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ZINC CHLORIDE FOR FIRE FIGHTING
680
Letters
to
the Editor
"EFFORT SYNDROME" SIR,-There have recently been many learned and careful articles on effort syndrome in the medical journals. If one’s experience were limited to reading these alone, one would come inevitably to the conclusion that effort syndrome was a definite common disease, that was created in the beginning, walked out of the Ark, and brought forth after its" kind. The Oxford dictionary definition of syndrome is a concurrence of several symptoms in a disease," so that if the word syndrome is used one is justified in assuming that it represents a definite disease process. However, one’s experience is not limited to the journals. One sees patients. And here I would like to put forward a purely personal point of view, which may arouse some disagreement ; but I do not apologise for it, for it is sometimes profitable to question the value of established concepts. In seven years of very varied psychiatric practice I have never seen a case of effort syndrome. Since the beginning of this war I have been constantly seeing Army and Air Force patients, and though looking for the condition I failed to find it. Had I been missing it ? In view of its importance as judged by the press this seemed extremely odd. Had I lost my ability to diagnose patients and correlate my reading with clinical experience ? Or perhaps I was calling it
something else, or again, even more rebellious thought, perhaps there was no such thing. Obviously the latter view was most pleasing to me, and hence this letter a mere popgun (or sling ?) breathing a brief defiance at some of the heaviest artillery which it is the pride of the medical profession to muster. After all, did not GroupCaptain Symonds recently beard the psychologists in their own den ? I will take courage and proceed. Even a psychiatrist is entitled to do his bit of bearding. To elucidate this problem I thought of several cases I had seen which might have been diagnosed as suffering from this mysterious complaint. One in particular impressed me. Let us call him The Marine who was Angry." I was called to see a 24-year old marine, a burly well-built fellow, complaining of tremor, palpitations, pain over his heart and excessive sweating. Instead of diagnosing effort syndrome however, I had taken a history which led to a rather different conclusion. A healthy and somewhat hot-tempered fellow, he had carried out his duty on board his ship in the Indian Ocean until 5 months previously. He had lent jE4 to a mate who had failed to return it. A fight resulted. He was brought before the captain who said that not only had he disturbed the ship with brawling but he had also broken regulations by lending money. Discipline must be preserved,he would therefore forfeit the money and do ten days C.B. The marine did his punishment, but with black rage in his heart. On ending it he went on parade. The officer inspecting stopped opposite him and said " Look at this silly fellow (or words to that effect). What do you mean by coming on parade with long hair like a girl ? " The marine trembled, his heart raced, he sweated from every pore in his body, he grasped his rifle, he raised it a little from the ground to bash the officer for such an ill-timed insult. But fortunately he restrained himself. The palpitations and the sweating and the trembling however recurred whenever he was with an officer, especially that officer. This was noticed, and he was asked what was the matter. Not considering it tactful to reply, Because I want to bash you, Sir," he said he just felt bad and trembly. He was sent to the M.O., an officer in whose company the symptoms persisted. He was put in a shore hospital in Africa. A physician there demonstrated him before five students as a case of Graves’s disease, saying that he would never be well until he had his thyroid out. This gave the marine food for thought. He was obviously really ill. He began to suffer from choky feeling, pain round the heart and thought perhaps he had heart trouble too. Fortunately no surgeon could be persuaded to attack his throat, and during the next four months he gravitated slowly, through many hospitals, to England. "
"
’
His mental state when I saw him could be summarised as of pent-up fury. An opportunity to tell his story, general appeasement, and release of some of his anger, helped him greatly. It was at first difficult to persuade him that he was not really ill, but demonstration as a case not suffering from
one
heart disease, in front of fifteen students, of his healthiness. There were many other difficulties about which he needed help, such as his deserGraves’s disease
or
finally persuaded him
by his mother at an early age, his early struggles in orphanage, his intolerance to authority, his sensitivity
tion
an
to
criticism and his intention never to marry because his mother had failed in her duties. One could give these psychological factors names like frustrated Oedipus complex or overcompensated inferiority complex, if one had a taste for jargon, but it would serve no useful purpose. Nor does it serve any useful purpose to call his bodily symptoms by the name " effort syndrome." Simple psychotherapy on the above lines enabled him to return to duty within three weeks with his aggression directed to more useful channels and unlucky would be the German foe who should cross his irate path.
There are many similar cases to this. This man was not suffering from any disease at all, except perhaps what Mr. Russell Howard used to call " iatrogenic " or doctor-produced disease. The symptoms of the anxiety state are protean, but it is surely illogical to split off the cardiac symptoms and dignify them with the high sounding term " effort syndrome." Why not gastric syndrome, head syndrome, abdominal syndrome ? I would suggest that the effort syndrome represents no disease at all. It is only an idea, an idea which served a useful purpose in the last war, but it is now an idea which has outlived its usefulness. Cannot all the cases at present classified as effort syndrome be more reasonably diagnosed as (1) suffering from anxiety state ; (2) post-infective neurocirculatory asthenia-e.g., after ’flu; (3) undiscovered organic disease, such as sinus infection, early tuberculosis, or even cardiac rheumatism or syphilis; (4) cordite poisoning; (5) weedy fellows who can’t do much at all ?P Effort syndrome, in fact, is strictly analogous to the term " vapours" as used in the eighteenth century to cover conditions such as early tuberculosis, vaso-vagal attacks, petit mal, hysteria and tight corsets. FELIX BROWN. Guy’s Hospital. PITUITARY SHOCK SiR,-Your leader of May 10 on pituitary extract in obstetrics reminds me of an experience some years ago. I was called out to see a case in a so-called twilight sleep maternity home where the night nurse, through ignorance or carelessness (or both), had been giving the patient, instead of hyoscine hydrobromide gr. 1/400, an injection of pituitary extract 1 c.cm. every hour for at least four hours. I found the patient profoundly shocked. Her face was cold and clammy ; her pulse was rapid, about 160 and of small volume ; she had sighing respirations. The uterus was in tonic contraction. She was obviously suffering from pituitary shock, and I thought we were going to lose her. The foot of the bed was raised by placing it on the seat of a chair, hotwater bottles were placed in the bed and extra blankets added, and hot tea with plenty of sugar was given by mouth. In half an hour her condition had improved and next day, with the aid of a little chloroform to relieve the terminal pains, she gave birth to a full-term child which seemed not to have suffered in any way. C. HORWITZ. London, N.I. ZINC CHLORIDE FOR FIRE FIGHTING come to my knowledge that solutions of zinc chloride are being sold to the public for attacking incendiary bombs through the stirrup hand-pump. I am informed that these solutions contain about 70% of zinc chloride, and it seems right to issue a warning against the use of such solutions, especially in confined spaces. Zinc chloride in this strength is a corrosive poison, and if some of it got into the eye it would be extremely painful, it would produce temporary blindness, thus immediately incapacitating the operator of the pump. and even if effectual treatment was applied at once permanent damage would be likely to result. I am further informed that when these solutions are brought into contact with burning magnesium, fumes of hydrochloric acid and zinc chloride are evolved. If such fumes are inhaled there may be serious effects in the respiratory passages. Finally, if such solutions come into contact with the skin and are not washed off they may cause skin lesions.
SiB,—It has
681 I am not in a position to express any opinion as to whether such solutions are greatly superior to water in dealing with incendiaries and the fires caused thereby, but I do express the opinion that, unless this be so, the possible dangers involved from their use are such that it would be most undesirable for the public to have unrestricted use of them. St. Mary’s Hospital, Paddington.
G. ROCHE LYNCH.
SULPHADIAZINE
SiR.-The clinical trials with what you call in your annotation of Feb. 15 a promising new sulphonamide - sulphadiazine-have exceeded much of the original hopes for it. It has been found to be exceedingly well tolerated by the human body, much better so than sulphathiazole or sulphapyridine. Whether or not it is inherently more active, as you have pointed out, is questionable, but higher blood concentrations are well tolerated in man as was suggested by the experimental work with animals. This has resulted in more effective action on the setiological agents of the various infections in which it has been used. These have included pneumococcal, streptococcal, Welch bacillary, staphylococcal and Friedlander’s bacillary infections. The effect of sulphadiazine on refractory cases of gonococcal infections in man is being investigated by Dr. Hugh H. Young and his co-workers at the Johns Hopkins Hospital. Experimentally type A as well as type B Friedlander’s bacillary infections have been successfully treated with sulphadiazine. Experimentally, also, the work in progress at the school of medicine of the University of Rochester indicates that sulphadiazine is much more effective in the treatment of Welch bacillary infection than any of the other sulphonamides. This infection was produced in dogs in such a manner that it very closely simulates gas gangrene as it is found in the field. Stamford, Conn., U.S.A.
W. HARRY FEINSTONE.
" SCIATICA "
gratifying to note that Dr. Walshe agrees with me in stressing the frequency with which sciatic neuritis is wrongly diagnosed. The diagnostic criteria which he lays down for this complaint, such as pain along the course of the nerve, pain on pressing or stretching the nerve, pain and tenderness in muscles supplied by it," were however present in my 70 cases, and it was precisely these signs that had led to the diagnosis of sciatic neuritis by various doctors whose competence SIR,-It
was
"
cannot be doubted. These signs are so familiar to us all, that in my case-reports they were for brevity covered by this single term " sciatica." The fact that Dr. Walshe still regards these signs as reliable evidence of neuritis shows a happy disregard for the mass of original work which has been done on this subject during the past 30 years, and suggests that the diagnosis of sciatic neuritis will continue to be made with great frequency. J. H. KELLGREN. Leavesden Hospital. ENDOCARDITIS LENTA I SiR,-May ask Dr. Parkes Weber in what way his case of subacute bacterial endocarditis, and the others mentioned by him, differ from the well-known clinical picture of the bacteria-free stage described by Libman (Amer. J. med. Sci. 1913, 146, 625). I have seen at least one case recently in which the blood-culture was repeatedly negative and even at autopsy bacteria were not found in the vegetations. Neither heparin nor sulphonamides were used in this case. In reviewing cases of endocarditis lenta it should be remembered that spontaneous remissions occur, and that the disappearance of organisms from the blood and heart valves in no way negatives a fatal termination to the disease. Westminster Hospital.
MAGNUS HAINES.
GEORGE THEODORE ROBERTSON WATT M.B. ABERD. ; SURGEON LIEUTENANT, R.N.V.R. Surgeon Lieutenant G. T. Robertson Watt is reported to have been lost during the evacuation of the Imperial Forces from Greece, and the Admiralty have intimated that he must be presumed to have been killed on active service. Watt, who was in.his 29th year, was the eldest son of Mr. Theodore Watt, LL.D., managing director of the Aberdeen University Press, and Mrs. Watt of Culter House, Aberdeenshire. He spent 13 years at the Aberdeen Grammar School, and during his last year he was a prefect. He graduated in medicine at Aberdeen University in 1936, and became assistant to Dr. George Mitchell of Insch. The following August he was appointed a resident medical officer at Aberdeen Royal Infirmary. Later he became house-surgeon at Mount Vernon Hospital, at the Aberdeen Maternity Hospital, and at the lor Jessop Sheffield, for j essop Hospital. nOSpl1JI:tl. oneiiieiu., :M had already determined to specialise in obstetrics and gynaecology. In June of last year he was commissioned as a surgeon lieutenant in the R.N.V.R., and shortly afterwards was posted to H.M.S. Wryneck. L. F. writes : George Watt had a wide interest in student activities but was happier breathing the free air of the Cairngorms than on the organised playing-field. He was willing to fight and die for his country, knowing that liberty itself was in jeopardy, but had he been spared to see his country victorious he would still have fought on for the creation of peace and unity among nations. His vision was the wide vision of youth. —————— ——
SiR,-In the official memorandum on Gas Casualties printed in your issue of May 10 (p. 613) should not the first sentence of the concluding paragraph, which reads The gas-mask, if adjusted properly and in time, gives full protection to the lungs and eyes against all these gases " have added to it the words except carbon "
"
monoxide "? A. G. SANDERS.
———...——.
JOHN MURDOCH McKILLOP GLASG. ; LIEUTENANT, R.A.1BLC. Dr. J. M. McKillop was educated at the Kelvinside Academy and Glasgow University. He was a young man of powerful physique, keen on all sports. At school he played rugger and he was an enthusiastic yachtsman ; for many years he competed in the Loch Long dinghy 1BI.B.
class.
1938
He qualified
and
M. B.
in
held resident
appointments at three of the at corporation hospitals Stobhill Hospital lie was house-physician to Prof. B oah -
Morris. McKillop was a careful worker and his frankness combined with a well-developed sense of humour made him popular with his patients. He joined up as soon as war was declared and he served as a lieutenant in the R.A.M.C. attached to the 2nd battalion of the Seaforth Highlanders. He went to France in October, 1939, and on June 11. 1940, he was wounded at IngouvilleHe died the sur-mer, Seine.
Murdoch McKillop Jack
CARBON MONOXIDE
Oxford.
Obituary
McKillop
was the only son of the late Mr. and Mrs. Nora McKillop. He was 26
years old. The Minister of Food has made an order, to come into force June 2, prohibiting, except under licence, the manufacture or sale of vitamin C. The order does not apply to the manufacture or sale of vitamin C for medicinal, pharmaceutical or scientific purposes. Applications for licences should be made to the Ministry at St. John’s College, Oxford. on
Letters
to
the Editor
"EFFORT SYNDROME" SIR,-There have recently been many learned and careful articles on effort syndrome in the medical journals. If one’s experience were limited to reading these alone, one would come inevitably to the conclusion that effort syndrome was a definite common disease, that was created in the beginning, walked out of the Ark, and brought forth after its" kind. The Oxford dictionary definition of syndrome is a concurrence of several symptoms in a disease," so that if the word syndrome is used one is justified in assuming that it represents a definite disease process. However, one’s experience is not limited to the journals. One sees patients. And here I would like to put forward a purely personal point of view, which may arouse some disagreement ; but I do not apologise for it, for it is sometimes profitable to question the value of established concepts. In seven years of very varied psychiatric practice I have never seen a case of effort syndrome. Since the beginning of this war I have been constantly seeing Army and Air Force patients, and though looking for the condition I failed to find it. Had I been missing it ? In view of its importance as judged by the press this seemed extremely odd. Had I lost my ability to diagnose patients and correlate my reading with clinical experience ? Or perhaps I was calling it
something else, or again, even more rebellious thought, perhaps there was no such thing. Obviously the latter view was most pleasing to me, and hence this letter a mere popgun (or sling ?) breathing a brief defiance at some of the heaviest artillery which it is the pride of the medical profession to muster. After all, did not GroupCaptain Symonds recently beard the psychologists in their own den ? I will take courage and proceed. Even a psychiatrist is entitled to do his bit of bearding. To elucidate this problem I thought of several cases I had seen which might have been diagnosed as suffering from this mysterious complaint. One in particular impressed me. Let us call him The Marine who was Angry." I was called to see a 24-year old marine, a burly well-built fellow, complaining of tremor, palpitations, pain over his heart and excessive sweating. Instead of diagnosing effort syndrome however, I had taken a history which led to a rather different conclusion. A healthy and somewhat hot-tempered fellow, he had carried out his duty on board his ship in the Indian Ocean until 5 months previously. He had lent jE4 to a mate who had failed to return it. A fight resulted. He was brought before the captain who said that not only had he disturbed the ship with brawling but he had also broken regulations by lending money. Discipline must be preserved,he would therefore forfeit the money and do ten days C.B. The marine did his punishment, but with black rage in his heart. On ending it he went on parade. The officer inspecting stopped opposite him and said " Look at this silly fellow (or words to that effect). What do you mean by coming on parade with long hair like a girl ? " The marine trembled, his heart raced, he sweated from every pore in his body, he grasped his rifle, he raised it a little from the ground to bash the officer for such an ill-timed insult. But fortunately he restrained himself. The palpitations and the sweating and the trembling however recurred whenever he was with an officer, especially that officer. This was noticed, and he was asked what was the matter. Not considering it tactful to reply, Because I want to bash you, Sir," he said he just felt bad and trembly. He was sent to the M.O., an officer in whose company the symptoms persisted. He was put in a shore hospital in Africa. A physician there demonstrated him before five students as a case of Graves’s disease, saying that he would never be well until he had his thyroid out. This gave the marine food for thought. He was obviously really ill. He began to suffer from choky feeling, pain round the heart and thought perhaps he had heart trouble too. Fortunately no surgeon could be persuaded to attack his throat, and during the next four months he gravitated slowly, through many hospitals, to England. "
"
’
His mental state when I saw him could be summarised as of pent-up fury. An opportunity to tell his story, general appeasement, and release of some of his anger, helped him greatly. It was at first difficult to persuade him that he was not really ill, but demonstration as a case not suffering from
one
heart disease, in front of fifteen students, of his healthiness. There were many other difficulties about which he needed help, such as his deserGraves’s disease
or
finally persuaded him
by his mother at an early age, his early struggles in orphanage, his intolerance to authority, his sensitivity
tion
an
to
criticism and his intention never to marry because his mother had failed in her duties. One could give these psychological factors names like frustrated Oedipus complex or overcompensated inferiority complex, if one had a taste for jargon, but it would serve no useful purpose. Nor does it serve any useful purpose to call his bodily symptoms by the name " effort syndrome." Simple psychotherapy on the above lines enabled him to return to duty within three weeks with his aggression directed to more useful channels and unlucky would be the German foe who should cross his irate path.
There are many similar cases to this. This man was not suffering from any disease at all, except perhaps what Mr. Russell Howard used to call " iatrogenic " or doctor-produced disease. The symptoms of the anxiety state are protean, but it is surely illogical to split off the cardiac symptoms and dignify them with the high sounding term " effort syndrome." Why not gastric syndrome, head syndrome, abdominal syndrome ? I would suggest that the effort syndrome represents no disease at all. It is only an idea, an idea which served a useful purpose in the last war, but it is now an idea which has outlived its usefulness. Cannot all the cases at present classified as effort syndrome be more reasonably diagnosed as (1) suffering from anxiety state ; (2) post-infective neurocirculatory asthenia-e.g., after ’flu; (3) undiscovered organic disease, such as sinus infection, early tuberculosis, or even cardiac rheumatism or syphilis; (4) cordite poisoning; (5) weedy fellows who can’t do much at all ?P Effort syndrome, in fact, is strictly analogous to the term " vapours" as used in the eighteenth century to cover conditions such as early tuberculosis, vaso-vagal attacks, petit mal, hysteria and tight corsets. FELIX BROWN. Guy’s Hospital. PITUITARY SHOCK SiR,-Your leader of May 10 on pituitary extract in obstetrics reminds me of an experience some years ago. I was called out to see a case in a so-called twilight sleep maternity home where the night nurse, through ignorance or carelessness (or both), had been giving the patient, instead of hyoscine hydrobromide gr. 1/400, an injection of pituitary extract 1 c.cm. every hour for at least four hours. I found the patient profoundly shocked. Her face was cold and clammy ; her pulse was rapid, about 160 and of small volume ; she had sighing respirations. The uterus was in tonic contraction. She was obviously suffering from pituitary shock, and I thought we were going to lose her. The foot of the bed was raised by placing it on the seat of a chair, hotwater bottles were placed in the bed and extra blankets added, and hot tea with plenty of sugar was given by mouth. In half an hour her condition had improved and next day, with the aid of a little chloroform to relieve the terminal pains, she gave birth to a full-term child which seemed not to have suffered in any way. C. HORWITZ. London, N.I. ZINC CHLORIDE FOR FIRE FIGHTING come to my knowledge that solutions of zinc chloride are being sold to the public for attacking incendiary bombs through the stirrup hand-pump. I am informed that these solutions contain about 70% of zinc chloride, and it seems right to issue a warning against the use of such solutions, especially in confined spaces. Zinc chloride in this strength is a corrosive poison, and if some of it got into the eye it would be extremely painful, it would produce temporary blindness, thus immediately incapacitating the operator of the pump. and even if effectual treatment was applied at once permanent damage would be likely to result. I am further informed that when these solutions are brought into contact with burning magnesium, fumes of hydrochloric acid and zinc chloride are evolved. If such fumes are inhaled there may be serious effects in the respiratory passages. Finally, if such solutions come into contact with the skin and are not washed off they may cause skin lesions.
SiB,—It has
681 I am not in a position to express any opinion as to whether such solutions are greatly superior to water in dealing with incendiaries and the fires caused thereby, but I do express the opinion that, unless this be so, the possible dangers involved from their use are such that it would be most undesirable for the public to have unrestricted use of them. St. Mary’s Hospital, Paddington.
G. ROCHE LYNCH.
SULPHADIAZINE
SiR.-The clinical trials with what you call in your annotation of Feb. 15 a promising new sulphonamide - sulphadiazine-have exceeded much of the original hopes for it. It has been found to be exceedingly well tolerated by the human body, much better so than sulphathiazole or sulphapyridine. Whether or not it is inherently more active, as you have pointed out, is questionable, but higher blood concentrations are well tolerated in man as was suggested by the experimental work with animals. This has resulted in more effective action on the setiological agents of the various infections in which it has been used. These have included pneumococcal, streptococcal, Welch bacillary, staphylococcal and Friedlander’s bacillary infections. The effect of sulphadiazine on refractory cases of gonococcal infections in man is being investigated by Dr. Hugh H. Young and his co-workers at the Johns Hopkins Hospital. Experimentally type A as well as type B Friedlander’s bacillary infections have been successfully treated with sulphadiazine. Experimentally, also, the work in progress at the school of medicine of the University of Rochester indicates that sulphadiazine is much more effective in the treatment of Welch bacillary infection than any of the other sulphonamides. This infection was produced in dogs in such a manner that it very closely simulates gas gangrene as it is found in the field. Stamford, Conn., U.S.A.
W. HARRY FEINSTONE.
" SCIATICA "
gratifying to note that Dr. Walshe agrees with me in stressing the frequency with which sciatic neuritis is wrongly diagnosed. The diagnostic criteria which he lays down for this complaint, such as pain along the course of the nerve, pain on pressing or stretching the nerve, pain and tenderness in muscles supplied by it," were however present in my 70 cases, and it was precisely these signs that had led to the diagnosis of sciatic neuritis by various doctors whose competence SIR,-It
was
"
cannot be doubted. These signs are so familiar to us all, that in my case-reports they were for brevity covered by this single term " sciatica." The fact that Dr. Walshe still regards these signs as reliable evidence of neuritis shows a happy disregard for the mass of original work which has been done on this subject during the past 30 years, and suggests that the diagnosis of sciatic neuritis will continue to be made with great frequency. J. H. KELLGREN. Leavesden Hospital. ENDOCARDITIS LENTA I SiR,-May ask Dr. Parkes Weber in what way his case of subacute bacterial endocarditis, and the others mentioned by him, differ from the well-known clinical picture of the bacteria-free stage described by Libman (Amer. J. med. Sci. 1913, 146, 625). I have seen at least one case recently in which the blood-culture was repeatedly negative and even at autopsy bacteria were not found in the vegetations. Neither heparin nor sulphonamides were used in this case. In reviewing cases of endocarditis lenta it should be remembered that spontaneous remissions occur, and that the disappearance of organisms from the blood and heart valves in no way negatives a fatal termination to the disease. Westminster Hospital.
MAGNUS HAINES.
GEORGE THEODORE ROBERTSON WATT M.B. ABERD. ; SURGEON LIEUTENANT, R.N.V.R. Surgeon Lieutenant G. T. Robertson Watt is reported to have been lost during the evacuation of the Imperial Forces from Greece, and the Admiralty have intimated that he must be presumed to have been killed on active service. Watt, who was in.his 29th year, was the eldest son of Mr. Theodore Watt, LL.D., managing director of the Aberdeen University Press, and Mrs. Watt of Culter House, Aberdeenshire. He spent 13 years at the Aberdeen Grammar School, and during his last year he was a prefect. He graduated in medicine at Aberdeen University in 1936, and became assistant to Dr. George Mitchell of Insch. The following August he was appointed a resident medical officer at Aberdeen Royal Infirmary. Later he became house-surgeon at Mount Vernon Hospital, at the Aberdeen Maternity Hospital, and at the lor Jessop Sheffield, for j essop Hospital. nOSpl1JI:tl. oneiiieiu., :M had already determined to specialise in obstetrics and gynaecology. In June of last year he was commissioned as a surgeon lieutenant in the R.N.V.R., and shortly afterwards was posted to H.M.S. Wryneck. L. F. writes : George Watt had a wide interest in student activities but was happier breathing the free air of the Cairngorms than on the organised playing-field. He was willing to fight and die for his country, knowing that liberty itself was in jeopardy, but had he been spared to see his country victorious he would still have fought on for the creation of peace and unity among nations. His vision was the wide vision of youth. —————— ——
SiR,-In the official memorandum on Gas Casualties printed in your issue of May 10 (p. 613) should not the first sentence of the concluding paragraph, which reads The gas-mask, if adjusted properly and in time, gives full protection to the lungs and eyes against all these gases " have added to it the words except carbon "
"
monoxide "? A. G. SANDERS.
———...——.
JOHN MURDOCH McKILLOP GLASG. ; LIEUTENANT, R.A.1BLC. Dr. J. M. McKillop was educated at the Kelvinside Academy and Glasgow University. He was a young man of powerful physique, keen on all sports. At school he played rugger and he was an enthusiastic yachtsman ; for many years he competed in the Loch Long dinghy 1BI.B.
class.
1938
He qualified
and
M. B.
in
held resident
appointments at three of the at corporation hospitals Stobhill Hospital lie was house-physician to Prof. B oah -
Morris. McKillop was a careful worker and his frankness combined with a well-developed sense of humour made him popular with his patients. He joined up as soon as war was declared and he served as a lieutenant in the R.A.M.C. attached to the 2nd battalion of the Seaforth Highlanders. He went to France in October, 1939, and on June 11. 1940, he was wounded at IngouvilleHe died the sur-mer, Seine.
Murdoch McKillop Jack
CARBON MONOXIDE
Oxford.
Obituary
McKillop
was the only son of the late Mr. and Mrs. Nora McKillop. He was 26
years old. The Minister of Food has made an order, to come into force June 2, prohibiting, except under licence, the manufacture or sale of vitamin C. The order does not apply to the manufacture or sale of vitamin C for medicinal, pharmaceutical or scientific purposes. Applications for licences should be made to the Ministry at St. John’s College, Oxford. on