940 ELIZABETH GARRETT ANDERSON : PIONEER.

Poor though this country may be under thestress’ of recent events, we are boundlessly rich incomparison with enslaved Belgium; and we haveevery confidence that once again the medical andpharmaceutical professions of Great Britain andIreland will come to the assistance of the BelgianDoctors’ and Pharmacists’ Relief Fund.

Annotations.

ELIZABETH GARRETT ANDERSON: PIONEER.

" Ne quid nimis."

THE death of Dr. Elizabeth Garrett Anderson atthe ripe old age of 81 years ends a career conter-minous with the entrance of women into the medicalprofession. Elizabeth Garrett was the first. womanto obtain a registrable medical qualification in thiscountry, and although on the advice of the Attorney-General the Royal College of Physicians of Londonat the time " courteously declined " to admit herfor examination or to grant her a licence to practisephysic, she was able to obtain a high medical quali-fication at the University of Paris after havingbeen through the ordeal of an anatomical dissectionheld in public by Professor Broca and his colleagues.Such courage and persistence could not fail of itsreward. THE LANCET was among those who recog-nised at the time that Miss Garrett had "surmountedthe great difficulties which surround the attain-ment of a complete method of education for womenwith singular energy and perseverance, at greatcost, and after long years of arduous labour." The

opening of a dispensary for women and childrenwhere she could put her attainments into usefulpractice followed as a matter of course, since themanagement of no public charity would at thattime have ventured to offer her a staff position.Her return four years later by an overwhelmingmajority as a member of the Marylebone Divisionof the Metropolitan Education Board confirmedher public position. Controversy about womendoctors was set aside to enable the appearance onthe School Board of one whose warm sympathyfor school-children was combined with a practicalknowledge of the means for their physical and mentalelevation. To the present generation the prejudicesof the early "seventies" may well seem to belong toa different world altogether; but the revolution inoutlook has occurred within the span of a singlelife-time, and Mrs. Garrett Anderson’s work wasthe first stage in that medical emancipation of

women, whose far-reaching effect is seen in thework of medical women in the present emergency.Not least seen in the war hospital under the com-mand of Elizabeth Garrett Anderson’s daughter,which is run exclusively by medical women andorderlies.

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THE INFECTIOUSNESS OF TRENCH FEVER.

ALTHOUGH neither the infecting organism northe method of conveying infection has been finallysettled in the case of trench fever, suspicion centresincreasingly round the louse, and thus it comes tobe regarded as possible that soldiers arriving homefrom the Front with infected lice upon them mayconvey the disease to other members of their house-hold. Information on this point is very desirable,and the small committee dealing with the study oftrench fever at the Royal Army Medical Collegewould be glad to know of any cases coming under

the personal observation of our readers. We maywell recall in this connexion that in Professor-G. H. F. Nuttall’s exhaustive study of the louse in theNovember number of Parasitology, it is stated thatunder favourable circumstances lice may even bedistributed by the wind. V. Schilling first made theobservation in 1916, and it has since been confirmedby other observers, one of whom narrates that aftersome unpleasant experience he made it a habit ofexamining lousy men while standing to windwardof them. Information may be sent to Surgeon-General Sir David Bruce at the Royal Army MedicalCollege, Grosvenor-road, London, S.W. 1.

THE CHRISTMAS CALORIE.

THE will to make Christmas a time of cheer inspite of calorific limitations will be a capital accom-paniment to the national. appeal to husband our-

resources. In the knowledge that the observanceof a restricted dietary is furthering the great andhigh aims of the nation, the season should still bemade a joyous one; aware that self-denial means astep to victory the nation will pass through thecustomary festive occasion with light diet but stoutheart. It is quite certain that, as the suggestedallowances stand, no harm, and most likely good,will accrue to the health of the community gene-rally by keeping their bodily needs just withinphysiological bounds. Festive occasions celebratedby hearty feeding and drinking do not, as a rule,leave the individual in a higher state of health.There is nothing at all in the public health returnsto show that any deterioration in the health ofthe public is taking place as a result of foodrestriction. The immediate future does not augurwell for increased supplies, and therefore it wouldbe a splendid patriotic effort if this year the greatChristmas festival were allowed to pass as a dayof determined sobriety and sacrifice. It is to beremembered also that to a large number Christmas-time means some days of rest from toil, and thesedentary life calls for a smaller requirement offood than the restless, active one. There is atthat time less call for repair. The nation mightwell regard the season as a few days off from

routine, which give a relief to taxed energies andtherefore diminish the call for high calorific values. r

SMALL CUTANEOUS ANEURYSMS AS A SIGN OFPREMATURE SENILITY.

, IT is not uncommon to notice in elderly peoplethe more or less insidious appearance on the skinof punctiform heamorrhages, scattered irregularly orwith a confluent tendency, and sometimes associatedwith small angiectases, particularly in situationsmost prone to impeded circulation, such as the legs.The changes in the arterial system and alteration inthe condition of the skin in advancing age are wellknown, but hitherto few observers have drawnattention to the possibilities of changes in the wallsof the cutaneous arteries. Professor Arullani,1 ofthe University of Turin, has made some interestinghistological researches on the skin of personsprematurely old from physical or intellectualoverwork, progressive toxic diseases and variouscachexiæ, and describes marked and constantchanges both in the superficial and deeper layers.Apart from the dilated capillaries which are

scattered at wide intervals on the surface, he foundvarious degrees of dilatation in the lumen of

1 Il Morgagni, Part I., Sept. 30th, 1917.