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Specific treatment demands accurate diagnosis, andlooking about for means of establishing a closerrapproachement with the practitioners of medicine Dr.Crossley-Holland developed the thesis that pharma-cists should turn their attention to medical diagnosis." It would," he said, " be of the greatest assistance tothe doctor if he could depend upon the pharmacist toundertake the examination of body secretions andexcretions, to examine pathological urine and othermorbid products .... carry out blood counts andgenerally to engage in the conduct of laboratory aidsto diagnosis." But whether this is work properly tobe undertaken by a pharmacist, however skilled in hisown profession, is open to question. As Dr. Crossley-Holland said, it requires knowledge and manipulativeskill; and though the pharmacist must possess thelatter his present training is not calculated to fit himto deal with diagnostic problems. In fact nothingshort of a full medical training can do that.

SOCIETY OF MEDICAL OFFICERS OF HEALTH

WE have received a communication from Dr. R.Veitch Clark, president, and Mr. G. L. C. Elliston,secretary, of the Society of Medical Officers of Health,stating the policy of the Society undertaken in behalfof public health medical officers which they believeto have the approval of the public health service. Thewriters set out the aims of the Society, its servicesin behalf of the public and its members and itsfreedom from political bias, And they call attention tothe cooperation existing between the British MedicalAssociation and the Society, in view of the activitiesof a medical body, which they do not name, but whichthey assert is for the first time claiming to representthe interests of public health medical officers. Thecouncil of the Society, through the president andexecutive secretary, are therefore reaffirming their

position, drawing the special attention of publichealth medical officers to a leading article on thesubject which appeared in the British MedicalJournal of June 1st (p. 1127). "They feel that itis of the utmost importance that both public healthmedical officers and local authorities should notbe confused by the arbitrary action of anothermedical body in putting forward a new salariesscale and a new method of negotiation, the adoption ofwhich is being urged upon medical men and localauthorities on grounds not dis-associatedfrom politics."The council believe that it is unnecessary to appeal tothe loyalty of the fellows towards securing that theirpresent objects and methods of action are adhered to.With regard to the main practical point in whichthe cooperation between the B.M.A and the Society ofMedical Officers of Health exists, namely, that ofthe scale of salaries, a scheme arranging the scaleswas adopted in 1925, has been in existence ever sinceand has always been supported by THE LANCET.

SURVIVAL BY PERFUSION

HITHERTO the perfusion of isolated mammalianorgans has been limited to experiments of shortduration owing to the numerous conditions whichmilitate against the indefinite maintenance of anartificial circulation. The difficulties lie not so muchin the attainment of asepsis as in the gradual deteriora-tion of the preparation from other causes ; in an

experiment which is only going to last for a few hoursaseptic precautions are usually regarded, perhapswrongly, as a waste of time. Either as a result of

procedures to render it incoagulable, or because it iscirculating in an unnatural environment, the shed

blood used for the perfusion develops " toxic " pro-perties which lead to progressive vaso constriction andcedema in the isolated organ. For this reason lungsare usually inserted in the circuit to

" detoxicate "

the blood, but they also become cedematous in time;J. de B. Daly believes the toxic properties to be due tothe precipitation of some solid material which isfiltered out by the lungs, and has successfully replacedthese by filters, but it is doubtful whether this is acomplete solution of the problem. Another importantfactor is the intermittency of the circulation. It iswell known that a mere head of pressure equal tothe arterial pressure is useless for prolonged perfusion,and that a pulsatile flow must be provided. Owingto the almost inevitable inclusion of rigid glass tubesin the circuit, it is impossible to guarantee that amechanical pump will reproduce the heart beatexactly from the point of view of the organ ; more-

over, although immense improvements in perfusionpumps have been made, a certain degree of traumato the blood is inevitable, and this may have some-thing to do with the development of its toxic properties.Therefore as we pass from the heart-lung to thepump-lung, and from this to the pump-oxygenatorcircuit which contains no vital tissue except the organunder investigation, the difficulties of even short

perfusions increase enormously. Even when " success-ful " the organ is not necessarily working normally;thus the kidney secretes urine, but it is not normalurine. These are but the outstanding and well-

recognised difficulties, and the claim recently reportedfrom Dr. Alexis Carrel’s laboratory in the RockefellerInstitute, New York, that organs have been kept aliveunder artificial conditions for as long as twenty daysimplies that the additional problem of eliminationof metabolites has been solved and that one of themost sensational advances in the history of physiologyhas been made. The details of the Carrel-Lindbergh" life-chamber " will be awaited with keen interest toall those engaged in the study of normal and abnormalfunction.

THE Dr. Jessie Macgregor triennial prize in medicalscience has been awarded to Dr. Mary BroadfootWalker, of St. Alfege’s Hospital, London, for her workon physostigmine in the treatment of myastheniagravis.THE death is announced at Philadelphia of Prof.

Thomas McCrae, physician to the Jefferson and

Pennsylvania Hospitals, Philadelphia, whose collabo-ration with Sir William Osler in the production of the" System of Medicine " has made his name deservedlyfamiliar to the medical world. Prof. MeCrae was .

65 years of age.

A DOMINION LUNCHEON.-Three medical menwho have held, or are holding, high office in theDominions-namely, Sir Stanley Argyle, late Premierof Victoria, Dr. H. A. Bruce, Lieut.-Governor of Ontario,and Mr. S. M. Huggins, Prime Minister of SouthernRhodesia-were entertained at a luncheon given atGrosvenor House, Park Lane, on June 27th, by officersof the British Medical Association. Those present includedMrs. Bruce, Lord Dawson, Sir Humphry Rolleston, SirGeorge and Lady Badgerow, Sir Harry Batterbee, SirHenry and Lady Brackenbury, Sir Thomas and LadyDunhill, Sir Thomas Stanton, Sir Holburt Waring, Dr.and Mrs. G. C. Anderson, Mr. and Mrs. Rowley Bristow,Dr. Alfred Cox, Dr. and Mrs. J. S. Fairbairn, Mr. and Mrs.L. Ferris-Scott, Mr. and Mrs. Bishop Harman, Dr. C. 0.Hawthorne, Dr. and Mrs. Robert Hutchison, Dr. andMrs. E. K. le Fleming, Dr. and Mrs. W. Paterson, Dr. S.Watson Smith, and Mr. H. S. Souttar.