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dental stress, or if this is greater an increase of

,peristalsis. Finally lack of normal psychic interestmay be as injurious as excessive emotion, and patients,he suggests, should be warned against eating " when.absent-minded, mentally upset, or greatly fatigued."’This is advice which could be very generally appliedwith profit, and to the I3ippocratic’ precept we mayadd a codicil to the effect that between labour andmeat a short interval of rest should intervene-sucha pause being desirable not only to get over theinhibitory effect of severe exercise (if any), but alsoto restore emotional harmony and allow the mind tosettle down as it should to enjoy the pleasures of thetable. After the meal is over it is reasonable tosuppose that we may safely obey our own internalprompting, whether this is to jump up and down onofas or recline on them at full length.

SEPTICÆMIA DUE TO BACILLUS

FUNDULIFORMIS.

A GENERAL infection, due to an anaerobic organismhitherto supposed to be entirely saprophytic, isreported by Teissier, Reilly, Rivalier, and Layani.l’The patient was a healthy male, aged 38, who was- suspected of small-pox. He was taken suddenly ill-with headache, backache, vomiting, and purpura.Later there was jaundice and generalised vesicular.and pustular eruption. The coagulation time wasprolonged-as was to be expected in the presence ofjaundice-and there was no change in the bloodpicture. He died within a week. Lesions were almostconfined to the liver which contained many abscesses ;the biliary tract was nowhere involved, and theabscesses were confined to the parenchymatous tissues.Small abscesses were present in the kidneys. From thepustules during life, and from the blood, pure cultures i- of an anaerobic Gram-negative bacillus, recognised bythe authors and by Veillon as B. funduliformis, wererown, and post mortem it was found in the hepatic.abscesses. This organism was first identified by Halléin the female genital tract, and has since been fairly iwidely found, but always saprophytically. It is not, ian a rule, pathogenic to laboratory animals ; but inthis case it proved fatal to guinea-pigs and rabbits,.always giving rise to hepatic abscesses on intravenousinjection. The authors of this paper believe that theorganism got through the intestinal tract into the

portal blood, since it cannot live in the presence ofbile, and did not infect the biliary passages. Theirdescription is noteworthy, since cases of generalisedinfection with anaerobic organisms, whether of.established virulence or not, are uncommon.

ENDEMIC AND EPIDEMIC MALARIA IN

SOUTHERN RHODESIA.

Dr. J. Gordon Thomson has done notable work onmalaria and blackwater fever in Southern Rhodesia,and in a paper read to the Epidemiological Section ofthe Royal Society of Medicine on April 26th he gave afurther critical review of the malarial conditions inthis attractive territory. The youngest of the self-governing Dominions, it is twice the size of GreatBritain, and enjoys for the most part a climate wellsuited to white settlers. The census of 1926 showed anindigenous negro population of just under a million.and about 39,000 Europeans. Since then some

10,000 new white settlers have probably been added.’The country is a high plateau lying between latitudes15° S. and 25° S.-i.e., within the tropics. Most ofthe whites live along the watershed running S.W. toN.E. at 5000 feet above sea-level. About a quarterof the entire area lies at 4000 feet, and there is muchgood agricultural land at 3000 feet above sea-level.The work of Christophers has established that

malarial hyperendemicity lies in the fact that whilethe adult indigenous inhabitant is tolerant to malaria

1 Paris Méd., March 30th, p. 297.

and seldom suffers from an acute attack, the infantssuffer for the first few years of life from acute malariawith numerous parasites in their blood, and a veryhigh infantile mortality is the result. The survivorsof this " acute infestation " gradually develop a

tolerance to the parasite and acute attacks becomeprogressively less frequent (" immune infestation "),till finally the adults are completely tolerant andseldom show parasites in the peripheral blood,although all are presumably infected with the parasite.In Southern Rhodesia hyperendemic malaria prevailswith yearly seasonal epidemics among the non-immunes-namely, the indigenous negro children,and the whites of all ages. All these non-immuneslive in a country where for about six months in theyear the density of anopheline mosquitoes whichbite man is high, and the atmospheric temperatureand humidity are eminently suitable for the develop-ment of the malaria parasite in the common carrier4y2opheles garnbiae (A. costalis). The hyperendemicityof malaria in Southern Rhodesia is shown by thefact that the enlarged-spleen rate in children is wellover 50 per cent. ; often over 90 per cent. in thosebetween 2 and 10 years of age. Moreover, theparasite rate (endemic index) in the negro childrenis extremely high. The charted records of 1924-26demonstrate that the amount of malaria varied fromyear to year directly with the rainfall; as the rainscontinue, so increases the number of cases of malariaand blackwater fever. The peak of the acute malariaincidence amongst the whites is in April; there is aquick drop in May and June with the onset of the coldweather, and it is interesting to note that Leesonreports that A. gambiae appears first in late Novemberand remains till early June, when it disappears.Hyperendemic factors such as those operating

now in Southern Rhodesia, and, moreover, associatedalmost entirely with the malignant tertian malariaparasite, make it plainly impossible for a non-immunewhite population to live there healthily unless theydevote some intelligent, withal simple, effort toprevent malaria. But, in fact, carelessness and thestubbornness of ignorance lead to needless deaths andto much sickness from malaria among the whitesettlers, especially in the rural areas. Dr. Thomson, atfirst-hand experience, agrees heartily that " theattractions of Rhodesia are manifold and well-nighirresistible, and to the right type of immigrant itoffers a home well worth living in, and developing forfuture generations." But he emphasises that thesettler must be of the right type; and clearly thismeans right-thinking about malaria and mosquitoes.He deplores the fact that to-day so many of the whitesettlers are as individuals apparently blind to thefact that prevention of malaria is for them a personalaffair, and many of these blind resist enlightenment.No doubt in the process of development the diseasewill some day, in Rhodesia, be reduced to a minimum,where now it is of maximum importance. Meanwhilean intelligent settler in that country may protecthimself and family from malaria by a well-constructedand screened house, with a strict and careful use ofwide mosquito nets for the beds, by destroyingmosquito larvae in and around his living quarters,and especially by keeping negro children far awayfrom his living quarters. Dr. Thomson points outthat there are many white settlers in rural SouthernRhodesia to-day who live free from malaria by justthese measures. These many might and should bemany more.

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" No practitioner is safe against becoming involvedin very costly litigation arising out of his practice.This risk is one against which insurance should alwaysbe effected." So runs a sentence in the annual reportof the Council of the London and Counties MedicalProtection Society, and it may be taken as the moralof the many instructive stories which the reportcontains. No one would claim any novelty for thesentiment, since it is repeated monotonously every