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with teak-topped tables in which are covered sunkenwells with a sink and water, electric and gas con-nexions. Power connexions are disposed wherenecessary. In the basement there are a number ofrooms devoted to the anatomy department as wellas a demonstration theatre capable of seating 70students. There is a well-ventila,ted tank-room,connected with the other floors by an electric lift, areception and preparation room, a, store room, and alarge workroom equipped with a machine for cuttingfrozen anatomical sections, as well as photomicro-graphic and dark rooms.The new extension here described was designed

largely with the object of providing better facilitiesfor collaboration between the various non-clinicaldepartments which are now, with the exceptiononly of pathology and pharmacology, all housedunder one roof. A rather striking rearrangement isthe grouping of histology with human anatomy, butthis is in line with the view that the study of micro- iscopic and macroscopic anatomy should be closelyassociated. The provision of a room for surgicalresearch in close association with the anatomy depart-ment was also well planned, and should be fruitfulin work useful to the school and hospital. It isunfortunate, but inevitable, in such a district as theBorough that the new extension should be partlyovershadowed by neighbouring buildings, so that, inspite of the very large window space, the lighting onthe lower floors is not very good. This is particularlynoticeable in the physics laboratory, where artificiallighting has had to be provided on a lavish scale, andapplies also, though in lesser degree, to the histology

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laboratory. The lighting of the dissecting room,however, is magnificent, and this is perhaps the onlydepartment in which it is essential.The buildings as a whole are admirably equipped, and

students of Guy’s cannot fail to react to the stimu-lating effect of spacious rooms so well adapted to theirpurpose. We congratulate them on their new college.

RESEARCH IN TROPICAL DISEASE.

III. THE LISTER INSTITUTE OF PREVENTIVEMEDICINE.

THROUGHOUT its history the Lister Institute hasnever ceased to take an active share in elucidatingproblems of vital importance in tropical disease. Ithas been enabled to do so, not so much by the despatchof scientific experts to tropical regions, though thisform of activity has by no means been ignored whenthe necessary funds permitted, as by providingfacilities for systematic research, both static andexperimental, in those basal sciences protozoology,entomology, bacteriology, experimental pathology,and biochemistry, &c., which determine more andmore, as time goes on, the lines of solid advance.

In 1906 the late Prof. Minchin was granted labora-tory accommodation in the Institute for his workas university professor of protozoology. A specialdepartment of protozoology was thus formed in whichsystematic research on protozoa generally, as well ason those responsible for disease in man and animals,could be intensively followed. Even before thearrival of Minchin some notable studies on theexperimental infection of rats with trypanosomes andthe influence of chemotherapeutic agents on suchinfections, by the late Prof. Plimmer and variouscollaborators, had emanated from the Institute.From Prof. Minchin’s department came manyimportant contributions to our knowledge of trypano-somes and, more especially, of their developmentalcycles in hosts like the tsetse-fly and the rat flea.Both Prof. Minchin and Miss Muriel Robertson alsoenjoyed a lengthy field experience in Uganda inconnexion with their trypanosome studies. TheIndian Plague Commission, appointed jointly bythe Secretary of State for India, the Royal Society,and the Lister Institute, engaged the services ofvarious Institute experts, all of whom contributedmaterially, whether at home or at Bombay, to the

solution of the plague problem as one determinedessentially by the bionomics of the rat flea. Toother plague-stricken areas, Manchuria, Egypt,&c., the Institute has lent its experts. In 1911 adepartment of entomology was instituted, in chargeof which was placed the late Arthur Bacot, whoseunique talents, already displayed in working out thebionomics of the rat flea on behalf of the PlagueCommission, were thus recognised. Bacot’s achieve-ments during the following 12 years up to his lamenteddeath from typhus in 1922 are possibly fresh in theminds of many readers, but here may be mentioned

I his work with C. J. Martin on the precise mechanismby which B. pestis is transferred from flea to rat, his.elaborate study of the bionomics of Stegomyia jasciatf’tfor the West African Yellow Fever Commission, andhis last experimental studies on the viruses of trenchfever and typhus fever carried out at home, inPoland, and in Egypt.The departments of protozoology and entomology,

now sadly deprived of their distinguished chiefs, havethroughout acted as nursing grounds for researchworkers from many lands in search of the knowledgethat would render them more efficient for prosecutingresearch in tropical climes. No department of theInstitute, however, has failed to yield its contributionto the sum total of studies specially devoted to tropicaldisease problems. Subjects such as snake-venom,bacillary dysentery, cholera, leprosy of man and rat,ankylostomiasis, and leishmaniasis have at varioustimes engaged the attention of staff or voluntaryworkers, British and foreign. The departments ofexperimental pathology and biochemistry have, as iswell known, undertaken, in recent years, intensivestudies on certain diseases of nutrition, beri-beri,pellagra, rickets, osteomalacia, and scurvy. Theboundary line between diseases of tropical andtemperate climes wears somewhat thin at times, andsuch studies as these cannot fail to influenceprofoundly standards of hygiene and well-being inthe tropics as elsewhere.

TREATMENT OF EARLY MENTAL CASESIN GENERAL HOSPITALS.

INAUGURATION OF WARDS AT MIDDLESEXHOSPITAL.

THE two new wards at the Middlesex Hospital forthe treatment of early mental cases " by membersof the staff of St. Luke’s Hospital " were formallyinaugurated on June 28th, at a meeting attended byrepresentatives of the public bodies concerned. It willbe remebered that St. Luke’s Hospital for Lunatics,formerly situated in Old-street, E.C., was closed inDecember, 1916, when it was announced that it was.to be re-established as soon as circumstances wouldpermit near Gerrards Cross, Bucks. At the presentmoment the hospital has central offices at 19, Notting-ham-place, London, W. 1, and runs a convalescenthome at Gerrards Cross, so that the establishment ofbeds in the Middlesex Hospital marks a considerableadvance towards its actual re-establishment as a,

mental hospital.Cooperation between St. Luke’s and Middlesex

Hospitals.I Lord Athlone, treasurer of the Middlesex Hospital,expressed his gratitude to the authorities of St.Luke’s Hospital for the part they had played inbringing about the establishment of these wards.The principle of cooperation between general andspecial hospitals had been widely discussed andgenerally accepted, but he believed this to be thefirst example of carrying it into practice. Mr. ArthurCross Powell, treasurer of St. Luke’s Hospital,mentioned the fact that St. Luke’s was founded in1751, only six years later than the Middlesex, andhad spent the greater part of its existence on a sitewhich, although ample in size and held on a perpetuallease at an exceedingly low rental, had come tobe surrounded by tram-routes, the noise of which

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by day and by night hardly contributed to the well-being of the patients. A few years ago the new sitehad been acquired in Buckinghamshire, and it washoped to proceed with building there at an earlydate. He welcomed cooperation with the MiddlesexHospital in the present venture, and wished and pre-dicted every success to it. Sir Coles Child describedthe new wards as a step beyond the out-patientdepartments which have already been established atsome mental hospitals for the benefit of the same typeof patient. The utility of these departments wasseriously discounted by the fact that many peopleobjected to going anywhere near an asylum. Thepresent arrangement obviated this, while providingtreatment by the staff of an institution devoted tothe care of the insane. He saw no reason why generaland mental hospitals should not cooperate in thisway throughout the country. Dr. C. Hubert Bond,Commissioner of the Board of Control, expressed hisgreat personal satisfaction, and that of the Board ofControl, at the step which had been taken. Hitherto,the general hospital out-patient department hadpresented an impervious screen which no case ofmental disease had been allowed to pass. He hadlong hoped that the Middlesex would find the meansof doing something for these patients, and hadadvocated a scheme of this nature some years ago.The doors were now open, and he hoped that allteaching hospitals would follow suit.

The New Wards.The new wards occupy the second floor of the

out-patient department, which has been recon-

structed for the purpose, and consist of a male and afemale ward, each containing three beds, and lavatories,bathrooms, and nurses’ room. The wards present amost attractive and restful appearance, being well-lighted, quiet, cool, and tastefully decorated in themanner of a bedroom in a comfortable private house.These wards are intended for the treatment of suchcases of functional nervous disorder as appear likelyto derive benefit by hospital in-patient treatment.Chronic cases, and those which have failed to respondto treatment elsewhere, as well as patients likely tocause annoyance to others, or cases of frank insanity,will not be admitted. Patients will be admitted fromthe out-patient department of the Middlesex Hospital,and during treatment they will be under the super-vision of Dr. R. W. Gilmour, who was assistantmedical officer of St. Luke’s in its last years in theCity. The resources of all the special departmentsin the hospital will be available for such methods ofinvestigation and treatment as are found desirable.

NATIONAL BABY WEEK CONFERENCE.THE Conference opened on Monday, July 2nd, and

owing to the large number of delegates was held inthe Caxton Hall instead of at Carnegie House, asoriginally intended.

Dr. G. F. STILL took the chair at the morningsession, when the presidential address was deliveredby the Rt. Hon. NEVILLE CHAMBERLAIN, M.P., Ministerof Health. He said that, in his opinion, the mosturgent matters calling for attention in regard to

maternity and child welfare were an increase in thenumber of infant welfare centres and of health visitors,and schemes of this kind would be regarded by himwith a favourable eye. He would like to see furtherprovision to assist in reducing maternal and earlyinfantile mortality, in which but little progress had beenmade, and an improved midwifery service. A greatdebt was owed to volunteers who started maternity andchild welfare work, and there was no sphere in whichvoluntary assistance could be more profitably employed.

Dr. J. S. FAIRBAIRN opened the discussion on the

Causal Factors of Infant mortality up to One llfonthof Age,

dealing specially with the antenatal causes. Maternaldisease and prematurity, he said, were conditions I

largely affecting early infantile mortality, and thediseases likely to damage the child were those inwhich there was some poison of the system, chemicalor bacterial, or where there was formation of deleteriousproducts in the body or accumulation owing to defectiveelimination. Diseases due to poisons formed withinthe body included the group known as toxaemias ofpregnancy, of which eclampsia was the most dramaticexample ; those due to defective elimination coveredalbuminuria, kidney disease, and the like, any ofwhich might terminate the pregnancy or cause earlydeath of the infant. It was common knowledgeamong obstetricians that mothers seriously ill often hadaverage infants ; the placenta and placental cells hadfirst claim, and the foetus lived like a parasite on themother. Syphilis-a common cause of stillbirth andinfantile death-was a curable disease, but hard torecognise in women at an early stage. Toxemias ofpregnancy, on the other hand, were usually easy todiagnose but hard to treat.

. Dr. EARDLEY HOLLAND considered that intranatalcauses of death might be summed up in the one word" injuries," the majority being injuries to the head.The delicate structure of the head at birth was liableto injury from forceps or even in spontaneous birthwhere there was a contracted pelvis. Tearing of thedura mater and cerebral haemorrhage were speciallyapt to occur in premature cases, and intracranialinjuries were frequent in breech presentations, theinjury being caused by too quick rather than tooslow delivery of the after-coming head. Dr. Hollandhad, in his experience, seen one infant of seven months,who died of something else, in whom a healed tearwas visible.

Prof. LouisE MCILROY said that birth should beconsidered as an episode, the nine previous monthsbeing regarded as equally important with later life.She believed sepsis was usually introduced by lacera-tions, however small they might be. In the periodof rather more than two years that her special depart-ment had been working at the Royal Free Hospitalthere had been no case of eclampsia. The babieswere not subjected to violent artificial respiration withexposure to cold air, but were wrapped in a warmtowel, their respiratory passages cleared of mucus,and left quiet. They were oiled, but not washed forthree days, to prevent shock and loss of heat.

The afternoon discussion on the

Value of 3[maternity Ilomes in a JJ;[ aternity andChild Welfare Scheme.

was interesting for the variety of opinions expressed.Dr. JANET CAMPBELL, as chairman, said that theMinistry of Health’s policy of a large number ofsmall maternity homes had been criticised on thescores of extravagance in expenditure and staff, thedifficulty of maintaining a high standard of midwiferypractice in isolated units, and the small value of suchinstitutions as training schools, all of which criticismsshe thought were justified. In 1922 there were 107maternity homes with 1275 beds ; some had not beenused to their full capacity, and Dr. Campbell thoughtthat fees had perhaps proved deterrent though theywere not meant to be so. There was some discussionas to the class of patient who should be eligible formaternity homes, most speakers favouring the viewthat they should be for normal cases. Differing viewswere held as to the advisability of utilising isolation

hospitals for maternity cases, Dr. W. ALLEN DALEYand Dr. S. G. MOORE both approving the idea, MissJ. C. WzsHtT thinking it unwise, and Dr. E. R.WooDHOUSE, of Llandudno, feeling convinced thatpatients would be frightened to use them. A refresh-ing speech was made by Councillor Mrs. LEWTS, ofBarry, who said she spoke as a working woman,and knew that the women of Barry regarded the homemade for them by their own man as the only properplace in which to have their babies. She would

greatly like to see a rota of efficient home helps whowould take complete charge of the work of the homesfor at least a fortnight.