A discussion on ankylostomiasis / G.M. Giles [and others].

Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A discussion on ankylostomiasis / G.M. Giles [and others]. Source: Wellcome Collection.

    15/16 (page 549)
    1138 Tn Btmn 1 Medical JocrhaiJ CORRESPONDENCE. [0 'OT- »3. 1900. Clinical lectures should Btill be delivered, and might with advantage, I think, be increased in number.—I am, etc., Cornwall Gardens, S.W., Oct. 5th. C. Frank WlGHTMAN. ®IR.—Your recent article on the above subject deals with a matter of great interest and practical importance. The respect paid to the lecture fetish seems visibly declining. Once ^“Oroughly laid it is to be hoped that not even Plato’s year will witness its resurrection. It is of course evident that two factors must enter into the training of the medical, as indeed any other, student, prac¬ tical observation resulting in first-hand knowledge, and some means by which he may be brought into contact with the 0 iservations of others, this latter having both a direct and an 1 j ject beariflg upon the former, serving at once to widen and direct it. These means resolve themselves into two—the lecture and the textbook. The lecture is a kind of middle¬ man’s product coming between observation and reading and is unnecessary, as such products usually are. I dare affirm i*h&t very few students, even the most brilliant, ever come asvay from a lecture with the consciousness of a thorough m istery of the subject descanted upon. A good lecture de¬ livered by an impressive speaker instinctively sends a man to his book to read the subject up.” His practical work will do this even more surely. No one, however, having mastered a division or subdivision of a subject in his textbook ever feels impelled to attend a lecture to cement his knowledge. He may go to the wards. b Inen, again, it seems tome that the psychological processes involved in earnest book study are more conducive to com¬ prehension and retention than those called into play in listen- uig to a lecture. If invoked, the shade of Macaulay’s school¬ boy would ^ tell us that visual perception, at least in adult life, is the most important of the psychological processes underlying cognition. Tne eye, moreover, is capable of a more prolonged stimulation that the ear without lapse of attention or sense of fatigue. In listening to an ordinary lecture the presentative aspect is purely auditory, the visual element being merely representative (as regards subject matter). In conning one’s textbook the visual process is both presentative «■ representative, and we can get auditory presentation as we«l if we read aloud. We can also invoke the powerful aid of repetition. Who would not rather follow a long close unin¬ terrupted stream of reasoning from his book than from a lecturer however eloquent ? lastly, the matter gained from a chapter in a good textbook well-digested and self-arranged is far more the product of one-8 own mind, and the action and interaction between the knowledge thus gained and the first-hand knowledge bom of observation far more valuable than can ever be the case with the predigested pap of the explanatory lecture, or the undi¬ gested encyclopaedic lucubration which does duty for the ambitious one.—I am, etc., Broomkill, Oct. gth. • E. W. Adams. INTRODUCTORY ADDRESSES FOR THE ROYAL COL¬ LEGE OF PHYSICIANS AND SURGEONS OF EDINBURGH. Sir,—After reading in the British Medical Journal the Various introductory addresses given to the students on the occasion of the opening of the session of some of the uni¬ versities and colleges of London and the provinces, it occurred to me what a pity it was that at the Royal College of Physi¬ cians and Surgeons of Edinburgh (one of the oldest, if not the oldest college), on the commencement of a new session, no such address of welcome and advice is given to the students. There is no doubt that such an address, which need not necessarily be a lecture, would appeal to students at once, especially to those coming probably direct from school or home, loaded with good advice perhaps from relatives, but not such advice as would be of use in giving them an all¬ round view of their studies. What an amount of guidance they would obtain at the commencement of their medical career advice and guidance of such a kind as they could only get from a lecturer or professor of their college. There always appeared to me to be some want of co-opera tion on the part of the lecturers and a lack of interest ' students as a body, which cannot but have Borne effect on the students individually. It must be evident to a good many that a good introductory address, such as is delivered at other colleges from time to time, given by one of the lecturers or by one of the members of the Governing Board, would be of infinite worth to a young student fresh to his work, and probably with not over-abundant knowledge as to the best steps he should take in his education for a medical career. The Royal College of Physicians and Surgeons of Edinburgh has many things in its favour and it ought to be to the fore;but is that interest for the well-being of its students shown to them by the lecturers which should ever be evident in a well- organised college, and which Would do much to improve the tone of a college, not altogether in the background ?—I am etc., Rusden, Nortbants, Oct. gth. P. Ashworth Wedgwood. THE PREVENTION OF PLAGUE. Sir,—It may interest Dr. Haynes to know that an officer in India offered to stop the plague in Bombay by burning down all infected houses when the disease was somewhat limited, and thus (so he thought) effectually putting an end to plague in Bombay. His offer was declined by the municipal autho¬ rities. A large number of houses and outhouses were, how¬ ever, levelled to the ground (without fire) with the hope of destroying every possible nidus for the plague germ, but without success, and many of the inhabitants were put to a great deal of inconvenience for want of houses. Other and less expensive methods have since been adopted, and appear to have been equally if not more effective, and certainly less inconvenient to householders. Would it not be as well, therefore, to study these methods before adopting the some¬ what radical cure suggested by the officer referred to above and Dr. Haynes, which will of necessity increase the troubles of the already overburdened taxpayer, and may after all be of little use in staying the disease, or preventing a recrud¬ escence of it, as it must be remembered that it is always liable to appear in one of our large ports.—I am, etc., Bedford, Oct. 10th. __ G. F. Poynder. THE DEBATE ON ANKYLOSTOMIASIS: A CORRECTION. Sir,—In the recent debate on this subject at the British Medical Association meeting, Major Giles is reported in the British Medical Journal of September ist to have said : J will not here enter into the old controversy as to whether this in¬ creased mortality known by that name (kala-azar) is due, as 1 maintain, to ankylostomiasis plus malaria or to malaria plus ankylostomiasis, as ad- vanded by Captain Rogers and Major Ross. What an utterly incorrect statemeafTof my views this is will be at once evident from the following quotation from my original report on the subject, in which I sum up the conclu¬ sion derived from a large amount of evidence on this point, thus: These facts prove incontestably that whatever kala-azar may be it is not ankylostomiasis, and, what is more, the latter disease is not even an essential factor in the production of the disease, and only complicates it in some 6 or 7 per ceDt. of the eases, just as it occasionally compli¬ cates every disease in Assam, aDd especially on tea gardens, and also I have no doubt in nearly every other part of India. Many other passages to the same effect might be quoted, but that my meaning was quite clear is evident from the fact that Surgeon-Colonel Stephen in his review of my report writes that he quite agrees with me that the facts I have re¬ corded “proveincontestably that, whatever kala azar may be, it is not ankylostomiasis, and that ankylostomiasis is not an essential factor in its production.” I have never, then, ad¬ vanced the view that kala-azar is malariap/us ankylostomiasis, but have always maintained that it is purely malarial in its causation and pathology, so that I regret to say that the dif¬ ferences between Major Giles and myself are not so slight as he has deemed it convenient to assume, since Major Ross has so definitely confirmed my work upon the subject, as shown in the quotations of my contribution to tbp recent debate. I may also take this opportunity of pointing out that when Major Ross says, in his paper in the same issue, that Giles’s work on the life-history of the ankylostoma has not yet re¬ ceived either confirmation or rejection, he appears to have overlooked the paper of the late Dr. Macdonald in the report of the first Indian Medical Congress, in which he states that