799 minate all rental agreements by administrative action. But his present intention was not to withdraw a facility unless there was a reasonable alternative available.
Notes and News HANFORD EVIDENCE REVIEWED
Obituary GEORGE FRANCIS ABERCROMBIE
V.R.D., M.A., M.D.Camb., F.R.C.G.P. Dr Abercrombie, who was President of the Royal College of General Practitioners from 1959 to 1962, died on Sept. 25 at the age of 82. He was educated at Caius College, Cambridge, and St Bartholomew’s Hospital, London, where he held house appointments, before going on to the Hospital for Sick
Children, Great Ormond Street. He entered general practice in 1924. He was lecturer in general practice at Barts from 1953 until his retirement in 1966. He had a long association with the R.N.V.R. and he was appointed honorary physician to King George VI in 1950.
A.T.R. writes: "General practice has good reason to be grateful to George Abercrombie. In 1950, he was one of a group of general practitioners who established the Section of General Practice of the Royal Society of Medicine; he became the first president of the section, and was later elec:ed an honorary fellow of the Society. From the beginning, the section flourished; its meetings were well attended and the calibre of speakers, both in opening papers and in debate, was high. Two years later a steering committee was formed to establish a college of general practitioners. Of the ten general-practitioner members of that committee, six, including George Abercrombie, were members of the council of the section. Their experience of working together to establish the section helped greatly in the formidable task of founding the College. In both these tasks, Abercrombie played an outstanding part. He was the first chairman of council of the College, and served under the first two Presidents, William Pickes and Ian Grant. He himself became its third President in 1959. So, for ten years and more, he was in office helping to shape a course for the -infant College. His thoughtful counsel did much to ensure the weathering of the first difficult years and the laying of sound foundations for the future of the Royal College."
Prof. HENRY BEDSON
A member of the W.H.O. Special Study Group for Poxvirus Infections, sends this addition to our obituary of Sept. 16 (p. 641):
opinion the work he did with Keith Dumbell, which simple method for the differentiation of smallpox and alastrim viruses (alastrim will not grow above 375°, smallpox will grow at up to 38-5°), and the discovery of a third type of ’intermediate’ smallpox in East Africa, probably represents the greatest contribution made by laboratory workers to the study of smallpox since the virus was first isolated. His studies on genetic hybrids of smallpox would, if finished, provide clues as to why smallpox and alastrim differ so much in virulence. More recently he had also been analysing the biochemical basis for the differences between smallpox and alastrirr viruses and was beginning to apply these techniques to the socalled ’wild-white’ poxviruses. It is these viruses, isolated frorr African primates and rodents, which pose the greatest problems as the smallpox eradication campaign reaches its climax for laboratory studies have so far failed to distinguish then from smallpox virus. It is because of circumstances such as thi’ "In my
provided
a
that the W.H.O. Eradication Unit needed to obtain more dat: on smallpox and related viruses, while trying to restrict theil study to as few laboratories as possible."
Two years ago Dr Alice Stewart presented to the Health Physics Society meeting at Saratoga Springs, New York, an analysis of certified deaths of employees at the Hanford Works in Richland, Washington, where work involving exposure to ionising radiation had been carried out for over thirty years. No-one denies that the Hanford experience ought to be a good one for study by those interested in the effects of radiation on health, but, both before and after publication,the "Mancuso study" has been heavily criticised. The practical conclusion of the study was that generally accepted doubling doses for malignant disease induced by ionising radiation are wrong. The National Radiological Protection Board2has gathered together some of the criticisms, including unpublished comments from Dr C. E. Land of the National Cancer Institute. The main criticisms are that the doses were so low that background and non-occupational exposure must confound interpretation; that dose records are incomplete (and so may be ascertainment of cause of death); that the statistical methods may not be appropriate. The N.R.P.B. concludes: "... a wide body of experts agree that there is no evidence in the Hanford data to support the suggestion that ICRP values do seriously underestimate the risk."
REPORTS ON SI]DE-EFFECTS OF DRUGS AN item in a recent issue of Scrip (Sept. 16, p. 6), a periodical of pharmaceutical news which circulates largely within the pharmaceutical industry, suggested that The Lancet had undertaken to consult with a manufacturer before publishing any report on side-effects associated with one of his products. This is not true.
BASIC HEALTH SERVICES AT a world consultationlast year on the roles and education of health-care personnel the view was repeatedly heard that health services in many countries were not keeping pace with changing populations, either in quantity or quality. Dr T. Fulop, director of the W.H.O. Division of Health Manpower Development, said that in over half those countries inhabited by the majority of the world population there are less than 5 physicians per 10 000 people. In Thailand, for example, the ratio of doctors to population is 1/7600; in Zaire it is 1/27 000. Medical manpower in developing countries is often concentrated in urban areas, because of a reluctance among trained personnel to work in the poorer rural districts. Training in primary health care is also regarded by many as less important and satisfying than more specialised work. The result is an unbalanced and fragmented health service, often completely unsuited to the needs of a largely uneducated rural population. Several delegates from both developed and developing countries called for a radical change in manpower planning with greater emphasis on the provision of care at primary level, a call repeated last month at the Alma-Ata conference.’ In the third world the traditional western system of medical training, 1. Mancuso, T., Stewart, A., Kneale, G. Hlth Phys. 1977, 33, 369. 2. An Assessment ofthe Mancuso Study. By J. A Reissland, M.R.P.S. 3. The Changing Roles and Education of Health Care Personnel Worldwide in view of the Increase of Basic Health Services. Papers from a consultation sponsored by the Society for Health and Human Values, 1100 Witherspoon Building, Philadelphia, Pennsylvania 19107 4. See Lancet, Sept. 23, 1978, p. 666
800 which
Dr Ruthven Mitchell has been appointed director of the Glasgow and West of Scotland Blood Transfusion Service which covers a population of approximately 3,000,000 in the West of Scotland.
emphasises prevention of disease rather than mainof health is often unsatisfactory because it minimises people’s responsibility for their own health. Several countries have revised their medical training programmes: in parts of South America students are required to work in rural hospitals during their sixth year and much of the teaching is done by tenance
The Tuberous Sclerosis Association of Great Britain will hold itsI annual meeting on Nov. 11, 1978 at the Conference Hall, National Children’s Bureau, 8 Wakley Street, London EC IV 7QE. Details may be had from Mrs Ann Hunt, Church Farm House, Church Road, North Leigh, Oxford OX8 6TX.
rather than doctors; in China the peasant barefoot docreceives basic training which is supplemented by mobile health-care teams from the city hospitals, and roughly a third of China’s medical students come from barefoot origins. The development of primary health services is also receiving more attention in developed countries. In Sweden, for instance, postgraduate students must complete a period of 21 months’ general service, which includes 6 months’ training in primary health care. There was, however, a general feeling among the delegates that the undergraduate medical course should include training not only in primary health care but also in the social services and the humanities. nurses
tor
The University of London Institute of Obstetrics and Gynaccology will hold a symposium on Respiratory Distress Syndrome at Queen Charlotte’s Maternity Hospital, London, on Dec. 8, 1978. Details may may be had from the Symposium Secretary, Institute of Obstetrics and Gynxcology, Queen Charlotte’s Maternity Hospital, Goldhawk Road, London W6 OXG. The Indian Society of Human Genetics will hold its 5th annual conference in Bombay on Dec. 20-24, 1978. The conference will include an international symposium on population structure and human variation. Details may be had from Dr Lalit M. Ambani, Institute for Research in Reproduction, Bombay-400012, India.
SARCOIDOSIS AND OTHER GRANULOMATOUS DISEASES THOSE who met at a recent international conference in Cardiff agreed that sarcoidosis is distributed worldwide and must be distinguished from other granulomatous disorders. Diagnosis requires proof of multisystem involvement-e.g., centralnervous-system and cardiac lesions-and can be aided by electronmicroscopy (to assist in excluding known granulogenic agents) and new techniques such as computerised tomography which join the still useful transbronchial biopsy and KveimSiltzbach skin test. The serum-angiotensin-converting enzyme concentration is also of diagnostic value and is both course and steroid dependent. Like the less specific serum-lysozyme, this enzyme is probably derived from granuloma cells. Family studies on an association between HLA-B8, erythema nodosum, and arthritis have been inconclusive. Pulmonary-lavage fluid has a raised Ig level and-unlike the blood-an adequate number of activated T lymphocytes. Why they are there is unclear. Lung function tests may show diffusion defects and also some degree of chronic airways obstruction. The steroid response depends upon the degree of fibrosis, and increasing awareness of myocardial involvement suggests a further indication for treatment. The conference discussed the pathology of granulomas in detail. The constituent cells of sarcoid granulomas have a complex relationship and granulomas of other diseases consist of similar, sometimes identical, cells.
Proceedings of the VIIIth International Conference on Sarcoidosis. and Other Granulomatous Diseases will be obtainable from Alpha Omega Publishing Ltd, P.O. Box 88, College Buildings, University Place, Cardiff CF1 ISA.
University of London Dr A
of
The British Heart Foundation will hold a symposium on non-invasive techniques in cardiology at the Imperial College of Science and Technology, London, on June 26-28, 1979. Details may be had from Conference Services Ltd., 43 Charles Street, London Wl.
Correction Lead and Renal Disease.-We apologise to Dr R. P. Wedeen for the mis-spelling of his name in his letter (p. 477) and on the title page of our issue of Aug. 26.
Diary
of the Week
OCT. 8 TO 14
Tuesday,
’
10th
INSTITUTE OF CHILD HEALTH, 30 Guilford Street, London WC1N 1EH 5.30 P.M. Mr Stanley 0. Aylett: Total colectomy and Ileorectal anastomosis in the surgical treatment of ulcerative colitis m the young. (Alex Simpson Smith lecture.)
Wednesday,
llth
INSTITUTE OF NEUROLOGY, Queen Square, London WC1 6 P.M. 1’rot. N. A. Mnchison, F.R.S. Cellular interactions in immunology. 7 P.M. Prof. W. Bryan Matthews: Neurological comphcanons of sarcoidosis. (Sandoz Foundation lectures.) INSTITUTE OF ORTHOPAEDICS, 234 Great Portland Street, London WIN 6AD 6 P.M. Mr R. Saunders: Recent Advances in Skin Cover. 7 P.M. Mr J. C. Angel: Functional Cast Bracing. WEST LONDON HOSPITAL, Hammersmith Road, London W6 5.30 P.M. Mr Alan G. Johnson: The pylorus and peptic ulcer. (Alex Simpson Smith lecture.) ROYAL COLLEGE OF SURGEONS OF EDINBURGH, Nicholson Street, Edinburgh EH89DW 4.30 P.M. Mr A. G. D. Marran: Malignant disease of the oral cavity.
Thursday, 12th
Garner, reader in experimental pathology
Ophthalmology has pathology at the Institute. tute
The W.H.O./Menarini symposium, entitled Renal Pathophysiolwill be held in Florence on Jan. 26-29, 1979. Details may be had from Prof. A. Leaf, Harvard Medical School, Massachusetts General Hospital, Boston MA 02114, U.S.A.
ogy-Recent Advances,
been
appointed
to
the Instithe chair of at
Dr J. C. Gunn, senior lecturer in forensic psychiatry at the Institute of Psychiatry has been appointed to the chair of forensic psychiatry at the Institute. Dr P. H. Millard, senior lecturer in geriatric medicine at St George’s Hospital Medical School and director of the Geriatric Teaching and Research Unit, has been appointed to the Eleanor Peel chair of geriatric medicine at the school. Prof. Alison McDonald of McGill University has been appointed to the chair of epidemiology and preventive medicine at St. Mary’s Medical School.
ROYAL COLLEGE OF PHYSICIANS OF LONDON, 11 St. Andrew’s Place, London NW1 4LE 5 P.M. Dr James Spencer Malpas: Cancer in children. (Lockyer lecture.) ROYAL COLLEGE OF SURGEONS OF ENGLAND, Lincoln’s Inn Fields, London WC2A 3PN 5 P.m. Prof. J. Leigh Collis: The organisation of the specialty of cardiothoracic surgery. (Tudor Edwards lecture.) ST. MARY’S HOSPITAL MEDICAL SCHOOL, London W2 1PG 5.15 P.M. Prof. Stuart Campbell: The application of ultrasound in clinical obstetrics and gynxcology. (Aleck Bourne lecture.) ONCOLOGY CLUB, Royal Marsden Hospital, London SW3 6JJ 6.30 P.M. Dr Eve Wiltshaw: Carcinoma of the Ovary.
Friday, 13th SOCIETY
6.30
SOCIAL HISTORY OF MEDICINE School of Hygiene and Tropical Medicine.) Dr Robert Heller: The education of the blind in the 18th century.
FOR THE P.m.
(London
Notes and News HANFORD EVIDENCE REVIEWED
Obituary GEORGE FRANCIS ABERCROMBIE
V.R.D., M.A., M.D.Camb., F.R.C.G.P. Dr Abercrombie, who was President of the Royal College of General Practitioners from 1959 to 1962, died on Sept. 25 at the age of 82. He was educated at Caius College, Cambridge, and St Bartholomew’s Hospital, London, where he held house appointments, before going on to the Hospital for Sick
Children, Great Ormond Street. He entered general practice in 1924. He was lecturer in general practice at Barts from 1953 until his retirement in 1966. He had a long association with the R.N.V.R. and he was appointed honorary physician to King George VI in 1950.
A.T.R. writes: "General practice has good reason to be grateful to George Abercrombie. In 1950, he was one of a group of general practitioners who established the Section of General Practice of the Royal Society of Medicine; he became the first president of the section, and was later elec:ed an honorary fellow of the Society. From the beginning, the section flourished; its meetings were well attended and the calibre of speakers, both in opening papers and in debate, was high. Two years later a steering committee was formed to establish a college of general practitioners. Of the ten general-practitioner members of that committee, six, including George Abercrombie, were members of the council of the section. Their experience of working together to establish the section helped greatly in the formidable task of founding the College. In both these tasks, Abercrombie played an outstanding part. He was the first chairman of council of the College, and served under the first two Presidents, William Pickes and Ian Grant. He himself became its third President in 1959. So, for ten years and more, he was in office helping to shape a course for the -infant College. His thoughtful counsel did much to ensure the weathering of the first difficult years and the laying of sound foundations for the future of the Royal College."
Prof. HENRY BEDSON
A member of the W.H.O. Special Study Group for Poxvirus Infections, sends this addition to our obituary of Sept. 16 (p. 641):
opinion the work he did with Keith Dumbell, which simple method for the differentiation of smallpox and alastrim viruses (alastrim will not grow above 375°, smallpox will grow at up to 38-5°), and the discovery of a third type of ’intermediate’ smallpox in East Africa, probably represents the greatest contribution made by laboratory workers to the study of smallpox since the virus was first isolated. His studies on genetic hybrids of smallpox would, if finished, provide clues as to why smallpox and alastrim differ so much in virulence. More recently he had also been analysing the biochemical basis for the differences between smallpox and alastrirr viruses and was beginning to apply these techniques to the socalled ’wild-white’ poxviruses. It is these viruses, isolated frorr African primates and rodents, which pose the greatest problems as the smallpox eradication campaign reaches its climax for laboratory studies have so far failed to distinguish then from smallpox virus. It is because of circumstances such as thi’ "In my
provided
a
that the W.H.O. Eradication Unit needed to obtain more dat: on smallpox and related viruses, while trying to restrict theil study to as few laboratories as possible."
Two years ago Dr Alice Stewart presented to the Health Physics Society meeting at Saratoga Springs, New York, an analysis of certified deaths of employees at the Hanford Works in Richland, Washington, where work involving exposure to ionising radiation had been carried out for over thirty years. No-one denies that the Hanford experience ought to be a good one for study by those interested in the effects of radiation on health, but, both before and after publication,the "Mancuso study" has been heavily criticised. The practical conclusion of the study was that generally accepted doubling doses for malignant disease induced by ionising radiation are wrong. The National Radiological Protection Board2has gathered together some of the criticisms, including unpublished comments from Dr C. E. Land of the National Cancer Institute. The main criticisms are that the doses were so low that background and non-occupational exposure must confound interpretation; that dose records are incomplete (and so may be ascertainment of cause of death); that the statistical methods may not be appropriate. The N.R.P.B. concludes: "... a wide body of experts agree that there is no evidence in the Hanford data to support the suggestion that ICRP values do seriously underestimate the risk."
REPORTS ON SI]DE-EFFECTS OF DRUGS AN item in a recent issue of Scrip (Sept. 16, p. 6), a periodical of pharmaceutical news which circulates largely within the pharmaceutical industry, suggested that The Lancet had undertaken to consult with a manufacturer before publishing any report on side-effects associated with one of his products. This is not true.
BASIC HEALTH SERVICES AT a world consultationlast year on the roles and education of health-care personnel the view was repeatedly heard that health services in many countries were not keeping pace with changing populations, either in quantity or quality. Dr T. Fulop, director of the W.H.O. Division of Health Manpower Development, said that in over half those countries inhabited by the majority of the world population there are less than 5 physicians per 10 000 people. In Thailand, for example, the ratio of doctors to population is 1/7600; in Zaire it is 1/27 000. Medical manpower in developing countries is often concentrated in urban areas, because of a reluctance among trained personnel to work in the poorer rural districts. Training in primary health care is also regarded by many as less important and satisfying than more specialised work. The result is an unbalanced and fragmented health service, often completely unsuited to the needs of a largely uneducated rural population. Several delegates from both developed and developing countries called for a radical change in manpower planning with greater emphasis on the provision of care at primary level, a call repeated last month at the Alma-Ata conference.’ In the third world the traditional western system of medical training, 1. Mancuso, T., Stewart, A., Kneale, G. Hlth Phys. 1977, 33, 369. 2. An Assessment ofthe Mancuso Study. By J. A Reissland, M.R.P.S. 3. The Changing Roles and Education of Health Care Personnel Worldwide in view of the Increase of Basic Health Services. Papers from a consultation sponsored by the Society for Health and Human Values, 1100 Witherspoon Building, Philadelphia, Pennsylvania 19107 4. See Lancet, Sept. 23, 1978, p. 666
800 which
Dr Ruthven Mitchell has been appointed director of the Glasgow and West of Scotland Blood Transfusion Service which covers a population of approximately 3,000,000 in the West of Scotland.
emphasises prevention of disease rather than mainof health is often unsatisfactory because it minimises people’s responsibility for their own health. Several countries have revised their medical training programmes: in parts of South America students are required to work in rural hospitals during their sixth year and much of the teaching is done by tenance
The Tuberous Sclerosis Association of Great Britain will hold itsI annual meeting on Nov. 11, 1978 at the Conference Hall, National Children’s Bureau, 8 Wakley Street, London EC IV 7QE. Details may be had from Mrs Ann Hunt, Church Farm House, Church Road, North Leigh, Oxford OX8 6TX.
rather than doctors; in China the peasant barefoot docreceives basic training which is supplemented by mobile health-care teams from the city hospitals, and roughly a third of China’s medical students come from barefoot origins. The development of primary health services is also receiving more attention in developed countries. In Sweden, for instance, postgraduate students must complete a period of 21 months’ general service, which includes 6 months’ training in primary health care. There was, however, a general feeling among the delegates that the undergraduate medical course should include training not only in primary health care but also in the social services and the humanities. nurses
tor
The University of London Institute of Obstetrics and Gynaccology will hold a symposium on Respiratory Distress Syndrome at Queen Charlotte’s Maternity Hospital, London, on Dec. 8, 1978. Details may may be had from the Symposium Secretary, Institute of Obstetrics and Gynxcology, Queen Charlotte’s Maternity Hospital, Goldhawk Road, London W6 OXG. The Indian Society of Human Genetics will hold its 5th annual conference in Bombay on Dec. 20-24, 1978. The conference will include an international symposium on population structure and human variation. Details may be had from Dr Lalit M. Ambani, Institute for Research in Reproduction, Bombay-400012, India.
SARCOIDOSIS AND OTHER GRANULOMATOUS DISEASES THOSE who met at a recent international conference in Cardiff agreed that sarcoidosis is distributed worldwide and must be distinguished from other granulomatous disorders. Diagnosis requires proof of multisystem involvement-e.g., centralnervous-system and cardiac lesions-and can be aided by electronmicroscopy (to assist in excluding known granulogenic agents) and new techniques such as computerised tomography which join the still useful transbronchial biopsy and KveimSiltzbach skin test. The serum-angiotensin-converting enzyme concentration is also of diagnostic value and is both course and steroid dependent. Like the less specific serum-lysozyme, this enzyme is probably derived from granuloma cells. Family studies on an association between HLA-B8, erythema nodosum, and arthritis have been inconclusive. Pulmonary-lavage fluid has a raised Ig level and-unlike the blood-an adequate number of activated T lymphocytes. Why they are there is unclear. Lung function tests may show diffusion defects and also some degree of chronic airways obstruction. The steroid response depends upon the degree of fibrosis, and increasing awareness of myocardial involvement suggests a further indication for treatment. The conference discussed the pathology of granulomas in detail. The constituent cells of sarcoid granulomas have a complex relationship and granulomas of other diseases consist of similar, sometimes identical, cells.
Proceedings of the VIIIth International Conference on Sarcoidosis. and Other Granulomatous Diseases will be obtainable from Alpha Omega Publishing Ltd, P.O. Box 88, College Buildings, University Place, Cardiff CF1 ISA.
University of London Dr A
of
The British Heart Foundation will hold a symposium on non-invasive techniques in cardiology at the Imperial College of Science and Technology, London, on June 26-28, 1979. Details may be had from Conference Services Ltd., 43 Charles Street, London Wl.
Correction Lead and Renal Disease.-We apologise to Dr R. P. Wedeen for the mis-spelling of his name in his letter (p. 477) and on the title page of our issue of Aug. 26.
Diary
of the Week
OCT. 8 TO 14
Tuesday,
’
10th
INSTITUTE OF CHILD HEALTH, 30 Guilford Street, London WC1N 1EH 5.30 P.M. Mr Stanley 0. Aylett: Total colectomy and Ileorectal anastomosis in the surgical treatment of ulcerative colitis m the young. (Alex Simpson Smith lecture.)
Wednesday,
llth
INSTITUTE OF NEUROLOGY, Queen Square, London WC1 6 P.M. 1’rot. N. A. Mnchison, F.R.S. Cellular interactions in immunology. 7 P.M. Prof. W. Bryan Matthews: Neurological comphcanons of sarcoidosis. (Sandoz Foundation lectures.) INSTITUTE OF ORTHOPAEDICS, 234 Great Portland Street, London WIN 6AD 6 P.M. Mr R. Saunders: Recent Advances in Skin Cover. 7 P.M. Mr J. C. Angel: Functional Cast Bracing. WEST LONDON HOSPITAL, Hammersmith Road, London W6 5.30 P.M. Mr Alan G. Johnson: The pylorus and peptic ulcer. (Alex Simpson Smith lecture.) ROYAL COLLEGE OF SURGEONS OF EDINBURGH, Nicholson Street, Edinburgh EH89DW 4.30 P.M. Mr A. G. D. Marran: Malignant disease of the oral cavity.
Thursday, 12th
Garner, reader in experimental pathology
Ophthalmology has pathology at the Institute. tute
The W.H.O./Menarini symposium, entitled Renal Pathophysiolwill be held in Florence on Jan. 26-29, 1979. Details may be had from Prof. A. Leaf, Harvard Medical School, Massachusetts General Hospital, Boston MA 02114, U.S.A.
ogy-Recent Advances,
been
appointed
to
the Instithe chair of at
Dr J. C. Gunn, senior lecturer in forensic psychiatry at the Institute of Psychiatry has been appointed to the chair of forensic psychiatry at the Institute. Dr P. H. Millard, senior lecturer in geriatric medicine at St George’s Hospital Medical School and director of the Geriatric Teaching and Research Unit, has been appointed to the Eleanor Peel chair of geriatric medicine at the school. Prof. Alison McDonald of McGill University has been appointed to the chair of epidemiology and preventive medicine at St. Mary’s Medical School.
ROYAL COLLEGE OF PHYSICIANS OF LONDON, 11 St. Andrew’s Place, London NW1 4LE 5 P.M. Dr James Spencer Malpas: Cancer in children. (Lockyer lecture.) ROYAL COLLEGE OF SURGEONS OF ENGLAND, Lincoln’s Inn Fields, London WC2A 3PN 5 P.m. Prof. J. Leigh Collis: The organisation of the specialty of cardiothoracic surgery. (Tudor Edwards lecture.) ST. MARY’S HOSPITAL MEDICAL SCHOOL, London W2 1PG 5.15 P.M. Prof. Stuart Campbell: The application of ultrasound in clinical obstetrics and gynxcology. (Aleck Bourne lecture.) ONCOLOGY CLUB, Royal Marsden Hospital, London SW3 6JJ 6.30 P.M. Dr Eve Wiltshaw: Carcinoma of the Ovary.
Friday, 13th SOCIETY
6.30
SOCIAL HISTORY OF MEDICINE School of Hygiene and Tropical Medicine.) Dr Robert Heller: The education of the blind in the 18th century.
FOR THE P.m.
(London
