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-this report is that many proprietary infant foodsare not in fact suitable for the feeding of infantsunder 7 or 8 months of age, and that they may causeinjury: firstly, from the presence of starch in

greater or less amount; secondly, from the presenceof excess of carbohydrates-starch or sugar-withrelation to the protein and fats; and thirdly, froma deficiency in fat. Dr. Coutts concludes thatthere is evidence to show that the extravagant state-ments of some manufacturers and dealers withregard to the value of the infants’ foods they selldo in fact mislead many poor people to entertainan exaggerated belief in the virtues of these foods,and to use them for very young infants for whomthey are entirely unsuitable or even injurious.Legislative action is suggested which may requirethat all preparations offered or sold as food forinfants should be certified by a Government analystas non-injurious, and that each packet should con-tain its analysis. This recent report is a valuableaddition to the series issued by the Local Govern-ment Board on " public health and medical sub-

jects," and it discloses a good deal of painstakingwork.

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INFECTION FROM IMPORTED TONGUES.

IN recent years a good deal of attention has beendirected at our principal ports to the subject of thepossible importation of diseased meat into thiscountry. The importance of this work has beenaptly illustrated by a very interesting report pre-sented lately by Dr. E. W. Hope to the LiverpoolPort Sanitary Authority, in which it is stated thatin consequence of the food inspectors having aboutthe middle of 1913 come across certain indicationsof disease in frozen ox-tongues imported fromSouth America a systematic examination was

ordered of all such consignments arriving at

Liverpool. Up to the end of February, 1914, nofewer than 147,501 tongues had been carefullyexamined, and 3809, or 2’5 per cent., were founddiseased. The services of Professor J. M. Beattieand Dr. D. Moore Alexander, of the BacteriologicalDepartment, Liverpool University, were securedto conduct the strictly scientific portion of the

inquiry. The number of tongues affected indifferent consignments varied to a great extent,some being practically free, while other con-

signments showed a comparatively high per-centage of infection. The lymphatic glands at theroot of the tongue were chiefly affected, beingapproximately three times more frequently involvedthan the "blade" of the tongue. The glands werefound softer and more easily broken down thanusual, and in some pus had formed, while in otherscaseation or calcification was taking place. Thediseased conditions were shown to be mainly dueto actinomycosis, but in some cases tuberculousglands were found, inoculation from which wasfollowed by tubercle infection in experimentalanimals; in a few instances a mixed infection ofactinomycosis and tuberculosis was present. Itmay be also mentioned that imported ox-cheeksfrom South America with the submaxillary glandsattached have been found showing evidence ofactinomycosis. Most of the tongues imported fromSouth America have the lymphatic glands attached,but those from the United States are trimmed, andexported after the removal of the glands ; so that itis more difficult in the latter case to find whetherthe tongue is or is not diseased. As actinomycosisand tuberculosis are known to affect cattle in the

United States as well as in Argentina and otherparts of South America it is important that theglands should in all cases remain attached to thetongues, so that they may be examined beforethey are admitted into this country. Actinomycosis,or ray-fungus disease, is produced by the growth ofa highly developed bacterial fungus belonging tothe group trichomyces ; it is mainly seen in cattleand pigs, more rarely in man. It is originally foundin plants, barley, and other grasses on which cattlefeed; it may occur in animals fed on dry fodder.It can hardly be regarded as a contagious diseaseof animals. When it attacks man it probably arisesfrom a similar source as that which affects cattle.Abrasions or ulcerations in the mouth predisposeto the infection, and it is said to occur frequentlyin some countries after outbreaks of foot-and-mouth disease. Cases are on record where the biteof an animal has conveyed the malady to man. It

is, however, reassuring to learn from Dr. Hope thatno human instances have come to light where thesufferer had consumed infected meat. Nevertheless,these imported tongues, if they show signs of disease,should not be admitted to this country whether theycause actinomycosis or not. There is undoubtedlydanger of tuberculosis infection in some cases,so that it would be advisable to reject everyimported tongue that affords any evidence ofglandular infection of whatever sort. It is satis-factory to hear from Dr. Hope that recent con-signments of tongues from South America bearevidence that the majority have been more care-fully inspected before exportation than was the casein previous years. We understand that Dr. W. J.Howarth, medical officer of health of the City ofLondon, and Dr. Herbert Williams, port medicalofficer, have issued a joint report on this subject,their conclusions being in the main in the samesense as those of Dr. Hope.

POLYURIA AND BASAL BRAIN LESIONS.

THE pathology of diabetes insipidus remainsobscure, but there is some evidence that in certainof these cases there has been a lesion in the neigh-bourhood of the pituitary gland. This has beenshown both by the growth anomalies allied to

acromegaly which often accompany descriptionsof diabetes insipidus cases, and also by the fact thatin many cases there is some limitation of the fieldof vision, a state of affairs of frequent occurrencewith pituitary lesions. Some experiments havebeen made which throw some light upon therelation of polyuria to brain lesions. Dogs wereoperated upon, and in different animals variousportions of the brain were destroyed, and theeffect upon the urine secretion was noted. Theareas thus destroyed were those in the immediatevicinity of the hypophysis; in some animals thehypophysis was also destroyed, either at one opera-tion or subsequent to a previous destruction ofbrain tissue. Some 18 animals were used. Theimportant fact comes out that polyuria may resulteven when the lesion is not limited to the hypo-physis. In five instances the experimental punc-ture did not touch the hypophysis, yet polyuriaresulted. The type of polyuria thus produceddiffers in no respect from pituitary polyuria.There is a limited area of brain tissue, situated.in the vicinity of the hypophysis, ablation ofwhich induces polyuria. Anteriorly it appears to-

1 Camus, J., and Roussy, G.: Comptes Rendus de la Société de Biologie,1914, lxxvi., pp. 773 and 877.

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’be bounded by the optic chiasma and posteriorly’by the protuberance ; the area exists in the

vicinity of the infundibulum. An observation wasthat if the hypophysis were removed but the’infundibulum preserved there was no polyuria.Basal destruction affecting this special area, fol-

lowing a previous hypophysis ablation, increasedthe degree of polyuria. The writers consider thatthis zone of tissue appears to regulate the reten-tion of water in the organism. They found alsothat this mechanism was less perfect in younganimals than in old. It is a function whichseems to have some general controlling effect

upon water retention, and which assumes a greatersignificance and value as age advances. It is

possible that observations of this nature may aidin furnishing additional data for the localisation ofbasal tumours.

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DIET AND TUBERCULOSIS,

WE have received an interesting report upon aninvestigation into the dietary of the labouring,classes of Birmingham with special referenceto its bearing upon tuberculosis. It has beencarried out by Dr. A. E. A. Carver and pub-lished by authority of the Public Health andHousing Committee of the corporation ofBirmingham. The questions to which the

investigation was directed are especially the

following: Can the labouring classes, with theirpresent means, obtain a proper dietary ? If properdietary is within their reach, do they obtain it ?Has their dietary any bearing upon the prevalenceof disease, particularly tuberculosis, among them ?Comparisons were made upon 80 families in Bir-mingham or its immediate neighbourhood, theheads of which were willing to supply the neces-sary information. In 40 of the families themembers were healthy, and in the other 40 one,or more of the members were suffering from tuber-culous disease, so that the families are dividedinto two main classes-the tuberculous and the

healthy. They are subdivided into five groupsaccording to the income, the first being composedof families whose total weekly income was under.25s. a week, the second those with weekly incomesfrom 25s. to 29s. 6d., the third from 30s. to 35s.,the fourth from 36s. to 42s., and the fifth withincomes over 42s. a week. Almost all the neces-sary visiting was done by the nurses of the GeneralDispensary’s Tuberculosis Department, who wereequipped with tested spring balances and speciallyprepared note-books. A daily visit was paid duringthe whole period of the study to each family, andevery article of food brought in was weighed and ’

the price noted. Tables showing the foods in mostgeneral use, with their composition, energy value,and predominating price per pound in Birminghamduring the time of the investigation, are given.Some very interesting results were obtained in

regard to the energy value of the dietaries. It wasfound that the last three healthy groups obtained adietary with a caloric value approximate to thatgenerally recognised as sufficient for a man doingmoderate work, which is given as between 3000 and.3500 calories-the highest of them giving an

average of 3178 calories. The two poorer divisionsof the healthy group are slightly below 3000. It is- somewhat significant to notice that in all five.divisions of the tuberculous series the energy value.of the food is on an average below 3000 calories,:the average for all the groups being 2667 calories.

Dr. Carver summarises his conclusions by pointing’out that the total energy value of every tuberculousgroup is below the standard which he advocated-

namely, 62 grammes of protein, 110 of fat, 425 of

carbohydrate, giving a total energy value of 3020calories,a standard which is byno means a liberal one,more especially in protein. He also points out thatin every tuberculous group it is below the standardobtained in the healthy groups. The quantity ofprotein shows but little variation, and that anirregular one, in all of the groups. It is alwaysbelow Atwater’s standard. There is apparently amost unmistakable craving for more fat. Thehealthy groups always succeed in getting more fatthan the corresponding tuberculous groups. Inregard to carbohydrate the experience of thehealthy groups shows that about 425 grams is asuitable quantity for a moderate worker. None ofthe tuberculous groups attained to this standard.The deficiency in the energy value in the tuber.culous groups is due to shortage of fat and carbo-hydrate. From a careful analysis of his resultsand from the experience afforded through hisvisitors, Dr. Carver concludes that the labouringclasses both need and desire instruction in foodvalues, and he recommends that such instructionshould be given to girls from the ages of 12 to 14at elementary schools and to mothers at specialclasses, at mothers’ meetings, and at their homes,by competent district visitors. At the present timesuch information would seem to us to be of a

special value when the question of husbandingthe national food-supply owing to the exigenciesof war is desirable.

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WOUNDS IN THE REVOLUTIONARY WARS.

Alsace and Lorraine were the scene of perpetual: combats between the Napoleonic forces and theAustrian and Prussian armies. In Erckmann-Chatrian’s " Histoire d’un Paysan," an admirablesequence of romances dealing with the wars

between 1780 and 1815, the horrors of that timeare depicted with masterly fidelity. But surgeryhas wrought one great change. The soldiers’greatest foe after battle a hundred years ago wasnot famine or pestilence, or the wandering andstarving village dog, not the forest wolf, nor eventhe camp follower so vividly described in Hugo’s"Les Miserables"; it was the putrescence of wounds.The paysan of the famous French romancists, whowas assuredly an actual person, describes withmuch vividness and detail how he encounters anold comrade lying under the colonnades of the townhall at Phalsbourg in 1795. The man has beenwounded in the hip by a

"

biscayen," and hiswound is so offensive as to cause nausea to thosenear him. He is carefully nursed in a privatehouse, but his presence there is such a danger tohealth that only the brave Dr. Steinbrenner-surely a historic personage-and the peasant andhis wife can venture near him. The local mid-wife, acting as nurse in those days before the RedCross was known, is driven away from her

improvised bed on the landing. The drawingforth of the " biscayen " causes the sick manto groan so loudly that his voice is heard

through the floor of his room. Surely a vividtouch. The horrible carnage of battle con-

tinues to-day, but modern surgical sciencehas triumphed marvellously over the stillgreater horrors that in old times were wont tofollow.