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to the meclical pensioner’s prescriptions for himself,even when the chemist’s bill is paid by the State.But when it comes to the charging of a fee for themedical care he renders to himself, the matter is some-what different. The French Ministry of Pensions holdsthat such charges are not permissible ; Dr. Boudin,on the other hand, while admitting that there is

something " inelegant " about them, does not believe. they are strictly illegal. There is common sense as

well as a legal aspect to this problem. A prescriptioncan be scrutinised and analysed ; and there are limitsto the amount of drugs that even the most receptivepatients can accommodate. But medical care, withappropriate advice, is a far less tangible commodity ;and the medical pensioner, free to rate the visions ofhis head upon his bed as consultations worthy ofremuneration, might well experience some difficultyin maintaining his normal ethical " elegance " as heattempted to assess the value of abstract thought interms of hard cash.

MARGARINE IN DISGRACE

A report by Prof. L. Hugounenq to the FrenchAcademy of Medicine on Feb. 27th dealt with mar-

garine as a food, its dangers to health, and its inade-quacy. as a substitute for butter. Many of the failingsof margarine are already well known, but there havepreviously been few indictments of it so sweepingand sustained. Its faults, he said, include a compara-tive lack of digestibility, a deficiency or lack ofvitamins, and the absence of acids which give butteran attractive smell and taste. Butter also containsphosphorus which is not to be found in the materialsfrom which margarine is made. In response to thisreport the following resolution was adopted : "TheAcademy, considering that certain margarines provokedigestive troubles in certain persons that thesetroubles are undoubtedly due to faulty conditions ofmanufacture and purification, that certain margarinefactories elude the supervision and control providedby the law, that margarine is a substitute for butterwhich does not, however, contain all the elementsof natural butter (vitamins and fatty acids) recom-mends that all undertakings, without distinction,which deal with animal fats intended for food,should be under supervision and inspection and

subject to full legal control in the interests of publichealth."

OBITUARY

DAVID LEES, M.B., Ch.B., F.R.C.S. Edin., D.S.O.

WE regret to record the death of Dr. David Lees,surgeon to the Royal Infirmary, Edinburgh, whichoccurred on March 25th after an operation, in hisfifty-fourth year.David Lees was born in Tarbolton, the son of

Mr. Robert Lees, of Lagg, a veterinary surgeon, andwas educated at the Ayr Academy and at the

University of Edinburgh. He graduated as M.B.,B.Ch. in 1907, and was a distinguished student,becoming later resident house surgeon at the RoyalInfirmary and house physician at the Royal MaternityHospital, Edinburgh. He was for a time assistantmedical officer at the Bangour Mental Hospital, andthen for four years served in France with variousunits, being several times mentioned in despatchesand obtaining the D.S.O. in 1917. In 1918 he obtainedthe diploma of F.R.C.S. Edin., and was elected

surgeon to the Royal Infirmary, and consultingsurgeon for veneral diseases to the Royal MaternityHospital. Of these diseases he made a particular study,his advice being sought in many directions ; he was,for example, delegate of the British Social HygieneCouncil to Cyprus and to India during 1926-27, withthe responsibility of advising various governments onsystematic methods of dealing with venereal disease.He had already written largely and practically on thesubject, producing papers on vaccine therapy in

gonorrhoea, and writing the article on the VesiculaeSeminales in the Encyclopaedia Medica ; and in 1927his book entitled " Practical Methods in Diagnosisand Treatment of Venereal Diseases " went speedilythrough two editions. This book brought togetherin readable form the latest ideas and the most recenttechnique. Some of the plates should have historicvalue, as they picture syphilitic rashes of which thepresent-day student sees little owing to effectivetherapy. And Lees’s wide personal experienceenabled him to make useful generalisations aboutvarious kinds of therapeutic measures. At the B.M.A.meeting of 1927 he recorded observations on 6000cases of syphilis treated with bismuth, and recordedhis own opinion that, valuable as it was for its easeand safety of administration when organic disease

was present, bismuth should always be combined witharsenic, except possibly in pregnancy. Brought incontact in the Edinburgh clinic with a highly floatingpopulation Lees was early and strongly impressedwith the need to follow up the treatment of venerealdisease to a successful conclusion if public health -

was to be efficiently served. He was prominentlyassociated with the compulsory measures embodieda few years ago in the Edinburgh Corporation Bill,believing that, without some kind of assurance ofcontinuous treatment, many sufferers from venerealdiseases would neither be cured themselves nor beprevented from remaining a danger to the community.

Lees was a good teacher, emphatic and picturesque,speaking with conviction of things of which hehad personal knowledge, and how valuable his serviceswere at the Edinburgh Infirmary is well set out in thefollowing estimate from a distinguished colleague :-" There are certain people who occupy positions whichare peculiar and unique because they have createdthem themselves. David Lees was such an one. Hisdynamic personality, combined with his obvioussincerity, enabled him to get things done accordingto his own well-considered plans. His departmentcould not be thought of apart from himself as it wasthe expression of his character and his energy. Hisbroad interest in medicine made his opinion on allmatters connected with his specialty of peculiar value,and his medical and surgical colleagues availed them-selves freely of his ever-ready help. Whilst clear-headed and dogmatic in his views, he was singularlyfree from all conceit, and a saving sense of humourpreserved harmony whenever a clash of opinionsthreatened discord. His interests were widespread ;a keen sportsman he took an active part in the athleticside of university life. As secretary of the Medico-Sociological Club he was the moving spirit in promotingdiscussions on broad public questions in their relationto medicine. It is, however, as an enthusiastic,helpful, and loyal colleague that he will be missed themost by his medical associates in Edinburgh. Hehad made such a bold and characteristic niche forhimself that it is difficult to see how it can be filled.He has left us a very vivid picture of how a man of- character and personality may create for himself and

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his specialty a position of undisputed authority andimportance. "-D. P. D. W.Another personal friend adds to the picture with

these words :-" David Lees had a robust personality ;opposition did not damp but rather stimulated himto renewed attempts to carry his point. His argu-ments were not inspired by a subtle diplomacy butby confidence that logic demanded the acceptanceof the conclusions to be drawn from the availableevidence. If any were irritated by this attitude, theywere forced to respect the man, and his influence inthe development of his specialty was indubitable,even though he failed to carry through one projectwhich he had most at heart, the making in Scotlandof venereal diseases notifiable. In the pursuits ofhis leisure David Lees presented the same almostboundless energy. A keen golfer, he was so muchinterested in the encouragement of golf as a game forchildren that he often gave up his own sport, when onholiday, to organise competitions for boys and girls.His cheerful good nature will be greatly missed atthe northern golfing resorts where he spent hissummers. His own son shows a remarkable aptitudefor the game."David Lees leaves a widow and one boy.

SAMUEL LODGE, M.D., B.S. Durh., O.B.E.THE death occurred on March 19th at his residence

in Harrogate of Dr. Samuel Lodge, well known inBradford and Halifax and outside his immediatecircle as a specialist in diseases of the eye and ear.He was 68 years of age.Samuel Lodge was a native of Bradford, the son

of a medical man of the same name, and received hisearly education at the city Grammar School. Heentered St. Thomas’s Hospital as a medical studentand attended courses at various times at Leeds andat the University of Paris. He graduated as M.B.,B.S. Durh. in 1887, and was for a time medical andsurgical assistant at the Royal Infirmary, Newcastle-on-Tyne. He shortly afterwards began to specialisein the subjects in which he made his considerablename, was elected surgeon to the eye, ear, throat, andnose department of the Halifax Infirmary, and surgeonto the Bradford Royal Eye and Ear Hospital. Duringthe war he was medical officer to the 6th Battalionof the West Yorkshire Regiment, being already asurgeon-major in the Volunteers, and did excellentorganising work, receiving for his services on the

Army Medical Boards in Bradford and Leeds theO.B.E. Dr. Lodge’s connexion with the Halifax

Infirmary extended over nearly a quarter of a century,but he had lived recently in semi-retirement. Heleaves a widow and four sons, three of whom are inthe medical profession, and one of whom succeededhis father at the Halifax Infirmary. Another son,who died recently, was ophthalmic surgeon to theLeeds Infirmary.

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SYDNEY GUY BILLINGTON, M.B., B.S. Lond.,F.R.C.S. Edin.

THE death occurred on March 17th of Dr. SydneyGuy Billington, who had undertaken much indepen-dent research in the attempt to discover biochemicalremedies which might be of value in several conditions-notably, influenza and rheumatism and malignantdisease. He received his education at the Birminghammedical school, took the English double qualificationin 1910, and in the same year graduated at theUniversity of London as M.B., B.S. He lateracquired the diploma of F.R.C.S. Edin. He was

a successful student, filled house appointments atthe Queen’s Hospital, Birmingham, and later becameresident pathologist at the General Hospital,Birmingham, while he held the same post for a timeat Wolverhampton General Hospital. For the last.17 years he was very interested in promoting the useof " Billington’s Antibody," and published, in certainquarters, reports on the use of the remedy purportingto show its value in many conditions, in malignantdisease among others. He was unable to obtain thesupport which he considered his due from membersof the medical profession in regard to either histheories or his results ; his industry and’enthusiasmwere undoubted, and certain supporters of his viewsconsider that his work, or some of it, may yet receivemore consideration than it did during his lifetime.

MENTAL AFTER-CARE ASSOCIATION

Lord Wakefield of Hythe presided at the annual

meeting held on March 20th at the Haberdashers’ Hall,when Mr. L. G. Brock, chairman of the Board of Control;Dr. Nathan Raw, Lord Chancellor’s visitor in lunacy;Dr. Reginald Worth, chairman of the Association, andMr. J. M. Oakey, the treasurer, spoke of the activitiesof a year in which 2865 had been helped. The Associationboards out patients in cottage homes for a period of con-valescence, arranges residence for them during attendanceat clinics, gives them grants of money or relief in kind,gives maintenance while work is being found, obtainsemployment suitable to their abilities, supplies clothing,tools, &c., necessary for employment, and, generallyspeaking, acts as a personal friend with sympathy, under-standing, guidance, and help. The council reportedassistance rendered to many societies and hospitals whichhad referred difficult cases to them. During the year alarge number of old patients had applied for help andadvice, an encouraging feature of the work being theway in which those who had once been assisted turnedto the Association in their later troubles. Help given atthe right time is responsible for averting relapses andconsolidating recoveries ; in 1933 the Association dealtwith 591 "

pre-care " patients, the great majority ofwhom were prevented from becoming patients in a mentalhospital. New developments in the Association’s workinclude cooperation with the L.C.C. in the supervision ofpatients leaving its mental hospitals, and the supply tocounty and other authorities of social workers. Thetreasurer described the ratio of administration expensesto revenue as one of the lowest of any benevolent organisa-tion in the country. The secretary of the Association isMiss Vickers, from whom particulars can be obtained atChurch House, Dean’s Yard, Westminster.

NEWCASTLE ROYAL INE’1RMARY : ANNUAL REPORT.The Royal Victoria Infirmary, Newcastle-upon-Tyne,last year admitted 12,842 new in-patients, whose averagestay was 15-8 days. This was an increase of 590. Therewere 110,708 out-patients. With the opening of a specialnew block of buildings for the treatment of orthopediccases, and the heightening of two pavilions to add newwards, and thereby replace the two. wood-constructedwards erected temporarily during the late war, 54 bedshave been added to the bed strength, bringing the presentcomplement of beds in the voluntary side of the hospitalup to 645. The new orthopaedic building cost 31,000.It is hoped that the additional beds will make a sensibleimpression upon the waiting-list of nearly 2000. Therewere 1108 motor traffic cases, of which 416 were admitted,involving an average daily occupation of 18 beds. Thetotal cost was 1:2413, of which E444 was received frominsurance companies. On an average only 30 per cent.of the accounts submitted by the hospital have been paidby the companies.

Since the beginning of this year the Royal VictoriaInfirmary has benefited by five bequests of the totalvalue of 4900.