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Parenl's C,ptioll PolicY

THE MEDIGAT SIGKNESS SOGIETY IIIEOICAL SICKNESS AiINUITY

&

Specially designed Inswance Policies from the Medical "a d Dental Professions' otn Insurc ce Societv

LIFE ASSURANCE SOCIETY LIMITED

7-lo CHANDOS STREET, CAVENDISH SQUARE, LONDON, W.1 Tel:MUSeum 1685


BOOKS

THE LARGEST STOCK

Medicol, Dentol,

OF BOOKS ON

Nursing, Veterinory

MEDICINE AND

ALLIED

SURG'CAL'NSTRUA,IENTS

IN

SUBJECTS

THE

WEST OF ENGLAND

lnsttument rcpoirs also undertoken

For

oll your

r€quirements

Medicol Book-Wright's Deportment selling hos o long - stonding Jeputotioir for the high stondord of its service. You dre encouroged to browse in the reloxed otmosphere of the

bookshop.

Experienced stoff velcome enquiries ond vill give oll possible ossistonce. 2-3 mlnutes walk

from the University ORDERS BY POST RECEIVE IMMEDIATE ATTENTION

lf

you rculd I'ke details of new publrcarons on the subjec$ of speci.l inrerest ro you. WrighCs l"ledical Book Service will advise you. Your name will be entered on the special-subject mail'ing l;st

WRIGHTS

regularly.

Telephone:

and the informatior which you require will be sent to you

44 Triongle West, Clifton, Bristol 8 2lll5


Q. What are the positive benefits of ATROMID-S

to

patients with angina pectoris, or with biochemical evidence indicating enhanced liability to myocardial infarction ?

A. ATROMID-S has been

shown to conect or favourably affect all the blood lipid (cholesterol and triglyceride) and thrombogenic factors which are correlated with enhanced liability to infarction.

In long-tenn but uncontrolled tria,ls in p&tients with angina pectoris and a history of myocard,ial infarction, the mortalily qnd recurrence tate6 arc lowet than those of other published series of cases. Figures from controlled trials of ATROMID-S are not 'available yet but it would certainly seem more than justifiable to use ATROMID-S at least selectively at this stage. 250 mg,

clo,lbrat.

in red soitcapsules Thc usualdosar. h

2or3 c.psulcs ifter lood {aeerag. 8 capsuls daily)

Atromid-S A product of original I.C.L research lmperial Chehical lnd!sfiies

Limited PharmiceuticakDivkion

AlderleyPark l4a..ldsneld Cheshire


Galenicals

University of Bristol Yol.22 No. I

Chairmon: F. J W.

Lewis, M.8., Ch.B.

Vice-Choitmon:

Mr. K. G. Buckler. M.8., Ch.B., D.Obst., R.G.D.G., F.R.C.S.

Editots :

Eloine Flover Alon Fishfol

Editot: R. Simpson, M.B., Ch.B. Business Monogers: GeoffreyPerhom

Alumni

Richord Hording

Distribution Monager:

M. Rigler

Dentdl Reprcsentdtive :

Bob Miller

Co-opted Members:

Sister M. A. Priest Jone Nickler Julio Lumley

BLACK BAG


BTACK BAG $prins 1e66 CONTENTS pace

Editorial

5

B.M.S.A.

6

The Drug lndustry and Profit

9

tl

Forty Yesrr On

I Dont Like !h€ Look of Rugby and Soccer

Mod Panto. Trad

Gnndad

t6

.

SLrccess

Fluoridarion for Brisrol

l4

?

t8 20

Athens, Roskilde, M.lta

2l

Pompeii

24

Dental Students' Soci€ty News Pantomime

1965

30

The Dentkts' Dilemma For Your Reference

36

Galenicalr B@kstall

37

Book Reviews

38

Examination ReslJlts

43


EDITORIAT The Medical School is now comPleted. The ruins of 5t. Michaels Hill are crumbling into the mud, the Students' Hottel is nearl) finished, as is the Outpatient Block at the Children'5 Hospital, and we have got a pedestrian traffi€ lights crossing at the Royal Infirmar),. We have progresed, Physically at

But as we queue for coffee in the Common

Room and canteen, so we queue at the bedside to examine a patient's liver. And if you're the fifteenth, and the Patient has had enough, understand:bly, then /our chance to appreciate the point has gone. With twice the normal numbert on most firms, the founh and fifth years are getting half the teaching.

This is tolerable for a few months, but when it is for the greater part of the.linicil training period,

it

becomes a more imPortant

ln October 1966, 120 medical students enter the second year. They will ule the Medical School, including the Studentt Common Room. which starts to look crowded

The newly approved clinical students, during their first medical or surS;cal firmt (Oct-Dec) have been faced with no less than four terminal examinations (2 bacteriology; I pathology, I pharma.ology). Ihis situation has led to apathy on the wards and in most cases the results have indicated the lack of point of these examinations. The final part of third f4.8. is eighteen months away, hence examinationr in pathology and bacteriolog/ could well be more realistically related to this exam, and not ro grouped together that it becomes imporsible to keep pace with

The extension of the ptychiatri€ firm from to two months with a fortnighCs stay at either Glenside or Barrow Hospitals, is a progresrive move emphasizing the growing importance of ps/ch;atry in modern medacine. It seems strange, however, that although a large percentage of strdents will eventually become General PractitioneB their clinical experience of this field of medicine remains one

at a bare two weeks.

with fifty p€oPle in it. By the time lhere students reach their clinicaj yean, the Present curriculum cha^8e chaos may have ttarted to sort ittelf out- There are Pltns to ute more of the hospitals in the Bristol area as full tea.hing ones, but reorganization again will be necessary. k is ess€ntial b) that time. a Staff st!dent Curriculum commiftee must b€ well establirhed, to hear student opinion, and to

make cenain that adequate teaching and workins conditions, reatonable numbe6 of students on firms, are considered Priorities in the Medical Faculty. which €xisa Primaril)' for the training of doctors.

All copy for the next edition of

Black

Ba8 should be received by the Ed;tors c/o

Old Lodge, B.R.l., or

Students Common

April l9th. We welcome /our ideas and aniclee-let us have them. Room, B.R.i., by

There have been some queries regardinS the quality of paper used for pr;nting Black Bag, it is felt it increases the cost of the magazine. However the price of printing materials is a very smali percentage of the final cost, and to redu.e the quality of paper wo{ld make very little difference to the sellin€ price.


B.M.S.A. PAUL LEWIS gives an account of the

Annual General Meeting and outlines events and policies Th. Annual General Meeting of the British Medical Studentr Association for the ),€ar 1964-1965 'tt^t held in Cardiff in November, th€ hosts being the Cardiff f4edical Students Society. The Clinical Secretary, Paul Lewis, and the Preclinica-l Secr€tary, Rodney Payne repr€rented Bristol, and Paul Boswell as Chairman of the Mid and Region was a member

of the

Executive Council.

Ihe

meeting was addressed by the lVinirter of Health, f4r. Kenneth Robinson, who after asking the press to leave, eave a superflcial

and halfhearted speech, then declined to

answer many questions on the grounds that

lr

was not his department. He said that 'BMSA reports have filled great gaps in the rift beNeen fully fledged doctors and the ministry, the reputation of the BMSA being unrivalled and rhe riotous good hearted living medical students readily forgiven. ln Great Britain today medical practice is som€-

of the

what unsettled and the Junior

Hospital

Doctors are voicing their opinions. Yet the medical schools are receiving more applicant' and standardr rising all the time and it is not

for to

1965

1966 jt will

be like in twenty a resulr of more communicatiof between th€ doctors and the Government. Th€ alteration in the rare of easy

se€ what

ycars time, even as

chanee dep€nds of money and manpower. It does not just mean new ichools or providing mor€ place' in old schools, but further opportunities for post-graduate training. Th€ doctor can thus gain responsibility and independence'. He also went on to say ' We must keep our doctors, we nust relieve them of

those jobs which can easily be done by others. We cannot afford to see too many

doctors going abroad '. He asked 'that male or female, married or single, we should be prepared to give back to the people of this country as they have given, to enable you to be doctors. We should have some renre of obligation'.

At

quesrion tim€ he said he would 'look

l. 2. L

Vacation gnnts Livingaccommodation Provi'ion of f4arried Quane6.


the use of Senior Students as for housemen should be consider€d as an esrential pan of Medical

8. That

MEDICAL EDUCATION

This year has been an important one for Medical Education, with the i^auguration of a Royal Commitsion on Medic!'l Education (R.C.M.E.), and the reappraisal of Medical Edocation by the General Medical Council. At the A.G.M. r workinS parq/ considered the qoestion of Medical Education, and the Education Repon of the BIVSA was proposed to be used as futur€ BMSA poli.y. This repoft hat already been sent to the Gl4C and l4edical School Deans. lt was also ruggested that the report be used at future meetingr of SSCC-but Bristol siill lackr: Student statr Curriculum Commiitee ! However the production of the Erisrol Education Survey roored much interest. 'Thit war very well €xe.uted and presents v€ry interesting reading especiallt owing to their very high percentage of returned questionnaires.' l. war alto proposed that a memorandom be sent to rhe RCME in the form of 'Suggestions for rhe f!ture I Thes€ are :

locums

9. That the pre-registrition period should be a period of post-gnduate tnining and not iust one of cheap labour. GRANTS AND WETJARE

The recuring prcblemr with regard to Gnnts and welfare, National Inruran€e, Married accommodation were again in eviat a working party. The policy stateof the BMSA relating to Grants and Welfare which are to be submitted to the dence

ments

aPProPriate authorities are

:

Central Grants Awarding Body.

l. k is felt that a gnnt appeel body be srabliihad until ru.h rime rhar a central Gnnts Awarding Body extends it3 aurhoriry to rhe condition of the awards. This is to

in

a. Student! applling after the staft of a d€signated courre b€ing excluded from getting a 8rant.

2. The Seminar System should be integal part of the.eaching prognmme in all medical rchools and, in :ddition, each rtudenr rhould have a peBonal ruper-

b. Those who have alread), attended a designated course in higher education or who require a double degree, e.g. in faciomaxillary s(rgery being excluded from getting a 8r.nr.

l.

lncrease the use

of clinical material

non-teaching hotpitak.

A

gr€ater interrelation betw€en preclinical and clanical subiects. 4. Awarding of a de€ree ar the end of 3.

preclinical rtudier.

5. f4ore teachlng in rhe field of Gen€rdl 6. Durins Midwifery appointments deliveries should be done in the district. 7. The system of SSCC should be €ncouraged in all schook so that there is consultation with studenB in matt€B concerning their own education and

2. Means Tesr. Due ro constant refusal of th€ Miniiter of Education to take any action concerning the means test, it was felt that the strongest mearures poss;ble should be taken to allevi.te this injustice, i.e. a. That a student reachinS the age of 2l or starting the clinical co'rrse be considered

b. That parents sign a de.lantion that they will pay th€ parental contribution. 3. Awards, BMSA proposes that a minimum

of 4% be made, plus any factor to r:ke into account increase in Hall

annual increase


of Residence charges. Also that the minimum grant rhould be ll00 and comPulsory r€tidence charges be abolished.

BMSA d€ploret the Pre5ent terms and .onditions of Junior Hospital Staff. lmmediate action must be taken by the reviewing body wirh particular referen.€ to the following :

l. Houiemen should be p.id a minimum of f1000 per annum, and rhere ihould be an exemprion from retidenc€ charges. 2. Accommodation does not r€ach th€ minimum standardt as laid down by 6e Ministr/. Marri€d accommodation thould be INTERNAIIONAL AFFAIRS

pre-clinical students ako. The conference in su.h people as Lord Brock. President of the RCSi Sir Hector Maclennon, President of R.C.O.G.; and sir Charler Dodos. President of R.C.P. has very distinguished patrons

The larSe international events are

the

Medicdl Summer School in Scandinavia from August lst-20th, contisting of five days at Aarhus, Oslo, Gothenbrrg and Copenhagen, each centre dealing with research and tr€at-

menr, Shock. Orthopo€dics and Sexolog) respectively. The f€e

ii

about $120. Applica-

don forms are available from Paul Lewh. Ako rhe rixteenth I'ledical tummer school in Denmark is either a preclinical school .t Aarfius or a clinical s€hool in Copenhas€n, b€tween AuSusr 5th-26th. Th€ fee is about

attended the working Pany of lnternational Affairs and am Pleased rc say that for the third year in succession Bristol sent a higher number of medical studentt abroad

I

than any other English Medical

to

School.

Through BMSA Bristol has sent 57 PeoPle abroad in the last three years and in 1965 25. The biggest change made in lntemational

Affairs was the formation of the BMSA bureau of American Exchange. For the prerent there is only a leaflet available describing how to go to America, but it is hoped to produce a booklet How to go to America'. lnformation on Canadian Exchanges is includ€d in 'How to go Abroad'. This Amedc:n Exch:nee aims to build uP a nucleus of American Medical Aslociation Hospitals in ea€h rtate with rvailable clerk-

ship appointments. h alio aifi3 to make conract with the U.S. lmmigr.tion and Naturalisation authorities lo cl€ar uP the present chaotic situation.

for the bi8 even6 in 1966 being organised by BMSA and IFMSA are well in hand. Next year's A.GM. of BMSA Arrangemen6

is to be held in London from APril lTth-l9th It is to be preceded by a four day National

Clinica'l Conference alonS the lines of previous oner, but it ie hoped, for int.r€tt

$85 and cheap air flight5 are

available.

Funher details :re on the EMSA noticeboard, why not consider one of these for your

lf

you have any queries regarding B|4SA it can otrer you or yo! can otrer it

on whar

then see your BMSA representative now-

tr

TENNIS

!

Our sole fixture against the vititing Danish Medi.al Students ended in victory and we are now the holders of rhe Yofie) CUP; previoudy regarded as Danish propert),. This international triomph wa, achieved with the aid of a typical summer day, cold, cloudy, with gale force winds, and through

of one of our LR.l. who so dhtracted one memb€r of nurset, a crucial set vhiring team thar he lost the the

selfless efforts

Next sea3on we hope to be a lirde more ambitious and form a re€ular team with lixtures against other Medical Schools and local clubs. Members of the Facuity who are k€en to play will be verr welcome.

c. a. wEsTwooD


the drug

industry and profit The Ministry of H€alth by means of its Volunrary Price Regulation Sdeme has made an etrort to r€duc€ the Prices charg€d by th€ National Health Service; in sPite of this' enormous profits haY€ been mad€. Table A Yqr Ended March ll Boot5 Pure

Drugs

1963

Beecham Group Glaxo Laboratories

British Drug

1000

1000

13,718

2,038

9,580

2,014

93A7

1,247

825

186

March li of Britain 1962 5,142 Great

2000

lndustries ; Cynamid

These profits are not all derived from the of drugs on prescription to the National

sale

Health Sewice, since many firms sell drugs direct to the public, Ako, Boots are retail as well as manufacturing chemists, and onl/ a

quarter

of

Beecham's Profits come from

medicinal product-food, soft drinks and toilet products supplying the other three quarteE. Howeyer, American and Continental companies are less divertified than the British, and the profits are a more accunte

measure of what they make out of the National Health Sewice. Cynamid the biggest U.5. subsidiary makes insecticides' but probably the greater part of the t5 l million profit made in 1962 came from drugs 55 per cent of the market for PrescriPtion drugs is supplied by American subsidiaries and about 75 per.ent Continental and American subsidiaries combined. " The profits of drug companies inevitably tend to fluctuate from year to year according ro the success of panicular drugs but the tendency for both British and foreign subsidiar;es is stronely upwards. Smith Kline

and French and lntemational

Chemical

Laboratories have both more than doubled their profits in the pdt five Years.

"Only

Ela Lilly and Abbott Laboratories setbacks. ln the case of Eli had serious have

Lilly how€ver, the setba.k is more aPParent than real, as table B shows. lt is not the abtolute amount of profit but the Profit in relationship to the capital invested, which really matterr to the investo6 in an industry The avenge return on capital in the chemical

industry

ir about l8%. But Eli Lilly, even


BRAND

after a big drop in profits secured a retum equal to 66 per ce't of its capital." (Financial

NAME

Bayer

Times 15.11.52. The Statist 8.3.63).

Table B. Examples of Trading Profit Percentage of N€t As'ets YEAR

FOREIGN

6

ENDED

Phillip, S.ot & Turner

a

%

Cynamid of

Great

78-l Dohme Dec. 31 1961 657 Eli Lilly & Co. Merck'Sharp and

Boots Pure

Drugs

Glaxo

Mar.

1962

65.0

3l 1961 l0 1962

25.3

June Britirh Drug Houses Dec, 31

1962

Tabalgin

West Pharma€euticak

Calpol

Calmic

The fir5t two of these firms both belong to the Starling-Winthrop Group. Mr. Cledwyn Hughes, Labour M.P- for Anglesey, said in the debare on Dec- llth 196l that these were

Britain Nov. l0 1962 83a

Smith Kline & British French Nov. 30

FIRM

virtually the same preparation under different names, and asked what was the reason for this duplication of effon and research except

234

CAN PRICES BE KEPT DOWN

10.3

}

ln r€latio' to the hospitals the f4iniltry en use its power of bulk purchase to break the monopoly positions of drug firms, and

Not one American Company made less than a 40 per cent return. The drug firms always attemPt to iusti4' their high prices and prcfits by the need to spend large sums on research. However, the money spent on research after doubling in the five yearc preceding l96G6l rose only from I7.5 million to f/3 million in 196142' and therefo.e seems to be levelling otr.

has b€en imponing cheap antibiotics from Italy and Denmark. However, the bulk of

are supplied to the National Health Service through doctors, and here the Ministry can only use the Voluntary Price Regulation Scheme which most firms have accepted. The scheme has lopholes, su.h as the right of a lirm to charge any prescription drugs

(Financial Times ll.l2.6l). The U.K- industry spends about twice as much on advertising and promotion as it doe' on research' The Association of the British Phamaceutical

three year Penod aftet pnc€ tor the 'nitial inrroduction of a drug. Also sin(e the lcheme

Swiss firm Crba have the pflce of one of it! drugs selling at twice the Price of an

is voluntary the

lndultry informed the Ministry that Promoting the sale of drugs to doctors in 196l cost 16.5 million (Committee of Public

refused

to

reduce

unbranded equivalent.

Accounts 196l-62). Advertising to the Public co!8 about a further flo million making a

So long as the industry is in the hands of pnvrte enterpnse the problem of excessive drug prices is unlikely to be seriousl), tackled. An enquiry into this huge, powerful and extremely profitable comPlex of firmt

total of fl6+ Much of the research done by the drug firms is in making modifications to €xisting drugs, in order to patent new bBnd names. Evidence about an analgesi. called para <etamol was giyen to the Committee of Public A..ounts in the 1952-63 session- Th€re were four bnnded equivalents made under million.

and more so itt narronalisatron is necesiary. The nation's health is a matter of national con(em and should not be a field of Pnvrte enterprise and profit-

lohn Collins

l0


en.ountered

in our ward rounds.

and

The patterns of ditease have gre:tly changed. Anaemia, in its many manifestations

ls still with us, but chlorosis or green sickness of young girls, a disease of unknown aetiology has disappeared. ln the edition of Osler that I used (1920) it was sometimes referred to as " Anaemia d'amour," but whether love or the endocrines played any part in rhe causation Osler wa, unable to say. Bland s pill wai the specifrc remedy. I recollect giving a Nationat Heakh Certificate bearins this diagnotis, which led to some

FORTY YEARS

amusing corresponden.e with the Ministry of Health. Pernicious anaemia was recognized, though its causation and treatment

ON

were just being elucidated in my student days. lwell remember an elderly music teacher, a case of chronic rheumatoid arthritis, who on recovering from lobar pneumonia develop€d an acute episode of Addironian anaemia.

This is not a lecture, or even a paper, but a few nndom thoughts that occurred to me

viewing the .hanging scene in General Practi.e over the last fort/ yea6. The request to give them came from one of the Black Bag editors, so that I hope lcannot be accrsed of ruthiDg to print.

lqualifed in

Aberdeen

in

1924. Even at

dirpensary attached to the Medical School, and attendance at this for six months was a

pan of the final

I have reen cases of tuch severiry that the effort of the heart to maintain the circul:tion literally shook the patients' bed. cases of acute pulmonary oedema were then frequently bled 20-30 oz. with amazing results. Who does venesection nowadays ? Diabetes was then treated sol€ly by diet in varying forms, insulin had just been discovered but war not /et in general use. Lobar pneumonia, a clinical Erity now, was miss them.

medical

examinations. Final year students attended the poor in their homes under the supervision of Gen€ral Pnctitioners, whose ability as clinicians and teachers \{as recogniz€d by the UniveBity. lt was a mott useful experience tor all of us before entering the rough and tumble of General Pnctice. for we saw disease

M/ith

Rheumatic carditir was extremely prevalent, with the various classical rubs and murmurs so audible that only the deaf could

that date it was in advance of its time, for ther€ was a flourishing Seneral pn.tice

compulrory

Ihis I was treating

liver in large amounts and an intra-mutcular preparation which was, I believe, call€d Etamen. Her anaemia improved and her crippled finge.s became much more mobile, I hate to think of the number of rheumatoid patientt I subjected to this regime, in the hope that I had discovered a cure for this crippling diseare but alas, all to no avail, and my name remained unsung.

in an entirely different form to that

ll


of frequent occurrence-the Captain of the men of death, till the advent in the early

Ps/chiatry was little undeBtood, though I it har now gone to the other extreme. Psychiatrists reem to have almost all the answers to cases of delinquency, rarely admitting that punishment is requir€d. However, they are of immense help in some sometim€s feel

thirties of prontosil, l4&B and later penicillin and other antibiotics. Scarlet fever even in irs dreaded malignant form, was frequent and disabling, a, was also chronic n€phritis, There were too, che bow legs of rick€ts, and the mutilating lesionr of syphilis. lr€member

caies

with their ever

changing array of

wonder drugs. Schizophrenia does no longer mean a liferime in a m€ntal hospital,

a well meaning old lady who took pity on some Australians one Chrirtmar early in the first War. She brought them home for rupper, during which rhey lib€rally plied her with " Red Lady." When she came to next morning her guesrs were gone, and in a few years she displayed a gumma on her for€" head almost the size of a florin, exposing the fro6tal bone below. She outlived her hurband who d;ed rome years of specific aortitis.

There have been vart and often bewildering chang€s in therapeutics, to that in many ways I do not envy the present day Medical Student. His fate only serves to endors€ the

truth of the quotation: " Since tis naturet law to change Constancy alone ie strange."

'ater

Dr. R. J. St€phen

Diphtheria, especially the laryngeal type,

of the rece^t introdu.tion of antitoxin. Aorti. ane!rysm was not un.ommon. cretinism, myxoedema and acromegaly, lsaw at various times. Septicaemia was common and invariably tatal, mastoid disease crippling and destructive. Tetanus, with full display of "rirus sardonicus " woold crop up most years. Summer diarrhoeas continued to take deadly toll of infant lives, for we had not recognized the urgent need for fluid replacement, and was a deadly disease, in spite

THE COLLEGE OF GENERAL PRACTITIONERS

rri:s

present d€adl), Tuberculosis scourge, leading to long years ot crippling illness and eventually almort cerlain death; rest and good f€eding being the only treat" ment, Lumbago and sclatica wer€ common, prolapsed discs beinS then quit€ unknown. lt

to

prove,

ho* |

budenBwhoi:aonDhhdr 6 {i'. ' -Frt ;Y. but n€cd not {uirlnr n ,laqhd to h:'e F.! .

there were no :ntibiotics.

may be diftcult

or r5O rc dr! drne

roon rh. ardid . mur b. lito. d!r.d ro d. o{krr 6y th. hBily do.bi rri *hom h. k ri. on dorourilv, .n..!rced ro irrin i hrr m.tenrl, ti. rud. rioul! rv. .d.q!*. ..*J.Enoi "n.nti?; bdh th..lhk{ rid rodrl *D.4 cl !l'. ind riw :n .Drr*hdoi or ti. lrillt o d hdrd! rtr rd;drk rnd ondtr dnmnv ol rh. nlhit

b! nrk.d !rdr. thd. lour h.rdiirr; oir ct Yilw .id tunhtt rir nn.dri {abo6ilh*.v l,soo wddr) d.lld b. !tr. rld. dilv ol arnc rrD.r. ADrlk! d6i lornr irrr b. obdi.d rio'i tir O nl cft.r or rl'r {rd.i!! n!dr; nh.o Th. rDolieron lclmr mut b. tio D.rn of th. n.dkn Kiocl, or ih iop r, nd by it. s.Nrr pnctirloi.r 6r('n.d, r(red rFn indiridlr ho nt h.v. irqi dr Fin Errnnnroi b.tor. d. <cnnr d ..r il'. ilno*kon. Drcrld.d tirF obnn*loD in b..n rir th! crinol ';ddrcd 'ork.ndb.r.ru rni[ rh. in.r by d. .iidrdrk ompei.d e ..rBtnioi (r.., ikiir ri. r iv.r tr., qlrifiqdoi)

but lf€el that

carcinoma of the lung murt have been an extreme rarity, even with one knowledge of

symtomatology which hind sight brings. of the coronary arteries has cenainly become more common, I personally believe because of the lncreasing tempo of mod€m

Disease

life.

l2


May we remind you

-"r

CBEAM

I'iii *

t*tnnt, .*ro" r-" SPECIAL

*

sepaRArl"

+

TROPICAL

* ctutost-^

* iu*o*uto +

HEMOLAL

r

LACIDAC

^.

i tjll"''"Ji''oo" * BEURLAL* PEPTALAC ^ .o'

i'Jo;io.'

'

l:'S'-'i"^*' *

FRAILAC

:i:$nt';:

Y l"';;q1ffi.'*n' This book of easy refererce coDkining complere details of aI

t1rc

Cow & Gate Milk Foods with aaalyses, calorfic values and dieretic itrdicatiors, etc. can bc obtaincd oD application to

The Medical and Research DepL, Cow & cate Pltblished

b

the Maheft

Ltd, cuildfor4 Surrey.

of


I

don't like the look

of grandad News from Alumni Doreen M.Connell ('53), and Cecil Ewins ('50, Ass'stant Professor of Ophthalmology at Saskatoon), all live in Canada.

Fortunately I had no delusions of ghndeur about my appointment as editor of this section of the BLACK BAG. I hardly expected to be as bur/ a5 the News desk editor of a national newspaper, with copy coming from

Surgeon Lt.-Cdr. E. P. Beck, R.N., is at the U.S.N School of Ayiation l',ledicine, Pensicola,

Florida; Dr Marjorie williams ('44), is Director of Pathology in Washingto^, D.C. A recent article on Liver Disease in " British Medical Extracts " was written by a Michael D. Turner, M.D., Ph.D., M.R.C.P of the

all directiont, rhe telephone ringing inces santly and a pile of letters to sort through, bur ldid hope for some work to do. M), telephone rings fairly frequently, usually

with messages that Sandra keeps fainting right otr", or "l don't like the look of grandad ", but it never bears any Alumni

Universiry

of

Rochester School

of

Medicine,

New Yorki Iwonder if this is the l''like Turner who qualified in 1950 ? While sending best wishes to Dr. A. E- A- Read. on his six-month visit to the same UniveBity, could lask him to verify this point and, if so, pe^uade him to join the Alumni ? Another 1950 gnduate, Dr. Leslie Spence,

news. My postman brings me the usual crop

of bills and advenisements, also reqo€sts for cotton wool or another bottle of tonic, but he has not brought one single " letter to

As I am in danger of being declared redu^dant, may lappeal to membe^ to write to me with news of themselves and/or other Alumni. There must be many memben living in interesting places or doing intereiting work; a shon anicle from them on one or other such topic would be greatly appreciated. On browsing thrcugh the files of our very able secretary, Dr. Tony Dickens, I note chat we have many membeE living abroad; those of us who spend all our working days within the boundaries of our Univenity cit), would like to hea. of your expenence'-

At Un;versity College Hospital, lbadan, Nigeria, Mary Huggins is doiDg an S.H.O. job in Anaesthetics and finding that the houB worked are the same as those of a Houseman i. England I Climatic variations are more pronounced, but she is enjo/ing a job which gives quite different experience from ones in this country- Ako at U-C.H., lbadan are Dr. E. O. Olukin ('58), his wite, Dr O. O. Olukin, n6e Odutola ('s9), and Dr. N. lkoku ('61). Yet another Bristol gEduate th€re is Dr. A. B. O- Desalu ('61), who has r€c€ntly obtained his I'lSc. from Harvard University. Recently Dr. A. S- E. N. lkedife has joined the surg;cal staff, after a

k may interest r€aders to see how w€ll we are represented in various pans of the world:

Drs. Norman Glen ('a7), Dnimmond ('ao). Roger Hawey ('sl),

Bowden, M.D.

l4


Gen€nl Pactitioner in Bristol. Dr. Moore

Michael Cox ('5a), M.R'C.O.G., and A. G. W. Bnnch are also in Nigeria, R. wDigby ('54) is at Kitwe, Zambia, and A. S Nethercott ( 44) in Natal, SA. Even funh€r afield are Dr. June Morgan ('49), at the Christian Hospital, Manorom, Thailand, and Dr. U. Viswalingam :t Klang,

makes a comment, expressed by man), mem-

bers on joining the Alumdi, that he looks foruard to receiving the 'dear old BLACK

however, he continles, "l some affe.tion, as it wat during the war that two other students and myself deided to bring it back to life, as th€re had been a lapse of some yea6 without it appearing. I well rememb€r helping to cut the stencils on the typewriter of the President of the Union, and rolling otr, I rhink, fifty copies and stapling them together latt€r two processes being carried -these ou n ihe Common R@m ar Cloucester House, Southmeid Hoipital. (Wasn( thar the Nurses' Home ?-Ed-). Reading rhis made me real;se how insig nificnt our present-day problems are in produ(ing the BLACK BAG. Feeling that we owe a debr ol gnrrude ro these three students, I have just telephoned Norman of the other Moore ro €nquire the 'dentiry Glen add iohn two; they were Norman Beatson ( a7). I hope John w,ll forg,ve my clling him a 'dark horse : he has never once mentioned this to me, although I have been in Pncric€ with him for the past ten yea.s ! Before (losing, mar I remind you of tome daies lor your draries: Galenicalr' DrnnerDan.e is on wednesday,22nd March. lf the demand is sufficient, we hope to have an '' Alumni Table . Our Annual Reunron this year is on Friday and Saturday, May 6th and 7rh. ln(idenrally, it was noti.€d at last year\ reunion that seveal members were armed with camens: assr:ming that (he resultant photographs have not been sold to a fore;gn pow€r, the Committee would like to see

BAG

speak

14:rlaysia-

Also in rhe Secretar/'s files, lnoticed a request from Dr. N. H. Gr€enberg, M.D.,29 O'borne Te.race, Newark, N.i, UsA, to contact other members of his gnduating class, 1934. This is a service I would be pleased to undertake for other membeFin exchange for news, views or articl€s for the SLACK BAG. Of coorce, such a service would not be confined to those living abroad;

am just at anxious to hear from fellow members in the U.K. Apan from Providing me with magazine material, I hope this will also encourage more direct contrct between

I

For example, llearn that Dr. D, Edgell has just taken up an appointment at an Admlnirtrative Medical Omcer to the Newcastle Regional Horpital Board- Dr. Edgell ('61), and his wife, Linda, n6e Flint ('62), live at 13 Kingtton Close, Whitley Lodge, wnirley Bay. Nor(humberland. Dr. K. L. L. Brown ('6a), ir in General Pactice at Newcasrle: he becomes a junior panner in July.

Addres!:

Prorpec( Hous€ , Prcspe(r Place. Newcasrle-upon Tyne. 4. Dr. Ceorge Kerr. D.P.M.. is nor lar away at S'rnderland. Dr. Dennrs Sra),re ( 59), t.N.T. Registrar at the Counry Hospital, York, has just obtained the D.L.O. Perhapt ar rhis sraee I rhould wam lriends

or Dr. win;rred Iribe (18). that

she hes vows and does final in a Convent now taken corresPon wrsh ro re(erve an) funher nor

again

";

of it with

Finally, may I repeat my request, please send me your news and views; my home address is: 144 Stoke Lane, Westbury-onTrym, Bristol, 9.

Jurr belore go,ng (o Press, Dr. Dickens har brought me a most rnteresling letrer from Dr. w. H. N. Moore (a7), now a

RON SIMPSONt5


ouBelves unpopular in some spheres by hadng to.ancel matcher. The reasqs thar

UNITED BRISTOL HOSPITATS RUGBY FOOTBALL CLUB

most players give when they cannot play are quite valid, but are not often insurmountableSuccess depends on enthusiasm right down the line, and it is to be hoped that those who

The season started with a flourish when Major Gâ&#x201A;Źnenl G. F. Watson opened the new sPons ground at Brislington House- ln front of a voluable crowd, the firet XV played well and narrowly lost to St- Thomas's Hospital in a very exciting and hard fougtu match, which justified its en.ounging publiciry. The club is very gnteful to all those who have brought this venture to fruition, the Board of GovemoB, Mr. 'ncludingDr. Tinkler, Mr. Criscuolo, Mr. Bourns, Eickell, Mr. Wearherhead, and the grounds, man, to name only a few. On this note of enthusiasm rhe club continued, the teams played very well bllt were denied favounble resuks by the facr that our opponeDts were so formidable, however the game ir the thing, and these have been most enjoyable. Lately we have made

wear our tie

will

make

a real effort in

At the annual dinner a very conrcientious committee was elected including Peter Cook, Graham Steer, Paul Davis, Mike Golding, Dave Wilson and Dave Webster. We have also been lucky enough to secure the services of some very able newcomers, upon

whom the future suc.ess of the club will depend. One last thing, we seem to have c.ossâ&#x201A;Źd swords with the Union again, we are no longer able to entertain our guests in the Union Bar-this a bit rad MICHAEL RICHARDS, Captain.

..aa..aaaaa.aaa

(i rv'"2 St. Mary's? fJ niv. College?

I

prithee. where is

N ewest knowledge? N eedless wink to Itr ach pre-clinical S oundest drink to

s et on pinnacle!

Fot a Lee copy ol this inpottant bit they telt our otthe M-8. sylabus, wne

t6

b:

GuiDness, a

B.ket Steet, London, W.t.


UNITED BRISTOL HOSPITALS SOCCER CLUB

The club welcomed many

excellent

medical and dental Pre clinicals this year,

a

veteran of many matches for U.C.H. in Gordon Cochran, and some fresh talent hiding under bushels in the Den61 Hospital. There extra players were

to

prove e'sential,

as many old members sustained

injuries,

including our cap$in Bob Binnertley. However the club still won over half i& matches, the play of goalkeeper cochran and inside right and Vice Captain Craig Walton being

outstandinS. Some dramatic improvements were seen, David Bell scoring some splendid 25 yarders with his right foot.

The friendly spirit of the amateur game to the fore, although the author admits to suppressing a temptation to obstruct opponents in the d/ing minuter of matches on wirdswept Whitchurch aerodrome (our grourd) when his leaden tegs rebelled. ln fairness to the rest of the team, we usually appeared the fitter side, and it was Pleasing to see rhe 'veterans' such as Frank Poku and Peter Froud more than holding their own in the last match before Christmas aga;nst Redland College, after they had both been awa/ from Soccer for a long was alwayr

Miss Patricia Bassett appears in this picture, in distuise. She is not a delicate Rugby

team cheer leader, nor

a

linesman All members (21 have represe.ted the club

What is she saying I No-one will ever know. What is she doing ? Read all about it on P.30

this season) would like to thank the ofiicers for their excellent arrangements. Th€

rreasurer. john Luc,a. has be(ome a veritable

lack of All Trades, playing goal, harlf-back, foMard and alio drivrng.he Mrcr@oach ro awar rar.hes. The tasl ahead I To win the lnrer-Fa.ulry League and ro revers€ (he defears br rhe odd goal aga,nst the two Ro/alr-the Military College and the Agri-

*** It

cultural College.

happen€d 200 Iears 16,614 gallons

sumed G. C. PURNELL

lnfi

l7

ago-

of ale and beer were

by patients in the Bristol

rmary-their routine drink.

con. Royal


MOD PANTO TRAD SUGCESS .. EUPHORIA '' DENTAL HOSPITAL DEC. t5 - t8 t965

MIKE GOLDING AS FAIRY SNOW

SOME OF THE CAST

l8


Room, with its low ceilins, central Pillar, permanent partirion aPPaEtus and fragile structu.e. A Pred;ctable number of Things

Consider a long-forgotten lndependenr British Possession. location unknown, tPlit atunder b), ideologically opposed factionstmagine rhe exploitt of a pair of Foreign Omce tpecial agentt sent to ensure that the demo.ntic principle prevails. Not, yoLr might think, a typical pantomime situation, but when the offspring of the resPe<tive leaders of the two waring grouPs are revealed as clandettine sweethearts; when the espionage duo are identified as MetsrsBond (not James but Ba'ildon) and Hig€ins (Albert, a "son of plumber", who's only there by accident); when the audience is introduced to two fairies wirh a rctal of five legs between them, then

it

went Bump on the Night, but nevertheless elaboEte scen€ changes were achieved. The designs w€re functional, and stage manager John Harr and hi' team of helpers, unnamed on rhe prognmme and destined to remain so, must be congntulated. Rod Staines Produced his usual reliable line in effects, and rhe lighting, malgre tout, was adequate in design and slick in operation. The ladies of the wardrobe had obviously worked hard and long, and the result cerrainly juttified their effons- Front-of-house manager Susan Hunr,

with lirtle recognition, turned her deparr ment into the most elfiicent ot the whole

becomes aPParent

that Mr. Flemingi influef,ce has been suPer-

A full review of the cast would be imPosin the space available, but ;f an)one ir 'ible to be mention€d it must be Dave Hawkesby Mullins for his Rebel Chief, with acknow ledgment to Bernard M;les; and Mike Goldring for hir show stoppinS dance as Fair)

always this strong but dangerous 's to discard tradirional formulae temptation and evolve an original and " switched-on " plot for a hospital pantomime. lt is possible in this way to be lured into following the least :ttractive trends of commercial enter' tainment. A combination of actors who can

There

Snow. Other useful performances were those of Rod Barrington, Bob Binnersle)', Anne

imitate the voices and mannerisms of televi5ion comedians, guitarkts versed in the current idiom, and a plot consisting of a series of tenuous excuses to exhibit these talents, does not constitute a Pantomime.

Evans, Manin Ellratt,

This is a critiqoe, and there is much to criticise in any prcduction. The writ€r world be failing in his duty if he were less than scrupulously hon€st- As a whole, the evening

True success consists in sending the audi ence away impressed and stimulated as well as laughing. This ha5 been achieved in hospital shows, but onl/ by ereful phnning

succeeded overwhelmiDgly,

was neat, complete, and, within its coDtext, quite credible. Chancters were boldly pointed, both in the writing and the production.

ir a

of

nightmare

its

The in.lunon oI ballet rn an enteftainment

of rhir kind

course, the whole venture

in the

but litde of

success on be aftributed to certain membeE of the chorus. who for most of their time on stage would have done credit to a Method dass rmpeBonating a vegetable garden. The produ.er made a rod for his own back in employing such a large cast, and economy mighr well have been pn(tised, for e,ample. among the Ladies of the Court.

in great detail long before the event. This i' a lesson which lohn Lucia leamed long ago, and his plot, though complicated, was clearll €xpounded, due to the careful amngement of stru.ture and sequence. The d6nouemeni

Technacally,

Nicki Spencer and Bob

Miller.

is justilied only rf

ir

holds the

a(tenhon ol the audience. who are usually Iar

Students'Common t9


minor ones, any amount of praise would seem shallow. ln fact,.,ohn Lucia, writ€r, muri€ian, producer and technical director,

from being connoisseur', by can/ing pan of the plot, or by being so technically brilliant as to thrill them. On this occasion neither of there crit€r;a was satisfied. The writer is not conpetent to criticis€ the performance aj such, but its function ar a part of " Euphoria" war strongly 5!sPect. The growth of the cast's confidence during the we€k was shadowed by a regretrable spate of adJibr, m.ny of which bore the odour ot painful preparation. Some of these additions served as hil.rious lifelines in emergency, some were embarassing. Without these reservations, which are

must be regarded as an asset which the Dental Hospital will have difilculty in replacing. His production was unqueltionably the best of the batch in 1965, both aesthetically and financially. lt is appropriate that he, rather than his cast, should receive the credit for this success. which was due to months of hard work completed before most of the acto6 ever heard of it, Prolpectiv€ producers

for

1966 please note

!

DENS

FLUORIDATION FOR BRISTOL ! ln this way the

Two meetings were held by Bristol City Council in which members of the Staff of the Dentarl Hospiral were invited to speak on the problems involved in adding sodium fluoride to the water supply. On each oc(a-

to the

to

be

were compleely biased against the scheme €ven b€fore the evidence for fluoridation had been deiivered. lt would be interesting to know whether the opposition was trul/ repres€ncative public opinion, or simpl/ acting as the Devil's Advoc.te. The;dea of administering fluoride ions by tablet seemed largely acceptable by those oppored to fluoridation of water supplies. However the problem of endeavouring to ree that children take the t$tet reSularly, wat recognised, and

sion both speakers were ardently support€d by a strong contingent of dental students, many of whom expressed their views without Those oppored

dis.ussions tended

technic.lly frustnting, as the less informed nembers of the public regarded all technical information with scepticism. lvost of them

scheme consist€d

mainly of a more dlderly crosr re.tion of the

€eneral public (could one ventore to say, eccentric l) who though largely uninfom€d medicelly, came armed wirh alarming statiscics against fluoridation, extracted from the of research. A notable item was the

ev€n then the benellts of pre-natal protecrion

archiv€s

reply by Mr. D. Phillips to a sBtement by a member of the audience. This gendem.n

in the formation of the teeth in utero would be completely lost.

claimed thar a research worker in America had thowed that fluoride had induced cancer

Bristol is not practis€d, could lack of support

lt

mice. Mr. Phillips replied on behalf of thore supporting fluoridation, that the same

in

of the water suppliet in

from qualiff€d memben of the Dental Profession be blamed I Few were presenr at

in

worker had induced cancer

fluoridation

mice by

feeding them with onnges.

R, MILI.ER 20


ATHE]IS ROSKITDE

MATTA We publish accounts

of three more journeys from Bristol one leaves profoundly impressed by the relict of classical timer;t is the people ot this

Greece is a land of great contEsts not only between ittelf and other EuroPean countrier but ako between its own com' munitier, climates and countryside. The cit/

country who impress you far more than rheir monuments. The Greeks have always felt themselves to be a separate people and this feeling comes ovâ&#x201A;Źr as strongly toda/ as in clasrical literature. Neither the PeloPonnesian war. the curse of Turkish dominarion, nor the recent political disturbances have sapped the unity and the andivid!alit/ of Greece. The people have the same emotions and ideals as the Greeks of Aristophanei, in spite of a turbulent history of 2500 years.

of

Athens resembles many other EuroPean capitah, with a Hilton Hotel, coffee bart and Volkswagens, and yet in a few hours one

can be among countryside and PeoPle not greatly changed since clasical times. The best hospitals have facilities which are very good but genenl medical care throughout the .ountry has many deficiencies. For the tourist there is mu.h to see and learn and although

al


POMPEII

-

ON THE WA'


(Howard Snith)

Y TO AN

ELECTIVE


, , r . and in the north hour call on eve.y alternate day headed by

Roskilde it th€ biSgest ProYinci.l town in zeehnd, the latter being the larg€rt of the hlands that make up Denmark ln the Middle Ages Roskilde wat the most imPortant spiritual c€ntre in Northern EuroPe. The cathedral of Rotkilde i5 the most jmPortant edifice in Denmark with a wealth of eccleriastical aft and memories of glorious perjods of the patt. Thit has been the burial place of th€ Danish kings and queenr for a

either the Chief or the Assistant Chief Surgeons, and one of th€ Number One Surgeons.

* The four operadng theatre! are quite modern with lots ofSpace. The w.rds themselver took me by surprise, €ach.ccommodatinS

or even just on€ patient each. This se€med jdeal as far as th€ patienCs privacy and peace was concern€d. A differen( surprise awaited me-something I fo!nd hard to believe and did not think much of at first-when I learnt that all the anaesthetists except for their.hief w€re not doctor. They were all nurses, who had done a special cou6e in anaestheriolog' as it i' called in Denmark. However my initirl overwh€lming apprehension soon subsided when I dis.overed the efficacious manner in which they performed their task.

* Medial servicet in Denm.rk are f,ot verv unlike thote in grinin in that there is a similar son of National Health Scheme As far as surger/ is concemed, several hosPitals scattered all over the <ountry coPe wjth the surgical cases in their own regions The surgical depirtment of the hotPital I was at' Roskilde Amt' og Bys Sygehus, which literally translated means the County and City hospital at Roskilde, has the largest turnoYer of patients in th€ .oontr/ lt is ttaffed by a

t The genenl atmorphere in the hospital was very friendly. The lack of formality between all membe's of the staff in the

of

surS€on' led by Chief SurSeon Dr. Med. C. L. S. Bohn, not only a famout Senenl surgeon in Scandinavia but alto a Urologist of international repute whore work hes been team

not more than six patien6, many

havinS three

hoipital simply amazed me. I was delighrfully surprited when on a round one day with one

of rhe senior surSeons, the skter on a ward, rhe nuRe, the stud€nt nurse, the domestic on the w.rd, the surgeon and myself all sat at the same table in th€ sist€r's room for a

in Am€rica and in teveral Europe. Under him is an countries of Surgeon, two Number One Arsistant Chief (the €quivalent called they are Surgeons, as country) and tix ReSistrars in our of S€nior 1nd hou5e surSeons. surgeons or seven iunior It i3 intereirng to notr thatwhile all of them work the normal day, which being from 8 a.m- to lunch time is quite shon compared with ours. halt the staff is on twentyJour publirhed both

coffee and some cake.

* ln the pr€mises of the hotpital and yet set apan from ;t with th€ aid of int rvening gardens and trees, stood houses and blockr of flatt for the statr. One of the two fl:ts 16


making up

a

in vain to make m/self underttood with the most exasPerating gestures to an old m:n, he scampered out of the room staring at me as thoush he had seen a ghost !

house, served as our abode.

Adequately furnished, internal and external

telephone included,

it

was sewiced every

day. We had our mexls with the nurses and thir proved very useful in making contact with young people who could converte in

Talking about language, I was rather imprested by the fact that it is now compuhory for Danish children to study English as well as two other languaget apart from their own, for three or five yeart at schools. thur one finds that most young people today speak Englirh, their {uency depending on the amount of practice they have had. This did

English, especially since there were no medical students at the hospital. To be quite fnnk this was alto a great asset

,r

very little to increase my incentave

The working day at hospital started at I a.m. I found the freedom of the wards in an/

of the hospital qlite useful and often spent long periods in the Obstetrics and G/nae(ologt ward. I wai free to asist at an/ of the operaoons Soine on or jus( watch them in progress- This was an advantage srnce alrer watching routine

learn

After lunch I lapsed anto the habit that I had acquired while in the tropics-that of a siesta. Th:s was followed by a few hours with my books, a game of tennis and an almost invariable trip to Copenhagen in the evening. The capital with itr ancient history,

depanment

opention' hke the striPprng ol

to

Danish.

its interesting architecture, some of which to the Renaissance. and its vast diversity of entertainment was easily acces-

vancote

to helP in the oPentiont when su(h department casualry for very sPecialised going on. Except were (:rdrac and turgery neurosurgery fields lrke all of surgical deals with the hospital rypes veins several umes lpreferred

dates back

cases. The surgeons spared no

sible, being only thirty-two kilometres awa/. lwould certainly re€ommend to anyone a visit to the f,lureum of Thorvaldsen, Denmark's most famous sculptor.

to

effort in trying

explain surgical procedure to us and were

alway5 very willing to answer que\tioh since opeEtion! ac(ually staned a( 8 am

Sweden,

I

(the anaenhetists had got to work on the

a very hurried three days in one :t Gothenburg, itt largest seaport, another at J6nk6Ping, one of

patients well before that time) we vi/ere all a( cofiee by 9.30 or l0 a.m. AlthouSh somerimes operadons drd go on unol alter midday, on most days we were free after coffee, certainly as far a5 the oPerating lists were

Sweden's oldest cities on the shores of Lake Vatt€rn, and the third at Marstrand, a litde island town devoid of vehicles, whote quaint houses gave it the appeaEnce of having come risht out of a fairy t.le. Here I had the

spenr

fortune of witnessing the af,nual regatta in which about fiv€ hundred ships participated, one of the finest sights I have ever seen.

I could now help in the casualty departmenr or,n the out patr€rts dePartment, bur the latter was of very little value to me considering that t was not exactly an expert at eign language and even if I had been. I Ether doub( that my average nonEnglish speaking Danith patient would have understood me. ln fact I realised this at my concerned.

ln

Denmark there is a great shonage of

doctors making

it

essential

for hotpitalt to

employ a large rrumber or adyanced medical studen$ as acting do€to6 for periods of one or two months. lcould hardly believe m)

expense when on one oc€ation, having tried 17


ean when told by a medical student' a contemponry of mine, that he earned fl50 a month and that when in Sweden during his previous hotiday he had earned {450 a month ! A student nurse there eams more than a houseman here !

meanwh ile

back on

!

The facilities enjoyed

by the

student

nu6es ther€ would €ertainly be the enYv of their counterparts in this €ountry. Betides thejr higher htes of Pay they have a ver)' convenient tyttem of dutie5. Night dot)' begins at midniSht which it ver/ uteful if one is out for the evening. A nurse starting duty at midnight can stay away until 2 or l a.m. if her social enSagement is a late one' prcvided a friend will stand in her stead. On rhe oth€r hand a nurse finishing dutl at

the med Ar lwrit€ this l'm still

(which is not incidenrally a Home for Old N'r6er) and looking out onto sunthine and palm tre€s. Having read the advenbementt betore com'ng lexPected warmth and sunshine at !his time of year' lanuar/ l found tunshine, yet, but warmth, not much' itt still winter coat and llre weather' Everyone I meet telk me I've come at the wrong time of year, but it's still veq' Pleasant and guaranteed no snow

midnight may leave two or three hourr earlier under the rame circumitances.

The Danes are a very friendly PeoPle and their hospitality knows no boundt, a fact I

had learnt from

a

Previous

Yisit

l

el€cting in Malta,

sitting in my room in the Old Nurt€s Horne

sPent

several enjoyable evenings ar the homes of some of the doctors and of other families in Copenhagen. Ar far as the electiYe is concern€d the change of environment made it

This is an enormous hosPital, St Luke!' and an old medical school which sit! on the top of a hill near Valletta, the caPital, .nd conmands a marvetlous view from the toP, which is (he maternity section. Easy landing for storks ? The horPirel has over 600 bedt and deals with all branches of medicine. Visiting it at restricted tim€s here and it't a huge crowd collecting quite a sight to 'ee outride the gates which are firmly sh(t in their faces until d€ad on time Thev are mainly women; there :re far rhan men in Malta, often in black and many rremendously fat ca'n/ing in oranges. which are sdld on barrows outside the gates

a sort of holiday. The daily work in theatre h€lped me to Sain a Sreat deal of Prdcticrl surgical expefl€nce and as a resuh of th€ shon working houB I turPrised mytelf with the fajr amount of r.ading I manaSed to get

done. Quite jmponant too. I found my electiye an outstanding oPPonunity io €et e fair insight into the way of life of the Dan€s' studying their attitude towards life in Senenl and greatly broad€ning my own outlook. All in all it wat an excellent exPerience ,om* thing I thould hate to have mksed.

For anyone an.ient emPle and churchminded, Malta is the Place. there is an abundance of interesting rhings (o se€' which is made easy by the excellent' if bumpy, buses whi(h are Pa'nted ditrerent

ALSAN BARR(X DsA 1A


colourr according to dertination for the illaterate (it also helps even if you can read).

coming to, but by reports from othe6 best in April/f4ay or September/October, as the real summer is very hot and quite humid. Most excha.ge students want to come in the summer and thie is of course a very papular place. So if /ou seek the sun, apply early, accommodation is arnnged in the hospital.

The island is small, approximately 100 square miles, so that it is easy to get right round it.

It is nther

barren but the orange) stone

run-soaked and indâ&#x201A;Źed it is. Life moves at a leirurely pace here and the people are friendly and mostly speak at least some English. The oranges and cheese cakes makes

it look

are delicious.

All round, a

place well worth

Sandra Mooney

DENTAL STUDENTS SOCIETY NEWS I'lr. Shaw is taking up an appointment as deputy Hospital Secretary ar King! College

Calendar Feb. 22nd " Rally Driving', a talk by l'4r. T. Lewis

Mar. 8th 'Ski-ing',

Mr. lan Kelly was elected Student President in succesion to Mr. David Lewis, i. November. Mr. Kelly who lives in Cowes, l.O.W., w:s eduoted at Elizabeth College, Guernsey. On leavinS school he spent a period of tlme sailins the hish seas with Mesr6. Shaw, Savil,le and Albion after completidg a course at the Univefiity of south-

a talk by lYr. williams,

Physical Education, Univ- of Mar. loth l4ar. llth Dental Ball Apr- 26th Comedy film niSht

May

6th

ampton School of Navigation. Finding himself

May lorh A.G.t'4. May lTrh Talk on Homosexualit/ by D.. W.

embarrassed for some G.C.E.

'A'

Levels. he

July l6th Cricket match v. Staff Lart year! Dental rep. for Black Ba8, l'4iss Betty Liptrot, who qualined last December,

spent rwo yea6 at Ponsmouth Technical Cdllege correcting this situation before entering Bristol UniveEit/ in October 1963. The new President, who is a keen sailor, describes his sporting activitiee in Bristol as ch;efly iddoors. Hii potential for efilcient organjsation was recenlly demonstrated when he arnnged a h;ghly successful weekend trip to Paris, an ambitious undertaking-

has since married Mr. Tony Shaw who comes from Bettyt home town of Wolverhampton.

R. MILLER

lune 29th Bar-B-Q Sept. l6th Annual Dinner Dance

july llth

Social evenins

in the 'Horse

and

29


PANTOMIME Thir year's B.R.l. pantomirne " PuLl uP the Beanstalk" was an ambitious undertaking considering rhe relatively small size of the ream. The o!tpatlent dePartment was once again scaffolded and draPed, and many hours h:d obviously been spent in PreParing the

stage, lightlng, sce.ery and costumes The effecr was very pleasing io the eye' the countryside scenery being Particularly attrac' rive and imaglnative and the audience settled down for an enrertaining evening However rhe rea sruff of pantomime is not made of scaffolding and canvas and rhc most

lo.k, hn

e

Aathet ond Pdsteurclla

aborare

1965

stage is of no vaLue Lrnless the action is interesting, the dialogue entertaining and rhe show goes with : swinS Thâ&#x201A;Ź audlence mus! be kep! interested and mutt be co._ stantly sLrrpr sed by the Play itself, and if th s is dull and fat no amount of theatrical rririmlngs wil prevent rhe evening being The play was a convention:l version of the beanstalk story and the cast contained the usual pantomime .haracters, bur neirher the

di:logue nor lhe speed

ar whch

things

moved were sufflcient to keeP the audience really intere5ted for one and a half hotrs Certaln parts were funny and imPress ve but

on rhe whole it did not succeed l'4ichael Richards was the mainsray of rhe cast and his enerey on stage helPed to PU I the show :e.rons of rnadeqLare t Pt

He looked as though he was enjoying him )plf. "no he,ped to esrabl,sl' I 'e clmosPhere

of p"ntorime Ln He also n ade a vFrl fine job of the cow, Pasturella, comPlete with pa^lomime pl rtrbr18. Howaro Snrtl' as Oeel' se-,.1t .erta nl/ d on I la.k enerS) a-d gave a nost atl-letc Perforran-e Hi5 mare-up wa\ sood a-d mu.l' of 1rs d alogue very funny, but he rePeated hls mlttake o' r8 h s 'i'es a5! )eir e'actly br nor ''trcLlat Filry Snow (Patricia Bassett) had some

e\cel ert racial e^Presions ano sPoke l-er ine\ w rl rhc conviction of a t'u ) Sullrble fai'y :nd the yokels (Colin Ade), Peter Clarke' Paul Lew s) worked hard to Pur some energv

ano BJsto 'to tl'ei'/e'l pedettria'sc'Pt Ron Gannaway sang to hls own Suitar and dld i( we I bur the rest of the mls c didn't wake up untll rhe 1a5t chorus lf the whole show had moved with the Pace and energy ol this \ong rr woJla have been 4n entprtdin ing evening. As ir was the scriPt was th n


make a panromime dame. Frederlck Stamp looked the part of Ogel Bogel in his splendid uiiform and was a yery genrlemanly ogre indeed. The cosrumes (Susan Gage) were genera

lf very .olourful

and gay and lane

ro be congatulated on her excellent back cloths. The beanstalk too was splendid but what a pir), rha. it grew up such an obvious draw string when some nyloi Slshop ls

thread would have made iis enrry a comp ete

To pur on a pantomime ar Chrjstmas in rhe teeth of exams, outpatien6, obsterrics and holidays is no mean a.hievement in itself and it would be a pity if this rradition died However, wirhout the pace and fun of a good play il wont suryive on a few well worn â&#x201A;Źags about vulnerable members of sraff, and a good set. whatever rhe cast may ger our of ir for the audiefce the plal is stili the thlng lrat

rinohciot

o.otnt:ee t 41i

ANTHONY E. A. GIDDINGS Ihe

Ogel

r

se.vdnr

and eeked out with meaningless pauses and.he busi ness of the show (5uch as the chase in Ogelr palace)

was nor supporred by suit abLe dialoguei grunts and screams wouid have done if

rhey had been

energetic enough. Roger Phillips gave a slow performance as lackt

nother in an

irritating rained falcerto: he above all sho!ld have been full of energy-it takes more than a badly stutred bosom to

3l


ln the Summer l96s Edition of Black Bag an article by B€tty Liptrot appeared entitled " lledico-Dental Relations ". This article considered how the two profesiions overlapp€d and whar benefits could b€ Eained by borh side6. \/v€ publish the .orrerpondence that result€d from this articl€.

THE DEI{TIST$' DILEMMA rhe problem afresh, it can be seen to resolve itself into several headings r-

COUNTY HOSPITAL YORK 8th September, I965.

DENTISTS

Dear Sir,

" lt is very vulgar to talk like a d€ntist " (r) Your article on medico-dental relation' /Liptrot, B, The Elack Bag, Summer 1965, pp. l0-ll) cannot be allowed to pass unchallenged, ro full is it of vague statements,

AND PATIENTS

One can hardly deny the value of the den-

tist, particulatly in extracting teeth for severe

pain, for dental pain has been described " transcendental " (3) and " there never yet was philosopher that could endure th€ toothache patienrly ". G) ln addition, dentisti treatment may help ro arr€st the progress of de.tal disease and may encourage the development of a cosmetically acceptable dentition. Again, the production of prostheses for edentulous patients may be helpful, though there are dangers inherent in these (5673), panl/ due to dentists' efforts ro a5

illogical argument and basel€ss optimism so commonly found in popular writirg ('1) but hardly appropriate to a journal aiming at scientific accura.y. The overall impression conveyed is as inaccurate as the above quotation, which have, of course deliberately removed frcm its context to demonstrate the point. lf one may be permitted to examine

I

31


the care of patientr, as I have alread/ indi .ated, in the same way as are dieti.ians, chiropodists, etc. Dental tr€atment, by and large, overcomes inconvenien.e rather than serious ill health. Even by sir William Osler't definition t, a dentist could at best b€ half : diagnostician ! One hesitates to bring in the vexed question of yocation, as then one comes to lerr f:ctual grouf,d and definition is difficult. That of L. P. Smith l might be taken to imply that dentis$ had a very definite vocation, though I doubt if man/ enjoy the drudger/, if drudgery it be, as

of prostheses preferred by but without knowledge of their distant effects. However, in fairners, it

produce the son

patients, more

murt also be acknowledged that lack of den-

turet may alto have attendant danger.

{e)

These functiont are very limited in scope and are largely of a purel/ techni€al nature, and

although important, are no more so than, for example, the provision of specta€les by opticians or wigs b), wig-makers.

On the debit ride there are other.onsidentjons-prescribing antibioticr it now a major science fraught with danger and dentists are just not adequatel/ equipped to prercribe antibiotics, and the prescription of p€nicillin as described by l4iss Liptrot illustrates this very well. The administntion of general anaesthesia by dentistt is a barbaric

much as the financial rewardr of th€ drudgery.

Cenainly, no dentist lndergoes the sort of drudger/ involving himrelf and his fimily for

many /ears, ar do do.,o.r ,|l). Again,. how many dentis$ are available except during " omce hours " f Mosr ab5olutely r€fuse lo see patients afrer rhey heve stopped work for the day (a( a veD/ early hour by docrors'

anachronism and this plus rheir inability and/or refusal to extract te€th with their patients in the horizontal position with th€ pharynx properly packed har retarded rhe advance of anaesthesia by many y€:rs. :nd has been responsible for man/ de.ths, and for the inhalation of foreign bodiet, blood

standards) even for revere haemorrhag€ re5uhing from their own manipulations. Nearly all dental emergencies, including reactionary and recondary haemorrhaSe following dental extraction are dealt with by doctors, and motr Casualty Ofilcers and E.N.T. House Surgeons quickly become pro-

and vomitus and the ,equelae of these. Again, the diagnosir and treatment of non-dental

oral conditions by dentists is quite unaccep. able, limited as they are jn thejr outlook and in their knowledge of systemic diseate. Regarding treatment of fractures of th€ face and jawr, the proportion of dentists who are able to deal with these is extremely small indeed ,and those who do so 3re usu:lly

ficient at re5urcitating patients suffering from atrcr-eff€c.s of dentittry. Yer again, one has heard of dentirtr refusing to carry out neces-

s:q/ treatment which they do not consider ro be sufiiciently lucntjve. All these f€atures hardly add up to a profession or a vocation equiYilent to that of medicin€.

medically qualified. Ev€n extr:ction of

impact€d " lower eight! " is usually carried out by medically qualified people. DENTISTS

DENTISTS

AND SOCIETY

One must delve more deeply than i5 done in Miss Liptrot's article in order to determine the sub@nscious motivatiof, underlying the

AND DOCTORS

The relationship of the dentist ro the doctor is a simple one that the Registration of Dentists has done little td alter As their work touche, upon such a limited :spect of

t "On. fir8lr in the thrcat .nd dlet . eed diag@rti.ia.."

medicine and sur8ery they are really medicl auxiliaries,:nd of cou6e are important in

I'

aftempc of dentilts and other para-medical

33

lhe ten of r yoarion

is

one in th€

tfi. lov.

ot

r..tuh

th. druds.ry


ficial " enrente cordiale ". We murt face rhe fact that the dentist is, basically, a "puller and plugger of teeth ", to quote 14iss LiptroCs words. h might be worse-Hazlitt s.id that '' a tooih-dnwer was a kind of un.onscion-

to gain incr€ased status, Panly by "courting" the medical profession and by

workers

emphasising

their allegedly close association

with it. Eventt in Fnnce in U89 and in Russia in l9l9 haye been followed by a worldwide, ev€r-increasins search for so<ial

able tnde, because his trade was nothing elie but to tak€ away those things whereby every

lpsradins by individuals and g/ouPs, and it is important to view medico-dental relations in this conrext. Psychologically, ihe prime mover in rhis may be unrelated ro religion, philosophy, sex or money, but more concerned with . form of desire for PeBonal fuinlm€nt (s€e Herman Wouk's theory of " Hirs " 01)). Similar resrictive movemenrs may be !€€n in th€ demands of all tyPes of unions and societies for the exclosiv€ riSht to practise their variout o<cuPations as and how they may determine (ree the re€ent action by the Pharmaceutical So.iety (o prevent pharmaceotical dePanments being open€d in Supermarkets.{r3) :lthough wth

min gets his living ", and the phnse " lying like a dentist ' (r7) seems to have passed into disuse, in English, a. any rdte. B€rides, some of my best friends are dentists ! Youru faithlully,

(D.

J. Stayte, M.8., Ch.B., D.L.O.)

l. osr wird. (rats) Ii. rbrqbr(. of sdnp L C.4., M- H, (r9al) " Dd.5 ir lolc{ I Ndton. r, rhons H6on. ,,A t.u. story , . I: i\ifir.,. ,. ,.r!.h Ado r'oui N.rhrns . A( v, s, 8rir,rm, r. r., !rk. n.d. 1., lr tutr, t165, p, 30r, 6, P{lrdtr, C, N. ! Slryk, D, Au.u{, rra5. r. r01. Bnr. h.d. 1., ll Alrut. 1965, D. 4:to,

modern packaging processes pharmacists are rapidly becoming unneceslary). A similar instance concern! spectacles, which may now

"!{3.lftl6hhrfr..R'.gn!.i!d'l''1.A4[..

9. sqr&. o. 1.,8rn. n.d j,, 1s.rrm6.r, t965, D,59t. r0_ Lo!.n P.,rt[ snki, r,lt, . Ah.d.usiQ ' ll. ,od[oi r,rarr.r. " N.$ , Auiun, lr6s, r, 30. 12. H.rnM w.uk (1961), - rtrrdori. a.mtmsr ', c:D.,

be obtained only at an artificially inflat€d price from carefully restricted tources, whereas previoudy one.ould purchate cheap new or secondhand specta€le! without reference to an opri.ian, by " trling them on " and often find a pair which suited. All this and much more has been done by tnding

lr

chD. xxx. Dr. _

]7tll5,

lh. tuidl lin6 ', 1r lurr. 1965, p, .r, .ok. 1 & l. ra. nanl l.f, rori D.d nici .r hd.Dd.n4 " 4!r, l! y t776. " rh. Gcndoldr ", r, 16. ".ll'. i{dnioi or sr, Joi ur d.

d.

'

ii (|f, troe.rb).

upon rhe reflected goodwill from the public's

high r€Card for the medical professionWhere will it all end ? " All men are created equal " (ra) and " All shall equal be " {r5)

CRITICISING THE CRITICISM, A MEMBER OF THE DENTAL SCHOOL,

are romantic premites unruPponed by fact, Christian PhilosoPht. (r6 ) What I am trying to show is that the present inflation of the " image " of dentistr/, uting the medi.al profession as an unwitting tool, is part of a much wider trend, is artificial and quite unrelared to merit. Let us maintain good relations with denti5tt by all means, but let the basis of thir be clear, ac€urate, t.ief,tific appnisal of their work unclouded by a tentimentel and arti-

BRISTOL,WRITES,.. Dear Editor,

Miss Liptrot's article may be open to it ought to be fa'r and

criticism but surely 34


He stares that " Dendsts are just not

just. I can onl), presume with some cenainty rhat f4r. Sta/te is wearing dentures which cause him continual pain-Prcbably because they were bought or borrowed on the same basis as the spectacles of which he writes. f4uch of his letter is just offensive and will be ignored but in his role as distinguished scientirt he .laims to be offended by " vague statements, illogical arguments :nd baseless optimism ". lf he means this then he should not himrelf offend, particularly when he does

"The

diagnosis and treatment

of

adequately equipped to prescribe antibiotics." Presumably he does not mean that thel lack syringes and needler but that they are not

properly trained to prescribe tuch drugs. ln charit/ on€ must presume that he has studied the dental undergraduate'r curriculum and h:s then forgotten it for the rtatement is quite untrue. He escapes by using the term 'adequately.' Perhaps he would agree that on this basis I could saI he

adequately

non-

As for his par.graph on " Dentists and Doctors'l -he states only a peEonal point of yiew which appears to be intentionally otrensive. lt needs no reply. som€ of the later .riticismr are unfortunately t.ue of some dentists, but since he quoEes rhe scriptures might I repl), with another quotation from the same source. '' Let him who is without sin cast the fi6t

onl

conditions by dentists is quite unacceptable-" What evideDce has he that dentists in geneEl treat such conditions ?

dental

ir'not

equipp€d' either as a surgeon

Why should they not diagnose them i And to whom other than himself is ;t unaccePtable ? Let us have the evidence from our " The administrarion of geneal anaesthesia by dentists i5 a barbaric anachronism," This is no more nor less true than the same words applied to antra washouts by E-N.T.

All of the

lt is mere vituPeEtion'' Their inability or refusal to extEct reerh with their patients in the horizontal position with the pharynx PrcPerly Packed has retarded the advance of anaesthesia by surgeons.

criticisms made could appl/

almost equally to bad E,N.I. surgeons who presume must exist unles

I

I

have misunder-

st@d the qualification D.L.O. and it is intended to mean Deputy Lord Orlmighty. Finally, since old sayings are the order of the day-in a letter which criticises vague statement, illog;cal :rgument, etc.," may I add the old English saying, 'To rmell like an otorhinolaryngologist." The origin of thit saying is also as anon),mous ar it is untrue. " lt mal be very vulgar to talk like a dentist," was one man's opinion. Many have now the opponunity to decide for themselves whether it is not even more offe.sive to write like an otorhinolaryngologitt or at last like one of them for lat least have no wish to genenlise from the particular.

many years and has been resPonsible for

manydeaths.--" This rtatement is described by a senior anaesthetist as the most ignorant rubbish. I find it almost libellous, for my knowlede€ of the tacts suggests that dental anaesthesia in the dental surgery is extremely safe. As for the advan.e of anaesthesia-has Mr. Sr.yte forgotten that nitrous oxide anaesthesia owes much of its origin to deniistry. He alro dislikes ina.curate statementslet me quote him a few from his own letter: '' Even extraction of impacted " lower eights" is utually carri€d out by medicalll qualified people." This is very far from being true and cannot be aljowed to pass with@t a requett for figures to suPPort it.

" A O€r$irt." 35


ment plan designed to restore, as nearly as is the complete well-being of the patient. Because rhese duties are not the life-

And tn reply

possible.

The aim of my anicle was to appraise the possible relationship between the rwo professions. lt was nor me:nt ro be an attempr on the dentisti behalf to claim more merir than we are due by basking in the refl4ted

saving ones are they

to be

ac.orded

less

is dependent on the knowledge and skill, to a lesser degree as the individual

Each prcfession

other: pani.ular

gr€ater or circumstan.e di.tates. Little advance in mutual understanding can be a.hieved however, while the one's ability is deemed less worthy of esteem than rhe othertE. A. Liptrot,

glory of the medical profession. Dr. Stayte's reply demonstrares very well how little co,operation can, at times, exist between doctor and dentist. 'The purely

technical funcrions " performed by the dentist a.d some of the other spe.ialists in the medical field are pans of a whole trear-

.lond the.oties,onden e js now tlosed t-Ed-)

FOR YOUR REFERENCE clinical papers by members of staff Problems in rhe Treatment

of Pi.

M.S., F.R.C 5 .

Py@yanea

lnfections. N. Slade and K. B. Linton.

W A.

G;lle\pie, M.A.. M.D.,

F-R.C.P.1., F.C,Path., M.R.C.P.

Heart Sounds and Pressures in Atrial Septal Defect, D. W. Barrin, D. H. Davies, G.

lnfecrions

ot the

Tuberculosis,

1965

(Lond).

lJrinary Tncr Excluding

Ash(on Miller,

MD..

F,R.C.S.

Not€s on the Acid Elution Test for Detecting

PsychotheEpy in Approved Schooh, Frank Bodman, M-D., D.P.M. Placentai Localization by Aneriograph),, 14. B. W;ngate and N. D- O'Connell. Copy of Paper Dr. Campbell Save ar rhe Me€ting of the Asso.iation of Neurologis.s in Flor€nce, Dr. A. M. G. campbell. Some Clinical notes and Electroencephaiographi. firdings in Cerebnl Pals/, Gnce

Foetal Erythrccytes, A B. Raper.

The Naturdl History of Detention,

Frank

for Chloroquine Retinopathy, W. Monckton Copeman, T. K. Cowell,

Screening Test

P.

N L D:llar Circulatory and Acid Base Changes during Opention for Abdominal Aorric Aneurysm, G W. Burton, Margaret C- Holderness, H. T.lohn.

Cytological Screening for Pre - invarive Cewi.al Cancer: A pilot study in

Histologi.al, Thermal and Biochemi.al Etrec.s

Of

Ultrasound on rhe Labyrinth and TempoEl Bone, j. Angell James, c. A. Dalton, H. F. Freundlich, M. A- Bullen, P. N. T. weus, D. A. Hughs, l. Chow. Long-Term Catheter Dainage in the Male, j. B. f4. Roberts, Ch.M-, F.R.C.S., K. BLinton, B.Ssc,. Ph.D., B. R. Pollard, M.8., B.Chir., M.C. Path., l. P. Mitchell, T.D.,

Bristol, J. S. Cornes, Valerie Way, 14. B.

for Pharyngolaryngecromy with .olonic replacement, A. P. Gorham, 1..1-B-, Ch.B., F-F-A.R.C.S., P. J. F. Baskett, BA-, I,t-B-, B.Ch., BA.O_, F_F.A.R.C.S., I. A. Clement. M.8.8.S.. F-F-A.R.C S

Anaesthesia

36


A Reprinr from The

Encyclopaedia of Genehl Practi.tsMoles and Naevi. D. C.

by Auto Analyser, M. R. \,r'ills, B. C. Gray.

Chromosome Abnormality as a Possible Cause of Habitual Abonion, L/dia Win-

Bodenham.

Carcinoma in Situ in a Young Primigravida,

M. B. wingate and

j.

gate.

Chrcnic GEnuloma of the Orbit Caused by Greas€-Gun lnjury, N. L. Dallas. Anti-inflammatory Agents in the Management of lnterstitial Cystitit, H. P. Guerrier J. N. M. Robens and N. Slade

S. Cornes.

The Saprophytic Growth of Non-KeEtinophilic Funei on Keratinized SubstEta and a Comparison with KeEtinophilic Fungi, Mary P. English. Penicillin Treatment Failures;n Male Gonorrhoea. N. L. Dallas. Hypophysectomy in Genenl Medicine and

We congratulate the following membeB of staff on their appointments:Mr. W. M. Capper, Hunterian Professor of Rolal College of Surgeons. Evans, Professor of Radiology, Unive6ity of Wales. Dr. J. S. Cornes, Codsultant Cytologist to United Bristol Hospitals. Mr, W. F- Southwood, Consultant Surgeon to Bath Hospital Management Committee. Mr- G. M Fitzgibbon, President of British

Surgery, J. Ansell James.

Pdl/tomographl in

Otolaryngology,

Dr. K- T

J.

The Physical and Biological Prcpenies of Ultnsound and Clinical Expenence, J. Adgell James, H. F. Freundlich, M. ABullen, P. N. T. Wells, D. P. C- Williams. The Effect ot Ultrasonics on the Temponl Bone, J. Angell James, G. A- Dalton, M- A. Bullen, H. F. Freundl;ch, P. N. T, Wells. Tomography in atresia of the Ext€rnal Auditory meatus, l. Angell iames, F. G. MSpurious Hyperkalaemia, M. R. Wills,

l.

Association of Plastic Surgeons. Mr. Ashton Miller, President of the Urological Secdon of RoFl Socieq, of Medicine.

Mr. M. P. Mitchell, Vie.-President of the Urologi€al Section of Royal Society of M€dicine; Secretary of the The British Association of Urological surgery.

D.

Post ixchange Anaemia in Rh Haemolytic Ditease, L D. Fraser, T. E. Oppe, G. H-

Tovey, D. A. Webb. Thnsplacental Foetal Blood mon Event.

lD

Loss

:A

Dr. P, J. A. Baskett, Consultant Anaesth€tist to United Bristol Hospitali. Dr- Johnton, Consultant Radiologist in Don-

Com-

Dr. W. H. Lloyd, Geriarric

Fraser.

Mi.ro-method for the esdmation of calcium

Physician to

Unit€d Bristol Hospitals.

GALENICALS BOOKSTALL The'

August, although many people left

amateur, cadaver-and-frog-stained,

do-it-yourself

, take-it-orleav+it'

it

until

five minutes before the doors opened, before dumping the old friends that had kept them amused du.ing the cold nights before 2nd M.B-, I suppose they'd grown attached to the tatty old pages. Books wer€ grdded according

bookstall

went into business once more last October, and prcved for the second year running, that a small profit can be made, and that the Medical Faculty does not have more than its fair rhare of kleptomaniacsCollection of books began officially in

to edition and condition and selling prices fixed to give a prcfit margin of l0%. 37


lnstruments went through the able hands of Mr. D- T. l4ccarthy. The small lecture theatre was turned into a Medical Petticoat Lane, and after three hectic sessions the following

BOOK REVIEWS

moneys Yrere realised. CREDIT from

of books a3l3 9

6

'ale expenses {281 8 0 DEBIT repa),ment TOTAL PROFIT {32 I 6 CREDIT from sale of instru-

ments

DEBIT

.

-..

Although a copy has nor been received for review in our columns, the Editors would like ro drrw the attention of readers to a recently published textbook 'Basic Gastroenterology' by Dr- A. E. A. Read (Reader in Medicine (U. of Bristol) and Dr. l. M. Nairh (lecrurer in l4edicine, U. of Bristol). This g'ves an excellent account of alimentary tract (and liver) disease, including the relevant physiolosy and all medical, sursical and radiological techniques of diagnosis and treatment. The style is succlnct, very informative and well illustrated with good clear diagrams. This book is recommended as a very readable wa/ of asrimilatinq fact without the weight of a ponderous larSe textb@k. Even at 55/- it is not to be misred.

.

fl4 76 fI2 13 O PROFIT TI 9 6

TOTAL Best sellers were the standard big textbooks e.g. Grays and BDS, but trade suffered seriousl/ due to the change of statr in the Phlsiology Dept. and to .hange of ideas in the Anatomy Dept. as 130 Cunninghams, 34

Tho?e Biochemistry and 15 Garvens Histology remained unsold. The present third )€ar will have a problem next October, as it seems in these day! of rapid progress, particularly in Physiology and Biochemistry, textbooks are becoming obsolete. Perhaps the Bookstall's f!ture function will be the sale of relatively old favourites, Gray,, Hamiltons and the like. Everyone eventually rece;ved their cheques, a slight delay .esulting from the ne.€ssary calcularions from the complicated, triplicated, security-ridden recordr. h wat a pleasure to fnd that p;lfering had been reduced to a minim'im (we had an efficient security staff),8s.6d. wodh of books were 'missing', these being of the pocket handbook variety, a definjtion somebody reems to have taken too literall/. Thanks go to l'4iss A. Shepherd, f4es'rs. 8. Attock, R. Pearson and P. Brown, and other membefi of th€ Fa.ulty who helped maintain security during the sale. Bookstall .an be a tuccers, and it ir hoped that it will continue to thrive next October. secretary D. J. Morri' Chairman

Concis€ Medical Textbooks-8io.h€mistry-

S. P. Datta and j. H. Ottawa/. Bdt//iere, Tindoll. ond Cosse/r. London 1965 Review of Physiologiol Chemistry lfth Edition. H. A. H^rpet. Lange l edi.al Publicotions. U.S.A. 1965.

I find m/self in a quandar/. I want on the one hand to recommend th€se books warmly to medical students, whilst cautioning, on the other hand, in their indiscriminate use. Both books are admirably up to-date, thouSh the absence of any mention of the carnitine shutde in lip'd metabolism in the book by D:rta and Ottaway surprises, and neither book deals properly with the fastest expand ing territory in biochemistry, that of metabolic contrdl mechanisms- Yet. the over rid'ng impresrioD is one of well expanded

C A Westwood

Committee D.

J.

lecture notes. As such, they furnish the indigestible sinews of biochemistry. The

Mccanhy

*** !8


danger and fallac/ of these books resides in the user who believes lhat this is all that

about anatomical relations. The remaining chapters in the Obstetr;c section are of an equall), good standard. ln the G/naecological section rhe author

is knowable of biochemistry, and all that is needed to be known. The) are essentially source books of fact, and meritworthy at

describes both pathdlogical and clini.al features of d;sease. This part it only 70 pag€s long but is a useful preliminary to

such. They requ're as accompaniment a jovial

lecturer who clothes the anatomical starkness

of metabolic

pathways

with meaningful

Gynaecology-

inte.relationships in physiology at a.oordinated bodyJLrnction level, and in cell biology with the architecture of a cohere^tly

scientific "

weltanschauung

". They

M.

ako

revision of this available. I would have but one reservation about the warmth of my recommendation of the books under review. Buy Fruton and Simmonds firrt !

concisel, vrritten, and a section of the chapt€r

on

C. F. PHELPS

Students Guide

to

Y. RUCK

Clinical Chernical Patholog. C. H. GrayEdwatd Atnold. 20s. The fourth and latest edition is quite definitely the best book on chemical pathology for medical students. lt is set out in good form which is easily read and understood. The excellent chapters on renal and liver functions and their disorders are

require something more, in my view, something that five years ago was given by the readable, thought provoking and exemplary textbook of Fruton and Simmonds. Were a

A

J-

plasma proteins deals adequatel/ with

immunoglobulins. The chapter on acid-base balance is a good exporition of a traditional stumbling block. Obstetrics and Gyna€-

It

<olog/. C. J. Dewhurst.

is 217 pages lonS and cost'

20s.

P. M. LEWIS

Thir book is intended for the student who has already received rome clinical instru€tion in Obstetrics and Gynaecolog/. lt as concisely

The New Look at M€di<ine s€rici, publisfied by Pitmon, and comprising 5 volr. at 7/6d. each, A New Look at Medic.il Education,

wrkten in short well laid out chapteE which are easy to read. The emphasis is on the phcticrl application of the subject Ether than on the theoretical side. this of course being ersential for students who intend to become geneal practitioners. The first.hapter is concerned with the physiolog),

of

pregnancy

from the

Anaesthetics, Preventive Med'cine, Geriatrics, rnd Social Medicine. These small paperbacks are a valuable contribution to the modern literature on the changing face of medicine. Their purpose is to present in an easily assimilated manner, a €ritical review of the present trends in particular fields of medicine, and to outline

implan-

tation of the ovum to delivery and Clso the diagnosis of pregnancy. This lfind is an essential basis to uDderstanding the subiect. I think the anatomy of the pelvis could be described in more detail, especially the mus.ulatory aDd peritoneal relations of the uterus. This would seem to refreth onet memory as lexpect most people are hazy

the further progrest that must be

made.

Attractively bound, and well presented, these books pro de a welcome change from the

purely factual textbooks on the subjectr, and enlarge the concept of the study of branches 39

of

medicine.


A New Look at Medical Education by.t. Anderson and F. J. Robenr (the latter is a

of so many volum€s from this country. But the text is liberally interspersed with large

le.turer in l4ental Health, Univ- of Bristol) is particularl) good- lt reviews post graduate

clear diagnms, which make the .oncentrated writing easier to digest. The book stans with some excellent chapters on the anatomy,

a5 well as grad!ate training and presents tome chrllenging ideas on the curricula of medical tchools, and preparing of the doctor for work jn modern society. A New Look at Anaesthetics b/ J. Parkhoure suggests how the study of anaesthetics rna/ be improved, and the volumes on Preventive Medicine (P. W. Bothwell), Ger;atrics (R. Kemp) and Social f4edicine (J. A. D. Anderson) are excdllent r€ading in subj(ts where there are not very many readable textbooks available General Ophthalmol

development and examination of the eye, and then proceeds to review the diseases of each anatomical part. This is a book ro learn from rather than to read through, and for the average student probably contains more facts than he can assimilate during the rhort Ophthalmolog/ appointment, but for further knowledge of the ;nterested, or fo. a junior

member of staff wanting review, it is : good buy.

an up to

Lecture Not€s on Genenl Surg€ry b/ Ellit and Calne, p./b/ished by Blockwell at 42s. This is a further addition ro the lecture notes series, and the price may be a litde dkconc€rting to anyone wishing to buy the book simply to work for an exam, or to

y by

Daniel Vaughan, Robert Cook, and Taylor Asbury, publhhed

by Blackwell at 45.. This is an American textbook laid out in the typewritten, small headings style, typical

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date

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However it ;s well wonh the cost in providing a concise, well tabulated summary of the estentials of the subiect. The text provides the basi. facts, laid o{t in a digestable form, and is not merely a potted Bailey and Love. There are large, clear diagnms and details of operational techniques are only included for the common conditions or where it makes the text easier to folloe, The b@k can be

BAILLdRE, TINDALL

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C. ALI-AN BIRCII, M.D.. F.R.C.P.. Pbysici.n, Chase

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d a slosery arc included.

rhis book will doubtless continue to be popular with student nursesThe revited intrcduction includes some simple chemistry which the least a<ademic of stud€n$ should find qsy to undeEtand. One feels that the amounr of detail included with the skeletal system can have little significance for the ttudent nurse, and that the space could have been better devoted to more explanatory detail of the

:lrl Drg6

GYNAECOLOGY

Univc6ny College H6pi1al. London, Tbis book ptuvids*e \ixdm1 willl !h. rundmental principl6 of synr@losy on which his fulure pHcrice

my

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lri

EMBRYOLOGY M. B. L. CRAIGMYLE M.8.. CH,B., M-D-, Srior Ldlurer in AElomy and Histoloey, UniveNity

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basic

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This book will serye to provide the beginner with the basic facts and will sufiice if supplemented by good terching.

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4l


many

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students are probably unaware of the sP€€ial

G.S.

lntroduction to Geriarrics by Bernard |taacs. aoillierc, Tindoll ond Cosse/,. 212 pages. 30t, Since geriatrics as such is not included i^

the

medical .urri€ulum

at Brittol

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old people. to d€cide if he hat the time and interett to read about the subjst. Bernard lsaact has written a book which ir easy to read and of

Clinical Pharmacoloey (Dilling). 2lst edition. Aoillierc, Tindall ond Cosseir. 700 pages. 35r. Pharmacolog as a subject to be learnt has never been a favourite amon8st medical trudents, but this hew edition of Dilling cenainly offers them some relief. lt is well written and recapitulates oh cenain aspects of physiology which are importaht in the und€rstanding of the mechanism of activity of drugs. lt is more than adequate for clinical *udents and can be kept as a ver/ Sood ref€rence book, during ones clinical ),ears.

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Mi.ha.l Er.df eld Rob€rt5

Adri.n Hahilton

Michrel John Yarnton Ruck Gr.ham B€ntl€y S.lmon Rosehar/ Joan Simpson

V€roniq

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Se.ond Exaninltion for the Degr€.

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DECEMSER I965

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Fin.l Enhinatio. lor th€ D.cr.e of B,D,S. (S€cion llt OECEMBER I965

ot B.D.S. PASS

Darius Sorabji Godivali

ln s€ction

Re€d

ll (conpletins th.

h

Third Examination lor thc D€8re€s of M,8., Ch.B.

Section

ll (complctins th€

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Chinanlal N.rbheam Chauhan lan Christopher Shim€ld Final Ehmihation

lor the Des.ec

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DECEMBER I965 T€rence Richarn Stone

ln S..tion I (Anatomy and

M.rc.ret Caroline Clark DaYid

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ln Part ll (completins the

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DECEMBER I965

Albin Av€lino John Baros D

M.urice Keith Ba!l€y

lohn Mi.hael Prkwofth

Royston Ronild Pinson

lohn Goldrinc

In Group I (Gen€ral Patholosy)

Ba on Rich d Lerli. Bi/lisMichael Leonard

The D.gree of Docto. ol DECEMBER

I'65

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Arthur Frank G.rnett

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Th€ Dear.e of Master ot Su.sery DECEMSER I965 Dennis Neville walder

Marsaret Seymour lones

H€ather Fances Keable

lhe

Barbara Ruth Anne Mlndox Sanda Elizab.th Mooney

Charles

Robin

John Fred./ick Hamblin

William Alfr€d Vernon Hend.60n Vivien Margaret Hesketh

Brian lam.s

Degr€€

ol Do.tor ol

Medicine

DECEr',t8ER 1965

Ri.hird Ma6hall

Chrntopher William M.y

Anthony Robert Dani€l

William Pin€ree Desmond lohn Gilmor€ Pyp€r

43

(cont.)


BRISTOL ROYAL HOSPITAL NuBe roRETz Jodith carolinc ThG followins Nu6.r wer€ .. PAYNE Anne Winifr.d 3uc.e$ful .t th. odober 1965 ., POUITER Glend. K.t.

final State Exrmin:tion

Nu6.

,, ,, ,. ,, ,,

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HILL Eliz.b€th Ann ILES

Rn.

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lldhh

Mon.

LAWRENCE Susrn Ru(h

From the Editor Stud€nts joumal

ts

ROYNON

Mrrc.n

sEtwOOD Alic€

Sheron

SNELI H.len M..gar€t WHEETER JiII

COOPER Rach.l Miry RANDELL Par.ici. Ann SOLLEY ludith

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SAUNDERS M.ry Ans€l:

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Th. followin€ Nu.5.i w.r€ su..esiular rhe Octobe. 1965 Preliminiry Sr.t€ Exlmination

Partsl.nd2to!.th.r

,,

S.

A. Arnsrrong

,,

J_

A. Hi

,,

j-

H-

.,

j.

M. Bell

,,

5. Holkhrn-l.nn.r

,,

M- E.sncll

Mediol

Dear Si.. Thank you for allowing me to avail myself parr of your co.re'pondence colunns to make- an appeal to you. reade6 for contributions to the British Medical Students' lournal. This Journal is the official org of the British Medical Students' Association, the only faculty organization of;ts kind in the country which has its own loum:l. This publication

of

is distributed three times 3 yeer,

L Thai.

Spring

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satire, history

on forcign clerkshiPs. Send your.ontributions to, The Editor. B.M-S.J., B.MA. Hou'e, Tavisto<k Square.

experiences abroad

Yours sin.erely,

Colin 3. Brown (Editor).

4

J€an

GASSON Ros€m.ry lane

A- C.

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HISTOLOGY A. w' H^r, M.8.. F.R,I.C.S.. and T- S. L6oN. M.4.. M.D.. Blh- (Canlab ) The fifih edidon of a w.ll-*no*n ed {idely u*d booli wbose popularily continues to inree and shich is regailql .s ote of the BHte* in its field. Up to dare in ev€ry r6tEt, this edirion folloss the successful Errem ot in Drcdcceson, brinsins loFrhcr in one vollme lhe relction ihio\ ot d,roiv, pbysioloey. patholosy .n'l biochemi{fy lD 'he {ud\ ol tissue. Dr. Ham\ leil is authorilatiE and ils clanry ir enl'anced by nume'oa eteu.nr illusEabda An imporlanl addibon lo any medical

ESSENTIALS OF BACTERIOLOGY R. G. Vr'srE, M.4.. D.M,

This rc^rb@r, exolaih. as bneny ds oosible. how brclenr. fune, \iruscq ,nd ;ck6ilsi,e tct in rcladon lo rhe €usation of di\sase, Thiq book sh6uld b€ of inr.rcsr ro rhe medi@l and denbl sludenl, Filst Edilion. 1961,

ESSENTIAL PRINCIPLES OF PA1HOLOGY .I,

w'

L^NDELLS,

M.4.. M.8., F.R.C.P,

This book R d6iq.{ mmarilv for ft. mcdical rtudcnr ar thc lBrt ot hii chnical coure. ir pr6vid.s hiD wnh rn ourlinc $hkh- ahhoush the comnon condirions arc ad.quately @vcrcd-nak.s no arEmpl lo bc aD exhau3rive rcvi.w. Tle booL has'ben produced wirh clarirv anU inrellis_ ibiliry in mrnd and should b. ! gFar as;r to lhc srud.nc peBonallibrarv

FnsiEdidon.

A

1959.

255. ncl

SHORT TEXTBOOK OF HAEMATOLOGY

R. B- THoMP$N. M.D.- F.R.C.P. Thh is th. s.mnd .didon of a new bool( *hich had imd.diale slcc€ss on Dublicadon. It !iv.s a cl.ar Dr.cdcal aeounl of dhordcrs of rhe blood and i'tood{orminc oi.ens. wrirdn Darticularly for rhor $ho finJ $. sundard bookt on haein.r6losr r@ d.tailed and speci.li*d Second Ediiion.

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47


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PHILIP H. ADDISON Dental Secretary

A. H. R. ROWE,

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M.D.s., F.D.s.

Printed by F. Bailey & Soir rrd.. Du6ley, Clos.


1966 1