468 T

pro-oestrus and the corpus luteum phase or the phas(of pseudopregnancy. In the normal human menstrualcycle ovulation occurs about the fourteenth day aftejthe beginning of the last menstrual period and anactive corpus luteum persists in the ovaries untilshortly before the onset of the menstrual discharge.The premenstrual phase of the human menstrual

cycle is therefore homologous with the experimentalpseudopregnancy of the rabbit and ferret and withthe pseudopregnancy phase of the sexual cycles ofsuch animals as the bitch and sow. In a recent

paper D. Macomber attempts to identify a separateclinical state of pseudopregnancy in the human female.Two cases are described in which patients passeddecidual tissue from the uterus after having been11 and 14 days overdue with their periods. Inboth cases chorionic villi could not be found in the

discharge. In one case the husband was proved tohave aspermia, in the other the husband’s fertilitywas shown to be extremely low. The interpretationplaced upon these cases is that they represent compar-able states to the pseudopregnancy of lower animals.This interpretation of the two cases demands severecriticism. In one of the cases the patient is statedto have had irregular menstrual periods, in the otherno details are given of the past menstrual history.It is not uncommon for women to have prolongedmenstrual cycles and Wilfred Shaw 9 has shown thatsuch cases can be attributed to irregular ovulation ;it is therefore possible that the two cases can beexplained along these lines. During the late pre-menstrual phase of the cycle the stroma cells of theendometrium hypertrophy to such a degree that theyresemble the decidual cells of early pregnancy;indeed it is often difficult to distinguish between thedecidual reaction of the late premenstrual phase andthat of early pregnancy. Similarly ectopic decidualcells can be demonstrated in the ovaries during thelate premenstrual phase of the cycle. Macomber’s

explanation of his cases is therefore unconvincing,for both the missed periods and the discharge ofdecidual tissue from the uterus can be accounted forwithout resorting to the hypothesis of a pseudo- Ipregnancy. Moreover, as has been indicated above,the premenstrual phase of the normal cycle is

homologous with the pseudopregnancy of loweranimals.

____ ,

THE PAGET TRADITION.

Sir James Paget had many contemporaries ofdistinction but none of them has so captured theimagination of a generation that never knew him.His " Memoirs and Letters " are read and re-read bymany who ordinarily have little taste for mattershistorical. When Prof. Grey Turner received theHenry J. Bigelow medal of the Massachusetts MedicalSociety at Boston last June it seemed quite naturalto him and to his hearers that his addressl° should beabout the " Paget tradition." There were specialreasons, too, for the choice of subject. Paget was aman after Bigelow’s own heart ; in 1882 he waselected an honorary member of the society ; and in

company with Dr. Harvey Cushing, another memberof the society, the lecturer was one of the six perpetualstudents of Paget’s old hospital. Most of my teachers,Prof. Turner remarked, had come under the spell ofPaget, with them his example was a tradition, fromthem the torch was thrown, and I felt I was onlyfulfilling a sacred trust to hand it on. Foremost inthe Paget tradition he put his example as a worker,

8 Jour. Amer. Med. Assoc., Jan. 23rd, p. 304.9 Jour. Obst. and Gyn. Brit. Emp., 1929, xxxvi., 1.

10 Published in New England Journal of Medicine, 1931, ccv.,622-9.

ie for like John Hunter his friends always found him:d employed, and it has been said that he so lovedtr work that he estimated the worth of his acquaintances.n by their output of it. In public duty he was punc-il tilious to a fault and careful of the time of others,

as he would expect them to be of his own. As amedical writer he had no rival, using pure and perfectEnglish without effort. In an age of orators he was

h acknowledged one of the best speakers of his time.f Many of his published lectures rank among the classics.t of medical literature and are read to-day for theire grace and charm, as well as for their wisdom. He. made great contributions to clinical surgery, and his.1 original papers on the diseases of the breast and ofi the bones associated with his name still remaini complete and perfect descriptions. He might, con-3 eluded Prof. Turner, have been a success in any) honourable walk of life, but he had chosen the-

profession of medicine, he loved his avocation, andi had the highest sense of the importance and dignity- of his calling. And in simple and reverent language,. enhanced by apt quotations from Paget’s writings,

Prof. Turner drew a picture of the man as he livesin our memories, with his tenderness and austerity,

. the light heart of his seriousness, the gentleness of

. his firmness. ____

VOTING AT EPSOM COLLEGE.

: WE are asked to give publicity to the following: statement : "Although the Governors of Epsom

College unanimously decided at an extraordinary: general meeting in June, 1931, to take the necessary

steps to abolish the voting system, no change canbe made until the scheme has received Parliamentaryconsent. The earliest date at which Parliament cansanction the proposed legislative changes, coupledwith the statutory requirements and other unavoid-able preliminaries of an annual election by votes ofthe governors, makes the cancellation of this year’svoting in June impracticable, and therefore it willbe necessary to adhere to the system of voting forthe year 1932. Voting papers will be forwarded to.all governors in due course."

BLOOD-GROUPS AND PATERNITY.

I IN Dublin lately the blood-group test of relationship.was accepted as evidence, for the first time, it is said,in any court in the British Isles. A district justicehad made a maintenance order against an elderly manon the complaint of a young woman on behalf of her-illegitimate child. The defendant appealed to thecircuit court, and evidence was produced to showby blood-gro’uping that he could not be the father-of the child. The test was carried out in the presenceof the solicitors of the two parties by Dr. G. C.Dockeray, Dr. J. H. Stephens, and Dr. J. McGrath.Other evidence was also produced, and the judge,reversed the decision of the district justice. Thetest is widely used in Germany, Austria, and

Scandinavia, but, as already stated, we do not knowof its application in this country. It may be recalled’that the precipitin or immunological test for humanblood was accepted in criminal cases in Ireland forsome years before it appeared in the courts of GreatBritain. It was introduced to Ireland by the late-Prof. E. J. McWeeney.

WE regret to announce the death on Wednesday,Feb. 24th, of Sir Frederick Andrewes, F.R.S., Emeritusprofessor of pathology in the University of London.

1 See Schiff, F., THE LANCET, 1929, ii., 921.