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of Groningen in 1960. This designation is repeated elsewherein the Continental literature by Borglin.1We hope that Dr. Hewett’s excursions into the relative

merits of description in terms of the oestrane ring or in terms oftestosterone- will not distract attention from the central factthat the compound his company is marketing is a 19-nortesto-sterone compound. We have no quarrel with the use of

oestr-4-en-17-ol except that it is impossible to say and inprint the clinical mind baulks at it. The term 3-desoxy-19-nortestosterone was used by Willemsen and gave us the formulafor allylestrenol without reference to the list issued by theGeneral Medical Council. There is a difference of choice, notof fact, between us in the argument about names.

A. KLOPPERM. C. MACNAUGHTON.

Medical Research CouncilObstetric Medicine Research Unit,

Medical School,Aberdeen.

1. Borglin, N. E. Acta endocr. Kbh. 1960, 35, suppl. 58.

SIR HAROLD GILLIES MEMORIAL FUND

G. H. MORLEYPresident,

British Association of Plastic Surgeons.

SIR,-With the approval of Lady Gillies, the BritishAssociation of Plastic Surgeons has opened a fund tocommemorate the pioneer work of the late Sir HaroldGillies and to perpetuate his lifelong devotion to thedevelopment of plastic surgery and to the encouragementof younger surgeons during their period of training to beplastic surgeons.

It is proposed to endow a fund to provide for:(1) An annual lectureship on a plastic surgical subject, to

be known as the Gillies Memorial Lecture.

(2) Grants to foster education, study, and research in plasticsurgery.

Contributions to this fund are invited and shouldbe sent with the name and address of the donor to theWestminster Bank Ltd., 154, Harley Street, London,W. 1, marked " Sir Harold Gillies Memorial Fund".An acknowledgment will be sent as soon as possible.

Parliament

Commonwealth and Common HealthIN the debate on Feb. 22 on aid for underdeveloped coun-

tries, Baroness SUMMERSKILL asked whether we should besatisfied with our record in social welfare in the Common-wealth. There was urgent work in medicine which we had

neglected. Throughout the Commonwealth there were grossinequalities. In some parts there was a struggle for medicalwork, and precious time was wasted on trivial complaints; inother parts there were large numbers of seriously ill patientswith little hope of any medical service. In Britain, a doctor’smaximum list was 3500 patients-and even this figure wasrightly regarded as too high. In Sierra Leone there was 1 doctorto 26,000 people, in Nigeria 1 doctor to 57,700 people, inKenya 1 doctor to 10,500 patients, in Uganda 1 doctor to

15,900 patients, and in Northern Rhodesia 1 doctor to 8140

patients.We should take to the underdeveloped countries medical

services which would be widely appreciated and well withinour means. No doubt much good was done when our well-meaning missionaries carried the Bible to distant lands; buttoday the rod of Nsculapius would prove a more formidableweapon. Men and women throughout these countries knewthat poverty, hunger, disease, and ignorance could be remedied;and they would incline to the nation which offered them reliefand help. Here was an opportunity for the Minister of Healthto undertake a task of real nobility. We needed an all-embracingmedical plan for teaching and research over the whole Common-wealth. Indeed, if we in this country prepared a plan, it could

be regarded as a prototype for other nations throughout theworld. Some small attempts had been made by individualsimpelled by idealism to meet the needs of the underdevelopedcountries; but something more comprehensive was neededwhich would inspire men and women to give their servicesabroad. The Prime Minister could raise the matter of a medicalservice within the Commonwealth at the next Prime Ministers’conference, and a Commonwealth Medical Conference couldbe organised.

In his reply the Earl of PERTH said that we had over here at

the moment 2000 medical students; in the Colonies there werea further 1300 medical students, and in Nigeria 220. It wasalready perfectly possible for doctors or medical teachers whowanted to go out to be financed from this country (if theywere going into public service) under the Overseas ServiceBill, which the Government hoped to pass in a short time, or(as medical teachers) under the technical assistance agreements,None the less, this was a tremendously important subject, andhe would certainly draw the attention of the Minister of Healthto the thought that, whereas education was the subject at theFinance Ministers’ Conference at Montreal, we, as a Common.wealth, might now think even more about health.

Tuberculosis and Food-handlers

ON Feb. 21, at the report stage of the Public Health Bill,Lord AMULREE moved to insert a new clause prohibitingpeople with tuberculosis from handling food. Though thedanger of spreading the disease through a food handler wasnot great, in his view it existed. He suggested that someonewho went regularly to the same restaurant for a midday andevening meal might, through getting massive regular dosesof tubercle bacillus in his food, eventually suffer by thatinfection getting into his pulmonary system and giving himpulmonary tuberculosis. People with tuberculosis employedin preparing and cooking food could be a great danger tothe colleagues working with them, often in small kitchens. Insnackbars a tuberculous assistant handing food across a

counter might infect a customer. A waiter with active pul-monary tuberculosis might infect some of his customers.Treatment for pulmonary tuberculosis was far more satis.

factory than it was not long ago; and many people were cured,Therefore we wanted as many people as possible to go intohospitals or sanatoria or even have treatment in their ownhomes, rather than to carry on working, rather uncomfortably,and infecting the people working around them.

’

Lord TAYLOR opposed the clause, which he thought wasfounded on a misconception. Bovine tuberculosis could be

spread by milk, but there was no evidence that anything exceptdroplet spray carried infection of other forms of tuberculosi.If Lord Amulree wanted to prevent that, the clause shouldinclude cinema usherettes and assistants in any crowded stote.There was no reason to single out the food trade. BaronessSUMMERSKILL disagreed with this point of view. Surely thedried sputum of a tuberculosis patient carried infection. Evenbus carried a notice saying that the penalty for spitting was ? 5Much of our preventive medicine had been introduced becausestatistically it had been proved that there might be evidencewhich perhaps pathologically we had not necessarily beenable to deduce. She agreed that the clause should also appl1to cinema usherettes, but that would be impracticable. Thete’fore we must do what we always did in this country: adjust iour legislation to the needs of the time and do it in piecemeslfashion.Lord NEWTON said that in the view of the Government’s

medical advisers there was no special risk of the transmisgmddisease through the handling of food which would justiÍ1singling out in general legislation this particular activity f«

prohibition to people with tuberculosis. It was generally hetttby the medical profession that pulmonary tuberculosis was 0airborne and not a food-borne infection and that infection wasby inhalation rather than by ingestion of droplets. The PublicHealth Laboratory Service had confirmed that, in their ??’there was no danger arising from the handling of food by tubetculous persons. Tuberculous people working in a restaua"’!

515

café, bar, or teashop were not any more or less likely to infectpeople who came into those premises than those who worked inshops or offices or other confined premises. A regular customerwith tuberculosis was just as likely to infect other customersas an infected waiter or barman. Lord Newton also agreedthat people who had open tuberculosis should not be en-couraged to go about too much among the community untilthey were under proper drug-control, but legal restrictions ontheir movements could be justified only on the ground of riskto others. It was for their own medical advisers to persuadethem to do what was for their own good. Admittedly the pro-visions of this clause had been included in many local Acts,because it was then believed that tuberculosis was due to aninfection of the alimentary tract, but this view had now beensuperseded in the medical profession.Lord AMULREE, withdrawing the clause, admitted that he

was not entirely convinced by the Government’s arguments.He believed that, if people who had open tuberculosis werehandling food and serving other people, they were more liableto infect those other people than if they had not got it.

QUESTION TIMECost of Prescription Refunds

Mr. G. R. CHETWYND asked the Minister of Pensions andNational Insurance what had been the average administrativecost to the National Assistance Board of an application for a re-fund of the prescription charge; what estimate he had made ofthe cost when the charge was doubled; and what was his estimateof the additional applications that would be made.-Mr. J. A.BOYD-CARPENTER replied: The estimated total administrativecost of refunds of prescription charges by the National Assist-ance Board is at present about E145,000 a year. This has to beset against a total amount refunded of El,066,000 in 1960, andrepresents rather more than 1. per ls. prescription item.The increase in the charge should of course tend to reduce theadministrative cost in proportion to the amount refunded,since the administrative cost of refunding 2s. must be approxi-mately the same as that of refunding ls. Some increase in thenumber of applications for refunds may be expected.

Refunds of N.H.S. ChargesIn 1960 grants made for N.H.S. charges from the National

Assistance Board totalled E2,154,000, of which E2,002,000 waspaid to people already receiving a regular weekly NationalAssistance grant and U52,000 to other people.

Consultants and Their Awards

The following table gives the number of consultants in theNational Health Service in England and Wales in each specialtyand shows the distribution of merit awards:

If a consultant practises in more than one specialty, he has been includedin each.

Cost of Pharmaceutical Services

The cost of the N.H.S. pharmaceutical services in Englandand Wales during 1958-59 falls under the following headings:Payments to dispensing doctors for services and for E

drugs, appliances, and dressings supplied.... 2,300,000Payments to chemists and appliance contractors in

respect of:(a) Dispensing fees and rota services.... 12,750,000(b) Oncost allowances......’ .... 10,430,000(e) Allowances for containers ...... 1,370,000(d) Cost of appliances and dressings .... 2,080,000(e) Cost of prescriptions specifying drugs by

standard names.......... 9,180,000(f) Cost of prescriptions specifying drugs by pro-

prietary names .......... 30,450,000

68,560,000

Payments to chemists at (a) and (b) constitute payments for over-heads, professional services, and profits. The total of payments at(d), (e) and (f) includes an estimated sum of E630,000 for purchase-tax. Wholesalers’ margins are estimated to account for t51/2 million-E6’/s million of the total of the payments at (d), (e), and (f).

Obituary

HAROLD CHARLES CORRY MANN

O.B.E., M.D. Lond., M.R.C.P.

Dr. Corry Mann’s investigation into the nutrition ofboys of school age attracted much attention when it wasmade some thirty-six years ago, and in its application ithas proved of permanent benefit to the nation.He qualified from Guy’s Hospital in 1903. After holding

appointments at Guy’s as medical registrar, tutor, and assist-ant demonstrator in pathology, he decided to specialise inchildren’s diseases, and he joined the staff of the Evelina Hos-pital for Sick Children. He was also physician to St. Saviour’sand St. Olave’s grammar schools.

He soon became interested in nutritional problems,and in 1914 published an important paper on the feedingof infants and prevention of rickets. After the war heundertook research work for the Medical Research Coun-

cil, and his first report in 1922, on environment and dietas causes of rickets, was a continuation of his earlier work.In 1919 the Committee on Accessory Food Factors issueda memorandum stressing the importance of includingvitamin-containing foods in all dietaries. Milk had beendistributed in some London schools as early as 1908,and in order to obtain further scientific data on the sub-

ject the Ministry of Health in 1924 asked the M.R.C. toconduct a field experiment. Sir Gowland Hopkins, aschairman of the Accessory Food Factors Committee,entrusted this work to Corry Mann.He carried out his inquiry among boys of a London insti-

tution who lived in villas of 30-35 boys each, under comparablehousing and domestic conditions. They all had the samebasic diet, but to some groups Corry Mann gave an additionalpint of pasteurised milk daily. Records were kept of theirheight, weight, physical fitness, and general health for 1-3years.

Corry Mann carried out this work with unflaggingindustry and meticulous care; and in his report, whichwas published in 1926, he was able to show that the boyswhose diet was supplemented with milk gained moreweight and grew faster than the controls. Similar experi-ments by Orr, Leighton, and McKinlay confirmed hisfindings. The milk-in-school scheme was started by theBoard of Education, and by 1934 three million childrenwere receiving milk daily at school. Corry Mann’s find-