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two hours later the patient complains of a feeling ofpressure in the rectum, due to the swelling of thepiles, but usually this is not noticed. The piles mustbe reduced immediately after injection, as delaymakes the procedure difficult. Post-operative treat-ment consists of fluid diet to minimise peristalsis,and opium, if necessary, for the same purpose.Retention of urine sometimes occurs in elderly people,but is never severe enough to need catheterisation.On the fourth to fifth day an aperient is given, andolive oil or paraffin per rectum to soften the faeces.It is remarkable that the motion is usually quitepainless. As soon as the bowels have acted thepatient is allowed up, and on the seventh to eighthday he may walk. External haemorrhoids or thosesituated on the anal margin are not favourable forinjection treatment, as they are liable to becomeinfected. We review a small treatise on the injectiontreatment of haemorrhoids by carbolic acid on p. 1249- of this issue.

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HEINRICH QUINCKE.THE death of Prof. Quincke last month at the age

of nearly 80 years has removed one of the greatfigures in German clinical medicine. The son of adoctor, he was born at Frankfort-on-Oder, studiedmedicine in Berlin, Wurzburg, and Heidelberg, becameassistant in 1866 at the Bethanien Hospital in Berlin,and next year was attached to Frerichs’s clinic.In 1873, when he was only 31 years of age, he wassummoned to the chair of internal medicine atBerne, and five years later succeeded Bartels in thesame chair at Kiel, where he remained for 30 yearsuntil 1908, when he retired from his professorialduties and went to live at Frankfort-on-Main.Quincke’s whole life was devoted to medical researchin close relation to clinical practice. The mostimportant of his contributions to the advance ofknowledge was his discovery of lumbar puncture,independently of Dr. Essex Wynter’s well-knownwork in this country ; but in the field of pulmonarysurgery and in the differentiation of affections ofthe liver he was also much in advance of histime. The actual technique of lumbar punctureas now everywhere practised arose out of Quincke’sexperiments on dogs while investigating the propertiesof cerebro-spinal fluid. For years he made observa-tions on the pressure, specific gravity, albumin andcell content of the cerebro-spinal fluid in variousdisorders. He then conceived the idea of using thismethod therapeutically for the relief of hydrocephalus,and later in the treatment of meningitis. It wasQuincke who introduced the operative treatment oflung abscess and gangrene at a time when the surgeonhardly ventured to open the pleural cavity. Hisfirst publication on the subject dates from 1887, and ’,six years later appeared in collaboration with Prof.C. Garre, of Bonn, a small work on the Surgery of theLung, which later was rewritten as a substantialtreatise, and has been done into English by Dr. D. M.Barcroft. He described in 1882 the acute localisedœdema which still bears his name. Quincke combinedin high degree an appreciation of the value of oldand new. The pathology and therapy of digestivedisturbances were his special care, and he was

constantly evolving new methods of approach.Work on the haemoglobin content of the blood, onpernicious anaemia, on siderosis, on heat development,on the capillary pulse, on the origin of the heartsounds and heart murmurs, was each and all carriedout in the same inquiring spirit. But at the sametime he never lost sight of ’the virtues of simplemethods in the treatment of disease ; he frequentlypractised venesection, and he did much to popularisethe vapour bath, change of posture for the drainageof dependent parts of the lung, and the use of varioussimple baths and douches. A rotating wooden hutwhich could be turned to face sun or wind was alreadyin the " eighties " available in the garden at the Kielclinic for the treatment of consumptives. Quinckehad considerable vogue throughout Germany as a

consultant, but his time and labour were mainly spentin his own clinic teaching his students, and throughouthis life ne was a firm friend of the general practitioner,and a critic of over-specialisation in medicine. Deathcame quietly as he was sitting writing at his table.

THE REGISTRAR-GENERAL’S REPORT.

THE annual report of the Registrar-General forScotland has been issued recently at £2 17s. 6d., andwe cannot help feeling that such a price may preventthe report from obtaining any large circulation inScotland. We understand now that the price for theEnglish report may show an advance on a similarscale. In that case the Registrar-General’s AnnualReport for England will cost at least £4, and probablymore, and we regard the inflated figure with consider-able apprehension. It is important that these reportsshould be in the hands of public health officers andeasily procurable for reference by medical men whorequire to verify the statistical basis of their work. Itwill not be possible for every medical man who requiresto consult this report to find so large a sum of moneyfor his authority ; it is not even certain that at theenhanced figure public libraries or official departmentswill buy the document and thus make it easy of accessto groups of readers. The additional misfortune herewill be the breaking of the series. Presuming, as anatural explanation, that the price has been fixed sothat the cost of production of the report may berapidly covered, we feel that the policy is one whichan experienced publisher would consider more thandoubtful. The attempt to make profits out ofsmall sales of highly priced articles has met in

many instances with failure.

THE VINCENT SQUARE INFANTS HOSPITAL.

’ THE Infants Hospital, which was opened in 1903 inHampstead, largely owing to the energy and generosityof Mr. Robert Mond, was removed in 1907 to Vincent-square, Westminster, where it was housed in a largeand commodious building with full equipment for50 cots. In 1914 the hospital was extended, a new out-patient department, an adequate research laboratory,and resident home for nurses being added, but theexpectations that this hospital would become a

teaching and research centre have not yet been fulfilled.The management has now decided to reorganise alldepartments of the hospital and pursue an active andprogressive policy to carry out the original intentionof the founders. With this object a new post ofmedical director has been instituted and a new staffwill shortly be appointed. Dr. Eric Pritchard hasaccepted the directorship. Owing to the completenessof the equipment of the hospital it is hoped to attractstudents for clinical study and research and to throwthe hospital open to probationers and others who arequalifying for posts as health visitors or infants’nurses. It is also hoped to make it a consultativecentre to which the medical officers of welfare centrescan send their cases for diagnosis and treatment.Thus a regular system of consultation would beestablished at which these medical officers can

attend in person and take part in a general discussionof the cases. In order to carry out clinical andlaboratory research work and to supervise the workof students, a special appointment will be made of apathologist and research supervisor.

THE Cavendish Lecture of the West London Medico-Chirurgical Society was delivered before a large audienceon June 13th by Prof. Harvey Cushing, M.D., hissubject being The Meningiomas. The lecturer dis-cussed in some detail the pathology and origin ofneoplastic tumours arising from the meninges, andtouched briefly on their diagnosis and treatment. Healso described a number of typical cases, and illustratedthem with lantern slides. The lecture will be pub-lished in due course in the Proceedings of the Society.