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carry to success the object they had worked, for during long years. Misrepresentation and intrigue did their work. The Royal British Nurses' Association, led by certain ardent spirits to believe that it would be swallowed up and lose its individuality, woke into sudden activity, withdrew from the proposed union, and fell into the arms of the pioneer registrationists with whom it had not been on speaking terms for several years! The College of Nursing went on its way, drafted several registration bills, held long conferences with its opponents in the hope of getting an agreed bill—and all in vain. One would have thought that, to gain its long-pursued object, the pioneers would have made concessions and marched side by side with the new organisation to victory. But no! Motives are difficult to fathom, but it certainly has seemed for years as if the pioneers would rather have no registration than one with divided honors. Negotiations were broken off and Parlia ment was again faced with two Bills and open dissension in the nursing world. Naturally the result was the same, neither Bill passed. At last the Government, realising the need for some measure, undertook to bring in a Bill of its own, which bill has since become law.

The main points of difference between the two parties over the Registration Bill were: (1) The pioneers objected to the incorporation of the College of Nursing in the Bill, which would have automatically put on to the State Register the nurses on the College register. As these were all fully trained nurses, no harm would have been done. (2) The College wanted the Pro, visional Council formed under the Registration Bill to retire within a year and become elective; the other party wished them. to continue in power for three years. (3) The pioneers objected to a clause in the College Bill which gave power to form supplementary registers of nurses with special training only. (Such power, however, could not have been used without a two

thirds majority of the electorate of nurses.) The Pioneer Bill contained no such clause, but when the House of Commons actually put in a clause establishing a register for children's nurses, no protest was made. Fourthly, the pioneers claimed that their bill was the outcome of years of thought and work, and should be supported by the newer body.

Apart from divergence on details of registration, the pioneer registrationists with their new allies, the Royal British Nurses' Association, are now unsparing in their criticism of the College of Nursing. They object to it as a society of "employers" designed to keep the nurse in subjection, and they object to its appeal to the public for funds to help nurses in need, which they term pauperising. The first criticism has a grain of truth, the second none. It is true that the first College Council was composed entirely of matrons, and that its chairman and honorary secretary are hospital. officials. But after the first three years the Council was made elective; that is to say, one-third of its members are due to retire every year and it is the nurses on the register who elect the new members. If the nurses elect their matrons or anyone recommended by their matron, it is their own fault; they have the ballot and they are free to use their judgment. Either that, or else they think sincerely that their matron is their best representative. But this year, for the first time, two rank and file nurses (one married and one in private work) have been elected. We may hope that this is only a beginning and that in time the ordinary nurse will be in a majority on a body which naturally is composed of thousands of nurses, and at most a few hundred matrons. Perhaps it would have been better if from the very beginning the Council had insisted on a certain proportion of nurses on its Council, instead of forming itself of matrons, and keeping them in power three years before having an election.

As to pauperising, the taunt is cruel but

has fortunately not succeeded in hindering the excellent work of the "Nation's Fund for Nurses." We all know that, in the past, nurses have been underpaid and overworked; with the result that there is now a sad band of elderly women, many of whom are in ill-health and almost penniless, who, but for the help given by the Fund, might end their lives in a poor-house. These women must be helped, and at the same time present-day nurses must be paid enough to enable them to provide for old age. As a token of the gratitude of the nation towards the nurses who devoted themselves to the wounded, an appeal was made for a fund to help these helpless ones, a burden which could never have been borne by nurses alone.

The Nation's Fund for Nurses, governed by a committee on which are several nurse representatives, has done noble work and the nursing profession has cause to be grateful. Meantime to make conditions better for present-day nurses, the College of Nursing has made an investigation and published a report advocating generous increases and improved conditions all round, and there is a general tendency toward shorter working hours and better pay. The success of the Registration Bill must rest largely with the General Nursing Council. At any rate the long war is ended, for the time at least. Amendments will be needed as time goes on, but at least a start has been made for which we are all devoutly thankful.

A Case of Hemophilia

JOHANNA G. MEENGS, R. N. Field Worker among the Cheyenne Arapahoe Indians

A tap on the shoulder and a few whispered words that I was wanted outside at once, made me leave the church one Sunday night to find an Indian waiting at the door.

He said his wife was to be confined and could she come to The Lodge. I had been told they were expecting an addition, but my informant also told me that this was to be the sixth child and they had never had a doctor or nurse, so I was surprised at this request.

Upon inquiry, I found the patient had been in labor some twelve hours, was in a tent a quarter of a mile away, felt pretty bad now, but they could still bring her in a wagon. I went home, called the doctor, started a fire and was ready for them when they came in. In less than half an hour a beautiful seven-pound, robust girl was born. It was a breech birth with the cord around the neck and the mother had a severe hemorrhage following the birth of

the child. However all went well until the second day, when we noticed blood coming from the nose and mouth of the child. I notified the doctor and he said it was so slight that we need have no fear. There was no apparent change until the fourth day when I noticed it was weak, did not cry and would not nurse after I bathed it. I sent for the doctor and when he came the child was having a severe hemorrhage from the umbilical region but not one drop from the cord. The doctor tried pressure, tight bandage and every styptic found in the drug room of a hospital on an Indian reservation, but all to no avail, and in two hours the child died. The father was away for the day and upon his return I had to greet him with the news.

Five months later I learned the mother was pregnant again and I immediately set to work to get what history I could and if in any way possible prevent a recurrence.

I found the mother was about thirty years
old, weighed about 200 pounds, had had
five children, three dying immediately after
birth, two were breech births, the two liv-
ing were puny children, and the mother
had always lost much blood at the time.
And about ten days before each confine-
ment had slight hemorrhages from the
lungs. The mother's mother and several
brothers and sisters had died of pulmonary
tuberculosis and had severe hemorrhages.
No known history of any other hemor-
rhages or bleeding of any kind. I went
to the doctor and it was decided to watch
her carefully, and instruct her to watch for
any unusual or
unfavorable symptoms.
Ten days before confinement she began
having slight hemorrhages from the lungs,
so we brought her to The Lodge, put her
to bed and gave her calciul lactate I
drachm three times a day until she gave
birth to a nine-pound girl, very, very
robust. It was a normal birth and while
the mother lost considerable blood, it
formed unusually firm clots. This child
never hemorrhaged from nose or mouth,
but on the fourth day had a severe hemor-
rhage from the umbilical region, but not
a drop from the cord. I sent for the doc-
tor at once and he ordered sufficient cam-
phorated opium to keep it absolutely quiet,
and gave it 250 units of diphtheria anti-
toxin and repeated this dose in about fif-
teen hours. (The antitoxin was the only
thing in the drug room containing horse
serum.) There was no special bleeding
from the prick of the needle, but we found a lifetime.

[graphic]

MARGARET W. LUMP MOUTH AT 6 MOS.

the blood lost in the hemorrhage had not clotted at the end of three hours. From an unusually robust child it had changed to what looked like a bloodless and almost lifeless child. We gave it water by mouth when we could, and normal saline per rectum every four hours. In twentyfour hours it nursed. Recovery apparently is complete, for at the age of six months. it weighs twenty-four pounds. The mother never spit up any blood after the birth of the children. I have been told that statistics give this as happening once in a thousand times. Interesting as these cases were to us, two inside of one year is enough in

Good, If Not New

A correspondent recalls a good story. It is not new, but many stories have this habit. However, it is bright.

It happened at a school where the children were hopelessly involved in miscellaneous subjects, such as grammar, phy

Teacher-" What are the principal parts of the body?"

Sharp Pupil-"The body consists of three principal parts-the head, the chest, and the bowels, of which there are five:

Told by the Night Supervisor

Beyond the Law

AGNES JAMES, R. N., & KATHARINE JAMES

Lots of things happen in hospitals to bring the mysteries of life pretty close and unless they infringe on our time or personal convenience we scarcely notice them. Miss Rawle says we do not take death seriously enough, and to the average nurse it only means a little less or a little more work, and something she hopes won't happen till after she has got off duty.

Miss Rawle is very careful about trying to instill a right attitude and very strict about the observance of every little thing that can give comfort to a dying patient. I will always remember the endless trouble she went to, to find someone belonging to that pretty girl who died in the maternity ward last winter. A real beauty she was, and wouldn't tell a word about herself. The baby was a picture, but born dead and it was only when the girl knew she had no chance, eclampsia you know, and Miss Rawle had talked and talked to her, that the poor thing told her anything.

Then Miss Rawle got busy in a hurry and in a very few hours I was called to take in a little woman in a rusty black cloak and bonnet. She wasn't really very old but just bent up with grief, I think. It was a dreadfully pathetic scene and we left them alone of course, as long as we dared. The poor old soul was awfully brave till the end and after it was all over I took her into my office and let her have it out. Dreadfully bitter she was.

"He's sent my only girl to her grave," she said, "and please God I'll do the same to him."

"Oh, hush," I said, "don't say that." "And why for not?" she asked looking up at me. It isn't that he seduced her,"

much to blame as the other in that, and it wasn't that he didn't marry her, even as he promised, but to take another woman and wed her while my girl yet had her trouble was what killed her. Him that can't keep faith with one woman, won't with another, marriage or none, and he's better off the earth."

Of course I didn't know who she referred to but I gathered it was someone quite influential. I kept her till the morning but as soon as it was light she left.

It was six months later that Miss Carney told me there was a new patient, a little old woman, in No. 17.

"It was really quite gruesome," said Carney, "she came in this morning, asking to see the rooms. She looked so poor I showed her the cheaper ones, but nothing would suit her but 17. She has an inoperable carcinoma, and had found out from Dr. Staniford just about how long she can expect to live and she says she wants the best she can afford till the end. She saw Miss Rawle and made every arrangement --funeral and all, and if she lives longer than the money holds out, she wants to be put in the ward."

"What a strange idea," I said, "what are her people like?"

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"There be things for me to do yet," she said, “but strength will be given me."

She was absolutely no trouble as a patient but I soon found out the nurses had another reason for liking to take care of her. She had been a professional medium and fortune teller, and highly envied were ones who had a chance to get into No. 17. She shared in popularity with the patient in No. 19 across the corridor, a big man with a broken leg.

Andreas Perron always made me think of that line of Tennyson, "Oh the Earl was fair to see!" Old family, money and attainments, made him more or less a public character and a good many adventures of sorts were attributed to him. However he had recently married a lovely young wife and they were ideally happy when misfortune in the shape of an automobile accident came upon them. He had a compound comminuted and it looked as if he were in for a long siege.

For a time he had two specials, then he did so well he said it made him nervous to be fussed over, so he got along with the floor nurses and they adored him. The old woman seemed to know all about him and when I said rather sharply, that I didn't allow the nurses to discuss the patients, she told me calmly they had not, they could not tell her anything about Andreas Perron anyhow!

The way she said it made me shiver, and gave me my first inkling of her connection with Perron. That she was powerless to harm him was a comforting certainty. Of course if he had been guilty it was very dreadful, but it was not for me to judge. Thinking it might ease her mind. I encouraged her to talk and I must admit I found her sane and sensible on every other subject. But I tell you it was gruesome sometimes in the middle of the night to hear her speak to dead people as if they were right there. I cautioned her against scaring the young nurses but there was no need. She only told their fortunes she

said, and rubbed in they would prosper and get everything they wanted if they minded "those in authority," for the poor old soul idolized Miss Rawle.

However much I hated to believe anything bad of Andreas Perron, this discovery influenced me and I spent less time with him and one night he sent for me.

"You've been neglecting me Miss Dick and I miss you-in fact I'm lonely." I hastily made my excuses.

"I forgive you," he said, "but don't let it happen again. Truth to tell my confounded nerves are going back on me and I am sleeping badly-at least I sleep but I have rotten dreams. Please come in often and help the night through."

It is true, he had manifested nervous symptoms which were puzzling at this date and a distressing thing that happened next day didn't help matters. I had it from Miss Carney who was dreadfully upset. An emergency perforated gastric ulcer was put in the next room. The poor girl died in a few hours and the new orderly going to fetch the body walked right into No. 20 with the stretcher. You know what the stretcher looks like from the morguethere's no mistaking it.

"It was awful," said Carney. "Mr. Perron laughed, said it was a bit premature, but he went white and his hands twitched all over the bedclothes. Dr. Beckwith is talking specials again, but I can't get anyone to-night."

I said I'd give him all the time I could. and I did stay in there quite a bit. I felt sorry for him he was so helpless fastened there on his back and afraid to go to sleep because of those awful dreams. Once over,

when he wakened, he insisted we'd brought a coffin in and put it on the bottom of the bed, and I had quite a time convincing him it was just the way the "cradle" looked to him.

The old woman was worse, too, weaker that is, but she seemed very serene. She said that her "controls" were going for

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