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of complete disability and confinement to bed for severalmonths. While the x rays so generated are not as activein bringing about a dermatitis as are the rays from a

tube excited by a coil, yet such rays can, and will, produce ’,burns that are just as bad as those chargeable to the coil-excited apparatus if proper precautions are not taken.In view of the fact that the static machine is very exten-sively used for x ray work in America, as compared withthis country, these remarks must carry considerable weight.That the rays from a tube excited by a static machine

possess much less tendency to burn has been common

knowledge among x ray workers but it has always seemedto us dangerous to assume that such rays are devoid of anysuch power. As a matter of fact, dermatitis has been pro-duced in London by means of a tube excited with a staticmachine. It thus follows that those who practise radio-graphy with a static machine should be none the less

careful in their precautions against the production ofundesired dermatitis than when using a coil.

THE MEDICAL DEPARTMENT OF TRINIDAD ANDTOBAGO.

Mr. Hugh Clifford, Colonial Secretary of Trinidad and

Tobago, in his report on the Blue-book of the colony for1903-04, remarks that the total cost of the medical depart-ment for the year under review amounted to 81,233, ofwhich 34,912 were expended on personal emoluments and<&46,321 on other charges. This sum, which shows anincrease of Z6300 over the expenditure under the same

heading in the preceding year, is equal to one-tenth of thetotal expenditure of the colony, and it not only exhibits atendency annually to increase, but advances automaticallywith the growth of population of the colony, in a

fashion which, under the existing system, defies control.

In Trinidad not only has the Government taken uponitself to provide the services of qualified medical officersin districts where the practice available is insufficientto remunerate adequately a private practitioner but it hasalso assumed as part of its duty the support of a variety ofinstitutions which in Europe are usually maintained eithersolely or principally by voluntary contributions. The con-ditions which prevail in this colony are, of course, widelydifferent from those which obtain in most Europeancountries. The number of the very wealthy is here far

smaller in proportion to the population ; the average of

poverty is greater, though indigence in the tropics is robbedof many of the terrors which it has in colder climates; andthere is lacking in Trinidad that strong well-to-do middleclass which, both in France and in England, forms the back-bone of the nation. The few really rich men in Trinidad

have innumerable calls upon their generosity ; the less

wealthy have little to spare when the demands made

by the high cost of living have been satisfied ; the poorerclasses, from whom the principal users of the Governmentinstitutions are naturally drawn, are unwilling to pay forwhat they receive there, even when they can do so althoughat the cost of some personal inconvenience. The reason forthis is partly that the system under which natives of India.ire introduced into Trinidad necessitates the establishmentof estate hospitals and the appointment of medical officersin the districts which immigrants inhabit. The other

labouring and the poorer classes, not unnaturally, con-

sider that they have an equal right with the imported EastIndian to the privileges and advantages which, in this

respect, the latter enjoys ; and they are not, therefore, pre-pared to pay, if payment can be evaded, for what theyregard as no more than their due. Beyond this, how-ever, it has seemingly become a fixed idea in -the

popular mind that the Government is able to provide allthat is desired by the individual at the charges of the State

without injury to the remainder of the community ; thatGovernment property, being public property, is somethingof which each taxpayer has a right to make use wheneverthe opportunity serves for his personal advantage ; and thatthis can be done without the capacity of the Governmentfor useful expenditure in other directions being sensiblyimpaired. Mindful of the fact that, more especially in atropical country, the public health is a matter of the first

importance, the Government has found itself obliged to

maintain, practically single-handed, a number of institutionsfor the treatment of the sick, the insane, the decrepit, andthe diseased, and in so doing is so unfortunate as to lackthe support of that sound public opinion which shouldforce those who are able to pay to decline to receivethe charity of the State whenever payment, thoughpossibly irksome, is within their means. That the

position is fast becoming serious is indicated by thefact that though the annual expenditure of the medical

department, including the cost of medical and charitableinstitutions, amounts to one-tenth of the total annual expendi-ture of the colony-that is to say, to over <&81,OOC&mdash;thereimbursements derived from paying patients, includingmembers of the police force and others from whose paydeductions are made for the purpose, do not average E3000

per annum. During the year under review 13.493 personswere admitted to the various Government hospitals, 12,110were discharged relieved or cured, and the deaths numbered1524. The number of patients in the other Governmentinstitutions on March 31st, 1904, was as follows : lunatic

asylum, 610 ; leper asylum, 313; and house of refuge,St. Clair, 371. The total number of inmates of Government

hospitals and institutions on March 31st was 2248, being alittle more than 0’ 7 per cent. of the entire population of thecolony.

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IODOFORM FILLING FOR BONE CAVITIES.

THE success attending the ordinary operation of filling orstopping carious teeth has doubtless suggested to many

surgeons the desirability of employing some similar sub-

stance for filling the cavities left in bones after operations.When the cavity is aseptic, as after the removal of a cyst,it apparently fills with blood clot which organises and so thecavity is obliterated but when a bony cavity is septic theprocess is very tedious for the discharge of pus generallycontinues for months. About five years ago Professorvon Mosetig Moorhof of Vienna commenced to study the

question of the best method of filling bone cavities. At

first he employed an iodoform paste of the consistence of

putty but this did not reach the minute recesses of the

cavity and therefore he devised a liquid filling of whichhe gave an account last year in the Dentseke Zeitschrift fi&THORN;J’C)cir2crcie, and we publish in this number of THE LANCET(p. 146) a description of Professor Moorhof’s method andresults by Mr. B. Seymour Jones. The filling lately employedconsists of iodoform, spermaceti, and oil of sesame, andmelts at 122&deg; F. (500 C.), so that when melted it can be

poured into the cavity and fills it completely. It has been

found necessary that the cavity should be aseptic and quitedry; these essentials are obtained by methods very similarto those employed in filling carious teeth and if the

filling is properly applied only slight serous exudationoccurs. For the mode of introduction of the fillingand the precautions taken we refer the reader to thearticle mentioned but here we will consider the results.

Since iodoform gives a dark shadow in a skiagram it is easyto follow the course of events in the bone cavity. The

dark area is gradually replaced by lighter patches, showingthat the plugging material is absorbed and replaced bygranulation tissue, but so slow is this process of absorptionthat no symptoms of poisoning ever occur. In its turn the