OCT 1951

SI SPECULUM PLACET, INSPICE SPECULUM THE JOURNAL OF THE Melbourne Medical Student's Society

"Speculum" is published for private circulation among members of the M.S.S. Copies are not supplied to non-members of the Society.

EDITORS M. D. GROUNDS K. A. GRABAU G. McKENZIE

Business Manager E. SINCLAIR

CONTENTS

Pad EDITORIAL 7 PROFESSOR MacCALLUM 8 PROFESSOR E. J. KING 9

PROFESSOR S. L. TOWNSEND 10

Dr. J. A. LARWILL 10

LYSENKO — RIGHT OR WRONG . W. SCHNUR AND C. PRINGLE 12

NEW DEAL FOR JUNIOR R.M.O.'s P. W. GRAHAM 25

PANDEMIC PROF. S. D. RUBBO 30

A CHRISTIAN MEDICAL SCHOOL IN INDIA PROF. E. W. GAULT 33

TWO NEW RELIGIONS 38

MEDICAL SERVICE IN NEW GUINEA 40

CHILD WELFARE IN NEW GUINEA—Some Comments C. W. BAIRD, B.Sc. 41

THE WOMEN'S HOSPITAL 43

PSYCHOLOGY AND SICKNESS F. E. EMERY, M.A. 47

CHINESE SPIRITUALIST MEDICINE TUNG SLEW YOON 51

RESEARCH NOTES 53

BOOK REVIEWS 57

M.S.S. NOTES 59

YEAR NOTES 60

SPORTS NOTES

SPICULA 7 1 SPECULUM 7

EDITORIAL

Speculum is an unusual magazine. There The present editors do not want to write are few other medical magazines which learned articles,* and the contributions to exclude articles on the anabolic effects of other magazines show that very few testosterone on the premature baby. There undergraduates do. are few whose back pages are so popular. Others criticise the political nature of our We have heard criticisms of both these articles. We questioned a group of friends characteristcs of the magazine. Criticism on this matter, and they were unanimous of Spicula we refer to 1950's M.U.M., which in saying that Politics should be out. But neatly summarises the Spicula Controvery none of them classed one article in the past of 1949, and to the Speculum of November, three issues as political. They considered 1 949, where the matter is ably debated. that "political" articles relating to the struc- Criticism of the nature of our articles is ture of medical practice should be included, less easy to answer. Previous editorials have and we could not agree more. Yet we have justified Speculum's policy, but as long as been told that if we want it non-academic we Criticisms continue the editors must answer should nevertheless exclude all political them. articles. We admit that in politics the Some of our critics call for a more magazine has shown bias, but if no stalwart academic magazine. The more academic conservative will produce an article in student magazines with which we exchange defence of the status quo while radicals have, and must have, advisory councils of attack it, we must continue to show bias. graduates. (Montreal, for instance, has a Gentlemen wishing to demonstrate the Council of 16 graduates, the least of whom benevolence or wickedness of Generalissimo is a B.A., M.D.) An academic Speculum Stalin may go elsewhere, but those with would serve little purpose. It is not the views worth reading on the politics of function of the Medical Students' Society to medicine will always be found space. teach itself. The acquisition of medical We welcome criticism, but we will con- knowledge is a matter between the faculty tinue to publish a magazine which, while and individual students, not the society. medical above all, is readable, political, and Resides, any contribution Speculum could unsuitable for mixed company—designed make to our knowledge would be insignifi- for the members of the society, neither pruned for prudes nor written for cant alongside the faculty's contribution. exhibitioners. Speculum would merely provide some of us with practice at writing academic articles. * Nor could they. SPECULUM

PRESENTATION: Professor MacCallum

At the annual general meeting of the for him. In consequence, we have procured M.S.S. in first term the society presented an instrument which we hope will appeal the retiring professor of Pathology, Peter to his tastes, scientific and aesthetic. MacCallum, M.C., MA., N.z., M.Sc., N.z. It is my privilege, Sir, to present to you & MELB., M.B., Ch.B., D.P.H., EDIN., this watch on behalf of the Medical Students F.R.S.E., with a gold evening watch. In of the Melbourne University. You will making the presentation the secretary (Mr. find it engraved: G. Crock) gave the following address: Professor Peter MacCallum. From the Medical Students' Society, Mr. Chairman, Professors, Ladies and Melbourne. 1951 Gentlemen— This is our token of esteem for you per- Today, we have come to one of the sonally and for your able work as a medical milestones in the history of this Medical educator in the University of Melbourne. School and of this Society. Today, Professor Peter MacCallum formally retires as Presi- The professor's appreciation of that great dent of this Society — as he has recently concept, Time, his use of which has made retired from the Chair of Pathology. him legendary among students, has guided I have not come as an enconiast to the executive in its choice of a presentation embarrass our president with well chosen In thanking the society, Professor phrases of praise — but I do feel that this MacCallum said that the presentation had occasion demands from me a brief outline taken him by surprise. He thanked the of the Professor's career. secretary for his remarks, and dealt with his Peter MacCallum graduated from the own history. University of New Zealand in 1908 as M.Sc., Having been in the Melbourne Medical M.A., and in 1909 he proceeded to Edin- School for 26 years, he identified himself burgh, having been Canterbury College with Melbourne before his other two univer- candidate for the Rhodes Scholarship. sities. He thought of himself as part of this He distinguished himself as a scholar school. and built up a reputation of nimble-footed- The . Medical profession in Australia ness by gaining blues for Rugby and attracted a better type of student than in Athletics. England, he had found. There, Law, Arts, He graduated in Medicine in 1914 with the Church, and the Services were held in first-class Honours and in the following year higher esteem than Medicine, so that the proceeded to the Great War. During that cream of the student body was to be found campaign he was awarded the Military in other faculties. An Englishman who was Cross. associated with overseas students had told He came to Melbourne as Professor of him that Australian doctors chosen to go Pathology in 1924. As a professor in the overseas were "world-beaters," as their Melbourne University he has held the records showed. highest positions—five times president of the With the appointment of Professor King M.S.S.!!—Dean of the Medical Faculty, and to the chair of Pathology, all the professors Acting Vice-Chancellor of the University. and Stewart lecturers would be graduates We have had, then, a man of many parts of Australian universities. Whether or not guiding this - medical school for the past this was in all ways desirable, it was quarter of a century. healthy sign that Australian universities SPECULUM 9

Were making their mark, since it was purely boundaries, to enter more into the life of by the chance that the best men available the community. Thus the Medical School Were Australian graduates. He had the should extend more into the hospitals of utmost confidence in the staff. the city. The future of this University, as of others, The professor then modestly thanked us lay not so much in expansion within its for our gift, which, he was sure, he would own grounds, but in extension of its present find of great use.

APPOINTMENT : Professor E. S. J. King

The Council at its August meeting lieutenant-colonel in command of an Aus- appointed to the Chair of Pathology, soon tralian General Hospital. He was appointed to be rendered vacant by Professor to his present post of Pathologist at the MacCallum's retirement, Dr. E. S. J. King, Royal Melbourne Hospital early in 1947. Pathologist at the Royal Melbourne Hospital. Professor King combines in an unusual Edgar Samuel John King was born in New degree first-rate ability as an operative Zealand in 1900 and educated subsequently surgeon, morbid anatomist and clinical at Melbourne High School. He matriculated pathologist, and his record since graduation in 1917 and graduated M.B., B.Sc., in 1923, has been one of sustained , brilliance. He M.D. in 1926, M.S. in 1930, and D.Sc. in has the great distinction of having been 193 3. He was appointed Stewart Lecturer in awarded, on three separate occasions, the Pathology in 1928, and Stewart Scholar in Jacksonian Prize of the Royal College of Surgery in 1935; for varying periods during Surgeons, the Alvarenga Prize of the College Professor MacCallum"s absence he has been of Physicians of Philadelphia, and the Syme appointed Acting Professor of Pathology. Prize, the latter in 1931. He is the author His clinical teaching experience in Pathology of two books on subjects as diverse as bone and Surgery has been almost continuous diseases and surgery of the heart, as well as some seventy scientific papers. since the date of his graduation, and he has There is little doubt that the University held clinical appointments at the Alfred, has secured in Professor King a successor Royal Melbourne and Children's Hospitals. worthy, by his unique personal qualities as In 1939, Dr. King enlisted in the by his great prestige in medical science, of A•A.M.C. and served in the Middle East, the tradition already set for the Melbourne Australia and New Guinea until late in 1946, Chair of Pathology by the late Sir Harry by which time he had risen in rank to Allen and Professor Peter MacCallum. SPECULUM

APPOINTMENT: Professor S. L. Townsend

The Council has appointed to the Chair He served afloat during the evacuation of Obstetrics and Gynaecology Dr. Sidney from Dunkirk, and in the Mediterranean as Lance Townsend, M.B., B.S., F.R.C.S. (E.) , senior medical officer at Port Said. In 1943 F.R.A.C.S., M.R.C.O.G., D.T.M. & H. he was promoted surgeon lieutenant- (Lond.). This Chair has been vacant since commander and in June was transferred to the death of Professor Marshall Allan in the Far Eastern Fleet, with headquarters, as 1946, and has been administered first by senior medical officer, at Colombo. Dr. Dr. W. Ivon Hayes, and since 1948, by Dr. Townsend returned to the United Kingdom J. W. Johnstone, in an acting capacity. and was demobilised in August, 1946, with Dr. Townsend completed the medical the rank of surgeon-commander. After a course in March, 1936. He went to London further year as first assistant at his old in 1938 and studied at the British Post- teaching hospital, tthe West Middlesex, he Graduate School, being admitted to Mem- returned to Australia at the end of 1947. bership of the Royal College of Obstetricians He commenced private practice as con- and Gynaecologists, and to the Diploma of sultant in Obstetrics and Gynaecology and Tropical Medicine and Hygiene in June, 1939. He was appointed a Registrar in the was appointed Demonstrator in Anatomy in Obstetrical and Gynaecological Unit of the this University in April, 1948. Dr. Towns- West Middlesex Hospital, University of end is a member of the honorary staff of London, and held the appointment for a the Women's Hospital and the Austin year until his enlistment as surgeon-lieu- Hospital. The new Professor of Obstetrics tenant in the Royal Navy. and Gynaecology is 38 years old.

OBITUARY: Dr. J. A. Larwill

The sudden death of Dr. James Alfred death came unexpectedly to many and to the Larwill on April 5 came as a great shock deep regret of all. to a wide circle of friends and associates. Educated at Brisbane Grammar School, Though he had suffered a severe cardiac Fred Larwill did not commence his medical illness in 1944 which permanently damaged course until after the First World War, when his heart, few knew it and from his cheerful he entered the Melbourne Medical School bearing none could have guessed it. His as a young ex-serviceman who had served • SPECULUM 11

overseas as a pilot with the Australian were delighted to welcome him as a full-time Flying Corps, with the rank of Lieutenant, colleague. He entered on his new duties in the Second Flying Squadron. In 1925 with rare enthusiasm and took a lively he graduated M.B., B.S., with Honours in interest in all departmental activities. He all final subjects (Medicine, Surgery and was a clear and attractive lecturer with a Obstetrics and Gynaecology), and a high personality that awakened not only interest place on the final list ensured his appoint- and respect but also affection. There is ment to the resident medical staff of the abundant testimony that his reputation stood Melbourne Hospital, where he remained for high with his students. 12 months. Following this appointment he But Dr. Larwill was more than a good entered private practice in Moreland. He instructor. He was the ideal colleague, and rapidly established himself in the community those of us who knew him well will always not only as a sound and skilful practitioner think of him as a loyal and lovable friend. but also as a wise and understanding confi- He came to the Department at a critical dant. This period of his career was passed period when attempts were being made to with conspicuous success. Despite the rebuild the staff which the war years had exacting demands of a large and busy eroded away. None could resist his sincerity, practice, Larwill managed to find time to essential friendliness and desire to help, and Maintain a close association with the medical these qualities did much to make new mem- school and his old hospital. In the former bers feel at home and to create the happy he served for many years as a part-time atmosphere which prevails in the Depart- demonstrator in Histology, and on one ment. Years in general practice had given Occasion as acting lecturer, and in the latter him a wide and deep knowledge of men as an honorary clinical assistant. He was and human affairs and he was quick to sense interested in all outdoor sports, particularly the difficulties and problems of others. We bowls and football, being for several years can only speak in the most grateful terms honorary medical officer to the Melbourne of the valuable assistance that he rendered Football Club. the Department in a variety of ways, and Driven by a strong sense of duty and of the unsparing help and encouragement responsibility to his patients, pressure of that he gave others at every opportunity, Work, particularly over the war years, took more especially the younger generation for heavy toll of his health, and in 1944 he whom he had a fond attachment. We deeply suffered the severe illness which terminated regret that he was not permitted to remain his career as a general practitioner. At longer with us as a colleague and a friend. this time there was a vacancy on the staff He is survived by his widow, two sons and of the Anatomy Department for a senior a daughter, to whom we extend our sincere lecturer in Histology and Embryology. Dr. sympathy. Larwill's long association with the Depart- —S.S. ment as a part-time officer responsible for instruction in these subjects, together with • • his numerous other qualities, made him the obvious person to fill the vacancy if his health would permit him to accept the post. We are grateful to the editor of the Fortunately this became possible. Though University Gazette Pr allowing us to reprint he was no stranger to the Department we these three items. 12 SPECULUM LYSENKO Right or Wrong

The study of heredity is of obvious relevance to Medicine, and we learn in First Year a system of laws based on the observations of Mendel (the nature of heredity) and Morgan (the mechanism). However, these laws have been loudly denied in post-revolutionary Russia, by Michurin and his follower Lysenko. In these articles the pros and cons of the controversy are discussed by Walter Schnur, B.A. (Zool.), Texas, Second Year, and Clive Pringle, B .Sc., Melb., of Fourth Year.

I: RIGHT by CLIVE PRINGLE

"It is possible, with man's intervention, to force any form of animal or plant to change more quickly in a direction desirable to man. There opens before man a broad field of activity of greatest value to him." I. V. Michurin.

The major problem with which this article for Russian agriculture. In 1898 the United deals is whether one can induce those States Department of Agriculture, hearing of hereditary changes we desire in organisms. Michurin's work, sent Professor Meyer to The question is important not only to agri- visit Michurin with an offer to purchase his culturists and geneticists, but to us as medical nursery and an invitation to work in Amer- students and future doctors, for we shall ica, such was the high regard with which be faced with the problem of hereditary Michurin's work was then held. Michurin diseases. And if, as many now suspect, the refused this offer. Following the path indi- heredity of organisms can be altered in a cated by Michurin, Lysenko and many other Neo Lamaarkian fashion, then clearly we Soviet scientists have increased our know- must completely revise our attitude towards ledge on the directive role of the environ- such diseases. ment in changing the heredity. In the following article experimental data concerning micro organisms, plants and Wheat animals will be reviewed to show that, under In recent years the experiments under- the influence of the environment, the here- taken in the Soviet Union demonstrating dity of an organism can be changed in a the conversion of winter varieties of wheat predictable fashion. to spring varieties have received considerable discussion and publicity. This work repre- SOVIET EXPERIMENTS sents an extension of Lysenko's earlier contributions on vernalisation — a pre- Within Russia, evidence pointing to the treatment enabling winter wheat to be grown possibility of the inheritance of acquired as spring wheat, but not inducing an hered- characters, and of directing the heredity of itary change. That this conversion was organisms in a desired fashion, has been effected by a modification of the vernalisa - accumulating for almost 70 years. Thus tion technique must be emphasised, other- Michurin ( 1855-1936 ) , a plant breeder, wise certain statements, critical of these produced 350 new varieties of plants useful experiments, can be misleading. Thus SPECULUM 13

Darlington (1947) writes: "He can ver- These experiments were designed to meet nalise his wheat once, and all succeeding all the criticisms levelled against similar generations will be born vernalised". Such a experiments of Magnus, 1907. claim has never been made by Lysenko; Firstly, when female rabbits had been actually the complete conversion only spayed in connection with other work they occurred following the repetition of the had never observed any evidence of regen- process over several generations. eration of ovarian tissue — they remained .Discounting the distortions, the major sterile with no sign of ovarian activity. criticism against this work was that Lysenko Secondly, the mesovarium of the rabbit had used grain initially heterogeneous in its was sufficiently distinct to enable them to resistance to the treatment, i.e., that Spring completely remove an ovary. wheat existed as an impurity in the winter Thirdly, when a 1/4 - 1/2 of the original wheat; thus his pre-treatment was purely a mass of ovarian tissue was deliberately left, screening process which the resistant grain atrophy rather than regeneration of an ovary survived. In answer to this Simanskii from the remaining tissue occurred. (1940) and Kononenko (1942) claimed Fourthly, purity of the material, so far that all or most of their grain survived the as colour was concerned, was controlled by treatment. However, the crucial experiments using albino rabbits. Of Stoletov (1948) answer these criticisms. Hence the most sensible conclusion is that Firstly, he demonstrated the conversion of the ovary of the albino has undergone a winter wheat to spring wheat with single change in its heredity as a result of the grains, thus answering the objection of selec- influence of the body of the black recipient. tion of pre-adapted wheat. Secondly, the new spring wheats differed in several Physiological characters from the normal Vegetative Hybridisation spring wheat, and only became typical spring The final series of Russian experiments to wheat after sowing for several generations be quoted are those on vegetative or graft as spring wheat. Thirdly, the occasional late hybridisation. This technique was originally ears produced by spring-sown winter wheat used by Michurin when he desired to obtain do not give rise to spring wheat, which fertile hybrids from a sexual crossing which, answered the suggestion by Ashby that if done directly, would yield sterile hybrids. Partial vernalisation of the seed occurred Thus he grafted, for example, slips of moun- On the plant (Huxley, 2). tain ash (scion) on the to the pear (stock) and found that on subsequent pollination effected between the stock and scion fertile Rabbits hybrids were obtained. What was more Working with rabbits, Barasnikov, Zaks important, however, was the observation that and Pavlov (1950) have shown that if an changes induced in the scion under the ovary is transferred from one rabbit to a influence of the stock could be transmitted previously spayed female, then the progeny in subsequent sexual hybridisation. Isayev of the latter displayed unmistakeable evi- (1948) related that the fruit of the apple- dence of an effect of the recipient's body pear vegetative hybrid acquired a particular on the heredity of the transplanted ovary. character—pear-shaped apples—as a result In their experiment they transferred the of grafting. When these apples were crossed ovaries of an albino rabbit to a spayed with other varieties of apples, this character black female which, when subsequently appeared among the progeny. In these Mated with an albino buck, gave the follow- crosses the apple-pear hybrid was chosen as ing results: the paternal partner so as to obviate the 1st litter-1 albino, 1 black. slight differences known to arise between the 2nd litter-1 albino, 1 black. progeny of reciprocal crosses. (Two indi- 3rd litter-0 albino, 3 black. viduals each homozygomus with respect to 4th litter-0 albino, 3 black. character A and B can be crossed in two 14 SPECULUM ways. A female-B male and A male-B through the use of different varieties by female. Some small differences attributable workers outside the Soviet Union. Thirdly, to material inheritance are seen between the the experiments undertaken to test Lysenko's progeny of the two crosses). claims have a very recent history. Possibly Hence a hereditary change had been our friends who portray Soviet geneticists as induced in the scion (apple) under the incompetent would do better to practise a influence of the stock, there being no sexual little humility by admitting that they them- crossing as cross pollination had been selves have yet to gain competence in the prevented. use of these techniques. These experiments have been criticised In concluding this section on Soviet evi- from various angles: dence, it is interesting to note that the 1—genetic purity of the components; problem of vegetative hybridisation is still 2—the possibility of grafting chimeras confusing non-Soviet geneticists so much which result from the growth of the cells that, while denying any modification of of one into the other; heredity, they admit there are instances of 3—non-statistical treatment of data and such changes; thus Huxley (2) produces failure to set up controls; evidence from beans. 4—the inability of the other workers to get similar results. NON-SOVIET EXPERIMENTS These criticisms are extremely patronising and serve to cast doubts on the competence In this next section, instances of inheri- of Soviet geneticists and Soviet science in tance of acquired characteristics will be general, for Soviet biologists, specialising in reviewed in the works of non-Soviet scien- genetics, received experience in their courses tists. These examples are taken from the of other biological subjects where scientific genetics of skin and bacterial adaptation to procedure and methods are taught. The new substrates and drugs; in addition, a set suggestion that they fail to use variation of observations on Paramoecia, which indi- statistics is likewise false. Noudjin pointed cate the occurrence of hereditary differences out that Gluschenko's monograph on vege- not attributable to differences in genes or tative hybridisation, published in 1948, plasmagenes, will be presented. contains all the necessary evidence to show that even prior to the erudite criticism of Skin Huxley, Hudson, Richens, and their ilk, The epidermal cells of the skin are Soviet geneticists used variation statistics. generally believed to be of unitary origin, As for Soviet scientists not having heard i.e., they are all derived from the basal about control experiments, I leave that to germinative layer, the Malpighian layer. This the reader's intelligence. is incorrect. The cells of the epidermis of That other plant workers are unable to man, the guinea pig, and the pig, consist of repeat these experiments on vegetative cells of two distinct genera, the Malphigian hybridisation is not damning. Firstly, the system and the Epidermal Glial System Soviet geneticists have done more in this (dendritic cells). This discovery was made field in the past 20 years than the rest of by Langerhans in 1868 and has been the world combined; if western geneticists frequently confirmed, e.g., Becker, 1927). deny vegetative hybridisation, then one would In pigmented skin, the dendritic cells are hardly expect their literature to abound the sole origin and seat of pigmentary with experiments designed- to achieve activity, as shown by Billingham, 1948, and this. Secondly, Michurin laid down certain Bilingham and Medawar, 1948. The den- principles about vegetative hybridisation, the dritic cells may be further classified accord - result of more than 50 years' experience; ing to the colour of the pigment which they he stressed that results were not always produce—black, brown, red, sepia, etc., or obtained easily, but persistence was required. no pigments at all. These differences are Almost certainly difficulties would arise hereditary ones, i.e., they are conserved

SPECULUM 15 indefinitely in future generations of the cell. normal medium, readily lose their What is of greatest interest about these adaptation; cells was the observation by Masson (1948), 2—A stage of difficult reversion, i.e., the of their property of inoculating melanin cells lose their adaptation only after granules into the cytoplasm of the Mal- repeated culture in their normal medium. Phigian cells with which their processes 3—A stage of relative stability, i.e., the make functional contact. Moreover, it was adaptation is retained when grown in normal also noted that when the processes of a pig- medium. mented dendritic cell made contact with a These facts can be explained by the non-pigmented dendritic cell the latter and mutation theory as follows: As the strain is its lineal descendants became permanently cultured repeatedly in the training medium, converted to pigmentary function. This is the variants best suited to grow under these a very clear and striking example of a conditions increase in number and propor- very specific change induced in the heredity tion, the less favoured ones being gradually of a cell by a change in its cytoplasm— eliminated. Reversion will be possible as the addition of a cytoplasmic enzyme system. long as any of the less favoured cells remain, and the ease of reversion will be Bacteria directly related to the number of less To explain the phenomenon of bacterial favoured cells in the population. when the adaptation two theories have been suggested: less favoured cells are completely eliminated, 1—Spontaneous mutations occur among reversion no longer occurs and the strain the cells of a particular strain, and as a is stably adapted. result of selection those mutants best suited However, Hinshelwood (1946), a physical to the environment survive, whereas the chemist and bacteriologist, says of this rest die. selection hypothesis: "With suitable auxiliary 2—That there is an actual directive assumptions, some form of selection hypo- influence of the environment itself on the thesis can be made to account for nearly constitution of the bacterial substance all the facts, but it is because these auxiliary formed. assumptions themselves appear to increase The observations on which the former in arbitrariness and complexity as one pro- theory is based were made by Massini ceeds, that one concludes by declining the (1907), with Bact. coli mutabile. He found main thesis as improbable". that when this strain was grown on glucose Hinshelwood considers the selection agar and transferred to lactose agar, a small hypothesis as improbable for these reasons: but constant fraction of the cells transferred 1—There are many instances of variant grew on the agar. It was inferred from this strains arising in cultures originating from that during its normal growth on glucose one cell. Thus modification of individual Bact. coli mutabile gave rise spontaneously cells must have occurred at some stage. to mutants, capable of utilising lactose. 2—Adaptation may result in the acquisi- However, Manini (1907) and Baerthlin tion of many new characters, which may (1912) reported instances in which rever- not only be held in different combinations, sion of lactose to non-lactose fermenters but may develop independently and at occurred on transfer back to glucose. Too different rates; thus Bact. lactis aerogenes great a stability, however, would be con- may be adapted to various combinations of ferred on the variants according to mutation sugars. On the selection hypothesis, this theory for this reversion to occur. requires an almost unlimited series of sub- In the adaptation of bacteria to a new strains, which must increase in number environment (new substrate or a particular and variety with each new adaptation experi- Concentration of drug), three stages are ment performed, so that one arrives at successively observed: something like a reductio ad absurdum. stage of easy reversion, i.e., the 3—With adaptation of bacteria to drugs, adapted cells, when transferred to their the degree of adaptation is exactly graded to 16 SPECULUM correspond with the concentration of the A, B, C, D, E and G. Thus the anti-serum drug used in training. Such a quantitatively derived from a rabbit previously injected adjusted response is best interpreted as a with A would paralyse A, but not the others. shift in enzyme balance of all cells, rather These differences in serotype were inherited than by selection of a few which happened through countless cell divisions in subse- to be formed with accidental immunity. quent asexual division. 4—Reversion of stably adapted strains, On examining the basis for the heredity ex hypothesi, now a pure strain, indicates of these serotype differences, two possibili- changes in individual cells. ties were examined: (1) Is it in the nucleus Concerning the mechanism of adaptation and genes, or (2) Is it in the cytoplasm? to drugs, Hinshelwood bases his theory on By allowing serotypes A and B to conjugate, the knowledge that drugs are known to act it was found that the mates were not sub- selectively by retarding certain stages of the sequently identical, although during conju- metabolic process. This retardation is over- gation the mates would acquire identical sets come by the expansion of the uninhibited of genes. One remained A, the other B. enzyme systems, which now produce greater These results were obtained when other concentrations of key intermediates whose serotypes of the same race were mated, utilisation has been restricted by the drugs. therefore all the serotypes had the same type This enables those cell processes inhibited of genes. Hence the basis of the heredity by the drug to fulfil their normal functions, of the serotypes did not rest on the genes. so that cell growth may proceed to the point By allowing extensive exchange of cyto- of cell division. At this stage the cells are plasm to occur during mating, it was adapted, but revert easily on transference to observed after separation that one serotype a drug-free medium. was changed to another; thus when an A The stabilising of the adaptation of cell to and B were mated in this fashion the B was the drug only occurs as a result of repeated transformed into an A. In these trans- training. The reason for this, according to formations a definite system of dominance Hinshelwood, appears to be due to the occurred. This experiment showed that the alteration of the enzyme balance of the cells. basis for serotype differences resided in the Thus the adaptation process described above cytoplasm. resulted in an expansion of the uninhibited In experiments designed to test the possi- enzyme systems, with no change of the bility of differences in serotype originating inhibited ones. Such a disturbance must from differences in plasmagenes, no evidence secondarily affect the supply and demand of such differences was obtained. Hence the of other cell functions. Only when the cells problem is: Among a race of paramecia have become adapted to these secondary there exist six stably inherited serotypes changes is the adaptation stable. It is these which do not differ as regards genes or latter which determine the length of training plasmagenes. Each serotype may be con- required for the cell to become stably verted to another serotype by the use of its adapted. specific anti-serum and subsequent growth under controlled conditions—the conditions Paramecium determining the direction of the change. Finally, we shall consider the experiments Transformation of one serotype to another described by Sonneborn (1948-49) with can also be effected merely by controlling Paramecium. Sonneborn has shown that the the temperature and food supply of the paramecia of a particular race can be classi- serotype. fied into several serotypes on the basis of their antigenic structure. Thus, with a parti- SUMMARY cular race, in number 51, he found that In the preceding pages material on there were six serotypes, each of which, on heredity from a variety of sources, and injection into a rabbit, gave rise to a specific dealing with all manner of organisms, has anti-serum. These serotypes he designated been presented. The instances have been SPECULUM 17 chosen because they raise problems which Finally, the experiments of Sonneborn can only be resolved by discarding present are most critical. Here we find that a race ideas of a hereditary substance which of paramecia can exist in several alternate Changes in a manner completely unrelated genetic forms, although no differences in to any change in the environment. Thus the genotype or plasmagenes can be detected the gene theory of heredity admits that these to account for this. genes undergo changes which, however, can All the evidence seems therefore to indi- Only be influenced in the sense that the cate the correctness of Lysenko's statement, Changes can be speeded up by certain treat- that "heredity is inherent; not only in the ments, but not altered in a directive fashion. chromosomes, but in any particle of the Where changes in heredity appear to be living body". obviously related to environment, factors, classical geneticists would say the direct REFERENCES relationship is only apparent; mutations 9ceur spontaneously, the environment factor Baerthlin, K. 1912. Central bl. f. Bakt. 66. lust speeds up the process, and one of these 21. happens fortuitously to produce properties Barasnikov, Zaks and Pavlov. 1950. Isvestia Which suit it for that environment. Hence, Akademii Nauk. S.S.S.R. No. 6. 85. according to the classical geneticists, the Becker, S. W. 1927. Arch. Derm. Syph. environment acts like a sieve. N.Y. 16. • 259. The contrary view expressed by Lysenko Billingham, R. E. 1948. J. Anatomy. 82. 93. is that the environment plays an active Billingham, R. E., and Medawar, P. B. directive role in changing heredity. If the 1948. J. Heredity. 2. 29. reader carefully examines each of the cases Darlington, C. D. 1947. The Nineteenth Mentioned, he will see that this idea is borne out. Century and After. Hinshelwood, C. N. Chemical Kinetics of In the rabbit experiments, the albino the Bacterial Cell. Cambridge, 1946. 9varies have undergone a hereditary change in a particular environment - the body of Hudson, P. S., and Richens, R. H. The the spayed black female rabbit to which New Genetics in the Soviet Union. hey were transferred. The sex cells of the Cambridge. 1946. "thine, ovaries do not undergo mutations Huxley, J. Soviet Genetics and World In albino females suddenly, and for no Science. Chatto & Windus. 1949. a PParent reason, and give rise to coloured 1-P. 73; 2-P. 80. litters. This is well known. The change Isayev, S. I. The Situation in Biological Which they have undergone in the body of Science. Foreign Languages Publishing the black female is the result of a direct House. Moscow. 1949. effect of this new environment on them. Kononenko, M. V. 1942. Proceedings Lenin With the development of resistance to Academy Agricultural S c i en c e, rigs by bacteria, we have seen how neatly U.S.S.R. No. 1-2. 40-44. 1 e adaptation is adjusted to the concentra- Langerhans, P. 1868. Virchow Archiv. 44. ti on of the drug in the training media. 325. Ascribe the adaptive change to spontaneous Massini, R. 1907. Archiv. f. Hyg. 61. 250. mutation if you will, but then you must Masson, P. 1948. Sp. Pub. N.Y. Acad. Sc. e?( Plain the phenomenon of induced rever- 4. 15. of stably adapted strains, e.g., Bact. act's Aerogenes loses its resistance to Simanskii, N. K. 1940. Jarovizacija. No. 4 Proflavine if treated with small quantities of (31) 25-29. - Phenols. These phenols themselves are not Sonneborn, T. M. 1948-49. Harvey Lec- lliutagenic agents, an assumption which must tures. P.145. i e Made if you ascribe drug resistance to Stolotov, V. N. 1948. Trud. Inst. Genetiki. mutations. No. 16. 38. 18 SPECULUM

II: WRONG by WALTER SCHNUR

An introduction to this article is made In wishing to get rid of unwelcome necessary by the nature of a "controversy" observed facts, Lysenko and Co. merely emanating from eastern Europe. The con- declare such facts to be "inadmissible". In troversy, as you will judge, is in fact ficti- wishing to get rid of unwelcome ideas or tious, but is such as to appear to place the even scientists, certain "heretical" labels are science of genetics, as understood by gene- attached, including: heretical (the most ticists and biologists, on the defensive. The damning label), metaphysics, vulgar mater- group attacking this science attacks it on ialism, capitalism, idealism (including alogical grounds, demanding, not proof, but deism), fascism, abioligism, Weismannism adherence to authority, and to a philosophy and "Mendel-Morganism", formalism, and known as "dialectical materialism". The the transferring of conclusions from one level very nature of the dialectics used to to another (as the relating of genetical denounce genetics as understood here is findings to social science). Most damning alogical, since it is made to mean what the are multiple labels, e.g., heretical, Weisman' particular authority wants it to mean. Thus, nian—Mendel-Morganist idealism (That one is a beaut!). the attack appears to be political. It is not in an attack by free scientists. While the To "explain" the science of genetics attackers insist that Darwin is the authority 2000 or 10,000 words is as difficult a task — after Marx, Engels, Lenin and Stalin — as to explain the science of physics in so they choose to disregard those parts of their many words. Perhaps my best hope is to authority which do not conform to their give you an insight into the complexities pre-formed concepts and ideas. of the science and to explain why it is a, Whereas Darwin, a careful scientist, science. At any rate, in a campaign 01 insisted on controls, careful measurement, words and defamation I cannot compete and painstaking experiment, the followers of with my masters, I can only hope that the T. D. Lysenko in the U.S.S.R. claim that scientific brains in the U.S.S.R. will again controls are not needed, careful measure- be allowed to be used as such. Much ment unnecessary, and painstaking experi- damage has been done already. I hope tha t ments are superfluous. To us Darwinism you who read this will also use some scierr represents the idea of evolution, founded tific reasoning and resolve the controversy on observed facts. He postulated how for what it is. changes in evolution might have occurred, Since the start of the struggle not a single, but as he admitted, this was pure speculation geneticist of the free West has "gone over to Lysenko and his fellow Lamarkians. No t and untested. To Lysenko, who has t denounced intra-species competition for J. B. S. Haldane, a good geneticis even 111 and a good Communist, has done so. survival, i.e., survival of the fittest, which r, was Darwin's keystone in the means to the fact, the latest rumours have it that Professo Haldane is now only a good geneticist all°, evolutionary end, coupled with variation l within the species, only Darwin's unsup- is being added to the ranks of the heretica ported Lamarkian concepts were accepted by his former comrades. as "true" Darwinism. His main ideas, Lest the so-called "discussion" at th e intra-species competition in particular, are Lenin Academy of Agricultural Science in dismissed as not in keeping with "dialectical 1948 be presented as a true scientifi c materialism" or with the higher authorities. o confab at which the scientists of the Therefore, "Darwinism East" means one U.S.S.R. decided freely in favour of Lysenk thing; "Darwinism West" signifies another. quote in resolving the "controversy", let me SPECULUM 19 from Lysenko. This quotation in his "Con- sounds almost as bad as the four Marx [no cluding Remarks", as published in the relation] brothers). The greatest of scien- shows that the conference was tific virtues, complete objectivity, which has indeed a trap, since the scientfic points been acquired slowly through centuries of had been judged and "decided" by a non- human intellectual effort, is now to go by scientific governmental agency before the the board. conference was even convened. Lysenko The repudiation of statistical methods said, "Before I pass on to my concluding seems to arise from the complete inability remarks I consider it my duty to make the of Lysenko to grasp the statistical meaning following statement: of chance and probability. Thus, he is led The question is asked in one of the to the absurd conclusion that whereas notes handed to me, 'What is the attitude of chance and the laws of probability reign the Central Committee of the Party to my supreme in western genetics, they have been report?' I answer: The Central Committee eliminated from chemistry and physics, of the Party examined my report and which have thus, according to Lysenko, approved it". become exact sciences! One wonders how For the last of the geneticists still alive far modern atomic physics would get without the recantation queue started forming "at the assistance of the Theory of Probability the left". and other statistical concepts. Contrary to Lysenko's belief, modern chemistry and The features of the experiments under- physics have become exact sciences because taken by Lysenko may be outlined as physico-chemical laws are, in fact, statistical follows laws. (1) Inadequate controls were used and * * * very often none were used; Now, let my article lead where it may. (2) There is a repudiation of all statis- The followers of T. D. Lysenko refer to tical methods for establishing the significance genetics as a set of untested hypotheses of observations; or points of view. This is false and unfair. (3 ) There is a failure to use genetically Genetics is an organised and classified body t"omogeneous material — this of course of knowledge. It is a science. (nllows the rejection of modern genetics. This science consists firstly of a large One cannot emphasise too strongly that body of known facts or of factual data, any while Lysenko's results can be fitted into or all of which may be tested. Secondly, e framework of Western genetics — even from the data a number of laws have been if only by querying some of his crude tech- evolved to explain the data. Thirdly, genetics methods—the acceptance of Lysenko's consists of, what Huxley calls, a body of theories'lleories would leave unexplained an enor- "mathematical data derived from the appli- mous body of well-established, harmonious cation of mathematical reasoning to the and entirely objective data. facts and laws". Lastly, it consists of a Many experiments listed by the Lysenko "general theory, or over-all framework of !env have proved unrepeatable when concepts, which give the simplest general "` tempted. We are told our conditions are explanation of ALL the observed facts and not adequate. We never learn what condi- separate laws". ions are required. The factual data consists of many thou- b The repudiation of established fact as sands of experiments, recorded in journals "inadmissible", is explained by and monographs over the past 50 years, in aone of Lysenko's followers, who addition to facts of observation in many hhasthe recently said that one must not make fields which can be related to evolutionary 0 e error of being objective when interpreting genetics. Then, there are known cytological btle' results. The facts, he continued, must and biochemical facts concerning genes and ,i nterpreted_ in the light of the teachings chromosomes, which help establish the °f Marx,Marx, Engels, Lenin, and Stalin! (It physical basis of the science. These facts 20 SPECULUM and observations are subject to constant gested that the genes were strong in linear reduplication and review. order within the chromosome when it was observed that Mendel's Second Law did not Although one may argue about the - interpretation of the observations, the data, always hold. With extra tests this modifica subject to test and checking, is not false. tion was shown to hold, and has required For instance, Mendel's original experiments scant modification since it was brought forth. with sweet peas resulted in certain data. Now, Mendel's Second Law is modified to When he crossed known pure strains of include only genes on different chromo - yellow by green peas the initial offspring, somes. Cytological examination of chromo - the F 1 generation, were all yellow. Taking somes at meiosis and other observations was these yellow F 1 peas, and inbreeding them, in conformity with this modification. he obtained in the F2 generation an approxi- Thus did develop the chromosome theory mate ratio of yellow : green equal to 3 : 1. of heredity, combining the facts drawn from This identical experiment, repeated over a breeding experiments with those derived period of years by seven other geneticists from microscopic observation. "Chromo - also as a check, resulted in a ratio of 3.003 some maps" were developed showing the to 1, a remarkable concordance! The results theoretical position of the genes on the were tabulated in 205,147 F2 seeds counted, chromosome on the basis of the tendency for with 153,902 being yellow, and 51,245 the unit characters (genes) on the same green. chromosome to resist segregation. Then , From these results, Mendel's First Law, breeding predictions were stated on tthe basis the Law of Segregation, was evolved. This of those maps which on experimentation law means that, whatever factors in here- held true. ditary constitution are responsible for the After the rediscovery of the giant chromo - appearance of character that behave this somes (Balbiani discovered them in the late way, they must persist from generation to 19th century, but did not know what they generation without contaminating or diluting were) in the salivary glands of the dipteran each other, and must segregate or separate fly, Drosophila melanogaster, by Dr. T. S. from each other when the time comes for Painter, of the University of Texas, cyto - forming the sexual cells or gametes. logical evidence was again presented as proof , From this law with its facts we may of Morgan's theory. predict other happenings. For instance, if The theory of the "why" of the difference s a hybrid F1 is "backcrossed" to a pure was early set forth by De Vries in his theory recessive (green), the law indicates that we of mutation. That is, certain unexpected and would obtain in the F2 generation a ratio of infrequent changes occurred in the otherwis e 1 : 1 for green and yellow. Since in practice i.e., the highly stable gene which bred true, this does occur, the law appears to hold. changed gene was itself now stable. The ' direction of the change could not be pre' dicted. Work by Muller, again at the Univer - But, "laws" are not static. They are sity of Texas, in 1926 (for which work he, subject to change and modification as new received the Nobel Prize in Medicine and facts are uncovered. Thus, Mendel's Second Physiology in 1946, although not a physician Law, the Law of Independent Assortment, or physiologist) confirmed, elaborated and has had to be modified to conform to modified this theory. Mutations could nal observed facts of "linkage", that is, the be produced artificially. tendency for some characters to segregate All these theories, like any scientifi,e, together, rather than to separate. The idea theory, has positive predictive functions: 11 that the chromosomes, which had been e true, certain results should follow. Thes earlier observed and described, were the predictions can be tested. When fulfilled they "bearers" of the character or "genes" was provide further confirmation for the gener al framework of concepts which we call th suggested by Professor T. Morgan and his , workers at Columbia University They sug- theory. When they are not fulfilled exactlY

!lc!,

,H ■ SPECULUM 21 the theory has to be amplified or slightly is now trying to popularise this development modified. If we obtain results which are as he helped popularise hybrid corn.) incompatible with the theory. the theory On the basis of Muller's theories of trust be scrapped, and a new one substituted. induced mutation by X-ray, and now To date, the chromosome theory has stood extended to include many mutagenic agents, every test, and is being further reinforced work was instituted during the war in Peoria, and buttressed daily by many more new Illinois, at the Northern Regional Research facts. Laboratory by U.K. and U.S.A. workers to To outline every aspect of every predic- increase the production of penicillin, first tion of genetics would be futile and boring. developed by Fleming and Florey in There are many excellent references, a few England. This work, to produce Penicillium of which have been included at the end of notatum mutations with greatly increased this article. penicillin yields, was not successful. How- * ever, certain theoretical facts were discov- The followers of Lysenko have claimed ered, and helped confirm the work being that the science of genetics, as understood done at the California Institute of Tech- by every biologist outside the so-called nology by two workers, and also to support People's Democracies", has produced no work done on how eye color in D. melano- Practical results, that the geneticists are gaster develops. The information known racial bigots, obscurantists (whatever that was used to increase penicillin yields on the cans), imperialists, capitalist toadies, boot- order of thousands. The theories were that lickers of fascism and "fly-lovers". (In this any gene controls part of an enzyme system latter bit of name-calling they probably refer in biochemical synthesis, and hence acts as to the theoretical work done on D. melan- a limiting factor. Further, a gene operates, °gaster in the U.S.A. and the U.K., and on directly or indirectly, on a given substrate. O. virilis in Japan and elsewhere, and other Now, if in a genetic strain one gene limits Species.) Here, then, is some proof, if any the amount of substrate produced for the Were needed, of the value of the science. next gene to act on, adding additional sub- The outstanding example is in the devel- strate to bypass, as it were, the laggard, in 2Pment of hybrid corn in the U.S.A. by the form of soluble nutrients, which the 41111, Jones, East and others on the basis penicillium mold could absorb and the gene of neo-Mendelian, i.e., modified Mendelian, following the laggard could act on, the yield genetics. The work involves strict inbreeding would increase greatly. Of course, the and selection and then crossing of these biochemists were called in to unravel the inbred lines in particular ways to provide a mystery of the penicillin molecule, and how Maximum of "inbred vigor", this latter it theoretically was constructed by the mold. depending on a complex interaction of corn- Then the geneticists were able to go to work. Phrnentary genes. The pure inbred lines Here is an example of inter-relationship 430k and are miserable, but the hybrids are between different sciences. The reasoning 1 far superior in vigor, size, disease and may appear complex, but on the theoretical Climate resistance, so much so that the maize basis, and with some planning, the 1 crop in the U.S.A. is increased by 500 predictive results held. ["With such a science Million bushels yearly on far less acreage (i.e., genetics as understood in the free than before the introduction of this seed. In Western World), it is impossible to plan, to tact, 90 per cent. of commercial maize work towards a definite goal; it rules out F°w11. in the U.S.A. and Canada is from scientific prediction"—T. D. Lysenko, 1948, 11, Ybrid seed, developed from more than one Situation in Biological Science.] hundred thousand inbred strains (Recently, Let me digress yet another minute. There Henry Wallace's son announced the develop- has been a complete repudiation by the Tent of hybrid chickens, developed along Lysencoists (they call themselves Darwin- the same lines, which are meatier, consume ians and Lamarkians) of the idea that one less food, and develop earlier. Mr. Wallace of the basic functions of science is to gain 22 SPECULUM knowledge and understanding. The only No one who knows, least of all a gene- interest Lysenko and his followers have in ticist, says that a gene causes any gross the study of heredity is its possible practical character. The basic action of a gene may value. If modern genetics is unable to be minute, such as the inability to produce promise the moon, T. D. Lysenko will! One an enzyme which splits a ring in phenylala - should recall Faraday's well-known remark nine metabolism, which condition is a known when questioned about the practical value familial disease. Even then, the action of of his experiments on the electromagnetic the gene may be restricted to one step only effects of a current passing through a coil: in the synthesis of the specific enzyme. "What use is a baby?" A gene never acts in vacuo, it acts in all Faraday's baby developed into the electric environment and is acted on by its entire motor and the dynamo. Roentgen's baby environment. From this, asking whether provided the foundations for modern X-ray environment or heredity is more important, technology. In fact, almost every great is quite absurd. The environment, every advance in physical science had its origin phase of it, and the gene, i.e., the heredity, in so-called pure research. Sturtevant and are interdependent. Beadle at CalTech little dreamed that their Neurospora crassa, a mold, would contribute so much to medicine in the form of penicillin production. And, the terms "pure" and In blood • typing, discovered by the "applied" are misnomers in science. There Austrian physician, Landsteiner, the genetic is science with short-term results and science basis is used in medico-legal work to deter- with long-term results, all contributing to the mine disputed parentage. In 1940, working structural edifice of a knowledge of Nature. with Wiener, Landsteiner, this time in Porto In Denmark the entire dairy herd of well Rico, in the Caribbean region, discovered over a million is the end product of just a new blood factor in the rhesus monkey, five bulls, selected on a genetic basis and which he called the Rh factor. This factor bred on theoretical grounds. (Ain't science was found to be present in about 85 per wonderful—five bulls and a million cows! cent. of the American population. It also was But don't forget artificial insemination!) shown to have a genetic basis and is used In medicine, the genetic nature of certain in medico-legal work. Further, the Rh factor diseases allows the knowing physician to was shown to be the culprit in an infantile advise patients and to exercise prevention. condition called erythroblastosis foetalis In one case I came across in my studies, and in certain previously unexplained a woman developed a breast cancer which cases of blood transfusion incompatibility. was successfully removed. Her sister, an It was found, without exception, that where identical twin, but a "mirror image", due there was a case of erythroblastosis the possibly to separation of the zygote into two father was always Rh positive and the after orientation of the cells in the early mother Rh negative. The child also was stage, was advised to be on guard. Six always Rh positive, and often was not the months later, a cancer of the opposite breast first child. Now, the predictive functions was diagnosed and removed, also with come forward. We can determine when success. Don't jump to any conclusions. The there might occur cases of this disease. genetic basis of cancer is a long way from Wiener postulated a single gene at work, being proven, although on a statistical basis but it was soon shown that there were several there seems to be a familial tendency for Rh types. Wiener did not discard the findings, but modified his theory to include for some types of cancer. Certain cancers , are known to have a genetical basis, as the further facts. Meanwhile, in England retinitis pigmentosa, and some are infectious, Fisher and Race in trying to explain the as is a particular liver cancer in Egypt, different Rh types known postulated that traced to certain Nile River parasites. they were the end result of three closely * * * linked genes which these workers called C, SPECULUM 23

I), and E. On that basis, Drs. Fisher and distribution in inheritance depends on the Race predicted the future discovery of still behaviour of the chromosomes, which con- unknown Rh types, listing the ones still to tain the genes, which in their turn are the be found. By last year, every prediction material units of heredity. (The field of of Fisher and Race had come about, and study of just how the gene works is called the original ideas on the inheritance of the physiological genetics. There is a growing Rh factor as proposed by Lansteiner and mass of data associated with this field.) Wiener became history. (The predictions by (2) All changes in the hereditary con- fisher and Race remind me of the predic- stitution are mutations — i.e., changes of tions of Mendeleef and his periodic table.) definite extent; these changes are usually Although the genetic basis of blood typing within individual genes, but .sometimes is well understood in reference to disputed involve the addition or subtraction of whole Parentage, unfortunately justice is sometimes genes or of strings of genes up to chromo- blind due to the inability of many laymen somes and entire chromosome sets. (This is to understand the basis of these tests. The especially true in plants.) Thus all mendel- tests are sure only in so far as they can izing differences between individuals owe say that a person is not a parent or that the their origin to past mutation. person may be, but is not necessarily, a (3) Evolutionary change, large or small, Parent of the disputed child. is almost entirely due to differential survival of mutant genes and their combinations, harmful ones being eliminated and useful On the basis of the theory of mutation ones being favored and eventually becoming as known today, we can understand normal for the stock, through automatic Darwin's ideas on evolution. Darwin's operation of natural selection. The material theories, based on observation, are under- basis of evolution is thus the differential standable, and have lately been proven, to survival of genes and gene-complexes, and the satisfaction of geneticists and others, in mutations are the quanta of evolutionary the field and in the laboratory. Professor Th. change. Dobzhansky has been able, by means of (4) Mutations and the effects they pro- huge breeding cages for his experimental duce, though always definite in extent, may Material, D. melanogaster, at Columbia be very small, and these small mutations are University, to demonstrate many of the ideas the more important in evolution. As a Of Darwin, and to bring evolution up to result, the variation actually found in a date by showing the ability of certain indi- species of animal or plant is generally con- viduals to survive better among a large tinuous without sharp breaks, even though number of individuals when the survivors it is based on discontinuous differences in have certain genetic differences. Were the the genes. survival differential to be as low as one per * * * cent. per generation, considered much too To claim that neo-Mendelian genetics high by evolutionary genetics, over the supports the "superman" race theories, as number of generations known, profound the followers of Lysenko claim, is to be Changes in the organism would be expected. ignorant of neo-Mendelian genetics. The The field work, over a period of years, fact that non-geneticists, pseudo-geneticists, carried on in a single area in mountainous fascists, crackpots and so-called eugenists country with the wild population, has shown have seized on genetics to "explain" race, a very considerable change in the genetic with the explainer naturally considering Make-up of the population. himself the superior, we admit. But, the Julian Huxley, in his recent readable book, differences between "races" is minute, so Heredity, East and West, sums up the minute as to be insignificant. In fact, general theory as follows: the differences between what is called (1) Almost all heritable differences "races" on the average is far less than the between individuals `mendelize'—i.e., their difference found within a "race". As a 24 SPECULUM matter of biological fact, all mankind belongs tions stated, or else they cannot be accepted. to one race only, Homo sapiens. To speak Facts which are not in conformity with of races of man today is a falsehood in accepted theory cannot and must not be biology, which understands "race" to be one discarded as false. Rather, the theory must species. In all probability in pre-civilisation be modified or discarded to account for any eras there were other races, but today we new facts discovered. In this way the theory are in fact, if not in deed, one. of relativity has superseded Newtonian In 1939, almost all of the top geneticists physics. Genetics, as we know it, stands on of the world published the "Geneticist's the facts accumulated. The interpretation Manifesto", in which they stated their belief of the facts may be poor, but the facts in the oneness of man, and violently con- stand undisputed. And science is facts. demned racial bigotry and prejudice. Some interesting material may be found It would be well in the face of the in— political attack on genetics by the philosophy Huxley: Heredity, East and West. of the U.S.S.R. to reiterate a few points in Snyder: The Principles of Heredity. science. Facts w' 'c't are observed and can be Kalmus and Crump: Genetics (Penguin) - repeated a r. Experiments mat lend Lysenko: Heredity and Its Variability. themselves t reproduction with all condi- Scheinfeld: You and Heredity.

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1 2 3 WILLIAM STREET, MELBOURNE, C .1 SPECULUM 25 New Deal for Junior R.M.O.'s by P. W. GRAHAM The allowance paid to Junior Resident of our case, expressed interest and sympathy Medical Officers at Teaching Hospitals has and invited us to present a written case. always been inadequate, but except for The case was subsequently prepared and occasional and isolated solicitations by the with some minor amendments was approved residents themselves this state has been by the M.S.S. Committee. accepted as inevitable—a sort of premature The Hospital Boards of the three Teach- Penance for earning a high income (no ing Hospitals were provided with a copy of longer so relatively high) in later private the case and were at the same time informed Practice. There have been several increases of our intention to present it to the Hospitals the allowance over the past two years, and Charities Commission. The Hospitals de mainly to the activity of the Royal and Charities Commission received the case Melbourne Hospital R.M.O.'s, unsupported on 6th May, 1951, and sent the following b, Y their more discreet colleagues of other reply on 15th May. hospitals. However, in this post-war and inflationary Mr. P. W. Graham, Period many residents, particularly married Dear Sir, ex-servicemen, are finding it increasingly Your memorandum on behalf of the difficult to keep out of debt. Their plight Medical Students' Society Committee Was brought to the notice of an M.S.S. regarding consideration of higher allow- committee meeting in November of last ances for Junior Resident Medical Officers Year. A sub-committee consisting of P. W. at Teaching Hospitals has been read with Graham (convener) and W. Donald and much interest. Weber was set up to investigate the The attitude of the Commission is one matter thoroughly. The first move was to of sympathetic understanding towards the obtain an interview with a Commissioner case so ably outlined by you, and we believe °f the Hospitals and Charities Commission it is desirable to review the salaries paid. to discover if that body (which holds the At an early date a conference will be Purse-strings of Public Hospital finance) called of representatives of Metropolitan The be willing to review the allowance. Hospitals to discuss the subject. lie convener interviewed on 8th February Yours faithfully, °f this year a Commissioner, Dr. J. G. (Sgd.) JOHN GARY AN HURLEY Hurley, who, after hearing the main facts Commissioner

TKE CASE FOR HIGHER ALLOWANCES FOR JUNIOR RESIDENT MEDICAL OFFICERS OF TEACHING HOSPITALS (As presented to the Commission) (1) Cost of the Medical Course that six years' training should entitle The cost of the medical course, including graduates of even one year standing to a fees, books, instruments, living expenses, higher remuneration than the basic wage. excluding loss of earning capacity over thine six years, has been conservatively (2) Age on Graduation estimated by us at Z2,000. The average age of the present Final o any industry it is common practice Year group of students by the time they t there are marginal payments for graduate will be 26 1/2 years, higher than specially trained employees and we consider the pre-war age on graduation because of 26 SPECULUM the large number of ex-servicemen. Many, they work related to the normal working therefore, intend to marry on the comple- week of 40 hours, their present allowance tion of their course or after their first year would fall far short of the basic wage, and as Junior R.M.O. The allowance of a it has none of the usual industrial conditions Junior R.M.O. does not permit him to save such as payment for work on statutory holi- for marriage or for the purchase of a prac- days, week-ends and the like. tice. Soon, of those who have won a hospital The usual work roster for R.M.O.'s (e.g. , residentship through merit, only those who at the Alfred Hospital) is a half-day off can afford it will be able to accept the each week and three week-ends in six. appointment. We know of several residents We asked one resident in a Medical Ward who have had to cut short their stay as a at a Melbourne hospital to note his actual Junior Resident through financial hardship hours of duty for one seven-day week begin- and in the present final year group some of ning on a Monday. He regarded it as an the most able among the married students "easy week", but he was on duty for 70 have no intention of applying for a resident- hours in 5 1/2 days. His week-end off duty ship at a Teaching Hospital for the same fell in this seven-days' period. When he reason. worked over the week-end he was on duty for an additional 28 hours. R.M.O.'s in (3) Duties and Responsibilities of charge of surgical wards, and in Casualty, Junior R.M.O.'s work even longer hours. On graduation, the graduate is registered, We have no quarrel with the length of becoming a Registered Medical Practitioner, time worked, and are well aware that the with full legal responsibility under the Act. R.M.O.'s themselves would be the first to He is not legally an apprentice. As an protest were any arbitrary restrictions placed R.M.O. he is essential for the functioning on their hours of duty. We regard it as of Public Hospitals, and therefore performs necessary for the smooth running of the a vital and responsible service to the health hospitals. It is a concession to the fact that of the community Few graduates in any they are gaining valuable experience meas- other vocation are required to assume such ured in the hours as well as the months of serious responsibilities so early in their appointment; but we insist that this 70-10 0 careers. hours' week is 70-100 hours of work at The duties of R.M.O.'s include: Admis- least as valuable to the hospitals as the sion of all patients, taking of histories and 40 hours spent by other employees. physical examinations, making a provisional diagnosis and prescription of treatment, (5) Ex-Servicemen regular examination and care of patients, For ex-servicemen, the year spent as a performance of many biochemical and ward Junior R.M.O. has particular hardships. In procedures, administering anaesthetics, the first place their average age on gradua - interviewing friends and relatives of patients, tion is higher than non-ex-servicemen and and Casualty work. In the Casualty Depart- in a precarious world it is more urgent for ment most of the cases are not seen at all them to be financially secure. Furthermore , by senior men and the Resident provides a large number are married and many more the full treatment. He performs many feats intend to marry on completion of their of minor surgery and treats the many course. common complaints which actually comprise the major part of a general practitioner's THE PRESENT FINAL YEAR GROUP practice. No. of ex-servicemen . 86 Average age of ex-ser- (4) Hours Worked by Junior R.M.O.'s vicemen on gradua- The long hours worked by Junior tion . . . 28 1-3 years R.M.O.'s should not be forgotten in com- Average age of all puting their remuneration. Were the hours students .. 261/2 years SPECULUM 27

No. of ex-servicemen 42—i.e., approx. of one resident we consulted (wife and two married .. 50 per cent. children) that he "didn't know what to sell No. of families with 24—i.e., approx. next to pay the bills". children . 50 per cent. This committee believes that such a situa- tion has for so long gone unremedied only C.R.T.S. REPAYMENT because the Hospital Boards and the The Commonwealth Rehabilitation Train- Charities Commission are unaware of its ing Scheme living allowance for the last three gravity. Years of their course is a loan and they are This problem will be present for the next required to begin repayment one month four or five years as shown by these figures after completion of the course. If the of the number of ex-servicemen in the earlier ex-servicemen has completed the course in years of the course. six Years, he will have to pay back approxi- mately £500; if he has repeated one or 1st year .. 1 These figures are an More years, he will pay back proportionately 2nd year . . 9 understatement as some inore. 3rd year .. 20 students have not yet The first £50 is repaid at the rate of 4th year .. 35 1 filled in their enrol- per month interest free, and each 5th year .. 74 ment cards. succeeding £50 at the rate of 10/- per 6th year .. 86 Month at 2-2 1/4 per cent. interest. There- fore, owing £500 he would pay back at (6) Remuneration Received and Com- ,the rate of £6 per month (including parative Remuneration of Other Interest, £1/10/- per week.) If the graduate finds he is unable to repay at that Hospital Employees rate, he must report to the Repatriation ,`-°Inmission, and on stating his salary a Junior R.M.O.'s . L364 p.a. and board rate may be assessed. The longer and lodgings he Ile delays, of course, the more interest he *Almoner Cat. 1 . £439 (assistant), Pays. The repayment is "interest and plus £26 p.a. capital" interest being reduced with each *Hospital Bacteri- Payment. ologist (1st year) £509 p.a. Married R.M.O.'s are more directly Physiotherapist affected by the alarming cost of living rises (1st year) . . . £241 p.a. (approx.) than single ones, for it makes little difference (6-day week, from the family's costs to have one member 9.30 a.m. to 1 p.m.) Zingliving away from home. Many of them claim 'at they are actually worse off than as a * Salaries recommended recently by the student receiving a C.R.T.S. allowance, e.g. Hospitals and Charities Commission.

C•R.T.S. allowance £ 6/7/6 per week, We point out that Bacteriologists and for married man, (inc. 10/- travel- Physiotherapists, through their hospital t„.wife and one child . ling allowance) appointments, are gaining valuable experi- `,19spital allowance . £7 per week ence which will later give them a higher `- .R•T.S. loan repay- status and higher salaries in their respective ment £ 1/10/- professions in the same way that a period Nett £ 5/10/- per week of residency at a Public Hospital bestows advantages on a medical graduate. It can Besides debts to the government, many, be seen that even if "board and lodgings" through the inadequacy of their C.R.T.S. are taken into account, Junior R.M.O.'s re ante have incurred debts with friends, are underpaid compared with other equally ore'e,,Ilatives and business people. The plight junior professional workers, and if hours ex-servicemen is illustrated by the remark worked are considered, they are grossly 28 SPECULUM underpaid. After all, "living in" at the The general public is quite unaware of hospital is necessary only because of the the meagre allowance of the R.M.O., and it long hours worked, and any other establish- affords the resident some ironical amuse - ment requiring their employees to work a ment when working at 3 a.m. in Casualty 70 to 100 hours' week would have to provide to be told by a patient that "he must earn board and lodgings free or for a purely a lot in overtime". nominal charge. (7) Capacity of the Hospitals to Pay THE CLAIM We realise that hospitals are short of The salary paid to R.M.O.'s at Heidelberg money and that each year finds them with a Repatriation Hospital, £1100 approxi- greater deficit. However, we consider that mately, and board and keep is, we consider, economy in the R.M.O.'s allowance is a an ideal salary for a Resident Medical false husbandry. More would be gained in Officer. efficiency from having contented and finan- However, we would prefer the remunera - cially unworried residents, than would be tion of a Junior Resident Medical Officer spent in pounds of hard cash. at a Public Hospital to be still regarded as Residents' salaries form a very small part an "allowance", not a salary, but we ask of hospital expenditure. It not infrequently that it be an adequate one. We file a costs as much as £50 a week to treat one separate claim for married residents, most patient alone. of them ex-servicemen, for the very pressing There are 460 (approximately) employees reasons already given. at the Alfred Hospital, excluding the medical and nursing staff, most of them Single Junior R.M.O.'s £ 500 p.a• costing the hospital more than a Junior R.M.O. There are 20 Junior R.M.O.'s. Married Junior R.M.O.'s £ 600 p.a• (8) The Social Status of the Medical The difference between these allowances Practitioner in the Community and the ideal salary of £ 1100 p.m. is a Very few medical graduates have a private concession to our inexperience and the fact income, but on graduation they share the that we are "learning". social status of medical men in general, a We consider that some attempt should high one in this country. They are ill able be made to preserve the real value of this on £364 p.a. to take part in social living allowance by similar cost of living adjust', in a way befitting the dignity of their ments to those applying to other hospital profession, and expected of them by the employees on a comparable remuneration . rest of the community. Many students It has been brought to our notice that receive much hospitality and generous help first-year residents at the Women's Hospital , throughout the long years of their course though they are almost all doctors with at, from relatives and friends. Their resident's least two years' experience at Genera' salary does not allow them to return it and Hospitals, are paid no more than a Junior instead the married ones, at least, are forced R.M.O. at a General Hospital. We ask still to lean heavily on their friends. This the Commission to correct this obvious state of affairs is neither desirable nor anomaly. The sections headed (1) Cost of the, necessary, and we think it is unjust that d austerity for all and hardship for some Medical Course, (6) Remuneration Receive during hospital residency should be an added and Comparative Remuneration of other burden to that already borne over the Hospital Employees, (7) Capacity of th e previous six years on the slender excuse of Hospitals to Pay, are intended more as "apprenticeship" and the hope of a high points of interest than arguments of mile' income in later practice. weight. SPECULUM 29

Carlton Slum ?

No, the Back Lane of the Medical School in June, 1951

We are happy to report that it has since been repaved. 30 SPECULUM

Pandemic

The story behind our tender forearms

by PROF. S. D. RUBBO

Throughout the world, among civilised changed in virulence towards man. There and uncivilised peoples, a new infection has is no single case recorded in which B.C.G. appeared. While it is difficult to state has been shown as the cause of tuberculosis precisely when this essentially European in the clinical sense. It can, therefore, be infection passed beyond the frontiers of regarded as a virus fixe. the old world I think 1947 would be a The pandemic of "becegitis" was initiated generally accepted date. This "new" by the Danish Red Cross when it started its epidemic, unlike those which are naturally mass B.C.G. vaccination campaigns in occurring, has been intentionally created and Europe in 1947. In March 1948 the Inter- has gained widespread approval as the most national Tuberculosis Campaign (I.T.C.) powerful weapon in the fight against tuber- was set in motion by combining the resources culosis. I refer to the present, and I hope of this Scandinavian voluntary organisation continuing, pandemic of "becegitis" induced with U.N.I.C.E.F. as a Joint Enterprise. The by the injection of an attenuated strain of Joint Enterprise (J.E.) is a co-operative the tubercle bacillus, universally known as effort on an international scale whose B .0 . G. primary object is to assist national health B.C.G. is a variant of the bovine type of authorities in the execution of mass B.C.G. Mycobacterium tuberculosis, which is vaccination campaigns and in introducing avirulent for man and animals. It was this method as one of the tools in the long- developed by Calmette and Guerin in 1920 range control of tuberculosis. The second by successive subculturing of an acid-fast Annual Report of I.T.C. records that no organism originally isolated in 1908 from the less than 10,845,555 persons in Europe, udder of a tuberculous cow. B.C.G., there- North Africa; Eastern Mediterranean and fore, is not a new organism and it was first South-East Asia were vaccinated under the used as an immunising vaccine against auspices of this body during the year ending human tuberculosis in Austria, France, June 1950. If we include B.C.G. pro- Poland, Yugoslavia and Czechoslovakia grammes outside I.T.C. it seems safe to during 1926 and 1928. Apart from its assume that 12 million people were vac- avirulent character B.C.G. grows more cinated in 1950 and that this figure Will readily on bacteriological media than the probably be 20 million in 1951. This is a pathogenic forms of the tubercle bacillus pandemic of planned infection never before and, over the passage of years, it has never equalled in the history of natural diseases. SPECULUM 31

But why insist that the B.C.G. vaccination literature on B.C.G. to indicate that this is, in fact, an infection? Here is the vaccination is of definite worth. [Aronson evidence. and Palmer (1948); Ferguson (1946); In the vaccination procedure a suspension Heimbeck (1947); Hyge (1947) ; Levine of living B.C.G. bacilli is injected intra- and Sackett (1946); Rosenthal, Bland and dermally (0.1 ml) into an individual who is Leslie (1945); Wallgren (1948)]. Admit- not, or has not been, infected with tubercle tedly some of the findings may be criticised bacilli (Mantoux-negative individuals). The on matters of detail, as pointed out by organisms multiply at the site of injection Wilson (1947), but the accumulated body (usually middle of the deltoid region) and of knowledge, without exception, shows that Within a few days (or perhaps hours) they B.C.G. immunisation reduces morbidity and pass via the lymphatics to the regional lymph mortality in tuberculosis. In five years, nodes (axillary and supra-clavicular) and when the present mass immunisation cam- thence to the blood stream. A generalised paigns can be reviewed, an unequivocal sub-clinical infection follows associated with answer, if it is required, will be the development of small foci throughout forthcoming. the body. After three or four weeks a visible We should appreciate, however, that the local inflammatory reaction, the primary immunisation is by no means absolute and tuberculous ulcer not more than 10 mm in cases of super-infection occur in spite of diameter, appears at the site of vaccination. B.C.G. prophylaxis, but the incidence is This indicates the first signs of allergy, the about one-seventh that expected among the degree of which, together with glandular Mantoux-negative individuals exposed to the involvement, depends on the number of same risks of infection. Further, we are organisms still persisting in these areas and not entirely clear on the duration of this the intensity of the allergic response of the increased resistance which has been vari- host. According to Ustvedt (1949) the ously stated as three, five or ten years or Persistence of allergy (and immunity) more. Re-vaccination at five-yearly intervals depends on the survival of living B.C.G. in during the first three decades of life would the tissues (most probably lmyph nodes) seem most desirable. and not at the site of inoculation. Complica- In regard to the question as to who should tions will arise in less than one per thousand be vaccinated the policy of the I.T.C. is to vaccinated (0.25-0.3) as a suppurating vaccinate, on a voluntary basis, all non- or in 1 to 5 per 1000 as a reactors to tuberculin over the age of one localH3eal ulcer greater than 10 mm. in diameter. year. In European countries about 80 per From the foregoing it must be agreed cent. of the population at the age of 25 that uncomplicated "becegitis" is a self- convert naturally so that B.C.G. is used limiting harmless infection resulting in a principally among the younger members of F,,hanged allergic status of the individual. the community. In Australia, which is not a The Mantoux conversion rate (or to put it participant in the Joint Enterprise of I.T.C., another way, the B.C.G. infection rate) all persons exposed to infection (medical following vaccination varies between 95 and students, nurses, contacts, etc.) are advised, 100 per cent. We must now ask the question if non-reactors, to have B.C.G. There seems Whether this acquired sensitivity to tuber- little doubt that this advice will be given to culin is an index of an increased resistance all members of the community as facilities or immunity to tuberculosis. for Mantoux testing and inoculating increase c In a disease like tuberculosis, which is in this country. It might be added that °Liten characterised by an insidious onset and isolation after inoculation is unnecessary. enronicity of signs and symptoms, it is In conclusion, may we hope that every extraordinarily difficult to evaluate the student reading this short statement will efficiency of preventive and curative meas- regard it his or her duty, when qualified, 1res. There are, however, a number of to contribute to the B.C.G. campaign by Classical studies reported in the voluminous directing the attention of his patients and 32 SPECULUM their families to the importance of this Heimbeck, J. (1936), Tubercle, 18, 97. preventive immunisation. In this way, he Heimbeck, J. (1947), Irish J. Med. Sci., 65, can feel that he has rendered a service in 689. preventive medicine and something beyond Hyge, T. V. (1947), Acta tuberc. Scand., the immediate horizon of specific therapy. 21, 1. Levine, M. I., and Sackett, M. F. (1946), REFERENCES Amer. Rev. Tuberc., 53, 517. Aronson, J. D., and Palmer, C. E. (1946), Rosenthal, S. R., Bland, M. and Leslie, Publ. Hlth. Rep. Wash., 61, 802. E. I. (1945), J. Pediat., 26, 470. Calmette, A., and Guerin, C. (1920), Am. Ustvedt, H. J. (1949), Conference European Inst. Past., 34, 553. B.C.G. Programmes p. 225. Ferguson, R. G. (1946), Canad. J. Publ. Wallgren, A. (1948), Brit. Med. J. 1, 1126. Hlth., 37, 435. Wilson, G. S. (1947), Brit. Med. J. 2, 855.

BIRTH CONTROL GOODBYE THAT B— BEDPAN The reason why plants grow in such These lines were written by a patient as he profusion. left a city hospital. Is sexual confusion. Violets are blue Farewell old Pan, And roses are red, What moments we have had And they grow up together in bed, when thou and I In a communal bed. Beneath the sheet would closely lie And so it is that the hydrangea In direst perturbation. Is constantly in danger Smooth and shining wert thou, From the promiscuous But treacherous, and how Hibiscuous. You'd slide and buck about Trees and shrubs and miscellaneous weeds Like some wild steed, and all And very nearly throw me out, Find out about the birds and flowers when Until at last in desperate need they are only small. I'd ride thee firmly, and the while I'd grasp the bedding with all my might Take the case of sourgrass, And valiantly strive to win the fight. A filthy little b And when that fight was at its worst, They say he rhododendron Would enter someone—no knock first— When he was only three; And at the height of my travail And in nine months, two days and one hour Some little miss would say "Oh, here's your She presented him with a son-flower. mail". Now while all this overcrowding leads to Shades of ignominity much extra-marital bliss, What a situation The point is this: For someone suffering constipation. Excessive copulation Means over-population. Now comes the end The only plan to stop this that could And almost thou hast come my friend. possibly meet with a good reception Indeed, as thou art borne out through the Is contraception. door But wouldn't the lily I think, of thee I'll see no more. Look silly? But whilst I wave a sad farewell, "LE FRANCAIS." My joyous bowels shriek "GO TO HELL!" SPECULUM 33

The Christian Medical College at Vellore, South India

by Melbourne Grad., Dr. W. E. GAULT, Professor of Pathology

The Christian Medical College at Vellore The examining body is the Madras Came into being through the life and work University, to which we are affiliated and of a wonderful woman, Dr. Ida S. Scudder, we have to satiny its demands as regards Who is now nearing 80 years of age, but still equipment and teaching standards. Madras Possessed of great enthusiasm and vision, has maintained these standards on a high with a keen eye to beauty and a love of plane and its degree is equal to the best tennis. Fifty years ago she started medical found in other parts of the Commonwealth. Work at Vellore in one room of her bunga- Our students come from all parts of India, low and from this has grown a hospital of with a sprinkling from Pakistan, Ceylon, 480 beds. Thirty years ago she started Burma and Malaya. The medium of instruc- training doctors and today there is a medical tion as in all University work throughout College which is becoming famous through- India, is in English. If South India has its out the East. It may be of interest to Aus- way English will long remain as the medium tralian students and doctors, whose know- for higher education, as it provides a ledge of India is being sharpened by world common language for all India, and an inter- affairs, to learn what is being attempted at national medium by which she can maintain Vellore, and how medical education is intellectual contact with the outside world. proceeding in this land. Our students after passing their high school Until 1947 Vellore only admitted women examination (roughly equivalent to the students, as it had been started to train Melbourne University Leaving) go to wpmen doctors to meet the desperate con- colleges for a two years' course known as ditions which women in this land had to intermediate. Here they do a two years' endure. But with the passing of purdah and inter-science course, which corresponds to the desire of the Church to train both men Matriculation and First Year Medicine in and women in the best possible way, Vellore Australia. They enter the medical course to has started to admit men. While women start on Anatomy and Physiology, which students still outnumber men (there are they complete in the first two years. In the 160 Women to 61 men) the future plans third, fourth and fifth years they do clinical are that 25 men and 25 women shall be work with the other subjects of the usual admitted each year. course, but Pathology is given special 34 SPECULUM emphasis, being taught in the third and and correlated with the candidates' Univer- fourth years, and continued as Surgical sity results and the recommendations which Pathology in , the fifth year. Most of our accompany their applications. We then students do a year's house surgeonship after selected 70 candidates to come to Vellore graduation, but the Madras University is and for three days members of the staff now considering making this an essential undertook interviews, group tests, and dis- part of the course. cussions with small groups so that in the The problem of the increasing demands final selection we had some indications of of the curriculum affects India as it affects the personality, and suitability of the can- other parts of the world. There is too little didates as well as their intellectual ability. time for the students to think for themselves We finally selected 16 men and 17 women, and each speciality presses for more time for the number of men being limited by the instruction. Tropical medicine, parasitology, capactiy of the temporary hostel. One of the eye, ear, nose and throat, dermatology and big needs of the college is a permanent leprosy need much more time in India than hostel for men. A well has been dug and in the course in Melbourne, so that there stone is available for building, but we have is the constant danger that the student not got the capital funds to go ahead with becomes surfeited with lectures and clinics. the work. Added to this our students are studying in One of the most interesting features of a language which is not their native tongue. the college is its international character. This does account for some allowance of Doctors from all over India and from thinking in some students. I remember a U.S.A., Canada, the United Kingdom and doctor who worked with us in North India Australia form a very varied staff. The exnlaining that when she got a history from surgical team is a particularly strong one. a patient in Hindi she thought through the Dr. Reeve Betts comes from a famous diagnosis in English, then made some thoracic team in Boston. Dr. Jacob Chandy adjustments in her mind in her native tongue —a South Indian trained under Penfield in (Canaresex) and finally spoke to the patient Canada as a neurosurgeon. Dr Paul Brand in Hindi. This explained why she sometimes comes from University College, London, and seemed slow in arriving at a conclusion, but he is revolutionising the treatment of leprosy I found it often resulted in a more accurate deformities by his orthopaedic surgery. Dr. diagnosis than my more hurried method. The Howard Somervell has spent most of his life students from South India are better with at Neyyor, in Travancore, and is an expert their English than those from North India, in gastric surgery. Dr. John Carman, from for in the south English is used so much U.S.A., specialises in urology. Dr. Norman and children start learning it at an early Macpherson does mainly general surgery, age, and it is often the only common but is specially interested in plastic surgery. medium for cummunication between the Dr. Hilda Lazarus is an experienced gynae- different language groups, while in North cologist of all-India fame. These surgeons India Hindi is the common medium. I have provide most interesting material and stimu- taught and worked with both Indian students lating discussions for the pathology depart - and doctors whose thoughful approach to ment. The thoracic surgical team and the medicine was equal to that which I have neurological team come on different days to known anywhere else. the department to cut up lung and brain The selection of our students presents specimens which have been injected soon many problems as far more students apply after removal. These are compared with the than we can accept. This July (1950) 230 X-rays and interesting discussions are held men and 98 women applied for 35 places. on diagnosis and treatment which iron out The applicants did preliminary tests in the differences which arise out of difficult Physics, Chemistry and Biology at different X-rays and frozen section diagnosis. centres in India, Pakistan and Ceylon. The Such discussions are an interesting feature results of these tests were carefully analysed of the work of the hospital. The final year SPECULUM 35 students attend the surgical and medical students with specimens to illustrate the grand rounds, where interesting and difficult course of lectures. We do not intend to cases are presented. In these rounds there expand this section as it is now almost is a very frank expression of the opinions of complete, but plan to replace specimens as members of different departments on the they fade, or use better specimens as they cases presented. Since all our staff and come to hand. We hope also to build gradu- students are full-time resident members of ally a set of lantern slides in this section the hospital or college, and private practice to display photomicrographs and other goes to the hospital, there is a spirit which teaching material. This section of the does not mean that staff members have any museum does not contain rare or unusual false prestige to maintain or fear to admit specimens, but is a straightforward teaching mistakes when they have been made. This section. An interesting exhibit here is a is especially evident in pathological con- series of blood cell models made out of ferences, also held each week, when autopsy paraffin wax to which colours have been and biopsy material is presented and the added to make excellent illustrations. My diagnosis and treatment of the cases are colleague, Dr. Balasubramanyan, by his discussed. We have maintained such confer- artistry and study of blood cells, has given ences now for five years, but are beginning us a most valuable adjunct to our teaching. to intersperse them with lantern slide presen- My colleague, Dr. Frank Lake, has intro- tations of special subjects, illustrated by our duced two most valuable aids to teaching. own material, following the pattern of the One is an apparatus by which 110 slides Royal Melbourne Hospital. We have also are arranged on an endless belt so that they tried the method of getting a clinician to can be rotated under a microscope. A discuss a case from the clinical notes and descriptive guide in card form is attached later present the postmortem findings as is and the student can easily examine any of done so successfully in Boston. Reviews of the more important conditions histologically such objects as ovarian tumours, liver while in the museum. Dr. Lake has done biopsies in relation to cirrhosis, osteogenic the same thing for parasitology, using plus sarcoma or amoebic infections, proved 10 lenses so that helminthology and ento- stimulus to both senior students and staff. mology are easily available. The other big One of the most interesting tasks I have contribution he has made is to prepare wall had in the past six years has been to help charts which hang in the corridor outside in the building of a museum. We decided the museum, following the pattern of the some time ago to do away with the upright, Welcome museum in London. In these the glass-fronted museum stands. They are a life cycle, symptoms, diagnosis, treatment Poor method for display as the student has and prevention of most of the parasitic to look through two layers of glass—that diseases a r e cleverly illustrated a n d On the stand and that on the jar—and it described. is very tiring to go around such museums The other section of the museum has and twist in uncomfortable positions to see been devoted to rarer and more unusual specimens. We have built special frames specimens of medical, surgical, gynaecolog- made from wood and asbestos sheeting, so ical, obstetrical and forensic interest. We arranged that four rows of specimens can have not been very satisfied that this meets be seen from a sitting position with a desk the need of postgraduate students and are in front of the student for books and notes. at work on what we hope will be a most Many of the specimens are mounted in valuable teaching aid. A hexagonal frame Watch glasses as used in Boyd's famous is being built to hold six complete cases. In museum in Toronto, and we have found each section there will be four parts, which that coloured paper placed behind these will be lighted from a central neon light. throws the specimen into relief if different They can be seen from a reading desk at colours are used for different specimens. which the student will sit. Above will be the One part of the museum is arranged for original X-rays; below this, set at a slightly 36 SPECULUM different angle, will be photos and photo-, 7.30 a.m. and the students seldom leave micrographs; then below this the case history the hospital before 5 p.m. Still there is and descriptions of macroscopic microscopic time in the evenings for games and from pathology and in the lowest section will be where we are living we can see them playing be the specimen. We are starting with cases tennis, basketball, volleyball and ring tennis. obtained from the thoracic unit and if it The men have a cricket pitch and recently proves satisfactory will extend the same a hockey and soccer field has been built. scheme to neurology, urology and gastro- I have the privilege of being Dean of intestinal conditions. Our aim has been to men, which involves me in advising students keep the museum free from clutter and to about their work and being in charge of the remove faded specimens. If these have still hostel. They have recently formed their some value they are kept in weak formalin own governing body, planned out their own rather than on display. A big museum does rules and the hostel in many respects not necessarily mean a good museum. It resembles the life and activity of a Mel- needs constant change if it is to be of real bourne college. Dr. John Moody, a dentist value. from Melbourne, and the Rev. Scott Sim- The problem of obtaining autopsies is a monds—the resident chaplain—also from real one and requires the close co-operation Melbourne, have given invaluable help to of clinicians, nurses and pathologists. We the hostel. have been able to average a postmortem rate But this college is unique from an even of about 25 per cent. of all deaths. Muslems, more important aspect. It is a Christian like Jews, very seldom give permission, but college in a non-Christian land. It is hard with great care in postmortem technique for people in Australia to realise fully how we have been able to reassure Hindu and much all that is best in the profession owes Christian relatives that deformity will not its origin to the Christian motive. We seek result from postmortem examinations and to carry this over to India through our are getting an increasing number of teaching, chapel services, bible classes and autopsies. in daily contact with our students. It is Some aspects of the college make it not just more nurses and doctors that India unique. Roadside ambulances go out during needs, but those who come to their job with the week along the main roads from Vellore the right attitude. While our numbers may and treat patients who gather from villages be small in the face of India's need we are at regular stops. Up to 300 patients are the only Christian medical college in India treated in a day. Students go out with the and we believe that its contribution to India the doctor and learn how to cope with emer- and, indeed Asia, today is of great import- gencies with a minimum of equipment. The ance. Our doctors and nurses will go not opthalmologist, who has a separate hospital only to mission hospitals, but will help to of 40 beds, arranges eye camps out in some leaven Government and private practice. At of these villages, where he may remove 70 Vellore we are seeking to go beyond the to 100 cataracts in one day, arranging for mere healing of the body or the mind by an the after-care of the patients in any large attempt to integrate the whole personality. building that may be available. The bible class I am leading is studying io • Nursing training proceeds side by side the fascinating topic of the integration of with medical training. In addition to a the Christian gospel with scientific medicine. certificate course like that in Melbourne, This is the culminating study of a series Vellore now has a B.Sc. course affiliated spread over the whole course, which covers with the Madras University, which prepares the growth of the Church, Christ's teaching nurses for executive and teaching responsi- and the relation of Christianity to other bilities. This resembles the courses being world movements. For unless our students given in U.S.A., Canada and Sweden. can go out to heal the body, mind and The medical course is a long and arduous spirit we are not meeting India's need more one. In the clinical years lectures start at effectively than a secular college. rriiie =nor. *wawa, ..13¢

SPECULUM 37 To finance such a college offers great on in the belief that this is one of the most problems. We receive help from nearly 40 important tasks to be found anywhere. missionary societies and many individuals. Australia and India are not so far removed The Government grant is a relatively small and it may be that the Vellore College and one based on the number of students from the Medical School in Melbourne may be the Madras presidency. The financing of the more closely linked in the future by an hospital is becoming easier as it attracts patients from all over the East and an interchange of postgraduate students and enlarged private ward section is being built. teachers so that both may benefit in the Funds for capital expenditure and for expan- friendship and stimulus that contact between sion are still very inadequate, but we press the East and West can provide.

-11

IF THERE WEnE Ho FRICTION 6 41tric -r- T ' E Fi_oca yo u wouLD 4Rv e -TRE PLE.K1SuRe of SE.Eir44 11:)uR. LEGTORER GLADE G4Hc,EFULI.y -114-Rout4 TI4E- 38 SPECULUM

Two New Religions

"Psychologists tell us that the pattern of man's behaviour is profoundly influenced by the basic instincts of self preservation." ("Humanist": Speculum, October, 1950.)

From these psychologists, says "Humanist", of morals. But alas. We search again in we can learn that men eat when they are vain! For time has prevented our philosopher hungry, and run away when afraid, and from printing, for the benefit of the millions here his theory has been proven by scientific of misguided folk who still vainly believe in observation. But surely it was not from the the powers of a mystical Almighty, the psychologists that he has acquired his staggering series of arguments whereby he concept of Religion, which has neither scien- must have disproved the existence of God, tific nor any other sort of observation to the life of Christ upon earth, and the origin support it. of the ten commandments. In the course of his article "Humanist" So much for "Humanist's" theories on has denied emphatically the existence of the origin of Religion—let us now to his God and the value of any form of Religion, equally outrageous advice for human con - all in direct contradiction to the beliefs of duct, wherein he proposes a changing code countless milions of human beings over the of morals to suit the whims of men, and past few thousand years. Moreover, his bewails the fact that "the ten command - statements are made, not in the form of a ments must forever be the basis of the theory, but in a manner which suggests that morality of mankind". Surely an approach they are proven fact. "A few sagacious such as this cannot be justified. If we accept individuals . . . concocted the anthropo- that certain things are morally wrong, then morphic concept of a God." surely they must remain wrong as long as Does he realise that to propound a theory mankind does not basically change. Thus, as radical as this one, and expect any normal if it were wrong to kill one's fellow-man individual to give it credence, he must either back in the stone age, it will also be wrong be able to produce evidence in support of today, regardless of what our own private it, or at least be able to discredit the opinions on the matter might be. The fact currently accepted Christian theories, which that men kill one another much more fre' are in direct opposition to it? As regards quently in one century than was the case the first proposition, viz., the production of in the previous one does not make each supporting evidence, we must assume that individual crime any the less serious. lack of space prevented him from printing On the other hand, "Humanist" has the interesting tale of his long search through proposed that we change our moral code as the pages of history in order to identify the it suits us—that if we are prevented from "few sagacious individuals". How interested doing something because it is wrong, the we would have been to hear who they were! problem should be overcome by changing Having found no evidence in support of our concepts of right and wrong so that this theory of "Humanist", we now search the thing will now become right. Acting through his article for anything which might on these principles, we could do well nigh tend to disprove the current theory in anything without offending our consciences , opposition to it, viz., beliefs in the existence which would be moulded so as to agree, of God and the divine origin of our code with every act we do. In short, we would SPECULUM 39 eventually reach a stage where nothing we right to be born, improve our economy so did would be wrong. as to prepare for their arrival? If, as he A further suggestion in the course of this claimed, the birth rate is "hopelessly out- article was that we should "modernise" our stripping the world's total food production", civilisation by a wide use of those popular then our policy should be to make room for varieties of murder, euthanasia and birth these new arrivals by improving our accom- control—that once a person reaches a stage modation position and increasing our food where he or she has no longer anything to production so that they might be enabled to contribute to society, they should be quietly live in comfort with us. Even apart from put out of existence. Is this not infringing the moral •issue, surely it is outrageous, in the inherent right of all human beings to a country of 3,000,000 acres and 7,000,000 live? But, of course, it would not be such people, to think of such a thing as birth under the new system, for here the natural control. laws would all be changed to suit the So much, then, for "Humanist's" formula demand, and any sort of crime would be for a new and a better world — he and his Justified. crusaders may adopt it if they wish, but There is also his plan for wholesale and let them leave us Christian folk to our widespread birth control, once a country's "mysticism" with its "prejudices and Population is considered to be economically dogmas". We would rather live on in our sufficient. What a defeatist attitude this is! present old-fashioned way than adopt the It is like dealing with a shortage of hats by New Order which we have seen put partly cutting people's heads off, instead of trying into effect—and with what devastating to augment the supply of millinery. Why success—in the gas chambers of East hot, instead of denying human beings the Prussia and the salt mines of Siberia.

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Medical Service in New Guinea

An opportunity for Melbourne Students

On June 13 Professor S. D. Rubbo, the medical party is provided by the village supported by Mr. Yorke (Fifth Year), with adequate shelter, and often with flowers addressed an M.S.S. meeting on the Medical on their table! Services of New Guinea. Mr. Yorke showed The New Guinea medico leads a some- slides illustrating the nature of the country, what adventurous type of life. He has to the people, and the work, and Professor contend with a rough, inhospitable country, Rubbo told us of the advantages of practice rain, mountains, reptiles, and fearsome- in New Guinea for the enterprising young looking natives (who are actually as fear- doctor, and outlined a scheme to enable some as sheep). Professor Rubbo considers medical students to do responsible work the central plateau to be one of the best there in vacations. areas of the world, with beautiful scenery, magnificent rivers and a good climate. New Guinea provides a unique oppor- The Professor had suggested to Dr. tunity to the enterprising medico. "There Gunther (director of the service) that is opportunity for treating diseases in a studentships should be made available to manner that would never be allowed on the Melbourne students in the "long" vacations mainland. There is a tremendous field for after fourth or fifth years to act as medical experimentation." New Guinea tuberculosis orderlies (with responsible jobs). Since this is more often osseous and glandular than university gives less training in tropical pulmonary, and natives present with tre- medicine than any in Australia, it is not mendous swelling in the neck — an ideal politically possible to apply this scheme to field for dissection of the glands of the neck. Melbourne alone. But Professor Rubbo Skin diseases are common, and the budding made an "excellent impression", and a com- dermatologist is able to try "this pot, that promise has been reached. pot, of ointment". Furthermore, there are The present scheme is this—this year diseases amongst the natives never met on two or three Melbourne students will go to the mainland—particularly Yaws, caused by New Guinea. Professor Rubbo will act as a spirochaete, which is horribly disfiguring, Dr. Gunther's advisor in selecting from the but confined to the natives, who lack some applicants, and the successful students will of the most elementary principles of hygiene. go to New Guinea for five or six weeks. The The natives are "not particularly odifer- air fare is 170, but the salary is guaranteed ous; they are particularly friendly; they are to cover this charge. Those wishing further polite, and extremely co-operative". In information on the New Guinea service will Australian New Guinea proper, one says "I find it in an article by Dr. Gunther in the would like to do such and such", in Man- M.J.A. of May 12, 1951. dated Papua "I will do such and such". Both produce the same activity; natives will What about it, fellers? The beer is expen- stand in pouring rain waiting for the doctor sive, but there's no duty on spirits. French to do, say, a mantoux test on them, while liqueurs flow like water. SPECULUM 41 Child Welfare in Papua

Some Comments by C. W. BAIRD, B.Sc.

Old Territorians have said: "Come to (ii) STAFF — Staff trained in British Papua for two weeks and write a book on countries is hard to get. However, numbers Papua; stay two months and write an of migrant medicos have been employed as article; stay two years and write nothing". a stop-gap measure. While a short stay in Papua does not The employment of migrants has its fit one to write with authority on the native disadvantages, however, as- or his problems, it may qualify one to (i) Many D.P. doctors come from cold comment on certain aspects of the White climates. For some, their first experience of Man's activity. tropical medicine came when confronted by Bearing these limitations in mind, some their first native patient requiring treatment. comments on the Child Welfare Service (ii) Language difficulties. organised by the Department of Public Ideally, completion of native language Health, under its Director, Dr. John and tropical medicine courses should be Gunther, are not entirely out of place. required of applicants in the Government Medical Services. This naturally could not OBJECTS be put into effect at present, as in spite of As I see it, the objects of such a service the high pay (approximately £ 1300 per are : annum) of medical officers, applications are A—(i) Prevention of disease. few. (ii) Treatment of disease if prevention Perhaps in the future, when the advan- fails, in children from birth until attaining tages (high tax-free income, research poten- the age of approximately 10 years. tialities) of such positions are realised by I3—The provision of such care in the graduates from the southern Australian native villages themselves. States, these opportunities will be snapped Ideally the standard of treatment should up. It would seem that publicity given to approach that available in the great cities the area by medical students who have of the world, but owing to certain limita- worked in Papua will also be a powerful tions, as will be pointed out, this is not yet, factor. This, no doubt, was the object of or indeed, never may be, possible. the Public Health Director in Papua, when he made such positions available. LIMITING FACTORS (iii) HOSPITAL FACILITIES — These Essentials include: are limited at present, but a £7,000,000 (i) Finance. scheme is afoot for the provision of hospital (ii) Staff. facilities throughout the Territory. It seems (iii) Hospital facilities. as though this essential will soon be satisfied. (iv) Adequate transportation systems. (iv) TRANSPORTATION — Ground (v) Confidence of the people for whom transportation is woefully inadequate. Many the service is provided. roads built during the war have already been Considering these factors in turn. swallowed by the jungle, while many more (i) FINANCE — has to be obtained are threatened by the same fate. troll). Australian Government sources as— Consequently, much valuable time is (a) Natives too poor to contribute. wasted travelling, often on foot, from village (b) Few private enterprise concerns to village. This problem would take much operate in Papua; hence taxation would time and money to overcome. One wonders provide only a fraction of the cost. whether ground transport development is an 42 SPECULUM economic proposition. The alternative, air ing results is in operation. These records transport, is certainly uneconomic for short will be of great value in the future. distances. It would be a great asset, in my opinion, In my opinion, this problem will be the if staff and equipment were available, to hardest of all to solve. One wonders whether include a pathologist in each team. The the prospect of further world conflict may opportunity for gathering clinical material, have some influence. coincident with specimens of pathological (v) CONFIDENCE OF THE NATIVE interest, would be welcomed by the research- —This is a difficult factor to assess, but it minded, while the certainty of diagnosis, in is conceded by most of those who know conditions such as malaria, where the slides that the native does not like to be in hospital could be examined on the spot, would be of — and hospitalisation is essential for dis- value to the team as a whole. orders incapable of efficient treatment in the As mentioned above, difficulty is encoun- field. tered in referring to hospital patients who Red Cross has done much useful educa- require more intensive treatment than the tional work in breaking down prejudice by infrequent visits of the team can provide, the establishment of Junior Red Cross owing to the limiting factors outlined above. branches in some of the native villages in As many of the complaints encountered the vicinity of Port Moresby. In addition, can be traced to poor nutrition, issues of the work of the Government Medical Ser- Marmite and condensed milk are given to vices, in conjunction with Red Cross, during lactating mothers. Malarial prophylaxis is the Mt. Lamington disaster, will do much. not yet given as a routine. It is regrettable also that diseases due to unhygienic living PRESENT SERVICES conditions, which are a fertile field for pre- Having considered some of the pre- ventive medicine, cannot be prevented at requisites and difficulties of any scheme, let present. Unfortunately education of the us briefly examine the scheme at present native will take a long time. operating. CONCLUSIONS Clinics When one sees the system operating, one A permanent clinic has been set up it cannot help feeling admiration for those a village near Port Moresby, while two far-sighted enough to envisage such a ser- mobile clinics (a third was in the process vice, and further—having the courage to of establishment when Mt. Lamington blew overcome, partially at least, many of the up), consisting of a doctor, nurse, orderly obstacles. and interpreter, cover villages over a radius As it operates admittedly on a small of up to 40 miles from Port Moresby. scale at present, it is undoubtedly a success. Many of the advantages of such mobile It has not been operating long enough teams are lost, however, as- (approximately four years) for analysis of (i) Due to transport difficulties outlined the records to be of significance, but without above, their mobility is low. doubt the results will show in future (ii) There are insufficient teams to make generations. visits to the villages sufficiently frequently. Methods in the Clinics Acknowledgments The head man of the village is notified My thanks are due to officers of the beforehand of the arrival of the clinic. On Public Health Department, Port Moresby, the appointed day the clinic arrives, all avail- R. O. for valuable information, and to Mr able mothers and children gather around, Wardrop for helpful criticism. and the work proceeds. Examinations are necessarily of the Answer to problem on page 34. briefest, but routine weighings of all children Fun period fun period fun no period -- are made, and an efficient system of record- worry, worry, worry! SPECULUM 43

SPECULUM REPORTS ON The Women's Hospital

Early results were promising .

but we soon found the work . . a Little Warming

44 SPECULUM

Good excuse No excuse

Painless Extraction No Contractions? SPECULUM 45

Gambling-house Lucky Dip

Jackpot

Monacrin is a non-staining acridine chemotherapeutic Ni112 which inhibits the growth of a wide range of both MONACRIN gram-positive and gram- negative organisms. 5-aminoacridine hydrochloride Isotonic solutions may be dissolving monohyd rate prepared by Monacrin in a buffer solution.

N.12 Neomonacrin is a non- staining acridine similar NEOMONACRIN to Monacrin, having low systemic toxicity. It is I-methyl 5-aminoacridine hydrochloride compatible with normal saline.

Zephiran is an effective antiseptic of high germi- C11 3 C113 ZEPHIRAN cidal and bacteriostatic potency. Very rapid in >CH.2 CI Alkyldimethylbenzylammonium action, virtually non-toxic, chlorides it possesses remarkable detergent and penetratina properties;

BAYER PHARMA PTY. LTD. 56 YOUNG STREET, SYDNEY SPECULUM 47

PSYCHOLOGY AND SICKNESS

A review of some recent work

by F. E. EMERY, M.A.

It is trite to state that medical problems not discounting such factors Barker et al are permeated with psychological problems. point to certain aspects of the situation as It is, on the other hand, not so trite to it exists for the patient, which lead to these specify some of the actual forms of permea- forms of behaviour. tion. Because such specification is rarely The diagnostic situation may appear to done, and even less frequently done well, the doctor as a' routine technical job. To there is some value in considering the work the patient, however, the situation is much of Barker, Gonick and Wright.* Bringing more personal, much more significant. together the results of research already con- Consider a person who regards himself as ducted in this field they attempt to draw a healthy but is concerned about certain More complete picture and suggestions for disturbing symptoms. He will want to seek remedial measures. medical attention because he believes that To confine ourselves to their findings and it will lead to a remission of symptoms and suggestions regarding "acute illness' we find a return to a state of good health. On the them posing three questions— other hand he will want to avoid medical What are the peculiarly psychological attention because he feels that it is itself problems of acute illness? painful, expensive, or time consuming, or How do these arise? because he fears that it will confirm a state By what means can they be solved? of serious illness. Thus, such a person is Thus, within the framework of the medical inevitably in a state of conflict, although the problems of diagnosis they point to the strength of the conflict will vary with differ- following psychological problems: ences in attitude towards these alternatives. 1. Reluctance of persons to seek early It is this state of conflict that enables us medical advice and diagnosis. to understand why many are so reluctant to 2. Emotionality of persons during diag- seek medical advice and why so many tend nosis .(with occasional effects on such to exhibit emotional behaviour to the doctor; diagnostic methods as basal metabolism why it so frequently happens that some test). persons are continually deciding to visit the 3. Unreliability of patient's statements doctor (or dentist!) "next week" only to about their own symptoms. put it off again when the time draws near. Do these problems arise simply from So long as the situation retains unattractive Ignorance of when medical advice should features a person will tend to keep away be sought, from traits of nervousness in from it — a tendency which will increase Some persons, or from lack of training or rather than decrease the closer an individual natural inability in self observation? While comes to it. (This conforms to the well established psychological law that the forces "Adjustment to Physical Handicap and Illness: away from an unattractive situation increase t Survey of the Social Psychology of Physique and more rapidly than the forces toward an )i sability", by Roger G. Barker, Beatrice A. Wright attractive situation as the distance between and Mollie R. Gonick, Social Science Research Council Bulletin, N.Y., 55, 1946. the person and the situation decreases.) 48 SPECULUM

This increasing tendency to avoid the tially painful always is. To "solve" the diagnostic situation explains the unreliability problem by informing the patient of as little of a patient's observations of his own symp- as possible, and then only in general terms, toms and case history. Even when face to is to ensure a general maximum of anxiety face with the doctor they will have a ten- in patients. dency towards getting out of the situation In the reduction of the financial grounds by underestimating their own symptoms or of conflict sufficient has been done to indi- concealing their case history. Thus McNemar cate that "the adequate practice of preventive and Landis obtained a correlation of .50 medicine and treatment of long continuing between patients' reports of frequency of diseases requires the removal of this financial illness and their hospital records. Striking obstacle". This factor is of even greater examples of this phenomenon are the importance for the treatment situation. So persons who lose their symptoms when long as it exists many tubercular and heart entering a doctor's office (or a dentist's). disease cases must continue to shorten their As medicine has become more preventive lives and endanger the lives of others because the necessity to reduce this reluctance has they are unable to face costs of their become increasingly important. Medical treatment in terms of the loss of wages and practitioners in their various' capacities have social status. already taken many steps in this direction. Of the psychological problems entailed in It is useful to consider the significance of minimising the resistance arising from social these steps. attitudes towards illness as a sign of weak- As one such step, much has been done ness, of feminity or of sin, and the resistance to make the public aware of the dire conse- arising from fear of pain we merely know quences that may follow from failure to seek sufficient to realise the value of further early medical advice. While this measure research. may be effective in increasing the number The above considerations are concerned of persons who seek early advice it will do with the person who believes himself healthy so only at the expense of increasing the but is anxious about certain unusual symp- strength of conflict and hence the associated toms. Once a person has accepted the fact anxiety. This conflict and anxiety will that he is ill the situation of diagnosis and be reduced only if the unattractive features treatment takes on a very different meaning. of the diagnostic situation are diminished. While some anxiety will still be generated Of these unattractive features, Barker et al by the unfamiliarity of the situation it will point specifically to those arising from the be seen as the only means of getting well. unfamiliarity of the patient with the diag- Under these circumstances the patient will nostic and treatment techniques, the expense frequently seek as much treatment as of medical care, the social attitude towards possible as quickly as possible. The desire illness and the pain involved. to get well, with all that this means in terms Reduction of the anxiety arising from of earning power, social life, lack of pain, unfamiliarity may be overcome by the etc., is often such that where suitable physician giving to the patient greater medical treatment is slow, expensive or information about the instruments and techniques of diagnosis and treatment and lacking, patients turn to quacks. of his program of action; by carrying out Lastly, there remains unconsidered the the interview under conditions approxi- person for whom illness is a refuge. Such mating to a normal office of, say, a lawyer. persons require psychiatric treatment and Recognising that it may be desirable to keep hence need to be differentiated from those, the patient in the dark about some distressing considered above, for whom medical treat- treatment which might cause undue worry ment is primary. Three criteria for differen- or resistance the fact remains that most tiation arise from the differences in the medical procedures are not in themselves situations they face even when both believe sources of anxiety, but the unknown, poten- they are sick. SPECULUM 49

1. The former magnify their symptoms and By bringing together and systematically depreciate the effects of therapy; the interpreting a mass of relatively narrow latter minimise their symptoms and exag- researches Barker et al have succeeded in gerate the effects of therapy. creating a basis for the fruitful development 2. The prevailing mood of the former will of joint medical and psychological research, be depressive and pessimistic as com- for the explicit injection of certain simple pared with the optimism of the latter. but valuable psychological principles into 3. The symptoms of the former will show medical practice. No attempt has been made considerable variability—as one is cured another will appear. In the latter case, to indicate the range of problems over which symptoms will be more constant and will their analysis extends, but rather to present be related to the real physical condition their views on a single problem so as to of the patient. reveal the nature of their approach.

Extract from "Bones and all that". 6. Describe the nerve supply of the Test Paper 1 following: ANATOMY — MED. II B. (a) salivary glands (b) adrenal glands Pass and honour (c) heart (Female students may omit whichever (d) stomach questions they like) in each of the following situations: 1. Describe the extra-cranial course and (i) after sighting a large meal. relations of the greater splanchnic nerve. (ii) after eating it in a storm at sea. If you can think of a better course for (iii) after a session in a parked car. it, describe that instead. 7. Outline the distribution of skin and fascia in a perfect subject. Use diagrams 2. Which is the most pearmeable material: (a) capillary walls, or 8. What would happen if the inferior vena (b) brain. cava emptied into the stomach? Illus- If you have forgotten, write (b). trate with diagrams. Does it? 3 . If you were to cut a transverse section 9. Do you think Prof. Townsend knows through your neck with a cut-throat much about female anatomy? Discuss, razor, what would you say? Give details. with examples from your practical work: 4. When you play football, about how (a) in the dissecting room (b) elsewhere (be explicit). many muscles do you use? N.B.—Only honours candidates should (a) 23/4 (b) 50, or attempt this question. (c) 1900? 10. Give the relations of the kidney and If (c), enumerate them. bladder to: Only footballers should answer this (a) whisky and rhinegold question. (b) cheap beer. 6 Extra marks will be given for practical • Enumerate: suggestions on how to improve the func- (a) the hairs on Red's head (b) any other structures that interest tioning of these organs. you. Erratum: For 'say' in question 3, read 'see'.

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Chinese Spiritualist Medicine

by TUNG S1EW YOON

Some of the Chinese who are ill or priest standing by his side only being able worried believe in supernatural advice. This to translate them. Can usually be obtained by consulting Then the consultants file before him. One Certain spirits with the help of a medium by one, they tell him of their misfortunes, who in everyday life is like anyone of us. ailments and worries. Depending upon the This art is not uncommon amongst the case, a prescription written with the tradi- Peoples of the East. The employed methods tional Chinese brush and ink in a language are different from those of the African witch only understood by him is given. It is doctors. It can be traced to a tradition which supposed to be burnt and the ashes are to is said to be related to religious elements be drunk with water blessed by him, too. earlier than Buddhism. He may give a very reassuring and confi- Such professional people are usually dential piece of advice or he may prophesy. found in the Chinese Temples. The cere- Apparently there is practically nothing in monies performed are very impressive. this world whether physical or spiritual in Before burning joss-sticks, candles and which he will not be able to assist you. flickering oil lamps and in an atmosphere Whatever doubt we may have of him, I feel filled with the incense of burning sandal- that the medium is a man of great ability. wood, offerings are made before the spirit His performances are so very impresssive they happen to believe in. The occasional that I leave them quite convinced of his sounding of brass gongs breaks the silence. capabilities. On the other hand, the border The priest enters in a flowing golden robe separating the supernatural and medicine is followed by the medium. More offerings rather vague to me. are made and prayers are read. Invocations It may appear to be very strange for are uttered so that the spirits familiar to such practices to flourish if viewed from the the medium may be able to transcend into Western mind But to those who have been his soul. Whether you believe it or not, brought up so that their judgment is after some time, his body begins to vibrate, entirely based upon the philosophical out- Which indicates that he has already fallen look so characteristic of the Chinese, we into a trance. Sometimes, at this stage, he will be able to account for it. Many Chinese May cut his tongue with a sword reserved believe that human fortunes are to a very for such an occasion, or he may prick his great extent governed by the wishes and body with several silver pointers of lengths activities of certain spiritual elements at varying from six inches to two feet. Blood work in this Universe. Is usually drawn, but when he returns to When in trouble, they summon for help formal, the wounds are very superficial! to counteract and placate these evil A very interesting stage is reached when influences which appear to threaten their it is not surprising to find him making pro- happiness. It is an art of medicine very nouncements which appear to be full of widely practised. If we believe in such Wisdom. He speaks in the language of the supernatural powers of healing, we can spirit. Words are mumbled expressively, the understand how reassuring a few sincere 52 SPECULUM

words can be to a person in times of To serve as an adjunct, I am adding this adversity or in illness. They restore his story into the article. During the Jap occu- faith. Then the distinction between the pation and after the end of the war, people ' absurdity or sensibility of this practice will living in the neighbourhood of a certain not be so indistinct as at first sight. An stretch of Changi Road, in Singapore, were alternative is provided to him, for then, very certain that on certain night, they heard instead of consulting a genuine Chinese very distinct and consistent wailings which physician, he will be able to obtain some they attributed to the spirits of people who relief from these supernatural spirits. had died in the agony of hunger and pain. Judged from the Western mind, we They subscribed the money necessary for believe in a certain. thing because the ques- the erection of a Temple, which today tion of cause and effect can be ascertained. stands upon a small hill overlooking the Experiments of a scientific nature are mass graves of a good number of Allied carried out before a new method is adopted. soldiers and civilians who were massacred We have, therefore, faith in the man who and buried there. It appears that the spirits has carried out such studies of this nature. have ceased to wail now, for they have found We have to acknowledge that one of the a home in this Temple. Annually, there is important elements in curing is the patient's a Festival for the Hungry and Unfortunate faith in the physician and the methods he Ghosts. decides to employ. In a way we can there- Next time you find yourself in trouble, fore believe to a certain degree that "spirits" if you are near a Chinese temple, do try to can be used for spiritual and psychological summon the spirits to assist you. I am on purposes. the borderline of doubt and belief.

TEXT BOOKS Medical and Dental • • MICROSCOPES DISSECTING SETS • • HALF SETS OF BONES HAEMACYTOMETERS • • SURGICAL INSTRUMENTS REPAIRS AND ALTERATIONS W. RAMSAY (Surgical) Pty. Ltd. 340 SWANSTON STREET, MELBOURNE Phone: FJ4123, FJ4124 AND AT ADELAIDE, BRISBANE, PERTH, HOBART

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RESEARCH NOTES

PATHOLOGY DEPARTMENT

Claude Bernard subdivided the approaches "rheumatoid disease" has been carried out to medical research into two categories. In by one worker. the first, deductions are made from facts 3. Observations on changes in lymph nodes. observed in the naturally occuring state; this An attempt to correlate the pathological he called "the science of observation". changes and clinical manifestations of Within the span of the centuries, names as diseases giving lesions in lymph glands has eminent as those of Aristotle and Charles been made. The bulk of the material was Darwin could be cited as exponents of it. obtained from conditions related to a chronic In the Pathology Department, this is the disease of lymphoid tissue of unknown Method applied in the fields of clinical aetiology known as Hodgkin's Disease. observation and morbid anatomy. 4. A survey of the changes of tuberculin The other approach to medical research, reaction in medical students. Bernard has called the "science of experi- Work in which you all have played a vital mentation". This concerns itself with part is the tuberculin survey of medical deduction from facts observed under a set students, now in its fourteenth year. Much of conditions specifically provided to facili- interesting data has been collected and are tate their elucidation. Whereas in other now awaiting analysis. branches of research this method can be 5. Studies on leukaemia. employed on the same basis as the method Leukaemia is a fatal disease in which of observation, in the medical research field many immature leucocytes are released into It is used usually only at the laboratory level. the blood stream. The condition occurs in In the Pathology Department, the method of an acute form in children and investigations experimentation is followed in such work as are being carried out to assess the efficacy that on the nature of tuberculin sensitivity; of new drugs (such as aminopterin) on the or the method may be combined with that prognosis of this disease. Of observation in the morbid anatomical or 6 Surgical pathology of the ear, nose and Clinical fields. throat. Here are a few examples to illustrate my Investigations have been carried out on Point. Subjects using the method of obser- Meniere's syndrome (a condition in which vation include: episodes of dizziness are associated with 1 . New methods in cytology. varying degrees of deafness). The same , The technique of freeze-drying of tissues worker has prepared a paper in which the Is being developed. This is important pathology of non-specific infections of the because of elimination of the distorting nose and accessory nasal sinuses have been effect of chemicals usually used in the correlated with the clinical condition. Process of tissue fixation. Work in which the method of experimen- , The use of radio-active isotopes is being tation is predominantly used include: Investigated by means of auto-radiogra phs. 1. The nature of tuberculin sensitivity. Radio-active iodine and its effect on the One worker has been analysing the com- thyroid gland is the subject of the present ponents of the tubercle bacillus with a view in, vestigation. to clarifying the nature of tuberculin Investigations in morbid anatomy. sensitivity. Work on diaphragmatic deformities pro- 2 Post-mortem temperature changes. duced in the liver and on the nature of the Of great medico-legal significance are the Pathological changes in the viscera found in post-mortem temperature changes under 54 SPECULUM different conditions and a long-term project for many years. The clinical condition in has been begun. a large series of cases has now been followed 3 Work on the aetiology of glomerulo- for several years. The pathological findings nephritis (Bright's Disease). have indicated that it has a definite relation This is a chronic non-inflammatory with tuberculosis. disease of the kidneys usually beginning in 2. Sudden death in infants. childhood. The role of homologous kidney Cases which have usually been labelled, antibodies in the causation of the condition by the lay press as "death by suffocation is at present under investigation. A series were extensively investigated. In a large of animal experiments to produce the series of cases a definite alternative cause of condition in such a manner as to parallel death was demonstrable, usually in the the human clinical sequence has been nature of a severe intercurrent infection contemplated. related to the infections prevalent at the The following research projects combine time. both the methods of observation and The knowledge acquired in the physical and biological sciences, which may have experimentation: seemed rather sterile in its immediately I. Sarcoidosis. practical possibilities, is all actively employed Sarcoidosis is a condition giving rise to in the study of derangements of the body

( multiple lesions which microscopically and abundantly justify the effort expended , resemble tuberculosis. The aetiology is whichever direction is followed. There is unknown and a controversy as to the rela- so much to be discovered that everything ■ tion to tuberculosis has been in progress we see can be a subject for research. ;;

* "41

PHYSIOLOGY DEPARTMENT

A. GENERAL PHYSIOLOGY its action and to find clinical indications allowing a better choice of suitable patients. 1. Ionic relations in the body. It was found that the patients retain lithium The main work on the general problem while the maniacal attack lasts and excrete of renal activity in the presence of stresses it profusely as soon as the mania abates' on ionic equilibrium in the body has con- the effect of the therapy appears to depend tinued. As a part of this work the technique on whether it is possible to obtain a sans' of producing respiratory acidaemia in the factory degree of lithium retention withou t sheep has been developed. This presents exceeding the tolerance limit of the patient. a laboratory method of producing the same The above work has made use of the changes in the ionic pattern in the body as flame spectrophotometer for the estimation those which occur in chronic pulmonary of sodium, potassium and lithium (see Med . emphysema in man. In both the experi- 1' J. Australia, June 23, 1950, p. 821 — f° mental and the clinical cases there is an the principles of flame photometry). alteration of renal activity in response to The effect on smooth muscle of the cations the additional stress (low pH). of the series Mg, Ca, Sr, Ba, progressively Several fatal cases of lithium poisoning changes from inhibition to excitation. No were reported in U.S.A. and in this country. such reversal of effect occurs when striate d The action of lithium on the healthy as well muscle is used. This phenomenon is boil as on the maniacal patient was investigated analysed in an attempt to correlate it with with the purpose to establish the mode of other properties of these cations.

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2. Electrophysiology. to be a mono-amine-oxidase. Attempts at The shape of the action potential in nerve its purification have been made. has been studied by non-electrical stimula- 6. Tissue Injury. tion. It has been shown to exist in at least Tissue injury has been studied from a two forms, of which only one has hitherto number of angles. been known. Also the "foot" of the action (a) In anaphylaxis the use of salicylate potential, upon which so much of the compounds was found to inhibit the release classical theory of the initiation and propa- of histamine The implications of this with gation of the impulse has been built, has regard to para-amino salicylate therapy in been shown to be almost consistently absent. the exudative type of tuberculosis have been This must lead to a reconsideration of our considered. ideas of the role of electrotonus in (b) The injection of chloroform into the propagation. perfused head of the guinea-pig was found The investigation has been carried out to liberate acetylcholine, but there was no using a biological cathode ray oscillograph, release of histamine when the vessels supply- constructed in the department. ing tissue other than the brain were occluded. In conjunction with the Alfred Hospital Preliminary electronic studies showed that an electrocardiograph for observation of following the injection of chloroform an both standard leads and vectograms in action potential was detectable in the frontal and sagittal planes has been occipital pole of the brain and the accessory developed, and is now in use. nerve. This work is proceeding. Work is also proceeding on an electro- (c) In a study of the effects of repeated cardiograph which will embody all the avail- injection of diphtheria toxoid, it was found able cardiographic information about the that this increased significantly the histamine patient in one simple display. output by trypsin and the resistance of the 3. Experimental Cardiac Surgery. animal to histamine This has certain immunological implications. Attempts have been made to maintain (d) The effects of the injection of grass the circulation of dogs during intra-cardiac extract on the uterus of the cat and rat were operations by means of an extra corporeal studied, and the results indicated that it Pump. The many difficulties encountered was distinct from ergotoxine. Excision of during the procedure were studied. the suprarenals considerably reduced the An Operating Cardioscope was developed vasopressor effect. for operations on the mitral valves under (e) In infants the mortality from pneu- direct vision. Successful operations were monia was found to be 33 per cent. in spite carried out on dogs and the procedure is of antibiotic therapy. Even in uncomplicated being further developed. pneumonia it was 10 per cent. Possible 4. Assay of Secretin. ways of minimising this mortality are being investigated. The technique of secretin assay has been worked out in conjunction with workers B. PHARMACOLOGY from the Biochemistry Department. Experi- ments on the effect of circulatory changes 7. Pharmacology of Adrenaline. and obstructions of the duct on pancreatic The oxidation of adrenaline in phosphate secretin have been carried out. buffer has been compared with its oxidation in bicarbonate buffer and in unbuffered 5. Lung-enzyme inactivating serum vaso- solutions, and the course of adrenaline constrictor. oxidation in the presence of catalase and The lung-enzyme reported to inactivate catalase-containing body fluids was invest- lungs vaso-constrictor was investigated on tigated with the purpose to characterise and 'angs which were perfused to remove the localise the hydrogen peroxide forming step last traces of blood. The enzyme was found in adrenaline oxidation. 56 SPECULUM

8. Vasoconstrictor Activity of Serum cologically distinct types of cells in sympa- Preparations of a partially purified vaso- thetic ganglia. The above apparatus is being constrictor substance from blood serum used in an attempt to substantiate this idea have been made. It has been shown that and further, to investigate the action of the vasoconstrictor so prepared is, in fact, certain ganglionic paralysants which may be the vasoconstrictor substance which appears of use in hypertension and infantile paralysis. in blood during clotting. When serum is 11. Tigloidine as a substitute for atropine made by clotting cell-free plasma, it yields in Parkinsonism. no vasoconstrictor substance on chemical extraction. Attempts have been made to In experiments with isolated frog muscle further purify the active preparation. it was observed that Tigloidine (a by-alka- Ultra violet spectroscopy and pharmaco- loid of Duboisia myoporoides) had the same logical actions of the vasoconstrictor sub- delayed recovery effect as atropine, but it stance strengthen the view that it is a trypta- lacked the usual toxic effects of the latter. mine derivative. Its pharamacological The drug was therefore tried as atropine properties are closer to those of tryptamine substitute in the treatment of three cases of Parkinsonism. It showed, though in higher than to those of any other substance. It dosage, equal therapeutic effect as atropine, contracts isolated vessels and constricts but without the distressing side-effects. The vessels of the hind limb and kidney of the investigation was limited by the rarity of dog and cat in situ. It contracts the rat uterus, the guinea pig jejunum, the nicti- the naturally occurring alkaloid. tating membrane and pupillary sphincter of 12. Measurement of Analgesia. the cat and stimulates the cat's adrenal A new qualitative technique in analgesio- medulla. metry has been developed. It is now possible The presence of the vasoconstrictor in to test new synthetic morphine derivatives species other than mammals is being more speedily than before. Substances which explored. It is present in the bird and in antagonise the narcotic activity of morphine the turtle. do not lessen its analgesic activity. 9. Pharmacology of Morphine and Acetyl 13. Toxicity Testing. choline. Tests of synthetic triazoles and thiazoles In order to investigate the theory that the and of products of Australian timbers have action of morphine is connected with brain been carried out on various animals to acetyl choline metabolism, attempts have determine toxicities and harmful side-effects. been made to synthesise acetyl choline in brain homogenates. The assay for acetyl choline has also been investigated, and a method has been devised for separating this substance from interfering material. Several new analeptics against morphine have been discovered, including the alkaloid APOLOGY nicotine. "The Battle of Furunculus" was not first 10. Ganglion Transmission. published in Speculum, as we stated in our Electronic apparatus has been built to last issue. It was written by R. B. Price record simultaneously four variables, namely for the St. Bartholomew's Hospital Journal, blood pressure, vasoconstriction and dilata- in 1909, and is reprinted under copyright in tion in the ear, contraction or relaxation of Round the Fountain, which is reviewed In the nictitating membrane, and the recording this issue. of "bursts" of nerve impulses originating The Editors of Speculum must apologise from the superior cervical ganglion. for unwittingly breaking copyright, and for Previous work within the department has printing the verse in what we now know to shown that there are probably two pharma- be a mutilated form. SPECULUM 57

ROOK REVIEWS

Wheeler & Jack's Handbook of Medicine. Notes on Communicable Diseases of Laboratory Animals 1 I th Edn., revised by Dr. Robert Coope. (Edinburgh: E. and S. Livingstone Ltd.) (Edinburgh: E. and S. Livingstone Ltd.)

Considering the small size of this book This booklet presents in a very concise and the vastness of the subject which it sets form, a great deal of information essential out to treat, a remarkable amount of the to the successful management of an experi- field has been covered. Thus almost every mental animal house. The research worker subject of any importance receives good must feel confident that his experimental attention, usually in proportion to its merits, results shall not be influenced statistically by Making the book a most efficient medium concurrent clinical or inapparent infection. for a quick and concise coverage of the Therefore, an animal house cannot fulfil its subject of Medicine. scientific function unless it is capable of The main disadvantage of the book con- maintaining a continuous supply of disease- cerns its sections on medical treatment, free animals. Although the ideal arrange- Which are, in a number of cases, somewhat ment is a perfectly healthy animal popula- brief and superficial. While it must be tion, maintained in the strictest quarantine, admitted that certain out-dated aspects of in very few instances if this practicable for treatment might well be left out of modern any length of time. Medical textbooks, it is possible to overdo Dr. Parish has drawn on his long such deletion to the detriment of the work, experience in the field of clinical research, and such has been the case in some sections and as director of that aspect of the exten- of this book. sive and varied activities of the Beckenham On the whole, however, the book gives Laboratories, to present to the scientific good coverage in a remarkably short space, world in the compass of a short monograph and, while not sufficient of itself as one's a wealth of information accessible otherwise Sole book of reference, might well find its only after long and tedious reading through I,'' ay onto the student's bookshelf as a very a host of references. It does not aim to be handy summary of the theory and practice either completely comprehensive, nor to be of Medicine. the last word on the subject, but as a R. M. BIGGINS practical manual, it is a very significant Honorary Physician to Out-patients, contribution to an important aspect of St. Vincent's Hospital. biological research. It should not be omitted from the library of any institution which breeds or maintains experimental animals. D. F. GRAY. Assoc. Prof. of Bacteriology 58 SPECULUM

Industrial Health Round the Fountain An introduction for students by R. Round the Fountain — Pieces from St. Passmore, M.A., D.M., F.R.S.E., and Bartholomew's Hospital Journal, Fifth Ed Catherine N. Swanston, M.R.C.S., D.P.N., tion (Pp. 243). D.I.N., with foreword by Professor F. A. E. This collection of verse and sketches has Crew, F.R.S. been revised and enlarged in this, the first Published by E. S. Livingston Ltd., Edin- edition for 22 years. The period covered burgh (1950), pp 110. is from 1893 to 1949, but we don't have This small book, written for students in to have lived in 1899 to appreciate the Edinburgh, should be of use also (as the humour of "The Malingerer", or to have authors point out) to personnel officers, been a "Bart's" man to sympathise with the works managers, trades union leaders, indus- House Surgeon in "An Affair of Beds' • trial nurses, etc. The standard of the humour is uniform-1Y Although written primarily with refer- high, without recourse to smut, and all those ence to conditions and legislation in Britain who enjoy Medical Humour will get much it will be found valuable to English-speaking entertainment from the 100 or so pieces. students anywhere. Some serious verse is included. Correction of certain loosely expressed It is interesting to compare conditions ideas and incorrect statements would under which students in London worked at enhance the value of the book. the beginning of the century with those For example: Chapter two. "Health is under which we work today, and also to an individual subjective sensation". read the opinions of those on the receiving Chapter five: "A disease is occupational end of the percussing finger. when it occurs as a risk . . ." On page 56 the statement "at least 90 per cent. of all industrial poisoning follows the inhalation of dust, fumes or vapour" occurs. Surely "Gas' should be included. On page 58, para (4), "Particle" Size: This is probably the most important factor in the absorption of dusts through the lungs". This statement ignores the chemical nature E. & S. Livingstone, of 16-17 Teviot of the particles, and their number. Place, Edinburgh, 1, will be happy to for- Page 67. "The substitution of cellulose ward a copy of their 1951 catalogue of for benzene". The meaning can be guessed Medical books to anyone interested. at, but the statement as it stands is absurd. Page 55. "Substances such as phenol, lime, and inorganic acids, are dangerous because of their caustic properties". Surely Phenol is also dangerous if -inhaled as vapour. In dealing with factors affecting output no mention is made of nutrition, rationing, difficulties of housekeeping or fatigue due to The Editors wish to acknowledge receipt queueing for hours. of the following journals from other Medical The authors rightly stress the importance Students' societies: of the occupational history in diagnosis. The Review (University of Adelaide)' In spite of these faults this little book The Oxford Medical School Gazette, Revue can be recommended as an introduction to Medicale (1'Universite de Montreal), Irma"- the subject of Industrial Health. (University of Sydney), Trephine nimate D.O.S. (University of Queensland). SPECULUM 59

M.S.S. NOTES

During 1950 the Medical Students' audience. Despite the good attendance at Society conducted the usual functions, and this function, the Dinner was again a drain the traditional apathy of students towards on our resources. organised events was not always as marked In the realm of Sport, we were second in as history would have it. the Inter-Faculty football competition, and Lunch Hour talks were held on four saw some good tennis played in a match occasions. Dr. John Horan addressed the between the clinical and pre-clinical students Society on Recent Advances in Medicine —the latter were successful. as seen in America; Professor Sunderland, The crowning success of the year's activi- On. his return from overseas, gave us his ties, however, came in November, when the °Jmnion on Medical Schools in North Medical Medleys were held on the 30th America; the Professor of Biochemistry from of that month at the St. Kilda Town Hall. the University of Malaya, Professor Lugg The credit for this great event must go to formerly of this school), delivered a very Mr. Alister Cole and his sub-committee. Mr. interesting address on conditions in Univer- Cole proved himself one of the most active his of the Malay States, and illustrated members of the M.S.S. during 1950. In ins lecture with a beautiful set of koda- addition, we wish to extend our thanks to chrome transparencies—same showing Pro- all those who gave their time to the produc- fessor Trikojus in holiday mood. Our final tion of such an excellent floor show. Finally, speaker in this series was Dr. MacLaren_ our thanks are due to Mr. Leon Stubbings former Professor of Psychiatric Medicine. as producer of the show. He recounted his long experiences as a The First Year students rejoined the Medical missionary in Korea. Faculty in Melbourne in 1950. They showed The Lunch Hour films were supported in great signs of activity, even going to the reasonable measure, until word got around extent of organising their own dance. This about a colour film by the Parke Davis year, those who survived are welcomed into on the secretions of the Pituitary, Second Year, and we hope that their organ- SuprarenalNiprarenal and Ovaries. Interest waxed ising ability will be directed into the channels strong in the endocrines and scarce one of the M.S.S. Isolationism, now that Mildura absentee was noted among the pre-clinical is closed, will in the future be frowned upon. students. A collection on that occasion A vote of thanks is due to the Presidents boosted the petty cash balance considerably. —Profesor MacCallum, who retired during On June 23 the Annual Medical Dinner the year, and Professor Townsend, who took Was held in the Union House. The guest his place, both of whom were enthusiastic sPeaker, Professor Burke, spoke on the and efficient in their office, and were respon- °Pening of an Art exhibition, and was sible for much of the Society's work applauded vigorously by a very appreciative throughout the year. 60 SPECULUM

YEAR NOTES SIC ITUR AD NAUSEAM

FIRST YEAR

"Nature and Nature's Laws lay hid in night. all apparently survived to attend more God said, "Let Newton be", and all was lectures. light. Having struggled through myriads Of "It shall not be", the Devil howling Ho. physics problems, a few chemistry problems "Let Einstein be", restored the Status Quo. and some incomprehensible notes on an First Year of 1951 extends a warm wel- obscure topic cognomened Scientific Method , come to all overseas and interstate students h over our vacation, we have returned wit who are with us and we wish them all the renewed vigour to settle down to some success we hope we have ourselves. serious(?) study. Not until third term will It is a difficult task for some 200 students we fully realise and appreciate the benefits to familiarise themselves with one another of our hour's study between 2 p.m. and in three months, but it is felt that we have 3 p.m. on Wednesdays. done pretty well. Almost all of us can boast No-one in first year has done anything, of making at least one acquaintance whose spectacular this year, with the exception 01 christian name we know. The male students one individual who nonchalantly forsook are indignant, and rightly so, at the fact his career one week after the course began that there are not enough women to go for the delights unknown. This has made around. But then, some just aren't interested us very sober. in women when there are boys around(?) It is regrettable indeed that the writer As the year has progressed we have all can add no comments on Romance in firs t become intimately acquainted with the little .0 year, but we sincerely look forward to trials and tribulations the Med. student is 1° merry party in Wilson Hall early forced to overcome, viz., Mantoux tests, November, when we intend to show ou r B.C.G. injections and Scientific Method lec- examiners exactly what the younger genera' tures. First term's latter days found us all tion can assimilate in a series of 55-minute in the vicinity of the Medical school queued a play periods. This may be something of up with arms bared preparatory to having revelation to examinees also! our tender skins punctured. However, we But "Press on Regardless". SPECULUM 61

SECOND YEAR In second year we are a happy lot, In sport we were well represented by despite the loss of many friends to the axes Bruce (Spike) Jones, first in Melbourne of the first year examiners. To these, our High Jump and second in Hobart in Inter- sympathy, and to Andy, congratulations, for Varsity athletics. he is our first to take the matrimonial Theatrical talent is well to the fore. Revue plunge. artists from our ranks include John Booth, There has been no pairing off amongst Bruce Crawford, Bob Gunter and Joe Russo. us yet, but Frank and Heather have been Others made their appearances in the '50 seen in each other's company. Who is Freshers and to these, to Ralph Howard this man who furiously courts the fair Beryl, for his capable work as M.C., and to all We would like to know. Tony seems to who helped, go our grateful thanks. In show a lot of interest in the north side of this regard, Flossie claims that notwith- the dissecting room. standing a new body and two new engines, Some keen souls have been working, and the Renault is a genuine 1913 model. Also, it has been established that Mr. Legge is Beverley is reported to be speaking to Dick lecturing on Biochemistry. Rumours that again. hurricane lanterns were to be purchased for Congratulations are due to Les Heming- way, who took all last year's exe's, and to use in certain Anatomy lectures proved to Bob Saunders, who won the Zoology Prac. be groundless, but local medicos are doing Prize. Near misses were scored by Dick good business treating stiff necks. Despite Galbraith and Peter Kudelka. Miss Dyason's efforts last year, unkind Well that seems to be all the slander for remarks have been made in many Physiol. this year folks, so, with November looming, Prac. books. The fault is surely not lack I'll leave you to it. of Scientific Method. "Scalpel, Nurse; Read on, McDuff."

THIRD YEAR Nineteen hundred and fifty-one's third 3. A worthy member of the M.S.S. His Year is, like all others, a polyglot of last sterling work demands a mention. Vern Year's second and third years, who are now thinks he's crazy, but each according to in the traditional state of overwork. his ability .. . Among the personalities bequeathed us 4. A dark horse who won his way to We have: the S.R.C. 1 - A student of astounding spontaneous We've had no detectable shotgun wed- knowledge of very wide scope; one couldn't dings. We've had no weddings at all, as a Call him an encyclopaedia, but perhaps a t matter of fact. Nor have any murders, ext-book would fit the bill. Doubtless engagements, criminal libels or other such Bologna still mourns its loss. , 2. An Olympic Star who spends his spare crimes reached our ears. But C.C. and time exhorting us, both the athletic and the Roy still find things to say in odd corners, ordinary* to join the various inter-faculty and who says you can't make love in the *earns. dissecting room, while everyone else is at One foot in the grave. lunch, Peter?

62 SPECULUM

We were shown an envelope early in Paula Pitt, and Lizzie Sinclair. We must second term; it was addressed to— turn the tables on the women (and vice- •r. Max S versa) this year, boys, or they'll be getting 4th Year Medical Student ideas. Royal Melbourne Hospital On dit: and labelled Personal. We thought Maxie That Margaret P k Thought she was had been spinning a line, but he declares Going to be Sick. he never even tells them he's a med. student. That they took pity on Bernie last Spoils his chances, he says. November. Farrago tells us that self-confessed brat That all Short Sunderlands aren't flying - Bruce F thinks the women are beaut. boats. Or was that just a hasty cover-up, Bruce? That we're in the Hardest Year of the Congrats to Ex. winners Vern Marshall, Course.

ROYAL MELBOURNE HOSPITAL

Fourth Year Now Rina makes the nurses see That studes are glam—not drak. Whilst Dottie M. and Susie G. Of all the "studes" who pace the wards. Were moved a clinic back. There's none like Mrs. S. She never rests her vocal chords, And would it were Olympic Games Or gums—we must confess. Our Lethlean knows the pace. If Passion Pure the heart inflames 'Mongst gentlemen who nurses court Then Hopkins' is a case. There's none just like our Harry; But every sparkling eye knows Mort Of all the girls who bash the work, Who in the wards doth tarry. Good luck to Gwenda Chitty. To Phyl—Does love life make you shirk? Thus so, it is a Pity .. . When Pat arrived with inky red Some colleagues turned quite pale, Not killed as yet by motor bikes, They'd missed their chance. As good as Our Ray is full of go. dead, Perhaps there is a girl he likes Consoled themselves with ale. Who makes him drive 'em slow.

We have the leader of the Blues Intruders and Police and all. Who likes his ladies fit. What dangers now in college, There's Bremner who has lots of clues, But Heath and Di—beyond recall And Arnold who's a wit (?) Love to increase their knowledge. SPECULUM 63

McNeil and Roberts play good jazz and married at such a rate that we probably While Martin, fast with skis, haven't caught up with all of them. Amongst others Dot Bailhache and Al Cole, Len Has kept himself away from cas Weber and Boggy Grounds are engaged --The clues on birds and bees? without looking further afield than the R.M.H., as well as Hugh Williams, Neville There is no need to reach 5th year York, Len Champness, and Carl Schneider. To know about Obstets, Those who took the final plunge to the altar Jackson and Foster make it clear were Fred Hocking, Ian Nicol, Leg Sloane, 'No sleep when baby frets. Max Upfal and Jock Hill. Furthermore, Ken Digwood and John Morris are walking Perhaps the fact that Cony's rash around with proud grins on their faces, Has made him take the plunge. having recently both become fathers—both girls. And would Hale like the grogs that clash, Turning to outdoor sports, Ken Brealey Or is he just a sponge? led the R.M.H. tennis team which defeated St. Vincent's for the Haras Shield, while He leaves the wards at supper time Bill Prott led the R.M.H. football team And hurries off with books, which lost to St. V.'s (see below). Yes Rymer's keen. Now Dux (no rhyme) The Women's is living up to its reputation as a destroyer of souls. Even Buddha Baird A new nose for his looks. was reduced to playing solo. By a strange A case of verbal diarrhoea coincidence the Midwifery trainees' passing- out party was held on the same night as Oh, can it start with C? the Students' last night party (also a "pass- And does Bat Business include beer? ing out" party from all accounts). A good And congrats, Dickie G. time was had by all, and Ron Benson was congratulated by the Med. Super on being "But when our six long years are out the first student ever to coax a Tutor Sister Oh, then I'll marry Sally, into the students' quarters, let alone in the Oh then we'll wed, and then we'll bed early hours. But not in our alley". There must be a lot more gossip around which we haven't heard, and we apologise With apologies to Henry Carye, author of to those who should have rated, but didn't. Sally in Our Alley". We could mention George Bearham's short- lived attempt to hide his face, Bill Orchard's overwhelming keenness, etc., but we'll let it go at that till next year, when we'll all be Fifth Year , working hard and wishing we hadn't had Having been hounded by the editors for such a wonderful time in fifth year. Lseveral weeks we suppose that something On Wednesday, July 4, a vast crowd nad better be written concerning our doings, estimated at between 15 and 20 saw the although with a group and a bit away at battle of the "giants", when St. Vincent's e Women's and the Children's it is a bit played the R.M.H. at the Royal Park Mental hard to keep up with the gossip. With the Home ground. St. V.'s were a bit annoyed ertlyorary respite from exams the social at being classed the home team, but since acties are playing a prominent part and they were the challengers they had to lump most of us wonder what it feels like to open it and risk not being allowed to leave. Gerry a text-book in search of knowledge. "Barber" Warming led the St. V.'s team erhaps the absence of exams this year and Bill "Dasher" Prott the R.M.H., while hasput blokes off their guard, or maybe it's Ken Twiddy was in charge of the game. To e weather, but blokes are getting engaged make up for this R.M.H. tried to play 19 64 SPECULUM men after half-time, but decided that 19 ROYAL MELBOURNE were even worse than 18 and John Lear- Patron: Les. month joined the supporters on the fence. Coach: Sir Mac. Burnet. Captain Prott gave a stirring address to Backs: Devine, Rose, Hayward. his charges before the game. "Not too hard H.B.: Thomas, Coates, Kaye Scott. now—it's only a social game”. "None of C.: Grice, Keon-Cohen, Pennington your Socialism here, Prott", retorted Bill H.F.: Grayton-Brown, Heinz, Fairley. Orchard. With just enough good players to F.: Bolton, Julian-Smith, Frew. stop the game being a shambles a good Ruck: Dunlop, Ackland, Eddie. time was had by all. R.M.H. had cunningly 19th: Hughes Jones. brought along plenty of reserves and all the Trainers: Hooper, Rank. crocks went off at half-time and half a dozen Oral fluids (alcoholic) : Deverman. fresh men came on. Despite this St. V.'s Goal Umpires: Travers, Shaw. came from behind to win by a point. Both Boundary Umpires: Hilda Gardner, Beryl sides cheered when Hugh Boy kicked the Splatt. equalising goal. Gerry Warming sportingly Scorer: Gleadell. said after the match that he wished it had ended as a draw, and this and the rest of ST. VINCENT'S the game were discussed with many "draws" Patron: A. Brenan. at the Post Mortem held at the Mayfair. Coach: Keane. The R.M.H. wishes to thank St. V.'s for Backs: Biggins, Cahill, Healy. arranging the match and have issued a H.B.: A. Kelly, Osborn, Bilings. challenge for a return match. Tentative C.: D'Arcy, Rush, Morgan. H.F.: Newing, K. Hadley, Hayden. teams are: F.: Horan, R. Hadley, O'Loughlin. Ruck: Hughes, Johnson, F. Colohan. Final Year Trainers: Connaughton, Mortensen. The editors regret that these notes were Oral Fluids: Rowan. not requested until early in second term, Goal Umpires: Brew, O'Day. and that at this time there was no student Boundaries: Harty and Carey. willing to do the job. We know at least Scorer: Furnell. that Final Year at the R.M.H. is mad with The game is to be umpired by "Lightning the work! Trumble, of the Alfred Harriers.

ST. VINCENT'S HOSPITAL

Fourth Year John A— lamented his abysmal know' ledge of Anatomy, but few bit. The clinical supervisors looked at each Equipped with stethoscopes, plessors, and other, then at the Heavens, then settled the like, we set out on our new adventure; down in patient resignation — the Fourth It is thought that the talents of certain 0" Year students had arrived. our number were not fully appreciated by Spewed forth from the Physiology School certain Clinicians from the outset, which fae,t with the enquiring mind so characteristic of bears witness to their depressing lack 0' that hallowed place, we began, with the discernment. exception of Adrian, to peer into almost Interest in clinics rose high, and our desire everything Adrian peered into everything. to elicit histories became almost overwhe101; We had many odds, and quite a few sods. ing as we asked questions eagerly, and SPECULUM 65 nodded wisely to vague replies—and the accomplishments. Let us hope we see their vaguer they became, the more wisely we names appear once more in public when nodded. the results come out. Attendances at Post Mortems were nothing short of wonderful. Many of us qualified for the Brave New World as we carefully Fifth Year noted verbatim all that was said. Pity we Despite an altogether too brief holiday, didn't read it later—such a waste of pearls. everyone looked fresh and ready for some That soupcon of love was provided type of work when we resumed on January touchingly by Margaret and Steve, and 16 at the Women's. Tales of such epic Adrian took care of the lust. Dave Q feats as Gerry's holiday driving and Des' the People's choice, played football for the mountaineering were soon interrupted by Blacks, and became not only our Year Rep., the arrival of the inevitable Hugh, who but also one of the Med. Reps. of the S.R.C. landed along complete with his life-size Leo F (Bacillus Pestis) talked, and plaster cast of half a female abdomen at Hubert sneered. We all sneered, but Hubert term. There was a lot of conjecture as to more so than others. L. F. J. C who might have been the model. chortled, Syd grunted, and Bill H Having changed into the all-white colors gnawed his moustache as he thought of of the club, the budding Obstetricians ven- Anne. In fact, several of the gentry proved tured forth into the fray, reassured by the regular cards—these, however, were outdone encouraging thought that what you can't by J. G. G--, who returned regular cards manage can always be buried. They who from the local golf course. retained their enthusiasm beyond a certain Life for a harassed Fourth Year student period of time were promptly dubbed revolves around various foci, both severally "Jacks", and, being considered outcasts from and simultaneously. Daybreak Dan in the Society, ran a constant danger of having early hours of the morning, then a tutorial their spirits dampened by anything from a or Prac. work. Next comes a Sectio (or cup full to a cement bag full of H 2 0. The bissectio) Hodie, followed by lunch, remainder of the troops, comprising all but Which can be an adventure in itself, and about three, proceeded to partake of a most finally the Clinics. weird series of entertainments, ranging from It is at the Clinics that we really show our fake phone-calls to a most intriguing varia- talents, for the strains of "lovely case, boys", tion of the old war-time occupation of dive- or the dulcet tones of The Constable were bombing. In between times, one J. M enough to inspire confidence into the lowest would entertain unlimited numbers with life- of the low. like impersonations of Bill Chin's complaints A touch of variety was provided by Joe about the antibiotic shortage. C--, who would cheerily greet our long- Loudest voice was undoubtedly that of coated friends as "resident", "mate", or K. T y; who would parade the floor like "sport". Even the "Super" found himself a miniature sergeant, ordering the delivery relegated to the rank of "cobber". list, or letting fly with sundry comments An occasion of great rejoicing was Bill about the latest of "Hugh-boy's" achieve- MeC—ery's visit to the Hospital, about ments, or the approaching death, from the middle of first term. It is reported that collapse, of "DOS". "Chunder" had every- he came over to borrow a library book. one astounded — both because of 1 Tom K twirled his spectacles in amaze- unlimited capacity for downing the most ment at this unexpected honour. crude of beverages, and for his ability to So much, then, for our cheery band — converse 'with J. M for hours about his tis pity we have not the room to mention navel, or some other marine manifestation More of them. 'Tis even greater pity that of Oriental mysticism. the laws of human conduct will not allow "Anger" did not disappoint us — he kept us to print some of their more noteworthy up a constant barrage of work despite 66 SPECULUM temptations of the Plebs. Zac had all his In spite of all these distractions, we usual troubles, above all a severe U.R.T., managed ten deliveries apiece. and felt outdone in this respect when Having left the Women's, we moved en I. O'S— copped an acute appendix. masse to the Children's, where we learnt "DOS" was busy most of the time with his even less. (Except Zac, who found out the camera, but had considerable trouble with meaning of a dark shadow in a pelvic the fathers of his infants, who would persist X-ray). Here the most noteworthy happen- in ringing up this fountain of information ings were June's tireless efforts to clean up to inquire after the health of their offsprin , the students' room (it didn't do her any good Leon came near to having a nervous break- —she has since contracted appendicitis), down, not so much as a result of his Obstet- and the ingenious devices employed by some rical enthusiasm, but rather by reason of to get the required number of histories the never-ending vigilance which he kept written up. Here necessity was truly the in order to defend his domain against the mother of invention. savage hordes who would fain have ravaged Finally, we must give honourable mention it. Foremost in this latter group was to Andy A'H and John M—, who "Wilbur", who has since renounced his war- have decided (or, rather, consented), to like manner and became more docile under assume the double harness. We wish them the heel of the gentler sex. all the best in their more subdued lives. But above all else was the solo. Here And now we're back home with Hughie enthusiasm reached it's greatest heights, and and the Constable. the dulcet tones of Dick or "Roo" might be heard at any hour as they described their fortunes with the most delicate of phrases. Final Year From time to time the walls would rever- Work. Then work. Then more work. berate to the tones of "Hey, E., come Such were the thoughts which ran through and make a fourth", or "Struth, Bob, that's McArdle's mind as he slowly turned over the first three-trick foreign I've ever seen". the pages of the Sporting Globe, and soothed Meanwhile, on a lower floor, a "beginner's" a brow still hot from last night's party. The school was in progress, and here the voice only comforting factor was the knowledge of "Dool" might be heard to proclaim: that most of his fellow men were his equals "Hey, Wilbur, you've trumped my b— in ignorance. And as he sat he began to ace!" think—not, unfortunately, of the vast quan- More strenuous activities were also to tities of toil which might well excite his be seen—cricket was played in an atmo- attention, but rather of the doings of the sphere which might have put Lord's to past 12 months, and the amount of time shame, with Keith G and Des B— which he and his confreres had managed well to the fore. The latter entertained all to abscond with, without acquiring any and sundry with exciting tussles against knowledge whatsoever, or troubling con- Gerry on the tennis court, when not required sciences battered into submission by many on the cricket field. Finally, there was a years of loose living. little informal gathering on the last night, And he thought of the clinics which he had whereat K. G and "Syd" showed sur- missed (they took a good deal of thinking prising dexterity in transporting a heavy about, being very great in number), and of the day when one K. W— asked whose cylinder up two flights of stairs, and several turn it was to sit down in the clinic, whereat of the staff were cordially invited to supper. the clinician was greatly displeased, being The entertaining qualities of "Syd" and greatly his senior and therefore much more Jim P were never more in evidence in need of a seat. And it amazed him that than on this occasion, when they offered, the aforementioned K. W should still free of charge, many a helpful and practical find time, despite the demands of 'his final suggestion to the residents. year, to teach the juniors the art of Solo, SPECULUM 67 lest a fine tradition, built up through many despairing features of Banting which he had Years, should be allowed to die. How just witnessed. And the sight of the wise honourable of him to give his time to such mien of Griffin seemed to cheer the sleeper, a cause! And there came to his mind the for he was heard to cry out in his sleep, story of Thomas S g, who would not "At least, here is one who is not doomed let thoughts of the approaching battle to failure". remove from his countenance a radiant smile Even more distressing scenes were yet to Which has graced more weddings and cele- meet his eyes, for there came into view a brations this year than ever before in its group of white-coated students, among long history. The features of "Doom" next whom could be distinguished the counten- appeared before him, snarling at a host of ances of J. Sy, P. K y, and another Clinicians and doubting the existence of who was called Fraser. And as they walked, Rheumatic Fever—what a brilliant future their paths diverged, whereat some were must lie ahead of this sage. seen to lick their lips and enter a swinging As time drew on an overpowering weari- door, while others, carrying golf clubs, ness fell upon McArdle, whereupon he fell journeyed on. At this sight McArdle's face asleep. But even here his musing did not was seen to undergo horrid contortions, and end, for his tormented mind was seized by his body began to writhe. a terrifying nightmare, in which he saw his But fate willed that he be spared further friend and adviser, T. P. B g, lured horrors, for he was at this stage aroused from his work by the wiles of woman—no from his slumbers by Banting, who had just ordinary woman at that, but rather one of returned from celebrating the last few hours the Hospital staff with whom his relations of one M. O'L . For alas! the latter was were known never to stretch beyond the to be wedded on the morrow! academic. And there appeared also in this And so our medico aroused himself, and terrifying dream the form of Allan D betook him to his study, where there met his taking stock of his position, whereat the gaze a turbid mass of papers and books, dreamer began to despair lest he take stock some of whose pages had never yet seen too frequently. the light of day. Thus equipped, he set about In the course of time the dream began his task, locked his door, and at the time to change, and there came to his eyes one of the printing of this work there are many Marius G , his face shining as with who fear for his welfare, for he has never knowledge, in strong contrast to the drawn, since been seen by human eyes.

ALFRED HOSPITAL

Some may come, some may go, but we go Fourth Year on for ever. "Of making many books there Thus we weathered the storm. Many is no end, and much study is a weariness of moons have passed since our entrance to the fiesh"—but really, we need no encour- this hospital of hospitals—although I doubt agement from the Bible. II our young Romeo Dick has seen such So we are meeting the world. Perhaps Moons when outing with our fair ladies of it is the hospital atmosphere of having mercy. reached the tape in third year, but we are Mat. Med. with our Shakespearean friend more independent in our stroll, our broad- Was our interesting encounter, although mindedness is more in evidence, and we are some of us have yet to make the so seldom thoroughly enjoying the atmosphere of said statement, that "our numbers are up". medical B.O. 68 SPECULUM Some of our learned colleagues sallied Fifth Year forth in the May vac. to return with black haunting beards cultivated off the coast of Six months of the year have gone and Tasmania. We are wondering whether the everyone is saying that they really must endocrine disturbance was caused by the start work some time—secretly horrified at healthy sea atmosphere or the alteration of the thought and with not the slightest inten- the chemical environments of the cells tion of doing anything. themselves with the medicinal tincture of Of course, we started off on the wrong the non-stop Tasmanian hotels. Indeed a foot. First, at the Children's; there we had stimulus from the Tasmanian damsels may eight weeks of glorious summer weather have excited such a growth. not to be neglected by those interested in One of our inquisitive friends was heard sailing, golf and women, etc.; that is, in to ask B.G. about her health recently. "Not short, everybody. While this was going on so good. I have a sore on my lip." "Looks half our number were still on Vac. and like Herpes Labialis to me". "Don't be later on back at the Alfred, doing as much disgusting!" was the reply. as we were. Heard in a clinic—"Those lumps on his Following the Children's came six weeks abdo. stand out like dog's-er-tonsils." Now at the Women's, at the very mention of Betty B. didn't see what was so funny about which even the strongest amongst us turn this, so she made inquiries about it. "You pale and feel slightly nauseated at the take a look at a dog's tonsils," they said. thought of Liquor A. and stale beer. "I'm not going to go around looking at dog's Tempered by an unaccountable loss of L3 tonsils," she told them, "I might get bitten." each which was appropriated for no "Tommy" M. modifies his nocturnal apparent reason. Although we really think it activities during the day to become the is a paltry commiseration for the Women's hospital's "human proctoscope". after having G ge the Urger there John G. finds his stethescope works much for six whole weeks— better with the ear-pieces in his ears. The honorary thought so, too. And then, of course, there were several small suppers ably provided for by our While girls are dodging spirochaetes, mutual friend, our mentor, our guide — Hank is chasing preachers, Mrs Dorgan — and presided over by Cl-ve, And Bell is straining anal sphincters alias Bertie, assisted by our friend from To please his clinical teachers. St. V.'s, Gor - - n R. Yes, the verses really Sig R. shocked us by making an honest were sung by K . . . . y C. and the chorus. man of himself. We have seen the car and And we are being sent back there next are really beginning to wonder whether there Christmas, of all times; well, we can't lose is a girl. As for Maxy, he is worried lest another 3. . . . his twins should arrive at supps. time. Now back home at the Alfred, united with With no more ado let me say this now, our wives and such amongst the Nursing The IVth year students think life a wow. There are hard days ahead, Staff—telling everyone how hard we worked Tears may be shed; at the Children's and Women's. Diseases are rife, so I do you implore, Heard at the Women's by a Ward Sister Get off your tails you solo men four. —"I don't know what this place is coming And Baldy take note, Joanna you, too, to; I saw one of my Nurses the other daY, This going to "Claridge's" never will do. coming from the direction of the students So chaps at the Alfred, now turning that quarters at 6.45 a.m.—and she had to be soil, on duty by 6.30 a.m.—they all seem to be Wake up and start burning the midnight's so tired and listless on duty. . Ask fine oil. C.C . . . 1 W., Sister, or perhaps J . . . . n M.

SPECULUM 69

Among those who are openly flaunting Final Year their engagements are Bill Walsh and Ken For us, time, always valuable, is now Leversha. Geoff WW. . . . y is not so blatant. e,Precious as the weeks hurry on towards Dave Hodson is now obviously a father. September. Peter H. is the only one who He has asked us in these columns to extend has yet dared to wear a long white coat. an invitation to all 6th year to be at "Max's" The indomitable E.C. is still an habitue of on the day the results come out. Drinks on Phial Year. What will Speculum do for Dave. Alan Riseborough and Ceph. Day howlers when she graduates?* She recently are also new fathers. added yet another disease to the medical d Snowy T. still has a hankering after ictionary—"Policeman's Knee". schoolgirls, whereas Nellie W . . . . t .. . Final Year was well represlented at the well, he went to a bodrding school! Phil 1.:".11. "At Home" at the Dorchester on C . . . n is suffering fr in the hysterical- prilA 26. G. J. St . . . . t and Gaby phthisico-cholecysto-renal syndrome, pro- • n escorted two arctic foxes. nounced incurable. Ferg's cupidity has is said to be allergic to Jaguars. begat a Bugatti but forg,.. (sorry) forgot, Although the function was socially and However, it alcoholically a success it is rather a strain to tell him how to run cin the benevolence of the Students' Club may be in running order d the post- tc) bear a loss to the tune of £ 19. One finals pub crawl. Well-known honorary was unable to attend * Has Miss C. reform- d it are her because of previous "solid" Anzac Day colleagues merely forge 1? She has reunions. Another was able to attend in escaped Speculum this A'fred fifth Spite of them! year's, please note.—Ed. 70 SPECULUM

SPORTS NOTES Training has shown that Wright and fact, the backbone of the Shop team was Russell will be prominently listed in the undoubtedly the select group of medicos -- epics of forward division play again. In off the field. an effort to shock the opposition, 20-stone It was noticed that most of the Medical Mighty Menelaus was signed up, but instan- Faculty athletes competing in Inter-Club taneously cleared when he broke down and activities also went away to the Inter-Varsity confessed that he couldn't see the ball until Carnival in Hobart and it was not the fault it was six feet away. Ron Clayfield, who of that stalwart band that Melbourne were was injured 27 times last season, is reported defeated soundly. For the sake of brevity to be fit and keen as is centre half-back let us mention some performers and their Warming, who will be hard to toss. Finally, placings in various events. it is with deep regret that we announce the Carl Schneider, hop-step and jump, 5th• retirement of veteran Bill Reynolds. As is Maurice Dowall, pole vault, 3rd. known, Bill gave his best in Brisbane during Brendan Dooley, 440 yds. hurdles, 3rd. the last war, but endeavoured to help 'the Bruce Jones, high jump, 2nd. team along until his hearing and sight Keith Lethlean, 3 miles, 2nd. gradually faded away. A testimonial was Peter Bladin, discus, 1st; javelin, 2nd. arranged and the committee decided to Inter-Club athletics still awaken bitter present Bill with an inscribed chair from memories in M.U.A.C. members' hearts' which he could watch the football in his Old Melbournians scraped home by one remaining days. point in their semi-final against us. An offer by Miss Keogh to act as the The Medicos were fortunately able to add team's masseur was rejected by the chair- some vertebrate stability to the rougher man's casting vote. The selectors are schools around Hobart. This, of course , indebted to Dick and Lew for their offer being in a different sphere to the athletics of a nine-gallon in the event of Med's gaining before mentioned. At the conclusion of entry to the finals, and are confident, with e the carnival, our men returned to Melbourn the number of recruits available, of success. for a well-earned (?) holiday. The moral of it all is: "If there is one THE DIURETIC EFFECT OF CASCADE form of life more virile than a medical As usual, the Medical Faculty had its student, it is an athletic medical student." quota of athletes competing in Inter-Club "Oh, my shout? Mine's a Cascade, what's and Inter-Varsity Athletics in 1950-51. In yours?"

For all sporting equipment see the M.S.D. Correct sports equipment increases your enjoyment and ability at any game. See the M.S.D. first for your equipment and for helpful sporting advice. MELBOURNE SPORTS DEPOT 55 ELIZABETH ST. and 255 SWANSTON ST., MELBOURNE. 4 MU724 SPECULUM 71

spicula

Grant's Atlas, Preface to the Second Edition: "I am grateful also to . . . Mrs John Ross for figure 210." Figure 210 is "The floor of the Female Pelvis, from above, showing the relative positions of the bladder, vagina, rectum." Noble of her.

"Sir, could you make a hormone?" "Blood' oath!" Your seat is adjustable to suit your Convenience. — Airline Information Sheet. Dr. Fantl, in Biochemistry: In the latest planes, we believe, things "Some babies cannot tolerate mother's are the other way around. milk; they absorb it without breaking it down. These poor babies become skin rashes." Starling, 9th edition, page 1061. (A pointer legend in a diagram of Ougenesis.) Pansy explained the course of a half- "Maturbation Period". penny in a kid's alimentary tract. After it ound's illy, doe n't it? gets to the colon, well— "Subsequent events depend of the nation- ality of the kid's parents." "After each call, the donor has the option of serving again or withdrawing." —Red Cross information sheet. Heard in Zoology Prac.:— "You should be on to the thorax by now. I notice that some students are still playing EXPERIENCED FEMALES! with their Urinogenitals." Zig Zags. Folders. Overlock ers. Editor: "Could you contribute any article Pressers. of interest to Speculum?" Examiners. Freshette: "Well, if I could, I'd be too Advertisement for lingerie workers in ashamed to admit it." Carlton Chronicle. Heard in Dissecting Room: Lecturer, with hand in pocket: T.R.: "Well me dead." . . . now here we have an excellent Nearby woman student turns around. Physiological tool . M.M.: "Not you lady, you're next."

JIL 72 SPECULUM Second year Dissecting room chatter: "You don't see much for your money , "I've never spent all night with a bone and yet the perineum is a most important yet." region." —Anatomy tutor.

"Sufficient rest is not necessarily obtained The Neck is the hardest part of the by spending a certain number of hours in anatomy to get a grasp of." bed." —Anatomy tutor. —Miss Millis in Biochemistry. Which doesn't account for its popularity in that respect. "I got this off a lavatory seat, Doctor." "Funny place to take a woman."

He: "May I show you the way?" She: "No, thanks. I was shown that years Yank Student (answering a question in ago." a lecture): "Carncentration gradient." Pansy: "Yeah — er, yes, that's so."

"Nobody is quite sure how the lovely Their Douglas Bag result was very blushes are brought to the maiden's cheek abnormal. —I mean, in the nervous system." Miss L n asked them: "Are you —Pansy. sure you didn't have a leak?"

We learn that the publishing trade uses these code names for some of Shakespeare's There are three coverings of the eye: two works: lids and the micturating membrane, which 10in. . . The Taming of the Shrew. makes the eyes water." 6in. . . . The Merry Wives of Windsor. —Nurse's Physiology paper. Douche Love's Labour Lost. Wet . . A Midsummer Night's Dream. 2in. . . . Much Ado About Nothing.

What is man but a diverticulum? Second Year: "Is it possible to have a What is woman but an invagination? herniation from the scrotum to the inguinal canal?" Prosector Paula P "I don't see what you mean." Second Year: "You know, backwards." Bill Prott, giving the history of a female Paula: "I still don't see." patient:— Second Year: "You know, up from the "Her present condition really dates back scrotum to the inguinal canal—" (blushing) to the time of her first contact with Mr. "you know, in vasodilatation." Hughes-Jones." Paula: She MUST be a good sort." SPECULUM 73

Examiner in Anatomy Oral: "Is the Glans Heard at a college dinner table: Penis proximal or distal?" First Med.: "Hey B , have you Friction Fairy: "Proximal, Sir." drunk that urea yet?" Ex.: "It may be proximal to you; dear, Engineer: "What's this?" but it's distal to me." Second Med.: "I have to get up in the morning and drink a solution of urea." Engineer: "Cripes! Your own?" Woman undergoing Sigmoidoscopy in Alfred Clinic: "Shall I take my teeth out, Doctor?" "What do you think of the Korean position?" "Not bad, but the Portuguese is better." Dr. D y, to aged patient: "What can't you do now that you'd like Man presents at Alfred with three-day to do?" history of tumbler and bottle of vaseline in Rectum. Student: "Could I see you at your con- Condition relieved by Forceps Delivery. venience, sir?" Lecturer: "See me in my office, it's much Student: "Why did you come to the more comfortable." doctor?" Patient: "I had an appointment." Student: "Yes, but what brought you Z A in quiz talk: here?" "There are four types of secretion: Patient: "Taxi." internal, external, abnormal and menstrual." Student and nurse were leaving the Tom: Ah, Paris, it's a wonderful place. Nurses' Home at a highly illegal hour of Soon as you arrive they provide you with night, when they met a Sister and a Resident. taxi, a beautiful meal, a room in a good Embarrassed, the nurse stammered: hotel, food, wine, sexual pleasures at night, "We're just going out after hours, sister." and give you 500 francs besides." "That's all right, nurse, we're just coming Dick: "Garn, you've never been to Paris." in after ours." Tom: "No, but my sister has." Physiology Lecturer: "You use your rods during the night . . ."

An S.R.C. member's habit of wearing a short button-up-the-front dress to meetings was distressing Pooh-Bah Farfor. As she sat opposite him at one meeting he said: "For God's sake, why don't you wear a longer dress?" And Innocence replied: "I like showing my slit"! First Nurse: "What do you think Weary will set in the Nurse's Anatomy paper." Second Nurse (veteran of 12 weeks in 7 ,ccti North): " 'Describe the operation for the anastomosis of the oesophagus with the There is a divinity . . anus'."

7,!

74 SPECULUM "In animals with laterally placed eyes, you can't come up behind them and surprise them." —Physiology Lecturer.

"Do you know what good clean fun is?" IT'S "No, what good is it?"

Roy E n, when asked by the Prof. to define "labour": SO MUCH "It's expulsion of the products of contra- ception." He's a married man, too!

— EASIER Bill D at W.H.: "Dyspareunia doesn't mean it's hard to get." iopay by cheque Student Nurse in Anatomy paper: "The Anus is an orifice guarded by a spinster." (As told by Sir R. W-J.) D U R I N G and after your How to make a peach cordial — buy het University career, it's much easier to a drink. pay your accounts by cheque than by cash. You save time, there's no risk of loss and there's no need to carry A young American was boasting that they'd never get him in the Army. large sums about with you. Call "Look at my flat feet," he said. upon the Manager of our University "Listen, buddy," said a listener, "they're taking them into the Army with anything Branch—he will be pleased to give from club feet up." you further information. His last wish being to see the beautiful Korean countryside, the lad asked his doctor to castrate him. The obliging medico performed a bilateral orchidectomy in due course, and some weeks THE NATIONAL BANK later our hero received his call-up. Confidently he stripped for examination. of Australasia Limited "You could never get into the Army," said the M.O. "Look at your flat feet."

Library Digitised Collections

Title: Speculum: 1951

Date: 1951

Persistent Link: http://hdl.handle.net/11343/24174

File Description: Speculum: 1951