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developments. The specialties appear to be particu-larly well served. The professor of psychiatry (Dr.R. W. Dawson) and his assistants now carry out theirwork as part of the daily routine of the hospital.The attendance at the venereal diseases clinic, firstestablished in 1917, has latterly become so great thatit has been found necessary to limit the number ofpatients on any particular day. The department ofurology was developed as a result of the generosity ofDr. Gordon Craig, who contributed .820,000 towardsthe establishment of an urological department at theuniversity, while the committee controlling the140,000 collected for a cancer research institute inconnexion with the University of Sydney and thesupply of radium made available by the CommonwealthGovernment has provided facilities for colloidal leadtreatment at the hospital and has also installed a deepX ray therapy plant. Every cancer patient is reviewedby a conference of experts, and a decision is madewhether operative surgery, radium, or deep X raytherapy or lead will be utilised. Since the establish-ment of the clinic there has been a marked influx ofpatients from New South Wales and the adjoiningStates. The students should also benefit from theestablishment of a social service department, sincethey are apt to neglect during their hospital yearsthose problems of environment and economic condi-tion, the adjustment of which forms such a large partof their duties in private practice.

MAN AS A CARNIVORE.

IT is widely believed by medical men that the consumption of large quantities of meat causes a strainon the cardiovascular and excretory systems whichmay be at least partly responsible for the productionof arterio-sclerosis and nephritis. Moreover, a sectionof the profession is at the present time engaged inpreaching the doctrine that meat is a dangerous formof food for human consumption on account of the riskof auto-intoxication following the absorption of

putrefactive products formed from it in the largeintestine. Neither of these beliefs or theories rests onany very solid foundation of established evidence,though it is possible that they are of real practicalvalue to the clinician as a guiding principle. Anydirect evidence that promises to shed even a gleam oflight on the vexed problem of the harmful or beneficialeffects of meat diets on mankind will always bewelcome. An experiment has been recently carriedout in the United States to test, as thoroughly asmodern clinical and laboratory investigations willallow it to be done, the effect on man of an exclusivemeat diet lasting for one year. The subjects of theexperiment were the arctic explorer Stefansson (whohad previously lived in the arctic regions for sevenyears on a similar diet) and his colleague Andersen.The exhaustive metabolic, bacteriological, andchemical investigations carried out during the yearhave not yet been reported in full, but a brief sum-mary of some of the main results has been publishedby Dr. C. W. Lieb,l who took part in the work. Nodecrease in physical or mental vigour was observedeither subjectively or objectively in either of the men,although sedentary lives were led by both. Theyendured the hot weather of a New York summer justas well as in former years, and at the end of the testperiod had a very good colour. Andersen noted thathis hair stopped falling out shortly after the meat dietwas started. Stefansson maintained a blood pressureof 105 systolic and 70 diastolic throughout the wholeperiod, in spite of the fact that he had lived on anexclusive meat diet for seven years before the presenttest was begun. Andersen’s blood pressure was 140systolic and 80 diastolic at the beginning of the test,and 120 systolic and 80 diastolic at the end of theyear. The average protein intake was not reallyexcessive, amounting to 100 to 140 grammes a day.The bulk of the diet in each case was composed of fat.Most of the meat eaten consisted of boiled or stewed

1 Jour. Amer. Med. Assoc., July 6th, p. 20.

cold storage meat. Stefansson occasionally took eggswhen he could not get meat; Andersen took no foodbut meat the whole time. In spite of the fact thatthis diet contained but very small amounts of calcium,no evidence was obtained by radiography that therehad been any absorption of calcium from the longbones. At no time were there any signs in eithersubject of disturbance of the renal functions, andchemical analyses of the blood revealed no significantalterations apart from a temporary lipsemia after verylarge amounts of fat had been eaten. In the case ofAndersen, a sugar-tolerance test carried out at theend of the meat-eating period produced a typicaldiabetic curve. It was noted that the stools of bothsubjects remained inoffensive, very few putrefactivespore-bearing organisms ever being found. Theintestinal flora were in both cases simplified as regardsboth types and total numbers of bacteria. For thefirst few days of the test period Stefansson was givennothing but lean meat, and he predicted that he wouldsoon feel ill. After two days he developed nausea anddiarrhoea with lethargy and general weakness. Theaddition to his diet of suitable quantities of fat wasfollowed in two days by complete recovery, and forthe remainder of the year no further trouble of thekind occurred. At the end of his test period Andersenhad an attack of lobar pneumonia. He made anuninterrupted recovery, and it was noticed that heshowed few of the toxic symptoms of other patientsin the hospital with the same type II. pneumonia.While the results of these observations are notintended to be regarded as a piece of propaganda infavour of the consumption of large quantities ofbutcher’s meat, they are of very great interest as ademonstration of the apparent harmlessness of a meatdiet to healthy white men living in a temperateclimate.

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A CASE OF GENERALISED BLASTOMYCOSIS.

GENERALISED blastomycosis is not common, anda case from the clinic of Prof. Kerl, in Vienna, recentlydemonstrated by Dr. E. Urbach, presents unusualfeatures. A patient, aged 30 years, who has beenunder observation at the clinic for ten months, gavethe history that two years ago a swelling appearedon his gums, with ulcers, and that this was followed,after six months, by swellings on the thigh, theabdomen, the neck, and face. Surgical treatment wastried, as well as X rays applied to the gums. Whenthe patient was seen first by Dr. Urbach, a thin,purulent secretion was oozing from the lanced tumourson the neck, thigh, and abdomen. Syphilis wasexcluded, and all examinations of the blood, sputum,and cerebro-spinal fluid gave negative results. A

mycotic disease was suspected, and microscopicexamination showed the presence of a yeast in pureculture in all secretions ; the yeast was found also insections of the swellings included in giant cells. Thepatient gave a distinct allergic reaction on intra-cutaneous injection of blastomycin, and the organismwas lethal to experimental animals (mice and rats).The patient suffered from chronic bronchitis. Yeastfungi were found in the sputum and cultivated, bothfrom the urine and from the cerebro-spinal fluid.Treatment of the generalised infection with auto-genous vaccine, with X rays, with intravenousinjections of iodine, in large doses, had some tem-porary effect, but the patient soon relapsed. Recentlyhe has had a high temperature, with rapid extensionof the disease in the mucous membranes. The meningesare now affected, and the prognosis is regarded asbad. The newly instituted laboratory for mycoticdiseases, attached to the Vienna dermatologicalclinic, has lately been able to establish the mycoticorigin of many rare affections of the skin, and ofcertain cases of chronic bronchitis and bronchiectasis.It is possible that the yeasts are responsible when44 oidium albicans " is frequent in the mouth, theoesophagus can easily be affected. Hitherto, blasto-mycosis has not often been reported in Austria, butnow we must be on the lookout for it.