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climates. After discussing climatic effects on the

digestive and urinary systems, and on endocrinemetabolism, he passes on to the effects of pressure,and some of the local winds of the tropics. A furtherinteresting section, on the rays of the sun, containsresumes of experimental work in connexion with theabsorption and properties of these rays from the

point of view of tropical medicine, and after someconsideration of chronic skin irritation and of pig-mentation the paper concludes with practical hints onclothing.The section on the effects of heat contains useful

information on the various ways of taking tempera-tures. Sir Aldo says that if a temperature readingin the axilla is to correspond with a reading in themouth the axilla must be dry ; in the tropics theremay be several degrees difference between axilla andmouth. Pembrey and Nicol point out that thetemperature in the mouth is apt to vary considerably,and that it is not reliable in cold weather or afterexercise, and Haldane has found that it varies greatlyin different people. In warm and moist air the mouthtemperature approaches the rectal. The reason whythe oral temperature is lower than the rectal is saidto be that in cold air the proximity of the skin, andpossibly the nasal cavity as well, has a cooling effect,whereas in warm air there is no such difference. InIndia, Crombie found in 15 careful observations thatthe mouth temperature was on the average 022° F.below that of the rectum, whereas Pembrey found thedifference as much as 1 v0 F. during cold weather inEngland. As regards the time the thermometer shouldremain in the mouth when taking temperatures, SirAldo considers that if nothing hot or cold has latelybeen placed in the mouth, and it has been keptclosed for a short time, two to three minutes shouldsuffice. In his experimental work in India, Crombiefound that to get accurate results ten minutes werenecessary in the well closed and dry axilla, eightminutes in the mouth, and three or four minutes inthe rectum.

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THE TECHNIQUE OF BIRTH CONTROL.IN a recent corresponclence in the ’1’1,mes about

the low birth-rate attention was drawn by FatherFrancis Woodlock, S.J., to the fact that fewest ’’,children occur in families whose eugenic value is ’,highest, because the parents of those families practise ’Ibirth control. " Don’t blame Nature " writes Father IWoodlock, " but give the Devil his due." Thisletter evoked a reply from Lord Dawson of Penn who,while urging the desirability of adequate parenthoodfor the well-being of husbands, wives, families, andthe community, denied that the practice of contracep-tion was necessarily diabolical. Few people, however,would deny that birth control, as practised in thecommunity to-day, acts on the whole dysgenically.While the existing contraceptive methods are practic-able by the better educated classes, they are ill-adapted to the use of unintelligent and improvidentcouples, or couples in which either partner drinks.Of all the psychological characteristics which are

likely to promote fertility in England to-day, there isprobably none more potent than habitual drunkenness.If the self-possession necessary to the taking ofcontraceptive precautions at the appropriate momentis lacking in either husband or wife an enhanced fertilitywill result. The dysgenic effects of contraception to-day are therefore intimately related to the problem ofdrunkenness in the slums. If these dysgenic effectsare to be abolished, it is essential that a harmless and

Ireliable contraceptive method should be discoveredwhich will ensure a continuous period of sterility for a Iminimum of several weeks at a time, and which willdemand no forethought on the part of wife or husband.Such a method is practised in the clinics of Johann

Ferch, in Austria. Another and quite differentmethod was described by Dr. Ernst Grafenbergand Dr. Norman Haire at the Third InternationalCongress of the World League for Sexual Reform,which met in London last week. The method consists

in the insertion into the body of the uterus of a smallsilver spiral ring which is left in situ for a year.Dr. Grafenberg laid stress on the difference betweenhis method and those involving the insertion offoreign bodies into the cervical canal, by whichascending infections are facilitated. He claims thathe has used his method upon over 1100 women, thatas long as the genital tract is healthy when the coilis inserted sepsis never ensues, and that sterility isnever caused. In fact, the coil has several timesbeen inserted as a treatment for sterility, and thewoman conceived after its removal. Accordingto Dr. Grafenberg, the endometrium has but oneresponse to mechanical stimulation-namely, hyper-trophy. The hypertrophy caused by the coil is suchthat the fertilised ovum is incapable of embeddingitself and conception cannot take place. Though this shypertrophied endometrium is shed at each menstruumneither menorrhagia nor dysmenorrhoea is caused.The coil never embeds itself in the uterine wall, andthe incidence of neoplasia is no greater in his seriesthan in the normal. The theoretical considerations swhich underlie Dr. Grafenberg’s method do notcommend themselves to orthodox medical opinionin this country. Nevertheless, his paper was keenlydiscussed at the conference, and deserves the mostimpartial consideration. Dr. Haire also drewattention to this method in his paper. He pointedout that the Russian observers believe that its efficacydepends on a physico-chemical change which preventsfertilisation of the ovum. In his opinion it mightwell be that the Russian view and Dr. Grafenberg’sview were both correct.

Further evidence as to the practicability of theuse of existing contraceptive methods by proletarianwomen has been submitted at a medical con-

ference held on July 10th at the invitation of theNorth Kensington Women’s Welfare Centre. Briefreports in response to a questionaire were submittedby medical officers from nine birth control clinicsthroughout the country and the following resolutionwas passed. " This conference .. of medical officersof birth control clinics ... considers that a regularexamination with a speculum is essential before amethod of conception control is recommended ; andit urges the committees of such clinics to affordfacilities to their medical officers to make this examina-tion." As one of the medical officers present said,the speculum examination makes the differencebetween a scientific and a philanthropic approach tocontraception. Follow-up systems are by no meansuniversally in use at these clinics, so that it is difficultto appraise the practicability of the methods advised.A significant note, however, is made by Dr. KathleenSlim, of Wolverhampton, who says that " 50 percent. of women that were fitted with Dumaspessaries were advised by the doctor to use solublepessaries also, and one box was given with the initialoutfit. With two exceptions no one has renewed thesupply." At Wolverhampton also Semori tabletswere used in cases in which patients had a pronouncedobjection to using a rubber pessary. Semori is afroth-producing substance, made in Germany, forwhich powerful germicidal powers are claimed. Itwas too soon, however, for an opinion to be given asto the results. Though the patients are asked attheir first visit to return after a week and then everysix months, all the clinics appear to lose touch with anumber of them.

So far as they go, the figures submitted at thisconference support the conclusion of Mr. NormanHimes, who made a careful statistical survey ofBritish birth control clinics in 1927. This con-

clusion was that the methods then taught werenot satisfactorily practicable by the least desir-able elements of the population, whose fertilityis most burdensome to the State. The impor-tance of discovering a really reliable contracep-tive, which is also harmless and fool-proof, willtherefore be grasped by everyone who shares FatherWoodlock’s sociological in contrast to his theologicalopinions.