47

from pauperism." I suggest that that statementis merely a playing with words without referenceto the ideas which they represent. What our fatherscalled pauperism has now been relabelled publicassistance, and presumably in the future as in thepast sickness will be one of the principal reasons whypeople need to apply for public assistance. Some

people think to have reformed the poor-law bygiving to outdoor relief the new label of domiciliaryrelief, it is equally ineffective to relabel the formerpoor-law sick wards as public health hospitals whilekeeping the same doctors, the same nurses, the samediseases, and the same buildings.

I am, Sir, yours faithfully,Cambridge, June 25th, 1933. W. D. BUSHELL.

A FOREIGN BODY IN THE HAND

To the Editor of THE LANCETSIR,-A woman, aged 67, was recently admitted to

the out-patient department of St. Mary’s Hospitalwith an injury to the right hand. A radiographicexamination, besides showing an oblique fracture ofthe fifth metacarpal, also demonstrated the presenceof a portion of needle 1 inch long, lying in the depthsof the fourth intermetacarpal space. On beingquestioned concerning this foreign body the patientremembered well having run a needle into her hand,and as there had been at the time some discussionas to whether it should be removed or not, she wasable to fix the date exactly-viz., 1883-50 yearsago. During the whole of that period she had had

. no single symptom referable to the presence of theneedle in her hand.The moral to be drawn from this case seems to be

the avoidance of the many useless and often mutilatingoperations performed (especially on the hands andfeet) in the search for foreign bodies which, in mostcases, can be safely left to look after themselves.Unless a foreign body is either so accessible as to beremoved with ease, or so placed that it gives obvioussymptoms, a search for it would seem to be bothunwise from the surgeon’s point of view, and unneces-sary from the patient’s.

I should like to thank Mr. C. W. Gordon Bryan,on whose behalf I saw this case, for permission topublish this note.-I am, Sir, yours faithfully,

ARTHUR E. PORRITT,Surgical Registrar.

St. Mary’s Hospital, W.2, June 26th, 1’933. ".,a...",,..,.

SWIMMING BATH DANGERS

To the Editor of THE LANCETSiR,-The leading article in your issue of June 17th

concerning the observations and recommendationsof the American workers, Mallmann and Cary, withregard to the bacteriological examination of swimmingbath waters, includes the following statement :-

" The contention of the authors, that the routine methodsof examination of swimming-pool water treated withchlorine, chloramine, or any similar bactericidal substancemay give an entirely false sense of security, would seemto be clearly established ; and their recommendation thatthe source of error they have indicated should be removedby neutralising the free chlorine with sodium thiosulphatewhen the sample is collected-since routine testing atthe bath side is obviously impossible-merits seriousconsideration." "

We entirely agree with this, but would point outthat this source of error has for years been recognisedand eliminated in the aboye-mentioned manner byourselves and other bacteriologists engaged in Britishwaterworks practice, and reference is made to thismatter in the fourth edition of the " Examinationof Waters and Water Supplies " (p. 691). Since so

many drinking-water supplies are to-day treated bychlorination or its modifications, it is equallyimportant to observe the same precautions in thesecases also.-We are, Sir, yours faithfully,

T .r..TT...-r"’lJ1 1 t r mJOHN F. BEALE,E. V. SUCKLING.

The Counties Public Health Laboratories, QueenVictoria-street, London, E.C., June 22nd, 1933.

INTESTINAL TUBERCULOSIS

To the Editor of THE LANCETSIR,-I hope that Dr. McLaughlin’s interesting

paper in your issue of June 24th will stimulatefurther inquiry into the early diagnosis and treat-ment of intestinal tuberculosis. X ray examinationafter a barium meal has certainly facilitated the

diagnosis, but physical signs and symptoms are, inmy opinion, of still greater importance. Fishberg("Pulmonary Tuberculosis," p. 158) goes so far asto say that with autopsy control X rays only givea correct diagnosis in 50 per cent of cases, whereaswith clinical observation 75 per cent is the figurereached. I can fully endorse Dr. McLaughlin’sstatement that when taken early and properly treated,intestinal tuberculosis has a moderately good prognosis.I have so far been disappointed with cod-liver oiland tomato juice, possibly because the patientstreated were already on a diet unusually rich in freshvegetable produce and animal fat. Light treatmentI have found useful in raising the general healthin a considerable proportion of cases, but in othersminimal doses cannot be exceeded without the

production of unfavourable symptoms and thetreatment is best abandoned. Light is much moreuseful in peritoneal than in intestinal tuberculosis.As regards other remedies, I think the main pointto have constantly in one’s mind is that a tuberculousintestine, like any other organ affected by the disease,requires rest. Foods containing much fibrous residueshould be avoided as liable to irritate the wall ofthe bowel ; similarly if milk, peas, or beans causeflatulent distension they must be excluded. Intra-venous injections of calcium chloride, which mustbe given for a period of many months, I have foundof great value ; I believe they act by reducing theirritability of the smooth muscle of the intestinalwall, and thus providing rest to the affected part.Most important of all, so long as active symptomsare present and for some time afterwards, the patientshould be rested strictly. Infection of the bowel byswallowed sputum and continued irritation by thesame means may often be prevented by the timelyuse of artificial pneumothorax, especially when acavity is present.-I am, Sir, yours faithfully,

ANDREW MORLAND.

The Mundesley Sanatorium, Norfolk, June 27th, 1933.

PERSONS AND SITUATIONS

To the Editor of THE LANCETSiR,-When reading an examination paper lately

I came across the following sentence : " Sulphonalis very useful in cases of insomnia in which the case(may italics) after sleeping soundly until about 4 A.M.,&c." This strikes me as a choice example of thattendency to confuse " case " and " patient " whichis becoming so frequent in medical writings, and Ithink you would be doing a service by using yourinfluence to check it.-I am, Sir, yours faithfully,

Devonshire-place, W., June 24th. ROBT. HUTCHISON.

***It is not only flurried examinees who thusmisuse English ; the error is corrected weekly inimportant contributions to our columns, and some-times wins its way into print by persistence.-ED. L

48

Perspective drawing of the new buildings viewed from Montague Place, looking northwards along Malet Street

LONDON’S UNIVERSITY

" A NOBLE ENTERPRISE "

IF, as has been aptly said, the design of London’suniversity resembles that of a battleship, the founda-tion of its embodiment in stone by His Majestythe King on June 26th was as inspiring a ceremonyas the launching of a big ship. It providedoccasion for a display of robes and hoods at least asrich in texture and colour as the flags of the manynations whose learned bodies sent delegates ; andthe order of proceedings was so planned that whiledecorum was in nowise sacrificed, the decorativevalue of academic panoply was exploited to providea pageant that will not soon be forgotten by thoseprivileged to witness it. Stands, erected on silveredmetal, provided seats for 3000 persons on a plot ofground just opposite the ceremonial dais. Thesestands seemed nearly full an hour before the Kingand Queen were expected ; but when the processionof professors and readers in the various faculties,led by their respective deans, reached the stands aftercircling the arena, they found places each next tohis guest. A second procession consisted of theofficial staff of the University; the standing com-mittee of convocation ; the senate ; the court;the representatives of sister universities abroad ;the chancellors, vice-chancellors, and principals ofuniversities and university colleges in Great Britainand Ireland ; the leaders of London civic life ; andfinally, the principal officers of the University.Lord Athlone, as its chancellor, and CouncillorFred Howard, mayor of Holborn, received the Kingand Queen, with whom was Lord Irwin, presidentof the Board of Education, and presented to themProf. L. N. G. Filon, vice-chancellor of the University ;Mr. S. L. Loney, chairman of convocation ; LordMacmillan, chairman of the university court ; SirErnest Graham-Little, M.P., chairman of the externalcouncil; and Mr. Edwin Deller, Ll.D., principal ofthe University.

In the course of his address the Chancellor spokeof the abiding faith in the great future of the Universityheld by those who had watched her achievementsin the past. " During her span of life," he said," she has sailed majestically through stormy seas

and calm waters as all ships must do that travel agreat distance, and is now riding triumphantlyon the wave of success and progress. The students

in her colleges and under the direction of her teachersnumber over 12,000 and the numbers of externalstudents are not less." The University had strivento fulfil the great purpose ordained in her charter" to hold forth to all classes, without any distinctionwhatsoever, an encouragement for pursuing a regularand liberal course of education." But she hadnever till now possessed a home of her own, suitedto her special needs and worthy in spirit and in formof the great city whose name she bears. .

The King, in reply, said that the University, ofwhich the Queen and he were proud to be honorarygraduates, had now completed a century of

distinguished and honoured life, and that all would

rejoice to see the beginning of a finely plannedgroup of buildings which would serve as headquartersfor her far-reaching work and influence. Hecontinued :

" I count it of good omen that in these difficult timeswe have the opportunity of showing an unshaken faithin the inestimable benefits of knowledge and education.No less auspicious is the alliance in this good cause betweenfriends of education in the Old World and the New. TheRockefeller Foundation, our own Government, the citizensof London in corporate and in private capacities all sharein a memorable achievement.

" In addition to the chancellors of British universities,we welcome here to-day representatives of foreign anddominion universities and of learned societies, whosepresence lends a special interest to the proceedings.

"

Bloomsbury has long been a centre of learning, andit is appropriate that we should inaugurate here, on thisgreat site, a stately plan of buildings worthy of Londonand of her University. I hope that this noble enterprise,which has begun so well, may attain an early andtriumphant completion."

The Archbishop of Canterbury then offered a

prayer and the whole assembly sang a hymn.The King crossed the dais to the great stone,

which was suspended over a block of granite, whererepresentatives of the Students’ Union were presentedto him. In a cavity in the granite was placed a

casket containing documents pertaining to theoccasion and coins minted in 1933 ; and using trowel,mortar, spirit level, and mallet the King, with theguidance of Mr. Charles Holden, the architect, Mr.George Burt, representing the contractors, and fourworkmen, laid the foundation-stone and declaredit to be well and truly laid. A fanfare of trumpetssounded, further presentations were made, and havingsigned the visitor’s book of the University, the