156

stituent, the other silicates may prove to be important ;physicochemical interaction between the combustiblecoal and its associated silicates may give adjuvant orinhibitory effects, differing with the class of coal; thevery mixed character of the mineral fraction of theinhaled dust, including aluminous and other possiblyantidotal substances, may mean that the pathogenicaction of the dust is the -resultant of the effects of anumber of its constituents ; and the knowledge of thepart played by infection in pneumoconiosis is far fromcomplete. Much further research will be required toelucidate these matters, and it is hoped that informationwill come from medical and scientific workers in SouthWales and elsewhere, as well as from the MRC’s Pneumo-coniosis Research Unit, in process of formation in Cardiff.The practical outcome of even our limited present

knowledge is that the control of the more dangerous com-ponents of inhalable dust in coalmines must depend uponcontrol of the whole of the dust. We can say with assur-ance that while sandstone-rich strata are the most potentsources of dangerous dust, harmful siliceous matter isalso intimately associated with the coal seams themselvesas they are worked, and indeed is contained within theinterstices of the coal itself.

It is regrettable if statements in the MRC reports as tothe apparent non-pathogenicity of the pure coal sub-stance are being interpreted as meaning that " coal dust "is not dangerous to breathe. The reverse is certainly the

case, and for this reason it is necessary to regard all dustgenerated within the coal industry as a potential hazard,and all available means should be employed to controland suppress its concentration in the air inhaled by theworkers.

E. J. KING,British Postgraduate Medical School.

P. D’ARCY HART,Medical Research Council.

CANCER IN A NATIONAL MEDICAL SERVICE

SIR,—In your issue of July 21, Mr. G. F. Stebbing,discussing how cancer shall be dealt with in a NationalMedical Service remarks that the " disease starts irr asmall and localised lesion." To most practitioners thiswill seem an eminently reasonable statement; but it is notaccepted by the Ministry of Health, which includes underthe heading " cancer " all sorts of generalised endo-thelial hyperplasias such as leukaemia, not to mentionpolycythaemia, multiple myelomatosis, and even suchragbag syndromes as mycosis fungoides.l One cannothelp suspecting that the Ministry’s idea of what consti-tutes cancer is governed very largely by whether anyparticular syndrome does or does not respond to W raysor radium-i.e., that sociopolitical considerations con-cerned with " cancer centres " and " cancer specialists "have been allowed to colour scientific pronouncements.Even if this suspicion is quite unwarranted it must stillremain highly undesirable that a National MedicalService should incorporate cancer campaigning basedupon fundamental uncertainties, with the production ofstatistics which are bound to be fallacious. The point atissue is very short. Are we to agree that cancer is justany disease treated at a cancer centre, or may we stillconfine the term to a disease which "starts in a small andlocalised lesion ? "

,

Sevenoaks, Kent. _

GORDON WARD.

1. Treatment of Cancer: Directions for the Use of Record Cards,1945.

BRITISH ASSOCIATION OF UROLOGICAL SURGEONS.—Thefirst annual general meeting of the association was heldin London on June 29 at the Royal College of Surgeons, when itwas announced that honorary membership had been acceptedby Sir Arthur Ball, Sir Girling Ball, Surgeon Rear-AdmiralG. Gordon-Taylor, Sir Hugh Lett, Mr. Cyril Nitch, Mr A.

Ralph Thompson, Prof. G. Grey Turner, Mr. Henry Wade,PRCSE, Sir Alfred Webb-Johnson, PRCS, and Surgeon Rear-Admiral R. J. Willan. Seventy home foundation membershad been elected and names were accepted of five honorarymembers, forty-eight full members, and ten associate membersfrom overseas. Dr. Fey, professor of clinical urology in theUniversity of Paris, was welcomed as a visitor, and waselected an honorary member. In the afternoon the membersvisited the spinal injury centre at Stoke Mandeville Hospital.

On Active Service

CASUALTIES. DIED

Lieut.-Colonel GILBERT CLEARY BABINGTON, MD LOND., MRCP, RAMO

AWARDSMBE

.

Captain E. J. JONES, MRCS, RAMC ,

Flight-Lieutenant A. G. HARDY, BM OxFD, RAFVRFlight-Lieutenant F. W. LAURIE, MB EDIN., RAFVR ,

One night in December, 1944, in bad weather, a Lancaster aircraftcrashed and caught fire outside an airfield boundary. Flight-Lieutenant Laurie, the station medical officer, went to the assistanceof the injured crew. He arrived when the worst of the fiames hadsubsided, but there was some danger from the fire which was stillburning. Working under appalling conditions amongst the wreck-age, in rain and deep mud, he rendered first-aid. The mud pre-vented ambulances approaching the crash and thus delayed theremoval of the injured. Some of the crew undoubtedly owe theirlives to this officer’s prompt and skilful attention. After taking theinjured to station sick-quarters, Flight-Lieutenant Laurie, althoughvery tired, tended them for a further 12 hours. In January, 1945,two Lancaster aircraft, both carrying long-delay-action bombs,crashed at dawn within a few minutes of one another. Flight-Lieutenant Laurie assisted the crew from the first wrecked aircraft,which did not catch fire, rendering first-aid as necessary, and ignor-ing the potential danger of bombs exploding. He then turned hisattention to the second aircraft. This had caught fire on hittingthe ground and two explosions of, bombs had already occurred.After seeing one survivor into an ambulance he went amongst thewreckage to search for other survivors. He was fully aware thatthere was a considerable danger that further bombs might explodewhilst he was so engaged. Flight-Lieutenant Laurie has set afine example of gallantry and devotion to duty and has done muchto maintain the morale of air crews.

MENTIONED IN DESPATCHESRNVR 1 Majors (cont.)

Surgeon Lieutenants ! R. M. CAMPBELLD. A. T. FARRAR, RNVR W. A. CAREYW. L. LESLIE, RCNVR H. J. CROGHANCommands and Staff L. F. DAWES

Brigadier F. H. EDWARDS, MCH. G. WINTER, late RAMC A. B. EVANS

RAMC , F. I- EVANS

Brigadier W. R. EVERATT

D. F. PANTON H. K. FIDLERT. E. FIELD, MBE

Colonels -

M. C. K. FINLAYSONS. W. K. ARUNDELL E. FoWLER

_

J. H. BAIRD A. M. GILESA. 0. BEKENN, OBE E. H. C. HARPERG. W. R. BISHOP, OBE L. HEASMANJ. R. DAWSON ! G. M. HOBBINJ. M. MACKENZIE, OBE, MC 0. P. D. LAWSONR. -E. REES, MC , R. J. B. McEwENJ. T. R6BINSON W. M. MACLEOD

Lieut.-Colonels K. C. MALLENT. M. R. AHERN P. C. MITCHELL, MO ,

F. AYREY ’, P. B. L. NICHOLAS

D. H. D. BURBRIDGE ’i W. F. NICHOLSONA. BURNS H. D. O’BRIEN

W. M. CAPPER R. G. W.’OLLERENSHAW

J. H. CROOM I, P. J. O’CONNET.LS. B. DIMSON P. L. O’NEILLG. Y. FEGGETTER J. D. O’RIORDAN

H. GASS A. ORLECK, MBER. T. GRANT D. L. OWEN, MBEG. B. HEUGH J. H. PATTERSON

K. McNEILL, OBE G. W. PINDER ,

H. MANNINGTON C. I. RAERURN

A. J. MARTIN ’I - A. S. RAMSEY

J. S. MILLER , C. G. ROB, MCT. P. P. MURPHY G. I. M. Ross

’

H. W. L. NICHOLS H. L. SETTLE

R. J. NIVEN, MC ’

, J. F. STOKES

T. A. PACE R. THORNLEY

J. P. RABAN R. A. R. TOPPING

0. A. SAVAGE , D. J. D. TORRENS

H. L. SHEEHAN P. K. NVALIKEP.J. R. STEEN F, E. WHEELERJ. TROTTER, OBE A. B. WHITE

R. L. TURNER, OBE W- J. WILES

D. S. VALENTINE W. WILSON

H. S. WARD, OBE I J. Yo FE

E. J. M. WENYON i CaptainsMajors

’ J. P. ADLAM

K. D. G. ABBOTT D. BLACKLEE ,

D. G. ADAMSON J. R. BENNETT

D. W. ASHCROFT D. C, B. BRAMWELLD. S. AUSTIN A. L. BROWND. M. BAKER J. S. BRTTNTON

,

H. M. BARNARD ’ L. CAMRASSD. BELL B.E.CAMUSH. BRIDGES

’ S. CITRONA. S. BLTLLOUGH P. J. R. DAVIS

157

MENTIONED IN DESPATCHES (cont.)Captains (cont.)

P, H. DAVISOND. S. DICK

. J. W. DOUPEF. J. DOWNESH. W. W. GOODE. GREENWOODA. A. GUILDD, R. GuNNA. M. GWYNNJ. A. J. HAMMONDH. L. HARTJ. C. HENRY

’

A. B.,J. HILLL. P. HODGSONP.M. JAMES ’,J. C. JEFFREYG. H. P. JOHNE. L. H. JoNEsR. M. J. KEIRH. C. KENNEDYJ. C. LEASK

-

H. LEVINE’ R. J.,A.,MACDONALD, MBE

J. M. MCINROYH. G. MCQUADEN. C. MONDL. C. MONTGOMERY IH. B. MORRISH, MOWSCHENSONJ. O’HARAK. I. PECKITTN. PEDERSEN, MCJ. PINCHINGJ. J. REEKSG. T. ROBERTSONA. F. RODGER

. R. W. RossR, SHIELDSH. G. STANTONA. M. STEWARTG. B. TAIT

Captains (cont.)V. N. TAYLORH. D. S. VELLACOTTD. B. WATSONB. G. WELLS sR. B. WRIGHT

LieutenantsR. FRAMEN. L. L60SMORED. J. L. ROWLANDE. D. WATERS

1MB-Lieut.-Colonels

J. H. ARTHUR, MBEM. L. A. DEWANG. B. JACKSONJ. L. O’NEILL

, A. D. WILSON

MajorsL. M. KELLY, MBER. M. NAIRS. K. SENS.F.THOMAS

CaptainsJ. AITKENM. K. AKHTARS. K. BANERJEER. K. CHAKRAVARTY

[ B. B. DUTTAD. I. GANTZERBiMALENDTJ GHOSKA. C. GREENE ,

C. S. MENDIRATTAI V. V. S. MUDAI.IAH

E. B. NAUGS. R. RAYSUKUMAR SANYALJ. C. SEN

. LieutenantS. C. DUTTA

MEMOIR

Surgeon Lieut.-Commander G. N. MARTIN, who died at theRoyal Naval Hospital, Haslar, on June 30, at the age of 58,was the youngest of four brothers who all became doctors.Their father, the late Dr. J. W. Martin, was for many years

-

medical officer to the Jessop Hospital and lecturer on mid-wifery at the Sheffield School of Medi- cine. Lieut.-Commander Martin was

educated at Elstowe School, Bedford,and at the London Hospital. In 1913he took the Conjoint qualification, andwhen war broke out he was a house-physician at the Royal Sussex CountyHospital, Brighton. One of the firstmen in the country to volunteer, he wasat once given a commission in the RoyalNavy and was serving in HMS Percywhen she was sunk on Sept. 22, .1914.After he was demobilised in 1919 hesettled in practice at Eccleslaall in

Staffordshire. Later he accompanied the expedition sentto. the Antarctic to find Shackleton. But his health hadsuffered during his war service and in 1931 he retired fromactive practice, though he continued to do temporarywork whenever he was well enough. In 1938. he joined.Elders and Fyffes Shipping Company as one of their surgeonstill in 1940 he was transferred to the Royal Navy. Heserved through most of the Battle of the Atlantic and wason the Canute when she was sunk in 1941. He and his com-

panions spent many hours in a small boat, and it was hispresence of mind, courage, and cheerfulness which saved theparty. He always made light of his experiences, and a friendrecalls the matter-of-fact way in which Martin recounted howhe instructed his sick-bay steward to reduce his Colles fractureand put it up in a plaster-of-paris splint. After a short periodin Egypt he was invalided home and for the past year had beenstationed at the RN barracks at Devonport., " Gerald Martinhad an adventurous nature," writes a colleague,

" which foundthe humdrum round of a peace-time doctor’s life irksome andsomewhat uninspiring, though no-one took more trouble withhis patients, especially those who were really ill. He practisedsocial medicine in its widest sense, and knew all the circum-stances, emotional and material, of those he attended. His

loyalty and constancy endeared him to men and laid thefoundation for the friendship which with time merges into love."

ObituaryWILLIAM- THOMAS GORDON PUGH

M D LOND., F R C S

Dr. Gordon Pugh, formerly medical superintendentof Queen Mary’s Hospital for Children, at Carshalton,Surrey, died on July 22 at the age of 73, after a fewhours’ illness.

’

He was a Middlesex Hospital man, gaining an entrancescholarship in 1889 and after-wards the Lyell gold medaland scholarship and the seniorBroderip scholarship. In theMB BS examinations of 1895 hetook honours in medicine andobstetric medicine and first-class honours in surgery.

. In 1897 he entered the serviceof the late Metropolitan Asy-lums Board as an assistantmedical officer at the NorthEastern Hospital, and in 1907,at the early age of 35, he waspromoted to be medical super-intendent of Gore Farm (nowthe Southern) Hospital. In1909 he was appointed as thefirst medical superintendentof the, Children’s Infirmary,afterwards so widely known as Queen Mary’s Hospitalfor Children, Carshalton. He later became hon. con-sulting surgeon to the King Edward VII Welsh NationalMemorial and chief medical officer (children’s institutionsand surgical tuberculosis) to the Metropolitan AsylumsBoard and in due course to the London County Council.Although in 1905 Gordon Pugh published a Method

of Staining the Bacillus, diphtheriœ his chief clinicalinterest lay in the treatment and aftercare of childrensuffering from non-pulmonary tuberculosis. In 1909 hewas stressing the need for open-air treatment, and in 1912the hospital school at Carshalton received his enthusiasticsupport. His orthopaedic work was characterised byclose attention to detail and he early realised the im-portance of open-air heliotherapy and actinotherapy asancillary methods of treatment. He devised and

perfected the Pugh frames and carriage and in hispresidential address to the orthopaedic section of theRoyal Society of Medicine in 1926 he said : " Whenan appliance fails we are apt to blame the nurse or thepatient or both. It is for the surgeon to considerwhether his splint is not partly responsible and toeliminate the causes of failure. Thus there were gradu-ally evolved the frames and the carriage which I haveused at Carshalton for a number of years." The Pughframes for the treatment of tuberculosis of the spine andhip allow for facility in nursing, minimal attention tothe back once a month only, and regular exercise to thearms, legs, and lungs, and not only facilitate heliotherapyand actinotherapy but save the children from beingconfined within the boundaries of their wards. Hisknowledge and experience of non-pulmonary tuber-culosis in childhood was eneyclopaedic and his opinionwas widely sought and freely given.Queen Mary’s Hospital was opened to accommodate

sick, debilitated, and convalescent children ; but itbecame, almost entirely because of his ability andenthusiasm and the development of its many sppcialiseddepartments, not only the largest but also one of thebest-known children’s hospitals in the country. Graduallyunits were opened for the treatment of children sufferingfrom marasmus ; non-tuberculous orthopaedic conditions,particularly poliomyelitis, cerebral palsy, and osteo-myelitis ; congenital malformations ; and (in 1926)juvenile rheumatism. The unit for the treatment ofjuvenile rheumatism was developed in collaborationwith the late Sir Norman Gray Hill, who was his deputy,and in 1937 when he retired it consisted of 390 beds.Gordon Pugh had wide interest in all hospital matters,

and at Carshalton " nothing was too trivial for hisattention, nor too big for him to deal with satisfactorily."He was an invaluable member of the LCC’s departmentalcommittee on hospital standards. A large number ofmedical officers were, during his long service, attached