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OBITUARY

JANE WALKER, C.H., M.D., LL.D.

Dr. Jane Walker died on Nov. 17th, in her eightiethyear, at her home in Harley-street. Her friends anda,dmirers in medicine and in the many spheres inwhich she moved-social service, education, politics,art, and music-find it difficult to realise that her

dynamic personality has left them, and still more

difficult to evaluate what she meant not only to thembut to her times.Jane Harriett Walker was born in Dewsbury,

the eldest of the eight children of Mr. John Walker,a blanket manufacturer, and was educated in South-port. When her schooldayswere over she entered theLondon (R.F.H.) School ofMedicine for Women, goingto Dublin to qualify L.R.C.P.I.and L.M. in 1884, and toScotland for the L.R.C.S.Edin.in 1889; she went also toBrussels to take her M.D.in 1890 and spent some timeat the University of Vienna.After a few years in generalpractice she was appointedassistant physician to theElizabeth Garrett AndersonHospital (then the New Hos-pital for Women). One daysome friends asked her whatshe knew of the open-airtreatment for tuberculosis, asa brilliant young journalisthad become affected by thisdisease. The prompt andcharacteristic reply was : " Idon’t know anything aboutit, but I’ll go and see."She went to Nordrach inthe Black Forest to studythis new method underOtto Walther. This experiencechanged the whole trend ofher career, and she returnedto England determined to introduce the treatmentinto this country.She began in Norfolk in a very modest way in

1892, treating cases in a farmhouse at DownhamMarket. The work developed speedily. In 1898Edward VII as Prince of Wales made that memorablestatement which gave fresh life to the campaignagainst tuberculosis : If preventable, why not

prevented ? " Jane Walker’s response was to find asite in Suffolk for what came to be known as theEast Anglian Sanatorium and to open there an

institution for paying patients-embodying all thebest of the new ideas on treatment-in January, 1901.Shortly after, hospital-class patients began to betreated in pavilions in the same grounds. A furtherdevelopment of the scheme was the opening of theEast Anglian Children’s Sanatorium-during 25 yearssome 2700 children, either infected with tuberculosisor in danger of becoming so, passed through thissanatorium-and, in 1916, a section for the trainingof soldiers disabled by tuberculosis, to be followedin 1919 by provision for officers’ training. Thework continued on these lines throughout thefirst quarter of this century until a few yearsthe institution became converted entirely to

the treatment of patients sent by various publicauthorities.

Of Dr. W’alker’s quality as a physician one of herclose associates at Nayland writes : "To see herexamine a patient was a lesson in keenness of

observation, gentleness, and tact. Her attention todetail was remarkable and her zeal in performing thesame duties over a period of many years never

flagged." The side of her work at Nayland thathad to do with young people gave Dr. Walkerthe greatest happiness. To see children who hadpreviously lived in crowded areas regaining theirhealth and enjoying life in open spaces, learningmusic and singing, was a continuous pleasure to her.

Another of her deep interestswas the future of her patients.She tried to train them for

employment in every possiblesphere to avoid the dangerof their return to unsatis-

factory surroundings; andshe herself was so anxiousto do her share in this respectthat at one time out of herstaff of 150 people over 60were ex-patients.

It is a measure of Dr.Walker’s immense vitality,both physical and mental,that her work in the treat-ment of tuberculosis at Nay-land and as consultant inher house in Harley-streetonly formed part of theactivities for which she was

justly famed. She was a

founder (1917), first president,and later in turn honorarytreasurer and honorary secre-tary of the Medical Women’sFederation, and in recognitionof her services was recentlymade a life member of thecouncil of the Federation.The welding together of thevarious associations of medical

women in different parts of the country under aconstitution which would provide a representa-tive body able to speak with authority and yetleave local autonomy was no light task, and itwas in large measure due to Dr. Walker thatthe Federation emerged, and has since expanded,on such sound lines. Her activities outsidemedicine were not less noteworthy. She was a

magistrate for the county of Suffolk. She was oneof the founders and for long chairman of the

governing body of Godstowe, a preparatory girls’school closely associated with Wycombe Abbey.A list of the titles of her books and articles. of herappointments, of the committees, official and unofficial,on which she served throughout her career, show hermajor interests to have included, besides tuberculosisin all its aspects, diseases of women and children, theeducation of mothers, inebriety, the work of Borstalinstitutions, notably at Aylesbury, infantile mortality,the housing problem, nutrition, agricultural wages,and indeed the improvement of social and economicconditions throughout the country. On all thesesubjects she wrote well and. spoke even better, withpersuasive tongue and such vigorous advocacy of acause as to compel attention and even action among

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those whose interest in the subject had been languidor absent.

Those who have enjoyed her hospitality andlistened with joy to her disquisitions on politics,religion, music, and art-all subjects in which sheknew a great deal-will sadly miss the gatherings ofwhich she was the centre, to say nothing of the goodstories which she told with such point and gusto.As a hostess she refused to be limited by convention-and some of her dinner parties were the more livelyfor being composed of men and women invitedwithout their mates. For years she had womenmedical students to live with her in Harley-street,and protested that she gained quite as much fromtheir company as they did from hers. Some of them,and even some of the older people who came intocontact with her for the first time, were alarmed byher brusque manner, and a blunt approach to anycontroversial subject that left little opportunity forcalm discussion. It was not until she had passedmiddle age that she was able to subdue or mask herintolerance of officialdom and cooperate cordially withgovernment departments. Her certainty that hercase was impregnable and that her opponents wereentirely misguided was contagious or irritating,according to the temperament of her confidante.She had a most fertile mind and was constantlyevolving original ideas and progressive schemes, notalways practicable, but her enthusiasm and drivesucceeded in overcoming formidable obstacles againsttheir execution and her path was rich in achievement.

Unconventional in appearance as in mind, Dr.Jane Walker was not likely to be ignored in anyassembly. Her short sturdy figure, upright carriage,distinguished features, and bright complexion were socharacteristic that no one who ever saw her couldreadily forget her. At meetings large or small,professional, philanthropic, or social, she was usuallyto be seen in a prominent place at the chairman’selbow. She made no secret of her pleasure in exer-cising her gift for public speaking, especially afterdinner, and at one of the last functions she attended-a dinner given by the Medical Women’s Federationpartly in her honour-she gave some useful hints toyounger colleagues on the preparation and deliveryof such speeches.

Stimulating, lovable, amusing, Jane Walker wassought as a companion by friends of all ages. Asshe grew older in years (but not in outlook) shesucceeded in her aim not to lose touch with youngpeople. Her wide interests embraced the collectionof works of art and the critical appreciation of goodmusic. Her native town is to benefit by her collectionof pictures. Originally nonconformist, she becamean ardent and devoted churchwoman. She enjoyedher work as a magistrate, especially in the juvenilecourt. At Nayland the supervision of farm and

garden was a particularly congenial task, and thetraining of the patients for industrial and other worka matter of constant concern. The plan to endow aresearch clinic at Nayland for the treatment of

physically subnormal children in honour of hereightieth birthday next year had been broachedsome weeks before her death, to her great satisfaction,and we may hope that it will receive generous supportas a memorial to a gallant pioneer.

Dr. Ethel M. N. Williams, J.P., one of the fivemedical women associated with Dr. Walker in thefoundation of the Medical Women’s Federation,writes : " Dr. Walker in* point of years was youngerthan the pioneers who had blazed a way for womeninto the medical profession, say, Dr. Elizabeth

Blackwell and Dr. Elizabeth Garrett Anderson, butshe was essentially in all her methods and in thehabits of her mind a pioneer. She was the first tointroduce the open-air treatment of tuberculosis inthis country at a time when it was more uncom-fortable than it became later, but the kindness andunderstanding with which she handled her patientsneeded to be experienced to be really understood.She did not suffer fools gladly, especially weak fools,but even to them there was always kindliness in hersallies. There is a small sitting-room at Naylandwhich still goes by the name of the idiots’ parlour,’though few remember how the name originated. Inthe old days of sanatorium discomfort a little groupof thin-blooded shivering patients used to assemblethere and cower over the fire. Dr. Walker passingdown to the dining-room swept by all the winds ofheaven would fling the epithet idiots’ to the littlegroup ! In every piece of work she took up she wasa pioneer. She was a founder and first president ofthe Medical Women’s Federation; she held all thehonorary offices in turn. She served a term as

president of the Tuberculosis Association. She heldinnumerable offices connected with different organisa.tions for social betterment and was always a spiritworking with generosity and courage. The world ispoorer and emptier because that spirit is no longerwith us."An old inend a<1<1s: .. ur. Jane vv alker-or Lmy

Jane as she was affectionately called by many of herfriends-was a glowing, radiant personality. Impul-sive, too. She had a shrewd Yorkshire sense of values,yet was often at the mercy of her intuitive impulses.It was as if her spontaneity was constantly out.

running her cautiousness, leaving it behind lamelyprotesting. Clinical work represented only a fractionof her many interests ; she was in close touch withpolitics and leading statesmen, with literature andmodern authors, with science and living scientists,and so on. Indeed, her interests were so varied thatbut for quick perceptions, and a gift for getting tothe heart of things easily, she would have risked

becoming a jack of all trades and master of none.What were the secrets of her success in life’! Someof them were health, wealth, and the happinesswhich she derived largely from her love and interestin her fellow beings. From start to finish she wasengrossed in the study of them, not so much

analytically as intuitively, by mental leaps andbounds rather than by that process of slow thinkingwhich men call reason. Her sense of humour was

delightfully infectious and her stories, told with racyenjoyment, lost nothing in the telling. As a hostessshe knew not only how to put her guests at thenease, but also how to draw out the best of each.She was resourceful, too. One day she invited a

nervous young doctor to share a dish of plums asthey stood together in the hall of her house in Harley.street. As the young man wondered what to do withhis plum stones, she solved the problem by openingthe street door and hurling one stone after anotherinto the hallowed roadway as if Harley-street werenothing more than a gutter. Now that was a verycharacteristic gesture ; she made good in life largelybecause she had the courage, figuratively speaking.to dispose of awkward plum stones in the simplestpossible way and to defy silly conventions and childishinhibitions. She got things done. Sometimes thevhad to be undone. In which case she would set abouther task with her cheerful optimism quite undauntedWhat vigorous, constructive Elizabethan courageHer hatred of shams and manners was not alfT’voiced in strictly Parliamentary terms, and be’

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enthusiasm for things good and noble was as unstintedat 80 as at 18. How wonderful to retain an unboundedcapacity for enthusiasm for people and things whenfour score years have been reached !

"

Dr. Walker was buried at Nayland on Nov. 19th.Among other apt comments on her life and work

Bishop Crotty, vicar of St. Pancras, said : " She is amemory that will not easily leave us, and her recordof human achievement is immense and outstanding.That Companion of Honour in which her Kingenrolled her well became her, and her place amongthe great women of her nation and her generationis assured."

PATRICK WATSON WILLIAMS, M.D. Lond.

Dr. Patrick Watson Williams, who died at his homeat Clifton on Nov. 14th at the age of 75, had beenconnected with Bristol Royal Infirmary for thewhole of his professional life. He worked there asa student, as house physician, for more than thirtyyears as an active member of the honorary staff, and,since his retirement, as a member of the managementcommittee. He was one of the few remaining Britishlaryngologists who began their career as generalphysicians.Patrick Watson Williams was the son of a Clifton

doctor, Dr. Eubulus Williams, and was born at Clifton

in 1863. His mother was a sister of Sir PatrickWatson, the Edinburgh surgeon. He was educatedat Clifton College and at what was then UniversityCollege, Bristol. He qualified in 1884 and took hisLondon 3LB. with honours in 1885 and his M.D.in 1891. After holding several house appointmentselsewhere, he became house physician at Bristol

Royal Infirmary in 1887, and in the following yearwas elected assistant physician. As a physicianhe showed remarkable originality and independenceof thought, being one of the first to administer freshthyroid to cases of myxcedema ; he used personallyto superintend the removal of the glands from

slaughtered animals. During this period he turnedhis attention to rhino-laryngology, and acted as

clinical assistant at the London Throat and EarHospital and the Central London Throat Hospital.He was responsible for the sections on diseases ofthe throat in the "Medical Annual" from 1890onwards and in Allbutt’s System of Medicine, andin 1892 published his " Diseases of the Upper Respira-tory Tract " with excellent llustrations by himself,

which met with immediate success. He possessedthe enviable faculty of condensation, and yet hisknowledge of general medicine allowed him to viewhis specialty with a wide perspective. From 1897to 1905 he was physician to Clifton College. In1905 he became full physician at the Royal Infirmaryand soon afterwards was put in charge of the newlyformed throat and nose department. His surgicalcolleagues at first strongly opposed his claims to

operate, but his technical skill and his ingenuity indesigning new apparatus overcame their misgivings.In 1910 Watson Williams was president of the

laryngological section of the Royal Society of Medi-cine, and in 1911 he represented the Society at theBerlin International Laryngological Congress. Heknew much about the technical aspects of printingand illustration-he was a talented black-and-whiteartist-and initiated many improvements in theBristol Medico-Chirurgical Journal during his

editorship from 1912 to 1926.During the late war Watson Williams served with

the R.A.M.C. as major, and was consulting ear, nose,and throat surgeon to the Southern Command.In 1925 he delivered the Semon lecture at London

University on the relation of chronic nasal sinusinfection to what William Hunter called " septicpsychoses." In 1927 he was president d’honneurof the Societe francaise d’otologie et laryngologie inParis. Since his retirement in 1921 he had takenan active part in the management of the RoyalInfirmary as a member of the governing body, and in1934 his services to Bristol University were rewardedby an honorary M.D. He will be remembered as aman of dignified and courtly presence, who won theconfidence of his patients and colleagues by his

dexterity and unremitting attention.In 1889 Watson Williams married Margaret, a

daughter of Dr. Edward Long Fox of Clifton. Heleaves a widow, three daughters, and two sons, oneof whom occupies an honoured position in his father’sspecialty.

SIR JAMES BARR, C.B.E., M.D. Glasg., F.R.C.P.

Sir James Barr, who, before he retired twelve

years ago, was one of the outstanding figures ofmedical life in Liverpool and had been a powerfuladvocate of prison reform, died at Putney on Nov. 10that the age of 89.James Barr was born in 1849, the eldest son of

Samuel Barr, a magistrate in co. Derry, and hisUlster blood and upbringing were to come out stronglyin his love of controversy in later life. He waseducated at Londonderry and Glasgow University,qualifying in 1873 and taking his M.D. in 1882. In1878, after holding house appointments and visitingSouth Africa, he started practice in Everton andbecame physician to Stanley Hospital and medicalofficer to Kirkdale gaol. At Kirkdale he advocatedimprovements in feeding and living conditions thatled to a rapid fall in the tuberculosis-rate among theprisoners. At that time he was severely wounded inprotecting a warder from a negro prisoner who wasrunning amok. Through the evidence that he gavebefore a Government commission he was responsiblefor valuable reforms in the methods of carrying outexecutions. When the Home Rule controversy wasat its height he was sent by the Home Office to

inquire into conditions in Irish prisons, and hebrought a storm on his head in 1887 by reportingthat the Nationalist prisoners were being treated withgreat leniency considering their refusal to obeyprison rules. After this his home in Liverpool was

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under police protection for six months although hedeclined protection for himself, and Mr. Balfourhimself protested against the virulent attacks madeon " one who had always done his duty fearlesslyand always performed his public functions most

ably and conscientiously."About this time Barr was appointed honorary

physician to the Northern Hospital, where he intro-duced his treatment of pyrexia in enteric fever bycontinuous immersion, and in 1898 he was elected tothe staff of the Royal Infirmary. " When I was seniorresident medical officer at Mill Road Infirmary,"one of his pupils recalls, "Barr would come up onan afternoon and spend two or three hours goinground my wards and discussing the cases. This waswhen he was probably the busiest man in Liverpooland I one of the juniors of the juniors. I do notknow of any other man who would have wasted ’his time in this way." Barr was an ardent and

untiring clinician, patient and kindly, and a mostaccurate diagnostician. As long as a patient wasalive he never gave up trying and he imbued thoseunder his care with the same spirit of confident

optimism. Hecontributedlargely to theT,iverpool Medico-Chirurgical Jour-nal, of which helater becameeditor, and toother journals,his main interestbeing in cardio-logy. He took a

leading part inthe proceedingsof the BritishMedical Associa-tion in Liverpooland was made amember of thecouncil and latervice-president ofthe Association.In 1906 he went

’ to Canada toaddress theToronto meeting

of the B.M.A. and was given an honorary LL.D. byToronto University. In the following year he deliveredthe Bradshaw lecture at the Royal College of Physiciansand was president of the preventive medicine sectionof the Public Health Congress. During the late warhe served as a lieutenant-colonel in the R.A.M.C.at the First Western General Hospital. Thoughnearly seventy his physical stamina was such that hecould work ninety-six hours a week as county directorof voluntary aid. For his war services he was madeC.B.E. and a Knight of Grace of the Order of St. Johnof Jerusalem.

All his life he held strong views on eugenics,denouncing, for instance, improvements in housingas tending to check the elimination of the unfit. In

controversy his weapon was the bludgeon rather thanthe rapier, though at heart he was abnormallysensitive to praise or blame. He certainly madeother people think and helped them to justify ifthey could the faith that was in them.

In 1882 Sir James married Isabelle, the daughterof Mr. J. Wooley. His only son was killed in thewar and his wife died last September. He leaves onedaughter.

GENERAL MEDICAL COUNCIL

PRESIDENTIAL ADDRESS

Sir NORMAN WALKER, in his presidential addressto the General Medical Council on Tuesday afternoon,began by speaking of the death of Sir Robert

Johnstone, whose loss would be greatly felt. He hadalso to report the death of Mr. Harper, solicitor tothe Council since 1911. The seat left vacant by theretirement of Prof. J. B. Leathes, F.R.S., after overnineteen years of distinguished service, has beenfilled by Dr. G. A. Clark, his successor in the chair ofphysiology and the deanship at Sheffield. Under theDentists Act, 1921, the Privy Council have appointedMr. J. Ainsworth Woods to succeed the late Mr.J. W. A. McGowan. As a visitor to the session SirNorman welcomed Dr. Willard C. Rappleye, dean ofColumbia University, New York.

After referring to the international crisis and theobligation on the Council to ensure that in war as inpeace tne supply 01 properly qualmed recruits to theprofession should not be allowed to fail, the Presidentspoke of the new register of medical and dentalstudents which will show the numbers of personswho have commenced medical or dental study properin each academical year. Thanks to the good officesof the authorities of the schools of medicine anddentistry it could already be anticipated that the newregister would be a better statistical instrument thanits predecessor.

Turning to Imperial affairs the President said thatSir Richard Needham sets out this week for anotherseries of visits to medical institutions in the Far Eastwhich teach and examine candidates for diplomasrecognised by the Council. He is to visit Hong-Kong,Singapore, Rangoon, and possibly also Ceylon." Some time ago we received an invitation from theUniversity of New Zealand to make an informalsurvey of their examinations, but action was deferredin the hope that the Australian universities wouldassociate themselves with the proposal, and so enablea fuller survey to be made, and a frank exchange ofviews to take place on the question of our relationswith the States of the Commonwealth to whichPart II of the Act of 1886 applies. Meanwhile I amable to announce a beginning." Having ascertainedthat Prof. Stuart McDonald, who has just retiredtrom tne JJurnam cnair 01 patnology ana tne leansmpof the medical school in Newcastle-upon-Tyne, is

shortly starting on a tour round the world, Sir Normanhad suggested that he should take the opportunityof informally visiting the examinations, and thissuggestion had been warmly accepted by the NewZealand authorities. "I I hope that it is not too

optimistic to regard this visit as inaugurating an eraof closer cooperation between the authorities respon-sible in the Dominions for medical education andregistration on the one hand, and ourselves on theother."

RECIPROCITY AND ITS DENDNCI1TIOT

" ventured to suggest to you a year ago," con.tinued the President, " that geographical distance initself was diminishing in importance as an obstacle tothe appreciation by widely separated authorities ofeach other’s policy and point of view. But, in thisas in other spheres, the mind may have difficulty inkeeping pace with the rapid march of mechanicalinvention and development. If it is now easy flu

an envoy from the Council to travel by air to J

Dominion, it is equally easy for a letter, or even 1