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custard filling, and this was filled into the shells ofpastry by means of a pressure gun ; this is an instru-ment difficult to clean, and in the one used a con-siderable film of dry custard was noted. The sourceof contamination of the custard, or pastry, was

not ascertained. There were several batches ofeclairs, and all were not filled with custard at thesame time. This may be the explanation of the factthat only a proportion of the consumers were made ill.Cooking experiments at the bakery of custard

artificially inoculated with the staphylococci showedthat even in a concentration of 2,500,000 per cubiccentimetre of liquid custard they were completelydestroyed by the cooking process, which is done at85° C. for ten minutes. The question of destructionof toxins-and the symptoms were due to the toxicproducts-does not seem to have been inquired into.But though the origin of the staphylococcus infectionwas not clearly studied, the association of the outbreakwith the toxins of this staphylococcus must be

accepted as reasonably established. It adds anotheroutbreak to the small group with this peculiar causa-tion. It is noteworthy that all or nearly all have beenassociated with the use of milk, either as milk or insome product such as cream cakes, cakes containingmilk or, in one outbreak, cheese. Although the

possibility of this type of food poisoning is now wellrecognised in this country, it is of interest that nocase has so far been reported. Human volunteersseem essential to proof since animal experiments arenegative ; but the readiness to sacrifice oneself in thecause of science may be less evident on this side of theAtlantic.

EVIPAN ANÆSTHESIA

A PAPER by Dr. E. Kobel 1 beards out some of thechief conclusions arrived at by the AnaestheticsCommittee and printed in our issue of July 1st (p. 43).He refers to the inconvenience of attempting, with asingle dose of Evipan, operations which outlast itsterm of anaesthetic action, and he believes that muchcaution is needed even when the drug is used for shortperiods. Not all patients can be safely left to go homesoon afterwards ; a proportion, he declares, sufferfrom delayed restlessness or double vision to a degreewhich makes it undesirable for them to be left totheir own devices. He is much impressed with theadvantages of evipan as an introduction to anaesthesiaand, like the committee, he says that when it is usedin this way the anfesthetic must be started withinfive minutes after injection of the evipan. Kobelhas made no investigations into the use of the drugfor long operations by repetition of the injection.

ALCOHOLISM IN MEDIAEVAL ENGLAND

THE sequel to Dr. J. D. Rolleston’s observations onalcoholism in ancient Greece and Rome 2 was heard

by the Society for the Study of Inebriety on July 11th,when he spoke on alcoholism in mediaeval England.The chief sources of information on this subject were,he said. not the contemporary medical writers, butrather the laymen-especially poets, historians, andecclesiastics. In the Middle Ages, as in classical times,distilled liquors were unknown as a convivial beverage,and alcoholism was due mainly to indulgence in ale,and to a less extent of wine. Inebriety was, however,much more widely spread throughout society, thoughit predominated among the clergy (in spite of theprotests of leading churchmen such as Anselm, Bede,Dunstan, Boniface, and Wycliffe) and universitystudents. The mediaeval publican had a remarkablybad reputation for fraud and dishonesty, while the

1 Deut. med. Woch., June 30th, p. 996.2 See THE LANCET, 1926, ii., 866.

tavern was usually regarded as a place of ill repute.Dr. Rolleston remarked that though poetry was oftenassociated in the popular mind with praise of strongdrink, the three great English poets of the Middle Ages,Chaucer, Langland, and Gower, were keenly alive tothe evils connected therewith. In one respect,however, these were less serious than to-day; therewas no syphilis, and alcohol did not play its presentpart as an incentive to exposure to infection and asan aggravating factor in the disease once it is acquired.It is noteworthy that whereas legislation dealing withdrunkenness or control of the liquor trade was

unknown in the ancient world, the Middle Ages sawthe introduction of taxation of drink, reduction ofthe number of hours of sale, and diminution in thenumber of taverns.

THE CHILDREN AND YOUNG PERSONS ACT

THE Home Office has made an " appointed day "order bringing the whole of the Children and YoungPersons Act of 1932 into force as from Nov. lst, 1933,so far as not already in operation. The only exceptionis Section 51, sometimes called Lady Astor’s clause,which enables a local authority to make by-laws as tothe employment of persons under 18. It must beremembered that almost all the 1932 Act has been

repealed and replaced by a consolidating statute

passed last April, and this more recent consolidatingstatute is to’take effect when the 1932 Act (exceptSection 51) has been wholly brought into force.This means therefore that the new 1933 Act willtake effect next November. Already rules havebeen published which constitute the new children’scourts under the 1933 Act. The principal portion ofthe 1932 Act which is left to come into force next

September is Part V. This consists of an amendmentof Part I. of the Children Act of 1908 and deals withinfant life protection. The consolidation of 1933did not touch Part 1. of the 1908 Act or Part V. ofthe 1932 Act, possibly because a line was being drawnbetween matters dealt with by the Home Office andmatters dealt with by the Ministry of Health. The

foregoing observations relate only to England andWales. Possibly Scotland will bring its own Act of1932 into force on the corresponding date but Scotlandhas yet to undertake the task of consolidating theenactments.

HEALTH IN SCOTTISH PRISONS

THE annual report of the Prisons Department forScotland (Cmd. 4336, Is. 3d.) is now available forthe year 1932. Health was good ; prisons and similarinstitutions were free from any disease attributableto sanitary defect or other remediable cause. Dr.Robert A. Fleming, medical adviser to the Depart-ment, once more emphasises the fact that the greatmajority of prisoners greatly improve in physicalcondition while in prison and alludes to the use ofmore elaborate psychological treatment of young delin-quents. Success has apparently attended psychologicalexamination in Borstal institutions in Scotland,and special attention is being given to patients whosemental state seems abnormal. Though little can bedone to influence the young offender whose prisonsentence is short, Dr. Fleming holds out the hope ofextending the methods of expert preliminary investi-gation and treatment " when financial considerationspermit." Unemployment is an element to be reckonedwith both in the statistics of crime and in the after-care of discharged prisoners. One strange effect ofit, mentioned by the governor of the Barlinnie prisonin Glasgow, ought somehow to be avoided. Twenty-three juvenile adults were admitted to his prison