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occurred in these reactions. I have employed the agglutina-tion reaction with various micro-organisms in several hundredcases both in man and animals, but I have only met withsuch a condition in the cases already referred to and havenot seen it recorded in the literature.

I am. Sirs. yours faithfullv.

July 6th, 1904.LEONARD S. DUDGEON,

Superintendent of the Clinical Laboratory,St. Thomas’s Hospital.

PROPOSED TESTIMONIAL TO DR. EYRE.To the Editors of THE LANCET.

SIRS,-In August, 1903, Dr. J. Eyre was investigating somepoints in the biology of the micro-organism of Malta fever inthe bacteriological laboratory at Guy’s Hospital when heaccidentally inoculated himself with this micro-organism. Afew days afterwards he developed an attack of Malta fever,causing incapacity for work for six weeks. As he was

insured in a company against accidents and several diseases,including septicaemia, he made a claim under his policy. Ashe had been given to understand by the agent who inducedhim to take out the policy that it included accidentalbacterial infections, contracted in his laboratory, he wasastonished to find his claim repudiated. Acting on theadvice of counsel Dr. Eyre insisted on his claim, and thedispute, owing to a clause of the policy, had to be decided,not publicly in court but by private arbitration. Thedecision of the arbitrator was in favour of the company.This decision is, I think, one of great importance to membersof the medical profession who hold accident policies. Dr.Eyre’s costs for the arbitration amount to some £140 and itis thought by many of his friends, amongst whom I count

myself, to be a fitting opportunity to present him with=atestimonial in order to assist him in meeting these costs.Cheques may be sent addressed to me at Guy’s Hospital.

I am, Sirs, yours faithfully.J. H. BRYANT.

Mansfield-street, Portland-place, W., July 7th, 1904*** Dr. Bryant incloses a list of subscribers of sums vary-

ing between Z3 3s. and 10s. 6d., showing that the medicalprofession are recognising’ the hardship which Dr. Eyre hasundergone. The circumstances will be found in detail inTHE LANCET of June 25th, p. 1811. We shall publish thelist of subscribers next week.-ED. L.

ACCIDENTAL VACCINIA OF THE NASALCAVITY.

To the Fditors of THE LANCET.SIRS,-Mr. W. H. Bowen’s account of a case of the

above in THE LANCET of July 2nd, p. 20, exactly describes acase I had some years ago, except that in my case I founda well-marked vesicle inside the ala nasi. Shortly after-wards I had a similar case in which the vesicle appeared onthe lower lip. Both were women and no trouble ensued.

I am. Sirs. vours faithfully.Stonebroom, Alfreton, July 5th, 1904. R. M. H. WALFORD.

IN THE MATTER OF PATENTMEDICINES.

To the Editors of THE LANCET.SIRS,-I should be greatly obliged if you could give an

authoritative answer to the following questions. May amedical man if he knows the composition of any patentedproprietary article prescribe its exact formula so as to haveit made up as an ordinary prescription or is a hospitaldispenser legally entitled to make up any proprietary articleof which he can discover the formula or composition ? Ifthe general answer to these two is in the affirmative wouldthe answer also be in the affirmative if the article in questioncould only be made by special patented process ?

I am, Sirs, yours faithfully,July 4th, 1904. INQUIRER. VACCINATION GRANTS.-Mr. J. D. Staple, public

vaccinator of the Ashley district of the Bristol union, hasbeen awarded the Local Government Board grant forsuccessful vaccination for the fourth consecutive year.-Dr. A. W. Woodman Dowding has obtained the grant for successful vaccinations in the St. Newlyn East district ofCornwall.

THE INTERNATIONAL HEALTH OFFICE.PROGRESS AND MODIFICATION OF THE PROJECT.

(BY OUR SPECIAL SANITARY COMMISSIONER.)

Paris, July 4th.AT the last official International Sanitary Conference which

met off and on in Paris from Oct. 10th to Dec. 3rd, 1903, aresolution was adopted in favour of constituting a permanentInternational Sanitary Office. This proposal, as related atthe time, was not unanimously approved and the representa-tives of the British Government notably made some reserva.tions. Since then there has been time for reflection, for afurther exchange of views, and for a better understandingof the project. The idea has been ripening and withinthe last few days a distinct step forward has been

taken. On the other hand, there has been no unduehaste. For more than half a century various govern-ments of Europe have held international conferences onsanitary matters. There have been in all 11 such official

gatherings and it cannot be said that they have overburdenedthe world with proposals, schemes, and projects of legisla-tion. The first conference met at Paris in 1851 and 12nations were represented ; the last conference met in 1903,also at Paris, but there were no less than 24 nations andgovernments represented. The earlier conferences were

more like scientific gatherings. The governments wererepresented by diplomatists who held a sort of watchingbrief while men of science discussed. Motions were carriedand pious wishes were expressed. This sort of platonicprocedure prevailed at the conferences held in 1851at Paris, in 1859 at Paris, in 1866 at Constantinople,in 1874 at Vienna, in 1881 at Washington, and in 1885 atRome. At Vienna in 1892 a considerable change tookplace. Europe was then menaced with the cholera and nowthe representations of the various governments began to takeaction. Conventions were signed and the conference metagain the next year at Dresden and again, the year following(1894) at Paris. Later, in 1897, the tenth InternationalOfficial Conference was held at Venice and this time forthe purpose of drawing up an international convention inregard to the precautions which were to be taken to preventthe spread of plague. Thus out of 11 conferences onlythe last five have resulted in the signing of inter-national treaties and agreements. It may be said that,while the first conferences met to discuss theories and tostudy sanitary problems, this task has of late years beenrelegated entirely to the international medical and sanitarycongresses. The official conferences, therefore, now meet,not to discuss theories, but to legislate ; the debates relateto the regulations that it may be thought wise and possibleto impose and to the international conventions that are neces-sary for such purpose. So far the object of such under-standing was to prevent the spread of disease from onenation to another while at the same time striving to reducethe inconvenience of such precautions, notably of quaran-tines, to the lowest possible degree.These various agreements were grouped together and

codified at the conference held in Paris last year. The newconvention thus drawn up, which codifies and ratifies all theprevious agreements, bears the date of Dec. 3rd, 1903, and isdivided into six chapters with 184 clauses or articles. Butthis international convention of 1903 not only codifies, it alsomodifies the measures to be taken so as to bring them inharmony with the more recent discoveries of science. Forinstance, it is now believed that the period of incubationfor plague is only five days, so that the period of observation)f the passengers coming from a ship where there has beencases of plague on board has been reduced from ten to fivelays. Also it is now no longer necessary in such a case toretain the passengers in quarantine for these five days : they)an be allowed to proceed if they are going to a place wherethere is a competent sanitary administration which can keepthem under efficient observation. Then, again, accordingto the Venice Convention, every government had to notifyto all the governments which had signed the conven-tion whenever a case of plague occurred. But if this- casecame from abroad and the disease did not spread to in-habitants of the country then it was not necessary to takerny measures against the district in question. In practicemany authorities failed to notify the first case and only