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Westward Ho
EDITORIALS T h e new officers elected to serve in 1951 a r e : President, Derrick Vail, Chicago; president-elect, James Milton Robb, Detroit, Michigan; 1st vice-president, Francis E . Le Jeune, N e w O r l e a n s ; 2nd vice-president, Peter Kronf eld, Chicago; 3rd vice-president, Frederick A. Figi, Rochester, Minnesota. T h e new councillor is John H . Dunnington, N e w York. Members of the Academy will be de lighted to know that William L. Benedict has been elected executive secretary-treas urer to serve full time. H i s election assures us that the magnificent work of this ex traordinary organization will continue to thrive under his valuable direction. D r . George W . Corner and Dr. George Smelser were elected honorary members of the society in recognition of their outstand ing contribution and work on the film of the "Embryology of the eye." The social side of the meeting was not neglected. T h e usual smoker and banquet were attended in force, and, at the latter, 10 honor keys were presented to faithful instructors who have devoted many hours to the scientific work of the Academy. T h e next meeting of the organization will be held in the Palmer House, Chicago, October 14 to 19, 1951. Derrick Vail.
W E S T W A R D HO The American public is faced with the problem of achieving a better distribution of medical care. An equally pressing prob lem is that of making available adequate clinical material for the teaching of resident staffs. The fact that no part of this nation or its possessions is now farther away from any other part than two days by air suggests the possibility of transporting doctors still in training to areas where large quantities of clinical material are available and at pres ent inadequately cared for. The work of men still in their residencies must, of course, be
1805
supervised by qualified specialists, but this problem, though difficult of solution, need not prove insurmountable. Last year Duke University and the Alaska Department of Health collaborated in a note worthy educational experiment in ophthal mology and otolaryngology which may ulti mately be extended to other specialties. After completing the first year of the com bined residency in ophthalmology and oto laryngology offered at Duke, one of the young residents, Dr. A. W. Vogel, went to Alaska for a six-month period (July 1, 1949, to January 1, 1950) which he spent in the Territory as a clinical ophthalmologist and otolaryngologist under the supervision of a consultant certified in both specialties. The young doctor's first tour of duty was one month at the Mt. Edgecumbe Medical Center at Sitka where wards of the Alaska Department of Health and the Alaska Na tive Service come for certain types of special medical care and for certain educational needs that cannot be met in the smaller com munities. Here Dr. Vogel, in addition to learning how to carry on his work without the benefit of the equipment available in a large university medical school, was able to participate in a research project on phlyctenulosis which was being conducted under the auspices of the United States Public Health Service. During the remaining five months, Dr. Vogel worked in 10 widely separated com munities throughout the Territory, travelling as far north as Point Barrow, as far west as Nome, and as far south and east as Sitka. He encountered the same types of pathologic conditions which occur in the States but their relative frequency varied interestingly, the high incidence of phlyctenulosis being an outstanding variation. In his report he ex pressed great satisfaction with his service and with the challenge to his ingenuity. The success of this first experiment in widening the scope of a university medical center geographically much farther than is
1806
CORRESPONDENCE
ordinarily considered feasible, suggests one way of reaching larger segments of the population with more and better medical care. W h a t has been done in ophthalmology and otolaryngology could be done in other specialties as well. The problem of supervi sion is a difficult one but, so far as Alaska is concerned, qualified supervision is at pres ent available in general medicine, phthisiology, orthopedic surgery, and thoracic sur gery, as well as in ophthalmology and oto laryngology, and, as time goes on, there will no doubt be an increase in the number of trained supervisors in the Territory. The Alaska Department of Health, which is under the direction of Dr. C. E . Albrecht, has recently published a brochure describing the residency project, and has offered affilia tions in ophthalmology, otolaryngology, or preferably both, to all universities wishing to participate in it. Each affiliation carries a stipend of $200 a month in addition to room, board, laundry, and first-class air transporta tion to and from and within Alaska. It is my opinion, and I have observed at first hand the first phase of this residency plan in operation, that the program offers a most unusual opportunity to a young resi dent, with a spark of adventure in him, to broaden his own experience by living and working in this land of incomparable beauty, and to contribute to the health and welfare of the native people of our last frontier. It should take its place with the Heed fellow ships as one of the major extracurricular educational opportunities available to young American ophthalmologists in training. Phillips Thygeson.
CORRESPONDENCE ASTEROID
HYALITIS
Editor, American Journal of Ophthalmology: I have had the impression for several years that asteroid hyalitis occurs much
more frequently in the left eye, although I have never seen anything in the literature to bear out my impression. Checking over our records, I find that we have had 20 patients showing asteroid hyali tis in a period of 11 years, divided as to eye, sex, and so forth, as follows: EYE
O.D O.S O.U
4 IS 1
20% 75% 5%
20
100%
Male Female
9 11
45% 55%
Total
20
100%
13 6 1
65% 30% 5%
20
100%
Total SEX
VISION
20/20 or better 20/30 to 20/40, inc 5/200 Total AGE
Youngest Oldest Average
45 83 63 RACE
White Colored
19 1
95% 5%
Total
20
100%
O u r experience may have been excep tional and for that reason I should like to know the experience of those with a much larger number of cases. ( S i g n e d ) Charles A. Young, ST., Roanoke, Virginia. PHYSIOLOGIC
GLUE
Editor, American Journal of Ophthalmology: In the June, 1950, issue of the JOURNAL. two papers were published on the use of thrombin plus plasma in ocular surgery. I have been working on this problem since 1947 and published a paper in the Klinische Monatsbldtter f. Augenheilkunde (115:4, 1949). I am very glad to be able to corrob orate the findings of the JOURNAL authors.
W E S T W A R D HO The American public is faced with the problem of achieving a better distribution of medical care. An equally pressing prob lem is that of making available adequate clinical material for the teaching of resident staffs. The fact that no part of this nation or its possessions is now farther away from any other part than two days by air suggests the possibility of transporting doctors still in training to areas where large quantities of clinical material are available and at pres ent inadequately cared for. The work of men still in their residencies must, of course, be
1805
supervised by qualified specialists, but this problem, though difficult of solution, need not prove insurmountable. Last year Duke University and the Alaska Department of Health collaborated in a note worthy educational experiment in ophthal mology and otolaryngology which may ulti mately be extended to other specialties. After completing the first year of the com bined residency in ophthalmology and oto laryngology offered at Duke, one of the young residents, Dr. A. W. Vogel, went to Alaska for a six-month period (July 1, 1949, to January 1, 1950) which he spent in the Territory as a clinical ophthalmologist and otolaryngologist under the supervision of a consultant certified in both specialties. The young doctor's first tour of duty was one month at the Mt. Edgecumbe Medical Center at Sitka where wards of the Alaska Department of Health and the Alaska Na tive Service come for certain types of special medical care and for certain educational needs that cannot be met in the smaller com munities. Here Dr. Vogel, in addition to learning how to carry on his work without the benefit of the equipment available in a large university medical school, was able to participate in a research project on phlyctenulosis which was being conducted under the auspices of the United States Public Health Service. During the remaining five months, Dr. Vogel worked in 10 widely separated com munities throughout the Territory, travelling as far north as Point Barrow, as far west as Nome, and as far south and east as Sitka. He encountered the same types of pathologic conditions which occur in the States but their relative frequency varied interestingly, the high incidence of phlyctenulosis being an outstanding variation. In his report he ex pressed great satisfaction with his service and with the challenge to his ingenuity. The success of this first experiment in widening the scope of a university medical center geographically much farther than is
1806
CORRESPONDENCE
ordinarily considered feasible, suggests one way of reaching larger segments of the population with more and better medical care. W h a t has been done in ophthalmology and otolaryngology could be done in other specialties as well. The problem of supervi sion is a difficult one but, so far as Alaska is concerned, qualified supervision is at pres ent available in general medicine, phthisiology, orthopedic surgery, and thoracic sur gery, as well as in ophthalmology and oto laryngology, and, as time goes on, there will no doubt be an increase in the number of trained supervisors in the Territory. The Alaska Department of Health, which is under the direction of Dr. C. E . Albrecht, has recently published a brochure describing the residency project, and has offered affilia tions in ophthalmology, otolaryngology, or preferably both, to all universities wishing to participate in it. Each affiliation carries a stipend of $200 a month in addition to room, board, laundry, and first-class air transporta tion to and from and within Alaska. It is my opinion, and I have observed at first hand the first phase of this residency plan in operation, that the program offers a most unusual opportunity to a young resi dent, with a spark of adventure in him, to broaden his own experience by living and working in this land of incomparable beauty, and to contribute to the health and welfare of the native people of our last frontier. It should take its place with the Heed fellow ships as one of the major extracurricular educational opportunities available to young American ophthalmologists in training. Phillips Thygeson.
CORRESPONDENCE ASTEROID
HYALITIS
Editor, American Journal of Ophthalmology: I have had the impression for several years that asteroid hyalitis occurs much
more frequently in the left eye, although I have never seen anything in the literature to bear out my impression. Checking over our records, I find that we have had 20 patients showing asteroid hyali tis in a period of 11 years, divided as to eye, sex, and so forth, as follows: EYE
O.D O.S O.U
4 IS 1
20% 75% 5%
20
100%
Male Female
9 11
45% 55%
Total
20
100%
13 6 1
65% 30% 5%
20
100%
Total SEX
VISION
20/20 or better 20/30 to 20/40, inc 5/200 Total AGE
Youngest Oldest Average
45 83 63 RACE
White Colored
19 1
95% 5%
Total
20
100%
O u r experience may have been excep tional and for that reason I should like to know the experience of those with a much larger number of cases. ( S i g n e d ) Charles A. Young, ST., Roanoke, Virginia. PHYSIOLOGIC
GLUE
Editor, American Journal of Ophthalmology: In the June, 1950, issue of the JOURNAL. two papers were published on the use of thrombin plus plasma in ocular surgery. I have been working on this problem since 1947 and published a paper in the Klinische Monatsbldtter f. Augenheilkunde (115:4, 1949). I am very glad to be able to corrob orate the findings of the JOURNAL authors.