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alarm reaction characterised by increased corticoid secretion;resistance; and exhaustion-which constitute a "general adaptationsyndrome". If the third stage is reached, death quickly follows. Hisso-called diseases of adaptation-such as rheumatoid arthritis, acutegastrointestinal erosions, some renal disease, and some circulatorydisorders-would result from abnormal endocrine responses tostress. He was thus one of the first to use corticotropin in thetreatment of rheumatoid arthritis.He published over 1600 articles. His 33 books include Chemical

Prevention of Cardiac Necroses (1958), Calciphylaxis (1962), TheMast Cells (1965), Thrombohemorrhagic Phenomena (1966), andStress Without Distress (1974).

Parliament

Hospitals ReprieveThe closure of 40 beds at the Great Ormond Street Hospital for

Sick Children, due to have taken place last Monday, was averted atthe last moment by a Government grant of;C100 000 which will tidethe hospital over its crisis until December. The deputy housegovernor, Mr Graham Humphreys, said that proposals to close bedsat the hospital could now be deferred until further notice. Despitethe public concern which has probably arrested the erosion offacilities at Great Ormond Street, the fate of Tadworth CourtHospital in Surrey, which provides long-term care for severely illchildren and offers parents a respite from caring for chronicinvalids, is still in the balance. Tadworth Court is threatened withpermanent closure from next April. Mr Norman Fowler, Secretaryof State for Social Services, warned when he announced the grantlast Friday that the grant had merely served to keep the hospitalopen until he meets the governors on Nov. 17. The Minister for,Health, Mr Kenneth-Clarke, has asked for a full financial report onthe two hospitals.

’

Voluntary Organisation on Alcohol MisuseMr Clarke announced Government support for the establishment

of new national organisation to take over the work of the fourvoluntary bodies concerned with alcoholism and funded largely bythe Department of Health and Social Security. A report publishedin April by the National Council for Voluntary Organisations andthe D.H.S.S. Policy Strategy Unit found deficiencies in voluntarywork for alcohol misuse because the services were provided by fourseparate agencies: the National Council on Alcoholism, the MedicalCouncil on Alcoholism, the Federation of Alcoholic RehabilitationEstablishments, and the Alcohol Education Centre. Mr Clarke,who would like the new organisation to start work in April next year,has suggested setting up a steering group to discuss plans.- Theorganisation would extend local services and training initiatives,provide information for local agencies, and cooperate with theHealth Education Council.

Royal Assent for Mental Health (Amendment) Bill

Royal Assent to the Mental Health (Amendment) Bill last

Thursday has meant the first changes to the 1959 Mental HealthAct clarifying the position of detained patients. The Mental HealthAct Commission will be set up to safeguard patients under sectionby visits, investigation of complaints, advice on good practice,reviewing the use of legal powers, and giving a second opinion inindividual cases. The new Act will halve the period before which adetention order for treatment must be reviewed, so that patients willhave twice as many opportunities to apply to the independentMental Health Review Tribunal. New rules for treating patientswithout their consent are to be introduced: some treatments will notbe allowed without the patient’s consent and an independent secondopinion; and others may be given without consent or a secondopinion. Social workers are to be specially trained for their workunder the Act so that they will be involved even where the nearestrelative has applied for the patient’s admission. For the first time,voluntary patients will be allowed to register on electoral rolls, andlegal assistance by way of representation will be made available bythe Government at tribunals.

Notes and News

TOKEN OFFERING TO HEALTH RESEARCH FROMTHE TOBACCO INDUSTRY

THERE seems little real intention on the part of the Government tolimit either the activity or the profits of the tobacco companies in thelatest voluntary agreement, announced by the Minister for Health,Mr Kenneth Clarke, on Oct. 27. The agreement, which will last for31/2 years, includes a meagre increase in the space devoted to theunchanged Government health warning (which will also appear onadvertising material at sponsored sports events) on cigarette packetsand advertisements, and a progressive reduction in the amountspent on poster and cinema advertising. Mr Clarke expressedgratitude that the tobacco industry had agreed to these measures.Ll million is to be provided by the companies over this period to

establish the Health Promotion Research Trust, which, under thechairmanship of Sir John Butterfield, regius professor of physic andmaster of Downing - College, Cambridge, will functionindependently of both Government and the tobacco industry. TheTrust will commission, fund, and publish (at the trustees’discretion) results of a programme of research into healthpromotion, "other than studies designed directly or indirectly toexamine the use and effects of tobacco products".Dr Keith Ball, vice-president of ASH (Action on Smoking and

Health), commented that £3 million a year for research was "lessthan the cost of a single cigarette brand launch" and feared that theindustry might use the research as a "smokescreen to obscure theunparalleled dangers of smoking compared to other health risks".The British Medical Association also criticised the limitation on theresearch programme.Mr Clarke hopes that no-one will be able to smoke cigarettes

without being aware of the risk to health and that the "moreobtrusive forms of cigarette advertising" will be restrained by thisnew agreement. Despite Mr Clarke’s efforts, Dr Ball warned,cigarette promotion was likely to continue in the U.K. at a rate of100 million a year. ASH, meanwhile, is to receive a Governmentgrant of D 15000 in the current financial year, as a hardly lavishaddition to the figure of over 2 million earmarked for theantismoking campaigns of the Health Education Council.

NEW CENTRAL PUBLIC HEALTH LABORATORY

IF everything continues to go according to plan the Central PublicHealth Laboratory at Colindale will move down the road to theirnew quarters in 1984. The purpose-built laboratory will provide,under one roof, about twice the area of floor space of the presentaccommodation, where the Laboratory has been housed since 1946in what was the Government Lymph Establishment, and to whichseveral temporary outbuildings have had to be added. The newbuilding is budgeted to cost f 15 million. Construction work, whichbegan 18 months ago, has been on schedule, and the foundationstone was laid last week by Sir Robert Williams, former director ofthe Public Health Laboratory Service.

GOODBYE DHOBI’S ITCH

THE nomenclature experts have been at it again and connoisseursof the eponym will mourn. This time the victims are the mycoses,infectious diseases caused by fungi. 52 experts from twenty-sevencountries have contributed to the latest volume in the jointC.I.O.M.S./W.H.O. project, the International Nomenclature ofDiseases. The list runs from "0001 mycosis" to "2300 mycoticonychia" and condenses a global collation of synonyms to just over ahundred recommendations. There is a touch of sadness in the logicof it all. The feet of athletes and all those eponymous itches are

1. C.I.O.M.S./W.H.O. International Nomenclature of Diseases Vol II, infectious

diseases; part 2, mycoses Geneva: Council for International Organisations ofMedical Sciences. 1982 Pp 47. SwFr 15. Obtainable from W.H.O sales agents.

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tineas qualified in Latin. And it is farewell too to San Joaquin Valley"bumps" (pulmonary coccidioidomycosis), asperigilloma(pulmonary aspergillosis), Madura foot (eumycetoma), and manyothers, favoured and obscure.

University of London

The following have been appointed to university chairs: Prof. M.Bobrow (University of Amsterdam) to the Prince Philip chair ofpaediatric research at the’United Medical Schools of Guy’s and StThomas’s Hospitals; Dr P. J. S. Hamilton (CaribbeanEpidemiology Centre, Port-of-Spain) to the chair of communityhealth at the London School of Hygiene and Tropical Medicine;Prof. N. McIntyre to the chair of medicine at the Royal FreeHospital School of Medicine; Prof. D. L. Miller (MiddlesexHospital Medical School) to the chair of community medicine at StMary’s Hospital Medical School; Dr M. J. Tynan (Guy’s Hospital)to the Joseph Levy chair of paediatric cardiology at the UnitedMedical Schools of Guy’s and St Thomas’s Hospitals; Dr B. A.Wood to the S. A. Courtauld chair of anatomy at the Middlesex

Hospital Medical School.The title of professor has been conferred on the following in

respect of their posts: Dr S. R. Bloom (Royal Postgraduate MedicalSchool); Dr D. A. Brewerton (Westminster Medical School); DrA. L. W. F. Eddleston (King’s College Hospital Medical School);Mr H. Ellis (Westminster Medical School); Mr R. M. Greenhalgh(Charing Cross Hospital Medical School); Dr George Janossy(Royal Free Hospital School of Medicine); and Mr Christopher

Wastell (Westminster Medical School).

Action on Smoking and Health

Prof. Peter Sleight, of Oxford University, is the new chairman ofASH. He succeeds Dr Keith Ball, who remains on the council asvice-president with Sir Richard Doll.

National Head Injuries Association

After severe head injury, patients often have marked changes inpersonality as well as physical disability, a burden which familiesmay have to bear for a lifetime (see p. 1034). HEADWAY is a newvoluntary organisation to encourage the self-help of families with ahead-injured member. With encouragement from regionalneurosurgical and rehabilitation centres, support groups are beingestablished in several parts of the U.K. so that volunteers from thehealth and allied professions may become actively involved withfamilies. Further information about these groups may be obtainedfrom HEADWAY, National Head Injuries Association, 17-21Clumber Avenue, Sherwood Rise, Nottingham NG5 1AG

(telephone 0602 622382).

U.S. Diabetes in Early Pregnancy ProjectMalformations in infants born to diabetic mothers are being

studied by the National Institute of Child Health and HumanDevelopment, which is recruiting diabetics and controls beforepregnancy. Pregnancy is diagnosed by (3-HCG measurement within21 days of conception. Clinicians in the Boston, New York,Pittsburgh, Chicago, and Seattle areas who know of insulin-

dependent diabetic women who are planning to become pregnantare invited to contact Dr James L. Mills, Diabetes in EarlyPregnancy Project, N.I.C.H.H.D., Landow Building, Room 8B06,National Institutes of Health, Bethesda, Maryland 20205.

At the annual general meeting of the Association of Clinical

Pathologists held in London on Oct. 14, Prof. N. F. C. Gowing was electedpresident and Dr W. Jones-Williams was elected president-elect.

A national policy-making conference of the Medical Campaign AgainstNuclear Weapons will take place at the Wolfson Institute, Royal Post-graduate Medical School, Hammersmith Hospital, Du Cane Road, LondonW12, on Nov. 13-14. Further information may be obtained from Dr AlisonWorsley, 83 Sortram Crescent, London W9 (daytime telephone 01-743 2030,and evenings 01-968 9618).

A one-day conference to explore mind-matter frontiers on Heart and Soulwill be held at Kensington Town Hall, Horton Street, London W8, on

Saturday, Nov. 13. Details are available from the conference secretary,Brahma Kumaris World Spiritual University, 96/98 Tennyson Road, LondonNW6 (telephone 01-328 2478).

Nominations are invited for the medal of the Society for Endocrinologywhich is awarded annually, with D 00, for outstanding work in promoting thedevelopment of endocrinology in the U.K. and the Commonwealth. Forms areavailable from the Business Office of the Society, 23 Richmond Hill, BristolBS8 1EN, and should be returned by March 1.

Correction

Voluntary Agreements Do Not Stop Epidemics.-Asiatic cholera reachedLondon in 1832, not in 1831 as stated in this editorial (Oct. 16).

Diary of the WeekNOV. 7 TO 13

Tuesday, 9thINSTITUTE OF DERMATOLOGY, St John’s Hospital for Diseases of the Skm,

Lisle Street, Leicester Square, London WC2H 7BJ4.45 P.M. Dr I. Sarkany: Physiology of Itching.

MEDICAL COUNCIL ON ALCOHOLISM12 P.M. (B.M.A. House, Tavistock Square, London WC1) Sir Douglas Black:

Rough Justice.LONDON MEDICAL GROUP

5.45 P.M. (University College Hospital, Gower Street, London WCI) Symposium.-Doing What Comes Naturally: Shouldn’t Women Choose the Method ofBirth ?

MANCHESTER MEDICAL SOCIETY, Stopford Building, University of Manchester,Oxford Road, Manchester M13 9PP

5 P.M. Mr H. H. G. Eastcott: The Total Care of the Artenosclerotic Patient.

Wednesday, 10thROYAL COLLEGE OF PHYSICIANS OF LONDON, I St Andrew’s Place, London

NW1 4LE5 P.M. Dr Wallace Fox: Compliance of Patients and Physicians (Mitchell lecture).

INSTITUTE OF DERMATOLOGY5.45 P.M. Dr W. A. D. Griffiths: Pityriasis Rubra Ptlans and Keratodermas.

INSTITUTE OF ORTHOPAEDICS, Royal National Orthopaedic Hospital, 234 GreatPortland Street, London WIN 6AD

6 P M Mr R. Campbell Connolly: Early Management of Head Injuries.7 P.M. Dr C. D. Evans: Rehabilitation After Severe Head Injury.

ROYAL FREE HOSPITAL SCHOOL OF MEDICINE, Rowland Hill Street, LondonNW3 2PF

5 P.M. Prof. L. A. Turnberg: A Fresh Look at the Gastric Mucosal Barrier-Implicationsfor the Pathogenesis of Peptic Ulcer Disease.

NORTHWICK PARK HOSPITAL AND CLINICAL RESEARCH CENTRE,Watford Road, Harrow, Middlesex HA1 3UJ

1 P.M. Dr P. M Jeffreys: Confusion in the Elderly.4.30 P.M. Dr L. L. Iversen: Chemistry and Pharmacology of Spinal Cord Pain

Mechanisms.CHACE POSTGRADUATE MEDICAL CENTRE, Chase Farm Hospital, The

Ridgeway, Enfield EN2 8JLI P.M. Mr J. S. Kenefick: Vascular Surgery in a District General Hospital.

JOHN RADCLIFFE HOSPITAL, Headmgton, Oxford OX3 9DU5 P.M. Prof. S. Cohen: Immunology of Malaria.

MANCHESTER MEDICAL SOCIETY5 P.M. Prof. M. Richmond’ The Impact of Molecular Biology on the Future of Medical

Microbiology.

Thursday, 11thROYAL COLLEGE OF PHYSICIANS OF LONDON

5 P.M Mr Richard Darwin Keynes: The Ion Channels in Nerve Membrane

(Oliver-Sharpey lecture).ST MARY’S HOSPITAL MEDICAL SCHOOL, Norfolk Place, London W12 IPG

5 30 P.M. Dr William Kearns: Health Problems in Big Cities-New York, Detroit,and London (Aleck Bourne lecture).

ONCOLOGY CLUB, Chester-Beatty Research Institute, Fulham Road, London SW36.30 P.M. Dr Robin Weiss: Human Tumour Viruses-the Latest.

LONDON MEDICAL GROUP6.15 P.M. (Westminster Hospital Medical School, Horseferry Road, London SWI)

Dame Cicely Saunders: The Nature and Management of Terminal Pain.EXETER POSTGRADUATE MEDICAL CENTRE, Royal Devon and Exeter Hos-

pital, Barrack Road, Exeter EX2 5DW12.45 P.M. Dr M. Roberts: Solvent Abuse.

Friday, 12thROYAL COLLEGE OF SURGEONS OF EDINBURGH, Edinburgh EH8 9DW4.30 P.M. Prof. 1. H. Thomas: Caisson Disease of Bone-the Seed and the Soul

(Ist Lister lecture).INSTITUTE OF DERMATOLOGY4.45 P.M. Dr D. D. Munro: Too Much or Too Little Hair.

Saturday, 13thNUFFIELD ORTHOPAEDIC CENTRE, Headington, Oxford OX3 7LD8.30 A.M. Dr A. H. Laing: Osteogemc Sarcoma: the Place of Chemotherapy.9.30 A.M. Dr E. C. L. Fletcher’ Therapeutic Arterial Embolisation.