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or tabes ; one had suffered from an acute syphiliticmeningitis (during which time the Targowla reactionwas positive), while the four remaining were withoutany signs or symptoms whatever. These authorstherefore claim that not only is the parallelism ofthis simple test with the Wassermann reaction suffi-ciently striking to make it of great value, but alsothat in cases of cerebro-spinal syphilis other thangeneral paralysis or tabes it is actually even morereliable. Difficult biochemical and pathologicalproblems immediately arise if these results can berepeated by other observers, but the very simplicityof the reaction certainly seems to warrant its closeinvestigation in this country.

DENTAL PROPAGANDA.

THOUGH pain will often recall the prodigal patientto his dentist, the population at large suffers dentaldisease more or less gladly because it produces nodiscomfort comparable with the harm it is causing.The insidious nature of the damage gives a realand special importance to public instruction on

the care of the teeth. What form this propagandashould take may be in question, but the necessityfor it is beyond doubt. In an address on the

subject at the British Dental Hospital on Oct. 15th,Dr. James Wheatley rightly laid more stress on thecultivation of hygiene than on preventive dentistry,and emphasised the need for providing an incentiveto right living as well as instruction on how to achieveit. Knowledge is one thing, conduct is another. Inparticular, he believes, it is necessary to find anincentive for the adolescent who has thrown off thecontrol of parents without accepting the bonds ofpurpose or of any real object other than pleasure.To excel in sport and to excel in beauty are aims whichcan be legitimately exploited, and it must be moregenerally realised that health is a thing to be proudof and that disease is usually the reverse. Theambitious scheme for widespread propaganda putforward by the Dental Board has already been describedin our columns.l Dr. Wheatley welcomes the actionof the Board as likely to educate the public in oralhygiene, but is concerned that it should fit in withthe general scheme of public health education. Theinfluence of the Board might be very valuable in acentral propaganda organisation loosely attached tothe Ministry of Health which should coordinate andassist the work of the health services and voluntaryorganisations ; but in direct public propaganda itsinfluence would be less useful. Dental propaganda,he considers, should be an inseparable part of generalhealth propaganda ; it must continue over manyyears and can only be effectively undertaken by thosebodies which have access to the homes and schools.Its presentation to the public depends as much ormore upon understanding the mental capacity,attitude, and general environment of the peopleapproached, as upon a complete knowledge of the

science, and advocacy of dental treatment is lesslikely to be suspect to the more ignorant section of thepopulation if it does not come directly from the dentalprofession. Dr. Wheatley again drew attention tothe significant fact that after 50 years of universaleducation 20-70 per cent. of parents refuse skilleddental treatment for their children when it is providedfree of charge, and he suggests to education authoritiesthat they should look upon acceptance or refusal ofdental treatment as evidence of the true success orfailure of the education in their districts.

A MEXICAN PUBLIC HEALTH BULLETIN.

THE appearance of the first number of whatis intended to be a quarterly Bulletin 2 affordssatisfactory proof of the intention of the presentrulers of Mexico not to lag behind the rest ofthe civilised world in matters of hygiene. If the

1 THE LANCET, August 15th, p. 342.2 Boletin del Departamento de Salubridad Publica, No. 1, 1925.

Editorial Cultura Mexico D.F. Pp. 254.

programme outlined in this volume is effectivelycarried out, no easy task in a country with such aturbulent population, it will be a great achievementfor the Government, and in any case is evidence thatin the matter of public health they have high standardsbefore them. With a view to greater efficiency, thedepartment seems to have been more or lessreorganised at the beginning of this year, and nowconsists of the following sections : Infectious diseases;disinfection ; tropical diseases; sanitary engineering;legislation ; demography ; chemistry and pharma-cology ; and food and drinks. It also controls thefollowing services : Sanitary inspection ; the direc-tion of venereal dispensaries ; the institute of hygiene ;the Hospital Morelos (maternity) ; the section ofpropaganda and hygienic education ; the antirabicinstitute ; and the school of health-a sufficientlycomprehensive list of sections. As regards its actualwork, a strong line has been taken with regard tovaccination. Authorised by a clause in the Federalconstitution, the department " established a sanitarydictatorship in the State of Vera Cruz and sent downvaccination brigades " to carry out the law whichnow makes it compulsory on all. The central depart-ment has power to compel the enforcement inindividual States of sanitary measures which are notprovided for by the State laws, and is convening acongress of State sanitary authorities to consider theunification of the whole administration throughoutthe Federation. Besides small-pox, special measureswere taken against cerebro-spinal fever, malaria,rabies, and bubonic plague, whilst it is recorded withsatisfaction that the fight against yellow fever hasresulted in its almost complete disappearance. Thecampaign against tuberculous and venereal disease isbeing actively carried on, and in both cases dispen-saries for treatment are being established. It is ofsome importance to note that apparently in thefuture it will be necessary for those wishing to practisein Mexico to pass examination by the universitythere, but the conditions are not made clear. Themain part of the Bulletin is taken up with the usualreports of the activities of the various departmentsand statistical returns. An unusual feature is a sectiondevoted to sanitary progress abroad, and here theeditors pay a high compliment to England by reprint-ing in full a translation of Sir George Newman’saddress on Public Education in Hygiene, with someshort papers from France and the United States.The volume is well printed and produced. If succeedingvolumes show similar results, Mexico will have noneed to be ashamed of its Ministry of Health.

BEFORE AND AFTER THE PANELCONFERENCE.

THE annual conference of local medical and panelcommittees, of which an account appears on p. 934,was held on Oct. 22nd in London. The impendingshadow of the Royal Commission’s report tended tocool the atmosphere of its deliberations, though hereand there a speech recalled the warmth of a smallermeeting on the day before. A resolution of confidencein the Insurance Acts Committee as the one and onlybody qualified to represent the panel committees tothe Government provoked a discussion from whichit was learnt that all parties appreciated the valueof unity in the profession, and this was reassuring.It would, indeed, be unfortunate if this unity wereimperilled on minor differences of policy rather thanof principle. The policy of the majority is at presentnoticeably cautious, and whatever may be the advan-tages of individual initiative there is no doubt thatUnity is most easily wooed amongst the big battalionswhich she invariably patronises. It was abundantlyclear that the value of personal liberty and the possibledangers of bureauctacy are acknowledged through-out the profession, and if that liberty should bedefinitely and deliberately challenged united actionwould doubtless take the place of the united inactionwhich the majority now desires. The relations of theinsurance practitioner, the Ministry of Health, and

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the law, whilst they deeply interested the PanelConference, did not, however, take up most of itstime. Deficiencies or inaccuracies in the presentmachinery were suitably exposed, and the interestingquestion of collecting statistics was discussed at somelength. It is admitted that the available informationon panel and private practice, its costs, and theirrepayment, is at present deficient, and if a clearercase is to be 1,.--:sented for raising capitation fees andaltering present, conditions it is very desirable thataccurate knowledge should be obtained. In answerto a proposed scheme it was suggested (to misquoteJ. M. Barrie), that the fault, dear Brutus, lay not inour staffs but in ourselves, and it is undoubtedly truethat whatever organisation comes into being for collect-ing statistics must have the real personal cooperationof members of the profession if it is to accomplishanything useful. ----

THE SIZE OF THE THYMUS.

THE real facts about the weight of the thymushave been fairly well known for some time, but thegeneral opinion of morbid anatomists has been always sa good deal coloured by their own experience. Andit is in connexion with the thymus that the rarity ofchances of carefully dissecting the normal human bodysoon after death has been particularly misleading-truly ignorance of the anatomy of the averagepeople who walk about the streets is one of themain obstacles to the further progress of pathologyespecially along statistical lines. In the currentnumber of the Journal of Pathology and Bacteriologywill be found an analysis by Dr. A. B. Bratton ofdata which, collected in Prof. H. M. Turnbull’sInstitute at the London Hospital, probably formas satisfactory a mass of material as can behad. They comprise 337 persons up to 16 yearsof age who died from accidents, burns or scalds,asphyxia, under anaesthesia, or from the imme-diate results of these. In other words, the ordinaryhospital population is excluded, for it is now

realised that it is difficult for a child to get intoa hospital and more difficult for it to reach the post-mortem room without suffering from something whichcauses wasting of the thymus. In line with this,Dr. Bratton shows that the thymus is larger andpersists longer than is commonly supposed. Itincreases rapidly in weight during the first two years,then changes little till the seventh year, when it againincreases to fall slightly after the eleventh year tillthe sixteenth. But more important are two otherconclusions which emerge. In the first place, theweight of the normal thymus at any age is so variablethat it is practically impossible to say in any individualcase whether it is too large or too small. Thus themean weight at 5 years is about 25 g. But thecoefficient of variation of the weights of which thisis the mean is about 35, so that a range from 16 to 34 g.will exclude about a third of the cases, and one cannotsay that any one thymus is abnormally large unlessit weighs fully 42 g. or too small unless it is lessthan 8 g. The second conclusion is that " we knowof no gravimetric evidence that such a condition as, status thymicus ’ exists." It seems time that somecaution should be exercised in finding in a normalthymus a satisfactory cause of a healthy child’sunexpected death. ____

THE LONDON SCHOOL OF HYGIENE ANDTROPICAL MEDICINE.

IT was on August 1st, 1924, that the London Schoolof Tropical Medicine became merged in the newLondon School of Hygiene and Tropical Medicine.At a meeting of the court of governors on Oct. 22ndsome account was given of the present position andprospects of the school. The site for the new buildingis near the British Museum and has frontages onKeppel-street, Gower-street, and Malet-street. It wasbought by the Ministry of Health in 1923 for 252.610,and it is hoped that on the plans of the architect,Mr. P. Morley Horder, the new home of the school

will be ready for occupation in 1928. One cause ofanxiety to the governors has been removed by thegenerous action of the trustees of the RockefellerFoundation, who have amended their original under-taking, to provide a sum of$2,000,000 by promisingto pay z460,830, which is the value in sterling of themoney offered in 1922. By this the RockefellerFoundation has cancelled the loss due to the gradualrise in the cost of sterling which threatened the schoolwith a diminution in the value of the gift of morethan .850,000 if conversion had been made at therate of exchange now established. Concurrently withthe task of preparing for the building, the EducationCommittee and the Director have given considerablethought to the general educational organisation, andthe Board has recognised the necessity for taking earlysteps to secure the services of piospective heads ofdivisions in order particularly to have their adviceand assistance before the details of accommodationin the new building and of its equipment are finallysettled. A grant has been made by the UniversityGrants Committee for this purpose, and in order tosupplement in some essential respects the teachingfor the Diploma in Public Health, which is now givenat University College, Middlesex Hospital, and at theRoyal Institute of Public Health. Arrangements willalso be made for the equipment and organisation ofthe museum, which will play an important part inthe educational work of the school. The Director,Dr. Andrew Balfour, has issued a report on the workof the Tropical Division for the year 1924-25. Thenumber of students was 227, which was a record, andon the research side there have been importantdevelopments. A field station ha been established inSouthern Rhodesia, in pursuance of the view thatavailable research funds shou Id be a ’plied primarily tosetting up field stations, though fxpditionary workmay be undertaken in excepLionni circunances.Four research studentships in London have beenarranged, and the general courses in tropical medicine;and hygiene will in future be spread over 20 WP’.K&bgr;instead of 13, and much more time will be given toclinical demonstiations and to the teaching of tropicalhygiene. There is no doubt that this will equipstudents far more fully for their work abroad, andthat the already excellent reputation of the schoolwill be enhanced.

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SHAKESPEARE AND MEDICINE.

ON the occasion of the first social evening of thesession of the Royal Society of Medicine a very largegathering of members and guests assembled at1, Wimpole-street, W., to hear the President, Sir StClairThomson, discourse on Shakespeare as a guide inthe art and practice of medicine. Having introducedhimself as a lecturer, in a neat and witty speech,the President referred to the remarkable knowledgedisplayed by Shakespeare of the history of medicine,to the references to the status of medicine in his ownday, and to many startling clinical pictures scatteredthrough his plays, and then proceeded to consider inhow much the wisdom of the great dramatist couldassist the doctor as a guide in the practice of his art,for " If our virtues did not go forth of us, ’twere allalike as if we had them not." From a large andbrilliantly compiled selection of quotations we mayselect a few, seriatim, which any modern doctormight study with profit. No finer panegyric of themedical profession could be written than that putin the mouth of Cerimon:-

By turning o’er authorities, I have(Together with my practice) made familiarTo me and to my aid, the blest infusionsThat dwell in vegetives, in metals, stones ;And can speak of the disturbances that NatureWorks, and of her cures ; which doth give meA more content in course of true delightThan to be thirsty after tottering honour,Or tie my treasure up in silken bags,To please the fool and death. Pericles, iii., 2.

It is to be noticed that Shakespeare, in these lines,recognises even in those Elizabethan days of super-stition and wholesale drug-taking the vis medicatrix