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Notes, Short Comments, and Answersto Correspondents.THE STATE AND CHILD LIFE.

"THE securing of a fair chance for our boys and girls touches thefuture life of the State. Compassion has suggested an increasingprovision by the public for the needs of the old, but after all the oldbelongs to the past; the future rests with the young; and it is

unquestionably in our power, as a feature in the system of ourcivilisation, so to deal with our young people that the miseries whichare so marked a feature of our modern life shall be greatly abated."So said Mr. Winston Churchill at Brighton on April 2nd, where theHome Secretary had an opportunity of seeing the practical work ofthe Brighton Police-aided Scheme for Clothing Destitute Children, anexcellent undertaking of which we have made previous mention atdifferent times. During the winter months Lhe police frequentlyobserve children insufficiently,clothed in the streets, and exposedto consequent danger and suffering. The constable takes the namesand addresses of these children and reports the matter to the

superintendent of his division. The homes of the childrenare then visited by the police, and if it is found that thefather is in employment, earning sufficient to provide clothing for hischildren, he is told to have them properly clothed at once or he willbe prosecuted under the Prevention of Cruelty to Children Act.But if it is found that the parents are out of employment and thecase is a deserving one, an allocation of suitable clothing is made, andthe children are told to attend at a building used by the police as awardrobe where the clothing is distributed. Before distribution eacharticle is stamped, and a copy of that stamp is supplied to the pawn-brokers with a view of preventing the clothing being improperlydealt with by unscrupulous persons. But the work has not endedhere. In the course of inquiries respecting little children it has

been found that there are families with young girls ranging from14 to 19 years of age, whose parents can scarcely feed, much lessclothe them. They are unable to gain employment, there being nofactories in Brighton, and the only course open for them is to enterdomestic service. Here also the police have, as it were, filled thevoid. After the strictest inquiry many have been provided with aservant’s complete outfit, and, what is more, with a situation. Since

February, 1904, when the scheme was initiated, no fewer than 4829children have been clothed and 188 young girls placed in domesticservice.Mr. Churchill saw 80 ragamuffin boys and girls transformed into

well-dressed children, well-dressed, be it said, with due regard tohealth rather than appearance’ sake, particular attention being paidmore to the under garments than the outer ones. The Home

Secretary expressed his admiration for the scheme, and said hewas not without hopes that Sir Edward Henry might see his way toextend it to the great metropolitan area. The scheme, Mr.Churchill said, opened up a new sphere of police activity and notonly gave a powerful influence to social work, but would, he thought,enhance the popularity of the police force generally.

INFANT MORTALITY AND THE "SOOTHER."

To the Editor of THE LANCET.SIR,-Dr. Burnet has done good service in bringing this important

subject under notice, and I trust you will give effect to his recommenda-tion and allow the matter to be discussed in your columns. Its con-sideration is all the more urgent when we remember that summer willsoon be here again, at which time we may hope to be favoured with somehot weather. While the use of the rubber "soother" and the long-tube feeding-bottle is to be condemned at all times, the evil is muchgreater during the warm season.

It is impossible to describe in detail the possible bad effects that maysupervene when the articles just mentioned are employed, but it canhardly be doubted that they play some part in causing the deaths ofmany infants, to say nothing of the local injuries and disturbances togeneral health that may accrue to their use. For instance, it is notimprobable that the "dummy-teat" may aid in the spread amonginfants of such diseases as enteric fever, zymotic enteritis, tuberculosis,&c., while in the hot weather of summer it is most difficult to keep thelong-tube feeding-bottle clean, and, if not clean, rapid multiplication ofinnumerable bacteria takes place within the tube. It can easily beunderstood that gastro-enteric disturbances and much ill-health mayarise from this cause.As to the best means of dealing with the matter, I am at one with

Dr. Burnet in believing that the manufacture and sale of the articlesshould be forbidden. Some little time ago I saw recorded the fact thatn one of the countries on the Continent the sale of long-tube feeding-

bottles had been prohibited by law. Such a recommendation as that

just mentioned is, therefore, quite within practical politics, but I amafraid it is hopeless to expect any legislation in this matter in theimmediate future.

In the meantime we must adopt other means to try to miti-gate the evil, and in my opinion some good might be done byeducative measures. While I do not think that the distribution of

printed leaflets should be neglected, I doubt if they will do muchgood. The chances are that such leaflets will not be read by theclass of persons who are the worst offenders. The suggestion thatlarge posters containing warnings of the risks involved should be dis-played is admirable, for if conspicuously placed they would certainlyattract the attention of the public. Much more, however, can be doneby verbal instruction, which could be given through the medium ofvarious officials. With the adoption of the Early Notification of BirthsAct (1907) by a local authority one or more lady health visitors areappoir.ted, and these ladies in the course of their visitations candistribute much valuable information regarding feeding-bottles and’’soothers." In some districts the work of these ladies has been verysuccessful, and many of the mothers, especially the younger ones, notonly eagerly look forward to future visits from these ladies, but alsoendeavour faithfully to carry out the instructions received. Membersof hospital staffs, district nurses, and those engaged in charitable workcan also assist. Medical practitioners should take every oppor-

tunity of pointing to the dangers likely to arise. There is a

good deal of truth in Dr. Burnet’s assertion that they are oftenremiss in this respect, for they too frequently maintain a posi-tion of masterly inactivity. They must expect rebuffs, becausein many instances, when the advice is tendered the information is

received with the utmost incredulity. While it must be admitted that

the evil is greater among the poor it is unfortunately true that those ingood positions are not blameless. Some amelioration might be expectedif the educated classes could be made to realise their error and could be

persuaded to assist in educating the ignorant by themselves setting theexample. Education by popular lectures and the instruction of thesenior girls in all schools in the management of infants must not beforgotten. The latter can hardly be over-estimated, for is it not thecase that many of these girls on leaB ing school are given the charge oftheir baby brothers and sisters, while in populous districts especially anumber become mothers at a very early age ?Personally, I have not experienced much difficulty in persuading

mothers to give up using the long-tube bottle, but it has been other-wise with the rubber "soother." The use of the "soother cannot be

supported on medical grounds, and it may be remarked that if aninfant is not accustomed to have a "comforter" he or she will nevermiss it. It might be an excellent plan if among the poor an arrange-ment could be made so that long-tube feeding-bottles would be

exchanged for boat-shaped or other more suitable varieties, a practicethat is in vogue in some children’s hospitals.The matter could be dealt with indirectly in various ways, but space

forbids my traversing these by-paths, however interesting that mightbe. From what I have said it will be apparent that I believe that somegood might follow a vigorous campaign of education, but, in conclusion,I would again submit that the most satisfactory remedy would be theprohibition by Act of Parliament of the manufacture and sale of long-tube feeding bottles and rubber " soothers."

I am, Sir, yours faithfully,Edinburgh, March 22nd. JOHN ArsArt.

THE SUGGESTED COMMUNICATION OF LEPROSY BY MEANSOF CAVIARE.

A NOTE in the Torg.’Prom. Gazeta of the Russian Government saysthat the Medical Council, in view of an article that has appeared inan American paper alleging the possibility of the spread of leprosy inAmerica from Russian caviare, declares that "after a detailed

examination of the question on all sides there is not the slightestground for ascribing the role of ’leprosy disseminator’ to caviare,the more so in that it is mostly the poor who suffer from leprosy andthey never use caviare; and further, in scientific works by variousauthorities who have investigated this disease there is no word of thebacillus of leprosy having been found in fish caviare."

EXPLOSIVE COUGH MIXTURE.

To the Editor of THE LANCET.

SiR,-Reverting to recent correspondence in THE LANCET relativeto "An Explosive Cough Mixture," I have read with interest theannotation in your issue of March 26th relative to spirit of nitrous etherand impure gum in mixtures. However, I have learned that evenwithout the nitrous spirit a mixture may be explosive if it containsmistura amygdalæ.

I recently had the pleasure of a visit from my old friend Sir FrancisR. Cruise who spoke on this subject. He tells me that he formerlyprescribed such a cough mixture, which he derived from the late SirWilliam Jenner. The formula was as follows : Tinct. camph. co.,

syrupi scillae, va 3iii.; aeth. chlorici, 5ii. ; ext. liq. glycyrrhizse, 3ss. ;potassee chloratis, ii. ; mist. amygdalæ, ad 3viii. A tablespoonful whencough is troublesome. Sir Francis Cruise adds that in many casesin his experience this mixture when kept in a warm room for a fewdays exploded-sometimes expelling the cork and at other times

bursting the bottles.In one case an eminent Church dignitary was rudely wakened from

sleep by so violent an explosion that he feared an earthquake. On

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lighting a candle he found it was only the bottle containing his coughmixture that had blown up! Another case ended more seriously,A lady had a bottle with similar contents corked in her hand whenit exploded, and a fragment of glass opened the radial artery whichhad to be tied by operation under ether.Needless to say, Sir Francis Cruise gave up that prescription, but

found that if the mist. amygdalae was omitted and another menstruumused, such as infusum lini, aqua chloroformi, &c., no explosion followed.

I am, Sir, yours faithfully,Dublin, March 29th, 1910. NINIAN M. FALKINER.

THE NEW EXAMINATION HALL OF THE ROYAL COLLEGESOF PHYSICIANS AND SURGEONS.

A RECENT number of the Building News contained illustrations of thedesigns which gained the first two premiums awarded in the recentcompetition for the new " Conjoint " Examination Hall to be erectedin Queen-square. Mr. T. E. Collcutt, F.R.I.B.A., who acted as

assessor in the competition, awarded the first premium to Mr.Andrew N. Prentice, F.R.I.B.A., and the plan and elevation whichhe submitted are also published. The following description is givenof the new buildings :-

" The scheme is planned to form a compact block on the front ofthe site. The students enter on the basement level at the rear,near their cloakrooms, and do not confuse with the official businessof the ground floor. The administrative portion of the buildingshas been placed to the front of the site, so that callers can reacheither of these rooms without mixing in the general circulation ofstudents. The waiting-hall is placed at the back, in communicationwith both staircases. The entrance corridor is so arranged that thesestaircases can be reached from the main entrance without enteringthe waiting-hall when the viua voce students are there. The

large examination halls have been placed along the front of sitewith the smaller examination halls, on a central axis with them.This allows the rooms to be easily supervised when they are usedjointly. Externally, the building is designed to harmonise withthe surroundings, and is treated in an early Georgian styleadapted to modern requirements as to height. It is proposed touse red bricks with the lower storey, cornices, and window

dressings, &c., in Portland stone. A little sculpture is introduced.It is proposed that the small figures in the frieze should carryinstruments suggesting the nature of the building, and should bein low relief."

TANNIN IN TEA.

To the Editor of THE LANCET.

SiR,-Old superstitions seem to die hard. I see in THE LANCETof March 26th an account of a new kind of teapot, designed toexclude tannin from the infusion. The object of doing so is not veryclear. I am aware there is a prejudice against tannin in tea, thoughwhy I could never ascertain. Personally I prefer tea with a fair amountof tannin, and I think the taste of most people is the same, though theyfancy it is more wholesome without it. I have never knowntannin to do any harm to man, woman, or child. On theother hand, it is a useful astringent and antiseptic to themucous membrane. We take tannin lozenges, we paint the throatwith glycerine of tannin, we take tincture or infusion of cinchona

and port wine (some of us) without protest. It is only when

it happens to be in tea that we fancy tannin is injurious. Surely it isthe theine, not the tannin, that causes insomnia and other nerve

symptoms in tea-drinkers. There is a firm now selling coffee fromwhich all the caffeine has been extracted. I presume they will soon dothe same for tea. If they do I hope they will at least leave us thetannin. Tea without theine and without tannin will be rather poorstuff, undistinguishable to the uninitiated from unadulterated or slightlyshaded hot water. I am, Sir, yours faithfully,London, S.W., March 28th, 1910. J. FOSTER PALMER.

STANDARDISATION OF BREAD.

THE Bread and Food Reform League has published another pamphleton the " Standardisation of Bread," again urging the necessity of

securing purity from adulteration and abolition of injuriouschemical processes in preparing flour and bread, and the establish-ment of a standard for what is sold as household bread not only withregard to flesh-forming materials but also with respect to mineralsubstances. An analysis of flours from several districts made forthe league by Mr. C. G. Moor, F.I.C., is given, showing a

great deficiency of these important substances, which were con-

siderably below the recognised standard for ordinary white flour, axidit is stated that the old-fashioned household flour, advocated

by the league, containing 80 per cent. of wheat, retaining the germand the semolina, has 55 per cent. more mineral matter. Wholemealis said to have 247 per cent. more, but as the old-fashioned householdflour has a small amount of woody fibre and produces cream-coloured,well-aerated bread it may meet with approval from those who nowobject to brown bread. The council of the league directs attention tothe fact, to which we have given publicity, that the brown bread,sometimes called "black bread," used in Germany is found to bemore nourishing and sustaining than over-refined white bread. As a

supply of pure bread, containing a sufficient supply of all theelements of nutrition, is of vital national importance, the Councilof the Bread and Food Reform League urges the necessity of makingevery effort to raise the standard of bread so that it may become amore complete and healthier food for all classes, and better deservethe title of the staff of life. The address of the honorary secretary ofthe Bread and Food lteform League is 5, Clement’s Inn, Strand,London, W.C.

TERATOLOGY IN ITALY.

FROM no country could Geoffroy St. Hilaire’s classic treatise on

monstrous births be more richly supplemented than from Italy-except, perhaps, from Spain, which (according to the Maestro Rossini)has earned the gratitude of all Italians by saving their nationalityfrom the reproach of being the most backward in Europe. Ignorance,superstition, and life under hard conditions such as these countriesare still subjected to seem to favour what the older teratologists usedto call "lusus Naturae" (Nature’s freaks or practical jokes). Thelatest of these (a rather gruesome one) is reported from Avellino,some 50 miles south-east of Naples, where a peasant woman, BiancaFierro by name, aged 25 years, gave birth to a female "creatura" on the evening of March 22nd. This creature, the outcome, it seems,of "illicit amours," could, according to the medical reporter, "givepoints to Victor Hugo’s Quasimodo." Its mouth was that of a

reptile, portentously wide; the nose bifurcated; the cranium com-pressed ; the ears of great size; one eye placed below one of the eara,the other in the middle of the forehead; one leg attached to theimmediate neighbourhood of the umbilicus, and the other below thespine in senso inverse (turned the wrong way). The " creatura " livedfor some 24 hours, emitting " grida stranissime " (very strange cries),and, naturally enough, ’’ha vivamente impressionato questo popo-lino " (made a vivid impression on the population of Avellino). Its

destination, of course, is not the " campo santi," but the localmuseum-if not that of the Neapolitan school, from one of whichan interesting paper on the phenomenon may shortly be expected.

ALCOHOLISM IN RUSSIA.

THE Novoe Vremya recently welcomed a proposal of the Minister ofFinance (at the instigation of Professor Bechterieff) to allot 100,000roubles (JB10,625) to found a clinic for alcoholics in connexion with thePsycho-Neurological Institute. Hitherto practically nothing hadbeen done in Russia to counteract the drink habit, which is said to beresponsible for 200,000 deaths in the Empire each year. The chartsshown at the recent exhibition at the institute in question displayedthe curve of the progress of "paralysis of the brain" in the com-munity, and this was closely proportionate to the increasing consump-tion of drink per head of the population. Phthisis, moreover, whichdestroys 700,000 people in the year, very often has its origin inalcoholism. M. Tchelischeff, a member of the Duma, said in a speechthat only 40 per cent. of the recruits called up in 1909 were fit for

military service, and he had a letter from one officer saying thatof all the recruits that came before him at the last requisition only8 per cent. were not drinkers, whilst 30 per cent. were in such badhealth as to pass into the Reserve inside three months, whereas20 years ago only from 4 to 8 per cent. were so released in that periodof time. Only a few private institutions are available for the treat-ment of alcoholism, and their charges are very high. It cannot bewondered at that many seek refuge in quack establishments in hopeof cure. Self-taught hypnotists without any medical knowledge per-form their manipulations over whole parties of patients at a time.It is said of one such St. Petersburg quack that he causes parties of15 persons of both sexes to lie down side by side, then performs his" passes," and leaving them there two hours goes into another roomto repeat the performance over another party. The proposed newclinic will include hypnotic suggestion in its treatment, and theremoval of bad cases after treatment to a sanatorium for dipsomaniacsis contemplated.

COMMUNICATIONS not noticed in our present issue will receive attentionin our next.

M E T E O R O L O G I C A L READINGS.

(Taken daily at 8.30 a.m. by Steward’s Instruments.)THE LANCET Office, April 6th, 1910.