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important manufacturing concern now identified withfine chemicals, and especially with quinine. Duringthose nine years many small-scale experimentalprocesses were tried at Plough-court, and incidentallyit was realised, with the assistance of two outbreaksof fire, that the heart of the city was not the idealplace for the production of chemicals. John ThomasBarry, who was admitted a partner in 1818, had ahighly individual method of dealing with suchtroubles. Finding, one Sunday morning, that smokewas issuing from a cupboard, he pasted strips of paperover the crevices and sat down to read his Bible,correctly estimating, as it turned out, that the supplyof air would soon be exhausted. Barry is chieflyremembered by his invention of evaporation invacuo, the details of which were given in a paperpresented to the Medical and Chirurgical Society in1819. William Allen, Barry’s senior partner, becameby degrees a figure of European fame. A friend of theDuke of Kent, Queen Victoria’s father, he took aleading part in religious and humanitarian projectswhich had the Duke among their patrons, andtravelled extensively to promote their success. Thevolume in which the story is told is admirably printedand illustrated, although it is odd that none of thecompilers (of whom there have been three) has seenfit to correct " the Linnaean Society " and " SirHumphrey Davy." But the difficult transition fromthe record of past achievement to the description ofpresent methods of manufacture has been accom-plished with discretion.

THE INVESTIGATION OF OTOSCLEROSIS.

AT a recent meeting of the Section of Otology of the Royal Society of Medicine the President, Mr.J. S. Fraser, delivered an interesting address uponotosclerosis, in the course of which he made a

proposal for a national investigation of the condition,saying that, while the problems appeared to concernotology alone, for their satisfactory evaluation thecooperation of other branches of the medical profes-sion was required. " Some medical men failed," hesaid, " to diagnose the disease when confronted with it.When he began the study of otology in 1904 he spentmany useless hours in the hospital in testing patientswho were supposed to be suffering from chronicotitis media, and who showed no improvement aftermiddle-ear inflation. It had since dawned on him thatotosclerosis was not an uncommon disease, and hefound that 10 per cent. of his patients suffered from it.If the victims of it had been exclusively old, or pastmiddle life, it would not be so serious, but most ofthe cases were in young people. Females were mostaffected, in the proportion of three females to onemale. At least 50 per cent. of the subjects of it gavea history of deafness in the family. Microscopicalexamination carried out in early stages showed areasof spongy bone in the labyrinthine capsule and at theanterior margin of the oval window. Some of thecases had also fragility of bones and blue sclerotics.Dr. Albert Gray’s estimate was that 1 in every200 people suffered from otosclerosis. In its produc-tion the main fault seemed to lie in some abnormalityof endocrine glands, but inquiry had yet to go a longway before any association could be establishedbetween this disease and malformation or inadequacyof ductless glands." Mr. Fraser went on to pointout that careful researches on the subject were nowproceeding in America, but he deprecated waitingfor the American results, believing that cooperationwas better than competition, and that an internationalinquiry would be the most potent means of arrivingat the truth. The Otological Section thoroughlyendorsed the proposal which his words led up to-namely, that a central committee should be formedby the Section to coordinate and organise research ofa wide character, the suggestion being to enlistthe help of the large hospitals and teachingschools of the United Kingdom. The proposalwas supported by Mr. Sydney Scott, Dr. KerrLove, Sir William Milligan, Sir James Dundas-Grant,

Mr. G. J. Jenkins, Mr. Herbert Tilley, Mr.J. F. O’Malley, and Dr. Dan McEenzie amongothers, and the council of the Section was empoweredto act in accordance with it.

HEALTH EDUCATION OF THE PUBLIC.Sir Arthur Keith, in an admirable after-dinner

speech which we report elsewhere (p. 1149), remarkedon the real difficulty of getting through to the publicwith scientific medicine. Year by year young menand women, equipped with the spirit and knowledgeof their craft, go out into the world to succumb tothe craving for magic which lies deep in humannature. The British Association, of which he isthis year President, has for its central aim to sharethe knowledge of trained observers with the publicat large. Another agency for the same purpose isthe League of Red Cross Societies, which publishesa monthly review in three languages, of which theEnglish edition is called The World’s Health. Thecontents of this review are not copyrighted, repro-duction of the articles being welcomed, provided thatdue acknowledgment of their source is made. Aspecial number for October deals with certain problemsof health education. Dissemination of knowledge,as Sir George Newman lays down in a foreword, isuseless unless it is in a form readily understandableby those to whom it is addressed. The channelsalong which knowledge should be made to flow arefive in number: (1) sanitary environment; (2) healthyrace ; (3) resistant body ; (4) methods of reducingmass infection; (5) early diagnosis and treatment ofdisease—and. tne neld lor public education in tnesematters is boundless in extent and full of opportunity.Dr. Rene Sand, who advises the League on popularhealth education, remarks that up to quite recenttimes it was possible for a man to assume highresponsibilities in mercantile life without having theslightest notion of the importance of hygiene inindustry ; and for citizens to found families whilebeing quite ignorant of domestic or sex hygiene. Hedeprecates the use of technical arguments in mattersof diet, and advocates simple advice along the linesof what might be called intelligent omnivorousness.The place par excellence for health education of thiskind is in the schools. It is a side of the work whichthe school medical service, as at present constituted,cannot adequately tackle, and there is urgent needto improve the standard of health knowledge amongthe teaching staffs in all the schools of the country,and, having done it, to send them out with a realdesire to teach what they know. Twenty minutes aweek devoted to the simple things of health in everyschool would within ten years do away with the needfor most of the posters and pamphlets which Dr.Sand deals with so well. Any practitioner havingto deal with young persons in industry will realisethat one of the most hopeful ways of attempting tobridge the " gap " from 14-16 years of age in themedical benefit is so to educate children at schoolin the care of their health that they will be able inno small measure to bridge the " gap " for themselvesby the simple method of avoiding sickness. Common-sense rules, devoid of fussiness or of the technicalitieswhich Dr. Sand condemns, will, if inculcated at schoolduring the plastic age, last as an abiding asset throughlife. There are many excellent black-and-whitereproductions of various health propaganda postersin this number of The Fo7’M’s Health, together witha coloured inset of posters from different industriesin all parts of the world. These are chiefly attemptsto educate workmen in accident prevention. Theart of producing attractive posters is comparativelynew, and the specimens here given are good of theirkind ; but it is necessary to be aware of certaindrawbacks to their use. Employers may spendmuch money on these things and forget the less

spectacular but more important side of health

education-namely, the written and, to a still greaterdegree, the spoken word. There is one curiousomission from this health educational number-at

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a rough computation 20 per cent. of the loss toindustry in sickness is due each year to the commoncold, which many believe to be largely preventableby more careful attention to ventilation and properworking temperature. _

AVERTIN.

SOMEWHAT conflicting reports come from Germanyregarding the recently introduced narcotic, avertin 1(E 107, tribromethylalcohol). Some surgeons find thatthe anaesthesia it produces is as efficient as any thatthey know, besides being more pleasant, whilst othersdeclare that the dangers of avertin put it out of courtas a means of anaesthesia in practice. Experience isnot yet very wide-some 3000 cases form the largestseries yet reported-but it is probable that a definitegenerally held opinion will eventually be forthcomingas to the advisability of adding avertin to the com-monly used anaesthetics. British anaesthetists wouldnaturally like to play a part in the formation of thisopinion by investigations of their own, and we are gladto know that through the zeal of Dr. Fritz Eichholzand the good offices of Dr. H. H. Dale, a certainamount of avertin is likely to be available in the nearfuture for a limited number of clinical trials in thiscountry. It is obvious enough from what has alreadybeen done that the solution of avertin requires of theanaesthetist special care in its preparation and testingshortly before use, and that the risks associated withall forms of rectal anaesthesia are certainly no less,even if they are no greater, with avertin than they arewith ether.

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WATER DIVINING.

Prof. J. W. Gregory, the well-known geologist, ina paper read on Nov. 17th at the Public Works, Roads,and Transport Congress, gave an historical account ofthe alleged art of water divining with descriptions andsummaries of critical tests to which the method hasbeen subjected. The use of the divining rod goes backto ancient times, and even to-day public bodies employ Idiviners to recommend sites for well-sinking. Somesupporters claim that the rod responds to externalphysical influence, and the diviner himself usuallydenies exerting any muscular force when the rod isstrongly moved. That such a widespread and powerfulinfluence should exist and be incapable of otherexperimental demonstration is difficult to reconcilewith scientific knowledge, and all the movements ofthe rod can be produced by anyone who cares to learnhow to hold it. An alternative view admits the partplayed by muscular action, but retains a claim for the emysterious by postulating a kind of second sight, bywhich the diviner senses the presence of any objectfor which he is searching, such as oil, metals, buriedtreasure, letters in an envelope, future events,underground water, or some special person. Thisfrankly places the divining rod in the same categoryas planchette and other spiritualist mechanisms. Athird explanation brings such mechanisms intorelation with other phenomena that have alreadybeen investigated by medical psychologists. Thetheory of dissociation of consciousness, which conformsto the scientific canons in so far as it usefully sum-marises many happenings and does not clash withanything in the general body of human knowledge, I;allows us to regard the water diviner as possessedof information and- powers of deduction which heunwittingly applies in producing movements of therod, just as the hysteric will, under the influence ofmotives not fully conscious, produce muscular move-ments or paralyses which he declares to be independentof volition. Whilst it does not involve the accusationof conscious fraud, this explanation denies to thediviner any knowledge that he could not attain bythe exercise of his ordinary senses. Prof. Gregorydescribes many tests in which such knowledge failedto manifest itself. It is freely admitted that water isoften found by sinking where the rod has given

1 THE LANCET, 1927, i., 718, 1037, and 1266.

indications of its presence, but for obvious reasonsnegative findings are rarely tested, and he givesexamples where only the hits were counted. Thediviner is often ludicrously astray when he is testedover areas where the distribution of water is accuratelyknown. Diviners who claimed to detect undergroundoil were tested at the research station of the Anglo-Persian Oil Company and their results accorded withrather unlucky guesswork. Prof. Gregory fears thatit may seem disrespectful to those who believe in thedivining rod to compare it with such an obsoletehabit as witch-hunting, but he remarks that thehuman mind in all people and amongst all ages hasmany features in common and is greatly influenced bycoincidences and unexplained phenomena. If waterdivining really has such close affinities with witchcraftand fetish as he believes the widespread trust in themethod is rather disconcerting in a scientific age.

PROF. PIRQUET’S VISIT.THE visit to London of Clemens Freiherr von Pirquet

has given the medical profession an opportunity ofattaching more personal characteristics to the eponymof a tuberculin reaction and the originator of a world-wide system of dieting children. There are some,apparently, who are unaware of an intervening periodin Dr. Pirquet’s career, when he occupied the chairof pediatrics at Johns Hopkins University and infusedan element of freshness into child study in America.Dr. Pirquet (as he prefers to be called) has recentlybeen elected president of the " Save the Children "International Union at Geneva, and in this capacityhe addressed, while in London, a large gathering ofsupporters of this Fund. He gracefully acknowledgedthe help given by this country to the children ofVienna during the famine years, and attributeddirectly to this foreign help the fact that Viennaitself is now doing more for its children than everbefore. Timely help in the crisis of their infancy hasbrought the children back to an almost normal stateof health. Rickets, then extraordinarily prevalentin Austria, seems likely to disappear there entirelywithin the next few years, and Dr. Pirquet is optimistenough to believe that the same may be true oftuberculosis in a quarter of a century. Summerdiarrhoea among children, he said, was also dis-appearing in many countries; only in France isthe disease still rife, not because the French holdchild-life in any less esteem than we do, but becauseof the prevailing custom to send the children intothe country during the summer, where they drinkunsupervised milk. He put in a plea for regardingthe common cold as highly infectious to infants,many of whom, he thought, died from pneumoniaarising from a simple cold in the head. His finalremark, that possibly not more than 2 per cent. ofinfantile deaths are unpreventable, was coupledwith the practical suggestion to concentrate on districtswhere a specially high mortality is recorded.

TREATMENT OF HICCUP WITH CARBONDIOXIDE.

IN a recent paper 1 Dr. R. F. Sheldon discusses thetreatment of hiccup by the inhalation of carbondioxide. Hiccup is a spasmodic contraction of thediaphragm, and its cause is probably abnormalstimulation of the respiratory centre, either directlyor through afferent fibres in the phrenic nerve. Thestimulus to the centre which produces normalbreathing is an increase in the tension of carbondioxide in the blood, and 5 per cent. of CO2 in theinspired air is more effective than anything else forincreasing the depth and strength of respiration. Withthis maximal stimulus it is reasonable to suppose thatabnormal or lesser stimuli causing hiccup will beineffective, and that respiration will be uninterrupted.In administering CO2 for this purpose Dr. Sheldonused the Henderson-Coburn machine in hospital and

1 Jour. Amer. Med. Assoc., Oct. 1st, p. 1118.