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in the journev back to the surgeons and hospitals.Larrey saw that this delay meant death to many.Using as his pattern the light guns or artillerie volante,he devised amb1tlallces volantes, small wagons withlarge springs and stuffed mattresses, drawn by twohorses (for two lying patients or four sitting) or

four horses (four lying or eight sitting). These couldcome up to the firing-line, and even accompanycavalry, and they carried medical staff and dressingstwo the line. The wounded were now collected, dressed,.and taken at once in ambulances to the surgeon atwhat we would call the main dressing station ; theywere operated on very early, and then conveyed.quickly to hospitals three to ten miles in the rear,where they were all in bed within 24 hours, even afterthe great battle of Austerlitz. There was less suffering,he discovered, in rapid evacuation than in confine-ment in crowded hospitals. Larrey also improvedtreatment, recommending that the skin round woundsshould be kept very clean, that salt and chlorinated,soda solutions should be used instead of ointmentsin the treatment of wounds, and that dressings shouldbe done as rarely as possible. His chief insistencewas on the urgency of amputation where it wasrequired, and it is now clear why this promptnesswould prevent tetanus, as he asserted. Resections, heconsidered, should be done instead of amputationswherever possible. He found blood-letting uniformlydisastrous, and blisters of no avail-the raw surface,moreover, being liable to moist gangrene-and insisted,Hippocrates notwithstanding, that wounded menrequire a generous diet. Larrey was much beloved by’the soldiers, and treated French and enemy wounded.equally ; it is said that this practice saved him whenhe was captured by the Germans after Waterloo,and sentenced to be shot. Recognised by a

German doctor, he was taken to headquarters andreleased by Blucher whose wounded son he once hadsaved. After Austerlitz Napoleon had made himBaron Larrey, giving him a pension of <B300 a year,and after Waterloo he continued to be much respected,being made surgeon of the Royal Guard and havinghis pension restored. When he visited London in1826 he was cordially received by the English medicalprofession. At the age of 7C) he inspected the Frenchhospitals in Algeria, but contracted pneumonia onhis return to France, and died at Lyons in 1842. Hewas buried in Pere la Chaise in Paris, and his name ison the Arc de Tricmphe. Napoleon, in his will, lefthim 100,000 francs, as " the most virtuous man I haveever known," and in French, as Captain Edgar pointsout, the word " virtuous " means more than inEnglish, for it conveys the idea of bravery and utilityto the State. In the old days Baron Larrey used to bequoted as proof that France recognised more generouslythan England the services of her doctors, but he hada specially great opportunity and used it magnificently.

THE GARDENS OF MADEIRA.1

an interesting little publication, Dr. MichaelGrabham assumes the mentality of the British touristas receptive and intelligent even if uninstructed, andproceeds in friendly vein to identify for him the moreprominent features in the Madeira flora, if with specialreference to gardens still with wide notice of generalbotany. The book is certainly an invitation at thisperiod of the year, for those who can accomplish suchcharming plans, to sojourn in Madeira round aboutChristmas time. When shortening days here givea foreboding of the approach of winter many whoknow the rigors ahead, with which they can cope onlymiserably. will feel tempted to resort to an islandwhere " Spring is perpetual and Summer occur-s inalien months.’’ Dr. Grabham reminds those in chargeof such patients that the transit from winter tosummer conditions can now be made with complete

1 The Garden Interests of Madeira. By Michael ComportGrabham, M.D., LL.D., Fellow of the Royal College of Physicians.London : Printed by William Clowes and Sons, Limited.1926. 5s.

comfort in less than three and a half days, and welearn that the visitor arriving at Christmas will findflowers which we associate with spring and earlysummer blooming in full profusion and occurringpromiscuously with the numerous conspicuous andfragrant plants indigenous to Madeira, which in thiscountry decorate glass-houses or make but a transientappearance in the open. Mid-winter vegetables con-tinue their autumnal yield through December andJanuary, and green peas and cauliflowers have becomeabundant. Speaking from the botanical point of view,he notices that in general character the flora of Madeiraconfirms the rule relating to an insular collection,showing many orders with one genus only, and generawith a solitary species. Analysis of the comprehensiveflora of the island has been due to the descriptive andidentifying work of British botanists, and a commenton the profusion of specimens as well as upon the easycircumstances of growth and reproduction is furnishedby a semi-apologetic phrase in which Dr. Grabhamconfesses that his plan for taking the garden flowersin monthly sequence has been baffled by " theexercise of a perverse exuberance in the genera, anda tendency to transgress all limits and break forthanew in unseasonable revivals."

CHINA MEDICAL ASSOCIATION.

IN spite of the political situation the China MedicalAssociation held its eighteenth Biennial Conferenceat the beginning of this month in Peking. Since thelast of these conferences the Association has droppedthe word " Missionary " from its title so as to becomemore representative of medical interests in China, andthe broadened basis has brought an increase of member-ship. Those who administer its affairs are doing goodwork under considerable difficulties, and during thepast year or so these have been increased by theenforced invaliding from China of the President andVice-President of the Association and the Editor ofits journal. Missionaries seldom have large financialresources and the Association is without any endow-ment fund. It would hardly have been possible tocarry on the work at all but for assistance from theChina Medical Board of the Rockefeller Foundation,which during the past five years has contributed25,000 dollars towards its expenses. Unfortunately,the period of this grant now comes to an end, but thesuccessful record of the Association’s work shouldstrongly recommend renewal of the subsidy. Eventhe precis of papers read at the Conference make itobvious that really valuable work is being done invarious parts of China by members of the Association,and the programme shows that they have an efficientorganisation; the China -3-ledical Journal, whichrecords their research and opinions, has becomefamiliar throughout the wonld. At the suggestionof the Association the various medical societiesof China have formed a joint council which is

working for public health, and the courageousway in which the immense sanitary problems of thatcountry are thus being faced makes it reasonable tohope for important if gradual reform.

ON SUSPICION OF RABIES.

OUR medico-legal correspondent on page 72,t tellsof a dog which was clubbed to death a fortnight agoat Balham on a suspicion of iabies and he querieswhether police otiicers are properly instructed to dealwith such an occasion. The larger question ariseswhether it is now reasonable for anyone in this countryto suspect an animal of having rabies. With theexception of Australia this infectious disorder ofanimals is to be found in all parts of the world,although, as we are reminded in the most recentmonograph 1 on the subject, the number of cases

1 Lyssa bei Mensch und Tier. By Prof. Dr. R. Kraus, Dr. med.vet. F. Gerlach. and Dr. F. Schweinburg. Berlin and Vienna:Urban and Schwarzenberg. Pp. 464. M.30.

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has greatly diminished in civilised countries in

comparison with earlier times when epidemics werefrequent. The Netherlands have, in fact, recentlybecome quite free. Great Britain in 1895 had to recordmore than 600 cases in 30 counties, and it was onlythe quarantine for which the late Lord Long was socruelly abused which rid us of an anxiety ever presentin countries where dogs and human beings live inclose proximity. From 1903 on Great Britain wasfree from rabies, and the relief would have remainedcomplete had it not been for the thoughtless or

criminal evasion of quarantine regulations by thosewho reached this island by sea or air. In 1918, asthe result of an outbreak in Devon and Cornwall,introduced by aeroplanes reaching Plymouth, 30persons were bitten by dogs ascertained to be rabid,and in the following two years 150 cases were notifiedfrom 14 counties and 33 from 9 counties, so that theMinistry of Health felt itself obliged to set up anumber of centres at which Pasteur treatment couldbe initiated without delay. In the House of Commonsat that time Sir A. Griffith-Boscawen remarked thatdogs suffering from rabies had been known to wandergreat distances from their homes, although the farthestrecent excursion was one of 50 miles. The incubationperiod in one case was as long as seven and a halfmonths, although the disease did not occur in anydog following release from its six-month quarantine,and the Ministry of Agriculture then and since wassatisfied that existing regulations are adequate.Happily, since 1921 this country has remained com-pletely free from imported rabies, and while thesmuggling of dogs must still be regarded as a con-ceivable possibility, the risk of reintroduction of thedisease should be very small indeed.

WHAT IS A SAUSAGE?

THE answer of the Edinburgh city analyst, Mr.A. Scott Dodd, to this conundrum is " a bag of

mystery." In examining 50 samples of sausagesmade in various parts of the country Mr. Dodd foundthat the moisture varied from 31-2 to 58-2 per cent. ;the fat from 7-0 to 42-9 per cent. ; the starch, flavour-ing, &c., from 5-3 to 33-7 per cent. ; the proteids from5-6 to 12-9 per cent., and the meat from 29-6 to80 per cent. During the meatless days of 1918

sausages were included in the Meat Rationing Order asmeat, and the minimum quantity of meat was fixedat 67 per cent. for first quality and 50 per cent. forsecond quality sausages. Even in this Order,which has now been revoked, no distinction was madebetween fat and lean meat. In view of the possibilityof sausages being made mainly of fat and "starchfiller," Mr. Dodd thinks it would be advisable to limitthe permissible proportion of fat. It would beimpossible to determine accurately the proportion ofliver, gristle, &c., but the proportion of nutritiousfat-free meat may be satisfactorily deduced from thepercentage of proteid nitrogen present, as gristle doesnot contain much nitrogen. As the result of hisexperience Mr. Dodd suggests the following standards :(1) sausages to be of two grades only ; (2) first-gradesausages (to be indicated by a band and con-

spicuously labelled) to contain not less than 67 percent. of meat, second grade not less than 50 per cent. ;(3) fat to be included as meat but not to exceed halfthe total meat present.

Dr. Charles J. Martin (Director of the ListerInstitute and Professor of Experimental Pathologyin the University of London) and Sir Frederick G.Hopkins (Professor of Biochemistry in the Universityof Cambridge) have been appointed members of theMedical Research Council to fill the vacancies causedrespectively by the death of the late Lieut.-GeneralSir William B. Leishman and by the retirement ofProf. T. R. Elliott. ____

ALTHOUGH arrangements for the coming sessionof the Royal Society of Medicine are not yet complete,there is every indication that it will be very successful.

Besides the ordinary meetings of the sections therewill be one special discussion on Blood-letting by thethe Society as a whole, and ten discussions heldjointly by two or more sections. The first socialevening will be held on Monday, Oct. 18th, when theguests will be received by the President, Sir JamesBerry, and Lady Berry, at 8.30 P.M., and at 9.30 P.M.Sir Arthur Keith will give a short address entitledJohn Bull: a Study in Anthropology, with lanternillustrations. It has been found necessary to makea rule that guests at these receptions, unless accom-panied by a Fellow, Member, or an Associate of theSociety, will need an invitation card ; this may beobtained by Fellows, Members, or Associates on applica-tion to the Secretary of the Society. The annualdinner has been arranged for Thursday, Nov. 18th,at 8 P.M., at the Hotel Victoria, Northumberland-avenue. The Prime Minister has consented to bethe Society’s guest of honour if his duties permit.

The Services.ROYAL NAVAL VOLUNTEER RESERVE.

proby. Surg. Lts. H. M. Petty, F. M. B. Allen, and E. E.Henderson to be Surg. Lts.

ROYAL ARMY MEDICAL CORPS.Col. E. T. Inkson retires on ret. pay.Lt.-Col. C. C. Cumming to be Col., vice Col. E. T. Inkson,

to ret. pay.Maj. H. Harding to be Lt.-Col., vice Lt.-Col. C. C.

Cumming.The undermentioned Capts. to be Majs. : W. Bird (Prov.),

A. C. Jebb, J. B. Minch, T. I. Dunn, C. Popham, A. J. O’B.O’Hanlon, W. G. Shakespeare (Prov.), 0. C. Link (Prov.),E. E. Holden (Prov.), W. Campbell, W. H. Cornelius, R,. G.Martyn (Prov.), N. Cameron (Prov.), C. F. Burton, S. D.Robertson, and R. H. Hodges (Prov.).

ROYAL ARMY RESERVE OF OFFICERS.

Lt.-Col. C. F. Wanhill, having attained the age limit ofliability to recall, ceases to belong to the Res. of Off.

MILITIA.

Maj. R. Magill retires on reaching the age limit.

TERRITORIAL ARMY.

Capt. H. P. Gabb, from Active List, to be Capt.Capt. J. S. Cooper having attained the age limit, is retd.

and retains his rank.Lt. C. C. Taffs is seed. under para. 137 T.A. Regulations.W. H. M. Jones to be Lt.

ROYAL AIR FORCE.

Flying Officer D. Magrath is transferred to the Reserve,Class D.2.

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INDIAN MEDICAL SERVICE.

Maj. C. R. O’Brien to be Lt.-Col.Ephraim Benjamin to be Temp. Lt.The King has approved the retirement of Lt.-Col. Padmakar

Krishna Chitale.

Summer Time, which commenced on AprillRth, willcease on Sunday next, Oct. 3rd, at 3 A.M., when the clockwill be put back to 2 A.M. The hour 2-3 A.M. summer timewill thus be followed by the hour 2-3 A.M. Greenwich time.

KING EDWARD’S FUND.&mdash;This great Fund’stwenty-ninth annual report, which has just been issued,shows that the income for the last financial year was&pound;413,872, and the expenses 312,420. The receipts included&pound;50,000 from the estate of the late Mrs. John Wells, and&pound;85,000 from that of the late Lord Mount Stephen. Theunexpended balance was placed to the Funds and CapitalAccounts. Since the establishment of the Fund in 1897the receipts have amounted to &pound;8,846,357. Of this totalthe British Red Cross Society and the Order of St. John ofJerusalem have contributed &pound;259,000, the Combined Appealproduced &pound;395,000, and &pound;383,000 has been provided by theLeague of Mercy. The distributions to hospitals, con-

valescent homes, and sanatoria for consumption come to&pound;5,263,000, and the working expenses are less than 3d.;n every pound received.