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more seriously ill, while the lower decks have beenarranged for ambulant patients, with bunks, tablesand chairs. The third-class saloon bar has beentransformed into a dressing-room where minoroperations can be done, while the first-class dining-saloon has been made into a ward for officers. Theship’s galley provides meals for the staff and patientsin transit ; as on the train the personnel live on theboat. They are all trained in A.R.P. work and thesteps to be taken in every calamity that can befall aship at sea ; every bed has its lifebelt at hand, andlifebelts for the staff are distributed so that they areinstantly available. The beds are swung so thatthey sway with the movement of the ship, thusgiving comparative stillness to the patients.

Part of the port accommodation has been taken

over by the army authorities, and stores of linen,blankets, food and medical supplies for both trainsand boats are kept there. On arrival the patientsare carried from the boat into a shed (where thestretchers are placed on trestles) and they are thereexamined for classification by the five port doctors,three army, one air force and one naval. While theexamination is going on, Miss Baxter, known toLondon’s homeless as " The Silver Lady," with aband of voluntary helpers, distributes tea, biscuitsand cigarettes among the men. A boatload of

patients fills two trains, the average time betweenboat and train being an hour and a half. Thepatients are under cover practically all the time, thedistance between boat and shed, and shed and train,being very short.

OBITUARY

HARVEY CUSHING

C. P. S. writes: May I add a small personal tributeto the memory of Harvey Cushing? It was my fortuneto meet him first when I was an undergraduate at

Oxford, and before I had any thought of medicine’as a profession. It was at lunch with Sir WilliamOsler and the talk between them was of books, theair alive with enthusiasm and banter. A servantcalled Osler out. He returned in a few minutes witha gleam in his eye. "Harvey," he said, "you mustcome-a wonderful case ! " Their meal unfinished, offthey went like a pair of schoolboys and swept me withthem. The case was one of obstruction of the sub-clavian artery by a cervical rib in a lad and Ilistened for half an hour while they discussed it. ForCushing it illumined a pathological principle-a newlight. Osler had all the literature of the subject athis command. I felt as a boy might feel who listenedwhile Drake and Hawkins compared notes of a newlandf all.

It was several years later that I served for a shorttime as Cushing’s intern at the Peter Bent Brigham.I have never worked with any man whose energy andenthusiasm were so radiant. It is true that the glowsometimes scorched. A rebuke from Cushing direct-or more often implied-blistered. This, however, wasfelt as stimulus rather than injury by those who knewhim. It was but evidence of the fire that burnedwithin. No feverish heat this but a steady flame,whether in the operating theatre, on ward round or inthe post-mortem room. Two memories of him in thistime stand out. One of a ward round attended bymany distinguished visitors; Cushing’s interest was

suddenly engaged by a small point in a history, andhe sat on the bed for half an hour, his audienceforgotten, quietly interrogating, patient and intent.The other is that of a Saturday afternoon in the

post-mortem room-a blazing day in August whenmost chiefs after a far less strenuous work wouldhave been relaxing. But Cushing had a problem tosolve. A postgraduate student had suggested a diag-nosis that was new to him. The chief had openlydismissed it. The patient died with symptomssuggesting that this diagnosis was correct. The post-mortem proved it so. Cushing turned to the studentand told him first that the diagnosis had probablybeen a fluke, second that if it wasn’t, here was anopportunity to learn. He bade him leave all otherwork and start on Monday morning to delve into theliterature, look into the records for other cases, discusspoints of anatomy and pathology with the bestinformed, nor rest -till he had something to report.The student during the week-end reflected that itwould be more pleasant to continue his work in the

wards for the short period of his stay than stew in alibrary. He appeared on Monday and told thechief he would like to postpone the research until hisperiod of internship was ended. I was witness of thescene. Cushing turned upon him. " Don’t you know,"he said, "that the time to start work on a problemis while it is white hot? ° Do you read German 1 Ifnot, I have told my secretary to have anything youwant translated."

Others have written of his readiness to keep alivein correspondence the spirit of inquiry. I was doubt-less one of many who wrote to him two or three timesa year of clinical problems. I never failed to get areply, full of interest in my questions and withinspiring news of his own work. When he visitedthis country he would sometimes dine with a few ofthe younger neurologists in London and talk late intothe night of the untravelled world of medicine and ofthe explorer’s path. He was a great leader, and attimes a hard taskmaster, but in discussion he neverstood on his dignity, never played the elder. Likethe most junior of us he was fellow student, fellowexplorer. He was a grand man, and it is good toknow that both in this country and in others thereburn torches kindled at his flame.

EDWARD PALMER POULTON

M. C. writes : "Poulton had joined the EmergencyMedical Service and was posted to the Kent CountyHospital at Pembury, near Tunbridge Wells. Heappeared happier than many others who were thustransported and had entered with enthusiasm intomaking a moderate-sized county hospital into a largeteaching hospital. Probably he was working too hard.On Oct. 17 he seemed as usual full of energy, but hedied suddenly in his sleep early the next morning.

" His enthusiasm for research was his greatest andmost abiding professional characteristic. It was

well shown when with members of his family heendowed the Hilda and Ronald Poulton fellowship atGuy’s by which a fellow or two students could workin the medical investigation department. His ownresearch started with the physiology of diabetes andketosis. Then from 1920 to 1925 he was continuallystudying dyspnoea in connexion with the oxygen andcarbon-dioxide carriers in the blood and the bloodpH. In Addison ward at Guy’s an oxygen chamberwas installed and this pointed the way for his greatinterest in oxygen therapy and the use of oxygentents. At the same time he was interested in pain ingastric ulcer and sensation in the oesophagus; hecarried out investigations on himself and others byintroducing into the oesophagus a balloon which couldbe distended while the subject was under X-ray

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observation. The mechanical side of any investigationalways made a great appeal to him, and much of hislater work was concerned with developing apparatus,such as positive-pressure machines and oxygen tents.Although his earlier tents were extremely complicatedin appearance, the final version was a neat and beauti-ful piece of apparatus.

" Poulton had many qualities which endeared himto his friends, especially his courage and enthusiasm,his simplicity and honesty, and his kindliness and

gentleness. As a young man, he was above the

average at most games and at Oxford played for theuniversity hockey XI; this must have made the chancediscovery that he had heart disease all the more of ablow, as it was the end of any really active part ingames. Although he must have been aware of thedanger of dying suddenly, owing to his heart affection,I never heard any complaint, and it was his wife whohad to try and see that he got some of the extra restthat was needed. His regular hospital duties, hisresearch work, his books, and his many societies andmeetings show how little he let his health stand in hisway. In recent years he spent much time with the

affairs of the League of Nations Union, of which hewas a keen supporter. Everyone liked Poulton andeven when they differed from him about some pointof hospital policy they always knew his radicalismwas due to his enthusiasm for what he thought bestand that there was no hidden or ulterior motive."

Dr. ALEC LANDALE CLARK, who died from the resultsof a motor accident in the dark on Nov. 5, will bemissed by a host of friends who knew him for hisdevotion to duty, keen sense in things medical, greatmusical talents, and above all, his kindly attitude toall from the highest to the lowest in the land. No man,writes N. B. W., ever heard Dr. Clark belittle anyone,and a mean act or utterance was completely foreignto his nature. As an Edinburgh man he will be longremembered for his magnificent voice. He was forover ten years secretary of the Edinburgh UniversityClub of London and he was a founder -of the ScottishMedical Golfers’ Society. The loss of his formerpartner, Dr. Brunton Blaikie, left him with greatresponsibilities and these he carried with surprisingease.

PARLIAMENTARY INTELLIGENCE

ON THE FLOOR OF THE HOUSE

By MEDICUS, M.P.THE House is now sitting regularly on Tuesday,

Wednesday and Thursday, and there is talk of thissession coming to an end at the end of November andof a new session, with a King’s Speech, beinginaugurated within a few days. There is the prospectof a break at Christmas-time, although it is not

impossible for the House to sit then if any emergencyshould require it. Meanwhile the private member is.doing well. Mr. Dingle Foot on Tuesday last madesome very effective criticisms of the powers conferredon the Home Secretary under the Emergency PowersDefence Act which led to an offer by Sir SamuelHoare to introduce an amended set of regulations afterconsultation with the Liberal and Labour oppositions.It was a remarkable personal achievement and a

remarkable victory for democratic common sense. OnWednesday Mr. Kenneth Lindsay, parliamentary’

°

secretary to the Board of Education, announced thatthe schools in the towns were to be reopened but didnot explain that as more than half of them have beenrequisitioned for first-aid posts or other purposes ofcivil defence the accommodation will be very limited.This reopening of town schools coupled with thedemand for a payment by parents for evacuatedchildren controlled by a means test is thought likelyto have the effect of bringing back children in largenumbers from the country. If there are " serious air-raids " the schools are to be closed. Sir WilliamDavison said that this change of policy ivas " likelyto cause a rush back" of children, but Mr. KennethLindsay replied that it provided no justification forparents bringing their children back from the recep-tion areas. But combined with the coming of Christ-mas it will probably have that effect. Neverthelesssteps are now to be taken to provide school medicaland nursing services and other public health servicesin the reception areas on a larger scale than alreadyexist there.

It is an unfortunate fact that up to about 80 percent. of the nursing staff of the various public healthservices have left their ordinary work in the townsand enlisted as first-aid workers at first-aid posts,

mobile units or in hospitals. These nurses can all bereplaced in the casualty services by nurses alreadyon the lists of the Civil Nursing Reserve and it wasstrongly suggested in the debate that this course

should be taken. With schools in the towns reopeningand winter coming on in the country the need ofthe school nurses in town and country will be great.Mr. Walter Elliott, in a very interesting resume ofthe state of evacuation to date, laid great stress on thefact that epidemics in September and October of 1939were actually (on the whole) less than in 1938. Itis true that healthier country conditions may havesomething to do with this, but it is also probable thatthe more favourable weather of 1939 was also a factor.Mr. Elliott said that many of the children in the

reception areas had taken root in the country, andhe appeared to anticipate that a large number of themwould remain there permanently, at least during thewar. Nevertheless they will only so remain if theconditions are and remain good, and, as one membersaid, every effort should be made now to perfect andimprove the conditions in the schools and the receptionareas and the conditions of living in these areas ofthe evacuated children so as to set up a natural attrac-tion to the country and to provide good conditionswhich will be available if and when another big rushof evacuation takes place after the bombing of cities.In view of this possibility, it might be thought thatthe Government would take compulsory powers to

keep children in the country when they have once beentaken there and paid for at Government charge. Butthis Government does not like doing anything com-pulsorily if it can be arranged with administrativeofficials to do without compulsion. Just as the Ministerof Food shies at rationing, although informed opinionconsiders that rationing would be the fair way ofsecuring an equal distribution of food, so the homedefence authorities shy at compulsory evacuation.British freedom includes not only the right to getdrunk but the right to get bombed-and no doubt theright to grouse about it afterwards in the case of thosealive to do so.

* * *

On Wednesday the House discussed a Labour motionurging " an immediate improvement in the positionof old-age pensioners." That the pensions of the aged