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physician in psychiatry at the Hospital and teacher of genera-tions of students in the Medical School; Queen Char-lotte’s and the Royal Masonic Hospitals were also faithfullyserved by him. His patients came from many countries. Hewas not a prolific writer, but his papers were always to thepoint, valuable, and based on his remarkable clinical acumenand experience.

" His leisure hours were richly filled and enjoyed. A keenyachtsman, a prolific reader especially of history, and a goodFreemason, he was at his happiest as a genial host, enjoyinggood company, good food, and good wine. His family life wasa constant source of joy to him, and he had many serene yearsof retirement."

TERENCE CHARLES ST. CLESSIE MORTONC.B., O.B.E., M.D. Edin., F.R.C.P.

Air Vice-Marshal T. C. St. C. Morton, formerlyconsultant in pathology and tropical medicine to theRoyal Air Force, died on Oct. 16 at the age of 75. Hejoined the R.A.F. in the year of its formation, and he sawthe celebration of its 50th anniversary before he died.He was educated at Stewart’s College, Edinburgh, and

trained in medicine at Edinburgh University and UniversityCollege London. He joined the R.N.V.R. as a surgeon pro-bationer in 1914, and after passing his M.B. in the followingyear he became a temporary surgeon. He was in action in thebattle of Jutland in H.M.S. Temeraire and finished his navalcareer at Longside Airship Station. His service in the RoyalAir Force, to which he transferred on its formation in 1918,lasted 33 years, during which he undertook a wide varietyof duties from commander to consultant at home and abroad.In 1922 he took the M.D. He was appointed o.B.E. in 1935and he was mentioned in despatches for his work as principalmedical officer, British Forces in Iraq, during the 1939-40rebellion. By 1943 he gave his professional time principallyto pathology and tropical medicine. In the following year hewas elected F.R.C.P., he was appointed consultant in pathologyand tropical medicine to the R.A.F., and he was made anhonorary physician to King George VI. His final promotionwas to air vice-marshal in 1948, and in the same year he alsobecame the senior R.A.F. consultant. In 1950 he was

appointed c.B. and in the following year he retired from theR.A.F. This was the beginning of a third career-he becamethe area pathologist for West Cornwall, a post he held for thenext ten years.He is survived by his wife, Emily Frances.G. H. D. writes:" Morton was an imposing man: a fine presence, an alert

mind, and a sympathetic personality. His main professionalinterest was tropical medicine, particularly dysentery, sprue,and snake-bite, in all of which he had a considerable reputa-tion. But he did not shut himself in the laboratory. He pre-ferred contact with his patients, and he was an enthusiasticmember of the Association of Clinical Pathologists, serving onthe council from 1950 to 1953. He was also a member of thecouncil of the Royal Society of Tropical Medicine and Hygienefrom 1948 to 1951." He was a fine teacher and a lecturer of the first order.

Much of his work was published, and he was also the author ofa novel, All Square with Fate (1933). Despite so full a profes-sional life, he found time for sport: in his youth rugby, latershooting, fishing, and golf. Wherever he went, he made friendswho reacted to his gentle manner and his sympathetic charac-ter. Sailor, airman, doctor, teacher, writer, sportsman: a fulllife." "

A service of thanksgiving for the life and work of the lateSir Arnold Walker is to be held on Wednesday, Nov. 6, atnoon, in the Priory Church of St. Bartholomew-the-Great inthe City of London.

Notes and News

EPIDEMIOLOGY OF COMMUNICABLE DISEASES

Dr. George Macdonald, director of the Ross Institute andprofessor of tropical hygiene at the London School of Hygieneand Tropical Medicine, died on Dec. 10, 1967. His memorywas celebrated on Tuesday when Prof. L. J. Bruce-Chwatt,Macdonald’s successor in the chair, delivered the GeorgeMacdonald memorial lecture.

Professor Bruce-Chwatt recalled that mathematical methodwas widely applied to the study of malaria at the beginning ofthis century. Sir Ronald Ross’s key contribution led to theformulation of a discipline given the name of " a-prioripathometry ", which presumed a knowledge of causes of aninfectious disease, constructed a series of equations derivedfrom numerical values of separate factors, and finally comparedthe calculated results with the observed data. General interestin this approach soon waned, but was revived in the 1950s byGeorge Macdonald, whose work had a profound impact onmalariology since it coincided with the beginning of the world-wide malaria eradication programme coordinated by the WorldHealth Organisation. Macdonald sought to select the importantfactors in the transmission of this disease, to give themnumerical values, and to construct a mathematical model thatcould be used wherever a malaria control or eradication pro-gramme was planned or carried out. The keystone to under-standing of the dynamics of transmission of malaria was the" basic reproduction-rate " of the disease or the number ofsecondary infections that would originate from a single primarycase of malaria. Some of the most important factors in theepidemiology of malaria related to the vector. The proportionof the population of Anopheles which survived long enough forthe development of malaria parasites in them, and for trans-mission of the infection to another person, depended on themortality to which these mosquitoes were exposed. Macdonald’smodel of malaria infection gained rapid acceptance because,although it represented a complicated chain of events, eachelement could be well defined and was potentially measurable.An important feature of this model was that its equilibriumwas very sensitive to variations in the mosquitoes’ behaviourpattern and longevity. The new picture of the dynamics ofmalaria had a great influence on the theory and practice ofmalaria eradication. Practical applications of Macdonald’sdynamic models of malaria had been tested either by analysinga specific malaria situation from the collection of observedfield data or by designing specific control or eradication pro-grammes from a theoretical model and selecting a yardstick ofexpected progress. Time-consuming calculations involved inthe operational use of Macdonald’s models had been enormouslyspeeded up by the use of computers. A number of modifica-tions could now be introduced to run off a score of simulated

happenings in order to see which most closely fitted theobserved events. Some of these had been compared withactual happenings in malaria-eradication projects in Nigeria,Syria, and a few other countries; and the results were generallysatisfactory. The fact that many epidemiological factors ofmalaria transmission could be meaningfully represented inmathematical form should not hide the real problem of measur-ing directly in the field some of the basic variables. Thus thelack of standardised, simple, and reliable methods affected thecollection of entomological data in the field.Models developed by Macdonald for malaria could not be

directly applied to other communicable diseases but this typeof approach is of considerable promise. A tentative mathe-matical model of transmission of schistosomiasis was based onthe sexual differentiation of the parasite. The eggs, miracidia,and sporocysts in the snail as well as the free-swimmingcercarias were either males or females; and the dynamics oftransmission depended on the rate of production of eggs bythe female worm and on the probability of the male and femalecercariae coming together in the vertebrate host. This modelhad been used for calculation by computer of the outcome of

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the interaction of different parameters operating for variousperiods. In the field the value of this model, requiring thecollection of data on the effective infection-rate in the snail, hadbeen assessed in East Africa and on the island of St. Lucia.

Transmission of filariasis was also susceptible to mathe-matical analysis, although the discrepancy between the value ofinoculation-rate in the insect and the age-gradient of theincidence in the human population presented some difficulty.Measles epidemics and arthropod-borne infections other thanmalaria could also be analysed by modifying one of Macdonald’smodels.

Macdonald was far from being a narrow specialist, a

theoretician interested only in mathematical analysis of trans-mission of communicable disease. He was passionately devotedto the improvement of health and social conditions in develop-ing countries. He sounded a warning to those who thought thatinfectious disease had been conquered, and that tropicalmedicine was a vestige of the old " colonial past " and can nowbe safely forgotten. He believed that prevention of tropicaldiseases demanded active intervention, and special knowledgeand competence. He also felt that Britain had a moral obliga-tion to increase the share of her help to developing countriesof the world: the growing gap between the rich and the poorcountries was a menace to mankind.

George Macdonald’s colleagues, friends, and pupils all over theworld have decided to collect funds to endow an annual prize for animportant advance in preventive medicine in the tropics. Contribu-tions may be sent to the Dean, London School of Hygiene andTropical Medicine, Keppel Street, London W.C.1, marked" Macdonald Memorial Fund ".

ROYAL SOCIETY OF TROPICAL MEDICINE

AT a meeting of the Royal Society of Tropical Medicine onOct. 17, Prof. P. C. C. Garnham, F.R.s., presented the O’Connoraward for filariasis jointly to Prof. J. C. C. Buckley and Mr.R. McMahon, in recognition of their pioneer work on thecontrol of Simulium flies, the vectors of onchocerciasis, and ofProfessor Buckley’s important taxonomic studies of filariasis,especially the brugia species. As a result of their work, largeareas of Africa have been freed from filariasis.

Dr. F. Hawking presented a paper by himself, M. J. Worms,and K. Gammage on 24- and 48-hour cycles of malariaparasites in the blood. Gametocytes of malaria parasites, hesaid, are mature for only a few hours during the night, at thetime when mosquitoes feed. The cyclic development ofthe parasite is therefore in step with the feeding habits of thevector. In certain infected monkeys the appearance of themicrofilariae in the peripheral blood is determined by changesin temperature. Dr. Hawking and his colleagues used monkeysinfected with Plasmodium knowlesi. Some of the monkeys werecooled during the day and warmed at night, i.e., the reverse ofthe normal rhythm. Cooling delayed the time of schizogony.After cessation of daytime cooling the cycles took about 16 daysto return to normal. When a parasite shows a biologicalrhythm, said Dr. Hawking, this can usually be shown tofacilitate transmission to a new host. The question is, whatmechanisms maintain the cyclic rhythm, and how do they doit ? This is difficult to unravel, but the answer may be foundin a study of all the aspects of the transmission of the parasites.

In the discussion Prof. L. J. Bruce-Chwatt pointed out thatmany body activities, including D.N.A. synthesis, have a dailyperiodicity. Mr. P. G. Shute recalled that in an outbreak ofP. vivax malaria on the Isle of Sheppey in 1918 the vectorAnopheles maculipennis fed as readily by day as by night, andbecame equally heavily infected at whatever time it fed. Dr.R. S. Bray suggested that periodicity in the maturation ofparasites was an elegant instance of darwinian selection byenvironment. There were, however, many anomalies, one ofwhich was that P. ovale had a 50-hour cycle, and in the courseof 10 paroxysms of fever schizogony moved back from night toearly morning. Prof. J. D. Gillet raised the point that changesin light had an important influence on circadian rhythms.

Natural selection, he stated, brings parasite rhythm into linewith vector rhythm.

THE FAMILY PLANNING ACT

A NATIONWIDE survey by the Family Planning Association 1reveals a wide variation in the extent to which local healthauthorities are implementing the powers granted to themunder last year’s Family Planning Act. Only 34 of the 204local authorities in England and Wales are providing freeadvice (in their own clinics or through the agency of theF.P.A.) to all who want it, with free supplies for medicallyor socially needy cases. 39 authorities have so far taken no

action, but 15 of these are still having discussions with theF.P.A., and 9 are deferring their decision until next year.129 authorities, however, have decided to restrict their servicesto women referred to the clinics on medical grounds and tothose who cannot afford to pay. Although the Act made nodistinction between the married and unmarried, nearly halfthe local authorities are not offering advice to unmarriedwomen.

EQUAL RIGHTS FOR ALLFEW would admit to actively discriminating against the

" poor ", but it is a sad failing of our Welfare State that theyare still considered as an alien " them ", as receivers of charity,and as a burden to the taxpayer. Mr. Tony Lynes, in hisforeword to a pamphlet published by the Child Poverty ActionGroup and the London Cooperative Society Education Depart-ment,2 argues that until they are given full rights as equalcitizens, no attempt to raise their inadequate standard of livingwill succeed. He suggests that under-use of benefits is one ofthe main faults of our system. These are badly publicised andclaim forms are difficult to fill in. As a result, families livingon low pay, who are eligible for supplementary benefits, donot receive their due, whereas families on National Assistancefare much better. He cites as an example the rates-rebatescheme-only half the families entitled to claim under thisscheme have done so. (Writing in Poverty,3 Mr. Lynes showsthat the complicated forms, the warnings, threats, and con-ditions are enough to deter any potential applicant. The con-ditions have the effect of reducing security of tenure becausethe Council can withdraw the rebate if, for instance, the

dwelling is under-occupied and the tenant refuses to accepta smaller one. A family could be threatened with eviction fornon-payment of arrears resulting from cancellation of a

rebate.) Prof. Richard Titmuss claims that the institution ofselective means-tested benefits will make matters worse.

Selectivity denies rights, so that the poor will be categorisedas a

" lower class ". Universality, on the other hand, gives aright to benefits and a responsibility to pay contributions forthese.

Mr. Michael Zander considers, in particular, how the

wealthy have an unfair, if unintentional, advantage over thepoor in matters of Law. He points out that a poor man is lesslikely to know what legal rights he has, and, in any case, isless likely to win a law-suit than a wealthy one. The legal aidand advice scheme has done little to remedy this. The Ameri-cans have been more successful; for their neighbourhood lawfirms, which are financed by federal funds and which work inpoor areas, give free advice and representation. These firms

regard themselves as the champions of the local community.They have managed to turn the Law to the advantage of theirclients, whom they pursue to tell them when they have theright to claim legal action. Legal etiquette in the UnitedKingdom prevents such positive action. Mr. Zander pro-poses that, as in America, the courts here should be open to" interest groups ". This means, for instance, that if a tenantis up before the court, the tenants’ association would have the

right to argue before the court on his behalf as an interestedparty.

1. Family Planning, 1968, 17, no. 3, suppl.2. Unequal Rights. By TONY LYNES, R. M. TITMUSS, and MICHAEL

ZANDER. Copies may be had from Child Poverty Action Group, 1Macklin Street, London W.C.2, price 1s. 6d.

3. Lynes, T. Poverty, 1968, 8, 15.

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The Liverpool Personal Service Society, a voluntaryorganisation, has prepared a booklet 4 to encourage peopleliving on low incomes to make greater use of the selectivebenefits which they have a right to claim. It is complementaryto the entitlement campaign recently launched by the Ministryof Social Security and consists of a guide to benefits withdetails of how to claim them and a list of who has a right todo so. Many social workers, doctors, and members of thepublic who are asked for advice are confused by the numberof available benefits, and for those who live in Liverpool thisbooklet will be invaluable.

THE DISAPPEARING GIRLS

MORE girls enter grammar schools than boys and yet at

university 7 out of 10 undergraduates are men. At eleven, girlsscore significantly higher in tests of verbal reasoning, English,and arithmetic, especially if these rely heavily on memory androutine operations. One reason may be that girls maturephysically earlier than boys, although no conclusive proof linksquicker mental growth with the earlier onset of puberty. Girlsin general are expected to be more docile, thus being preparedto learn the mechanics of reading, writing, and arithmetic moreeasily. By the time it comes to taking 0-level exams, the girls’performance is already lagging behind, and in the sixth formboys far outnumber girls and take more A levels. The girls aretrebly handicapped in finding a university place: the olderuniversities do not have as many places for girls, the girls havefewer A levels, and these are in the wrong subjects-arts,rather than sciences, where competition is fiercest. Despitethis, those who do win through to university have a highersuccess-rate than boys, 82% compared with 76%.What is the solution? The supplement to Where,5 from

which this information comes, describes the organisation ofRosebery County School for Girls, Epsom, where the sixthform contains nearly half the whole school and the academicrecord is outstanding. The school is noted for the tolerance ofits staff, a good staff-pupil relationship, a high degree of pupilparticipation in running the school, its unique general-studiesprogramme, and its specially designed sixth-form building.The supplement also shows that middle-class girls in co-

educational schools maintained the lead they had over boys ateleven and stayed on longer than girls at single-sex schools.But this may be offset to some extent because it is the brightermiddle-class girls and the less intelligent middle-class boysthat go to mixed grammar schools. Both boys and girls,particularly the girls, were in favour of coeducation.

CAREERS FOR DENTAL TECHNICIANS

THE dental technician’s craft " has acquired an adversereputation and is no longer recommended by careers mastersor youth employment officers as a worthwhile career; and

dentists, asked if they recommend apprenticeship, are boundto answer, in all honesty, in the negative. A subcommittee ofthe Standing Dental Advisory Council 6 supplements this

qualitative judgment with statistical evidence of a falling-off inrecruitment. The problem is complicated by the fact that thevast majority of technicians (5300 in 1966) are working in thegeneral dental services where the Ministry of Health has nopower to intervene on pay or conditions. The dramatic changein emphasis from prosthetic work to the making of bridges,crowns, and inlays over the past twenty years has led to ashortage of technicians well versed in these special skills. Non-teaching hospitals employed 342 dental technicians in 1966, but70 posts were vacant. Much of the disenchantment with thiscraft can be blamed on an archaic apprentice scheme and alack of opportunities for promotion. As a solution, the sub-committee suggests that technical services for specialties other4. Welfare Benefits. A Guide for Welfare Workers in Liverpool. Copies

may be had from the Liverpool Personal Service Society, 34 StanleyStreet, Liverpool 1, price 3s. 6d.

5. Educating Girls. Where supplement 16. (Copies may be had from theAdvisory Centre for Education, 57 Russell Street, Cambridge, price7s. 6d.)

6. Dental Technicians: report of a subcommittee of the Standing DentalAdvisory Committee. H.M. Stationery Office, 1968. 2s. 3d.

than maxillofacial work should be concentrated in large areaunits which would offer a career structure and on which training-schools could be based. Training-posts at these schools mightbe made available, on a repayment basis, to nominees of generaldental practitioners and small commercial laboratories. Thesubcommittee points to the three-year scheme organised atR.A.F. Halton as a model. Two three-year courses leading toa dental technicians’ certificate have just started-in London(Norwood Technical College) and Sheffield (RichmondTechnical College).

A CLASSIFICATION STANDARD FORMEDICAL LIBRARIES

AT the request of the Association of Special Libraries andInformation Bureaux (ASLIB), the British Standards Instituteis issuing an English edition of the universal decimal classifica-tion, a library aid for the indexing of books, pamphlets, andfilms. The biological sciences have already been dealt with,and the mammoth B.S. 1000 is now moving steadily throughu.D.c. 61 (medicine). To date six parts of this section have beenissued: each consists of an alphabetically arranged cross-

index and a detailed schedule (cxsarean section gets in as

618-5-089-888-61). The medical sections are numberedB.S. 1000 followed by 611 for Anatomy down to 618 for

Gynaecology and Obstetrics, and the price varies between 15s.and 25s.

_________

University of LondonDr. J. C. Waterlow, director of the Medical Research

Council Tropical Metabolism Research Unit in the Universityof the West Indies, has been appointed to the chair of humannutrition at the London School of Hygiene and TropicalMedicine.

Dr. Waterlow, who is 52, was educated at Eton College, CambridgeUniversity, and the London Hospital. He graduated M.B. in 1942and, after working as an assistant at the Human Nutrition ResearchUnit at the London Hospital, he became a member of the scientificstaff of the M.R.C. In 1948 he took the M.D., and since 1954 hehas been director of the M.R.C. Tropical Metabolism Unit in

Jamaica. He took the M.R.C.P. in 1961 and he was appointedhonorary professor of experimental medicine at the University ofthe West Indies in 1957. His main research interests are the meta-bolic implications of nutrition.

University of ManchesterMr. R. G. Ainley has been appointed senior lecturer in

ophthalmology and Dr. M. K. Wang and Mr. Peter Andersonhave been appointed lecturers. Dr. Mary I. Wright has beenappointed senior lecturer in otolaryngology, and Dr. H. P.Ferrer lecturer in social and preventive medicine.

Study of Responsibilities and Functions of ConsultantsThe Minister of Health and Secretary of State for Scotland

have accepted the recommendation of the working-party on theresponsibilities of the consultant grade (see Lancet, Sept. 7,1968, p. 582) that a consultant working in a non-teachinghospital should be invited to join them in their discussions.Dr. J. H. Friend (Stoke-on-Trent) has agreed to becomea member of the working-party.

Department of Health and Social SecurityMr. Stephen Swingler, Minister of State at the Ministry of

Transport, and Mr. David Ennals, Under-secretary of Stateat the Home Office, have been appointed Ministers of Stateof this new Department under Mr. Richard Crossman, whowill be Secretary of State for Social Services. On the dis-solution of the Ministry of Health Mr. Kenneth Robinson,the Minister, has been appointed Minister for Planning andLand.

CORRIGENDUM: Escherichia coli Serotypes in Urinary-tractInfection in a Medical Ward.-In the article by Dr. A. G. Spencerand colleagues (last week, p. 839), Mr. K. A. Bettelheim’s namewas spelt incorrectly.