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venous injection of peptone solution, as practised forsome time by Dr. A. E. Gow. In any case the dangersof the proceeding can scarcely be exaggerated, and thetherapeutic use of animals’ blood should only be prac-tised with great circumspection. Modern refinementsof knowledge concerning incompatible bloods andblood groups are apparently ignored by Prof. Cruchetwhen he advocates a return to the crude methods ofthree centuries ago. --

A YEAR’S WORK OF THE ROCKEFELLER

FOUNDATION.

FROM the review of work for 1921 just issued by theRockefeller Foundation we learn something of theworld-wide activities of the Foundation in regard topreventive medicine, to the training of public healthpersonnel, and to medical education and public healthgenerally. During the year a quarter of a milliondollars were granted to the School of Hygiene andPublic Health of Johns Hopkins University, twomillion dollars were pledged to Harvard for a Schoolof Health, and contributions made to public healthtraining in Czecho-Slovakia, Brazil and the UnitedStates. The Pasteur Institute of Paris was helped inrecruitment and training of personnel; an experimentalpay clinic was underwritten in the Cornell MedicalSchool; a complete modern medical school and hospitalin Peking were formally opened; 25 other medicalcentres in China were assisted; surveys were made ofthe medical schools in China, Japan, the Philippines,Indo-China, Straits Settlements, Siam, India. Syria,and Turkey. A million dollars were promised for theMedical School of Columbia Universitv. The Founda-tion also contracted to appropriate three and a halfmillion dollars for the rebuilding and reorganisation ofthe medical school and hospital of the Free Universityof Brussels ; supplemented the laboratory equipmentand supplies of other five medical schools in CentralEurope; supplied American and British medicaljournals to 112 medical libraries on the Continent;provided 157 scholarships in hygiene, medicine,physics, and chemistry. The campaigns againstyellow fever and hookworm disease were continued ;the goal of transferring to French agencies anti-tuberculosis organisations in France was broughtnearer; and many other matters of direct interest inthe promotion of the health and well-being generally,and much team-work for world health were under-taken. Not the least interesting parts of the reportare the remarks on health training at home and abroad,changing ideals of health, progress in prevention, theresponsibility of the public, and the r6le of the nursein cure and prevention.

EFFICIENT VACCINATION.

IN order to be of value for protective purposesagainst small-pox the operation of vaccination mustbe thoroughly carried out. The ordinary patientdoes not know what a proper and sufficient vaccinationconsists of, and medical men must not allow themselvesto be drawn into the performance of this operationin a haphazard and perfunctory fashion. The benefitof multiple insertions has been proved many yearsago by Marson, Gayton, Cory and others. The morethorough the vaccination the more pronounced will bethe immunity and the longer will it be effective.The examination of smallpox patients in hospitalshas shown that those who have only a small scar ofvaccination are more numerous, and have the diseasemore severely than those who show a higher numberof scars. Imperfect vaccination in a community isalmost worse than no vaccination at all, for theimmunity is short-lived and the individual whoimagines himself protected is not really so. Whensmall-pox appears and those with imperfect immunityare attacked, as they frequently are, advantage is

1 Quart. Jour. Med., xiii., 49, 82.

taken of the fact by the anti-vaccinators to show thatvaccination has no protective influence. It is theduty, then, of the medical man to explain to his patientswho, through ignorance, put forward a request forone or two insertions why the Government requirementaims at producing good-sized vesicles of a total areaof not less than half a square inch. Teachers ofvaccination under the Ministry of Health have beenfor years urging on medical students the value of fourinsertions in all cases. It is hoped that all medicalmen who have been so taught, and who know thevalue of vaccination when efficiently carried out, willnot give way to ill-informed pressure, but endeavourto educate the public to maintain the high standard ofefficiency laid down by the Ministry of Health. It isthought that some supervision might be exercised bythe Ministry of Health in regard to the manufacture ofcommercial vaccine lymph as regards its preparationand potency, so that it may reach as high a standardas that issued by the Government Lymph Establish-ment.

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A HOSPITAL FOR GENTLEWOMEN.

THE gap between the expensive nursing home andthe voluntary hospital is still wide, and the disposalof the gentlewoman who shrinks from public wardsbut has not the means to pay for the privacy whichshe covets when ill is one of the most difficult problemsher doctor has to tackle. St. Saviour’s Hospital forladies of limited means contains 21 beds in twowards and three private rooms, the charges to patientsvarying from 2 to guineas. Of the active medical andsurgical staff, who give their services gratuitously,five are also on the staff of the Middlesex Hospital,which hospital appears long to have been a willingrecruiting ground for St. Saviour’s ; names of themembers of the consulting staff are further testi-mony to the fatherly interest taken by the largerinstitution in the smaller. The history of St.Saviour’s is romantic. It was erected by Dr. Puseyin the middle of last century to house a religiouscommunity of women, under vows, in the Church ofEngland. Originally a home for the sisters, it wasadapted as a hospital in 1877 and was taken underthe control of the All Saints Community in 1892,whence it passed to the Sisters of the Community ofthe Epiphany in 1913. A feature of the building isthe wood-carving in the chapel, which dates fromthe early seventeenth century. The carving wasbegun by two Carthusian monks in a small monasteryin the Alps in 1600, and it took 50 years to com-plete the remarkablv fine work which has beenreassembled here, and is well worth inspection.The conditions of admission to St. Saviour’s involve

only the signing of three forms-a certificate fromthe patient’s medical attendant, another showingthat she is eligible to the hospital, and an undertakingby some responsible person to pay weekly fees inadvance. Chronic, incurable, infectious, maternity,mental, epileptic, and throat, nose, and ear cases arenot taken, nor are emergency cases received as arule. There is a well-equipped operating theatre,and though the administration is in the handsof a religious sisterhood, the actual nursing isunder the care of fullv trained nurses. Practitionersare invited to recommend suitable patients foradmission. St. Saviour’s Hospital is unendowed ;subscriptions and donations should be sent to thehon. secretary, Sir Cyril Cobb, at the hospital,Osnaburgh-street, London, N.W. 1.

LEAD POISONING IN THE POTTERY INDUSTRY.

DISAPPOINTMENT must be felt that the numberof cases of lead poisoning in the pottery industrynotiiied to the Chief Inspector of Factories hasincreased during the last two years, and particularlyin 1921. The subject was raised by Mr. CharlesSitch in the House of Commons when he drew

particular attention to the increase in fatal cases, of ’