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DENTAL BOARD OF THE UNITEDKINGDOM.

AT a meeting of the Dental Board in Committee,held on Feb. 14th at 44, Hallam-street, London, W.,the Rt. Hon. FRANCIS DYKE ACLAND, M.P., presided,and 11 out of 12 members of the Board attended.

Standard of Qualification.A communication was read from the Privy Council

notifying approval on Jan. ] 6th of the Regulationsadopted on Dec. 9th, 1921, and adding :-"As regards Chapter 5 of the Regulations-’ The Pre-

scribed Examination ’-I am to take this opportunity ofstating that their Lordships would deprecate the enforce-ment of any higher standard of qualification than is abso-lutely necessary for the protection of the public."

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The appointment of Mr. G. P. Blizard as AssistantRegistrar was approved.The Registrar reported that, the prescribed con-

ditions having been duly fulfilled, the followingnames had been restored to the Dentists Register,erased in conformity with Sections 12 of the DentistsActs, 1878 and 1921 : Frank Allday, Charles A.Lightfoot, and Francis Youngman. I

Report on Registration.The Registrar made the following report in regard

to registration :-The Regulations were received from the Privy Council on

Jan. 16th, and were published on Jan. 27th.1 The staffwere called together on Jan. 25th in order that the wholeprocedure might be explained to them, and the office wasopened for the receipt of applications on the 27th.The applications for forms under the various headings

have been, approximately, as follows : For those in practicefor five years, A. (2), 3093 ; Members of Incorporated DentalSociety, A. (4), 1700 were sent to the Secretary ; Pharma-ceutical Chemists, &c., A. (6), 307 ; Dental Mechanics, B.(1), 356 ; Those in practice for less than five years, B. (5),119 ; Companies, C. (1), 20 ; Directors, D., 23.The applications having been considered satisfactory, the

names of 17 applicants who have been in practice for overfive years have been forwarded to the British Dental JO’l/rnaZfor publication in its next issue, and, if no objections arereceived, the persons concerned will be entitled to registra-tion on about March 15th.A large number of applications have been received from

the Incorporated Dental Society ; 41 certificates have beenissued, and the remainder are being dealt with as quicklyas circumstances permit. Of the Pharmaceutical Chemists,applications are complete ; of the Dental Mechanics, threeapplications are complete ; of the persons in practice forless than five years, two applications are complete ; of theCompanies and Directors, no applications have been returned.A question has been asked as to whether the names of

Pharmaceutical Chemists, Dental Mechanics, and Practi-tioners for less than five years are to be published. Withregard to the first, the point is not so much as to the goodcharacter, because the appearance of the name in the listof the Pharmaceutical Society may be taken as evidenceof this, but as to whether the statements in regard to sub-stantial practice in dentistry are accurate. With regard tothe other two categories, it might be that a person who wasconfident of passing the examination, and who thoughtthan an objection might be made if his name appeared inprint, would apply under one of these headings, and theinstructions of the Board are asked for on these two matters.

Several applications for registration as mechanics havebeen refused on the ground that the applicant has notreached the prescribed age. Complaints have been made tothe Registrar that in several cases these persons have beenmechanics for some years, and that lack of means preventsthem from endeavouring to obtain a licence in dentistry,and the Registrar has been asked if it will be possible toprovide any assistance. The reply given is that at presentit is quite impossible to answer the question, but that thebest thing to do is to pass the prescribed preliminary exami-nation as quickly as possible in case financial help can begiven at a later stage.

There has been a large demand for the Regulations, and1571 copies have been sold.

Following a suggestion from the British DentalAssociation it was agreed that the names of all appli-cants for registration under Clause 3 of the DentistsAct, 1921, should be published.

1 THE LANCET, Jan. 28th, p. 193.

REPORT OF THE

MANCHESTER AND DISTRICT RADIUMINSTITUTE.

THE report by Dr. Arthur Burrows on the work ofthe Radium Institute in Manchester for the yearending Dec. 31st, 1921, begins by pointing out thatthe year has been one of transition, inasmuch as theInstitute has been transferred from the ManchesterRoyal Infirmary to a separate building in Nelson-street, where, largely owing to the generosity ofSir Edward Holt, a complete hospital for radiumtreatment has been constituted. This transfer hasbrought about a number of changes, including theprovision of 13 beds used solely for radium treatment.783 cases presented themselves during the year witha view to radium treatment ; 564 were cases ofmalignant disease, of which 60, or 12 per cent. (exclu-sive of rodent ulcer), were rendered free from signsand symptoms of the disease. This includes 4 casesof carcinoma of the uterus previously inoperable,which were rendered operable and the operationsperformed. One case of carcinoma of the anus,5 cases of carcinoma of the breast, 27 cases ofcarcinoma of the cervix of the uterus, 7 cases

of carcinoma of the mouth and tongue, 12 cases ofcarcinoma of the skin, 4 cases of sarcoma, 3 cases ofendothelioma, and one other make up the 60 cases.An analysis of over 2500 cases, treated at the

Institute between the years 1915 and 1919, shows thatof these patients 1753 were suffering from cancer,267 from rodent ulcers, and 575 from various condi-tions which are usually described as non-malignant,although a considerable proportion of them will, ifallowed to progress, terminate in death. 135 cases ofmalignant disease, the vast majority of which wasbeyond operation, have remained alive for periodsvarying from two to over six years, and are well atthe present time.Rodent ulcers, benign tumours, exophthalmic

goitre, uterine haemorrhage, Hodgkin’s disease, keloid,spring catarrh, and lupus vulgaris have all also showna large percentage of gratifying results. The techniqueof radium treatment is steadily improving, and Dr.Burrows anticipates that in the future the results oftreatment will be still further improved.

Non-Malignant Conditions.The section on the radium treatment of non-

malignant conditions is interesting and is herereproduced at length :-

Exophthalmic Goitre.-Fifty-two of these cases are

recorded as cured, that is to say, all symptoms and signs ofdisease have disappeared, except sometimes some slightexophthalmos, for over two years, and only one recurrence isrecorded. Many cases have already when they come fortreatment definite myocardial failure, which may persist, andalthough the hyperthyroidism is cured they cannot berecorded as cured cases. The application of radium is aprolonged process and much patience is needed because thetreatment may last from 2 to 3 years.

Hodykira’s Disease.-The cases sent by physicians andsurgeons for treatment by radium may be divided into thoseunder 25 years of age and those middle-aged. The formergive excellent results. Three of them have been alive andwell between 6 and 7 years, one between 4 and 5 years, threebetween 3 and 4 years, and one between 2 and 3 years. Theniddle-aged cases seem almost hopeless except for a goodpalliation. Perhaps they are two different diseases.Keloid and Vicious Sears.-These nearly always yield to

adium treatment, and although some mark must always’emain, many of the results are so good that 16 have beenclassed under the heading ‘‘ cured." Treatment of this;ondition also tends to be rather a long process.Spring Catarrh.-With care and perseverance radium

;ures almost all these cases. In fact, it is the only satis-actory treatment of this hitherto incurable disease.Cavernous Nmvus.-Fifty per cent. of these cases are cured

practically without any mark remaining at the site of theumour. Radium, if persevered with, always stops thegrowth of these naevi and reduces their size.Capillary Nævi.-In the treatment of this condition the

Lifficulty is to know when to stop. They can always be made)aler, but if treatment is kept on too long telangiectases will

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appear. Occasionally a perfect result is obtained in a smalllesion.

Excessive (Tierine Hæmorrhage.-Radium is a specific forthis condition. The Manchester Radium Institute recordsonly one failure, and this patient did not submit to a secondapplication. Two patients died of other causes. In middle-aged women the menses can be stopped entirely, but if byusing a small dose the risk of the necessity of a possiblesecond application of radium is taken, with young womenmenstruation often returns to normal, and cases are recordedin which they have married and had children subsequently.Lupus Vulgaris.-Contrary to general expectation, a good

proportion of lupus vulgaris cases, if not too advanced, canbe cured by radium.The physicist to the Institute reports that during

the year 526 emanation plates and 1281 emanationtubes were made.

VIENNA.(FROM OUR OWN CORRESPONDENT.)

Medical Men in Political Life.IN Austria medical men seldom entered into politics

before the upheaval of 1918 ; at present five SocialDemocrats and three members of other parties in theNational Assembly have medical degrees ; municipalboards and local administrative corporations in theprovinces now frequently include medical members.The National Assembly contains no more than 3 percent. of doctors, which explains the easy passage ofmeasures detrimental to the interests of the profession.Such medical organisation as we have encourages itsmembers to stand for election wherever opportunityoffers. In Germany there are seven medical menamongst roughly 380 members of the Reichstag ; inEngland there are 11 doctors in over 700 Members ofthe House of Commons ; but in France, I believe,nearly 10 per cent. of members of the LegislativeAssembly are medical men.

Statistical Data of the Krankenkassa in Austria.During the recent prolonged conflict between the

sickness insurance clubs and their medical staffs,certain statistics were made known, which, beingauthoritative, show very clearly how these institutionsare working. The figures given comprised the year1919 and part of 1920 and showed the changes relatingto 540 out of 740 such clubs ; 785,095 members, ofwhom 343,994 were females, is the average figure forthe time under consideration. Out of each 100members. 46 became ill and received medical attendancefor 30-4 days each. Taking the whole number ofmembers in consideration, it must be stated that eachmale was ill for 13.8 days and each female for 11-39days, including childbirth cases. Of the total femalemembers 2.15 per cent. belonged to the latter group.’The mortality was fairly high, being 1-97 per cent.of the grand total. The financial position of theseclubs is best judged by the figures referring to incomeand expenditure. Whilst the first amounted to nearly75 million kronen a year, the latter reached 67½ million{36 million for sick pay, 3} million for medicines,hospital charges over 4 million, funeral expendituresover 3 million, and 8 million for doctors’ fees andcontrol staff, the remainder being spent in adminis-tration). Sick pay went up by 300 per cent., and otheritems in about the same ratio, whilst medical fees onlyadvanced 30 per cent. on the previous year. This wasthe chief reason for the recent dispute, and the profes-sion gained a great deal of support, especially amongthe working classes, when the public was informed ofthis discrepancy between the other increases ofpayment -and the medical fees.

Anti- Alcohol Movement in Austria.For some weeks a very energetic anti-alcohol

campaign has been conducted in this country by theauthorities and by private organisations, for purelyfinancial reasons. Expenditure on alcoholic beverageshas reached such a high fi gure that it actually endangersthe public welfare. Better payment of manual workhas prompted the labourer not to increase his standardof life but to drink more wine and beer. The Govern-

ment tried vainly to prevent the increase by refusingto grant new licences to public-houses. The bulk ofwine and beer is imported from abroad, and pricesrose to fantastic figures ; more than 6 million poundssterling--a sum equal to the total expenditure of thecountry in that period-went abroad last year inpayment for alcoholic liquors. To check the alarmingspread of drinking a sum of 50 million kronen is to bespent in leaflets, through travelling lecturers and byexhibitions. The next step will be an increase of thealcohol duty to a prohibitive figure, in order to throttlethe import, production, and consumption of alcoholicbeverages. The education of adolescents is recog-nised as a most important step, and cooperation withexisting private temperance organisations is encouragedby the Government.

The Race Factor in Immunity.In an interesting communication to the Jewish

Board of Guardians in Vienna a medical contributorpoints out that the Jewish race displays certaindeviations from the health standard of the populationamongst which it is more or less scattered. In two orthree Austrian cities, where large numbers of Jewslive in the same manner and under the same conditionsas the Gentile population, the former still show distinctfeatures as regards pathology and immunity. Theaverage duration of life is longer than amongst theGentiles, no doubt owing to lower infantile death-ratein spite of, or because of, the smaller number of childrenin the average Jewish family. Jews are mostly town-dwellers, living in overcrowded districts, yet they areless prone to tuberculosis. Syphilis is rather infrequent-perhaps because of circumcision, for gonorrhoeais as frequent as with Gentiles---and alcoholism isalso rare. The real domain of the Jew is nervousdisease and disturbances of metabolism ; he is morefrequently diabetic than his Gentile fellow-citizen, andmore prone to rheumatism and gout. In the Jew,psychoses, hysteria, and neuroses predominate overorganic nerve disease ; as a rule he is more delicate,but more enduring, than the Gentile, and under equalconditions he has a better expectation of life.

Pathological Changes after Mushroom Poisoning.In Austria during the last few years many people

have died of mushroom poisoning. At a recent meetingof the newly-formed " Anatomo-Pathological Societyof Vienna " Dr. Sternberg read a paper embodyingthe results of his investigations into 19 fatal cases, inwhich he examined chiefly the histo-pathologicalchanges of the liver. He discriminates between acutecases living up to five days after poisoning, and chroniccases, or rather subacute cases ; the longest observa-tion lasted 25 days. He saw 1 acute cases, which gavethe following picture : first degenerative, afterwardsinfiltrative fatty changes; isolated necrosis of thecells, never very extensive ; very often regenerativeprocesses in the liver-cells were observed. The changesbore a very marked resemblance to intoxication withphosphorus, but were absolutely different from acuteyellow atrophy of the liver. In the subacute cases,(living 8 to 25 days) the central parts of the lobuleswere completely necrotic, whilst the periphery showedregeneration, like that in the recrudescent atrophy ofthe liver. This suggests that the original mushroompoison does not produce the necrosis, for the acutecases do not show it; it must, on the contrary, beassumed that a subsequent metabolic change occurs.The clinical picture of the subacute fatal cases showsa gradual improvement and a latent stage ; on thesixth or seventh day rapid loss of function suddenlyensues, soon followed by death. Prognosis is thereforealways very uncertain, and effective treatment availsonly in the first day or two, before the poison has hadtime to produce irreparable changes.

Remarkable Range of a Singer’s Voic,,.At a recent meeting of the Austrian Phonetic

Society Prof. Rthi demonstrated a well-known singer,44 years old, who shows quite an abnormal vocal rangeand claims to be able to cover five octaves. The lowestnote produced by him is the contra F with 42 vibrations,