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exceptions, in the States where they are admitted,is the pregnancy of the girl while it also becomespossible to raise the.age minimum. The comparativefigures in European countries and in the Britishdominions for the age of marriage are rather surprising.Great Britain, for instance, and Australia, have thelow minimum age, not subject to exception, of 14years for males and 12 for females ; South Africa has12 for females, part of Poland 7 for both males andfemales. On the other hand, subject to exception,Belgium has 18 and 15 years for males and femalesrespectively, Denmark 21 and 18, Finland 21- and 17,France 18 and 15, and Germany 21 and 16. Withregard to the age of consent, too, there are greatdiscrepancies. In Great Britain and most of theAustralian provinces it is fixed at 16, withoutexception, for both sexes, the figure for France being13, Belgium 16, and Italy 12 ; while among countrieswhich have an age limit subject to special provisos,in the United States of America this varies between10 and 18 in the different States ; in parts of Czecho-slovakia, for both sexes, it is fixed at 14, and in SouthAfrica, for women only, it is 16. The figures are notall strictly comparable, since they are formulated onentirely different bases. In the laws of Easterncountries there is also a marked divergence. In Japan,the marriage age, subject to exception, is 17 for malesand 15 for females, and in China 16 for both sexes notsubject to exception. The age of consent, not subjectto exception, laid down for females only, is 13 in Japanand 12 in China. In Egypt the age neither of marriage(18 for males and 16 for females) nor of consent (14for both sexes) is subject to exception.’

In many countries, however, the minimum age ofmarriage bears little relation to the lowest age at whichmarriage actually takes place. In Great Britain, forinstance, it must be many years since any marriage of agirl at the age of 12 has been recorded. But in someraces, notably in India, a very low age of marriage isstill the custom. The Indian press has recently givenmuch publicityto proposals for alterations in legislationfor the ages of both marriage and consent. The positionin India is complicated, as regards the contraction ofmarriage, by the necessity of providing for so manydifferent communities. The actual age at whichmarriage may lawfully be contracted is, except inChristians, undefined, but marriage cannot lawfullybe consummated in females under the age of 13.Dr. MARGARET BALFOUR and Dr. RUTH YoUNGin a book reviewed on p. 613 note that the principleon which the Hindu custom of early marriage isfounded is that young people of both sexes are likelyto lead chaste lives and form lasting affections for eachother if brought together early. But they state thatthe progress of education as well as legislation istending to discredit early marriage. The age ofconsent in India (14, or 13 if the girl is married)applies only to females. The revival of interestin the subject in India at the present time may be duepartly to Miss MAYO’s book " Mother India " andpartly to the fact that the committee appointed byGovernment to consider the age of consent is expectedto report shortly. The committee has, we understand,recommended the raising of the age of consent, and hasexpressed the opinion that a law penalising marriagesbetween parties below certain ages is essential. Theneedfor registration of marriages, which is not at presentcompulsory, is likely to be emphasised in the report.Meanwhile there are indications that any reasonablestrengthening of the existing regulations would receivepublicsupport. At arecent meeting of the Social HygieneCongress in London, Prof. CREW expressed the opinionthat there is little or no difference between the age ofpuberty in the tropics and temperate climates.This view was not contradicted, although it is not inaccordance with the general teaching of the past.If it proves to be well founded there can be no goodclimatic reason for maintaining such pronounceddifferences in the age of marriage as at present existin different countries, and the trend of legisation islikely to be in the direction of uniformity at the higherage limits.

Annotations.

NOISE.

"Ne quid nimis."

SOME of our newspapers reproduce each day, fromtheir hundred-year-old files, extracts whose trivialitydoes not prevent their being sometimes more instruc-tive than the records of important events. Thus welearn that the Times of Sept. llth, 1829, reportedcomplaints that officers had seized the horses of astage-coach in the City and threatened to take themto the green-yard. The Lord Mayor, whose orderswere in question, explained that it was his wish toprevent the disturbance of divine service, and that noone who went to church could deny that the noise ofthe stage-coaches frequently drowned the voice of theclergyman. Earlier references to the nuisance ofstreet noises in London can be found, and residents ofwhat is now the West End once complained bitterlyof the bellowing and quacking that accompanied themarket methods of the day. It is probable thattraffic in our cities is now quiet in comparison withearlier periods, for the noisy impact of iron upongranite has been replaced by the almost silent contactof rubber and wood, though the spasmodic explosions,rattles, and hootings of to-day may be more disturbingthan the continuous din of bygone times, and thehouseholder living by a busy traffic route must reconcilehimself to sudden onslaughts of rumbling and shaking,which may easily upset his temper and damage hisdwelling.

Noise has lately become the subject of vigorousprotest, and many ills are attributed to it. A directeffect is to be observed in boiler-makers’ deafness, inconcussion deafness, and in the temporary loss ofhearing caused by exposure to the loud noise ofmachinery. The inability to converse with ease in atube train affects alike all people with ordinary powersof hearing, and is accepted as inevitable. A similarinability in proximity to a pneumatic drill is apparentlyaccepted as inevitable by the operator, but calls forthemphatic complaint from victims slightly more remote.Such obvious physical results of noise are not, however,its only offence. Health is said to be affected, and inhis annual report for 1928 Dr. C. W. Hutt, medicalofficer of health for the Borough of Holborn, suggeststhat the use of the pneumatic drill should be pro-hibited on the ground of injury to the health of theworkmen using it. Evidence of such injury would bea valuable contribution to the subject for, apart fromthe cases of deafness noted above, demonstrable effectsof noise upon health are rare. Workers in noisytrades are not known to suffer from illnesses attributedto noise, and records of its influence upon output donot appear to be available. The Duchess of Bedford,in describing her recent night to India and back,noted casually that all communications with the pilothad to be carried on in writing ; yet the effect of noiseupon the health of long-distance aviators is not aproblem of importance, nor did anyone anticipate evilresults to the contestants from the terrific roar of themachines in the recent Schneider Cup race. Theordinary noises of modern life are trivial when com-pared with this vibratory assault upon the humanframe.The real mischief of noise is not, then, any

demonstrable physical effect upon health. It isunfortunately obvious that too many people-somedrivers of commercial vehicles, for example-canendure it with equanimity, so long as they are pro-ducing it themselves ; but to the busy brain-worker,to the sick, the nervous, or the wakeful, noise is aserious infliction to which adaptation may be impos-sible, though it is perhaps an unsafe proposition toadvance that it can of itself induce nervous troubles.A distracted woman, who recently committed suicideafter killing her daughter, left an emotional descriptionof the noises that she declared had so toimented her

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as to lead to the final tragedy. The description wasevidence of a mind that would have grasped at anyobject upon which to project its inner troubles, butthe uncritical publicity given to the case fosteredthe idea that noise can serve as a primary cause ofinsanity or suicide-an idea which, in view of thecontagiousness of emotional states, would be wiselyomitted from anti-noise propaganda. Such argumentsare not needed. It is sufficient that many nervouspeople are peculiarly susceptible to all kinds of stimuli,and they have at least the right to be protected fromthose unnecessary noises that the ordinary man iresents. This resentment may well serve as our i

standard, for our unsophisticated likes and dislikes arereasonable guides to conduct, and did not, for example,await the progress of science to tell us that butter wasa better food than margarine, or fresh air and sun-shine healthier than the smoke of the town. Weneed not wait for scientific proofs of ill-effects frommodern din ; our desire for peace and quiet is thejustifiable foundation of the campaign against noise.

STREPTOCOCCUS IN RHEUMATIC FEVER.

IT is perhaps nothing more than a coincidencethat the production of highly plausible evidenceincriminating the streptococcus in scarlet fever hasbeen followed by a recrudescence of the old theorythat rheumatic fever is caused by an analogousorganism. There is, however, a considerable differencebetween the two cases. In scarlet fever there isfound a streptococcus which produces an exotoxinwhich kills rabbits and behaves like other exotoxins.In rheumatic fever a remarkably neutral organismis held responsible ; and whatever toxin it producesis certainly of small virulence to animals. Threestrains of this organism are discussed in the annualraportl of the Metropolitan Asylums Board. Theseare Small’s Streptococcus cardioarthi-itidis, Birkhaug’sstrain, and that of Lazarus-Barlow isolated in England.Dr. Lazarus-Barlow has described in an earliercommunication how he extracts from these organismsan endotoxin which, when injected into* rabbits, causesa slight rise of temperature and ill-defined lesions.He now relates an attempt to produce antisera tothese three strains, and finds the rise in temperaturediminished (but not prevented) when it is administered.But the antisera were strictly specific, each to its ownstrain. He concludes that the lesions produced inno way resemble those of rheumatic fever, and thoughhe considers there is evidence of some endotoxin,this is no more virulent than that obtained from manystrains held to be saprophytic. Of exotoxin there isno evidence at all. In a companion paper2 Dr. N.Gray Hill is unfeignedly sceptical of any advantagesfollowing the administration of antisera preparedfrom these strains in acute rheumatism. Rheumaticfever, he remarks, is a disease running an uncertainand complex course, not to be compared with that ofscarlet fever. Improvement following injections needscareful analysis and control, and in the 15 caseshe describes he could find no evidence of improve-ment although serum rash was troublesome. Anattempt was made to discover the frequency ofoccurrence of this type of organism in rheumatic andcontrol cases. Fifty throat swabs in each series wereforwarded, unidentified, to Dr. Lazarus-Barlow ; ’,34 per cent. of the rheumatic and 42 per cent. of thecontrol cases showed the organism. During the lastthree years Dr. J. C. Small, of Philadelphia, hasrecorded a remarkable series of cases showing theadvantages of serum treatment with his specificantisera. The smaller series at Carshalton must beweighed in the balance on the other side of the scale.This series seems to show quite clearly that theincriminated organism is as widely spread among

1 Further Investigations into the Ætiology of Acute RheumaticFever. By P. Lazarus-Barlow, M.D., assistant bacteriologist,Queen Mary’s Hospital for Children. Annual report for 1928-29,p. 379.

2 The Relationship of Streptococcus Cardioarthritidis to AcuteRheumatism. By N. Gray Hill, M.C., M.B., B.S., D.P.H.,assistant medical officer at the same hospital, ibid., p. 385.

normal as among abnormal children, that it is of smallanimal virulence, and that evidence of antitoxinformation is scanty. Allowance must be made forvariations in technique, but in the main Small’stechnique was followed by Dr. R. G. White at the-Belmont laboratories of the M.A.B.

THE PREVALENCE OF GALL-STONES.

A STATISTICAL review of cholelithiasis, based on a.scrutiny of the records of 9531 consecutive autopsieson patients of all ages performed in the GeneralInfirmary at Leeds, is given by Dr. D. M. B. Gross,.of the Department of Pathology of the University of:Leeds. The basis of this review is the sounder for-the fact that an autopsy is made on nearly everypatient who dies in the infirmary. Taking the figures,.then, as representing some 10,000 unselected individualsit appears that 6 per cent. of all men and 12 per cent..of all women have gall-stones. The age-incidenceshown in the charts which Dr. Gross has drawn doesnot differ materially from what is commonly assumed,.except for the demonstration that the solitarycholesterol stone is quite rare until the sixth andseventh decades. An entirely new fact, however,emerges from the statistics in regard to latency.In the 800 autopsies in which cholelithiasis was.

present the corresponding clinical notes and historygave no suggestion of their presence in 576 cases;. ;.in other words, cholelithiasis was latent and symptom-less, so far as could be judged from the records, inabout three cases out of four. The widely acceptednotion that pregnancy contributes to cholelithiasisis negatived by this study ; it offers no supportto the view that gall-stones are more frequent inmarried than in single women. The conclusionDr. Gross draws is that " the factors influencinggall-stone formation are common to both sexes,

but more potent in the case of women. In additionto the common factors there is a sexual one, otherthan pregnancy, acting in women alone." The-survey provides confirmation of the current opinionthat faceted stones and pigment concretions are-

associated with cholecystitis, whereas the solitarycholesterol and mulberry stones are not. The asso-ciation between the " strawberry

" gall-bladder and!the ’’

mulberry " calculus is established on statisticalgrounds, apparently for the first time. There appearsto be a definite relationship between diabetes andcholelithiasis, and also between athercma and chole-.lithiasis. But no association between cholelithiasis-as distinct from cliolecystitis-and peptic ulcerationcan be seen in the data here given.

THE DISCOVERY OF TWO DIFFERENT FORMSOF HYDROGEN.

WiTHiN the past two years a discovery of morethan ordinary importance was made in Germany,.and excited great interest in scientific circles. Thediscovery consists in the theoretical prediction,followed by the experimental proof, that in ordinaryhydrogen gas the molecules are of two kinds insteadof being all alike. The new work led to much discusssion at the recent meeting of the American ChemicalSociety at Minneapolis, and thus arose an impressioruin uninstructed circles that it had its origin in theUnited States. The discovery does not in any wayupset present-day views upon the intimate atomicstructure of matter, according to which the ultimateatoms of any element are composed of a positivelycharged nucleus inside a surrounding shell of nega-tive electrons which annul the central charge. Theatom of hydrogen consists of the simplest possiblenucleus carrying a simple unit of positive charge,.together with one neutralising electron outside. Irlthe atoms of elements other than hydrogen the.nucleus itself has a definite structure, being built upof a number of hydrogen nuclei together with a.

lesser number of electrons intimately welded togetherby forces whose nature is not yet understood. The