The Health bulletin [serial] - University of North Carolina at Chapel Hill

14 The Health Bulletin July, 1951ther responsibility.A third aspect of general practice isthe responsibility for a patient, evensometimes against his will; a responsibilityboth for him and his family, inhealth and in sickness, from birth untildeath. In general practice a visit to apatient does not involve just that patient'ssymptoms. It involves acuteanxiety on the part of the family; ifyou like, a temporary mental illness,an anxiety state, of all concerned. It ispart of general practice to relieve thisalso in such a way that there may beno lasting effect. One has to handlebirth and death, in which the principalplayer is usually the least concerned.In chronic cases it is often said thatnothing can be done. But general practiceconsists in doing something tomake life as bearable as possible for thepatient, and to make him live as comfortablyas he can with his disability.Many people seem to think that thebulk of general practice consists of trivialities.There is no case, however trivial,which is completely without interest.Careful attention to hundredsof apparently trivial cases is more thanrewarded as one catches the earliestpossible stage of serious illness. Muchbecomes almost a reflex action in time,so that one has a tentative diagnosissometimes, arrived at between the timethat the patient opens the door, andwhen he sits down in the chair.Dr. J. D. Simpson, in the discussion:A young man, aged 22, with an excellentathletic, Service, and scholastic record,reported sick on a Monday saying:"Doctor, I have a strained heart. At theend of the course we rowed on SaturdayI felt awful." He was the only son ofdevoted parents. His heart and lungswere normal, b. p. 120/80; exercise tolerancetest good. Saturday he had beento a 12-1 lecture, had lunch in collegeand the boat was out at 1:45 p. m. Hehad had a long wait at the start of a20-minute row and it was a bitterly coldday.My advice was to go straight down tothe river, have a light outing and thenreturn to the VIII next day. He hasrowed and been fit ever since.A cardiological opinion would havetaken two to three days to arrange, andby the time the boy had been examinedhe would have been well on the way toa cardiac neurosis and would have missedhis place in the VIII—a very importantmatter to him.I hope every general practitioner intowhose hands this journal comes willtake this editorial to the editor of hislocal paper, and request publication inpart and editorial comment. You mightwell, also, call attention to the othereditorial in this issue on the generalpractitioner; and take along to yourpaper your copy of S. M. & S. for December,1950, and call attention to theeditorial on pages 408 and 409.It is wonderful to have a great Britishspecialist who does practically all hiswork in oflEice or hospital say that "thefamily doctor can be, of all people, inbest position to give an accurate diagnosis,prognosis and treatment;" andcompare treatment in hospital withtreatment in the home, much to theadvantage of the latter.FROZEN, CONCENTRATEDORANGE JUICE AS NUTRITIOUSAS FRESH FRUITApproximately 98 per cent of the vitaminC in fresh oranges can be retainedin the frozen, concentrated juiceif proper methods are used, a reportto the Council on Foods and Nutritionof the American Medical Associationrevealed.The report, published in the Journalof the American Medical Association,said "the frozen concentrated productcan be as valuable from a nutritivecontent as is fresh orange juice."It was pointed out that fresh orangesof good quality picked at the propertime were essential to insure a highvitamin C content in the concentratedproduct. The report said:"For example, studies indicate thatthe vitamin C content of fresh orangesmay show considerable variation. Thisis due in part to seasonal influences.In general, fruit picked in midseasontends to be higher in vitamin C than