UNt6N292S"6

THE JOURNAL OF THE BRITISH MEDICAL ASSOCIATION.

Including an- Epitome of Current Medical Literature.WITHrf SUPPLLEMfE4NT.

No. 357 1. SATURDAY, JUNE 15, 1929. Price 1/3

~~JjPOPUL'I

CONCEALED CONSTIPATIONi]Half the constipation in the world is never recog- unpleasant symptoms of constipation-headache,nized. So long as some measure of intestinal malaise, lassitude, etc.-are produced. It iselimination occurs daily, it is commonly assumed surprising how promptly and completely thesethat in this department of physiology all is well. symiptoms are cleared up by a regular morningYet the degree of coitcealed constipation may be glass of Eno's "Fruit Salt" taken before thepronounced, and the large bowel may never be early cup of tea.

up, and the intestina iciouss clrcle bthus set As is generally known among medical men,diminishingly responsive and progressively atonic. binoatsion ofalkalies withcafuiltlyacbildnded iom-The functional interrelation of the body's whole absolutely free from such nauseating mineraleliminatory chain is such that intestinal stagna- purgative salts as the sulphates of soda andtion causes a general hold-up of the scavenging- magnesia. It contains no sugar or added flavour-processes even in the remotest tissues. It is ing agents, its palatableness being due to itsprobably thus, ratther than through direct absorp- physical texture and the uniforni solubility oftion of toxins from the intestines, that most of the its graded particles.

"The Doctor's Emergency/ Remintder."T¶le Proprietors of Eno's " Fruit Salt " will deem it a privilege to send to anv meniberof the Medical Profession a copy of the latest addition to their series of " MedicalReminders "-with or without a bottle of their preparation (Handy or Household sizes*gTeqiuired). " The Doctor's Emergency Reminder " summarises briefly a few points inconnection with the treatment of.poisoning and various other emergency cases. It isbound in black niotooco jimp -eo conform to the style of the previous publications in

this series.

J. C. ENO LTD., 160, PICCADILLY, LONDON, - W.1

ISSUED WEEKCLY]- -- {OOPVRIT-. --]----REGISTERED AS A NEWSPAPER

JuN1 15, rg929] MEMORANDA -Tf trt nsu 1077_~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ,-lA- OUU

floor of tlw aperture, entering aind leaving the seroussurlface al)lpproximately a quarter of ain inch from thlemiarginis of the ulcer. The remiiaininig snittires O(ctlpy p)OSL-tioiis a little to the gastric and duodenial sides of the ulcer,anid iii each case the ends of the stitehes are grasped bv

aIni' of lighit forceps. The effect produced is that ofani arclhway of sutures placed in the lonig axis of the gLutaIn extendfing oni each sidlc for at Ieast tkhrec-qcuarters ofani illII bevolnd tlhe ulcer cavity.A lon, oniantal stranid, of niot too slenler f)Joportionl,

is niow sought out and a fine sutur e passed thlroucgll itsextremity. Forceps readily draw the sutnire and onmentunthrough the arelway, anid the tip of the str-and( is finallyanclhored by a couple of stitches to the serous aiid miuscularcoats ini the region of the l)ylor'ic aiitrium. The suturi-esforminig the ar-chway are now tied off; those beyond themarngins of the cavity are firm-ly kniotted, whilst quiite afair degree of tension can be placed uipon the stitchestraversinig the crater since the omnentuni belhaves as a softresilienit cushiion, which prevents the catgut from cutttingthroughi tlhe rigid tissues.Wheni it has been established that the new attachiiient

of the omiz'ntum has left no loop which iiiiglht stranlgulateai segment of tlle intestine, the gastric clamp is reiimovedalld the abdominal contents are re)laced, The peritonealcavity is gently swabbed until it is fair-ly dcl, anid if per-foration has preceded operationi by a lonlger- period th.antwelx-e hours suprapubic drainage is inistituted, otherwisethe incision is simply closed in layers.

Oni theoretical gr-ounds it muight be argueid that thismetlhod should niot succeed, silnce it stranigulates tIme omen-tumiii over an are.a where infection- is distinctlv liable, andhence tlhit sloughing anid reopeninig of the crater siouldbe time outcome of the procedure. In no instance, however,has this aecident occurred, anid an op)portunlity was givenfor observing the late results of the operation when apatient, wh-'io had been operated on- two years previoIllv,underweent laparotomy for cholelithiasis. In this case thleuilcer seemned to be completely liealecl, the diocleilnum ex-hiihited little evidence of scarring, anid was mnerely thick-cuied somiiewvhat over the por'tioIn of the outer wall wi-herethe omenlturni had beeni applied. Loca-l adhesions wereconspicuous bv their absence.An imminediate mortality of 17.6 per cent.-nine ca,ses

out of a groulp of fift-y-one-hlas already becnI admIlitted illan earilier section of this p)aper, aniid calls for some furtherexplanation. In onie instaniee o1lv did death occur wlheoperlation followed withiln twelve hours of peiforation. Illtwvo cases from sixteen to eighteeni hour.s lhat( elapsed,w-hilst ill two others there was an int:ervcuing period ofmore thani twenity-four hours. T'je re-.ainiinmg fatal caseswere not operated upon until mtlore thiani forty-eight hoursafter pwiforation, when well-marked peritotnitis was alreadyesta'blislhed.

- tentranba:MEDICAL, SURGICAL, OBSTETRICAL.

FRACTURE OF ANTERIOR ILIAC SPINE.TME fo1loWing case seems to be worth recording sinc-e Ican fild onil one reference to this cndition in the litera-tuie at mu (disposal-faname1y, in Wilsoni and1 Cochrane'&sFractoires undI Dislocatiosns, 1929.'A strong youing man, aged 19, had been practising for some

sports, and had taken part .in putting the weigltt and hiigh aadlong Jumping. He then tried a hundred yards sprlint, but aftertiavelling some seventy-five yards he felt "somethilLg give," anidhad severe pain in the groin, causing him to fail. HI-e was raisedto his feet, but could not flex the right thigh.Whlen examined he was found to have perfect passive moveenieiit

of the knee and 'hip, but hyperextension of the thigih producedsliglit pain in the right groin. On walkinig he *had to drag theright. limb forward, being unable to ilift the foot off the floor,itntess by great effort. On deep palpation over the anterior part,of the iliac crest, something was felt to slide backwa,rds anidfo.rwards, anid as the anterior superior spiiie was ill defined, thediagndsfs of -avulsion of the anterior superior iliac spine by thes.artoxius mutscle wa made. 'This was confirmed the following dayhy an ?-Srav examination, wh4n the spine w4s found to be lyingabout ojet ineh below its normal situation withi the patient in theeciUnibent p6sition.

Thie, initerest of this case seems to lie in the fact tlhat thepatieIlt W-.is usin'gfli sar-toriuis to a less extenit whilerunniniirg tflan while luiig jtumping, etc., aiid secondly inthe comparative rarity ofi a fractured anterior sulperiorspine by inidirect -iolellce.

(Ci.iwtserit. JAMNIFS CR AW\FORD, M.B., Clu.B.Edl.CE1RVICAL SUBLUXATION FOLLOWING

-ANNAEbSSTHVES-L.TiiE follo-linlg (c1as`e seeims of' suifficient initer-est to wi-arrantrecording.

La,st lFeruary tlle )atienlt, a uil age(l 9, was, operated oniin hospital undi(ec-r general anacstlheili. WhIenl, 1he1 parnentstooklieu holime thev tated tfaiat her- hlcad( wa;is twiiste(l and

sttick to' onCe side.' She wais talven to on1e of tite RoyalNational Orthlopledic Cllinics (operated in conljiuinctionI wl-ithi'~~~~~

Before operl tion. Aftcr operation.

..-....X..^.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~...... 11|Il ...

B3efore operation After operation.

...

loc'l authzorities) and onl excamun'itionl it n-a.s seenl tInt hverheaWd wras bent towzards; thelekft shoulder andl the faceetwi.sted towards the left side. The( righ,lt scalene4 wertep>rom iiient and spalsmodlicall,y conltracted, the right and lrftsterno-rnastoids prom7inenxt, though relaxed, anle the? childcoultd not movXe her head. She complainedt of a dragginigpain radiating tow.awds 'the left shoulder. Stereosco.icx-rayz p3hotographs; w-ere mWadle, but they- affordled nso helpin diagnlosis. A tenltativ-e di.agnoais of a subluxuatedicervical. vertabu'a was madle, and tElechlild admitted to thlecountry branchX of the hospiotal at Stannhore.At the operatioe, which watsp'rforned si neek.s after

the onsset of thle sy-mptom.s, thie headl was foundle to be fixedin. thle deformed position, a transverse p)roces.s on the lesft.si(le beinlg;Ilunusually prlominent. On palpation of thlephauynx. a halrd bony- mas.s w^a.s felt prlojectin1g l)osteriorlyanid to the left, at about thle levecl of thle top) of thle lefttonlsillar fo.ssa. Reductionl wsas attem-lptedl by extenlsionand( man1iplauttion, w0ithl capparent success. There was no0'clickv," prtobably) owngils to the l)iesence of adlhe.sionRs and

to thes leni'thl of timle tha<t hadsc elapsedl, bult after theull}?litillthe bjony mas.s felt l Eellcrl ;s l

medlian inl paseitton and( nlo longer l)romniwnslt. The chlild.hasl. regainedl a fuxll ianlge of mov-emenlt., withlout de:formlity.

1 ihate to thlank D)r. C. W\. Dulrward for excellent photo-}.raphs of thle paltienlt, taken before and after operation.alN.. J. B. BRNE.TT, F.W .S.

R-l -t nal Orthiopaedlic HSospital.Stanmore.

1102 JUNSE 15, 1929] UNIVERSITIE5S AND COLLEGES. THE BaInsu

service. The univerisal senise of loss whlicll is felt ilEasthbournie is a testimiiony to the service lhe gave inpJractically every direction. Besides the ianypl)eo)lCe w-liolave lost a great friend, the towni as a whole is in mourin-i,ig for the death of one of its most active aild uisefulc'i L izens'.

WA-hile at Bart's Harding was a renowned Rugby foot-l)aller, and in his time played also for Middlesex anidElngland. His initerest in spor't did niot enld wh-lien lhesettled in Eastbouine. He was on thle committee of theE'ast)ourne Ciicket and Football Club for manyav years, andlacted for a time as its treasurer; lie was aldso iiifltieitialin resuscitating Rugby football in Eastborirne. The highre(rardt in wlich his colleagues anid fellow students h-eldl lhillmmaV be juidged fronm the fact that he was the only countrygeneral piactitioner who took the chair at a St. Bartholo-meOw's Hospital past anid plresent dinner. The seriolusepidemic of inifluenza during the past winter- claii2medl himas one of its victinms; he never thoroughly recovered frohis attack, anid died of heart failure.

W. G. W.

SIR WVILLIAM FAIRBANK, K.C.V.O., M.R.C.S.,Honorairy Suirgeon-Apothecary to ils Majesty's Houselhold at

Windsor.17 regret to record the death, in Ihis seventy-ninth vear,of Sir 'William Fairbanik, which took place oni Juniie 10tlh athiis homne at Windsor.

After receiving his early education at the Forest School,W'althanistow, Williamii Fairbank enltered, in 1868, as amedical studenit at St. Bartholomew's Hospital, where lhewas dresser to Sir Ja.mes Paget; in. 1872 he obtained theLicenice of the Society of. Apotlhecaries, and was admiittedaimember of the Royal College of Surgeon's of Englanld inthe following year. In 1875, hav-ing completedI ani al)l)point-muont as resident medical officer to the Royal Albert Inifir-mary, Wigan, he wenit as house-surgeon to the Rotun(taHospital, Dublin, and in 1877 became a licenitiate in mid-wifery of the Royal College of Physicians of Trelaiild. In1880 he was appoinited surgeon-apothecary to QueeniVictoria's Household at Windsor, and surgeoni to Prinice andPrinieess Christiani, in place of his elder brother, Dr.Thomas Fairbank, who lhad just died suddenlV. He tllebecame in turn surgeon-apotlhecary at Windsor to QueenVictoria, to King Edward, and to Kinig George.

Sir William Fairbank held a number of hospital an-dpuiblic 'appointments. For many years lhe was suigeoni tothe M indsor Royal Infirnary, being at the time of hisdeath honorasry consulting surgeonl to its sutccessor, theKing lEdward VII Hospital; lhe was local conisultin'g physi-cian to tlhe Royal Ventuor Hospital for Consumption chair-man and president of the Royal Albert Institute at

ill(nsor; examiner, and, for thiirtv-nine year.s lettirer, tothle Order of St. John of Jerusalefib; a member of theBerkslhire Counity Council, anid from 1919 to 1920 muayorof Windsor. In recognitioni of hiis maniy seervices bIe w-ascreated M.V.O. in 1911, and promaoted C.V.0. in 1921 anidK.C.V.O. in 1924. In 1921 Fairbank was a mueilber of the(lelegationi of British mayors who visited the devastatedareas of Franlce, and after WVindsor had adopted Harder,ourt-auix-Bois lie raised funds for the reconstrtuetioin of the-illage, whichi afterwards he visited every year. In appre-ciation of hlis efforts the inhabitanits of tihe v-illage reniamedafter him their square and maini street.

Sir William Fairbaiik married in 1879; le is survived bytwo sons and tlhree daughters.

Dr. JOHN BROWN, who died n-ear Capetowni on May 7tl,in his eighty-sixth year, received his iimedical e(lucationat Aberdeen Uniiversity, where he graduated M.D. (withlionours) and C.M. (higlest honours) in 1863. After s,pend-ing ten years in Wvynberg, Cape Colonv, where he btuiltuilp a .successful. practice, he returned to Edinburgh, andbecame demonstrator in anatomy at the Unii ersitv. In1877 hte toc,' the diploma of public healtht, Cambridge,-nd in 1878 the Fellowship of the Royal College of Surgeons;of England, and a degree in public -health at Edin-buri gh).,W1e are indebted to Dr. Athelstane Nobbs for the follow-ilng

appreciation: So xwell eq.nipped was John Biown thiat lieighlt successfullyx lave invaded Charlotte Squiare, or cormie

Souith to the puhilieus of Cavendish Square, but hie electedto work amoing the workers of Lancashire, and becamejunior partner to a Dr. Briggs in Burnley. In due coursele became the senior partier when a certain brotherAberdonian, one James Mackenzie, became the junior-Bitown being the surgeon, as it were, annd Mackenzie thephysician of the partnership. There can be no doutbt thattile man who later was to become the acknowledged i-masterof the science of cardiology benefited by this early, collabora-tion, and to the end Sir James Mackenzie, as hie became,and his old seniioi, whose partner hie had been in Burnleyfor twenty years, vere thie closest friemids. Joliii Browni,wiho, by the way, was a cousin of his namesake, the authorof Bab atid His Frientds, hlad marri-ied a dauighlter of aformer Premier of Cape Colony, and( when he. retired fromnp)ractice, shortly after the Soutl African war, r'eturi-nedto thie Cape, but never to idleness. He leaves behind himthe miiemiiorv of one of God's good men, absolutely straighitainid humii-ane, a schlolar void of pedantry, withi the capallehiands of thte ideal sur-geon.

UNIVERSITY OF OXFORD.AT a congregationi held onl June 8th the following medlicaldegrees were coniferred:D.M.-G. I. Evans.B.M.-R. M. J. Harper, D. C. Shields, M. V. Bhajekar, II. G. W ells.

UNIVERSITY OF CAMIBRIDGE.DR. R. A. WEBB lhas beeu appoinlted Uniiversity Demonistiadtor inPathology, anid Messrs. G. Anrep anii( H. E. Tunnicliffe UniversityDemonstrators in Physiology.At a conigregationi held oll Jnue 8th the (legree of lBachelor or

Medlicine (M.B.) was conferred on R. Gallimore.

UNIVERSITY OF LONDON.THE following candidates have been approved at the examinationiudicated:THruD M.B., B.S.-*iC. F. Cosin. *-I[E. A. Hunter (University medal),*IA. L. Light, * sIE . G. M. Palser. *IIS. F. Russell. *1H. A. H. Selbourne.

*IC. H. W. Wheaton, Lucy E. Arthur, Mabel A. Baker, C. G. Bowen,Annie G. Busher, E. C. B. Butler, Alison Al. Clarl, Rosa 0. J. Clark,S. L. A. Clarke, Joan C. Clatworthy, F. S. Cooksey, IHilda C. Dean,C. G. de Couilliard, V. P. de Zoysa. C. J. Donelan, D. L. Duinnill,Dorothy V. Dunolly, A. M. Easton, A. C. Elkin, C. N. Evans,G. S. Ferraby. Kathleen E. Gamlbrell, I. Gordon, D. P. Gray.Bridget S. P. Gturney, C. E. Hagenbach, Emil M. Hall, H. N. W'.Harley. R. L. Harward, F. F. Hellier, C. F. Howes. E. C. H. Huddy,W. F. Hudson, H. E. Janres, P. Kaplin, D. W. S. Kayo, H. J.Krichefski, S. C. H. Lane, A. J. C. Latchmiore, I. B. Limiibery,G. H. Livingstone, W. S. McConnell, J. V. Macgregor, M. L. MistriAnna P. Montgomnery, Jocelyn A. M. Moore, Joyce Morgan, D. T. R.Morris, C. B. Nicholson, C. G. MacM. Nicol, C. G. Paine, Keren I.Parkes, G. C. Pether, A. P. Petigura, C. B. Picken, Betty J. W.Pilsworth, G. L. S. Pluiibly, H. W. A. Post, I. Preiskel, K. H.Pridie, E. I. Puddy, W. G. Richards, Marjorie E. Roberts, 1. Al.Robertson. B. D. Robinson, Janet M. Rocke, A. P. Ross, A. S. D.Russell, Beatrice A. Savill, J. E. Schneider, E. M. Sharples, D. Shaw.C. G. Sinclair, N. Sinnadurai, E. J. J. Smith, P. A. MI. Soutter,3. B. Sugden, A. R. Thompson, F. S. Tlhornton, Decimiia M. Tracey,Frances J. Vinter, Nora W. Wamsloy, A. J. Watsotn, S. A. Wickrama-singhe, P. Wiles, W. A. Wilson, A. Wiseman, E. A. W ood, Joyce Ri.Woods, Mary Worthington, T. C. Yip, 11. A. Young.Group I.-Ellen M. Barnes, J. N. lBhada, C. V. Bloom, Wl'. E. R.Brauch, Eileen A. Chennell, Mlabel J. Cooke, W. V. Crluden,Catherine Day, R. F. Fidler, Alice -E. N. Gilby, D. It. (irifflth,

E. Grundy, F. B. Gusterson, CT. F. Harrison, E. P. Hewlitt,J. F. L. King, G. Lee, Dorothy M. Lufkin, Dorothy F'. McIntosh,T. H. Negus, A. T. Pagan, L. M. J. A. Pilot, J. C. Saldanha, C. P. Scott.Mary Scouloudi, Mary H. Sharp, R. Shelley. A. G. Signy, MarjorieV. N. Sudds, K. G. Sugden, C. B. V. Tait, L. E. Vine.Groiep Ir.-A. M. Boyd, Bertha A. Briant, Lilian P. Edwards,

H. K. Evans, R. Evans. B. M. Fonseka, Ruth C. Galletly, V. F. Hall,Margaret L. Hamaburger, G. B. M. Heggs, R. A. Iing. K. E. Lane,L. P. E. Laurent, A. Levy, F. J. G. Lishmiian, E. W. Martindell,R. Oliver, B. Purvis, Sylvia M. Ransford, J. A. Robson, R. C. N.Shires, W. D. Steel, S. A. Underwood. E. MI. Wijerama,m N. Ri. W.Wynn-Williams.

* Honours. 1 Distin-uished in Mledicine.I Distinguished In Forensic Medicine. 1! Disting'uisihed in Surgery.I Distinguished in Midwifery.

UNIVERSITY OF DURHAM.ON Junie 5th the Duke of Northiuniberland wvas inistilled asChalncellor of the Uiiiversity of Durham, in successioII to the lateEarl of Durham. The flrst part of tite cerenrony was hleld inthe qtuadrangle of Durhanm Castle, where the Vice-Chancellor,Sir Thomas Oliver, M.D., conferred uiponi tihe Dulike the (de(ree olD.C.L. by dipIoma ai'id installe(d himi in office. After a thankls-givinig service in the cathe(dtal, wheni 61i ac1ddress was given b1 theBishop of Durham, coInvocation was resumnie(d in the ChIapter lIonse,where the new Chancellor contferred houorary degrees upou a

JUNE, '5, 1929] MEDICAL NEWS. TBRBtmrnu 1103

LM In

inumber of distingiuishedI persons, including the Presidlent of theRoyal College of Physicians of Londona and the Presidenit of theRoyal College of Surgons of EuglauA, who each received thedegree of D.C.L. ir John Rose Bradford vas preuented byProfessor Situart McDonald (Dean of the College of Medicine) andLord Moynihau by Professor Grey Turner. The degree of D.Sc.was conferred on Lord Rayleigh, Emeritus Professor of Physis inthe Imperial College of Science, anid on Dr. C. Tit Regan,Direclor of the Natural History Museum.

ROYAL COLLEGE OF PHYSICIANS OF IRELAND.DR. DaIxis JOHN COFFEY, Presidenit of the Irish Medical Council,Presidenit oF Uiniversity College, Duiblini, andcl Vice-Chancellor of theNational Uniiversity of Irelanid, has been unanimously electedl anhoniorary Fellow of the Collefe.The following canidi(lates, liaving passed the exauminiationi for the

Membership, were ditly admitted as Licentiates in MTedicine andMembers of the College: J. Lait and(I F. MacSorley.Re portshave been received from therepresentaitives of the College

oni the Irish Medical Council aud on the Genieral MledlicAl Couniciloni. the recent procee(liugs of those bodies.

at a_-

THF Williamn Mackenzie medal for 1928 for originalcontributions to ophthalmology of outstanding merit has been

awarded to Mr. W. S. Duke-Elder of Londloni. The GlasgowEye Infirmary, the custolians, have made the award oni thea(lvice of a comnmiittee representative of the University of

Glasgow, the surgeons of the Glasgow Eye Infirmiiary and ofthe Glasgow Ophthalmic Institution, and the Fellows of the

Royal Faculty of Physicians and Surgeons of Glasgow.PROFESSOR GREY TURNER, M.S., F.R.C.S., professor of

surgery in the Uiniversity of Durham, is taking charge ofthe teachinig in the suirgical unit of St. Bartholomiiew's Hos-pital, in place of Professor Gask, -for a fortniglht from Junie10th to 22nd. It will be remembered that on forner occasioinsProfessor Harvey Cushing of Bostoni, Professor fugh Cabotof Ann Arbor, and Lord Moynihaii have acted in a similar way.THE third annual MacAlister Lecture of thie Lonidon Clinical

Society will be delivered at the London Temiiperaniec Hospital,Hamnpstead Road, N.W.1, on Thursday, June 20th, at 8.45 p.i.,by Sir Humphry Rolleston, on "Medical frieindships, clubs,societies." The lecture is open to all iedeclical practitioniers,wlho are invited to bring their friends, ladies or gentlemlen.The honorary secretary, Dr. F. Temple Grey, 86, HarleyStreet, W.1, will be glad to be notified of those wlho proposeto attend.

A COURSE of instruction in the technique of tissue culturewill be given at the Strangeways Research Laboratory from

-July 9th to August 10th. Only a limited number of applicantscan be received. Notification from thOse wishing to take thecourse should be sent, not later than June 30th, to Dr. H. B.Fell, Strangeways Research Laboratory, Cambridge.THE summer nmeeting of the Section of Otology of the

Royal Society of Medicine will be held at Cainbi-idge onJune 21st and 22nd. A cineraatograph demnonstration of aprostateetomy, a litholapaxy, and an internat urethrotomywill be given at the sumnmer meeting of the Section ofUrology on June 27th, at 8.30 p.m.A MEETI'N4G of the Biochemical Society will be held at the

John lunes Horticultural Institution, Merton, Surrey, to-day(Saturday, June 15th), at 11.45 a.m. The subjects on whichcommunications will be made include: carbohydrate meta-bolism in avitaminous birds, absorption of liquid paraffinfrom the alimentary tract of the rat and pig, the associationof vitamin A activity 'vith carotene iu the carrot root, andthe nature of the vitamin A constituent of green leaves.THE annual meeting of the Incorporated Lancashire and

Cheshire Society for the Permanent Care of the Feeble-minded will be held at the Sandleari(dge Instituition,Alderley Edgp, on Fridlay, June 21st. The chair' will betaken by Sir Lewis Beard at 3.15 p.m.THE annual meeting of King Edward's Hospital Fund for

Loindon was held at St. James's Palace on June 11th, thePrince of Wales presiding. In the course of his address HisRoyal Highbness read a message from His Majesty the King,expressing delight at the response which had been made tothe recent appeal for funds, and stated that dulring 1928 theamnount distributed had for the first tiime reached a total of

£ 5̂0,030. Loans of radium, bought with Sir Otto Beit's gift,had been niade to twenitv hospitals, on the principle thatthere should be a few hospitals with a sufficient supply to actas radium centres, and a rather larger number with enougyhra(liutn to provide effective treatment. Thie Prince paid

trib)ute to the generosity of the British public, wlicIl in tlhe3course of a single week contributed the money required for

the radium side of the Thank-offering Fund. An account ofthe proceediugs of the meeting will be given in next week'sissue.A CROWDED congregation, consisting largely of patients of

the late Dr. R. E. Ingram-Johnson, filled the parish church ofSouth Moor, Durham, on June 2nd, when a brass tablet to hismemory was unveiled by Sir Thomas Oliver, Vice-Chancellorof the University of Durham. After its dedication by theRural Dean, Sir Thomas Oliver addressed the conaregatiol,paying a special tribute to the unselfishness that had alwayscharacterized Dr. Ingram-Johnson. Sir Thomas spoke inwarm terms of the friendship between themn, and mentionedthe regrelt he had felt -when Dr. Ingram-Johnson decided togo out to India and later to Malaya. There he had devotedhimself particularly to the problem of malaria, and had con-ducted researchi which led him to the belief that treatmenltwith the serumii of deDgue fever cases had a definite curativevalue in malaria. Dr. Iugram-Johnson, who died in May, 1928,was a strong supporter of the British Medical Association.THE Fellowship of 'Medicine and Post-Gradiiate Medical

Association has arraniged two lectures for candidates for theMI.R.C.P. examination, one by Dr. H. Gardiner-Hill on Ju-ne18th, and the other by Dr. Harold Pritchard on Junie 21st,at 8.30 p.m., at 11, Chandos Street, Cavendish Square, W. Afree lecture on the aniagaement of patients suffering fromcaucer of tlle breast will be given on J-uLe 18th, at 4.45 p.m.,by Dr. Hernaulan-Johlluson, at the British Institute of Radio-logy, 32, Welbeck Street, W. There is one week left of thefollowing courses: in oplhthalmnology, at the Royal West-minster Ophtlalmnic Hospital, in diseases of the chest, atthe Victoria Parlk Hospital, Victoria Park, E., in gynaecologyat the Clhelsea Hospital for Womnen. Fromii Junie 24tlh to 29t liani all-day cotarse in proctology will be givel at St. Mark'sHospital for Diseases of the Rectumn; lee £3 3s. From June24tlh to July 6thi the Norths-East London Post-Graduiate College(Prince of WVales's Getneral Hospital, Tottenham], N.) hlasarranged an intenisive "refresher " course in nmedicine, sur-gery, annd the specialties, fee £5 5s. or £3 3s. for either week.Also beginning on .3-uiie 24tlh and continuing unitil July 7th, theChildren's Clinic, in association with several other lhospitals,will give a comprehensive course of instrLuCticn in diseases ofchlildren andl infants; fee £2 2s. Copies of all syllabuses,the complete list of special courses for 19, information ongeneral post-gradnate workc, and specimen copies of the Post-Gradu&ate 3Medical Journat, may be obtained from thesecretary, Fellowship of Medicine, 1, Wimpole Street,London, W.1.

WVs are in.ormed by Sir James Barr that the followingnamiies are to be added to the signatories of the letterpublishel on May 11th (p. 879) in support of the testimonialto Sir Ronold IRoss: lProfessor Umberto Gabbi (Turin), Pro-fessor C. Savas (Athens), Dr. Anton Breinl (Townsville)- andProfessor C. Schilling (Berlin). A list of contributors to thefund was printed in our last issue (p. 1065). Donations shouldbe senit to Lloyds Banik, Ltd., 110, High Street, Putney,S.W.15, cheaues to be crossed "Ross Award Fund a/c."THE Medical Research Council, after consultation with the

MHinistry of Health and the Board of Education has appointeda committee to inquire into the prevalence and mode of spreadof minor epidemics in residential schools, especially thosebelieved to be spread by "droplet infection," and to reportupon the means by which thevymay be prevented or restrieted.The personnel of the committee is as follows; Sir GeorgeNewman, M.D. (chairmnan), Dame Janet Campbell, M.D.,Dr.- R. H. Crowley, Surgeon Coml;mander S. F. Dudley,Dr. J. A. Glover, Professor M. Greenwood, F.R.S., Dr. L. t.Lempriere, Miss E. M. Newbold, M.A., and Professor W. W. C.Toplty, M.D., with Dr. Joyce Wilson as secretary.IN conitinuation of the series of visits to famious buidings

in aid of King Edward's Hospital Fund for London, arrange-ments have been milade for parties to visit tlhe Foreign Office,India Office, and Admiralty on Saturday, June 22nd, at 2.45 p.w.On Friday, July 19th, at 4.30 p.m., a party will be conductedround Westminster Abbey, and on August 9th and 21st, at2.30 p.m., visits will be pai(d to the Tower of London, whenMr. Walter Bell will give au address on the Tower and itshistory. Tickets, price 7.s. G., can be obtained on applicationto King Edward'aHospital Fundlfor London,7Walbrook, E.C.4.AT a meetinig of the Central Midwives Board for England(I

and Wales held oln June 6th, with Sir Franjcis Champneys inthe chair, a letter was read fromn the towvn clerk of York,su-ibmittitng a scheme of lectures to be delivere(d at YorlkMTaternity Hospital by Dr. A. M. Hughes and Dr. Lister.The scheleme Nvas approved.

TiImJ Medical Rescarch Council announce that oni belalf ofthe Roclefeller Foundation they have miiadle the followingawards of travellin! fellowships for the aca(ldoic year1929-30: Olive Btirton Buckley, B.M., M.R.C.P., Kilng'sCollege Hospital, London ; George Alecl Ciocker Gougl,B.Sc., Ph.D., National Institute for Medical Research,

1104 JUNE 15, 1929) LETTERS, NOTES, AND ANSWERS. [TIEMEDICAJU.

London; William Robert Henderson, M.B., Royal Infirmary,Eclinburgh; Donald Hulnter, M.D., F.R.C.P., assistant phy-sician, Londotn Hospital; George Eric Lewvis, B.A., M.R.C.S.,London Hospital; Moses Myer Suzm-an, M.D., M.R.C.P.,College of Medicine, Neweastle-upon-Tyne; Janet MariaVauglhan, B.A., B.M., University College Hospital, London.These Rockefeller medical fellowships are awardedl tograduates who have had some training in research workeither in the primary scienees of medicine or in cliniicalnedicine aiid surgery, and wlho are likely to profit by ap)eriod of work at a chosen centre in America or, in specialcases, in Europe, before taking up positions for higher teach-ing or research in the British Isles. Dr. Gough's felloWvshipis tenable at the University of Munich; the others at centresin the United States. Dr. Lewis has been appointed onmlodified conditions while receiving emolumnents from anothersource.ON JuLne 10th, at the Tower Bridge Police Court, a man

charged with obtaining mnoney by false pretences and withiinteDt to (lefraud, pleaded guilty and was sentenced toimprisoninent for three mxionths in the second division. Onl)ehalf of the Plharmaceutical Society of Great Britain it wasstated that the accusedl, lhavinig represented himself as afully qualified chenist, obtained the post of manager toa cheumist's shop. In substantiation of hiis claim he hadproduced a certiflcate under the Act which, though genuine,had been altered by the substitution of the accused's lnamefor the one it; bore originally. The accused, in the course ofa statement, sai(d that since lhe lhad manaled the slhop lhe haddispensed 50,000 prescriptions, and there lhad never been auytrouble and everything had been in order.THE; niinth annual congress kcnown as t}e Joinrn6es

M6dicales de Bruxelles wvill he held at BrnsSels ruoiniJune 22nd to 26th, under thie presidency of P-rofessor HenryCoppez. Addresses will b)e delivered, among otlhers, byEmile Sergent of Paris, Blurn of Strasbouri, Nordlenison ofUpsala, tipillmann of Nancy, Putti of Bolo-na, Fromiment ofLyons, Eastmuan Sheahau of New York, Goniin of Lausanne,Hymans van den Bergi of Utrecit, anld Tricot-Royer ofAntwerp. The opeining (discourse will be given by tImeParisian oto-rhino-larysmgologist, Dr. Nepveu, wiho is wellknown in tte literary world, as Liuc Durtain. The subscrip-tion Is 75 francs. Further infornmation can be obtained frointhe genieral- secretary, Dr. R. Beckers, 62, Rue Froissart,Brussels.DR. G. WAYLAND ANCRUM of Gloucester and Dr. Richlard

Davies of Chieltenham have been appointed to the Commissionof the Peace for the county of Gloucester.

All communications in -regard to editorial business shoulld beaddressed to The EDITOR, British Medical iournai, BritishMedical AssociatI@on House, Tavistook Square, W.C.I.

ORIGINAL ARtTICLES anld LETTERtS forwarded for puiblicationare understood to be offered to the British Mledical Journalalone unless the contrary be stated. Correspondents wvho wishnotice to be takcen of their communicationis slhould authenlticatethjem witi their names, not inecessarily for publication.

Authiors desiringa REPRINTS of their articles publislhed in theBritish Alcdic(il Joutrnial must commuinicate witlh the FinancialSecretary and Business MIanager, Britislh Mledical AssociationHouse, Tavistock Square, W.C.1, on receipt of proofs.

All commtunications witlh reference to ADVERTISEMENTS, as wellas orders foi copies of the Journal, slhould be addr-essed to theFinancial Secretary and Businiess Manager.

Thle TELEPHONE NUMBERS of the Br-itisht Medical Associationand the IBitish Aledic(ll Journlal are AJUSEUAI 9861, PS62, 986$,and 9S64 (initernal exchange, fouir lines).

The TELEGRAPHIC ADDRESSES are:EDITOR1 of the Britisht Jlcdical Journal, A itiology Westcent,

FIN-ANCJAIL SECRETARY AND BUSINESS MANAGER(Advertiseinents, etc.), A ?ijinlate Wcsitrciit, LonJdo.t

M1EDlCAL .SCUE:ltUTA tY, Alrdisecra Wcstcciut, Lo,,ldon.Thje addr ess of the lirislh Ofice of the British Medical Association

is 16,- Soiitlh Frederick Shect, Dublin (lelegrai's Bacillus,Dublin; telepsonie 62550 Dublin), anid of the Scottish Office,7, 1)D"ru5lietiihl Gardens, Edinbnirhli (telegr anms: Associate,Edini brttuah1; tciepliouie 21361 Eel iunirgt).

QUERIE3 AND ANSWERS.

UN1B1ILICAI. DISCHARGE.INV. D." vrite3: Can anyone sugigest the cause o0 ani occasionialdischaarge from the uillmi)ilicus int a.vom-m of 32 ? The di(seiageis seroiis in charaicter, and occuirred first at abotit thie a(-e of14 years, and(i reappealred about thiee years ago.

WATKER SOFTFNEB.,'S.MEMBER OF FOwIrTY YK:ALS' STANDING " asks wlvetlier it is a(lvis-'a)Je to use for the wvhole of the wvater supply (Kentisl lhardwater) to his.house onie of the water softeners oni the market.Is tets softetned water palatable, and(i does it conitaini any substanjceilnjulliolus to lealttl ? Is ntiy one method of softening speciallyrecomm-lenided ?

INCONniM.- TAX.Appointmenit.: Wlhether Liable to Tlx.

..I. P." fir-st commence(d earning a salar in September, 1926,as all assistanlt, and his earniings lave beeni as follows:

September, 1926, to Decemiiber, 1926 ... £69Year to December, 1927. ... ... ... ... ... 231Year to December, 1928 . .. ... £290Three months to April, 1929 ... ... £109

lTe intqniires wle'ether lhe is liable to assessment, alnd as to whliatstops lie shidoltl( take.

** He is liable as follows:For the year 1926-27: £69+one-quarter of £231-that is, £127-exempt.For the year 1927-28: three-quiarters of £231+oue-quarter of £290-

that is, £245-£618s. tax.Forthe year1928-29: three-qtiarters of £231+ one-quarter of £290-

that is, £215-£6 18s. Lax.In explanitationi of the abbve the basis of assessmeut vas thectiurrent year's earninigs up to 1927-28 ineltusive, and afterwardEthe previous year's earninlgs; inl calcutlatinig the tiax payable onilyearni-ed inicomie relief and-tihe £135 personal allowanice have beenideducte( any life assuiranice relief would reduice the tax paya-blestill fuirther. It will p)robably be best for "W. 11..P." to getin touchi witlh the local inspector of taxes aiid make hiis formilal*returns.

Change of Einployment."R. C. F. S." was actinig as a general assistanit to.December 20th,

1927, and( became a schlool nie(dical officer undi(ier a pu-llblic authorityas from Janiary 1st, 1928. Whlat is hiis correct basis of assess-wienit for the year to April 5tlh, 1928?* * The actuial amounit of hiis earninlgs for that year. Whtere

a sulbstantial chanige in tlhe niature anld coniditiotns of the em)ploy-ment takes place, as las occurred lhere, the correct mietlhod is toregard the former employmenit as lhaving ceased anid a niev onieas la*vinig comimiienCe(l. The facts do niot justify a claim toconltin-iuity of employmenit.

LETTERS, NOTES. ETC.

THE COCKTAIt, HABIT IN FRANCE.IN our issue of Janullary 5th (p. 31) we nioted Professor IV. E. Dixon'swarninlg abouit the inijutrious effects of cockltail ad(liction ; recenitlya simtiilar deniunciationi lhas been madle at the Acad6niie de M6de-cine by Professor Georges G(ullaini, wvho occufpies the clhair ofnervouts diseases in the Paris Facuilty of Medicine. BSefore thevar, lie states, this practice, importedl from America, had beencotnlined to cer-tain sections of Frenichl society, particularly iracinig,literary, andt dramatic circles, but lately it hias become prevalenitamulonig the well-to-do classes genierally. The cockltail -bar is tobe founid not otnly in lhotels and restaurants, but eveii in thelhomes of the richi. Furniislhing firms make it their businiess tosupply more or less eleganit bars suitable for drawitig roons,eveni for motor cars, whlile special lhampers containing theingre(lienits anid( uitenisils uised in the pireparation of cocktails areoni sale everywvhere. As ini this coutntry, the' principal victiintsof the hiabit are- youing meni and women of the " sniart " set, anidamonig them Professor Giuillaitn lhas often founid obvious signis ofclhroniic alcoholismii. Commonlly miiet witli are digestive disturb-anIces, mauiifested as loss of appetite, Iihyperchlorhydrlia, pyloricspasm, congestioni of the liver, anid &iteritls, anid suchl circulIa-tolry symptoms as tachycar(lia, precordial paiin, andi( a tend(lencyto syncope. The most importanjt dlisorders, hiowever, are refer-aide to theniervous system, anid inclu(de i:nlsomllia, phyli)sical andpsychical astlieniia, depression, anid disincliniationi for nienltilworic. in several inistanices epileptic attacks, attribuited to tihecoclctail habit, hlave occurred for tle first time in indivi(dtuals of-25 to 35 years of age. Professor Guiilaii urges that young peopleof the wealthy classes shlould be enlightened as to the disastrotfseffects of cocktail drinking, both oln their owtn plhysical aunmiienital equilibrium aud oni that of their descenidants.

VOTES FOR EPSOM COLLEGE.DR. BERNARD ROWLANDS (LoidIOnll, N.15) writes: I appeal oni belaLlfof Johni Horace 'Brockman WIhite to aniy wlho have votes forEpsom College. Conitemporaries of hiis fatlher, Chtirles Powell-Vhite, M.A., M.D.Camb.,' F.R.C.S.Eng., vho klefheimai agoo(d surgeoni anid researchi worker, wvill regret to kniow that thisalppeal is nlecessary.

VACANCIES.NOTIFICATIONS of offices vacant -in universities, medical colleges,and of vacant resident and other appointmeints at hospitals, wllbe found at pages 41, 42, 43, 47, 48, 49, anid 50 of ouir advertisementcolumns, and advertisements as to partnerships,assistautships,.and locumtenencies at pagets 44, 45 ande 46.'. . .A short summary of vacant posts notified in the advertisemeu6

columns appears in the Supplemenlt at page 235.