Appointments
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682 study of goitre in the Mosul Province by Ghalioungui et awl. 4 These workers used a slightly different classification. They state: " In comparing our results with that of Caughey and Follis, account must be taken of the difference in our standard of classification. As they included in their Group 1 ’ any gland that is visible and/or palpable and one causing slight alteration in the contour of the neck ’, glands that we classified as ’ X ’ would belong to their Group 1. Adding our ’ X ’ figures would thus bring our figures very near to theirs ". The figures are as follows (in percentages): Medical School, Pahlavi University, Shiraz, Iran. J. E. CAUGHEY. PRECISION IN DEATH CERTIFICATION Sir should like to draw the attention of doctors to the need for having certain details of diagnosis on death certificates. The International Statistical Classification of Diseases, Injuries and Causes of Death (I.C.D.) is used the world over to classify the causes of death from a death certificate and it is of course from these certificates that mortality statistics are derived. The I.C.D. is revised every ten years, and, as medical progress leads to more precise diagnosis, so the classification becomes more detailed. The 8th Revision of the I.C.D. came into use in 1968. In response to requests from epidemiologists and other research workers, category 151, malignant neoplasm of stomach, is now broken down into 151-0 cardia, 151-1 pylorus, 151-8 other specified parts, and 151-9 part unspecified. Where the certifying doctor writes only " cancer of the stomach " an inquiry form is sent from the General Register Office, since more precise information may be available, and the replies confirm that it often is. Such inquiries are a nuisance to the doctor especially if further information is not available. They could be avoided if doctors would specify the part of the stomach involved where this is known, or write " part of stomach unknown " otherwise. In addition to this particular example there are other sections of the I.C.D. which have been improved by greater precision, and so it is important in general, when writing diagnoses for death certificates, to be as specific as the available information allows. The histological type of cancer should be given if known. Doctors may be assured that their efforts in this field are greatly appreciated; the certificates are essential for the production of statistics and for many research projects. A. M. ADELSTEIN Chief Medical Statistician, General Register Office (England and Wales). Somerset House, London W.C.2. 4. Ghalioungui, P., Demarchi, M., Abudl Mawjoud, A. M., Dabbagh, T., Dabbagh, Z., Abdulnabi, M., Taj El-Din, H., Shafik, S. J. Fac. Med. Baghdad, 1968, 10, 41. Appointments HILTON, D. D., M.B. Mane. D.P.H., D.OBST., D.T.M. & H.: deputy M.O.H., deputy principal school M.o., and deputy port M.o.H., Portsmouth. NEWTON, M. A., M.D. Cantab., M.R.C.P. : consultant physician, Central Middlesex Hospital and Neasden Hospital, London. NICHOLAS, A. D. G., M.B. Cantab., F.F.A. R.C.S.: consultant anaesthetist, United Sheffield Hospitals. SMITH, H. G., M.A., M.D. Dubl., M.R.C.P. : consultant in infectious diseases, Neasden Hospital, London. ZINNA, R. F., M.D. Naples: consultant child psychiatrist, Bournemouth, Wessex R.H.B. London Transport Board: ACRES, G. C., M.R.C.S., D.I.H.: M.o. in charge, south-west division, Chiswick. GILKS, A. W., M.B. Lond., D.P.H., D.I.H.: senior M.o. MYERS, C. E. N., M.B.E., M.R.C.S., D.I.H.: M.O.H. in charge, north-east division, Manor House. RAFFLE, P. A. B., M.D. Lond., M.R.C.P., D.P.H., D.I.H.: chief M.O. Obituary PHILIP CYRIL POWTER CLOAKE M.D., B.Sc. Lond., M.D. Birm., F.R.C.P. Prof. Cyril Cloake, who held the chair of neurology at the University of Birmingham, died on March 14 at the age of 78. After an early career in science, in which he obtained a B.sc. from the University of London at the age of 19, he studied medicine at the London Hospital, qualifying in 1915. During the 1914-18 war he served with the R.A.M.C. In 1923 he took the M.D., and he held posts as medical registrar at the Hospital for Epilepsy and Nervous Diseases, Maida Vale, as assistant physician to the Metropolitan Hospital, and as honorary physician to the psychological department at Addenbrooke’s Hospital, Cambridge, before going to Birming- ham as physician to outpatients at Queens Hospital in 1925. He was later appointed to the visiting staff of the Birmingham and Midland Hospital for Nervous Diseases and the West Bromwich and District General Hospital, and in 1931 he became honorary physician to Queens Hospital. In 1934 he was appointed to the chair of medicine in the University of Birmingham, and in the following year he took the M.D. Birm., and he was elected F.R.C.P. In 1947 he became professor of neurology, and at Queen Elizabeth Hospital he built up a large university department which included neurosurgery and psychiatry as well as neurology. Under his leadership the department maintained a considerable output of valuable research and trained many who are among the leading neurolo- gists of today. He contributed a number of papers on neurology, including one of the earliest accounts of temporal arteritis. In 1947 he gave the first Humphry Davy Rolleston lecture to the Royal College of Physicians, taking as his subject disseminated sclerosis-a disease in which he had always been especially interested. He was a member of the Association of Physicians of Great Britain and Ireland and of the Association of British Neurologists, and he was president of the West Midlands Physicians Association. For many years he served on the Central Consultants and Specialists Committee. He retired from the university in 1955. He is survived by three daughters and his second wife, whom he married in 1958. A. G. W. W. writes: " Professor Cloake made invaluable contributions to the University of Birmingham, to the United Birmingham Hos- pitals, to medicine in the Midlands, and to neurology through- out the world. He devoted his life to his profession and to his family, and those who worked with him and knew him well were his life-long admirers and friends. His retirement from the hospital and the chair of neurology brought memorable demonstrations of the regard in which he was held, and since his retirement his occasional appearances at the hospital and at meetings of the West Midlands Physicians Association have given great pleasure. His later years were marred by serious illness, which he faced with a courage and cheerfulness that excited the admiration of all who knew him. He was a delightful companion whose death will bring sorrow to all his colleagues, his old students, and those whom he trained so ably and so kindly in neurology." GEORGE EDGAR SEPTIMUS WARD M.B. Lond., F.R.C.P., hon. F.F.R. Dr. G. E. S. Ward, who was on the consultant staff of the Middlesex Hospital for thirty-five years, died on March 19 at the age of 80. He was educated at Epsom College before entering the Middlesex Hospital Medical School in 1906. After graduating M.B. in 1911 he was a house-physician and medical registrar at the Middlesex, taking the M.D. in 1913 and the M.R.C.P. in the
Transcript of Appointments
682
study of goitre in the Mosul Province by Ghalioungui et awl. 4These workers used a slightly different classification. Theystate:
" In comparing our results with that of Caughey andFollis, account must be taken of the difference in our standardof classification. As they included in their Group 1 ’ any glandthat is visible and/or palpable and one causing slight alterationin the contour of the neck ’, glands that we classified as ’ X ’would belong to their Group 1. Adding our ’ X ’ figures wouldthus bring our figures very near to theirs ". The figures are asfollows (in percentages):
Medical School,Pahlavi University,
Shiraz, Iran. J. E. CAUGHEY.
PRECISION IN DEATH CERTIFICATION
Sir should like to draw the attention of doctors to theneed for having certain details of diagnosis on death certificates.The International Statistical Classification of Diseases, Injuriesand Causes of Death (I.C.D.) is used the world over to classifythe causes of death from a death certificate and it is of coursefrom these certificates that mortality statistics are derived.The I.C.D. is revised every ten years, and, as medical progressleads to more precise diagnosis, so the classification becomesmore detailed.The 8th Revision of the I.C.D. came into use in 1968. In
response to requests from epidemiologists and other researchworkers, category 151, malignant neoplasm of stomach, is nowbroken down into 151-0 cardia, 151-1 pylorus, 151-8 otherspecified parts, and 151-9 part unspecified. Where the certifyingdoctor writes only " cancer of the stomach " an inquiry formis sent from the General Register Office, since more preciseinformation may be available, and the replies confirm that itoften is. Such inquiries are a nuisance to the doctor especiallyif further information is not available. They could be avoidedif doctors would specify the part of the stomach involved wherethis is known, or write " part of stomach unknown " otherwise.
In addition to this particular example there are other sectionsof the I.C.D. which have been improved by greater precision,and so it is important in general, when writing diagnoses fordeath certificates, to be as specific as the available informationallows. The histological type of cancer should be given ifknown. Doctors may be assured that their efforts in this fieldare greatly appreciated; the certificates are essential for theproduction of statistics and for many research projects.
A. M. ADELSTEINChief Medical Statistician,General Register Office(England and Wales).
Somerset House,London W.C.2.
4. Ghalioungui, P., Demarchi, M., Abudl Mawjoud, A. M., Dabbagh, T.,Dabbagh, Z., Abdulnabi, M., Taj El-Din, H., Shafik, S. J. Fac. Med.Baghdad, 1968, 10, 41.
AppointmentsHILTON, D. D., M.B. Mane. D.P.H., D.OBST., D.T.M. & H.: deputy M.O.H.,
deputy principal school M.o., and deputy port M.o.H., Portsmouth.NEWTON, M. A., M.D. Cantab., M.R.C.P. : consultant physician, Central
Middlesex Hospital and Neasden Hospital, London.NICHOLAS, A. D. G., M.B. Cantab., F.F.A. R.C.S.: consultant anaesthetist,
United Sheffield Hospitals.SMITH, H. G., M.A., M.D. Dubl., M.R.C.P. : consultant in infectious diseases,
Neasden Hospital, London.ZINNA, R. F., M.D. Naples: consultant child psychiatrist, Bournemouth,
Wessex R.H.B.
London Transport Board:ACRES, G. C., M.R.C.S., D.I.H.: M.o. in charge, south-west division,
Chiswick.GILKS, A. W., M.B. Lond., D.P.H., D.I.H.: senior M.o.MYERS, C. E. N., M.B.E., M.R.C.S., D.I.H.: M.O.H. in charge, north-east
division, Manor House.RAFFLE, P. A. B., M.D. Lond., M.R.C.P., D.P.H., D.I.H.: chief M.O.
Obituary
PHILIP CYRIL POWTER CLOAKE
M.D., B.Sc. Lond., M.D. Birm., F.R.C.P.
Prof. Cyril Cloake, who held the chair of neurologyat the University of Birmingham, died on March 14 atthe age of 78.
After an early career in science, in which he obtained aB.sc. from the University of London at the age of 19, hestudied medicine at the London Hospital, qualifying in 1915.During the 1914-18 war he served with the R.A.M.C. In1923 he took the M.D., and he held posts as medical registrarat the Hospital for Epilepsy and Nervous Diseases, MaidaVale, as assistant physician to the Metropolitan Hospital, andas honorary physician to the psychological department at
Addenbrooke’s Hospital, Cambridge, before going to Birming-ham as physician to outpatients at Queens Hospital in 1925.He was later appointed to the visiting staff of the Birminghamand Midland Hospital for Nervous Diseases and the WestBromwich and District General Hospital, and in 1931 hebecame honorary physician to Queens Hospital. In 1934 hewas appointed to the chair of medicine in the University ofBirmingham, and in the following year he took the M.D. Birm.,and he was elected F.R.C.P. In 1947 he became professor ofneurology, and at Queen Elizabeth Hospital he built up alarge university department which included neurosurgery andpsychiatry as well as neurology. Under his leadership thedepartment maintained a considerable output of valuableresearch and trained many who are among the leading neurolo-gists of today. He contributed a number of papers on neurology,including one of the earliest accounts of temporal arteritis. In1947 he gave the first Humphry Davy Rolleston lecture to theRoyal College of Physicians, taking as his subject disseminatedsclerosis-a disease in which he had always been especiallyinterested. He was a member of the Association of Physiciansof Great Britain and Ireland and of the Association of British
Neurologists, and he was president of the West MidlandsPhysicians Association. For many years he served on theCentral Consultants and Specialists Committee. He retiredfrom the university in 1955.He is survived by three daughters and his second wife,
whom he married in 1958.
A. G. W. W. writes:" Professor Cloake made invaluable contributions to the
University of Birmingham, to the United Birmingham Hos-pitals, to medicine in the Midlands, and to neurology through-out the world. He devoted his life to his profession and tohis family, and those who worked with him and knew himwell were his life-long admirers and friends. His retirementfrom the hospital and the chair of neurology brought memorabledemonstrations of the regard in which he was held, and sincehis retirement his occasional appearances at the hospital andat meetings of the West Midlands Physicians Associationhave given great pleasure. His later years were marred byserious illness, which he faced with a courage and cheerfulnessthat excited the admiration of all who knew him. He was a
delightful companion whose death will bring sorrow to allhis colleagues, his old students, and those whom he trainedso ably and so kindly in neurology."
GEORGE EDGAR SEPTIMUS WARDM.B. Lond., F.R.C.P., hon. F.F.R.
Dr. G. E. S. Ward, who was on the consultant staff ofthe Middlesex Hospital for thirty-five years, died onMarch 19 at the age of 80.
He was educated at Epsom College before entering theMiddlesex Hospital Medical School in 1906. After graduatingM.B. in 1911 he was a house-physician and medical registrar atthe Middlesex, taking the M.D. in 1913 and the M.R.C.P. in the
