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Kaiser Wakes the Doctors
BOOK NOTICES ture, scope, and significance of aniseikonia." The classification of types of aniseikonia, particularly the description of various normal forms, should aid many ophthalmologists in their understanding of this condition. Dr. Lancaster discussed the mechanisms by which abnormal aniseikonia is dealt with by the organ ism; he posed the very interesting ques tion of how aniseikonia causes the symp toms of eyestrain. Dr. F. H. Verhoeff presented a "Simple quantitative test for acuity and reliability of binocular stereopsis." Directions for the construction of this device are included, and a system presented for the grading of acuity of stereopsis, based on the Snellen notation for visual acuity. The test is compared to the Howard-Dolman test for stereopsis. The abstract of the discussion of this paper presents several interesting views on the determination of binocular stereop sis. Of the four papers that comprised the symposium on "Geriatrics," three are reproduced in this volume. They are: "Medical geriatrics" by Dr. George M. Piersol, "Neuropsychiatrie geriatrics" by Dr. Henry W. Woltman, and "Aging process in eye and adnexa" by Dr. Con rad Berens. This last paper is a detailed consideration of senile changes—"nor mal"—of each of the ocular and orbital tissues, as well as pathologic senile changes in the retina, lens, and optic nerve. Glaucoma, malignancies, and cata ract are discussed. Dr. T. L. Terry presented "Fibroblastic overgrowth of persistent tunica vasculosa lentis in premature infants. IV. Etiologic factors." Here Dr. Terry speculates on the possible causes of this uncommon condition and suggests a theory based on the precocious increase in blood pres sure before disappearance of the hyaloid artery. This would stimulate a fibroblastic overgrowth to support the hypertrophied
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hyaloid system. Dr. J. Goldsmith con tributed a detailed, carefully worked-out study of the "Dynamics of intracapsular cataract extraction." Using freshly enu cleated cadaver eyes, a series of experi ments was performed under slitlamp ob servation leading to the conclusions that Hanover's canal is an anatomic, closed space ; that the hyaloid membrane has no zonular fibers in relation to it; that, in intracapsular extraction, tumbling coupled with external pressure over the scierai surface produced the most effi cient and least traumatizing rupture of the zonule. This article is accompanied by numerous photographs. Dr. Moacyr E. Alvaro, guest of the Section on Ophthalmology, presented "Effects other than anti-infectious of sulfonamide compounds on the eye." This paper summarizes the ocular complica tions of sulfonamide therapy reported in the literature, with special emphasis on transient myopia, the most commonly re ported complication. Dr. Alvaro points out that there is some relation indicated between the amount of sulfonamide ad ministered, the duration of the therapy, and the degree of myopia. The exact mechanism of the phenomenon is not yet known. Dr. Edward Steiren presented to the meeting a "Metal safety and glare goggle." The numerous excellent papers in cluded in this volume are in keeping with the high standards of the Section on Oph thalmology with regard to research and observation. Benjamin Milder. KAISER W A K E S T H E DOCTORS. By Paul de Kruif. Clothbound, 158 pages. New York, Harcourt, Brace and Company, 1943. Price, $3.00. This book is written in the usual dra matic style that the author has assumed in
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order to catch the attention of the public. Such a method does not lend itself to a scientific portrayal of a subject, but the latter would not be read by the general public. De Kruif states that he has al ways been an enthusiastic admirer of physicians, but that after a careful study of the economics of prepaid medical care as illustrated in the hospitals established by Henry J. Kaiser in connection with his shipbuilding plants and earlier Grand Coulee Dam project, he has become con vinced that this, contrary to the opinion of organized doctors, is a most desirable method of handling the problem of sup plying adequate medical treatment to the middle-income patients, who cannot af ford the best that medicine has to offer unless they are willing to accept charity. In this book he describes in great de tail the experience of Dr. Sidney Garfield with prepaid care, first among the men engaged in construction on the Arizona desert and later in the Kaiser projects. According to the author, this experiment was astonishingly successful not only in the care of the patients but also finan cially. Modern hospitals were built at great expense but were rendered free from debt in a miraculously short period of time, due only to the payment of from 5 to 7 cents per patient per day, which covered 60 percent of the expense, the money paid by interested insurance com panies accounting for the remaining 40 percent. Not only were beautiful hos pitals built but they were equipped in the most approved modern manner, even in cluding air conditioning, and a very com plete staff of young physicians was em ployed at excellent salaries. According to the author, stout objec tion to these projects was registered by organized medicine and by many of the local physicians, but the essential value of the projects and the efficiency of their
management were such as to overcome all objections. The author admits that this ideal han dling of medical needs cannot be accom plished everywhere in the United States without modification for the local condi tions. He urges that it be directed by physicians themselves and not by the cen tral government. He is convinced that it should be and will be the best method of administering medical care in the future for those who cannot provide for the great expense of physicians employed privately and who are not in the indigent class. Lawrence T. Post.
OBITUARY CLIFFORD BLACK WALKER, M.D. 1884-1943 Clifford Black Walker died on July 3, 1943, at the age of 58 years. He died dur ing an acute exacerbation of a prolonged illness. This illness had interrupted his re search of incalculable importance on separated retina. Dr. Walker was born in Cambridge, Vermont, on August 9, 1884. When he was three years of age his family moved to South Pasadena, California, where he received his preliminary education. He was graduated from the University of California in 1906 with the degree of Bachelor of Science and entered the School of Engineering, receiving his de gree. In 1911 he received the degree of Doctor of Medicine with honors from Johns Hopkins Medical School. It was at Johns Hopkins that Dr. Walker's genius was first recognized. Dr. Harvey Cushing referred to him as "the modern Helmholtz." Dr. Cushing influ enced Dr. Walker to come to Boston and in association with Cushing he did his
nos
hyaloid system. Dr. J. Goldsmith con tributed a detailed, carefully worked-out study of the "Dynamics of intracapsular cataract extraction." Using freshly enu cleated cadaver eyes, a series of experi ments was performed under slitlamp ob servation leading to the conclusions that Hanover's canal is an anatomic, closed space ; that the hyaloid membrane has no zonular fibers in relation to it; that, in intracapsular extraction, tumbling coupled with external pressure over the scierai surface produced the most effi cient and least traumatizing rupture of the zonule. This article is accompanied by numerous photographs. Dr. Moacyr E. Alvaro, guest of the Section on Ophthalmology, presented "Effects other than anti-infectious of sulfonamide compounds on the eye." This paper summarizes the ocular complica tions of sulfonamide therapy reported in the literature, with special emphasis on transient myopia, the most commonly re ported complication. Dr. Alvaro points out that there is some relation indicated between the amount of sulfonamide ad ministered, the duration of the therapy, and the degree of myopia. The exact mechanism of the phenomenon is not yet known. Dr. Edward Steiren presented to the meeting a "Metal safety and glare goggle." The numerous excellent papers in cluded in this volume are in keeping with the high standards of the Section on Oph thalmology with regard to research and observation. Benjamin Milder. KAISER W A K E S T H E DOCTORS. By Paul de Kruif. Clothbound, 158 pages. New York, Harcourt, Brace and Company, 1943. Price, $3.00. This book is written in the usual dra matic style that the author has assumed in
1106
OBITUARY
order to catch the attention of the public. Such a method does not lend itself to a scientific portrayal of a subject, but the latter would not be read by the general public. De Kruif states that he has al ways been an enthusiastic admirer of physicians, but that after a careful study of the economics of prepaid medical care as illustrated in the hospitals established by Henry J. Kaiser in connection with his shipbuilding plants and earlier Grand Coulee Dam project, he has become con vinced that this, contrary to the opinion of organized doctors, is a most desirable method of handling the problem of sup plying adequate medical treatment to the middle-income patients, who cannot af ford the best that medicine has to offer unless they are willing to accept charity. In this book he describes in great de tail the experience of Dr. Sidney Garfield with prepaid care, first among the men engaged in construction on the Arizona desert and later in the Kaiser projects. According to the author, this experiment was astonishingly successful not only in the care of the patients but also finan cially. Modern hospitals were built at great expense but were rendered free from debt in a miraculously short period of time, due only to the payment of from 5 to 7 cents per patient per day, which covered 60 percent of the expense, the money paid by interested insurance com panies accounting for the remaining 40 percent. Not only were beautiful hos pitals built but they were equipped in the most approved modern manner, even in cluding air conditioning, and a very com plete staff of young physicians was em ployed at excellent salaries. According to the author, stout objec tion to these projects was registered by organized medicine and by many of the local physicians, but the essential value of the projects and the efficiency of their
management were such as to overcome all objections. The author admits that this ideal han dling of medical needs cannot be accom plished everywhere in the United States without modification for the local condi tions. He urges that it be directed by physicians themselves and not by the cen tral government. He is convinced that it should be and will be the best method of administering medical care in the future for those who cannot provide for the great expense of physicians employed privately and who are not in the indigent class. Lawrence T. Post.
OBITUARY CLIFFORD BLACK WALKER, M.D. 1884-1943 Clifford Black Walker died on July 3, 1943, at the age of 58 years. He died dur ing an acute exacerbation of a prolonged illness. This illness had interrupted his re search of incalculable importance on separated retina. Dr. Walker was born in Cambridge, Vermont, on August 9, 1884. When he was three years of age his family moved to South Pasadena, California, where he received his preliminary education. He was graduated from the University of California in 1906 with the degree of Bachelor of Science and entered the School of Engineering, receiving his de gree. In 1911 he received the degree of Doctor of Medicine with honors from Johns Hopkins Medical School. It was at Johns Hopkins that Dr. Walker's genius was first recognized. Dr. Harvey Cushing referred to him as "the modern Helmholtz." Dr. Cushing influ enced Dr. Walker to come to Boston and in association with Cushing he did his