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SERUM TESTS FOR SYPHILIS.
510
compounds than are the leucocytes of normal people. teacher or another, and most of those who answered The problem which Dr. Colebrook has been studying the question about the essential ingredients for is particularly well suited to the technique evolved success in practice put character and hard work first. in the laboratories of Sir Almroth
the to
result assess
Wright, but as is somewhat tentative, it is difficult the clinical value of the work so far
accomplished.
____
The report, with all the details which it gives, deserves’ careful study because it represents the aims of the average good-class practitioner and not those of the avowed reformers and reactionaries who alone are commonly vocal. ____
MEMORIAL FUND TO SIR DAWSON WILLIAMS. IT was naturally decided, and very rightly, that the movement for a testimonial to Sir Dawson Williams, which was started the week before his death, should continue, and that the resulting fund should be employed in the institution of a memorial to him, connected in some intimate and fit manner with the advancement of medicine. The fund will remain open for a time in order that answers to the appeal may be awaited from medical men resident abroad. All who wish to be included in the lists, the first one of which will be published shortly, are requested to send their contributions at once to Sir StClair Thomson, 64, Wimpole-street, London, W., to whom cheques should be made payable, while the envelope should be marked " Dawson Williams Testimonial."
MEDICAL EDUCATION. IT is often said that academic teachers have too much say in medical education and practising doctors too little. The reply that medical education is an educational and not a professional problem and should therefore be dealt with by educational rather than professional experts is probably not altogether sound in medicine or in the other technological subjects of university training. However that may be, the Commission on Medical Education, which has its headquarters in New Haven, U.S.A., gives in its second report a very interesting account of its attempt to obtain the views of medical men in
ordinary practice on the subjects with which the Commission concerns itself. A circular was sent out to a number of doctors named by their local medical societies as successful practitioners and over 1600 replies were received. These were divided into three groups, the first graduating before 1900, the third in 1911 or later. Owing to the rapid changes which have taken place in medical education in America, these three groups had themselves received very different training. Thus only 20 per cent. of the first group had had as much as four years’ instruction (i.e., beginning with anatomy and physiology) against 100 per cent. of the third group, 53 per cent. had had no pre-medical university teaching compared with 18 per cent., 61 per cent. had h3ld no house officership against 8 per cent.,70 per cent. were in independent practice when they were 25 years old compared with only 6 per cent. But when the medical men trained in these diverse ways stated their opinions as to what training was desirable, there was remarkable unanimity, whether they had themselves experienced what they recommended or not. Thus over 90 per cent. in all three groups consider pre-medical university work desirable, nearly every one thinks a four-year medical course necessary, and an internship desirable. What was good enough for them is not good enough now. But while these practitioners think well of some of the main changes which have overtaken the curriculum, they are, of course, far from satisfied with the present arrangements. The overcrowding of the course and consequent absence of time for study, undue emphasis on laboratory work, too much attention paid to rare and too little to common diseases are among the most frequent criticisms. At the same time the Commission reports that it is generally appreciated that the acquisition of a proper of scientific method by the student during his training will largely determine the level of his is no serious suggestion practice in the future, and there focused on practical be should course that the doctors reported that they alone. Many problems from one frnitful and inspiration had received
philosophy
signal
SERUM TESTS FOR
SYPHILIS.
THE Meinicke micro-reaction, on which Dr. David Prentice reports in our present issue (p. 493), represents a further stage in the search for some simple and quick modification of the Bordet-Wassermann test for syphilis-a search which has already resulted in the development of the Sachs-Georgi, the sigma, and the Eahn tests. The reaction may be performed either macro- or microscopically ; and while Dr. Prentice’s paper deals with the latter method a full account of the macro-reaction by Dr. E. A. Rucker and Dr. L. E. H. Whitby may be found in the February number of the British Journal of Experimentat Pathology. In its barest essentials the technique consists in the admixture of a certain quantity of the serum to be examined with a certain quantity of a special " antigen." Full details of the preparation of this antigen are given by Rucker and Whitby, but those who wish to perform only a limited number of tests will probably find it easier to procure it from Meinicke’s laboratory. As the reaction depends upon precipitation, and the complement is not concerned, the serum to be examined requires no preliminary inactivation. The report given in both papers is favourable, and in the hands of these three observers the reaction gave results closely approximating to those of the WasserRucker and Whitby point out, however, mann test. that they obtained no evidence that the Meinicke reaction is more sensitive than the Wassermann, which makes them regard it as definitely less sensitive than the sigma. For the present there is obviously no question of the Meinicke reaction or any of its precursors replacing the Wassermann reaction in the diagnosis of syphilis, but in its microscopic form, which requires only a few drops of blood withdrawn by puncture of a finger, it has great advantages in psediatric and asylum practice. The macroscopic technique, furthermore, seems to be an advance on all previous reactions of its kind and certainly marks an important step towards a method which will send the Wassermann reaction into honourable but unregretted retirement. ---
MEDICAL AND DENTAL REGISTERS. WE have received from the General Medical Council the three official registers for the year 1927. The Medical Register, among its 102 prefatory pages, includes the amending Act of 1927 giving effect to the mutual registration as between Great Britain and the Irish Free State. In this section the important warning notices have been revised and brought up to date, the warning in regard to association with uncertified women practising as midwives having taken more precise form in view of recent legislation. In the warning notice addressed to dentists has been inserted a paragraph on dangerous drugs, similar to that addressed to the medical practitioner. The only other substantial addition to the prefatory section is a somewhat melancholy table showing the several British possessions and foreign countries with which reciprocity formerly existed and no longer exists. Belgium, of course, renounced this kind of cooperation seven years ago, but the Canadian provinces of New Brunswick, Ontario, and Saskatchewan have thought better of their reciprocity within the past two years, and in the case of Ontario the change has only just come into force. The number of persons on the Medical Register at the beginning of the present year was 53,769, being an increase of 1155 on the previous year. During the year 1927 1941 names were added to the Register, 971 in England, 462 in Scotland, 274 in Ireland, 215 and 19
compounds than are the leucocytes of normal people. teacher or another, and most of those who answered The problem which Dr. Colebrook has been studying the question about the essential ingredients for is particularly well suited to the technique evolved success in practice put character and hard work first. in the laboratories of Sir Almroth
the to
result assess
Wright, but as is somewhat tentative, it is difficult the clinical value of the work so far
accomplished.
____
The report, with all the details which it gives, deserves’ careful study because it represents the aims of the average good-class practitioner and not those of the avowed reformers and reactionaries who alone are commonly vocal. ____
MEMORIAL FUND TO SIR DAWSON WILLIAMS. IT was naturally decided, and very rightly, that the movement for a testimonial to Sir Dawson Williams, which was started the week before his death, should continue, and that the resulting fund should be employed in the institution of a memorial to him, connected in some intimate and fit manner with the advancement of medicine. The fund will remain open for a time in order that answers to the appeal may be awaited from medical men resident abroad. All who wish to be included in the lists, the first one of which will be published shortly, are requested to send their contributions at once to Sir StClair Thomson, 64, Wimpole-street, London, W., to whom cheques should be made payable, while the envelope should be marked " Dawson Williams Testimonial."
MEDICAL EDUCATION. IT is often said that academic teachers have too much say in medical education and practising doctors too little. The reply that medical education is an educational and not a professional problem and should therefore be dealt with by educational rather than professional experts is probably not altogether sound in medicine or in the other technological subjects of university training. However that may be, the Commission on Medical Education, which has its headquarters in New Haven, U.S.A., gives in its second report a very interesting account of its attempt to obtain the views of medical men in
ordinary practice on the subjects with which the Commission concerns itself. A circular was sent out to a number of doctors named by their local medical societies as successful practitioners and over 1600 replies were received. These were divided into three groups, the first graduating before 1900, the third in 1911 or later. Owing to the rapid changes which have taken place in medical education in America, these three groups had themselves received very different training. Thus only 20 per cent. of the first group had had as much as four years’ instruction (i.e., beginning with anatomy and physiology) against 100 per cent. of the third group, 53 per cent. had had no pre-medical university teaching compared with 18 per cent., 61 per cent. had h3ld no house officership against 8 per cent.,70 per cent. were in independent practice when they were 25 years old compared with only 6 per cent. But when the medical men trained in these diverse ways stated their opinions as to what training was desirable, there was remarkable unanimity, whether they had themselves experienced what they recommended or not. Thus over 90 per cent. in all three groups consider pre-medical university work desirable, nearly every one thinks a four-year medical course necessary, and an internship desirable. What was good enough for them is not good enough now. But while these practitioners think well of some of the main changes which have overtaken the curriculum, they are, of course, far from satisfied with the present arrangements. The overcrowding of the course and consequent absence of time for study, undue emphasis on laboratory work, too much attention paid to rare and too little to common diseases are among the most frequent criticisms. At the same time the Commission reports that it is generally appreciated that the acquisition of a proper of scientific method by the student during his training will largely determine the level of his is no serious suggestion practice in the future, and there focused on practical be should course that the doctors reported that they alone. Many problems from one frnitful and inspiration had received
philosophy
signal
SERUM TESTS FOR
SYPHILIS.
THE Meinicke micro-reaction, on which Dr. David Prentice reports in our present issue (p. 493), represents a further stage in the search for some simple and quick modification of the Bordet-Wassermann test for syphilis-a search which has already resulted in the development of the Sachs-Georgi, the sigma, and the Eahn tests. The reaction may be performed either macro- or microscopically ; and while Dr. Prentice’s paper deals with the latter method a full account of the macro-reaction by Dr. E. A. Rucker and Dr. L. E. H. Whitby may be found in the February number of the British Journal of Experimentat Pathology. In its barest essentials the technique consists in the admixture of a certain quantity of the serum to be examined with a certain quantity of a special " antigen." Full details of the preparation of this antigen are given by Rucker and Whitby, but those who wish to perform only a limited number of tests will probably find it easier to procure it from Meinicke’s laboratory. As the reaction depends upon precipitation, and the complement is not concerned, the serum to be examined requires no preliminary inactivation. The report given in both papers is favourable, and in the hands of these three observers the reaction gave results closely approximating to those of the WasserRucker and Whitby point out, however, mann test. that they obtained no evidence that the Meinicke reaction is more sensitive than the Wassermann, which makes them regard it as definitely less sensitive than the sigma. For the present there is obviously no question of the Meinicke reaction or any of its precursors replacing the Wassermann reaction in the diagnosis of syphilis, but in its microscopic form, which requires only a few drops of blood withdrawn by puncture of a finger, it has great advantages in psediatric and asylum practice. The macroscopic technique, furthermore, seems to be an advance on all previous reactions of its kind and certainly marks an important step towards a method which will send the Wassermann reaction into honourable but unregretted retirement. ---
MEDICAL AND DENTAL REGISTERS. WE have received from the General Medical Council the three official registers for the year 1927. The Medical Register, among its 102 prefatory pages, includes the amending Act of 1927 giving effect to the mutual registration as between Great Britain and the Irish Free State. In this section the important warning notices have been revised and brought up to date, the warning in regard to association with uncertified women practising as midwives having taken more precise form in view of recent legislation. In the warning notice addressed to dentists has been inserted a paragraph on dangerous drugs, similar to that addressed to the medical practitioner. The only other substantial addition to the prefatory section is a somewhat melancholy table showing the several British possessions and foreign countries with which reciprocity formerly existed and no longer exists. Belgium, of course, renounced this kind of cooperation seven years ago, but the Canadian provinces of New Brunswick, Ontario, and Saskatchewan have thought better of their reciprocity within the past two years, and in the case of Ontario the change has only just come into force. The number of persons on the Medical Register at the beginning of the present year was 53,769, being an increase of 1155 on the previous year. During the year 1927 1941 names were added to the Register, 971 in England, 462 in Scotland, 274 in Ireland, 215 and 19