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rhe 21st the flap was lifted from its bed. and loweredover the face and the large granulating scalp wound was"covered with Thiersch’s grafts. Both flap and grafts werecovered with a salt water compress. On Jan. 2nd, 1902, the-flap was sutured in position. The superior maxillse werevivified by dissecting off the scar tissue with forceps, knife,scissors, and a sharp spoon. Union took place throughoutexcept at a limited space below the nares which was closedlater after the nasal cavity had been opened by an incision- through the flap. On April 10th the left lower eyelid and- on the 22nd the right were restored by a flap from thetemporal region. In January, 1903, rhinoplasty was per-formed by Konig’s method. The final result was a greatimprovement. The patient could speak plainly and neithersaliva nor food escaped during mastication.

THE SUPPLY OF VACCINE LYMPH INSCOTLAND.

IN the matter of the supply of vaccine lymph Scottishmedical practitioners have for some years felt them-selves to be at a disadvantage as compared with theirbrethren in the southern portion of the United Kingdom.’Glycerinated calf lymph is universally recognised as

possessing, on the whole, several advantages not obtain-

able with humanised lymph whether employed by the

method of arm-to-arm vaccination or otherwise, and’in England the Government laboratories manufacture-it on a large scale, sending hundreds of thousands of tubesvo the National Vaccine Establishment of the Local Govern-ment Board for distribution every year. In Scotland, on the-other hand, compulsory vaccination was introduced in 1863,but neither in the Vaccination Act of that year nor in anysubsequent enactment is there any provision for the supply iof calf lymph. With the object of remedying this defect’there has recently been held in Edinburgh a con-

ference attended by representatives of the RoyalColleges of Physicians and Surgeons of ’Edinburgh, theFaculty of Physicians and Surgeons of Glasgow, themedical faculties of the four Scottish Universities, the

Scottish Branch of the Incorporated Society of Medical-Officers of Health, and the recognised teachers of vaccina-tion in Scotland. It was unanimously resolved that the conference was of opinion that an institution for the preparationof calf lymph should be established by Government in

<.Scotland and a committee was appointed to draw up a

memorial in this sense for submission to Lord Balfour of

Burleigh, Secretary of State for Scotland. In the memorial-and in an appended statement it is mentioned that calf

lymph is in great demand in Scotland both for primary- vaccination and revaccination and that the only availablesource of supply is by purchase from private manufacturers,- over whose method of preparing it no external supervision ispossible. The memorialists ask that vaccine lymph shall’be distributed gratuitously to all medical practitioners under- such regulations as may be considered necessary, and theyargue with perfect correctness that the outlay requiredfor this purpose would be very moderate in comparisonwith the expenditure on epidemics of small-pox. The

memorial was presented to Lord Balfour at the London

,office of the Secretary of State for Scotland on July 15tb,the case in support of it being stated by Sir Thomas R.Fraser, Dr. R. Farquharson, M.P., Baillie A. Graham of

Glasgow, Councillor Lang Todd of Edinburgh, and Sir

Michael Foster, M. P. Lord Balfour, in his reply, criticisedthe terms of the memorial with much frankness and

remarked that the conditions of vaccination in England andScotland were by no means identical. He urged the deputa-tion to take care that they did not do anything to destroythe system of vaccination that had gained the confidence ofthe people of Scotland. Sir John Batty Tuke, M.P., in thank..ing Lord Balfour for receiving the deputation, promised that

further definite information on the subject would be

supplied. -

THE ILLNESS OF LEO XIII.

UNDER date Rome, July 13th, one of our Italian corre-spondents writes : "His Holiness, contrary to all prevision,professional or lay, is still maintaining his struggle for

life and that with a serenity, not to say bonhomie,most remarkable. He seems, indeed, less anxious and

preoccupied than are those in immediate charge of hishealth. To-day’s bulletin, issued at 9 A.M., announces

that his condition, tranquil before midnight, was dis-turbed at intervals during the small hours, the rest.

lessness resulting in slightly increased depression this

morning. The pulse was 82, the respiration 32, the tempera-ture 360 C., and diuresis still scanty-a symptom coincidentwith the formation of liquid in the pleura. Paracentesisthoracis up to the hour of sending off this letter has not

again been practised, but Dr. Lapponi and Professor Mazzonimay have to resort to it once more, as it is always well borneand produces instantaneous, if only temporary, relief. It isremarked that Dr. Rossoni’s signature for two days has notappeared below the bulletins with those of Dr. Lapponi andProfessor Mazzoni. This is ascribed to his having beentaken ill, but such, I am informed, is not the fact. Thetruth is that that able and experienced consultant found hecould do no more than confirm the diagnosis and treatmentto which his two colleagues had adhered and so, while

always at hand to reinforce them with his skill, he has, onhis own initiative, retired for the time from assisting at theconsultations. That the report should have got about thathe was ill is hardly to be wondered at. The anxiety, theexcitement, caused by the vicissitudes of the HolyFather’s illness and the momentous issues its fataltermination would involve, have told heavily on the wholepersonnel of the Vatican, not excluding the medical staff andthe brethren of the Apostolic College. Even the gentlemenof the press’ have had their ranks thinned by the laboriousroutine they have to observe- bivouacking till a late, or

rather till an early, hour under the Bernini colonnades, whiletheir colleagues, off duty for the time, have been takingwhat rest they could snatch in the cafes adjoining the Piazzaof St. Peter’s. The demand for news as to the illustrious

patient is as widespread as it is insatiable and theresources of the lay journals of both hemispheres are

taxed as they have never been before. Returning to themedical aspects of the situation I may add that in spite ofthe Holy Father’s tenacious physical and moral fibre, in spiteof his indomitable will to live,’ and notwithstanding theacknowledged ability and sleepless vigilance devoted to hiscare, to-day’s prognosis in professional circles is in fullaccord with the tenour, far from sanguine, of this morning’sbulletin." " The telegrams of July 14th and July 15th tell a

story of almost imperceptible sinking. There is no changefor the worse save what is implied by there being no changefor the better. Dr. Rossoni’s name re-appeared on the

evening bulletin of Wednesday last.

A DEPUTATION from the Parliamentary Association of theBritish Union for the Abolition of Vivisection waited uponMr. Akers-Douglas on Wednesday, July 15th, to protestagainst the increase of vivisection and received from theHome Secretary in his reply a very salutary reproof.

THE proceedings of the annual Congress of the RoyalInstitute of Public Health commenced in Liverpool on July15th at St. George’s Hall, when an address was delivered bythe President, the Earl of Derby, K. G.

THE Jenner Institute of Preventive Medicine has circu-lated a memorandum with regard to the proposed change of