870

succinctly, clearly and wittily. The ’little belyacher’ is a clichewhich has become a diagnostic label. Writing came easily to him andhe made many contributions to paediatric literature; his noteworthybook reviews were astute and kindly critical; and he enjoyed medicalediting. He was a voracious reader and admitted that much of hiswriting was modelled on regular reading of the Authorised Versionof the Bible, a practice he often commended to his registrars."John was a natural leader and although he avoided medical

politics he was much sought after as a chairman for scientificmeetings and president of several societies. His capacity to getcooperation between people with various interests had itsculmination in his outstanding leadership of the team at the Saigon-Children’s Hospital during the height of the war in Vietnam."He was a man who, with the constant support of his charming

wife, Poo, enjoyed life to the full. As host in his lovely Georgianhouse in Bath he entertained many and was an acknowledged con-noisseur of food and wine. He found time not only to make anoutstanding contribution as a citizen but also to enjoy a good gameof chess and to become an accomplished clarinet player. He will begreatly missed by his very wide circle of friends abroad and nearerhome and especially the paediatricians of the South Western Regionto whom for many years he was a father figure."

WILLIAM JAMES BELL

M.B. Edin., F.R.C.P.E., D.P.H.

Dr Bell contributed much to the investigation and treat-ment of tuberculosis in Africa. He later became assistant

director, scientific services/medical services, Severn TrentWater Authority. He died on July 24, at the age of 60.

He was educated at George Watson’s College, Edinburgh, andEdinburgh University, where he graduated in 1943. After serving inIndia with the R.A.F. he worked at Bangour Hospital, training inrespiratory medicine. He later became senior assistant physician atthe Red Cross Sanatorium of Scotland at Tor-Na-Dee. In 1956 hewas appointed director of the tuberculosis research unit of the WestAfrican Council for Medical Research and so began the most pro-ductive years of his career, including many research projects on theepidemiology and chemotherapy of tuberculosis in West Africa.

- The results were a unique contribution to the subject at the time,though they were little noticed in the United Kingdom. He con-tinued his interest in the treatment and management of tropical dis-ease when he joined Pfizer International in 1962. He entered a newsphere of medicine in 1975, with the enthusiasm of a much youngerman, when he was appointed chief medical officer of the SevernTrent Water Authority.He had immense energy and integrity and he committed himself

totally to whatever he undertook. He was happiest when conductingresearch, and his intellect, powers of observation, careful study ofthe data, and profound respect for the correct use of the English lan-guage made him the ideal research worker. Though forthright in ex-pressing his opinion on medical and other topics (and, disconcert-ingly, he was usually right), he was kind and gentle, and deeply con-cerned for the wellbeing of those around him, to which manypeople, especially in West Africa, can testify.He is survived by his wife, Helen.

M. W. R.M.W. RP.P.P.B. J.G.

Dr J. W. ALDREN TURNER, who was neurologist to St

Bartholomew’s Hospital, London, died on Oct. 12.

Mr W. I. DAGGETT, formerly senior ear nose and throat surgeonto King’s College Hospital, London, and consultant to the Mauds-ley Hospital, died on Sept. 26, aged 79.

Dr PEARL KENDRICK, who was closely concerned in the earlywork on whooping-cough vaccine, has died at Grand Rapids, Michi-gan, at the age of 90.

Notes and News

FOCUS ON THE FAMILY

THE present Government has frequently avowed its support of andbelief in "the family", but what exactly is meant by this has notbecome clear. Cuts in welfare services and social security benefits,together with high unemployment, have combined to make life hardfor British families, particularly those with young children. Policyseems directed chiefly at getting married women to stay at home, theaim being presumably to ease pressure on child-care services and onthe labour market. The married woman, with less job security thanother workers, is in any case finding herself willy-nilly unemployedas the recession deepens. But families are in fact unlikely to benefitfrom having the mother back at home. For, as the second reportfrom the Study Commission on the Family points out, manyfamilies have come to rely on the wages of both mother and father inorder to avoid poverty. Indeed, the main thrust of the pamphlet, onlow pay and family poverty, is to refute the conclusion of the RoyalCommission on the Distribution of Income and Wealth that familypoverty and low pay were no longer, in 1978, closely associated.The authors of the Study Commission report believe that this

contention is based on a false interpretation of the data, and theyargue that in many low-income families both the husband’s and thewife’s earnings are low, so that their joint contribution is often nomore than the income of families with a single breadwinner. Theheaviest burden of poverty, which was concentrated on the elderlyduring the 1960s, is now carried by families with children, and thispamphlet succeeds in pressing home the urgency of the situation,which can only get worse as more and more families are forced onto asingle wage (or none at all). It is a pity, therefore, that the onlysolutions proposed are long-term and, given present conditions,idealistic, and that the authors make no suggestions as to how andwhen they could be achieved. They call for: "considerable

improvements in the statutory rights of working women and in thepay and conditions of industries in which women’s employment isconcentrated", and for "the state provision of adequate day-carefacilities for children".The Study Commission, which is an independent body set up

under the chairmanship of Sir Campbell Adamson, with financialsupport from the Leverhulme Trust, declares its aims to be to makea practical contribution on issues important to family life and tohave an impact on those responsible for policy. So far it seems still tobe finding its feet, for its first report, a review of marriage in Britainsince 1945,2 provides useful background material but has little

positive to say to the policy-makers. Written by a psychiatrist, DrJack Dominian, who has made marriage and especially maritalbreakdown his particular study, the pamphlet offers in its first twosections a historical and demographic look at marriage. It picks outthe key elements in the changes that have been taking place-forexample, the shift away from parental choice of spouse, longerduration of marriage caused by increased longevity, smaller familiesand different attitudes to children resulting from factors such aslower infant mortality and more reliable contraception. In the othertwo sections Dr Dominian describes the life cycle of marriage andcomments on value systems and conflict, with the emphasis on thestress points that can lead to breakdown and divorce. He makes abrave attempt at suggesting the huge variations in marital patterns.But with such a broad remit and so little space he tends to lapse intogeneralisations and statements of the obvious. For instance, we aretold that the arrival of the first child is one of the most importantevents in the first phase of marriage: "The couple now become atriad; the wife has to learn how to be a wife-mother; the husband,husband-father." But doubtless once the Study Commission hasdone its basic groundwork it will have some more forceful things tosay.

1. Low Pay and Family Poverty. By Marie McNay and Chris Pond. Study Commission onthe Family, 231 Baker Street, London NW1 6XL. 80p (+ 30p postage).

2. Marriage in Britain 1945-80. By JACK DOMINIAN, F.R.C PSYCH £1.30. London:Study Commission on the Family. 1980.

871

COPING WITH RESTRICTED GROWTH

THE Association for Research into Restricted Growth has pub-lished a booklet on this subject by a founder member of the Associa-tion, Mary Lindley. It is intended to answer the questions most com-monly asked by people whose height is severely restricted and bytheir families, friends, and professional counsellors. It deals witheach stage in life and indicates the difficulties which commonlyarise. In offering information and practical advice on the physicalproblems of everyday life, it adopts an encouraging and optimisticattitude towards the thoughtlessness and occasional discriminationof other people, which can undermine the confidence of a person ofrestricted growth. This sensible and helpful booklet seeks to pro-mote the integration in society of people of restricted growth andtheir recognition as members of the natural range of humanvariation.

THE ONUS TO ASK

Maybe I Didn’t Ask is the title of a report on the experience ofwomen having their babies in the new obstetric unit of WestminsterHospital. It is the result of a detailed survey undertaken by theKensington, Chelsea and Westminster (South) community healthcouncil. The most striking point to emerge is that advice and

support for mothers are readily available, but the onus rests heavilyon the mothers to ask for information. The crowding in antenatalclinics and continual changes of staff inhibit the necessary sense offreedom to ask personal questions on such matters as pain relief indelivery. Hence mothers arrive ill-informed at the hospital. Thereport clearly indicates the scope for helping the mother and fatherto plan the pregnancy and choose the style of delivery.

ERICA WACHTEL MEMORIAL FUND

THE British Society for Clinical Cytology has opened a memorialfund to commemorate Prof. Erica Wachtel, who died in June. Shewas emeritus professor of gynaecological cytology in the Universityof London, a post which she held at the Institute of Obstetrics andGynaecology, Hammersmith Hospital. Professor Wachtel was aleader in the development of clinical cytology in Britain and she hadan international reputation for her research and teaching of thesubject. It is intended that the income from the memorial fundshould be used either for an Erica Wachtel lecture to be given by aninvited speaker at the annual scientific meeting of the BritishSociety for Clinical Cytology or for a travel fellowship. Donations tothe fund are invited. They should be payable to the Erica WachtelMemorial Fund and sent to Dr K. J. Randall, honorary treasurer,British Society for Clinical Cytology, Pathology Department,Orpington Hospital, Orpington, Kent BR6 9JU. Covenant formsare available from Dr Randall.

APPROVED NAMES

THE Medicines Commission has issued a further supplement (no.7) to its booklet Approved Names (1977):

Approved name Other namesAlclometasone 7&agr;-Chloro-11&bgr;, 17&agr;,21 -trihydroxy-

16&agr;methylpregna-1,4-diene-3,20-dione.Corticosteroid (Schering); Sch 22219 is the 17a, 21-dipropionate.

1 Coping with Restricted Growth. By Mary Hindley 40p to non-members. Associationfor Research into Restricted Growth, 2 Mount Court, 81 Central Hill, LondonSE19 1BS.

2. By Christine Hogg and Judy Hague. Available from the Council at 89 Sydney Street,London SW3 6NP.

Alfentanil N-1 1-ethyl]-4-(methoxymethyl)-4-piperidyl} = propionanilide.Narcotic analgesic (Janssen); R 39209 is thehydrochloride.

Alinidine N-Allyl-2,6-dichloro-N-(2-imidazolin-2-yl) aniline.Antiarrhythmic (Boehringer Ingelheim); St 567-BRis the hydrobromide.

Amrinone 5-Amino-3,4’-bipyridyl-6(lH)-one. Cardiacinotropic (Sterling-Winthrop).

Astemizole 1-(4-Fluorobenzyl)benzimidazol-2-yl[ 1-(4-methoxyphenethyl)-4-piperidyl]amine.Antihistamine (Janssen); R 43512.

Auranofin S-(Triethylphosphoranediylaurio)-1-thio-&bgr;-D-glucopyranose 2,3,4,6-tetra-acetate. Treatment ofrheumatoid arthritis (Smith, Kline & French);SK&F D-39162.

Bifonazole 1-(a-Biphenyl-4-ylbenzyl) imidazole. Topicalantimycotic (Bayer); BAY h 4502.

Brotizolam 2-Bromo-4-(2-chlorophenyl)-9-methyl-6H-thieno[3,2-j] [1,2,4]triazolo[4,3-a] [ 1,4]diazepine.Hypnotic (Boehringer Ingelheim); We 941-BS.

Bucindolol 2-[ 2-Hydroxy-3-(2-indol-3-yt-1,1 -dimethylethyl-amino)propoxyl]benzonitrile. Beta adrenoceptorblocking agent (Bristol-Myets); MJ 13105-1 is thehydrochloride.

Budesonide 16&agr;,17&agr;-Butylidenedioxy-11&bgr;,21-dihydroxypregna-l,4-diene-3,20-dione.Corticosteroid (Astra); S-1320.

Buspirone 1- =piperidine-4-spirocyclopentane-2,6-dione.Tranquilliser (Bristol-Myers); MJ 9022-1 is thehydrochloride.

Ceftazidime (Z)-(7R)-7-[2-(2-Aminothiazol-4-yl)-1-(1-carboxy-1-methylethoxyimino)=acetamido]-3-(1-pyridiniomethyl)-3-cephem-4-carboxylate.Antibiotic (Glaxo); GR 20263.

Ciclacillin (6R)-6-(1-Aminocyclohexanecarboxamido)=penicillanic acid. Antibiotic (Ayerst); Wy 4508.

Ciclobendazole Methyl 5-(cyclopropylcarbonyl)=benzimidazol-2-ylcarbamate. Anthelmintic (Cilag Chemie).

Ciclosidomine N-Cyclohexylcarbonyl-4-morpholinosydnone imine. Antihypertensive(Boehringer Ingelheim); PR-G 138-CL is thehydrochloride.

Ciclotizolam 2-Bromo-4-(2-chlorophenyl)-9-cyclohexyl-6H-thieno[3,2-JI [1,2,4]triazolo[4,3-a] [1,4] diazepine. Anxiolytic (Boehringer Inglelheim);We 973-BS.

Clavulanic acid (Z)-(2R,5R)-3-(2-Hydroxyethylideney7-oxo-4-oxa-1 -azabicyclot 3.2.0] heptane-2-carboxylic acid.(3-lactamase inhibitor (Beecham); BRL 14151.

Clobuzarit 2-(4’-Chlorobtphenyl-4-ylmethoxy)-2-methylpropionic acid. Antirheumatic (I.C.I.); ICI55,897.

Cysteamine Mercaptamine. Antidote to paracetamolpozsoning.

Epoprostenol sodium Sodium(Z)-5-{3aR,4R,5R,6aS)-5-hydroxy-4- (E)- (3S)-3-hydroxyoct-1-eny)] perhydro = cyclopenta[b] furan-2-ylidene}valerate; prostacyclin. Plateletaggregation inhibitor (Wellcome; Upjohn).

Etifenin 2,6-Diethylphenylcarbamoylmethyliminodi =

(acetic acid). Diagnostic aid (Solco Basle;Radiochemical Centre); 99mTc-SOLCO HIDA;Technetium (EHIDA) agent.

Flunixin 2-(a3,a3,a’-Trifluoro-2,3-xylidino) nicotinicacid. Anti-inflammatory, analgesic (Schering); Sch14714 is the meglumine salt.

Flutamide a’,a’,a’-Trifluoro-4’-nitroisobutyro-m-toluidide.Anti-androgen (Schering); Sch 13521.

872

Nobel Prizes

The 1980 Nobel prize for medicine is shared by Prof. JeanDausset (University of Paris), Prof. George Snell (JacksonLaboratory, Bar Harbor, Maine, U.S.A.), and Prof. BarujBenacerraf (Harvard). The award is for their’ work on

immunogenetics.

The Nobel prize for chemistry is shared among three men fortheir work on gene structure: Prof. Paul Berg and Dr Walter Gilbert(United States) and Dr Frederick Sanger of the M.R.C. Laboratoryof Molecular Biology in Cambridge. Dr Sanger won this award in1958 also, for work on insulin structure.

Society of Authors: Medical Writers GroupThis group’ is formed by members and associate members of the

Society of Authors and seeks to further the interests of medicalwriters (not necessarily doctors). On the basis of self-help and expertadvice, the Society hopes to build up its membership. Thoseinterested in joining or obtaining more information should write toMiss Philippa MacLiesh, Society of Authors, 84 Drayton Gardens,London SW10. The first annual general meeting of the group onOct. 9 was attended by nearly half the 87 members. The revised con-stitution was adopted and the provisional committee confirmed inoffice for a further year.

University of GlasgowThe Fraser Foundation is to provide 150 000 over three years for

equipment and staff to be used in clinical research on peripheral vas-cular disease. The grant has been awarded to Dr A. Murray Harper,Mr John G. Pollock, and Prof. David C. Carter, of the universitydepartment of surgery at Glasgow Royal Infirmary.

Prototype Nucleus HospitalThe first nucleus hospital acute ward was opened on Oct. 14 at

Pinderfields General Hospital, Wakefield, Yorkshire, by Sir GeorgeYoung, Parliamentary Secretary for Health and Social Services.

H.R.H. the Duchess of Kent is to be patron of the Christie Hospital andHolt Radium Institute, Manchester, where she recently opened the build-ing housing the whole-body scanner, a development financed by the Pat Seedappeal.

The 1980 conference of the National Association for the Welfare ofChildren in Hospital will take place on Nov. 18 at Church House, West-minster. Further information can be obtained from Peg Belson, 41 York Man-sions, Prince of Wales Drive, London SW 11.

Sir Henry Benson will give the Alan Davson lecture, entitled The Profes-sions and the Community, at the Royal Institution of Chartered Surveyorsat 6.15 P.M. on Wednesday, Oct. 15. Tickets may be obtained from SusanLippmann, Conference Unit, Royal Institition of Chartered Surveyors, 12Great George Street, Parliament Square, London SW1P 3AD (tel: 222-7000,ext. 217).

A pamphlet entitled Exercise can Help your Breathlessness (see Lancet,Sept. 6, p. 514) is published by the Chest, Heart and Stroke Association,Tavistock House North, Tavistock Square, London WC1H 9JE.

The 5th residential course on Biological Basis of Ageing will be held atthe University of Leeds on April 5-8. Further information is available fromDirector of Special Courses, Department of Adult Education and ExtramuralStudies, The University, Leeds LS2 9JT.

A memorial service for Prof. W. J. E. Jessop will be held at 5.15 P.M. on Fri-day, Oct. 31, in the chapel, Trinity College, University of Dublin.

1. See Lancet 1979; ii: 863.

International Diary

1981

University of California School of Medicine International DiagnosticRadiology Seminars: Bora Bora, Tahiti, March 30-April 3 (DiagnosticRadiology Seminars, 200 Southwood Road, Kentfield, California 94904).

Meeting of the American Heart Association on Coronary Artery Disease1981 : Milwaukee, Wisconsin, April 9-11 (Dr J. C. Manley, 5810 West Okla-homa Avenue, Suite 201, Milwaukee, Wisconsin 53219).

Hypertension: Its Etiology and Treatment: University of South Caro-lina School of Medicine, Columbia, Feb. 20 (Jeri McClain, University ofSouth Carolina School of Medicine, Office for Academic Affairs, Columbia,S.C. 29208).

International symposium on Tourette Syndrome: New York City, May28-29 (Dr Arnold Friedhoff, Director, Millhauser Laboratories, New YorkUniversity School of Medicine, 550 First Avenue, New York, 10016).

International Hospital Exhibition 1981: Munich, May 19-22

(Miinchener Messeund Ausstellungsgesellschaft mH, Messegelande, Post-fach 12 10 09, D-8000 München 12).

Diary of the Week

OCT. 19 To 25

Tuesday, 21stLondon Medical Group

5.45 P.M. (Middlesex Hospital Medical School, Mortimer Street, London W 1P 7PN)Symposium.-The Place of Birth: a Mother’s Choice?

Royal Society of Medicine, 1 Wimpole Street, London W1M 8AE6 P.M. Lord Scarman: Medical Practice and Legal Liability (Jephcott lecture).

Wednesday, 22ndInstitute of Neurology, Queen Square, London WC1 I

6 P.M. Prof. P. N. Campbell: The Control of Protein Synthesis.7 P.M. Dr Richard Watts: The Neurology of Defective Purine Metabolism.

Northwick Park Hospital, Watford Road, Harrow, Middlesex HAl 3UJ1 P.M. Dr A. 0. Frank: What is Industrial Therapy?

Royal Free Hospital, Pond Street, London NW3 2QG5 P.M. Symposium.-Collagen and the Liver.

Hospital for Sick Children, Great Ormond Street, London WCI7 P.M. Dr Rosemary Stephens: Clinical Spectrum of the Gangliosidoses.

John Radcliffe Hospital, Headington, Oxford5 P.M. Dr Peter J. L. Cook: Genetics and Natural History ofo, I -Antitrypsin Deficiency.

Thursday, 23rd -

Institute of Obstetrics and Gynaecology, Queen Charlotte’s Hospital Goldhawk Road,W6 OXG

12.45 P.M. Dr Jim Smart: Infant Feeding: Mother’s Antenatal Attitudes and Subsequent’ Practices.

London Medical Group5.45 P.M. (Royal Free Hospital, Hampstead) SympostUm.- The Wrong Doctors:

Selection or Training at Fault?

Friday, 24thInstitute of Laryngology and Otology, Royal National Throat, Nose and Ear Hospital,

Gray’s Inn Road, London WC1X 8EE4.30 P.M. Sir Douglas Ranger: The Significance of Pain in the Diagnosis and

- Management of Otolaryngological Conditions.Institute of Dermatology, St John’s Hospital for Diseases of the Skin, Lisle Street, Leicester

Square, London WC2H 7BJ4.45 P.M. Dr R. Marks: Epidermal Function.

Royal Institution of Great Britain, 21, Albemarle Street, London WIX 4BS9 P.M. Prof. C. K. Simpson: Modern Methods of Crime Detection.

Northwick Park Hospital9.10 A.M. Dr J. M. Gumpel: Arthritis3.30 P.M. Mr W. Morris: Application of Counter-current Partition Techniques to

the Separation of Rat Liver Organelles.Royal Liverpool Hospital, Prescot Street, Liverpool, L7 8XP5 P.M. Prof. J. T. Scales: Bone and Joint Replacements: Factors Influencing Perform-

ance.

Saturday, 25thNuffield Department of Orthopedic Surgery, Nuffield Orthopedic Centre, Oxford8.30 A.M. Dr M. J. 0. Francis: Genetically Distinctive Types of Collagen.9.30 A.M Dr R. Lindenbaum: Genetic Mechanisms behind Congenital Malformations