1289

(3) The fascia transversalis having previously been exposed,the handles of the forceps are depressed so that the pointsof the forceps carrying the suture project upwards. Theseare cut down on through the fascia transversalis and peri-toneum, exposed, and the ends of the suture grasped withanother pair of Spencer-Wells forceps.

(4) All the bulky redundant portion of the sac is cut away,leaving enough with the suture, and the suture is then pulledthrough from above, which readily delivers the sac into theabdomen ready for ligation. ’

This method saves time, is absolutely safe, avoidsdamaging the structures constituting the femoral canal,and brings the sac exactly into the place where it is

required.London, W.1 D. H. SANDELL.D. H. SANDELL.

1. Manson-Bahr. P. E. C. Docum. Med. geogr. trop. 1952, 4, 97.

KWASHIORKOR

P. E. C. MANSON-BAHR.

SIR,—I was glad to see in Professor Platt’s article ofNov. 6 a confirmation of my observation i in Fiji thatthe advice to mothers to wean their babies at nine monthsin communities where cow’s milk is not available (inslavish imitation of European practice) is a considerablefactor in the production of kwashiorkor. I remember anassistant medical practitioner friend telling me an uncon-firmed story of an outbreak of cedema in infants on asmall Pacific island after the visit of a New Zealand sisterwho applied her Karitane training in an unintelligentmanner.

Nairobi, Kenya. P. E. C. MANSON-BAHR.

ISOBEL CRIPPS CENTRE

Mr. Charles A. Neil, principal of the Isobel CrippsCentre, 18, Lansdowne Road, London, W.11, writes :

May I explain something about the Isobel Cripps Centre ?There are a number of doctors who know the centre well,but there are others who are not fully informed about ourwork and recently have made somewhat misleading statementsabout it. Since more and more doctors are using the servicesof the centre-both for personal study and for their patients-it is important that the following facts should be known.

This centre is a school of self-management, not a clinic.We teach people to overcome bad habits of posture, movement,and tension, our object being, in fact, to teach them to managethemselves better. We neither diagnose nor treat disease :we are neither qualified to do so nor is such our function.This is made clear in our literature, in a notice appearing inour waiting-room, and at the interview with the prospectivepupil.There are two categories of pupils. Firstly there are those

who come to be taught, with the object of improving theirposture, movement, and ability to relax in order to do sometask better--e.g., the musician who wishes to be more released,more skilful, and perhaps less exhausted by his work. Thereare also children and others who come to improve postureand movement for aesthetic reasons or because they appreciatethat their awkward, tense behaviour is - literally a disorderand they wish to overcome it. These are people who neitherneed nor seek medical advice.In the second category of pupils are those who have symp-

toms of illness such as backache, asthma, migraine, &c., or

are very " nervously tense." Some of these are advised tocome by their doctors. Many, however, come directly andin such cases we write to the pupil’s doctor, explaining thathis. patient has been to see us and stating in what way wemight be able to help in the overcoming of the awkwardmovement and undue tension, and we ask if he has anyobjection to our teaching his patient in this way.

I believe that the re-educational work of the kind we dohere has something of importance to offer the medical profes-sion, as the rapidly increasing number of doctors who aretaking an interest in this centre seems to confirm.We have built up this happy cooperation with members of

your profession by following strict ethical principles, by’avoiding hasty and over-enthusiastic claims, ..and, above all,by not meddling in fields in which we are not qualified. Itwould be a pity if this cooperation were to be marred byavoidable misunderstanding. -

Obituary

JOHN MACLEOD HENDRIE MACLEOD

M.A. St. And., M.D. Aberd., F.R.C.P.

Dr. J. M. H. MacLeod, con-sulting physician fordiseases of the skin to Charing Cross Hospital, died onDec. 10 at his home at Farnham, Surrey, at the ageof 84.He was born at Galston in Ayrshire, the son of the late

Dr. J. B. MacLeod, but the family soon moved to Dundeewhere his father became physician to the Dundee RoyalInfirmary. Dr. MacLeod began his studies at the Univer-sity of St. Andrews where he graduated M.A. in 1890.He then moved to the Univer-sity of Aberdeen where he tookthe degree of M.B. in 1894. Fora time he acted as assistant tothe professor of physiology, andhe later spent some years in

postgraduate studies in Paris,Vienna, and Hamburg where heworked under -LTnna.

In 1898 he took his M.D.

degree with honours and soonafterwards he settled in con-

sultant practice in London. Hequickly won recognition andwas appointed to the staffs ofCharing Cross Hospital, theVictoria Hospital for Children,and the London Hospital forTropical Diseases. He becamediT’eftoT* of pathology at St.John’s Hospital for Skin Diseases, and he also lecturedon dermatology at the London School of TropicalMedicine. In 1916 he was elected F.R.C.P.

Dr. MacLeod published many articles in German andEnglish journals, and at the beginning of this centuryhe became editor of the British Journal of Dermatologyand Syphilis, a position which he held for the next fiveyears. But he did not allow this charge to interrupt hisown writing, and his Practical Handbook of the Pathologyof the Skin appeared in 1903, Burns and their Treatmentfollowed in 1918, and his comprehensive Diseases of the Skinin 1920. He also contributed articles to several encyclo-paedias of medicine. He was a corresponding memberof many foreign dermatological societies, including thoseof the United States, Denmark, France, and Japan.He was president of the London branch of the ClanMacLeod Society.

1. M. writes : " MacLeod loved companionship, andhis friends rejoiced in the warmth of his hospitality, hisdry humour, and the enchanting twinkle of his eyes whichshowed his appreciation of what was said and done." From all his students he expected thoroughness,

clarity, and honest devotion to their profession. Tothose whom he encouraged to enter the specialty he wasa severe taskmaster. There were no short cuts to thehigher rungs of the ladder and the first few were to bethe most difficult. As a pupil of P. G. Unna of Hamburghe laid particular stress on the importance of a soundknowledge of general pathology and its application toskin diseases, and his textbook, written over fifty yearsago, remains a masterly tour-de-force of a hitherto littleexplored field. As a teacher of clinical dermatology heexcelled. By bringing himself down to a level just abovethat of his students he unravelled the most puzzlingcases and led them logically to the final diagnosis. Hismodesty in exposition encouraged them to follow thisstudy with him, and he always brought home its finalpurpose-‘ having acquired a thorough knowledge ofpathology, diagnosis, and therapy, don’t forget thepatient behind the disease.’

" His love for the profession and his patients wasperhaps best expressed in his work for those with leprosy.Few knew anything of his untiring efforts for that cause,particularly in the leprosy colony in this country, ofwhich he was for many years the senior physician andorganiser. The patients were his family, and in the earlierdays of inadequate treatment his successes were, I feel,mainly a measure of his devotion to the cause and the