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office is notified by telephone of the child’s sex,the words " son " or

" daughter " being used toavoid phonetic confusion, and the hospital entrynumber is obtained and entered in the time-book andon the history-sheet. Only after this has been donemay the child be removed from the labour ward.The child’s footprints are now taken, one copy onthe mother’s labour record and one on a pink sheetwhich is given to the mother to keep ; this sheet alsobears, in addition to the other chief particulars, theubiquitous navel-wrist number, which further appearson the crib-card when the child is sent to the nursery. IThe mother generally knows her baby before the cordwith the navel tag falls off ; if she does not, she stillhas the wrist number and back plaster to help her.The baby goes home wearing these two documents,which are often kept by the mother as souvenirs,together with the navel tag and pink sheet. In caseof doubt, the evidence of these records taken togetherwould be sufficient for any jury. Dr. de Lee anxiouslyinvites criticism, but we do not think many readerswill be able to find a loophole in his organisation.

IODINE DEFICIENCY AND GOITRE.

MUCH scientific war has been waged around the Iproblem of endemic goitre, and at least six theories Ihave been put forward to account for its occurrence.Prof. D. W. Carmalt-Jones’s paper before the Sectionof Medicine of the Royal Society of Medicine onTuesday last was a lucid and convincing accountof the work in New Zealand, where, as he said, the firstthing that strikes the eye of a stranger in the streetis the preponderance of goitres. It has been statedthat Maoris do not suffer from the complaint, but.although this is true of the coastal Maoris, thosewho have been driven inland have had in theirlanguage a word for goitre as long as tradition goesback. In a recent survey of 300 of them, 18 percent. were found to have enlarged thyroids. Theprevalence amongst Europeans has been noticedsince 1888, and 1500 men were refused for the Armyout of some 130,000 examined when conscriptioncame in during the war. Whatever the environ-mental factor may be, it does not act uniformly allover the islands, for the incidence among school-children is 16 per cent. in Auckland and 28 per cent.in Wellington, rising to 56 per cent. around Canter-bury. With a selective regional incidence like thisresearch workers had something to go on. Faecalcontamination in the drinking-water was excludedby the fact that Christchurch has quite as good astandard of water-supply as Auckland ; radio-activityof the water from artesian wells was put out ofcourt by the fact that the incidence was 60 per cent.in an area where the water runs freely in the open.The incidence was high in places where the water-supply was entirely taken from the roofs, and lowestof all in a limestone district, so the suggestion thatsalts in the water had some setiological significancecould be disregarded. Diet is strikingly uniformall over the country, said Dr. Carmalt-Jones, andcould not be held responsible for a condition withsuch variations in degree. Geological considera-tions put forward in Europe could not now hold for z’

New Zealand, but as soon as Hercus examined samplesof the soil of the different districts for iodine-content.a striking parallelism between low soil iodine and highgoitre-rate was manifest. The preventive treatment,therefore, was to add iodine to the food, and earlyfailures in this direction had been found to be dueto overdosage. The amount required was minute,four parts per million being the proportion allowedby the Health Department. The problem of toxicgoitre, Dr. Carmalt-Jones pointed out, is much morecomplicated, and an overdose of iodide in simplegoitre may well produce serious toxic symptoms.In the subsequent discussion Dr. Scott Williamsonsaid that the endemic goitre of India is quite certainlynot the endemic goitre of New Zealand. McCarrisonhad found an abundance of iodine in the soil and the

vegetable food, and his work was as convincing asthat of the New Zealand workers. Dutch investi-gators have made the interesting observation thatthose who are susceptible to toxic goitre in Hollandare all immigrants, in the third generation, fromSwitzerland, whose ancestors were liable to simplegoitre. Ancestral predisposition possibly plays a partin causing the condition, and, as Dr. Williamsonsaid, there seems little doubt that simplegoitre can arise from a number of causes. It may bethat there are two quite different types, with differentaetiology and different pathology. It is by carefulwork of the kind done in New Zealand that we shallreach more definite conclusions.

WE report elsewhere in this issue that the Senateof the University of London has appointed a

committee to consider the situation arising out of thedecision of certain London hospitals not to admit anymore women students.

Dr. W. W. Jameson, medical officer of health andschool medical officer for Hornsey, has been appointedto the University Chair of Public Health, tenableat the London School of Hygiene and Tropical

Medicine. A report of the appointment appears in

our news columns (p. 679).

THE death has occurred in Glasgow of Dr. GeorgeStevenson Middleton, consulting physician to theRoyal Hospital for S:ck Children and the RoyalInfirmary. Dr. Middleton, who was 75 years of age,was at one time President of the Association ofPhysicians of Great Britian and Ireland.

A DESCRIPTIVE account and catalogue of theexhibits in the Home Office Industrial Museum hasbeen issued by H.M. Stationery Office (price 3s. 6d.).The Museum, which was opened in December lastby the King and Queen, has the primary object ofinforming all who are connected with industry inthe latest and best methods of promoting the safetyand health of workers ; it also affords in a compactand convenient form an object-lesson to medicalpractitioners and students of the medical side ofindustrial problems. The Museum has been wellvisited by many classes of inquirers since it was

opened three months ago, and the handbook willserve as a guide to a well-spent visit, while manyvisitors will find it useful to refresh their memoryfrom it with a view to paying further visits with moreinstructed minds. The promoters of the Museumintend to keep in touch with the authorities ofsimilar museums abroad, using the interchange ofinformation and ideas to make for progress inindustrial hygiene on an international basis.

THE National Association for the Prevention ofTuberculosis has issued a fifth edition of its Handbookof Tuberculosis Schemes for Great Britain and Ireland.This useful compilation is in effect a tuberculosisdirectory of the various administrative areas in sofar as mortality from tuberculosis and provisionfor its control and treatment are concerned. Theinformation is obtained from trustworthy sources

and has been brought carefully up to date. In thepresent edition data for the Channel Islands are

included and the addresses of care committees andof health departments are given. Unfortunately,in many cases there is still no care committee to givean address of. Included in the Handbook are acouple of striking graphs giving the death-rates fromtuberculosis in the year 1926 for the various adminis-trative counties, from which the reader can at aglance pick out those in which effort has been appa-

, rently less successful. The Handbook will, we maytrust, serve a purpose in exciting rivalry between

- county areas for a good place on these graphs. Theprice of the handbook is 7s. 6d. post free fromthe Association, whose address is for the present,

1, Gordon-square, London, r.C’.1.