1
344 The change thus affected had a very swift effect. The much more equitable part-time offer contained in the circular of Nov. 29 reversed the whole position very satisfactorily. As I pointed out in the Times of Dec. 29 (Dr. Anderson misrepresents my letter), within a fortnight of the offer being made the Minister was able to announce in Parliament on Dec. 14 in answer to my question that 337 out of nearly 800 specialists had accepted it. Unfortunately, in the same answer the Minister declared that the offer could not be extended as I asked to members of the E.M.S. receiving the second- grade salaries for whole-time service, as " this sugges- tion had not been made by the Special Committee." This refusal was repeated by the Minister for the same reason on Jan. 25. Dr. Anderson now announces, with what authority I do not know, that this com- mittee has recently recommended the extension which I asked for on Dec. 14. I submit, Sir, that this account of the events in the E.M.S. since the war opened is more reliable than that offered by Dr. Anderson. The Minister in his answer to me on Feb. 8 gave information disclosing the composition and functions of committee No. 4 in my list.2 I am, Sir, yours faithfully, House of Commons. E. GRAHAM-LITTLE. THE MIND OF HITLER SIR,—Drs. Dillon and Ross have torn from its context a phrase of mine in praise of Hitler contained in a scientific paper which I read to the British Association on Sept. 3, 1937. At that time I was trying to get an interview with Herr Hitler, in the interests of psychology, and therefore could not stress the defects of his qualities such as were already becoming apparent. I am, Sir, yours faithfully, WILLIAM BROWN. RANK AND EXPERIENCE SIR,—Rubbing salt into the wounds of punishment is an old torture, but may I humbly call further attention to our military medical services ? It is almost six months since the hundreds of medical men from the reserves were called to the colours. Many had served for several years as volunteers. Many again complained in the early days of this war to their representative association, the B.M.A. All com- munication with the Association to which we have again honourably and hopefully subscribed has been turned aside to the Central Emergency Committee, no matter how personal its nature, as long as it came from a serving officer ! Is the Central Emergency Committee no longer an arm of the B.M.A.? It appears to be fettered by service bureaucrats, and its rosy promises remain unfulfilled. Six months ago few of us could have conceived the bitter treatment which continues to be measured out to many of our " reserve " friends, both by local and high administrative officers. They block the " usual channels " of communication through which we might complain or even inquire. They delight in our sub- jection, and their cool indifference is not offset by the knowledge that our country is at war. Mature physicians and established consultants in all branches of medicine and surgery are not only waiting in relative idleness, but are being subjected to petty dictatorship by those who are their juniors. The R.A.M.C. is old and has traditions; the R.N.V.R. is mature and has a peculiar task; the R.A.F.V.R. is in 1. See Question Time in Parliament p. 338 of this issue. 2. Lancet, Feb. 3, 1940, p. 241. its infancy, and has no history except its prodigious growth. Many of us have worked annually in units of these services, doing our best to be prepared for this emergency. We were welcomed, personally and officially, and our numbers have been used to aid the boast of political debate; but now neither our advice nor our feelings are regarded, and our complaints ignored. The personal position of many of us may be happy, but I speak too for those gentlemen in the profession whose experience and character we have learned to admire and respect in civil life-the staffs of our teaching hospitals, both in London and the provinces. Surely there must be sowe men whose influence and courage are unchecked either by service bureaucracy or by the B.M.A. There must be some solution to a problem which is growing intensely critical, to the detriment of professional harmony. I am, Sir, yours faithfully, JUNIOR. WHEAT GERM AND VITAMIN B1 SIR,—In the annotation on pink disease in your issue of Feb. 3 (p. 229) you write " Forsyth has been favourably impressed with the oral administration of £ vitamin B in the form of wheat-germ oil, Bemax or the crystalline preparation ..." It is not clear whether these are Forsyth’s words or your own; in any event they point to a suspension of natural phenomena. Vitamin B 1 (aneurin chloride hydro- chloride) is a water-soluble substance completely insoluble in oil; wheat-germ oil is, as it must be, completely devoid of vitamin Bi. If Forsyth’s treat- ment succeeded with wheat-germ oil, then it must have been due to something fat-soluble; if his treat- ment succeeded with crystalline aneurin, then it must have been due to something water-soluble. It is difficult to understand how he can have achieved a genuine success with both substances. I am, Sir, yours faithfully, Glaxo Laboratories Ltd., Greenford. A. L. BACHARACH. ** Dr. Forsyth was writing of wheat germ, not wheat-germ oil. We regret the slip.—ED. L. PRIVATE PRACTICE IN FRANCE EVEN before the war the lot of the general practi- tioner in France had become hard owing to congestion in the profession, rising taxation, and the extension of public and charitable medical services provided for the poor and exploited by the well-to-do. The war has supplied the last straw ; more than half the doc- tors in France have been swept into the army in which they have been aimlessly kicking their heels while waiting for war-time casualties. One would think that the remaining civilian doctors must be over- worked and earning handsome incomes. A hint as to the fallacy in this assumption is to be found in a Government order, dated Dec. 1, 1939. This points out that army doctors are forbidden to give their services to persons outside the army, except for humanitarian reasons, and that no army doctor may accept a fee from a civilian. Another order, dated Nov. 1, expresses disapproval of doctors who have joined the army being stationed in areas in which they practised in peacetime-a provision obviously in- tended to prevent a doctor from carrying on his pri- vate practice in spite of his whole-time service in the army. Civilians show a growing tendency to seek free medical advice from doctors in uniform, and when doctors return to their private practices they may find their patients even less willing to pay for services rendered than before. Many a doctor now receiving a regular income from the army dreads the day when he will again have to face the vicissitudes of private practice.

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344

The change thus affected had a very swift effect.The much more equitable part-time offer contained inthe circular of Nov. 29 reversed the whole positionvery satisfactorily. As I pointed out in the Times ofDec. 29 (Dr. Anderson misrepresents my letter),within a fortnight of the offer being made the Ministerwas able to announce in Parliament on Dec. 14 inanswer to my question that 337 out of nearly 800specialists had accepted it.

Unfortunately, in the same answer the Ministerdeclared that the offer could not be extended as Iasked to members of the E.M.S. receiving the second-grade salaries for whole-time service, as " this sugges-tion had not been made by the Special Committee."This refusal was repeated by the Minister for thesame reason on Jan. 25. Dr. Anderson now announces,with what authority I do not know, that this com-mittee has recently recommended the extension whichI asked for on Dec. 14. I submit, Sir, that thisaccount of the events in the E.M.S. since the waropened is more reliable than that offered by Dr.Anderson.The Minister in his answer to me on Feb. 8 gave

information disclosing the composition and functionsof committee No. 4 in my list.2

I am, Sir, yours faithfully,House of Commons. E. GRAHAM-LITTLE.

THE MIND OF HITLER

SIR,—Drs. Dillon and Ross have torn from itscontext a phrase of mine in praise of Hitler containedin a scientific paper which I read to the BritishAssociation on Sept. 3, 1937. At that time I wastrying to get an interview with Herr Hitler, in theinterests of psychology, and therefore could not stressthe defects of his qualities such as were alreadybecoming apparent.

I am, Sir, yours faithfully,WILLIAM BROWN.

RANK AND EXPERIENCE

SIR,—Rubbing salt into the wounds of punishmentis an old torture, but may I humbly call furtherattention to our military medical services ? It isalmost six months since the hundreds of medical menfrom the reserves were called to the colours. Manyhad served for several years as volunteers. Manyagain complained in the early days of this war totheir representative association, the B.M.A. All com-munication with the Association to which we haveagain honourably and hopefully subscribed has beenturned aside to the Central Emergency Committee, nomatter how personal its nature, as long as it camefrom a serving officer ! Is the Central EmergencyCommittee no longer an arm of the B.M.A.? Itappears to be fettered by service bureaucrats, and itsrosy promises remain unfulfilled.

Six months ago few of us could have conceived thebitter treatment which continues to be measured outto many of our " reserve " friends, both by local andhigh administrative officers. They block the " usualchannels " of communication through which we mightcomplain or even inquire. They delight in our sub-jection, and their cool indifference is not offset by theknowledge that our country is at war. Maturephysicians and established consultants in all branchesof medicine and surgery are not only waiting inrelative idleness, but are being subjected to pettydictatorship by those who are their juniors. TheR.A.M.C. is old and has traditions; the R.N.V.R. ismature and has a peculiar task; the R.A.F.V.R. is in

1. See Question Time in Parliament p. 338 of this issue.2. Lancet, Feb. 3, 1940, p. 241.

its infancy, and has no history except its prodigiousgrowth. Many of us have worked annually in unitsof these services, doing our best to be prepared forthis emergency. We were welcomed, personally andofficially, and our numbers have been used to aid theboast of political debate; but now neither our advicenor our feelings are regarded, and our complaintsignored. The personal position of many of us maybe happy, but I speak too for those gentlemen in theprofession whose experience and character we havelearned to admire and respect in civil life-the staffsof our teaching hospitals, both in London and theprovinces.

Surely there must be sowe men whose influence andcourage are unchecked either by service bureaucracyor by the B.M.A. There must be some solution to aproblem which is growing intensely critical, to thedetriment of professional harmony.

I am, Sir, yours faithfully,JUNIOR.

WHEAT GERM AND VITAMIN B1

SIR,—In the annotation on pink disease in yourissue of Feb. 3 (p. 229) you write " Forsyth has beenfavourably impressed with the oral administration of £vitamin B in the form of wheat-germ oil, Bemaxor the crystalline preparation ..." It is not clearwhether these are Forsyth’s words or your own; inany event they point to a suspension of naturalphenomena. Vitamin B 1 (aneurin chloride hydro-chloride) is a water-soluble substance completelyinsoluble in oil; wheat-germ oil is, as it must be,completely devoid of vitamin Bi. If Forsyth’s treat-ment succeeded with wheat-germ oil, then it musthave been due to something fat-soluble; if his treat-ment succeeded with crystalline aneurin, then it musthave been due to something water-soluble. It isdifficult to understand how he can have achieved agenuine success with both substances.

I am, Sir, yours faithfully,Glaxo Laboratories Ltd.,

Greenford.

A. L. BACHARACH.

** Dr. Forsyth was writing of wheat germ, notwheat-germ oil. We regret the slip.—ED. L.

PRIVATE PRACTICE IN FRANCEEVEN before the war the lot of the general practi-

tioner in France had become hard owing to congestionin the profession, rising taxation, and the extension ofpublic and charitable medical services provided forthe poor and exploited by the well-to-do. The warhas supplied the last straw ; more than half the doc-tors in France have been swept into the army in whichthey have been aimlessly kicking their heels whilewaiting for war-time casualties. One would thinkthat the remaining civilian doctors must be over-worked and earning handsome incomes. A hint asto the fallacy in this assumption is to be found in aGovernment order, dated Dec. 1, 1939. This pointsout that army doctors are forbidden to give theirservices to persons outside the army, except forhumanitarian reasons, and that no army doctor mayaccept a fee from a civilian. Another order, datedNov. 1, expresses disapproval of doctors who havejoined the army being stationed in areas in which theypractised in peacetime-a provision obviously in-tended to prevent a doctor from carrying on his pri-vate practice in spite of his whole-time service in thearmy. Civilians show a growing tendency to seekfree medical advice from doctors in uniform, and whendoctors return to their private practices they may findtheir patients even less willing to pay for servicesrendered than before. Many a doctor now receivinga regular income from the army dreads the day whenhe will again have to face the vicissitudes of privatepractice.