1856 STATUES ON NEW BUILDING OF THE BRITISH MEDICAL ASSOCIATION.

anthrax, papulo-necrotic erythema. The last three, andespecially the last two, forms are very rare. None of thereactions are serious or produce adenopathy or fever. Com-

plete recovery takes place in one or two weeks. This reactic nis applicable at all ages and in all forms of tuberculosis.In the immense majority of cases the cutaneous reaction, like’the ocular reaction, is positive only in tuberculous children’

and is negative in those free from the disease. However,in cases of subacute infection (g’l’anulie) and in cases ofadvanced pulmonary tuberculosis the cutaneous reaction,like the ocular, may be negative. Sometimes the cutaneousreaction is negative in a patient who is very ill but becomespositive when he improves (when the temperature falls,strength is regained, and the pulmonary focus dries up)Conversely, when the reaction is positive while the child isfairly well it becomes negative when he becomes ill. The

negative reaction in advanced tuberculosis is not an import-ant drawback of the method. The important point is to

recognise tuberculosis in its initial stage when the reactionis of service.

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THE STATUES ON THE NEW BUILDING OF THEBRITISH MEDICAL ASSOCIATION.

IT is sincerely to be hoped that the authorities of theBritish Medical Association will turn a deaf ear to the sugges-tion that the simple and forcible figures which adorn theStrand façade of the new buildings of the Association oughtto be removed. They are good and dignified sculpture, theyare suitable to the building, and could only offend the sort ofnasty-minded person whom it is useful in the cause of

morality to offend and to keep on offending ; and if the

Association at the bidding of an ignorant outcry removesthem it will not improva its reputation with the medicalprofession for pluck, for decency, or for knowledge ofart. Some of the critics of these statues, fearing to becalled pruriently prudish, say that they object to the statuesnot because they are naked but because they are ugly ! In

the name of common sense is a nude less harmful to publicmorals when made to be alluring ? The outcry against thesefigures is so silly that there must be some reason behind it.

PERSISTENT HÆMATURIA FROM VARICOSE VEINSOF A RENAL PAPILLA.

IN the Boston Medioal and Surgical Journal of May 21st:Dr. W. F. Whitney has reported a case of hæmaturia dueto a very rare cause-varicose veins of a renal papilla. A

middle-aged man was admitted into the MassachusettsGeneral Hospital with a history of repeated attacks ofhsematuria for a considerable period. Careful examinationfailed to reveal the cause. Cystoscopy showed bloody urineissuing from one of the ureters. The corresponding kidneywas removed. After removal it appeared to be somewhatpale but otherwise normal. However, on closer inspectionthe tips of one or two of the papillae were observed tobe reddened and a little spongy. They were cut out at

once, hardened, and stained. On microscopic examina-

tion the venules at the tip of the papilla were seen tobe dilated irregularly to twice or thrice their normal sizeand to be covered on their free surface with a fine film of

connective tissue and a single layer of epithelium.Here and there they projected as varicose knucklesabove the surface. The conditions were such that the

slightest violence must have caused rupture and extravasa-tion of blood. In many cases the lumen of the vessels wasfilled with finely granular detritus and occasional blood cor-puscles. That haemorrhage must have taken place here wasborne out by the fact that the straight tubules containedblood corpuscles. The condition described was adequate toaccount for frequent and severe haemorrhage, for an in-

significant lesion will produce severe epistaxis. In this

connexion it is interesting that there is an abundant vascuta’rplexus at the apex of the normal papilla and that thevessels are separated from the surface only by a thin

layer of tissue. After studying this case Dr. Whitney’sattention was called to a series of cases reported byMr. E. Hurry Fenwick under the title of "Painless

Hæmaturia of Angioma or Capillary Na3vu3 of a RenalPapilla." Dr. Whitney regards his own case as belong-ing to this class but considers that the condition isone of varicose venules rather than of angioma or naevus.The following is one of Mr. Fenwick’s cases. A girl, aged18 years, had suffered for five years from intermittenthæmaturia. Astringents had no effect. Bacteriological andmicroscopical examination showed no evidence of the natureof the disease. On one occasion dark blood was seen issuingin jets from the left ureter. As the patient became veryanæmic the kidney was explored and brought out on the-loin. It was healthy to sight and touch. On incising thepelvis what appeared to be a villous tumour of a papilla,was seen with the electric light. A tuft of vessels sur-rounded the apex of a papilla. With a Volkmann’s spoonthe papilla and half of the pyramid were cut out. The-

vessels of the mucous membrane covering the papilla weremarkedly varicose. Mr. J. H. Targett examined the speci-men and reported that there was no evidence of growth butthat there was congestion of vessels with extravasation ofblood and increase of the cellular stroma. The hæmaturiaceased.

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THE NATIONAL ASSOCIATION FOR SUPPLYINGFEMALE AID FOR THE WOMEN OF

INDIA.THE Viceroyalty of the late Earl of Dufferin was certainly

one of the most beneficial events that our great EasternDependency ever experienced. But not only did the Viceroyinsure by his wise statesmanship a calmful rest to the some-what troubled waters that were existing when he took up thereins of office but he was well seconded by the able counselsof his wife. Through her instrumentality the School for theTraining of Christian Indian Women as Medical Missionarieswas established to work in connexion with all Protestant

missionary societies. The purpose of this school was to-

enable them to obtain a Government diploma in medicine,surgery, and obstetrics; in it they were to be trained as

nurses, compounders, and midwives, whilst at the same timethey were to labour in evangelistic work amongst theirpatients. That such trained women were necessary was atonce evident when we consider that the Indian woman is

jealously guarded from the eyes of Europeans. For instance,a medical man would be expected to make a diagnosis byfeeling the pulse of a patient’s hand thrust through ahole in a purdah. Only female doctors having entranceto Mussulman and Hindu homes would have opportunitiesfor carrying enlightenment on religious subjects to mothersdominated by beliefs, creeds, and superstitions some of whichwere cruel and most of which were grotesque. To set asidethese ancient superstitions was a work of enormous magni-tude when we consider the innate conservatism of the Indian

people, and the only hope of doing so was by the founding, of a school such as the Countess of Dufferin originated., Each succeeding year since its inception has shown in-I creasingly gratifying results. The last report, for instance, for the year 1907 demonstrates that at the Memorial Hospital. of the school situated at Ludhiana there were 1188 in-; patients, 16,517 out-patients, and a total of attendances of- 52,374, or more than 1000 a week. The total operations.s were 583. There are 100 beds and at the present moment1 43 students are undergoing training. In addition, however, to) the hospital at Ludhiana the report shows the great work- that has been accomplished by the numerous Dufferin hos-s pitals throughout the length and breadth of India, not only