1146

to suppose that any poisoning took place. Nor werethose forms of anaemia which certain observershave affirmed to be a common result of the absorp-tion of antimony in industrial preparations metwith in these workers, even though the most

elementary precautions were neglected and the in-gestion of small particles of antimonial substancesmust have been frequent. The conclusionseemsto be that if antimony has any, effect in causinganaemia or other morbid phenomena among workersit must be extremely slight.

INCOME-TAX RATES FOR THE YEAR 1915—16.

: FOLLOWING on the articles in THE LANCET of-April 24th and May lst on "The Medical Man’sIncome-tax," and of May 15th on " Service MedicalOfficers and Income-tax," it may be useful to havetheseveral rates of tax in concise form, which we’extract from an explanatory article in the DailyTeJegraJ!h of May 25th :-

.

,. n ".

In the .e.

Normal Rate ......................... 2s. 6d.Modified Rates:

_ (a) Reduced Rates on Small Incomes :Incomes exceeding Z300 but not exceeding6500 ........................ 2s. 4d.

‘ ’ Incomes not exceeding 6300............ 2s. Od. ’

(b) Relief for Earned Income:Any individual who claims and proves that

’

his total income from all sources does notexceed .62500, and that any part of that

. income is Earned income, to be entitled tobe charged on his Earned income at the

following rates, viz. : -

Total income not exceeding &pound; 1000........... ls.6<.Total income exceeding &pound; 1000, but not exceeding

.61500 ............ ls. 9d.Total income exceeding .61500, but not exceeding

.B2000 ........................... 2s. Od.Total income exceeding .62000, but not exceeding

.62500 ........................... 2s. 4d:

It should be noted that the relief in respect ofearned income is required to be claimed at the timea return is made, and in any case before Sept. 30th,1915. It is supplemental to any relief underpara-graph (a) above. --

PULMONARY TUBERCULOSIS IN THE TROPICS.

IN the tropics it is the infectious disorders thatcause the high death-rate among human beings,coloured or white. Van Loghem draws attentionto the increasing importance of pulmonary tubercu-losis as a cause of death in tropical countries, andparticularly in the Dutch Indies. The annualdeath-rate from phthisis in Amsterdam for theyears 1900 to 1904 was 152 per 100,000 living, inLondon 163. The figures in subtropical and tropicaltowns are often much larger, as, indeed, isthe general death-rate, and Van Loghem quotesthe following figures : Havana, 348; Batavia, 409;Rio de Janeiro, 463 ; Manila, 486 ; Santiago,492; Bombay, 635 ; Tunis, 691; and Singapore, 692,adding that they probably err by being too lowrather than too high. The death-rate from phthisisamong the whites alone is higher in the DutchIndies than in Holland ; for the years 1908 to 1911it stood at about 125 per 100,000 living in Holland,whereas in Batavia it was 177, at Semarang 200,and at Surabaya 232. The cattle here are free frombovine tuberculosis, so that there can be no questionof the infection of human beings with tubercle bacilliof the bovine variety. Stress is laid upon the fact thatthese figures only apply to the large centres of1 Nederlandsch Tijdschrift voor Geneeskunde, Amsterdam, 1915, i., 1300.

population, the coast towns, where the admixtureof natives with civilised and tuberculous whitesis most thorough. Inland the mortality due to

phthisis, and indeed the incidence of any form oftuberculous infection, fall away to almost nothing.The cutaneous tuberculin reaction of von Pirquet,obtained in 92 per cent. of the students at Leydenby Nolen (1911), was obtained in only 3-2L per cent.of the. inland Javanese inhabitants of Sumatra(Heinemann, 1914). to’ quote a single instance.Thus, tuberculous infection during childhood is ararity among natives uncontaminated by contactwith a higher civilisation. The result, as Van Loghempoints aut, is that among such people tuberculosisis an acute infectious disorder very fatal toadults; for they have not been protected, as

Europeans have, by a mild attack of tuberculosisduring their youth. Heinemann describes tubercu-losis as an acute or subacute disease, rarely chronic,among the uncontaminated Javanese, with a greattendency to the production -of generalised tubercu.losis such as it seen mainly in infants andyoung children in Europe. So Van Loghem callsout for some method of vaccinating natives againsttuberculosis, and -for the enforcing of all sanitaryand hygienic regulations that tend to prevent thedissemination of tubercle bacilli, as two urgentneeds in tropical countries where the native in-habitants are naturally free from tuberculosis.

EMETINE IN THE TREATMENT OF CHOLERA.

Sir Leonard Rogers reports the results of treat-ment of cholera by this drug in the Indian MedicalGazette (1915, vol. 1., p. 4). No benefit can bederived from its use, he concludes. It was thoughtfrom the good results which follow its administrationin amoebic dysentery, occasionally in sprue-likediarrhoea, and also in haemoptysis and haemorrhagefrom the gastro-intestinal tract, that it might bebeneficial when there is, as in cholera, extensiveloss of fluid through the mucous membrane of thesmall intestine. During an epidemic of choleraa series of 32 cases was treated with half a grainof emetine night and morning, in addition to intra-venous injections of hypertonic solution of salineand potassium permanganate by the mouth. Thesecases were not selected; they were also comparedwith 32 similar cases which were taken alternatelywith the test cases but not treated with the emetine.The observations extended over two months. Nobenefit could be recorded. The whole mortality ofthe 64 cases was 12’5 per cent. A comparisonof the two groups of cases showed the followingfeatures :-

Emetine. No emetine.No pulse on admission ......... 10 ...... 15Blood specific gravity above 1065 ... 8 ...... 3Two or more intravenous salines ... 10 ...... 10Age over 50... - ............... 1 ...... 1Deaths .................. 4 ...... 4

THE Cavendish lecture of the West LondonMedico-Chirurgical Society will be delivered onFriday, June 25th, by Professor Arthur Keith, F.R.S.,at the West London Hospital.

A SESSIONAL meeting of the Royal SanitaryInstitute will be held in the Guildhall, Bristol, on Friday,June llth, when a discussion will take place at 11 A.M.on "The Coordination of Military and Civil Sanitary Servicesin War Time," opened by Lieutenant-Colonel D. S. Davies,R.A.M.C. (T.), medical officer of health of the city, andMr. L. S. McKenzie, A.M.LC.E., the city engineer of Bristol.