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owners had tried the experiment of providing changing housesand baths for the men at the pit’s mouth, but always foundthat they declined to avail themselves of these conveniences ;yet in Germany it is a usual custom for bathrooms to be

provided at the pithead, where the miners take off their

clean clothes before descending, and where they changetheir dirty clothes and bathe on returning from the pit.As many as 500 separate cabinets and shower baths are

sometimes provided in one bathroom. A miner covered with

coal dust is never seen outside a colliery in Westphalia, weare told, and a German miner is never seen on the road inhis pit clothes. In the Coal Mines Bill now before Parlia-

ment provision is made for suitable accommodation and

facilities for taking baths and drying clothes for personsemployed underground " in mines. The use of these is to be

obligatory on the colliers, and each miner is liable to

contribute ld. per week towards the expenses of main-

tenance. It is quite time that this sanitary reform

was instituted, so as to bring our practice up to the

level of that obtaining in Westphalia and Belgium. Weunderstand that in South Wales the miners’ leaders are

in favour of this provision, and that baths are to be erectedat the Harris Deep Navigation Colliery in Monmouth-

shire. The Ogmore Vale urban district council has

adopted resolutions in favour of petitioning the local

colliery owners to adopt the prosposal. Mr. Henry Davies,director of mining education for Glamorgan, is dealing withthe subject in a pamphlet shortly to be issued, and there islittle doubt that the importance of this sanitary improve-ment will become generally recognised. It is matter for

regret that Great Britain should have so long been behindcontinental industrial hygienic practice in this respect.

A VENOUS HUM IN THE EPIGASTRIUM IN

CIRRHOSIS OF THE LIVER.

IN the American Journal of Medical Sciences for March

Professor W. S. Thayer of the Johns Hopkins University hasreported a case of venous hum in the epigastrium in cirrhosisof the liver. The patient was a physician, aged 49 years,who had led an exceedingly active life. He had lived fairlywell and probably taken whisky three or four times daily.Two years before he came under observation he had hæmat-

emesis after a heavy supper. After that he remained well

until 11 days before he was seen, when, while driving, hecoughed up about an ounce of dark blood. The hasmatemesis

continued and was accompanied by melasna. On examina-

tion on Nov. 3rd, 1905, he was extremely blanched. The

apex beat of the heart was in the fourth space within the

mammillary line, and a blowing systolic murmur was heardall over the prascordium. The liver was felt one or two

finger-breadths below the costal margin, and the spleen twoor three finger-breadths below on deep inspiration. The

haemoglobin amounted to between 20 and 30 per cent. Theveins in the epigastrium and along the costal margin were alittle distended. He was admitted into hospital andBlaud’s pills were given. On Nov. 20th the haemoglobinamounted to 56 per cent., and the systolic murmur

had disappeared. At the base of the xiphoid cartilagea loud continuous venous hum, slightly increased on

inspiration, was heard. It was transmitted a little down-

wards, but disappeared before the tip of the ensiform

cartilage was reached. It was transmitted 4 centimetres tothe right and 6 to the left. He left hospital on Nov. 27thand returned to his work at Christmas. In January, 1906,he vomited a tablespoonful of blood. A loud venous hum wasaudible in the xiphoid notch. Attacks of melaena and

hæmatemesis followed. In April there was increasing cedemaof the legs, and a fine thrill was felt in the epigastrium. The

patient recovered health and for four years led an active

life, though there were occasional dark-coloured stools. On

Oct. 16th, 1910, an attack of vomiting occurred, and hebecame drowsy and then comatose. On the following daythe venous hum in the epigastrium had disappeared, asciteswas present, several violent convulsions occurred, and hedied. There was obviously cirrhosis of the liver, during thegreater part of the course of which ascites was absent owingto a free anastomotic circulation. What was the cause of the

epigastric murmur and thrill ? The latter suggested that thevibrations must have arisen in veins near the surface.

Probably it arose in varicosities dependent upon anasto-

moses between dilated venules in the suspensory

ligament and radicles of the internal mammary veins.

Many observers have referred to the thrill and murmur whichmay be heard at times over the varicosities occasionally seenabout the umbilicus and in the epigastrium in cirrhosis ofthe liver. Cases have also been recorded in which a loud

epigastric hum was heard in cirrhosis of the liver withoutthe presence of notably large cutaneous veins. In 1859

Sappey described a case which was demonstrated to him byTrousseau. At the necropsy was found a voluminous vein

extending from the sinus of the portal vein towards the

umbilicus, where it ramified and anastomosed with the epi-gastric veins. In most of the cases in which cutaneousvaricosities were absent the murmur was heard best aboutthe umbilicus and along the middle line of the epigastrium-i.e., along the course of the round ligament. In a few of

these cases it has been found that the incompletely closedumbilical vein had become greatly dilated as a result ofincreased portal pressure. In others a large dilated vein hasbeen found in the round ligament running alongside of theobliterated umbilical vessel, doubtless a dilatation of a smallparumbilical vein. These murmurs must be distinguishedfrom the slight venous hum sometimes heard in the anæmic

just above and to the right of the umbilicus over the

inferior vena cava-murmurs which may be brought out bypressure in thin persons.

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CAN THE ANTELOPE IN UGANDA ACT AS ARESERVOIR OF THE SLEEPING SICKNESS

VIRUS P

NEARLY three years have passed since operations on a

large scale were carried out in Uganda with a view to

stopping the spread of sleeping sickness by depopulatingthe area around the great Victoria Nyanza. It was con-

fidently expected that if the tsetse flies had no opportunityof biting infected persons the infection in these insects

would in time tend gradually to disappear, seeing that thereis no hereditary transmission of Trypanosoma gambiense inthe Glossina palpalis. Unfortunately these anticipationswere not realised, the investigators sent out by the RoyalSociety having found that the flies are still at the presenttime infected and capable of conveying the disease. It was

suggested in explanation of this that either the tsetse flieslived longer than two years, continuing capable of conveyingsleeping sickness, or else, and more probably, that wild

animals or birds living in the region round the lake had

become infected with T. gambiense and were now actingas a reservoir of the sleeping sickness virus. In order to

test the truth of this latter view Colonel Sir David

Bruce, F.R.S., with his two colleagues, Captain A. E.

Hamerton, R. A.M. C., and Captain H. R. Bateman, R. A. M. C.,members of the Royal Society’s Sleeping Sickness Commis-sion, undertook a series of experiments on the spot, andtheir interesting and valuable report was presented at theJanuary meeting of the society. It appears from this reportthat since the native population and their cattle were

removed from the vicinity of the Victoria Nyanza, that area