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These are a few of the problems which phage-typing canhelp to solve.

Staphylococcus aureus is one of the most ubiquitous ofpotential pathogens, and coagulase-positive strains canreadily be isolated from many domestic animals. Thereis little information about the relation of animal strainsto human disease. Macdonald 3 has shown that bovinemastitis in Norfolk is caused by a single phage-type ofstaphylococcus, in contrast to the multiplicity of typesfound in human disease. This has been confirmed forother areas by Smith,4 and it may prove of interestin the study of the ecology and perhaps also in the

evolutionary history of the staphylococci. Smith hasalso shown that the single bovine phage-type can besubdivided by using additional phages. This was made

possible by the acquired phage-resistance of some of thestrains. He points out that apparent differences in

phage-type may sometimes be caused by such acquiredphage-resistance. The different phage-types are quitestable in the laboratory, but Smith reminds us thatstaphylococci, like most living things, may also becomeinfected with other phages, or with viruses. Phage-typing is essentially a means of experimental infection,and whether the test animal be guineapig or staphylo-coccus its past experience may influence its presentbehaviour.

SIXTY YEARS OF MEDICAL DEFENCEIN the early 1880’s two Dulwich doctors, though

successful in defending themselves against a charge ofmanslaughter and a claim for damages, found themselvesout of pocket by over 1000. Soon afterwards a Chester-field practitioner, accused of an attempted assault upona woman patient, actually served eight months in prisonbefore vigorous professional protests secured him a freepardon. Sir William Jenner initiated funds in the onecase to make good the loss and in the other to re-establishthe victim of a tragic ordeal. These experiences showedthe need of some organisation for mutual help, and in1885 the Medical Defence Union was born. All will

join in congratulating it upon the successful record of

Sixty Years of Medical Defence written by its presentsecretary, Dr. Robert Forbes. -

The M.D.U. began modestly with 400 members andan annual subscription of 10s. Its present membershipis over 31,000 and its reserve funds exceed "f:175,000.Practitioners,- we learn, have besought its aid in smallthings as well as great-the too insistent crowing of aneighbour’s cock or the tracing of a drunken locumtenens who had run off with the cash in hand and the

keys of the surgery. One member complained that hewas being hypnotised ; another wanted help in controllinghis wife. The major activities within its proper provinceranged from prosecutions for the false assumption ofmedical titles (as when a commercial " Botanic Company"was found to be selling the titles of M.D., B.C.) to detectivework in tracking down cases of impersonation. Newdifficulties merely stimulated progress. Just ’as theunion was arranging to increase its members’ indemnityto E3000, there came the staggering award of 25,000against two doctors, in Harnett v. Bond and Adam, forwrongful detention under the Lunacy Acts. The union

boldly decided to give thenceforward unlimited financialprotection against damages and costs incurred in defen-sive or offensive litigation, provided that the memberaccepted the council’s decision and advice. How soundthat advice could be we can judge from the fact that,out of the 448 libel and slander cases undertaken inthe years from 1896 to 1905, only 3 were lost. Unques-tionably the continuity of expert legal guidance, happilyassociated with two generations of the firm of Hempson,played a great part in these successes. In 1934 the

3. Macdonald, A. Mon. Bull. Min. Hlth E.P.H.L.S. 1946, 5, 230.4. Smith, H. W. J. Hyg., Camb. 1948, 46, 74.

enactment of the Law Reform (Miscellaneous Provisions)Act brought another enlargement of scope. The Actmade it possible to maintain an action for personalnegligence against the estate of a deceased practitioner.In one well-known case, where the defendant doctordied in the course bf the hearing and his widow remainedliable, a verdict of E5000 was awarded for a failure todiagnose tuberculosis. Hitherto the membership of theM.D.U. had been personal and benefits had ceased withdeath ; new provision was needed for this new liability.It is not perhaps surprising that the membership, whichhad nearly doubled itself between 1919 and 1930,continued to increase. The Harnett case had brought arecord new entry. -A little earlier, in Claydon v. Wood-Hill, B750 damages had been given against a defendantpractitioner for negligent treatment of a fractured femur,and his financial loss amounted in all to some 2250.The profession was shocked to learn that he was not amember of any defence society and naturally the needof universal protection was canvassed afresh. The councilof the British Medical Association passed a resolutionand its organisation committee invited representativesof the two defence societies to a conference, but, afternegotiations which Dr. Forbes describes, it was appreciatedthat individual medical defence was not likely to bebetter or more cheaply conducted than by theexisting bodies.Amalgamation of the two has, of course, been suggested.

Soon after its formation in 1893, the London and CountiesMedical Protection Society (now the Medical ProtectionSociety) approached its older rival with a proposal.A few years later, in 1899, it tried again. Our columnsof that date contained a recommendation for a singlestrong organisation ; we had hinted a criticism of theapparent reluctance of the M.D.U. as illogical and

non-cooperative. Ideas of centralised medical defence,periodically ventilated at meetings of the B.M.A.,presupposed the pooling of the experience and resourcesof the existing bodies. The two societies, working onparallel lines not only for individual protection but alsofor professional standards and harmonising their activitiesand their objects through their standing joint committeeestablished in 1894, continue their separate work.Meanwhile the costs and risks of litigation are rising.The other day a judge candidly increased an award ofdamages on the ground of the diminished purchasingvalue of money.

Close on fifty years ago THE LANCET vigorously advo-cated membership of a defence society, and that adviceis just as necessary today. Both the Medical DefenceUnion and the Medical Protection Society are doinginvaluable work for the profession.

TUBERCULOSIS IN SCOTLAND

NEWS of an increasing incidence of tuberculosis inScotland, on which we commented in a leading -articleon July 24, has been followed by the appointment of acommittee to examine the position. Established by theScottish Health Services Council at the instigation ofthe Secretary of the State, the committee includes threemembers of the council : Captain J. P. Younger (chair-man), Dr. Matthew Fyfe, and Dr. J. R. Langmuir.The other members are : Prof. Charles Cameron, Prof.F. A. E. Crew, F.R.s., Dr. H. C. Elder, Dr. Stuart Laidlaw,and Dr. A. B. Maclean.

Dr. T. CRAWFORD has been appointed to the universitychair of pathology at St. George’s Hospital medical school.Since 1946 he has been director of pathological services.at the school.

Dr. D. V. DAVIES, lecturer in anatomy in the Universityof Cambridge and fellow of St. John’s College, has beenappointed to the chair of anatomy at St. Thomas’sHospital medical school.