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Reviews and Notices of Books.PRACTICE OF MEDICINE.

Edited by FREDERICK TICrJ. M.D., Professor ofMedicine and Clinical Medicine, and Head of theDepartment of Medicine, University of Illinois,College of Medicine. Ten Volumes and DeskIndex, each volume about 600 pp. London:Butterworth and Co.; Hagerston, Maryland:W. F. Prior Co. 1924..821.POSSESSORS of this new system of medicine may, by

subscribing jEl 15.<. per annum, receive sets of new pagesevery year, and in this manner it is hoped that thesystem, which is bound in leather on the loose-leafprinciple, may be kept perpetually up to date. Thework is entirely American, and is issued under the chiefeditorship of Dr. Frederick Tice, Professor of Medicineto the University of Illinois. Assisting him are

Dr. Julius Friedenwald, of the University of Maryland,Dr. Julius Grinker of the Northwestern UniversityMedical School, and Dr. Luther F. Warren, of theLong Island College Hospital, who are concerned withediting the articles dealing with gaatro-enterology,neurology, and general medicine. More than 100contributors are responsible for the text, their namesincluding those of Walter C. Alvarez, F. H. Baetjer,Lewellys Barker, Nathan E. Brill, Thomas RichardsonBrown, B. B. Crohn, Charles Lyman Greene, B. B.Vincent Lyon, C. E. de M. Sajous, and many othersfamiliar to British readers. The first volume containsfive chapters devoted to the history of medicine,after which come chapters on

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hypersensitiveness,"infection and immunity, focal infections, oral sepsis,the analysis of urine and cerebro-spinal fluid, and case-history taking. Following this somewhat disorderlybeginning the second volume takes us to a sectionwherein the tests of functional efficiency of stomach,pancreas, liver, circulatory system, endocrine glands,and kidneys are discussed in detail. Thenceforwardthe work proceeds on more familiar lines, specific and ’

tropical infections being completed by the middle of Ithe fifth volume, after which diseases of the variousorgans are dealt with systematically. The eighthvolume is devoted to diseases due to intoxications andthose of the endocrine glands, whilst Vols. IX. and X.are almost wholly confined to the nervous system.A general survey of this work leads to an impression

that the general editing leaves much to be desired.The extraordinary assortment of subjects in thecommencing volume is particularly open to criticism.On what grounds was it decided to lay such stress onallergy as a general factor in pathology ? Why isfocal infection brought into such vivid prominence,with emphasis on the work of several observers whoseinteresting publications still await any convincingmeasure of confirmation ? And why is the historyof medicine included in a work whose voluminouspages still find no place for diseases of the skin ?These things seem to us to betray a distorted perspec-tive which robs the work of much of the value itshould possess. The inclusion of detailed descriptionsof methods of studying the functional efficiency ofvarious organs is certainly defensible, and it maybe noted that the various authors have in some

cases devoted considerable space to full descrip-tions of methods which they afterwards condemn ;since their condemnation is reasoned, and full referencesare given with each article, this section should be ofconsiderable value to those physicians who appreciatethe value of help from the laboratories. In principle,however, it is not easy to see why chemical laboratorymethods should be quoted in full when equally expertmatters such as bacteriological methods are treatedquite briefly. No serious attempt is made to dealsystematically with the general pathogenic effectsof various important organisms such as the pneumo-coccus, the streptococcus, or the Bacillus coli communis,save in a chapter on certain septicaemias. As a resultthe reader who desires to ascertain, for example, an

author’s views on infections due to Friedlander’sbacillus, may find himself in difficulties. The indexgives no help in this respect, nor can any referenceto the subject be traced throughout the work exceptin a chapter on broncho-pneumonia, where it is statedthat this disease is sometimes caused by Gram-negative cocci ! When we say that this chapter issandwiched between one on tuberculosis of the genito-urinary system and the one on the septicaemias alreadyalluded to, the reader will realise that the generalarrangement may waste the would-be reader’s time.

The index is unworthy of the labour spent incompiling these volumes. Each of these is broughtto a conclusion by a page which urges the reader

to consult the special desk index which is boundseparately. This index is itself introduced by a

somewhat unctuous page of advice to the reader, whoon seeking to make use of the vaunted volume maybe gravely embarrassed. For example, no reference isgiven to coeliac disease ; under cirrhosis of the liverwe find no mention of progressive lenticular dpgenera-tion, and as that disease is described and indexed as" Wilson’s disease," a reader unfamiliar with thattitle would have difficulty in tracing it. Anotherrare but well-recognised nervous disease, amauroticfamily idiocy, is completely omitted from the index,though a sufficient description of it may be foundon p. 198 of Vol. X. Other omissions couldbe cited which are inexcusable in an index whichgives heavy-type references to chappara amargoso,cholamin, krameria, speidel salts, pomegranate root,papain, kamala, and other somewhat obscure nostra.The fact that under Milroy’s disease this index givesno fewer than 26 references, all referring to the threepages in a single volume where that disease is dealtwith, conveys a good idea of how stupidly this partof the work has been performed.We have devoted much space to discussing the

arrangement and indexing of this system of medicinebecause it is upon these factors that its general utilitymust largely depend ; of that part of the text whichdeals with the major descriptions of the variousdiseases, their clinical features, diagnosis, and treat-ment we have far more pleasant things to say. Manyof the articles are excellent. Special tribute is dueto Dr. Herman 0. Mosenthal for his excellent treatiseon diabetes mellitus ; and the thorough study of

hepatic diseases by Drs. John Ferguson and W. E.Ferguson, and the chief editor’s article on pericarditisare admirable. Most of the articles are followed bya bibliography, which even when incomplete is a

valuable feature. If the scheme of issuing newpages yearly is carried out with thoroughness, and ifproper care is given to the revision of the index, thepublication of this ambitious work will have beenamply justified, for a full index will meet many of thedifficulties in locating information.

THE LEUCOCYTE IN HEALTH AND DISEASE.

By C. J. BOND, C.M.G., F.R.C.S., Fellow ofUniversity College, London; Hon. ConsultingSurgeon to the Leicester Royal Infirmary ; Memberof the Cancer Committee, Ministry of Health.London : H. K. Lewis and Co., Ltd. 1921.Pp. 83. 12s. 6d.THE author records the results of a number of

experiments upon the reaction of the leucocytes toartificially induced changes in their environment.Many of these observations are of interest, as, forinstance, the author’s clear demonstration of thereturn of exuded leucocytes into the granulation tissueof a wound surface. Dr. Bond apparently believesthat some change in the activity of these cells isbrought about by their sojourn in the " liquor puris."On the basis of certain other experiments withincubated blood-clot he claims to be able to renderthe polymorphs actively phagocytic of red cells.both homologous and heterologous, and this leadshim to the conclusion that substances toxic to leuco-cytes, when present in excess, may in higher dilutionsact as opsonins. In the absence of evidence in the

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shape of protocols, either of experiments or controls,it is impossible to judge of the validity of theseconclusions. Of many of the other observations it isdifficult to understand the purpose, a difficulty whichis enhanced by the author’s somewhat inconsecutiveand disjointed manner of presenting his facts. Itis an index to the highly specialised nature of hisresearches that of the 33 references given 14 are toDr. Bond’s own works. The book concludes with48 half-page microphotographs showing leucocytes,mostly in obviously indifferent health as the resultof the author’s attentions.

COLLECTED PAPERS.

Collected Papers, Physiological Laboratory, King’sCollege, London. No. XVII. Edited by W. D.ELMBURTON, M.D., LL.D., F.R.C.P., F.R.S.1923-1924.THE present collection of papers will be the last to

appear from the Physiological Laboratories of King’sCollege Hospital under the editorship of Prof.Halliburton. That it need represent the editor’s actualfarewell to physiology there is fortunately no reasonto anticipate. Of the 24 papers dealing with originalresearch comprised in the collection, only two-oneon the Appendages of the Brain, and a second shortnote on the Formation of a Reversible Clot by theAction of Pancreatic Juice on Milk-are from his ownpen, but all bear the marks of his inspiration. Thepapers fall into several groups, of which the largestare those constituted by the publications of C. A. daFano, on histological subjects, and by Dr. J. W.Pickering in collaboration with other members of thelaboratory staff, on various points in connexion withthe coagulation of the blood. Of Dr. da Fano’s paperssome deal with the Golgi apparatus of the cell, somewith the histology of epidemic encephalitis withparticular reference to the " minute " bodies firstdescribed by this observer, and some with the histo-logical changes to be observed in the central andsympathetic nervous systems in the " deficiency "diseases. Dr. Pickering has brought to light manypoints of interest in connexion with the coagulationof the blood. Among other things he has been able todemonstrate that the anti-coagulant action of peptoneon intravenous injection cannot be due, as in the viewof Howell, to the production of antithrombin by theliver, for it occurs even when that organ is shut outof the circulation. He believes that neither " throm-bin " nor " antithrombin " has anv existence as

an entity, and that coagulation of the blood dependsupon the disturbance of a system formed by a pro-tective colloid united to a fibrinogen-prothrombincomplex. Dr. J. A. Hewitt, who also writes as oneof Dr. Pickering’s collaborators, contributes twopapers dealing with the metabolism of the carbo-hydrates-one a destructive criticism of recent workon the relationship of the production of y from a anda glucose to diabetes, and one on the absorption ofvarious sugars from the gut. Dr. J. A. Shaw- z,Mackenzie has papers upon his serum reaction forthe diagnosis of carcinoma and upon the treatmentof inoperable carcinoma by the intravenous injectionof sodium oleate.

BIOCHEMISTRY.Monographs of Biochemistry. Edited by Prof.R. H. A. PLIMMER and Prof. F. G. HopKiNs.The Simple Carbohydrates and the Glucosides.Fourth edition. By E. FRANKLAND ARMSTRONG,D.Sc., Ph.D., F.R.S., F.I.C., Fellow of the Cityand Guilds of London Institute. London : -.Longmans, Green and Co. 1924. Pp. 293. 16s.IN the past Germany has been regarded as the home

of specialised scientific publications. Thus theBiochemisches H andlexikon and the PhysiologischeArbeitsmethoden, edited by Prof. Abderhalden, havebecome world-farrxous as collections of articles byspecialists. We should not be going too far, perhaps,to state that these German publications have onlytwo serious rivals-namely, the American Journal of

Physiological Reviews and the "Monographs ofBiochemistry." The latter, under the generaleditorship of Prof. Plimmer and Prof. Hopkins,have earned a well-deserved popularity in thiscountry, and many of the monographs have runto several editions. The volume under considera-tion has reached the fourth edition and has beengreatly enlarged. It contains a masterly summaryof the present state of knowledge on the simplecarbohydrates. An account of the recent work ofIrvine and his co-workers on the constitution of thepolysaccharides has been included; the chapteron the relations between configuration and biologicalaction has been rewritten, and special, but notperhaps sufficiently detailed, reference is made toinsulin. A very fine bibliography is added.We congratulate Prof. Armstrong on the new

edition, and strongly recommend it to the study ofbiochemists. &mdash;&mdash;&mdash;&mdash;

Practical Biochemistry. Second edition. ByW. A. OsBORNB and W. J. YourTG. Melbourne :W. Ramsay. 1924. Pp. 151. 12s. 6d.THE elementary class in practical biochemistry

for medical students always presents difficulties tothe teacher. In this country the class is composedof two types of men : candidates for universitydegrees with a certain amount of training in organicchemistry, and students for examination of theConjoint Board by whom very little knowledge ofthe subject has been acquired. The former classtreat the elementary biochemical tests with con-

tempt, since they have performed the majority ofthem before, whilst the latter are bewildered byeven the most simple organic problems. The existingEnglish books on practical work are of very littleassistance in overcoming these difficulties, since theyare either too chemical or contain soul-destroyingexperiments with bread, butter, and milk.The authors of the present volume are to be

congratulated in that they have balanced pure andbio-chemistry very evenly, with the result thatthe reading and experimental matter are of interestto all types of students. The biochemical significanceof all the reactions is emphasised, and futile experi-ments are not described. The section dealing withcarbohydrates is admirable ; for example, the explana-tion of the butylene oxide formula for glucose, as

here set out, must lose its terror, even for the mostelementary student. It is unfortunate that no

clinical blood estimations are included, but we mayexpect this in the promised companion volume onadvanced biochemistry.

HYGIENE AND PUBLIC HEALTH.Fifth edition. By BIRENDRANATH GHOSH,F.R.F.P.S. London : Simpkin, Marshall,Hamilton, Kent and Co., Ltd. ; Calcutta : Hiltonand Co. 1924. Pp. 586. 9s. 6d.THE fifth edition of this concisely written but

comprehensive text-book will be welcomed by studentsof sanitation in India and the tropics. Every chapterhas been carefully revised, and it has been foundnecessary to increase the size of the book by 79 pages.The experience of the war has altered many of ourideas on the subject of the purification of water, andthe chlorination of water is now dealt with in somedetail. Many of the lessons learnt during the war asto the disposal of refuse, the incineration of night-soil,and the use of improved types of latrines have alsobeen drawn upon. In the chapter on the disposalof sewage the activated sludge process is dealt with.We note, however, that the blowing-in of air isdescribed as a necessary feature of this new process,whereas experience in Sheffield and other places hasshown that the simpler and less expensive plan ofaerating the sewage by means of paddle-wheels givesequally good results. In the chapter on food, vitaminsare less fully treated than is usual nowadays. Littleattention is given to the use of dried milk. The opinionof most public health workers in the tropics is that

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dried milk especially prepared and packed for thetropics is almost an ideal way of meeting the manydifficulties involved in securing a satisfactory milk-supply in hot countries.The smoke nuisance receives little or no attention ;

we believe that some attempt has been made by theresponsible authorities to tackle the factory smokenuisance in Calcutta and other parts of India. Thechapters on vital statistics and maternity and childwelfare indicate the immensity of the problem. Forexample, the average infantile mortality-rate forCalcutta during recent years has been well over 300 per1000, and about 25,000 to 30,000 mothers in Bengaldie every year from causes connected with child-bearing. The chapters on the transmission of diseasesby insects and on animal parasites are especially good.A useful section on village sanitation and the sanita-tion of fairs and religious festivals conclude thebook. There are many new illustrations in thisedition.

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HOME SEWAGE DISPOSAL.

By W. A. HABDENBERGH, Sanitary Engineer andDirector of Rural Sanitation, Jefferson CountyBoard of Health, Alabama. London : J. B.Lippincott Company. 1924. Pp. 274. 16s.THIS book fulfils its object in supplying reliable

data for health officers and sanitary engineers engagedin solving sewage disposal problems for single homes,small communities, and institutions, and at the sametime lays down the principles imderlying suchproblems. The early chapters show the extent ofthe difficulties encountered in the U.S.A. The authorestimates that only 40 per cent. of the population,practically all living in cities, are provided with sewers,and that to the remainder, numbering some 65millions, the lessons of this book apply. He goes onto show that wherever, as the result of a survey,sanitary privies have been installed in place of ’unsanitary, a great reduction in the prevalence oftyphoid fever has followed. The importance of a Isanitary disposal of the body wastes in the prevention I

of diarrhoea, dysentery, and hook-worm disease (from iwhich disease two millions of the U.S.A. populationare said to be suffering) is also emphasised. Detailsare given of various types of closets and types ofseptic tank treatment which have proved satisfactoryin the U.S.A. The essentials laid down for any methodare that it must prevent : (1) the access of flies oranimals to the excreta ; (2) the scattering of excretaso as to cause soil pollution ; (3 the pollution ofdrinking water or ground water. The English readermay be surprised to find no mention of earth closets.There is certainly difficulty in inducing a rural popu-lation to take the trouble required for the propermanagement of earth closets, but, when this inertiacan be overcome, the earth closet, in the opinion ofmost medical officers of health confronted with theproblem in this country, is the best solution. It maybe that the prevalence of hook-worm disease rendersthe earth closet unsuitable for use in America.

DR. PORTEOUS.

By ARTHUR BREBNER. London : A. M. Philpot,Ltd. 1924. Pp. 260. 7s. 6d.Tms book is a thoroughly well written account of

the life of a general practitioner before the passageof the Insurance Act, and, as questions concerningthe vast medical side of this legislation are alwayswith us, and just now bid fair to be brought to thepolitical front, it deserves close perusal for otherreasons than its merits as a story. Those merits, itmay be said, are high, for it is a well-written and well-observed study of the doctor’s life at the end of thelast and the beginning of this century. The episodesare, no doubt, arranged for purposes of compositionand would not necessarily occur in the lives of manypractitioners, or in the same circumstances or in thesame order, but as episodes they are illustrative andoften poignant.

Certain lines of quotation, placed on the title-page,explain why the hero is found at the end of the bookto have deserted the calling of medicine : they are," let every man be artist of his days, and carve intohis life his own caprice." This motto dictates a

transfer of Dr. Porteous’s energies from generalmedical practice into the pursuit of art, where hiscareer is triumphant but hardly so close to the factsof life as are his experiences as medical student,assistant, and general practitioner. Indeed. hishistory as an artist cannot often have been paralleled,and medical men who employ their leisure in paintingneed not think that their talents can usually be putto such fruitful use. Certainly Dr. Porteous conductedhis art education in an effective manner, for duringhis career as a student he found time to sketch, tocopy, to study masterpieces in galleries, to secure

models among the porters at the hospital, and to copewith the theories of perspective. By chance he madesome water-colour drawings to illustrate a text-bookof dermatology by one of his chiefs, and as eventsturned out, this was a critical action in his life, forwhen, after many bitter experiences, failure as a

medical practitioner seemed to stare him in the facea substantial cheque for these drawings arrived, and,further, the eminent dermatologist, who had beenhis teacher, put him into touch with an amazing artagent who gave large cheques for pictures on theirmerits without regard to their market value or theirsignatures. This gentleman saw one of Dr. Porteous’scanvasses, immediately gave him 900 for it, andorganised an exhibition on the opening of which thecritics confirmed the great merit of the work. At whichpoint the book ends in the distinct promise that thehero will carry all before him in the world of art andlive happy and prosperous in the companionship ofthe devoted wife, who had supported him in histroubles.

Dr. Brebner, who died some ten years ago, hadalready two successful novels to his name when hewrote this posthumous work.

PICKETT-THOMSON RESEARCH LABORATORY.Annals of the Pickett-Thomson Research Laboratory.Vol. I., No. 1., July, 1924. Issued from St. Paul’sHospital, London, W.C. Pp. 216. 25s.

THIS handsome volume is prefaced by photographsof Sir Ronald Ross and Mr. Pickett, and three viewsof the interior of the laboratory, which appears to be’a very pleasant and well-equipped building. The majorpart of the Annals consists of three papers by Dr. DavidThomson, entitled Researches on the Virus of Variola-Vaccinia, Researches on the Etiology of Measles, andResearches on the Etiology of Scarlet Fever, whichoccupy about nine-tenths of the volume. These articlesare not reprints of papers published elsewhere, but arerather specially written essays. It should be mentionedat once that the researches chronicled are mainly thoseof workers outside these laboratories, which occupysome 123 pages whilst those of the author, excludingillustrations, only occupy 27 pages, a certain pro-portion of which is given up to discussions andconclusions. A good deal of Dr. Thomson’spersonal investigations are concerned with attemptsto grow the viruses of the exanthemata in a

large variety of media and in tissue cultures. Theresults in the first case are mainly negative, and inthe second are uncertain and inconclusive. Thus,whilst the review of literature is sound and full,and whilst this portion of the volume may beof assistance to those anxious to obtain a resumeof current and past ideas on the subject covered,the amount of original work is relatively insig-nificant. The conclusions arrived at, briefly sum-marised, are that the Guarnieri bodies of variolaare true parasites, and that as regards measles "thesuspicious organisms so far which deserve furtherinvestigation are the diplococcus of Tunnicliffe, thestreptococci, influenzoid bacilli, and the spirocha?teof Salimbeni." The streptococcus is favourablyregarded as the causal agent in scarlet fever. The

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papers are abundantly illustrated by some excel-lent photographs and coloured plates. Otherminor papers bear upon the value of

" detoxicated "vaccines in the complications of scarlet feverand in the tuberculin test in cattle, as wellas upon experiments on the various methodsof detoxication ; there is also a description ofcertain cultural characters of organisms of themeningococcus, gonococcus, and catarrhalis groups,and the distinctive appearances of types andstrains which, following Atkin, are utilised fortheir identification and grouping. The last paper,a clinical one in the main, contains an interestingdescription of cases of gas poisoning resultingfrom the breaking down of ammunition in thefactory of F. N. Pickett et fils. This comes withsomething of a shock in reviving almost forgottenmemories of matters which were so vividly in the fore-front of our preoccupations some eight or nineyears ago.

It is not easy to understand quite why the presentvolume has been written. If it is to be taken as apractical attempt to contribute to our knowledge ofdisease, as the title of the various papers suggests,it must be said that from the point of view of thelaboratory worker it does not succeed in this aim.

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MEDICAL INSURANCE PRACTICE.Second edition. By R. W. HARRIS and LEONARDSHOETEN SACK. London: The Scientific Press,Ltd. 1924. Pp. 347. 7s. 6d.A SECOND and revised edition of this useful little

book has appeared within two years of the first. Itis described by the authors, one of whom was formerlyassistant secretary in the Ministry of Health, and theother is a barrister-at-law, as a work of reference tothe medical benefit provisions of the National HealthInsurance Acts. The revised edition incorporates theamendments effected by the Regulations of 1924, anasterisk being placed against new or amended para-graphs in order to call the reader’s attention to pointson which he should refresh his memory. We havealready commended this book as indispensable to thepractitioner who wishes to give the best service to hisinsurance patients with the minimum of risk andinconvenience to himself, and we do so again.

JOURNALS.

BRITISH JOURNAL OF OPHTHALMOLOGY, August,1924.-F. A. Williamson-Noble describes an apparatusfor performing a retinoscopy on a patient withundilated pupil. The apparatus is fixed, and thedetermination of the shadow movement is effectednot by the tilting of the mirror, but by the movementby the observer of his own head.-C. H. Usher Icontributes a note on the Dog’s Tapetum in I_,early life. The tapetum is the structure that causesthe green or yellow reflex that is apparent on

illuminating the fundus of many animals. Usherby repeated examination has found that it is absentin young puppies up to about the seventh week of life,and that when it is first seen the appearance differsmarkedly from that seen in the adult animal.-G. F.Rochat and W. Mulder contribute a clinically impor-tant paper on Progressive Atrophy of the Iris withFormation of Holes and Glaucoma. It has generallybeen thought that atrophy of the iris is a conditionsecondary to disease of the eye, either glaucoma orcyclitis. A few cases, however, have been describedin which atrophy and formation of holes in the irishave existed without any apparent cause. Theauthors describe a case in which the condition was wellmarked and in which at first the eye was otherwisenormal in every respect. Some years later, however,it became blind from glaucoma. In this case therefore,the atrophy of the iris appears to have been theprimary disease.-H. J. Flieringa describes a case ofuniocular paralysis of accommodation in a girl of 10occurring after an affection of the throat which waspresumably diphtheritic and clearing up in theordinary way. A one-sided case of this sort is a rarity.

Public Health Services.REPORTS OF MEDICAL OFFICERS OF HEALTH.

THE following table gives some of the principalhealth statistics of seven boroughs during 1923 :-

Paisley.Dr. G. V. T. McMichael includes in his report a

drawing of the elevation, and also the plans, of theCentral Medical Institute for the mothers and childrenof Paisley, presented to the town by Miss Russell, ofMuirfield. The elevation shows a handsome buildingoccupying a corner site. On the ground floor are thetuberculosis department and the maternity and childwelfare department. On the first floor are the minorailment clinic and the special treatment clinic fordiseases of the eye, ear, nose, throat, &c., also themain office of the school medical department. On thesecond floor are the dental clinic, the orthopaedicdepartment, and an X ray department. The plansindicate a building excellently equipped for itspurpose. Dr. McMichael, in discussing the housingproblem, suggests that it will never be solved untilit is lifted right out of the domain of party politics,and a national policy formulated by experts agreedon by all parties. No one, he says, can honestlybe satisfied with the present environment of theworking classes, especially in our large industrial towns.

Paisley has its special difficulties, as we are told inanother part of the report that 69 per cent. of thehouses are of one or two apartments. A very satis-factory arrangement has now been made by whichall cases of small-pox in Renfrewshire are to be accom-modated in the West Renfrewshire small-pox hospital.This arrangement makes the Paisley small-poxhospital permanently available as a clearing house forall cases of tuberculosis requiring institutional treat-ment. Dr. McMichael is well satisfied with the actionof the local authority in 1922 in making all forms ofpneumonia notifiable. This has enabled the depart-ment to offer hospital treatment to all the severe casesof measles and whooping-cough. A further need isconvalescent home treatment for these two diseases.An unusual occurrence mentioned in the report is anoutbreak of dysentery. Six members of one householdwere attacked, the infective organism being theFlexner (Z) bacillus. The first case, a boy of 7,died within 24 hours. At first food poisoning wassuspected. The other five cases recovered. Inquiryshowed that the father, an ex-Service man, hadsuffered from dysentery while in the army and hadhad recurrent attacks of diarrhoea ever since hisdischarge.

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Antenatal work makes progress. During 1923,404 expectant mothers attended the antenatal clinic,whilst the total births in the year numbered 2020.Dr. McMichael would like to see the Barshaw Maternity