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medical men or laymen, will feel themselves bound to

the autumn holiday by the dates of their children’s

school holidays, but, however unpopular be the sug-

gestion, we venture to remark that in certain instances

and when funds permit a separate holiday for the

breadwinner may afford him a rest unattainable in the

company of his family. In any case there are a largenumber of childless practitioners to profit by our advocacyof the springtime holiday, which must, however, be read asconditional upon a reasonable attitude on the part of theweather, for a wet May will not only be as annoying as awet August but in all probability will be a good deal colder.But we must close this recommendation of the spring holidayby admitting that the counsel to take it is a counsel of per-fection, for we know that medical men in full swing cantake only too often no holidays at all.

MEDICAL MISSIONS AND THE SOCIETY FOR THEPROPAGATION OF THE GOSPEL.

THE 208th anniversary of this society will be held fromApril 24th to 30th, and on April 28th at 8 P.M. a meet-ing will be held at the Church House in connexion with

the Medical Missions Department. The speakers will in-

clude Sir Dyce Duckworth, Dr. F. H. Champneys, and MissJane Walker, M.D. The connexion between the priest andthe medical man is, of course, a very ancient one, and medicalmissions are one of the most valuable portions of missionwork, for the healing of the sick leads in very many casesto those who are healed and their friends listening to

the new message. The society appeals for fully qualifiedmedical men and women, but, of course, the fulfilment ofthis idea will cost money. Not only does it involve the

keep at least of the medical missionaries, but money is alsoneeded for hospitals and dispensary buildings and the supplyof instruments, drugs, dressings, and the like. There is nowa movement both in medical and religious circles as to a

closer union between the work of the physician and that ofthe priest, and the work of medical missionaries is one of thebest ways of showing that these two offices may be combinedin one person without the functions of the one in any way

infringing the responsibilities of the other.

A MODIFICATION OF THE CUTANEOUS TUBER-CULIN REACTION.

THE cutaneous tuberculin reaction for the diagnosis oftuberculosis was first introduced by von Pirquet and thetechnique recommended by him was as follows. The skin,preferably of the arm, where the test was to be made wasthoroughly cleansed and a drop of a 25 per cent. solution ofKoch’s old tuberculin was placed on the arm ; the skin wasthen scratched through the drop by means of a vaccinatinglancet or Pirquet’s raspatory.. For purposes of control other

scratches were made without the tuberculin having beenapplied. Von Pirquet subsequently thought it better to use

different concentrations of the solution. After about one anda half hours a very slight redness appeared at the spot ofinoculation and also at the spot of the control scratch. Thiswas regarded as due to the slight traumatic irritationcaused by the actual performance of the inoculation. Thisredness disappeared after an hour or two, and if a positiveresult followed on the site of the inoculation of tuber-

culin, in about three hours a reddening of the skin

appeared, which increased until it reached a maximum ; thisusually took from 12 to 24 hours. In the Répertoire dePharmacie for February a description is given of Lautier’smodification of the above process. A pledget of cotton-

wool of the size of a pea is moistened with three drops of asolution of tuberculin and applied to the unbroken skin on the

outer surface of the arm. The application is covered withgutta-percha tissue and a pad of cotton-wool, kept in positionwith a bandage. It is important that the skin should beintact and cleansed with alcohol and ether just before thedressing is applied. Within 24 hours, if the reaction is

positive, the patient will complain of irritation whichincreases during the ensuing 24 hours. The dressing is thenremoved, and, in the case of a positive reaction, redness andsometimes papules will be observed. The reaction maymanifest itself within half an hour and varies in intensity asregards redness, swelling, dryness to the touch, and tendernessproduced by pressure. The results of this method were

controlled by the ophthalmic reaction.

THE NURSING AND MIDWIFERY CONFERENCE.

DURING last week a Nursing and Midwifery Conference andExhibition was held in the Grafton Galleries, Bond-street,London, W. It was opened on April 14th under the chairman-ship of Mrs. Stephen Glanville, and continued for four days,during which many matters important to the profession ofnursing were dealt with in a series of debates. We may mentionespecially the remarks of Dr. T. 0. Wood, who in reviewingthe present position in the nursing world said that the chiefwant felt was a uniform system of training, examination,and certification ; that a definite standard of proficiencymight be reached which would entitle successful candidatesto a qualification-not of this or that hospital-which mightbe a variable quantity-but of one great qualifying body.Nurses might broadly be divided into the following classes :(1) those trained at general hospitals in both medicaland surgical nursing ; (2) general hospital nurses who havein addition special hospital training, as in fever or children’shospitals ; (3) obstetric nurses or midwives ; and (4) male andfemale nurses trained in asylums to attend upon the insane.He referred to the several organisations that existed to registerthese classes-namely, the Royal British Nurses’ Associa-

tion, which was promoting legislation for the State registra-tion of nurses, and the Medico-Psychological Association ofGreat Britain and Ireland, which had already one uniformstandard of training, examination, and certification through-out the kingdom and the colonies. Dr. Wood also mentionedthe Asylum Workers’ Association, Queen Victoria’s JubileeNurses, and the association known as the Midwives Institute.Dr. Wood said that he was glad to see that in the Bills beforeParliament for the State registration of nurses the medicalprofession was well represented upon the proposed council.If State registration became an accomplished fact the scaleof fees would have to be arranged upon a reasonable basis,as otherwise many nurses would be debarred from registeringand the movement would be a failure. On the same day adiscussion was held upon the period of time requisite to trainmidwives in aseptic principles, when it was generally agreedthat the three months enforced by the Central MidwivesBoard was inadequate for the purpose and that a year’straining was desirable. On the last day of the CongressDr. David Walsh dealt with the vexed question of hospitalaccommodation for the middle classes.

CONDEMNED FOOD.

THE annual report of the Manchester Port SanitaryAuthority shows that instead of becoming less there is alarge increase in the amount of condemned food-stuffs.It may be remembered that not very long since Liverpooltraders protested against what they seemed to consider theundue severity of the tests used by the Manchester authority.The gross total of condemned food was 881 tons, a largeincrease on the 216 tons condemned during the ten monthsin the previous year. Of grain, 694 tons have been:seized