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Notes, Short Comments, and Answersto Correspondents.

THE MEDICAL PROFESSION IN NORWAY IN 1816.IN a brief but interesting account of the position of medicaland surgical practitioners in Norway a hundred years agoDr. M. Soegaard gives a reproduction of the first officiallist of those then authorised to practise in that country.The list was issued by the Third Department of theGovernment and is dated Feb. 20th, 1816. The first thingthat strikes the reader is its brevity ; it contains no morethan a hundred names. Norway was one of the countriesthat had the misfortune to back the losers in theNapoleonic wars. In 1800 the Danish Government, thepredominant partner in the union of Denmark andNorway then existing, committed the Norwegians to thesecond armed neutrality. When this was broken upby the bombardment of Copenhagen, Denmark andNorway supported Napoleon against both Englandand Sweden in 1807. Rapid economic ruin was theresult, and in 1814 Frederick VI. of Denmark cededNorway to Sweden. Sweden had previously joinedthe Allies against Napoleon; the Act of Union madeSweden and Norway equally independent countries, boundtogether under a single king in an offensive and defensivealliance, which survived till 1905. To return to the year1816, it may be said that the economic condition of Norwaywas then deplorable; trade was bad, there was muchgeneral poverty, the country was bankrupt. The popula-tion numbered something over 900,000 souls, yet, as Dr.Soegaard proves by quotations from letters written bymedical men at the time, many of them found it hard toearn even a livelihood. "How I shall get on this year andin the future," writes Chief Surgeon Bencke, of Fredriks-vaern, "I do not know; my time is stolen from me, Iam a slave from morning till night. My pay is about64 skillings a day....... I do not even know the name of civilpractice here." The skilling was worth nearly a halfpenny.Two medical men practised in the town of Stavanger; thesenior of these, Landphysicus (or chief district physician)Fangel, writes of his junior, the assistant physician, " he isso good in helping the poor that with my whole heart Iwish this brave man an old age free from crushing anxietyabout his daily bread, for the hundred rigsbankdaler hegets as assistant at the hospital barely supply the firstnecessities of life." The rigsbankdaler or rixdollar of 96skillings was worth less than four shillings ; clearly this Iassistant was not one of those passing rich on (nearly)twenty pounds a year. It is not surprising to read thatwhen Chief Naval Surgeon Heiberg won a large sum ofmoney in the Hamburg lottery of 1814 he hastened to throwup his practice and go into business as a shipowner andwholesale merchant. But in 1828, alas, he failed, and hadto return to his old profession as regimental surgeon atHorten. Here, " separated from his family, he lived in avery small way until he was appointed district doctor atTonset." Clearly the hundred medical men practising inNorway in 1816 had a hard time of it. Yet few and ill paid asthey were they all had official titles, many of them titles asmagnificent as apparently empty of all save credit andrenown. Most of these titles had to do with surgery, andat least a dozen varieties of surgeons are distinguished inthe official list of 1816. Twenty-seven of the hundredpractitioners it contains are described as " uexamineredeBataillonschirurger," battalion surgeons who had notpresented themselves-or who had not successfully pre-sented themselves ?-for examination. Seventeen are regi-mental surgeons, 11 are district surgeons, 6 are candidatesin surgery. Others are set down as town surgeons, minesurgeons, senior surgeons, under surgeons, companysurgeons, battalion surgeons, divisional surgeons, super-numerary regimental or battalion surgeons, or town anddistrict surgeons. The mere physicians are fewer thanthe surgeons in the list, but enjoy a no less copious andperplexing variety of titles. Two are described as doctorsof medicine, though 11 others are mentioned as hold-ing the degree of Dr. Med.: one is a doctor of bothmedicine and surgery, and 6 are described as "Land-physici," or head physicians of their districts. Aseventh " Landphysicus " is set down as also a

medical candidate, as though not fully qualified, whilean eighth is described as " Bergmedicus " (or minemedico) as well as " Landphysicus," though the distinctionbetween the capacities of a "medicus and a " physicus" isnot at once apparent. Apart from the doctors of medicine,the " medici," and the " physici," come practitioners of afourth description, those set down in Norwegian as" Laeger," or, in English, leeches. The leeches existed invarious capacities, and are distinguished as leeches, prac-tising leeches (what did a leech do if he did not practise ?),

works leeches, infirmary leeches, private leeches, districtlepches, under leeches, and Lazareth leeches. Finally,there may be mentioned two practitioners described asmedical candidates, comparable in status to the surgicalcandidates, no doubt. One of these medical candidateswas also professor of botany at Christiania; the other wasalso a private leech. The Lazareth leech was in practiceat Larvik, and is described in the list as a surgical candi-date and 11 physics " as well. His Lazareth or lazarettomay have been either a fever hospital or a hospital forlepers, but it may be added that special provision wasmade for leprosy in Norway by the appointment of an"unexamined assistant" at the Stavanger Radesygehus,or home for lepers, and a " Titular Professor," who wasalso chief inspector for leprosy," at Tonsberg. Yetanother professional title may be mentioned, if only forits grim sincerity. At Vinger there practised a " Forhen-vaerende Regiments Feltskjaer," or ex-regimental fieldshearer, to give a literal translation of his official title,as though the surgery on the field of battle had con-sisted mainly of immediate amputations.

VACCINATION ON THE FOOT.

To the Editor of THE LANCET.SIR,-I shall be glad if any of your readers can give me

the particulars and results of vaccination on the foot.I am, Sir, yours faithfully,

JAMES MARSH, M.B.Edin.114, High-street, Atherton, near Manchester, Dec. 22nd, 1916.

LETTS’S "QUIKREF" DIARIES.WE have received some specimens of the diaries publishedby Messrs. Cassell and Co. under the above title. The listincludes books for the office, the study, the counter, andthe pocket, the sizes varying accordingly, and the bindingsfrom leather through the various forms of cloth to paper.The prices are from ls. to 16s. An accident insurancecoupon accompanies each diary. For medical men a diary7 in. by 3 in. is provided, showing a week at an opening oftwo pages and ruled with columns for the insertion ofvisits to 54 patients. Bound in cloth, with pencil, theprice is 2s. 6d., or in French morocco, with tuck and twopockets, 5s. There are intermediate prices according tostyle of binding. An excellent diary for nurses, price2s. 6d., bound in red leather cloth, contains, in addition tothe usual almanac, spaces ruled for nurses’ reports of thepatients’ progress and an index. The diary shows a weekin an opening.At a season for exchanging gifts, when necessary

economy and generosity are likely to clash, a diary maysolve the difficulty. All the above-mentioned books areprinted on good tough paper and bound with an eye tohard wear.

PUBLIC HEALTH AND VITAL STATISTICS OFCYPRUS.

ACCORDING to the Cyprus Blue-book for the year 1915 theestimated population of the colony is 294,664. In 1915 therewere 9141 births, the rate being 31 per 1000 ; the number ofdeaths returned was 5473, or 18’5 per 1000. The publichealth and general sanitary condition of the island havebeen satisfactory; there was complete immunity fromplague and cholera, and no severe quarantine restrictionswere imposed. The number of cases of typhoid fever,which in Cyprus is generally of a mild type, was 267, ascompared with 341 in 1914. On the other hand, 11 casesterminated fatally, as against 8 in the previous year.There were 9 cases of diphtheria with 6 deaths, but only6 cases of cerebro-spinal meningitis (5 deaths). 6701 vacci-nations were performed during the year, and there wasno case of small-pox.This is the third year of the campaign against malaria

initiated by Sir Ronald Ross in 1913, and it is satisfactorythat the reduction in the casea of malaria and the spleen-rates is considerable. There were 2083 cases less than in theprevious year, and the spleen-rate, which was returned at22.8 per cent. in the spring of 1913, has now fallen to11’5 per cent. The reduction is fairly evenly distributedover the island, but the greatest decrease is shown in theLarnaca and Famagusta districts, which were also themost malarial, and this is due in great measure to theextensive drainage works that have been carried out. Thecases of malaria admitted to the six district hospitals in1915 amounted to 167, of which only 6, or 3’5 per cent.,terminated fatally.Further work in improving the Nicosia General Hos-

pital, a Government institution, has been carried out.The electric light installation is now complete, andan X ray apparatus has been provided. Two separatewards for dealing with septic cases in the women’sside of the hospital have been built. The number ofbeds remains at 53. A total of 1196 patients receivedtreatment in the wards of the institution during the

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year and there were 59 deaths. 6881 persons obtainedtreatment in the out-patient department. The districthospitals of Larnaca, Limasol, Famagusta, Paphos, andKyreniaohave continued to carry out their valuable work;the total number of in-patients during the year was 1278and of out-patients 12,303. There were only 5 admissionsto the leper farm, as against 12 in 1914, and there were 10deaths. The number of cases living in the farm at theclose of the year was 92, the lowest on record in the presentcentury.

It is recorded that the island has been in use by themilitary authorities as a convalescent resort. There havebeen constant arrivals and departures of convalescents fromEgypt and elsewhere, and the benefit they derived fromthe salubrious climate has been considerable. The absolutemean temperature for the year was 66.48° F., as against65.21° in the previous year The mean rainfall was 16-12inches, as against 23-49 inches during 1914, and an averageof 21-89 inches during the last ten years.

MILK IN THE REARING OF INFANTS.To the Editor of THE LANCET.

SIR,—Will any of your readers kindly inform me whatshould be done in the rearing of infants when milk cannotbe taken ? The child in question is now 15 months old andrefuses milk in any form; if pushed she retches.

I am, Sir, yours faithfully,Dec. 26th, 1916. M.D., M.R.C.P.

One of Them.—We understand that the arrangement of localcollectors for Epsom College has not been discontinued.In numerous districts, however, the honorary localsecretaries are engaged on military duties, and at theirrequest the central office is looking after the local sub-scriptions. New collectors will, we are informed, bewelcomed in districts where the College is not alreadyrepresented.

Medical Diary for the ensuing Week.SOCIETIES.

BONTGBN SOCIETY, Institution of Electrical Engineers, VictoriaEmbankment, W.C.TUESDAY.-8.15 P.M., General Meeting. Paper :-Mr. C. A. Schunk:

A Spectroscopic Investigation of Some Sources of Ultra-VioletRadiation in Relation to Treatment by Ultra-Violet Rays -Dr. Batten will describe a Simple Cross-thread Frame for Usein Localisation.

_____

LECTURES, ADDRESSES, DEMONSTRATIONS, &c.POST-GRADUATE COLLEGE, West London Hospital, Hammersmith-

road, W.MONDAY.-2 P.M., Medical and Surgical Clinics. X Rays. Mr. Gray:

Operations. Mr. B. Harman: Diseases of the Eye. Dr. Simson :Diseases of Women.

TUESDAY.-2 P.M., Medical and Surgical Clinics. X Rays. Mr.Baldwin : Operations. Dr. Banks Davis: Diseases of the Throat,Nose, and Ear. Dr. Pernet: Diseases of the Skin.

WEDNESDAY.-IOA.M.,Dr. Saunders : Diseases of Children. Dr. BanksDavis: Operations of the Throat, Nose, and Ear. 2 P.M.. Medicaland Surgical Clinics. X Rays. Mr. Pardoe : Operations. Dr.Simson: Diseases of Women.

THURSDAY.—2 P.M., Medical and Surgical Clinics. X Rays. Mr. Gray :Operations. Mr. B. Harman : Diseases of the Eye.

FRIDAY.-10 A.M., Dr. Simson: Gynaecological Operations. 2 P.M.,Medical and Surgical Clinics. X Rays. Mr. Baldwin : Opera-tions. Dr. Banks Davis : Diseases of the Throat, Nose, and Ear.Dr. Pernet: Diseases of the Skin.

SATURDAY.—10 A.M., Dr. Saunde’s: Diseases of Children. Dr. BanksDavis: Operations of the Throat, Nose, and Ear. Mr. B. Harman :Eve Operations. 2 P.M., Medical and Surgical Clinics. X Rays.Mr. Pardoe: Operations.

NORTH-EAST LONDON POST-GRADUATE COLLEGE, Prince ofWales’s General Hospital, Tottenham. N.MONDAY.-Clinics:-10.30 A.M., Surgical Out-patients (Mr. E.

Gillespie). 2.30 P.M.. Medical Out-patients (Dr. T. R. Whipham):Gynaecological Out-patients (Dr. Banister). 3 P.M., MedicalIn-patients (Dr. R. M. Leslie).

TUESDAY -2.30 P.M., Surgical Operations (Mr. Carson). Clinics :-Medical Out patients (Dr. A. G Auld); Surgical Out-patients(Mr. Howell Evans); Nose, Throat, and Ear Out-patients (Mr.C. H. Hayton). Radiography (Dr. Metcalfe). 3.30 P.M., MedicalIn-patients (Dr. A. J. Whiting).

WEDNESDAY.—Clinics:—2.30 P.M., Throat Operations (Mr. C. H.Hayton). Children Out patients (Dr. T. R Whipham); Eye Out-patients (Mr. R. P Brooks) ; Skin Out-patients (Dr. H. W.Barber). 5.30 PM., Eye Operations (Mr. R. P. Brooks).

THURSDAY.-2.30 P.M., Gynaecological Operations (Dr. A. E. Giles).Clinics :-Medical Out-patients (Dr. A. J. Whiting); SurgicalOut-patients (Mr. Carson ; ; Radiography (Dr. Metcalfe). 3 P.M.,Medical In-patients (Dr. R. M. Leslie).

FRIDAY.-2.30 P.M., Surgical Operations (Mr. Howell Evans).Ulinics :-Medical Out-patients (Dr. A. G. Auld) ; Surgical Out-patients (Mr. E. Gillespie); Eye Out-patients (Mr. R. P. Brooks).

THE THROAT HOSPITAL, Golden-square, W.MONDAY.-5.15 P.M., Special Demonstration of Selected Cases.THURSDAY.-5.15 P.M., Clinical Lecture.

ROYAL INSTITUTION OF GREAT BRITAIN, Albemarle-street,Piccadilly, WChristmas Lectures: -The Human Machine which All must Work

(adapted to a Juvenile Auditory).TUESDAY.—Prof. A. Keith : Living Pumps.THURSDAY.-Prof. A. Keith: Living Bellows.SATURDAY.-Prof. A. Keith: Living Workshops.

EDITORIAL NOTICES.IT is most important that communications relating to the

Editorial business of THE LANCET should be addressedexclusively "To THE EDITOR," and not in any case to anygentleman who may be supposed to be connected with theEditorial staff. It is urgently necessary that attention shouldbe given to this notice. It is especially requested that early intelligence of local

events having a medical interest, or which it is desirableto bring under the notice of the profession, may be sentdirect to this office.

Lectures, original articles, and reports should be written onone side of the paper only, and when accompanied byblocks it is requested that the name of the author, and ifpossible of the article, should be written on the blocks tofacilitate identification.

Letters, whether intended for insertion or for private informa-tion, must be authenticated by the names and addressesof their writers--not necessarily for publication.

We cannot prescribe or recommend practitioners.Local paper? containing reports or news paragraphs should

be marked and addressed To the Sub-Editor."Letters relating to the publication, sale, and advertising

departments of THE LANCET should be addressed Tothe Manager."

We cannot undertake to return MSS. not used.

Offices: 423, STRAND, LONDON, W.C.

MANAGER’S NOTICES.

ALTERATION IN THE PRICE OF " THE LANCET."INCREASED war expenses and cost of production necessitate

an increase of the price of THE LANCET. Commencing withthe first issue in the New Year, the price will be 8d. insteadof 6d. The rates of subscription will remain as revisedin October.

TO SUBSCRIBERS.WILL Subscribers please note that only those subscriptions

which are sent direct to the Proprietors of THE LANCET attheir Offices, 423, Strand, London, W.C., are dealt with bythem? Subscriptions paid to London or to local newsagents(with none of whom have the Proprietors any connexionwhatever) do not reach THE LANCET Offices, and con-

sequently inquiries concerning missing copies, &c., shouldbe sent to the Agent to whom the subscription is paid, andnot to THE LANCET Offices.Subscribers, by sending their subscriptions direct to

THE LANCET Offices, will ensure regularity in the despatchof their Journals and an earlier delivery than the majority ofAgents are able to effect.THE COLONIAL AND FOREIGN EDITION (printed on thin

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TO COLONIAL AND FOREIGN SUBSCRIBERS.Subscribers abroad are particularly requested to note the rates

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METEOROLOGICAL READINGS.(Taken daily at 8.30 a.m. by Steward’s Instrzcrraerats.)

THE LANCEr Office, Dec. 27th, 1916.

Other information which we have been accustomed to give in theseReadings" is withheld for the period of the war.

The following Journals, magazines, &c., have been received :-Proceedings of the Royal Society of M dicine, Medical Times,British Journal of Dental Science. Military Surgeon, CanadianPractitioner and Review, Liverpool Medico-Chirurgical Journal,Archives of Radiology and Electrotherapy. Annali d’ Igiene, Annalesde I’Institut Pasteur, Surgery, Gynecology, and Obstetrics, TropicalDiseases Bulletin.