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A. D. Jameson have been appointed to the EasternCommand.

VOLUNTEER CORPS.

Royal Garrison Artillery (Volunteers) : The Highland :Surgeon-Captain J. M. Moir to be Surgeon-Major (datedDec. 23rd, 1905).

Rifle.. 4th Volunteer Battalion, the Royal Scots (LothianRegiment) : Surgeon-Lieutenant J. T. Titterton resigns hiscommission (dated Dec. 23rd. 1905). 3rd (Renfrewshire)Volunteer Battalion Princess Louise’s (Argyll and SutherlandHighlanders) : Surgeon-Lieutenant C. Whish to be Sur-

geon-Captain (dated Dec. 23rd, 1905).VOLUNTEER OFFICERS’ DECORATION.

The King has conferred the Volunteer Officers’ Decorationupon the undermentioned officers of the Volunteer Force :-Eastern Command: Artillery.. : 1st Cinque Ports RoyalGarrison Artillery (Volunteeis) : Surgeon-Lieutenant EdwardAlexander White and Surgeon-Lieutenant John WilliamHarrison. Rifle : 1st Volunteer Battalion the Queen’sOwn (Royal West Kent Regiment) : Surgeon-Major CharlesBoyce, Brigade- Surgeon-Lieutenant-Colonel, Senior MedicalOfficer, West Kent Volunteer Infantry Brigade. ScottishComnaand : Artillery : The Highland Royal GarrisonArtillery (Volunteers): Surgeon-Major Murdo Mackenzie.-rifle: : 5th (Glasgow Highland) Volunteer Battalion the

Highland Light Infantry : Surgeon-Major Quintin Chalmers,Brigade-Surgeon-Lieutenant-Colonel, Senior Medical Officer,Highland Light Infantry Volunteer Infantry Brigade.Southern Command.. : Ri,fle: 2nd Volunteer Battalion the

Hampshire Regiment : Surgeon-Lieutenant-Colonel ArthurBreedon Wade. Welsh and Midland Command: : Rifle: :lst Shropshire and Staffordshire Royal Garrison Artillery(Volunteers) : Surgeon-Lieutenant-Colonel John PayneMassingham.

THE RECENT WAR OFFICE APPOINTMENTS.There appears to be general satisfaction at Mr. Haldane’s

appointment as Secretary of State for War. He has verywisely let it be known that he will take time to make up hismind on the question of army reorganisation. Sir WilliamNicholson’s appointment as Quartermaster-General and

Military .Member of Council is very popular in militarycircles. Why he left Pall Mall is not understood and it is

hoped that he may eventually become chief of the staff, forwhich position he is believed to be well qualified. As

regards army medical organisation and future arrangementsit need scarcely be said that much depends upon havingthe right man-that is, the most competent-in the rightplace.

’ THE PHYSIQUE OF MILITARY OFFICERS LATELYAPPOINTED.

It is satisfactory to learn, when there is so much saidabout our alleged national degeneration, that there is nofalling off among the newly appointed officers from theRoyal Military Academy, Woolwich, in respect of physicaland mental qualifications. At Major-General Hutchinson’srecent inspection of the cadets at the Woolwich Academy,when commissions were granted in the Royal Engineer andRoyal Artillery Corps to 37 candidates, there were no

failures. The average age of the cadets promoted was19 years and 9 months and the average weight 12 stones9 pounds. The physical standard was exceptionally high,27 per cent. having a chest measurement of over 40 inches.ELEMENTARY DRILL AND USE OF THE RIFLE IN SCHOOLS.At the concluding meeting of the annual conference of

headmasters it was agreed, on the resolution of Dr. James(Rugby), to ask the military authorities to issue a

memorandum of instructions in elementary drill and theuse of arms for the guidance of headmasters and officers ofpublic school cadet corps. We are glad to notice that

progress is being made in this direction for the reasons whichwe have already stated.

PRACTICAL GRATITUDE.—Mr. John F. Obree,J.P., of Southampton, as a thank-offering for partial recoveryfrom a long and severe illness, has just made the followingmunificent donations : to the Royal South Hants and

Southampton Hospital, £1000 ; to the Southampton Dis-pensary and Free Eye Hospital, £500 each : to the HantsFemale Orphan Asylum and the Seamen’s Institute, Z250each ; and to the Jubilee Nurses’ Institution, the ShipwreckedMariners’ Society, and the Shirley Children’s Hospital, £100each.

Correspondence."Audi alteram partem."

A CASE OF CLAY-COLOURED STOOLSWITHOUT JAUNDICE BUT ATTENDEDWITH COPIOUS BILIOUS VOMIT.

To the Editors of THE LANCET.

SIRS,-During the past four years I have had the oppor-tunity of examining, chemically and microscopically, over100 specimens of fseces from parents suffering from diseasesof the pancreas sent to me by Mr. A. W. Mayo Robson andby a number of other surgeons and physicians. Myexperi-ence may therefore be of some interest as bearing on thequestion raised by Dr. W. Gordon as to the cause of thewhite or clay-coloured stools met with in some cases of

pancreatic disease.The results of my analyses may be briefly summarised as

follows. 1. Quantitative examination of the stools shows thatthe colour varies directly with the 1 ereentage of fat present,the largest amount being found in those specimens which arewhite to the naked eye and the least in those which approxi-mate to the normal colour. 2. The glistening white appear-ance is most marked in those specimens which are foundmicroscopically to contain large numbers of fatty acid

crystals, probably for the same reason that snow and othersubstances of a finely crystalline character appear white inmass. 3. The white stools on being heated on the waterbath assume a dark brown colour. 4. Removal of the fatwith ether leaves a residue similar to that obtained fromnormal fæces. 5. Stercobilin is found in all specimensfrom patients not suffering from cancer of the headof the pancreas or some other cause of complete obstruc-tion of the biliary passage, the amount being pro-portional to the quantity of non-fatty residue. In casesof pancreatic disease associated with incomplete obstruc-tion to the flow of bile into the intestine the amountof stercobilin varies with the degree of obstruction. 6. Thewhite stools occasionally met with in tuberculosis of theintestine and other conditions where there is defective

absorption of fat are similar microscopically and chemicallyto those seen in typical cases of pancreatic disease, althoughthere is no obstruction to the flow of bUe and the pancreasis not affected.

This evidence points, I think, to the presence of an excessof fat in the fæces being the primary factor in determiningthe abnormal colour met with in pancreatic disease. Thatit is not the only one is for those who hold a contraryopinion to disprove by bringing forward satisfactoryexperimental and clinical evidence in support of theircontention. In some cases of disease of the pancreas Ihave found the fæces to yield from 80 to 90 per cent. oftheir dry weight as fat and it does not appear to me to

require a great exercise of the imagination to understandhow such a bulk of material, especially when in the

crystalline form, may induce a white stool both from itsown physical properties and from the diluting action iteffects in the pigments present.

I am, Sirs, yours faithfully,P. J. CAMMIDGE.

Beaumont-street, Portland-place, W., Dec. 23rd, 1905.

To the Editors of THE LANCET.SIRS,-Dr. W. Gordon can very readily satisfy himself thata stool such as (he) describes, pale cream-coloured whenpassed, contains as much unaltered rich brown pigment as anormal motion of the same size " by simply extracting thefat from the motion by means of ether. After treatment of

clay-coloured fæces by this method the motion will appearto be of the normal dark-brown colour whether it be theexcrement from a patient who is suffering from simpleobstruction of the pancreatic duct or of the bile duct. Thedemonstration of this dark-brown pigment in fasces of ob-structive jaundice after the removal of the fat clearly showsthat the colouring matter of the fæces-" stercobilin "-isnot, at least always, derived from the bile. The bile pigmentsare all absorbable and Professor Bunge is of opinion thatthe faecal pigment consists, sometimes at_least, of has matinand sulphide of iron.

In carrying out some observations I found that, if the

1952

:above-mentioned elherial solution of fat be kept at a tem-rerature of 370 C. until the ether hag evaporated, whilst the,greater portion of the fat was in a liquid state, yet someof it had solidifhd on the sides of the test-tube. This wouldseem to indicate that it is possible that some of the fatswhich have a lower melting point f-olidify in the fascesbefore defsecation takes place ; consequently it is not sur-

prising that Dr. C. J. Vlirland reported that the motionswere clay-coloured when passed. I would suggest that thecream or primrose colouring of some of the motion was dueto the fat plus undigested starch, for the latter is said toproduce a yellow colour in the fæces.

I am, Sirs, yours faithfully,Denmark-hill, S.E., De. 26th, 19 :5. FRANK A. WATKINS.

THE LEPTUS AUTUMNALIS.10 the Editors of THE LANCET.

SIRS,-From Dr. W. McLennan’s paper on this subjectin THE LANCET of Dec. 16h I suppose we may assume thatthe" harvester" or "harvest bng" is less well known illScotland than in England. These larvm are troublesomefrom the end of July to the beginning of September in

- chalky districts and places near the sea and become a seriouspest during hot, dry summers. I have never noticed thatmen are more affected than women but there is no doubtthat the larva burrow-i into the true skin. Those whowalk without protection are bitten below the knees,about the ankles and in the popliteal spaces if thefield grass has been at a’l long, while those who in-

cautiously lie on the ground are attacked between theshoulders. Sportsmen try to protect their legs with p3raffinand it might be worth while to anoint the legs with aninfusion of coarse tobacco or with citronella oil, which isvaluable for keping off midges and mosquitoes. But I havefound that the best and safest remedy after being bitten issome variation of the sulphur ointment to which so manygenerations have been indebted to get rid of scabies. Theointment allays the irritation which, in sen,itive people,becomes almost unbear Lble.

I am, Sirs, yours faithfully,,Cavendish-square, W., Dec 27th, 1905. F. M. SANDWITH.

THE HETEROGENETIC ORIGIN OFCANCER CELLS.

To the Editors of THE LANCET.

SIRS -In his important lecture on Cancer is a Pdra--sitic I)isease Mr. H. T. Butlin suggests, though he con- ,fesses to some hesitation in putting a speculation so

heterodox into words, that the malignant cell is a para- site arising by heterogenetic transformation of the tissuecells. Hauser’s conclusions in this re-pect are support-d ,by Professor J. B. Farmer, Mr. C. E. Walker, and Mr. ]J. E. S. Moore who say, " in this and in other casesthat we have examined we were irresistibly driven to theconclusion that the growth had not originated from a singlecell, or even from a few cells, but was being evolved bythe direct conversion of a great many elements definitelyfunctionating as mucous cells into those of a truly malignanttype." In an abstract of a paper by the same authors readbefore the R >yal Society on Dec. 7t,h, 1905, I read, "theyfind evidence, derived from all the young growths they haveexamined, of a t’ansmutation of functional somatic intocancerous cells." This, then, would appear to be a definiteprocess of heterogenesis, such as D.’. H. Charlton Bastian haslong been describing for different kin Is of independent livingunits, such as monads, amoebm, ciliated infusori, &.c.2The analogy is all the more complete seeing that we aretold by Dr. E. F. Bashford 3 that cancer cells have, like lowerorgamsms, an almost infinite capacity for self-multiplication.Thus he says : -The transference of cancer cells from one mouse to another, therefore,

affords them an opportunity for continuing to grow in a successionof animals. Jensen’s tumour is growing to-day with undirni..ished.enm g four year3 after the death of the mouse in wliiuh it arose.III our own experiments growth has proceeded in some 3000 micesuccessively, all of which are now dead, et the tumour cells themselvesare multiplying in other mice as activoly as ever Mid producingenormous masses of tissue.

1 Transactions of the Pathological Society, 1905, p. 379.2 See his " Studies in Heterogenesis "Williams and Norgate, 1903,

and his "Nature and Origin of Living Matter," Fisher Unwin, 1905.3 THE LANCET, Dec. 9th, 1905, p. 1673.

Is not this, then, a new race of organisms, of verydefinite and specific kind, which has arisen by heter’-gene’-is in the tissue cells of another organism ? Dr.Bashford’ti work leads him to say : "Sporadically tLedisease arises de novo in each organi,,m attacked and

appears to be a process to which the tissues of the mostdivergent organisms are liable in the old-age period oflife." The notion that cancer was "started in remote

geological ages" (just as orthodox biologists consider thatall lowly species were started) and that this primaevalcancer was the source from which others have descendedis one which he regards as "entirely irrational." Thuswe cannot, with Mr. Butlin, say "cancer is a parasiticdisease" unless we follow up such a statement with themost important qualifications. All parasitic diseases are

supposed to owe their origin to processes of infection or

contagion-to the entrance of a living thing into the bodyof the host affected. Here, however, we seem to haveevidence of the d.- novo origin of the cancer in each personattacked, and, according to Hauser, Farmer, Walker, andMoore, the multiple origin of its cells in the tissues affected,by the hitherto discredited process of het royenesis.

I am, Sirs, yours faithfully,C. W. SALEEBY, M.D.Edin.

Greville-place, N.W., Dec. 22nd, 1905.

PROPOSED ASSOCIATION OF HOLDERS OFASSISTANTS’ CERTIFICATE OF SOCIETY

OF APOTHECARIES.

I To the Editors of THE LANCET.

SIRS,-With the aid of some of my colleagues in the publicservice I am desirous of forming an association of holders ofthe asisstants’ certificate of the Society of Apothecaries ofLondon. I therefore beg to ask you to be good enough togive me your valuable assistance by allowing me to make anappeal in your columns to all who may be interested in thematter, especially to those holding appointments in the

public and hospital services. Several of us have felt for sometime past that our interests are greatly imperilled throughlack of organisation and we feel that the time is ripe to com-bine to enable us to protect the undoubted privileges andadvantages which we possess.

I may say that I have had a personal interview w;th Mr.A. M. Upton, clerk to the Society of Apothecaries, whoassured me of the sympathy and support ot that body. Healso promised a very substantial aid by offering, subject tothe approval of the master and wardens, to place a room atthe Society’s hall at our disposal in which to meet anddiscuss the several questions which are now agitating thewhole dispensing body. I therefore earnestly invite allthose who may be willing to join such an association toforward to me their names and addresses at their earliestconvenience. Should this appeal meet with a satisfactoryresponse I will at once take steps to call a meeting.

I am, Sirs, yours faithfully, --

ALBERT HOWELL.

Hackney Union Dispensary, Rosebery-place, Dalston, N.E.,Dec. 27th, 1905.

THE INFLUENCE OF POSTURE ON THENORMAL CARDIAC SOUNDS AND

DULNESS.To the Editors of THE LANCET.

in THE LANCET of Nov. l8th (p. 1473) must, in my opinion,have excited the special interest of radiographers. Perhapsthe following note may be of general interest. In measuringthe exact cardiac outlines by means of the x rays, using themethod known as "ortho-diagraphy" which enables the

taking of a parallel projection of the shadow and thereforeof the exact outlines of the object, the following is found.In the erect posture the shadow of the heart is narrower inwidth and at a lower level in the thorax; the longitudinalaxis of the organ assumes a position nearer to vertical. Inthe recumbent position the reverse takes place : the heart isseen higher up in the thorax, broader in width, and lyingmore horizontally. Analogies to these conditions exist in

respiration, inspiration bringing about analogous con.

ditions to the erect posture and expiration to the recumbentone. I am, Sirs, yours faithfully,Bad Nauheim, Dec. 20th, 1905. P. C. FRANZE, M.D.