390 Obituary ALFRED SCHWEITZER bi.D. Cologne, Ph.D., D.Sc. Lond. Dr. Alfred Schweitzer, reader in experimental physio- logy at University College, London, was killed in a mountain accident in the Dauphine on Aug. 9. He was 43 years of age. Schweitzer was educated in Germany and took his M.D. at Cologne in 1932. In 1934 he worked under Koch in the Kerckhoff Institute at Nauheim where he acquired an interest in the physiology of the carotid sinus. At this time he also wrote his book, Die Irradia- tion Autonomer Reflexe, which was published in 1937. He came to England in 1935 and immediately settled down to a most fruitful research partnership with Prof. Samson Wright at the Middlesex Hospital Medical School. Their studies on the actions of acetylcholine and anticholinesterases on the reflex activity of the spinal cord marked the first experimental attack on the problem of chemical transmission within the central nervous system. These investigations continued up to the war when Schweitzer turned his attention to more immediately pressing problems and worked with Prof. G. A. H. Buttle and Prof. Alan Kekwick on the value of plasma and serum in the treatment of experimental haemorrhage. In 1940 he went to the department of physiology in Leeds, where he remained as lecturer until 1947. He there worked with Prof. Albert Hemingway on, the isolated kidney and they studied the cardiac output in exercise. During the latter part of his sojourn in Leeds he worked with Dr. Eric Neil on many aspects of the physiology of the sino-aortic nerves. Schweitzer con- tinued and expanded these studies when he was appointed as reader in experimental physiology under Sir Charles Lovatt Evans at University College. In conjunction with Dr. Michael de Burgh Daly he had recently demonstrated reflex effects from the carotid sinus and carotid body on bronchomotor tone, and his develop- ment of a technique for measuring blood-flow through the minute carotid body was a technical tour de force. Schweitzer and Neil were writing a book on the baroreceptor and chemoreceptor activities of the sino-aortic nerves. Besides his versatile research activities Schweitzer was a wonderful teacher whose enthusiasm and powers of expression were reinforced by a real anxiety to make his point clear to everyone, so that no trouble was too great to achieve this purpose. From the day of his arrival in this country he wanted to attune himself to the British way of life. It seemed perfectly natural for him to accept our ideals and aspirations, and he was never in any sense of the word a foreigner. Schweitzer loved people and was the most delightful companion imaginable. He wanted everyone to be his friend, and it was not his fault if they were not. His kindness and generosity were proverbial, and if he did occasionally become indignant about something it was always on behalf of someone else. It is indeed most tragic for his wife and family and for his innumerable friends that a man of such inspiring character should be lost to us at the very height of his powers. He was gifted in many ways. He was a first-rate violinist and had a prufuuncl knowledge and under- standing of music, which was one of his great passions in life. He was a most experienced and able mountaineer, and in recent times he went annually to tackle the formidable peaks of tht- Dauphiné. These arduous holidays meant much to him, and they seemed to give him inspiration fur the rest of the year. It is fitting that he should loe buried in a village among the mountains which he loved. C. A. K. LIONEL NATHAN GRUNBAUM M.A., M.B. Camb., M.R.C.P. Dr. L. N. Grunbaum, an assistant chest physician at Edmonton, died on Aug. 2. after an attack of poliomyelitis. He studied medicine at the University of Cambiidge and at St. Bartholomew’s Hospital. After qualifying in 1939 he spent a year doing house-jobs in the Barts sector before he turned to pathology at the Radcliff- Infirmary, Oxford. While there he produced one of the first of a series of Christmas pantomimes of great merit performed during the war by the Oxford clinical student-. From 1942 to 1946 he served in the R.A.M.C. with th rank of major as a specialist in pathology, but after the war he felt the need for the direct personal contact: between patient and doctor which clinical medicin’- affords. He took his M.R.C.P. in 1949 and he chose chest medicine as his specialty. Later he held registrarship-. at the Westminster Hospital and at Fulham chest clinic. He was working as a chest physician at Edmonton and was preparing a thesis on Mantoux conversion of tuberculous contacts at the time of his death. C. M. F. writes : " Lionel Grunbaum brought to medicine an understanding of many things. Profoundly musical, he was an accomplished pianist. A most shrewd judge of character, he showed a humorous tolerance of human foibles. It was his great interest in people that led him to forsake the humanities, in which he had taken his degree at Cambridge, and start upon his medical course at Barts later than his contemporaries : and his deep concern for the material well-being of those less privileged than himself led him to argue and work for Socialism. His fellow-students at Barts will recall many loud-voiced arguments on politics with him. which often verged on the acrimonious until his sense of humour came to the rescue, and agreement, or agreement to differ, was reached with an increase of understanding on both sides. He will be remembered by many friends among his colleagues, his patients, and in many other walks of life, orthodox and bizarre. We shall miss his shrewdness, his sympathy, and his loyal friendship: but the liveliness of his memory will go with us, and he will not have lived and worked, played and talked. in vain." MR. H. E. MOORE H. O.-C. writes : " One of H. E. Moore’s outstanding traits was his modesty. No doubt this is the reason why his remarkable contribution in the field of rehabili- tation received such mediocre recognition in his lifetime. The value of curative workshops in military orthopedic centres had been well recognised by Sir Robert Jones in the first World War, and after the war quickly forgotten by most surgeons. Moore was the real pioneer of the rehabilitation of injured workmen in this country. He, almost alone, appreciated that a half-hour spent receiving passive treatment three times a week in the massage department of a hospital was neither the best way to mobilise joints and restore muscle-power, nor the way to instil into patients the confidence without which they could not recover. Indeed apathy and despair were often induced-and still are-by passive methods of treatment. It has taken nearly thirty years. the investigations of many committees, and another world war to impress this obvious lesson on our profession and its auxiliaries. " Moore was appalled by the conditions of railway workers coming to his hospital at Crewe ; after 1(.,nz periods of ’treatment’ elsewhere most of them were dispirited and seemingly incapable of improvement. In the early days of his work at this hospital, of 165 patient, of this type 115 were returned to their former employ- ment after an average period of seventeen days’ rehabili- tation. In those days this was a startling achievement accomplished entirely by active exercises with simple gymnastic apparatus, and above all by Moore’s dynamic driving force which inspired confidence where hope recovery had long been lost. This same technique and the instigation of this same spirit--the will to recover-- he brought to the rehabilitation centres of the Rr,:-à! Air Force during the second World War. Before then it had been confidently predicted that all injured air-crew personnel would be useless for further military dutie-- so seriously complicated and multiple were their injuries True enough their injuries were complicated and multiple- but 77 °o of injured airmen were returned to full duty- It is therefore hardly surprising that the Royal Force has with great benefit continued its rehabilitatier centres to this day embodying everything taught by Moore. Throughout Britain and the British Commer- wealth there are old R.A.F. pupils of his, all too few. carrying on his principles and emulating his practice.
Transcript
390
ObituaryALFRED SCHWEITZER
bi.D. Cologne, Ph.D., D.Sc. Lond.Dr. Alfred Schweitzer, reader in experimental physio-
logy at University College, London, was killed in amountain accident in the Dauphine on Aug. 9. Hewas 43 years of age.
Schweitzer was educated in Germany and took hisM.D. at Cologne in 1932. In 1934 he worked underKoch in the Kerckhoff Institute at Nauheim where heacquired an interest in the physiology of the carotidsinus. At this time he also wrote his book, Die Irradia-tion Autonomer Reflexe, which was published in 1937.He came to England in 1935 and immediately settled
down to a most fruitful research partnership with Prof.Samson Wright at the Middlesex Hospital MedicalSchool. Their studies on the actions of acetylcholineand anticholinesterases on the reflex activity of thespinal cord marked the first experimental attack on theproblem of chemical transmission within the centralnervous system. These investigations continued upto the war when Schweitzer turned his attention tomore immediately pressing problems and worked withProf. G. A. H. Buttle and Prof. Alan Kekwick on thevalue of plasma and serum in the treatment ofexperimental haemorrhage.
In 1940 he went to the department of physiology inLeeds, where he remained as lecturer until 1947. Hethere worked with Prof. Albert Hemingway on, theisolated kidney and they studied the cardiac output inexercise. During the latter part of his sojourn in Leedshe worked with Dr. Eric Neil on many aspects of thephysiology of the sino-aortic nerves. Schweitzer con-tinued and expanded these studies when he was appointedas reader in experimental physiology under Sir CharlesLovatt Evans at University College. In conjunctionwith Dr. Michael de Burgh Daly he had recentlydemonstrated reflex effects from the carotid sinus andcarotid body on bronchomotor tone, and his develop-ment of a technique for measuring blood-flow throughthe minute carotid body was a technical tour deforce. Schweitzer and Neil were writing a book on thebaroreceptor and chemoreceptor activities of thesino-aortic nerves.
Besides his versatile research activities Schweitzerwas a wonderful teacher whose enthusiasm and powersof expression were reinforced by a real anxiety to makehis point clear to everyone, so that no trouble was toogreat to achieve this purpose.From the day of his arrival in this country he wanted
to attune himself to the British way of life. It seemedperfectly natural for him to accept our ideals andaspirations, and he was never in any sense of the worda foreigner.
Schweitzer loved people and was the most delightfulcompanion imaginable. He wanted everyone to be hisfriend, and it was not his fault if they were not. Hiskindness and generosity were proverbial, and if he didoccasionally become indignant about something itwas always on behalf of someone else. It is indeed mosttragic for his wife and family and for his innumerablefriends that a man of such inspiring character shouldbe lost to us at the very height of his powers.He was gifted in many ways. He was a first-rate
violinist and had a prufuuncl knowledge and under-standing of music, which was one of his great passionsin life. He was a most experienced and able mountaineer,and in recent times he went annually to tackle theformidable peaks of tht- Dauphiné. These arduousholidays meant much to him, and they seemed to givehim inspiration fur the rest of the year. It is fittingthat he should loe buried in a village among the mountainswhich he loved. C. A. K.
LIONEL NATHAN GRUNBAUMM.A., M.B. Camb., M.R.C.P.
Dr. L. N. Grunbaum, an assistant chest physician atEdmonton, died on Aug. 2. after an attack of poliomyelitis.He studied medicine at the University of Cambiidge
and at St. Bartholomew’s Hospital. After qualifyingin 1939 he spent a year doing house-jobs in the Barts
sector before he turned to pathology at the Radcliff-Infirmary, Oxford. While there he produced one of thefirst of a series of Christmas pantomimes of great meritperformed during the war by the Oxford clinical student-.From 1942 to 1946 he served in the R.A.M.C. with thrank of major as a specialist in pathology, but afterthe war he felt the need for the direct personal contact:between patient and doctor which clinical medicin’-affords. He took his M.R.C.P. in 1949 and he chose chestmedicine as his specialty. Later he held registrarship-.at the Westminster Hospital and at Fulham chest clinic.He was working as a chest physician at Edmonton andwas preparing a thesis on Mantoux conversion oftuberculous contacts at the time of his death.
C. M. F. writes : " Lionel Grunbaum brought to
medicine an understanding of many things. Profoundlymusical, he was an accomplished pianist. A mostshrewd judge of character, he showed a humoroustolerance of human foibles. It was his great interest inpeople that led him to forsake the humanities, in whichhe had taken his degree at Cambridge, and start upon hismedical course at Barts later than his contemporaries :and his deep concern for the material well-being of thoseless privileged than himself led him to argue and workfor Socialism. His fellow-students at Barts will recallmany loud-voiced arguments on politics with him.which often verged on the acrimonious until his sense ofhumour came to the rescue, and agreement, or agreementto differ, was reached with an increase of understandingon both sides. He will be remembered by many friendsamong his colleagues, his patients, and in many otherwalks of life, orthodox and bizarre. We shall miss hisshrewdness, his sympathy, and his loyal friendship:but the liveliness of his memory will go with us, and hewill not have lived and worked, played and talked.in vain."
MR. H. E. MOORE
H. O.-C. writes : " One of H. E. Moore’s outstandingtraits was his modesty. No doubt this is the reasonwhy his remarkable contribution in the field of rehabili-tation received such mediocre recognition in his lifetime.The value of curative workshops in military orthopediccentres had been well recognised by Sir Robert Jonesin the first World War, and after the war quicklyforgotten by most surgeons. Moore was the real pioneerof the rehabilitation of injured workmen in this country.He, almost alone, appreciated that a half-hour spentreceiving passive treatment three times a week in themassage department of a hospital was neither the bestway to mobilise joints and restore muscle-power, nor theway to instil into patients the confidence without whichthey could not recover. Indeed apathy and despairwere often induced-and still are-by passive methodsof treatment. It has taken nearly thirty years. the
investigations of many committees, and another worldwar to impress this obvious lesson on our profession andits auxiliaries.
" Moore was appalled by the conditions of railwayworkers coming to his hospital at Crewe ; after 1(.,nzperiods of ’treatment’ elsewhere most of them weredispirited and seemingly incapable of improvement. Inthe early days of his work at this hospital, of 165 patient,of this type 115 were returned to their former employ-ment after an average period of seventeen days’ rehabili-tation. In those days this was a startling achievementaccomplished entirely by active exercises with simplegymnastic apparatus, and above all by Moore’s dynamicdriving force which inspired confidence where hoperecovery had long been lost. This same technique andthe instigation of this same spirit--the will to recover--he brought to the rehabilitation centres of the Rr,:-à!Air Force during the second World War. Before thenit had been confidently predicted that all injured air-crewpersonnel would be useless for further military dutie--so seriously complicated and multiple were their injuriesTrue enough their injuries were complicated and multiple-but 77 °o of injured airmen were returned to full duty-It is therefore hardly surprising that the Royal Force has with great benefit continued its rehabilitatiercentres to this day embodying everything taught byMoore. Throughout Britain and the British Commer-wealth there are old R.A.F. pupils of his, all too few.
carrying on his principles and emulating his practice.
391
" It is sad. however, to see how slow the developmentof rehabilitation facilities has been in civilian practice.In a letter written a few weeks before he died Mooredeplored this tardiness ’ as a brake on the economicrecovery of the country by an unnecessary wastage ofman-power, and a diminution of the span of humanhappiness and the enjoyment of living ’ ; and he exhortedus to spare no effort to advance the importance of amore comprehensive remedial service for the injured.
.. :Moore was an inspiring companion and a mostdelightful and cooperative colleague. His life work,performed so efficiently and effectively, is a lastingtribute to his philosophy as a staunch believer in thepower of mind over matter. We often deplore thepropagandist in medicine, but it is a thousand pitiesthat Aloore’s modesty prevented him from being a moreoutspoken evangelist of what he knew so well to betrue--that men and women could be restored to workingcapacity by simple, practical, but essentially personalmethods, methods which he lived to see abundantlyproven in the hard schools of industry and war."
1. Public Health (Ships) Regulations, 1952. Pp. 21. 9d. PublicHealth (Aircraft) Regulations, 1952. Pp. 15. 6d. H.M.Stationery Office.
2. See Lancet, 1952, i, 1216.
Public Health
PoliomyelitisPOLIOMYELITIS notifications (uncorrected) in the week
ended Aug. 9 (the 32nd week of the year) were (previousweek in parentheses) : paralytic, 167 (139) ; non-
paralytic, 83 (91) ; total, 250 (230).The following table compares this year (up to and
including the 32nd week) with the preceding five years.Year Total c"es up to and Cases in
including 32nd week 32nd week1947 2252 6241948 912 391!H9
‘
1457 25419,i0 2986 3931951 1511 112mj-2 1910 250
Slaughter of HorsesThe Public Health (Meat) (Amendment) Regulations,
1952. which come into force on Aug. 31, give effect toan announcement by the Minister of Food that horseslaughterers would be required to notify authorities oftheir intention to slaughter.The purpose of the amending regulations is to put the
slaughter of horses, asses, and mules for sale for humanconsumption on a similar basis to that of cattle, sheep,goats. and pigs. The chief requirement is that anyoneintending to slaughter horses, asses, or mules must giveat least three hours’ notice to the local authority. Where,however, slaughter takes place at a particular place atfixed times, no individual notices are required ; andwhere immediate slaughter becomes necessary because ofaccidental injury, illness, or exposure to infection, noticemust be given as soon as possible before or after slaughter.Responsibility for enforcing the Public Health (Meat)
Regulations remains with the local authorities. Thepresent amendments will help local authorities in theirtask of arranging for the inspection of horse-meatintended for sale for human consumption. Local authori-tirs will also be placed in a better position to executeand enforce the provisions of the Slaughter of AnimalsActs. which are designed to ensure that animals areslaughtered in a humane manner.
Revised Regulations for Sea and Air Travel1’h.. Minister of Health has made certain changes in
th regulations governing travel bv sea and air.l Therevision became necessary when the Fourth World HealthAssmblyadoptedthe International Sanitary Regulations,2which will replace the present International SanitaryConventions on Oct. J next. Though the British regula-tions have not been under general review since 1933, nosubstantial alterations affecting the traveller have beenmade The personal declaration of origin and health,at present required from all persons arriving by air, isto be abolished. The rev ised regulations will also comeinto force on Oct. 1.
Notes and News
DISTRIBUTION OF DANCKWERTS AWARD
THE additional remuneration for general practitioners forthe period ended March 31, 1949, and for each of the yearsended March 31, 1950, March 31, 1951, and March 31, 1952,and the provisional addition for the quarter ended June 30,1952, is to be divided among executive councils in proportionto the amounts already allocated to them from the practi-tioners’ fund for each of those periods-including the allocationfor temporary residents. The distribution of each council’sshare of the additional remuneration among the doctors whowere included on its medical list at any time between July 5,1948, and June 30, 1952, will similarly be made in proportionto the amounts allocated to the doctors out of the council’s
practitioners’ fund-i.e., excluding mileage payments. Theamount due to each doctor for each period can convenientlybe represented as a percentage of the amount already allocatedto him. Further particulars of the procedure to be followedwill be found in E.c.L. 65/52.
DOMESTIC SUPERVISION
THE hospital service probably employs more domesticworkers than any other organisation in the country. Asdomestic labour today costs a good deal-though probablynot more than it should-’ wages
"
are a heavy item in theNational Health Service budget. The Ministry of Health isrightly anxious that those who earn these wages should beefficiently and economically organised. In a memorandumon hospital domestic management (R.H.B.[52]91) the Ministryaffirms that any hospital with a domestic staff of over 75would probably save money by employing a domestic super-intendent who would give all her time and attention to
organising this large and important part of the hospital service.Outlining the duties of a domestic superintendent, the
Ministry suggests that she should be directly responsible tothe matron, but should keep in close touch with the headsof all departments. Besides organising the work of thedomestic staff she would be responsible for their engagement,training, and welfare. Supervision of the work and allocationof duties within the wards and departments would probablycontinue to be undertaken by the sisters and officers in charge.The Ministry do not however propose any hard and fastrange of duties for the post. In a smaller hospital, forinstance, the duties might well be combined with catering,and an appointment of housekeeper-caterer made. On theother hand in a large hospital the domestic superintendentmight well require an assistant.
People with suitable qualifications for these jobs, the Min-istry admits, are scarce and anyone with experience of large-scale domestic management should be considered ; but ideallya domestic superintendent should have completed a two-yearcourse in institutional management, should hold a degree ora recognised certificate or diploma in household and socialscience, and should have had one or two years’ practicalexperience.
___
University of CambridgeOn Aug. 2 the following degrees were conferred :M.D.-G. S. (’rockett, M.A. Floyer, E. L. Mc Donald, K. V.
Palmer, * J. S. Pegum. D. R. Smith.M.B., B.Chir.-* 1). M. E. Allan, J. D. C. Anderson, N. W.
Ashworth, * P. A. J. Ball, Robert Baxter, A. W. Beard, KathleenM. Bennison, M. H. H. Bishop, C. J. Booth, * M. J. Boyle, June E.Brett, * H. G. Britton, B. W. Broadhurst, David Bryant, * G. M. B.Bulman. T. F. Bushby, A. R. Butterfield, * G. R. C. Campion,* S. MeC. Camiicott, * Harold CaplaM. * J. B. C’halman, * BettyC’hester, * W. J. Colbeck, * R. R. A. Coles, * C. E. T. C’ones, A. S.Cooper, Betty R. Corbin. * P. F. A. Crawshaw, * R. G. Daniels,* J. G. Davies, * J. 1. W. Davie, * R. J. L. Davis, * R. H. Davison,* P. J. Dawson. E. M. Douglas, * I. (’. Dow, * Michael Dulake,* A. V. Dunlop. * Warren Eade, J. H. Edwards, * J. R. Edwards,* J. X. T. Evans, R. T. D. FitzGerald, * J. R. Flury, * H. BB’. S.Frands. * 0. M. French. * Nathan Gee, 1. M. Glynn, * RainerGoldsmith. Peter Grittiths. Eric Hainsworth, Thomas Hall. * DouglasHarrett. * Rex Harri,.:on, * D. S. Harry, * E. P. Hilary-Jone-,* A. L. Hilton, * John Innes. * D. S. Jerfery, * J. M. A. Jepps,* J. H. Jones, * D. H. Kay, * E. 1. Kohorn, J. S. Lewis, * JamesLiddell, * J. . H. Lodge, * A. B. Lowther, * P. J. Lyne, * J. M. S.Mc-Cov, * J. A. Mc Hardy. * P. J. lirt,luade, * Roger Mangnall,* R. J. Mather, * M. K. Mead- * G. C. Metcatfe. * J. F. Newcombe,* R. C. Norton, J. O. Ojukwu, BB-. X. B. I-arker, J. E. Phillips,* Cyril Rashbass, * T. W. Rayuer. P. S. Reay-Young, J. M. Rigg,J. H. Robson, R. BV. Ross Rusi-eU, Vishnu arma, * J. H. Sewart,* C. A. Sharples, G. M. Shaw, Hilary J. Shimmin, * M. P. Siddons,J. M. Simister, * F. V. Simpson, G. W. Smallcombe, * R. L. Smith,R. J. Spray, * R. M. Standish-White, C’. )1. Stafford, * J. W. M.Stone, * J. H. Swallow, D. G. Thomas, * M. L. Thomas, D. H.Trapnell, * B. G. S. F. Vergano, G. 1. Verney, D. G. D. Vint,
