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enriched by wonderful stories which brought the house downand made learning easy and a pleasure. His considerable clini-cal experience also stood him in good stead when he was con-sulted by his clinical colleagues over a difficult diagnostic ortherapeutic problem, and his opinion was not infrequentlysought by clinicians and pathologists outside U.C.H.

As a man Monty was modest, shy, and retiring. He despisedlifemanship, shunned social occasions, and regarded adminis-tration as a chore. He had a marvellous sense of humour andhis choice of words was always superb and fitting, whethercensuring an ill-chosen investigation requested by a juniorhouseman, or congratulating a member of staff on the safearrival of an offspring. The width of his reading was shown bythe ease with which á quotation fell from his lips on such occa-sions. He took great personal interest in his staff and acted ascounsellor and friend to all of them; he always acted in theirinterests even when this meant parting with a most valuableassistant. He had a great feeling of compassion towards the lessfortunate members of society, and anyone who applied for apost in his department who had a physical handicap or was arefugee was unlikely to be turned away. Many will recall withgratitude the help that he offered them at a critical time intheir lives, and all who knew him will remember his greathumanity.He is survived by his wife, Dulcie, and their daughter.

F.V.F.

JOHN CECIL RANKIN BUCHANANK.C.M.G., M.D. Edin., F.R.C.P.E., F.R.A.C.P., D.T.M. & H.

Sir John Buchanan, formerly chief medical officer tothe Colonial Office, died on Feb. 19 at the age of 79.

After service with the Black Watch in the 1914-18 war heentered the medical school in Edinburgh, at the same time par-ticipating in the rugby activities of his old school, Stewart’sCollege. These efforts were rewarded by his being chosen toplay rugby for Scotland in 1921. Thereafter he was capped inall 16 times, and in 1924, the year after he graduated M.B.from Edinburgh University, he captained the national side inall four internationals. The following year he joined the Col-onial Medical Service and set off for Tanganyika, then moreremote and primitive than many territories. I well rememberhis account of an early posting to the Rubwa Valley in south-east Tanganyika, the breeding-ground of the menacing redlocust,.which took him more than two weeks foot-sloggingthrough tsetse bush to reach.

After Tanganyika, it was British Somaliland, Aden,Uganda, and the 1939-45 war, in which he served in theR.A.M.C. and attained the rank of colonel. Then in 1945 hewas appointed inspector-general of the South Pacific HealthService and director of medical services, Fiji. He remained inthe Pacific until 1948, when he was appointed to the ColonialOffice in London. There he continued, rising to chief medicalofficer, and in 1961 he saw the metamorphosis of the ColonialOffice into the Department of Technical Cooperation. As chiefmedical officer of the Department he retired in 1962.The death of John Buchanan, sadly, breaks one of the rela-

tively few remaining and rapidly diminishing links with thefirst half of the century. "J. C. R.", as he was known to rugbyfans in the 1920s, and "Buchie" to his friends in many lands,was in his personality typical of the interesting, elegant, andcolourful period in which most of his life was spent. His in-terests were many, and prominent and enduring among themwas the work of the St. John Ambulance Association, whichhe supported for many years. He was appointed a Knight ofSt. John in recognition of his work. Almost until his retirementhe acted as external examiner in tropical medicine in the Edin-burgh membership examination.

Buchie was always impressive. His tall, elegant, and digni-fied appearance, and his reserved yet warm personality, madehim a valued friend. He will be greatly missed.

J.M.L.

Notes and News

SEAT BELTS -

By the surprisingly large majority of 110 the House of Com-mons, in a free vote on March 1, gave a second reading to theRoad Traffic (Seat Belts) Bill. It now seems almost certain thatfailure to wear a seat belt while in the front of a car in motionwill become a criminal offence in Britain (but not Northern Ire-land) and punishable by a fine of up to 50. A long list ofexemptions is likely, and the Government will be guided by themedical profession on some of these. The debate, as expected,centred on the issue of individual freedom. There was notmuch quarrel with figures supplied by Mr John Gilbert, Minis-ter for Transport-namely, that if 90% of drivers and front-seat passengers wore seat belts the annual saving might be1000 deaths, 11 000 serious injuries, and £ 60 million inN.H.S. and police costs and loss to the economy.

DEVOLUTION AND THE N.H.S. IN SCOTLAND

THE National Health Service in Scotland already enjoys afair degree of autonomy (being financed by a block Treasurygrant and being under the direct responsibility of the Secretaryof State for Scotland), but the Scottish Nationalist Partybelieves that Scotland’s health service has suffered in the pastfrom periodic shifts in direction and switches in emphasis fol-lowing successive Governments in Westminster, and that thecountry’s burden of ill-health and social deprivation can onlybe lightened by providing continuity and stability in a

devolved health service. The S.N.P.’s proposals for the healthservice, put forward in a leaflet from its health policy com-mittee, include the establishment of a Scottish Health Com-mission and a Scottish Academy of Medicine. The health com-mission would come under the direction of a healthcommissioner, who would be appointed for a 7-year periodfrom within the health professions, and would be responsiblefor the health of the nation (and for all medical research pro-grammes) to an all-party committee (chaired by the Ministerof Health) of the Scottish Assembly. The commission would in-clude nominees of the health professions as well as representa-tives from its own subcommittees and direct nominees of theMinister of Health, the object being to improve the balance ofviews between the health professions and the Government.The Scottish Academy of Medicine, to be set up alongside theRoyal Colleges, would have what is called an integrating func-tion with regard to professional education, regulation, andrepresentation (although existing arrangements for union

membership, discipline, and licensing would continue), andwould act as a source of unified advice to the Government andthe public on broad social and ethical questions. Other pro-posals accord with much current opinion elsewhere in theUnited Kingdom-that the Salmon structure for nurses

should be abandoned, and specialist career grades created inboth clinical nursing and administration, and that health ser-vice administration should be simplified by removing one ofthe tiers (the area health boards in the case of Scotland) sothat the service would be run from the district health boards,which would be directly accountable to the health commission.As at present, the Scottish health service would be funded di-rectly from taxation, but the Scottish Government woulddecide what percentage of public money should be spent onhealth care. The S.N.P. would like to see special attentiongiven to primary care, the needs of the rural areas (where com-munity hospitals would be retained and developed), the

elderly, emergency services, health education (with a compre-hensive programme for all schoolchildren from the age of 10),occupational health and safety (not least in the oil-related in-dustries), and pollution control. Where possible the Scottish

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N.H.S. would be encouraged to buy its supplies from Scottishfirms, and the hope is that a pharmaceutical industry could bedeveloped in Scotland.

MASTECTOMY BEFORE OUR TIME

ON Sept. 30, 1811, a team of surgeons in Paris removed theright breast of Madame D’Arblay. In the context of the timesthe diagnosis is, perhaps, less important than the nature of theoperation, and the interest in the case lies more with the parti-cipants. The leading surgeons were Baron Larrey and the in-ventor of the Dubois forceps, and the fact that the patient wasthe prolific correspondent better known as Fanny Burneyensures that a detailed account survives; so too, happily if im-probably, did the patient (she died in 1840). The prospects ofan operation for a breast growth were so appalling at that timethat the surgical policy was to remove every bit of affected tis-sue to give the courageous patient the best chance. The dili-gent search for "peccant attoms" is, perhaps, a foretaste oflater controversy in breast cancer. Speed in a surgeon wasgenerally reckoned an attribute, but Liston, writing of breastsurgery in his book Practical Surgery (1837), thought that theduration of the operation should not be considered. MadameD’Arblay suffered for twenty minutes with a glass of wine cor-dial as the sole anaesthetic. Six months later she referred to herdescription of this ordeal’ as a "doleful ditty", and throughouther account she finds time to spare for the strain on her sur-

geons, who were clearly much distressed by knowledge of theall too likely outcome.

CARDIAC CATHETERISATION FIFTY YEARS ON

THE story of how a 25-year-old intern in a small hospitalnear Berlin passed a catheter into a vein in his left arm, andthen into his heart, without anaesthesia but with radiologicalevidence, has passed into medical history. Now that haemo-dynamic cardiac catheterisation is so often done routinely, itis easy to forget that it is little more than 30 years since thetechnique was introduced into medical practice.2 3 Thistechnique has in turn led to many wider applications; the wholebasis of coronary-artery surgery today depends upon catheters,permitting coronary arteriography and left-ventricular angio-graphy. Likewise, the surgical treatment of valvular and con-genital heart-disease still depends overwhelmingly on theresults of catheter investigations. Non-invasive procedures arehelpful but have not yet fulfilled the promise and answered thequestions in the way that cardiac catheterisation in its variousforms does. It is thus useful as well as entertaining to haveavailable Werner Forssmann’s autobiography, in which the

story of the first procedure is again described.4 SubsequentlyForssmann underwent many vicissitudes, and there were thedifficulties of medical life during and after the 1939-45 war,but then recognition came in 1956 when he received the Nobelprize. Shortly after Forssmann catheterised himself he andWilhelm His discussed, but dismissed from their minds, thepossibility of passing electrodes to record the activity of theconducting system within the heart. Now, some 47 years later,this is one of the most useful extensions5 of the technique ofcardiac catheterisation that dates back to Forssmann’s self-in-

vestigation.

1. The Journals and Letters of Fanny Burney; vol. VI, France 1803-1812.Edited by JOYCE HEMLOW and others. London: Oxford University Press.1975. £13.50.

2. Richards, D. W., Jr., Cournand, A., Darling, R. C. Gillespie, W. H., Bald-win, E. de F. Am. J. Physiol. 1942, 136, 115.

3. McMichael, J., Sharpey-Schafer, E. P. Br. Heart J. 1944, 6, 33.4. Experiments on Myself: Memoirs of a Surgeon in Germany. By WERNER

FORSSMANN. Translated by Hilary Davies. London: St James Press. NewYork: St Martin’s Press. 1976. Pp. 352. £4·95, $10·95.

5. Puech, P., Grolleau, R. l’activité fu faisceau de His, normale et pathalogique.Paris, 1972.

University of SouthamptonTHE honorary degree of D.M. is to be conferred on Dr Wil-

liam Macleod, and the honorary degree of M.S. on Mr JohnBarron.

University of GlasgowProf. C. R. Whitfield, professor of obstetrics and gynmcology

in the University of Manchester, and honorary consultant toUniversity Hospital and St. Mary’s Hospital, Manchester, hasbeen appointed to the regius chair of midwifery in the Univer-sity of Glasgow in succession to Prof. Ian Donald.

Queen’s University of Belfast

Dr R. R. Gillies, reader in bacteriology in the University ofEdinburgh, has been appointed to the chair of bacteriology. DrK. D. Buchanan, senior lecturer in medicine at the Queen’sUniversity of Belfast, has been appointed to a personal chairin metabolic medicine. Dr D. A. D. Montgomery, consultantphysician and physician-in-charge of the Clark Metabolic Unitat the Royal Victoria Hospital, Belfast, has been appointed toan honorary professorship in the department of medicine.

GerontologyThe journals, Gerontologica Clinica and Gerontology, pub-lished by Karger of Basle, have combined to form a new inter-national journal of experimental and clinical gerontology,called Gerontology, published six times a year. Letters con-cerning recent contributions to the journal will be encouraged,The managing editor is Prof. F. Bourliere (Paris), the execu-tive editor, Dr H. P. von Hahn (Basle), and the clinical editorDr James Andrews (London). Those resident in the UnitedKingdom may place subscription orders with John Wiley &Sons Ltd., Baffins Lane, Chichester, Sussex.

An international conference on breast cancer, sponsored by thePhysicians Associated for Continuing Education, Johns Hopkins Uni-versity, the American Cancer Society, and the Swiss League AgainstCancer, is being held in Lucerne on Aug. 1-4. Details may be hadfrom Dr Erwin Witkin, 6609 Reisterstown Road, Uptown FederalBuilding, Suite 208, Baltimore, Maryland 21215, U.S.A.

Diary of the Week

MARCH 7 TO 13

Tuesday, 9thLONDON MEDICAL GROUP

5.45 P.M. (University College Hospital Medical School, University Street,WC I.) Dr Jack Dominian: Marital Breakdown.

Wednesday, 10thINSTITUTE OF NEUROLOGY, National Hospital, Queen Square, London WCIN

3BG5.30 P.M. Prof. George Houssemayne du Boulay: Animals Have Arms as wdl

as Legs..(Inaugural lecture.)NORTHWICK PARK HOSPITAL, Watford Road, Harrow, Middlesex HAt 3UJ

1 P.M. Dr Ashley Price: The Diagnostic Value of Rectal Biopsy m MedicalPractice.

ROYAL FREE HOSPITAL, Pond Street, Hampstead, London NW3 2QG5 P.M. Dr O. F. W. James: Paracetamol Toxicity.

Friday, 12thROYAL POSTGRADUATE MEDICAL SCHOOL, Hammersmith Hospital, LondoaWl2

OHS3 P.M. Mr R. W. Blarney: Measurement of the Immune Reaction against an

Allograft.INSTITUTE OF LARYNGOLOGY AND OTOLOGY, 330/332 Grey’s Inn Road, London

WCIX 8EE5.30 P.M. Mr Peter McKelvie: Hypophysectomy.

ROYAL FREE HOSPITAL4 P.M. Prof. R. Schmid (San Francisco): Mechanisms of Asthma.