1086

and skin, as well as the nerve structures exerting asecretury influence upon glands ; it also embraced certainorgans with cross striated muscles, such as the heart, thebeginning and the end of the alimentary canal, and themuscles of the genital apparatus. Anastomoses were

common among the nerve fibres of the vegetative system.This system also had a much more independent action, andit reacted to drugs in an altogether different manner ;indeed, it was from the latter that so much had been learnedabout it. A sort of balance seemed to be maintainedbetween the autonomic and the sympathetic systems, so

that one assumed an exaggerated action if the influence ofthe other were interfered with. Both systems were muchaffected by the secretions of various endocrinic glands. Dr.Orr and he had demonstrated that changes could be producedboth in the vegetative system and in the central nervous systemby placing a capsule containing pathogenic organisms in theneck, near the carotid artery, or in the abdominal cavity ;and they suggested that the distutbances in this system wereclosely connected with the origin of the lesion in the centralnervous system, a view which was supported by clinicalevidence, instances of which were given. Major Rows spokeof the importance of investigating the emotions from thebiological side. In conclusion, he said that medical menwould probably learn much if, instead of separating thebrain from the spinal cord, and the latter from the vegeta-tive system, in their investigations, they would regard thenervous system more as a whole, and appreciate more fullyto what extent a disturbance in one portion might interferewith the functional activity of the remainder.

Reviews and Notices of Books.Bernhardi and Cf.eation : A New The01’Y of

Evolution.By Sir JAMES CRICHTON-BROWNE, M.D., DSc., LL.D.,F.R.S. Glasgow: James Maclehose and Sons. 1916.Po. 72. Price 1. net.

Sir James Crichton-Browne starts by finding that thewar has caused a rude shock tu science in that herfinest discoveries and best energies have been requisi-tioned not for the saving or the adornment of humanlife but for its destruction. He proceeds to make hayof the theory that war is justified on the Darwinian or

struggle-jor-existenee principle, pointing out thac Bernhardiwhen taking up this view regards varieties as species,forgetting the physiological unity of the one and the

ethnological diversity of the other. But while war

is a reproach to science, he finds it to be a greatstimulus to religious thought, and he expects thatoar present trials will prove a stimulus to the growthof altruistic feeling which has already been a c.iarac-

teristic of the civilised nations during the last century."The war," he pleads, "has in some ways fanned thesparks of religion and brightened them into flame.With no return to mediaeval superstition, there is a wide-

spread realisation of the supernatural ...... a feeling thatwe cannot stop at the Sermon on the Mount, but mustascend to the Incarnation. At home there has been a

quickening belief in the spiritual life, and men and womenwho doubted it before have felt its inrush in prayer, notmere mechanical mumbling: and in moments of patrioticexaltation or of profound solitude, in hours of intense

anxiety or poignant sorrow." Sir James C1 ichton-Browne’sessay is eloquent and inpiring.

Clzesnicccl Constitution ancl P7tysiological Action.By Professor Dr. LEOPOLD SPIEGEL. Translated withadditions from the German by C. LUEDEKING, Ph. D.

Leipsic. and A. C. BoYLSToy, A M. Harvard. London :Constable and Co., Limited. 1915. Pp. 155. Price 5s. net.THE profusion of syntheticc, while somewhat bewildering,

has been largely responsible for remarkable development ofknowledge as to the relation of chemical constitution to

physiological action. This is demonstrated in the evolutionof organic arsenic molecules which now find application inthe treatment of syphilis. Progress has been made easierby the facility with which organic compounds can bemodified by substituting fresh groups or giving the samegroups different positions in the molecule. This small

1 volume deals with such questions, and, as might have becni anticipated, the subject-matter relates chiefly to organic3 compounds, only 24 pages out of a total of 155 being allotted3 to inorganic compounds. It amounts to an instructive study3 of certain groupings which furnish the preliminary basis for. certain effects. We learn, for example, how the physio-1 logical action of compounds can be modified, weakened, or

; strengthened by the action of individual side-chains, and1 a very clear account is given of the present position of theI relationships of chemical constitution to physiological action,) so far as the investigations have been pushed. The further

study of the subject promises interesting developments.

Experimental Organie Chemistry.i By JAMES F. NORRIS, Ph.D., Professor of Chemistry in

Vanderbilt University. London and New York : McGraw-Hill Book Company, Inc. 1915. Pp. 215. Price 5s. 3d. net.

A VERY useful and instructive set of experiments is herel outlined and the practical directions given evidence a

familiarity with successful laboratory manipulations. The directions cover a wide range of compounds, and yet the book is convenient in size and the type is bold and clear. TheI opening chapter on laboratory methods is one of the mosti useful in the book and prepares the student for the subsequent

practical work described. It is not often easy to obtain organicI compounds in a pure state, or in many instancts in good. crystalline form, but the author is careful to instruct his, readers on those important details which when followed give

satisfactory results. The book can be strongly recommendedto all those who rt quire a sound knowledge of technique andanalytical operations connected with the chemistry of thecarbon compounds.

LIBRARY TABLE.An Irishwoman in China. By Mrs. DE BURGH DALY,

London : T. Werner Laurie, Limited. Pp.294. Price 10s. 6d.net.-This interesting book is exactly what it purports to be-a simple record of the life of ordinary European residentsin China. No doubt such residents may have no very deepknowledge of the history, the psychology, or the racial

aspirations and developments of the Chinese. But livingamong them, and feeling friendly towards them, they get aninbight into their domestic manners and ideals which in thiscase has prompted the production of a book. "An Irish-woman in China" will be of more interest to ordinarypeople than many works written by experts in history orsociology, and Mrs. De Burgh Daly’s chatty pages (if she willforgive the adjective) are well illustrated by photographicreproductions.

The Other Side of the Lantern. By Sir FREDERICK TREVES,Bart., G.C.V.O C.B., LL. D. London, New York, Toronto,and Melbourne : Cassell and Co., Limited. Pp. 424. Price2s. 6d. net.—This is a cheap issue of Sir Frederick Treves’swell-known book of travels. The first part gives the author’sexperiences in the Mediterranean and the Red Sea, the secondhis impressions of India, the third describes Burmah and

Ceylon, the fourth and fifth China and Japan respectively,and the sixth deals briefly with his journey home acrossAmerica. The sections devoted to India and Japan are thelongest, and the former is full of anecdotes illustrating thehistory and life of the empire. The book has been reprintedmany times, and we welcome its appearance in cheap form.The itinerary was neither novel nor adventurous, but thesimple record makes instructive reading.

Bussaco : Its Monastery, Battle, and Woods, -and its Usesas a Health Resort. By Dr. D. G. DALGADO, of the Aoademyof Sciences of Lisbon. With two plans and a map. Lisbon:forres and C.ta 70-74, Rua Nova do Almada. 1916.Pp. 116. Price 2s. 6d. net.-Dr. Dalgado, who has writtensome popular books on the climatology of Portugal andthe merits of its health resorts, has added to the series an

account of Bussaco (sometimes spelt Buçaco), celebratedalike for its ecclesiastical and secular history, and itsmagnificent woods. Dr. Dalgado claims that the p’ae is" justly reputed as the best inland sylvan resort of lowaltitude in the whole of the Iberian Peninsula." He devotesa chapter to each of its prominent features, describing themonastery of the monks, the invasion of Portugal by theFrench and the battle of Bussaco in 1810, the fauna andflora of the neighbourhood, and, lastly, the uses of thethermal waters in cases where high altitudes are contra-indicated.

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THE LANCET.

LONDON: SATURDAY, MAY 27, 1916.

Military Service Bill: The Positionof Medical Practitioners.

THE Military Service Bill, which is to receivethe Royal assent this week, now contains a

provision of significance to medical men, and,we think, of great value both to the militaryauthorities and the public at large. On themotion of Lord SANDHURST, on Monday in theHouse of Lords, the following clause was insertedin the Bill :-

" Regulations made under the second scheduleto the principal Act shall provide for the establish-ment of professional committees to deal with claimsfor exemption made by duly qualified medical prac-titioners ; and any application made by such amedical practitioner on any ground, other thanthat of conscientious objection, for a certificate ofexemption shall be referred by the tribunal towhom it is made to such a committee in accordancewith those regulations ; and the recommendationof the committee on the application shall be bindingon any tribunal constituted under the principal Act."The meaning of this clause will be perfectly clear

to all our readers, and its insertion accords directlywith the course which we have on several occa-

sions suggested might be adopted. Under the

scheme of voluntary enrolment a very large bodyof men pledged themselves to accept commissionsin the Royal Army Medical Corps, or, if preferred,in the Royal Naval Medical Service, and to come upif their services should be required. But at thesame time a considerable number who might havebeen expected to enrol abstained from doing so.

In some cases exemption from compulsory servicehas been obtained by practitioners from local

tribunals, and it was widely felt that it wouldhave been more satisfactory to the public,to the military authorities, and to the medicalmen who had enrolled, if the arguments for

exemption had been produced to a professionalbody. It is extremely difficult for any except medicalmen, who have actual experience of medical prac-tice in its various branches, to decide whether aman best serves the public and the army by remain-ing in civil practice or by accepting a commission.The difficulties in such cases follow no generalplan, and where one man is the master of his fateano-her will be so in the hands of circumstancesthat he must obtain assistance before he can

venture to enrol. Localities, again, vary in theirsupply of medical practitioners and in theirdemand for medical service. It is obvious that the countryside requires a larger percentage of medical men to population than the urbandistrict, because of the time that must be spent, not in visiting the sick, but in travers- ing the distances between their homes; but, (

inside this broad differentiation, every locality wi:have its peculiarities which can only be fullknown perhaps to local residents, and thei

significance can certainly only be appreciated bthose who are familiar with the exigencies o

medical practice in its various forms. The institution of professional committees to choose whic:men shall, and which men shall not, be selected focommissions is, we venture to think, a thoroughlwise move. The machinery is in existence andindeed, has already been working in the indicate<direction. We have every reason to hope that b;its energies an adequate supply of medical officers

, will be found for the navy and army, and tha

they will be chosen with the minimum hardshilto the practitioners accepting commissions aniwith the maximum regard for the wants of thElocalities. When it was first mooted that application for exemption from compulsory service ba qualified medical man should be made to someprofessional body more able to consider thE

problems involved than any tribunal of laymencould possibly be, the objection was raisedthat it would be difficult to grant privilegeEto one professional class rather than to another,In the House of Commons, on the considerationof the Lords’ amendments, several members tookthis line, but their arguments had no real force, forthe medical man is the only man who is wantedexactly as he is, and who can be taken straightfrom civilian work, given a commission, and

accepted directly into the scheme of a fleet or an

army on active service. The public and the Govern-ment have seen the justice of this view, and theinstitution of professional committees has followed.We learn that the War Office has decided to

recognise, under the regulations to be made infulfilment of the new clause, the three existingprofessional Committees-viz., the Central MedicalWar Committee, the Committee of Reference of theRoyal College of Physicians of London and the RoyalCollege of Surgeons of England, and the ScottishMedical Service Emergency Committee. Thesebodies have for some time been utilised by theGovernment in arranging for the selection ofmedical men for service as doctors in the naval and

military forces of the Crown, and in connexionwith the work of the Central Tribunal. TheScottish Medical Service Emergency Committee

possesses a detailed knowledge of the medical mencoming within its sphere of work which the Englishbody with its larger scope can, perhaps, not claim,but Local War Committees have been established

throughout England and Wales in connexion withthe Central Medical War Committee, and the workof these numerous bodies has grown in efficiency asthe members have become familiar with the

problems before them. The Committee of Refer-ence appointed by the Royal Colleges will havereferred to it the cases of medical men on the

staffs, residential and teaching, of the hospitals andmedical schools of London, and any other caseswhich the Army Council or the Central MedicalWar Committee may think desirable. We under-stand that an Order in Council, under the newclause, with the Regulations, will be issued at once.