BRITISH MEDICAL JOURNAL
NEWS
18 FEBRUARY 1978
449
AND NOTES
Vewzvs Women who succeed do so because they are lucky or highly motivated, rather than because of skill or ability. In contrast, male failure is due to luck: success is expected of men. These, says Helen Weinreich-Haste in the British J7ournal of Social and Clinical Psychology (1978, 17, 37), are the stereotype attitudes. When she put them to the test at the University of Bath she found some confirmation; but she also found that women were realistic rather than anxiety-ridden about the consequences for relationships of successful competition by either partne-.
J7ust how appalling a disease rabies is in developing countries is shown by a WHO report that in Sri Lanka there are over 300 deaths in a year; hardly any patients are given antirabies serum after being bitten, despite the high prevalence of the disease.
Not everything that comes out of Quebec these days is political, and Minerva is delighted to welcome the appearance of a new journal, Clinical and Investigative Medicine, with an exThomas's and Mayo Clinic man, David Shephard, as its executive editor. Though his two principal colleagues are also based on McGill University, the editorial board has cast its net widely and includes a brace of British knights, Richard Doll and Arnold Burgen, as well as Franz Ingelfinger from Boston and Priscilla Kincaid-Smith from Melbourne. One aim of the journal is to try to prevent good Canadian scientific medical papers from being published outside the country, but since it will also print articles written in French (with every English article having an abstract in French) the hope is that doctors from French-speaking Continental countries will also submit papers to it. Published by Pergamon, the journal has got off to a good start with three editorials, two annotations, four originals, and a first-rate review article on fibre.
Coming back from the Canadian launching party, Minerva was delighted by a sign of the times: so many people wanted non-smoking seats that the air hostess had to apologise that theyj had run out. British Airways (and, she suspects, ASH) have done a good job to make travel in the aircraft tolerable for non-smokers. Would that the British Airports Authority would do the same. Once again she was sickened by the smoke-laden atmosphere of Heathrow's Terminal 3 departure lounge-with its so-called non-smoking areas with small, ineffectual notices prohibiting smoking and providing tall ashtrays to encourage smokers to ignore the ban. When will the azuthority realise that it has a duty to enforce the rules and give the non-smoking majority the clean air it has a right to ? Americans are much concerned with hyperactive childrenthe diagnosis is made much more readily in the United States than in Britain. In 1973 Ben Feingold, a San Francisco allergist, suggested that the condition might be due to food additives and recommended treatment with a diet containing no synthetic colours or flavours and no salicylates. Claims that half of hyperactive children improve on this regimen have been challenged in a series of controlled trials (American 7ournal of Diseases of Children, 1977, 131, 1204), but the Feingold supporters still
refuse to accept these results, claiming that the trials were financed by the food industry.
"Science" observes (1978, 199, 516) that the Feingold diet is only the latest in a long series of purported cures for hyperactivity: among the suggested causes of the syndrome are refined sugar, tight underwear, and fluorescent lighting. To these Minerva would add American parents. After which there is a reassuring English quality in Neville Oswald's account in the Reports of the Transactions of the Devon Association for the Advancement of Science of the summer of 1551, when the sweating sickness spread through the country for the last recorded time. This influenza-like illness killed within a few hours and struck regardless of rank-hence its popular names "Stop Gallant" and "Know thy Master." So many London merchants died in July that Edward VI moved to the safety of Hampton Court. The epidemic stopped abruptly in September, never to be heard of again. Are the old professional courtesies on the way out? Minerva heard recently of a young assistant in a city general practice who developed appendicitis. His principal made the diagnosis and sent him to hospital through the bed bureau-apparently making no effort to make personal contact with any of the local surgeons.
Ambivalent as Minerva sometimes is about the equality of the sexes, she is more muddled than ever about which side to take after reading Women, Sexuality, and Social Control, edited by Carol Smart and Barry Smart (Routledge & Kegan Paul, C2-95), a reasonably unhysterical book about the subtler forms of oppression to which women are subject. Nevertheless, to be told that a woman's functions are "the production and maintenance of the present labour force, as well as being principally responsible for the consumption of the goods produced," is a little daunting even if true. It's also true that heifers gain weight faster if kept apart from young bulls or bullocks. Apparently the male smell has an anorectic effect on the adolescent female-which, no doubt, accounts for the hearty appetites and sturdy limbs of Minerva's schoolgirl acquaintances at unisex boarding schools. Doctors will not be surprised to learn that there are more suitable candidates than places for medical courses. But the 1976-7 annual report of the Universities Central Council on Admissions shows that the number accepted by UK universities in 1977 (3742) was the highest ever, while the number of candidates (12 098) was somewhat less than the peak of 13 003 in 1974. Moreover, the proportion of candidates accepted at the late "clearing" stage-300%'-had risen slightly, though it was well below the proportion for most other subjects. But there's no risk of standards going down: even those who scrape into medical schools by the skin of their teeth apparently have good GCE qualifications. MINERVA
450
BRITISH MEDICAL
MEDICOLEGAL
belt was that it might aggravate rather than diminish the injuries in the event of an accident. However, it would be wrong to regard the new ruling as a loophole in the Court of Seat-belt phobia Appeal decision. Mere dislike of belts or a belief that they are dangerous will not suffice FROM OUR LEGAL CORRESPONDENT to avoid a finding of contributory negligence, and judges are unlikely to be impressed by In a judgment' in December last year Mr evidence of phobia unless it is supported by a Justice Bristow held that a 53-year-old doctor's testimony. woman's phobia about wearing seat belts was Condon v Condon, The Timves, 9 December 1977. justification for not doing so, and he therefore made no deduction from the j11 090 damages 2 Froom v Butcher (1976), QB at p 295. he awarded her for injuries suffered in a road accident in October 1974. In 1975 the Court of Appeal finally resolved the previous differences of opinion between High Court judges by holding that the failure of a driver or front-seat passenger to wear a seat belt was contributory negligence if an accident occurred. Accordingly, even where a plaintiff is entirely without blame for the Employment protection accident, his damages will be reduced in partproportion to the extent that his injuries were Two private members' Bills have recently caused or aggravated by the absence of a belt. had their second reading in the House of Lord Denning2 said that the reduction should Commons. The first, introduced by Mr Ted be 25 ° of the damages where the evidence Fletcher, seeks to deal with the problems showed that the injuries would have been pre- which have arisen for the Advisory, Conciliavented altogether by wearing a belt and 15 % tion, and Arbitration Service in carrying out its if the injuries would have been a good deal less duties of inquiring into and reporting on severe with a belt worn. workers' recognition issues. The other, preLord Denning also stated that mere forget- sented by Mr Ian Mikardo, is intended to fulness was no excuse for failure to wear a belt validate agreements by independent trade but that the law would admit some exceptions unions for restricting references of recognition to the general rule. He mentioned "a man who issues to ACAS. Both Bills have been supwas unduly fat or a woman who was pregnant, ported by the Government. Mr Albert Booth, because if there was an accident, the strap Secretary of State for Employment, told the across the abdomen might do them more harm Commons on 20 January that the Government than good." Mr Justice Bristow reminded was keeping a close watch on the working of himself of those words in the present case, the Employment Protection Act to identify where the plaintiff injured her right eye and further amendments that might be necessary. suffered a permanent disability to her vision after an accident in which she was the frontseat passenger in a car which hit a telephone Questions in the Commons pole. The judge said that he was far from convinced that the failure to wear a belt had con- Medicines-prescription only tributed to the plaintiff's injuries: he thought that it was just as likely that the piece of glass The Medicines (Prescription Only) Amendwhich damaged her eye was dislodged from ment Order (11 February, p 377) came into the windscreen when the car hit the telephone operation on 11 February. Reporting this in a pole as by any impact between her head and written answer on 10 February, Mr Roland the windscreen. But even though Mr Justice Moyle said: "By virtue of this Amendment Bristow found that no reduction in the damages Order medicinal products for human and was merited on the facts of the case, he went animal use, that before 1 February 1978 could on to give his view of the law. He was satisfied legally have been sold or supplied without a on the medical evidence that the plaintiff had prescription, and which became subject to a genuine phobia about wearing a seat belt prescription only control under the principal because of her fear of being trapped in the Order, will be allowed to be sold or supplied event of an accident. She was therefore not an without prescription for a further period of ordinary case, but an exception-like the six months. The Amendment Order provides that where previous legislation required the corpulent man and the pregnant woman. sale or supply of such products to be recorded in a register or made against a signed order those procedures should be followed during View of risks the six months' period as if the requirements The judge appreciated that the Court of had continued in force." Mr Moyle also reported that the Medicines Appeal had held that it was unreasonable for a plaintiff to act on his own view of the risks in (Labelling) (Special Transitional) Regulations preference to the widely publicised evidence 1978 had been laid before Parliament. "These that seat belts reduced the risk of injury, but regulations," he explained, "are designed to he did not think that that was what the plaintiff deal with problems which could arise with had done. Given her phobia, it was enough to regard to the labelling of medicines by virtue say that she had not failed to take reasonable of the introduction of this transitional exemption. They provide that during the same period care for her safety by wearing the belt. The case confronting Mr Justice Bristow of six months the requirements of the Mediwas not entirely analogous to the examples cines (Labelling) Regulations 1976 will be mentioned by Lord Denning, since in the case deemed to be satisfied by the labelling of of the corpulent man and the pregnant woman medicinal products which but for the prothe reason for excusing them from wearing a visions of the Medicines (Prescription Only)
PARLIAMENT
JOURNAL
18 FEBRUARY 1978
Amendment Order would have satisfied those requirements." Nurses In an oral answer on 7 February Mr Eric Deakins reported that "the number of qualified nurses and midwives registered as unemployed in England in December 1977 was about 100 lower than in September, and now stands at 4013. Posts are available in the National Health Service for qualified nurses, but some may be unable or unwilling to move to areas where there are vacancies." At the same time, he said, there were over 2000 vTacancies for qualified nurses registered with the Employment Services Agency in December.. Answering the comment from Mr Evelyn King that "if only we could get rid of this monstrous army of clerks we could afford to pay the nurses," Mr Deakins said that in March 1977 there were 214 000 qualified nurses employed -an increase of 9000 over the previous year. It was up to area health authorities to decide their establishment, and in the financial year ended March 1977 health authorities had increased the proportion of their revenue expenditure which was spent on nurses.
Poliomyelitis vaccination In a written answer on 7 February Mr Roland Moyle said, "It is estimated that about 26 %1 of children have not been vaccinated against poliomyelitis by the end of the second year after their year of birth. The proportion who remain unvaccinated by the age of 16 is likely to be of the order of 15 The estimates are based on information up to the end of 1976. Information for 1977 is not yet available."
Nursing (Briggs Report) In a written answer on 7 February the Secretary of State announced that "if time can be found the Government would like to introduce this session a short Bill to implement those recommendations of the Briggs Report relating to a new statutory framework for nurse education and training." Mr Ennals said that he hoped that the Government could count on the support of the Conservative
party.
Hospital beds In a written answer on 31 January Mr Roland Moyle set out the average daily number of available beds in hospitals in England from 1970 to 1976: 1970 1971 1972
1973 1974 1975 1976
423 419 412 403 396
600 600 700 500 200 387 600 383 100
Medical Bill The Medical Bill, which seeks to amend the constitution and functions of the General Medical Council (4 February, p 311), had its third reading in the House of Lords on 2 February and has passed to the House of Commons.
BRITISH MEDICAL JOURNAL
18 FEBRUARY 1978
451
MEDICAL NEWS Number of cases of malaria notified, 1948-76. The 1976 figure, 1162, was almost double the 1953 peak (which was due to the return of servicemen from the Far East). The rate was highest in the 15-44 age group and almost twice as high in males as in females. The prominent parasite species was Plasmoditum vivax and the main source of infection was the Indian subcontinent. From Statistics of Infectious Diseases 1976 (MB2 No 3),
Occupational mortality Social class differences in mortality continue to be apparent in the latest decennial supplement of Occupational Mortality (Government Statistical Service; HMSO, £4 75). From the 1970-2 figures, professional men's sons could expect to live 71 years on average but those of unskilled labourers less than 66 years. Within classes, the self-employed fared better than employees, and employers than managers in industry. The class gradient applied to most diseases. Previously the high rates for bronchitis in dusty trades has been attributed to the men's general circumstances and way of life rather than the dust as such. The report points out, however, that the 1970-2 rates cannot just be explained by social class. Similarly, cerebrovascular disease and stomach cancer (though this has diminished since the war) appear to be associated with dusty occupations.
1200
1000 E c
800
a a
UN
o
600 400 200
-
0
1950
1955
1960
1965
1970
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Government Statistical Service; HMSO, 1978 (price 1-75). Crown copyright.
tained on dialysis, he said, had risen by 100%. is to increase understanding among all staff During January 78 patients had transplants, dealing with disturbed offenders, and thus four more than in December. The number lower the risk of violent outbursts. waiting for transplants was 1177, compared with 1198 in December. New professor of physiology
New vaccination campaign Public Health Laboratory Service A publicity campaign telling parents about the benefits and risks of the basic vaccinations offered to children, including vaccination against whooping cough, is to start next month, Mr David Ennals announced in the House of Commons last week. This follows the advice of the joint committee on vaccination and immunisation, which supports the continued use of whooping-cough vaccine. The facts about vaccination will be publicised by advertisements in the national press and posters and leaflets in health clinics. In 1977 over 17 000 cases of whooping cough and eight deaths were reported in England and Wales, compared with just under 4000 cases and three deaths in 1976. This year 5600 cases had been reported by 27 January.
Dr B R Jewell has been appointed to a new chair of physiology at Leeds University, to take effect from 1 September 1978. Dr Jewell has been reader in experimental physiology since 1970 at University College London, where he is also vice-dean of the faculty of medical sciences. He obtained his BSc at Charing Cross Hospital Medical School and returned there to complete his medical degree after working for a PhD at University College London. After various house appointments and a year in the department of zoology at Oxford, he went back to University College as a lecturer in physiology. In 1967-8 he was a visiting assistant professor at Harvard Medical School. Dr Jewell's major research interest is the study of how the force of the heart beat is regulated.
In 1976 the 54 laboratories of the Public Health Laboratory Service received 5-3 million specimens-some 10 % more than in 1975, according to the PHLS's latest annual report. Twenty-seven per cent were urine samples, and automated methods are being developed to identify those samples containing appreciable numbers of bacteria and needing full analysis. Virus isolation is performed in 43 of the laboratories, and the 8% increase in specimens demanded considerable resources; nine laboratories had 5000-10 000 specimens. With the simpler methods now available 41 laboratories now test for hepatitis B surface antigen. Sera for rubella antibody testing increased 32 °,, probably because of attempts to step up immunisation programmes. Training courses being organised by the Mycology New professor of genetics Reference Laboratory should make diagnostic Road and rail casualties Dr D A Ritchie, senior lecturer in the mycology more widely available and should, The total economic cost of road casualties says the report, enable many patients with Glasgow University department of virology in 1977, it was reported in the House of fungal infections to have earlier appropriate since 1972, has been appointed to the chair of genetics at the University of Liverpool, which Commons, was about C500m, and of casualties treatment. became vacant on the death of Professor P M in rail accidents £5m. Sheppard. Dr Ritchie graduated from LeicesPrison medical services ter University in 1959 with a BSc in botany. In 1964 he was awarded a PhD in microbial Treatment of kidney disease Some 15-20 °'o of all offenders and over genetics by the University of London after Mr David Ennals announced in the House of half the women in custody have some form spending five years at the Medical Research Commons last week that an extra £Im of psychiatric treatment during their sentence, Council Microbial Genetics Unit. After would be available for special haemodialysis according to Prisons anid the Prisoner (Home working for two years as a research associate at units. Funds had already been made available, Office; HMSO, £5 25). The psychiatric Johns Hopkins University, Baltimore, he he said, to help regions to develop paediatric services have developed substantially in the became lecturer in the Glasgow department of dialysis facilities. This additional money would last few years. Of the 101 full-time prison virology in 1966. His present research is on the be for a few limited-care units, designed to medical officers, two-thirds have had psy- molecular genetics of viruses. cater for patients who no longer needed full chiatric experience outside the prison service; hospital facilities, but who for one reason or there are also 66 visiting psychotherapists another-perhaps because they lived alone- and eight consultants in forensic psychiatry New standard to reduce radiation effects could not have dialysis at home. The DHSS shared with area health authorities. Many on patients will shortly be approaching regional health offenders besides those who are manifestly A new standard for the medical electrical authorities about allocating these extra funds. ill need some psychiatric support, especially Mr Ennals said that he was concerned about during a long sentence. Grendon Prison, the industry is intended to help both manufacthe continuing shortage of donor kidneys for first psychiatric prison, is pioneering the turers and medical workers to reduce the transplantation and was launching a kidney treatment of personality disorders in prison; radiation exposure of patients having radiodonor card publicity campaign in the next few offenders may receive psychiatric care at logical examinations. The International Elecmonths. He thought that the kidney donor several prison psychiatric centres, and special trotechnical Commission announces a safety card system was successful, as there had been a treatment for alcoholics and drug addicts standard-IEC publication 580-for area 14%O increase in the number of transplants in is given in some prisons. An important part exposure product meters, with specifications 1977. The total number of patients main- of the medical officers' work, says the report, for construction of components, performance
452 and acceptable factors of error. The first world-wide general safety standard for the manufacture, installation, and application of medical electrical and electronic equipment was issued by the commission in January as IEC Publication 601, Part One. This includes information on the compatibility and interchangeability of medical electrical devices.
BRITISH MEDICAL JOURNAL
Socialist Medical Association-Day seminar on "Thirtieth anniversary of the National Health Service-what of the future ?", 12 March, London. Details from SMA, 9 Poland Street, London W1V 3DG. (Tel 01-439 3395.) Camden Association for Mental HealthDetails and copies of the programme of a monthly series of lectures and discussions on "To calm the troubled mind" are now available from the Association, Raglan Day Centre, Raglan Street, London NW5. (Tel 01-485 0229.)
Radiological protection The National Radiological Protection Board has advised the Government that the recommendations of the International Commission on Radiological Protection provide a satisfactory basis for controlling the exposure of people to ionising radiation in work places and in the general environment. The central theme of the new recommendations is the system of dose limitation. The main features of this are: no practice involving radiation exposure shall be adopted unless its introduction produces a positive benefit; all exposures should be kept as low as can reasonably be achieved, economic and social factors being taken into account; and the "dose equivalent" to individuals shall not exceed the limits recommended for the particular circumstances by the commission. The NRPB considers that many specific points in the recommendations need to be interpreted. It has therefore established a new report series, Advice on Standards for Protection (to be sold through HMSO), for publishing its comments.
Help for the mentally ill and handicapped
SOCIETIES AND LECTURES For attendintg lectures marked * a fee is charged or a ticket is required. Applicationzs shouild be made first to the
inlstitution concernzed.
Monday, 20 February INSTITUTE OF LARYNGOLOGY AND OTOLOGY-5.30 pm, Professor R M H McMinn: Electron microscopy of the tympanic membrane.
Wednesday, 22 February INSTITUTE OF DERsoATOLOGY-4.30 pm, Dr R H Mears: Skin manifestations of internal malignancy. INSTITUTE OF NEUROLOGY (QUEEN SQUARE)-Sandoz Foundation advanced lectures, 6 pm, Professor M Coltheart: Cognitive psychology and acquired dyslexia. 7 pm, Dr Hazel E Nelson: The role of memory in childhood dyslexia. INSTITUTE OF ORTHOPAEDICS-5 pm, Mr D M Dunn: Slipped upper femoral epiphysis. 7 pm, Professor B McKibbin: Treatment of Perthes's disease. INSTITUTE OF PSYCHIATRY-5.30 pm, Dr J C Gunn: A study of Grendon Prison. ROYAL FREE HOSPITAL SCHOOL OF MEDICINE-5 pm, Dr R G Petersdorf (Washington): Factors affecting antimicrobials. UNIVERSITY OF OXFORD-At Radcliffe Infirmary, 5 pm, Dr N A Wright: Cell kinetics, tumour growth, and cancer therapy.
Thursday, 23 February CAMBRIDGE UNIVERSITY-At Department of Genetics, Downing Street, 4.30 pm, Dr C Bostock: Analysis of satellite DNAs on individual human chromosomes. PHARMACEUTICAL SOCIETY OF GREAT BRITAIN-Joint evening meeting with Guild of Hospital Pharmacists at Pharmaceutical Society's Headquarters, 7 pm, Dr R P Enever: The application of innovative dosage form design to improved drug therapy. WESTMINSTER MEDICAL SCHOOL-5.15 pm, Dr F I D Konotey-Ahulu (Ghana): Clinical and public health aspects of sickle-cell disease in West Africa.
Mr Alf Morris, Minister for the Disabled, has urged local authorities to make more use of the provisions of the Chronically Sick and Disabled Persons Act to improve the quality of life of the mentally ill and handicapped as Friday, 24 February well as of people who are physically disabled. INSTITUTE OF LARYNGOLOGY AND OTOI.OGY-5.30 pm, Dr G A S Lloyd: Radiology of the parainasal sinuses. Speaking in London to representatives of some COLLEGE OF SURGEONS OF ENGLAND-5 pm, 40 national voluntary organisations, Mr Morris ROYAL Hunterian lecture by Professor A J MacGregor: The radiological assessment of lower third molars. At said that families who care for a mentally ill Birmingham Dental School, 5 pm, Hunterian lecture or handicapped relative at home not only give by Professor R M Baddeley: The management of gross refractory obesity by jejuno-ileal bypass. a better kind of care than an institution could but also save the community a lot of money. Under the Act local authorities can relieve BMA NOTICES these families of some of the strain by providing help in the home-for example, an adapta- Central Meetings tion or aid, or a home help or meal in the home. FEBRUARY "Such help can make all the difference," he Medical Academic Staff Committee, 10.30 said, "to a family struggling to keep a relative 20 Mon am. out of an institution." Scottish Joint Consultants Committee 21 Tues 22 Wed
People in the news
22 Wed
The honorary gold medal of the Royal College of Surgeons has been awarded to Professor T Cecil Gray, past dean of the faculty of anaesthetists of the Royal College of Surgeons of England and of the faculty of medicine, University of Liverpool, in recognition of his outstanding contributions to medicine and
23 Thurs
surgery and to the science of anaesthesia.
COMING EVENTS International Symposium on Current Trends Tumour Immunology - 10-12 March, Cremona, Italy. Details from Organising Secretariat, Piazza del Carmine 4, 20121 Milan, Italy. in
(7 Drumsheugh Gardens, Edinburgh EH3 7QP), 10.15 pm. Finance and General Purposes Committee,
10 am. Executive
Subcommittee (SHJSC) (7 Drumsheugh Gardens, Edirnburgh EH3 7QP), 1 pm. New Charter Working Party (GMSC), 10 am.
MARCH
1 Wed
1 Wed
Private Practice Committee, 10.30 am. Rheumatology and Rehabilitation Group Committee, 2.30 pm.
General Purposes Subcommittee (GMSC), 10.30 am. 3 Thurs Scottish General Medical Services Committee (7 Drumsheugh Gardens, Edinburgh EH3 7QP), 10.30 am. 2 Thurs
18 FEBRUARY 1978
Aldershot and Farnham-At Camberley Heath
Golf Club, Thursday, 23 February, 8 for 8.30 pm, annual dinner.* (Guests are welcome.) Birmingham-At Birmingham Medical Institute, Tuesday, 21 February, 8.15 pm, joint meeting with Medical Women's Federation, Midland Medical Society, and Midland Veterinary Association, "Zoonoses and rabies." Bradford and Airedale-At Bradford Royal Infirmary, 'Wednesday, 22 February, 8.30 pm. Professor John Marshall: "Models of the central nervous system." Bristol-At Bristol Royal Infirmary, Wednesday, 22 February, 8.30 pm, Professor John Mitchell: "Antique maps." (Preceded by informal dinner, 7 pm.*) Bromley-At Farnborough Hospital, Thursday, 23 Februarv, 8.15 for 8.30 pm, Dr D K Browne will give an illustrated talk on Malawi. Burnley-At Burnley General Hospital, Friday, 24 February, 8 pm, joint meeting with Burnley and District Incorporated Law Society, Mr Nigel Keddie: "Res ipsa loquituir or does it ?" Croydon-At Conservative Club, Thursday, 23 February, 8 pm, second annual joint meeting with BDA Croydon Division with buffet supper.* (Wives welcome.) Gateshead-At Queen Elizabeth Hospital, Friday, 24 February, 7.30 pm, joint party for members and guests with British Dental Association.* Greenwich and Bexley Divisions-At Greenwich District Hospital, Friday, 24 February, 7.30 for 8 pm, dinner for members and guests, speaker Dr A L De Silva: "My eyes have four legs."5 Harrow-At Northwick Park Hospital, Meoinday, 20 February, 8 pm, joint meeting with Harrow and Hillingdon Branch of the Pharmaceutical Societv of Great Britain, speaker Dr Peter Boreham: "A scientific safari to Africa." Holland Lincs-At Pilgrim Hospital, Saturday, 25 February, 7.30 pm, Dr Richard Fox: "Suicide."5 (Followed by buffet supper.) Manchester-At Boyd House, Tuesday, 21 February, 8 for 8.30 pm, scientific meeting, Dr T R Wilson: "Current treatment of depressive illness."5 Salop-At Medical Institute, Friday, 24 February, 8 pm, Mr Martin S Brookes: "Hypnosis in medicine and dental surgery." (Spouses are welcome.' Scarborough-At Scarborough Hospital, Thursdav, 23 February, 8.30 pm, Dr George Cust: "The ill made wvell; the well made ill." Scunthorpe-At Scunthorpe General Hospital, Tuesday, 21 February, 8 pm, meeting. South-west Durham-At Bishop Auckland General Hospital, Tuesday, 21 February, 8 pm, buffet meal followed by lecture. South-west Wales-At Ivy Bush Royal Hotel, Carmarthen, Saturday, 25 February, 7 for 7.30 pm, annual dinner and BMA lecture by Dr K P Duncan: "Is work good for you ?"* (Guests are invited.) Swindon-At Princess Margaret Hospital, Thursday, 23 February, 7.30 for 8 pm, early music evening.* (Guests are invited.) Wakefield-At Stoneleigh Hotel, Thursday, 23 February, 7.30 for 8 pm, informal lecture dinner, Dr Ian Adams: "Sports media."* (Guests are welcome.) Woking and Chertsey-At St Peter's Hospital, Wednesday, 22 February, 8.30 pm, Professor Roger Dyson: "The place trade unions occupy in the NHS today, and their anticipated role in the future, with particular reference to the implications this may have for the medical profession." (Members of neighbouring
divisions welcome.)
Regional Meetings South-east Thames Regional Council-The meeting arranged for Tuesday, 28 February, has been postponed to April.
Notice to authors When original articles and letters for publication are not submitted exclusively to the British Medical Journal this must be stated. For detailed instructions to authors see page 6 of the issue dated 7 January 1978. Correspondence on editorial business should be addressed to the Editor, British Medical _ou4rnal, BMA House, Tavistock Square, London WC1H 9JR. Telephone: 01-387 4499. Telegrams: Aitiology, London WC1. Communications will not be acknowledged unless a stamped addressed postcard or an international reply coupon is
enclosed. Authors wanting reprints of their articles should notify the Publishing Manager, BMA House, Tavistock Square, WC1 H 9JR, on receipt of proofs.
Division Meetings
© British Medical Journal 1978
Memnbers proposing to attend meetings marked * are asked to nlotify in advance the honorary secretary cotncerned. Aberystwyth-At Swyn-y-don Hotel, Saturday, 25 Februarv, 7.30 for 8 pm, dinner and talk by Mr Adrian M Evans: "A native returns." (Guests are invited.)
All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording otherwise, without the prior permission of the
or
British Medical _ournal.
NEWS
18 FEBRUARY 1978
449
AND NOTES
Vewzvs Women who succeed do so because they are lucky or highly motivated, rather than because of skill or ability. In contrast, male failure is due to luck: success is expected of men. These, says Helen Weinreich-Haste in the British J7ournal of Social and Clinical Psychology (1978, 17, 37), are the stereotype attitudes. When she put them to the test at the University of Bath she found some confirmation; but she also found that women were realistic rather than anxiety-ridden about the consequences for relationships of successful competition by either partne-.
J7ust how appalling a disease rabies is in developing countries is shown by a WHO report that in Sri Lanka there are over 300 deaths in a year; hardly any patients are given antirabies serum after being bitten, despite the high prevalence of the disease.
Not everything that comes out of Quebec these days is political, and Minerva is delighted to welcome the appearance of a new journal, Clinical and Investigative Medicine, with an exThomas's and Mayo Clinic man, David Shephard, as its executive editor. Though his two principal colleagues are also based on McGill University, the editorial board has cast its net widely and includes a brace of British knights, Richard Doll and Arnold Burgen, as well as Franz Ingelfinger from Boston and Priscilla Kincaid-Smith from Melbourne. One aim of the journal is to try to prevent good Canadian scientific medical papers from being published outside the country, but since it will also print articles written in French (with every English article having an abstract in French) the hope is that doctors from French-speaking Continental countries will also submit papers to it. Published by Pergamon, the journal has got off to a good start with three editorials, two annotations, four originals, and a first-rate review article on fibre.
Coming back from the Canadian launching party, Minerva was delighted by a sign of the times: so many people wanted non-smoking seats that the air hostess had to apologise that theyj had run out. British Airways (and, she suspects, ASH) have done a good job to make travel in the aircraft tolerable for non-smokers. Would that the British Airports Authority would do the same. Once again she was sickened by the smoke-laden atmosphere of Heathrow's Terminal 3 departure lounge-with its so-called non-smoking areas with small, ineffectual notices prohibiting smoking and providing tall ashtrays to encourage smokers to ignore the ban. When will the azuthority realise that it has a duty to enforce the rules and give the non-smoking majority the clean air it has a right to ? Americans are much concerned with hyperactive childrenthe diagnosis is made much more readily in the United States than in Britain. In 1973 Ben Feingold, a San Francisco allergist, suggested that the condition might be due to food additives and recommended treatment with a diet containing no synthetic colours or flavours and no salicylates. Claims that half of hyperactive children improve on this regimen have been challenged in a series of controlled trials (American 7ournal of Diseases of Children, 1977, 131, 1204), but the Feingold supporters still
refuse to accept these results, claiming that the trials were financed by the food industry.
"Science" observes (1978, 199, 516) that the Feingold diet is only the latest in a long series of purported cures for hyperactivity: among the suggested causes of the syndrome are refined sugar, tight underwear, and fluorescent lighting. To these Minerva would add American parents. After which there is a reassuring English quality in Neville Oswald's account in the Reports of the Transactions of the Devon Association for the Advancement of Science of the summer of 1551, when the sweating sickness spread through the country for the last recorded time. This influenza-like illness killed within a few hours and struck regardless of rank-hence its popular names "Stop Gallant" and "Know thy Master." So many London merchants died in July that Edward VI moved to the safety of Hampton Court. The epidemic stopped abruptly in September, never to be heard of again. Are the old professional courtesies on the way out? Minerva heard recently of a young assistant in a city general practice who developed appendicitis. His principal made the diagnosis and sent him to hospital through the bed bureau-apparently making no effort to make personal contact with any of the local surgeons.
Ambivalent as Minerva sometimes is about the equality of the sexes, she is more muddled than ever about which side to take after reading Women, Sexuality, and Social Control, edited by Carol Smart and Barry Smart (Routledge & Kegan Paul, C2-95), a reasonably unhysterical book about the subtler forms of oppression to which women are subject. Nevertheless, to be told that a woman's functions are "the production and maintenance of the present labour force, as well as being principally responsible for the consumption of the goods produced," is a little daunting even if true. It's also true that heifers gain weight faster if kept apart from young bulls or bullocks. Apparently the male smell has an anorectic effect on the adolescent female-which, no doubt, accounts for the hearty appetites and sturdy limbs of Minerva's schoolgirl acquaintances at unisex boarding schools. Doctors will not be surprised to learn that there are more suitable candidates than places for medical courses. But the 1976-7 annual report of the Universities Central Council on Admissions shows that the number accepted by UK universities in 1977 (3742) was the highest ever, while the number of candidates (12 098) was somewhat less than the peak of 13 003 in 1974. Moreover, the proportion of candidates accepted at the late "clearing" stage-300%'-had risen slightly, though it was well below the proportion for most other subjects. But there's no risk of standards going down: even those who scrape into medical schools by the skin of their teeth apparently have good GCE qualifications. MINERVA
450
BRITISH MEDICAL
MEDICOLEGAL
belt was that it might aggravate rather than diminish the injuries in the event of an accident. However, it would be wrong to regard the new ruling as a loophole in the Court of Seat-belt phobia Appeal decision. Mere dislike of belts or a belief that they are dangerous will not suffice FROM OUR LEGAL CORRESPONDENT to avoid a finding of contributory negligence, and judges are unlikely to be impressed by In a judgment' in December last year Mr evidence of phobia unless it is supported by a Justice Bristow held that a 53-year-old doctor's testimony. woman's phobia about wearing seat belts was Condon v Condon, The Timves, 9 December 1977. justification for not doing so, and he therefore made no deduction from the j11 090 damages 2 Froom v Butcher (1976), QB at p 295. he awarded her for injuries suffered in a road accident in October 1974. In 1975 the Court of Appeal finally resolved the previous differences of opinion between High Court judges by holding that the failure of a driver or front-seat passenger to wear a seat belt was contributory negligence if an accident occurred. Accordingly, even where a plaintiff is entirely without blame for the Employment protection accident, his damages will be reduced in partproportion to the extent that his injuries were Two private members' Bills have recently caused or aggravated by the absence of a belt. had their second reading in the House of Lord Denning2 said that the reduction should Commons. The first, introduced by Mr Ted be 25 ° of the damages where the evidence Fletcher, seeks to deal with the problems showed that the injuries would have been pre- which have arisen for the Advisory, Conciliavented altogether by wearing a belt and 15 % tion, and Arbitration Service in carrying out its if the injuries would have been a good deal less duties of inquiring into and reporting on severe with a belt worn. workers' recognition issues. The other, preLord Denning also stated that mere forget- sented by Mr Ian Mikardo, is intended to fulness was no excuse for failure to wear a belt validate agreements by independent trade but that the law would admit some exceptions unions for restricting references of recognition to the general rule. He mentioned "a man who issues to ACAS. Both Bills have been supwas unduly fat or a woman who was pregnant, ported by the Government. Mr Albert Booth, because if there was an accident, the strap Secretary of State for Employment, told the across the abdomen might do them more harm Commons on 20 January that the Government than good." Mr Justice Bristow reminded was keeping a close watch on the working of himself of those words in the present case, the Employment Protection Act to identify where the plaintiff injured her right eye and further amendments that might be necessary. suffered a permanent disability to her vision after an accident in which she was the frontseat passenger in a car which hit a telephone Questions in the Commons pole. The judge said that he was far from convinced that the failure to wear a belt had con- Medicines-prescription only tributed to the plaintiff's injuries: he thought that it was just as likely that the piece of glass The Medicines (Prescription Only) Amendwhich damaged her eye was dislodged from ment Order (11 February, p 377) came into the windscreen when the car hit the telephone operation on 11 February. Reporting this in a pole as by any impact between her head and written answer on 10 February, Mr Roland the windscreen. But even though Mr Justice Moyle said: "By virtue of this Amendment Bristow found that no reduction in the damages Order medicinal products for human and was merited on the facts of the case, he went animal use, that before 1 February 1978 could on to give his view of the law. He was satisfied legally have been sold or supplied without a on the medical evidence that the plaintiff had prescription, and which became subject to a genuine phobia about wearing a seat belt prescription only control under the principal because of her fear of being trapped in the Order, will be allowed to be sold or supplied event of an accident. She was therefore not an without prescription for a further period of ordinary case, but an exception-like the six months. The Amendment Order provides that where previous legislation required the corpulent man and the pregnant woman. sale or supply of such products to be recorded in a register or made against a signed order those procedures should be followed during View of risks the six months' period as if the requirements The judge appreciated that the Court of had continued in force." Mr Moyle also reported that the Medicines Appeal had held that it was unreasonable for a plaintiff to act on his own view of the risks in (Labelling) (Special Transitional) Regulations preference to the widely publicised evidence 1978 had been laid before Parliament. "These that seat belts reduced the risk of injury, but regulations," he explained, "are designed to he did not think that that was what the plaintiff deal with problems which could arise with had done. Given her phobia, it was enough to regard to the labelling of medicines by virtue say that she had not failed to take reasonable of the introduction of this transitional exemption. They provide that during the same period care for her safety by wearing the belt. The case confronting Mr Justice Bristow of six months the requirements of the Mediwas not entirely analogous to the examples cines (Labelling) Regulations 1976 will be mentioned by Lord Denning, since in the case deemed to be satisfied by the labelling of of the corpulent man and the pregnant woman medicinal products which but for the prothe reason for excusing them from wearing a visions of the Medicines (Prescription Only)
PARLIAMENT
JOURNAL
18 FEBRUARY 1978
Amendment Order would have satisfied those requirements." Nurses In an oral answer on 7 February Mr Eric Deakins reported that "the number of qualified nurses and midwives registered as unemployed in England in December 1977 was about 100 lower than in September, and now stands at 4013. Posts are available in the National Health Service for qualified nurses, but some may be unable or unwilling to move to areas where there are vacancies." At the same time, he said, there were over 2000 vTacancies for qualified nurses registered with the Employment Services Agency in December.. Answering the comment from Mr Evelyn King that "if only we could get rid of this monstrous army of clerks we could afford to pay the nurses," Mr Deakins said that in March 1977 there were 214 000 qualified nurses employed -an increase of 9000 over the previous year. It was up to area health authorities to decide their establishment, and in the financial year ended March 1977 health authorities had increased the proportion of their revenue expenditure which was spent on nurses.
Poliomyelitis vaccination In a written answer on 7 February Mr Roland Moyle said, "It is estimated that about 26 %1 of children have not been vaccinated against poliomyelitis by the end of the second year after their year of birth. The proportion who remain unvaccinated by the age of 16 is likely to be of the order of 15 The estimates are based on information up to the end of 1976. Information for 1977 is not yet available."
Nursing (Briggs Report) In a written answer on 7 February the Secretary of State announced that "if time can be found the Government would like to introduce this session a short Bill to implement those recommendations of the Briggs Report relating to a new statutory framework for nurse education and training." Mr Ennals said that he hoped that the Government could count on the support of the Conservative
party.
Hospital beds In a written answer on 31 January Mr Roland Moyle set out the average daily number of available beds in hospitals in England from 1970 to 1976: 1970 1971 1972
1973 1974 1975 1976
423 419 412 403 396
600 600 700 500 200 387 600 383 100
Medical Bill The Medical Bill, which seeks to amend the constitution and functions of the General Medical Council (4 February, p 311), had its third reading in the House of Lords on 2 February and has passed to the House of Commons.
BRITISH MEDICAL JOURNAL
18 FEBRUARY 1978
451
MEDICAL NEWS Number of cases of malaria notified, 1948-76. The 1976 figure, 1162, was almost double the 1953 peak (which was due to the return of servicemen from the Far East). The rate was highest in the 15-44 age group and almost twice as high in males as in females. The prominent parasite species was Plasmoditum vivax and the main source of infection was the Indian subcontinent. From Statistics of Infectious Diseases 1976 (MB2 No 3),
Occupational mortality Social class differences in mortality continue to be apparent in the latest decennial supplement of Occupational Mortality (Government Statistical Service; HMSO, £4 75). From the 1970-2 figures, professional men's sons could expect to live 71 years on average but those of unskilled labourers less than 66 years. Within classes, the self-employed fared better than employees, and employers than managers in industry. The class gradient applied to most diseases. Previously the high rates for bronchitis in dusty trades has been attributed to the men's general circumstances and way of life rather than the dust as such. The report points out, however, that the 1970-2 rates cannot just be explained by social class. Similarly, cerebrovascular disease and stomach cancer (though this has diminished since the war) appear to be associated with dusty occupations.
1200
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600 400 200
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Government Statistical Service; HMSO, 1978 (price 1-75). Crown copyright.
tained on dialysis, he said, had risen by 100%. is to increase understanding among all staff During January 78 patients had transplants, dealing with disturbed offenders, and thus four more than in December. The number lower the risk of violent outbursts. waiting for transplants was 1177, compared with 1198 in December. New professor of physiology
New vaccination campaign Public Health Laboratory Service A publicity campaign telling parents about the benefits and risks of the basic vaccinations offered to children, including vaccination against whooping cough, is to start next month, Mr David Ennals announced in the House of Commons last week. This follows the advice of the joint committee on vaccination and immunisation, which supports the continued use of whooping-cough vaccine. The facts about vaccination will be publicised by advertisements in the national press and posters and leaflets in health clinics. In 1977 over 17 000 cases of whooping cough and eight deaths were reported in England and Wales, compared with just under 4000 cases and three deaths in 1976. This year 5600 cases had been reported by 27 January.
Dr B R Jewell has been appointed to a new chair of physiology at Leeds University, to take effect from 1 September 1978. Dr Jewell has been reader in experimental physiology since 1970 at University College London, where he is also vice-dean of the faculty of medical sciences. He obtained his BSc at Charing Cross Hospital Medical School and returned there to complete his medical degree after working for a PhD at University College London. After various house appointments and a year in the department of zoology at Oxford, he went back to University College as a lecturer in physiology. In 1967-8 he was a visiting assistant professor at Harvard Medical School. Dr Jewell's major research interest is the study of how the force of the heart beat is regulated.
In 1976 the 54 laboratories of the Public Health Laboratory Service received 5-3 million specimens-some 10 % more than in 1975, according to the PHLS's latest annual report. Twenty-seven per cent were urine samples, and automated methods are being developed to identify those samples containing appreciable numbers of bacteria and needing full analysis. Virus isolation is performed in 43 of the laboratories, and the 8% increase in specimens demanded considerable resources; nine laboratories had 5000-10 000 specimens. With the simpler methods now available 41 laboratories now test for hepatitis B surface antigen. Sera for rubella antibody testing increased 32 °,, probably because of attempts to step up immunisation programmes. Training courses being organised by the Mycology New professor of genetics Reference Laboratory should make diagnostic Road and rail casualties Dr D A Ritchie, senior lecturer in the mycology more widely available and should, The total economic cost of road casualties says the report, enable many patients with Glasgow University department of virology in 1977, it was reported in the House of fungal infections to have earlier appropriate since 1972, has been appointed to the chair of genetics at the University of Liverpool, which Commons, was about C500m, and of casualties treatment. became vacant on the death of Professor P M in rail accidents £5m. Sheppard. Dr Ritchie graduated from LeicesPrison medical services ter University in 1959 with a BSc in botany. In 1964 he was awarded a PhD in microbial Treatment of kidney disease Some 15-20 °'o of all offenders and over genetics by the University of London after Mr David Ennals announced in the House of half the women in custody have some form spending five years at the Medical Research Commons last week that an extra £Im of psychiatric treatment during their sentence, Council Microbial Genetics Unit. After would be available for special haemodialysis according to Prisons anid the Prisoner (Home working for two years as a research associate at units. Funds had already been made available, Office; HMSO, £5 25). The psychiatric Johns Hopkins University, Baltimore, he he said, to help regions to develop paediatric services have developed substantially in the became lecturer in the Glasgow department of dialysis facilities. This additional money would last few years. Of the 101 full-time prison virology in 1966. His present research is on the be for a few limited-care units, designed to medical officers, two-thirds have had psy- molecular genetics of viruses. cater for patients who no longer needed full chiatric experience outside the prison service; hospital facilities, but who for one reason or there are also 66 visiting psychotherapists another-perhaps because they lived alone- and eight consultants in forensic psychiatry New standard to reduce radiation effects could not have dialysis at home. The DHSS shared with area health authorities. Many on patients will shortly be approaching regional health offenders besides those who are manifestly A new standard for the medical electrical authorities about allocating these extra funds. ill need some psychiatric support, especially Mr Ennals said that he was concerned about during a long sentence. Grendon Prison, the industry is intended to help both manufacthe continuing shortage of donor kidneys for first psychiatric prison, is pioneering the turers and medical workers to reduce the transplantation and was launching a kidney treatment of personality disorders in prison; radiation exposure of patients having radiodonor card publicity campaign in the next few offenders may receive psychiatric care at logical examinations. The International Elecmonths. He thought that the kidney donor several prison psychiatric centres, and special trotechnical Commission announces a safety card system was successful, as there had been a treatment for alcoholics and drug addicts standard-IEC publication 580-for area 14%O increase in the number of transplants in is given in some prisons. An important part exposure product meters, with specifications 1977. The total number of patients main- of the medical officers' work, says the report, for construction of components, performance
452 and acceptable factors of error. The first world-wide general safety standard for the manufacture, installation, and application of medical electrical and electronic equipment was issued by the commission in January as IEC Publication 601, Part One. This includes information on the compatibility and interchangeability of medical electrical devices.
BRITISH MEDICAL JOURNAL
Socialist Medical Association-Day seminar on "Thirtieth anniversary of the National Health Service-what of the future ?", 12 March, London. Details from SMA, 9 Poland Street, London W1V 3DG. (Tel 01-439 3395.) Camden Association for Mental HealthDetails and copies of the programme of a monthly series of lectures and discussions on "To calm the troubled mind" are now available from the Association, Raglan Day Centre, Raglan Street, London NW5. (Tel 01-485 0229.)
Radiological protection The National Radiological Protection Board has advised the Government that the recommendations of the International Commission on Radiological Protection provide a satisfactory basis for controlling the exposure of people to ionising radiation in work places and in the general environment. The central theme of the new recommendations is the system of dose limitation. The main features of this are: no practice involving radiation exposure shall be adopted unless its introduction produces a positive benefit; all exposures should be kept as low as can reasonably be achieved, economic and social factors being taken into account; and the "dose equivalent" to individuals shall not exceed the limits recommended for the particular circumstances by the commission. The NRPB considers that many specific points in the recommendations need to be interpreted. It has therefore established a new report series, Advice on Standards for Protection (to be sold through HMSO), for publishing its comments.
Help for the mentally ill and handicapped
SOCIETIES AND LECTURES For attendintg lectures marked * a fee is charged or a ticket is required. Applicationzs shouild be made first to the
inlstitution concernzed.
Monday, 20 February INSTITUTE OF LARYNGOLOGY AND OTOLOGY-5.30 pm, Professor R M H McMinn: Electron microscopy of the tympanic membrane.
Wednesday, 22 February INSTITUTE OF DERsoATOLOGY-4.30 pm, Dr R H Mears: Skin manifestations of internal malignancy. INSTITUTE OF NEUROLOGY (QUEEN SQUARE)-Sandoz Foundation advanced lectures, 6 pm, Professor M Coltheart: Cognitive psychology and acquired dyslexia. 7 pm, Dr Hazel E Nelson: The role of memory in childhood dyslexia. INSTITUTE OF ORTHOPAEDICS-5 pm, Mr D M Dunn: Slipped upper femoral epiphysis. 7 pm, Professor B McKibbin: Treatment of Perthes's disease. INSTITUTE OF PSYCHIATRY-5.30 pm, Dr J C Gunn: A study of Grendon Prison. ROYAL FREE HOSPITAL SCHOOL OF MEDICINE-5 pm, Dr R G Petersdorf (Washington): Factors affecting antimicrobials. UNIVERSITY OF OXFORD-At Radcliffe Infirmary, 5 pm, Dr N A Wright: Cell kinetics, tumour growth, and cancer therapy.
Thursday, 23 February CAMBRIDGE UNIVERSITY-At Department of Genetics, Downing Street, 4.30 pm, Dr C Bostock: Analysis of satellite DNAs on individual human chromosomes. PHARMACEUTICAL SOCIETY OF GREAT BRITAIN-Joint evening meeting with Guild of Hospital Pharmacists at Pharmaceutical Society's Headquarters, 7 pm, Dr R P Enever: The application of innovative dosage form design to improved drug therapy. WESTMINSTER MEDICAL SCHOOL-5.15 pm, Dr F I D Konotey-Ahulu (Ghana): Clinical and public health aspects of sickle-cell disease in West Africa.
Mr Alf Morris, Minister for the Disabled, has urged local authorities to make more use of the provisions of the Chronically Sick and Disabled Persons Act to improve the quality of life of the mentally ill and handicapped as Friday, 24 February well as of people who are physically disabled. INSTITUTE OF LARYNGOLOGY AND OTOI.OGY-5.30 pm, Dr G A S Lloyd: Radiology of the parainasal sinuses. Speaking in London to representatives of some COLLEGE OF SURGEONS OF ENGLAND-5 pm, 40 national voluntary organisations, Mr Morris ROYAL Hunterian lecture by Professor A J MacGregor: The radiological assessment of lower third molars. At said that families who care for a mentally ill Birmingham Dental School, 5 pm, Hunterian lecture or handicapped relative at home not only give by Professor R M Baddeley: The management of gross refractory obesity by jejuno-ileal bypass. a better kind of care than an institution could but also save the community a lot of money. Under the Act local authorities can relieve BMA NOTICES these families of some of the strain by providing help in the home-for example, an adapta- Central Meetings tion or aid, or a home help or meal in the home. FEBRUARY "Such help can make all the difference," he Medical Academic Staff Committee, 10.30 said, "to a family struggling to keep a relative 20 Mon am. out of an institution." Scottish Joint Consultants Committee 21 Tues 22 Wed
People in the news
22 Wed
The honorary gold medal of the Royal College of Surgeons has been awarded to Professor T Cecil Gray, past dean of the faculty of anaesthetists of the Royal College of Surgeons of England and of the faculty of medicine, University of Liverpool, in recognition of his outstanding contributions to medicine and
23 Thurs
surgery and to the science of anaesthesia.
COMING EVENTS International Symposium on Current Trends Tumour Immunology - 10-12 March, Cremona, Italy. Details from Organising Secretariat, Piazza del Carmine 4, 20121 Milan, Italy. in
(7 Drumsheugh Gardens, Edinburgh EH3 7QP), 10.15 pm. Finance and General Purposes Committee,
10 am. Executive
Subcommittee (SHJSC) (7 Drumsheugh Gardens, Edirnburgh EH3 7QP), 1 pm. New Charter Working Party (GMSC), 10 am.
MARCH
1 Wed
1 Wed
Private Practice Committee, 10.30 am. Rheumatology and Rehabilitation Group Committee, 2.30 pm.
General Purposes Subcommittee (GMSC), 10.30 am. 3 Thurs Scottish General Medical Services Committee (7 Drumsheugh Gardens, Edinburgh EH3 7QP), 10.30 am. 2 Thurs
18 FEBRUARY 1978
Aldershot and Farnham-At Camberley Heath
Golf Club, Thursday, 23 February, 8 for 8.30 pm, annual dinner.* (Guests are welcome.) Birmingham-At Birmingham Medical Institute, Tuesday, 21 February, 8.15 pm, joint meeting with Medical Women's Federation, Midland Medical Society, and Midland Veterinary Association, "Zoonoses and rabies." Bradford and Airedale-At Bradford Royal Infirmary, 'Wednesday, 22 February, 8.30 pm. Professor John Marshall: "Models of the central nervous system." Bristol-At Bristol Royal Infirmary, Wednesday, 22 February, 8.30 pm, Professor John Mitchell: "Antique maps." (Preceded by informal dinner, 7 pm.*) Bromley-At Farnborough Hospital, Thursday, 23 Februarv, 8.15 for 8.30 pm, Dr D K Browne will give an illustrated talk on Malawi. Burnley-At Burnley General Hospital, Friday, 24 February, 8 pm, joint meeting with Burnley and District Incorporated Law Society, Mr Nigel Keddie: "Res ipsa loquituir or does it ?" Croydon-At Conservative Club, Thursday, 23 February, 8 pm, second annual joint meeting with BDA Croydon Division with buffet supper.* (Wives welcome.) Gateshead-At Queen Elizabeth Hospital, Friday, 24 February, 7.30 pm, joint party for members and guests with British Dental Association.* Greenwich and Bexley Divisions-At Greenwich District Hospital, Friday, 24 February, 7.30 for 8 pm, dinner for members and guests, speaker Dr A L De Silva: "My eyes have four legs."5 Harrow-At Northwick Park Hospital, Meoinday, 20 February, 8 pm, joint meeting with Harrow and Hillingdon Branch of the Pharmaceutical Societv of Great Britain, speaker Dr Peter Boreham: "A scientific safari to Africa." Holland Lincs-At Pilgrim Hospital, Saturday, 25 February, 7.30 pm, Dr Richard Fox: "Suicide."5 (Followed by buffet supper.) Manchester-At Boyd House, Tuesday, 21 February, 8 for 8.30 pm, scientific meeting, Dr T R Wilson: "Current treatment of depressive illness."5 Salop-At Medical Institute, Friday, 24 February, 8 pm, Mr Martin S Brookes: "Hypnosis in medicine and dental surgery." (Spouses are welcome.' Scarborough-At Scarborough Hospital, Thursdav, 23 February, 8.30 pm, Dr George Cust: "The ill made wvell; the well made ill." Scunthorpe-At Scunthorpe General Hospital, Tuesday, 21 February, 8 pm, meeting. South-west Durham-At Bishop Auckland General Hospital, Tuesday, 21 February, 8 pm, buffet meal followed by lecture. South-west Wales-At Ivy Bush Royal Hotel, Carmarthen, Saturday, 25 February, 7 for 7.30 pm, annual dinner and BMA lecture by Dr K P Duncan: "Is work good for you ?"* (Guests are invited.) Swindon-At Princess Margaret Hospital, Thursday, 23 February, 7.30 for 8 pm, early music evening.* (Guests are invited.) Wakefield-At Stoneleigh Hotel, Thursday, 23 February, 7.30 for 8 pm, informal lecture dinner, Dr Ian Adams: "Sports media."* (Guests are welcome.) Woking and Chertsey-At St Peter's Hospital, Wednesday, 22 February, 8.30 pm, Professor Roger Dyson: "The place trade unions occupy in the NHS today, and their anticipated role in the future, with particular reference to the implications this may have for the medical profession." (Members of neighbouring
divisions welcome.)
Regional Meetings South-east Thames Regional Council-The meeting arranged for Tuesday, 28 February, has been postponed to April.
Notice to authors When original articles and letters for publication are not submitted exclusively to the British Medical Journal this must be stated. For detailed instructions to authors see page 6 of the issue dated 7 January 1978. Correspondence on editorial business should be addressed to the Editor, British Medical _ou4rnal, BMA House, Tavistock Square, London WC1H 9JR. Telephone: 01-387 4499. Telegrams: Aitiology, London WC1. Communications will not be acknowledged unless a stamped addressed postcard or an international reply coupon is
enclosed. Authors wanting reprints of their articles should notify the Publishing Manager, BMA House, Tavistock Square, WC1 H 9JR, on receipt of proofs.
Division Meetings
© British Medical Journal 1978
Memnbers proposing to attend meetings marked * are asked to nlotify in advance the honorary secretary cotncerned. Aberystwyth-At Swyn-y-don Hotel, Saturday, 25 Februarv, 7.30 for 8 pm, dinner and talk by Mr Adrian M Evans: "A native returns." (Guests are invited.)
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British Medical _ournal.
