History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: January, 1949 Vancouver Medical Association Jan 31, 1949

Item Metadata

Download

Media
vma-1.0214291.pdf
Metadata
JSON: vma-1.0214291.json
JSON-LD: vma-1.0214291-ld.json
RDF/XML (Pretty): vma-1.0214291-rdf.xml
RDF/JSON: vma-1.0214291-rdf.json
Turtle: vma-1.0214291-turtle.txt
N-Triples: vma-1.0214291-rdf-ntriples.txt
Original Record: vma-1.0214291-source.json
Full Text
vma-1.0214291-fulltext.txt
Citation
vma-1.0214291.ris

Full Text

 THE
BULLETIN
Published By
The Vancouver Medical Association
EDITOR:
dr. j. h. MacDermot
EDITORIAL BOARD
DR. D. E. H. CLEVELAND
DR. H. A. DesBRISAY
Editorial and* Business Office
203 Medical-Dental Building
Vancouver, B. C.
DR. J. H. B. GRANT
DR. D. A. STEELE
Publisher and Advertising Manager
W. E. G. MACDONALD
Vol. XXV
JANUARY, 1949
No. 4
OFFICERS,   1948-49
Dr. Gordon C. Johnston Dr. W. J. Dorrance        Dr. G. A. Davidson
President Vice-President Past President
Dr. Gordon Burke Dr. Henry Scott
Hon. Treasurer Hon. Secretary
Additional Members of Executive:
Dr. A. S. McConkey, Dr. Rocke Robertson
TRUSTEES
Dr. A. M. Agnew Dr. G. H. Clement Dr. A. C. Frost
Auditors: Messrs. Plommer, Whiting & Co.
SECTIONS
Clinical
Dr. E. B. Trowbridge. Chairman Db. J. A. Ganshorn Secretary
Eye, Ear, Nose and Throat
Dr. G. H. Francis Chairman Dr. J. F. Minnes ..-Secretary
Paediatric
Dr. G. O. Mathews Chairman Dr. A. F. Hardyment—Secretary
Orthopaedic and Traumatic Surgery
Dr. H. H. Boucher——Chairman Db. Bruce Reed Secretary
Neurology and Psychiatry
Dr. A. E. DAvn>soN___Chairman Db. G. H. Gundbt Secretary
llll Radiology
Db. Andbbw TuBNBUiX—Chairman Db. Mabvin R. Dickey—Secretary
STANDING COMMITTEES
Library:
Db. F. S. Hobbs, Chairman; Db. R. A. Palmer, Secretary; Dr. R. P. Kinsman;
Dr. S. E. C. Tubvey; Db. J. E. Walkeb and Db. E. F. Wobd.
Summer School:
Db. A. B. Manson, Chairman; Dr. E. A. Campbell, Dr. J. A. Ganshorn,
Dr. D. S. Munroe, Dr. D A. Steele, Dr. G. C. Large.
Credentials: jp£
Dr. H. A. DesBrisay, Dr. Frank Turnbull, Dr. G. A. Davidson.
Representative to B. C. Medical Association: Dr. G. A. Davidson.
Representative to V. O. N.: Dr. Isabel Day.
Representative to Greater Vancouver Health League: Db. J. W. Shier:
: ,  '
■ 1
KEEP
THE
OSTIA
open
COLDS
Patency dE the normal drainage e:stsl|£ the
2&sal, accessory sinuse^ is of /great important in the ^ire o&pper respiraiory
infections.
Neo*Synephrine hydrochloride applied
by any of the common methods—dropper,
spray, tampon, displacement^ constricts
the engorged mucosa surrounding the ostia,
promoting free drainage and ai^Jpbn.
NEO-SYNEPHRINE® Hydrochloride
Brand of PHENYLEPHRINE HYDROCHLORIDE
"#1111^
Solution 0.25%   (j^^^y>r wi|p aromatics)
*-aad 1%-f-1 o|f bottles;
Jelly fe% —• h oz. tubes.
.JBEOSYNEPHRINE.Jwidejnark reg..U. S. & Canada.
423 Ontario Street East, Montreal, P. Q.
^Jeatom-
inc.
New Yo*k J3'n:y.- - WmDSO*, Owr.
1019 Elliott Street West, Windsor, Ontario VANCOUVER  MEDICAL   ASSOCIATION
Founded 1898    :  :    Incorporated 1906
January    4.
January 18.
February    1.
PROGRAMME FOR FIFTY-FIRST ANNUAL SESSION
(Spring Session)
GENERAL MEETING—
"Experiences in Cleft Palate Repair"—Dr. J. R. Neilson.
"Radiology in Abdominal Pain in Children"—Dr. Wallace Boyd.
CLINICAL MEETING—Vancouver General Hospital.
GENERAL MEETING—
e'The Management of Pregnancy in cases of Hypertension and
Toxemia"—Dr. E. B. Trowbridge.
"Hypertension and Cardiac Complications in Pregnancy"—Dr.
J. Caldwell.
CLINICAL MEETING—St. Paul's Hospital.
March    1.    OSLER DINNER AND LECTURE—Hotel Vancouver (Mayfair Room)
Osier Lecturer—Dr. Murray Baird.
March 15.    CLINICAL MEETING—Shaughnessy Hospital.
April    5.    GENERAL MEETING—
"Prostatism"—Dr. L. G. Wood.
April 19.    CLINICAL MEETING—Place of meeting to be announced.
May    3.    ANNUAL MEETING—Auditorium, Medical-Dental Building.
February 15.
Breaks the vicious circle of perverted
menstrual function in cases of amenorrhea,
tardy periods (non-physiological) and dysmenorrhea. Affords remarkable symptomatic
relief by stimulating the innervation of the
uterus and stabilizing the tone of its
musculature. Controls the urero-ovarian    J
L   circulation and thereby encourages a    M
normal menstrual cycle. ,
• MARTIN H. SMITH COMPANY
^. ISO UUAYITTl   I Will. NCW TOM.  N. T.
Full formula and descriptive
literature on request
Dosage:   l to 2 capsules
3 or 4 times daily.   Supplied
in packages of 20.
Ethical protective mark MHS
embossed on inside of each
capsule, visible only when capsule is cut in half at seam.
Page 78 A     NEW     POULENC     THERAPY
DILVASENE
SYNTHETIC     VASODILATOR
r,we
\Jralli
y
lore
stable     ^Jhan    ^tcetulcholi
r
xne
The effect of this original compound—iodomethylate of dimethylamino, 1,
methylene, 2, 3-dioxy propane—is particularly remarkable on the peripheral
vascular system. Essentially a parasympathomimetic drug, Dilvasene (F. 2249)
induces arteriolar vasodilatation accompanied by vasoconstriction of the
venules with reduction of the periopheral capillary stasis. The marked stability
of Dilvasene, unlike that of acetylcholine, also renders it highly effective by,
mouth. This achievement deserves serious consideration: it saves the patient
from being subjected to repeated injections while employing a vasodilator
agent of proven effectiveness.
INDICATIONS
Raynaud's disease and disturbances of the peripheral vessels, acrocyanosis, chilblains, erythro-
melalgia and other painful manifestations of peripheral vascular disease, scleroderma, vascular
diseases of the limbs, migraine, meningeal or idiopathic headaches, delayed wound healing,
scar formation, varicose ulcers, and many others.
POULENC
Montreal VANCOUVER HEALTH DEPARTMENT
CASES OF COMMUNICABLE DISEASE REPORTED IN THE
CITY
STATISTICS—NOVEMBER,  1948.
Total Population.—Estimaad j  3 54,045
Chinese Population—Estimated       7,979
Hindu Population—Estimated i  275
Rate Per 1000
Number Population
Total  deaths :     288 9.9
Chinese deaths       10 15.3
Deaths, residents only     271 9.6
BIRTH REGISTRATIONS:
Male .     3 36
Female    '^•■-■Spj!'- 296
• 9
632
21.8
INFANT MORTALITY: Nov., 1948 Nov., 1947
Deaths under 1 year of age ! !       14 15
Death rate per 1000 live births 1        30.0 25.5
Stillbirths (not included above) 1         6 7
CASES OF COMMUNICABLE DISEASE REPORTED IN THE CITY
Number    Rate Per 1,000 Population
Dec, 1948 Nov., 1948
mi
Cases     Deaths       Cases    Deaths
Scarlet Fever-
Diphtheria	
Diphtheria Carrier  0
Chicken Pox i  352
Measles :  9 6
Rubella  8
Mumps  11
Whooping Cough ^  0
Typhoid Fever (Carriers)  0
Undulant Fever .  1
Poliomyelitis  1
Tuberculosis i i i  3 5
 i S'^jf,  °
  0
  0
  2
  0
   0
  0
  0
Erysipelas	
Meningococcus  (Meningitis).
Infectious Jaundice	
Salmonellosis	
Salmonellosis (Carrier)	
Dysentery !	
Dysentery (Carrier)	
Tetanus	
Syphilis	
  35
Gonorrhoea ji  197
Cancer (Reportable):
Resident ;  g 5
Non-Resident I  21
2
0
0
0
0
0
0
0
0
0
0
15
0
1
0
0
0
0
0
0
0
0
0
0
8
0
0
306
61
10
17
0
2
0
2
42
1
1
0
1
0
1
0
0
26
171
77
42
0
0
0
0
0
0
0
0
0
0
0
6
0
1
0
0
0
0
0
0
1
0
0
0
Page 79
■
• r-q
Three COMBINED ANTIGENS
Now in  General Use
DIPHTHERIA TOXOID and PERTUSSIS VACCINE (Combined)
Diphtheria toxoid of a high degree of potency combined with pertussis
vaccine — for the prevention of diphtheria and whooping cough.
DIPHTHERIA TOXOID, PERTUSSIS VACCINE and TETANUS TOXOID (Combined)
Diphtheria and tetanus toxoids combined with pertussis vaccine — for
the prevention of diphtheria, whooping cough and tetanus.
DIPHTHERIA TOXOID and TETANUS TOXOID (Combined)
A combination of diphtheria and tetanus toxoids—indicated for
primary immunization of school children or adults, or for administering
recall doses to school children previously receiving a full course of injections
of combined diphtheria toxoid, pertussis vaccine and tetanus toxoid.
DOSAGE
Three doses of 1 cc. at
monthly intervals and
a reinforcing dose of
1 CC; after an interval of
at  least three months.
HOW SUPPLIED
For the inoculation of one child—Package containing Pour 1-cc. Ampoules.
For a group  of  nine  children—Package  containing  Six   6-cc.   Ampoules.
CONNAUGHT MEDICAL RESEARCH LABORATORIES
University of Toronto Toronto 4, Canada
DEPOT FOR BRITISH COLUMBIA
MACDONALD'S  PRESCRIPTIONS  LIMITED
MEDICAL-DENTAL BUILDING, VANCOUVER, B. C. *7Ue. ZdUtriL Paae.
We publish in this issue two articles that we believe every medical man in Canada
should read carefully and consider in.all their implications. We would go further, and
say that we believe every responsible taxpayer should read them, and ask himself what
his attitude should be towards extensions of Social Service in this country, and especially'
towards the socialisation of medicine which is being so strongly urged everywhere,
often by people who have not really studied the question in all its possible ramifications.
We refer to the report on State Medicine (for it is nothing less) as it now obtains
in New Zealand, that country which has for so long been touted as being a modern
Utopia by the socialist element in our community. The other is a more ex parte condemnation of socialised medicine as it affects the medical profession in Great Britain.
This attack, however, is made by a very prominent British physician, Lord Hordey, and
its dispassionate, categorical presentation must carry considerable weight with us. It,
too, should be read and studied, not only by those of us who, since we practise medicine,
may be considered to be bi?sed in th^ matter. But what Lord Horder says is of intense
interest to every citizen. One of the most essential things to that citizen is that he
should have at his call a medical profession with high standards of education and
practice; that this profession should be capable of continual growth in these standards;
that the doctor he consults should have ample time to devote to him, and to the
consideration, diagnosis and treatment of his case; that the professional relation between
himself and this doctor should be a personal one, based entirely on his needs and the
obligations imposed by the professional relationship, and in no way subject to control
or interference, and worse still, limitation or curtailment of any necessary treatment,
by a third party, whether this be an insurance company, a group insurance plan, or the
state.
Further, the cost of such medical care, whether paid by personal fee, or through
group insurance plans, or even through government action, should be such that every
citizen can secure the care, and afford to pay for it and no part of it should go to any
third party.
When one reads the article about New Zealand, one is appalled to find that practically
every one of these postulates is ignored. In New Zealand, we are told, the standards and
work of the medical profession are deteriorating-—doctors are put under continual pressure to be slack, dishonest and inefficient—improvement, as by postgraduate work, is
becoming a thing of the past—corruption in matters of drugs, sick benefits and so on, is,
if not common, at any rate infinitely easy, and generally uncontrolled or undetected.
Time to consider and diagnose a patient's condition cannot be had. Added to all this
is that medicine has become tremendously costly to the community. There is no check
on expenditure—and we are told that the cost is becoming unbearable.
Lord Horder's remarks bear a great deal of this out, especially as regards the
impossibility of good, personal attention by the doctor. If things are not yet as bad in
Great Britain as they have apparently become in New Zealand, it is merely that they
have not yet had time to deteriorate as far, or else that the medical profession has not yet
relinquished quite all its independence. But Lord Horder's measured words leave little
doubt that it is only a matter of time before medicine in Great Britain will sink to a
very low level.
We in Canada should and must ponder well over these things. The simple truth is
that we are going much tco far, too fast, in the direction of social assistance. To give
this to those who need it, to lift up the fallen, to assist the we?k and *ct°A ?r>A defective,
the casualties of industry, and so on, is right and good.|| To offer to the hale and
robust, who can work for what they need, and if they will work, can pay for what
they need, whether they do it individually or collectively, free medicine, free hospital,
Page 80
111 free this and free that, is a policy that is basd on a fallacy. This fallacy is that you
can get any of these things free. The New Zealand taxpayer, the British taxpayer, is
coming to know that not only can you not get them free, but that actually this new
method costs more than the old, bad as the old method may have been in some particulars. Waste, bureaucracy, the creation of vast civil lists of operatives needed to do
the paper work, add enormously to the cost, and it all has to come out of the taxpayer's
pocket. To assail this policy is not the attitude of ignorance or selfishness or reaction,
it is merely to read the handwriting on the wall: and the writing is that of our socialist
friends.
It is high time that we stopped listening to this pie-in-the-sky propaganda, and
came down to earth—to common sense and realism and honesty. We are only entitled-, in
this world, to what we earn, by the work of our minds .or our hands, or both. To look
for anything else means we are weaklings, or defective, or infirm. To listen to those who
preach socialism, state control, and promise impossible and visionary Utopias (to be
run strictly by themselves) is utter folly and will lead to nothing but disillusionment
and disappointment in the end, while in the meantime it leads to debt and more debt,
and, as our New Zealand friend predicts may be the case in his country, to eventual
bankruptcy.
It is for us of the medical profession to do three things: first, to oppose state
medicine with every weapon at our command because we believe it to be pernicious and
anti-social; secondly, to educate the public to know that what they want can be better
and more cheaply obtained by adherence to a system of free enterprise, and freedom
of professional work and professional relationships, with modifications where advisable
or necessary; and thirdly, to study ways of extending present systems of group practice,
under our own control, in such a way that we can offer to the people a better scheme,
more efficient, less costly, and one unimpeded by bureaucratic control, than any scheme
of government-controlled or state medicine that can be devised.
APPLICATIONS WANTED
"The Calgary Associate Clinic, Calgary, Alberta invites applications  for the
following two posts:
1. A physician to take charge of a Clinic Department handling General
Medicine. Applicants should have three or four years experience in
general practice and interests which are mainly concerned with medicine
rather than surgery, and also organized ability.
2. A recent graduate to act in a junior capacity in the above Department.
The work will include outpatient department work, externe calls and the integration of general family practice with the specialized Sections of the group."
Page 81 Library  Notes
HOURS—
Monday, Wednesday, Friday | 1 9:00 a.m. to 9:30 p.m.
Tuesday and Thursday 9:00 a.m. to 5:00 p.m.
Saturday - * 9:00 a.m. to 1:00 p.m.
RECENT ACCESSIONS TO THE LIBRARY—
Disease of the Nervous System, 3rd edition (2nd imp.), 1948, by W. Russell Brain.
Diseases of the Nervous System in Infancy and Childhood, 2nd edition (3rd printing), 1948, by F. R. Ford.
Heart—A Physiologic and Clinical Study of Cardiovascular Diseases, 1948, by
A. A. Luisada.
Peripheral Vascular Diseases, 1948, by Allen, E. van N., Barker, N.W., and Hines,
E. A.
Practical Bacteriology, Hematology and Parasitology, 10th edition, 1948, by Stitt,
E. R., Clough, P.W., and Braham, S. E.
Principles and Practice of Rectal Surgery, 4th edition, 1948, by W. Gabriel.
Private Enterprise or Government in Medicine, 1948, by L. H. Bauer (from the
Committee on Medical Economics).
Symposium on (1) Gynecology and Obstetrics and (2) Streptomycin in the Surgery of Tuberculosis, December, 1948, Philadelphia Number, Surgical Clinics
of North America.
Taylor's Principles and Practice of Medical Jurisprudence, Vol. 1, 10th edition,
1948, edited by S. Smith with a complete revision of the Legal Aspect by
W. G. H. Cook and of the Chemical Aspect by C. P. Stewart.
The following journals are being taken by the library now:
Diseases of the Chest—The official publication of the American College of Chest
Physicians  (Monthly).
Journal of Mental Science (Quarterly).
Pediatrics—The Journal of the American Academy of Pediatrics (Monthly).
Quarterly Review of Psychiatry and Neurology (Gift of Dr. J. C. Thomas).
Texas Cancer Bulletin (Bi-monthly).
ifl
PRELIMINARY ANNOUNCEMENT
The Tenth Annual Spring Post Graduate Convention of Ophthalmology and Otolaryngology will be held in Portland, June 19-24, 1949. Another fine program has been
arranged by the Oregon Academy and the University of Oregon Medical School. We are
particularly fortunate in having four outstanding men in their respective fields as guest
speakers.
$0jDt. Lawrence R. Boies, Professor of Ophathalmology at University of Minnesota
Medical School, Minneapolis.
Dr. Leland Hunntcutt, Associate Clinical Professor of Otolaryngology at University
of Southern California, Los Angeles.
Dr. James H. Allen, Professor of Ophathalmology at Iowa State University School
of Medicine, Iowa City.
Dr. Edmund B. Speath,Pro£essor of Ophthalmology at Graduate School of Medicine,
University of Pennsylvania, Philadelphia.
There will be lectures, clinical demonstrations and ward rounds.
Preliminary programs will be out about May 1st and you may secure yours, and
further information, from
DR. DAVID D. DEWEESE, Secretary,
1216 S.W. Yarnhill Street, Portland 5, Oregon.
Page 82 *r
Vancouver  Medical   Association
President   Dr. Gordon C. Johnston
Vice-President ■ . Dr. W. J. Dorrance
Honorary Treasurer j Dr. Gordon Burke
HonorarySecretary 1 j • Dr. Henry Scott
Editor j Dr. J. H. MacDermot
GOVERNMENT   MEDICINE   IN  NEW   ZEALAND
Its Social, Economic and Political Implications
An Address by A. LEXINGTON JONES, D.D.S., M.S., Christ Church, N. Z.
Perhaps before dealing with the main subject of my address it may be pertinent to
give you a thumbnail sketch of New Zealand—it will give some background and enable
you to appreciate more fully what has to follow — a clearer picture from which to
evaluate the economic and medical features.
The Dominion of New Zealand consists of an isolated group of islands, two of which
are comparatively large. This group is situated approximately 1200 miles east of
Australia, 6000 miles west of South Africa and 1600 miles north of the Antarctic* Continent. The principal islands lie approximately between the parallels of 34 degrees and
48 degrees south latitude and the meridians of 166 degrees and 179 degrees east longitude.    The total area including annexed islands is 103,935 square miles.
The dominion has a climate of marine type—not excessively hot in the summer and
not unpleasantly cold in the winter. Most parts of the country enjoy ample rainfall
and a liberal share of sunshine. The mean daily temperature (Fahrenheit) is around
about 44 degrees to 64 degrees.    This is an average taken over many years.
The population — 1,646,000 whites
98,000 Maori
85,000 Island Territories
1,829,000
(Cooks Nine Island, Kermadic, Tokelan, Portion
of Western Samoa and Campbell Island)
Females — 821,000 Males — 783,000
Maoris 48,000 50,000
New Zealand has been described by some people as the Socialistic Laboratory of the
world—thas may or may not be true. At least one other country in the world—a much
larger one and with a greater population claims this distinction. The methods adopted
in the implementation of the Socialist regime may be different, but the principle underlying that order of life is the same.
The Socialization of Medicine in New Zealand was completed in 193 8 and became
operative on April 1, 1939.
The principal objects of the Social Security legislation are as follows:
1. The substitute for the system of non-contributory civil pensions—for example old
age pensions, widows' and other pensions, of a system of monetary benefits on a contributory basis.
2. The inauguration of a system of medical and hospital benefits and other related
benefits—e.g., pharmaceutical, dental, masseur, etc.
It is with Section No. 2 that I have to deal with today—but Section No. 1 requires
some elaboration so that you may judge whether or not the latter was desirable or
necessary.
The system under which we operated, pre 1938, was in effect much the same as the
Page 83 one at present existing in America today. Provision was made for the aged, infirm and
sick to secure state assistance in the form of pensions and free hospital treatment where
necessary. The system was augmented by means of Benefit Lodges, Insurance companies
and other private means of providing self security in time of need. Such private schemes
became inoperable after the introduction of "Social Security" as sponsored by the Government and in effect became impracticable and have almost gone out of existence.
The introduction of the government scheme compelled everybody in New Zealand
to come within its scope and the payment for the stupendous undertaking was provided
for by means of direct taxation.
The net income of everybody in New Zealand is taxed 23c (one shilling being
approximately 20 cents). This tax is calculated on the first dollar of income and no
exemptions are allowed. You will note that 5/4 c out of every dollar of income or
salary is collected as a special tax. This amount only partly covers the cost of administration of Social Security. In addition the fund must be subsidized from the Consolidated Fund of Government.
The Taxation Revenue of General Government fund in 1945-46 was $460,000,000,
an amount equalling $268 per head of the population. In that same year the expenditure on Social Security alone was $104,000,000—equalling a sum of $60 per head of
population. Nearly one-quarter of the Government income was expended on the Social
Security programme.
Gentlemen, I present these figures to you so you may acquire a right perspective of
the cost of each individual in our country and dispose of any ideas that the benefits of
Socialization of Medicine and related professions is free to any fellow citizen. Can any
economic system stand up to such an overload of taxation?
Let usv now consider the administration of this socialistic scheme. Medical, dental
and pharmaceutical practices are operated much in the same way as in this country.
Similarly does the hospital system resemble that adopted here.
We have our own state-controlled and privately-owned institutions to which any
person is entitled to be admitted, if there is available accommodation. Under the
amended Social Security Act, which came into operation on November 1, 1941, "every
person is entitled, without cost to himself (npte without cost) to such medical attention (with certain specified exemptions) as is ordinarily given by medical practitioners
in the course of general practice. The medical practitioner is entitled to receive the
sum of $1.50 for every time he renders any of the prescribed services. If the practitioner is called upon to provide, in response to an urgent request, services on a Sunday
or between the hours of 9:00 p.m. and 7:00 a.m. the above fee is increased to
$2.50. Mileage fees are also payable in certain circumstances. Any charges over, and
above the fees quoted are payable by the patient."
Gentlemen—
This is a copy of the section of the Act.
"Pharmaceutical Benefits are provided 'free of any cost to the patient'.
State Hospital Benefits are provided free of cost to the patient.
Private Hospital charges are provided up to $2.00 per day during period
of hospitalization."
Maternity Benefits free in state hospitals and subsidized in private hospitals.
Private practitioners' fees are in accordance with a prescribed scale and are to be
regarded as full settlement of their claim.  In case of specialists, additional fees over basic
allowances must be covered by the patient.
Besides these benefits we have Monetary Benefits listed under child benefits ($2.00
per week per child under 18 years).
Superannuation Benefit $40.00^to a maximum of $416.00 per annum. We have also
Old Age, Widows, Orphans, Invalid, Miners, Maori War, Unemployment Sickness,
Emergency, Dental, Laboratory, Nursing, Massage, X-Ray Diagnostic Service in addition.
The Chiropractors are now making presentation for their inclusion.    Additional to
Page 84 I
p
I
these we have our war pension, economic pensions, war veterans' allowance, emergency
reserve corps' pension and Mercantile Marine pensions. Truly a scheme to care for New
Zealanders from the womb to the tomb. Let us now consider the practical application
of the foregoing with regard to the Medical Practitioner. Please bear in mind the
quoted phrase "without cost to himself." A patient visits his doctor. At the conclusion of his consultation he signs a form. That form is signed by the doctor and directed
to the health department for whatever sum involved, a minimum of $1.50 per visit.
The form is a simple one. The doctor's name appears on it, the number of visits
the patient has made and the total cost. The claim is then signed by the doctor and
paid without query or question.
The patient is free to visit as many doctors as he wishes per day, per week, or per
year "without cost" to himself at the time of the visit. He may obtain from each
doctor a prescription which he may have filled without cost to himself. He may be
signed over to any one of the subsidiary benefits for a pension, admission to hospital,
massage, X-Ray and so on. He may indulge in this peregrinating pastime among the
doctors till his heart is content, or until he finally interviews a doctor who will do as he
bids, give him the medicine he desires and put him in the institution of his choice and
place him on the advantageous "pension list."
This he may do without cost to himself. The one and only condition is that he be
prepared to wait in a queue of people on similar business bent. He may even be ill and
in need of urgent attention, but he will of necessity have to join the endless chain of
the sick and the imaginary sick. All of this he is legally allowed to do and all of these
charges he is permitted to incur by the law of the land, the Social Security Act,
November, 1941. I have presented you with facts only as published in the Abstract
of Statistics of 1947.
The interpretation of the Act is the one in force and duly exercised. The number
of indoor patients treated in Public Hospitals in 1945 was 165,000. We may assume
that another 40,000 were treated in private institutions, making a grand total of 206,000
or 12% per cent of our total population under hospital care, a startling figure for a
country the size of New Zealand. Based on this figure America would have to provide
accommodation for 17,000,000 as a permanent hospital population.
Nobody will deny the sick of any country the right to adequate treatment, but the
cost to the country is tremendous, not because the money is being spent on the individual but because of the immense cost of administration and the abuse of the system
under a Socialist Government.    Some of these abuses I will refer to as I go along.
The questions we ask ourselves in New Zealand are
1. Are we getting our money's worth?
2. Has the system improved medical service to the people?
3. Has the system reduced the incidence of disease?
To question one I reply, most certainly not. A great part of the money we are taxed
is absorbed in the cost of administration—in the paymenjt of a large body of civil
servants and for the payment of doctors for visits that were never necessary and for
prescriptions given by them.
To question two, I again say no. The Medical Profession has so many consultations
that it is impossible for them to devote the necessary time to each patient, evaluate their
symptoms and give a careful and considered diagnosis. I do not say this in any derogatory way regarding the members of the profession. It is not humanly possible. Too
many are consulting their physician unnecessarily, taking up his time which would be
better given to people really needing his attention.
Regarding question three, the figures speak for themselves. A very small amount
of money is voted for research work. The physicians have little or no time for reading
and investigation, and little incentive to study abroa9.
The system as operated in New Zealand allows of such abuse that it has almost
become a farce and I have listed a number of questions that I feel are in the minds of
you present.
Page 85
s.'i minds of you present.
1. Are medical services available at no cost to the patient?
My answer. Of course not, the average cost to each individual is $60.00 per annum.
To many it is not this high, but to many more a great deal higher.
2. Has it raised the status of Medical Profession, |||:1
My answer. No. It has lowered their prestige, owing to known abuses that may be
practised by unscrupulous members. $0$
3. Is it possible for unscrupulous members to be dishonest? Hz^0$s&
My answer.   Blatantly so.   A form could be filled in for more visits than the patient
paid to the doctors, a signature could be forged, forms could be filled in by friends
of the doctor when no visits were made.
4. Can the pharmaceutical benefits be made available wrongfully?
My answer. Yes, as any prescription signed by a B.M.A. member must be filled by
the chemist without question.
5. Is there any competent check made of medical claims made?
My answer. No. They are checked by departmental clerks whose duty in the
main is to compute the amount for direction to the Treasury for a cheque to be
paid out to the doctor each month.
6. Is Socialized Medicine less costly to the patient than other schemes?
My answer. The average cost per head is $60.00, but many poeple pay much more.
In a very small minority this scheme may save money. To the great masses it is far
too high.   In 1941 medical schemes took care of people unable to meet medical fees.
7. Was Medicine the first profession to be brought within the orbit of state control?
My answer.    Such a step is embodied in the prepared plan for all Communistic
activities.    Lenin said, "Socialized Medicine is the Keystone to the Arch of the
Socialist state."    In New Zealand they have been true to form.
Question: Do you consider there is much waste of money in the administration of
the scheme?
Answer: Yes. An army of civil servants is engaged full time in routine work,
checking claims, etc., for all benefits under the scheme. In 1940 much of this work
was done voluntarily by lodge members or by secretaries to lodges and to doctors. Most
doctors have found it necessary to engage a full-time secretary whose work is to have
forms signed and checked, etc.
Pharmaceutical benefits are particularly abused. Because it costs the patient nothing.
They do not use all that has been prescribed or they use much more than necessary.
Many of the homes in New Zealand could discover a dozen or so bottles of medicine
only half empty. There is an old saying, "Anything acquired for nothing is worth
nothing."   I fear the people in New Zealand have that attitude to their free medicine.
Question: Do you think the economic structure of New Zealand can stand up to
this tremendous charge?
Answer: I think the day of reckoning must come. It is the great waste of money
and time that will bring ruin to the scheme.
Question: Did the people of New Zealand oppose the introduction of the scheme?
Answer: Yes. A small section, the B.M.A. They were very vocal in opposition but
they were not supported by the business community. The people in New Zealand
failed to realize that this was the socialist technique and did not appreciate the effect
it would have on their lives. It was their apathy in opposing the Socialists that made
passage of our law possible. They were hoodwinked by promises of something for
nothing. It was the "thinking" people of my country who did not register their opposition. They are the people in this country upon whom must be impressed that the
price of security is their freedom.
Question: Do you think that the incentive for post-graduate work has been removed?
Answer: Members of the profession feel that any higher qualifications or advanced
study is discouraged. Such a course is expensive and probably not recoverable from the
public.
ds£ Page 86 Question: Has it had any effect on the relationship between the doctor and the
patient?
Answer: Most certainly. That confidence, so necessary, has been lessened because
the dignity and prestige of the profession has suffered.
Having thus far dealt with the actual Socialization of Medicine in my country, its
cost to the public, its objective, its apparent good and its apparent evil, may I now
address to you some remarks, bearing upon the impact on society which socialization
has had.
These views are my own, but they are shared, I am bold enough to say, by the
majority of New Zealanders.
Since 1941 the New Zealand Government has brought under its powers the Bank of
New Zealand, the Dental Profession, Chemists, Masseurs, National Airways, etc. This
merely goes to prove thatc the regimentation of the Medical Profession was the
forerunner of a carefully calculated procedure as outlined by those fellow travellers,
the Communists. And here I should sound a note of warning—take heed America lest
it happen here. Don't say it cannot. New Zealand said it and so did every country
that today is under the heel of dictatorship. It can and ivill unless you band yourselves
together in a national forum and oppose it with all the strength you can muster. Passive
resistance, subdued mumblings of disapproval among yourselves will get you nowhere.
The people of this great country must be informed of the danger that stalks them, all
sections must be made aware of the subtle methods adopted by the exponents of social-
They must be made aware of the inevitable developments if such a system is
ism.
countenanced in this fair land. The people must be warned of the honeyed words of
the advocates, the sly and camouflaged propoganda, the fallacy of the plan of "Utopia
in our time" and "something for nothing" theorists. They must be convinced that in
the realm of politics, sociology and economics the layman is very liable to accept bad
practices if they are adroitly concealed with good intentions. Every collectivist argument involves the "welfare" of the people and such specious statements are misleading
and misguided. There is no important difference between the collectivist systems, be
it Socialism, Communism, Naziism or Fascism. In the end they all reduce the citizen
to the position of abject submission to cruel and capricious bureaucrats, a condition
which adherents to this collectivist system, seem to condone. Adherents and advocates
of a system which subjugates the rights of the individual to the state have a "modus
operandi" so to speak. It is a constant equation. It never changes. They advance upon
society and incorporate it in the state—piecemeal—cell by cell. In this manner they
never raise the voice of objection of the masses of the people at once and so avoid concerted opposition. Like Hitler, "we have no further territorial ambitions" till all is
quiet and the stage set again for "peaceful penetration." I do not propose delivering a
diatribe on the strategy of Socialism. I merely mention these points because in New
Zealand I experienced this form of collectivist strategy. The majority of the inhabitants of my country failed to appreciate the end result and refused to heed the warning
given, refused to hear the word of reason, and as a result Socialism took the helm.
Gentlemen, I am a father of seven children and it is my duty and my pleasure to
provide them with food, clothing, and shelter, and by precept and example make them
good citizens. I wish to see them develop the attributes of courage, initiative, enterprise, self-reliance and good Christian characters. Is it possible under a Socialist dom--
inated country where the only avenue of employment will be with that of a soulless
state, as a mere automaton, a cog in the vast machinery of collectivism?
In my opinion Socialism encourages indolence, it disapproves of the development
of individualism or self-reliance, it strikes at the very moral fibre of our young people
and destroys the fabric of their character. I do not wish to see my family grow up
unaware of the dignity of work and devoid of the sense of pride of achievement. I
wish them to have to work and shape their own destinies, to learn of the value of adversity
and enjoy the sweet fruits of success gained for themselves and by their own effort.
Page 87 Hi I do not wish them to grow up the dupes of arrogant and calculating wreckers whose
ambition will be realized only when Communism becomes a reality and then the opportunities of their country, this world and their lives have been frittered away. Then it
will be too late to save themselves for the final reason that there will be nothing to save.
That is why I suggest that all Christian people should band themselves together and
form that National Forum and face up frankly and brutally to the question, "Are we
going to stand it any longer?"
There is no hysteria about this. I am speaking from experience. I am speaking as
a lover of freedom who sees liberty being filched from me by impractical ideologists who
have become fanatics.
The world today is one vast seething mass of discontent, suspicion, unhappiness and
uncertainty. We have just concluded a war against German National Socialism, the
most bloody war the world has ever known. Six long years of bestial brutality. We
witnessed the cities of Europe being bombed and blasted and burnt. Tens of thousands
of our best men and women had laid down their lives on the battlefields and in
the cities of war-torn Europe and the Pacific, thousands of little children were killed,
thousands of others died of disease and starvation—all to halt the Nazi hordes. The
cost in human life and misery was great—all this to stem the tide of dictatorship. Today we face the possibilities of yet another brutal war. This time, against another
country, but against a similar enemy and for the same reason, to preserve our way of life,
our freedom and liberty. I see in the Socialization of Medicine the first stake of the
encrouchment upon our civil liberties and we must convince all of our people that their
freedom is undoubtedly tied up with every other section of the country.
The greatest tyranny has the smallest beginnings. From precedents overlooked, from
remonstrances despised, from grievances treated with ridicule, from powerless men
oppressed with impunity, and overbearing men tolerated with complacence, springs the
tyrannical usage which generations of wise men may later perceive, lament and resist in
vain. At present, common minds no more see a crushing tyranny in a trivial unfairness
or a ludicrous indignity than the eye, uninformed by reason, can discern the oak in the
acorn or the utter desolation of winter in the first autumnal snowfall. Hence the necessity
of denouncing with tireless perseverance every single act of oppression. Let it alone
and it stands on record. If the country has allowed it and when it is at last provoked
to indignation and resistance it finds itself gagged with the record of its t>wn inertia.
Socialists are flying in the face of the natural law. This law cannot be shouted
down by mobs, nor argued out of existence by doctrinaires or repealed by governments.
It has stood the test of time and around it has developed our society as we know it now.
In effect, Socialism seeks to take away someone's rights to which, under custom and
belief of the people, he is rightly entitled. I have said that Socialism strikes at the very
roots of democracy. Karl Marx wrote: "The democratic concept of a man is false
because it is Christian. It holds that each man has a value as a sovereign being. This
is the illusion, dream, and postulate of Christianity."
Hitler wrote: "To the Christian Doctrine of the infinite significance of the individual's human soul, I oppose with icy clarity the saving doctrine of the nothingness
and insignificance of the individual human being."
Under these two isms God can have no place in the totalitarian state. In his place
stands the Dictator.    Our Civilization is based on Christianity.
Gentlemen, I appeal to you to be up and doing. In the unchangeable pattern of
Socialism you are to be the next victims. Should you submit—then you permit the
laying of the foundation for a totalitarian structure to be built. If you allow totali-
tarianinsm to exist here on any scale, then you expect it to be maintained by Gestapo
police methods—dictatorship, loss of liberty and opportunity and resultant degradation
of the mass of people.
In conclusion, gentlemen, I hope nobody says "I have enjoyed your speech." I have
not given it for your enjoyment. I hope it worries you excessively. I hope it causes you
sleepless nights until you have done something about it, until you join the National
Page 88
m
■ I.
Forum. I hope your action willbe affirmative and effective so that you will safeguard
your rights of democracy—your way of life—the American way of life.
Wendell Wilkie once said: "This programme will not interest those people who regard
America as a Socialistic Laboratory. It will not interest those people who regard this
country as a free lunch counter. It will certainly not interest those people who imagine
this country as somewhat of a worked-out gold mine out of which they wish to snatch
a nugget or two for themselves. It will only interest those people who know and love
their land—who know that its prosperity was only built up by the thrift and industry
of its people and whose greatness can be retained in no other way."
Thank you very much.    I wish you much worry and real concern.
*■«
THE HEALTH SERVICE ON TRIAL
By Lord Horder
The National Health Service has now been in action for five months. It is perhaps
to early to judge how much the patient on the one hand, and the doctor on the other,
has gained or lost by the government's attempt to nationalize medicine. Birth pangs
were to be expected and the Minister and his fellow apologists have been quick to point
out that a machine designed to carry a measure of great social betterment cannot be
expected to "tick over" smoothly until it is properly "run in."
So far as the patient is concerned the rnachine has not broken down because, as yet,
the load it has been required to carry has not been great. In other words, the general
level of health of the community has fortunately been high. The proportion of domiciliary visits, both for the general practitioner and for the consultant, has been low.
Indeed, a very large section of the public has got quite a "kick" out of exchanging the
public benches of the hospital casualty department for the relative privacy of the doctor's waiting room, not realizing that this time, and from no fault of the doctor's, they
are quite likely in many instances to get nothing for something, assuming it to be real
doctoring that they are after.
There are two matters in which the patient is actually feeling the pinch. One is
the difficulty he has in getting his medicines without paying for them and the other is
the sudden and considerable rise in the cost of beds in private hospital wards.
The Doctors' Dilemma'
The citizen as taxpayer, however, will have noted with some alarm that the estimated
budget for the Service has been greatly exceeded in more than one large item and threatens to be exceeded in others. A variation on a current jibe might be to say that we
seem likely to get not only the best Government, but also the worst Medicine, that
money can buy. But taxation is not, physically speaking, a painful disease, and so the
patient does not squeal. It can, however, in course of time, be very lethal to the body
corporate.
The position as it affects the doctor is more apparent; the defects of the Service
stand.out clearly.   "Evidence is accumulating," says the Secretary of the British Medical
Association, "that the burden of work, particularly paper work, has greatly increased;
that in many cases income has gone down; that private practice ... in many areas has
virtually disappeared."   Dr. Dain, Chairman of the B.M.A. Council, repeats the dirge:
We have two difficulties—the demands on the doctors made by the patients
and the insufficient pay for the doctors for the demands made upon them. ...
We warned the Government that there was not the man-power in the medical
profession, or the nursing profession, nor the hospital beds available to implement
this Service.   Our warning was not heeded, and now we are reaping the unfortunate consequences.
Page 89 The tragedy is that, since the warning was made to men whose precipitancy for
nationalization made them deaf to any word of caution, the one sure method of crying
"Halt" in the public interest was sabotaged by the British Medical Association itself
when it advised the profession to serve under the Act.
It is only the doctor who knows what is good doctoring and what is bad, and the
public has a right to expect good doctoring. If the machine through which doctoring
is to be done was so rapidly and imperfectly constructed that inspection of it caused
those responsible for working it to "warn" the makers that it was not safe, they would
have conferred a benefit upon the public by declining to work it until it was improved.
The public would have gratefully respected their action.
The hundreds of letters that have been sent to the newly-formed Fellowship for
Freedom in Medicine, which exists primarily to "do everything in its power to render
the highest standards of practice possible," record a number of anomalies and obstructions. These are being analyzed by a special committee of the Fellowship. They range
from objections to the existing scheme on high moral grounds to economic considerations as homely as how to keep the wolf from the door.
One doctor writes:
I find that the whole ethical basis of my daily work has been undermined. I
have either to adhere to private work, leave my poorer patients to go elsewhere,
and suffer grave financial loss, or else go in for the National Health Service wholeheartedly and, in order to make both ends meet, take on far more patients than
I can hope to look after adequately. At the moment I compromise by limiting
my National Health Service list . . . but it is a difficult position and may not be
tenable for long.
Many other letters state the same sort of difficulty.   Says another doctor:
I have carried on a successful general practice in this house for over 28 years,
earning up to £3,650 a year at its peak. Sow I have collected only 1,286 units
in the Service, which represents a loss of 75 per cent of my private patients. My
bare expenses, which cannot be reduced, easily amount to £1,500, and my list
will bring me roughly £1,000 a year.
Both types of letter could be multiplied indefinitely. Does someone say "But this
is only the doctor's point of view?" My reply is, "There is no such thing as only the
doctor's point of view." Bureau or no bureau, the basic element in any Medical Service
is, and must always be, the doctor. It was the crass folly of not recognizing this, and of
assuming that personnel can be nationalized, that led to this colossal blunder. The
essence of good doctoring is diagnosis, and diagnosis calls for time and a close-up with
the patient, both of which are at the moment denied to thousands of practitioners.
Good doctoring calls for two other things, things that concern the doctor personally
—a feeling of satisfaction in the work that he is doing and a sense of economic security.
Looking around at the faces of a group of doctors to whom I was speaking recently I
wondered why it was that they all seemed so unhappy. Then I realized the cause: their
job no longer held for them the spice that it did: the savour had gone out of their work.
As for a sense of security, in many quarters this had been rudely shaken. The
indecent haste with which the National Health Service came into operation made a
proper assessment of the just payment for a doctor's work quite impossible. The Minister did not wait to receive the report of the Spens Committee on remuneration of the
doctor, and even now these recommendations have not been implemented. Not only
is the whole question of remuneration in a state of flux, the equally important question
of security of tenure is also unsettled, whether for the general practitioner or for the
specialist. And the knowledge that the Minister's powers under the Act are, as I have
so often pointed out, unlimited, spreads much fear and anxiety.
If my insistence on the importance of the personal factor in Medicine be admitted
then all this is bad for doctoring. It is not so much a question whether or no a doctor
is going to stand up against all these handicaps in his work, the question of importance
Page 90
i
C»; to the public is whether or no he should have been put in the position in which he finds
good doctoring difficult and bad doctoring easy. That a doctor cannot pay his way
unless he has at least 4,000 patients on his list is as great a disservice to the public as it
is to Medicine. No medical man or woman should be "at risk" for 4,000 patients. That
may be making Medicine available for every citizen, but is it Medicine?
"Where do we go from here?" Will the Minister react to this very unsatisfactory
position in such a way as to maintain the fabric of his Act and yet enable the doctor
to preserve his essential loyalty to his patient? His powers are so great under the Act
that he can correct evils by regulations just as he can create them. Or will he prove an
even greater dictator than he has hitherto appeared to be? The former policy may
avert a breakdown; the latter will make a breakdown certain. Dr. Dain adopts, once
more, an attitude which bespeaks concern for the common weal.    He says:
If we do not get satisfaction quickly it will not be beyond the bounds of possibility to withdraw our services, not entirely because we are not getting enough
money, but because under the conditions of obtaining we cannot properly "deliver
the goods."
Let us hold up the Chairman's arms.   They must not fall down a second time.
*R
rm
RECENT ADVANCES IN OPHTHALMOLOGY
By E. F. Raynor, M.D., CM.
One of the most important advance in the field of ophthalmology has been the
invention of the Berman localizer. This instrument, built on the principle of the mine
detector is used in the localization of foreign bodies in the eye and orbit. X-ray localization has never been very satisfactory except to indicate the actual presence of a foreign
body and its approximate location. There has long been a need for more accurate pinpoint localization since even the giant magnet with its terrific pull has to be brought
in close proximity to the majority of ocular foreign bodies to be effective. With the
Berman localizer foreign bodies can now be localized to within a millimeter. With the
use of this instrument it can also be determined whether foreign bodies are of steel or
some other metal and whether they are magnetic or not.
Since the war there has been a great improvement in the manufacture of artificial I
eyes. Eyes made of glass were fragile and the eye secretions etched the glass which made
the socket irritable.    For this reason they usually had to be replaced after a year even
with the best of care.   Another disadvantage was the fact that highly skilled artisans
were necessary for their manufacture and huge stocks had to be carried in order to fit
a patient.   With the new all plastic artificial eyes patients can be more readily fitted
and the size and shape of the eye can be easily modified to suit each individual socket. I
They are unbreakable and are not affected by the eye secretions.
Many ingenious implants have been devised during the past few years to be buried
in the tissues after enucleation of an eye in order to transmit movement to the artificial eye. The latest integrated implant is the Stone-Jardon, and although there are
several similar types on the market I personally think that this is the best one. It
consists of a plastic ball with a tantalum mesh on its anterior surface and a small
plastic face with a rectangular depression in its centre. The muscles and conjunctiva
are sutured to the tantalum mesh and the face is left exposed. In other words, the
implant is only partially buried. This does not seem like sound surgical technique but
not one of this particular type of implant has ever been extruded. The plastic arti??^
ficial eye has a stud on the back of it which fits into the depression on the implant
and movement is then transmitted directly to the artificial eye. The movement of the
artificial eye with this combination is very natural and is a great advance over the older
methods. Even an eye that has been removed for several years can have this type of
implant inserted provided there is good socket movement.
Page 91 You have all heard of contact lenses which fit on the front of the eye with a solution
between the lens and the cornea. The most recent development along this line is the
corneal contact lens which fits on the cornea only and there is no solution between the
lens and the eye. It stays in position by capillary attraction. In the older type of contact lens the solution became cloudy and because of this could only be worn for a few
hours at most. The new corneal contact lens can be worn all day without discomfort
because the thin layer of fluid between the cornea and lens is constantly being replaced
and does not interfere with corneal nutrition.
In 1942 Terry described a disease occurring in premature infants in which an
opague tissue forms behind the lens after birth. He named this disease retrolental
fibroplasia.T^In a fully developed stage of a typical case, an opaque, vascularized membrane lies against the posterior surface of the lens. The globe is often smaller than
normal, the anterior chamber is frequently shallow, and sometimes glaucoma results.
The disease leads to complete blindness, and there is no effective remedy. The incidence is
about 12 per cent in infants weighing less than 3 lbs. at birth. The disease was thought
to be the result of fibroplasia of the embryonic tunica vasculosa lntis but this concept
has recently been disproven by Owens and Owens. They were able to observe this
condition develop in premature infants. The earliest sign of this condition occurred
between the second and fifth months of post-natal life. The general course of the disease was as follows: Any visible signs of the embryonic hyaloid system disappeared early
in post-natal life. The fundus was indistinguishable from the normal fundus of premature infants who did not develop this disease. The earliest detectable abnormality was
a slight dilatation of the retinal arteries and veins. This dilatation of vessels gradually
increased but was more marked in the veins which increased to about three times their
normal size. The vessels also became very tortuous and was very pronounced in the
arteries. This angiomatous dilatation and tortuousity of the vessels was soon followed by
one or more greyish yellow elevations of the retina in the far periphery. The dilated
and tortuous vessels coursed over these elevations. Soon the margins of the disc became
blurred and generalized retinal oedema developed. The greyish masses of elevated retina
in the periphery incrased in height, and other greyish yellow areas appeared scattered
throughout the fundus. After a short time a grey membrance with numerous vessels
coursing over it billowed forward in folds at the periphery of the retrolental space.
At this stage the fundus could only hazily be seen and bands of tissue extended from
the areas of detached retina in to the vitreous. Finally a complete retrolental membrance was formed by gradual extension and fusion of the peripheral folds and broad
ciliary processes were seen extending onto the membrance at its periphery, and numerous
vessels were present on the surface of the membrane. These vessels appeared to radiate
from the centre. The diameter of tne cornea was usually smaller than normal and the
anterior chamber became shallow. Sometimes glaucoma developed. Both eyes were not
always equally affected and the disease was often interrupted at one stage or another.
The disease is probably in the nature of a hemangiomatosis of the retina. The prognosis is very poor.
Friedenwald has recently developed a technique for the visualization of the blood
vessel in preparations of the whole unsectioned retina, and although this technique has
been developed only very recently, it has already advanced our knowledge of the pathology of certain conditions. He uses a special staining method known as the Hotchkiss
stain which brilliantly stains the basement membrane of the arterioles and the elastic
membrane of the arteries. We have believed in the past that one of the characteristic
ophthalmoscopic manifestations of diabetes was numerous pin-point haemorrhages in
the posterior pole of the fundus, but by using this technique of staining the whole retina
it has been shown very conclusively that many of these so-called minute haemorrhages
were actually minute capillary aneurysms. Of course haemorrhages do also occur. Many
other interesting facts have come to light with the use of this technique but are not of
general interest. In connection with diabetes it might be mentioned that it was thought
that the retinal haemorrhages that do occur in this disease might be due to a lack of
Page 92 vitamin C. This was due to the fact that diabetics failed to excrete vitamin C in their
urine even when enormous amounts were administered. However, these patients were
found to have quite normal plasma levels of vitamin C and their lack of excretion of it
was due to a high renal threshold rather than due to a deficiency. Cases of retinal
haemorrhage in this disease are helped to a great extent by the administration of Rutin
but the dosage must be fairly high and maintained until the haemorrhages disappear,
and then a maintenance dosage established which varies with the individual case. The
recommended dosage of Rutin is 150 mg. daily. Results of the use of Rutin have been
remarkable in some cases not only of diabetes but also in other haemorrhagic retinal
conditions.
There has been considerable research in the past few years on the electoretinogram.
In taking the electroretinogram one electrode is placed on the cornea and another on
some other part of the body such as the ear or the forehead. On flashing a light into the
eye a definite curve results that reflects the total response of the retina. It may be possible soon to differentiate between various component parts of the retina. Already it is
showing some positive results in determining the prognosis in cases of retinal detachment and in cases of cataract but a great deal more research may be necessary before
the electroretinogram comes into common office usage.
There has been a great deal of publicity during the past few years on the treatment of retinitis pigmentosa and many patients afflicted with this condition have formed
societies for study and treatment of this disease. Retinitis pigmentosa has been defined
by Duke-Elder as "a disease of unknown etiology, but with a definitely hereditary tendency, characterised by a chronic course and a progressive habit, which although rarely
manifest at birth, becomes apparent in childhood and frequently results in blindness in
middle or advanced age." Because of the narrowing of the blood vessels in this disease
various types of vasodilator drugs have been used, many operations designed to reduce
the ocular tension performed, and even section of the sympathetic supply to the eye
has been done in order to increase the blood supply of the retina. None of these procedures were ever effective. Glandular therapy was tried unsuccessfully and administration of massive doses of vitamins had no effect. Filatov in Russia used injections of
cod liver oil several years ago and reported improvement. Next he tried embedding
placenta under the conjunctiva and obtained equally good results. Then he has had
results with injection of placental extracts and the subcutaneous implantation of liver.
Gordon of New York has used injections of aloes but favors implantations of auto-
claved cadaver skin. All this prompted Vail to the use of the term "Witches Brew."
My only execuse for including this in this discussion is to emphasize that there is no
effective remedy for this condition and demonstrates the futility of attempting to
change the character of chromosomes.
Page 93
£.*> We regret to record the passing of a number of pioneer doctors of British Columbia:
Dr. A. P. Wells of Duncan.
Dr. E. J. Gray of Vancouver.
Dr. J..C. Stuart of Lillooet.
Dr. G. Price of Victoria.
Dr. H. Roy Mustard and Dr. H. C. Powell have received honors from the Venerable
Order1 of St. John of Jerusalem for the service they have rendered to that association.
Dr. A. L. Cornish has been elected President of the Boy Scouts' Association of
New Westminster.
Dr. J. E. Hill, of the Pathology Department of the Vancouver General Hospital, is
taking a special course at the Memorial Hospital in New York.
Dr. J. F. Anderson has been elected President of the Campbell River and District
Liberal Association.
Dr. S. A. Creighton, coroner's pathologist in Vancouver, has resigned to accept an
appointment as pathologist to a Seattle hospital. He will also undertake teaching duties
at the University of Washington Medical School.
Dr. P. S. Rutherford has accepted an appointment as pathologist at the Royal
Columbia Hospital in New Westminster.
Dr. James Murison has been appointed Medical Health Officer for the Powell River
District by the Provincial Government.
Dr. W. J. Stark has left Vancouver to do post-graduate work at the Ross Noos
Clinic in Los Angeles.
Dr. C. L. Hunt, formerly with the Saanich Health Unit has been appointed physician in charge o fclinics for the Division of V.D. Control.
At a recent meeting of the Industrial First Aid Attendant's Association of B.C.,
Dr. D. J. Millar was presented with a Certificate of Merit for work done in the. early
days of the Association.
Dr. Elizabeth Mahaffy has been appointed assistant medical health officer of the
Union Board of Health of Victoria.
Dr. N. B. Reilly, formerly of the Royal Jubilee Hospital in Victoria, has gone to
Edinburgh, Scotland, for post-graduate work.
Dr. J. Guild has left Fort Nelson and is now with the Allen Memorial Institute in
Montreal.
Dr. S. McClatchie has left New Westminster to go to the University of Toronto for
post-graduate study.
Dr. J. Dixon has left Tulesquah and is now at the Queen Mary's Veterans' Hospital
in Montreal.
There have been a number of changes of locations in the past few months:
Dr. K. R. Blanchard formerly of Alert Bay is now at Abbotsford.
Dr. H. Cantor has left Vancouver and is now at Ladysmith.
Dr. E. R. Hall formerly of Chermanius is now practising at Alert Bay.
Dr. D. W. Lim has recently completed a month's locum at Hazelton.
Dr. G. E. Little has left Bralorne and is now practising in Burnaby.
Dr. J. S. Miller formerly of Nova Scotia is now practising at Creston.
Dr. F. H. Prouse has left Hazelton to take up practice in Smithers.
Dr. M. Uchida has left Taylor Lake and is now practising in Kamloops.
Dr. L. M. Green formerly at Smithers is now at Powell River.
Dr. G. A. Wright has left Victoria to practise at Langord.
Page 94
■
Pi EXCLUSIVE RfllBULRnCE
S SERVICE
mmmm
VANCOUVER: 13th Avenue and Heather Street        fflir. 0080
NEW WESTMINSTER: 814 London Street [IUJ,   60
We Specialize in Ambulance Service Only
J. H. GRELLIN W. L. BERTRAND
CAMPBELL & SMITH LTD.
820 Richards Street   ::    Vancouver, B. C    ::    PAcific 3053
ll
WW
lzatl<jz iJ^%intina
■'ii

Cite

Citation Scheme:

        

Citations by CSL (citeproc-js)

Usage Statistics

Share

Embed

Customize your widget with the following options, then copy and paste the code below into the HTML of your page to embed this item in your website.
                        
                            <div id="ubcOpenCollectionsWidgetDisplay">
                            <script id="ubcOpenCollectionsWidget"
                            src="{[{embed.src}]}"
                            data-item="{[{embed.item}]}"
                            data-collection="{[{embed.collection}]}"
                            data-metadata="{[{embed.showMetadata}]}"
                            data-width="{[{embed.width}]}"
                            async >
                            </script>
                            </div>
                        
                    
IIIF logo Our image viewer uses the IIIF 2.0 standard. To load this item in other compatible viewers, use this url:
http://iiif.library.ubc.ca/presentation/cdm.vma.1-0214291/manifest

Comment

Related Items