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may be no loss to the Government on the sale of the twoformer articles the traffic is vicious and will tend to growunless checked. On meat, however, there must be a loss, asfrom market quotations the Admiralty must be paying from6d. to 7d. per pound for it; to retail it at 4d. per pound withpermission to take it on shore seems to be a mistake. This

privilege of taking meat on shore is a very old one and fewwould like to see it stopped in the case of married men whoreally require it for their own consumption, but the privilegewas never intended to extend into a traffic."

Surgeon-General W. Simson Pratt, C.B., A.M.S., principalmedical officer, Southern Command, made his annual inspec-tion of the Devonport Military Hospital and Military FamiliesHospital on June 2nd. He was accompanied by Lieutenant-Colonel H. G. Hathaway, R. A.M. C., and Colonel W. J. ReadRainsford, C.I.E., R A.M.C. Surgeon General Pratt inspectedOkehampton Camp (Devon) on June 4th.

Correspondence.

AUSTRALIA FOR THE SONS OFPROFESSIONAL MEN.

It Audi alteram partem."

To the Editor of THE LANCET.

SIR,—It is a good many years since I resided in GreatBritain, but even then the problem of " what to do with ourboys " pressed heavily upon the parents of the professionalclasses. The army and navy were closed to those who hadno private income, the clerical, legal, medical, and otherprofessions were overstocked, and the openings in commercewere only for those who had money or influential connexions.And everything that I can learn points to an intensificationof these conditions at the present day. The position, there-fore, of the man who has sons about to leave school must bea very difficult one, when he is face to face with the questionof how to give them a satisfactory start in life. It is the

hope of being able to do something to answer this questionwhich prompts me to beg for some space in your columns.For years, many of the sons of professional men have

emigrated to the United States or Canada. I come forwardwith the claim that Australia and New Zealand can offer

opportunities superior to either of these two countries toindustrious and persevering lads, who are prepared to acceptrough and strenuous conditions for the sake of obtaining acompetence in later life. I may say at once that there are noopenings in our large towns. All the city occupations arefilled to overflowing. But the Australian bush is calling forthousands of willing hearts and hands to subdue it and makeit fruitful. The wealth of Australia is immense and this ismostly due to the production of wool, wheat, sugar, butter,live stock, and fruit commodities, for which there is a greatand growing demand, at prices that are likely to be main-tained or increased. Life on the land therefore promises tohim who approaches it in a spirit both scientific and practicalthe opportunity not only for a healthy and natural existencebut the possibility of an independence. The glorious climateof Australia is all in its favour. Here there is no longrigorous winter. A man can work and stock graze in thefields all the year round. Much has been said about theAustralian droughts, but it is not generally known that thereare wide districts where drought is practically unheard of.And the conservation of fodder and the great irrigationschemes which are being carried out will henceforthrob the occasional droughts of much of their terror. InNew South Wales there has been only one total failure of thewheat crops in 17 years.

I do not for a moment suggest that lads should be sent outhere with some money to take up land for themselves straightaway. This would simply spell disaster. What I propose isthat the lad who has decided to make Australia his homeshould adopt one of three courses :-

1. He should enter as a student at one of the Governmentagricultural colleges, where, for about 30 a year, he willreceive a thorough training in scientific and practical farm-ing. The sum quoted includes board and lodging, both ofwhich I can guarantee to be excellent-quite as good as, ifnot better than, that provided at any English public schools.At the end of his two years’ course there he could take up

land for himself or spend another year in gaining experiencewith a practical farmer before launching out for himself.

2. He could be placed, as far as New South Wales is con-cerned, with a farmer holding high qualifications as a

teacher of agriculture, .who for £12 a year and his labourwould give him a training almost as good as that he couldobtain at a college. I am again prepared to guarantee thatany lads intrusted to this man would be properly looked afterand instructed.

3. The third alternative is that he could go to a Govern-ment farm for three months and receive, free of cost, instruc-tion in milking, ploughing, and the care of horses, pigs, &c.At the end of this time his services would be of sufficientvalue to enable him to be placed with a respectable farmerwho would pay him about 10s. a week and his board, andwould increase his wages gradually to 15s. or 20s. After an

apprenticeship of this kind for a year or two he would befitted to start on his own account.These three avenues to the land are open to all and there

exists a voluntary organisation here, the Immigration Leagueof Australasia, whose chief object is to welcome new-comersand afford them advice and assistance. The executive com-mittee are prepared to give information about Australia andNew Zealand to all who write to them, to arrange for theplacing of lads at agricultural colleges or farms, to act

generally in loco parentis towards them, and to see that theyare not taken advantage of in any way. The league numbersamong its members some of the leading men of Australia,and their desire is to help in the development of the continentand retain the British emigrant under the flag of Empire.We say, send your sons to us and we will insure them

proper treatment and a fair start. We do not want ne’er-do-wells or failures. Experience proves that such do no betterhere than in the old country. But steady, industrious ladsare bound to succeed here and in many cases their parentsmight be induced to follow them out here and prolong theirlives in this incomparable climate. We invite parents tocommunicate with us at Bull’s Chambers, Moore-street,Sydney, Australia, and we will give them full informationand send books and maps about Australia and New Zealandand prospectuses of agricultural colleges and schools ofmines. Some months’ notice is needed to enable a lad to beentered at an agricultural college.

I am, Sir, yours faithfully,. RICHARD ARTHUR, M.D.Edin.,

President, Immigration League of Australasia.

*** It seems to us a grave reflection upon our politicians,all parties alike being referred to, that England, Ireland, andScotland should offer no advantages, commensurate withthose offered by Australia, New Zealand, and Canada, tothose who wish to follow agriculture as a career. There are

in all three divisions of the United Kingdom large tracts ofland-only not regarded as large because of the inevitablecomparison with the vast acreage of the colonies mentioned-which would repay farming, at any rate " intensive "

farming, but which at present are almost out of cultivation,and these tracts are contiguous to thickly populated cities.That labour and produce are not forthcoming from themupon terms profitable alike to the public, the employer, andthe employed is a standing indictment of our rulers. Butthe home conditions being what they are we can onlycommend Dr. Arthur’s letter to the attention of any of ourreaders who have sons to bring Up.-ED. L.

MR. CORONER TROUTBECK AND DEATHSAFTER OPERATIONS.

To the Editor of THE LANCET.

SiR,-The coroner’s office is a very ancient one and has nodoubt in its time done useful work in promoting the publicwelfare. None the less there are not wanting some amongus who regard its survival as an anachronism, its machinerycumbrous and antiquated, and think that the public safetymight be quite as efficiently protected in a simpler and less

expensive manner. If all the coroners in England and Waleswere to tread in the footsteps of Mr. Troutbeck it is notunlikely that the number of those holding such views wouldbe much augmented. Last week an inquest was held inSouth-West London on Gertrude Helen Muirhead, a teacherof music, who was the patient of an eminent London

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surgeon, and unfortunately died a short time after an

operation performed to relieve a necessarily fatal disease.The operator attended and after giving evidence ex-

pressed his surprise that an inquest had been held on

the case; but Mr. Troutbeck is reported to have said:"That it was the opinion of all coroners in Englandthat if an operation was a material part of the cause ofdeath an inquest must be held," and he further stated thatI it was impossible to dissociate the operation entirely fromthis woman’s death." What is meant exactly by " a materialpart of the cause of death might furnish matter for a verynice argument, but it would be interesting to know if all thecoroners in England agree with Mr. Troutbeck in his sweep-ing definition that it is a material part of the cause of deathwhen it cannot be dissociated from the cause of death. Ifthey do, it is perhaps fortunate for the public that they donot act up to their opinion.

In nearly all cases where deaths follow after operationsit would be impossible to dissociate the operation entirelyfrom the cause of death, so that it would practically meanthe holding of an inquest on every death after an operation.If such a course were adopted it would be a fatal barto all progressive surgery, and it is shocking to con-

template the probable effect it would have in increasing thesum of human misery. Few operations would be performedwhere any risk was involved, and palliative operations wouldrarely, if ever, be done. Great enough in all conscience isthe worry and anxiety that every surgeon has to undergoafter a serious operation, and to have superadded to it theknowledge that if the result is unfortunate he will be requiredto justify all the details of the operation before a dozenignorant jurors, presided over by a coroner possibly in thisrespect equally ignorant, is a prospect that few surgeonscould view with equanimity.

I am, Sir. yours faithfully.

June 5th, 1908.MAJOR GREENWOOD, M.D. Brux., LL.B.,

Barrister-at-Law.

THE GRAND DUCAL HESSIAN STATE ANDTHE ST. GEORGE’S-NAUHEIM

INSTITUTE.To the Editor of THE LANCET.

SIR,-There have recently appeared in the lay pressnotices relating to an injunction which was by consent ’,,granted against this institute at the suit of the Hessian Government. As such notices in their abbreviated form andin the absence of an explanation are calculated to cause anentirely erroneous impression regarding an institution ofwhich, in conjunction with my colleague, Mr. W. de MarchotHill, I am in charge, I ask of your courtesy to insert thisletter in your widely read paper. This institute has beenunder my control for the past few months, and whilst dis-claiming any responsibility for the action of the directorsbefore my connexion with the institute I feel that it is due tomy colleague, myself, and those of my profession who have socordially supported me that an explanation of the very mis-leading paragraphs that have appeared in the leading dailyjournals should be given. The injunction was, inter alia, torestrain the St. George’s-Nauheim Institute from represent-ing that they were the agents of the Hessian Government,from using the Hessian arms, from representing their busi-ness as a branch of the Government, and from using thename Nauheim without clearly distinguishing the baths ofthe institute from those of the Government.From the fact that the injunction was consented to it

might be inferred that the St. George’s Institute had wrong-fully committed all these acts, but as a matter of fact Mr.Cosens Hardy, who represented this institute at the trial,particularly repudiated such a state of affairs and agreed tothe injunction because it necessitated absolutely no changein any detail whatsoever in the present conduct of theinstitute. Mr. McNaughton, K.C., on behalf of the HessianGovernment, stated that the directors of the St. George’sInstitute had claimed that the Nauheim system can cureevery malady that flesh is heir to. Although in no wayconnected with, or responsible for, the statements referredto, I should like to point out that the list of ailments pub-lished bv the directors of the institute is identical with thatpublished by the Society of Physicians at Bad Nauheim intheir prospectus, so that it would appear that the Hessian authorities are complaining of the act of their own Societyof Physicians.

Personally, I think most medical men will agree with mein supporting the Hessian Government in their condemnationof this extraordinarily prolific list of diseases. At allevents, since taking charge of the institute I have very muchcurtailed the list of indications. As for many months pastthe institution has been conducted on methods above re-

proach and approved by many of the leading physicians andmedical journals, this short explanation will suffice to removeany doubts that may have been raised by the reports in thelay press. Trusting that I have not encroached too muchon your patience and space,

I am, Sir, yours faithfully, .

W. BAIN, M.B., B S. Lond.George-street, Hanover-square, London, W., May 28th, 1908.

TANSINI METHOD FOR THE CURE OFCANCER OF THE BREAST.

To the Editor of THE LANCET.

SIR,-I have read in THE LANCET of March 28th a criticalletter from Mr. W. Sampson Handley about the Tansinimethod for the cure of cancer of the breast. I do notunderstand the allusion to the deep band, as by Tansini’smethod it can be removed more easily than by any othermethod without extensive dissection, which is to be avoidedboth from the point of view of the patient and of thetechnical excellence of the operation. Perhaps on accountof the shortness of my note I did not insist sufficiently onwhat is, for the most part, well known, that even with moreradical methods recurrence in the skin is often observed inthe immediate neighbourhood of the scar. I have oftenobserved a recurrence in the skin when by the ordinarymethods it has not been removed freely enough owing toanxiety to obtain direct union of the wound. It is necessaryto remove as much skin as possible; it is especially on thisaccount that Professor Tansini devised his plastic opera-tion, and he was not alone in thinking it necessary tohave recourse to such a measure as a remedy for theremoval of the skin. Others have proposed to obtain theflap from the skin near the wound left by the operationor to fill this up by transplanting the breast of the oppositeside. Professor Tansini has devised a very rational plasticprocedure which offers other advantages which I have

already mentioned. All surgeons recognise the necessity ofextensive removal of the skin and we cannot affirm that it ispossible to join the flaps direct if all the skin of the breasthas been cut away. If it be objected that the cutting of theflap makes the operation a little more complicated it must beborne in mind that in any case the operation is a very seriousone, that relapses are frequent, that as a rule, at least inItaly, patients come to be operated on with the diseaseadvanced, and that the statistics have improved sinceextensive removal of the skin has been performed. Unlessthis principle, which is now generally accepted, be abandonedI must persist in recommending the Tansini method as oneworthy of being widely known and employed.

I am, Sir, yours faithfully,Fana, June lst, 1908. Prof. FRANCESCO PURPURA.

THE ADMINISTRATION OF VACCINES BYTHE MOUTH.

To the Editor of THE LANCET.

SIR,-Dr. Clive Riviere, in THE LANCET of June 6th,states that it is impossible to prove that tuberculin and othervaccines are absorbed when administered by the mouth in adisease such as pulmonaty tuberculosis, as he holds that " inthis disease auto-inoculation is continually going on and theopsonic index is continually fluctuating." He therefore asksfor proof of absorption in cases of localised disease with astationary index. I do not agree with his argument or withhis conclusion, but gladly supply the proof he requires.Chart 31 (showing indices of 1’3 and 14) in the paper 1 referredto by Dr. Riviere is an example of the effect of the oraladministration of tuberculin in a case of localised infectionof glands in which the index had been 0’ 6 or 0’ 7 for severaldays before tuberculin was prescribed. Chart 15 is an

example of the absorption of staphylococcic vaccine when

I given by the mouth. In this instance the index fell from

1 Proceedings of the Royal Society of Medicine, Medical Section,vol. i., No. 6, p. 195, April, 1908.