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Lunacy Commissioners at the Ministry of the Interior.A decree of Feb. 2nd, 1910, has established at the

Ministry of the Interior a special commission which willadvise on all questions concerning the engagement, pro-motion, discipline, and remuneration of the officials of the

public lunatic asylums, as well as on all subjects which maybe referred to it either by the Minister or by the director ofthe Assistance Publique or by the department of publichealth. The commission consists of seven members, of whomthree are medical directors or principal medical officers,elected annually by their colleagues, who have, moreover, tcelect a deputy. In questions of discipline affecting assistantmedical officers the three medical directors or principalmedical officers will be replaced by an equal number ofassistant medical officers.

Soci6t4 Nationale du Chien Sanitaire.In France, as in other countries, there exists a SociétéNationale du Chien Sanitaire for training dogs to find thedead and wounded on the battlefield. The French societyheld its general meeting in Paris on April 30th at the Mairieof the Eighth Arrondissement. The President said that themembership had almost doubled since last year, during whichthe society also took part in the dog show in Paris. During1910 the society will be represented at various shows andexhibitions, as well as at courses of instruction in connexionwith the service de santé in Paris and at rehearsals of findingwounded soldiers both by night and day. At the request ofthe Association of French Ladies, a demonstration will begiven before long at Auteuil. M. Laval has been appointedto collect information with respect to this class of traineddogs in various countries, and at the next general meetingM. Grandjux will open a discussion on the question, Whoought to provide the necessary supply of these dogs for thearmy in time of mobilisation ?

Traumatic Osteoi7ia.At a meeting of the Paris Society of Medicine held on

May 13th, M. Dabout showed a patient upon whom he hadoperated for a traumatic intramuscular osteoma in the rightvastus externus. At the same time he showed the tumourand radiographs bearing on the case, the disease being con-secutive to the kick of a horse. M. Dabout laid great stressupon the length of time the tumour had taken to develop, fora radiograph taken some six weeks after the accident wasquite negative. M. Caudray said that the periosteal origin ofosteomas had given way to the theory that they were due toa myopathy, except in the case of osteomata growing near thearticulations or where they were obviously due to some

periosteal condition.May 17th.

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VIENNA.

(FROM OUR OWN CORRESPONDENT.)

Infantile Tubere2ulosis in Vienna.Dr. Pollak, speaking before the Medical Society of Vienna,

gave the results of investigations which he had made into theclinical and pathological details of tuberculosis amongstinfants. He has seen 92 cases of undoubted disease withinone year, of which 86 gave a positive tuberculin reaction and6 were seen at the necropsy. 30 cases were diagnosed inthe first year of life, 62 in the second year. The youngestinfant was 39 days old when the diagnosis was made. The

prevalent symptoms were those of tuberculosis of thebronchial glands, such as cough and expiratory râles ; in 22cases cutaneous tuberculides were present. In 17 cases

tuberculous meningitis was observed, and Dr. Pollakbelieved that it was mostly a fresh infection on accountof the absence of affections of the bronchial glands and theexistence of good general health at the onset. In three casesthere was nothing to indicate tuberculosis, except the factthat in spite of breast-feeding the infants became pale andlost flesh. The tuberculin reaction explained matters at once;wherefore it was very important, according to Dr. Pollak, toapply this test in similar cases. Untl quite recently the

prognosis of infantile tuberculosis was thought to be verybad, but it had now been found that this was not so. Of the92 children kept under observation 42 were still alive (in thefirst, second, and third year of their age), whilst the resthad died. The mortality of the infants who were found I

diseased in their first half-year was 87 per cent., while forthose who were attacked in the second half-year it was58 per cent. The age at infection was therefore very

- important. The severity of the disease was proportionate tothe severity of the disease in the person who infected the

, infant, and the prognosis was the better the more carefullythe child was nursed. Breast-feeding was not absolutelyessential, 30 per cent. of the survivors having been fed byhand from bottles. The surviving infants showed a complexof symptoms which was characteristic-the so-called tuber-culous habitus, which developed many months after

t infection, as the infected infant might appear healthyfor a considerable period. Dr. Pollak had examined

E all children who had come in contact with one of histuberculous patients, and who had therefore lived in tuber-culous surroundings. Of 200 children living under theseconditions, only nine did not react to tuberculin in a dose of

s 1 milligramme injected subcutaneously, a circumstancewhich was to be explained either by an absence of infectiveagency or by a minimal degree of infection. The investiga-tions conducted in a very searching way had brought to light

’- the fact that all children who had become infected wereunder four years old, whilst those above four years of agenearly always escaped. Of 243 children, all those becameinfected in whose case either one parent or both parentswere infected at the time when the children were born, butif the infection carrier did not become ill till after beingmarried several years the older children remained free. Dr.Pollak believed that older children acquired a sort of

immunity against tuberculosis (" Tuberculose-Festigkeit "),and he said that the habitus phthisicus indicated thatthe child had been infected in his first years of life, whilst

) tuberculous manifestations in older children were survivals of an infection contracted in very early life. Of course,

these conclusions require a much larger series of observationsbefore being accepted as convincing.

L The Comparative Chemistry of Brain Substance.Dr. Linnert, at a recent meeting of the Gesellschaft der

Aerzte, read a paper in which he gave some interestingdetails on the chemistry of the brain. He said that the lipoids

- formed the main bulk of the brain. Analysis showed thatthey consisted of the elementary substances oxygen, hydrogen,

nitrogen, carbon, and phosphorus, with some sulphur. Thebrain of the higher animals was fairly constant in its com-

E position; the quantity of the brain increased with the bulk of) the body, the dry substance and the lipoids being mainly

responsible for this increase in weight ; the human braincontained more lipoids than any other brain. The cortexcontained more water than the white substance ; the drysubstance of the cortex had 45 per cent. of lipoids, the whitesubstance 75 per cent. ; the latter had also less phosphatides,whilst the pons and the medulla had the largest proportionof water in the whole brain. The cerebellum containedmuch water, but only a small proportion of lipoids andphosphatides. The spinal cord was poorer in water than thebrain ; its dry substance might contain as much as 80 percent. of lipoids, whilst the entire brain had 60 per cent. ofits weight in lipoids.

Taxation of Medical Practitioners.L A report recently issued by the Revenue Office gives somel interesting particulars relative to the rates and taxes payableL by Austrian medical practitioners, and the following figures

are worth recording. The doctor in this country has to payfirst the so-called occupation-tax (Erwerbsteuer), which isassessed according to the locality, the extent of the district,

: and the quality of practice under consideration. Theminimum tax is levied on beginners and amounts to about

: 8s. a year, but it soon increases, and the average amount isabout ten times that sum, whilst of course in cities the figures

: go up to Z40 or .650 a year, especially with specialists ofrepute. The amount paid under this heading by medicalmen in Vienna is about £16,000. In the next place,a practitioner has to pay income-tax. He has to show howmuch of his income is derived from his medical practice andhow much from other sources. The proceeds of practice aretaxed so that annual incomes up to £125 pay 1 per cent. andthose from .6125 to £250 pay 1 1/2 per cent., whilst for everyadditional E80 of income an additional 1/4 per cent. (approxi-mately) has to be paid. The maximum is reachedwith a tax of 5 per cent. on a practice of .E2000.

The amount thus paid by medical men in Vienna reaches

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.626,000. It can hardly be said that these figures allow anypositive conclusions to be drawn as to the actual amount ofthe income of the medical profession in this city, but it maynevertheless be remarked that the income-tax is equivalent toabout .6800,000 earned by the medical men. The averageamount paid by a practitioner in this city in the shape ofrates and taxes is from 3 to 4 per cent. of his earnings.Incomes derived from appointments, as well as those ofofficers of public health, are taxed only on the sliding scaleof the income-tax, no occupation-tax being payable on

account of them.

Introductory Lecture by Professor Wertheim.Professor Wertheim, the newly-appointed director of the

Second Gynæcological and Obstetrical Clinic, opened thesummer session of his clinical course by a short introductorylecture, which was attended by many professors, by thewhole Senate of the Medical Faculty, and by numerousstudents. After a sympathetic allusion to the career of Pro-fessor von Rosthorn, his predecessor, Professor Wertheimexplained his attitude to the problems of modern gynascologyand obstetrics. He considered that caution and patiencewere qualities indispensable to an obstetrician, emphasisedthe overwhelming importance of asepsis in obstetrics,especially when midwives were in attendance on the patient,and spoke of the necessity of expertness in performingoperations and making a diagnosis. As regards gynxcology,he said that for any success to be obtained in cases of cancerradical and surgical treatment must be commenced as earlyas possible. He also cited some examples of the mutualrelations existing between general medicine and hisspecialty, and advised the students to.pay close attentionto these relations.May 14th.

____________________

UNITED STATES OF AMERICA.

(FROM OUR OWN CORRESPONDENT. )

A Commission on Public Safety.A PLAN has been put forward in Minnesota for the forma-

tion of a State Commission on Public Safety. It is suggestedthat this body, which it is proposed should sit all the yearthrough, should take over all the functions now exercised bythe Board of Health, the administration of the pure-foodlaws, the work of the Bureau of Labour, and of all otherdepartments of the public service whose object is to safe-

guard life, limb, and health. The originator of the plan isDr. Henry M. Bracken, secretary of the Minnesota StateBoard of Health.

Cancer Research.Cancer research in the United States will be benefited by

the munificence of Mr. George D. Barnard of St. Louis, whohas provided the funds for a new four-storey hospital build-ing, to be shortly opened for the St. Louis Skin and CancerHospital, which was founded by the same generous donor in1906. The entire fourth floor of the new buildings will bereserved for a research laboratory, which is to be fullyequipped for cancer research, and the sum of$8000 has beenset aside for that purpose. Professor Leo Loeb, of theUniversity of Pennsylvania, has been selected as director ofthe new laboratory. Since the foundation of the St. LouisSkin and Cancer Hospital four years ago much good workhas been done in the institution, which, unlike most hospitalsin this country, is a purely charitable institution, havingneither pay wards nor pay beds. Efforts are being made toraise a much larger endowment fund to ensure the per-manence of this work. ,

A Life Insurance Company Aids the Attending Physician.A novel departure has been made by the Metropolitan Life

Insurance Company of Philadelphia. This company hasentered into an arrangement with the District Visiting NurseSociety of the city to supply nurses-for night service wherenecessary as well as for day-to visit its sick policy-holders,irrespective of the amount of their insurance or of any otherconsiderations, in cooperation with the attending physicians.By seeing that his orders are carried out, and by obviatingthose difficulties that so frequently arise from ignorance ornegligence, the company believes that its own interests, aswell as those of the policy-holding patient, will be preserved.The move is admittedly a pure business proposition.

The Sanitary Condition of the Isthmus of Panama.

Probably no document ever issued showed so conclusivelythe beneficial results of intelligent sanitary administration asthe recently published report of the Department of Sanitationof the Isthmian Canal Commission for 1909. In 1906 the

general death-rate was 41 - 73, in 1907 28-74, in 1908 13·01,and in 1909 10 - 64, in spite of the fact that there were 47,167employees in 1909, as against 26,547 in 1906. The typhoiddeath-rate for the year was only 0 - 27 per 1000. The deathsfrom malaria-that erstwhile scourge of the country-wereonly 52. Not a single case of yellow fever, small-pox, orbubonic plague occurred. When the frightful conditions inregard to disease that formerly made the region a veritabledeath-trap and caused the failure of the French canal projectare recalled, the result is surely a most convincing testimonyto the value of scientific sanitation.

Death of Dr. F. Byron Robinson.Dr. F. Byron Robinson of Chicago, who died recently at the

age of 53 years, was a most tireless worker as an anatomist,investigator, and teacher, and a prolific writer on manysubjects. He was also an accomplished surgeon in the fieldof intestinal and gynaecological surgery. He had heldmany teaching posts, and was held in the highest regardby all his old pupils, who were very numerous, as well.asby a wide circle of professional friends.May 9th.

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NOTES FROM INDIA.

(FROM OUR OWN CORRESPONDENTS.)

Reorganasatinn of the St. John Ambulance Association inIndia.

A MEMORANDUM has recently been issued by the executivecommittee of the Indian branch of the St. John AmbulanceAssociation regarding the extension of the sphere of useful-ness of the branch. The Viceroy as president takes a deeppersonal interest in the matter, and the idea is that "thetime has come when the active support of the heads of localgovernments, of the rulers of Indian States, and of theleaders of non-official organisations, industrial and com-mercial, is essential to secure the desired expansion and toplace the working of the association on a sound and

permanent footing." The committee has accordinglyinvited the various authorities and associations indicatedabove to cooperate in the matter and to take the initiative inprovinces, states, and large towns with a view to carryingout the new scheme. Individuals in India are liable tosudden transfers, and to place the organisation of the associa-tion on a sound basis it has been deemed desirable that thelocal authorities and heads of the community should becomeex-officio the local leaders of the association, instead of

leaving it entirely to the individual efforts of private personswhose transfer may cause centres practically to cease toexist. In England and the Colonies a fee similar to thatlevied by other educational bodies is charged by the associationfor holding examinations under its auspices. As a specialconcession to the peculiar needs of India this fee need notnecessarily be charged, and a charge of six annas (sixpence)for each certificate to cover the cost of printing, examiner’sreport form, registration, &c., is the only charge made inaddition to the cost of books and appliances. The costinvolved is, therefore, not very great, as 250 persons can becertificated for about Rs.100 (£6 13s. 4d.). The certificatesare in the form approved by His Royal Highness the Presi-dent of the association. They are sent out in bulk fromLondon and are issued from the stores depot, Bombay, onreceipt of an attendance register and examiner’s report onthe prescribed forms. Information with reference to theformation of classes is laid down in pp. 16-19 of thepamphlet "The St. John Ambulance Association in India."Lecturers should as a rule be commissioned medical officersor fully qualified medical men or women, but where circum-stances render it desirable military or civil assistant surgeons,hospital assistants, or certified practitioners may be appointed.Any person qualified to lecture may also examine classes, butexaminers should as a rule be detailed by district secretariesand no lecturer can in any circumstances examine his ownclass. One of the main objects of the branch is to place the