733

GENERAL MEDICAL COUNCIL

PRESIDENT’S ADDRESS

THE 162nd session opened last Tuesday with an addressfrom the President, Sir HERBERT EASON. He beganwith a tribute to three former members of the Councilwho had died since the last meeting, Sir HumphryRolleston, Mr. Hey Groves and Sir Robert Kelly. Herecorded with regret the retirement from the Council ofSir Henry Tidy, whose modesty and integrity made himone of its most influential members ; of Mr. E. L.’Sheridan, chairman of the Dental Board, " a mostcharmirig colleague and one who represented the highesttraditions of the dental profession," and of Prof. J. H.Burn, whose profound knowledge of pharmacology wasof value to the pharmacopaeia committee. He welcomedLord Moran as representative of the Royal College ofPhysicians of London, Prof. W. J. Dilling as representa-tive of the University of Liverpool, and Mr. JamesLyons as an additional member under the Dentists Act,and he congratulated Dr. E. W. Fish on his appointmentby the Privy Council as the new chairman of the DentalBoard.

REVISION OF THE CURRICULUM

On Sept. 18, the President said, a letter was receivedfrom the Minister of Health referring to the report ofthe Interdepartmental Committee on Medical Schools(the Goodenough Committee) and saying that it wouldgreatly assist him to know whether early action wouldbe taken by the Council with regard to the revision ofthe medical curriculum, and if so what was likely to bethe general nature of such action. " In view of thiscommunication from the Minister I called a joint meetingof the education and examination committees on Oct. 4,And the Council have resolved that in view of the report ofthe Interdepartmental Committee, the Council are pre-pared to take the initiative forthwith in the matter of therevision of the medical curriculum. In order to giveeffect to this resolution a revision. will be undertakenforthwith of

(1) The recommendations in regard to the registration ofmedical students, incorporating resolutions in regard togeneral education and preliminary scientific subjects,adopted by the Council on May 28, 1937. -

(2) The resolutions in regard to professional education

adopted by the Council on May 29, 1936.(3) The recommendations in regard to professional examina-

tions adopted by the Council on May 25, 1933.Four committees have been appointed to consider andreport jointly to the education and examination com-mittees on the various stages of the curriculum."

EDUCATION IN THE COLONIES

Since Sir Richard Needham’s visit to the schools ofmedicine in Uganda and Nigeria made in 1939-40, theSecretary of State for the Colonies has appointed acommission under the chairmanship of Sir Cyril Asquithto consider the principles which should guide thepromotion of higher education, learning, and researchand the development of universities in the Colonies ;and to explore means whereby universities and otherappropriate bodies in the United Kingdom may be ableto cooperate with institutions of higher education inthe Colonies. The President reported that on July 27he gave evidence before the commission.

THE FACTORY DEPARTMENT IN 1943

THE annual report of the Chief Inspector of Factoriesfor 1943 1 reflects the quickening of interest in thehealth, safety and welfare of factory workers. Thestory of the year’s work is one of achievement carriedout in a breathless tempo with a depleted staff. Forthe first time since 1938 there have been fewer accidents,and the reduction in fatalities noted in 1942 has beenmaintained. The number of accidents to women hasrisen, but more women were working in factories, andthe accident-rate to women in the munition industries-the main source of such accidents--has fallen b) about3 per 1000 Nevertheless the total of 309,924 non-fataland 1220 fatal accidents shows that there is still need forimproved methods of accident prevention.

1. Cmd. 6563. HMSO. 1944. 1s.

The reduction in accidents took place during the latermonths of the year and coincided with a widespreadshortening of working hours. Sir Wilfrid Garrett quotesthe experience of a large factory where three-qua,rters ofthe accidents happened between 4.30 PM and 6.45 PM,a fact which reinforces the argument for a shorter workingday. The general tendency is to reduce hours of employ-ment, but long hours are still being worked in somefactories vital to the war. Experience in 1943 has againshown that production is not in direct ratio to the hoursworked. A recent report by the Industrial HealthResearch Board stresses the difficulty of isolatingreduction of hours from other factors affecting output,but Sir Wilfrid says that inspectors all agree, and manyin management concur, that reasonable hours have agreat effect on the well-being and efficiency of all con-cerned. As regards accident prevention, Sir WilfridGarrett thinks it a misdirection of energy for safetyorganisations to try to make the worker accident-conscious by methods akin to high-pressure salesmanship." Education in method has its place but general exhorta-tions to workers to be careful are of little value unlessit is abundantly clear that the management has doneeverything possible from its end."The special investigations carried out by the depart-

ment include the effects of radioactive substances and-X rays ; the danger of fire and explosion when grindingmagnesium and aluminium, and of petrol fires in testingaircraft engines ; the health risks inherent in handlingleaded petrol, in patent fuel and flax factories, in steelfounding, boiler-scaling and welding. The ventilationand conditions of work in electrical power stations anddrop-forging establishments also received attention.An agreement on improved conditions in boiler-scalingand the cleaning of oil-fuel tanks and bilges on boardship was made during 1943 with representatives ofemployers’ and workers’ organisations. The reportdiscusses the difficulty of harmonising the demands ofthe fuel economy campaign with adequate heating.Ventilating engineers and others too often regard generalventilation by fans as an acceptable method for removingdust or fumes. The department makes a clear dis-tinction between general ventilation and local exhaustventilation, the latter being required by law to take dustand fumes away from the workrooms. Great improve-ments in factory lighting were made during the year.

DISEASES OF INDUSTRY

Dr. E. R. A. Merewether, in his chapter on industrialhealth, discusses the effect of war-time processes on theincidence of notifiable industrial diseases. The numberof cases of lead poisoning notified during the year (46with 5 deaths) is the lowest ever recorded. No casesoccurred in people engaged in shipbreaking and vitreousenamelling, and only 2 were found in potteries and 4 inthe painting of buildings. All these processes havebeen restricted during war-time. On the other handthere have been more cases of poisoning concurrent withgreater activity in the smelting of metals and themanufacture of paints and colours. Two cases of

phosphorus necrosis of the jaw were observed in menworking at a phosphorus filling factory. Poisoning byphosphorus is now never seen in peace-time. Cases ofchrome ulceration rose from 89 in 1942 to 226 in 1943,largely because 131 people were affected in a new processof handling sodium chromate ; the nasal septum wasthe site of the lesion in all except 2 of these cases. Therewere 16 cases, with 4 deaths, of toxic jaundice ; 14 ofthese (3 fatal) were caused by TNT and the other 2 bydinitrotoluene and chlornaphthalene. Of 19 casesnotified as toxic anaemia, 7 had an occupational cause ;6 were due to TNT and 4 of these were fatal. Only 79cases were notified as aniline poisoning, comparedwith 204 in 1942 ; TNT was responsible for 62 ofthem. Poisoning by TNT can thus be notified as toxicjaundice, toxic anaemia or aniline poisoning (cyanosis)according to the predominant signs and symptoms.The single case of chronic benzene poisoning notifiedwas in a .man of 40 who had been employed for about19 years on spreading cloth with a celluloid rubbersolution containing benzene ; he died from aplasticanaemia ending in acute leukaemia.

Only 2 cases of arsenical poisoning were notified, butone of these, a maker of sheep-dip containing sodium