Canad. M. A. J.

Junel947;vol. 56 i

CLINICAL AND LABORATORY NOTES.

667

pose of base beds, in association, at present, with

CLINICAL and LABORATORY
the medical centres of Edinburgh and Glasgow.
NOTES
London presented a special problem, as
Greater London includes about 25% of the popuREGULATIONS FOR THE USE OF
lation of England. It has been divided into SHORT-WAVE DIATHERMY EQUIPMENT
four regional areas. At this time one of the
If you employ short-wave diathermy in your
diagnostic centres has been established. The
existing department of rheumatic diseases of practice, the law on the suppression of radio
the West London Hospital represehits the first interference is of vital importance to you.
of these centres. Certain of the other teaching Briefly stated, you are required to suppress the
hospitals have special departments dealing spe- radiation from short-wave diathermy machiines
cially with these conditions which will no doubt effective January 1, 1948. Most therapeutic
be utilized as the scheme grows. The base bed radio-frequency generators now in use, because
problem is difficult to adjust due to shortage of of inherent frequency instability, will not be
beds. However, at this time part of a county permitted to operate after January 1, 1948,
council hospital and a fifty bed experimental without being adequately shielded. The Canaunit are caring for some of these patients. As dian Broadcasting Act, 1936, included a section
well as these, there are a limited number of beds for the control of radio interference, and regulations were subsequently made under this
in the teaching hospitals.
In review, the main advantages of the scheme Section in February, 11941. Owing to the
shortage of material during the war, it was
presented above would appear to be:
A. Provision for early case finding by means considered impracticable to enforce these Reguof: (1) Peripheral clinics supervised by physi- lations with regard to short-wave diathermy
cians trained in diagnosis and investigation of equipment. As material is now available, and
these conditions. (2) Postgraduate training of the interference is becoming more and more
general practitioners in the recognition of the critical, all interference of this type must be
suppressed.
early manifestations of rheumatic diseases.
Radiation from electro-medical apparatus
B. Provision for trained specialists and investigation facilities to enable adequate early including tube-type diathermy and short-wave
machines occurs in two ways: (a) into space
diagnosis, and facilitate research.
all directions and for'great distances; and
C. Provision for long term hospitalization and in
(b) along power transmission lines. This radiarehabilitation of this long neglected group of tion
of energy is causing serious interference
chronic sick.
to radio communication as the radiations are
transmitted on frequencies allotted to radio
I am very grateful to Dr. W. S. C. Copeman, O.B.E.,
M.D., F.R.C.P., medical secretary to the Empire Rheu- aids to navigation, aviation communication and
matism Council, for making available considerable of the control systems, etc. It will readily be apinformation in this report and for his helpful criticism. preciated that interference of this
type is far
more serious than extraneous noises on your
REFERENCES
1. United States Public Health Service: The Magnitude favourite radio programi as it is capable of proof the Chronic Disease Problem in the United
ducing hazards .to life.
States, National Health Survey, No. 6, 1935-36.
2. DAVIDSON AND DUTHIE: Reports on the Chronic RheuBy agreement between the Department of
matic Diseases, Vol. 4, H. K. Lewis & Co. Ltd.,
Transport in Canada and the Federal ComLondon, 1938.
3. HORDER, LORD: A Plan for National Action, H. K.
munications Commission in the United States,
Lewis & Co. Ltd., London, 1941.
three radio frequencies have been allotted to
4. DAVIDSON, L. S. P.: A National Plan of Treatment for
the Chronic Rheumatic Diseases, Glasgow Med. J.,
non-communication radio frequency generators,
23: 107, 1944.
which include electro-medical equipment, and
5. Department of Health for Scotland, Chronic Rheumatic Diseases, The report of the Medical Admanufacturers are now producing short-wave
visory committee, 1945.
diathermy machines which maintain their alk.
lotted frequency within the limits proposed.
As the responsibility for suppressing the
interference lies with the user of the apparatus,
I see more hope for ourselves as doctors and for two courses of action appear to be open to
the people who will come under our care, in the doctors who employ electro-medical equipment.
future of Medicine than perhaps in any other single These consist of (a) replacing existing equipthing in the new world towards which we are hacking ment with new frequency-controlled units; or
our way. We at least have not-yet-forfeited the
(b) providing adequate shielding for existing
trust of people for whom we work; we at least have
equipment. Either of these alternatives will
not-yet-turned inwards in despair, bartering our subject the user to considerable expense, in the
spirit of adventure for a mere hope of security. We first case for the purchase of new equipment,
stand for sane knowledge, selflessness, and mercy in a or in the latter instance in providing a comworld gone mad. We cannot let these people down pletely shielded room, booth or cubicle, as well
who trust our profession, and it is in this firm resolve as a surge trap or filter for the power lines.
that we shall face the future of Medicine.-Lord
Full technical details of the requirements
Eorder, The Lancet, p. 458, April 5, 1947.
have been incorporated in the following memo-

668

CLINICAL

AND

LABORATORY NOTES

randa issued by the Department of Transport,

Radio Division: SII-13-25 dated December 11,
1941; SII-13-28 and SII-10-39 dated October
19, 1946.
Advice, testing and inspection services are
available to users of electro-medical equipment
by consulting the local representatives of the
Radio Division of the Department of Transport
listed below.
It is important that you prepare to comply
with the regulations which will become effective in less than one year. Investigate the possibility of adapting your present equipment so
that interference is actually suppressed and,
if you are considering the purchase of new
equipment, be sure that it complies with the
new requirements.
The Controller of Radio, Department of
Transport, Ottawa.
The District Superintendent of Radio, Department of Transport, 413 - 418 Belmont
Building, Victoria, B.C.
The Supervising Radio Inspector, Department
of Transport, 539 Public Building, Winnipeg,
Man.
The Supervising Radio Inspector, Department
of Transport, 566 Dominion Public Building,
Toronto, Ont.
The Supervising Radio Inspector, Department
of Transport, 404 Public Building, Calgary,
Alta.
The Supervising Radio Inspector, Department
of Transport, 400-401 Public Building, Regina,
Sask.
The Supervising Radio Inspector, Department
of Transport, 400 Youville Place, Montreal,
Que.
The District Superintendent of Radio, Department of Transport, P.O. Box 217, Halifax,
N.S.

Danger in the Kitchen

The Statistical Bulletin of the Metropolitan
Life Insurance Company estimates from studies
among Metropolitan industrial policyholders and
among other groups that about 6,000 persons
are killed annually in the United States from
mishaps in the kitchen and that many times
that nuinber are injured more or less seriously,
though not fatally. In no other room in the
house does such a concentration of hazards
exist. The most frequent type of fatal accident
in the kitchen is burns and scalds. Falls, which
rank second, are said to be responsible for about
1,500 deaths in kitchens annually. Among the
hazards contributing to these falls are wet or
waxed floors, worn linoleum or other floor coverings, unanchored small rugs, pails or other
objects left on the floor; falls from tables,
ladders, windows, chairs and highchairs. Gas
poisoning is a relatively frequent cause of aceidents in the kitchen, more particularly among
men who doze off while heating coffee or other
fluids whiclh boil over and put out the gas flame.

[Canad. M. A. J.
[June 1947, vol. 56

Trouble may arise from a defective&pilot light

which is out or is not functioning; gas jets may
be turned on unknowingly by persons brushing
against them; some people may turn on the gas
and forget to light it. Other contributing conditions to such deaths are burning gas with an
excessively high flame in a poorly ventilated
kitchen, improperly installed heaters and gas
appliances in poor repair. Fatalities in the
kitchen are also caused not infrequently by such
poison compounds as roach powders or rat
poisonino carelessly kept and mistakenly used
for flour or baking powder. The modern kitchen
is a combination bakery, cannery, laundry,
restaurant, factory and butcher shop and playground. In industry, where similar hazards
exist, either state officials or trained employees
help to control accidents, but in the home this
responsibility usually falls on the woman of the
house, who should know where the chief dangers
lie.-A condensation in J. Am. 31. Ass., 133:
1295, 1947.

Comprehensive Medical Care

"But what is comprehensive care? The term
has been miiuch used by the public, by politicians,
by social reformers, as well as by some physicians, but it is doubtful whether it means the
same to all who use it. Perhaps a simple definition is the best. Comprehensive- medical care
should make available all that modern medical
science can offer toward the preservation of
health and prevention and cure of disease.
Naturally it includes appropriate use for adults
as well as for children of all procedures for
immunization. It implies measures for prev enting the spread of infectious diseases, not only of
the contagions of childhood, but also to tuberculosis, where the responsibility involves both
case finding and case supervision, and to veneral
disease, where care does not stop with diagnosis
and treatment of individuals, but extends to the
discovery and management of those who have
been exposed. Provision of comprehensive medical care implies frequent contact between physician and patient. Health supervision should
start at conception, and should extend throughout the entire life of an individual. Health
records compiled jointly by parents, physicians,
and patients should be kept for everv individual,
and should include not only the occurrence of
disease, injuries, and operations, but also the
time of all immunizations, of specific treatments,
as well as of examinations, x-rays, and laboratory
procedures. Access to the physician should be
easy and unobstructed. It should not depend
alone upon the accident of illness. Examinations
should be sufficiently frequent and searching to
permit early recognition of physical and psychological abnorimalities. Comprehensive medical
care cannot draw a line between diseases of the
body and diseases of the mind, but must take
full cognizance of the problems involved in preventing and treating both physical disease and
emotionial maladjustments. "-D. P. Barr, The
Diplomtte, March, 1947.