THE NEED OF RESEARCH

New Zealand Herald, Volume LXII, Issue 18943, 14 February 1925, Page 11

THE NEED OF RESEARCH

MEDICAL PROFESSION'S VIEWS. attitude of the minister. representations ignored, further action contemplated Officials of the British Medical' Association in Auckland express keen disappointment at the manner in which the Minister for Public Health, Sir Maui Pomare, has ignored the request by resolution of a record meeting of the profession for the establishment of an adequate research organisation for the investigation of infantile paralysis and other infectious diseases. Moreover, they dissent sharply, but in good temper, from "the Minister's immature conclusions on the subject," and announce definitely that it is the intention of the association as a whole to pursue the matter to essential finality. " The whole question of medical research," said an official of the B.M.A. in Auckland yesterday, " is fo come up for consideration before the council of the New Zealand branch of the British Medical Association at its annual meeting at Timaru on February 21, and the association is determined. that this matter of vital interest to the public shall be brought to a clofmte and adequate concluson. The Wellington division of the B.M.A. has passed a resolution similar to that of the record meeting of members in Auckland, and we want the State Administration to understand that our recommendation to the .Minister for Health is not merely the expression of a passing opinion. It is in no sense the impulsive product of this epidemic of infantile paralysis. Wo are determined to show that our recommendation represents the unanimous considered opinion of the medical profession on this fvit&l matter of research. The B.M.A. is the only organisation in New Zealand that is competent to deal with the position, and we are going to insist that this shall 1h; done." Tac Ministerial Review. The latest Ministerial statement on the subject of medical research was published in the New Zealand Herald yesterday. It reviewed the measures that have been taken by the Department of i Health in combating the epidemic of infantile paralysis and conveyed in plain terms to the public a suggestion that such mens- 1 ures were -complete in themselves, that the British Medical Association had 110 further precautions to recommend, that in the matter of research two experienced bacteriologists had been set apart for investigation of the disease, and that, in respect of treatment of cases Now Zealand was particularly fortunate. That is a scrupulously fair epitome of Sir Maui Pomare's statement. It may lie added, however, that the Minister concluded his review of the position with this observation: " Generally, I think it will be conceded that in this present epidemic, wc have done as much as, if not more than, any country with a similar visitation." This statement of Dr. Pomare was submitted to Auckland officials of the B.M.A. for consideration, and, if necessary, for an expression of opinion. A considered opinion was given, after inquiry and reflection, and it is of the first importance that the public should note with care the points of the official medical statement on the subject. Ho Hostility to the Department. " It should be understood very clearly that the 8.M.A., neither in whole nor in part, is hostile to the. Minister or to the Department of Health. The association's appreciation of what the department has done in co-operation with the public, the medical profession, and the press has been expressed, and it stands. There is nothing to retract, and no qualification is required. We have no quarrel with the department in respect of precautionary measures or with the equipment of hospitals for the treatment of cases' of infantile paralysis. There has been no necessity at any time for discussion of these questions either by the Minister or by members of the B.M.A. They do not come into the field of consideration at all. The supreme question for serious consideration is that of medical research. _ In this we must differ from the Minister for Health. Our considered opinion is that what has been done for the promotion of research is quite inadequate and far short of the aims of the Auckland and Wellington divisions of the New Zealand branch of the British Medical Association, as embodied in plain resolutions recommending the establishment of adequate investigation of this dread disease. "The Minister's latest statement, as published in the Herald, contains no new information for the medical profession. All that Sir Maui Pomare says was known at the record meeting of Auckland members of the B.M.A. That meeting was attended by SO per cent, of the total roll of Auckland members. "Ihev knew that Dr. Lynch, of Wellington, had been set apart from his duties at the Wellington Hospital for the purpose of investigating infantile paralysis. I hey also knew that Dr. Lynch was coming to Auckland, as he has come, to confer with I)r. Gilrnour, bacteriologist and pathologist at the Auckland Hospital, and also that Dr. Gilmour was to be switched on to similar research work. Apathy and Evasion. " In spite of that knowledge the great and unprecedented meeting of Auckland doctors, representing 90 per cent._ of the profession, deliberately and unanimously passed a resolution expressing the, opinion that further research work offered the only means of establishing the early diagnosis and successful treatment of infantile paralysis, and urging the Governrient to extend its efforts iri this direction by providing an adequate fund to pursue bacteriological and experimental research by medical practitioners. " The Minister for Health supported the resolution and assured the meeting tlrast he would do his utmost to carry it out. He practically guaranteed for it the sympathetic consideration _of the Massey Government. Is it surprising that we are now disappointed at the Minister s response? Indeed, there has really been no response at all. The result is rather more than apathy and administrative hikewarmness. The Minister has entirely ignored our recommendation. And yet we had the Minister's assurance that what w e had requested would be carried out! Ample Scope for Research, " Tt cannot be pretended that what lias been done for promot ing investigation of infantile paralysis is anything like adequate research. We know that Dr. Gilmour is not giving, nor can he give, all his time to research. He is an excellent man for such work, but unless a substitute is found to take over his important duties as pathologist for the Auckland Hospital, he cannot be switched on to give all his time to the investigation of infantile paralysis. The hospital patients and the medical profession depend on Dr. Gilmour's laboratory work and cannot do without it. There is no other equally competent man in the Dominion free to tako over Dr. Gilmour's routine duties, and it is nonsense to declare that he has been released by the Auckland Hospital Board for research .Work There is ample scope for medical research. So far in New Zealand we are Acquainted with the observations of similar epidemics in other countries. Our scientific medical knowledge of the disease is really negligible. That is a fair way to put the position. " The mam point of research concerns treatment of tho disease. At present the on jy treatment is by the injection of coniValescent blood into patients. We have no means just now of measuring the poWllfejr >of convalescent bloods. , There is

no practicable method of estimating their potency. They differ, but as to what extent*and why, we do not know. The very fact that large doses can bo given harmlessly may be evidence of impotency. We do not know. Hero is an important field for research, involving very patient and exhaustive investigation. Meanwhile, treatment by serum is largely an operation in the dark. The virtue of its defects is the lack of danger. No harm can be done to the patient through an overdose. But, in view of the inevitable limitation of supplies, exact knowledge of potency and the measure of dosage for different cases would be invaluable. That knowledge can be secured only through adequate research. " There is no other serum available, and there are no known method of producing another. Hence the need and importance of research. Diagnosis of the Disease. " Another important point is that we have no means of diagnosing cases at a sufficiently early stage to give proper treatment with serum. A further point is that 80 per cent, of all the cases that are infected do not develop paralysis. The patients are not paralysed and we cannot isolate them or quarantine _ contacts with them. Thus there is a tremendous possibility for the dissemination of infection. The germ may be lurking in such cases. Wo have ho means of determining the position. Research is essential. " The effects of serum treatment are still under consideration. It is_ still too early to promulgate definite opinions. No finalised effect has been established, and we have no means of standardising the serum. There is no end of valid reason for adequate research, and less reason against its immediate establishment. What is Wanted. " We do not look upon the Ministerial arrangements as representing a serious attempt at research. Nor do we consider it reasonable to anticipate conclusive results from such arrangements. "What is wanted is the establishment of a department of research under the control of a competent director with a fulltime researcher in each of the. four main centres, which soon will all be equipped with adequate laboratories. The research officers should be paid adequately, so that the best available men would be obtained and encouraged to devote all their time and enthusiasm to their important and laborious work. " The sum of £IO,OOO has been suggested as a fund for .the establishment of an efficient department of research. If politicians be inclined to consider that amount as beyond the resources of this prosperous country let them set it against | the enormous economic loss through the ' permanent effects of infantile paralysis. That loss is enormous. It. is practically certain that the Rockefeller Institute would be ready and willing to lend an expert to supervise the establishment, of a medical research department for New Zealand. The institute has already achieved wonderful results in Queensland I concerning the ravages of the hookworm. "In any case, wo are determined to pursue, our recommendation to practical finality."