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further interesting feature of the subacute form is thelong-continued septicaemia. This has been regarded asdue to a failure of the patient’s eliminating mechanism.So far as can be judged this view is not correct,for the majority of patients have a markedly increasedamount of antibodies, and their blood is quite unsuit-able for the growth of the organism. Others believethat the organisms develop enhanced resistance tothe destructive agencies at the patient’s command.Others again have sought the explanation in theanatomical peculiarities of the lesion which preventthe access of cells to the organisms. These thenmultiply in the vegetation and escape mechanicallyinto the blood, remaining there, without multiplication,until they are removed and destroyed. It is well-knownthat though infarction and embolism are common,suppuration is very rare. There is no evidence thattreatment on specific lines has any effect on the con-dition. The same may be said of all other methods.

Infective endocarditis is merely a special case of thelocalisation of infecting agents. A full understandingof it involves consideration of certain problemspeculiar to its anatomical situation, thrombosis andvascular injury, and of others of a more generalinterest, the nature of bacteriæmia, the mechanismof defence against the streptococci, the classification ofthe streptococci. The therapeutic problem is thatof an inoperable focus of chronic infection ratherthan that of a pure bacteriæmia. Solution of theproblems of infective endocarditis would be a largecontribution to pathology, and for its solution searchmay have to be made in fields far removed from humancardiology, not least perhaps in the realm of compara-tive pathology. The Secretary of the Research Fundis Dr. P. SEYMOUR PRICE, of 41, Sloane-gardens,London, S.W.1, to whom information should be sent.Scientific workers and clinicians are invited tocommunicate with him as to lines of research whichthey think likely to prove helpful.

THE DANGERS OF GASEOUS ANÆSTHETICS.THE increasing use of clienticallv active gases as

anaesthetic agents should bring home to theadministrator the great need of care to avoid therisk of ignition or explosion. Nitrogen is such aninert gas that the impression has got abroad thatnitrous oxide is also inert, the practitioner havingforgotten his early days in the chemical laboratorywhen a glowing splinter thrust into a cylinder ofthis gas broke into name, much as it would have done in oxygen. For nitrous oxide contains nearlytwice the proportion of oxygen in the atmosphere.At the request of the Joint Anaesthetics Committeeof the Medical Research Council and the RoyalSociety of Medicine Prof. II. B. Dixon, F.R.S.,has been conducting a series of researches on theburning of gases in nitrous oxide. full details ofwhich have been published in the Proceedings ofthe Manchester Philosophical and Literary Society(vol. lxxi., Dec. 10th, 1926), and we are happyto print on another page a short account by theauthor of his results. From this it appears thatnitrous oxide is even more active than oxygen itselfin supporting the ignition and explosion of suchanaesthetic agents as ethylene and propylene. TheCommittee thinks it advisable to warn anaesthetistsand the medical profession generally of this fact,ignorance of which might lead to a serious or evenfatal explosion.

INDEX TO "THE LANCET,"VOL. II., 1926.

THE Index and Title-page to Vol. II., 1926, whichwas completed with the issue of Dec. 25th, is nowready. A copy will be sent gratis to subscribers onreceipt of a post-card addressed to the Manager ofTHE LANCET, 1, Bedford-street, Strand, W.C. 2. Sub-scribers who have not already indicated their desireto receive Indexes regularly as published should doso now.

Annotations.

PSYCHOLOGICAL EXPERIMENT BY WIRELESS.

"Ne quid nimis."

o AN initial difficulty ill the collection of data forL psychological study is that of obtaining a, randome and sufficiently large sample of human material. Ant investigator may have access to groups of people inn schools, colleges. factories or otfices, but a large sampley of the public selected without reference to age, set,

social position, education, or occupation, can rarelyn be made the subject of the simplest investigation.

Prof. T. H. Pear has, therefore, been favoured withan almost unique opportunity in the experiment just

- conducted by him with the aid of the British Broad.casting Corporation, for the only factors involved

e in the selection of his material were the opportunityto listen and the will and ability to write a shortreport. lie arranged that nine speakers should inturn read the same passage-a fragment from" Pickwick Papers " was chosen—and the public

l were invited to listen to the voices thus broadcast’f and answer a set of questions about the sex, age,t birthplace, profession, and accent of each speaker,r and to express a judgment as to whether he or she

was likely to be capable of leading others. Thee primary aim was to ascertain whether there is any

general accuracy in such conclusions when they arebased solely upon the voice, but from the psychological

’ department of Manchester University we may1 confidently expect other interesting results from the) thousands of replies that Prof. Pear has certainly. received. Each reporter is asked to state his name,

address, and occupation, and on this basis the repliesmay give information of philological interest, forthe detection of the locality indicated by an accentwould, we may expect, vary with the locality of thelisteners. To some Londoners, as a negative

. example, the accent imparted to the words of Sam- Weller suggested that one speaker was a stranger- to the dialect of London, and the positive diagnosis’ of a specific accent might come with especial frequencyfrom the district where it prevails. T3esides thedirect aim of estimating the validity of judgmentsbased upon the qualities of a voice, we may expectother results to emerge from the statistical exam-inations of the sex, address, and occupation of thereporters. What people show interest in this experi-ment ? :, Is occupation or station in life correlatedwith accuracv of judgment ? Do men or womenmake the wildest shots ? Perhaps these questionsmay not be answered, but if the statistical machineryof Manchester University is capable of dealingeffectively with the material obtained, we hope t4see other interesting results from a mass experimentthat would have been impossible before the generaluse of wireless. _____

THE MENSTRUAL TEMPERATURE CYCLE.VARIATIONS in body temperature dependent on

critical periods in females, and especially on men-struation, associated with organic disease and par-ticularly with tuberculosis have been dealt withby various observers. In more recent years changesin the endocrine glands have been shown as possiblesources of disturbance of thermogcnesis, and menstrua-tion, or as it is better called, the ovular cycle, hasbegun to be considered, independently of any otherpathological condition, as the determining cause ofexcessive thermic variations. Excluding all thosecases in which hype thermia could be referred topathological conditions in some organ or system,the number of clinical observations on subjectsshowing, during the premenstruum, a temperatureabove normal have been very limited. Dr. G. Avezzu,of the University of Paflua, has published twointeresting cases which bear on the subject of the

1 Il Policlinico, Medical Section, Dec. 1st, 1926.

241

influence of neuroglandular dystonia in producingcertain changes in the body temperature duringthe premenstrual period. IIavimg eliminated the

possibility of a. febrile condition imputable to someform of organic disease in the pelvis or elsewhere,and especiallv early or latent bacillosis, there remainto be considered other aetiological factors and pre- ’,cisely the secretory functionality of one or more

endocrine glands and the disequilibrium betweenthe two antagonistic systems of vegetative life. This is, moreover, what has been done by otherauthors who, occupied with the same argument,and meeting with symptoms of hypersympathismusand manifestations, more or less clear, of increasedendocrine functionality, especially thyroid, havedescribed a sympathetic fever, or fever associatedwith hyperthyroidism. The observations of A. P.Cawadias and Mme. Hovelacque may be men-

tioned in this respect. The charts of Dr. Avezzu’stwo cases show a premenstrual rise of temperature uf two kinds : (1) the monothermic type, the daily oscillations never reaching 0’5 of a degree centigrade;and (2) inverted distribution—i.e., the axillary Itemperature being higher than the oral. The formeris never met with in any of the great varieties offevers due to the direct action of a definite microbeor of its pyretogenous toxins. The latter anomalyhas been noted by Lucatello in a particular groupof subjects with thyroid disturbance of the hyper-secretory type, the external axillary figure beinggreater than the internal oral by two- or three-tenthsof a degree centigrade. In both the cases described,Marañon’s sign—friction of the prethyroid regioncausing erythema—Bram’s test, tolerance to quinine,Goetsch’s test, injection of adrenalin causinglowering of the diastolic with increase of the systolicblood pressure, and Porak’s test, bradycardia, andglycosuria after injection of pituitrin, all these werereacted to in a strongly positive manner. To explainthe pathogenesis of the increased premenstrualtemperature, attention must be drawn to thefunctionality of the sanguineous glands duringthe cycle of maturation of the ovary-i.e.. that thereis a displacement of glandular equilibrium such asto cause in every premenstruum physiologicalphenomena of hyperluteinisrn and of hyperthyroidismwhich are substituted for diametrically oppositeconditions during the menstrual phase and thefirst few following days. Most physiologists admitthat the Graafian follicle ruptures about 12 daysafter menstruation, and the corpus luteum reachescomplete secretory functionality on the seventeenthday, but continuing to increase up to one or twodays from the sanguineous flow, at which period itsinvolution begins which is completed eight days afterthe menstrual period. In the case of pregnancythe corpus luteum remains active for a long time andits secretory activity fades only about the

third month. The hyperthermia therefore, whether pre-menstrual or gravid, follows on parallel lines theevolution of the corpus luteum and seems to be closelyconnected with it.

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THE DIETARY VALUE OF THE SOY BEAN.

For, the last 2000 years the soy bean has been used in North China for making bean curd, a thicknutritious jelly eaten daily by all classes of the people.A vegetable oil is also expressed from it and is

widely employed, the refuse serving for cattle-foodand manure for sugar plantations. About 100 yearsago the bean was introduced into England, but noattempt was made to cultivate it and it is only duringthe present century that its remarkable merits havearoused interest. English iirms have taken a largepart in its export from Manchuria and as long ago as 1911 the amount exported rose to about half a million tons annually. In 1910 experiments were ‘begun which demonstrated that the soy bean could he grown throughout South Africa and its cultivation there was strongly advocated. 1 It was shown that

1 THE LANCET, 1916, i., 168.

besides being useful fur animals, it could form thebasis of substitutes for flour, meat, chocolate,macaroni. cheese, and coffee, and a few years latermuch interest was aroused in this country by anattempt to exploit a sov bean product as

"

syntheticmilk."2 That from the standpoint of nutritionthis attempt was not unjustified is evident from thedescriptions and analyses of the bean which we havefrom time to time published, but it has been founddifficult to popularise its use owing to the disagreeabledigestive disturbance to which it may give rise.Even under the stress of the late war its general adop-tion was found impossible in Germany. In an

article which we publish on page 267 Prof. T. R.Parsons shows that a new phase has been enteredupon, owing to the discovery by Dr. Berczeller inVienna that the obnoxious constituents of soybean can be removed by special milling and fractionaldistillation without interfering with the high nutri-tional value of the resulting meal. Prof. Parsons

bases on these facts a well-considered appeal foran investigation on a large scale, hazarding theopinion that Haberlandt’s prescience may yet berealised and the soy bean come to be extensivelyutilised in the diet of the masses to supply theproteins and fats needed in supplement of theabundant carbohydrate which they obtain from thepotato. His facts and figures should certainlyreceive the attention of all who are interested inthe feeding of men or animals.

MOVING RADIOGRAMS.

APART from its use for purposes of demonstration,it has long been evident that the cinematographmight be of much value for research if continuouspictures illustrating the passage of opaque meals couldbe obtained. Many technical difficulties have stoodin the way ; direct pictures could not be taken, as thesize of the ordinary X ray shadow would necessitatethe use of enormous films ; the employment of anindirect method, in which ordinary photographsare taken of the image seen on a fluorescent screenpresents other difficulties, such as protection of thepatient and camera and the securing of a sufficientlybright image. For nearly six years Dr. RussellJ. Reynolds has been grappling with these and ascore of equally awkward technical difficulties, whichhe described in full in a communication to the RontgenSociety on Jan. llth. BVe are glad to note that heis now able to secure satisfactory moving picturesof the bony parts, although his apparatus is not yet

sufficiently perfected to enable him, we gather, toget serial views of the viscera in action. When weconsider the advance that has followed the study of thekinetics of the heart as revealed, however imperfectly,by the electrocardiogram, and the change in thoughtthat has occurred since recognition of the fact that thedissecting-room gave an illusory picture of theanatomy of the alimentary canal, it seems clear thatif, as the result of Dr. Reynolds’s researches, we becomeable to get clear moving pictures of these viscera,great advances in medical physiology and clinical

medicine may result. Phenomena such as the massperistalsis of the colon, or the mechanics of theduodenal cap call for considerable elucidation.Applied pharmacology may reveal the secrets hiddento-day under the names of vagotonia and sym-patheticotonia. Experiments have already beenmade to study the intimate movements of the heartbv means of the slow-motion cinematograph, butthese and other inquiries are held up by the relativelyimmense costs. We say relatively immense, for it istrue that such sums are trivial in comparison withthose expended by modern " photo play

"

producerswhen seeking some realistic reconstruction of theTower of Babel or the Burning of Moscow. It seemsreasonable to hope that in the near future somehero or heroine of the " movies " may divert a portion

2 THE LANCET, 1912, ii., 1095.