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without the advantages of such contacts. Further,while hospitals are to take their proper placein general medical organisation, much of thetime and money wasted in out-patients depart-ments would be saved through the general practi-tioner’s efforts, while he in his turn, especiallythrough the Home Hospitals, would be able to turninstitutional experience to the advantage of hispatients and himself. The legislation required forsuch ends would take the form mainly of amend-ments to the National Health Insurance Acts, andis of the sort that can be readily justified to voters,but the financial side of the scheme is less promising.This matter is not closely dealt with in the proposals,as it is realised that before they can become practicalpolitics their financial aspects must receive expertattention.

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Annotations.11 Ne quid nimis."

IN MEMORY OF HARVEY.

LAST year, during the celebrations by the RoyalCollege of Physicians of London of the tercentenaryof the publication of De Motu Cordis, Sir JohnRose Bradford published an appeal to the medicalprofession, intended also for the information of thepublic, in respect of the condition of the tower ofHempstead Church. William Harvey was buried inthis church, and the tower collapsed some 50 yearsago and has never been replaced. A strong com-mittee was formed last year having for its objectthe raising of sufficient money to re-erect the towerof Hempstead Church as a memorial to Harvey.The sum of £5700 is estimated to be necessary forthe work projected, of which £1500—and probably alittle more-have been received, leaving the balanceof £4000 to be obtained through the generosity ofsubscribers, individual or corporate. The appeal wasprimarily to the medical profession and has resultedso far in this creditable response, to which the greatmedical institutions have contributed as well as

Caius College, Cambridge, where Harvey received hiseducation, and Merton College, Oxford, where laterhe was warden. Harvey is among the greatest ofEnglishmen, and the memorial thus suggested isout of all comparison small when set beside hisachievement, for all mankind has benefited to anincalculable degree from work which provided a

new and true foundation for physiology. So thatthe small sum needed to erect a material monumentto his fame ought to be forthcoming promptly.Donations should be made payable to the HarveyMemorial Fund and sent to the hon. treasurer, Mr.A. W. Ruggles-Brise, Spain’s Hall, Braintree, or toDr. Arnold Stott, 58, Harley-street, W.l, joint -hon.secretary with the vicar of Hempstead.

RADIUM IN THE TREATMENT OF INTRA-

OCULAR TUMOURS.. IN the April number of the British Journal ofOphthalmology we read of what we take to be the firstcase of sarcoma of the choroid cured by the insertionof radon seeds. The patient was a man aged 65with a large typical sarcoma of the choroid, who wasfirst seen at Moorfields by Mr. W. S. Duke-Elder.As the unaffected eye was blind the patient notunnaturally refused to have his only seeing eyeexcised-hitherto the only treatment found effectivein preventing the spread or dissemination of a malig-nant tumour of the retina or choroid. The case was,therefore, suitable for experimental treatment byradium, and was transferred to the care of Mr. FosterMoore at St. Bartholomew’s Hospital for the purpose.

At first a radon seed of 1 millicurie strength, filteredthrough 0.5 mm. of platinum, was introduced througha minute incision in the sclera, and left embeddedin the tumour for 14 days, after which it was removedby the same route through which it had entered. Novery obvious change in the condition of the eyefollowed, and about four months later a second seedwas inserted, this time of a strength of 5 millicuries,with the same filter as before. Less than threemonths afterwards it was clear to all observers thatthe growth was shrinking. Five months later still(February, 1930) Mr. Duke-Elder reported that themass had shrunk to about one-quarter of its size whenhe had last seen it a year ago. The residue, he thinks,is merely fibrous tissue. Mr. Foster Moore’s commenton the case is that the point of paramount importanceis the fear of dissemination. When the growthbegins to shrink are we justified in assuming thatthe danger of dissemination has ceased ? It seemsunlikely, he says, that actively growing cells will bethrown off from a tumour which has begun to regress.If so, the eye no longer remains a menace to thepatient, and he is as much protected against dissemi-nation (no more and no less) as if he had had it removed.If, he goes on, we are prepared to accept this view,it seems reasonable to treat any case of accessibleintra-ocular sarcoma by the foregoing means whenthe growth has not as yet seriously spoiled the eye,and in the rare cases when the growth occurs in anonly eye, or the only useful eye, it appears to be theproper treatment.

Mr. Foster Moore has adopted the same treatmentfor glioma, in the case of a boy of 4 years old, one ofwhose eyes had already been excised two yearspreviously for the same condition. In this case thestrength of the radon seed was 3 millicuries, and itwas left in the tumour for ten days. As the date ofthis insertion was only last November, it is too soonto be certain of a complete cure, but the growth hadvery largely disappeared when he reported it to theRoyal Society of Medicine.

EARLY MORNING IN HOSPITAL.

THE rearrangement of the ward work at theMiddlesex Hospital in order to avoid disturbingpatients before 7 A.M. has stimulated other authoritiesto consider whether these adjustments are worthmaking. The Central Bureau of Hospital Informa-tion, established under the auspices of the BritishHospitals Association and the Joint Council of theOrder of St. John and the British Red Cross Society,has received replies from 63 provincial hospitals toa questionnaire on the subject. The accommodationin these hospitals varies from under 100 to over

1000 in-patients, and the wards contain from 13 to 40beds ; each ward needs a day staff of from 3 to 11and a night staff which in no hospital exceeds two,supplemented in eight hospitals by " runners " totake urgent messages. The information providedincludes also the times at which day and night staffscome on and off duty, at which work commencesin the wards, and at which breakfast is served topatients and nurses. The hour at which wards areready for visiting by the resident medical staff isalso stated and the hour of attendance by thehonorary medical staff, with the earliest operationhour in routine work. The Bureau also asked eachhospital to estimate the additional staff required toavoid disturbance of patients before 7 A.M., and togive an opinion on the wisdom of such a change.An examination of the figures supplied shows thatthe day nurses mostly come on duty at 7 A.M. and thenight nurses go off duty between 8 and 8.30 A.M.,overlapping with the day staff in the morning forone hour to an hour and a half. In three hospitals(Nos. 9, 14, and 63) there is no overlapping in themorning. In 45 hospitals work begins in the wardsbefore 6 A.M., and in 18 at 6 A.M. or later. The

1 Proc. of Roy. Soc. Med., February, 1930, p. 475.