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the normal, and at Newquay 5’0 in., or 1’2 in. 1more than the normal. In the Midlands the :fall generally exceeded the average, although insome localities rain was less frequent than in the.south and south-west. At Nottingham there wereno more than 14 days with rain, against 20 inBrighton and Torquay, but the total fall, 3’64 in.,was an inch above the normal. At Buxton, wherean average October gives 5’4 in., last month yieldedno more than 4’6 in. On the Continent the weatherwas generally much less rainy than in this country..At Berlin the total fall was 0’6 in., at Brussels1’4 in., and at Paris 1’8 in. In the southerncountries there were a few heavy local falls, butthe general character of the weather was dry andbright. In these islands it is now far too late forthe total duration of sunshine for the year to

equal the average, but last month did its best hereand there to make up the deficit, although itsbest was not very striking. At Kew the totalnumber of hours of bright sunshine was 97,an excess of only 3 hours on the average, but inmany places the deficit grew even larger than atthe end of September. At Brighton the total ofiit iluujL’s wetti 13 ueurs less tnan Liie normal, anu III rthe Midlands and north of England the weather was 0mostly less bright than usual. At Nottingham, the ttotal sunshine, 76 hours, was 17 below the normal, and Eat Harrogate, where the figure was 67 hours, it was r28 hours less. On the extreme south-western coast tthe sky cleared more frequently. At Torquay the zsun shone for 113 hours, about the average figure, (and at Newquay for 122 hours, an excess of 11 hours Aon the average. Jersey was brighter than any place (farther north, having the good total of 147 jhours against an average of 127 hours. Absolutely Isunless days were not often experienced in anypart of the kingdom. At Kew there were only 4,and in the Midlands 6, 7, or 8, while on the southcoast there were only 2 or 3, and at Newquay notone. At Jersey, however, there were 3 sunless

days. At Kew the brightest day was the 31st, whenthe sun shone during seven hours, but over thekingdom generally the maximum amount of sun-shine was recorded on various dates-mostly afterthe 15th. Some places on the south and south-westcoasts had between 8 and 9 hours on one day, and afew between 9 and 10 hours. Compared with thesouth and south-west of these islands and Jersey,Paris was dull. On 5 days the sky was overcastthroughout, and the aggregate amount of sunshinefor the month was no more than 106 hours, or 41hours less than at Jersey and 16 less than at

Newquay. ____

THE ANTHRAX COMMITTEE.

AN opportune announcement was made at the Iclose of last week by the Home Secretary that hehas appointed a committee of nine to inquire intothe dangers from infection by anthrax in thevarious processes incidental to the wool and hairindustry, and to consider and report upon anyamendments to the existing regulations which maybe desirable. The chairman is Sir Thomas Whittaker,M.P., and the committee contains representativesof the more important interests affected, suchas the Bradford Chamber of Commerce, theBradford Trades and Labour Council, the NationalUnion of Woolsorters, and the Bradford andDistrict Wool Top and Noil Warehousemen’sUnion. The medical and scientific representationalthough small, is extremely efficient. It is certainthat with Professor F. W. Eurich, of Leeds Univer-sity, and Dr. T. M. Legge, of the Home Office, upon

the committee this side of the inquiry will receivefull attention. Professor Eurich, as bacteriologistto the Bradford Anthrax Investigation Board andspecialist medical referee to the Home Office foranthrax, has identified himself with the subjectunder investigation; while Dr. Legge, as one of HisMajesty’s medical inspectors of factories, has ex-ceptional. experience of industrial diseases, andchose as the subject of his Milroy lecture beforethe Royal College of Physicians of London, in 1905,Industrial Anthrax and Serum Treatment. The

secretary to the committee is Mr. G. E. Duckering,of the Home Office, and communications relatingto the subject of the inquiry may be addressed tohim at 72, Bridge-street, Manchester.

LARGE AMOUNT OF UREA IN THE PERICARDIALEFFUSION IN BRIGHT’S DISEASE.

THOUGH pericarditis is a well-recognised com-plication of Bright’s disease, the connexion betweenthe two is still disputed. Some writers attributethe pericarditis to toxemia; others to a superaddedinfection, usually to a pneumococcic one. In arecent thesis M. Andre Weill has given the resultsof the examination of 11 cases. In 2 there was lessthan 2 grammes of urea in the pericardial fluid, in6 there were between 2 and 3 grammes, and in 3more than 3 grammes. Bacteriological examina-tion gave the following results. In 4 cases it was

negative; in 2 colonies of the colon bacillus wereobtained but the organism was not agglutinated byserum obtained from the patient during life-evi-dently the infection was agonal; in 1 case there wasfound a streptococcus and in 4 cases the pneumo-coccus. At a meeting of the Societe Medicale desHopitaux of Paris on Oct. 24th M. E. de Massaryand M. P. Chatelin reported the following case. Awoman, aged 33 years, was admitted into hospitalon March 3rd, 1913, complaining of general weak-ness, cramps in the lower limbs for two months,and dyspnoea. She said she had never previouslybeen ill and had five healthy children. How-ever, two premature labours occurred in 1912,the second at three months on Dec. 27th.Since the end of October she felt fatiguedand suffered from pains in the calves and

thighs and lost appetite. The miscarriage accen-tuated this condition. In January, 1913, the legs

’ became a little swollen and the urine was examined: and found to contain a large quantity of albumin.. She was put on a milk diet but she did not improve,’ vomiting occurred four or five times a week, and

she lost flesh. On examination she was thin,sallow, and pale. The respiration was shallow andirregular (20 to 22 per minute). There was a little

oedema, localised exclusively behind the malleoli. The liver was enlarged, and there was a history of) alcoholism. At the outer base of the left lung there3 was slight dulness and crepitation was heard. Somer thick mucus was expectorated. The cardiac dul-y ness was enlarged transversely and the apex beaty was in the seventh space. A little above it a thrill, was felt. At two foci-in the fourth and fifth lefts intercostal spaces and in the second left intercostalJ. space-marked friction was heard in the form of ae rough double sound, which was not transmitted tojl other parts of the chest and did not exactly coincided with the cardiac pulsations. The pulse was 100,s strong, and a little irregular. The urine contained1 8’64 grammes of urea and 6’25 grammes of albuminn per litre; 500 grammes were passed daily. Ther- arterial tension was 22/14 with Pachon’s instru-n ment. The blood serum contained 4’2 grammes

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of urea per litre. From March llth to 15tlthe amount of urine in the 24 hours fell’ t(300-350 grammes, and the patient vomited anccould retain nothing on her stomach. Explorator)puncture at the left base yielded serous fluid. Shebecame somnolent and at times the right eyeshowed external strabismus. The breath developedan ammoniacal odour. The pericardial frictiondiminished, but the dulness remained about thesame. On March 22nd general convulsions occurred,lasting 10 minutes, during which urine escaped.In the evening she became comatose. Deathoccurred on the following morning. Soon after-wards 40 to 50 grammes of haamorrhagic fluid werewithdrawn with antiseptic precautions from thepericardium. It contained numerous red corpuscles,some white ones, and patches of desquamatedcells. Examination’ of a film obtained aftercentrifuging and staining with phenolised thionindid not show any microbes. Also a cultureon the serum of the rabbit was negative, as

was also inoculation of a mouse.- The peri-cardial fluid contained 6’4 grammes of urea

per litre. At the necropsy 90 grammes of

haemorrhagic fluid was found in the pericardium,on which there was a fibrinous deposit. The

kidneys were granular and much atrophied; theright weighed 80 and the left 40 grammes. Theliver weighed 1300 grammes and was soft and fatty.The lungs were oedematous, and at the left basethe tissue was a little more dense and was con-

gested. Sections of the pericardium were exa-

mined microscopically for microbes without result.Evidently the pericarditis was due to retention ofurea in the system and its accumulation in the

pericardium. ____

ACUTE TYPHLITIS.

SINCE the discovery of appendicitis the term

typhlitis has almost disappeared from medicalliterature, and it is generally held that the casesdescribed by the older writers under this designa-tion were examples of appendicitis. That theywere not entirely wrong is shown by the followingcase of primary acute typhlitis reported in theAustralian Medical Jozc7°nab of Sept. 27th byDr. Geoffrey Owen, who also refers s to a verysimilar case previously recorded in the same

journal. He was urgently summoned to a woman,aged 25 years, who had been well till two days pre-viously, when she was seized with abdominal painand vomiting. At first the pain was referred to themiddle of the abdomen, but after 24 hours itbecame localised in the right lower quadrant. Atthe end of 12 hours the vomiting ceased. Therewas no history of previous illness except slightanaamia. On examination she did not look ill. The

temperature was 99’2°F., the pulse 88, and the

tongue clean. Abdominal respiration was good, butthere were definite tenderness and rigidity in theright lower abdomen. The bowels had acted afterthe administration of castor oil. Acute appendicitiswas diagnosed, and though there were no urgentsymptoms an operation was advised and was per-formed next morning. Slightly turbid fluidwas found in the peritoneal cavity. Imme-

diately under the peritoneum a mass ofomentum was encountered, and on attempt-ing to unravel this it was found to be intimatelyconnected with the bowel and the incision had tobe considerably enlarged to make out the condition. i

The caecum and part of the ascending colon were Jfound surrounded with omentum, which was glued 1

to them by recent delicate adhesions. The con-dition of the bowel was remarkable. The caecumwas studded all over with injected vessels, whichextended well up the ascending colon. The appendixlay tucked behind the caecum and was not nearly soinjected as the colon. It presented no other signof disease. The omentum which was wrappedround the large bowel also presented the samecurious appearance of acute injection, and inaddition was very friable, tearing on the leasttouch to separate the adhesions. Its terminal

part formed aedematous masses. This looked so

rotten that it was deemed advisable to ligatureoff and remove several large pieces. The appendixwas removed in the usual manner. Recovery wasuneventful. Dr. Owen concludes that the case wasone of primary acute typhlitis in which the

appendix was only involved in the general processand was not the primary seat of the disease.

MEDICAL TRANSPORT WITH NAVIES.

THE October number of the M’ilitary Surgeon, aninteresting Chicago publication, is mainly filled witharticles on the management of the wounded innaval actions. Director-General C. F. Stokes, of theUnited States Navy, has worked up a scheme whichdetails a "medical transport," a ship of 10,000 tonsor more, to each division of the fleet, a divisionincluding four battleships with destroyers andauxiliaries. After a battle the medical transportarrives and sends to each of its battleships, or to itsdestroyers, a section of its boats with a dozenmedical officers and sick-berth stewards and fourdozen sick-berth attendants. They all get on boardthe battleship of whatever sort it may be, give whatadditional attention is required to the wounded, andmove these into the boats and take them to themedical transport for conveyance to the base. Thisscheme was obviously suggested by the fieldambulances or bearer companies of the army. Itis too elaborate to be of use at sea. In bad weatherDirector - General Stokes proposes to transferwounded in cots along an aerial railway, slidingthe cots on a wire hawser stretched from the sternof their ship to the bow of the medical transport.A similar method was tried in our navy for coaling1_’:__,.." ......L J. ...... t....,....L -L .....1.:’....1 -1 -1 r........w..snips at sea, out aid not give satisiaction.

The first essential for the satisfactory care of thewounded in a naval action-namely, that theirfleet must be brought out victorious-is forgotten.Extemporised measures will secure a higher per-centage of recoveries for the victors than the mostelaborately prepared plans can hope to achieve forthe vanquished. So it is a serious matter to pro-pose to make arrangements to help the woundedwhich shall in any way hamper the fightingefficiency of their ship or squadron. SurgeonJ. L. Pleadwell’s paper on the Relationship of theHospital Ship to the Fleet in Time of War is mostinstructive in this connexion. The problems of themedical officer in charge, although so tangled, are veryclearly stated and resolved. This thoughtful articleshould be read by every naval medical officer. Asimilar remark applies to Captain Lazell’s paper onMental Hygiene, and the improvement of the rankand file in army and navy. The Association ofMilitary Surgeons of the United States, includingArmy, Navy, and Public Health Services, held itsannual meeting at Denver, Colorado, in September,under the presidency of (Fleet) Surgeon W. C.Braisted, United States Navy; and Surgeon-GeneralW. H. Norman, representing the Royal Navy and