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decorated than in any of the other wards of thehospital; but he rightly goes on to suggest otherpossible explanations of this observation-e.g.,coincidence, the tact of the sister-in-charge, thepride induced by living in a show ward, and so on.Moreover, the effect of suggestion cannot be over-looked ; a patient with neurasthenia lost his head-ache after living in the purple room in which hehad been told that his headache would disappear.The same thing would possibly have happened if thepresence of venetian blinds or the smell of hyacinthsin the room had been the curative factor emphasised.We agree with Dr. Snowden’s conclusion that ahappily decorated hospital must be a more cheerfulplace to live in than one that is decorated with theusual dull colours chosen for utility and economy;but much more evidence of the curative value of aparticular colour scheme is required before anyconclusion can be drawn upon its merits.

DOES EPIDEMIC INFLUENZA AFFECT THELOWER ANIMALS?

IN former days there was a general impressiorthat influenza when epidemic in man spread tcsome of the lower animals, such as the horse, foiexample. In more recent times this view was considered to be untenable, and it has to be admittedthat little evidence of any scientific value has eveibeen brought forward to support the contentionthat any of the domestic animals were susceptibleto the disease. During the course of the presentpandemic the question has again been raised,chiefly in the lay press. A Central News message,published in a London newspaper on Nov. lst,1918, from Johannesburg, mentioned that " anextraordinary development

" of the influenzaepidemic, then raging in South Africa, had beenthe excessive mortality that had occurred amongthe African monkeys. Reports from areas in whichthese animals abounded stated that the monkeyswere " dying in hundreds," and that in some placeswhole troops of baboons had been found dead, theresult apparently of " pneumonic complications."These statements were supplemented by the CapeTown correspondent of the Times on Nov. 5th, whosaid that influenza had spread to baboons, of which alarge number existed in the kloofs and hills aroundMagaliesburg, in the Transvaal. These animalswere " dying in scores " and their dead bodies werebeing found on the roadsides and in the vicinity ofhomesteads, the epidemic having apparently ledthem to forsake their usual haunts. Recent experi-ments in France, conducted by British researchworkers, have proved that influenza can be trans-mitted to monkeys by the inoculation of infectivematerial; so that it may be concluded that theseanimals are susceptible to the disease, but whetherthey can contract it also in the natural way is notyet clear. Reports from Canada, at the end of 1918,stated that woodmen employed in clearing the bushin Northern Ontario had observed an unusualmortality among moose, and this they believed tobe due to the current influenza epidemic. TheTimes of Jan. 10th supports this statement and saysthat in Northern Canada influenza was "deci-mating the big game," and that for some timesmaller animals had also shown marked symptomsof the disease. The Times of Feb. 20th contains acommunication from its correspondent at Butte,Montana, mentioning the fact that the YellowstoneNational Park, in which bison, elk, and otheranimals are strictly preserved by the United States

i Government, had been " swept by an epidemic of. influenza," and that already 31 "buffaloes" " had, been found dead as a result. On March 10th it was, reported by the Times that a veterinary surgeon atKirkby Stephen, who was inspecting officer for theWestmorland County Council and for the Board ofAgriculture, had lately observed an epidemic illnessamong sheep in the district, and that he had

diagnosed it as " influenza"; it was also stated that

I this veterinary surgeon during his 30 years of pro-fessional life had never, till now, met with an out-break of a similar kind. Several flocks were at

I present affected, and many sheep had died as aresult of the epidemic.

It cannot be said that in any of the above-mentioned instances have definite proofs been

I brought forward to show that these outbreaks werecaused by epidemic influenza. It is difficult tounderstand how wild animals like the moose orthe bison could primarily get infected by influenza.With domestic animals it is conceivable that theycould get infected by their human owners or otherpersons attending to them. It seems desirable that,when suitable opportunities occur, some carefulinvestigation of alleged outbreaks of influenza inthe lower animals should be undertaken, and espe.cially of such occurrences among domestic animalslike the dog and the cat, which are in more intimateassociation with 6man. Such investigations mightsettle the question, once and for all, whether thelower animals are really susceptible to influenza,and whether, if attacked, they are capable of trans-mitting the infection to man or to other species ofanimals.

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FEEBLE-MINDEDNESS FROM TWO STANDPOINTS.SOONER or later, it may reasonably be anticipated,

a Ministry of Health will take over all the powersand duties of the Local Government Board, the-Home Office, and the Board of Education, in regardto lunacy and mental deficiency. When that timecomes there will arise some pretty problems in

harmonising the practice of the different depart-ments. As an illustration there may be taken thedifferent attitudes adopted by the Local Govern-ment Board and the Home Office towards the lessmarked degrees of mental defect which are coveredby the term

"

feeble-mindedness." Under theLunacy Act, 1890, certain classes of lunatics, notdefined exactly but in practice comprising thequiet and harmless insane, together with imbecilesand idiots, can be received into workhouses bymeans of a much simpler procedure than applies inthe case of asylums. For detention two medicalcertificates and an order under the hand of a

justice are required, but the justice need not seethe patient if he does not think it necessary,and the order is valid, without renewal,for an indefinite period. Following out thisprinciple of imposing less exacting conditions inless marked cases of defect the Local GovernmentBoard, through the instrumentality of orders madein 1897 and 1911, allows feeble-minded personsunder the age of 21 and chargeable to Londonparishes to be received into the institutions con-trolled by the Metropolitan Asylums Board withoutany order made by a justice, if an applicationsupported by the guardians’ medical officer is madeby their clerk. Under the Mental Deficiency Act,1913, the tendency is to increase the stringency ofthe conditions regulating admission to an institu-tion as the intellectual status of the patient rises.The feeble-minded person, like the idiot or

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imbecile, may be dealt with either by means of anorder made by a justice, after the presentation ofa petition, a statement of particulars, a statutorydeclaration, and a couple of medical certificates,or, if below the age of 21, as the result ofan application by his parent or guardian. Inthis latter case, however, there are required notonly two medical certificates but also two certifi-cates by " a judicial authority." The contrast inmethods does not end with the reception of thepatient. Cases under the Mental Deficiency Acthave to be seen from time to time by visitingjustices, reports about them have to be sent to theBoard of Control, and, generally, they are responsiblefor the consumption of much paper and ink. LocalGovernment Board cases carry on quite satisfactorilywithout these refinements. There is no authorityfor their detention-they simply stay. It is ratherstriking to find in one institution and in the sameward of the institution two patients of similar typeyet under such diverse conditions. We are not, atthe moment, concerned to point the moral, but thesituation is worthy of the attention of those whomay have to reconcile the vagaries of the lawrelating to mental defect.

INTESTINAL ENTOZOA AMONG THE NATIVELABOURERS IN JOHANNESBURG.

THE South African Institute for Medical Researchhas recently published an interesting report byMiss Annie Porter, D.Sc. Lond., parasitologist tothe Institute, entitled " A Survey of the IntestinalEntozoa, both Protozoal and Helminthic, ObservedAmong Natives in Johannesburg from June toNovember, 1917."

1 The natives employed inJohannesburg are gathered from various parts ofAfrica, including the East Coast, Cape Province,the Transvaal, Basutoland, and Natal, and amongthem infestation by endoparasites, both protozoaand helminths, is common. As many as six kindsof parasitic organisms have been found simul-taneously in a single intestine. The parasiticprotozoa found in the stools of the nativesinclude Entamaeba histolytica, Giardia intestinalis,Trichomonas intestinalis, and Chilomastix mesnibi ;the first of these is associated with amoebicdysentery and the last three with various flagellatediarrhoeas; and Isospora bigemina, which can

cause coccidial diarrhoea. Entamceba coli and

Spirochteta eurygyrata are very widely distributedparasites; they have long been habituated to lifein the human intestine, but nevertheless it hasbeen found that they multiply more abundantly inan unhealthy intestine, and their presence in largenumbers may serve as an indication of intestinaldisorder. Miss Porter regards the number ofinfections with E. histolytica as some index of thenumber of sporadic cases normally present amonga population living under normal conditions; andalso as an indication of the possibilities of amoebicdysentery occurring in epidemic form should con-ditions of living lower the standard of health nowprevailing. It is suggested that under less favour-able conditions it is possible for diseases, now rela-tively quiescent and sporadic, to become fulminatingand epidemic. The main modes of transmission ofE. histolytica to man are by direct infection of foodand water and indirectly by the agency of flies.Carriers of cysts are serious sources of danger topersons with whom they may associate. The same

1 Publications of the South African Institute for Medical Research.Edited by W. Watkins-Pitchford, M.D. Lond. No. XI. Pp. 58. 5s.

remarks apply to such parasitic flagellata as

Giardia intestinalis, Trichomonas intestinalis, andChilomastix mesnili, each of which is capable ofproducing flagellate diarrhoea; each of them alsois difficult of elimination from the alimentarytract when once established there. Distressingdiarrhoea in adults and some forms of "green"or infantile diarrhoea in Johannesburg have beentraced to the presence of these parasites, andwith their elimination by treatment the diarrhoeahas ceased. There is a possibility that manyobscure intestinal troubles, difficult to deal with,may be due to these organisms. Natural reservoirsof these flagellates are found in such domesticvermin as rats, mice, and cockroaches, whoseexcrement may infect cereal or farinaceous food.The other source of infection is the cysts voided inthe stools of human carriers. The danger from thepromiscuous habits of some of the natives isevident; they may by their evacuations con-

taminate water and foliage, as well as afford oppor-tunities for transmission of infection by flies.Helminthic infections are widely distributed

among the native workers of Johannesburg ; eosino-philia and anaemia are common results of worminfestation, and generally lower the vitality of theinfected person. For eliminating worm infec-tions it is necessary to inculcate sanitary habitsnot only as regards the preparation of food butalso with respect to the disposal of excrement.Numerous cases of infestation by Taenia saginataand T. solium were detected arising from the eatingof imperfectly cooked beef or pork. The disposalof infected human excrement containing tapewormeggs should be effected in such a way that no con-tamination occurs of herbage on which pigs orcattle may feed. By preventing the developmentof tapeworm eggs into bladder-worms in pigs andcattle, the development of tapeworms in man isrendered impossible. The presence of Hymenolepsisin man is the result of defective protection of foodfrom contamination by rats and mice, the fleasinfesting these animals conveying the bladder-worms to human food. Nematode infections in thenatives were common, especially ankylostomiasis ;Ascaris lumbricoides and Trichuris trichiura werealso found frequently. A few cases of trematodeinfection were discovered-namely, Schistosomamansoni. Miss Porter concludes her paper bysaying that ".No animal parasite is entirely harm-less to man," so that neither protozoon nor helminthcan be disregarded.

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AN Inter-Allied Conference of Red Cross Societieswill shortly be held in Cannes to consider theprogramme of a meeting to be called at Geneva 30days after the signing of peace, for the purpose ofextending the scope and broadening the basis ofRed Cross work throughout the world. A number

: of important medical and surgical questions willcome up at the Conference and require expert

.

discussion; among those who have placed theirservices at the disposal of the British Red CrossSociety for this purpose are Sir Arthur Newsholme,

: Sir Ronald Ross, Sir Robert Philip, Dr. F. N. Kay-

Menzies, Dr. F. Truby King, Sir Walter Fletcher,l Sir Leslie MacKenzie, Colonel S. Lyle Cummins,. and Colonel L. W. Harrison. As was pointed outI by Sir Arthur Stanley in an address given before’’ the Brighton Division of the British Red Cross

Society on March 14th, wherever distress and.

suffering exist there the symbol of the Red