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THE RESULT OF AN APPEAL.1’o the Editor of THE LANCET.

SIR,—My appeal on behalf of a doctor, publishedin your issue of Dec. 4th last, brought in a sum oft114 19s. 6d. This is additional to the subscriptionwith which the list was opened. Will you and thet2 subscribers please accept my thanks.

I am, Sir, vours faithfully,Harley-street, W., April 2 rd, 1927. HILDRED CARLILL.

TESTS FOR DRUNKENNESS.To the Editor of THE LANCET.

SIR,—May I trespass further on your space to makea few observations on Sir William Willcox’s letter.In the first place I should like to ask for the sourceof the evidence which proved conclusively to theCommittee " that in the performance of complexoccupational acts such as the driving of a motor-caran experienced driver might be little affected byrelatively large amounts of alcohol since his longexperience of driving has caused his control of thecar to become almost automatic." More particularlyI wish to know why the Committee conclude thatthe judgment of the alcoholic is little impaired, forthis matters just as much as having complete controlof the levers of the car. A friend of mine accustomedto alcohol in a concentrated form (he has got to thestage when he prefers his whisky neat) tersely andcandidly states the difficulty when he says that hegets home more quickly in his car after a few whiskiesat his club than when the drinks are omitted tillhe gets home. Then as to Sir William Willcox’sobservations on the legal objections to the test-I have never advocated taking blood samples ;in fact, in the paper I stated that there are obviousobjections to the direct metnod ot obtaining tile

blood concentrations by taking blood samples, &c. Ifthe accused person is unwilling to pass a urine sampleI think this should be used in evidence against him.

It is refreshing to learn that Sir William Willcoxadmits the legal value of the chemical proof of absenceof alcohol from the urine of a person arrested fordrunkenness. But why restrict the value to a negativeresult only ? Even if it be not admitted that thereis a correlation between concentration’ of alcoholin the urine and toxic symptoms produced (I thinkthat those who will actually test this out for them-selves will agree with me, however, that these factorsare related) surely it will be of service to the presidingmagistrates to be able to state from a quantitativeanalysis of the urine that the accused must havetaken at least so much alcohol ? A case in pointcame to my notice some months ago ; a motorist,after zigzagging on the wrong side of the road, grazinga train-car and knocking a cyclist down, then tooka tram standard head on, with the result that theimpact flung him violently against the steering wheeland he fractured some ribs. The injury caused adelay of some weeks in the trial-he was arrestedfor being drunk in charge of a motor-car. The policesurgeon who saw him three-quarters of an hour afterthe accident considered him not drunk at that time.His urine was sent me for analysis. It contained268 mg. alcohol per 100 c.cm. This man must havedrunk at least the equivalent of the alcohol in six largewhiskies (i.e.. 7! oz. whisky 30 U.P.) to produce thisconcentration, and yet the accused on oath statedhe had had only one gin to drink, which will yieldamaximum concentration of alcohol in the urine of notmore than 50 mg. The man was simply fined fornegligent driving !The last two paragraphs of Sir William Willcox’s

’letter seem to me to be a quibble. The Committee(page 54 of this report), considering the tests forestablishing the fact that an individual is under theinfluence of alcohol, place first on the list the establish--ing of the fact as to whether or not the person hasrecently consumed alcohol. The whole of the dailypress read the report in the sense I indicated in myletter. But whether the test of smelling alcohol

in the breath can or cannot be regarded as an essentialtest for alcoholic intoxication, I repeat my chargethat the test is unsound and utterly unscientific.

I Sir William Willcox has shown the value of a

positive quantitative estimation of arsenic in theurine in bringing offenders against society to book.May I, in conclusion, appeal to him as Advisor tothe Home Office to give the urine estimation a fairtrial with all the material that is available in theMetropolitan area ? I shall be very glad to pass onmy apparatus for this purpose, as alas! I have no timenow for further investigation along these lines.

I am. Sir. vours faithfullv.Croydon, April 26th, 1927. H. W. SOUTHGATE.

COMPENSATION FOR A DAMAGED HAND.l’o the Editor of THE LANCET.

SIR,—A recent case was heard at the ShoreditchCounty Court arising out of an accident in which ayouth lost the last joint of his right middle finger.;S50 was paid into court by way of compensation,but the claimant through his mother claimed ;S100.Judge Cluer, in rejecting the application of theemployer, remarked to the mother that " if you hadlost the top of the right middle finger you wouldhave wanted £200 and so would I." The Workmen’sCompensation Act has been in force just on 20 yearsand it still remains without a schedule of fixed amountsfor definite injuries. Assessments are still arrivedat by a more or less rule of thumb. We have theschedule of the Ministry of Pensions with which alarge number of medical men have become conversant,but it is of no practical use in dealing with claimsunder the Workmen’s Compensation Act. Under thisschedule the right middle finger is assessed at £40whilst two of its joints are worth JE30 and one joint .825.Loss of the right middle finger, together with eitherthe index- or ring-finger entitles one to a life pension of20 per cent. which at present rates means 8s. a week.

I am. Sir. vours faithfullv.Old Broad-street, E.C., April 25th. J. J. SCANLAN.

LOOKING BACK.To the Editor of THE LANCET.

SIR,-I enclose a local paper ; a paragraph on p. 3,col. 3, has led me to write.My father, who died in 1888, took his L.R.C.S. in

1828 when 19 years of age, there being no restrictionas to age then. I took the same qualification in 1867,just after completing my twenty-first year ; so thisis a period of 99 years of practice conducted by fatherand son.

Looking back many things strike me, noticeablythe great decrease in the rural population of thisdistrict, the very small birth-rate (10-1 instead of 30),the great diminution of infectious disease treated athome, and the increase in the number of doctors.Once upon a time the nearest hospital was 17 milesdistant, and there were little or no facilities in theway of nursing for the public. Practices were notsold and there were no locum tenents, and an indoorassistant was considered well off with £40 a year.Every practitioner dressed in a surtout and a tall

silk hat. He visited his patients within the townpostal delivery by walking, and the country patientson the back of a horse or in a gig, or by a combinationof the local railway (when it came), and walking. Inmy opinion a good saddle horse was the best way ofconducting country work. On more than one

occasion I have ridden 50 miles, returning homewithin eight hours. I learned cycling when 50 yearsof age, thinking to save money, and I have even useda motor-cycle, and now on occasions hire a car.

I am, Sir, yours faithfully,Crieff, April 18th. 1927. JAMES GAIRDNER.** * The Strathearn Herald, which our correspondent

forwards, announces Dr. Gairdner’s increase of salaryby the Crieff Parish Council, in appreciation of hislong service as medical officer of health, suitablemention of which is also made on the minutes of thecouncil.—ED. L.