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. 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(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 nature 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.