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211 In England Now A Running Commentary by Peripatetic Correspondents AT a recent trial, the learned judge rebuked a medical witness for using the term " anxiety state." " One of those cliches," he said. " I suppose you mean the man was worried." No doubt our poor colleague would have preferred to point out that anxiety state is not merely a synonym for worry, but it takes some courage-or shall I say audacity ?-to argue with the Bench. Why, a couple of years ago the word " sibling " was derided as " one of those meaningless psychological terms," yet the speaker refrained from exhorting His Lordship not to expose his ignorance ! Medical jargon is one of the outstanding stock Aunt Sallies and is even in the running with kippers, mothers- in-law, seaside apartments, and the rest of the red- nosed comedian’s repertoire. There is ample scope for facetiousness over our polysyllabic phraseology and anybody with an elementary classical knowledge can ridicule the hybrid constructions and the absurd revela- tions of etymological analysis. Even in our own private circle we are inclined to laugh at ourselves ; witness the attempt to select or construct a word which properly connotes what we call venereology. And although at first I resented it, I am now reconciled to having patients referred to me, the neurotic specialist. " A severe contusion of the infraorbital integuments with marked extravasation of blood and ecchymosis of the surrounding cuticular tissue which was in a tumefied state. There was considerable abrasion of the cuticle." You can bet pretty confidently that whenever a new textbook on forensic medicine appears, this alleged description of a black eye will be the example of how one should not talk when giving evidence. During the last twenty-five years I have written to the Lancet and British Medical Journal three times when I encountered a resurrection of this imperishable monstrosity of eircum- locution to inquire for its origin. I first heard it nearly half a century ago when I was a little boy. Such an elaborate construction could never have been produced on the spur of the moment; it smells too much of the lamp. I can imagine some wag pruning and polishing it and keeping it in cold storage until an opportunity arose, but so far I have had no response to my request for the identity of the said wag. It is high time that those who chide us for our periphrasis found some substitute example which is easier to remember and more plausible. Other professions and occupations have their techni- calities, yet nobody criticises them. We don’t admonish the mathematician because he talks of logarithms or exponential curves, and invite him to use plain English. Once I sat in company with a couple of engineers and of their conversation I could not understand two words in ten ; yet I attributed my inability to my ignorance, not to their eclectic affectation. * * * Doctor’s letter to Hospital Physician : " Night sweats. Please investigate." Hospital Physician to Patient : " Do you sweat at night ? " Patient: " Dreadful " Hospital Physician : "What is your job P" Patient: " Night stoker:" At the back of the bookcase I have found a bacterio- logical scrap-book whose first entries are of 1896 and the last of 1902. Before the war the compiler used’to visit the laboratory regularly, an old man very curious after the new knowledge of others and far too prone to belittling his own. In spite of his long connexion there are few records of him in this laboratory which he founded and financed in the spring days of bacteriology ; the part- authorship of an " Atlas of Bacteriology to which no- one now refers (to the loss of everyone ) ; a minute and archaic autoclave ; and the book of lecture notes which he brought back from Paris when he had attended a course at the Institut Pasteur. Alas, by that time the eponymous director no longer lectured and it was young Roux who taught, but our visitor had seen and spoken to the man who had so inadvertently founded "a new science. - I am afraid, Mr. Editor, that it is your contemporary that furnished most of the cuttings. They concern bacteriology only ; they are not indexed ; one misses the comments in the correspondence next week. But in manner and matter they do not differ much from the published articles of today. The subjects ? I quote at random : " The sterilisation of milk and its effect on the nutritive values " ; " The bacteriology of infantile diarrhoea " ; " The antitoxin treatment of diphtheria " ; " Serum diagnosis " ; " The epidemiology of malaria " ; " The parasites of smallpox and chickenpox " (arte- facts I fear in this case). I have not consulted the index for 1945 but I suspect that all these subjects would appear there. But- with one honoured exception-the names would be different. And what names ! The scrap-book reads like the Court Circular of Valhalla : Koch, Manson, Ross, Wright, Haffkine, Martin, Houston, Celli, Cantlie, Delepine, &c., &c., &c. (for once I see point in the tri- petition). Unlike those heroes of the older Valhalla who needed bards to tell their stories, these have written their own, in plain English and without using the word " evaluate." But, like the old old tales, their stories are powerful in dispelling any &bgr;&rgr;&tgr;&sfgr; that may overcome a bacteriologist of today after digesting the banquet of reading matter that showers through his letter-box. We have not yet convinced our legislators that a sterile milk compensates for some small loss in nutritive value. Infantile diarrhoea is one of the commonest hardy peren- nials of Adam Street, and no praise is ever given to the woman who, with a bit of muslin and a dozen beads, made a milk-jug fly-proof. " Serum diagnosis " is a handier phrase than agglutination reaction, and I wish I had had Celli’s article on malaria to read in the Arakan. History merges into mythology and I would like to have known more personalia of the heroic age. Did they wash with alcohol and soap and water before they shook hands with a visitor ? Or did they light their pipes at the bunsen, or hum Dolly Gray as they worked at night alone ? No hint appears in all these papers of the cramped quarters, the improvised apparatus, and meagre recognition enjoyed by these men among whom the compiler was not the least. Before the haze of time covers the view, someone should write the story of the anni decem mirabiles of bacteriology, 1896-1905. * * * . My young friend Cash in the village stores, who figured in these columns about -a year ago, is even thinner and is more often away ill. She was taking down my order a few days ago and concurrently lamenting our diet. I tried to comfort her by saying that things would probably be better later this year. " If we’re not all invalids first," she sighed. In her mind it is a race with time. * * * If plain living and high thinking go together, then I must be well above the mental average, for so far I have seen no improvement in the amount or quality either of rations or luxuries. Even the belt that I am advised to tighten is getting a bit frayed. Usually I do not notice such mundane things, but there are occasions when my proud citadel gets painfully assaulted, par- ticularly when I see a borrowed magazine from the United States. On the advertisement pages, which seem to make up eighty per cent. of the publication, are all kinds of goodies, friendly to tongue and innards, beautifully tempting in all their natural and tinned colorations, and lacking only in availability. There, from the glossy pages, they stare back at me-lobster, lettuce, and salad cream ; fruits of extreme’delicacy and bloom ; bronze-tinted hams and streaky bacon slices ; port and sherry to tempt even a teetotaller ; orange and lemon drinks to satiate the most dehydrated abstainer. " What’s the matter, Jack ? " says my wife, hearing me smack my lips, " Are you hungry ? " And before I have time to answer this disastrous reminder of my newly acquired condition she continues, " It’s sausages today ; very badly needing using up, I think, but all I could get." I have no real grudge against those fine folk of the United States, their President, or their constitution ; but I do wish they would not upset my morale like this. During the war I occasionally got an American medical journal with an article or two painted black by the censor (it took me quite a time to work the black off) ; isn’t
