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British Institute of Radiology). For students taking thisLondon course Cambridge was simply an examiningbody. The first course began in the spring of 1920,and more than 500 candidates from all parts of the worldhave now taken the diploma, which has kept its leadingplace among the qualifications founded later. In 1921

Liverpool instituted a diploma, to be followed by Edin-burgh in 1926, and by London University and theConjoint Board in 1933.

Of those who worked hard to give the Cambridgediploma life and vigour Shillington Scales ’will beremembered as an enthusiastic secretary of the managingcommittee and lecturer in radiology from the time of thefoundation of the diploma till his death in 1927. Muchof the apparatus on which he demonstrated in Adden-

.

;brooke’s Hospital he made himself. His place as uni--

versity lecturer was taken with equal energy andenthusiasm by Dr. A. E. Barclay ; physics was taughtby Prof. J. W. Crowther until 1924 and then by Prof. G.Stead until 1941, and Professor Stead was also secretaryfrom 1927 to 1943 of the managing committee, overwhich four regius professors presided in succession.The London teachers included Dr. Harrison Orton, Dr.Russell Reynolds, as well as the late Robert Knox,Stanley Melville and E. P. Cumberbatch. Prof. SidneyRuss, besides teaching throughout the whole period, wasalso tireless in committee. Regrets there may well be,but the DMRE Camb. has done its work and leaves anhonourable record.

QUININE CONTROLTHE quinine order of last summer has been superseded

by a second order which came into force at the new year.In several of its provisions this new order is much moredrastic than the first, for at least two reasons : Britishpractice had to be brought into line with- that of the otherunited nations ; and the spirit of the previous order wasnot being carried out closely enough. Doctors wereevidently not sufficiently aware of the position, thoughthe medical journals have done their best to keep themposted. It is not easy to drop the habits of years inprescribing but the war in the east depends much onantimalarial measures ; the bulk of the world’s cinchonais in the hands of the Japanese, and it has become a dutyto conserve quinine. Yet one pharmacist was reproachedlast month by an eminent consultant because he couldnot provide a quinine tonic for a patient’s hair. Wastagedue to the use of quinine in proprietary medicines wasadequately controlled by the first order; withdrawalof quinine except as an antimalarial should cause littledifficulty. As an antipyretic quinine has been super-seded by the modern synthetic drugs ; and as a stomachicit has no special merit save its bitter taste. Obstetriciansmay find it inconvenient to do without quinine but thedifficulty is not insuperable as Mayes showed in a recentarticle 1 own quinine substitutes. In malaria, however,quinine is irreplaceable despite the introduction of

mepacrin and pamaquin ; in any case the production ofthese new synthetic drugs is complicated. The neworder makes it illegal to prescribe, dispense or supplycinchona and its preparations, cinchona alkaloids, theirsalts and preparations, mepacrin or pamaquin, except inthe treatment of malaria; or quinidine except - inthe treatment of cardiac arrhythmia. All stocks whichare equivalent to more than 16 oz. of quinine must benotified to the Ministry of Supply. When any of thecontrolled materials, or preparations or mixtures thereofare prescribed, the name and address of the patient andof the prescriber must both be set out. The only excep-tions to these rules are granted under special licenceissued by the Ministry. Such powers have not beenassumed lightly. Those who have had experience in theEast know how devastating the effects of a large scalemalaria epidemic can be. Our armies must be protected

1. Mayes, B. Med. J. Aust. 1942, ii, 408.

; from this danger; once this is fully understood the spirit, of the order will be carried out unquestioningly.

EOSINOPHILIAMILD increases of eosinophil leucocytes above the

normal of about 250 per c.mm. occur in several conditionssuch as asthma, urticaria and other allergic states,hydatid disease, parasites in the intestine, some skindiseases, certain infections particularly scarlet fever, andthere is a rare familial form. Sustained eosinophiliawith high percentages of an increased total leucocytecount are much less common. The classical example istrichiniasis, in which counts of 15,000 eosinophils perc.mm. (making up 85% of the leucocytes) have beenrecorded ; other well-documented instances are inangioneurotic cedema, pemphigus, uncinaria infestationand Hodgkin’s disease. There is also the mysteriouscondition called eosinophil leukaemia; mysterious becausealthough it shows the characteristics of myeloid leuk-aemia—leucocytosis, enlarged liver and spleen, infiltrationof eosinophils into various tissues-the eosinophilleucocytes are mostly adult forms and there is none ofthe immaturity that typifies leukaemia generally. Finally,there is the odd combination of transitory lung infiltra.tions with eosinophilia in the blood known as L6fflersyndrome. In this issue Dr. Weingarten describes indetail a tropical eosinophilia that occurs in India andthat seems to fit into none of the recognised cate.

gories. It is accompanied by lung symptoms-attacksof bronchial asthma and focal bronchopneumonic infil-trations affecting both lungs uniformly-but unlikeasthma or Lomer syndrome the disease is accompaniedby serious general symptoms, including loss of weight,and it continues for weeks at a time. The conditionquickly responds to organic arsenicals, one course usuallybeing sufficient.

MIND WHAT YOU’RE DOINGTHERE is something affronting in the idea of lives lost

through personal carelessness. The fact that 8000

people die yearly from accidents which have nothing todo with either the roads or industry suggests that we area fumbling ham-fisted lot; and some might say thesefatal accidents served the victims right. An analysisby the Royal Society for the Prevention of Accidents of

1153-such cases, however, shows that the victim is notnecessarily the careless fellow ; he may be some perfectlyinnocent second party, often a child. Thus nearly afifth of the deaths were due to burns and scalds, and80% of the scalds were received by children under fourwho had been left near teapots and kettles, and hadpulled them over on themselves ; of the 142 deaths fromburns, 44 were of children playing near unguarded firesor lighted candles, or left alone in the house. Of 73children under 15 who were drowned 20 were under school

age and had strayed unaccompanied near water. Apartfrom children, old people are common victims of acci-dents. Thus 395 of the 582 victims of falls were over theage of 65. Other causes of accidents were explosions-12 due to tampering with live munitions and 31 fromcarelessness with firearms-and electrocution, sometimesdue to a combination of faulty apparatus and wet(achieved for example, when a woman uses a defectiveiron while standing on a-wet floor). The moral is clear,but difficult to press home. The association does itsbest by reminding us : to allow for the weakness of oldpeople ; to light stairs properly ; to leave fires guarded ;and to keep an eye on the young.

Dr. Joinsr RYLE, regius professor of physic in theUniversity of Cambridge, has been appointed to the newchair of social medicine recently created in the Universityof Oxford by the Nuffield Provincial Hospitals Trust.

Sir WM. ARRGTHNOT LANE, consulting surgeon toGuy’s Hospital, died on Jan. 16 at his London home inhis eighty-seventh year.

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REHABILITATION SCHEME FOR VARIOUS TYPES OF DISABLEMENT(BEING THE APPENDIX TO THE TOMLINSON REPORT)