The Medical Board of Trinidad and Tobago; Part 2: from conquest to independence - a brief survey of its background and scope

Medical practice in this country is supervised by a domestic body provided by Legislation as enacted by Parliament, and embodied in the Medical Board Act 1960 of which Section 3 states the Medical Board Ordinance of 1887 and continued under the former Ordinance shall from the commencement bear the name of "The Medical Board of Trinidad and Tobago." Medical practice was however controlled for a century and a half before. This is a unique British institution whereby in the absence of Administrative courts, tribunals perform functions which are best left to domestic bodies free from state immediate control. (AU)

Observations on toxaemias of pregnancy

In the Obstetric Department of the General Hospital at San Fernando, the pregnancy complications from South Trinidad are treated. This is a drainage of a population of 300,000 which represents 30-36 thousand women of child-bearing age. The incidence and attitude to toxaemia will be discussed against the background of other pregnancy complications, facilities, and education in maternal care. The present observations represent certain aspects of the disease which may help to elucidate the many facets of this disease. 1. There seems a curious reversal of the established fact that 60 percent of sufferers are primigravida. 2. Water and salt retention syndrome may exist as an isolated phenomenon and may occur in an trimester of pregnancy. 3. The incidence of pre-eclampsia is peculiarly distributed in regards to protein and carbohydrate eating habits which is conditioned by religious fads, economic or social factors. 4. Fluctuation in the seasonal incidence of pre-eclampsia seem to indicate that regional or seasonal variations of humidity and temperature may affect water retention in the body and so aggravate toxaemia. 5. The final problem that I pose to this gathering and which I hope to make a study of, is the problem of the foetus. If the maternal response to the vaso-pressor substances is so marked and so disastrous, what then of the child. (a) What are the criteria of foetal malnutrition and are babies constantly affected? Weight related to maturity may provide an index. (b) Is the foetus hypertensive? If not, why not? How is foetal hypertension to be studied? It must be done in utero. What indices must we use in the assessment of the stigmata of hypertension in the neo-state? (c) If there is no foetal hypertension, then there must be some protective mechanism. Recent work shows that much of the placental bed shares in the vasospasm. We know that much of the placenta is defunctioned. It must be that the mechanism of protection , if there is one, is located at the placental level (AU)