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surface, for a considerable quantity may be blown outinto a handkerchief although this was impossible before.Repeat this process every two hours. I find that itaborts a cold completely within a day or a day and ahalf, whereas otherwise it would have lasted a week ormore. I call it the " explosive gargle " and I havefound it far more effective than ordinary gargling or anyform of nasal spray. I understand that nasal spraysare to be used for the administration of patulin, soperhaps this idea may be useful.

Spalding, Lines. E. PICKWORTH FARROW.

THE NURSE IN CHARGESIR.,—Your leading article mentions one of the diffi-

culties in the medical treatment of the junior nurse.Most adults, when they feel the need of advice, can godirect to a doctor. Surely the nurse should be able todo the same, without the intervention of the nurse incharge and the home sister ? When the probationerreaches the doctor she may be shy of discussing her affairsbefore a sister and, as you say, in the absence of a specta-cular rise in temperature, she may feel that she is con-sidered to be making an unnecessary fuss. In such anatmosphere it is difficult for the doctor to do his bestfor the patient.

I believe the junior nurse would be more likely to seekearly treatment and to benefit by it, if her contact withthe doctor were direct. If she wished, she should beable to take a friend with her and the family doctorrelationship should be established as nearly as possible.

Oxford. VICTORIA SMALLPEICE.

THE NURSE’S PAY

SIR,—The scales published in the second Rushcliffe report have received the approval of the general pressand the nursing profession will welcome them as a whole,but there are inconsistencies, particularly- in regard tothe salaries of ward sisters and women staff nurses.As your annotation of Dec. 11 (p. 740) points ’out,discrimination in favour of men is very marked, andas before the ward sister comes off poorly. Under theLondon County Council, the male student nurse, whenhe becomes state-registered, gets a higher salary in hisfourth year of training than the ward sister in her firstyear, and the staff nurse in her tenth year in that grade(i.e., after fifteen years of service). In the same way,the male charge nurse, who corresponds to the wardsister begins under the LCC at a salary of £300 6s. ayear, while the ward sister’s maximum only reaches£ 300 after ten years’ service in that grade ; and themale assistant nurse after only two years’ training startsat a salary of £232 14s. a year, while the ward sisterwith probably four years’ general training, and at leastone year’s experience as a staff nurse, only begins at.8230. Surely the fully qualified woman should receivemore than the less highly qualified man. You notethat the health visitor receives a higher salary than thedistrict nurse ; she also has the advantage over theward sister. Under the LCC a health visitor receives£300 a year rising to £390 a year compared to the wardsister’s £230 rising to .8300. A health visitor in theprovinces gets .8270 rising to £360. The report statesthat the salary is designed to induce suitable candidatesto enter and stay in this branch of work : surely it isequally important to induce suitable persons to becomeward sisters.

Nursing Times.KATHARINE F. ARMSTRONG,

Editor.

SPINA BIFIDA, HYDROCEPHALUS ANDOXYCEPHALY

SIR,—It is with pleasure we read your leading articleof Nov. 27, not only because you envisage a more hopefulprognosis in suitable cases by reason of endoscopicelectrocoagulation and other means, but also becauseyou focus attention upon aspects of these diseaseswhich are so little known. However, we suggest thatthe subject is even more intricate than you describe.Thus it is not- generally appreciated that the " con-volutional thinning " to which you refer in associationwith craniostenosis is equally common in cases ofspina bifida and hydrocephalus, and is sometimes seen

even in normal infants. Indeed, it is doubtful if thethinning is " convolutional," since careful examinationshows that the areas of thinning do not correspond inposition to the gyri, and also they differ markedly inradiological appearances from those seen in " thumbing "of the skull, which are due to convolutional pressure inknown cases of cerebral tumour, &c. In many cases,such as myeloceles, the intracranial pressure cannot beincreased and yet the " convolutional thinning " maybe very pronounced ; other evidence of raised pressure,such as the increased size and width of the fontanellesand sutures, may not be present, the thinning havingbeen shown to be independent of whether the suturesare closed, exaggerated, or normal in width. Moreover,the bone formed between the areas of thinning may betwice as thick as the normal skull, so that pressureatrophy cannot be the whole story. Finally, this" convolutional thinning," which has been called cranio-lacunia or craniofenestria according to its degree ofdevelopment, offers a valuable guide to the prognosisof operations, and will help other surgeons to selectfavourable cases and to approach the excellent figuresof Ingraham and his associates, which you quote.Manchester.Isleworth.

J. BLAIR HARTLEY.C. W. F. BURNETT.

ObituaryJOHN MICHAEL BARKLA

MB EDIN, FRCSE; FLIGHT-LIEUTENANT RAF

J. Michael Barkla was born in 1915, two years after hisfather Prof. C. G. Barkla, a Nobel laureate, had left theWheatstone chair of physics in London to occupy thechair of natural philosophy inEdinburgh. Michael enteredMerchiston Castle School in 1925where he took a prominent partin games and in the musical activi-ties of the sehool. He was wing’three-quarters in the first xv, andin his last year won the 100 yardsand the quarter-mile, equalling theschool record in the former. Butafter entering the medical schoolof the university in 1933, he gaveup all formal athletics, and in thevacations walked and climbedwith student friends in this countryand on the Continent. His uni-versity course was a series ofsuccesses. In 1938 he was

awarded the Ettles- scholarship asthe most distinguished graduate of the year, and in thefollowing year the Allan fellowship for clinical medicineand clinical surgery. After graduating he worked at theRoyal Infirmary as clinical assistant and house-physicianto Dr. Fergus Hewat and as house-surgeon to Prof.J. R. Learmonth. later becoming clinical tutor. For atime he lived at the Eastern General Hospital, where hewas resident surgical officer-to deal if need be with civil .air-raid casualties. He was also university demonstratorof anatomy under Professor Brash from 1939 to 1941.In the autumn of 1942 Barkla joined the RAF and thefollowing spring he went to North Africa as surgeon witha mobile field hospital. He spent a short time workingin the hospital on Lampedusa, but after returning to theneighbourhood of Tunis he lost his lifein a motor accident.

Professor Learmonth writes : " With Michael Barkla’sintellectual ability went practical capacity and wisejudgment of uncommon degree ; and all these giftshe wore with a modesty that was an example to those lessfortunate. He gave scrupulous care to every aspect ofhis work, and gained at once the respect and the confid-ence of those shrewdest of judges, his patients and hisstudents. When he left to go on service, he had a finerecord in the surgery of emergencies, and these practicalsuccesses depended as much on his devotion to hispatients as on his operative dexterity. He was a gayand stimulating colleague, whose untimely death robsthe Edinburgh school of a career that could not but haveadorned it, and his associates there of a lovable friend."