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medical institutions the report of the Foundationdescribes some of its biggest individual efforts. AtLyons there is to be a contribution towards the

purchase of land and the cost of construction of abuilding to house the Faculty of Medicine and

Pharmacy, next to the site of the large new hospitalwhich the municipality has been building. At Tokio,the Keio University Medical College has receivedfunds to provide an earthquake- and fire-proofbuilding and for equipment for new laboratories ofhygiene and parasitology, whilst another new under-taking in 1927 was aid to the National School ofMedicine and Pharmacy at Port-au-Prince, Haiti.In this country the work of the Foundation is ofcourse well known. The help given to the LondonHospital and Medical School for the unification of thepathological laboratory and other laboratories of thehospital made it possible to open new buildings notlong ago, and at University College the Foundationhas provided endowment for the increased maintenancecosts in the departments of anatomy, physiology, andpharmacology.

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A CENTENARY AND A CONGRESS IN EGYPT.

THE Kasr-el-Ainy Hospital is one of the manylegacies of Napoleon’s adventure in Egypt, for itwas converted from a palace into a hospital in 1798by his director of medical services, the famous BaronLarrey. Rebuilt in 1812, it later became the firstGovernment medical school in the country, and thecentenary of this school, to be celebrated in December,will be an event of importance to Near Easternmedicine, because King Fuad will then lav the founda-tion-stone of new buildings on Roda Island. Thesewill comprise a hospital of 1500 beds, and largeschools of medicine, dentistry, and pharmacy con-structed to the plans prepared by Messrs. Nicholasand Dixon-Spain of London. This immense medicalcentre is the first item of the Egyptian Government’sprogramme for increasing hospital accommodation,and the centenary celebrations will gain in prestigeand interest from the presence in Egypt of an Inter-national Congress of Tropical Medicine and Hygienewhich is to meet in Cairo from Dec. 15th to 22nd.This congress promises to be exceptionally successful,for nearly 1500 members have already arranged tobe present, and there will be a full week of scientificmeetings. At its conclusion members will be able,if they wish, to spend Christmas at Luxor underconditions which are described as ideal, and we learnthat they will benefit by substantial reductions insteamer passages, railway fares, and hotel charges.The arrangements for travel and excursions havebeen entrusted to Messrs. Thomas Cook and Son, towhom application may be made at their variousofSces; or, if so desired, the committee will under-take this work for members. The secretary-generalis Dr. Mohammed Khalil, who may be addressed atthe Faculty of Medicine, Cairo.

DIABETES AND PREGNANCY.

REVIEWING the results of treatment for diabetic Iwomen who have become pregnant, Mr. A. L. Walker 1says that 19 cases of diabetes mellitus with pregnancyhave been described during the last six years. Thisshows that the condition is very rare, but it is nonethe less important, if only because the recorded casesgive a good idea of the value of insulin. Before thissubstance was available Whitridge Williams collecteda series in which 18 out of 66 patients died duringpregnancy, labour, or puerperium-a mortality of27 per cent. Insulin seems to have changed theoutlook altogether, for Walker states that only oneci the 19 recent cases was fatal, and she had sufferedfrom a severe toxaemia of pregnancy. Furthermore,only two of the other patients seem to have lostground during their pregnancy, and one of thesegot better again later. The flgurea for the children

1 Jour Obst. and Gyn, Brit. Emp., 1928, xxxv., 271.

also show considerable improvement on the mortalityof 41 per cent. recorded by Whitridge Williams. Ifwe add to Walker’s series the case which Dr. N. M.Goodman reports on p. 862 of our present issue, wefind that the 20 women had 23 pregnancies, and that17 children were born alive. There were four still-births and one woman had two miscarriages, so thatthe total mortality of children was only 26 per cent.

These results are so good that the inference mightbe drawn that a diabetic woman runs little risk inbecoming pregnant, and Goodman’s case shows thatthe issue may be satisfactory under conditions whichwould be considered unfavourable. But this inferencewould be wrong, for conception always exposes thepatient to the risk of developing some complicationduring the pregnancy, labour, or puerperium. If thediabetic woman gets any complication she will needmore insulin ; she may be in grave danger of herlife unless the dose is rapidly increased, and onrecovery she may require more insulin than before.Nevertheless, provided the patient and her husbandknow the risk which is being run, there is no reasonwhy the pregnancy should not be permitted. Inconsidering the treatment to be adopted it maybe noted that in two cases the child was deliveredby Ceesarean section so as to sterilise the woman.The question whether sterilisation should be per-formed must be very carefully considered, and itshould only be done at the explicit request of thepatient and husband. Both male and female diabeticpatients often ask whether it is certain that a childborn of a diabetic parent will be a diabetic. So farthere are no data available to answer this question,and it is only possible to express the opinion that ithas a greater chance of developing diabetes than achild of a non-diabetic parent, though it does notfollow that it will do so. None of the children of Mr.Walker’s series had any signs of diabetes at birth,and so far no accounts of their fate have appeared.The various authors who have reported these casesshould certainly report any future developments sothat facts may be available instead of impressions.

HALLOWEEN, 1828.

A-LLHALLows Eve marks one of the most ghastlyof medical memories, for it was on this night a hundredyears ago that Burke and Hare committed their lastmurder. Though the story has often been told,l theoccasion demands a brief repetition. Burke and Harehad a short run of less than a year ; 15 murders werecommitted without suspicion of foul play, but thesixteenth was brought to light, and they and theiraccomplices were arrested and tried for their lives.Hare and his wife turned King’s evidence, Burkewas hanged and dissected. The murders began inthis way. On Nov. 29th, 1827, an old army pensionerdied in Tanner’s-close, West Port, Edinburgh. Hewas in debt to his landlord, Hare, to the amount ofJB4. Hare decided to reimburse himself by selling thebody. It was removed from the coffin and a bag oftanner’s bark substituted ; after the funeral of thebark Burke and Hare went to the University intend-ing to bargain with Monro (tertius). While theywere inquiring for Monro’s rooms one of Knox’sstudents happened to pass by and suggested thatthey should try Knox’s rooms at 10, Surgeon’s-square. This they did, and Knox bought the bodyfor £ 7 10s. Here was an easy way of making money ;too lazy to undertake the hard work of the resur-rectionist, and finding it tedious waiting for anothernatural death at home, Hare suggested enticing theaged and infirm into his house and doing them in.Their first case was an old woman market-fresh fromGilmerton, near Edinburgh. Hare got her into his den,gave her more whisky, and when she was dead drunk,he placed his hands nrmly over her mouth and noseto stop respiration, while Burk laid himself acrossher body to ensure stillness. The body brought j61Q.

1 See, for instance, a leading article in THE LANCET, 1921,ii., 190.