jlstfiraiutatE Itaircal 3imal

LONDON: DECEMBER I, I939.----^---

The Rockefeller Foundation.On May 23, 1937, JOHN DAVISON ROCKEFELLER, founder of the Rockefeller

Foundation, died in his ninety-eighth year.His passing, perhaps, marked more than the death of a very great and dis-

cerning philanthropist, for the great era of free-giving which marked the periodof his zenith shows signs of passing too.

In a recent report* Mr. RAYMOND B. FOSDICK, the President of the Founda-tion, reviewed its work, and unwittingly emphasizes the generosity and univer-sality of its Founder's gifts.

Mr. Rockefeller's gifts totalled $530,000,000 (£Io6,000,000), and were mainlydirected to establishing four funds, of which the Foundation was one.

He was far-seeing in his views and as MR. FOSDICK says he "trusted thefuture".

As he gained experience in philanthropy, he gradually withdrew restrictionswhich he had originally placed on the purposes of his funds, and in I920 (whenhe was 8I years of age) he wrote: "if in any gifts heretofore made to you by methere are any restrictions . . . . I hereby revoke such restrictions".

In addition he allowed principal to be spent as well as income, as he did notconsider it wise to maintain foundations in perpetuity. He knew that what wasgood and desirable for to-day, might become an embarrassment in the future, sothat many of his activities such as the General Education Board, are now approach-ing liquidation.

We have seen funds and gifts protected by covenants and restrictions carriedon into times not visualised by their founders, with results not commensurate withthe original gift, but it takes a great man to appreciate that this can be so in thecase of his gift.

In 1937 $2,400,000 was given to the medical sciences, and $I,Ioo,ooo to thenatural sciences.

The Foundation operated in 52 different countries, from Norway to the FijiIslands, and $400,000 was given to rural reconstruction in China.Forty-five per cent. of the money allocated went to foreign countries, leavingfifty-five per cent. to be spent in the United States.In 1937 emphasis was being laid on psychiatry and on experimental biology.As is well known, the Foundation is not an executive organisation, and carries

out no research of its own, but works by supporting existing organisations, suchas universities and research institutes. This in itself must tend to widen the scopeof the Foundation geographically, for it allows gifts to be made exactly where theyare most required, and tends to minimise the creation of fresh vested interests.

Unfortunately some difficulty has been experienced even in carrying out thispolicy, for it has been found that "disinterested research ... withersunder the efforts of governments to impose uniform ideologies and to circumscribe

* The Rockefeller Foundation, Annual Report, 1937.

in the interests of a dominant regime the area of intellectual liberty". This is theexperience of the Foundation, and has had a considerable influence on theirpolicy, for they have 'found themselves stopped at frontiers, behind which thesearch for truth is not encouraged.

The Report itself makes excellent reading, and should be read by all thoseinterested in research and the advance of knowledge, but one or two of the highlights may be quoted.

For instance it is noted that advance in medical knowledge must be acceptednot only by the doctors but by society at large, and, to illustrate this, tuberculosisand syphilis are quoted.

The incidence of tuberculosis has been reduced by two-thirds since I900, andthe death rate has fallen from 202 to 56, without any specific treatment having beenfound.

In the case of syphilis where efficient specifics are available, the incidenceremains the same, because the disease bears a social stigma, and society will notaccept knowledge which is theirs for the asking; and in many cases prevents anyopen reference to the problem. In this country, too, successive efforts to applyknowledge have met with little success.

This argument is then extended to the question of psychiatry, and it issuggested that a similar attitude is involved, reference being made to the fact thathistorians estimate that " the mass delusion of witchcraft in the Middle Ages resultedin the torture and execution of over a quarter of a million individuals whose onlyoffence was that they were insane".

Although doctors realise that insanity is a disease, Society is only just begin-ning to do so, and the Foundation feels that it is impossible to over-estimate theimportance of psychiatry at the present time.

Since I932 £I,200,000 has been given for this purpose. In 1937 apart fromlarge grants to the Universities of Harvard, Cincinnati and Colorado, over £8,ooowas allocated to Cambridge, for the provision of a pathologist, research radiolo-gist, and psychiatrist.

It will be of considerable interest to observe the effect of this policy, but weventure to think that some of its effects are already visible, for there can be littledoubt that a considerable revision of public opinion is noticeable.

With regard to experimental biology, the report notes that a "physiologicalprocess seems to lose something of its full natural character when it is isolatedfrom the complete animal for purposes of experimental study". The deductionis made that some doubt exists whether a living organism is the sum of its parts,and that "wholeness" or individuality may have biological sanction. The prac-tical application to man lies in the suggestion that "the material, mechanicalcivilisation he has evolved may easily become a monster to destroy him unless helearns better . . . . to control his biological nature".

The conclusion is reached that as biology is, broadly speaking, a hundredyears behind chemistry and physics, it is wise, at the present time, to support it,and the hope is expressed that "far-reaching consequences" may come from suchsupport.

The Foundation accordingly allocated £220,000 to this field in 1937, andincluded Copenhagen, Sweden and the Netherlands in its grant.

A very interesting chapter of the President's review is devoted to Chemistryand Medicine, and special note is made of the pre-eminence of Germany just beforethe war of I914-1918.

388 POST-GRADUATE MEDICAL JOURNAL December, 1939

This has some special significance now for it is recalled that in I9I4 a singleGerman dyemaneufacturer employed 307 expert chemists and 74 technologists, andthat Germany was manufacturing three-quarters of all the coal tar products usedin the world, and had a practical monopoly in the dye industry, and some concernis expressed that although England and some other countries have made muchprogress since then, America is not apparently doing her rightful share. Annteresting sidelight shows the complete divorce of industrial from academicchemists in the United States; and it is suggested that the' support given to theacademic chemist by industry in England may account for the strides made,nevertheless it is not thought that this remedy could be adopted in the U.S.A.

In view of this the Foundation have thought it wise to give some "strategic"assistance to organic chemistry.

Judging from the facts and theories quoted, it is evident that the Rockefellerphilanthropies have had in the past, and will have for some years to come, aconsiderable leavening influence in scientific work, and that this influence has beendirected entirely to the assistance and betterment of such work.

The remainder of the Report will be dealt with in a later issue.

British Journal of Rheumatism.This journal announces that it proposes to continue publication during the war

period. After mentioning the difficulties which are found particularly in the fieldof chronic rheumatic diseases in the abnormal circumstances now prevalent, thepublishers ask for continued support and state their intention of continuing theournal even if it has to be in a restricted form and published at less frequentintervals.

F.R.C.S. (Final) Examination.As there will be an F.R.C.S. (Final) Examination, starting on February ist,

Ig40, the Fellowship of Medicine is arranging instruction as follows:MR. RONALD RAVEN will take a class at the Royal Cancer Hospital, Fulham

Road, S.W.3, from 9.30 a.m. to I.O p.m. Mondays to Fridays, and II.0 a.m. toI.o p.m. Saturdays, from December IIth, 1939 to January 27th, 1940 (excludingChristmas holidays). The teaching will include clinical instruction in the wardsand O.P. Department, lectures, X-ray and museum demonstrations, and tutorialclasses (including answering set questions). Fee £7 7s. to Members of the Fellowship,or £7 I7s. 6d. to non-Members.

MR. C. E. SHATTOCK will give courses in pathology in the Museum of theRoyal College of Surgeons, Lincolns Inn Fields, W.C.2. Each course will consistof two demonstrations (in one week) from 2.0 to 3.30 p.m., and will be limitedto six post-graduates. Fee £I IIs. 6d. to Members, or £2 2s. to non-Members.(This instruction will be repeated, for fresh classes of six post-graduates, if thereis sufficient demand. No post-graduate may attend more than one course.)

It is hoped also to arrange clinical instruction at another hospital, of whichdetails will be available shortly.

Arrangements are being made for a series of Surgical Tutorial Classes to begiven twice weekly at 4.30 p.m. in the lecture room of the Medical Society ofLondon. These will start about the second week in December and the detailedsyllabus is now being prepared.

December, 1939. EDITORIAL NOTES 389

410 POST-GRADUATE MEDICAL JOURNAL December, 1939

each worker must use a diet made frommaterials available locally which suits hisstock animals. If this is not done, comparisonwith the records of other work is not possible.It is emphasised that, when determinations ofthe vitamin content of a test substance are beingmade, an equal number of animals must bekept on the standard vitamin.

Basal diets are given for use in testing Vita-mins A, B1, C and D and the methods of assessingthe results fully dealt with. In the chapteron Vitamin D it is brought out that Vitamin Dand irradiated ergosterol are not the same sub-stance and that children and rats can use boththe forms but that chickens cannot make use ofthe irradiated ergosterol form of Vitamin D.

In the most interesting chapter on the inter-dependence of the vitamins, experiments aregiven showing that an excess of any one vitaminin a diet used for the determination of anotherwill have no influence on the result, whereas apartial deficiency will do so. One should there-fore always give a sufficient quantity of vitaminsin a basal diet.The second part of the book deals with the

standard deviation and the accuracy obtainablein the determination of various vitamins.The book covers a wide field and all pursuing

vitamin research should possess a copy of sucha useful and excellent work.

ARTIFICIAL LIMBS ANDTHEIR RELATION TO

AMPUTATIONS.(Published by His Majesty's Stationery Office,London. 1939. Price 3s. Od.)Between the covers of this slim volume is a

rich mine of information on problems that havelong remained controversial, problems that willconfront those surgeons privileged to deal withthe treatment of the heavy toll of casualtiesimpending amongst civilians and His Majesty'sForces. There is a refreshing finality about theconclusions drawn from a quarter-century ofintensive study and research. If the instruc-tions to surgeons seem dogmatic, they are basedon arguments and facts that are clearly setforth, and their soundness cannot be gainsaid.The gradual evolution of ideal prostheses has

been achieved by an unremitting search for ideas,

wherever these were born, whether in our owncountry, on the Continent or in the United Stateswhere the experience of their "industrialsurgeons" has proved valuable.The succinct style of the author can be

gauged by this enunciation of an axiom that" whilst a good surgical result is not alwaysgood prosthetically, a good prosthetic resultmust of necessity be a good surgical result."And again "It is extremely rare to find anabove-knee stump of the ideal length" (that is10 inches to 12 inches from the tip of the greattrochanter) "suffering from circulatory disturb-ance at the extremity even after 20 years."

Reluctantly the older surgeons see relegatedto their place in history many ingenious ampu-tations such as the Syme, the Pridgin Teale andthe Stokes-Gritti, but the demands of theprosthesis-maker are inexorable and must beobeyed.The section on the causes and treatment of

troublesome affections of stumps-bulbousnerve-endings, bursae, osteophytes and furuncu-losis-is specially instructive. The centralorigin of 'painful sensations cannot be regardedas fully proven for all cases, but the possibilitywill give pause to those who plan operationswhich admittedly are often futile.With the mechanical details of the various

artificial limbs surgeons are less immediatelyconcerned. To the many beautiful illustrationsof these might be, with advantage, added a fewdiagrams e.g. one shewing clearly the optimumsites for amputations of the limbs.There is scarcely a sentence of this admirable

monograph which is not pregnant with practicalknowledge and wisdom.

PHARMACOP(EIA & VADEMECUM.

Edited by J. WICLIFFE PECK. The Infants'Hospital. 1939. Revised Edition. Price3s. 6d.This book is of its kind one of the most com-

prehensive. No nurse should be without a copyand every practising doctor would find greathelp in his work by having such a handbook inhis visiting bag. The subject matter is well setout and the chapters on diet and infectiousfevers are eminently practical. The publicationis unusual inasmuch as it is both useful andinteresting.

Forthcoming Medical Books.HENRY KIMPTON,263, High Holbom, London, W.C.1." Textbook of Nervous Diseases," byRobert Bing. From the Fifth Germanedition. In one large octavo volume of838 pages with 207 illustrations includ-ing 9 in colour. Cloth. Price 50s. net.

"Nitrous Oxide - Oxygen Anesthesia."McKesson-Clement Viewpoint and

Technique, by F. W. Clement, M.D.In one royal octavo volume of 274pages, illustrated with 70 engravings.Cloth. Price 18s. net.

Deceber,193. BOK RVIEW 41

"Clinical Pathology and Treatment of theDental Pulp and Periodontal Tissues,"by Edgar D. Coolidge, B.S., M.S.,D.D.S. In one royal octavo volume of461 pages, illustrated with 289 engrav-ings. Cloth. Price 30s. net.

"Experimental Pharmacology andMateria Medica," by Dennis E. Jackson,Ph.D., M.D., F.I.C.S. Second edition.In one large octavo volume of 906pages with 892 illustrations including55 coloured plates. Cloth. Price 50s.net.

"A Handbook of Charting for StudentNurses," by Alice L. Price, R.N., B.S.232 pages, size 10y'X77", punched tofit standard two- and three-ring binders.Price 7s. 6d. net.

"Diseases of the Skin," by Richard L.Sutton, M.D., Sc.D., LL.D., F.R.S.(Edin.), and Richard L. Sutton, Jr.,A.M., M.D., L.R.C.P. (Edin.). Tenthedition, revised, enlarged and reset. Intwo royal octavo volumes of 1,549 pagesand 1,452 text illustrations and 21coloured plates. Cloth. Price 70s. net.

"Primer of Allergy," by Warren T.Vaughan, M.D., Richmond, Virginia.In one crown octavo volume of 140pages, with illustrations by John P.Tillery. Cloth. Price 7s. 6d. net.

" The Infant and Child in Health andDisease," with Special Reference toNursing Care, by John Zahorsky, A.B.,M.D., F.A.C.P., and Elizabeth Noyes,R.N. Second edition. In one octavovolume of 496 pages, illustrated. Cloth.Price 14s. net.

EDWARD ARNOLD & CO.,41 & 43, Maddox Street, London, W.1." The Louse," An Account of the Licewhich Infest Man, Their Medical Im-portance and Control, by Patrick A.Buxton, Director, Department ofMedical Entomology, London Schoolof Hygiene and Tropical Medicine.xii + 116 pages, with 28 diagrams.7s. 6d. net.

" Vade Mecum of Medical Treatment,"by W. Gordon Sears, M.D., M.R.C.P.,Medical Superintendent, Mile EndHospital, London. Second edition.viii + 376 pages. 10s. 6d. net.

Miscellaneous.Thts Section deals with New Drugs, Preparations, Surgical Instruments, etc. The description of each article issupplied by the Producer. Particulars regarding insertions, which are free of cost, may be obtained from the

Business Manager, Fellowship of Medicine and Post-Graduate Journal, 404, Grand Buildtngs, W.C.2.

An impressive and fully illustrated bro-chure is available from the Anglo-French

Drug Co., Ltd., of 12, GuilfordAnglo-French Street, London, W.C.1, regard-DrugCo.,Ltd. ing the properties of FOILLE,

a new type of treatment forburns and traumatic wounds.

In addition to presenting the clinicalrecords of a number of cases, with photo-graphs showing various stages of treatment,the booklet explains the different develop-ments in the manufacturing process ofFOILLE. It is demonstrated that withthis product burs and wounds may betreated immediately at the scene of accident,since the ensuing therapy employed by thephysician is aided by the emergency treat-ment instituted. Pain is quickly controlled

and infection combated, FOILLE beingboth analgesic and antiseptic.FOILLE is described as a stabilised

water-in-oil emulsion accomplished throughprocessing several drugs of well-knowntherapeutic value in a vegetable oil vehicle.Chemical action effects combination of cer-tain elements and at the completion of the

-processing the active ingredients may bestated as follows: Alcohol 1.4%, Benzocaine1.3%, Oxyquinoline base 0.2%, Phenol2.8%0, Calcium Soap 0.39%, Calcium Iodide0.25%, Potassium Iodide 0.14%, CalciumThiosulfate 0.02%.The clinical evidence produced in the

brochure, with untouched photographs,covers reported cases of sunburn, bums byflame, electricity, scalds, hot metal, cement,acid and X-ray.

December, 1939. BOOK REVIEWS 411

41 OTGAUT EIALJUNL Dcme,13

INFLUENZA VIRUS VACCINE.For immunization against the primary

etiological agent of epidemic influenza, theInoculation Department of St.Parke Davi Mary's Hospital, London,issue an Influenza Virus

Vaccine. This consists of a formalinizedsuspension of several strains of the viruswhich have been isolated from cases ofhuman influenza and shown by animalexperiments to be the true virus of influenza.It has been shown that immunity to thevirus remains at a high level for threemonths after inoculation with virus vaccine.In order to protect against theYbacterial fac-tors responsible for the serious complications,it is recommended that the virus vaccineshould be used in conjunction with a bac-terial vaccine such as Anti-Influenza Vaccine(Mixed) St. Mary's Hospital Formula. Sincethe immunity following Influenza VirusVaccine takes about two weeks to reach itsheight, the vaccine should be administered

some weeks before an epidemic is likely tooccur. As there is no means of telling whenthe disease will break out, it would beadvisable to commence inoculation inOctober. This would ensure a high immunityuntil January, when further inoculationsshould be given. There is, however, noreason why treatment should not be com-menced in November or December, or evenlater, and the second series given threemonths later.The first course of doses consists of one

dose of Influenza Virus Vaccine and twodoses (0.5 c.c. and 1 c.c.) of the Anti-Influenza Vaccine (Mixed). The secondcourse consists of a 1 c.c. dose of VirusVaccine and a 1 c.c. dose of the Anti-Influenza Vaccine (Mixed).

Supplied in packages containing 2 x 1 c.c.ampoules of the Influenza Virus Vaccinewith one 0.5 c.c. dose and two 1 c.c. dosesof Anti-Influenza Vaccine (Mixed). Single1 c.c. ampoules of either vaccine are alsoavailable.

LIST OF OVERSEAS MEMBERS OF THE FELLOWSHIPMEDICINE AT PRESENT IN ENGLAND.

OF

(NOTE: The Fellowship of Medicine does not undertake to forward circulars.)AUSTRALIA:

Dr. W. T. G. ATKINS, c/o Australia House, Strand, W.C.2.Dr. J. M. BONNIN, Central Middlesex County Hospital, Acton Lane, N.W.10.Dr. G. BOWEN-THOMAS, c/o Fellowship of Medicine.Dr. R. H. BRENT, c/o Bank of New South Wales, 47, Berkeley Square, W.1.Dr. H. L. BREWER, London House, Guilford Street, W.C.1.Dr. W. S. CHARLTON, c/o E. S. & A. Bank, Limited, 5, Gracechurch Street, E.C.3.Dr. J. E. CLARKE, London House, Guilford Street, W.C.1.Dr. DORA S. DAVIES, Borough Maternity Hospital, 770, Dunstable Road, Luton, Beds.Dr. K. J. B. DAVIS, c/o Bank of New South Wales, Berkeley Square, W.1.Dr. M. T. DRUMMOND, c/o Bank of New South Wales, Berkeley Square, W.1.Dr. R. Du VAL, Claybury Hospital, Woodford Green, Essex.Dr. C. C. FINLAY, C/O Australia House, Strand, W.C.2.Dr. W. R. GAYTON, C/O London House, Guilford Street, W.C.1.Dr. A. H. GEE, c/o Bank of New South Wales, 47, Berkeley Square, W.1.Dr. W. C. GLEDHILL, c/O E. S. & A. Bank, Ltd., 5, Gracechurch Street, E.C.3.Dr. J. A. INGLIS, London House, Guilford Street, W.C.1.Dr. M. JOSEPH, c/o Bank of New South Wales, 47, Berkeley Square, W.1.Dr. P. J. KENNY, London House, Guilford Street, W.C.1.Dr. O. W. LEITCH, C/O Union Bank of Australia, 71, Cornhill, E.C.3.Dr. J. F. LIPSCOMB, c/o Fellowship of Medicine.Dr. F. H. LORD, c/o Australia House, Strand, W.C.2.Dr. A. E. McGuiNNESS, c/o Commonwealth Bank of Australia, Australia House, Strand, W.C.2.Dr. G. B. MURPHY, c/o London House, Guilford Street, W.C.1.Dr. F. C. OLIPHANT, c/do Commercial Bank of Australia, Ltd., c/o Messrs. Bryce White & Co., Ltd., Deseronto

Wharf, Langley, nr. Slough, Bucks.Dr. H. M. REES, c/o Fellowship of Medicine.Dr. T. F. ROSE, c/o Australia House, Strand, W.C.2.

412 POST-GRADUATE MEDICAL JOURNAL December, 1939

ADVERTISEMENTS

LIST OF OVERSEAS MEMBERS.Contd.

AUSTRALIA (contd.):Dr. P. N. SIMONS, London House, Guilford Street, W.C.1.Dr. ESTHER I. SKELTON, C/O Bank of New South Wales, 47, Berkeley Square, W.1.Dr. W. EMMET SPRING, Central Middlesex County Hospital, Acton Lane, N.W.10.Dr. M. J. L. STENING, London House, Guilford Street, W.C.1.Dr. HELEN M.. TAYLOR, C/O Bank of New South Wales, 47, Berkeley Square, W.1.Dr. J. McR. YEATES, Queen Mary's Hospital, Carshalton, Surrey.

CANADA:Dr. C. H. HOLLENBERG, 89, Eyre Court, Finchley Road, N.W.8.Dr. ROGER WILSON, C/O Fellowship of Medicine.

NEW ZEALAND:

Dr. A. C. BEGG, C/O Bank of New Zealand, 1, Queen Victoria Street, E.C.4.Dr. A. C. BELFIELD, c/o 415, Strand, W.C.2.Dr. J. HARBUTT, C/O 415, Strand, W.C.2.Dr. E. V. NEWLANDS, c/o 14, Pembridge Gardens, W.2.Dr. D. G. PHILLIPS, C/ 415, Strand, W.C.2.Dr. W. M. PLATTS, c/o 415, Strand, W.C.2.Dr. C. GRAHAM RILEY, c/o Grindlay & Co., 54, Parliament Street, S.W.1.Dr. G. L. M. SCHOLEFIELD, c/o Fellowship of Medicine.Dr. DOROTHY SPENCE-SALES, c/o Fellowship of Medicine.Dr. B. G. SPIERS, c/o Bank of New Zealand, 1, Queen Victoria Street, E.C.4.Dr. S. H. SWIFT, c/o Chartered Bank, 38, Bishopsgate, E.C.3.Dr. A. K. TULLOCH, C/O 415, Strand, W.C.2.Dr. P. C. S. UNWIN, c/o 415, Strand, W.C.2.Dr. W. J. WATT, c/o 415, Strand, W.C.2.Dr. J. D. WILLIS, C/O Bank of New South Wales, Berkeley Square, W.1.

SOUTH AFRICA:

Dr. F. BANDO, C/O Barclays Bank (D. C. & 0.), Circus Place Branch. London Wall, E.C.2.Dr. B. A. BRADLOW, C/O E. Green & Sons, 46, St. Andrew's Square, Glasgow.Dr. T. S. V. Buss, c/o Barclays Bank (D. C. & 0.), 1, Cockspur Street, S.W.1.Dr. A. M. CHANOCK, C/O Standard Bank of South Africa, 9, Northumberland Avenue, W.C.2.Dr. F. L. A. GACE, c/o Standard Bank of South Africa, 9, Northumberland Avenue, W.C.2.Dr. K. T. GOLDSWAIN, C/O Barclays Bank (D. C. & 0.), 1, Cockspur Street, S.W.1.Dr. W. A. M. MILLER, C/O Standard Bank of South Africa, 9, Northumberland Avenue, W.C.2.Dr. L. MILNER, 33, Green Walk, Hendon, N.W.4.Dr. C. T. MOLLER, C/O Standard Bank of South Africa, 10, Clements Lane, E.C.4.Dr. MAURICE NELLEN, C/O Standard Bank of S. Africa, 9, Northumberland Avenue, W.C.2.Dr. A. RABINOWITZ, c/o Scholefield Goodman & Sons, Limited, 23 Lime Street, E.C.3.Dr. H. D. RUSKIN, 24, Clanricarde Gardens, W.2.Dr. E. W. D. SWIFT, c/o Standard Bank of South Africa, 9, Northumberland Avenue, W.C.2.Dr. J. A. WEIR, c/o Standard Bank of South Africa, 9, Northumberland Avenue, W.C.2.

RUTHIN CASTLE, NORTH WALESA Clinic for the diagnosis and treatment of Internal Diseases (except Mental or Infectious Diseases). The

Clinic Is provided with a staff of doctors, technicians, and nurses.The surroundings are beautiful. The climate is mild. There is central heating throughout. The annual

rainfall is 30-5 inches, that is, less than the average for England.The inclusive weekly fees are from 15 guineas a week, according to the room occupied; rooms with bath-

room are from 21 guineas. An examination and consultation fee of 15 guineas is charged on the first visit only.SPECIAL FEE FOR INVESTIGATION ONLY-30 GUINEAS, including stay up to 10 days and

report to doctor.For particulars apply to THE SECRETARY, Ruthin Castle, North Wales.

TelVrwm: Castle, Ruthin. Tee/hoene: Ruthin 66

Fellowship of Medicine and Post-GraduateMedical Association

I, WIMPOLE STREET, LONDON, W.I. Telephone-LANGHAM 4266.

PRESIDENT:The Rt. Hon. LORD HORDER, G.C.V.O., M.D., F.R.C.P.

CHAIRMAN OF EXECUTIVE:HERBERT J|. PATERSON, C.B.E., M.C.

HONORARY TREASURER:J. SWIFT JOLY, F.R.C.S.

HONORARY SECRETARIES:H. V. MORLOCK, M.C., M.D.DAVID LEVI, M.S.

HONORARY EDITOR:ERNEST FLETCHER, M.B., M.R.C.P.

ASSISTANT HONORARY EDITOR:

RONALD W. RAVEN, F.R.C.S.

EXECUTIVE COMMITTEE, I938-I939 --DENIS BRINTON, D.M., F.R.C.P.

G. T. CALTHROP, M.D., D.M.R.E.

LEONARD FINDLAY, M.D., F.R.C.P.

KENNETH HERITAGE, M.S.

Sir ROBERT HUTCHISON, Bart., M.D.,P.R.C.P

B. T. PARSONS-SMITH, M.D., F.R.C.P.

CHARLES READ, F.R.C.S., M.C.O.G.

SECRETARY:Mona L. Worth.

(Office Hours: ro a.m. to 5.30 p.m.Saturdays 10.0 amj. to I2.30 p.m.)

The Post-Graduate Medical Journal is the official organ of the Fellowship of Medicine and Post-Graduate Medical Association.

Notice to Subscribers.See special Blue Form inset in centre of Journal.

Notice to Contributors.The Joural is intended for the publication of matter of special interest to the Post-Graduate. The

substance of Lectures (either abridged or in extenso) as well as Reports of cases demonstrated to Post-Graduatestudents are specially invited,

Communications submitted for publication must be type-written. All illustrations should be in the formof positive prints with specific directions regarding their position in the text. Communications published becomethe property of the Journal and permission to re-publish must be obtained from the Editor.

Contributors will be supplied with one galley-proof; an allowance of ten shillings per sheet of 16 pagesis made for corrections. Each contributor is entitled to fifty separate copies of his article (if the article hsmore than one contributor the fifty copies are divided among them). Extra copies may be had from theprinter at a moderate charge.

All correspondence regarding the Journal must be addressed to the Honorary Editor, Fellowship ofMedicine, I Wimpole Street, W.I., except that dealing with advertisements and business matters, which shouldbe addrssed to the Business Manager, Fellowship of Medicine and Post-Graduate Medical Journal404, Grand Buildings, Trafagar Square, W.C.. (Tel.: Abbey 6988).

INDEX TO VOLUME XV. (NEW SERIES).

JANUARY TO DECEMBER, 1939.

PAGE

ACUTE mastoiditis. J. Douglas McLaggan .. 335Annual Meeting Report . .. .. 110

BIOCHEMISTRY of Vitamin B complex andtheir clinical importance, Recent advancesin the. J. Norman Davidson .. .. 236

Blair, Donald. The treatment of epilepsy bySodium- Di - Phenyl Hydantionate(Epanutin) . .. .. .. . 344

Blood transfusion by the continuous dripmethod. R. A. King . .. .. 390

Brain and their treatment, Tumours of thetemporal lobe of the. C. P. G. Wakeley 165

- tumour, The investigation of a case ofsuspected. C. M. Hinds Howell .. .. 141

Bronchiectasis. A. Lisle Punch .. .. 88Bull, H. Cecil. Radiology in the diagnosis of

duodenal ulcer .. .. .... 53

CANCER of the breast. R. W. Raven. .. 82Carcinoma of the lip, Treatment of. D.

Waldron Smithers .. .. .. 376Cases shown at F.R.C.S. demonstration. A.

Cameron MacLeod .. .... 382Chyluria. R. W. Raven . ... 363Cutaneous lesions of acquired syphilis. H.

Haldin-Davis .. .. .. .. 293

DAVIDSON, J. Norman. Recent advances inthe biochemistry of the Vitamin B com-plex and their clinical importance .. 236

Debate on State Medical Service .. 112Dermoid sarcoma of rectus abdominalis, Case

of. Harold Dodd .. .. .. 96Diagnosis of duodenal ulcer, Radiology in the.

H. Cecil Bull .. . .. . 53Dodd, Harold. Case of dermoid sarcoma of

rectus abdominalis .. .. .. 96Duodenal ulcer, Radiology in the diagnosis of.

H. Cecil Bull .. .. .. .. 53

EDITORIAL-A new form of treatment for cancer .. 323A State medical service .. .. .. 105British Journal of Rheumatism . 389Centenary of Medical Press & Circular 34Difficult cases . . . . 289Heberden Research Medal and Lecture-

ship . .. .. .. .224Hospital blood repositories . .. 255Hunterian Society Gold Medal for practi-

tioners .. . . . 106Intracranial tumours .. .. .. 137Medical research .. .. . .. 223Observations on the treatment of air raid

casualties in Barcelona .. .. 371Radium therapy ..... .70The medical uses of radium . 1The Rockefeller Foundation .. .387The war and the medical profession .. 355Traumatic and industrial surgery .. 33

PAGE

EPANUTIN, The treatment of epilepsy bySodium-Di-Phenyl Hydantionate. DonaldBlair . . .. .. . 344

Epilepsy by Sodium-Di-Phenyl Hydantionate(Epanutin), The treatment of. DonaldBlair .. . .. . 44

FIBROSITIS by manipulation, Treatment of.Frank Romer .. . .. . 24

Flint, E. R. Pre- and post-operative manage-ment of surgical cases (I) .. .. 227

--(T) .. .. .. .. .. .. 269

GAUCHER'S disease (from the clinical point ofview). Bernard Myers .. . . 20

Gloyne, S. Roodhouse. Pleural effusions intuberculosis .. . .. . 99

Goldman, Victor. Vinyl ether for minorsurgery and dentistry .. .. 58

HALDIN-DAVIS, H. Cutaneous lesions ofacquired syphilis .. 293

Halls-Dally, J. F. Low arterial pressure .. 327Head injuries, The immediate treatment of.

Kenneth L. James .. .. .. 277Headache with special reference to migraine,

Observations on persistent and recurrent.Part I. C. Worster-Drought .. .. 258

--Part II.-Migraine. C. Worster-Drought 309Hoskin, T. Jenner. Some conditions with

which hypertension is associated . 73Howell, C. M. Hinds. The investigation of a

case of suspected brain tumour .. .. 141Hypertension is associated, Some conditions

with which. T. Jenner Hoskin .. 73

IIMEDIATE treatment of head injuries, The.Kenneth L. James .. .. .. 277

Intracranial tumours, The pathology of.Dorothy S. Russell . .. . 150

Investigation of a suspected case of braintumour, The. C. M. Hinds Howell .. 141

JACKSON, Harvey. Meningeal tumours .. 183James, Kenneth L. The immediate treatment

of head injuries .. ...... 277Jefferson, Geoffrey. 'umlours of the frontal

lobe .. ... .. .. . 170

KING, R. A. Blood transfusion by the con-tinuous drip method .. . .. 390

Knight, Geoffrey. Subtentorial tumours .. 195

Low arterial pressure. J. F. Halls-Dally .. 327

MCLAGGAN, J. Douglas. Acute mastoiditis .. 335MacLeod, A. Cameron. Cases shown at

F.R.C.S. demonstration .. .... 382

2 INDEX TO VOLUME XV.

PAGE

Manipulation in the treatment of rheumaticdiseases, The value of. James Mennell 301

Mastoiditis, Acute. J. Douglas McLaggan .. 35Mendelism and medicine. Maurice Shaw .. 37Mennell, James. The value of manipulation in

the treatment of rheumatic diseases .. 301Migraine, Observations on persistent and

recurrent headache with special referenceto. Part II. C. Worster-Drought .. 309

Myasthenia gravis. J. Shafar .. .. 358Myers, Bernard. Gaucher's disease (from the

clinical point of view) .. .... 20

NEURO-SYPHILIS, Prevention and treatment of.B. Buckley Sharp . .. .. 5

Nevin, Samuel. Hypothalamic and pituitarytumours .. .. .. .. .. 210

OBSERVATIONS on persistent and recurrentheadache with special reference tomigraine. Part I. C. Worster-Drought 258

-- Part II.-Migraine. C. Worster-Drought 309Occipito-posterior case, The. Gilbert 1.

Strachan .. .. .. .. .. 263

PATHOLOGY of intracranial tumours, The.Dorothy S. Russell .. .. .. 150

Pleural effusions in tuberculosis. S. RoodhouseGloyne .. .. .. .. .. 399

Pre- and post-operative management ofsurgical cases (I). E. R. Flint .. .. 227

- (II). .R. Flint .. .. .. .. 269Prevention and treatment of neuro-syphilis.

B. Buckley Sharp .. .. .. 5Punch, A. Lisle. Bronchiectasis .. .. 88

RADIOLOGY in the diagnosis of duodenalulcer. H. Cecil Bull .. .. .. 53

Raven, R. MV. Cancer of the breast .. .. 82---Chyluria .. . .. .. . 363Recent advances in the biochemistry of the

Vitamin B complex and their clinicalimportance. J. Norman Davidson .. 236

REVIEWS-Adventures in respiration. Yandell

Henderson .. .. .. .. 249Aids to bacteriology (6th edition).

William Partridge. Revised by H.Scott-Wilson .. .. .. .. 29

Aids to embryology (3rd edition). R. H.Hunter . .. .. .. . 99

Aids to public health. (Students' AidSeries). (4th edition). LlewellynRoberts . .. .. .. .. 133

Anatomy, Part IV (5th edition). (Cate-chism Series) . .. .. .. 406

Arthritis, fibrositis and gout. C. W.Buckley .... .. .. 220

Artificial limbs and their relation toamputations. (H.M. Stationery Office) 410

A short practice of surgery (4th edition).Hamilton Bailey and R. J. McNeill Love 130

A textbook of clinical pathology. Editedby R. R. Kracke ... . 66

A treatise on the surgical technique ofotorhinolaryngology. Georges Port-mann . .. . .385

Biological standardisation of the vitamins.Katharine H. Coward .. .. .. 409

PAGE

Brompton Hospital reports. Vol. VI 62Brompton Hospital reports. Vol. VII,

1938 . .. .. .. .. 384Cabot's physical diagnosis (12th edition).

R. C. Cabot and F. D. Adams .. 283Cardiovascular disease in general practice.

Terence East .. .. .. .. 283Cardio-vascular diseases. David Scherf 407Chronic diseases of the abdomen; a

diagnostic system. C. JenningsMarshall.. .. .. .. .. 284

Chronic interstitial toxaemia and itstreatment. James W. Wiltsie .. 220

Chronic rheumatic diseases. Edited byC. W. Buckley .. .. .. .. 133

Classic descriptions of disease (2ndedition). Ralph H. Major .. .. 383

Climate and acclimatization (2nd edition).Sir Aldo Castellani .. .. . 29

Clinical paediatrics (the baby). W. R. F.Collis .. .. .. .. .. 351

Clinical roentgenology of the digestivetract. Maurice Feldman .. .. 220

Clinics on secondary gastro-intestinaldisorders reciprocal relationships.J. Friedenwald and T. and S. Morrison 282

Common happenings in childhood. SirFrederic Still .. .. .. .. 100

Control of conception (2nd edition).R. L. Dickinson .. .. 285

Dietetics in general practice. LeslieCole .. .. .. .. .. 251

Essentials of fevers. Gerald E. Breen.. 406Essentials of modern surgery. R. M.

Handfield-Jones and A. E. Porritt.. 62Everyday surgery. Lambert Rogers and

A. L. d'Abreu .. .. .. .. 102Evolution of obstetric analgesia. A. M.

Claye .. .. .. .. .. 285Gas and air analgesia. R. J. Minnitt .. 221Handbook of skin diseases. Revised by

J. Kinnear (4th edition) .. .. 353Heart disease and pregnancy. Crighton

Bramwell, and Edith A. Longson .. 63Iodine metabolism and thyroid function.

A. W. Elmer .. .. .. .. 249Macleod's physiology in modern medi-

cine (8th edition). Edited by PhilipBard . .. .. .. . 65

Manual of determinative bacteriology(5th edition). David Bergey, R. S.Breed, E. G. D. Murray and A. ParkerHitchens . . .. .. .. 408

Medical jurisprudence and toxicology(6th edition). Edited by John Glaister 383

Medical practice in residential schoolsF. G. Hobson .. .. .. 248

Midwifery by ten teachers (6th edition).Edited by Clifford White, Sir ComynsBerkeley and Frank Cook . .. 131

Midwifery, Parts I and II (4th edition).(Catechism Series) .. . .. 406

Minor medical operations. Kenneth andEdith Harris .. .. .. .. 281

Modern anasthetic practice, No. III.Practitioner Handbooks. Edited bySir Humphry Rolleston and Dr. AlanMoncrieff . .. .. . 368

Modern treatment in general practice YearBook, 1939. Edited by C. P. G. Wakeley 318

INDEX TO VOLUME XV. 3

REVIEWS (contd.)- PAGE

Modern treatment in general practice,Vol. IV. C. P. G. Wakeley .... 64

Neurology (2nd edition). Roy R. Grinker 29Oxygen and CO2 therapy (2nd edition).

Argyle Campbell and E. P. Poulton 250Pharmacopoeia and vade mecum (revised

edition). Edited by J. Wycliffe Peck 410Physiology of the nervous system. J. F.

Fulton .. .. .. .. .. 250Play therapy in childhood. C. H.

Rogerson .. .. .. .. 318Population, race, and eugenics. Morris

Siegel .. .. .. .. .. 407Practical child psychotherapy. CurtBoenheim .. .. .. .. 352

Practical pathology (3rd edition). JamesMiller and James Davidson .. .. 99

Practical procedures, Vol. II. Edited bySir Humphry Rolleston and A.Moncrieff .. .. .. .. 66

Pye's surgical handicraft (llth edition).Edited by Hamilton Bailey .. .. 281

Rheumatism. Bertram S. Niss6 .. .. 284St. Thomas's Hospital Reports, Vol. III

(2nd series) .. .. .. .. 353Shock and related capillary phenomena.

Virgil H. Moon .. .. .. 384Surgical anatomy of the head and neck.

J. F. Barnhill .. . .. . . 351The abnormal in obstetrics. Sir Comyns

Berkeley, V. Bonney, and D. MacLeod 249The British encyclopadia of medical

practice, Vol. 9, Vol. 10. Edited bySir Humphry Rolleston .. .. 101

The British encyclopaedia of medicalpractice, Vol. 11. Edited by SirHumphry Rolleston .. .. .. 368

The chemistry of the sterids. HarrySobotka .. .. .. .. .. 101

The construction of vulcanite applicatorsfor applying radium to lesions of thebuccal cavity, lips, orbit and antrum.D. G. Walker .. .. . 66

The dysenteric disorders. P. Manson-Bahr .. . .. .. .. 407

The emotional factor in visceral disease.H. G. McGregor .. .. .. 100

The foot (2nd edition). Norman C. Lake 99The handicap of deafness. Irene R. Ewingand Alex. XV. G. Ewing .. .. 351

The health of the nation and deficiencydiseases. John Maberly .. .. 352

The infant: a handbook of management(2nd edition). W. J. Pearson and A. G.Watkins .. .. .. .. .. 409

The medical application of the short-wavecurrent. W. Bierman.... 318

The nose, ear and throat for nurses anddressers (2nd edition). Michael Vlasto 351

The Physiology of the kidney. HomerW. Smith .. .. .. .. 64

The stuff we're Inade of. W. O. Kermackand P. Eggleton.. .. .. .. 132

The Surgery of pain. Rene Leriche .. 406Textbook of medicine (4th edition).

Edited by J. J. Conybeare .. . 368Textbook of neuro-radiology. C. P. G.Wakeley and Alexander Orley 30

Textbook of nutrition. J. A. Nixon andDoreen Nixon .. .. .. .. 132

PAGE

Thoracic Surgery. F. Sauerbruch andL. O'Shaughnessy .. .. .. 63

Treatment in general practice, Vols. Iand II (2nd edition) .. .. .. 248

Treatment by manipulation in generaland consulting practice (3rd edition).Edited by A. G. Timbrel Fisher .. 368

Whitla's dictionary of treatment (8thedition). R. S. Allison and C. A.Calvert .. .. .. .. .. 285

Worth's squint (7th edition). F. BernardChavasse.. .. .. .. .. 409

RHEUMATIC child, Some problems of the.C. E. Sundell .. .. .. .. 244

Rheumatic diseases, The value of manipulationin the treatment of. James Mennell .. 301

Romer, Frank. Treatment of chronic fibrositisby manipulation .. ... . 24

Russell, Dorothy S. The pathology of intra-cranial tumours . .. .. .. 150

SARCOMA of rectus abdominalis, Case ofdermoid. Harold Dodd .. . .. 96

Shafar, J. Myasthenia gravis .. .. .. 358Sharp, B. Buckley. Prevention and treatment

of neuro-syphilis .. .. .. .. 5Shaw, Maurice. Mendelism and medicine 37Smithers, D. Waldron. Treatment of carci-

noma of the lip .. .. .. .. 376Some conditions with which hypertension is

associated. T. Jenner Hoskin .. .. 73Some problems of the rheumatic child. C. E.

Sundell .. .. .. .. .. 244State Medical Service, Debate on .. .. 112Strachan, Gilbert I. The occipito-posterior

case .. .263Sundell, C. E. Some problems of the rheumatic

child . . .244Surgical cases, Pre- and post-operative manage-

ment of (I). E. R. Flint .. .. 227- (II) .ER. Flint .. .. .. .. 269Syphilis, Cutaneous lesions of acquired.

H. Haldin-Davis .. .. .. .. 293

TREATMENT of carcinoma of the lip. D.Waldron Smithers .. .. . 376

Treatment of chronic fibrositis by manipula-tion. Frank Romer .. .. .. 24

Treatment of epilepsy by Sodium-Di-PhenylHydantionate (Epanutin). Donald Blair 344

Treatment of head injuries, The immediate.Kenneth L. James .. .. .. 277

Treatment of neuro-syphilis, Prevention and.B. Buckley Sharp .. . .. 5

Treatment of rheumatic diseases, The value ofmanipulation in. James Mennell . 301

Treatment, Tumours of the temporal lobe ofthe brain and their. C. P. G. Wakeley .. 165

Tuberculosis, Pleural effusions in. S. Rood-house Gloyne .. .. . 399

Tumour, The investigation of a case ofsuspected brain. C. M. Hinds Howell .. 141

Tumours of the frontal lobe. GeoffreyJefferson .. .. .. .. 170

- Hypothalamic and pituitary. SamuelNevin .. .. .. .. . 210

- Meningeal. Harvey Jackson .. .. 183---of the parietal and occipital lobes.

A. Dickson Wright .. . .. 179

4 INDEX TO VOLUME XV.

PAGETumours, The pathology of intracranial.

Dorothy S. Russell .. .. .. 150---Subtentorial. Geoffrey Knight.. .. 195---of the temporal lobe of the brain and

their treatment. C. P. G. Wakeley .. 165

VINYL ether for minor surgery and dentistry.Victor Goldman .. .. .. .. 58

Vitamin B complex and their clinical import-ance, Recent advances in the biochemistryof. J. Norman Davidson .. .. 236

PAGEWAKELEY, C. P. G. Tumours of the temporal

lobe of the brain and their treatment .. 165

Worster-Drought, C. Observations on persis-tent and recurrent headache with specialreference to migraine. Part I .. .. 258

---Part II.-Migraine .. .. .. .. 309

Wright, A. Dickson. Tumours of the parietaland occipital lobes .. .. 179

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