IMPROVED WASHER FOR USE WITH GAS CYLINDERS

521 was shown the starting-handle of a car knife and fork, and questions about these constituted the whole of this part of the viva. In the clinical. the examiner’s opening question was " Who was Sun Yat en and the rest of the viva revolved around this opening gambit. But I could fill very many pages nf your with similarly fatuous true records of cnal vivas. What about the students who have been asked to identify mining drills, pieces of various mineral rocks, and capsules containing various drugs? What of the examiners whose sole repertoire is, " Who was and so and so and so and so ?" These peculiar examiners ask these peculiar questions because they think these are matters of great importance which all doctors should know. These are the things which they themselves tf.K’h students. There has been much praise of the tutorial system at Oxford which boasts that each tutor looks after but one ’rudent at a time. But Oxford has a clinica] intake per vear of only 32 and, in your educational number several of the London teaching schools boast that they cater for Oxford and Cambridge clinical students. Teaching singly ic. a fine ideal, but where are Dr. Ellis and his friends going to find the type of tutor he describes in anywhere numbers ? Certainly, from my experience of them, there must be very few suitable among the London teaching hospital registrars at present. The number of physicians from the teaching hospitals who themselves would comply with Dr. Ellis’s standards are very very few. Lastly, why all this decrying of and sneering at factual you cannot be a good doctor without a good deal of factual knowledge. For example, how can you begin to understand clinical neurology without the factual knowledge of the manifestations of lesions of various parts of the nervous system ? Can you be a rompetent doctor without the factual knowledge of the. dosage and uses of commonly used drugs ?

viva’’ (sic) he .;nd bter

a

"

journal

THERMOMETERS FOR HYPOTHERMIA

Mr. H. M. Fisher, technical manager of Sierex Ltd., 241, Tottenham Court Road, London, W.1, writes : Dr. Stride and Mr. Davis (Aug. 11) suggest that no instrument on the market fulfils the five criteria they list. The ‘

Electrothermometer ’ satisfies these criteria and is, we to the device described by Dr. Stride and Mr. Davis. The electrothermometer is a thermo-electric instrument which uses constantin/stainless-steel thermo elements which giveextremely stable temperature readings and require little or no calibration after long use. Automatic temperature compensation is built into the unit,which enables its accuracy of ±0.1°C to be maintained even in rooms of differing ambient temperatures. The speed of response is far quicker than with the thermistoT type of instrument. The measuring portion of the instrument comprises an extremely sensitive and robust mirror-galvanometer which gives a discrimination on a 6 in. scale of 005°C. A wide range of sterilisable applicators is supplied with the instrument, suitable for measurements of surface, intramuscular, and intracardiac temperatures and A of the temperature of .the rectum, œsophagus, &c. special selector enables up to 15 temperatures to be selectively measured either on one patient or on a number of

believe, superior

patients.

near sufficient

knowledge ?Surely

M. H. PAPPWORTH.

London, W.1.

IMPROVED WASHER FOR USE WITH GAS CYLINDERS

SIR,—The fibre washers now in general use with valves for oxygen, nitrous oxide, and other gases have long been a of annoyance and source nncertainty to persons continually using them. There !. now available in the Seal ’a washer which Dowty is efficient and easy to handle and which provides a gas-tight seal with finger-tight pressure. It consists of a cadmiumplated steel washer to the inside of which a synthetic rubber’ ring of special section is chemically bonded. In the accompanying figure, A shows the seal in its " free " position, and B the seal in its working" position. B shows also how increasing pressure tends further to enhance sealing efficiency, by forcing the rubber lips tighter against the abutting

reducing

"

surfaces.

AGS 1186 A fits the ordinary reducing valve and satisfactory in anaesthetic practice. These are suitable for use with the non-interchangeable about to be introduced.

roving

of Cheltenham, for taking and for providing samples for

ank Messrs. Dowty Ltd., arefest

m

enham.

this

problem

J. SHEGOG RUDDELL.

Medicine and the Law The Witness in

Jeopardy A RECENT inquest1 illustrates the position of the coroner

in cases where claims may later come before the civil The Coroners’ Rules, 1953, clearly state that, courts. when giving a verdict, care should be taken to avoid expressing an opinion on civil liability. This does not mean that evidence should be excluded solely because it tends to show the liability in tort of some person concerned. At the same time, the coroner must restrain questions tending to apportion blame rather than to establish the cause of death. This can put the coroner in an invidious position. He must- make full inquiry and seem to be doing so ; yet counsel, who appear in his court only by his leave, have, rightly, a keen eye on claims arising out of negligence. A man died four days after a motor-cycle accident, from ruptured oesophagus and fractured skull. When he was first seen by a casualty officer, the skull fracture was not diagnosed and the man was sent home by ambulance, though he had walked into the casualty-room. Next day, X-ray examination failed to show the skull fracture, which was demonstrated post mortem. At the inquest, the following exchange took place after a question had been put to the casualty officer by the dependants’

solicitor.

Solicitor : Do you agree that this man would not have died if a fractured skull had been diagnosed on the first

day ?

Coroner : I don’t think he can answer that. Solicitor : Surely as an expert witness he can. Coroner : I am not going to have this Court turned into a High Court. If there is a claim in this matter this is not the place where it should be made. I am agreeable to a certain amount of latitude, but I don’t think any doctor can answer that

question.

Solicitor :

Casualty

It is his officer : I

opinion am

not

I

am

asking

willing

for.

to express

an

opinion.

The reJatives’ representative was clearly trying to establish liability by an admission from the casualty officer. His question was reasonable from a tactical standpoint : but it did not help in the investigation of the This is the kind of issue,which must not cause of death. be determined in a coroner’s court and the coroner’s refusal puts the principle concisely. 1. Manchester

Guardian, Aug. 31, 1956.