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glycerine; it also explains the slight antiseptic valueof solutions of silver nitrate and mercuric chloridein absolute alcohol. Professor Maillard mentions, in

passing, that the antiseptic power of aqueous solutionof phenol is increased by the addition of sodium chloride.A study of electrolytic dissociation is helpful in avoidingincompatibles. The extent of dissociation of an electrolytemay be diminished by the addition of other electrolytes andof non-electrolytes, especially viscous and colloid bodies.Uric acid affords an interesting instance of the general rulethat the lowering of ionisation is most noteworthy in feebleelectrolytes. It is only slightly dissociated in solution andits salts are scarcely more so. If a solution of sodium

chloride-i.e., an abundance of sodium ions-be added to asolution of sodium acid urate, its dissociation is diminishedand molecules of the urate are re-formed and precipitated.The addition of sodium carbonate or bicarbonate also lowersthe solubility of the urate. Hence the unexpected con-clusion is reached that when sodium bicarbonate is admini-stered to a gouty patient the uric concretions are not dis-solved, but that, on the contrary, there is a tendency forurates to be precipitated. The salts of lithium, piperazine,and various other remedies for gout have a similar effect.It would thus appear that the explanation of the efficacy ofan alkaline treatment in uric acid diathesis lies elsewhere ’,than in the solution of the uric concretions.

THE ETHICS OF FASTING.

IN some measure the fasting enjoined by the Churchduring the season of Lent may be defended, at all events ina large number of cases, on physiological as well as on moralgrounds. Mere discipline, of course, invariably acts healthilyon both body and mind at whatever season of the year it maybe practised and no particular religious creed need be

followed as the sine lua non of a course of self-denial.The custom of the Church is a very old one and thoughmodern life has rendered the carrying out of fasting on strictlines untenable, yet most intelligent people are prepared toconfess an admiration for, and a sympathy with, the generalprinciples of a scheme which has for its object the dis-cipline and well-being of the body and the mind. That beingso, the strength of purpose is more likely to receive helpwhen a specific season for carrying out the disciplinaryexercise is selected than if the time were chosen in

a haphazard way. Lent may therefore be regarded as aconvenient season when the individual addicted to variousobvious luxuries and excesses can effectually brace his moralstrength to forego those things which he knows perfectlywell he can do very well, if not better, without. From theChurch’s point of view there is, of course, a widerand deeper significance attached to what she regardsas a holy season, but it is only in our province to

consider the subject in its bearing upon the welfareof the body. The season gives the creature of more

or less selfish or bad habits an excellent opportunityof relinquishing those habits for at any rate a certain periodand he may, and probably will, receive a salutary and morallesson which may induce him to lead a better and physio-logically happier life. He may be poisoning himself, for

example, by over-indulgence in tobacco, alcohol, or even

food, and he may find that, as a result of his determinationto give up these excesses for a season, his mental and

bodily activities are improved, his health is altogetherbetter, and so he is constrained to go on with the

"godly, righteous, and sober life." It would be difficult,if not impossible, to defend by physiological arguments theexcessive fasting of the old ascetics, but fasting from luxuryand excess is a procedure absolutely in harmony with avigorous, healthy, and moral condition. The conduct indi-

cated, therefore, in the Lenten fast of the Church is

calculated to lead the erring into the paths of physiologicalrighteousness. Self-denial is, however, a poor thing if itdoes not benefit others besides ourselves.

THE LADIES’ HOME AT CANNES.

THIS institution was established 24 years ago with the

object of affording rest and change of scene to British andAmerican ladies of small means who are in enfeebled healthor suffering from the effects of overwork and prolongedstrain. Patients who are in actual ill-health or invalids

requiring constant nursing are not admissible, but thosetroubled with minor ailments and who can take exercise are

eligible. No mental cases are admitted or any of an

unfavourable tuberculous character. The home is situatedabove the town of Cannes in the healthiest surroundings.Each inmate has a private room and there are a commonsitting-room and dining room, also a private chapel. The

sanitary conditions are of the best. The medical supervisionis conducted by two British physicians of Cannes each forthree months during the season which extends from Nov. 1stto the end of April, and they give their services gratuitously.There are an experienced lady superintendent and a trainednurse on the staff. Accommodation for 34 ladies is provided.The home does not appear to be as well known or appreciatedas it ought to be. It is entirely maintained by subscriptionsand donations of the British and American residents andvisitors to Cannes. It should only be necessary to make theexistence and purposes of this useful home better known

to the medical profession in this country to insure an

increase in its revenue. There must be not only manyfitting candidates ready to secure its advantages but also

many persons willing to help in so good a work. The benefitsof the home are well recognised by all who are connectedwith it, providing, as it does, a well-ordered residence in theworst months of our climate in one of the brightest andmost favoured spots of the Riviera. The selected inmates

pay their own fares out and home and £1 per week formaintenance and there is no limit to their stay duringthe season. Application should be made to Miss Hankey(H6tel des Anglais, Cannes, during the winter, and ThePalace, Much Hadham, Herts, in the summer), who willfurnish all particulars.

YELLOW FEVER IN CUBA AND ITS MEANS OFPROPAGATION.

Dr. A. M. Fernandez Ybarra of New York has on severaloccasions both spoken and written against the acceptedtheory that mosquitoes are solely or mainly responsible forthe propagation of yellow fever. He has written to us

recently on the subject, taking as his text the numerouscases of yellow fever which occurred in Cuba in 1905 and1906. It appears from statistics quoted by him that the

disease was fairly prevalent in certain districts of Cuba duringthose years, and that a grand total of 89 cases of yellowfever, with 37 deaths (a death-rate of 41’ 57 per cent.),have occurred in the island since the promulgation of thetheory that the female stegomyia fasciata was the sole

agent in the propagation of yellow fever. He further

points out that these cases arose in the western

part of the island, where it is stated that measures forthe extermination of the stegomyia fasciata have beencarried on continuously since Feb. 15th, 1901, while theeastern part of the island in which the deadly epidemic thatoccurred during the Spanish-American war took place andwhere, according to Dr. Ybarra, no vigorous action hasbeen directed against mosquitoes since that time, has beenentirely free from the disease. He gives clinical details ofnine cases of yellow fever, the history of which is, in his

opinion, incompatible with the mosquito theory of trans-

mission. He states that in all these cases except one

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the disease developed after six days’ exposure to the sup-posed mosquito infection, the longest recognised period ofincubation of yellow fever, and that in several of the

cases quoted such infection could not have possibly existed.He asserts that the sanitary authorities of Cuba in their

campaign against the disease relied solely upon the preven-tion of the hatching of mosquitoes and upon such protectionof imported cases of yellow fever as would insure thatno mosquitoes could become infected from them. Generalsanitation was neglected and to substantiate this charge herefers to the report of a commission of medical men sent toCuba by the Nero York Herald to investigate the health

conditions of the island. This commission stated thatsince the Cubans had again come into control of theirdomestic affairs the sanitary state of the towns espe-cially had become very unsatisfactory. Dr. Ybarra isof opinion that for the eradication of yellow fevercleanliness and sanitation are quite as essential as

measures dealing with mosquitoes. Referring to the factsthat the American commission of 1900 adopted the mosquitotheory of the etiology and propagation of yellow fever andthat observations supporting this theory were made inde-pendently in Brazil by the French commission, by theEnglish commission from the Liverpool School of TropicalMedicine, and by the German commission from Hamburg,Dr. Ybarra criticises the manner in which the experimentswere carried out and thinks that the results obtained by allof these investigators are untrustworthy. His article is notwithout interest but will hardly modify the opinions of thosewho have made a study of the subject and have concludedwith the several commissions that yellow fever is propagatedby mosquitoes.

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THE COMPARATIVE EFFICIENCY OF SILVER

NITRATE, PROTARGOL, AND ARGYROL.

IN the Ophthalmoscope for January is published a com-parison of the efficiency of silver nitrate, protargol, andargyrol which has been made in cases of acute muco-purulentconjunctivitis by Dr. T. Harrison Butler at the British Oph-thalmic Hospital in Jerusalem. For many years silvernitrate was successfully employed at the hospital in the formof a 2 per cent. solution, without producing irritation orcauterisation of the lids even in infants. Solutions strongerthan 3 per cent. had a caustic action. In infants the eyewas washed out with boric lotion after the application of thesilver nitrate. Protargol and argyrol were freely used ina 33 per cent. solution, the excess being left in the eye.The solutions were applied by means of small pellets ofcotton-wool held in catch forceps. Drops for home use werealways given, silver nitrate 0’ 2 per cent. and argyrol andprotargol 5 per cent. in strength. Cases were chosen inwhich the disease was in an early stage and the two eyeswere nearly equally affected. One drug was applied to theright eye, another to the left, while the third was given forhome use. 42 cases in which protargol and silver nitrate

were compared gave the following results. Protargol wassuperior in 62 per cent. of the cases, silver nitrate in 10 percent., while in 28 per cent. the results were equal. In 22

. cases protargol and argyrol were compared, when protargolproved to be superior in 50 per cent. of the cases, argyrol in0’45 per cent., an even result being observed in 49’45 percent. The inferiority of argyrol to protargol was so

pronounced that the comparison was not continued,especially owing to the production of great irritation

by argyrol in four cases, a symptom never observed byDr. Butler with silver nitrate or protargol. In 13 cases

argyrol was tested against silver nitrate; in seven of themthe effects were equal and in the remaining six cases argyrol

1 Compare THE LANCET, Feb. 16th, 1907, p. 425.

showed a slight superiority. But in many of the cases inwhich protargol proved superior to argyrol the difference wasvery pronounced. During the summer of 1906 Dr. Butlerused protargol in several hundred cases of the disease andobtained decidedly better results than had been obtainedwith silver nitrate in former years. Thus protargol is a moresatisfactory agent than either argyrol or silver nitrate in thetreatment of acute muco-purulent conjunctivitis, while

argyrol is better than silver nitrate. The application of

protargol causes much less pain than silver nitrate but morethan is produced by argyrol.

THE STARVATION MEAL OF THE INFANT.

THE number of mothers who purchase machine-skimmedmilk for the feeding (sic) of their infants is perfectlyappalling. We have again and again called attention inour columns to this scandalous state of affairs, but stillthis traffic of stunting the growth if not annihilating thelife of the infant altogether continues. If further evidencewere wanting it appears plainly enough in a report recentlymade at the instigation of the council of the British DairyFarmers’ Association by its consulting chemist. The brandsof condensed milk obtained proved to be identical with thosepurchased by mothers for feeding their babes and in everycase the largest sale of condensed milk was for what isknown as machine-skimmed, with at least 70 per cent.

of the fat abstracted and in one case no less than90 per cent. There was a comparatively small salefor condensed whole milk. A little calculation showedthat the purchasers of these condensed milks actuallypay ld. per pint for the skimmed milk which has been con-densed. Dairymen would willingly supply, we should think,perfectly fresh skimmed milk at this price and the additionof from 45 to 50 per cent. of sugar would be unnecessary,and indeed its omission would most likely be in favour ofthe baby’s health and vigour. But skimmed milk, whetherfresh or condensed (and subsequently diluted), is entirelyunsuited for a baby’s nourishment and it is scandalous thatsuch a fact is so widely and persistently ignored. Wewould have all tins of machine-skimmed milk compelled tohave marked upon them by the State in bold plain letteringthe words, UNSUITABLE FOR THE FEEDING OF INFANTS.

NEGLECT ON THE PART OF A NURSE.

A sERious case of neglect on the part of a monthlynurse came before the coroner’s court at Kingston-on-Thames on Jan. 23rd. The deceased, who had had threechildren and was expecting her fourth child in Decemberlast, engaged a monthly nurse named Colson to attend her inher confinement without a medical man. The nurse, in

answer to a question from the coroner, admitted that shehad no certificate of training and had only spent four and ahalf months at York-road Lying-in Hospital. She had been

acting as a monthly nurse for 21 years and had never givenit out that she was qualified nor had she before thisoccasion taken a case without a medical man. Dr.Pattison Armstrong, resident medical officer at the Kingstonworkhouse infirmary, stated that deceased was admittedto that institution on Jan. 14th, having, as he understood,been confined a fortnight previously. She was in an ex-

tremely dirty condition, her appearance evidencing gross andcontinued neglect. She was suffering from severe abdominalpains and abscesses, her temperature on admission being101° F., while she was perspiring profusely. Despite everyattention pneumonia supervened on Jan. 17th and she diedon the 19th. After making a post-mortem examination hecame to the conclusion that death was due primarily to bloodpoisoning following labour and also to pneumonia and heartfailure. The coroner, in summing up, said that a woman