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bleeding from her mouth and the stools were blood-stained. IAt the end of January her scalp suddenly became swollen, asdid also her eyelids. In this condition she was taken tothe surgical section of a hospital, where she was kept underobservation until Feb. 12th. The diagnosis was hsematoma.capitis. The swelling diminished visibly after the applica-tion of wet compresses, so that at the time of her dischargefrom th3 hospital no tumour could be felt. On Feb. 2&thshe was again taken to the hospital. She then lookeddelicate and was very ill developed, but there were nocharacteristic signs of rachitis. The shafts of the left

thigh-bone and the left tibia were enlarged and on palpa-tion hard, irregular swellings could be felt. Over both

parietal regions of the skull there was a swelling, throughwhich, on deep pressure, the sparsely covered bone could befelt. Both the upper and the lower eyelids were generallyof a bluish-red colour. From these symptoms the diagnosisof Barlow’s disease was established. The following sym-ptoms were especially characteristic : rapid development,pains in the limbs, subperiosteal hemorrhages over the longbones and the bones of the skull, and haemorrhages from themouth and the bowel.

The Ears of School C7til(Zren.At a recent meeting of the medical society of a consider-

able country town in Hungary a school medical officerpresented an interesting report on the examination of theears of 1000 school children. The investigation was under-taken with the objects of ascertaining the amount of eardisease in children of the poorest class, and if necessary ofdrawing attention to the subject. For the purpose of thisinspection ears were considered to be normal when themembranes presented the usual appearance and the whispered.voice could be heard at a distance of from eight to 12 metres.Inability to pass this test with one or both ears was presentin 634 out of 1000 children. Foreign bodes were found inthe ears of 16 children, of whom 13 were girls. Of 107cases of deafness there were adenoids in 91 ; 270 of thetotal number of children had a discharge from one or bothears and in 74 cases the discharge was suppurative. Thenumber who had previously suffered from middle ear dis-charge was 219 and of these 183 had adenoids, and perfora-tion existed in 49, while adenoids occurred in 416 children,of whom 387 presented some aural troubles.

A New VTet7od of Percussion.It is well known that among men similarly trained some

are more expert than others in the use of percussion as Ia means of diagnosis. This shows that even in such asimple matter there is room for the exercise of skill.A common error in employing percussion is for the band tobe laid flat upon the surface to be examined ; this has theeffect of diminishing the resonance, and the proper methodis to place only the extremity of the " anvil finger " on thesurface to be examined. An improvement has been suggestedby Dr. Janos Plesch, a Budapest practitioner. Instead of

placing the hand on the surface in the manner just describedhe flexes the middle finger of the right hand at a right angleat the joint between the first and second phalanges, only thepulp of the finger being brought into contact with thesurface, by forcibly extending the joint between the secondand third phalanges. Percussion is then practised on thelower epiphysis of the first phalanx. This it is claimed givesa clearer resonance and has the advantage of enabling theobserver to limit his investigation to a smaller area of thesurface. In abdominal percussion this method is less dis-turbing to the patient than when the flat of the hand isapplied to the surface.May 13th.

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NOTES FROM INDIA.(FROM OUR SPECIAL CORRESPONDENT.)

The Appallir/g Nortality from Plagtte.BESIDES the appalling mortality from plague there is

little of medical interest to record. For the week endingApril 13th 87,561 cases with 75,472 deaths were reported.This is an increase of some 14,000 cases and 12,000 deathsover the previous week. The Punjab heads the list with45,296 cases and 39,084 deaths ; then following are : United.Provinces, 27,236 cases and 23,948 deaths ; Bengal, 7915<cases and 7092 deaths ; Bombay, 4092 cases and 2981-deaths.; Central Provinces, 1218 deaths; and Rajputana,

348 deaths. , Besides these weekly returns it is of interestto calculate the recorded mortality from the present epidemic’of plague since its commencement. From October, 1896, toDec. 31st, 1906, the total deaths reported have been 4,411,242,and during the first three months of the present year noless than 495,000 deaths have been known to occur. The

mortality has fluctuated greatly :-In 1901 there were reported 274,0C0 deaths.1902 " 57,000 "

1903 " 851,000 "

1904 ., 1,022,000 "

,; 1905 " " 951,000 "

" 1906" " 332,000 "

With the intensely severe recrudescence which has occurredduring the present year, especially in the north-westportion of India, even the highest of these figuresmay be exceeded. It will be noticed that the BombayPresidency now takes a much better place than formerlyand it would almost seem as if - the disease were

dying out gradually in that province. On the otherband, it must not be supposed that the official figuresare accurate. The returns of plague in many places donot account for the whole of the increased mortality, andif that can be clearly shown for places where the registra-tion of deaths is fairly correct it is reasonable to assume thatplague carries off many more victims than the above figuresshow. In addition to plague there has been an increasedmortality from all other causes. The death-rate for the wholeof India has increased steadily during the past five years-viz., from 29 per 1000 in 1901 to 36 per 1000 in 1905. Whenit is found, however, that Madras recorded the low rate of21’ 4 during 1905 one looks with suspicion upon the returns,notwithstanding that this province is practically free fromplague. Amidst these unsatisfactory returns Calcutta takesa comparatively enviable position. The plague returns fromthis city, which has now been infected for over nine years,are very small compared with other places. It is urue thatover 50,000 people have died in the city, but this is a smallnumber in all the circumstances. Last year there were

only 2600 deaths and the recrudescence this year, thoughsomewhat more severe than that of 1906, is less than halfthe severity of that of 1905. It has been noticed during thepresent outbreak that the average duration of each fatal caseis about five days.

Tile Plag1w Department in Cczleutta.The question of the amalgamation of the plague depart-

ment in Calcutta with that of the health department ofthe corporation is again up for discussion. Up to the

present the plague department has been under the

Bengal Government and has been worked smoothlyand satisfactorily. Motives of economy occasionallysway the corporation and it is supposed that by takingover the subordinate staff of the plague department allthe previous work of the two departments can be accom-plished by the health department. The opportunity is beingtaken also of improving the status of the district healthofficers and of introducing new men. In the long run verylittle expense will be saved but if the new health officersand the new district officers are suitable men the transferenceof the plague department may be successful. It is the

general opinion that the change if made with the existingstaff would be disastrous.April 26th.

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Obituary.SAMUEL LODGE, L.R.C.P. EDIN., M.R.C.S. EJm.

Mr. Samuel Lodge of Bradford, Yorkshire, died at hisresidence in that city on May 9th at the age of 83 years,during 25 of which he had held the position of policesurgeon. He had been for a much longer time one of thepoor-law medical officers and had been in receipt of a retiringallowance in that capacity for several years before his death.Mr. Lodge was the oldest medical practitioner in the cityand with his departure the chief representative of whatmay be called the old school medical practitioner hasdisappeared. Sprung from substantial yeomen parents inWitney, Oxfordshire, and the eldest of a family of 11,all of whom predeceased him, he obtained the beginningof his medical education under the old system of apprentice-ship as an articled pupil of Dr. W. Field. Before thattime Mr. Lodge had been a schoolmaster, but the teaching