730 with dignity: he would have had no patience with those clinical scientists who practise useless and wearisome tests on patients obviously beyond recovery. He was a little vain of his excellent sense of smell and his ability to diagnose ketosis at the door of the ward. He was not .above emphasising physical signs in the chest, when demonstrating to undergraduates, by altering the angle of his percussing finger. Whcn accused of this by his residents in the privacy of his room he would deny it with a wicked smile. " An accomplished clinical pathologist, he treasured a supply of Romanowsky stain which he had acquired during the 1914-18 war. He would use this sparingly to produce beautiful pictures of rare or interesting blood diseases. His lectures were not appreciated by all his students, for he would not pander to mediocrity. Many will remember his careful qualifications, and the characteristic ’ I think we may safely say ’. He did not have the flair for acting possessed by his brilliant colleague, Prof. W. J. Tulloch, in bacteriology. Some undergraduates thought him rather formidable, but he had a dry sense of humour and was always considerate and charming. His women students and colleagues were treated with an old-world gallantry which had no trace of condescension. He invariably identified himself on the telephone as Dr. Patrick, and -rarely used his professorial title. " A hard worker himself, he expected his housemen to be likewise. On the morning after receiving day he expected :all case-reports to be fully written up with details of urinalysis, haemoglobin and white cell counts, and, where .appropriate, such investigations as Ziehl-Neelsen staining of sputum or c.s.F. examination. All of these were per- formed by the housemen in the ward side-room. Adam Patrick referred to his present and past house-physicians as ’ my young men’, and was proud of their achievements in their chosen careers. All of his young men will remember him with great affection and be grateful for having been introduced to medicine by a gentleman, a scholar, and a -true physician." ANNE FRANCE DARQUIER DE PELLEPOIX B.M. Oxon., D.P.M. Dr. Anne F. Darquier De Pellepoix, formerly senior lecturer in psychotherapy at St. Bartholomew’s Hos- pital, London, died on Sept. 9 at the age of 40. She was an open scholar at St. Hilda’s College, Oxford, and completed her medical training at St. Bartholomew’s Hospital, having graduated B.M. in 1955. After obtaining some experience in general medicine and neurology, she entered psychiatry. From the first she was interested in psychotherapy, undertaking a training analysis and being admitted to membership of the Society for Analytical Psychology. At the same time she realised the value of a general psychiatric training, and she spent 3 years at the Bethlem Royal and Maudsley Hospitals, gaining the D.P.M. in 1961, before continuing her general training as a senior registrar at the Westminster Hospital. Then she specialised in psychotherapy, working at the Middlesex, Westminster, and Hammersmith Hospitals before being appointed senior lecturer at St. Bartholomew’s Hospital in 1968. C. M. B. P., to whom we are grateful for this bio- graphy, writes: " Anne Darquier was a good general psychiatrist in addition to being a talented psychotherapist. She was an excellent teacher, and was very interested in students. She organised a psychiatric service at King’s College for students, and gave evidence to the Royal Commission on Medical Education. She was greatly appreciated by her colleagues, both for her professional skills, and for her selfless and courageous personality." Notes and News EMPLOYMENT OF PROVISIONALLY REGISTERED DOCTORS A MEMORANDUM from the Department of Health and Social Security 1 announces changes in the grades of appointment open to doctors with provisional registration. The Medical Act, 1956, did not preclude a provisionally registered doctor from holding a resident post in an approved hospital at a higher grade than house-officer. Now the Secretary of State, in consultation with hospital authorities and representatives of the medical and dent21 professions, has decided that in future provisionally registered doctors, whether they have qualified in the United Kingdom or overseas, shall not be employed in approved hospitals in grades above the level of house- officer; doctors appointed to posts in the grade of senior house-officer or above should be either fully or temporarily registered. Provisionally registered doctors who have completed their 12 months’ preregistration appointments and have applied for full registration may be appointed to senior-house-officer posts provided that they have obtained full registration by the time they take up their duties, or, if the post is resident and in an approved hospital, provided that they have obtained registration within 14 days of taking up the post. Doctors from overseas may, where their experience justifies it, hold senior-house-officer or higher posts, under temporary registration. Where hardship arises as a result of the application of these new employment principles, as may happen exceptionally, hospitals are asked to consult the Department. These restrictions in the posts available to provisionally registered doctors will make it particularly necessary that such doctors are able to find preregistration house-officer posts, and hospitals are enjoined in the memorandum not to fill these posts with fully or temporarily registered doctors unless there are no provisionally registered applicants, or unless the tem- porarily registered doctor, in the view of the General Medical Council, needs the experience at this level. These changes will come into effect at once, but provisionally registered doctors at present holding posts above house- officer grade may continue in these posts until their current appointments expire. EDUCATION OF MENTALLY HANDICAPPED CHILDREN THE transfer of responsibility for the education of men- tally handicapped children, under the Education (Handi- capped Children) Act, 1970, will come into effect on April 1, 1971. A circular from the Department of Educaticn and Science is now being sent out to local authorities, giving guidance on the administrative organisation of the change, and encouraging local education authorities to give early consideration to the broad strategy of educating mentally handicapped children. A child who before the Act was classified as unsuitable for education at school will now be noted as requiring special educational treatment. The circular expresses the hope that the transfer will " permit a greater flexibility in adapting the education available to each child at different stages in his develop- ment and according to his individual needs ". The educa- tion authorities will be responsible for seeing that children who have been found to be incapable of responding to any form of educational stimulus are kept under regular review. Local authorities are asked in the circular to submit to the Department their proposals for the status after transfer of existing junior training-centres, special care units, and schools in hospitals for the mentally handicapped. Hostels 1. H.M. (70) 54.
Transcript
730
with dignity: he would have had no patience withthose clinical scientists who practise useless and wearisometests on patients obviously beyond recovery. He was alittle vain of his excellent sense of smell and his ability todiagnose ketosis at the door of the ward. He was not.above emphasising physical signs in the chest, whendemonstrating to undergraduates, by altering the angle ofhis percussing finger. Whcn accused of this by his residentsin the privacy of his room he would deny it with a wickedsmile.
" An accomplished clinical pathologist, he treasured asupply of Romanowsky stain which he had acquired duringthe 1914-18 war. He would use this sparingly to producebeautiful pictures of rare or interesting blood diseases. Hislectures were not appreciated by all his students, for hewould not pander to mediocrity. Many will remember hiscareful qualifications, and the characteristic ’ I think wemay safely say ’. He did not have the flair for actingpossessed by his brilliant colleague, Prof. W. J. Tulloch,in bacteriology. Some undergraduates thought him ratherformidable, but he had a dry sense of humour and wasalways considerate and charming. His women studentsand colleagues were treated with an old-world gallantrywhich had no trace of condescension. He invariablyidentified himself on the telephone as Dr. Patrick, and-rarely used his professorial title.
" A hard worker himself, he expected his housemen tobe likewise. On the morning after receiving day he expected:all case-reports to be fully written up with details of
urinalysis, haemoglobin and white cell counts, and, where.appropriate, such investigations as Ziehl-Neelsen stainingof sputum or c.s.F. examination. All of these were per-formed by the housemen in the ward side-room. AdamPatrick referred to his present and past house-physiciansas ’ my young men’, and was proud of their achievementsin their chosen careers. All of his young men will rememberhim with great affection and be grateful for having beenintroduced to medicine by a gentleman, a scholar, and a-true physician."
ANNE FRANCE DARQUIER DE PELLEPOIXB.M. Oxon., D.P.M.
Dr. Anne F. Darquier De Pellepoix, formerly seniorlecturer in psychotherapy at St. Bartholomew’s Hos-pital, London, died on Sept. 9 at the age of 40.
She was an open scholar at St. Hilda’s College, Oxford,and completed her medical training at St. Bartholomew’sHospital, having graduated B.M. in 1955. After obtainingsome experience in general medicine and neurology, sheentered psychiatry. From the first she was interested in
psychotherapy, undertaking a training analysis and beingadmitted to membership of the Society for AnalyticalPsychology. At the same time she realised the value of a
general psychiatric training, and she spent 3 years at theBethlem Royal and Maudsley Hospitals, gaining the D.P.M.in 1961, before continuing her general training as a seniorregistrar at the Westminster Hospital. Then she specialisedin psychotherapy, working at the Middlesex, Westminster,and Hammersmith Hospitals before being appointed seniorlecturer at St. Bartholomew’s Hospital in 1968.
C. M. B. P., to whom we are grateful for this bio-graphy, writes:
" Anne Darquier was a good general psychiatrist inaddition to being a talented psychotherapist. She was anexcellent teacher, and was very interested in students. Sheorganised a psychiatric service at King’s College forstudents, and gave evidence to the Royal Commission onMedical Education. She was greatly appreciated by hercolleagues, both for her professional skills, and for herselfless and courageous personality."
Notes and News
EMPLOYMENT OF PROVISIONALLYREGISTERED DOCTORS
A MEMORANDUM from the Department of Health andSocial Security 1 announces changes in the grades of
appointment open to doctors with provisional registration.The Medical Act, 1956, did not preclude a provisionallyregistered doctor from holding a resident post in an
approved hospital at a higher grade than house-officer.Now the Secretary of State, in consultation with hospitalauthorities and representatives of the medical and dent21professions, has decided that in future provisionallyregistered doctors, whether they have qualified in theUnited Kingdom or overseas, shall not be employed in
approved hospitals in grades above the level of house-
officer; doctors appointed to posts in the grade of seniorhouse-officer or above should be either fully or temporarilyregistered. Provisionally registered doctors who havecompleted their 12 months’ preregistration appointmentsand have applied for full registration may be appointed tosenior-house-officer posts provided that they have obtainedfull registration by the time they take up their duties, or,if the post is resident and in an approved hospital, providedthat they have obtained registration within 14 days of takingup the post. Doctors from overseas may, where theirexperience justifies it, hold senior-house-officer or higherposts, under temporary registration. Where hardship arisesas a result of the application of these new employmentprinciples, as may happen exceptionally, hospitals are
asked to consult the Department. These restrictions in the
posts available to provisionally registered doctors will makeit particularly necessary that such doctors are able to findpreregistration house-officer posts, and hospitals are
enjoined in the memorandum not to fill these posts with
fully or temporarily registered doctors unless there are noprovisionally registered applicants, or unless the tem-
porarily registered doctor, in the view of the GeneralMedical Council, needs the experience at this level. These
changes will come into effect at once, but provisionallyregistered doctors at present holding posts above house-officer grade may continue in these posts until their currentappointments expire.
EDUCATION OF MENTALLYHANDICAPPED CHILDREN
THE transfer of responsibility for the education of men-tally handicapped children, under the Education (Handi-capped Children) Act, 1970, will come into effect on
April 1, 1971. A circular from the Department of Educaticnand Science is now being sent out to local authorities,giving guidance on the administrative organisation of thechange, and encouraging local education authorities to giveearly consideration to the broad strategy of educatingmentally handicapped children. A child who before theAct was classified as unsuitable for education at school willnow be noted as requiring special educational treatment.The circular expresses the hope that the transfer will" permit a greater flexibility in adapting the educationavailable to each child at different stages in his develop-ment and according to his individual needs ". The educa-tion authorities will be responsible for seeing that childrenwho have been found to be incapable of responding to anyform of educational stimulus are kept under regular review.Local authorities are asked in the circular to submit to the
Department their proposals for the status after transferof existing junior training-centres, special care units, andschools in hospitals for the mentally handicapped. Hostels
1. H.M. (70) 54.
731
which provide term-time accommodation for children
attending training-centres should in general remain withthe local health authority, but where the link between hosteland training-centre is very strong, the education authoritymay wish to establish a residential special school. Theeducation authorities must also discover what buildingprojects are currently planned for the education of mentallyhandicapped children, and be prepared to assimilate theseinto the system of control applied to special school buildingprogrammes. All staff whose primary function is teachingwill be transferred, but in some situations the function willnot be clear-cut, and education and health authorities mayneed to discuss individual cases. The training of teachers ofmentally handicapped children will be integrated as soonas possible into the ordinary teacher-training system, andwill consist of 3-year courses in colleges of education.During the transition period, special 1-year conversioncourses will be available in some colleges for those who haveobtained the diploma of the Training Council for Teachersof the Mentally Handicapped.
CHILDREN LIVING IN FLATS
THE building of flats-both high-rise and low-rise-hasnow become one of the king-pins of Britain’s housingpolicy. Housing authorities must be alarmed, therefore, bythe results of a new study, made by the N.S.P.C.C.,r whichshowed that 85% of flat-dwellers interviewed would ratherhave been living in a house. It appears that they have goodreason for this preference. The N.S.P.C.C. survey had theprimary purpose of discovering the results of living in aflat on the bringing up of children. The report does notpretend to be comprehensive or conclusive, but is based on astudy of the existing research, a probe by questionary andinterview into the living conditions of 280 families (in bothprivate and local-authority flats) and their opinions on theseconditions, and a brief survey of attitudes to flat-dwellingamong local authorities. The survey did not attempt to
study the children themselves, and the society hopes thatresearch on this will follow; nonetheless, the answersobtained from parents, and a general study of amenities inflats, show beyond doubt that the child living in a flat mayeasily be deprived of freedom of play, exercise, and contactwith other children. This deprivation can lead to a deteriora-tion of the relationship between parents and child, and canresult in serious damage to the child’s intellectual andemotional development.For families with children, the common drawbacks to
living in flats are: lack of suitable play areas, both outdoorsand indoors; lack of space, both for play and for storage ofthe child’s possessions; the difficulty of getting out of theflat, and the resulting lack of contact (however trivial) withthe outside; the danger (real or imagined) of the childfalling, and of the lifts; noise (both that made by otherpeople and things, and that made by their own children);loneliness; and a lack of contact with other mothers andother children. Inadequacy of play facilities is one of themost glaring lapses in flat design, partly because it isvirtually universal, and partly because it would seem to be soeasily remedied. Apart from a few notable exceptions,blocks of flats contain no indoor play area, and most outdoorplaygrounds are small, unattractive, unpractical (many ofthem have concrete, tarmac, or gravel surfaces), anddangerous (with direct access to traffic, or sited on theopposite side of a main road from the flats). The result isthat the children, at least up to the age of 5, are confinedto the flat all day: the study discovered that for 51-5% ofchildren, the flat was the main play area. This confinementcan only lead to friction between the mother and the child:
1. Children in Flats: A Family Study. By W. F. R. STEWART. Develop-ments Department, N.S.P.C.C., 1 Riding House Street, LondonW1P 8AA. 6s.
the child’s play is probably restricted because of his
parents’ embarrassment at the noise he might create, and theparent is irritated botn by the noise itself and by feelings ofguilt about constantly restraining the child. The cumulativeeffects of confinement, irritation, boredom, loneliness, andlack of outside contact, can be very damaging. One survey,in fact, revealed that the morbidity of families who lived inflats was 57% greater than of those who lived in houses, thechief causes being respiratory infections in young womenand children, and psychoneurotic disorders in women.More research, and better planning and design, should
reduce some of these problems. For instance, it has beenfound that there is much more likelihood of chance contactbetween neighbours in balcony, or gallery, access flats, thanin flats with well or corridor access. But the N.S.P.C.C.found that at present, " planned facilities, aimed at thedevelopment of a community consciousness and of acquaint-anceships, were as a rule conspicuously lacking ". When
questioned, most local housing authorities said thai theirpolicy was not to house families with young children in highflats, and that they had little difficulty in carrying out thispolicy; but the evidence refuted many of these claims, andthe N.S.P.C.C. suggests that the authorities are painting" roseate pictures ". It is not at all easy for a family to get
out of a flat once it is in. One woman said in her interview
(which is reproduced verbatim in the report) that she wouldhave to have another baby to stand a chance of transfer to ahouse. Suitable play facilities, inside and outside flats, mustbe a priority, and the N.S.P.C.C. suggests that communityworkers employed as caretakers might also be of help. Itsown plan of action is, first, to distribute its report to allhousing authorities, and then to set up pilot playgroups, andto continue research.
APPROVED NAMES
THE Medicines Commission with the British Pharma-
copoeia Commission has issued a revised list of accumu-lated approved names, and the following supplementarylist:
Cross-references for proprietary names are as follows:Proprietary Name Approved Name
30803-Ba BenzoctamineBrocadopa LevodopaCytembena Bromebric AcidDuphalac LactuloseDW 61 FlavoxateEMD 19698 PeratizoleFB b 4231 GlisoxepideH 4170 Tolpiprazole,Larodopa, L-dopa LevodopaLysenyl LysurideR & S 218-M AlletorphineR & S 5205-M HomprenorphineSteranabol Clostebol AcetateSymmetrel Amantadine
Wy-21901 Indoramin
University of LeedsThe Faculty of Medicine inaugural lecture will be given
on Thursday, Oct. 15, at 3 P.M., by Sir Derrick Dunlop.His subject is the problem of modern medicines.
University of GlasgowThe Medical Research Council is to provide a grant of
E13,727 to set up a small centre for the study of humanrhythms in health and disease, under the direction ofDr. Hugh Simpson (department of pathology, RoyalInfirmary). Projects already under way include a study ofthe effects of a 21-hour-day system on human renal excre-tory rhythms, mental acuity, and muscle power, a study ofthe circadian rhythm of sodium excretion in hypertensives,and an analysis, by disease, of the time-of-death in Scotland.
Sidney Farber Medical Research AwardThe Sidney Farber medical research award of the
Children’s Cancer Research Foundation, Boston, Massa-chusetts, has been awarded for 1970 to Sir Alexander
Haddow, former director of the Chester Beatty ResearchInstitute, London, and past president of the InternationalUnion Against Cancer.
Mammalian Responses to ColdThis is the subject of a symposium to be held by the
Society for Low Temperature Biology on Friday, Oct. 9,at 2 P.M., at the British Institute of Radiology, WelbeckStreet, London W.1. Details may be had from Dr. D. Leeat the Clinical Research Centre Laboratories, NationalInstitute for Medical Research, Mill Hill, London N.W.7.
Stouffer PrizeThe Stouffer prize for research on heart-disease has been
awarded for 1970 to Sir George Pickering, master ofPembroke College, Oxford University, and formerly regiusprofessor of medicine at the university, and to Dr. Irvine H.Page, of the Cleveland Clinic Foundation, Cleveland, Ohio.
The Dark Side of Adoption is the title of a Hilda Lewis lecture,to be given by Dr. Christopher Ounsted, on Wednesday,Oct. 14, at 5 P.M., at 1 Wimpole Street, London W.1.
From Oct. 1, all letters relating to the publication, sale, andadvertising departments of the Medical Officer should beaddressed to Mr. J. Ashley-Brown, Macmillan (Journals) Ltd.,Little Essex Street, London W.C.2. Editorial correspondenceshould, as before, be addressed to the editor, Mr. G. L. C.Elliston, at 15 St. Catherine’s Drive, Guildford, Surrey.
CORRIGENDA: Paying for Medical Care.-In the article byR. F. L. Logan, R. E. Klein, and D. A. T. Griffiths (last week,p. 647) the figure raised by a surgery-visit charge of 12s. 6d.would be a notional E100 million.
Mr. Malcolm Weller, M.A., was wrongly (or prematurely)described as a doctor on the contents page for Sept. 12.
Diary of the Week
OCTOBER 4 TO 10
Wednesday, 7thINSTITUTE OF DISEASES OF THE CHEST, Brompton, London S.W.3
5 P.M. Dr. S. J. Steel: Lung Biopsy.INSTITUTE OF ORTHOPEDICS;, 234 Great Portland Street, LondonWIN 6AD11 A.M. Prof. Jack Joseph: Functional Anatomy of the Hip.6 P.M. Mrs. M. M. Shepherd: Hip Assessment.
INSTITUTE OF PSYCHIATRY, De Crespigny Park, Denmark Hill, LondonS.E.55.30 P.M. Prof. J. M. Hinton: Psychiatric Disturbances in Patients
with Malignant Diseases.INSTITUTE OF UROLOGY, 10 Henrietta Street, London W.C.2
5 P.M. Mr. H. G. Hanley: The Pelvi-ureteric Junction.ROYAL FREE HOSPITAL, Gray’s Inn Road, London W.C.1
5.15 P.M. Dr. F. Schaffner (New York): The Spectrum of AlcoholicLiver Disease.
MANCHESTER MEDICAL SOCIETY5 P.M. (Medical School.) Dr. Stanley Miles: Living Under Water.
Friday, 9thINSTITUTE OF LARYNGOLOGY AND OTOLOGY, 330/332 Gray’s Inn Road,London W.C.14.30 P.M. Mr. Terence Ward: Oral Surgery in its Relations to Oto-
laryngology.
Appointments
BRIGGS, J. D., M.B. Glasg., M.R.C.P., M.R.C.P.E. : consultant physician inrenal disease, Western Infirmary, Glasgow.
GALLOWAY, R. K., M.B. Edin., M.R.C.O.G., F.R.C.S.E. : consultant obstetri-cian and gynaecologist, Bellshill Maternity Hospital, Lanarkshire.
GALLWEY, J. M. D., M.B. Sheff.: consultant venereologist, RadcliffeInfirmary, Oxford.
LAWRENCE, A. C. K., M.D. Lond., M.R.C.PATH.: consultant hæmatologist,Northern General Hospital, Sheffield.
PORTE, H. E., M.B. Mane., F.R.C.S.E., D.L.O. : consultant E.N.T. surgeon,Lincoln County Hospital.
ROBERTSON, P. D., M.B. Aberd., M.R.C.P.E. : consultant physician,Caithness Central Hospital, Wick.
