Because it is a "live" question-one that merits discussion-we are glad to print the following interesting editorial comment by Dr. F. H. McMechan of Avon Lake, Ohio, who, as secretarytreasurer of the Interstate Association of Anesthetists, is the leading figure in the crusade against the employment of nurses in this field: It is interesting to note that the nurse-anesthetist abuse is receiving attention on the part of the profession and state boards in neighbboring states.

In an editorial in The Journal of the Michigan State Medical Society, Dr. F. C. Warnshuis, Secretary-Editor, and also a member of the Michigan State Medical Board, writes as follows, in the November issue:

". . . The movement on the part of the Ohio State Medical Board to abolish the nurse-anesthetist abuse, should and must receive the approval and support of a united profession. The administration of an anesthetic should never be entrusted to any but skilled individuals, trained to select the safest agent for each individual case. That nurses, after three years hospital training and a few months experience in the giving of an anesthetic, are deemed competent anesthetists, is preposterous, if not criminal. Such individuals are wholly incompetent to make a

physical examination, to detect renal, circulatory and respiratory defects. Neither can such nurses estimate the variance from the normal that disease or surgical conditions have produced. Consequently there will be evidenced a marked inability to select the safest indicated anesthetic agent or to be alert to the precautions that must govern its administration. It is from the legal standpoint unlawful and a violation of the Michigan Medical Act for other than registered physicians to administer an anesthetic. They who violate the law are amenable to its penalties."

Dr. Warnshuis' announcement is all the more important as he is the member of the Michigan State Medical Board responsible for the standardization of hospitals and provision for the fifth interne year.

How quickly the matter of the nurse-anesthetist was handled in Michigan is exemplified in the action of the Surgical Staff of Harper Hospital, Detroit, headed by Dr. Angus McLean, which on information from the Interstate Association of Anesthetists that the Assistant Superintendent had three nurses in training for introduction as anesthetists into the surgical clinics of the hospital, put a "kibosh" on the whole affair in five minutes. This Assistant Superintendent was a former Lakeside Hospital em

ployee, and was attempting to introduce the nurse-anesthetist into Michigan, but his efforts were nipped in the bud. The Surgical Staff refused to concede that a hospital which had organized and perfected a post-graduate course for its internes, in every phase of medical practice, was unable to teach anesthesia to any but

nurses.

The profession of Kentucky, however, has taken the most radical action possible against the nurse-anesthetist. During the meeting of the House of Delegates at Hopkinsville, October 17, the report of the Committee on Ethics, including the following, was unanimously adopted:

". . . Your Committee desires to call your especial attention to a violation of the principles of ethics in the employment by surgeons of nurses and other anesthetists, who are not trained in the practice of medicine. It is urged that this is a procedure under the control of the surgeon, but we submit that neither law nor usage permits surgeons to decide who shall be permitted to practice medicine. In addition few surgeons are qualified better than others of the profession in the administration of anesthetics. In order, therefore, to stop this evil now, your committee recommends that the Medical Association of Kentucky requests its members not to employ others than qualified physicians as anesthetistis, except in cases of emergency. In order to make the request urgent and effective we would suggest that the profession should not refer cases to hospitals where nurses are allowed to give anesthetics, and that hereafter no member who so violates the law and ethics shall be considered in good standing in the Association. . .

This resolution, unanimously carried by the Kentucky State Medical Association, practically challenges the ethical standing of every surgeon, employing a nurse anesthetist, not only in Kentucky, but in the whole United States. Kentucky has taken a crucial action, which eventually, the American Medical Association must endorse, or else see the whole system of control of medical practice collapse. The anesthetists of Ohio will ask the Ohio State Medical Association at Springfield to emulate the decision of the Kentucky State Medical Association and thereby conserve the professional rights and privileges of those specializing in this vital phase of surgery.

Toledo-Dr. Edwin D. Tucker has moved his offices to 2016 Second National Bank Building.

Marion-Dr. C. E. Sawyer, on December 13, addressed the Baltimore Medical society, Baltimore, Md., on "Mental Disorders as Related to Physical Disarrangement."

Cincinnati-Dr. Louis Markle has succeeded Dr. Milton Cohen as bacteriologist of the city health department. Dr. Cohen has accepted a similar position in Cleveland.