win4d - BMJ · 2008-12-29 · MYOCLONIC ENCEPHALITIS TREATED-BY PATIENT'S SPINAL FLUID. DR....

tTUNE 28, 19Q41 MEMORANDAL. E T Bit LL2A

Graph II shows that high wind velocities, as shown byhigh drv kata jeadinigs, cause a slight lowering of exhaledair tenlperature, especially wheni associated with a low drvbulb reading. Low temperatures not associated' witlh win4ddo not produce a significant fall.

Neither highi black fur readiigs-for examiple,, at 560 C.,.600 C., 56.90 C., 44.70 C.-nor even a dry builb reading of4*.70 C. (iIIn the drying room of a laundry) lhave aaiy sig-nificant effect on the exhaled. air temperaiture. T-he last-leadinig shows how warm air when iihaled is cooled downanid exhialed at approximately body temperature. The in-haling of drv hot air miust therefore enhanee the flow ofblood andl evaporation of water from the respiratorymembrane, just as does the inlialationi of cool air. Inlhala-tion of warm moist air lessenis both,. and thus lower s theresistance of the menmbrane to catarrhal ilnfectionis.

UFYFEREY.NcS.WW. A. Osborne, JTorn. of Physiol., Proe. Plivs-iol. Soc., October 18til,

1913. 2 The Science of Ventilation and Open Air Treatment-1. SpecialReport Series, No. 32, 150, 1919: Medical Research Cotilneil. Smisihieawl Open Air, p. 38: Arnold, London, 1924.

MEDICAL, SURGICAL, OBSTETRICAL.MYOCLONIC ENCEPHALITIS TREATED- BY

PATIENT'S SPINAL FLUID.DR. ABRAHAMSON repoirts a most interesting case of en-cephalitis lethargica of the myoclonic type at a meetinig ofthe Royal Academy of Medicine in Ireland (BRITISHMEDICAL JOURNAL, Juine 7th, p. 1003). I met witlh a caseof a similar natuire about six weeks ago. The patient, aw-omani aged 40, had myoclonic spasms of the abdominialmuseles, about seventy to the minutite, as (lescribe(i by Dr.Abrahamson. It is a most pitiable and distr essing siglhtto see patients inl such a state: they can nieither iest niorsleep, and rapiidly become exhalusted aiid delirious.Morphine certainily relieves the paini associated w ithi it,but the spasmiis still pirevent rest and sleep. In the casehere riecorded lumbar punct-tuie was performed everyv dayvithout relief, until finally shle had to be anaestlhetizedto l)poclure aniy rest at all. AVhen the spinal fluid was with-drawn on the fifth day 10 c.cm. of it were injected initro-Vellously; tilis was followed by improvement for abouttwelve hours, but the patient again relapsed. Twenity-fourhours later this was repeated with very gratifying results.The spasms and paini disappeared; they' lhave niot recurredsince and the patient has made a good recovery.

This line of treatment is advocated bv Piticariu ofRumania (Mledical Anwtial, 1924, p. 157), who recordssimilar cases.

I am indebted to Dr. HIebblethwaite for his permissionto carry out this procedure and report the case.

R. WOOD POWER, M.B., F.R.C.S.I.General Hospital, Cheltenlham.

RECURRENT INTUSSUSC EPTION.THE following case is perhaps of sufficient interest to meritpublication.A male child, aged 3 moniths 27 days, was admitted to theDeaconess Hospital, Edinburgh, on May 31st, 1]923, with a history

and signs and symptoms of acute intussusceptioii.First Operation.

The patient was operated uponi shortly after admission bv Mr.W. J. Stuart. An ileo-caecal intussusception was found, theitnvaginated bowel extending to midway between the hepatic andspleinic flexures. The condition was rectified and the abdominalwound closed.After the initial shock of the operation had passed, the child

was spoon-fed with mother's milk diluted with water.. Rectalsalines were also given. On the morning of June 1st the patientseemed a little better, the pulse 150, respirationls 40, temperatur e990. Feeds were taken well, but the child vomited a little. At9 p.m. a little dark blood and flatus were passed; pulse 158,resoirations 36, temperature 99.4O.At 5 a.m. on June 2nid the patient took a breast-feed well.

During the morning the bowels were open three times. Darkbrown faeces and a little mucus were passed; the child seemiled

rather better than on the previous day. In the afternoon thebowels were again open with a normal result.At 12.15 a.m. on June 3rd the patient became somewliat

callapsed. The- foot -of the bed was raised and rectal salines wereccnitinued during the early morninig. During the morning the,bvowels were open several times. with only some mucus evacuated.At 8 a.m. the appearance of the patient was improved; pulse 160,respirations 38, temperature 98.46. During the forenoon all feedswere vomited. In the afternoon, however, a feed was r-etained,anid the child, slept from 5 to 8 p4m., when. another feed was given,which was vomited immediately- afterwards. The patient seemedin great pain, screaming alcud, and being almost convulsed;pul-se 130, respirations 40, temperat-ure 100.40. At 9 p.m. theabdomen was tense and distended, the child screarming on palpa-tion. Mr. Stuart saw the case immediately afterwards, the patienthaving niow become somewhat collapsed; pulse 200, respirationis 34,temperature 1030.

We coed Opcration,Immediate operationi was considered necessary. On opening the

abdomeni an einteric initussusception was found about the lowerend of the iejunum. The bowel was inivaginated to the extenit ofabout seven inches. This intussusception was reduced fairly easily.The bowel was sliglhtly congested anid movement passed on wellafter reduction.After the shock of lthis second operation had. passed the patient

made fairly good progress. His breathing, however, becamelaboured oin June 7th, and bronchopnemanionia set, in. The con-dition of the patient uinfortunately gradually became worse, aniihe died on Jutne 21st.

I wishl to express my indebtedness to Mr. Stuart for permissionto publish this report.

J. H. CLARKE, M.D.,Late Resident Medical Officer, Deaconess

Hospital, Edinbutigh.

X RAYS IN LUPUS OF THE NASAL MUCOUSMEMBRANE.

TN vour issue of March 8th, 1924 (p. 423), Dr. Harri;sondescribes the successful treatment hr diathermyiV of apatient su1ffering from lup-us of the soft lpalate an1d fauces.SIluch of course, involves a certaini am10oun1t of destrutctionof tlhe sUrro1uinding hlealthy, or at least uniiaffected, tisstuesas wsell as the patches of lupus. That better results aireobtainable by x-ray treatment, which must of course besufficiently penetrating to reach the lesfons affected, isilltustratedi bv tlhe following:

V. E., aged 15 (in 1922), had been treated for lupus at an out-patienit department of a larae hospital in 1919. The Wassermanaireactioni was negative on two occasions. As the condition wasprogressing. she was transfer-red to the Austin iHospital for Incur-ables. When I first saw her in 1922 she had considerable deformityof the cartilages of the inose resulting from lupus, also numeroussmall ulcers of the mucous membrane of the palate, extenidingalmost as far as the uvula, causing much diistress, especiallyduringcr mastication, etc.

OInly onle exposure of de-p x rays (voltage 200,000) was given-namely, on September 14th, 1922-with the mouth closed.Improvement was very rapid, so that nothing remained of theulceration except some scarring. Owing to pyorrhoea, all herteeLh lhave since beeni extracted, and she has been wearing a fullset of artificial teeth witlhout any discomfort. Since lher dischargeshe has beeni reguilarly employed for the past twelve months, hasgained at least a stone in weight, and has not had a day's illness.

Melbourne, Victoria. H. FLECKER, F.R.C,S.

TREATMENT OF ANGINA PECTORIS.Two days before I read Professor Weniekebach's lecture(BRITISH MEDICAL JOURNAL, May 1Oth, p. 809) a patienltof mine died from a form of angina. pectoris that wasnew to me.

He was a farmer, aged 71, who for some years had beentreated for arterio-sclerosis. Occasionally he suffered from slightattacks of syncope, but he never had marked precordial pain.On the mnorniing of the day he died I was called to see himas he was feeling out of sorts. Beyond the usual signs of hiscomplaint I could find nothing abnormal. I told him to stayin bed fbr a few days and carry out the usual treatment. Thesame evening r had an urgent summonis to go and see him.Apparently he had been seized with an agontizingf pain overthe heart on trying to get out of bed. I foundi him completelypulseless, and only a few faint sounds could be heard over theheart, the auricle apparenitly beina in a state of fibrillationr.The pain was obviously still intense. I immediately gave himinjections of digitalin, camphaor, ether, and olive o3il, and inhala-tions of amyl nitrite, wrapped him in a heated btlanket, anldcupped the precordial region. He rtevived cli fhtly for a fewminutes, but after about ai quarter of anl hour hle was seized withlan intense exacerbation of the pain anId b)ecame completely

x130 JUNE 28, 19241 ACTIVE MOVEMENT IN SURGERY. t !u BEJITIrcollapsed. I continued with the cupping and inhalations, .andthouglh he revived slightly he soon relapsed into unconscious-ness and died two hours afterwards; the attack lasted aboutfour hours.No post-mortem examination was performed, but I formed

the opinion that death was due to coronary embolism. Thequestion which has exercised my mind is whether I waswrong in giving digitalin. I think the exacerbation of thepaini must have been due to it. I cannot see what othertreatmenit could have been adopted for the acute heartfailure witli a fibrillating auricle.Great Horkesley, Colchester. CYRIL HELM.

ACTIVE MOVEMENT IN SURGERY.AT a meeting of the Medico-Chirurgical Society ofEdinburgh held on June 4th, with Sir DAVID WALLACE,President, in the chair, Mr. J. W. DOWDEN gave a com-munication on the principles of active movement in relationto injury and disease. He regarded active movemiienit asa new principle in surgery, and made reference to theanatomical adaptation of bones, muscles, tendons, etc., sothat everything could be carried out in the easiest possiblemanner in performing work. It was common knowledgethat any interference with the use of a joint led tolimitation of movement and adhesions which were difficultto remove once they had formed. The nerve control of theparts was mentioned, and their useful function in thismethod of treatment was cited. Active movement might becarried out till pain was just induced, and this was a readyinidicator as to the amiiount of movement permissible ineach case. The method was of use in fractures, sprains,post-operative conditions, sutured tendons, infected joints,cellulitis, and other forms of suppuration. To bethoroughly effective active movement must be started atthe earliest possible moment-within twenty-four hoursif possible. The result of employing this principle ofactive movement was to prevent adhesions and to stimu-late the healing process, gradually transforming a bad dis-placement into good position again through the healingprocess in the bone. The muscle tone was improved andmaintained.A series of lantern slides was shown to demonstrate the

excellent functional results to be obtained by this methodof treatment. Not only were good functional resultsobtained, but good anatomical effects developed, and wereclearly demonstrated by x-ray photographs. Several photo-graplhs were shown to illustrate the process of callus forma-tion and the final effects obtained by a rounding-offprocess durinig union, giving wonderful results from thepurely anatoiimical point of view. Several series of x-rayphotographs were shown to illustrate the process. of healingin a bone, from considerable malposition to the stage whereno evidence of inijury could be noted by x rays.

In the discussion that followed Sir DAVID WALLACEreferred to the fact that the Edinburgh surgical school hadfor many years treated fractures by early movemlient, andreferred to a demonstration of the late Mr. John Duncan'sin 1892 illustrating the difference between the Edinburghand London methods. He referred to a statement ofLucas-Championniere in 1905, who said, " immobilizationis death."Mr. CATHCART referred to the fact that Professor John

Chiene was one of the first in Edinburgh to adopt massageand movement for sprains. He considered that thosesurgeons who said a good physiological result after fractureentirely depended on a good anatomical result based theirstatement on theory, not observation. They ignored thecompensatory power of Nature, of which Mr. Dowden hadsupplied such excellent illustrations.

Dietetics.Dr. MURRAY LyoN, in a short paper on dietinig in

medicine, summarized the primary objects of feeding, andreferred to Mellanby's observation that too much attentionhad been paid to the calorie in the construction of dietsand that other factors were of greater importance. Certaini

diseases, such as diabetes, nephritis, and peptic ulcer, werediscussed from the dietetic stauidpoint, and the well knownfacts in relation to diet restrictions were outlined. In rela-tion to diabetes, the work of Newburgh and Marclh, alsoShaffer anid Woodyatt, on the ratio between the ketogeiiieand the antiketogenic substances was cited, and mentionwas made of intravin-a fatty substance which could betaken freely without risk of acidosis. In dealing withnephlritis less certainity was present in giving a suitable dietthan in the case of diabetes. Epsteini's views as to theharm-iiful action of protein-free diets were mentioned.Shennian and Gettler had shown that certain foods, whenbuirned outside the body, yielded an acid ash, and othersani alkaline ash, and the foods wlhichl left an acid aslhwere those wlhich had long been knowni to be deleteriousto nephlritis cases-for example, red meats and eggs. Intreating peptic ulcers Dr. Lyon claimed to have had greatsuccess with Sippy's method. Thle quLestion of diet in,hospital practice was briefly touched uponi. Maniy formnsof special diet were complicated, requirilng exact imieasuringand careful preparation. The American plan of uitiliziniga special dietetic official, who translated a diet prescrip-tion in calories into appropriate meals, was commentedoni favourablv.In the discussion that followed Dr. CHALMERS WATSON

referreed to his observations on excessive meat eating, withreferenice to the bacteriology of the alimentary tract. Dr.CLAUDE KER pointed out that in the treatment of typlhoidfever his experience showed that patients would do equallywell on a diet which would support a working man, or ona very moderate allowance of fluid foods, or on a starvationiregime of water alonle for a few days at a time. He pre-ferred thel milk diet, lhowever, in such cases. He lhadsatisfied himself of the value of eggs being added to the dietof cases witlh albumiiuLria lasting three weeks; the additionof this protein cleared up the miiajority of cases.

Mr. PIRIE WATSON showed a remarkable specimeni of abilateral hydronephrosis due to blockage of each pelvis by asingle calculus. The condition was a long-standinig one,and the stones were very firmly impacted in the tissiues.The amou-nt of renal tissue present in the kidneys was soslight as to be almost unrecognizable.

EMERGENCIES IN GENERAL PRACTICE.AT a meetinig of the London Association of the MedicalW^omen's Federation, held at. the Elizabetlh Garrett Ander-son Hospital on Junie 17tlh, witlh Dr. AMY SHEPPARD illthe chair, a paper was read by Dr. CHRISTINE MURRELLon emergencies in general practice. Slhe said that inmost cases the difficulties and embarrassments of emer-

gencies in general practice were due to the facts that onthose occasions the doctor was the central figure, thateveryone. was standing around waiting for the doctor to dosometlhing, and that the atmosphere was one of hurry andagitation. If one remembered that in practically only twoconditions-namely, foreign bodies in the air passages andhaemorrhage-was excessive haste the onie essential forsuccess in treatment, it became clear that the usual emer-gency was really a matter for calmness and deliberation.Most emergencies happened at niight, ancd the doctor wasusually summoned to themn by a messenger. It must neverbe forgotten that the messenger might be able to furnishmost valuable information-for example, in cases ofpoisoning-and much time might be saved in the lonagrun by questions at this stage. Dr. Murrell theni dealtserintim with various kinds of emergency, tellinig anecdotesillustrative of the dangers and difficulties that might besetthe general practitioner. Haemorrhage and foreign bodiesin the air passages were dealt with as the most uirgentconditions. Oedema of the glottis was anothel, almost asurgent. Fractures were considered to be emergencieswhich allowed of deliberation and indeed demanded it, theimperative need for care here, especially tlhe takinig of an

x-ray plate for thle protection of the practitionler, beingstressed. Infectious diseases might prove very trouble-somle, especially when the diagnosis was not quite certain,anld thle question of the adv-isab)ility of waiting; for theresult of the examination of ax throat swab before giving

JUNE -, s, 1924] OBITUARY. T Bufam.W 115Jthe doctor's duty to give at a moment's notice as manycertificates as they may think fit to ask for, and it isregarded as a grave offence if there is any demur on hispart.When a working man is sick it is not unusual for him to

ask for four or five certificates, as follows: (1) nationalinsurance; (2) one or more friendly societies; (3) some news-paper's insurance department; (4) a private slate club;(5) the man's employer. Many a doctor grants in this wavtwenty to fifty certificates in a day .nd often with nioassistance. It is not surprising, then, that there is laxityand carelessness, which are really symptoms of mentaloverstrain, and with such a state of affairs these mistakesand errors, which may have occurred in all good faith,should not merit a vote of censure by the Council.The Council appears to have three judgements: (1) case

unproved; (2) vote of censure; (3) erasion fromn the Register.Has not the time arrived when the Council should considersome intermediate judgement or judgements?-I am, etc,Chichester, June 18th. ARTHUR M. BARFORD.

Dr. EDWARD CHICHESTER of Colchester, who died recently,aged 57, was the fourth son of Captain Nugent Chichesterof the 7th Dragoon Guards and a member of the ancientfamily of Chichester of Calverleigh, De'von. He waseducated at Prior Park, Bath, and at the London HospitalMedical College. He took the diplomas of M.R.C.S.,L.R.C.P.Lond. in 1891, and graduated M.B.Lond. in 1894,gaining honours in anatomy at the intermediate M.B.At the London Hospital he held the offices of house-surgeon,house-physician, and resident accoucheur. Some twenty-three years ago he went to Colchester, where he establisheda large practice. He was honorary surgeon to the EssexCounty Hospital, and in recognition of his special servicesto the institution was recently made a vice-president. Hewas formerly chairman of the North Essex Division of theBritish Medical Association. Dr. Chichester is survivedby his widow, two sons, and a daughter. The funeral tookplace at Calverleigh on May 31st.

Old graduates of Queen's College, Belfast, will regretto hear of the death of Dr. JOHN FREDERIVK GORDON onJune 17th at Maghull, near Liverpool. lie was educatedat the Royal Academical Institution, Belfast, and took hisarts course in the old Queen's University, graduating B. A.in modern languages and winning the senior scholarshipin modern languages in his college. He obtained the M.D.degr ee of the Royal University of Ireland in 1886 andwent to Maghull, where he remained ever since. He sawthe foundation of the epileptic colony at Maghull, andafter Dr. Alexander's death, in 1919, was appointed medicalsuperintendent of the colony. His success in treating theinmates was fully appreciated by the committee and wasa large factor in the esteem in which the institution isheld. For many years he was an international lacrosseplayer, and possessed an attractive tenor voice. He wasvery popular with all with whom he came in contact. Thelarge attendance at his funeral showed something of theesteem in which he was held and the regret widely felt athis death. He married Miss Jane Gardiner, who diedabout eight years ago. He is survived by one daughter,with whom sincere sympathy is felt.

Dr. JOHN HONEYFORD, who died recently, was educatedat the University of Edinburgh, where he graduated M.B.,Ch.B. in 1910 and M.D. in 1912, and took the F.R.C.S.E.diploma in 1914. He served as senior clinical assistantin the ear, nose, and throat department of the RoyalIlnfirmary, Edinburgh, and was for twelve months seniorhouse-surgeon to the Leicester Royal Infirmary andChildren's Hospital. He volunteered for war service andobtained a commiiission in the R.A.M.C. He served at theEdinburgh War Hospital, Bangour, after which he becamesurgical assistant at the military hospital, EdinburghCastle. In 1917 he was appointed senior resident surgeon

at the Bristol Military Orthopaedic Centre, and in June,1918, surgeon to the Beaufort Hospital, with sole chargeof over 400 beds. He was subsequently surgeon in chargeof the Derry City and County Infirmary, but had torelinquish that post owing to ill health.

Dr. CLARENCE A. J. WRIGHT of Levtonstone, who diedon May 28th, aged 58, was the son of Dr. Arnold Wriglht,durbagh surgeon to the Rajah of Mysore. He received hismedical education in Madras and the Surgeons' Hall,Edinburgh, took the Scottish triple qualification in 1889,and became F.R.C.S.Edin. and L.R.F.P.S.Glasg. in 18.c8.For a time he was demonstrator of anatomy in the Presi-dency Medical College, Madras. On his return to thiscountry he star-ted practice in Rochester. Some twenty-six'years ago he removed to Leytonstone, where he achieve(imuch success. He had been associate editor of Medic(lElectrology and Radiology, and wrote many papers oiiradiotherapy and kindred subjects.

We regret to record the death in Edinburgh, on June lst,at the age of 74, of Dr. ARTHUR JOHN VAUSE, J.P., whohad practised for some thirty-six years -in New SouthWales. He studied medicine at the University of Edin-burgh and graduated M.B., C.M. in 1875, after whiclhe served as resident physician in the university clinicalwards of the Royal Infirmary, Edinbufgh, and held juniorhospital appointments at Leeds. In 1878 he went toAustralia, and after a short period as resident physicianto the Sydney Hospital he began practice as a mentalspecialist, with a private hospital for the insane at BayView House, Tempe, Sydney, where he resided until 1914.He then retired from practice on account of his health andreturned to England. During the past three years he hadlived in Tasmania, but returned to this country early thisyear. Dr. Vause joined the British Medical Association in1884, and was for thirty years a member of the New SouthWales Branch.

Dr. BRUCE FERGUSON, who died at Surbiton on June 10that the age of 60, graduated B.A.Camb. in 1883, took thediplomas of MI.R.C.S., L.R.C.P. in 1890, graduated M.B.,B.Ch. in 1892, received his M.D. in 1895, and took theD.P.H. of the English Conjoint Board in 1907. Hereceived his medical education at St. Mary's Hospital. Hewas engaged for nearly thirty years in general practice at.New Southgate, where he gaine(d the affection and respectboth of his patients and his fellow practitioners. He wason the medical staff of the Passmore Edwards Hospital,Wood Green, and for a time chairman of the council. Dr.Ferguson was author of Aids to the Mathematics of Hygieneand of many papers on ophthalmic subjects. He leaves awidow, three daughters, and a son, who, with a large circleof friends, will deplore his death.

Professor VAN DEYL, a well kn'own ophthalmologist ofPrague, has recently died at the age of 69.

UNIVERSITY OF OXFORD.AT a congregation held on June 19th the degree of doctor ofmedicine (D.M.) was conferred upon N. F. Smith.The Rolleston Memorial Prize has been awarded to Francis

John W. Roughton, Fellow of Trinity College, Cambridge. Theprize, which is of the value of about £100, is given once in twoyears for original research in any subject comprised under thefollowing: Animal and vegetable morphology; physiology andpathology; and anthropology.The University has accepted the bequest of the late Mrs.

Constance Jenkinson of £2,216 for the foundation of a JohliWilfred Jenkinson Memorial Lectureship in memory of herhusband (a Fellow of Exeter College and a captain in the12th battalion, Worcester Regiment, who was killed in the war)for the encouragement and advance of research in comparativeand experimental embryology.

UNIVERSITY OF CAMBRIDGE.AT congregations held on June 21st and 24th the following medicaldegrees were conferred:M.D.-H. W. Featherstone.B.Ca.-C. G. Taylor, H. G. Wiltshire.

I160 JUNE 28, 19241 MEDICAL NEWS. [ THU BRrYMJ9EDICAL JouRNA

QUEEN'S UNIVERSITY, BELFAST.DR. R. H. HUNTER, demonstrator of anatomy at UniversityCollege, London, has been appointed lecturer in anatomy atQueen's University, Belfast.

ROYAL COLLEGE OF SURGEONS OF ENGLAND.ONE HUNDRED candidates presented themselves at the examina-tion for the primary Fellowslhip held from June 10th to 18th, ofwhom thirty-one were approved and sixty-nine rejected. Thefollowing are the successful candidates:

J. L. Armour (Liverpool), Alfreda H. Baker (Belfast), H. Barbash(Cambridge and St. B3artholomew's), G. A. F. Barnett (Otago andMiddlesex), P. G. Bentljif (Cambridga and Middlesex), R. H. Boggon(St. Thomas's), A. 'Byrne-Quinn (St. Thomas's), F. A. Brynins(King's College and St. Mary's), H. J. Burrows (Cambridge andSt. Bartholomew's), J. B. Crabtree (St. Bartholomew's). J. L. Diggle(Melbourne and Middlesex). S. W. Drinkwater (Manchester), V. T.Ellwood (Oxford and St. Thomas's), E. S. Frischm-iann (;Manchesterand St. Mary's), R. A. Graff (Middlesex), W. A. Gray (Edinburghand St. Mary's), P. Hack kGuy's), J. A. James(Sydney and Middlesex),P. P. S. Kelman (Otago), V. E. Lloyd (Guy's). E. E. Mackay (Mel-bourne and Miid(dlesex), J. McMichael (Edinburgh and St. Bar-tholomew's), D. S. Middleton (Edinburgh and St. Mary's), F. W. G.Nash (Middlesex), C. H. Osborn (Melbourne and Middlesex), C. L.Owen (Cambridge), A. H. Reid (Liverpool and Middlesex), J. Roberts(Liverpool), H. P. Susman (Sydney and Itiddlesex), S. N. Taylor(Manchest2r and St. Mary's), C. I. Tuckett (St. Mary's and Middlesex).

ROYAL COLLEGE OF SURGEONS IN IRELAND.THE following officers have been elected for the ensuing year:President, Mr. Robert Chiarles Butler Maunisell; Vice-President,Mr. Andrew Fullerton; Secretary, Sir Frederic Conway Dwyer;Connicil, Mr. J. B. St:)ry, Sir Thomas Myles, Major-General R. H. S.Sawyer, MIr. Arthur W. WV. Baker, Sir Arthur Chance, Sir Robert H.Woods, Mr. R. Lane Joynt, Mr. Thomas Eagleson Gordon, SirFrederic Conwvay Dwyer, Mlr. Alexander J. Blayney, Sir WilliamTavlor, MMr. Trevor Nathaniel Smith, Mr. Seton Pringle, SirWilliam I. de C. Wheeler, Sir C. Arthur K. Ball, Mr. R. AtlkinsonStoney, Mr. Edward Sheridan, Mr. William Pearson, aud Mr.Adams A. McConnell.The new President is a graduate in medicine and surgery of the

University of Dublin. Ile has been a Fellow of the Royal Collegeof Surgeons since 1900 anid was elected to the Council in 1904.Two years ago he was unanimously elected Vice-President. Mr.Maunsell is the senior surgeon to Mercer's Hospital, having beenappointed to the staff of that hospital in 1898. During theEuropean war he was surgeon to the Castle Red Cross Hospitaland consulting surgeon to the Hermitage Red Cross Hospital, andfor a time served in France as surgical specialist to the " Dublin"(83rd) General Hospital.

SOCIETY OF APOTHECARIES OF LONDON.THE following candidates have passed in the subjects indicated:SUIRGERY.-F. James, R. D. M. Tims.MEDINE.-K. It. Cbaudhri, H. T. Chiswell, C. E. Donaldson, A. Kotbi.FORENSIc MEDICINE.-W. Bentley, H. P. Burns, K. R. Chaudhri, A.

Kotbi, J. Wilson.MIDWIFERY.-R. D. Jones, W. R. A. Line, M. Schwartzman, J. Wilson.The diploma of the Society has been granted to Messrs. H. T.

Chiswell, F. James, A. Kotbi, and W. R. A. Line.

INDIAN MEDICAL SERVICE.- ANNUAL DINNER IN LONDON.

THE annual London dinner of the Indian Medical Service washeld at the Trocadero Restaurant on June 18th, when ColonelJ. J. Pratt, F.R.C.S., was in the chair. The number of officerspresent was 89-the largest attendance at these meetings saveon one previous occasion. There were two guests, a representa-tive of the British M1fedical Journal (Sir Dawson Williams)- anidof the Lancet (Dr. E. C. Morland). The followinig is a list ofthe officers present:Major-Generals: Sir R. 11. Clharles, G.C.V.O., K.C.S.I., T. Grainger, C.B.,

G. F. A. Harris, C.S.I., Sir P. lIehir, K.C.I.E., C.B., C.M.G., H. Hendley,C.S.I., J. B. Snlith, C.13., C.I.E.Air-Commodore: D. Mtinro, C.B., C.M.G.Colonels: J. Crimmin, V.C., CD.B., CIE., C. M. Goodbody, C.I.E.,D.S.O., T. A. Granger, C.M.G., C. R. M. Green, A. J. Macnab, C.B., C.M.G.,

J. J. Pratt, H. Atusteni Smith, C.IE., T. Stodart, C.I.E., R. G. Turner,C.M.G., D.S.O., C. N. C. Wimberley, C.M.G.Lieut.-Colonels: A. Alcock, C.I.E., J. Anderson, C.I.E., G. T. Birdwood,

Sir T. J. Carey Evans, M.C., A. W. Cook-Young, D. G. Crawford, J. M.Crawford, O.B.E., H1. M. Cruddas, C.M.G., O.B.E., R. 11. Elliot, F. F.Elwes, C.I.E., J. Entrican, C.I.E., A. M. Fleminm, J. K. S. Fleming, O.D.E.,A. B. Fry, C.I.E., D.S.O., 1I. Greany, J. W. Grant, E. C. ifodgsoii, E. V.Hugo, C.M.G., J. G. Hulbert, C. I. James, C.l.E., J. G. Jordan, H. C.Keates, R. S. Kennedy, D.S.O., M.C., II. Kirkpatrick, J. C. C. Kunhardt,Clayton Lane, W. B. Lane, C.I-E., C.B.E., J. Lloyd-Jones, J. McC. A.Macmillan, H. M. 1I. Melhuish, D.S.O., A. Miller, R. K. Mitter, T. R.Mulronev, F. O'Kinealy, C.I.E., CA'.O., S. E. Prall, J. W. F. Rait,Sir L. Rogers, C.I.E., R. Steen, A. Street, C. Thomson, W\r. II. Thornhill,G. Tate, J. 1I. Tull WValsh, H. J. Walton, D. P. Warliker, C. G. Webster,R. T. WN'ells, C. E. W-illiams, H. R. Woolbert, A. C. Younan, T. C. McC.Young.Majors: H1. C. Brown, C.I.E., 1-1. J. M. Cnrsetjee, D.S.O., W. J. Fraser,

D. L. Graham, O.B.E., N. H. Hume, L. C. Irvine, E. OG. Kirwan, P. S.Mills, W. S. Nealor, A. N. Palit, M. L. Puri, M. J. Quirke, J. G. B. Shand,H. H. Thorburn, C.I.E.Captains: N. Briggs, J. C. De, G. Kumar, J. G. McCann, V. R. Mirajkar,S. Nag, V. S. R. Pandit, R. Sweet, D.S.O.

ROYAL ARMY MEDICAL CORPS.Major-General J. R. McMunn, C.B., C.M.G., late R.A.M.C., is

appointed Honorarv Surgeon to the King, vice Major-General E. M.Pilcher, C.B., C.B.E., D.S.O., late R.A.M.C.(ret.).Major-General S. F. St. D. Green, C.B.E., late R.A.M.C., is

appointed Honorary Physician to the King, vice Major-General SirW. W. 0. Beveridge, K.B.E., C.B., D.S.O., late R.A.M.C.(ret.).

DEATHS IN THE SERVICES.Lieut.-Colonel Charles William Stanford Magrath, R.A.M.C.(ret.),

died at Ballycastle, co. Antrim, on May 19th, aged 68. He wasan Ulsterman, but was born at St. Be3es, in Cumberland, wherehis father was a Church of England clergyman. He was educatedat Rossall, at Guiy's, and at Edinburgh, where he graduated M.B.and C.M. in 1880 and M.D. in 1892. He entered the army assurgeon in July, 1881, became lieutenant-colonel after twentyyears' service, and retired on February 2nd, 1911. He served inthe Egyptian war of 1882, was present at the action of Tel-el-Kebir, and received the medal aiid the Khedive's bronze star. lIthe Sudan campaign of 1884-85 lie was with the Nile column,receiving a clasp to the Egyptian medal. He served also inBurma in 1886-87, gaining the Indian frontier medal with twoclasps. Soon after the recent war began he rejoined for service,anid after serving for a time in the Southern Commanid was forabout a year in charge of a hospital ship; then for some threeyears he was employed on various duties in and around Ports-mouth. The last few years of his regular service were spentat 'Hilsea, at the north of Portsmouth, and after his retirementhe settled at Cosham, close by. After the end of the war hemnoved to Ireland and went to reside at Ballyeastle. He had onlyonie child, Major Meyrick Magrath, R.F.A., who was killed illaction towards the enid of the war; his wife also died soon afterthey ivent to Ballycastle.Lieut.-Colonel Herbert Ward Austin, R.A.M.C.(ret.), died at

Plymouth on February 3rd, aged 59. He was born at Poplar, waseducated at St. Bartholomew's Hospital Medical School, and tookthe M.R.C.S. and L.R.C.P.Lond. in 1885. He entered the armyas surgeon in 1886, became lieuitenant-coloniel in 1906, and retiredin 1911. He served in the South African war in 1900-01, when hewas on garrison duty at St. Helena, and received the medal.After his retirement he was employed as medical officer at FortStamford, Staddon.Surgeon Commander Norman Lloyd Richards, R.N.(ret.), died

at the Royal Naval Hospital, Haslar, on May 28th. He waseducated at Guy's Hospital Medical School, took the M.R.C.S. andL.R.C.P.Lond. in 1890, and after serving as clinical assistant anldophthalmic assistant at Guy's, entered the navy; he retired afterthe war, when he settled at Lyme Regis, Dorset.

A HERBALIST'S CONVICTION.THE Court of Criminal Appeal (the Lord Chief Justice, Swift andActon, J.J.) on June 23rd, 1924, refu3ed leave to appeal againstconviction and sentence to five years' penal servitude for falsepretences passed upon Clement Humphrey, a herbalist, of PrichardStreet, Chorlton-on-Medlock, Manchester, at Manchester Assizes.The Lord Chief Justice, giving judgement dismissing the appli-

cation, said the prisoner was a West Indian who undertook tocure epilepsy, rheumatism, fuberculosis, nervous depression, andother diseases, and the evidence showed that in all these casesthere were no cures. There was ample evidence on which thejury might find tUat it was a clumsy imposture, and there wasno reason for the court to interfere either in the matter ofconviction or sentence.

DR. JOHN PURSER, Regius Professor of Physic at TrinityCollege, Dublin, has offered £10,000 to the College to be usedfor the beneflt of the School of Physic and the Schools ofExperimental and Natural Science.THE RT. HON. JOHN WHEATLEY, M.P., Minister of Health,

has appointecl Mr. S. F. Perry, M.P., to be his ParliamentaryPrivate Secretary (unpaid).DURING the Annual Meetling of the British Medical Associa-

tion at Bradford a Ladies' Golf Competition has been arranged.It will be an eighteen-hole medal competition on handicap, tobe played at the Bradford Golf Club, Hawksworth, on Wednes-(lay, July 23rd, Prizes will be given by Arthur J. Hill, Esq.,,J.P., President of the Bradford Golf Club. The competitionwvill be held under the Ladies' Golf Union-rules and will be intwvo divisions: First division handicaps, 1 to 20 inclusive;second division handicaps, 21 to 36. Conveyance will beprovided from the Church House for competitors and others.Luncheons and teas provided at the Club House. Entriesmay be sent to Mrs. Buchan, 15, Heaton Grove, Bradford, asearly as possible. Other information will be found on thenotice board in the Social Club.

TE 28 =4 EIA ES ~~hL i6

THE annual dinner of the Federation of Medical and AlliedServices was held on June 20th at the Connaught Rooms,London, with the President, Sir BerkeleyMoynihan, in thechair. A letter to Sir Thomas Horder from Mr. RamsayMacDonald expressed the Prime Minister's regret at beingunable to attend, and his good wishes for the success of theFederation's efforts in consolidating the agencies that workfor the health and comfort of the community. The chairman,in proposing the health of the Minister of Health, extendedto Mr. Wheatley a very cordial welcome, remarking that theFederation had no political attachments. Mr. Wheatley, inreply, spoke of the useful purpose that would be served if theobjects of the Federation were fully realized and the collectiveopinions of the medical and allied professions were turned toaccount. National organization for applying medical know-ledge would enable the country to use its stock of health tothe utmost advantage. The toast of prosperity to theFederation was proposed by Sir W. Joynson-Hicks, who wasMinister of Health in the last Government. He prophesieda great extension of national health insurance, a co-ordinationof pensions and insurance against old age, and provision forwidows and fatherless children.THE committee of the Hayling Mosquito Control, of which

Sir Richard Gregory, D.Sc., is chairman, has issued a wellillustrated report for the year ended May, 1924, drawn upby the honorary director, Mr. J. F. Marshall, M.A., F.E.S.A system of control was organized in 1920 to carry outexperimental investigations relating to the mosquitos whichevery summer and autumn create an almost intolerablenuisance in a number of resorts situated along the coast ofDorset, Hampshire, Sussex, and Kent. The nuisance is duechiefly to a culicine species of mosquito-Ochlerotatits detrituts-which breeds in stagnating salt water and has a -widerrange of flight than most freshwater mosquitos. Thescheme of work has been to locate the different breedingplaces and to drain or fill them up. A good deal of successhas attended the work both in Hayling itself and in Gosport,in which an organization based on the Hayling Control wasstarted last year. The total cost for the year was£232, andlof this amnount £80 was provided by the Ministry of Healthand £75 by the Havant Rural District Council. Similar workinitiated by Surgeon Commander D. H. C. Given, R.N., hasbeen done in the Alverstoke district with appreciably goolresults.THE annual inspection of the National Physical Laboratory

at Teddington was attended by a large number of visitors,who were received by Sir Charles Sherrington, O.M., Presidentof the Royal Society, and chairman of the board of manage-ment of the laboratory, by Sir Arthur Schuster, F.R.S., andby the director, Sir Joseph E. Petavel, D.Sc., F.R.S. All thedepartments were open for inspection, and in many of themexperiments were shown. In the aerodynamics departmentthe wind channels were in operation, and in the national tanlia model in load condition with screw propeller. The wirelessdivision attracted the interest of many amateurs. In thephysics department methods of measturing daylight illumina-tion in various types of rooms were demonstrated by meansof large scale models. In the electrotechnics department thearrangements for approval of ships' navigation lights wereexplained, and also the methods of measurina standards ofluminous intensity in terms of the international candle. Theother departments open for inspection were the engineering,the muetallurgy, and the metrology.

SIR DONALD MACALISTER, Bt., K.C.B., Principal and Vice-Chancellor of the University of Glasgow, and President of theGeneral Medical Council, has been admitted to the roll offreemen of the city of Glasgow.As the result of the election of direct representatives on

the Dental Board of the United Kingdom the following havebeen duly elected for England and Wales: Qualified dentists-Mr. W. H. Dolamore and Mr. W. R. Ackland; dentists regis-tered under the Acts of 1921 and 1923-Mr. Butterfield andMmr. Bowen. The election toolk place under the scheme of theProportional Representation Society. As there was only onenomination in Scotland and one in lreland, Mr. William Guy(Edinburgh) was elected for the former and Mr. John JamesAndrew (Belfast) for the latter.THE, Fellowship of Medicine and Post-Graduate Medical

Assbciation announces that the only post-graduate workoffered for the first week of July is that which is availableat the various hospitals to holders of general ticlkets underthe Fellowship of Medicine, as the first special course in Julydoes not begin until the seventh of the month. As announcedlast week, this will consist of a series of lectures anddemonstrations on diseases of the eye at the Royal E3yeHospital, Scuthwark. An intensive course in general andspecial nmedicine and surgery will begin at the North-EasternPost-Graduate ColIege, Tottenhamn (the Prince of Wales'sGeneral Hospital), on July 21st. Three special courses have

been arrange( for the holiday month of August, so that post-graduates interested in children's diseases, chestdiseases, orneurology will be able to study these subjects at the Queen'sHospital for Children, Bethnal Green, from August 11th ta23rd, at the Brompton Hospital during the same period.,and at the West End Hospital for Nervous Diseases froniAugust11th to September 6th. Copies of the syllabus of allcourses, and particulars regarding fees, etc., can be obtainedfrom the Secretary) Fellowship of Medicine, 1, WiimpoleStreet, W.1.

SIR ARTHUR KEITH, F.R.S., will present the prizes to thesuccessful students at the London Hospital Medical Collegeon Monday, June 30th, at 3.30 p.m.THEMinister of Agriculture flnds that "1a large nunmber of

the recent outbreaks of foot-and-mouth disease have occurredin slaughterhouses," and while there are indications that theseverity of the disease is diminishing the Ministry of Healthhas thoug,ht it desirable to send a circular letter to sanitaryauthorities asking them and their officers to devote specialattention to the inspection of meat in order to ensure theprompt detection of meat or offal showing indications of thedisease.

SIR JAMES PURVES-STEWART has been elected an associatemember of the American Neurological Association.THE annual meeting of the Society for the Study of

Inebriety will be held at 11, Chandos Street, W.1, on Tuesday,July 8th, at 4 p.m. Sir William Willcox will deliver a shortpresidential address on the aims and work of the society,after which a discussionwill be opened by Dr. Walter Astenon the institutional treatment of the alcoholic inebriate andthe drug addict.THE International Labour Office at Geneva, at the request

of a meeting of representatives of disabled men of sixEuropean nations, asked Dr. Florent Martin, director of theTechnical and Scientific Institute of Artiflcial Limb Fitting,Brussels, to make a report on artiflcial limrlbs. An Ennglishversion has just been issued, and can be obtained (price 5s.)from the International Offiee, 26, Buckingham Gate, S.W.1.Thie report contains a useful summiary of the principles ofprosthetics and probably gives a good representation ofContinental practice. Unfortunately Dr. Martin is not wellinformed as to British practice before the war, and butimperfectly as to the improvements effected during and sincethe conflict. He divides artificial limbs generally into

' European" and "American," but he would have beenmore accurate had he substituted "Continental" for"European," seeing that British practice has longs differedmuch from that described byhim asEuropean. For instance,in the United Kingdom the sockets of most artificial legslhave long been made of woodl and not of leather as in the"European" patterns, according to Dr. Martin. Despitethese drawbacks the report represents a praiseworthyattemnpt to provide amputees with a cheap and completaguLide to the selection of an artificial limb, and it rnay balhoped that a secon(d edition -will soon be called for in whichthe defects of the flrst will no doubt b3 remedied.IN connexion with the arrangements for the annual meeting

of the Medico-Psychological Association at Belfast fromnJuly 1st to 5th the paper by Dr. F. R. Martin on the reactioliof the blood to the ingestion of protein in the psychoses willbe given on July 2nd and not July 1st as previously arranged.It will be followed by a paper by Dr. Houston on the ex-amination of cerebro-spinal fluid, with demonstration.THE Royal Sanitary Institute has electedl the following

distinguishe(d foreign sanitarians to be honorary Fellows;Professor Leon Bernard, Institute of Hygiene in Paris; Dr.Carlos Chagas, of the National Health Department, Brazil;Surgeon-General Hugh S. Cumming, U.S.A. Public HealthService; Professor C. Eijkman, Utrecht; Professor J. J. VanLoahem, Amsterdam; Professor Th. Madsen, Director ofthe State Serum Institute, Copenhagen; Professor DonatoOttolenghi, of the University of Bologna; Dr. W. H. Park,Bacteriologist to New York City; M. Albert Thomiias, Director'of the International La.bour Office, Geneva; andl Mlr. 0.Velghe, of the Department of Hygiene in the BelgianMinistry of the Interior.THE Chartered Society of Massage and Medical Gymnastics

is about to award two Lucy Robinson bursaries, each of thavalue of £ZO-one to a student in training, the other to amasseuse wbo holds a certiflcate in massage, is a muember ofthe society, and is in need of assistance to obtain furtherInstruction in nmedical gymnastics or medical electricity.Applications must be received by the secretary of the society,157, Great Portland Street, London, W.1, not later thanJune 30thl.THE issue of the Zentralblatt f1i- Chirurqie of May 31st

commemorates the centenary of the birth of Gustav Simon,an eminent German surgeon, andl foeiuder of the Gerns-n,Society of Surgery, who died in 1876.

;rUNE 28, 11,9241 MIEDICAL NEWS. Tim Bnmxg ii6iT MEDICAL JOURIgAiL-

n162 JUINF. 28, 1924] LETTERS, NOT1ES, AND ANSWzR3. (MIDICAL JOUaNAL

DR. R. A. LYSTER 31.0.H. Hampshire and lecturer in PublicHealth at St. Bartholom-iew's Hospital, has been electedPresident of the Society of Medical Officers of Health for theSession 1924- 25; he will deliver his presidential address onOctober 17th, and on the evening of the same day the aunualdinner of the society wvill be held at the Hotel Cecil.MEMBERS of the British Medical Association attending the

Annual Meeting at Bradford next month who desire to spendthe week-end at Scarborough can obtain accommxo(lation atthe Crown Hotel or at the Royal Ilotel, Scarborough, theterms being 40s. and 35s. respectively for the week-end.ON June 14th the "King's Services Choirs" gave their

fifteenth concert at the Chelsea Polytechnic Institute. Thewembers are ex-service men from the-Ministry of PensionsHospitals, trained by teachers provided by the Vccal TherapySociety. The men are mainly sufferers from neurastlhenia,and if the advance in the quality of the singing as comparedwith the former concerts is to be taken as a criteriou, thesingina and the deep breathing it involves has worlea verywonderfully.THE Rev. John W. Arthur, M.D., has been appointed an

unofficial member of the Legislative Council of the Colonyof Kenya.WE have received through the Red Cross Society of Russia

(150, Southamupton Row) a copy of a niew periodical, I'lTeRussian Eitgenicatl Journal, edited by Professor Kolizoff ofMoscow. Amiong the papers it contains is on_ by the editoron the genetical analysis of the psycliical funictions in man,and another by Czullkoff on the genealogy of the To:sloifamily.

X,stttSZl AJafItsl t1stU xPzlUtlSz.CommnunicationIs intcnded for the current issute should be posted soas to arr-ive by, the (ijst post on Alond(ni or at latest be reccivednot lutcr than ?'utsdoy morinozzg.

CORRESPONDENTS Wo WISh) oe0t!ce to be taken of tlleir communica-tions should'auithenticate tlhemn with their names-not necessarilyfor publicatioln.

ORIGINAL ARTICLES and LE'ETRS forvar-dcd for publicationare uniderstood to be o/ft-red to the BRITISH MEDICAL JOURNALalone unless the con trner be st(ited. Authors destring reprints oftheir articles published iD the BRITISl MEDICAL JOURNAL arerequested to conluuunicate with the Firnancial Sectetary andBusiness Manager, 429, Strand, W .C.2, on receipt of proof.

ALL coinmuiicjat ions with reference to advertisements as well asorders for copies of the JOURNAL should be adddressed to theFiiiancial Secretary and Butsinress Manages-, 429, Strand, London,W.C. Attentionr to this request will avoid delay. Courtnuni cationswitlh refer-enice to editorial business shotld be addressed to theEditor, LI3ITISII MEDICAL JOU7RNAL, 429, Strand, W.C.2.

TniE telephione tiuixibei of the Beririsu MEDIcAL ASSOCIATioN andBRITISH MEDICAL JOUTItNAL is Geiiatrd 2630 (Internal Exchange).The telegr aphic addr-esses are:

EDITOR of thie BRITISI MEDICAL JOURNAL, A ittology Westranid,Lontdon.FINANCIAL SECRETARY AND BUSINESS MANAGER

(Advertisernents, etc.), .4 11tcaltetWestra iud, Lonidon.MEDICAL S ECRETA BY. Aedistera. Weetrand, Londont.The address of the Irish Office of the British; Medical Asso-

ciation is 16, Sotitth Frederick Street, Dublin (telegrarsisBtcdllus, Dublini; teleplhone 4-737, Dublin), and of the Scottish;Office, 6 Rutltland Squiare, Edinburgh (telegrams: Associate,Edinburgh; telephone, 4361. Central).

QUERIES AND ANSWERS.

"M. D." asks for information conicerning Sicily as a winter resortfor a mar suffering from fibrositis.

"W. P. K." asks for information rezarding a preparation forsuboutaneons or ietrarnuscular inijectionl whichi is usedl iu thetreatmnenit of exophthalmic goitre.

'J. T." asks (1) how fouled closet seats such a4 are found inschoo's are best cleaned, and (2) for an easy aud efficient methoclof preveuitiiig a patienit slipping dowii in bed.

** (1) Whlere tbh3 seat3 are fouled witlh faeces it is tlle mucusthey co;3tain wlvich makes the fi'tlh stick. MIIUcus is soluble inweak alkaline solutions and precipitated by weak acids. Warmwater in which ordiiiary washiiig so(l is dissolved is rbcom-mended. A rag soaked in the solution should be laid on tosoften the filth after any accutmulation las beeni scraped off svitla blunt knife. (2) Raisiiig thie foot of the bel 9 or 10 inchles orplacing a pillow secured by a belt or strap to the top of the bed-stead under the hams of the patient. Several bedrests to meetthe difficulty have been designed and could probably be obtainedfrom a dealer in sick-room furniture.

OPT.G AT1ROPHY IN TABES."S. B." asks for advice ini the tre-itmnent of optic atrophy in

locomzlotor ataxia. The other symptoms preient are ArgyllRobertson pupils and(i absence of ktnee-jerks. For a year thepatient had inicontinenoe, but this disappeared three years agoafter treatnmenit by thyroid extract. The W'assermann reactionis negative. Neosalvarsan, iodides, and strychnine have beenused, but loss of vision during the last four years hias beenprogressive.

LETTERS, NOTES, ETC.

A GRAIN OF OATS IN THE CONJUNCTIVA.DR. W. T. G. BOUL (Ipswich) writes: It is possible that the followingmay be of some interest to the readers of the BRITISH MEDICALJOURNAL. On May 9th, 1924, a child, aged 6, was brought to me10by the father, who complained that for some months past oneeye ha1 been painful and bloodshot. There was some c-n.junctivitis, aill on pressing down the lower eyelid a large grainof (ats, over a centimetre in lenuth, was seen and easilyextracted. The grain was swollen, quite black, and sproutinlg;it had eroded into the mucous membrane. The most interestiingpart of tlie case is the lhistory. Iu September, 1923, thle childwhilst playing in a corn mill had a handful of oats thrown at lhisface; he immediately c:mplained of pain, and said somethiniglhad gone in hiis oeye. Dotubtless the grai lhad remained in theeye for eight mont".ls; it is remarkable that so little damage hadbeen done.

GONORRHO1EAL IR1TIS.Dn. Al. W. B.OWDY (London), in, the course of a letter, writes:That a forgotten attaCck of gonorrhoea may be the cause ofsymllptoms remnote to tile uro-genital tract, mauy years afterinllection, is often overlooked; hience the value of the paper byMr. E. it. Chambers on gonorrhoeal iritis in your issue ofMay 3r-d (p. 781). Such a case of clhronic recurrenit iritis, lastingover teni years, I describel in a paper some years ago (Practitioner,October, 1911). High blood pressure aud sclerosis of the arteriesarising in miiddle-agedl nmen is often due to a chronic absorptionof toxins from a "sealed " gonorrhoeal prostatitis atid vesiculitis,bLhL ulnfortuniately is not always recognized. Such a case I haveat present unlder my care, a clerk witli a blood pressure of240 mm. and its coilsequent sequelae. He had beeu treated byseveral pliysicians witllout much benefit. lie consulteJ me, aslhe had become retrospe3tive as regards lls sexual history.I found(I his prostate enilarged and was able to express massesof purulent debris containing gonococci. After a fortniglht'streatmenlt the blood pressure fell 50 mm. Such ca-es are notunicommon, but attentiou is ilot drawn to the uro-genital organsas no local symptoms are complained of.

THE USE OF STRYCHNINE IN SHOCK.Dr. I. DAVID (Colombo, Ceylon) writes: On page 632 of theBRITISH MEDICAL JOURNAL dated April 5th, 1924, in reviewingthe book ilinical Menr(laid jor Genetral P'ractitioners, by Alex.Thieodore Branid andl John Robert Keith, you state that "the useof strYchnine is adlvccated at one place, while at another Crileis quoted in autthority against it." I hope you will forgive meif I pointt out that, accor(lipg to Crile, gr. 1/10 of strychninsincreases shock, but gr. 1/50 repeated each hour reduces it.

VILLAGE LECTURERS.MR. WILFRED MAIRK WEBB, lionorarv secretary of the SelborneSociety (The Hermitage, Hanwell, W.7), writes: For the lastten years the Selborniie Society has systematically sent outlecturer3 to societies and schools. The list for the coming se%sonhas just been published, and it may be said that although theoriginal object of It lpina small societies to get something reallygood has n)ever beeni forgotten, so many schools and importantbodies have talken advantage of this educational side of thesoaiety's work that it is intended to emphasize what can still bedone for village clubs an(d charitable organizations by issuinga special list for them. 1-t will contain the names and subjectsof practically all the existing lecturers, for the unanimity withwh,ich they offered to help where possible is most striking.Otlhers withi a special desire antd aptitude for the vork will beadded to the niew list, and the main object of this letter is to asktho3e wlhose livelihood does uot enitirely depend upon theirlectures, but wlho lhave an initeresting story to tell, to send intheir names to me with a view to their being included.

No TIME TO BE BRIEF.IT iS cu3tomary to attribute the only excuse for prolixity to the

Scottisih miniister who apologizel for the length of his sermonby alleging thiat lie liad beell too.busily engaged to make it shtort.Mr. Alban lDorau iiiforms uis that the original source is inPascal's Lettres Plortincittles (end of sixteenith letter " aux Pere3j6suites"): "Je in'ay fait celle-cy plus longue quo par ce queje n'ay pas eu Is loysir de la faire plus courte."

VACANCIES.NOTIFICATIONS of offices vacanit in ulliveri ties, melical colleges,and of acant residtent anl other appointmeneits at hoasuitals,will be found at pages 36, 37, 40, anld 41 of our adlvertisemenltcolumns. and( advertisemenlts as to partnerships, assistantships,andl locumtenlencies at pagtes 33 and( 39.A short summary of vacan1t posts notified in the advertisement

columns appears in the Suppellement at page 307.