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these cases the mean auscultatory reading was’8 mm. Hghigher than the intra-arterial. Varying the width of thecuff from the standard 13 cm. to 20 cm. improved theaccuracy of both the systolic and diastolic readings insome obese subjects ; but in most subjects, particularlythose with thin arms, the wide cuff yielded readingswhich were too low. Though their numbers are rather’few, these workers produce figures which suggest thatin people with large arms (circumference 30-42-5 cm.)the auscultatory estimate of diastolic pressure becomesan additional 3 mm. Hg too high for each 1 cm. increasein the circumference of the arm above 30 cm. They saythat the sudden fading of the sounds is a more reliableguide to’ the diastolic pressure than their complete dis-appearance. These findings remind us that clinicalreadings of blood-pressure are merely approximate,though if recorded carefully they provide a useful guideto diagnosis and prognosis. It is clear that in plumpsubjects a wide cuff should be used before any opinionis given about a slight degree of hypertension.

RADIOTHERAPY OF CANCER

WITHIN the last few years two advances in radiologyhave revolutionised its value as a therapeutic agent.First, we can now control with exactitude the surfacedoses of X ory rays; secondly, it is possible to estimatethe distribution through the living tissues of radiationsat various distances and in different directions from the

place of their application, so that the dosage throughoutthe irradiated parts can be regulated with a high degreeof accuracy. - The calculation required before applyingdeep therapy, whether by X or y rays, needs a speciallytrained physicist who may or may not be the radiologisthimself. For the moment the facilities for using thelatest knowledge in this department of medicine are notwidespread, and there are formidable obstacles to theirextension. Among these obstacles are the difficultieswhich beset the specialist in radiology. To acquire theknowledge necessary to practise this particular kind ofwork is a task arduous enough to discourage any but themost determined aspirant, and when he has overcomeevery intermediate obstruction and gained his diplomahe finds that he cannot freely practise what he professes.Radiotherapy, being a relatively new form of specialism,is not allotted beds in most hospitals. Cases submitted tothe radiotherapist for treatment are not as a rule of hisown selection, but are filtered through the hands of thehonorary staff in whose wards they are kept and underwhose care they nominally remain. These disadvantageshave had to be faced by every new branch of medicalspecialism in turn and must be attributed to humannature, but they have been and will be overcome. Itwould be a pity, however, if the usual road is followedin this instance. The denial of hospital beds to specialistsin the past led to the establishment of a number ofindependent special hospitals, with detrimental effectson the medical schools. There is much to be said for

making a fully equipped radiotherapeutical departmentan integral part of every teaching hospital, with officersin charge whose status and voting powers are equal tothose of any other member of the visiting staff. To sucha vision there is yet another obstacle-the expense. Butthe war with its necessities has taught us to revise ournotions of this barrier.

SULPHATHIAZOLE OINTMENT IN IMPETIGO

WORK on the use of the sulphonamides and theirderivatives locally in skin and wound infections has

naturally suggested their use in impetigo contagiosa.This in its turn has raised the old question whetherimpetigo is streptococcal or staphylococcal in origin.The prevailing view is that it may be either, with the, added factor that some streptococcal cases may becomesecondarily infected with staphylococci, though a year

ago, R. E. Hope Simpsonl put forward a strong case for aspecific "inpetigococcus." A. J. Steigman2 examined25 cases of impetigo bacteriologically and found haemolyticstreptococci in 12 cases, Staphylococcus aureus in 8cases and a combination of both in 5 cases. Thisprompted him to try 5% sulphathiazole in an ointmentbase and he found that healing took place in about 4days compared with an average of 8 days required toobtain a cure when ammoniated mercury ointment wasused. L. H. Winer and E. A. Strakosch3 treated 60cases of impetigo with 5% sulphathiazole in cod-liver oilointment and obtained a cure in an average of just over4 days. They selected cod-liver oil ointment as a basebecause it was an easy medium to use and it did notdiminish the activity of the drug. They also treated20 patients with sulphathiazole by the mouth and nolocal treatment and obtained cures in an average of 92days. Pillsbury and others4 went further and treated avariety of infectious dermatoses with sulphathiazole, andalthough some of their results in other conditions weregood the cases of impetigo responded far and away thebest. They thought that an oil-in-water emulsion wasthe best base but obtained good results with an ointment.All these observers urge the importance of frequent andthorough removal of crusts and scales before applying theointment, and favour application 4-6 times a day. It

appears then that a 5% sulphathiazole ointment willcure impetigo in 4 or 5 days. This is a real advance on

any previous method of treatment, and in so infectious adisease a reduced period of infectivity should lessen thenumber of contact cases. Judging by the results so farpublished there is no object in giving the drug by mouth.

Mr. A. SEYMOUR HARDING, F.S.S., has retired fromthe general secretaryship of the Royal Institute ofPublic Health and Hygiene on -account of ill health.He had completed 30 years of service with the presentinstitute and with the former Institute of Hygiene, andthe good wishes of the whole fellowship go with him.THE death is announced from Lucerne of Dr. EDWARD

NEUMANN who was associated with Dr. Lucius Spenglerin the foundation of the Schatzalp, a luxury sanatoriumhigh up above Davos-Platz. Neumann as resident hadall the burden of administration, which was very welldone, but he was also an essential partner in the earlywork on pneumothorax, for which Brauer paid occasionalvisits from Hamburg. As a guide and friend Neumannis still gratefully remembered by British and Americanex-patients.THE Minister of Health and the Secretary of State for

Scotland have appointed a committee " to inquire intothe organisation of medical schools, particularly in

regard to facilities for clinical teaching and researchand to make recommendations." The following haveaccepted invitations to serve : Mr. W. M. Goodenough(chairman), Prof. T. R. Elliott, M.D., F.R.S., Dr. A.M. H.Gray, Prof. James Hendry,CF.R.C.O.G., Prof. A. V. Hill,F.R.B., Sir Wilson Jameson, M.D., Prof. J. R. Lear-month, F.R.C.S.E., Sir Ernest Pooley, Sir John Stopford,M.D., F.R.S., and Dr. Janet Vaughan.1. Lancet, 1941, i, 683. 2. Brit. med. J. 1942, i, 12.3. J. Amer. med Ass. 1942, 118, 221.4. Pillsbury, D. M., Wammock, V. S., Livingood, C. S. and Nichols,

A. C. Amer. J. med. Sci. 1941, 202, 808.

ROYAL COLLEGE OF OBSTETRICIANS AND GYNaeCOLOGISTS.-After July candidates for the membership of the collegemay not proceed to the examination till their case-recordsand commentaries have been accepted by the examinationcommittee. At present the case-records are submitted aspart of the examination, but after July they must be pre-sented not less than nine weeks before the examination.Candidates not attending for examination within three yearsof acceptance of their case-records will be required to presenta new set. Further particulars may be had from the secretaryof the college, 58, Queen Anne Street, London, W.1.