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13 ovember 1965
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S. A. M·E 0 I CA L J 0 URN A L 1055
A SIMPLE MODIFICATION OF THE HEAF MULTIPLE PUNCTURE APPARATUS, MARK III
TO PREVENT ALTERAno OF DEPTH OF PENETRATIO r
In a recent article in this Journal in which a field experience
of mass percutaneous BCG inoculation with the Heaf Multiple
Puncture Apparatus Mark III was described,' the authors
stated that, in determining various factors in relation to the
instrument, 'A large capped screw that retained needles in
position in the needle block required periodic tightening to
prevent loosening of needles, which affected depth of penetration'.
This difficulty was encountered during the early stages of
the vaccination programme in Durban, and a simple modification
of the capped screw (or retaining cap) was devised, which
prevents rotation of the cap and subsequent loosening of the
needles. Before this modification of the apparatus it had been
our experience that, without frequent tightening of the retaining
cap (a procedure which involves unscrewing the head and
the removal of the needle block-thus slowing the rate of
vaccination), penetration had become progressively less until
finally the needles, instead of puncturing the skin, were
pushed back into the needle block when the instrument was
'fired'.
The modification, which was first described in an official
State Health Department memorandum on BCG vaccination
in June 1963,' is carried out as follows:
I. After needles have been inserted in the block and the
cap fully tightened, a groove is filed in the side of the
retaining cap to correspond with the groove on the needle
block into which the depth-setting screw projects.
2. A pin, 9·5 mm. in length (which may conveniently be
cut from a discarded needle), is positioned in the grooves on
the needle block and retaining cap, and the assembly, with
pin in place, is inserted into the head in the usual manner.
The distal end of this pin rests on the internal projection
of the depth-setting screw. Its length is such that any of the
three depth settings can be chosen; and when the apparatus
is in use, the needle block and retaining cap 'ride' on the pin,
which prevents rotation of the cap.
The illustration shows an 'exploded' head with corresponding
grooves on needle block and retaining cap, and a needle block
with retaining cap fully screwed home and a pin in position.
T. F. B. ColLINS, M.B., B.CH .. King George V Hospiral, Durbal/
This paper is published by permission of the State Health
Department.
REFERENCES
I. Spencer, I. W. F., Coster, M. E. E., McPhail, A. V. and Richter, M.
(1964): S. Afr. Med. J., 12, 223.
2. Dormer. B. A. and Collins, T. F. B. (1963): BCG Vaccination. Circular
of the South African State Health Department. Fig. r. See text
Dr. A. W. Sichel, of Cape Town, wrires:
IN MEMORIAM
MATTHEW ROBERTSON DRENNAN-A FURTHER TRIBUTE
The late Prof. M. R. Drennan was such a notability in the
medical and scientific worlds that, complementary to the
obituaries which appeared in the Journal of 9 October, some
further notes on his career will not be amiss.
A'S a student of anatomy Drennan studied under Professor
Cunningham, the eminent anatomist and author of the wellknown
Textbook of Anatomy and the even better known
Manual of Pracrical Anaromy. Assistant to the Professor was
Dr. David Waterston who later succeeded to the Chair of
Anatomy at the University of St. Andrews. Waterston gave a
series of tutorials for senior students each morning from 9 to
10 a.m., at which latter hour the Professor himself was due
to deliver his formal lecture. Waterston illustrated his demonstrations
by the most beautiful crayon diagrams drawn on the
blackboard in various colours for each structure and meticu-
lously accurate to the finest detail. The students copied these
drawings as best they could in the time available but had to
work rapidly because, hardly had Waterston laid down his
crayon a few minutes before 10 a.m., than a lab. boy came in
and with a wet duster erased the drawings from the blackboard
in preparation for the Professor's lecture. No doubt Drennan
acquired his art of illustrating lectures, as recorded by Professor
Bromilow-Downing, through attending Dr. \Vaterston's
demonstrations at Edinburgh.
No reference has been made in the published obituaries of
Drennan's activities in the affairs of the Medical Association
of South Africa. He was a staunch member of the Council of
the Cape Western Branch during the period 1920 - 1930 and
was President of the Branch in 1922. Becoming more and more
absorbed in his professional duties at the University he found
less time for extra-academical work and eventually resigned
his membership of the Medical Association.

1056 S.A. TYDSKRIF VIR GENEESKUNDE 13 November 1965
The time has now arrived following the death of Professor
Drennan to relate, if only for the record, an episode which
hitherto had been regarded as strictly confidential. In 1952
the Medical Association was in great difficulty with regard to
finding a full-time editor of the Sourh African Medical Journal.
Drennan, who at that time was approaching the normal retiring
age as a professor, was interviewed and an offer made to him
to be appointed Editor at a salary which to him must have
been very attractive. After serious consideration, although
there is no doubt that he would have been happy to accept,
he felt that he was not sufficiently bilingual for the post. The
then officials of the Head Office of the Association, while
recognizing what Drennan himself stressed, nevertheless considered
that his personality would compensate for any other
shortcomings. They thereupon decided to send Drennan on a
tour of the principal centres in the Union, ostensibly to meet
members of the Association, but in reality to see how they
would react to the proposed appointment. Drennan was received
everywhere with great enthusiasm, especially by his old
students, so much so that when he returned to Cape Town
there seemed no reason why he should not accept the appointment.
True to his character, when all seemed set he finally and
firmly declined (for reasons which do not have to be explained
here). It was typical of Drennan that at meetings where he
took part in a debate and appeared to be completely in agreement
with the proposal before the meeting, he would sayjust
as the motion was about to be put to the vote-that after
all there might be something to be said for the other point of
view, and in this way the whole debate was re-opened.
Another characteristic of his was the frequent repetition of
words or a phrase while he was lecturing or addressing a
meeting. He would say, for instance, 'Mr. Chairman, it is quite
obvious to me-(pause)-it is quite obvious to me that .. .'
In private conversation he was loquacious, very dogmatic
and inclined to be critical of his colleagues. When the memorandum
issued by the Royal College of Physicians on smoking
and lung cancer appeared, I can remember him commentinj!
that he was not at all convinced by what had been stated and
that much more investigation was needed.
Drennan was a man of outstanding ability, a clear thinker
and a brilliant teacher who has left his mark on all those
whom he taught and indeed on a much wider circle of
personal friends. When he was able to relax from work he
loved to potter about in the garden of his delightful home and
to receive visitors. At one time he derived much pleasure from
playing golf, and I can recall a particular occasion when he
put in an unforgettable score which was duly celebrated in
good old Scottish fashion.
Mr. W. Lennox Gordon, of Cape Town, wrires:
Professors Dart and Bromilow-Downing have paid tribute
to the lute Matthew Robertson Drennan as a distinguished
teacher and scientist at the University of Cape Town. No
mention has been made of his brilliant academic career at
Edinburgh University.
He entered the Arts Faculty of the University with the
George Heriot Classical Bursary, graduated M.A. Honours
and was awarded the Neil Arnot prize in Natural Philosophy.
From Arts he turned to Medicine and qualified in 1910, M.B.,
Ch.B. with Distinction and Honours. The degree of M.D.
followed, and in 1913 he became a Fellow of the Royal
College of Surgeons, Edinburgh. In the Faculty of Medicine
he was awarded 6 medals, 2 first prizes, 3 bursaries and the
Buchanan Scholarship in Midwifery and Gynaecology which
carried with it the resident appointment as house surgeon to
the gynaecological wards of the Royal Infirmary, Edinburgh.
In 1911 he was appointed full-time Demonstrator of Anatomy
under Professor Robinson, which post he held till he
sailed for South Africa, where he started as a general practitioner
in Aliwal North. It was there that he met and later
married Miss Susan de Wet.
During the 1914 - 1918 War he saw service in South West
Africa with the S.A.M.C. until a serious bout of enteric fever
put an end to his military career.
On Professor Thompson's retirement in 1919, Drennan was
appointed to the Chair of Anatomy, and it was then that my
association with him began, an association which extended
beyond the Anatomy Department to sketching outings,
archaeological expeditions and many other interests of this
multi-faceted man. Proof of these wide interests and the value
set on his expert knowledge and sound common sense is
shown in the number of committees on which he served-the
Medical Association of South Africa, the South African
Museum, Michaelis Art School, Koopmans de Wet House, and
the Red Cross Society, to name but a few.
The style and purity of English used in his textbooks and
many articles, scientific and popular, are a tribute to his early
classical education, while the many anatomical models in the
Anatomy Department bear witness to his skilful handicraft.
To work with Drennan was stimulating-his views on anatomy.
surgery, politics and men were stringent and refreshing.
THE BICKERSTETH MEDICAL SOCIETY : DIE BICKERSTETH MEDIESE VERENIGING
CLINICAL EVE I G, SOMERSET HOSPITAL, TUESDA Y 28 SEPTEMBER 1965
Cases Presenied
1. Dr. R. I. Samson presented a 76-year-old man with
uraemia and pyelonephritis with a satisfactory response to
rehydration and antibiotic therapy. The main interest of the
case was in the associated congenital abnormalities, viz.
kyphoscoliosis, apparent macroglossia, symmetrically large
hands and feet due to excessive soft tissue, cutis laxa, hyperextensibility
of the joints of the hands, a soft-tissue tumour of
the right forearm, and cafe au lait. The skeletal X-rays showed
generalized osteoarthritis and kyphoscoliosis. There was no
family history of similar abnormalities, and no evidence of
skin fragility.
Dr. Samson reviewed the osteochondrodystrophies. Dr. L.
Chanock and Dr. D. Stein suggested that the case was one of
Ehlers-Danlos syndrome. Dr. . Shapiro thought that neurofibrcmatosis
should be excluded by a biopsy of the forearm
tumour although the symmetry of the abnormalities was
against such diagnosis.
2. Dr. M. Fredman presented a 4-year-old child with a
I-week history of a tender swelling over the head of the
fibula. On X-ray there was an osteolytic lesion with an overlying
periosteal reaction, and an osteogenic sarcoma could not
be excluded. A biopsy revealed only chronic inflammatory
change. The subsequent Wassermann reaction of the child and
mother was strongly positive.
This is yet another instance of congenital syphilis as a reminder
of the recent increasing incidence of venereal disease.
PHARMACEUTICAL NEWS : FARMASEUTIESE NUUS
CINE AWARD WON BY ORTHO FOR FILM ON OBSTETRICS
Ortho Pharmaceutical Corporation has won the ClNE Golden
Eagle Award for the teaching film on childbirth 'Modern
Obstetrics: ormal Delivery', which was judged as best of
500 in the competition. Cl E (Council on International Tontheatrical
Events) functions as a nOli-profit agency to judge
American-made films and to select them for foreign showings
and competitions.
The film was produced under the joint sponsorship of the
American Medical Association, the American College of
Obstetricians and Gynecologists, and Ortho last year. It is the
first approved teaching film on the subject since 1936.