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Clinicians as teachers of prevention
PUBLIC H E A L T H .
I924 . REVIEWS. C L I N I C I A N S AS T E A C H E R S O F PREVENTION.
In some quarters the strange doctrine that the teaching of prevention should be delegated to the ordinary clinical teachers of the medical schools has been preached industriously, but up to the present there seems to be little or no indication that the clinicians concerned are as a whole in the slightest degree interested in the subject. W e have on numerous occasions expressed our dissent from such a suggestion, as a wide experience in teaching has convinced us that no specialist in any particular subject is tikety to prove a good teacher in another branch even if the two are more or less intimately associated. Our contention is that the average clinician is not in any way interested in prevention and is never likely to be a good teacher of it even if he could be persuaded to undertake to devote a few of his lectures t o that part of the subject. In view of our expressed opinion, which we adhere to in every way, it gives us particular pleasure to record the publication of two handbooks of eminent clinicians which deal adequately and scientifically with the subject of prevention. Both these writers are prominently associated with prevention and are at the same time skilled clinicians. Their textbooks are likely to be of the greatest possible use to the average student and medical practitioner, and will at the same time be read with much interest and considerable profit by every medical officer of health. 1. Gynaecology with Obstetrics. A Text Book for Students and Practitioners, by John S. Fairbairn, B.M., B.Ch., (Oxon.), F.R.C.P. (Lond.), F . R . C . S . (Eng.) Published by Humphrey Milford, Oxford University Press, '1924. Price 25s. net. In Dr. Fairbairn's prologue he discusses the relation of midwifery to general medicine and surgery, and gives his view of the importance of the reproductive cycle to the community and discusses its public health and social bearings. Throughout the book he emphasises the preventive side, as, for instance, in such things as abortion, the medico-legal and ethical sides of which are thoroughly discussed; similarly in the chapter on the toxaemlas of pregnancy. Considerable public health interest is also contained in the discussion on the management of labour and uterine inertia. In the sections dealing with the newly-born infant and breast feeding the
323
subject is viewed largely frorn the physiological side. Even in such a subject as dysmenorrhoea the preventive treatment and investigation receives considerable attention as is also the case in the section dealing with the nervous and psychical aspect of gynaecology. The last section on public health, and social and ethical aspects, is one which will appeal specially to all people interested in public health, and is obviously written by one who is an enthusiast on public health and preventive progress. The book is evidently the work o f an experienced and enthusiastic teacher with the highest ideals, and it will be read with a great deal of pleasure by all. 2. Venereal Disease: Its Prevention, Symptoms and Treatment.
By H u g h W a n s e y Bayly,
M.C., formerly Pathologist to the London Lock Hospital, etc. Published by J. and A. Churchill. 1924. Price 7s. 6d. Few textbooks can compare with this medium sized production, either in clearness of arrangement, excellency of type, or useful illustrations. As would be expected in a production from Major W a n s e y Bayly, the subject of prevention receives special attention, an~ is dealt with efficiently. Anyone who desires to have a concise and accurate summary of the present position of prevention of venereal diseases will obtain such knowledge from this book. The medical student, and practitioner, and also the V.D. officer will find the book of very great use in all branches of their studies and their work, both practical and theoretical, and the book can be unreservedly recommended. The five sections into which the volume is devoted are respectively, (1) Prevention, (2) Syphilis, (3) Gonorrhoea, (t) Non-Specific Lesions, (5) The Patient. In the last section useful advice is given with regard to the equipment of the consulting room, methods of home treatment, examination of patients, taking of specimens, marriage, sterility, neurasthenia. The book is written in a clear, attractive and practical style, and its issue at the low price of seven shillings and sixpence should insure a large sale. 3. A Text Book for Midwives. Papers for Practising Midwives : edited by M. Olive Haydon, published by " N u r s i n g N o t e s , " price Is. These papers entitled respectively, " B o o k i n g of Patients, . . . . Discomforts of P r e g n a n c y , " " T h e Midwife and the Nervous P a t i e n t , " " M a n a g e m e n t of Labour that will Avoid Complications, . . . . Posture in Obstetrics (illustrated)," " T h e Comfort and Proper Dieting of the Lying-
324
SEPTEMBER, :924 .
PUBLIC HEALTH.
in Mother, . . . . The Midwife and the DoctOr," " T h e Good-bye Visit," " T h e Management of the District B a b y , " "Breast-feeding and Its Difficulties in District Practice," cover most of the grounds of the midwife's practice, and every paper is fuI1 of sound advice which, if read, understood, and carried out by the midwife, would result in a vast improvement in the general midwifery practice in this country. It is written by a midwife and teacher of very great experience, and one who evidently understands f u l l y the difficulties of midwifery practice. The booklet might usefully be placed in the hands of all practising midwives.
CORRESPONDENCE.
The Editor does not accept responsibility f o r the opinions of correspondents.
SIR GEORGE NEWMAN'S ANNUAL REPORT. The Annual Report for 1923 of the Chief Medical Officer of the Minis}ry of Health has just been issued. The Report is in form similar to that of previous years and contains vital statistics showing that ttie year under review was the healthiest on record. The chapters a r e devoted to a number o f subjects'concerned with personal and public health, including Tuberculosis, Maternity and Child Welfare, the Insurance Medical Service, the P o o r Law Medical Service, etc. Particular reference is also made to the remarkable decline in the mortality from typhoid during the last 50 years, the smallpox outbreaks, and human nutrition. The R e p o r t , including f o u r short Appendices, is 211 pages in length and may be obtained either direct from I{is Maiesty's Stationery Office or through any bookseller, price 3/-.
W O M E N IN P U B L I C H E A L T H APPOINTMENTS. Sir,--Reference your p a r a g r a p h in "Public I l e a l t h " of August, 1924, and the letter in the B.M.J. of 9th August, I think more could be done to prevent such unfortunate situations, but it seems unfair to blame these young inexperienced women entirely. It is not only women who accept these posts as seen, for example, from the recent appointment at Leeds of a male assistant M . O . H . a t less than t h e minimum salary. With regard to the fair candidates for the Moray Education posts two of the candidates were daughters of medical men of (understood) good-standlng and one has accepted the post below minimum salary as assistant to the Aberdeenshire Education Authority. Medical men on the Committee frequently take no step to prevent these appointments and yet they (the successful candidates) are allowed to continue members of the British Medical Association. The salaries of senior Public Health Officers in Scotland are in many cases below that of assistant Medical Officers in England, which must make some difficulty in maintaining the minimum £600 per annum for assistants in Scotland, heence there are apparent more "black legs" in the North. WOMAN ~SSISTANT MEDICAL OFFICER,
A section has been added to the United States education law providing that a specialist shall assist the State Medical inspector when he makes eye and ear tests on public school pupils. Mr, W. H. S. JONES, Fellow of St. Catharine's College, Cambridge, has edited the earliest Greek, Latin and Arabic MSS. of the " H i p p o cratic O a t h , " the famous .oath upon which the ethical rules of the medical profession have been based. In addition to the MSS., the volume will contain translations, an essay and an appendix; it will be entitled " T h e DoctOr's O a t h : a n Essay in the History of Medicine," and will be published by the Cambridge University Press. The death occurred suddenly on 7th July of Dr. William Arnold Evans, of Oakworth, near Keithley, Yorks., for over twenty years medical officer of tiealth for the city of Bradford. Dr. Evans was found in a state of c o l l a p s e in his surgery and died before medical a i d could reach him. Dr. Evans qualified in 1883 a s M.R.C.S. and L.S.A. In 1888 he too,k the M.D. of the London University, in 1890 D . P . H . Camb., and B.Sc. Vict. in 1904. Before settling in practice in Bradford, he was for a time h o u s e physician in the Wolverhampton General Hospi~tal, house physician at the Manchester Royal Infirmary, and resident at Monsall Fever Hospital. He was appointed medical officer of health for Bradford in hence there are apparent more "black l e g s " in t o o k up practice in Oakworth.
I924 . REVIEWS. C L I N I C I A N S AS T E A C H E R S O F PREVENTION.
In some quarters the strange doctrine that the teaching of prevention should be delegated to the ordinary clinical teachers of the medical schools has been preached industriously, but up to the present there seems to be little or no indication that the clinicians concerned are as a whole in the slightest degree interested in the subject. W e have on numerous occasions expressed our dissent from such a suggestion, as a wide experience in teaching has convinced us that no specialist in any particular subject is tikety to prove a good teacher in another branch even if the two are more or less intimately associated. Our contention is that the average clinician is not in any way interested in prevention and is never likely to be a good teacher of it even if he could be persuaded to undertake to devote a few of his lectures t o that part of the subject. In view of our expressed opinion, which we adhere to in every way, it gives us particular pleasure to record the publication of two handbooks of eminent clinicians which deal adequately and scientifically with the subject of prevention. Both these writers are prominently associated with prevention and are at the same time skilled clinicians. Their textbooks are likely to be of the greatest possible use to the average student and medical practitioner, and will at the same time be read with much interest and considerable profit by every medical officer of health. 1. Gynaecology with Obstetrics. A Text Book for Students and Practitioners, by John S. Fairbairn, B.M., B.Ch., (Oxon.), F.R.C.P. (Lond.), F . R . C . S . (Eng.) Published by Humphrey Milford, Oxford University Press, '1924. Price 25s. net. In Dr. Fairbairn's prologue he discusses the relation of midwifery to general medicine and surgery, and gives his view of the importance of the reproductive cycle to the community and discusses its public health and social bearings. Throughout the book he emphasises the preventive side, as, for instance, in such things as abortion, the medico-legal and ethical sides of which are thoroughly discussed; similarly in the chapter on the toxaemlas of pregnancy. Considerable public health interest is also contained in the discussion on the management of labour and uterine inertia. In the sections dealing with the newly-born infant and breast feeding the
323
subject is viewed largely frorn the physiological side. Even in such a subject as dysmenorrhoea the preventive treatment and investigation receives considerable attention as is also the case in the section dealing with the nervous and psychical aspect of gynaecology. The last section on public health, and social and ethical aspects, is one which will appeal specially to all people interested in public health, and is obviously written by one who is an enthusiast on public health and preventive progress. The book is evidently the work o f an experienced and enthusiastic teacher with the highest ideals, and it will be read with a great deal of pleasure by all. 2. Venereal Disease: Its Prevention, Symptoms and Treatment.
By H u g h W a n s e y Bayly,
M.C., formerly Pathologist to the London Lock Hospital, etc. Published by J. and A. Churchill. 1924. Price 7s. 6d. Few textbooks can compare with this medium sized production, either in clearness of arrangement, excellency of type, or useful illustrations. As would be expected in a production from Major W a n s e y Bayly, the subject of prevention receives special attention, an~ is dealt with efficiently. Anyone who desires to have a concise and accurate summary of the present position of prevention of venereal diseases will obtain such knowledge from this book. The medical student, and practitioner, and also the V.D. officer will find the book of very great use in all branches of their studies and their work, both practical and theoretical, and the book can be unreservedly recommended. The five sections into which the volume is devoted are respectively, (1) Prevention, (2) Syphilis, (3) Gonorrhoea, (t) Non-Specific Lesions, (5) The Patient. In the last section useful advice is given with regard to the equipment of the consulting room, methods of home treatment, examination of patients, taking of specimens, marriage, sterility, neurasthenia. The book is written in a clear, attractive and practical style, and its issue at the low price of seven shillings and sixpence should insure a large sale. 3. A Text Book for Midwives. Papers for Practising Midwives : edited by M. Olive Haydon, published by " N u r s i n g N o t e s , " price Is. These papers entitled respectively, " B o o k i n g of Patients, . . . . Discomforts of P r e g n a n c y , " " T h e Midwife and the Nervous P a t i e n t , " " M a n a g e m e n t of Labour that will Avoid Complications, . . . . Posture in Obstetrics (illustrated)," " T h e Comfort and Proper Dieting of the Lying-
324
SEPTEMBER, :924 .
PUBLIC HEALTH.
in Mother, . . . . The Midwife and the DoctOr," " T h e Good-bye Visit," " T h e Management of the District B a b y , " "Breast-feeding and Its Difficulties in District Practice," cover most of the grounds of the midwife's practice, and every paper is fuI1 of sound advice which, if read, understood, and carried out by the midwife, would result in a vast improvement in the general midwifery practice in this country. It is written by a midwife and teacher of very great experience, and one who evidently understands f u l l y the difficulties of midwifery practice. The booklet might usefully be placed in the hands of all practising midwives.
CORRESPONDENCE.
The Editor does not accept responsibility f o r the opinions of correspondents.
SIR GEORGE NEWMAN'S ANNUAL REPORT. The Annual Report for 1923 of the Chief Medical Officer of the Minis}ry of Health has just been issued. The Report is in form similar to that of previous years and contains vital statistics showing that ttie year under review was the healthiest on record. The chapters a r e devoted to a number o f subjects'concerned with personal and public health, including Tuberculosis, Maternity and Child Welfare, the Insurance Medical Service, the P o o r Law Medical Service, etc. Particular reference is also made to the remarkable decline in the mortality from typhoid during the last 50 years, the smallpox outbreaks, and human nutrition. The R e p o r t , including f o u r short Appendices, is 211 pages in length and may be obtained either direct from I{is Maiesty's Stationery Office or through any bookseller, price 3/-.
W O M E N IN P U B L I C H E A L T H APPOINTMENTS. Sir,--Reference your p a r a g r a p h in "Public I l e a l t h " of August, 1924, and the letter in the B.M.J. of 9th August, I think more could be done to prevent such unfortunate situations, but it seems unfair to blame these young inexperienced women entirely. It is not only women who accept these posts as seen, for example, from the recent appointment at Leeds of a male assistant M . O . H . a t less than t h e minimum salary. With regard to the fair candidates for the Moray Education posts two of the candidates were daughters of medical men of (understood) good-standlng and one has accepted the post below minimum salary as assistant to the Aberdeenshire Education Authority. Medical men on the Committee frequently take no step to prevent these appointments and yet they (the successful candidates) are allowed to continue members of the British Medical Association. The salaries of senior Public Health Officers in Scotland are in many cases below that of assistant Medical Officers in England, which must make some difficulty in maintaining the minimum £600 per annum for assistants in Scotland, heence there are apparent more "black legs" in the North. WOMAN ~SSISTANT MEDICAL OFFICER,
A section has been added to the United States education law providing that a specialist shall assist the State Medical inspector when he makes eye and ear tests on public school pupils. Mr, W. H. S. JONES, Fellow of St. Catharine's College, Cambridge, has edited the earliest Greek, Latin and Arabic MSS. of the " H i p p o cratic O a t h , " the famous .oath upon which the ethical rules of the medical profession have been based. In addition to the MSS., the volume will contain translations, an essay and an appendix; it will be entitled " T h e DoctOr's O a t h : a n Essay in the History of Medicine," and will be published by the Cambridge University Press. The death occurred suddenly on 7th July of Dr. William Arnold Evans, of Oakworth, near Keithley, Yorks., for over twenty years medical officer of tiealth for the city of Bradford. Dr. Evans was found in a state of c o l l a p s e in his surgery and died before medical a i d could reach him. Dr. Evans qualified in 1883 a s M.R.C.S. and L.S.A. In 1888 he too,k the M.D. of the London University, in 1890 D . P . H . Camb., and B.Sc. Vict. in 1904. Before settling in practice in Bradford, he was for a time h o u s e physician in the Wolverhampton General Hospi~tal, house physician at the Manchester Royal Infirmary, and resident at Monsall Fever Hospital. He was appointed medical officer of health for Bradford in hence there are apparent more "black l e g s " in t o o k up practice in Oakworth.