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THE BLINDING FILARIA IN EAST AFRICA
SPEED LIMIT FOR
DOCTOR’S CAR
this office have witnessed a revolution in public health practice, for a new standard of housing has been set up providing for the separation of the sexes over ten years of age and space for the increasing family, while a date has been fixed after which it will become an offence for either landlord or occupier to overcrowd a house in excess of its legal standard. By arduous tours through the country Sir Hilton contact with the medical .came personally into officers of health on whom the execution of this programme will so largely rest, and now it will fall to his successor to see the scheme for abolishing slums put through. But in the House of Lords Sir Hilton will find many opportunities of using his great knowledge of public health and his interest in the lives of the people. Sir Kingsley Wood, who leaves the post office to be Minister of Health, is no stranger to the department, for he served as Parliamentary Secretary some years ago. He has another practical qualification for the insurance side of the work, since he was one of the original members of the London Insurance Committee, and became its chairman for the year 1917-18, receiving the honour of knighthood during his year of office. Sir Kingsley is a solicitor and his firm has for many years been associated with one of the largest industrial approved societies. In the early days of the scheme he paid special attention to the problem of the adequacy of the medical service for the insured population in London, and sanatorium benefit, which at that time was administered by insurance committees, also received his intensive consideration. SPEED LIMIT FOR DOCTOR’S CAR USED AS AMBULANCE
USED AS AlIfBULANCE
1399
facts is not as weighty as a ruling by the High Court, the result is a useful precedent. To come within the exemption of Section 3 the car must be " used for ambulance purposes," and the case must be one where reduction of speed to 30 miles would hinder those purposes. The best rate of speed to minimise the jolting of an injured patient is a question which the magistrates might need expert evidence to decide. THE BLINDING FILARIA IN EAST AFRICA
ONCHOCERCIASIS has appeared in East Africa and there is little doubt that it is taking the blinding form whose devastating effects in the Belgian Congo and the Sudan were noted in our issue of June 1st. P. G. Preston has reported from Kenya onchocerca nodules, steadily increasing for two years and proved to be such by microscopic examination after excision. They were taken from a man who, except for service as a porter in the King’s African Rifles near Kilimanjaro during the late war, had always lived in the Kisii Reserve. From time to time he had suffered from pain as if a knife were thrust behind the eyes, with periodic blurring of the vision, which latterly seems to have become permanent. Preston believes this to have been the first case of onchocerciasis microscopically identified in Kenya. Further, A. J. Boase2 reports from Uganda the case of a Muganda with ciliary congestion, posterior synechise, and a hazy cornea through which the fundus could not be seen ; the corneal microscope revealed microfilari2e judged to be a third of a millimetre long. The man had 3ff. persians in the blood, but the size of the corneal micronlaria was that of the larvae of 0’M.coce?’c
practitioners, along with all other motorfilaria. ists, being summoned for exceeding the speed limit blinding of 30 miles per hour imposed by the Road Traffic Act LEGACIES AND GIFTS FROM PATIENTS of last year. A doctor who said he was hurrying to an No practitioner is safe against becoming involved urgent maternity case found the magistrates in a lenient mood. ’ Where a patient is being taken in in costly litigation arising out of his practice " is a well-worn sentence in the report of the Council to the emergency to surgery or hospital by motor-car, there is a possible exemption under Section 3 of the Act. In general meeting, held last Wednesday,of the members somewhat verbose language the section declares that of the London and Counties Medical Protection the provisions of any enactment, statutory rule or Society. It is a statement which hardly needs making order which impose a speed limit shall not apply to to members of such a society, but one to which heed any vehicle on an occasion when it is being used for should at once be given by those-now happily fewfire brigade, ambulance, or police purposes, if the who have not joined one of the societies formed to protect their interests. The report contains much to observance of those provisions would be likely to show how watchful is the council of this society over hinder the use of the vehicle for the purpose for which it is being used on that occasion. Last April a doctor the old recurring difficulties of professional life and arranged to drive a patient of hers to a maternity the new difficulties which are constantly arising. A home as soon as necessary. She was sent for one day fortnight ago (p. 1296) we dealt with the claims against and, as soon as she saw the patient, she realised it was a deceased practitioner’s estate opened up by a an urgent case. She had to drive 12 miles to the home, legislative Act of 1934. The report contains also a and in traversing a built-up area she was said to have timely reference to the legal difficulties which may travelled between 38 and 40 miles an hour over six- arise where a doctor accepts a gift from a patient. tenths of a mile. For this the Tunbridge Wells Their confidential relationship sets up a legal presumpmagistrates fined her f:2. She appealed to the West tion of undue influence unless it can be shown that the Kent Appeals Committee-i.e., to quarter sessions. patient received independent advice. Another point Police witnesses said that the saving of time by the of the general law appears to be imperfectly excess speed was only one minute. On the other side, appreciated. If a medical man is asked to witness the it was proved that the patient’s medical adviser had signature of a patient’s will, his attestation makes void pronounced the case to be one of great urgency, that any legacy which the patient may have left to him. the patient had to be assisted from the car on arrival, The law insists that, if the attesting witness (or his or and that the child was born within an hour of the her wife or husband) is the sole beneficiary under a mother being admitted to the home. In the mother’s will, then the will is invalidated altogether. If the witness (or his or her wife or husband) is only one of it was further time in car the condition, said, any would have precipitated matters. The Appeals the beneficiaries under a will, then the will stands Committee allowed the appeal and, although the 1 Jour. Trop. Med. and Hyg., 1935, xxxviii., 81. decision of quarter sessions upon a particular set of East African Med. Jour., 1935, xi., 326. MEDICAL are
"
DOCTOR’S CAR
this office have witnessed a revolution in public health practice, for a new standard of housing has been set up providing for the separation of the sexes over ten years of age and space for the increasing family, while a date has been fixed after which it will become an offence for either landlord or occupier to overcrowd a house in excess of its legal standard. By arduous tours through the country Sir Hilton contact with the medical .came personally into officers of health on whom the execution of this programme will so largely rest, and now it will fall to his successor to see the scheme for abolishing slums put through. But in the House of Lords Sir Hilton will find many opportunities of using his great knowledge of public health and his interest in the lives of the people. Sir Kingsley Wood, who leaves the post office to be Minister of Health, is no stranger to the department, for he served as Parliamentary Secretary some years ago. He has another practical qualification for the insurance side of the work, since he was one of the original members of the London Insurance Committee, and became its chairman for the year 1917-18, receiving the honour of knighthood during his year of office. Sir Kingsley is a solicitor and his firm has for many years been associated with one of the largest industrial approved societies. In the early days of the scheme he paid special attention to the problem of the adequacy of the medical service for the insured population in London, and sanatorium benefit, which at that time was administered by insurance committees, also received his intensive consideration. SPEED LIMIT FOR DOCTOR’S CAR USED AS AMBULANCE
USED AS AlIfBULANCE
1399
facts is not as weighty as a ruling by the High Court, the result is a useful precedent. To come within the exemption of Section 3 the car must be " used for ambulance purposes," and the case must be one where reduction of speed to 30 miles would hinder those purposes. The best rate of speed to minimise the jolting of an injured patient is a question which the magistrates might need expert evidence to decide. THE BLINDING FILARIA IN EAST AFRICA
ONCHOCERCIASIS has appeared in East Africa and there is little doubt that it is taking the blinding form whose devastating effects in the Belgian Congo and the Sudan were noted in our issue of June 1st. P. G. Preston has reported from Kenya onchocerca nodules, steadily increasing for two years and proved to be such by microscopic examination after excision. They were taken from a man who, except for service as a porter in the King’s African Rifles near Kilimanjaro during the late war, had always lived in the Kisii Reserve. From time to time he had suffered from pain as if a knife were thrust behind the eyes, with periodic blurring of the vision, which latterly seems to have become permanent. Preston believes this to have been the first case of onchocerciasis microscopically identified in Kenya. Further, A. J. Boase2 reports from Uganda the case of a Muganda with ciliary congestion, posterior synechise, and a hazy cornea through which the fundus could not be seen ; the corneal microscope revealed microfilari2e judged to be a third of a millimetre long. The man had 3ff. persians in the blood, but the size of the corneal micronlaria was that of the larvae of 0’M.coce?’c
practitioners, along with all other motorfilaria. ists, being summoned for exceeding the speed limit blinding of 30 miles per hour imposed by the Road Traffic Act LEGACIES AND GIFTS FROM PATIENTS of last year. A doctor who said he was hurrying to an No practitioner is safe against becoming involved urgent maternity case found the magistrates in a lenient mood. ’ Where a patient is being taken in in costly litigation arising out of his practice " is a well-worn sentence in the report of the Council to the emergency to surgery or hospital by motor-car, there is a possible exemption under Section 3 of the Act. In general meeting, held last Wednesday,of the members somewhat verbose language the section declares that of the London and Counties Medical Protection the provisions of any enactment, statutory rule or Society. It is a statement which hardly needs making order which impose a speed limit shall not apply to to members of such a society, but one to which heed any vehicle on an occasion when it is being used for should at once be given by those-now happily fewfire brigade, ambulance, or police purposes, if the who have not joined one of the societies formed to protect their interests. The report contains much to observance of those provisions would be likely to show how watchful is the council of this society over hinder the use of the vehicle for the purpose for which it is being used on that occasion. Last April a doctor the old recurring difficulties of professional life and arranged to drive a patient of hers to a maternity the new difficulties which are constantly arising. A home as soon as necessary. She was sent for one day fortnight ago (p. 1296) we dealt with the claims against and, as soon as she saw the patient, she realised it was a deceased practitioner’s estate opened up by a an urgent case. She had to drive 12 miles to the home, legislative Act of 1934. The report contains also a and in traversing a built-up area she was said to have timely reference to the legal difficulties which may travelled between 38 and 40 miles an hour over six- arise where a doctor accepts a gift from a patient. tenths of a mile. For this the Tunbridge Wells Their confidential relationship sets up a legal presumpmagistrates fined her f:2. She appealed to the West tion of undue influence unless it can be shown that the Kent Appeals Committee-i.e., to quarter sessions. patient received independent advice. Another point Police witnesses said that the saving of time by the of the general law appears to be imperfectly excess speed was only one minute. On the other side, appreciated. If a medical man is asked to witness the it was proved that the patient’s medical adviser had signature of a patient’s will, his attestation makes void pronounced the case to be one of great urgency, that any legacy which the patient may have left to him. the patient had to be assisted from the car on arrival, The law insists that, if the attesting witness (or his or and that the child was born within an hour of the her wife or husband) is the sole beneficiary under a mother being admitted to the home. In the mother’s will, then the will is invalidated altogether. If the witness (or his or her wife or husband) is only one of it was further time in car the condition, said, any would have precipitated matters. The Appeals the beneficiaries under a will, then the will stands Committee allowed the appeal and, although the 1 Jour. Trop. Med. and Hyg., 1935, xxxviii., 81. decision of quarter sessions upon a particular set of East African Med. Jour., 1935, xi., 326. MEDICAL are
"