1207MEDICINE AND THE LAW.-BERLIN.

out-of-date conventions, and, contemptuous of the B.M.A.’spower to strike him off its register, is reported to have struckhimself off. The B.M.A. can do-just nothing.

Mr. Stuart Bevan, for the British Medical Associa-tion, described that article as seriously defamatoryof the Association, and of its policy and of its methods,the whole of the comments being entirely unjustified.On the institution of proceedings, without waitingfor the action to come to trial, the defendants’ adviserssubmitted to the plaintiffs the following statementwhich was read in court :-

It has been pointed out to us that an article publishedin the Star of Sept. 2nd, 1926, on the subject of the NewHealth Society and the retirement of Sir William ArbuthnotLane (first President of that Society) from membershipof the British Medical Association, has been construedas imputing improper motives and behaviour to the BritishMedical Association-particularly that the Associationwas oppressive upon medical practitioners, registered as

well as unregistered ; that its hostility to the educativemethods of the New Health Society arose from a desire toprevent any improvement in the public health becausethis would involve loss of fees to medical men ; and thatthe Association was actuated solely by the desire to benefitthe medical profession without any regard whatever to publichealth or public interest.We disclaim the intention of making any such imputa-

tions, and we are fully satisfied that such a conception ofthe work and outlook of the British Medical Associationwould be wrong in fact and unjust ; and we regret anywrong impression which the publication of the article mayhave created.

Mr. Bevan then pointed out that the Aseocia-tion has itself been much concerned-and hascaused research work to be undertaken-in theprevention of disease. Mr. Norman Birkett, forthe defence, said that he agreed with the statementof the terms of settlement.His lordship indicated his assent to the discon-

tinuance of the action, each party being content tobear its own costs.

Damage from Horse-bite.If a horse bites other horses is it to be deemed

likely to bite human beings ? The old idea that ananimal is " allowed one bite " received fresh illustra-tion lately in the High Court in the following circum-stances. A man was crossing Ludgate-hill and passedin front of a stationary horse and van which were atthe moment unattended. The horse was muzzled,but stretched out its head and made for the passenger’shead, thereby injuring his face. Evidence (to provewhat lawyers call the scienter) was called to establishthat the horse had previously bitten another horse.A jury in the Mayor’s and City of London Courtawarded the plaintiff £25 damages, but the judgegave judgment for the defendants, and the High Courthas confirmed his view. The jury had found that thehorse was dangerous to other horses and also tomankind, but no evidence had been given to showthat a horse which will bite another horse is likely tobite a human being. People, said Lord Sterndale,M.R., in Manton v. Brocklebank four years ago, arenot safe in acting upon what they believe to becommon knowledge without evidence. Lord JusticeScrutton quoted this remark with approval andadded that horses are subjects upon which peopleoften disagree.The plaintiff put his case in this way. Horses, as

we know them in the London streets, do not bite.Once you find a biting horse, you find an animal whichis outside its class, and therefore must be deemed Idangerous in the sense that its owner keeps it at hisperil and is liable for any damage it may do. But,said the Lord Justice, there is no legal authority forthe proposition that, if an animal is known to bedangerous in one particular way, its owner thereuponbecomes liable for any other kind of damage it may do,however unexpected or unusual.

Friendly Society’s Convalescent Home and Income-tax.The Royal Antediluvian Order of Buffaloes has

established a convalescent home at Redditch largely

by subscriptions from within the Order. It issupported by the general funds of the Order, and thebeneficiaries must be members of the Order, thoughonly 20 or 30 patients out of 2,000,000 members couldbe accommodated at a time. The General Commis-sioners of Income-tax made an assessment of £180gross (£146 10s. net) on the premises, but Mr. JusticeRowlatt has ruled that it is a "hospital" withinRule 1 (c) of No. VI. of Schedule A of the Income-taxAct. The Solicitor-General, who appeared for theInland Revenue, seems to have admitted that the factof the institution covering only a small field of hospitalwork did not prevent its being a " hospital." But theCrown argued that the home was really a privateestablishment which the Buffaloes could close at anytime and that there was no such element of publiccharity about it as would entitle it to exemption fromtax. The judge said it was unlikely that the activitiesof the home would be stopped and the profits throwninto the general funds of the Order. The home wasan eleemosynary establishment maintained by theOrder for the benefit of a few of its members. Thefact that it was limited to members of the Order madeno difference. A hospital established for the membersof a profession or trade was not prevented from beinga hospital within the meaning of the statutoryexemption.

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

I German Orthopcedic Congress.THE German Orthopaedic Society, at its annual

meeting in Nuremberg, devoted considerable atten-tion to arthritis. Prof. Heine (Rostock) opened adiscussion on arthritis deformans, which, he said, isfound most often in the knee-joint and less commonlyin the elbow, hip, and shoulder. The knee is neveraffected before the fortieth year, and the hip beforethe fiftieth. Up to the age of 60 the disease is moreoften seen in men than in women. Pathologically itis a peculiar condition of the mesenchyma, dependingon age and constitution. Dr. Krebs (Aachen) pointedout that X rays do not always reveal the cause ofthe pain, since it is often due to alterations of thejoint-capsule and of the subchondral tissue. Heconsidered that muscular atrophy is a result not ofinactivity but of atrophic disturbances of a specificcharacter. Hyperæmia is, he said, the essentialcurative agent, and may be produced by mud orother baths ; after treatment at Aachen, 64 per cent.of the patients are able to work. Prof. Vulpius(Heidelberg) said that when the capsule was contractedthe joint should never be extended with vigour, butvery cautiously. Prof. Spitzy (Vienna) advocatedstretching of contractions by a single manipulation.The aim of an operation should be ankylosis in theknee-joint but mobility in the hip. Dr. Kruz (Berlin)said that in women arthritic pain in the knee-jointusually develops between the fortieth and fiftiethyear, a fact probably connected with diminishedresistance at the climacteric and the increase ofweight at that period. In the more acute cases fixationof the joint, in chronic cases a Hessing apparatus,and in less serious cases medico-mechanical treatment,is required.

In a discussion on scoliosis, Prof. Galeazzi (Milan)explained his method of curing scoliosis by gypsumdressing in stages on a special table in the horizontalposition. Dr. Gaugele (Zwickau) said that old-standing scoliosis is the result of fixation and ofcompression, caused by the weight of the trunk,relaxation of muscles and ligaments, and generalweakness. Whilst the fixation is not remediable,compression may be influenced by a gypsum dressing ;in debilitated persons gymnastics are useful. Dr.Valentin (Hanover) spoke on heritable orthopaedicconditions, and said that brachydactylia, syndactylia,Dupuytren’s contracture, chondrofibromatosis, and a

1208 BERLIN.—IRELAND.

tendency to habitual luxation of the shoulder areoften hereditary. Dr. Maus (Berlin) referred to thefamiliar occurrence of club-foot. It is not yet ascer-tained, he said, why this condition is more frequentin males than females. Dr. Brandes spoke on

retarded consolidation after osteotomy, which hadoccurred in 6 per cent. of his 4485 operations, andin his view had local causes. Dr. Simon (Frankfort)said that this retarded consolidation is fairly commonin women between the ages of 18 and 25, and is causedby reduced vitality of the sclerotic bone. Dr.Königswieder (Vienna) agreed with this statement,and advised his hearers to abstain as far as possiblefrom cosmetic operations at that age. He believedthat endocrine troubles were responsible for theretardation.

Prosecution for Injury by Neglect.Some time ago a medical man and a nurse were

found guilty of injury by neglect because the nursehad forgotten to apply the filter in using X raysfor curative purposes, the result being a severe burn.The court considered that it was the doctor’s dutyto ascertain whether the nurse had applied the filter ;he had, however, left the room after having adjustedthe apparatus. On appeal the High Court in Leipzighas cancelled the verdict so far as the medical manis concerned. It regards the application of X raysas a merely technical procedure, including the useof a filter in every case, and holds that the medicalman was justified in believing that it had beenemployed in this particular case as in any other.Administration of X rays may be likened to that of apoisonous drug ; it requires certain precautions, butis, as a rule, entrusted to trained nurses, no medicalman being expected to supervise their administrationpersonally if he has assured himself that the nurseis trustworthy. The case has, however, been referredback to the local court, because it had not been madeclear whether the nurse was or was not sufficientlyexperienced to be left in charge by the doctor.

Dental Treatment in Russia.Prof. Dauge, of Moscow, in a paper recently read

before the Society of Socialist Medical Men, explainedthat in Russia dentistry is regarded as a specialbranch of general medicine like other branches, andthat the dentist is expected to be familiar withmedical science as a whole. In Leningrad and otherplaces there are stomatological clinics with largestaffs where some 9000 dental surgeons have alreadybeen trained. Whereas in Leningrad there were,five years ago, about 500 private dentists, there arenow only 50. Dental treatment is carried out at12 great dispensaries maintained by the State, wherethe working time of the medical man is only five hoursdaily.

Insurance against Accidents.According to a recent statistical report there were

in 1925 837,695 industrial concerns whose employeeswere insured against accidents, under the Workmen’sInsurance Act, to the number of 11 millions. Therewere also 4,601,916 agricultural enterprises with14 millions of workers, and 880,194 employees of theState and municipalities. The total number ofinsured persons was thus about 25 millions, being anincrease of 1 million compared with the previousyear. Compensation for the first time was securedby 107,517 persons, of whom 53 per cent. were

industrial, 42-6 per cent. agricultural, and 4-4 percent. employees in public works. The percentage ofcompensation payments for each 1000 accidents hasmuch increased compared with 1924. The rate per1000 was 5-2 (4-4) among industrial workers, 3-2(2-6) among agricultural workers, and 5-4 (4-2) forState and municipal workers, the figures in parenthesesbeing those for 1924. The increase is partly due tolegal extension of insurance to the time of transportto and from work. The accidents were fatal in 7-5per cent. of cases, and 1-1 per cent. of them causedtotal incapacity for work.

IRELAND.

(FROM OUR OWN CORRESPONDENT.)

- Deep X Ray Treatment in Dublin.AN improved apparatus for treatment by deep

X rays has been installed at the Royal City of DublinHospital, and the treatment rooms were publiclyopened by the Governor-General last month.The treatment room contains a switch-table which

places the whole apparatus under the completecontrol of one operator. Projecting through thewall between the machine and treatment rooms aretwo large metal cylinders. Each cylinder, which canbe raised or lowered by means of a motor mechanism,contains one X ray tube, thus enabling the simul-taneous treatment of two patients, who are placedon couches either beneath or over the cylinders,according to the type of treatment being given.The cylinders, which weigh one ton each, are coatedwith lead a quarter of an inch thick, thus affordingcomplete protection for the operator and enablingthe doctor or sister to be in close touch with thepatient, heretofore impossible owing to the graverisks run from stray radiation due to imperfectlyprotected apparatus. The facilities for treatmentprovided will be available for patients at otherhospitals, and also for private patients on the recom-mendation of their own medical attendants.

University College Medical Society.The opening meeting of the University College

Medical Society was held at Dublin on Nov. 18th,Dr. D. J. Coffey, President of the College of Physi-cians, in the chair. The President of the Societyfor the coming session is Prof. J. M. O’Connor, whodelivered an address on the Physiology of Equili-bration. He described, with the aid of the lantern,the investigations carried out by the late Prof. Magnusof Utrecht, and laid stress on the fact that in theseimportant experiments no expensive apparatus hadbeen required, but that the cooperation of severalworkers, including skilled surgeons, had been essential.An interesting discussion followed the address, thespeakers being Prof. H. Pringle, Prof. E. P. McLaughlin,Dr. H. Quinlan, and Dr. E. P. Freeman.

The Approved Societies and Medical Benefit.The annual meeting of the Approved Societies

Association of Ireland was held in Dublin last week.The annual report was concerned chiefly with therecent report of the Committee of Inquiry on NationalHealth Insurance and the Medical Service. In theopinion of the Association the time has come for acomprehensive reform of the Poor-law medicalservices. If this cannot be achieved they favour ascheme of medical benefit for insured persons andtheir dependents, with an increase if necessary in theweekly contribution, not exceeding 3d. a week, orif this is not feasible, a scheme of medical benefit forinsured persons only, with an additional weekly con-tribution not exceeding 2d., the Association to beconsulted in the preparation of the scheme. Thereport shows that there has been an abnormal increasein the benefit payments in 1926 and 1927 as comparedwith 1925 ; societies were probably not referring theirdoubtful cases to the National Health InsuranceCommission for examination by the medical referee,which was provided free of cost. The report alsodealt with the inadequacy of the Sanatorium BenefitFund, and with the Departmental Committee’s recom-mendations on workmen’s compensation with regardto the National Health Insurance Acts.

Mr. J. D. Nugent, Secretary of the Ancient Orderof Hibernians Approved Society, said that the Inter-national Labour Conference in Geneva last June had,in its recommendations, to a large extent adopted thesystem of health insurance in operation in GreatBritain. Ireland was hampered because she had notsuch a system. The Geneva report had recommended