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with real leather. The side screens are rigid and neatin their thin steel frames, and a rear screen is part ofthe standard equipment. The floors have black

druggets, besides a rubber covering. On the dash-board are a speedometer, clock, lamp, and

" strangler "

for starting ; throttle and ignition controls are fittedon the steering-wheel and the gear and brake leversare on the right-hand side. The engine is not reallya 13 but an 11.9, for its capacity is only 1500 c.cm.It is well designed, except that the magneto andcarburettor are rather inaccessible ; it would be an

improvement to change the magneto and generatorabout, for the latter is mounted high up on the off-sideand is very easy to get at. The brake adjustmentsare placed conveniently, and the tool-kit is adequate.The chassis is lubricated with a grease-gun in accord-ance with the latest practice. The driving positionis comfortable, and the front seat will slide back farenough to give long legs plenty of room, but only,of course, at the expense of any passengers behind.Possibly a very tall driver might find that the gear-driven screen-wiper and the top rail of the screen gotrather awkwardly in his line of sight, but a lesser manwould drive comfortably enough. The hand-brakelever is a shade too near the side of the body, butmight perhaps be bent inwards a little. The gear leverhas a long travel and gives a comfortable and quietchange.The new Clyno is a nice car to drive, as the engine is

quiet and well behaved, the steering is extremelydelicate, and the four-wheel brakes will work gentlyas well as pull the car up abruptly when reallynecessary.The gear-box has only three speeds, and perform-

ance on middle is a little disappointing, this gearbeing far too low. It seems to be impracticable tobalance mass-production engines so accurately thatthey will spin up to the top of their power-curvewithout complaining. The remedy is either to havefour speeds with a fairly high third-and this isexpensive-or to have an engine so large that it willtake nearly everything on top, like an American car.The Clyno engine is not big enough for this. It is,however, an excellent car of its class, and may wellbecome popular among medical men.

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

Combating Venereal Diseases in Recsza.AT a joint meeting of several Berlin medical societies

Prof. Bronner, head of the venerological departmentof the Russian Commissariat for Health, recentlydescribed the campaign against venereal disease inRussia. In Moscow, he said, there is a central institute Ifor the training of medical men as specialists. Thecourse lasts a year and 600 medical men have alreadyhad instruction. At first a course of three to sixmonths was the rule, but this proved too short. Thetimes of attendance are early in the morning and latein the evening, so that workmen may have time tovisit the institute without losing time at their work.The law allows only qualified medical men to attendpatients, and quackery is nearly extinct in present-day Russia. Great stress is laid on the education ofthe public in hygiene. Persons suffering from venerealdisease are advised to undergo treatment, but thereis no regulation compelling them to do so. In theprovinces there are similar institutes to the one atMoscow, and arrangements have been made to supplyinformation to correspondents who lack the time tocome themselves. Prostitution, says Prof Bronner,almost disappeared during the time when workingwas compulsory for everybody, but after the neweconomic policy was adopted prostitution beganagain, and is tolerated because the authorities considerthat as long as they are unable to procure work foreveryone, it would be wrong to hinder women fromearning their living in any way they like. An energetic

war is, however, being waged against brothels, andinfected prostitutes are conveyed into a home calleda prophylacterium, where they find not only medicalattendance but also food and work. To inquire intothe state of things in the country at large commissionsof medical men with assistants have been sent out,and it has been ascertained that in some villages upto 45 per cent. of the population have venereal disease.In about 90 per cent. of these the infection is extra-genital, and is due to the primitive housing accom-modation and the deficient hygiene of the ruralpopulation. On an average in the provinces 1.5 to4 per cent. suffer from syphilis, but in regions likeTurkestan, with a native population, the percentagerises to 15 or 25, whilst amongst the Mongols of theBaikal provinces it is as high as 45. The reduction inthe population of these tribes is ascribed in largemeasure to their being affected with venereal diseasein a severe form. Prof. Bronner states that, whilstthe cases of chancre are increasing, secondary syphilis,on the other hand, is diminishing, obviously owing toearlier treatment than formerly. In 1920 the amountof salvarsan produced in the Russian chemical factorieswas 65 kg. : in 1925 the output had risen to 1800 kg.,besides 100 kg. imported from abroad. Before it isdispensed to the public the drug is submitted to athorough chemical and biological test. Prof. J.Jadassohn, the President of the Association for thePrevention of Venereal Diseases, stated at the meetingthat in his visit to Russia he had gained a very goodimpression of the work done by the Russian Govern-ment. In Russia more than elsewhere the prevalenceof syphilis was due to failure of personal hygiene.Similar conditions had existed in Germany during thewar and shortly afterwards.

The late Prof. Israel.The death in Berlin on Feb. 20th of Prof. James

Israel removes one of the most celebrated of Germansurgeons. Born in 1848 in Berlin, he studied inthe university there, and after qualification continuedhis medical training at Vienna, London, and Edin-burgh. Returning to Berlin, he became assistant atthe Jewish Hospital under Langenbeck, the surgeon,and Traube, the physician, and when fully equippedby all his experience was appointed chief surgeon tothe Jewish Hospital, where he remained until hisretirement in 1913. It was Israel who first describedactinomycosis in men as early as 1878 ; formerobservers had not clearly understood its nature. Hisresearches covered many branches of surgery, but hisprincipal work concerned the kidneys, and in 1901he published his standard treatise on renal diseasefrom a surgical point of view. Only two years beforehis death he issued, in collaboration with his son,a new work on the diseases of the urogenital system.Amongst other things, he showed that removal ofone kidney may prevent the spread of the disease toother organs. Prof. Israel was not a universitylecturer, but trained a large number of assistants,of whom his successor at the Jewish Hospital, thelate Prof. Karewski, may be mentioned as one. Hehad a very large international practice, and wasfrequently called into consultations abroad, on oneoccasion being called to St. Petersburg to see theCzarevitch, who was suffering from haematuria dueto haemophilia. He enjoyed special renown among theJews of the East, who before the war used to flockto consult him, not only on surgical matters, but for.many bodily and psychical ailments. He was a manof high culture and very representative. Although78 years of age, he was engaged in practice until afew weeks before he died.

Financial Difficulties of German Universitit’’.The number of German universities is undoubtedly

much too large. Apart from the older ones, whosefoundation partly dates back to the Middle Ages,there is a number of others recently established.Shortly before the war Frankfort was made the seatof a university which is not supported, like the others,entirely by the State, but largely out of municipalfunds and by private endowment by the inhabitants

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of that once wealthy city. Even since the war newuniversities have been opened in Cologne and Hamburg,whilst the old university of Munster has been enlargedby the addition of a medical faculty. Dusseldorf hasbecome the seat of an academy for post-graduate study,and it is intended to make this also into a university.It is characteristic that the new foundations are not,like the older ones, situated in medium-sized andsmall towns, but in large cities. Several of the smalleruniversities are said to be in financial difficulties, forthe State cannot afford to give them adequate grants.This applies to the one at Giessen in Hesse, wherethe pharmaceutical institute has already been closedand amalgamated with a technical college atDarmstadt. It has been suggested, indeed, that theUniversity of Giessen should be closed altogether, forothers abound in the neighbourhood. The Germanuniversities, of course, vary greatly in size. Berlinis the largest, with 10,000 students ; Munich has7068 ; Cologne, 4609 ; Leipzig, 4400 ; Breslau, 4288 ;Bonn, 3209 ; Freiburg, 3020 ; Frankfort, 2635 ;Tubingen, 2533 ; Munster, 2531 ; Heidelberg, 2516 ;Gottingen, 2593 ; Halle, 2301 ; Marburg, 2156 ;Wurzburg, 2124 ; Hamburg, 2075 ; Jena, 2015 ;Konigsberg, 1643 ; Kiel, 1601 ; Giessen, 1308 ;Erlangen, 1292 ; Greifswald, 947 ; and Rostock, 784.In those smaller towns where the economic prosperityof the population mainly depends on the under-graduates, the idea of abolishing the universities hascreated some anxiety, but so far the discussion hasonly been purely theoretical.

BUCHAREST.

(FROM OUR OWN CORRESPONDENT.)

The Shortcomings of Pri2ate Practice.MEDICAL ethics are in the limelight just now.

Allegations against a surgeon who refused to visita patient as soon as he was called have recently beenthe pretext for a vicious outburst against doctors ina section of the daily press. Other journals havetaken up the cudgels on behalf of the profession,against its gossiping detractors, but a certain amountof public dissatisfaction is evident. This makes arecent address given by Dr. Janos Sandor all the moretopical in its interest. His subject was the cessationof private practice.A change in the relations of doctors to the public

and to each other, is, he considers, imminent. Ifthe doctor is to be at the disposal of every sick man,giving to everyone the same unselfish service and thesame knowledge and care, then the whole system ofprivate practice must be abolished, and the sanitaryservice must be put into the hands of the State,which will supply its citizens with physicians, drugs,and surgical treatment, just as it supplies them withthe machinery of the law. It may be argued that thiswould deprive patients of the right to choose theirown medical advisers, said Dr. Sandor, but alreadymost of the population have been deprived of thisright. The peasants in the villages have only onedoctor at their disposal ; the workers in towns mustattend those appointed by their assurance offices.As for sick clubs. Dr. Sandor remarked, the fees ofthe club doctor are so small that no physician canregard appointment to a club as his main vocation,

and he is forced to put his heart mainly into his privatepractice-a fact very well known to his patients.It is notorious that the private doctor examines hiscases, as a rule, much more conscientiously than doesthe badly paid club doctor. But if there were nopaying and non-paying patients this abuse wouldcease.

It would not take long, Dr. Sandor considers, forpeople to get used to the fact that they could notchoose their own doctor. If one of our forefathersof the eighteenth century were to rise from his gravehe would undoubtedly consider it an unheard-ofinterference with his rights when he found that hecould not build a house on his own ground without

conforming to the municipal regulations about site,material, and construction. He would think itintolerable that he should not be allowed to drivehis horses along the street at more than five milesan hour ; that he must go to bed before 1 o’clock inthe morning ; that he should have to open and close-his shop, fix the prices of his goods, cleanse his side-walk, vaccinate his children, and do a hundred andone other things as the law prescribes. Thoughused to the abuses of absolutism in government, thevisitor from the past would consider all this inter-ference with his rights utterly preposterous, and wouldhurriedly return to the grave whence he came. Yetwe consider these regulations reasonable; in thesame way our descendants will learn to regard anationalised health service as something natural. " We-doctors," continued Dr. Sandor, " know perfectlywell that the public is mainly incapable of using itsright of free choice; as a rule it cannot accuratelyjudge of the capabilities, knowledge, and conscien-tiousness of a doctor, and often it prefers the well-advertised man who talks a lot to the quiet man whois efficient. Experience shows that it is not the bestdoctor that has the biggest practice."

Public institutions maintained by the State are,he admitted, to a certain extent unpopular, and donot always deal uniformly and fairly with everycitizen. Nevertheless this uniformity in treatmentwould in course of time become the tradition of a.

State medical service. Doctors, moreover, wouldbe relieved of the cares of gaining a livelihood, for-obviously the State would have to give them adequate-remuneration and provide suitable pensions for oldage or sickness. In some countries, he added, themedical service is already nationalised, to the complete-satisfaction of both doctors and public.The advantages of nationalisation would be many.

" My idea," said Dr. Sandor, " is that every physician-should have his own district with really well-equippeddispensaries for ambulant patients. Specialists and-consultants could be summoned by the doctor inattendance or, in serious cases, by the patient himself.Night service would be organised in towns and cities."’As things are at present the practitioner spends most-of his time wearing out health, clothes, and boots by-attending patients at opposite ends of a large district.If a postmaster handed a postman a bunch of unsorted,letters to deliver in all parts of a big city he wouldbe thought crazy; everyone finds it natural thata postman should have his designated streets. Why,then, should doctors alone have to fight against alack of system in their work ? Reorganisation wouldnot benefit the doctor only; it would enable his-patients to get him quicker in emergencies. Fewerdoctors would be needed and the present regionaldisproportion could be adjusted. (In different partsof Roumania the number of doctors per 100,000 of-inhabitants varies from 117 to 18.) The unfortunate-economic situation in continental countries at presentoften prevents people incurring the expense of calling-in a doctor till a disease is well advanced. With free-medical treatment it would be otherwise.

It may be objected, said Dr. Sandor in conclusion,-that the removal of personal profit as a motiveand the cessation of competition would make for-poorer work. Yet thousands of medical men spendyears and years in clinics, hospitals, and laboratories,working hard for nominal salaries, and sacrificingtheir lives to science or chanty. A perfect Statesystem does not exclude the possibility of risingaccording to merit. Selection of doctors should beginin the university, and only those should enter theservice who are led to it by a love of the medicalvocation and have the needful moral and physicalcapacity. If doctors were not created haphazardthere would be fewer problems in medical ethics." It is my firm conviction," said Dr. Sandor, " thatwithin a short time the whole of mankind will hold itmost natural that just as every passer-by can availhimself of the pavement and lighting of the street,so also everyone should have an equal right to free-medical attention."