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hundred miles from the patient operated upon, andthe result was entirely successful. Success can be gotby using the corneas of cadavers, but actually in one ortwo attempts of this kind he had not been successful.The cases selected, however, were not promising.

Dr. LA ROCCA (New York) showed a film of a newmethod of stitching when operating with corneal grafts.

Mr. F. E. PRESTON (London) demonstrated a newunobtrusive occluder for raising the vision of

amblyopic eyes, and for other cases in which itbecomes necessary to occlude. It presents a betterappearance than do black shades and entirely opaqueglass screens. Its value in amblyopia was doubtedby some members on the ground that it does not

sufficiently eliminate vision.Mr. P. G. D OYNE (London) gave a short communica-

tion entitled Number Forms. It seems that about oneperson in thirty sees numbers as patterns of weirdshape, curved or angular, with some of the groupsaccentuated. They are set in space as a picture byvisual memory. They are thought to be caused bysuch things as the remembered arrangement of clockfaces during infancy, and tend to persist in the

proportion stated. This method of figure visualisa-tion is thought to account for the phenomenon oflightning calculation. Those who do not see figuresin this way find the process quite beyond theirunderstanding.

Mr. THOMSON HENDERSON (Nottingham) putforward the question, How is a hyphaema or a hypo-pyon resorbed ? He maintained that extensive

section-cutting of the eyes of mammals reveals noanatomical barrier at the angle to prevent the freepassage of aqueous into the suprachoroidal space.He is convinced that this is the normal physiologicaldrainage route of the aqueous.The annual dinner was held on July 6, when there

was an attendance of about 130, including Prof.R. R. Macintosh (Oxford) as guest of honour. Mr.P. H. Adams (Oxford) acted as deputy master of thecongress and Mr. F. A. Anderson (Shrewsbury) ashon. secretary.

SOCIETY FOR THE STUDY OF INEBRIETY

AT a meeting of this society on July 11 a discussionon

Alcohol and Drug-addiction in Relation toCrime

was opened by Dr. NORWOOD EAST, who said thatGreat Britain had the lowest crime-rate of anygreat European community and a much lower onethan the United States of America, especially as

regards violence. In 1937, of 805,336 personsconvicted 52,425 (just under 6t per cent.) were guiltyof drunkenness, as against an annual average of193,354 in 1910-14. The number had declinedcontinuously from 1920 to 1932 but had increasedeach subsequent year. In 1937 the number ofknown drug-addicts was 620, but only 31 personswere dealt with for offences under the DangerousDrugs Acts, 1920-32, and Regulations thereunder.Apart from drug-addiction, crime might be associatedwith drug-addiction if a criminal became a drug-addict or if an addict committed a crime, but thiswas unusual. In fact, in this country the relationof drug-addiction to crime was insignificant incomparison with alcoholism.As regards the incidence of alcoholism in the

parents of criminals, in 4000 youths at WormwoodScrubs prison in 1930-37 a family history of alcoholism

was found in 52 per thousand, being more frequentin association with offences against the person,discipline, and property and with multiple convictions ;the incidence of a family history of drug-addictionwas insignificant (2 per thousand). Dr. East had

investigated the incidence of alcoholism among100 men and youths tried for murder in post-waryears (90 of them in the last ten years) and hadfound alcohol as a predominant or a contributorycause in 19. He had also examined between April,1907, and December, 1910, 1000 cases of men andyouths charged with attempted suicide and hadfound alcohol as an important cause in 39-3 per cent.He did not know of any statistics showing the relationof alcohol to sexual crimes in this country ; but in1924 he had found only 9 alcoholics among 150 mencharged with exhibitionism. Criminals sometimestook to alcohol to nullify their inhibitions, and theassociation of alcoholism with prostitution was

sometimes due to the same purpose. Every practicalcriminologist would attach some importance to theassociation of alcoholism with crime, but it was veryeasy to over-emphasise the connexion.

Insanity might lead to drunkenness, and viceversa. The typical crime committed in mania a

potu was one of violence, and the terrifying halluci-nations of delirium tremens might be responsiblefor murder, suicide, violent assaults, or damage toproperty. In the more chronic forms of insanity,theft, fraud, and sexual offences were not uncommon ;crimes of violence might be due to hallucinations orto delusions ; and crimes of violence, sexual offences,thefts, embezzlement, or vagrancy might be causedby mental deterioration brought on by chronicalcoholism. Criminal conduct was obviously favouredby the abnormal mental condition due to drunkennessapart from insanity. The impairment of reason,the lack of appreciation of the consequences, theemotional disturbance, the divorce from reality, theloss of inhibition, and the consequent unleashing ofpersonal predilections were responsible for manycrimes committed by alcoholics.There was a tendency in some alcoholics for

subsequent crimes to be of the same pattern as a

previous crime, thus resembling some cases of crimedue to epilepsy. This resemblance might be accen-tuated if there were no subsequent recollection ofthe criminal conduct ; and, if an epileptic had takenalcohol before committing a crime, the diagnosisbetween alcoholic and epileptic automatism might beimpossible. It was also important to remember thatafter certain illnesses, such as head injury, braindisease, or a previous attack of mental disease(especially delirium tremens), the offender might bemore susceptible to alcohol than formerly-theso-called pathological drunkenness.

In considering the legal aspect Dr. East said thatformerly drunkenness was not accepted as an excusefor crime, because the defendant did wrong in gettingdrunk, and an offender under the influence of drinkcould derive no privilege from a madness voluntarilycontracted. Later it was ruled that, on an indictmentfor murder, intoxication of the accused might betaken into consideration to show that the act wasnot premeditated. In 1920 the House of Lordsdecided that insanity, whether produced by drunken-ness or otherwise, was a defence to the crime charged.The treatment of the alcoholic and the drug-addict

guilty of a major crime was not difficult, for thesentence imposed was usually long enough for theefficient withdrawal of the drink or drug as well asfor general and special medical treatment. It wasmore difficult in petty crime associated with alcoholism

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or drug-addiction because of the shortness of thesentence. Compulsory detention of inebriates inthe past had been found ineffective in the moreadvanced cases. Medical treatment might be moresuccessful if tribunals had authority to enforce

compulsory detention on criminal alcoholics and

drug-addicts for considerable periods early in theircareers. Clause 34 of the Criminal Justice Bill nowbefore Parliament proposed to enable courts ofassize and quarter sessions to pass two new typesof sentence : corrective training for not less thantwo and not more than four years on offendersbetween 21 and 30 whose records, character, andhabits made such a sentence expedient for the

training of the offender ; and preventive detentionfor a similar period on persons over 30 whose criminalantecedents and mode of life made such a sentenceexpedient for the protection of the public. Underthese provisions some of the more criminal alcoholicswould be detained with benefit to themselves andthe public. Clause 38 enables a medical report onthe mental condition to be obtained without remandingthe accused; ’thus inebriety and drug-addiction asthe underlying cause of the crime might be diagnosedearlier. Clause 19 enables offenders with some formof mental illness or abnormality, though not certi-fiable, to undergo medical treatment as either residentor non-resident patients.Too much reliance should not be placed on psycho-

therapy. Evidence was given before the PersistentOffenders Committee in 1931 that psychotherapyhad proved successful in only 2 or 3 cases of inebrietyout of 60, and in only 1 case out of 11 morphia addicts.In an investigation of the psychotherapy of crimeat Wormwood Scrubs in 1934-38 no case of alcoholism /

had been treated by this method, and 4 carefullyselected cases of drug addiction gave disappointingresults. In the report based on this investigationDr. East and Dr. W. B. de B. Hubert had recommendedthe establishment of a special penal institution wherepsychiatric treatment could be given more effectivelythan in an ordinary prison to mentally abnormalbut not defective or insane prisoners. Furtherinvestigation, however, was necessary before treatmentof confirmed alcoholics or drug-addicts could beundertaken with confidence.Some women were repeatedly sentenced to short

terms of imprisonment for drunkenness and made

up the " stage army " of inebriates in the women’sprisons. Dr. J. C. Mcl. Matheson, governor of Hollo-way prison, had said that of 2222 women received intothat prison in 1936 for various offences 1112 hadbeen convicted of drunkenness, the youngest being22, 5 per cent. under 30, 55 per cent. 31-50, and 40per cent. over 50. Dr. East had been much impressed,when an inspector under the Inebriates Act, 1898,by the fact that a considerable proportion of womenin the institutions remained in residence indefinitely,although they had not been received under theact and were at liberty to leave. They found inthe institutions the shelter, companionship, sympathy,interest, and freedom from anxiety denied to themin the outer world. According to Sir Samuel Hoarethe number of habitually inebriate women was

steadily and quickly decreasing.In conclusion Dr. East said that, though the

alcoholic, the drug-addict, and the criminal wereabnormal, the clue to much that arose from theirassociation would be found in the study of normalbehaviour. Medicine could contribute much tothe solution of the problems raised by them, butfuture social progress and administrative action mustbe relied on for large-scale results.

ASSOCIATION OF CLINICAL

PATHOLOGISTS

Clinical Pathology of TuberculosisAT a meeting of this association held in the

Coventry Joint Laboratory on July 1, with Dr.A. F. WRIGHT in the chair, a paper on

TESTING MILK FOR TUBERCLE BACILLI

was read by Dr. S. ROODHOUSE GLOYNE (London).He said that there are three possible methods of

carrying out the test-namely, direct film examina-tions of the centrifuged deposit, cultivation on non-glycerinated egg medium, and guineapig inoculation.In his experience direct film examination only yieldsabout a tenth of the number of positives that animalinoculation does. Cultural methods, though valuablefor other fluids and for sputum, are of little use inmilk-testing, owing to the prevalence of saprophyticaerobic spore-bearing organisms. The guineapig testnot only gives the highest percentage of positivesbut it is also the only test which can be used asabsolute proof in a court of law. The drawback ofthe test is, of course, the length of time taken toobtain the answer. He recommends that 100 c.cm.of milk should be centrifuged for half an hour at3000 revolutions per min., and that the centrifugeddeposit should be treated for the same length of timewith normal soda to destroy secondary organisms andthen neutralised with normal hydrochloric acid beforeinoculation. The animal should be killed not lessthan five weeks afterwards and no case must be

reported as positive without definite naked-eye signsof tuberculosis (including infection of the regionallymph-glands) and the finding of acid-fast bacillimicroscopically. Dr. Gloyne’s earlier figures-1560tests for the years 1928-31-showed 9.1 per cent. ofpositives, whilst his latest figures-3960 for theyears 1935-39-show only 6-2 per cent. Althoughthe two series are for various reasons not strictlycomparable it looks as though some improvement inour milk-supply is at last taking place. A series of276 pasteurised samples, however, yielded 2-5 percent. of positives, which seems to indicate that notall pasteurisation plants are efficient.

COMPARISON OF CULTURE AND ANIMAL TESTS

Dr. E. N. DAVEY (Gloucester) pointed out that itis in respect of the bacillus most associated with hisname that the postulates of Koch are most com-

monly broken, in that as a rule no attempt is madeto isolate tubercle bacilli from suspected cases byculture. This is because of the difficulty experiencedin culturing the organism, but this difficulty has to agreat extent been overcome by the introduction ofthe media of Lowenstein, Petragnani and others.Dr. Davey’s present series of results are based oncultures on Lowenstein medium, but he believes thatPetragnani’s medium gives greater speed and richnessof growth. After describing his preparation of themedium and his method of preparing the inoculumby digesting it with 4 per cent. sodium hydroxidefollowed by repeated washings with saline or steriledistilled water, he detailed his results in a series of112 specimens of sputa, pleural exudates, urines, pusand cerebrospinal fluid. He had 18 per cent. positiveon films, 32 per cent. on cultures and 29 per cent. inanimals, when the identical material was used ineach instance. In another series of 150 cases he had18-5 per cent. positive in films and 33 per cent.positive on cultures. These specimens were selected