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Dr. JAMES HENDRY described a case of

Amenorrhœa Following Severe Trauma.Jn May, 1919, the patient reported three months.amenorrhoea without other signs of pregnancy. Her

appearance suggested thyroid insufficiency andthere was no sign of pregnancy. The disturbancessuggesting hypothyroidism were only of recent date.Health previously had been normal. Treatmentwith thyroid extract was prescribed and continuedfor a few weeks without improvement, and, in fact,-the patient became stouter and stouter and more andmore drowsy and apathetic. On again reviewing herhistory in detail it was discovered that a few weeksbefore the patient first missed a period she hadfallen on the back of her head. Next day her sightwas affected and vision was almost lost, but hadalmost completely returned. Dr. Hendry thenthought of a possible lesion of the pituitarv glandand administered, orally, tablets of pituitary(whole) gland without any success. By June, 1920,Frohlich’s syndrome had developed - dystrophiaadiposo-genitalis, with lethargy and somnolence,and menstruation had returned in a scanty form,lasting one day. A skiagram of the skull to showthe sella turcica was obtained and signs of a fracturewere seen. The patient could inject 300 g. of glucosewithout glycosuria. The oral administration ofextract of pituitary gland having proved unsuccessfulpituitrin administered hypodermically was triedwith no success. Five months ago hypodermicinjections of antuitrin (Parke, Davis and Co.’sextract of anterior lobe) were commenced andweight is steadily diminishing, although food intakeis normal. Regarding sugar tolerance, 120 g.of glucose now produces glycosuria. The specialinterest in this case is the association of an-ieiiorrhoeawith hypopituitary function.

Reviews and Notices of Books.IRONTGEN DIAGNOSIS OF DISEASES OF THE ALIMEN-

TARY CANAL.

Second edition. By RUSSELL D. CARMAN, M.D.,Rontgenologist, Mayo Clinic ; Professor of

Rontgenology, University of Minnesota. Londonand Philadelphia : W. B. Saunders Company.1920. Pp. 676. 42s.

THE first edition of this book appeared in 1917and was accorded the favourable reception it welldeserved, for the work is characterised by a thorough-ness and accuracy well up to the high standard of thefamous clinic with which Dr. Carman is associated.It has been thoroughly revised in the light of recentlyacquired knowledge, and new chapters have beenadded on the hour-glass stomach and the pneumo-peritoneal method of examination of abdominallesions. A valuable feature is the description ofthose small details of manipulation of the patientduring the examination which will best bring outthe points most useful in diagnosis. This speciallyapplies to investigations of the stomach andduodenum. The chapter on the X ray diagnosisof gall-stones shows a considerable advance since thepublication of the first edition. Throughout thework many new cases are illustrated and describedin detail, and the volume is one that cannot fail tobe interesting and instructive to medical men whoare actively working in abdominal disease fromwhat-ever point of view.A brief passage in the chapter on Interpretation is

worth quoting : "The veteran rontgenologist, as

well as the novice, is tempted to see too much ratherthan too little. Once the observer has acquired somefamiliarity with his work he will find that directsigns of lesions will be manifest quickly or not at all."This comment seems to us significant and well worth..remembering.

RADIOLOGIE ET RADIUMTHERAPIE.

By BÉCLÈRE, COTTENOT, and Mme. LABORDE.Paris : A. Maloine et Fils. 1921. Pp. 520.Fr.30.THIS is the thirty-second volume of a series being

published in Paris under the direction of Drs. Sergent,Ribadeau-Dumas, and Babonneix, with the generaltitle, "Traité de Pathologie Medicale et de Thera-peutique Appliquee." An introduction is contributedby Dr. M. Beclere, in which the history and presentposition of the use of the X rays and radium inmedicine is reviewed. X ray diagnosis and X raytreatment are dealt with by Dr. Paul Cottenot,ancien interne des Hopitaux de Paris, and forms avery complete yet concise treatise on the whole sub-ject. His style is clear and his methods are practical.A number of the radiographs have suffered in repro-duction, but this is compensated for by the freeuse of numerous diagrams, which frequently are moreuseful for teaching purposes. The section on X raytherapeutics is very complete, forming a soundtreatise on a difficult subject, and one that will be ofgreat value to students.For the final section on radiumtherapie, by Mme,

Laborde, we have nothing but praise. The subjectis handled with scientific knowledge and thoroughness,and with a clarity that excites our admiration. Thevolume will be of great interest to those radiologistswho like to keep in touch with the work of theirFrench colleagues.

INFANT EDUCATION.

Second edition. By Epic PRITC’HARD, M.A.,M.D.Oxon.,M.R.C.P. London: Henry Kimpton.1920. Pp. 22G. 6s.

THIS little book originally consisted of lectureswhich were given to the health visitors of the St.Marylebone Health Society in its earlier days.Since its first edition in 1906, 15 years haveelapsed, and during this period its author has seenthe wide dissemination of many of the principlestherein enunciated and the development of a largeschool by which they are accepted. Moreover, therapid and great strides of the infant welfare move-ment, in which the author has played a prominentpart, and the formation of numerous infant welfarecentres, have augmented the value of a book whichsets out to instruct the lay worker in the elements ofinfant education based upon considerations ofphysiology.From their very nature these lectures of necessity

contain a vein of dogmatism. Again, it would beidle to expect that in such a subject the authorwould be able to steer clear of contentious matter.There emerges, therefore, a book in which there aremany statements. clear and definite enough. andadmirably expressed, but for which it would bedifficult to provide proof and about which there areopinions more conflicting than a perusal would leadthe lay reader to suspect.

In the present edition four new chapters have beenadded, one on the care of the new-born infant. oneon the feeding of children at and after weaning, oneon the practical details of infant feeding, and oneon rickets. The author is an exponent of the caloriemethod of infant feeding, basing his recommendationsas to the total quantities of food to be given at thevarious months on the supposed caloric requirementsof the infant. ’

There are many who would join issue with regardto this advice. It might reasonably be askedwhether we have sufficient knowledge to decide uponthe average number of calories required by aninfant of a particular age ; whether the physiologicalvariations are not too great for the reasoned applica-tion of a method so precise in its nature ; andwhether cow’s milk is a food of standard caloricvalue. " If we wish," writes Dr. Pritchard, " toknow, for instance, how much of any particular foodshould be given to ’a baby four months old, the

1138

calculation can be made in the following manner :On reference to Table, p. 100, we see that the caloricrequirements of a child of this age are 612 caloriesfor the 21 hours ; from this it is again easy to estimatehow much condensed milk, dried milk, or othersubstitute food must be given in order to supply therequired number of calories." Even the adherentsof the system, we think, would qualify this state-ment, for the question of the weight of the babyis omitted and apparently plays no part in thecalculation.Other dicta which we think would provoke

criticism from a medical audience is that the food ofinfants should adhere to the standard of breast milkthroughout the first year of life, and that the weanedchild requires rather less protein than before weaning.Also that an excessive nitrogenous diet as judged bythis standard always leads to pathological results ofwhich " intestinal toxaemia, liver attacks, migraine,neurotic conditions, sleeplessness, offensive breath.muddy complexion, eczema. and a thousand andone ailrnents commonly regarded as ‘ gouty ’ " arecited as typical.The chapter on rickets includes an exposition of

Dr. Pritchard’s views on this disorder, long held byhim but still awaiting general acceptance. It is anauthor’s privilege to expound his own views in asdecisive e a manner as he desires, but these fewillustrations of the more contentious statements inthe lectures-and there are many more of the samecategory-will serve to show that the lay readerwill have no little difficulty in distinguishing howmuch is accepted as truth and how much is hypo-thetical.We hasten to say that the book serves a very

useful purpose in stating in simple language and lucidstyle the principles which underlie infant training,hygiene, and dieting and that any reader whoimbibes these principles, even to the written detailsof their application, will have an eminently safeoutlook on the management of healthy infants.

THE GREAT RIDDLE.

The Action and Effects of Natural Forces andConditions in The Creation. By FRANK HoR-RIDGE. London : Kegan Paul, Trench, Trubnerand Co. 1921. Pp. 98. 3s. 6d.

WE gather from some reviews and a ballad whichare quoted (as an advertisement) in this book thatMr. Horridge is favourably known as a writer ofballads, and the particular one quoted is certainlygood. In the volume now before us he has made anew departure and has set about finding a solutionto the origin of life, which apparently he considersas

" all that we understand under the term creation."His theory is simple enough, but it does not explainthe mystery. " We have only to conceive a certainmixture of the elements as having taken placeand carbon derived from carbonic acid acting so tospeak as the keystone of the physiological archwhich constitutes the nucleus and over which thesuperstructure of organic life in all its various formsis raised and the problem in its initial stage is solved"(p. 25). Mr. Horridge’s other thesis is that " everypart and organ of the human body or that of anyliving creature depends for its position, its form,its function and very existence on that which onemay term its dynamic environment." Mr. Horridgeattributes the transparency of the stratified epithe-lium of the cornea to the vibratory effects of therays of light (p. 55), but he does not explain whyrays of light beating on other parts of the body donot produce transparency there. On p. 11 heseems to us to use the words " mobile " and mo-bility " in the two senses of " easily moved and," capable of independent movement." Thus hesays " Protoplasm though like air and water inbeing mobile differs from both in being more com-plicated," and his conception of the ether seems to us to be extremely hazy. The book is interesting,but we cannot think it of any value as a contribution to knowledge.

DE 1/ANAPHYLAXIE A L’IMMUNITÉ.

By M. ARTHUR. Paris : Masson et Cie. 1921.Pp. 361. Fr.20.

IN 1903 Arthus announced that horse serum,harmless to a normal rabbit, causes in a rabbit

previously treated with injections of the serum aseries of local, general, immediate and remote ill-effects. This fundamental discovery, known since asArthus’s phenomenon, is one of the stones on whichthe immense superstructure of anaphylaxis has sincebeen reared. The present volume is in no sense anattempt to survey the whole subject with its relatedtopics of protein poisons in general and resistance;it is a synthetic account of the experiments whichthe author has made himself. most of which havebeen already described in various periodical publi-cations. The narrative is detailed and the result ismore suitable for the technical expert than for thegeneral reader. There are no guinea-pigs with theirdramatic deaths from bronchial spasm, but there isan immense amount of information about the effectsof different proteins on the blood pressure and respira-tion of rabbits, data which do not perhaps generallyreceive the attention they deserve. In an interestingpreface the author gives some account of his viewson the methods of scientific investigation ; he classestheorisers with poJiticians, though the rest of the bookis not nearly as dull as this would lead one to expect.Noteworthy, too, is his belief in the supreme value ofsolitary meditation-testimony from an old andexperienced worker which is of value in these daysof ceaseless and restless experimentation.

VETERINARY HYGIENE.

By R. G. LINTON, M.R.C.V.S., Professor of

Hygiene, Royal (Dick) Veterinary College, Edin-burgh. Edinburgh : W. Green and Son, Ltd.Pp. 429. 26s.HITHERTO veterinary literature has been more

concerned with the cure and treatment of diseasethan its repression and prevention. But there hasalways been room and need for stressing the lessonsof hygiene and for their presentation in compre-hensive form. The work under consideration hasbeen written for veterinary practitioners and studentsand others concerned with the well-being of animals,whilst the requirements of those studying for theDiploma of Veterinary State Medicine have not beenforgotten. It may be said at once that Prof. Lintonhas done his work well, and has, moreover, had theassistance of collaborators who are all experts in theirprofessions.The book is divided into seven sections, dealing

respectively with Water. Meteorology, Sanitation, Airand Ventilation, Building Construction, PreventiveMedicine, and Sanitary Law.The chapter on sanitary law will be of high practical

use to the veterinary inspector, as it deals quitecomprehensively with all the various Acts and Orderswith which he ought to be familiar. The generalpractitioner will be chiefly fascinated with thechapters on building construction and preventivemedicine. Too many men with very imperfectknowledge as to the hygienic requirements of horses,cows, and pigs still have the prime voice in theconstruction or improvement of their housing. Theconstruction of cowsheds is well discussed in thisvolume. The reasons given for the adoption of awide milking passage may be’supplemented by thefact that if there is plenty of room dung is less likelyto contaminate the milk pail when the attendantpasses up and down behind the cows. We mayadd that the passage should be 3 or 4 inches belowthat of the cows’ beds, as this enables the milker toget more readily at his cows and, moreover, wherethere is a shallow side to the gutter, the work ofshovelling up the manure is rendered easier. Weare glad to note that the author lays stress on the needfor cleansing and disinfection of premises in cases ofswine fever.

Professor Linton shows his knowledge of theconditions met with in practice by the sage remark

1139

that " an outbreak of disease is often the onlyopportunity there is to get a place clean ; it iswell then to make the most of it." We have notmuch faith in insect powders either for the preventionor eradication of fleas in dogs or cats, and there arefar simpler remedies for lice in horses and cattle thanthose mentioned by the author, and they are quite aseffective.Professor Linton’s book will convince the reader

of the importance of adequate representation ofveterinary surgeons at the counsels of the Ministry ofHealth.

HANDBOOK OF OPERATIVE SURGERY.

Second edition, revised and enlarged. By K. K.CHATTERJI, F.R.C.S.I. London: W. Thackerand Co.; Calcutta and Simla : Thacker, Spinkand Co. 1921. Pp. 311. Rs.10.

THE author of this handbook does not claim morefor it than its title implies. It is necessarily restrictedin extent, and many of the operations are describedin few words. It is, in fact, rather a summary ofoperative surgery for the student than a text-book forthe practitioner, but to the former it should proveextremely useful. The surgical anatomy of the

parts and the indications for operation are clearly andconcisely given. The diagrams are good as far asthey go. The operations described embody several" author’s modifications," but it may be doubtedwhether these are all original; the methods-conformon the whole to the older orthodoxy, and a number ofrecent modifications of operations other than theauthor’s might have been introduced with advantage.An unusual feature, which should be particularlyuseful to those for whom the book is primarilyintended, is a description of the operations for

elephantiasis and tropical liver abscess.

MANUFACTURE OF SUGAR FROM THE CANE AND BEET.

Monographs of Industrial Chemistry. By J. H. P.HERIOT. London : Longmans, Green and Co.1920. Pp. 426. 24s.

’

IN this interesting and readable volume Mr. Heriothas endeavoured to show that successful practicein the manufacture of sugar is now more thanever dependent on scientific principles, and thatthese can be studied more effectively outside thaninside the factory. Attention is directed to the rathernarrow outlook of the British Cane Sugar producer,and it is urged that the student of sugar technologyshould keep in touch with all branches of sugarproduction even though he may only specialise inone. This volume will enable him to study the caneand beet sugar industries side by side and to note theprogress made in each.The subject-matter is treated generally and

concisely under the following heads. The extraction,composition, and treatment of juice from the cane andbeet ; the evaporation of water from the juice ;crystallisation ; extraction of sugar from molasses ;by-products ; and the refining of cane and beetsugars. A number of good illustrations will befound of material assistance to the reader.Mr. Heriot has produced a useful volume and it

should help in the propaganda which, it is hoped, willresult in the development of a beet-sugar industryin this country.

MILK TESTING.

By C. W. WALKER-TISDALE. London : J. North.1920. Pp. 90. 3s. 6d.

ALTHOUGH a considerable amount of data havebeen collected by officers of county councils andother officials bearing on the quality and quantity ofmilk yielded by cows in herds, it is obviously moresatisfactory if the farmer can carry out systematictests for himself. It is for those connected with thedairy industry who would not describe themselves

as analysts, but to whom accurate tests are never-theless of great importance, that this little volume isintended. The author gives a clear and conciseaccount of the methods usually employed in theanalysis of milk. A number of well-selected illustra-tions will doubtless be an aid to the comprehensionof the working details by the non-expert. Wethink, however, that whilst it is quite possible forthe farmer or buyer to learn or to be shown how towork mechanical processes such as the " Gerber"test, he would be wise to leave the chemical techniqueinvolved in the examination for preservatives, andin the catalase and reductase tests, to those who areexperienced in such matters.

THE ART OF ATTAINING HIGH HEALTH.

Together with Aristology or The Art of Dining.By THOMAS WALKER. Also A Sure Method ofAttaining a Long Life. By LEwis CORNARO.The Pilgrim’s Books, No. 5. London : PhilipAllan and Co. 1921. Pp. 271. 5s.

THESE three essays are rightly included in a

series for pilgrims. They set forth ways and means-for making the best of our earthly pilgrimagethrough temperance and the reasoned enjoyments ofthe pleasures of the table. Health both of body and,mind, which connotes a well-spent life and the per-formance of our duties both to ourselves and to ourneighbour, is thus to be attained. The Walker ofthe nineteenth century and the Cornaro of thesixteenth had both assimilated the old Greek adage of-" Nothing too much," and both brought upon them-selves the ridicule of acquaintances, but theypersevered, and like Bunyan’s pilgrim found them-selves able to say-

" Who so beset him roundWith dismal storiesDo but themselves confound,

His strength the more is ;No foes shall stay his might,Though he with giants fightHe will make good his right

To be a pilgrim."Mr. Walker tells us that during childhood and

adolescence, he was scarcely ever free from illness,but one day while reading Cicero’s De Oratoresome passage suggested to him the expediency ofmaking a study of the improvement of his health." I rose from my book, stood bolt upright, anddetermined to be well." And he succeeded to aremarkable degree. He dieted himself and made apractice of taking the air before eating any thing-i.e.,of going out before breakfast, although he does notseem to have adopted the simple plan of sleepingwith his window open. But he attained to sucha condition that even when he walked on a dusty-road no dust adhered to his feet or shoes or stockings." By way of experiment I did not wash my face fora week, nor did anyone see, nor I feel any difference.One day I took hold of the branch of a tree to raise-my self from the ground, when I was astonished tofeel such a buoyancy as to have scarcely any senseof weight." The famous Lord Herbert of Cherburyalso attained to a purity of body such that, as hetells us in his autobiography, " the shirts, waistcoats,and other garments I wear next my body, are sweetbeyond what either easily can be believed or hathbeen observed in any one else." Moreover, " Ihave weighed myself in balances often with menlower than myself by the head, and in their bodiesslenderer and yet was found lighter than they."-It is but a step from the stage attained by LordHerbert and Walker to the powers of levitationenjoyed by many holy men both of the West and theEast, powers which they could impart to inanimate-objects, e.g., in the case of St. Piran, who sailedfrom Ireland to Cornwall on a millstone.

Mr. Walker having attained high health pro--ceeded to enjoy it with the restraint which is fitting,and hence the discourse upon Dining, which is fullof sound sense, although here and there we disagreewith him-for instance, where he says that " port.

1140

only taken with or without a little water at dinner isexcellent." But his remarks upon claret and cham-pagne, together with his insistence on simplicityin everything at table, whether linen, plate,china, glass, or food, with the proviso that every-thing should be the best of its kind, are outsidecriticism. One of the good points which he makesis that the fire should be " one of the party," bywhich he means that no one should have to sit withhis back to the fire and the fire screened off, but thatthe place opposite the fire should be left vacant.Altogether Mr. Walker’s papers are well worthreading and remembering, even if the reader may sighfor the days when. in speaking of claret at a famousclub, he says,

" I would not wish better than thatgiven at the - at three and sixpence a bottle."

Cornaro’s paper has been a classic for centuries, andmost of the books upon diet and long life are foundedthereon, but we are grateful for a handy reprint.

A HANDBOOK FOR NURSES.

Sixth edition. By J. K. WATSON, M.D. London :The Scientific Press, Ltd. 1921. Pp. 770.10s. 6d. ’

Dr. Watson’s Handbook for Nurses is well knownto the nursing profession, and the revised editionwill be welcomed by probationers and qualifiednurses alike. It includes valuable chapters on theSymptoms of Disease, Electricity and Massage, Ear,Nose, and Throat Affections, Skin and VenerealDiseases, whilst every chapter of the former editionhas been carefully revised and brought up to date.The number of illustrations has been considerablvincreased, and an appendix of questions based onthe contents of each chapter should prove useful tostudent nurses.

If the worth of a general text-book may be assessedby its popularity, this book is a valuable contributionto the education of nurses. ’

NURSING IN EYE, EAR, NOSE AND THROAT DISEASES.

By A. EDWARD DAVIS, A.M., M.D., and BEAMANDOUGLASS, M.D. Philadelphia : F. A. Davis Co.1921. Pp. 346. $2.50.

As a guide, for nurses and students, in the care ofthe diseases of the eye, ear, nose, and throat,this book is a valuable supplement to a generalnursing text-book, and the instruction should be ofgreat help to many who have failed to obtain practicalexperience in these special branches during their

general training. A brief outline of the anatomy- and physiology of the special organs treated and asound chapter on Drugs and Prescribed Treatmentshould increase the professional interest of thenurse in her duties.

Dr. Davis strongly advocates a general trainingfor all nurses who intend to specialise in ophthalmicnursing.

- " WADE IN SANITARY."

The Story of a Division Surgeon in France.By Lieut.-Colonel RICHARD DERBY, M.C., U.S.A.London and New York: G. P. Putnam’s Sons.Pp. 260. 12s.

THIS is an interesting book, but one which has twogreat blemishes. First, there is no index, and

secondly there is no map, and as the incidents in thebook occur in a great variety of places the want of a map is much felt. However, Colonel Derby gives a imost graphic account of the work of the American Medical Department, and very good work it seems !to have been, especially that for which he was re-sponsible, concerning which he is most modest.It was due to him that the plan was adopted ofhaving a hospital as close up to the firing line aspossible. This made it possible for the wounded tobe dressed and cared for within some twelve hours

or less of the reception of the wound, a practicewhich resulted in a great saving not only of suffering,but of life. The victims of mustard gas were

especially benefited by rapid treatment, and thenearness of the hospital made the surgical practiceof complete excision of the wound tract as a preven-tive of infection practicable, with the result of anenormous diminution in mortality. This plannaturally entailed very rapid evacuation of thewounded and a consequent responsibility uponstretcher-bearers and ambulance drivers, to whomColonel Derby awards unstinted praise.Apart from the purely medical and military

details in the book, there are a number of remarksupon the social and political aspects of the warand post-war period which are well worth reading,especially in the chapter entitled ’ Wise in Time,"taken from Roosevelt’s pregnant motto, " Ninetenths of wisdom consists in being wise in time."

JOURNALS.

Jozcrzzal of the Royal Naval Medical Service.-From theApril issue we learn how important to the fighting serviceare men with normal binocular vision and binaural hearing.Surgeon Commander W. K. D. Breton tells of the ingeniousmachine there has been made for him in H.M.S. Excellent tomeasure the degree of stereoscopic vision possessed by menwho are to be trained as stereoscopic range-takers. Threeneedles are arranged in a plane, six metres from the observerand at right angles to the line of sight. The central needleonly moves forward or backward, and the small distancesthrough which it can be moved without appearing to theobserver to be out of that plane are measured. This mayeasily be 8 cm. (1’3. per cent.) either way. The smallesterror noted in the paper was 5 mm., less than 1 per 1000of the range, and this range-taker, luckily, also made themost consistent observations. Commander Breton alsogives a very clear account of the evolution of stereoscopicvision in animals and in man.—Surgeon CommanderE. D. Rutherford tells of the tests that were required in theselection of men to be trained as anti-submarine detectors.Thev were preferred of ages 18 to 25 (as they trained morequickly), and should have rapid judgment, good hearing,and capacity for localising the direction of sounds anddiscriminating their intensities. He mentions that of menwith enlarged tonsils 9U per cent. failed to reach therequired standard of hearing, but only 75 per cent. failedof those who had had their tonsils removed. This papershould be read by all who desire to realise how manyand novel were the probiems that pressed for immediatesolution during the war.—Surgeon Commander A. R. Fisherhas a paper on otitis media as it occurred among the cadetsat Osborne in the ten vears 1K10-19. He thinks it asequela of a " common cold," and to be avoided by theHancock nose drill. The fauces of the patient are cleanedby a saline douche (glucose. borax, and bicarbonate of soda)at 1000 F., from a Higginson’s syringe. Such a faucialdouche is far more effective than gargles or sprays. Inthe 10 years quoted there were 303 such cases, and 41additional in which it was only a complication.-Surgeon-Lieutenant Commander H. E. R. Stephens contributes tothe "Naval Medical Historv of the War " a paper onImmediate Surgery in Fighting Ships. There are no

bullet wounds, but the casualties are often large concussionsdue to the men being hurled by explosions against the sides ofthe ships. Then there are large ragged contusions byfragments of shell, but these fragments are so often raisedto a high temperature in their passing through the sidesof the ship that they sear the tissues like a cautery anddiminish hæmorrhage. In a pause of the action thewounded can be collected. Then the skin about the woundscan be washed with ether soap, and torn muscle handled,but very gently for fear of the secondary wound shock ; thislast is best relieved by Bay liss’s gum acacia solution. Largevessels must be tied or Cheatle’s metal tourniquet appliedto the main artery. After checking hæmorrhage, it is best toput a drainage-tube to the bottom of the ragged wound,pack sterile gauze around it, and syringe in eusol every twohours. All burns require to be cleaned up thoroughlyunder a general anaesthetic ; on the completeness of theinitial cleansing depends the outcome of the case. Oilyapplications retard cleaning, and are not recommended forJ1I’st-aicl dressings. But when the burn has been cleanedthe best application is carron oil, i., with menthol, gr. 3,and eucalyptus oil, m3. Chloroforul is the best anaesthetic ;for one thing ether is inflammable. This a tiele deals onlywith immediate surgery ; the wounded should then pass toa hospital ship, whose share of the work the next articleivill consider.