THE

VOL. XXIV N.. 277

NOVEMBERLf',, '-U'\, it4 ;,,- /

THYROTOXICOSIS

INTRACRANIAL TUMOURS

RECURRENT UMIILICAL PAIN.IN CHILDHOOI

T"JCYI~Gi14AR):RF GASTRIC AND DUODENAL ULCERATION

PRECORIIAL PAIN

A NEW APPROACH TO ACUTE *TITIS IN INFANCY

Published y111 : T

THE

POST GRADUATEMEDICAL JOURNALVOLUME XXIV NUMBER 277 NOVEMBER 1948

CONTENTSPAGE

EDITORIAL 569

THYROTOXICOSIS Sir Carrick Robertson, F.R.C.S.,F.R.A.C.S., Hon. F.A.C.S. 571

INTRACRANIAL TUMOURS C. Worster-Drought, M.A., M.D.,F.R.C.P. 579

RECURRENT UMBILICAL PAIN INCHILDHOOD John Apley, M.D., M.R.C.P. 588

THE CHANGING NATURE OF GASTRIC ANDDUODENAL ULCERATION J. Donaldson Craig, M.D., M.R.C.P. 593

PRECORDIAL PAIN Bruce Maclean, M.D., F.R.C.P. 6oi

A NEW APPROACH TO ACUTE OTITIS ININFANCY Prof. Henryk Lewenfisz, M.D. 609

POST GRADUATE NEWS 6I5BOOK REVIEWS 624

All rights reserved. No part of this journal may be reproducedin any form without permission in writing from the publishers.

EDITOR:Andrew Monro, M.A., M.D., F.R.C.S.

ADVISORY EDITORIAL BOARD:Maurice Davidson, M.A., D.M., F.R.C.P.

Charles Read, F.R.C.S., F.R.C.O.G. A. Clifford Morson, O.B.E., F.R.C.S.David Levi, M.S., F.R.C.S. K. 1. Nissen, F.R.C.S.Harold Davis, M.B., M.R.C.P. R. S. Bruce Pearson, D.M., F.R.C.P.Colin Edwards, M.B., M.R.C.P. N. Lloyd Rusby, D.M., F.R.C.P.Terence Millin, M.Ch., F.R.C.S. Sol. M. Cohen, M.A., F.R.C.S.

PUBLISHERS:The Fellowship of Post Graduate Medicine, i, Wimpole Street, London, W.I.

BUSINESS MANAGER:R. H. Blythe, 24, Margaret Street, London, W.I. LANgham 4526.

POST G;RADUATE NEWSNovember 1948

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 orfurther information should be made direct to the spomnorsof the course.

FELLOWSHIP OF POST GRADUATEMEDICINEGeneral Medicine Revision Course. November Istto December 7th. 5 to 8.30 p.m. daily, Mondays toFridays. St. Stephen's Hospital. Limited. Fee,,C24 3s. od. (No entries accepted until the syllabus ispublished and circulated.)Ear, Nose and Throat Diseases. November 27thand 28th. All day Saturday and Sunday. MetropolitanE.N.T. Hospital. Specially intended for GeneralPractitioners. Fee, £2 12S. 6d.Infectious Diseases (M.R.C.P.). December 4thand 5th. All day Saturday and Sunday. Park Hospital,Hither Green. Limited. Fee, £3 3s. od. (No entriesaccepted until syllabus is published and circulated.)Please note that instruction arranged by the Fellowshipof Post Graduate Medicine is open only to Members(annual subscription, from month of joining, ios. 6d.). Inthe case of ' limited' courses no entries are accepted inadvance of the detailed syllabuses being published andcirculated; post graduates (whether Members are not) arenot automatically included in the mailing lists, but mustnotify the Fellowship of Post Graduate Medicine, I,Wimpole Street, London, W.i, if they wish to be sentsyllabuses as published, and must specify the subjects inwhich they are interested. Information regarding coursescan be obtained from the Office, dailv between io a.m. and5 p.m. (Saturdays io a.m. to 12 noon). Telephone:Langham 4266.

ROYAL COLLEGE OF PHYSICIANSA course of post graduate lectures in Medicine will begiven from November ist to December 17th, I948.There will be approximately 26 lectures. The inclusivefee for the course will be £7 7s. od., and the total entrywill be limited to 200.

Applications should be made to the Registrar, RovalCollege of Physicians, Pall Mall East, S.W.I.

ROYAL COLLEGE OF SURGEONS OFENGLANDThe following lectures will be delivered, admissionfree:Bradshaw Lecture. Thursday, November iith, at5 p.m., by Mr. L. E. C. Norbury, O.B.E., on' Proctologythroughout the ages.'

Thomas Vicary Lecture. Wednesday, November17th, at 5 p.m., by Mr. Geoffrey Keynes, on ' Theportraiture of William Harvey.'Imperial Cancer Research Fund Lecture. Tues-day, November 23rd, at 3.45 p.m., by Dr. CuthbertDukes, O.B.E., on 'The significance of the unusual inthe pathology of intestinal tumours.'A programme of post graduate teaching has beenarranged, including study of the basic sciences, surgeryand surgical and allied specialties. In the basic sciencesin addition to Lectures, Practical Demonstrations ex-tending over a period of three months are also held.The following post graduate lectures and demonstrationswill be held at the College:Anatomy, Applied Physiology and PathologyOctober 25th to December I7th (72 lectures).April, May and June, I949 (72 lectures).Anatomy, Applied Physiology and Pathology,Practical DemonstrationsOctober iith to January i4th.March, April, May and June, I949.Surgery and Allied SpecialtiesApril, I949 (24 lectures).AnaestheticsApril, 1949 (45 lectures).Plastic SurgeryMarch, 1949 (12 lectures).Details of the above courses will be published later.

FACULTY OF DENTAL SURGERYAnatomy, Applied Physiology and Pathology intheir application to Dental SurgeryJanuary 24th to February i8th, 1949 (24 lectures).July, 1949 (24 lectures).General, Oral and Dental SurgeryFebruary 21St to March i8th, I949 (24 lectures).September, 1949 (24 lectures).Lecture-Demonstrations in Anatomy, AppliedPhysiology and Pathology in their applicationto Dental SurgeryJanuary 24th to March i8th, I949.July and September, 1949.Details of the above courses will be published later.

Fellowship and Dental Examinations. SpecialFinal Fellowship Examinations have been instituted in

POST GRADUATE MEDICAL JOURNAL

Ophthalmology and Oto-Laryngology. A Fellowshipin Dental Surgery has also been instituted.Conjoint Examinations. The Diplomas of L.R.C.P.,M.R.C.S., are granted jointly with the Royal College ofPhysicians, as well as Diplomas in i i specialties.Scholarships and Prizes. The College grants manyResearch Scholarships and Prizes and in certain casesmakes grants in aid of surgical research, the work beingcarried out either in the College or elsewhere.HOSTEL. Residential accommodation will be availablein the College for post graduate students from January,'949.Full particulars may be obtained from the Secretary, PostGraduate Education Committee, Royal College ofSurgeons, Lincolns Inn Fields, W.C.2.

ROYAL COLLEGE OF OBSTETRICIANSAND GYNAECOLOGISTSA course of advanced lectures will be given as followsNovember15th I2 noon. Mr. A. M. Claye. The use of analgesic

drugs in labour.5 p.m. Mr. H. H. Evers. Post-menopausalhaemorrhage.

i6th 12 noon. Mr. H.3'. Drew Smythe. Induction oflabour.5 p.m. Dr. E. Rohan Williams. X-ray pel-vimetrv.

I7th 12 noon. Dr. R. A. Lennie. Obstetric opera-tions in difficult labour.5 p.m. Dr..7. E. Morison. The establishment ofextra-uterine respiration.

i8th 12 noon. Mr.J7. E. Stacey. Obstetrical damageand repair.5 p.m. Mr. S. G. Clayton. Endometriosis.

i9th 12 noon. Mr. A. Y. Wrigley. Dysmenorrhoea.5 p.m. Dr. A. Wr. Spain. The place of svm-physiotomy in modem obstetrics.

The fee for the course is £4 4s. od., or Ios. 6d. a singlelecture.Applications should be addressed to the Secretarv, RoyalCollege of Obstetricians and Gynaecologists, 58 QueenAnne Street, London, W.i.

SOCIETY OF APOTHECARIES OFLONDONDiploma of Industrial Health. The examinationsare held in July and December each year.Diploma of Mastery of Midwifery (M.M.S.A.).The examinations are held in May and November eachyear.A course of lectures on Modem Therapeutics is beingdelivered in the Hall, Blackfriars Lane, at 5 p.m.Novemberist Dr. Eliot Slater. The cornstitutional factors in

psychological medicine.2nd Dr. Peter Bishop. Use of sex hormones in thera-

peutics.sth Piofessor E. C. Dodds. Endocrinology and its

relation to diagnosis and therapeutics.Fee, 7s. 6d. a single lecture.For regulations relating to the examinations, and applica-tions to attend th-e lectures, apply to the Registrar, Society-of Apothecaries, Blackfriars Lane, E.C. -.

MEDICAL SOCIETY OF LONDONNovember8th 8.o p.m. Pathological Meeting.22nd 8.30 p.m. Discussion on Gastroscopy to be intro-

duced by Dr. Avery Jones, and Mr. HermonTaylor.

i 8th 5.o p.m. Lloyd Roberts Lecture. Mr. J.Johnston Abraham. 'Victorian Doctor.'

December13th 8.30 p.m. Discussion on Therapeutic Applica-

tion of Anti-Coagulants to be introduced byDr. Paul H. Wood and Mr. A. Dickson Wright.

For further inforrmation apply to the Registrar, MedicalSociety of London, i I Chandos Street, Cavendish Square,W.I.

ROYAL INSTITUTE OF PUBLICHEALTH AND HYGIENEThe next course of instruction at the Institute for theCertificate in Public Health, and for Part i of theDiploma in Industrial Health-which is the same andruns concurrentlv-will begin on Friday, March 25th,1949. Successful candidates thereat who desire to doso, will proceed to the course of instruction for theDiploma in Public Health, beginning in August,1949. The course for Part II of the D.I.H. begins onFebruary 18th, I949, for those eligible to take it.The following lectures will be delivered in the LectureHall of the Institute at 3.30 p.m.November3rd Mr. S.. Yohnson-Marshall. The planning of a

modem school in relation to the public health.ioth Dr. N. L. Lloyd. Placing the impaired worker in

industry. (Illustrated.)17th Dr. P. G. H. Gell. Food-and resistance to

disease. (Illustrated.)24th Miss L. M. Clinch. The care and correction of

dental defects in children. (Illustrated.)Admission free, without ticket.Further information can be obtained from the ,SecretaryRoyal Institute of Public Health and Hygiene, 28 PortlandPlace, W. i.

UNIVERSITY OF LONDONThe following lectures will be given, admission free,without ticket:University College (Anatomy Theatre), GowerStreet, W.C.1, on Friday, November 5th, at 5 p.m.,by Professor G. Levi, on ' Relations of interdependencybetween various parts of the nervous system in theembryo and in the adult.' (The lecture will be deliveredin French.)Royal Society of Medicine, 1 Wimpole Street,W. 1. Semon Lecture, on Thursday, November 4th,at 5 p.m., by Mr. G. Ewart Martin, on ' Broncho-oesophagology in Great Britain-the decline of ascience; a plea for better co-operation and teaching.'Westminster Medical School, Myerstein LectureTheatre, Horseferry Road, S.W.1, on Tuesday,November i6th, at 5 p.m., by Dr. Charles Swan, on' Rubella in pregnancy as an aetiological factor incongenital malformations and still birth.' On Friday,November 26th, at 5.30 p.m., by Professor D. Baird onSocial factors in obstetrics.'

6i6 November 1948

Post Graduate News

DENTAL BOARD OF THE UNITEDKINGDOMActing upon the recommendation of the Joint AdvisoryCommittee on Post Graduate Dental Education, aDental Post Graduate Information Bureau has beenestablished for the purpose of collecting and makingavailable to those who require it all possible informationon this subject.

Application for general information should be addressed tothe Director (Brigadier R. A. Brode, ick, D.S.O., M.C.,M.D.S., M.B.), Dental Post Graduate Bureau, 44Hallam Stireet, London, W. .

BRITISH POST GRADUATE MEDICALFEDERATION (University of London)Refresher Courses for General Practitioners will be heldas follows

GeneralNovember 22nd-27th. Royal Sussex County Hospital,Brighton.November 29th-December I ith. Royal NorthernHospital, N.7.MedicineNovember Ist-5th. St. Alfege's L.C.C. 'Hospital,Greenwich.

Fees: £io ios. for 2 weeks' course; £5 5s. for i week.Schemes of financial assistance are available subject tocertain conditions, for (a) demobilized geneial practi-tioners and (b) N.H.I. practitioners.

Applications for places and for further information shouldbe made to the Secretary, British Post Graduate MedicalFederation, 2 Gordon Square, London, W.C. T. Theyshould state if the practitioner is applying under (a) or(b) above, or neither.

INSTITUTE OF CARDIOLOGY(National Heart Hospital) (University ofLondon)Full-time course of instruction lasting three months isavailable for Membership candidates and generalphvsicians. Fee, C26 5s. od.A limited number can be accepted for casual attendanceat Out-patient sessions only. Fee for each attendance,5s.Special short courses lasting two weeks are given atintervals. Fee, £I2 12S. od.Series of lectures on Fridavs at 5 p.m. for generalpractitioners are held from time to time. Fee for theseries, C£i is. od.

Further details and applications for admission to thesecourses should be made to the Dean, Institute of Cardi-ology, National Heart Hospital, Westmoreland Street,London, W.i.

INSTITUTE OF DISEASES OF THECHEST (Brompton Hospital).(Universityof London)The Institute of Diseases of the Chest (MedicalSchool of the Brompton Hospital). The teaching isprimarily by means of attendance on hospital practice,

students enrolling for three months or more on what isat present approximately a half-time course of instructionconsisting of clinical work on the wards and out-patients departments and a certain number of lecturesand demonstrations. For this the fee is 5 guineas forone month or I2 guineas for three months. In specialcases a whole-time programme can be arranged, but thenumbers are restricted for the present by lack of accom-modation. There are three terms annually, com-mencing in January, April and September.For further information applications should be addressedto the Dean, Institute of Diseases of the Chest, BromptonHospital, Fulham Road, S.W.3.

INSTITUTE OF CHILD HEALTH (Uni-versity of London) (Hospital for SickChildren)The Institute of Child Health is associated withthe Hospital for Sick Children, Great Ormond Street,and the Post Graduate Medical School at Hammer-smith Hospital, and also has an arrangement with theQueen Elizabeth Hospital for Children, Hackney. Inits programme, teaching on every aspect of child healthis provided, including the Department for the new-bomand premature infant at the Post Graduate School,Maternity and Child Welfare Clinics, Nursery Homes,etc. The Institute provides tuition throughout the yearin three terms of three months' duration each, com-mencing in January, May and September, and inaddition a series of lectures by specialists and expertsin various spheres is given each term. The fees varyfrom 25 guineas for six months' attendance to 3 guineasfor a week.Applications should be made to the Dean, Institute ofChild Health, Hospital for Sick Children, Great OrmondStreet, London, W.C. i.

INSTITUTE OF DERMATOLOGY (St.John's Hospital for Diseases of the Skin)(University of London)The Institute of Dermatology, (Medical Schoolof St. John's Hospital for Diseases of the Skin). Clinicalteaching takes place in the out-patient department twicedaily, for which the fee varies from i guinea for oneweek to I5 guineas for a year. There are also facilitiesfor study and tuition in the pathological laboratory, butowing to the present restricted accommodation, no wardinstruction is possible as yet. A short course of lecturesis intended for the summer months, and a longer andmore systematic course in the winter. The fees forthese courses will be approximately 4 guineas and ioguineas respectively. Clinical Assistantships will bearranged for the more advanced students.A course of lectures is being given from October, 1948to March, 1949, at 5 p.m. The programme for thefirst two months is as followsNovember2nd Dr. I. Muende. Histopathology of the skin.4th Dr. G. B. Mitchell-Heggs. Complications in

eczema.gth Dr. H. Corsi. Scars.

i ith Dr. L. Foreman. Pruritus.i6th Dr. I. Muende. Histopathology of the skin.17th Dr. C. W. McKenny. X-ray technique.

November I948 6I7

POST GRADUATE MEDICAL JOURNAL

November23rd Mr. A. K. Monro. Abnormalities of the

cutaneous circulation in the lower limb.30th Dr. I. Muende. Histopathology of the skin.

December2nd Dr. G. B. Dowling. Scleroderma.7th Dr. W. _'. O'Donovan. Hysteria cutis.gth Dr. J. L. Franklin. Seborrhoeic dermatoses.14th Dr. I. Muende. Histopathology of the skin.15th Dr. C. W. McKenny. X-ray technique.2Ist Dr. F. Ray Bettley. Cutaneous reticulo-endo-

thelioses.28th Dr. I. Muende. Histopathology of the skin.30th Dr. Brian Russell. Affections of the lips and

mucous membranes.An examination will be held at the end of the course,in April, when the Chesterfield Medal will be awardedto the best candidate, provided the required standard isreached.

Clinics. Instructions will be given in the out-patientdepartment to a limited number of Post Graduates.

Laboratory. Arrangements can be made for Classes,individual instruction or for research work.

Thefeefor the lectures is £Z 2S. od. per month (£xo Ios. od.for six months). Enquiries should be made to the Dean,Institute of Dermatology, St. John's Hospital, 5 LisleStreet, Leicester Square, London, W.C.2.

INSTITUTE OF LARYNGOLOGY ANDOTOLOGY (Royal National Throat, Noseand Ear and Golden Square Hospitals)(University of London)A comprehensive course lasting 20 weeks and designedto cover the whole field of the specialty is held twice ayear in January and July. This consists of lectures,demonstrations and attendance on the practice of thehospital, with facilities for dissection. A special point ismade of the anatomy, physiology and pathology relatedto the subject. Advanced students mav obtain additionalexperience by appointment as Out-patient Assistants.The composite fee, including enrolment as a clinicalassistant, attendance on the hc spital practice and at oneof the comprehensive courses, but excluding dissection,varies from 35 guineas for three months to 4 guineas fora year. There are lower rates for attendance on thehospital practice only.For further information applications should be addressedto the Dean, Institute of Laryngology and Otology, 330Gray's Inn Road, W.C.x.

INSTITUTE OF OBSTETRICS ANDGYNAECOLOGYQueen Charlotte's Matemity Hospital and the ChelseaHospital for Women have combined with the PostGraduate Medical School of London to form an Instituteof Obstetrics and Gynaecology. Courses of instructionand training for advanced students began on OctoberI st, I 948.Requests for information and applications for enrolment,stating qualifications and previous experience, should be

sent to the Secretary, Institute of Obstetrics and Gynae-cology, Post Graduate Medical School, Ducane Road,London, W. 12.

INSTITUTE OF OPHTHALMOLOGY(Royal London Ophthalmic, Royal West-minster Ophthalmic; Central LondonOphthalmic Hospitals) (University ofLondon)A course of lectures and classes extending over a periodof five months, to meet the requirements of candidatesentering for the examinations for Diplomas and Degreesin Ophthalmology, will be given by members of theHonorary Staff of the Hospital and others, commencingon March Ist and October iSt of each year.

Part I. Anatomy (including embryology and his-tology), physiology of the eye, optics (elementary andphysiological). Composition fee, £15 15s. od.

Part II. Bacteriology, pathology, operative surgery,ophthalmoscopic conditions, medical ophthalmology,lectures on extemal diseases, retina and optic nerve,motor anomalies, uveal tract, etc. Composition fee,,C26 5s. od.

Students can attend the clinical practice of the Hospitaland hold the appointments of Junior Clinical Assistantsand Clinical Assistants concurrently with the abovecourse.

Extra Courses. Slit Lamp Microscopy (fee,£5 5s. od.), Orthoptic Training (one week's intensivecourse, fee, £5 5s. od.), Contact Lenses (one week'sintensive course, fee, £io IOS. od.).

For further information applv to the Academic Secretary,Institute of Opthalmology, Judd Street, London, W.C. i.

INSTITUTE OF ORTHOPAEDICS(University of London)The Institute is concemed with post graduate educationin orthopaedics and with research. The practice of thehospital, both at the Central Hospital in Great PortlandStreet, and at the country branch at Stanmore, is opento post graduates, who may attend for various periods.In addition to hospital practice, formal courses of variouslengths are held during academic terms. Selectedstudents have opportunities of taking an active part inthe work of the Institute and Hospital and of spendingin the Institute up to two years of their training; a highstandard is demanded and they should bave previoussurgical training, experience or qualification, or previousanatomical, physiological or pathological experience.A systematic course in orthopaedics started on October4th and will continue until March igth, with a breakfrom December sith to January ioth. This is a com-prehensive course including the full practice of theTown and Country Hospitals and over I50 demonstra-tions and lectures. The ' practice of the hospital ' isopen to post graduates who can join at any time.Facilities for adNanced clinical work are available forselected candidates having a suitable scientific or surgicaltraining.Furrher particulars may be obtained from the Dean,Institute of Orthopaedics, Royal National OrthopaedicHospital, 234 Gutat Portland Street, W4.7.

6i8 Novemnber 1948

Post Graduate News

INSTITUTE OF PSYCHIATRY (BethlemRoyal Hospital and Maudsley Hospital)(University of London)Lecture and demonstration courses for the session1948-49 will take place, at the Maudsley Hospital, asfollows:

First-year Students. First term, io weeks beginningOctober 4th, second term, io weeks beginning January3rd, and third term, jo weeks beginning April 4th.

Second-year Students. First term, io weeks be-ginning October 4th, second term, io weeks beginningJanuary 3rd, and third term, IO weeks beginningApril 4th.

Application for further information must be made to theSecretary, Institute of Psychiatry, Maudsley Hospital,Denmark Hill, London, S.E.5.

INSTITUTE OF UROLOGY (CombinedSchool of St. Peter's and St. Paul'sHospitals) (University of London)Three courses are held annually, January to April,April to July, September to December. Instruction in-cludes systematic lectures, out-patient sessions, wardvisits, operation sessions and tutorial demonstrations.All post graduates attending a course are expected toattend lectures, and may attend all the tutorial demon-strations. They will be allotted individually to certainout-patient sessions, ward visits and operation sessions.Fee, ,£15 I 5s. od.A short intensive course of two weeks duration, forpost graduates taking higher surgical examinations, isheld in early September and April.

Applications should be addressed to the Secretary, St.Peter's Hospital for Stone, Henrietta Street, W.C.2.

NATIONAL HOSPITAL, Queen Square(Institute of Neurology)Post Graduate training is provided in the various depart-ments of neurology. The out-patient practice is openat io a.m. every day, except Saturday. A fee of£2 2S. od. per month is charged for attending the out-patient department only. The in-patient practice isopen at io a.m. and a limited number of Clinical Clerksare appointed. Fees, three months, £15 I5s. od., sixmonths, £29 8s. od.

Applications should be addressed to the Dean, MedicalSchool, National Hospital, Queen Square, London, W.C. i.

POST GRADUATE MEDICAL SCHOOLOF LONDON (University of London)The Post Graduate Medical School of London (formerlythe British Post Graduate Medical School) is associatedwith the Hammersmith Hospital, Ducane Road, W.12.It has University Departments in Medicine, Surgery,Obstetrics and Gynaecology, and Pathology. TheDepartment of Obstetrics and Gynaecology togetherwith Queen Charlotte's and the Chelsea Hospitals, nowforms the Institute of Obstetrics and Gynaecology. Theteaching in the clinical departments, which is of anadvanced nature and based on ward work, is continuousand is supplemented by lectures during three io-week

sessions starting in January, April and October.Suitable students are encouraged to undertake researchwork. A course for the University Diploma in ClinicalPathology, lasting one year, is available for a limitednumber of selected students. This commences inOctober. In anaesthetics, short practical courseslasting a fortnight, and longer periods of training for sixmonths, are provided. The Department of Radiologyof the Hospital provides courses for the Diplomas inMedical Radiology of the University and ConjointBoard. The fees vary from £3 for one week to £c60for a year.

For further information application should be made to theDean, Post Graduate School of London, Ducane Road,W.12.

DREADNOUGHT SEAMEN'SHOSPITAL, Greenwich, S.E.10Clinical Demonstrations

Novemberi8th Mr. D. M. Cooper. Surgical ward round.

Dr. R. L. Mansi. X-ray films.

There is no fee for attendance.

LONDON CHEST HOSPITALA course of lectures and demonstrations will be held at5 p.m. on Fridays, as follows:Novembersth Mr. V. C. Thompson. Surgery of the oesophagus.12th Dr. R. Sleigh Johnson. Acute respiratory in-

fections.igth Dr. _J. R. B. Hern. Asthma.26th Dr. Franklin Wood. X-ray kymography of the

heart and lungs.December3rd Dr. R. A. Beaver. Anaesthesia for thoracotomy.

ioth Dr. Y. Smart. Mediastinal tumours.

17th Dr. Shirley Smith. Clinical and cardiographicmethods in the diagnosis of coronary syndromes.

January7th Mr. T. Holmes Sellors. Surgery of the heart

and pericardium.i4th Dr. N. Lloyd Rusby. The application of collapse

therapy in pulmonary tuberculosis.21st Dr. N. S. Plummer. Pain in the chest.28th Dr. Y. L. Lovibond. Extrathoracic pain in cardio-

vascular disease.

February4th Dr. E. H. Hudson. Differential diagnosis of

carcinoma of the lung.iIth Dr. K. F. W. Hinson. Pathology of pneumo-

coniosis.i8th Mr. J3. W. S. Lindahl. The place of E.N.T.

surgery in the treatment of chest diseases.25th Mr. D. S. M. Barlow. Treatment of empyema.

March4th Dr. Bertram Jones. Atypical pneumonia.

November I948 6I9

POST GRADUATE MEDICAL JOURNAL

Marchi ith Dr. Parry Brown. General anaesthesia for sur-

gery of the heart.i8th Dr. J. Browning Alexander. Acute pericarditis.25th Dr. H. V. Morlock. Indications for broncho-

scopy in chest diseases.

Fee, C3 3s. od., except for serving and demobilizedmembers of H.M. and Allied Forces.

Applications should be addressed to the Dean, LondonChest Hospital, Victoria Park, London, E.2.

LONDON SCHOOL OF HYGIENE ANDTROPICAL MEDICINE (University ofLondon)Course of study for the University of LondonCertificate and Diploma in Public Health. Thecourse is designed for qualified medical practitioners andis intended primarily to prepare them for the AcademicPost Graduate Certificate and Diploma in Public Healthof the University of London. The preliminary part isintended to meet the needs of registered medicalpractitioners who intend to devote themselves to anybranch of Public Health work, and the full course isintended to provide more advanced instruction forthose practitioners who wish to qualify themselves forappointments in which they are required by law to holdregistered Diplomas or Degrees in Public Health (orState Medicine). The preliminary course lasts threemonths, and the complete course covers one academicyear of nine months, and tuition begins at the end ofSeptember in each year. The tuition fee for the coursefor the Certificate in Public Health is £2I, and for thefull course is £56 14S. od. (both payable at the time ofenrolment). These fees include payments in respect ofwork in a public health department, instruction in in-fectious diseases and hospital administration, and certainvisits. They do not include University registrationand examination fees. The registration fee, payable tothe University by students who have not previouslymatriculated in the University of London, is £3 3s. od.Application for admission to the course should be madeto the Registrar of the School. Applications fromnationals from Pakistan and India should be madethrough the offices of their respective High Commis-sioners in London. Part-time students are not at presentadmitted to the course. The detailed regulations,govemed by the Rules of the General Medical Council,are issued by the University of London.

Course of study for the Diploma in TropicalMedicine and Hygiene (England). The course isintended primarily to prepare qualified medicalpractitioners for the examination of the Conjoint Boardfor the Diploma in Tropical Medicine and Hygiene.The course is open to any qualified medical practitioner,but those not holding a medical qualification registrablein England should consult the Secretary of the Con-joint Board, 8, Queen Square, London, W.C.I, re-garding their admissibility to the examination for theDiploma. The course is a continuous one of five monthsduration, preparing for a single examination by theConjoint Board. The tuition fee for the whole courseis /:40, but it does not include the examination feepayable to the Conjoint Board.

Application for admission to the course should be madeto the Registrar of the School. Students from overseasare advised to make application as early as possible in

order that they may be assured before sailing that thereis a place available. Applications from nationals fromPakistan and India should be made through the officesof their respective High Commissioners in London.

Course of study for the Academic Diploma inBacteriology. This course is designed to preparecandidates for the Academic Post Graduate Diploma inBacteriology of the University of London. The courseis open to graduates in medicine, science and pharmacyof the London or another approved University, whoseprevious training has, in the opinion of the LondonUniversity fitted them to profit by the course; reg-istered medical practitioners and other students who,though not graduates, have obtained a qualification andundergone a previous training which, in the opinion ofthe London University, has fitted them to profit bythe course. The course begins about the first week inOctober in each year and lasts one academic year ofnine months. The examination for the Diploma isheld once in each year beginning on the Thursdayfollowing the third Monday in June. The compositefee for the course is £56 14S. od. ; this includes tuition,hire of microscope, and the provision of a clean gownand towel each week. The examination fee is £;5 5s. od.The registration fee, payable to the University bystudents who have not previously matriculated in theUniversity of London, is £3 3s. od.Applications for admission to the course should be sub-mitted to the Registrar of the School, and should beaccompanied by a statement of the candidate's pastexperience, and of the particular branch of bacteriologythat he intends to take up in the future. A list ofpublications, if any, should also be included. It isimportant to know whether the candidate is going to takeup bacteriology as a whole-time career. The number ofplaces is strictly limited. Applications for admissionshould be received by the end of March; candidateswill be informed by the end of April whether or notthey can be admitted.Applicants who are interested in hospital pathology asopposed to public health bacteriology are reminded thata course for the Diploma in Clinical Pathology is avail-able at the Post Graduate Medical School of London.

Short courses in the principles of MedicalStatistics and Statistical Methods. In addition*to the general course of instruction in medical statisticsand elementary statistical ideas and methods whichforms part of the curriculum of students working foracademic diplomas, the Department of Medical Statisticsoffers a short and rather more advanced three monthcourse in these subjects. In this short course particularattention is given to the analysis of medical statisticalmaterial and students are taught, in lectures and bypractical work, the more important methods of treatingand interpreting numerical data. Special lectures aregiven on the general principles of statistical inferenceand the elements of the theory of probability. Thenature and source of medical-statistical data are dis-cussed and lectures given on statistical-epidemiologicalaspects of diseases and on such subjects as occupationaland social aspects of mortality and morbidity, popula-tion sampling methods and tests of inoculation pro-cedures. The programme consists of 4-5 lectures and6-7 hours of practical work each week, usually arrangedto occupy two whole days. The days and hours ofattendance are not fixed but are arranged from term toterm to fit in with other courses in the School and tomeet, when' possible, the needs of students who wishto take this part-time course and to carry on with otherwork at the same time. Those with more time at their

620 November ii948

Post Graduate News

disposal are able to do additional practical work and areassisted in analysing statistical material of their ownoutside the fixed hours of classes. The course laststhree months and is held twice a year, beginning in thefirst week of January and about mid-April, if sufficientapplications are received. The fee for the course is,CI2 I2S. od. Application should be made to the Registrarof the School not less than one month before the courseis due to begin.

Course in Applied Helminthology. A short courseis held from time to time, and is designed for membersof staffs of agricultural colleges, officers or intendingofficers of the Colonial Agricultural and VeterinaryServices, and officers engaged under local authorities.The course lasts three weeks and is held in the monthof July, but it is not held every year. The fee for thecourse is £4 4s. od.

METROPOLITAN EAR, NOSE ANDTHROAT HOSPITALThe post graduate training is the traditional one ofbeing appointed as clinical assistant to one of thehonorary surgeons, taking part in the out-patient clinicsand assisting at operations. Special four-week coursesare held for general practitioners, which necessitateattendance at the hospital at least twice a week forlectures, practical demonstrations and training in theexamination of patients. In addition there are frequentintensive week-end courses for general practitioners.There is a daily HIearing Aid clinic at the Hospital.

For further information applications should be addressedto C. Eisinger, M.D., Metropolitan Ear, Nose and ThroatHospital, 14-I6 Granville Place, W.i.

ROYAL EYE HOSPITALThe following lectures are open to both post graduateand undergraduate students :-

Anatomy of the Eye and Orbit. Professor ThomasNicol, at 5.30 p.m. on Mondays, November 29th toJanuary 24th (excluding December 27th).

Operative Surgery Mr. B. W. Rycroft. At 5 p.m.on Wednesdays, November 24th to February 2nd(fortnightly).Science and Art of Refraction. Dr. T. H. Whit-tington, at 5.0 p.m. on Tuesdays, November 2nd toDecember 14th. (A practical course will be arrangedin conjunction with the lectures. Fee, £5 5s. od.)

Ocular Aspects of Diabetes. Dr. R. D. Lawrence,at 5 p.m. on Wednesday, November I7th.

Ophthalmic Neurology. Mr. L. H. Savin. At S p.m.on Wednesdays, December Ist to January I2th (excludingDecember 22nd and January 5th).Genetics in Ophthalmology. Professor ArnoldSorsby. At s.o p.m. Thursdays, December gth, x6th,January 13th, 20th.Practical Course in Pathology and Bacteriology.Dr. 3. D. Gray and Dr. A. Cunliffe. At 4.0 p.m. onTuesdays, December 7th to January 25th (excludingDecember 2Ist and 28th). Fee £5 5s. od.

Practical Course in Operative Surgery. Miss

Y. M. Dollar and Miss Mary Savory. By artangement.Fee, £5 5s. od.

Tickets of admission for the lectures are, obtainable fromthe Secretary, Medical School, Royal Eye Hospital, St.George's Circus, S.E.i.

ST. GEORGE'S HOSPITAL MEDICALSCHOOL (University of London)The following lecture-demonstrations will be givenin the Large Lecture Theatre at 4.0 p.m. on ThursdaysNovember4th Dr. Feiling.iith Dr. Curran.i8th Dr. Feiling.25th Dr. Curran.

December2nd Dr. Feiling.gth Dr. Curran.i6th Dr. Feiling.

Open, without fee, to all practitioners and seniormedical students.

For further information apply to the Dean, MedicalSchool, St. Georgv's Hospital, Hyde Park Corner, S.W.i.

ST. STEPHEN'S HOSPITAL(Rheumatism Unit)Two concentrated week-end courses in the RheumaticDiseases are given each year, in March and in October,under the auspices of the Fellowship of Post GraduateMedicine.A limited number of post graduates 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 COUNCILA lecture course in the Rheumatic Diseases will begiven in the Apothecaries Hall, Blackfriars Lane, QueenVictoria Street, E.C.4 on Friday afternoon, November26th, all Saturday, November 27th and Sunday morn-ing, November 28th. Fee for the course is £2 2S. od.

Applications should be addressed to the General Secretary,Empire Rheumatism Council, Tavistock House, (N)Tavistock Square, W.C.i.

LONDON COUNTY MEDICAL SOCIETYA Clinical Meeting will be held at the Lambeth Hospital,Brook Drive, S.E.ii, on November 3rd, at 3.0 p.m.

For further information apply to Hon. Sec., LondonCounty Medical Society, St. Giles Hospital, St. GilesRoad, S.E.s.

November x948 62I \

6zz

BRISTOL

POST GRADUATE MEDICAL JOURNAL

EDINBURGHMedical Post Graduate Department of theUniversity of Bristol

C.P.H. (Certificate in Public Health) and D.P.H.(Diploma in Public Health). Preliminary course forthe C.P.H. occupies ten weeks. Final course for theDiploma occupies the Spring and Summer Terms.Courses run concurrently and begin in October.

D.M.R.D. & T. (Diploma in Medical Radio-Diagnosis and Radiotherapy). The D.M.R.D.covers a period of i8 months. The D.M.R.T. covers aperiod of two years. Course begins in October.

D.P.M. (Diploma in Psychological Medicine)Part I. The course covers a period of ten weeks andbegins in September.

D.C.H. (Diploma in Child Health). A courselasting three months begins in October.

Application for further information and for enrolment incourses should be made to the Director, Medical PostGraduate Studies, The University, Bristol, 8.

CARDIFFThe Welsh National School of Medicine

C.P.H. Wales (Certificate in Public Health).Three months' 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 (Tuberculosis 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.

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,io The Parade, Cardiff.

DUBLINUniversity CollegeThe following courses will be held during the session,1948-49C.P.H. Course and examination. Michaelmas Term.

D.P.H. Course and examination. Hilary and TrinityTerms.

D.P.M. Course and examination. Michaelmas Term.

D.C.H. Course and examination. Michaelmas Term.

Courses, in Tuberculosis, and in Venereal Disease, willbe given during the Michaelmas Term.

Fwither particulars may be obtained on application to theReg.iatrar, University College, Earlsfort Terrace, Dublin.

November I948

Edinburgh Post Graduate Board ofMedicineInternal Medicine. A course lasting 12 weeks, suit-able for graduates wishing a refresher course, or tospecialize in Medicine, begins on April IIth, i949.This course consists of 300 hours instruction comprisinglectures, clinical demonstrations and ward visits. Fee,£31 IOS. od. A similar course will begin October, 1949.

Paediatrics. A short course is run in conjunctionwith the courses in Medicine, and is primarily intendedfor those who wish additional experience in this subject.A small fee is charged and the numbers are limited.

General Surgery. A five months' course of postgraduate surgery will begin on March 28th, 1949, and issuitable for surgeons requiring a refresher course in thecurrent outlook on general surgery, or for graduatespreparing to specialize in surgery ; approximately 280hours of instruction are provided. Fee, C36 i5s. od. Asimilar course will begin October, 1949.

Refresher course for General Practitioners. TheFourteenth General Fortnight Refresher Course,primarily for demobilized Medical Officers (Class II)and for Insurance Practitioners, will be held in May,1949. Twenty hours are devoted to lectures cover-ing a wide range of subjects, with emphasis on re-cent advances in treatment. Fifty hours are allottedto clinical demonstrations and ward visits. Fee forgraduates not claiming expenses from Governmentsources, £Io IOS. od.

Applications should be addressed to Director of PostGraduate Studies, University New Buildings, Edinburgh,8. Applicants for courses in Basic Sciences, InternalMedicine and Surgery should supply particulars ofqualifications and post graduate 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 MelbournePlace, Edinburgh, i.

LEEDS

University of Leeds Post GraduateCommitteeA week-end course in Dermatology will take place onNovember 6th and 7th at the Leeds General Infirmary.

Further information and application forms can be obtainedfrom the Senior Administrative Officer, School of Medicine,Leeds, 2.

Post Graduate News

LIVERPOOLUniversity of Liverpool

The following full-time post graduate courses of in-struction are offered:

Orthopaedic Surgery. A full-time I5-month courseleading to a Mastership in Orthopaedic Surgery(M.Ch.Orth.) open to all medical graduates of ap-proved Universities and to graduates in other facultieswith qualifications in medicine and an F.R.C.S. of oneof the British colleges or its equivalent. The fee for thewhole course is £8o. High priority is given to candidateswho have already attained an F.R.C.S. and to those withexperience in approved centres in general surgery and/orin orthopaedic surgery.

Radiology. A full-time two-year course leading to aMastership in Radiology (M.Rad.) which can be takenin either Radiodiagnosis or Radiotherapy, open tomedical graduates of approved Universities and tomedically qualified candidates who hold approved highermedical diplomas and a degree in a faculty other thanmedicine. The courses amply cover the requirementsof the D.M.R.D. and D.M.R.T. of the Conjoint Board.The fee for the full two-year course is £ioo.

Surgery. A full-time one-year course leading to theMastership of Surgery (Ch.M.) of the University ofLiverpool, open to medical graduates of approvedUniversities and to graduates in other faculties withqualifications in medicine and an F.R.C.S. of one of theBritish colleges or its equivalent. The course is suitablefor candidates who have already completed the Primaryof their F.R.C.S. and will not include instruction inanatomy and physiology suitable for this examination.The fee for the course is £60.

Public Health. A full-time one-year course leading tothe Diploma in Public Health, open to candidates witha medical qualification from an approved University ormedical school. The fee is £60. All courses of in-struction begin in October.

Anaesthesia. A full-time course of post graduateinstruction, limited to ten -students, will begin onOctober Ist and last for one year. This course has beenaccepted by the Conjoint Board of England as fulfillingthe requirements of candidates for the Diploma inAnaesthetics. The fee for the course is £60.

Internal Medicine. For graduates proceeding to ahigher qualification in medicine (e.g. M.R.C.P. orM.D.) there is a part-time course lasting one year.This comprises lectures and demonstrations in path-ology, bacteriology, general medicine, neurology, cardi-ology and radiological diagnosis. The course normallybegins in October, but graduates mav join at other timeswithout disadvantage. The fee for the year's course isC20.

Refresher courses for general practitioners arearranged from time to time.

Applications for further information should be addressedto the Dean, Faculty of Medicine, The University,Liverpool, 3.

MARKET DRAYTON, SALOPTuberculosis Educational InstituteClinical courses at the Cheshire Joint SanatoriumMarket Drayton, Salop, will be held as follows:November 23rd, 24th and 25th; December 7th, 8thand gth, I948. The programme will include chestsurgery, anaesthetics, pneumoconioses, bronchoscopy,artificial pneumothorax, gas replacement, etc., labor-atory work, sanatorium administration and treatmentand internal pneumolysis, and rehabilitation. Limitedto four doctors for each course. Fee, £3 3s. od.Application for further information and enrolment in anyof the courses should be made to Dr. Harley Williams,Tavistock House North, Tavistock Square, London,W.C.I.

OXFORDUniversity of Oxford (Post GraduateMedical Education Committee)Refresher courses for general practitioners have beenarranged as follows

Royal Buckinghamshire Hospital, Aylesbury,November Ist to I5th.Northampton General Hospital, Northampton,November 29th to December ioth.For further information apply to the Chairman, PostGraduate Medical Education Committee, 9I BanburyRoad, Oxford.

SOUTHENDSouthend General HospitalAn abdominal operation session is held every Saturdayafternoon from 2 p.m. to 7 p.m., at which Post Graduatesare welcome. There is no fee. Trains from FenchurchStreet to Southend or to Westcliff are as follows, butPost Graduates are advised to check them in case ofalterations, the time of arrival is stated in brackets.To Southend: I2.1 (1.7), 12.7 (1.19), I2.13 (1.25),12.25 (1.32), 12.32 (1.46). To Westcliff: 12.1 (I.3),I2.7 (I.I5), 12.25 (1.28), 12.32 (1.44). Trains re-turning to Fenchurch Street are as follows. FromSouthend: 7.34 (8.55), 8.4 (9.56). From Westcliff:7.3 (8.30), 7.39 (8.55), 8.8 (9.56).

CONFERENCES, ANNUAL MEETINGS,ETC.Gifford Edmonds Prize in Ophthalmology. ThePrize of £ ioo awarded every two years is offered for thebest essay on a subject dealing with Ophthalmology andinvolving original work, and is open to any BritishSubject holding a medical qualification. The subjectfor the next essay is: ' The Pathology, Aetiologyand Clinical Course of obstruction occurringwithin the Retinal Venous System.' Preferencewill be given to original work based on any branch ofthe subject, rather than to compilations of the writingsof previous observers. Essays must be sent in notlater than December 3Ist, 1948. A leaflet giving fullparticulars of the prize may be obtained from the HouseGovernor, Moorfields, Westminster, and Central EyeHospital, City Road, London, E.C.i.

623November I948

624

BOOKS RECEIVED'Post Mortem Appearances.' By Joan M. Ross,

M.D., B.S., M.R.C.S., L.R.C.P. sth Edition.Geoffrey Cumberlege, Oxford University Press.London. (Pp. 308. 8s. 6d.) I948.'The Rh Blood Groups and their Clinical

Effects.' By P. L. Mollison, A. E. Mourant andR. R. Race. H.M. Stationery Office, London.(Pp. 74. Iis. 6d.) 1948.

' Blood Derivatives and Substitutes.' By CharlesStanley White, M.D., Sc.D. and Jacob JosephWeinstein, B.S., M.D. Williams and Wilkins,Baltimore. Bailliere, Tindall and Cox, London.(Pp. xViii + 484. 4IS.) 1947.

' Bergey's Manual of Determinative Bacteriology.'Edited by Robert S. Breed, E. G. D. Murray andA. Parker Hitchens. 6th Edition. Bailliere, Tindalland Cox. (Pp. xvi + 1529. 8zs. 6d.) I948.'Textbook of the Rheumatic Diseases.' Edited

by W. S. C. Copeman, O.B.E., M.D., F.R.C.P.E. and S. Livingstone, Edinburgh. (Pp. viii + 6I2.With 35I illustrations. 50s.) I948.

' Modem Treatment Yearbook 1948.' Edited bySir Cecil Wakeley, K.B.E., C.B., F.R.C S.,F.R.A.C.S.(Hon.) The Medical Press, London.(Pp. viii + 338. With 26 illustrations. I5S.) 1948.'An Elementary Atlas of Cardiography.' Edited

by H. Wallace-Jones, M.D., F.R.C.P., E. NobleChamberlain, M.D., F.R.C.P. and E. L. Rubin,M.D., F.F.R. John Wright and Sons, Bristol.Simpkin Marshall, London. (Pp. io8. With 99illustrations. I2S. 6d.) I948.

' Introduction to Diseases of the Chest.' ByJames Maxwell, M.D., F.R.C.P. 3rd Edition.Hodder and Stoughton, London. (Pp. xi + 307.With 66 illustrations. 12S. 6d.) 1948.

' A Short Practice of Surgery.' By HamiltonBailey, F.R.C.S., F.A.C.S., F.R.S.E. and R. J.McNeill Love, M.S., F.R.C.S., F.A.C.S. 8thEdition, Part II. H. K. Lewis, London. (Pp. iii+ 420. With 271 illustrations, including 8icoloured plates. £ 12S. 6d.) I948. In five parts,not sold separately.

' Edinburgh Post-Graduate Lectures inMedicine. Volume IV.' Oliver and Boyd, Edin-burgh, for Honyman Gillespie Trust. (Pp. xi +582. i8s. od.) I948.'A Textbook of Clinical Pathology.' Edited by

Francis P. Parker, M.D., University of Virginia.3rd Edition. Williams and Wilkins, Baltimore.BailliRre, Tindall and Cox, London. (Pp. xx +1023. With 229 illustrations. sos.) 1948.'Heart: A Physiologic and Clinical Study of

Cardio-Vascular Diseases.' By Aldo A. Luisada,M.D. Williams and Wilkins, Baltimore. Bailli6re,Tindall and Cox, London. (Pp. xii + 654. With352 illustrations. 55S.) I948.'Textbook of Genito-Urinary Surgery.' Edited

by H. P. Winsbury-White, M.B., F.R.C.S.(Ed).,F.R.C.S.(Eng.) E. and S. Livingstone, Edinburgh.(Pp. xv + 1046. With 45I illustrations, manyin full colour. gos.) 1948.

' Demonstrations of Physical Signs in ClinicalSurgery. Part II.' By Hamilton Bailey, F.R.C.S.,F.A.C.S., F.R.S.E. iith Edition. John Wrightand Sons, Bristol, and Simpkin Marshall, London.(Pp. I96. Freely illustrated. 8s. 6d. per part) 1948.

'Hodgkin's Disease and Allied Disorders.' ByHenry Jackson Jr., A.B., M.D. and Frederic ParkerJr., A.B., M.D., Harvard Medical School. GeoffreyCumberlege, Oxford University Press, London.(Pp. x + 177. With I5 plates. 45s.) 1947.

MISCELLANEOUS NOTESThis Section deals with New Drugs, Preparations, Surgical Instruments,etc. The description of each article is supplied by the Producer.

'ESTIGYN''Estigyn,' known chemically as i7-ethinyl cestradiol,

is an ethinyl derivative of the naturally occurringcestrogenic steroid, alpha cestradiol. It is one of themost potent cestrogens known and is highly active whengiven orally, the ethinyl radicle delaying the decom-position of the cestradiol molecule in the stomach,intestine and liver. It is exceptionally well toleratedand, being derived from natural sources, possesses theadvantages inherent in natural cestrogens. It is usefulfor hypo-ovarianism, menopausal disorders and func-tional uterine bleeding.

Irregular uterine hxemorrhage, when due to non-

ovulation, may be corrected by giving ' Estigyn ' indoses of 0.05 mg. six times daily for 20 days, togetherwith progestin 5 mg. on each of the last five days. Thecourse may be repeated as necessary, starting at the endof the period of hiemorrhage which follows a few daysafter the previous course of treatment.

For mammary engorgement smaller doses of'Estigyn ' than those suggested to inhibit lactation maybe given to protect or relieve engorgement of thebreasts. Doses of o.os mg. one to three times a day aresuggested, decreasing the dose as necessary.

Further information and literature will be gladlysupplied on request to the British Drug Houses Ltd.,London.

FELLOWSHIP OF POST GRADUATE,MEDICINE

,, WIMPOLE ST , LONDON, W.iTdephone: LANOIAM 4266

<,. : XPesident<)SIR GORDON GORDON-TAYLOR, K.B.E., C.B., M.S., F.R.C.S.< Chairn of Executive Committe

MAURICE DAVIDSON, D.M., F.R.C.P.Honorwy Treaswer

8 CHARLES D. READ, F.R.CS., F.R.C.O.G.: Honorary Secretarie

MAURICE DAVIDSON, D.M., F.R.C.P.DAVID LEVI, M.S., F.R.C.S.

S> Executit-e ConimitteeCOLIN EDWARDS, M.B., M.RC.P. A. CLIFFORD MORSON, O.B.E., F.R.C.S.HAROLD DAVIS, M.B., M.R.C.P. K. I. NISSEN, F.R.C.S.TERENCE MILLIN, M.ch., F.R.C.S. R. S. BRUCE PEARSON, D.M., F.R.C.P.N. LLOYD RUSBY, D.M., F.R.C.P. SOL. M. COHEN, M.A., F.R.C.S.

Editor SecretaryANDREWN MONRO, M.D., F.R.C.S. Miss M. L. WoXrH

Assistant SecretaryMiss E. A. FoRDER

Only qualified medical practitioners may become Members of the Fellowship of Post Graduate Medicine., Instruction arranged by the Fellowship of Post Graduate Medicine is open only to Members on payment of the

requisite fees. Post graduates (whether Members or not) are not automatically included in the mailing lists,,. but must notify the Fellowship of Post Graduate Medicine, if they wish to be sent sylabuses as published,

and must specify the subjects in which they are interested. Information regarding courses can be obtained from', the Office, daily between io a.m. and 5 p.m. (Saturdays lo a.m. to I2 noon). Telephone: Langhanm 4266.

< )

Please mark clearly which subscription is required-A, B, or C.A. I wish to become a Member of the Fellowship of Post Graduate Medicine; annual subscription, Ios. 6d.B. I wish to subscribe to the monthly POST GRADUATf MEDICAL JouRNAL; annual subscription, 248. pOSt

:: free.C. I wish to become a Member of the Fellowship and also to subscribe to the PosTGRDuATE MEDICAL

JouRNAL; combined anual subscription 34s. 6d.> (All subscriptions from month of joining unless otherwise requested. If syllabuses are required, please

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Applicants for Membership of the FeRowship must also complete the folowing:Medical qualifications, University or Medical School and year of graduation

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November i 948Banker's order form for subscriptions to the JouRNAL are obtainable on request.