1173A CHRISTMAS APPEAL.-VACCINES IN AMPOULES

count should not lightly be disregarded unless over-whelming evidence is produced to show that normalfluctuations regularly pass outside the limits definedabove. I am, Sir, yours faithfully, ,

L. E. H. WHITBY.Middlesex Hospital, W., Nov. 14th, 1933.

THE LATE PROF. EMILE ROUX

To the Editor of THE LANCET

SIR,-As one of those who, in 1890, attendedRoux’s famous course of bacteriology at the PasteurInstitute-to which allusion is made in the obituarynotice in THE LANCET of Nov. llth-I should like torefer to his remarkable powers as a teacher. Althoughso many years have passed since then I still retain avivid recollection of his lectures. They were deliveredin fluent and lucid French, easy to follow even bythose whose knowledge of the language was limited.On one occasion he lectured continuously for twohours on rabies, holding his audience spellbound byhis eloquence while he described the means by whichPasteur and he had worked out and established themethods of making the antirabic inoculations andgave convincing proofs of their success. Ten years,he said, had been devoted to this investigation andperhaps his share in Pasteur’s great work has scarcelyreceived the recognition it deserves. As rabies hasfor long ceased to exist in this country the importanceof their work can hardly be realised. I have onlyseen one case of rabies in this country 45 yearsago, but that was sufficient to enable me to realise theenormous value of antirabic inoculations in countrieswhere the malady still persists. Roux’s teaching andexample inspired hundreds of workers. His insistenceon accuracy and attention to every detail in hispractical class, and his scathing remarks about anymistake or carelessness, were a valuable training inscientific method.

I am, Sir, yours faithfully, H

Manchester, Nov. 13th, 1933. GEORGE R. MURRAY.

A CHRISTMAS APPEAL

To the Editor of THE LANCET

SIR,-For many years you have kindly allowed meto appeal through your columns for the ChristmasGift Fund of the Royal Medical Benevolent Fund. Itis natural, as the existence and the usefulness of thisbenevolent fund become more widely known, that thenumber of our beneficiaries should steadily increaseeach year. During 1932 the fund was assisting over650 beneficiaries and it has been our custom to givea Christmas gift to all the annuitants and to the

poorest of the grantees.I feel it is a great responsibility that none shall be

disappointed this year. I ask, Sir, for your approvaland support of my appeal. I am confident that itwill be the wish of many that our beneficiaries whoare either infirm or invalid doctors, widows or daugh-ters of deceased medical men whose total incomes arenot even .E100 a year, may be given again thisChristmas a gift of 30s. each.Such a gift is not a luxury when the recipients are

pressed for the necessities of life. It can but givesome warmth or clothing to many who dread thewinter months. Donations may be sent to thehon. treasurer, Royal Medical Benevolent Fund,11, Chandos-street, W.l. Every contribution will bedistributed without deduction of expenses.

I am, Sir, yours faithfully,

Nov. 10th, 1933.THOS. BARLOW,

President of the Royal MedicalBenevolent Fund.

TUBERCULOSIS AMONG THE NORTHAMERICAN INDIANS

To the Editor of THE LANCET

SiR,-In an annotation in your issue of Sept. 23rd(p. 715) occurs the following statement : "Theproblem of tuberculosis among Red Indians hasceased to be one of any importance, for that noblerace is almost extinct. Civilisation offered a poorexchange when the first of the gunmen replaced thelast of the Mohicans." This statement is not inaccordance with the facts, for the North AmericanIndian is not dying out, nor is he showing any decidedinclination in this direction. According to thecensus of 1930 the number of Indians in this countryis 332, 397 against an enumerated Indian populationof 237,196 in 1900. As the result of an enlightenedpolicy increased appropriations and constant attentionto the subject, the tuberculosis death-rate of our

North American Indians seems to have been success-

fully arrested. The medical service for our Indianshas been decidedly improved, and now gives on thewhole reasonable satisfaction to a widely scatteredpopulation. Certain small tribes are unquestionablydying out, but the more predominating tribes, suchas the Sioux, Chi-ppewas and Navajos, are showingmarked increases over previous years. This is

particularly so of the Navajo, which is the finest typeof surviving Indians in this country. They inhabita vast reservation under practically ideal conditionsof Indian life. A full report of Indians by tribesis in course of publication by the United StatesCensus Office, but this will not be available for sometime to come.The tuberculosis problem as it affects our Indian

population remains, however, of outstanding import-ance. In 1930, out of 5384 deaths from all causes

among our Indians, the number of deaths from allforms of tuberculosis was 1175 or about 22 per cent.

Among the Indians of British Columbia, in 1931 therewere 512 deaths from all causes, of which 165 werefrom all forms of tuberculosis, or about 32 per cent.In British Columbia the death-rate from all formsof tuberculosis was 657 per 100,000 in 1931, a markedincrease over the rate for 1922 which was 385. This

compares with a rate of 189 for the Chinese of BritishColumbia, and 171 for the Japanese. I regret Icannot give the precise rates for this country sincethe Indian population of the registration area isnot yet available, but it is probably safe to assumethat it is not very much in excess of 300 per 100,000- which, of course, is still extremely high. Underour present medical policy in the Bureau of IndianAffairs, a marked reduction in the tuberculosismortality can be anticipated in the near future.We are providing better housing facilities and betterprovision for sanatoria, while much is being donealso to improve the nutritional condition of theIndian population.

I am, Sir, yours faithfully,F. L. HOFFMAN.

Wellesley Hills, Massachusetts, Oct. 21st, 1933.

VACCINES IN AMPOULES

To the Editor of THE LANCET

SIR,-May I call attention to the great inconveni-ence caused to practitioners by the custom of sendingout vaccines in many coloured ampoules containing aseries of doses determined without any knowledge ofthe needs of the individual patient. Sometimes apatient will come, with a box of these ampoules, askingthat a course already commenced may be continued,