Document DMg9Kmzwrx5pO8NKRjQvRBqrB

258 THE PENNSYLVANIA MEDICAL JOURNAL J anuary, Additional Data on Medical Economics Bucks County ..................................................... p. 274 Delaware County ................................................ p. 277 M E D IC O L E G A L Employer Must Pay for Medical Service Al though Em ployee's Claim Is Disallowed.--The Ne.w York Appellate Division, Beckman vs. Clainan, 280 N. Y. S. 75, holds that the fact that the claim of an employee under Workmen's Compensation Law was subsequently disallowed by the State Industrial Board because not filed within the statutory period does not /gljeye jjje employer of his obligation to pay a third person who furnishes medical service on the employer's authorization and without knowledge of any disallow ance of the employee's claim.--Medical Record, Oct. 15, 1935. Inadequate Damages.--The New York Appellate Division, Mathews vs. Brooklyn etc. Corp., 280 N. Y. S. It3, held that a verdict of $200 to a woman injured in a car accident and $125 to her husband for expenses and loss of services w'ere inadquate where the wife's injuries were an inflammatory condition oi the bursa of the right ankle, sprained ligaments, contusions of both legs and of the muscles of the lower part of the back and right side of head, resulting in severe headaches and necessitating confinement in bed for 3 weeks, and th husband's actual expenses' were over $250.-- Medical Record, Oct. 15, 1935. Surgeon's A uthority to A uthorize O peration at E m ployer's Expense.--It) an action by a surgeon against an employer for services rendered to a person who had been employed for 12 years by the defendant and who, 5 days prior to the operation in question, had been laid off temporarily, the New York Appellate Di vision, Moss vs. McCarthy, 280 N. Y. S. 137, held that the evidence sustained a finding that the plaintiff called the surgeon, who was clothed with apparent authority to bind defendant for medical services rendered to em ployees of the defendant, and that the surgeon, with authority to act for the defendant, authorized the opera tion to be performed at the expense of defendant.-- Medical Record Oct. 15, 1935. I Iffi;. M ississippi's S trong M edicine.--Driven to drastic measures by the alarming increase in unjustified mal practice suits, the Central Mdical Society of Missis sippi has adopted a series of resolutions stating that to carry these suits thrugh the `courts often requires the collusion of members of the legal and medical profes sions; it speaksiioi them as legalized blackmail. In order to combat this ; increasing tendency, the organ ization has forbidden.:-`every Member of the society to give evidence in malpractice action unless the testimony has been examined and proved by those designated in the society for the purpose. Through various steps all the evidence is investigated and then put up to impartial medical "consultants," who then express in writing their individual opinion as to the validity of the suit. The physician will be encouraged or forbidden to testify ac cording to the opinion of these consultants, who are considered to be absolutely fair and impartial experts. If the physician testifies without paying proper atten tion to this deftiston, he will be expelled from the .so ciety for .unprofessional conduct.---N. Y. Stale J. Mr., Oct. 1, 1935. M edical T extbooks in Evidence.--The knowledge and qualifications of a witness as a medical expert nrajnjjtekll be tested as against accepted authorities on the subje|p:=|,. * testified about. And the Texas Court of Civil Ag? peals, Hess vs. Millsap, 72 S. W. (2d) 923, holds that the same rule should apply to a picture as to the writf.T . ten text. In an action for burns allegedly caused, by the negligent operation of roentgen rays, resulting.bj .. baldness, while the plaintiff was being treated for viis, a picture from a medical textbook was allowedit^^. < be introduced in evidence to test the weight of the Stfcjj mony of a physician, the witness on cross-exaniinatiofl describing the picture as showing "a moderate iniectiogf,' because the patient has hair scattered over his scalp/, Medical Record, Oct. 2, 1935. HOSPITAL ACTIVITIES A dm inistrative Problem s.--The depression have been trying years lor commissioners, trustees,, superintendents, and administrative officers of hospitaU. Trying in the sense that the hospital, despite a decrease- in revenue, must remain open and be efficiently main- `"'f j a a w tained. and an adequate personnel must- be retained and ;Lj-'bf'S paid a living wage. All hospitals, large or small, have suffered, bul.tljp /- small hospital has possibly suffered the most. In oonr.e stales federal aid has been possible. In Pennsylvania we have had to rely on the generosity of the comino^ wealth through its state-aided system. Administratively,,a hospital is not unlike running a machine. If the car is fairly modern,.controlled by safe hands, and its mechanism kept in order, mainte nance resolves itscjf .-into the cost o the operation, .* . minor mechanical adjustments, tires, gas, and oil. |p time, however, the uj^chine collapses and accidents ar prone to . occur. . . 3` Many hospitals tonday are.;not new.,, The physical units are in need ofir.epairs and adjustments. Mainte- j hancc allowance resolves itself into tires, tubes, and oil. Mny` a're forced to use old tires with but one result, a blow-ot, and a horrible catastrophe will'ensue. Particularly is this true in mental hospitals through out the country which have not been fortunate enough to, procure federal relief. Money for capital outlay is hut a.hoy sent on. a man's errand. Overcrowding and fire hazards exist) the tires and tubes figuratively speak ing re worn to the thread. Ttyc .S.Lge is all set for a catastrophe th^.t will startle the civilized world, and beneath the smouldering embers 0|je beholds the remains of what the world has been looking for--"the forgotten man." .Fate and tragedy will have revealed him. Such possibilities make our administrative problems trying indeed.--Mental Health Bulletin, Oct. 15, 1935. INDUSTRIAL M EDICINE Lung Disease Increases W ith `Asbestos Indus try.--A serious public health problem, pulmonary asbestosis, has arisen in recent years as a result of the fourfold increase in the manufacture bi asbestos prod ucts. The health hazards of the asbestos industry were pointed out to the American Publi Health Association by Dr J. Connolly, Huntersville, N. C. Lack of protection from the inhalation of asbestos dust has been the cause of the .disability of many work- FILE NAME: Pennsylvania (PA) DATE: 1936 Jan DOC#: PA005 DOCUMENT DESCRIPTION: Medical Journal Article - Lung Disease Increases with Asbestos Industry . 3 J anuary, 1936 THE PENNSYLVANIA MEDICAL JOURNAL ers. Rontgen-rav films were.made o 151 worker's in asbestos mills; 52 films showed definite evidence Of lung disease. Of the 151 workers, 86 had worked in the industry for periods varying from 4 to 20 years. In this group were found 51 of the positive cases of asbestosis, a percentage of 59.3. Only one case with positive roentgen-ray evidence of asbestosis had worked in the industry less than 4 years. The positive cases were 34.4 per cent of the total, 151. Five films of this series showed a healed tuberculosis with no asbestosis, and 3 showed a healed tuberculosis complicated by as bestosis. These workers had spent from 4 to 10 years in the industry. There was no evidence that their work tended to reactivate their tuberculosis lesions. Asbestosis is a slowly progressive condition after it is once acquired, even though there has been cessation of exposure to the dust for extended periods.--Science News Letter, Oct. 19, 1935. Propose an In sti.u te of In d u strial Medicine.-- A national institute of industrial medicine to protect the health of American workers was proposed to the American Public Health Association by Dr. Henry H. Kessler, medical director of the New Jersey Rehabilita tion Commission. The working group must not be looked on as a special class, for today it forms the larger part of the entire population and, since the mechanization of agriculture, includes the farmers of the country. The average worker lives 6 or 8 years less than the average member of the population, Dr. Kessler pointed out in calling attention to the need for special means of protecting this important class. The institute as outlined would have a fourfold func tion. It would promote research in industrial diseases, sponsor a campaign to teach the worker how to pro tect his own health, promulgate legislation for the pro tection of the worker, and develop standards of in dustrial health. Aii important function of such an institute would be the creation of a panel of qualified medical and non medical experts who could be called on in litigation over industrial diseases, compensation cases, and the like, thus correcting the present abuses in law cases involv ing occupational disease. The proposed national institute of industrial medicin is in line with the present trend of governments assum ing more and more responsibility for the protection of life and health of individual citizens. The 2 chief occupational diseases are silicosis in the dusty trades and skin diseases from exposure to imitat ing chemicals in various, industries. -Scknce News Let ter, Oct. 19, 1935. New Bl< >d T est Reveis Approach of Lead Poisoning.--A tes` which shows the appro; :h of lead pfllsdning before the disease has actually developed was fpofted by Drs. Carey P. MlcCord and F. R. Holden and Jan Johnston of the Industrial Health Cpnservancy Laboratories, Cincinnati, to the American Public Health Association. The test is: particularly valuable in protecting in dustrial workers who are exposed to lead in he course of their work. By means of the test, which ,is called the basophilic aggregation test, the physician can tell whether or not lead poisoning is the early prospective lot o* the individual being examined. "In this test," Dr. McCord explained, "counts are made of embryonic Hood cells, which in normal persqn rarely exceed 1 per cent the total number of red cells in th blood but which in the case of lead poison ing may amount to much higher percentages, such as 4, 6, or 10 per cent." An extensive lead poisoning epidemic which took place in the automobile industry in 1934 and 1935 pro vided an opportunity for evaluating the new diagnostic procedure. In this epidemic 8000 tests were made with results more than 95 per cent accurate. The epidemic resulted from the use of metallic lead in automobile body production. Lead in the form of dust and fumes was inhaled by exposed workers, with the result that many hundreds were injured by this industrial intoxication. The total number of persons either affected with clinical lead poisoning or who evinced evidences of lead absorption is not known for the entire industry, but it has been set approximately at 4000. This epidemic of lead poisoning has led to many changes in manufacturing processes in order to obviate repeti tion of this occupational disease outbreak. Already in many automobile plants control appliances and prac tices have been installed sufficient to make unlikely any large number of poisoning cases.-- Science News Letter, Oct. 19, 1935. PHYSICAL THERAPY Light Therapy and Roentgen Therapy in T uber culosis.--Edgar Mayer, New York (Journal A. M. A., Nov. 16, 1935), points out that light therapy, both natural and artificial, is of definite value in the treatment of some forms of tuberculosis. Natural heliotherapists, especially those working in high altitudes, eitiphasize solar radiation and aerotherapy. On the other hand, those in cloudy climates have stressed the use of arti ficial lights and still others, on occasion, the roentgen rays. Benefits are undoubtedly obtained by patients suffering from tuberculosis of the bones, articulations, peritoneum, intestine^ lymph nodes, and larynx when the entire body is exposed to carefully graded doses of natural sunlight or to radiation emitted by certain arti ficial sources of light rays. The beneficial results of such irradiation are due not only to ultraviolet rays. The visible and infra-red rays, as well as the condi tions of the atmosphere, play a certain part in the therapeutic effect. In tuberculosis of the skin, lupus vulgaris alone can be said to respond specifically to light. Scrofuloderma and erythema induratum react favorably at times to general and local exposure, al though not as constantly. Lupus erythematosus does not respond to and may be aggravated by light. In tuberculosis of the b nes an articulations, it is general ly agreed that suitable, graded exposure to natural sun light is most effective in aiding the healing accomp.ished by' orthopedic and 'ther measures. Exposure to arti ficial source' is ; second choice. Pulmonary tubercu losis is not an indication for light therapy; stationary pleural tuberculosis has often been helped by this meas ure. Genito-urinary tuberculosis deserves a trial of such treatment in combination with other measures. Local exposure to ultraviolet rays of circumscribed tuberculous lesions of the urinary bladder has been shown to yield favorable results, but the method re quires special applicating devices and, above all, skill ful treatment of. the bladder lesion. Ocular tuberculosis and aural tuberculosis respond infrequently to light. Oral tuberculosis is, most resistant. Fistulas .are often resistant to such treatment. Postoperative sinuses, in contrast, are most responsive. Intestinal, peritoneal, and lymph node tuberculosis especially indicate therapy and often are rapidly responsive. In tuber-