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Obituary

EDITH JOAN MILLARM.B.Durh., F.F.A. R.C.S.

Dr Millar, a former senior consultant ansesthesist tothe Newcastle regional cardiothoracic surgical service,died on July 21 at the age of 68.

She graduated from Durham University in 1932 and spentmost of her career as an anxsthetist in thoracic surgery. WithDr Philip Ayre she was involved in the early thoracic oper-ations in the North East of England, and, in 1940, she cooper-ated with the late Mr George Mason in establishing a smallthoracic surgical unit for battle casualties at Stannington Hos ’-pital. She was concerned in the creation of the regional centreat Shotley Bridge General Hospital in 1943, and later shepioneered the development of cardiopulmonary bypass foropen-heart surgery at Shotley Bridge. She was president of theNorth of England Society of Anaesthetists in 1953-54.

E. A. C. and J. A. G. H. write:"The development of thoracic surgery in the North of Eng-

land could not have progressed so smoothly without her un-flagging loyalty and wise judgment on clinical matters. Herorganising ability, her dedication to team work, her skill inanxsthesia, in diagnostic procedures, and in pre and post oper-ative care earned the profound respect of her colleagues. Upto the day of her retirement, although she had by then builtup an excellent team of younger colleagues, she insisted on tak-ing a full and unvarying share of operating lists and emer-gency duties both for surgery and in the intensive-care unit.

Apart from her work she will always be remembered by count-less visitors to the ’clinic’ at Shotley Bridge and by her profes-sional colleagues throughout the North of England for her un-failing kindness and consideration."

LORD PLATT OF GRINDLEFORD

H. T. N. S. sends this further tribute:

"I was privileged to work with Robert Platt in the depart-ment of medicine when he was in Manchester, and I saw himat close quarters, perhaps in an unusual light, from the view-point of a general practitioner. He had asked me to take overthe follow-up care of his large collection of hypertensives, who,in 1954, could be offered effective treatment for the first time.When we published a joint paper in The Lancet in 1956, I littlerealised how unusual it was to be: a future P.R.C.P., writingwith a general practitioner. It was his interest in, and care ofthe patient as an individual that was immediately apparent.He knew them all by name, and I was introduced personallyto each one, whom he had hitherto seen himself in his roomat the Infirmary. So keen was he on the care of the whole per-son that he paid many a visit to general practices, includingmine in Cheshire, to see how they worked. Always with someoriginal thought about a problem, and often laced with hispuckish sense of humour, he would sit through whole sur-geries. He was as interested in the short cuts as in the attentionto detail and investigation in general practice. A kind, warmman with breadth of vision and an incredible knack of gettingto the core of a problem, or seeing a completely different angle.Above all, his patients loved him."

"

Dr A. C. STANLEY SMITH, who served for over fifty years asa medical missionary in Uganda, Rwanda, and Burundi, diedon Aug. 1.

Dr CALVIN WELLS, a distinguished authority on palxopath-ology, died on July 31.

Notes and News

OF MUTANT MICE AND MONITORS

ONE of the most exciting recent advances in genetic researchin Britain has been the discovery, by Dr R. Gardner and DrC. E. Graham of the zoology department at Oxford University,that teratocarcinoma cells maintained in vivo or in vitro can,when injected into early mouse embryos, take part in normaldevelopment and give rise to various tissues, including germcells. This discovery, reported by a subcommittee of the Medi-cal Research Council appointed to review the state of clinicalgenetics in the U.K.,’ could perhaps lead to an explanation ofhow malignancy can be modified; it may also mean that newmouse models can be created for specific inborn errors ofmetabolism, by the incorporation of tumour cells selected invitro for particular metabolic defects.The mouse is probably the most widely used mammalian

model in biomedical research, and the subcommittee suggeststhat a centre for breeding and maintaining mutant mice, ofwhich over 400 strains have so far been described, is now apressing need in genetic research. Many of the more specialisedgenetically marked strains are at present obtainable only froma laboratory in the U.S.A. A central cell bank for tumour cells,mutants, and hybrids would also be valuable, but it would bevery expensive to set up and run, and the subcommittee sug-gests that extra financial support for the few laboratories thatalready have experience of producing certain kinds of cellswould be a useful first step towards the establishment of sucha centre.

On the clinical side, the subcommittee emphasises the needfor monitoring systems to provide feedback about the effective-ness of genetic services offered to the public. A national regis-ter of amniocenteses, for instance, could be used to assess thereliability of prenatal diagnosis and the safety of amniocentesisand would enable the incidence of fetal abnormality in variouscategories of pregnancy to be determined. Prospective studiesof genetic counselling would show whether the service is reach-ing all social classes, whether the clients understand the advicegiven, and whether they act upon it. An assessment of this kindmight also reveal a need to give information about other ser-vices, such as family planning. A major challenge to geneticcounsellors is how to advise patients of reproductive age whohave been successfully treated for Hodgkin’s disease or lym-phoblastic leukaemia with multiple chemotherapy and radia-tion. Not all will be made infertile by their treatment, but itis not yet possible to say what risk the fertile patients run ofproducing a malformed fetus or whether the risk diminisheswith increasing time after completion of chemotherapy. Earlyassessment based on a well-designed monitoring system wouldclearly be valuable.

PAYMENTS TO THE VACCINE-DAMAGED

THE scheme for vaccine-damage payments2 will provide for£ 10 000 tax-free for persons who have, since July 5, 1948, suf-fered severe damage as a result of vaccination (under routinepublic policy vaccination programmes) against diphtheria,tetanus, whooping-cough, poliomyelitis, measles, rubella (alsowhen given to women of childbearing age), tuberculosis

(B.C.G.), and smallpox (up to July 31, 1971). The criterion forpayment will be disablement due to vaccine damage assessedat 80% or more, according to the established rules for indus-trial injuries disablement benefit, and the receipt of attendanceor mobility allowance for conditions which could be attributedto vaccine damage will be accepted as evidence of severedamage. These payments will not prejudice the rights of those

1. Review of Clinical Genetics. A Report by the M.R.C. Subcommittee toReview Clinical Genetics, 1978.

2. See Lancet, 1978, i, 1028, 1056.