GENERAL PRACTICE A SPECIALTY?

675

problem

of

membership of

an

organic society

has been

demonstrated by the conception, growth, and downfall of National Socialism in Germany. Communism shows no likelihood of providing anything more satisfactory. Both these low-grade attempts at finding a cure for man’s isolation have been and are of the nature of a church, and effective membership of a better sort, of church would

to be the right answer, as Dr. Halliday would probCan any other Foundation be laid than is laid already : JOSEPH V. WALKER, Medical Officer of Health. Ramsgate. seem

ably agree.

THE NURSING SYLLABUS must have read with some considerable apprehension the revised syllabuses for both the preliminary and final State examinations, especially since on the front page appears the statement " As approved by the, General Nursing Council for England and Wales." I can hardly believe that they are approved by either the medical and nursing profes. sions or the hospitals who will have to administer them. In my opinion, many of the subjects have nothing whatever to do with the training of a practical nurse. For instance, on p. 7 of the subjects for the final State examination appears a paragraph : " Structural defects of houses unfavourable to good domestic management." It would be interesting to know exactly what this means. In both syllabuses appears the word " lighting," but nowhere has any provision been made for some instruction in electricity. Although there are many and varied electrical appliances used in hospitals, few, if any, student nurses know the difference between alternating and direct current, why an earth is necessary, or the meaning of voltage. Nor, as a rule, is any instruction given in the proper use of electrical heating

IR,—I think many

Obituary z

STANLEY WOODWARK

CBE, M D LOND., F R C P. J P, D L Sir Stanley Woodwark was not a great physician in the academic sense, but he was certainly an outstanding member of the profession, notable in, any medical assembly. In some ways his mental gifts were the counterpart of his physical attributes ; and with a clear appreciation of his natural advantages he rose to success in his undertakings. " I first saw him," writes A. A., " in 1911 when as curator of the museum at St. Bartholomew’s and medical tutor at King’s College, he was closely in touch with the students. by whom he was recognised as an exceptional and highly successful coach. I recall his addressing a large audience of the Abernethian Society on the subject of general practice and the impression-one might say the sensation-he created by his fluency, his elocution, his sense of the dramatic, and his ability in the subsequent discussion to speak extempore. I had written an editorial article in the hospital journal upon Clinical Education, and submitted it to him for an opinion with a lively expectation of approval. ’It’s mud,’ he said, as he handed it back, adding as an afterthought, No. There’s some sort of substance in mud ; it’s just ditchwater.’ That was hardly a propitious start of a friendship and professional association which was to conKT, CMG,

pads, surgical diathermy machines, electric cradles, &c. Surely some simple instruction could be given on these matters, and on the simple precautions which must be taken when using electrical appliances. Unfortunately, there have of late been several accidents in a literary venture. hours he had invited in hospitals, caused entirely by this lack of knowledge. For this was characteristic of the man of that time. I feel that the time has now come when a firm stand Generous in appreciation when he approved, he found it should be made against the arbitrary manner in which the General Nursing Council treat both the nursing difficult to refrain from indulging his love of logical profession and the hospitals. Almost daily in the press exposition and his ability for pungent criticism. There there are paragraphs complaining of the shortage of is reason to suppose that he prejudiced his early career nurses, but instead of making matters easier, the General by his outspokenness, by alienating those in authority. Nursing Council seem intent on making it more difficult And although to some extent this propensity persisted for a girl to train as a nurse. throughout his life, he mellowed considerably and few

myco6peration

Royal Hospital, Richmond, Surrey.

AUCKLAND.

PRACTICE A SPECIALTY? I find myself in general agreement with the views of Mr. Douglas Robb, and particularly with his statements that the attempt to combine general practice with a [different]specialty results in both fields suffering, I should like to comment briefly on two points from his article quoted in your annotation of May 19. First as to scientific method. The good general practitioner must be an artist, but he must also be a scientist: the scientific method is just as necessary in the extraction, evaluation, and comparison of his patients’ histories as it is in any laboratory procedure. Where the mistake lies is not, I submit, in trying to work " under the discipline’of modern science " but in trying to learn and use the techniques of other specialties. The second point is the question of " dull " work. Now, Sir, work is dull when it does not make us stop and think : this may occasionally be due to the fact that there is nothing to think about, but nearly always to one of two causes-either, as in the case of the overworked and underpaid, panel doctor, to sheer lack of time, or, in the case of most of us, to inadequate and unsuitable training which fails to make us realise the need to think. How manv of us could sav that we have completely solved all the problems which any one patient’s illness presents to us ? The inauguration of the new National Health Services provides a unique opportunity for raising the status of the general practitioner : an intelligent community, which believed that prevention was better than cure, would seek to have its best doctors go into generaltpractice. The question is, are we an intelligent community ? GRAY. London, WV18. GENERAL

SiB.—Whilst

F.

men can have had a wider circle of friends and no man a wider circle of acquaintanoes. He had been a diligent student who passed his examinations with ease, and with a certain degree of distinction (honours in MB, BS Lond. and subsequently MD) but he was conspicuous more for character and capability than cleverness. He did not take a house appointment at his own hospital but filled several resident posts at the Royal Free. After some experience of general practice he decided to embark upon a career as consultant ; and although disappointed of election to the staff of a teaching hospital he was fully occupied in practice and with a great deal of tuition when war broke out in 1914. " Almost remarkably his organising and administrativeability became speedily recognised at the War Office. In a short time he was engaged in multiple official duties

as

deputy assistant director-general, deputy assistant

director of medical services for London, and consulting physician to Queen Alexandra’s Military Hospital. and he earlv reached the rank of colonel. After the Armistice he was chiefly concerned with demobilisation of the RAMC. For his services he was awarded the CMG in 1918 and the CBE in 1919 (he was knighted in 1932). On his return to civilian life at the age of 45, he considered his future with a certain degree of anxiety, and his election to the staff of Westminster Hospital gave him considerable satisfaction, especially as the simultaneous office of dean to the medical school provided an outlet for his organising enthusiasm. At the time of his election the clinical school had fallen to the lowest possible numbershort of complete extinction. When he resigned after 14 years in office, it was full to capacity. " His consulting practice was considerable, but his heart was never in clinical medicine. In his earlier days he wrote a Manual of Medicine, but this was designed