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TH E VOL. 32 Ne. 3CS JUNE EIITeRIAL THE PLACE OF RESPIRATORY FUNCTION S IN CLINICAL MEDICINE P. V. Rates, M.9.R.C.P. TIHE HAZARDS *Fl TRANSFUSION H. F. Srew I.E., J.Ck.(Cant,a.) SOME PRACTICAIS ECTS OF MIEDICAL S'I'A'ITIS'I'ICS ,,l T. H. Gerrill, M.P. THE MAN AOGENT *F RIGHT SUPRAHEPATIC ABSCESS F. G. Smiddy, F.R.C.S. ORAL AIMINIS'4TrIN OF PHENOXYMETHYL PENICILLIN (DISlTAUAINE V) L. Henry,4., Ch.l., 31.R.C.S., L.R.C.P., aId M. J. Meynell, M.P., M.R.C.P., ..P.H. MULTIPE PSEUDO-CYSTIC TUIERCULeSIS OF lONE IN AN AGED AbULT R. J. Harrisen, M.R.C.P. MANUFACTURERS' NTE *OOKS RECEIVED I*BK REVIEWS POSITGRADUATE NEWS 31& `E L 3 /6 Y' i1iLY (ANNUAL SUISCKIPTION 36/-) Published by HI I *F "I G i A IA1" i E C I N

Transcript of 31&/6 1iLY - BMJ

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THE

VOL. 32 Ne. 3CSJUNEEIITeRIAL

THE PLACE OF RESPIRATORY FUNCTION S IN CLINICAL MEDICINEP. V. Rates, M.9.R.C.P.

TIHE HAZARDS *Fl TRANSFUSIONH. F. Srew I.E., J.Ck.(Cant,a.)

SOME PRACTICAIS ECTS OF MIEDICAL S'I'A'ITIS'I'ICS,,l T. H. Gerrill, M.P.

THE MANAOGENT*F RIGHT SUPRAHEPATIC ABSCESSF. G. Smiddy, F.R.C.S.

ORAL AIMINIS'4TrIN OF PHENOXYMETHYL PENICILLIN (DISlTAUAINE V)L. Henry,4., Ch.l., 31.R.C.S., L.R.C.P., aId M. J. Meynell, M.P., M.R.C.P., ..P.H.

MULTIPE PSEUDO-CYSTIC TUIERCULeSIS OF lONE IN AN AGED AbULTR. J. Harrisen, M.R.C.P.

MANUFACTURERS' NTE

*OOKS RECEIVED

I*BK REVIEWS

POSITGRADUATE NEWS

31&`E L 3/6 Y'i1iLY(ANNUAL SUISCKIPTION 36/-)

Published byHI I*F "I Gi A IA1" i

E C I N

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June 1956 HARRISON: Multiple Pseudo-Cystic Tuberculosis of Bone in an Aged Adult 305

necessarily associated with a bone focus, they mayresult from a synovial infection or a breakingdown gland.The resistance of normal bones to tuberculosis

is high; they are attacked when their resistance islowered by tuberculous toxaemia, by tuberclebacilli disseminated in the blood stream. In thiscase there was no evidence of pulmonary tuber-culosis, clinically, radiologically or post-mortem.The primary site must have involved the lymphnodes.

Primary infections can occur in old age; Pagel(1953) states that typical primary complexes,recently acquired, are met with in adults of allages; one of his cases concerned a man aged 64;he also cites a patient aged 80 reported byTerplan (1940).

There is some evidence that resistance totuberculosis is lowered in old age. Arnstein(I941) states that the process of 'endogenouslymphoglandular recrudescence ' is a typical eventin old age tuberculosis.The pseudo-cystic appearances in the bones in

sarcoidosis are almost entirely confined to thephalanges; in this case there were no cystic changesin the phalanges and also tubercle bacilli weredemonstrated.

SummaryMultiple pseudo-cystic tuberculosis of bone

occurring in an aged adult is described.It is emphasised that sinuses in this condition

may result from synovial infection or a breakingdown gland, and not necessarily from a bone focus.

In sarcoidosis the pseudo cystic appearances arealmost entirely confined to the phalanges.

I am grateful to Dr. M. Walker for her help;to Dr. R. O. Murray for his interest and usefulcriticisms; and Miss E. Mason for the photographs.

BIBLIOGRAPHYALEXANDER and MANSUY, M. N. (1950), Radiology, 4, 839.ARNSTEIN, A. (1941), Tubercle., 22, 28I.JUNGLING, O. (1920), Fortschr. Rontgenstr., 27, 375.KOMINS, C. (1952), Brit. Jour. Radiology, 25, I.MURRAY, R. 0. (1954), Proc. Royal Soc. Med., 47, I33.PAGEL, W. (1953), ' Pulmonary Tuberculosis,' Oxford Univx. Press,

p. II9.'rERPLAN, K. (1940), Am. Rev!. Tuberc., 46, Supplens XLII.

/llaK6actaeti lVoeBoots Pure Drug Company Limited announce

the availability of the following Boots Hydro-cortisone Topical Preparations:

Basic N.H.S.Tubes Price

HydrocortistabOintment .. % 5 g. 5s. 3d.

i5 g. I3s. 3d.Hydrocortistab

Ointment .. 2.5% 5 g. I2s. od.I5g. 29s. 6d.

HydrocrotistabEye Ointment.. 2.5% 3 g. 8s. od.

Hydrocortistab BottleEye Drops .. I / 3 cc. 4s. 6d.

NUTINAL-BOOTSNutinal Tablets each contain i mg. of benacty-

zine hydrochloride. This drug raises the thresholdbelow which external sources of anxiety producepsychosomatic tension. It is indicated in thetreatment of psychoneuroses especially if they areassociated with anxiety, depression, obsessive-compulsive traits and psychosomatic symptoms,

such as palpitation, sweating and facial flushing.The normal dosage range is i to 3 mg. three timesdaily. Nutinal is supplied in bottles of Iootablets.

Basic N.H.S. Price-3s. 4|d. per bottle of Iootablets.

NEOMYCIN-BOOTSThis antibiotic is particularly valuable for the

local treatment of pyogenic skin diseases and forthe control of eye infections. Conditions whichhave responded to Neomycin include impetigo,folliculitis barbae, sycosis barbae, ecthyma, ecze-matoid dermatitis, furunculosis, hordeolum, ble-pharitis, otitis externa, and secondarily-infecteddermatoses, wounds and burns. Neomycin-Boots is available in two forms, each of whichcontains 5 mg. neomycin sulphate per gramme.

Basic N.H.S.Tubes Price

(a) Neomycin ointment .. 30 g. 5s. 3d.(b) Neomycin eye oint-

ment .. .. 4 g. is. 8d.Literature on these Boots Products may be

obtained on request from the makers.

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FocX !2eceLveiThe Editorial Board acknowledge with thanks receipt of the followingvolumes. A selection from these will be made for review.

' Sexual Precocity.' By Hugh Jolly, M.A., M.D.,M.R.C.P. Pp. xiii + 276, with 69 illustrations.Oxford: Blackwell Scientific Publications. 1955.50s.

'The Clinical Approach in Medical Practice.'By G. E. Beaumont, M.A., D.M., F.R.C.P., D.P.H.Pp. xiv + 469, with 74 illustrations. London:J. and A. Churchill Ltd. 1956. 45s.

'Studies on Fertility 1955.' Edited by R. G.Harrison, M.A., D.M. Pp. ix + 156, illustrated.Oxford: Blackwell Scientific Publications. 1955.25S.

'Modern Treatment Yearbook, 1956.' Editedby Sir Cecil Wakeley, Bt., K.B.E., C.B., LL.D.,M.Ch., D.Sc., F.R.C.S., F.R.S.E., F.R.S.A.,F.A.C.S., F.R.A.C.S. Pp. viii + 344, with 47illustrations. London: Bailliere, Tindall & CoxLtd. I956. 25s.

'Cardiovascular Innervation.' By G. A. G.Mitchell, O.B.E., T.D., M.B., Ch.M., D.Sc.,Pp. xii + 356, with 217 illustrations, many in colour.Edinburgh: E. & S. Livingstone Ltd. I956. 55s.'Brompton Hospital Reports. Volume XXIII.'

1954. Pp. ix + 326, illustrated. Aldershot:Gale & Polden Ltd. 1956. I5s.'Ciba Foundation Symposium. Porphyrin

Biosynthesis and Metabolism.' Edited by G. E. W.Wostenholme, O.B.E., M.A., M.B., D.Ch., andElaine C. P. Millar, A.H.W.C., A.R.I.C. Pp. xi +308. London: J. & A. Churchill Ltd. I955. 30s.

'Child Health and Development.' Edited byR. W. B. Ellis, O.B.E., M.A., M.D., F.R.C.P.,F.R.S.E. Second edition. Pp. x + 525. London:J. & A. Churchill Ltd. I956. 42s.

' Radium Therapy. Its Physical Aspects andExtensions with Radioactive Isotopes.' By C. W.Wilson, M.Sc., Ph.D., Inst.P. Second edition.Pp. ix + 286. London: Bailliere, Tindall & CoxLtd. 1956. 37s. 6d.

' Peptic Ulcer. Diagnosis and Treatment.' ByClifford J. Barborka, M.D., M.S., D.Sc., F.A.C.P.,and E. Clinton Texter, Jr., M.D. Pp. xiii + 290,

with 33 illustrations. London: J. & A. ChurchillLtd. 1955. 50s.

'Outline of Orthopaedics.' By John CrawfordAdams, M.D., F.R.C.S. Pp. vii + 423. Edinburgh:E. & S. Livingstone Ltd. 1956. 32s. 6d.

'Premature Infants.' By Ethel C. Durham,M.D. Second edition. Pp. xii + 459, with 41illustrations. London: Cassell & Co. Ltd. 1955.63s.

' Hydrocortisone in Orthopaedic Medicine.' ByJames Cyriax, M.D., M.R.C.P. Pp. 3I. London:Cassell & Co. Ltd. 1956. 5s.

'Polymyxin, Neomycin Bacitracin. AntibioticsMonograph No. 5.' By E. Jawetz, M.D., Ph.D.Pp. 96. London: Interscience Publishers Inc.1956. $4.00.'Medical Terms. Their Origin and Construc-

tion.' By Ffrangcon Roberts, M.A., M.D., F.F.R.Pp. viii + 88. London: William Heinemann Ltd.1956. 6s.

'Poliomyelitis.' By W. Ritchie Russell, C.B.E.,M.D., F.R.C.P. Second edition. Pp. xi + 147,with 40 illustrations. London: Edward ArnoldLtd. 1956. i6s.

'Edinburgh Post-Graduate Lectures in Medicine.Volume VII. 1954.' Twenty contributors. Pp.xi + 256, illustrated. Edinburgh: Oliver andBoyd Ltd. 1956. zIs.

'Progress in Clinical Obstetrics and Gynae-cology.' By T. L. T. Lewis, M.B., F.R.C.S.,M.R.C.O.G. Pp. viii + 594, with 90 illustrations.London: J. & A. Churchill Ltd. 1956. 55s.

'Diseases of the Ear, Nose and Throat.' ByI. Simson Hall, M.B., Ch.B., F.R.C.P.E.,F.R.C.S.E. Pp. xi + 463, illustrated, with eightcolour plates. Edinburgh: E. & S. LivingstoneLtd. I956. 2os.

'Sick Children. Diagnosis and Treatment.' ByD. Paterson, M.D., F.R.C.P. Revised by R.Lightwood, M.D., F.R.C.P., D.C.H., assisted byF. S. W. Brimblecombe, M.D., M.R.C.P., D.C.H.Pp. ix + 593, with 8i illustrations. London:Cassell & Co. Ltd. 1956. 42s.

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POSTGRADUATE NEWSJune 1956

The information contained in this section is published by courtesy of theorganizations concerned and no responsibility for any changes of detailor omissions can be accepted by the publishers. In all cases, applicationsfor enrolment or further information should be made direct to thesponsors of the course.

FELLOWSHIP OF POSTGRADUATEMEDICINEThe following courses are planned but the dates anddetails are subject to alteration.General Medicine (M.R.C.P.) Week-end. June 16and I7. All day Saturday and Sunday. Queen Mary'sHospital for the East End. Limited. Fee C3 3s. od.Proctology. June 18 to 30. St. Mark's Hospital.All day. Limited. Fee £8 8s. od. (No entriesaccepted until syllabus is published and circulated.)General Medicine (M.R.C.P.). August 13 to Sep-tember 15. Daily 5.30 to 8.30 p.m. (Saturdays, 2 to4 p.m.). Whittington Hospital, Archway Wing.Limited. Fee £23. (No entries accepted until syl-labus is published and circulated.)Children's Diseases (D.C.H.). August 27 to Sep-tember 8. Daily 5.30 p.m. Princess Louise KensingtonHospital. Limited. Fee £5 5s. od.Surgery (F.R.C.S.) General and Genito-Urinary.September Io to 26. Mondays and Wednesdays at5.0 p.m. Whittington Hospital, Archway Wing.Limited. Fee £5 5s. od. (No entries accepted untilsyllabus is published and circulated.)Obstetrics (D.Obst.R.C.O.G.). September 17 to 22.All day. West Middlesex Hospital. Limited. Fee£4 4s. od.Surgery Revision (F.R.C.S.). September 17 toOctober 12. Monday, Thursday and Friday mornings.Royal Marsden Hospital. Limited. Fee £15 15s. od.(No entries accepted until syllabus is published andcirculated.)Orthopaedic (F.R.C.S.) Week-ends. September29-30, October 6-7, and 20-21. Saturdays and Sundays.Rowley Bristow Orthopaedic Hospital, Pyrford. Limi-ted. Fee I£2 12S. od. (No entries accepted untilsyllabus is published and circulated.)Surgery (F.R.C.S.). October 3, 10, 17, 24. Wednesdaysat 5.0 p.m. Whittington Hospital (St. Mary's Wing).Limited. Fee £4 4s. od. (No entries accepted untilsyllabus is published and circulated.)Infectious Diseases (M.R.C.P.). Week-end. Novem-ber 3 and 4. All day Saturday and Sunday. HitherGreen Hospital, London, S.E.I3. Limited. Fee£3 3s. od.Please note that instruction arranged by the Fellowshipof Postgraduate Medicine is open only to members (annualsubscription, from month ofjoining, Ios. 6d.). In the caseof 'limited' courses no entries are accepted in advanceof the detailed syllabuses being published and circulated;postgraduates (whether members or not) are not automatic-ally included in the mailing lists, but must. notify theFellowship of Postgraduate Medicine, 60 Portland Place,

London, W.I, if they wish to be sent syllabuses as pub-lished, and must specify the subjects in which they areinterdsted. Information regarding courses can be obtainedfrom the office daily between Io a.m. and 5 p.m. (Saturdays,10 a.m. to 12 noon). Telephone: Langham 4266.SOCIETY OF APOTHECARIES OF LONDONDiploma in Industrial Health (D.I.H.). Theexaminations are held in July and December each year.Diploma of Mastery of Midwifery (M.M.S.A.). Theexaminations are held in May and November each year.The annual course of lectures in modem therapeuticswill be held at the Hall at 5 and 6. 5 p.m. on October 31,November 8 and 14 next. Full details will be publishedin due course.For further information applications should be addressedto the Registrar, Society of Apothecaries, Black FriarsLane, London, E.C.4.ROYAL COLLEGE OF SURGEONS OFENGLANDThe following lecture will be given at the College.Admission free.June14 at 5.0 p.m. Prof. C. Marks. Observations on thesurgical sequelae of bilharzial disease.Application for further information should be made toMr. W. F. Davis, Deputy Secretary, Royal College ofSurgeons, Lincolns Inn Fields, London, W.C.z.

DENTAL BOARD OF THE UNITEDKINGDOMThe Dental Postgraduate Bureau has issued threebooklets, as follows:Facilities for Dental Postgraduate Study in the UnitedKingdom and Ireland,' containing a list of schools andinstitutions at which postgraduate courses are held orwhich provide facilities for individual students, and analphabetical list of subjects showing where instructionin each can be obtained: ' Scholarships and Student-ships for Advanced Studies and Research in Dentistry,'including many open to British subjects tenable abroad;'Higher Dental Qualifications,' setting. out in generalterms the conditions to be satisfied by candidates.Copies of these booklets, particulars of films of interest todentists, and further information can be obtained onapplication to the Director, Dental Postgraduate Bureau,44 Hallam Street, London, W. .

BRITISH POSTGRADUATE MEDICALFEDERATION (University of London)The Federation provides:

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3I4 POSTGRADUATE MEDICAL JOURNAL June 1956

(I) Training for prospective specialists, supplementingthe work of the undergraduate medical schools.

(2) Advanced revision for practising specialists.(3) Instruction for medical practitioners who, though

not specialists, desire more detailed knowledge ofany branch of medicine.

(4) Instruction for general practitioners.Comprising the Federation at present are the Post-graduate Medical School of London, Institute of CancerResearch, Institute of Cardiology, Institute of ChildHealth, Institute of Dental Surgery, Institute of Diseasesof the Chest, Institute of Laryngology and Otology,Institute of Neurology, Institute of Obstetrics andGynaecology, Institute of Ophthalmology, Institute ofOrthopaedics, Institute of Psychiatry; associatedinstitutes are the Institute of Basic Medical Sciences,Institute of Dermatology and Institute of Urology.Courses for general practitioners will be held as follows:CardiologyJune i to 22. Institute of Cardiology, London, W.I.Obstetrics and GynaecologyJune x8 to 23. Institute of Obstetrics and Gynaecology,London, S.W.3.GeneralJuly 2 to 7. London Undergraduate and PostgraduateTeaching Hospitals.Applications for places on the above courses should be madeto the Secretary, British Postgraduate Medical Federation,and should state if the application is or is not made underthe scheme for N.H.S. practitioners.Extended and Week-end CoursesPaediatricsJune 2 and 3 (Week-end). Childrens Hospital, Syden-ham, London.ObstetricsJune 9 and Io (Week-end). Mothers Hospital, London,E.5.Applications for places on the above courses should be madeto the hospital concerned.All the courses are available to N.H.S. practitioners,for whom fees and allowances (travelling expenses,locum fees, etc.) are provided for courses equivalent to22 half-day sessions in an academic year, subject tocertain conditions. Grants are also payable in respectof assistant practitioners under certain conditions.Other practitioners may attend on payment of a fee ofio guineas for two weeks, 5 guineas for one week or-extended course of 1i sessions, iI guineas for a week-endcourse.

Applications for further information should be made tothe Secretary, British Postgraduate Medical Federation,18 Guildford Street, London, W.C.I.

POSTGRADUATE MEDICAL SCHOOL OFLONDON (Hammersmith Hospital)The Postgraduate Medical School of London hasUniversity Departments in Medicine, Surgery andPathology. The Department of Obstetrics and Gynae-cology, together with Queen Charlotte's and the ChelseaHospitals, now forms the Institute of Obstetrics andGynaecology. The teaching in the clinical departments,which is of an advanced nature and based on ward work,is continuous and is supplemented by lectures duringthree ten-week sessions starting in January, April andOctober. Suitable students are encouraged to under-take research work. A course for the University Diplomain Clinical Pathology, lasting one year, is available for alimited number of selected students. This commences inOctober. The Department of Radiology of the Hospital

provides courses for the Diplomas in Medical Radiologyof the Conjoint Board. The fees vary from C3 for oneweek to £75 for a year.Anaesthetics. The Department of Anaesthesia offersa course of instruction for the academic year beginningOctober 2, to a limited number of postgraduates wishingto specialize in anaesthesia. A comprehensive teachingprogramme has been established and the subjectscovered include anatomy, pathology, pharmacology andphysiology. In addition to systematic lectures inanaesthesia, medicine and surgery, clinical training isprovided in the wards and operating theatres and specialprovision is made for the demonstration of techniquesnot in common use. Fee for the course, £75 plus £3enrolment fee.For further information application should be made tothe Dean, Postgraduate Medical School of London,Ducane Road, London, W. z.

INSTITUTE OF BASIC MEDICAL SCIENCES(Royal College of Surgeons of England)The Institute co-operates with other specialist Institutesof the Federation in providing facilities for practicalwork and instruction in the basic medical sciences.Twice a year, beginning in February and September,there is a full demonstration and lecture course which isfull-time and extends over a period of three months.Applications for this course are strictly limited, andthe next course will begin on September 17, I956. Inaddition, there are two revision courses a year of lec-tures only, which take place at the same time as theother course. Applications for this course can beaccepted up to a week before the course begins. Fees:Demonstrations and lectures, £63; lectures only,,36 I5s. od. A two-months' course for Primary F.D.S.candidates is also held twice a year in January andJune and the next course will begin on June 4, 1956.The course is full-time and the fee £31 ros. od.For further information please apply to the Secretary,Institute of Basic and Medical Sciences, Royal College ofSurgeons of England, Lincolns Inn Fields, London, W.C.2.

INSTITUTE OF CANCER RESEARCH (RoyalCancer Hospital)Postgraduate lectures and courses of instruction are heldin biophysics for students studying for the M.Sc.degree in Biophysics, and for students studying for aDiploma in Medical Radiotherapy.Enquiries should be made to the Dean, Institute of CancerResearch, Royal Cancer Hospital, Fulham Road, London,S.W.3.INSTITUTE OF CARDIOLOGY(National Heart Hospital)Courses of instruction lasting I weeks are available forboth full-time and part-time students; fees £26 5s. od.and £12 I2s. od. respectively.Special short courses lasting two weeks are held inFebruary, June and November; fee £12 I2s. od.Enquiries, and applications for admission to courses, shouldbe addressed to the Dean, Institute of Cardiology, 35Wimpole Street, W.I.

INSTITUTE OF DISEASES OF THE CHEST(Brompton Hospital and the London ChestHospital)The Institute of Diseases of the Chest (Medical Schoolof the Hospitals for Diseases of the Chest) is situated inthe grounds of the Brompton Hospital, S.W.3.

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June 1956 Postgraduate News 315MedicalInstruction in diseases of the chest including tuberculosisis conducted during three terms of ten weeks each year.It consists of clinical work in wards and out-patientdepartments, lectures and demonstrations. A whole-time programme is arranged for not more than x2graduates each term, preferably those specializing indiseases of the chest. The lectures and demonstrationsare so arranged that the subject of chest disease iscovered during the two terms beginning in October andJanuary. The lectures during the summer term arearranged as a general revision course. A larger numberof graduates can be accepted for part-time study. Ifvacancies are available it may be possible to acceptgraduates for shorter periods of part-time study.SurgicalA whole-time course in chest surgery is conductedduring the terms beginning in October and January. Itincludes attendances at out-patient clinics, operatingsessions, ward clinics, case demonstrations and lectures,and is held partly at the Brompton Hospital and partlyat the London Chest Hospital.Fees for whole-time course (Medical or Surgical) are£20 for one term and 35 for two terms, and for part-time courses £14 for one term or £6 for one month.RadiologyPart-time instruction in radiology of the chest for traineeradiologists only is given each term. Fee £Io for oneterm.Clinical demonstrations are given on Fridays at5 p.m. Open lectures are given on Wednesdays at 5p.m. Admission free.Consultants' Course. A special course for consultantswill be held from July 9-I3.Surgical Aspects of Cardiology. A special course forconsultants will be held from September 24 to 28.For further general information application should beaddressed to the Dean, Institute of Diseases of the Chest,Brompton Hospital, Fulham Road, S.W.3.INSTITUTE OF CHILD HEALTH(Hospital for Sick Children, Queen ElizabethHospital for Children, Postgraduate MedicalSchool)The Institute of Child Health is associated with TheHospital for Sick Children, Great Ormond Street, thePostgraduate Medical School of London at Hammer-smith Hospital, and the Queen Elizabeth Hospital forChildren. In its programme teaching on every aspectof child health is provided. Visits are arranged to thedepartment for the new-born and premature infant atthe Postgraduate Medical School of London, Hammer-smith Hospital, Maternity and Child Welfare Clinics,Nursery Schools, etc. The Institute provides tuitionthroughout the year in three terms of 12 weeks' durationeach, beginning in January, May and September.Two or three guest lectures are given during thesummer term by visiting paediatricians from abroad.The fees are 20 guineas for one term and 35 guineasfor two terms.Applications should be addressed to the Dean, Instituteof Child Health, Hospital for Sick Children, GreatOrmond Street, London, W.C.I.

INSTITUTE OF DENTAL SURGERY(Eastman Dental Hospital)The Institute holds courses in orthodontics (full- andpart-time, up to one year), and in periodontology, con-servative dentistry, prosthetics, minor oral surgery ahdchildren's dentistry (variable length, full- and part-

time). Refresher courses are arranged twice yearly forgeneral practitioners. Courses are also held in conjunc-tion with the Faculty of Dental Surgery of the RoyalCollege of Surgeons and are particularly intended forcandidates preparing for the final examination for theFellowship in Dental Surgery of the College. Thesebegin in May and November (lasting for approximatelyeight months), fee £60, and in May and October thereare revision courses lasting eight weeks, fee 31I Ios. od.Special arrangements can be made for students requiringcourses of study and research experience not fallingwithin the scope of the courses listed above.For further information apply to the Dean, Institute ofDental Surgery, Eastman Dental Hospital, Gray's InnRoad, London, W.C.I.

INSTITUTE OF DERMATOLOGY(St. John's Hospital for Diseases of the Skin)Hospital Practice. This includes clinical instructionin the Out-Patient Department daily, in the In-PatientDepartment twice weekly, tutorials in clinical dermat-ology and histopathology, attendance in the Departmentof Pathology and other Departments of the Hospital.Fees: Two guineas for one week; £25 for one year.Laboratory. The facilities for students include tech-nical work in histology, bacteriology and medicalmycology.Exhibitions. Two semi-permanent exhibitions will beavailable during the summer course. The second,from June 5 to 30, will be on ' Ringworm Infections ofthe Hair' (Department of Medical Mycology).Museum. A collection of moulages is available. Thereis access to a large collection of histopathological sections.Lectures. A winter course, extending over six months,begins in October and a summer course is held in Mayand June. Both these courses consist of lectures at 5.30p.m. on Tuesdays, Wednesdays and Thursdays.Clinical demonstrations held on Fridays at 5.30 p.m.are designed for those intending to sit for the M.R.C.P.examinations.June

I Dr. P. D. Samman. Clinical demonstration.5 Dr. R. H. Meara. Xanthomatosis.6 Dr. R. W. Riddell. Differential diagnosis of

mycotic infections.8 Dr. G. B. Dowling. Clinical demonstration.

io Dr. G. C. Wells. Drug eruptions.13 Dr. R. W. Riddell. Recent advances in the study

of mycotic disease.14 Dr. H. Haber. Cytodiagnosis in dermatology.15 Dr. R. M. B. McKenna. Clinical demonstration.I9 Dr. D. I. Williams. The use of vitamins in

dermatology.20 Dr. H. Haber. The dyskeratoses.22 Dr. B. Russell. Clinical demonstration.26 Dr. R. T. Brain. Virus disease in children.27 Dr. A. Tickner. Vitamins and skin metabolism.28 Dr. H. Haber. Histology of some skin conditions in

children.30 Dr. P. J. Hare. Clinical demonstration.Enquiries should be made to the Dean, Institute of Der-matology, St. John's Hospital for Diseases of the Skin,Lisle Street, Leicester Square, London, W.C.2.

INSTITUTE OF LARYNGOLOGY ANDOTOLOGY(Royal National Throat, Nose and EarHospital)A comprehensive course lasting 36 weeks and designedto cover the whole field of the speciality is held twice a

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year beginning in February and August. This consistsof lectures, demonstrations and attendance on thepractice of the hospital, with facilities for dissection. Aspecial point is made of the anatomy, physiology andpathology related to the subject. There is also anintensive lecture course of six weeks twice yearly inpreparation for practical clinical training. An AdvancedRevision Class (io weeks) for M.S. and F.R.C.S.students is also given twice yearly. A practical revisionclass for Part II D.L.O. students is held twice yearly.Week-end courses in endoscopy, in aural surgery andin pathology are held twice yearly. The composite fee,including enrolment as a clinical assistant, attendanceon the hospital practice and at one of the comprehensivecourses, but excluding dissection, is £52 Ios.For further information application should be addressedto the Dean, Institute of Laryngology and Otology, 330Gray's Inn Road, W.C.I.

INSTITUTE OF NEUROLOGY(The National Hospital, Queen Square, andthe Maida Vale Hospital for NervousDiseases)The teaching is mainly by attendance on the hospitalpractice. Some advanced students are appointed asfull-time clinical clerks at the National Hospital, QueenSquare, or to the electro-encephalographic or one ofthe other special departments, or to the research labora-tories. A limited number of part-time clinical clerkshipsare available at the Maida Vale Hospital with opportunityfor examining patients.In addition two full-time courses of ten weeks' durationare given each year, namely in the autumn and springterms. The first portion of each course deals with theanatomy and physiology of the nervous system, neuro-pathology and psychology, and consists mainly oflectures and demonstrations. The second portion dealswith clinical neurology, medical and surgical, neuro-ophthalmology, neuro-otology and radiology, andincludes lectures and demonstrations. Special lecturesby neurologists from outside London and from abroadare held throughout these courses. Fees for the tenweeks' full-time course, £25; for attending hospitalpractice, £I8 for three months or £32 for six months.Part-time teaching is given in the Out-Patient Depart-ment, at the National Hospital, Queen Square, on fivedays a week throughout the year (public holidaysexcepted) and at Maida Vale Hospital.Lecture. June 4 at 5.0 p.m. Dr. Ludo Van Bogaert(Belgium). Title to be announced later. Admissionfree, without ticket.Courses of clinical demonstrations are given on Wednes-days and Saturdays at the National Hospital, QueenSquare. Advertisements concerning these appear fromtime to time in the medical journals. The presentcourses commenced on Wednesday, April 4, and onSaturday, April 7, and continue for I2 weeks.For further particulars please apply to the Dean, Instituteof Neurology, National Hospital, Queen Square, London,W.C.I.

INSTITUTE OF OBSTETRICS ANDGYNAECOLOGY(Queen Charlotte's Maternity Hospital,Chelsea Hospital for Women, Department ofObstetrics and Gynaecology of Hammer-smith Hospital).Two terms of 13 weeks each are held, beginning in thesecond week of March and the first week of September(enrolment fee £3; £36 for the term's course). General

practitioners are accepted to attend for short periodsduring term time (fee £3 Ios. od. per week). Generalpractitioner refresher courses lasting one week are held atthe end of February and the end of June (fee £5 ss. od.).Ministry of Health grants are payable for approved prac-titioners attending either for two weeks during term,or the one week refresher course. An intensive coursesuitable for those preparing for higher examinations isheld during the first two weeks of December and thefirst two weeks of June (fee £14 I4s. od.). A limitednumber of postgraduates can be accepted to attend thepractice of the hospital during the winter vacation (fee£I per week). Laboratory training in pathology, endo-crinology and cytology is available for a limited numberof postgraduates. The Institute has hostel rooms atQueen Charlotte's Hospital and Hammersmith Hospital.Further information and enrolment forms can be obtainedfrom the Secretary, Institute of Obstetrics and Gynaecology,Chelsea Hospital for Women, Dovehouse Street, London,S.W.3.INSTITUTE OF OPHTHALMOLOGY(Royal London Ophthalmic, Royal West-minster Ophthalmic, Central LondonOphthalmic Hospitals)Courses of lectures and classes beginning March i andOctober I each year to meet the requirements of can-didates entering for the examination for the Diploma inOphthalmology and other ophthalmological examinationswill be given by members of the staff of the Hospital andInstitute. Each course is designed to extend over twoterms of approximately I8 weeks each and is normallydivided into two parts.Part I. Anatomy (including embryology and normalhistology), elementary physiology of the eye, optics(elementary and physiological), practical tutorials inrefraction work and clinical subjects.Part II. All clinical branches of the subject, togetherwith bacteriology and pathology. Students can attendthe daily clinical practice of the two branches of theMoorfields, Westminster and Central Eye Hospital, andhold the appointments of Clinical Assistants con-currently with the above courses. A composition feeof C26 5s. od. will admit students, once to the lecturesand tutorial classes of any one term, with six months'clinical practice in the hospital.Extra Courses. Slit lamp microscopy (fee £5 5s. od.);orthoptic training (one week's intensive course, fee£5 5s. od.); contact lenses (one week's intensive course,fee £xo Ios. od.) Additional courses by arrangement.Hospital Practice only. Fees as follows: One month,£2 2S. od.; three months, £5 5s. od.; six months,£IO IOs. od.Facilities for research.For further information apply to the Dean, Institute ofOphthalmology, Judd Street, London, W.C.I.

INSTITUTE OF ORTHOPAEDICS(Royal National Orthopaedic Hospital)The Institute is concered with postgraduate educationin orthopaedics and with research. The practice of theHospital (both at the town section in Great PortlandStreet and at the country section at Stanmore) and aRadiological Museum and the Wellcome Museum ofOrthopaedics are open to postgraduates, who mayjoin at any time. In addition to hospital.practice, formalcourses of various lengths are held during academicterms.

Teaching ward round at Stanmore, June 9, at io.o a.m.,Mr. J. A. Cholmeley. Senior Clinical Conference on

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June 27, at 8.0 p.m., Mr. D. M. Brooks, film on Gait.Senior Clinical Conference, July 4, at 8.o p.m., onAnoxia. Teaching ward round at Stanmore, July 14,at io.o a.m., Mr. D. Trevor.Facilities for advanced clinical work are available: forselected candidates having a suitable scientific orsurgical training.Further particulars may be obtained from the Dean,Institute of Orthopaedics, Royal National OrthopaedicHospital, 234 Great Portland Street, London, W.I.

INSTITUTE OF PSYCHIATRY (BethlemRoyal Hospital and Maudsley Hospital)The Institute is concerned with postgraduate educationin psychiatry and allied subjects, and with research. Acourse of instruction covering up to three years, andstarting in October yearly, is provided for medicalpractitioners who wish to specialize in psychiatry or toprepare for the Diploma in Psychological Medicine.Clinical instruction, which includes cast conferences,seminars, and practical experience in case taking, isgiven at associated hospitals in the mornings, andsystematic lectures and demonstrations are arranged forthe afternoons. Students may also enrol for shorterperiods or for single series of lectures.The subjects covered include anatomy and biochemistryof the nervous system, neurophysiology, pathology ofnervous and mental diseases, psychiatry of children andadults, delinquency, principles of psychotherapy,forensic psychiatry and criminology, psychology, mentaltesting and statistics. There is a special six months'course in child psychiatry; comprising clinical instruc-tion and lectures, which starts on October i. Lectureson subjects of special interest are arranged from time totime. The tuition fee for a full year's course isL53 ios. od., including enrolment fee. For shorterperiods the fee varies with the type of course chosen.Selected students are eligible for appointments on thestaff of the Joint Hospital.Facilities for research and supervision of study forhigher degrees can be provided in clinical work and inthe biochemical, physiological, neuro-endocrinological,neuropathological and psychological laboratories.A course for Honours Graduates in Psychology is avail-able in clinical psychology for the Academic Post-graduate Diploma in Psychology. In conjunction withthe Institute of Neurology, a course in the techniques ofelectroencephalography is provided for doctors whoexpect to take up electroencephalographic appointmentsin hospitals.Further information may be obtained from the Dean,Institute of Psychiatry, Maudsley Hospital, DenmarkHill, London, S.E.5.INSTITUTE OF UROLOGY (St. Peter's, St.Paul's and St. Philip's Hospitals)Week-end courses of lectures and demonstrations,beginning on Friday afternoon and ending on Sundayabout tea-time, are given about once a month, fromOctober to April, as advertised. Fee £5 5s. od. for eachcourse.Lectures for general practitioners are given on Wednes-days, throughout the winter months, at 4.30 p.m. for5 p.m. No fee.The practice of the hospitals, including the use of theInstitute museum, reading room and library, is open tostudents attending the courses.Applications should be addressed to the Secretary, Instituteof Urology, Io Henrietta Street, Covent Garden, London,W.C.a.

EAST HAM CHEST CLINICOut-patient teaching. Mondays at 2.30 p.m.Apply Senior Registrar, East Ham Chest Clinic, KatherineRoad, Forest Gate, London, E. 7.

LONDON SCHOOL OF HYGIENE ANDTROPICAL MEDICINE(University of London)Courses of study are arranged for the C.P.H. andD.P.H. (London University); D.T.M. & H. (Eng.);and Academic Diploma in Bacteriology. Short coursesare arranged in the Principles of Medical Statistics andEpidemiology, Statistical Methods and their Applica-tion in Medicine, and Applied Helminthology.For further information and enrolment application shouldbe addressed to the Secretary, London School of Hygieneand Tropical Medicine, Keppel Street, Gower Street,London, W.C.I.

NORTH LONDON POSTGRADUATEMEDICAL INSTITUTECourses in advanced medicine, advanced surgery, andobstetrics and gynaecology. Instruction in pathology,anaesthetics and radiodiagnosis. Clinical instruction atBearsted Memorial Hospital, Chase Farm Hospital,North Middlesex Hospital, The Prince of Wales'sGeneral Hospital and St. Ann's General Hospital.For further information apply to the Dean, the Prince ofWales's General Hospital, London, N. 15.

PLAISTOW HOSPITAL CHEST UNITIn-patient round every Thursday at 4.30 p.m.Apply Registrar, Plaistow Hospital, Samson Street,Plaistow, London, E. 3.

ROYAL LONDON HOMOEOPATHICHOSPITALClinical Tutorials. Practical instruction in the appli-cation of homoeopathic principles is given by theTutors, Dr. W. L. Templeton and Dr. D. M. Foubister,at their tutorial clinics in the O.P. Department onMonday at 2 p.m. and Thursday at 1.30 p.m. through-out the year. Open to medical practitioners withoutfee.A set course of Instruction in homoeopathy is given atintervals during the year.For further information application should be made tothe Dean of the Education Course, Royal London Homoeo-pathic Hospital, Great Ormond Street, London, W.C.I.

ST. MARY'S HOSPITAL MEDICAL SCHOOLA course of six Almroth Wright Lectures will be givenin the Lecture Theatre of the Wright-Fleming Instituteof Microbiology at 5.0 p.m. Admission free.June5 Prof. C. H. Stuart-Harris. Recent studies in

acute respiratory disease.12 Prof. R. Hare. The transmission of infections of

the respiratory tract.Obstetrical and Gynaecological Conferences willbe held in the Wright-Fleming Institute Theatre onFridays at 5 p.m. as follows:June8 Mr. J. B. Blaikley. Impressions of obstetrics and

gynaecology in the U.S.A.

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ST. STEPHEN'S HOSPITAL(Rheumatism Unit)A concentrated weekend course in the rheumatic diseasesis given each year, in March, under the auspices of theFellowship of Postgraduate Medicine.A limited number of postgraduates can attend the out-patient sessions of the unit on Wednesday and Fridaymornings at io a.m.Applications for attendance at these sessions should bemade to the Medical Registrar, Rheumatism Unit, St.Stephen's Hospital, Fulham Road, S.W.io.

EMPIRE RHEUMATISM COUNCILLecture courses in rheumatic diseases are arrangedfor general practitioners and other postgraduatesperiodically.Particulars are obtainable from the General Secretary,Empire Pheumatism Council, Tavistock House (N),Tavistock Square, London, W.C.I.

ROYAL INSTITUTE OF PUBLIC HEALTHAND HYGIENEThe Royal Institute of Public Health and Hygieneconducts recognised courses of instruction (startingannually in March and October) for the examinationsof the Conjoint Board of the Royal College of Physiciansof London and the Royal College of Surgeons oEngland for the Diploma in Public Health. Studentsare also prepared for the Diploma in Industrial Healthexaminations of the Conjoint Board and of the Societyof Apothecaries of London. Courses may be takenwhole-time or part-time, and consist of both lecturesand visits. In the D.P.H. the practical work is carriedout at a county borough.The General Medical Council have intimated that therevised rules for the D.P.H. are due to come intooperation on October i, 1956; these will 'provide fora single unified course, and make no provision for thegrant of a certificate in public health after a preliminaryexamination. The subjects specified in the revisedcurriculum, however, do not in themselves differmaterially from the subjects specified in the formercurriculum considered as a whole.Prospectuses, enrolment forms and full particulars may beobtainedfrom the Secretary, The Royal Institute of PublicHealth and Hygiene, 28 Portland Place, London, W.I.Telephone: Langham 2731-2.

TUBERCULOSIS EDUCATIONALINSTITUTEThree-day Clinical Courses will be held as follows:King George V Hospital, Godalming, October 3, 4and 5; Colindale Hospital, London, October I6, 17and I8. Fee, £3 3s. od. each course (excluding accom-modation).Sheffield. A course will be held from September ioto 14 on 'Tuberculosis in children and young adults.'Fee £5 5s. od.Further information may be obtained from the Secretary,Tuberculosis Educational Institute, Tavistock House North,Tavistock Square, London, W.C.I.

BIRMINGHAMIndustrial Ophthalmology. July 23 to 27. Thecourse is for ophthalmologists and industrial medicalofficers, but is open to all medical practitioners. Itwill include clinical demonstrations, lectures on indus-trial diseases and injuries, also visits to local factories

and to the Burns Unit of the Birmingham AccidentHospital. Fee, £5 5s. od. for the full course; £2 12s. 6d.,for the morning sessions only.Syllabus can be obtained from the Secretary, IndustrialOphthalmology Course, Birmingham and Midland EyeHospital, Church Street, Birmingham, 3.BRISTOLMedical Postgraduate Department of theUniversity of BristolDiploma Courses. These begin in October and areadvertised in the medical press in April. Provided thereare sufficient candidates, instruction is provided in childhealth; radiodiagnosis (Diplomas of Conjoint Board);Public Health (C.P.H. and D.P.H., Bristol).Further information, copies of regulations for the BristolDiplomas and application forms for the courses may beobtained from the Director of Medical PostgraduateStudies, The University, Bristol 8.

CAMBRIDGECambridge University Medical SchoolSummary of postgraduate facilities for general practi-tioners from October x, 1955, to July 31, 1956. AtAddenbrooke's Hospital, unless otherwise stated.First week in each month. Monday: Abnormalante-natal clinic, 10.30 a.m., Maternity Hospital, MillRoad (Miss J. Bottomley). Medical ward round(every Monday), 10.30 a.m. (Dr. A. P. Dick). Diag-nosis and treatment of cancer, 2.30 p.m., Radio-therapeutic Centre, Addenbrooke's Hospital (Prof. J. S.Mitchell). Psychiatric cases or subject, 2.30 p.m.,Out-Patients' Department, 2 Bene't Place (Dr. D.Russell Davis). Tuesday: Dermatological clinic (everyTuesday), 9.I5 a.m. and 2.15'p.m., Out-Patients' De-partment (Dr. A. J. Rook). Medical ward round (everyTuesday), 10.3o a.m. (Dr. L. B. Cole). Psychiatry,2 p.m., Griffith and Hatton Wards and Out-Patients'Department (Dr. R. A. Noble). Wednesday: Derma-tological clinic (every Wednesday), x: a.m. and 2;30p.m., Out-Patients' Department (Dr. C. H. Whittle).Thursday: Medical ward round (every Thursday),10.30 a.m. (Dr. L. B. Cole). Ward round (everyThursday), II a.m., Thoracic Surgery Unit, PapworthHospital (Mr. C. Parish). Cardiac clinic (every Thurs-day), 2.15 p.m., Out-Patients' Department (Dr. L. B.Cole). Orthopaedic cases or subject, 2.30 p.m.,Orthopaedic Out-Patients' Department (Mr. T. J.Fairbank). Friday: Chest diseases, 2 p.m., The Clinic,Shire Hall, Castle Hill (Dr. W. Paton Philip and Mr.C. Parish). Dermatological clinic (every Friday), 2.15p.m., Out-Patients' Department (Dr. A. J. Rook).Endocrine clinic (every Friday), 2.30 p.m., Out-Patients'Department (Dr. L. C. Martin). Gastro-enterologicalclinic (every Friday), 2.30 p.m., Out-Patients' Depart-ment (Dr. A. P. Dick and Dr. F. R. Berridge).Saturday: Medical ward round (every Saturday),10.30 a.m. (Dr. L. B. Cole). Ophthalmic cases orsubject, 10.30 a.m., Out-Patients' Department (Mr.E. G. Recordon).Second week in each month. Monday: Medicalcases or subject, 2.30 p.m., Griffith and Hatton Wards(Dr. L. C. Martin). Tuesday: Diagnostic radiology,2.30 p.m., X-ray Department. Thursday: Plasticsurgery clinic, 9.30 a.m., Out-Patients' Department(Mr. L. M. Rouillard).Third week in each month. Monday: Surgicalcases or subject, 2 p.m., Albert Ward (Mr. B. McN.Truscott). Tuesday: Gynaecological cases, 9.30 a.m.,Out-Patients' Department (Mr. O. Lloyd). Clinical

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psychiatry, 3 p.m., Out-Patients' Department (Dr. E.Beretford Davies). Wednesday: Urological andgeneral surgical cases, 9.30 a.m., Out-Patients' Depart-.ment (Mr. J. F. R. Withycombe). Orthopaedic casesor subject, 10.30 a.m., Orthopaedic Out-Patients'Department (Mr. R. W. Butler). Radiological demon-stration 2.30 p.m., Out-Patients' Department (Dr.F. R. Berridge). Clinico-pathological conference,5 p.m., Lecture Theatre, Department of Pathology,Tennis Court Road (Dr. A. M. Barrett). Thursday:E.N.T. cases, xo.3o a.m., Out-Patients' Department(Mr. A. S. H. Walford). Friday: Paediatric cases,2.15 p.m., Children's Ward (Dr. D. M. T. Gairdner)Fourth week jn each month. Monday: Generalsurgical cases, 9.30 a.m., Tipperary Ward (Mr. P. H. R.Ghey). Ophthalmic cases or subject, io a.m., Out-Patients' Department (Mr. G. F. Wright). Tuesday:Demonstration of cases and methods, 10.30 a.m.,Department of Physical Medicine (Dr. W. A. Fell).Wednesday: E.N.T. cases or subject, 2 p.m., Out-Patients' Department (Mr. K. F. Wilsdon). Thursday:Psychiatric cases, Out-Patients' Department, 2 Bene'tPlace (Dr. D. H. Clark). Friday: Haematological clinic,I0 a.m., Department of Medicine, Tennis Court Road(Staff of Department).Post-mortem demonstrations daily (except Satur-days) at 12.I5 p.m.The following one-day symposia will be held mbnthlyon Saturdays (except in August and September) from10.30 a.m. to 5 p.m. The subject-matter and clinicalmaterial will be chosen for its special appeal to thoseengaged in general practice. June 9, Respiratorydiseases. July 7, Gastro-enterology.Further particulars may be obtained from the Secretary,Cambridge University Medical School, Tennis CourtRoad, Cambridge.CARDIFFThe Welsh National School of MedicineC.P.H. Wales (Certificate in Public Health). Threemonths' full-time course, October to December.D.P.H. Wales (Diploma in Public Health). Twelvemonths part-time course, January to December.T.D.D. Wales (Tuberculous Diseases Diploma).Five to six months' full-time course, January to June.D.M.R.D.Eng. (Diploma in Medical Radio-diagnosis). Eighteen months' full-time course fromOctober.D.C.H.Eng. (Diploma in Child Health). Two sessionsweekly for 12 months.The number of admissions to each of the above courses isstrictly limited and early application should be made tothe Secretary, The Welsh National School of Medicine,34 Newport Road, Cardiff.DUBLINUniversity CollegeThe following courses will be held during the session1955-56:-C.P.H. Course and examination. Michaelmas Term.D.P.H. Course. Hilary and Trinity Terms.

Examinations. Summer Term.D.P.M. Course. Michaelmas Term. Examination,

summer term.Further particulars may be obtained on application to theRegistrar, University College, Earlsfort Terrace, Dublin.

DUNDEEtUiversity of St. AndrewsThe following lecture will be given in the Lecture

Theatre, Physiology Department, Queen's College,Small's Wynd, Dundee, at 5 p.m. Admission free:June7 Sir Harry Platt. The backache-sciatica problem.

For further information application should be made tothe Convener, Postgraduate Committee, Medical School,Dundee.

EDINBURGHEdiiburgh Postgraduate Board for MedicineGeneral Surgery. A three months' course of post-graduate surgery suitable for surgeons requiring arefresher course in the current outlook on generalsurgery or for graduates preparing to specialize insurgery, is arranged to start on October i, I956. Theprogramme has been reorganized so as to provide co-ordinated clinical and systematic instruction in generalsurgery wards and specialized surgical units in Edin-burgh. Fee £31 os. od.Medical Sciences. A three months' course in appliedanatomy, physiology, pathology, bacteriology and bio-chemistry will begin on June 25, 1956. This course issuitable for postgraduates wishing to take the PrimaryFellowship Examination, as a final preparation in thesesubjects. Considerable basic knowledge is highlydesirable prior to taking this course. Fee £3I Ios. od.A course in the basic sciences (anatomy, physiology,pathology, including bacteriology) will be conducted bythe Fellows of the Royal College of Surgeons, and others,under the aegis of the Edinburgh Postgraduate Boardfor Medicine. This course, comprising lectures anddemonstrations, will begin on October 15, 1956, andcontinue for ten weeks. Fee £26 5s. od.Internal Medicine. A course lasting 12 weeks, suit-able for graduates wishing a refresher course, or tospecialize in medicine, begins on September 24, 1956.These courses consist of 320 hours' instruction, com-prising lectures, clinical demonstrations and ward visits.Fee 31 I os. od.Additional instruction in clinical paediatrics and tropicalmedicine is arranged in conjunction with the course inmedicine, for which there is a small fee; the numbers arelimited.Applications for enrolment should be addressed to theDirector of Postgraduate Studies, Surgeons Hall, Edin-burgh 8, supplying particulars of qualifications andpostgraduate experience.Royal Medical SocietyThe meetings of the Society are held in the Society'sHall on Friday evenings during the Autumn and SpringTerms. Meetings consist of Private Business (at 7 p.m.)and Public Business (at 8 p.m.) in which dissertationsby members or addresses by prominent medical men onsubjects of medical interest are given. Clinical meetingsare held periodically in the Royal Infirmary and filmshows of the latest medical films are given in the Society'sRooms. Prospective members will be welcomed on anyFriday evening in the Society's Hall before publicbusiness.Applications for further information should be addressedto the Secretary, Royal Medical Society, 7 Melbourne.Place, Edinburgh, i.

LIERPOOLUniversity of LiverpoolThe following postgraduate courses of instruction areoffered:Surgery. A full-time course of one year suitable forcandidates who have already completed the Primary

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Examination of the F.R.C.S., or undertaken post-graduate study in anatomy and-physiology. On com-pletion of the course students become eligible to takethe Mastership of Surgery (Ch.M.) of this Universityprovided they are graduates of an approved Universityor otherwise comply with the regulations. The fee forthe course is £60. The course begins in September.Orthopaedic Surgery. A full-time 12-month courseleading by examination to a Mastership in OrthopaedicSurgery (M.Ch.Orth.) open to all medical graduates ofapproved Universities (and to graduates in otherfaculties with qualifications in medicine) who hold anF.R.C.S. of one of the British colleges or its equivalent.The fee for the course is £70. The course normallybegins in January.Radiology. A full-time course of two academicyears leading to a D.M.R. (D. or T.) open to medicalgraduates of approved Universities and to medicallyqualified candidates who hold approved higher medicaldiplomas and a degree in a faculty other than medicine.The course allows a candidate to hold suitable approvedhospital appointments during the second year andcovers the regulations required by the Conjoint Board.The fee for,the two-year course is £63. The coursebegins in October. The degree of M.Rad. may, afterreport by the Faculty, be conferred on holders of theD.M.R. (D. or T.) of this University under certainconditions.Public Health. A full-time one-year course leading,tothe Diploma in Public Health, open to candidates witha medical qualification from an approved medical schoolor licensing body. This qualification should have beenobtained not less than two years before admission tothe course. The fees amount to £73 I3s. All courses ofinstruction begin in October.Tropical Medicine and Hygiene. A full-time three-month 'course leading to the Diploma in TropicalMedicine and Hygiene (D.T.M. & H.) open to candi-dates with a medical qualification from an approvedmedical school or licensing body. The course begins inSeptember and January. Fee £53 I s.Anaesthesia. A full-time course of postgraduateinstruction, limited to ten students, begins on October Iand lasts for one year. The course combines instructionin the practical administration of anaesthetics with lec-tures and demonstrations in anatomy, physiology,pathology, physics, pharmacology, medicine and surgery,and anaesthesia. For the purpose of gaining practicalexperience, the students are found suitable appointmentsin recognized General Hospitals within the Liverpoolarea. The fee for the course is £60,Psychiatry. A part-time course begins on January Iand lasts for two years. It is divided into two partscorresponding to the two parts of the Diploma in Psy-chological Medicine awarded by the Examining Boardin England (R.C.P. Lond. and R.C.S. Eng.). Part Iprovides instruction in (a) anatomy (macroscopic andmicroscopic) and physiology of the nervous system, and(b) psychology. Part II deals with (a) clinical neurologyand neuropathology and (b) psychological medicine,including psychoneuroses, mental deficiency, childpsychiatry, forensic psychiatry and social psychiatry.Parts I and II will be held simultaneously. Studentsmay enrol for either part separately but, except inspecial circumstances, will not be permitted to takeboth parts concurrently. Applications to attend inrespect of a special subject in Part II (e.g. mentaldeficiency) will be considered individually. Feesi£2 I2s. od. per term or £70 for the whole course.Applications for further information should be addressedto the appropriate department of the University, Liver-pool, 3.

MANCHESTERUniversity of ManchesterThe following postgraduate courses are offered:-D.P.M. A part-time course beginning in October andextending over eight academic terms.D.P.H. A part-time course began in October inalternate years and extending over two academic years.The next course will begin in October, 1956.D.M.R.D. A full-time course began on October i,1955. Applicants must fulfil the requirements of theExamining Board in England.Further particulars may be obtained from the Dean ofPostgraduate Medical Studies, The University, Man-chester 13.NEWCASTLEThe Medical School, King's College(University of Durham)Public Health A part-time course is held for theD.P.H. The course occupies five terms, two-and-a-halfdays each week being- occupied in whole-time study,leaving the remainder of the time free for remuneratedemployment. The course is held biennially and the nextcomplete course will begin in October, I956.Psychological Medicine. Courses for the D.P.M.(Dunelm) are held as follows: Part I, part-time courseextending over three terms and beginning October.Part II, full-time course extending over two terms alsobeginning in October. Part I and Part II may be takentogether.For further information application should be made to theAssistant Registrar, Medical. School, Kiw,g' College,Newcastle upon Tyne.

OXFORDPostgraduate Medical StudiesSummary of ward rounds, clinics, demonstrations, etc.,open to general practitioners from September, 1955,to July, 1956, in the Radcliffe Infirmary unless otherwisestated:Medicine, ward rounds, Mondays, Tuesdays, Wednes-days, Thursdays, Fridays and Saturdays, Io.15 a.m.(on Mondays 9.30 a.m. in X-ray Department). Medicalconsilia, Wednesdays, 5 p.m. (alternate weeks in fullterm). Clinical demonstrations, Thursdays, 2.15 p.m.Clinico-pathology conferences, Wednesdays, 5 p.m.(alternate weeks in full term). Chest Diseases, clinicaldemonstrations, day and time by arrangement with Dr.Ridehalgh, Osler Pavilion. Paediatrics, clinical demon-strations, Saturdays, 10.30 a.m.; out-patients, Thurs-days, 2 p.m., by arrangement with Dr. Victoria Small-peice. Child Welfare, clinics (City), day and time byarrangement with Dr. Mary Fisher. InfectiousDiseases, clinical demonstrations, day and time byarrangement with Dr. Warin, Slade Hospital. Psy-chiatry, clinical demonstrations, Fridays, 4 p.m.,Warneford Hospital. Geriatrics, clinical demonstra-tions, Mondays, 2.I5 p.m., Cowley Road Hospital.Social Medicine, demonstrations, Social MedicineUnit, 8 South Parks Road, by arrangement with Dr.Alice Stewart. Neurology (medical and surgical),out-patients, Tuesdays and Wednesdays, 1.45 p.m.Clinical, demonstrations, Thursdays, 5 p.m. (in fullterm). Venereal Diseases, out-patients (female).Mondays, 6 p.m., and Wednesdays, 2.30 p.m.; (male),Wednesdays, 5.30 p.m., and Saturdays, 2.15 p.m. SkinDiseases, out-patients, Mondays and Fridays, 2 p.m.Surgery, accident service, daily io a.m. Ward rounds,Mondays, 9.30 a.m., Thursdays, 10.30 a.m., Churchill

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June 1956 Postgraduate News 32IHospital. Clinical demonstrations, Tuesdays, 4.30 p.m.(in full term). Plastic Surgery, out-patients andclinical discussion, Thursdays, Io a.m., and Fridays,2 p.m., Churchill Hospital. Orthopaedic Surgery,clinical demonstrations, Thursdays and Saturdays,9 a.m., Wingfield-Morris Orthopaedic Hospital. Ob-stetrics, lecture demonstrations, Mondays, Tuesdays,and Fridays, 9.15 a.m., ward rounds, ii a.m. Gynae-cology, ward rounds, Tuesdays, 1 a.m., Wednesdays,10.30 a.m. and 5 p.m. Ante-natal clinics, Mondays,a p.m., Wednesdays, Io a.m., Thursdays, 2 p.m.,Fridays, 2 p.m. Mondays, 2 p.m., and Fridays,io a.m., Churchill Hospital. Post-natal clinics, out-patients, Tuesdays, Io a.m., Wednesdays, 2 p.m.Doctors wishing to avail themselves of the facilities set outin this schedule should apply to the Director, PostgraduateMedical Studies, Osler House, 43 Woodstock Road,Oxford.

CONFERENCES, PRIZES, Etc.Buckston Browne Prize Essay. The prize, consistingof a medal, together with the sum of £ioo, will beawarded for the best essay on 'Hypertension,' sub-mitted by August 31, 1956. The prize is open to anymember of the medical profession registered in theBritish Isles or Dominions, and is limited to candidatesunder 45 years of age.Further particulars may be obtained from the HonorarySecretaries, Harveian Society of London, i ChandosStreet, Cavendish Square, London, W.I.British Association of Urological Surgeons, Homeand Overseas. The Annual Meeting will be held inLiverpool on June 28, 29 and 30, 1956.Full particulars from the Honorary Secretary, BritishAssociation of Urological Surgeons, Home and Overseas,46 Lincoln's Inn Fields, London, W.C.2.Butterworth Gold Medal is presented annually to theCollege of General Practitioners by Messrs. Butter-worth & Co., the medical publishers, for an essay bya member or associate of the College on a subjectconnected with general practice. The subject for thisyear's essay is 'The care of the elderly in generalpractice.'Essays, identified by motto only (with the author's nameand address in a sealed envelope) and not exceedingo0,000 words, should be submitted to the Chairman of theAwards Committee, College of General Practitioners,14 Black Friars Lane, London, E.C., not later thanSeptember 17, I956.University of Edinburgh, Faculty of Medicine.University (Fellowships, Scholarships and Bursaries)Scheme Ltd. In terms of the above-named scheme,certain funds have been amalgamated to form a MedicalFaculty Scholarships Fund, from which awards ofFellowships and Scholarships will be made under thefollowing conditions. Graduate Research Scholar-ships. Four are offered for award, each tenable forone year and, in certain circumstances, renewable fora second year. For the first year the minimum valueshall be 500o and for the second year £600. TheScholarships shall be open to graduates in the Facultyof Medicine of any University; to graduates in theFaculties of Arts or Science of any University who holdan Honours Degree; and to licentiates in medicine.They shall not be open for award to any applicant who,excluding any period spent in National Service, hasheld a degree or licence for longer than three years.Those to whom awards are made shall be required toundertake research work in a department within theFaculty of Medicine. The Scholarships will normallybe. awarded at the beginning of each academic year in

October. Graduate Research Fellowships. Threeare offered for award, each tenable for one year, renew-able for a second year and, in special circumstances, fora third year. For the first year, the minimum valuewill be £700; for a second year, £800; and for thethird year, £9oo. The Fellowships shall be open tograduates as for Research Scholarships above; theresearch work shall be required to be undertaken ina department within the Faculty of Medicine, and theawards will normally be made at the beginning of eachacademic year in October.Applications for the Scholarships or Fellowships (whichare to be made on the prescribed applicationform obtainablefrom the Faculty of Medicine on request) must be sub-mitted, through the Head of the Department concerned,to the Dean, Faculty of Medicine, University New Build-ings, Teviot Row, Edinburgh 8, by April 30 in the year ofaward, and should be accompanied by a statement of thework which the applicant proposes to undertake.Sir William Lister Award in Ophthalmology.Travelling Scholarship. An award will be made by theRoyal College of Surgeons and Moorfields, West-minster and Central Eye Hospital. Candidates mustoutline the course of study or programme of work theydesire to follow and the Ophthalmological Centre orCentres they propose to visit. A sum of £3oo will bemade available for the Scholar, who will hold the titlefor 3 years, during part of which he will be required totravel abroad.Preference will be given to candidates under 40 years ofage, and all candidates must be British subjects orCommonwealth citizens.Full details available from the Secretary, Royal Collegeof Surgeons, Lincoln's Inn Fields, London, W.C.2. towhom applications must be addressed before October i, 1956.

NAPT

THEPROTECTION OF

THE NURSEAGAINST

TUBERCULOSISbyF. A. H. SIMMONDS

M.A., M.D., B.Chir., D.P.H.Medical DirectorClare Hall HospitalMiddlesex

Clothbound 10s. 6d. Illustrated

NAONASOATIONALASSOCIATIONFOR THE

PREVENTION OF TUBERCULOSIS

Tavistock House NorthTavistock Square, London, W.C.1

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THE

POSTGRADUATEMEDICAL JOURNAL

VOl. l',1 2 \ 1M1 1 . ;,N Jl'NI- I()56

CONTENTSI'.A.\ I

EDIT'ORIA I 273TIlE PI,AC'I: ()I IESII RAT(.-I()RY 1-'L "NC'()N 'I'lIS'l'S IN (' INI(AI NI t''IC'N

/ ).I' . Ht//e.s, .ll)., .1J.R./ '.1 . 74TIl, .\ )III ,()() I)'i' .\NI.' l SI-()N //. /.'. /r, t, .1.1)., I '.(('//.In/lh,.) ,7,SOME !'I'I(.\" , .\ASI'lE,"''S ( ')!('\1.\';S '.\'1'1 S'l'l(' S'. i //. ,r/il//,.lD./).X87THE IMANA (;E INII' 'I 'S()IRAl' PA'11'I1' AISC'ESS /".(;. .SSmiddv' , I.R.(.S'. 2( 2

ORAL AI)IMINIS'lRA''ION 01 P1IEHNOEX IE''I IlYI^, PENICI.I.1IN (DIS'I'AQUAINE, V)I.IenrL , B.,('n., .R.(,I. R.('.B.LR. P., and Al. 7. MIeYvncll, M.D., AI.R.('.P., D.-'.11. 297

MULTIPI,E P'SEUDI)(-CYST'IC 1't'lRCLIL.OSISOF HONE IN AN AGED ADUL'I'R. J. Ilarrison, AI.R.( .P. 301

MANUFA'lREIRS' NOTE()'' 305

BOOKS RE'CEIV\'I) 306BOOK RE'VIEWS 307

POST(;RAD'AT.I'E NEWS 313

-1/1 rights reserzcd. .\o par t ,f this journal maY be reproducedin any forim wcithout permission in zriting from the publishers.

EDITORProf. C. G. Rob, .I.C., M.CHIR., F.R.C.S.

ADVISORY EDITORIAL BOARDR. I. S. Bavliss, MI.D., MI.R.C.P. David Levi, M.S., F.R.C.S.J. W. D. Bull, M.D., F.R.C.P. A. A. G. Lewis, 3M.D., .MI.R.C.P.Maurice L)avidson, 1).. .... I. issen, .R.C..S.Colin EdG.ards, MI.., I.R.C.P. ;. S. \X. Organe, M.D., F.F.A.R.C.S.F. Dudley Hart, M.D., F.R.C.I'.. R. V. Pulvertaft, O.B.E., M.D., F.R.C.P.John Howkins, MI.D., M.S.,WF.R.(t.).(;. XV. Somerville, M.D., M.R.C.P.

Editorial Representative for Australia: Cliv- l'Fitt, MI.D.(MIelb.), I.R.C.P.(London), I.R.A.C.P.Editorial Representative for Ceylon: MI. MI. A. Cader, MI.S.(Lond.)

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