101 in evidence to impair their usefulness as rail- way servants and to reject them. I can recall no instance in which a man rejected for a nervous stammer was also found to be red- green blind. During the past three years I have carefully watched for such a combination. There is a complete record of all cases examined in this office. In one case only was a man rejected for defective colour sense who also had a nervous stammer. He was normal by Holmgren’s wools, but he named pale green white in the lantern. Un- fortunately at that time I had no knowledge of the value of either Stilling’s or Nagel’s test and there- fore cannot state the real value of his colour defect. From this evidence it is at least probable that a nervous stammer is much rarer in colour-blind persons than in colour-normal persons. I am, Sir, yours faithfully, GEORGE HENRY TAYLOR, Railway Medical Officer. Medical Officer’s Office, New South Wales Government Railways and Tramways, Sydney, Nov. 11th, 1914. THE ABUSE OF TEA. To the Editor of THE LANCET. e SIR,-While conducting investigations into the dietary of the labouring classes I have been most forcibly impressed by the injurious effects of excessive tea-drinking amongst them. Tea is the invariable accompaniment of every meal, and as though this were not sufficient it is frequently drunk between meals. The effects of this over- indulgence, though noticeable on all sides, are particularly pronounced in the case of nursing and expectant mothers. the general disturbance of nutrition, in addition to local digestive troubles, being accentuated in them. I feel sure that the abuse of tea is one of the most potent causes of the inability of the women to suckle their babies, and is thus an indirect cause of a high infantile mortality. In Birmingham during the hot weather 30 times more bottle-fed babies die than those breast-fed, and among the survivors the bottle-fed are at a great disadvantage as compared with the naturally fed babies. In my work at Birmingham I have therefore sought to find a substitute for tea. It is of no use to counsel moderation and advance the virtue of plain water; the poor refuse to consider such a change. Cocoa, however, has proved in practice an acceptable alternative to them, and I am satisfied as to the good results which accrue to the mother and the children when cocoa is substituted for tea as the family beverage. It seems to me that the present is a favourable time for urging a general reform in this direction- first, because the price of tea has increased beyond that of cocoa; and secondly, because the people are now more open to receive and follow advice with regard to their food. I should be much obliged if you could give publicity to this matter, which, though it may appear trivial, is, I am convinced, of national importance. I am, Sir, yours faithfully, Birmingham, Dec. 29th, 1914. A. E. CARVER, M.D. A. E. CARVER, M.D. TENDIMUS HUC OMNES. To the Editor of THE LANCET. SIR,-We are all aware that " to every man upon this earth death cometh soon or late," but the usual impression is that the man whose profession is fighting runs a greater risk than the civilian, and when he enters on a campaign, that his chances of escaping from " this muddy vesture of decay" are appreciably increased. An American statistician has, however, stated that " ominous as are the soldier’s dangers in war, they are really but little greater than are the civilian’s dangers of dying before he has time to set aside the necessary nest egg for his dependents." By comparing the statistics of the four considerable wars of the last 50 years-namely, the American Civil War, the Franco-German War, the South African War, and the Russo-Japanese War of 1904-05-he finds that the average mortality from all causes, including the killed in battle and the deaths from wounds and disease, amounted to 90’1 per 1000 per annum ; in the Civil War it was yet higher; in the South African War it was only 40’2. The deaths from disease were practically double those from wounds in the Civil War (66 compared with 32’5) and in the South African War (26 compared with 14’3) ; the proportions were reversed in the Franco-German War (28’8 and 67’7) and in the Japanese War (25’1 and 54’2). Mr. E. B. Phelps, editor of the American Underwriter, of New York, whose figures I am quoting, calculates that if the present war continues for a full year, the number of men engaged amounting to five, or possibly six, millions, it will cost more lives than all causes will demand among the entire adult male population of the United States. But he then says that, as amatter of experience, the chances of even the youngest man of marriageable age living long enough to set aside the most modest competence for his family when he is gone are not much better than are the soldier’s chances in time of war ; instancing, as an example, that whereas out of 92,637 young men, aged 20, engaged in war 84,290 might be expected to be alive at the end of a year’s fighting ; out of the same number of men of that age engaged in ordinary occupations not more than 84,000 would survive to 32 years of age. By a similar comparison he finds that the fighting soldier’s chance is better than that of a civilian of 30 surviving to 41, of 40 surviving to 49, or of 50 to 56. These figures are rather startling, and would ’ indicate that the soldier’s dangers in war are really but little greater (and in some cases actually less) than are the civilian’s chances of dying before he has time to set aside the necessary provision for those dependent on him. The bearing of this observation lies in the application of it, which is, of course, that everyone should insure his life, and that the earlier he begins the better bargain he will make. I am, Sir, yours faithfully, Jan. 4th, 1915. A. M. D. Medical News. UNIVERSITY OF LONDON.-At the First Exami- nation for Medical Degrees held recently the following candidates were successful :- Gerald Victor Wright Anderson, University of Bristol and University College (distinction in physics); Maurice Aronsohn, London Hos- pital ; Terence John Doyle Atteridge, St. Bartholomew’s Hospital; Julia Bell, London (Royal Free Hospital) School of Medicine for Women ; Thomas George Doughty Bonar, Hymers College, Hull; Jean Auguste Andre Bouic, Guy’s Hospital; Sarah Aileen Florence Boyd-Mackay, London (Royal Free Hospital) School of Medicine for Women; Norman Carwardine Cooper, Univer- sity of Bristol; Ursula Beatrice Cox, London (Royal Free Hospital) School of Medicine for Women; Carl Knight Cullen, London Hospital; Jose Joaquim da Gama Machado, St. Bartholomew’s Hospital; Edith Margery Pearce Davies, London (Royal Free Hospital) School of Medicine for Women; Thomas Davies, B.Sc., University College, Aberystwyth, and private study ; John Joseph Philip de Chaumont, King’s College; Jacob Franks, London Hospital; Dorothy Margaret Greig, The Grove School, Highgate, and Northern Polytechnic Institute ; Magdalena Augusta Hilda Hamel, London (Royal Free Hospital) School of Medicine for Women; Christopher Langton Hewer, University CollegeSchool and St. Bartholomew’s Hospital; Arthur
Transcript
101
in evidence to impair their usefulness as rail-
way servants and to reject them. I can recallno instance in which a man rejected for a
nervous stammer was also found to be red-
green blind. During the past three years Ihave carefully watched for such a combination.There is a complete record of all cases examined inthis office. In one case only was a man rejected fordefective colour sense who also had a nervous
stammer. He was normal by Holmgren’s wools, buthe named pale green white in the lantern. Un-
fortunately at that time I had no knowledge of thevalue of either Stilling’s or Nagel’s test and there-fore cannot state the real value of his colour defect.From this evidence it is at least probable that anervous stammer is much rarer in colour-blind
persons than in colour-normal persons.I am, Sir, yours faithfully,
GEORGE HENRY TAYLOR,Railway Medical Officer.
Medical Officer’s Office, New South Wales GovernmentRailways and Tramways, Sydney, Nov. 11th, 1914.
THE ABUSE OF TEA.To the Editor of THE LANCET.
e SIR,-While conducting investigations into thedietary of the labouring classes I have been mostforcibly impressed by the injurious effects ofexcessive tea-drinking amongst them. Tea is theinvariable accompaniment of every meal, and asthough this were not sufficient it is frequentlydrunk between meals. The effects of this over-
indulgence, though noticeable on all sides, are
particularly pronounced in the case of nursing andexpectant mothers. the general disturbance ofnutrition, in addition to local digestive troubles,being accentuated in them. I feel sure that theabuse of tea is one of the most potent causes ofthe inability of the women to suckle their babies,and is thus an indirect cause of a high infantilemortality. In Birmingham during the hot weather30 times more bottle-fed babies die than thosebreast-fed, and among the survivors the bottle-fedare at a great disadvantage as compared with thenaturally fed babies. In my work at BirminghamI have therefore sought to find a substitute fortea. It is of no use to counsel moderation andadvance the virtue of plain water; the poor refuseto consider such a change. Cocoa, however, hasproved in practice an acceptable alternative to
them, and I am satisfied as to the good resultswhich accrue to the mother and the children whencocoa is substituted for tea as the family beverage.It seems to me that the present is a favourabletime for urging a general reform in this direction-first, because the price of tea has increased beyondthat of cocoa; and secondly, because the people arenow more open to receive and follow advice withregard to their food. I should be much obliged if youcould give publicity to this matter, which, thoughit may appear trivial, is, I am convinced, of nationalimportance. I am, Sir, yours faithfully,Birmingham, Dec. 29th, 1914. A. E. CARVER, M.D.A. E. CARVER, M.D.
TENDIMUS HUC OMNES.
To the Editor of THE LANCET.
SIR,-We are all aware that " to every man uponthis earth death cometh soon or late," but theusual impression is that the man whose professionis fighting runs a greater risk than the civilian,and when he enters on a campaign, that hischances of escaping from " this muddy vesture ofdecay" are appreciably increased. An American
statistician has, however, stated that " ominous asare the soldier’s dangers in war, they are really butlittle greater than are the civilian’s dangers ofdying before he has time to set aside the necessarynest egg for his dependents." By comparing thestatistics of the four considerable wars of the last50 years-namely, the American Civil War, theFranco-German War, the South African War, andthe Russo-Japanese War of 1904-05-he finds thatthe average mortality from all causes, includingthe killed in battle and the deaths from woundsand disease, amounted to 90’1 per 1000 perannum ; in the Civil War it was yet higher;in the South African War it was only 40’2.The deaths from disease were practically doublethose from wounds in the Civil War (66 comparedwith 32’5) and in the South African War (26 comparedwith 14’3) ; the proportions were reversed in theFranco-German War (28’8 and 67’7) and in theJapanese War (25’1 and 54’2). Mr. E. B. Phelps,editor of the American Underwriter, of New York,whose figures I am quoting, calculates that if thepresent war continues for a full year, the number ofmen engaged amounting to five, or possibly six,millions, it will cost more lives than all causes willdemand among the entire adult male population ofthe United States. But he then says that, as amatter ofexperience, the chances of even the youngest man ofmarriageable age living long enough to set aside themost modest competence for his family when he isgone are not much better than are the soldier’schances in time of war ; instancing, as an example,that whereas out of 92,637 young men, aged 20,engaged in war 84,290 might be expected tobe alive at the end of a year’s fighting ;out of the same number of men of that ageengaged in ordinary occupations not more than84,000 would survive to 32 years of age. Bya similar comparison he finds that the fightingsoldier’s chance is better than that of a civilian of30 surviving to 41, of 40 surviving to 49, or of50 to 56. These figures are rather startling, and would ’indicate that the soldier’s dangers in war are reallybut little greater (and in some cases actually less)than are the civilian’s chances of dying before hehas time to set aside the necessary provision forthose dependent on him. The bearing of thisobservation lies in the application of it, which is,of course, that everyone should insure his life, andthat the earlier he begins the better bargain hewill make. I am, Sir, yours faithfully,Jan. 4th, 1915. A. M. D.
Medical News.UNIVERSITY OF LONDON.-At the First Exami-
nation for Medical Degrees held recently the followingcandidates were successful :-
Gerald Victor Wright Anderson, University of Bristol and UniversityCollege (distinction in physics); Maurice Aronsohn, London Hos-pital ; Terence John Doyle Atteridge, St. Bartholomew’s Hospital;Julia Bell, London (Royal Free Hospital) School of Medicine forWomen ; Thomas George Doughty Bonar, Hymers College, Hull;Jean Auguste Andre Bouic, Guy’s Hospital; Sarah AileenFlorence Boyd-Mackay, London (Royal Free Hospital) Schoolof Medicine for Women; Norman Carwardine Cooper, Univer-sity of Bristol; Ursula Beatrice Cox, London (Royal FreeHospital) School of Medicine for Women; Carl Knight Cullen,London Hospital; Jose Joaquim da Gama Machado, St.Bartholomew’s Hospital; Edith Margery Pearce Davies,London (Royal Free Hospital) School of Medicine for Women;Thomas Davies, B.Sc., University College, Aberystwyth, andprivate study ; John Joseph Philip de Chaumont, King’s College;Jacob Franks, London Hospital; Dorothy Margaret Greig, TheGrove School, Highgate, and Northern Polytechnic Institute ;Magdalena Augusta Hilda Hamel, London (Royal Free Hospital)School of Medicine for Women; Christopher Langton Hewer,University CollegeSchool and St. Bartholomew’s Hospital; Arthur
102
St. Geo. Joseph M. Huggett, S.W. Polytechnic Institute and St.Thomas’s Hospital; Herbert Vivian Jackson, University of Bristol;Jerusha Jacob Jhirad, Grant Medical College, Bombay, and privatestudy; David Lavington Glyde Joseph, Charterhonse and Guy’s Hos-pital ; John Wilfred Joule, St. Paul’s School; Ernest Francis Kerby,Guy’s Hospital; Maurice Edmund King, University College; MauriceLaurent, University Tutorial College (distinction in inorganicchemistry); Tercsa Jadwiga Lesser, London (Royal Free Hospital)School of Medicine for Women ; Glyndwr Morison Lewis, UniversityCollege ; Douglas McClean, Berkhamsted School and St. Thomas’sHospital; Murdo Mackenzie, Guy’s Hospital; Arthur GeorgeAbraham Miller, B.Sc., Middlesex Hospital; John Clifford RowlandMorgan, University College, Cardiff, and private study; RobertGordon Morrison, Epsom College and St. Thomas’s Hospital;William Drew Nicol, St. Bartholomew’s Hospital; Robert HughesParry, Middlesex Hospital; Percival George Quinton, UniversityCollege ; Arthur Hywel Richards, Epsom College; Esther Rickards,Birkbeck College; Jessie Craig Ritchie, London (Royal Free Hos-pital) School of Medicine for Women; Frank Paul Schofield,St. Bartholomew’s Hospital and private study (distinction inphysics); Marguerite Garnett Sheldon, University of Liverpooland private tuition ; Satyavan Singh, University College ; VictorAlexander Trevor Spong, Dulwich College and St. Bartholomew’sHospital; Horace Rees John Thomas and John Phillip Traylen,London Hospital; and Reginald Frank White, University ofBristol.
N.B.-This list, published for the convenience of candidates, isissued subject to its approval by the Senate.
ROYAL MEDICAL BENEVOLENT FUND.-At thelast meeting of the committee 29 cases were considered andgrants amounting to Z237 were voted to 25 of the applicants.The following is a summary of the cases relieved :-Widow, aged 74, of M.R.C.S. Eng. who practised at Braintree.
Husband died 23 years ago and lelt her without means. She hasmanaged to support herself, but unable to save, until incapacitated byold age. Lives with married son, who has three children and only asmall salary. Voted j2H and referred to the Guild.-M.R.C.S. Eng. andL.R.C.P. Lond., aged 48, who practised in Lancashire. Has become ’,blind. Married; two children. Wife and children live with relatives.Wants a little help to obtain some training in massage. VotedB10 and referred to the Guild.-Widow, aged 56, of L.S.A. Lond.who practised at Bournemouth. At her husband’s death in 1913was left without any income and unable to obtain suitable employ-ment. Only income 10s. per week from the Society of Apothe-caries. Voted £12 in six instalments and referred to the Guild.-Daughter, aged 45, of M.D. Edin. who practised at Southampton.Trained as a midwife, but recently had to undergo a serious operationand has been ten weeks in bed. Voted f:1O in two instalments andreferred to the Guild.-Daughter, aged 40, of M.D. St. And. who prac-tised at Swinton, Lanes. Was a teacher, but underwent a severe opera-tion in September, 1913, and has not been able to work since. Motherhas only a small annuity and has to keep an invalid son. Voted f:18 in12 instalments.—Daughter, aged 68, of M.R.C.S. Eng. who practised inLondon. Has been a teacher for 40 years in England, Russia, andGermany. On account of the war had to return from Moscow fourmonths ago, where she had been in one post for seven years All hersavings were in the Deutsche Bank, Berlin, and could not obtain any.Voted :E12 in 12 instalments and referred to Guild.-Widow, aged 66,of M.R.C.S.Eng. who practised at Heywood, Lanes. Has endeavouredto earn a living by acting as housekeeper and cook, but owing to age andthe war finds it impossible at present to obtain a suitable post. VoteiE2 and referred to the Guild.-Daughter, aged 74, of M.R.C.S. Eng.who practised in London. Up to quite recently has acted as a churchvisitor at B35 per annum, but owing to age has had to give it up. Has asmall pension from the Mercers’Company. Voted £ 12 in 12 instalments.- Daughter, aged 47, of M.D. St. And. who is too old to practise and toopoor to help. Earned her living as a teacher until three months ago,when owing to internal trouble had to enter a nursing home, and nowall her savings are gone. Voted B5 and arrangements to be made tohave the applicant operated upon.-Widow, aged 40, of M.R.C.S. Eng.and L.R.C.P. Lond. who practised at Norwood. Husband died quitesuddenly from typhoid, leaving the applicant and three young childrenin straitened circumstances. Voted £5.—Daughter, aged 50, ofM.R.C.S. Eng. who practised at St. Clears. Has double curvatureof the spine. Lives with mother, who is a pensioner of theFund, and two delicate brothers who cannot afford to keepher. Relieved once B6. Voted B6 in 12 instalments.-Widow,aged 41, of M.R.C.S. Eng. who practised in N. Wales. Has twoyoung children. Endeavours to earn a living by selling clotheson commission, but owing to the war the sales have greatlydiminished. Relieved three times, £30. Voted :EI0 in two instal-ments.-Widow, aged 60, of L.R.C.P. & S. Edin. who practisedin London. Present distress caused by death of only son whosupported her. Earns a little by needlework. One daughterallows her 5s. per week, otherwise no other support. Relievedtwice, 220. Voted B10 in two instalments.-Daughter, aged 56,of L.R.C.P. Lond. who practised at Hammersmith. Unable towork through ill-health. Only income a little from the Guild andoccasional gifts of food and clothing. Relieved seven times, B86.Voted BIS in 12 instalments.-Widow, aged 69, of M.R.C.S. Eng. whopractised in Ireland and America. auSers from muscular rheu-matism. One son who has not been heard of for a long time.No income and unable to work. Relieved five times, 260. Votedf:12 in 12 instalments.-Daughter, aged 68, of M.D. Edin. whopractised at Cheltenham. Eyesight very bad, and ill-health pre-vents her doing any work. Only income BIS 10s. per annum, and alittle from friends. Relieved once, B12. Voted B12 in 12 instalments.- Widow, aged 68, of M.R.C.S. Eng. who practised at Yelverton. Takespaying guests, but owing to the bad season is in difficulties. Relievedfive times, B52. Voted B12 in 12 instalments.-Daughter, aged 58. ofL.R.C.P. Lond. and L.S.A. Lond. who practised at Brierley Hill.Health very bad and unable to do any permanent work. Income aR.U.K.B.Assoc. pension of B21 per annum and from friends 10s. permonth. Relieved seven times, £41. Voted £12 in 12 instalments.-Daughter, aged 52, of M.R.C.S Eng. who practised in London. Hashad several internal operations and obliged to mortgage her smallcapital to pay for same. Lives with married sister, who gives her a
home but unable to keep her. Relieved five times, £54. Voted £ 10 intwo instalments.-Daughter, aged 63 years, of M.R.C.S. Eng. whopractised at Northampton. Health very indifferent. Has a smallannuity, but not sufficient to live on. Relieved once, 25. Voted £5.—Daughter, aged 47, of M.R.C.S. Eng. who practised in India. Isbedridden and quite helpless. Only income an annuity fromthe British Home for Incurables. Relieved three times,£36. VotedB12 in 12 instalments.—Widow, aged 43, of M.D. Irel. who prac-tised at Newcastle-on-Tyne. Health indifferent, but endeavoursto make a little by taking lodgers. Allowed .E25 per annum foreducation of only child. Relieved four times, .E30. Voted £5.—Daughter, aged 48. of M.R.C.S. Eng. who practised at Gillingham.Has very indifferent health and unable to find suitable employment.Recently has been selling papers in the streets at a remuneration onlysufficient to pay the rent of a room. Relieved once, :E5. Voted £12 in12 instalments and referred to the Guild.-Widow, aged 56, ofL.S.A.Lond. who practised at Limehouse. Endeavours to make aliving by letting rooms, but not very successfully. Two daughters,who are in service, can only allow her 5s. per month. Health bad.Relieved nine times, £46. Voted :E12 in 12 instalments.-Daughter,aged 66, of M.R.C.S. Eng. who practised at Great Torrington. Has,acted as housekeeper and general help, but at present out of employ-ment, as her age is against her. Relieved once, 212. Voted £1 andreferred to the Guild for report.In addition to the above the committee appointed from thegrantees six annuitants at R20 each. This brings the totalof annuitants up to 142. Contributions may be sent to the
honorary treasurer, Dr. S. West, 11, Chandos-street, Cavendish-square, London, W.
ROYAL COLLEGE OF SURGEONS IN IRELAND.-Ata meeting of the College held last week Professor EdwardH. Taylor was unanimously elected to the place on thecouncil vacant by the death of Mr. F. T. P. Newell.
ANTHRAX AND ITS NOTIFICATION.-An adjournedinquiry was concluded on Jan. 4th by Dr. F. J. Waldo, atthe Southwark coroner’s court, into the death of a butcher’s.manager named Tarrant, aged 46, who died in Guy’s Hos-pital from anthrax. It was stated that Tarrant’s employerpurchased his meat from a firm whose head slaughtermandied from anthrax at Croydon, and about the same timethe deceased complained of a pustule on his neckwhich was diagnosed as anthrax. A clerk of thesame wholesale firm and a son of Tarrant’s employer,were also suffering from the same disease, but were
recovering, and another man had since contracted thedisease and a horse had died from it. Dr. T. M. Legge,H.M. Inspector of Factories and Workshops, in the course ofhis evidence, stated that anthrax was a notifiable diseasewhen occurring in a factory, but a butcher’s premises werenot technically a factory. He had never heard of anthraxbeing communicated by frozen rabbits. The coroner read aletter from the High Commissioner for New Zealand inform-ing him that there had not been a case of anthrax in thatcountry for years, and that frozen rabbits had never
been known to carry the infection. Dr. Legge furtherstated that in some districts registrars of deaths reporteddeaths from anthrax to the chief factory inspector,which was very useful, and in his opinion the diseaseshould be compulsorily notifiable to coroners in fatalcases. Evidence on behalf of the wholesale firm showedthat great care was taken in the purchase of cattle, and thatsince the present cases their premises had been thoroughlydisinfected. Dr. R. V. Clarke, medical officer of health ofCroydon, said that every possible assistance had been givenhim by this firm, who had supplied a complete list of allanimals they had dealt with and their sources. He agreedthat it would be very useful if all deaths from anthrax werereported to the coroner. He had never seen anthrax infrozen meat. The city coroner, in the course of his
summing-up, said that he had always advocated the additionof anthrax to the list of infectious diseases compulsorilynotifiable to the medical officer of health. The Guy’sHospital authorities always notified fatal cases of anthrax tohim. It seemed strange that whereas all cases of anthraxin the human subject were not compulsorily notifiable, allcases in the lower animals were compulsorily notifiable underthe stringent regulations of the Contagious Diseases (Animals)Act. The jury returned a verdict of " Death from anthrax,"but added that there was not sufficient evidence to show howit was contracted, the verdict amounting thus to one of’’ Death from misadventure." In a rider they suggested thatall doctors attending such cases should be compelled to notifyto the medical officer of health, and that all deaths should becompulsorily reported to the coroner. This recommendationwill be forwarded by the coroner to the Local GovernmentBoard and other authorities.
