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need be said, as this is being done at present, but ifthe collaboration of the general practitioner is requiredno time should be lost in arousing and guiding theresearch flair which is probably to be found in thefamily doctor just as much as in the other ranks of theprofession.

It is vexatious and humiliating to be brought faceto face with cases such as the following and not to beable to give a definite opinion.A young woman suffered from nephrosis in winter of

1927-1928 ; has been recently a candidate for Civil Serviceexamination when the urine was quite clear. A young manwith brilliant prospects had an attack of nephrosis inMarch, 1928 ; albumen persisted for about nine monthswhen the urine became free ; after an influenzal attack arecurrence took place and persisted for some time. Theurine is now clear.

These are the problems which are continuallymeeting every practitioner, and it is an opprobriumto medicine that no serious effort is being made totackle them. Does law or engineering allow itself tobe baffled by comparatively simple problems ?

T HTY) Cir vnnra faUhfnIlv

Belfast, June 18th, 1929. R. M. FRASER. M.D.

VACCINAL REACTION.

To the Editor of THE LANCET. 1

SIR,-I recently vaccinated 88 Europeans on aship bound from India to England. The vaccinationswere performed on four consecutive days, and five (days after the last was performed the whole group ofcases was inspected either by another medical manwho was travelling on board the ship or by myself, ]or (as a rule) by both of us. The vaccine appearedto have taken in 64 cases, or 73 per cent. of the total, ]and this percentage of successful vaccinations surprisedme, because : (1) All the 88 persons had been in ]countries (chiefly India) where small-pox is an endemic ’disease. In the 87 cases in which the period of ]residence in such countries was ascertained itsaverage length proved to be nine years. (2) Theaverage number of previous vaccinations, as statedby the. subjects themselves, was 4,7. (3) Two Ipatients had had small-pox some years previously.One of these, who had had it as a child, was among ithe " takes the other, who had had it as an adult,was not. I considered a " take " as something definitelymore than the inflammatory lesion to be expected fromvaccination with (say) aseptic normal saline. ]

Nobody would say that on board ship is a place ofideal surgical surroundings, but the other doctor on "board considered that I could acqu;t myself ofcausing sepsis and that the clinical character of thelesions supported me. The vaccine was from a "

continental source. ’

I am, Sir. yours faithfully, ]

London, June 20th, 1929. G. PRATT BROOKS.

THE "PHYSIOTHERAPY CLINIC" AND THEPRACTITIONER.

To the Editor of THE LANCET. F,SIR,-If I may still return to Dr. Matthew Ray’s tjletter in your issue of April 20th it is to bring to your h

notice, as likely to be of interest, the Comely Bank dClinic, Ltd., Orford-road, Walthamstow, which is I

run on lines which meet all the objections he raises. c

The Clinic is a private limited company run by a nboard which, with one exception (a solicitor), consists t,of local medical men. This Clinic employs a specialistwho attends at the Clinic two days in the week and at Lother times when necessary. The specialist alone is S

entirely responsible for treatment, which is carried out Sby the staff of fully trained and certificated persons Lunder his direction. The doctor sends, or, if he prefers n

it, brings his patient to see the specialist at the Clinic. itNo charge is made for the consultation unless the dcase is considered unsuitable for treatment by iielectrical or physical methods when the modest fee pof 10s. 6d. is requested. p

In this way specialist treatment is secured withoutthe [specialist rate of fees, the treatment is carriedout by fully trained and certificated persons underspecialist direction, and there is no fear of the doctorbeing deprived of his patient, as the patient nevercomes into contact with any local practitioner. Atthe end of the treatment the specialist communicatesto the doctor who sent the patient the results obtainedand returns the patient to him.

I am, Sir, yours faithfullv,

June 18th, 1929.

A. POTTINGER ELDRED,Chairman of Board of Directors,

Comely Bank Clinic, Ltd.

PRESENTATION TO SIR RONALD ROSS.

WHETHER or not the general public is mindfulof the immense service rendered to medical science bySir Ronald Ross, there is ample proof that hiscolleagues have never forgotten it. Last week twoseparate societies-one chiefly concerned with theadvance of clinical medicine in highly civilisedcommunities and the other with tropical hygienein its widest aspects-summoned their memberstogether for the purpose of presenting him withtokens of admiration and esteem,At a meeting of the Royal Society of Tropical

Medicine and Hygiene, the newly installed Presidentof the Society, Dr. G. Carmichael Low, handed theManson Medal to Sir Ronald Ross, who receiveda great ovation from the large assembly. The Presidentin a brief address recalled the famous researcheswhich had elucidated the whole life-cycle of themalaria parasite. When Sir Ronald began workin India in 1889 he was attracted to the study ofmalaria, a main cause of death to the people of thatcountry. W’hile in England on leave in 1894 hemet Manson and learnt from him the hypothesis-Manson’s great induction-that there were stagesin Laveran’s parasite the purport of which was toinfect mosquitoes which sucked the patient’s blood.Struck by this idea and stimulated by his talks withManson, Sir Ronald, on returning to India in 1895,started on the researches, now of world renown, whichwere ultimately to make clear the true history of themalaria parasite in its passage from man to man.The story of the difficulties, disheartening disappoint-ments, and trying work in a tropical climate, crownedfinally by complete success, were to be found inSir Ronald Ross’s memoirs. No one reading thisaccount could fail to appreciate the energy, persever-ance, and ability of the man who carried them out.A remarkable feature of the work was that itcompletely elucidated the whole life-cycle of themalaria parasite, and that it had stood unalteredto the present day. Sir Ronald Ross was the Society’sfirst Vice-President under Manson’s presidency,and himself held the chair from 1909-1911. Hiswork had brought him many deserved honours ;among them the Manson Medal would surely rankhigh, for it associated his name with that of an oldfriend who had encouraged and helped him in tryingtimes. After Sir Patrick Manson’s death the Societyhad founded the Manson Medal to be awarded fordistinguished meritorious work in tropical medicine.It would be strange indeed if this medal did notcarry the name of Ross as a recipient, for the twonames of Manson and Ross would go down togetherto posterity as the conquerors of malaria.On the same evening, at a meeting of the West

London Medico-Chirurgical Society, Dr. HaroldSanguinetti, who was in the chair, presented toSir Ronald the Triennial Gold Medal of the Society.Dr. Sanguinetti pointed out that, though the discoverymade by Ross was all-important to medical science,it was certainly not a money-making one for thediscoverer, who would have done better for himselfin the worldly sense if he had discovered a new bootpolish. Malaria was not, as was supposed by somepeople, only a disease of the East: At one time it

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was fairly common in our Fen country and evennow was sometimes found in the South of England.

Sir Ronald Ross was able to be present at bothmeetings, and though he was not well enough to makea speech, his silent appreciation of the honours paidto him was manifest.

The Services.ROYAL NAVAL MEDICAL SERVICE.

Surg.-Lt. A. P. Anderson-Stuart to be Surg. Lt.-Comdr.F. L. A. Hughes, J. B. Douglas, and H. G. Wells to be

Surg. Lts.The following appointments are notified : Surg.-Capts.

P. T. Nicholls to Victory, for R.N. Hospital, Haslar ; andJ. McCutcheon to Victory, for R.N. Barracks, Portsmouth ;N. S. Meiklejohn to Vivid, for R.N. Hospital, Plymouth :and A. R. Thomas to Maine. Surg.-Lts. D. F. Walsh toAphis; M. J. Brosnan to Co7zstance and E. S. Bolton toCicala. Surg.-Comdr. T. R. L. Jones to T’ictory. Surg.Lt.-Comdr. (D.) D. Paterson to (7?’eeKMtc.

ROYAL NAVAL VOLUNTEER RESERVE.

Surg. Sub.-Lts.,D. M. Craig and H. L. Hoffmann to beSurg.-Lts.

-

ROYAL ARMY MEDICAL CORPS.

Capt. A. McD. Simson, from the secd. list, is restd. to theestabt.

Lt. H. McVicker to be Capt.Temp. Lt. J. Ryan relinquishes his commn.

REGULAR ARMY RESERVE OF OFFICERS.

Maj.-Gen. D. J. Collins, late R,.A.M.C., having attainedthe age limit of liability to recall, ceases to belong to theRes. of Off.

MILITIA.

Maj. S. Miller relinquishes his commn. and is granted therank of Lt.-Col.

TERRITORIAL ARMY.

Capt. R. S. Strachan to be Maj.Lt. J. C. Andrews to be Capt.A. C. Sinclair to be Lt.Supern. for serv. with the O.T.C. : Lt.-Col. J. du P.

Langrishe, Res. of Off., to be Lt.-Col. and to comd. the Med.Unit of the Edinburgh Univ. Contgt., Sen. Div., O.T.C.

TERRITORIAL ARMY RESERVE OF OFFICERS.

Lt.-Col. (Bt.-Col.) F. A. E. Crew from Active List (Supern.for serv. with O.T.C.), to be Lt.-Col. (Bt.-Col.).

Capt. L. B. Maxwell from Active List (Supern. for serv.with Med. Unit, Univ. of Lond. Contgt., Sen. Div., O.T.C.)to be Capt.

ROYAL AIR FORCE.

Squadron Leader J. H. Peek relinquishes his short servicecommission on account of ill-health.

RESERVE OF AIR FORCE OFFICERS.

Flight-Lt. J. A. Quin is transferred from Class’’D2 toClass Dl, and is re-employed with thr Regular Air Force.

INDIAN MEDICAL SERVICE.

Lt.-Col. C. W. F. Melville to be Col.Lt.-Col. L. E. Gilbert retires.Lt. S. N. Evans resigns his commn.

I.M.S. ANNUAL DINNER.

The annual dinner of the Indian Medical Service was heldat the Trocadero, London, on June 19th, the Chairmanbeing Lieut-Colonel D. G. Crawford, the historian of theService. Dr. N. G. Horner and Dr. E. C. Morland werepresent as guests. The 92 officers of the Service who attendedwere as follows :-

Major-Generals : A. A. Gibbs, K.H.P.; G. F. A. Harris, C.S.I.;A. Hooton, C.I.E.; Sir Leonard Rogers, C.I.E., F.R.S.

Colonels : J. Anderson, C.I.E. ; R. F. Baird ; C. M. Goodbody,C.I.E., D.S.O. ; T. A. Granger, C.M.G. ; C. R. M. Green;G. Hutcheson: J. J. Pratt; F. Wall, C.M.G.; C. N. C.Wimberley, C.M.G.

Lieut-Colonels : A. Alcock, C.I.E., F.R.S. ; W. G. P. Alpin,O.B.E. ; G. T. Birdwood ; E. W. Bradfield, O.B.E. ; Harold E.Brown ; J. T. Calvert, C.I.E. ; D. Coutts ; J. M. Crawford,O.B.E. ; C. D. Dawes ; C. H. Fielding; H. R. B. Gibson ;

T. H. Gloster ; H. Greany ; D. Heron, C.I.E. ; E. V. Hugo,C.M.G. ; Dalzell J. B. Hunter, O.B.E. ; J. W. Illius ; R. S.Kennedy, D.S.O., lBLC.; H. H. King ; J. Kirkpatrick ; J. C. G.Kunhardt ; Cla,yton A. Lane ; W. B. Lane, C.I.E., C.B.E. ;Rigby G. Ly nn, D.S.O. ; A. A. Macneight; F. 0. N. Mell,C.I.E.; A. Miller; T. R. Mulroney ; J. H. Murray, C.I.E.;B. E. PI. Newland ; E. S. Phipson, D.S.O. ; E. Rost, O.B.E. ;A. J. H. Russell, C.B.E. ; Seymour R. B. Sewell; Jagoe W. S.Shaw ; N. S. Simpson ; G. M. C. Smith, C.M.G. ; R. Steen ;Ashton Street; W. A. Sykes, D.S.O. ; C. Thomson ; G. SloaneThomson; W. H. Thornhill; E. L. Ward, C.B.E. ; W. L.Watson, O13.E.; A. C. Younan.

-Al,ijors: T. J. Anderson, M.C. ; H. Chand, M.C. ; J. C.Chukerbuti ; G. Covell ; W. E. R. Dimond; Sir T. CareyEvans, M.C. ; A. H. Harty ; J. M. R. Hennessey ; W. P. Hogg,M.C. ; R. N. Kapadia, M.C. ; J. G. McCann ; A. N. Palit;B. Prasad : W. C. Spackman ; H. J. H. Symons, M.C.

Captains : J. H. Barret; Thaw Ba; A. T. Cox ; T. J.Davidson ; D. A. S. Hari ; A. V. Lopes ; D. P. McDonald ;A. Rosenblom ; A. N. Sharma ; D. R. Thapar.

Lieutenants : H. J. Boultbee ; T. W. H. Caughey ; A. M.Fra;ser; F. T. Harrington; W. P. Lappin; P. Shannon;D. L. Trant; H. S. Waters.

___

COMMISSIONS IN THE ROYAL ARMY MEDICALCORPS.

As will be seen from our advertisement pages 25 com-missions in the Royal Army Medical Corps will be offeredin July. Particulars may be obtained on written or per-sonal application to the Under Secretary of State, the WarOffice (A.--NI.D.1), Whitehall, London, S.W.

Medical News.UNIVERSITY OF CAMBRIDGE.—At recent examina-

tions the following were approved :-M.CHIR.

J. Gray and R. H. Metcalfe.

THIRD EXAMINATION FOR M.B. AND B.CHIR.Part I., Surgery, Midwifery and Clncecolo,gy.--C. Arthur,

A. R. Banham, D. W. Bawtree, G. H. Bradshaw, J. W.Bromley, G. E. Grove, G. Herbert, H. L. Hoffman, F. W.Holdsworth, H. P. Hutchinson. R. W. McConnel, W. M.Macgregor, G. C. C. MacVicker, R. B. Mayfield, I. B. Morris,G. W. Pickering, P. H. L. Playfair, R. B. Pringle, B.Rothery, M. C. Seward, J. D. Simpson, F. J. G. Slater,J. H. Smith, E. C. Sugden, W. E. Tucker, J. K. Willson-Pepper, W. R. Winterton, and H. M. Yardley.

Part Is, Physic, Pathology and Pharmacology.--C. P. Campion,A. J. W. Chamings, C. J. Grosch, C. Hill, T. A. A. Hunter,P. G. S. Kennedy, L. W. A. Lankester, J. F. V. Lart,G. E. Lewis, T. K. S. Lyle, F. H. McCay, R. A. Maynard,A. D. Morton, W. G. Oakley, J. R. Peacock, G. W. Pickering,L. J. Rae, F. Ram, T. S. Read, J. E. Semple, M. C. Seward,D. M. Stern, C. G. Townsend, W. E. Tucker, J. F. Varley,J. Vaughan-Bradley, B. M. Willmott, K. Wilson, andF. W. J. Wood.

SOCIETY OF APOTHECARIES OF LONDON.-At recentexaminations the following candidates passed in the under-mentioned subjects :-Surgery.-A. Campbell, Edinburgh ; R. Gilmore, Manchester

and Charing Cross Hosp. ; and S. R. G. Pimm, Guy’s Hosp.J7edtCtK6.—P. S. Balachandran, Middlesex Hosp. ; G. A. F.

Holloway, London Hosp. ; P. Hortop, Guy’s Hosp. ; andB. J. Niall, London Hosp.

Forensic A/ed’tCMte.—A. Clark, Glasgow and London Hosp. ;H. G. Edmunds, Univ. Coll. Hosp. ; B. J. Niall, LondonHosp. ; and Z. Risk, Birmingham.

jtjMtM/er!/.—L. P. Clarke. St. George’s Hosp. ; W. T. Ellis,Manchester and Charing Cross Hosp. ; J. Gordon, St. Mary’sHosp. ; W. M. Hamer, Manchester and Charing Cross Hosp.;J. H. Johnston, St. Bartholomew’s Hosp. ; E. J. O’Loughlin,Birmingham : and P. U. Rao, Charing Cross Hosp.

The Diploma of the Society was granted to B. J. Niall.

A dinner was held by the Society at their hall on June 18th,which had for its main purpose the bringing before theassembly the need for pecuniary assistance arising out ofthe recent necessary rebuilding and repairs of the interestingpremises. The Master of the Society, Lieut.-Colonel C. T.Samman, who presided, made out a good case for the stimu-lation of subscribers, when he alluded to recent efforts onthe part of the Society to keep in touch with medical pro-gress. Dr. R. W. Statham, an ex-Master of the Society,introduced Sir William Hale-White as a recipient of thehonorary freedom of the Company, and the toast of TheLivery, proposed by the Master, was replied to by Sir GeorgeMakins, Prof. Dixon, and Dr. A. P. Gibbons. Sir GeorgeS. Buchanan gave the health of the guests, to which SirEwen J. Maclean, President of the British Medical Associa-tion, and Mr. Francis Weston, Master of the Cutlers’ Com-pany, responded.