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Notes and News

NEW YEAR HONOURS

The honours awarded to members of the medical pro-fession in the list published on Jan. 1 include:G.C.B. (Civil)

Sir George Godber, chief medical officer, Department ofHealth and Social Security, Department of Education and

Science, and Home Office.D.B.E. (Civil)

Kate Isabel Campbell, paediatrician of East Kew, Victoria,Australia.

K.B.E. (Civil)Brian Gerald Barratt-Boyes, surgeon-in-charge of the cardio-

thoracic unit, Green Lane Hospital, Auckland, New Zealand.

Knights BachelorWilliam Melville Arnott, William Withering professor of

medicine, University of Birmingham; Wylie McKissock, surgeon,National Hospital for Nervous Diseases, Queen Square, London;Sydney Lance Townsend, professor of obstetrics and gynaecology,University of Melbourne.

C.B. (Civil)Henry Yellowlees, deputy chief medical officer, Department of

Health and Social Security.C.M.G.Ronald Lawrie Huckstep, honorary surgeon-in-charge, Round

Table Polio Clinic, Kampala, Uganda.C.B.E. (Military)Group Captain David John Dawson.

C.B.E. (Civil)William Roy Billington; Arthur Ivan Darling; James Lear-

month Gowans; Edward Stuart Reginald Hughes; James HolmesHutchison; John Arthur Reginald Miles; James Walker; AndrewWilson.

O.B.E. (Military)Lieut.-Colonel Arthur Wynyard Beasley; Lieut.-Colonel

Norman George Kirby.O.B.B. (Civil)

William Boyd; Charles Duguid; Leslie Halberstater; JefferyGraham Harrison; John Plaistowe Horder; Kenneth NevilleIrvine; Emyr Wyn Jones; Jacobus Marthinus Lourens Klopper;John Francis Lowe; James Duncan Macgregor; Gilbert Maclean;James Sloan Mutrie Robertson; Roy Frederick Rhodes Scragg;Christopher John Wells.Honours awarded to people outside the medical pro-

fession include:

C.M.G.Stanley Mason Davies, assistant secretary, Department of

Health and Social Security.C.B.E. (Civil)

Grace Mary Jones, assistant secretary, Department of Healthand Social Security; Henry Roderick Moore, chairman, Board ofGovernors, the London Hospital.O.B.E. (Civil)George Smith Innes, consultant in medical engineering,

St. Bartholomew’s Hospital, London.

TRAINING IN THE REMEDIAL PROFESSIONS

A COMMITTEE of the Council for Professions Supple-mentary to Medicine has been studying the future ofoccupational therapy, physiotherapy, and remedial gym-nastics, and, in particular, whether greater integration couldbe achieved in training for these three professions. In its

report,l the committee states that integration is madedifficult because the three professions have developed1. Report and Recommendations of Remedial Professions Committee.

Council for Professions Supplementary to Medicine, York House,Westminster Bridge Road, London S.E.1. 1970.

separately-each has a separate administrative structure

within the National Health Service, with different terms andconditions of service, and three separate statutory boards.Efforts are, however, being made in places to set upmultidisciplinary schools, which usually involve thesharing of accommodation and facilities and, occasionally,lectures. Unfortunately, these ventures generally concernonly schools of physiotherapy, radiography, and nursing,and do not provide training for all the remedial professions.The committee, having carried out some investigations,feels satisfied that there is enough common ground betweenthe three subjects to justify the introduction of somecommon teaching in the basic subjects-anatomy, physio-logy, kinesiology, psychology, medicine-which might leadlater to the institution of a common course. However, thecommittee does not favour the breaking down of alldifferences between the professions to create a

" universalremedial therapist ". It believes that facilities for post-registration training should be improved, and that financialprovision should be made for staff to take advantage ofsuch courses; there is a definite need for the institutionof higher qualifications in the remedial professions, to

improve standards and raise status. A degree course, per-haps common to the three professions, could be establishedfor selected students, and might encourage recruitment.The second half of the committee’s report contains detailsof the terms of entry and the general structure of trainingcourses for the remedial professions, and the aspects whichare common to all three and those which are divergent areset out. The committee feels strongly that the rigidity ofpresent examination structures should not be allowed toobstruct developments in the closer integration of training.

STAFFING MENTAL DEFICIENCY HOSPITALS

A SUBCOMMITTEE investigating the staffing of mentaldeficiency (subnormality) hospitals in Scotland found thatalmost no research at all had been carried out into thefunction and organisation of these hospitals. Surveys of2 Scottish hospitals were made, but much more work isneeded to determine for each hospital its detailed need ofstaff and facilities. Mental deficiency hospitals havesuffered in the past from being isolated from other hospitalsand services, and many of the subcommittee’s recom-

mendations 1 are aimed at linking the hospital servicewith the community. Shortage of staff of all kinds hasbeen one of the results of isolation; for example, only oneof the 22 mental deficiency hospitals in Scotland has ahouse-officer; only 5 employ psychologists; 15 have nosocial worker; and only 3 are visited by paediatricians.Approximately 40% of nursing staff in all the hospitalshave no professional nursing qualifications. The sub-committee felt that mental deficiency should not beregarded as a specialist field clearly demarcated from therest of medical practice, and that the medical and nursingfunctions of these hospitals had not been adequatelydefined. The two essential categories of medical specialistfor mental deficiency hospitals, the report says, are psy-chiatrists (child and adult) and paediatricians;, and it isrecommended that they are employed on a joint appoint-ment basis, working partly in the mental deficiency serviceand partly outside it; experience in mental deficiencyshould therefore be a required part of training for all

psychiatrists and paediatricians.Nurses in mental deficiency hospitals have to care for

a very heterogeneous population, many of whom do notrequire nursing as such, but the subcommittee felt very

1. The Staffing of Mental Deficiency Hospitals. Report of a Sub-Committee constituted jointly by the Standing Medical AdvisoryCommittee and the Standing Nursing and Midwifery AdvisoryCommittee. Scottish Home and Health Department. H.M.Stationery Office. 1970. 8s.

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strongly that nurses should not take over training andeducational functions. They should be recruited from allparts of the Nursing Register, and the present distinctionbetween mental and mental deficiency nursing should beabolished. The shortage of psychologists in the mentaldeficiency service is serious, and it is recommended thatthere should be as many posts established for psychologists,both clinical and educational, as for medical consultants.The hospital schools should become the responsibilityof the local education authorities, and nurses should besupported by a full complement of occupational therapists,trainers, physiotherapists, social workers, domestic staff,and voluntary helpers. Nurses, as well as doctors, shouldnot confine their duties to the hospital, and the reportsuggests that doctors and nurses should work in assessmentunits, outpatient clinics, and patients’ homes. Staff should,in fact, be attached to the mental deficiency service, andnot just to the hospital, and there should be more flexibilityin recruitment coupled with a more accurate definitionof the function of the mental deficiency hospital and ofthe roles of those who work in them.

COMMUNICATING STATISTICS

Social Trends, an annual publication from the Govern-ment Statistical Service,l is an attempt, and a good one,to recognise the importance of making key figures aboutmeasurable aspects of the British way of life readily avail-able. Of course, it is no substitute for the detailed figuresissued by Departments and other bodies, but these are oftentoo bulky and expensive for common use; it is helpful tohave, in a manageable package, a summary of the maindata in areas such as health, education, housing, nationalincome, taxation, and population growth. The emphasisthroughout is on trends, though, as with N.H.S. expendi-ture as a proportion of total expenditure in the publicsector (8-8-9-2% throughout the ’60s), a trend maynot always be detectable. The first issue is prefaced by fourgeneral articles on social statistics, public expenditure onthe social services, population projections, and housingrequirements. The publication is full of information and isattractively presented: it will settle many an argument, and,no doubt, start a whole lot more.

A RUGBY CENTENARY

Adam Lindsay Gordon, who died in 1870, is best re-membered for his lines:

No game was ever yet worth a rapFor a rational man to play,Into which no accident, no mishap,Could possibly find its way.

That same year The Lancet, 2 quoting " A Surgeonwriting to The Times, said that " the game of football, asplayed at Rugby, must be as fertile a source of danger tothe boys as it is one of lucrative practice to the medicalmen of the neighbourhood ". The surgeon referred to sixinjuries to boys, and The Lancet, ever careful, stated: "Ifthis be a correct statement, we certainly concur in thinkingthat the sooner the specialty about the Rugby style ofplaying football is dropped the better."

In a letter to the Editor 3 Robert Farquharson, the schooldoctor, refuted the surgeon, saying there had been nofractured collar-bone, the injury to the groin damaged noimportant organ, the severe injury to the ankle was a strain,as was the injury to the knee. The two others injured didgo home on crutches: one boy had slipped in the street,1. Social Trends, 1970, no. 1. H.M. Stationery Office. 65s.2. Lancet, 1870, ii, 755.3. ibid. p. 804.

the other injury was caused by a twist; and none was dueto

" hackingFarquharson’s interest in adolescent health is exemplified

by his early description in his book School Hygiene (1885):" A curious form of sprain special in my experience to footballis a small bursal swelling in the sheath of the quadriceps extensortendon, exactly over its insertion into the tubercule of the tibia.It is most remarkable how much inconvenience this apparentlytrifling disability causes, by weakening the leg, and most especiallydiminishing its kicking power, a serious matter to a lad in theprime of muscular vigour, and a prominent football performer.There is a good deal of analogy between this and that effectionso well-known and dreaded by horsekeepers under the name ofa ’ curb ’, the treatment being slow and unsatisfactory, andnature effecting a cure leisurely and in her own way by hardeningof the surrounding tissues."

This antedates Osgood by 18 years and Schlatter by 23years.

University of LondonDr. Rainer Goldsmith has been appointed to the chair

of physiology at Chelsea College.Dr. Goldsmith, who is 43, received his medical education at

the University of Cambridge, graduating M.B. in 1952. After ahouse-appointment at the North Middlesex Hospital he was for2 years a medical officer in the R.A.M.C., and then ship’s surgeonwith the P&O Line. From 1955 to 1957 he was medical officerand physiologist with the Commonwealth TransAntarctic Expedi-tion. He joined the scientific staff of the National Institute forMedical Research in 1957; in 1958-59 he was seconded to

Johns Hopkins University, and in 1964 to the InternationalLabour Organisation. In 1967 he was appointed senior lecturer inphysiology at the University of Aberdeen, and in 1969 he becamesenior lecturer in physiology at the University of Nottingham.The title of professor of embryology has been conferred

on Dr. Felix Beck in respect of his post at the LondonHospital Medical College.

Dr. Beck, who is 39, graduated M.B. from the University ofBirmingham in 1954, and M.D. in 1963. He held house-appoint-ments in the United Birmingham Hospitals before doing hismilitary service. In 1957 he was appointed assistant lecturer inanatomy at University College, Cardiff, becoming lecturer in1960 and senior lecturer in 1965. In 1963-64 he was Fulbrightscholar at the Carnegie Institute of Washington. He was appoin-ted reader in anatomy at the London Hospital Medical Collegein 1968.

Dr. L. E. W. Vollrath has been appointed to the reader-ship in anatomy at King’s College. The title of reader inhsmatology has been conferred on Dr. G. C. Jenkins inrespect of his post at the London Hospital Medical College.

University of LeedsDr. S. R. Stitch, director of the division of steroid

endocrinology and senior lecturer in the department ofchemical pathology, has been awarded a personal professor-ship.

University of GlasgowThe Bellahouston medal for 1970 has been awarded to

Dr. A. M. Mackay for his M.D. thesis on an electron

microscopic study of the normal and abnormal humanadrenal cortex.

University of EdinburghThe honorary degree of D.SC. (faculty of medicine) will

be conferred on Prof. C. A. Clarke (Liverpool) and Prof.U. S. von Euler (Stockholm).

University of OtagoMr. A. M. Clarke has been appointed Ralph Barnett

professor of surgery. Prof. T. V. O’Donnell has beenpromoted to a personal chair in medicine, and Prof. J. S.Loutit to a personal chair in microbiology.

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Royal SocietyProf. W. R. S. Doll has been appointed a vice-president.

Singapore Academy of MedicineDr. Seah Cheng Siang has been elected master for

1970-71.

Society for the Study of International Medical CareAt the next meeting of the society, to be held on Friday,

Jan. 22, at 6.30 P.M. at the Spastics Society, 12 ParkCrescent, London W.1, Lord Rosenheim, P.R.C.P., will talkon medical migration and medical education. Visitors willbe welcome. Those wishing to attend should notifyDr. G. E. Ffrench, Occupational Health Unit, CentralMiddlesex Hospital, Park Royal, London N.W.10.

New Aspects of Infant FeedingThis is the subject of a one-day meeting to be held on

Feb. 11 by University College Hospital Medical School.Applications for tickets (40s.), to be returned by Jan. 25,may be had from the secretary of the Obstetric Unit,88-96 Chenies Mews, London WCIE 6HX.

Alcoholism and Drug DependenceAn international conference on alcoholism and drug

dependence is to be held at Liverpool University on March28 to April 1. Details may be had from Mr. W. H. Kenyon,executive director of the Merseyside Council on Alcoholism,B15 The Temple, Dale Street, Liverpool L2 5RV.

Istituto Superiore di SanitaThe Istituto Superiore di Sanita of Rome invites appli-

cations for 19 scholarships for research in its laboratoriesin 1971. The scholarships, of approximately E1250, willbe paid over 10 months for study in biology, chemistry,biochemistry, physics, microbiology and epidemiology,parasitology and epidemiology, veterinary studies, andsanitary engineering. Applications must reach Rome byJan. 25. Details may be had from the Bursary Department,Italian Institute, 39 Belgrave Square, London S.W.1.

AppointmentsCHILD, DOROTHY, M.B. Edin., F.F.A. R.C.S., F.F.A. R.C.S.I.: consultant

anesthetist. Western General Hospital and Royal Infirmary,Edinburgh.

SMALL, P. G., M.B. Sheff., F.F.R., D.M.R.D.: consultant radiologist,Nottingham General Hospital.

East Anglian Regional Hospital Board:BLACK, A. J., M.D. Cantab., M.R.C.PATH.: consultant pathologist,

North East quadrant of the region.MACLACHLAN, T. K., M.B. Edin., D.P.M.: consultant child psychiatrist,

United Cambridge Hospitals and the Cambridgeshire and Isle ofEly County Council.

OGDEN, JEAN S. M., M.B. Lond., F.F.A. R.c.s., D.A.: consultant aneesthe-tist, North East quadrant of the region.

Leeds Regional Hospital Board:HEYCOCK, M. H., M.B. Cantab., F.R.C.S. : consultant plastic surgeon.

Kingston General Hospital and Hull Royal Infirmary.IMRIE, A. H., M.B. St. And., M.R.C.O.G. : consultant obstetrician and

gynaecologist. Hull area.MANOHITHARA.fAH, S. M., M.B. Ceylon, M.R.C.P., M.R.C.P.E. : consultant

in hasmatology and blood transfusion.RICHARDS, BRIAN, M.D. Cantab., F.R.C.S.: consultant urologist, York

area.

SHAW, A. B., M.B. Lond., M.R.C.P.: consultant in general medicine,St. Luke’s Hospital and Bradford Royal Infirmary.

Manchester Regional Hospital Board:BERNSTEIN, ABRAHAM, M.B. Dubl., M.R.C.P. : consultant physician,

Salford hospital group.JACKSON, S. M., M.D. Manc., F.F.R., D.M.R.T.: consultant radiotherapist,

Christie Hospital and Holt Radium Institute.SARLASHKAR, M. D., M.B. Bombay, F.F.A. R.C.S., D.A.: consultant

anaesthetist, Preston and Chorley hospital group.WALLACE, T. J., M.B. Edin., M.R.C.P.E.: consultant physician, Oldham

and District hospital group.

Pamphlets and ReportsThe New General Practice. A collection of twenty-seven

articles first published in the British Medical Journal in 1968-70describing developments in five areas of general practice-theteam, family doctors and hospitals, services, records, and

planning. Many of the articles on " the team " relate to the useof nurses in general practice; the planning section includesarticles on Milton Keynes and the Livingston project. (Obtain-able from the British Medical Association, Tavistock Square,London W.C.I. 25s.)

Demography of Medical Education. A statistical reviewof medical-school places in relation to population and proportionof population seeking higher education for European countries.(Not for sale, but distributed by the W.H.O. regional Officefor Europe, Copenhagen, Denmark.)

A Select Bibliography of Medical Biography. Thesecond edition of the list prepared for the Library Association,by J. L. Thornton, librarian at St. Bartholomew’s HospitalMedical College. (Obtainable from the Association, 7 Ridg-mount Street, London W.C.I. 30s. ; 24s. to Association mem-bers.)

Chester Beatty Research Institute Serial Abridged LifeTables England and Wales 1841-1960: supplement. Thesupplement gives tables for the years 1961-65 and provisionalestimates for 1966-70. (Obtainable from the Institute at theRoyal Cancer Hospital, London.)

Cancer Incidence in Five Continents: vol. II. 359 pagesof tables edited by R. Doll, C. Muir, and J. Waterhouse for theInternational Union against Cancer. Most of the data comefrom analyses of cancer cases registered in different countries inthe 1960s up to 1966. (Berlin and New York: Springer-Verlag.DM90,$25.)

Determination of Steroid Hormones. In this pamphletDr. I. F. Sommerville, of the Institute of Obstetrics and Gynae-cology, London, reviews the use of labelled agents in the mea-surement of steroid hormones. There are 168 references. (Ob-tainable from the Radiochemical Centre, Amersham, Bucks.)

Biological and Pharmaceutical Aspects of Pharmaco-kinetics and Therapeutics..A short report on the proceedingsof an international symposium held in Stockholm in June.(Obtainable, free of charge from R.U.F.I. Service AB, Sveavagen24-26, 111 57 Stockholm.)

Scottish Health Statistics, 1968. Population and vitalstatistics, morbidity, maternity and child health services, togetherwith cost analyses of various branches of the Health Service.

(H.M. Stationery Office. 65s.)

Holidays 1971, for the Physically Handicapped. Thelatest edition of this useful booklet, produced jointly by theCentral Council for the Disabled and the British Red CrossSociety, gives details of hotels, guest houses, and holiday centresthat offer accommodation for the disabled. (Obtainable from theCouncil, 34 Eccleston Square, London S.W.I. 5s.)

Diseases of Joints. A series of thirteen articles first publishedin the British Medical Journal in 1969. (London: British MedicalJournal. 15s.;$3.)

Sex Education. After reading this entertainingly criticalsurvey by Maurice Hill and Michael Lloyd-James one can onlyconclude that writing a good pamphlet or book on sex educationmust be a very difficult task. Of 42 offerings looked at by thesecritics, only 1 is recommended and 3 are tolerable. Subtitled" the erroneous zone " this booklet gives examples of errors ofcommission (including some very disturbing howlers by medicalauthors) and omission, including the sometimes striking lack ofdata about contraception. In some respects, no doubt, theseauthors would have been better employed writing a sex-educationmanual of their own, though one does not need to be old-fashionedto wonder if their remarks on oral and anal intercourse in acomment on moral rules are really ideal meat for beginners.(London: National Secular Society. 5s.)