'M56JUNE:1I,I9271ltEMORANDAi. t THE BRITrsg1056 JUNE, II, II)271 I_ _ EMRADA MDICAL .TOWWA

MEDICAL, SURGICAL, OBSTETRICAL.

THE LEUCOBLASTOSIS OF GLAND ULAR FEVER.A HEALTHY boy, aged 4 years, had been ill for one day.There was nmarked enlargement of cervical glands on bothsides; the tonsils were red and swollen, and the temperaturewas 1030 F. In three days he was much better, the tonsilswere still large, and the swellings at the angles of thejaw were even greater. He made a good recovery.On the fourth day, when glanidular swelling was most

marked, blood films showed normal red corpuscles, andconsiderable leucocytosis, with differential count: poly-morphs 50 per cent., cosinophils 2 per cent., mast cells1, per cent., lymphocytes 29 per cent., mononuclears 13 percont., plasma cells 1 per cent., myelocytes 1 per cent.,leucoblasts 3 per cent. Leucoblasts in films, fromii anginawere new to me at the time (Septemvber, 1920), andl, withthe remarlable glandular enlargement, suggested incipientleukaemia. In referring to glandular fever Pr ofessolGulland' said that he had never seen myeloblasts (leuco-blasts) in the blood of these cases. As textbooks arereticent about these cells, it may be useful to describethem briefly.The leucoblast resembles a large mononuclear cell. Its

basophil cytoplasm is ample and may show azule granules.Its large oval or reniform nucleus stains well in a stripedpattern . But cells differ in age, and, therefore, vary inform and staining. The form commonly seen is (1) a bigcell with large kidney-shiaped nucleus and amiple light bluecytoplasm with or without scanty azure points. Develop-ment now prooeeds in one of two directions: (2) thenucleus stailns with denser stripes, and the cytoplasm showsnumerous coarse, dark violet gralnules; or, (3) the nucleusbecomes irregular, even polymorph, and the cytoplasmpaler or lilac; these cells are. sooni indistinguishable fromlargo mononuelears.Some of the first are easily identified, aind the second

formn is quite characteristic and not to be mistaken forany other cell of the blood. For this reason I iincludedonly the socond form in my differelitial count and under-estimated the leucoblasts present.The description is in terms of Romanowsky staining, |

and for identifying leucoblasts I prefer the polychromeManson blue method,2 because it brings out the coarse,violet granules better alnd in a greater proportion of cells,just as in benign tertiall infectioiis it deeply stainsSchiiffner's dots. Jennier-Giemsa fails to do tllis.West Ealing. ROBERT CRA.IK, M.D.

PULMONARY EMBOLISM FOLLOWING FRACTUREOF LEG.

THE following case is of interest in conlnexion with themodern treatment of fractures by early massage, and raisesthe question whether it is likely to cause separation ofblood clot and the resulting tragedy of pulmonaryembolism. The case occurred at the height of tlhe recentinfluenza epidemic, and splints were taken down only threeor four times when the joint was very gently massaged bymyself. Had my attentions been more frequent or vigorous[ should probably have charged imiyself with being theunwittinig inistrument of causing this unfortuniate man'sdeath. It would be of interest to kniow how oftenipulmoliary embolism follows fractures, whetlher treated bymassage or otlherwise.A stone-breaker, aged 62, of spare build and in good health,

fell when getting over a stile and sustained a simple Pott'sfracture of the right ankle, the fibula being fractured about aninch and a half above the external malleolus and the medialmalleolus torn off. Under chloroform the fracture was set andkrept in position by lateral splints;i the leg was hung in aSalter's cradle. Union was perfect, and movement quite eood.Three weeks after the inljury the patient complained of pain in

-1BRITISH MEDICAL JOURNAL, 1926, ii, 593.' Ibid., 1924, ii, 788.

the left side for which I was unable to account; I could detectno abnormal souinds, and put it down to a slight pleurisy due tohis sleeping tliree feet away from an open window. I orderedmustard plasters, which were used for four or five days; thepain did not subside, though the patient was in excellent healthand in the very best of spirits, expecting to be allowed. ul? oncrutches in a few days.On the twenty-fourth day of the injury the patient -was

laughing and joking with his neighbours; on the twenty-fifth dayhis dauglhter was wakened at 6 a.m. by her father's peculiarbreathing; slhe got up and went for a neighbour. The patientwas dead before her return in a few minutes. A post-mzo) tciTexamination was not performed.As these was no heart lesion or other organic disease

I think thero is no doubt that this was a case of pulmonary,embolism.

ERSKINE FARTAKER, M.R.C.S., L.R.C.P.Keinton Mandeville, Somerset.

etpoUts of *orietiet.CLEFT PALATE.

A DISCUTSSION took placo in the Section of Surgery of theRoyal Society of Medicine on June 1st on the operativetreatmiient of cleft palate. In the afternoon a number ofcases in whiclh operation lhad takeni place some years pre-viously with good aniatomiiical and phonetic results wereexhibited, and a discussion began at five o'clock which,with a brief interval for dinner, colntinued until after teln.Mlr. V. WARREN Low presided.

Sir JAMES BERRY exhibited, several patients upon whomhe had performed his lateral approximation operation, andthe speech results wele demiionstrated to the meeting. Theltest sentence which they were asked to repeat was: " Ona bridge, by a church, I met a flock of turkeys "; but oneof tho patients, a young man, said that he was not goingto utter such nolnsense, anid he nmade a perfect little speech,in whicll lie paid a tribute to his old nurse, who had takenpailns after the operatioll in his childhood to educate himin voice formation. Sirb James Berry said that the main,almiiost the only, object of operating upon a cleft palatewas to enable the person to speak intelligibly. The viewformerly held by some that the operation might be regardedas a life-saving one was now, he thought, exploded. A smallproportion of clefts whiclh were very narrow and limited totlle soft palate could doubtless be closed within the filrstweeks or months of infancy by the operation of lateralapproximation; but in tlle vast majority of cases it ,wasimnpossible at this very ear-ly stage to perform the operationwith any reasonable chance of success owing to thel widthof the cleft and the lowvness of the palatine arch. The ageof operation should be tlle earliest at which, in the oxpe-rionce of the operator, a lateral approximation opelatioiwould givo a reasonable chance of closing the cleft.Generally this was froom 18 months to 4 years. In, 'thereally difficult cases, such as a wide cleft involving tlhesoft and most of the hard palate, it was often a good planto close the cleft of the soft palate first and to leave thehard palate unclosed for a time, rather than risk failureof the wholo line of unioln by attempting too much. It wasthe soft palate that was most important to closo. Ifthe hard palate was closed and the soft left unclosed afteran operation little good usually was done; on the otherhand,. if tho soft palate were successfully closed and thehalrd palate left unclosed the patient m-night be greatlybelefited. His ownl views as to operation were basedupon 276 cleft-palate patients, uponi wiomii lie had operateddurin-g the last thirty-three years. Befolre operation grcssdefects of teeth and tonsils should be remnedied, though liethought routine excision of tonsils or adenoids unnecessary.Iti the case of wide and difficult clefts lateral incisiolns torelieve tension were frequently necessary on one or botlisides, but .they should, in his opinion, be as short aspossible, seldom more than 1/2 inch in length, except inthe case of secondary operations for large holes in -he hardpalate. Of late years he had been using lateral incisionisless and less, replacing them as regards the soft palate bythe use of deep tension stitches and rubber plates after thO

JUNE ITt;,I,I9271 BIRTHDAY HIONOURS. TIm BRJITISH 1077JUNE~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ MEIA JOUNA"T927

BIRIHDAY IIONOURS.THE lhonouirs list issued on thei occasion of His Majesty'sbirthiday inieluded th-e nam-les of the followinig memberscf the medical profession:

K.C.V.O.EDWARD FARQUHAR BUZZARD, M.D., F.R.C.P., Plhysician

Extraordinary to the Kinlg; Physician to St. Thomas'sHospital.

K.B.E. (Civil Division).CHARLES PERCY BARLEE CLUBBE, M.R.C.S., L.R.C.P.,

F.A.C.S., Consulting Surgeon, Royal Prince Alfred Hospital,Sydney, in recognition of services to the Commonwealth ofAustralia.

Knighthood.CHARLES JAMES MARTIN, C.M.G., D.Sc., LL.D., D.C.L.,

F.R.S., M.B., F.R.C.P., Director of the Lister InstituteLondon (formerly Chairman of the Science Committee of theBritish Medical Association).

Louis. EDWARD BARNETT, C.M.G., M.B., C.M., F.R.C.S.,Professor of Surgery, Otago University, Dominion of NewZealand; President of the Australasian Medical Congfress heldat Dunedin, 1927, under the auspices of the British MedicalAssociation.

C.B. (Military Division).Major-General JOHN MACFARLANE SLOAN, C.M.G., D.S.O., M.B.,

late R.A.M.C., Deputy Director of Medical Services, SouthernCommand, India.

C.B. (Civil Division).Colonel CHARLES PYE OLIVER, C.M.G., T.D., M.D., late Territorial

Army.C.V.O.

HENRY LINNINGTON MARTYN, M.V.O., M.B., F.R.C.S., SurgeonApothecary to H.M. Household at Windsor.

C.I.E.Lieut.-Colonel JOHN CYRIL HOLDIcH LEICESTER, I.M.S., lately

Officiating Surgeon-Genieral to the Governiment of Bengal.Major ALFRED GEDDES TRESIDDER, I.M.S., Surgeon to His

Excellency the Governor of Bombay.

C.B.E. (Military Dirision).Surgeon Captain ALFRED JAMES HEWITT, R N.

C.B.EF. (Civil Division).NE1L MORRISON MACFARLANE, M.D., C.M., Principal Medical Officer,

Basutoland.WILLIAM MARSHALL PHILIP, M.B., C.M., lately Medical Officer

of Health, Colombo Municipal Council, Ceylon.

O.B.E. (Military Division).Surgeon Commander GuY LESLIE BUCKERIDGE, R.N.Major CHARLES MORGAN FINNY, M.B., F.R.C.S., R.A.M.C.Major JoiiN HEATLEY SPENCER, M.D R.A.M.C.Captain HAROLD WILLIAMSON, M.B., .R.C.S., I.M.S.

O.B.E. (Civil Division).Dr. EDMUND LLOYD, M.B.E., Church Missionary Society.Captain MAHOMED FAZAL-UD-DIN, I.M.S., Agency Surgeon at

Jandola, South Waziristan.ATTILIo CRITIEN, M.B.E., M.D., Chief Government Medical

Officer anid Superintendent of Public Health, Malta.MrS. CHARLOTTE ELIZABETH FERGUsoN DAVIE, M.D., in recognition

of her services in the Straits Settlements.JOHN RANDALL PHILLIPS, M.B., Senior Member of the Legislative

Council of Barbados.Major HASAN SUHRAWARDY, Indian Territorial Medical Corps,

medical practitioner, Bengal.

M.B.E. (Military Division).Subassistant Surgeon Subadar GURDITT SINGH, I.M.D.Quartermaster and Lieutenlant JOSEPH EDWARD PUGH, R.A.M.C.Jemadar SAYED GUL ARBER SHAH, Subassistant Surgeon, 2nd

Cavalry -Regiment, Iraq Levies.Assistant Surgeon (2nd Class) HENRY CARLYLE WILLIAM WINDSOR,

I.M.D.

H.B.E. (Civil Division).KOBAD DHUNJIBHAI MUGASETH, Medical Practitioner, Calicut,

Madras.

Kaisar-i-Hind Mcdal (First Class) (for Public Services in India).Miss ETHEL ADELAIDE DOUGLAS, M.B., B.S., Medical Officer in

Charge of the Kinnaird Women's Hospital, Lucknow.Dr. CARL FREDRIK KUGELBERG, Church of Swedenl Mission,

Tirupattur, Ramnad District, Madras.The Rev. CALEB DAVIES, Medical Superintendent, Sonthal Mission

Eospital, Sarenga, Bankura, Bengal.

A111niot nf ontJ iMvica.[FROM OUR CORRESPONDENT IN PRETORIA.]

ENZ'o6TIC RABIES.ALTH1O(UGH several outbreaks of rabies, nmore or less serious,'w-ere described as hiving occurre-d in Soutlh Africa lastcoiitury, the diseaso has been almost entirely uniknown inthe Ulnion during the pas-t thirty years. Thero has beenlnothinig comparable to the post-war prevalence whichoccurred on the continenit of Europe. Of lato years, how-ever, disquieting evidence has emerged of tho existenceof rabies among two species of wild animnals of the Union-the yellow mongoose and the genet cat. Both aro smallcarnivores, the former belonging to tho Viverridae and thelatter to the Felinae. Both are shy animals, normallynever approaching homesteads. But according to reliablenative evidence they periodically go mad, anld will thenapproach human habitations and actually attack persons.These natives maintain that a person or animal so bittenwill often within a period of a month or two dio after,having showvn signs of madness.

Since 1916 six cases have been described by country prac.etitioners with] symptoms indistinguishable from thoso ofrabies, where the biting animal was shown to have beeln amlongoose. These cases have invariably been fatal after anillness never lasting longer than six days; in all it wasfound oln subsequent inquiry that the patient had beenbitten a montlh or six weeks previously by a mongoose.Ulnfortunlately in none was pathological confirmationi pos-sible, as post-mortem material, when forwarded, invariablyarrived at the laboratory in a decomposed state, so thatneither recognition of Negri bodies nor inoculation testswere possible.In December, 1920, a European male clhild on a farm in

the northern Free State died two days after symptoms ofrabies had appeared; six weeks previously he had beenbitten in the shoulder while interfering in a fight betweenhis domestic cat and a mongoose. The cat survived untilafter the death of tlle child, when it was killed anid thehead senit to the South African Institute for MedicalResearch in Johannesburg. The result of the examinationwas negative. Three years later a case was reported froma farm in the Middelburg district of the Transvaal. Eightweeks, previous to the onset of symptoms the patient, anagricultural student, aged 21 years, had giveln chase toa yellow mongoose wlhich he had come across wanderingaimiilessly on the veld. Ordinarily this creaturo is veryactive, and quito impossible to catch by chasing; yet thisspecimen was caught after being followed by its captorthrough four well strung barbed wviro fences. It was,therefore, certainly not in normal health. When caught itbit the man savagely in the finger, and held oln sopertinaciously that a knife had to be used as a lever toopen the jaws. The case was described by the attendingpractitioner in the South African Medical Record, anld thecareful account left little doubt that the case was onie ofrabies. The relatives would tnot consent to a post-miortemexamination, and the practitioner was unaware that suchan examination could be ordered by tho magistrate underSection 34 of the South African Public Health Act. TheDepartment of Public Health was notified too late forconfirmation by post-nmortem and laboratory examinationto be possible.

Last Junle a case was reported from a farm in tleWolmaransstad district of the Transvaal. A Europeanboy, aged 7, was bitten by a yellow mongoose in the righthand, between the thumb and the first finger. He hadfound the animal lying ill in a prospector's hole. On liftingit, it took such a firmii hold of the boy's hand with its teeththat his companions had to hit the animiial with stones toinduce it to let go. The wound healed cleanly, but somiie sixweeks later the boy became drowsy anld the site of the bitepainful. Typ-ical sy7mptoms developed; spasm of the throatmuscles of increasing violence occurred on attemlpting todrink; by the morning of the third day the lad was quiteunable to swallow anything; the mere mention of flui~would bring on a violent spasm. Death occurred on tht

10C83 JUSE ii, 1927 MIEDICAL NEWS. -[' Tiaz Bitrost1083 ,TuNE ZT, 19271 ~~~~~~~~~~~~~~~~~~~~~~~~~IMZDICALJOURNAL

improve^d. It was not true to say that he was dying, but hishealth was not improving, anid consequently the Governmentreleased him unconditionally.

-Shop Acts, 1.920 and 1921.Wlheni the Committee whiclh is considerinig thlie Slhop Acts of

1920 and 1921 met on May 31st Dr. Marion Plhillips and Mrs.Adamson gave evidence on behalf of the Standing JointCommittee of Industrial Women's Organizations. They saidinquiries showed that there was no real demanid for later hoursin confectioners' shops. Girls employed were often extremelyyoung, and suffered physically from the lonig lhours. Instanceswere giveln of sickness anid genieral debility amonig them.

The General Mledical Council.-Answering Mr. Macquisten, onJune 2nd, Mr. Chamberlain said he did not think that moderndevelopments in therapeutics necessitated any revision of thepowers and duties of the General Medical Council. He added thatthe Earl of Balfour shared this view. Mr. Macquisten, in his ques-tion, had asked for the appointment of a Royal Commission toinquire into the operation of the Medical Acts and the powers andprivileges of the General Medical Council.Number of Insured Pcrsons.-Mr. Chamberlain announced that

at the end of 1926 there were, exclusive of persons over 70 whohad ceased to pay contributions, 9,857,000 males insured inEngland and Wales under the National Health Insurance Act and4,658,000 females. Since the end of 1925 the increases were 251,000and 68 000 respectively. In Scotland the comparable figures atthe end of 1926 were 1,144,000 males and 571,000 females, beingan increase in the year of 28,000. In Northern Ireland the figuresfor 1926 are not expected to show material change from those for1925, which were 194,300 males and 139,700 females.

Notes in Brief.The latest official information from the Bombay Presidency

indicates that conditions continue to improve in the four districtsaffected by cholera. In the week ended April 30th 1 092 attacksby, and 461 deaths from, cholera were reported in thes'e districts.in a reply to Mr. Groves, Mr. Chamberlain said he would not

introduce legislation requiring parents who believed in vaccinationto make a statutory declaration of belief in order to lhave the rightto subject their children to it.Mr. Chamberlain states that the substantive regulations dealing

with the standardizing of vaccines and serums will be laid beforeParliament, anid will be available immediately after the Whitsunrecess.Mr. Baldwin has stated that no useful purpose would be served

by setting up -a Royal Commission on the financial difficulties ofthe voluntary hos-pital system.The Minister of Health announces that it is proposed to instal

artificial light treatment at the North Wales Sanatorium, Denbigh.Arrangements have been made for it at the Orthopaedic Hospitalat Gobowen and at the Wrexham Dispensary.A bill to provide for the humane slaughter of aniimals in

Scotland was presented, on June 2nd, by Colonel Moore, supportedby Dr. Drummond Shiels.No women police doctors have been appointed in the Metropolitan

Police area.No standard tests are prescribed to ensure that imported con-

densed milk complies with the Public Healtlh (Conidenised Milk)Regulations, but tests are made at discretioin by the Governmentchemist and by public analysts.

UNIVERSITY OF CAMBRIDGE.AT a congregation held on June 4th the following medicaldegrees were conferred:M.D.-C. IT. C. Dalton, E. HI. H. Granger, L. E. H. Whitby.M.B., B.CHIR.-R. K. Debenham, R. L. Lancaster, R. D. Milford,

J. H. Randall, R. E. Smith.M.B.-H. V. Dicks, H. V. Coverdale.

UNIVERSITY OF LONDON.THE following candidates have been approved at the examinationindicated:THIRD M.B., B.S.-51G. C. Babington, *1+?Max Barer (University medal),

*11E. A. Freeman, *fG. R. N. Henry, *+§ Winifred A. Ladds, *l FlorenceLouis, *11 J. M. Turner, *1E. C. Warner, *ftH. L.-C. Wood, C. E. H.Anson, C6cile H. D. Asher, A. L. Banks, J. T. Barr, R. E. Barrett,D. E. Barton, A. D. T3elilios, Joan H. Blackledge, D. A. BIount,Eleanor D. Blunit, Hilda M. P. Bond. D. G. Bown, D. A. Brigg,Muriel Brighton, Margaret H. Brown, Helen M. Browne, Helen R. B.Buck, T. S. Cochrane, A. Cohen, Mary C. E. Constantine, E. S.Curtiss, F. J. D)arbyshire, G. I. Davies, T. E. Davies, J. Dean,A.VE. de Chazal, Jean M. Dollar, Margaret R. Dunlop, M. H. C.Dyson, J. Evans. F. M. M. Eyt n-Jones, Dora J. Fox, A. E. Fraser-Sm-iith J. Gabe, B. NI. C. Gil.enan, A. S. Gough, W. P. Greenwood,C. H. Hampshire, Kathleen Heyes, Hf. F. Hiscocks, Janet I. Hoare,Joan Houseman, E. G. Howe, Ausa H. Jackson, Margaret E. LIedger,NV. Leslie, A. H. Levers, Marian Lones, Joan L. Lush, JoyceMcConnell, A. C. MacLeod, G. S. Malik, C. W. Marshall, I. Muende,J. W. Nankivell, Helen E. M. Newman, Joan Nixon, Marjorie E.Parfitt, S. M. Power, Marion Ravell, J. H. 0. Roberts, L. Roberts,W. C. Robinson. Enid H. Rockstro, S. T. Seccoilibe, M. Sendak,J. Silverstone, K. S. Smllith, G. E. F. Sutton, F. W. Ta'Bois,Kathleen E. Tresilian, MIaeve Whelen, Elizabeth M. Whishaw,J. S. Whitton, H. K. Williams, B. H. H. Wooderson, 13. Wornum.Honours. t Distinguished in Medicine.

S Distinguished in Pathology. a Distinguished in Surgery.* Distingiushed in Midwifery.

Group I.-Marjorie F. Brierley, D. A. Dewhirst, Phyllis M. Edgar.L. Fatti, A. Golombek, C. 'B. Huss, Caroline M. Kingsnmill, F. E.Kingston, It. A. V. Lewys-loyd, Isalbella L. H. Livingstone, W. E.Lock, Helen E. Mayfield, Bertha I. Meyer, Ethel E. M. Ogilvie.Evelyn D. Owen, G. E. B. Payne, Margaret E. Peaker, K. R, T.Peiris, E. S. Phillips, R. L. Quilliam, E. W. Skipper, J. R. 0. Spicer.Victoria W. Symonds, Olive M.-Thomas, F. S. Thornton, Winifred M.Turner, Joan B. Walker, R. F. Ward, It. M. Williams, H. D. Wyse.Groip rr.-G. T. Allerton-, C. A. Amesur, V. FitzC. Anderson, C. G.Bowen, F. W. Bradley, P. J. L. Capon, J. A. Cholmeley, Doris B.Clay, R. R. Fells, P. H. Flockton, J. R. Forrest, K. T. Gajjar.Dorothy Godden, C. H. Harper, T. H. Hobbes, K. H. Lachlan, M. L.Maley, W. D. Nicol, N. D. Patel, G. M. Phadke, B. F. lRussell,C. F. J. Smith, W. R. C. Spicer, Kathleen M. Stuart-Harris, Olive F.Sydenham, E. C. Tamplin, F. Welsh, J. G. Weston, C. L.Worthington, Elsie B. Wright.

UNIVERSITY OF BIRMINGHAM.DR. I. DE BURGi DAI,Y, Lecturer in Experimenltal PhysiologyWelsh National School of Medicine, University of Wales, Cardifthas been appoilnted to the Chair of Physiology, vice ProfessoiE. Wace Carlier, retired.At the aniniuai degree conigregatiou to be held on Saturday,

July 2nd, the honorary degree of LL.D. will be conferred upou thefollowing members of the medical profession: Sir David Ferrier,F.R.S., Sir Watson Cheyne, Bt., K.C.M.G., F.R.S., and Sir WalterFletcher, F.R.S., secretary of the Medical ilesearch Council.

ROYAL COLLEGE OF SURGEONS IN IRELAND.AT the anuual meeting of the Royal College of Surgeons in Ireland,lheld on Juue 2id, a reso'tltion wvas adopted untanlimouisly thankingMr. R. Charles B. Maunsell, tlhe ex-President of the College," for the admirable anid successful services lhe rendered the College,aud, indeed, the profession in Ireland in geueral, in connexio wViththie settlemeent of medical registration in the Free State, afterconsultation with the members of the Executive Council of theDail."

INDIAN MEDICAL SERVICE DINNER.THE annual dinner of the Indian Medical Service will be held atthe Trocadero Restaurant on- Wednesday, June 15th, at 7.15 for7.30 p.m., wlhen Major-General R. W. S. Lyons will take the chair.Tickets and all particulars may be obtained from the joint bonorarysecretary, Colonel J. J. Pratt, I.M.S. (ret.), 18, Nevern Mansions,Warwick Road, London, S.W.5.

DEATHS IN THE SERVICES.LIEUT.-COLONEL EDWARD TEMPLE HARRIs, D.S.O., I.M.S., died ofperitonitis, on May 24th, at Mayoyo, Burma, aged 49. He wasborn on April 27th, 1878, the son of the late Dr. A. B. Harris ofFalmouth, and educated at Christ's College, Cambridge, and at theMiddlesex Hospital. He graduated as B.A. and B.C. in 1903, and asM.B. in 1904, at Cambridge. After filling the post of house-physician at Middlesex Hospital, he entered the I.M.S. on August31st, 1903, and attained the rank of lieutenant-colonel on February28th, 1923. He served throughout the recent great war, was thricementioned in dispatches, and received the D.S.O. in 1917.Captain Gautam Kurpar, I.M.S., died on April 4th, aged 32. He

was born on June 15th, 1894, and educated at the Punjab University,Lahore, where he graduated M.B. and B.S. in 1918. Entering theI.M.S. as a temporary lieutenant on July 23rd, 1918, he receiveda permanent commission on November 1st, 1920, and became captainon July 23rd, 1921. He served in the latter part of the recentgreat war.

THE ninety-first annual report, for the year 1926, of theRoyal Medical Benevolent Fund is a volunie of 200 pagles, alarge proportion of them, in the nature of thiugs, being givento lists of donors and subscribers. Matter of most generalinterest will be found in the brief report of the Committee otManagement, presented to the annual meeting two nmonthsago, and reported in our issue of April 16th, p. 740. It will berecalled that during the year there was an iDcrease of £1,050in new subscriptions, and altogether 622 persons were relievedby grants or annuities. The incoine from subscriptiois anddonations was £7,250, and from invested property £4,718. Thetotal distribution was £10,770, aud the working expenses were£1,367. Discussing the flnanicial position genierally the com-mittee expressed the hope tllat as the result of the organiza-tion set up by the British Medical Association, the inicomle ofthe Fund would increase, and thus enable assistance to bedisbursed on a larger scale. Gratefiil acknowledlgement ismade to the continued assista-nce of the Association in collect-ing subscriptions from its mBembers; these amiotiunted to £1,141in 1926. Thanks are also tendered to the edlitors of the BrdtishMedical Journal aind the Lancet for their hell) by publishingCmonthly reports of the meetings and in other wvays.-

JUNE IT, 19271 I,TTERS, NOTES, ANSWERS. IIMEDATLBJURsN 1087

IN connexion with the approaching Annual Meeting of theBritish Medical Association in Edinburgh next month it may*be well to remind members proposing to attend that theHotels and Lodgings Committee has taken over all theavailable rooms in the city. Dr. Drever, the ScottishMedical Secretary, 6, Drumsheugh Gardens, Edinburgh, hasundertaken the work of allocation, and members requiringrooms should communicate with him without delay. Veryfew single roons are available in hotels, but there are somein boarding houses and hostels, and there are plenty ofdouble rooms. Members proposing to attend the meetingwho have made their own arrangements for accommodationare requested to notify Dr. Drever.THE summer dinner of the Australian and New Zealand

Medical Association in England will be held on June 17thl atthe Piccadilly Hotel. Mr. Joseph Cunning will be in thechair, and Sir John Bland-Sutton, Bt., will be the official guest.MedicalVisitors are invited to communicate with t-he honorarysecretaries, E. T. C. Milligan and Bedford Russell, 86, HarleyStreet.THE annual meeting of the Sheffield Association of the

Medical Women's Federation will be held in the MedicalLibrary, the University, Sheffield, on Saturday, June 25th,at 3.45 p.m., when an address will be delivered by Dr. HelenBoyle (Brighton) on' manifestations of nervous instability.A cordial invitation is extended to all members of the pro-fession to be present.THE next meetiing of the Biochemical Society vill be held

in the Biochemical Department, The Museum, Oxford, to-day(Saturday, June l1th) at 3 p.m.SIR RICHARD T. GLAZEBROOK, K.C.B., F.R.S., formtierly

Director of the National Physical Laboratory, lhas beenappointed a mlemuber of the Advisory Counicil for Scientificandi InduLstrial Research.THE General MIedlical Council has republished the report on

the conditions iinder which me(lical an(d dental practitionersregistered or legally qualified in their own counitry m-laypractise abroad. The book first appeared in 1910 and sub.sequent -editions were issued up to 1921. Lists are includedof couintries in which medical practice is permissible withoutlegal qualifications, and of those where naturalization is anessential requirement. The information given is for themost part of a general nature, but in every case ani adldressis supplied of an official from whom further ilnformation imiaybe obtained. The voluLme, which is obtainable fromii Messrs.Constable and Co., Ltd. (10, Orange Street, LondoD, W.C.2),at the price of 2s. 6d. (postage extra), will be found veryvaluable by tho.e who are contemplating medical practicein foreign lands. Tue Dental Board of the United Kingdomhas prepared a nlemorandum (price ls., post free) on the pro-cedtire to be adopted by those who wish to enter the denitalprofessioni, with notes on the costs and prospects. Rsferenceis made to the system of bursaries instituted by the Board,and it is suggested that a considerable increase in thenumber of dental students is (lesirable. Furtlher Informa-tion about these bursaries nmay be obtained from theRegistrar of the Dental Board, 44, Hallam Street, PortlandPlace, W.1.AN employment bureau for convalescent patients from

tuberculosis lhas been opened by the Society of Superintend-ents of Tuberculosis Institutions, with a temporary office at122, Harley Street, W.1. Lists of vacant posts will be suppliedat intervals to members of this society and the TuberculosisSociety.THE fifth congress of French-speaking pediatrists will be

held at Lausanne next September, when the following ques-tions will be discussed: Treatment of paralyses in chiildhood;vaccine treatment of bronchopneuinonia.THE Accademia (lei Lincei of Rome, foundedin 1603, has

received ani annual donation of 4,275 dollars fromi the Rocke-feller Institute for the puLrchase of scientiflc periodicals.A BUST of Emil von Behring was recently unveiled in the

hall of honour of Mexico University, of which he had beenmade a doctor honoris cautsa in 1910.DURING 1926, 1,614 cases of acute poliomyelitis with 171

deaths, and 6,787 cases of puerperal fever with 1,872 deaths,were notified in Germany.WE have received a copy of the fourth volume of papers

emanating fromn the Obstetrical and Gynaecological Clinic -ofCopenhagen UTniversity. It consists of a collection of seven-teen articles in French, German, English, or Danish, whichhave been published elsewhere, with an appendix dealingwith the statistics of the clinic for the year 1925.A PAMPHL,ET describing the natural brine baths of Droitwich

aan be obtained from Mr. EI. Berkeley Holiyer, iBaths Offices,Droitwich. A detailedl aeconuat is given of the variouls formnsof treatment and of the surrounding country, with n.umerousillustrations.

All communications in regflard to editorial business slhould beaddressed to The EDITOR, British Medical Jcurnal, BritishMedical A ssociation House, Tavistock Square, W.C. 1.

ORIGINAL ARTICLES and LETTERS forwarded tor publicationare understood to be offered to thle BItsTISH MEDICAL JOURNALalone uniless the contrary be stated. Correspondents who wishnotice to be taken of their commrunications shiould authenticatethem with their names. not necessarily for publicationi.

Authors desiring REPRINTS of their articies publislhed in theBRITISH MEDICAL JOURNAL must communicate with the FitiancialSecretary and Business Manager, British Medical AssociationHouse, Tavistock Square, W.C.1, on receipt of proofs.

All communications witlh reference to ADVERTISEMENTS, as wellas orders for copies of the JOURNAL, should be addressed to theFinancial Secretary and Business Manager.

The TELEPHONE NUMBERS of the Britislh Medical Associationand the BRITISH MEDICAL JOURNAL are dIUSEULA 9861, 9862, 9863,and 9864 (inlternal exchange, four lines).

Thle TELEGRAPHIC ADDRESS&S are:EDITOR of the BRITISU MEDICAL JOURNAL, Aitiology WVestceut,

Lonidont.FINANCIAL SECRETARY AND BUSINESS MANAGER

(Advertisements, etc.), Ai ticulate Wcstcentt, London.MEDICAL SECRETARY. jlcdisecra Wcstccnt, Lontdon.

The address of the Irish Office of the Britislh Medical Association is16, South Frederick Street, Duiblin (telegramss: Bacillus, Dublin;telephoine: 4737 Dublin), anid of the Scottish Office, 6, DrIunislicughllGardens, Edinburgh (telegrams: Associate, Edinibur-gh; teleplhone:4361 Central).

QUERIES AND ANSWERS.

T. D." asks ror advice in the treatmenit of a main, aged 62, wlho,for the past thiee years, has suiffered every three or foutr veeksfrom attacks of vomniting, accompanlied by profuse. perspiration,and lasting from onie to six hours. Thle patient lias beeni ex-amined by a specialist and has been given laxatives, withoutimproveinent.

NEURITIS AND ULTRA-VIOI,ET RAYS.DR. C. BURGOYNE PASLEY (I'erak, F.M.S.) ask(s for suiggestiolns

for the treatment of a womani, a(ed 40, in whosn n-euritis de-veloped after exposure to iltra-violet rays. Slie hadl residedlill the tropics for imianiy years, buit uniiderwenet tNvo operationswhile oii leave recenitly in Enigland (tonisillectomy for sel)tictoinsils anid gastro-jejuniostomy for gastric iulcer). Sinice lherrettirn to the East slhe has suffere(d from assaemia aild genieraldebility. She was treated by moderate doses of ultra-violet rayswhich were inicreased weekly up to ani exposure of six miiiuttes.She always complained of fatigue after the treatmenit, but herappetite improved somewhat. Early ill March she conitractedinflueniza anid was ill for a week. Fotr days after recoveryratiler severe sciatic paiins (leveloped aiidl persisted for tvo Cays,anid she was theni attacked by acute neuiritis in both lhasid(s. Thiethenar emillenlces, thumbs, anid ind(lex fingers were chieflyaffected ; the pulp of tlhe terlminal phalasuges became veryteuse andI paintful, and(I there was mo(lerate paini over theshoulder girdle auid posterior aspect of the nieck. At the presenttime (onie mionth after the commliencemenit) the pain is ratherless in all regions. Little beniefit resulted from drugs, with theexception of local applications of belladonniia; a short exposureto ultra-violet light seemied to increase the pain. Dr. Pasleyasks whether the neturitis could have been caused by the lighttreatnment, anid if it is contrainldicated in suclh a case..

- PRECORDIAL PAIN.A. 0. W." writes in reply to thie melical man, residenit abroad,whose inquiry appeared oil May 14th (p. 908), suggesting that heshould whollv abaildoii the uise of tobacco ail ilot expect muchbenefit for fouir to six weeks, as it talkes that time to elimiuate thenicotille. Meanwhile, let him talke small- (doses of calomiiel-say,1/5 grain-every night till he gets fairly free motions, aud tlhreetimes a day 5 grains of aspiLrini of a high quiality.

INCOME TAX.Paymnent of Bank Interest.

S. P." paid £82 interest oin bank overdraft, and claime(d repay.meilt thereon on the grounid that tlhe iilterest was p.aid otut oftaxed income. The amounlt repaid lias been reduced by settinigoff the armounlt of earnied inicome relief due in respect of £82.

*** The grouind for the set-off is prestumably that the over-draft was obtaitne(d for professiolial purposes and that the amiiountof the interest could have been de(dtcted as a professional expense.If that is so the earned relief woild have been affected byreductioln of the amonlnt of earned income assessed and anappeal would not be advisable.

.Obsolescence.of Car.."F. H." has forwarded a cop)y of the local inspector's filgures,from which it appears that inl compulting thle obsolescence alilow.raulce he has dleduceted from the cost of thle car (£252) thle totalamount of wear anld tear during the life of the cart, isustead of