From the archives: the Ulster Medical Journal, April 1934, Volume 3, Number 2.

This edition opened with an editorial by acting editor, Dr Richard H Hunter, appealing for readers to support the Royal Medical Benevolent Fund Society of Ireland in assisting “medical brethren who have fallen on difficult times, and … their widows and orphans, so often left without even the necessities of life”. Dr Hunter referred to the great financial depression and how it has affected the medical fraternity.

The fund distributed grants of £2267 [approx. £140 400 today] to 69 widows, 17 orphans and 8 doctors in Northern Ireland in the previous year. Each county had its own individual treasurer, whose contact details were given.(1) The modern reader is liable to forget that in 1934, all doctors were essentially small businessmen – not all were successful.

Immediately after this was an obituary for one of the most successful, Sir William Whitla. Born in Monaghan in 1851, he came to Belfast as an apprentice to a leading firm of dispensing chemists and decided to read medicine. He qualified in 1877, when he obtained his MD with 1st class honours and a gold medal. He was appointed resident medical officer and superintendent of the Royal Hospital. His exceptional ability both as a physician and administrator soon became evident and he “quickly revolutionised the working of the whole institution”.

After his term in the Royal, he went into practice in Belfast and soon established an extensive general practice. Prof Gordon invited him to assist at all his private operations and then he was appointed as Physician to the Royal hospital. This gave him an opportunity to demonstrate his ability as a clinical teacher, and he soon attracted a large clinical class.

His book,” Materia Medica and Therapeutics” was a pronounced success and reflected his initial training as a dispensing chemist as well as his medical training. After the resignation of Prof. Seaton Reid, he was appointed Chair of Materia Medica in Queens College and produced a further remarkable book – “The Dictionary of Treatment”. This textbook sold widely both in the UK and America. Many honorary degrees were conferred upon him. A further textbook, “A Dictionary of Medicine” soon followed.

The Medical Institute, the home of the Ulster Medical Society, contained a bronze plate with the following inscription: “This Building Was Erected, Equipped and Presented to the Ulster Medical Society by Sir William Whitla, MD”. The cost of the building exceeded £6000 [approx. £570 000 today]. When people tried to thank him, he simply replied, “I owe it to the profession; they gave me the money for my book”. He was appointed as Honorary Physician in Ireland to His Majesty the King. His health was not so good in later years and for almost 4 years, he was unable to leave his room. The obituary, written by A.B. Mitchell, ends “William Whitla has not lived in vain”. (2)

After the obituary, came clinical papers. The first of these, “Some recent advances in the diagnosis and treatment of pulmonary tuberculosis”, is of interest to the modern reader.(3)

If the patient fails to produce an adequate sputum specimen… ”a laryngeal mirror inserted into the mouth without warning excites a spasmodic cough. … The method does not conduce to the popularity of the physician, but TB bacilli are often recovered from sputum adherent to the mirror”.

Sanatoria and rest treatment were recommended along with “collapse therapy”; artificial pneumothorax, phrenic avulsion, adhesion cutting, apicolysis and thoracoplasty. In bilateral cases, the more affected lung should be collapsed and possibly a partial collapse of the better lung attempted. A heavily scarred lung would be unlikely to collapse fully and thoracoplasty was a better option.

Sanatorium stays could be up to 2 years.

The first drug to be mentioned is sanocrysin, “a double salt of gold and sodium” given intravenously. Side effects of albuminuria or diarrhoea could occur. If sanocrysin could not be used, tuberculin was used as a therapeutic agent to boost immunity. In some cases, tuberculin was said to be the equal of sanocrysin.

A review of developmental and generalized bone disease by R Maitland Beath from the RVH contained X-ray illustrations of various conditions such as the punched out cranial lesions of multiple myeloma. The quality of image reproduction in the Journal is excellent and comparable with modern textbooks.(4)

After a few short case reports and textbook reviews, the Journal listed minutes from various Northern Ireland medical associations such as BMA county branches and the UMS itself. Several of the lectures at UMS meetings appear as papers in subsequent issues of the Journal. Minutes of the Lisburn and District Medical Guild and Londonderry Medical Society are included. At the Derry meeting, speaker Dr FMB Allen condemned the “so universal and fashionable” use of glucose in the treatment of “every and any sick child”. (5)

There were many more adverts in the journal than nowadays – many of these were non-medical (Figure 1). A Rover

Fig 1

A reproduction of p. 127 from the journal, a page of adverts for medical texts and journals. The author notes that the British Journal of Surgery was “under the control of a large and influential editorial committee”.

“Speed Twenty” saloon car could be purchased from the Ulster Motorworks Ltd, Great Victoria St, Belfast from £495. Lilliput Laundry and Dye Works, Dunmurry near Belfast offered to clean your summer wardrobe. Robinson and Cleaver offered “ready for service” lounge suits for up to 130 shillings.