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scientific men who predict with confidence that the world’ssupply of food (it may be at a distant day) will be producedabundantly and constantly by humanly devised processeswhich will place questions of quantity on more certain basesthan agriculture can promise to do. It is difficult not to be

sceptical about such a contemplated consummation of man’singenuity, and certainly much of the joy and romance of theworld would be taken out of it if the rearing of plants andanimals ceased to be a necessity of its existence. Still, the

triumph which would imply that albumin, starch, sugar, andfat could be fashioned out of the mineral elements, carbon,hydrogen, nitrogen, oxygen, sulphur, and phosphorus is notbeyond the bounds of imagination, only we must not wait forit to put an end to the I I cornering " of the people’s food.

DOUBLE HÆMOTHORAX IN MENINGOCOCCICMENINGITIS.

DOUBLE nsemothorax is a very rare condition. At a

meeting of the Société Medicale des Hopitaux of ParisM. E. Apert reported a case, apparently unique, in which itoccurred as a complication of meningococcic meningitis. A

boy, aged three and a half years, was taken to hospital onJan. 28th last in a state of collapse. The face was livid,the lips were pale, and the respirations were feeble and slow.He had been in good health until the previous day, when heawoke feverish; in the evening he vomited and cried. On

admission pallor, coldness of the surface, feebleness of

pulse and respiration, and general weakness were thedominant symptoms. The child lay prostrate and motionlesson the bed and groaned. The abdomen was not retracted,there was no rigidity of the neck, and Kernig’s sign wasabsent. The sounds of the heart could scarcely be heardand the respiratory murmur was very feeble. The child was

covered with flea-bites, but there were also two purpuricspots of the size of a lentil on the lower limbs. The tempera-ture was 99’3° F. In the evening the temperature rose to101-1° and at 3 A.M. the child died. At the necropsy,on opening the thorax, the lungs had a greyish tintinstead of the rosy colour which they show at this age.

They appeared to be void of air and blood and were

in a state of atelectasis, like the lung of a foetus. On

raising the lungs this condition was explained: each

pleural cavity contained a gelatinous mass of clotted bloodwhich occupied the whole of the costo-vertebral gutter andextended as high as the axillary line, pushing the lungsforward. In aspect and consistence the mass resembled

quince jelly; in the upper part it was transparent andof a yellowish or slightly rosy tint, in the lower part it was

thicker and brown. Evidently blood to the extent of morethan a litre had been extravasated into each pleura. The

peculiar appearance of the clot was due to slow coagulation,which allowed the red corpuscles to collect at the lower part.Slow coagulation is the rule in effusion of blood into the

pleural cavity. But what was the cause of this effusion ? 7The lungs and the pleurse were quite sound. But the cellulartissue of the costo-vertebral gutter was oedematous and theintercostal and azygos veins were thrombosed and distended

by black non-adherent clot. All the thoracic and abdominal

organs were normal. On the convexity of the brain, in thefissures, and in the course of the vessels there were a dozenpurulent spbarachnoid tracts, the beginning of suppurativemeningitis. There were no lesions at the base of the

brain. Films of the pus showed in small numbers diplo-cocci, mostly intracellular, which did not retain Gram’sstain. The symptoms were thus due to the internal

haemorrhage. The child died before symptoms of meningitishad time to develop. The fact that the meningitisremained localised to some of the fissures on the convexityof the brain explained the absence of rigidity of the

neck and Kernig’s sign. The existence of hsemorrhagicforms of purulent meningitis is well rècognised; but in thecases described the haemorrhage has taken the form of

purpura ; sometimes haemorrhage from mucous membranes hasoccurred, but never heamothorax. Further, double bsemo-thorax is in itself a rarity. M. Apert has been able to find onrecord only two cases. Zahn of Geneva described one which

resembles the case now reported in the fact that the venaazygos was thrombosed. M. Apert was unable to explain theconnexion between the meningitis and the hsemothorax, andon reading this careful clinical account the difficulty will berecos’nised.

THE RETIREMENT OF DR. JOHN TATHAM.

WE learn that Dr. John Tatham, who has for manyyears been Superintendent of Statistics at the General

Register Office, will shortly be retired under the age clausefrom his important post. Dr. Tatham has earned the grati-tude of the medical profession generally, and in particularof those officially responsible for the public health of the

country, by his admirable Supplementary Reports on theMortality of England and Wales. His great statistical

powers have ever been placed readily at the service ofthe medical profession where puzzling situations have arisen,and his exposition of medical statistics in the first volume ofAllbutt’s "System of Medicine " (second edition) is an intro-duction to a difficult subject which has been found of thehighest value by many practitioners. We are informed thatDr. Thomas Henry Craig Stevenson, who has been assistantmedical officer of the Education Branch of the Public Health

Department of the London County Council, will succeed Dr.Tatham as Superintendent of Statistics. Dr. Stevenson isthe joint author with Dr. A. Newsholme, the principalmedical officer of the Local Government Board, of the

"Graphic Method of Constructing a Life Table " and of otherstatistical papers. He was formerly assistant medical officerof health of Brighton, and he brings considerable experi-ence to his new and important post.

THE LODGING ARRANGEMENTS FOR THESIXTEENTH INTERNATIONAL CONGRESS

OF MEDICINE.

THE central booking office of the Royal Hungarian StateRailways has issued a circular letter, dated April 15th, toexplain the arrangements made for lodging members of theforthcoming International Congress of Medicine to be heldat Budapest between August 29th and Sept. 4th. The officestates that it has been intrusted with the arrangements foraccommodating visitors to the Congress for its whole duration,and intends to make these arrangements in advance by issuing"accommodation orders." Such accommodation orderswill be for seven days in hotels and eight days in privatedwelling-houses, on the understanding that the day ofarrival at hotels is to be taken as August 28th, but at

private dwelling-houses August 27th. Should the arrivalat Budapest take place after these respective days or the

departure from Budapest before Sept. 4th, no reimbursementwill be made for the time the lodgings are unused. The

following tariff of lodgings is given :-In hotels (atrival onAugust 28th and departure on Sept. 4th): rent for a stay ofseven days, prices in kronen (which may be tead as

shillings): Series A : single bed, K. 70-140 ; double bed,K. 84-210 ; three beds, K. 105-245. Series B: single bed,K. 48-69; double bed, K. 64-83; three beds, K.80-100. SeriesC:single bed, K. 48-69; double bed, K. 35-63; three beds, K. 42-79. In private dwelling-houses (arrival August 27th, and

departure on Sept. 4th) : rent for a stay of eight days,prices in kronen : Series D: single bed, K. 51-70; double

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bed, K. 76-100 ; three beds, K. 91-115. Series E: single bed,K.31-50; double bed, K.46-75 ; three beds, K.61-90. SeriesF:single bed, K. 16-30; double bed, K. 30-45 ; three beds,K. 44-60. Such apartments may be engaged by the personwho requires lodgings stating in which series and at whatprice he desires a room with one, two, or three beds andwhether it is to be in an hotel or in a private house. He

will be free to choose the price which he is prepared to payaccording to the scale set out above, and this price must besent to the central booking office in advance. In return for

this remittance an "accommodation order " for an appro-

priate lodging will be sent to the applicant. The committee

of the Congress has arranged that a commission of K. 8.50per person shall be paid to the booking office in returnfor its trouble and expenses. This commission is to

be sent at the same time as the rent and the

receipt of it will be acknowledged separately. If a

person thus taking a room should be prevented fromattending the Congress and notify the fact before

August 20th, the rent paid in advance will be refunded

upon production of the accommodation order with a deduc-tion of 10 kronen a head, but should such notice reach thecentral booking office after that date 20 kronen will be

deducted for each person. We would add for our readers’

benefit that members who desire to avail themselves of the

proposals contained in this communication should considerthem carefully and keep every document in connexion withtheir bargain, as failure to produce written evidence of

similar contracts proved a fruitful source of trouble at theMadrid meeting of the International Medical Congress.

INFLAMMATION OF BURSÆ AND "RHEUMATISM."

IN spite of recent progress in diagnostic accuracy theterm " rheumatism " is still used vaguely and is applied to i,

many different conditions, often to any articular affectionthe nature of which is unknown. Bacteriology has done ’,something to diminish the evil by separating from thismiscellaneous group gonorrhoeal and pneumococcic arthritisand acute rheumatism, but much still remains to be done.In the Boston Medical and Surgical Journal of April lst,Dr. E. A. Codman has called attention to the fact that

many obscure cases of pain about joints termed "rheu-matism " are due to inflammation of bursse or of the areolar

tissue between the different planes of muscles. In the

human body those tissues which move on one another

and bear weight-namely, joints-have their points of

friction defended by articular cartilage, but where thereis much movement but no weight is borne a simplesynovial membrane is interposed for the purpose of diminish-ing friction. Tissues which move on one another only to aslight extent are provided with an interposed layer of areolartissue, the spaces of which act like a compound bursa. The

cracking and snapping about joints which occurs in some

persons is usually produced in bursæ. The very existence ofmost of the bursas is often forgotten, and therefore an

altered condition in them is not entertained in diagnosis,but no matter how small they are subject to inflammation.Normally their walls are very thin, but when inflamed theymay become much thickened. Dr. Codman has recentlycalled attention to the frequency and importance of inflam-mation of the subacromial bursa. Inflammation of bursæ

may be due to injury, infection, toxic waste products in thecirculation, and over-use. Dr. Codman thinks that the stiff-ness which occurs after unusual exercise is due to mild

temporary inflammation of bursæ, tendon sheaths, andareolar tissue. The wonderful self-oiling mechanism of thebody is thrown temporarily out of order. The bursse become

thickened with congestion and acute cedema, and theirsecretion becomes too viscid and fibrinous to allow easy

motion. The areolar tissue being in a sense a compoundbursa may also become inflamed. This Dr. Codman regardsas the pathology of lumbago and" stiff neck." The func-tion of the serous membranes—pleuræ, pericardium, and

peritoneum-is the same as that of the bursae, the diminu-tion of the friction of parts which move on one another.Their inflammations may consequently be regarded as

analogues of bursitis. This opens up an interesting fieldfor comparisons when affections of bursæ have been more

fully investigated ; at present we have not much material iorbroad deductions.

____

THE EFFECTS OF WIRELESS TELEGRAPHY ONOPERATORS.

IT has been remarked that each step taken in the onwardmarch of any applied science seems to bring into notice somefresh special pathological condition. Various previouslyunknown diseases dogged the steps of the earlier engineers,electricians, chemists, and balloonists. The dangers lurkingin the Crookes tube-beneficent though it be when used

under proper control-have been of late made tragicallyprominent. Amongst the numerous persons who are now

learning to fly possibly some new pathological curiosity willbefore long come to be recognised. According to M. P, Bellile,a French naval surgeon on board the Desoartes, which has beenengaged in the campaign in Morocco, the members of theship’s company who were employed in wireless telegraphduty developed various affections in consequence of the

action of the Herzian waves. Most commonly the tele-

graphists complained of their eyes, a slight conjunctivitissimilar to that occurring amongst those who work witharc lamps being found. Although this of itself was not

generally at all serious, yet in one case where the attacksrecurred again and again, keratitis was produced whichresulted in a leukoma of the right cornea and consequentimpairment of vision. In order to protect the eyes fromdamage by the ultra-violet rays of the electric emanation,which have a very powerful action, it was recommended thatyellow or orange glasses should be worn. Not only were theeyes of the operators affected, but two cases of eczema-one of the wrist and one of the eyelid, both very difficultto cure-were seen, probably due to the same cause.

Lastly, one of the officials who had been employed forseveral years in wireless telegraphy suffered from painfulpalpitation of the heart which came on after working for anylength of time at the instruments for sending messages.This man was quite free from any organic lesion of the heart.M. Bellile is disposed to think that a good many of the casesof "nervousness" and neurasthenia which seem now to be

getting rather common among naval men may be due to thework which is being done in wireless telegraphy.

CONGENITAL NEPHRITIS.

THE kidneys of young children appear to be very sus-

ceptible to irritation from causes which have little or no

influence in adult life. Thus, in addition to the ordinarycauses of nephritis, such as passive congestion, ingestedirritants, and the infections, such conditions as acute indi-gestion, inflammatory conditions of the alimentary tract,cold plunges, exposure to high degrees of heat, calcareous andhasmosiderin deposits in the tubules, interstitial haemorrhages,and even icterus, may all be concerned in the production ofnephritis in early life. Other causes. are uric acid infarcts

and parental syphilis, both of which may produce changes inthe kidneys before birth. In the latter case the nephritis isusually of interstitial type, but parenchymatous changesoccur in some cases. Dr. Howard T. Karsner contributes an

interesting study of these conditions to the Februarynumber of the Proceedings of the Pathological Society of