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Notes, Short Comments, and Answers to Correspondents.

A WARNING.

To the Editors of THE LANCET.

SIRS,-I am reluctant to trespass upon your space but I shall hevery glad if you will permit me to give my brother practitioners aword of warning through your columns ; it may save them from beingvictimised as I have been. There is a certain practitioner at

present doing locum work who has caused me annoyance and injuryto an extent that is hardly credible. From what I hear he hastreated other medical men in a similar manner and I wish to putmy fellow practitioners on their guard against a man whomit is dangerous to employ. The person in question is an Eurasian

(I make no complaint here against either Eurasians or Indiansas a class) and can be identified by his extraordinary flow of

eloquence upon the subjects of his own abilities and experiences. Iconfess I was not entirely free from suspicion as to his characterwhen I engaged him at rather short notice to do a few weeks’ locumwork. Neither his appearance nor manner inspired confidence. Ibelieve now that he wished to give me such a bad impression of himthat I would be inclined to pay him a sum down to be released fromthe arrangement. I sincerely wish now that I had made the sacri-fice. After I had left home he tried to give my family the im-pression that he was a dangerous man to cross. He boasted of

having made himself so obnoxious to two former employers that

they had severally offered him .E100 to leave their neighbourhood.This I can readily believe. He also declared it was his habit to

revenge himself upon any who had injured him in a manner

quite Eastern in its completeness. On my return from the country Ifound a very unsatisfactory state of affairs. I discharged the man forinsulting young girls, for neglect of duty, and for making libellousstatements to the patients about myself. The man’s conduct is hardto understand except on the hypothesis of mental trouble, for Ihad done nothing either by word or deed to arouse his hostility.He had no sooner left my house than he began a system ofmalicious persecution. He went round among my patients repeat-ing his libellous statements and in some instances telling those whoowed bills that they need not pay them, as the fees were not legallyrecoverable. This in one case necessitated my suing the debtorin the county court. As for the charges he made against me, theywere so obviously untrue that I am glad to say very few of mypatients gave them any credence. - Not content with the revenge hehad taken he called upon my dispenser and tried to get his assistancein opposing me and upon the dispenser’s refusal he made use ofthreats. I discovered that during my absence he had called in afriend of his to pose as a consultant. He obtained a fee of R3 3s.for his friend and handed over the case to him entirely, of courseto my detriment. No doubt the medical friend kindly acts as a

reference in return for such favours. All I have stated is capableof legal proof. If any other medical practitioners who have had asimilar experience to mine will kindly communicate with me

through the medium of this paper it may be possible to bring thematter to the notice of the General Medical Council. It may beasked why I have not already taken legal proceedings instead of

writing this letter. Well, an appeal to the law is expensive andtedious. I have neither the time nor the money to spare for a prosecu-tion ; nor have I written this letter for the gratification of revenge. Ishall be content if through my action the medical profession is savedfrom further discredit and the public protected from insult and injuryat the hands of a man of criminal tendencies. I inclose my card, andwith apologies for the length of this letter,

I remain, Sirs, yours faithfully,April 23rd, 1906. VICTIM.

’’B* The agent through whom the locum-tenent was obtained shouldbe communicated with. If only a fraction of what our correspondentsays can be proved to the satisfaction of a respectable agent Othello’soccupation will be gone.-ED. L.

THE DURABILITY OF CARDIAC MUSCLE.

Professor Lortet, member of the French Academy, has publishedan interesting report upon the condition of the heart and visceraof King Rameses II. (the Greek Sesostris) after their embalmmentfor 3164 years. It seems that some months ago the governing bodyof the Musees Nationaux du Louvre in Paris acquired possession oftour beautiful canopic vases covered with blue enamel and bearingthe insignia of the-ancient Egyptian monarch referred to. Thesewere handed over to Professor Lortet for a chemical and micro-scopical examination of their contents, and Professor Hugounenq,Professor Renaut, and Professor Rigaud were associated with him inthe work. Three of the vases were filled with linen bandages, impreg-nated with soda and glued together with aromatic resinous substancesot a red colour. There were also present certain indeterminablegranular substances, mixed with pulverised soda, which are conjec-tured to be all that is left of the stomach, the liver, and the intestinesof the great king. The heart was found in the fourth vase, which isornamented on the lid by a jackal. , The appearance of the organ isthat of an egg-shaped plate about eight centimetres long by four

centimetres broad. Its tissue was found to be so solid and horny thatin order to separate a portion from it recourse had to be had to thesaw. A section was subsequently removed with a razor and submittedto the microscope, when the horny substance was seen to be composedof bundles of muscular fibre, arranged in the cross mesh peculiar tothe formation of cardiac and glossal muscle. The tongue of KingRameses II. is, however, undoubtedly present in the royal mummyfound in 1881 at Thebes and deposited in the Egyptian Museum atCairo in 1886, so that there seems to remain no doubt that the organobserved by Professor Lortet is the heart. Rameses II. died 1258 B.C.The 3000 years that have since elapsed and the desiccating effect osoda and aromatic gums have been able to reduce the bulk of the

king’s heart but not to alter its anatomical formation, while theother viscera have been changed to unrecognisable dust.

MONSTERS.

To the Editors of THE LANCET.

SIRS,-I should be greatly obliged if, through the medium of yourcorrespondence columns, any of your readers could give me informationabout the literature of fcctal malformation or "monsters."

I am, Sirs, yours faithfully,April 17th, 1906. X.

AN UNFORTUNATE CIRCULAR.

A MEDICAL man, who makes no pretence of disinterestedness, writes asfollows :-

The following notice has been sent to every tenant of St. James’Court, Westminster, a block of residential flats in which I and manyother medical men have patients residing. Two copies of thisnotice have been handed to me by patients on whom I am in actualattendance at the moment:—

"The Resident Estate Manager begs to inform the Tenants ofSt. James’ Court that Dr. W. Moyle O’Connor has taken up hisresidence in No. 43 and 44, Queen’s House as Resident Physician tothe Court, and that his services are available for the tenants at anytime they may be required."

Dr. O’Connor will be well advised to check the resident estate

manager’s zeal in his behalf. Probably Dr. O’Connor knew nothingof that gentleman’s ill-designed efforts, while the resident estatemanager may be supposed to be ignorant of the fact that medicalmen, who are not allowed to advertise themselves, are also notallowed to benefit by the advertisements of others. We sympathisewith the resentment of our correspondent.

IS BARLEY WATER A SUITABLE FOOD FOR INFANTS ?

To the Editors of THE LANCET.

SIRS,-The letter of "Lacto"in THE LANCET of April 21st, p. 1150,shows very clearly the confusion which arises owing to the use of theterms caseinogen and casein for the chiet proteid of milk and his im-plied protest is certainly wanted. Surely the time has come to abandonthe use of the term "caseinogen"; philologically it is barbarous-casein is from the Latin caseum, gen is the Greek root &ggr;∈&ngr;, and wherethe "o" comes from is a mystery. The root ’yeP means to beget and isquite rightly used in hydrogen, oxygen, &c., but in "caseinogen" ithas apparently altered its meaning as this substance is not one which

begets caseino but which splits up into casein and other products ofhydrolysis. Again, "caseinogen" forms salts with bases; are

these to be called caseinogenates ? and if so, how is the wordto be pronounced? The so-called "casein" is really only oneof a whole series of compounds produced by the hydrolysis of

"caseinogen," and it is only the accidental property of the insolubilityof its acid double salt with calcium phosphate that leads it to be pro-duced. Surely, it is better to keep the name "casein" for the parentsubstance, as is done on the continent, in America, and by a largesection of chemists in England. Let us wipe the monstrosity" caseinogen

" from the language and avoid the confusion into whichall sooner or later are led. I may instance this confusion by referringto a very recent book, Mann’s .. Chemistry of the Proteids" ; in a foot-note he states that he has adopted Halliburton’s nomenclature; in thetext he actually uses the words casein and caseinogen indiscriminately.

I am, Sirs, yours faithfully,H. DROOP RICHMOND.

Woodfield-road, Ealing, W., April 21st, 1906.

THE EFFECT OF SUPERAERATED WATER UPON FISH.

UNDER normal conditions fish live in water which contains no moredissolved air than may be absorbed spontaneously at atmosphericpressure and the prevailing temperature. If, however, this amountis greatly exceeded-that is, if the water becomes superaerated, thefish exhibit remarkable symptoms often ending in death. A markedanalogy exists between this affection and caisson disease in man. Inthe latter the body sustains an actual increase of pressure which issubsequently removed and the symptoms follow. This change ofpressure has no counterpart in the case of the fish, except that thesupersaturation of the water with the atmospheric gases is referableto an increase of pressure. At the station of the United StatesBureau of Fisheries at Wood’s Hole, Massachusetts, a quantityof sea water became supersaturated with air and the ScientificAmerican of March 31st published some details of the effect pro-duced. The absorption of air was due primarily to a leaky suction-pipe which allowed air to pass with the water into storage-tankswhere it was subjected to a pressure of about eight pounds per

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square inch. From these storage tanks the water flowed to aquariaand being again at atmospheric pressure was in a condition of

supersaturation with air. The fish showed a variety of symptoms.There was first a precipitation of very minute bubbles upon theirbodies and Iiiis, completely covering them. After a longer timesmall collections of gas formed in the skin, chiefly of the tins, andsometimes made the fish so buoyant that they could scarcely keepbelow the surface. Death resulted after a longer or shorter timefrom gas embolism or the presence of free gas within the blood-vessels. Often the vessels of the gill iilaments were filled with gasand the ventral aorta and bulbus of the heart were distended withit and quite empty of blood. This gas contained about 97 per cent.of nitrogen.

HOW TO MAKE HUMANISED" MILK.

To the Editors of THE LANCET.

SIRS,-In answer to your correspondent " B. (Medicus)" inTHE LANCET of April 21st, p. 1150, as to the making of" humanised" milk the following directions for making artificialhuman milk are taken from Playfair’s "Science and Practice of

Midwifery": "Take half a pint of skimmed milk, heat it to about960 F., and put into the warmed milk a piece of rennet about an inchsquare (or Clarke’s essence of rennet may be used). Set the milkin the fender or over a lamp until it is quite warm. When itis set remove the rennet, break up the curd quite small witha knife and let it stand for ten minutes or a quarter of an hour,when the curd will sink. Now pour the whey into a saucepan andboil it up quickl). Measure one-third of a pint of this whey anddissolve in it, when hot, 110 grs. of milk sugar. When this one-

third of a pint of whey is cold, add to it two-thirds of a Dint of newmilk, and two teaspoonfuls of cream, and stir. The food should be madefresh every 12 hours and warmed as required. The piece of rennetwhen taken out can be kept in an egg-cup, and used for ten days or afortnight. It is advisable during the first month to use rather morethan one-third of a pint of whey, as the milk is apt to be rather too richfor a newly-born child." I am. Sirs, yours faithfully,

JOHN E. H. PARSONS.

Shipton-under-Wychwood, Oxford, April 23rd, 1906. i

TWO OLD MEDICAL BOOKS.

A CORRESPONDENT writes : " I recently picked up in an old book shopthe following two medical books: 1. ’Profodia Chirurgica,’ publishedby C. Corbett at Addison’s Head and Richard Chandler at the

Flower-de-Luce, both without Temple Bar. 1732. The author’sname does not appear and there is a long dedication to a Mr. Shipton.2. ’Anatomical Plates of the Arteries of the Human Body.’ These arestated to be accurately colonred and reduced from the Icones ofHaller with concise explanation. The book is published by E Cox,St. Thomas’s-street. 1808." The writer adds that the plates in thesecond book are very fine and that both books are well bound in

leather, and he inquires if any reader can tell him their value.

THE THERAPEUTIC VALUE OF CHEWING GUM.

THE habit of chewing a resinous substance after meals as an aid todigestion is very prevalent in the United States of America and inCanada. The preparations in most demand are known under thenames of "chewing gum," "pepine gum," and "pepine." Thecustom is not unknown among Eastern peoples; thus, in Indiabetel nuts and areca nuts are mixed with lime and used in a similarmanner. In a recent number of the Bulletin des Sciences Phar7iza-cologiques Dr L. Meunier has given the results of an investigationinto the physiological aspect of the chewing habit and has drawnattention to its value in therapeutics. As a result of masticating apiece of chewing gum containing a small proportion of alkali theflow of saliva is increased to five or six times the usual volume.Herein lies the therapeutic value of the habit in cases %here thegastric juice is excessively acid and so hinders the digestion of starchyfoods. The acid is partly neutralised by the ealiva which is

thereby enabled to convert the starch into soluble products. A

number of patients were put on a diet of 60 grammes of breadand 250 cubic centimetres of water per meal for two consecutive

days. A masticatory consisting of an aromatic resin was givenafter each meal on the second day only. The gastric liquidwas analysed half an hour after each meal, when the amylolyticchange was considered to be complete and the figures show that themasticatory had in all cases increased the quantity of soluble

products produced from the starchy food. Allowing for the dilutionof the gastric contents by the increased flow of saliva the figuresobtained in ten cases showed a gain of from 30 to 40 per cent. in thesoluble starch products due to the use of a masticatory substance.Dr. Meunier has obtained satisfactory clinical results in all casesof hyperacidity treated by him during a year, which tends to showthat the Amexican custom of chewing gum, though based on

empiricism, may be supported on scientific grounds. Dr. Meunierdoes not state the exact kind of resin which he employed, butmastic is a suitable substance for the purpose. It is the resinobtained from Pistacia lentiscus, a small tree growing in Seio and inother islands of the Grecian Archipelago, where the resin has beenproduced from very early ages. It is mentioned in the works ofDioscorides and Pliny. It occurs in small rounded tears, pale yellowin colour, with an agreeable aromatic odour and taste. When chewedit readily forms a tenacious mass which does not stick to the teethand so can be retained in the mouth for a considerable time.

! MEDICAL REFEREES TO INSURANCE COMPANIES.

To the Editors of THE LANCET.

SIRS,-May I through the medium of THE LANCET call attention towhat I consider a pernicious practice on the oart of some life assurancecompanies ?-viz., in a small town with perhaps half dozen medicalprac-titioners one only holds the appointment of referee to a big insurancecompany. By this appointment he gets into touch with the othermen’s patients and the local agent spreads the fame and skill of "our

doctor." This is touting, and touting of the worst sort. Perhapsthose who have been victims to this system, like myself, will givetheir opinion on the question. In a small town-say, of 2000 or 3000inhabitants—why not appoint all the medical men instead of one only ?The latter plan would, I feel certain, tend to cause a better feelingamong the profession and in the end would work well in the interest ofthe insurance companies. Thanking you in anticipation of yourpublishing this letter, I am, Sirs, yours faithfully,

April 24th, 1906. CYGNUS.

C. B -We agree with our correspondent that there is no necessity forsuch advertisement, as the patients on the books of the practicehave been privately notified of the intending dissolution. At anyrate, one insertion in the local papers would suffice.

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

Medical Diary for the ensuing Week.OPERATIONS.

METROPOLITAN HOSPITALS.MONDAY (30th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St.

, Thomas’s (3.30 P.M.), St. George’s (2 P.M.), St. Mary’s (2.30 P.M.),Middlesex (1.30 P.M.), Westminster (2 P.M.), Chelsea (2 P.M.),Samaritan (Gynaecological, by Physicians, 2 P.M.), Soho-square(2 P.M.), City Orthopaedic (4 P.M.), Gt. Northern Central (2.30 P.M.),West London (2.30 P.M.). London Throat (9.30 A.M.), Royal Free(2 P.M.). Guy’s (1.30 P.M.), Royal Ear (2 P.M.), Children, Gt. Ormond-street (3 P.M.).

TUESDAY (1st).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St.Thomas’s (3.30 P.M.), Guy’s (1.30 P.M.), Middlesex (1.30 P.M.), West-minster (2 P.M.), West London (2.30 P.M.), University College(2 P.M.), St. George’s (1 P.M.), St. Mary’s (1 P.M.), St. Mark’s(2.30 P.M.), Cancer (2 P.M.), Metropolitan (2.30 P.M.). London Throat(9.30 A.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat, Golden-square (9.30 A.M.), Soho-square (2 P.M.), Chelsea (2 P.M.), CentralLondon Throat and Ear (2 P.M.), Children, Gt. Ormond-street

(2 P.M., Ophthalmic, 2.15 P.M.).WEDNESDAY (2nd).-St. Bartholomew’s (1.30 P.M.), University College

(2 P.M.), Royal Free (2 P.M.), Middlesex (1.30 P.M.), Charing Cross(3 P.M.), St. Thomas’s (2 P.M.), London (2 P.M.), King’s College(2 P.M.), St. George’s (Ophthalmic, 1 P.M.), St. Mary’s (2 P.M.),National Orthopaedic (10 A.M.), St. Peter’s (2 P.M.), Samaritan9.30 A.M. and 2.30 P.M.), Gt. Northern Central (2.30 P.M.), West-minster (2 P.M.), Metropolitan (2.30 P.M.), London Throat (9.30 A.M.),Cancer (2 P.M.), Throat, Golden-square (9.30 A.M.), Guy’s (1.30 P.M.),Royal Ear (2 P.M.), Royal Orthopaedic (3 P.M.), Children, Gt.Ormond-street (9.30 A.M., Dental, 2 P.M.).

THURSDAY (3rd).-St. Bartholomew’s (1.30 P.M.), St. Thomas’s(3.30 P.M.), University College (2 P.M.), Charing Cross (3 P.M.), St.George’s (1 P.M.), London (2 P.M.), King’s College (2 P.M.), Middlesex(1.30 P.M.), St. Mary’s (2.30 P.M.), Soho-square (2 P.M.), North-WestLondon (2 P.M.), Gt. Northern Central (Gynaecological, 2.30 P.M.),Metropolitan (2.30 P.M.), London Throat (9.30 A.M.), Samaritan(9.30 A.M. and 2.30 P.M.), Throat, Golden-square (9.30 A.M.), Guy’s(1.30 P.M.), Royal Orthopaedic (9 A.M.), Royal Ear (2 P.M.), Children,Gt. Ormond-street (2.30 P.M.).

FRIDAY (4th).-London (2 P.M.), St. Bartholomew’s (1.30 P.M.), St.Thomas’s (3.30 P.M.), Guy’s (1.30 P.M.), Middlesex (1.30 P.M.), CharingCross (3 P.M.), St. George’s (1 P.M.), King’s College (2 P.M.), St. Mary’s(2 P.M.), Ophthalmic (10 A.M.), Cancer (2 P.M.), Chelsea (2 P.M.), Gt.Northern Central (2.30 P.M.), West London (2.30 P.M.), LondonThroat (9.30 A.M.), Samaritan (9.30 A.M. and 2.30 P.M.), Throat,Golden-square (9.30 A.M.), City Orthopaedic (2.30 P.M.), Soho-square(2 P.M.) Central London Throat and Ear (2 P.M.), Children, Gt.Ormond-street (9 A.M., Aural, 2 P.M.), St. Mark’s (2.30 P.M.).

SATURDAY (5th).-Royal Free (9 A.M.), London (2 P.M.), Middlesex(1.30 P.M.), St. Thomas’s (2 P.M.), University College (9.15 A.M.),Charing Cross (2 P.M.), St. George’s (1 P.M.), St. Mary’s (10 P.M.),Throat, Golden-aquare (9.30 A.M.), Guy’s (1.30 P.M.), Children, Gt.Ormond-street (9.30 A.M.).

At the Royal Eye Hospital (2 P.M.), the Royal London Ophthalmic(10 A.M.), the Royal Westminster Ophthalmic (1.30 P.M.), and theCentral London Ophthalmic Hospitals operations are performed daily.

SOCIETIES.TUESDAY (1st).-PATHOLOGICAL SOCIETY OF LONDON (St. Bartholo-

mew’s Hospital).-5 P.M. Prof. Klein : (1) Bacillus Equi; (2) Con-veyance of Plague by Feeding.-Mr. F. A. Rose: Carcino sarcoma ofLarynx.-Dr. Andrewes and Dr. Horder: Classification of Pathogenic

Streptococci.WEDNESDAY (2nd).-OBSTETRICAL SOCIETY OF LONDON (20, Hanover-

square, W.)--8 P.lII. Specimens will be shown by Dr. Lewers, Dr.McCann, Dr. Tate, and Dr. J. 1. Parsons. Short Communication :-Dr. Lewers : Three Cases of Epithelioma of the Vulva with Historysubsequent to Operation. Paper :-Dr. Herman: A Case showing(1) Uterine Contraction without Retraction; (2) Prolonged HighTemperature of Nervous Origin.