992 a

two-hour result

over

120

mg/dl. In 2 patients there was mild

deterioration in glucose tolerance, but,

the other hand, 5 patients showed improvement during treatment. 9 further patients had diabetes mellitus; the control of their diabetes was not affected by long-term bumetanide. These observations, taken with those of others 1-4, indicate that bumetanide has little, if any, effect on carbohydrate metabolism and can be used with relative safety in diabetics. While we agree with almost all the points made in your editorial, we felt it a little unfair to relegate bumetanide to the role of reserve diuretic. In our long-term studies5 we found bumetanide produced an excellent diuretic response in all 38 patients. No clinically significant biochemical or hmmatological abnormalities were encountered. A potassium supplement of 16 mmol K given with 1 mg of bumetanide protected against hypokalaemia. From our experience over the past two years and the fact that bumetanide is substantially cheaper than frusemide, we have come to the conclusion that bumetanide is an entirely satisfactory short-acting diuretic for routine use. on

Burton Road Hospital and The Guest Hospital, Dudley, West Midlands.

the

possibility that

it

doctor in the present

might not be an indigenous disease. The case

had fallen short of the standard of

by a general practitioner in his Had the disease been diagnosed was and position, negligent. and treated in time the patient would have had a good chance of recovery. His widow succeeded in her claim, and was entitled to k 15 093 damages.

care

that should be observed

Langley v. Campbell. Queen’s Bench Division: Cusack, J., Nov. 5, 1975. Counsel and sohcitors: James Comyn, Q.c., and Roy McAulay (Crossman, Block, & Keith); Anthony McCowan, Q.c., and Guy Boney (Le Brasseur & Oakley RACHEL DAVIES, Barrister-at-Law.

Obituary ALBERT GORDON BAIKIE

M.B.Glasg., F.R.C.P.E., F.R.A.C.P., F.R.C.Path., F.R.C.P.A., M. M. KUBIK E. BOWERS

1.

Olesen, K. H., Sigurd, B., Steiness, E., Leth, A. Acta med. scand. 1973, 193,

2.

Davies, D. L., Laut, A. F., Millard, N. R., Smith, A. J., Ward, J. M., Wilson,

119. G. M. Clin. Pharmac.. Ther. 1974. 15. 141. 3. Murdoch, W. R., Auld, W. H. R. Postgrad. med. J. 1975, 51, 10. 4. Singh, B. B., Watt, D. A. L. ibid. 1975, suppl. 6, 51, 71. 5. Kubik, M. M., Bowers, E., Underwood, P. N. Br. J. clin. Pract. (in the

press).

Medicine and the Law Negligence of Doctor in Malaria Case AN Englishman returned from a visit to Uganda on July 1, 1970. He felt unwell on the evening of July 9, and the doctor was sent for on the following day. The symptoms included headache, fever, sweating, and shivering, and the doctor diagnosed pyrexia of unknown origin, and prescribed ampicillin. He called again on July 11, 13, and 15, and all the time the patient’s condition deteriorated. His temperature remained high and he developed new symptoms. He complained of a tight band around his head, and had difficulty in talking, eating, and drinking. He started hiccuping and vomiting, and on July 15 the doctor prescribed tablets for hiccups. The patient’s family told the doctor on his first visit, and repeated it on later visits, that he had recently retured from Uganda, and that he had suffered from malaria during the war. Also they suggested that he should have a blood-test. The doctor assured them that the patient was suffering from influenza, not malaria, and when, on July 15, they asked for a second opinion, he said he had already discussed it with his partner, who agreed that it was not malaria. The partner later denied that the matter had ever been discussed with him. On July 16 the family called in the partner and he transferred the patient to hospital, where malignant tertian malaria was immediately diagnosed by two Asian doctors. That diagnosis was correct, and the patient died on July 18. His widow claimed that his death was caused by the doctor’s negligence, and sued for damages. The doctor had died in the meantime, and the action was brought against his widow as administratrix of his estate. Mr Justice CUSACK said that medical evidence showed that a patient with ordinary influenza began to feel better after three or four days, and if his condition deteriorated he should be the cause of special concern. The doctor in the present case did not show special concern. The ordinary general practitioner did not normally come across cases of malaria, but if he knew that his patient had just returned from the tropics and was not improving, it should occur to him that he might be dealing with a tropical disease of some kind. Although he might not be capable of diagnosing malaria, he should consider

D.P.A.

Dr A. G.

Baikie, professor of medicine in the University of Tasmania, and senior physician to the Royal Hobart Hospital, Hobart, Tasmania, Australia, died in the Radcliffe Infirmary, Oxford, on Oct. 26; he was 50. A Scotman, he was born in Lowestoft and was educated in Glasgow at the Albert Road Academy and at the University of Glasgow, graduating M.B. in 1949. He found time during his course to edit Surgo, the medical students’ journal, and also to obtain the University’s diploma of public administration in 1949. He worked at Stobhill Hospital and at the Glasgow Royal Infirmary where he was a Beit memorial fellow in the department of medicine with Prof. L. J. Davies. He left Glasgow to become a foundation member of the M.R.C. Clinical Effects of Radiation Research Unit at the Western General Hospital, Edinburgh. Here he carried out some of the earliest work on the cytogenetics of human leukaemias. In 1959 he married Dr Margaret J. King, and in 1960 he was appointed honorary consultant physician to the Western General Hospital. In 1963 he moved to the university department of medicine at St. Vincent’s Hospital, Melbourne, Australia, where he was successively senior lecturer and reader in medicine. In 1967 he was appointed foundation professor of medicine in the University of Tasmania. He is survived by his wife, who is a hsematologist, and a son and daughter.

A. S. D. S., phy, writes:

to

whom

we are

grateful for this biogra-

"Albert Baikie’s period in Melbourne was marked by notable contributions to medical education, by the continuation of his clinical and cytogenetic research in the leukaemias, and by the initiation of cytogenetic studies in the malignant lymphomas. At St. Vincent’s Hospital his name was a byword for clinical judgment and scientific acumen and his departure to take up the chair in Tasmania was deeply regretted by his many friends. He met the many challenges of his new post with characteristic energy and drive, building a strong department of medicine which combined research with a heavy teaching load and the running of a busy clinical service. He contributed much to the steady and vigorous growth which has characterised the new Medical School of the University of Tasmania. As senior physician to the Royal Hobart Hospital and a

993 which he wrote in the medical journals; his Services in England was published in 1947.

on

member of the Tasmanian Cancer Committee and the Asthma Foundation, his extramural activities were onerous, but thanks to a seemingly unlimited capacity for work, he was also president of the Australian Haematology Society, a council member of the Royal Australasian College of Physicians, and chairman of the Medical Research Advisory Committee of the National Health and Medical Research Council. "An appreciation of Albert Baikie’s distinguished career must take account of his stature as a scientist: he was an international authority on cytogenetics, oncology, haematology, and epidemiology. These talents were combined with an ability beyond the ordinary to administer, to direct research, and to inspire the scientific endeavours and the personal loyalty of others. As a medical educator, his talents were as clearly demonstrated at the bedside with a small group of students as they were at meetings of the professorial board. More important than all these were his personal qualities-unfailing courtesy and kindliness, constant interest in the problems of his junior colleagues, a broad knowledge of literature and art, a keen sense of humour, and a love of humanity which was apparent to all."

R. H. P. writes: "His many friends will be very sad at the death of Prof. Robert Wofinden. His physical health had deteriorated rapidly during the last few years, but his mental alertness was as alive as ever. In spite of ill-health his Yorkshire tenacity and determination kept him on top of his work to the very last moment. "I was privileged to be his colleague for many years. I remember well, when the vacancy of deputy medical officer of health was advertised, that his name and references were well up on the list. Lord Moran and Sir Wilson Jameson had both been his teachers-the former at St. Mary’s Medical School and the latter at the School of Hygiene; both wrote of him as a brilliant scholar and an outstanding student. "I personally could’not have wished for a better deputy. He was an energetic student of the problems of local government, devoted to his work, and a most loyal colleague. I was delighted when the City and University decided, twenty years ago, that he should take over the reins of office. The present state of the public health services of Bristol is a tribute to his great service to the City."

D. A. G. G. adds: "I first met Albert Baikie when he was a member of the Medical Research Council’s Clinical Effects of Radiation Research Unit at the Western General Hospital, Edinburgh. Baikie’s role was to coordinate the clinical and haematological aspects of the work with the fundamental laboratory research, esin cytogenetics. This cooperative effort led within a few years to the collection of a mass of new information of outstanding importance on the cytogenetic abnormalities present in leukaemia, particularly chronic granulocytic leukaemia. In this disease an abnormal chromosome, almost always present in the bone-marrow cells, was correctly identified as belonging to one of the pairs of small acrocentric chromosomes, and was not an abnormal Y chromosome as originally suspected. The Unit workers named this chromosome ’Philadelphia’ (or Ph’), where it had been first described. Baikie played a large part in working out the distribution of the Ph’ in the blood and bonemarrow cells at different stages of the disease and in correlating the changes with the ,dtment administered. He knew every clinical and hæmatological detail of his patients, and with prophetic insight he could pick out the significant observation from a mass of undigested data, using it effectively in planning the next step in the investigation. Albert Baikie was an outstanding clinical scientist, and a warm friend who will be greatly missed."

pecially

EVELYN MAUD FINNIE M.D.

was

educated

at

holding junior clinical appointments in Glasgow she appointed registrar in pathology at the Royal Free Hospital, London, before going to the University of the West Indies in 1965 to become lecturer in microbiology. There she was awarded a fellowship by the Ministry of Overseas Development to study hospital infections by klebsiellas, which formed the subject of her M.D. and M.SC. theses. Before returning to England in 1971 she had been appointed consultant microbiologist to the University Hospital, Jamaica, and had held a Pan American Health Organisation fellowship in immunology. After serving in the Public Health Laboratory, Derby, she was appointed, in 1973, consultant microbiologist at the Coventry Public Health Laboratory, of which she became director in April, 1975. She was also honorary consultant microbiologist to the Coventry hospitals. Evelyn or, as she preferred, Lyn Finnie was an intelligent, was

Rotherham Grammar School and St. M.B.

M.Sc. West Indies

and after

61. He

Glasg.,

Dr Evelyn M. Finnie, consultant microbiologist and director of the Public Health Laboratory, Coventry, died on Oct. 6 at the age of 43. She graduated M.B. from the university of Glasgow in 1959,

ROBERT CAVILL WOFINDEN M.D. Lond., F.R.C.P., F.F.C.M., D.P.A., D.P.H. Dr R. C. Wofinden, professor of public health in the University of Bristol, died on Nov. 7 at the age of

Mary’s Hospital Medical School, London, graduating

book Health

in

1937 and M.D. in 1939. He became F.R.C.P. and F.F.C.M. in 1972. His first appointment in public health was as assistant medical officer of health in Rotherham, where he subsequently became deputy medical officer of health and senior school medical officer. He moved to Bradford as deputy medical officer of health in 1946, and then to Bristol in 1947. He was appointed medical officer of health, principal school medical officer, and port medical officer to the City of Bristol in 1956-the same year in which he became professor of public health in the University of Bristol. His work in public health was well known, both at home and abroad; he was a consultant to the World Health Organisation and a member of the International Epidemiological Association, as well as serving on numerous national committees. He was particularly interested in the development of health centres, which was one of several subjects



experienced, and enthusiastic microbiologist; she was mamly oriented towards clinical bacteriology, and her special interest lay in the genus Klebsiella. She was one of the few microbiologists in this country able to type them reliably by serological techniques, and consequently her services and advice were in growing demand by other microbiologists concerned in tracing the origin of these troublesome infections. But she was no narrow specialist, for she brought to the everyday problems of medical microbiology a wide understanding derived from her academic days and a sound clinical judgment. She much enjoyed teaching, and her appointment at the University of Warwick, where she made an invaluable contribution to the teaching of medical microbiology to B.SC. students, was a source of considerable satisfaction to her. Colleagues in Coventry had just come to know this delightful person who exemplified the feasibility of combining an active and successful professional career with a domestic life as a wife and mother, and a number had already experienced the warm hospitality of the home she shared with James Finnie and their three children. They will remember particularly the remarkable fortitude with which she faced the disease which struck her.

J.E.M.W.

Albert Gordon Baikie.

992 a two-hour result over 120 mg/dl. In 2 patients there was mild deterioration in glucose tolerance, but, the other hand, 5 patients showed im...
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