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674 water and covered our exposed heads with our towels. For ten minutes it blew, hotly suffocating, then the dust thinned out and big splashes of rain- began to fall. Bigger and faster they came until it was a deluge, and the spray from the splashes was whipped violently away by the wind and blown down the river like a mist. Another ten minutes and like a tap turned off the deluge ceased, the sky cleared, and the sun once more blazed down. The air smelt invigorating and clean, and the dusty bushes and drooping palms looked fresh and alive and intensely green again. The -birds returned to their incessant twittering in the trees and the storm over Burma was over. * * * Not even our best friends could describe us as highclass ; nevertheless, and in spite of ourselves, we are being steadily forced up the social ladder by the gardener. When he told us that he intended to put in seakale this year we were all for it, for like most sensible persons we are partial to a bit of seakale just as we don’t turn up our noses at asparagus or spinach or even strawberries. But our personal likes and dislikes had nothing to do with the gardener’s reason for planting seakale. " I don’t like to see a gentleman’s garden wi’out seakale " growin’ in it was how and why we got it. By the same authority, we are disallowed radishes. " They’m a workin’ class vegetable," he says firmly, and that closes the conversation. The fact that social distinctions extend to the vegetable kingdom is new to me, though I have once heard winkles, cockles, and muscles snobbishly referred to as " poor man’s fish." ,-
.
Letters
TRANSFUSION
CASUALTIES DIED
’
W. F. CALDWELL, GLASCt., RAMC
Captain GORDON HOUSEMAN, MRCS,
MRCS, RAFVR
WOUNDED
Captain MB
WILLIAMS,
RAMC
-
I
Lieut.-Colonel G. E. ORD, MB ABERD., RAMC Captain W. H McN. Wuso, MB
GLASG., RAMC
AWARDS
MEMOIR J. N. WILLIAMS, who
was born in 1915, studied medicine at Guy’s Hospital and qualified in 1939. After holding house-appointments at Belgrave Hospital, the Seamen’s Hospital, Greenwich, and King George’s Sanatorium, Liphook, he was appointed to a commission as flying-officer in the medical branch of the Royal Air Force Volunteer Reserve in 1941. He died on May 10 of injuries received in an accident while serving as medical officer at an airfield wing headquarters in NW Europe.
Squadron-Leader
SERVICE
with the result that the staff has grown accuetomed to unstinted supplies. During the past two years, we have used at this hospital approximately 1000 pints of blood and 1000 pints of plasma, annually ; this works out at 2-5 pints of each per occupied bed, involving the bleeding of approximately 4000 donors per annum. And the amount steadily increases. Whilst it is possible that a substitute for plasma may be forthcoming, it isdifficult to imagine a future when whole blood would not be required. Blood-transfusion is one of the most valuable therapeutic measures available, but (like other treatment) it costs money and must be paid for. Questions to which I would like an answer are these : (1) .Can an adequate supply of blood donors be obtained
hospitals,
(2) (3)
without payment and/or pressure on relatives and friends of patients to supply blood ? How far should the personnel employed in bleeding, grouping, and administration of the service be on a voluntary basis ? Are we to continue to enjoy the valuable aid of the Ministry of Health in the processing of plasma and the supply of apparatus ? Can we rely in the future on the help of special laboratories, such as the Galton Laboratory at Cambridge, to help in elucidating grouping
problems ?
On Active Service
JoHN NORMAL
the Editor
SIR,-Through the generosity of blood donors during the war, ample supplies of whole blood and plasma have been available for the treatment of civilian patients in
.
Squadron-Leader
to
These are questions which must be in the minds of many transfusion officers, and now with peace in Europe demand an early and satisfactory answer. E. BIDDLE, Transfusion Officer, East Suffolk and Ipswich Hospital. THE MEDICAL SUPERINTENDENT SiR,-Sir Frederick Menzies does well to point out the difference between special and general municipal hospitals, for herein lies the crux of the problem of administration. The special hospital employs as a rule only one team, firm, or unit of doctors, the senior member of which is not only the head of the hospital but also the chief administrator. In practice he delegates much of the day-to-day administration to a lay secretary. But nowadays quite a different state of affairs exists in the more enlightened municipal general hospitals. In these there are now full-time or part-time .specialists in charge of the different departments, who are of equal who until a few status ; and the medical superintendent, " " years ago was the only specialist in the hospital (apart from occasional visits from odd visiting ones), is now one of many. Should he under these altered conditions continue to exercise autocratic powers;? Should ’’ of the he continue to be the " boss " or " captain hospital ? Or should these powers be’surrendered to a committee of the responsible specialists ?P On this point the recommendations of the Goodenough report on medical schools (p. 67, paras. 19-21) are clear and concise. T. M. J. D’OFFAY. Leicester. PSYCHOSOMATIC MEDICINE AND THE BIRTH-RATE to express my appreciation of the should like SIR,-I article by Dr. J. L. Halliday in your issue of May 12. The fact, and the widespread incidence, of social disintegration need emphasis, especially in these days of wishful thinking ; though, to be sure, the history so far of the present century is sufficient proof for all with eyes to see. I particularly agree with Dr. Halliday’s tracing of the pathology of the condition to the loss of the individual person’s sense of belonging to some society greater than himself, with consequent isolation, insecurity and anxiety, frustration, and resentment. But are Dr. Halliday’s remedies, as far as he has stated them, sufficient ? Doctors are notoriously chary of venturing outside the scope of their science and art into wider philosophical issues ; but inasmuch as health truly means wholeness, and that of the personality in all its aspects, in this particular matter they can hardly avoid doing so. The failure of a purely secular solution to this ’
.
Letters
TRANSFUSION
CASUALTIES DIED
’
W. F. CALDWELL, GLASCt., RAMC
Captain GORDON HOUSEMAN, MRCS,
MRCS, RAFVR
WOUNDED
Captain MB
WILLIAMS,
RAMC
-
I
Lieut.-Colonel G. E. ORD, MB ABERD., RAMC Captain W. H McN. Wuso, MB
GLASG., RAMC
AWARDS
MEMOIR J. N. WILLIAMS, who
was born in 1915, studied medicine at Guy’s Hospital and qualified in 1939. After holding house-appointments at Belgrave Hospital, the Seamen’s Hospital, Greenwich, and King George’s Sanatorium, Liphook, he was appointed to a commission as flying-officer in the medical branch of the Royal Air Force Volunteer Reserve in 1941. He died on May 10 of injuries received in an accident while serving as medical officer at an airfield wing headquarters in NW Europe.
Squadron-Leader
SERVICE
with the result that the staff has grown accuetomed to unstinted supplies. During the past two years, we have used at this hospital approximately 1000 pints of blood and 1000 pints of plasma, annually ; this works out at 2-5 pints of each per occupied bed, involving the bleeding of approximately 4000 donors per annum. And the amount steadily increases. Whilst it is possible that a substitute for plasma may be forthcoming, it isdifficult to imagine a future when whole blood would not be required. Blood-transfusion is one of the most valuable therapeutic measures available, but (like other treatment) it costs money and must be paid for. Questions to which I would like an answer are these : (1) .Can an adequate supply of blood donors be obtained
hospitals,
(2) (3)
without payment and/or pressure on relatives and friends of patients to supply blood ? How far should the personnel employed in bleeding, grouping, and administration of the service be on a voluntary basis ? Are we to continue to enjoy the valuable aid of the Ministry of Health in the processing of plasma and the supply of apparatus ? Can we rely in the future on the help of special laboratories, such as the Galton Laboratory at Cambridge, to help in elucidating grouping
problems ?
On Active Service
JoHN NORMAL
the Editor
SIR,-Through the generosity of blood donors during the war, ample supplies of whole blood and plasma have been available for the treatment of civilian patients in
.
Squadron-Leader
to
These are questions which must be in the minds of many transfusion officers, and now with peace in Europe demand an early and satisfactory answer. E. BIDDLE, Transfusion Officer, East Suffolk and Ipswich Hospital. THE MEDICAL SUPERINTENDENT SiR,-Sir Frederick Menzies does well to point out the difference between special and general municipal hospitals, for herein lies the crux of the problem of administration. The special hospital employs as a rule only one team, firm, or unit of doctors, the senior member of which is not only the head of the hospital but also the chief administrator. In practice he delegates much of the day-to-day administration to a lay secretary. But nowadays quite a different state of affairs exists in the more enlightened municipal general hospitals. In these there are now full-time or part-time .specialists in charge of the different departments, who are of equal who until a few status ; and the medical superintendent, " " years ago was the only specialist in the hospital (apart from occasional visits from odd visiting ones), is now one of many. Should he under these altered conditions continue to exercise autocratic powers;? Should ’’ of the he continue to be the " boss " or " captain hospital ? Or should these powers be’surrendered to a committee of the responsible specialists ?P On this point the recommendations of the Goodenough report on medical schools (p. 67, paras. 19-21) are clear and concise. T. M. J. D’OFFAY. Leicester. PSYCHOSOMATIC MEDICINE AND THE BIRTH-RATE to express my appreciation of the should like SIR,-I article by Dr. J. L. Halliday in your issue of May 12. The fact, and the widespread incidence, of social disintegration need emphasis, especially in these days of wishful thinking ; though, to be sure, the history so far of the present century is sufficient proof for all with eyes to see. I particularly agree with Dr. Halliday’s tracing of the pathology of the condition to the loss of the individual person’s sense of belonging to some society greater than himself, with consequent isolation, insecurity and anxiety, frustration, and resentment. But are Dr. Halliday’s remedies, as far as he has stated them, sufficient ? Doctors are notoriously chary of venturing outside the scope of their science and art into wider philosophical issues ; but inasmuch as health truly means wholeness, and that of the personality in all its aspects, in this particular matter they can hardly avoid doing so. The failure of a purely secular solution to this ’