36

apparent effects of nutritional and morbid disturb-ances upon the rhythm of growth. For example,a group of 40 stature graphs from a small rural schoolin Cardiganshire showed a curious broken line indicat-ing first normal growth, then a check, and later asteady and continuous resumption. Inquiry suggestedthe explanation that a number of children came toschool from such long distances that they could notgo home for dinner, and that the adverse effect ofthe lack of a proper midday meal was not imme-diately apparent but was later reflected in stuntedgrowth. In the interim a scheme was started forproviding such children with a hot midday meal ;the stunting was checked and normal growth ensued.

TREATMENT OF NÆVI

ALMOST all dermatologists would agree withE. H. Molesworth that vascular nsevi should bedealt with at the earliest possible moment. It istrue that spontaneous involution sometimes takesplace, but this does not happen often enough to

justify a policy of laissez-faire. The question remains,however, What should be done to them ? In thiscountry the carbon dioxide pencil is the favouriteweapon, and after a little experience such treatmentcan be safely employed for naevi of all but the largestand most deeply situated cavernous types. It istherefore somewhat disturbing to find Molesworth

advocating radiotherapy as preferable to freezingfor all radiosensitive tumours ; that is to say, pre-sumably, for all those that are still growing-a pointwhich may be hard to decide. He himself prefersX rays to radium, but apart from other considera-tions this has the objection that the infants maybe thoroughly frightened and struggle. In earlycases, he says, the dose required is never more

than a normal tolerated skin dose, but he does notexplain what happens if this proves insufficient.Does he repeat it, or does he resort to other methodswhich may include CO2 or diathermy Those whohave seen some of the late results of radium treat-ment applied for relatively trivial conditions inthe early days of its discovery will be inclined

perhaps to deprecate the views set out in this

paper.For the cavernous naevus, G. B. Dowling’s method

(recalled by Mr. A. P. Bertwistle on p. 22 of our

present issue) deserves extended trial. He injectsthe ordinary quinine urethane solution in commonuse for varicose veins in a dose of 4-5 minims ateach session. "The needle is passed in near thebase of the nsevus and about a minim is injectedin three or four places... the immediate effect isan apparent solidifying of the whole naevus. In a

fortnight the lesion flattens down somewhat.... Itis then treated in the same way again, selectingparts which appear to have been unaffected by thefirst treatment." Three or four such applicationsmay be required, but when he described the methodin our columns in 1929 Dowling cited five cases inwhich he was satisfied with the results, and the onlycomplication reported was a little sloughing. A weeklater Mr. Eric Lloyd wrote urging the surgical excisionof cavernous naevi at the earliest possible moment ;but not everyone will agree with his’statement thatthe removal of a nsevus is " one of the most

satisfactory little operations in the surgery of child-hood." Any loss of blood, such as is inseparablefrom an open operation involving the removal of avascular tumour-not to mention the dangers of

anoesthesia-ought to be avoided at these very early

1 Med. Jour. Australia, 1933, ii., 217.

ages if other and harmless methods of treatmentare available. -

The suggestion (by no means, original) put forwardby J. K. Friedjung 2 to vaccinate with calf lymph atthe margins of the growing nsevus need not be seriouslyconsidered in these days of surgical asepsis. It is a

procedure which courts infection as a method of cureand cannot be recommended in any circumstances.

PROFESSOR COSSAR EWART

James Cossar Ewart, whose death is announced,.was an authority on many branches of zoology, andan important experimenter in animal breeding.Originally educated with the intention of enteringthe profession of medicine, he graduated as M.D. inthe University of Edinburgh, and for a period heldthe position of demonstrator of anatomy in the-medical school. A series of studies at diverse univer.sities, English, Scotch and Continental, was followedby his appointment to the chair of natural history inAberdeen, and later, about 50 years ago, to theposition of Regius professor of natural history inthe University of Edinburgh. This chair he heldfor 45 years. His researches in ichthyology gainedhim his first wide recognition, and having started asmall marine station near Aberdeen, he became a.

member of the Fishery Board for Scotland, andorganised. and carried on scientific work in thisconnexion for ten years. Later he carried on investi-

gations into various fishery questions in the UnitedStates, Canada, and Scandinavia. To medical men,Cossar Ewart’s work on breeding and in-breedingwere of closer interest than his studies of fisheries,.and on hybridity and the phenomena of telegony he.wrote in 1889 an informing book, entitled thePenicuick Experiments; Penicuick being the property-attached to his residence in Midlothian. For Prof.Ewart there was no such thing as telegony, thephenomena which appear to be of that nature heexplained as being really due to ancestral traits

arising in the offspring. But in writing on the subject,he gave fair play to both sides, even while alluding tothe " damnable iteration " of Lord Morton’s experi-ment with the Arabian mare and the quagga. Prof.Cossar Ewart was prominent also in the field of

geology, and indeed was in the great Scottishtradition of the general man of science.

The death is announced of Prof. Swale Vincent,which occurred on Sunday, Dec. 31st, at his home inSt. Albans, in his sixty-sixth year. He was professorof physiology in the University of London for ten

years, 1920-30, and had made original studies of theprocesses of secretion.

2 Wien. klin. Woch., Dec. 15th, 1933, p. 1520.

PREVENTIVE ASPECTS OF MEDICINE.-This serieswill be resumed at King’s College Hospital on Jan. llthat 4 P.M., when Prof. R. Tanner Hewlett will speakon the prevention of diseases conveyed by food. Sub-sequent lectures will be as follows: Jan. 18th, Prof.Major Greenwood on epidemiology and its lessons ;Jan. 25th, Dr. R. A. O’Brien on the control and preventionof infectious diseases ; Feb. 1st Dr. F. J. Poynton on theprevention of rheumatism; Feb. 8th, Dr. A. S. MacNaltyon the prevention of tuberculosis ; Feb. 15th, Sir CharltonBriscoe on the prevention of respiratory infections ;Feb. 22nd, Dr. J. C. Bridge on the prevention of occupa-tional disease ; March 1st, Dr. S. A. Kinnier Wilson onhow to live the life of modern times ; March 8th, Dr.A. Douglas Cowburn on preventive medicine and the law.Dr. C. B. Heald’s lecture on the value of sport and exercisein the prevention of disease has been provisionallypostponed until March.