Annals Ofthe Royal College of Surgeons Ofengland

Annals ofthe Royal College of Surgeons ofEngland

Editor A J Harding Rains MS FRCS Assistant Editor R M Kirk MS FRCS Associate Editors J E Riding MD FFARCS representing the Faculty of Anaesthetists, and K P Liddelow CBE FDSRCS FDSRCSEd representing the Faculty of Dental Surgery Executive Editor (British Medical Association) D I Crowther BM BCh MRCS LRCP Published by the Royal College of Surgeons of England in conjunction with the Joumal Department of the British Medical Association BMA House Tavistock Square London WCIH 9JR Copyright ) I979 by the Annals of the Royal College of Surgeons of England This publication is copyright under the Berne Convention and the International Copyright Convention. All rights reserved. Apart from any relaxations permitted under national copyright laws, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission of the copyright owners. Permission is not, however, required to copy abstracts of papers or of articles on condition that a full reference to the source is shown. Multiple copying of the contents of the publication without permission is always illegal.

Printed by Dorriston Ltd., Dorriston House, 21/25 Earl Street, London, EC2A 2HY

Subscription rates. United Kingdom and Ireland £20 per annum post free. Overseas US $49.00 per annum post free. Payment for overseas subscriptions should be made in US dollars or in your national currency based on the prevailing exchange rate to the US dollar of that currency, payable to the British Medical Association/ARCS a/c. Orders can also be placed locally with any leading subscription agent or bookseller. For the convenience of readers in the USA subscription orders, with or without payment, can also be sent to Professional and Scientific Publications, 1172 Commonwealth Avenue, Boston, Mass. 02I34; cheques should be made payable to PSP/ARCS a/c. Single copies: Inland £4.00; Overseas US$g.oo per copy post free. Quotations for full volumes and back numbers will be given on request. All enquiries concerning subscriptions and sales should be addressed to the Subscription Manager, Annals of the Royal College of Surgeons, BMA House, Tavistock Square, London WCiH 9JR. Authors wishing to submit original scientific papers for publication, other than those giving statutory and postgraduate lectures, are requested to write in the first insance to the Editor at the College.

(College information on inside back cover) Annals of the Royal College of Surgeons of England

VOLUME 6I January-November 1979

Editor A J Harding Rains MS FRCS Assistanti Editor R M Kirk MS FRCS Associate Editors J E Riding MD FFARCS (representing the Faculty of Anaesthetists)

K P Liddelow CBE FDSRCS FDSRCSEd (representing the Faculty of Dental Surgery) Executive Editor (British Medical Association) D I Crowther BM BCh MRCS LRCP

Published by The Royal College of Surgeons of England in conjunction with the Journal Department of the British Medical Association, B.M.A. House, Tavistock Square, London, WCiH 9JR CONTENTS Volume 6i January-November 1979 Page SCIENTIFIC ARTICLES Blast injury with particular reference to recent terrorist bombing incidents J F Hill 4 Factors affecting the fibrinolytic response to surgery N J Griffiths 1 2 The surgical management of the arthritic hand S H Harrison I 7 Some landmarks in the surgery of the rheumatic diseases W A Law 29 Non-invasive investigation of the upper gastrointestinal tract using technetiumn-gm T V Taylor 37 The plain abdominal radiograph in acute appendicitis J A C Thorpe 45 A new approach to the surgical treatment of reflux oesophagitis N A G Jones and C J Anders 48 Haemorrhoidectomy without tears D A Berstock 51 Surgery in children with homozygous sickle cell anaemia P G Bentley and E R Howard 55 Prediction of postoperative respiratory complications by simple spirometry M B Clague, J Collin, and L B Fleming 59 Tumours of the liver Sir Rodney Smith 87 Investigative approaches to the problem of pancreatic cancer A R Moossa 100 The radiological assessment of ectopic lower third molars A J MacGregor I07 The lymphatics of the prostate gland and their role in the spread of prostatic carcinoma P Shridhar "14 Gastroduodenal haemorrhage R T Grime I23 The surgical treatment of thyroid disease in modern perspective Selwyn Taylor 132 A simple clinical approach to quantifying losses from the extracellular and plasma compartments W M Roberts, J V Parkin, and M Hobsley 142 Extended deep femoral angioplasty and lumbar sympathectonmy as a limb salvage procedure I M Stevenson, P N Wake, and G J Santer 146 Fibrous histiocytoma: benign and malignant variants M S Barsoum, S S Eissa, and M A Mansour I49 British Association of Clinical Anatomists: abstracts of papers presented at Summer Meeting, 1978 152 Recent trends in the practice of sphincter-saving excision for rectal cancer I C Gouigher I 69 Concepts of occlusion G C Dickson I 77 Abnormal liver function during nutritional support in postoperative cancer patients F D Skidmore, D E F Tweedle, E N Gleave, E Gowland, and D A Knass 183 Clinical implications of cell function in osteogenesis S Nade I89 Surgical treatment of bronchiectasis D K Chattapadhyay I95 The surgical anatomy of the superficial and perforating veins of the lower limb H Thomson I98 The muscle content and contractile capability of the common bile duct T H Walsh and T Akoglu 206 Abdominal testis with extended epididymis A Azmy and J 0 N Lawson 210 Palliative pulsion intubation in oesophageal carcinoma I B Angorn and M M Hegarty 212 An open technique of pleural biopsy in the diagnosis of tuberculous effusions D H Thompson, A Edwards, and A E Mills 215 Iliopopliteal Dacron grafts as an alternative to amputation R E Horton, A E B Giddings, and A C Parkes 217 Pancreatic Society of Great Britain and Ireland: abstracts of papers presented at the third Annual Meeting 230 The aetiology of suture-line recurrence I L Rosenberg 251 Restenosis of the mitral valve J R Belcher 258 Page Urinary schistosomiasis in Saudi Arabia D M Wallace 265 The postural function of the iliotibial tract P Evans 271 Duplication of the upper urinary tract P Smith and M Dunn 28I The isolated circuit diathermy I P Mitchell 287 Comparison between general and local anaesthesia for repair of groin hernias T Makuria, J Alexander-Williams, and M R B Keighley 291 Axillary hyperhidrosis: surgical cure with aesthetic scars N M Breach 29=, Kutler repair for the amputated fingertip M Gaber 298 PTFE (Goretex) femoropopliteal reconstruction for limb salvage C A C Clyne, J A McVeigh, M J Fox, G H Jantet, and C W Jamieson 301 A double aneurysm forceps T V Taylor 304 Management of the diabetic foot J A Dormandy 305 British Association of Clinical Anatomists: abstracts of papers presented at the Annual General Meeting, 1979 312 Burns: Mclndoe's contribution and subsequent advances Douglas MacG Jackson 335 Hyperplasia and neoplasia of the intestinal tract R C N Williamson 341 The significance of the evolution of the cerebrospinal fluid system Gordon Brocklehurst ,+9 The embryological congruity of the human hip joint G D Rooker 357 The diagnosis of primary hyperparathyroidism James S Hilary Wade 362 Anaesthesia and the potter K A Cowan 367 Postoperative analgesia using continuous infusion of papaveretum E N S Fry 371 Contact cholangioigraphy D C Baxter-Smith and M D Middleton 373 The scrotal pouch operation for undescended testis Stephen Brown and A E Mackinnon 377 Measurement and control of postoperative pain J Nayman 4I9 Glucose homoeostasis following injury Peter D Wright 427 Bile studies after liver transplantation Paul McMaster 435 An appraisal of maximal faradic stimulation of pelvic muscles in the management of female urinary incontinence A G Turner 44i Bum wound dressing with human amniotic membrane B Bose 444 The clinical value of ultrasound in biliary tract and pancreatic disease N V Addison 448 Transabdominal bilateral adrenalectomy for metastatic breast carcinoma E A Benson 452 Evaluation of dextran with local anaesthesia for short-stay inguinal herniorraphy A N Kingsnorth, S S Wijesinha, and C J Grixti 456 Prostatectomy at a district general hospital R D Leach 459 Cardiovascular changes during induction of anaesthesia: influence of three anticholinergic premedicants R K Mirakhur and I W Dundee 463 Value of the Tinel sign in brachial plexus lesions Antonio Landi and Stephen Copeland 470 Hyperbaric oxygen therapy in acute trauma R E Loder 472 An improved peroperative test of vagal section T P J Hennessy and W A Tanner 474 Outp2tient preoperative assessment: the surgeon's view R E Ferner 477 HISTORICAL ARTICLES David Bayford: his syndrome and sign of dysphagia lusoria N A Asherson 63 The surgical apprentice, 1829 R Milnes Walker 68 The Hunterian Professors and Arris and Gale Lecturers H Ellis 71 Some controversial aspects of John Hunter's life and work. Part I George Qvist 138 Peel's fall A G W Whitfield I58 Some controversial aspects of John Hunter's life and work. Parts 2 and 3 George Qvist 219 A portrait of Thomas Hollier, Pepys's surgeon G C R Morris 224 Some controversial aspects of John Hunter's life and work. Part 4 George Qvist 309 Some controversial aspects of John Hunter's life and work. Part 5 George Qvist 38i The 'Neanderthals' of the College of Surgeons B A Wood 385 The kiss of death A G W Whitfield 390 Some controversial aspects of John Hunter's life and work. Part 6 George Qvist 478 Page OTHER ARTICLES From the President Uniform requirements for manuscripts submitted to biomedical journals 321 Pearson and the patient Robert B Duthie 393 A new approach to a final examination in surgery A Cuschieri, F A Gleeson, R M Harden, and R A B Wood 400 POINTS OF VIEW A Smith and Nephew Fellowship I P Collins 73 In defence of the MRCS J McFarland iGi Haemorrhoidectomy with or without tears? A P Rubin 233 Monitoring emergency care R F Evans and J P Bull 234 Future of the Royal College of Surgeons M Roberts 3I6 The present role of the Fellowship A Lettin 3I9 Medical anatomists-a dying race R M H McMinn 4o6 Local anaesthesia for herniorraphy C D Hanning 484 Kutler repair for amputated fingertip J E Crockett 485 Management of the diabetic foot J H Newman 485 Postoperative analgesia using continuous infusion of papaveretum J M Cundy 486 Early experience with PTFE femoropopliteal reconstruction J W L Fielding, R A Hurlow, G Slaney, and F Ashton 486 COLLEGE AND FACULTY NEWS American College of Surgeons, Joint Meeting 235 Anaesthetists, Faculty of 75, 76, 8I, 239, 240, 325, 328, 409, 410 Annual Meeting of Fellows and MeTmbers, I978 76 Appointments of Fellows and Members to Consultant and similar posts 8I, 243, 327, 415, 495 Consultant posts, assessment of content I65 Contributors, notice to 321, 407, 469 Council Dinner to Board of Regents of the American College of Surgeons 237 Council election 41 I Council Meetings 75, I63, 239, 324, 408, 488 Court of Examiners, Reports 243, 495- Court of Patrons, admission: Mr W F Davis 412 Deaths of Fellows 8o, I64, 240. 325, 4II, 490 Dental Surgery, Faculty of 239, 245, 325, 409, 410, 4I6, 489, 491,i 494 Diary 82, i 66, 245, 329, 497 Donations 75, I63, 239, 325, 411, 490 Election of President and Vice-Presidents 408 Election of Professors and Lecturers, 1979-80 49,0 Executive Committee Meeting 489 Frilows of fifty years standing 411, 494 FRCS Regulations: recipro-city of Primary Examination 325 Holiday lectures for young people 496 Honorary Fellowship: Professor Nils Kock 79 Dr Frank E Stinchfield 236 Honorary Medal: Sir Charles Hayward 79 Honours conferred on Fellows and Members 164, 411 Tn Memoriam: N R Barrett 4I4 Sims Commonwealth Travelling Professors 325 Visit to Australia and New Zealand G J Hadfield 327 NOTES ON BOOKS 83, I67, 246, 329, 4I6, 498 NOTICES 86, i68, 249, 333, 418 INDEX TO VOLUME 6i 501 College news

Meeting of Council Friday 20th April (afternoon)-Hunterian Lecture by At a Quarterly Meeting of the Council held on Professor M J Kelly on 'Wound infection: a con- 12th October I978 with the President, Mr Reginald trolled clinical and experimental demonstration S Murley TD, in the Chair, the appointment was of the pathogenic importance of synergy between confirmed of Professor John S Cameron, of Guy's aerobic (Escherichia coli) and anaerobic (Bacter- Hospital Medical School, as Sir Arthur Sims Com- oides fragilis) bacteria' and Arris and Gale Lecture monwealth Professor to visit Canada and the West by Mr N J McC Mortensen on 'The gastrin cell Indies in '979. at the Royal Infirmary, Bristol. Council recorded its thanks to Fellows in Swansea, WVednesday 30th May or 6th June (afternoon)- Hun. and in particular to members of the local organising terian Lectures by Professor C W Venables on committee, for all that they did to make the Annual 'The influence of fibreoptic endoscopy upon gas- Meeting there on 28th-29th September successful trointestinal surgery and its future role in therapy' and enjoyable. and by Professor G Proud on 'Blood transfusion and organ transplantation' at the Royal Victoria Mr D Innes Williams was congratulated on his Infirmary, Newcastle upon Tyne, followed by a appointment as Director of the British Postgraduate College subscription dinner. Medical Federation. Further details will be available from the College Mr Basil Helal FRcSEd was elected to the Fellow- Adviser and Tutors in each ship ad eundem. Surgical Region. The title of Honorary Research Professor in the Donations to the College College was conferred upon Professor Ward Faulk, who will become Director of the Mclndoe Memorial During the past few weeks the following generous Research Unit at the Queen Victoria Hospital, East donations have been received: Grinstead, on Ist January 1979. One covenant totalling LI05 Diplomas of Fellowship were granted to Richard Ten legacies totalling £40 587 James Tuft and Ivor Fussey. Gifts of £500 and over totalling £5ooo Gifts under totalling Mr P S Boulter FRCS, of Guildford, was appointed £5oo £3374 Adviser on the Training of Surgeons for the South- West Thames Region in succession to Mr A York College Dinners Mason. The College Dinner on Wednesday i oth January 1979 is to be followed by an address by Sir David Meeting of Board of Faculty of Anae- Napley, Past President of The Law Society. sthetists The Dinner on Wednesday 7th February is to be followed by an address by His Grace the Lord Arch- At a meeting of the Board of Faculty of Anaesthe- bishop of Canterbury. tists held on i8th October 1978 the Fellowship Prize was awarded to Dr J A M Keogh. Applications for tickets for the Dinners, price £io Diplomas of Fellowship in the Faculty of Anae- including cocktails and wines at table, should reach sthetists were granted in accordance with the pass Mr W F Davis at the College not later than io list (p. 8I). days before the date of the Dinner. Council provincial visits College Evening During the Hunterian 25oth anniversary celebrations A College Evening (advanced discussion group for in I978 there was an extension of the practice de- Fellows of the College) on 'Abdominal trauma' will veloped in recent years of decentralising the delivery be held on Monday sth February 1978 at 6 p.m. of College statutory lectures and in appropriate cases under the chairmanship of Professor Harold making the delivery of a College lecture the occasion Ellis DM Mch FRCS. The programme will be as follows: for a visit by the President and other Members of 6.oo Radiology-Mr M H Gough (Radcliffe Council to a Regional centre. The Council are grate- Infirmary, Oxford). ful for a number of similar invitations for the first 6.30 Closed injuries to the liver-Professor L H half of I979 and arrangements are now being made Blumgart (Glasgow Royal Infirmary). for the following lectures to be delivered outside 7.oo Gunshot wounds of the abdomen-Professor London: A D Roy (Royal Victoria Hospital, Belfast). 7.30 Buffet supper. Wednesday 3Ist January (4.30 p.m.)-Arris and Gale 8.30 to 9.30 Discussion. Lecture by Mr T W O'Brien on 'Fibrinolytic Fee of £4.50 includes buffet supper. Cash bar activity in the gastrointestinal tract' at Hope Hos- available. Applications for tickets to the Surgical pital, Salford. Training Office before Wednesday 31st January 1979. 76 College news H J Windsor Prize, 1979 American College of Surgeons will take place in London from 12th to i4th March 1979. The pre- Applications are invited for the third H J Windsor in Prize established in I976 by the late Dr H J Windsor liminary programme has been sent to all Fellows KSG CBE FRCS, of Brisbane, Australia. the British Isles. Further copies and details are Preference will be given on this occasion to young available from: Joint RCS/ACS Meeting, Confer. Australasian Fellows proposing to undertake a re- ence Services Ltd, 43 Charles St, London WIX 7PB. search or educational project in the UK. Applica- tions should reach the Secretary of the College by 3Ist March I979 and should include a brief curricu- Faculty of Anaesthetists: Bernard John- lum vitae, an outline of the research or educational son Adviser project envisaged, and supporting letters from a The Secretary of the Faculty of Anaesthetists invites consultant in Australasia and the person in the applications from consultant anaesthetists for the United Kingdom under whom the work is to be post of Bernard Johnson Adviser in postgraduate carried out. anaesthetic studies. Applicants should be interested The value of the prize is £250, to which it may and experienced in postgraduate education and be possible to add a supplementary travel grant. should be prepared to devote a minimum of one half-day per week to attendance at the College in Joint Meeting with the American London in addition to service on the Education Com- mittee of the Faculty. An honorarium is available. College of Surgeons, March 1979 The post is tenable for five years. Applications should Fellows are reminded that the first joint meeting of be submitted in writing to the Secretary of the the Royal College of Surgeons of England and the Faculty before 3Ist January I979. ANNUAL MEETING OF FELLOWS AND MEMBERS, 1978 The Annual Meeting of Fellows and Members was the hallmark of a well-trained dental surgeon. It held on 28th September I978 at the University is therefore very appropriate that in this year which College of Swansea. The President, Mr R S Murley marks the 25oth anniversary of the birth of John TD, was in the Chair and those present included I6 Hunter, who did so much to establish dentistry as other members of Council (including the Vice- a science, the Faculty should introduce a higher Presidents and the Deans of the two Faculties), six qualification for general dental practitioners-the other members of the Board of Faculty of Dental Membership in General Dental Surgery (MGDS). Surgery, five other members of the Board of Faculty 'For a long time the Faculty has been seeking a of Anaesthetists, and 72 other College and Faculty closer liaison with general dental practitioners and Fellows and Members. ways and means of helping them in their aspirations to achieve continual improvement in their pro- Honorary Fellowship fessional knowledge and skills, and it thinks that the establishment of the MGDS examination will go a Professor Nils Kock was introduced and a citation long way to meeting these aspirations for it will pro- delivered by Sir Alan Parks. Professor Kock, having vide a goal at which practitioners can aim and signed the Roll, was thereupon admitted as an canalise the postgraduate experience and tuition Honorary Fellow. (See report on p. 79) which so many practitioners are now demanding and which is becoming much more freely available Cecil Joll Prize to them. Mr J S H Wade MC TD FRCS was introduced and 'The Faculty was made very much aware that the President handed to him the Cecil Joll Prize for the introduction of the Membership will fill a long- 1976-78, together with a document declaratory of felt need by the fact that the number of applicants the award. for the first examination, to be held next May, was far larger than was expected, and it was with regret that a limit had to be imposed on the numbers to President's Address be accepted, since the administrative and logistic The text of the President's address to the Meeting demands of the examination are both complex and will be found on p I of the present issue. demanding on both examiners and administration as well as on the candidates. To compensate those Address by Professor K P Liddelow candidates who may have been disappointed by not CBE, Dean of the Faculty of Dental having been accepted the Faculty is proposing to hold a second examination in November 1979. Surgery 'Also as a result of the. number of candidates 'Mr President, Members of Council and Boards of applying for admission to the examination certain Faculty, ladies, and gentlemen, modifications have had to be made to its conduct, 'In 1859 the Royal College of Surgeons took a and these have been published fully in the British powerful initiative in raising the standard of dental Dental Journal. care for patients by establishing the LDS diploma, 'Before leaving the subject I should like to pay and for over a century this qualification has been a very sincere tribute to the members of the com- College news 77 bined British Dental Association/Faculty Working together with the constant stream of information Party under the chairmanship of Professor Kramer, from Regional Educational Advisers there is little the administration of both the College and Exam- likelihood of the Board losing touch with its inland ination Hall, Mr David Downton, Chairman of the Fellows. As many Fellows know, some years ago Examinations Committee, and by no means least, the Board felt that improvements were desirable in Mr Ben Fickling, Chairman of the Panel of Examin- the manner in which posts were considered for ap- ers, for- the truly monumental labours which they proval. A Hospital Recognition Committee was set have performed to produce a functional organisation up and has made such excellent progress that it has for the Membership diploma. now, under the chairmanship of Dr Aileen Adams, 'While the introduction of this diploma may be been accorded the status of a standing committee the biggest single achievement of this year, the of the Faculty. Faculty has continued with its normal routine work. 'It is encouraging to be able to report that the Some excellent postgraduate meetings and Faculty number of candidates entering our examinations evenings have been held. The three-week residential remains very high. In the last two Primary examin- course was run for the third time last spring and is ations no fewer than 712 candidates entered and obviously meeting a real need, for it was over- in the last two Final examinations 580. In a recent subscribed. Final examination a multiple choice questionnaire 'The work of assessors on advisory appointments on medicine and surgery was introduced in place committees has not only continued but these labours of essay-type questions. After long consideration the have increased because of the need to assess those Board had come to the view that by this means a applying for regrading as hospital practitioners. fairer test of knowledge of these subjects can be Agreement has also now been reached with the Chief made. Medical Officer and with the Welsh Office that both 'In the field of higher professional training I can new consultant posts and those coming up for renewal now report that something like 30o doctors are may be inspected prior to advertisement in the enrolled in the scheme at any one time and that interests of the maintenance of standards. approximately I00 annually are granted Certificates 'The Board is very conscious of the debt it owes of Accreditation of completion of training. A revised to its Regional Postgraduate Advisers and its many Memorandum on Higher Professional Training is at Fellows who so willingly give up time and frequently an advanced stage of preparation and should be avail- travel long distances to undertake what can some- able early in the new year. There is no doubt that times be a difficult and arduous task of acting as the Joint Committee, whatever its demerits, has had assessors. But, as the President has already said, the an immensely beneficial effect in assuring a more College is a quality-controller and it is only by this balanced training to prepare for consultant status. work that standards can be maintained. 'Since about IOO doctors per year are granted Certi- 'At the last Board meeting in June it gave us great ficates of Accreditation it may seem strange that there pleasure to admit the newly elected Members, Dr exists in certain parts of the United Kingdom a serious Tohn Rayne and Mr Derek Henderson and Mr Peter shortage of trained anaesthetists. Only too often the Harvey, the latter representing the Licentiates in Faculty is informed by Regional Hospital Authorities Dental Surgery. It was also a great pleasure for the that an advisory appointments committee has been Board to be able to congratulate Sir Rodney Smith, cancelled because of lack of suitable applicants or Past President of the College, upon his elevation to that the committee has met and made no appoint- a life peerage and Mr Walpole Lewin, who has been ment. What are the reasons for this? Well, there are made a Commander of the Most Excellent Order of many possible reasons, not all of which apply in any the British Empire. It also gave Members of the specific instance. It is still the case that some senior Board great pleasure that the FRCS was conferred registrars are reluctant to apply for consultant posts upon the immediate past Dean, Mr John Hovell, as because of the sometimes substantial reduction in a mark of esteem and appreciation not only for all salary that is almost inseparable from appointment that he has put into dental surgery but also for the as a consultant. This difference is very difficult to excellent manner in which he guided the Faculty make up and undoubtedly acts as a deterrent. There over the three difficult years that he was Dean.' is no doubt, too, that many posts are considered un- attractive, perhaps because of geographical location, Address by Dr J E Riding, Dean of the an uninteresting spread of work, sometimes the mere impossibility of attracting junior staff, or frankly poor Faculty of Anaesthetists physical facilities. Faculty visitors are well 'Mr President, Members of Council and Boards of acquainted with the spectacle of anaesthetists making Faculty, ladies, and gentlemen, valiant attempts to undertake intensive therapy in 'I am glad to be able to report that the work the most dreadfully unsatisfactory circumstances. of the Faculty continues at a high and productive 'Loss of anaesthetists by emigration continues, as is level. One of our most fundamental roles as a Col- made very clear by the information provided by the lege is the inspection and approval of posts in con- Faculty's Regional Educational Advisers. Of course nection with the examination regulations. The high- some, having completed training here, return to their est value is placed on these visits for they offer such mother countries. Many senior registrars undertake~ excellent opportunities to meet colleagues and to a period of training in approved overseas centres and discuss local problems and Faculty policy. Board not a few find circumstances sufficiently attractive to Members undertake about IOO visits per year so that induce them to emigrate. It is a fact.that anaesthesia 78 College news is a world shortage specialty. The FFARCS is an in- tended to be nationalistic but to strengthen the links ternationally accepted qualification and British- between the College and surgeons in Wales. Now trained anaesthetists are much in demand in many that the Wales Act had received the Royal Assent a parts of the world. Whilst a better standard of living referendum might lead to the creation of a Welsh is often cited as the principal attraction to emi- Assembly that would assume the powers now given gration, conversations often suggest that this explana- to the Secretary of State under the National Health tion is too facile. I have little doubt that in many Service Act 1976, including power to make regula- cases better conditions of work, well-equipped tions governing, for example, the appointment of hospitals, advanced intensive therapy units, research consultants. Mr Mitchell reminded the Meeting that opportunities, and the abandonment of hope that other Royal Colleges had a Welsh Division or Com- long-sought improvements in hospitals here will ever mittee of Welsh Affairs and suggested that this Col- be made are important influencing factors. Regret- lege should ensure the presence of a Welsh repre- tably there is at present no clear indication of any sentative on Council (by election or co-option), form substantial change in the extent of loss by emigration. a Welsh Standing Committee to bring informed 'I would like to refer briefly to the work of the united opinion on Welsh affairs to the Council, and Education Committee of the Faculty, latterly under change its name to the Royal College of Surgeons of the chairmanship of Professor Thornton and now Dr England and Wales. Enderby, which has arranged during the past year an Seconding the motion, Mr M C Mason FRCS re- attractive programme of meetings. The desire for called an earlier approach to the Council by the continued education could not be better demonstrated Welsh Surgical Society and urged the Council to than by considering the attendances at recent meet- respond speedily to ensure that a strong and power- ings. One two-day symposium last year attracted ful College was closely involved in the surgical affairs something like 6oo anaesthetists, two other meetings of Wales. have attracted almost 400 people each. The next Replying, the President stated that the College's two-day meeting on "Control of bleeding in surgery" name did not restrict its sphere of action and that to promises also to be highly successful. In addition the change it would require an amending Charter. The three-week course on anaesthetics for those preparing Council was not constituted on a geographical basis for the Final FFARCS regularly attracts a capacity but represented surgery as a whole and the national entry of over Ioo students. interest. Local advice was always available from the 'Mr President, before closing this brief review of Regional Advisers. some aspects of the work of the Faculty I would like Professor M D Vickers pointed out that possible to refer to changes in the membership of the Board. changes in the government of Wales would necessitate Professor Hunter, a former Vice-Dean, has retired the creation of a structure comparable to that in after completing two terms of service as a Member other Colleges that would be able to deal with mat- of the Board. In his quiet way Professor Hunter has ters arising from government sources which would served in a tireless and selfless manner both the differ from those in England. Board and the Joint Committee for Higher Training Mr W I Jones FRCS supported the motion. of Anaesthetists. Happily his unique knowledge of The President urged caution and care in dis- the working of MCQ examinations will continue to tinguishing between academic and medico-political be available. Dr Sellick likewise has completed two matters but undertook that Council would discuss the terms, and since he was Vice-Dean at the time when questions raised. I assumed office I have special cause to be grateful for his personal support and for his assiduous concem 2) Due notice having been given, Mr Patrick Smith and sound advice on Faculty matters. Both these FRCS proposed the following motion: men have laboured long and hard, often unobtru- 'That Council should seek new ways of improving sively, for the Faculty and its Fellows and are most communications with Fellows and Members of the deserving of our greatest gratitude. In their places Dr Rosen and Dr Zorab joined the Board in March College.' and have already thrown themselves most energetic- He asked that the facilities of the College build- ally into the work of the Faculty. ings should be improved to provide better surround- 'Mr President, may I say that your warmth and ings for Fellows wishing to meet informally or in humour and your seemingly inexhaustible knowledge groups as well as for conferences, and he suggested of every aspect of College life never fails to enliven that in some Regions the system of Advisers and the meetings of the Faculty?' Surgical Tutors was not working well; in particular he favoured the election rather than selection of Motions by Fellows or Members Regional Advisers. Seconding the motion, Mr Michael Roberts FRGS i) Due notice having been given, Mr J E Mitchell reported disquiet among surgeons in the South Wes- FRCS proposed the following motion: tern Region at their relationship with the College. 'That the Fellows of the College in Wales would There were many cauises of surgical unrest, amongst like to have their identity with the College ex- which the fragmentation into specialty groups made pressed in a more tangible way.' the role of the College more important than ever before. Among Fellows there were two common Mr Mitchell began by welcoming the College to attitudes, apathy and concern about their lack of Wales and explained that his motion was not in- involvement in College decisions; the activities of College news 79 pressure groups were therefore valid and Mr Roberts Ihe Meeting took place during the I I th Provincial supported Mr Smith's request for election of Ad- Meeting of the College, which was held in Swansea visers, who ought not to be Council Members. He on 28th and 29th September I978. would also like to see the College active in clinically The formal orientated research and the Annals providing answers Meeting was followed by a Moynihan to questions from Fellows. Lecture delivered by Professor Nils Kock Hon.FRcs Mr J a of entitled 'A new look at faecal and urinary diversion G Hadfield, Director Surgical Studies, procedures'. In the evening a Reception given by the explained the evolution of the method by which University of XVales and University College of Swan- Advisers were selected after extensive consultation sea preceded a Dinnier attended by some 2i0 Fellows, anid appointed initially for three years. and Professor A J Harding Rains stated that the Members, guests. Annals welcomed 'points of view' but doubted the The programme for the following day consisted of value of worldwide publicity for what might be only symposia on the following topics for which there a local problem. were approximately 250 registrations: Mr F D Skidmore FRCS suggested that the College Gynaecology for the general surgeon should be less introspective and explain its position Some airway problems publicly. Granulomatous disorders in the orofacial region In his reply to the debate the President explained New concepts that many of the points made had already been Progress in analgesia and sedation anticipated in the College. Rooms were made avail- Welsh Forum able inexpensively to various associations and societies; a Fellows' common room already existed; Orthodontics and surgeons in training were represented on relevant Problems of prosthetic surgery committees. There was widespread apathy, but com- The arrangements for the Meeting were under- munication must be two-way and there was a need taken by a local committee consisting of Mr J E for constructive criticism. Mitchell FRCS, Mr E J R Morgan FDSRCS, and Dr The President then declared the Meeting closed. M H Thorpe FFARCS. PRESENTATION OF HONORARY MEDAL Sir Charles Hayward On 27th October I978, at a small ceremony, Sir 'That the Honorary Medal be awarded to Sir Charles Hayward was presented with the Honorary Charles Hayward CBE HOn.FRCs and Patron, in Medal of the College. recognition of his generous benefactions to this College over the past fifteen years and for the The President, Mr Reginald Murley, spoke of Sir advancement of medicine through his gifts to other Charles's election to the Court of Patrons in I964, of medical institutions.' his admission as an Honorary Fellow in 1970, and of I'he President then handed Sir Charles the Honor- his many generous benefactions to the College. He ary Medal and a Certificate, saying, 'With warmest drew attention to the fact that the room they were congratulations I offer you these'. in was named the 'Charles Hayward Room' in Sir Charles replied, saying he was most grateful i969 and his Arms were displayed on the wall. He for this wonderful gesture and was very proud to quoted the Resolution of Council of i3th April 1978: receive this honour. ADMISSION TO HONORARY FELLOWSHIP Professor Nils Kock At the Annual General Meeting held in Swansea on both his surgery and his research activities, which 28th September 1978, Professor Nils Kock, of have all had a strong physiological flavour ever since. Goteborg, was admitted to the Honorary Fellowship On joining the permanent staff of his old medical of the College. A citation was delivered by Sir Alan school he set up a clinical and experimental Gastro- Parks Mch FRCS as follows: enterological Research Unit from which have ema- nated many original papers and doctorate theses. 'Nils Kock, known as Nicke to his friends, was The variety of his research interests has been re- born in Jakobstad in Finland in 1924. He served markable; for example, with his associates he has with the Finnish Army at a very young age for three produced papers on "The innervation of the urinary years during the war and then went to medical school bladder", "Studies on gastric emptying mechanisms", in Helsinki, graduating in I95 i. Not content with "Liver blood flow", and "The haemodynamic effects this he proceeded to the University of Goteborg, of glucagon". He has over 200 original articles to where he graduated yet again in I955. After routine his credit, a prodigious feat. It is not possible in the resident training in Goteborg he took a step which time available to list the prizes, distinctions, and was formative for the rest of his career: he spent honours which have been conferred upon him three years carrying out research in the Department throughout the world. In 1974 he was made full of Physiology. This has had a profound influence oni Professor of Surgery in Goteborg. 8o College news 'We honour him today not so much for his position too hard to have time to deveclop those traits or to as for his contribution to thc science and art of sur- commit some of those things about which legends gery. It was in I969 that the first news of a develop- arise. Hc was formerly fond of sailing a large yacht ment which has since made him world-famous was among the many islands of southern Sweden. Now published. He had realised that if you can have an however, he has an island all of his own, where he ileostomy bag outside the body you can have one in- has turned the knife into the ploughshare and clears side instcad, with much less trouble. His ileostomy scrub and rocks to bring order out of chaos. pouch operation, based on several years of physio- 'What he has achieved he has done through dog- logical and experimental work, has been the main gedness and determination. From Sweden again I am source of his fame. This work has been greeted with informed that he is strong, stubborn, indefatigable, acclaim, especially in the United States and in this and often uncompromising. The world is in need of country, and has been widely adopted throughout such men. You see him, Sir, before you, a giant of a the world. He has made us think again about a sub- man in all ways, a great Scandinavian, and a great ject which had long been neglected; we had accepted European. It gives me the greatest pleasure therefore the inevitability of the ileostomy appliance as part to commend him for admission to the Honorary of the price paid for ridding someone of a dread Fellowship of this College.' colonic disease. He has not only been an innovator but a catalyst. The President then admitted Professor Kock to 'I have tried hard to find some personal anecdote the Honorary Fellowship and warmly congratulated with which to regale you but have failed. By letter I him. received the following comment, "Carpentry and anything that has to do with repair seems to be one In reply Professor Kock said that he was very of his real foibles, although it may be questioned pleased to be with them, and even more pleased to whether he has any foibles at all". Only a few days have been admitted into the College. He thought ago I asked some of his colleagues if they had any- that for a Scandinavian surgeon it was the greatest thing to tell of him, some idiosyncrasy or some honour and he appreciated it very much. He regarded eccentricity which I might entertain you with today. it as an honour given to his institute, to his university, Alas, they said, Nicke Kock was not that sort of and to those who have worked with him, and he person. I suspect myself that he has in fact worked expressed his sincere thanks. DEATHS OF FELLOWS, 1978 The following is a list of those. Fellows and past GARDNER, Arthur Duncan FRCS office-holders whose death has been notified to the GORDON-SMITH, Ian Christopher FRCS College during I978: GRAY, Arthur Oliver FRCS ABDALLA, Mohamed Ahmed FDSRCS HANDFIELD-JONES, Ranald Montagu MC FRCS ABEL, Arthur Lawrence FRCS (Past Member of (Past Member of the Court of Examiners) Council) HARRIS, Charles Wilbur FRCS ADAMS, William Stirk FRCS ASHWORTH, Harold Kenneth FFARCS HESLOP, James Firth MBE FRCS ATKINSON, Eric Miles FRCS HERRON, Robert Alexander Crosthwaite FFARCS BARBOUR, John Russell FRCS HOLDEN, Norman Thompson FRCS BARLING, Eric Vernon MBE FRCS HUNTER, Adam Irvine FRCS BARRY, Geraldine Mary FRCS HURLEY, Dennis William Hamilton FRCS BATES, Ralph Marshall FRCS HUTCHINSON, William Robert Soutter FRCS BAXTER, Vincent Terry FFARCS JANES, Bernard Victor FDSRCS BEARE, Stanley Samuel OBE FRCS JARVIS, John Fulford FRCS BEDDARD, John Roger Jordin FFARCS KEMBLE, James FRCS BLAND, John Hopkyn Lloyd FFARCS LINDON, Sir Leonard Charles Edward FRCS BLISS, Roger Percy FFARCS LOUGHRAN, Arthur Morris FRCS BOLTON, Paul Mackay FRCS MACAFEE, Charles Horner Greer FRCS BRILL, Neils FDSRCS McDOWALL, Andrew TD FRCS BROADBENT, Holly Hon.FDSRCs MACLAY, Charles Workman FRCS BUTTSWORTH, Bert Wilfred FRCS MALIPHANT, Richard Glyn FRCS CAVES, Philip Kennedy FRCS MARSHALL, Timothy FFARCS CHESTER, Aileen Mary FFARCS MEHTA, Prabhakar Mayabhai FFARCS CONNELL, Richard Francis FFARCS MELVILLE, Charles Bernays FRCS COOKE, Robert Victor FRCS (Past Member of MENZIES, Sir Robert Hon.FRCS Council) MES, Gerrit Marie FRCS CORRIGAN, Melville John FRCS MILL, James Crowe Davidson FRCS DAR, Ghulam Nabi FRCS MILLAR, Edith Joan FFARCS DICKINSON, Osler Briggs FRCS MITCHELL, Douglas Harold FRCS DUKE-ELDER, Sir Stewart (William) FRCS (Past MUGGOCH, James Wilson FFARCS Member of the Court of Examiners) MURPHY, Michael Kevin FRCS FITZSIMONS, Robert Allen FRCS NICHOLAS, Charles Philip FRCS FRYITNCK, Jan Roeland FRCS NORD, Charles Frederick Leopold FDSRCS College news 8I NUTT, Albert Boswell FRCS (Past Member of (Past Member of Board of Faculty of Dental Council) Surgeons) OWVEN, Charles Langley FRCS SPIRO, Isidore FRCS RANSOM, Shila Gwynne FFARCS STALLMAN, John Frank Herbert FRCS ROBERTSON, James Sloan Mutrie FRCS STOTT, John FDSRCS ROSE, Baron Theodore FRCS SYKES, Charles Ernest FFARCS RYAN, John Francis FFARCS THOMAS, Gareth Gambold FRCS SAMPSON, Noel John FRCS THOMAS, Kenneth Bryn FFARCS SCOTT, James Christopher FRCS TRATMAN, Edgar Kingsley OBE FDSRCS SCOTT, Robert Delmage FFARCS WHEELER, Robert Oliver FRCS SHARPE, Dorothy Anderton FRCS WHITE, Norman Lewis FRCS SHEPHERD, Francis William FRCS WINSTON, Percy FRCS SKEOCH, Hugh Hedley FRCS WINTER, John Stephen CBE FRCS SOIJTHWELL, Wilfrid Beric Beauvais TD LDSRCS WOODRUFF, Keith Montague Cumberland FFARCS APPOINTMENTS OF FELLOWS TO CONSULTANT AND SIMILAR POSTS S T HO FRCS Associate Professorship in Surgery, ogy, Royal Victoria Hospital, Belfast. Singapore General Hospital, Singapore. W RAJASOORIYAR FFARCS Consultant Anaes- P M H CHERRY FRCS Staff Ophthalmologist, To- thetist, Ratnapura General Hospital, Sri Lanka. ronto General Hospital; Assistant Professor in A BROUGHTON FRCS Consultant in General Sur- Ophthalmology, University of Toronto. gery, Pontefract Health District, Wakefield AHA. J N LEVERMENT FRCS Consultant in Cardio- L B FREEMAN FRCS Consultant Ophthalmologist, thoracic Surgery, Leicester AHA (T). Cheshire AHA. A J WARRINGTON FRCS Consultant in General W K WALSH FRCS Consultant in Orthopaedic Sur- Surgery, Sunderland AHA. gery, Hexham and District Hospitals, Northumber- R GOODWIN FFARCS Consultant in Anaesthetics, land AHA. Durham Health District, Durham AHA. A T CROSS FRCS Consultant in Orthopaedic Sur- N A BOYD FRGS Consultant in Orthopaedic Surgery, gery, Sunderland AHA. Isle of Wight AHA. W LEES FRCS Consultant in General Surgery, South H A CROCKARD FRCS Consultant Neurosurgeon, West Durham Health District, Durham AHA. National Hospital for Nervous Diseases, Queen M A QUADER FFARCS Consultant in Anaesthetics, Square, London. Darlington Health District, Durham AHA. A M HAY FRCS Consultant General Surgeon, Salop AHA. V Y SUBHEDAR FRCS Consultant in Charge, Casu- Correction alty Department, West Birmingham Health District, We regret that in reporting the appointment of Mr Birmingham AHA (T). P Vijayan in our September issue the State of Qatar Miss H J FRANK FRCS Consultant in Ophthalmol- was wrongly described as being in India. It is of ogy, Dorset AHA. course an independent sheikhdom on the Persian C J F MAGUIRE FRCS Consultant in Ophthalmol- Gulf. REPORT OF THE BOARD OF EXAMINERS FOR THE FELLOWSHIP IN THE FACULTY OF ANAESTHETISTS, 21St JULY 1978 At the recent Final Examination for the Fellowship §SARAVANAPAVANANTHAN, Thanalakshmy in the Faculty of Anaesthetists 289 candidates pre- (Sri Lanka). sented themseilves for the Examination, 97 of whom SLATER, Noel Arthur John (Birmingham). acquitted themselves satisfactorily. MUTHUKUDA, Abraham Leslie Siripala Rana- The following are the names of the 95 candidates singhe (Sri Lanka). who, having complied with the regulations, are §GHOSH, Nila (Calcutta). entitled to the Diploma of Fellow in the Faculty of ~CHIBBER, Vijay (Punjab (India)). Anaesthetists: §BENES, Zdena Anna Frantiska (Prague). §LAMB, Joan MRCS (Royal Free). PEIRIS, Richard Somapala Mapitiya (Sri Lanka). WELLS, John Christopher Durant MRCS (Liver- §BORALESSA, Harsha (Sri Lanka). pool). GIRGIS, Magdy Sobhy (Cairo). §BEGG, Jane MRCS (St Bart's). KHALIL, Khalil Abd El-Monem (Ain Shams). PRING, John Ernest MRCS (The London)., §MATHUR, Chandra Prabha (Vikram). ROBINS, David William MRCS (The London). COOK, Steven (Newcastle). FRIEND, Jonathan Peter Daniel MRCS (KCH). §HAMID, Rukaiya Kamal Abdul (Punjab (Pak)). FENECK, Robert Owen MRCS (Middlesex). §.JACKSON, Katherine Alice (Melbourne). PAPWORTH, David Peter MRCS (KCH). WANNINAYAKE, Herath Mudiyanselage §MANN, Mary Sue MRCS (Wake Forest). (Sri Lanka). FALTAOUS, Makram Abd-El Noor (Alexandria). WARD-McQUAID, John Michael (Ireland). §Woman 82 College news §ANANDASAKARAN, Rathidevi (Sri Lanka). GLASSER, Jonathan Michael (Glasgow). DESAI, Ahmed Farouk (Cairo). GLAZEBROOK, Clive William (KCH). §GUNAWARDENE, Welagedara Mudiyanselage, HENEGHAN, Christopher Paul Hamilton Swarnamali (Sri Lanka). (St Bart's). JEEVANANTHAN, Vaidialingam (Sri Lanka). HULSE, Michael Graham (St George's). §KASIPILLAI, Gladys Aloysia Letitia (Bangalore). KAHN, Barry Joseph (UCH). §LEWIS, Margo (Wales). KEOGH, John Anthony Martin (Cork). MARSHALL, Alistair Graeme (Otago). LANDES, Alain Henri (Guy's). §SCRIVEN, Patricia Mary (Manchester). §ONG, Kiem Kiok (Singapore). TANTLA, Din Dayal (Punjab (India)). RAFFERTY, Michael (Bristol). WIJESEKERA, Srikantha Abeygunawardena (Sri §THOMPSON-HILL, Lesley Margaret (KCH). Lanka). §WATSON, Philippa Jane Quartly (Dundee). BENCINI, Anton Francis (Malta). WEETCH, Gordon Andrew's (Glasgow). BROWN, Philip Michael (Leeds). WOLFE, Martin James (Middlesex). §GUNAWARDANA, Rani Hemalatha (Sri Lanka). §CALTHORPE, Christina Mary O'Reilly (Dublin). JAYASURIYA, Jayantha Premalal (Sri Lanka). CARNIE, John Charles (Edinburgh). NATRAJAN, Krishnamoorthy (Madras). CHEUNG, Wing Cheong (Belfast). NIGHTINGALE, Keith William (St Mary's). COGHILL, Jonathan Christopher (Bristol). RAJENDRAM, Radhamani (Sri Lanka). CONIAM, Stephen William (Westminster). REDPATH, James Barron Scott (Edinburgh). §COOTE, Alison Marjorie (KCH). TAGGART, Patrick Campbell Millar (KCH). DOODNAUGHT, George (Glasgow). BILTON, Alan Herbert (Sydney). GOULDEN, Paul (Leeds). BOND, Gerald Frederick (Manchester). HOO, Hock Wah (Leeds). BRYANT, Lindsay John (New South Wales). §HURST, Jane (Liverpool). FERRIS, Paul Leslie Gordon (Sheffield). JAMES, Herbert William Heinrich (St Mary's). IBRAHIM, Mohamed Namazie (Madras). JEFFS, Nicholas Graham (Middlesex). MULES, Robert Marwood (Otago). JOHNSTON, Richard (Aberdeen). PURVES, Peter George (Leeds). §JONES, Barbara Morag (KCH). REYNOLDS, Anthony Douglas (Wales). TORDAN, Michael John (St Thomas's). BASTIAENEN, Henry Louis Robert (Bristol). McCLURE, John Hayden (Edinburgh). §BROWN, Jane Louise (Dundee). MORRIS, Alexander James (Aberdeen). CHMIELEWSKI, Andrzej Trevor (Guy's). PARK, Gilbert Richard (Edinburgh). §COUSINS, Christine Gillian (Bristol). PATEL, Abhilash (Newcastle). DAVIES, Graham Kenneth (Newcastle). POWVLES, Allan Badgett (KCH). §DAVIES, Sara Ruth (Leeds). STRAKA, Pavel Frantisek (Aberdeen). FARNELL, Alan (Otago). §THOMAS, Catherine (Liverpool). .1Woman COLLEGE DIARY January for obstetricians and gynaecologists begin Monday I Tuesday i6 COLLEGE CLOSED Date of election of Fellows in Dental Surgery to Friday 5 the Board of Faculty announced Basic Medical Sciences lectures and demonstrations Last date for nomination of Licentiates in Dental for surgeons end Surgery as candidates for co-option to the Board Saturday 6 of Faculty Annual Anaesthetics Examinerships advertised Wednesday I 7 Monday 8 Joint Committee for Higher Training of Anaesthe- DIH examination begins tists (1 .30 a.m.) Wednesday lo Thursday l8 Ceremony of Presentation of Diplomates (11 .30 Final FFA examination begins a.m.) Monday 22 College Dinner (7.30 p.m.) D Med Rehab examination begins Thursday iI Tuesday 23 Quarterly Council (2 p.m.) Arris and Gale Lecture-Mr D C Herbert-The Wood Jones Medal Lecture-Professor A J E Cave anatomical basis of facial reconstruction (5 p.m.) A constellation of Conservators (5 p.m.) Voting papers issued for election of Fellows in the Primary FDS examination begins Faculty to the Board of Faculty of Anaesthetists Saturday 13 Wednesday 24 Names of candidates for election to the Board of Hunterian Trustees (2.30 p.m.) Faculty of Anaesthetists announced Friday 26 AMonday 15 Board of Faculty of Dental Surgery Basic Medical Sciences lectures and demonstrations Hunterian Lecture-Professor J D W Barnard-- College news 83 The effect of extreme cold on sensory nerves Monday 26 (5 p.m.) Basic Medical Sciences lectures and demonstra- Final LDS (Part I) examination begins tions for surgeons begin First Membership and DMRT examinations begin Wednesday 3I Arris and Gale Lecture-Mr T E O'Brien-Fib- Wednesday 28 rinolytic activity in the gastrointestinal tract Primary FFA examination begins (4.30 p.m.) (at Hope Hospital, Salford)

March February Thursday i Thursday i Otolaryngology Lecture-Mr E Douek-Cochlear Otolaryngology Lecture-Mr G Westbury-Man- implants (5.30 p.m.) agement of tumours involving the tongue DCH examination begins (5.30 p.m.) Monday 5 Friday 2 Erasmus Wilson Demonstration-Dr j L Stanford Faculty of Dental Surgery Evening-Full dentures: Ubiquitous mycobacteria and their relation to have we progressed? (6 p.m.) disease in man (4.30 p.m.) Monday 5 Wednesday 7 College Evening-Abdominal trauma (6 p.m.) Election of Fellows in the Faculty to the Board of Last date for applications for anaesthetics exam- Faculty of Anaesthetists inerships Saturday io Tuesday 6 Surgery Course begins Final LDS Part III examination begins Last day for nomination of candidates for election Alonday 12-Wednesday 14 as Fellows in Dental Surgery to the Board of JOINT MEETING WITH THE AMERICAN Faculty COLLEGE OF SURGEONS Wednesday 7 Tuesday I3 College Dinner (7.30 p.m.) Voting papers issued for election of Fellows in Thursday 8 Dental Surgery to the Board of Faculty of Den- Ordinary Council (2 p.m.) tal Surgery Arris and Gale Lecture-Mr T L Dormandy- Friday i 6 Free-radical reactions in biological systems Faculty of Dental Surgery Scientific Meeting- (5 p.m.) The patient with special problems (9.45 a.m.) Primary Fellowship examination begins Monday I9 Monday I2 Last day for application for Annual Examinerships IBMS Symposium-Computing in surgery DOrth. (Part I) examination begins Wednesday 2I 3Ist FACULTY OF ANAESTHETISTS ANNI- Wednesday I4 VERSARY JOHN HUNTER born 1728 Board of Faculty of Anaesthetists,(9.30 a.m.) Hunterian Oration Mr George Qvis- Some Anniversary Forum-Regional Analgesia (II a.m.) controversial aspects of John Hunter's life and Annual Meeting (4 p.m.) work (5 p.m.) Frederic Hewitt Lecture-Professor J Parkhouse- Hunterian Dinner The journey and the arrival (3 p.m;) Thursday I5 Anniversary Dinner (7.I5 for, 7.45 p.m.) Basic Medical Sciences lectures and demonstra- Arris and Gale Lecture-Mr J M A Northover- tions for obstetricians and gynaecologists end Damage to bile-duct blood supply-a significant Hunterian Lecture-Professor H J H Fry-The cause of postoperative morbidity? (5 p.m.) pathology and treatment of nasal trauma (5 p.m.) Monday 26 Friday i6 Final Membership examination begins Basic Medical Sciences lectures and demonstrations for anaesthetists end Wednesday 28 Hunterian Lecture-Professor J R Belcher-Re- Monday '9 stenosis of the mitral valve (5 p.m.) DMRD examination begins Date of Council Election announced Tuesday 20 Saturday 31 DOrth. (Part II) examination begins Vacancies on the Court of Examiners advertised