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379 Obituary JOHN PRESTON MAXWELL M.D. Lond., F.R.C.S., F.R.C.O.G. Prof. Preston Maxwell, who died in Cambridgeshire on July 25 in his 90th year, had spent the greater part of his working life in China, latterly as professor of obstetrics in Peking. After qualifying from St. Bartholomew’s Hospital in 1896, he took the F.R.c.s. in 1897, and then graduated M.B. in the University of London with a gold medal in obstetrics, and B.S. with first-class honours and gold medal. He proceeded, under the auspices of the English Presbyterian Missionary Society, to Yung-Chun, in South China and from there went to Yi-Yuan, not far from Changsha, the capital of Hu-nan Province. Here he was instrumental in building up an effective hospital which became known as "The Dr. Maxwell Hospital", or, in anglicised Chinese, " Ma Dai Fu "; and under this name the fame of the hospital and its director spread. In 1919 he was invited by the Rockefeller Foundation to come to Peking as professor of obstetrics and gynxcology in the then almost completed Peking Union Medical College. Before leaving Peking in 1937, he had held the post of director of the Medical College. His services to China were recognised by the award of the Order of the Splendid Jade. E. W. H. C. writes: " Energy and distinction were the hallmarks of Preston Maxwell’s medical career. By his Chinese name he became known to countless hundreds not only because of his skill as a surgeon but because of his manifest love and admiration of the people of China. Here was a missionary and surgeon who did not need to preach concerning his Christian faith; in his daily life he was the very embodiment of it. He was a colleague and friend characterised, not only by brilliance in his profession, but by a quiet dignity, an unfailing energy in the service of others, and a deep knowledge of human character. To those, like myself, who knew him in China, his passing leaves a clear memory of a most gracious personality, of a colleague whose brilliance professionally was matched by his charm of manner, selflessness, and unfailing kindness." Appointments Liverpool Regional Hospital Board: CoHEN, R. I., M.B. Lpool, F.R.C.S., F.A.C.S.: consultant general surgeon, Newsham General Hospital. HUMPHREYs, JOHN, CH.M. Lpool, F.R.C.S., F.R.C.S.E. : consultant general surgeon, Southport hospital group. WAKELEY, J. C. N., M.B. Lond., F.R.C.S.: consultant general surgeon, Chester hospital group. Manchester Regional Hospital Board: McCoNNAcmE, R. W., M.B. Aberd., M.R.C.P.E., D.P.H.: consultant geriatrician, Blackburn and district hospital group. WICKHAM, H., M.B. Lpool, F.R.c.s.: consultant E.N.T. surgeon, Preston and Chorley hospital group. WILLIAMSON, P. J., M.B. Lond., D.P.M.: consultant psychiatrist, Stockport and Buxton hospital group. Yui,E, J. H. B., M.CH. Oxon., F.R.C.S. : consultant surgeon, Blackpool and Fylde hospital group. Western Regional Hospital Board, Scotland: BLACK, W. P., M.B. Glasg., F.R.C.S.E., M.R.C.O.G., D.OBST. : consultant obstetrician and gynxcoiogist, Royal Infirmary and Eastern District Hospital, Glasgow. ISAACS, BERNARD, M.B. LOnd., M.R.C.P. : consultant physician, regional geriatric service. RoBERTSON, J. M., M.B. Edin., D.P.M.: assistant psychiatrist, Bellsdyke Mental Hospital, Larbert. SWINNEY, G. E., M.B. Aberd., D.P.M.: consultant psychiatrist and physician-superintendent, Woodilee Mental Hospital, Lenzie, Glasgow. THOMSON, T. J., M.B. Glasg., F.R.F.P.S., M.R.C.P. : consultant physician, Stobhill Hospital, Glasgow, for duties at the Western District Hospital. Births, Marriages, Deaths WILKINSON.—On Aug. 1, to Clodagh (nee Boyd), wife of Dr. J. B. Willcinson, of 3, Greestone Place, Lincoln-a daughter. Notes and News THE OLDER WORKER PREVAILING attitudes towards the older semiskilled worker have been studied in some of the larger manufacturing firms on Merseyside by the Medical Research Council’s unit for research on the occupational aspects of ageing.! Managers and foremen agreed that, of the changes that accompany increasing age, some are for the better (e.g., the older worker is more " steady " and more responsible) while others (e.g., slower movement and slower rate of learning) may impair efficiency. In the eyes of his superiors, the worker’s skill, born of years of experience, often compensates for his slowing-up; but too little attention has been given to the fact that an ever-increasing strain is placed on the older man if he continues to do exacting work. While it is generally accepted in industry that middle-aged and older men should be transferred from physically heavy work, little is said about the unsuitability of work making a constant demand for speed or for close concentration. The crucial age at which the effects of a demand for speed are felt is the late 40s or early 50s; but, because often the only alternative offered involves loss of status and loss of pay, many older men may remain too long at the job they are doing. For the semiskilled worker to find new employment in the second half of his working life may be difficult because he does not want to suffer loss of earnings while he becomes familiar with a new job, and because he may not relish the prospect of getting used to new faces and other ways. On the other hand his chances of getting new employment (even in his own firm) do not seem to be good after the age of 50. Consequently he is apt to go on until he can no longer make the grade, and then spend his last few years in a relatively menial occupation, and perhaps in correspondingly low spirits. An increasing rate of technical innovation in industry may mean that a single group of limited skills will no longer last a man throughout his working life. Both this possibility and the present problems faced by the older worker point to the need for re-training, and this report suggests that industry should examine methods of training and re-training in relation to the special needs of the semiskilled worker after the age of 40. WHOLE-TIME WORK IN A PARIS HOSPITAL For a variety of reasons, France has been reluctant to accept the conception of whole-time service by consultants in hospital. By tradition, French consultants have devoted part of their time to hospital but have spent most of the day attending to private patients. The National Medical Association, which acts as intermediary between the medical profession and the public authorities, has been far from quick to accept the idea of whcle-time service. Professor Kourilsky’s new book 2 gives his experience in the four years after he and his assistant undertook full-time work at the Saint-Antoine Hospital in Paris-a hospital which has 170 beds and deals with chest cases. The change, it seems, had remarkable consequences-an increase of about 72% in the turnover of patients, and a reduction of 51 % in their average stay; a fall in bed occupancy from nearly 93% to 81%; and a fall from 6% to 3% in discharge against medical advice. The increased turnover led to an increased cost of maintenance per patient-day, but the cost of maintenance for the whole stay in hospital of each patient was reduced by 21%. In France neither administrators nor doctors will be able to ignore this cool analytical approach to a subject which is rarely discussed without exciting passion. In this country it is of interest to know that arrangements in France are still so different from arrangements here. 1. Ageing and the Semi-skilled: A Survey in Manufacturing Industry on Merseyside, by ALASTAIR HERON and SHEILA M. CHOWN, assisted by M. S. Featherstone and Catherine M. Cunningham. Medical Research Council memorandum no. 40. H.M. Stationery Office, 1961. Pp. 59. 5s. 2. Kourilsky, R. Étude analytique de l’activité d’un service hospitalier Parisien à fonction plein temps. Paris: Association des Amis de l’Assistance Publique à Paris. 1961. Pp. 264. 12 N.F.

NOTES AND NEWS

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Obituary

JOHN PRESTON MAXWELLM.D. Lond., F.R.C.S., F.R.C.O.G.

Prof. Preston Maxwell, who died in Cambridgeshire onJuly 25 in his 90th year, had spent the greater part of hisworking life in China, latterly as professor of obstetricsin Peking.

After qualifying from St. Bartholomew’s Hospital in 1896,he took the F.R.c.s. in 1897, and then graduated M.B. in theUniversity of London with a gold medal in obstetrics, and B.S.with first-class honours and gold medal. He proceeded, underthe auspices of the English Presbyterian Missionary Society,to Yung-Chun, in South China and from there went to Yi-Yuan,not far from Changsha, the capital of Hu-nan Province. Herehe was instrumental in building up an effective hospital whichbecame known as "The Dr. Maxwell Hospital", or, in

anglicised Chinese, " Ma Dai Fu "; and under this namethe fame of the hospital and its director spread. In 1919 hewas invited by the Rockefeller Foundation to come to Pekingas professor of obstetrics and gynxcology in the then almostcompleted Peking Union Medical College. Before leavingPeking in 1937, he had held the post of director of the MedicalCollege. His services to China were recognised by the awardof the Order of the Splendid Jade.

E. W. H. C. writes:

" Energy and distinction were the hallmarks of PrestonMaxwell’s medical career. By his Chinese name he becameknown to countless hundreds not only because of his skill as asurgeon but because of his manifest love and admiration of the

people of China. Here was a missionary and surgeon who didnot need to preach concerning his Christian faith; in his dailylife he was the very embodiment of it. He was a colleague andfriend characterised, not only by brilliance in his profession,but by a quiet dignity, an unfailing energy in the service ofothers, and a deep knowledge of human character. To those,like myself, who knew him in China, his passing leaves a clearmemory of a most gracious personality, of a colleague whosebrilliance professionally was matched by his charm of manner,selflessness, and unfailing kindness."

Appointments

Liverpool Regional Hospital Board:CoHEN, R. I., M.B. Lpool, F.R.C.S., F.A.C.S.: consultant general surgeon,

Newsham General Hospital.HUMPHREYs, JOHN, CH.M. Lpool, F.R.C.S., F.R.C.S.E. : consultant general

surgeon, Southport hospital group.WAKELEY, J. C. N., M.B. Lond., F.R.C.S.: consultant general surgeon,

Chester hospital group.Manchester Regional Hospital Board:McCoNNAcmE, R. W., M.B. Aberd., M.R.C.P.E., D.P.H.: consultant

geriatrician, Blackburn and district hospital group.WICKHAM, H., M.B. Lpool, F.R.c.s.: consultant E.N.T. surgeon, Preston

and Chorley hospital group.WILLIAMSON, P. J., M.B. Lond., D.P.M.: consultant psychiatrist, Stockport

and Buxton hospital group.Yui,E, J. H. B., M.CH. Oxon., F.R.C.S. : consultant surgeon, Blackpool and

Fylde hospital group.Western Regional Hospital Board, Scotland:BLACK, W. P., M.B. Glasg., F.R.C.S.E., M.R.C.O.G., D.OBST. : consultant

obstetrician and gynxcoiogist, Royal Infirmary and Eastern DistrictHospital, Glasgow.

ISAACS, BERNARD, M.B. LOnd., M.R.C.P. : consultant physician, regionalgeriatric service.

RoBERTSON, J. M., M.B. Edin., D.P.M.: assistant psychiatrist, BellsdykeMental Hospital, Larbert.

SWINNEY, G. E., M.B. Aberd., D.P.M.: consultant psychiatrist andphysician-superintendent, Woodilee Mental Hospital, Lenzie,Glasgow.

THOMSON, T. J., M.B. Glasg., F.R.F.P.S., M.R.C.P. : consultant physician,Stobhill Hospital, Glasgow, for duties at the Western DistrictHospital.

Births, Marriages, Deaths

WILKINSON.—On Aug. 1, to Clodagh (nee Boyd), wife of Dr. J. B. Willcinson,of 3, Greestone Place, Lincoln-a daughter.

Notes and News

THE OLDER WORKER

PREVAILING attitudes towards the older semiskilled workerhave been studied in some of the larger manufacturing firms onMerseyside by the Medical Research Council’s unit for researchon the occupational aspects of ageing.!Managers and foremen agreed that, of the changes that

accompany increasing age, some are for the better (e.g., theolder worker is more " steady " and more responsible) whileothers (e.g., slower movement and slower rate of learning) mayimpair efficiency. In the eyes of his superiors, the worker’sskill, born of years of experience, often compensates for hisslowing-up; but too little attention has been given to the factthat an ever-increasing strain is placed on the older man if hecontinues to do exacting work. While it is generally accepted inindustry that middle-aged and older men should be transferredfrom physically heavy work, little is said about the unsuitabilityof work making a constant demand for speed or for closeconcentration.The crucial age at which the effects of a demand for speed

are felt is the late 40s or early 50s; but, because often the onlyalternative offered involves loss of status and loss of pay, manyolder men may remain too long at the job they are doing. Forthe semiskilled worker to find new employment in the secondhalf of his working life may be difficult because he does notwant to suffer loss of earnings while he becomes familiar witha new job, and because he may not relish the prospect of gettingused to new faces and other ways. On the other hand hischances of getting new employment (even in his own firm) donot seem to be good after the age of 50. Consequently he isapt to go on until he can no longer make the grade, and thenspend his last few years in a relatively menial occupation, andperhaps in correspondingly low spirits.An increasing rate of technical innovation in industry may

mean that a single group of limited skills will no longer lasta man throughout his working life. Both this possibility andthe present problems faced by the older worker point to theneed for re-training, and this report suggests that industryshould examine methods of training and re-training in relationto the special needs of the semiskilled worker after the ageof 40.

WHOLE-TIME WORK IN A PARIS HOSPITAL

For a variety of reasons, France has been reluctant to acceptthe conception of whole-time service by consultants in hospital.By tradition, French consultants have devoted part of theirtime to hospital but have spent most of the day attending toprivate patients. The National Medical Association, whichacts as intermediary between the medical profession and thepublic authorities, has been far from quick to accept the ideaof whcle-time service.

Professor Kourilsky’s new book 2 gives his experience in thefour years after he and his assistant undertook full-time workat the Saint-Antoine Hospital in Paris-a hospital which has170 beds and deals with chest cases. The change, it seems, hadremarkable consequences-an increase of about 72% in theturnover of patients, and a reduction of 51 % in their averagestay; a fall in bed occupancy from nearly 93% to 81%; and afall from 6% to 3% in discharge against medical advice. Theincreased turnover led to an increased cost of maintenance perpatient-day, but the cost of maintenance for the whole stay inhospital of each patient was reduced by 21%.

In France neither administrators nor doctors will be ableto ignore this cool analytical approach to a subject which israrely discussed without exciting passion. In this country it isof interest to know that arrangements in France are still sodifferent from arrangements here.

1. Ageing and the Semi-skilled: A Survey in Manufacturing Industry onMerseyside, by ALASTAIR HERON and SHEILA M. CHOWN, assisted byM. S. Featherstone and Catherine M. Cunningham. Medical ResearchCouncil memorandum no. 40. H.M. Stationery Office, 1961. Pp. 59. 5s.

2. Kourilsky, R. Étude analytique de l’activité d’un service hospitalierParisien à fonction plein temps. Paris: Association des Amis del’Assistance Publique à Paris. 1961. Pp. 264. 12 N.F.

Page 2: NOTES AND NEWS

380

ADMISSION OF PATIENTS TOPSYCHIATRIC HOSPITALS

THE Joint Consultants Committee met in London on July 25,under the chairmanship of Mr. T. Holmes Sellors.

Representations have been made to the Ministry of Healththat rigid zoning of catchment areas of psychiatric hospitalsshould be avoided. The committee realises that a hospitalmay not be in a position to accept a patient when requested ifall beds are occupied or the case is unsuitable for that particularhospital, but this is a domestic matter and the advice of theconsultants concerned would have to be sought. The Ministryhas pointed out that defined catchment areas will be necessaryfor some years to come. It is essential that some hospitalsshould be responsible for compulsory emergency admissions.This and the uneven distribution of beds makes catchmentareas necessary. In some areas hospital boards are very rigidin their application of catchment-area boundaries, but it ishoped that with the development of psychiatric units in

general hospitals and the fall in demand for beds in psychiatrichospitals catchment-area arrangements can gradually be relaxed.

WORLD PSYCHIATRIC ASSOCIATION

AN International Society for the Organisation of WorldCongresses of Psychiatry has been in existence since 1950.This year, at the third World Psychiatric Congress held inMontreal in June, it was decided to change this organisationinto a World Psychiatric Association, with functions of widerscope. The headquarters are to be in Geneva, and the firstspecial general assembly will be held there next -year.The first officers of the Association are: president, D. E. Cameron

(Canada); vice-president, F. G. Braceland (U.S.A.); general secre-tary, H. Ey (France); assistant secretaries, W. Sargant (GreatBritain) and J. J. Lopez Ibor (Spain); and treasurer, P. Sivadon(France). A committee has been formed of 25 members from theparticipating countries.

University of OxfordOn July 29 the degree of B.M. was conferred, on R. S.

Cormack.

University of LondonOn June 21 the degree ofM.D. was awarded to the following:D. F. Eastcott, P. D. Meers, Felix Post, M. H. P. Sayers.

University of BirminghamOn July 14 the honorary degree of D.SC. was conferred on

Prof. P. B. Medawar; and on July 15 Prof. James Mackintoshand Mr. Leslie Farrer-Brown received the honorary degree ofLL.D.

Royal College of Surgeons of EnglandAt a meeting of the council on Aug. 3 with Sir Arthur

Porritt, the president, in the chair, Mr. R. L. B. Beare wasadmitted to the board of examiners in dental surgery (surgicalsection), and Dr. J. Alfred Lee for the fellowship on theFaculty of Anaesthetists. Sir Wilfrid Le Gros Clark wasappointed the Edridge-Green lecturer for 1961.

Surgeon Rear-Admiral D. D. Steele-Perkins was admittedto the fellowship (ad eundem) and a diploma of fellowshipwas granted to Sim-Fook Lam.

Diplomas were granted, jointly with the Royal College ofPhysicians, to those mentioned in our issue of Aug. 5 (p. 326).Faculty of Anœsthetists

Diplomas of fellowships have been granted to the following:R. E. Graham, R. B. Roberts, W. D. Writer, Syed Ahmed Kabir,

I. McI. Cochran, Barbara W. Cooke, R. E. C. Gibson, Jean M. Allison,C. J. Friendship, A. S. Gardiner, B. G. Pirie, Mendel Kaminer, C. G. Lloyd,R. E. Steele, P 0. Bodley, Ray McKenzie, G. W. Macnab, Eva R. Seelye,J. B. Burn, R. A. Butler, Phool Chandra, J. P. Davie, Shu Poh Ma,N. P. Murray, Margaret M. Voysey, Bridget A. Jepson, S. S. Lutchman,D. C. Maxwell, T. 0. Ormston, Nalin Jagmohandas Paymaster, El TahirFadl, Arumugam Ganendran, G. B. Gillett, A. M. C. Jennings, H. G.Schroeder, J. H. L. Bland, A. V. Dreosti, Bruce Foster, S. M. Hart,D. A. Nightingale, J. F. O’Donnell, B. le G. Waldron.

Royal Medical Benevolent FundThe annual general meeting will be held at 5 P.M. on

Tuesday, Sept. 5, at the house of the Medical Society ofLondon, 11, Chandos Street, W.1.

University College Hospital Medical SchoolPostgraduate demonstrations will be held at the medical

school, University Street, London, W.C.1, on Thursday andFriday, Oct. 26 and 27. The annual dinner will be held at theSavoy Hotel, Strand, W.C.2, on Oct. 27, at 8 P.M. Tickets forthe dinner (36s.) may be had from the hon. secretary, OldStudents’ Association, at the medical school.

Society of Apothecaries of LondonFaculty of the History of Medicine and Pharmacy.—Applica-

tions are invited for the 1962 Maccabaean prize and medal,which are awarded annually by the faculty for an essay con-nected with the history of medicine or pharmacy. Particularsand entry forms, which should be returned by Oct. 15, maybe had from the hon. secretary of the faculty, Dr. F. N. L.Poynter, Wellcome Historical Medical Library, , WellcomeBuilding, Euston Road, London, N.W.l.

British Association of Physical MedicineThe annual meeting of this Association will be held on

Friday and Saturday, April 27 and 28, at University CollegeHospital and the R.A.M.C. College, Millbank, London.Members wishing to read a short paper or show a film shouldsubmit the title, together with a brief abstract, to the Associa-tion, 47, Lincoln’s Inn Fields, W.C.2, by Sept. 30.

Carlsberg-Wellcome Travelling Research Fellowships.

The Carlsberg Foundation (Copenhagen) and the WellcomeTrust (London) announce the awards of these fellowships,which they jointly created in 1957.The successful candidates for 1960-61 are Dr. Emil Poulsen,

senior lecturer at the Royal Veterinary and Agricultural College,Copenhagen, who will work at the Medical Research Council’sToxicology Research Unit at Carshalton on the neurotoxic influenceof alicyclic phosphates and similar compounds; Dr. A. F. Hayward,of the anatomy department of Glasgow University, who will workat the Carlsberg Laboratory in Copenhagen, under the directionof Dr. H. Holter, studying the electron-microscopic appearances inpinocytosis; and Dr. S. L. Rowles, a member of the externalscientific staff of the Medical Research Council at the School ofDental Surgery in Birmingham, who will work with Dr. TovborgJensen of the Royal Veterinary and Agricultural College, Copenhagen,on the chemistry of the calcium phosphates with special reference tothose in oral tissues.

Dr. B. C. Flather, of Newton, British Columbia, has been

appointed M.B.B. in recognition of his part in rescue operations aftera rock fall at the Home Sound Co. mine.

Dr. T. C. Gibson has been appointed assistant professor ofmedicine in the University of North Carolina, U.S.A.

Applications to attend a refresher course for consultant ophthal-mologists, which is to be held at the Courage Laboratory of theRoyal Eye Hospital, St. George’s Circus, London, S.E.l, fromFeb. 19 to 23, should be sent to Prof. Arnold Sorsby at the hospitalbefore Dec. 1.

Courses on the rehabilitation of the amputee will be held forphysical medicine consultants and geriatricians on Oct. 4 and 5, andfor orthopaedic consultants and senior registrars from Oct. 30 toNov. 3, at the Limb Fitting Centre, Queen Mary’s Hospital, Roe-hampton, London, S.W.15. Application should be made to theprincipal medical officer, Artificial Limbs and Appliances (Med. 7)at the hospital.On Wednesday, Aug. 16, at 5.15 P.M., at the Royal Free Hospital,

Gray’s Inn Road, London, W.C.1, Dr. R. S. Yalow, of New York,will talk on assay of insulin.

On Tuesday, Aug. 15, at 5.30 P.M., at the Institute of Laryngologyand Otology, 330, Gray’s Inn Road, London, W.C.1, Dr. Barry J.Anson, of Chicago, will speak on features of otological anatomycontributory to problems in endaural surgery. -

The Children’s Hospital, Aghia Sophia, in Athens, which is s

Greek psediatric postgraduate school, is trying to establish a libraryand would be grateful for back numbers of The Lancet, up to thebeginning of this year. Offers of bound volumes, or complete half-yearly sets suitable for binding, should be sent to the library at thehospital. ,