A DOCTOR DEBATES

Otago Daily Times, Issue 23649, 5 November 1938, Page 4

A DOCTOR DEBATES

LAY AND MEDICAL QUESTIONS " Notes From a Backblock Hospital." By G. M. Smith. Christchurch: Caxton Press. 7s 6d. This is a book which would be difficult to catalogue, for it contains chapters that are directed to the intelligent layman, chapters that have their principal interest for hospital and nursing authorities, and some, of a technical nature, upon which few but members of the medical profession could pass judgment. From the lay reader's point of view, Dr Smith's discussion of " The Essentials of a National Medical Health Service for New Zealand" is undoubtedly the most important part of the work, for it presents in reasonable detail the outline of a system with unfamiliar features. The author proceeds on the assumption that the system which has existed to the present "does not make available to the people of New Zealand the benefits that modern medical science has made possible." He claims that the direct financial interest of the doctor in his patient is in antithesis to the health objective of the latter. He recognises that complete economic security for the doctor is his first and essential requirement in a changed order, and advocates that the principle of the guild should be introduced in order to give medical men a rhance of administering their own profession. The " complete nationalisation " of the hospitals is postulated as the first step in the provision of a national health service, and the author would have highly-qualified surgeons and directors from overseas appointed to each of the large central hospitals. These would be allowed to appoint their own staffs, and would be held responsible for all work performed in their particular spheres. The special clinic system would be developed, with specialists in each branch—cynsecological. psychological, orthopaedic, and so on—making available expert specialist attention to everybodv. The modern general practitioner " will do quite different work. His work will mostly be preventive; and he will be a specialist at his job and will require special training. All this will take time, and will probably have to be done gradually A great deal of domiciliary work done at present by doctors is reallv nurses' work. A really sick man should be in a properly staffed and equipped hospital.' In his evidence before the National Health InvesHsation Commission last year Dr Smith provided n summary of the system which he advocates for the country districts and (his is reprinted here. , The Mareo murder trial gives the author opportunity for an examination of the case which leads him to the conclusion that the accused was convicted on the most slender and dubious evidence. His experience in Native districts is made the basis for suggestions for the education of the Maori race upon lines that are now finding some favour with the Administration. In subsequent chapters Dr Smi'h explains, for the benefit of the profession, his technique of painless childbirth, by the use of nembutal with hyoscine. a treatment of which he has made a special study, and one attended by great success at the Hokianga Hospital, of which he is medical superintendent The advantages and disadvantages of this technique are discussed at length, and there is a record of 100 consecutive cases in which all relevant statistics are r 'iven. Statistical tables compare

the results of this technique with the results from the St. Helens Hospitals in the main centres. Other chapters deal with the surgical use of cod-liver oil, a method of closed or semi-closed anaesthesia, a medical "log" of a case of ruptured uterus, and "upanishads" for " occasional" surgeons. Mr Douglas Robb, F.R.C.S., contributes a chapter on injection procedures in surgery. " Notes From a Backblock Hospital" is a provocative book. Its author holds many views upon medical theory and practice which are not those of the members of his profession generally, and as many upon economic questions on which economists differ. But it is also a very stimulating book, in those chapters in which a non-medical critic may assume to exercise his judgment, and it must rank as an interesting contribution to New Zealand literature in a specialised sphere. J. M

Hardy Inn A correspondent of the Saturday Review of Literature reports the discovery of a Thomas Hardy Inn at Stonington, Conn. The Hardy commemorated is Sir Thomas, in whose arms Nelson died at Trafalgar ("Kiss me. Hardy"). He reports also that the house passes a decanter of sherry offering the visitor a complimentary drink to Sir Thomas's health. Mr Noyes's "Voltaire" Messrs Faber and Faber announce a re-issue of "Voltaire," by Mr Alfred Noyes. The controversy arising out of this book occasioned a long correspondence in The Times The new publisher's announcement follows a letter in The Times in which Mr Noyes declared that "the whole affair" had reached " a satisfactory conclusion." Thomas Wolfe The American press records the death at Baltimore in September of Thomas Wolfe, the author of " Of Time and the River," in his thirty-eighth year. In an editorial tribute the Saturday Review of Literature states: The sense of young dying in Tom Wolfe's case comes less from his age than from the sense that he was unfinished, perhaps not yet developed fully, though full still of a seeing, hungry remembering of life and the eager energy to set it down. But, as Tom Wolfe, living and writing, was almost a figure for the personification of Life, so in his dying he moved out of life not in the sentimentalised terms of a minor poet who died young but as almost a legendary figure in man's ancient and unequal conflict with the grisly adversary New Zealand Tales in Canada The Canadian press contains lengthy notices of the recently-published "' Tales by New Zealanders," edited by C. R. Allen. All the reviewers express interest in a venture which brings the writers of a sister Domh.ion into print. The Montreal Gazette remarks upon the evidence in the book of a culture characteristic of New Zealand, and the idea of the British Authors' Press in introducing works which will help to familiarise the different peoples of the Empire with the life of their neighbours is commended. In more than one notice reference is made to the unfamiliar beauty of Maori legend, and it is interesting to find the Canadian critics continually tracing an identity between the concern of New Zealand authors with their Native race and the early preoccupation of Canadian writers with the Red Indians.

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