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PATRICK JOHN SINCLAIR HAMILTONMB Edin, FRCP, FFCM

Patrick Hamilton, professor of community health at theLondon School of Hygiene and Tropical Medicine, died onJune 12 in Ougadougou, West Africa, in the course of amission to the WHO Onchocerciasis Control Programme.He had not been in good health; but, characteristically, hethought that he should honour an important commitment.His death, at the age of 53, robs community medicine of oneof its most gifted members.He graduated in medicine in 1958, having studied at Cambridge

and Edinburgh. Military service in Nepal aroused his interest intropical diseases, and he went on first to work in a leprosy hospital inWest Bengal and then as lecturer in medicine at Makerere, Uganda.Afterwards he returned to the London School of Hygiene andTropical Medicine, where the late Donald Reid recognised hisremarkable talents in epidemiology and the organisation of research.The Whitehall Study of cardiorespiratory disease in 18 000 CivilServants was proposed by Reid; but it was Hamilton, with hissuperb powers of organisation and diplomacy, who turned the ideainto reality. This study, from which so many important findingshave emerged, was the first of the new pattern of very largeepidemiological surveys, based on high-quality standardisedmethods.

In 1971 he became the first head of the new TropicalEpidemiology Unit at the London School of Hygiene and TropicalMedicine, where his success led to his appointment by WHO in1975-whilst still only 40 years old-to inaugurate the CaribbeanEpidemiology Centre in Trinidad. He proved an ideal choice,combining experience in epidemiology and tropical medicine with awarm, enthusiastic outgoing personality and an ability to get thingsmoving. These were the most successful and happiest years of hisprofessional life.

In 1982 he came back to the London School of Hygiene andTropical Medicine as head of the Department of CommunityHealth. His return coincided with hard times for universities andmedical research; his plans for new developments met manyfrustrations, and he was saddened by unfulfilled expectations.These are traumatic days not only for research but also for

researchers, especially those with enthusiasm; health services

research in particular has been an intractable problem.His wide experience and tremendous zest made him a natural

leader. He was President of the Harveian Society, and councilmember of (inter alia) the Osler Society and the Association for theStudy of Medical Education. Within community medicine heworked successfully to counter the separation of its academic andservice branches.Few men had so many friends, both within medicine and outside

it. They will remember him with deep affection for his warmth andhis total absence of guile, and with respect for his high expectationsof himself and others and for his personal courage and commitment.Behind his public life lay the support of a strong family life and of hiswife, Fiona, and their two children.

G. R.

International Diary

1989

7th annual symposium on Clinical Update in Anesthesiology: PuertoVallarta, Mexico, Jan 14-21 (Helen Phillips, Mount Sinai Medical Center, 1Gustave L. Levy Place, Box 1010, New York, NY 10029, USA).

5th meeting on Alzheimer’s Disease: Zurich, Switzerland, Jan 21-22(Prof R. J. Wurtman, Building E25-604, Whitaker College, MassachusettsInstitute of Technology, Cambridge, MA 02139, USA).

Workshop on The Role of Women in Health Sciences and HealthCare in Developing Countries: Madras, India, Feb 1-5 (Prof C. V.Ramaknshnan, Honorary Programme Director, COSTED, Gandhi

Mandap Road, Guindy, Madras-600 025).

Notes and News

MENINGOCOCCAL VACCINATION FOR PILGRIMSTO SAUDI ARABIA

PILGRIMS going to Saudi Arabia for the Haj, which starts on July20, will be required by the Saudi authorities to show written proofthat they have been immunised with meningococcal vaccine.Immunisation is not required for other travellers to Saudi Arabia,but the Department of Health and Social Security advises that itshould be offered to business or other travellers who will be in

Jeddah during the period of the Haj.The meningitis outbreak during last year’s pilgrimage was a

group A meningococcal infection, but meningococcal vaccineagainst serogroups A and C are not at present licensed under theMedicines Act 1968 and must be obtained directly from themanufacturers on a named-patient basis. The vaccines may beobtained in single-dose vials from Merieux UK Ltd (telephone0628 785291) or in ten-dose vials from Smith, Kline and FrenchLtd (telephone 07073 25111). Merieux provide a certificate ofvaccination for completion when the vaccine has been administered.Individuals receiving Smith, Kline and French vaccine will alsoneed written evidence of vaccination. A single injection of vaccineprovides immunity against appropriate meningococcal groups forapproximately 3 years.The Saudi authorities have stated that the certificate of

vaccination should have been issued not more than 2 years and notless than 3 weeks before the date of arrival. It is not known how

strictly the 3-week limit will be enforced.

PATHOLOGICAL SPECIMENS BY POST

THE deputy chief medical officer and safety officer to the PostOffice, Dr M. A. H. Webb, has issued the following reminder tomedical and laboratory staff wishing to send pathology specimensby post:

"Deleterious substances and things likely to injure other postalpackets or persons engaged in the business of the Post Office arenormally prohibited from transmission by post. However,pathological specimens, excluding those known or suspected tocontain Hazard Group 4 pathogens, requiring examination oranalysis may be transmitted by post provided that they are sent inpackaging which meets Post Office requirements.

"Specimens may be sent by a qualified medical practitioner or aregistered dental practitioner or a veterinary surgeon or a registerednurse or a recognised laboratory or Institution."Under no circumstances may members of the public post any

pathological specimen unless it is at the specific request of aqualified medical practitioner or a registered dental practitioner or aveterinary surgeon or a registered nurse or a recognised laboratoryor Institution. In such cases, the person or organisation making thisspecific request of a member of the public must supply the approvedor specified packaging and provide clear instructions on its use.

"Only the first class Letter Post or Datapost services may be used.The parcel post service may not be used."

Details of packaging requirements are included in the Post OfficeGuide, which can be bought from main Post Offices or fromHM Stationery Office.

SEXUALLY TRANSMITTED DISEASES 1986

FIGURES published last week by the Department of Health andSocial Security’ show that the number of new cases seen at NHSgenitourinary medicine clinics is continuing to rise, reaching647 000 in 1986. In that year 46% of new cases were in women,compared with 40% in 1976. About a quarter of new cases in bothsexes proved not to need treatment. The incidence of syphilis andgonorrhoea accounted for only 7% of new cases in 1986, compared

1 DHSS Statistical Bulletin 2 7 88. New cases seen at NHS Genito-Urinary Clinics inEngland 1976-1986 ISBN 1-85197198 X. Department of Health and SocialSecurity, Information Division, Canons Park, Government Buildings, HoneypotLane, Stanmore HA7 1AY £2

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with 16% in 1976. The incidence of these two diseases is an

important indicator of the spread of human immunodeficiencyvirus infection, and the DHSS suggests that the faster fall in theincidence of gonorrhoea in men than in women may indicatechanging patterns of sexual behaviour in male homosexuals as theybecome aware of the mode of spread of AIDS.

Non-specific genital infections were twice as common in men asin women in 1986 (740 and 364 cases per 100 000 population,respectively), but the rate for women was 2 times its 1976 level,whereas the rate for men had risen by only 37%. The incidence ofgenital warts has been rising steadily over the past 10 years in bothsexes, but again the rate has increased much faster in women(trebling in 10 years), although the incidence is still higher in men.This is of particular concern because of the possible link betweenpapillomavirus infections and cervical cancer.

LEGAL DEFEAT FOR US TOBACCO COMPANY

A New Jersey jury last week found the Liggett Group, a UStobacco company, partly responsible for the death from lung cancerof a woman cigarette smoker and awarded her widower damages of$400 000. This was the first defeat in the courts for the tobaccocompanies and is likely to lead to many similar trials, but the majorclaims that Liggett, Lorillard Inc, and Philip Morris Inc haddeliberately conspired to mislead smokers in the 1950s and 1960sabout possible health risks were dismissed. However, Liggett wasfound to have guaranteed, falsely, that its products were safe in1950s advertisements; Liggett will appeal against the decision, butthe tobacco companies will be hampered in future cases by theforced disclosure of thousands of internal documents that showedthe extent of the industry’s knowledge of possible health risks beforepublic warnings were made.

British Heart Foundation

The British Heart Foundation has awarded 11 new research

fellowships, totalling over L600 000. 71 500 has been awarded toMr Gianni Angelini, Department of Cardiology, University ofWales College of Medicine, Cardiff, for a 3-year study designed toimprove the patency rate of coronary artery bypass grafts. Dr PaulMcKeigue, University College and Middlesex School of Medicine,London, has been awarded 79 000 for a 3-year confirmation studyof the reasons for the high incidence of coronary heart disease inAsians living in the United Kingdom.

Chimpanzees Threatened by AIDS Research

The chimpanzee could be in danger of extinction if USGovernment scientists are allowed to take the thousands of chimpsfrom the wild that they claim are necessary for the development of acure for AIDS, according the the Fund for Replacement of Animalsin Medical Experiments (FRAME).

Cyclotron for St Thomas’ HospitalThe Government has announced a C6 million capital grant to the

Cyclotron Trust, which plans to provide a 60 MeV cyclotron toaccompany a positron emis; on tomographic (PET) scanner to beinstalled by St Thomas’ Hospital, London.

Video for Parents of Glue Sniffers

The society for the Preventi- - of Solvent and Volatile SubstanceAbuse (Re-Solv) has produceú video to help parents, teachers,doctors, and youth workers prevent and reduce the abuse ofsolvents. The video, which was funded by the Government, isavailable GC20, cheques payable to Royal Society of MedicineLtd) from the Royal Society of Medicine, Film Distribution, POBox 82, Worcester WR6 6YN.

Annales de Médecine Interne

The editorial board of the journal has decided to accept articlesfor publication in English. These articles will be accompanied by asummary in French.

An exhibition entitled Health For All-The Origins of the NationalHealth Service 1848-1948 is being held at the Wellcome Institute for theHistory of Medicine, London NWl, on June 7-Sept 2: Dr LindsayGranshaw, Exhibition Organiser, Wellcome Institute for the History ofMedicine, 183 Euston Road, London NWl (01-387 4477 ext 3035).

A workshop on Platelet-activating Factor-Its Role in Pulmonaryand Cardiovascular Disease is to take place at the Cardiothoracic

Institute, London SW3, on Friday, July 1: Mrs P. de Chazal, PostgraduateCourse Administrator, Cardiothoracic Institute, Fulham Road, LondonSW3 6HP (01-3518003).

A seminar entitled Natural Food Toxins will take place at 15 BelgraveSquare, London SWl, on Friday, July 1: British Nutrition Foundation, 15Belgrave Square, London SWIX 8PS (01-235 4904).

A conference on The Treatment of Stroke is to take place at Regent’sCollege, London NWl, on June 27-29: Dr Jackie Spiby, King’s FundCentre, 126 Albert Street, London NW1 7NF (01-267 6111).

A course on Refugee Community Health Care will take place at theImperial College of Science and Technology, London, on June 27-July 1:Catherine Gibb, Bureau for Overseas Medical Service, Africa Centre, 38King Street, London WC2E 8JT (01-836 5833).

A conference on Medicine and Charity is to take place at ExeterUniversity on July 8-10: Honorary Secretary, Linda Bryder, QueensCollege, Oxford OXl 4AW.

Corrections

Pancreas Transplantation for Diabetes.-In Dr E. R. Sutherland andcolleagues’ letter (May 14, p 1100) paragraph 4, line 10, should read"recipients are insulin-independent at 1 year ...".

Rapid Diagnosis of Cytomegalovirus Infection by In-situ Hybridisation inLiver Grafts.-The authorship of this paper (June 18, p 1361) should haveincluded, in fourth position, Dr Sheena Sutherland.

Diary of the Week

JUNE 26 TO JULY 2

Monday,,27thINSTITUTE OF LARYNGOLOGY AND OTOLOGY, 330/332 Gray’s Inn Road,

London WCIX SEE5.30 pm Mr A. Baxter: Eustachian Tube Function.

ST GEORGE’S HOSPITAL MEDICAL SCHOOL, Cranmer Terrace, LondonSW I7 ORE

12.30 pm Mr P. Mason. Staging Carcinoma of the Cervix

Tuesday, 28thICRF CANCER EPIDEMIOLOGY AND CLINICAL TRIALS UNIT, Ida Green

Serrunar Room, Observer’s House, Green College, Oxford5 pm Elizabeth Greenhall and Mike Murphy: Subfertility in the Community and

Effects of Infertility Treatment on Subsequent Children.

Wednesday, 29thROYAL FREE HOSPITAL, 10th Floor, Pond Street, London NW3. 5 pm Dr B. Hendry: Cell Membrane Transport in Renal Failure.CHACE POSTGRADUATE MEDICAL CENTRE, Chase Farm Hospital, The

Ridgeway, Enfield, MiddlesexI pm Prof John Lumley: Confidential Enquiry into Postoperative Deaths.

Thursday, 30thROYAL POSTGRADUATE MEDICAL SCHOOL, Hammersmith Hospital,

Du Cane Road, London W12 OHS12.30 pm Prof Simon Howell: Insulin Secretion.

INSTITUTE OF OBSTETRICS AND GYNAECOLOGY: Queen Charlotte’s.

Maternity Hospital, Goldhawk Road, London W12 OHS12.30 pm Dr Shortland: The Outcome of Pennatal Leukomalacia.

UNITED MEDICAL & DENTAL SCHOOLS OF GUY’S AND ST THOMAS’SHOSPITALS, St Thomas’ Campus, Lambeth Palace Road, LondonSEl 7EH

4.30 pm Prof D. A. G. Galton: Chronic Lymphoid Leukaemias (Gordon Wetherley-Mem memonal lecture).

Friday, 1stCARDIOTHORACIC INSTITUTE, Fulham Road, London SW3 6HP

8 am Dr Peter Roberts (New Zealand): Eosinophils and Asthma.