BIOPHYSICAL ASSISTANTS.

1156 of their predecessor’s work whose results in Egypt proper, for instance at Kom Omro, on the east bank of the Nile north of Aswan, have been of such striking value to a country in which most of them no longer

-work. At the other end of the continent, the South African Union’s Institute for Medical Research has played its part in the Union’s malaria problems by a mosquito survey in eastern and northern Transvaal, carried through by A. Ingram and B. de Meillon.3 It is believed that the two main local carriers wf malaria are Anopheles gambice (A. costalis) and A. funestus, particularly the former, since during an

epidemic at Rustenburg, it was captured in houses, ,gorged with blood, and is much the more numerous of the two during the malaria season. Two observa’tions, published since this report was made, suggest nesitation in accepting these conclusions. J. ’Schwetz4 has shown in the Belgian Congo that the percentage of infected mosquitoes in his particular Hatches were, for A. gambice 18, A. funestus 4, A. nili 13, and A. marshalli 8. The two last are among the ’1’4 anopheline species reported from the Transvaal, to be added to the list of malaria that when species sanitation is investigated in South Africa these two mosquitoes also will have to be considered. The second significant observation, by L. W. Hackett,relates to malaria in Sardinia, where anopheline density during the malaria season was negligible, although two months earlier it had been heavy. When, then, it is noted of Brits, in the ’Transvaal, that during the malaria season of 1926 A. gambice and A. funestus were absent, it need not signify that they are not important local carriers, but it does show the vital importance of carrying a local survey over a whole year.

and have

carriers ;

now

so

BIOPHYSICAL ASSISTANTS. glad to see that the Society of Apothecaries ,,of London, at the instigation of the British Medical Association, is taking steps to establish a roll of persons of guaranteed training and competency to whom medical men can confidently issue prescriptions for treatment by electricity or irradiation. An .approved course of training will be required of all technicians who desire to be placed on the register, and all applicants after May 31st, 1930, will be required to pass an examination ; the details of the requirements in these respects have not yet been issued. Meanwhile, following the tradition of similar schemes of qualification, technical assistants of .approved standing and experience may be admitted to the roll, the main requirement being two or three years’ practice in an approved institution. This is by no means an extravagant demand and it may possibly prove to be too lenient. Registered members on the roll will on their side undertake to conform to various professional obligations, the most important being that they will not undertake the treatment of any patient except under the direction and control of a registered medical practitioner. The mechanical and technical apparatus of medicine Tias become so complicated that there is bound to be .a progressive movement in the direction of this scheme for technicians of biophysics-a queer name, though it is hard to think of a better one. Pharmacy has long since shown the way and has realised a high and rising ideal. The clinical laboratory is catered for -by the Pathological and Bacteriological Laboratory Assistants Association which, in collaboration with the Pathological Society, issues certificates of proficiency to technical assistants who can satisfy stringent requirements of training and knowledge, - tested by examination. This association is of particular interest because it was founded by the assistants -themselves without any very clear demand from outside, and it has progressed to its present position

WE

are

3 Publications of South African Institute for Med. Research, 1929, iv., 83. 4 Trans. Roy. Soc. Trop. Med. and Hyg., 1929, xxii., 457. 5 Ibid., p. 477.

of authority and usefulness along the lines of an old-fashioned trade-union. In some ways this seems to us a rather better plan than that undertaken by the Society of Apothecaries. Once the right standard is set, the members of a technical association may be trusted to guard their qualifications as jealouslv as any outside body, and we hope that in the end the biophysical technicians may have a large share in the conservation of their own roll. In any case we wish the movement success, and look forward with interest to the publication of the conditions of training and examination which will come into force next year. THE SALFORD V.D. SCHEME. IMPORTANT changes in the scheme whereby the city of Salford attempts to cope with the venereal disease problem were made on April 1st, 1928, and the report of the first nine months of work has now been issued by the medical officer then appointed. From 1917 till April, 1928, a treatment centre was housed in the out-patient department of Salford Royal Hospital. It was open only on four daysa week for a limited time, though intermediate treatment could be obtained daily during one hour by women and during two hours on three days in the week by men. The medical officers, four in number, attended during 12 hours each week on a part-time basis, and there was no official director. The municipal clinic established last year to replace this centre was placed under the supervision of Dr. E. T. Burke, who is responsible to the medical officer of health. Dr. Burke works on a whole-time basis, as does also the assistant V.D. medical officer, Dr. F. W. F. Purcell; they attend the clinic for at least 60 hours per week. It is open for five days from 8.30 A.31. till 8.30 P.M. each day, on Saturdays for 5t hours in two separate periods. and on Sundays for 6 hours in two separate periods. The clinic is housed in premises specially arranged and equipped for venereal disease work alone. -Six beds are already available for in-patient treatment, but more beds are said to be required. The main principle of the clinic as now organised is that the unit to be treated is not the individual but the family. Thus, if a child is suffering from venereal disease, every effort is made to get the parents and other members of the family to attend for examination and, if necessary, for treatment. Statistics are given to show that the number of cases dealt with in the nine months (1220 new cases, 35,503 total attendances, and 26,155 intermediate attendances out of a population of 247,600) compares favourably with that of other treatment centres concerned with a similar size of population. Dr. Burke attributed the immediate success of the clinic to the fact that the treatment is given in an institution specially organised for the purpose by a staff of workers whose whole time is devoted to their duties. In his view such a clinic is more able to render efficient service than one attached to a general hospital, and the patient is quick to realise the fact. When there is a medical school in a town it is essential that the clinic should be within the teaching hospital, but he holds that it should be a distinct department and not a mere annexe to the general out-patient department. It should be linked up with the other teaching activities of the school, and the medical officer in charge should have the full status of honorary member of the staff. The question of defaulters is discussed in the report. During the nine months under review 433 letters were sent to patients who had ceased their attendance at the clinic prematurely-that is, when their superficial and obvious symptoms had disappeared, but before they were officially discharged. These letters brought just under a third of the defaulters back to the clinic, and of these, 116 are still attending. Twenty-eight of those returning have since been discharged, 6 were transferred, and 10 returned for a period only. Six reported that they were under their own doctor, and 13 gave other causes for their absence. Of the rest, 118 had given wrong addresses,