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 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 WC iH 9JR Copyright ©) 1975 by the Annals of the Royal College of Surgeons of England. All rights of reproduction are reserved in respect of all papers, articles, tables and illustrationis, etc., published in this journal in all countries of the world. Printed by Dorriston Ltd., 21/25 Earl Street, London EC2A 2HY Subscription rates, United Kingdom and Ireland £1o per annum post free. Overseas ixi (US $28.25) per annum post free. Back numbers Li.25 per copy post free. 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 thani those giving statutory and postgraduate lectures, are requested to write in the first instance to the Editor at the College. College address for correspondence College facilities Royal College of Surgeons of England, Lincoln's Users of College facilities: Those eligible in- Inn Fields, 'London WC2A 3PN. Telephone oi- clude Fellows, Members, aivid other Diplomates, 405 3474. Telegrams: Collsurg, Holb, London. postgraduate students and research workers, mem- Secretary of the College, the Faculties of Dental bers of the Specialist Associations linked to thc Surgery and Anaesthetists, and the Joint Commit- College by the joint Secretariat, and those who tees for Higher Surgical Training, Higher Training are introduced as guests. in Dentistry, and Higher Anaesthetic Training: The Library (Librarian: Eustace Cornelius, MA' R S Johnson-Gilbert, MA. ALA) iS open each weekday from IO a.m. to 6 pm. Appeal Secretary and Secretary of the Institute (Saturdays I O a.m. to 12.30 p.m.). Closed during of Basic Medical Sciences: W F Davis. August and on Bank Holidays. 'It is a reference Finance Officer: G A Taylor FCA. (continued on inside back cover) Annals ofthe Royal College of Surgeons ofEngland

VOLUME 56 January-June 1975

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)

K P Liddelow 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 56 January-June 1975 Page SCTNIETFIC ARTICLES Unresectable carcinoma of the oesophagus G B Ong 3 A military surgical team in Belfast N A Boyd I5 Choledochal cysts N A Olbourne 26 Traumatic intraperitoneal haemorrhage 1 K Tucker, R A Hurlow, and K K Mahajan 33 Museum preparations of the conducting system of the heart D H Tompsett and G S Barrett 38 Intravenous nutrition H A Lee 59 Cholecystectomy and gallstone dyspepsia A G Johnson 69 Porphyria in relation to surgery and anaesthesia E Sumner 8i Liver biopsy R W Raven 89 Split ileostomy in the treatment of Crohn's disease of the colon E Lee 94 Gynaecology and general surgery M Cameron II5 How should the common bile duct be explored? A L G Peel, J B Bourke, J Hermon-Taylor, A D W MacLean, C V Mann, and H D Ritchie 124 Assessment and treatment of recurrent peptic ulceration D M Steinberg, B A Masselink, and J Alexander-Williams 135 'There but for the grace of God .' W D Wylie I7' A cytological study of mammary disease A J Webb i8i Movements at the hip joint J Joseph 192 Surgical pathology of the spleen M H Irving 202 Immunity in acute bacterial infections A A Glynn 212 Hypovolaemia and phaeochromocytoma Lord Brock 218 SI units: Definitions, normal ranges, and conversion factors 222 Page

The intestinal phase of gastric secretion R C Kester 23I Research at the IBMS, 1974 246 Strangulated obturator hernia R E Jenner 266 Cosmetic result in thyroid surgery D Chavatzas 270 Battle casualties M A Melsom, M D Farrar, and R C Volkers 289 Anaesthesia in the Yom Kippur War J T Davidson and S Cotev 304 Transplantation and regeneration of striated muscle D Allbrook 3I2 Sphincter patency and hepatic BSP uptake after biliary sphincterotomy A L G Peel, H B Devlin, and H D Ritchie 325 Late infection in Dacron arterial grafts D R Harvey and B P Bliss 334 HISTORICAL ARTICLES Patients and their ills in Vicary's time F N L Poynter '4' Letters from the past 48, I03, I53, 225, 274, 337

OTHER ARTICLES Editorial C J C Kirk I The new medical teaching centre in Cardiff A T Jones 43

COLLEGE NEWS Address by Sir Harry Platt 49 Annual Meeting of Fellows and Members I55 Appointments of Fellows and Members to consultant and similar posts 56, I 09, i 66, 284 British Journal of Surgery I '3 Ceremony for presentation of Diplomates i6o Council meetings 338 Council visits '54 Court of Examiners, Report I62 Criteria for consultant status 340 Deaths of Fellows, I974 54, 227, 277 Page

Diary 57, I 10 i67, 228, 284, 34I Donations 49, I04, 155, 226, 276, 340 Faculty of Anaesthetists 49, 276, 278 Faculty of Dental Surgery 226 Fellowship in Dental Surgery 278 Fellowship in the Faculty of Anaesthetists 279 Gifts to the College 278 Honorary Fellowship: Dr Michael DeBakey 53 Honorary Medal: Norman Capener CBE FRCS 105 Honours conferred on Fellows and Members I04 In memoriam: R J McNeill Love 55 Sir Zachary Cope 276 Joint Committee for Higher Training in Dentistry 226 Lectures etc. I64, i65, 227, 228 Library, books and pamphlets added I05, 280 Lister Medal 339 Ophthalmological Society of the United Kingdom 52 NOTES ON BOOKS AND FILMS I I0, i68, 285, 341

NOTICES 58, II4, I69, 229, 287, 343 College news

Faculty of Anaesthetists: election to £900.00 The late Mrs H M Cowlins (further Standing Committee, Scotland payment of legacy of quarter In the absence of other nominations, Dr A H B residuary estate) Masson has been declared re-elected to the Scottish £5oo.oo The late Miss A L Pennyfather Standing Committee of the Faculty of Anaesthetists. (legacy) o500.oo Guinness Peat Group of Companies (promise of 5 annual payments of Donations to the College £ I oo-further gift) During the past few weeks the following gencrous £300.00 Anonymous donations have been received: £298.50 Albert Evans, Esq (io-yr covenant £ I 5 ooo.oo Anonymous £20 p.a. + tax) £I2000.00 Mrs A M C Martin (to establish the £250.00 The late Mr A P Hayes Alexander MacCormick Fund for Mrs P S Whitehead the promotion of education and Io50.00 research, in memory of her late io50.00 Trustees of the late Lady Hind father) (further gift) £I25o.00 The late Miss Alice Corry Jones £i oo.oo Anonymous (first payment of legacy of half In addition there have been a number of gifts residue of estate) under £ioo which total £455.99.

COLLEGE MONTHLY DINNER, gth OCTOBER 1974 Address by Sir Harry Platt Bt LLD MD MS FRCS after the occasion of his 88th birthday on 7th October I must thank you, Mr President, for having me as bered that I had been continuously involved in a guest at this College Dinner and for inviting me the life of the College for 34 years-the span of to speak on changes in the College during the a surgical generation-and that some of my memo- past 30 years. An invitation from the President to ries might be of interest. a Fellow of the College can hardly be refused; it is perhaps in the of a command-I know this as I myself have sat in the seat of authority. The College 1940 -41 I accepted the invitation, however, with some em- I was admitted as a Member of Council in July barrassment. There were rumours that the occasion 1940. On the same day two notable Middlesex Hos- Would in some sense be related to my advanced pital surgeons were admitted to serve their second age*. By this time surely I had become accustomed term of 8 years-Alfred Webb-Johnson and Gordon to references that I had joined the gerontocracy- Gordon-Taylor. What was the physical structure that in fact I had reached the third Age of Man- of the College in 1940? It is difficult now to recall 'youth; middle age; and how well you are looking'. the picture. Essentially it was the early igth century Then I also wondered what impresson an octo- College of Sir Charles Barry (architect of the House genarian might have on this assembled company. of Commons) with three additional museums opened Would some of them remember the words in Mr in I852 and I893. There were five museum rooms Harold Macmillan's diary, the description of a cer- in all. There was also a 20th century addition: the tain statesman-'His speech was slow, but it easily two storeys on the old College to house the Bern- kept pace with his thoughts'? But finally I remem- hard Baron Laboratories opened in 1937. The igth century College had one small lecture theatre and the beautiful library. During the last years of the *A birthday cake was presented to the speaker Victorian age and the years of the Edwardian age 50 College news the life of the College had progressed at a rela- Surgery and Anaesthetists, which have brought tively quiet tempo. The First World War of course immeasurable strength to the College and wisdom had brought new responsibilities, but it was under to its counsels, had also been established. The the impact of the six years of the Presidency of Council had also widened its vision by the co-option Sir Berkeley Moynihan (Lord Moynihan to bc), the of members of branches of medicine and surgery years I926-32, that the College experienced an not represenited through the ordinary electoral pro- awakening-or so it seemed. It must have been cedure so, for Moynihan, the supreme egotist in surgery, Alfred the Great, the Prince of Beggars, lived often told us that this is what had happened! I to see the second phasc of the restoration completed, remember his words at an evening reception in but not the third phase, in which his original the College in the 193os-'When I took office, at plan for the siting of the approach to the Hunterian meetings of the Council, all eyes were on the agenda Museum had been changed. During his long Presi- papers. It was a matter of prime importance dency the College was essentially a man's world, and whether Mrs Higginbottom-a generic title-was he showed that he intended to keep it that way. to be paid a shilling an hour more to clean the But under his successor, Sir Cecil Wakeley, it be- College. Now all eyes are on the activities of the came evident that the furnishings of the Council College in research.' He was of course referring Room and Great Hall, and later of the Nuffield to the new Bernhard Baron Laboratories and to College-the choice of curtains, cutlery, table linen, Down Farm, the gift of George Buckston Browne. glass, and so on-was a woman's job. So the first All eyes on the agenda papers! But during some Ladies' Committee, under the Chairmanship of Lady of the more soporific years of the College it could Wakeley, was formed. Since that time the social be observed that at the end of Council meetings, a life of the College, which adds grace to its academic number of envelopes containing agenda papers were life, has rested on the devoted labours of the Col- left behind unopened! I have this on the un- lege ladies. We are dining tonight in the Great challengeable authority of Mr Kennedy Cassels. Hall of Alfred Webb-Johnson's College, and it is our pious duty to remember him as we remember 1941 -destruction of the College our heroes of the i8th and igth centuries, John Those of us who saw the College after the mas- Hunter and . sive destruction by bombing over the weekend of ioth/iith May I94I cannot easily forget the tragic picture. The inner hall was open to the sky; the The College today beautiful library ceiling was destroyed. A note And so through the years of physical restoration of thankfulness was that 3850 of the Hunterian and the years which followed we and the nation specimens had survived the holocaust. The total now enjoy a new kind of College, its buildings specimens saved out of the College museum col- and scientific departments endowed by generous lection was 26 ooo. The Council of the College benefactors whose names are writ large for all to was still very museum-conscious, and the rebuilding see. Wc have a Court of Patrons devoted to our of museums was regarded by some of its elder survival and to our future; we present our academic statesmen as a priority. But at the July Council image to the public in diploma-granting ceremonies in I94I Alfred Webb-Johnson was elected Presi- twice yearly-an idea we owe to Kennedy Cassels. dent. Providence had decreed that he was the man What are the aims of the College, now and for the of the momcnt, and in the eight years of his Presi- future? How can we justify the continued existence dency his concept of a restored College dominated of a surgical college as an independent self-govem- the thinking of Council and the plans of the archi- ing institution-a uniquely British contribution to tects. Five new museums, no; but one Hunterian the comity of world surgery, and one which has in- Museum as the jewel of the design, yes. It was to be spired the creation of surgical colleges in the a college of scientific departments, supported by English-speaking nations of the United States of a residential college, which he often referred to America, Canada, Australia, and South Africa? as a future All Souls of surgery. Before Alfred The College exists in the first place to maintain Webb-Johnson laid down the burden of the office of and enhance the standards of the art and science President he had persuaded his friend William of surgery for the benefit of sick people everywhere. Collins to endow chairs of pathology and anatomy This is its humanitarian aim. True to its Hunterian and Lord Nuffield to give us the residential college heritage the College has the responsibility of pro- which bears his name. The Faculties of Dental viding for the advancement of knowledge by teach- College news 51 ing and research through the media of its scienltific The College tomorrow departments, its splendid library, its museums, and And now I must say something of the future plans not least the standards of its examinations, especially of the College as revealed to me by the President. those for its higher diplomas-the various Fellow- They are indeed imaginative. The international ships of the College. All this in popular terminology links of the College, secure in the Commonwealth is the academic image of the College, some aspects and in the English-speaking world of surgery, must of which have come down to us from the igth century and early years of the 2oth century. now for a time at least be contemplated in their European context. There has long been a European But new responsibilities are presenting themselves Common Market in surgical ideas. Even with the as we go into the last quarter of the 20th century. slow pace of communications in the I8th century, One is the need to proclaim and foster the unity of 's writings soon found their way to surgery in an era which has seen the fragmentation France. There are Hunterian documents in the of surgical practice resulting from specialization. library of the Academie de Chirurgie in Paris. But Although there may no longer be such a thing the mutual recognition of schemes and standards as general surgery or an omnicompetent general sur- for the education and training of future surgeons geon, there is still what Norman Capencr has called the 'gencrality' of surgery. It is this concept amongst the countries of the EEC has posed a which justifies the claim of the College, advised new problem. If our College is to keep its posi- by the powerful specialist associations, to be the tion of leadership in the affairs of world surgery final arbiter on the standards of schemes for the it must provide accommodation for some sort of education and training of the surgeons of the future European centre or bureau. In Queen Square there in all branches of surgery. I would hope that in is the Examination Hall, a solid Edwardian building, this national task the College will maintain a now obsolescent for its primary purpose. A new broad and liberal attitude, suspicious of plans which but different Examination Hall is needed on this become inflcxible and bureaucratic. But this prob- valuable and accessible site. For the examinations a the lem is no longer exclusively national one, and of the next quarter of a century the Hall will need College is now in action on a wider front in col- laboration with its sister colleges in Scotland and to be equipped with computer techniques and Ireland, in the USA, in South Africa, and in the sophisticated audiovisual apparatus. A new Hall two major Commonwealth nations of Canada and could also be a centre for patient-monitoring Australia. machines with lines of communication, by inven- tions yet to come, between Lincoln's Inn Fields From this symbiosis of surgical colleges in the and a number of selected hospitals. Pioneer work in English-speaking world our College played a major this field has already been launched in the College role in the launching of the International Federation Research of Anaesthesia. The Hall founded in Stockholm in Department of Surgical Colleges 1958. also house the with the The prime catalyst in this movement was un- might European bureau, doubtedly the American College of Surgeons, but it main international centre of affairs in Lincoln's Inn was the wish of two of the Federation's most dis- Fields. But we come back again to the inspiration of tinguished founding fathers, the late Professor I S John Hunter in this College-'why not try the ex- Ravdin, of Philadelphia, and Professor Walter Mac- periment?' Research, more interdisciplinary and kenzie, of Edmonton, still happily with us, that perhaps on a more limited number of problems, in the first headquarters of the new Federation should Lincoln's Inn Fields and at Downe, where there is be in the Royal College of Surgeons of England. room for an extended centre, will be a major pre- So this new international body, in some sense an occupation for our successors. At Downe there is now international senate of surgery, began its life with one of the finest primate colonies, and the work on the great advantage of having the guidance of the of malforma- able executive officers-first caries and production congenital supremely Kcnnedy has been acclaimed. Cassels and then our own present College Secretary, tions already widely Ronald Johnson-Gilbert. The Federation has now I have merely touched on some of the ideas for moved to Edinburgh, the Athens of the North, where the future now germinating in the minds of the in the Edinburgh Royal College of Surgeons we President and Council. They are, as I have said, wish it well. imaginative and inspiring. What does the College 52 College news need to launch this new era? Not less than Cooke, like myself born in the County Palatine, ten million dollars! in his address to Congress in Washington on the All truly great institutions which look to the occasion of the 2ooth anniversary of the first meet- futurc must be mindful of their heritage from the ing of the Continental Congress, used these words: past from which they draw strength and sense of 'I have seen the past and it works'. I have lived purpose. Without such a heritage they are poor long enough to have seen some of the past of this indeed. Years ago Henry Ford is reputed to have College. I know that it works; and so will its said, 'History is bunk'. A few weeks ago Alistair future.

OPHTHALMOLOGICAL SOCIETY OF THE UNITED KINGDOM Brief History of the Society The Ophthalmological Society of the United King- surgeons practising in London and from those prac- dom was founded in I88o with Sir William Bow- tising in the provinces. man Bt LLD FRS as its first President. The To assist in the furtherance of ophthalmology object of the society is the cultivation and promo- there are certain prizes and lectures awarded for tion of ophthalmology, and it holds an annual Con- merit or, in the case of the Treacher Collins Prize, gress, the meetings of which are held on two or for the best essay submitted upon a subject selected more consecutive days. The date and place of the by the Council. The Treacher Collins Prize is meeting is chosen by the Council and when an awarded every three years and the subject for the ophthalmic surgeon from one of the provinces essay may be purely ophthalmological or connected is the President it is customary for him to suggest with a closely related subject. the venue of the Congress. Recently the President The Bowman Lecture was originated in I883 has been chosen alternately from the ophthalmic when a resolution of the Council which met on

vx/4 Ophthalmological Society of the United Kingd6m-Council I974. From left to right: Mr V A F Martin, Dr David Christison, Mr T Stuart-Black Kelly, Mr M H Whiting (Past President), Mr John Whitwell, Miss M Hislop, Mr J L Kennerley Bankes (Senior Hon- orary Secretary), Mr L E Werner (President), Mr R F Fisher (Junior Honorary Secretary), Mr J L S Smith, Mr P G Watson, Mr I M Strachan, Mr J H Dobree (Vice-President), Professor Desmond Archer, Mr P A MacFaul. Absent: Mr 0 Gayer Morgan (Past Presi- dent'), Mr Frank W Law (Past President and Honorary Treasurer), Sir Stewart Duke-Elder (Past President), Sir Tudor Thomas (Past President), Mr T Keith Lyle (Past President), Professor G I Scott (Past President), Mr A G Palin (Vice-President), Mr K C Wybar (Vice-President), Mr Lorimer Fison (Vice-President), Mir P D Trevor-Roper (Editor), Mr P J Holmes Sellors, Mr M D Sanders, Mr H F T MacFetridge, Dr R J S Smith, six overseas representatives. College niews 53

18th Septcmber of that year was recorded as on any subject previously selected and announcedi follows: by the Council of the Ophthalmological Society. 'That in recognition of Mr Bowman's dis- Affiliated with the Ophthalmological Society of tinguished scicntific position in ophthalmology the United Kingdom are the Oxford Ophthal- and other branches of Medicine, and in com- mological Congress, the Midland Ophthalmological memoration of his valuable services to the Society, the North of England Ophthalmological Ophthalmological Society, of which he was the Society, the South-Western Ophthalmological So- first President, the Council shall each year, or ciety, the Southern Ophthalmological Society, the periodically, nominate some person to deliver a Scottish Ophthalmological Club, the Irish Oph- lecture before the Society, to be called "The thalmological Society, the Ophthalmological Society Bowman Lecture", which shall consist of a criti- of South Africa, the All-India Ophthalmological cal resume of recent advances in ophthalmology Society, the Ophthalmological Society of Australia, or in such subject or subjects as the Council the Canadian Ophthalmological Society, and the shall select, or of any original investigation, and Ophthalmological Society of New Zealand. the shall be delivered at a special meeting of since its inception, taken a very held for the purpose, at which no other The society has, Society active part in the advancement of both clinical business shall be transacted.' the ophthalmic ophthalmology and ophthalmological research in Many Bowman Lecturers have been have many members living others have been distinguished phys- United Kingdom. We surgeons and abroad, and many of these members attend our icians and surgeons in related specialties. broaden the made by the society is that of Congresses regularly and considerably A further award of the society. the Nettleship Prize and this is entrusted to three outlook members of the society appointed by the Council. The Transactions of the society are published It is confined to British subjects and is awarded annually and include the proceedings of the affilia- for the most valuable contribution to ophthalmology ted societies. The Transactions therefore represent during the three years immediately preceding or an important contribution to the annual ophthal- since the last award, or for the best work done mic literature of the world.

ADMISSION TO HONORARY FELLOWSHIP Dr Michael E DeBakey At a special meeting of Council helcl on gth Octo- life had becn mainly spent in the southern United ber I974 Dr Michael E DeBakey, of Houston, States. The best known of all his personal charac- Texas, USA, was admitted to the Honorary Fellow- tcristics was his energy. His day started at about ship. Mr H H G Eastcott gave the citation in 4.30 a.m.; by 5 a.m. he was at his horseshoe- his honour, saying that the College was honouring shaped desk attending to his many editorial duties, a man who had become a legendary figure in his breaking off at 7 a.m. for a surgical conferencc own lifetime. As Wellington in war and Churchill at the Methodist Hospital. At 7.30 a.m. he would in statesmanship, so DeBakey had already estab- be operating, and as the day lengthened so did the lished his position in surgical history while he list of large cardiovascular operations safely com- was still in the process of making it, by bringing pleted. There would be no meal break, and after to the art and science of our work a new dimen- several hours, at the end of which hearts and aortas sion. He had shown that the cardiovascular systems were safely repaired, the ward round would begin of the body were as amenable as any others, indeed in the early evening. Mr Eastcott described this as more so than most, to the direct structural inter- follows: 'This is for all the world like an English ventions that nature needed to correct her mistakes. fox hunt in its furious progress, with DeBakey as Such was his modesty that we knew far more about the fox, well in the lead, flying along the corridors, his works than about the man himself, and Mr disappearing into a sick room, quite unexpectedly, Eastcott continued to give a morc personal intro- throwing off the pursuit. Once inside, all is calm, duction of Dr DeBakey. deliberate, and relaxed, with a smiling patient look- Miclhael Ellis DeBakey had his origins in the ing up, a warm handshake from the master, a ques- Middle East, in Syria and the Lebanon, though his tion to the resident, and a penetrating glance at 54 College news an X-ray film or laboratory report, then to dart to the untold advantage of countless patients to off again with the pack in full chase after him, whom his work had brought a rescue from mutila- students in the lead, foreign visitors usually last, tion or death and a return to a healthy useful life. exhausted by now; but there is worse to come for Mr Eastcott then presented Dr Michael DeBakey the most privileged of these, as it was for me to the President for the receipt of the Honorary on my visit. This last and greatest ordeal is the Fellowship of the College. hurtling drive home to visit with him for dinner. He drives, as he operates, with great skill, speed, The President, Mr Rodney Smith, then admitted and determination; as we made our astonishing Dr DeBakey to the Honorary Fellowship with the way through Houston's evening rush hour, traffic words, 'Surgery is a profession wherein all of us miraculously parted before us like the tissues before through our lives are involved not only in treating his knife'. patients as best we may but also in advancing Once home there were no interruptions by the knowledge so that what is done year by year is telephone, as all calls were intercepted by his 24- done with greater effect. In the case of Dr DeBakey hour secrctarial service, to be dealt with after the Council can only feel the same emotions that have departure of his dinner guests. Dr DeBakey did been expressed by Mr Eastcott. It is with personal not sleep much, and Mr Eastcott once asked him pleasure and by the authority of the Council and whether he had arrived at any conclusions as to the powers vested in me by this Royal Collegc that the causation of arteriosclerosis. 'Well, yes', he I hand you this scroll, admit you to the Honorary drawled, 'I guess it's from sleepin' too much and Fellowship of this College, and congratulate you'. livin' too high on the hawg'. Dr DeBakey should be quite free from it. Dr DeBakey replied as folloxvs: 'Mr President, distinguished members of the Col- Dr DeBakey was the man who was the friend of lege, ladies, and gentlemen. It is difficult at this time President Kennedy and President Lyndon Johnson to express adequately my feelings, my gratitude, and and who, with ex-President Hoover, worked out and my sense of humility. Anyone in the field of surgery saw completed the plan to set up a National Library throughout the world looks up to the Royal Collegc of Medicine in Washington. It was DeBakey who of Surgeons of England as an institution that has had chaired, presided, and advised at just about held the banner of surgery high since virtually the every aspect and stage of medical and surgical inception of surgery as an art and as a science. We progress. He was President of Baylor University in America have a great reverence for the Royal and prized his position as head of the Houston College of Surgeons for that reason, because it has Symphony Orchestra. established and set up the highest standards to Honours and awards of every kind had come achieve in the field of surgery; and to bestow the to him such as the one this College was proud for honour of admission to its Fellowship as an Honor- him to receive today, but the real reward had been ary Fellow is a means of expressing to that in- for him to see his methods of arterial grafting and dividual that he has accredited himself in the field repair and the grafts that he had designed, de- of surgery. I can only say to all of you that I am veloped, and tested now in use in every part of the deeply grateful and shall treasure this memory for world, made safe for hands of lesser skill than his, the rest of my life'.

DEATHS OF FELLOWS, 1974 The following is a list of those Fellows who are ESPLEN, Joseph Rentoul FFARCS known to have died during 1974: EVANS, Frankis Tilney Hon FFARCS FRCS ARCHER, Charles John Trevail FFARCS FISH, Sir Eric Wilfred CBE FRCS FDSRCS BASDEN, Margaret Mary FRCS GIBSON, Edwin Charles FRCS BOWEN, Trevor Llewellyn FRCS GREIG, George William Vause FRCS BRIDGEMAN, Geoffrey John Orlando MC FRCS HILL, Edward Falkner Hon FFARCS CAMPBELL, John Menzies Hon FDSRCS JONES, Harry Clifford FRCS CLARKE, Gordon FFARCS LEWIS, James Monahan FDSRCS EDWARDS, Henry FFARCS LOVE, Robert John McNeill FRCS (Past Member College news 55 of Council and Court of Examiners) RHYDDERCH, Alun Iorwerth FRCS LYTLE, Samuel Norman FRCS SHERNE, Jacob FRCS MAHFOUZ, Naguib Hon FRCS MILLAR, Alexander McCallum FFARCS WHITTINGDALE, John FRCS NEGUS, Sir Victor Ewings FRCS WOODMAN, Edward Musgrave FRCS NEWTON, Noel Curtis FRCS WRIGHT, Arthur Paterson FFARCS

IN MEMORIAM Robert J McNeill Love mandatory in cholecystectomy. He was possessed of many attributes of great value in a surgeon: shrewd judgement, a deep sense of humility, genuine humanity, and an abiding interest in the young both within and outside his own profession. Robert's father was an Ulsterman who came to England virtually penniless, though he eventually built up a substantial and highly successful ware- ...: } housing firm in Plymouth, where he became Mayor. r~~~~~~~~~~~~~~~~~~.._ His mother was a farmer's daughter and Robert himself was bom at Devonport on 2nd May I89I. At one time the family lived at 'Outlands', a house in Devonport formerly owned by Scott of Antarctic fame and destroyed, it is believed, in World War II. His old friend and colleague A C King FRCS re- minds us that one of the earliest memories Robert had was of being lifted up to see Queen Victoria on her Diamond Jubilee visit to Plymouth. After education at Devonport High School and Taunton, Robert moved to The London Hospital, where he qualified with the Conjoint diploma and the London MB BS in 1914. He was in the RAMC from Robert John McNeill Love died on ist October I914 to 19I9, serving in India, Mesopotamia, and 1974 at the age Of 83. His services to surgery and the Dardanelles, for part of this time as a surgical this Royal College are well known. He was a mem- specialist. Returning to civilian life, he was house ber of Council from 1945 to 1953, choosing not to surgeon at The London Hospital and resident sur- stand for election for a further period of eight years. geon at Poplar, completing his final FRCS in 1920 He served the Court of Examiners from I949 to and the London Mastership in the following year. I955 and was latterly its chairman. He was also Later, in I938, he was elected to the Fellowship a past Hunterian Professor and Erasmus Wilson of the American College of Surgeons. He also sup- Demonstrator. ported the International College of Surgeons. McNeill Love was a great surgical teacher and In the early years of his training and as registrar ever ready to give freely of his time to postgrad- and first assistant at The London (together with uates, who were always welcome at his clinics. Hamilton Bailey, his future literary collaborator) Together with Hamilton Bailey he produced what he acknowledged the inspiration of Hugh Lett, Mal- is probably one of the best known surgical textbooks colm Rigby, and Russell Howard. He also had a in the world. His monograph on The Appendix and special affection and regard for George Grey Tumer, his textbook of Surgery for Nurses were also highly who was formerly his commanding officer in Meso- popular. potamia. In 1926, neither he nor Bailey having been Though never especially concerned with surgical appointed to The London Hospital staff, the Royal technique, Love was an early exponent of peropera- Northern was astute enough to snap them both tive cholangiography, which he came to regard as up simultaneously. Robert also served the Metro- 56 College news politan Hospital and Mildtnay Mission Hospital down from Cambridge would, but for his untimely until his retirement in I956. death, have taken over managemcnt. On a happier Outside his strictly surgical work he was appointed note it shouild be recalled that Robert was no mean a director of the Medical Sickness Annuity and farmer. He also had a reputation as the slickest Life Assurance Society in 1928 and he was its and quickest gelder in the county. Former members chairman from 1941 to 1973. The impressive pro- of the Court and Council, as well as his surgical gress of that organization as well as its high reputa- colleagues, will remember the celebrated 'farm sup- tion for integrity were in no small measure due pers' served in a marquee. They will remember too to his inspiration and shreNvd commercial sense. the lovely wvalnut tree before the house and the Other medical interests ranged from his special highly skilled demonstrations of archery by the industrial tribunal work to the physical welfare of Bowmen of Barnet; also the occasional fracas when the Arsenal Football Club. his surgical guests tried their hand with these un- There are other important aspects of Robert familiar weapons. Love's life which were little known to many of But above all Robert Love was a basically good his colleagues. His biography prepared for the Lives man, and this was shown by his kindness andl of the Fellows of this Royal College includes the extraordinary thoughtfulness for others. He was a laconic entry 'Commissioner, Poplar Boy Scouts'. devout churchman, a regular communicant at Brick- In fact he had a deep concern for the poor and endon, and formerly churchwarden at Potters Bar. underprivileged in the East End. In the early 1920S, He died, as he had lived, with dignity, courage, while he was resident surgical officer at Poplar good humour, and the greatest consideration for his Hospital, he spent his entire savings of £500 to family and friends. He had attended Collegc month- purchase part of a wood at Goffs Oak, near Cufflcy ly dinners up to a short while before. Three months in Hertfordshire. There every year he took his scout prior to his death he consulted a physician about troop from dockland and the East End, never spar- some unpleasant symptoms. He declined detailed ing himself in their service. A number of men of investigation, treated his physician with the utmost humble origin attribute their later success to the in- courtesy, and was kind enough to keep the precise spiration and guidance of McNeill Love. That wood nature of his illncss concealed from his family until is still used by both the boy scouts and the girl shortly before his death. So characteristic of him was guides. a last gesture in the week before his death. Chancing Robert Love was twice married: first in 1930 to to hear that the son of a colleague would shortly Dorothy Borland, who died in 196I, and secondly graduate in medicine Robert ordered the publishers in I962 to Rhoda Mackie, a clergyman's widow. to send the lad a copy of the I6th edition of 'Bailey He had two children, a son and a daughter, by his and Love', due out in the following month. To first wife and his domestic life was entirely happy, the father of the young man he sent a label to marred only by the loss of his son at the age of 23. insert in the book when delivered. This was in- Robert was a lover of country life, a staunch scribed 'With best wishes for a long and happy conservationist, and an active vice-president of the professional life' and this obituary can concluide with Hertfordshire Society. Having inherited a farm from no more appropriate sentiment. his mother's family in Devon, he later bought Sew- ard's Farm, near Brickendon, where his son recently REGINALD S. MURLEY APPOINTMENTS OF FELLOWS TO CONSULTANT AND SIMILAR POSTS A S HASSAN, FRCS Consultant Ophthalmic J M THISTLEWOOD, FFARCS Assistant Surgeon, Al Ramad Eye Hospital, Baghdad. Professor, Department of Surgery Anaesthetists, B N BHARGAVA, FRCS Medical Superintendent, McMaster University Medical Centrc. Santokba Durlabhji Memorial Hospital, Jaipur. l I McGILL, FRCS Consulant Ophthalmologist to India. Southampton and SW Hants District based at the R J STEWART, FRCS Lecturer in Surgery, Southampton Eye Hospital. Christchurch Clinical School (University of Otago), M G WHITTAKER, FRCS Consultant in General Christchurch Hospital, Christchurch, New Zealand. Surgery, Darlington District (Durham AHA), Joint M K LEE, FRCS Medical and Health Officer in appointment with Yorkshire RHA in Northallerton Orthopaedic Surgery with the Hong Kong District of North Yorkshire AHA. Government. B G WATSON, FFARCS Consultant in Anaesthetics, College news 57

Cardiothoracic Regional Service based on NW Hospital, Canberra, Australian Capital Territory. Durham District (Durham Area). R N P CARROLL, FRCS Consultant Urologist, A R ELKINGTON, FRCS Consultant/Lecturer in Manchester AHA (T) Central District. Ophthalmology to Southampton and SW Hants A G MAHAJANI, FRCS Surgical Specialist, District. Darwin Hospital, NT, Australia. F D SKIDMORE, FRCS Lecturer in Surgery at C H ANYANWU, FRCS Lecturer and Consultant . in Cardiothoracic Surgery, University of Nigeria B W RASIAH, FFARCS Anaesthetist, Palmerston and University of Nigeria Teaching Hospital, North Hospital New Zealand. Enugu. B GOSWANI, FRCS Consultant in Traumatic and D COOPER, FRCS Consultant General Surgeoit, Orthopaedic Surgery, Tameside AHA. Royal Jubilee Hospital and Victoria General S D CHOWDHURY, FRCS Consultant Urologist, Hospital, Victoria, BC, Canada. Burnley District. U SHARAN, FRCS Lecturer in Surgery and P J POWNALL, FRCS Consultant Traumatic and Surgeon I/C Genito-urinary Surgery, Rajendra Orthopaedic Surgeon, Bolton AHA. Medical College and Hospital, Ranchi, Bihar, India. R KIRBY, FRCS General Surgeon, Hartlepool J A S CARRUTH, FRCS Consultant in ENT District. Surgery to Hampshire Area, jointly with the I S BRUCE, FFARCS Consultant in Anaesthetics, University of Southampton. S Tyneside Area. A M BILLEWICZ-DRIEMEL, FFARCS R G CHECKETTS, FRCS Consultant in Consultant Anaesthetist, E Birmingham Health Orthopaedic Surgery, Sunderland Area. District, Birmingham AHA (T). R A DENDY, FDSRCS Consultant in Dental C J TALLENTS, FRCS Consultant Surgery, E and SW Cumbria Districts. Ophthalmologist, Hereford/Worcester AHA. D W HERRING, FRCS Consultant in Gcneral K F MOOS, FDSRCS Consultant Oral Surgeon, Surgery, Durham District. Regional Plastic and Oral Surgery Unit at D C TOWNSEND, FFARCS Consultanit in Canniesburn Hospital (Greater Glasgow Health Anaesthetics, SWV Durham District. Board). D G M BISHOP, FFARCS Consultant in B P SAMANTA, FRCS Senior Adviser in Surgery, Anaesthetics, Darlington District. Command Hospital, Southern Command, Poona, A MANN, FRCS Consultant Surgeoni, Canberra India. COLLEGE DIARY February Monday 3 Hunterian Oration-Mr Rodney Smith--The DTM & H Examination begins. Hunters and the Arts (5 p.m.). Thursday 6 Hunterian Dinner. Otolaryngology Lecture-Mr R A Williams- Tuesday i8 Hypophysectomy, its present indications, surgery, DOrth (Part II) Examination begins. and results (5.30 p.m.). Friday 21 Friday 7 Basic Medical Sciences Lectures and Last day for nomination of candidates for Demonstrations for anaesthetists and for co-option as Licentiate in Dental Surgery to the gynaecologists end. Board of Faculty of Dental Surgery. AMonday 24 Monday IO Basic Medical Sciences Lectures and College Evening-Portal hypertension (6 p.m.). Demonstrations begin. DOrth (Part I) Examination begins. First Membership and DMRD Examinations WVednesdav 12 begin. Hunterian Lecture-Professor J C Postlethwaite- Wednesday 26 'rhe importance of plasma fibrinogen in arterial John Keats Mcmorial Lecture-Lady surgery (5 p.m.). Birkenhead-Joseph Severn, friend of Keats College Dinner (7.30 p.m.). (5 p-m-). Friday I4 Thursday 27 JOHN HUNTER born 1728. Primary FFA Examination begins. library whose stock comprises some i50,000 bounid Su'bscription Dinners are held on the first of volumes of periodicals, pamphlets, and books and second Wednesday of each month, excluding August it receives some 700 current periodicals. There are and September. All enquiries to W F Davis. large -collections of manuscripts, autograph letters, engraved portraits, and photographs. The Library College -; cuff-links, badges, squares, cravats, is particularly rich in its collection of the literature and sc- are obtainable on enquiry to Messrs of surgery and its specialties, including anaesthesia T M kt' . nd Sons, Io6 Jermyn Street, St and oral surgery, and of anatomy, physiology, and James's, .1don SWi. general pathology. College imeraldic shields in light or dark oak All the collection is available for consultationi in are obtainable on enquiry to Messrs E H Rann, 2I the Library. Although items are not lent to in- Sicilian Avenue, Southampton Row, London WC 1. dividuals, books, pamphlets, and periodicals less Hunterian and Arris and Gale Lectures than 50 years old are lent to other medical libraries. Fellows and Members wishing to apply to give a MEDLARS searches can be processed and informa- Hunterian or Arris and Gale Lecture are advised to tion on specific subjects (including subject biblio- obtain the regulations from the Secretary. Appli- graphies) can be supplied where detailed discussion cations are invited by advertisement in the medical is possible between the enquirer and the staff of journals in March each year. Applicants are asked the Library. In other cases the Library will offer to submit 35 copies of a synopsis of approximately advice on how best to obtain the information re- 500 words describing the subject of the proposed quired. Photocopying, which is chargeable, can be lecture. The degree of originality should be in- undertaken. dicated. Work carried out under a superior must Lists of books added to the Library will appear be shown to have the latter's approval before being from time to time in the Annals. submitted. No special form of application needs to Museums. The Hunterian Museum (Curator: be completed. Miss Allen) is open each weekday from Io a.m. to 5 p.m. Closed on Saturdays and during August and College publications onI Banik Holidays. The Wellcome Museums of An- The following publications are issued or sponsored atomy and Pathology (Conservators: Professors R by the College and may be obtained from the M H McMinn and J L Turk) are open during nor- Librarian. All prices exclude postage. mal working hours. The History of the College. By Sir Zachary Cope. 376 pp. £3.15 Down House, Downe, Kent, BR6 7TJ (Tele- The Lives of the Fellows I930-5I. By Sir D'Arcy phone 66-59II9). Hon. Curator: Sir Hedley Atkins Power and W R Le Fanu. 889 pp. £6.oo IKBE FRCS. The home of in the The Lives of the Fellows 1952-64. By R H 0 B possession and under the care of the College. Visit- Robinson and W R Le Fanu. 470 pp. £6.oo oon most welcome. Open each day except Mon- A Catalogue of the Portraits and other Paintings, days and Fridays and Christmas Day (open on Drawings and Sculpture in the College. By W R Bank Holiday Mondays) from I I a.m. to 5 p.m. Le Fanu. i84 pp. 4 coloured plates, 52 black and Admission 30p for adults, iop for children. Taxis white plates. LX.50 and buses (146) from Bromley North or South sta- Descriptive Catalogue of the Physiological Series tions or taxi from Orpington. in the Hunterian Museum. Parts I and II. Two Nuffield Coliege Facilities. Accommodation: volumes. £5.40 each Subject to availability rooms may be booked for Descriptive Catalogue of the Pathological Series in long or short periods, including some rooms for the Hunterian Museum. Parts I and II. Two married couples. Enquiries to the Warden. Bar and volumes. £5.40 each lunch: Snacks, salads, and grills are served in the The Odontological Museum. By Professor A E W bar between 12 noon and 2 p.m. Mondays to Fri- Miles. i i pp. Iop days (closed August). Advance orders to the Cater- History of the Trustees of the Hunterian Collection. ing Manager. Also a cafeteria is open for coffee, By Sir Victor Negus. 148 pp. £I.50 lunch, and tea on weekdays. Conservators of the Hunterian Collection. By Miss College facilities for functions and con- J Dobson. 39 Pp. 25P tfwerces. All enquiries to the Principal Admin- Additional publications of the College are adver- istrative Assistant. tised from time to time in the Annals.