Doctor Questioned

Hawke's Bay Herald-Tribune, Issue 131, 19 June 1937, Page 6

Doctor Questioned

BATH TREATMENT No Risk if Meticulously Carried Out 9 ' "CONSPIRACY" DENIED Practically the whole of this mornlng's session of the Royal Commission investigating the affairs of the Napier Puhlic Hospital was devoted to the further evidence of Dr. J. Allan Berry, the greater portion of the evidence being in support of his action in ordering the hot-bath treatment, and the reading of articles by authorities in support of heat treatment. Pollowing this he was suh- • jected to a lengthy cross-examina- ' tion by Sir James Elliott, who completed his questioning by remarking upon what he termed "the remarkahle lapse of memory of witness on critical points," and questioned whether witness considered that this amnesia was pathological. Dr. Harold Berry sat beside Mr. A. E. Lawry at the legal table as a technieal adviser in the cross-examination regarding the treatment at the hospital To Mr. N. A. Foden, Crown -Solieitor, Dr. J. A. Berry said he realised there were serious discrepancies in the evidence given by himself and the other witpesses. The literature on the pyretic treatment was concerned mainly with adults. He did not consider it prudent to make no alteration to the treatment when applied to children. Mr Foden: Are you certain that you did not know what Dr. Foley was going to put in the death certificate on September 10? Witness: Quite. Witness said to Mr. A. E. Lawry, who represented witness and the sister, that whep he conducted the , post-mor-tem he f ound the Mps in perfect order and condition. The hot-haths treatment had not affected the hip adjustnnents in the slightest degree. Witness said there was absolutely no element of dangef when the hip baths were of a temperature ranging from 102 degrees to 106.8 degrees as he had ordered, The children would not be distressed during the bath treatments, though they might become a little fretful towards the end of the hour. Dr. Whyte's Patients! , . Witness said that he had assumed that Dr. Whyte had told the sister to give the children the heat treatment.' He would certainly have resented another doctor giving the treatment to any of his patients without his eonsent, and he certainly had not given directions that the other children should have the treatment. At the time of the outbreak of the disease it was widespread knowledge that witness and his brother were keenly interested in heat treataient, and then again the latest information in journals and other papers were giving prominence to the question. Mr. Lawry: What have you say about the suggestion that there was a conspiracy between you and the sister? Witness: It is absurdi Mr. Foden: I didn't use the word "conspiracy." I suggested secrecy. Witness; Well, that's just about as bad. Mr. Lawry: It has been suggested that this treatment was experimental? Mr. Foden: Dr. Berry agreed. Witness: I agreed that all treatment was experimental. Mr. Lawry: You were not the - first to try out the treatment? Witness: Oh, no. It goes back to 1883. I would say that the treatment is now more or less standardised. , You have read a considerable lot of literature about it? — "Yes, a good deai in the last year or two." - A't this stage Mr Lawry intimated that he proposed to guestion the witness technically on the treatment and had a number of extracts that he desired to have placed before the commission. The chairman: Have the other expert witness had an opportumty to view them? Mr. Lawry: I will gladly make them available to the experts, Sir. Dr. Harold Berry's Eemark. Mr Foden: I feel compelled, Sir, to report what I consider a rnost improper

happening. I just overheard Dr. Harold Berry say to counsel: "Why can't they get their own?" Dr. Harold Berry: May I answer that? The chairman: You may not. Mr. Lawry: I have said, Sir, that I will gladly see that the experts have the opportunity. The chairman: As any reasonable member of the legal profession would, Mr Lawry, and I know you are a reasonable member. Counsel then proceeded to read a number of extracts from artieles written by American and British authorities regarding pyretsc treatment and ask witness a number of questions regarding them. Examples of the heat treatment were read, giving the accounts of doctors who had successfully treated both adults and young children suffering from gonococal intfection. Regarding the risks of the treatment, witness said that the main risk was that his instructions were not meticulously carried uot and that the temperatrres of the body were raised beyond the temperature he wanted. There was a point beyond which there wias a danger. Mr Lawry: You instructed the sister of the dangers? Witness; I told her to start the baths at 100 degrees and to raise the Water to 110 to 112 degrees; see that it did iiot fall below 110 degrees, for that was the main point to be aimed at; and take rectal temperature readings every 15 minutes." Mr Mosley: Did you give the nurse detailed instructions so as to avoid possible dangers? Witness: Yes. , What did you say? — "That if the temperature exceeded 106. degrees and the pulse became too rapid, then the treatment was to be diseontinued." The Limit Temperature. What was the temperature you considered the limit?-— "106 degrees," That was. the limit? — "Yes. If the temperature was 106 degrees and the pulse strong, then the . treatment was good. " You had every confidenee in the sister? — "Yes. She had taken a keen interest in the treatment and had read extracts and literature I had given, her." Did you - tell her to consult your brother? — "Yes, He would be visiting the hospital and she could ref er anything to him if she wished to do so." And you are sure that you, gave detailed instructions?— "Yes. As Lrecall the whole case, I- was very meticulous in my instructions concerning the treatment and the case/' Counsel proceeded to read further reports, of cases. where the treatment was carried out, the baths being of longer duration than, in the present case. Witness said that the children * were under supervision all the. time. The pulse beats were to be taken every 15 minutes, and there was a trained nurse in attendance throughout. In addition there was a medical adviser available afc any tiine if wanted. Witness further said that when the child was admitted the father automati^aily signed a eonsent order to operative treatment if necessary. He said that local treatment. for venereal diseases were not advisable. inlact, it was notoriously unsatisfactory and certainly was slow and tedious. There was a possibility of a relapse after local treatment. Mr. Lawry :. Vulvo vaginitis can cause complications ? Witness: Yes, it can catise death. What do you say about therapathy? — "It is quick and much more effective than any other treatment." To See What Child coiild Stand. , Regarding the bath at 120 degrees. temperature, witness said that it was given to see how much the cliild could stand comfortabiy. Recent nursing text books give hot baths at from 110 to 112 degrees. * ' . Mr. Mosley: It was another experiment on your part? Witness : Yes, in a way. Mr. Lawry ; Nothing " but the comfort of the child made you try to find out when it wduld whimper.? Witness: Yes. And did it cry£— "No, I took it out, at the first- whimper. The temperature was only momentarily 120 degrees, if it was actually that." ' Though it was an experiment, did the child suffer any after effect?— "Not the slightest." In reply to a further question, witness said that the report from Dr, Lynch indicated .that there was nothing to determine the ,cause of death, aud that the findings did not throw cnuch light upon it. The chairman: Regarding the postmortem. You agree that it'was unwise to have conducted that? — "No. I think it was a wise thing to ascertain the cause. of death." And that you should have conducted the post-mortem? Witness replipd that he had not consicored. the mattsr i:om that aspecc. He had been rather shaken by the chairman 's remarks yesterday, but realised now that they were passed in releience tc his having conducted the post-mcr!em, and not that a post-mor-* tem should not have been made. Mr. Mosley: And the fact also that you had conducted an unautlioriscd' post-ruortem. Witness: That is so. I roaliso your poiut now. I suppose you have conducted other post-mortems?— "Yes." Witness admitted in reply to further questioning by Mr. Lawry that he had said in the examinatioh-in-qhief that ho had carried out a post-mortem in the presence of his brother and Dr. Foley, but now recalled that he had started the post-mortem before Dr. Foley entered the room. Mr. Mosley: That point was put to you from every possible ahglo, but you stuek to it yesterday, — "1 overlooked in the past that I seut my brother to get Dr. Foley, and started tho postmortem without them. Mr. Mosley: It was put in so many different anglea that it looked exti-a-Ordinary. Mr. Lawry: Now, regardie* the discussion in "the sicle room after the collapse of the child, have you anything to say regarding your evidence? At this stage Mr. Foden commented that it seemed that witness was now being led to give amendments to his evidence despite tbe pressing quostioniug. i

To further questioning, witness replied that he was extremely fond of the child and she of Mm. Mr, Foden: You and your brother knew all about this literature when you embarked on this trpatment?— » "Yes." You did not outline all the circumstances to Dr. Lynch? — "It was unlikely." 'Replying to Miss Cecilla McKennie, witness agreed that it would be diflicult to take a count of the pulse during the treatment when the, temperature were high.. - To 'Mr. Foden, he said that none of the subordinates had any practieal experience in the heat treatment, not •even the sister. (Proceeding).