Dr Tod on being a Cambridge GP between 1923-1973
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“My first impressions of Cambridge were not favourable.” wrote Dr Henry Tod in 1973.
Henry and Kathleen Tod arrived in Cambridge in 1923. Dr Tod took over a practice either near or on the site of the Cambridge Medical Centre. He was a Cambridge Borough Councillor and later Mayor in the 1950s, Chairman of the Electric Power Board and honorary surgeon to the Cambridge Volunteer Fire Brigade. He was a charter director of Cambridge Rotary, a foundation member of the Cambridge Historical Society and held other offices too numerous to mention. Kathleen was one of the few people awarded the Companion of Honour from the Red Cross and was also active in the community.
The Cambridge Museum has a manuscript written by Dr Tod about his medical practice in Cambridge (ref 3220.4) excerpts of which are reproduced here.
Medical Practice 1923-1973
by Dr H C Tod, MBE, MB, ChB
My first impressions of Cambridge were not favourable. In 1923 June was a very wet month. There were lots of deciduous trees. The fallen leaves lay neglected and rotting on the ground. The footpaths were very few and in most streets non-existent. Many patients attended surgery by horse-drawn vehicles or on horseback.
There were two nursing homes in Cambridge. Whitiora, a general purpose hospital in Hamilton Road and a maternity hospital in Thornton Road. Whitiora was in use for many years but closed when the new Government Maternity Hospital was opened in [Taylor] Street on October 7, 1962.
Many patients were nursed in their own homes by untrained women, who besides nursing the mother, cooked and kept house for the husband and the other children.
The Early Days
When I started work in that June of 1923, conditions were vastly different from those of today. The principal differences were (1) much worse roads, poor communication, slower and less comfortable cars, and (2) visits to homes were more numerous over a wider area, Arapuni, Tirau, Matamata, but over the years this steadily declined as patients came to the surgery in greater numbers.
My first car was a Model T Ford with celluloid curtains which soon became cracked and discoloured then non-existent.
Apart from Victoria Street, which was sealed, all other streets and district roads were gravelled. No sealing meant dust in summer and mud in winter. The wise motorist always carried a set of chains to put around his tyres if it came on to rain. Even the main road to Hamilton was unsealed and for the first three winters impassable. The roads through Matangi and Kaipaki soon followed suit. District roads were full of pot-holes which had to be straddled by the car wheels and which became bog-holes in the rain. Te Miro was practically cut off in winter while the Tauwhare Hills road was notorious. Although tyres were of the high pressure variety and the wheels were higher and narrower the cars really went over the bone-shaking roads very well.
Visiting usually started about 9am and seldom finished before noon. Consultations were from 1pm to 3pm and from 7pm to 8pm onwards. Urgent cases telephoned to the doctor on his rounds could cause frustrating delays to his routine. Maternity cases were frequent and caused many a disturbed night, as in the 1920s and 30s the mother was nursed at home by trained midwives and often too by untrained people. This aspect of the practice became more pleasant and less time-consuming when the birth took place in a nursing home or maternity hospital. Since 1926, all maternity work in the home (domiciliary) was stopped and all cases are conducted in fully equipped maternity hospitals with fully trained staff.
In my early days the GP was expected to do much more and varied work than he does today. The doctor had to treat minor fractures, often without X-ray confirmation and he had to grapple with severe cases of pneumonia, pleurisy and rheumatic fever alone. There were no antibiotics. Now the base hospital in Hamilton attends to all fractures, and the X-ray department and laboratory is available for such diagnosis and treatment.
Principal Advances in Treatment during the past 50 Years
Insulin for the treatment of diabetes had just been discovered in 1923. This extract of the pancreas enabled diabetics to live up to the usual life span without starvation diets. With controlled injections of insulin, children, previously doomed to die at an early age, were enabled to live normal lives, get married, have children and reach the allotted span.
The field of treatment has also been considerably widened by the discovery of various drugs to be given by the mouth. In the early 1920s pernicious anaemia was considered a fatal illness. The unfortunate patient had to consume large quantities of raw liver, but this was later administered in powdered form. This preparation smelled like a small freezing works and was very nauseating. In due course concentrated extract of liver was contained in capsules or injected by hypodermic at regular intervals. Early laboratory diagnosis has helped a great deal.
Antibiotics
The sulphonamides and later penicillin and other antibiotics are easily the most important discoveries in recent years. These drugs have the power of destroying bacteria in the bloodstream and may be given by mouth or by injection. They have completely changed the pattern of treatment and have reduced to very small proportions the great killers of old. Pneumonia, meningitis, syphilis and even tuberculosis are seldom troublesome now and all are curable with reasonable care and proper doses of the appropriate remedies. No longer do medical men wait helplessly for the crisis in pneumonia nor watch the fading away of a pulmonary tuberculosis victim.
Vaccines
After the last war the Health Department introduced a successful scheme for the protection of children. By the injections of vaccines diptheria has practically disappeared, tetanus is rare, and whooping cough a much less serious complaint. Gone are the days when we watch a young child dying with laryngitis diptheria, unable to get its breath even after a tracheotomy. Some ten years later a vaccine for the prevention of poliomyelitis (or infantile paralysis) was discovered by Dr Salk in America. This was first used as an injection but is now given by mouth, in two or three doses at intervals. There has been no positive case of poliomyelitis in New Zealand for ten years. When these measures were started in 1944-45, I remember being subjected to a great deal of abuse, both by letter, phone calls and personal encounter. Any doctor who practised and gave these injections was accused of being little less than a murderer. “Surely nothing but great deterioration of mind and body would follow!” Almost miraculous results from these wonder drugs have proved the wisdom of the doctors’ course of action. Many arguments still continue because of opposition to the fluoridation of water for tooth decay. Many of us still recall the first modern Battle of Hastings on this issue. It is significant that a dental nurse was once required for every 400 school children for the treatment of dental caries. Now one dental nurse is able to care for 900 children.
More and More Doctors
In spite of all the advances the medical profession has not decreased in numbers. The constant cry is for more doctors both in practice and in the hospitals. The great killers of the present time are heart disease in all its many forms and malignant disease which is generally incurable. Operation in early stages is still the best line of treatment. Motorcars are responsible for the third highest death rate from excessive speed on the highways, and the number of accidents cannot cope with the demand for admissions. There is a continuous cry for more and more beds and more and more staff. Advances in medical science have caused a great geriatric problem. People are living longer and care of the aged has become a great national challenge. Homes for the elderly are springing up in every town and still there are shortages.
Drug Abuse
Finally, with greater prosperity and more leisure, people are turning to drugs. Alcohol, sleeping tablets and tranquillisers of all types are commonly used. Addication is fast becoming a great social problem. Without a stiffening of the moral fibre drug abuse will lead to our deterioration and decay. Most babies are born healthy and with efficient treatment should remain so. The average age at death has now reached approximately 72 years for men and 77 for women. What it will reach in the future is unknown. The span of life will gradually rise. Let us not squander our health through over-indulgence of any kind.