729A NEW NURSING HOME AND CLINIC FOIt LONDON.

TORIES (Albert-street, Camden Town, London, N.W.).The intestinal lubricant, Nujol, which is manu-

factured to a. rigid standard of viscosity, proved tobe correct by exhaustive clinical research, was shownby the representatives of this laboratory, whopointed out that the cost of the preparation has beenconsiderably reduced. Mistol, a combination ofMenthol, Camphor, and Eucalyptol, with a puremineral oil for use in an atomiser or with a dropperfor medicating the mucosa of the nose and throat,was also demonstrated.—EVANS, SONs, LESCHERAND WEBB, LTD. (56, Hanover-street, Liverpool ;50, Bartholomew-close, London, and at Runcorn),made a prominent exhibit of Hepatex, a highly con-centrated extract of liver which is put up in bottlesof 4 oz. containing the equivalent of 64 oz. of freshliver. It is palatable, and it is not necessary to addit to soups or similar vehicles. Another outstandingexhibit of this firm was Quinine and Urethane solu-tion for the injection treatment of varicose veins,while prominence was given to a vaccine for thecommon cold, and to Medisoaps, medicated soaps forskin treatment.-G. W. CARNRICK Co. (Brooks andWarburton, Ltd., 40-42, Lexington-street, London) showed Endocrine products in great variety. Theseare made from the fresh glands of healthy animals, Iand the standardisation and analysis of the prepara-tions are supervised by expert chemists.--THE

BRITISH ALKALOIDS, LTD. (104, Winchester House,London, E.G. 2), again made prominent T.C.P.(Trichlorophenylmethyliodosalicylic acid in H2O) withpowerful germicidal properties, analgesic, anti-thermic, keroplastic, non-haemostatic, non-caustic,non-toxic. T.C.P. B3 Colloidal Emulsion is recom-mended in cases of intestinal toxaemia and its sequelae.Ferro Vitamines, Yeast dried at low temperature invacuum containing all the water soluble vitaminscombined with the polyhalogen : Ferrobromoacetyl-iodosalicylate, also attracted considerable attention.-THE SANDOZ CHEMICAL WORKS (5, Wigmore-street,London) made a special feature of Sandoptal (Iso-butyl-allyl-barbituric acid). This new hypnotic is oflow toxicity and non-irritant, while it is claimed tobe free from dangerous subsidiary actions. Amongother products shown by this firm were Femergin(ergotamine tartrate), the pure active specific alkaloidof ergot of rye ; Lobeline for the relief of graverespiratory troubles of central origin; and Bella-foline, the total natural alkaloids of atropa bella-donna.-DESHELL LABORATORIES, LTD. (Braydon-road, London, N. 16), drew attention to the emulsionof medicinal paraffin and agar-agar, known as Petro-lagar, for the treatment of intestinal disorders,which is supplied in four forms-namely, plain,phenolpthalein, alkaline, and unsweetened.

, (To be continued.)

A NEW NURSING HOME AND CLINICFOR LONDON.

CONSIDERABLE interest was excited in the Harley- street area by the appearance on the morning of IThursday, Sept. 20th, of a large board at the cornerof Devonshire-place and Marylebone-road, announcing Ithe proposed erection of the London Clinic and INursing Home (see Fig. 1) on the site immediatelyeast of theboard. Thearea to becovered(approxi-mately40,000 feetsuper.) isshownbelow(Fig. 2). Thepropertywill be eheld on a

lease fromthe LordHoward deWaldenEstate for aterm of 99years, com-puted fromJuly 6th,1926, at aground rentof £2250, therent fromJuly 6th,1926, toJuly 6th,1927, being£750, andfrom July6th, 1927,toJuly 6th, 1928, £1500. We have made inquiries into thepurpose and scope of the institution, the building ofwhich will cost £300,000, and learn that it is beingestablished as a nursing home with 175 beds for payingpatients. Moreover, the group of consultants, repre-senting various branches of medicine and surgery, whooriginated the scheme have expressed their willing-ness to rent. consulting rooms at the clinic if they are

FIG. 1.

The London Clinic and Nursing Home as it will appear

provided with these rooms and other amenities under! one roof. They will act in consultation with a patient’sown medical man, and if necessary with one another.i In the nursing home there will be suites of roomswith every luxury to meet the wishes of the wealthyclasses, and also rooms where the total charges made

will be based on a scale suitable to patients withmoderate means. It is hoped that it will be foundI possible to take some deserving cases at less than cost.The fees quoted for accommodation in the nursinghome will so far as possible be inclusive. , Space has

been pro-vided forradium,X ray, deepX ray,hydro- anda c t i n o -therapy,and forbacterio-logical,p a t h o -logical,and bio-chemicall a b o r a -tories. Twomedical officers willreside on

the pre-mises. Thefollowingmedical consultantswill act asanhonoraryadvisorycommittee:Dr. H.MorelandMcCrea(chairman),Sir G.

Lenthal Cheatle (vice-chairman), Dr. A. P. Beddard,Mr. W. R. Bristow, Mr. H. D. Gillies, Mr. W. G,Howarth, Mr. H. Tyrrell Gray, Prof. J. W. H. Eyre,Dr. Bertram Shires, Mr. A. H. Levy, and Mr. A.Pallant.

It is hoped that eventually it will be possible todevote a proportion of the profits to the provisionof facilities for research. In the proposed memorandum

730 INSOLATION AND PULMONARY TUBERCLE.

of association Section (6) reads : To provide facilitiesfor the study and prevention of disease and to pro-mote information on medical subjects by lectures, dis-cussions, books, correspondence with public bodiesand individuals or otherwise, and also to encouragethe study and prevention of disease, and for thatpurpose to make donations on such terms and condi-tions as may from time to time be prescribed of aprize or prizes or other rewards or distinctions.

FiG. 2.

Map of neighbourhood showing position of the new building.

The Financial Side.The company has a capital of £250,000, which is

to be subscribed privately.From the figures set out in the prospectus, which have

been based on an 85 per cent. occupancy, we gather thatthe estimated revenue from all sources is £118,700, and theestimated annual expenditure £85,000. This would leave anet income of £33,700 which would be subject to income-taxand would be available for dividends on the £117,500preference shares (7 per cent.) now to be issued, andthen for distribution of dividends on the ordinary sharecapital of £125,000, and for contributions to researchand to a reserve fund. An insurance scheme has beenarranged for the completion of the purchase of the build-ing ; after the expiration of 25 years a sum of £15,300,comprising the annual interest and premium charge, willbe added to the profits, which, according to the estimates,would then represent approximately 41 per cent. of therevenue.

Shareholders in the company will be provided withforms of recommendation in proportion to theirholdings. Other considerations being equal, patientsso recommended will as far as possible be givenpriority of admission.

It is not stated what fees it is proposed to charge forbeds, and whether medical and specialist services areto be included or to be arranged separately. Manyother questions will suggest themselves to our readersand will doubtless be answered shortly by a moredetailed account of the scheme than is available in theprospectus submitted to us.

MANCHESTER ROYAL INFIRMARY.-The governorsof the East Lancashire Homes for Disabled Sailors andSoldiers have resolved to hand over Grangethorpe Hos-pital as a free gift to the Manchester Royal Infirmary oncondition that the institution remains an orthopaedic hospitalfor the treatment of ex- - ervice men referred there by theMinistry of Pensions. The chairman of the infirmary hasaccepted the gift on behalf of the board of management.Grangethorpe cost ;Ell,OOO in 1918, and it is stated thatsince that date the Government have spent sums amountingto £100,000 on the erection of wards and reception huts inthe extensive grounds for the patients. The date on whichthe Ministry of Pensions will relinquish control is not yetfixed.

Correspondence."Audi alteram partem."

INSOLATION AND PULMONARY TUBERCLE.

To the Editor of THE LANCET.

SIR,—From the letters of " M.R.C.S. " and Dr.F. R. Walters on " insulation in pulmonary tuber-culosis (THE LANCET, Sept. 15th, p. 580; 22nd,p. 630), it is not quite clear what they actually meanby this term. If " insolation " means exposure tohot summer sunshine in ordinary clothing for anylength of time, such as the usual sanatorium middayrest hour, I am in complete agreement with them aboutits dangers. When a patient has an unexpectedevening temperature in the summer time, it has longbeen my custom to ask if he has been sitting in thesun for any unusual time. My own pulmonarypatients are not allowed to be in the sun for theirrest hour, unless actually carrying out heliotherapy.

It would appear, however, that some confusionexists between the effect of " insolation," as definedabove, and the effect of properly conducted helio-therapy. The one is undoubtedly often harmful, theother has proved in my own hands of undoubtedbenefit. In those cases in which fever can be con-trolled by rest, heliotherapy can generally be employedwithout any of the ill-effects usually ascribed to it.The one great precaution, as with any treatment, isadequate control. The explanation of this apparentcontradiction in the effect of sunshine is probablythat in the one case the body is grossly overheated,exposure being followed by depression and even

reactivation of disease ; in the other the body is keptfrom overheating by the cool circulating air (orpreferably wind), exposure producing a sense of well-being apparently followed by increased resistance.

Whilst heliotherapy is little used in other sanatoriafor pulmonary tuberculosis in this country, the useof powerful carbon arcs in small ill-ventilated andover-heated rooms is fairly common, a method oftreatment perilously akin to " insolation." I shouldlike to take this opportunity of emphasising theimportance, when administering any form of lighttreatment to pulmonary cases, of proper pulse andtemperature records, before and after exposure, andof avoiding sweating. When carefully administeredand controlled, I believe that both natural andartificial light play an important part in the treat-ment of pulmonary tuberculosis.

I am, Sir, yours faithfully,J. E. WOOD,

Medical Superintendent, King George’s SanatoriumSept. 26th, 1928. for Sailors, Liphook, Hants.

SUPRARENAL APOPLEXY.

To the Editor of THE LANCET.

SIR,—In your annotation last week on a paper byF. Pearl and H. Brunn it is stated that " any combina-tion of symptoms may form the clinical picture, butasthenia is the most constant and characteristic of allsymptoms." The subject is discussed fully in myrecent book, " Fever, Heat Regulation, Climate, andthe Thyroid Adrenal Apparatus." where it is shown,with references to the literature, that the condition isfrequently associated with a sudden pyrexia. Thecondition then simulates an acute infection in itssymptoms, and if the patient dies in that condition ithas frequently been wrongly diagnosed as such-e.g.,purpuric small-pox, scarlatina. Sometimes the fevermay subside, to be followed by a subnormal tempera-ture and asthenia, or the asthenia may be the firstsymptom which has been noticed.

I am, Sir, yours faithfully,London, Sept. 28th, 1928.

yours faithfully,

W. CRAMER.