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high pressure steam autoclaves, instrument and basinsterilisers, and hot and cold water and saline sterilisers.Adjoining the theatre is the anaesthetic room. Offthe anaesthetic room open three specially heatedrecovery rooms for animals after operation. Besidesthe protected steam pipes which pass through theserooms, plugs are provided for the supply of electricmats for cases in which the supply of warmth is ofspecial importance. A small post-mortem room

completes the operating department, which is flooredthroughout with rubber and can be Hushed withwater in its entirety. A biochemical room is equippedfor chemical investigation in relation to experimentalwork and will have a close liaison with the correspond-ing clinical laboratory in the hospital. A small room,which can be steamed to provide a sterile atmospherefor inoculating culture media and for post-mortemexaminations in which bacterial contamination mustbe rigidly excluded, is found at the entrance to theexperimental floor. Adjoining the professor’s roomon the experimental floor is the dictaphone and steno-grapher’s room, where records of experiments can

be made without delay.Animal Houses.-Direct access from the experi-

mental floor is obtained by means of a covered bridgeand gangway to the newly constructed animal housesand to the elevator leading to the teaching department.In order to meet the greatly increased demands forexperimental animals the animal houses, formerlya collection of one-storey buildings, have been doubledin size by building a second storey. Central heatingis provided throughout, the walls are of glazed Keen’scement and can be easily flushed down. The windowsand roof lights are of Vita glass to permit of thepassage of ultra-violet rays, and next the operatingdepartment is a bathroom, fitted for washing animalsbefore operation.

A VISIT TO SOME OF THEWEST GERMAN SPAS.

OPPORTUNITIES were recently given to representa-tives of the British llIedical Journal and THE LANCETto make an official tour of spas in Western Germany,of which little has been heard in this country since1914. Ten spas were visited, and the brief noteswhich follow are given in the order in which the visitswere paid.

NEUEXAHR.This little spa is situated in the valley of the river

Ahr, a few miles from the pointwhereit joins the leftbank of the Rhine, and is reached by train from Colognein about two and a half hours. It is a well-wooded,sheltered place with clean, smooth gravel paths androads which make walking possible immediately rainceases. The Kurhotel, with its 350 rooms, said to bethe largest hotel in West Germany, is modern andcomfortable, and its kitchens are models of cleanlinessand efficiency. Facing the Kurbotel, and separatedfrom it by lawns and gravel paths, stands the Kurhaus(i.e., Casino) with its band-stand, concert-room,theatre, café, dancing hall, and American bar. Here ethe young and the holiday makers can amuse them-selves without disturbing those who are taking thecure. Behind the Kurhaus, and separating the spagrounds from the small town, runs the little riverAhr, which has the appearance of a good fishingwater and is said to be well stocked with trout.The spa grounds contain the warm, ferruginous,highly carbonated springs, the discovery of which ledto the development of this place some 70 years ago.The bath establishment adjoining the Kurhauscontains 120 bathrooms, mostly constructed for givingonly simple immersion baths in the thermal water ;there are also rooms for massage, packs, and variouselectrical treatments, but it is evident that theseaccessory treatments are of secondary importance.Neuenahr specialises in the treatment of diabetes

and obesity and of sufferers from gastric and duodenalulcer. Here more attention is given to diet than in

most German spas, and in the Kurhotel all menusare divided into three parts; the first the ordinarymenu, the second for those with digestive troubles,and the third for the diabetic and obese. The essentialfeatures in the diabetic diet are the provision of specialbreads, biscuits, and puddings with low carbohydratecontent but still quite palatable, and the substitutionof saccharine for sugar in cooking. The use of thewaters is empirical and there is no up-to-date labora-tory for clinical investigations. Urinary sugar isestimated, but blood sugars are estimated only in thepresence of acetonuria, and, as coma is said to bealmost unknown during treatment, it must be assumedthat severe cases of diabetes form a small minorityof the cases sent here. But with the water drinkingand bathing, diet, and graduated exercise it is saidthat good results are obtained.The place has an attractive simplicity and shows

what can be done in the development of a small spawithout lavish expenditure, provided that the localwaters and surroundings are suitable.

EMS.Ems lies in a deep, rather narrow valley, the con-

figuration of which is reminiscent of Matlock Bath.In the bottom of the valley runs the river Lahn, whichis big enough for rowing and sailing regattas to beheld here. The town is about equally divided bythe river, which is conveniently bridged. Some ofthe warm springs contain 2 g. of sodium bicarbonateand 1 g. of sodium chloride per litre, this quantity ofwater yielding from 500 to 600 c.cm. of free carbonicacid gas. The hydrotherapeutic and electrical equip-ment are modern, and there is a clinic with a Statedoctor in charge of biochemical and bacteriologicallaboratories and of the X ray outfit and electro-cardiograph. Whilst it is claimed that all catarrhalconditions from eye to bladder benefit by Ems treat-ment, it is best known for the treatment of bronchitis,asthma, emphysema, and their secondary cardiacdisturbances. The pneumatic compression chambers,inhalation, gargling, and spraying rooms are wellconstructed and provide accommodation for largenumbers of patients.

LANGENSCHW ALBACH.

Langenschwalbach may be reached from Ems bycar through the forests covering the Taunus mountains.On the hillside are the large barracks built for theFrench Army of Occupation, which have recently beentaken over by the British. The iron drinking watersare used in the treatment of anaemia and dyspepsia.Carbonated chalybeate waters are also used forimmersion baths, but best known of all are the chaly-beate mud baths, of which some 6000 a year are

given for inflammatory conditions of the pelvis,rheumatism, and chronic fibrositic conditions. Therather deserted appearance of this little spa in thehills is probably due in part to a fall in the pre-warnumber of 6000 visitors per annum to about 2000 atthe present time, but it has an attractive and restful Ilook.

SCHLANGENBAD.’This is a pretty hillside health resort among the woods

where the wells are carbonated water of low mineralcontent. The " steam bath," in which the waterflows continuously through the bath, has been founduseful for skin diseases ; Schlangenbad is a suitableplace for rest cures and here come people sufferingfrom insomnia, neurasthenia, and nervous breakdown.

WIESBADEN.Wiesbaden lies at the foot of the Taunus Mountains

and is a handsome, modern city with beautifulsurrounding woodlands. The splendour of theKurhaus and of the Kaiser Friedrich Bad, completedin 1914 regardless of expense, is somewhat over-

whelming. Sodium chloride is the chief mineralconstituent of the hot springs, and gout and rheu-matism are the complaints for which these waters seemmost suitable, but the equipment of the bathingestablishments is so complete that practically all

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diseases amenable to spa treatment can be dealt with.At the general hospital, of which Dr. Geronne is incharge, there is also a well-equipped balneothera-

peutic department. One half of this hospital is at

present occupied by the R.A.M.C. as the centralhospital for British troops in occupied territory.Several of the private hotels, such as the " FourSeasons," have their own thermal springs and bathhouses, so that patients can take their immersionbaths with the minimum amount of trouble.

KISSINGEN.There is an old-fashioned stateliness about Kissingen

and a quiet dignity even in its newest spa buildingswhich is very restful and in pleasing contrast to themore ornate decoration seen elsewhere. The balneo-logical plant is modern, and experimental work inthe collection, analysis, storage, heating, and manipula-tion of the highly carbonated saline waters is carriedout by an able chemist, who is the State mineralwater engineer for this and other Bavarian spas.Dr. Granville’s letters to the Tines in 1850, describingthe wonders of the newly discovered great artesiansalt spring issuing at a temperature of 66° F., mayin part account for the large number of Englishvisitors of former times. The cold saline watercontains an exceptionally large quantity of freecarbonic acid gas. Chalybeate waters and mud bathsare used, and the complaints mainly treatedare diseases of the digestive system, arterio-sclerosis,gout, and rheumatism.

NAUHEIM.Nauheim was well known to English people in

pre-war days. The free supply of carbonated salinechalybeate waters issuing at a temperature suitablefor bathing without artificial heating or cooling, andin various strengths of saline content and free carbonicacid gas, explains in part why the spa became knownas a health resort for people suffering from circulatorydisturbances. The mineral water engineering here isparticularly interesting. Carbonated saline waters arecommon in Germany, and other spas claim to givetreatment for disorders of the heart as well as Nauheim.The arguments current there as to the absorption orthe reverse of carbon dioxide through the skin, asto the different action of artificial and natural CO..,and as to the importance of the proportions of sodiumand calcium salts to one another and to other saltsare entertaining if not convincing. In Nauheim,however, the dogmatist of the combined auscultation-percussion method, with his gradually diminishingblue-pencilled outlines of the heart, is somewhatcurbed by the orthodiagram, electrocardiogram, andgalvanometer. The State clinic, where these controlsare employed, is under the direction of Prof. Weber,who has further research in view. At one privateclinic, run on

" Duff House " lines, both investigationand treatment are on up-to-date lines. All formsof heart disease are treated in Nauheim, but renalcalculus, chronic Bright’s disease, and recent cerebralhaemorrhage are regarded as contra-indications.Whilst the modern spa physician does not claim toreduce the size of the old hypertrophied heart, he doesclaim to improve functional efficiency in suitablecases.

WILDUNGEN.This small spa lies in a little valley surrounded by

leagues of hill and forest. There are several springs,the principal one being a carbonated iron water con-taining little sodium chloride. A large business is donein bottling and exporting the waters which are bestknown for their action in diseases of the urinary system.Contracted granular kidney, stone, enlarged prostate,cystitis, and the like are treated here, but thelarge white kidney with marked albuminuria is notconsidered suitable for these waters. The baths arebuilt in the ground floor of the large FiirstlichesBadehotel, where are Turkish baths, douche, and Iinhalation rooms, although the water, drinking and Ibathing, are considered the most important parts of Ithe treatment. Ten kilometres away in the RiverEder there is excellent trout fishing, at all events for I

the provident angler who has brought the necessarytackle with him.

PYRMONT.

Pyrmont is renowned for its mud baths, of whichsome 300 are given daily, in addition to about 1500mineral water baths in the full season. They have ahigh reputation in the treatment of sterility in thefemale, and it is the custom for young brides fromthe surrounding country to come here for a courseof baths if pregnancy does not result within a reason-able time after marriage. The baths are also used forpost-operative and other inflammatory conditions ofthe abdomen and pelvis. The six chalybeate springshave varying quantities of iron and saline, and oneused solely for bathing has a large quantity of carbonicacid. There are also radio-active brine springsbesides the enormous quantities of mud, which in thisneighbourhood contain sulphuric acid and ammonia.The gardens of Pyrmont are a notable feature, andthe presence of palms and other subtropical treesindicates a mild climate.

OEYNHAUSBN.This has been termed " the town without steps."

The district is flat, and for the convenience of patientstaking the cure, and especially those in bath chairs,little slopes take the place of steps wherever possible.The carbonated saline waters come from a depth of700 metres and the free gas in consequence comes offmore slowly than from most other springs. One litreof water yields 900 c.cm. of carbon dioxide. A newspring with a high calcium chloride content is nowbeing bored and is expected to be of value in thetreatment of heart diseases. There are also salinebaths without carbon dioxide. Diseases of the centralnervous system, gout, rheumatism, and circulatorydisturbances are all treated here. The newcomer isat once struck by the large number of patients inbath chairs. This is not entirely accounted for bythe numbers of paralysed and lame people who comehere for treatment, but because the local doctorsfavour this form of " carriage exercise " as a meansof ensuring the requisite number of hours rest forthose taking the cure. The town is surrounded bya lovely park with well-kept paths and seats atconvenient intervals.

PARIS.

(FROM OUR OWN CORRESPONDENTS.)

The Witness of Psychopaths.AT the recent Congress of Legal Medicine Dr.

Rogues de Fursac, medical officer to the MentalHospital of Ville-Evrard, read an interesting reporton the witness of psychopaths, considered both fromthe point of view of truthfulness and of knowledge ;the former being determined by the ratio of exactdeclarations to the sum of exact and false ones, thelatter by the ratio of exact declarations to the totalquestions asked. Generally speaking, the witness ofpsychopaths is inferior to that of the sane, but acertain number are found whose coefficient of truthis equal or superior to the lowest coefficient in sanepersons. The witness of the psychopath cannot,therefore, a priori be turned down. Provisionallypsychopathic states can be graded in regard tofidelity of witness in the following diminishing order :melancholia, chronic delusional psychoses, chronichallucinatory psychoses, mania, cerebral traumatism,schizophrenia, mental retardation, epilepsy, generalparalysis, senile dementia, and cerebral arterio-sclerosis. The extent of knowledge shown by thepsychopath is generally very slight, much slighterthan its truthfulness. It is manifested in the smallnumber of questions answered rather than in thenumber of errors committed. Knowledge is generallygood for spacial relations and for acts, bad for personaldescription, colours, words, localisations in time andduration. Psychopaths are very unequally suggestible.From the point of view of suggestibility the author