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favour of further biological processes which will producethe stiff linen without starch or borax.

THE TROPICAL DISEASES RESEARCH FUND.

IN no department of medicine have such signal advances Ibeen achieved of late years as in that of tropical medicine.Considering the comparatively small pecuniary encourage-ment which it has in the past received from the State forthe purpose of scientific research, it is surprising to learnhow much has been already accomplished. There are some

signs that the Imperial and Colonial Governments are nowmore favourably disposed towards the efforts which are

being made by the medical profession to prevent the ravagesof tropical disease and to render some of our colonies moresafely habitable. These remarks are prompted by the

perusal of the recently issued annual report for 1909 of theAdvisory Committee for the Tropical Diseases Research Fund.This committee was constituted in 1904, at which time the

Imperial Government and various other bodies made them-selves responsible for certain sums as annual contributionsto the Research Fund for a period of five years. As

that period terminated in 1909 the committee had to

face the possibility of some at least of the contribu-tors discontinuing their subscriptions. Fortunately, all

the previous subscribers have agreed to renew their

contributions for another period of five years, and thereis also some prospect of further payments being receivedtowards the fund from certain of the smaller British colonieswhich have not hitherto contributed. The total amount of

revenue at the disposal of the Advisory Committee in .1909was .&3470, of which .81000 were contributed by the ImperialGovernment, E500 by the Government of India, E200 by theRhodes trustees, and £1770 by various colonial Governments.The expenditure during the year amounted to £3333, ofwhich .e1383 were voted to the London School of TropicalMedicine, .e1000 to the Liverpool School of TropicalMedicine, £750 to the University of London, and £200 to theUniversity of Cambridge. Most of the money granted tothese institutions was devoted to payment of the salaries ofspecial professors or lecturers on tropical medicine,protozoology, parasitology, and economic entomology,also towards defraying part of the expenses of labora-

tories in which research work is carried out. It is

obvious that much good is likely to follow this ex-

penditure of money for special instruction in the various

branches of tropical medicine to medical men about to

proceed to our colonies and dependencies. In our opinionthis wise expenditure is likely to bear good fruit in futureyears. No grant was made from the fund in 1909 towardsthe costs of the sleeping sickness investigations in Ugandafor the reason that money for this purpose was forthcomingfrom other sources. Reference is made by the AdvisoryCommittee to the work of the Sleeping Sickness Bureau,which in its opinion has amply fulfilled the hopes whichwere expressed in the report for 1908 concerning it. The

Australian Institute of Tropical Medicine, towards the

establishment of which the committee in 1908 contributed

£400, has now been definitely constituted and a directorappointed. Adequate contributions for its future mainten-ance will be obtained in Australia; the Universities of

Sydney and Melbourne are also interested in the matter. A

small bacteriological laboratory under the charge of a skilledbacteriologist has been established in the island of St.

Lucia, and the Advisory Committee hopes to include in itsreport next year some record of the work done in the newlaboratory. The committee was consulted by the Secretaryof State for the Colonies as to a proposal to enlarge the

Medical Research Institute for West Africa at Lagos, andplans were ultimately passed for extension of the building at

an estimated cost of £2350. The committee has been greatlyinterested during 1909 in the question of malaria and itsprevention. Appended to its report is a copy of a circular

despatch which the Colonial Secretary addressed in March oflast year to all the tropical colonies in which malaria is pre-valent. Enclosed with the despatch was a reprint of a letterto the editor of the Times, by Professor W. Osler of OxfordUniversity, on the subject of " Malaria in Italy : a Lesson inPractical Hygiene." Replies were invited from the variouscolonies as to the extent to which preventive measures againstmalaria had been carried out. The answers received showthat on the whole a good deal had been done generally tocombat the disease. Special attention was directed to thereply from Ceylon, containing as it did full and

excellent statistics on the subject. Mention is also

made that in Mauritius much had been done at a

comparatively small outlay. In the colonies as elsewhere

progress is hindered for want of funds and also by theattitude of many native races respecting measures for theirown and others’ benefit. An instance of this may be quotedfrom the report of Dr. D. M. Macrae, medical officer of theBechuanaland Protectorate, who says that little can be doneuntil the natives are educated up to some civilised ideas ofdisease and its prevention. At present they are largely inthe hands of wizards and impostors, and notwithstanding acentury of zealous missionary work among them and 25 yearsof administrative control the Bechuanas remain exactly wherethey were. Even the great medical missionary David Living-stone, who spent 13 years teaching them, was inclined to regardthem as a "lost race." Hundreds of children and adults, saysDr. Macrae, have perished among the native population whoselives could certainly have been saved by the administrationof quinine, yet though this drug is always within reach thenatives somehow prefer to die rather than take any " whitemedicine." " The committee append reports on the excellentwork done at the Schools of Tropical Medicine in Londonand Liverpool ; the report of the professor of protozoology atthe University of London; an account of the work performedby the research student in entomology at the University ofCambridge and in the Quick Laboratory ; a report on workdone in the experimental treatment of trypanosomiasis underthe supervision of a subcommittee of the Royal Society ; andreports on the work at the several colonial laboratories,which have been sent in accordance with requests made bythe Secretary of State for the Colonies. In these appendicesare given the full details of the investigations carried out,and of the papers published in connexion with the grantsmade by, and under the supervision of, the committee.

CEREBRAL ABSCESS AND BRONCHIECTASIS.

IN the Revieiv of Neurology and Psychiatry for February acase is reported by Dr. Edwin Bramwell of Edinburgh whichpresents unusual and interesting features. A man, aged53 years, who had suffered from bronchiectasis for morethan two years, complained one day of headache and giddi-ness. On the following day he had an epileptic fit, precededby a visual aura, which was likened by the patient to thesensation one might expect if a bright light from a mirrorwere flashed into the eyes from time to time. A second iden-tical fit followed two days after the first. Examination revealeda right homonymous hemianopsia for white, complete in extentbut only relative in degree. Further, the patient was unableto recognise a red object as red to the right of the middle line.There was no visual aphasia of any sort, nor were there anyother focal symptoms. The optic discs were normal. The

diagnosis of abscess in the left occipital lobe was made, but, increase in the severity of the pulmonary symptoms made, operation inadvisable. Death ensued six weeks after thei first cerebral symptoms had appeared. At the necropsy a

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localised empyema. In addition to certain other intracranial

lesions which need not be specified, an abscess of about the sizeof a walnut was discovered situated in the second and third

left temporal convolutions, immediately anterior to the lateraloccipital sulcus. Microscopical examination showed that

the inflammation round the abscess had extended into the

optic radiations. The interest of the case lies in the asso-

ciation of cerebral abscess with pulmonary disease and in therarity of hemiachromatopsia as a symptom. The infrequencyof the former of these is amply evidenced by the con-

clusions of the late Dr. G. 1. Schorstein, who stated 1 that of3700 necropsies at the Brompton Hospital during the years1882 to 1904 inclusive, and of over 10,000 post-mortem exa-minations at the London Hospital from 1894 to 1904, therewere only 19 cases of cerebral abscess associated with pul-monary disease. In his opinion, based on a consideration offurther statistical data, bronchiectasis is the most frequentpulmonary antecedent of brain abscess. In the 19 cases the

average duration of life from the appearance of the first

cerebral symptoms was only ten days. Visual auræ in asso-

ciation with organic brain disease are indicative of corticalchanges involving the occipito-parietal region, a subjectto which attention has recently been directed by Sir

William Gowers.2 The existence of a hemiachroma-

topsia, coupled with a less pronounced hemianopicdefect for white, is a phenomenon the exact signifi-cance of which is not yet clearly established, thoughit has been observed with some frequency. While it is

possibly the case that the colour-blindness in the half fieldis due to the reduction in the light sense, hemiachromatopsiamay occur by itself, sometimes when the optic tract or

chiasma has been pressed on. Swanzy supports the viewthat a relative cortical hemianopia is a manifestation of a

lesion of less intensity than that which causes cortical

hemianopia, and in the present instance this interpretationof the symptom is probably correct.

ELECTROLYTIC DISINFECTANT.

SEVERAL sanitary authorities were invited on March 3rdto inspect the latest development of the plant installed

at Poplar some years ago for the production of electro-

lytic disinfectant on a scale sufficient to supply the

borough with fluid for ordinary disinfectant purposes. Con-

siderable advances have been made since the plant was firstlaid down, and the present satisfactory stability of the

electrolysing machine and of the fluid produced is due to thezeal and energy of the medical officer of health of the borough,Mr. F. W. Alexander. There used to be trouble with the

original tanks adopted and the electrolysers, but now thesehave been replaced by porcelain containers which have

overcome some peculiarly trying difficulties. There is an

ingenious arrangement also by which the electrolysed fluidis stirred and kept uniform by electric motor paddles, and animprovement has been gained in the preparation of hydrateof magnesium, the addition of which serves to keep theelectrolysed fluid perfectly stable. In Poplar the supply ofcurrent is on the three-wire system, so that one generator.can be attached to the positive and the other to the negativepole, the neutral points being on the top and the "live’’ points below, and consequently "short circuiting" " is avoided.The fluid, the disinfectant action of which depends upon thepresence of active hypochlorites, is remarkably stable and isgiving great satisfaction in sanitary practice. It is furtheran insecticide as well as a germicide and deodorant. One

1 Abscess of the Brain in Association with Pulmonary Disease,THE LANCET, Sept. 18th, 1909, p. 843.2 Special Sense Discharges from Organic Disease, THE LANCET,

Dec. 18th, 1909, p. 1806.

of the latest applications of the electrolysed fluid has beento clean the water in the swimming baths. The cost of

production is comparatively small, and the improved plantworks continuously without, it is eaid, giving any trouble.

HENOCH’S PURPURA ASSOCIATED WITHINTUSSUSCEPTION.

ONE of the most striking forms of purpura is that to

which the name of Henoch has been attached. While it

cannot be said that our knowledge of the etiology of the

several varieties of purpura is by any means complete, theevidence at present available appears to point to the presencein the blood-stream of some toxin which, by damaging thecapillary walls/leads to a localised effusion of blood. The

source of these toxins is, however, not always easily deter-minable, but when we find that one striking variety of

purpura is associated with marked intestinal symptoms, andoften with definite intestinal lesions, we are justified in

thinking that the bowel is, in these cases at least, the

source from which the toxin has been derived. Thereis perhaps at the present time a certain tendency to

designate as Henoch’s purpura all cases of purpura mani-festing intestinal symptoms, and it is not easy to draw

a well-defined boundary-line so as to mark off typical casesof Henoch’s purpura from other varieties of the disease. It

has been shown that in a certain number of the reportedcases of Henoch’s purpura an intussusception has been foundto be present and demonstrated by operation. In the presentissue of THE LANCET appears a record of an important casewhich was under the care of Dr. F. W. Collinson of Preston,which is remarkable both for the association of purpura withan intussusception and also for the recovery which followedenteric resection. The patient was a child, 4 years old, whodeveloped two attacks of purpura on the legs at an

interval of a day or two, on each occasion accompaniedby abdominal pain. During the second attack the painin the abdomen was so severe that the child was takento. the Preston Infirmary, where Dr. Collinson operatedand found an irreducible enteric intussusception. This

was excised, and by means of two Paul’s tubes the

bowel both above and below the resection was fullydrained. Four days after the first operation the abdominalwound was reopened and end-to-end anastomosis was

performed. Complete and rapid recovery followed, andwe must congratulate Dr. Collinson on his success. The

treatment of an irreducible intussusception in a child is

extremely difficult. Complete resection and immediateanastomosis of the ends are nearly always followed by death,when the operation is performed on a small child ; moreover,immediate anastomosis does not usually lead to rapid empty-ing of the large amount of accumulated fsecal matter, andany attempt to empty the distended bowel before completingthe anastomosis could only serve by prolonging the operationto diminish the chances of the child recovering. We con-sider that the expedient adopted by Dr. Collinson was fullyindicated in the circumstances, and in a matter like thiseach surgeon is justified in adopting that procedurewhich in his own opinion is best calculated to leadto the recovery of the patient. One risk of delayingthe union of the bowel is the fear that wasting mayresult from the diminution of the absorbent area ofthe small intestine. This danger was obviated in thecase we have quoted by the early performance of the

operation of intestinal anastomosis. It is to be hoped thatall cases in which intussusception is associated with purpuriceruption will be placed on record. Further, if a case of

acute purpura should manifest severe intestinal symptomsthe possibility of the presence of intussusception should beborne in mind, though it must not be forgotten that in cases