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Notes and News

I THE CAPITATION FEE

LAST Saturday the Ministry of Health announced thatthe capitation fee payable to doctors for each insured personon their lists under the National Health Insurance Acts hasbeen increased from 10s. 6d. to 12s. 6d. with effect from Jan. 1,1946. Accumulated back payments will be made in the nearfuture-if possible at the end of September.The extra cost of the new fee during the period between

Jan. 1, 1946, and April 1, 1948, when the National HealthService will come into operation, will be about JE4,500,000.Discussions on the subject between the Ministry and theInsurance Acts Committee were summarised in our issue ofAugust 3 (p. 166).

THE STUDENTS’ JOURNAL

THE development, in a few years, of the British MedicalStudents’. Association from a relatively sluggish section ofthe National Union of Students has been almost as remarkable

as the metamorphosis of a caterpillar. This year the associa-tion has published the first issue of the British MedicalStudents’ Journal, an international number, well written andproduced, and illustrated by good photographs. It tells the storyof the first World Student Congress to be held since the war.

’’ On the 17th November, 1939, the Charles University inPrague was closed by the German authorities, nine heads ofthe students’ organisation were shot, and a large proportionof the male student population was thereafter thrown intoconcentration camps or sent to forced labour inside

Germany." "

Refugee students and British students decided together thatthe day should be remembered as International Students’Day ; and the first celebration of it was held in Prague lastyear. The great welcome given to students of all countrieswho went to this gathering and the plans made for theirdiscussions and for their entertainment evidently moveddeeply those who attended, and must have done much toestablish that sense of fellowship on which the peoples of theworld must rely for a safe and constructive future.

This journal makes impressive reading.

PATENT-LAW REFORM

THE Joint Chemical Committee on Patents submitted amemorandum to the Board of Trade Patents Committee in

September, 1944 ; some aspects of the views therein contained,especially in relation to chemical manufacture, the exploitationof medical discoveries, and the preservation of secrecy, werediscussed here at the time (Lancet, 1944, ii, 542). In June of

this year the Joint Committee produced a second memoran-dum, covering wider considerations of patent-law reform.The two documents have now been reprinted in a single volumepublished by the Association of British Chemical Manu-facturers (3s. post free). Some of the recommendations have

already found favour and are included in the Second InterimReport of the Departmental Committee (Cmd. 6789). Patentlaw is repulsively technical, but those who understand thesemysteries will find much to interest them in the new publication.To take a casual instance of the complication of the law, the

awkward interpretation of words like " manner of manu-facture " has been illustrated by the recent discovery ofpowerful insecticides. Hitherto little more than chemicalcuriosities, certain substances have been found to possessgreat industrial significance. Being new, the discoveriesshould confer patentable "subject matter" in their novelindustrial application as insecticides. The application is themanufacture, but, since the substance was already known, themanufacture lacks novelty and is unpatentable. Killinginsects is not manufacture. The only patent cover obtainableis for some novel composition containing the active substance- in other words, for the mixing of the substance with adiluent. So what is intrinsically unpatentable becomespatentable by the addition of a non-inventive stage. Themanufacture would be patentable, if novel ; the mixing of somecommon diluent is relied upon to provide the necessarynovelty. In Holland and the United States, as in pre-warGermany, it appears, the use of substances as insecticides hasbeen patentable.

’

Two matters in the memorandum may be mentioned as ofinterest to the medical profession. Under section 38A of thePatents Act, compulsory licences may be granted in respectof patents relating to food and medicine. No great use hasbeen made of the powers in the section, though they may have

indirectly inclined pharmaceutical manufacturers to grantlicences by voluntary agreement. The Joint Committeeobserve that difficulty has occurred in interpreting section 38Abecause the section deals both with chemical inventions andalso with inventions relating to food and medicine. Theysuggest that when the Act is rewritten the section should besplit and the two classes of invention separately treated.

Secondly they note that the royal prerogative reserved tothe Crown by section 97 has lately been exercised to refuse apatent concerning a device for calculating the " safe periods

"

for marital intercourse, and that under section 75 patents havebeen refused for contraceptive chemicals and devices. TheAct at present embodies this jurisdiction to refuse recognitionto patents "contrary to law or morality." The Joint Com-mittee think that the words " or morality " might be deletedfrom the statute. Such inventions, they say, may be usefulcontributions to medical knowledge and it is difficult today toregard them as necessarily contrary to public morals. "

Manypatented inventions are capable of abuse with much moredevastating results, and we urge that patent specifications area form of literature which should be regarded as ’ technical’equally with the Lancet and the British Medical Journ,al."

CENSUS OF HOSPITAL CASES

THE Glasgow Bureau of Health and Sickness Records,of which Prof. T. Ferguson is chairman, is undertaking acensus of all hospital-treated sickness occurring among peopledomiciled in the county of Stirling (including the

"

largeburghs " of Falkirk and Stirling) during the year beginning onOct. 1. The intention is to cover all kinds of sickness, includingmental illness, and to collect information about Stirlingshirecases not merely from hospitals within their area but also fromcity and other hospitals to which patients in the countycommonly go for treatment. The aim is to get a fairly com-plete picture of the nature and extent of hospital-treatedsickness in what is a fairly typical and representative Scottishcounty area. The information thus obtained may well pointthe way to useful administrative action.

BRITISH BOOKS ON SHOW IN SWITZERLAND

AN exhibition of British books, old and modern, generaland technical, will be opened in Berne on Sept. 3, and willlater be shown in Bale. Zurich, Geneva, and Lausanne. Thefirst exhibit is an original leaf of the Chronicles of England,printed by Caxton in 1480. A separate section will be devotedto the periodical press. The display, devised by the BritishCouncil, follows four months after an- exhibition of Swissbooks in London.

INVALID AND VOIDABLE MARRIAGES

"MARRIAGES are also void in the case of certain diseases.Information about these should be sought from a reliablemedical man." Reading this statement in a book, a clergymanasks us for further facts.

There are certain requisites for a valid marriage, and ifany of these is absent the marriage is void ab initio : (1) bothparties must be over sixteen years of age ; (2) both partiesmust be mentally capable of understanding the nature of thecontract ; (3) the parties must not be within the prohibiteddegrees of relationship ; (4) both parties must freely consent,consent obtained by duress or force being void, but notconsent obtained by fraud ; (5) there must not be an alreadysubsisting marriage which is valid ; and (6) the ceremonymust be in proper form.

It will be seen that there is no provision for invalidity onthe grounds of disease, apart from (2) above. There arecertain grounds upon which a marriage is voidable, but thisdoes not mean that the marriage was originally unlawful,and indeed in all these cases it is entirely at the option of theparty aggrieved whether the marriage is avoided or not.Even in the case of venereal disease the petitioner mustsatisfy the court that he or she was unaware of it at the timeof the marriage and refused intercourse on learning of it(Matrimonial Causes Act, 1937). The clear implication istherefore that such disease is no bar to a valid marriage.The grounds of voidability are (1) incapacity due to incur-

able physical mental or moral disability ; (2) wilful refusal toconsummate ; (3) unsound mind or mental deficiency of oneparty of which the other was ignorant at the time of themarriage ; (4) communicable venereal disease subject to theproviso above mentioned ; (5) pregnancy of the respondentby another man at the time of marriage. In all these casesthe marriage is valid until avoided, and in the last three

petition must be made within a year of marriage.

332

MEDICINE IN THE ROUGH

Dr. Edwin Seaborn has produced an unusual volume ofmedical history.l It is an epic of the adventures and untolddifficulties of the pioneer surgeons of the prairies, and it tellsof traders and log cabins, of medicine chests, wagons, andcanoes, of sorties and ambushes, of buffaloes trapped in thesnowdrifts, and of amputations rudely performed with thehuntsman’s knife. We read of Francois Guitault, Cartier’sown physician on the voyage of 1534, who saw the Indiansprescribe, for the treatment of scurvy, a broth of the greentips of spruce; of Andre Arnoux, who dressed the wounds ofMonctalm after the battle on the plains of Abraham in 1759 ;of Sieur de la Salle, whose romantic travels ended, after

rebuilding the fort at Starved Rock, in the naming of theState of Louisiana for his monarch Louis XIV ; of ReneGoupil, surgeon of Anjou, and later donne in the JesuitMission at Quebec, who, after being cruelly tortured by thenotorious Iroquois, was treacherously slain with a tomahawkin the Huron territory ; and of Etienne Bouchard, of Montreal,who in 1654 perfected for his patients a comprehensive einsurance scheme against all illness other than plague, small-pox, leprosy, epilepsy, and stone requiring the knife.

Indians abandoned themselves to unmitigated sorrow andceremonial dancing when the smallpox was rife, for deaththey expected daily. Wolf Chief, the Brave, cocked his gunas naked he advanced on the fort, swearing vengeance onthe pale-faces whom he blamed for the fatal disease : and thepipe remained unsmoked so long as the daily toll of victimsgrew. The practice of inoculation seems to have been knownto the Red Indians, but Dr. Seaborn is surely in error when heasserts that George Christian Anthon was a protagonist ofvaccination before Jenner ; for the account he gives earlierof the practice of vaccination, is that of inoculation. Thebackwoods of medicine in the raw are shown up in the storyof the theft of the solitary iron bedstead from the Port StanleyCholera Hospital, of the futility of the hospital at TurkeyPoint which cost :S53 but was never used, and of the objec-tionable practice of salting up for future dissection the

unhappy victims of the gibbet.We like the illustrations of Patrick Donnelly with his

Schubert-like face, of Henry Saunders with his speedy pennv-farthing, and of George H. Wilson who dressed like a cossack.We are taken also with the pictures of the early medicalschools and of Dr. Joseph Lancaster’s unique octagonalhouse. Dr. Seaborn’s careful research into the history ofCanadian medicine will rank as a classic of its kind, and thereader will pay his tribute to those who practised their artand profession and gave of their best on the lonely trails ofthe West.

DOCTORS TO BELONG TO TRADE-UNION?

AT a recent meeting of the Salford city council a resolutionwas passed recommending the council to direct that all its

employees " shall be members of their appropriate trade-unions or organisations." A suggestion in the lay press thatthe British Medical Association would not be recognised asa suitable organisation has been denied by the promotersof the resolution, who have also stated that the resolutionwas intended to refer primarily to non-union manual workers,and that if it was applied to doctors and nurses they. wouldbe free to join any association they choose. We understandthat in fact the doctors and nurses working for the councilhave not so far been asked to comply with the resolution.Dr. J. L. Burn, the medical officer of health, has informedhis colleagues that he would strongly resist any suggestionof pressure on the medical staff to join a trade-union or anyparticular organisation.A resolution in similar terms is, we are informed, being

considered by other local authorities.

Mr. A. TUDOR EDWARDS, surgeon to the Brompton Hospitaland surgeon in charge of the department of thoracic surgeryat the London Hospital, died at St. Enodoc, Cornwall, onAugust 25. He was 56 years of age.

Dr. EARL CARLSON, of New York, will deliver a lecture onCerebral Palsy in Children at 4 P.M. on Monday, Sept. 9, at theLondon School of Hygiene, Keppel Street, W.C.1.The Croix de Chevalier of the Legion of Honour and the

Croix de Guerre avec palme have been conferred on Mr.ROWLEY BRISTOW.

1. Seaborn, E. March of Medicine in Western Ontario. Toronto:Ryerson Press. London : obtainable from Hatchards. Pp. 386.30s.

Return to PracticeThe Central Medical War Committee announces that the

following have resumed civilian practice :Mr. D. N. MATTHEWS, o.B.E., M.CH., F.R.C.S., 152, Harley Street,W.l. (Welbeck 2714.)

Dr. KENNETH ROBSON, F.R.C.P., 57A, Wimpole Street, W.1.(Welbeck 0270.)

Miss MARGARET SALMOND, M.B.E., F.R.C.S., F.R.C.O.G., 121, HarleyStreet, W.l.

Medical DiarySEPT. 1 TO 7

Monday, 2ndROYAL COLLEGE OF SL-RGEONS, Lincoln’s Inn Fields, W.C.2

3.45 P.M. Prof. R. A. Willis: General Pathology of Tumours:Definition, Classification, and Nomenclature.

5 P.M. Dr. C. A. Keele : Autonomic Drugs.

Tuesday,3rdROYAL COLLEGE OF SURGEONS

3.45 P.M. Prof. R. A. Willis : Structure and Growth of EpitheliaTumours.

5 P.M. Dr. C. A. Keele : Autonomic Drugs.

Wednesday, 4th ,

ROYAL COLLEGE OF SURGEONS3.45 P.M. Prof. R. A. Willis : Structure and Growth of Mesen.

chymal Tumours.5 P.M. Dr. Michael Kremer : Spinal Cord.

MEDICAL SOCIETY OF THE L.C.C. SERVICE3 P.M. (Queen Mary’s Hospital, Carshalton.) Clinical meeting.

Thursday, 5thROYAL COLLEGE OF SURGEONS

3.45 P.M. Prof. R. A. Willis : Structure and Growth of NeuralTumours.

5 P.M. Dr. Michael Kremer : Cerebellum.

Friday, 6thROYAL COLLEGE OF SURGEONS

3.45 P.M. Prof. R. A. Willis : Structure and Growth of EndocrineTumours.

5 P.M. Dr. Michael Kremer : Concussion.

AppointmentsHARKNESS, J. W. P., C.M.G., M.B. Glasg. : medical adviser to the

Comptroller for Development and Welfare in the West Indies.KING, D. P., M.A., M.D. Camb. : bacteriologist, Charing Cross

Hospital, London.TIBBLES, SYDNEY, L.R.C.P.E. : eye specialist to Kent and London

county councils.London County Council mental health services :BUTLER, E. N., M.R.C.S., D.P.M.: first asst. M.o., Cane Hill Hos-

pital, Coulsdon.CRAWFORD, J. M., M.D. Edin., D.p.M. : first asst. m.o., St. Bernard’s

Hospital, Southall.KiRMAN, B. H., M.D. Lond., D.P.M. : deputy medical superinten-

dent, Fountain Hospital, Tooting.STIRLING, PAULINE, M.B. Edin., D.P.M. : first asst. M.o., Friern

Hospital, New Southgate.TucKER, G. M., M.B. St. And., D.P.M. : first asst. M.o., Darenth

Park, Dartford.Royal Sheffield Infirmary and Hospital:BRODY, H. P., M.R.C.P. : physician.LEISHMAN, A. W. D., D.M. Oxfd, M.R.C.P.: physician.SKIPPER, E. W., M.D. Lond., M.R.C.P. : physician..

Births, Marriages, and DeathsBIRTHS

BRINTON.—On August 24, in London, the wife of Dr. W. D. Brinton,of Victoria Road, W.8-a daughter. ’

CURNOCK.—On August 17, at Chingford, the wife of Dr. HenryCurnock, of Wanstead—a son.

DAY.-On August 20, at Cranford, Middlesex, the wife of Dr. T. D.Day-a son.

DIVINE.—On August 19, at Huddersfield, the wife of Dr. T. A.Divine—a daughter. ,

GOTLA.-On August 17, the wife of Dr. Dudley Gotla-a son.HUTCHIN.—On August 18, the wife of Dr. K. C. Hutchin, of Hatfield,

Herts-a daughter.JONES.—On August 18, the wife of Dr. J. M. Jones, of Shoreham.

Sussex-a son.KELLY.—On August 18, in London, the wife of Dr. Reginald

Kelly-a son.LANKESTER.-On August 21, at Oxted, Surrey, the wife of Dr. John

Lankester-a son.MURRAY-LYON.—On August 17, in Edinburgh, the wife of Dr.

Ranald Murray-Lyon-a son.RICHARDSON.—On August 21, the wife of Mr. J. E. Richardson,

M.S.—a daughter.SCoTT.-On August 15, the wife of Dr. C. J. Scott, of Chilham,

Canterbury, Kent-a daughter.WooD.-On August 20, at Oxford, Dr. Elizabeth Wood (n6e

Sutcliffe), wife of Dr. Ben Wood-a son.

MARRIAGESWASS—BLAIKIE.—On August 20, at Brighton, Samuel Hall Wass,

F.R.C.S., of Kensington Mansions, London, S.W.5, to June MaryVaudine Blaikie.

DEATHSKINSEY-MORGAN.—On August 21, at Boscombe, Bournemouth,

Augustus Kinsey-Morgan, F.R.C.S.E.TUDOR EDWARDS.—On August 25, at St. Enodoc, North Cornwall,

Arthur Tudor Edwards, M.D., M.CHIR. Camb., F.R.C.s., aged 56.