CORRESPONDENCE
HOSPITAL ECONOMY (To the Editor). Sir, —There has been much of late in your columns upon the score of hospital administration. Your correspondents have, however, taken up the subject from one standpoint only. Perhaps it would be interesting to view it from, another rather different angle. Economy! Economy! Economy! These words fall with nauseating effect upon the ears of a tired and jaded nursing staff, but nevertheless they continue to be the slogan of the authorities at the present time. Why? Perhaps the general public is not aware that, with the reduction of unskilled labour for assistance with the indoor work, the nurses have these duties added to their own. At one time a ward-orderly was supplied to each individual ward and one to the operating theatre, as well as a ward-maid to each of the two large wards. Now there are two orderlies to the entire hospital, and for the rest the duties fall to the nurses. Does the general public know also that, added to this deficiency, there is a very decided decrease in the numbers of the nursing staff itself? Where three or even four nurses were previously on duty, now there remains never more than two. Who then does the work? For any one who knows anything at all of hospital life very well knows the work must be done, and done to time.
It may be noted how very decreased the staff is >hen some twelve are patiently awaiting their three weeks’ annual leave, with apparently no hope of being relieved. This is despicable, as the summer days are fast drawing to a close. In speaking of holidays, it might be well to add that three weeks is the extent of a nurse’s leave for a whole year. At this Hospital there is no such thing as a day off. as in most hospitals. When the size of the staff warranted it, the night nurses have been able to have a night off a week, or a fortnight; even this is no concession, as night duty consists of not less than nine hours. However, this also is a thing of the past. Day nurses do a minimum duty of 56 hours, and the days off were distinctly promised, with the added accommodation of the new home recently opened. Fortunately, there has been comparatively little actual sickness amongst the staff of late, but the fact that four or five of the nurses have been “on duty” with septic fingers and hands goes to show a lowered vitality amongst those who should be in the best of health before being able to competently care for the sick.
This brings us to a climax —the relation of the tired nurse to the patient. Those who have had any experience in sick nursing will know that to restore a sick person to health again requires not only medical and surgical skill, but. added to it. tact, perseverance, sympathy ,and all other refinements of nature, and, I ask you, are these qualities generally found in tired and over-work-ed individuals? Is it to be expected, then, that a nurse, who is really only human behind her uniform, is to show all these good qualities and at the same time bear the loads of two or three in the carrying on of the routine of a ward as well as her own skilled work? It transpires, then, that it is the patient- he first consideration of all in hospital management —who suffers. Can it be but deplored that the administrators and officials neglect this point, the centre around which all else should revolve in their headlong attempt to economise? True it is that any large enterprise should call forth the greatest economy, so long as that runs along right lines; but surely that is false economy which lays added strain, mental and physical, on already heavily
burdened shoulders, for the sake of lowering cost.
Tn general fairness, then, to the nursing staff, the ratepayer and, above all, the patient and his friends, it seems only right to publish a few of the facts existing in relation to the nursing side of “Our Hospital.”—l am. etc., KI TIAKAI. HOSPITAL ADMINISTRATION (To the Editor). Sir,—Your correspondents, “Economy,” “A.8.C.,” and “Justice” have opened up a big subject and, to my mind, it is a pity that each shows party bias. Any one reading carefully will, I think, come to the conclusion that the form is against the government and that the two latter partisans of the management. It is also clear that each of the writers have the run of the inner workings. “A.8.C.” is correct when he says that good honest criticism does good, but accusing of ignorance leads nowhere. The letter of “Economy” in your issue of 29th ultimo calls for an answer by the Hospital Board, not by any irresponsible critic. I was pained to read the charges of extravagance and say most emphatically that if true the management should be altered. At present I have no reason to believe that they are true.
Most readers of your paper will remember that in 1924 I had a very considerable amount of correspondence in both local papers and spent a lot of time in obtaining information on this subject from all parts of the Dominion. The papers kindly published all my letters and reports on the subject, with the result that the Hospital Board set up a committee to go into the whole matter of hospital management in this district. The report of that committee was published in local papers on September IS, 1924. It made certain recommendations in the interest of efficiency and economy. On June 19, 1924, Mr Fletcher, on his re-election as chairman, in thanking the members, said: “I want to impress on the Board the urgent necessity of trying to retrench in some way. The expenses per bed were rather out of the ordinary. I am afraid we often voted for expenditure without due consideration. I trust that the members will try to economise as much as possible.” I accepted the admissions of chairman and Board, and, as I have already stated, have no reason to doubt but that economy has been enforced. I must candidly admit that I have not considered the matter since 1924, but if “Economy” can show clearly that the Hospital Board are squandering public money he can rest assured that I am behind him to the last ditch. In the past I have protested against administrative officers being allowed too much discretion in spending money that is not their own. I have great respect and confidence in the secretary of the Hospital Board, but “Economy’s” statements must be proved to be false.—l am, etc.,
J. SIDDELLS. THE HISTORY OF LIFE (To the Editor.) Sir, —One hardly knows what to make of “Plain Bill.” After stating that scientists have jettisoned the recapitalation hypothesis he proceeds to quote “authorities.” But not one authority supports him. All Professor Scott does is to warn students against pushing any theory too far—and rightly so. The quotation from “The Theory of Evolution” impliedly admits that the recapitulation theory is “a fruitful one.” And Professor Bateaon is only telling the truth when he says that the law of biogenesis is “only a rough approximation.” Haeckel said no more and no less. There are great gaps in the records of embryology, and Haeckel in several of his works states that it is only the lowest forms of life that the full stages in the evolutionary process arc shown. For instances he states, “Evolution of Man,” page 179, “However, this direct application of ontogenetic facts to phylogenetic ideas is possible without limitations only in a very small section of the animal kingdom. ’ ’
Professor Gamble is quoted by your correspondent, but again only half the truth is given. “P. 8. in his quotations usually knocks off when the authority states anything against him. For instance, just beneath “P.B. ’s” quotation from Gamble on page 231 the author distinctly states “The study of the development of organs leads to the conclusion that there is a broad recapitulation of past history in the development of the individual.’-’ Of course, as the professor states, man is at no time a fish, an amphibian, or a reptile, and no informed man said so. “The older history like a papyrus has received additions and alterations at a later date.” And no doubt these account for the gaps in the ancestral history of higher life. The quotation from McCabe is quite misleading: “We must confess that this embryonic development is still a profound enigma.” McCabe is not referring in this to the “recapitulation theory” as “P. 8. mistakenly thinks. And what in the name of goodness has Darwin’s discarded theory of “Pangenesis” to do with the matter? Is it honest to quote McCabe’s “We do not know,” as though this referred to the recapitulation theory, when McCabe is simply putting the helploss position of the neo-vitalists who when they postulate a mysterious entity causing life, instead of defining it in terms of mechanism ,speak in the hopeless words “We do not know.” Now, either “P. 8. knew that McCabe was not referring to the recapitulation hypothesis in his reference to pangenesis and to the vitalists, or he did not know. If “P. 8. did know, then he was not honest with the readers of the “Chronicle”; if he did not know, he
has not right to be taking part in this controversy. So, too, your correspondent is not strictly honest when he quotes Keith. Keith repeatedly says in his “Human Body” and in “Engines of the Human Body” that, roughly, ontogeny recapitulates phylogeny. Why, when quoting from page 95 of the “Human Body,” does not “P. 8. turn over to page 96, where Keith says. “We cannot expect the embryo to reproduce for us the early ancestral forms of life; these have been much modified and some of them replaced to suit the phase of existence within the womb.” And he goes on, “Yet in a broad way we see various stages indicated during the building up of our bodies.” And proceeds to give instances. He says of the grooves or depressions in the human embryo at a certain age, “There can be no doubt these represent the gill slits of fishes.” Again I ask, is it fair or honest to present this great scientist as though he were a disbeliever in the recapitulation theory? Sedgwick, quoted by your correspondent, belonged to a bygone age. As McCabe says, “Principles of Evolution,” the professor missed the whole argument by “ignoring the blood-vessels beneath the skin.’.’
To suggest that Professor Macßride is opposed to the recapitulation theory is just rubbish. See his “Introduction to the Study of Heredity” page 56-61, and particularly at page lOS, where he speaks of the “recapitulation of ancestral history which is such a prominent feature in animal development.” What do readers of the “Chronicle” think of the methods of such a controversialist as “P. 8. What is his object, I ask again? As an old university student myself, and as the father of a youth entering on a scientific course in the university, I have had occasion lately to look into the works on biology used in our four university colleges. They comprise works like Thomson’s Zoology, Parker’s Biology, Dendy’s Evolutionary Biology, etc, etc. Not one of these works throw the least discredit on the recapitulation hypothesis; in fact .they ail teach it. I ask “P. 8. again, are our university colleges, and the eminent professors therein, teaching their students a fabrication? Will he make a protest against such teaching to the governing bodies of these institutions? If the hypothesis has been jettisoned, as “P. 8. states, why did such eminent men as J. A. Thomson and Arthur Dendy teach it in England? Can he name one prominent university or one eminent biological teacher who doe.s not teach it?
In conclusion, Air Editor, may I ask how is it that men like Bateson and Macßride are so often quoted as though they were opposed to evolution? Certainly neither of them is in the first flight as a scientist. In fact Professor H. F. Osborn in a recent number of “Science” says that “Bateson is quite outside the main current of biological discovery and his opinion that we have failed to discover the origin of species is valueless and directly contrary to the truth.” Bateson is often quoted by religious apologists like “P. 8. as though he were quite opposed to evolution, whereas in fact if “P. 8. will extend his reading he will find in numerous writings that Bateson has expressed his faith in evolution. For instance, in “Huxley and Evolution” he writes, “The grounds of the evolutionary faith are otherwise so solid that no alternative can now be considered.” In view of the use that was being made of his name as though he, opposed evolution Bateson was forced to make a public disclaimer that he was opposed to evolution. Macßride is the only biologist in England who believes .in the transmission of acquired characters, but as a scientific reviewer in the “New York Nation,” of his work on “Heredity” shows, he has no acquaintance with the latest research work in biology during the last 10 years. It is useless quoting second raters on this question of recapitulation, particularly when the second-raters, as well as the more eminent scientists, are all in favour of the hypothesis. I am glad that we have “P.B.’s” admission that Sir A. Keith does not believe in “missing links.” No one believes in “a” missing link, and the idea that scientists believe in “one” missing link is just a flight of imagination on your correspondent’s part.—l am, etc., JOHN BLUNT.
LIFE HISTORIES (To the Editor). Sir, —I have read with interest the correspondence in your columns on the subject of “life histories,’’ and was very pleased to find so much study devoted to this very fascinating problem. Your correspondents certainly produce an imposing array of authorities, but I cannot altogether admire the way “Plain Bill” displays his case. It is very misleading to dissect a lecture and pick out a sentence here and there, without any reference to the context, and pretend that this is the author’s view. For instance, he says Prof. Macßride says that “many naturalists now speak slightingly of this theory” (recapitulation); but he omits to add that this distinguished zoologist in the very next sentence says, “although recapitulation is the main factor in determining development, other factors have co-operated,” etc., etc. It is the same when he quotes Sir A. Keith as saying “the general feeling is one of disappointment,” etc. He does not add that Dr. Keith further explains this by observing “The truth is we expected too much. . . higher animals are adapted for two lives —one a peculiar vegetative existence within the womb, and the second a conscious life which commences with birth. . . but there never was, there could not be, an individual or ancestor which passed its whole life thus .enclosed within an cnevelope of foetal membranes.” Considering the wide knowledge of “P. 8. he might also have told us what Prof. Thomson (surely a zoologist of some merit) has to say on this point. He refers to “serious errors in the careless statement often made that man in his development is at one time like a little fish, at a later stage like a little reptile. . . primitive mammal,” etc., ‘ ‘the comparison should be made with embryo-fish, embryo-reptile embryomammal, and so on. It is in the making of the embryos that the great resemblance lies.” It is trespassing on your good nature, Mr Editor, to take up too much of your valuable space, but I think it is unfair, to say the least of it, to pretend that these scientists are in accord with “P.B.’s” hazy opinions. Thanking you in anticipation, —I am, etc., OPEN MIND.
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Bibliographic details
Wanganui Chronicle, Volume LXXXIII, Issue 19504, 4 February 1926, Page 10
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2,663CORRESPONDENCE Wanganui Chronicle, Volume LXXXIII, Issue 19504, 4 February 1926, Page 10
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