481

(13 per cent.), cancer (12 per cent.), diseases of thenervous system (9 per cent.), and tuberculosis (8 percent.). These five conditions, accounting for 65 percent. of the death-rate, are the outstanding physicalscourges which we have to combat to-day. The year1928 was exceptionally healthy.An outstanding event of the year on the adminis-

trative side was the preparation of the Local Govern-ment Act. The Report discusses carefully the newduties laid upon the County Medical -Officers ofHealth, and the Principal Medical Officer has nodoubt that the reforming Act offers big potentialitiesif it is administered carefully. Also he sees no reasonwhy the - magnificent tradition of the voluntaryhospital should not become widely established inmunicipal hospitals free from the taint of pauperism.He advises the municipal hospitals to imitate all that’has proved good in the voluntary hospitals, andurges mutual cooperation. The great essential hereis the preservation of the integrity of the medicalprofession ; prevention and cure and their respectiveexponents must not be divided. So long as no onecomes between the doctor and his patient all will bewell, and local authorities ought to be trusted to seethat such interference never takes place. In thiscountry, the principle of local self-government hasbeen generally recognised as the essence and geniusof our national vigour. Our public health work is z’

safeguarded by a comprehensive system of law,by-law and regulation, exercised by central andlocal authority working together, administered partlyby a number of elected voluntary representatives andpartly by a substantial number of medical advisorsand trained sanitary and health officers. The chiefbusiness of the Ministry of Health is unification andcoordination ; its chief purpose is to secure soundnational progress. This progress will be made certainin proportion as the State, the doctor, and thepublic work along right lines harmoniously.We shall deal with the Report in further detail in

subsequent issues.

Medical News.MEDICAL SOCIETY OF LONDON.—A programme for

the first half session 1929-30 has been issued. Mr.Donald Armour will deliver a presidential address entitledSome of Lettsom’s Contemporaries on Oct. 14th. Mr.Hayward Pinch and Prof. Sidney Russ will open a discussionon Radium Therapy on Oct. 28th. On Nov. lltha discussion on the Relative Value of the DifferentMethods of Diagnosis in Gastric Disease will be introducedby Dr. J. A. Ryle, Dr. Harrison Orton, and Prof. E. C.Dodds, and a discussion on the Treatment of Head Injuriesbv Mr. Wilfred Trotter on Dec. 9th. Sir John ThomsonWalker will give the Lettsomian lectures on EnlargedProstate and Prostatectomy, and Sir Arthur Keith theAnnual Oration on Modern Medicine and Evolution.

Sir George Newman, who has been since 1919 aCrown Representative for England on the General MedicalCouncil, has been re-nominated for a further term of fiveyears from Oct. 9th next.

THE Medical Research Council announce thereceipt from Mrs. Odo Cross of a sum of 40,000 as theendowment of a trust for the establishment of researchfellowships in the study of tuberculosis, to be known as the" Dorothy Temple Cross Research Fellowship Fund."

Dr. W. E. Gye writes to disclaim responsibility forstatements contained in a Sunday newspaper of August 25thconcerning his work on cancer. It is true, he says, that asomewhat lengthy paper is in preparation, but the sugges-tion that he has something new and sensational " toreport is a guess and is untrue.THE RADIUM HOSPITAL FOR WOMEN.-It is

expected that this hospital will be opened in September byMadame Curie. It is housed in the former residence of thelate Mr. John Petrie, R.A., in Fitzjohn’s-avenue, Hamp-stead, which has been converted by Mrs. Elizabeth Scott, thearchitect. The large and lofty studio has been made intothe chief ward and holds 15 beds ; other small wards accomo-date another ten beds. It is hoped to build another wardover the studio with X ray and other necessary equipment.The medical staff consists entirely of women.

Notes, Comments, and Abstracts.THE TECHNIQUE OF STUDY.

BY G. F. WALKER, M.D., M.R.C.P.,MEDICAL TUTOR AND REGISTRAR IN THE UNIVERSITY OF LEEDS,

AND THE GENERAL INFIRMARY AT LEEDS.

To add one single drop to the torrent of written andspoken advice which almost overwhelms a medical studentat varying phases in his career requires explanation. I amemboldened to submit the following notes because, whilestill retaining vivid memories of the doubts and difficultiesof my own student days, I find myself engaged in tutorialwork in a large teaching hospital. Much of what follows hasnecessarily been gleaned from my own teachers quiterecently, and I hereby make acknowledgment, but some,I trust, is new.

Personal Factors." The first wealth is health." Medical students are far

too ready to slump into a condition of middling physicalhealth. A reaction against the athleticism of some publicschools tends to set in early, forcibly and far too frequentlywhen undergraduate life is reached. But sound physicalhealth is all-important and must be maintained. The richopportunities given by University or community life for thepreservation of physical fitness should be exploited fully.Indeed, a certain portion of each week and each year shouldbe set aside exclusively for recreation. Of collateralimportance is the development of mental stamina. Thisterm is comprehensive and includes not only the acquisitionand maintenance of will and judgment, remote alike fromrashness and pusillanimity, nor merely the ability tosacrifice the present to the future, but also the cultivation ofthe gentler arts of this world. Medicine may be a jealousmistress, but he who gives her his all will never experiencethe content and philosophical security which a broad generalculture imparts. In the years of student-life time must befound for the study of a science for its own sake-anyparticular field of study such as astronomy or theology orany subject which happens to appeal to the individual-orfor the cultivation of literature or an art. In this connexionmust be mentioned the necessity for travel in the studentyears. Many great cities of Western Europe are cheaply andeasily accessible and should be visited in the holidays. Ifthese cannot be reached then-speaking to Leeds students-Edinburgh, York, and London must suffice. During thesetours, whether at home or abroad, there can be no harm invisiting the hospitals and schools, but any attempt atpromiscuous study should be firmly suppressed. But I havenot forgotten that the medical student has to study medicine,and all through the student years the habit of study has tobe diligently cultivated.

The Technique of Study.Much knowledge has to be acquired in a relatively short

time. It is necessary, for instance, to know that the isletsof Langerhans are not in Polynesia. But this loading upwith necessary facts is by no means the hardest or themost important part of the curriculum. Of much greaterimportance is the acquisition of technical skill, dexterity,practical experience, and clinical acumen. Of greaterimportance still is the keeping of a proper perspective duringthe various stages and appointments of the curriculum aswill appear. In reading and practical work every studentshould periodically examine his methods of study, ruthlesslyscrapping unprofitable habits and customs. Reading shouldbe done in the evening. And the minute technique ofreading is worth more than scanty consideration. At thevery outset the student should decide whether he remembersbest by merely looking at the written word, or by writing itdown personally, or by hearing it spoken. That is to say,he should decide whether he has a " visual " memory or an" auditory " memory. The former is fortunately the morecommon, but no general rule can be laid down. By actualexperiment every student must investigate his powers ofmemory, decide his own classification, and work on it.Once the most favourable channel for reception of facts isdecided upon details of study can be regulated. Study frombooks should be done with elbows on the table. It shouldbe done in privacy and in an environment conducive toalertness and clarity. Anything conducive to too muchphysical comfort must be shunned. No attempt should bemade to read soon after a meal or when tired. Reading inthe train or ’bus, or " at any old time," is waste of energyand promotes staleness. As a general rule, if the practicalwork of a working day has been faithfully performed, twohours’ book work in the evening is ample, and it is thenthat reading should consolidate and fix the practical workdone during the day. Therefore it should be an inviolable