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injured ends. Later, the hyperaemia of the adjacentbone causes further absorption of lime salts, and asthe hsematoma becomes alkaline in reaction thecalcium is precipitated on the newly formed fibrils.Immobilisation of the fractured ends reduces thereactive hyperaemia, and the use of the limb thusprotected re-establishes the normal alternationbetween ischaemia and hyperaemia. The value of

massage, as Blaire sees it, is in the aid it gives to thisalternation. Where there is already severe decalcifica-tion it is obvious that harm will be done by methodsof treatment which induce hypermmia, such as radiantheat and hot baths.

GLIAL CHANGE IN THE PSYCHOSES

Biopsy studies of the brains of schizophrenic andmanic-depressive subjects have lately been publishedby Elvidge and Reed,l working at the MontrealNeurological Institute. Small bits of tissue wereobtained by brain puncture in an adequately con-trolled series of 19 psychotic patients, including 13with schizophrenia, 5 with manic-depressive psychosis,and 1 with so-called toxic encephalitis. Care wastaken to avoid complicating factors such as dehydra.tion, fever, malnutrition, and the use of sedatives.Suitably stained preparations of this tissue showed" acute swelling " of the oligodendroglial cells of thewhite matter. This change, which is of a degenerativecharacter but reversible in its earlier stages, is knownto accompany coma and stupor as well as experimentalintoxications in laboratory animals. It also appearsrather rapidly after death ; hence the necessity ofusing biopsy material if the true condition of the

oligodendroglial cells in vivo is to be investigated.The demonstration of this change in psychoticpatients suggests that the mental condition maydepend upon toxsemia or some disturbance of meta-bolism. The limitation of the change to the whitematter suggests further that the attack is primarilyupon the nerve-fibres and secondarily upon the oligo-dendroglial cells. Hortega has shown that these cellsstand in as intimate a relationship with the myelinatedfibres of the central nervous system as do the sheathof Schwann cells in the peripheral nerves, and it hasbeen maintained very plausibly that they are closelyconcerned with the nutritional requirements of themyelin sheaths. If this is true any structural altera-tions in the oligodendroglial cells might be expectedto have serious repercussions upon the efficiency withwhich nervous impulses are conducted and henceupon the association of cerebral functions. Whateverthe right explanation may be, the demonstration ofthis specific change in the neuroglia will stimulatefurther histological work in a sadly neglected field.

A BUREAU FOR HUMAN MILK

IT is announced that a National Mothers’ Milk iBureau will be opened by the National Birthday <Trust Fund at the new Queen Charlotte’s Hospital,Hammersmith, on Jan. 1st, 1939. The bureau is to be under the supervision of the hospital staff, butthe cost of maintenance will be borne by the fund. I

Through the generosity of Sir Julien Cahn, chairman <<

of the fund, the most modern equipment is beingprovided. The object is to make human milk available 1for delicate babies for whom it has been medically 1prescribed. Details of price and methods of preserva- 1

tion and of guaranteeing the health of the donors 1

are not yet available, but it is probable they will be <

largely based on the methods now used at the ten i

1 Elvidge, A. R., and Reed, G. E., Arch. Neurol. Psychiat.,Chicago, 1938, 40, 227.

human-milk centres in the United States of America.The working of the scheme at the wet-nursing bureauof California’s Babies Hospital, Los Angeles, hasbeen described 1 in an illustrated article latelyappearing in a popular publication and pictures of theprocedure adopted at the Children’s Welfare Founda-tion in New York were reproduced in the NursingTimes of Nov. 26th. At Los Angeles the motherwishing to supply milk is registered, with full parti-culars of her health and that of her baby. What isdescribed as a strict medical examination is thencarried out, including examination of a sample ofblood taken from a vein. Details of expressing themilk are not given, but within two minutes of beingobtained the milk is poured into moulds and frozensolid into discs. These are stored in a refrigeratorand can be sent through the post in a sealed jar,which can be used for thawing the milk when required.At the Los Angeles centre mothers receive 5d. perounce of milk supplied, and a mother can earn up to25s. a day. The price charged for the milk is notstated, but it is supplied free for those who are toopoor to pay. Low-temperature refrigeration is themethod of preservation generally used in America,and for storage of large quantities of human milk forlong periods it is probably the method of choice. Forsmaller schemes and when it is anticipated that themilk will be used soon after it has been obtained-as in a children’s hospital-fractional pasteurisationis probably less expensive in the outlay for plant andin the upkeep. A method based on these lines at theInfants Hospital, Westminster, was described at ameeting of the section for the study of disease inchildren of the Royal Society of Medicine by Dr.M. J. Wilmers earlier this year.2 The details of thenew national scheme will be awaited with interest.

MEN OF THEIR DAY

AT a reception held at the Royal Society ofMedicine on Tuesday evening Sir StClair Thomsonentertained the guests with thumbnail sketches ofmedical notabilities of the Victorian age, illustrated bycartoons from Vanity Fair signed either " Ape "(Carlo Pellegrini) or " Spy " (Sir Leslie Ward). The

society possesses 31 copies of these cartoons. VanityFair was started in 1868 by T. G. Bowles, who haddeserted the Inland Revenue for journalism andpolitics. Pellegrini, a native of Capua, fought forGaribaldi before coming to England in 1864. Wardbegan to produce these cartoons in 1873 and con-tinued to do so for thirty-six years. The biographicaldetails which accompanied them were written byBowles under the pseudonym of " Jehu Junior." SirStClair selected ten for his commentary : Sir WilliamJenner (1815-98), Sir William Gull (1816-90), SirRichard Quain (1815-98), Sir James Paget (1814-99),Sir Francis Laking (1847-1914), Sir William Dalby(1840-1919), Sir Alfred Cooper (1838-1908), Sir AlfredFripp (1865-1930), Sir John Bland-Sutton (1855-1935), and Sir Thomas Barlow. He had some

amusing situations to narrate. Thus, Jenner told hisstudents that, when he began to practise, he kept oneof his trousers pockets for fees, the other for insults.At first he kept them both open, and the one for feeswas always the less full; when he had made hisway, he buttoned up the pocket for insults andwould brook no affront from any man. Once QueenVictoria sent for him to come to Windsor, where heexamined her and wrote a prescription. Her inlajestynext sent for Gull, who did likewise and confirmed

1 Pearson’s Weekly, Oct. 22nd, 1938.2 Proc. R. Soc. Med. 1938, 31, 759.