764

.and two of the three who blow the nose after emerging Ihad had ear inflammations. There was an impressionthat salt water was more injurious than fresh, probablybecause it encouraged nasal secretion and blowingof the nose. Dr. McAuliffe’s conclusions seem sound-namely, that in a healthy ear the use of plugs areunnecessary ; that the only time that a plug isneeded is when there is an open perforation or whenthe skin of the canal is irritated by the water; thatbathers should not swallow while swimming, andthat they should let the water drain from the nose andavoid blowing on coming out of the water. If blowingthe nose and swallowing are avoided, no ear complica-tion will occur.

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THE ROYAL COLLEGE OF PHYSICIANSOF IRELAND.

SINCE the establishment of the Irish Free Statemany of the chartered corporations in Ireland havefound that their charters have become in some pointsdefective. The Royal College of Physicians, for- example, has found itself without visitors, since thepublic officials designated in its charters no longerexist. A more serious disability has been the suspensionof its power to make new, or alter old, by-laws. Fora by-law of the College to become effective it had toreceive the approval of the Lord Lieutenant in Council.The Lord Lieutenants to the Privy Council disappearedwhen the Free State came into being, and while someof their powers were transferred to other bodies, inregard to others no such arrangement was made.The result, as far as the College of Physicians wasconcerned, was that there was no machinery by whichit could make or amend by-laws, and several intended.amendments have been held up for some years past.An Act for the amendment of charters passed theOireachtas, however, a few months ago, whichremedied this defect, and suitable action has nowbeen taken. The Minister for Justice, as empoweredby the Act, has issued an Order making the necessaryamendments in the Charter of the College. TheChief Justice and the President of the High Court ofthe Irish Free State are nominated as visitors, andthe Minister for Justice is himself constituted theapproving authority for by-laws in place of the LordLieutenant in Council. In future, therefore, theCollege will be free, with the approval of the Minister,to make such bv-laws as it thinks fit. The firstchange, which has already passed the College, willbe to widen the scope of the examination for

membership. ____

ENCEPHALO-MYELITIS FOLLOWING a

VACCINATION.

WHEN reviewing recently 1 a series of cases of’encephalo-myelitis in which, according to Prof. H. M.Turnbull and Prof. James McIntosh, vaccination wasa definite causal factor, we had occasion to referto cases occurring in Holland during 1925. Furtherallusion to these cases appears 2 in an article byDr. F. S. van Bouwdyk Bastianse, of The Hague,in its clinical and histological aspects in collaborationwith Dr. J. P. ]3ijl, of Utrecht, who records his.experiments on animals. Dr. T. T. Terburgh, of TheHague, supplies the epidemiological data. Theirobservations are based on their experience in Hollandwhere from Jan. 1st, 1924, to July 1st, 1925, 35 cases,of which 15 were fatal, occurred of encephalitisfollowing vaccination after an interval usually of10 to 13 days. The cases were chiefly met with in- small communes, sometimes closely adjacent to oneanother, and more than one case was often observedat one time in the same commune. Most of the caseswere notified in March, when epidemic encephalitiswas more prevalent than in the other months ofthe year. The vaccine used for the children whodeveloped encephalitis came from three different

institutions, and 12 calves served to provide the

1THE LANCET, Sept. 4th, p. 504.2 Nederlandsch Tijdschrift voor Geneeskunde, Sept. 18th,

1926.

lymph. Dr. Terburgh found that encephalitis couldbe produced by inoculating the brains of rabbitswith vaccine lymph and that in the brains of theseanimals a virus could be demonstrated which wasapparently identical with Levaditi’s neuro-vaccine.No infective agent could be found in the cerebro-spinal fluid of the affected children during life or

after death. The writers’ conclusions are as follows :1. It is impossible to deny a connexion betweenvaccination and the encephalitis which follows it.2. Post-vaccinal encephalitis is probably caused by anultra-virus. 3. It is very improbable that post-vaccinal encephalitis is caused by the direct or

exclusive action of vaccine lymph-there must besome unknown contributory factor. 4. It is mostlikely that the process of vaccination has given riseto the activation of a latent virus. 5. The suppositionthat this virus is the virus of epidemic encephalitisor one closely related to it offers the readiest explana-tion of the clinical and histological picture as well asof the epidemiological facts. The proof of the last twoconclusions, however, is not yet forthcoming, and weare more inclined to accept the views of Turnbull andMcIntosh.

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PROFESSOR SCHMIEGELOW.

Dr. Ernst Schmiegelow, of Copenhagen, celebrateshis seventieth birthday on Oct. 13th, when he retiresfrom active service as chief of the Oto-laryngologicalClinic at the Rigshospital. His friends in manycountries are marking the occasion by presenting tothe clinic a medallion portrait in bronze of theirprofessor. The Royal Society of Medicine will berepresented by Sir StClair Thomson, a past-presidentof that body, who will contribute a communication ata meeting of the Danish Oto-laryngological Society, tobe held on Oct. 12th. Addresses will also be given byProf. H. Burger (Amsterdam) and Prof. Carl von Eicken(Berlin). and other European leaders propose to unitein doing honour to the doyen of Danish oto-laryngology. Prof. Schmiegelow, who was a pioneerin his subject, studied for a time at the London ThroatHospital, and has been a frequent visitor to thiscountry, where he has many admirers and friends.

THE LIVERPOOL HOSPITAL CONTRIBUTORYSCHEME.

I AT a public meeting held in the Liverpool Town

Hall on Sept. 27th a scheme of voluntary workmen’scontributions towards the support of hospitals wasadopted with practical unanimity. This schemeprovides for the amalgamation of the existing HospitalSaturday and Sunday Funds and for the formationof a Liverpool Voluntary Hospitals’ Council, to whichshall be appointed an organising secretary of highstanding-a whole-time official. The new councilproposes to organise collections amongst workmen onthe basis of 1. per f of wages per week, to which itis hoped that employers will add one-third more.The money thus collected will be handed over inproportionate sums to the various voluntary hospitalsand convalescent homes in the district, with whom itis stated the entire responsibility as to its expenditurewill rest. No charge will be made to the necessitouspoor, but all other non-contributors to the scheme willbe asked to pay towards their maintenance in hospital.Contributors and their dependents will be admittedand treated free. Judging by the success of theSheffield scheme, the amount raised should be ample tosolve all the financial problems of these institutionsif it were not for the casual nature of a large part ofthe employment in Liverpool. A meeting of the newcouncil will be summoned at an early date.The scheme introduces a number of problems of

vital importance to the medical profession in Liverpool,where there exists a Hospital Staffs Association inwhose hands local interests may safely be left. In

voluntary hospital administration elsewhere theprinciple holds that payment of a contribution doesnot of itself carry the right to the services of the local