- Email: [email protected]
FAMILY PLANNING AND THE RURAL CLINIC
720 FAMILY PLANNING AND THE RURAL CLINIC SiR,ŁYour annotation (Jan. 8) encourages me to report my activities in this field. My present practice serves a total population of nearly 40,000 people, besides the non-entitled population of another 60,000 in this area, who are also welcome in the intrauterine device (l.u.D.) clinic which is held once a week. The population is not " highly literate ... organised, and responsive to Government direction ". I began the programme in July, 1965, and in 7 months 557 " Lippes loops were inserted. The best propaganda is word of mouth " by the satisfied women. The news is passed from friend to friend. I insert the I.U.D. about 6 weeks post partum, or immediately after menstruation. Complications like mild infection and metrorrhagia have been seen. Perforation of uterus has been reported,1 but fortunately not in my series. Cases of cancer have also been reportedand I feel that a long-term study is needed-perhaps on a much larger sample. Although the present study is of short duration, the acceptance of the method has been satisfactory-to make it successful doctors or trained personnel with the missionary spirit, who would be able to establish personal contact, are needed. Propaganda and pressure will not help.
S. N.
CHATTERJEE.
A NEW NEEDLEHOLDER SIR,-Conventional surgical needleholders are not designed to permit fine manipulation in confined areas. The needleholder (see accompanying figure) described here has a sliding lock to fix various sizes of round or curved needles; this avoids the need to spread a pair of jaws. The instrument is designed to permit one-handed operation, the thumb and forefinger controlling the slide lock. The needleholder can be rotated between thumb and forefinger, a
Slide-lock needleholder.
precisely controlled movement which is not easily accomplished with customary instruments. The size of the tip and the length of the shaft can be modified independently of the handle and locking device, providing uniformity of feel for a variety of instruments. In practice, the instrument locks the needle securely in the desired position and has not been found tiring It is machined from rust-resistant Monel metal, and is 51/2 in. in length. It is designed and constructed by me. Suitable modifications for special purposes are easily made. Surgeons who wish to acquire one of these needleholders may write to me at 60, Anthony Circle, Newtonville, Mass.
to use.
02160, U.S.A.
Khan, Z., Wishik, S. M. Excerpta med. Int. Congr. Ser. 1964, 86, 31. Zipper, J., Garcia, M. L., Pastene, L. L. ibid. p. 91.
1. 2.
Obituary BERNARD HART
C.B.E., M.D. Lond., F.R.C.P. Dr. Bernard
medicine on
to
Hart, consulting physician in psychological University College Hospital, London, died
March 16
He
at the age of 86. educated in London
at University College School and at University College Hospital. After qualifying in 1903 he held house-appointments at the East London Hospital for Children. But on his return to this country after postgraduate study in Paris and Zurich, he took the first steps in his specialty and worked as an assistant medical officer at Long Grove Asylum and at Herts County Asylum. He was awarded the University College School research medal in 1911, and the following year he took his M.D. In 1913 he was appointed the first physician for psychological medicine at University College Hospital, but his work there was interrupted almost immediately by war service with the R.A.M.C. He was lecturer in psychopathology at Maghull Military Hospital and consultant in mental diseases to military hospitals in London. On demobilisation, he returned to University College Hospital, and also joined the staffs of the National Hospital, Queen Square, and of the Maudsley Hospital. He lectured in his subject both at U.C.H. and at the Maudsley. In 1925 he was elected F.R.C.P., and he was chosen as Goulstonian lecturer for the following year. He was also elected a fellow of University College. During the late war he gave valuable help in the planning of the Emergency Medical Service and as an adviser to the Ministry of Health. For this work he was appointed C.B.E. in 1945. Two years later he retired and settled in Eastbourne. R. F. T. writes: Bernard Hart retired from clinical psychiatry and teaching some 20 years ago, and developments since then have tended to make some forget his work, which was in its day a landmark, and which has important sequels today. Though an excellent clinician, it is by his writings that he was best known; his most read book was, of course, the Psychology of Insanity, which has become a classic. It was one of the first, and still is one of the most successful, attempts to reduce the intricacies of psychopathological theories and terms to good English and to phrases intelligible to the layman. It thus made possible and set a "
was
ALAN J. MISHLER.
pattern (not always followed) for later education. And, it did more, for it provided some common ground between the followers of various schools of psychology and psychotherapy and the more numerous doctors in mental hospitals trying to find some system in mental symptoms and some grounds for rational treatment. Hart was himself a bridge, for he was both an academic psychopathologist of distinction and the superintendent of a successful mental hospital. The fact that his book has recently been republished as a paperback-a status symbol which he would have found odd-is evidence of its value today. "His other major contribution, the Goulstonian lectures on the development of psychopathology and its place in medicine, set out his views with equal clarity, but it was written for very different readers and had less popular appeal. It was republished in 1927 under the title of Psychopathology, combined with two other papers. The first, on the psychology of rumour, written in 1916, is a most interesting essay for its time, and deserves to be read as much as its contemporary Instincts of the Herd in Peace and War, by his colleague Wilfred Trotter, to which it was in some ways complementary. The second, on methods of psychotherapy, is an early attempt to systematise and evaluate psychotherapy, a task which is still to be done. "Hart was always a friendly and cheerful colleague, and sympathetic and human in his clinical work. His breadth of mind and balance, displayed in his writing, led him to many outside interests, of which his study of French history became absorbing after his retirement."
JAMES WILSON MILLEN M.D., D.Sc. Belf., M.A., Sc.D. Cantab. Dr. J. W. Millen, reader in anatomy in the University of Cambridge, died on March 14 at the age of 51. His father
was a schoolmaster at Bangor, Co. Down, and he educated at Bangor Grammar School and at Queen’s University, Belfast. After graduating M.B. with honours in 1937 he held house-appointments at the Royal Victoria Infirmary. He then joined the university department of anatomy as senior demonstrator, later becoming a lecturer. In 1943 he was awarded the gold medal for his M.D. thesis. He moved to Cambridge on his appointment to a demonstratorship in the anatomy school there, and in 1949 he was given a university lectureship and became a member of Clare College. He was promoted to a readership in 1957, and two years later was
S. N.
CHATTERJEE.
A NEW NEEDLEHOLDER SIR,-Conventional surgical needleholders are not designed to permit fine manipulation in confined areas. The needleholder (see accompanying figure) described here has a sliding lock to fix various sizes of round or curved needles; this avoids the need to spread a pair of jaws. The instrument is designed to permit one-handed operation, the thumb and forefinger controlling the slide lock. The needleholder can be rotated between thumb and forefinger, a
Slide-lock needleholder.
precisely controlled movement which is not easily accomplished with customary instruments. The size of the tip and the length of the shaft can be modified independently of the handle and locking device, providing uniformity of feel for a variety of instruments. In practice, the instrument locks the needle securely in the desired position and has not been found tiring It is machined from rust-resistant Monel metal, and is 51/2 in. in length. It is designed and constructed by me. Suitable modifications for special purposes are easily made. Surgeons who wish to acquire one of these needleholders may write to me at 60, Anthony Circle, Newtonville, Mass.
to use.
02160, U.S.A.
Khan, Z., Wishik, S. M. Excerpta med. Int. Congr. Ser. 1964, 86, 31. Zipper, J., Garcia, M. L., Pastene, L. L. ibid. p. 91.
1. 2.
Obituary BERNARD HART
C.B.E., M.D. Lond., F.R.C.P. Dr. Bernard
medicine on
to
Hart, consulting physician in psychological University College Hospital, London, died
March 16
He
at the age of 86. educated in London
at University College School and at University College Hospital. After qualifying in 1903 he held house-appointments at the East London Hospital for Children. But on his return to this country after postgraduate study in Paris and Zurich, he took the first steps in his specialty and worked as an assistant medical officer at Long Grove Asylum and at Herts County Asylum. He was awarded the University College School research medal in 1911, and the following year he took his M.D. In 1913 he was appointed the first physician for psychological medicine at University College Hospital, but his work there was interrupted almost immediately by war service with the R.A.M.C. He was lecturer in psychopathology at Maghull Military Hospital and consultant in mental diseases to military hospitals in London. On demobilisation, he returned to University College Hospital, and also joined the staffs of the National Hospital, Queen Square, and of the Maudsley Hospital. He lectured in his subject both at U.C.H. and at the Maudsley. In 1925 he was elected F.R.C.P., and he was chosen as Goulstonian lecturer for the following year. He was also elected a fellow of University College. During the late war he gave valuable help in the planning of the Emergency Medical Service and as an adviser to the Ministry of Health. For this work he was appointed C.B.E. in 1945. Two years later he retired and settled in Eastbourne. R. F. T. writes: Bernard Hart retired from clinical psychiatry and teaching some 20 years ago, and developments since then have tended to make some forget his work, which was in its day a landmark, and which has important sequels today. Though an excellent clinician, it is by his writings that he was best known; his most read book was, of course, the Psychology of Insanity, which has become a classic. It was one of the first, and still is one of the most successful, attempts to reduce the intricacies of psychopathological theories and terms to good English and to phrases intelligible to the layman. It thus made possible and set a "
was
ALAN J. MISHLER.
pattern (not always followed) for later education. And, it did more, for it provided some common ground between the followers of various schools of psychology and psychotherapy and the more numerous doctors in mental hospitals trying to find some system in mental symptoms and some grounds for rational treatment. Hart was himself a bridge, for he was both an academic psychopathologist of distinction and the superintendent of a successful mental hospital. The fact that his book has recently been republished as a paperback-a status symbol which he would have found odd-is evidence of its value today. "His other major contribution, the Goulstonian lectures on the development of psychopathology and its place in medicine, set out his views with equal clarity, but it was written for very different readers and had less popular appeal. It was republished in 1927 under the title of Psychopathology, combined with two other papers. The first, on the psychology of rumour, written in 1916, is a most interesting essay for its time, and deserves to be read as much as its contemporary Instincts of the Herd in Peace and War, by his colleague Wilfred Trotter, to which it was in some ways complementary. The second, on methods of psychotherapy, is an early attempt to systematise and evaluate psychotherapy, a task which is still to be done. "Hart was always a friendly and cheerful colleague, and sympathetic and human in his clinical work. His breadth of mind and balance, displayed in his writing, led him to many outside interests, of which his study of French history became absorbing after his retirement."
JAMES WILSON MILLEN M.D., D.Sc. Belf., M.A., Sc.D. Cantab. Dr. J. W. Millen, reader in anatomy in the University of Cambridge, died on March 14 at the age of 51. His father
was a schoolmaster at Bangor, Co. Down, and he educated at Bangor Grammar School and at Queen’s University, Belfast. After graduating M.B. with honours in 1937 he held house-appointments at the Royal Victoria Infirmary. He then joined the university department of anatomy as senior demonstrator, later becoming a lecturer. In 1943 he was awarded the gold medal for his M.D. thesis. He moved to Cambridge on his appointment to a demonstratorship in the anatomy school there, and in 1949 he was given a university lectureship and became a member of Clare College. He was promoted to a readership in 1957, and two years later was