196
Inquest on a Curriculum
employed on prostrate animals whose treating had
become slow and shallow, probably with benefit.
In animals showing tympany, the use of the trocar
and canula to relieve intra-abdominal pressure on
the thorax is undoubtedly an essential precaution.
In 1937 a line of treatment was adopted which
gave results of immediate and very obvious benefit.
The formula adopted was based on the suggestion
of Bunyea (1935) and consists of the hypodermic
injection of the following solution:
Sodium nitrate . . .
Sodium thiosulphate . .
Water . . . .
3 gm.
15 gm.
20 mils
This injection has been given to a number of
cattle which appeared to be on the point of death;
some of them have responded immediately and
have got up within a few minutes, and all of the
cattle treated have recovered. There has been
sufficient evidence to support the opinion that this
treatment is specific. There is evidence, too, that
cattle will not tolerate a dose much in excess of
that mentioned.
SUMMARY
1. An account of a number of serious losses from
sudan grass poisoning has been given and is sup-
ported by a tabulated statement of some principal
data.
2. There is evidence that pure sudan grass may
be just as toxic as are its hybrids with sorghum.
3. The seasonal conditions which predispose to
intoxications are those in which rain falls during
the heat of the summer, inducing optimum growth
of the plant.
4. Sudan grass which has been eaten to the
ground by grasshoppers and which is re-growing
rapidly after rain has proved, in almost all cases,
to be at the dangerous stage.
5. A few mortalities on other sorghum species
such as ambercane, Johnston grass and broom
millet are also recorded.
6. Particulars are given of what appears to be a
specific line of treatment, especially if adopted
along with symptomatic treatment.
7. In conclusion it can be postulated that none
of the sorghum species can be considered safe to
feed off to cattle at any stage of their growth
following the conditions which have been described,
REFERENCE
Bunyea, H. (1935). J. Amer. Vet. med. Ass. 86, 666
INQUEST ON A CURRICULUM
(Reprinted from The Lancet August 30, 1941)
KNOWLEDGE of medicine is handed from seniors
to beginners according to the Hippocratic
rule, and perhaps in no other profession is
learning so generously and directly shared. But
medicine stands alone in that the leaders and
teachers live and practice in a different world from
the great body of the profession. It is an old cry
that the aim of the medical curriculum should be
to turn out good general practitioners: how do
we set about it ? From the moment of registration
the student is taught by specialists, most of whom
have no experience of general practice. At the
end of the course, and of a few resident appoint-
ments, he is well—even brilliantly—equipped to
start specializing. He has a sound general back-
ground of all that is rare in medicine and surgery,
but he has learned to think of common diseases as
humdrum. He can discuss points of technique in
all the specialities; but he has had no chance to
treat the minor ailments, because these do not
reach the hospital clinic. In the one direction—
obstetrics—where specialization would not come
amiss he is under texperienced. He has usually
delivered about twenty normal maternity cases
(without analgesia) and has watched the R.O.O.
dealing with abnormals; in general practice nor-
mal cases will usually fall to the midwife while he
is summoned, often late, to the abnormal case. He
has had no instruction whatever in certification or
the management of a panel practice; he is usually
shaky on prescribing; he may or may not be a
competent anaesthetist; he thinks the business of
making the patient comfortable is work for the
nurse; preventive medicine seems to him to be the
province of the public health service; his ideas
about the social and industrial responsibilities of
medicine are vague and general; and he does not
even realize that to sign a patient off as 'fit for
work' is an act of faith unless he is clear what
strains that work applies. He begins his life's work
as a fumbler, lacking half the tools of his trade;
and he learns skill at the expense of his patients.
Every general practitioner remembers his first
week in the surgery, the confusion of mind produc-
ed by the rich variety of certificates, the growing
sense of dis-appointments as ' just another rheu-
matism' came in, the guess-work which supple-
mented his ignorance when the patient asked for