Vol. 60, 1909 - University of North Carolina at Chapel Hill

160
ing in nursing, after having had only a
theoretical or correspondence course of instruction).
4. Provisional Nurses. (Those having
been engaged in nursing for a year or more,
i.e., the so-called practical nurse).
This will be a distinct advance in the
profession of nursing. It will give all the
worthy an equal chance, and will eliminate
the unfit. It places the control of the nursing
profession where it belongs, namely, in
the hands of its creators, the physicians.
DR. GH«g. DUPPY.
The Journal is intensely grieved to record
the death of another of North Carolina's
grand old physicians. On the morning of
August 18, Dr. Charles Duffy passed away
at his home in New Bern, N. C. Death
was not unexpected, since Dr. Duffy had
for some time been afflicted with cancer,
for which he was operated on last February.
Following this operation he was greatly improved
for a time, but afterwards rapidly
grew worse. The oldest physician in New
Bern, Dr. Duffy was also one of the oldest
in the whole State. Born in Onslow county,
July 18th, 1838, he was therefore seventyone
years of age. Graduated from the University
of New York in 18.59, he had been
in active practice for fifty years. In 1870,
he became a member of the North Carolina
Medical Society and from 1872 to 1878
served as a member of the State Board of
Medical Examiners. In 1877 he was appointed
a member of the State Board of
Health by the State Medical Society, which
position he occupied for one year. He was
vice-president of the Society in 1873, and
president in 1879. Dr. Duffy thus held
every important office within the gift of his
professional brethren of the State. Prominent
in Medical Councils he was likewise
recognized as one of the finest physicians
in North Carolina. He was a magnificent
specimen of that type of old-time doctor,
now too rapidly disappearing. Although a
student before the days of modern development
in medicine and surgery. Dr. Duffy
was never left behind. He kept himself
thoroughly up-to-date in medical progress.
A courtly gentleman, a genial lovable doctor,
he held a place in the hearts of his
friends and patients that will not easily be
filled. As chairman of the State Board of
Public Charities, Dr. Duffy has carried on
a work worthy of the man. The good he
has done can be known only by Him who
permits no good deed to go unrewarded.
Entering his profession just on the eve of
that great conflict between the North and
the South, he volunteered his services and
become a surgeon of the Confederate Army,
THE CHARLOTTE MEDICAL JOURNAL.
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in which capacity he served throughout the
war.
The Journal takes this opportunity of expressing
its profoundest sympathy for his ]!
bereaved family and relatives. W'e merely
voice a sorrow which is universal throughout
the whole State.
X-RftY BURNS. i
The subject of X-raj' "burns" has occu- .,
pied considerable attention in the last two i
or three years. So much publicity has been :
given to it that not only patients, but even
many physicians have formed the opinion I
that the Roentgen ray is too dangerous to
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be used at all.
This is quite as erroneous a view as the
one that the ray is entirely harmless.
It brings out the point that the ray should ]
be used cautiously and by skilled hands. |
Under these conditions it is not only prac- i
cally devoid of danger, but it is one of our
most useful measures in a number of diseases,
to say nothing of its diagnostic value,
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The so-called X-ray "burn" is really an |
inflammatory condition set up by an over- i
dose of the Roentgen ray; therefore its lech- j
nical name of dermatitis. This term, loo, |
is inadequate in the case of deep "bums"
v;hich involve tissues far below the skin.
To get results from the Roentgen ray it
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must be absorbed, just as it is necessary to :
have absorption of drugs in order to get j
their effect. j
As the skin absorbs by far the greater j
portion of the rays, so the reaction is quicker ;
and more pronounced in the skin.
X-ray dermatitis is wholely and solely a i
question of dosage, or perhaps we should i
say over-dosage, for that is what it really is. i
A proper dose of the ray produces no i
burn. A full dose just brings the tissues to
the condition represented by the full physi- i
ological action of a drug. Carry the dose ;
beyond this point and we have a pathologi- j
cal condition produced as the result of an >
over-dose, just as with an over-dose of strych- i
nine or arsenic.
Just as soon as the dosage of the X-ray is :
better understood, and is easier to accur- i
ately measure, then "burns" will be as rare j
as are over-doses of strychnine, morphine i
or arsenic, and will only be the result of
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gross ignorance or gross carelessness, ex- i
cept when intentionally produced. i
It is customary to treat cases with the i
X ray until a visible reaction takes place i
in the skin. However mild this may be, it
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is in reality a dermatitis and marks a cor- (
responding step beyond the physiological !
dose of the ray. As long as it is slight it is i
harmless and is at present our only sure I
sign that we have given a maximum dose j
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