional SchooJs in different parts of the country.

_ The recommendations made by the :Matron-inChief at the British Red Cross Societv Education Committee regarding the qualifications of applicants who wish to give lectures or conduct examinations in Home Nursing wee accepted.

In addition to appealing to League Secretaries for personal contributions, the English Table Tennis Association is to hold an exhibition tournament in which world champions and international players will take part. Mr. Elvin, of the Wembley Stadium, zz has offered the free use of the Empire Pool and Sports Arena for the finals of the English championships. The National Amateur Rowing Association has given £25 as a start, and the Amateur Swimming Association is getting busy. Their help cannot fructify until later on.

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WHY AND WHEREFORE IN FIRST-AID.

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THE

St. John Ambulance Association

Its History and its Part in the Ambulance Movement

By N. CORBET FLETCHER, M.A., M.B., M.R.C.S.

This book, fro.,. cov 10 COt is full of lnformlJiion of grealest int est and imparlance to .ro..-yo.", in the A mbulance Movel12mt."St. Jobn :ambula nce <IiaJettc.

Price 3 6 Postage 6d. StOTa ST. J 0 H N 'S GAT E, LON 0 0 I'It E. C. 1 •

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EVERYTHING FOR SAFETY EVERYWHERE 'NOVOX' and 'NOVITA' Oxygen + CO, or Oxygen RESUSCITATI NG APPARATUS for the apparently asphyxiated or drowned.

SMOKE HELMETS of all Patterns.

'PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

'PURETHA' GAS MASKS for Naval, Military and Industrial purposes and for Civilian use.

DUST and SPRAY MASKS and all other Safety and Protective Devices.

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Important to Parents

A

NE\V service is offered to " Gazette" readers which will be of great help in their family lives and will be of value to all parents. It is the introduction of a special Child Psychology Section in NEW HEALTH (Consulting Editor, Sir W. Arbuthnot Lane, Bt., C.B.). This Secti on is under the direction of a European psychiatrist of repute and gives detailed guidance on the many problems of psychology with which all parents arc faced. This teature was introduced in the January, 1937 issue) and has proved an outstanding success. Advi ce is being sought by readers all over the country.

« Gazette" readers who are regular readers of NEW HEAL TH are invited to send their problems to this bureau for free guidance.

NE\V HEALTH is the most popular orthodox health journal in the country and has associated with it man: distinguished medical and scientific authorities. It is on sale at bookstalls and newsa gents on the 1st of each month, price 6d. In case of djfficulty, send 8d. for each issue post free, to :

(S.J.) NE\V HEALTH, 39. Bedford Square, London, W.C.l

mbe 3Jobn

OFFICIAL GAS CHARTS

No. I Chart shows gas derivations.

No. 2 is a full and complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee

Important-

Readers of this Gazette who have made First Aid and Nursing their chief interest in life should not fail to read-

The Nursing Journal that is more advanced in every way. Each week it describes and illustrates all the modern methods and treatments and is therefore invaluable to those wishing to increase their knowledge.

Ask your Newsagent to reserve or deliver you a copy weekly-Price 3d.

A specimen copy will be gladly sent on application to :

Whippendell Road, Watford, Berts

HOBSON & SONS

POUNDED

(LONDON), Ltd. SPECIALISTS IN UNIFORMS.

MANUFACTURERS OF EVERY DESCRIPTION OF UNIFORM CLOTHING AND EQUIPMENT for St. John Ambulance Brigade.

JACKETS, TROUSERS, GREA TCOA TS, CAPS. BELTS, GLOVES, HAVERSACKS, WATERBOTTLES, ETC.

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THE ST. JOHN AMBULANCE GAZETTE is published on the th of each month. The annual subscription is F. 6d., post free; single copies 3d. Brigade Reports and Photographs should be addressed to the Editor, at 32, Shoe Lane, E.C.4. Reports and phot(},graphs should reach him as early in the month as possible.

Subscriptions and Advertisements should be forwarded to tbe publishers:

Messrs. British Periodicals, Ltd., 19, 19a, CursitorStreet, London, E.C.4.

CONTENTS

Editorial

First A.id and Home Nursin g

The Main Arteries and Their Pressure Points

Reviews

Overseas News

Railway N e ws

First Aid in Relation to Mine s Rescue .Work

Obituary

Briga de News

Interesting Cas e R e ports

Questions and Answers

Air Raid Precautions

How to Form a Unit of the St. John Ambulance Brig ad e Priory for WaJes __ Red Cross and Sc. John War Organis a tion

CHANCERY OF THE ORDER, ST. j n HN's GATE,

CLER KEN WELL, LONDON, E.C. I.

Pro Utilitate Hominum

THE ORDER OF ST. JOHN OF JERUSALEM

AWARDS OF THE LIFE SAVING MEDAL

THE MARKHAM COLLIERY DISASTER ON M AY la, 193 8

LIFE SAVING MEDAL IN GOLD

AWARDED TO DIVISIONAL SURGEON J. S. McKAY

Dr. J. S. McKay was sent for when the disaster occurred. The following details of his action were brought to the notice of Chapter-General :-

(I) That he is not a colliery official and that it was no part of his duty to endanger his life by going down the mine (which he did within ten minutes of being called), and indeed that he went down in spite of some opposition.

(2) That by taking over control and organising artificial respiration squads he saved many lives.

(3) That he penetrated into the most dangerous part and by there examining all cases and segregating the dead from the living and concentrating on the latter, he saved further lives.

(4) That so generously did he risk his life that he was eventually overcome by the fumes when he was alone working on a case and could only be partially revived even in the surface ambulance room. It was only in the Chesterfield Hospital that he was eventually brought round.

Dr. McKay was one of the last men to be brought alive out of the pit, and he owes his life to the fact that whilst l ying unconscious he was trod upon by a stretcher squad carrying a corpse, wbich caused rum to utter a groan, whereupon the squad removed the corpse from the stretcher and brought out Dr. McKay Dr. McKay was three days in Chesterfield Hospital, and three da ys in bed at his home.

H.R.H. The Grand Prior was satisfied that Dr. J. S. McKay endangered his own life to the very limit of losing it, and he saved many lives by his action, and on the recommendation of Chapter-General awarded him the Life Saving Medal in Gold.

LIFE SAVING MEDAL IN SILVER AWARDED TO MR. R. RINGHA1-.1

The followin g details of his action were brought to the notice of Chap t er-General :-

Mr. R. Ringham is chief agent for the collieries He was responsible for organising and leading the rescue. He partially collapsed in the mine three times, but on recovery continued to direct the rescue work and refused to permit himself to be removed to the surface.

H.R.H. The Grand Prior was satisfied that Mr. R

Ringham saved many .lives by his effective direction of the rescue work and also that he risked his life, for several of the rescuers were k.illed, and on the recommendation of Chapter-General awarded him the Life Saving Medal in Silver.

AWARDED TO :MR. F. HOLTHAM

The following details of his action were brought to the notice of Chapter-General :-

Mr. Holtham's shift had finished their work and had commenced to return to the surface when the explosion occurred: he remained belQw (along with many others) and at once commenced the work of rescue long before the rescue Brigades with their protective apparatus could arrive and take over.

Mr. Holtham was conspicuous in this rescue work and continued working strenuously. Many members of the shifts that stayed underground as he did, without apparatus, lost their lives.

H.R.H. The Grand Prior was satisfied in the case of Mr. F. Holthamthat owing to the efforts of his shift, among whom he was conspicuous, many lives were saved and that every man of this shift who stayed below risked his life very gravely by carrying out rescue work without protective apparatus, and indeed, many of them lost their lives, and on the recommendation of Chapter-General awarded him the Life Saving Medal in Silver.

In addition H.R.H. The Grand Prior, on the recommendation of Chapter-General, directed that a Certificate of Honour should be awarded to the Staveley Corps and a separate one to the Markham Colliery Ambulance Division, most of the members of which were engaged for a long period both above and below ground.

LIFE SAVING MEDAL IN BRONZE

AWARDED TO FIREMAN ERNEST WALTER BOATWRIGHT

The following details of his action were brought to the notice of Chapter-General :-

On June 2.1, 1939, at about 9 a.m., Fireman Ernest Walter Boatwright was standing on the platform at North End Railway Station, Port Elizabeth. A train which had been given a non-stop run through the station was just commencing to pass through the station, travelling somewhere about 30 miles an hour, when a woman stepped on to the lines, apparently intending to cross them and being unaware of the train. When she did see it she appeared" confused" to one witness and " petrified with fear" to another, and sat, or crouched down between the rails in front of the oncoming train.

Fireman Boatwright flung himself at her "with a beautifully-timed rugby tackle," according to one witness, and shot himelf and the woman on to the opposite track. The pair " rolled in a bundle" out of harm's way, the woman sustaining injuries and the train missed them by a mere fraction, a matter of inches.

The evidence is that of experts, two signalmen and the station-master, who were all full of admiration for the courage Fireman Boatwright showed.

28

In view of this evidence, H.R.H. The Grand Prior, on the recommendation of Chapter-General, awarded Mr. E. W. Boatwright the Life Saving Medal in Bronze.

First Aid and Home Nursing RESIDENTIAL INTENSIVE TRAINING

A residential scheme of Intensive Training in First Aid and Home Nursing was recently formulated and has now been put into operation. There are two schools open, in the counties of Oxfordshire and N orthamptonshire.

The scheme is under the auspices of the St. John Ambulance Brigade, and the following extract from the Nursing Times shows that it is looked upon favourably by the Nursing Profession :-

" An interesting experiment in the training of nursing auxiliaries is going on at Bicester and Northampton. Training schools have been started. . . . In these the students will reside for about two weeks during which time they will have their lectures on first aid from a doctor and home nursing from a State-registered nurse. By this arrangement the schools, which are smail, enable the students to spend much more time in the supervised practice of the arts of bedmaking, bandaging and treatment than is usual in these courses. The organisers hope that the y will be better prepared to give valuable assistanc e as nursing auxiliaries in the wards and will get a sounder idea of hospital discipline-which is, after all, at the best merely consideration for others of superior, equal and inferior rank. We shall be interested to watch the progress of this venture."

Those wishing to apply as prospective students for these courses should write to The Lady Superintendent-in-Chief, St. John Ambulance Brigade , 3, Belgrave Square, London, S.W.I, stating to which Training Centre they prefer to go.

New Headquarters

Kensington Nursing Division celebrated the opening of its new Headquarters in Gledhow Gardens on Thursday, January 2.5, with a musical social.

The Mayor of Kensington, Councillor J. D. C. Jenkins, J.P., L.e.e. (who brought with him Sir Allan Powell, Chairman of the B.B.e.), the Mayoress and Dr. James Fenton, the Medical Officer of Health and Mrs. Orpen and her Commandant, representing the Red Cross, all of whom take the keenest interest in the local First Aid and A.R.P. organisations were present, and also Mrs. Atkinson, Lady Superintendentin-Chief, Lady District Superintendent Miss A. M. Walker, District Officer Mrs. McKenna, Mrs. Tapply, Miss Tuckwell and Miss Watson. and the Editor, THE ST. JOHN AMBULANCE GAZETTE.

The Kensington Nursing Division is to be congratulated on a very sUlccessful evening.

The Main Arteries and Th .eir Pressure Points

By N. CORBET-FLETCHER,

M.A., M.B., M.R.C.S., Surgeon-in-Chief, St. John Ambulance Brigade

PART II

(Contimled fro171 page 358, December issue)

Compression of the Popliteal Artery is best made by flexion of the limb on a large pad (size of lawn tennis ball) placed behind the knee-joint and kept in position by bandaging the leg to the thigh. The Textbook no longer includes this among its Pressure Points; and consequently it is, in my opinion, guilty of inconsistency. It were better if it had applied the same restrictions as it does to compression of the Brachial Artery at elbow-joint and ruled that the Popliteal may be controlled by flexion at knee-joint-" in urgent necessity and as a purely temporary measure."

The Anterior Tibial Artery (the smaller of the two end branches of the Popliteal) can be marked out by a line drawn from the front of the head of the fibula to a point on the dorsum of the foot, midway between the two prominences or knots of the ankle, that is, in middle of front of ankle-joint. At this point (pressure Point No. 12) the artery can readily be compressed by thumb or by pad and bandage. The vessel first passes forwards between the bones of the leg and then runs down on the front and outer aspect of the leg to the front of the anKle-joint, where it is continued as the Dorsal Artery of Foot. It is accompanied by two veins which inter-communicate freely.

The Posterior Tibial Artery is the larger of the two branches into which the Popliteal divides, and extends from the base of the ham-space downwards and inwards between the muscles to a point midway between the lower end of the tibia and the inner knob of heel-bone, where (Pressure Point No. I 3) it can be easily compressed by thumb or by pad and bandage. In its origin it is deeply placed; but in its lower third the vessel approaches the surface and ends by division into the Internal and External Plantar Arteries. It is accompanied by two veins.

The term "tibia" signifies "a flute" and has reference to the shape of the shin-bone, whereas ,. fibula" is the Latin name for "a clasp" or H a brooch" and refers to the function of the fibula, which acts a clasp to the tibia and helps to form the ankle-joint. ,

The Dorsal Artery of Foot, the continuation of the Anterior Tibial, lies between tendons on the frortf aspect of the ankle, crosses the bones of the foot, and passes down between the first and second metatarsal bones into the sole of the foot to join up with

the External Plantar, The artery may be indicated by a line drawn from the centre of the front of the ankle-joint to the space between the two inner toes. The Plantar Arteries take origin from the Posterior Tibial at the ankle-joint. The Internal Plantar is smaller than the External, and passes forward along the inner side of the sole of the foot usually to the space between first and second metatarsal bones. The External Plantar is the larger of the two, passes at first downwards and outwards across the sole of the foot to the base of the fifth metatarsal bone. There, bending forwards and inwards, it sinks deeply into the foot and ends in the space between first and second metatarsal bones by joining the branch from the Dorsal Artery of Foot. Its course across the foot presents a slight curve, with convexity forwards, which is known as the Plantar Arch, and which may be compared with the Deep Palmar Arch of the hand. From it branches are given off, which, as in the hand, divide to supply neighbouring sides of the phalange s and surrounding tissues.

Kensington Inter-Post 'WTins Competitions

BROMPTON HOSPITAL POST WINS ST. JOHN UNITS' SEMI-FINAL

Kensington's Inter-Post Competitions-embracing all aspects of First Aid and A.R.P. work-organised by Dr. James Fenton, the Medical O]:icer of H ealth, will be concluded on Februar y I4.

Brompton Hospital Aid Post, one of th e keenest posts manned b y St. John units, will represent the Brigade. This team secured 2.GG t mlrks out of 300 in the semi-finals.

The team will meet the winning B.R.e.S . team in a spirit of the kee nest and friendliest rivalry in the finals for the silver cup presented by the Borough Council at the Convent of the Assumption, Kensington, on February 14.

St. J ohn t eam: Miss Hudson (Leader), Miss Cooper, Miss Crossley, Mrs. Hamilton, Miss Marsh, Miss Parfitt, Miss Price and Miss Swains on.

Dr. Fenton is to be congratulated on the organisation of the competiti ons which have resulted in enthusiastic practice on the part of all the comp eting teams.

Correction

The recipient of the Meritorious First Aid Certificate recorded in our last issue was Mr. H. Hockey, Clerk, Goods Dep art ment, Manchester, not Mr. H. H. Clerk .

OVERSEAS NEWS II

SOUTH AFRICA

JOHANNESBURG

The 46th annual report on the work of the Transvaal Centre of the St. John Ambulance Association was recently submitted by the Committee. It states:

The scheme to stimulate training and extension of St. John influence in all spheres of life and in every portion of the Transvaal has been carried through with complete success. There has been a consistent expansion in the classes held in the subur bs, outlying Districts, throughout Reef townships, and in many country districts.

One hundred and fifty classes were held during the year in Johannesburg and on the Reef ; in this

Brigade. The requests from the Association for the supply of trained demonstrators and instructors have been many, but the response of the Brigade members has enabled us to meet all demands. Classes have been held at aJl times during tbe day as well as in the evenings and it has been very gratifying to see the ready manner in which members have given their services voluntarily for this work.

Progress made in the Brigade during the past six years has been so marked that I feel the following comparative figures for the years I933, I936 and the present year (I939) will be of considerable interest.

of Di visions .. Numer of Members

KENY A POLIC E DIVISIO N (M O MBASA)

connection the thanks of the Association are due to many members of the medical profession who lectured to and examined these classes; and, equally to the Brigade members who acted as demonstrators.

The annual street collection realised £446 14S. 9d. Outstanding work to which the Association wishes to make special reference concerns the successful training carried out among members of the non-European races in St. John Ambulance duties.

In . his report for the year ended September 30, 1939, Lieut.-Colonel Gerald E. Peacock, M.R.C.S., L.R.C.P., Commissioner for the St. John Ambulance Brigade, Transvaal District, states :-

The past year has been one of great activity in the

During the past year 18 new adult and Cadet Divisions were formed and 83 I new members enrolled.

Total all ranks, 2,056.

In addition to the many calls for staff for training, the members have undertaken an increased number of public duties. I am sure that I voice the feelings of the organisers of entertainments sporting events when I express to our members on my own and their behalf, our great appreciation of the ready manner in which they have responded to the calls made upon them.

Members of Nursing Divisions have continued to show keen interest in practical training at the hospitals -both civil and military.

The unsettled state of aifairs overseas has, somewhat naturally, given rise to many requests for in Air Raid Precautions. It has however been deCided that such instructions should meantime be confined to members of the Brigade. A course of instruction was organised during the year for instructors, demonstrators and general certIficates. Nearly two hundred members were enrolled fo r these courses.

The standard of efficiency of the members has been well maintained and I would take this opportunity of thanking senior Officers, Divisional Surgeons, Medical Officers, Divisional Officers and members individually for their keenness and interest in the work.

WEST AUSTRALIA

BOULDER, DECEMBER 9, I939

In an address of welcome to teams who were to compete on December 10 for the Western Australian Chamber of Mines Challenge Cup, Mr. V. Treloar (Chairman of the Boulder Centre of St. John Ambulance Association) said he was pleased to see so many St. John Ambulance workers present. One team from the Big Bell G.M. had travelled 800 miles to take part in the competition.

Responding to the toast of " The Chamber of Mines," Mr. Truscott expressed great pleasure at the enthusiasm displayed by mine employees in first-aid work. He hoped the time was not far distant when all miners would make themselves proficient in the good work taught by the St. J ohn Ambulance Association.

Mr. A. Sampson (Secretary of the Association), replying to the toast of "The St. John Ambulance Association," stated that during the last six years the Boulder Centre had trained 2 50 men and 2 5 \:llOmen in first aid.

The contest conducted by Dr. P. W. Shanahan (Divisional Surgeon) was judged on the points as laid down in the Textbook of the St. John Am bulance Association, 39th Edition.

The test case-such as is commonly met with in the g.old mines of W. Australia-was as follows :" A man is working in a stope when there is a fall of earth. A large stone falls on his left foot, crushing it badly. He is in a lot of pain, and passing a little bloodstained urine. He has a deformity of his left shoulder, and the elbow of his left arm cannot be brought down to his side."

Treat his injuries. Time to be counted only if contest is close.

Results were as follows :-I, Lake View No. I ; 2, Great Boulder; 3, Lake NO .3.

Southern Railway (COKTRIBUTED BY E. UZZELL)

DrvISIO AL CO M PETITIO NS

First-aid competitors will be sorry to learn that in view of the present conditi ons and the difficulty that would be experienced in arranging the annual divisional competitions, the Centre Committee have decided that they shall be cancelled for the period of the war.

It is hoped, however, that members of the First Aid movement will not allow their interest to wane, and neglect their practice, but will make every endeavour to maintain their efficiency in this important work by regular attendance at classes.

There was never a time when this was more essential than at present, and it is felt that the Southern First-aiders will fully appreciate the position so that when hostilities are over our competitions can be resuscitated with lively vigour, and the customary happy rivalry.

The undermentioned members of the staff were granted the Meritorious First Aid Certificate at a recent meeting of the Southern Railway Centre Committee.

Police Constable R. Barton, Portsmouth. Fireman A. S. Garrett, Easdeigh.

These men rendered first aid at Fratton on July 25 when Foreman Shunter H. Turton was knocked down by an engine and recei ved serious injuries. Constable Barton was quickly on the scene, and was soon joined by Fireman Garrett. The wounds were dressed, and the patient sent to hospital by ambulance. Lengthman W. E. Coster, Virginia Water.

Whilst assisting in relaying work between Ashford and Feltham on October 15, Lengthman J. Sample, of Feltham, came into contact with t;he live and running rai ls, sustaining burns of both legs and one arm.

Coster was on the spot and after removing the patient from contact, applied artificial respiration. Upon restoration of the breathing he very efficiently treated the burns.

Porter W. Lemon and Porter W. Sisley, of Havant,. rendered first aid to two lady passengers involved in a train accident at Havant on June 17. One lady had a deep scalp wound down the right side of the face, two fingers torn off, also arterial hremorrh age of the palmar arch, lacerated ri gh t leg, bruised left leg, and severe shock. The other passenger received injuries to the legs and shock

Doctors at the hospital to which the patients were conveyed congratulated the two men on the efficient work performed and stated that, without doubt,

Porter Sisley had saved the life of the fin;t-mentioned passenger.

Lengthman J. Hyland and Sub-Ganger E. Smith, of Selhurst.

Hyland, with the assistance of Smith, was instruin. removing Sub-Ganger F. Slapgood from the live ral1 when the latter's shovel came into contact with the rail at Windmill Junction, causing a short circuit. These two first aiders removed the man from the live rail and performed artificial respiration. After a few minutes breathing was restored. The y also treated the patient for burns. .

When working at Burgess Hill on June IO last Labourer W. Harrod was found lying on the conductor rail. Relayer W. Downs, of Burgess Hill, applied artificial respiration on the patient for 2.0 minutes, which was continued for 25 minutes by Relayer Denman, also of Burgess Hill, until breathing was restored. Meanwhile a doctor was sent for who ordered the patient'S removal to hospital.

COMPETITIONS

As many· members of the Ambulance Movement no doubt anticipated would be the case, the Centre Committee have decided that the Divisional Competitions for the Directors' Shield and Cups shall be cancelled for the duration of the war.

Similarly, in view of the altered conditions prevailing consequent upon decentralisation of the staff, it has been decided that the " Sir Herbert: Walker" trophy for the best district results shall not be considered for awarding until normal are resumed.

These decisions were reluctantly arrived at, especially as such a tremendous interest in First Aid wQrk is being evinced throughout the system.

The Inter-Railway Competition wiN also not be held 4during the period of hostilities.

The Ambulance class at London Bridge, comprising staff from the three London Terminal stationsCharing Cross, Cannon Street, and London Bridgewhich only began in October last, held its first presentation of awards recently, under the chairmanship of Mr. E. Ca r d, Station-master, London Bridge. !he large assembly was a fine testimony of the lllterest being displayed in the First Aid movement at these stations.

Mr. P. Nunn presented the awards, and gave some encouraging adviee, and in congratulating the class as a whole remarked how essential it was that they should continue to take an interest in this important work.

Mr. E. Uzzell also congratulated new candidates on their success, and thanked Mr. Card for the zeal he had displayed in getting his staff together.

First Aid in Relation to Mines Rescue Work

By C. M. l(itto, M.E. (Superintendent, New Tredegar Mines Rescue Station)

In the light of recent mining history there need be no apology for bringing this subject to the notice of the readers of THE GAZETTE. Although science is proving of immense value in the promotion of safety in mines generally, yet colliery disasters occur with seemingly fatalistic regularity.

The year 939 has to record an explosion in Scotland; and it is at least ironical that the occurrence should have taken place in a mine where no expense had been spared in endeavouring to reduce the accident liability, this particular colliery having been instanced as an example of comparative safe working.

Previously, on :May 10, 1938, an. explosion occurred at the Markham Colliery, Derbyshire, which again might have been considered exemplary in the matter of safety precautions and appliances, according to the following quotation of the Commissioner who held the enquiry: "If the explosion had not happened, I think it clear that anyone experienced in these matters would have said that it was practically impossible for an explosion of Coaldust in the East Plane to have been propagated to any great extent. It was indeed by a sequence of events, each one almost fantastically improbable, that this explosion was brought about and developed." Going back to the disaster at Gresford Colliery, North Wales, which shocked the country on September 2 I, 1934, we find another instance of a catastrophe occurring in a mine which could not have given grounds for anticipating an explosion.

The import of these references is that the possibility of minin g clisasters must never be regarded as remote.

In the early history of mine rescue work far less importance was attached to first aid than to rescue operations; and it was not until I928 that the possession of a recognised first-aid certificate was made obligatory upon all members of permanent corps and rescue brigades. The report on the medical treatment of men burned in colliery explosions, published in 1933, brought out very clearly

some of the salient points regarding first aid in rescue work; and it is now more fully recognised that the application of first aid can be of great service in preventing injuries from becoming more serious. For example, many years ago there was an accident in which 13 men were gassed in a mine; and during the course of the rescue operations they were rushed out into the cold night air with the result that they all developed pneumonia. .

The Rescue and Aid Order says: "As soon as possible a base or bases shall be established in fresh a'ir and as near the irrespirable zone or zones as safety permits. Each Base shall, if possible, be connected by telephone to the surface of shaft bottom. Whenever men are at work beyond the Base there shall be stationed at the Base as soon as possible the following: (a) Two men of whom at least one should understand Rescue Appliances and First Aid; (b) a spare Brigade with Rescue Apparatus and ready for service; and (c) one or more reviving apparatus, stretchers and birds."

First-aid men who are able to detect mine gases would naturally assist rescue brigade men. Instruction in the signs and symptoms of carbon monoxide poisoning and special drill on the carrying of a stretcher along the narrow and low colliery roadway form a necessary part of the training of the colliery first-aider, who should be able to treat men injured by the violence of an explosion or suffering from the effects of noxious gases or air deficient in oxygen, and particularly men suffering from burns and shock, as well as being able to arrange for transportation to the surface, hospital or home. He may be required also to deal sympathetically with exhausted and possibly injured rescue men and should be able to prepare the rescue and aid room at the colliery surface, both in respect of the reception and care of patients and in the matter of refreshments of men in the work of rescue and recovery. Major Inl.unes, such as severe hremorrhage, compound and spl11al fractures would have received first-aid treatment on the spot by the rescue men; and the ambun:en should be prepared to supplement this lmprovised dressing, if necessary, when the patient reaches the base, in order to make him as comfortable as possible before being taken to the pit top.

In all cases ambulance men in the mines should be how to administer oxygen or a dicarbox n:lxt:rre of 93 per cent. oxygen plus 7 per cent. carbon dlOxlde by means of the "Novita" or "Novox" appa,ratus, either of the lung-governed or niechanically applied type or by " Haldanes " type of administra-

A thorough knowledge of artificial respiration lS of the greatest value in this connection; and it that the practice of ,artificial respI.ratlOn IS a neglected part of first-aid work, pOSSIbly owing to its laborious nature. Although Schafer's method is now accepted as the easiest method, artificial respiration calls for considerable effort. Attempts to simplify this operation for

prolonged application have resulted in the production of apparatus such as the iron lung, the Drin ker respirator, the Bragg-Paul pulsator and the rocking stretcher. An excellent example of the " Rocking" type is "Rilleys Rocking Stretcher"; but as this is not suitable for use in restricted spaces underground a simple type known as "K. J." has beeIf installed in all the collieries connected with one of the mines rescue stations in South Wales.

After a colliery explosion, burns cau sed by the resultant fire are a serious problem. It is recorded that from I93 I to 1933, 62 persons suffering from burns caused by explosions were brought to the surface alive, but 45 or practically three-fourths of this number died subsequently in hospital. Circular No. 64 issued by the Mines Department in 1933 should be read carefully therefore by all first-aid men.

(To be continued)

Obituary

We regret to record the death of Major J. H. Thornley, M.e, M.B., Ch.B., one of the County Surgeons for the North Riding, who died at his home at Scarborough recently, at the age of sixty-three.

Dr. Thornley, Surgeon to the Scarborough Ambulance Division for many years until appointed Count y Surgeon in I926, was always deeply interested in first aid work. He instructed and examined many classes. .

The large number of friends who attended the funeral service was evidence both of the universal respect in which he was held and of the diversjt y of his interests. A Guard of Honour was provided by members of the Scarborough Division. Representatives of the Nursing Division and local B.R.es. Detachments were also present.

His work as County Surgeon will not be forgotten by his colleagues on the county staff.

We regret to record the death of NIts. Clementina E. H. Rowcliffe, president of the Cranleigh Ambulance and Nursing Divisions.

During an exceedingly active public life Mrs. Rowcliffe had been a true friend and guide to many organisations. Her chief was in connection with the Red Cross and St. John Ambulance Brigade. For her services in connection with hospital work during the Great War she was awarded the Order of the British Empire and was made an Officer of the. Order of St. John of Jerusalem.

In addition to relative s, friends and representatives of the many organisations with which Mrs. Rowcliffe , 'was associated attended a memorial service held in Cranleigh Parish Church.

The St. John Ambulance Brigade News

NO.1 (PRINCE OF WALES'S) DISTRICT

ENFIELD

The twenty-first anniversary of the formation of the 46th Division-the oldest St. John Ambulance Nursing Division in Enfield and District-occurs in April. Reference was made to' this fact at the annual meeting, which was held recently.

The president, Cr. Derek Parker-Bowles, was in the chair.

An important incident in the proceedings was the formal presentation to him of the silver badge of effice, by the Lady Divisional Superintendent, Mrs. Frances A. Phypers, on behalf of the members of the Division.

In her report on the werking of the Division the Lady Divisional Superintendent stated that the membership had increased, numerous classes had been held in First Aid, and that attendances had been good with a high percentage of passes in examinations.

Some hundreds of hours had been veluntarily worked by the members in teaching bandaging at Council classes. Besides the fully-trained Officers and Ambulance Sisters there were also probationers, honorary members and auxiliary reserves attached to the Division. Practically all of these were engaged at the present time on full or part-time work at First Aid Posts or on hospital duty.

She tendered grateful thanks to' their surgeon, Dr. Brass, Officers and all associated with the Divisien for the loyal way in which they helped to suppert the Brigade, and hoped they weuld leng continue to work happily tegether and to de their utmest fer the sick and injured in time of need.

No. 2 DISTRICT (COUNTY OF GLOUCESTER) CHELTENHAM

At the annual meeting of the Cheltenham Friendly Societies Division of the St. John Ambulance Brigade, Superintendent L. M. Starr presided. There was a good attendance.

The Secretary (Ambulance Officer Skinner), in the annual report, reported that the strength of the Division was 93 officers and men-an increase of 35 over the previous year. Three senior efficers had been on the Divisional Roll since its inception 31 years ago, one of whom-Corps Officer W. H. Ball-had been promoted" Officer of the Order," a well-merited award.

Members had attended 520 first-aid cases, carried out 214 public duties. Ambulance headquarters dealt with I, I 7 1 removals.

Officers and members had spent censiderable time in training classes in first-aid for the local A.R.P. authorities, with ex<:ellent results.

Seven members were on active service; ethers would follow shortly. A committee was formed to keep in contact with those in the Forces, and it was unanimeusly agreed to send them gifts of Cigarettes and checolates from time to' time.

No. 3 (EASTERN) DISTRICT NOR THAMPTON

Recently Corps Sergeant-Major George Hines completed 50 years service with the Brigade. He joined Northampten Corps in December, 1889. Promoted Sergeant, 1899. Served with Territorial Army from August, 1914, to' April, 1919. Holds Long-Service Medal of the S.J.A.B. with six bars. Admitted to the Order of St. John as Serving Brother, 1930. He is still carrying out his Corps duties.

We cengratulate him on a splendid record.

No. 6 DISTRICT (EAST RIDING OF YORKSHIRE) HULL

A few weeks ago, at Brigade Headquarters, Hull, Mr. W. T. Atkinson, who has recently retired from the position of County Commissioner for the East Riding of Yorkshire, was presented with a wireless set and cheque in appreciation of 43 years service to the Brigade and Association during which time he rose from the rank of Private to be County Commissioner. The presentatien was made by Sir Arthur Atkinson, as Chairman of the East Riding St. John Ambulance Association. Lady Atkinson (Lady County Superintendent of the Brigade) presented Mrs. W. T. Atkinson with a handbag and a bouquet.

Among others present were County Commissioner Dr. N. Jennings, Assistant County Commissioner G. Edwards, Dr. L. F. Wilson, Corps Superintendent E. Eggleton and a large-number of County, Corps and Divisional officers, members and friends.

The services of Mr. Atkinson are not to be lost to the Brigade: the County Commissioner has appointed him as Inspecting Officer on his staff.

No.8 (DUKE OF CONNAUGHT'S) DISTRICT ADDLESTONE

The annual meeting of the Chertsey and Addlestone Division was held recently.

Dr. J. D Vaile (Divisional Surgeon) presided. The Divisional Surgeon, in his report, mentioned that Drs. Crickmay and McMurdo were en active service. Dr. D. P. McIver was called on for active service, and for a time they were without a Medical Officer ef Health, but when Dr. McPherson came he threw his whole weight intO' · organising First Aid Posts and A.R.P. generally. They were grateful to him .

The Divisional Superintendent's report stated that it had been a very busy year. Early in January a section was formed at the Airscrew werks, and in Marcb another at Woodham. They had alsO' given a ceurse of instruction in First Aid to the Air Raid Wardens. They did the usual duties at Brooklands, and also toek part in a display at Addlestone, as well as taking duty with the Chertsey Ambulance.

Dr. Vaile thanked Superintendent Gristock for the tremendous amount of work he had done for the Division; he was a most extraordinarily tireless person in the ' interests of the Brigade.

Ambulance Division.-County Competition, MarcusHare Cup (Team), District Competitions: Cup, Lady Forester Competition (Team), Area Competition, Hoerman Cup, Private H. Courtice. MID-DEVON AREA TORBAY

Officers and members in this Area, as elsewhere, have played an important part in the formation of A.R.P. Casualty Services.

Divisional Surgeon G. E. Sawdon is in charge of the Mobile Post. Dr. Muriel Morris ani Dr. Helen

In his report the Secretary mentioned the fact that on the outbreak of war the Division manned First Aid Posts for 24 hours daily. The year started with a membership ef 33 and concluded with 37, an increase of four. There was also the Airscrew section of 24 lance Officer Miss Shaddick. District : Burn Shield (Team), National Trephies Corbet Fletcher and Chalmers (Team), Ellis Cup for Team Leader gaining highest marks, Miss Shaddick (Lady Ambulance Officer).

and the Woodham section of 10. They held 4 8 drills, which were all well attended, and 22 members passed their re-examination.

NO. 9 DISTRICT

COUNTY OF NORTH, EAST AND MID-DEVON NOR TH DEVON AREA BARNSTAPLE

A complimentary dinner was given recently to Barnstaple Divisions in honour of their competition successes in 1939. Mr. A. J. Manaton, Chairman of the Barnstaple Branch of the Association, presided, supported by the Mayor and Mayoress of Barnstaple, Sir Richard Acland, Bt., M.P., and other prominent officials of the Asseciatien.

The following are the successes:Nursing Division.-County Competitions, Marnhead Shield (Team), Vick Cup (Individual), Lady Ambu ... 35

Bumstead are in charge of the First Aid Post at Paignton.

Assistant County Commissioner G. W. Hingst on is Area Ambulance Officer. Members of the Brigade, together with the Reserve which they have trained, form the personnel of First Aid Posts at Brixham and Paignton, and Mobile Posts at Paignton and Torqu ay ; alsO' First Aid parties at Paignton and Torquay. Members ef Kingsbridge Ambulance and Nursing Divisions, in conjunction with members of Pl ymouth Divisions, did some very efficient and useful work recently in connection witb shipwreck on the SouthWest coast of Devon. The Chief Commissioner wrote a personal letter of thanks to Officers and members concerned in this work.

EAST DEVON AREA

New Nursing Divisions have been formed at Silverton and Woodbury-Salterton.

I · Interesting Case Reports .

CASE RE:ORT No. 160.-The Officer-in-Charge of the CountIes of Leicester and Rutland S.J.A.B. reports the efficier:t performance of first aid by a me.mber of the Club and Institute Division, LeIcester Corps, In the following circumstances :-

On No;ember 4 a engineer, whilst working at s Factory, CoalvIlle, came into contact with ele.ctncal apparatus and received a shock of 440 volts. Faulkner at once commenced artihClal respuatIOn on the patient, who was completely unconscious and had ceased to breathe and se-?-t for a doctor. When the latter arrived 20 mInutes. after accident, the patient was ' slowly recovenng conSCIOusness. He, therefore, orde:ted his removal b y ambulance to hospital, where he subsequently a complete recovery. The Royal SocIety awarded their certificate to Pnvate Faulkner ill recognition of his successful efforts to save bis patient's life.

the first object if first aid is to life zt not often a first aider has an opportumry qf domg. In these ctrcumstances we offer cordial congratulat20n:f to Thomas Faulkner on the fact that; when hIS oppo rtumry ·he it and 1:y the performance of artificzal respzration restored his patzent to life.-N. C. F

ELECTROCUTED IN BATH

. H. W. (Birmingham).-Herewith an interesting rep?rt of death by electrocution of a young man while drymg himself in the bath. The electrical stated at the inquest that he found an unusual conditIOn and one that not met previously in over 30 Y:'ears of electncal mstallation work. The news cuttmg reads as follows :-

. "Recording verdict of ' Accidental Death' the City that the inquest was important in draWl?g to the importance of seeing that electncal fittmgs in bathrooms were placed in such a way to be out of reach of any person who might be usmg the bath.

"Expert e:vidence showed that when the bulb was pushed mto the electric holder it caused the outer case to. become alive. It was neither of shockpr.oof matenal nor out of reach of anybody who :rught be in the bath. These were very Important pomts m regard to bathrooms.

the ?pinion of the expert witness that, wbjle drymg himself, deceased probably came in contact with the light holder.

" Professor. Ha.swell Wilson, who made a postexammatIOD, said he found a small area of blistermg on t?e ball the left thum.b and he came to the conclusIOn that It was an electric burn which was followed immediately by death.

youth was in a state of inferior health and would be easily susceptible to death from electric shock."

N. grateful to yotl for a ve,,:; interesting report.-

1,1::=

TREATMENT OF HEAD INJURIES

F. B: (Muswell Hill).-Under the treatment of conCUSSIOn and compression of the brain, the Black states (and recent competitions have stressed that 1n case cold dressings a!e. to be applied to the pattent s head. In my Opl1l10n, however, it would better to apply such only in the case of compresslOn of the brain and either to leave the face or merely to sprinkle the face with cold water 111 case. concussion. To me it appears incorrect to gIve sun;.lar treatment for two vastly different espeCIally as the condition of shock is very SIffi1lar to that of concussion, and no one suggests that we should apply cold dressincrs to the head of a person suffering from shock. b

The. Textbook recommends applit'ation of cold to the head wIth .cases of. injuries becauJ-e there may be deep-seated t11Jury whIch Will sooner or later develop into of the brain. l1z. a case recently under my care It took fourteen days for Signs of compression to show !! the head of a concusJed patient wIth cold IS not/o be because it might prectpltate thts conditzon, as is specificallY stated zn Rule 3 on p. 16 4 of the T extbook.

If: however, the is unmistakably one of concusszon, then 1 agree. wzth you that cold applications to the should be. because the less the patient is dISturbed the qutcker wzll be his recovely.-N.C. F.

TREATMENT OF FRACTURED TARSUS

B. (Muswell Hill). -The Black Book (39th editton) does not cover fractures of the tarsal bones although the 38th Edition told us to treat this injur; for a crushed foot." To me it appears that a splint beneath the sole of the foot could not possibly " fix" fractures of many of the bones of the tarsus because of the ankle can take place and th.at a thorough Job can only result in conjunction wIth an " L" splint. As the Black Book is all too hazy this point, your opinion would be much apprecIated.

With fractures of the tarsal boms (which are part of the f?ot) the lor crushed foot will be quite effective provzded that It zs carrzed out as laid down in the Textbook and. that all movements of foot and limb are . If thzs be done, then af!Y slight movement of the ankle Jomt can. cause no aggravation of the fractured tarsal bones-prevention of which is the prime oiject of first aid! In .words, 1 !ad tf) see af!Y advantage accruing from the addltzon of a right-angled splint as sttggested by you.-

N. C. F.

EMBROCATION FOR FIRST AID KIT

B. R. (Sale).-As a member of the Brigade and a regular reader of THE GAZETTE I would like to know if an embrocation consisting of a pint of vinegar and a pint of turpentine with two egg shells is a safe and efficient remedy to have in a first aid kit. If it is not, then please make suggestions as to a suitable one for use when the occasion arises.

Embrocations are prescribed by doctors for various and different conditions. It follows, therefore, that your sugremedy, useful as it may be for cases, might be unacceptable to the doctor who has taken charge of the patient. Of course, you realise that the use of embrocations is outside the scope offirst aid.-N. C. F.

MEMBERSHIP OF BRIGADE

E. K. (Halifax).-Is it possible to become a member of the Brigade and yet not to wear uniform? In other words, can one attend classes and retain an interest in the work without actually wearing uniform and doing public duties? I shall be grateful for your answer.

It is possible to be a member of the Brigade without wearing uniform. Since, horJJever, performances of publit' duties is the primary object of the Brigade, a non-uniformed member-1vhethet surgeon or lay-person-is not able to play his (or her) proper part in the work of the Brigade, and-except where his services are of peculiar value to the Brigade or his unit-is rather " a hanger-on JI who seeks membership for personal reasons.

STRETCHER EXERCISE No. II

J. P. (Hounslow). - Knowing yo ur desire to maintain the fullest accuracy in the Textbook, I suggest that, in the description of Stretcher Exercises for Three Bearers, the wording of the first line on p. 21 9 should be amended to : "No. I . passes his hands under the patient's thighs and legs."

Meanwhile my thanks for your always helpful comments on queries submitted to you.

Thanks for your letter and corection which has been dulY noted in my copy of the Textbook. It is good to know that you are practising )'0141' qualifications as a first aider!

-N. C. F.

FRACTURE OF SPINE IN CERVICAL REGION

J. P. (Hounslow).-With a fracture of the spine 1n the cervical region causing loss of power and sensation below the seat of fracture, would there be paralysis of the chest muscles, resulting in asphyxia? Your ruling will be greatly appreciated.

If the lesion is below the fourth cervical vertebra the muscles qf the chest wall would be paralysed but aspl:!Jxia would not result because the diaphragm is not affected.

If, hmvever, the lesion is above the fot/rth cervical aspl:!Jxia ,vould result because paralYsis would Involve (hest musclu and diaphragm-provided that the

spinal cord IS completely crushed. Such cases are almost invariably fatal.-N. C. F.

FRACTURE OF SPINE IN SACRAL

REGION

J. P. (Hounslow).-With a fracture of spine in the sacral region, should the treatment be as for fracture of the spine? Also, would there be no los s of power and sensation in the lower limbs? Please accept my thanks in anticipation of your reply.

Yes-you would treat a fracture of the spine in the sacral ref!,ion as a fracture of pelvis. As, however, the spinal cord ends at the second lumbar vertebra (Textbook, p. 153), the usual loss of power and sensation below the lesion associated with fracture-dislocation oj the spine would not be present.-N. C. F.

PULMONARY BLOOD VESSELS

E. K. (Halifax).-Further to your repl y published under the above heading in the January issue of THE GAZETTE, I have long been puzzled by something in this connection and I wonder if you will be so good as to point out wherein lies my mistake.

On p. 103 of the Textbook the pulmonary artery is said to carry b lood to the lungs and the pulmonary veins to the heart. Now I wonder if this artery and these veins, being parts of the pulmonary ci rculation, do n ot conform to the rule that arterial and veinous blood are bright red 'and dark red respectively, seeing that the pulmonary artery would be carrying impure blood to the lungs and the pulmonar y veins pure blood from the lungs.

I have not been able to obtain an answer to the problem that satisfies me, and I shall be glad if you will kindly put me right.

The objects oj the general circulation are to carlY oxygen and nourishment to the tissues, these being given off thrmtgh the capillaries. In exchange for these the blood-s tream receives altered oxygen (carbonic acid gas) and 1vaste products. ConsequentlY the blood returned to the heart via the general circulation is impure.

To correct this, the blood is sent through the pulmonary arteries to the lungs where the blood is purified. It follows, therefore, that the contents of arteries and veins in the pulmonary circulation are the reverse of those in the vessels of the general circulation.

In othel' 1vords, the vessels 1vhich carry blood from the heart are ahvqys arterieJ, while those 1vh;ch carry blood to the heart are always veins.-N. C. F.

DIGITAL COMPRESSION OF AxILLARY ARTERY

J. P. (Hounslow). -When we apply digital pressure to the axillary artery, should the position of patient and operator be similar to those adopted for digital pressure of the brachial artery, except that the bleedincr part is elevated in order better to maintain in the armpit? We await your answer with interest.

As the Textbook states on p. 120, digital compression of the axillary artefY in the armpit is practicallY impossible 1vith a normal individual. If, however, the patient be much emaciated, it might succeed, for which pH/pose stich compression would be facilitated if the upper limb be k.ept close to the body and all muscles relaxed.-N. C. F.

Air Raid

GOVERNMENT SIIORT

CO URSE IN FIRST AID

(See Home Office Circular, 26 January, 1939, Ref. 70;191/1).

In this the last lecture of the short course, the whole question of" Unconsciousness" due to nerve injuries has to be crammed in. It must be borne in mind that unconsciousness will form a very high proportion Of the first-aid cases after an aerial atta-ck by bombs of various sorts. Unconsciousness resulting from asphyxia has been dealt with, but even so, a long list of the qmses of unconsciousness from Brain Effects remains,and the list is confusing: (I) To make a quick diagnosis of the cause and (2) to adopt promptly the right treatment to save life. This last is most important because even to lower the head may kill some and to raise it cause death in others, and your decision and prompt action is to be done with scores of casualties around you, demolished buildings, and even a continuance of bombing. Therefore a member of a First Aid Party must think quickly and act quickly, and both can only be done by definite knowledge previously acquired and practical experience.

, The easiest way in this short course is to divide the causes into two groups :-

1. II.

I. Concussion

2. Faint.

3. Shock.

4. Collapse.

I. Compression , 2. Apoplexy.

I.-The first group are a/I caused by too little blood in the brain and are the more important.

(I) Concussion is due to a blow on the head short of fracturing the bone. Commonly called "stunning ." In a slight blow the unconsciousness is of short duration, in a severe blow it may be prolonged to a day or two. A falling building or bomb fragment may easily do either. The concussion causes less blood in the brain. If there is less blood, is the face paler or redder? Paler. Is the pulse stronger or weaker? W

(2) Faint (Bad).-Same causes in increasing severity.

(3) Shock (Worse).-Same symptoms-less blood in head.

(4) Collapse (Worst).-Therefore, colour pale, pulse feeble, breathing shallow.

II.-(l) Compression due to pfessure on the brain,

By W. C. BENT ALL, O.D.E., F.R.C.S., F.R.G.S., Assistanf Suryeon-i,,- C hiel

Precautions

Lecture

most commonly caused by a depressed fracture of the skull pressing the bone in and on to the brain, and the patient is unconscious until the surgeon trefines or cuts the skull and levers up the fragments and removes the pressure, then consciousness gradually comes back. In compression the actual pressure increases the blood pressure, therefore colour is red or fl,ushed, pulse is strong, and breathing deep or snOrIng.

(2) Apople:x:y is just the same as compression except that the pressure is not from a broken skull but from a blood clot which foims when a small blood vessel in the brain breaks. The symptoms are the same as for compression. Apoplexy or a broken blood vessel in the brain usually happens in an old man who has "done himself" rather well over the the years, often of the stout and florid type, and some upset, burst of temper or over anxiety or exertion raises the already high blood pressure and the little artery snaps, bleeds, clot forms, and the internal pressure on the delicate nerve material of the brain produces unconsciousness. Do not try to memorise the symptoms and treatment, but always think of the cause and condition, and the symptoms and treatment must come naturally to the mind.

In Group I.

Too little blood in head :-

Colour: pale.

Pulse: feeble.

Breathing: shallow.

Skin: cool or cold.

Treatment.

In Group II.

Too much blood in head :-

Colour: flushed. Pulse: strong.

Breathing: deep. Skin: warm.

Head: down. Head: up. Stimulate. Do not stimulate.

Apply warmth. Apply cold to head.

If there is too much blood in head, would you lay his head down? No. If his pulse is strong, would you stimulate him? No. And the reverse holds good alI through. To do the opposite thing may kill your patient.

There only remain two conditions of unconsciousness in an adult, viz:, Epilepsy and Hysteria.

Epilepsy is a fit of youth and early age, and the fit comes on at intervals, and a fit means that he or she

throws himself about or writhes, and then passes, into unconsciousness. It is not likely to be assocIated with air raids or accentuated thereby The story the fit gives you the tip of the cause, treatment IS to put a pencil or rolled between the teeth because they generally bue then tongue and make the foam from the mouth The only other thing is to prevent them lllJunng themselve s by falling into the fire or down a well or froI? an eminence, They never die except from .the of a fall, and sleep it off, and know nothing about It, Hysteria occurs in young ish folk of an excitable nature and may resemble Epilepsy. The upset of an air raid may produce an attack in young people. A tactful mixture of firmness kllldness is correct, easy to remember, mighty t,o perform! And I close my short course WIth thIS disease which calls for more tact, common knowledge of human nature of which the Fust Alder is supposed to have an unusual amount.

A.R.P. Questions· and Answers

J. H. B. (Liverpool, 19).-As a subscriber t? the GAZETTE I should be glad if you would explam. to me exactly what you mean by the "demolition bomb," which is referred to III pages 323 and 333 of the November

As an A.R.P, warden I am not fa111lliar with the expression and I am anxious to ascertain its exact meaning.

The gas chart produced /J.y O/lr Gas, courses wken they started in JulY, 1935, used a word, at tune subsequently had a special tJleamng, t.e " Demolztlot! Bomb" 7vas supposed to be a bomb ,wkich a, buildjng and at the same tjlJJe evolved 111 tts burstmg elthel Mustard Gas or Lewisite.- W. C. B, E. D. C. (Ewell).-Our members are enga9,ed on A.R.P. First Aid work and have become cO,mpetition-minded" in view the of holdlllg competitions between the varIO US posts In the London Region. My Committee asks if you could say, six previous issues of THE GAZETTE contallllllg such competitions, Is this possible? We should appreciate your help in this matter.

Could you also tell me if these competitions are published in pamphlet form, and where I could obtain them.

While THE GAZETTE has not pttblished such a series, I wOf-tld advise .you that the Home Ojjice in No. 10 and Circular No. 260 have given more detads zn this matter, and the }{andbook actual!J prints the courses of exam. papers about which you ask.

Of course such public pape?'s are ha:·dfy thing to you further competitions and aI'e maznIY gwen to local leaders 7vith ideas for m7V and fresh UVit h the aid of such exam. papers a leader 1'}lzth kno:vledge. and imagination could produce an almost endless vanel), oj competitions.-W. C. B.

HOW TO FORM A UNIT OF THE ST. JOHN AMBULANCE BRIGADE

The St. John Ambulance Brigade is a disciplined, trained and uniformed body under supervision of the Order of St. It IS ?irectly under a Chief Commissioner, and IS orgarused by counties or areas under a Commissioner: It about 85 000 members, and is orgarused m mer: s units Ambulance Divisions women's uruts called Nursing Divisions, under own. officers. To show the value of the work carned out It may be stated that throughout the United Kingd?m last year 614,000 cases of accident and sudden lllness were dealt with.

In many large firms, especially in the it has been found advantageous to form speCIal of the St. John Ambulance Brigade for first, a,ld ,m the works. Experience has sh0V:'n that lllJunes are dealt with at once by effiCIent first alders, th.e injured person recovers much more quickly no first aid is available on the spot. O.le collier) manager stated that he reckoned that presence of an efficient first-aid detachment saved him one penny a ton on all coal produced on account of the shorter time that injured people were away from work.

In order to form a St. John Ambulance unit, the personnel must through a course of SIX lectures given b y a qualified surgeon and pass th e requisite examination of the St. J ohn Association. The cost of these courses and exaffilnation is about £8.

A unit of the Briaade may then be formed of those who have passed ilie examination,. a?-d the officers are appointed by the from the members forming the urut. The :would come under the supervision of the COmm1SSlOner of the area or county, and in firm and for general public dut y In thel! spare bme when required to do so.

To maintain efficiency, each member is required to attend at least twelve practices a year! pass. an annual re-examination, and attend an annualmspecbon arranged b y the Commissioner of the area.

Accommodation for class and practice usually supplied by the firm ' to which the urut IS attached.

Uniforms may be purchased b y the o,r by funds raised for the purpose by dances, whlst drIves, etc., or by contributions.

In addition to normal first-aid duties, members of the Brigade are now going through a course of

trrurung in Air Raid Precautions. In the case of factory units these duties would be confined to their own factories, unless individual members volunteer for general duty in their spare time.

In the case of factories, business or other institutions which wish their workpeople trained in Air Raid Precautions duties, the St. John Ambulance Brigade, which has a large body of trained instructors, will undertake the instruction. A short course of four lectures for general instruction can be arranged or a more comprehensive course of eight lectures, the charge being £1 IS. each lecture. Those who attend the latter can sit for an examination and obtain the Certificate of the St. John Ambulance Brigade, which is recognised by the Home Office. Those who obtain the certificate may be enrolled in the A.R P. Auxiliary Reserve of the Brigade for general service under the Home Office Air Raid Precautions Scheme. No certificate is necessary, though it is advisable.

For the arrangement of courses for first aid or A.R.P. managers of factories in London or Greater London should apply to the Commissioner of NO.1 District, St. John Ambulance Brigade, St. John's Gate, 10, Briset Street, Clerkenwell, E.C. 1.

The principal objects of the Brigade are (a) ' to afford holders of First Aid Certificates from the St. John Ambulance Association* opportunities of meeting together for ambulance and nursing practice with the object of combining individual efforts for the public advantage; and (b) to render first aid to the sick and injured on public and other occasions, with the sanction of the police and other authorities, and to maintain in readiness for duty a body of trained men and women qualified so to act.

The Brigade is composed of Ambulance (men) and Nursing (women) Divisions. The minimum establishment of a Division is :AMBULANCE

Surgeon Superintendent I Ambulance Officer.. 1

Sergeant

Corporals

Privates 2 16 NURSING

Surgeon Lady Superintendent Nursing Officer (Trained Nurse) Lady Ambulance Officer Ambulance Sisters 12.

Sixteen men over 18 years of age holding First Aid Certificates may be registered as an Ambulance Division; and twelve women holding First Aid and Home Nursing Certificates as a Nursing Division. Each Division nominates its own officers who are appointed by the Chief Commissioner. Officers, Sergeants and Corporals of an Ambulance Division are required to pass an examination in stretcher drill and in elementary infantry drill.

After enrolment officers and members are required to maintain the following standard of efficiency each year :-

>II The certificates of the British Red Cross Society and the St. Andrew's Ambulance Association may be accepted for enrolment.in a Division

(a) To pass a re-examination in first aid; and in the case of a Nursing Division in both first aid and home nursing (N ursing Officers excepted) ;

(b) To attend not less than 12 dr.ills or practices;

(c) To attend the annual inspection;

(d) To be certified by the Superintendent as efficient in drill or nursing duties; and

(e) To turn out to such officer's satisfaction when called upon to perform public duty, except when enrolled for purely V.A.D. purposes.

Every three years' efficient servic e qualifies a member for the Service Chevron and fifte e n years' effi:ient service for the Service Medal of the Order of St. John. Members are also eligible fo r other awards of the Order in recognition of meritorious serv ice.

Efficient members of the Brigade are eligible to volunteer for enrolment in one of the following Reserves maintained b y th e Bri g ad e :-The Royal

watches supplies being packed for troops o vers eas

Naval Auxiliary Sick Berth Reserve and the Military Hospitals Reserve; also in Voluntary Aid Detachments, particulars of which can be obtained on application.

Any responsible per son desiring to form a Division will, on application to the Secretary of the St. John Ambulance Brigade, St. John's Gate, Clerkenwell, London, E.C. I, be placed in communication with the Senior Officer in charge of the County or Area concerned.

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd . ., Cardiff

GENERAL INTEREST

PRIORY HEADQU ARTER S NOTES

An unusually big increase in the number of Classes in First Aid and Home' Nursin g held under the Priory for Wales during 1939 was reported to the monthly meeting of the Ambulance Committee at which Captain J. McLeod Carey presided on January 30 The total of 1,577 examinations arranged is 5 50 higher than that of the preceding year. The wider diffusion of First Aid knowledge stimulated under Air Raid Precautions can be welcomed by all as one diversion of energy and money necessitated by A.R.P. which has a definite and far-reaching value, in civilian life, in addition to its potentialities as an important branch of the Defence Services.

In recognition of long periods of gratuitous service as Lecturers, the following doctors were appointed by the Ambulance Committee on January 30 Honorary Life Members of the Priory :-

Div. Surgeon W Bathgate, Cardiff Nursing Division.

Div. Surgeon S. N. Chopra, Brynmawr Division.

Div. Surgeon T. W. David, Aberdulais Division .

Nursing Divisions of the Brigade in Glamorgan are to be encouraged to emulate the example of the Cardiff Emergency Nursing Division in organising among their membership and friends working parties for the knitting of comforts on behalf of the Glamorgan County Welfare and Comforts Association, of which the Earl of Plymouth, P.c., is Chairman, the object of which is to co-ordinate the provision for the Navy, Army and Air Force. Nursing Units in other counties of Wales are being informed how they can purchase wool at half price for a similar purpose.

An extension of the assistance rendered by the Priory to the Hospital Library Services has been invited by Mr. Harry Farr, the Cardiff City Librarian, in connection with the libraries at Merthyr and Aberdare General Hospitals. Despite the present overwhelming demands upon Brigade members, Nursing Officers in Cardiff have not failed to maintain the arrangement whereby on Friday afternoons weekly two St. John members attend at each of the three principal hospitals to carry out the extremely interesting and sometimes strenuous work of honorary librarians, helping each patient to select something to suit his fancy and so help to while away the trying time in hospital. The stock of books provided by the Cardiff City Council is supplemented by a regular supply of magazines collected by the Staff at Priory

House, which are appreciated by those unable to enjoy more constant reading.

The following extracts from the City Librarian's report indicate the value of this particular Brigade duty: -

"During 193?), the work of the Hospital Lihrary Service at Llandough Hospital has been carried on steadily, with the exception of the evacuation period. We have been fortunate in retaining the help of the voluntary helpers from the St. John Ambulance and the Red Cross Society, who have been with us from the beginning and have not yet been called away to any war work. . 11,18 books were issued during 1939,"

"The Hospital Library at the Cardiff Royal Infirmary is now in the fourth year of its existence. It is very well used by Sisters, nurses, doctors and patients ... The issue shows an increase of 1,806 on last year: 1937-38, 13,676; and 1938-39, 15,482. The British Red Cross Society and the Order of St. John still continue to help us in spite of the increased demands upon them.

AMBULANCE TRANSPORT PROVISION

During the year ended December 31, 1939, the service of ambulances maintained by the Priory carried 22,446 cases, involving a total mileage of 351,756. These figures show an increase of cases and 38,762 miles on the previous year; and continues the unbroken sequence of annual increases in this Department of Priory activities since the establishment of the Service in 1919.

The following schedule will show that the rise in last year's totals reflects the greater use made of the cars rather than the extension of the Service, as the only new Station opened in 1939 was not operating until October 5. This ambulance serves the residents of Abercarn, under contract with the Abercarn Urban District Council; and, as part of the co-ordinated system of ambulance transport which has gained high esteem for the Priory Service, it backs up the next neighbouring Ambulance Station at Cross Keys, which is supported by local colliery companies and employees and oth er bodies of workmen :-

STATION. Cases. Mileage. Abercarn 39 83 6 (from October 5) Aberdare 2,05 8 II,734 Ammanford (Accident) 36 2. 9,17 0 Ammanford 2.,14 1 25,97 1

Bryn 586 10,752

Cardiff 2,5 18 27,89 2

Clydach 955 12, 20 4

Coedely I,3 08 22,23 8

Crosskeys 51 8 9,614

Cwmllynfell I,3 52 28,882

Cymmer 77 6 21,618

Gowerton 753 9,7 19

Gwaun-Cae-Gurwen I,628 25, 68 5

Kenfig Hill . . 686 14,802

Llanbradach 464 8,7 88

Llanelly 86 5 6,29 0

Pencoed 80 3 18,25 1

Pontardulais 1,24 8 20,9 04

Pontypridd 57 2 11,993

Trimsaran 997 22,816

Tumble 1,817 3 1,597 22,446 35 1,75 6

While the cars in the colliery districts are intended primarily to serve under contract the needs of the employers and employees, the service throughout is available to the general public on terms which compare favourably with those of other ambulance transport services. Considerable time and thought has been spent recently, in conjunction with the various authorities in planning a measure of cooper3tion for A.R.P. purposes without prejudicing the claims of colliery companies to the first call on the cars at all times.

OBITUARY

The Priory records with deep regret the death of Mr. Lemuel Jones, J.P., of Aberavon, Port Talbot, a Chapter member, who was well known and respected throughout Glamorgan chiefly on account of his outstanding services to the Ambulance movement, of which he could fairly claim to have been Qne of the first pioneers. Though he died at the venerable age of 83 years, he relinquished active Brigade office as recently as 1939; and he attended monthly meetings of the Council and Ambulance Committee in Cardiff with commendable regularity until his health was shaken by a motor accident two years ago. One of Mr. Jones's most cherished possessions was the Association Medallion, which he gained in 1893, before when he had already been instrumental in forming ambulance classes at Port Talbot. He had good reason to be proud of the growth of St. J OM activities within the Aberavon County Area during his long term of office as Assistant Commissioner from 1921 to 1939; and the Priory was pleased to recommend his admission to the Order in the grade of Serving Brother in 1923, further recognition following by his promotion to the grade of Officer in 1927 and Commander in 1932. The last tribute of appreciation took the form of a Priory Vote of Thanks

which he received at the hands of the Prior, H.R.H. the Duke of Kent, in 1937.

Members of Council present at the meeting over which Dr. D. Rocyn Jones presided on January 30, stood in silence as a tribute to his memory.

CENTRE REPORTS

BOROUGH OF MERTHYR CENTRE

Captain 'Yo! . J. Canton, LL.B., is to be congratulated 1.pon the welcome expansion both in number of Units and total strength indicated in the following report for 1939, which he has submitted to Priory Headquarters as Commissioner for the Borough of :Merthyr Tydfil, while it is particularly gratifying that the Merthyr Corporation has entrusted such vital and onerous duties under the A.R.P. Scheme to the Brigade within the Centre :-

"Until September our Divisions were stm suffering from unemployment and migration of their members, and five divisions are still weak for those reasons.

The only hope for these Divisions lies in the establishment of Cadet Units, but there is an unfortunate disinclination among boys leaving school to take up first aid work, and assistance from the education authority would be welcomed.

As a result of the war there has been a general increase in strength, viz. : Ambulance, 23 ; Nursing, 112 - Ambulance Cadets, 18, and Nursing Cadets, 29.

The exceptional increase in nursing strength is due to the formation of new Nursing Divisions at Becilin o g, Penydarren and Merthyr Vale as a result of recruiting for service in the Civil Nursing Reserve at local hospitals and in First Aid Party Depots and Mobile Units. A new Ambulance Division has been formed at Pant (Dowlais) and additional divisions are now under consideration. The chief difficulty is that of obtaining medical practitioners for classes in First Aid, and I would 1espectfully renew the suggestion which I made last year that under the stress of war conditions selected officers and senior N.C.O.s should be permitted to conduct classes.

The Divisions in this county welcomed the opportunity of attending the General Inspection of the Brigade at Cardiff by H.R.H. the Duchess of Kent on July 27, and there is reason to believe that this has assisted us in maintaining our strength and in increasing that of the Nursing Divisions.

The task of completing the instruction of Brigade personnel in Air Raid Precautions has been practically completed and 3,248 cases of sickness and accident have been attended; but the outstanding feature of the year was, firstly, the fact that since the outbreak of war we have, at the request of the Mertilyr Corporation, conducted short courses in First Aid for nearly 450 members of the A.R.P. services, and for 370 school-teachers. Secondly, we were asked by the Corporation last September to provide personnel for one First Aid Post, eight First Aid Party Depots, two Hospitals and two :ivlobile Units. There IS

!eason to believe that these two services, which were undertaken and executed at very short notice, have been greatly appreciated by local authority and the public, and have conSIderably enhanced the reputation and efficiency of the Brigade.

Owing to age and exempted employments, we have lost very few members as a result of the war. Ten of our members are serving in His 11ajesty's Forces, two in the A.R.P. Service and 360 in the First Aid Post., First Aid Party Depots and Civil Nursing Reserve. Eighteen are in paid full-time service.

I have been appointed Ambulance Officer under the Merthyr Corporation and, since September have organised the Ambulance Service for the Borough by means of omnibuses and a large number of private cars.

I desire to thank the Commissioner and the staff of the Priory for Wales for their invaluable assistance, and the Officers and members of the Bri g ade in my Area for their loyalty and untiring work during the most difficult period in my experience as Commissioner."

BOROUGH OF NEWPORT CENTRE

The St. John Ambulance Brigade , was associated with the civic recognition accorded to 180 students who had gained First Aid certificates at recent examinatior:s arranged by the Priory as part of the civil defence organisation of Newport (Mon.) whose Mayor, Councillor Richard Davies, presented the a.wards at the Town Hall on January 27.

His Worship the Mayor expressed the gratitude of the town to those who had come forward voluntarily to assist in the casualty serv ice. Alderman F . J. Humphries, J.P., Chairman of Newport Health Committee, presided.

The Principal Secretar y and Commis sioner for Wales (the Hon. J. H. Bruce, J.P., D.L), proposing a vote of thanks to the Mayor, said it was good to see the work sponsored by the Town's Chief Citiz en. Newport had a good record in St. J OM Ambulance activities, and he was glad that Brigade members had been entrusted with responsible duties in its excellent A.R.P. organisation. Dr. S. McCormac, Commissioner for Newport, seconded the vote to the Mayor, who, he said, they were proud to have as President of the Centre.

Thanks to the Chairman were expressed by Councillor T. F. Mooney and Mr. C. J. Burr, First Aid Commandant of Auxiliary Services. In the course of the proceedings tribute was paid to County Officer Mr. G. J. Rowlands, and Corps Superintendent J. Bellew, for helpful assistance in organising First Aid Posts.

NEWS IN BRIEF

The Service Medal and Bars awarded in 1939 bring the total awards to members of the Brigade in Wales to 794 Service Medals, 347 First Bars, 142 Second Bars, 34 Third Bars and 3 Fourth Bars, and one Fifth Bar.

43

An invaluable FIRST AID

MILTON antiseptic

The swift irrigation of wounds or cuts with a dilution of Milton ensures surgicall y clean surfaces r ea d y.; to heal.

For Milton IS of the same chemical nature as the famous Carrell-D a kin solution "plu s "-plus stability, plus absolute uniformity of strength, plus non-causticity.

Milton has immense germicidal strength and some ten times the penetrative power of iodine.

And because of its great stren g th Milton is most economical to use i a dilution of one part in 20 of water is sufficient for most purpos es . A·R·P·

The cle a ning of gas masks, among other u ses , is most effieiently and most economically done with Milton. The routine is wash the mask in wa ter , wash again in Milton 1 in 50 solution and finally rinse in pla in water.

THIS IS THE CHEAPEST POSSIBLE )/lTAY A whole Winchester of Milton costs seven and six , and your dilution is half a teacupful to a gallon of waterenough for 50 masks!

KEEP MILTON HANDY FOR FIRST TREATMENT OF DEODORISING & CUTS ALL REQUIRING COMPLETE & WOUNDS CONDITIONS ANTISEPSIS MI L TON

Born during the last war - best during this 6d .• 1/-. 1/6 and 2 / 6 per bottle. Winchesters 7/6

Red Cross and St. John War Organisation

(Continued from page 22 January issue)

The War Organisation appeals for volunteer male ambulance personnel for service overseas. Lieut.General Sir Sidney Clive, the Red Cross Commissioner in France for the Red Cross and St. John War Organisation, asks for an ambulance convoy as soon as the ambulances can be obtained and the personnel equipped.

NUMBER REQUIRED

Each ambulance is manned by two men and provision is made to maintain a ten per cent. reserve of men and vehicles. Thus, 275 volunteers are wanted. Offers from men over the age of 41 are invited, who should be physically fit and have good eyesight. That they wear glasses is not a disqualification, so long as their sight is satisfactory with glasses.

QUALIFICATIONS NEEDED

It must be stressed that a contract with the War Organisation does not absolve anyone from liability to military service. Those whose offers are considered will undergo a driving test on an ambulance. Those engaged will be employed not only as drivers but also as stretcher bearers. Knowledge of first aid and stretcher drill are, therefore, desirable qualifications.

The duties will not be light, or easy, or pleasant: but here is an opportunity for service awaiting those whose position permits them to volunteer.

TERMS OF ENGAGEMENT

V olunteers whose services are accepted will be provided with free uniform. Rations and billets will be provided also at no cost to themselves.

They will, when selected, be invited to agree to serve for a period of six months. At the end of that period they will be given free transport to their homes. if in Great Britain. If they desire to continue their engagement after this period, they will be granted leave with free return transport overseas.

DUTIES UNDER ORDERS

The personnel will be under the control of officers of the War Organisation, who will take their orders through the Commissioner from the military authority.

Applications should be sent to the Transport of Wounded Department, Red Cross and St. John War Organisation, 12, Grosvenor Crescent, London, S.W.I, marking the envelope" Ambulance Driver» in the top left-hand corner.

CONSTITUTION OF JOINT BODY

The Red Cross and St. John Joint War Organisation is a body formed by agreement between the British Red Cross Society and the Order dated September 2, 1939, the resolutions necessary for the purpose of 44

entering into the agreement having been passed b y the Society and the Order.

As then-formed, the War Organisation consisted of 4 8 members, of which one balf was appointed by each of the two bodies. Since that time, under the terms of the agreement, additional members have been appointed.

COMMITTEES AND OFFICERS

The agreement specified the appointment of an executive committee and of a finance sub-committee and a Chairman and a Vice-Chairman. The agreement gave the War power to appoint a secretary and such other officers as necessary and to appoint other sub-committees. To date, no subcommittees other than the Finance Sub-Committee have been appointed. The references which will be made to other committees are to departmental committees concerned with the work of a particular department.

Irs DUTIES AN D POWERS

The particular purpose of the War Organisation is to secure the better co-operation of. the two bodies comprising it and to prevent overlapping in their respective operations in the 'Yar. Thus, the Joint Body is an organisation brought into being by the war and one which would not exist if there were no war.

The agreement to form the Joint War Organisation does not in any way affect the status of either of the two bodies from which it is formed; or their powers, duties, privileges, and uses under Charter or Bye-laws. Except so far as the war itself and the condition s arising from it affect the specific powers and duties of either of the two bodies, they continue as in time of peace.

Irs FUNDS AND THEIR USE

The Joint Organisation, being an organisation which carne into existence only when war broke out, had no funds at its disposal at that time. The funds of the British Red Cross Society and of the Order were and are the concern of these bodies. The funds of the War Organisation are entirely derived from the appeal initiated by the Duke of Gloucester on September 8, 1939, and organised by the Lord Mayor of London from the Mansion House.

LOCAL COLLECTIONS

All the moneys the War Organisation receives, b y the terms of the agreement, are to be applied for the relief of the sick and wounded in the war. Neither body may make a collection nor open a subscription list for the sick and wounded during the war without the consent of the War Organisation. But the agreement specifically states that either or both bodies

On the

LONDON COUNTY COUNCIL AMBULANCE TRAIN S

is the selected Antiseptic

-and here are the reasons

I. It is really SAFE. .

T c.P. is completely free fr?m pOI sono us It is non-llltlammabie. irritating pr?pertrs, be applied at full strength does not stalll. t can letel fulfils the straight from the bottle It comp S) A A Text requirements l aid down III the new , Book.

2. It is doubly effectivle S in preventing SEPS .

T.C.P. has a double antiseptic :action when applied to any injury:-

(a) It acts as a powerful, penetrating germICIde -a nd effective y sterilises the affected tissues.

(b) It stimulates the activity of t.he 11 the area and thus lllcreases blood ce s m '.. resistance of the tissues to mfectlOn.

3. It relieves PAl N.

Applied to any painful injury- a burn.or _ C P. has an almost imm ed Iate brmse T. '. 1 bl cases of « shock. relieving actIon-mva ua e m

4. It promotes faster and cleaner HEALING.

T C Promotes particularlv clean and rar id h 1· be'c!use it actually stimulates the formation eaIng, . of healthy granulation tissue. Does the antiseptic which you are a; 0 these 4 biD' advantages. no , uSl.n g, offer y a trial and a copy .of WrIte tFo- datYA·d Book sent FREE on applIcatlOn T .C.P. ITS 1 to:-

Prices

may make local collections in respect of local work carried on by its or their branches.

LIMITS OF ITS POWERS

Such, briefly, are the constitution and the powers of the War Organisation which the two bodies have set up by agreement. It will be useful to consider one or two points arising out of them. In the first place, it may be noted that the War Organisation is a central body. It has no power to recruit for individual membership or authority to form local branches. It has no authority over the internal affairs of either Society or the Order. It has no power to lntervene. 111 the. relations of either the Society or the Order wIth then local branches or associations. It cannot amend, alter or ch-ange bye-laws rules reo-ula-'b nons or any conditions under which either body conducts its affairs.

PRINCIPLE OF CO-OPERATION

Though the preceding paragraph deals with limitatIons on the powers of the War Organisation, they are, in fact, minor features of the agreement come to by the two bodies. The big principle contained in the is: that two bodies merge their separate 111 a J0111t Body for war purposes.

Expenence 111 the. 1914-18 showed conclusively that the two bodies could not carry out their war services as efficiently as both desired to do unless they worked as a joint organisation.

DIVISION OF DUTIES IMPOSSIBLE

It was not possible then, and it is not possible now, to the war activities of the two bodies. They meet and o:verlap and interlace at a hundred points in the daily round. In fact, so far as the activities the Headquarters War Departments are concerned 1t would be quite impossible in practice to say that particular duties fall within the scope of one or other of the two bodies.

FUSION OF CENTRAL COUNCILS

The agreeI?ent which gives effect to the principle of .co-operatlOn and. prevents overlapping applies only to the war serVIces work of the two bodies at Headquarters.

It does not bind, the local units of the two bodies to co-operate in the same way in respect of their war services, neither do es it such co-operation. Indeed, 1t can be saId that It provides a standard for consideration.

The War Organisation, while it represents a fusion of the central councils of the two bodies for War service, does flot involve a fusion of their The departments of the War OrganIsatlOn are mainly departments which the conditions of. the .war have created. In some instan ces, the y ill but have been brought by the war illto assoClat1on wlth the War Organisation.

DEPARTMENTS OF THE JOINT BODY

The Secretariat, for instance, while of course a war service, is directed by officials seconded from the Secretariat of the two bodies. The Central

Hospital Supply Services, Comforts

Hospitals and Medical Personnel, Prisoners of War, Publicity, and Stores Departments are entirely war departments. The Trained Nurses Department and the Transport Department have a peace-time existence, but are now engaged in war service. The Voluntary Aid Detachments and the Red Cross and St. John Library also have peace-time activities. They occupy a special position in relation to the War Organisation as they are associated with it, but are not under -.its control.

CENTRAL HOSPITAL

SUPPLY SERVICE

During the past few weeks gifts have more than trebled. They number 55,858. A consignment of splints made by Freda, Lady Forres' Work Party is of a high order of workmanship. From the Surrey War Work Men's Party has come a consignment of bed rests, foot rests, cradles, bed tables and crutches.

Large supplies are coming from Singapore and Penang. Regular contributions are received from Norway, Holland and Belgium. From the Channel Islands a constant supply is being received. A letter from Alderney says: "We cannot undertake much work at once as our knitting population is very small

The Island measures 4 miles by mile, and supports only one village. We shall be very glad to make the operation stockings. We have made great efforts and have coUected £ 50 in cash in less than a m o nth."

News from further afield is that in Brazil an organisation of over 1 ,000 members is workin g for Red Cross Supplies and from Buenos Aires com es the information that 4,000 women are working on Red Cross patterns in the Argentine.

A total of 6,777 garments and 6,440 swabs made from Central Hospital Supply Service materials was received between November 20 and December 4.

PRISONERS OF W A R, WOUNDED AND MI SS ING

The Prisoners' ParceJs Section is sending three I lb. standar d parcels of food a fortni g ht to each

R.A.F. prisoner of war. Durin g the fortnight ended December 2, 148 parcels (clothes, food, bread and medical) have been despatched. Since the last report 19 cards acknowledging earlier parcels have been received.

At Geneva a store o f overcoats, blankets and food is kept, from which supplies are sent to newlycaptured pri so ners to keep them g oin g until they receive par cels from the Department.

It is hoped to be able to send a special Ch ristmas parcel to every prisoner.

The Overseas have promised a gift of 25,000 ci g arette s

Civilian internees in Germany 102 in number are also bein g sent three standard 'food parce ls a fortnight. Bulk supplies were sent to the British civ ilian internment camp on November 29. Goods sent cov er e d ov er twenty articles and included bl ankets, boots, mufflers, overcoats, pullovers, shirts, slippers, soap, towels, socks and pyjamas.

MANUALS OF FIRST-AID, &C.

8, II. CORBET FLETCHER, M.B., B.C., M.A. (Cantab.). M.R.C.S.

AIDS TO FI RST -AID.

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Third Edition Price 11. net, pos t free, h. 3d.Prolliem. in Study, Treatment and ExamInation solved for Senior Studenh, dIlubl the boole WIll be of greal serVlCe In the t,u1n ng o those for wiwm it II designed."-BRITISH MRDICAL JO U RNAL. COMMON ERRORS IN Price la. net ; post free 11. 2d.

AMBULANCE COMPETITION TESTS.

IStnotcher, Individual and Question-Six Folders) Price 6d each post ltd. kach Folder con tams special article on CompetitIon :-No. 1, Tralnmg of Com· petition Teams

Price 11. net, post free 1s. 2d. Dlftlcultil' In Study and Treatment solved by Question and Answer. IV, commen<t thos book to ucturers and Students who wiiJ find it of gre<Jl -FIRST AID HINTS FOR HOSPITAL ORDERLIES. Pnce 6d. net, pos ree Bel. Orderly Duties Simplified and Tabulated, with Aid, to Memory. " A mo " como "" hrnchurt conta1»S much use!ul in!ormafIOt1 "-PRltaCIlJBRa

St. John Ambulance AS ' sociation

Its History and its Part in the Ambulance Movement

By N. CORBET FLETCHER, M.A., M B., M R.C.S. Tilis book, from cover to cover is full of itifo, tion of"creaJesJ itlierest a 11 Importance to everyo1Ul in the A mbula..u M ovem.etltSt. :T obl1 'RllIbulal1ce ala )ette. Price 3 6 Postag e 6d. Storn Dept.: ST. J 0 H N • S GAT E, LON DON. E. C f

CLASSIFIED ADVERTISEMENTS.

AtiJJerfi.ftmmls witb remiJJaIKe should be senllo Ibe SI. john AmlmJan4 Gtr:(.,,,,, 19, Cllrsilor Street, E,C' 4 ' 2-d. per word, minimum 3S

SCENT CARDS A:-.rD SACHETS, pnnted with your announcements are splendid mone y raisers and show 300% profit. Sampl e s free on request -AIR&DAL& PRESS , Bra dford PE N CJLS OF S UPERIOR QUALITY pnnted with y our Corp s Name a.nd announcement, s e U easily Sampl e freeAIREDALE PRESS. Bradford.

SCENT-CARDS (printed )" .-144 3 9, 500 10 -. 1,000 1619. Tic kets, handbills. S a mples free.-" S ,. TICES , II, Oak-ands Grove. London, W 12

EVERYTHING FOR SAFETY EVERYWHERE 'NOVOX' and , NOVITA' Oxygen + CO. or Oxygen RESUSCITATING APPARATUS or the apparently asphyxiated or drowned. SMOKE HELMETS of all Patterns.

'PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

'PURETHA' GAS MASKS for Na val. Military and Industrial purposes and for Civilian use.

DUST and SPRAY MASKS and all other Safety and Protective Devices.

All communications

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FLAG DAY EMBLEM S, BUTTONS &. BADGES, CARNIVAL GOODS. P rice L ists on application. For all supplies write : THE UNIVERSAL BUTTON CO., SuratSt Be t hna l Green,E;.2

3fobn

OFFICIAL GAS CHARTS

No. Chart shows gas derivations. • No. 2 is a full and complete educational chart of "Typical War Gases."

Everyone taking an teA.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee. I

HOBSON &SONS

1880. (LONDON), Ltd.

SPECIALISTS IN UNIFORMS.

MANUFACTURERS OF EVERY DESCRIPTION OF UNIFORM CLOTHING AND EQUIPMENT for St. John Ambulance Brigade.

JACKETS, TROUSERS, GREATCOATS, CAPS, BELTS, GLOVES, HA VERSACKS, WATERBOTTLES, ETC.

ESTIMATES AND SAMPLES ON REQUEST

All enquiries to154 - 164, TOOLEY

"Triers, Leeds."

THE JOURNAL OF THE VENERABLE ORDER OF THE HOSPITAL OF ST JOHN OF JE.RUSALEM Vol. 13. NO·3· MARCH 1940

THE ST. JOlIN AMBULANCE GAZETTE is published on the 15th of each month. The annual subscrzption is F. 6d., post free; single copies 3d Brigade Reports and Photographs should be addressed 10 the Editor, at 32, Shoe Lane, E.C 4. Reports and photographs should reach him as early in the month as possible

Subscriptions and Advertisements should be forwarded to the publishers:

Messrs. British Periodicals, Ltd., 19, 19a, Curs itor Street, London, E. C.4:

CONTENTS

Conditions and Terms of Sen, ice in the Clvil Nursing Reserve Priory for Wales

Test Red Cross and St. John War Organisation

CHANCERY OF THE ORDER, ST. JOHN'S GATE, CLERKBNWELL, LONDON, E.e I. A Unique Competition

What was described by the Mayor, Councillor R. e D. Jenkins, L.ee, J.P., as" a unique competition -the first of its kind to be held in London," took place in the South Kensington stretcher-bearer depot, the Convent of the Assumption, recently. It was the final of a competition for a silver cup, presented by the Borough Council, in which teams from all the First Aid Posts in the borough took part. Posts run by B.R.eS. trained nurses h::l:d held a

preliminary compet1tlOn, and their winner, the St. Charles' First Aid Post, met the Brompton Hospital First Aid Post, winners of a similar competition organised for St. John trained personnel.

In the final competition, Brompton Hospital First Aid Post-a St. John Post-won, scoring 273 points to their opponents' 267, out of a possible 300 points.

An audience of more than 200, which included Lady Louis Mountbatten, President of the County of London St. John Ambulance Brigade, Lady Limerick, President of the County of London Red Cross Society, watched the competition, which was in two stages : The treatment of poison gas casualties; and First Aid. Time limits were set for each stage.

For the occasion the main hall of the stretcherbearer depot was converted into a replica of a First Aid Post. with all the modern equipment of the borough Posts.

The team was composed of eight nurses, and each team diagnosed and treated four casualties, who were suffering from cuts, fractures, lacerations and hremorrhage.

The different technique in the methods of treatmen t was interesting, but both impressed the audience by their calm and efficient manner.

The Mayor drew attention in a short speech he made in presenting the cup to the high standard of efficiency.

. The "high total of points scored by each team and the narrow margin between them are evidence of the very good standard which First Aid . efficiency has reached in the borough," he said.

The Mayor complimented the Public Health officials who had organised the competition, and the officers and men of A company stretcher-bearers for their assistance and appearance.

Lady Louis Mountbatten proposed the vote of thanks to the Mayor and congratulated the Brompton Hospital First Aid Post team on their success. In a short speech, seconding the vote of thanks, Lady Limerick expressed her appreciation of the work

done by Dr. J. Fent on, the Medical Officer of Health, regretted that illness had prevented his attendance.

Dr. H. M. Davis, A.R.P. Medical Officer, was the judge of the First Aid se ction of the competition, and Dr. Stansfield judged the gas section at the cleansing station in the grounds

Mrs. Conrad, Mrs. Butcher, Miss Bailey, Miss Fry, and Mrs. Krieusslach

Among those present were the Countess of Limerick, the Hon. Mrs. Orpen, the Mayoress, Lady Powell, Mrs. Fenton, Dr. Russell, Lady Atkinson, Miss Thompson, Dr. Alice Pennell, Mrs. Tapley, Dr.

The Brompton H ospital (St. John) Aid Post Team at work. Dr. D avis, A.R.P. M edical Officer questions a member of the team

THE TEAMS

The Winning Team.

Brompton Hospital First Aid Post (St. John) : Miss M. Hudson, Miss J. Crossley, Mrs. M. Hamilton, Miss O. Parfitt, Miss H. Swainson, Miss O. Cooper, Miss V. Price, Miss E. Marsh.

The Runners-up.

The St. Charles First Aid Post (B.R.C.S ) : Miss Hay,

Miss Edden, Mrs. Prentice, Mrs. PleydellBouverIe, and Lady District Superintendent Miss Walker.

The Commandants and members of the staffs of all the First Aid Posts were also present. Kensington is to be congratulated on this first war-time competition, which cannot fail to make for added efficiency and keenness amongst the posts in the borough, and it is hoped that other boroughs will follow this excellent example.

OVERSEAS NEWS

ASSOCIATION NOTES"

INDIA

Colonel H. Stott, O.B.E., LM.S., has, on return from leave, assumed the office of Chairman of the Bihar Provincial Centre of the St. John Ambulance Association, and Commissioner of No. 9 District (Bihar), St. John Ambulance Brigade Overseas.

BRIGADE NOTES

His Excellency Sir Thomas Stewart inspected 52.

and Nursing Divisions of the NO.9 D1stnct (Bihar), St. John Ambulance Brigade Overseas, at the Medical College Hospital at Patna. In the course of his address His Excellency referred to the urgency of such humanitarian work at a time in the history of the world when there was a great need for the application of these principles and for the organisation of the means to give them practical dfect. At the conclusion of the inspection, the Governor invested the following members with the

Insignia of the Order: Lt.-Col. J. c. John, I.M .S., Dr. T. N. Seth and Miss C. Tyzack

Sir Ernest Burdon, Chief Commissioner, St. John Ambulance Brigade Overseas for the Empire of India, accompanied by Major-General P. S. Mills, I.M.S., Commissioner No. II District (Bengal and Assam Provinces), inspected the parade of the Calcutta Police Sub-District. The sub-district, consisting of sixteen ambulance divisions, was drawn up under four Corps.

After the inspection, a first aid demon stration was staged.

The Chief Commissioner presented Service Medals and bars of the Order to officers and personnel and congratulated them on their excellent turnout, and on their keen interest in the work and for doing useful work during the Pujah, Moharrum and other festivals.

The Chief Commissioner carried out a similar inspection of a parade of the Bengal Sub-district and No. 6 District (E.I. Ry.). The parade was held near the Cenotaph in the Maidan. Sir Ernest Burdon presented long-service medals and bars of the Order, and in a speech paid a tribute to the Brigade members and laid stress on the importance of the work during the difficult times through which we were passing.

Steps have now been taken for the formation of a new brigade district in the Province of Assam and thus all the major provinces will have their own Brigade organisations for their areas. Assam District will be No. XIV.

Under the auspices of His Excellency the Viceroy, and with the patronage and support of the Governors of Provinces and Rulers of Indian States, the Joint War Committee of the Indian Red Cross Society and the St. John Ambulance Association (Indian Council) appeal for funds to enable them to finance throughout the duration of the war Red Cross work for troops serving in India and sent overseas from India.

In India both the Headquarter and Provincial Branches of the Red Cross Society and the St. John Ambulance Association have already made preparations "for their task in the present war and have started work. The St. John Ambulance Association is busy training personnel for the ambulance and nursing units of the St John Ambulance Brigade and to take part also in the general work of the Red Cross Society, both personal service and the provision of hospital supplies and comforts for the troops in the field. The Provincial Joint War Committees with augmented personnel have organised work parties

53

all over India who are engaged in making hospital dressing and articles 6f extra clothing and in collecting and packing miscellaneous comforts. Definite requests have been received from the Indian contingents overseas and every effort is being made to meet · these. A Red Cross Commissioner has been appointed to direct and co-ordinate the great volume of work that is thus entailed.

For all this ample funds are required and will continue to be required while the war lasts. Subscriptions may be sent either to the Honorar y Treasurer of the Indian Red Cross Society, Headquarters, New Delhi, or to the Honorary Treasurers of the Provincial and State Branches. All contributions however small will be gratefully received Recurring subscriptions will be specially useful.

His Excellency the Viceroy has been pleased to open the Fund with an allotment of Rs. I lakh from. his " War Purposes Fund" to which Ruling Prince s and others have already given spontaneously.

Journal of the Indian Red Cross Society.

Bristol Centre

The following is an extract from the fifty-ninth Annual Report presented to members of the Bristo l Centre, on January 30, 1940

Number of classes in First Aid and Home Nursing reached a total of 2.04. Number of people attending classes were: Senior, 6,177; Junior, 2.I1. The total number of awards of all kinds was 4.3 IO. Fifty-one teams competed in the Annual Stretcher Competitions.

The Port of Bristol Authority, including various other undertakings situated in the docks area, also increased their activities, the number of those passing efficient being larger year by year.

New divisions are being added to the County of Bristol St. John Ambulance Brigade, whilst scores of members are being added to existing divisions.

War Organisation

Home Nursing Class

A new Class will begin on April 5th at 7 p.m. at the War Organisation Detachment Department, Belgrave House, Belgrave Square, S. W. I.

For further particulars apply Mrs. Peter Cheyney, Class Secretary, 3, Belgrave House, Belgrave Square, S.W.I.

Progressi\?e Training

in Air Raid

Within the last month, far-reaching developments h ave been taken b y the Ministry of Home Security in the A.R.P. department, in the matter of org:;tnised and progressive training for the workers of this rapidly developing service, in everyone of its separate services and their co-relation to each other for coo peration work.

Classes for the training of instructors in this Progressive Training have already been held in the various Regional Centres, and those trained instructors are now holding courses for the heads of the various services in the areas of the Scheme-making Authorities.

I am hoping to pass on in these A.R.P. monthly articles as much as possible of this "Progressive Training. "

This first article will give a survey of the whole training, its purpose and scope, and subsequent ones will deal with the training as applied to each Service, such as Police, Fire, Rescue Parties, Decontamination Squads, etc., etc.

THERE ARE SEVEN STEPS OF THIS PROGRESSIVE TRAINING

1. Individual or Basic Training

This refers to the early classes in each section, such as First Aid, Gas lectures, Firemen and Wardens' early lectures, etc , taken by many four or five years ago. Such first training for recruits includes :-

(a) Elementary in eaGh section of the service.

(b) Also for the general public as distinct from recruits for the services- a most valuable training often lost sight of by the scheme-making authorities.

(c) Such trainees may gradually act as supernumeraries to the more advanced workers but never in large numbers until further trained.

2. Individual Advanced Training

This depends which service the candidate desires to enter. Thus: if for fire he passes on to the special training of the auxiliary fire service, the same for wardens, rescue parties, first aid and casualty services, decontamination parties and so forth.

In this section training must be continually advancing with the frequent new orders which the Ministries issue in each sector, and no training can ev er be considered finished-it is alwqys progressive.

B!I W. C. BENTALL, O.B.E., F.Il.C.S., F.R.G.S., AssistanC SU1'geon-in-Chief

Precautions

3. Team Training

The first point in team training i s to have most carefully selected leaders. This is most important. A highly trained man or woman may not make a good leader. The position must certainly not be given because of seniority. A personality who can get the best out of a team without upsetting any of them is required. A strong leader without being selfwilled and autocratic, able to work harmoniously and get the best out of his team without crossing anyone of them. Such leaders must be most carefully chosen. They are worth their weight in gold. Without them a good team cannot be produced and the whole organisation will break down in a big and produce constant friction in peace. Such leaders will attend lectures like those in the various areas and learn how to train and lead small teams. A most excellent book for such leaders is that produced by the Army on infantry trainin g for N.C.O.s.

4. C o-ordinated team training

When the teams in each service are form ed and well led, then the several teams of the same service should practise together. Thus, in the casualty se rvice several stretcher parties should practise with a large number of casualties, or parties of wardens for various areas should combine with other areas. The same with firemen, decontamination squads, etc.

5. Combined Training

At this stage the various services should work together, first in a small way such as a rescue party and a first aid party. The former excavates the casualties, the latter renders first aid as led by their leader and there may be several parties of the same service, e.g., two or three or four rescue parties, and two or three or four first aid parties, and they should arrange for one officer to take charge temporarily. This should be arranged in a friendl y talk over procedure the night before.

This combined training should be graded up until a full-blown exercise is arranged under the A.R.P. organiser. But when such a combined exercise is anranged it too often shows weakness because the training as above has not gradually led up to the big scheme. Every weak link tends to produce an unreliable chain, but with every link well forged the

whole chain will work perfectly. Some organisers may hold that failures enable them to discover and correct weaknesses and prefer to strengthen the whole by that method. But surely if adequate training on the Government lines can produce a more perfect exercise why not adopt it ? Too often workers in the No. or basi-c training stage are brought into a big exercise which is sure to produce criticism or even breakdowns. Thus, a warden who has no advanced training under No. 2 may be the cause of the message not getting through the control, producing delay in sending out the first aid parties, etc.

6. Depo t Training

This is a new section of work, and should be carried on together with and at the same time as the foregoing five stages. It is most important when you have a large section of paid workers as in a county borough. One of the chief complaints now i,s that there is nothing for the workers to do and they go slack. Depot training prevents this "dry rot" and with paid workers is essential. Such worker s are forming a new army-there is a militar y, naval, air and A.R.P. service to-da y and we are seeking to build up and establish the last-named, and it has only had five years of preparation compared with the centuries of the Army and Navy !

Depot training means a tirrie-table definite and hard and fast according to the place and the following is a suggested programme :-

8 a.m. Breakfast.

9 a.m. Physical drill o r rout e march (a g ood local advertisement).

10 a.m. Lecture-well thought-out in the whole scheme, not a hotch-potch of an old course of lectures, which too man y teachers are apt to adopt.

I I a m. Examination of equipment acc o rding to each service, e.g., casualty service :-The first aid post equipment-medical, surgical, clothing; fire serv ice :- En gine, pumps, hose.

Rescue parties :-Ladders, ropes, shovels, etc., etc.

1 2-2 Dinner and rest.

2 p.m. Team games or route march. F oo tball, hockey, etc.

4 p.m. Lectures.

5 p.m. Discussion and free debate with leaders and talks on difficulties, etc.

6 p.m. Evening meal.

7 p.m. Evening should have regular entertainment arranged by a committee of the whole personnel.

This will prevent" dry rot." foolish and ignorant gossip and criticism leading to ill-feeling, and will promote the efficiency of the Corps as a whole, and leaves any amount of variance accordin g to the vision a nd imagination of the leaders !

7. Training of the Higher Staff

Details of this will be given in the ne x t article and will refer to work done at the top in the Control Rooms.

These seven steps in Progressive T raining must be SPEEDILY WORKED into the whole A .R.P. Tho se who know talk about three or fou r weeks to ge t ready for bi g things-" Verb. Sap," o r, in language, " A wink i s a s good as a n o d t o a blind horse."

A.R.P. Questions and Answers

1. Q. In absence of oilskin glo v es, ho w far would rubber gloves go ?

A. In proportion to their thickne ss; th u s the surgeon's operati n g gloves would be of ver y little use: the domestic rubber g lo v e would be a little bette r

2 Q. Can y ou use anti-dim on g o gg le s t o prev e nt them from steaming up ?

A. That is what it is for.

3· Q. Re undressing, if the protective clothin g sui t is covered with liquid gas, will n ot a strong vapour be g iven off, sufficient t o blister the bare skin when clothing i s removed?

1. 2. A It is recommended in so sever e a contamination with liquid, the wearer with such prot ective clothing should be well hosed o v er befo re undressing is commenced.

A Q. A Q A D o ctor has sent the following questions :How is it possible to undo buttons collarstuds if y ou are wearing protectiv e gloves ? I have undone buttons easily and less easily with protective glove s o n. How is it possible to ad just a respirator o n somebody else if y ou have contamina t ed gloves on?

If it is necessar y fo r a man in a cas ualty clearing part y to adjust a respirator owing to the presence of g as, the outside of the respirator and the patient's head and face is already gassed, and the slight touchin g with the o-loved hand would make no appreciable difference in the amount of co ntaminati on ex isting already

3- Q. H o w can a member of a stretcher party handle a pair of scissor s if he is wearin g protective clothing?

A. I have cut with s cissors with pr o tec t ive g lov es on. The questioner seems to have missed the point that a casualty clearin g party should conv ey a patient with all possible speed t o a Fir st Aid Post, and no dressings should be done on the spot unless life it self neces s it ates it, e.g., a sev ere hremorrhage.

DOME NURSING PAGE

The Nursing 0/' Infectious Diseases MEASLES

By MISS A. E. POWELL, Lady Divisional Surgeon, 103 Nursing Division

Measles is a .serious disease because of its complications. It is most prevalent inJanuary, February, March, May and June, but it can and does appear at any season and no age is exempt. The majority of cases, however, are under five years of age. The death rate is highest in the second year. It is possible -and frequently undertaken now-to inject serum from the blood of a convalescent patient intO a person, usually a child, who has been exposed to the infection. If given within five days of exposure t? infection it prevents an attack; if given within SlX to IO days it prevents a serious attack: the immunity conferred by such an attack lasts at least two years.

Measles is the most i17fe.ctious of all the specific fevers: few children escape if exposed to the infection. It .most important to prevent an attack if possible1t 1S a very wrong, if not a criminal, idea which some people have that" the child may as well have it and get it over"-the complications are too serious to risk. If a child has been to a party or in a school where another child is known to have developed measles he should be carefully watched for at least I7 days, which covers the longest incubation period. The doctor should be informed as he will in all probability take steps to procure convalescent serum, or failing this-which is not always obtainable-he may give an injection of whole blood from a suitable donor.

How the Injection Enters the Bocfy

The infection is inhaled: it is carried in the :' droplets" from the nasal, mouth and eye secretions, rnfecting the immediately surrounding air and any article which has been used recently by the infectious person, such as handkerchiefs, cutlery, crockery, toys and school pencils.

The Incubation Period is eight to I7 days, with a usual average of 10 days.

The Invasion Period is from two to four days: during this time the patient is highly infectious. The symptoms are: sneezing, running of the eyes and nose, a harsh dry cough, and a hoarse voice; quite frequently there is some diarrhcea. The temperature is variable, often I02.-103 on the first day when it falls again to normal, rising again on the fourth day when the rash appears; in other cases it remains round about IOI from the first symptoms until the rash fades on the sixth or seventh day. The child presents the appearance of a severe cold and this can be very misleading, particularly in the type

where the temperature falls after the first day and rises again on the fourth. It is a safe rule to regard every child with a severe "running" cold a suspicious case of measles, particularly if there has been a case at the school which he or other children in the house attends.

There is one very diagnostic symptom which if discovered and preventive treatment by serum is given will at least modify an attack. Small bluishwhite spots appear on the insides of the cheeks opposite the first molar (grinding) teeth: they appear on the second day of the disease- that is, the sneezing and running of the eyes are the first symptoms and the spots (called Koplik's Spots) should be searched for the next day. They must be looked for in daylight.

The Advance Period

The rash on the body appears on the fourth day: by this time the Koplik's Spots will have disappeared. The rash begins at the roots of the hair and behind the ears, spreading to the face, neck and the rest of the body. It consists of dusky red spots which tend to run together in crescentic blotchy patches, leaving white unaffected areas between. The child's eyes are sore and he resents the light: he looks, and is, thoroughly miserable. The pulse rate is increased and the respirations are much increased.

The Defervescence or Resolution Period

The rash fades on the sixth or seventh day and the temperature falls, the rash fading as it came, from the face downwards. If the temperature does not fall at this time complications must be watched for.

Nursing

The child must be isolated in a large well-ventilated room. It is a mistake to think that a hot stuffy room will prevent chest complications: a child properly clad can, with very good results, be nursed by an open window or on a It is of course essential to close windows or move the cot from the balcony for bed-making and bathing. The room should be darkened because of the painful eyes: a child being nursed on a balcony will need an eyeshade. A light flannel gown should be worn and a "pneumonia jacket" made from Gamgee Tissuecotton wool between layers of gauze-it should be made like a sleeveless vest to fasten under both arms with tapes: it should fit well up to the neck and below the waist. The cut edges are bound with tape or a cotton bandage. The diet should be fluid during the feverish stage and solid diet introduced

sparingly if there is any diarrhcea. The mouth and tongue require great care and should be gently swabbed with peroxide of hydrogen 10 volumes, one part to six of tepid water. The eyes also need great care and should be bathed frequently with boracic lotion. The patient should remain in bed for at least a week after the temperature is normal.

Complications

Broncho-pneumonia is the most important and the most fatal complication. The symptoms are great increase in the respirations-which may be 60-7 0 times per minute in young patients-breathing is ciifficult and the face is pale, the nostrils distend as the child breathes: this complication occurs most frequently in children under two.

Eye Complications

These may be very serious, ranging from conjunctivitis (inflammation of the lining membrane of the eyelids and the covering of the eyeball) to ulcers of the Cornea (the opaque" windows" of the eye).

Inflammation of the Middle Ear may occur and is shown by earache, discharge from the ear and increase in temperature.

Sore Mouth (Stomatitis) is a common complication which occasionally leads on to a serious gangrenous condition of the mouth.

First Aid in Relation to Mines Resclle Worl{

By C. M. Kitto, M.E.

(Superintendent, New Tredegar Mines Rescue Station)

(Continued from page 33, February issue)

In the treatment of burns oil must not be used. This may seem a superfluous statement, but the erroneous method still persists with great disadvantage to the patient, instead of the picric acid dressings or large mine dressings which may be moistened with a I per cent. solution of picric acid.

Shock cannot be too strongly and frequently kept in the minds of first-aid men; and in no case does shock playa more prominent part than in burns after mine explosions. , Shock from bums is often complicated by the effects of gases which may have been present; and in these cases a treatment by a mixture of carbon dioxide and oxygen is of vital importance. However slight these symptoms may be, a free use of the dicarbox mixture is always safe and helpful.

A practical instance of the effective use of dicarbox was the explosion at Markham Colliery, where between 35 and 40 victims 'undoubtedly owed their lives to this treatment. When dealing with men who are exhausted or affected by poisonous gas or have been breathing air deficient in oxygen great care must be taken to conserve their remaininoenergy. The temperature should be kept up by

application of blankets and warm drinks, particularlv if those affected are being brought out over the roadway of a mine, intake or return, which is normally cool. Patients should be carried in all circumstances, despite an expressed desire to walk rather than give trouble, one of the effects of monoxide being to create a feeling of obstinacy, which must be overcome by persuasion. There have been numerous instances where men not appearing to have been badly injured have struggled out and died in hospital, whereas more seriously injured men who have been carried out and properly treated have survived; and in cases where the patient has not died, this using up of energy often results in prolonged suffering or permanent disablement. Such difficulties are likely to arise from the false economy of keeping too few firstaid men available.

Two squads of first-aid men should be the minimum kept at each base. Of course, workmen can be made use of as stretcher bearers to carry men out of the mine provided they are in charge of a qualified man to attend to the patient on the journey and to arrange for proper changing of bearers. First-aid treatment should be given as early as possible at the base. First-aid men should have been trained in the administration of dicarbox with the minimum of delay, while treatment of burns with its far-reaching results should receive attention. As previously mentioned, injuries such as fractures, combined with hremorrhage and bruises, should be attended to, even though the rescue brigade has done something to alleviate the condition, as it must be remembered that a man wearing a rescue apparatus is handicapped. All wounds and bruises must be covered and splints used, if necessary. The first-aider must endeavour to inspire confidence in the patients, who should be kept as calm as possible and given warm stimulants where available and suitable. The most appropriate means of removal must be used; and the first-aid men, who should form a link between base and surface, hospital or home, must be able to load an ambulance car efficiently, to prepare a suitable room at the surface, possibly the ambulance or rescue and aid room, to arrange for the comfort of rescue brigade men, and hold themselves in readiness for whatever the mine manager or rescue station superintendent may require, remembering always that in no circumstances must they assume the doctor's duties. At all times they must relieve rescue brigades at the surface or at the base so that the latter's usefulness in irrespirable atmosphere may not be impaired.

A common fault among first-aid men is that in their eagerness to assist they rush to the scene of any disaster instead of reporting to their headquarters, notifying their officers or the manager of the mine if they are attached to a colliery brigade, of their presence and willingness to assist. They would then be properly organised, supplied with all necessary material, and be able to take shifts as required, generally making use of thei r specialised abilities and means at their disposal.

57

II The St. John Ambulance Brigade News.

O. I. (PRINCE OF WI ALES'S) DISTRICT

CENTRAL AREA GAZETTE

The Acting Assistant Commissioner is anxious to keep in touch with the present activities of the Area Officers in charge of Ambulance and Nursing Divisions are requested to send all particulars of their Divisional A.R.P. Practices and of their members taking part in other A.R.P. work, direct to him at the end of each month. This will enable A.R.P. records to be kept complete and up-to-date.

D.O. 1794

Additional attendants for Civil Ambulance Trains are required. Volunteers must be 30 years of age or over. Any members of Ambulance Divisions wishing to apply should send name, address and age . to :-Ministry of Health, Regional Establishment Office, 21, Cromwell Road, S.W.7.

D.O. 1795.

Stretcher bearers are required for the War Emergency Service. Full-time work, £3 l?er week, less £1 for billeting and IS. 7d. for 111surance. Four days on and two days off. Only men over 30 years of age need apply. Applications to: The Commissioner, 97, St. John Street, E.C. r.

With many Superintendents away on service or evacuated it is possible that the G AZE TTE is not reaching some Divisions. Officers temporarily in charge of Divisions who are not receiving copies should communicate with the Acting Assitant Commissioner without delay.

No. 2 DISTRICT (COUNTY OF SOMERSET)

MINEHEAD

The annual general meeting of the Minehead Division was held recently. The chair was taken by Dr. W. Bain (Divisional Surgeon).

The Committee's Report was read by the Secretary. The following is an extract :-Strength of Division, 54 members, an increase of 12 over last year. Cases transported by motor ambulances, 328 ; miles travelled by motor ambulances, 7,544; total cases attended, 671; public duties, 603; transport duties, 1,194; voluntary hours service given by membelis, 5,472; drills held, 37; average attendance per drill, 30 members.

The report shows that during the year the Division were successful in winning the" Lewis Lovell" and cc Lady Forrester" Cups. The" Luttrell" Cup was won b y Sergt. L. Jordan'S team; the" Duck" Cup by Pte. J. Askew.

The Division are responsible for the staffing of the First Aid Post and three .stretcher Parties under the Air Raid Precautions Scheme.

Members have given instruction in A.R.P. and First Aid throughout the district; as a result of this three new divisions have been formed in the area.

CorpI. W. Pring reported that the Cadet Division, 14 strong, were now equipped with uniform and 30 recruits were undergoing training.

In his address, Dr. Bain said it was a splendid report excellently drawn up, that he would like to compliment the Secretary on the splendid way the records were kept and the Treasurer on the healthy state of the Division's finances. He would like to see more stress laid on the amount of time given to Air Raid Precautions, for they must remember this is quite apart from their normal brigade work. In this connection Superintendent Tarr alone had given a tremendous amount of vo luntary service.

Dr. Bain concluded b y than ki ng all members for supporting the Division so well during a very tryin g year.

No. 2 DISTRICT (COUNTY OF OXFORDSHIRE)

WITNEY

The importance and success of the work done b y the Witney Division was referred to by Mr. J. C. Chesterman, Divisional Superintendent, when he presided at the annual meeting of the Division.

The report of the retiring Divisional Secretar y (Mr. S. Collis) showed that the membership of th e Division was 36, an increase of three during the year. Fifty-two drills were held with an average attendance of 18. First-aid was rendered to 153 people. Members of the Brigade attended many public duties Twentyfive of the 26 officers and men who attended the annual re-examination passed.

Membership of the Cadet Sec tion was 23; 37 drills were held, with an aver age attendance of 15. All boys under sixteen years of age who attended the annual re-e xamination in preliminar y first-aid passed.

The "Chesterman" attendance cup was won b y Pte. R. Lawrence with 100 per cent. a ttendance.

Pte. D. Godfrey won the Cadet Attendance Cup with 69 marks out of 72.

The Chairman presented Mr. Collis with a mirror, subscribed for by members of the division to mark his retirement.

Mr. C. Hudson succeeds Mr. Collis as Divi sional Secretary.

LUTON

No. 3 (EASTERN) DISTRICT

The Vauxhall Motors Division recently contributed two Stretcher Parties, complete with Ambulances, to the Luton Town A.R.P. rehearsal.

No. I Party vias made up of day workers and No. 2 of night men, so that members who work together in the event of raids took their exercises together at this rehearsal.

The Chief Constable of Luton (in charge of A.R.P. for the Borough) said that all members performed their duties excellently. It is hoped that the Division will be able to join in similar exercises in the future, so that as many as possible of the Division's 200 members can participate in turn.

N.C.O.s Classes are h eld on alternate Mondays (the intervening Mondays being full Divisional practices). At week-ends, squ ads carry out A.R.P. rehearsals, particularl y those calling for the do nnin g of anti-gas clothing.

Lectures by Divi sional Surgeon E. A. Butterworth are g iven on Full Divisi onal Practice Nights.

N o . 4 (LANCASHIR E) DISTRICT CLEVELEYS

Since th e outbreak of war member s of the Clevele ys Nurs,ing Division have entirely staffed a temporary hospItal for evacuate d children-on a voluntary

basis - under the able leadership of Lady Divisional Superintendent Mrs. A. H. Cooke.

This Division, formed only some twelve m o nth s ago, and the Ambulance Division (four ye ar s old) are now working hard raising funds for building a Headq uarter s .

Recentl y, a " Lon g Night Dance" was organised with great success by Ambulance Officer J. F. !?avies. It is hoped to hold similar functions from time to time.

No. 6 DISTRICT (NORTH RIDI NG OF YORKSHIRE)

The East Cleveland Divi sion held their first ann ual competition for the SkiI111ingrove Iron Compa n y's cups a few weeks ago.

Members of the winning team were Ptes. J. Blenke y (Captain), J. Bennetts, J F. Cuthbert and G. Beadnall. Each received a silver teaspoon to commemorate the occasion , and will retain a silver cup until th e end of the year. Pte. J. F. Cuthbert won th e prize for the highest individual mark s.

The judges were Divisional Sur geon D r. Dunn and Dr. Kirkpatrick of Skelton

The presentation of the cups, prize s, and awar d s for 1939 was made b y Mr. W. S. B Bos anquet , managing director of the Skinningrove Iron and Steel Works.

NO.7 DISTRICT (COUN TY OF HEREFORD ) KINGTON

The third annual competition for the " Pritchard" Cup was held recently. Four teams competed, and were judged b y Dr. C. D Edwards. Among those present were :-Dr. W-. Logan Jack (Divisional Surgeon), Mr. E. Harding Roberts, Mr. G. N. Bullock (Acting County Commissio ner), and Mr H. J. Harri s (Corps Cuperintendent, A .R.P. staff). The timekeeper was Ambulance Officer D avies.

The cup was presented to the winners (A team), by the Acting County Commissioner, who, in cong ratulating them, praised the action of the Division in keepin g th e competition going during such difficult times.

Later, Corps Superintendent Harris proposed the toast of " The Divisio n," and e::-..-pressed pleasure at seeing so many new members p resen t and no apparent slackening-off of old members. It was also very encouraging to find such old frien d s as NIt. Harding Roberts still taking an active interest in their work.

Repl yi ng, Mr. Harding Roberts assured the Division of his continued support, alth ough he was past the stage where h e could bec ome an a cti ve member of the Division.

The most popular toast of the evening was to "Our A bsent Friends," proposed b y Ambu lance Officer Davies, who made special reference to the County Commissioner, Dr. I. W. MacGregor, now on active service with the R oya l Naval Res erve

59

Interesting Case Reports

CASE ·REPORT No. I6I.-The Officer-in-Charge of Central Area No. I (Prince of Wales's) District

S.J.A.B. reports the efficient performance of Erst aid by a member of No. 126 (Barclays Bank) Division, in the following circumstances :-

On January 27 Private W. G. Fuggle found his brother in a state of coma in the bath. Having sent for a doctor he withdrew him from the bath and at once administered artiEcial respiration. After a short period breathing was restored; but the patient's pulse was very weak. He was wrapped in blankets, and hot water bottles were placed at the feet, stomach and the chest.

After Eve minutes the patient suddenly went completely stiff and the pulse was not discernible at the wrist. Pte. Fuggle then endeavoured to assist circulation by rubbing the upper limbs. After another Eve minutes the stiffness went off and the pulse improved. Shortly afterwards the coma disappeared; and in about another Eve minutes the patient came round and was able to swallow some hot tea.

During this time (some twenty-Eve minutes), a doctor was unobtainable. So it was arranged to send the patient to hospital, where he was retained for 24 hours. Later it was learned that the cause of the accident was inhalation of the fumes from a gas geyser, the outlet of which was blocked by the snow.

COMMENT.-Cases of asplijxia are often accompanied ry convulsions. The probable explanation, therefore, of the delqyed recovery in this case is that the patient had 'a mild convulsion consequent on the asplijxia and the continued presence of carbon monoxide in his blood even after breathing had been established. For this reason it has been suggested that all cases of gas poisoning should undergo venesection to get rid of the carbon monoxide.

In these circumstances Private W. C. Fuggle merits our cordial congratulations in that within six months of taking his first-aid certificate he was able to render e.fJicient assistance to his own brother who was likelY to lose his life from gas poisoning.-N. C. F.

Questions and Answers

ApPLICATION OF HEAT WITH

BLEEDING

E. K. (Halifax).-I enclose the attached newscutting and shall be glad of your comments thereon :-

First-aid workers are being taught all over the country that they should apply cold to check bleeding, but Mr. S. Brandon Stoker, assistant hon. surgeon, Dewsbury InErmary, described in this week's British Medical Journal a series of experiments which showed that-contrary to general belief-heat ,shortened bleeding time, but cold greatly prolonged it.

" Bleeding is controlled by plugging the damaged

60

vessels with blood clot," he writes. "Heat is obviously the means to attain this rather than cold, which merely narrows the vessels without accelerating the plugging process."

Mr. Brandon Stoker points out that men bleed from a shaving cut much longer on a cold winter day than on a warm summer day.

Whilst it is correct that the application of hot water assists in controlling hamorrhage, the water must be very hot to be effective. For first aid purposes, however, it is hardlY likelY that hot sterile water would be available or that conscious patients would endure such f1·eatment.

The suggestion is not new, and is clearlY unacceptable to the Textbook Revision Committtee which in the current edition no longer advises first aiders to "give ice to suck or cold water to hold in the mouth J' and if this is not successful, to give water as hot as can be borne to hold in the mouth 11 fo?" the treatment of bleeding from mouth. As senior members will remember, this instruction figured in the Textbook up to the 38th edition.-N. C. F.

TREATMENT OF CAMPHOR POISONING

P. S. (Coventry).-I was recently called to a child who had eaten some camphor moth balls and was rather at a loss because the Textbook seems to be silent about this poison. In these circumstances will you please tell me the signs, symptoms and treatment of Camphor Poisoning?

The Textbook is not silent about Camphor Poisoning, since it tells you to treat arry case of poisoning, in which the patient's mouth is not burned, as for Non-Corrosive Poisoning. Had you been content to sqy that this poison is not specificallY named in the Textbook 1 could have agreed with you!

The leading signs and symptoms of Camphor Poisoning are a peculiar odour of the breath, giddine ss, noises in the ears, delusions, convulsions especiallY in children, cold clammy skin, weak and rapid pulse and difjiculty in breathing. Such cases frequentlY give rise to alarming symptoms, but they are rarelY fatal. - N. C. F.

TREATMENT OF PATIENT WITH CRUSHED THIGHS

D. P. (East London).-War brings its own problems to Erst-aiders! I have learned some by bitter personal experiences during the Great War and teach my classes accordingly. I hear that not all Surgeons are of my opinion, and, as a Brigade Surgeon, I would be grateful to hear your views.

My Erst problem is as follows :-

Suppose a person is found with ,a heavy beam lying across both his thighs with complete fractures of both of them. I instruct my students Erst of all to feel for the pulse at the ankle, or if this is impossible, to pass tourniquets above and below the beam; or again, if this is difficult, simply to apply digital pressure above the beam over the artery and only then to .lift and take away the beam. My idea is that the femoral artery may be tom as well a1fld only the weight of the beam prevents a very serious and possibly

fatal hremonhage. The digital pressure or the tourniquets are of course relaxed if no hremorrhage occurs when the beam is raised from the thighs.

On this problem 1 agt"ee withyou.-N. C. F.

TREATMENT OF PATIENT WITH CRUSHED RIB S

D . P. (East l,ondon).-My second problem deals with a patient who may be found with a heavy beam lying across his chest and who exhibits obvious signs of fractured ribs. With such a patient I instruct my students to remove the beam immediately; but before they touch the patient I tell them to ask him, if conscious, to move his Engers and toes to test for a spinal fracture and to transport him accordingly, carefully, and face upwards. If the patient is unconscious, I tell them to treat as a spinal injur y and to transport patient face upwards as is taught in the Textbook.

On this problem also 1 agree with you.-N. C. F.

TRE ATMENT OF COMPOUND FRACTURE

D P (East London).-My last problem IS as follows :-

When we have to bandage and to transport a case of compound fracture with bone sticking out, the usual method is to bandage the injured limb to the sound one. Even with the greatest care one cannot help depressing the projecting bone back into the wound. Consequently I instruct my students to cove r the wound with a sterile dressing, to place on the top a large ring pad and to Ell the space between the limb and the splint with anything handy (i.e. a jacket, coat, towel), and only then to apply the bandages round the limb and splint so that no pressure is exercised on the fractured portions of the bone, and the limb is properly fixed.

Though you do not scry so, 1 take it that y ou are thinking of fractures of the shaft of the femur. In these circumstCl;nces, 1 question the value of the ring pad. Further, though 1 agree that this might afford some benefit in protecting the wound, its preparati on and application would involve delcry in the removal of the patient, for whtch purpose speed is all imp01·tant. From your letter it is not clear at ,vhat point you consider that there ,vould be space between limb and splint,. but, of course, 1 agt'ee that such ' space, wherever it occurs, should be packed for the comfort of the patient and the pt'otection of his f racture -N. C. F

TREATMENT OF FRACTURED SPINE

H. V. we have to treat a patient for spine and End him lying in some awkward pOSltlOn, ought we to tie his feet, knees and thighs he is in this position or ought we Erst to roll hIm gently and evenly on to his back before the limbs are sec.ured? Your kind ruling on this point will be apprecIated

p'rovided body and limbs are properlY steadied durzng the turmng movement, 1 question if there is arrything 6r

to choose between applYing the bandages to the patient as found or after his position has been adjusted. In actual circumstances you would select the method which seems easier and more effectz've.-N. c. F.

NECK P AD WITH FRACTURED SPINE

H. V. (Maidstone).-In the treatment and transport of a case of fracture of spine in the cervical region, ought the four-inch pad to be placed under the patient's neck before he is lifted on to the stretcher in the face upward position or ought it to be inserted under the neck as the patient is being lowered? The Textbook (p. 74) is silent on this point on which I ask your kind advice.

Also, if patient is unconscious, I presume that an attendant would have to secure his tongue, as I do not think that his head shou ld be turned to one side.

The Jess the patient is moved, the more e.fJicient will be the first-aid treatment. ConsequentlY it is better to place the neck pad in position on the stretcher before the patient is loaded there on.

Since there are no manipulations as in the Silvester Method of artificial respiration , there is little risk of the tongue falling backwards. You would, however, watch for this complication, and if it occurred you would detail a B earer to control the tongue.-N. C. F.

TREATMENT OF HEAD INJURIES

N. B (Cardiff).-Recently I had occasion t o treat a man who was unconscious consequent on head injuries sustained as the result of falling off a wall. waiting for the ambulance I applied smelling salts to the patient's nostrils For this action I wa s later taken to task by my instructor, who told me that I was wrong in so doing. In these circumstances I shall appreciate yo ur opinion and ruling.

Smelling salts have a true stimulating effect on the brain centres through the nerves of smell. ConsequentlY with head il,!juries, in zvhich hamon-hage of the brain mqy or may not be present, they should alwcrys, in 179 opinion, be withheld because they will certainlY cause a l·ise of pressure within the skull and they might aggravate (and even cause) compression of the brain .-N. C. F.

SHOC'R AT SIGHT OF BLOOD

P. W. (Southlands).-I am a member of the Brigade and am worried because I am very easily made faint or feel inclined to vomit if I see a wound, or anything like that. As I am a very interested member, I feel that my services will be required any time now in the course of this war, and I would like to be cured of these symptoms.

Medical students, at the outset of their careers, oftell experience the same feelings and find that these pass as they get accustomed to the sight of blood. Sol advise that you persevere and 1 hope that you will quicklY cure yourself.N. C. F.

Bllt remeJnber- Ovaltille results are ohtained only with Oval tine

I N these days there is nothing more essential than nerve-restoring sleep. Obviously no bedtime beverage can give you this kind of sleep unless it has definite properties.

Long experience and independent scientific tests have amply shown that' Ovaltine' provides the essential nerve-building elements and gives outstanding beneficial results in all forms of sleeplessness.

Remember that' Ovaltine ' is entirely free from drugs. Its exceptional properties are largely derived from the new-laid eggs which are liberally used in its manufacture. No tonic food beverage could be complete. without eggs.

, Ova.ltine is a llcientifically perfect food. It supplies the esslmtial food elements required for maintaining health and vitality at the highest level.

It be a simple matter to cheapen 'Ovaltine' by altering the proportions of its health-giving ingredients and adding other substances. But the result would not be 'Ovaltine,' which is sold at the lowest possible price consistent with the quality and benefits it provides

/Jrink delicious

note the difference

RAILWAY NEWS

Southern Railway (CONTRIBUTED BY E. UZZELL)

Skilful assistance was rendered by motorman Crouch, of Blackfriars, when Gunner GiUing was knocked down recently by an engine at Blackfriats. The patient's leg was badly injured. It eventually had to be amputated.

Motorman Crouch applied tourniquets to the limb, and his efficient first aid is highly commended upon by the officer commanding "D" Battery, H.A.e., and by the staff of St. Bartholomew's Hospital, to which Gunner was conveyed.

The work of all who assisted at the time of thi s accident is most highly appreciated.

London Midland and Scottish Railway (CONTRIBUTED BY GILBERT S. HILL)

DERBY

Mr. E. Pugson, Derby, L.M.S. Carriage and Wagon Superintendent, was presented with a fountain pen and pencil by Mr. T. Allen, on behalf of members of the Carriage and Wagon Ambulance Corps at the annual dinner of the Corps held recently.

Mr. Allen, making the presentation, stated that Mr. Pugson had been President of the Corps for nearl y ten years, and his work had been of great value.

Mr. Pugson thanked members for their gift ar: d said that he was happy to see that the Corps was 1ll such a fine position.

Competition results for last year showed a great improvement on those of 1938. In 1939 9 5 presented themselves for the St. John ExanunatlOn and 94 passed.

Twenty-five obtained certificates, compared with 19 in 1938, elev:en vouchers were obtained, nine medals and 50 labels.

The Corps has suffered one great loss by the death of Mr. H. Hobson.

Obituary II

LADY MARIA TURNER FURLEY

We regret to report the death of Lady Maria Turner Fudey, Dame Grand Cross of the Order of St. John, R.R e., which occurred on February II at 13, Lathbury Road, Oxford, at the age of 97·

In 1874 she had married Sir John Furley, a Knight of Justice and a pioneer in the work of Order who was largely instrumental in the formatlOn of the St. J.A.A., and a member of the Ambulance Council for nearly fifty years Lady Fudey accompanied her

husband when he went as Commissioner to the South African War in 1899, where she served as a nurse for three years.

She was devoted to Ambulance work, and always did her utmost to promote the work of the Order by her generosity and her unfailing kindness to all those connected with it. She was President of the Oxfordshire District of the Brigade and subscribed liberally to its funds, and had presented in 1936 a valuable cup, " The Fudey Challenge Cup," for annual competition by Divisions in the County. She will be greatly missed as she had been greatly loved by all ranks in Oxford.

The funeral took place at St. Margaret's Church, Oxford, and the Order of St. John was represented by Dr. W. E. Audland, Kt. of J., who also represented the <;::ounty Commissioner, Dr. Gardiner-Hill. The officers and men of the Oxford Corps, under Corps Officer H. W. Hinds, lined the approach to the church.

We regret to report the deaths of Lady Superintendent Mrs. Eastham (Brigade Reserve), Lytham Nursing Division, and of Ambulance Officer J. P. Thomason, J.P., Fleetwood Division. Both officers were members of the Order and had served the Brigade over a long period. Mr. Thomason will be remembered as the organiser of the Cadet Competition held annually for the Fleetwood Fish Merchants' trophy. Our deepest sympathy is extended to the relatives.

We regret to report the death of Private F. Parker, Haworth Division, Keighley Corps, on February 4. Private Parker had been a member of the Haworth Divisi on since its formation in 1899.

REVIEWS

THE NURSE'S DICTIONARY. Revised b y Florence Taylor, S.R.N. Faber & Faber, 24, Russell Square, W.e. 1. Price 3S. net.

This Pocket Dictionary, which is now in its 17 th edition, has been thoroughly revised for this issue t o ensure that its contents are both comprehensive and up to date. As previously, it provides an accurate and yet a simple system which will be found useful as a guide to accurate pronunciation. New ' terms have been added with appropriate explanations and new theories are given regarding the courses of certain diseases. The number of illustrations of surgical instruments has again been increased; and at the end of the book there is a list with page refer-

ences of the instruments illustrated in the book. Six useful appendices are included and deal with urine testing, poisons, dilution of lotions and drugs, dietary, recipes for sick people and first aid. The Dictionary has long enjoyed a great reputation, and the present edition, with its many improvements, should advance still further that reputation -N. e. F. ROLLER AN D TRIANGULAR B ANDAGING ILLUSTRATED.

By Mary Farnworth, S.R.N.

Faber & Faber, 24, Russell Square, W.e. 1.

Price 3S. 6d. net.

This is an interesting and instructive book on bandaging, one advantage being that it is of su ch size that it can be carried in the pocket and studied at odd moments. In its 144 pages it sets out the whole art of roller and triangular bandaging; and it is primarily intended for those who, having learned the rudiments of bandaging and wishing to become more find frequent attendance at practice classes difficult. Its letterpress, which contains clear and concise instructions, is illustrated by 161 excellent illustrations, these being collected togethe r at the end of each chapter. We note with interest that the St. John arms ling (without acknowledgment) rightly finds its place in the chapter on the triangular bandage. -N. C. F.

Conditions and Terms of Service in the Civil Nursing Reserve

A leaflet clearly setting out 'the conditions and terms of service in the Civil Nursing Reserve has been published by the Ministry of Health for issue through the Local Emergency Organisations (excepting in the London Area*) to all members of the Civil Nursing Reserve.

Every Lady Di visional Superintendent should fully understand these conditions of service, and if they have not already received a copy of the leaflet (e.N.R. Memo I) from Brigade County Headquarters, application should be made for a copy to their Lady District or Lady County Superintendent or Officer. The Divisional Superintendents should, in their turn, make sure that those of their members who have enrolled or are enrolling in the Civil Nursing Reserve understand the terms of service for which they volunteer.

* Officers and members in charge of Nursing Divisions in the London County Area are asked to inform the Lady District Superintendent, Miss Walker, without delay how many copies they will require for their present and prospective members of the Civil Nursing Reserve.

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

A.R.P. IN ST RUCTORS

Grade 1 Instructors, of whom there are 710 on the Priory Register, will welcome the announcement that the A.R.P. Department of the Home Office has informed the Chief Commissioner that it has now been agreed that Grade 1 Instructors, including _ Grade I (External) Instructors, who have been examined or re-examined in Anti-gas measures during the past two years, may be recognised as qualified to gIve the full course, the voluntary aid course, and the short course in Anti-gas measures as set out in Home Office Circula! 26/1939 dated March 21, 1939.

The use of smelling samples and the passing of through gas, or H testing the fit of respirators

In a gas chamber or gas van," must, however, be supervised as hitherto by an Instructor A.R.P.S., G.A.G.S., L.A.R.P., L.A.G.C., or other Instructor specially approved for this purpose. Commissioners will be invited to select those Grade I Instructors whom they consider competent to carry out this additional training and submit the Grade 1 certificates of those selected to the Chief Commissioner with their recommendation for endorsement.

On the recommendation of Commissioners or their A.R.P. Officers, the Priory will be supplying the Local Authorities with a list of the Grade 1 Instructors complying with the above conditions, resident in their respective areas; and the discouraging effect of the Home Office Circular referred to above, which limited the recognition of Grade 1 Instructors to the V olufitary Aid Course, will thus be removed.

PANEL OF HOME NURSING EXAMINERS

Following the decision of the St. John Ambulance Association to recognise certain members of the N,:rsing Profession as Examiners in Home Nursing, Miss .L. J. Ottley, Matron, Ro-yal Gwent Infirmary HospItal, Newport, Mon., has been appointed Matron of the Priory, to act in an advisory capacity in connection with applications.

CENTRE REPORTS

ANGLESEY CENTRE

The following extracts from the report of Sir Henry Mulleneux Grayson, Bart., K.B.E., as Commissioner, indicates that the Order's work is being kept well up to date in the northernmost Centre of the Priory :-

" The past year was one of much activity and the 64

maj.ority of the members are now fully trained in antI-gas measures.

usu al, Brigade personnel attended at gather-

In parts of the County and carried out vanous pubhc duties.

". The Holyhead Nursing Division was formed the year, and after Hospital Training, n::embers. were regIstered as Nursing AUXllianes 1n the Civil Nursing Reserve.

"At the of war? the members put in some work 1n sandbaggm g the First Aid Posts and assIstmg the A.R.P. Medical Officer in training stretcher bearers, ambulance attendants and ambulance drivers; and and training additional personnel for HospItal and Fust Aid Posts.

." A new motor ambulance for the H o lyhead pIVlSlOn was dedicated in February, and the debt was wiped off b y the end of the year 1939, 106 patients were co nve ye d a total dIstance of 3,000 nilles.

" accordar:-ce with a suggestion from the Priory, a JOInt Committee has been fQrmed t o co-ordinate the activities of the Order with those of the Britis h Red Cross during the continuation of the war. This Committee is .co mposed of six representatives of the Order and SIX representatives of · the Red Cross an? meets under the Presidency of Sir R!chard Williams-Bulkeley (Lord Lieutenant), with SIr Henry M. Grayson (Commissioner for Anglesey) as. Chairman and T. R. Newton (County of the Bntish Red Cross Society) as ViceChauman. One of the first duties of this Committee was to organise a collection in the County for the Lord Mayor's Fund."

BRECKNOCKSHIRE CENTRE

A progressive account of the past year's work i n County of Brecknock is given by the Commissioner C. G. Cole-Hamilton, CM.G., D.S.O.)

In the followmg paragraphs from his annual report :_

" The strength of the Centre has increased during 1939 by .members, bringing the total strength to 97 6 , compnsmg 2 Ambulance, 12 Nursing, 8 Cadet Ambulance and 9 Cadet Nursing Divisions.

"I have to point out the continued scarcity of who are willing to give the necessary lectures In this and this has been accentuated by the extra throv:n on doctors by the Civil Defence and ffillitary reqUlrements.

H On the A.R.P. side not only have we been able to meet all the requirements of the County Medical

Officer of Health but have a substantial surplus of personnel in reserve."

MONMOUTH SHIRE CENTRE

The value of a knowledge of first aid was emphasised at an ambulance gathering held at the St. John Ambulance Hall, Abergavenny, at which Captain S. T. Beard, O.B.:g. (Commissioner for Monmouthshire), presided, supported by the Mayor of Abergavenny (Alderman W. Rosser), the Mayoress (Mrs. Rosser), Miss Rosser, Mrs. Whitehead (President of the Abergavenny St. John Nursing Division), Dr. G. P. Humphrey and Councillor Max L. Beveridge.

Captain Beard explained the o bjects of the Ambulance movement and stressed the value of everybody having a knowledge of First Aid.

In presentin g the certificates to the successful

movement had always been arduous and far-reaching, but now the demand on it had multiplied a hundredfold. Because it was essential that the members of the Order in the city should have a meeting place and permanent centre for their activities she had the grea test possible pleasure in declaring the hall open.

Dr. Edgar Llewellyn, the COmnllssioner for Cardiff, expressed his keen delight on the very happy outcome of their search for accommodation. The occasion marked the fulfilment of his gre atest ambition as Commissioner.

Alderman G. Fred Evans, J.P. (Centre Chairman), presiding at the ceremony, said that the Centre was carrying out work of a social importance which was increasing from year to year.

D.B.E. (Lady President), The Hon. J H. Bruce, JP., D.L. (Commissioner for Wales), Mr. W Mabon Abraham (Brigade Secretary) and Alderman W. H. Petbyb ridge

students, the Mayor congratulated the recipients on their success

Mrs. Whitehead, whose personal interest and generous assistance are a source of encourao-ement to the Nursing Divisi ons, presented the to the women.

CITY OF CARDIFF CENTRE

Members of the Ambulance and Nursing personnel presented an sma rt appearance as the y were drawn up outSIde the buildin o- in Cardiff Castle which had been placed at the disposal of the Br:gade free of · any char ge by the Marquis and Marchioness of Bute, D.B.E., who have had it suitably adapted to the needs of an Ambulance Headquarters.

formally opening the building, Lady Bute, Lady PreSident of the Centre, said that the work of th e

The J. H. Bru.ce Secretar y and ComffilsslOner of the Pnor y tor .Wales) said he had made a special point of being present to pay tribute to the great help giv en to the Order by Lady Bute . F rom the beginning, -Lord and Lady Bute had taken an active interest in the work of the Cardiff Centre and Lady Bute, as the lady President, had laid banque ting hall and other rooms of the Castle at the disposal of the committee for its meetino-s from time b to hme.

Others who spoke were the Cardiff Secretary (Mf. Bernard E. Brown), Corps Superintendent MacDonald and Lady Corps Superintendent Miss W. Rees.

In addition to the speakers those supportino- the Chairman and Lady Bute were: Mrs. E. Brown, Sir Robert Webber, J.P., D.L., and Lady Webber, Mr. R. T. R ichards, J.P. (Hon. Centre

Treasurer), Alderman \V. H. Pethybridge, Mrs. Edgar Llewellyn, Captain F. P. Robathan, M.e., and Mr. W. Mabon Abraham (Brigade Secretary).

Barry Corps' Splendid Service.-Mr. F. R. Hortop, in his report as Assistant Commissioner, states that the Barry and District Corps, which has a total personnel of 302, rendered first aid to 5,543 cases during the year 1939.

The Medical Comforts Depot continues to serve a real need, 199 surgical articles having been loaned out to sick and needy persons, in most cases free of charge.

High tribute is paid to the Medical Officers of the Ambulance and Nursing Divisions, who in spite of the extremely busy times have devoted much personal attention to the work of the Brigade.

RHONDDA CENTRE

The Sub-Prior, the Earl of Plymouth, P.e., has approved the appointment of Mr. Hubert McVicar, J.P. (General Manager of the Rhondda Fawr group and Gilfach Goch Powell Duffryn Collieries) as President of the Rhondda Centre, in succession to Mr. W. Bryrunor, who is not now resident in the Rhondda.

BoROUGH OF SWANSEA CENTRE

The Commissioner for Swansea (Dr. Urban Marks) is' to be congratulated on the interest taken in the Casualty Service organisation in that Borough by representatives of the Ministry of Health at a recent A.R.P. exercise, the following being an extract of the interesting account of the organisation which he subsequently submitted to them: (C As Commissioner of the Brigade in Swansea, I was asked by the Borough Council in April, 1939 to accept the post of Commandant of the First Aid Parties. I consented with the proviso that Mr. Hugh S. Cann, my Assistant Commissioner, should also be my deputy for this work. This was agreed. At the outset of the war I called a meeting of the personnel of the Brigade and British Red Cross Detachments in Swansea at which 100 trained men were enrolled for duty. There were 14 depots to be manned, with I 5 stretcher parties distributed among them. It was therefore only possible to make one trained man a stretcher leader and to give him three others untrained as volunteers came along. Classes were then formed to undertake the instruction of the new recruits.

After qualification each man was posted to the nearest depot to his home; and before Christmas we had 234 trained men working at the Depots.

"Within a month I hope to get 100 men who will be specially trained by Mr. Cann and myself."

Team Test

GAUNT TROPHY AND WALLACE RA NKINE NESBITT CADET TROPHY

The members of your First Aid team are preceptors or instructors at a boys' camp where you have a small First Aid hut with one bed and a complete First Aid kit, including a stretcher and some blankets.

One bright morning, the team is scattered atound the camp but the 66

captain is in the hut, when a bqy runs in and tells Y0U that one of the y oungsters has been brought out of the water. Almost immediately word comes to you that one of the boys on a bike along a road by the lake had fallen off a large rock about 100 yards from camp. The nearest doctor is five miles away. It is summer weather but a bit chilly. What do you do?

Immediately call rest of team

Go at once to waterfront

Examine boy from water

In meantime detail No. and No 2 of team to go to second patient, taking stretcher

Have someone telephone for doctor

Patient conscious (no)

Any bleeding (no)

Patient breathing (no)

Immediately perform artificial respiration

Information given re second patient if asked for.

Patient conscious but seems groggy

No severe hremorrhage

Bruise on chin

Capillary hremorrhage

No irregularity of head and face bones

Clavicles normal

Right arm, forearm, and hand norm a1

Left arm shows deformity

Irregularity in line of humerus

No bleeding

Cannot move arm

Suspect simple fracture

Further examination reveals ribs and spine normal

No deformity to right thigh, leg or foot

Left leg shows swelling at ankle

Patient can move ankle slightly

No misplaced bones at ankle

Slight discolouration

Suspect sprained ankle A ction taken:

one of boys to steady ankle and make comfortable.

As you are working on second patient who becomes unconsciolls the first patient has started to breathe and the Captain directs NO.3 to warch patient, and if possible to get him into the hut. The

Captain goes to the second patient.

Further information 011 second patient given is asked for:

Face flushed

Breathing has become laboured

Pulse slow and full

One pupil larger tban other

Serum and blood from the ear

None from nose

Eyes sligbtly

AIR RAID FIRST AID

Editor: ROBERT J. BLACKHAM, C.B., C.M.G., C.LE., D.S.O ., K.St.J., M D. , M.R.C.P.Edin., F.R.F.P.S.Glas. , D .P .H Eng.

Chevalier if tJu Legion of Honour,. French War Cross,. Formerly Deputyl Director if Medical Services if an Army Corps; Formerly Hon. Surgeon to the Vi&e roy if India.

There are 15 charts covering all the duties of a First Aid Worker, giving full instructions as to precautions, effects, recognition and treatment.

L-Bombs-Incendiary High Explosive, Gas. 7.-Insensibility, table sbow ing var ious kinds.

2.-Gases-how to recognize them. 8.- Poisoning, general treatment.

3.-Asphyxia, causes of. g.-Wounds, general treatment {.-Fractures, Dislocations and Sprains. 10 and I I.-Triangular Bandaging.

5.-Bones, Arteries and Pressure Points. 12 to I5.-Roller Bandaging

6.-Hremorrhage, arrest of. Over 80 illustrations.

Printed on strong, antique paper and mounted on a roller for hanging. Price 7/6 net. Postage 6d.

JOHN BALE MEDICAL PUBLICATIONS, LTD.

85 GREAT TITCHFIELD STREET, LONDON, W.I

Red Cross and St. John War Organisation

(Continued from page 30, February iss1IB)

Under the terms of the Geneva Convention of 1929, each belligerent Power and each neutral Power having belligerents in its care is required to establish an official bureau to give information about prisoners of war. Further, societies for the relief of prisoners of war regularly constituted in accordance with the laws of their country, and having for their object to serve as intermediaries for charitable purposes, are to receive from belligerents all facilities for the efficacious performance of their tasks within the limits imposed by military exigencies

INTE RN ATIONA L RED CROSS COMM ITTEE

In addition, the Conv ention prescribes that a central agency of information regarding prisoners of war shall be established in a neutral country. Its duty is to collect information regarding prisoners of war which it can obtain through official or private channels and to transmit it to the prisoners' own country or to the Power in whose service they have been. It is the duty of the International Red Cross to propose the organisation of this agency to the Powers conc:erned, and in September of last year it informed them that it was setting up a Central Agency for this purpose at Geneva.

It also announced that it was sending missions to Great Britain, France, Poland and Germany to work out in conjunction with the Governments and Red Cross Societies in those countries the most effective means of carrying out its work.

W A R ORGANIS ATION ACCEPTS DUT Y

In June, 1939, the War Office, in teply to an enquiry from the Joint War Emergency Sub-Committee, assumed that if there should be a yvar the Joint Bodies would again function in r€spect of prisoners of war as they did in the " 1914-18 "War. On this information the Department was included in the War Organisation. As the result of conferences with the War Office the War Organisation undertook the duty of despatching parcels to prisoners of war and of helping to supply information as to their whereabouts and well-being. It also undertook to organise the service of searching for and answering enquiries from relatives about wounded and missing men.

THE DEPARTMENT'S MANY CONTACTS

, The Department, in this way, obtained its official recognition and standing. Its duties require it to maintain contact with a number of Government Departments, including the. Foreign Office, the War Office, the Admiralty, the Air Ministry, the G.P.O. and the Postal Censorship, and complete compliance regulations issued by these Departments is e$sentia1. Further, it maintains continuous contact the International Red Cross.

NEED FOR PRISONERS' PARCELS

While the International Convention prescribes a minimum standard of food for those who have the misfortune to be made prisoners of war, there can be no question of the need to supplement it by supplies from other sources. Indeed, the food in the country in which prisoners may be is at times quite unsuitable In addition, there is need for clothing, for articles of personal use (soap, towels, and so on), for medical supplies; and to relieve the boredom of imprisonm ent, books and games are essential.

CONTENTS OF PARCEL S

What may be included in parcels under r e gulati o n s issued by the bellige r ent countries r equires the strictest supervision. What is suitable for packin g in parcels, particularly in the way of food, is the outcome of experience. What is needed in the shape of clothing is obtained only by knowled g e of conditions prevailing in the districts in which the prisoners are interned These considerations make it ver y necessary that the service of parcels to prisoners of war should be standardised and should be conducted under expert direction. Hence the need, as the" 1914- 18" Wa r proved, of a Department expre ssly organise d t o perform this service.

REGULAR SERV I CE M A I N T AINED

The Department maintains a regular service o f food parcels to prisoners of war. At present it is sending two 10 lb. parcels each week to each prisoner. One of its problems is that of ensuring a supply of English-type bread. The foodstuff parcels are standardised and have been made up after consultation with dietetic authorities. "Invalid comforts" are sent as necessary In addition an "initial" parcel of clothing is sent to a prisoner of war as soon as his name and camp address are received by the Department.

DEPARTMENTAL PACKING CENTRE

All parcels for prisoners of war have to go through the packing centre of the Department where, owing to censorship requirements, private parcels have to be opened and repacked. Unsuitable articles and prohibited articles have to be removed, and unfortunately the desires of relatives do frequently require this action to be taken. The Department has, therefore, been obliged to refuse all offers of food parcels; but so that relatives may feel that they are participating in these activities on .behalf of prisoners of war, the Department welcomes gifts of money towards the contents of parcels.

The Department, of course, sees to it that all prisoners are sent parcels, the cost of which, if not

War Emergencies

Uq. Sod. Chlorinat is very caustic. It falls in strength houri,y and fresh supplies take time and technical skill to prepare. The advantages and economy of a standard, stab4e, non-caustic preparation are therefore obvious.

Milton Antiseptic

is therefore the ideal antiseptic for first-aid use in all crises

There is no mystery about it. Milton is of the S31l'1e chemical nature as the famous Carrell-Dakin solution that so SWiftly reduced the figures of deaths and amputations (due to infection) in the last war.

Keep Milton handy-you'll need it for

Cuts and Wounds Burns and Scalds Deodorising Cleaning Gas Masks

Personal uses such as : Sore Throat Catarrh Influenza etc.

Light on the pocket, too

MHton Fluid antiseptic is the most inexpensive you can use consistent with efficient results. This very powerful germicide is fully effective in dilutions of I in 100 for most purposes; that is, three tablespoons to a gallon of water , or t a teaspoonful to a tumbler.

CUTS, INSECT

STRAINS BITES, SCRATCHES get your tin of this

and

complaint. SOLD EVERYWHERE 6d., 1/3, 3/- & 12/· per tin

HUMAN ANATOMY, OSTEOLOGY, -----------------ETC . ______ Articulated and Disarticulated SKELETONS HALF-SKELETONS.

Articulated & Disarticulated SKULLS. PELVES, FOETAL SKULLS. CL HANDS and FEET. ,f7' Loose Human Bones 0 of Every 0 Description. S

Born during the last war-best during this 6d., 1/-, 1/6 and 2/6 a bottle VVinchesters at 7/6

",,0(\0" Anatomical Models & Wall Charts, etc

Largest Selection in the Country. Inspection invited. Telephone:

received from relatives, is met out of the War Organisation's Fund. Once a quarter relatives may send, through the Department, a " personal " parcel which may be composed of such articles as woollens, chocolate and tobacco. The parcel has, of course, to be opened and repacked by the Department to meet censorship requirements.

ACKNOWLEDGMENT OF RECEIPT

A card of acknowledgment of receipt is enclosed with every parcel. Some hundreds of acknowledgments, as well as most appreciative letters, have already been returned to the Department, proving that the parcels have reached the prisoners to whom they were addressed. Parcels are sent not only to prisoners of war of the Fighting · Forces, but to British civilians-just over 100 in number-who are interned in Germany. The needs of other special €lasses of prisoners of war have also to be dealt with by the Department.

NEUTRAL CAMP INSPECTORS

Opportunity to be informed that prisoners of war are adequately accommodated and that the conditions in which they pass their days are satisfactory is provided by the Geneva Convention. Delegates of the International Red Cross Committee have the power of inspection of prisoners' camps and of personal conversation with the prisoners themselves. In this country, the Department collaborates with the Government authQrities who have the responsibility for ensuring that the arrangements prescribed by the Convention are carried out.

WOUNDED AND MISSING

An entirely different phase of the work is that of tracing wounded and rruSSlng men. Notification of a missing man is normally reported officially to the Casualty Branch of the Service Department concerned from the theatre of war in which the missing man was serving. Such information is passed to the Prisoners of War Department which would then set in motion its organisation to endeavour to trace him. One source of information is through the Central Agency for Prisoners of War at Geneva, since the missing man may be a prisoner of war, or some prisoner of war may be able to supply information respecting him.

ORGANISATION AT HOSPITALS

Further sources of information are from wounded men who were serving in the same locality as the m1ssmg men. To comb such possible sources of information requires an at each base hospital in theatres of war, to be staffed by men whose duty it is to make enquiry from patients likely to be able to give information. In the same way, an organisation is requi red at home hospitals receiving patients from theatres of war. Those who are selected to make enquities need to exercise considerable skill, tact and patience in their investigation. The value of the service is, however, proved by the experience of the

" I9 4- I8 "War. The number of enquiries received in that period was nearly 3 50,000, and approaching 400 ,000 were obtained. Anxiety and uncertainty were removed from many homes as the outcome of the efforts of those who volunteered their assistance in this work.

Happily, again, there has as yet been no call for this service; but the organisation has been set up, and it is ready to operate when it is required.

INTERNATIONAL ACTIVITIES

On this Department also falls the responsibility of maintaining relations with the International Red Cross Committee at Geneva. It must be remembered that in war-time the Red Cross Societies in the different belligerent countries are the organisations through which many forms of human suffering and distress caused by war can be mitigated. The Department acts as the link with the International Red Cross Committee at Geneva in a variety of ways with this end in view.

INTERMEDIAR Y F OR ENQUIRIE S

It receives enquiries from people in enemy territor y as to the welfare of their relatives who are prisoners of war or-civilian internees in this country, 'Or who are interned or lost in one of the British Dominions, Colonies or Mandated Territorie s It receives from British and foreign individuals living in Great Britain similar enquiries for their relatives in enem y territor y and enemy-occupied territory.

MARRIAGES, BIRTHS, DEAT HS

It acts as an intermediary through which families communicate with each other on matters of famil y concern- marriages, births, deaths. A characteristi c of this war is the separation and distribution of members of the same family throughout the world. It is to the Red Cross in each country that members of such families turn for help in communicating with one another or making efforts to be re-united. A constant stream of callers come daily to the Department for some assistance of this kind. Brought into personal contact with these cases one realises what war has meant to many thousands in other countries and what we have so far happily escaped.

The Department also receives many calls for its services from Government Departments concerned with British citizens who are stranded or in difficulties owing to the war. It maintains contact with the national Red Cross Societies in other countries in carrying out this part of its work.

POSTAL MESSAGE SCHEME

In order to alleviate the mental distress of hundreds of separated people, the Department initiated the Red Cross Postal Message Scheme. on Red Cross forms are sent by individuals of British or foreign nationality to their relatives in enemy territory or enemy-occupied territory. lvIore than 6,000 forms were sent off from London alone during the week before Christmas.

PRACTICAL

by N. CORBET FLETCHER, M.B., B.C., M.A.(Cantab.), M.R.C.S.

AIDS TO FIRST-AID Ed.)

First-Aid Simplified and Tabulated With Aids to Memory. Price 1 / - (Post 2d.)

EfFICIENCY I N FIRST-AID (3rd Ed.)

Problems in Study, Treatmen and Examinat ion solved for Senior Students. Price 1/- ( Post 3d )

COMMON ERRORS IN FIRST-AID

Errors in First·Aid Detailed and Explained. Price 1 / - (Post 2d.)

WHY AND WHEREFORE IN FIRSTAI D (5th Ed.)

Difficulties in Study and Treatment Solved by Question and Answer Price 1/ - (Post 2d.)

AIDS TO HOME-NURSING

Home Nursing Simplified and Tabulated, with Aids to Memory Price 1 / - (Post 2d ).

AMBULANCE COMPETITION TESTS

Stretcher, Ind ivid ual and Question

Each Folde contain specia article on Competltl(m:- o. I! Trru IJlng o Compe titi on Tea ms; No 2, Conduct.of Team ill Competttton Room ; No.3 Common Errors n Compe tl llOn No 4 F urt

HINTS FOR HOSPITAL ORDERLIES

Orderly Duties

Obtainable from :

THE FOUNTAIN PRESS

19 CURSITOR STREET, LONDON, E.C.4 , The St. John Ambulance Association. Its History and its Part in the Ambulance Movement. By N. CORBET FLETCHER, M.A., M.B., M.R.e.S. book f,om cover to cove" '$ full of'tlformation of '_<lSI .N porlatlC4 to elleryone ,tI lise Ambulance Movem.mJSt. John Rmbu[:mc e (!ia3ette. Price 3 6 Postage M. SbG Dllpt. 8 T. 01 0 H N 8 QAT E LON DON J It • C. 1 •

CLASSIFIED ADVERTISEMENTS.

AdlIerti.rt1JJcnts with remittance should be !ent to the St. John A mbuian"e Gt1zefte, 19, Cursitor Street, E.C·4· zd. per word, minimum 35

SCENT CARDS AND SACHETS. pnnted with your announce· ments, are splendid money raisers and show 300% profit. Samples free on request.-AIREDAl X PRESS. Bradford PENCILS OF SUPERIOR QUALITY, printed with your Corps Name and announcement, sell easily. Sample free.AIREDALB PRESS. Bradford.

SCENT-CARDS (printed) .- 144 3 / 9, 500 10 / -, 1,000 16 9.

Tickets, handbills. Samples free -" S "TICES, 11, Oaklands Grove, London, W.12.

RAZOR BLADES FOR FUND RAISING. Et ch ed (Printed) with your Name, Section o r any Announ ce ment on request. Best quality British Fits all 3 p eg razors. Sells at Id. each or Cartons of 6 blades 6d W e are equipped to supply v ery s mall q uantities Samples, price a nd p a rticulars fr ee - RoBERTs BROS. 8.: Co., 143 , TaWIl Street B eest o n L eed s, 11. 7 1

EVERYTHING FOR SAFETY EVERYWHERE

• NOVOX' and , NOVITA' Oxygen + COs or Oxygen RESUSCITATI NG APPARATUS for the apparently asphyxiated or drowned.

SMOKE HELMETS of all Patterns.

• PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

'PURETHA' GAS MASKS for Naval, Military and Industrial purposes and for Civilian use.

DUST and SPRAY MASKS and all other Safety and Protective Devices. All communications SIEBE, GORMAN & Co., Ltd. "GRANGECLARE,"

5th Edition revised Questions and Answers in Air Raid Precautions , the Pr o tection of the Civil Population in Chemical Warfare , Gas II First Aid and Nursmg of II Gas" Casualti e s . By

OFFICIAL GAS CHARTS

No. Chart shows gas derivations.

No. 2 is a · full and complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which ar.e now available for general issue to all St. John organisations at a nominal fee.

1

THE JOURNAL OF THE VENERABLE ORDER OF THE

OF ST. JOHN OP JERUSALEM

HOBSON & SONS

"OUNDI!D 18150. (LONDON), Ltd. SPECIALISTS IN UNIFORMS.

MANUF ACTURERS OF EVERY DESCRIPTION OF UNIFORM CLOTHING AND EQUIPMENT for St. John Ambulance Brigade.

JACKETS, TROUSERS, GREATCOATS, CAPS, BELTS, GLOVES, HA VERSACKS, WATERBOTTLES, ETC.

ESTIMATES AND SAMPLES ON REQUEST

All enquiries to154 - 164, TOOLEY STREET LONDON BRIDGE, S. E. 1

Telephone-Hop 2476 (4 line.). Telegrams-" Hobson. Boroh. London." North of England YORK PLACE, LEEDS. Telephqne: 23334 Leeds. Telegrams: Trier.;, Leeds,"

THE ST. JOHN AMBULANCE GAZETTE is published on the 15th of each month. The annual subscription is F. 6d., post free; single copies 3d . Brigade Reports and Photographs should be addressed to the Editor, at 32, Shoe Lane, E.C.4. Reports and photographs should reach him as early in the month as possible.

Subscriptions and Advertisements should be forwarded io the publishers: Messrs. British Periodicals, Ltd., 19, 19a, Cursitor Street, London, E.CA.

CONTENTS

Editorial Home Nursing Page Grand Priory Appointments Red Cross and St. John War Organisation Overseas News Brigade News

Interes ing Case Reports Questions and Answers Priory for Wales Correspondence Obituary Reviews

Progressive Tra!ning in A.R.P.

CHANCERY OF THE ORDER, PAGE ST. JOHN'S GATE, CLERKENWELL, LONDON, E.C.I.

Ambulances for France

In the Quadrangle at Buckin g ham Place on Friday, March 15, Their Majesties the King and Queen inspected the first Ambulance convoy of the Red Cross and St. John War Organisation, prior to its immediate departure overseas.

It was formed of Section A, No. Motor Ambulance Company. It comprised twenty ambulances, each of which bore the name of the donor, the whole Section being made up of presentatio? ambulances.

No.

r. "Transvaal."

2. "Cape of Good Hope.

3. "Natal."

4. "Orange Free State." (From the South African Red Cross Society.)

5. "Cape Town" (Fairhaven Work Party).

6. From the Tanganyika Red Cross Fund.

7. From Nkana War Service League, Northern Rhodesia.

8. From Mrs. A. D. Viney (Johannesburg).

9.}From the Jamaica Central War Assistance 12. Committee.

13. From British Residents in Brazil, through the to Comite Britannico de Socorros as Vitimas

16. da Guerra.

r 7. From the British Central Committee of Bogota, Colombia.

18. From the Hertfordshire Branch, B.R.C.S. 19. From" Old Carthusians."

20. "Glasgow Yeoman "-From T.L.G The Company is under the command of Dr. Wilfrid Fox. The Assistant Commandant is Colonel W. McClure. The other officers of the Unit are Majo! J. Ashton, Mr. C. Fuller-Nixon, Mr. J. W. Boumphrey and Mr. A. S. Ro ger. The personnel is composed of unpaid volunteers.

The ambulances have all been built to the special design of the Transport of Wounded Department, of which Sir Alexander Roger is Chairman and Mr. \ H. T. Ferrier, Director, thereby ensuring standardisation. The Section represents, of course, but a very small number of the ambulances which, so far as can be seen, will be needed, and elsewhere reference is made to an appeal by the Lord Mayor for donations from towns, organisations and firms to provide them without calling upon the main Fund of the War Organisation.

The cost of a complete ambulance i s £ 55o.

HOME NURSING PAGE

The Nursing 0/· Children

By Dr. ALICE M. PENNELL, M.B., B.Sc.(Lond.)

differ in many ways from adults, and theu nursmg demands special study, training and care, .as well as endless patience, sympathetic understanding and resource. Their treatment has to be modiEed because they are growing, their physical and mental powers are still being developed. This throws a strain on their organs, whether of digestion or those that have to do with blood-fonning or their mental and nervous systems.

Therefore'a proper appreciation of their needs and their capacities must be part of the nurse's equipment.

good. nurse realises how the organs of digestIon of a child are able to deal with certain foods, according to its age and its state of health. She must study the right proportions of the different elements constitute a meal for the age of her patlent. If the child is on whole milk or one of the artiEcial foods or has a formula prescribed by the doctor or has progressed to "greens" and fruit pulp or other foods, she must be able to prepare them and must observe scrupulous cleanliness in their absol,ute accurac y where required and punctuality In feeding the child.

Food be attractively presented to any sick person, child or adult, and with a child the nurse may have to use her powers of persuasion and all hut.?-0ur and inventiveness perhaps, if the chIld IS peev1sh or has been badly trainea. But a nurse who is fond of children and understands them -:will have many ideas on this subject and be able to lllvent games and stories tha t will interest the child and ind uce it to take its nourishment without struggle, with its resulting dep ressio n and fatIgue.

It may rest with the nurse to see that the child gets a properly balanced diet, and therefore it is most that sbe should study dietetics during her tra1n1n g. Too often, alas! children suffer for the ignorances and inefficiences of their parents or the people who provide their meals. A nurse must unders.tand the needs of the growing infant, what IS best 1n infancy, during and after teething peri od, during sickness and convalescence. She must understand about these matters and not only talk about" vitamins," and so on.

Rest and Sleep.-Children need much more rest and sleep than adults. Even in health they must

have long hours of quiet, when they can kick and crow and not have their brains taxed by kindly intentioned but foolish mothers and nurses who want to entertain them.

In sickness they need still more rest and to ensure this, darkened rooms, a nice warm bed, and physical comfort and cleanliness contribute largely.

Pulse and Respiration. -A nurse must be familiar with the rates of pulse and respiration in health, so that she can note any deviation from the normal in sickness. An ir:fant's rate is 130 per normally, and 1tS respuatlOns 35-40 per minute, At 12 years of age the pulse rate is 80 pe.r ffilnute, normally,. and its respirations 24 per ffilnute, normally. Children therefore need purer air and their bodies need to be kept warmer than adults.

In sickness the vitality is lowered, and warmth and a supply of fresh air are still more essential. No woman should undertake the nursing of children unless she is really fond of them, understands them can enter into their minds with sympathy, and can' bear with them their perversities with patient kindliness when they are ill. To gain a child's conEdence and affection is the only way to ensure success in nursing it.

A nurse must have her powers of observation highly trained, for she will have to depend, very often, on what she herself notices in the child under her care, to where the pain it is crying about is or whether 1t 1S hungry or wanting i ts soiled garments or whether it is only tired and in need of qUIet and sleep.

Crying.-Crying is the lan guage of an infant and a nurse has to learn to understand this form of complaint and ascribe it to its proper cause.

(I) The Cry of Runge?' i s usually accompanied by c.lenchlng of the hands and placing the closed Est 1n the mouth, and bendin g the limbs.

(2) Prolonged Crying may be due to int e stinal troubles, and in these cases there will a l so be restless movements of the body and drawing up of the knees.

(3) Earache must be suspected if the child's cry is constant and if it presses the side of its head al1d face against it s mother's breast or puts its hand to its ear.

(4) Hoarse feeble crying may be due to jnflammation of the air passages.

(5) Tearless crying is due to bodily pain, while a of tears may a!1se from mental causes.

(6) Absence of crying may be a sign exhaustion or of a serious turn lil the conditlOn of a sick child. posture .-The observant nurse will always note h ow a child is lying in bed.

(I) A 1vell child lies partly on the side with its cheek on the pillow.

(2) In exhaustion or serious disease the child lies on its back, with the face upwards and the e yes closed.

(3) Lying on the side with the head partly drawn or thrown back suggests some affection o f the brain; or if associated with difficult

resents any change in its routine WIth familiar friends and accustomed ways. It is important that the nurse should begin by winning the child, otherwise the wh.ole period of its illness may prove to be a long exhaustlilg time, with practically no real progress towards convalescence, or only a delayed one, injurious to the child's nervous system and of more than doubtful value to anyone concerned. A nurse must realise that the period of sickness is not primarily on e of moral reform nor is she necessarily the appoin t ed "reformer." Bad bringing-up is probably .for a child's temper and disobedience, but whIle it IS ill it cannot be, and should not be, punished or .have its faults corrected. The nurse needs real patience in these cases, but she will be amply rewarded when her little patient, responding to her care. a,nd standing sympathy, learns to giv e her obedience, and all its nau ghtiness yields to affectlon.

breathin g, it may be that there is trouble in the air passages.

(4) If the child is on its stomach (prone) with the face pressed into the pillow or on its back (supine) with the legs drawn up, one would suspect abdominal trouble.

The nurse must note any chan ge in the child's .complexion and in its expression. Both will give indications of any change in its condition.

When be g inning an illness children are apt to be peevish and cross and "difficult." The intelligent and sympathetic nurse will realise the cause of their ill-humour a nd seek to alleviate it If she is strange to the child she will need tact and resourcefulness to win its confidence at this stage, when it naturally 77

A child's nurse must be cheerful and optimistic. 'The psychological effect on the patient is very :-narked of a gloomy, pessimistic nurse, not to the unhappiness caused to the parer:ts fnends interpr et the nurse's moods as Indicatlllg a serlOUS view of the case.

It is most important that a nurse should study the temperament of her patient as well as make herself acceptable t o the household. Here agair: her ne ss is called into play. She has too the hIgh p!!vllege and function of bringing hope and courage, patience and o-allant endurance into action if she herself is wise,Osympathetic, full of hope for the faith in the treatment, and knows how to 1nspue these qualities in others.

'i,

The Grand Priory in the British Realm of the Venerahle Order of the Hospital of St. John of Jerusalem

His Majesty the King has been graciously pleased to sanction the following Promotions in, and Appointments to, tht Venerable Order of the Hospital of St. John of Jerusalem :-

FOR PROMOTION TO THE GRADE OF DAME GRAND CROSS

The Marchioness of Bute, D.RE. (from Dame of Justice).

FOR PROMOTION TO THE GRADE OF KNIGHT

The Viscount Nuflield, O.RE (from Commander),

Major-General Ernest William Charles Bradfield C I. E., O B.E., KH.S., I.M .S (from Commander).

H.E. Sir Mark Aitchison Young, KC.M.G. (from Officer), Governor of Tanganyika.

Lieut.-Colonel Sir Herny Mulleneux Grayson, Bt., KB.E. (from Co=ander).

FOR PROMOTION TO THE GRADE OF DAME

Margaret Elizabeth, Lady .'I,.nn st rong·Jones (from Commander).

FOR ADMISSION IN THE GRADE OF CHAPLAIN AND APPOINTMENT AS SUB·PRE LATE

The Rt. Rev. William Thomas Havard, M.C., Bishop of St Asaph

FOR PROMOTION TO THE GRADE OF COMMANDER (BROTHER)

Bertram George Sandys B e las L.RC.P. & S.I. (from Officer).

George Edward Kingsnorth (from Officer).

Major Robert Lindsay Loyd, O.B .E., M.C. (from Officer).

Captain The Hon James Moncreiff Balfour, O.B.E (from Officer)

FOR ADMISSION IN THE GRADE OF COMMANDER (BHOTHEH )

Sir Frank Henry &water.

FOR ADMISSIClN IN T HE GRADE OF COMMANDER (SISTER)

Lady Muriel Barclay·Harvey

Josephine Mary, Lady Young.

Ethel Anita, Lady Bowater.

The Lady Wakehurst.

The Duchess of Beaufort.

FOR ADMISSION IN THE GRADE OF ASSOCIATE COMMANDER (SISTER

Madame Peggy de Gripenberg.

FOR PHOMOTION TO THE GRADE OF OFFICER (BHOTHER )

Gilbert Hill (from Sen>ing Brother)

Arthur Philip GIbbons, M B., M.RC.S. (from Serving Brother).

William Leonard Pollock (from Serving Brother).

Reginald Ringham (from Serving Brother).

Sidney Cooper (from Serving Brother).

Ernest Benjamin Brown (from Serving Brother)

Captain William James Hutchinson (from Serving Brother).

Edward John Herrington Budge, L.RC.P. & S. (from Honorary Associate).

Ernest Jesse Prew (from Serving Brother).

Joseph Alwyne Ilott (from Serving Brother).

FOR ADMISSION IN THE GRADE OF OFFICER (BROTHER )

Colonel Walter Angus Mulier.

Captain Alasdair Hew lain Fraser.

Charles Edward Westbrook, O.B.E

Lieut.-Colonel The Lord Wyfeld, D.S.O., M V.O.

1.ieut.-Colonel Norman Hillary, M.C., T.D.

William Allen Daley, M D., F.R.C P.

Captain Archibald Frederick Hordern, A.F.C.

Captain Russell Vyvyan Steele, M.B., late RA.M.C

Colonel Herbert Anderson Cape, D S .O.

The Hon. Denys Burton Buckley.

Colonel William Francis Henn

Ernest Cordley Bradford, M.B., M.RC.S.

Lient.-Colonel Sir Charles John Howell Thomas, KC.B., K.C.M G., T.D

FOR ADMISSION IN THE GRADE OF OFFICER (SISTER)

Mrs. Jane William.s.

MIs. Gwet;ldoline Nita Wallace.

FOR ADMISSION IN THE GRADE OF SERVING BROTHER

Cyril Searle Gideon, M.D., M.RC.S

Robert Askew, O B.E.

Christy Gribble.

Arthur Joseph Hale

Captain Henry Edward Cooper.

Louis Yewdall.

John Strickland.

Gavin Muir, M.B.

James William Wes moreland.

John Joseph Scarth.

James Eli Trickett.

'Herbert Leonard Gregory.

Mrs.

FOH ADMISSION IN THE GRADE

Chesterman.

Mjss Marion Sergeant Stow.

Miss Phyllis Annie Dowdall.

COMMANDERY IN SOUTHERN AFRICA

FOR PROMOTION TO THE GRADE OF KNIGHT

Colonel Eustace H enry Cl uve (fro m Commander).

FOR PROMOTION TO THE GRADE OF COMMANDER (BROTHER )

William James Kinlay Skillicorn (from Serving Brother).

FOR ADMISSION IN THE' GRADE OF COMMANDER (BROTH E R )

Adrian J obannes van der Spuy, V D., M.B., D P H.

FOR PROMOTION TO THE GRADE OF OFFICEH (SISTER)

Mrs Edith GoldSbury Slade (from Serving Sister).

FOR ADMISSION N TH E GRADE OF SERVING BROTH ER

Charles George Boo ke r, M.B. Abraham Joh annes Coetzee.

E rnest oh n Hamlin.

Arthur James Rowles

FOR ADMISSION IN THE GRADE OF SERVING SISTER

Mrs. Edith Hollon Mowat.

COMMANDERY IN NEW ZEALAND

FOR ADMISSION IN THE GRADE OF KNIGHT

Sir Rob ert Albert Anderson, C.M .G

FOR PROMOTION TO THE GRADE OF OFFICER (BROTH ER)

H erb ert Augustus Robert Huggin (from Serving Brother).

FOR ADMISSION IN THE GRADE OF OFFICER (BROTHER)

George Alfred Maddison.

FOR PROMOTION TO THE GRADE OF OFFICER (SIST ER)

Miss Frances L elia Cooper (fro m Serving Sister).

FOR ADMISSION IN T H E G RADE OF SERV I NG BROTHER

Cyril Edgar Heapby

Percy CcIEns Wilkinson

Clarence Meachen.

Keith Alexande r Falconer.

FOR ADMISSION N T H E GRADE OF SE RVING SISTE R

Mrs. Margaret Wilson.

Mrs. Margaret Lambto n Gibb.

INDIA

FOR ADMISSION IN THE GRADE OF OFF I CE R (BROTHERI

Colonel Thomas Crawford Boyd, M RC.P F.RC.S. D.P.H I.M S Lieut.- Colone l Alister John Ransford, C.I.E ., R. E.

FOR ADMISSION IN THE GRADE OF SERVING BROTIIER

Lieut.-Col onel Hobert Forrester Douglas MacGregor, M.e., M.B., M R.C.P., I. M.S. BURMA

FOR ADMISSION IN THE GRADE OF SERVING SISTE R

Mrs Florence Lillian Beaman.

AUSTRALIA

NEW SOUTH WALES

FOR ADMISSION IN THE GRADE OF SEHVING BROTHim J ohn Kerr, M B.

FOR ADMISSION IN THE GRADE OF SEJ<VING SISTIrR

Mrs Aida Poate.

Mrs. Ada Beveridge.

VICTORIA

FOR ADMISSION IN THE GRADE OF OFFICEH (BROTH ER

Allan Robert Stanley Vicke rs, M.B

Ralph Jackso n Coto, M.B., B.S., F.RC.S.Ed.

CEYLON

FOR ADMISSION IN THE GRADE OF OFFICER

Mrs Freda Pickering.

FOR ADMISSION IN THE

Mrs Ka te Beatrice Bruce GRAD E 0F SERVING SISTER

R 'ed Cross and St. John War Organisation

(Continued from page 70, March issue)

FRENCH RED CROSS

The Exe cutive Committee has approved of a donation of £ 1,000 being made from the funds of the War Organisat ion to the French Red C:r<;>ss. It is intended as a mark of the deep appreCIatiOn felt by the War Organisation for the service which the French Red Cross are rendering in many ways to the members of the British Expeditionary Force. In particular, the Executive Committee had in mind the valuable work being carried on by the French Red Cross for British troops in canteens and at railway stations

FROM THE SUDAN

From Khartoum comes a letter from the Honorary Secretary of the Red Cross Society in the Sudan. She writes that at the beginning of December last as the result of an appeal for the Lord Mayor's Red Cross and St. J OM Fund she had sent as a first i nstalment the sum of £1,75°. The feature of the response was that although no direct invitation to contribute was made to other than Europeans, onethird of the amount was given spontaneously by the Sudanese.

Great pleasure 'Vas felt by the acknowledgment made through the British Broadcasting Corporation In English and Arabic, subscribers in distant and isolated places in the Sudan being in this way directly informed of the receipt by the Lord Mayor of their donations. By the end of January, the response had increased to nearly £4,000.

COMFOR TS AND COLLECTIONS

Over 3,000 gifts were received during the last two weeks of February. They included twO invalid chairs and a number of thick dressing gowns and ward slippers. Another bale of blanket felts came from Messrs. Matthew Walker, and Mackenzie Traders sent ca1pet squares.

The Pardess Syndicate of Palestine Citrus Growers has presented fifty cases of Jaffa oranges . British women in Bahrein on the Persian Gulf, having with some difficulty secured wool from Australia, have knitted a number of comforts, which are on their way to this department in a merchant ship, the captain of which is meeting the freight charge on them

Slippers used in the Canadian Hospital at Orpington, Kent, .in the last war gave so much satisfaction that Canadian soldiers in hospital in Canada are requesting slippers of the same type. Patterns have been obtained and are on their way.

Tinfoil when mixed with metals is used in modem aircraft and naval CO!tl&t.J;uction and as an ingredient i n shell -resisting stee l. Collectors are asked not to screw it up in a tight ball: Sheets shou ld be spread

79

out flat and pla ced one on the other. When a convenien t number has been collected the sheets can be folded.

PLEASE NOTE

The Trained Nurses Department i s no longer at 7, Belgrave Square. It has moved into new offices at 15, Grosvenor Crescent, S. W. 1. Its new telephone number is Sloane 515 I. Lord Stanmore and Mr. Wells have also moved from Belgrave House to 15, Grosvenor Crescent. The Enquiry Department is now accommodated in much more convenient and suitable offices at Nos. 14 and 15, Grosvenor Crescent. Telephone: Sloane 51 5I and 5191. Callers will find a commodious waiting room provided for them.

CENTRAL HOSPITAL SUPPLY SERVIC E

During the last two weeks February 29,6.9 2 articles made from Central HOSpItal Supply Serv1ce materials were received Gifts numbered 64,63 I articles. Among them were blankets, scarves, tens and bed socks made by children of five to eIght years of age attending Longford Church of England School, Coventry, from wool purchased out of saved pennies.

A number of articles have been sent through the East London Branch of the South African Women's AuxiLary Service.

A BOOK HOSPITAL

There are at present 3,000 books which need rebinding and mending, and the number increases each week. To meet the problem a room is being set apart in Belgrave House as a book hospital. It will be staffed with one professional binder and a number of volunteer workers. In this way, it is hoped effectively to deal with casualties.

NEEDS OF HOSPITALS

Captain Malcolm Bullock has returned from his visit to the B .E.F. and the Department is now better acquainted with the needs of the men in hospitals for books and the d.ifficulties to be overcome in meeting them Field Ambulances, Casualty Clearing Stations and Re ception Stations require a regular supply of magazines, illustrated papers and papercovered books of the "Penguin» type. Books are for base hospitals, and in these institutions steps are being taken to build up goo d and varied libraries with someone to take charge.

The Under-Se cretary- General of the Australian Red Cross Society, Melbourne, writes: "We have found , The Summary of Work' very useful and valuable. We sh ould be most gratefu l if you could let us have two comple t e sets of those issued to date and include us in your mailing list for future issues."

ApPEAL FOR AMBULANCES

Lord Iliffe announced that the Director-General of Medical Supplies in France had informed the War Organisation that he would welcome 125 fully equipped ambulances for use in France. A grant of £40,000 had been made for the purpose of providing 75 ambulances complete with staff, · and an appeal would shortly be made to firms, cities and individuals to raise the cost of the remaining 5o. The cost of a complete ambulance is £550 and the name of the donor can be displayed on a plaque placed prominently on each vehicle.

CENTRAL HOSPITAL SUPPLY SERVICE

The number of articles received during the first two weeks of March, fr<:Jm materials supplied by the Central Hospital Supply Service, is ,5,448. Gifts during the same period totalled 58,963, Consignments have been received from Basle, Geneva, Brussels, Malaya, Montevideo, Antwerp; Buenos Aires, New Zealand, Norway, Washington, Shanghai, Peru and St. Johns, Newfoundland.

A Ministry of Health order for bandages has been completed. The regions are to be congratulated upon the manner in which the work has been done.

COMFORTS COLLECTIONS

Three thousand gifts have been received during the first two weeks of 1\1.:arch. Contributions in kind have come from Slazenger's and from Dunlop'S. Miss Florence Desmond has sent a further parcel of knitted comforts made by the chorus girls during their rehearsals. A splendid parcel-the third-has come from the Mansion House Work Party. A big consignment has also come from the Cambridge Red Cross Comforts Dc;pot.

WAR ORGANISATION DISPLAY

The thirtieth Annual Hospital, Nursing, Midwifery and Public Health Conference and Exhibition is being held under the auspices of the Nursing Mirror from April 8 to 12 inclusive at the New Horticultural Hall, Westminster, Lundon, S.W.l.

This year the Exhibition is being held in close collaboration with the Red Cross and St. John War Organisation, who will stage a large and interesting display, indicating departmental activities. All profits ftom the Exhibition will go to the Red Cross and St. John Fund.

DISTINGUISHED PATRONAGE

For many years this Exhibition and Conference has enjoyed royal patronage. Her Highness Princess Marie Louise, c.l., V.A., G.B.E., is Patron, and will open the Exhibition. Princess Marie Louise, who is a granddaughter of Queen Victoria and daughter of Pdncess Christian, has for many years taken a thoroll gh and active interest in nursing and kindred matters.

In addition, the Medical Directors-General of the

VALUABLE LECTURES

The Exhibition, with its carefully arranged and graduated series of lectures, all by acknowledged authorities, offers a splendid opportunity to all nurses and nursing auxiliaries to further their knowledge in some particular branch of the science in which they are primarily interested.

WARTIME NURSING

A special feature this year wilt illustrate wartime nursing. A diorama will demonstrate the organisation by which a wounded man passes from the front line to a home hospital, and Dr. Gerald ParsonsSmith, who is engaged in the Blood Transfusion Service, is arranging a display showing modern metho'ds of blood transfusion by means of the Government apparatus.

All members of the medical and nursing professions are invited to free admission to the Exhibition by ticket which will be supplied on application to :

The London Nursing Exhibition, Dorset House, Stamford Street, S.E. 1. In applying, the status in the medical or nursing world of the applicant should be indicated. Please mark your envelopes C( Nursing Exhibition."

OVERSEAS NEWS

CEYLON

COLOMBO

The following is a short extract from the report of the Inspector-General of Police for the 12 months ended September 30 1939 :-

Total strength of the Ceylon Police Corps of the St. John Ambulance Brigade is 2,331. A total of 1,748 certificates and awards of the Royal Life-Saving Society have been gained by members.

Medical Officers throughout the Island have been most helpful in taking Classes in First Aid, in holding Refresher Courses and in holding annual re-examinations. The brunt of this work falls on the Pollee Surgeon (Dr. S, F. Wickremasinghe) in Colombo. Some idea of the work involved may be gathered from the fact that this year the Pollee Surgeon has held Courses of Instruction for 171 members of the Force to enable them to gain the First Aid Certificate on first appointment, has put 600 members of the Force throu gh Refresher Courses and re-examined 9°5 men who hold First Aid Certificates. This work is entirely outside the scope of the ordinary duties of the Police Surgeon.

As in past yeafs Captain W. T. Brindley, assisted by Mr. C. Weerasuriya, has been responsibie for the organisation of the annual training and re-examination.

80 Royal Na'; y, the Army Medical Services and the Royal Air Force Medical Service, have extended their patronage for the first A number of distinguished authorities on nursing, health and hospital matters will lecture, includin g Dame Beryl Oliver.

The St. John Ambulance Brigade News

No. (PRINCE OF WALES'S) DISTRICT

THE ORDER OF ST. JOHN A!'JD BRITISH RED CROSS SOCIETY

The Sub-Prior, Major-General the Earl of Scarbrough, desires that the relationship between the above shall be clarified and made known to all officers and members of the Brigade.

1. As regards Precedence. The" Order" is the senior member of the Red Cross Organisation. In times of peace the badge of the Order will take precedence. In times of war, the Red Cross, which is the badge of the Society, is the only emblem rec ognised under the Geneva Convention, and both bodies, therefore, work under it. Following the last war it was agreed that the B.R.C.S. should take precedence during times of war, while the order takes precedence in peace times.

2. As regards D ivisions. When it was seen in 93 8 that a very great call would be made for First Aiders, which either body separately would be unable to meet, it was decided to suspend the agreement under which each body refrained from starting units in localities where the Order was sufficiently represented.

No. 2 (Haggerston) Division held a successful concert at their Divisional Headquarters on February I2 in aid of Divisional Funds In a speech during an interyal, the Mayor of Shoreditch, Councillor T. J. Sillltoe, J.p., expressed appreciation of the invaluable help given by this Division to the Shoreditch Borough Council A.R.P organi sations.

* * *

We congratulate Superintendent Stitcher (No. 30 East London) Division and his family on what we believe is a record of Brigade service. Superintendent Stitcher has been a member of his Division since 1902. Mrs. Stitcher is Lady Vice-President of the No. 76 (East London) Nursing Division. She holds a first aid certificate and is at present attached in a voluntary capacity to the 1;.,ondon Hospital F.A.P. Their three sons are all members of No. 30 East London Division. A photograph of the family appears on page 83.

No. 2 DISTRICT MINEHEAD

The annual dinner of the Minehead Division was held recently. Dr. W. Bain (Senior Divisional Surgeon) presided. Others present included Mr. G. F. Luttrell (President), Colonel O. N. Moriarty, b.s:o. (Area Organiser A.R.'P.), Captain F. Glanville (Assistant Organiser A.R.P.), Dr. H. M. Chappel and Divisional Officers.

The toast of "The Minehead Division" wa proposed by Mr. Luttrell, who assured the company that he was very proud to be their President, b ecause the Division was one of the most efficient in the country, and he considered this condition was due, to a great extent, to the help and inspiration given by Dr. Bain. He concluded by \vishing the Division every success in the future.

Superintendent F. C. Tarr responded.

The toast of " The Guests" was given by Sergeant L. W. Harrison, and replied to by Colonel Moriarty, who spoke of the work of A.R.P . organisation. " You have done an extremely good piece of work," concluded Colonel Moriarty. "Stick it to the bitter end and you will reap a good reward in knowing that you have behaved as men."

The evening concluded with a musical entertainment.

No . 3 DISTRICT (EASTERJ."J) NORTHAMPTPN

The following is an extract from the Annual Report (I939) of the Northampton Corps :-

First Aid was rendered to 5,040 cases-an increase of I,537 over the previous year . Work generally has been very heavy, especially with the Motor Transport; Northampton, Daventry and Towcester covered a total of 23,986 miles, and in the process dealt with 2,796 removal cases and 304 accidents.

The increased calls on the Transport Services has called for extra duties from members, and it is pleasing to report that since the outbreak of war, an additional driver and attendants with an officer in charge have been on night duty vo luntarily at Headquarters. '

The Transport Committee desire to place on record their appreciation of the voluntary services rendered.

The strength of the Corps, which has increased by I02 members during the twelve months December 31, 193 8, to December 3I, I939, is 369.

LUTON

The first informal supper of the Vauxhall 11otors D ivision took p lace recently, with Superintendent R. R. Hunter in the chair. Captain Knight (County Commissioner, Bedford) was the guest of honour.

Mr. C. J. Bartlett (Managing Director of Vauxhall Motors) proposed th,e health of the Brigade, coupled with the name of Captain Knight, after it had been announced that 1\1r. Bartlett had ag reed to become the Division's first Pres ident

In his speech Mr. Bartlett said that it have been impossible for Vauxhall to organlse an ..

scheme (recently praised by Wing Commander Hodsell, Inspector-General of A.R.P. for the Home Office, as one of the best in the country) without the help and the good counsel of the St. John Ambulance organisation.

The health of the Vauxhall Division was proposed by Area President Sir Thomas Keens. lvlr. Hunter replied and reported that attendance at drills in I940 had averaged 92, that 4I public duties had been carried out, and that 226 had secured First Aid certificates since the beginning of last year. He said also that the management of Vauxhall Motors had decided to assist towards the equipping of some 60 officers and men with uniforms, and that this would also apply to the newly formed Nursing Division under Miss Wilson.

After the toast of "Vauxhall Motors' A.R.P. Organisation" had been proposed and replied to, the County Commissioner presented a Long-Service Medal to Private C. Pearce.

Orchestral and vocal items brought a most enjoyable evening to a close.

HINCKLEY

The Hinckley Division recently held their 'Annual Dinner and Meeting. Councillor F. Burton presided, in the absence of the President (Mr. A. J. Pickering) and Vice-President (Mr. G Jenning.)

The following are extracts from the reports of the Superintendent and Transport Officer: The strength of the Division was 62 officers, N.C.O.s and men Cases reported, 3,444. Public duties fulfilled at all out-of door functions and cinemas. First Aid lng for A.R.P. personnel was five full courses and seven short courses. A total of 9 6 calls had been received entailing some 7,500 miles Ten members were serving with the R.A.M.C.

In the Nursing Division the personnel totalled 34 officers and Nursing Sisters. Public duties were fully maintained, also attendance at Hinckley and District Hospital.

Awards included 214 certificates in First Aid and Home Nursing. Two Nursing Sisters were on active service.

In his address, Mr. F. Burton expressed the thanks of Hinckley residents for services rendered and for the valuable and ready response of all ranks to take on A.R.P. duty and to teach other A.R.P. sections first aid.

During the evening ex-Divisional Superintendent A. T. Mehew was presented with a gold-mounted walking cane on his transfer to Reserve after 3 5 years service as Divisional Superintendent NO.5 DISTRICT (NORTH-EASTERN)

GRIMSBY

The Annual Dinner of the Grimsby Corps was held. on 1vIat'ch 7. Corps President M. Morgan preSIded. Among others prese,nt were the Vice -

82

President (Mr. G. Bartle), Corps Superintendent J. H. Theaker, Lady Superintendent L. Doughty, the Mayor (Councillor G. H. Spavin), Police Superintendent Dolby and Dr. W. Hartston (lvledical Officer of Health).

Awards and prizes were presented to members by the President.

THORNTON

About fifty members of the Thornton Division were present at a supper and social held recently. Corps Sergeant-Major J. Hill was the guest of the evening.

Divisional-Superintendent F. Carr reviewed th e work of the Division-formed only six months agoand said it was highly satisfactory, that members were co-operating splendidly, and that the fact that 20 out of 22 new members had passed their examination for first-aid certificates was excellent proof of their efficiency.

In presenting Divisional Surgeon Dr. \"i/. N. Blackmo re with an inscribed cigarette box, on behalf of members, Superintendent Carr paid tribute to the help and advice given b y him to members of the Division.

An oak timepiece suitably inscribed was presented by Corps Sergeant-Major Hill to Superintendent Carr to mark the appreciation of members for his efforts in forming the Thornton Division.

No. 6 DISTRICT

MIDDLESBROUGH

At the Annual General Meeting held recently Divisional Surgeon F. W. Hebblethwaite presided.

In declaring the meeting open, the Chairman welcomed the County Commissioner (F. P. Wilson) and thanked him, on behalf of members, for the interest he had shown in the Division.

The County Commissioner complimented th e Division on their work during the past twelve months, also the high standard of efficiency they had maintained , despite the heavy call of duties they had had to fulfil.

The total membership of the Division is 130, of which 30 are probationers.

The Long-Service Medal was presented to Ambulance Officer E. Fellows by Divisional Surgeon F. W. Hebblethwaite, and County Commissioner F. P. Wilson presented 23 labels, 3 medallions and two vouchers to members.

BLYTH

Recognition of her long and meritorious service in the Blyth and District Nursing Division was paid to Lady Ambulance Officer Miss M. A. Kelsey when, at a recent social evening held by members, she was presented with the insignia of Serving Sister of the Order .

The ceremony was performed, in the absence of Lady County Officer Mrs. Anderson, by Lady Di v isional Superintendent Miss M. Poulter.

Miss Poulter referred to Miss Kelsey's 30 years' splendid service in the Order and sai d it was a great pleasure for her to hand over the insignia.

Miss Poulter also presented to Miss Ella Soulsby the Service Medal in recognition of 15 years' efficient service in the Divi sion.

No. 8 (DUKE OF CONNAUGHT'S DISTRICT)

GurLDFORD

March 3 marked the 50th anniversary of the formation of the Guildford St. John Ambulance Brigade,

foun ded by Dr. R. F. Ru ssell and Mr. Hartin Williamson. It had been intended to organise a big review to celebrate this interesting jubilee, but the celebration had to be postponed until more normal times.

An annual report of the Guildford Brigade , dated 1892, and probably the first published, shows that in the year under review the.bri ga de moved 35 patients, travelling 85 Hules with hand-litter in the performance of the duty, and the total monetary turnover in that year was £24. By way of comparison, the Brigade turned out 94 times during a recent week, and the year's turnover to-day is nearly £3,000.

A very charming letter has recently been received by the Corps from the Duke of Connaught who,

slnce 1920, has been the Pre side nt, congratulating them upon the excellence of their annual report. The Duke had also sent a fine autographed photograph of himself, which has been placed in the Corps' headquart ers.

HOR SHAM

An informal gathering was held recently at the Headquarters of the Nursing Divis ion.

Among those present were: The Countess of Bessbor oug h (Hon. Lady County Preside nt) , Miss E. p. Biddulph (Lady Superintendent), Miss Hubbard (the newly-appointed Lady District Officer), and Mrs. M. C. Lancaster (Hon President).

In the absence of Assistant Commissioner David Bryce, Miss E. P. Biddulph presided.

Lady Bessborough, replying to a spee ch by Miss Hubbard, who presented her with her Warrant of Office, thanked those present for the honour they had done her in coming to the meeting, and said: "I have always been interested in the work of the St. John Ambulance Association, and whilst my husband was Governor-General of Canada the Ambulance Bri gade was started in that countr y, so we saw a grea t deal of its excellent work." Lad y Bessbotou gh concluded b y saying : " I shall alway s do everything I can to further the interests of the Brigade in this country of West Sussex."

Lady Bessborough then presented the Warrant on appointment as Lady Ambulance Officer tQ Mrs. Shelley.

Two members of the Division, Miss W. Foster and Miss D. Weatherley, were presente d with medallions by Mrs. Lancaster, who afterwards received her Badge of Office from Lady Bessborough.

o. 9 DISTRICT

WEYMOUTH

The annual presentation of awards to members of the Nursing and Cadet Divisions took place on March 21. Dr. Cooper (Divisiona l Surgeon) presided. Others present included r.ifrs. Cooper (Lady County Superintendent), Mrs. Davison (Vice -President), and Mrs. Bartlett (Lady Divisional Superintendent).

The following is an extract from the Secreta1')I" s report for 1939 : Personnel, 57; I, I 90 cases treated; 699 public duties; 621 hours hospital dut y; 47 Divi siona l meetings. Total number of awards gained was 152. Members had staffed the First Aid Post since September I and had assisted with evacuees.

The Lady Cadet Superintendent stated that there were 2I Cadets and 10 Probation ers. The two outstanding events of the year had been the winning of the County Competition (Martyn Cup) and the qualifying of eight members for the Grand Prior badge.

The awards were presented by Mrs. Cpoper and Mrs. Davison.

Interesting Case Reports

CASE REPORT No. 16z.-:-The Officer-in-Charge of Central Area No. I (Pnnce of Wales's) District

S.J.A.B. reports the efficient performance of first aid by a member of No. 30 (East London) Division in the following circumstances:-

On December 5, 1939, Private Eric M. Stitcher :vhile visiting a City house on business, was called lDto a workroom where he found that one of the employes had accidentally pushed his hand throuah a pane of glass and was bleeding profusely fromb a ws>und of.the right forearm consequent on severance of the radial and ulnar arteries.

Imme.diately :levating. the injured limb and seating his patient Pnvate. .StItcher applied pressure by flexlOn at the elbow JOIDt and controlled the bleeding. He then dressed the wound, treated the patient for shock and arranged for his removal to hospital, wher.e he was congratulated b){ house surgeon on his successful treatment.

COMMENT.- Words oj praise from the doctor who takes charge of the case are alwqys a source oj pride and to a first aider. On this, therefore, and also on hzs and treatment of the patient we tender cordtal congratulatwns to Private Eric M. Stitcher.N. C. F.

CASE REpORT No. 163.-The Officer-in-Charge of t.he County of Cambridge S.J.A.B. reports the effiClen.t performance of first aid by a member of the Cambndge Cadet Division in the following circumstances :-

On 7, 1939, Cadet Sergeant D. Ralph was cycling to school when, in Emmanuel Road he saw a lady fall from her bicycle riaht in front a motor bus which passed over both b her lower limbs. He at once went to her assistance and found that her leg was crushed the knee, the injury beIng by severe arterial bLeeding, and also that her nght leg was fractured. As the patient was conscious and rolling herself to and fro, Sergeant Ralph at once asked two men to keep her quiet while he applied digital pressure to the left femoral artery. He kept up pressure for six minutes before the ambulance arrived in answer to his call. Then, having assisted the ambulance attendants to complete the necessary attention to the patient, he cycled off to school.

COMMENT.-It is pleasing once again to record good w.ork well done by one of our junior members, if onlY because on our Cadets rests the future welfare of the Brit,ade. these Sergeant D. Ralph cordtal congratulatzons on hIS prompt and efficient he prevented further aggravation of his patzent s z"!Jurzes and perhaps preserved her life.-N. C. F.

Questions and Answers

FIRST AID IN MATERNITY EMERGENCIES

G. E. (Twickenham).-Some members of this Division have enquired (I) as to the position of; and procedure to be adopted by, a Brigade member who may be called upon to attend a case of childbirth in the street or in a public place, no medical attention being immediately available.

.cases have recently been reported in the Press; and It IS suggested that cases of this nature might occur during possible air-raids.

Also (2) I would be grateful for your advice as tc or Brigade contemplate g1VlDg any lDstructIOn in this connection as, I understand, is given by other organisations. Consequently, I wonder if it would be in order for this Division to arrange for instruction to be given in emergency treatment of such cases by our Divisional Surgeon.

Please accept our thanks in anticipation of your kind help.

(I) As you state, such cases do occasionallY occur, and the real danger is from meddlesome interference Th e patient skould be kept in recumbent position and 1varm/y wrapped zn blankets, due attention being given to the child who might quite easilY be suffocated. Then, if medical aid is not available, patient should be placed on a stretcher and lifted into the ambulance, care again being taken to protect the child.

The delivelY is natural, though precipitate,. al1d the of serious hcemorrhage are not great, though those of sepszs mqy be greatfy accentuated by the circumstances.

Las tfy , if the need should arise for a male first-aider to treat. and accompany such a patient during transport to hospztal, then common sense suggests that, in the absence of a friend oj the patient, he should appeal to a woman zn the crowd to render tvhat help is required both during treatment and transport.

(2) Hist01Y disproves the insinuation contained in your second query! Far from discouraging nursing in m!)l form, the since its foundation has .rystematical(y encouraged tts stucfy and pracftce. In 1884 it introduced a regular course of training (eight weeks) in Distrz'ct Nursing at St. John's House, Worcester, and supplemented this in 190Z a si:nilar course at Chelsea Infirmary. Further, zt zmtzated zn 1902 a course oj training in Cottage and Maternity Nursing and issued certificates after examination to "women of the working class jvho were between the ages of 22 and 45 and 1vho held its first aid and home nursing certificates."

_ courses lapsed when, in 191 I, the NJlrsing Dzvzs:ons. of the Bngade. commenced training in Hospital Nurszng zn London and zn the Provinces, though it tvould appear that at no time was there any real demand by lqy persons for training and certification in District, Cottage or Maternity Nursing.

Circumstances have altered since those earfy dqys, and

legislation in tbis cOJlntry bas graduallY tended to probibit the practice of all professions except by qualified exponents thereof and to place each in charge q! its own official Board of Control. In recent times strict latvs have been passed with reference to Midwifery, andyou can now see that if the Association 01" Brigade 1vere directfy to re-institute or indirectlY to recognise a Midwife1Y Course, thry would at once e:x;pose themselves to prosecution for defying the laws 1vhich have led to the disappearance of the old-time unqualified "Maternity Nurse" immortalised in exaggerated fashion as " Sarah Gamp.1}

Nevertheless, it is open to the Surgeon of any Division of the Brigade at his (or her) discretion to conduct a s eries of talks on this subject so that their members mqy deal confidentlY with maternity emergencies Sh014ld the need arise; and, finallY, I knOJv several Division.) in which this haJ been done.-N. C. F.

TREATMENT OF CARBOLIC ACID POISONING

A. H. (Croydon).-At our First Aid Post a trained Nurse gave a lecture and asked us questions on poisons and the treatment of same. She would not accept Epsom or Glauber salts or even cold water as the treatment for Carbolic Acid or Lysol poisoning, saying that the salts would act as an emetic and the water would make the acid boil. Her treatment was to lave the stomach (tube and funnel) with a demulcent. I would like your opinion of this.

All these statements-whether actualfy made or merelY misunderstood-are contrary to fact. Epsom and Glauber salts do not act as an emetic, Carbolic Acid or Lysol added to water does not cause the 1-Vater to boil, and lavage of the stomach with tube Clnd funnel has no place in first aid treatmmt.-N. C. F.

FRACTURES OF RIGH:r CLAVICLE AND LE FT SC APULA

G. W. (Durham). - In our Division there has arisen a wide discussion as to the correct treatment of simple fractures of right clavicle and left scapula. As we cannot agree, we ask your kind help. .

With af!)1 combination of injuries it is, in my opinion, good first aid, fint, to give priority to the more serious and, to treat each separatelY as far as is possible, if onlY because such action facilitates examination of the patient 0' the doctor who takes charge oj the case.

Acting on this principle, therefore, and regarding the fractured clavicle as the more serious irgury I 1-vould remov e the patient's coat and then bandage the left upper limb (fl.exed at the elb01v) to the trunk. This done, I would deal tvzth the 1"ight clavicle as laid d01-vn in the Textbook. Incidentalfy I have stressed the importance of remov ing coat. because the axillary pad loses its if placed outszde the coat.-N. C. F.

COMPOUND FRACTURE OF HUMERUS

.G .. W. (Durham).-Similarly the members of our DIVISIOn cannot agree about the way in which a compound fracture of the humerus should be treated and would much appreciate your ruling and advice.

Your in thiJ matter is not clear. With this combination of irgttries you have a wound and a Jracture.

So, as the Textbook: (p. 127) teaches, you shot-Ild first

expose and dress the wound. This done, you would proceed to deal with the humerus-be the fracture close to the shoulder, near the middle of the shaft or involving the elbow joint-as is laid down in the Textbook (pp. 82-84), PULSE T AKING WITH THUMB

S. W. (Manchester).-Please tell me (1) if it is true that the pulse is usually slightly stronger on the right side than on the left; and (z) why the thumb is not used to feel the pulse.

(I) The pulse is usuallY qf the same strength in the right and left radial arteries. Occasionalfy, however, differences are noted, these being due to the fact that one artery is much smaller than the other. -

(2) Ifyou place your hand flat on the table, you will find that the th'umb is tilted towards the fingers at an angle of 45 degrees. Th i s peculiar relationship, therefore, causes you to feel the pulse in your O1vn thumb if you attempt to take a patient's pulse with your thumb, and so spoils the result oj yotlr investigation.-N. C. F.

ACTION OF PRUSSIC ACID

C. S. (Old Trafford).-I understand that prussic acid is not a corrosive poison in spite of its name. If this is so, please tell me what type of poison it is and how it acts.

The T extbook (p. 170) tells you that prussic acid is a convulsant (or potent nerve) poison and that it "acts on the nervous .rystem throttgh the blood circulating in the brain ."

It is so called because it was first obtained from prussian blue and is peculiar il1 that it produces its effects whether inhaled, s1-val101ved or applied to broken skin and mucous membrane. As a powerful nerve poison it mqy rapid(y cause parafysis qf nerves, of brain cells (including the centres 1vhich control respiration and circulation) and of heart muscles.-N. C. F.

OF DI SLOCATED ANKLE

H. C. (Morden).-At our First Aid Post we have had much discussion as to the treatment of dislocation of the ankle j oint. One side maintain that we should treat as for a fracture of the leg as on page 92 of the Textbook and the other side treat for a crushed foot. I should like to have your opinion on this matter in THE GAZETTE.

I have nothing to add to the instructions on p. 96 of th e Textbook .-N. C. F.

INSENSIBILITY WITH FRACTURED BASE

F. M. (Canterbury).-In the case of a patient who is unconscious and is suffering from fractured base of skull or jaw, is it possible for blood to run down into the stomach and afterwards to be vomited thus simulating the signs and sym ptoms of from the stomach? Your kind rUM a on this point will be very welcome. ::J

You overlook the factJ that during insensibility nothing can be swallmved and passed into the stomach and also C ontimted Oil page 90

Priory for .Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

STRIKING INCRE ASES RECORDED FOR 1939

Considerable expansion in the principal actIvltles of the Priory for Wales is reflected in the summaries recorded at the close of the past momentous year.

First, the Association Department shows an increase of nearly 75 per cent. in the number of First Aid and Home Nursing Awards gained, the total of 27,594 being II,226 higher than the figure for 1938. With the one exception of the Rhondda every centre of the Priory contributed to this total; and the number of classes held during the year rose to 1,584 from 1,027 in 1938. The number of students who attended courses of instruction without necessarily sitting examination totalled 32,3 5, as against 18,908 for the previous year.

The membership of the Brigade in Wales increased b y 1,640 to 12,794 as at December 3I last. The figure comprises 7,142 men, 2, 029 women, 3,270 boys and 1,393 girls.

The Motor Ambulance Transport Department records a total of 22,446 cases carried, involving 351,756 miles travelled, which are 2,685 cases and 38,762 miles more than in 1938.

From the 94 Medical Comforts Depots operating under the Priory, 11,4 52 articles were issued, the increase being 2,0 13, while eight new Depots were opened during the year.

CENTRE REPORTS

DENB1GHSH1RE CENTRE

Dedication of Ambulance.-A new motor ambulance to be used by the W rexham Division of tbe Order of St. John and increasing the fleet to three was dedicated at the W rexham County Buildings on March 10 in the presence of a large gathering. The ceremony was performed by the Rev. T. Jones, vicar of Berse, Hon. Chaplain to the Division, who was assisted in the religious service by the Rev. Ezekiel Williams, representing the Nonconformist Churches.

Mr. G. T. Guest, the Assistant County Commissioner, after welcoming Sir Alfred McAlpine, who has been appointed president of the Division in succession to the late Lieut.-Colonel J. E. H. Davies, D.S.O., M.R.C.S., said the work of the Division was increasing year by year, and the number of cases carried in 1939 was 1,400. All the ambulance work was done voluntarily by a fOta of members, who were continuously on duty throughout the day.

Sir Alfred paid a tribute to the efficiency of the members and particularly to the coolness and courag e with which they did their work and said the public scarcely realised the debt they owed to this wonderful service.

The Mayor, Councillor John Davies, in presentin g warrants of appointment as Divis iona l Superintendent to Capt R. H. Guest Williams and Amb ulanc e Officer to Mr. George Peters, Rossett Division, said the people of Wrexham responded to no appeal for support with more enthusiasm than they did on the St John Ambulance Flag D ay.

Colzryn Bay D ivz'sion.-An increase in membership by over 50 per cent. on the previous year, making a total of 104 members, the gai ning of 156 awards and an estimated number of 3,174 hours spent on public duty, were interesting features in a report on the past year's work given b y Mr. P. W. Lumley at the annual "hot-pot" supper and distribution of awards of the Colwyn Bay Division. Mr. Lumley is the County Officer for West Denbighshire, and Deputy Medical Officer of Health under the A.R.P. Scheme. He stated that during the winter of 1938-9 members of the Division had give n a course of first aid training to five Bo y Scout Troop s in the district, and had assisted with the R o tary Boys' Club and the class which the Medical Officer of Health, Dr. McKendrick, had at Rydal School. Following an arrangement with the Ministry of Labour and the Postmaster, members of both staffs had taken a course and had all passed. With the coming of th e war the Division had assisted the Medical Officer of Health in a number of mixed classes. Mr. Lumley welcomed the new President, Mr. Sutcliffe, and said he felt sure he would follow in the very good steps of his predecessor. Councillor Walter Howarth, the new Vice-President, and Dr. Jeffrey Jones, the Divisional Surgeon, were also welcomed.

Mr. Sutcliffe, in proposing the loyal toast and a toast to the 18 members of the Division serving with the Forces, congratulated the men on the work they had done and the awards they had gained and said he was proud to be connected with such an organisation.

A toast to the guests was proposed by Dr. G. Pari Huws, Commissioner for West Denbighshire, who linked with it the names of Mr. Sutcliffe, Dr. McKendrick and two representatives of the Voluntary Motor Ambulance Corps present. He referred to the work the Division had done in connection with

the reception of the Liverpool to Colwyn Bay. The mobile first-aid van had been 1n when the children arrived and there were first-aId units at the schools.

Mr. A. E. Roberts, Divis ional Superintendent, supported Dr. Huws' and expressed a. that the comradeship eXIsting between the DiVISIOn and the ambulance corps would continue. The Mayor, Alderman John Roberts, responded.

GLAMORGAN

CENTRE

In his annual report on the activities of the Order of St. John in the county, given to a meeting of Glamorgan County Centre Committee held at the Bridgend Hospice, on March 21, the Commissioner, Mr. D. M. Evans-Bevan, stated that the past year had brought about more changes in the regular routine than for many years. The war bad provided one of the greatest opportunities for revealing that they had succeeded in training men and women to do what was the fundamental object of the Order, to be of service in time of need in rendering first-aid i n an efficient manner and assist in home nursing. During 1939 all members showed a sincere desire to train as intensively as possible. Classes were well attended and many cadet Units were formed. He stressed the importance of looking after the cadet units, the future backbone of the Order. The last six months of the year, in particular, called for the highest praise for senior members of numerous units, who had spent many of their leisure hours each week in lecturing to' classes in towns and v illages ins truc ting those anxious to assist in war-time duties. First-aid posts had been manned day and night with a good proportion of voluntary personnel from the Brigade; and in A.R.P. the Order had done its best to co -operate to the fullest degree with municipal authorities.

A number of men had joined the Forces and others had left to do duty at hospitals. In spite of depleted strength, however, the Divisions maintained their public duties, attending cinemas and other functions calling for their presence. Reports received on nursing units were very favourable and the standatd of efficiency was very high.

The Principal Secretary (the Hon. John H. Bruce), i n the course of his remarks, reported that of the 14>434 members of the Bri gade recorded at Decembe r, 1939, 4,24 0 belonge d to units in the eight Count y Areas of the Glamorgan Centre. Students in First Aid and Home Nursing Classes held within the Glamorgan Centre had gaine d 5,695 of the 27,594 awards gained during 1939; and of the 4,963 A.R.P. awards issued by the Priory, 1,278 were awarded in the Centre.

1{ONMOUTHSH1RE CENTRE

Captain S. T. Beard, O.B.E., Commissioner for Monmouthshire, and his three Assistant Commissioner s are to be congratulated upon the results ot the year 1939. His 4-nnual report reveals

new Nursing Divisions formed at Blackwood, Cefn Fforest, Monmouth, Oakdale, Pontllanfraith, Tredegar and Y nysddu.

Medical Comforts Depots in the County have functioned in a very satisfactory manner, and Ambulance Cars at Monmouth, Abergavenny and Usk have done excellent work. Although the service is voluntarily undertaken, the cars turn out in very short time at need.

In most areas Brigade members are associated prominently with the Casualty Services and the Divisional Ambulance Halls have been made available for this purpose. In this connection, mention is made of a new Ambu lance Hall completed and brought into use during the year at Y nysddu.

CITY OF CARDIFF CENTRE

The Principal Secretary of the Priory had great pleasure in passing on the following letter of commendation from the Medical Officer of Health for Cardiff to Cadet R. Wilcox of the Cardiff City Cadet Division, who is due shortly to enter the ranks of the senior Division on reaching the age of 17 years :Air Raid Precautio ns Combined Exercise, Sunday, February 25, 1940 Cadet R. Wilcox, 398, Grand Avenue, Cardiff

" DE AR MR. BRUCE,-I should like to bring to your notice the excellent impression created by the work of the above -named Cadet during an A.R.P exercise on February 25, 1940.

" While proceeding to report for duty at the Insole Court First-Ai d Post , he was requested by a Warden to render first aid to a number of imaginary casualties caused by a high-explosive bomb in Grand Avenue, Ely. He quickl y summed up the situation and proceeded to deal with the casualties, showing consideration, discrimination and dexterity in the handling of the cases. When he had exhausted the contents of his haversack he improvised slings, etc., and b y making intelligent use of b ys t anders, he had the situation well in hand b y the time the A.R.P. ambulance services arrived on the spot. By directing the First-Aid Parties and ambulance drivers to the more seriously injured casualties and b y indicating those which were of minor importance, he showed a sound knowledge of first-aid principles. His behaviour was highly commented upon by the various official representatives of the A.R.P. services who were acting as umpires at the site of the occurrence and at a subsequent conference of these umpires I was asked to record our appreciation of thi.s Cadet's conduct and general efficiency.

" Yours faithfully,

"( Signed) J. GREE1'-.T\VOOD WILSON. "

RHONDD A CENTRE

Captain T. E: Richards, J P , M.E., in his report on the past yea r, discloses that the mobilisation of the Military Hospitals Res erve has taken over 160 members away from their Units-two Di visions, in particular, having lost their entire membership.

Despite the depressing condition of the staple industry of the Rhondda Valleys-the coal trade-the Centre has held its own. A.R.P. Classes continued to attract large numbers of students, no fewer than 775 St. John A.R.P. awards being gained during 1939. Rhondda Centre Cha irmamhip .-In connection with the appointment of :NIt. Hubert McVicar, J.P., as Chairman of the Rhondda Centre, it is of interest to note that the new Chairman, who is General Manager of the Rhondda Fawr group and Gilfach Goch Powell Duffryn Collieries, has had a long connection with ambulance work dating back to his qualification for a First Aid Certificate iri 1908. The promotion of colliery ambulance work has always received his personal support and he has always been ready to encourage his employees to take up Brigade work. Mr. McVicar held office as Honorary President, Ebbw Vale Division from 1928 to 1933, and when he became President of the Lower Rhondda Corps, and his services to ambulance work were recognised by admission to the Order in the grade of Officer in 1935. The Rhondda Centre may well be proud of a Chairman who in 1927 was awarded the Gold Life Saving Medal of the Order in recognition of heroic services in connection with the rescue operations following the Cwm Colliery disaster

NE WS IN BRIEF

During 1939 students in A.R.P. Classes organised under the Priory gained 4,963 -A.R.P. awa r ds, viz. : 117 Grade I; 150 Grade 2; 1,402 A.R.P. Certificates; 283 A.R.P. Vouchers; 2,941 G.P Certificates and 70 G.P. Vouchers.

Correspondence

To the Edit01', ST. JOHN AMBULANCE GAZETTE

DEAR SIR,-It having been my unfortunate lot to be called upon to settle several arguments lately relative to the respecti ve seniority of the St. John Ambulance Brigade and the British Red Cros!, Society, I should be pleased if you could publish the following dates:-

1. Inception of the Orde.r of St. John.

2. The granting of the Charter to the Orde r in England.

3. The formation of the St. John Ambulance Association.

4. The formation of the St. John Ambulance Brigade.

5. The creation of the British Red Cross Society.

6. The inception of the International Red Cross. Also the address of Headquarters and of the English Branch, if any.

If, as I believe, the Order is senior to the Society, for what reason is the latter given preference on all publications, appeals, posters, etc., and in fact the Order so very often not mentioned even.

So frequently does one find that the term Red Cross refers entirely to the B.R.C.S. with no mention in many cases of the Brigade at all.

Yours faithfully,

G. H Corps. Supt.

The anst:JJers to the various questions yotl ask in yotlr lette?' can be found in Colonel King's "History of the Order J) and Dr. Corbet Pletcher} s "Histo?) 1 of the St. John Ambulance Association." ApproximatelY the dates are as fol101JJS :-

r. IIl8-H.

2. 1142.

3· 18 77,

4· 188 7,

- 5, 19 0 5. Ju(y 17·

6. 1863. ( Gen eva) 14, Grosvenor Crescent, London, S. W, (temporarilY at Bastbourne).

Every country which is a wember of the G eneva Convention is allowed to have three separate organisations which make tip the Red C ross of that country In the case of England the three organisations in order of seniority are :-

1. The Order of St. Joh11

2, Th e St. Andrew's Ambulance Association.

3. The British R ed Cross Society.

In time of all Red C ross activities must be tinder the Red Cross Emblem, and 1vhm used indicates the joint work of the three Societies mentioned above. The present activities are called t he " War Organisation of the British R ed Cross and Order of St. John," and, for short, " Th e R ed C1rOSS}) in public speeches, etc.

EDITOR,

To the Editor, ST, Jm-IN AMBULANCE GAZETTE

DEAR SIR,-I would like, through your magazine, to express my appreciation of the staff at Templecombe in connection with my recent accident, more especially to Lengthman V. Greenslade for the first aid he rendered to me on arrival at that station. His . method of transport and general effort to deal with my case was most praiseworthy, and I am glad to say that my arm at the time of writing is mending, although the progress is slow.

Yours truly, (Signed) FIREMAN E. G. WICK HAM. Yeovil.

88 I · understand that both the Order of St. John and the British Red Cross Society are equally members of the International Red Cross Organisation, and that neither has any prior claim to represent such organisation. Can you please confirm, or inform otherwise.

Obituary

-An appreciation ·of the Late Mrs. A. Cottle, C.B.E. by MRS. LANCELO T DENT, A.R.R.C., Lady intendent-in-Chief, St. John Ambulance Bngade Overseas 1921-1938

By the death of Mrs. Cottle at Plymouth on February 7, the Order and the Brigade Overseas have lost one of their oldest and most loyal workers. As a )Toung woman, she became deeply interested in First Aid and Home Nursing in England. On her marriage she went to Calcutta. She saw what a vast possibility there was for Brigade work in India not only amongst the European population but also amongst the Indians themselves, a.nd at. set about interesting people in the Nursmg D1vis10ns.

Her charm of manner, her great strength of character and sound judgment, gained for her the respect and confidence of those with whom she. in contact; and the Government, as well as ffillitary and municipal authorities, soon realised that they could turn to her for assistance and support.

But perhaps it was not till the outbreak of war in 19 1 4 that Mrs. Cottle's great organising powers were fully appreciated and her services to I?-dia. w ere recognised by her being awarded the KaIser-I-Hind Medal.

As Lady District Superintendent for Bengal, 11:rs. Cottle endeared herself to all those who had the good fortune to work under her; firm and just, sympathetic and kind, she expected from others ,what she was always so ready to give herself--efficIency and service; but she had no patience for slackers or for those who were working for their own ends.

Sorrows came rapidly and mercilessly to Mrs. Cottle and her husband by the loss of their three sons as a result of the war. After Mr. Cottle's death, she felt that she would like to devote the rest of her life to the work she loved so much in India.

However, a few years ago her sight began to fail and she knew that the time had come to hand on the Torch, \-vhich she had kept burning so brightly, to someo ne else.

Havi ng had the privilege of working ;vith Mrs Cottle for seventeen years, few can appreCiate more fully her great sense of loyalty, courage and of discipline; and her memory will, I know, always ·serve as an inspiration to those who are carrying on the work she started and loved so well.

" Let those who come after see to it that name be riot forgotten."

What ' • IS the ' best antiseptic?

In the course of a recent lister Memorial lecture an eminent surgeon declared that" the best antiseptics are not those which, in vitro, have the greatest germicidal power, but those that have a powerful proteolytic action, such as Dakin's fluid, which rapidly destroys dead or dying tissues •... "

Milton is of the same chemical nature as CarrellDakin solution, that great life-saver of the last war.

The Dakin solution must always be mixed afresh to ensure strength: MILTON IS STABLE With Dakin solution there is a tendency to causticity: MILTON IS NON-CAUSTIC. Milton has not only full germicida l power but that destructive action on pus and dead tissue that leaves a wou nd surgically clean.

Which is the least expensive antiseptic?

Milton unquestionably-consistent with achieving proper conditions of antisepsis. Its great germicidal power makes possible effective dilution of as little as I In 100, or three tabiespoons to a gallon of water.

Questions and Answers

( Continued from page 85)

that an unconscious patient cannot vomit the contents of the stomach. In these circumstances it is practicallY impossible to mistake fractured base of skull or jaw for htemorrage from the stomach.-N. e. F.

TREATMENT OF STINGS AND PLANTS

S. W. (Manchester).-Please tell me why in the revised Textbook ammonia is omitted from the treatment of stings and plants. Is it found to be of little avail or does the Textbook give us enough alternatives.

I think that the explanation of the omission of ammonia is because the Textbook now suggests remedies which are most Iik.e!J to be found in the average household.-N. e. F.

STRETCHER DRILL

J. B. (Garston).-Further to the query answered by you under the above heading in the January issue of THE GAZETTE, I should like to know the positions of the bearers when lifting such cases as patients suffering from fractured patella, from wounds of abdominal wall with bowel protruding and from compound fracture of pelvis with lower limbs flexed. Your further assistance will be much appreciated. The drill laid down in the Textbook is based on the R.A.M.C. Training Manual,. and in warfare it will happen that one man fullY trained will have the assistance of three untrained stretcher bearers. In such circumstatUes he would take up the position in which he could give most support to the if!Juries.

In civilian organisations, such as the Brigade, all members are given ejJicient training. Consequent!J any member of the stretcher party is capable handling the if!Juries with due care. There is, therefore, seldom any need 01 Bearer No. 1 to change his position. Should he, however, have to use untrained bearers he is allowed to exercise his discretion and to change his position as is laid down in the note at the foot of p. 207 of the Textbook.-N. e. F. TREATMENT OF BURNS

C. S. (Old Trafford).-I wonder (1) if there is any special reason why the" eyes" have been omitted in the mask, as suggested on p. 179 of the Textbook, for the treatment of burned face and also (2) if the old rule of treating "with flames uppermost" still holds in the case of a person whose clothes catch fire. Please accept my thanks in anticipation of your replies to both queries.

(1) In the !reatment of burns the correct method is to cover the 'J?lhole area immediately (Rule 3 on p. 178 of Textbook) and so exclude the air,. but it is obvious that, in the case of a burned face, this rule must be modified to allow breathing through nose and mouth. Further, it is not a simple procedure to cut holes in the mask to fit the eyes accuratelY,. and still, the time occupied in attempting this delqys the covering of the face. In other words, it seems to me that the omission is intentional.

(2) Yes.-N. C. F.

REVIEWS

FIRST Am COMPETITIONS. By Captain A. e. White Knox, M.e., M.B., Ch.B. London: Dale, Reynolds & Co., 46, Cannon Street, E.e.4. Price 1 s. post free.

This excellent 40-paged booklet has been compiled by Dr. White Knox who, as an Assistant Commissioner of the Brigade and a member of the Textbook Revision Committee, is well known to all ambulance enthusiasts. It is based on a long and wide personal experience in the competition a1:ena; and it sets out useful and practical hints to competitor s in their training for and action during competition s and also to judges in their preparation of tests and conduct of competitions. As illustrations of his suggesting Dr. White Knox presents the marking sheets which were used in the Inter-Railway and Brigade Final Competitions of 1939. In short, all aspects of competition work are well and fully considered, except the actual organisation of competitions and the duties of stewards who play such an important part in the success of all such contest s; and I hope that, when the book is re-published, a chapter on this subject will be added.

Incidentally, the historical note in the introduction is not strktly correct. Competitions were started within a year or two of the founcation of the Association in r877; and the year r897 is remarkable only because in that year The Order initiated the first Inter-Railway Competition and officially recognised the Brigade Competition which was first held at the r893 Brigade Camp of Instruction.

N. C. F.

/ 250 A.R.P. QUESTIONS ANSWERED, published by ] ordan & Sons, is a very comprehensive covering of this rapidly evolving service for Home Defence. It is particularly useful inasmuch as it combines the more recent subjects relative to High Explosives, Incendiary Bombs, Shelters, etc. If any criticism might be mentioned, it would be that the lastmentioned section of shelters and trenches is rather too technical for a small book to help the beginners for the basic training section of their work th<1 diagrams are similar to many produced in technical instructions to builders, which might confuse the uninitiated. Under the First Aid Section words like " antiseptic" might with advantage be followed by " like methylated spirit" as many could not name an. antiseptic easily to hand. This is representative of too many medical words insufficiently explained for the lay mind. These are small points compared with the successful many in which the authors have covered a wide range of subjects. And, without doubt, the book will help a large number of those rendering service in this great national work.

W C. B.

S.J.A. NEW REGULATION APRONS for Ambulance Sisters. Made from hard-wearing linenfinished apron cloths. Price includes cross. Waist: 28 30 or 32. in. Lengths: 26, 2.8, 30, 32, 34 in.

BRAND'S ESSENCE

The finest NON-ALCOHOLIC STIMULANT

Throughout the civil medical and nursing professions, and the medical services of H.M. Forces, Brand's Essence is constantly prescribed for combating critical weakness arising from physical or mental exhaustion and shock.

Its uses, when First Aid is rendered to the injured, will be apparent from the following brief summary of its advantages:

Brand's Essence is a NON.ALCOHOLIC STIMULANT.

h: is assir:nilated in its entirety, QUICKLY AND WITHOUT STRAIN, BY EVEN THE WEAKEST SYSTEM.

Its stimulating effect is PRACTICALLY INSTANTANEOUS.

Brand's Essence DOES NOT PRODUCE AN AFTER-STATE OF MELANCHOLIA.

It not only conserves strength-IT BUILDS UP STRENGTH QUICKLY AND SAFELY.

IT CANNOT CAUSE THIRST.

Be sure fo have a supply for the freatment of all cases wh ere a sfimulanr is indicored.

ProgressifJe Trainin!5 in

By W. C. BENTALL, D.n.E., F.R.C.S., F.R.G.S., Assistant Surgeon-in-Chiel

Air Raid Precautions

TRAINING OF THE HIGHER STAFF AND REPORT CENTRES

Last month seven steps in Progressive Training were laid down :-

1. Individual or Basic Training.

2. Individual Advanced Training.

3. Team Training.

4. Co-ordinated Team Trainin g.

5. Combined Training.

6. Depot Training.

7 Higher Staff Training.

This month NO.7, H igher Staff T raining, will be dealt with. It is well to realise that while Basic Individual Training is at the bottom of the ladder we have to climb, the Higher Staff and Report Centre should control our trainees, and therefore, though last on the list, an understanding of the whole control and Higher Staff is essential for complete understanding of the scheme.

The training of the Higher Staff like the training of the Rank and File is progressive all the time and must follow the same sequence :-

I. Individual training.

2. Team training.

3. Combined or exercise training.

I. Individual Training;-

(a) Telegraphists in the control room must practise the following points :-

(i) Phonetics: Practice properly to pronounce every word used. Carefully read and practise the instructions clearly laid down in every telephone directory, which so few people do. See Preface, pp. 3 and 4, in all directories, especially para. 5 "Aids towards clearness of speech" for figures, names and difficult words.

(ii) Writing; Master the special forms for writing down messages, e.g., M.l, M.2, etc., and use no other odd pieces of paper. Write names in BLOCK letters, and be very clear in ordinary writing so that all may read it easily. It is wise to have your pencils sharpened at both ends in case one point breaks, to save timelives may be lost by delay- ! Make yourself familiar with local names of streets, places anq people as far as possible.

(iii) 24-hour clock time method must be practised the correct way to write it. Thus:-

This will save misunderstanding and confusion and is the method with which telephonists and such workers in A.R.P. must be quite familiar.

(iv) Alwtrys repeat the message for con:6rmation. Time is saved and muddle prevented.

(b) Messmgers.-The following points are essential and without training in them a messenger is a " washout."

(i) Local Geography must be well known. Adjoining areas also. Always bear in mind the chance of blocked roads and therefore know what alternative routes are available.

(ii) Map reading must be well practised by a messenger.

(iii) Knowledge of ojjicials in other places beside the Repo rt Centre and their names and addresses should be famili arised.

(iv) Avoid messages word mouth, always have them written and g et the receiver to initial the receipt of them.

(c) Control Room Staff-These consist of the Controller, Plott ing Officer, Chartwriter, Umpires and the 1Y1edical Officer of Health, and Surve yor should be there in an advisory capacity. Their special training should consist of the following points :-

0) Individual duties.

(ii) Khowledge of the lower and higher officers in the Control Room.

(iii) Knowledge of local geography and map reading.

(iv) Understanding of plotting movements of various services on charts so that they can see at once where a rescue party has been sent, or an ambulance, etc. Various coloured pins or flags are moved and record the result of the telephone instructions, so that at any

Learn

Massage

-the Profession with Prospects

YOUR knowledge of First Aid, and your interest in such useful hum a nitarian work, will you to master quickly and thoroughly the prlllclples and practice of SvYEDISH :\lASSAGE as taught by the Northern In stitute since 1924. The demand for :;\IassA.ge Operators is still, a nd will be always, greater than the supply, and there are job s waiting TORTHE.RNtrained students- in :i\Iuni eipal HospItals, In st ItutIOns. Naval and Military IIospit a ls, in the field of Sport and in profitable private practice.

Your Passport to Prosperity

A Northern training is your Passport to Prosperity. NORTIIERN stud ents LEARN and EARN. Some are making as much as £15 a ,,·eek , and many who pre.viousl.y worked in dead -e nd jobs are no,"" forgmg a h ea d m then new career, bringing help and healing to sufferers, and being w e ll paid for their work. You can do th e snme. NOHTHEHN ha\' e trained a large numb er of Fll'St AId workers who are now earning comfortable income s in their conge.nial occupations a s Massage Op erator s, and the DIPLOMA of the Institut e s awarded to a ll students who are successful in the Final Examination WRITE for this BOOKLET To-day

The Co urse se t bv th e NO RTHERN In stitut e s int en eJyi nt eresting instruc ti v<", and thorou ghly IIp-to-d lte;" and i s fully expla med u1 the book let "The Power in Your Hand s Vnte for your copy

moment the exact pos1t1on of various units can be seen on the charted wall maps.

(v) Training in message writing-not too brief to be clear, not too verbose to be confusing; both equally important and only acquired by careful practice. Advancing years and habit may a difficulty either way!

2. TEAM TRAINING

This must only follow after adequate individual training. Confusion and apparent failure in exercises is most often cau sed by inadequate individual training and practice.

(a) Tra in the Con tro l Room higher staff as a whole. The Controller or a chosen director should be in charge, and an umpire or more than one in the message room simulating messages having a most carefully prepared plan of accidents. Several umpires should meet the night before and discuss their plans and draw them up in detail, visualising all possible contingencies. This needs much thought, ingenuity and detail.

(b) Train the whole staff of the Control Room, with telephonists and messengers. Several wardens who have carefully prepared as above should be in another room acting as wardens telephoning through messages and pre-arranged messages, and evolve likely complications in the plans of accidents.

This team training should be first practised in slow time throughout and then in quick time. The care in preparing needs much vision and practice; to do it hurriedly is to court failure. It is wise also to practise first with the fewest control room officers as possible, and then to gradually introduce the fuller staff, this gives confidence and knowledge to those earlier trained, helping the newer ones and preventing confusion. They should also practise reporting major damage to higher Regional Control because major damage is national damage. It is wise to practise the possible fact of some interfering local chipping in on the 'phone needing to be dealt with by tact, but firmness ! Such training of the higher staff in the Control Room should be followed by a conference w i th v ery frank praise and criticism. In real cases reports should be passed through to higher authorities at 06 00 and 18.00 hours. Also points of real news value should be passed to the Ministry of Information, only to be passed to the Press as they deem wise, not by local authorities or personalities. Privacy, it need hardly be added, is a national responsibility of all concerned.

Next month one of the services will be dealt with under Section 2, viz., individual advanced training.

A.R.P. and Answers

Q. As an alternative to protective gloves would the hands be protected against gas contamination if the surgeon or undresser wore surgical rubber gloves, clipping them frequently in 94

bleach and then washing them ill running water?

A. Surgical gloves are very clliE.cult for the inexperienced to put on: they are very easily impaired, as we surgeons know well, and their thinness affords a very temporary protection against mustard gas. Therefore they are unsuitable. \

Q. Should cellophane and newspaper be stuck inside or outside the glass of windows?

A. Inside only.

Q. Is the civilian respirator efficient in rain or does rain affect the container?

A. It is quite efficient in rain.

Q. If the civilian duty and civilian respirator containers are similar, how does the former protect for 40 minutes and the latter for only 10 minutes?

A. The question states an error. The civilian duty respirator is effective for from 20 to 30 hours , and the civilian respirator for from 8 to 10 hours , and the Service respirator for from 50 to 60 hours The difference is in the amount of filtering materi al in the containers.

Q. What advantage has formalin over izol as a cleanser for the civilian respirator?

A. The construction of the civilian respirator is different to the Service and civilian duty respirators, and this altered construetion makes izol unsuitable whereas formalin is quite suitable.

Q. How should hair be treated after contamination with liquid mustard?

A. Most effectively by cutting off.

Q. Should Lewisite blisters be broken by First Aiders?

A. Only by those who understand the correct technique of antiseptic opening of such blisters.

Q. If mustard gas (liquid) was dropped into a bowl of water, would it drop to the bottom or float on the top ?

A. It lies at the bottom in globules.

Q. What are the nurses to have as they will be in First Aid Posts?

A. Do you mean drinks, clothes or knowledge ?

Q. After use of waterglass would the floor s require further treatment after the waterglass has worn off?

A. Yes.

Q. Does the waterglass permanently seal off?

A. No.

Q. If you decontaminate Bli ster Gas by sealing, is this a permanent job, and if so, how long must you leave the sand or earth, etc., before it can safely be moved?

A. Depends on nature and strength of sealing material.

Q. Would not taking the contaminated civilian gas mask back (to get another) contaminate t;he depot?

A That is the receiver's business to prevent.

If W. C. B. r{

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The St. John Ambulance Association. Ite History and its Part in the AInbulance Movement. By N. CORBET FLETCHER, M

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DUST and SPRAY MASKS and all other Safety and Protective Devices. All communications SIEBE, GORMAN & Co., Ltd. "GRANGECLARE," PARK LANE, ASHTEAD, SURREY Telegrams: Davis, Asbtead. Telephone: Asbtead 3142 4 linea FLAG DAY EMBLEMS, BUTTONS & BADGES, CARNIVAL GOODS. Price Lists on application. Fo r all supplies write : THE UNIVERSAL BUTTON CO., 13,15,17, Surat St. Bethnal Green,E.2 T elephone Advance 22 54. WANTED T elegrams: Unibutco, Beth, L ondon. Copies of The St. John Am bulance Gazette dated May 1939. Send to the Publishers, The St. John Ambulance Gazette, 19, Cursitor Street, London, E.C.4.

mue 310un OFFICIAL GAS CHARTS

No. I Chart ·shows gas derivations.

No. 2 is a fill I and complete educational chart of "Typical War Gas es."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee.

I

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All enquiries to-

THE S T. JOHN AMBULANCE GAZETTE is published on the 15th of each month. The annual subscription is F. 6d., post free; single copies 3d. be addressed R eports and the month as Brigade Reports and Photographs should to the Editor, at 32, Shoe Lane, E.C·4· photographs should reach him as early in possible.

Subscriptions and Advertisements should be forwarded to the publishers .Messrs British P eriodicals, Ltd., 19 , 19a, Cursitor Street, L ondon , E.C.4.

CONTEN TS

Editorial

Red Cross and St John War Organisation

Home Nursing Page

Brigade Nc\vs

Special Service

County of Hampshire

Interesting Case Reports

Questions and Answers

Northern Ireland

Priory of Wales

Air Raid Precautions

Railway News

Major Carver Cup, Individua l Tests

Obituary

C H AN CER Y OF THE ORDE R,

S T. JOHN' S G A TE, C LER KENWELL, LONDON E C.I.

Am bulances for France

Fo ll o win g th e in sp ecti on by t h e K in g an d Qu een of. t he N o : M o t or Ambulan ce Co m pan y (Sec ti o n A)

p n o r t o Its d eparture overseas, Lo rd Cro m er di sp a tche d the. follo w in g m ess age t o Sir A lexand er R oge r, Chauma n of th e T ra n sp o rt of Wo und e d Co mmittee :-

"As Chairman of the Executive Committee of the British Red Cross and St John War Organisation, I wish to express to you and to all members of your Committee and the Staff of the Transport of Wounded D epartment the congratulations of our Executive Committee on your achievement in equipping and preparing for dispatch to France the whole of this Convoy in so efficient an d effective a manner.

" You had occasion from to-day's inspection to learn from the King himself how gratified Their Majesties were in being able to conduct this inspection and how highly satisfied they were with the smar t appearance of all the vehicles, as well as with the turnout of the officers and men .

" May I the n ask you to be the means of conveying to Dr Fox and all ranks of the Convoy the pride which our Organisation felt in them and their offer of service in the humanitarian cause for which our B ody exists?

" A t the same time would you please convey to Dr. Fox and all ranks our best wishes that all success may attend them and the work which they are shortly undertaking in the war area in France "

I n a reply of thanks to Lord Cromer, D r. Wilfrid Fox, the Officer commanding the Company, said: "Offi cer s and men of Section A, No. I Motor A mb u lance Compan y, req u est me t o convey their mos t sincere thanks to Lor d Cromer and members of the Exe cu t.ive Commi ttee, Sir Alexander R oger and members of the Transport Committee, and to all m em b ers of staff and vol untary workers , for the care and tr o uble th ey h ave taken i n e quip p ing t he Se ction an d looking aft er their comfort. The Sectio n trusts th ey will wor thily uph o ld the tra diti o n s of the B ri t ish Red Cr oss and Ord er of St. J ohn."

Red Cross and St. John War Organisation

(Continued from page 80, April issue)

OVERSEAS

The arrival in France of Section A of No. Motor Ambulance Company is reported. Every vehicle and all the personnel reached their destination overseas withouJ mishap. The first portion of the Convoy was inspected by Lieut.-General Sir Sidney Clive, the Red Cross and St. John Commissioner with the B.E.F., and -the Base Commandant. The ambulances are recorded as making" a very impressive showing." Intimation has been received by the Base Stores a large consignment of oranges have arrived at a French port as a gift from Cyprus, and arrangements are in hand for their distribution.

HELP :FOR THE ORKNEYS

The Orkney Islands, the first place in the British Isles to suffer civilian casualties from German air raids, have received large supplies of hospital dressings, garments and furnishings from the Scottish Branch of the British Red Cross Society. Future supplies have been promised as may. be necessary, and it has been decided to present six ambulances to the military authorities there.

INDIAN WAR ACTION

The Indian Red Cross Society and the St. John Ambulance Association, like their parent societies in England, immediately on the outbreak of war placed their war activities under a Joint War Committee. This body is responsible for all decisions regarding policy and executive action. Its work falls roughly under four heads. The first is the raising of funds in response to an Appeal issued under the patronage of the Viceroy in November, 1939. The second is the formation of the V oluntary Aid Service for training women as nurses to supplement the Nursing Branch of the Army and men for ambulance service. Thirdly, it is concerned with the formation of Ladies' Work Parties and finally with the of hospital supplies and comforts not ordinarily Government issues.

HOSPITAL COMFORTS PROVIDED

A large number of ho spital requirements have been sent by the Joint Committee to Egypt, Malaya and the North-West Province. Special comforts were sent at Christmas time to these areas and also to Aden, Hong Kong, Iraq, Africa and the Royal Indian Navy. A special fund, known as "The Amenities for Troops Fund," supplies comforts for hale and hearty troops. Throughout India the war work of the Indian Red Cross Society is being carried on with great enthusiasm and energy, almost entirely by voluntary workers. First Aid, Home Nursing and A.R.P. courses are being given extensively.

JOINT ACTION IN NORFOLK

The service to deal with shipwrecked persons on

100

the Norfolk coast is a good illustration of joint action. It has been organised by the Joint British Red Cross Society and Order of St. John War Committee, to supplement the work of the Shipwrecked Mariners' Society, the coastguard officers and the lifeboat representatives. An organiser has been appointed by the Joint Committee for each of the four Lifeboat Sectors into which the coast is divided. These organisers have arranged first-aid parties for the whole coast line to be on call day and night. Each organiser has a store of clothes and comforts from which the Shipwrecked Mariners' Society and local hospitals can draw. These supplies have been provided in response to a local appeal. The Joint Committee in addition provides each de stitute shipwrecked man with a "treasure" bag containing soap, flannel, toothbrush and comb; a writing wallet, including stamped postcard; cigarettes or pipe and tobacco; matches; chocolate.

RED CROSS AND ST. JOHN LIBRARY

During the two weeks to Easter, II,700 books, 2,777 magazines and 10,894 papers were received. Of these 8,915 books, 8,126 papers and all the magazines were found to be suitable for use in hospitals. Approximately II,830 books, magazines and illustrated papers were distributed in the same period. Included among the books were French, German and Spanish books which were asked for by a military hospital overseas, and a selection of textbooks on engineering and photography. The request for these came from a home naval hospital.

Altogether the dispatches comprised sixteen cases, four bales and 92 parcels to hospitals at home and overseas, a hospital ship and to the Base Depot. A selection of books has also been dispatched to the War Organisation's Nurses' Convalescent Home in France for the purpose of starting the library in that institution.

Monthly parcels of magazines, illustrated papers and paper-covered books are being sent to R.A.F. sick quarters with the B.E.F.

To maintain distribution a constant flow of books, magazines and illustrated papers is required. A number of books received, as will be noticed from the reports, are unsuitable for distribution to hospitals. If tbey are in good condition they are sold and suitable books are purchased with the proceeds.

COLLECTION AND TRANSPORT

Methods employed . in collecting books vary. Press appeals have been found to be disappointing. Window cards and house-to-house distribution of leaflets have good results. Notices given out in churches are sometimes helpful. Most productive of results is the system of appointing a head collector

fDr a district or parish who, in turn, appoints collectors to make personal appeals to residents. Conveyance of books from collectors to the depot is best done by voluntary transport over short distances.

THE PALACE INSPECTION

The inspection of Section A, No. Motor Ambulance Company by their Majesties, a report of appeared in the April GAZETTE, was very thorough. It lasted approximately three-quarters of an hour. The King and Queen spoke to almost every man on parade. They were keen to know who had served in the " 19 14- 18 " War. One driver, their Majesties were interested to learn, was driving an ambulance which he had himself presented.

SECTIONS "B" AND "C"

In collaboration with the Personnel Department preparations are well in hand for the formation of Sections" B " and" C" of No. I Motor Ambulance Company. Certain specialised vehicles are in the course of construction, including a workshop lorry, stores lorry and a field kitchen. Those who will have charge of these vehicles overseas are assisting in their production.

RHO KANA CORPORATION

From the Rhokana Corporation £500 has been received towards the upkeep of the Ambulance which it has presented. A further £500 for the same purpose has been proposed. A short-wave broadcast of thanks was made possible and a message from the Managing Director reads: "I should mention that the broadcast which you so kindly arranged went through splendidly and greatly gratified all subscri bers."

STAMP CENTENA RY EXHIBITION

Among the many methods whereby funds have been raised for the Red Cross and St. John War purposes, not the least interesting is from the profits of the Centenary Exhibition, which commemorated the issue of the first adhesive postage stamp, exactly one hundred years ago to the day ofthe opening (May 6). The Exhibition was be under the auspices of the Royal Philatelic Society of which Sir John Wilson, Bt., is the President. Since 1938 he has been Curator of the King's stamp collection. Sir John took a prominent part in the organisation of the Exhibition, which was open to the public from May 6 to May 14 at the London Museum.

POST OFFICE EXHIBIT

The Postmaster-General associated his Department with the Exhibition, and provided an interesting loan exhibit from the muniments of the G.P.O. A special obliterator was also installed in the Exhibition. Those who wished to post letters were able to purchase specially designed commemorative envelopes and have them posted direct from Lancaster House. The sale of all such envelopes will go to swell the Red and St. John Fund.

H.M. THE KING'S EXHIBIT

Furthermore, his Majesty the King consented

to exhibit from his world-famous collections, and supporting exhibits were lent by the Royal Philatelic Society and by the leading collectors in Great Britain. The Exhibition concentrated on the birth of the postage stamp (May 6, 1840) and on British issues of stamps . A special effort was made to interest the general public in such matters as the design and production of ' stamps. A comprehensive catalogue of the Exhibition was prepared and sold for the benefit of the Red Cross and St. John Fund

SPECIAL STAMP ISS UE

A special issue of stamps commemoratin g the centenary was prepared for use on May 6 and those who desired to have souvenirs of the anniversar y in the form of the special commemorative stamps were able to buy these in Lancaster House, fix them to the special envelopes and hand them in to be obliterated.

For the Red Cross Sale, the Prime Minister has sent a copy of Far Awcry and Long Ago, b y W. H . Hudson. He has inscribed it with the following message: "I offer this book, an old friend of mine, to the Red Cross Society as a tribute to their magnificent work for humanity.-Neville Chamberlain, April, 1940."

PHOTOGR APHS OF PRISONERS OF WAR

Should Prisoners of War be photographed? The question was put in the House of Commons recently to Mr. Oliver Stanley, the Secretary of State for War. The Member who enquired thought that there had been considerable propaganda value to German y in the publication in neutral countries of photographs of Bri tish prisoners. Mr. Stanley replied that he did not consider it to be desirable to grant facilities for photographing ' German prisoners. It was, he thought, against the ideas of most people in the country-as it was against his-" to make peepshows of people who have the misfortune to be Prisoner s of War."

TRANSPORT OF WOUNDED

Major-General Sir Percival Wilkinson has been invited, and has expressed his willingness, to serve as Vice-Chairman of the Transport of Wounded Committee.

Preliminary steps are being taken with regard to the provision of the Ambulance Convoy destined for the Middle East.

The nucleus of personnel of Sections "B" and " C" of the No. I Motor Ambulance Company has been dispatched overseas. Included in the draft are men who have charge of special vehicles, such as the mobile kitchen, the stores lorry, completely equipped to meet any demand, and the b reak down truck.

A fully equipped motor ambulance for service in France was presented to the War Organisation on April by the Duke of Abercorn, Governor of Northern Ireland, from whose fund the vehicle was purchased.

101

DOME NURSING PAGE

The Nursing Care of Pneumonia

By ALEC WINGFIELD, M.D., M.R.C.P.(Lond.), Assistant Physician, .' Seamen's Hospital, Greenwich

Pneumonia is an acute inflammation of ·the lunas to infection with certain specific bacteria, the pneumo-coccus is by far the most common.

In Its most classical form pneumonia affects one lobe of one lung and begins with startling suddenness. In the days before the modern lines of treatment were available the illness continued for some seven to days with a high .temperature, rapid breathing, hecbc flush. and a persIstent irritating cough which produced and often blood-stained sputum.

More It has become possible to recognise in a syn:Irome known as pneumonitis, in which the mflammatIOn of the lung substance is patchy and may affect several areas in many different lobes.

The treatment of a patient suffering from pneumorua depends more upon a good nurse than upon a good doctor, and since the introduction some few years ago, of sulpha-pyridine, more monly known as M and B, 693, this has more than ever becoI?e The role of the physician in the IS liffilted to making the original diagnOSIS, prescnbIng the appropriate dosage of sulpha-pyndine, and to prescribing such remedies maY:" be needed for the relief of pain and for the InductlOn of sleep. Frequent examinations of the chest are both unr:ecessary and unwise during the early stages of the Illness it is only towards the end of a week that careful examination is needed in order to detect. any possible complication, such as empyema, that .IS to in pleural cavity. C?n the nursIng SIde It IS essential to aim at prodUCIng a calm and peaceful atmosphere, provIde his requuen;-ents with the least possible disturbance and to aVOId, so far as is feasible unnecessary movement. Patients are generall y 'most when nursed in a somewhat upright poslt:on wIth the supported by many pillows with a back-rest m the bed. Daily blanket baths WIll be and a bedpan is an essential, while careful of the teeth and gums will do much to aV:0Id. mfectlOn of the salivary glands. Should C0D:stipatIOn be present it will be necessary to act entuely under medical advice and oftentimes an enema will I?rove t? be the most satisfactory remedy. Frequent dnnks WIll be needed and for this purpose glucose to lemonade, orangeade or lemon barley-water IS very valuable. As a general principle

it may be said that the more fluid the patient is able to take, the more rapid the recovery. Solid food is not but 0e patient's appetite remains good IS. no O?JectIOn to light fish and milk pudding beIng While sulpha-pyridine is being gIven to the patient he must eat no eggs, no onions, and must have no Epsom salts. The illness is, however, of short duration, and it is harmful to force the patient to eat. against his will. Tempe ra tur e, pulse and respiratIOn rates will be recorded fourhourly and preferably will be incorporated in a chart so any. variations may be quickly appreciated. Routine testmg of the urine should be carried out each day. The appearance of the stool should be noted and abnormal stools should be preserved for the doctor's inspection. The sputum pot should contain only on .the first day as specimens may b e requued for ffilcroscopic examination. On su bsequent days carbolic acid : 20, should be used as a n Paper tissues are useful for wiping the VISC1d sputum from the patient's lips and the se tis sues can be Many patients suffering expenence much pain in the chest OWIng to pleunsy, and even in the absence of medical it is to provide a gamgee Jacke.t or an antlphlogistIne poultice, but an electric pad IS more efficient than either. As an immediate remedy a hot-water bottle provided with a flannel cover may be use.d. It will be the nurse's duty to ensure that there IS an abundance of air in the sickroom but to exposing the patient to any draught. At the same a great influx of cold air might be harmfuL It IS not so common nowadays to require oxygen In !he treatment of pneumonia, nevertheless, when pOSSIble, it is wise to have a cylinder available. The funnel method of administration is to be deprecated as both wasteful and inefficient the two methods of choice being either the of a catheter into the nose or the use of the oxygen tent.

The results of treatment with sulpha-pyridine have remarkable and the mortality rate from this has very considerably since the introductlOn of this drug. It still remains true however that the first few days of the illness are' the and sympathetic nursing during this penod IS as Important to-day as it was before this speCIfic remedy became available.

The St. John Ambulance Brigade News

NO.1. (PRINCE OF WALES'S) DISTRICT

No. 140 (Paddington District P.O.) Division took part in an rehearsal recently, at the request of the Metropolitan Borough of Paddington. Ambulance Officer J. F. Head, in charge of the Division, received a letter of appreciation from the District Postmaster, who forwarded a copy of a letter he had received from the Paddington Borough Chief Warden. The letter expressed appreciation of the co-operation between the A.R.P. organisation of. the Division and that of the Wardens. The Assistant Commissioner is g lad to know of this efficient co-operation which re flects credit on all concerned.

No. 2 DISTRICT

ALDERS HOT

A First Aid and Home Nursing competition was recently held b y the Aldershot Cadet Nursing DiviSIon. The WInner, Cadet-Sgt. Jo yce Martin, and runner-up, Cadet Vera Atkins, were presented with cups by Lady Cadet Superintendent Mrs. N. Maling and County Officer A. R. Morley. The cup s will be held for six months.

No. 3 (EA STERN) DISTRICT LUTON

After the striking success of the Vauxhall Motors Division, whose personnel has increased from 38

SOUTHGATE

On Sunday, April 14, a competition took place between the staffs of three First AId Posts and two Mobile Units.

Competitors had questions on surgical instruments; how to prepare a bed to receive a street accident; application of dressings, and preparation of dressing trays.

The judges were the Matron of the North Middlesex Hospital and the Medical Officer of Health for Wood Green. Both were very impressed with the efficiency of the teams.

Results were as follows: I, D.A.P. No. 2 (Bowes Park Church Hall), 88.5 per cent.; 2, MobIle Umt No. I (Isolation Hospital), 80 per cent. ; 3, Mobile Unit No.2 (Grovelands), 77 per cent. Mayoress of Southgate presented the cup to the wInmng team, all of which were members of the St. John Ambulance Brigade.

( members) in ovember, 1938, to 140, excludmg . A.R.P. in 1940, the Company have obtaIned authonty for the establishment of a Nursing Division. This new Division, like the (Men's) Division, is to work in conjunction WIth the Compan y's A.R.P. organisation. All members have duties in that scheme and the two activities materially assist one another in buildin O' up knowledge and experience. 0

Members of the ursing Divisio n are eqUIpping A.R.P. by the local Industnes anti-gas exammatIon. MISS NL \Vilson is the Lady Superintendent.

No. 4 (LANCASHIRE) DISTRICT LIVERPOOL

NIr. S. Bowman presided at a recent presentation of awards and Erst aid certificates. He was supported by County Surgeon Dr. Murra y Cairns, C.B.E., Mr. G. L. Grant, Divisional Vice-President, and other

Also present were the management of the BrItIsh American Tobacco Co.

Mr. Bowman paid tribute to members of the B.A.T. Ambulance Division for their unstinted services and devotion to the objects of the Order of St. John. .

The County Surgeon presented the Vice-President's of Office and Warrant to Mr. G. L. Grant. first-aid certificates, including tIOn certificates, were presented b y Mr. and Mrs. Bowman.

Since 1922-the year in which the Division was formed-members have attended 20,943 public duties and treated 5,490 cases.

COLNE

Councillor A. Parkinson, JP., presided at the annual tea, concert and dance of the local Association Centre. He w.as by the Mayor (Councillor Burrell), DIstnct Officer J. Aitken, Corps Super1ntendent H. Allum and other officers.

It was announced that the CoIne Corps had trained 600 in First Aid and Home Nursing 1939 In connection with the town's A.R.P tralrung: ..The work of the Corps since the outbreak of has been greatly appreciated by the public o f CoIne and district

SHEFFIELD No. 5 DISTRICT

" A ;, the of the Sheffield Nursing i! and B DIVIsIOns, Lady District Officer Miss G. Ashb e.rry presided. of lady duty officers showed that "A" DIVIsIOn attended 2,109 duties, and treated 976 cases. " B" Division, recently formed, attended 420, and treated 8 cases.

Miss Ashberry said they had reason to feel proud of work they we r e doing. Members were In a tremendous amount of voluntary service, while others were engaged in full-time A.R.P. work. Later she presented medals for 15 years' service to Mrs. Tye and Miss Higgins. The medal awarded to the late Miss L. Booker was presented to the famil y Nineteen awards gained during the year, and seven members qualified for medallions and 2 for labels and pendants.

others present were Lady Corps Officer Miss E. Daniel, Miss J Beaumont and Mrs. E. Ward Lady Divisional Superintendents of "A" and " B" Divisions respectively.

As KE RN

A t the annual concert and distribution of award s to members of Askern Main Corps, presentations were made also to Mr. Morgan, agent of the colliery, Mr. Matthew Thompson and Mr. Charles Smith in recognition _ of their bravery in rescuing a feU;wworker, Mr. Liversedge.

Mr. Llew Jones, director and general manager of the Coal and Iron Co., Ltd., making the presentatIOns, saId that the circumstances of the accident were that there was a substantial fall about 20 feet high, and Liversedge was under it. Smith did everything they could to liberate him WIthout immediate success. Mr. Morgan, the agent, was in the district and went to help. The only way to effect a rescue was to get through a small hole had been. by steel props. Through hole? the dImensIOns of which were about 30 w1de and 12 inches high, Thompson went in on his trying to get through, but came out after gOlng a certain distance. More work of clearin g was done. Mr. Morgan went in, on his back, so as to be able to bend upwards. He succeeded in reaching Liversedge and brin g in g him out through the hole. Any undue movement might have filled up that small hole with terrible results.

Mr. Jones said they all admired the ver y great pluck and courage shown on that occasion.

A from the chairman of the compan y, congratulatIng the three men, was also read, and a letter to Mr. Morgan expressing appreciation of "gallant courage" was received from the A s kern branch secretary of the Yorkshire Mineworkers Association. Another letter from the general secr eto the rescue operations and the great rIsk Incurred by the rescuers and added that the hi&hl y .appreciated the spirit of her oism which was marufest In those operations.

In Mr. Morgan said that durin g th e tIme that was trapped the spirit and courage whIch he displayed encoura g ed the rescuer s to greater efforts.

Among others present were Mrs. Llew Jon es Mrs. G. Morgan, Dr. and Mrs. Hart, Dr. and Mr s: Malloch, Mr. A. Riley, manager of the colliery. Hart, recently appointed County Surgeo n , distnbuted the awards.

No. 6 DISTRICT

D A RLI N GTO N

a social held recently b y the Darlin g ton F r i endl y SOCleties Divisi on, Corporal W. Hod g e wa s pr esented WIth the J. H. T.a ylor Efficienc y Troph y b y Mrs. F. Hope WIlson, WIfe of Divisional Vice-Pr es ident Hope Wil son. Co rporal Hodge had the splendid record o f 222 duties during 1939.

Divisional President Councillor J. H. Taylor, M.e., who g ave the trophy for annual competItIOn, preSIded at the presentation.

A vote of thanks was acc o rded t o the D ivi sional and Mr s Ta ylo r for their continued inte r es t In the Division.

No. 8 (DUKE OF CONNAUGHT'S) DISTRICT

JERSEY

There was a attendance at the annual mee tin g of the Jersey DIVISIOn held under the chairmanship

of the County President, Mr. A. M. Coutanche (Bailiff of Jersey). Among the officials present were:

Dr. J. R. Hanna (County Surgeon), Mr. O. L. Aubin (District Officer), Miss M. M. Messervy (Lady District Officer), Mr. W. S. How (Chairman, Central Finance Committee, and Mr. H. L. Bohea (Divi sional Superintendent).

After the reports of the year's work were read, the County President addressed the meeting. He said they remembered with gratitude those members who were serving with the Colours. That service, of course, was inevitable; they had trained for years and the call came as they must have expected it. But the work of the Brigade had to go on. It was up to them all to pull their weight, and even more, in order to keep the flag flying. It gave him particular pleasure to know, he went on, that they had received official recognition of the good work done. One

they took up nursing. Sergeant Caw is at the Cheltenham General Hospital; Sergeant CockburnMercer at the local General Hospital.

A life-saving bronze medal was also presented b y Mr. Coutanche to Nursing-Cadet Joan Keig ler, an d a bar to her medal to Nursing Cadet Valerie Cav ey

Since Lady Cadet Superintendent Mrs. A. Mcfad yen took over the Division in September, 1937, no fe w er than 39 proficiency badges have been obtained.

In expressing thanks to the Bailiff for pres i ding, and to all who had helped the Bri g ade in the past, Dr. Hanna said that during this year of stre ss a l o t of work had been thrown on to their hands, b ut the " old toughs" had done the work, and done excellently without grumbling. Referring to the voluntary aid detachments, he said he was pleased to sa y that owing to the generosity of the Public Ass istance Committee the use of wards had been granted at the

example, as they knew, was that the Airport authorities had gratefully accepted the services of members of the Brigade, and the Piers and Harbours Committee were also very thankful. Another point was that they were indebted to Dr. Hanna, for it was thanks to his services that members of the paid police had come into the fold of the St. John Ambulance Brigade. A number of P.e.s were now fully qualified, and he hoped shortly, in company with Dr. Hanna, to present the badges to these men. He hoped later to see more members of the Force wearing the honourable badge of the Brigade.

At the conclusion of his address Mr. Coutanche presented the badge of the Grand Prior to two members of the Nursing Cadet Division: Sergeants Charlotte A. Caw and Kathleen M. CockburnMercer.

Both these Cadets are proving the value of their preliminary training. Shortly after war was declared 105

General Hospital, and there excellent w ork w as being done under the supervision of Mis s d' Authreau t o whom he wished to thank for the valued hel p she had given him during the year.

In conclusion, Dr. Hanna referred to the formation of a class for home nursing for men, and hoped that all those who attended would bring a friend, for , after all, nursing was as much a man' s job a s a woman's.

No. 9 DISTRICT (NORTH, EAST AND

MIDDEVON)

TORQUAY

Lady Divisional Superintendent Miss S. Collihole was recently presented with an illuminated address and cheque in recognition of he r twenty-six ye ars ' service with the Torquay Nursing Division. Alderman Mrs. E. Field (Vice-President) made the presentation on behalf of the Division.

2.

In reply to an address by the Vice-President: and by Miss D. Whitehead (Lady County Officer), Miss Collihole paid tribute to those who had worked with her. In this war, she said, the work was not the same as in the last. A.R.P. work had upset the Division, but she was sure that members, whether engaged in A.R.P. or not, would do their best.

Colonel E. C Ellis wished Miss Collihole long life and prosperity. She had done her wmk faithfully and well.

Others present included Mr. H. J. Vick (County Commissioner), Dr. M. LambIe (Divisional Surgeon), Mrs. A. Drew (Divisional Superintendent) and Mrs. C r. Ellis.

H.R.H. The Duke Birthday

On May Lord Scarbrough sent the following telegram to His Royal Highness, The Duke of Connaught :-

" Grand Prior and all M {fmbers of Order of St. John send heartfelt congratulations.-Scarbrough, Sub-Prior.')

The following reply was received by the Sub-Prior on May 2 :-

"Please convry my grateful thanks to Grand Prior and all Members of the Order for their kind congratulations .-Arthur.))

St. Day

]m..TE 24, 1940

The Dean of St. Paul's has invi ted the Order of St. John to hold its Commemoration Service on St. John's Day, June 24, in St. Paul's Cathedral at , 2.3° p.m. Members of Chapter-General will attend in their robes and seating will be for other members of the Order who apply to the Secretary, Order of St. John, St. John's Gate, Clerkenwell, E.C. for tickets before June roo 106

Special Service at Westminster Abbey

Readers of the GAZETTE will be interested to know that the Dean of Westminster is holding a Special Service of Prayer and Music in the Abbey on Monday, June 3, at 5.30 p.m., as a prelude to the nation-wide appeal which will be made during the following days in support of the Lord Mayor's Joint Red Cross and St. John Fund. An Ambulance Parade is being arranged outside the West Door of the Abbey and members of the Society and the Brigade are invited to attend the service in uniform. Special prayers will be offered for the men and women serving in His Majesty's Forces, for the sick and wounded, and for the British Red Cross Society and the Order of St. John.

Some of our finest musicians are giVIng their services and the music will include Handel's B fhit Concerto for Organ and Strings, played by Dr. Bullock with Orchestra; the Lark Ascending, played by Jelly d'Aranyi; and the new settino- of b Zadok the Priest composed by Dr. Bullock for the Abbey Choir on the occasion of the recent Maundy service and distribution honoured by the presence of their Majesties the King and Queen.

An appeal for the Fund will be made.

At this time in our history when the powers of darkness are unleashed and the merciful shadow of the Red Cross is cast over the whole of suffering Europe in direct opposition to the evil shadow of the swastika, the Fund is in need of every possible support.

Similar services are to be held in many of our great cathedrals-in St. Paul's on Tuesday, June 4, and in Canterbury, York, Exeter and others.

Applications for tickets for free admission to Westminster Abbey should be made in writing (enclosing a stamped addressed envelope for reply) to Mr. H. G. Sykes, The Lord Mayor's Red Cross and St. John Fund, The Mansion House, E.C4, marking the envelope in the top left-hand corner" Cathedral Service." For the other services, application should be made through the Joint Organiser in the appropriate area.

County of Hampshire

A conference was held at County Headquarters, Bournemouth, on April 3, to discuss in what way the services of Presidents and Vice-Presidents of Corps and Divisions could best be utilised. The Lady Superintendent-in-Chief, Mrs. St. John Atkinson, attended this conference and addressed the meeting. She spoke of the importance of the Honorary Staff and suggested that Corps and Divisions might co-operate more fully with their Presidents and Vice-Presidents. After some discussion it was decided that steps should be taken to bring this into effect.

The Lady Louis Mountbatten has been appointed President of the County Brigade. The Dowager Lady Swaythling, the Hon. Mrs Ingham Whitaker, Mrs. Harcourt and Mrs. Lionel de Rothschild have been appoint ed County Vice-Presidents.

On April 3, 1940, the Lady Superintendent-inChief, accompanied by His Worship the Mayor of Bournemouth, the County Commissioner, the County Staff and Lady Croft, President of the Nursing Divisions, inspected the Nursing Divisions of Bournemouth Corps at the Town Hall, Bournemouth. She expressed herself as being extremely pleased, not only with the general smartness on parade and in the March Past, but also in the practical work performed by teams of the nine Divisions of the Corps. Three hundred and four officers and members were on parade.

Review

A CATECHISM OF AIR R AID PREC AU TIONS.

This well-established booklet of Major Norman Hammer's has proved itself of great value to increasing numbers of people during the last few years, and this revised edition has been wisely increased to a small second volume covering the latest development of this rapidly increasing Government service. The two books are amazing condensations of so large a subject, and are full, exact and comprehensive. Amongst so much that is valuable, the two closing sections are especially so on " Organisation" .and " 1tfiscellaneous Notes." The section on "First Aid and Casualty Service Volunteers" is outstandingly fine and most valuable. Dr. Hammer has cleverly avoided technical phrases except in the one section "Therapeutic Oxygen Administration," and it is doubtful if more than a very few of the workers and readers could explain the word "Therapeutic." But such rare points are insignificant in so fine a production which surely will meet the large circulation it so highly deserves.

W. C B.

Rochdale Depot

The Rochdale Depot of the above is a very active centre, held at the St. John Ambulance Drill Hall, Holroyd Street.

The Hon. President IS Mrs. Tweedale, CB.E., A.R.R.C, J.P. (as officer in charge) , with the Mayoress (Mrs. Clarke) and the Deputy Mayoress (Mrs. L yo n Taylor) as . Vice-Presidents, and the secretaries, Miss Shanks, Mrs. Lawson, and Miss R. Parkinson.

There are 72 sub-centres attached, each with its own President and Secr etary, the workers number 1,200, and it takes a great deal of material to keep them all busy.

All the work is voluntary, including packing, dispatching and cleaning.

Over 10,000 articles have been made.

Funds for the following have been provided locally: 4,863 articles, includin g surgeons' masks, helpless case shirts, operation stockings, be d jackets, socks, many-tailed and roller bandages, etc. These have been sent through CH.S.S as gifts.

1,263 woollen articles have been sent to the Navy, 867 to the Army, and 630 to the Air Force These include 12 pullovers and 35 blankets, including a beautiful one made by an old lady of 83 and others by young Cadets-all from wool provided from local funds-showing that young and old can help.

A certificate has been received from the Royal Air Force Comforts Committee.

l q

Headquarters Home Nursing Course for Men and Women

A course of Home Nursing Lectures will be given at Belgrave House, Belgrave Square, beginning on May 20, at 7 p.m. Apply for further particulars to Mrs. Peter Che yney, Class Secretary, 3, Belgrave Square, S.W.I.

Found

MEDALLION No. 84,492

This will be forwarded if the owner "Frederick J. Moore," applies to Ambulance Officer F. Firth, Belvedere, The Common, Kippax, Leeds.

Interesting Case Reports

,CASE REpORT No. I64.-The Officer-in-Charge of MIdland .(\.rea No. V District, St. J.A.B., reports the performance of first aid by a member o.f the Clty of Bradford Police Corps in the following CIrcumstances :-

About 8.20 p.m. on December 22, 1939, a man, at a mill in Bradford, was attending a willeymg machine when the clothing of his left forearm :vas caught and the limb was dragged into the machinery, the limb being completely amputated except for some two or three inches of torn flesh left hanging from the shoulder.

P.c. R. W. Ingleson arrived with the Police Ambulance eight minutes after the accident. He at once digital the axilla and stopped the bleedi.ng, the patIent haVIng by this time lost a large quantity of blood in spite of similar attempts made by. The application of a tourniquet bemg ImpossIble oWillg to the loss of the limb, P.c. InglesQn. kept up digital pressure while the patient was carned by two workmen down two flights of a very narrow and circular staircase and ' in the ambulance its arrival at the Royal Infirmary. There he contmued to pressure while his patient wa.s prepared for Immediate operation and was only relieved from this task when at 9.20 p.m. the surgeons commenced operation.

In short, .P.c. Ingles<?n maintained digital pressure for. a perlOd of 52 minutes without aSSIstance ill most difficult circumstances.

C?MMENT.-Reading this report we do not know which qualtty most commands our admiration-the skill the perseverance or the physical strength of P.c. Ingleson. We do that on this occasion he accomplished a magnificent ptece of work which merits and receives our most cordial congratulations.-N. C. F.

II Questions and Answers

FRACTURE OF SPINE IN CERVICAL REGION

F. A. S. Rhodesia).-On page 37 of the February Issue of THE GAZETTE you replied to a query the above heading as to the extent of upon fracture of the spine in the cervIcal reglOn. The following case, which occurred a few years ago, is quoted in illustration of your reply to the above-mentioned query :-

A man dived into water which proved to be shallow; and he sustained a fracture of the 6th/7 th The diaphragm was not affected; but otherwIse he was completely paralysed. This mishap place at the port of Beira, Portuguese East Mrlca. An ambulance officer of the Brigade chanced to be near; and, with assistance, the patient was

108

removed from the water, and a doctor called. Meanwhile the patient remained conscious. The medical practitioner (who was not a Britisher) decided to take the patient to hospital by ordinary motor-car, and-in broken English but none the less testilythreatened to abandon the case when the ambulance officer, tactfully offered to improvise a spinal stretcher. Later.ln the the patient (after his spine had been duly Immobllised at the local hospital) was put into passen&,er train for a 204 mile all-night (12 hour) Inland to Umtali in S. Rhodesia (British terntory). The ambulance officer travelled with the wh.o .still remained conscious. Sips of liqUlds were administered by means of an ordinary tea-pot. The patient was naturally very depressed, the ambulance officer had constantly to cheer him up - not an easy task with a patient who was fully aware of his sad predicament and all that it implied. At the termination of the train a Brigade squad carefully removed the from the train and, no ambulance being avaIlable, transported him to hospital on an ordinary motor-lorry. The fact that he lived for three weeks afterwards, and was thus able to see his relatives was due in no small measure to the watchful care during the long journey to British medical ald. I have to-day verified the facts in conversation with the ambulance officer who handled the case.

We are grateful to you for this report of a case which the first aid qualifications of the ambulance ojjicer In more than one! We ask you, therefore, to convey our cordtal, if .congratulations to him on the proper use of these qualiftcatwns and also on the success which attended his efforts and handling of the patient.-N. C. F.

TREATMENT OF PRUSSIC ACID POISONING

M. S. (Bristol).-Please tell me which is the more urgent, the of Prussic Acid Poisoningthe admirustratlOn of the remedies indicated in Rule 2 on p. 176 of the Textb9ok, provided that the patient can swallow or the administration of an emetic.

The administration of an emetic, if at all possible, is the more urgent step in treatment because it conforms to Principle No. 2 on p. 23 of the Textbook and removes the cause.-N. C. F.

I COMPOUND FRACTURE OF THIGH, BONE PROTRUDING

M. S. (Bristol).-Please tell me if in the treatment of. a patient suffering from fracture of the th!gh or leg bone protruding, it would be allowable, :V1th due precautions, to place the limb straight if It were bent at the knee.

Yes-provided that your manipulations of the limb do not exert a'!Y fraction the fracture and more particularb do not drag the protrudmgfragments back into the wound.N. c.P.

THE TEXTBOOK AND ITS GENERAL RULES

R. D. (South Nutfield).-For treatment of Insensibility the Textbook tells us in General Rules

(page 154), "If breathing is absent perform artificial respiration. "

This appears to be a very hard-and-fast rule, allowing us no discretion at all, and one might easily do the wrong thing in some cases, besides making oneself look ridiculous in the eyes of bystanders.

For example, one is called to an insensible patient who is clutching a revolver and has a bullet wound in front of forehead. Pulse and respiration are absent.

Again, one is called to a patient who has collapsed; pulse and respiration are absent. In this case there is a known history of chronic heart disease.

We are not to assume death, yet according to the General Rules we should apply artificial respiration in both the above cases.

I shall be glad if you can give any guidance.

It is said that there is an exception to every rule. Nevertheless, general rules are positiveb invaluable especiallY in the teaching of a practical science like first aid. You err in that you quote extreme cases in support ofyour argum ent; and you overlook the real significance of the warning given in Principle No. on p. 23 of the Textbook, which te!!s you that " it is much better to treat a dead bocfy than to a!!ow a living person to die for want of first aid.)) FinallY, the science of first aid ca!!s for much common sense, a little specialised knowledge, and as much practical experience as possible.-N. C. F.

TRE ATMENT OF FRACTURED CLAVICLE AND ARM

W. D. (Newcastle-under-Lyme).-I shall appreciate a ruling on the treatment of a fracture of left clavicle which is accompanied by a fracture of the left humerus near the shoulder joint. This combination of injuries was give in a recent competition to several members of my Division, who flexed the upper limb to a right angle at the elbow and steadied it against the body by passing a broad bandage round the shoulder and another round the forearm, being tied off in the nipple line on the uninjured SIde of the body. They were told that the proper treatment was to place the forearm across the chest with the fingers pointing towards the shoulder of the uninjured side, as is done in the case of fractured clavicle, and .then secure the limb to the body with a broad bandage. Please say which method you would adopt.

Provided that the movements of the limb an made carefullY, I do not think that there is much to choose between the two methods. Nevertheless, I prefer the one which, as tiS, the members ofYO"Ir Division adopted, because mvolves less risk of aggravation to the fractured humerus which, -as the more serious i1!Jury, demands priorit)' in treatment.-N. C. F.

LOADING FOR FRACTURED THIGH

J. J. (Middle Lane).-Is it to be taken for granted that, when the left thigh is fractured, three Bearers must be on right side and only one on the left? Such seems to be implied by the illustration on page 209

of the Textbook, bearing in mind the instructions on p. 2 07· If so, what advantage would be obtained by being on this side and being on the right knee instead of left?

We shall appreciate your guidance.

The usual position of the three Bearers when loading stretcher, is on the left of the patient. The answer to your query, therefore, is in the negative, except when B earer No. for some reason decides otherwise. This migh t arise when he has three partlY-trained assistants and elects to take charge of the injured left side. - N. C. F.

Northern Ireland '

BELFAST

An interesting dual ceremony took place recently in the Ker Memorial Hall, Belfast, when an Inspection of the nine Belfast Nursing Divisions was carried out by their first County President (Lady Di xon, D.B.E.). The inspection was followed b y a presentation from members of the Brigade in Northern Ireland to Miss Rosabelle Sinclair who has recently retired from the post of Lady District Superintendent. Later the Commissioner (Mr. Ian Fraser, M.D., M.Ch., F.R.C.S.), who presided, formally welcomed Lad y Dixon to her new appointment, alluding to her wellknown interest in public affairs, and especially in all work connected with hospitals and the nursing profession. He recalled that there had been 100 members at the first Inspection by the Duchess of Abercorn some 10 years ago, and that to-day these numbered between 2,000 and 3,000. He referred also to the present demand made upon the Brigade by the Arm y, C.N.R., A.R.P., etc. After presentation of the President's Badge, Lady Dixon expressed her ap preciation of the honour conferred upon her and congratulated the Brigade on such a splendid turnout, saying that they could not be doing a .finer work for their country, whether in the stress of War or in time of Peace.

The Commissioner then proceeded to do honour to the work of Miss Sinclair, both during the last war and at home, and said it was to her ability and self-sacrifice that the Brigade in Northern Ireland owed its present position.

Mrs. Wallace, who recently succeeded Miss Sinclair as Lady District Superintendent, also spoke most warmly of Miss SinClair's achievements, and presented her with a gold watch and wallet, as a token of appreciation from the Brigade in Northern Ireland.

In acknowledging, Miss Sinclair said she was proud to have been associated with the work, and that in leaving it for the future with Mrs. Wallace, she was confident it was in good hands.

Colonel Gibbon, A.D.M.S., and Professor GreggWilson briefly addressed the meeting, after which First Aid Demonstrations were carried out under the direction of Assistant Commissioner Allen, by the four senior Nursing Divisions in Belfast.

Outstanding Advantages of Ovaltine Sleep

1 Ovaltine Sleep is Inore Restful

A series of scientific te sts conducted over a long period shQwed that • Ovalt ne' alQne. taken regularly at bedtime. cut down tossing and turning and gave a feeling of being" b etter r ested" in the morning.

2 O 'valtine Sleep restores theAfrves

The

3 Ovaltine Sleep re-crea!esE.nergx • Ovaltine

1- Ova/tine Sleep builds·upJfealtlJ:

Priory for Wales

He adquarters: Priory House, 4 Cathedral Road, Cardiff.

GENERAL INTEREST

The summar y of Brig ade Stren g th as at December 3 I, 1939, was reporte d to th e mittee held on April 30, und er the chaIrmanshIp of the Director of Ambulance, Pr o fe ss or George Knox, M.I.M.E., F.G.S., when sanction was given to the registration of the followin g n ew U nits formed since the last meetin g : Bang or City No. 2 Ambulance Division (Caernarvonshire), Cardiff Corporation Electricity Division , and t w o Ambulance Div isions at Ruthin and Uw chaled (Denbi g h shire); Nur si n g Divisions at Br ynmawr (Breckn o cks hire) and Maesmarchog (Glamorgan); Cadet Ambulance Divisions at Porthcawl and Pontypridd. It was noted that new Nursing Units had been p ro visionally formed at Bedwas, Llanishen and Pen g am in M o nmouthshire, and Cwmdu in Glamorgan.

Dr. Thomas McClure, Su rg eo n to the Cwmrach Division, Dr. Geoffre y G. O we n E va n s, Surge on to the Pontardawe Divis ion, and D r. Phillip Gibbins o f Whitland, were elected Hon o rar y Life Members o f the Priory in recognition of their g ratuitous services as Honorary Lecturers.

It was noted that durin g th e first three months of the year arrangements had b een made for 243 classes to be examined or re-examined in First Aid, and that the number of succes sful exami ne es i n classes held under the Priory during the yea r 1939 r ea ched the record tot al of 27,594.

It was announced th at the Director of the Ambulance Department of the Ord er , Brig.-General Sir Joseph Byrne, G.e.M.G., K.B E., e.B., had met a deputation from the Priory for Wales on the First Aid in Coal Mines Tex tboo k, due for publication shortly, with a view to this important subject being taken as a subsequent course by those alr eady in possession of First Aid Certificates. The Prior y was entrusted with the drafting of the textbook, and is particularly indebted to Profe ss or George Knox, Major A. W. Anderson, M.B., Ch.B., Professor T. David Jones, and Dr. T. W. David for their untiring services in this connection.

At a meeting of Council of the Priory held subsequently, it was noted that the Sub-Prior, the Earl of Plymouth, P.e., had approved the appointments of Mr. Thomas Andrews as Chairman of the Borough of Merthyr Tydfil Centre, the Viscountess Clive as Lady President, Montgomeryshire Centre,and Sir Charles B. Lowther, Bart., D.S.O., and Mr. F. H. I

Sutcliffe as Chairmen for E ast D enbigh shirc and West Denbighshire Centre r esp ec ti ve l y

JOINT

CO UNTY CO MM ITT E ES

The m a jo rity of counties in Wale s now have their Joint Committee s , w hich can g r eatly as si st the Headquarters of the War The I? os t rec ent development of this conn ectIOn IS the up a Joint Committee for whic? held ItS inau g ural m ee ting at the Ot y HalJ on A pnl G, under th e chairman ship of the Rt. Hon. the Earl of Plymouth, P.e., Lord Lieut en ant o f the Count y, and Sub-Prior of the Prio ry fo r Wales. Sir Ewen M a clean ,

The first task undertaken b y t he G la morg an Committee wa s the or g ani sati on o f the J oi nt Flag Days throughout the county. F o ll ow ing a communicati o n from the Chairman to all Mayo r s o f B o ro ug hs and Chairmen of Councils , represe nt at ive co mmitt ees have b ee n set up in eve r y t ow n and villa ge ; and th e re is ever y rea so n to re spect succ essfu l fla g da y effor ts. A small Ex ecutiv e Committee w as app ointed t o d eal with the other acti v iti es del eg ated to County Committee s , e. g ., the Pri so ne rs of War A d op ti on Sch em e ; and the Commi ttee is alr ead y i n touch w ith the Mili t ary and Ci v il Ho spita ls acc o mmodation Service Patients for the purpose of o btainin g hospital comforts

NEW TRED EGAR D IVISI O N IN EMERGENCY UNIFO RlvI

The If/ustralioll shOJI)s hOlV this Jo.Jol11J10tlthshire Unit has endeavoured at its olvn expense to tJleet the Heed of the moment by adopting a 1Inique III1i/orm which has the twofold olject of lessening the J.-ear of the more expensive official ulli/o rm and enabling members to be identified ea.iify ill the black -out. ALI the remainino member's-elevCIJ havlllg left for ser vice in H.lvJ. Forces-are voltmt eers itl the L ocal Allthority's Castral;;' Se rVIce, each one hav1llg taken St. John A.R P Awards and advanced training ill High Explosives and In cendiary Bombs. The D ivision holds a m ccessftll competitive record; and during the past year u'on the fo llOlving C orps T rophies :-Rhymney Valley Ambu ance League C up and Rhymnry VaLley Corps Leagfle C up, and the Edmllnd Mitis Hanl1 Shield.

T.D. , J.P., D.L., M.D., representing the B R.e.S. , was appointed Vice -Ch airm an; and in additi on to an equal numb er of repre senta ti v es of th e two bodie s co ve ring all p arts of the count y, certai n repre se ntatives of allied organisati o ns we r e co-opted, includin g Mr. Harry Farr, the Cardiff Ci t y Co uncil Librari an, who has accepted the impo r tant dut y of w o rkin g up a Glamorgan Book D ep o t. For som e years past the two bodies hav e been co-op er atin g with Mr. F arr in the maintenance of hospital libraries at the principal Cardiff institutions, through the voluntary services of uniformed personnel who attend regularl y a t the hospitals on "Library Days" to assist in the distribution of books. III

CENTRE REPORTS

C A RDIFF CEN TRE

Alderman G F Evans, J.P., p r esided at a me e ti n g of the Cardiff Centre Co mmittee, held on April 24, for the first time in th e co m f o r t a ble headquarters placed at its disposal b y th e M ar quis and Marchi one ss of Bute in the beautiful g r o und s o f Cardiff Castle. The Commissi oner fo r Cardi ff, Fli ght Lieutenan t Edgar Llewellyn, M.D., was w arml y con g ratulated on what w as consi d er ed a satisfact o r y and h ig hl y commendable report, from which the follow i n g is an extract:

" The year under revie w has fo r v arious reason s

been a hard and trying one for all ranks. Through the requirements of Air Precautions, Auxiliary Fire Services, War Police Reserve, and other causes, the Corps was deprived of the use of the Police Drill Hall, Cathays Park, which had been utilised as its headquarters for a number of years. This caused considerable inconvenience and for some ' weeks Divisions were at a loss to know how to carryon, more especially the Cardiff Emergency Ambulance and Nursing Divisions, and the Cardiff Ambulance and Nursing Divisions. Fortunately, through the generosity of Lady Bute, it was announced on June 8 that excellent accommodation would be provided in the Castle grounds and members were able to proceed forthwith towards the formation of First Aid classes and general Brigade training. In this connection our gratitude is due particularly to Mr. Bernard Brown and Mr. R. T. Richards, Honorary Secretary and Honorary Treasurer respectively, and Mrs. E. Llewelly.t;l, who were entirely responsible for the decoration and furnishing of the headquarters.

Large classes specially arranged for the genera l public were held during the year in the city, at which several hundred women received instruction in First Aid and Home Nursing.

In November a meeting of all ranks was called 'at the Centre Headquarter and addressed by the City Medical Officer of Health, who was assured of the whole-hearted assistance of the Brigade in Casualty Service Schemes.

Since the outbreak of war the Corps has co-operated with the Medical Officer in manning the First Aid Depots throughout the respective war areas.

First aid and stretcher drill instruction has been given by able and competent Brigade instructors to men of the Balloon Barrage Corps located in Cardiff.

The many calls on the services of the personnel in the Corps have been heavy and arduous, and I would like to pay tribute to the wonderful response shown by Units when the first Joint Flag Day was held on Saturday, October 28.

ABERDARE CENTRE

Mr. W. A. Morgan, agent to the Powell. Duffryn group of collieries, opened the Deep Duffryn Colliery Division's new Ambulance Hall on Saturday, March 30 in the presence of a large gathering. In his remarks Mr. Morgan stated that no fewer than 65 8 employees in the Deep Duffryn Colliery had qualified in first aid; and a Cadet Unit 73 strong would secure the future continuity of the senior Division. They were indebted, he said, to Mr. Frank Hann, the General Manager, for his instrumentality in having the building, formerly a colliery lamproom, converted for use as an Ambulance Headquarters.

The Hon. John H. Bruce, J.P., D.L. (Principal Secretary and Commissioner for Wales) expressed the gratitude of the Priory and the Division for the furniture provided by the Miners' Welfare Fund. Awards were presented by the Hon. Mrs. Bruce, Mrs. Martha Bath, J.P., Chairman of Mountain Ash Council, Mr. J. W. Grant, J.P., the Rev. T. C. Bowen, County Officer E. James. The Cadet Cup was presented to Lewis Parfitt, Mountain Ash, the Senior Cadet Cup to Alfred Price and the Ambulance Class Cup to Neville Jones.

CARMARTHENSHIRE CENTRE

Commissioner E. D. Jones, reporting on the past year's work in the County of Carmarthen, writes :" The numerical strength of the Brigade has increased during the year despite several members having to leave the county owing to unemployment.

A new Ambulance Division was formed at Coomb with the assistance of Lady Kylsant, C.B.E., wife of a former Sub-Prior of the Priory, who has provided accommodation for practice and lectures; and provided the members with uniform.

A new Nursing Division has been formed at Pwll, where Lady Howard Stepney has taken keen interest and has accepted the position of Divisional Superintendent, havin g purchased Uniforms for th e members.

The V.A. Detachment (Nursing) at Llanell y maintained its efficiency; and two members mobilised on the outbreak of war are still on active service.

Air Raid Precautions and examinations continue to be held and 176 qualified during the year in their various grades.

GLAMORGAN CENTRE

Ambulance workers in Glamorgan will learn with regret of the death of Mr. Dafydd Caredig Williams, of Rhiwglyn, Bridgend, who died on April 26. Mr. Williams, an Officer of the Order, was among the pioneers of Ambulance work in the Ogmore Valley; and since 1923 has held the rank of County Officer. Since the Commissioner for the Bridgend County Area has been engaged in military duties, Mr. Williams has acted as his deputy, in addition to carrying out the important duties of Honorary Secretary of the Glamorgan Centre Committee. His death is a distinct loss to Ambulance work in the county.

NE WS IN BRIEF

During the March quarter, the Priory Ambulance cars carried 5 cases, involving a total mileage of 86,I4 0

Progressi\'e in Training

By W. C. BENTALL, O.B.E., F.R.C.S., F.R.G.S., Assistant Surgeon-in-

C

hie!

Air Raid Precautions

ADVANCED AND TEAM TRAINING FOR CASUALTY SERVICE

fDr. W. C. Bentall, O.B.E., F.R.C.S., F.R.C.S., Assistant Surgeon-in-Cbie/, St. Jobn Ambulance Brigade, bas been appointed by Ibf lvlil1istlY of l-lealtb 10 co-operate il1 tbe training of CasuallJ l Services in tbe South-Eastern Region.-EDIToR]

As indicated in the articles of the last two months, this is one of the steps in Progressive Training as laid down in " Training Manual" NO.2. Each service of A.R .P. has its own specialised advanced team training and I now deal with that for the Casualty Services.

ADVANCED AND TEAM TR A INING

A Gas and First Aid certificate is not a completed training but only a necessary stepping-stone to advanced training, and bearing this in mind further teaching must be pursued-what that really means ' I now want to make clear.

1. For First Aid Part£es

(I) There must be knowledge of the general A :R.P. Casualty Service, e g., specific details of your local scheme. Where the First Aid posts are situated, the hospitals to which casualties must go, the depots of and ambulances, complete arrangement for dIsposal of casualties. If the Regional Training Officer does not appoint a special teacher for these things, there is no reason why a goo d leader should not instruct the members of several teams to gether.

(2.) Details of equipment should be mastered from the circulars issued; details of blankets, stretchers, splints, dressings , etc. The completion of these things should be looked to, their method of distribution, and the system of shuttle exchange fully understood.

(3) Most important of all is a clear and vivid description of large numbers of serious casualties, not so much with a view to careful and detailed treatment of each case, but to act quickly and with decision in sorting out those cases whose life depends o n priority action-fractures seldom i f ever kill a few days, but hremorrhage 'or shock' ma y kIll wlthm an hour, and you can save them if you spot them early. Do not kneel down at the first fracture yo u s.ee and put it up for a show competition! By the time you have finished there will probably be who have died from not having received your and prompt attention and yotl are the cause ot their death.

(4) Learn the types of air-raid injuries, countershock measures, methods of transportation-hand sea ts most important, stretchers, loading and

of ambulances must be practised-gen tle handling must not be sacrificed for speed.

Clever artists or amateur dramatists should take special training in faking casualties to imitate the real thing. If cri ticism be made that women workers will faint at gruesome sights, remember that it is better to faint before a real casualty, and so get used to the appearance of ghastly wounds.

2. For First Aid Posts and Mobile Units

The Medical Officer in charge of the Post is responsible to the M.O.H for the collective training of the personnel of a First Aid Post or Mobile Unit.

(a) Each member of the team should be appointed to her special duty and practise it in conjunction with others, e.g , instruments for the doctor, lotion to be ready, dressin gs prepared, water heated and ready continuously, waste dressings cleared away. Each member should be rt:sponsible for each item as detailed and others as the doc tor may decide. A special dut y with a special training is the programme.

(b) Always practise the speedy recognition of priori!} cases for treatment in relation to saving life.

(c) Look out for sp ecial letters marked b y the First Aid Party members with indelible pencils on the foreheads of patients . T for Tourniquet, M for morphin, X for perforated wounds of A bdomen or Thorax, C for gas contamination.

(d) Practi se filling in forms like :NLP.C.46 and M.P . C.44. If these are not done carefull y the casualty may lose all claim to a pension at a later period and you will have caused a life-long injustice to the wounded person!

(e) Practices with :NIobile U nits are strenuous and urgent. Team work here is most important. Duties on reaching the action station should be rehearsed and the methods of unloading equipment and setting up the temporary dressing station in various types of buildings or in the open should be assiduously practised with military precision.

3· alJd Attendants of Ambulances

(a) Team training should be first practised without equipment, in the technical points of parking ' to allow for unloadin g , o r blocking of other ambulances on

return journey. This should be practised in daylight and

(b) Master the rules of reversing and not leaving an ambulance in a cul-de-sac, or over a manhole which may be needed for hydrants, drains or stopcocks.

(c) Give Fire service priority of road and do not drive over Rat or full hose pipes.

(d) Drive with great care and take your corners slowly or you may convert primary shock into secondary shock. It is better to arrive late with a live patimt tha11 ear!J 1vith a dead one.

All members of all teams should have a chance of seeing the work of the Control Centre Staffs at the Control Room so that they may realise how their orders are received and sent out.

A.R.P. Questions and Answers

Q.-I find it difficult to tie bandages on a patient when I am wearing the gloves.

A.-Practise and you'll find it's easy.

Q.- Why are not the gloves made a tighter fit to facilitate work?

A.-Because of multitude of sizes, cost, and difficulty of distribution when all work in a rush.

Q

.-Could not a decontamination squad have a cylinder of compressed air to blowout bod y vapour from suits?

A.-Yes, he could if yo u like to add -to the weight, cost and complication of dressing.

Q.-In the absence of correct clothing are bicycle oil suits any good?

A.-Yes, helpful; any mackintosh is better than a cloth coat.

Q.-Would it be of any use to hose down the man entering the room after contamination?

A.-I'd rather do it in the street than in the room!

Q.-Is there a possibility of a person dying from general infection as a result of septic absorption from septic blisters alone?

A.-In the Great War about one case in 2,000.

Q.-As we are told, mustard gases are absorbed by oils and fats; why is it not absorbed by the oilskin protective clothing?

A.-Because of the method of manufacture of the cloth.

Q.- Why is it so important for a man before being dressed to remove his own underclothing and put on clean underclothing?

A.-Because the sweating is so copious that it is better to have clean undergarments soaked in sweat than dirty ones.

Q.- Why not a valve in wall of protective room, similar to respirator canister, to allow purified air to enter?

A.-Because of the great expense; this can be done and is done in making large protected rooms for big numbers of people.

II

RAILWAY NEWS

Southern Railway Contributed b y E. UZZELL

Seven Teams competed in the annual Railway Ambulance Competition for the cup presented by Mr. R. E. L. Maumell at Ashford.

- G. H. Morse's Team won; H. Coombe's Team were runners-up.

The cup, p rizes and annual class awards were presented by Mrs. Slade and 30-year certificates were also presented to Mr. G. Fuggle and Mr. R. H. Baldock.

Mr. E. Uzzell (Welfare Officer), who presided, thanked the audience for their support and congratulated all the competitors and members of the class on their excellent work. He applauded the efforts of the staff at Ashford in connection with the Company's A.R.P. scheme and made especial reference to the work of the three Instructors from Ashford, viz., Messrs. Henneker, Morse and White.

The annual dinner of the Poole and District ambulance class was held recently. Mr. A. Holdaway (Station Master) presided. Awards won during the year were presented by Mr. C. N. Anderson (Assistant Divisional Superintendent).

Mr. W .. Stempt, proposing the health of the visitors, welcomed their Welfare Officer, Mr. E Uzzell.

Mr. Uzzell, responding, said the work of the Order of St. John was very dear to all of them. It was one of the oldest services of chivalry and they were proud of their link with the past. He expressed the appreciation of the directorate and general manager of their efforts and congratulated them on their work in having gained the same number of awards as the previous year. He mentioned also that at the Waterloo first-aid post the I,oooth accident case had that day been dealt with, and concluded by appealing, on behalf of the Southern Railway Ambulance Centre, for new and increased strength in the movement, requesting the older members to maintain their interest, and more particularly to bring back to their fold those who had discontinued their refresher course. This was of paramount importance consequent upon loss of the younger members due to expansion of H.M. Forces.

In the competition for the Spooner Cup held recently- at Ramsgate, Mr. C. Silk obtained top marks and the runner-up was Mr. S. Redwood.

In the absence of Mrs. Spooner, the cup and other prizes were presented by Dr. Gordon, who remarked upon the good work of the first-aiders and paid tribute to the efforts of the new members.

His colleagues in the Ambulance world will be pleased to hear that Mr. E. J. Prew (District Ambulance Secretary for No. I b District) has been

BRAND'S ESSENCE

The finest NON·ALCOHOLIC STIMULANT

Throughout the ch 'il medical and nursing professions, and the medical serrices of H.M. Forces, Bran d 's E ssence is conslantly prescrib ed for combating criticalH'eakness arising from physical or mental exhaust ion and shock

Its uses, when First Aid is rendered to [he injured, lI ill be apparent from the folloll"ing brief summary of ilS adl'an(ages:

Brand's Essence is a NON-ALCOHOLIC STIMULANT

It is assimilated in its entirety, QUICKLY AND WITHOUT STRAIN, BY EVEN THE WEAKEST SYSTEM.

Its stimulating effect is PRACTICALLY INSTANTANEOUS.

B:-and's Essence DOES NOT PRODUCE AN AFTER-STATe OF MELANCHOLl Q.

It not o n ly conse rve s strength-IT BUILDS UP STRENGTH QUICKLY AND SAFELY IT CANNOT CAUSE THIRST.

Be sur e to hare a slIpply for The TreGlm ellt 0/011 cases where a stimulallt is indicated.

CHICKEN

From all Chemists in J ars an.i TillS.

promoted Officer (Brother) of the Venerable Order of the Hospital of St. John of Jerusalem.

London Midland and Scottish Railway

(CONTRIBUTED BY GILBERT S. HILL)

The following is an extract from the annual report of the Ambulance movement in Scotland, Session 1.93 8-39.

The number of Sections in the Brigade is now 8 I, new sections having been formed at A viemore, Balloch, and Glasgow (Shields Road).

Total number of employees passing examination during the year ended March 3 was 2,168. Si x t yseven first aid lectures were held in connection with the Brigade; many sections in addition to their first aid classes also held classes for Air Raid Precaution instruction.

Sixty-five teams took part in the annual competitions. Twelve of these qualified for the Final, held in Glasgow on April 18. The competition was conducted by the St. Andrew's Ambulance Association. Dundee West, Motherwell, and Mossend were first, second and third respectively. Dundee West also won the Scottish Railways S.hield Ambulance Competition from Mossend, with Motherwell third.

In the Women's Ambulance Competition one of the Scottish teams representing Glasgow (Locomotive Accountants) qualified to take part in the Final Competition held in London on April 14. They gained .the second prizes.

Motherwell team won both the "Cowan Cup" and "Presidents' Cup" in the St. Andrew's Ambulance Association Competitions.

The number of Long Service Gold Medals awarded to members of the staff throughout the line is :Scotland, 899; England and Wales, 3,464.

Team Test

MAJOR CARVER CUP INDIVIDUAL TEST

You are in a station and are summoned to to a man found ill in a compartment of the train which is in the station. Tbere is pool of blood by his left wrist. Attend to bim until a doctor arri ves in 5 minutes.

MARKS. Max. Obtd

Exact site of bremorrhage? (Incised wound abOlle wrist )

Type of bleeding? (Arterial)

Patient conscious? (Yes, but refuses to speak)

Local digital control. (No t sujjicientj

Remote digital control z

Any sign of fracture? (No)

Elevate the limb 2

Control at elbo w joint. (Af. 120)

Wou..'1d clean? (Yes)

Temporary dressing

General examination for other injuries. (Nil)

GENERAL CONDITION:

Face? (Pale)

Breathing? (QJlick)

Pulse? (Rapid and poor)

Odour of breath? (Pe culiar) Max .obtd.

Condition of moutb? (Inj!amed and parchrd, lilith small alllount of bltlish vomited matter nearby)

Any vomiting? (Painful Retching)

Preserve any vomited matter

Any bottle nea rby? (None visible)

Find bottle in coat pocket 2

Does odour of breath correspond to tbat of the bottle? (Yes)

Conterlts of bottle? (Iodine)

Preserve bottle and contents

Send for starch and wa te r, or cereals, etc.

Administer any ava il ab le emetic.

Administer starch and water, etc.

Demulcen ts after emetic

Treat sbock and collapse

Apply antiseptic and clean dressing to wound

Apply pad and firm bandage

Slacken tourniquet

Leave in place

Continued watch on bremorrbage Report · to doctor

An invaluable FIRST AID • MILTON antiseptic

T he swift irrigation of wounds or cuts with a dilution of Milton ensures surgically clean surfaces ready to he al.

Time limit: 5 minutes

WHAT IS SHOCK?

A condition of sudden depre ssio n of tbe nervo us system z

Resulting from and occurrin g after every case of sudde n ilL1ess and accident

WHAT ARE ITS STAGES?

Varies from feeling (s lig ht) of faintness

To a condition of collapse

From wbich d eath may result

WHAT ARE THE OBJ ECTS OF TREAnlENT ?

To promote warmth of the body

To encou rage a better circulation

To keep patient's mind and body at rest

GIVE DETAILS OF TREATMENT:

Two sections of treatment-immediate; at sbeln;r

Immedia te:

Arrest severe hremorrhage, if present

Lay patient on his back on a rug, etc.

Stead y and support any in jured part

Place h ead l ow and turne d to one side

Loosen clothing about the n eck , chest a nd waist, provide p lenty of fresh air

Prevent aggravation of any injuries by temporary measures

Cover lJ)e// with rugs, etc.

Raise well lower limbs

Smellin g salts to nose, except in bead inju ry

Encouraging words

Ensure freedom from excitement and worry

Do 110t discuss patient's condition and injurie s in his hearin g

Remove patient to sbelter as early as practicable

..1t J helter :

Wrap in blankets, apply hot water boctle s to sides of body, between legs , and to feet

If able to swallow:

Give hot strong tea or coffee, with pleney of s ugar

Except in case of internal injury "

Avoid alcohol

Examine for and treat all injuries, avoiding all Ul1l1CCCSSaiJI handling in re g ion s of inj uries

Total

For

BURNS

accidents

Wo:ld's Greatest For all kinds of skin d1seases and s kLll

Fo r Milton is of the same chemical nature as the fa mous Carrell-Dakin solution "plus "-plus stability, plus absolute uniformity of strength, plus non-causticity.

Milton has immense germicidal strength and some ten ti mes the penetrative power of iodine.

And because of its great strength Milton is most economica l to use; a dilution of one part in 20 of wa ter is sufficient for most purposes.

A·R·P·

The cleaning of gas masks, among other uses, is mo st efficiently and most economically done with Milton. The routine is wash the mask in water, wash again in Milton 1 in 50 solution and finally rinse in p lain water.

THIS IS THE CHEAPEST POSSIBLE liVAY

A whole Winchester of Milton costs seven and six, and yo ur dilution is half a teacupful to a gallon of wateren ough for 50 masks!

KEE P MILTON

TR EATMENT OF DEODORISING HANDY CUTS ALL & REQUIRING COMPLETE FOR FIRST & WOUNDS CONDITIONS ANTISEPSIS

MIL T ON

Born during the last war - best during this 6d., 1/-. 1/6 and 2/6 per bottle Winchesters 7/6 II7

URGENTLY WANTED!

OBITUARY

The Chief Commi s sioner re g rets to announce the death at Sy dney o n March 8, 1940, of Dr. W. Brodi e Grant.

Dr. Grant wa s a Serving Brother of the Order and Divisional Surgeon of the Balmain Ambulance Divisi on in w hich position he had serv ed since 19 21 . His loss will be sev erely felt by members of the Brigade in the New South Wales Distri ct.

We re g ret to record the recent death of Dr. A B. Fitzsimons, who for fi ve years had identified himself very closely with the welfare of the Brigade, both as Div isional Surgeon in Belfast Central Ambulance Division and as a much-valued expert a nd judge of competition work in Dublin and Belfast.

His connection with the North Ireland district ceased when he took up a po s t in Glasgow last y ear, but news of his death has been recei v ed with the deepe st regret by all who were associated with him i n the Brigade.

We re g ret to record tp.e death of Ambulance Officer

T J. Dyte, secretar y and transport officer of the Bath City Division.

Mr. Dyte joined the Division in I9I6 and, during his 25 years' service, travelled an average of four to five thousand miles per annum in the course of his duti e s.

He served in the R.A.F. in France durin g the Great War, and afterwards heiped to re- es tablish civ ilian work in Bath, in particular, invalid transport.

The large attendance at his funeral testified to the affectionate regard in which he was held b y all who knew him.

We regret to record the recent death of Superintendent A. J. Barrell (No. 10 District, County of Essex). Superintendent Barrell gained his First Aid Certificate in 1908. Six years later he joined the V.A.D., in which he served throughout the Great War. When a d e tachment of the S.J.A.B. was formed in his village in 1920 he was one of the first members to )om. In 1926 he was promoted to Sergeant. He held that rank until the detachment became a Division -in I936-when he was promoted to Superintendent. He was a keen and active member of the Brigade until a week before his death, and was in charge ot the A.R.P. Point and F.A. Party. He will be sorely missed by his many friends.

We re g ret to record the death of Miss E dn a Jackson at the ag e of 22. Mi ss Jackson was a member of the We y mouth Cadet Nursin g Divi sion and one o f the team which won th e Count y Co mpetition in I939.

National Flag Days

We are asked b y Se cretary-General to giv e the followin g information i n connection with th e National Flag Days which ar e t o b e h eld this yea r on June 5 and in October :-

It h a s been st ated on more than on e o ccasi o n th at fift y pe r cent. o f th e n e t procee d s r ai se d in each count y will be r emitted b y th e War Or gani sati on toward s indi v idual n eeds of t h e t w o bodie s withi n the c o unt y . F ro m corre sp o nd en ce r eceiv e d, it do es not se em to be so g enerall y und ersto o d that th e porti o n of the fift y p er cent. of th e net p rocee d s which C o unt y Branche s o f th e B r i tis h R e d Cros s Societ y and Centre s o f the St. Jo h n A mbul ance Ass ociati on and Unit s o f th e St. J o hn A mbul an ce Brig ade ma y r e ceive as th eir allo tm ent i s thei r s to sp e n d as the y ma y decide- w ithin th eir rules , of co u rseand that rio person or o th e r b o d y, includin g th e J oint Count y C o nunittee, h as a claim or li e n u pon it at all.

H avin g cleare d u p tha t p o int, r efe renc e may b e made to an o th e r m a tte r a r o und which an atm o sp h er e o f doubt ap pe a r s t o linger. J oint Count y Commi ttees, it w ill have b een r eali sed b y thi s tim e , are likely t o pla y a n imp o rtant p ar t in j o int w ar ac tivi ti e s in the counti es Their shar e in th e i ss u e of su p pli e s to home ho spitals, militar y and civ il, wh ere Servi ce patients are ta ke n, is , f o r example , alr ead y a c o nsider able re sponsibility F u rth er, th ey have b een invited b y the War Or gani sa ti o n , o n the g r o u n d th at the y are more cl os ely a cqu ain te d w ith lo cal co ndition s than an y Committee a t H ea dquarters can b e, to u n dertak e th e allocation w i thin the count y o f th e full count y share of Fla g D ay p rocee d s . Other duties they will certainly b e asked t o underta k e b y the War Or g anisati o n a s w ar se r v ices de ve l o p.

The establishment o f Joi nt County Committees i s almo s t co mplete for En g land and Wale s It is h o p ed that the few counties w h e re a J oint C o mmittee ha s still. to be formed will so o n com e into lin e with th e majorit y . A number of Joint Committe e s have b een active for some time before the outb r eak o f the war.

E x p enditure incu rred in con sequence of the Joint Committee activities in the coun ty should n o t neces saril y fall upon local f und s The War Or g anisation realise s that it has a responsibilit y in this fi eld While it hopes that bodi es within the county ma y see their way to contribute t o w a rds the e xpenditure of Joint County Committee s to the ex tent that thei r resources justify, it is prepared itself to make grant s towards the cost of the war activities of these Committees where a satisfactory claim is made for an allowance.

PRACTICAL BOOI{S

by N. CORBET FLETCHER, M.B., B.C., M.A.(Cantab.) , M.R.C.S.

A IDS TO FIRST-AID (7th Ed.)

First-Aid Simplified and Ta bulated with Aids to Memory. Price 1/- (Post 2d )

E FFICIENCY IN FIRST-AID (3rd Ed.)

Problems in Study , Tre a tment and Examination solved for Senior Students. Price 1/- (Post 3d )

C OMMON ERRORS IN FIRST-AID

Errors in First-Aid Detailed and Exp ained Price 1/- (Post 2d )

W HY AID AND WHEREFORE (5th Ed ) IN FIRST-

Difficulties in Study and Treatment Solved by Question and Answer Price I I ' (Post 2 t d )

A IDS TO HOME-NURSING

Home NurSing Simplified a nd Tabulated , with Aids to Memory Price 1/- (Post 2 d ).

A MBULANCE COMPETITION TESTS

Stretcher, Ind ivid ual and Question.

from:

THE

FOUNTAIN

PRESS

19, CURSITOR STREET, LONDON, E.CA THE St. John Ambulance Association

Its History and its Part in the Ambulance Movement

By N. CORBET FLETCHER,

EVERYTHING FOR SAFETY EVERYWHERE 'NOVOX' and 'NOVITA' Oxygen + CO, or Oxygen RESUSCITATI NG APPARATUS for the apparently asphyxiated or

SMOKE HELMETS of all Patterns. 'PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

cpURETHA' GAS MASKS for Naval, Military and Industrial purposes and for Civilian use ALL A.R.P. EQU I PMENT

DUST Safety SIEBE, and SPRAY MASKS and all other and Protective Devices. GORMAN

mbe 310bn

OFFICIAL GAS CHARTS

No. I Chart shows gas derivations.

No. 2 is a full and ' complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee.

MANUFACTURERS OF EVERY DESCRIPTION OF UNIFORM CLOTHING AND EQUIPMENT for St. John Ambulance Brigade. JACKETS, TROUSERS, GREATCOATS, CAPS, BELTS, GLOVES, HAVERSACKS, WATERBOTTLES. ETC.

ESTIMATES AND SAMPLES ON REQUEST

All enquiries to154 - 164, TOOLEY STREET LON 'DON BRIDGE, S.E.1

Telephone-Hop 2476 (4 lines). Telegrams-" Hobson, Boroh. London." North of England Office:-22, YORK PLACE, LEEDS. Telephone: 23334 Leeds. Telegrams: Triers, Leeds." T HE JOURNAL OF THE VENERABLE ORDER OF THE HOSPITAL OF ST JOHN OF JERUSALEM

Vol. 13. No, 6. JUNE, 1940

THE ST. JOHN AMBULANCE G AZETTE is published on the 5th of each month The annual subscription is 4S., post free; single copies 3d. Brigade Reports and Photographs should be addressed to the Editor, at )2, Shoe Lane, E.C.4. Reports and photographs should reach him as earry il1 the month as possible.

Subscriptions and Advertisements should be fonvarded to the publishers:

Messrs. British P eriodicals, Ltd., 19, 19fi, C ttrsitor S t reet , London, E.C.4.

CONTENTS

Editorial

Home Nursing P age

Red Cross and St J ohn \Xl ar Organisation

The Brigade in War- time Brigade News

Home Service Amb ulan ce Committee

Royal Visit to J oint Organ isat on Interesting Case R ep o rts Ques tions and Answers

A ir Raid Precautions

Priory f o r Wales

O ve rseas Ne,vs

St. J ohn A mbulan ce Assoc iati on (In dian Co uncil) Obituary

CHANCERY OF THE ORDER}

A Busy Year

ST. TOHN'S GATE, • CLERKENWELL, PAGE 12 3 I24 12 5 I27 uS LONDON, E.C.I.

The annual report of the Chief Commissioner shows that the membership of th e Brigade ha s risen to 12 I,, 08.

The increase of 31,563 coveri ng England, Wales, Northern Ireland and Eire i s due to the fac t that many people felt they could best help the national war effort by assisting the sick .and wounded.

Brigade-operated ambulance s carri ed 101 ,875 cases 1,419,501 miles.

At civ il hospitals, clinics and welfare centres the attendance by Officers and ursing Division s during 1939 was 186,322-an increase of almost 150,000 over 1938.

On the highways Briga de men were in attendance and the record shows that there are now 430 roadside hut s, 677 first aid posts and 663 first aid cabinets established on main roads

Sin ce the war began the activities of the Brigade have greatly increased. In addition to cu stomary dutie s members have attended a number of seamen inju red by enemy action, and transported them from their ships : they have even gone out in lifeboats to render first aid

In A .R.P. the Briga de has worked in close cooperatio n with the Home Office and all units have energetically undertak en the work of instructing the public in first aid and in anti-gas measures .

The R oyal Navy Sick Berth R eserve, the Military Hospit al R eserve and the V.A D. are" fed" by the St . J A .B., and all were read y ,"vhen war broke out. On August 25, 19 39, the R.N.S.B.R. was called up and a total of 1, 606 reserv is ts f o rmed a very valuable reinforcement to the R oya l Navy. The Military Hospital R eserve was mobilised on Sep tember I and members were posted to military hospitals in England and Wales. Volunteers were aske d for and obtained for an immediate Ambulance Unit in the R. A.1I.C. for service abr oad

Th e t otal number of Bri ga de members who mobili sed in the R. A .M.C. at the end of las t year was ZAGo-a fine backbone of first aid technicians.

DOME NURSING PAGE

Our New Chemical Defences

By DR. ANNIS GILLIE, M.R.C.P.

Ever since Pasteur established that infective illnesses, whether of plants, of animals, or of human beings, were caused by living bacteria, men have been striving to find a chemical which would attack the bacteria in the body, without damaging the living tissues. Success has been achieved ifi a few directions; syphilis can be controlled by injections of arsenic compounds, and some eastern diseases can be cured by similar means but in the acute ififections there was failure after failure until about five years ago.

A small group of substances called the sulphanilamides were discovered to cut short the most serious infections due to virulent streptococci. Scarlet fever and erysipelas were both lessened in severity; th e mortality of child-bed fever was reduced to a fraction of its previous total; and even when the germ was growing in the bloodstream (so called blood poisoning) lives were often saved. A little later it was found that some acute infections of the bladder and kidneys due to bacillus coli, responded miraculously to the same treatment, and gonorrhcea was also successfully treated, though many of these cases have relapsed. Pneumonia was benefited to a certain extent only.

Meanwhile an English pathologist, Dr. Lionel Whitby, and his colleagues were experimenting with other substances closely related to the original one. After thousands of experiments had been carried out upon nearly seven hundred different compounds, it was found that sulphapyridine, ma'rketed unde r the name ofM. & B. 693, was powerfully effective against even the most virulent types of pneumococci, and also against the meningococcus responsible for cerebrospinal meningitis. It is common knowledge that pneumonia can be cut short in 24 hours if treatment is started early and vigorously; it is less well known that spotted fever in its worst form has a death rate of only 10 per cent. when treated with this drug, instead of 90 per cent. or over. There is considerable hope that this same substance will attack the bacilli of gas gangrene when present in war wounds, though there has not yet been full opportunity to test this in the present war. It is a great safeguard against septic wounds and the blood poisoning which can arise from them.

These powerful substances are not entirely without bad effects on the body. Headache and nausea, even

vomiting, are common symptoms, though th ey 24 hours after the drug ceases to be taken. When given over long periods the chemicals can destroy the white cells in the blood; and if sulphur is taken in the food they combine with blood pigment and sulphur to form a substance that does not absorb oxygen easily, and the patient has a bluish tinge. All these side effects are known and watched for.

Large doses must be given at the outset either by mouth or by injection, as the germs can adapt themselves to small doses, and so become immune to further treatment-an interesting cause of some failures.

When properly used and carefully supervi sed, treatment b y proptosil, or streptocide, rubiazol or proseptacine; as the sulphanilamides are called by th e manufacturing firms, or by M. & B. 693, has produced cures as brilliant as have ever been recorded in the histo ry of medicine. They apply to certain definite i nfections, others are untouched by them; the y can be harm ful if not carefully used, but thev have already saved untold lives and eliminated of invalidism in a long list of the most dano-erous diseas es to which man is exposed in peace and in war.

Ulster Centre

EXTRACT S FROM THE ANNUAL REPORT FOR THE \:-'EAR ENDED SEPTEMBER 30, 1939

Two hundred and eleven classes were held in first aid; 3,861 persons attended the fu ll course of instr uction, 3,336 certificates, 127 vouchers, I 10 medallions and 24 labels bein g awarde d.

Fifty-six classes were held in Home Nursing; 1,031 persons attended the full course of lectures; 95 I certificates and 30 pendai1ts were awarded. Two preliminary hom e nursing examinations also were held and 17 certificates awarded.

Classes in A.R.P. were held in the City of Belfast and throughout Ulster where the formation of classe s in first aid and home nursing created much interest.

During the year Doctors Olive Darling, Eileen Gibson and Hugh H. Collier were elected hon. life members of the Association.

Red Cross and St. John War Organisation

(Continued from page 101, May issue)

FOREIGN REL ATIONS D EPARTMENT

Many enquiries are received for missing re latives in belligerent and enemy-occupied countries. These enquiries the Department passes through to the International Red Cross Committee at Geneva. They are sent by that Committee to the relevant Red Cross Organisation. If the country to which the missing relative has fled is known, the enquiry is passed s traight from London to the Red Cross Society of the country concerned. More than two thousand e nquiries have been sent through since the War s tarted. In addition, Polish enquiries number many thousands. They are first dealt with b y the Polish Co mmittee in London, and are then forwarded t o Geneva by the Foreign Relations Department.

With the help of the Nursing Divisions of the Sheffield Corps of the St. John Ambulance Brigade, Lady Riverdale, Lady Divisi onal Superintendent of the Ranmoor Nursing Division, and Miss Ashberry, the Lady District Officer, at the request of the officers and Medical Officer of the 7Ist Ridin g Field Regiment, R.A.T.A., opened a sick bay in January last and have recently admitted their hundredth patient. The sick bay is entirely staffed with St. John Ambulance Brigade nurses.

The Santa Barbara Branch of the British War Relief Associatio n aims at sending £100 a month to its Los Angeles Headquarters to be forwarded to London. It has been organised for three months. In that time, it held a cinema show, exhibiting" The Kino-'s People," and made a net profit of £170. A dance brought in £200. Nearly a hundred women members are making hospital garments. Our correspondent writes: "We are doing everything in our power to help our King and Country."

RED CROSS AGRICULTURE FUND

.Agri culture, which during the War of 1914-18 no than £1,024,808 for Red Cross purposes, IS agatn belDg called upon for a similar effort on behalf of the Lord Mayor's Appeal for the Duke of Gloucester's Red Cross and St. John Fund for th e present war.

The Red Cross Agriculture Fund Committee has therefore been appointed to oro-anise the activities of the agricultural community the country. The. committee includes representatives of every sectlOn of farming-landowners farmers · farmworkers, and the many industries' ancillary 'to agriculture.

Although no publicity ha s yet been undertaken on behalf of the fund, already in many districts sales of ' stock and farm produce are being arranged. Village flower shows are to be held during August. Through

12 5

the good offices of the Milk Marketing Board over 15,000 milk producers have already agreed to a voluntary levy of 2 S. 6d. per quarter being deducted from their milk cheques. 1;{ed Cross scrap metal dumps in rural areas are being arranged.

Thi s is an encouraging start, but only a start. Schemes on a national scale are now being organised for operation through county committees and, while the difficulties of the present time are well appreciated, an earnest appeal is made to the farming community and the important interests associated with agriculture for generous support to enable the fund to be worth y of the great industry whose name it bears. Communications should be addressed to the Secretary of the Fund at 30, Belgrave Square, London, S.W.I.

RURAL SCR AP COLLECTIOK

The collection of scrap metal in rural districts is a matter in which the Lord Mayor's Fund is directly interested. The :Nlinis ter of Supply told the House of Commons recently that a scheme was being prepared b y his Department in conjunction with the Red Cross Agri culture , Committee for organising village dumps for scrap iron.

The ' preliminary work of organising the dumps is bein g undertaken by the Ministry of Supply, and it will have the responsibility for the local arrangements. Each dump will bear the sign " Red Cross Scrap Metal Dump," and it is proposed that the site shall be selected and a local guardian (unpaid) appointed at a local meeting. The Red Cross Agriculture Committee is to collaborate with the Ministry in obtaining publicit y for these plans and the Committee further undertakes to utilise its organisation through County Committees for assisting the scheme.

The scrap collected will be sold b y the Ministry and the proceeds are to be remitted direct and intact to the Red Cross Agriculture Fund.

AN URBAN EXPERIMENT

Scrap collection in urban areas requires diffe r ent treatment. With the object of assisting the Lord NIayor's Red Cross and St. John Fund, an experimental appeal was made to residents in Coventry to hand over vario us kinds of salvage. It met with a very considerable response. In less than two months, more than 309 tons of valuable material have been collected at practically no cost, and this material has been returned to industry. At the same time, the Fund has benefited by over £ 500.

This success has been achieved by mobilising the scrap trade in a special wartime Red Cross effort and, encouraged by the success of the Coventry experiment, the organisers of the Lord Mayor's Fund propose t o

their salvage operations throughout WarwickshIre and, gradually, throughout the country.

RESIDENTIAL TRAINING COURSES

H.R.H. The of Kent recently inspected the new St. John Tralnmg Centre at Dingley Hall, which has been opened for residentIal Intensive training courses in First Aid and Home. Nursing: St. John Atkinson, Lady Supenntendent-In-Chief of Nursino- Divisions b' accomparued Her Royal Highness. this development of the St. John Ambulance AssoClabon, students, instead of attendino- weekly lectures, attend a fortnio-ht's course devotino- their b b wh?le bme to lectures and practical demonstrations, which are followed by the usual examinations. The students are mostly training to serve as Mobile V.A.D.s or Nursing Auxiliaries. The fee for the course is £3, which covers meals accommodation and instruction. ,

Applications should be made to Mrs. Beckwith Smith, Lady County Superintendent for Oxfordshire who originated the trainino- centres at Rutland House' Bice?ter, or to Lady Wernher, Lady Count; PresIdent for Leicestershire, at Thorpe Lubenham, Market Harborough.

RED CROSS AND ST. JOHN LIBRARY

There is an urgent and pressing demand for French books. are for French-Canadian troops who are In hospItal. Their appreciation of the somewhat small selection which has been sent to the .was striking. The Library does really need quanbties more. Let it be quite clear that these books are books which Frenchmen would read.

AREA OF WORK INCREASING

The .area of work of the Department is constantly expanding. Large demands, for instance, are now bemg received from the Middle East. They come from ?gypt itself, from Aden, from Iraq and from Palestme. At the same time, consignments have to sent to Service patients in home and B.E.F. hospItals, and t? the Commission's Stores Department in France. NInety-five parcels, six bales and two cases were dispatched during the first fortnight in April.

LONDON BOOK COLLECTION

A small group of voluntary workers have set to work on a plan of organised book collections in London. Up to the present time in most metropolitan districts the book collections have not been carried out upon a systematic basis. It is true that a very large number have been received from individual coll.ectors: but it is believed that on an organised baSIS many thousands of books should be received. large is the number of books the Library does reqUIre to keep up supplies to hospitals may be gathered from a return for a Service hospital which shows that its patients borrow 1,200 books a week. On this scale, this hospital should maintain a library of 3,000 books.

126

How to Write to a Prisoner of War

WHEN You MAY WRITE

I.-YOU can write to a Prisoner of War as often as you like. But a Prisoner of War in Germany cannot se-?-d more than three letters and four postcards a month If an officer or a civilian, or two letters and four postcards if " other ranks."

WRITE CLEARLY

2.-YOU should write clearly. Your letter must not be more than two sides of a sheet of notepaper. If your letter is longer than this, or you do not write clearly, it may be delayed or may not be delivered.

WRITE CAREFULLY

3·-Do not say anything in your letter that may be useful to the enemy. Don't write where Jack's ship was last week, or where Bill's unit is now or at what wo.rks Tom is employed and ';'hat special he IS domg. It is well to say nothing about ratlOns or food, and to keep away from politics. Be on the safe side on these matters if you want your letter to get through.

No ENCLOSURES

4.-Do not put any enclosure in your letter. It get stopped or delayed if you do. Photographs, pIcture postcards and pictorial representations of any kind may not be sent. If you feel you must send a photograph of some family event, y our letter must sent in a covering letter to the Chief Postal Censor, Aintree, Liverpool.

WRITE IN INK

5·-Write the address on the envelope and in the letter distinctly, so that it can be easily read, and you must write it in INK. It is best to write the letter in ink also.

ADDRESS CORRECTLY

6.-Make quite sure that you put the correct form address on the envelope, and 1c ep eat it in the letter.

First put the Navy, Army or Air Force number and prisoner to whom you are writing. Then his lrubals and name. On the second line write "British Prisoner of War" and follow with his Prisoner of War number. You will find this number on his letters and cards. Then on the third line put his camp .number or the name of the place where he IS a pnsoner. This will also be on his letter or card. Finally, add the name of the country in which he is a prisoner.

NOTE INSTRUCTIONS

7·-0n the top left-hand corner of the front of the envelope write the words" Prisoners of War Post."

On the outside flap of the back of the envelope put your name and address: but if you are in the Navy, or Air Force, you must NOT put yot;r address. In this case put the address of a relative or a friend, and arrange for :treplies to be forwarded by him to you. Post the letter, but do not stamp it. It goes post free.

The Brigade

• In War-Time

(We publish below the" Talk" broadcast by Mrs. St. John Atkinson, Lady Supel"intendentin-Chief Nursing Divisions, S.J.A.B., on A1J't'il 28 this year)

Wherever accidents are likely to occur, in mine or railway, factory or dock, the St. John Ambulance Brigade is at work. In peace-time its benevolent action is familiar to everyone. What I feel is not so generally known is the work our members are doing in war-time, when our duties extend in many other directions. It is about that war work that I want to talk to you to-day.

Before I begin, I should like to correct a curious impression in the minds of some people that the St. John Ambulance Brigade is a purely peace-time o rganisation, and that in war its functions are taken over by the British Red Cross Society.

Last September the British Red Cross Society and the Order of St. John signed an agreement to work together in close co-operation for the period of the \var. That agreement is being faithfully carried out, and the Society and the Order are working side by side, in hospitals, in first-aid posts, or wherever their help is needed. They are acting as partners, but they retain their individuality as can be seen by the fact that the members of these two great voluntary organisations to wear their own distinctive uniforms.

The Brigade has never failed to respond to the calls made upon it during the 53 years of its exi stence. When war was declared its members welcomed the opportunity of once more doing service to their country. The response has been magnificent.

Two thousand four hundred of our ambulance men have enlisted in the R.A.M.C. and 1,606 in Naval Sick Berth Reserves. Others are serving in ambulance trains, at first-aid posts and in stretcher-bearer parties, while at sea ports all round our coasts many seamen injured by enemy action have been treated b y our ambulance men.

The duties of our nursing members are no less important. A great number of them have enrolled in the Civil Nursing Reserve or as Mobile V.A.D.'s, and are already allocated to hospitals all over the country; many more are eagerly awaiting their turn.

Thousands are serving in first-aid posts and on mobile units. Others are giving splendid help in the various departments of the Joint War Organisation. Still others are giving valuable assistance in training

students in first aid and home nursing. I think that there is hardly a member of the St. John Ambulance Brigade who is not taking his or her share of work for the country.

Although at the moment there does not appear to be much more that our nursing members can do, the time will come when there will be an enormous demand for extra help in the hospitals. If and when the war develops, the hospitals-both Civil and Service -will require the assistance of ever y pair of hands they can obtain. Is it not ver y much better for th os e hands to be even partially trained, capable and ready to carry out any task that may be allotted to them, rather than (however willing) fumbling and useless?

I would say to you then, to an y y oung woman who has not yet decided what her war wor k is to be, come forward and prepare yourself n o w for what you ma y one day be called upon to do. Do not wait until it is too late and you are found unprepared.

One of the most recent activities of the Brigade i s the founding of a school for intens i ve training for women in first aid and home nursing. This training consists of a residential course of two weeks, during which the student takes six lectures in first aid and six in home nursing, the lectures being given by a qualified medical practitioner and a resident sister tutor. At the end of the fortnight's study examinations are held and the successful candidates are ready to go on to the necessary hours of hospital instruction. If any of my listeners are interested in these courses and would like to know more about them, will they write to Mrs. Beckwith Smith (the originator of the scheme), Rutland House, Bicester, Oxfordshire, who will give them all particulars.

I hope that in this brief summary I may have succeeded in telling you something of the work the Brigade is doing in war-time. Enough perhaps to convince you that every member is endeavouring to carryon the great traditions of the Order of St. John which is, so to speak, the parent of the Brigade; that ancient Order whose descendants to-day are carrying out its foundations by caring for the sick and needy in peace-time, for the wounded in war, and are striving through peace and war alike to live up to its great precept: Pro Utj/itate Homintlm (To Help Humanity).

I The St. John Ambulance Brigade News

No. (PRINCE OF WALES) DISTRICT

Sir Richard Sennett, C. St. J., has presented a Georglan tankard as a challenge prize for the Bri aade b In appreclatlOn of his appointment as President of No. 17 (Wimbledon and Merton) Division.

Activity in A.R.P. continues. This has been particularly emphasised recently by the valuable work done at Clacton-on-Sea, where high praise has been given by all in authority for the work performed by every branch of the A.R.P.

Volunteers are urgently needed for the International Commission for the Assistance of Child Refugees. A limited number of women members are needed in the Angouleme District of France for work among the refugees from Alsace. Members will work with French and British trained nurses in hospitals for women and children. Volunteers should be between the ages of 25 and 40, have a good knowledge of French and German, and be able to drive a car.

No salary is offered but all expenses will be paid.

The Committee of the Civil Nursina Reserve met recently, were of the opinion rrught be enrolled in the C.N.R. after completing 50 hours' work in a hospital, in accordance with Part II of the Training Regulations, but it was recommended that a maximum of 96 hours should be done in order that the Auxiliaries might be more useful in an emergency.

No. 2 DISTRICT

BRISTOL

About seven hq.ndred members of ambulance and nursing divisions of the Bristol Corps were among a large congregation which attended recently at Temple Church for the ceremonial depositing of the colours of the Corps for the duration of the war.

During the the Lord Mayor of Bristol (Alderman A. W. S. Burgess) made presentations and awards to of the corps.

Among others present were the Lady 1YIayoress, M.t .. A. J. Owens Britton (Assistant County ComrrusslOner), Lady County Superintendent Mrs. Burgess and County Officer G. J. Creech.

The service was conducted by the Vicar, Archdeacon Welchman, who is also Brigade Chaplain and Sub-Prelate.

CHELTENHAM

The recently formed Cheltenham Spa Division has been chieRy recruited from first aid parties. 12.8

Several ex-members of the Briga d e, whose enthusiasm has been revived by A.R.P. duties, and members of the A.R.P. Casualty Service who have realised the advantages of regular organised trainina by th e Brigade have also joined. b

The present strength of the Division is 25.

The following appointments ha ve been made:Dr. Crabtree to be Divisional Surgeon; Mr. C. G. Collins, who has been a member of the Cheltenham Town Division for many yea rs and was partly instru:nental in forming the cadet divisions, is to be su perIntendent; Mr. W. Tahran Rees will be Ambulance Officer; the Secretar y is Mr. A. Bailey.

An immense increase in work has been undertaken b y the C?rps during the past eight months in staffing

A. R.P. ald posts and first aid parties-and in providing instructors in first aid and home nursing classes at th e request of local A. R.P. authorities.

Both ambulance and nursing divisions have recruited many new members.

The strength of the Corps is approximately 400.

LUTON No. 3 (EA ST E R ) DISTRICT

The first divis ional meeting of the Vauxhall Motors Division was held recently, under the chairmanship of Divisional Superintenden t R. R. Hunter. Ninetyfive officers, N.C.O. s and men were present. -

The followin g is an extract from the minutes of the meeting :-

Superin tendent Hunter reviewed the posmon of first aid material distributed round the factory for industrial and A.R.P. purpo ses, and gave details of the locations of stretchers. He indicated that the first aid box system was to be overhauled and brou g ht into active service.

Confirming that a number of the personnel of the Division would shortly be put into uniform, the Superintendent stressed that keenest members were to be chosen for this honour, and that this arrangement would be followed up on future occasions, when it might be possible to distribute further uniforms to those intending to carryon after the war.

(Sixty-one members are now in uniform.)

A vote was taken as to whether Monday was the suitable evening for practice night. This ch01ce was endorsed. A sugaestion that outdoor practices might be arranged 0; occasional Saturday afternoons was noted by the Chairman.

The recent ruling regarding volunteers for the R.A.M.C. not being accepted under the age of 29 was read out, as well as a list of members !ivin a b

near the Luton and Dunstable Hospital. Members on this list were asked if they would be prepared to act as stretcher-bearers at the hospital in the event of an air raid in Luton-provided no objection was raised by the company's A.R.P. Controller. Eighteen members signified their willingness to help in this way.

A question was raised as to whether it might not be possible for members to attend at the hospital at week-ends and on other occasions to secure knowledge and experience of hospital conditions and further surgical work. The Chairman promised to investigate.

(Twenty members have volunteered and reported for practice. The Medical Officer has commented favourably upon their skill and bearing.)

with enthusiastic support. It has an initia l enrolment of 28 boys. A jumble sale was held recently to raise funds for this branch.

No. 5 DISTRICT DONCA STER

Through the good offices of Lord Scarbrough, Sub-Prior of the Order of St. John, the personnel of No. First Aid Post have acquired a life-size model for practice work.

No. 8

(DUKE OF CONNAUGHT'S) DISTRICT FOLKESTONE

In the M,?rch issue we gave particulars of Brigade service rendered by Superintendent Stitcher (No. 30

NO . 4 (LANCASHIRE) DISTRICT

CLEVELEYS

The Nursing Division are still holding classes for training new recruits and have recently admitted twelve to the strength of the Division. All ha ve passed the Home Nursing examination-their success being to a great extent due to the splendid lectures given by Dr. J. Nuttall Horne, the Divisional Surgeon.

A large percentage of the Division are enrolled in the Civil Nursing reserve; two are serving in hospitals, others are on call as needed.

At the local A.R.P. exercises there was a one hundred per cent. attendance.

The Ambulance Division have had a Home Nursing examination, lectures for which were given by the Divisional Surgeon with gratifying results.

A Cadet Division in course of formation has met

12.9

East London Division) and his fami ly. Mr. L. B. Easton, Secretary of the Folkestone Corps, has submitted details which show that no fewer than 135 years have been served in this Corps by sixteen persons connected with one family, thirteen of whom are still serving.

We again offer our congratulati ons!

HOVE

At a concert given to Portslade Ambulance and Nursing Divisons badges of office were presented to the Presidents and Vice-Presidents of each Divisi on. First aid and nursing certificates were also awarded.

A tribute was paid to the keenness and enthusiasm of these newly-formed divisions by District Officer W. J. Noble, who made the presentations. An appeal for more funds to equip them was given by Divisional Surgeon Dr. E. N Gorman.

2.

The Mayor and Mayoress of Hove (Councillor A. W. Hillman, J.P., and Mrs. Hillman) were among those present.

HORSHAM

District Officer W. J. Noble, after inspecting the division, congratulated members on their efficiency and said: "You are a credit to our great movement."

Home Service Ambulance . Committee

EXTRACTS FROM TWENTY-FIRST ANNUAL REPORT

The Home Ambulance Service of the Order of St. John and the British Red Cross Society can now look back on twenty-one years' unremitting service to the community with justifiable pride, years in which the scheme for the organisation of a National Ambulance Service has grown to a truly gratifying extent, dependent as it is upon voluntary effort.

Since the declaration of war Home Ambulance Service stations, in spite of difficulties, have carried on. Much additional work has been undertaken.

The Evacuation of London and the large towns threw an extra burden on ambulance personnel, and, in addition to the long hours of service, conditions were rendered far more difficult and nerve-racking than in normal times by reason of the" black-out."

Much valuable work is being carried out b y Coastal Ambulance Service in connection with the removal of passengers and crews of shipwrecked vessels. Because of the necessity for secrecy it is not possible to indicate where the ambulances are stationed, the personnel of which undertake this arduous task.

The following extract from The Times illustrates how severely the organisation may be tested:"One wild night a steamer ran ashore nearly thirty miles away. This ship had on board, in addition to her own crew, sixty-two survivors of a liner which had been sunk twelve hours earlier. Two lifeboats went to the wreck and a life-saving crew clamber ed up the cliffs. Ambulance men and nurses arrived in cars at a cove near the wreck, and later ambulances went to join the life-saving company. They traversed several miles of narrow and tortuous lanes, hard going (or the big thirteen-stretcher ambulance. and .another, normally used for conveying cnppled children to school, were safely driven to the scene as well as a number of ordinary ambulance cars. Blinding rain and fog added greatly to the difficulties of the drivers, some of whom had been called from bed.

"The sixty-two survivors were the first to be brought ashore, and the women and children, under the care of nurses, travelled thirty miles in an 13°

ambulance heated by a hot-water , pipe system-a boon after their tWe;) ordeals in one day. The men survivors were also taken by ambulances the same distance, and later ambulance workers stood by on the cliffs as the crew came ashore in the breeche s buoy. Some of them, injured or feeling the effects of exposure, gratefully welcomed the assistance provided. No sooner had all these survivors been transported to hospitals and hostels than, within an hour, the organisation was called to the docks to deal with thirty-five survivors of a large vessel which had been torpedoed."

LONDON SERVICE

In 1938 the King Edward's Hospital Fund established its Emergency Bed Service. It was recognised that the Home Service Ambulance Committee might co-operate with that bod y in the provision of ambulances. The arrangements entered into proved so satisfactory that Headquarters were asked and had agreed to commence a 24-hour service in October, 1939, but on the declaration of war the entire staff of the Emergency Bed Service was taken over by the Ministry of Health and the Service suspended.

Early in October, however, an attempt was made to re-establish this Service with a skeleton staff. With the releasing of more beds for the ordinary civilian sick in the London hospitals, this effort proved entirely successful-c ircumstanc es at the moment, however, do not warrant the running of a 24-hour Ambulance Service for the Emergency Bed Service, night work being undertaken by the London County Council Ambulance Service.

The following figures show the number and class of patients carried during the year ended 1939, with the figures for the corresponding period of 193 8 :-

Much credit is due to the St. John and Red Cross nurses who, in the last year, have unselfishly given so much time in lPndly accompanying patients in the Headquarters' Ambulances.

Uniform Permits

In future all Nursing personnel of the Brigade will be required to carry a uniform permit when wearing uniform.

These permits will be issued by the Lady Divisional Superintendent or Senior Officer, and will be obtained by them through the DistrictCounty Organisation.

Royal Visit to Joint Organisation of British Red Cross and Order of St. John

Her Majesty the Queen, attended by the Lady Ka therine Seymour, visited the V.A.D. and Detachment Department of the Joint War Organisation of the British Red Cross Society and the Order of St. John at 3, Belgrave Square, on May 21.

Her Majesty was received b y Mrs. St. John Atki nson, Lady Superintendent-in-Chief Nursing Divisions of the St. John Ambulance Brigade, and Colonel De la Pryme, Acting Secretary for the V.A. D. Council.

The Queen visi ted each department and showed gre at interest in the work.

Her Majesty was particularly concerned to learn there was an urgent need for Nursing Auxiliaries for fu ll-time service in civil hospitals, and expressed the ho pe that the need would be met. The Queen was also gratified to know that a number of V.A.D. me mbers were taking up general training in order to become State Registered Nurses.

Her Majesty's visit was a source of great encouragement and an inspiration to everyone in the Department.

Hospital Train Service

Writing of the work recently carried out by members of the Birmingham Corps, Colonel Su Bertram Ford, T.D. , D.L., LL.D.-County Commissioner-in a letter to Major P. G. Da rvi l-Smith, C.B .E., Secretary of the Brigade, said ;-

" We received an intimation that a hospital train wo uld arrive at or near Birmingham the following evening. The actual station was not known. Arrangements were at once by telephone to warn some 60 officers and men to be ready to parade early the next evening, as the only time given us was , probably about du sk.'

"The next day several messages came along to indicate that the station would be Barnt Green-some I miles from the City centre-and that the time wou ld be 9 p.m. A lat er message said that the time of arrival would be midnight and a further message sta ted that the time would be approximately 4 a.m ., probably 4.25 a.m.

" Owing to the impossibility of ge tting men in from their homes at such an early hour, due to black-out and tran sport difficulties, I decided to parade all who had been warned for duty at our Headquarters at 10 p.m. When they arrived I explained the work to be done and the system by which it should be carried out.

"The men were then served .with hot tea, coffee 131

and sandwiches. All available stretchers were laid out with all the blankets we could get together and th e Assemb ly Room was turned into a dormitory -the officers using another room. The men were advised to lie down and sleep.

"At 2.30 a.m. all were called. Hot tea and coffee was served and a ration given out. Arrangements had been made for two Corporation buses which were go ing ou t for (sitting cases' to call at Headquarters at 3 a.m. The men were formed up and told off into sections and squads and officers posted, and at 3 a.m. we all moved off. A lamp was provided by us for each officer.

" The train arrived soon after 4.30 a.m. It carried 13 5 sitting cases and 70 stretcher cases.

" The stretcher cases were taken by two converted Corporation buses and two of my large 4-stretcher ...ambulances.

C< The whole train load was disposed of by 6.10 a.m.

C< The men were then formed up and, after receiving hot tea, were marched to buses, which took them to the nearest bus or tram routes for them to get to work.

« Th e system worked on was that of which .1 sen t you particulars a short time ago. It admirably, with great precision and speed, espeClally as we not unloading on to a platform, but on t o the line, and it was, of course, dark.

« The authorities expressed themselves delighted and amazed.

« The discipline, quietnes s and stead y persistent cheerful hard work of all ranks was admirable. I was very proud of them all."

Westminster City Council Centre for Refugees

At the request of the Council a St.) ohn Ambulance first aid post has been organised In connection with the Council's Centre for refugees.

Brigade members deal with casualties and cases of illness brought to the post. The Women's Service is doing splendid work in conneCi10.r: WIth the feeding and care of These dunes are covered dail y b y the London DIstnct

Found

MEDALLION No. 258859.

This will be forwarded if the owner, "Alice Hudspith," applies to : Miss Story, Honorary Secretary, Hastings Nursing Division, Flat 4, 42, Cornwallis Gardens, Hastings.

Interesting Case Reports

CASE REpORT No. 165.-The Officer-in-Charge of the County of Derby S.J.A.B. reports transport by ambulance efficiently performed on two consecutive days by members of the Derby Division-Corporal E. Ibbotson and Privates H. Hackett and A. Toonin the following difficult circumstances:-

On February 28 a call was received for the ambulance to proceed to a unit in the country for the purpose of transporting a sick soldier to the Derbyshire Royal Infirmary. As the location of the unit could not be given, a soldier was posted to meet and direct the ambulance. The snow was very deep, and the ambulance skidded on the frozen road, and heeled over on its side in a deep drift. The soldier reported the accident to the military authorities, who promptly despatched help. After some delay the ambulance was righted and the patient was quickly removed to hospital.

Oil February 29 a doctor tang from Etwall and asked that a soldier suffering from acute appendicitis should be removed to the Infirmary. The snowdrifts were in some places seven feet deep, and where the patient was living was half a mile from the road. Soldiers trampled down the drifts to enable the ambulance to get near and a horse-drawn snow-plough was also used to clear the way. These measures. not being successful, the patient was then placed on a stretcher which was strapped to the snow plough and carried to the ambulance, in which he was quickly transported to hospital for successful operation.

COMMENT.- Th is report is interesting, and we tender cordial congratulation to these members of Derqy Division on the scife accomplishment of their tasks in face of abnormal conditions and outstanding difJiculties.-N. C. F.

Questions and

.

Answers

1.1

11

TREATMENT OF DISLOCATED ANKLE

H. C. (Morden).-Further to your reply to my query published in the April issue of THE GAZETTE under the above heading, we are still in difficulties because we are taught to treat a dislocation as a fracture. Consequently, discussion is still going on as to the treatment of a dislocated ankle being given as stated on p. 92 of the Textbook. The index refers us to p. 92, whereas you in your reply quoted p. 96, on which I cannot find any answer to my question. Please may I have your further comments?

It is news to me that a dislocation to be treated as a fracture. The Textbook does not support this suggestion; and on p. 96-contrary to your statement-it describes the special treatment for a dislocation.

The index reference is palpablY a misprint, p. 92 being

quoted instead of p. 96. At least, I can find no reference to dislocation on the former page.-N. C. F.

FRACTURES OF RIGHT CLAVICLE AND LEFT SCAPULA

R. D. (Allestree).-With reference to your reply to the query published under the above heading in the April issue of THE GAZETTE, may I draw your attention to one obvious error, since your reply does not mention the scapula?

Incidentally, I also am of the opinion that, provided the braces are removed on the injured side, it is possible to place the axillary pad in the armpit with the coat still in position.

If you re-read the replY you will find these words: " and then bandage the upper limb (flexed at the elbow) to the trunk." These clearlY refer to my suggested treatment of the left scapula, the actual naming of which was not necessary qy reason of the context. So 1vhere is the" obvious error IJ ? -N. C. F.

TRE ATMENT OF FRACTURED PATELLA

W. A. (Blackpool).-The Textbook (p. 90) tells us in Rule under the treatment of fractured kneecap to lay patient on his back, to raise well and support head and shoulders, and to straighten and r aise the head. Please tell me if this means that the limb should be kept in a raised position during the securing of bandages A, B, and C, or if the limb should be left on the splint and on the ground until after these bandages are applied.

The object of raising both head and shoulders and also the limb is to relax the thigh muscles which may pull on the upper fragment of the broken patdla. Consequen tlY, as Rule 1 states, the patient should be placed in the correct position at the outset of treatment, and bandages A, B, and C should be applied to limb after it has been raised and supported on a back splint. - N. C. F.

ARTIFICIAL RESPIRATION WITH FRACTURED RIBS

H. R. (Freetown, Sierra Leone).-I would feel obliged if you could tell me if Schafer's method of artificial respiration may be used in the case of an apparently drowned individual who has a fractured rib.

I have explained to another S.B.A. that it is quite right to use this method, but he insists that it should not be used and one of the other methods used instead. He maintains that it would cause extensive damage to the fractured ribs and other organs. Would you please give me a detailed answer for which I enclose stamped envelope? If this could be done it would, I am sure, settle this argument.

Of course,you realise that the diagnosis of fractured ribs in an asphyxiated person may be a most dijjicult p r opositi011, and that such if!Juries are often missed in an emergenry.

Be that as it may, I consider that Schafer's method is the correct method in the treatment of a patient sufferingfrom asphyxia and fractured ribs, because pressure is exerted on the loins (namelY, the spaces between lowest ribs and crests of iliac bones) and not on the ribs. On the other hand

Silvester's" method would result in a big pull on the ribs, with consequent risk of simple being converted into complicated fracture of ribs.-N.

C. F.

TREATMENT OF PATIENT WITH CRUSHED THIGHS

J. P. (Whitechapel). -As one Brigade surgeon to another, may I be permitted to ask my colleague D. P. (East London) for explanations on the three problems which he raised in the Query column of the March issue of THE GAZETTE?

In an attempt to make myself clear, I have added certain comments after the questions. Now for the firs t problem which' was published under the above heading :-

(1) What is a " complete JJ fracture?

The term is meaningless. Even a simple fracture is complete.

(2) Is not the advice to feel the pulse at the ankle dangerous, and a 1vaste of valuable time?

The patient is described as having both thighs crushed by a beam which was "heavy." A sure indication for double amputation! Would anyone in his senses attempt to take the man's boots off? The shock in this case would be extreme. It would be difficult enough in such cases even to feel the feeble pulse at the wrist.

(3) pass tourniquets below as well as above the beam?

It would obviously be impossible to pass anything at all below the thighs till the beam was removed.

I am grateful to N. C. F. for the opportunity of repfjing personallY to the questions raised qy my Brigade colleague, as follows :-

(1) A fracture may be complete if a bone is broken right through, whereas an incomplete fracture is one in 1vhich onlY a part of the bone is damaged, stich as a green-stick fracttfre. The term is not meaningless, since in every textbook of surgery a difference is recognised bef1veen complete and incomplete fractures.

(2) The absence of a pulse does not indicate amputation! The artery may be simplY caught or compressed; and a sttdden rush of blood after the removal of the beam may burst it. AlternativelY it may be caught between the fragments of the bone.

Absence of the pttlse is an indication that a tourniqtfet should be applied immediatelY to prevent a fatal arterial hcemorrhage, or at best a tremendous loss of blood. The boots must be cut, and not taken off the feet. The popliteal artery may sometimes be palpated.

Time is valuable, but a human life is still m01-e valuable. Shock need not be severe at all, and in maf!)1 instances, in my own experience, it has not proved so.

(3) A severe venous htemorrhage may be expecterJ. As you cannot raise the limb, you will have to applY two ligatures round limb. So why not be reacfy beforehand?

In the mqjority of cases it is quite possible to pass a tourniquet or ligature round the limb 1vith the beam still in position, provided that one starts at the natural hol101v at the back of the ankle.

D. P (East London).

TREATMENT OF PATIENT WITH CRUSHED RIB S

J. P. (Whitechapel).-With reference to the second problem publi shed under the above heading, I would like to ask my colleague why the patient should be asked to m ove his fingers.

The spinal fracture, if any, would be in the thoracic and therefore the arms would be unaffected.

This would not necessarilY be the case. Further, in addition to the obvious irijury, there may be a latent one, caused,for instance, qy the fall itself-D.P. (East London)

TREATMENT OF COMPOUND FRACTURE

J. P. (Whitechapel).-This, the last of my colleague's three problems, is not a problem. The first paragraph only applies to one or two of the many such compound fractures possible in the body. Anyhow, this has already been shown to be foolish by N. C. F. in his answer.

Not quite so! Imagine that you have to transport the irijured patient for a few hours or even longer in a primitive convryance on a rough road. Then the importance of the fixation of the limb without depressing the infected bone back into the wound will at once become obvious. Further, N. C. F.' s opposition was to the time and not to the method.-D. P. (East London).

[N.B.-The Battle of the Three Problems is at an end !-N. C. F.]

STINGS OF INSECTS _lliD PLANTS

T. P. (Watford).-I have always understood that the poison injected with a bee sting and from a stinging plant contains formic acid, so that a weak alkali may be used as an antidote; but that the poison from a wasp sting is alkaline in nature, so that the addition of sodium bicarbonate or sodium carbonate (as suggested on page 181 of the Textbo ok) would not tend to soothe the irritation or counteract the poison. Am I mistaken? Also, is not the chief danger from infection of the wound in other ways than from the sting? Your kind help will be appreciated.

The venom it!jected qy the ant is known to be formic acid. In all other cases the nature of the venom is not knmvn ; but, on the analogy of the ant, it has been presumed that plants and insects i1!ject acid venoms. ConsequentlY treatment qy application of alkali solution has always been advocated.

In these latter days, though the fact has not got into the Textbook, the venom irijected qy t he wasp has been prov en (qy experiment with litmus paper) to be usuallY alkaline in reaction. This justifies the old-time habit of the farmer who i s reputed alwq)'s to applY slices of onion (which is acid) to zvasp stings; and it therefore suggests the advisability of appb,ing an acid solution to counteract wasp poison. Nevertheless, experience proves that application of an alkaline solution often gives even 1vith a wasp sting, as it may with a1'!)' form of skin i1-ritation.

Whilst owing to presence of a punctured wound it is possible for i1!/ection to rest-tit from other causes than the venom, this cannot be regarded as the chief danger, because it is comparativelY rare.-N. C. F.

Ad"anced Training

By W. C. BENTALL, O.B.E., F.R.C.S., F.R.G.S., Assistant Su rgeon-in- Chief

in Air Raid Precautions

DEPOT ROUTINE AND DISCIPLINE

In the last article on the subject of Advanced Training I dealt with the special points connected with the Casualty Services of A.R.P. There are similar points relating to Rescue Squads, Demolition Parties, Fire Service and Police Service, but the details of these are hardly suitable for publishing in a Gazette of first aid work. I therefore pass on this month to the subject of Depot Routine and Discipline, and this applies to every service in A.R.P., and I proceed now to deal with it as applied to the Casualty Services.

" Waiting" with insufficient active service is the great bugbear in the development of all new Services like A.R.P., and as the old Services, such as the Army and Navy, have long since proven the best corrective to prevent this trouble is sound routine.

Probably we should have had a more enthusiastic party of A.R.P. workers if vigorous warfare had immediately followed e;arly training, but its effectiveness would not have been a fraction of the effectiveness that will result when our Services are actually called upon if their hi£"her training depot routine and discipline has gradually welded all the various Services into one exhaustive whole that pecforms its duties almost automatically from prolonged and efficient training and practice. To throw raw recruits into the front line of big battle is certainly to court failureto throw men and women who have taken a course of first aid and gas into the front line following an extensive aerial attack in this country is also to court failure

Depot routine and discipline is very easily applied to the workers of a paid service, but it takes much more pains and infinite care to produce a similar system with a mixture of voluntary and paid help.

In many of the London centres, in large elementary schools evacuated under the war scheme, barracks have been produced for A.R.P. personnel. They live and sleep there; their life is as ordered as the life of soldiers in barracks and the procedure is comparatively easily carried out with enormous benefit, not only in producing teams which turn out much more quickly, but teams which also perform their work much more effectively.

In such a depot I have .seen First Aid Parties, Ambulance Drivers and Attendants, First Aid Post

Parties all barracked and training under a central organisation.

To achieve this ideal in provincial or rural areas is increasingly difficult, but towards that aim efforts should always be made .

Firstly, let me give an outline of the work carried out in such a depot, and secondly I will make su ggestions for the planning of the voluntary and paid personnel.

(1) A programme for each day's procedure should be definitely drawn up. Each place will ha ve its own programme, which is not necessarily standardised for town and country, and the following is a suggestion of the principle involved :-

8.00 Breakfast.

9.00 Inspection. This refers to all types of equipment which Government supplies for every service department, e.g., Fire Brigade apparatus-the cleaning of their engines, polishing of their buttons, etc., etc. In the Casualty Serviceschecking over the condition of all respirators, protective clothing, pouches, haversacks, splints, etc. Demolition Parties should look over their extensive apparatus-winches, jacks, ropes, pulleys, acetylene cutters, etc., etc.

10.00 Pl?Jsical training. A most important item of the daily programme: a sound mind with speedy and thoughtful action can only happen in a body which is physically fit.

It is quite common for help to be applied for to local schools or army sections, when not too busy with actual war-time work, or to the Director of Education ' in the neighbourhood. These sources are prepared, where possible, to supply adequate physical trainers to drill the people. Combined with this, short route marches are good, or " at the double."

In addition to the advantage of physical training this is quite an excellent advertisement to the public, who wonder who these people are and what work they do. Interest is aroused, more knowledge spread and the slowly increasing appreciation of the big work we have behind us.

1.00 Lecture. A lecture in a special subject for which the Service is being trained, always followed

by a practical demonstration in which all members of the class should take part. Be very careful to choose a lecturer who does not send his class to sleep, and also one who adapt s his subject to the needs of the passing days, which means that a lecture by the same man to-day will be quite different from one a year ago and changed again a year ahead.

A stereotyped text book chapter read in a dull way does not constitute teaching, and pardon me for saying that even the wonderful lectures typed and given out at the Falfield School must not be the eternal text book of C.A.G.S. teachers.

13 .00 Dinner.

14. 00 Organised Recreation. Wellington said" the Battle of Waterlo.o was won on the playing fields of Eton " - this is true to-day. The best pla ye rs of team games are the best privates in a regimen t, and the best members of any strenuous team of workers.

Football, hockey, various athletic competitions: any of these and many more may go to make up the programme of organised recreation.

16.00 Tea.

17. 00 Lecture, again followed by special drill or practice.

19.00 Supper.

zo.oo Games, concerts, popular lectures of all sorts of genera l interest, or freedom, and all this last item of the day's programme should be in the hands of a committee of the members themselves to ensure popularity and variety, and should invariably be purely recreative.

There will, of course, be need to carefully organise the times of varying shifts. The twelve-hour shift is, perhaps, the best one, and this may be arranged for short or long periods of so many da ys or weeks accor ding to the judgment of the local organisers of the scheme.

Leave should carefully be arranged so that a safe number for the effective working of the partie s is always available, and needs careful planning.

(z) The combination of voluntary service with paid adds considerably to the comp lexity, but in no case should it completely baffie the organiser who wants to develop this side of the training. It does, of course, mean that you have to have a much larger personnel who are willing to give so many hours a week or so many hours a day, from which you can, with care, compile a list complete for every hour and in such a way that it enables them all-over the course of two or three weeks-to get through the whole programme. And it is interesting to note that the more thoroughly and carefully plans are made, the more eager and more enthusiastic will all workers gradually become, thus lessening the difficulty.

Possibly one of our greatest difficulties to-day

135

has been caused by the inactivity of the voluntary service after they have o0-ce been enrolled and taken through preliminary training. Following that, there was nothing more to be done and gradually those members faded away, whereas with properly organised discipline and routine, the numbers tend to increase rather than decrease.

A.R.P. Questions and Answers

Q. Should not the respirator to be put on a Ph osgene case immediately?

A Yes, if air is s till infected.

Q Is it any use laying Phosgene patient on his face to prevent fluid getting to lung s?

A. No.

Q. Is there not liability of permanent injury from nose gases on account of arsenical poisoning?

A. A very remote liability and only after repeated exposures.

Q. You say that respirators are 100 per cent. proof against sneezing gases. Why then did these gases penetrate the wartime gas-masks?

A. Because the early war respir ators did not filter the sneezing gases; but the y were quickl y altered to protect against sneezing gases zo years ago.

Q. Would you leave off the respirator to douche the eye with liquid gas in it ?

A. Yes.

Q . How can the eye be wiped or douched with the respirator on ? Yet to take the respirator off may be fatal by inhalation of another gas, i.e., Ph osgene. Which is the lesser of the two evils?

A. If the respirator is on no liquid gas will get in the eye.

Q. Would it be an advantage to encourage perspiration of a mustard case? Would that help to get gas out of the system?

A. No.

Q. What of the danger of swallowin g contaminated food or drink ?

A D ependent on the protection or neglect of food or drink.

Q. Should not all casualties be treated as contaminated and so cut out the uncontaminated rooms in a first aid post?

A No, it would cause delay and the waste of bleach powder.

Q. Would y ou not use bleach paste on the rubber boots before boiling?

A. You could if you like. Bleach should be conserved for essential purposes.

Q. Can we use front door as an entrance to air lock although it does not slope? Will curtain which overlaps be sufficient?

A. Yes, if you can keep the curtain in close contact with the door; the slope makes contact with door easier.

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

STRETCHER BEARERS AT CASU A LTY RECEIVING HOSPITALS

On receiving from Dr. A. Trevor Jones, the Hospital Officer for Wales, a list of the casualty receiving hospitals in Wales at which it was thought desirable for assistance for stretcher-bearing to be available if required, the Principal Secretary of the Priory for Wales addressed a letter to the Medical Superintendent of each Institution offering the assistance of local Ambulance Units. It was appreciated that the initiative was in the hands of the Hospital and it was suggested that the ambulance bodies in the neighbourhood might be entrusted with the full responsibilities for organisation and training of volunteers, or, alternatively, if the hospital preferred to retain responsibility, Brigade personnel would be encouraged to respond to any invitation to assist. Simultaneously, Commissioners and Assistant Commissioners of County Areas received the circular issued from Brigade Headquarters indicating the lines to be followed in organising the work in cooperation with the local representatives of the B.R.C.S.

The majority of the hospitals have gratefully accepted the opportunity of assistance in the organisation and training as well as recruitment of volunteers, and Brigade personnel are willingly responding to one more call upon their services.

N A TIONAL FLAG DAYS, 1940

Plans are well in hand for the joint Flag Days on behalf of the Red Cross and St. John Joint War Fund. Sponsored in many counties by the Mayor or Chairman of the Council, all organisations have combined to make the result worthy of the appeal; and Brigade Units have supported the efforts wholeheartedly, encouraged by the knowledge that a proportion of the proceeds will be returned to recoup the loss of revenue which Divisions would sustain by surrendering the Flag Day appeals organised in normal times for their permanent activitie.s. Uniformed contingents of Brigade personnel will attend the Cathedral Service wherever held in connection with the Appeal; and at a special service in Brecon Cathedral an address will be given by the Commissioner for Wales.

SERVICE AWARDS

The awards of the following Service Medals have been approved by the Sub-Prior, acting on behalf

of H.R.H. the Grand Prior :-Corps Treasurer T. D . Enright and Sergeant William King (Glamorgan) ; Corps Secretary T. J. Raines (Newport, Mon.); Ambulance Officers D. J. Thomas and Ivor Rees, and Corporals Glyn Davies and B. D. Oag (Carmarthenshire); Ambulance Officer R. Harvey (Monmouthshire).

Service IyIedal Bars indicating 20 years' service have been awarded to Corps Surgeon A. M . Robertson (Merthyr TydfiJ), and Ambulance Sister J Morgan (Cardiff). Second Bars have been awarded to Assistant Commissioner W. Owen Evans, M.B.E., J.P., M.B (Glamorgan) and Corps Superintendent A. H. G. Field (Cardiff), on completion of 25 years' service. Third Bars have been awarded to Assistant Commissioner F. R. Hortop (Barry County Area), and J. H . Davies (Rhondda) , who have completed 30 years' efficient Brigade service.

CENTRE REPORTS

CARM ART HEN SHIRE CENTRE

The Ammanford Ambulance, Nursing and Cadet Units paraded at almost full strength on Saturda y, May 17, when the opening of their Ambulance H all marked the fulfilment of a lon g -cherished aim. Th e ceremony was carried out b y Mrs. H. M. Llewellyn, J.P., Lady County Superintendent; and the Hon. John H. Bruce, Principal Secretary and Commissioner for Wales, gratefully acknowledge d on behalf of the Brigade Units and the Priory the generous assistance of Capt. M. H. Llewellyn, Managing Director, Amalgamated Anthracite Collieries, which had made the project possible. Gratitude was expressed also to the Joint Committee for Monmouthshire and South Wale s Miners' Welfare Fund for a grant of £ 300 and an issue of furniture to the value of £63. The balance of £9 I advanced to the Division b y the Priory is due for repayment over three years. With . such excellent facilities as are now the Priory looks to the local Units to make Ammanford a stronghold of Ambulance work in the Carmarthenshire Centre.

FLINTSHIRE CENTRE

As a result of a public meeting held under the chairmanship of Councillor T. C. Williams, the town of Rhyl is to have a Division of the Brigade. The meeting was addressed by Dr. J. Wells, Assistant Commissioner for Flintshire, Mr. Brooke Freeman, the Honorary Centre Secretary, and Dr. A. E. Roberts,

Assistant M .O.H. fo r the County. The Chairman explained that in forming the Divi sio n fhey were f ulfilling a promise given to th e Commissioner for Wales (th e Hon. John H. Bruce) when he conducted an inspection of the Briga de Units in Flintshire and Rh yl. He promised all the assistance he could g ive and an unanimous decision was given in favour of the registrati o n of the new Unit Good progress is being made under the leader ship of Mr. J. A Roberts, as Acting Superintendent.

In co-operation with Local Detachments of th e British R ed Cross Societ y, the Brigade participated i n the sale of the Joint Em bl em thro u g hout the City on Saturday, Jun e 1 and it can be said to their credit

a propo rtion were carrying out various A .R. P dutie s from which they could not be excused. Count y Officer Emrys James was in command, assisted b y Corps Superintendent D. Jen kins and W. Jackson

The In specting Officer was accompanied by th e Commissio n er, Dr. J. M. Wilson, Assistant Commissioner G. L. Davies, the Hon. Mrs. J. H. Bruc e (Acting Lady Coun ty Superintendent), Lady Count y Officer Mrs. G. L. Da vies and Mr. E. J. Jones, Vic ePre si dent of the A berdare Centre.

The parade assembled in the grandstand for an address b y the Inspecting Officer, who complimented officers and men on the smart turn- out. Recountin g th e activities carried out during the past year, he said

ANCE OPERA TED BY THE WREXHA.i\{ DIVISION, DENBIGHSHIRE

Thc above photograph, taken at the County Buildings on Mar ch 10, 1940, includes Sir Alfred McAlpine (President of the Division), the lvIayor of Wrexham (Councillor John Davies), the Deputy Mayor (Councillor A. Challoner), Mrs. F. W. Morris, Alderman C. O. Jones, l\'Ir. G. T. Gue s (Assista nt Commissioner), Mrs. J. E. H. Davies (wife of the late Surgeon-in-Chief for Wales) Mrs. Glyn Evans, j\{r. Edward Gillam, Mrs. E. S. Price, Mrs H. Chadwick, the Reverend Ezek iel Williams, Dr. Gl yn Evans, the Reverend T. Jones, Am bulance Officer J. W. Jackson

that very few members of the public were to be seen by evening who were not wearing the attractive flag.

ABERDARE CENTRE

The first bi g para d e of Bri gade p ersonnel since the ou tbreak of war was in spected b y the Commissioner for Wales, the Hon. John H. Bruce, at the A be raman Welfare Ground on Saturd ay, May 25, 1940, to w hich Officers an d members of the Upper and Lower Cynon Valley Corps marched, headed by the A beraman Silver Band.

Of the total stren gth of 922, members on parade n umbered 637, comprising 256 men, 39 nurses, 2 15 boy cadets and 137 gi rl cadets, which must be con sidered a good attendance when it is rea lised that J 37

that 3,902 cases of accident or sickness were treated and 310 attendances at hospitals or clinics were made b y nursing members rendering voluntary service. The Briga de membership with the Aberdare Centre represents over one-fifteenth of the total Brigade streng th i n Wales, recorded at Decembe r 3 1, 1939, as 14.434; and it was announced that a new Unit of 30 m em b ers was in course of formation at Treeynon. First Aid and Home Nursing classes in the Centre were attended by 744 students during 1939, of whom 709 qualified for Association awards, while 172 A. R.P. awards were gained. The recent appeal for stretcher-bearers a t casualty receiving hospitals placed an a dditional responsibility upon the Comm issioner for Aberdare, who had been requested

to make the necessary arrangements in respect of the Aberdare and District General Hospital.

CITY OF CARDIFF CENTRE

Members of the 17 Units in the Cardiff and District Corps are responding commendably to the increasing calls upon their time and energies. The majority of the male strength have undertaken A.R.P. casualty services, encouraged no doubt by the appointment by the City Corporation of a Corps Officer as Superintendent of First Aid Posts. Nevertheless, they are giving valuable assistance also to the hospitals in the efforts being made to increase the number of trained stretcher-bearers, in some cases taking over the full responsibility for recruitment and training.

The nursing members have enrolled as Nursing Auxiliaries, many being already mobilised for fulltime service. The emergency call for volunteers to be in attendance at refugee camps to render first aid did not go unheeded, an immediate offer of day and night service being made to the authority.

BOROUGH OF MERTHYR TYDFIL CENTRE

In his report to the Annual Meeting, the Commissioner for Merthyr, Capt. W. J. Canton, LL.B., said that the Centre had made a big jump in membership during the year. The total membership at December 3 was 718, comprised of 58 Officers, 2.66 men, 132 nurses, 188 cadets and 74 cadet nurses. These figures represented an increase of 196 over the previous year. In the Dowlais Corps, which included Dowlais, Bedlinog, Fochriw, Penydar:t;en, and Pant, there had been a decrease in the number of cadets, and he regretted that there did not seem to be any eagerness on the part of young people to join and study First Aid. He asked the officials of the Division to give the matter their attention, because other Centres were going ahead by leaps and bounds.

Mr. Canton added that the number of cases attended had increased enormously during the year, the total being 3,248 for the whole Centre. The Nursing Division put in 47e:l visits at the hospital and clinics. Referring to the comforts depot which is situated at Garthnewydd Social Club, Mr. Canton expressed the Centre's gratitude to the unemployed of the club for allowing them accommodation. A large number of utensils were distributed from the Depot, and it was rendering a service to public health.

RE SU LT OF COMPETITIONS

Merthyr Centre is to be congratulated on having brought off the Centre competition in a year so crowded with responsibilities. Five teams competed at Abermorlais Schools on May 4 for the Richardson White Shield, which was won by the Trehatris team with 225 marks, the other teams being placed in the following order :-Merthyr, 208 ; Merthyr Vale, J.73 ; Dowlais, 172, and Bedlinog, 167.

The Shield was presented to the winning team by Mr. Tom Andrews, ] .P., Chairman of the Merthyr Centre, who was supported by the Commissioner, Mr. J. Morgan (Centre Treasurer), County Officer T.

Aubrey Rees, and several Corps Officers. It was announced that plans were progressing well for the National Flag Day throughout the Borough on May 3 I and June and that the annual inspection of the Units in the Centre would be conducted by the Commissioner for Wales on June 15.

NEWS IN BRIEF

The Annual Meeting of the Chapter of the Priory f01; Wales will be held in the Council Chamber, City Hall', Cardiff, on Tuesday, June 25. There will be no meeting of General Assembly, nor Investiture this year.

The Viscountess Tredegar, who was recently appointed President of the Borough of Newport Centre, has given the lead to Lady Presidents in Wales. in wearing the new uniform approved for Presidents and Vice-Presidents.

RAILWAY NEWS

Southern Railway (CONTRIBUTED BY E. UZZELL)

RE ADING

For obtaining a pass in First Aid for 30 years in succession Driver R. Palin was recently presented with the certificate of the Centre. Clerk Edward HOP.kins received the gold medal for 2. 1 years' serVIce.

The awards were presented by Mrs. Uzzell at a social and dance arranged in conjunction with the Reading Corps of the Brigade. Cups and certificates were also awarded by Mr. C. A. Poole, M.A., County Commissioner for Berkshi re.

An appeal was made for increased membership in the Ambulance Movement.

K.A RACHI

An air raid demonstration was recently staged at K.arachi by the Sind A.R.P. Organisation and officers and men of the No. 10 District (Sind), St. John Ambulance Brigade Overseas, of which Colonel Briggs is the Assistant Commissioner.

The scene represented a busy cross-road, complete with shop fronts, hawkers and shoppers. Warden's and First Aid Posts were at the ends of the streets.

The air raid warning sounded. Wardens asked people to extinguish their li g hts. Soon after the alarm three bombers came over, dived to a low altitude and dropped high explosive, incendiary and gas" bombs." Rescue parties came into action and carried away "casualties" to First Aid Posts, Cleansing Stations and hospitals, while decontamina-

BRAND'S

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The finest NON-ALCOHOLIC STIMULANT

Throughout the civil medical and nursing professions, and the medical serl'ices of H.M. Forces, Brand's Essence is constantly prescribed fo r combating critical weakness arising from physical or mental ex haustion and shock.

Its uses, when First Aid is rendered to the injured, will be apparent from the following brief summary of its adl'Ontages:

Brand's Essence is a NON-ALCOHOLIC STIMULANT.

It is assimilated in its entirety. QUICKLY AND WITHOUT STRAIN, BY EVEN THE WEAKEST SYSTEM.

Its stimulating effect is PRACTICALLY INSTANTANEOUS

Brand's Essence DOES NOT PRODUCE AN AFTER.STATE OF MELANCHOLIA.

It not only conserves strength-IT BUILDS UP STRENGTH QUICKLY AND SAFELY.

IT CANNOT CAUSE THIRST.

Be sure to hape a supply for the treatmellt of all cases wh ere a STimu lant is indicated.

CHICKEN

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tion squads began demarking the contaminated area and treating it.

The air raid demonstration was preceded by demonstrations in First Aid by the Ambulance and Nursing Divisions.

His Excellency Sir Lancelot Graham and Lady Graham were among an appreciative audience.

NEW ZEALAND PUKEMIRO

A new ambulance station built by members of the Glen Afton and Pukemiro ambulance divisions was officially opened by Senior District Superintendent A. W. Probert, of Auckland, in April last.

The proceedings under the control of District Superintendent H. D. Cobb, District Officer E. A. Houston (Hamilton) and Divisional Superintendent J. Johnston (Pukemiro), were attended by a number of officers from Auckland and representatives of other ambulance, nursing and cadet divisions.

Before declaring the building Mr. Probert conveyed the thanks of Commissioner Tunks for the work which was being done at Pukemiro.

The Rev. G. E. Moreton (Chaplain of the Order) conducted the dedication service. Mr. R. H. Schoen, Inspector of Mines for the district, congratulated the Division on the erection of its own hall and on the work it was doing in the district.

Lady District Officer Mrs. H. Cammell appealed to the women of the district to form a nursing division.

Mr. Cobb also congratulated the Division and made a presentation of a wristlet watch, on behaLf of the Glen Afton-Pukemiro Division, to Mr. L. Kennedy for his services in connection with the building.

The front part of the hall is to be used as a firstaid and storemom; the remainder for lectures and .drill.

RHODESIAN RAILWAYS CENTRE BULAWAYO

The following figures indicate the extension that has taken place during the past five years in the work ,of the St. John Ambulance Association in Rhodesia. 1939 193 8 1937

140

St. John Ambulance Association (Illdiall Council)

Extract from the Rep01"t of the Chairman, Executiv e Committee, for the year ending December 3I, 1939·

The year 1939 has seen a remarkable increase in the work of the St. John Ambulance Association, the number of persons who received instruction in the various subjects being the largest since the formation of the Indian Branch thirty years ago.

A new sphere of work was opened up this year through the assistance of the Auditor General of India, who brought to the notice of Accountants General the beneficent work of the Order of St. John of Jerusalem and invited their co-operation in its development· among the staffs of their offices. By the end of the year many First Aid classes had been completed in several Accounts Offices all over India, while at least in two offices Ambulance Divisions of the St. John Ambulance Brigade had also been established.

About the close of the year the Home Department of the Government of India were approached with the object of enlisting the interest and support of th e various Departments of the Government of India in furthering St. John Ambulance work among the members of the secretariat staff, in order that this very valuable means of rendering aid to the sick and injured may be developed and promoted among the employees of the Central Governm.ent.

There has been a general increase in the work of the Association in all provinces.

Instruction in Air Raid Precautions has also made satisfactory progress during the year. A large number of classes for Brigade personnel and others have been held in many centres.

During the year 50,898 persons attended courses of instruction in First Aid, Home Nursing, Hygiene and Sanitation, and Domestic Hygiene and Mothercraft, of whom 340477 qualified for the Association's certificates. In addition, 778 persons obtained voucher certificates, 191 obtained medallions; 92 labels and 3 pendants were earned. The Mackenzie School Course continued to operate satisfactorily, and during the year under report II,635 students were instructed, of whom 8,701 qualified for certificates. It is gratifying to note than the number of persons trained this year in First Aid is the largest on record.

The extraordinary amount of work done this year has been made possible by the encouraging response given by an ever-increasing number of voluntar y helpers, both men and women, members of th e medical profession and others, all over India.

The Executive Committee also takes this opportunity to express its sincere appreclatlOn of the impetus given to the work of the Order by the visit of the Hon. Mrs. Copland Griffiths.

War

Emergencies

Liq. Sod. Chlorinat. is very caustic. It falls in strength hourly and fresh supplies take time and technical skill to prepare. The advantages and economy of a standard, stable, non-caustic preparation are therefore obvious.

Milton Antiseptic

is the ideal ant i s e p tic for f irst-aid use in all crises

There is no mystery about it. Milton is of the same chemical nature as the famous Carrell-Dakin solution that so SWiftly reduced the figures of deaths and amputations (due to infection) in the last war.

Keep Milton handyyou'll need it for

CUTS AND WOUNDS BURNS AND SCALDS DEODORISING STERI LlSI NG.

Personal uses such as SORE THROAT, CATARRH, HEAD COLDS, ETC.

Light on the pocket, too

Milton Antiseptic is the most inexpensive you can use consistent with efficient results. For most purposes t his very powerful germicide is fully effective in dilut ions of I in 100, that is, three tablespoons to a gallon of water, dr i a teaspoonful to a tumbler.

Born during the last war- best during this 7d. 1/2, 1/9 and 3/- a bottle Winchesters at 7/6

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BOOKS ON AMBULANCE WORK FIRST AID AND NURSING

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Obituary

We regret to record the death of Mrs. Edith Rhodes, who was a few years ago a prominent figure in the St. John Ambulance Brigade in Leeds.

:Mrs. Rh odes first came into the movement in 1908 and was instrumental in forming the Victoria Nursing Division of the Leeds Corps in 19I4. Later 'she became Superintendent.

During the Great War she was in charge of ambulance arrangements at Blackburn's aeroplane factory. Her activities in this sphere will doubtless be remembered by many people.

In recognition of her services she was appointed Serving Sister of the Order of St. John of Jerusalem, and in I92) was transferred to the Brigade Reserve of Officers. She maintained her interest in the Brigade, especially the Victoria Division, and supported it in many ways up to the time of her death. Her funeral was attended by Officers and members of the Leeds Corps.

We regret to record the death of Mr. William Entwhistle, who was for many years Superintendent of the Radcliffe Ambulance Division.

Mr. Entwhistle obtained his First Aid certificate in 1899. He served in the R.A.M.C. during the Boer War and the Great War.

The funeral service was conducted by the Rector, Canon A. Kershaw. A large gathering of relations and friends, including members of the Brigade and the British Legion, were present.

Members of the Radcliffe Division and the White.field branch of the British Legion acted as pall-bearers.

We regret to record the death of Mr. J. A. Shenton, member of the Newcastle-under-Lyme Division since I93 6 . At the funenl, members of the Newcastle-underLyme and Chesterton Divisions acted as pall-bearers. The coffin was draped with the Brigade flag, and a Guard of Honour was formed at the house and the graveside under Divisional Superintendent W. Deaville.

We regret to record the recent death of Miss Henrietta S. H. Sowerbutts, who joined the Preston Nursing Division in I90o.

Miss Sowerbutts was appointed Lady Ambulance Officer in 1903, and in I926 was admitted as Serving Sister to the Order of St. John. Owing to ill-health 'she resigned in 1931 and was transferred to the Brigade Reserve, and later to the retired list. Her unfailing devotion to her work will always be remembered by those with whom she came in contact.

A.R.P. in

There are 8 certificated instructors enrolled in th e Brigade. Throughout the year these have been employed in instructing members of the Brigade an d the general public. Fifty-three St. John anti-ga s classes (full course) and examinations for Certificates were held in 1939; 614 gained certificates.

The co-operation of the Brigade with the A.R.P . authorities is mos t gratifying. In many parts of th e county the A.R.P. First Aid Service has been entrusted to local Divisions. From reports receive d they are carrying out their duties satisfactorily. I n the Gerrards Cross Area an A.R.P. corps of th e Brigade has been formed with a transport section o f 26 women ambulance drivers.

Five hundred and seventy-six men and 136 wom e n are actively employed in A.R.P. duties. Allowin g f o r 225 members serving with the Forces, this represen b 70 per cent. of the available per s onnel. As the mot o r ambulance service of 20 vehicles ha s to be maintaine d , hospital and clinic attendances kept up, and personne l kept available for accident calls, this percentage is remarkable.

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EVERYTHING FOR SAFETY EVERYWHERE , NOVOX' and 'NOVITA' Oxygen + COl or Oxygen RESUSCITATI NG APPARATUS for the apparently asphyxiated or drowned. SMOKE HELMETS of all Patterns.

'PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

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OFFICIAL GAS CHARTS

No. Chart shows gas derivations.

No. 2 is a full and complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee.

Back row - left to right: Mr. H. S. Cann; Captain S. T. Beard, O.B.E.; Major W. Owen Evans, M.B.E., J.P., M.B.: Captain T. E. Richards. J.P.; Dr. D. T. Roc y n Jones, C.B.E., M.D.; The Rt. Hon. Viscou nt Tredegar; Sir John "TBeynon, Bart., J.P.; The Rt. Ho n. the Earl of Plymouth, P.C.; Professor George Knox, M.I.M.E., F.G.S ,; The Rev. Canon J. A. LeWIS, M.A,; Mr. Norman M Ingledew; Me. T. Edgar SInith: Mr. R. Wilson Bartlett, J P., F.S.A.A.; Mr. J. H. Davies; ]VIr F. R. Hortop; Alderman G. F. Evans. J.P.

Front row - left to right: Captain W. J. Canton, Ll.B.; Alderman Sir Wm. Jenkins. M.P., J.P.; Mr. E. D. Jon es Sir Robert Webber, D.L., J.P. The Hon. John H. Bruce, J P., D L. Sir William H. Seager, J.P., D.L. Major A. W. Anderson, M.B., Ch.B.; Dr. S. McCormac; Mr. Theodore Gibbins, J.P.; Mr.OliverHarris

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CONTENTS

Ed itorial

Home Nursing

Red Cross and St. John War Organi sat ion Ars ine-Detecr on and T rea tment

Brigade News

Grand Priory r \ppointments

St. John l \mbulance Bri gade Ovel seas Interesting Ca se Reports

Questions a nd A nswers

Cha nnel Isles Evacuation

Railway News

Team Te r

Air-Raid Precautions

Priory for Wa les Obituary

C H ANCE R Y OF THE ORD E R,

ST. J OHN' S G A TE CLER KENWELL,

Fi n l an d's Thanks L ONDON , E. C.

The fol101ving letter from Madame de Gripenberg, the wife of the Minister for Finland to this cotmtry and the representative here of the Finnish Red Cross, has been received ry Sir J ohn Kennecfy, as Vice-Chairman of the Executive Committee the War Organisation. lvJadame de Gripenberg w1-ites :-

" I have jus t ret u r n e d from Finland, where I have seen th e medica l s u pp li es sent b y the British R ed and Or d er of St. J ohn of J erusal em b eing u sed

In R e d Cro ss and o t her h os p i tal s all over t h e co un try, and I sh o uld li ke, th roug h yo u, t o co n vey to th e peo pl e o f Great B r itain and t h e Empire th e o- r ati t ude of the Finni sh p eople f o r all th e prac tic a l h elp w hich h as b ee n g iv en t o the m.

" I saw d espe ra te ly wo u nded soldiers lying in the hospi t als dresse d in B ritish helpless case shirts, and soft, cl ean pyjamas . T here were bandages, dressings an d splints ma d e by the R ed Cross and Order of St J OM de p o t s.

" The F innish do ct ors and n u rses, and the wounded th em selves, al though they were so t i red, would smile an d t ell me wha t a timely boon all these things were T he British Red Cross an d O rde r of St. John were t he first to sen d medi ca l supplies to Finland, and the y are s till sending hel p There is a unit of d octors and nurses ready to go the momen t they can get transportation, to help t he half-millio n homeless women and chi ld ren who need care

" D uring the w ar , fifty -four B ritish Quakers were driving ambulances jus t one mi le from the front line. These men were sent out under the auspices of the B ritish R ed Cross and Order of St. J OM, and once mo re the Quakers have shown their worth and covered themselves with glory. T he B ritish women ambulance drivers, the F.A.N. Y., reached Finland just after ho stilities had ceased, but have proved their worth b y d riving under terribl e conditions on ice-covered roads

" I can truly say that an y joy the Finns have experienced in these last weeks has come to them thro u gh t h e knowledge of the sacrifi ce of the British people who have sent clothing, money and even food to help alleviate their sufferings. Half-a-million F inns are homeless. When I was in a refugee camp and had seen some of the goods sent out to Finland being distributed, the refugees came to me and gave me a han d- woven towel which they asked me to bring b ack as a thank y ou' to the British Red Cross and Order of St John for all they had do ne for them.

" I n Finland it is felt that the sympathy the Finns received from Great Britai n is due to the fact th at Great B ritain, fighting for the cause of li b erty herself, unde rstoo d Fin land's needs Therefore the Finnish people h ave asked me to co n vey to the people of Gre at Br it ain an d the E m pi re a message of true u nd ers tanding, of s ympath y and frien d ship, and of d eep grati tude "

DOME NURSING PAGE

." Don't Forget to Read Your Manual"

By DR. F. W. HEBBLETHWAITE, M.B., Ch.B.

DIVISIONAL SURGEON, NO.6 DISTRICT, ST. JOHN AMBULANCE BRIGADE

These words must be very familiar to every member of a First Aid class, through having heard them repeated so often during the courses of instruction. And while many have profited by this advice, others, it is feared, particularly in the present stress of national emergency, have confined their energies to the work done in practical demonstrations, and have been apt to skip their theoretical work, considering it to be of but little importance. The result of this is often seen in examinations, where the candidate usually acquits himself well in his practical work, but shows weakness and confusion in answering his oral questions.

It was once said to me, "If I know how to apply correctly the bandages for the treatment of a fractured collar-bone, why should I have to know that such a fracture can be caused by either direct or indirect violence?" Yet a First Aider, faced with a patient who has fallen on his hand, and who may be complaining more of the abrasions on the palm than any other disability, may neglect to make an investigation of the collar-bone in his ignorance that a fracture of that bone may result from such a trivial cause. Why should we be at such pains nev er to confuse the definition of a compound fracture with that of a complicated fracture? Because we must always bear in mind the danger of aggravating a simple fracture into a more serious condition, requiring additional treatment.

While during our practices we playa game of makebelieve, when faced with the effects of a real accident we are not given the help of a label setting forth the specific injury we have to treat. It cannot be too clearly borne in mind that of the three essentials of First Aid, the diagnosis of the condition is usually much more difficult than deciding on the character of the treatment or its application. In First Aid, as in medicine, we need to be good detectives, where the signs and symptoms furnish the clues, and by the use of our eight qualifications, we arrive at the correct solution of the problem.

Yet we have to read our book with intelligence and common sense, for it is not always realised that while our teaching gives us a picture of a certain condition, seldom do we find in actual practice that the picture is complete in all its details. For instance, to consider the seven general signs and symptoms of 14 8

a fracture. Pain-is a variable factor and common to most injuries. Swelling-may not be marked, or altogether absent if seen early. Loss of power-is again extremely variable, depending upon the locality of the broken bone. One member of our Division worked for a fortnight with a fractured lumbar vertebra. Deformity and Irregularity-are not always easy to detect, unless there is gross displacement of the broken fragments. In spite of this, it is, however, necessary for us to be familiar with these classical signs, and in any case in which we are in doubt, we are taught to treat the condition as a fracture, in order to be on the safe side.

Much of our theory work is also contained in those important chapters dealing with the condition of insensibility. Therein we are given long lists of signs, by a -thorough knowledge of which we can make a differential diagnosis between all the causes which may bring about the unconscious state. Many students find such lists an extreme test for their memories, particularly so if they try to learn them off parrot fashion. They may endeavour to memorise a certain page in the book, instead of trying to visualise the appearance of a patient suffering from that condition. If only they would tr y to obtain a mental picture of their patient, they would stand a much better chance of recognising the condition when they met in actuality, almost as an old friend is recognised by his facial peculiarities

So while we are making ourselves proficient in the application of splints and bandages, in methods of transport, and other practical details, do not let u s despise the theoretical side of our work, nor forget to read our book.

Thank

YOU! I

Thanks to The British Navy, The R.A.F. I and the British Merchant Navy this Journal is on sale throughout the British Empire ; at the same price.

Weare relying on you for one new reader this month. Thank you.

Red Cross and St. John War Organisation

(Continued from page 126, June issue';

STORES DECENTRALISATION

Steps are being taken to place Red Cross stores at convenient centres in the country in order to ensure continuity of supplies should communication with London break down. Two types of stores are being arranged. The first type is the Provincial Branch Store. Stores of this character will be re plicas, on a reduced scale, of Headquarters Store. They Will be under the control of, and will be staffed by, Headquarters Stores Department. County authorities will be advised as soon as the stores are ready to be opened.

EMERGENCY STORES

Stores of the second type are known as emergency rese rve stores . Their positions have been comm unicated to the County authorities of both bodies. Respecting. the s.tores of this type, it is important to note that issue IS not to be made from them until transport and communication become impossible between Headquarters and County centres. The stores will remain unopened and unused until this condition of affairs arises. The y will then be opened on .the authority of the Joint County Committee, or of Its responsible officer.

FROM AUSTRALIA

The Australian Red Cross Society has voted £20,000 to the funds of the War Organisation as a of appreciation and In addition, It has cabled saying that it is remitting a further sum of £9,625 for the immediate purcha se of fourteen ambulances: Expressing deep gratit ude for these generous gIftS, the War Organisation has suggested the ambulances shall, if possible, be constructed In Australia and shipped direct to the Middle East Commission for the Allies' use

AMBULA CES FROM INDIA

A welcome addition to the War Organisation ambulance fleet comes from India. Intimation has been received that the Viceroy is transferring I t lakhs for the purchase of ambulances. It is estimated that with this sum approximately twenty fully equipped ambulances can be provided for an Indian Ambulance Section, Four of the ambulances will be the aift of the Bengal Police and sixteen the gift of H.H. Maharajah Scindia of Gwalior. The ambulances will be suitably inscribed with the names of the donors.

PETROL ECONOMY, PLEASE

The Divisional Petroleum Officer has written to the Petrol Officer at Headquarters emphasising the need for economy in the consumption of petrol. J:Ie asks members of the staff of the War OrganisatIOn and Its helpers shall, wherever possible make use of alternative means of transport.

149 SPORTS EQUIPMENT WANTED

Good use can be made of any quantity of sports equipment. It is wanted for temporarily shocked airmen in hospitals. The appeal is made by Lord Ebbisham, Chairman of the Comforts Collection Committee of the War Organisation. Tennis balls, netball equipment, badminton and croquet sets, boxing gloves, punchballs, footballs, and even vaulting horses are needed. Gifts should be sent to the Committee, 54, Victoria Street, London, S.W.I.

NURSING AUXILIARIES WANTED

The Parliamentary Secretary to the Ministry of Health, Miss Florence Horsburgh, M.P., writes that the Emergency Hospital Scheme is being brought into full action. The Ministry of Health has the responsibilit y of arranging for the treatment of all Service casualties, other than those accommodated at military hospitals, and of civilian casualties. Service convoys are being admitted to hospital, and there is work riow for f ull-time members of detachments, particularl y for those who are willing to be mobile. Commandants of Women Detachments have been asked to impress upon their members that this appeal is for duties for which they have vo lunteered and have been trained. Ever y member who can take a wholetime mobile post, or failing it, an immobile post, should give in her name and be ready to be posted

Ap P EAL FOR STRETCHER BEARERS

Many hospitals throughout the country, it was stated in a recent broadcast appeal, urgently require stretcher bearers. These volunteers, the appeal continued, should be over forty years of age, and they need have had no previous experience of First Aid. They will be required to work after air raids or at other times of emergency, when patients may have to be dealt with in lar ge numb ers

Volunteers were instructed to apply for registration at the nearest Divisional Office of the British Red Cross Societ y, the St. John Ambulance Brigade, the St. Andrew Ambulance Association, or at the hospital at which they wish to serve. It was emphasised that this service was quite distinct from the A.R.P. Casualt y Services.

VISITING CANADLI..N P _HIENTS

The Canadian Red Cross Societ y, Overseas Office, through the Chairman of its Information and Records Department, also asks for volunteers in the United Kingdom who are available to visit sick and wounded Canadian soldiers in hospital. A number of visitors has already been enrolled, but there is a difficulty in finding visitors at short notice, especially when men are taken ill on leave and are sent to local hospitals.

Joint County Committees will have been approached on the matter; but readers who are interested in Canada and Canadians, and are available for this service when required, are advised to write to the Canadian Red Cross Society at 20, Berkeley Square, London, W. I.

MIDDLE EAST

The Commissioner has paid a visit to Palestine. The formation of a Red Cross and St. John Organisation in Palestine has been put in hand. Contact has been made with the Australian Red Cross in Egypt and with represe:ntatives of other Dominion Red Cross Societies.

THE QU EEN'S WORK PARTY

Lady Falmouth, accompanied b y Lady GordonFinlayson, Regional Officer for London, recently visited the Work Party at Buc king ham Palace which, it will be remembered, was. organised by the Queen last September among members of the Palace staff. Her Majesty has taken a great personal interes t in the activities of the Party and has herself made a number of garments. Gifts received from this Part y have been distri buted to hospitals to which Her Majesty desired them to be sent as from the Bu ckingha m Palace Work Party.

V.A.D.'s FOR C.N.R.

In view of the need for nursing staff in the emergency ho spitals prepared for Service casualties from abroad an d air raid casualties at home, the Secretary of State for War has consented to the release of a large number of mobile V.A.D.s hitherto under obligations to the Army. They will then be free to join the Civil Nursing Reserve as nursing auxiliaries, prepared to serve whole-time in any emergency hospital in Great Britain to which they may be sent by the nursing officers of the Health Departments.

The V.A.D. Council has willingly agreed to this course, and is making arrangements to notify the individual members concerned of their release from Army obligations. V.A.D.s who enrol in the reserve at once will be eligible for I2 months' continuous employment on being called up for service in a casualty hospital.

RELATIVES' VISITS TO HOME HOSPITAL S

Her Majesty the Queen, visiting the wounded recentl y, enquired whether relatives · were able to visit them, and was told that arrangements for these visits were being made by the Red Cross.

The organisation of relatives' visits is under the direction of the Wounded, Missing and Relatives' Department of the War Organisation, which has the co-operation and assistance of the Joint County Committees in the formation of the local organisation required.

DANGEROUSLY WOUNDED

As regards dangerously wounded men in home hospitals, the first act is a telegram from the hospital to the relative saying that the patient may be visited. I,sO

The telegram also states that if the rdative is not in a position to pay the railway fare, a free travelling warrant will be available on application to the police station.

RELATIVE S RECEPTION

In the meantime, the representative of the Wounded, Missing and Relatives Department in the district in which the hospital is situated is informed of the telegram. It is her duty to receive the relative at the hospital, to find accommodation if the visit extends over a period, to see that the visiting relative has money for meals and incidental expenses, and generally to look after the relative's comfort and welfare during the visit.

JOURNEY ACROSS LONDON

If, as is often the case, the journey involves travelling to London and passin g from one terminus to another, the Department at Headquarter s takes the matter in hand. The R.T.O. at the t erminus of arrival informs the Department, which sends a car to meet the relative, sees to it th at he or she has a meal and money, and is accommodated, if a stay overnight in London is necessar y The relative is put on the train out of London for the final stage of the j ourney to the hospital. And on the return journey is again met in London and seen into the train for home.

VISITING THE " SERIOUSLY ILL"

In the case of patients who are reported as seriously ill or are not even so i ll as to be so classified, visits are allowable. In these cases, however, permission to visit has to be obtained from the Medical Officer. The Department will seek this permission on behalf of a relative, but it is within the discretion of the Medical Officer to grant or refuse it. If permission is granted, a half-fare voucher is allowed officially.

The War Organisation cannot assist towards the remaining cost of the fares in these cases ; but, as in the case of relatives visiting men who are dan gerously ill, it is able in other ways to help relatives of" seriously ill" men who have permission to visit them in hospital. Where the expenditure is justified, it can make sure that the relatives are provided with accommodation and have money for food and other necessary expenses.

LIBRARIANS WANTED

The Red Cross and St. John Library Department reports that there is still a shortage of librarians. V olunteers are wanted quickly for training as it makes all the difference to the value of a hospital library if it is conducted by a trained staff. The Library Department arranges for the training of would-be librarians in hospital libraries which are already under trained direction, and those who feel that they would desire to give voluntary service in this way should communicate with the Red Cross and St. John Library Department at Belgrave House, Belgrave Square, London, S.W.I, whose aim is to place a competent librarian in charge of every hospital library.

DETECTION AND Arsine as TREATMENT

G

(ARSENIURETTED J-IYDROGEN)

1. GENERAL

This substance is a true gas and should not be confused with the nose gases which are toxic. gases an d not true gases. It might be employed In gas form or as a .Calcium Arserude which resembles CalclUm CarbIde In appearance and generates arsine gas when in contact with moisture.

2. CHARACTERISTICS

(A) The gas is is and has no smell except in very high concentratlOns when there may be a faint smell of garlic similar to that of mustard gas. It may, therefore, except in very high concentrations, be detected only by the use of specially treated paper which will known Detector paper type "A." A .of this paper and its use is given in the to this note. The paper will not at present be except to Gas Identification Officers, but stocks WIll be held a1 Regional Stores ready for distribution if the need for them shou ld arise.

(B) The powdered Calcium Arsenide may as a grayish white powder on the gro und, but 1t WIll have no smell. It will, however, in contact with moisture continue to give off arsine for a period up to one hour whilst the chemical reaction is taking place. It is non-corrosive and non-vesicant. It contaminate any water into which it falls and shou ld therefore be considered as dan ge rous untIl treated by the medical authorities

3. LIMITATIONS OF ARSINE

It must be realised that there are severe limitations to the use of this gas by an enemy as it dissipates There are two probable means of attack, VIZ. :-

(a) As a gas in large aircraft bombs or in or cyJinder attacks, in which case concentratlOns cou ld be set up which would be effective

(b) By spreading the powder from or bombs or as an aircraft spray at frequent lntervals (e.g., daily over a period) to obtain cumulative effect with low concentrations.

These limitations make it unlikely that this gas could be used very effectively against the civil population.

4. EFFECTS

The gas acts as a blood poison and exposure without a respirator to high concentrations may pro:e fatal. Low concentration breathed for long penods of several hours or frequently at short intervals may also have serious results owing to the cumulative effect of the gas.

5· PROTECTION

The Government respirators give protection against the conce1ltrations which are likely to be met with in this country.

6. CASUALTIES

Persons suffering from the effects of the gas should be made stretcher cases, should be kept warm and given hot sweetened tea, and shou ld b.e taken to-, receive medical attention as soon as pOSSIble.

7. DE-CONTAMINATION OF GROUND CONTAM:q-;IATED W ITH POWDERED CALCIUM ARSENIDE

The same principles apply as those laid down for blister gas, except that this is not a protective clothing is not necessary, th ough resptrators should be worn.

APPENDIX

lNSTRUCTION FOR DETECTOR

I. STORING

These paper detectors are contained in envelopeE; each holding five. Envelopes will be use d protect the detectors not in use from contamlnatlon and weather. Further protection should be obtained .by storing envelopes in sealed WIt? adhesive tape. Detectors WIll qUIckly lose theIr efficiency if not protected.

2. METHOD OF USE

Detectors should NOT be put out horizontally like "Detectors Gas Spray" now in use, but hung vertically at about mouth level, so that the rur can circulate round them.

As there ma y be difficult y at night in telling by torchlight whether the has turned yellow, a piece of any ordinary white should be huna- alona-side the detector for companson. b b

3. REACTION

In the presence of Arsine the changes colour to a yellow or orange according to concentration, when the gas alarm must immedzateIY be given and respirators worn until fresh detectors show that no gas is present. Frequent tests should. be during the alarm by waving fresh papers In. the when they quickly show a change of colour, If gas IS. still present. Discoloured detectors should always be replaced b y fresh white ones after an a·ttack.

The detector papers are a ls o hydrogen sulphide but are much less senSItive to this gas than to arsine. After long exposure to traces to hydrogen sulphide the papers show a yellowish stain sor,newhat similar to that produced by low conce.ntratlOns of arsine. In higher concentrations of arSlne, such as are harmful for even short exposures, the orange colour which is rapidly produced on the test papers is readily distinguished from that given b y hydro&en sulphide. Since, however, traces of ?ulphide are often to be found in towns and lndustnal areas. Gas Identification Officers and others must exercise care before reporting the presence of arsine when only a faint yellowish stain is observed.

4. PorSON

The chemicals used in the detector s are p01S0nOUs. and must be kept dear of food an d drinking water. There is no danger in handling the detectors.

I The St. John Ambulance Brigade News

No. I (PRINCE OF WALES) DISTRICT

EASTERN AREA

Special attention of superintendents and members in charge of ambulance divisions is directed to the Circular from the Commissioner, dated May 21, Ref.S.B., sent to all ambulance divisions relating to the training of stretcher bearers.

Will superintendents please notify , the Area Staff at once when a new course of lectures in either first aid or home nursing is arranged. This is especially needed for the training of Civil Nursing Reserve candidates, who if they cannot obtain lectures in their own district may be able to go to another, as they

One hundred and twenty-three members out of a total of 128 passed the recent annual re-examination

No. 76 (EAST LONDON) NURSING DIVISION

Complete figures for the Flag Day in Stepney are not ye t to hand, but so far the total is £ 580. , In future every member, when in uniform, will be required to carry a uniform permit. These will be handed to members as soon as the y are to hand This regulation must be adhered to.

Miss Barnett has kindly undertaken to act as magazine and book secretary, and in future will be responsible for the or derin g of the ST. JOHN AMBULANCE

During the past eighteen months this division has been responsible for assisting in the training of over 3,000 persons in first aid and home nursing. A number of members are already in the Civil Nursing Reserve, others are completing their training in local and London hospitals.

No. 2 DISTRICT GLOUCESTER

Officials and members of the S.J.A.B. and B.R.CS. recently attended a service at the cathedral taken b y the Dean of Gloucester (Dr. Costly White).

The parade to and from the cathedral-in charge of the Assistant County Commissioner (Mr. H. J. Lewis)-was one of the most impressive demonstrations of vo luntary service ever witnessed in the city.

Among others present at the service were: Lord an d Lady Bledisloe (County Presidents of the S. J.A.B.), the President of Gloucester R.CS., the D owager Duchess of Beaufort, Sir Frederick and Lady Cripps, the Hon. Mrs. Talbot Rice, Lord and Lady Bathurst, Countess of Berkel y, Lady Marling, Lady Tubbs, and many other county and corps officers.

No 3 (EASTERN) DISTRICT LUTON

Stretcher bearers were recently needed to assist in receiving crippled children into the district. The ma j ority of the Vauxhall Motors Division could not be released because of war work, but a number of those on the night shift gave up a considerable part of their sleeping hours to help.

In a lett er to the Divisional Secretary, Dr. Bone of the Luton and Dunstable hospital expressed his thanks for the "valuable assistance given by the Vauxhall team," and said that, in his opinion, the work done by them was a first-class exercise for future services.

to whose and initiative the divisions are largely indebted for their new" home." , No.

5 DISTRICT THORNTON

Presenting certificates for anti-gas training, first aid, home nursing and life-saving to Thornton Ambulance Division, the Lord Mayor of Bradford (Alderma? M. F. Titteringt on) complimented the winners on theu success, and congratulated members on the progress made since the division was formed six months ago. Twenty members out of 22 passed the examination in anti- gas trainin g, and a vote of thanks was accorded to their instru ctor, Miss H. Rhodes.

ACOMB

Acomb Nursing Di vision has recently given a fully equipped ambulance to the War Organisation of the British Red Cross Societ y and Order of St. John for service where needed.

This division, of which Miss Barlow is the Lady Divisional Superintendent, ha s been doing excellent work for about ten years. At present a number of members are on active · service, others are engaged in hospital and First Aid Post duties.

For the past six ye ars members of the diVISIon have done valuable work in Mr. J. G. Craig's Orthopa;dic Clinic at the York County Hospital.

Northern Ireland

on Parade for Inspection by Sir Ernes[ Burdo n, K.C.I.E., C.s.T., r.CS., Chief

must not be kept waiting owing to the present state of urgency.

No. 30 EAST LONDON DI VISION

Her Mafesty The Queen, during a tour of Stoke Newington A.R.P. Depots, graciously complimented Sergeant Lush on his work at the Stretcher Party Posts of which he has charge.

A lecture given recently at the London Hospital by Dr. N. Pines to members of the division was illustrated by specimens from the Hospital's anatomical museum.

Superintendent D. Stitcher acted as Steward at the St. Paul's Cathedral British Red Cross and St. John Service on June 4.

GAZETTE and other periodicals. Members requmng copies of such journals shoul d contact Miss Barnett.

No. 72 TUDOR (ENFIELD) NURSING DI VISION, MIDDLESEX V.A.D.

Over one hundred nurses and probationers were on parade for the annual divisional inspection, which was taken retently by Lady District Officer Miss F. E. Cherry.

After watching a display of squad drill, first aid and home nursing, the inspecting officer congratulated all concerned on their general efficiency, and said it was extremely gratifying to learn that the membership of the division had trebled itself since her last visit only a year ago.

The Vauxhall Motors Divi sio n has contributed over £ I 0 towards a Red Cross and St. John appeal recently made b y the County Commissioner for Bedford, for replacing ambulances lost in France, and has a lso subscribed towards a collection, made throughout the Vauxhall works, for the Lord Mayor'S Fund.

No. 4 (CHESHI RE) DISTRICT MACCLESFIELD

The new headquarters of the Macclesfield ambulance and nursing divisions was opened recently by NIr. J. F. Morton (managing director of Hovis, Ltd.).

The County Commissioner (Lt.-Col. W. Chaloner, O.B.E., T.D., J.P.), and the Acting Assistant County Commissioner (Capt. P ercy R eay, M.C) were among those present at the ceremony.

Members of the Macclesfield divisions subscribed and collected £380 towards the cost of the building and a further £300 was received as a result of a public appeal launched b y the President of the ambulance division, Alderman.T. M. Abraham, J.P.,

Annual competitions of the Brigade in Northern 1reland were held recently in Belfast . Lady Clark, honorary President of County Antrim, handed the awards and was introduced by Professor Gregg Wilson, O.B.E., Deputy Commissioner, who congratula ted those present o n the splendid t.urn-out and extended a special welcome to the Dublin competitors and members of the Ro ya l Ulster Constabulary. The latter, taking part for the first time, were presented with a cup by Viscount Craigavon, Minister of Northern Ireland. A challenge shield was presented to the Belfast Nursing Di visions by thc;ir honorary County President, Lady Dixon, D .B .E.

In an address, the D eputy Commissioner said that he did not agree with people who considered that competiti ons should not be held at the present time. He thought there t\JlO good reasons why they should be held. Fust, because the y tended to improve the fitness of the competitors and made them ready for anything ; and secondly, because they acted as an incentive to those not ye t in the Brio-ade to come along and join it.

o Major Ian Fraser, ComrrusslOner, lD proposlDg a vote of thanks to Lady Clark, referred to her goo d work in connection with the loc al hospitals, and said he was also delighted to see present at the competitions a member of an ambulance division who h a d recentl y been doing real St. John work on board one of His Majesty's ships in the Narvik ar ea.

The Grand Priory in the British Realm of the Venerable Order of the Hospital of St. John of Jerusalem

His Majesty the King has been graciouslY pleased to sanction the follOlving Promotions in, and Appointlllent.f 10, the Venerable Order of the Hospital of St. John of J erusalem:-

FOR PROMOTION T O THE GRADE OF KNIGHT

Captain Lord Louis Fran<l. s Alber t Victor N cholas Mountbatten, G:C.V.O. RN. from Commander).

Sir Percival Horton-Smith Hartley, C.V O., M.D. (from Commander).

Colonel Augustus Mervyn Owen Anwyl-Passingham, O.B:'E. (from Commander).

FOR PROMOTION TO THE GRADE OF DAME

Edwina Cynth a Annette, Lady Louis Mountbatten (from Commander).

Jeanne Marie, L ady lIIalcolm, C.B.E. from Commander).

FOR PROMOTION TO THE GRADE OF ASSOCIATE DAME

The Dowager Lady Swaythling (from Associate Commander).

FOR ADMISSION IN THE GRADE OF COMMANDER (SISTER)

Jacqueline Aldine Lesley Lady Lampson.

The Viscountess Craigavon.

FOR PROMOTION TO THE GRADE OF OFFICER (BROTHER)

George Jackson (from Serving Brother)

FOR ADMISSION IN THE GRAD E OF OFFICER (BROTHER)

(from Serving Sister).

FOR ADMISSION I N THE GRADE OF OFFICER (SiSTER)

T'lorence Violet Dorothea, Lady Bradney.

The St. John Ambulance Brigade Overseas

INDIA

FOR ADMISSION IN THE GRADE OF SERVING BROTHEl{

Cockram.

Willi am David, M.RC.S., L.R.c.P.

Williams M.RC.S. , L.R .C.P.

FOR ADMISSION TN THE GRADE OF SERVI NG SISTER Mrs. Nora Anderson. Miss Elizabeth Ann Graven.or.

Mrs. Catherine Mary Lewis-Evans.

Mrs. Jenny Llewellyn.

COMMANDERY IN SOUTHERN AFRlCA FOI<- PROMOTION TO THE GRADE OF KNIGHT

Lieut.-Colonel Gerald Eustace Peacosk, M.RC.P. (from Commander).

COMIVIANDE RY IN NEW ZEALAND

FOR ADMISSION IN THE GRADE OF COMMANDER (BROTHER)

Sir Charles Manley Luke.

INDIA FOR PROMOTI.oN TO THE GRillE OF ASSOCIATE OFFI CER (BROTHER)

Major Sorab Kaikushru Engineer, O.B.E., F .RC.P.Ed. (from Associate Serving Brother).

FOR ADMISSION IN THE GRADE OF SERVING BROTHER Ferdinand Carroll, M.R.C.S., L.R C.P.

B URMA

FOR ADMISSION IN THE GRADE OF SERVll\G SlSTER

Mrs. Gladys Octavia Leonora D anker.

AUSTRALIA

NEW SOUTH WALES

FOR PROMOTION TO THE GRADE OF (B ROTHEl{

Albert Samu el Wilkinson (f rom Officer).

Lieut.- Colonel Wilfred Vickers, D.S.O., V.D., M.B. (from Officer). Rowland Griffiths Bowen (from Officer).

Wilham Batt y Kublg (from Serving Brother).

FOR ADMISSION IN TH E GRADE OF SERVING BROTHER

Alexander Burnett McIntosh.

Noel Hayton

Charles Keith Stewart.

VICTORIA

FOR PROMOTION TO THE GRADE OF COMMANDER (SISTER) l\>1iss Edith Jane Wells (from 01jlcer).

FOR ADMISSION N THE GRADE OF OFFICER (BROTHER)

Alan Joseph King, M.B.

SOUTH AUSTRALIA

FOR ADMISSION IN THE GRADE OF SERVING BROTHER

George Charles Wallace.

Arthur Walter Sydney J ames Wel ch.

WEST AUSTRALIA

FOR PROMOTION TO THE GR!\D E OF OFF CER (BROTHER )

Alexander Bruce (from Serving Broth er).

FOR IN THE GRADE OF OFFICER (BROTHEf<.)

Charles Harper. Frank Ernest Gibson

FOR ADMISSION IN THE GRADE OF SERV :\G BROTHER

John Faulkner Tomlinson. Reginald Dalton McKell ar-Hall.

John Cooke.

Thomas John. S mith.

Charles Clark Parker.

William Turnbull. Douglas Duncan McCowan, i\LB. ohn Patterson Myers_

George Charles Stewart.

T homas Rob ert Wood ro ffe. Ernest Nancarrow.

Albert Francis Noonan. Ernest Harold Boakes.

TANGANYIKA

FOR ADMISSION IN THE GRADE OF SERV fNG BROTHEl<

Arthur George Whitebead. Ch arles Kingham.

FO R ADMISSION I N THE GRADE OF ASSOCIATE SERV NG BHOTHEJ<

Oscar St jernholm>.

HONG KONG

FOR ADMISSION IN THE GRADE OF COMMANDER (BHOTHE !{)

Sir Alasdair Duncan Atho11 MacgregoF.

The following is an extract from the Annual Report of the Parsi Division, Bombay Corps, from January I, 1939, to December 31, 1939:-

The working of the Division shows increased activities and the continued progress it has hitherto made. It maintained its high rec.ord of performing public duties.

The strength of the Division in the beginning of the year was 117 members.

The main activities of the Division were chiefly directed by Transp.ort Officer and A.R.P. Instructor Z.M. Contractor towards the organisation of lectures .on Air Raid Precautions, both for Instructor's and Short Courses of lectures. He carried on an intensive propaganda in this connection in Bombay and in Native States of Bhavnagar and Navsari. Six courses of Instructor's Course and ten of Short Course were organised during the year. The former was attended by 598 persons of civil population, in cluding officers .of mills, lar ge commercial firms, public utility services, such as Municipality, Posts and Telegraphs, Royal Indian Navy, City Police, etc., I.M.S. Officers, doctors and lawyers-I96 of whom obtained Instructor and Pass Certificates.

Short courses of five lectures each were attended by 1,884 persons Also an intensive course of eleven lectures was given to 37 State Officials of Bhavnagar, where, by the special request of the Divan, Mr. Contractor delivered 16 lectures, with a dem.onstration of an incendiary bomb, which were very much appreciated by His Highness the Maharaja and State Officials In addition to the above courses, five public lectures were delivered and several demonstrations in incendiary bomb and exhibition of A.R.P. equipment were given in the presence of large audience. In all, about 8,80.0 persons derived benefit of these lectures

Practically the wh.ole Division derived benefit of one or the other course.

Dr. Dhunjibhai Hormusji Mehta, C.LE., presented 1 18 copies of Gujarati edition of A.R.P. book for distribution among the members.

Referring to these activities of the Division, the Times of l1zdia writes: "The Parsi community has shown commendable enterprise in this direction (A.R.P.)."

Regarding Mr. Contractor's lectures at Bhavnagar and Navsari, the Illustrated WeeklY of India writes: "Bombay's eagerness for A.R.P instruction is illustrated by largely attended lectures and demontrations with very up-to-date equipment and a great many volunteers have already been trained_ Tributes to their efficiency are the recent invitations to deliver courses of lectures extended by the Bhavnagar and Baroda States to the A.R.P. In-

structor (Mr. Z. M Contractor), of the Parsi Ambulance Division."

Calls public duties made for the services of members were satisfactorily carried out by members at a considerable sacrifice of their time and energy. They gave ab.out 1,2.00 hours in all in this humanitarian and philanthropic work.

The presentation ceremony of the motor ambulance presented by Mr. Dinshaw Darabshah Shroff was held in the Lady Willing don Building in Januar y, in the presence of District and Divisional Officers and members and Cadets of the Parsi Ambulance and Parsi Nursing Divisions.

His Excellency Sir Roger Lumley, Governor of Bombay, inspected the Division and other Divisions of Bombay Corps in March, when the members gave a display of first aid in a case of bomb explosion, and methods of transport of injured, which was watched with keen interest by His Excellency and by spectators.

His Excellency congratulated the Divisions on their fine record of service in the past year and impressed on the Divisions that the instruction the y had received had been well worth it.

The Parsi Nursing Division celebrated its Silver Jubilee with a most successful Exhibition, which was attended by 40,000 persons during the ten days it was open.

The Annual Inspection was conducted by Assistant Commissioner, Lt.-Col. A. J. Ransford, C.LE., R.E., assisted by District Surgeon Capt. F. N. Kapadia, M.D., and District Superintendent Major F. T . Deatker in November. The Inspecting Officers expressed their satisfaction at the efficiency of members.

THE P ARSI CADET &vrBULANCE DIVISION Extracts from Annual Report

(From January I, 1939, to December 3 I, 1939)

The Parsi Cadet Ambulance Division has now completed fourteen years of its existence It has continued to prove a good ground for recruitment to the parent Division

The annual re-examination was held in July b y Divisional Surgeon Capt. K. S. Patel of the Parent Division . Eight senior and 25 Junior Cadets passed_

The Annual Inspection was held in November , 1939, by the Assistant Commissioner, Lt.-C.ol. A. J. Ransford, C.LE , R E ., assisted by District Surgeon Capt. F. N. Kapadia, 1if.D., and District Superintendent Major F. T Deatker.

The Cadets were also inspc;cted with the Bombay Divisions by His Excellency the Governor of Bombay in March, when they took part in a First Aid Display. A First Aid C.ompetition was held on December 10, 1939·

Interesting Case Reports

CASE REpORT No. I66.-The Officer-in-Charge of Western Area No. I (Prince of Wales's) District S.J.A.B. reports the efficient performance of first aid by a member of the Putney and Wandsworth Division in the following circumstances :_

At I p.m. on January ,2 Private Edward T. King was called to a neighbollr<s house where he found a middle-aged woman suffering from coal-gas poisoning, her head pillowed in the gas oven. A doctor had already been summoned. Private Kino- promptly pulled the patient away from the oven, band, as she had ceased to breathe, he rapidly excluded further injurie.s, rolled her into the face-downward position and WIthout further delay applied artificial respiration by the Schafer method. Meanwhile, he instructed helpers to open all windows widely, to bring blankets and to prepare hot-water bottles. Twenty minutes patient showed signs of recovery and the doctor arrIved. The latter told Private King to continue his efforts for another quarter of an hour and then to put patient to bed pending the arrival of the ambulance. Later the patient was removed to Fulham Hospital, where she made an uninterrupted recovery.

COM1ffiNT.-Experience teaches that candidate.r in examination often fail to perf01'm artificial respiration {n these circumstances P rivate E. T. King ments cordzal congratulations in that, being able to carry out the movements ..skiiful!J' and ejjicietit!J', he succeededwhen the need arose-in saving the life of his patient.N. C. F.

[ Questions and Answers

TURPENTINE AS ANTISEPTIC

P. S. (Cardiff).-During a discussion on antiseptics a member ?f our Class said that oil of turpentille IS useful this purpose. Some of us disagreed and we dec1ded to your kind ruling on the point. 011 of turpentme zs an excellent antiseptic in an Since, however, it is also an irritant, it is 1vzse to sponge the wound and surrounding skin with a mop of cotton-wool, from which atry excess of the oil has been squeezed.-N. C. F.

THE VAGARIES OF A SURGEON-EXAMINER

D. N. (South Westland). - At a recent first-aid examination held in this area the examiner who is a Brigade Surgeon, had all the class sittin'g round the. and ga:re. us a long lecture on some subjects, my OP1nlOfl, were out of place in a first-aid exammatlOn.held under the auspices of the Association.

He asked us what was the correct treatment for a perforated gastric ulcer and what dose of insulin should be given in a case of diabetic coma.

1)6

We were asked practically no first-aid; and as up to now we have not had the result of the examination, I am asking your opinion on the conduct of the examination. Also, if we have not passed, should we be correct in protesting about the result, and, if so, to whom?

Your StOt)1 sounds too surprisi1tg to be true.

In rep!J' to your question, dissatisfied candidates have the right of appeal to the Chief Secretmy of the Association.

- N, C. F.

TREATMENT OF EPILEPSY

O. (Northampton).-Several of us were recently discuss!ng the treatment of Epilepsy and the question was raIsed as to whether or no first-aiders could by any means prevent the convulsive movements as part of ,the. treatment of a patient suffering from an EpIleptic attack. As we could not agree, we decided to submit the point for your kind ruling.

The convulsive movements must rU11 their course. Epilepsy has been called" a brain storm" 1vhich results fron: the sudden failure or loss of control of the highest bram centres. Consequent!J', the outstanding symptom JS stldden and complete loss of consciousness. This l1ZaJI (or mqy not) be followed rapid!J' bJl convttlsive movements, mterfe1'ence 1vith 1JJhich is not advisable because it I1lqy create an unconscious resistance bJI the patient.-N. C. F. FRACTURES OF RIGHT CLAVICLE AND LEFT SCAPULA

R. D. (Allestree).- With reference to your reply to my query in the June issue of THE GAZETTE relative to the query originally published in the April I tempted to encroach further on your valuable tIme In order to darify myself.

In the April issue the references were as follows: Priority injury-Right clavicle. (2) Secondary Injury-Left scapula. The treatment suggested was: (a) "Remove coat, braces, etc." (b) "Bandage left uppe: limb at elbow) to the trunk." (c) Treat the rIght claVIcle as laid down in Text Book."

From foregoing it would appear that the InjUry has actually received priority, and It IS thIS point about which I wrote and suggested that there was an error. Meanwhile, I thank you for continued help. " ,

1Y.0w. I see your. difjiculty, and I realise that you are restnctmg the meamng of the word" priority}J to a time factor, whereas, remembering the dictionary definition, " the state. of keing prior or in line, place or rank," I alwqys wzth reference to place in treatment J qj several Z1!Jurtes. and I zgnore the time factor as unimportant in thi.f connectton.

In the. named the f1"actured clavicle ';Jas, zn my opznzon, the more serious i1!Jury and as such demanded treatment as near as possible in accordance 1vith the instructions of the Text Book. Consequent!J' , I suggested thai the left upper limb should be bandaged to the trunk and so protected from further aggravation and that first-aiders should then concentrate on the treatment of the fractured

rtp}t clavicle. Further, such action has the advantage of facilitating examination (an important point in first aid) ,vhen the patient reaches medical aid.-N. C. F.

TREATMENT 'OF FRACTURED HUMERUS

D. S. (Chalk Farm). -Please tell me if, in the treatment of fractured shaft of the humerus for which no splints are available, you would continue to apply two bandages round the arm and chest above and below the fracture.

My own view is that this would definitely be cllngerous; and I suggest the use of a very broad bandage covering both ends of the fracture, as is use d for a fracture on upper third of humerus.

If thrry be proper!J' applied, I do not see what harm can be done bJI two broad bandages in the treatment of fractured shajts of humerus. On the contrar.Jl, I do not like youI' sttggestion of one bandage because it would be d(lficult to applY 14niform pressure; and if on!J' one bandage were available I 1vould prefer to use a piece of sheeting or a towel which 1vill distribute more elJen pre.rsure over the arm.N. C. F.

Channel Islands Evacuation

During the evacuation of the Channel Islands most valuable and self-sacrificing work was carried out by the members of the St. John Ambulance Brigade in Guernsey under great mental and physical strain. In addition to assisting the aged and sick to be evacuated in this island, a party of twelve Brigade members from Guernsey went to Alderney to assist in removing about thirty infirm and aged persons to Guernsey

The following letter has been received from the Rector of St. Sampson's, Guernsey :-" I think that it shou ld be put on record the gratitude Guernsey owes to the men of the St. John Ambulance Brigade, who gave unsparingly of their time and who were invaluable in the aid they gave to our evacuees."

A Surgeon writes :-" I am writing to tell you of the admirable and efficient work which has been accomplished b y the Guernsey Division of the St. John Ambulance Brigade. During the evacuation of a Jarge number of people from Guernsey, the Ambu lanc es have been working all day and part of the night, and men have been on duty for long hours contin uously. "

The Press has reported that one St. John man was wounded whilst attending to the sick during the bombing attack by the Germans.

County of Cambridge

June 29, 1940.

MAJOR-GENERAL SIR JOHN DUNCAN, K.C.B., C.M.G., C.V.O., D.S.O., Chief Commissioner, The St. John Ambulance Brigade.

DEAR SIR JOHN,-I have the honour to report that as a consequence of the first enemy bombs dropped in this county during the raid in the early hours of June 18, Brigade personnel were among the first services to be called into action. At Cambridge First Aid parties were in action, and Corps Surgeon Walker was also in attendance. I am informed that the Regional Defence Commissioner, Sir Will Spen s, has stated that the First Aid parties worked very satisfactorily and were deserving of the highest praise, and that similar remarks were made by the Bor ough Medical Officer of Health. The casualty list for the night were 9 killed and 16 injured. On the same night, also as a result of enemy bombs which resulted in one killed and one injured, the first aid party in Ely was in action, and also the First Aid Post. I was present in this instance, and certainly the work done by the Brigade personnel concerned was consistent with a high standard of efficiency.

Yours sincerely, (Sgd.) K. S. COU11ty Co mmissioner.

RAILWAY NEWS

Southern Railway (CoNTRlimTED BY E. UZZELL) II

SALISBURY

Long-s,ervice medals to Messrs. G. Dimmer and M. Glover (14 years) and Iv1r. P. C. Fulford (21 years) were among the awards recently presented by:Mrs. Barton, wife of the Locomotive Foreman, to members of the Salisbury Ambulance Class.

REDBRIDGE

The Certificate of Merit awarded by the Southern Railway Ambulance Centre for long and continued interest in the First-Aid caus e was recently presented to Mr. G. C. Wateridge, secretary, Redbridge Class.

\VEST CROYDON

At a gathering of members of the West Croydon class and others presided over by Mr. E. J. Prew (District Secretary) meritorious first-aid certificates were presented to Messrs. J. Hyland and E. Smith, members of the Engineer's department, in recognition of the first-aid they rendered to Sub-Ganger Hopgood at Windmill Junction. Other awards were presented by the Welfare Officer, Mr. E. Uzzell, who thanked all present for their help and co-operation.

The Cup that Cheers . In any emergency.

T HE exceptional value. of '. in every emergency IS bemg WIde ly demonstrated to-day After a period of nervous tension , for example, a cup of delicious 'Ovaltine' h as outstanding advantages. Its special properties rapidly soothe the ner ves, quickly induce sleep and help you to gain the utmost benefit from your sleep in g hours.

Remember that' Ovaltine is a s cientifically complete a nd perfect tonrc food. Prepared from Nature's finest foods, it provides concentrated nourishment to every cell and tissue of body, brain and nerves. In f ac , Ovaltine will, by itself, sustain stren gth and stamina. Its pre-eminent nerverestoring properties a re largely from the new-laid eggs liberally used III lts manufacture No tonic food beverage could be complete without eggs.

Moreover, is easily and quickly prepared. You will find it equally delicious and health-giving either hot or cold. It can also b e eaten dry if required.

With a ll its unique advantages Ovaltine is yet most economical in us e. The smallest size tin makes as many as 24 cupfuls. Packed in airtight tins, Ovaltin e • will keep in perfect co ndition over a long period.

For a ll these reasons make Ovaltine your constant stand-by as an ever-ready source of comforting, sustaining and nerverestoring nutriment.

OVALTINE TABLETS

An emergen cy ration ibrf?afing

'Ovaltine Tablets contain the energising and sus t a n n g elements of 'Ovaltine.' Carry an emergency supply in your pocket or handbag. In two sizes, 1 j3d. and 4d.

TEAM TEST

DEW AR CHALLENGE SHIELD

Time limit;

DUAL PRACTICALS

Introduction to Test. 15 minutes. Warning at 10 minutes BEARERS Nos 3 AND 4

It is 6 p.m.; and you are walking down a street of small houses o n your way to a cinema duty. Glancing through a window you sec a man paper-hanging his front room and you note that the steps o n which he is standing are awkwardly placed. If an accident happens, act as you see fit.

Action of Test.

Give Bearers the card of introduction and a haversac.

The paper-hanger is half-way up a pair of steps and is carryin g a piece of paper which he is about to apply to the wall. Feeling that someone is behind him, he turns round quickly and loses his bal a nce.

He slides down the steps and falls hea vil y on the ground enveloped in the paper. He is suffering from shock and fracture of leg.

His wife is the only other person in the house but knows nothin g a bout the accident. She will resent the sudden entry of Bearers, and if asked is quite willing to assist.

Stagil1g of Test.

Stage a front room of a small house with window and front d oo r.

Patient, dressed in shirt and trousers, is found lying on his ba,ck wit h his left foot everted and with his left trouser leg saturated in its low er third with bright red blood. He is suffering from shock and fro m compound complicated fracture of the leg. Hi s wife can suppl y t\vO blankets, two hot- water bottles, etc.

s

IMMEDIATE ACTION.

Promptly knock at door of the house

Tactful handling of patient's wife

Elicit that she knows nothing of the accident

Tactfully explain; and offer to assist.

Tactful words to patient. (Replies forlhwilh.)

Warn him not to attempt to move

Note deformity · of left leg. (FOOl evert ed.)

Note blood-saturated left trouser

Prompt digital compression femo ra l artery

Replaced by tourniquet at early moment 2

Method and efficiency of controlling bleeding 4

EXAMINATION OF PATIENT

Ask patient if in pain. (Middle left leg.)

If he has any pain elsewhere. (iVo.)

Examine leg first; decide expose freely

A sk permission to slit up seam of trouser

Explain tactfully reaso n for so doing

Note exact side of wound. (As ShOl1JJ1.)

Ask if wound clean. (Yes) " if foreign body. (N o.)

If irregularity of wound. (Both bones affeclcd.)

If wound lead s to fracture. (Bone protrudes.) "

Diagnose compound fracture

Ask colour of face. (Pale); breathing. (Shaii011J.)

Test pulse at w rist. (Weak); skin. (Cold.)

Method of excluding injuries elsewhere

Head, spine, ribs, a nd other limbs. (None.)

TREATMENT OF PATIENT.

Shock.

Avoid changes of position; raise feet

Keep head and shoulders low, head to side

Loosen clothing; give sips of cold water

Pass blankets under and over patien t

Prepare hot-water bottles and apply same

After testing heat and wrapping in flann el

Fractured Leg and TPound.

One Bearer steadies and supports leg

\Vhile the other prepares the equipment

And dresses wound; sterilizes fingers

Paints wound and skin with surgical spirit

Clean dressing; soft pad; bandage li g htly

Method used to ensure cleanliness .' ,

Both Bearers now combine together

To place 11mb in natural position

With great care, without using force

And without letting go till limb splinted

Apply inner and outer sp lints to leg

Reaching from above knee to beyond foot

A nd padded carefully to fit the limb "

Fix bandage above and below fracture

Just a bo ve knee; round ankles and feet

Las tly broad bandage round both knees

Relax tourniquet and ask result. (Bleeding.)

Re-tighten tourniquet; decide relax a ter

A FTER-CARE OF PATIENT.

Ask wife where docto r lives. (Five minutes' JJ)alk.)

If any means of telephoning him. (No.)

One Bearer goes off to fetch the doctor

While the other remains with the patient

Carefu l observation while awaiting doctor

Keep patient warm; give sips of cold water

Proper use of w ife's services throughout

Co -operation and efficiency of Bearers

O UES710N.

T ell me II hal are thc IIses of a cold compress and hOJl) it is applied NO·3 NO·4

Co ld compress is used to ease pain t t

T o less en swe llin g, or control intemal bleeding t

A clean handkerchief or piece of lint * t

Four-fo ld in thickness, s soaked in t

Cold water and carefully wrung out t t

T ill it does not drip when held up t t

And applied to the affected part t!

It must be frequently changed 1

In order to keep it cold and wet t t

Total

After-Care and Nursing

D ETAI LS OF TEST

A FTER-CARE AND NURSING OF BOYS.

P refilJJilla/]1 A ctiol/.

Immediately begin to prepare room "

Place bed suitable position, easy of access

Lig ht fire and put kettles on to boil

P reparatioll of Bed.

Tie piece of sacking to frame with tapes

Place mattress in position correctly

Tuck in under blanket smoothly and firmly

T uck in position under sheet similarly

T wo pillows in slips and correctly placed

T uck top sheet under mattress as necessary

T wo light and warm blankets similarly placed

Place light counterpane over bedclothes

Correctness of tucking in bedclothes and co vers

Carefu lly remove the upper bedclothes

App ly temporary blanket to protect bed

Place hot-water bottles in the bed

Receptioll oj Patient.

Take steps to ha ve hot blankets and tea ready

Have read y for doctor small table, basins, sterilised water (hot and cold), soap, towels, cotton wool, scissors, pins, pail for dirty articles, antiseptics and any dressings available

T ell keepers to place stretcher at side of bed

To take post on side furthest from bed

And to lift patient on to their bent knees

When patient lifted, push stretcher under bed

Tell keepers to rise, supporting boy on foreamls

T hen to step forward and place him on bed

Accuracy of instruction g iven to keepers

Cover boy warmly; protect knee with cradle

And renew cold application to head and knee

Keep head to one side, raise feet

Encourag ing words to the walking patient

Seat comfortably on chair; keep warm

Give drink of hot tea in sips

Check dressing of wo und on forehead. (!Vo bleeding)

Total

The response on National Flag Da y was even aenerous than the organisers expected. In the Oty London where a former Lord Mayor took a collecting box to the Stock Exchange, it was said to be unprecedented. Collectors were round the markets at 4 a.m., and earl y morning sales were so heavy that at 9 a.m. there were calls for more to replenish empty trays. Clubs, restaurants, big shops and stores had special depots. Many sellers had notes put in their bo xes and not all buyers were satisfied with the purchase of a single flag.

The Red Cross Sale at Christies began on Monday, July 8. It will probably last for fifteen days. of articles to be sold have been allotted to the vanous days. The response to this means of raiSing. funds has been so large that it has been agreed to give the country as a whole an o.f .sharing the effort by arranging for a senes of subsidiary sales in the big cities outside London.

In the meantime the Sales Committee asks for old gold and more old gold. It cannot have too man y old gold watches, gold chains, gold rings or ornaments. It has already received large quanhhes, but it feels that much more is hidden away in drawers, jewel cases and trinket boxes. They all have a real value as gold. Actually, the. Sales Committee. has realised already £20,000 of bullion from these articles. To that amount the Red Cross Fund has benefited. In addition, the Government, which cannot get enouah aold has been helped. The Sales Comb b Id '1 mittee, therefore, requests all who have go artie es to send them in to the Treasurer, the Red Cross Sale, 149, Park Lane, London, W. I.

Thousands of schools have responded to the Appeal under the chairmanship of Sir Edmund Phipps. They are helping the Lord Mayor's Fund by collecting metal foil. By the end of l'vlay, the schools had collected and dispatched to the central depot in London twenty and a-half tons. Bo y Scouts Girl Guides and other boys' and girls' have added another 7,699 Ibs. to the total.

Besides collecting foil, schools have devised a number of other ways of helping the Fund. So me have organised concerts, "socials," various forms of entertainment. Others have raIsed mone y by the sale of articles . or produce .grown b'y pupils. The total received ill cash to IS approXImately £4,000. This figure does not mclude contributed to local Red Cross Funds or the making of for the Comforts Collections Department . schools or groups of schools have opened subscription lists to provide ambulances.

Advanced Training in

By W. C. BEN'11 ALL, O.B.E., F.R.C.S., F.R.G.S., Assistant Swrgeon-in-Chiej, St. John A 'mbulance Brigade

Air Raid Precautions

FIRST AID POSTS-FIXED AND MOBIliE

Up-to-date knowledge and practice of this section of the Casualty Service is increasingly important, and the following few points may help to this end :-

History and Evolution

1. 1935 Elaborate early plans.

2 Decontamination changes and the use of the words " cleansing for casualties. JJ

3. Reduction of cost by simplifying buildings.

4· 1939· Taken over by Ministry of Health, followed by the using of clinics and hospitals, with provisions for more first aid and less gas. Mobile First Aid Posts introduced.

The Work First Aid Posts

I. To provide supervision and classification of cases by a doctor.

2. To treat slightly injured and keep the rush off hospitals.

3. To deal with pain, shock and urgency

4. To give warmth, comfort, rest and food

5. To reassure an agitated public and to give sedative treatment (e.g., morphia).

Structure of a Fixed Post

I. Outer shed to throw off grossly gassed clothing.

2. Reception room with clerks and door-keepers labelling with TvLP. C. 46, which are diagnosis labels.

3· Treatment-first aid, or gas, or both.

4· Rest and waiting roorp, which must be largt:>, for those treated cases who cannot leave until the "all clear" signal is given.

Abundance of lavatory accommodation, and an atmosphere of quiet confidence and smooth working is most essential.

There is a most detailed equipment specified in many official circulars issued since March 27, 1939, and any such may be seen on application to the Medical Officer of Health's o'ffice in any area. These include :-

I. Drugs, to be specially noted by the doctors in charge.

2. Dressings, to be specially noted by the nurse in charge.

160

3· Instruments, to be specially noted b y botl1 doctor and nurse.

4· Splints, basins, etc., to be noted b y the nur se in charge.

5· Screens, towels, etc., to be noted b y th e 11 tJ rse in 1:charge.

11 teams should be practised in handling thi s equIpment and seeIng each day that every article i s in its appointed place, and that all personnel is familiar with it and its use.

Treatment

This is: important for the doctor in charge to be faffi1liar wIth. TvIany of the points are technical, and full details should be read b y doctors and nurs e , and II/cry be read by other personnel, and is to b e found in "E.M.S. General 245," a small booklet of which copies may be had at the M.O.H.'s office o r bought for a few pence through your local bookshop Published by H.M. Stationery Office, Kin gs wa v, London.

Personnel

In areas classified as "vulnerable" (not what yOl t may think should be classified as such), a Post has a of 60. But in the large majorit y of area s not class1.6.ed as "vulnerable" the number of sta ff is 40. per cent. of these may be employ ed on a paId basIs and 70 per cent. on a voluntary basi s (see Circular 1869, Ministry of Health). To each po st there must be a qualified doctor and a qualified nurs e, who are the 1 st and 2nd officers in charo-e an d b responstble for the equipment, instruction an d training of personnel, and all orders for conduct o f the work.

Commandants of the B.R.C.S. or superintendent s of S.].A.B. may be deputed by the doctor for admini stration work, but they definitely are not the responsible officers. This is a point that has led to much discussion, and above is the correct ruling in the matt er n'aining

This is a most important matter. With who letime paid personnel it is easy, but with voluntary workers it is less easy and may be difficult and needin g much tact and organisation. It may be wise for th e doctor and the nurse to arrange for a Superintenden t

S.J.A B. or Commandant B.R.C.S. to take this administrative side over, and their organising ability and experience, especially in handling their own voluntary units is wise and useful, but they must hold their special position under the doctor and nurse, and must not control treatment except under these superior officers. Training should be systematic and regular. Checking of all the equipment, replenishment of used or broken materials, must be watched so that in a hasty emergency there is no -flaw in the supply or machinery of the treatment of -casualties. Under this heading the two pamphlets most helpful are :-(1) " E.M.S. General 226," and (2) "Training Manual No.2."

Mobile First Aid Posts Functions

(I) To set up a temporary post in an earmarked building previously selected and practised in.

(2) To augment an overworked Fixed Post on advice from the Control Centre.

(3) Local supervision in a bad smash to assist leaders of First Aid parties on the spot, when the doctor would take charge, with the leaders immediately under him, and who may turn to him for guidance in doubtful procedure or treatment

(4) Help in classification and evacuation.

(5) To form temporary casualty clearing stations with a surgical team.

Other details of a Mobile Post are similar to those of a Fixed Post. The work and evolution of a Mobile Post may be changed in the development of war or urgency, and, as I have often preached, constant change and evolution is a sign of healthy growth and vigour, whereas fixity and inability to recognise change is a sign of old age and death!

A.R.P. Questions and Answers

Q. Is Chloramin T recommended as treatment for Mustard Gas ?

A. Not by the authorities, who recommend the new Vanishing Cream Bleach Ointment.

Q. Would liquid mustard on eye cause blindness?

A. Yes, if untreated.

Q. Mustard gas is brought into a room heated by hot air circulation. All windows are shut How do we get rid of it ?

A. On the principles taught under Decontamination.

Q. Should earth for sealing be dry or moist?

A. Dry or slightly moist. Two shovelfuls of earth to one of bleach powder is the best.

Q. Can air-conditioning plant be used in buildings while air or gas raids are in progress?

A. Yes.

Q. Does the foam type of fire extinguisher serve to seal off liquid gas for any useful length of time?

A. No, not for any useful length of time.

Q. A . large proportion of tiled fireplaces have no jambs, but a flat surface. Kindly suggest best method of fixing three-ply, etc., to same.

A. The three-ply can be cut just to overlap the aperture all round the fireplace, and a broad strip of gummed paper will fasten it to the surround.

Q. Can any petroleum jelly be used in bleach for the ointment, or must white vaseline be used?

A. White vaseline must be used.

Q. In many towns there are trees, how will you treat mustard spray on trees?

A. If a heavy contamination is indicated the firemen on duty must spray them as they spray the roads or walls of buildings.

Q. Would chloride be eventually destroyed by being used?

A. Yes.

Q. What about contamination of dressings, materials, etc., carried by first-aid personnel, e.g., pouch equipment?

A. Apart from injuries immediately dangerous to life, e.g., excessive no Erst-aid materials should be used by casualty clearing parties. Of prime importance is speedy removal to first-aid posts, where necessary dressings will be used.

Q. How is a 50 per cent. solution of caustic soda made up?

A. The question emphasises the danger of teaching any such solutions or mixtures, and all such preparations will be given out to those who are to use them by the authorities in charge of the first-aid post.

A 50 per cent. solution means an equal quantity of a material in question with an equal quantity of water by weight.

Q. What is high-grade steel; how does it differ, say, from the steel of a galvanised roof?

A. A galvanised roof is not steel, but galvanised iron or tin. High-grade steel is a Bessemer preparation. Once again the question shows how careful the lecturer should be to avoid such technical phrases as high-grade steel, the answer leads you into the chemistry of steel manufacture, which is beyond the average understanding of a class.

Q. It is said that thick rubber must be used as a protection against mustard gas. Is not the civilian gas mask made of thin rubber?

A. Thick and thin are merely relative terms, the thicker the rubber the greater the number of hours it gives protection, the thinner the rubber the less time it gives protection. The rubber of the civilian respirator is sufficiently thick to give several hours of protection.

Q. Do steel helmets form part of protective clothing?

A When the first-aider is working inside a first-aid post it is not necessary, but when working out of doors in areas e}"''Posed to shelling or falling buildings the steel helmet is necessary. Officers in charge will give definite orders for members on duty.

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

ANNUAL MEETING OF THE PRIORY CHAPTER

The Earl of Plymouth, P.e., who presided over the annual meeting of the Chapter of the Priory for Wales, Order of St. John, in the Council Chamber, City Hall, Cardiff, on Tuesday, June 25, read the following telegram from the Prior, His Royal Highness the Duke of Kent :-

" Please conve y to Chapter of St. John of Jerusalem our deep regret at being unable to be present at annual meeting this afternoon. I follow with interest their valuable contribution to our national effort and I should like to congratulate them on upholding so nobly the traditions of the Priory. ( Signed) GEORGE."

Members were robed in the picturesque black mantles of the Order, and the meeting opened with prayers for peace) the King and all the Royal Family, members of the Order, the sick and wounded, prisoners and captives and all benefactors of the Order, said by the Chaplain, the Reverend Canon J. A. Lewis, B.A.

LORD PLYMOUTH'S ADDRESS

The Sub-Prior, Lord Plymouth, ' addressing Chapter, said they met for the second time only under war conditions, for the Priory held its initial meeting at St. John's Gate on March I, 1918. Comparing the outlook then and now, his Lordship said that in recent wars an Ambulance organisation may have had a more direct participation in hostilities and greater' responsibility for Auxiliary Hospital Services, byt to-day its contribution is far more varied and vital, if indirect and somewhat vicariously applied.

It was interesting to recall that recommendations made by the Priory for Wales urging consideration of the need for anti-gas measures were carried as far as the War Office. The Priory lost no time in organising courses as soon as the official textbooks were available and they could fairly claim to have been pioneers, but the initiative was quickly taken out of their hands by the Home Office scheme which had been considered by some to have swung to the other extreme of ousting the Ambulance organisations from a legitimate responsibility for the Casualty Services. It could be said, however, that it was to the credit of the Priory membership that they had responded to the appeal of the Local Authorities for volunteers to a new service alongside the untra.ined public with Qr without a measure of authority being assigned to responsible Brigade officers.

The two Ambulance organisations, St. John and Red Cross, had originated another measure which was taken up officially and launched under the regis of the Ministry of Health as the Civil Nursing Reserve.

As in the case of A.R.P., the problem was too vast to be solved b y Briga de and Red Cross personnel alone, who were therefore asked to volunteer to the Local Authority and merge their identity in a larger sphere of service.

Referring to the Joint War Organisation, the SubPrior said that some months before the war a Joint Committee for the Red Cross and St. John-the Red Cross takes precedence in wartime-set up various committees. When war was declared the J oint War Organisation established various Departments which have functioned with increasing momentum ever since; and reference was made to those which affected the Priory through the formation of J oint Committees, Red Cross and St. John, in each county. For instance, under the Central Hospital Supply Service, Re gional Supply Depots had beef!, established for North and South Wales with depots in each county, for the collection of gifts and the working up of goods supplied locally or from Headquarters b y sewing parties, which go either directly or via Headquarters to Military and Civil Hospitals taking Service patients . An ancillary service is that of the Hospital Libraries, which provide books and magazines under the supervision of Voluntary Librarian s. The Prisoner s of War D epar tment affords scope to counties for the adoption of Prisoners of War and Civil Internee s as well as the supply of regular parcels; a service which may be taken up by the Joint Flag Day Committees in each locality.

Returning to peace-time activities, Lord Plymo uth mentioned the production of an up-to-date "First Aid in Coal Mines" textbook, which the Priory had been entrusted b y the St. John Ambulance Association to draft, and was now in course of printing.

NEW ApPOINTMENTS

On the proposition of Sir Robert Webber, seconded by Mr. T. Edgar Smith, the following appointments were confirmed:-The Viscountess Tredegar as Lady President, Mr. W. E. Baines as Chairman a.nd Major S. E. Tyrwhitt as Assistant Commissioner (Borough of Newport Centre); Mr. R: J. Pritchard as Assistant Commissioner (Caernarvonshire Centre) , Dr. E. L. Davies as Assistant Commissioner (Car-

Throughout the civil medical and nursing professions, and the medical services of H.M. Forces , Bran d's Essence is constantly prescribed for combating critical weakness arising from physical 01' menIal exhaustion and shock.

Its uses, when First Aid is rendered to the injured, will be apparent from the follOll'in g brief summary of its ad l'antages:

Brand's Essence is a NON-ALCOHOLIC STIMULANT.

It is assimilated in its entirety, QUICKLY AND WITHOUT STRAIN BY EVEN THE WEAKEST SYSTEM

-Its stimulating effect is PRACTICALLY INSTANTANEOUS.

Brand's Essence DOES NOT PRODUCE AN AFTER-STATE OF MELANCHOLIA

It not only conserves strength-IT BUILDS UP STRENGTH QUICKLY AND SAFELY.

IT CANNOT CAUSE THIRST.

Be sure 10 ha ve a supply for The treatmenl of all cases where a STimulant is indicated.

diganshire Centre), Sir Charles B. Lowther, Bart., D.S.O., as Chairman (East Denbighshire), Mr. F. H. Sutcliffe as Chairman, Dr. G. Pari Huws as Commissioner, Mr. E. C. Marshall-Hughes as Assistant Commissioner and Mr. P. W. Lumley as Assistant Commissioner (Temporary) (West Denbighshire), Mr. D. M. Jones as Assistant Commissioner (Temporary) (Glamorgan Centre-Bridgend County Area), The Viscountess Clive as Lady President (Montgomeryshire Centre), Dr. T. E. Jones-Davies as Commissioner (Radnorshire Centre), Mr. Tom Andrews, J.P., as Chairman (Borough of Merthyr Tydfil Centre) and Mr. H. McVicar, M.E., as Chairman (Rhondda Centre).

Mr. Theodore Gibbins and Alderman Sir William Jenkins moved the election of the Standing Committee for the ensuing year.

TREASURER'S REpORT

In the absence of Mr. D. M. Evans-Bevan, J.P., Major A. W. Anderson, M.B., Ch.B., read the Report of the Treasurer, in which attention was drawn to the. increase in bank overdraft, now standing at £6,087 19s. 8d., due to abnormally high expenditure on the Ambulance Transport Service and advances made to Brigade Units enabling them to benefit by a percentage of grant aid towards the erection of Ambulance Halls. A welcome feature was the adoption of the seven-year covenant system of subscribing on the part of many supporters of Priory funds. The adoption of the Balance Sheet and Revenue Account for 1939 was seconded by Mr. Norman Ingledew and carried.

AMBULANCE DEPARTMENT

Submitting his report as Director of Ambulance, Professor George Knox said the transition from Peace to War had applied the initial test of the effectiveness of the measures taken to fulfil one of the object,s of the Priory which provided for the rendering of aid to the sick and wounded in war and the promotion of such permanent organisation in time of peace as would be at once available in time of emergency, including the provision of Technical Reserves for the Medical Forces of the Crown. By the end of 1939, 2,4 00 members of the St. John Ambulance Brigade, which alone supplied the personnel for the Military Hospitals Reserve, had been mobilised in the R.A.M.C.; and this fine backbone of first-aid technicians included over 400 members of the Brigade in Wales . .

The work of the Association Department had been intensified to an unparalleled degree, the number of First Aid and Home Nursing Classes examined during 1939 reaching the record total of 1,584, an increase of 557 on 193 8 , at which 27,594 students had passed for Association. awards, 11,226 more than in any previous year.

The summary of Brigade strength showed the

membership had grown by 1,645 in 1939 to a total of 14,434, comprising 7,742 men, 2,029 women, 3,270 boys and 1,393 girls. Notwithstanding the demands for national service to which the Brigade had responded wholeheartedly, Brigade activities had been energetically continued, the treatment of 7°,428 cases of accident and sickness being recorded for the past year.

AMBULANCE TRANSPORT SERVICE CO-OPERATING IN A.R.P.

Mr. Oliver Harris reported in the absence of Mr. James Griffiths, M .P., Director of Transport, that the co-ordinated Service of ambulances operated by the Priory for Wales had carried 22,446 cases involving a total mileage of 35 1,75 6 during 1939, an increase of 3,685 on 1938. The Service ' was serving 29 colliery companies covering approximately 50,000 and 13 other companies employing 5,000 men in respect of their statutory obligations, while 28,500 members of colliery lodges and over 10,000 other individuals were subscribing for a free call upon the ambulances for themselves and dependents. Close consideration · had been given, in collaboration with the Regional Commissioners and authorities concerned, to the preparation of a scheme for rendering assistance in support of the A.R.P. Ambulance Services in the counties of Carmarthen, Glamorgan and Monmouth, due regard having been paid to the necessity for reserving an exclusive service to fulfil commitments to subscribin g colliery comp anies.

MEDIC A L COMFORTS D E POT S

Viscount Tre de g ar, i n rende r ing a report a s Almoner, dealt with the development of the Medical Comforts Depots initiated in Wales at the end of the last war. The value of medical comforts had become appreciated throu g h the work of the private auxiliar y hospitals durin g war-t i me; and the application of their issue to peace-time conditions was an illustration of the stimulus applied by the pressure of war-time necessity to the alleviation o f everyday ills. With the aid of a g rant from th e Commissioner for Special Area s the Depots have expanded to a total of 94 functioning under the Priory, from which 11,4 52 articles had been issued on loan during 1939.

In the absence of Mr. E. L. Hann, the Registrar' s report was submitted by Mr. E. D. Jones.

Mr. R. Wilson Bartlett, representative of the Priory on the War Organisation of the British Red Cross Society and Order of St. John, gave an informative account of its activities.

An invaluable FIRST AID • MILTON

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For Milton is of the same chemical nature as the famous Carrell-Dakin solution" plus "-plus stability, plus absolute uniformity of strength, plus non-causticity.

Milton has immense germicidal strength and remarkable penetrative power

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Wholesale Prices to all Brigade Secretaries.

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OBITUARY

We regret to record the de ath of Alderman J G. Paris, an of the Order of St. J OM, and a trustee of the LIverpool Corps' Headquarters.

The Lord Ma!or of Liverpool (Sir Sydne y Jones) and of the St. John Ambulance AssoclatlOn and St. John Ambulance BriO'ade were among the large congregation at the Members of the Brigade formed a guard of honour and acted as pall-bearers. The blessing was pronounced by the Rt. Rev. the Lord Bishop of Liverpool (Dr. David).

During the I9I4-I8 war Major Paris served with the 9 th King's Liverpool Regiment. His services to both the Association and the Brigade will always be anc;l the deepest sympathy of all connected wIth the St. John movement in Liverpool is extended to Mrs. Paris.

We regret to record the of Miss M. E. Bell (Lady ?uperintendent of Halton Nursing Division).

Dunng the last war -Miss Bell served as a nursin g sister with the V.A.D. detachment at Halton. She was also secretary of the Whitkirk and District Nursing Association for many years.

B y her death the Leeds Corps has lost a most enthusiastic and loyal worker.

Many members of the Briga de att.ended the funeral.

"'\!f e regret to re:cord the death of Sergeant L. Elliott, secretary of the A. T.M. division, Liverpool D. Corps.

Among members of the Bri g ade who attended the funeral were Dr. W. Murray Cairns, M.B., O.B.E., Corps Officer D. J. Dee, an d the President and viceof the A. T.M. Di vis ion . The parade was In charge of Superintendent J. Bennion and Ambulance Officer C. Parr.

Standard Dimensions for Stretchers, Carriers and Trolleys

BOO KLET COMMENDED TO A LL TRANSPORT OFFI CERS

By R. R. HOPKINS

(Divisional Secretat:y and Transpo1't OlJicer, Vauxhall Motors Division)

There can be few transport officers who h ave not frequently corne up against the pr o blem of stretcher and ambulance equipment that is not standardised

Thispro.hlerr: has been especially acute amongst those working In A.R.P. organisations. Improvised ambulances have a habit of failing to accommodate all types of their locking devices are apt to prove unreliable; and where there is the need to operate in close combination with va rying hospital or surgery systems, the difficulty is taken a stage further.

166

Frequently a hard choice has to be made between limiting the amount of available equipment actually to ?e used and the risk of having to move an injured patIent from one type of stretcher to another before the transport is completed.

The first step towards the solution of this problem has surmounted in a booklet just published by .BntIs? Standards Institution and laying down DlmenslOns of Stretchers, Stretcher Carriers in Ambulances, and Hospital Trolleys."

The booklet, available from the publications department of the Institution, 28, Victoria Street, London, S. W. I, at 2S. net, or 2S. 2d. post free, has been p.roduced under the supervision of the Speci al Personal Safety Equipment and other bodies, IncludIng the St. John Ambulance Association.

No responsible transport officer should fail to booklet. He may not be able to take any Immediate steps towards standardising the equipment for which he is responsible, but at least no more need be constructed which do not conform to the new rulings.

Review

"Questions and Answers on Personal Protection ag ainst Gas, Part is a most us eful stu dent s' resum e of the subject of War Gases. The que stion and answer method prevents scientific discursiveness and keeps. a student's mind on the pithy individual questlOn s In the praiseworthy attempt at brevity note on Household Protection on page I3 is a bit overdone could be given a fu ll page in any subsequent editIon to advantage. It is one of the most concise products of its type that h ::. s been turned out.-W. C. B.

Subscribers Please Note!

Owing t o the increase in postage rates, the annual subscrip tion for th e GAZETTE will until notice be 4 S., instead of 3S. 6d. Subscnbers who do not wish to pay this additional charge should fill in the form below and hand it to their news agent.

PRACTICAL BOOKS

by N. CORBET FLETCHER, M.B •• B.C., M.A.(Cantab.). M.R.C.S.

AIDS TO FIRST-AID (7th Ed.)

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EFFICIENCY IN FIRST-AID (3rd Ed.)

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WHY AND WHEREFORE IN FIRSTAID (5th Ed.)

Difficulties in Study and Treatment Solved by Question and Answer. Price 1/- (Post 2id .)

AIDS TO HOME-NURSING

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AM BULANCE COMPETITION TESTS

Stretcher, Individual and Question.

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DUST and SPRAY MASKS and all other Safety and Protective Devices.

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Please order on my behalf a copy of "The St. John Ambulance Gazette)J which I will collect each month

Signed : (" St. John Ambulance Gazette)J is publzshed ry Messrs. British Periodicals Ltd., 19, I9 a , C"'trsitor Street, E.C.4.)

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mbe Jobn . OFFICIAL GAS CHARTS

No. I Chart shows gas derivations.

No. 2 is a full and complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nomi' nal fee.

any of the world's health problems are solved by , 'ASPRO', for 'ASPRO' brings within the reach of all freedom from , pain-the means to banish 'flu, colds and , rheumatic attacks. It protects the whole household from child to parent, brings sweet eep to the sleepless, soothes the irritable, , nishes headaches in a few minutes. Its fame as now flashed through the consciousness of the civilised world. 'ASPRO' is acclaimed eve.rywhere. It's the medicine that stops pain without harming the heart. or stomach-no harmful can after takmg 'ASPRO'tablets. The 'ASPRO service has spread throughout the

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THE JOURNAL OF THE VENERABLE ORDER OF THE

Hobson, Boroh, London. North of England Office:-22, YORK PLACE, LEEDS. Telephone: 23334 Leeds. Tek!grams: ,. Triers, Leeds."

Vol. 13. No.8. AUGUST, 1940

THE ST. JOHN AMBULANCE GAZETTE is published on the 15th of each month. The annual subscription is 45., post free; single copies ;d Brigade Reports and Photographs should to the Editor, at 32, Shoe Lane, E.C.4. photographs should reach him early in the Subscriptions and Advertisements should fo the publishers: Messrs. British Periodicals, Ltd., be addressed Reports and month. be forwarded 19, 19a Cursitor Street, London, E.C.4.

CONTENTS

Editorial

Overseas News

Home Nursing Page

First Aid in Coal Mines Priory of Wales

Brigade News

Interesting Case Reports Questions and Answers

Duties of Transport Officer in Time of War Red Cross and St. John War Organisation

A ir R aid Precautions

Talks on the Manual

CHANCERY OF THE ORDER,

ST. JOHN'S GATE, CLERK ENWELL, LONDON, E.C. I.

" We Cannot Count the Cost"

Almost Sir Philip Chet1'JJode's first dury as Chairman of the Executive Committee of the Red Cross and St John War Organisation was to broadcast a message to the United States of America. The text of Sir Philip's message is given below:-

" As an old soldier who has taken part in many wars, I thought I knew what war meant. But my heart went cold in my breast as I talked to-day with young men just back from France and Flanders.

"I learned from them of the abomination that modern weapons and their unscrupulous use have made of war; that it is not now an issue between armies, navies and air forces, but a horror which

civilians, old and young, women and children, are compelled to face

" To this view you in America need no conversion. At the very beginning of the war the American Red Cross made contact with us. They asked us what we wanted. We gave them a list of our most urgent requirements, and from time to time those requirements, many of which we could not obtain here, have been passing from the United States to Great Britain in a constant stream.

" For all this, we can never be sufficiently grateful to the American Red Cross. Had I, which I have not, the gift of words, I could not find those which could fully express our appreciation for all that the people of the United States have done and are doing.

"It may interest you to know to what uses the material you have sent us has been put and the general position of the British Red Cross to-day.

" That position is grave and serious and a cause of deep concern to all of us upon whom the responsibility rests for its work now.

" We have lost much material and many ambulances in France and Flanders. These we must replace, for we are determined to continue to aid the sick and the wounded regardless of the strain put upon our resources.

" We have afforded much help to the Red Cross of Norway and Finland, and we now have to deal with streams of our own wounded and Belgian and French refugees. We have to meet' the needs for the Middle East and for other possible areas of war, and for all this we need more ambulances, more medical stores, more hospital supplies and more surgical outfits to relieve suffering and effect cures. We have a large department which deals with parcels of food and clothing for prisoners of war. More than four million pounds sterling went into that alone in the last Great War.

"We have to maintain a large organisation for searching for missing men and enquiries about wounded in enemy hands. This is of inestimable comfort to their relatives.

"Such, briefly, are the main tasks of the British Red Cross. Time does not allow me to go into them in more detail.

" Let me say again that the British Red Cross are determined to carryon their work for the sick, wounded and wffering. We cannot count the cost. The work must be done.

"Let me repeat how deeply grateful we are for all that the people of the United States and the American Red Cross have done for us. Their help has enabled us to do far more than we could otherwise have hoped to have accomplished in alleviating suffering in this appalling struggle."

II OVERSEAS NEWS

NEW ZEALAND

Extracts from Report of Wellington District for the Year 1939

Reports from divisions of the Wellington Corps show that a wide field of activities has been covered and satisfactory work carried out. Lectures have been given by members of the medical profession, and instruction has also been given in anti-gas and Disaster Emergency Conditions. In the Hutt Valley a successful " Casualty Night" practice was carried out in the railway workshops where patients, placed at various points among the machinery in the shops, were treated and removed to the Dressing Station where they received by members of the Nursing Divisions. All injuries were marked by special bands which, by the skilful use of plastic material and pieces of bone, were made to look like actual injuries. The evening concluded with an exhibition of a patient being treated on the platform of one of the large overhead cranes and then being lowered to the ground by means of a C( Lowmore " stretcher.

Experience gained in connection with serious fires in Wellington has proved that it is necessary to have members available for duty at very short notice where large city fires occur. The Superintendent of the Wellington Fire Brigade was interviewed and arrangements made whereby a list containing the names? addresses and telephone numbers of senior officers of the Ambulance Brigade, any of whom can be communicated with in case of emergency, is lodged at the Central Fire Station.

It is recorded. that some 40 members of the Brigade (Ambulance and Nursing) are members of the Wellington Blood Transfusion Service and hold themselves in readiness to give blood transfusions when called upon.

With the opening bf the New Zealand Centennial Exhibition on November 8, 1939, the Brigade undertook the great responsibility of supplying first-aid service during the tenure of the Exhibition, i.e., six months. The Exhibition company provided the

Brigade with a suitable block of four rooms in one of the administrative buildings for dressing and staff rooms. In addition, the company has been most generous in supplying equipment and first-aid .material, and also arranged for the free admission to the Exhibition of Brigade members in uniform. In addition to attendance at the dressing rooms, it is necessary to arrange for the various Courts, Playland, and the Exhibition grounds to be continually patrolled so that from 20 to 30 members are required to be on duty, particularly in the evenings and on Saturday afternoons. The Directors of the Exhibition have expressed their entire satisfaction of the way in which the work is being carried out. Some idea of the extent of the service maybe gathered from the return of cases treated which show that from the opening of the Exhibition on November 8, 1939, to the end of the year-a period of less than two months1,084 persons received attention.

Bristol Centre

At the annual stretcher competitions recently held by the Committee of the Bristol Centre the following teams won:-

Beavis Cup: Butler's Division S.J.A.B. Lavington Cup: G. W.R. Filton. Mather Cup: North Somerset L.M.S. Novice Cup: John Robinson and Co. Walker Cup: NO.1 Nursing Division, S.J.A.B Squire's Cup: G.W.R., Filton. Weber Cup: The first junior trophy of the Bristol Centre: No. Nursing Cadets" A " Team.

Dr. Kettlewell, who acted as one of the judges, said that the work of all the teams was of such excellence that it was difficult to decide the actual winners.

Lady Wills presented the cups and souveni r medallions.

New Brigade Uniform for Nursing Personnel

The new hat authorised for Nursing Personnel is a riding hat type, turned down in front and slightly up at the back, with a band and bow for Ambulance Sisters, and a band and cockade for Officers. The badge is to be worn in the centre front on the ribbon .

The new design of coat is a double-breasted lancer front coat with a belt all round, which can be made up in the ordinary regulation grey material or in an approved showerproof dark grey gabardine..

In the interests of national economy, Officers and Members are urged not to buy new hats and coats unnecessarily.

Will Officers and Members kindly note that paper patterns of the Brigade uniform are not supplied by the Central Hospital Supply Service. Paper patterns of the dress, apron and overcoat can only be obtained from the Stores Department of the S. Willey Park, Broseley, Shropshire.

DOME NURSING PAGE SEPSIS

By DR. ANNIS GILLIE, M.R.C.P.

When we think of a septic wound, we mean one in which germs are not only present but in which germs are multiplying and spreading.

Even with the greatest care in the sterilising of s kin, hands, gloves and instruments, gowns and dr essings a few bacteria find their way into operation w ounds, though it is extremely rare that they find co nditions in which to grow and flourish. It is not surprising, therefore, that ev ery accidental wound is p otentially septic. The torn skin has not been sterilised and teams with staphylococci (the cause of boils and styes) even when daily baths are taken; the cl o thing has been contaminated from endless sources, soil or grit may be rubbed in carrying the sporebe aring o rganisms of gas gangrene and of tetanus.

I n addition to this there is blood clot and dead and dyi ng tissue in the wound which supply ideal condition s fDr bacteria to grow in; the patient is in pain, is frightened, has lost blood, has to face a journey to hospital which reduces his own fighting powers. What are o.ur resources for contending ag ainst the menace of sepsis in accidental wounds?

Shortly after Pasteur discovered the existence of microscopic organisms which infect animals and humans, Lister discovered that certain chemicals could destroy these organisms. It seemed as though the menace of infection were already counter-attacked and defeated. The last war was at a time when antiseptic treatment was at its highest peak in the treatment of infection and its result, inflammation. Antisepsis has wonderful uses but also sad limitations. If chemicals are to be strong enough to kill the most deadly organisms they destroy the vitality of living tissues, and they cannot pursue the germs as they multiply and spread in the crevices of tissue layers. The immediate application of an antiseptic as soon as the injury has occurred is of the greatest value, but for later treatment we have had to widen our view very

We rely more and more on giving the body the best possible conditions in which to rally its own defences, and in doing so we learn to have an increasing respect for the wonderful vigour of the natural power of a young and healthy person's tIssues.

Wounds are now treated as soon after injur y a s possible. A first-aid dressing is of course. a1?plied, but the minimum time is spent before adffilsslon to an operating theatre. This means that serious t r eatment can often bee-in before surgical shock has b appeared to any serious degree. If the 1S already shocked to any great ext ent, the adffilfll stration of morphia and a blood transfusion with routine shock treatment fits him for opera tlOn as soon as possible. The onset of shock sepsis. The sluggish circulation of a shocked patIent provides admirable condition s for the growth o f the germs.

/ Operation on an extensive wound consists ess entially in the removal of all dead or dying tissue, and the cleansing of the wound. Surgeons who ar e experienced in war surger y claim that soap and is a better cleansing agent of the tissues than anything else; it is thorough, but it is not cruel to the cells. No fragments of blood clot, no foreign bodies, whether of metal or of bone, and no unex plored corners of the wound are left, and all torn ed g es of skin are excised and bleeding points, of course , controlled. Finally, the wounded area is left .as open and shallow as possible. Extensive stltching IS not attempted, for unless there is a1-nost asepsis, the narrowing of the wound and the tenslOn on the tissues would favour the bacteria . In some campaigns, especially in Finland, the :wounds were packed with fish liver oil, for the vltarruns help the tissues to overcome infection and to grow to fill the spaces. In others gauze is used, either plain or unmedicated, or even soaked in ' Glauber's salt solution to draw ore-anisms and dead tissues to the b

173 surface.

In every case the wounded part is fixed so that the muscles are in a state of complete rest. This, more than anything else, has been found to favour the army of the body cells against the invading germs and to prevent the spread of the latter. Plaster of Paris may be used, with or without an underlYlng dressing, or splinting of a more open type. The most modern war surgeons favour reducing the number of dressings as far as possible. Instead of frequent changing of applications, each one involving pain

and damage to new growing cells, days or even two or three weeks may elapse between treatments if all is going well.

Additional after-treatments to contend against infection is the use of serum to counteract tetanus and other spore-bearing bacteria; the administration of the new drugs of the type of M and B 693 to counteract infection and avoid invasion of the blood stream by the germs. Blood transfusion may be repeated several times in severe cases both during and after operation, for no other treatment can act so miraculously in , turning the scale in favour of the patient's fighting power against the attacking infection. Freedom from pain is essential if the physical ' resources of the patient are to fight well, and this is secured by rest of the w-ounded part and by the use of morphia and other drugs when necessary. Anxiety and fear have a disastrous effect in favouring sepsis, as was found in those patients in Finland and Spain where hospitals were repeatedly and deliberately bombed.

But what if sepsis has already secured a firm hold before treatment can be carried out? When bubbles of gas are forming in the tissues, when blood clot is infected and streptococci are in the bloodstream?

Then the severe measures of amputation and the application of continuous irrigation of antiseptics must be tried, but the invading germs are already firmly established and a good result can rarely be secured In this war our whole First Aid organisation is based upon securing rapid dressing and transport, so that surgeons and hospitals may treat the patient in time to rally his own wonderful fighting power agaifist the septic bacteria in the wound.

Appreciation

I would like to make mention of the kindly treatment we received on the Queen Emma reaching Plymouth waters. A naval surgeon on a tender on finding the low state of health my wife was in offered to send her in a naval ambulance to a hospital with other wounded and sick people, and I, while appreciating his kindness, said I thought I could take care of her if I could get into an hote1. When we got to the embarkation office, and had our papers examined, she was changed over to a St. John Ambulance air-cushioned stretcher, and, through the kindness Qf Commissioner Hedley V. Miller, of this Association, in obtaining an hotel, sending his ambulance, stretcher bearers and a nurse, we put my wife comfortably to bed. I was somewhat anxious about what we could do on arriving, but the extreme kindness of Commissioner Miller in assuring us we would be all right, and the subsequent help he afforded us, will ever remain fresh in my memory.

The above is an extract from a letter received ry a Divisional Surgeon, Bournemouth Corps, S.J.A .B,., from his brother.

FIRST AID IN COAL MINES*

Reviewed by Professor T. DAVID JONES, Mining Department, University

College, Cardiff.

It has long been recognised that rrurung is a hazardous occupation, and it is on that account that the art of "First Aid for the Injured" has been practised and encouraged amongst the mining fraternity. This is reflected in the enthusiasm evinced by colliery workers to attain the highest possible standard of First Aid efficiency by regular study and competitive practice.

The hazards peculiar to mining are the remoteness of the working places from medical aid, the dirt, the restricted space, the urgency of the need for removal from a place of danger, the presence of asphyxiating or poisonous gases, the dangers and the violence of explosions or inundations, all of which create problems in the treatment of emergencies rarely met with to the same degree in other spheres.

It is thus with great interest that a new tex t -book, by the St. John Ambulance Association, is received. It deals with the subject of First Aid in coal-mines with the , fullness and yet brevity which would be expected from the organisation which has produced the many editions of " First Aid to the Injured."

The aim of those who have compiled this book is ambitious. It is intended to give instruction not only in the art of First Aid in the mine, but also to give the First Aider an intelligent understanding of the principles and the reasons for the acts which he must perform. The authors are to be congratulated upon recognising that the man who takes a live interest in First Aid in the mine is a man of some intelligence who is not content to be merely an earner 0f wages, but has aspirations to serve his fellow-men. It is not a bOOk which will ' prove eminently instructive or useful to the slow-witted, but it is a matter of satisfaction and pride that the mining industry contains a vast store of working men of a high order of intelligence, who can study, derive benefit and find great interest in a subject so clearly presented.

The book in nine chapters deals with the various aspects of prevention, organisation, equipment, treatment and transport, in a manner which every mine worker will find very instructive and satisfying. Many who take an interest in First Aid feel a sense of frustration that it cannot be followed to a more advanced stage. They want to do more than merely perfect themselves in work which they have already

done time and again. This book will meet the need and remove a possible complaint on the part of the mining student that First Aid stops just where it becomes interesting. Without encroaching on the preserves of the medical profession and so conducing to that state of little knowledge which is a dangerous thing, it enlarges more on the mining side and gives the student the facts and reasons for the dangers t o be apprehended and the action to be taken when calamitous circumstances claim their victim.

If one part can be lauded above the rest it is that dealing with the impurities in mine atmospheres and their effects upon the human body. This is a matter of truly vital importance in mining and of growing importance in all walks of life. It will inevitably reach a wider circle than the purely mining, and it is to be hoped that wide publicity will enable it to fall into the hands of more than those for whom it is intended primarily.

The book commences by giving data of the types o f accidents prevalent in coal mines and the causes giving rise to them. Thus by showing how the small fatalities caused by falls of roof and sides and ha ulage accidents, each claiming few victims, account fo r as great a proportion as 75 per cent. of the deaths, it may tend to correct the common view of the enh anced importance of explosions and big di sasters.

The organisation of First Aid in conjunction with th e operation of rescue teams is also dealt with and the connection between the two activities clearly es tablished.

That section dealing with ambulance equipment and is one which is of importance not only to those who are carrying out the First Aid work, but also the management of the mine who have to se e that the organisation is effective. It is in this r espect as much as others that mining conditions differ from factory conditions. Not only must a sufficient and effective central organisation exist centred on an ambulance room properly equipped and supervised, but also help must be available in the remotest part of the mine whenever any person may be there. The means of achieving that aim is no small problem, and it calls for continuous supervision and a living organisation to maintain the service in an efficient condition. The basis on which this organisation must be built is set out in the book for the guidance of those responsible.

Chapter V contains a table giving the "Physiological Effect of Lack of Oxygen and of Various Noxious Gases" which will be exceedingly useful to those working in mines and to many others. The subject is dealt with in detail, and forms a most valuable part of the book. The table and the chapter which follows giving the properties of the gases are of value to anyone likely to meet WIth Impure air from many other causes, e.g., a sewer or ventilated garage; and would enable them to recogruse the effects, symptoms and dangers in good time.

The resuscitation of persons suffering from the effects of any of the gases is fully dealt with and the warnings against subsequent exertion by those who have been gassed are timely.

The dangers inherent in the use of electricity are not limited to miners, and this chapter again confirms the opinion that the scope of this work is wider than that of mining.

The difficulty of underground transport is recognised by ample directions and by the description of special apparatus required. In particular, the transport of those suffering from spinal injuries, a rrpe ?f injury frequent in mines, has been dealt wIth. ill detail. The reasons for, and methods of, carrylllg on the face or on the back are dealt with fully, and now form an authoritative direction on that matter.

The advent of this book has been long anticipated, and it is a source of satisfaction to be able to affirm it has more than fulfilled expectation. It has received a blessing in the form of a foreword under the joint authorship of Sir Evan Williams, President of the Mining Association of Great Bnta.l1l, and Mr. Will Lawther, President of the Mineworkers' Federation of Great Britain. The Ambulance Department of the Order of St. John is to be congratulated on the production of this book for the assistance of the injured miner, and there is no doubt that it 'Yill receive very wide support in the industry for which it has been written.

Thank YOU!

Thanks to The British Navy, The R.A.F. and the Brltish Merchant Navy this Journal is on sale throughout the British Empire; at the same price.

We are relying on you for one new reader this month. Thank you.

These earlier sections are of concern to the organisation as a whole, from the manager to the newest recruit to the First Aid class, and even to those who may be subjected to the First Aider's attention in time of need. later parts of the book direct the attention to the First Aider himself. The generalisation of how to prepare for and deal with a casualty mining conditions is given, and the particular difficulties of dealing with wounds, ha::morrhage, shock and so on are enlarged upon. The treatment of small cuts and abrasions is essentially important I7S in rrurung; so many casualties causing loss of work and even death arise from pOlsorung following slight injury that this phase of Aid work has rightly received adequate attentlOn.

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

Meetings of Council and Ambulance Committee of the Priory were held at Cardiff on Tuesday, July 30, under the chairmanship of Dr. D. Rocyn Jones, CB.E., J.P., the Surgeon-in-Chief for Wales, the office of Director of Ambulance having become vacant by the recent departure of Professor George Knox, M.I.M.E., F.G.S., to Scotland. In his long and intimate connection with almost all departments of the Priory'S activities, Professor Knox had regarded with the highest esteem; and resolutions of sincerest regret upon his departure and good wishes for the future were recorded by all the Committees upon which he had served with distinction. His record of service includes membership of the Ambulance Committee since 1918, the Finance Committee from 1926, the Motor Ambulance Transport Sub-Committee from 1921, Council from 193 0 and ,Chapter from 193 I. Appointment as Treasurer in 1935 brought him added responSIbllities as deputy chairman of the Finance Committee; .and from 1936 he has presided at ,Ambulance COmmIttee meetings in the executive office as Director of Ambulance. As a Knight of Grace, Professor Knox will remain in fellowship with other members of the Order' and one of the best -memorials to his work will b; the" First Aid in Coal Mines" textbook the , publicadon of which by the St. John Ambulance Association just preceded his retirement.

Appointments in the St. John Ambulance Brigade sanctioned b y the Committee included those of Lady Twiston Davies and Miss G. Richards as Lady County Superintendent for Monmouthshire and Cardiff respectively. New Divisions of the Brigade were registered at Penarth, Pwll (Llanelly), Whitchurch, Pontygwaith, Risca, and Troedyrhiw; and Units provisionally formed at Blaenavon, Blaina and Holyhead.

Dr. John Hunter Sewart was appointed an Honorary Life Member of the Priory for Wales in recognition of his gratuitous services as Honorary Lecturer to the Whitchurch Ambulance and Nursing Divisions. It was noted that during the first six months .of the year the Priory had arranged examinations or re-examinations for 899 classes in First Aid and Home Nursing.

It was agreed to invite all Brigade Surgeons and Examiners to attend a week-end demonstration in October of certain methods of treatment set out in the new First Aid in Coal Mines textbook, which is 176

taken up with eager enthusiasm by colliery companies and their staffs.

The Principal Secretary (The Hon. John H. Bruce, J.P., D.L.) read to Council a letter from the Secretary to H.R.H. the Duke of Kent, acknowledging the thanks of Chapter for the message of greeting from H.R.H. the Prior. His Royal Highness expressed th e desire to be associated personally whenever possible with the Priory's activities.

At the quarterly meeting of the Motor Ambulance Transport Sub-Committee held on July 29 it was reported that a satisfactory scheme for co-operation on the part of the Priory with A.R.P. authorities had been finalised in consultation with the Commissioners of the No. 8 Region. Due care has been taken to maintain an adequate service to meet the statutory obligations of the colliery companies having contracts with the Priory.

As the following comparative summary for the June quarter shows, increasing use is being made of the Priory'S service of ambulances :-

CENTRE REPORTS

BRECKNOCKSH1RE

There was a very large and influential gathering on the Builth Wells Groe Park on Sunday, June 16, the occasion being the dedication of the New Builth Wells Ambulance, performed by the of Brecon, Ven. H. J. Church Jones, assisted by the Rev. J. Cradoc Owen.

In the course of address by the Hon. John Bruce, J.P., D.L. (Principal Secretary and Commissioner for Wales), he congratulated Builth Wells and also B.reconshire for what had been done in the county, which was largely due to the great work of Lieut.-Colonel C G. Cole-Hamilton, CM.G., D.S.O.,

Cole-Hamilton (Commissioner), the Hon. Mrs. A. Cooper (Lady President, Red ' Cross and St. John), Mr. A. H. Coppage (Assistant Commissioner), Mrs. M. Pas kin (Lady County Superintendent), Mrs. G. E. Sayce (Lady Corps Superintendent), Mr. M. A. Phillips (Divisional Superintendent, Builth Ambulance Division), Mr. Dyer (Divisional Superintendent, Llanwrthwl Ambulance Division), Mrs. D. M. Price (Lady Divisional Superintendent, Builth Nursing Division), Miss Wilson (Lady Divi siona l Superintendent, Garth and Llangammarch Nursing Division), Mrs. Wilson (Garth House), Sir William Parker, Captain E. Aubrey Thomas, Captain R. J. Owen, Captain R. W. Woosnam, Mr. B. R. Gibbins, J.p., and others.

the Commissioner. The old ambulance, he remarked, had been in service in the district for five years, and during that time it had been used for the conveyance of 400 cases and had travelled a distance of 10,000 miles. The Brecon 'ambulance had been used for the conveyance of 5°° cases and had travelled 6,000 miles. The cost' of the new ambulance was £3° 0 : £100 had been contributed by Headquarters and the other amount had to be found locally. He felt that they were greatly indebted to Mr. M. A. Phillips, the Divisional Superintendent, for hi$ long and faithful service; and spoke in appreciative terms of the service rendered by the drivers, the ambulance men and the nurses.

Amongst those present were the High Sheriff of Breconshire (Mr. G. E. Sayee), Lieut.-Col. C G. 177

The Brecknockshire Centre is to be conO'ratulated on having raised the sum of £550 to the cost of providing a Field Ambulance and £ 12 5 14s. 7d. for the Joint Red Cross and St. John Fund.

The Cadets are losing no opportunity of collecting tinfoil, 145 lbs. having been sent for sale in aid of the Lord Mayor's Red Cross and St. John Fund.

CARMARTHENSHIRE CENTRE

,The Commissioner for Carmarthenshire (Mf. E. D. Jone:;) reports with regret the death on June 4 of the Centre Treasurer, Mr. Owen Picton Davies, an Officer of the Order. Mr. Davies, a former High Sheriff of Carmarthenshire and prominent London Welshman, had taken a keen interest in the welfare of the Brigade and Association in the County; and 1.

his active support in the raising of funds will be greatly missed.

As a result the enterprising efforts on the part of Pumpsaint Ambulance Class an interesting was held on July 20 when a well-equipped Fust Aid Hut was officially opened by Mr. H. Lloyd Johnes, M.A., M.e. The Hut is stocked with three stretchers, bed, .table, supply of splints, dressings, bandages, first-a1d outfit, etc., and will be manned members of the Class. Captain Morris (Managing DIrector of the Baglan Tinplate Works, Swansea), who presented awards to the Class members, was thanked for his gift of an Aladdin Lamp for the Hut· and gratitude was expressed also to Messrs. e. N: Walter, &. Co. for the kind help of that company In secunng the Hut. The able and enSecretary J Emanuel) is hopeful that a DIVISIon of the Bngade may be established in Pumpsaint at an early date.

GLAMORGAN CENTRE

Pontardawe County Area. -A particularly interesting ceremony took place in Alltycham Road, Pontardawe, on July 20, when new Ambulance Headquarters was opened and dedicated. A representative gathering preser:t the Hon. John H. Bruce, J.P., D.L. (Pnncipal Sebretary and Commissioner for and Mrs. Bruce, Canon J J Hughes, B.A. (Vicar), who dedicated the building, Major W. Owen Evans, M.B.E., JP. (Knight of Grace and Assistant .who performed the opening, Mr. Theodore GIbbIns, JP. (County Chairman), exT. Williams (Alltwen, Staff Officer), Mr. S. S. LeWls, JP., Mrs. Hannah Lewis, J.P., and many others.

Dr. Evans said event was a crowning glory of ambulance work In Pontardawe, whilst it was also the occasion of his 46th year of service in the Order of St. John. There had been two difficulties in their way with regard to the Hall: first of getting a plot of land and, secondly, there was the finance part. Mr. S. S. Lewis, of Brynheulog, had, however, kindly come to the rescue with regard to the former whilst as to the latter, a great deal of money had been coUected voluntarily, and people had subscribed well. Doctor said he hoped that the people would utllise the Hall well to learn First Aid, Home and Sanit!ltion. In .declaring the Hall open, he wished to thank ex-Supenntendent Tom Williams for his and Mr. Christopher Hopper for his able secrellanal work. Mr. Bruce explained how this part of the world had lost the benefit of certain grants available only in the Special Areas, but when the Commissioner's office closed last March they were able to negotiate with the Miners' Welfare Fund and Committee for financial help. They had, however, gone ahead thereunder their Assistant Commissioner (Dr Owen E:ans), made them all feel grateful to hIm for his serVIce. After local sites had been inspected, the speaker had been relieved to hear that

Mr. Sidney Lewis had gallantly come to the rescue with regard to a plot of ground. He was helped in his task for negotiating, as they had got public subscriptions and other ways of securing a sum which totalled £400. Included in that was £50 from Mr. Charles Gilbertson; £25 each from Mr. S. S. Lewis, Dr. Owen Evans and ex-Superintendent Williams; 15 guineas from Mr. Evans Bevan; and ten guineas from Messrs. Richard Thomas & Co., and' smaller sums too numerous to mention. Their recent Flag Day in the district realised £376, therefore the total figure they had raised was nearly £800, which represented a general contribution to war as well as peace activities of ambulance work in Pontardawe. Mr. Bruce was grateful for what they had raised towards the hall, for the Flag Day, the latter effort being carried out by a committee presided over by Mrs. J. R. Williams, JP., whilst Mr. Hopper was secretary of both efforts. As the result of their efforts he was able to say to those with whom he had to negotiate that had made such a splendid contribution that he just had to ask for a balance, and that no doubt the hall would be opened free of debt.

The Hon. Mrs. J H Bruce, the Lady Staff Officer for Wales, said she was sorry there was no Nursing Division in Pontardawe, and she made a strong appeal that one should be formed.

Mr. Bruce presented Mr. Christopher Hopper with a Priory Vote of Thanks in recognition of the splendid secretarial work he had carried out, and the recipient suitably returned thanks.

CITY OF CARDIFF CENTRE

The Annual Inspection of the Ambulance, Nursing and Cadet Divisions, comprising the Cardiff and District Corps, was conducted by the Commissioner for Wales, the Hon. J. H. Bruce, JP., D.L., assisted by the Lady Staff Officer for Wales, the Han. Mrs. J H. Bruce, on Sunday, July 14, at the Brigade Headquarters in the Cardiff Castle Grounds.

Despite the many calls upon the voluntary services of the Brigade and duties which had to b e carried out at the time of the Inspection, over 400 members were present on parade.

Advantage was taken of the occasion to present the following awards :-

Warrants of Appointment to :-

Assistant Commissioner B. E. Maberly, on promotion from the rank of County Officer, which he had held from 1919.

Lady County Officer Miss G. Richards, promoted to Lady County Superintendent.

Lady Corps Superintendent Miss V. W. Rees, promoted to Lady County Officer.

Lady Corps Officer Mrs. M. A. Stephens, promoted to Lady Corps Superintendent.

Divisional Superintendent A. J Jenkins, promoted to County Officer.

Captain A. H. G. Field, promoted to County Officer. Dr. M. e. Myerson, as Divisional Surgeon.

Sergeant W. P. Pinches, promoted to Ambulance Officer.

Sergeant F. Stebbings, promoted to Ambulance Officer.

Dr. Enid Williams (Surgeon to the Cardiff Emergency Division) was presented with her Certificate of Appointment as an Honorary Life Member of the Priory in recognition of gratuitous service as Honorary Lecturer. County Officer H. G. Field received a second bar to the Service Medal, on completion of 25 years' efficient service in the Brigade; a first bar, denoting zo years' service, was presented to Ambulance Sister Mrs. J Morgan, Cardiff Nursing Division. The Inspecting Officer was supported by the Commissioner for Cardiff, Squadron Leader Dr. Edgar Llewellyn, Assistant Commissioner Captain F. P. Robathan, M.e. and Corps Superintendent J MacDonald.

NE WS IN BRIEF

During the first six months of the year the Association Department of the Priory for Wales had arranged examinations or re-examinations for 899 Classes within the Principality, the comparative figure for the first six months of 1939 being 968.

Reasons Why You Should Learn "First Aid to the Injured" and" Home Nursing"

(1) BECAUSE-

The knowledge may enable you to relieve suffering and save human lives.

(2) BECAUSE-

You are taught what not to do and thus saved fro1p inflicting further injury and suffering.

(3) BECAUSE-

The knowledge rightly applied assists the medical man and lessens the period of suffering for the patient.

(4) BECAUSE-

You never know when you yourself may need skilled First Aid.

(5) BECAUSE-

Everyone should acquire know ledge of a subject which has proved of inestimable value in all walks of life.

(6) BECAUSE-

The means of obtaining this knowledge is NOW within your reach.

The St. John Ambulance Brigade News

No. 1 (PRINCE OF WALES) DISTRICT

The Assistant Commissioner, accompanied by District Officer McBride, recently visited the headquarters of No. 22 (Hospital Saturday Fund) Division, Aldersgate Ward Schools, and with Lady District Officer Mrs. Tapply, No. 76 (East London) N. Division, at Beaumont Hall, Stepney, where he inspected a parade of members of the Division. Tests in First Aid were set. The general standard of the work was satisfactory and a credit to the Divisional Surgeon and Lady Divisional Superintendent Miss Minot, both of whom were present. The Headquarters of NO.2 (Haggerston) Divis ion and A.R.P. First Aid Posts in the City were also visited.

LUTON

No. 3 (EASTERN) DISTRICT

In addition to the £ 10 raised recently b y the Vauxhall Motors Ambulance and Nursing Divisions towards the cost of replacing ambulances los t in France, a collection at the factory organised by the nursing divisions in connection with the Red Cros s and St. John flag day during the first week in July brought in £3 The following week a collection throughout the whole of the factory resulted in a further subscription of £76 - £118 in all.

No. 5 DISTRICT

CHAPEL ALLERTON

At a special parade of the Chapel Allerton Nursing Cadet Division held recently under Corps Superintendent M. B Fenton, Leeds Corps, the Grand Prior's Badge was presented to two members-Cadet Corporal Elsie Crossfield and Cadet Corporal Dagney Lawson-by Lady Corps Superintendent Mrs. Renton. Mrs. Renton congratulated the recipients and expressed the hope that other cadets would soon be in a position to make a claim for the same high award. In an address Corps Superintendent Fenton congratulated the winners and said they had not only won a distinction for themselves but for the whole of the Division, and that he believed they were the first members of the Brigade in the Midland area to receive the Grand Prior's badge.

No. 10. DISTRICT

Teams from ambulance and nursing di visions in the County of Essex recently competed for the "Langley Jones" and "Lady County Superintendent" cups respectively. The nursing teams, competing for the first time, were judged by Count y Surgeon J. T. Whitley. Dr. M. Thomas and Dr. Gillingham judged the ambulance teams.

Results were :-Nursing Divisions: West Ivrersea 1St, 79 points; Wivenhoe 2nd, 50 points. Ambulance Divisions: Dunmow 1St, 195t; Burnham-on-Crouch 2nd, 169; Clacton 3rd, 167t.

Interesting Case Reports

CASE REpORT No. 167.-The Officer-in-Charge of Western Area No. (Prince of Wales's) District

S.J.A.B. reports the efficient performance of first aid by a member of NO.5 5 (Southall-Norwood) Division in the following circumstances :-

At 4.45 p.m. on June 7 Private H. W. Reynolds was working in his front garden when he heard shouts for help coming from the banks of the canal nearby. Hastening to the place, he was told that a boy (aged 4), while playing on the bank near a bridge with other children, had overbalanced and fallen into the water.

Private Reynolds quickly noted that a steam tug was approaching with a barge in tow, and that, the width of the bridge being very narrow, there was a grave risk of the boy being swamped or otherwise injured by the boats. So without a moment's hesitation he jumped into the canal fully clothed, swam out to the middle of the stream where the boy was, and brought him safely to the bank.

Private Reynolds then gave tJ:re- he>-y into the care of his mother, with instructions to home, to give him a hot drink and a put him to bed. He himself returned to his home, changed his clothes, and later in the day called at the home of the boy, whom he found none the worse -for his ducking.

COMMENT.-The report tells its own tale,. and all that remains is to tender cordial congratulations to Private H. W. Reynolds on good work promptlY and efficientlY performed at personal risk and inconvenience.

N. C. F.

Questions and Answers

RE-EXAMINATION OF NURSING DIVISIONS

E. M. (Highgate).-In view of the fact that matrons and certain other nursing officials "are now allowed by the Association to teach and examine candidates for the home-nursing certificate, I should like to know if these examiners can also now take the annual re-examination of Nursing- Divisions of the Brigade, or at least the nursing section thereof. -'

The repfy to your query is to be found in Para. 241 of Brigade Regulations, which reads :-" The annual reexamination of a Division will, whenever practicable, be conducted l:!Y the District or County Surgeon,. or, when impracticable, qy a Corps or Divisional Surgeon nominated or approved l:!Y him or her.)} In brief, the Brigade does not recognise matrons or other charge nurses as examiners.

Further, in the re-examination of a Nursing Division the main paf'f deals with tests on the knowledge of first aid

EXTENSION OF FRACTURES

J. P. (Hounslow).-Do fractures near joints (e.g., head of humerus or neck of femur) require no extension? Thus in treating the former there is no attempt at extension, but with a fracture near the middle of the shaft of the humerus extension is indirectly applied by the use of a small arm sling before splinting or bandaging the arm.

Exten-sion is used to overcome shortening due to overriding of the fragments of a broken bone, 1'})hich is not markedlY present at the sites named. Further, 1'})ith if!iuries of the upper and lower limbs it is extremefy unlikefy that first aiders will be able to locate the exact position of fractures.

ConsequentlY the essence of treatment is to avoid atrything suggestive of meddlesome action. In the case of the lower limb, where shortening mqJ be very marked, the Textbook (Rule 4, page 66) allows first aiders to appfy extension(1) 1vith great care, (2) without usingforce, and (3) lvithout letting go till the limb is splinted.-N. C. F.

TREATMENT OF FRACTURED KNEE-CAP

J. P. (Hounslow).-Please tell me if Bandage D should still be applied even when fracture of the knee-cap has resulted from a crush and the fracture is compound and comminuted.

The fact that the fracture is compound and comminuted does not contra-indicate the application of Bandage D (Textbook, Rule 6, page 91). Here again first aiders are faced with difficulties with reference to exact diagnosis, especiallY with a fractured knee-cap which, resulting /rom direct would be quicklY complicated l:!Y considerable swelling.-N. C. F.

TREATMENT OF FRACTURED LEG AND" FEMUR

A. O. (Addiscombe).-The Textbook on page 92 does not make it clear as to whether four or three bandages are required for the treatment of a fractured leg for which no splints are available. Your ruling will, therefore, be welcomed on this point, and also if, in case of need, similar treatment would be suitable in treatment of fractured femur.

With a fractured leg the Textbook seems to allow freedom of choice, namelY, four or three bandages. Personalfy, 1 prefer the latter, and would use a figure-qf-eight bandage to control ankles and feet, though in a conipetition 1 would allm'}) full marks for four bandages.

With a fracturedfemur for which splints are not available, the same treatment would sufJice, but, if available, an additional bandage could l!}Jith advantage be placed round the legs.-N. C. F.

180 "which under Anoriation and Brigade Rules must be conducted I?Y a qualified medical practitioner. PersonallY, 1 see no advantage, but rather a grave disadvantage, in using two examiners for a re-examination, one, a doctor, for the first aid, and the other, a nursing ojjicial, for the home-nursing section.-N. C. F.

ALCOHOL AS DISINFECTANT

R. N. (Liverpool).-Please tell us how alcohol acts and ho.:v it produces its effects as a disinfectant of the skin.

Alcohol is an excellent skin antiseptic because it dissolves fa t, enters the sweat and sebaceous ducts, and quicklY evaporates. It therefore cools the skin, which consequentlY becomes pale from the cont1'action "of the small blood vessels and so indirectlY causes less sweat to be excreted. Alcohol ha s the power of taking up water,. and it produces its antiseptic action l:!Y removing water from germs, which are t hus killed.-N. C. F.

COMPOUND AND COMPLICATED FRACTURE OF LEG

M. M. (Handsworth).-With regard to the" Dewar Test" published on pp. 158 and 159 of the July issue of THE GAZETTE, will you please clear up a few points o n the treatment of patient?

Upon examination, the paperhanger was found to h ave a fracture of left leg, with protrusion of bone and arterial ha::morrhage. Please state if it was really correct to :-

(I) To raise the feet.

(2) To place limb in natural position when the bone protrudes?

(3) To apply bandages round ankles and feet?

Wo uld this not cause a " pull" on the injured leg?

(4) Also why, in the "after-care," is a cradle necessary for the knee, and also why are cold comp resses applied to the knee? There does not appear t o be an injury there.

(5) The feet are again raised after patient is in bed?

Your reply will be received with interest as a similar case was given at a recent class practice and so me of the above points were discussed but not satisfactorily settled. .

(I) Detailed marking sheets are drawn up for the convenience of the judge. C onsequentfy all the various steps il1 treatment are included in the several sections. I t follows, therefore, that, althottgh the raising of the feet was, in this instance, raised earfy itz the "treatment of shock," this ,vas to be effected later after the fractured leg had been properfy controlled.

(2) This instrNction IS strictlY correct and in acco;dance with the Textbook, because it is to be carried out, as the marking sheet states in the next line, "lvith great care and without using force."

(3) This step in treatment is also correct because, eVe11 if shortening is present, the application of the figure-ofeight bandage round ankles and feet should not result il1 extension provided that due care and avoidance of force are exercised.

(4) and (5) YotJ have erred in assuming that the t1,})0 marking sheets 011 pp. 15 8 and 159 of the Jufy issue t o the same test. You 1vill note, on re-reading them, t hat the first deals with a man and the second with two bqys I I-N. C. F.

Duties of a Transport Officer in Time of War

PROBLEMS ENCOUNTERED IN AN INDUSTRIAL A.R.P. ORGANISATION

By R. R. HOPKINS (Divisional Secretary and Tran sport Ojjicer, Vauxhall Motors Division)

The Division to which I belong came into being largely as a result of the threat of war. Association Classes had previously been organised under the direction of the Vauxhall Motors A.R.P. Controller, Mr. Frank Southwell, and as a result there were a number of trained First Aid men round which a Brigade Unit could readily be formed.

The prime function of the new formation was to supply a framework for the company's A.R.P. scheme on the First Aid side; at the same time dovetailing with the ever-present need for comprehensive First Aid facilities in an industrial concern.

The transport side of this set-up was naturally modest previous to the actual outbreak of war, when there was need for only one ambulance, though the e xtent to which this has been used can be gauged from the fact that the mileage during the past nine months on industrial cases alone is just under 6,000.

In addition to this one Standard Bedford ambulance we have three converted vans. I give broad details of these because there is a very large number of unsatisfactory conversions in existence throughout the country, and a word or two on what to aim for may be helpful.

The vans are rated at 30/ 40 cwt. and have a capacity of 235 cu. ft.; interior width is 5 ft. 3 ins. and available length behind the driver 9 ft .; the interior height is 5 ft.

Loading height is 3 ft. I in. (a folding step is a " necessary part of the" conversion ") and the two rear doors open to provide a space 4 ft. 2 ins. high and 4 ft. 8 ins. wide.

The lower stretcher rack is 4i ins. off the floor and the top one 22i ins. above that. These particular measurements were arrived at after making experiments by loading patients on to both racks, with and without respiratm's.

A complication is introduced when we come to consider the stretchers to go into these vehicles. For industrial purposes it is general to use telescopic handle stretcher with canvas beds; for A.R.P. steel stretchers (with gas covers) are far more suitable.

It will frequently be found that the dimensions of the various types of stretchers are such that it is almost impossible to decide upon a common adjustment for the width of the stretcher racks. l'/lost of them, however, are quickly adjustable to suit the circumstances of the occasion, though it is as well to reduce the necessity for making adjustments to a minimum. Such things are apt to be overlooked in time of emergency.

The booklet recently issued by the British Standards

Irtstitution (referred to last month) will go far to removing this difficulty once and for all.

The vehicles in my charge each accommodate two stretcher patients and some 5 or 6 sitting patients, who take their places along a bench seat fitted opposite the two stretcher racks. St. John Ambulance First Aid Outfits and water bottles complete the essential equipment.

It is important watch springing and tyre pressures, both of which should be lighter than if the vehicles were fulfilling their normal functions as vans.

With a maximum of four ambulances available, most Transport Officers will (subject to instructions from their superior officers) probably decide to set one, or at the most two, aside for gas cases. Bearing in mind that an ambulance once contaminated cannot be used for non-gassed casualties before being de-contaminated. (Each ambulance bears a label reading "This ambulance is not contaminated." This label has to be removed by any driver encountering persistent gas.)

But the extent to which the ambulance can be split up in this way will obviously depend on how the vehicles are stationed. Even within the confines of a IGO-aCre factory it would be unwise for the ambulances to stand together at one point.

Incidentally, whilst on this point, do not overlook camouflage; it is probably as well to have the vehicles sprayed all over in "battleship grey"; certainly all chromium should be dulled down. Please yourself whether you have red cross insignia.

My own view is that some frontal indication (which will assist in rapid passage through traffic) is all that is likely to be really useful in the present circumstances.

At Vauxhall the four ambulances have two main functions in a raid-the collection of wounded for transport from the scene of the accident to the surgery (if not obviously hospital cases), and the removal of bad cases direct to the local hospital, which is some 5 miles distant. "Field treatment" is, of course, administe.red on the spot.

Although it is not directly a concern of the Transport Officer in fact, a direct responsibility of Divisional Superintendent R. R; Hunter, who is, of course, in charge of all ambulance operations), it is worth recorlling that special admission " traps" have been constructed for receiving cases from the ambulances into the surgery.

These traps !Day be likened to giant "service hatches"; an exterior flap is let down and the stretcher is placed on a shelf, the outer flap is then closed and an interior one is opened by the staff inside the surgery 15uilding; there is another of these traps leading from the reception or undressing room to the surgery proper.

Now for a word about personnel. For industrial purposes a rota of drivers is maintained, each man doing duty f<0r one week at a time; this in no way prevents drivers from following their usual tasks in

the factory when there is no call for their services at the al1ibulance base.

For A.R.P. the day-time strength is seven crews of two men each, together with three stretcher crews (of four). The night personnel is slightly fewer.

Arrangements have now been made, however, whereby various men living near by augment the night staff by reporting there are hostilities in the vicinity.

As far as possible, drivers have worked and practised together from the outset; they for the most part drivers of considerable experience but they have found it useful to put in time negotiating awkward corners in the black-out, backing up uneven

R. R. HOPKINS

Divisional Secretary and Transport Officer, Va uxhall Motors Divi sion

approaches and maintaining smooth running, whatever the conditions.

The fact that there have been minor mishapsoccasional bendings of wings and damaging of lamps -seems to prove that these practice runs are of benefit to the most seasoned drivers.

It is, perhaps, no coincidence that practically every member of the Vauxhall amb ulance crews is an enthusiastic Brigade member, registering a larg e number of attendances at drills and practices, undertaking public duties, and "doing turns" in the surgery.

Ambulance personnel who are not keen and ready to fill any emergency are as out of place on the transport side as they would be anywhere else in the conditions that prevail at present.

Red Cross and St. John War Organisation

(Continued from page 159, Ju!J issue) A MILE OF PENNIES.

The Falkland Islands, more than 8,000 miles from th is country, with Stanley, the only important settlement, having a population of r,200, recently held a mile of pennies collection under the auspices of the Branch of the British Red Cross Society. In four ho urs £r60 had been contributed in this way and the pennies were still being added to complete the r emaining fifth of the required distance.

CONYALES CENT HOMES

Of the ten thousand beds which the Ministry of Hea lth has invited the War Or ganisation to provide in Convalescent Homes for members of the Services who have been under treatment in Emergency Hospitals, the Executive Committee was informed that active preparation was being made for 4,000 of the be ds in premises which had been inspected. Accommodation for a further 3,000 beds was being inspected. It was considered that some accommodation would be ready for occupation early in August and that the r emaining beds would rapidly be made available.

TRACING THE MISSING

With the assistance of the Wounded, Missing and Relatives Department, "to whose devoted and p atient lab ours I should like to pay tribute," said Mr. Eden, the Secretary of State for War, in the House of Commons on July 9, a leaflet is being prepared exp laining the steps which are taken to trace missing Service men. The leaflet will be sent to the next-ofki n of officers and" men reported as missing.

A FLAG FOR CANADA

The first flag sold on Flag Day, June 5, was bought by Colonel Naismith, of the Canadian Red Cross, for the sum of one hundred thousand dollars. To commemora te this generous act,. Colonel Naismith has been presented with a replica of the flag in colo ured enamels by Sir Philip Chetwode. When accepting the gift, Colonel Naismith said that he would h ave the greates t pleasure in sending it to Toronto, where it would become a treasured possession.

FIRST-AID COURSES

An intensive course of First-Aid Lectures was held in the Dorchester Hotel Ballroom by kind permission of the directors early in July. It was attended by over a hundred students. Dr. Hammer gave the le ctures and Mrs. Peter Cheyney acted as Class Sec retary A further course began on July 17 at the Roya l College of Nursing; and on July 3 at the Dor chester Hotel.

MOBILE SURGICAL UNITS

The War Organisation is expending over £4,5°0 or:- two mobile surgical units fully equipped to deal WIth head and chest injuries. The Ministry of

Health is to construct and equip the unit s on behalf of the War Organisation. When completed they will be loaned to the Ministry, which will provide the medical staff. These units will proceed to any part of the country where special facilities for dealing with severe head and chest casualties-servi ce and ci vilian -are not available.

AMERICAN RED CROSS

The American Red Cross has presented £100,000 to the War Organisation. It has also established a Committee with Headquarters in London for the purpose of co-operating with the British Red Cross. The United States Ambassador, Mr Joseph Kennedy, is the Honorary Chairman of the London Committee. The Chairman is Mr. Daniel B . Grant.

This contributi on follows many other most generous gi fts of money, hospital equipment and supplies of all kinds. The first offer of supplies was made to the War Organisation by the American Red Cross in early September of last year, and the contact ha s been closely maintained to the present time.

MR. KENNEDY BROADC A STS Mr. Jo seph Kennedy has appealed through the National Broadcasting Company in the United States for support for the Committee. Everything indicated, he said, that Great Britain would be called upon to meet the greatest siege in the history of man. Sieges meant suffering and to relieve this suffering the Commitree had been set up. The American Red Cross had made expenditures and commitments for relief in Great Britain amounting approximately to $ 500,000, and to this was added a further $ I ,000,000, includin g the £roo,ooo already announced. It would be a mistake, Mr. Kennedy said, to regard that as more than a beginning: he concluded-" We cannot gi v e too soon-or give too much. "

BRITISH HELP FROM U.S.A.

. A con tinuous supply .of ambulances, up to eight y ill number, some of which are now on their way, is promised by the British War Relief Society of New York. The gift of ambulances is only one of its donations. The Society has offered, and the War Organisation has accepted, much valuable surgical and hospital equipment. It includes, for instance, Westinghouse multiplane mobile diagnostic X -ra y umts.

ATLANTIC TO PACIFIC

From British Societies in the United States consignments of hospital supplies and comforts have been received for months past in a constant flow Recently, money donations have also been sent. From these and other sources in the United States, (Continued on page 186)

Training

• 'In

By W. C. BENTALL, O.B.E., F.R.C.S., F.R.G.S., Assistant Sttt'geon-in-Chiej, St. John

Ambulance Brigade

Air Raid Precautions

AMBULANCE SERVICES

A chain is strong only in proportion to the streng!=h of its weakest link. The ambulance service is a link in the chain of the casualty services from the site of war damage to the hospital.

I am therefore anxious that this article may clarify the situation of the ambulance service in A.R.P. to-day, and help to strengthen this link of the chain we are so justly proud of in Civil Defence.

Up to · 1938 the Home Office issued circulars relative to the organisation of this service. These have been altered and stabilised under the Ministry of Health since January, 1939.

The situation will be considered under three heads :-

I. The Vehicles.

2. The Equipment.

3. The Personnel.

1. The Vehicles

(a) The larger type.

(b) The smaller type.

(a) The larger type is practically non-existent in peace time. It consists of single-decker 'buses with stretcher-carrying fitments, and is only used for transporting casualties between hospitals and for distances, and comes under the control of hospital officers.

(b) The smaller rype exists in peace time, but insufficient in numbers or styles for the present need. These are the responsibility of the scheme-making authorities, and exact details are laid down as to the type of procedure to obtain these. While many -individuals have varying ideas in this matter, such as the suitability of trailers, peace-time ambulances, etc., etc., the Government, after much experimental weighing-up of evidence, have issued orders on what is considered the best, so that they may all work everywhere in the smoothest possible way. And thus any individual suggestion which would queer the pitch of the smooth working of a national system should be deprecated, and real efforts made by all to fall into the line of the laid-down scheme. If every sergeantmajor pushed his own idea in opposition to the headquarters' decisions we should lose the war I

(See Circular 1764, January 10, 1939 Ministry o f Health.) The development of this special service passed through a stage of hiring a whole-time and a part-time service, but was stabilised in October, 1939 , by Circular 1893 by advice to authorities to purchas e suitable vehicles to replace the costly hiring o f whole-time vehicles. The cars were to be of a suitable type and size to allow the body to be scrapped and a light ambulance body to be built in, and th e total figure for purchase and adaptation was given as approximately £50. Nearly all authorities have no w secured these, with much saving in upkeep and inte rchangeability for mutual support in operational wa r work.

2. The Equipment (a) Fitments for Stretchers.-This fitment forms a unit designed to carry two stretchers. Vehicles o f the suitable size to take four stretchers can b e equipped with two units, one on each side of the vehicle, having a narrow gangway to enable the ambulance attendant to give any emergency attentio n while in transit. (See Circular 1794, April 3, 1939·)

(b) Stretchers.-Each ambulance should be fitte d with four of the green steel stretchers, which ar e made to work on the f1tments, are easily deco ntaminated if gassed, and are interchangeable throughout the system, and saves shifting a patient if change from stretcher bearer to ambulance, or from ambulanc e to hospital.

(c) Blankets.-Each stretcher is equipped with tw o blankets, making eight in all for one ambulance.

This system of equipment makes it possible for a patient to be picked up by the f1rst-aid party an d passed through to his f1nal bed in hospital withou t being moved from his blankets, or stretcher, thereb y minimising distress, shock or loss of time. Thus the first-aid party has its four stretchers and eight blankets, and when taking the case to the ambulance, the party takes the empty stretcher and blankets from the ambulance and places the patient with his stretche r and blankets in the vehicle. When the ambulance reaches the hospital, that institution has empty stretchers and blankets to hand back to the ambulance driver. Each hospital is allowed stretchers and tw o

blankets in proportion to 7 per cent. of th e ho spital beds. This system is known as the "Shuttle" system. It works well in actual practice and only fails when an old-fashioned stretcher is used in place of the regulation one; and such as wooden and canvas stretchers wou ld be very difficult to decontaminate if infected by mustard gas.

3. Personnel

This must remain over for our next monthly issue.

A.R.P. Questions and Answers

Q.-Is a drop of Mustard Gas in the eye intensely painful immediately?

A.-Yes.

Q.-Would it be practical to arrange a pocket on the protective clothing fastened by a zip fastener and containing a pad for removal of gas from the eye ?

A.-No, because a zip fastener is corroded b y Mustard Gas and n1ight jam.

Q. - Is the hearing badly impaired b y the protective hood?

A - No.

Q.-What happens to liquid g as washed down the drain when it arrives at the other end?

A -It depends what the scheme of drainage is, planned by the Authorities.

Q.-How do you make bleach paste?

A.-Add bleach powder to water to required consistency

Q.-Can Mustard Gas actually permanently destroy eyesight?

A.-Yes.

Q.- Which is the more injurious to the general public, Mustard Gas or Lewisite?

A.-Mustard Gas

Q. -Co uld you describe the · shape of the blisters: i.e., Mustard Gas, i.e., Lewsite ?

A. - Mustard Gas Blister-Battish. Lewisitelike an apple on a stalk, in an extreme case.

Q.- What is the effect on cattle?

A -Same as on humans.

Q. - How high does the vapour from Mustard Gas rise from street: wou ld it penetrate to a second Boor Bat?

A.-It depends on temperature and wind at the time.

Q.-Does the gas persist for any time after all liquid has evaporated?

A.-Depends on effect of wind, weather and topographical conditions.

Q.-Apart from arsenical poisoning, doe s Lewisite have same internal effects as Mustard Gas?

A .-Very similar but less severe.

Q.-Is it possible to detect Mustard Gas without personal injury?

A.-Yes, by a chemical detector.

What is the best antiseptic

t

In the course of a recent Lister Memorial lecture an eminent surgeon declared that" the best antiseptics are not those which, in vitro, have the greatest germicidal power, but those that have a powerful proteolytic action, such as Dakin's fluid, which rapidly destroys dead or dying tissues "

Milton is of the same chemical nature as CarrellDakin solution, that great life-saver of the last war.

The Dakin solution must always be mixed fresh to ensure strength: MILTON IS STABLE With Dakin solution there is a tendency to causticity : MILTON IS NON-CAUST IC. Milton has not only full germicidal power, but that destructive action on pus and dead tissue that leaves a wound surgically clean.

Which is the least expensive antiseptic

Milton unquestionably - consistent with achieving proper conditions of antisepsis. Its great germicidal power makes possible an effective dilution of as little as I in 100, or three tablespoons to a gallon of water.

Keep · Milton handy for:

CUTS AND WOUNDS ABRASIONS STERI LlSI NG DEODORISING NOSE AND THROAT CATARRH HEAD COLDS etc., etc.

Born during the last war - best during this 7d., 1j2, 1/9, and 3/- a bottle Winchesters at 7/6

w. C. B.

(Continued from page 183) excluding the American Red Cross, money contributions-all spontaneously given-amount to nearly £5 0 ,000.

Space prevents a detailed statement of the help given by these British Societies, which range from the British War Relief Associations of Northern and Southern California across the continent to the Greater New Bedford British War Relief Corps in Massach usetts.

INDIVIDuAL GIFTS

Many gifts have come from individuals. The Ust is too long to publish here. There is space to mention two-one of £5,500 from Mr. Paul Mellon, in memory of his father, for the purchase of ambulances; and one from Oklahoma of surgical instruments.

"THOUSANDS ANxIOUS TO HELP"

For the mention of one more gift space shall be found. The gift is from the British Ambulance Corps, New York City. It is one of a hundred ambulances-a very welcome donation in made the more welcome by the terms of the cable announcing it-" Almost no limit to number ambulances we can supply. Do not hesitate to ask for all you want.

" Thousands of people here anxious to help."

MIDDLE EAST COMMISSION

The Australian Red Cross was to present three ambulances to the Middle East Commission. Later _ advices from Egypt are to the effect that the gift has been increased to nine ambulances. _ It is also reported that the Commission has taken steps to establish a Prisoners of War Information Bureau.

MISSING MEN

Delay in obtaining information through the International Red Cross Committee at Geneva cannot be prevented. All communication with Geneva was cut on June .17. Telegraphic communication has now been restored. The War Organisation, with a view to relieving preventable anxiety, so soon as it was possible to make contact with Geneva by this method, arranged with the International Red Cross to telegraph the names of prisoners of war which had been held up during the time Geneva was isolated, undertaking to contribute to the cost out of its funds.

EARLIER INFORMATION

Under an arrangement made by Sir Philip Chetwode with the Adjutant-General, the names of prisoners of war are now received by the Missing and Wounded Department at the same time as they are notified to the Casualties Bureau of the War Office. This arrangement enables the Department to complete its files and inform relatives of news of prisoners much earlier than would otherwise be the case.

SEARCHERS ACTIVE

In addition to this action, the searchers of the Wounded and Missing Department have been busy in hospitals and elsewhere trying to get news of missing men from members of their units who have been wounded. Valuable news of the missing men has

been obtained in this way and the anxiety of relatives and friends has been relieved. Mr. Alan Lewis, who was Chief Searcher in France until the B.E.F. evacuated that country, has been appointed Chief Searcher in England.

CHANNEL ISLANDS

A new section of the Foreign Relations Department has been formed to deal with enquiries for persons who were residing in the Channel Islands. By post alone, at one time, the enquiries numbered up to 2,000 a day. A staff of ten persons is at present engaged in this section,

FRENCH SECTION

There has also been a considerable increase of work in the French Section. It is mainly due to anxiety on the part of persons in this country to ascertain the whereabouts of refugees who left northern France before the advance of the German Army into that region. Most of the enquiries received respecting wounded French soldiers in this country have been answered.

PRISONERS OF WAR

So that no prisoner of war shall be deprived of food parcels during the present difficulties of communication, the War Organisation has made an emergency grant up to £9,000 to the International Red Cross for the purchase of food. It will be sent by the International Red Cross Committee to Germany for distribution by responsible authorities to British prisoners of war.

PACKING CENTRES

At Brighton, Guildford, Hitchin and Carnarvon packing have set up and are now working. A packing centre has also been opened at Perth under the Scottish Branch of the B.R.C.S. and has been supplied with goods from the Stores Department. Other centres are to be opened shortly -one at Bromley, Kent, which will deal only with tobacco and cigarettes, another at Southall and a third at Leicester.

DONATIONS

Donations received during the first and second weeks of July amounted to £2,762 5s. Id. E xpenditure on stores for the Prisoners of War Department to date is nearly £38,000.

BOOKS WANTED

Countless requests are being received by the Red Cross and St. John Library Department for books in Dutch, Flemish and Polish, particularly the last named. Since they are difficult to procure, the Department urgently appeals for gifts of books in these languages to enable it to meet the demand.

SCRAPBOOKS

The Department has received a special appeal from a Service Hospital for scrapbooks containing humorous cartoons and strips. They should be light and easy to handle, as they will be used by patients who are not able to give their attention even to magazines or fiction. Scrapbooks of this kind may be sent to the Red Cross Library, 48, Queen's Gardens, London, W.2.

t86

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Throughout the civil medical and nursing professions, and the medical services of H.M. Forces, Brand's Essence is constantly prescribed for combating critical weakness arising from physical or mental exhausr;on and shock.

Its uses, when First Aid is rendered to the injured, will be apparent from the fol1owing brief summaty of its advantages:

Brand's Essence is a NON-ALCOHOLIC STIMULANT.

It is assimilated in its entirety, QUICKLY AND WITHOUT STRAIN, BY EVEN THE WEAKEST SYSTEM.

Its stimulating effect is PRACTICALLY INSTANTANEOUS.

Brand's Essence DOES NOT PRODUCE AN AFTER·STATE OF MELANCHOLIA.

It not only conserves strength-IT BUILDS UP STRENGTH QUICKLY AND SAFELY.

IT CANNOT CAUSE THIRST.

Be sure to hape a supply for the treatment of a/I cases where a stimulam is indica te d.

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W e reprin t belmv an art icle, cont ri buted sOln e y ears ago t o t his by t he late D r . L ak in. I t is especial ly app lz'cable to the thousands of am bula7zce and fi rst aid 1v orkers t o- day

There is. an index at the end of the Manual so make a ver y comprehensive one for your An index is not only a me,ans for easy reference, but it is a ver y useful means of revising your knowledge and testing yourself. Look up "Fracture" a?d test y our knowledge of the separate items menIf. y ou list all the various fr actures in your Index, a little t hought will show how extremely useful such a list will be Of course, it means work, but if done steadily and systematically, it does not u:ke up a great deal of time, and if you think you will discoyer that you waste a lot of time in unprofitable so your spare time into a means by which you gam knowledge that will be beneficial to you, an.d which will give you real happiness. Have something of real value to give to others, for it is eternally true that "it is more blessed to give than to receive," and what can you have better to give than " skilled assistance in cases of accident or sudden illness?" This is real service, and to serve others always brings happiness.

(B) PRACTICAL WORK.

The first point is to know how to apply bandages neatly and accurately. Neatness is only attained by careful practices and a determination to succeed. In any branch of wor k never be content with "Oh! that will do " It will not, and it is not wo.rthy of you or the Association to which you have the honour to b.el?ng, nor },s it.in the best interests of the patient, for It IS NOT skilled assistance." " The very best you can do" is the only method that must satisfy you. Try applying this test to every bandage you applf : "Is it neat?" and the meaning of that test IS :-

N Neat. Look up the meanings of the word in the dictionary.

E Efficient or doing the job it is intended to do. If it has to keep a dressing in place, you must 188

mak e sur e that it do es , and tha t th e d ressing cann o t mo ve. Th e Che st bandages as app li e d b y First Aider s usuall y allo w the dressing t o slip about an yw h er e-the se cr et i s in t h e h em

A Accur ate o r a ccordin g to t he Manual. Th e lower b order of b andages is a fr equ en t caus e of untid y banda g ing

T Tested or tried, that is, ev er y point has b een gone over a nd the b an d age m ad e as p erfect as possible before you are sati sfi ed. M ak e sure th e knots are "reef kn o ts." Pra ctise tyin g r eef knots until you can t ie th em accurat ely blindfold o r behind your b a ck , and alwa ys examin e them to see they are co rrect.

There is nothing that create s such a go od imp re ssi o n as a bandage neatly, correctly an d effi ci en tly applied . Shoulder , Chest, Knee, E lb ow and Foot ar e t h e bandages that are usually incorr ectly applied. Slings are invariably untidy and not a ccuratel y place d in position. Cultivate the habit of r epl acin g bandages that have been used in their proper manner and place. Dexterity means not onl y using appliance s efficiently and neatl y, but taking proper care of them. This may seem a small point, b u t think-a case of severe arterial bleeding occurs and y ou wish t o improv is e a tourniquet and there are no bandag es in the bandage cupboard or haversack, or the bandag es are all untidily heaped in the cupboard- the patient's life is endangered just because someone has been too lazy and too indifferent to finish his job properly (This must not be YOU.)

Knowing the Manual and the bandaging, the second point is to apply that knowledge practically, and practical work in treating a case is THE TEST of all your knowledge, for are you not applying "skilled assistance" and are you not a "trained person"? Make your answer" Yes." The notebook is of the greatest value here. Work out the

Iglodine is ready for immediate use-needin g no dilution. It is wise to apply Iglodine at once to all surface injuries-non-staining an d non-i rritant, it prevents infection, re duces inflammation and hastens healing.

GLODINE

THE SAFE PAINLESS

details of the practical work in your notebook after his fashion :-

Special Fractures which need special care and treatfI}.ent 1il addition to the general rules :-

HEAD. Skull. Face.

TRUNK. Spine. Ribs, Complicated Fracture. Sternum. Pelvis.

UPPER LIMBS. Scapula. Clavicle. Humerus at the Shoulder. Fracture at Elbow. Crushed Hand. Finger.

LoWER LIMBS. Thigh. Patella. Crushed F00t. FRACTURE OF RIBS.

(A) Simple

I. Patient sitting or lying down.

2. Two broad bandages overlapping; centre of bandages over the seat of fracture; knots slightly to the front. _

3. Tightness. Ask patient if he breathes without pain. " Yes," then bandage is correctly tightened. "No," then slacken bandage until he does.

4. Arm on injured side in a LARGE arm sling. Reason? or improvise

Folded towel or pillow slip, 8 ins. wide, pin firmly. Large arm sling.

5. After care. Shock. Transport.

(B) Complicated

Fracture of Ribs with injury to an Internal Organ, and danger threatened by Hremorrhage from an Internal Organ.

I. Patient lying down; BODY inclined to infured side. Reason?

2. Support body by a LONG PAD from head to pelvis-not head and shoulders only.

3. No bandages round chest. Reason?

4. Clothing loosened. Ice locally and to suck. Doctor early (send special written message and sign it). Why sign? Plenty of fresh air. Windows open, keep crowd away, fan patient if necessary.

5. Large arm sling on injured side.

6. Perfect rest, both physical and mental. Encouraging words. No questions. Allay patient's anxiety. No stimulants.

7. If Collapse threatens (keep in mind as a danger in every case), treat as Hremorrhage from a.g Internal Organ. Smelling salts. Sprinkle face with cold water. Bandage limbs and elevate them. Support in elevated position.

8. Watch breathing and pulse carefully and constantly.

9· Transport. Maintain position as in I and 2. Watch as in 6, 7 and 8. Careful instructions to bearers. All to go in ambulance, if necessary.

It is a wise plan for a First Aider to treat every case of bleeding as " severe," then you will be safe (and so will the patient). The plan of treatment or the needs of the patient are :-

I. Arrest the bleeding.

2. When the bleeding is arrested, treat the wound.

;. Take against recurrence of the hremorrhage.

4. After-care.

Work out how you would carry out this plan and check it by the Manual.

The advantage of working in this fashion is that you need a piece of paper and a pencil only, and you can have a practice or a revision in any odd five minutes in the train or bus, in fact, anywhere and at any time, and you are using your brains for thinking things out, instead of relying on rule-ofthumb methods and other people, and it is a splendid way of preparing yourself to render skilled assistance, either in practice or when the real need arises. Try the method and you will discover many other advantages, and the only disadvantage is that your friends will want to borrow your notebook-" neither a borrower or a lender be"-help and encourage them to make a notebook for themselves, and then compare notes.

(To be continued)

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To

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Signed : (CC The St. John Ambulance Gazette JJ is published by Messrs. British Periodicals Ltd., 19, I9 a , Cursitor Street, E.C.4.)

PRACTICAL BOOKS

by N. CORBET FLETCHER, M.B., B.C., M.A.(Cantab.), M.R.C.S.

AIDS TO FIRST-AID (7th Ed.)

First-Aid Simplified and Tabulated with Aids to Memory. Price 1/- (Post 2d.)

EFFICIENCY IN FIRST-AID (3rd Ed.)

Problems in Study, Treatment and Examination solved for Senior Students. Price 1/- (Post 3d.)

COMMON ERRORS IN FIRST-AID

Errors in First-Aid Detailed and Explained. Price 1/- (Post 2d.)

AIDS TO HOME-NURSING

Home Nursing Simplified and Tabulated, with Aids to Memory. Price 1/- (Post

Obtainable from:

THE

FOUNTAIN PRESS

19, CURSITOR STREET, LONDON, E.C.4

The St. John Ambulance Association. It. History and Its Part in the Ambulance Movement. By N. CORBET FLETCHER, M.A., M.B., M.R.C.S. 1 11" book. f,om COVilf to cove" is fuU of ,,.format'o,. of greaiesl tftllf'15I IINII''''PDrlafIU to IIJllfYOru

EVERYTHING FOR SAFETY EVERYWHERE 'NOVOX' and 'NOVITA' Oxygen +CO, or Oxygen RESUSCITATING APPARATUS for the apparently asphyxiated or drowned.

SMOKE HELMETS of all Patterns.

• PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

'PURETHA' GAS MASKS for Naval, Military and Industrial purposes and for Civilian use. ALL A.R.P. EQUIPMENT

DUST and SPRAY MASKS and all other Safety and Protective Devices.

SIEBE, GORMAN & Co., Ltd.

OFFICIAL GAS CHARTS

No; I Chart shows gas derivations.

No. 2 is a full and complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee.

I

Dressings of any length can be cut in an instant from the 'Elastoplast' Dressing Strip, which is elastic, adhesive and antiseptic. In 1t", 2f' and 3/1 widths, 1 yard long. Prices from I j 3d. each.

The 'Elastoplast' Surgery Case contains one each of the three widths; price 5/3d complete.

Write for further details to

NEPHEW, LTD. (Dept.

Cephos

Proprietors: Cephos Ltd.,

ORDER OF THE

THE ST. JOHN AMBULANCE GAZE'ITE is published on the 15th of each month. The annual subscription is 4S" post free; single copies 3d

Brigade Reports and Photographs should be addressed to the Editor, at 32, Shoe Lane, E.C.4. Reports and photographs should reach him early in the month.

Subscripti ons and Advertisements" should be forwarded to the pu'blishers :

Messrs. ' British Periodicals, Ltd., 19, 19a, Cursitor Street, London, E.C·4·

CONTENTS

Editorial Home Nursing Page

Promotions and Appointments

The Siege of Malta

Reviews

Red Cross and St. John War Organisation Priory for Wales Interesting Case Reports Questions and Answers Brigade News Transport Organisation

Air Raid Precautions

St. John Ambulance Brigade Overseas

CHANCERY OF THE ORDER,

ST. JOHN'S GATE, CLERKENWELL, LONDON, E.C. 1.

The Lord Mayor's Fund

Twenty-one millions of emblems were sold in June when the second National Flag Day of the War was held. The total sum received to the time of writing from their sale in England and Wales is £2.2.8,000. In addition, contributions from overseas have been received arnounting to over £49,000.

Many more returns from abroad have still to come in.

There was a magnificent response in all parts of Great Britain where civic authorities ce-operated with the Red Cross and St. John personnel. Some civic heads reported that the collections exceeded all records in their boroughs.

A larger number of copper coins was received on this Flag Da y than ever before. Many extra collecting tins were needed. The tins did not contain only coins. Many wedding rings were found in the boxes when opened.

The Joint County Committees will receive half of the money raised in their counties for allocation locally. Already over £70,000 has been distributed to the m from the June Flag Day collection. Substantial sums were made available to the local Red Cross and St. John branches following the Erst Red Cross Flag Day of the War. This revenue, together with a similar proportion of the collection which will be made in October when the tbird National Flag Day of the War will be held, for which preparations are already well advanced, will, it is hoped, provide the County Committees with the money that they need to finance the local pnits of the Society and the Order.

The response to a recent broadcast appeal for coins and medals for the Lord Mayor's Fund amounted to over one ton in one day. In all, more than a million coins have been received, but the Dean of Bocking, who is Chairman of the Committee, says that ther.e is still a vast amount of treasure in the way of coins and medals lying about throughout the country, All coins are gratefully received-old and modern. Those that have a collector's value are being set aside for sale by auction in the autumn. Others provide copper, nickel, tin and le2d of which we are in need. Already £1,000 has been raised from the metal value of such coins, Paper notes, whatever the currency and wherever they have circulated, are also welcomed, as they have a value amongst collectors.

HOME ,NURSING PAGE

NURSING CARE OF HEART FAILURE

By ALEC WINGFIELD" M.D., M.R.C.P.

(Assistant Physician, Seamen's Hospital , Greenwich)

Contrary to popular conception, heart failure is more frequently a chronic than an acute condition, and the illness, far from being dramatic, is in fact tedious and wearisome both to the patient and to the attendant. The onset is gradual in the majority of cases and it is· often not the patient but his medical attendant who first realises the seriousness of the condition. The commonest underlying causes are chronic valvular disease of the heart, arterio-sclerosis, various acute and chronic infections and and certain of the chronic The symptoms of failure will, however, be similar whatever the immediate or remote causative factors may be and in the gradually increasing disability the patient may perhaps fail to realise how far below normal his physical standard has fallen. Among the early symptoms will be dyspncea (shortness of breath), cedema (dropsy), generally of the lower extremities, palpitation more marked on exertion, giddiness and sometimes buzzing or ringing in the ears. At first only one of these symptoms may be in any way well marked and in any case the symptoms will always be more distressing on exertion and will tend to improve with rest. It is important to realise that the basic cause, at the time when failure becomes clinically manifest, lies in the weakness of the muscular tissues of the heart as a result of which the heart gradually becomes less efficient and less able to perform its normal pumping functions. If this happens, then at each beat of the heart a small proportion of the blood contained in the various chambers of the heart is not expelled, and in the following beat the capacity of the heart to receive blood is by that small amount impaired. This inefficiency eventually produces an excessive amount of blood in the vessels in the lungs and in the veins, both large and small. The congestion of the lungs ' results in deficient oxygenation of the blood and so produces dyspncea, while the congestion of the veins produces fluid stagnation in the tissues and so results in cedema. The mechanism of production of the other symptoms is less important and of greater complexity.

In a smaller number of cases the onset of failure will be sudden and in these cases the cause may lie in a spontaneous cJotting of blood in one of the arteries which supply the heart muscle itself. This

eondition, which is known as a coronary thrombo sis, has apparently become more common during the last decade. It produces an agonising pain in the chest which is associated with the whole clinical picture of shock and in no inconsiderable number of cases it results in death within a matter of hours. Those patients, however, who recover from the immediate attack are left with a considerable amount of cardiac damage, for the portion of the heart muscle which depends upon the clotted vessel for its blood supply must now undergo a process of necrosis and muscle must be replaced by fibrous or scar tissue. Some of the less severely damaged muscle fibres may b e capable of regeneration, but danger of failure as a result of the inefficiency of the musculature will for many weeks be considerable.

Once the presence of congestive cardiac failure is diagnosed, it is essential that the patient should be put to bed at absolute rest with the minimum of delay. In the more severe cases the patient may gladly resign himself to inactivit y, bu t in milder examples some persuasion may be required to impress upon the patient the necessity for so irksome a regime. Ideally, patients suffering from congestive heart failure should be nursed on a cardiac bed, which is so made that the upper po rtion can be elevated to form a rest for the back and the lower portion can be depressed so as to allow the legs to lie somewhat lower than the rest of the body; in fact it is a bed made so as to be capable of conversion into a species of large easy chair. If a cardiac bed is not available, and even iri hospital this is frequently the the patient should be nursed as nearly as pOSSIble In a sitting position. The upright position is by the fact that experience ha s shown that these patlents have much less difficulty in breathing when so placed, probably because the respiratory expansion of the chest is thus facilitated. In very severe cases the patient may in fact wish to lean forward and will sometimes utilise a bed table as a rest for this purpose. It is not possible in an ordinary bed to permit of dependency of the lower limbs, but this can be simulated by introducing a donkey support under the knees. CEdema in cardiac failure will always be hydrostatic-that ]s to say, it will gravitate to the part of the body which is lowest. In a patient nursed

in an ordinary bed cedema will therefore be found around the feet and ankles, and also in the lumbar region. In the more severe cases the lower extremities may be swollen up with cedema to as much as twice their normal circumference and the cedema may spread upwards to the abdominal wall and into the cavity of the abdomen, and in the terminal stages to the chest wall and the pleural sac. Nevertheless, experience has shown that the patient will be least incommoded if cedema is for the longest possible time restricted to the lower extremities. Insistence on absolute rest will th row an extra strain upon the n urses. It may be that the patient will not be permitted to attempt an y movement other than th a t of t he he ad and arms except when assistance is available, an d help will, therefore, be required for any change of position and f or the use of the bed pan. Two nurses will be required so as to lift the patient into position without allowing him to exert him self in any way. Blanket baths will, of course, be instituted from the first and attention to the pressure points in or der to prevent the oc curr en ce of bed-sores cannot be sta rted too soon. Temperature and pulse rates will, of course, be charted twice dail y or four hourly as ordered b y the doctor, and particular attention should be paid to the accurate recording of the pulse r ate sin ce variation may be of the grea test significance. As a considerable proporti on of patients will be fo und to be suffering from that continuous irregularity of the heart known as auricular fibrillation, the taking of the pulse rate may not be by any means simp le, and the not very experienced nurse would do well to re member that it is better to explain the difficulty than to record a pulse rate if there is any doubt as t o its accuracy. In most cases it would be of value t o keep a dail y record of fluid intake b y m o uth and of urinary output. If this is available the doctor, making allowance for fluid loss b y perspiration, will be able to form a fairly accurate opinion as to whether or not fluid retention is occurring. The bowels will re quire regular attention, but aperients shou ld not be giv en to these patients except under medical instructions. Diet will no doubt be ordered by the medical at tendant, but the main principle will always be that the patient should receive small light meals frequently and, as far as possible, should not drink and eat at the same time. The purpose of this is to prevent overloading of the stomach which, in a recumbent position, will produce pressure on the diaphra gm an d mechanical cardiac embarrassment. Patients sufferin g from heart failure frequently experience great discomfort at nights. Oftentimes attacks of shortness of breath will occur a short while after the pa tien t has fallen asleep. Thes e a tt acks are generally re ferred to as " cardiac asthma," though the y are in a ll probability due to failure of the left ventricle, producing cedema of the lungs. In this way acute respiratory embarrassment occurs and the patient wakes up with a sense of impending suffocation. These attacks are perhaps more alarming than dangerous, but for their quicker relief it woe.ld be very

helpful to assist the patient to lean forward and, if it is available, inhalat.ion of oxygen through a closefitting mask will be helpful. In the majority -of cases the attacks will pass in a few minutes, but they may recur several times in a night and eventually produce great phys ical and mental exhaustion.

Close observation of the various phenomena whic4 accompany the illne ss ma y be of great assistance to the doctor. Cyanosis-that is to say, blueness of the lips-may be either constant or transient. During sleep Cheyne Stokes breathing may be observed, a condition in which the respiration, from being very deep and full, gradually die s away until it becomes shallow and almost imperceptible, only gradually to recover as the fu ll cycle to deep adequate respiration is again restored. The full cy cle may take several minutes, and in the apnceic period, while breathin g has almost ceased, the inexperienced attendant might almost believe that death had occurred. Patients with cardiac failure sleep badly and the periods of sleep during the night and day should be carefully recorded, so that the doctor may be able to prescribe the necessary sedatives. These patients frequently suffer from mental confusion and tactful handling may be necessary. Such drugs and medicines as may be prescribed must be g iven regularly as ordered by the doctor.

It is well to make unobtrusive preparations for such procedures as bleeding by venese cti on or removal of collections of fluid by tappin g, and for these purposes several kidney basins, or porringers, an adequate supply of methylated or surgical spirit, and of clean cotton wool, with a piece of mackintosh sheeting and several cle an towels may be required. Occasionally venesection may become urgently necessary and the nurse who has made such preparations will do much to help her patient. Hypodermic or intravenous injections may at any moment become urgently necessary and, if possible, a ste rili sed 2 c.c. hypodermic syringe, together with a small quantity of boiled water, should be available at all times.

SUMMARY

T he duties of the nurse in charge of a patient who is suffering from cardiac failure may be summarised as follows :-

I. Ensure absolute physical rest and prevent any exertion. \

2. Record accurately temperature, pulse and respiration rates.

3. Record fluid intake and urinar y output

4. Keep the patient in a position in which the breathing is least labour ed.

5. Note an y unu sual symptoms.

6. Prepare for injections, venesection or tapping of effusions.

7. Give only such drugs as may be ordered.

The Grand Priory in the British Realm of the Venerable Order of the Hospital of St. John of Jerusalem

His Mqjesry the King has _ been gracious(y pleased to sanction the foll07ving Promotions in, and Appointments to, the Venerable Order of the Hosp ital oISt. John of Jerusalem:-

FOR PROMOTION TO THE GRADE OF OFFICER (BROTHER) John

L.RC.P. & S. (from Serving Brother).

IN THE GRADE OF SERVING SISTER

THE SIEGE

OF MALTA

History has rel?eated itself in a remarkable way in the work of the Order in Malta. For it is 375 years ago since Suleiman the Magnificent delivered his attack against this cruef bulwark of Christendom then defended by our gallant predecessors in the Order.

No greater display of heroism has ever been seen than that shown by the Knights and soldiers of the Order holding St. Elmo, a port gradually battered [Q pieces until over three-quarters of its garrison were killed or disabled. To quote from the official record, " the end was not far distant a.nd the besieged in the Fort being now o'ut of all hope of succour thought of nothing but ending their lives like good Christians and true religious. - For which purpose they were all night long preparing for it by receiving the Sacraments of the Church. When this was over and nothing remained but the giving up of their souls to God they embraced one another with tenderl'l.ess and returned to theit several posts in order to die with their weapons in their hands and expire in. the bed of 4onour. SUGh as were not able to walk

By Colonel J. L. Sleeman,

CB., CM.G., CB.E., M.V.O.

Chief Commissioner, St. John Ambulance Brigade Overseas \

the men are employed in hospitals others at Centres. Mass is said every morning in St. Elmo chapel and several of the personnel go to Ho(y Communion, keeping up the traditions oj the olden days."

That this same fort should be sustaining its tradition, not only as a defensive work of immense strength, but also in a spiritual way, is testimony not only to the unquestioned gallantry of the Maltese people, but also to that deep piety which has ever been a characteristic feature of them. And if only the stone s of that historic chapel would speak, what tales the y could tell of gallant men with heads unbowed in the sternest conflicts of battle, kneeling in all humility within its sacred walls not only in 1565, but three hundred and seventy-five years later.

So to-day, while that delightful island a.nd loyal colony is suffering enemy attack, Malta, yet once again, will emerge victorious and those who have the honour to belong to Establishments of our Order will ever have the recollection of having taken part in an historic event.

COUNTY OF NORFOLK

The Flag Da y on behalf of the British Red Cross and St. John Ambulance was mO,st successful. The sum collected was £4,683 9s. 8d.

Lady Cook, President of the St. John Nursing Divisions in Norfolk and wife of Sir Thomas Cook, the County Commissioner, has been elected to the Joint War Committee of the British Red Cross and Order of St. John in the County of Norfolk, where she will be very welcome.

REVIEWS

ANATOMY AND PHYSIOLOGY FOR NURSES. By Evelyn C Pearce, S.R.N. London: Faber & Faber. Price 5s. net.

This excellent little textbook of anatomy and physiology was first published in 1929 and has now _ reached its fifth edition. Its author i s Sister-Tutor of Middlesex Hospital, and in this issue she has brought the physiology up to date and abreast of modern advances.

New terminolo gy has been introduced where necessary; but, to avoid confu sion, alternative terms in the old terminology have been retained in the text, which is now arranged in a series of 22 chapters in place of the previous sections. The illustrations, many of which are new, number 137, while a picture of the ske leton showing front and side views has been added. The book reads easily and will continue t o prove most useful to probationer nurses, for whom it was written, and also to other students who, desiring to delve more deeply into anatomy and physiology, are looking for a sound and practi cal guide.

N. C F.

A.R.P. AND A.F.S. D LA.RIES FOR 1941. London: Jordan & Sons, Ltd. Letts' Quickref Diaries, Ltd. Price: 2S. t o 6s.

During my official tour of Malta in 1937 I inspected the Brigade in the ancient · Fort of' St. Elmo, but little }did I think when I visited its small chapel in which those gallant men of 565 had taken the last Sacraments for the last time, that history would repeat itself so soon. But our Commissioner in Malta, Colonel A. ]. Gatt, O.B.E., M.C, K.St.]., writing on August 3 from the same historic St. Elmo, writes as follows:-

" Dear Colonel -Sleeman, 1 am writing these few lines to let you know that the Malta members are doing their bit. Several ladies are employed as V.A.D.' s with the Services, others i11 the civil Government hospitals, while ma'!)' are doing volttmtary part-time work ,at First Aid Centres, etc., etc. Some of

19 8 by reason of their wounds, had themselves carried in chairs to the side of the Breach, where, armed with swords which they held with both their hands, they waited with a heroic resolution until such time as their enemies, towards whom they were not able to advance, should come and attack them in their post." \

Arrangements have been made for a County Stores to be set up in Norwich, where a certain number of the official stores can be purchased direct.

In case of extreme emergency arrangements have been made to deal with Brigade correspondence and business from the headquarters of the Joint War Committee, which would in such emergency be removed to another address outside Norwich.

Thank YOU!

Thanks to The British Navy, The R.A.F. and the British Merchant Navy this Journal is on sale throughout the British Empire; at the same price.

Weare relying on you for one new reader this month. Thank you.

These pocket diaries, edited respectively by J. Gordon Hassell, F.C.I.S., and C Clark Ramsay, author of Fireftghting in Peace and War, contain much useful information for Civil Defence workers. The Index in the A.R.P. edition, printed alphabetically, is particularly comprehensive. Both editions inClude many helpful drawings and illustrations, and these, with the official advice, which is given simply and concisely, provide answers to many of the minor problems which can arise during duty, and should enable those who have forgotten any points in their Defence training readily to refresh their memor y

R. J.

OBITUARY II

We regret to recor d the death of Dr. H. G. Cooper, M.B.E., M.A., B.CCamb., M.R.CS., L.R.CP., Officer of the Order of St. John and Honorary Life Member of the St. Jo hn Am bulance Association.

Dr. Cooper, one of the founders of the Altrincham Divis ion and for more than forty years its surgeon, gave much of his time in furthering the Brigade movement in his district. His los s will be keenly felt by those who knew him.

Red Cross and St. John War Organisation

The article contaim full about 7:vhat may or may no t be sent to British p r i soners of war zn Germ arry. Careful to the regulat zons 2S earnes t !;, requested ry t he Pris oners of War Departmen t of the War OrganzsattOn. If t hry are observed milch di sappo intm ent and m arry delays are avoided.

(Contined from page I86, August issue)

HEARING FROM PRISONERS

Not later. than week after his arrival in a prison carr:p, a can send a postcard to his family telling them of his capture and the state of his health. If the post is delayed this card may not be received for some time.

British prisoners in Germany are allowed to send per month: officers, 3 letters and 4 postcards; other ranks, 2 letters and 4 postcards; civilians, 3 letters and 4 postcards.

All correspondence to and from prisoners of war goes pmt free. Photographs may not be included.

WRITING TO PRISONERS

Letters should not exceed two sides of a sheet of notepaper. They should be posted in the ordinary way, but without a stamp. They should not be sent to the Prisoners of War Department at St. James's Palace. The sender's name and address should be written on the back of the envelope, except in the case a member of His Majesty's Forces, who must not gIve his address.

Such person, if he has a relative or friend in this country to whom the reply can be sent, must give the address of that person and arrange for letters so addressed to be forwarded to him.

It is not possible to write to a prisoner until the camp address is known.

In relating to a pri soner of war please put ht s servzce number, rank, name, regiment, shzp or squadron, and camp address if known, at the head of each letter or enquiry.

FORM OF ADDRESS

The form address on envelope containing a letter for a pnsoner of war IS as set out opposite. No attempt should be made to communicate with prisoners of war through people in neutral countries. No telegraphic communication is allowed.

CLOTHING

may se:r:-d by ordinary parcel post(no special label IS needed) SUItable clothes and toilet accessories to the ·Clothing Section, Prisoners of War Department, St. James's Palace, as soon as the permanent Camp address of the prisoner is known Only one IO lb. parcel (not counting packing) may be sent.

Owing to pressure of work and to the expense Involved, the Clothing Section cannot undertake to return items which make the parcel overweight.

The name and address of the prisoner of war and

name and address of the sender should be clear! y wntten on the outside and inside of the parcel. A list of the contents must be included.

RED CROSS STOC;:KS

Prisoners of war whose relatives cannot contribute clothing, or can only contribute a part of the .parcel, will be supplied from Red Cross stocks as soon as possible. It is hoped to be able to send a second parcel, which ma y contain uniform, when all prisoners

Write here

Sender's Name and Address

PRISONERS OF WAR POST KRIEGSGEFANGENENPOST NO STAMP REQUIRED

Service No Rank. Name

British Prisoner of War (No. ifk.nown)

have be en supplied with e ssentials Meanwhile, r elative s should bear in mind that it may not be possible to send a clothing parcel ag ain before the winter. They should therefore collect warm underwear, woollies, stout and comfortable shoes, and, if possible, a light blanket.

PROHIBITED ARTICLES

No food, tobacco or chocolate can be included in a clothing parcel. No tubes, jars or bottles are Clothes not allowed to be sent to prisoners mclude: Complete suits; coloured trousers; sports coats or blazer; macintoshes ; or any kina of overcoat O E jacket.

WHAT CAN BE SENT

The following items for ifl,clusion in the clothing parcel are suggested:

1 Shirt Handkerchiefs

1 Pants Brush and Comb Vest Hussif

Socks Shoes Towel Pipe Blanket

Windcheater

Pullover Grey Flannel Trousers

Toothbrush and Toothpaste in tins.

Razor, Blades, Shaving Stick.

FOOD

The only food that is allowed to be sent to prisoners of war is contained in the Red Cross Standard parcels, which come under the rigid control of the Censorship, and to which nothing may be added. Food (carefully analysed by a dietitian), soap, tobacco and cigarettes, costing about lOS. per week, are sent to all prisoners of war.

As the cost is met entirely by the War Organisation, donations towards this object are more gratefully received.

Cheques and postal orders should be made out to "Red Cross and St. John Fund, Prisoners of War Account," and sent to the Appeal Secretary, St. James's Palace, London, S. W. I.

BOOKS AND GAMES

Books, music, packs of cards, games and sporting equipment may be sent direct to prisoners of war through firms holding a permit to send printed matter abroad. Among others, the following stores hold this permit: Army & Navy Stores, Boots, Harrods, Lillywhites, Meccano, Selfridges, W. H. Smith & Son, Times Book Club, Truslove & Hanson.

The Educational Book Section of the Prisoners of War Department arranges for books to be sent to any prisoner wishing to study a special subject. Forms of request for these books are sent to the Prison Camps.

INVALID COMFORTS

Every four weeks the Invalid Comforts Section of the Prisoners of War Department dispatches consignments of ordinary household drugs, bandages, lint, dressings, etc., together with such things as cod liver oil, malt, tonics and invalid foods and comforts for distribution, addressed to the Senior Officer of tlle Prisoner of War Camp. In the case of illness or of minor injuries that are not sufficiently serious for hospital treatment, remedies are, therefore, at hand when needed.

Relatives of a prisoner can send to the Invalid Comforts Section medicines or special remedies direct from their O1vn chemist to be included in these parcels. They are labelled for the pris()ner for whom they are intended.

SPECIAL DIETS

, At the .request of the relatives, or the Senior Officer of the Camp, individual food parcels can be arranged

for serious or chronic cases reqUlnng special diet, in place of the ordinary weekly food parcels. Men who are known to be in hospital are sent a special parcel for four weeks.

TOBACCO

Seventy-five cigarettes (or the equivalent amount in tobacco) are sent to the Camps for each prisoner every week.

PERSONAL PARCELS

The personal parcels service, by which next-of-kin can send a parcel every three months to a prisoner of war, is temporarily suspended. A notice will appear in the Press when this service re-opens. In the meantime nothing but the articles listed in the paragraph headed " Clothing" 'on should be sent to Prisoners of War Department at St. James's Palace.

WHEN MAKING ENQUIRIES

The Prisoners of War Department urgently calls the attention of relatives who write for information respecting a prisoner, to the necessity o £ giving full particulars of the man-whether serving in the Navy, Army or Air Force; the name of his ship or his regimental number, regiment, unit or squadr o n, and his surname and his Christian name s or initials.

AMB

UL ANCE ADDITIO NS

Welcome additions to the War Org'anisation's ambulance fleet are recorded as hav ing recentl y arrived in this countr y from the United St ate s o f America. Notification has been r eceiv ed of the landing of 6I ambulances, which the Transp o rt o f Wounded Department is now in ·the process o f collecting from various ports. In addition , ten field kitchens have arrived and ten diagno sti c X-ra y unit s All these ambulances, field kitchen s and X-ra y units are gifts of the American Red Cross.

O V ERSEA S GIFT S

Gifts in kind for the War Organisation come from all parts of the world. The Central Hospital Suppl y Service has recorded that since Ma y consi g nmen t s have been received from places so far apart as Newfoundland and New Zealand and Penang and Panama. Places within the British Empire sending gifts include Newfoundland, New Zealand and the New Hebrides; Jubbulpore, Jodhpur, Dehra Dun, Colombo, Rangoon and Penang, Sarawak and Hong Kong; Sydney, N.S.W., Johannesburg, Salisbury (Northern Rhodesia) and Port Credit, Ontario.

From the U.S.A. gifts were sent to the Department from New Bedford and Boston, Mass., from Jacksonville and Sarasota, Florida, San Francisco, Be v erle y Hills and Los Angeles , Rhode I s land and from Jew York City .

South American consignments were delivered from Rio de Janeiro and Sao Paulo, Brazil, from Buenos Aires and Lima Central America is represented b y gifts from San Salvador and Panama.

Other places contributing in kind a re Mada g ascar, Shanghai, Honolulu and Batavia.

20I

Priory for Wales

Headquarters: Priory House, " Cathedral Rd., Cardiff

CENTRE REPORTS

ANGLESEY CENTRE

Certificates were presented to forty-seven new members of the Holyhead Ambulance and Nursing Divisions at a social evening ·held at the First Aid Post, Newry Beach. Sir Henry Grayson, Bart., K.B.E., County Commissioner, in opening the proceedin gs, remarked · that the testing time for the ambulance organisation had now arrived, since total war was being indulged in, and its effects would be felt even in Hol yhead. The struggle would be a hard and difficult one, yet he was convinced that success would be its ultimate reward. Sir Henry congratulated the Brigade upon its efficiency, and the . devotion of Dr. G. P. Williams, Divisional Surgeon, was worthy of the highest praise and recommendation.

After thanking Sir Henry and Lady Grayson for their interest, Dr. G. P. Williams congratulated Sir Henr y upon the signal honour which had been conferred upon him in his promotion to the grade of Knight of the Venerable Order of the Hospital of St. John of Jerusalem. This was the first occasion for the ladies and gentlemen of the ambulance movement to meet together at Holyhead, and if the call should come, they would answer it with efficiency.

Certificates were distributed by - Lady Grayson, and those present included Mr. R. H. Prothero, Chief Constable of Anglesey, and Assistant Cqunty Commissioner; Mrs. E. M. Prothero, Honorary Treasurer; Mrs. M. S. Lowe, Lady Superintendent of the Nursing Division, and Mr. F. Bell, Superintendent of the -Men's Section.

Church Parade.-Great interest was taken in the parade which was held in the town, when members of the Brigade attended divine worship at St. Cybi's Church, with members of the British Red Cross Society. The parade was led by Sir Henry Mulleneux Grayson (County Commissioner), who was accompanied by Lady Grayson, and others present included Admiral Sir Percy and Lady Grant, Mr. R. H. Prothero (Chief Constable), and Assistant County Commissioner and County Officer C. R. Hollyoake. The members assembled at Newry Beach, and then marched to St. Cybi's Church. where the service was conducted by the Vicar, the Rev. Canon R. Hughes, who also gave an inspiring and interesting address on the origin and foundation of the St. John Ambulance movement. The two divisions and the cadets after 101

the service proceeded to Newry Beach, where they were inspected by the County Commissioner, who, in presenting certificates to successful candidates, told the cadets that they should be proud of their associations with the Ambulance Brigade.

FLINTS HIRE CENTRE

The annual meeting of the Flint Division was held at the Central School, Flint, the President, Mr. P. E. Hammond, presiding, supported by the Mayor, Counc.i1lor E. \V. Shuttleworth; Corps Superintendent C. H. Shenton, and Superintendent J. H. Jone s Mr. T O'Neil submitted the financial statement, which showed a credit balance o f £27 lOS., which was unanimously adopted.

In his report, Superintendent J. H. Jones said that during the year there was an increase of member ship from twenty-five to twenty-eight, and eleven members had joined H.M. Forces since the last annual meeti n g During the year, members performed hundreds of hours of public duty, sometimes wo r king for twelve hours on end on such duties as the fittin g of respirators on the general public, instructin g teachers in the schools to fit respirators on children, assisting during the arrival of evacuees, attending sports and social functions, lecturing to A.R.P. volunteers, and taking stretcher cases from home to hospital. Superintendent Jones thanked the President, Mr. Hammond, the Vice-Presidents, Councillor E. W. Shuttleworth and Mr. F. Bayley, the Honorary Auditors, Mr. J. Bibby Denny and Mr. J. E. Shone, and members of the Flint Division for their assistance and l-oyal support.

Corps Superintendent Shenton announced the result of the First Aid Examination held in April under Dr. G. H. Buckley, which reflected credit upon the lecturer, Dr. W. Mackenzie Ross.

Mr. P. E. Hammond said since the commencement of the war the local Division had taken a very active part in the work of A.R.P. and many other duties in that connection; and he congratulated the unit upon the increase of membership, and the Mayor added his tribute of praise.

In the absence with H.M. Forces of the Divisional Secretary, Sergt. E. Wilson, Corporal R. J. Lloyd was appointed acting Secretary.

GLAMORGAN CENTRE Centre Secretaryship.-AII- ranks will the return of Mr. A. J. Esmond, of Briton Ferry,a former

County Officer of the Brigade, to a more acdve assdciation with Ambulance work, in the capacity of Honorary Secretary of the Glamorgan Centre Committee, the office recently left vacant by the lamented death of the late County Officer D. C. Williams.

Parade at Nelson.- The annual inspection of the Lindsay Corps took place at Nelson on Saturday, August 17, when the procession assembled at the G. W.R. Station and headed by the Melingriffith Works Silver Band, conducted by Mr. T. J. Powell, passed through streets lined with people to the Welfare Grounds, where the inspection took place. The units on parade were the Nelson, Trelewis, Gellygaer, Penalla, and Hengoed Ambulance, Nursing and Cadet Divisions (comprising the Lindsay Corps), Treharris Ambulance Division, Red Cross Nursing Members, Nelson and Trelewis sections of the Home Guard, Nelson Fire Brigade, and auxiliary firemen, . Nelson Air Raid Wardens , Nelson Wheelers, and local Councillors. The Chief Marshal was Corps Sergt. -major D. B- Pa yne, Trelewi s.

At the W elfare Grounds a lar g e crowd had assembled to witness the inspection by the Hon. John Bruce, J.P., D.L. (Commissioner for Wales), who was accompanied b y the Hon. Mrs. Bruce (Lady Staff Officer for Wales ) , Dr. S. B. Turner (Assistant Commissioner), Lady County Superintendent Mrs. Turner, and Lad y County Officer Miss Gravenor, Count y Officers T. A. Rees, C. Palmer, and D. J. Skryme, Dr. R. H. Terry, J.P., Councillors C. H. Davies and E dgar Morgan, Corps Superintendent Wm. Evans, Corps Secretary Samuel Hughes, and other officers. Addressing the parade, the Hon. John Bruce said he was greatl y impressed with the smart appearance of the variou s units. He was pleased to find that the Lindsay Corps was maintaining its fine traditions, and that the members had attended over i,ooo cases during the year. The Home Comforts Depot at Nelson was as useful to-da y as when it was established eleven years ago, and Mrs. A gnes Morgan (storekeeper) deserved praise for her splendid work there. He was pleased to know that premises had also been acquired for a Home Comforts Depot at Trelewis.

Mr. Bruce paid tribute to Dr. and Mrs. Turner and to Miss Gravenor for their valuable help to the movement, and referred to the organising ability of Corps Secretary Sam Hughes, concluding his remarks by thanking the volunteers who had joined the Nelson and Penallta Nursing Division, and made a strong appeal for more recruits.

MERIONETHSHIRE CENTRE

Brigade Ojjicer} s Departure.-Great regret - will be felt throughout the Merionethshire Centre on the resignation of Mr. Hadley S. Seabourne as County Officer, consequent upon his having taken up wartime duties in the Midlands. Whilst the Priory must grudge Mr. Seabourne's services to the country, It IS hoped that he will renew his connection with the Brigade on termination of hostilities.

Edeymion Division Awards.-Admiral StapletonCotton, Honorary President of the Ede yrnion Division, presided over a large attendance at the Le g io n Hut, Corwen, for the distl"ibution of awards in . connection with the recent examinati cm. The President said the Brigade had done a great deal of n o ble work in the district, and the results of th e r ecent examination which was announced b y Supe.rintenden t J. F. Owen reflected great credit upon the instructor and the classes.

The Commi ssioner (Dr. E. Lew ys-Ll oy d) u rged all to continue the good w ork. In pre sentin g th e Superintendent with an A. R.P_ certificate, Dr. Ll oy d said this was an award seldom g iv en The r e cipi e n t had rendered a great deal of v aluab le wo r k fo r th e Order, and wa s to be con g ratulated upon hi s succ ess. Dr. D. R Edwards, Corwen, w as presented, on behalf of the class, with a pipe and ca se in appreciati o n of his work as instructor. Mrs. Satchwell w as p r esented with a cutg la ss v ase for her services as anti -g a s instructor.

Proposing a comprehensi v e vo t e o f th an ks , the Rev. W. Morris Williams p aid a tribut e to the wo r k and thanked the Commissioner fo r hi s pre senc e a t the meeting and the interest he to ok in the cla ss at Corwen. Sec onding the vote of than k s, Mr. H. R added that the town and district sh o uld appr eCIate the work done b y the local doct ors in conn e cti o n with various organisations.

Mr. J. Fred Owen was pr es ented with a small toke n of appreciation from the members o f the clas s, and Sergt. J. Idwal Jones, on behalf of the Anti-Ga s Class, expressed thanks to Mrs Satchwell fo r her v aluabl e services as instructor.

MO NM OUTHSH IRE CEN T RE Po ntnezVY"!Y dd Ojjice( s P roJJJ ot ion.-A t P o ntne wy n ydd Ambulance Hall, presentations of an inscrib e d go ld watch, with a miniature badg e, were m a de t o Mr . E . Webster, the first Superintendent of Pont ne\.vy n ydd Division, who has left the Di vision on his p r omoti on to the rank of Corps Secretary .

Mr. George Williams, the new Pontne wyn ydd Divisional Superintendent, who presided, paid a warm tribute to Corps Secretary Webster for his splendid services to the Pontnew yn ydd Di v ision since its formation in 1924, and said it was largely due to hi s efforts that they now had their own ambulance h all at Pontnewynydd. Much credit was also due to Corps Secretary Webster for thei r havi ng had at Pontn ewynydd one of the strongest Nursing Di visi ons in th e valley.

The presentation of the watch was made b y NIt s F Duke, Superintendent of the Nursing Div i si on, and the badge was presented b y Mr. Charles Hatchar d , one of the oldest members of the Division. Oth ers who spoke were County Officer G. Tuckwell, A bersychan, Corps Superintendent Miles, Pont ypool , (Continued 011 page 206)

20 3

Interesting Case Reports

CASE REPORT No. 168.-The Officer-in-Charge of the County of Kent S.J.A.B. reports the efficient performance of 6.rst aid by a member of the Herne Bay Nursing Cadet Division in the following circumstances :-

On Sunday, June 30, Nursing Cadet Muriel Iddenden (age 16) was walking along the sea front at 7 p.m. when she observed a small boy standing on the end of a diving board. Immediately afterwards there was a splash, and she saw him s.truggling in the water and in danger of drowning.

Without any hesitation Cadet Iddenden proceeded to the rescue and removed her coat as she ran towards the sea. Diving into the water she swam out to the boy and had almost brought him to shore when he threw up his hands, caught her by the throat and dragged her under the surface At this point a passing sailor at her request came to her help, and between them they brought the boy ashore. Then, as the patient had ceased to breathe, Cadet Iddenden and the sailor both did artificial respiration. Shortly afterwards, his breathing being re-established" the boy was removed in a passing car to hospital, where he was detained and after two days made a complete recovery .

COMMENT.-It is alwq)1J a pleasure to record good work well done ry a junior member, especialfy when owing to it, as in this instance, a life was saved. In these circumstances we tender cordial congratulations to Nursing Cadet Muriel Iddenden 011 her prompt and ejJicient action at comidemble risk to her own C. F.

METAL STRETCHER FOR SPINAL CASES

R. D. (South Nutfield).-Please tell me if the A.R.P. metal stretcher is considered sufficient support, without transverse boarding, for the transport of cases of fractured spine is the supine position. Yes.-N. C. F.

STICKING PLASTER FOR WOUNDS

R. D. (South Nutfield). - Apart from a warning the use of sticking plaster may introduce Into a wound, I ,do not think there is any mention of this material in the Textbook. As there appears to be a difference of opinion amoqgst members as to whether it is permitted, .I should appreciate your ruling, in particular whether there is any objection to th.e use of adhesive strapping for securing small dresslngs, etc., O.f of the type with sterili'sed pad for dr@ssing small wounds.

The oijectien to tbe use of sticking piaster ry first aiders zs that it is a more 01 less permanent dressing choice

The advantages of using plaster as a means of keeping lint in position are that bandages mqy be saved and that the h-eated itijury is rendered less compicuous. In such cirC14mstances the modern dressing of a single piece of plaster Hnt or gauze attached has much to commend it.N. C. F.

USE OF TOURNIQUET

P. P. (Hounslow).- Where a wound coincides with Pressure Point No. 11, may the tourniquet be applied over the wound after 'it has been dressed? Your ruling will be appreciated.

The amwer to your query is contained in Rule 4 (b) on p. ro8 of the Textbook, 2vhere YON are told that if a wound . is large (as it would be in the circumstances named) direct pressure is to be made" as near as possible to the wound on the heart side." Consequen..tly the application of a toumiquet over a wound situated on a pressure point is contrary to the instructions of the Textbook / and in this instance 1 1vould control bleeding ry digital pressure 01/ Pressure Point No. lo.-N. C. F.

SCHAFER'S ARTIFICIAL RESPIRATION

E. Y. (Guildford).-A question has arisen among some of our members relating to the Schafer's method of applying artificial respiration.

The question deals with the position of the thumbs during operation. One section maintains that the thumbs should be pointing upwards, parallel and nearly touching (see Figs. 74 and 76 on pp. 145 and 147, of the Textbook). The .remainder, basing their argument on Fig. 75 on p. 146, maintain that the thumbs should lie in a line with the 6.ngers, and do not point · upwards.

I should much appreciate your opinion on this, as I think the illustrations give support to both sides. We thank you in anticipation of your reply.

In Schafer's Method the position of the hands is as shown in Figs. 74, 75 and 76. In Fig. 75, however, the angle at which the photograph has ·been taken gives the fals e appearance of the thumbs being in contact with the fingers, and in Fig. 76 of the thumbs being stretched and pointing upwards.

The hands are kept in position of relaxation and 1J)ith fingers in contact. ConsequentlY, the thumbs point tmvartiJ the ribs and not directlY upwards.-N. C. F.

END OF DESCENDING AORTA

S. W. (Manchester).-On p. I 13 of the Textbook the aorta is described as dividing into the right and left iliac arteries just below the second lumbar vertebra, while the skeletal diagram at the front of the book definitely indicates the fourth and shows the su bdivision taking place thereat. Other books I have,

204 of J:lJhich should be reserved for the dodo'/" J' and on several occasions 1 have had to tea?' off several Sf1·ips of plaster Jvhich an inejJicient first-aide?' had applied to a wound. As you state, the Textbook is silent on the point except that it forbids the application of plaster directfy to a wound. [Rttle 2 (d), p. 107.J

say the fourth. Is this a printer's error or how do you reconcile this apparent error?

The descending aorta is usuallY described as ending " opposite the fourth lumbar vertebra/' and 1 agree with you that the Textbook is definitefy inconsistent in this matter and that it should have indicated the same point of sub-division in context and frontispiece. - N. C. F.

HAEMORRHAGE FROM FEMORAL ARTERY

S. W. (Manchester). - Please explain why in connection with arrest of h<emorrhage from the femoral artery with tourniquet the Preliminary Course Textbook says "a hand's breadth below the groin," while the Adult Course Textbook says "as high up as the bandage can be applied."

The Adult Textbook is not quite as definite in its treatment of the femoral artery and its distribution and arrest of h<emorrhage therefrom as it might be. Perhaps you would be good enough to explain briefly.

Ifyou make a practical testYON will find that the instructions in the Adult and Preliminary Textbooks, though set OJ/t in different terms, give the same position for the pad of the toumiquet. EvidentlY the difference is accounted for ry the necessity to keep the z'})ording simple for juni01" students.

On your second point 1 cannot see how the description could be improved.-N. C. F.

COMPOUND, COMPLICATED FRACTURE OF LEG

A. S. (Derby).-With reference to the" Dewar Test" published in the July issue of THE GAZETTE, I would like to query two points.

The 6.rst concerns the treatment of patient under " Shock." Marks are given for raising the feet. As patient is suffering from a compound complicated fracture of leg, this is contrary to the teaching of the Textbook, which says on p. 108-" Elevate the bleeding part except in the case of a fractured limb." Of course, I realise that this is part of the treatment for shock as given on p. 44; but we are taught that h<emorrhage must be given priority in treatment.

The only way I can see to raise the lower limbs and to carry out the treatment of shock as laid down in the Textbook without aggravating the injury would be to raise the lower end of the stretcher after patient had been placed thereon, though in this case no stretcher was available.

My second query has reference to the fracture after it has been controlled. Surely there will be shortening present. So I ask if it would not be better to place a bandage round both ankles instead of round ankles and feet. The latter, if held firmly, would tend to produce extension of the fracture, which is contrary to the teaching of the Textbook, or if tied slackly, would be no use at all. Your kind help will be appreciated.

Yo ", have probably alrear/)! read my 1'epfy to the query

10,5

1vhich was published under the above title in the A ugust issue of THE GAZETTE. This P1'ovides the t%.ur two queries; and 1 have onfy to add that the which you quote (Rule 2, p. 108) refers to the zmmedtate treatment of wound. Nowhere does the Textbook say that YON may not raise a limb after a compound fracture ha s been properlY treated.-N. C. F.

COMPOUND FRACTURE OF LEG

H. R. (Leeds).-(I) I am working at a First Aid Post and have received different instructions from a doctor and a St. John instructor with reference to the treatment of a patient suffering from compound fracture of leg with bone protruding and with leg on injured side bent at the knee joint.

The doctor told us to get someone to steady the fracture and, this done, to straighten the knee and to bring the two lower limbs together. The instructo r, however, told me that this is wrong; and he said that we should leave the injured limb in the position in which it was found and then secure the limb by three splints, the first on outer side of sound limb, the second and the third across the legs at an angle so that the three splints form a triangle.

This second method takes a very long time, is very awkward for transport and requires a large number of bandages. So will you please say which is correct?

Also, could you please suggest the name of any book which deals with treatment of shrapnel wounds and limbs shot off?

(1) Th e method l(y the doctor is conect and complies with the instructions given for treatme11t of fractures in Rules 3 and 4 on p. 66 of the Textbook. On the other hand, the instructor was evidently seeking a wqy in which he could avoid all movements of the lower limb, but he overlooked the difficf,tlties zvhich, as you have stated, will occur during transport, particulm'fy in temp orary ambulances during air raids, and also the fact that bandages might not be plentiful.

(2) 1 believe that a book called" First Aid for War Casualties JJ (price IS. Sd. post free) will shortly be published ry Dale, RVmolds & Co., 46, Cannon Street , E.C.4, and that this will satisfy y our l'equirements.N. C. F.

ACTION OF TEA WITH BURN S

- P. N (Cardiff).-Please explain the action of infusion, which is now named b y the Textbook, In the treatment of burns and scalds and also tell me if it is in any way related to tannic acid which is to-day so often used for the same injuries.

Tea contains tannin and was used long )leal's agp l(y the Chinese in the treatment of burns and scalds. Tea tannin, however, is a different substance from tannic acid J' and its action is much milder than that of tannic acid. Indee d, experiments have shown that the latter is 2 5 I ncidentallY it is claimed that tea contamed 170 tatmm 1vould be a/most tasteless .-N. C. F.

I.N war-time service, either in the military hospitals or with the civil population, it will be found that a considerable proportion of patients are in a state of high nervous tension. The need for a restorative tonic food beverage, which is completely nourishing and easily assimilated, becomes urgent.

Ovaltine' meets this necessity in a highly satisfactory manner, both as an emergency measure and as a regular routine. The nutritive and energising constituents of 'Ovaltine' are rapidly assimilated, providing all the essential food elements and , at the same time, nervous tension in a most helpful way.

Now, as in 1914-1918 , (Ovaltine is widely used in the wartime hospital service, both in England and overseas. It is of exceptional value as a regular supplement to the dietary; it is designed to meet abnormal demands on the nervous system, and its use at night is an effective aid to sound, restorative sleep.

, Ovaltine' possesses many outstanding advantages. It is highly concentrated and is prepared, by exclusive scientific processes, from malted barley, full-cream milk and eggs from the world-famous , Ovaltine 'farms. It contains the essential vitamins and valuable mineral elements, (( first-class" protein, c.arbohydrate and fat in carefully adjusted ratio. Moreover, (Ovaltine' possesses special properties which make milk more digeshble, and thus easily assimilated, even by patients who are seriously ill.

Supplies are available to Hospitals and , Public Service Organisations in special packings and at special prices .

Write for details to .A. Wander, Ltd., 184, Queen's Gate, London, S W 7.

Priory for Wales (Contd. from page 2.03)

. Corps Storekeeper 1. Tibbs, Cwmbran, and Councillor C. H. Newman, Pontnewynydd.

A large framed photograph of Corps. ,Secretar y Webster, with the Pontnewynydd DIvIslOn, was formally presented to be hung in the hall, by Am?ulance Officer J, Pope, a smaller photograph ?eIn g presented by Mrs. E. Price, dent, to Mrs. F. Duke, in serv]ce s as Superintendent of the Nursing DIvlslOn.

BOROUGH OF MERTHYR TYDFIL CENTRE

'The annual parade and i nspection of the Merthyr County Centre of the St. John Ambulanc,e took place at Aberfan Park, Merthyr, the InSpectIng officer being the Hon. John J.P., D.L., Principal Secretary and ComrrusslOner for Wales, who was accompanied by the Hon. Mrs. Bruce, Lady Staff Officer for Wales.

C;pt. W. J. Canton, LL.B., Cou-?ty was in charge of the parade, which ,the Dowlais Corps, under Corps Superintendent Wilham Griffiths, and the Taff Valley Corps, under Corps Superintendent Lemuel Powell.

The Hon. John Bruce was accompani,ed in his inspection by the Mayor of Merthyr (CounCIllor J. .W. Watkin, J.P.), the Mayoress (Mrs. J. W. Watkin), and Mrs. Bruce. In his subsequent address, he congratulated the Commissioner on the of the Centre, the Brigade strength beIn g Increased b y 2QO in the past year to a total of 72.3, while new ing Divisions have been established at Bedlino g, Merthyr Vale, Pen ydarren and Troed yr hiw. Short courses in First Aid hav-e been given to 367 school teachers, 438 members of A.R.P. services, etc.

Among those present were Col. c., Richardson White, Messrs. Tom Andrews, J.P. (ChaIrman, Merthyr County Centre), John Morgan (Treasurer, Merthyr County Centre), and W. J., (President, Aberfan and Merthyr Vale DlvlslOn).

NEWS IN BRIE F

The Commissioner for Wales has sent a letter expressing the best wishes of the Priory for a safe and speedy return to Gunner A. G, Frost, whom the Bedwas Division, of which he is a member, reported to be a Prisoner of War. A letter has been sent also to Mr. Frost's parents, nad similar action will be taken in the case of any Brigade members who have the , misfortune to become prisoners of war, if their units will keep the Priory informed.

British Prisoners of War in Germany

Particulars about what mayor may not be sent and in what way parcels may be sent to British prisoners of war in Germany are given on page 200 of this issue,

The St. John Ambulance Brigade News

No. I (PRINCE OF WALES'S) DISTRICT

The Assistant Commissioner assisted at the recent ju dging of special tests of First Aid the. quarters of No . 103 (Paddington) NurSIng DIVISIOn. T hese and subsequent tests in bandaging and seats enabled him to form a very favourable OpInIOn of the efficiency and smartness of members of the Division.

Members of No. 7 (Toynbee Hall) Division, and o. 66 (Toynbee Hall) Nursing Division were in-

quarters for inspection, is the of Mrs. Paul, and is well equipped for all emergencIes.

No. 4 (LANCASHIRE) DISTRICT URMSTON

A presentation of a stretcher and accessorie s was made to the newly formed Urmston Ambulance Division by members of Davyhulme Park Bowling Club, at the Vice-President's Handicap held recently. Proceeds of the handicap were given to the Equipment Fund of the Division, and donations collected

spe cted by the Assistant Co:nmissioner, accompanied by District Officer T. McBrIde.

After the inspection and the demonstratIOn of pra ctical work which followed, Lady Louis Mo untbatten, Lady County President, addressed those present, expressing. appreciati?n of the general turn -out of the DIVISIOns and then work.

A visit was also paid by the Assistant Commissioner to No. 58-5 (Western Postal and St. Marylebone) DiVIsion. The Assistant Commissioner was interested to note that a number of those on parade were wearing the 1914 and Service Medal riband.

After the distribution of awards, a demonstratlOn of Stretcher Drill and First Aid was given. The ambulance, which was drawn up in front of Head-

207

by members and their friends amounted to over £ 10.

The Urmston Division has 29 trained and a further 37 are being trained.

Ambulance Officer T. T. Doole y received the equipment from the President and thanked the club for its generous support.

No. 7 DISTRICT IRONBRIDGE

During the past few weeks the newly formed Ironbridge Cadet Nursing Division has increased membership from 12 to 53.

On August z 3 a demonstration of First Aid and Home Nursing was given. Seventeen girls were presented with first-aid certificates by Lady Forester.

The cadets have adopted a minesweeper and have

recently collected £15 I 5S., which was spent om wool for knitting comforts, chocolates, etc. They have also sold flowers and vegetables, collecting more than £3 for the local St. John Flag Day Fund.

We congratulate this active division on its splendid achic;vements.

DEDHAM No: 10 DISTRICT

On Sunday, August 18, the new headquarters of the Dedham Division was opened by the Rev. Canon Rendall, D.D., LL.D.

Replying to congratulations on the equipment and the state of readiness for emergency existing in Dedham Division, Divisional Superintendent B. Clary said that the opening of the new headquarters coincided with the 21st birthday of the division, and that he had a very efficient and exceptionally keen staff under him.

Great credit is due to th@ members of this division who themselves entirely renovated " Sun Cottage"their present headquarters. Various furnishings were given by the public who always have supported the division in a manner.

Before the opening of the new headquarters, County Secretary Mr. A Poole, members ,of Manningtree Ambulance and Nursing Divisions, and Dedham Ambulance Division attended a church parade.

HARLOW

The new ambulance of the Harlow Division was recently dedicated by the Vicar, the Rev. H. C. Hargreaves, M.A.

Among those present at the ceremony were: Commissioner H. Langley Jones, Mr. H. Minall, Mrs. Calverly, O.B.E., B.R.C., Mrs. Frank H. Jones ; B.R.C., and County Officer T. C. Forbes.

I\1embers of the Harlow Ambulance Division attended under Divisional Surgeon W: N. Booth and Ambulance Officer R. F. Deards. The Nursing Diviiion, in charge of Nursing Officer L. Martin, was also well represented.

The Divisional Surgeon said that the purchase of the new ambulance had been made possible by the magnificent gift of '£600 from Mr. H. Minall and friends, and that in addition £300 had been raised by public subscription.

The Commissioner accepted the ambulance on behalf of the Joint Council of the British Red Cross and Order of St. John, and in thanking Mr. Minall for his gift, said that he was pleased to hear that the Division had no need to apply for a grant of £120 to which they were quite entitled, and congratulated the members on the splendid work they had done since their formation in 1929.

Channel Islands

Readers want to know how they can communicate with relatives and friends in the Channel Islands. , ,: Enquiries - of this nature should be sent to: The Foreign Relations Department of the Red Cross and St. John War Organisation, The Lord Chamberla[n's Office, St. James's Palace" London, S. W. I.

208

. Transport Organisation

By R. R. HOPKINS

(Divisional Sec'l'eta ryancl Transport Officer, Vauxhall Moto'l's Division)

In a few weeks' time ambulance personnel will be doing more of their duty in darkness than in daylight . And during the winter months there may be a recurrence of the extreme cold experienced a season ago

Many Transport Officers will have learned from that experience what precautions should be taken before the need actuallY arises; but they and others may be glad of a reminder.

You will, of course, see that your side, tail an d head lamps (one only of the latter properly shielded) conform to the general regulations for all road vehicles.

There is need also for a band of white paint on th e front and rear of you-r vehicle-and on ambulances, the wider and more conspicuous the band is the better.

It is important to have a supply of spare bulb s and fuses. And another wise investment-though not solely a winter safeguard-is a fire extinguishe r which should be affixed inside the cab.

Interior lighting is something of a problem. If you confine yourself to a single lamp -w hich must be specially fitted if your ambulance is a " converted " one-and have it " blued over" in accordance with the regulations governing exterior lighting, it will be more or less useless.

It seems to me that as shielded torches are permitted, and, in fact, issued to A.R.P workers as par t of their equipment, it is also permissible to have an interior ambulance light which will enable the vehicle to be loaded and unloaded without discomfort to the patient, and which will also provide adequate illumination for the attendant to watch the condition of the patient throughout a journey.

Many drivers show a marked desire to take their vehicle too near the scene of the actual incident when approaches are quite unsuitable. There is no point in trying to back an ambulance up a steep and uneven incline when there is a risk of damaging the vehicle and of losing valuable time. It is far better to park the ambulance speedily and safely in the nearest convenient spot and let the stretcher party transpor t

the patient the remainder of the way to the vehicle. It is not R.A.M.C. practice to take ambulances right into the forefront of the line, but to operate them from the nearest reasonable points. A.R.P. vehicles sho uld be similarly operated.

Against cold three things are essential-anti-freeze i1). the radiator, a muff (preferably with adjustable se ttin gs), and glycerine or some other precaution against a frozen windscreen.

There are many brands of anti-freeze : but it is important to order it in good time. There may be a shortage Once the anti-freeze mixture is in the radiator, see that the topping is done with care or some of the mixture will be lost every time water is added. This l oss causes more radiator trouble than any other factor-even in army vehicles .

Glycerine for the windscreen shou ld be kept handy :at all times and applied when the temperature calls for it. If you can get the authorities to allow you to fit a de-froster, so much the But glycerine is far more effective than potatoes or any other of the homely remedies suggested from time to time.

In the event of ambulances not being needed for 24 hours at a stretch, the engines should be run with muffs down for some five to ten minutes. This helps to keep the battery in trim, as well as warming up the engine and generally freeing the circulation.

Here are a few other points worth rememberino- 'o ·

The regulations regarding the immobilising of v ehicles has resulte d in an abnormal breakao-e of distributor rotors. It is therefore advisa ble toOkeep t wo or three spare ones at each base.

Blankets left in ambulances parked for long periods g et damp. They should not be placed in the vehicles until action is anticipated Keep them indoors. preferably in the warm, at all other time s.

Difficult,r is occasionally experienced in securing stretchers 1n converted ambulances. To the best of my know ledge, there is nothing to beat two leather straps, with two ends screwed to the racks and the other ends twisted round the stretcher handles before being fastened together.

Questions sometimes arise about ambulance crews' equipme?t. Crews should, of cour se, be provided With anti- gas clothlng, and should practice drivino- in respirators and anti-gas gloves (the latter are forgotten). The actual driver, not being expected to leave the vehicle, may in some instances not be issued with a " tin hat," though it is advisable for him to have one.

Other members of the crew will certainl y require helmets, and, with their anti-gas clothing, rubber boots. The driver may find himself handicapped by the rubber boots, and in such circumstances th ere is little need for him to wear them.

War Emergencies

Liq. Sod. Chlorinat. is very caustic It falls in strength hourly and fresh supplies take time and technical skill to prepare. The advantages and economy of a standard, stable, non-caustic preparation are therefore obvious.

Milton Antiseptic is the ideal antiseptic for first-aid use in all crises

There is no mystery about it. Milton is of the same chemical nature as the famous Carrell-Dakin solution that so SWiftly reduced the figures of deaths and amputations (due to infection) in the last war.

Keep Milton handyyou'll need it for CUTS AND WOUNDS BURNS AND SCALDS DEODORISING STERILISING. Personal uses such as SORE THROAT, CATARRH , HEAD COLDS, ETC.

Light

on

the pocket,

too

Milton Antiseptic tS the most inexpensive you can use consistent with efficient results. For most purposes this very powerful germicide is fully effective in dilutions of I in 100, that is, three to a gallon of water, or t a teaspoonful to a tumble

Born during the last war - best during this 7d. 1/2, 1/9 and 3/- a bottle Winchesters at 7/6

..

Ad"anced Training in

By W. C. BENTALL, O.B.E., F.R.C.S., F.R.a.S., Assistant

SU1ogeon-in-Chiej, St. John A1nbulance Brigade

Air 'Raid Precautions

AMBULANCE SERVICES

Continuing the article of last month on Ambulances I h ad referred to :-

1. The Vehicles.

2. Equipment.

3. Personnel.

Vehicles and Equipment were dealt with, and now I pass to Personnel.

3. PERSONNEL

(a) Paid and Voluntary.- There is no ruling- as to the exact number of paid personnel for this service. In general, the number of w:hole-time paid personnel should not be more than is necessary after taking into account the quota of part-time personnel which may be expected to be on dut y at a given time. The necessary measure of continuous manning of wholetime ambulances should be secured to the utmost extent by a rota system of part-time volunteers; the employment of full-time personnel is justifiable only in so far as adequate efforts by the Local Authority to recruit such volunteers falls shott of providing the strength for continuous manning of ambulances by rota.

(b) Depot Supe rin tendents.- Where six or more ambulances are stationed at a depot consigned to the ambulance service, a Depot Superintendent should be appointed to take charge. Details of this appointment are covered in A.R.P. Circular No. 217/1939'

(c) Drivers.-All drivers should hav e taken at least a short First Aid Course and one on gas warfare. Details of advanced training are given under paragraph (g) below. The majority of drivers should be women, but men between the ages of 30 and 50 are eligible for this service.

(d) Ambulance Attendants.-These should be women and they must have taken a full qualifying course of First Aid and a course of gas warfare. Their special function is to supervise the four casualties being conveyed by the ambulance, to supervise their condition or treatment, and to notify the driver if it is necessary to stop for treatment.

(e) Stretcher Bearers. - This is not a recognised service of the ambulances and has caused a considerable difficulty in varying places. Volunteers are

210

generally secured and in some places clergy have been very good in renderin g this service, but it i s an expert service needing drill and practice, so that the patients are lifted in or out accordin g to rule s which give the least disturbance and shock, and p rev ent confusion. Casual stretcher bearer s are a men ace to the patient and .a delay in valuable

(j) Organisation and Administration.-The imme diat e responsibility for this rests on the Ambulance Officer. His efficiency and energy should be consid ere d in such matters as :

(i) Thorou gh organisation of the personnel, e.g., regarding shifts and rotas .

(1i) Keeping of adequate records re perso nn e l, vehicles and equipment.

(iii) Regular supervision of the ambulance stations and planning their routine

(iv) Care and maintenance of vehicles and e quipment.

(g) Tra ining .-The individual trainin g of ambulanc e personnel is full y described in A.R.P. Training Manual No. 2, under Specialised and Advanced Training; the following points call for attention :-

(i) Drivers should be thorou g hl y profi ci ent in detailed knowled g e of the town and district in whlch they will operate. The y should know how to find alternative wa ys if main routes are blocked. There should be organised tests in this aspect of their duties in which th e am bulance attendant s might also be include d

(ii) The training should cover points with rega rd to the servicing and handling of their vehicles. There should be systematic checking of petrol , oil and water supply, and of tyre pressure. The changing of a wheel should also be practised. Rules for parking at a scene of o perations and interference with other cars such a s fire engines, party cars, etc., shou ld be s tudied by the drivers.

(iii) Ambulance personnel should be thorGlughl y familiar with the shuttle system of exchang e as regards stretchers, blankets and other equipment at loading and unloading points. The

BRAND'S ESSENCE

The finest NON-ALCOHOLIC STIMULANT

Throughout the civil medical and nursing professions, and the medical services of H.M. Forces, Brand's E ssence is constantly prescribed for combating critical weakness aris ing from physical or mental exhaustion and shock.

Its uses, when First Aid is rendered to the injured, will be apparent from the following brief summary of its advantages:

Brand's Essence is a NON.ALCOHOLIC STIMULANT. Brand's Essence DOES NOT PRODUCE AN AFTER·STATE OF MELANCHOLIA.

It is assimilated in its entirety, QUICKLY AND WITHOUT STRAIN, BY EVEN THE WEAKEST SYSTEM It not only conserves strength-IT BUILDS UP STRENGTH QUICKLY AND SAFELY.

Its stimulating effect is PRACTICALLY INSTANTANEOUS IT CANNOT CAUSE THIRST.

Be s ur e to halle a supp ly for the trea tment of all cases where a s tin:ula n t is indicated.

BRA N D'S

CHICKEN OR BEEF

E SSE NeE

From al! Chemists in Jars and Tins.

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--EQUIP YOURSELF FOR WAR EMERGENCIES--

Essential knowledge to treat successfully ALL possible injuries

THE HOUSEHOLD PHY ICIAN

A few of the subjects treated at length :WAR EMERGENCIES: PEACE-TIME SUBJECTS: Air Raid Precautions Influenza, etc., Measles, Mumps Catarrh Gas Warfare (Special Chart)

H <emorrhage Corns and Warts

First Aid

Bandages

Splints

Burns

Scalds

Fainting

What to Do in Emergencies Skin Diseases

Hygiene, Anatomy, Pharmacy Homreopathy, Neurasthenia

The Principles of Nursing Child Welfare

375 Prescriptions, etc., etc.

ACCIDENTS-What to do in all cases. HOW TO DIAGNOSE Diseases from appearance of Head, Face, Tongue, Throat, Chest, etc., etc.

THE YOUNG WIFE will find just the information she reqUires

HUNDREDS OF TESTIMONIALS " I have gained 100 % in each of the S test ••• the knowledge of which attribute to

situation of and method of approach to First Aid Posts and hospitals to which casualties may have to be taken.

It will thus be seen that a mere capacity to drive an ambulance by itself is completely inadequate for war-time service without continued practice and training in the above points and, at the present time .of war, much trouble is caused by those personnel who, in peace-time, did not adequately the points as laid down, whereas those who are rendering a service which is part of that great effiClency which has been trained for in all services from the magnificent triumphs of the R.A.F. to the mao-nificent work being rendered at the present time by personnel of the Civil Defence have unfailingly practised with diligence theu dutIes durin g the somewhat boring time of peace.

A.R.P. Questions and Answers

Q. - How are you as a First Aider to know whether a person is suffering from Mustard or Lewisite blister?

A.-As a First Aider, a blister is never seen because it takes eight or more hours to develop.

Q. - How is one to smell gas if respirator is worn ?

A.-You do not.

Q.-Should the blister of Mustard Gas be burst?

A.-Emphatically NO.

O.-Liquid in eyes: Is irritation felt immediately with both Mustard and Lewisite?

A.-Yes.

Q.-If exposed to vapour only without other protection than respirator would a man be blistered from his neck to his feet?

A.-Yes, if no preventive or first-aid treatment were adopted and the concentration were sufficient.

O.-How can one explain the term hydrolysis in connection with the decontamination of Lewisite?

A.-Hydrolysis means the chemical making-up of a substance by water. Lewisite is hydrolised by water.

Q.-Does respirator (Government) give protection against nitrous fumes?

A.-Yes.

Q.-Is a trench a good A.R.P. measure?

A.-Yes, against high exp losi ves.

Q.-Has sea water any different effect on these gases to ordinary water?

A.-Very little, if any. But a swim out to sea in a gas attack is not a bad idea!

Q.-Does Mustard Gas affect the ear in any way? the external ear might possibly be blistered if exposed, no effect on the hearing would result.

Q.-How can you know when the patient has a drop of Mustard Gas in the eye, instead of just vapour?

212

A.-By the immediate pain experienced. No other fmm of Mustard Gas infection produces immediate sympt01l1s.

0.- Would it be a First Aider's duty to open blister of Lewisite in the absence of Doctor?

A.-Yes, if he was a trained First Aider, and stood the meaning of opening a blister with aseptIC precautions

O.-Did I understand the lecturer to say that Bl;;:chino- Powder is effectual against Lewisite as against the book saying that it is no:?

A.-The position is that bleachlng powder IS essential for the decontamination of the effect of Mustard Gas, but for Lewisite it is quite unnecessary as plain water destro ys the effect of Lewisite.

Q. - When you state that Mustard Gas i s cUIl1ulative in effect what intervals are safe? Would doses separated b y, say, four weeks be cumul ative?

A.-A pat ient who received a dose of Mustard Gas havino- had one four weeks before would p robably b react more quickl y and more severe ly to the sec.ond dose than to the first, thou gh thi s is not so se nou s as it would be were the interval only a few days.

Q.-On chart (column 8) C.A.P. marked asLachrymator Skin Irritant. Is latter correct?

A.-Yes, but very slightly so, and only in high concentrations.

O.-If the effect of Pho sgene i s similar to drowning you promote circulati on by rub bin g limbs to heart?

A

.-The similarity of Phosgene poisoning to drowning was made in the description of the symptoms produced known as "water-lo gging" in the lungs, but under treatment great emphasis. ,:",as made on the need of absolute rest, not even nsking artificial respiration becau se of the liability of the heart to collapse. Rubbin g the limbs for the same reason should be absolutely avoided.

Q.-At what heigh t and over is spray!ng .from machine non-effective-that is, absorbed In au?

A. - It depends entirely on the amount of wind, · the pace of the fl ying machine, and the temperature of the atmosphere, and other factors also.

Q.-Would sneezing gases set up injury to th e throat or the nose through excessive strain?

A.-No such cases known to be recorded.

Q.-Has Phosgene delayed action?

A .-In some cas es, yes.

O.-If the tear gas has already taken effect, how can the respirator be put on?

A.- Why not? It would prevent continued weeping and lessen the time that the redness continues, and gives immediate relief.

O.-Is there any kind of sizing material that on"; may paint over porous material like bricks, to keep out Mustard Gas? ..

A.- Waterglass might be temporanly effective; no definite paint has so far been announced as effective.

W.C.B.

A TIMELY REMINDER THAT is slill the mosl economical general anliseptic for domestic use . . .

For hou seholds of moderate mean.s, the inexpensive bottle of Iodine, obtainable for a few pence from any chem ist, is .a sound recommendation for first aid application in minor injuries.

JiVrile for Free Eme?'gency Chart

IODINE EDUCATIONAL BUREAU Stone House, Bishopsgate , London, E.C.2

WATCH YOUR OWN HEALTH!

Be prepared jar excessive strain ALWAYS CARRY A PACKET OF

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REFRESHING

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6d a packet from aU chemists • ASURE PROTECTION AGAINST EXPOSURE

The St. John Ambulance Brigade Overseas

GIBRAL1AR

Contributed by MRS. PIERCE (Lady District Superintendent, Gibraltar)

"It is less than two years since our Nursing Division of 15 members, formed in 1937, grew to two Divisions, numbering altogether 75 members: this does not include about 130 A.R.P. nursing women all trained under the St. John Ambulance Brio-ade. Since the formation of these Divisions they given very valuable assistance to the Colonial Hospital when the staff were depleted there.

"Recently, over the evacuation of women and children to French Morocco the members have done really fine work, and it was no small task, for in all about I 2,000 people were evacuated. Our members were always in attendance on the quay to help the aged and infirm, and the mothers with children, and there were many of these, as well as tiny babies of a few days old. These girls toiled long hours in the hot sun carrying; babies, bundles of every description and kind, guiding the blind, and looking after the pregnant women and helping in innumerable ways in settling the sick in the ship's hospital and going the rounds of the holds, reassuring those nervous apprehensive / people, most of whom had never left the Rock in their lives, far less having been on board a ship.

"In addition to shore dut y six of our members always travelled on board ship for duty during the night. The ship usu$Llly sailed about 6 p.m., arriving at Casablanca about 9 a.m. next morning. I did the trip twice mY$elf and I can truthfully say that in all my nursing experience these nights the most dreadful I have ever known. The people were packed in the holds, usually about 1,000 a time, the portholes closed, as we had to travel in absolute darkness. The heat was intense and these poor evacuees were all very sick, yet wonderfully brave. In the morning the work of disembarking begananother long task. .

"Our members stood up to all this in a very praiseworthy manner. Twenty-two of them were evacuated with the rest, but they continued to work in the camps under our own doctors in French Morocco.

"Again we did useful work over the influx of Briti sh refugees from the South of France. One night 2.40 people were admitted to the Colonial Hospital: their plight was very miserable. Very man y more were housed all round the town.

"There a re now only 15 of us left in Gibraltar, and I am quite certain that other members, wherever they may be, will do their bit when they can."

Owing to the capitulation of France these refugee s had to be taken back to Gibraltar from F;ench

Morocco and re-evacuated from there to England. Members of the St. John Ambulance Brigade again looked after them on these further journeys and accompanied them to their various billets in this country.

On Thursday, August 15, the Hon. Mrs. CoplandGriffiths (Lady-Superintendent in-Chief of the J?rigade Overseas) entertained the members from GIbralta r to tea at St. John's Gate where ,Major-General Si r Percival Wilkinson, Colonel and Mrs. Woolrych Perowne, Colonel Sleeman, Sir Joseph Byrne, Brigadier Barne and Captain Goodley were there to meet them. About 40 members were present, led b y Dr. Durante and Mr. Brew. Members were shown th e Grand P r ior Church, the museum and other items o f interest.

NURSING DIVISIONS

The Lady Superintendent-in -Chief of the Nu:sing Divisions of the St. 10hn Ambulance Bngade Overseas wishes to d raw the attention of all Nursing Divisions to the fact that in future the new pattern hat, as worn by the Brigade at home, will be supplie d in the case of all orders placed in this country. Members in possession of the present type of hats will be permitted to wear them until they are worn out.

Subscribers Please Note!

Owing to the increase in postage rate s, the annual subscription for the GAZETTE will until further notice be 4S., instead of 3S. 6d. Subscribers who do not wish to pay this additional charge should fill in the form below, and hand it to their newsagent.

To

Please order on my behalf a copy of "The St. John Ambulance Gaze tte JJ which I will collect each month.

S igned (" Th e St. John Ambtt/ance Gaz ette JJ is pub/z'shed by Messrs. British Periodicals Ltd., 19, 19a, Cursitor Street, E.C.4.)

Oxygen + CO, or Oxygen RESUSCITATING APPARATUS for the apparently asphyxiated or drowned. SMOKE HELMETS of all Patterns.

'PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

'PURETHA' GAS MASKS for Naval, Military and Industrial purposes and for Civilian use. ALL A.R.P; EQUIPMENT DUST and SPRAY MASKS and all other Safety and Protective Devices.

GORMAN & Co., Ltd.

PRACTICAL BOOKS

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AIDS TO FIRST-AID (7th Ed.)

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THE Sr. JOHN .AMBULANCE GAZETTE is published on the 15th of each month. The annual subscription is 41., post free; single copies 3d Brigade R eports and Pho tographs should be addressed to the Editor, at 32, Shoe Lane, B.CA R ep orts and photographs should reach him early in the month.

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CONTENTS

Editorial

Home Nursing Page

Brigade News

Talks on the Manual

Railway News

Red Cross and St. John War Organisation

Blood Transfusion

Interesting Case Report

Questions and Answers

Brigade Overseas

The Casualty Service, A.R.P.

Priory for Wales

Manchester A.R.P. Casllalty Service

War Hospitals,Temporary Hospitals and V.A D , Emergency Hospitals

CHANCERY OF THE ORDER,

ST. JOHN'S GATE, CLERKENWELL, LONDON, E.C. I.

Red Cross Working Parties

Sir Philip Che t wode, Chairman of the Executi ve Committee of the Red Cros s a nd St. J ohn War Organisation, has written to members of Red Cross and St. ] o hn Working Parties throughout the Empire, t hankin g them for their invaluable wo r k.

Not on ly have working parties at hom e made up garments and othe r hospital stores from materials supplied b y the War Or ganis ation, but t o an ex t ent w hich is not ge nerally appreciated the y have also themselves purcha sed material, made it up, and

presented the completed articles to the War Organisation, when that body, for many reasons, has been prevented from finding the money with which to purchase materials. Overseas working parties have invariably provided their own materials

Thus, in addition t o the gift of service, working parties have cont ributed largely to the resources of the War Organisation by their gifts in kind.

When conve ying his thanks, Sir Philip Chetwode also again took the opportunity of dispelling any misunderstanding which may still exist respecting the supply of material from the Stores Department through the Central Hospital Supply Service to the working parties. Sir Philip points out that the quantity of material which can be distributed by the War Organisation to working parties for making up is dictated not only by finance but also by the limits prescribed by its Constitution upon the activities which can be carried on under the symbol of the Red Cross. It has to be remembered that these activities are concerne d on& with the sick and wounded members of the Forces and with civilians needing relief as the result of enemy action Red Cross material and money cannot be used to supply "comforts" for hale and hearty members of the Forces--excepting, of course, prisoners of war.

The problem with which authorities at the Headquarters of the War Org anisatio n are faced is not the number of articles which can be supplied by working parties but the extent of the demand likely to b e made in the immediate future upon its reserves of stores. If it were to keep the 250,000 members of working parties employed continuously during the hours which they could give, it is certain that a large proportion of its funds would have been devoted to t he purchase of mate rial. But no one supposes that the War Organisation should spend its funds in undue proportion on anyone service. The demand is the governing factor-an d the working parties provide the reserve of labour which the War Or gan isation can caU up on when required.

DOME NURSING PAGE

WHERE THERE'S A WILL. • •

By MURIEL J. L. FRAZER, B.A., M.D., M.R.C.P. Larfy Divisional Surgeon West Belfast Nurs ing Division

This is the story of a "wash-out"; of refugee billets, once ready for occupation to the last cuphook, but which have since been used for a variety of purposes far removed from those for which they were intended. Over the preparation of these billets the Division pondered and debated more about First Aid, Home Nursing, and Hygiene than ever before.

We were asked by the powers that be to prepare for" the impending arrival of a considerable number of Dutch and Belgian refugees of all ages, and for their reception. The Brigade therefore agreed to be wholly responsible for a certain number of billets. It is about one of these billets that this article is written.

Our potential billet was a large warehouse, four stories high, one huge room and one toilet on each floor. Accommodation was required for numbers estimated at between 150 to 240. The official supplies consisted of straw palliasses and blankets. When it was decided that all cooking must be done on the premises, two boilers and a gas cooker were added. The rest was up to us. Our temporary motto was" Scrounge all possible."

The ground floor was fitted up for domestic and messing purposes. One corner was sheeted off as a kitchen, part of which was sub-divided and fitted as a pantry. Trestle tables, forms and chairs were borrowed. The walls were brightened with posters given by travel agencies. The windows, blue-painted by the powers that be, for the "black-out," were furnished with thi ck curtains, and then cleaned. A large amount of crockery was obtained by means of a super-scrounge from a generous City hospital, the rest was brought by friends. Ultimately we had all conceivable neces;sities-even luxuries, such as fruit salad glasses !.

The dormitories were at first utterly bare except for the stacks of mattresses and blankets and the dust of ages . Scrubbing was the order of the day. The floors were then covered with thick brown paper where the mattresses were to go, the boards between the rows of beds being left bare so that they could be scrubbed regularly. No pillows had been provided, but they were quickly made. One end of each floor

220

was screened off for washing and a long shelf with a row of basins was fitted up.

So far, we had had a plain housekeeping job. Bu t some problems still remained, namely, protecti o n from fire, treatment of minor ailments, and prevention of epidemic disease. We decided that thes e could be solved only by keeping an adequate nursin g staff on duty-it must be recalled that our expecte d guests would know very little English, and that the y might not be keen to admit illness for fear of bein g carried off to the unknown terrors of hospital!

We arranged, therefore, to have four Ambulanc e Sisters on duty both day and night. A corner of th e first floor was sheeted off and furnished as " du t y room." One nurse was to be on each floor and on e " off duty" so that the actual working hou rs woul d be eight hours on and four off. Each nurse was t o have a whistle to her uniform for use in case of an outbreak of fire. (This seemed the bes t method of ensuring that an alarm could never b e raised by any unauthorised person). In th e event of a fire, the nurse on the affected floor would blow her whistle-once for the first floor, twice fo r the second. The three nurses would then see tha t everybody left the building, the first floor by the fron t stairs, the second floor by the back stairs, and th e third floor by the fire escape. The nurse" off duty " would run to a nearby alarm and summon the Fire Brigade. Plenty of fire extinguishers were available .

Medical and nursing care was to be provided b y arranging for a Divisional Surgeon to hold a Medical Inspection daily, and for simple treatment to be carried out by the nursing staff. Accommodation fo r the Surgery could only be found in what had be en a cellar under the stairs. Unpromising at first, it wa s cleaned and whitewashed; carpenter friends put up shelves, a poison cupboard, and a counter on which to set out lotions, instruments, etc. Lotion bowls, jugs, and a steriliser were all fruits of the "super scrounge" -they were hospital " condemns" rathe r chipped, past their first youth, but still perfectl y serviceable. Dressings were sterilised in seven tins , each holding what we thought would be enough for a day's work. As one tin was used it could be repacked

and sterilised, thus avoiding the risk of contamination of one large drum holding a week's stock.

The problem of infant feedin g was to have been dealt with by a Divisional Surgeon and Nursing Officer, their tasks being respectively to advise suitab le feeds, and to supervise their preparation.

The prevention of infection was perhaps the most serious problem of all. The refugees were supposed to be medically in spected on arrival, but it was always pos sible that one or two early cases might be missed. Skin diseases and insect pests we hoped to deal with by stencilling numbers on mattresses and pillows, and by giving each refugee a label bearing the same number as her bedding.

Other infections of which we were most afraid were cerebro-spinal fever' (meningitis)-always a risk in overcrowded sleepi n g quarters - and typhoid fever, which was at that time rife in Holland.

The overcrowding problem was partially solved by putting pillows at opposite ends of ad jacent mattresses so that the risk of breath-borne infection was diminished. The risk of typhoid was avoided by rigorous inspection of the toilets, by doing all the cooking oUIselves so that no refugee should handle the common food, and by boiling all dishes and cutlery after each meal. The voluntary workers were to wear overalls over uniform, to be very particular about their hands, and to keep strictly to their own china, etc. This was insisted on, so that no infection should be carried to the homes of workers.

It was therefore with a certain confidence that we waited the moment to see our plans in actual practice, a nd though our disappointment when the German drive to the ports prevented the embarkation of our re fugees was dwarfed by the greater horror of that black week, it was none the less keen.

Looking back, however, the whole experience was most profitable. It taught us to surmount difficulties, t o solve problems, to improvise equipment. Above all, it taught us, by the ·unselfish help we had from other divisions, what a real bond of union there is between all members of the Brigade.

OBITUARY

The Chief Commissioner regrets to announce the deaths of Lady District Superintendent Mrs. Maund and Divisional Superintendent A. J. Davies of the New South Wales District, Australia.

Mrs. Maund, who was an Officer of the Order, had been in charge of the Nursing Divisions of the New South Wales District since the year 1933, while Mr. Davies, who joined the Lithgow Division in 19 1 7, was a Se1'Ving Brother of the Order and holder of a Service Medal and two bars.

The decease of these Officers is much regretted, an d their loss will be greatly felt by the New South Wales District.

The St. John Ambulance Brigade News

No 3 (EASTERN) DISTRICT

TWYWELL

Twywell ambulance and nursing divisions were recently inspected b y the County Commissioner, Dr. L. W. Dr ylan d, D.L., who also presented service awards to some of the members.

The Commissioner congratulated the ambulance division on the fact that he had not previousl y had the pleasure of presenting service awards to so many men of a division on one occasion, and he trusted they would continue their work with the enthusiasm which had been so marked in the past. The County Di visions, he said, had supplied men for the Royal Naval Sick Berth and Military Hospitals, also for the R.A.M.C., and they were serving all over the world . The work of the Twywell Division at home (four members have joined the Forces) was particularly important, as most of the members were connected with the ironstone mining and smelting industries, and their ambulance training stood them in good stead daily.

The Twywell ursing Division was under the direction of the Lady Superintendent, Mrs. M. Tiney.

NO.5 DISTRICT

The personnel of the Clifton (York) Ambulance Division, formed only a few weeks ago, numbers 4 2 The Right Hon. The Lord Mayor of York is President of the Division. Dr. A Pool is Divisional Surgeon. The Officers, recently examined by Dr. E. Lodge, County Surgeon, are: Male Nurse W. Dearlove, S.R.M.N., Divi sional Superintendent and Mr. F. Searson, ex-P.O., R.N.S.B.R., ambulance Officer and A. R.P Instructor.

The headquarter;; of the Division are at the Congreo-ationa l Church, Burton Stone Lane, York, b where 18 months ago a Cadet Dlvlslon-no'\\numbering 65-was formed.

No. 8 (DUKE OF CONNAUGHT'S) DISTRICT EAsTBouRNE

Mrs. Forbes, the officer-in-charge of the Eastbourne N ursin 0- Division, speaking at the Ann..ual General of the strength and work of the Divisi on, b sai d that the number of nurses was now S1::»:ty-three

22.1 and that twenty more would shortly be joining. Twenty nurse s and one cadet won medallions this year, eight their pendant and label, and were entitled to a stripe. The training classes in first aid and home nursing had been carried on a break. Besides taking classes in various parts of the town, the Division had trained 386 students at their headquarters in twelve months.

Mrs. Forbes thanked the nurses for their loyalty, courage and devotion to their work.

TALI(S ON

By the late

Dr. A. T. Lal;'in, M.B.

.THE MANUAL

(Continued from page 190, August issue)

(c) Questions

Questions are an important part of competition work and the most frequent cause of lack of success so they should be well practised, not only in aiving correct answer, but in the manner of In order there may be no vain repetitions or waste of tIme.. At t±:e end of each chapter in the Manual IS a senes of questions. Work them out and WrIte down the answers in your notebook and then correct them. Do not work them out in your he.ad. for thereby you will deceive yourself Into- believmg you answered some things that you know very little about; the written answer wIll prevent such self-deception absolutely and will be wholes.ome self-discipline. When the answer is correct, out the important points and tabulate the answer m the notebook. Thus:-

HELP AVAILABLE. There can only be threeBystanders, Doctor, First Aider.

I. - Bystanders.

(a) At the scene of the accident.

(b) Near the scene of the accident shouting distance).

(c) Are they First Aiders ? Yes. No.

2. First Aider. (Me.) I have got common sense and knowledge, therefore, I must-

(a) Use in the use of bystanders.

(b) Be explicIt m gIVIng them instructions, and (c) Be tactful so that I can get the best help from them.

3. Doctor. Onl tw thin -b y 0 gs POSSI Ie-discrimination needed.

(a) Sen<;ling for. (Written message signed.)

(b) Taking to. (Report; care during tra1ilsport.)

In this you w.ill obtain not only the answer to questIOn but also a connecting link with your practIcal work .and the reason why certain things are clone. Durmg th.e study of the Manual it will be to make lists of various conditions. In dealing With general and descriptions, adopt a general plan and stIck to it for everything

222

and always take them in the same order. The order I adopt is:-

Head.-I, Back; 2, Front.

Trunk.-I, Back; 2, Front.

Limbs.-I, Upper; 2, Lower.

A definite... order always and always in the same order. !he reason why the bac k comes first is It may be overlooked, so put it first and make certam. Head a page of the notebook THE PULSE -and place here all the varying conditions and their cause.

THE PULSE Pulse absent.

Pulse slow.

Pulse quick.

Pulse feeble. Pulse irregular. Death, sometimes in Collapse. Hremorrhage from an Internal Organ.

Compression. Apoplexy Sunstroke. Syncope. Concussion. Shock. Collapse.

Danger of the heart failing altogether.

Complete the list and, in similar fashion list

Breathing, Eyes, Mouth, Blood from Mouth Temperature, degree of Unconsciousness, etc. Keep a watchful eye on the correspondence columns of the GAZETTE _ and copy _into the notebook the many helpful hInts you WIll find. A precis or extracts from the articles will be found very useful

The great secret of -?ote making is to make the note as soon as you. think of it, using any scrap of paper handy, then thmk about it and make the entry

In notebook later; if you defer or neglect the wntmg down, are sure to have forg0tten the note :v?en you wls.h to recall it. The simple act of WrItIng down WIll tend to make it stick in the memory once it is written down, it is yours for ever. ThIS may seem a lot of unnecessary work there are so many useful books of reference avaIlable, and all 0e facts are already in the Manual. The answer to thIS objection is that the facts are not of any use to you if they remain in the books and the best way of making them available for use is to get

them into your brain by way of the notebook and to the facts scattered throughout books by hstmg them under their proper headings in the notebook and making an entry in your index with cross references to the Manual. (I use " M " for Manual and " N " for notebook.)

It is worth-while work, for it is helping you to make the of and you are steadily and systematically buIlding up a splendid book of reference suitable to your own special needs, ready easy :-evisio? and help at any time you may need It; and If, by ItS use, you are able to help others that is an added advantage. One hour a day fot month will be sufficient to answer, correct and list the answers to all the questions in the Manual. There is also this big advantage for competition work: practice in writing down the answers to questions and the answers aloud will help you to answer questions properly. Use your hand s a1l: d fingers to check the separate headings; this WIll make you concentrate on the answer as well as assisting the memory and abolishing nervousness. "Name the varieties of fractures?" You know there six, so tell them off on your fingers; then you WIll be quite sure when you have named all of them. "Trace the course of the circulation from the left ventricle to the tip of the left little finger." In answering this type of question, actually trace the course on your body with you r finger and then you will be quite sure that nothing has been omitted. I do it regularly and find it of grea t help. I do it openly when lecturing, but .and. under the marking sheet when examinmg or Judgmg; then I am sure whether anything has b een omit ted or not, and if I find it helpful, then I am jolly sure that it will help you too.

RAILWAY NEWS

Southern Railway

Contribute d by "Exo "

Successful candidates of the Charin a Cross and Hither G.reen Ambulance Classes (T raffic and Loco. Departments) were presented recently with awards by Uzzell, who also made a specia l appeal to the WIves and dau ght ers of the staff to attend the for thcomi ng season's classes.

Mr. (Welfare Officer), after thanking Mr. Bassett (Statton Master, Charing Cross) and Mr. Scribbens (Class Secretary) for the work they had done, congratulated members of both classe s on success. He urged the necessity for more firstalders at the London Termini, and said there was room for more support from inspectors and other members of the supervisory o-rades throuahout the b b company s system, and that he felt his remarks would be appreciated.

223 LANCI G

Sixty-nine certificates were recently presented to members of the Lancing first-aid class by the Assistant Works Manager (Mr. F. B Ills ton), who congratulated the class on their excellent progress. Mr. A. Packham received the Certificate of Merit. REDHILL

The annual presentation of award s to members o£ the Redhill first-aid class took place recently. Mr. H. Honneybell (Class Secretary) gave his rep ort on the working of a most satisfactory session

Mr . Uzzell, conveying the appreciation of the Directors and the General Manager on the successful efforts of the class, referred to the work in the S.R. Centre and the desire that its activities should be increased at every station, every depot and in every place throughout the line which is one lon g battle front.

London Midland and Scottish Railw-ay Contributed by GILBERT

S. HILL

The following is an extract from the annual report of the General Ambulance Secretary on the work of ambulance movement in England and Wales for the 1939-40 session.

The result of the year's working shows a decrease of 54 8 in the number of students passing for examinations which ma y be regarded as satisfactory having in mind the conditions pre vailin g since the outbreak of war_

Every effort should be made to continue existing classes and organise new ones wherever there are prospects of fresh interest, and all possible assistance will be given to this end

During the past twelve months ther e have been man y instances of first aid of exceptional nature rendered by the staff. These are greatly appreciated and have been considered on thei r merits. There have been four awards of the Merito rio us First Aid Certificate.

The generous assistance provided by the raihvay company.in connection with the general organisation, long-servIce medals and bars, and the additional free tickets, etc., have been greatly appreciated by all concerned. And I would again pay tribute to the courtes y shown, and assistance given, by the officials of the St. John Ambulance Association and the Prior y for Wales.

Thank YOU! I

'Thanks to The British Navy, The R.A.F. ! and the British Merchant Navy this Journal is on sale throughout the British Empire; at the - same price. We 'are relying on you for one new reader this month. Thank YOlL

Red Cross and St. John War Organisation

(Continued from page 20I, September issue)

WINTER CLO T HING

With reference to the article published in THE GAZETTE last month, relating to parcels for prisoners of war, relatives will be pleased to learn that the Prisoners of War Department, in order to ensure that every prisoner shall have wa r m clothing before the winter, is arranging to send in bulk to the camps supplies of the necessar y garment s Blankets, toilet accessories. towels, handkerchiefs, and boots and shoes are also being sent in bulk.

PERSONAL PARCEL S

The personal parcels service by which next-of-kin send a quarterly parcel of clothing and other articles is still suspended. It is expected that this service will be re-opened shortly. In the meantilne relatives should not send parcels of clothing or other articles for prisoners of war to the Prisoners of War Department. The bulk supplies mentioned already should meet all immediate needs for clothing and toilet requisites.

OVERSEAS GIFTS

In one fortnight over 60,000 gifts were received from home sources, as well as I 8,788 from overseas. The largest consignment, which numbered 6,758 articles, came from Hawaii. Tsingtao in Northern China sent 2,406. Durban, Bloemfontein and Fort Elizabeth, South Africa, presented some 2,580 gifts. Approximately 2,500 gifts arrived from various parts of South and Central America-Chile, Peru, Panama and Costa Rica. The remainder of the gifts were dispatched from Oporto, Caliprina, Ceylon, New York and the New Hebrides.

FROM CA-N'ADA

The Canadian Red Cross Society, through its Overseas Office in London, has offered the War Organisation, for food parcels for Prisoners of War, considerable "quantities of tinned foodstuffs which it has on hand in this country. The offer, which is a most generous donation, has been very gratefully accepted by the War Organisation. The supplies include· quantities of beef, butter, jam, peas, pork and beans, sugar, sardines, tomatoes, soups, pears, peaches, other fruits, cocoa, coffee and "kippered snacks." They were originally intended for parcels for Canadian Prisoners of War but have not been required.

CANADIAN PACKING CENTRE

An interesting development is taking place in the dispatch of parcels of food to British prisoners of war in enemy hands. Colonel George Nasmith, the Canadian Red Cross Commissioner in London, has arranged for food parcels to be packed and dispatched in Canada to the number of five per week.

224

Mrs. Coste, who has been acting as chief packer at St. James's Palace, London, and who is a Canadian by birth, and herself the mother of a prisoner of war, has left for Canada to take charge of the packing and dispatch of food parcels in that country.

Since the information upon which this news was based came to hand, Colonel George Nasmith has received a cable saying that the Council of the Canadian Red Cross Societ y has unanimously and enthusiastically agreed to pack ten thousand prisoners' parcels a week and completely to meet the cost.

I TS BENEF ITS

This generous undertaking is far beyond that which the War Organisation suggested. In fact, it is twice the number of parcels, and the offer to meet the cost is a wholly spontaneous act on the part of the Canadian Red Cross Society. Much more relief arises from t his assurance than appears on the surface. As we all know, there is difficulty in obtaining tins, cartons and packing materials at the present timeand, in view of the journey which prisoners' parcels have to make thorough and careful packing is essential. These troubles are avoided by packing in Canada.

DOLLA R EXCHA GE

Further, much of the tinned contents of the parcels originates in America. Time and handling is saved by their direct dispatch to prisoners in ste ad of consignments being first sent here in bulk, then unpacked and stored, and then repacked for the prisoners' parcels. Finally, the arrangement with the promise to meet the cost is the more welcome since it disposes of the difficulty of the dollar exchange. By its action, the Canadian Red Cross Society has lifted a load of anxiety from the shoulders of the War Organisation.

CONVALESCENT HOMES

Accommodation for half of the first ten thousand beds in Convalescent Homes has been approved, and of this portion half are in process of being equipped. The War Organisation has been invited to provide convalescent accommodation for the trained nursing staff of the Army. A visit to the special Convalescent Home for head cases showed everything to be in working order. It was noticeable that the Occupational Therapy and Remedial Gymnastic Departments were proving to be of very good value. The patients who were seen at work in these departments seemed to be deriving great benefit therefrom.

CHANGE OF ADDRESS

The Hospitals and Medical Personnel Department has moved to 2, Grosvenor Crescent, London, S. W. I. The Department's telephone number is now SLOane

7 I 75·

THANKS

General de Gaulle has written to Captain Malcolm Bullock thanking him for the books which have been supplied by the Red -Cross and St. John Librar y to French soldiers in hospital in this countr y General de Gaulle wrote: "Please allow me to congratulate you on the excellent work you are doing, and to thank you on behalf of my fellow-count ryme n for your kindness towards the sick and wounded.

" We will not fail to let you know if there i s any French Hospital or Convalescent Home which ha s not received any French books, and also if there are any isolated convalescents who are in need of literature. I feel sure your books are very much appreciated by my unfortunate compatriots."

BUCK S WAR WORK

To collect the balance of the sum required for a quarter share in the purchase of a mobile X-ray Unit is reported to be the immediate aim of the Buckinghamshire Branch of the Biitish Red Cross Society. It has already sent £ 500 to this object, so the balance should not be difficult to raise . The Branch ha s already presented an ambulance and is contributing £IO a m on th towards the fund for Prisoners of War in Buckin g hamshire unit s of the Forces.

In addition, the C.H.S.S. in the cou nty has provided 124,000 hospital garments, supplies and comforts, and has a lso made up 21,430 articles from materials supplied b y Headquarters Three small depots have been set up so that hospitals in the county can be easily supplied in the event of transport difficulie s.

R ED CROSS SHOP

In Cambridge, Detachment members and their friends staff a Red Cross Shop from 9 a.m. to 6 p.m. The sales are varied-from jewellery and antiques, for which up t o £15 has been receive d, to fres h fruit and vegetables sold f or a few pence. By far the larger part of the receipts have come from the sale of articles of 5s. and under.

OTHER ACTIVITIES

In a town in Hertfordshire, the officers and members of Det achments organised the co llecti o n and sorting of salvage. In a very short time over £800 has been realised. The local authority has now taken over! Help with evacuees from Gibraltar has fallen to some Detachments of the Home Counties and they are finding it most interesting. Other Detachments are staffing a Sick Bay and a Fir s t Aid Room at a centre occupied by French seamen.

BOOK GIFTS

- Queen Mar y has sent a further gift of books to the Red Cross and St. John Lib rary Some 47,000 books, magazines and illustra ted papers were received by the London Headquarters durin g the past two weeks. There is still a dernand f o r books for Dutch and Flemisb patients.

Over 17,000 books, magazines and so on were dispatched from the London Headquarters, including twenty cases to a Middle East depot. Other consign-

ments included I 10 parcels and five cases to Home Civilian and Service Hospitals, and ten parcels and thirteen cases to County Dep ots VISITS TO COUNTY D EPOTS

With a view to making personal contac t with organisers of County B ook D epots, the Organising Secretary has recently v isited Bedfor dshire, Warwickshire, North Staffordshire, Norwich and the Chatham district of Kent. In three of the counties-namely, Bedfordshire, Staffordshire and Warwickshire, an additional book depot is to be established. Twentyone hospitals were visited and in nearly all of them arrangements were made for the appointment of voluntary librarians.

TR AIN NG LIBR AR I Al"fS

Training is essential if the voluntary librarian is to be successful in his or her job. It is now possible to secure the necessary training, as nearly every county has it s own training centre or one within easy reach. Excluding the well-known London centres, th e re are 29 training centres in the counties and additiona l ones w ill be established shortly. There are also 17 Hospital Library Organisers outside Lond on who ar e willing to give instructions.

Cou ! IT COLLECTION S

Many County D epots hold lar ge stocks of books which will be available to meet future demands. In the last six months these depots have collected 221,947 bo oks-this i s not a final figure as reports have not ye t come in from a number of depotsand, have dispatched about 99,770 books.

FOREIGN RELA TIO 's

The British Section of the Foreign Relations D epartmen t is fully occupied. A considerable number of B ritish subjects in France and in occupied territory have been traced. A good deal of correspondence usually arises in connection with each case as it is possible to arrange for financial assistance .to be given Th e French Section is now having satisfactory results as replies to enqtliries are being received daily from the International R ed Cross Committee. There has been renewed activity in regard t o Belgian enquiries Dutch enquiries are now almost entirely dealt with b y the London Committee of the Netherlands Red Cross. The Polish Red Cross Central Committee has sent parcels of winter clothin g for dispatch to Polish prisoners of war.

EDUCATIO JA L ApPEAL

The E ducational Appea l Section reports that to the end of August receipts from schools and colleges reached the total of £20,688. A large proportion of this sum has been received from elementary schools which have devised many methods of raising money. They include concerts, plays and other entertainments, the sale of articles made by pupils and of the produce of school gardens. Some schools have sent contribution s of money which would otherwise have gone on prizes. And mone y earned b y personal services, such as cleaning motor cars and bic ycles and by working in the fields, has been recei ve d

Blood Transfusion

By SIR UPENDRANATH BRAHMACHARI, Kt., M.D., Ph.D.

We publish belmv a" talk 11 by

by the

Sir Upendranath Brahmachari, Kt., M.D., Ph.D., recentlY broadcast

All-India Radio, Calcutta. The stlbject is one of vital importance at the present time

I wish to have a talk with you about what is known as blood transfusion for the relief of human suffering.

By blood transfusion I mean the injection of blood of one person into the veins of another person. It is indicated for the relief of certain forms of human illness, for instance, when a person is suffering from severe loss or want of blood due to disease or accident. We know quinine can cure malaria, antimony can cure kala-azar, but there is no medicinal treatment for certain types ana::mia except by -means of human blood. Unfortunately there is at present little or no properly equipped central organisation in Calcutta or perhaps in the whole of India for the mitigation of this condition which is the subject of my talk this evening, namely, " Transfusion of Blood in certain forms of ancemia, due to disease or loss of blood due to accident, or disasters due to war.l1

The Imperial Serologist has pointed out to me that at present he supplies blood donors to hospitals. This has been done by him in Calcutta for many years on a scale which is not large enough for Calcutta. Further this is entirely outside his work. The demand on him for blood donors is getting considerably greater than the supply at his disposal and in many instances requests for their supply have to be refused. In fact the demand for blood transfusion has very much increased in recent times.

There are arrangements in a few hospitals in Calcutta for donors whose blood may be available when needed for their relations or pa.id donors and their number must naturally be very limited. In most of the other hospitals no such service exists. A general hospital can hardly be expected to make out a complete list of unpaid donors from all over the city, whose blood has been or can be immediately grouped and who can be called u.p in time of emergency. Furthermore no hospital or laboratory in Calcutta has a Blood Bank for storage of blood for transfusion when an emergency occurs. To meet these difficulties there should be an institution where a list of donors from all over the city may be available and where there is provision for storage of blood for transfusion. I consider that ordina1iily such an

institution should be in intimate touch with hospitals as far as possible. We also intend to provide the list of donors to the hospitals and, if requested, to the consulting physicians, surgeons and obstetricians of Calcutta.

As Chairman of the Bengal Branch of the Indian Red Cross Society, I venture to issue this appeal to the public to enlist their active co-operation in a scheme of Blood Transfusion Service which this Branch has recently inaugurated in Calcutta. It is a purely voluntary organisa tion on the lines of similar services run and maintained by the Red Cross Societies in most of the grea t countries of the world. It is admitted on all hands that such a service under the Red Cross Society is of particular importance which would meet a real need for giving aid at all times to suffering humanity, especially in disasters due to disease or accident and would also give occasion for close contact between the Red Cross and the hospital organisation.

There must be hundreds of persons among us who would be only too glad to spare a little of their own blood, if thereby, they could help to save the life of a fellow-being. Many of us have perhaps known of cases of friends or relations whose lives were saved by a little blood transfused into their body. Others among us have perhaps had the terri-ble experience of the loss of some near relation whose life could have been saved by the timely administration of a little healthy blood. Many of us have perhaps a sincere desire to benefit our fellow-beings in an unassuming manner by the gift of a little of our blood to a suffering patient which sometimes acts like a miracle.

No proper system exists at present in Calcutta for enrolling or maintaining a list of voluntary unpaid donors pf blood and yet it is obvious t,hat through the lack of such information available and ready to hand in an emergency, a doctor must stand by helpless when by transfusion of a little human blood he could probably bring back to life a dying patient from death's door. Be it a woman gasping for breath on account of severe ana::mia during pregnancy or bleeding at child-birth, or a man collapsing from from an ulcer in the stomach or a

wounded artery due to an accident in the street or an air raid over the civil population of a country or a bullet wound in the fighting line in times of war, experience has shown that the transfusion of blood in such cases acts like a charm. "Blood, blood, anything for a little blood to save a life"-has not a doctor sometimes exclaimed to himself!

Blood may be supplied to a patient directly drawn from a donor, who may give his or her blood immediately for a relation of his or hers, as the case may be. Or a voluntary donor may give his or her blood for any patient when required. Before the blood of a donor is used his or her blood must be tested to determine whether it is compatible with that of the recipient, the patient, and sometimes the blood of a donor may be found incompatible with that of the patient. Here comes the value of stored blood.

THE NEED FOR BLOOD STOR AGE -BU)OD BANK

Let me give the following example :-Mr. X comes to give his blood for the treatment of his wife in an extreme emergency, but it is found that their bloods are not compatible with each other. No other donors are available at the time. What is to be done? Some suitable blood may be available from a blood storage known as "Blood Bank," where the blood of a safe universal donor has been kept stored. By a safe universal donor is meant one whose blood is compatible with that of any other individual. Or the blood may be obtained from that of A, B, C, or D, etc., which has also been kept stored in the "Blood Bank." These samples of blood were taken from the donors for the treatment of their respective relations, but having been found incompatible, have been kept in the "Blood Bank" for use in some other case. Some of these preserved bloods may be found after examination to be suitable for Mrs. X, and thus a disaster is avoided by giving it to her immediately on the spot.

I have given the above example in detail showing the utility of preserved blood, because many members of the public may not know that all samples of blood are not compatible with each other.

It will be seen from the above, that only stored blood can definitely solve the problem of supply of suitable blood in many cases. In brief, the advantage of a "Blood Bank" is that while donors may not infrequently be difficult to find, especially in cases of poor patients, stored blood is easily available at short notice. Some observers consider that the length of time during which stored blood may be utilised is about ten days Others hold that the period of therapeutic usefulness of stored blood , may continue for even thirty days.

Broadly speaking, the functions of a Blood Transfusion Service should consist, among others, of three parts :-

(I) of voluntary donors, grouping and examination of their blood, keeping a list of donors

whose blood may be available in times of emergency; (2) keeping a list of donors whose blood has been grouped and tested; and (3) maintenance of a " Blood Bank " for the storage of blood to be used when no suitable donor is immediately available for a patient who is hovering between life and death. It is our object to comply with the above require. ments, and early arrangements are being madt by our Blood Transfusion Committee which has been recently organised by our Branch of the Red Cross Society and has already succeeded in getting sufficient funds from the generous public to carr yo n the work, for the first two years in Calcutta. Our" Blood Bank » will be the first of its kind in the whole of India. Our donors must for the present remain unpaid till the time comes when we are in a sufficiently sound financial position to pay for donors. ( To be continued)

A South African Morning ,Market

Lieut.-Colonel F. W. SMYTH, Secretary S.J.A.A., Transvaal Centre

Recently in the vast main hall of the Central Station at Johannesburg, the combined efforts of the St. John Ambulance Association, Transvaal Centre, the South Afri can Railways Di strict and the Transvaal District of the St. John Ambulance Brigade were concentrated to raise funds for the Order of St. John by means of a Morning Market.

Fruit and vegetables of all kinds came pouring in from every direction, often from the most unexpected places. In Johannesburg sweets, jams and honey were among the produce donated in unrestricted quantities.

At a coffee stall run in conjunction with bottled provisions £400 was raised. A" White Elephant" stall also raised a considerable sum. £400 was taken at the Flower Stall. The sale of sweets and honey produced nearly £600. A stall-holder telling fortunes by teacups at 6d. a time raised £20.

These brief details give some idea of the effort made and the support received in organising this great undertaking. An d the co-operation and assistance given by the General Manager of the railways and many members of the staff contributed greatly to the success of the "market" and enab led us to raisein one day between the hours of 7.30 a.m. and 3 p.m. -the magnificent sum of £2,400, and made it possible for us to cable immediately £ I, I 00 to London for the provisio n of two ambulances for Expeditionary Forces.

2.27

[ Interesting Case Reports

CASE REpORT No. I69.-The Officer-in-Charge of Midland Area, West Riding of Yorkshire, reports the efficient performance of first aid by a member of the Victoria Nursing Division in the following circumstances :-

At 9 a.m. on July 23 a window cleaner fell through a glass roof at a house in Leeds, receiving injuries to face, neck, arms and legs. Ambulance Sister ]VI. Woods, who lives on the premises, was called at once; and noting the profuse bleeding from both arteries of the arms, she forthwith applied a tourniquet to each bractoral artery. She then dressed the numerous wounds as quickly as possible and sent for an ambulance in which she accompani ed the patient to Leeds Infirmary, a short distance away. The patient was admitted and had 15 Q stitches and 16 clips inserted in the many lacerated wounds of face, neck, arms and legs. Later he was discharged with both upper limbs in plaster of paris and is making good progress.

COMMENT.-It i s bryond all doubt that in this instance prompt action in controlling arterial bleeding re sulted in saving life. In these circumstances, we tender cordial congratulations to Ambulance Sister Woods on her prompt and successful treatment of a severelY irgured patient .-

N. C. F.

Questions and Answers

SHOCK FROM ABDOMINAL INJURY

P. S. (Cardiff).-Please tell me what happens and how we should treat a patient who is "winded" as the result of a violent blow in the pit of the stomach.

The condition of " winding" is om of shock resulting from abdominal itijury, which causes irritation of the sympathetic nervous system, and especiallY that part of it which is called " the solar plexus" and is situated in the region of the pit of stomach. In other words, it is, as the Textbook tells you on p. 43, "a condition of sudden depression of the nervous system 1'e sulting from and occurring after every case of accident or sudden illness"; and it may last onlY for a few moments or may develop into collapse.

The condition of "winding" usuallY res?,tlts from a sharp and sudden blow on the abdominal ')JJall, as by a fasttravelling football, and causes a temporary stoppage of b1'eathing which (fortunatelY for footballer s) is usuallY transient. The latter is a reflex effect of the abdominal i1!Jury,. and as the most marked symptom, it its name to the condition which may vary from a temporary incapacitation to a fatal syncope, the latter often without a?!)l apparent lesion

In these circumstances treatment should be as for shock as laid down in Chapter IV of the Textbook.-N. C. F.

228

TREATMENT OF FRACTURED CLAVICLE AND ARM

G. C. (Belfast).-Recently at a Divisi onal Practice, we took an imaginary case of simple fractures of the clavicle and of the upper third of humerus on the same side.

In the treatment of this combination of injuries some clail'l1ed that the latter was the more important and suggested that we should apply a Bat pad and broad fold bandage Others held that the clavicle should be given prior consideration, but suggested that the pad used for fractured clavicle would affect the upper end of the humerus and cause further aggravation of the latter injury.

It was thought rather an interesting problem and I shall be g lad to know how you would suggest that the patient should be treated.

TY/ht'le I agree that the fractmred arm is the more important injury from the first-aid standpoint I consider that the decision as to treatment depends on the degree of shock present.

If shock be mild and the patient a zvalk/ng case, thm I should content J7!),selj by flexing the f01 rearm at right angles to the ann and then fix ing the upper limb firmly (but not tightly) to the trunk with broad bandages round trpper end of humerus and round elbow. On the other hand, if shock be marked and the patient has to be removed on stretcher I should keep the il'[jured limb extended alongsIde and in close contact to the patient' s body by means of t1,vO broad bandages applied firmlY round arm and foreal'lJJ. -

N. C. F.

TREATMENT OF HEAD INJURIES

P. P. (Coventry) .-Recently we had a discussi on as to the use of smelling salts and more particularl y as to their use with cases of injuries to the head. Some of us were of the opinion that they should be withheld, but we could not give the reason In our difficulty we turn again to you and thank you in anticipation of your kind reply.

Smelling salts have a true stimulating effect on the brain centres though the nerves of smell. Cons equentlY zvith all head injuries, in zvhich hcemorrhage of the brain may or mqy not be present, thry should always, in 117y opinion, be withheld because thry zvill certainlY cattse a rise of pressure zvithin the skull and thry might agg1ravate (and even precipitate) compression of the brain. - N. C. F.

TREATMENT OF I NFANTILE CONVULSIONS

M. G. (Finchley).-The Textbook on p. 162 tells us under treatment of child in convulsions that we must " support" it in the bath. Please tell me why this must be done and what is the best method of doing so.

The child is to be supported in the hot bath because, being in a state of convulsion, he (or she) might very easilY become immersed and perhaps aspf?yxiated. As to method of support, z't is easier and safer to hold the child with one's hand in the armpits (and so ensure cove1ri ng the whole of the body up to the neck as laid down in Textbook) than round the middle of the boify, 7vhen the child's boc/.y and the first-aider's hands mre rendered slippery 'by contact 1JJith water.-N. C. F.

The St. John Ambulance Brigade Overseas

The Lady District Superintendent for Natal, South Africa, Mrs. Smiley, reports efficient rendering of first aid by a member of tbe Durban Centenary Nursing Division in the following difficult circumstances :-

" A European man was working on the roof of a theatre when a spar broke, drivin g a steel spike into his forehead and severing the temporal artery. Hi s Native assistant cried out for help. The call attracted the attention of Miss P. Horne, who lives nearby. Hastily collecting her first-aid case she hurried to tbe scene of the accident. In order to reach the patient she had to climb a narrow ladder to the roof

" Our chief work lately has been in preparing and allocating medical and other stores for Aid Posts. "Storage is always a problem in this humid climate, and simulated equipment has been used at all black-out practice s till now, but we are about to equip the Town Posts properl y and our officers will be respon si ble for airing everything. We have a standard position for all articles and each member ha s a list of these so that they can lay their hands on them at once in an emergency. All Divisions have or four practices at a Model A id Post with this In VIew

" About 20 of us are Anti-Gas Grade I Instructors

His Excellency The Governor, Sir I-larry Luke, K.C.M.G., and members of the Suva Nursing Division. The first to b e

of the buildin g She found the man bleedi?g profusely and in a serni-conscious state. She arrested the ha::morrhage, made the patient comfortable until the arrival of the ambulance, and helped to get him down to the ground. At the hospital the man underwent an immediate operation and eventually made a good recovery."

Mrs. Nelson, Acting Lady District Superintendent for the Malaya District, writes :-

" We now have 17 Nursing Divisions in Singapore. Our latest, just formed, is the Blood Transfusion Division composed of experienced members transferred there. The Principal of the College of Medicine who arranged their training says their work and ability have far exceeded 1;1is hopes and he is delighted with them.

and we are fitting each !nember with a civilian duty mask. Short Gas Courses are taken b y each Division, also lectures on Midwifery and Inva lid Cookery. "Four mornings a week there are S.J.A.B. and Red Crbss Wor king Parties at Government H ouse ." .lVErV ZEALA1VD HAMILTON

More than 350 members attended the annual church parade and competitions of the St. John Ambulance Association held on July I.

The parade was in charge of District Superintendent H. D. Cobb, assisted b y District Officer E. A. Houston.

The trophies were presented by the District Superintendent. Dr. E. C. Brewis spoke of the hiah standard of efficiency shown b y competing teams. a

Air Raid Precautions

By W. C. BENTALL, O.B.E., F.R.C.S., F.R.G.S., Assistant Surgeon-in-Chiej, St. John Ambulance Brigade

CASUALTY SERVICES

Since July, 1936, we have had our special articles In the GAZETTE on A.R.P. First, the origins of the scheme were. and then the progressive stages of tralnlng for our personnel-instructors, workers, doctors . afld the general public; then followed the evolution of the services and the advam:ed and team training of all sectors of the work. we are at war. Peace-time prognostications 11'1 relatIOn to aerial warfare are being fulfilled and many of those who used to ridicule the whole scheme a::e, with the rest of us, losing some of our folk, who SIt by our hearths and homes in rural England.

To-day it seems wiser to see what our trained personnel have achieved in war. The authorities both in the B.B.C. and the Press have testified in no measured terms, and ,in high appreciation of the A.R.P. Services wherever called upon. It is the adequate training of the past days and the foundation work of practice and patience that has enabled such services to act successfully in saving life and maintaining the morale of our people.

Sussex and Kent, it has been my pnvllege to see our S.J.A.B. men and women dovetailing. with the B .R.C.S. and members of the trained public in various casualty services. In many of our towns, our people are called out many times in the day nigh.t. AmoniSst jobs, it has been my pnvllege to Inspect Fust Aid Parties and Posts and ambulance services, and of late, to visit badly attacked areas to report on what our people have done.

Near the Thames side, four of our nurses threw themselves down on the ground of the Equipment a bomb fell just outside their post. An Incendiary bomb completely burnt the adjoining building and the splash of the crater caused by the bomb riddled the wall that protected them, but as soon as the firemen told them they were safe to come out they took their equipment and made their way to area where the services were pressed with the number of casualties and there they carried on. In another place, the drivers of a First Aid Party car was hit as he drove and the car turned over and was riddled with the splash of a crater on the tail of the ca:. The party members crawled out, dealt with their drIver, dragged out their equipment and did 2.3°

work amongst the casualties. Where in some cases our services have been asked out to help the R .A .F . at the bombing of an aerodrome, the local authorities received an official note of gratitude and appreClatlOn.

Men and women, carryon; use every bit of knowledge and ingenuity you have acquired, and in the saving of lives, we shall lessen the numbers on the casualty lists, and share with the fighters of air, sea and land, the victory which is coming.

A.R.P. Questions and Answers

Q.-Would you cause contaminated areas in towns to be railed off and "danger" notices displayed?

A.-Yes, this comes under the control of the decontamination squads.

Q.-Would not the heat generated by internal combustio!! engine help to decontaminate the metal parts of engine ?

A.-Yes, in those parts that were sufficiently for sufficient time, but don't forget it would Increase the vapour danger, and not knowing whether the heat sufficient would not justify omitting decontamlllatIOn as taught.

. R.-Why not a valve in wall of protective room, sltrular to respirator canister, to allow purified air to enter?

A.-Because of the great expense; this can be done and is done in making large protected rooms for big numbers of people.

Q.-Can we use front door as an entrance to air lock although it does not slope? Will curtain which overlaps be sufficient?

A.-Yes, if you can keep the curtain in close contact with the door, which the slope makes easier.

Q.-If you know gas is in the house should one open the door and windows to get rid of it, or what other remedy should the ordinary householder apply?

A.-If ga.s-free signal has been given open all doors and wmdows. If not, don't. '

Q.-Sulphuretted hydrogen-how do sewer men manage to avoid the danger?

A.-Ventilation of sewers where men go is carefully observed. Short time of exposure. Occasionally masks.

Q.-If carbon monoxide is heavier than air why are we not all gassed owing to number of motor cars on the roads ?

A.-Because of speedy dilution in open air.

Q.-As there are no symptoms for the first aid worker, is everyone not in the refuge rooms at the time of a mustard gas attack a " casualty" ?

A.-Yes-a potential one.

Q.-Can nothing be done during the treatment in the first aid post for those who have inhaled mustard vapour?

A.-It could, but it is unwise because the benefit would be slight, and the delay 'would hold up the rush of needy work being done.

Q.- Will the respirator protect the eyes from mustard gas ?

A.-Yes.

Q.-Can a first aider force a person whom he thinks has been infected with mustard gas to go to a first aid post for treatment?

A.-Not at present in democratic countries.

Q. - How is bleach paste applied to the body?

A.-With a brush. I prefer the hands. The new vanishing cream is better.

Q.-Would not normal saline (i.e., a teaspoon of salt in a pint of water) sooth the eyes?

A.-Yes, if you've got it ready.

Q.-In the event of having to deal unexpectedly with a case of blistering are there any immediate remedies one can apply as a temporary measure?

A.-Blistering cannot be "unexpected"; it is preceded by several hours with redness of the skin and irritation, and is usually seen after nine or ten hours.

Q.-In some Urban Districts the drainage system is by soakaways. Would it be advisable to use the hosing system for the removal of mustard gas?

A.-Yes, but mix bleaching powder with water or place bleach on the soakaway area.

Q.-In washing a contaminated article what do you wear on hands ?

A.-Rubber gloves and change water frequently.

W. C. B.

Review

FIRST AID FOR WAR CASUA LTIES. By Major Norman Hammer, B.Sc., M.R.C.S., L.R.C.P. London: Dale Reynolds & Co. Price IS. 6d. net; by post IS. Sd.

. A Co.unty Surgeon of the the author of this lnterestlng instructive book is well known as an

exponent of first aid in civilian emergencies or of "pure first aid," as he calls it. It is appropriate, therefore, that, as an expert in A.R.P. administration and practice, he should now tell us how first aid must be modified to deal with war casualties occurring at home from air raids and other forms of attack. Further, the author presupposes an accurate knowledge of the subject; and the book admirably performs its purpose of helping civilian first-aiders the better to understand and carry out their war-time jobs.

The first half of the book (which is divided into ten sections) deals fully with all phases of the workpossible war injuries, primary and secondary shock, types of wounds and fractures and burns. The second half describes and gives treatment for various conditions associated with but not specifically due to war injuries-head injuries, heart attacks, epilepsy, hysteria and sudden child birth; and it includes a vivid account of the First Aid Services in action. The book ends with three appendices of which the first sets forth the correct positions of casualties on the stretcher, the second gives hints for self-protection again st blast, noise , fire and gas, while the third presents a specimen marking sheet as used in training and competition.

N. C. F.

PRACTICAL BOOKS

by N. CORBET FLETCHER, M.B., B.C., M.A.(Cantab.), M.R.C.S.

AIDS TO FIRST-AID (7th Ed.)

First-Aid Simplified and Tabulated with Aids to Memory. Price 1/- (Post 2d.)

EFFICIENCY IN FIRST-AID (3rd Ed.)

Problems in Study, Treatment and Examination solved for Senior Students. Price 1/- (Post 3d.)

COMMON ERRORS IN FIRST-AID

Errors in First-Aid Detailed and Explained. Price 1/- (Post 2d.)

WHY AND WHEREFORE IN FIRSTAI D (5th Ed.)

Difficulties in Study and Treatment Solved by Question and Answer. Price 1/- (Post 2td·)

AIDS TO HOME-NURSING

Home NurSing Simplified and Tabulated, with Aids to Memory. Price 1/- (Post 2td).

AMBULANCE COMPETITION TESTS

Stretcher, Individual and Question.

19, CURSITOR

Obtainable from:

LONDON, E.C.4

Priory for Wales

Headquarters: Priory House, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

NEW

The Earl of Plymouth, P.c., Sub-Prior of the Priory for Wales, acting on behalf of the Prior, H.R.H. the Duke of Kent, has approved the following appointments consequent upon Professor George Knox, M.1.M.E., F.G.S., having vacated the offices of Director of Ambulance and Assistant Treasurer on removal to Scotland:-

1. D,'·. D. jones, IP., as Director of Ambulance

Dr. Rocyn Jones has spent a lifetime in the promotion of Medical Services, His public work as Medical Officer of Health for Monmouthshire is too well known to call for elaboration; and no one is more thoroughly conversant with Ambulance activities, St. John and Red Cross. For many years, Dr. Rocyn Jones held the Commissionership for lvlonmouthshir(;, and has been a Knight of Grace of the Order sinc(; 1924, in which capacity he serves as a Priory representative on Chapter-General. In accepting this high executive post Dr. Rocyn Jones has the office of Surgeon-in-Chief for Wales, as well as that of Director of Ceremonies to which he was recently appointed.

2. Captain Taliesin E. Richards, IP., as Director of Ceremonies.

Captain Richards is the oldest Conlmissioner in the Brigade and has maintained an intimate connection with the Priory. He is a representative Knight of Grace on Chapter, a member of Council and Standing Committees, and his assumption of executive office will be welcomed as a fitting recognition of his devotion to the cause of Ambulanc(; Work.

3. Mqjor A. W. Anderson, Ai.B., Ch.B., as Surge011-inChief for Wales.

This appointment will be welcome to Surgeons of the Brigade as well as to officers and all ranks. Major Anderson has been Assistant Surgeon-in-Chief for Wales since 1936, formerly occupying the Assistant Commissionership of Bridgend County Area from 19 22 Durin g the Great War, Major Anderson became Second-in-Command of the 130th St. John Field Ambulance. A Knight of Grace of the Order and member of Chapter, he is most assiduous in attendance at meetings of Council, Ambulance, Finance and Transport Committees.

4. Dr. S. McCormac, as Assistant Surgeon-in-Chief for Wales.

As Commissioner for the Borough of Newport

Centre since 193 I, Dr. S. lvlcCormac has just completed 25 years' service in the Brigade, having filled successive posts from the rank of Divisional Surgeon. A Commander of the Order, his services are well known and appreciated among a wide circle of Ambulance Workers, particularly in the capacity of adjudicator in Ambulance Competitions in England and Wales.

5. Sir William H. S eager, IP., D.L., as Assistal7 t Treasf;wer .

This appointment is in accord with the unanimou s desire of the Finance Committee on which Si r William has served since 1928, being al so a nominated member of Council on Chapter and a Commander of th e Order.

6. Mqjor OUJelZ Evans, IP., as A ssistan t L ibrarian

A representative Knight of Grace on Chapter and Assistant Commissioner for Pontardawe CountyArea, Major Owen Evans's appointment follows 45 yea rs' association with First Aid Work.

7. Colonel W. Talbo t Woods , D.L., as nominated member of Co uncil on Chapter.

Colonel Woods, an Officer o f the Order, has held the post of Assistant Director of Transport, presiding in this capacity at meetings of the Ambulance Transport Sub-Committee in the absence of the Director, Mr. James Griffiths, M.P.

CENTRE REPORTS

ANGLE SEY CENTRE

An interesting ceremony took place at Holyhead County School on September 18, when pupils who had been successful in the recent First Aid examination received their certificates from Lady Iris Mountbatten.

The Headmaster (Mr. J. M. Hughes) expressed his pride in the achievement of the pupils and paid high tribute to the effective work which had been carried out by Mr. S. Richardson, together with other members of the staff, in bringing into being th e Holyhead Cadet Division registered with a strength of 58, under the leadership of Mr. Richardson as Cadet Superintendent.

Divisional Surgeon G. P. Williams, who is in charge of the First Aid section of the local A .R.P. organisation, presided, and expressed the hope that the development wou1d serve as an encouragement and an incentive to the gir ls to form a Cadet Nursing Division. He referred with gratitude to the number of

senior boys who had volunteered for serVlCe as stretcher bearers with the Civil Defence. The town needed stre tcher bearers, and they deeply appreciated their contribution of service.

Mr. F. Bell, Superintendent of the Holyhead Division, welcomed the Holyhead County School Cadet Division to the Brigade in Anglesey. In praising their activities, Mr. Bell uttered a word of warning against allowing interest to wane, as the maintenance of efficiency was all important.

After the certificates had been distributed by Lady Iris Mountbatten, Sir Henry Grayson expressed his pleasure at being able to be present on such an important and possibly a historic occasion for Holyhead. "We have heard a great deal lately about the Hitler Youth," continued Sir Henry, "who have been trained and brought up in an atmosphere of hatred and malice, and who are not allowed to have an opinion of their own. How different is this g athering of British Youth, who of their own free will are d evotin g their time to learning how the y could r elieve sufferin g and render Erst aid to anyone in dis tre ss." The bo ys of Holyhead County School Cadet 'Divi sion had taken their first step in the Order of St. J ohn , which in conjunction with the Red Cross So ciety was doing such vital work for the nation in the se t errible times Sir Henr y briefly dealt w i th the t ra ditions which belonged to St. John Ambu lance Brig ade, and told how t he founder s we r e forced to seek refuge ultimately in Malta, where they conti nued their ho spital work under s uccessive Grand }.{asters. "The great siege of Malta by the Turks too k place in 1565, and no greater heroism has ever been seen than the defence by the old Knights of St. Jo hn. History is now repeating itself in a remarkable w ay, for to-day members of our Order in that island are carrying on their work of mercy admidst the I talian bombs, and still pray to God in the same chapel of St. Elmo, just as their predecessors did 375 years ago ."

In proposing a vote of thanks to Sir Henry Grayson and his party, together with other gentlemen, Hubert L l. Roberts, one of the prefects, who had passed the fi rst aid examination, referred to the great honour w hich had been conferred upon the gathering by t he presence of Sir Henry Grayson. He referred to the excellent tuition they had received from Dr. G. P. Williams and also thanked the members of the Holyhead Division of the St. John Ambulance Division for their encouragement and interest.

The resolution was seconded by Kenneth Jones and carried unanimously.

C '\.RDIGANSH1RE CENTRE

by Brig.-General L. Pugh Evans, V.c., C.B., D.S.O., Commissioner for Cardiganshire, the Hon. John H. Bruce, JP., D.L., inspected the Abery stwyth Nursing Division on August 30 at the Town Hall, Aberystwyth, where members paraded

under the command of Lady Superintendent Mrs. J. Lewis Evans. Other officers present being Mr s . Liptrot and Miss Harvey and the Divisional Secretar y, Miss Eirlys Morgan.

Among those present were Colonel Sit George Fossett Roberts, JP., and Lady Fossett Roberts, O.B.E., JP., the Rev. R. and Mrs. Ward, Mr. D. Alban Davies, c.c. (High Sheriff), Mrs. Hugh Bonsall, O.B .. E., J.P., Dr. D. 1. Evans (Divisional Surgeon), Dr. and Mrs. Williams, Dr. Hitchcock, Mrs. K. P. Davies (Llangeitho), lvIts. (Dr ) David Ellis, Mrs. Shaw, Mrs. Enoch J Morgan, Alderman J Lewis Evans, Major H. F. Stimson, T.D., Divisional Superintendent Harry Dav ies, Aberystwyth Division; and Mr. G. T. Morgan W ynne, C.M ., Devil's Bridge.

The Hon. John Bruce expressed his pleasure at being present and complimented the Aber ystwyth Nursing Di v ision upon its smart and efficient appearance and splendid work. He congratulated the Lady Superintendent, Mrs. J. Lewis Evans, upon the well-deserved honour of admi ssi o n to the Orde r in the grade of Serv ing Si ster, r efe r ring to her excellent serv ice s, whi ch had been reco g nised so m e years ago b y t he award of a v ellum vote o f thank s Referring to the prog r ess of ambulance w or k in Cardiganshire, Mr. Br uce s tated that in 1939, 1, °3 2 students sat for exa minatio n , bei n g an increase of 386 on the pre v ious year. O f these 825 were successful, being an increas e of 240, compar ed with those wh o qualified for awards in 1938. The stren g th o f th e Brigade in the t own o f Aber ystwyth was 188, comprising 89 men and 99 women.

Colonel Sir George Fossett R o berts distribu te d A .R. P. certificates to the 5° successful candidates , and in proposing a vote of thank s to the speake r, said it was a great encouragement to the memb er s that the Commissioner for Wales came t o in spe c t them.

Brigadier-General L. Pu g h Evans expressed pleasure at the increased membership of the Division during the past year and complimented the member s upon the result of the examinations.

DE BIGHSH1RE CE JTRE

The British Red Cross Society Detachments, Denbigh 20 and 34, and the Ruthin Division of the St. John Ambulance Brigade, held their annual distribution of awards at the Memorial Building Ruthin. The guests included his Worship the Mayor (Alderman T. E. Lewis), who presided; the Mayoress, Mrs. Rigby, County Director British Red Cros sSociety; Dr. G. Pari Huws, Commissioner, West Denbighshire Centre, Order of St. John; Mr. John Jones, County Secretary, B.R.C.S.; Mr. T. J Roberts, chairman of the Ruthin Evening Schools Committee; and Miss Hughes, Vice-President of the B.R.C.S.

The Chairman referred to the work done by the

two organisations and called upon Divisional Superintendent J. Curtis to introduce and we1come the guests, each one of whom took the opportunity of saying a few words.

:Mrs. Rigby presented the St. John certificates to Ambulance and Nursing Members, and the B.R.C.S. awards were distributed by Dr. G. Pari Huws, who gave a brief account of the history of the two organisations. He was pleased to announce that the Priory for Wales had conferred upon the Divisional Surgeon (Dr. T. O. Jones), Honorary Life Membership in recognition of his honorary services as Lecturer over a period of years.

Reports on the work of the respective units were given by Lady Spriggs on behalf of the two Red Cross Detachments, and by Ambulance Officer W. C. Hughes for the St. John Ambulance Brigade.

GLA110RGAN CENTRE

CaerphillY County A1·ea.-The final round of the ambulance tournament promoted by the Lindsay Corps was held at the Church Hall, Gellygaer, the finalists being Nelson, Trelewis, Penallta and Gellygaer. The competition was watched by the Assistant Commissioner, Dr. S. B. Turner and Mrs. Turner (Lady County Superintendent) and a number of other Brigade offic ers. The result was as follows :-1 Penallta, ' practical 74, theory 55 t--total 129; 2 Gellygaer, practical 79, theor y 44-total 12 3; 3 Trelewis, pr actical 68 t , theor y 5 I t--total 120; 4 Nelson, practical 67, theory 46t-total qt. The aggregate points scored by each team in the preliminary and final rounds were: Nelson 541, Penallta 524t, Trelewis 519, and Gellygaer 518 .

Dr. S. B. Turner presented the" Lindsay League" cup to the Nelson team and individual awards to the members; and the "Turner" cup to Penallta team, each member of the team being presented with a savings certificate.

Following the contest, Corps Secretary William Evans, Trelewis, presided at a presentation to exCorps Superintendent Wm. Davies and Mrs. Davies, who were the recipients of a leather writing set and a fruit set respectively, at the hands of Mrs. Turner, who thanked them for their work and wished them every success in their new home at Abercynon.

Tributes to the leadership of Mr. Davies were paid by Divisional Superintendent J. E. Davies and Corps Inspector of Stores Sam. Hughes and other Divisional officers within the Lindsay Corps.

RHONDDA CENTRE

National Flag Day. - The result of the National Flag Day effort held throughout the Rhondda in June is very gr.atifying to the Lady -County Superintendent Mrs. Ingledew, who was mainly responsible as the St. John representative, working in conjunction with Miss Nicholas on behalf of tbe British Red Cross

Society, for raISIng the sum of £75 ° for the Lord Mayor's Red Cross and St. Joh11 Fund.

Maincfy and Eastern Nursing Divisio1Z .-This unit can take pride in baving one of its members, Mrs. Hardie, selected for duty as a Nursing Member at the first Convalescent Hospital to be opened in the county under the Glamorgan Joint Committee, Red Cross and St. John War Organisation. Recentl y a presentation tea was held by Maindy and Eastern Nursing Division at the Ton Pentre Ambulance Hall, at which Mrs. Levi Phillips (Upper Rhondd a Corps President) supported by Lady Corps Superintendent Mrs. D. Venin g and Mrs. U. Jones. In presenting certificates in Home Nursing and A.R.P. Mrs. Phillips spoke of the good work being don e b y members of the Division and con g ratulated the m on their voluntary efforts to fit themselves for national service.

NE\VS

IN BRIE F

There is a great demand for copies of the new textbook" First Aid in Coal Mines," price 9d., postage extra. Details will be issued shortly of the certificate to be gained by those who pass the appropriate examination.

A total sum of £ 5,569 was collected within the County of Glamorgan on the June National Fla g Da y, 1940.

Correspondence

To the Editor, ST. JO HN A 1BULANCE GAZET TE DEAR SIR,-The wearing of uniform for par t-time members of the Brigade on A.R.P. work is permitt ed by the Brigade, and I think it gives the public more confidence in those workers. When the siren sounds men report to their first-aid post, b ut very often the anti-aircraft guns are already firing and jt means wearing the steel helmet, so that the round peaked cap has to be carried. Would it be possible for a Field Service Cap in black and white to be woro by members for the duration of the War? Thi s cap could be placed in the pocket. I think t his cap could be purchased very cheaply-about 5s. 6d.and I think it would be more convenient for the members. Wishing your GAZETTE every success, Yours, etc., AMB ULANCE OFFICE R

Change of Address

The address of No. (Prince of Wales'S) D lstrict is now:12 Northwood Way, Northwood, Middlesex, to which all communications should be sent

Manchester A.R.F. Casualty Services

STRETCHER DRILL

I. FALL IN

z. IN SINGLE RANK-SIZE

(I) Tallest on the Right. Shortest on the Left. (z) Number.

(3) Odd numbers one pace forward; even numbers one pace back-march.

(4) No. I-Stand fast. Ranks R. and L. turn.

(5) Form Company-Quick March.

3. FORM, SQUADS

(I) From the Right one pace extend-Right dress (rear rank cover off).

(z) Eyes front.

(3) Company-Number.

4. PROVE THE BEARERS

(I) Front Rank.

Odd Number-(No. I Bearer) Stand at ease. Even Number-(No. 2 Bearer) Stand at ease.

(2) Rear Rank.

Odd Number-(No. 3 Bearer) Stand at ease. Even Number-(No. 4 Bearer) Stand at ease.

(3) Company-Attention.

5. NUMBER THE SQUADS: No. I Bearers-Number.

6. SUPPLY STRETCHERS. QUICK MARCH

(I) Nos. 2 and 4 file from the Right-followed by Nos. 2 and 4 of the remaining squads.

(2) Take positions on the Left of the Stretcher, stoop, and grasp the near handle of the stretcher (runners to the right)-rise. Rejoin squad (passing round the rear of NO.3).

7. LOWER STRETCHER

( I) Lower the bottom pole to the ground.

(z) Lean to right and place pok in hand on ground.

(3) Rise smartly together.

8. LIFT STRETCHER

(I) Nos. 2 and 4 stoop. Grasp near handle of stretcher with Right hand, allowing stretcher to hang horizontally.

(2) Rise smartly together.

9. COLLECT WOUNDED

(I) Squad doubles by neatest route to patient.

( 2) Halt three paces from the head and in line with the patient.

10. LOWER STRETCHER: One-Two-Three.

I PREPARE STRETCHER

(I) While Nos. z and 4 blanket stretcher, No. I proceeds to the R., No. 3 to the L. side of patient's hlp, turn inwards and kneel on the left knee.

(2) Nos. 2 and 4 now proceed to the left side of patient, No.2 halting at the knees, NO.4 at the shoulders, turn inwards and kneel on the left knee.

(3) The bearers now pass their hands beneath the patient; No. 2 supports the legs, No. 3

the thighs and hips, and No. 4 the upper part of the trunk.

LIFT

(I) Carefully lift patient on to the knees of Nos. 2, 3 and 4 bearers. (2) No. I disengages, rises, steps back one pace, turns to his left, doubles to the stretcher, takes hold of it (left hand across, resting the near pole on his left hip). (3) He then returns and places the stretcher directly beneath the patient, kneels on the left knee and assists in lowering the patient.

LOWER

(I) The patient is lowered slowly and gently on the stretcher. (2) The bearers disengage, rise, turn and face the feet-end of stretcher. (3) Then resume permanent positions (Nos. and 2 step forward, NO.4 steps back, No. 3 takes a side pace to the left, turns about and proceeds round the head-end of the s tretcher to his place on the right o f the stretcher opposite NO.4).

12 CARRY PATIENT BY FOUR BEARERS STAND TO STRETCHER S Nos. and 2-toe-front end of s tretcher. Nos. 3 and 4-heel-rea r end of stretcher.

LIFT STRETCHER

All bearers stoop, grasp handles with inside hand, rise slowly together, taking time from No. 1.

ADVANCE

All step off with inner foot, taking a short shuffling step.

LOWER STRETCHER

All bearers stoop slowly together, taking time from No. I.

13. LOAD AMBULANCES

(I) Bearers turn inwards, stoop, grasp the poles, hands wide apart, (z) rise slowly with arms extended-lift (keeping the stretcher level). (3) All take a side pace to the ambulance. (4) Keeping the stretcher level, raise it to the level of the compartment to be loaded, place the runners on the runway and slide it into position.

14. UNLOAD AMBULANCES

( I) Squad proceeds to ambulance.

(2) Nos. 3 and 4 open out. (3) Nos. I and 2 pass between them and grasp the handles with both hands, withdraw it, slightly raising the handles at same time.

(4) Nos. 3 and 4 now take the further handles.

(5) All take the weight and lower stretcher with arms extended.

(6) Bearers turn away from ambulance. Lift stretcher with inner -hand and step off with inner foot.

An invaluable FIRST AID • MILTON antiseptic

The swift irrigation of wounds or cuts with a dilution of Milton ensures surgically clean surfaces ready to heal.

For Milton is of the same chemical natu re as the famous Carrell-Dakin solution" plus "-plus stability, plus absolute uniformity of strength, plus non-causticity.

Milton has immense germicidal strength and remarkable penetrative power.

THIS IS THE CHEAPEST POSSIBLE WAY!

A whole Winchester of Milton costs 7/6, and because of its great strength Milton is most economical to wse; a dilution of one part in 100 of water is sufficient for most purposes.

KEEP MILTON HANDY FOR FIRST TREATMENT OF CUTS & WOUNDS

DEODORISING & ALL CONDITIONS REQUIRING COMPLETE ANTISEPSIS

Born during the last war-best during this 7d., 1/2, 1/9 and 3/- a bottle Winchesters at 7/6

POUNDED 18BO. (LONDON), Ltd. SPECIALISTS IN UNIFORMS. MANUFACTURERS OF EVERY DESCRIPTION OF UNIFORM CLOTHING AND EQUIPMENT for St. John Ambulance Brigade. JACKETS, TROUSERS,

ESTIMATES AND SAMPLES ON REQUEST All enquiries to154 .. 164, TOOLEY STREET LONDON

War Temporary and V.A.D. Emergency Hospitals

By Colonel C. I. Ellis, C.M.G., T.D., M.D., etc.

Late Staff OlJicer for Voluntary Aid Organisations, Southern Command, Salisbury; late Surgeon-in-Chief, the St John Ambulance Brigade; late O.C. 46 C.C.S. and 41 Stationa1')1 Hospital, B.B.F.

The following is a suggested inspection form with hints for officers who may have to prepare emergency hospitals. It was drawn up during the last. war to enable full and clear reports on different types of hospitals to be presented, and has since been brought up to date.

GENERAL ARRANGEMENTS

I. Name of Institution.-.

2. Site. - Include a map and indicate (a) Aspect. (b) Altitude, height from sea level. (c) Record of hours of sunshine of town. (d) Information as to proximity to railway, details of train service, and availability of siding. (e) Will siding admit the approach of motor ambulance cars? Is height of platform suitable for unloading stretchers, or will a ramp be required? Is lighting suitable for unloading at night?

3. Property of-· . . .

4. Nature of Building.-Include a sketch plan, and indicate whether the building is a private house, hotel, or town hall, etc. Note also: (a) Size. (b) Continuity-that is, are the buildings continuous with one another? (c) Contiguity-that is, are the buildings near one another? (d) Number of floors. Are there any open-air spaces, and sheltered balconies for sun-bathing and/or fresh air?; kind of eaves. (e) Material- bricks, etc. (j) Old or new. (g) State of repair. (h) Not one near any military objective . (i) One not ear -marked by military authorities . (j) Is there a Reception Hall ?

5. Surroundings and Approach-for example, open grass country. (a) Is there a suitable turning space for motor ambulance cars or an in-and-out circle? Is the road metalled? (b) Are there spaces for convalescents to exercise-non-slip surface? (c) Is there an approach-for example, easy carriage drive through a garden? Cd) Is there space available for expansion by the erection of hutments or tents? (e) Landing for aeroplane ambulances ?

6. Nature of Soil.-That is, sand, gravel, limestone, or clay.

7. Number of Stretchers Available for Instant Use.(a) Where stored. (b) Number of blankets available for instant use. (c) Where stored. (d) Nature of stairs for st!etchers; wide, narrow, steep, or gradual? (e) Width of doors and passages: will doors easily

admit stretcher or bed without tilting? (f) Is a lift available, and will it take a stretcher ?

8. Transport.-(a) Ambulance wagons: (i) Horsed ambulances. (ii) Motors: Is a char-a-banc available for sitting cases? Are there available trade and private vehicles, baker's carts, small buses, light lorries, etc.? Is a list kept of vehicles which can be improvised and the capacity for lying cases in each vehicle? (iii) Sheds for same. (iv) Storage o f petrol. (b) Number of stretcher-bearers-St. John or Red Cross-during day and at night. (c) Numbe r of orderlies-St. John or Red Cross-during da y and at night. \

9· Nature of Wards.-(a) Are they cleared o f carpets, rugs, curtains, furniture, pictures, etc. ? (b) Walls, are they washed or papered? (c) Floors, are they even? Are they of wood? If so, are the y polished? Cd) Are (b) and (c) easily cleaned ? (e) Equipment of: re beds, bedding, lockers, etc. (To be continue d)

Subscribers Please Note!

Owing to the increase in postag e rates, the annual sub scription for the G AZETTE will until further notice be 4S., instead of 3S' 6d. Subscribers who do not wish to pay this additional charge should fill in the form below, and hand it to thei r new sagent.

To

Please order on my behalf a copy of "The St. John Ambulance Gazette 1) which I will collect each month.

Signed (" The St. John Ambulance Gazette JI is published by Messrs. British Periodicals Ltd., 19, 19a, Cursitor Street, E.C.4.)

Many of the world's health problems are solved by 'ASPRO', for 'ASPRO' brings within the reach of all freedom from pain-the means to banish 'flu, colds and rheumatic attacks. It protects the whole household from child to parent, brings sweet p to the sleepless, soothes the irritable, 2N&::::,b3Lnishes headaches in a few minutes. Its fame -_ "" now flashed through the consciousness of the civilised world. 'ASPRO' is acclaimed everywhere. It's the medicine that stops pain without harming the heart. or stomach-no harmful after-effects can accrue after taking 'ASPRO'tablets. The 'ASPRO' pain-relieving service has spread throughout the world- /' bringing health and happiness to all. It I'; now firmly established as

The St. John Ambulance Association. It. Hi.tory and its Part in the Ambulance Movement. By N. CORBET FLETCHER M.A., M.B., M.R.C.S. TMs book from

CLASSIFIED ADVERTISEMENTS

Advertisements 1vith remittance should be sent to the St J ohn Ambulance Gazette, 19 , C ursito r Street , E .C.

SCENT CARDS AND SACHETS , printed with your announcements, are splendid money raisers and show 300% profit Samples free on request.-AlREDALE PRESS, Bradford.

PENCILS OF SUPERIOR QUALITY, printed with your Corps Name and announcement, sell easily. Sample free.AIREDALE PRESS, Bradford.

RAZOR BLADES FOR FUND RAISING. Etched (Printed) with your Name, Section or any Announcement on r eque st. Best quality British. Fits all 3 peg r a zors. Sells at Id. eac h or Cartons of 6 tl a des Sd. We are equipped to supply v ery small quantities. Samples, price and particulars free.-ROBERTS BROS. & Co., 143, Town Street, Beeston, Leeds, 11.

EVERYTHING FOR SAFETY EVERYWHERE

• NOVOX' and 'NOVITA' Oxygen +CO, or Oxygen RESUSCITATI NG APPARATUS for the apparently asphyxiated or drowned. SMOKE HELMETS of all Patterns.

• PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS

'PURETHA' GAS MASKS for Naval. Military and Industrial purposes and for Civilian use_ ALL A.R.P. EQUIPMENT

DUST and SPRAY MASKS and all other Safety and Protective Devices.

SIEBE, GORMAN & Co., Ltd.

OSTEOLOGY, WALL CHARTS AND ANATOMICAL MODELS FOR LECTURE PURPOSES '

BOOKS ON AMBULANCE WORK, FIRST AID AND NURSING H. K. LEWIS (:I Co. Ltd. MedicaL Publishers and BookseLLer$ 136 GOWER STREET, LONDON, w.e.1

Utbe 8t. Jobn

OFFICIAL GAS CHARTS

No. I Chart shows gas

No. 2 is a full and complete educationaJ chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee. I

Dreisings of any length can be cut in instant from the 'Elastoplast' Dressing Strip, which J s elastic, adhesive , and antiseptic. In If , 2f and 3" 1 yard long. Prices from 1 / 3d. each. The • Elastoplast Surgery Case contains one each of the t hree widths; price 5/3d complete. ,Write for further

of each mont h. T he annual subs cnp tion is 45., post f ree; single cop ies 3d.

Brigade Reports and Photographs should be addressed t o the Edit or , at 32, Shoe Lane, E.C.4. R eports and photographs should reach him early in t he month.

Sub scriptions and Advertisements should be forwarded fa the publishers:

Messrs . B ritish Periodicals, L t d. , I9, 19a, Cursitor Stre et, London, E.C·4·

CONTENTS

Editoria Overseas Ncu's Railway News

Home Nurs ing Page

Talks on tbe Manual

How to Form a Class

St. John Ambulance Association

Air Raid Precautions

Brigade News

Interesting Case Reports Questions and Answers

Re v iews

Ro ll of H onour

Priory for Wa es

Re d Cross and St. J ohn War Organisation "

CHANCERY OF THE ORDER,

ST. JOHN'S GATE, CLERKENWELL , LONDON E C. 1.

Reorganisation as a War Measure of the System under which Classes in First Aid, Home Nursing, etc., are dealt with in the Counties of England

Th e o r gan is at i o n of t he St. John A mbulance Ass o ciati oll.\ a Foundation of th e V enerable Ord er of St Joh n of Jerusalem, pr o vides f o r the formation

S:>f g roup s of p er so ns who in defi ned ar eas v oluntari ly b and themselve s t ogether in order to assist in carr yi n O' out th e service s in the cau se o f humanit y outlin ed

i n the "Statutes and R egulat io n s of t he O rd er. "

Th ese g rou ps ar e calle d "Cent res": in some counti es th er e ar e ma n y of these Cen tr es an d i n o thers but one. Th e functions of a Cen tr e are :-

(i) Th e f o rm ation o f cla sses f o r the in st ruction o f p ers o n s in Fi r st Ai d, H o me N u r sin g, H o m e H ygie n e, and Sani tatio n

(ii) Th e dis tri b ution of amb u lance material.

(iii). Th e formation of Am b ulance De pots in or n ear centres of industry - and traffic and t he organisation of ' M edical Comforts D epots.

(iv) Th e transp or t of t he sick and i njur ed.

(v) Th e enc o u r a g emen t of t he fo r mation of unit s o f th e St. J oh n Ambu lan ce B r iga de. (vi) A nd g ener all y t he pr omotion and car rying out of wo rk s fo r the relief of t h e si ck an d i n jured i n p eace and wa r , i r res p ecti v e of rac e, class o r cree d.

As a w ar m easur e i t has b een deci d ed t o r elieve

Centres - wi th so m e ex cepti o n s- of the detailed wo r k co nnect ed w ith cl asse s of i n structio n and exa min ati o n s T hi s w ill enabl e th em th e b et te r t o co n centrate their effo rts on th e rem ai nin g functio ns

Wi t h t his end i n view an "As so ciation Co unt y Secre tar y" w ill in fu tur e be attached to the staff of ea ch Co unty Commissio n er of t he St . J ohn Am bulanc e Briga d e* o ffi,ce of the "Asso ciatio n Co unt y Secre t ar y Will be in the n atur e of an " Info rm ati o n Bureau," w h er e i n q ui r ies can b e made a b o ut cl asses for i ns t ru cti o n i n First Ai d , H ome Nu rsin g , etc. A r ecord o f classe s whi ch have b een h el d in t he co unt y will b e k ept i n t his office

Info rm ati on regar ding classes can be o btaine d eith er di rect from the Chi ef Secretary, St. J ohn *F o r the present the fo llowing County Centres will continue as b efore, with and it will n ot therefore be t o a pp omt an County Secretal),' '- : Bu ckinghaIfishire

Ambulance St. 10hn's Gate, London, E.C. (Temporary address: Willey Park, Brosdey, Shropshire), or from the "As-sociation County Secretary."

A leaflet entitled " How to form a Class" can be obtained either from the Chief Secretary or the " Association County Secretary."

A brief summary of "How to form a (Detached) Class" is given on page 247 of this issue.

OVERSEAS NEWS

ASSOCIATION NOTES

The M ysore State Centre of the St. lohn Ambulance Association is to be congratulated for organising First Aid courses fm bus conductors and drivers. .These courses were attended by 2,339 persons, of which number 1,983 passed the examination. First Aid courses were also held in the Police Training School at Bangalqre, the Engineering College and the Scout Headquarters. ,Demonstrations in A.R.P. and First Aid were given by Brigade members on the occasion of the 75th Anniversary celebrations of the Red Cross. Sir Mirza Ismail, in the course of his speech at the Annual Ambulance Competitions, said that every boy and girl, ever chauffeur and members of the railway and police departments should take training in First Aid.

The G.LP. Railway Centre, St. 10hn Ambulance Association, had at the end of 1939 6,085 employees who were in possession of First Aid certificates. In some of their cOffipuls.ory categories the number of qualified First Aiders is 100 per cent., while the average works out at 7.8 per cent., compared with the total strength of their staff. Twenty-three Medical Officers and subordinates received awards in recognition of their services, which include admission to the Order of St. 10hn, vote of thanks on parchment, vellum vote of thanks and honorary life member's certificates. During the year 34 classes -in First Aid were held at 20 stations attended by 468 candidates, of whom 239 obtained certificates, 9 obtai1'led vouchers, 2 obtained medallion and I obtained Label. No les3 than 224 men rendered First Aid in accidents more than 9 times, while 8,596 injuries received First Aid in all, in the workshops, etc. This number als<;:> includes, First Aid given 232 times to members of the public.

NORTHERN IRELAND WILLOWFIELD

At a meeting of the Willowfield Ambulance Division a presentatio1'l was made by members to Sergeant R. C. Maloney, who is shortly to leave the Division to enrol in the Royal Air Force.

RAILWAY NEWS

Southern Railway CONTRIBUTED BY " EXON."

GUILDFORD

Mrs. Hollihs (wife of the assistant locomotive super- intendent) recently presented the annual awards to members of the Guildford Class.

Mr. Bicknell, Class Secretary, in expressing thanks, apologised for the fact that the customary supper and concert had not taken place and said that the postponement was not regretted because during that week the Southern Railway had done something which they would never forget-helped in the evacuation from Dunkirk. Giving a brief outline of the classes, the Secretary said that membership was now 56, that 48 had sat for the recent examination and 45 had passed. , Classes were held on Wednesdays for 20 weeks and in addition a class had now been organised for men who had never done any first aid, and who would therefore be of some use in an emergency. Up to the end of last December 200 cases of injuries among loco men had been treated.

Mr. Uzzell, welfare officer, expressed the thanks of the Directors and the General Manager of the Southern Railway for the members' self-sacrifice and devotion to duty.

FELTHAM

Forty-six members of Feltham ambulance class received awards from Mr. E. S. Moore (Divisional Locomotive Superintendent) at the recent annual presentation.

Mr. F. E. Campion (Divisional Engineer) presented a Meritorious Certificate to Mr. E. Coster, of Virginia Water class, who, though having only just passed his first examination, restored breathing, gave treatment for burns, and arranged transpor! for a colleague who came into contact with a live rail.

Mr. E. Uzzell thanked the officials present for their co-operation arid stressed the need for first aid in both wartime and peace.

London Midland and Scottish Railway

CONTRIBUTED BY GILBERT S. HILL GURNOS

At a meeting, presided over by Mr. B. A. Kingham, first aid and A.R.P. awards were presented to members .of the L.M.S. staff at Gurnos, Ystalyfera and Pontardawe by Mr. Thomas, District Instructor, and Mr. C. H. Parmee, both of Gurnos. A presentation was also made to Mr. W. Hancock in recognition of his services as A.R.P. instructor. Votes of thanks were accorded to Mr. H. Wolfe, Glais A.R.P. examiner, and to Mr. Kingham for presiding.

DOME NURSING PAGE "AGGRAVATION"

By F. W. HEBBLETHWAITE, M.B., Ch.B., Divisional Surgeon, No. 6 District

One of our three main objects in the practice of First Aid is to prevent the aggravation of the condition until such time as professional assistance can be obtained. And with this in mind, it is not long before the student begins to realise that many of his preconceived ideas need to be and that experience has shown that what one nught call the natural thina to do is not always the best.

o

How often has one seen, when a person has been knocked down in a street accident, someone rush up and more or less clumsily, and without any previous examination of the casualty, attempt to assist him to his feet, and by a process of trial and error, find , out whether or not there is the presence of a fractured lower limb. At the same time, other well-intentioned persons crowd round, and not only keep air away from the patient, but greatly hamper those who are qualified to render assistance.

,

Similarly, should a person faint in a crowded and fall to the floor, in spite of kindly Nature havlllg placed him in the most suitable position for his bloodstream to -restore his an::emic brain to normal, and where lungs can inspire the fresher air at the lower level, too often is he dragged, thoughtlessly, into a sitting or upright position.

We have the example, too, of the hysterical patient, surrounded by anxious relatives, whose pleading and sympathy only aggravate the symptoms.

In cases of Epilepsy, where we may find the unfortunate individual threshing abC?ut on the. Boor, so often do we also find that far more force 1S used in restraining the unruly movements than is necessary.

Should a foreign body be swallowed, on tirst consideration it would seem right and proper to give an aperient if? order to get rid of it as soon. as possible. We are taught, however, to gIVe nothing by the mouth, as any purgative would render the contents of the bowel more fluid, and therefore more easily penetrated by a sharp object

Popular belief is to? often the reaso? for forcing stimulants into patients who may be 111 an unconscious or semi-conscious state, and alcohol particularly, even though it be only " to wet the lips,"

should be withheld by the First Aider, with but few . exceptions.

The patient himself is sometimes guilty doing the worst thing possible for his own good, as 1S times seen in cases of a bleeding nose. The head IS frequently hung down, and often violently over a receptacle, thereby increasing the congestlon of the part. The nose is blown, disturbing. the blood clot which is beginning to seal the leaking vessel, _ and with the added flow of blood his anxiety increases so that his heart beats quicker. All this aggravates the condition.

The.) same may be said regarding bleeding from the socket of a tooth, where the gap in the line of the teeth provides an irresistible fascination to an exploring tongue, which again removes any blood •clot as quickly as it forms.

Other fallacies which are too commonly accepted include the application of oil to. burns, and the puncturing of blisters. Here no thought is given to . the risk of sepsis which may so readil y follow. Also may be mentioned the application of ointments as a first aid dressing to open wounds, often used in the fear that a dry dressing may stick in the cut. Again we run the risk of sepsis, and while dressing which has adhered can readily be bathed free, the subsequent dressing of the wound is outside the scope of true Erst aid.

Finally, let us always be careflu to curb that natural desire to speak what is passing in our minds, and discuss the patient's condition in his hearing, particularly if our views on the seriousness of the situation are not too reassuring.

CORRECTION

Owing to a error, the notes on "Stretcher Drill" were published in the October issue under the title "Manchester A.R.P. Casualty Services," instead of" Manchester A.R.P. Ambulance Service."

The author of the notes is S. Thos. Beggs, Esq., M.D., B.S., D.P.H.

2

TALI{S ON

By the late A. T. Lakin,M.B.

THE MANUAL

(Continued fr2..m page 22), October issue)

(D) Notebook Practices.

Not@book p r actices cannot and are not intended to take place of actual practices. They are only a means to an end and not the end itself, but they will make you take a in First Aid and wlll enable you to derive the fullest benefits from the practices that are plann,ed for you.

This patient has a wound of the right forearrp. There is profuse arterial hremorrhage. Just as you reach him, he faints. as you would.

Read the earcl slowly and correctly, and try to visualise th@ conditi©n. A diagram will help, sodraw a right tOl1@arm and mark your wound in red ink-if you draw, then make a rough sketch. When you Ihorollg',hfy unde:rstand the card, you can begin.

I. What is the matter with patient? The card tells you. Wound, Arterial Bleeding, Fainting, ShocK., and there may follow Collapse.

2.. What does the patie!flt need? Now plan your work.

(a) Bleeding must have the first attention.

(b) mjm1y must be made safe, and. precautions taken against a recurrence of the bleeding.

(c) condition must be treated, .and this is a:lso part of the treatm@flt for shock. Preparations for After-Care and Transport. __ ,. How can I supply those needs? Work your plan.In a real practice, these preliminaries would be taking place in your mind, and part of the plan woulcl. be in work st.raightaway, but here there is no time limit afld you can progress as slowly as you like because you are mapping out your plan, and once you hav@the righ t methpcd in your mind, it is only a question of praetic:e to work it up to a speed limit. .

I. Patient will be lying down, so turn head to .one side.

2.. Immediate tligital pressure on right brachial artery.

2.4 6

(a) Nearest pressure point on heart side of wound. (b) No elevation of limb because there may be a fracture.

3. Expose wo und with the free hand.

4. Look and see if the hremorrhage is controlled. (Ask when looking.) The answer can only be "Yes" or "No."

" No" means that the pressure is not correct-i t cannot mean anything else-so remedy the pressure. Pulp of the fingersactually on artery-press against bonestop the artery and immediately relax pressure-look and ask again-the answer must -be "Yes."

You have one hand fully occupied, and the patient cannot assist you, and you want to get on with your plan.

5. Enquiry as to assistance. (Materials are no use at present.) "Yes" would be too easy, so make it "No help available."

6. Pad on the artery to replace the digital pressure. You cannot let go, so you have to imprqvise, using your right hand only. Pocket handkerchief rolled into a tight pad and placed on the artery-no, not under the other fingers yet-wound side of digital pressure-press the pad on the artery, and release digital pressure slightly-look at wound and ask:

7. Is bleeding controlled? (See 4.) " Yes." Keeping up the pressure on the pad, transfer . the fingers of left hand to it and take up the pressure, thus releasing the right hand. Look at the wound and ask:

8. Is bleeding controlled? H Yes."

The pad must he kept in place, so think out an improvised bandage. A tie will do. Your,s 01; the patient's? Take the patient's tie because it will help you at a later stage.

9. Remove patient's tie and £X pad in position. Look and ask :

10. Is bleeding controlled? "Yes."

The bleeding is now safe and you are ready to deal with the wound, and both hands are free. There are one or two points that arise from the

treatment so far. Make a general rule that in all cases of bleeding to ask whether bleeding is controlled whenever you do anything to the means of applying pressure or move the patient. You would look and see if you were treating an actual case and you should do it in your practices. Why not apply an improvised tourniquet? Try it and see. It is too difficult to make and apply satisfactorily with one hand.

(To be cont!nued.)

Correspondence .

To the Editor, ST. JO HN AMBULANCE G AZETTE DEAR SIR,-It is sugges ted that bo ys of fourteen yea rs of age should be taught first aid at school, and that teacher s holding first aid certificates should instruct them. This does not seem to me to be politic because first aiders have usually had little practical experience until the y have obtained their medalli on The tendency to allow more or less inexp erienced persons to teach first aid is, fortunately, not common, but to my knowledge there are men with not even one certificate takin g first aid classes, and others no better" qualified" in charge of first aid boxes and ambulance rooms. These conditions also obtain i n some A.R.P. and first aid services: they should be rectified

There are members of the Brigade in this country with many years' experience of first aid who would no d o ubt be w.illing to act as instructors were they to be asked to do so.

lf first aid is to be to schoolboys, then the Ministry of Health should employ only those persons who are fully compe tent to teach it. And in the selection 'of the instructors is there anyone better fitted t o give advice to that authority than officers of the St. John Ambulance Bri gade ? ' Yours, etc.,

SUPERINTENDENT R. B. COLES, Whitehaven Division

To the Eddor, ST, JOH N AMBULANCE GAZETTE DEAR SIR,-Cadets of the Ironbridge Nursing Division would be very glad to correspond with members of other Di visions who have obtained Proficiency Bad ges 0; are working for them, The Ironbridge Cadets would like also to receive any particulars regarding the examinations for the Badges.

Yours truly,

MRS. M. J. POTT S, Lady' Cadet Superintendent, Ironbriolge Nursing Divisi o n, Woodland Grange, Ironbridge, Salop.

How to Form a (Detached) Class

(I) Classes of instruction of persons over 16 yea rs of age (adults) in First Aid and Home Nursing can be organised by anyone who agrees to observe the 2.47

rules of the Association. From 20 to 30 is a suitable number for a class, but it may be larger.

(2) The organiser of a class is regarded as the Class Secretary, and will be responsible for the administrative and clerical work connected with the class and for the payment of the fees. Mixed classes are permitted. A suita ble place for hQlding the lectures must be found and it should be pointed out to those desirous of attending the classes that unless a ?s istanc e is obtained from public or other sources the class must be self-supporting and that each member will have to pay in advance a proportional share of tl),e t otal cost. In order to calculate this total cost the following items will have to be taken into considerati on ;-

(a) The cost, ,if any, of l ecture room, lighting and heating.

(b) The l ecturer 's fee-a matter for mutual agr;eement locally (maximum fee for doctors £1 IS., for trained nurses IDS. 6d. per lecture). A co urse consists of a minimum of 12 hours instruction, usuall y divided into six lectures.

(c) The hire of the necessary class stores (not includin g the textbooks which are supplied " on sale or return" at 2S. each in the case of " First Ai d to the Injur ed" and IS. 6d. each in the case of " Home Nursing ") for a period not exceeding three months or until the end of the course, whichever is the shorter period-maximum I 4 s ·

(d) The Examiner's fee. A class of 20 candidates £1 IS, and his plus IS. for each additional candidate in excess of 20. Trained nurses 12S. 6d. plus 6d.

(e) Headquarters' fee. A class of 20 candidates IDS. 6d. plus 6d. for each additional candidate in excess of 20 examined for a Certificate.

(j) Purchase of a stretcher (unless this can be borrowed locally),

(g) PDstage, etc.

(3) The next step will be to obtain the services of a local medical practitioner or trained nurse to give the required lectures, the sylla,bus of which can be seen in the St. John Textbooks. For the First Aid course only registered medical practitioners are recognised as lecturers, but for the H ome Nurs ing course trained nurses are also recognised.

(4) When it has been finally decided to proceed, the application for the formation of the class shoul d be made to the Chief Secretary, St. John Ambulance Association, St. John's Gate, Clerkenwell, London, E.C. (temporary address Willey Park, Brosele y, Shropshire), who will supply the necessary class attendance sheets and a copy of the regulations governing classes. These regulations will give full information regarding the appointment of an Examiner and other matters which cannot be gone into in this brief summary.

St. John Ambulance Association

AMBULANCE

DEPARTMENT

In a report made to Chapter-General July 19 the Director of Ambulance stated that he felt that some further measures designed to bring about a more effective liaison Hea dquarters and those in instructior1al work in the counties were desirable. Thereupon the Sub-Prior suggested that a Committee be appointed to examine this question and to report to him and that he should be permitted to take such action on the report as he deemed desirable and necessary. The ChapterGeneral unanimously approved of this suggestion.

The Committee thus appoInted held their first meeting on July 22 and their final meeting on July 30, they agreed to make the .recommendations which follow. These recommendations are based on the understanding that the Committee were to deal only with the waf situation ' and not with any permanent alteration of existing system and also that they were concerned solely with the instructional work (teaching and examinations) of the Ambulance Association, and that the other useful work performed by Centres of the Association would not in any way be affected by their recommendations, which they suggested should for the present be confined to England.

In the course of their deliberations they found that one of the main causes of complaint was the absence of a single clearly defined' authority in each county available to answer enquiries regarding the formation and financing of classes. Although in effect direct application to Headquarters for such information caused little delay there was, they felt, a natural desire for some personal contact with a representative of the Association within a county.

Having reached this conclusion they endeavoured to determine on the form of county representation, i.e., whether by an individual or by a Committee. They decided on individ.ual representation, for at a time of emergency like the present they considered that representation through a Committee such as a Centre was cumbersome and likely to cause delay.

As the St. John Ambulance Brigade has recently been organised on county basis they considered that a closer liaison between the Association and the Brigade would be an advantage. By attaching a representative termed the" Association County Secretary " to the staff of the County Commissioner of the Brigade they would not only attain their main Db ject, that is the applDifltment of an AssoCiation repreSentative within the county, but also closer union between

the Association and the Brigade. The duties of the "Association County Secretary," already outlined in paragraph 3, would not be onerous and they believed that some capable member of the Association or , Brjgade within the county would volunteer for this post.

They submitted these proposals as being suitable for the counties generally, but they felt that they might not be so suitable for the closely populated cities and borou ghs in which Centres of the Association already operate. They therefore recommended that certain Centres* should continue to function as at present.

To sum up the Committee recommended:-

(a) That certain selected Centres continue to function as before.

(b) That outside such Centres detached classes should be the rule and the regulations governing these detached class es should not at present be varied.

(c) That an " Association County Secretary" should be attached for special duty to the staff of the Brigade Commissioner of a county; his office would in fact be in the nature of an information bureau.

Should the scheme prove practicable the Committee suggested that the question of permitting the Association representative to nominate Examiners from the general panel be investigated. This is more or less the system in force in the Red Cross Society and the Committee believed that it might prevent uncertainties and delays that oc casionally now occur.

*It was recommended that the following Centres should continue to function as beFore :-Cheshire;-Birkenhead, Stockport; Derbyshire- Derby; Devonshire-Plymouth; Durham-Harl:lepools, South _ Shields, Sunderland; Gloucestershire-Bristol ; Hampshire-Bournemouth, Portsmouth, Southampton; Lancashire (East)-Blackburn, Burnley, Manchester, Oldham, Rochdale; Lancashire (West)Barrow-in-Furness, Liverpool, Preston, St. Helens, Southport; Northamptonshire-Northampton, WelEngborough '; Nonhumberland- Newcastle-on-Tyne; Suffolk-Ipswich; Warwickshire-Birmingham: Yorkshire (West)-Leeds, Sheffield. All Railway and " special" Centres, e.g ., Church Lads' Brigade, Hospital Saturday Fund, Polytechnic, Post Office Ambulance.

It was recommended that the foilowing Centres should continue to function as before pending further investigations :-Buckinghamshire-Buckinghamshire County; Cumberland-Cumberland Mines and Quarries; Durham-Stockton and Thornaby ; GlouceseershireCheltenham; Hampshire-Gosp.ort, Alverstoke and Fareham; Lancashire (East)-Accrington, Nelson; Leicestershire-Leicestershire County; Lincolnshire-Lincolnshire County; Norfolk-Great Yarmouth; Northamptonshire-Kettering, Peterborough; Northumberland- North Shields; Oxforclshire-Oxford County; Shropshire-Shrewsbury; Staffordshire-North Staffo.rdshire; SurreySurrey County; Warwickshire-Coventry; Worcestershire-Worcester; Yorkshire (East)-Bull and East Riding COWlty; Yorkshire (Notth)-North Riding County; Yorkshire (West)-Hilifax, Heavy Woollen District, Keighley, Wakefield, York.

Air Raid Precautions

By W. C. BENTALL, O.8.E., F.R.C.S., F.R.G.S., Assistant Surgeon-in-Chiej, St. John Ambulance Brigade

POSSIBLE GAS ATTACK AND ADEQUATE CLEANSING FOR GAS CASUALTIES

We note that our soldiers are wearing eye shields more than they did and that gas masks are worn by the military in the alert position whenever a siren sounds in one of our towns. Those in charge of First Aid Posts are being asked to look to the prepa'l:ation of the cleansing of gas casualties and public attention is being called, as in the early days of preparation, to the need of further teaching on "gas warfare."

These things draw our to a side of the modern war that so far has not fulfilled the predictions of the last five years. High explosives and First Aid work have kept us busy. Gas courses have rather gone out of fashion, and Hitler has a flame to activity along unexpected lines!

Weare winning the war because our preparations are well and carefully planned. Countries not so prepared have gone under. It is not safe to depend on present conditions and needs, without anticipating and preparing for th<i unexpected future.

Let us remind ourseJves that the first two groups of war gases, namely, the tear and 'choking gases, are largely "panic producers" for the ignorant crowds of the populace; but the choking and blister gases are " killers" to the unprepared.

Our Government has shown us how those two dangerous groups of gases need never kill man, woman or child, and most of us St. John and Red Cross people have had our gas courses and know the details of the prevention of all danger as well as First Aid treatment for gas infection, when preventive measures have not been pract.ised. Absolute pre-.. venti on of gas infection, as we know, is adequate preparation of the refuge room in our individual homes, and the practised use of respirators, which, to many, have ' become unfashionable. Many more gas courses are being attended and many more must be held and people interested in what can really be the most perfect preventi"on for all dangers from gas, so that if it is used, we shall be calmly safe and unalarmed.

Apart from the details of treatment, always remember the effect of wind: you can't be gassed if you go up-wind from the site of a gas bomb, but you may walk down-wind and be killed by it. As mustard only kills by causing broncho-pneumonia through breathing it through the nose and mouth,

a respirator is a perfect preventative of death from mustard gas, because the air breathed is filtered from its gas.

Many points may have slipped your memory in this time of bombing and wrecked homes. Never forget the great danger 0'£ gas in its subtlety and unexpectedness. Be prepared!

A.R.P. Questions and Answers

Q.-In the issue of the GAZETTE you publish an article on A.R.P. ambulance services. You quote extracts from Circular 1794, April 3, 1939, and Circular 1893, October, I939. Would you please advise me from where I can obtain original copies of these circulars.-L. P. J. (Bristol).

A.-At the of your local Medical Officer of Health you may ask to see these, but it is doubtful if he will have a copy to spare.

Q.-What has Mustard Gas on the hair in(a) vapour form? (b) in liquid form? How should each case be treated ?-M. B. (Stockport).

A.-(a) Vapottr.-If the hair is uncovered in an attack it will hold the gas, and be a source of danger to the owner unless it is quickly (within five minutes) washed with warm soap and water and well rinsed. (b) Liqttid.-Serious - thought should be given to promptly cutting it off. To decontaminate the hair so infected by means of bleach ointment would involve much skill, care and time, neither of which is likely to be ,available in a rush of cases. Of course it should be adequately protected by keeping in a gasprotected room as clearly laid down in the book for householders distributed free by Government over a year ago!

Q.-A Mustard Gas casualty would remove outdoor clothes in an outside shed. On entering the Post should the eyes be treated first before the rest of the clothing removed, or the clothes removed and then the eyes irrigated ?-D. M. C. (Hull).

A.-It would depend on two factors: (I) The condition of the patient. (2) The decision of the doctor in charge of the Post.

w. C. B.

The St. John Ambulance Brigade News

No. 3 (WESTERN) DISTRICT

BIRMINGHAM

The Birmci. ngham Divisions of the Brio-ade have been giving most valuable assistance, particularly to hospitals in the city eluring recent air raids. Between twenty-five and forty officers and men are on duty at Headquarters nightly, prepared for calls; they furnish nightly parties of men for the five principal hospitals and orderlies for the night ambulance

The Nursing Sisters also are playing an Important part.

After a bombing attack on a hospital the Chairman of the hospital wrote; "I hasten to place on record my gratitude and appreciation of the noble

rendered by the Ambulance Brigade last rught to my hospital. It was a truly magnificent effmt. In half an hour from the time the appeal for help was to the completion of the effort, close on seventy patients were evacuated No fuss, no hitch undismayed by blazing buildings nearby, the was smoothly and rapidly carried out under conditions calling for high courage and devotion. The Matron of the Hospital tells me that every member of Brigade set a high example of and effiCIency. "

WOLVERH.A'.MPTON

A new Division has been formed and approved by the Commissioner at Courtaulds Works, W olverhampton.

This is the first to be formed in

W olverhampton, and the Corps officers in expressing their pleasure at this venture hope that other works in the borough will follow suit.

The works manager, Mr. D. S. Dawson, is Presi dent; this fact has given considerable encouragement to members and greatly intensified their keenness

At a recent meeting, attended b y the President and Corps officers, the followin g promotions were made by the Corps Surgeon, Dr. Byrne Quinn. Mr. E. Leach, ambulance officer; Mr. J. Handley, superintendent; Mr. H. C. Dodd, sergeant; and Messrs. Irwin and Wainwright, corporals.

Division is especially indebted to Dr. J. Paling, who has become Divisional Surg eon.

Though the majority of those taking part had had little or no experience of competition work, the performances were of a high order and recei ved commendation from both the judges.

It is hoped that other Zones will arrange competitions. Plans are also under discussion for a transport competition.

At a recent meeting of ' the Division a general knowledge Bee was conducted by Ambulance Officer M McEvoy.

Questions were set, based mainly on the theoretical side of first aid with a view to impressing members with the importance of studying this section of the " black" book-not frequently dealt with on ordinary practice ni g hts.

Six teams of five men competed. (No prizes were awarded.) Maximum points obtainable-38. Results were as follows ;First Aid and Cleansing Station Zone

'EN ·TA -R'y

LUTON

No. 3 (EASTERN) DISTRICT

For A.R.P. purposes, Vauxhall Motors Ambulance Division operates in five zones, with the Ambulance Base and Surgery Staff making a sixth.

Recently Zones 4 and 5, under Ambulance Officer W. H. Evans, staged the first of a six-monthly series of inter-zone competitions.

An oral test was judged by Nursing Officer W Murray, of the Vauxhall Motors Nursing Division. Ambulance Officer R. McEvoy (in charge of training) judged the stretcher contests.

Shields and cups were provided by executives of Vauxhall Moto!s. Medals for members of winning teams were purchased by charging each competitor an ent!ance fee of sixpence.

A hi g h standard of knowledge was shown by most of the co mpetitors, and it was evident to judge and spectators alike that t he m ember s of the teams had spent a considerable part of thei r spare time preparin g f o r the examination. It i s hope d to h o ld another of th e se Bees in the near futur e.

BLACKP O OL

No . 4 LANCS DISTRICT

We con g r atul a te Lady Superintendent Mrs. Monks and h er o ffi cers on the progress of the South Shore Nursin g D ivis i on w hi ch has necess i tated the acquisition of a dditio n al pr emi ses at the Headquarters in Woodfield R oad . On October 12 th e official opening was p erform ed b y Councillor Mrs. Mabel Qua yle, Honorar y Presiden t Mrs. O g den presided.

Re fe rence was made t o the splendid wartime service of the members in the A.R.P. Medical Services and Civil Nursing Reserve b y Assistant Commissi o ner W. H. Gastall and the Medical Officer of Health, Dr. G. W. Murray. The Honorar y President pres ented various Association and Bri ga de awards.

NO.5 DISTRICT

GRIMSBY

Service medals were recentl y presented to four members of Grimsby Division by the Assistant Commissioner, M. C. Lavin, Esq., M.B., B.S.Lond., who congratulated the recipients.

Among those present were District Officer W. Gott, Cadet Officer J. Aitken, Officer W. Fletcher, and members of the Division.

The Grimsby Division is proud of the fact that 26 of its members have obtained these awards.

Since the war began three First Aid and two Home Nursing courses have been held, with gratifying results.

(Continued on page 25 5)

Interesting Case Reports II

CASE REpORT No. T7o.-The Officer-in-Charge of the County of SQmerset S. J.A.B reports the efficient performance of fust aid by a member of the Minehead ' Division in the following circumstances:- '

On October 4 while driving hls mail ·van on Exmoor, near the village of Exford, Sergt. L. Jordan came across a damaged car and two ladies and two gentlemen suffering from facial injuries with hremorrhage shock, two of the patients running about with thel! faces covered with blood. Sergt. Jordan pulled 1JP pis van and at once took the situation in hand. By the use of scarves, handkerchiefs and a roller bandage he improvised dressings, pads and bandages, -removed the cushions and rugs from the damaged car, and made the patients comfortable at the side of the road. Mter some 10 minutes another car came alohg, and Sergt. Jordan sent the occupants to Exford to summon the police, ambulance and district nurse. He also gave them instructions to bring back extra dressings, rugs and hot-water bottles which he utilised, and after some 20 minutes he was able to leave the patients in the care of the nurse and poliClg: They were later conveyed by motor ambulance to me Minehead and West Somerset where all are making satisfactory recoveries.

Jordan has had a big expe rience of competzttons zn the Brzgade, and this report well illustrates the va.lue of the training associated with such work. It only remaz'!s, th.erefore, to .tender to him cordial congratulations hts skzljul handlzng of an unusual emergency which znvolved the trea.tment offour patients.-N. C F.

Questions and Answers II

TREATMENT OF DIABETIC COMA

P. ·s. an article the oth€r day I read that the .1nc1dence of is increasing and that these pat1ents may go mto a state of coma. I would a,sk how we as :first aiders can recognise this condition ar:d treatment we should give. Your kind adv1ce WIll be appreciated. .

The Tex t book is silent about diabetes, probably because the members of the Revision Committee considered the far t?O technical and far too pregnant with risks for specific actton on the part of first aiders.

At a'!Y I take this view and have nothing to scry. So my advzce ts that you treat the unconscious state as laid down in the Textbook and getyour patient medical assi stance as quickfy as possible.-N. C F.

TREATMENT OF FRACTURED PATELLA

N. F. (DunmQre).-Although you will no doubt say that this is not the time for revisiom to the Text- I am taking the liberty of sending you {l suggestlOn made by Olle of the ,members of · the above

Division. The memorandum was, as you ' will see, addressed to our Divisional Surgeon, who has passed it on to me with the suggestion that it should be passed on for your comments. Th e latter tried it out on a recent evening when we were standing by at the local A.R.P. post, and is, I think, favourably impressed.

If you can spare the time to deal with correspondence at this difficult period your comments will be appreciated.

The following is the amendment 1:0 the instructions on p. 90 of the Textbook with reference to the treatment of fractured knee-cap :-

Paragraph 2 to continue, "when the leg of the patient shows well developed muscles or a distinct hollow under the knee, padding should also be applied there between the splint and the back of the knee."

Paragraph 6 to read: "A short splint should be placed under and across the long splint level with the body side of the joint and held in place by either the patient or an assistant. Then apply a narrow bandage with its centre immediately above the knee-cap and about one inch nearer the outer side of the leg, bring the two ends nearly straight down to the foot side of the cross splint, pass both ends under ends of cross splint and around once, then cross the ends of the bandage under the splints and bring them up on the body side of the short splint. Slide the cross splint towards the foot by pulling the ends of the bandage .in that direction, and thus pull the upper part of the broken knee-cap into place. Then brin g the two ends of the bandage up over the leg on the foot side of the lower part of the broken knee-cap, cross the ends and draw tightly bringing this part up t o the upper part. Now tie the ends just off the centre of the leg on the outer side.

Having carefulfy tested this ingmious suggestion for improvement on the instructions of the Textbook, I find that there is a tendency for the bandage, which controls the patella, to sJip out of position In short, the bandage fails to carry out its p rimary- object which is to hold the upper fragmmt of patella securely and to approximate the fragments. In these circumstances I consider that the suggestions, while it stimulates our admiration, offers no improvement on the method detailed in the Textbook.N. C F.

EFFECTS OF J3LAST ON LUNGS

D. S. (Chesham).-I have read with interest the recently published First Aid for War Casualties and note that on p. 14 it mentions the effects of blast on the lungs which may be left in a coUapsed condition. It does not tell us, however, the signs and symptoms likely to be found in this condition, and I shall be grateful if you will detail these in the next issue of THE GAZETTE.

As far as I know there are no definite signs and symptoms which mcry be recognised by first -aiders, and the patient

presents the usual signs and symptoms of aspf?yxia. Hence the need to recognise the pos si biliry of collapse of lungs as the cause - of the aspl?Jxia, and the neces sify for the adoption of transpiration (or mouth-to-mouth insufflation ) before resorting t o artificial respiration.

Theoreticalfy it seems to me that if after exposure to blast gentle pres sure on the loins of an aspf?yxiated per son jails to drive any air out of his lungs, then you have cause to suspect the p resence of collapsed lungs.-N. C F.

SALT IN TREATM ENT OF WOUNDS

M. B. (Hull).-The Textbook on p. 107 tells us that we may use normal saline solution in the treatment of wounds. Will you therefore tell me if this solution has an y antiseptic action '6r, alternately, what is its action?

Salt solution is used for irrigation of a wound to replace in part the blood salt which has been depleted by th e associated bleeding and thus to revitalise the tissues which are rendered mm"e resistant to infection. Its action is similar with protruding bowel which, if allowed to become dry, might receive irremediable irgury. In no sense can salt solution be regarded as an antiseptic.-N. C F.

Reviews

CASUALTY. By G. B. Shirlaw, L.R.CP., L.R.CS. London: Secker & Warburg. Price 8s. 6d.

This interesting boo k seeks to cover all aspects of the Civil Defence Casualty Service, and it has been written by a d oc tor who had practical experience in the Spanish War of 1937-38. It is divided into three parts which deal respec tively with training, organisation and administration.

Part I concentrates on training and describes the general outlines of A.R.P., types of bombs and their effects and estimation of numbers of casualties. The autho; presumes that his readers are qualified firstaid ers and so is content to introduce details of special significance in rendering first aid under war cQnditions, especially in connection with kinds of casualties, wounds and wound-producing agents, fractures, shock and resuscitation.

In this section the author indulges in a futile criticism of First Aid to the I njured, because, if you please, it includes the treatment of snake bite. As an examiner for the Association he should know that this Textbook drculates through the British Empire and so must consider needs other than those of civilian emergencies at home. Further consi deration ought to lead to the disappearance of this half page.

The St. John tourniquet also meets with adverse criticism, though in point of fact errGrs in its use are usually due to inefficient instruction.

Part II is concerned with the organisation at the scene of the incident and the evacuation, of casualties.

It includes a compact analysis of the present Government Scheme and at the same time it describes an alternative scheme which the author believes to be simple, efficient and suitab le to conditions at home.

Part III deals with the administration of the different parts of the Civil Defence Organisation and should prove most to t?ose concerned with Stretcher Party Dep ots , Fust Aid Po sts, port of Casualties, Equipment and. so on: In this section the author also seeks to exc1te the mterest of readers who wish to obtain a gene..ral picture of the scope of the Civil Defence Service and at the time to promote unanimity which will naturall y aSSIst the evacuation of casualties.

N. C. F.

INJURIES OF THE JAWS AND FACE.

By W. Warwick Jame s, O.B.E., F.R.CS., L.D.S., and B. W. Fickling, F.R.CS., L.D.S. London: John Ball and Staples, Ltd. Price 15 s. net.

This work is based upon a large experience which the senior author obtained in the last war, and is, therefore, lar gely concerned with gun -shot wounds. Although the authors state that it was. of produced hurriedly, they have ill produc.1ilg an admirable treatise of an admittedly difficult subject and one in which the general surgeon has little -opportunity of gaining much experience.

The authors insist upon the paramount importance of treating jaw and face injuries in special hospit als, or, better still, in special centres attached to a o-eneral hospital. In war, however, the early stages b of treatment are usuall y in the hands of a general surgeon and may so remain for many weeks. Yet the result of this early treatment may make all the difference to the final result, upon which the future welfare and happiness of the patient may largely depend.

To the general surgeon the early chapters will be of special interest and importance, and a careful study of the subsequent chapters may save him from making many serious errors in treatment of cases which are perforce left in his llands for a long period.

The book contains a good deal of useful information on the nursing and general management of these cases; and the nursing orderly who is undertaking work in a special . centre of this kind will do well to study the book himself, for there is much that is well within his comprehension, assimilation of which will greatly add to his usefulness.

The book is profusely illustrated with excellent reproductions of photographs and radiographs; and we congratulate both authors and publiShers on a singularly useful and elegant work.

S. B.

lRoll of lbOl10ttr

The Chief Commissioner with deep regret has to announce the death, whilst in the performance of their duty, of the following officers and men of the Brigade :-

District Staff OfJice r W. A. Roust, No. 1 District, on the morning of Thursday, September 26, 1940, when a high explosive bomb had fallen at the corner of Belgrave Road., demolishing the bank premises. In addition tt> the debris which was blocking the basement a water main had burst filling the basement. A fractured gas main added to the difficultie s of the rescue and stretcher parties; a still greater difficulty was _ the presence of an unexploded bomb in the centre of the original high explosive bomb. On hearing that the rescue and stretcher parties were unable to complete their tas k Mr. Roust, as was his usual custom, -went round to inspect and to direct further operations. By that time the rescue and stretcher parties had left, presumably on account of the presence of the unexploded bomb. Mr. Roust was standing near the edge of the crater discussing with a policeman how the buried persons could be reached when th @ bomb exploded and Mr. Rb ust received fatal injuries. Mr. Roust has set an example of courage which cannot be surpassed as he must have k nown of the presence of the unexploded bomb. By his death the Brigade has lost a devoted member whose courage and self-sacrifice will be an inspiration to all.

The Medical Officer of Health of the City of Westminster in forwarding the above particulars ·of Mr. Roust's gallantry added: "You have no doubt heard that all departments of. the City Council were represented at the funeral and that there were wreaths from the various Government Departments with which Mr. Roust had come in contact. We regarded him with genuine affection combined with high respect for his integrity and capabilities, and I should like you to know that the City Council shares the grief of the Olfder of St. John in the loss of so tine and gallant an officer."

A communication has also been received from the Town Clerk, who states: "Mr. Roust had been with the Council's First Aid training from the outset of the Council's activities in this respect, and, since June, 1939, had acted as whole-time officer responsible for the organisaHon and of the Council's stl'etGher parties. His lO1iD. g -as.sodation

with the St. John Ambulance Briga de had amply

Ifitted · Mr. Roust for this important work and he brought to the Council's stretcher parties the fine S spirit · of the Brigade. This, coupled with his unceasing and untiring efforts, resulted in the Council's stretcher parties being brought to a high standard of efficiency." !

Divisional Surgeon Dr. Leonard Moss and Private D. Morton Holmes, both ,members of No. 76 (Limehouse) -' Division, were killed by enemy action whilst on A.R.P. duty at a Stretcher Bearer Depot on September 18, 194°·

Ambulance , Officer P. C. Stevemon, N o 100/3 Bricklayers Arms Division, whilst on duty during an air raid on September 17, 1940.

Albert G: reen and E. P. IPard, both of Luton (Vauxhall Motors) Division during a bombin g a tt ack on the Works.

Ambulance Officer S. Avon, No. 16 (New Cross) Division. Killed whilst servin g with H.M. Forces by a bomb on September 5, 1940.

The followin g· deaths of members of the Ro ya.! Naval Auxiliary Sick Berth R ese rve whilst on service have been reported b y the Admiralty ;-

Allan Ellis, Brie rfield Di v i sion. (H.M.S. " Courageous.")

George William Hackett, Manchester and Salford Corps. (H.M.S." Courageous.")

John Curran, Chorley Division. (Devonport HospitaL)

Ernest Schofield, CrQmpton Division. " Rawalpindi.") (A.M.C

Kenneth Parker, Bristol Corps. (A.M.C" Rawal-pindi.")

Joseph J!7illiam Yule, Kensington Div ision. (Died w4ilst on leave.)

William Thomas Ramsden, Ashington Coal Co. Corps. (Lost at sea.)

Frank Maddocks, Cheadle and Cheadle Heath Division. missing.)

Stanlf!Y Mathers, South Metropolitan Gas Company Corps. (Died on active sefvice.)

Brigade News-Continued from page 25 1

The valuable help given to the Division by the Assistant Commissioner, acting on its behalf in the absence on war service of the Divisional Surgeon W. N. Hood, is greatly appreciated.

SADDLEWORTH

A demonstration in aid of the local Spitfire Fund was recently given by members of the Saddleworth Ambulance and Cadet Divis io ns. The Cadets began the demonstration and dealt with simple fracture of the forearm, crushed foot, and fractured jaw, including barrel bandage.

Fractured spine, supine and prone positions, fractured femur showing the use of the Thomas splint for transport purposes-shown to the public for the first time in the " treated" by the Ambulance Divis ion, who concluded their demonstration with a routine examination of a patient, pressure points, and artificial respiration (Shafers and Silvesters).

Councillor A. Wild, J.p., Chairman of the Council, took the chair He was supported b y Councillor J. J. Burridge, J.P., President of the Association.

The Saddleworth Cadet Division was formed last Ma y

No. 6 DI STRICT

GREAT AYTON

In 1939 we published a report of the activities .of the Great Ayton Division, and congratulated its members on "their resourcefulness and pro gressive spirit." It is evident that this Division retains " go-a h ead" spirit. During the past few rr:onths 1t has received magnificent help from four ladies, Mrs. J. Briggs, Mrs. H. P owell, Mrs. A. Thompson and Mrs. J. Brown. In twenty weeks these ladies have collected £ 100 for the St. John Ambulance Brigade in Great A yton, and they are now raisin g more money to provide every soldier from the vi ll age-there are 13 5-with a present of cigarettes-from Great Ayton Division. After this is accomplished the Division, with the help of these ladies, will collect for the purchase of a Sun-ray lamp, Ultra-violet Ray equipment, etc., for delicate children in the village.

We wish members of this Division and their lad y helpers every success.

NO.7 DISTRICT

HEREFORD

At the Annual Inspection of the Hereford City Ambulance, Nursing and Cadet Divisions Col. J L. Sleeman, CB., CM.G., CB.E., M.V.O., Chief Commissioner for the B-rigade Overseas, and the Hon. Mrs. Copland-Griffiths, Lady Superintendentin-Chief for the Brigade Overseas, were the inspecting officers.

The Parade was under the command of County Officer G. N. Bullock (Acting County Commissioner).

Among those present were the Mayor of Hereford, the Divisional Surgeons of the City Di visions, the newly-formed Lugwardine D ivis ion s, and the Chief Constable of Hereford, Mr. Freeman Newton.

Mter the inspection, Col. Sleeman and Mrs. Copland-Griffiths visited first aid depots and posts manned by the Brigade under the Lo.cal Authority A.R.P. Scheme. They expressed appreciation of all that they had seen and complimented the Divisions on their efficiency and turn-out. -

No. 10 (<;:OUNTY OF NORFOLK) DISTRICT NORWICH

The Acting County Commissioner, K. F. Lund, M.B., M.A., recently presented Service Medals to Ambulance Officer Farrant and Sergeant High, of the Lad's Club Division. The Chief Constable, Mr. J. H. Dain, O.B.E., was in the chair, and was supported b y Assistant Commissioner Dr. W. E. Rutledge, Lady County Superintendent Dr. May Rutledge, and County Officer B. E: Sewell, A.CA. Later the County Officers officially inspected a hosp1tal.

The county A.R.P. Officer, Mr. W. H. Balls, of Cromer, has passed the County Council Examination for L.A.R.P. The was Major R. D. Ambrose, D.CM.

Short courses in First .Ll\id have already been started for members of the Auxiliary Territorial Service.

Subscribers Please Note!

Owing to the increase in postage rates, the annual subscription for the GAZETTE will until further notice be 4S., instead of 3S, 6d. Subscribers who do not wish to pay this additional charge should fill in the form below, and hand it to their newsagent. To

255 L ady County Officer Mrs. Hopton and Corps Superintendent H. J. Harris acted as Liaison Officers and A.D.C to the Inspecting Officers.

Please order on my behalf a copy of "The St. John Ambulance Gaz..ette)J which I will collect each month. Signed

(" The St. John Ambulance Gaz.. ette" is published by Messrs. British Period;cals Ltd., 19, I9a, 'Cursitor Street, E.C.4.)

Priory for Wales

Headquarters .: Priory Bouse, 4 Cathedral Rd., Cardiff

GENERAL INTEREST

VISIT OF H.R.H. THE PRIOR

The Priory Wales was honoured on Wednesday, October 9, when H.R.H. the Duke of Kem included a tour of Priory House in a surprise flying visit to the City. It was a great encouragement to the staff and all connected with the Priory that in so crowded a day each of the eight departments at Priory House were visited, one of the latest Priory ambulances and the Headquarters Me<;lical Comforts Depot being inspected. The Prior was accompanied by the Right Hon. the Earl of Plymouth, P.c., Sub-Prior, and Colonel General Bruce (Joint Commissioner No. 8 Region).

HEADQUARTER NO'1'ES

Dr. D. Rocyn Jones, C.B.E., in his new capacity as Director of Ambulance, occupied the chair at the me eting of the Ambulance Committee held at Priory House on October 22, when it was reported that the number of examinations and re-examinations in First Aid and Home Nursing arranged by the Priory throughout the Principality during the first nine months of 1940 totalled I, 13 I.

Dr. William McKendrick, Divisional Surgeon to the Blackwood Nursing Division, was elected an Honorary Life Memb€r in recognition of gratuitous services as Lecturer to First Aid and Home Nursing classes. Dr. McKendrick was appointed also a member of the Examining Staff of the Priory, a si.rnilar appointment being conferred upon Dr. Henry Lloyd, St. Asaph, whose' services to the Ambulance l'yiovement was recognised in 1927 by Honorary Life Membership.

A report from the Motor Ambulance Transport Sub-Committee, which met on October 14 under the chairmanship of Alderman G. F. J.P., revealed that the Priory ambulances had dealt with the removal of 5,034 cases covering a total mileage of 83,816 during the quarter ended September 30. For the first time on record this total shows a slight decrease in comparison with previous q:uarters, due principally to the reduction of treatment cases carried owing to air raid cQnditions in certain areas.

Sanction was given to the registration of new Divisions of the St. John Ambulance Brigade as follows :-Ambulance (Men): Cal;'diff Corporation Transport; Cefn Mawr and Llay (Denbighshire) ; Neath G.W.R; (Glamorgan).'; Nursing (Women): Morfa (Carmarthenshire); Cwmgwrach (Glamor,gan);

Pontnewydd (Monmouthshire); and Ystrad Rhondda (Rhondda) ; Cadet Nursing: Ely and Fairwater (Cardiff); and two provisionally formed Nursing Units in Carmarthenshire at Llanelly Y. W.C.A. and Dafen.

It was decided by arrangement w.ith the Almoner, The Viscount Tredegar, to call a meeting of the Almonry Committee, to review the position of the 92 Medical Comforts Depots operating under the Priory for Wales throughout Wales, which during 1939 dealt with the issue of 11,452 medical requisites and sick-room requisites. It is proposed to invite the Commissioner of each Centre within the counties concerned to appoint a male and female representative to supervise the work of the Depots in their respective centres. More than £ 5,000 has been spent in the past few years on these Depots, involving responsibility for their proper administration and In notifying the suggestion of the J oint Regional Commissioners that the Priory should submit reports of acts of gallantry in dealing with the consequences of enemy action on the part of Brigade members, reference was made to a commendable instance of First Aid rendered by Private George Mansell, a member of the " John Summers" Division, Flintshire, who continued to apply digital pressure throughout a leg amputation in a manner which evoked the highest praise from the Surgeon who performed the operation.

Council of the Priory, which met subsequently, accepted with gratitude from the Chancery of the Order the gift of a set of engravings of the Grand Masters of the Order 6f St. John.

Arising from the visit of H.R.H. · the Prior to Priory House on October 9, Council was gratified to learn that His Royal Highness had been pleased to indicate to the Principal Secretary (the Hon. John H. Bruce, J.P., D.L.) readiness to sign personally the Priory votes of thanks.

PRIORY CHRISTMAS CARD

An attractive Christmas greeting card has been produced for. purchase by members of the Order, Association and Brigade in Wales at cost price, viz., 2d. each, inclusive of envelope, postage extra. On the inside a photograph of the Prior, H.R.H. 'the puke of Kent, taken during a recent visit to Cardiff is reproduced, while the cover shows a cluster of Order flags in colours. Orders, accompanied with the requisite remittance, should be placed immediately to avoid disappointment, as the supply is limited.

CENTRE REPORTS

CAERNARVONSHIRE CENTRE

Dedication of Ambulance.-In the grounds of Bodlcndeb, Conway's Civic Centre, on Sunday, September 8, the Vicar of Conway (the Rev. Daniel Thomas, B.A.) dedicated to service the new ambulance purchased by the local Division of the Brigade. A representative attendance included the Mayor, and members of the Borough Council, the Centre President, Lord Penrhyn, Assistant Commissioner T. J. Pritchard (Chief Constable), Dr. Hammond Gater, County Officer, officers and -members of the Brigade, officials and members of the Fire Brigade, A.F.S., Air Raid Wardens, members of the British Red Cross Society, Scouts and Guides.

Corps Superintendent H. Christmas Jones presided and called upon the Mayor (Alderman E. D. Rowlands), who pointed out that his predecessor in the Mayo ral chair; Councillor Jo seph T. Jones, was associated with the starting of the fund. He also expressed appreciation o f the work of other contributors to the acquisition of the ambulance, which was an essential part of equipment in the public services.

Alderman A. Ivor Parry, chairman of the Health Committee, referred to the pro g ress of the movement from the time when, a difficulty havin g been rai sed in the matter of finance, Councillor Joseph T. Jones, guaranteed whatever sum the Council might vote.

The Mayoress then unyeiled the ambulance which was impressively dedicat ed by the Vicar.

On behalf o f the Conway Division, Mrs. H. C. J ones presented a bouquet to the Mayoress. The ambulance was open to inspection by those present and a collection was taken for the fund.

FLINTS HIRE CENTRE

The services of Private George Mansell, John Summers Division, have been specially commended by the Priory for Wales for his conduct in connection with the treatment of air raid casualties, the details of which are contained in the following report from Dr. M. Gavin to the Divisional Superintendent, Mr. H. Brake Freeman :-

"As the Superintendent of the John Summers Divisi<?n of St. John Ambulance, I wish to acquaint you of the behaviour of one of your men, G. Mansell, Garden City, Queensferr y On August 30, 1940, he did some marvellous work in attendin g a little boy who had his ri ght leg shattered with all the arteries except the anterior tiabial completely sever ed. For a good time before I arrived he stopped what would have been a fatal h::emorrhage in a few minutes by pressure on the right femoral artery and at the same ime gave directions to apply a tourniquet. While It was there he continued with the di gital pressure for a time which to him must have been ages as such pressure is not an easy job. He gave me every possible assistance a few minutes later when I had to do an immediate amputation and his behaviour was ex-

cellent, while at the same time he lacked none of the kindness and sympathy which all First Aiders should have. As a doctor I feel it part of my duty to let you know of this, as in .my opinion no words of praise are good enough for him, and I hope you will bring the matter to the proper authorities as it ma y be an encouragement to others in their first aid work."

Flint Member's Misfortune.-The Commi ssione r for Wales has written a letter of sy mpathy and good cheer to Gunner R. Lewis, a member of the Flint Division, now prisoner of war in Germany Mr. Lewis attended a re-examination with his Brigade colleagues only a few days before departure for France, and there is little doubt that his seven years' Brigade service have pro vided him with many happy recollections, while the practical knowledge and experience gained will be of undoubted value in the present distressin g conditions.

CENTRE

Barry County Area.-Mr. F. R. Hortop, Barry, has retired after 41 years' voluntary service in successive ranks of the Brig ade, having held the important office of Assistant Commissioner for Barry County Area from 1928.

Mr. Hottop founded the first Dnit of the St. John Ambulance Brigade in Barry in 19°9 and he has maintained an active control ever since.

His first association with the Ambulance movement was in connection with the old Barry Railway Company in 1898, and ten years later he was organising first aid classes for the Glamorgan County Council.

His outstanding services to Ambulance work were recognised by his admission to the Order in the rank of Serving Brother in 1920, while he has been the recipient subsequently of the Vellum Vote of Thanks of the Order and the Vote issued by the Chapter of the Priory.

It is good to know that the benefit of such loner and practical experience in the work is secured tg the Priory by Mr. Hortop's continuance as a Member of Council, but it was felt that it would be unfair to ur ge Mr. Hortop to continue carry the responsibilities of Brigade office when his resignation is based upon ill-health. Mr. Hortop is succeeded b y Dr. M. V. Roberts, formerly Corps Surgeon, Barr y and District Corps.

T relewis Medical Co mforts D epot.-The Hon. J ohn H. Bruce, JP., D.L. (Principal Secretar y and Commissioner for Wales) opened a Medical Comforts Depot on Thursday, October IO, at Trelewis, where equipment to the value of £36 has been purcha sed with funds raised by the local D ivisio ns. Trelewis is in having both and Nursin g DIVISIOns, each supplemented With a Cadet DIii!:, comprising altogether a membership o f 96. The new development has already proved its worth and bids fair to rank well the neighbouring depots at Bargoed, from which 452 articles were issued durinob 1939, Nelson and Pontlottyn.

CENTRE

Cardiff Members on Parade.-A parade numbering - I 5° ambulance men, nurses and from the Cardiff and District Corps, proceeded from Sophia Gardens to Llandaff Cathedral headed by the Melingriffith Band (under Bandmaster T. Powell). Assistant Commissioner Captain F. P. Robathan, M e, was in command, supported by County Officer A. J Jenkins and Corps Superintendent J. MacDonald. At the Cathedral, Assistant Commissioner B E. Maberly was in attendance with members from the Whitchurch Ambulance a:.nci Nursing Units and Rhiwbina Nursing Division. Lady County Officer Miss Mar y Metcalf, R R.C., and Lady County Officer Miss V. W. Rees were present at the service.

New Units F irst Inspectio 1Z .-The Whitchurch Ambulance and Nursiflg Divisions inspected for the first time at the first aid post on Sunday, October 20, by the Commissioner, Squadron Leader Dr. Edgar Llewellyn. He was accompanied by Assistant Commissioner, Captain F. P. Robathan, M.C., Mr. B. E. Maberly, the Lady County Superintendent Miss G. Richards and Flight-Lieutenant Davies, among those present being Lady Corps Superintendent Mrs. Stephens and Dr. E. H. Spickett. Divisional Surgeon J. Hunter Sewart, to whose instruction and encouragement the new Divtsions owe their establishment, was presented with the certificate of Honorary Life Membership of the Priory, granted in recognition of his gratuitous services as Lectu,rer; and Warrants of Appointment were handed to Mr. Alan Spence Thomas (President), Mr. H. J. Peacock and Mr. J. E .. Alexander (VicePresidents), Mrs. B. Rees (Lady Lady Divisional Superintendent Miss M. Rees, Lady Ambulance Officer Mrs. E. Tucker.

First Aid, Honie Nursing and A.R.P. awards were presented; and demonstrations were given by Ambulance and Nursing teams.

NEWS IN BRIEF

It is gratifying to the Priory to know that one of the two classes to be continued during wartime at H.M. Prison, Cardiff, Women's Section, is that devoted to First Aid. This reflects creditably upon Miss M. Ker.nick, a Serving Sister of the Order and former Lady Divisional Superintendent in the Brigade who, since her appointment by the Home Office as an Honorary Teacher 14 years ago , has attended the Prison once each week with very few exceptions.

Obituary

We regret to record the death of Miss Annie L. Horn, who received fatal injuries in a recent motor accident.

Miss Horn was a member of Stansfield Nursing Division and secretary to the mobile unit of St . Luke's Hospital.

Her fellow-members and colleagues in the mobile unit lined the pathway leading to St. Mary's Church, Laistetdyke, where the funeral service was held.

'Red Cross and S.t. John War Organisation

(Continued from page 22}, October issue)

EXECUTIVE COMMITTEE

At a recent meeting of the Executive Committee of the War Organisation, the Committee expressed , its great appreciation of the underta king of the Canadian Red Cross Society to provide, pack and dispatch ten thousand parcels a week for prisoners of war, representing in terms of money a contribution of not less than £250,000 a year. The Committee confirmed the grant of £250,000 for national relief of air raid sufferers as well as one of £ 10,000 for books and games for prisoners Q.[ war. The Committee heard with satisfaction that ten th o usand beds in convalescent homes had been fully equipped or were in process of equipment. It will be ..recalled that the first request of the Ministry of Health to the War Organisation was for ten thousand beds for Service patients. Later, the Ministry asked for a further ten thousand beds to be provided.

CANADA AGAIN HELPS

Through the good offices of the Canadian Red Cross Society, 5°,000 packa ges of tetanus anti-toxin are being shipped immediately from Canada. The shipments are being made in response to an appeal from the War Organisation to Colonel Nasmith, the Overseas Commissioner in London of the Canadian Red Cross Society. The transaction was arranged by cable in less than a week from the request bein g first made by the War Organisation.

CZECHOSLOVAK HOME

The War Organisation has undertaken to co' operate with the Czechoslovak Red Cross in the establishment of a convalescent home for Czechoslovak soldiers and airmen in Great Britain. This decision breaks new ground on the part of the War Organisation, as it has not so far directly associated itself with the Red Cross Society of an Allie d country in the provision of conval escen t homes for Service patients in this country.

INJURED CIVILIANS

It will not be out of place to remind th ose concerned with the welfare of civilians who are injured as the result of air attack that their relatives may be helped to visit them in hospital. Hospital Liaison Officers have authority to help relatives of persons who are air raid casualties if they are asked by hospital or civil authorities to give them assistance. What help should be given must depend on the circumstances: but free travelling warrants and reduced -fa re s for relatives can be obtained through the Public Assistance Authority.

BOOKS AND MUSIC WANTED

The Red Cross and St. John Library Department is anxious fully to meet the great demand for books for civilians who have been injured during recent air attacks and are at present in hospital, and it urgently appeals for gifts of novels and other light reading matter.

COMFORTS COLLECTIONS

A billiards table, and pianola, wireless sets, . and games and chess sets are among the five thousand gifts which have been received recently by the Comforts Collection Department. Many people have sent clothing for air raid casualties, a large and particularly suitable consignment corning from the residents of Beaconsfield. Two manufacturer s each presented one thousand Emplo yees of' a firm have subsnibed to pr ovide football equipment which had been asked for by a hospital. Hospital shirts have arrived from Sydney, New South ' Wales.

OVERSEAS

Inconveniences of bulk transport between the War Organisation in London and its Red Cross Commission in the Middle East have been avoided in the case of ambulances by the generous action of the Australian Red Cross Society. It has presented nine all-steel motor ambulances to the War Organisation for use in the Middle East. Lord Somers, the Red Cross Commissioner, recently accepted delivery at Jerusalem.

A GIFT FROM BRAZIL

From the readers of the Diario de Pernambuco the War Organisation · Ius received a . contribution of £ 760 for the purchase of an ambulance. Owing to the special nature of this donation, the appeal for money for ambulances has been closed, it has been decided to allot an ambulan.ce which when in commission will bear the inscription-" Presented by Brazilian W ell- Wishers: Readers ' of the -Diario de Pernambuco in '.Pernambuco and Rio Grande do Norte, Acknowledging 'this gift, Sir Philip Chetwode has wri tten to the Editor: "During these strenu ous times the sympathy and support shown us by our friends overseas is. a great . encouragement to us :in the humanit arian 'York we are carrying out, and we are indeed grateful for their help."

AIDING RE1.ATIVES

The Relatives .Section reports thaf it has been able to establish very satisfactory co ntact between its liaison officers and the Citizens' Advice Bureaux and the Soldiers', Sailors' and AIrmen's Families' Association. Both org anisations have agreed to look after the homes of relatives who are visiting wounded or sick members of the Fighting Services in hospital, particularly where special supervision is needed for young children who have to be left behind.

PERSONAL PA R CELS SOON

The War Organisation is arranging for personal parcels from the next ::- of-kin of pl<isoners to be handled

within a short time. In the meantime, the Prisoners of War Department earnestly ask that no parcels of any kind should be sent to their headquarters at St. James's Palace. Every effort is made to dispatch Red Cross standard food parcels to prisoners reg ularly and with as little delay as possible. Relatives and nextof-kin will greatly help the ; Department in their heavy task of packing and dispatching many thousands of parcels every week if, in the light of this assurance, they will refrain from writing about the parcel service .

TEN V OLUNTEERS WANTED

:The Central Hospital Supply Service wants ten women volunteers. It wants them ur g ently. The duty will be to sort and pack hospital supplies at the eH.S.S. Store at 19a, Cadogan Gardens, S.W·3· The work is heavy and should only be undertaken by those who are really fit and are capable, the refore, of strenuous physical labour. We give these particulars so that no one who thinks of answerin g this call for service should be under any misapprehension as to what is required of her. But, we stress the point, whoev.er does volunteer will be undertaking really useful and much needed work.

Telephone Change. The t el ephone .number of the Transport of Wounded Department is now SLOane 8221.

RED CROSS AND HOME GUA RD

The Home Guard has an important position today in the home defence or g ani sation. It is, o f course, a combatant body which form s a corporate el ement of the military machine. In the event of an invasion members of the Home Guard will be called upon to - fight. The :British Red Cross Societ y, on the o ther hand, is a non-combatant body, and at no point do its activities and the duties of the Home Guard combine. Indeed, that one is non-combatant and the o ther is proof that their respective sphere s in a war cannot be brought into associati o n. E i ther bod y has its own war task. No active member of the British Red Cross Society could, therefore, serve in th e Home Guard and continue as an activ e member of the Society.

The question is not merely a personal matter

The Red Cross emblem in war enjo ys a privileged po siti o n and i t place s those who serve under it also in a priv ileged position. But its personnel, in consequence, is required to respect the conditions laid down for the use of the Red Cross emblem. One condition is that the personnel is non-combatant and from this condition it follows that the Red Cross Organisation in all countries is based upon the principle of neutrality. The neutral standing of the British Red Cross Society would therefore be gravely prejudiced if its members were permitted also to be members of a combatant ·body such as the Home Guard.

Just Pub1ished INJURIES OF THE ' JAWS AND FACE '

With special reference to War Casualties BY W. WARWICK JAMES

O.B.E., F R.C.S., L.D.S.Eng. AND B. W. FICKLING

F.R.C.S., L.D.S.Eng.

War wounds are more severe than those in civil life and, must, therefore receive chief consideration. One of the of this book having experienced the treatment of many casualties during the last war has recorded those experiences in great detail. There are nearl y 200 illustrations.

Roya18vo. (9l x 5t). Pp xii+200. Price 15/-, postage 6d. extra

JOHN BALE & STAPLES LIMITED

83·91 Great Titchfield Street London, W.I

A TIMELY REMINDER THAT is still the most economical general antiseptic for domestic use •••

For households of moderate means, the inexpensive bottle of loaine, obtainable for a few pence from any chemist, is a sound recommendation for first aid application in minor injuries.

W ri te /01' Free Eme rgency Chart ' IODINE EDUCATIONAL BUREAU Stone House, Bishopsgate, Londo·n, E.C.2

,

RECEIPT OF PARCELS

Do prisoners of war receive the parcels which are sent to them by the Prisoners of War Department?

There are sceptics; but evidence received by the Department points to the conclusion that the parcels, with few exceptions, do reach their destinations. When, before the evacu ation from France, parcels were addressed personally to prisoners, a postcard of acknowledgment , was encl?sed. The percentage of acknowledgments was, for instance, to the end of March-in the case of prisoners of war, 95, and civilian internees, 7"'1.

SIGNATURES GENUINE

Of course, it can be alleged-and in fact one correspondent did so maintain-that the signatures on the postcards are not the genuine signatures of the persons for whom the parcels are intended. It was an exp'ected charge to which the Department had provided them.selves with the answer. They submitted a number of signed cards to in order to satisfy themselves. In no case was any doubt thrown upon the genuineness of the signatures. More general evidence that the parcels were received is produced. There were, for instance, who wrote to the Department about the contents of their parcels. There were also reports of the delegate in Germany of the International Red Cross Committee and of the representative of the American Embassy in Berlin. The evidence could not but leave the firm that the parcels were reaching those to whom they were addressed.

A negative instance can be produced which bears out that view and, though it is a single case only, yet it does allow of the deduction that the machine for the distribution of parcels in Germany to prisoners of war functions squarely. An airman prisoner died in hospital seme weeks after his capture. Everyone of the parcels sent to him was returned to the Prisoners of War Department through the Germap and Belgian postal services marked "

PENNY-A- WEEK FUND

Mr. Herbert Morrison, M.P., the Minister of Supply, has sent a message _ to the Committee of the Penny-a- Week Fund in which he says-" The help given by the Red Cross to relieve distress caused by Hitler's barbarous air attacb is one more reminder of the good use being made of the Penny-a- Week Fund." ,

"From this Fund," he continued, "to which 3,500,000 wage earners now voluntarily contribute, and other Red Cross revenues, £250,000 has been allocated to help meet the immediate needs of those whose homes have been bombed.

" The Red Cross is a fine human undertaking and through the Penny-a- Week Fund wage earners now take a vital part in it. There must be hundreds of thousands of workers who are not yet regular contributors. I do not believe they will hesitate to join when they realise how greatly they caft help by small contributions given freely and: by many."

2.62

Brigade During the Blitzli.rieg "

The following duties have been carried out in a certain Midland town by members of the shire Central Corps during October :No. of

Hosp ita l Duties: Duties.

Pathological Laboratory (Blood Transfusions)

Ward duties during raids and alert periods

Main and Minor Casualties (Theatre duties during actual raids)

Transport Dutz"es during Raids:

Air raid casualties *

Bedridden invalids evacuated from delayed action and unexploded bomb areas

Street accidents and emergency removals during alert and raid periods

Normal Transport Duties:

Stretcher parties supplied for the evacuation of patients from {lospitals

General removal cases ..

* Published only by the Governmen-t.

Thank YOU!

Thanks to The British Navy, The R.A.F. and - the British Merchant ' Navy this Journal is on sale through-out the British Empire ; at the same price. Weare relying on you for one new reader this month. Thank you.

St. John Ambulance Association.

AmbUlance

CLASSIFIED ADVERTISEMENTS

Advertis ement s TJ)jth remittance should be sent to the St. John AlIlbNlance Gazette, 19, Ctlrsitor Street, E.CA· zd. per word, minimum 3s.

SCENT CARDS AND SACHETS, printed with your announce· ments, are splendid money raisers and show 300% profit. Samples free on request.-AlREDALE PRESS, Bradford

PENCILS

OF SUPERIOR QUALITY, printed with your Corps Name and announcement, sell easily. Sample free.AlliXDALE PRESS, Bradford.

RAZOR BLADES FOR FUND RAISING. Etched (Printed) with your Name Section or a ny Announ ce m ent on request. Best quality British. Fits all 3 peg razors. Sells at Id. each or Cartons of 6 tlades 6d. We are equipped to supply very small quantities. Samples, price and particulars free.-ROBERTS BROS. & Co., 143, Town Street, Beeston, Leeds, 11.

WANTED BACK NUMBERS OF THIS JOURN ALJan. to Jun e, 1928, D ece mber, 1928; March, Jun e , 1930 ; Feb. to March, 1931; Feb., 1932; J an., 1933, March to Sept., 1933; J a n. to Sept., 193 5; Jan. Marc.h, April, Jun e, 1936 ; March to J nly, I rl37 Please sen d WIth pnce to Box 93 c/o Publishers.

EVERYTHING FOR SAFETY EVERYWHERE 'NOVOX' and· 'NOVITA' Oxygen CO: or Oxygen RESUSCITATI NG APPARATUS for the apparently asphyxiated or drowned. SMOKE HELMETS of all Patterns.

'PROTO' & 'SALVUS' OXYGEN BREATHING APPARATUS , 'PURETHA' GAS MASKS for Naval, Military and Industrial purpose, and for Civilian use. ALL A.R.P. EQUIPMENT

DUST and SPRAY MASKS Safety SIEBE, and all other and Protective Devices. GORMAN & LONDON, S : E.1. Co.,

PRACTICAL BOOKS

AIDS TO FIRST-AID (7th

AIDS TO HOME-NURSING

AMBULANCE COMPETITION TESTS

Utlje 310bn OFFICIAL GAS CHARTS

No. I Chart shows gas derivations :-

No. 2 is a full and complete educational chart of "Typical War Gases."

Everyone taking an "A.R.P." Course should be in possession of these charts which are now available for general issue to all St. John organisations at a nominal fee.

Y of the world's health problems are solved by 'ASPRO' , for 'ASPRO' brings within the reach of all freedom from pain-the mea"""ns to banish 'flu, colds and rheumatic attacks. It protects the whole household from child to parent, brings sweet eep to the sleepless, soothes the i rritable ishes headaches in a few minutes. Its fame now flashed through the consciousness of the civilised world. 'ASPRO' is acclaimed everywhere. It's the medicine that stops pain without harming - the heart or stomach-no harmful after-effects can accrue after taking 'A SPRO' tablets. The 'ASPRO' pain-relievingservice has spread throughout the world- /' bringing health and happiness to all. It ij

the Editor, at 32, S hoe L ane , E.C.4. R epo rts and pho t ographs sh ould reach him not later t han the 28 t h o f t he month preceding the date of i ssue.

Subscriptions an d Advertisements should be f orwarded t o the publishers : Messrs . B ritish P eriodicals, Ltd., 19 , I9a, C ursitor Street, London , E·C. 4 Editorial Home Nursing Page Overseas News Pro UtiLtate Horrunwn

Railway News

Air Raid Precautions

CONTENTS

New Feature of Brigad e Work

Priory for Wales

Interesting Case R eports Questions and A n swers

Rev ews ., B rigade News _ Ob ituary

Red Cross a nd St. Joh n War O rgan isation Hints for F irst Ai d ers

Blood Transfus on Talks on t h e ¥anual

CHANCERY OF THE ORDER,

ST. J O HN'S GATE, CLERKBNWEL L LONDON, B.C.I.

Red Cross and St. John Fund

His Maj esty the Kin g has b een g raciously pleased to allo w the us e of ro o m s in St. J ames ' s Palace for the administrative o ffice s o f the Du k e o f Gl o ucest er 's Red Cro s s and St. John Appeal.

Many of our readers will be aware o f the sep a r a tion o f the Red Cross and St. J o hn Fund fr o m th e Mansion House, following th e Lord M ay or's decision to extend

his Lo n don Ai r R ai d D istress F und to assist air r ai d v i cti ms thro u g h o ut the count ry .

Comment ing on the change, The T imes, in a le a di ng ar ticle on Octo b er 28, said :- " B y the honour-ab le tra dition of his offi c e, the Lord Mayor of L o nd on i s ac cus t om ed t o lend t h e weight of his a u thority to w h a t ever is for the time being the most importan t ap peal being made to public benevo l ence A t th e beginning of the wa r it was adjudged t hat thi s description applied to the collection being made for the ma n y-si d ed wo r k of the R ed Cr oss; an d the L or d M ayo r a cc o r dingly a ccepted from the D uke of G l o uce ste r t he c ommission to collect for that grea t so ci ety So long as the two funds administere d f r om th e Mansion House were of different sco p e, t he o ne na ti onal for the R ed Cr oss, the other local for t he r elief of London dis tr ess, there was little risk of co nf u sio n. But n ow t hat b oth - are national, and b o th evi d ently of first -ra t e importance, t h eir continued association un de r the same roof may lead to inconvenience. I n their work, of course, the two o r ganis ati o n s can be expecte d to remain as closely a nd h a rmonio u sly connected as hitherto; the R ed Cros s Society, who have bene fited incalculably b y having the L ord Mayor as t h eir p r i n cipal al moner, a r e repaying- the service -b y supp l emen ting at many points t he work of t he lo cal aut hori ti es in air raid r elief. Bu t they have t hei r di stin ct work to do in many other fields, and t he p ositio n wi ll b e clearer to the averacre sub scriber now t ha t the financ i al a rr ange m ents of the two are to become visi bly sepa r ate. Inst ead of havi n g two Lord Mayor s F un d s, which may b e a good d eal more diffic ul t to dis tin guish in, say, than they are in Cheaps id e, the su b scriber will now b e able to draw a che qu e i n favour of t h e Lord Mayo r , for the relief of ai r rai d distress, or of the D uke o f G l oucester, for genera l Red Cross work, from whi ch air raid relief is not excluded , or in d eed che q ue s i n favour of both Su ch a chan ge i s m uc h mo r e lik el y t o increase than to dimini sh th e t o t al number of ch equ es."

HOME NURSING PAGE

CARE OF CHILDREN IN AIR-RAIDS

By ALICE ' M. PENNELL, ' O.B.E., B.Sc., M.B., B.S.

The War is teaching \1s to live and keep well mentally as well as physically, -under conditions that are quite new in the experience of even the oldest of us. This new way of life demands a new attitude.. of mind, and a wholly new set of qualities from those that were good enough for us in normal _ times before the Blitz and Black outs made our nights noisy and active, instead of quiet and peaceful. These new conditions are especially hard on young children, and it i s up to those who are older to make things les s difficult for them, less grim and nerveracking.

1. We all know that to face the dangers of Air:Raids we need real courage; not even the str ongest of us is unmoved by the nightly wear and tear of the sound of whiz zing b o mbs, o r the thud of mines, or the n oise o f Even if children seem not to mind v ery much, it is certain that their minds register impressi o ns t hat Jead to fear, their nerves are even more shattered than those of grown-ups, for they are m o re delicately strung, more lightly poised: have less" defence mechani sm, " so to speak, with which to meet the terrors of war. Fear is the r.eal Enemy that we all have to face and conquer, and in this war against FEAR, the strong must, as in all wars, try to protect the weak, and the weak include the aged, the sick, the infirm, and all childr en.

In conquering Fear the first thing to do is to face it. Don't let us pretend that it does not exist, or that i t need not exist. Repressed fear or hidden fear is much worse than Fear faced openly and squarely. Then let us acknowledge that we are afraid, but be careful not to lessen the children's confidence in us by sho wing fear. There. is something fine in courage that fights fear; there are some people who are not afraid, it is little glory for them to appear cal m in dang er. But it is grand when the really nerv ous' or frightened person puts up a barrage of courag e.

It is important that people should all pave their arrangeIDents made for sheltering during raids. If these occur during da ylight hours, matters are, as a rule, taken o ut of one's hands and one has to go to the shelter provided in the place where one happens to be.

But nowadays many homes are provided with shelters, or else people go to Public Shelters, early

.6'8

in the evening, before the blackout, and settle dow n for the night.

The very fact of having a safe place to go to helps to allay fear, and if the children are made to l ook upon it as a game or picnic, and are made to li ke thei r siren sui ts, and warm shoes, a nd m ak e a game of having their little bag s ready with a chang e of cl o th es, washing things, and packets of biscuits o r sandwiches, they will cease to be afraid, or at l eas t their fea r will gradually diminish Cust om, fa mi liarity with the idea of being ready, the disci p lin e of practising to jump up in the shortest time, and ge t dow n or upstairs-in short any exer cise w hi ch ad ds to t h e fun of escaping w ill steady nerve s that mi g ht otherwise be jarred and jumpy.

Many mothers and fathers hav e fo und that chi ldren find great comfort in learning w tru st the ms elves t o God's loving care through the hours o f raidin g Before getting into their beds , w h ethe r th ese ar e their own beds, or shelter bunks, o r ju st m att r esses under the ' dining-room t able o r s tair s, tr y and ad opt the bedtime methods that children ar e used t o-a bedtime story, their prayers, the go odni g ht kiss and blessing-so that it is not all n ew and st ra n g e.

Make the children feel resp ons i bl e f o r thei r own identity discs and little bags, and sho w them how the g rown-ups, too, have to hav e th eir own thing s, clothes, bags, m o ney and so o n, with th em; and readiJy available, when any emergency ari ses It helps children to be asked to remind " Mummy " o r " Daddy" about spectacles, or bedroom slippers, or something like that. It makes them feel important, and helpful.

In the morning if no disaster has occurred make a point of showing gratitude for It helps and encourages the children t o be optimistic and cheerful.

2 .: There are often many hour s to fill in bef ore bedtime, and it is well to have plenty of amusement or occupation for the children. A bove all, do not talk of Air-Raids, do not notice the Sirens unduly , just go on with whatever i s occupyin g the children, whether it is a story you are reading them, or a g ame they are playing, or knitting that the lli ttle g irls are doing, or drawing or making scrap -books, or showing Home Cinemas Let the stories you tell th em in shelters be chee r ful 0.£ funny ones, nothing sloppy or sad or depressing, or frightening.

The wireless g iv es t oo m any details o f raids, it is not g ood for th e child re n t o listen in t o the N ew s.

But Children's H o ur i s, as a rul e, q u ite goo d.

TA LK V ICTO R Y , if yo u ha ve t o r efer to the War, and co ntinu e t o tal k v i ct o r y.

Constructive Tho ui,ht is a g r eat corr ectiv e o f F ear.

Plan new houses, and n ew towns, g ettin g id eas f r o m b oy s and girls f or labour- sav ing de v ic es, and on th e hou ses the y aJr ead y kno w.

This IS a gr ea t w ay of stimulati ng them and m aki n g them look into the futu re. ' 3· To combat 'fear and i t s effe c ts o n e mu s t see t o the . of th e child ren as w ell as p r epanng th eu mllld s b y r eadin es s faith · o ccupati o n and trying to a feelin g o f n.ormalit y III th e b ed time co nditi on s :the sleep ing pla ce m u st b e comfortable, an d th e m.us t be ke pt wa r m . See th at th ere is en ou gh ven tIlatlO n , bu t no dra u gh ts A ho t dri n k o f milk o r o r w h a t eve r th e ch ild li kes, help s t o give th e fe elin g of w ar mth and securit y

B E R E AD Y

H A V E COURA G E.

H A V E F A ITH

T A L K VI CT O R Y .

MAKE PLANS FO R T H E FUTURE.

KEE P YOU R CHI NS UP

II OVERSEAS NEWS

SOUTH AFRI CA P RETORIA

T he annual in spection of D ivisions of the Pr eto ria Co rp s t ook p la ce recently . There were many sp ect at ors.

Li eu t -Co l on el F. H. Wels h , rep r esenting the Dire ct o r-G en er al of Medical Servi ces, and Lieut.Colon el G. E. Pe acock, M.R CP., the Commissio n er of the T r ansvaal D istr ict, inspec t ed the va ri ou s u ni t s, d raw n f ro m the Sub -D ist ri cts of t he Ea st ern T r ansva al , S.A . R ai lways and H arbo ur s, an d Pre t ori a.

T he U nits were un der t he comman d of the Acting Assi st ant Commiss i on ers, Li eut. -Co lo n el G L. van D yk and M ajo r L. Leve r , A ctin g Distric t Su periI).t end ent G . G emm ell, and L a dy D is tri ct Offi cer Mi ss G. C Ca rn ey Afte r th e i nspectio n service med als wer e p r esent ed b y L ieu t .- Co l on el W elsh t o Lad y District Superint end ent M rs . G. E. Slad e, Corp o ral P. K . Smith and P rivat e E. J. Platt . Lieut.Col o nel Welsh con g r atul a t ed the reci pient s and compliment ed all units p res ent o n th eir g ene ral smartness and efficienc y. Lad y Co rps Offi cer Mrs . K . A. B ev an, o n behalf of the Nu rsing Di vi si o ns, h ande d t o La d y District Sup erintend ent M rs Slad e a ch eq u e, b ei n g a special donation t owards the St. ] ohn Co nvalesc ent H o m e f o r So ldie rs in Joh annesbur g

BURMA

INDI A

Man y mem b er s of the Bu rma Nursing Divisions vo lu nteered an d have unde r gone hospital trainln g , at t he re q ues t of the Di r ec t or of Army Medi cal Services, wi t h a v iew t o worki n g as full -time Mo b ile V.A .D .'s.

M en and wo m en members are i n charge of the Firs t Aid P os t s. P ra cti ces h ave been held even du ring the m onsoon rain s, when Divisi ons have turned out ni gh t aft er nigh t in t he worst w eather conditions imagin able in order to become efficient in A.R.P. I n ju st over two mo n ths af t er t he Comforts Commi tt ee was st arted by-women mem ber s of the B rigade O verseas, ove r 4,000 garments we r e made and sent t o the Ce ntr al H osp ital Supp ly Service.

T en n ew Nursing D i v isions have alrea d y been fo r med si n ce Ja nuary; another two ar e in course of f o rmation

SINGAPORE

R ec ently Hi s Ex cellen cy t h e O fficer Administering the Gov ernmen t offi cially 13 First Aid P os t s m anned by men and w o men members of the Brig ad e Overseas in Singapo re. The Actin g Commiss i one r , Brig ade Overs eas in :i\1alaya, later received t he f oll owin g lett er fr om His Exce ll ency :

" D EAR M R DIVE, - I am sorry that there are still a n u mber of St. J ohn Am b ula nc e l vd Posts which I hav e no t b"een ab le to vis it . I h ope to call on them at t he next black -o ut , or, inde ed, at an y of their pract ice att en da n ces

I was i mp r essed by t he spirit of p u blic service shown by t he mem b ers of the loc al St. John's. I was told that in many cases att en dances involved pecuniary sac r ifice on the part of peop le who could scarcel y afford ev en t o co n templ ate it. One is disposed to admire, too, the loy alty of all those who for more than two yea rs hav e been p r eparing themselves against a da y which may never co m e, and most have suffered some emu,li in the proces s. '1 sincerel y hope t he day nev er will come, but i t was comforting to k n ow tha t if the worst befalls t here are man y de v oted souls '\vho are read y t o help overcome the disasters which will follow, and t o realise that Singapo r e its b and of public -spirited me n and women.

I offer my sincere congra tulations to all who have worked and are sti ll wo r ki n g t o maintain St. John's in Sin gap ore, and I repeat my offe r to visit those posts w hic h I h ave n o t yet been abl e t o inspec t.

Yours sinc erely, (Signed) S. \V. J ONES."

PRO UTILIT ATE

T ..&:.. ""'cr .&. V ...,Ib.. V

..&:... ""'0"'"

HOMINUM

The Commissioner, Metropolitan Police, has informed the Chief Commissi oner of the following magnificent example of first aid rendered by Corporal R. Dover, of the St. John Amoulance Brigade :-

During the blackout an H.E. bomb was dropped by an enemy plane on a railway track in the London area:. The engine and the two .first coaches of a passenger train were derailed, and the permanent track torn up for a distance of about fifty yards.

The fireman was pinned by his left arm beneath the footplate of the cabin. Before he could be released it was necessary to amputate his arm. There being no doctor present, and considerable danger of the boiler of the engine exploding owing to accumulation of steam, it was essential th.at the operation should be perfor!ned at once. Corporal Reginald Dover, No. I0826, of the St. John Ambulance Brigade, performed the operation with a pocket knife and a pair of scissors. He was assisted in the operation by Able Seaman (Signaller) George Vernon and Staff-Lieutenant Brown, both of whom were travelling in the train.

In order to reach the injured fireman the re scuers bad to crawl through a space about twe> feet wide between the footplate and the permanent way. There was heavy gunfire at the time and enemy aeroplanes were immediately overhead. Visibility was poor and the rescuers had to work with the light of very dim torches.

The action of the officer and seaman has been brought to the notice of their respective Commanding Officers arid statements of witnesses have accordingly been forwarded.

At the outbreak of the present hostilities Private William Griffen, of the Wigan Ambulance Division, a Sick ' Berth Attendant in the Royal Naval Auxiliary Sick Be rth Reser/e: volunteered for duty with the 8th Minesweeping Flotilla and was detailed to assist the Medical , Officer on board the flagship H.M.S. GJendower.

On the afternoon of May 3 H.M.S. GlendOJ:})er , with two other ships of the flotilla, SnaeJell.and Glen Avon, sailed for a destination _ known only to their captains. Later it was disclosed that the ships were bound for Dunkirk to assi st in the evacuation of

British troops. Griffen immediately began to prepare the GlendO/ver' s sick bay for casualties

On arrival at Dunkirk, H.M.S. SnaeJell ran aground on the beaches and proceeded to embark troops, many of whom were casualties. As the SnaeJell had no medical officer she was forced to signal to the flagship for medical assistance. Private Griffen was sent to take charge of the i nj ured on board the SnaeJell. The distance between the two ships was covered by means of a small boat, a journey which in Griffen's own words "was a little more than exciting"-the air was filled with bombs and shrapnel! When the Snaefell was reach ed, Griffen found that there were quite a number of casualties, twelve of which were stretcher cases. With the assistance of the ship's stewards he attended to every case during the return journey to Harwich.

On June I the SnaeJell, with still on board, in company with the Glendo zver, made a second journey to Dunkirk. As the first contingent of troops arrived at the SnaeJell's side a shell burst directly overhead, spattering them with shrapnel and causing many casualties. Griffen, although exposed to heavy shell fire, did magnificent service in dealing with the injured, some of whom were /Fre nchmen. When Harwich was again reached, Griffen had the pleasure to report that not one of his patients had died.

The following letter was received by the Superintendent, S.J.A.B., Wigan Corps, from Lieut.Commander F. Brett, R.N.R., Commanding Officer H.M.S. Snaefell, 8th Minesweeping Flotilla :-

" The narrative of the "-Epoch of Dunkirk' supplied to you by Sick Berth Attendant W. Griffen is a true statement of facts.

" Griffen displayed courage and Qutstanding ability during a most difficult operation. The ship was . continuously under enemy gunfire and air attacks.

" I am proud to have him under my command."

A very gallant piece of rescue work was carried out recently by Privates J. Francis, R. E. Plumby and L. M. Harwood, of the Gainsborough Division . They displayed magnificent coura ge in saving life at great risk to themselves.

These men, members of a First Aid party, were sent to a building which had been bombed and where

a f1erce fire was raging. Without regard for their own safety they entered the blazing building in search of casualties. In an underground room they found a man suffering from a broken spine. So badly was the room damaged that the patient's removal was an extremely difficult operation, but after obtaining a stretcher and with only one exit open to them they fearlessly performed their duty. During the operation the dome appeared likely to fall on them at any moment, but this did not deter them and they carried the patient out to the waiting ambulance

* * * *

On the occasion of th e bombing at Rushden, the members of the Rushden Division of the Brigade ' rendered most valuable assistance to casualties.

The County Controller, writing on the incident, says: "My Committee feel that the rapidity with which the parties turned o ut, and the skill and resource which they showed in 'dealing with the cas ualt.ie s is worthy of the highest commendation."

* * * *

On the bombin g of a certain aerodrome where a number of casualties o ccurred, the men of the works division were at once on the spot, and with great courage dealt with the wounded, although the building was still burnin g and the roof falling. The Di visio n received a letter of congratulation on their fine work from the Principal of the local hospital.

* * * *

A bomb recently fell on a well-known road in London causing considerable damage to houses and other property in the vicinity, amongst which was a certain club, of which Mrs. Murray, Lad y Ambulance Officer of No. 103 (Borough of Paddin g ton) Nursing Divisio n, is the Commandant. Mrs. Murray, with her staff, carried on in an admirable way in spite of difficulties with which she was surrounded. H avi n g to evacuate later, Mrs. Murray opened up a minor casualty depot, and treated cases whilst they were waiting to be sent to another post. Admiration was heard on all sides of the kindness shown to all the dis tres sed

* * * *

When a b o mb fell on a public building in one of Central Londods main thoroughfares, Private J. R os s, of No. I (St. John's Gate) Division, took a squad of men from his stretcher party to the scene. Immediately on his arrival another bomb was dropped, which blew him across the roadway into a wrecked building The bombed building was burning furiously, and although debris was falling around and upon him, Private' Ros s led his men into the basement shelter, and there treated and brought out the casualties. He worked in the building for several · hours, although it was being bombed continuously and was in dan ger of collapse. Finally when it became too dangero us he had to be restrained from re-entering. Ross's calm courage, unhurried and skilful workjust as though he were at enormously to prevent panic and enabled rescue work to be carried out with maximum efficiency.

RAILWAY NEWS

Southern Railway

CONTRIBUTED BY " EXON "

Ho VE

Mr. L. Brett, Class Secretary, presided at the annual presentation of awards to the Hove class.

The Chairman asked Dr. Richardson-lecturer to the Class-to accept the gift of a pair of gold cuff links as a small token of appreciation of members for his services.

The awards were presented b y Mr. F. A. Trott, of the General Manager's office, representing Mr. E. Uzze ll, Welfare Officer.

I SLE OF WIGHT

The annual distribution of awards to the Southern Railwa y Ambulance Class was held recently, when Mr. H Millichap (Stationmaster) presided.

The Chairman said the class had had a very successful year, though their numbers were small,er as a class had been started at Newport. He hoped more younger railwaymen would take an interest in the classes, and said he would do all in his power to forward the movement.

BARNSTAPLE

At the annual presentation of awards at Barnstaple Dr. Killard Leavey presided. A lecture was given by Mr. F. A. Trott, Ambulance and A.R.P. Inspector, who embodied three important subjects of Civil Defence, viz., First Aid, A.R.P. and Ro of Watching. Mr. Trott's many qualification s and actual wartime experience provided his listeners wiJ;h much useful information.

The presentation of awards was made by Mr. E. Uzzell, Welfare Officer.

CHATHA.tYf AND GILLINGHAM

The awa rds gained by members of the Chatham and Gillingham class were presented at Chatham recently b y Mr. W. W. Hunt (Stationmaster), who beartily congratulated the men on the proficiency and u sefulness of their work. He also e:JPressed pleasure in the fact that the membership was increasing every yea r.

EASTLEIGH

Th e annual presentation to members of the Eastleigh Runnin g Shed Class took place recentl y. Mr. J. T. Long (Running Shed Superintendent) occupied the chair. The awards were presented b y the Deput y Mayoress.

_ Entertainment was provided b y Harold Dunn and his Band, and other artistes, all of whom gave their services gratuitously, which made it possible for the Class Secretary to hand the sum of £5 to the Mayor's Comfort Fund for the Services This sum was augmented by a draw for a basket of fruit and a b ou quet ki.qdly given by M rs. G. J. Miles.

Air Raid Precautions

By W. C. BENTALL, O.n..E., F.R.C.S., F.R.G.S., Assistant Surgeon-in-Chiej, St. John Ambulance B1'igade

DEPOTS FOR A.R.P. SERVICES

At this time of active war, the co-operation of the various services is naturally becoming more near and active. Co-operative Training according to" Training Manual" Nos. I and 2, had been taught for ten months, and we have had our articles on that training in this series of A.R.P. notes in this GAZETTE.

To-day "training" work has given place to " operational work." And so it is our training has prepared us for &ervice, and service without proper training is inefficient and a trouble to all concerned; no a:mount of good intention or desire can replace training. Watch the training of our new Army; never are they slack, but always drilling, practising, working, and because of this, yictory will be ours. The same applies to the A.R.P. new army, in which you and I serve .

To -day we find that it is necessary for first-aid parties, ambulance drivers, and attendants, and in some oases the workers of first-aid posts, to live together in a depot, and even ' rescue squads, decontamination squads, or even A.F.S. men may share one depot. This means the mixing of various serv:ices living under the same roof, with canteen, drill, and practice rooms, sleeping accommodation, and the attendance of actual raids all formirlg part of one great the saving of life and the lowering of casualty figures.

This living together is gIvIng rise to all sorts of problems, a few of which we will look into.

(r) Paid and Voluntary Workers. In some areas the population .is able to produce a large' number of voluntary workers. These in time of peace are often peo'ple of leisure and independence. In other places there are many workers giving voluntarily of their spare time after working all day. Again, o-thers may find the calls of real war increasingly frequent, and they are not available for the call of the constant siren, or the demands for service while they are engaged in the-ir daily occupation, and so their much-valued help

can only be secured if whole time paid employment is given t o them. In many industrial areas, no voluntary whole-time service is available at all. So it is that Government becomes more liberal and sanctions an increase in the proportion of paid workers. This blending of voluntary and paid workets produces big problems in a depot, and we each have to face them from the other's point of view as well as our own!

(2) Varying temperaments, and varying educational backgrounds produce great demands on bearance and forbearance. We all have faults, and we all have good points; look for the latter, and pass over the former, and don't let us think that " I " am the only person who has no faults. '" This is a very real contribution to victory, and will prove of great value to us when the victory does come.

(3) Dress and Uniform. There are some in the black and white of S. lA.B., and there are some in the blue and gilt of B.R.C.S., and others in the overalls of the newer service. To all I say, be very careful that a just pride in uniform never degenerates into snobbery. AIt are doing their bit with a zealousness that mustn't be spoiled by things like that.

(4) Recreation and Games. Essential in a depot, but often apt to develop cliques amongst the various men and women. Use the game itself to rub off personal corners and to the development of a friendliness that could riot be otherwise gained.

Real Co-operation. Don't try and ,get your own special party always to go to the job together. It's ,amazing how in a real tighCcorner you will find the person with whom you could not get on shows some fine points that you never thought they had, and you're friends afterwards, but couldn't be before that nasty " blitzkrieg."

If you watch all these and many other chances of being decent, you will ca.-try your head higher in the march past after the victory 'has been won-and the peace that follows will b ri ng greater riches into your life.

New Feature of Brigade Work

By THE LADY LOUIS MOUNTBATTEN

Lady County President, County oj London S.J.A.B., No.1 (Prince oj District

Since 'the outbreak of war members of the St. John Ambulance Brigade have been found. in almost every branch of our Front Line, Civil Defence and other War Services, and this great body, with its high standard of peacetime efficiency, has built up a magnificent wartime organisation.

For months now our members have been glVlng wholetime service in many of the First Aid Posts in London, and in the last weeks they have also given invaluable help in the big Rest Centres established in the Metropolis for the temporary housing and feeding of people who have been bombed out of their homes.

Now a new call has been made on us to provide personnel for the First Aid Posts established in the Tubes and large Public Shelters in the Metropolitan Area. The staffing of a number of these points is now entirely in the hands of our members, and the magnificent response we have received to our appea1 for , volunteers is in the true spirit of the Brigade.

It has been my privilege to help in this work and I have spent much time among our members, who night after night, even following on a hard day's work, go voluntarily to these points to give First Aid and other medical and moral help to the densely packed crowc;ls. ' ,

It must be realised that hundreds and thousands of men, women and children go nightly to these shelters for a period varying from between twelve to sixteen hours. Many go there purely for safety, others go from homes which have been damaged b y bombs and are only semi-habitable, while some who have lost everything and for whom billets have not yet been found, look on these shelters as their second home. They eat, sleep and live there and fill every available corner so that one wonders how they could ever manage to sleep. The Tube steps, staircases and platforms ' are thronged from end to end and only the narrowest space is left for passengers to enter or alight from the trains, which continue running well after midnight. Nothing, however, deters the

sleepers; the noise of the trains and the ,denseness of the atmosphere, leave them quite unmoved. All these trials, which in peacetime would seem quit e unbearable, are borne now quite cheerfully and philosophically. The good temper which reigns everywhere is really remarkable and one is struck by the helpful and sympathetic attitude of one to the other. -

It is very apparertt, however, that with enormous masses of people herded together, the need for trained medical help is vital. The improvised First Aid posts are in some cases excellent, but in other cases they are still badly equipped and it needs all the resource of our members to deal with the situations with which they are faced. Ventilation, sanitation, lighting and water supplies are often bad and I have seen our members working successfully

conditions, which, according to our ' peacet1me standards; would seem utterly impossible.

, To the First Aid Posts are brought cases of every kind, ranging from serious injury to minor ailments such as sore throats, indigestion or purely nervous hysteria. Probably the most important duty is the diagnosis and observation of any patient suspected of infectious illness , The prevention of epidemics is vital and in these closely packed throngs is unfortunately a grave danger.

Canteens are now in the process. of being established in many of these Public Shelters, and it is hoped that sleeping accommodation and much better sanitation, ventilation and lighting will also follow.

Owing to the severe strain put upon Bri o-ade members in the Metropolitan area during the bpast months, we have appealed to volunteers from the country, I would like to express to them our deep apprec1at10n and gratitude for the wonderful way in which they have come forward and have im'mediately taken up their duties with competence and courage, very frequently at great inconvenience and expense to themselves. I have many workino- here now and am immensely struck by their and desire to help in any way that may be required of them, be .the work dangerous, strenuous, exacting or even , tedious: may be long when nothing much 1S re'qwred of them, excepting the public'S knowledge that help is at hand if needed a fact that is a vast comfort to many.

In the near future it is hoped that volunteers for this work whether they be from the country or the area, will be paid by the Borough Councils on the baw:; of full time work for a minimum of a fortat a time. Full time will constitute 96 hours m the two weeks and pay will be at the' rate of £2 .3S. 6.d. per week, members becoming automatICally msured against injury or illness contracted while duty at their posts, on registering for this work w1th the Borough Councils. Part-time workers are.also required, and although these will not be paid, theu travelling expenses to and from duty by public transport may be claimed.

Many volunteers will be needed for this work during the coming months and I know that we shall not appeal in vain. The pioneers who have been and are at present w-orking under difficult c:.onditiqns won my everlasting admiration - and respect. Thel! reward must be the immense gratitude and shown them by the public in general to whom thea St. John uniform stands for solid, s!lfe and utterly reliable.

Priory for Wales

Headquarters: Pdory Honse, 4, Cathedra] Roaa, Cardiff.

GENERAL INTEREST

GLAMORGAN JOINT COMMITTEE'S AC1'IVJ1'IES

, The Joint Committee set up in Glamorgan under the Red Cross and St. John War Organisation has undertaken responsibilities in every channel of service open to the County Committees. The most recent developments are the openino- of four Convalescent with others jn prgspect, and the opportU11.lt1es for employment as Nursing Members at these Homes have been eagerly sought by the St. John. and Red Cross personnel, who have been appomted on a fifty-fifty basis to staff them.

establishment of a Reserve Hospital Store ,in Car9iff has been completed, commodious premises hav1ng been placed at the disposal of the Committee free of cost; and this local §upply of Hospital Equipand Comforts would be of inestimable value 1n the event of 'it need arising in circumstances which would preclude the opportunity of obtainino- supplies from a distance. b

In past work of tracing the" Missing," delegated by Miss mg Wounded and Relatives Deof the War Organisation to Searchers' nommated by Joint County Committees was carried succe,ss by the Barrister appOlnted to work 1n this capaClty at the Hospital which at nearly 50 per cent. of the Serv1ce Patients In Hospital in the whole of Wales, and whose reports, following interviews with every officer and man in that hospital who was a member of the B.E.F., proved of great value. As most of the "battle casualties" have left hospital the labours have diminished of late. On the other hand the work of the Hospital Liaison Officer, anothe; group of volunteers coming under the same Department of the War Organisation, has been extended to c<?ver civilian which may easily assume cons1derable proportlOns In due course. The task of Liaison Officers, of whom 27 have been appolnted to hospitals in Glamorgan, is to provide the .comfort of relatives visiting casualty patients In hosp,1tal, wh.o are met at the railway station and helped In secunng accommodation, if necessary with monetary a1d from the War Organisation. Plans are now under discussion among the authorities confor. Hospital Liaison Officers to co-operate In the traclng of relatives of air-raid casualties in conj.unction 'With the Regional Register of the NatlOnal Council of Social Service of Hospital Library services is being

proceeded with, and it is hoped that in due .course ev,ery hospital in the county will be well supplied w1th books and the services of honorary librarians. The administration of the fund placed at the, Committee's disposal for relief of distress caused by enemy air action was delegated to the W.V . S. organisers; and assistance has been given to a considerable number of people, who have been helped over a difficult interval between loss of home or goods and the . receipt of statutory assistance, while other deserving cases which would not be eligible for official grants have been dealt with on compassionate grounds. investigation of cases has been carded out with the greatest care, avoiding duplication of efforts and grants.

CENTRE REPORTS

GLAMORGAN CENTRE

The Hon. John H. Bruce , J.P., D.L., Principal Secretary and Commissioner for Wales, accompanied by Mrs. Bruce, Lady Staff Officer for Wales, inspected the Bargoed First Aid Po s t at the invitation of Dr. and Mrs. S. B. Turner, Medical Officer and Commandant respectively, on Sunday, November 10. Advantage was taken of the occasion to present Dr. Turner, Ass is tant CommissIoner for the. Caerphilly County Area, with the Service Medal, awarded on completion of 15 years in the Brigade. Hi gh tribute was paid to the manner in which the int eres t of the Brigade had been served by Dr. Turner and his wife, the Lady County Superintendent fo r Glamorgan, who had been appoi)1ted by the Glamorgan Joint Committee to the office of Commandant of one of the Convalescent Homes set up under the War Organisation. Bargoed was fortunate in having four efficient Ambulance Units, viz., 46 men, 36 women, 3 boys and 31 gir ls, w.ith a t o tal membership of 144, all of whom are contributin g voluntary service to the maintenance of A.R.P. services in th e locality.

The Med ica l Comforts Depot, established by the Bargoed Nursing Divisio n in 1927, continues to fulfil a real need i n the area. Since its inception, 4,244 articles have been issued, and of the 452 issues made during 1939 172 were necessitous cases.

MONNIOUTH SH IRE CENTRE

Bri g ade members in Monmouthshire have learnt with deepest regret of the death on October 20 of Corps Superintendent James Leach, Islwyn Corps. In presiding at a meeting of the Ambulance Committee the day following the sad announcement, Dr. D. Rocyn Jones, C.B.E., J.P., who was for some years Com rnissioner for Monmouthshire, referred to Mr. Leach as a pioneer of Ambulance work in the county. At the Markham Colliery explosion in 1912 he took an heroic part in the rescue operations, for . which he was awarded the Edward Medal and also the silver medal and certificate of the Royal Humane Society. His services to the Order were recognised by admission to the Order in the grade of Serving Brother, and he had received the Service Medal and bar.

Abertyss'};))g Pruentation.- The Hon. John H. Bruce, J.P., D.L., Commissioner for Wales, paid a visit to the Abertysswg Divi sion on Saturday, November 2, ar:J.d presented certificates to Senior and Cadet members, con gratulating the Superintendent, Mr. T. E. Jones, upon th e excellent work carried out by him and his members. Mr. K. D. Woolley presided, and Mr: W. D. Woolley addressed the meeting. The Hon. Mrs. J. H. Bruce, Lady Staff Officer for Wales, presented awards to Nursing members, and expressed her keen appreciation of the enthusiastic way in which the formati on of a Nursing Division had been undertaken under the leadership of Mrs.K. D. Woolley.

• NURSING DI VISION RESUSCITATED

The registration of a new Nursing Division at Pontnew yd d ' was sanctioned by the Ambulance Committee on October 22. This is not a new innovation, as many years ago a Nursing Divis ion flourished at Pontnewydd. The fact that it has been resuscitated has , given general satisfaction and there is every prospect of progress under the newly-appointed officers, viz., Mrs. E. Cook, Superintendent; Mrs. C. Williams, Lady Ambulance Officer; Mrs. Hood, Treasurer; Miss Jeanetta Thomas, Secretary; Mrs. W. Lodge, Storekeeper.

BORO UGH OF MERTHYR TYDFIL CENTRE

Presentations at Abercanaid.-A presentation of certificates -to the Troedyrhiw and Abercanaid Nursing Divisions too k place by kind invitation of Mrs. Hughes , President of the former D ivision, at Pentrebach Hou se on November 25. Many members of these Units were presented in addition with their Civil Nursing Reserve badges. The Commissioner, Mr. W. J. Canton, accompanied by Mrs. Canton, Lady President of the Merthyr Centre, introduced the Hon. Mrs. John Bruce, Lad y Staff Officer for Wales, who in making the presentation spoke of new activities open to members in helping to staff rest shelters in London. She referred to t he value of having a lecture on emergency midwifery, and also welcomed the enrolment in the Division of a number of evacuated inhabitants from Deal.

The Commissioner for Merthyr, Captain W. J. Canton, is to be congratulated upon the progress being, made in wartime Brig ade strength, the latest enterprise being the formation of the G waunfarren Ambulance Division.

NEWS IN BRIEF

CHRISTMAS CARD

The demand for the Priory Christmas Card, on sale to members of the Order, Brigade and Association, at 2d. each, postage extra, has exceeded all expectations. It is unlikely there will be any surplus, so that orders should be placed as soon as possible, since they will be dealt with in rotation

Corporal' T. J. Bramwell, Newport Dock Street (Railway) Division, has been posted as a prisoner of war. The Commissioner for Wales has sent a message of good cheer to his Prison Camp address.

Interesting Case Reports

CASE REpORT No. I7I.-The Officer-in-Charge of the County of Northampton S.J.A.B. reports "the efficient performance of first aid by a member of the Northampton Division in the following circumstances :-

On September I7 a man, who was starting on the demolition of a grain silo at Nunn Mills, Northampton, was standing on the scaffold 45 feet above the ground prising layers of wood on top of the silo when he was seen to fall into the interior, a distance of 35 feet Help was immediately forthcoming, and a do ctor and ambulance were summoned.

Transport Officer H. Bland arrived with the ambulance, and, climbing to the top of the scaffold, descended into the silo by steps at the side. He found the patient suffering from shock, lacerations of scalp and elbows and an injury to the chest. Fearing fractured ribs, Transport Officer Bland decided that the stretcher must be lowered into the bin; and when this had been done, patient and stretcher were hoisted to the top of the silo.

It was then found impossible to take the patient down the three lengths , of ladder on the stretcher, and a hole had to be cut through the top girder to which a pulley wheel was attached. Meanwhile the doctor had arrived, examined the patient and dressed his wounds on the scaffold. Then the blocks and ropes being fixed, Transport Officer Bland supervised the lowering of the stretcher to the ground and without further delay removed the patient by ambulance to hospital, where he was admitted, and subsequently made a complete recovery.

COMMENT.-This report '-illustrates well how the qualifications of a first aider ought to be put into practice and is typical of the wqy in which members of the Brigade ..- overco1Jle difliculties. In these circumstances we tender cordial congratulations to Transport OjJicer Bland on the highlY successful application of his first aid qualifications to a diflicult problem in transport. - N. C. F.

1[ . :Questions

and Answers

TREATMENT OF FRACTURED ARM

E. M. (Birmingham).-In treatment of a fracture of the upper end of arm, the Texfbook tells us to apply a broad bandage round arm and trunk and to support the limb in a small arm sling. This means that the fracture comes under the broad bandage. Will not this bandage exert side pressure on the lower fragment of the broken humerus and pull it into the muscular tissues surrounding the bone?

To me the solution seems to be a pad placed between humerus and chest, and level with the fracture. Your kind ruling will be appreciated.

•

If treatmmt is carried out as laid dmvn in the Textbook there is absolutelY no risk of pressure being exerted and causing displacement of either fragment. In short, the Textbook method results in the immobilisation of the fracture at tht earliest m oment.

On the other hand, if, as you sugges t , a first aider manipulated the limb to insert a pad (of U1utated size and shape) in the axilla, he would be guilty of meddlesome first aid, because the manipulations and the pad might displace one of the fragmehts, cause it to penetrate the brachial artery or vein and so convert a simple into a complicated fracture.N. C. F.

TOURNIQUET WITH BLOOD PRESSURE PATIENTS

M. F. (Nottingham).-Is the usual twenty-minute application of a tourniquet safe with patients suffering from high blood pressure? I should imagine that, if the arteries are partly closed, there is danger of a clot forming in this time.

If this is so, would it not be a great safeguard to issue a small badge to such patients? Thj.s could be worn in a concealed position, such as under a lapel of the coat or hem of a garment, where the first aider would be warned to look as part of his routine examination.

Your suggestion is a reflection on the Textbook Had there been any such danger, the Textbook ?:vould have included it among those which are named on p. I I I. Further, first aiders should 110t be mcouraged to search the clothing of their patients.-N. ' C. F.

SIGNS AND SYMPTOMS OF CAMPHOR POISONING

M. P. (Finchley).-Reading the other day in my newspaper that a child had been taken seriously ill after swallowing a camphor moth ball, I opened my Textbook but found that it is silent with reference to this poison and its treatment. In these circumstances I shall be grateful if you will tell me the signs, symptoms and treatment of Camphor Poisoning.

The Textbook is not silent about Camphor Poisoning, since it tells you to treat as for Non-Corrosive Poisoning any case of poisoning in which the patient's mouth is not burned. Had you been to state that this poison is not specificallY named in the Textboole, 1 could have agreed with you.

•

The leading signs and .rymptoms of Camphor Poisoning are peculiar odour of breath, faintness, giddiness, noises in ears, delirium, convulsions (especiallY in children), cold, clammy skin, weak and rapid pulse and difliculty in breathing. Such cases frequentlY give rise to alarming .rymptoms, but they are rarelY fatal. Treatment, as alrea4J stated, should be on the lines laid doum in the Textbook (pp. 170-172) for Non-Corrosive PoiSo1Zing.-N. e. F.

TREATMENT OF NOSE BLEEDIN-c

R. M. (Old Trafford).-Under the treatment of bleeding from the nose the B.R.e.S. Textbook adds a note that elderly patients who develop bleeding from the nose should be placed recumbent. Is this good treatment, please? \

. If a patient /uffering from severe nose bleeding assumes or is blaced in a recumbent vosmon, the usual result is , .

that the blood pa.r ses backl,vards inta the throat and causes partial obstruction to breathing, especiallY whm the' blood is clotting. ConsequentlY the patient sits up suddenlY coughing and splu,ttering I- N. e. F.

TREATMENT OF SNA KE BITE

O. T. (Manchester).-In the treatment of snake bite (I) should warm water be used under t.he. tions of Rule 5 on p. I 33 of Textbook or IS 1t terial whether the water be warm or not? I ask this because the instructions for bite of rabid animal in Rule I (c) on p. I34 definitely names warm water. Also (2). should the wound of a snake bite be covered with a dry dressing like that of the bite of a rabid animal as laid down in Rule 4 on p. I3 5? I take it that the omission of any mention of a dressing is accidental and not intentional, and I shall appreciate your rulin g on both points.

PersonallY I consider that the dressing of the bite of a venomous snake should be identi;;al with that of a rabid animal/and I deem it unfortunate that the instruction s for these injuries differ in several respects in the Textbook.

ConsequentlY in the treatment of a snake bite (I) I Jvould Ivarm water if 011IY because it will dis solve the permanaal1ati of potash more quickly than cold, but I would not delcry action if this wa s not immediatelY av.ailable / and (2.) I would applY a dry dressing and retain it in position a bandage.-N. e. F.

SIGNS AND SYMPTOMS OF ALCOHOLISM

R. M. (Old Trafford) .-Can you please enlarge up o n the signs and symptoms of alcoholio insensibility as given on p. 174 of the Textbook? These do not seem to be as clear as those enumerated in the 38th edition.

FranklY I cannot agree you. I ndeed, I consider that the description of acute alcoholism in the 39th is a vast improvement on that il1 the 38th edition of the Textbook. Of course, you realise that for a complete picture the description on p. 174 should be combined 1vith that in the first tW() paragraphs on p. I 54.-N. e. F.

Reviews

IODINE FACTS. London: The Iodine Educational Bureau, Stone House, Bishopsgate, E.C.2..

The fact that iodine is no longer recommended by our Textbook in the emergency treatment of wounds has given rise among our members to the false impression that its use is everywhere discarded. Perhaps a large share of the disrepute into which iodine has fallen for this purpose was the result of its improper use, especially of the application -of lint or cotton wool saturated therewith, whereby burns were often added to the original wounds.

In these circumstances the Iodine Educational Bur@au (which was established in I938) has set out to gather and to correlate the vast body of iodine information which now covers a perioc\ of over one hundred years. _ As _ part of its endeavours it now

presents this very interesting pamphlet which. consists of forty-seven facts and reports. In the mtroduction we read that the Bureau places its reS6urces at the disposal of all who are interested and also . of the ge neral public, and that 1t welcomes enqUlnes.

N.

This book presents a collection of ideas. the care and nursing of war casualties and IS divlded into twelve sections each of which has been contributed by an expe:t, either a surgeon or a trained nurse. Among the conditions thus separately handled are the nursing of wounds and injuries to head, eye, face and jaw, chest and abdomen so on . .

It is not a textbook of general nursmg but IS rather desi gne d to illustrate in the peculiar and C(:>nditions associated with war the modificatIons which war has introduced into the work of trained and auxiliary nurses and the circumstances. in it is performed. Consequently it offers to junior nurses, while it tells those of wider expenence that there are adjustments to be made and that there are new problems to be faced. In b::ief, the book succeeds admirably in its purpose, which IS to show how the best service can be rendered and the maximum efficiency secured.

N. C. F.

The St. ' John Ambulance Brigade News

No. 3 (EASTERN) DISTRICT LUTON

Thouah few ceremonial parades were held on , Sunday this year, 55 officers, N.e.O.s and men of the Vauxhall Motors Division marked the occasion by turning out in uniform. A number of exService members joined other official detachments at St. Paul's Church, Luton

To fit in with varying hours of work, Divisional practices are now held at three alternative hours each fortnight. This arrangement gives every member the opportunity of attending.

The Committee is meeting monthly to advise on the success of this and other plans drawn up to meet conditions under which civil defence workers and oth ers are now living.

NO·4 (LANCASHIRE) DISTRICT CLEVELEYS

medallions and certificates for first aid and gas have been awarded to members of the Cleveleys Nursing Division Jo77

Since its formation two years ago this Division has t.rained 400 candidates. Some of these candidates are now members of the Civ i l Reserve, A.R :P. and W.V.S , and a number of them have joined the Division-bring ing the total membership - t o 50.

The prGceeds o f a w hist and bridge dri v e, recently o r g anised b y the Division, were handed over to the mobile X-ra y unit.

No. 5 DISTRICT

THORN T ON

Home Nursin g certificat es were recently awarded to m emb ers of the Thornton Ambulance Division by Mr. W i lson, w ho p aid a high tribute to the work of Divis i onal Surgeon Dr. Blackmore and Divisional Superintendent F. Carr.

When one realises, he said, that division was formed little more than twelve months ago, the standard of efficiency already achieved by i.ts members is remar k able. .

In the H o me Nursin g examination no candidate fai led to pass; 20 out of 22 passed in both First Aid and A nti-gas.

OBITUARY r

The Chief Co mmissioner much reg rets to announce the death of the followin g Commissioners:

Major John Orton, lYLD., Commissioner for NO.3 (Western) District, and Knight of the Order of St. John, died on September 3, 1940, at the age of 70 B y his death the Brigade loses the services of a devoted and experienced leader. He was one Df Coventry'-s most prominent citizens, and in I92 0 he became Regio nal Medical Officer of Health. He joined t h e Bri g ade in 19Q2, and up to his death de v oted a large pro portion of his time and energ y to its se rvice. Althou g h in poor he alth for the last few years, he refused t o spare himself, and was always read y to do his utmost for the good of the l3rigade. Recently he did much to make the WarWickshire Joint Red Cross ] ohn Fla g Day a success. His devoti o n to duty was w orth y of all prai se

Major N o rman F. C. Burgess, M.D., County Commissioner for Bristol ,., and an Officer of the Ord e r of St John, died on October 18,1940, at the early a g e of 38, after a long illnes s . He had a very disti ngu ished medical career, and was an ex-Vice-President of the British Medical Association Major Burges s becameCorps Surg eon of the Bri g ade in Bristol in 1929, and in January, 1937, was appointed County Commissioner. He devote d him self wh ole heartedl y to the service of the Bri g ade, and under him it advanced rapidly in Bristol both in numbers and effici ency . By his death the Bri g ade loses a devoted and trusted officer who alw ay s set am exa mpl e wrnch is worthy of all prais e.

Red Cross andSt.lohn III

War Organisation

(Continued from page 262, November issue)

Am FOR GREECE

Immediately the was published of the attack b y Italy upon Greece, Sir Philip Chetwode, on behalf of the War Or g anisation, cabled to the British Minister in Athens asking him to be so good as t o inform the Greek Red Cross that the War Org anisation placed all its resources at the disposal of that body. Lord Somers, the British Red Cross Commissioner in the Middle East, the ca ble continued, had been instructed to meet the requirements of the Greek Red Cross as far as it was po ssible for him to do so.

A message has been received from Lord Somers that he was already in touch with the Greek Red Cross, and would assist in every po ssible way

FRIENDS INDEED

Of the ambulances which have been to the War Organisation by the American Red Cross, the hundredth has recently arrived at a port in this country The event allows the W ar Organisati o n to emphasise the inestimable value to its work o f the mutually friendl y relations which exist between the tw o bodies. They are such that the War Organisation feels that when it has an urgent demand for Red Cross supplies which cannot be met in Great Britain, it can approach the A merican R ed Cross with the knowledge that if the y are obtainable, that body w ill provid e them. It is impossible to ex aggerat e the co nfidence which this go od will inspires throughout the War Organisation that the sick and wounded, and ind ee d all who come to-da y within the sc o p e o f R e d Cro ss relief, will ne v er appeal in v ai n for aid. It is not p os sible to record in the G AZETTE all o r even th e g reater part of th e g ifts in kind whic h come to the War Or g anisation fr o m o v e rse as. Bu t the y are many, valuabl e and varied. How v aried the y are i s shown by a reference to certain recent gi ft s from th e Am erican R eq Cro ss. They include thirt y steam di sinfectors, ea ch weig hing two and a half tons, two of which ha v e already been installed in emerg ency hospitals; a thousand Radius stoves for emer g ency cookin g in hospitals, shelters, rest centres, and so o n ; fifty mo t or cycles with combinati on outfits and spar e parts; and fifteen ohe-and-a-half ton lorries for the transport of supplies; and a con siderable quantity of ampoul e- syrin g es containing morphia solution. Thes e units are self-contained and eliminate the need for a hypodermic syringe.

ONE MILLION LETTERS

A figure which gives a vivi d idea of the immensity of the burden which a great war places upon th e

(Continued on page 280)

Hint s ' f or IMP ROVI SATION I

F irst Aider s - E specially for Cadet s

By N. S. B. VINTER, M.B., B.S., Corps Surgeon, County of Bristol No.2 Corps

Trai ning in first aid is largely a trammg in foresight We try t o foresee in practices the difficulties that may arise when we have t o t rea t a rea l patient. - O ur success in dealing with this pat ient will depend on how well we have been able to foresee what can happen, so that we know what we are going to do in any particular case This means that when the time comes we haven't got to waste time in making a plan of action, but can go straight ahead with the job.

If you have ever had the chance of watching a really good ambulance team at work in a competitio n , you will have seen that the leader is able to tell his men what to do without having to lose time in thinking out what comes next. All his directions seem to be ready at the tip of his tongue. And you will see that this is just the same, whether tl1e competition is one in which the full first-aid kit is being used or one which has been arranged as a test of improvised methods.

R apid and efficient improvisation is largely a matter of training ourselves to know beforehand what we can use instead of the specially made ma t erials in the usua l first-aid kit. The things for which we may have to find improvised substitutes are dressings (gauze or lint, and cotton wool), b and ages, antisep t ics, splint s, and t he stret cher.

The first dressing of a wound must be clean, dry an d absorbent. A clean handkerchief that has been washe d an d nGt used since washing is as good a material for dressing a wound as gauze. It is clean, dry and will absorb b lood from the wound. The in n er fo lds of a clean handkerchief are practically free fr o m germs that mig h t poison a wo un d . Washi n g a co tt on or linen ha n dkerchief ki ll s nearly all tbe ge rms t h a t may be on it, b ut it SQon picks up germs once it is unfolded and carried in a pocke t.

A n y cotton or linen rags w.ill mak e good dressings if th ey are thoroughly washed, ironed, fo lded, and kep t in a bag or a hox away from dust. \Vhen they are u se d , care must b e taken nC?t to touch the side that is going next thct: wound.

If a ready washed piece of stuff is not handy, any piece of cotton mate rial can be used if it is sterilised by sco r ching it with a flame in front of a fire, by ironing it with a very hot iron, or in a very hot oven The hea t should be just enough to the su r face of the rag go brown.

Instead of cotton wool to go over the dressing, clean cotton material is best. We need not be quite so part icular about its being free from germs as it does not touch the wOllild, but, of course, the cleaner i t i s the better. Woollen ShL..if, such as an old blanket, . can be used, and although it is less likely to be sterile than cotton, it is more springy and is therefore easier to bandage on comfortably. A thick pad of b lanket material is excellent padding for a splint , but hay, straw , wooeL shavings, or soft paper can be used for this purpose, if there is no risk of its coming in contact with a wound.

St rips or squares of any material can be used for bandages. Neckties and scarves are very useful for this purpose. I f you know how to put on a triangular bandage, you will not find it difficult to put oil an improvised bandage String or cord can be used, but if it has to b e pulled tight it is likely to cut into the patienes skin, so a good thick pad of some soft material should be put between it and the skin .

The best substitute for surgical spirit or other antiseptic for cleaning a wound and the surrounding skin is soap and water. If the skin around a '\vound is washed with wa r m water and soap, in a direction away from the wound, so t hat no dirty water trickles into it, a good deal has been done to prevent it being poisoned, which is one of the main objects of first aid. The ¥70und itself can be cleaned with soap and \vater, too, after the surroundings have been attended to, but a fresh basin of water should be used, with a clean swab, so that no germs which have washed off the skin are put back into the wound.

\Vater used for cleaning a wound and its SUtroundings must be clean. \Vater that is fit to drink

will almost certainly ' be clean enough for the purpose.

Water that has been boiled and kept covered is more nearly free from living germs which could do harm.

Tea in a teapot is therefore quite good for cleaning any wound, and is, of course, an excellent first-aid dressing for burns.

Anything that is long enough and strong enough can be used as a splint. It must be long enough to fix the joints at each end of the broken bone, and strong enough not to bend when the patient is moved.

Bits of wood, sticks from the walking sticks, umbrellas, broom handles, rifles, bayonets, ro'lled-up wall maps, rulers, pens, pencils and tightly rolled newspapers make quite good splints if they are long enough to secure the bone that is broken. It is waste of time to put on a splint that is too short.

One of the best improvised splints I have ever seen was made of linoleum, and was made by the captain of a Swedish ship for an engineer who had fallen in the engine room and had broken his shin bone.

There are several ways of improvising a stretcher described in the Handbook. Which one is; to be used depends on the circumstances. For most of them long and strong poles are needed. They should be between six and seven feet long if a 'full-grown man is to be carried lying down. Broom handles are neither long enough nor strong enough to take an adult's weight, but the ash handles of hay-forks make good stretcher poles.

To move a patient a short distance, a strong kitcp.en chair makes a useful stret<;:her, and can be used for carrying a patient upstairs. The patient sits on the chair, which is then tilted on to its back legs, until the patient is almost lying down. One bearer holds the back of the chair, while two othets hold the front legs. To go \lpstairs, bearer holding the back of the chair goes; first and goes up backwards, while the other two take their share of the weight by lifting the legs of the chair nearly level with their shoulders.

To avoid accidents with an improvised stretcher, it always be tested by someone heavier than the patient to be carried.

Improvisation is an important part of first aid, and it is well worth while to practise it. By being able to make use of the odds and ends under your hand in case of injury, you will diminish the patient's pain and shock, and so put him in a better way for recovery.

Another apticle by Dr. Vinter on Hints for First Aiders will be published in the January issue.

Red Cross & St. John War Organisation

(Continued from page 278)

International Red Cross Committee at Geneva is provided by the central office of its. Prisoners of War Department, which has just posted its millionth letter of the war. In addition, it has handled an incoming mail of over one million, one hundred thousand letters and postcards, and has telegraphed the names of more than 25,000 prisoners of war.

CHANNEL ISLANDS MESSAGES

The Under-Secretary to the Home Office told the House of Commons on November 5 that the Foreign Relations Department of the War Organisation had succeeded in arranging a Special Message Scheme for the Channel Islands. Under this scheme, persons desiring to communicate with their relatives or with friends in the Channel Islands can do so by taking their message, which must not exceed ten words, to certain Citizen Advice Bureaux, the addresses of which can be obtained at Post Offices. The cost of a message is sixpence, and it covers the cost of the reply. ' The messages have to be written in English or in French.

The messages must deal only \yith family matters.

_ The name and address of the sender and of the person to whom the message is must be clearly written in block capitals. 'The messages will be sent by air mail to Geneva where the y will be dealt with by the International Red Cross Committee. To prevent anxiety arising, the Department desires it to be understood that although the messages will be dispatched from this country by air mail, replies must not be expected by the senders for some weeks.

AMBULANCE TRAIN " COMFORTS "

Reports from Lord Somers, the Red Cross Commissioner to the Middle East, are to the effect that the organisation appears to be working smoothly. Deliveries or supplies and comforts to hospital and convalescent depots are up to date. In the main store, a large reserve is in hand. In addition, a sub-store has been established at a convenient centre. The ambulance train has been supplied with "comforts."

Canteens have been established at Cairo and elsewhere to meet the needs of the sick and wounded who travel by ordinary trains. A purchasing board under the chairmanship of Mr. J. Jardine, the Assistant Commissioner, meets twice a week.

WORK IN PALESTINE

A new convalescent home is being well equipped from the Commission's stores, and the Commissioner has purchased a launch for use by the convalescents in trips on the canal and the lakes. In Egypt, Lady Spinks is actively superintending the working parties; flnd in Palestine, Lady MacMichael has successfully raised local funds and has made responsible for the supply of materials to working parties there. The Deputy Commissioner for Palestine is Dr.

(Continued on page 232)

Reduction of infection In raid shelters * USE OF SODIUM HY·POCH·LORITE

RECOMMENDED BY THE' HORDER COMMITTEE'

The results of the long series of scientific experiments,* conducted in co-operation with eminent bacteriologists, to determine the value of Milton in air sterilization, have now been recognized in Paragraph 16 of the Horder Report:

" There is sufficient evidence for considering that the risk of air-borne infection may be reduced by spraying the atmosphere of shelters, On account of its easy procurability, cheapness in bulk and intrinsic merits the antiseptic recommended is sodium hypochlorite in aqueous solution:' The type of spray will vary from mechanically operated to hand operated apparatus according to the type and size of the shelter."

In .Milton, the common disadvantages of hypochlorites -instabi lity and causticity-have

been completely overcome, Milton is an electrolytic sodium hypochlorite of the standard strength. It reta ins its strength indefinitely and is non-irritant.

Local Authorities and other large consumers can obtain Milton in bulk from Milton Proprietary Ltd. on special terms. The general public can buy it in bottles at any cheffiists.

Methods of Spraying

For large shelters the electric Dynalysor* is availab le , but Milton can also be sprayed effectively with an ordinary hand spray.* For Anderson shelters and private refuges the Milton Nasal Spray, used in the treatment of catarrh, is ideal. All chemists sell it.

Milton-the stable sodium hypochlorite non-irritant and of standard strength

Milton costs 8d., 1/4, III It and 3/4 (including Purchase Tax). The Milton Nasal Spray, 3/6 (not subject to Purchase Tax). From all chemists.

Medical Officers and Medical Practition ers are ' invited to write for a copy of the report on the experiments referred to; also partieldars of the Dynalysor spraying unit and detailed directions for the hand-spraying of Milton. Apply to A1ilton Proprietary Ltd., John Milton House, London, N.7. 28r

Red Cr.oss & St. John War Organisation (Co!?liI1Ufd from page 2S0 )

George Stuart, and t he re are capable direct ors in TerusaJem, Haifa, and Jaffa. Sir Courtney Manifold has been appointed Deputy Commissioner for Cyprus.

HOS TELS AND LIBRARIES

The Austra lian Red Cross has put accommodation in its Hostel in Jerusalem at the disposal of the Comm ission. It is proposed, howeve r, that the Commission shall establish its own Nurses Hostel there and in Cairo. Th e shelves of the hospital libraries are f11ling up and the library service has been established for Cairo, the Western Desert, and the Canal Zone. Libraries, which are very much appreciated, have been formed at casualty clearing stations and field ambulances in the. desert. The Commissioner also reports the formation of a Prisoners of War Department. '

AMBULANCE POSITION

The Commission h as rune ambulances presented by the Australian Red Cross in addition to a fleet of Chevrolets. Auth ority has been given to the Commissioner to purchase a considerable further number of Chevrolets. The qli-estion of air am bulan ces is b ei na considered. At the request of the New Zealand Red b Cross, whi ch has placed a grant at it s disposal, the Commission i s acting for that body in supplying the needs of the New Zealand Forces in the Middle East.

SWEDEN TO EGYPT

The · personne l of the Friends Ambll lance Unit which went to Fi.rt.land under the regis of the ' War Organisation in January of this year proceeded to Stockholm when war in Finland ceased. Part then we nt to Norway and later arrived in this couni- ry. The rest remained in Sweden.

A special correspondent of The Times in a message of October 23 reports their arrival at Cairo for service with the ambulances of the Middle East Commiss ion. Their journey from Sweden to Egypt was b y way of Russia; Turkey and Palestine. For five months they were held up in Sweden awai ting Russian visas.

FROM HOME AND OVERSEAS

The Central Ho spital Supply Service Department recently received nearly thirty-nine thousand giftsin two weeks. Garments and bandages, 22,105 , for Service and civilian casualties, came from home sources. Overseas gifts, comprising 16,652 articles. included consi g nments from New York, San Francisco, Southern California, Philippines (Manila), China (Chefo o) , and Java.

In the same period, 38,962 ar ticl es made up from Central H osp ital Supply Service material were returned to store, including pyjamas, bedjackets, pullovers socks

COMFORTS COLLEcnoNs

Five pianos, induding two" grands," one a "ba b y," and WO radio g rams, were amo ng the nineteen h;m-

dred gifts received by the Comforts Co llections Department during the two weeks ending October 23. From Penns ylvania came a number of nightdresses for chil d air ra id vict.ims, and a work party in Sydney, New South Wa les, sent a large consignment of hospital shirts.

British and French residents in Brazil have met the cost of fiv e chests of cigarettes which are now on their way to -thi s country. Knitted ga rments have been dispatched from the Gold Coast. The residents ther.e are keen to send further gifts and ask what articles are most needed.

Other gifts include six footballs presented by a club in Southampton. Several work parties have undertaken to knit stockings.

The Department has been able to meet requests for football equipfnent which have be en received from a number of hospitals .

Several much-needed gifts, including a Ri n g-pong tab le, a cinematograph projector, a bo x of Elm s, an electric heater, a Sun R ay iamp and various games, were received from a young officer who was home on leave. .

Seventy-seven special boo ks and approximatelyr 4,000 other books, magazines and illustrated papers were recentl y dispatched b y the Department Consignments were sent to Home Service and Civilian H ospi tals, a County Depot and a Depot in Palestine. Gifts of books, magazines and illustrated papers found suitable for distribution were more than 8,000-a figure considerably below the average.

FOOD AND' CLOTHING SENT

In the present phase of the War there are difficu ltie s in the transport of parcels which were not experienced during the earlier period of hostilities. Nevertheless, the War Organisation is forwarding fooel and clothing for distribution to all prisoners of war camps in Germany, whether or not the names of individual prisoners are known to it. In order that it may learn whetber they are and distributed, the Prisoners of War Depar tment send, to the International Red Cross Committee and to the American Embassy, a list of the numbers of parcels of every kind dispatched, in this way giving the repr esentatives of the se tw o bodies the information necessary for supervising their distribution.

T elegr ams reporting the names of prisoners of war, co ntin,ue to be rece i ved nearly every day from th e International Red Cross Committee at Geneva, and the \)( ounded and l.vIissing Department is able to a lJ a y the anxie ty of next - of-kin at the earliest pos sible moment

Information concerning missing personnel of the Fighting Forces is also being received from the Searchers who are carrying out their enquiries in h osp itals in thi s country. Some two thousand reports have alr eady. be en received from thi s source.

282

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Blood Transfusion

By SIR UPENDRANATH BRAHMACHARI, Kt., M.D., Ph.D.

We publish below a" talk" by Sir Upendranath Brahmachari, Kt., M.D., Ph.D., recentiY broadcast by the Afl-India Radio, Calcutta. The subject is one of vital importance at the present time

(Continued from page 227, October iSJ.ue)

The personnel of our Blood Transfusion Committee consists of: -

(

I) Myself as Chairman.

(2) Col. R. N. Chopra, Director, Calcutta School of Tropical Medicine.

(3) Col. S. D. S. Greval, Imperial Serologist.

(4) Col. J. C. De, Principal, College of Bengal.

(5) Dr. M. Bose, Principal, Medical College, with (6) Mrs. Greval and Mrs. Macfarlane as co-opted members.

Our Society will act as a liaison between hospitals, the public and the military, if needed, and the " Blood . Bank" which will be located in a room in the Calcutta School of Tropica.l Medicine, very kindly provided for us by the Director.

This appeal is made to all healthy persons, male or female over 18 years of age, who are ready and willing to make a gift of their blood, to enrol themselves at once in the .list of unpaid voluntary donors. I hope that my appeal will meet with an enthusiastic and _sympathetic response from the public.

There is no danger whatsoever to healthy persons who give blood under proper precautions. _ Our experts will take the most scrupulous care in taking blood from a donor. · Nowadays there is no direct connection between the respective blood vessels of the donor and donee. Blood ma y be taken from a donor and after having been treated with sodium citrate to prevent coagulation may be injected into a patient's vein after several hours. It will not involve the slightest risk to him or her. In most cases the donor finds that he or she is better after some blood has been taken from him or her, a feeling which is no doubt, to S01;11e extent, due to the exalted mental "<itate resulting from the consciousness of being able to be of some service to a fellow-being who is dying ')r is sure to die from want of blood and whose life may be saved almost miraculously by a little blood transfusion. Generally speaking, the amount of blood contained in one's body is one-twentieth of one's body weight. Thus, an adult whose weight is 10 stone has six and a half pints of blood in his blood ves sels. He can give a few ounces of his blood with perfect safety and greatest ease.

Oftentimes it have been noted that a person whose blood has saved the life of a relation, again comes forward to give hi s blood for the treatment of another person who needs it. For such is man's sympathy for his fellow-being.

Our service is purely voluntary, and is intended only for relief of human suffering. Its aim is "to serve the afflicted." It is bound by no laws, political, religious or social, except the laws made by the donors themselves which can be summed up in the words" I serve." It is a cause in which a member of one community can help that of another and in which the rich and poor can join. It does not involve any obligation on the part of the donor, though the donation is oftentimes worth more than gold.

If anyone among us, while ·quite anxious to give a little of his blood for a fellow-being, is unable to do so on account of some physical inability, he still can do a tremendous amount of good by gentle persuasion of those who are able to make a gift of their blood.

May the medical men and the medical students of CalCutta as well as other parts of Bengal, come forward to join in this organisation. It is they who can easily make it a success and make others follow this noble example of endeavouring to give relief to the afflicted. In this the soldier, the policeman, the lawyer, the merchant, the tradesman, the clerk, the student, the teacher, in fact every healthy person, should take part, be he a European or an Indian.

Let all of us join in this noble work and induce our friends and relations to do so.

The need for a "Blood Bank" is g reat in times of war. Now that there is war in the world, which England has joined, a "Blood Bank" will be an imperative necessity in India.

I learn that in England, Bristol has been chosen by the British Government as national centre for a great blood transfusion service which I believe has come into operation. Blood will be collected from volunteers, brou ght to a central "clearing house" and sent in bottles by air directly from Bristol to any front, or to any part of Britain where it is needed for casualties.

(To be continued.)

WATCH YOUR OWN HEALTH!

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PRACTICAL BOOKS

by N. CORBET FLETCHER,

M.B., B.C., M.A.(Cantab.), M.R.C.S.

THE MANUAL

(Continued from page 247 November issue)

i I. Cover wound.

Clean, unprinted paper, if you have to improvise or whilst you are getting materials.

12. Have I any iirst aid mp.terial? " Yes, haversack or pouch."

13. Loosen clothing about neck, chest and waist. (See 8.)

14. Examine upper limb for fracture. "None."

15. Ekvate limb.

This could have been done quite easily and safely earlier, i( you had thought about it, by turning the patient well on to his left side, and that would also have kept the head well on its side. A chance for showing and' scoring extra marks for resourcefulness missed. Well, learn the lesson.

16. Treat the wound.

(a) Prepare all materials. Iodine, dressings, bandages, sling.

(b) Expose wound.

(c) Apply iodine and allow it to dry.

I. To my Engers and hand.

2. To the wound and surrounding skin.

(d) Examine wound for foreign bodies. "None."

(e) Apply sterilised dressing to wound. (Note: Look up and practise the correct method of dealing with a sterilised dressing so that it will not be made septic.)

(f) Bandage tightly.

(g) Afford support-limb in elevated pos1tion.

(Note: Work procedure, if you had to improvise.)

17. Relax pressure on brachial artery, but leave pad firmly but loosely tied in place. (Think out why this was not done before, IGIf.) 286

I §. Is bleeding still controlled? "Yes."

I 9. Treat fainting condition.

(a) Sprinkle face with hot and cold water. (Where could you obt'ain it?)

(b) Extra warmth to pit of stomach and over the heart.

(c) Friction of limbs.

(d) Smelling salts to nose. (Test before using.)

(e) No stimulants. Work.

20. Has patient recovered from faint? " No."

21. Continue treatment for fainting.

22. Has patient recovered from faint? "Yes."

23. Watch wound in case bleeding comes on as patient recovers from faint.

24 Examine for other injuries. "None."

2. 5. Prepare for transport.

Check your work by the manual, and enter your references. By writing it down step by step you have made quite sure of your work. It has been a good practice, a useful revision, and there are three weak points discovered-that must be remedied (15, IG/ e.g. Notes for further practice, IG /g, 19/a).

(To be cont inued)

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