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detailed review of the facts as to diseases spreadfrom contaminated milk and notes on pasteurisationmethods and practice.

In Poole compulsory pasteurisation powers are

being asked for in a parliamentary Bill in the formof power to make by-laws :

" The Corporation may make byelaws for prohibiting,regulating or controlling the sale or supply or the exposureor keeping for sale or supply within the borough for humanconsumption, or for use in the manufacture of productsfor human consumption of milk which has not been

pasteurised and at all times securely protected againstcontamination in such manner as may be prescribedby the byelaws."

Pasteurisation is defined in the same terms as inthe Milk (Special Designations) Order 1936. Themedical officer of health for Poole (Dr. R. J. M.Horne) has also submitted a valuable report dealing

with the dangers of raw milk and the need for thesepowers to require pasteurisation. Such reports,though they supply useful argument, cannot in thespace available review more than a small part ofthe overwhelming evidence available in favour ofcompulsory pasteurisation. Those interested will,however, be able to consult many other sources,

including the authoritative report by the Committeeon Cattle Diseases to the Economic Advisory Counciland the several reports of the People’s League ofHealth.We welcome the efforts of the corporations of

Glasgow and of Poole to carry out one of theirprimary functions, the protection of their inhabitantsfrom the risk of milk-spread infectious disease, byseeking to secure powers requiring the efficient

pasteurisation of the raw milk consumed withintheir areas.

OBITUARYJOSEPH FAYRER, Bt., C.B.E., M.D., F.R.C.S.Edin.WE regret to record the death of Lieut.-Colonel

Sir Joseph Fayrer which occurred in Gullane, EastLothian, on April 13th, in his 79th year. He wasthe second son of Surgeon-General Sir Joseph Fayrer,famous for his gallant service at the siege of Lucknowduring the Indian Mutiny, and author of theThanatophidia of India.Joseph Fayrer was born in 1859 and educated at

Rugby, Trinity College, Cambridge, and St. George’sHospital, where he commenced his medical studies.Later he went to the University of Edinburgh,where he took the diploma of F.R.C.S. Edin., latergraduating at St. Andrews as M.D. He went immedi-ately into the R.A.M.C., entering in 1886 at the topof the list. He was stationed for a year at EdinburghCastle, and was then dispatched on foreign service,where, following in the footsteps of his father, he spentmost of his time in India. His career there was thatof an energetic officer and he became specially markedout for his administrative work in hospitals. On

returning to England in 1894 he was appointed medicalofficer of the Royal Horse Guards, a post which he heldfor three years. He then went to India for furtherservice until 1903, when he returned to England asstaff adviser and secretary to the P.M.O. of theLondon Military District. At the expiration ofthat post he became superintendent of the Duke ofYork’s Military School, then situated in Chelsea,where his energetic and sympathetic activities gainedhim large credit. He held this post for five yearswhen he went to China in charge of the MilitaryHospital, Hong-Kong. In 1907 he succeeded to thebaronetcy, and while in Hong-Kong was appointedin 1911 superintendent of the Edinburgh RoyalInfirmary, a position which he held for 13 years, aperiod covering the years of the war. During thewar he was in command of the 2nd Scotch GeneralHospital, Craigleith, and was made a C.B.E. in 1919.He retired from the superintendency of the infirmaryin 1923 on the age limit. Both at the infirmaryand at Craigleith-his charm of manner and capacityfor friendship assisted him in a marked way in thedischarge of his duties.

Sir Joseph Fayrer married Ella, daughter of thelate Colonel W. J. Mayhew, and leaves a widow,two daughters, and one son who succeeds to the title.

A lifelong friend writes : "At Cambridge and atSt. George’s Hospital Fayrer collected friends, andthroughout a long and varied career he showed the

same power. He had an alert attractive appearanceand a sympathetic manner, the outcome not of adesire to please but of a willingness to be pleased.He was a game player and a sportsman when officialduties gave him the opportunity. He always sawthe best side of the other man, and had a gift forfriendship. His death will be regretted by verymany."

ROBERT LYALL GUTHRIE, O.B.E., M.D. Edin.Dr. Robert Guthrie, whose death occurred on

April 13th, was the son of the late James Guthrie,Hope Park, Broughty Ferry, Forfarshire. He wasqualified alike as doctor and barrister, commencingwith the medical profession, a connexion on whichhe always insisted. He graduated in medicine atthe University of Edinburgh as M.D., C.M. in 1892,and held several resident appointments. For a

time he practised at Bethnal Green, when he alsostudied law. He acted as deputy coroner to the lateDr. Wynn Westcott, and in 1897 was called to theBar at the Middle Temple. In 1903 he was deputycoroner for the Eastern District of the County ofLondon, the post which he was holding in 1914.During the war he was, at the outbreak, medicalofficer to the 7th London R.F.A., later he was com-mandant of the Fulham Military Hospital with therank of brevet major, and was then promoted lieut.-colonel and took command of the Belmont Prisonersof War Hospital. He was a successful administratorin all these posts and for his services received theO.B.E. After the war he resumed his duties as

coroner and in 1921 became coroner to the EasternDistrict. As a coroner he was primarily a doctorand refused to be diverted from what he held to behis basic duty-namely, to find accurately the causeof death. In his court one would frequently find casesbeing decided plainly and simply which were likelyto have had far-reaching consequences-cases ofaccidents at work, in docks or factories, where severalparties were interested in the issues. In these circum-stances his kindly attitude and his commonsense

decisions received wide appreciation-appreciationwhich led on one public occasion to Mr. GeorgeLansbury referring to him as the ideal coroner.

He was in addition a capable man of affairs, washonorary treasurer of the London and Counties MedicalProtection Society, and medical adviser to the LawUnion and Rock Insurance Company,

Dr. Temple Grey writes : " Legal medicine hassuffered a distinct loss in the passing of R. L. Guthrie.

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There were united in him all the qualities whichgo to make the best type of coroner: an up-to-dateknowledge of medicine, a sound grounding and gripof the law, and much shrewdness and tact in theconduct of an inquiry. Those who are not in closecontact with coroners and their work can have noidea of the services rendered to the public by such menas Guthrie. Of failing health for some years past,one could not but admire the way he stuck grimly tohis task to the end."

Dr. Guthrie died at his home at Wimbledon in his70th year.

____

CHARLES COLES, M.D. Lond.Dr. Charles Coles died suddenly on April 15th

at his home in St. Margaret’s-road, Oxford, where hehad lived in retirement for some years. He wasthe son of the late Mr. J. Coles of Uxbridge, and waseducated at St. Bartholomew’s Hospital, where hedistinguished himself as an athlete in football, cricket,and tennis. He filled there the offices of house physicianand house surgeon, and was also house physicianat the Brompton Hospital for Consumption. He heldthe Brackenbury scholarship at St. Bartholomew’sand graduated as M.B. Lond. in 1890. Two yearslater he took the M.D. degree, securing the goldmedal, and later was awarded the gold medal whentaking the M.D. degree in State medicine. For ashort time he was in practice in Leicester but gavethis up owing to temporary ill health, and enteringthe public health service was in 1899 appointedmedical officer for the combined districts of Leicester-shire and Rutland. In 1901 he was appointed medicalofficer for the Oxfordshire united sanitary districtsand in 1911 county and school medical officer to theOxfordshire county council. His work for the countycouncil was never spectacular but was always sound.It was not an easy task for the demand for an increasein the scope of the public health services was difficultto satisfy from the resources of an agricultural area.In these matters he was always loyal to the countycouncil while yet retaining the respect and regard ofthe medical profession.

Coles’s leisure time was spent in gardening andin the study of the natural history of the country-side, especially butterflies and birds. He had the

" gardener’s thumb," and plants flourished underhis care ; even in the poor soil of a north Oxfordgarden he made roses bloom to perfection. Hewould spend the greater part of the day after retire-ment in his garden, and his great delight was to pointout to the occasional visitor the points of growthand development of the different varieties and howhe had been able to produce the result. He had asmall greenhouse and grew roses in pots for earlyblooms. He had also an extensive knowledge offield botany.He was of a retiring habit and did not make many

friends, but his friendship when given was real andlasting. He leaves a widow, a son, and a daughter.

JOHN TAYLOR, M.D., Ch.M. St. And.lIuCA regret was felt at the announcement of the

death on April 14th, at the age of 44, of Mr. JohnTaylor, hon. surgeon in charge of the OrthopaedicDepartment, Dundee Royal Infirmary.

Mr. Taylor, who had been in poor health for abouttwo years, had been unable to carry on his practicefor some months. He graduated M.B., Ch.B. inSt. Andrews University in July, 1914, and a monthlater went out to France before the majority of theExpeditionary Force had left this country. He was,

however, early invalided home and in 1916 was

appointed resident surgical officer in the DundeeWar Hospital. In 1917 he proceeded to the M.D. degreeand again went abroad on service, on this occasionto Mesopotamia as surgical specialist. From thatfield of operation he was invalided, but later becamesenior medical officer in Bihar and Orissa. Afterthe war he continued in association with the Terri-torial Force, in which he ultimately held the rank ofcolonel and was A.D.M.S. to the 51st (Highland)Division. He was specialist in tropical diseases forthe Ministry of Pensions and surgeon to the Dudhopeorthopaedic annexe. When he rejoined the medicalschool he acted successively as assistant to theprofessor of pathology and lecturer in regionalanatomy at University College, Dundee. He wasappointed surgical tutor at Dundee Royal Infirmaryin 1920, later assistant surgeon, and finally ortho-

paedic surgeon. On his resignation in 1935 on accountof ill health he was appointed honorary consultingsurgeon. He was a fellow of the Association of Surgeons,member of the Anatomical Society, and associatemember of the Orthopaedic Society of Great Britain.He gave much time to research and for ten years,with Prof. Weymouth Reid and Dr. Stiven, carriedon investigations into the function of the pancreas.

His death is regretted among all classes of thecommunity in Dundee ; he was known as an ablesurgeon and a generous-hearted and kind friend.

DAVID SMART, M.B., C.M.Edin.Dr. David Smart, who died suddenly on April 7th

at Bootle, was medical referee to the ShippingFederation. A Scotsman born at Meigle, Perthshire,he was educated at Dundee High School and theUniversity of Edinburgh, where he graduated as

M.B., C.M., obtaining at the same time the Buchananfellowship. He was for a period resident in chargeof the gynaecological wards at the Edinburgh RoyalInfirmary and then went to Liverpool on appoint-ment to the Smithsdown Road Institution, becomingassistant surgeon to the Liverpool Hospital forWomen and the Toxteth Poor Law Hospital. At the

Liverpool Hospital for Women he met his wife,Dr. Blanche Z. Smart, who was also a medical officerat the institution, and for many years they were ingeneral practice in partnership. The war foundDr. David Smart well equipped. He had alreadygiven service to the old volunteers and when he cameto Liverpool continued his association with theterritorial army by joining the 6th Liverpool Rifles.He was associated with Dr. Graham Martin in raisingthe Liverpool bearer company, whose memberswere later transferred to the lst and 2nd WestLancashire Field Ambulances. During the war

he was Assistant Director of Medical Services to the57th and 73rd Divisions, and retired with the rank ofCol. A.M.S. (T.). Dr. Smart was highly respectedand popular in the city of Liverpool and his deathis a subject of general regret in the city and in theneighbourhood. The end was very sudden for hecollapsed and died while conducting an examinationof seamen at the Brocklebank dock.

NORMAN COLLUM PATRICK, M.R.C.S.Eng.,D.P.H.

THE death of Capt. Norman Collum Patrick, tookplace on March 24th in Belfast following a brief illness.As chief medical officer to the Ministry of HomeAffairs of Northern Ireland, Capt. Patrick was anoutstanding figure in the profession and was every.

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where respected for the devotion with which he carriedout his duties, and for his kindly and sympatheticdisposition. He was educated at Rossall and

Cambridge University and went for his medicaltraining to St. Bartholomew’s Hospital. After

qualification he served as dispensary medical officerto the Glenavy district of Co. Antrim and subse-

quently was appointed tuberculosis officer for the

county. At the outbreak of hostilities in 1914he volunteered for active service and served through-

out the greater part of the war as Captain R.A.M.C.attached to the 110th Field Ambulance, 36th UlsterDivision. After the war, when the Northern Govern-ment was formed, his professional ability was

recognised by his appointment to the Ministry ofHome Affairs and later in his rise to the rank ofchief medical officer. His loss is deeply regrettedby his associates at the Ministry and by many whofound in him a loyal friend and a wise counsellor.He is survived by his wife and one daughter.

CORRESPONDENCE

POSTURAL DEFORMITIES OF THE

ANTEROPOSTERIOR CURVES OF THE SPINE

To the Editor of THE LANCETSiR,—The communication by Mr. Philip Wiles

published in your issue of April 17th comes at anopportune moment when a national policy to improvethe physique of the people is being planned. Habitualuse of the body with any real increase of the normalanteroposterior curves of the spine is undesirable.Mr. Wiles states that voluntary control over themovements that correct a postural deformity iseasily taught when adequate mobility is present.In many cases, however, in view of the state of fatigueof the anti-gravity muscles and the general lackof responsiveness, it is not easy, in my opinion, toget these muscles to maintain an improved position.A period of reconstructive rest in bed for two or threeweeks may be necessary as a preliminary to exercises.The mattress should be firm. The patient lies on hisback with a low pillow beneath the head and kneesand three times daily, for half an hour, after meals,the thoracic spine is hyperextended by placing afirm pillow beneath it, the hands being clasped behindthe head. This leaves the lumbar spine unsupported,and exerts a slow, corrective leverage upon the wholespine. It opens out the subcostal angle, and allowsthe patient to be instructed in correct breathing.The patient is then turned over, to lie face downwardsupon a pillow placed lengthwise beneath the trunk ;hot fomentations may be applied to the spine for15 minutes, after which the patient resumes thefirst position described.

After ten days or so the improvement in the

mobility of the spine and in the pliability of themuscles may be quite astonishing. Now is the timeto begin spinal massage and instruction in a simpleseries of lying-down postural remedial exercises,designed chiefly to teach the patient how to flattenthe lumbar spine and to contract the side-abdominalmuscles. Exercises in control are far easier to learnwhen lying down. It is now in order to allow thepatient up for postural remedial training, the objectof which is to cause him to maintain an habituallyimproved attitude in standing, sitting, walking, andbreathing. As a useful temporary makeshift untilthe muscle-sense of proper balance is restored, a

light spinal back-brace to span the lumbar curveis often worn ; without it many quickly relapse intobad habits of poor posture, and therefore no hesitationshould be felt in prescribing its use.The order of treatment, then, is reconstructive

rest, remedial training, and support. The simplicityand lasting efficiency of these methods I have oftenproved in practice. They are not practised nearlyenough. One hears a great deal about the activeside of treatment, such as massage, exercises, andso on, and far too little, in my view, of the opposite,or passive, side which should precede and complete

the active side. Reconstructive, rehabilitating restand support are just as important as exercises as

a basis of restoration of correct use and function of thebody. When the three weeks’ period of rest is over,the patient should still, for a considerable time,have two half-hour periods of hyperextension on

the pillow daily. It is not a bad plan with slender,physically delicate subjects to make a posteriormoulded plaster-of-Paris shell in which the patient maylie at night, or for part of the night. In aggravatedcases it may be advisable to hyperextend the dorsalspine for a time upon an angled Bradford frame.

In the process of training, it should constantlybe remembered that in all body actions it is the headwhich leads in maintaining a proper static position.If the head is stretched up tall, with the chin held in,it causes the chest to be elevated and the diaphragmto work properly ; it draws up the abdominal contents,and gets the body forward on to the balls of the feet.The fixed, elevated thorax thus assists in affordinga strong basis of support for the action of the abdo-minal muscles. These muscles, after all, have to beallowed to assist the gluteal muscles in flattening thelumbar spine.-I am, Sir, yours faithfully,

W. A. COCHRANE.

, To the Editor of THE LANCET

SiR,-Your leading article last week on improve-ment of posture provided a valuable commentaryon Mr. Wiles’s paper, with an appreciation of theprotagonist of correct posture-Goldthwait of Boston-not mentioned by Mr. Wiles. The phrase " goodbody mechanics " first introduced by Goldthwait hashelped me very much to crystallise the generallyrather vague conceptions of what is to be gained byphysical exercises. Since seeing the results of histheories applied in practice at the Robert BrighamHospital in Boston, I have taken the opportunity ofstudying and correcting the bad mechanics of incorrectposture at the Charterhouse Rheumatism Clinic. Itis especially in rheumatoid arthritis and in spondy-litis adolescens (Marie Strumpel syndrome), and evenmore so during the prespondylitic stage of bilateralsacro-ilitis, that the very simple postural exercisesdescribed by Goldthwait (1922, 1934) have proved ofimmense benefit. I have adapted three for use, allof which are performed lying on the back on theground or other plane surface. As you yourselfsuggest, this is the position which provides ,thenecessary resistance to the flexors and support forthe (weaker) extensors.

1. Hands behind head, elbows pressed outward anddown, chest raised to the fullest extent. Breathe deeply10-15 times, without lowering the chest. According toGoldthwait and Loring Swaim, this produces full dia-phragmatic breathing, empties the splanchnic veins, andenlarges the abdominal cavity by widening the subcostalangle.

2. When chest expansion is poor and the subcostalangle narrowed, one hand is placed on top of the head,