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TAKING THE CURE
1169 be suggested clinically by unilateral absence of carotid pulsation high up in the neck, but a thrombosed carotid artery may become recanalised, and pulsation on both sides some time after an ictus does not rule out the diagnosis. At present the diagnosis can be proved with certainty only by demonstrating the
diagnosis ’may
block by
arteriography.
The thrombosis takes place most commonly in the carotid sinus at the beginning of the artery, but it may In occur in the part of the artery in the carotid canal. an exhaustive study Hultquist 6 found changes in the brain in only one-third of the cases of occlusion of the internal carotid artery below the origin of the ophthalmic artery, and possibly the lesion may sometimes give rise to no symptoms ; whether symptoms are produced or not presumably depends on the adequacy of the circulation through the circle of Willis. The commonest pathological basis for thrombosis appears to be atheroma in the carotid sinus ; and, as Chiari7 pointed out in 1905, atheroma of the carotid sinus can also be a source of More rarely the underlying arterial cerebral emboli. disease is thrombo-angiitis obliterans.8 The pathology and clinical characteristics of thrombosis of the internal carotid artery will be further clarified by routine postmortem examination of the whole length of the vessel, by keeping the condition in mind in cases of unexplained hemiplegia, and by arteriographic examination. TAKING THE CURE To provide an authoritative statement on the place of the spa in modern practice, the British Medical Association appointed a committee under the chairmanship of Lord Horder. Its report 10 forms a guide to all the spas in Great Britain, and describes the various forms of treatment obtainable at each. Among the conditions in which the committee believes that spa treatment can be of great value are chronic arthritis of the rheumatoid and degenerative types ; muscular, fascial, and fibrositic rheumatism ; infections of the urinary - tract ; pelvic disorders in women ; and certain cardiovascular and nervous disorders. It also thinks that far’more use could be made of the spas for patients recovering from acute illness, whether medical or surgical. Anticipating the argument that the physical treatment available at spas could be given equally well at any suitably equipped hospital, it points out that, apart from the-concentration of specialised medical facilities, the spas are attractive places with equable climates, and have the amenities of holiday resorts ; hence the benefits of physical treatment are supplemented by the important psychological effects of a complete change " in attractive surroundings with ample opportunity for recreation. The committee concludes that the profession in general tends to underestimate the value of spas, and in many ways fails to appreciate the progress made at these centres in recent years. Increasing cooperation between the spa hospitals and the universities and teaching hospitals will promote research, permit greater continuity of treatment and standardisation of investigation and follow-up, and help the spas.to take their proper place in the National Health "
Service. 6.
7. 8.
9.
10.
G. T. Über Thrombose und Embolie der Arteria carotis und hierbei vorkommende Gehirnstörungen. Jena, 1942. Chiari, H. Verh. dtsch. path. Ges. 1905, 9, 326. Antoni, N. Acta med. scand. 1941, 108, 502. Andrell, P. O. Ibid, 1943, 114, 336. The members of the committee were : Dr. R. G. ANDERSON, Dr. C. W. BUCKLEY, Sir HENRY COHEN, Dr. J. E. DAWSON, Dr. C. R. GIBSON, Prof. S. J. HARTFAIL, Dr. G. D. KERSLEY, Dr. T. G. REAH, Dr. F. A. SMORFITT, Dr. R. W. STEWART, Dr. D. F. WHITAKER, Dr. D. WILSON, Dr. H. B. WOODHOUSE, and Dr. W. YEOMAN ; the Ministry of Health was represented by Dr. E. T. CONYBEARE and Dr. F. S. COOKSEY. The secretary of the committee was Dr. E. E. CLAXTON. The Spa in Medical Practice. B.M.A. House, Tavistock Square, W.C.1. 1951. Pp. 96. 3s. 6d.
Hultquist,
THE JENNER MEDALLIST CELEBRATING the centenary of Jenner in 1896 the Epidemiological Society of London founded a medal to be awarded from time to time for distinguished work in epidemiological research or for pre-eminence in the prevention and control of epidemic disease. The ten recipients have been William Power, A. Laveran, Patrick Manson, Shirley Murphy, John McVail, Monckton Copeman, T. H. C. Stevenson, George Buchanan, Arthur Newsholme, and Major Greenwood ; and last week a new name was added to the list-that of James Alison Glover. In recounting Dr. Glover’s achievements to a meeting of the section of epidemiology of the Royal Society of Medicine, Dr. W. H. Bradley, the president, singled out three of them as sufficient evidence of great merit." First was his work on the Prevention of Cerebrospinal Fever, published by the Medical Research Council in 1920, which led the Army’s director of pathology to say that " he has been a good friend to the private soldier." Second was his report to the Ministry of Health in 1924 on the Incidence of Rheumatic Diseases, still cited as basic. And third were his Milroy .lectures of 1930, including some of his early observations on the streptococcal tonsillitis preceding acute rheumatism. " In all this work his concern has been for the sick person," and his qualities have endeared him to an ever-increasing circle. From 1934 he was the senior medical officer of the Board of Education, and now, ten years after reaching the Civil Service retiring age, he still puts in a good day’s work at the Ministry of Health, giving wise counsel at the highest level, although his rank is only that oftemporary ’ medical officer." On receiving his medal from Lord Webb-Johnson, president of the Royal Society of Medicine, Dr. Glover spoke of his father’s work as a port medical officer and attributed his own epidemiological contributions to the influence and help of his father and his friends. He commended the instruction graven on his medalveniente occurrite morbo-" run to oppose the coming "
"
disease." WORLD HEALTH ORGANISATION meeting of the Fourth World Health Assembly on May 16, Germany, Japan, and Spain were admitted to the organisation ; this brings the total membership of W.H.O. up to 78 full members and 1 associate member. The six countries elected to nominate members to serve on the executive board for the next 12 months were Belgium, Ceylon, Cuba, Greece, Lebanon, -and Liberia. These members will replace those whose term of office expired this year; other members come from
AT
a
Chile, El Salvador, France, Italy, Pakistan, Philippines, Sweden, Thailand, Turkey, United Kingdom, United States of America, and Venezuela. WE have to record the death
on
May
16 of
Surgeon
Vice-Admiral Sir BASIL HALL, K.C.B., medical directorof the Royal Navy from 1934 to 1937. Dr. R. ST. A. HEATHCOTE, F.R.C.P., formerly professor of pharmacology in the Welsh National School of Medicine, died in London on May 19, aged 62. THE death is also announced of Dr. J. R. C. GREENLEES, D.S.O., headmaster of Loretto from 1926 to 1945 and latterly chairman of the South Eastern Regional Hospital Board for Scotland.
general
MEDICAL REGISTER for 1951 contains 80,222 of doctors, an increase of 1082 on last year’s total. The new registrations in 1950 numbered 316U, which is 51 more than in 1949, and 32 above the average for the last ten years, but 808 less than in 1948 (the peak year). The Commonwealth list has increased by 494 to 7064, and the foreign list by 86 to 1991. The Register is pulsashed for the General Medical Council, 44, Hallam Co., Ltd., 10, Stre&oy London, W.1, by Constable & Orange Street, W.C.I. It is in two volumes, and the price is 42s. The
names
diagnosis ’may
block by
arteriography.
The thrombosis takes place most commonly in the carotid sinus at the beginning of the artery, but it may In occur in the part of the artery in the carotid canal. an exhaustive study Hultquist 6 found changes in the brain in only one-third of the cases of occlusion of the internal carotid artery below the origin of the ophthalmic artery, and possibly the lesion may sometimes give rise to no symptoms ; whether symptoms are produced or not presumably depends on the adequacy of the circulation through the circle of Willis. The commonest pathological basis for thrombosis appears to be atheroma in the carotid sinus ; and, as Chiari7 pointed out in 1905, atheroma of the carotid sinus can also be a source of More rarely the underlying arterial cerebral emboli. disease is thrombo-angiitis obliterans.8 The pathology and clinical characteristics of thrombosis of the internal carotid artery will be further clarified by routine postmortem examination of the whole length of the vessel, by keeping the condition in mind in cases of unexplained hemiplegia, and by arteriographic examination. TAKING THE CURE To provide an authoritative statement on the place of the spa in modern practice, the British Medical Association appointed a committee under the chairmanship of Lord Horder. Its report 10 forms a guide to all the spas in Great Britain, and describes the various forms of treatment obtainable at each. Among the conditions in which the committee believes that spa treatment can be of great value are chronic arthritis of the rheumatoid and degenerative types ; muscular, fascial, and fibrositic rheumatism ; infections of the urinary - tract ; pelvic disorders in women ; and certain cardiovascular and nervous disorders. It also thinks that far’more use could be made of the spas for patients recovering from acute illness, whether medical or surgical. Anticipating the argument that the physical treatment available at spas could be given equally well at any suitably equipped hospital, it points out that, apart from the-concentration of specialised medical facilities, the spas are attractive places with equable climates, and have the amenities of holiday resorts ; hence the benefits of physical treatment are supplemented by the important psychological effects of a complete change " in attractive surroundings with ample opportunity for recreation. The committee concludes that the profession in general tends to underestimate the value of spas, and in many ways fails to appreciate the progress made at these centres in recent years. Increasing cooperation between the spa hospitals and the universities and teaching hospitals will promote research, permit greater continuity of treatment and standardisation of investigation and follow-up, and help the spas.to take their proper place in the National Health "
Service. 6.
7. 8.
9.
10.
G. T. Über Thrombose und Embolie der Arteria carotis und hierbei vorkommende Gehirnstörungen. Jena, 1942. Chiari, H. Verh. dtsch. path. Ges. 1905, 9, 326. Antoni, N. Acta med. scand. 1941, 108, 502. Andrell, P. O. Ibid, 1943, 114, 336. The members of the committee were : Dr. R. G. ANDERSON, Dr. C. W. BUCKLEY, Sir HENRY COHEN, Dr. J. E. DAWSON, Dr. C. R. GIBSON, Prof. S. J. HARTFAIL, Dr. G. D. KERSLEY, Dr. T. G. REAH, Dr. F. A. SMORFITT, Dr. R. W. STEWART, Dr. D. F. WHITAKER, Dr. D. WILSON, Dr. H. B. WOODHOUSE, and Dr. W. YEOMAN ; the Ministry of Health was represented by Dr. E. T. CONYBEARE and Dr. F. S. COOKSEY. The secretary of the committee was Dr. E. E. CLAXTON. The Spa in Medical Practice. B.M.A. House, Tavistock Square, W.C.1. 1951. Pp. 96. 3s. 6d.
Hultquist,
THE JENNER MEDALLIST CELEBRATING the centenary of Jenner in 1896 the Epidemiological Society of London founded a medal to be awarded from time to time for distinguished work in epidemiological research or for pre-eminence in the prevention and control of epidemic disease. The ten recipients have been William Power, A. Laveran, Patrick Manson, Shirley Murphy, John McVail, Monckton Copeman, T. H. C. Stevenson, George Buchanan, Arthur Newsholme, and Major Greenwood ; and last week a new name was added to the list-that of James Alison Glover. In recounting Dr. Glover’s achievements to a meeting of the section of epidemiology of the Royal Society of Medicine, Dr. W. H. Bradley, the president, singled out three of them as sufficient evidence of great merit." First was his work on the Prevention of Cerebrospinal Fever, published by the Medical Research Council in 1920, which led the Army’s director of pathology to say that " he has been a good friend to the private soldier." Second was his report to the Ministry of Health in 1924 on the Incidence of Rheumatic Diseases, still cited as basic. And third were his Milroy .lectures of 1930, including some of his early observations on the streptococcal tonsillitis preceding acute rheumatism. " In all this work his concern has been for the sick person," and his qualities have endeared him to an ever-increasing circle. From 1934 he was the senior medical officer of the Board of Education, and now, ten years after reaching the Civil Service retiring age, he still puts in a good day’s work at the Ministry of Health, giving wise counsel at the highest level, although his rank is only that oftemporary ’ medical officer." On receiving his medal from Lord Webb-Johnson, president of the Royal Society of Medicine, Dr. Glover spoke of his father’s work as a port medical officer and attributed his own epidemiological contributions to the influence and help of his father and his friends. He commended the instruction graven on his medalveniente occurrite morbo-" run to oppose the coming "
"
disease." WORLD HEALTH ORGANISATION meeting of the Fourth World Health Assembly on May 16, Germany, Japan, and Spain were admitted to the organisation ; this brings the total membership of W.H.O. up to 78 full members and 1 associate member. The six countries elected to nominate members to serve on the executive board for the next 12 months were Belgium, Ceylon, Cuba, Greece, Lebanon, -and Liberia. These members will replace those whose term of office expired this year; other members come from
AT
a
Chile, El Salvador, France, Italy, Pakistan, Philippines, Sweden, Thailand, Turkey, United Kingdom, United States of America, and Venezuela. WE have to record the death
on
May
16 of
Surgeon
Vice-Admiral Sir BASIL HALL, K.C.B., medical directorof the Royal Navy from 1934 to 1937. Dr. R. ST. A. HEATHCOTE, F.R.C.P., formerly professor of pharmacology in the Welsh National School of Medicine, died in London on May 19, aged 62. THE death is also announced of Dr. J. R. C. GREENLEES, D.S.O., headmaster of Loretto from 1926 to 1945 and latterly chairman of the South Eastern Regional Hospital Board for Scotland.
general
MEDICAL REGISTER for 1951 contains 80,222 of doctors, an increase of 1082 on last year’s total. The new registrations in 1950 numbered 316U, which is 51 more than in 1949, and 32 above the average for the last ten years, but 808 less than in 1948 (the peak year). The Commonwealth list has increased by 494 to 7064, and the foreign list by 86 to 1991. The Register is pulsashed for the General Medical Council, 44, Hallam Co., Ltd., 10, Stre&oy London, W.1, by Constable & Orange Street, W.C.I. It is in two volumes, and the price is 42s. The
names