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local council. But since he would be organising theprophylactic health services-child welfare and schoolmedicine, ante- and post-natal services, industrial health,and diphtheria immunisation-through the health centre,it would be best for his administrative loyalties to be thesame as those of his clinical colleagues.

National OrganisationTwo parallel national organisations appear to be

needed. First, the Ministry of Health could performmost of its present health functions, and be responsiblefor allocating block grants to the Provincial Health’Councils. ,

Secondly, a supra-provincial council, representingall health interests, should be responsible for running.any services that must be organised on a national scale.Among other tasks this National Health Council mightfoster initiative and experiment in medical teaching andgive grants to medical schools. It would also allocategrants to the national specialist hospitals, essential forhighly specialised treatment, advanced teaching, andresearch, and might set up such new national specialisthospitals as were needed. It might finance the MedicalResearch Council. And it might decide on nationalrates of pay for members of the medical profession.

FAMILY PLANNING CLINICSA CONFERENCE of branches of the Family Planning

Association was held in London on June 19 with theLady Denman in the chair. The inauguration of clinicsfor the treatment and investigation of involuntarysterility, to be held on the premises of the present contra-ception clinics, was considered, and medical officers frommany clinics throughout the country thought the projecta good one. The association hopes to establish a Londoncentre at which pathological investigations and researchon, seminology could be undertaken ; many of themedical officers present undertook to attend a week-endinstructional school on modern methods of investigatingsterility.

Mr. CEDRiC LANE-RoBERTS pointed out that moststerile matings are due to some degree of subfertility inboth partners. Study of such cases has become so

complicated that many practitioners will probablybe glad to send patients to " motherhood clinics " ;the centre doctor must of course keep in touch withthe patient’s general practitioner. He had seen suchwork carried out at the Exeter clinic, where it has beenshown that, in spite of inadequate quarters and staff,it is possible to achieve the highest standard of efficiencyin advanced techniques. This centre is also doingvaluable research. He considered that a central bureauwas needed in London, where team work could beundertaken and from which research findings could bepublished.

Dr. MARGARET HADLEY JACKSON (Exeter) describedthe running of a "motherhood clinic " in the premisesof the contraception clinic. She had had full cooperationfrom the radiologist and gynaecological surgeons . ofthe area, as well as the help of the expert pathologists ofExeter, who were undertaking studies in seminology.On very simple premises it .had already been possibleto carry out insufflations, and many salpingogramexaminations, endometrial biopsies and Huhner’s post-coital tests. She emphasised that careful tabulation ofdata is an essential part of the clinic duties ; and pointedout that though some clinics might not be able to under-take such exhaustive examinations this was not importantsince many have the necessary facilities available atneighbouring hospitals.

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Mr. ALECK B0UBNE reminded the association of theenormous field for research which their clinical materialpresented. There is reason, he said, to believe thatthere is some real biological cause for the falling birth-rate, expressed in the increasing subfertility of male.and female individuals. The steady fall of birth-ratein such countries as the Balkans (where contraceptionis negligible) supports this view. Though there are greatdifficulties in establishing clinics for the treatment ofsterility, he believes that in doing so the associationwill be tackling one of its main objectives.)

In England NowA Running Commentary by Peripatetic CorrespondentsTHEY were talking in the night-nurses’ room over a

pot of tea. " He got a telegram this morning to sayhis wife had had a girl," said Smith, "and all yester-day evening he was sitting on the edge of his bed doubledup and groaning with pain. He said he could feel hisback opening and closing. He was certainly feelingsomething. He was as pale as a sheet and the sweat wasstanding out on his forehead and on his lip." " That’swhat they call couvade," said Jones. " South American.Indians or something do it. The man goes to bed andhas the witch doctor and all his friends round him andgets the pains, while the woman works in the fields andquietly has the baby under the hedge. A man in myvillage did it. He was real bad, and his wife never hadany pain at all."

" Well, this lad in A 23 was groaningall night," said Smith, " and he was fast asleep-nomistake. He was rolling. around in the bed half doubledup and groaning and fast asleep. He woke some of theother patients with the noise he was making, but henever woke. When I came on yesterday he told me hewas getting the pains every half-hour, and then later itwas every quarter of an hour. He thinks very highly ofme. I told him he would have a girl. It’s only an oldwives’ tale, you know-when the man has the pains,the baby is a girl. But sure enough, when the telegramcame it was a girl." " Do you think he was really inpain," I asked. " Or was he only feeling somethinghe thought was a pain ? " That stopped them.

* * *

If medical planners want to know what practice will belike under the control of a lay committee of a localauthority or group of authorities they need only asktheir colleagues whose life has been tied up with aldermenand councillors-the medical officers in the public healthservices. A sorry tale would be the outcome ; not somuch from juniors and assistants who to their electedbosses are less than the dust beneath thy chariot wheelas from chiefs and deputies who have to deal with theirlay masters in conference and committee. There are, ofcourse, chairmen who, being experts in their own privateaffairs, appreciate that their medical officer can also bea man of integrity of soul with a desire to do his best.Such a chairman is heaven-sent sunshine to the official,who can then get on with his job, feeling that in questionsof policy and finance he has the backing of real powerand democracy-the good of the neighbour. But thereis the other type, armed with brief authority but never-theless a potent nuisance. la him is concentrated thepower-urge ; he is chairman; his chief official is a

debased salary-slave to be ordered about; and only adoctor at that. Between these extremes, there are all theintermediate types; and the same can be said of thealdermen and councillors who go to form the rank andfile of the ruling committee. As individuals they aremostly decent men and women, eager to learn, fair intheir dealings, passionate in their desire to help society ;but in the concourse of a committee-room decisions areoften taken hastily in the babble of cross-talk and partystrife. Sober balanced argument, as one would have in awell-conducted debating society, with subsequent votingafter reasoned deliberation, is absent. Fortunately,larger issues may be left to the chairman and medicalofficer of health, or to a small subcommittee where moretime can be given to them, and where a carefully wordedreport has a chance of winning the day. But art andnot science is the basis of success ; and art withoutscience will not make for good doctoring. Utopia formedicine will need a new type of layman in the councilchambers of democracy if laymen are to have the finalsay in the destiny of our profession.

, , * * *

The Government has got the wrong idea about usgirls and our legs. There are two kinds of stockings inthis vale of tears, named, in the haberdasher’s jargon," unfashioned " and " fully fashioned." Unfashionedare made like a tube ; fully fashioned have curves tomatch nature, woven into the material. Owing to’thepeculiar contours of the human leg, unfashioned stockingsare so much salvage in a couple of days-well, say three.They begin by being too tight in the calves and above

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the knee, and too slack at the heel and ankle. The resultis not merely an aesthetic fiasco (which hardly mattersjust now) but a total loss. The tops of these unrealisticgarments (planned presumably to cherish the leg of adining-table) tear under the suspender, the back seamsgo into a row of little peep-holes down the calf, and theheels wear blisters in the owner and holes in themselvesin one diabolic combined offensive. No woman whowants to save time, money or material flings her sub-stance away on such trash. She buys a fully-fashionedstocking and goes on wearing it, often for months beforethe first darn (with a well-organised system of reliefs, ofcourse). It marks one of the first hitches in the utilitycampaign that the women of England are spending hoursof their brief leisure trudging from shop to shop on thetrail of the fully-fashioned breed. There are stockings,millions of stockings, all unfashioned and relativelyuseless; a fraction of the number of fully-fashioned wouldkeep the bright and beautiful English girl skipping roundthe lathes for months to come without a’darned thing onher mind--or on her feet either. As it is she is a crippledmiserable hag who spends every Sunday with the darningneedle. Let us have a decent lisle fully-fashioned stocking,deserving the honest name of utility, and which of us willhesitate to shake a pretty leg in the country’s business ?

* * *

Someone has no doubt remarked that our commonlanguage is one of the great obstacles to Anglo-Americanunderstanding. Postwar cooperation is going to bedifficult unless we appreciate that we are different nations,with different standards and different outlooks, but ifwe do realise our differences we shall be able to make fulluse of,the vast amount we have in common. Who butan American would end a letter " with Best Wishes forthe Empire " ? Even the bluest of die-hard tories wouldhesitate to use such a phrase. Or take the reaction tothe declaration of war in the States. Within a few weeksof the entry of America into the war I received a letterfrom the editor of an American journal informing me,with regret, that it had been decided to suspend publica-tion for the duration of the war. And now I havereceived the following from another American medicaljournal: " Because censorship laws during war-timerequire so much detail, it is practically impossible forour journal to comply with them. Therefore, we hopeyou will understand the removal of your name from ourmailing list for the duration of the war." What arethese censorship laws that are so troublesome thatjournals find it easier to avoid them than try to complywith them ? We have a strict enough censorship in thiscountry, but there is little difficulty in complying withit. But that the American censorship is complicated isconfirmed by the emasculated condition of certainAmerican journals when they arrive over here-withpages torn out and the title of the missing article heavilyblacked out in the index. Our librarian sublimates hiswrath at this interference with efficient cataloguing byspending long hours trying to decipher the blacked-outtitle.* A little cold water works wonders.

I only pray that our differences will never disappear.Hollywood, jazz, and American slang may be strange toour eyes and ears, but Americanisms are only unpleasantwhen perpetrated by Englishmen. Let us keep our

national characteristics, including our languages, andall will be well.

* * *

Came the time at last when your correspondent wastold that he was fit to be peripatetic and that a journeywas really necessary. With his overworked WVS wifehe made for the house of kind friends in his native land.Departure from London was a novelty-one of thenew double-decker sleepers, comfortable and matey.The ticket examiner said I must pay the full fare, but thecar-conductor aided my convalescence by contradictingand stating that a refund would be made on request.The journey on the main line was pleasant and unevent-ful. Table at breakfast was shared with a HLI majorand lady who made an ineffective effort to have the war-time sausage classified as not a meat course. She wasfirmly informed that she might have sausage or bacon,but not sausage and bacon.We saw our main-line train steam out punctually.

News of our connecting train before we started on abranch-line of the old Highland Railway was suspici-

ously vague. The air was keen, and consideration forhyperchlorhydria brushed aside patriotic feeling so thatwe crossed the road for a second breakfast. It was anhour and a half before at last we left, but comfort wasafforded by the news that the new train went straightthrough to our journey’s end. A travelling ticketcollector, an unexpected phenomenon, dispelled thatdelusion. We must change at X and again at Y." Would we catch the connexion at X ? " " Aye, if she’sstill there." After a pleasant and leisurely progressthrough fine scenery with a noteworthy absence of snowwe arrived at X to find that " she " wasn’t there. Anotherwait ensued, and we were thankful for that secondbreakfast. Prospects of catching the connexion at Yseemed dim, but it was some relief to hear that there wasa good bus service and that the buses started from justoutside the railway station. After three-quarters of anhour’s delay we were off again and shortly heard " Allchange here " at the county town, our penultimate stage.Yes, ’there was a train on (4t hours later)-" Fiveo’clock if ye care tae wait." We didna, but with hand-luggage (all we had) blithely passed the barrier to thebus outside. No such luck ; again we had been mis-informed, for all buses started nearly a mile away inthe High Street. Thither we went, uphill all theway, to find the next bus was due in an hour’s time.My wife knew from previous visits a good restaurantto which she guided me, but the door was shut and anotice up " Closed for the dinner-hour." Were we inCaledonia or Hibernia? But that lost journey was notafter all in vain-the sight of a garage opposite broughtfresh hope to two tired travellers. Certainly we couldhire a car, said the proprietor as he called a driver.The driver was not so sure,

" Should we no’ ask the polis’furrst ? " These scruples were quickly overcome, allwas well and our friends received us with Hielan’hospitality.

So was completed a journey of 660 miles. Once offthe main-line adherence to time-table was not too strictand trains naturally were not many, but everybody washelpful and cheerful, eager to answer the most stupidpassenger’s questions. What mattered it, then, if theinformation given, sometimes spontaneously, was notinvariably accurate ? Greased line, a small Green-Highlander and a 9-lb. salmon ended off a pleasant nightand day.

* * *

When one sees a cadaver lying on the post-mortemslab-gaunt, thin, uncovered-one is apt to reflect onthe stark unloveliness of the dead human. Comparedwith a deceased mouse or bird, their natural colours stillsplendid in the quiet dignity of death, there is somethinguncanny in the ashy’ pallor of man. So also in life weare at a disadvantage when undraped and in our birthdaysuits ; all of us reduced to a least common denominator.Even a pair of bathing drawers or a bath robe makes adifference, and a man can look the world in the face as anathlete or a philosopher. He is childish indeed who talksof the tyranny of clothes. Let him look at himself inhis mirror and observe the scraggy legs and pendantabdomen of middle age, the comical baldness of headand the less required hirsuties of other parts, and askhimself if he is the god-like fellow his patients think he is.Does he imagine he would get that consultant’s fee iftrousers, waistcoat and jacket did not cover his nudity ? ’eDoes he reflect what a sorry picture he would be withnothing but his binaural stethoscope dangling from hisneck in sartorial impudence ? Even a utility suit, how-ever sadly we deplore the absent turn-up, is better thanthat.

* * *

I had paid a visit to the blacksmith’s wife and steppedinto the forge to have a word about her with maister.He had just lifted a white-hot shoe out of the fire andwas hammering it on the anvil as though his life dependedon it. Sparks and chunks of glowing metal flew in alldirections, many alighting on my coat. I can take ahint as well as most, and, feeling de trop and a littlehurt, backed out of the door and into my car. Apolo-getic and sweating, the smith came running after me."

Zorry, doctor," he said, "I zeedyou come een but Icouddn stop. You got to strike while the iron’s ’ot."Of course you have. When confronted with the literalinterpretation of a proverb one ought to recognise it.