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of rooms, because gas-proof dugouts were foundeffective during the war, when conditions were muchmore favourable, and further experiments by theHome Office on a larger scale might provide valuableinformation. Meanwhile we suggest that those whoare alarmed by the 10 Cambridge scientists shouldturn to a Scottish one to hear the arguments on theother side, expressed with sanity, temperance, andhumour. Prof. James Kendall, F.R.S., is careful toexclude the Royal Society, the University of Edin-burgh, and the United States Navy Departmentfrom any responsibility for his statements. Thoughhe treads on many toes in passing, he stands essen-tially on his own feet. His primary object is toexamine in detail the question of the dangers of airattacks on Great Britain in the hypothetical nextwar and to place the facts and possibilities beforethe public in proper perspective. His conclusion isthat the creation of panic is the only real reasonfor an aggressor using poison gas on a large city, andthat therefore panic is the only real danger. Thereis no reason to expect that our morale would proveinferior to that of any other country if we had to beput to the test, and the plans so far made for preparingus find a good deal of support not only from the stand-point of " common sense " but from Dr. Rickman’sarguments as a psycho-analyst, published on anotherpage of this issue.

THREE RHEUMATISM RESEARCH FELLOWS

AT a luncheon given at the Athenaeum Club onMay 26th Lord Horder announced the appointment bythe Empire Rheumatism Council of three whole-timeresearch fellows. Dr. C. B. Dyson and Mr. H. J.

Taylor, Ph.D., will work at present in the laboratorybuilt and equipped by Mr. Alexander Maclean at theHospital of St. John and St. Elizabeth. Dr. W. S.Tegner, who holds the Sir Alexander Walker travellingscholarship, will spend a year studying methods oftreatment at clinics in Europe and North America.Dr. Dyson has been engaged for seventeen yearsin pathological research at St. Mary’s Hospital,Paddington. Dr. Taylor has been working for tenyears at the St. John Clinic, Pimlico. Lord Horderemphasised their appointment as the spearhead of amovement for intensive research into the causes ofrheumatic diseases. Other whole-time workers wouldbe appointed as funds became available.

APPENDICECTOMY FIFTY YEARS AGO

WE have received the following letter from SouthernRhodesia :-

DEAR Sm,-It may interest you to know that it is nowjust on fifty years since the first operation of the removalof the vermiform appendix was performed. It was per-formed in I think June 1888 by Mr. (afterwards Sir)Frederick Treves upon myself at my father’s house.I thought you might perhaps care to refer to it in yourjournal as the operation subsequently became so usual.(I wish Mr. Treves and I had patented it.)

I am, yours faithfully,SAMUEL JAMES SMITH.

Mr. Smith may well be right for on Feb. 4th, 1888,Mr. Treves had reported to the Royal Medico-

Chirurgical Society a case of relapsing typhilitis in aman aged 34 in which he had intended to remove theappendix and did not. The abdomen was openedduring a symptomless period after the subsidence ofa second attack, and a kinked appendix was foundwhich became straight at once after division of its

mesentery. Treves forbore to remove it ; the patientmade a perfect recovery and up to the time of the

report had remained free from further relapses. ToMorton of Philadelphia is given credit for theearliest of all successful appendicectomies (in 1887),and in this country Treves had many runners-up.At the same meeting of the Royal Medico-ChirurgicalSociety Mr. Timothy Holmes reported removal of

part of the appendix of a man aged 30, and Mr.Howard Marsh mentioned the case of a girl whodied from peritonitis from whom he had too lateremoved the appendix. Mr. Thomas Bryant, on theother hand, said he had never removed the vermiformappendix, although he felt there must be cases inwhich it was desirable. How the demand later grewin volume was recalled by Colonel Thornton on

p. 1256 of our last issue.

THE DIRECTION OF THE MARIE CURIE

HOSPITAL

WHEN in 1925 the decision was reached to developa scheme of controlled research in the treatment ofuterine cancer by radium, at four hospitals staffedby medical women, a director was needed tocoordinate methods and to analyse and recordresults. It so happened that Dr. Elizabeth Hurdonwas available and willing to accept a post for whichher previous experience had fitted her so well.Though born in Cornwall and an M.D. of Toronto,it was mainly at the Johns Hopkins University thatshe gained this experience, first in pathology underW. H. Welch, and later as assistant, as instructor,and finally as associate in gynaecology, when shetook her surgical fellowship. She worked, taught,and published jointly with H. A. Kelly duringthe period, early in this century, when the renownof the clinical research in progress at this famouscentre was attracting students from all over theworld. Before she started work with radium sheinformed herself by visits to the pioneer centres ofthis form of therapy of the most suitable technique,modified it where this seemed desirable, and, on theadoption of a uniform procedure by the surgeonsattached to the several hospitals, took responsibilityfor the dosage. The incorporation of the four clinicsinto one unit, the Marie Curie Hospital, took placein 1929 ; and the results achieved at this hos-

pital under her direction at first with radium aloneand more recently with X rays also have achievedwide fame as, in the words of Dr. Henri Coutard,among the best in the world.

Dr. Hurdon’s decision to resign from her arduouspost, which is recorded in the ninth annual reportof the hospital, was made long enough in advanceto enable the authorities to arrange for an overlapof two years during which her successor, Dr. M. D.Gilmour, has worked closely with her. The commentof the board of management on the inestimableservice rendered by Dr. Hurdon to clinical researchin the treatment of cancer by irradiation will beendorsed by her fellow-workers at home and abroad.

OTOGENOUS NON-PURULENT ENCEPHALITIS

FROM time to time a case of suppurative otitisis reported, with symptoms suggestive of cerebralabscess, in which an exploratory operation is performed,sometimes more than once, but no pus is found andthe patient finally makes a complete recovery. A fewfatal cases also are on record where post-mortemexamination has revealed no abscess but an area ofsoftened haemorrhagic brain tissue. If the patientrecovers one cannot exclude the possibility that anabscess has formed and been absorbed, or that ithas become encysted, though the latter is improbable

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if there are no subsequent symptoms. Jerlang 1 ofCopenhagen describes a case of this nature and hascollected some 18 others, and he gives a useful accountof the clinical features of the condition. The diag-nosis is extremely difficult. Sometimes the symptomsare so vague and atypical that the affection is eithermisinterpreted or is not recognised at all. In

Jerlang’s case cerebral puncture was performed infive different directions and cerebellar puncture inthree, and this procedure was repeated after fiveweeks, without striking pus, but the patient slowlymade a complete recovery and has remained well foreighteen months. Usually the diagnosis will bereached by exclusion with the help of the furthercourse of the disease. The temperature, however, isusually high and often of the septic type, and asubnormal temperature has never been recorded.The pulse-rate, too, is ordinarily proportionate to thetemperature and there have been no cases with truebradycardia. Lumbar puncture is no help in thediagnosis, for the cerebro-spinal fluid may presentany variety of picture, from normal to turbid withnumerous cells, with or without increase of pressure.Most cases have been treated as cerebral abscess,which could never be excluded with certainty, andfortunately exploratory puncture is not likely toincrease the encephalitis.There seems to be no doubt that otogenous encepha-

litis stopping short of suppuration is a clinical entity,and knowledge of its existence is important in theestimation of the prognosis of apparent cerebral abscesswhen puncture fails to reveal pus. The surgeon must notconsider such a condition hopeless and on that groundbe tempted to incise the brain without restraint.

Although a few reported cases have ended fatally theprognosis on the whole is good, and not only as regardslife. For even when intracranial symptoms have beensevere they have nearly always subsided entirely.

A VETERAN OF LEGAL MEDICINE

THE Medico-Legal Society, at its meeting on

May 26th, enjoyed an informal address by Dr. L. A.Weatherly, who is perhaps its oldest member and

certainly its oldest active member. Dr. Weatherlywas born in 1850 and qualified in 1873, so that hisexperience far antedates that of many practitionerswho have long retired from active life. About oncea year he delights the society with some selectionfrom his stored wisdom ; as the president, Sir TraversHumphreys, remarked, the society has good nights,better nights, and Weatherly nights. This time hisreminiscences included an account of a case in whichthe police suspected a certain barrister, of notablyeccentric conduct, of causing the death of a womanwhose body was found in a train arriving at Waterloo ;but they did not find enough evidence to justify acharge. Some years later the barrister became a

patient of Dr. Weatherly’s in his private asylum atBath. In the course of his treatment he obtained thefull confidence of the patient and was allowed accessto his diary. This showed that on the day of themurder the man had been staying with friends atBristol. Inquiries supported the diary, and itbecame clear that he could have had no knowledgeof the murder. Dr. Weatherly remarked that it hadalways been a great satisfaction to him that thispatient had died without knowing of the suspicionagainst him. Dr. Weatherly’s paramount interestshave always been in psychiatry, and it is naturallythat aspect of legal medicine, rather than its more

commonly emphasised pathological side, that most1 Jerlang, E., J. Laryng. May, 1938, p. 283.

appeals to him. His concluding remarks gave aclue to his dominant outlook on life. It is quite clear,he said, that we live in a big world which containswithin itself another big world of mentally abnormalpeople. This second world is the one in which he has

spent most of his working life, rubbing shoulders withpsychoneurotics day after day for 55 years. Hehas found that far above the value of medical treat-ment of any kind is the value of a kindly word, ashake of the hand and a clap on the shoulder, whichbring comfort and happiness to people whom theworld calls demented. He would like his epitaphto be " He tried to be a friend to the insane."

J. J. ABEL

LAST week we announced that Prof. John JacobAbel of Johns Hopkins Hospital had been elected aforeign member of the Royal Society : this week wehave to announce his death. He was 81 years old,having been born at Cleveland in 1857. He beganhis career as a schoolmaster and later as school

superintendent, went to Johns Hopkins as a graduatestudent in 1883, and did not take a medical degreetill 1888, when he was working at Strassburg. His

prolonged sojourn in German, Austrian, and Swisslaboratories and clinics ended in 1891, and a littlelater he was appointed first holder of the chairof pharmacology at Johns Hopkins University whichhe was to occupy for nearly forty years. His achieve-ments in it included the final isolation of adrenalinein a chemically pure state and the crystallisation ofinsulin ; but possibly more important than any ofhis own investigations was the influence he wieldedthrough so many years, both as professor and aseditor of the Journal of Pharmacology and Experi-mental Therapeutics. In awarding him its WillardGibbs medal in 1926 the American Chemical Societyannounced that it was " for having done more thanany living American to promote the human enjoy-ment of life without pecuniary advantage to himself."In England, besides the recent membership of theRoyal Society he received an honorary degree from

Cambridge in 1920 and a gold medal from the Societyof Apothecaries in 1928. He was president of theAmerican Association for the Advancement of Sciencein 1932, and in late life, as emeritus professor, wasdirector of the laboratory for endocrine research atJohns Hopkins. In the past few years he and hiscollaborators there have been working on tetanustoxin and have given reasons for believing that itdoes not, as is generally assumed, travel to the centralnervous system through the peripheral nerves buthas a powerful direct action on voluntary muscles.

THE library endowment fund of the Royal Societyof Medicine stands to benefit to the extent of nearlyjE34,000 under the will of the late Colonel Cecil Birt,late A.M.S. Colonel Birt was a regular user of thelibrary, and the bequest was made spontaneously asan appreciation of the services rendered by thelibrary to the fellows of the Society.THE Lister medal for 1939, in recognition of dis-

tinguished contributions to surgical science, has beenawarded to Prof. RENB LERICHE, who occupies thechair of clinical surgery in the University of Stras-bourg. He will deliver his Lister memorial lecturenext year at the Royal College of Surgeons of

England. This is the sixth award, which is made

by a committee representative of the Royal Society,the Royal College of Surgeons of England, the RoyalCollege of Surgeons in Ireland, the University of

Edinburgh, and the University of Glasgow.