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145 occupation. There were eight deaths from non- pulmonary tuberculosis in 1927 and four in 1926. It would be interesting if it were possible to obtain post-mortem examination of these small numbers of deaths yearly, in order to ascertain if the absence of the bovine bacillus confirms the claim that the cattle are free from tubercle. The respiratory death-rate was satisfactory except for the death-rate of children under one year, which would no doubt be improved by the work of health visitors. For years mumps was absent, but was introduced by school-boys from England during 1927. No cases of ophthalmia neonatorum had been notified for many years, but two cases, both ending in blindness, occurred in 1927, possibly because there were no health visitors to give the needed warning. The States have built 117 houses since 1921 and 80 were under construction during 1927, but Dr. Bishop would like to see baths installed in all the new houses. At present very few houses have baths and there is an urgent need for public baths. Although the water-supply is constant, there is no power to compel its being laid on to existing houses, and this lack of proper water-supply in some of the poorer parts is a great hardship and danger. As Dr. Bishop puts it-cleanliness being next to godliness-if the islanders were as well provided with baths as they are with churches and chapels there would be no cause for complaint. The last instalment of States houses will enable the worst slum to be cleared, but Dr. Bishop shows that several of the slum tenants will not willingly leave their present surroundings. PROFESSIONAL ETIQUETTE. THE recently published rulings of the General Council of the Bar upon doubtful points of etiquette and conduct are of interest to other professions. Two points in connexion with advertisement are specially dealt with. A barrister inquires if there is any objection to his broadcasting a short course of popular lectures on general topics of law with the usual insertion of his name and short particulars in the Radio Tiknes, and the description " barrister- at-law." He also asks-with a courage which will shock the older generation of barristers strictly trained in circuit discipline-whether his photograph may appear in the B.B.C.’s quarterly " Talks and Lectures." The General Council of the Bar answers that he may broadcast the lectures as given by a " barrister-at-law," but that his name, address, and photograph must not appear. Thus novel wireless ’, developments have raised an old issue afresh ; few barristers can have had any doubt as to how the Council would decide. The decision is in keeping with the long-established principle forbidding a member of the Bar to advertise himself bv articles under his own name on legal topics in popular journals. ’, Specialist articles in specialist publications like the Law Quarterly Review are, of course, on an entirely different footing. The second point of this nature dealt with by the Bar Council’s Annual Statement for ’, 1928 is the answering of legal questions by barristers z, in newspapers. Here the Council republishes a I former " warning notice " which it has caused to be displayed also on the screens of the Libraries and Common Rooms of the Inns of Court during the past year. The notice observes that the Council’s atten- tion has been called to the increasing practice of legal journals advising or professing to advise their subscribers on points of law arising in actual practice. It mentions a recent instance where a firm of pub- lishers has offered free advice on conveyancing matters to all subscribers to one of its publications. The Council has no means of knowing whether such advice is supplied by members of the Bar, but it believes that in some cases the advice is represented to the client as being "Counsel’s opinion." It reaffirms its former rulings and declares unequivocally that it is contrary to professional etiquette for a barrister to answer legal questions in newspapers or periodicals, whether for a salary or at ordinary legal remuneration: (1) where his name is directly or indirectly disclosed or liable to be disclosed, or (2) where the questions answered have reference to concrete cases which have actually arisen or are likely to arise for practical decision. A barrister inquired if the Council would give any further guidance by defining more narrowly the reference to " a par- ticular question likely to arise for practical decision." Not to be drawn into hypothetical cases, the Council replied that it was a matter for the discretion of the barrister himself. That final answer counts for much in these cases of doubt. If a professional man knows that certain forms of self-advertisement are illegitimate and contrary to the accepted traditions of his fellow-practitioners he can refrain from treading close to the border-line. Every profession has its members who sail close to the wind ; their colleagues know them and form their own opinion. In this matter of advising on technical questions in journals the legal profession has probably had some increased demand or opportunity lately in view of the revolu- tion in the law of conveyancing and real property which has sent back to school again many men of long experience and adequate instruction in the older law. The medical profession is here not quite in the same position as the legal. Advice upon health is a personal matter ; the patient must be seen by the practitioner, whereas in many cases a barrister might be able to give an opinion-upon the inter- pretation of a clause, for instance, or upon the inference to be drawn from correspondence-without an interview. Moreover, questions of health are usually more urgent than questions of legal rights ; a patient may be unwilling to wait a week for the printed reply. In other respects there is no great difference between the official standards of the Bar Council and the General Medical Council. In both professions there will be members, junior as well as senior, who are a law unto themselves. The standards cannot be upheld unless they are supported by the general approval of the rank and file. If they have that approval, they are entitled to the loyal obedience of all. CHRONIC ULCERATIVE COLITIS. DURING the last few years a good deal of interest has been shown in the subject of chronic diseases of the colon, and several important contributions to the medical literature have appeared lately. J. A. Ryle 1 has given a good summary of the clinical aspects and relationships of the visceral neurosis known as spastic constipation or spastic colon, with its allied condition muco-membranous colitis ; diverticulosis of the colon has occupied the attention of meetings of many medical societies, and a full description of its clinical features, complications, and treatment appeared in this journal last year 2; while chronic infections of the colon formed a subject of discussion at the meetings this year both of the British and American Medical Associations. The discussion at the former 3 covered the broad ground of the flora of the faeces and the relation of the bacteria found to diseases of the bowel and of the body generally. Part of the discussion turned on the possible causes of chronic ulcerative colitis and references were made to the claims of the enterococcus or faecal diplostreptococcus as a causative agent in this complaint; these claims were regarded as non-proven. At the meeting of the American Medical Association,4 4 however, strong support of these claims was brought forward by J. A. Bargen and others. In 189 cases of chronic ulcerative colitis observed at the Mayo Clinic, Bargen had isolated in pure culture a diplostreptococcus with definite morphological, cultural, and biological pro- perties, which he has come to regard as the aetiological agent in the disease. The strains isolated were 1 Ryle, J. A. : THE LANCET. 1928, ii., 115. 2 Spriggs, E. I., and Marxer, O. A.: THE LANCET, 1927, i., 1067. 3 Brit. Med. Jour., 1928, ii., 555; THE LANCET, 1928, ii., 295. 4 Jour. Amer. Med. Assoc., 1928, xci., 1176.
Transcript of PROFESSIONAL ETIQUETTE
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occupation. There were eight deaths from non-
pulmonary tuberculosis in 1927 and four in 1926.It would be interesting if it were possible to obtainpost-mortem examination of these small numbers ofdeaths yearly, in order to ascertain if the absence ofthe bovine bacillus confirms the claim that the cattleare free from tubercle. The respiratory death-ratewas satisfactory except for the death-rate of childrenunder one year, which would no doubt be improvedby the work of health visitors. For years mumpswas absent, but was introduced by school-boys fromEngland during 1927. No cases of ophthalmianeonatorum had been notified for many years, buttwo cases, both ending in blindness, occurred in1927, possibly because there were no health visitorsto give the needed warning. The States have built 117houses since 1921 and 80 were under constructionduring 1927, but Dr. Bishop would like to see bathsinstalled in all the new houses. At present very fewhouses have baths and there is an urgent need forpublic baths. Although the water-supply is constant,there is no power to compel its being laid on to existinghouses, and this lack of proper water-supply in someof the poorer parts is a great hardship and danger.As Dr. Bishop puts it-cleanliness being next togodliness-if the islanders were as well providedwith baths as they are with churches and chapelsthere would be no cause for complaint. The lastinstalment of States houses will enable the worstslum to be cleared, but Dr. Bishop shows that severalof the slum tenants will not willingly leave theirpresent surroundings.
PROFESSIONAL ETIQUETTE.THE recently published rulings of the General
Council of the Bar upon doubtful points of etiquetteand conduct are of interest to other professions.Two points in connexion with advertisement are
specially dealt with. A barrister inquires if thereis any objection to his broadcasting a short courseof popular lectures on general topics of law with theusual insertion of his name and short particularsin the Radio Tiknes, and the description " barrister-at-law." He also asks-with a courage which willshock the older generation of barristers strictlytrained in circuit discipline-whether his photographmay appear in the B.B.C.’s quarterly " Talks andLectures." The General Council of the Bar answersthat he may broadcast the lectures as given by a" barrister-at-law," but that his name, address, andphotograph must not appear. Thus novel wireless ’,developments have raised an old issue afresh ; fewbarristers can have had any doubt as to how theCouncil would decide. The decision is in keepingwith the long-established principle forbidding amember of the Bar to advertise himself bv articlesunder his own name on legal topics in popular journals. ’,Specialist articles in specialist publications like theLaw Quarterly Review are, of course, on an entirelydifferent footing. The second point of this naturedealt with by the Bar Council’s Annual Statement for ’,1928 is the answering of legal questions by barristers z,in newspapers. Here the Council republishes a Iformer " warning notice " which it has caused to bedisplayed also on the screens of the Libraries andCommon Rooms of the Inns of Court during the pastyear. The notice observes that the Council’s atten-tion has been called to the increasing practice oflegal journals advising or professing to advise theirsubscribers on points of law arising in actual practice.It mentions a recent instance where a firm of pub-lishers has offered free advice on conveyancingmatters to all subscribers to one of its publications.The Council has no means of knowing whether suchadvice is supplied by members of the Bar, but itbelieves that in some cases the advice is representedto the client as being "Counsel’s opinion." Itreaffirms its former rulings and declares unequivocallythat it is contrary to professional etiquette for abarrister to answer legal questions in newspapersor periodicals, whether for a salary or at ordinary
legal remuneration: (1) where his name is directlyor indirectly disclosed or liable to be disclosed, or(2) where the questions answered have reference toconcrete cases which have actually arisen or are
likely to arise for practical decision. A barristerinquired if the Council would give any further guidanceby defining more narrowly the reference to " a par-ticular question likely to arise for practical decision."Not to be drawn into hypothetical cases, the Councilreplied that it was a matter for the discretion of thebarrister himself. That final answer counts formuch in these cases of doubt. If a professional manknows that certain forms of self-advertisement areillegitimate and contrary to the accepted traditionsof his fellow-practitioners he can refrain from treadingclose to the border-line. Every profession has itsmembers who sail close to the wind ; their colleaguesknow them and form their own opinion. In thismatter of advising on technical questions in journalsthe legal profession has probably had some increaseddemand or opportunity lately in view of the revolu-tion in the law of conveyancing and real propertywhich has sent back to school again many men oflong experience and adequate instruction in the olderlaw. The medical profession is here not quite in thesame position as the legal. Advice upon health isa personal matter ; the patient must be seen by thepractitioner, whereas in many cases a barristermight be able to give an opinion-upon the inter-pretation of a clause, for instance, or upon theinference to be drawn from correspondence-withoutan interview. Moreover, questions of health are
usually more urgent than questions of legal rights ;a patient may be unwilling to wait a week for theprinted reply. In other respects there is no greatdifference between the official standards of the BarCouncil and the General Medical Council. In both
professions there will be members, junior as wellas senior, who are a law unto themselves. Thestandards cannot be upheld unless they are supportedby the general approval of the rank and file. If theyhave that approval, they are entitled to the loyalobedience of all.
CHRONIC ULCERATIVE COLITIS.
DURING the last few years a good deal of interesthas been shown in the subject of chronic diseases ofthe colon, and several important contributions to themedical literature have appeared lately. J. A. Ryle 1has given a good summary of the clinical aspects andrelationships of the visceral neurosis known as spasticconstipation or spastic colon, with its allied conditionmuco-membranous colitis ; diverticulosis of the colonhas occupied the attention of meetings of manymedical societies, and a full description of its clinicalfeatures, complications, and treatment appeared inthis journal last year 2; while chronic infections ofthe colon formed a subject of discussion at themeetings this year both of the British and AmericanMedical Associations. The discussion at the former 3covered the broad ground of the flora of the faecesand the relation of the bacteria found to diseases ofthe bowel and of the body generally. Part of thediscussion turned on the possible causes of chroniculcerative colitis and references were made to theclaims of the enterococcus or faecal diplostreptococcusas a causative agent in this complaint; these claimswere regarded as non-proven. At the meeting of theAmerican Medical Association,4 4 however, strongsupport of these claims was brought forward by J. A.Bargen and others. In 189 cases of chronic ulcerativecolitis observed at the Mayo Clinic, Bargen hadisolated in pure culture a diplostreptococcus withdefinite morphological, cultural, and biological pro-perties, which he has come to regard as the aetiologicalagent in the disease. The strains isolated were
1 Ryle, J. A. : THE LANCET. 1928, ii., 115.2 Spriggs, E. I., and Marxer, O. A.: THE LANCET, 1927, i., 1067.3 Brit. Med. Jour., 1928, ii., 555; THE LANCET, 1928, ii., 295.
4 Jour. Amer. Med. Assoc., 1928, xci., 1176.
