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tion of large series of cases. Two most importantquestions were (1) diathesis ; and (2) the low death-ratefrom the disease compared with the high incidence-rate.

Dr. JOHN SORLEY thought that some of thosewho held views on the production of immunity bysmall infecting doses did not always have the courageof their convictions and put these views into prac-tice. It might be possible to produce immunity byadministering small doses of living bovine bacilli tochildren in milk, but one could not guarantee thatdisaster might not result, and parents were notlikely to offer their children for experimentation inview of this uncertainty.

Dr. ELLIS showed the upper lobe of the lung of alion which had died of pulmonary tuberculosis. Thewhole lobe was one large cavity. The specimen wasobtained from the Zoological Gardens through thekindness of Dr. C. F. Sonntag.

Reviews and Notices of Books.DIATHERMY.

Its Production and Uses in Medicine and Surgery.By ELKIN P. CUMBERBATCH, M.A., B.M. Oxon.,M. R. C. P. London : Wm. Heinemann (MedicalBooks), Ltd. 1921. 44 illustrations. Pp. 193. 21s.

Tur author takes the trouble at the outset toexplain the term diathermy, which means the" through heating " which occurs on the passagethrough the body of an electric current of specialkind. A brief history of the way in which thesecurrents came into use is followed by the technicalfeatures which distinguish both their productionand their application to the body in conditions ofdisease.The subject is a comparatively new one ; the first

diathermy machine for medical use was introducedinto this country by the late Dr. Lewis Jones in 1909.Dr. Cumberbatch’s work on diathermy is well knownto those conversant with the subject ; the author’sparticular studies on the rise in temperature of variousparts of the body traversed by diathermic currentsform the subject-matter of Chapter VI. ; they willrepay careful perusal, for they are well-plannedexperiments. Further experimental work by Dr.Cumberbatch upon physiological lines-for example,the effect of diathermy upon blood pressure, pulse-rate, and respiratory exchange-paves the way for anappreciation of the medical possibilities of thisspecial form of electric current. One of the moststriking features of electrical currents, which alternatewith great frequency, is their inability to stimulatethe excitable tissues. Until quite recently no

explanation of this has been offered, but researchesupon this phenomenon have now shown that thepower of an electric current to stimulate the excitabletissues depends both upon the strength of the currentand upon its duration ; if the latter falls below acertain critical value the current loses altogetherthe power of excitation. The diathermic currentsflow for less than this critical period of time beforethey reverse and therefore have no stimulating action ;the sensation of warmth which is felt is due to theactual generation of heat within the tissues bythese currents. The body can tolerate sufficientlylarge currents of this kind to allow of a very con-siderable rise of temperature : herein lies the possi-bility of surgical applications of these currents,discussion of which forms the concluding chapter ofthe volume.The book is an excellent one. The subject is dealt

with in a thoroughly scientific manner, the descrip-tions of the various types of diathermy machinesat present in use are brief but lucid ; the authorhas a scrupulous regard for exactness in everydetail of his subject. On p. 16 an inversion ofsentences occurs which the author will doubtlesscorrect in future editions. The book is illustratedwith line drawings and plates which enhance butdo not over-balance the letterpress.

OBSTETRICAL AND GYNAECOLOGICAL MONOGRAPHS.Pelvic Inflammation in IVomen. By JoHrr OSBORNPOLAK, M.Sc., M.D., F.A.C.S., Professor ofObstetrics and Gynaecology, Long Island CollegeHospital, &c. London and New York : D. Apple-ton and Co. 1921. With 2 coloured plates and88 illustrations. Pp. 229..El Is.THIS monograph deals with the large group of

diseases peculiar to women which result from septic,gonorrhoeal, and tuberculous infections, and an

attempt has been made to give the accepted pathology,a definite clinical picture, and the treatment. Dr.Polak uses the term pelvic inflammation in the widesense, since he deals with this condition as it affectsall parts of the genital tract. The book contains agreat deal that is interesting. The author has a veryprofound belief in the prevalence of gonorrhoea inthe female, and considers it a potent cause of

pelvic inflammation and of one child sterilitv. Hequotes the well-known figures of Noggerath, theaccuracy of which we are inclined to doubt. However,as is well known, the proof is difficult to obtainowing to the rapid disappearance of the gonococcusin these cases. Dr. Polak maintains that pyogeniccocci not infrequently persist in the prostate ofmen who have had gonorrhoea, and that in some casesthey are the cause of infection in their wives. Con-siderable stress is laid upon the frequency ofgonorrhœal infection of the mucosa of the cervix,and its treatment by a cone-shaped excision of theaffected area is recommended in bad cases.The chapter dealing with gonorrhoeal infection is

a very good one, and in the section on treatmentgreat stress is laid on the importance of preventingthe upward spread of the disease. In discussing thetreatment of cases of puerperal infection the authorstrongly maintains that local interference is practi-cally always contra-indicated and entirely condemnsmanual manipulations within the uterus or the useof the curette. In dealing with cases of puerperalpyæmia and general puerperal infection, treatmentby sunlight, food, fresh air, repeated small bloodtransfusions, and general supportive stimulation isadvised. Dr. Polak believes that by the repeatedtransfusions of small quantities-300-500 c.cm.—ofcitrated blood it is possible to lessen the secondaryanaemia,to increase the number of active leucocytes,and to raise the blood pressure. Reliance is alsoplaced on postural drainage by Fowler’s position,proctoclysis, posterior colpotomy, and packing thepelvic cavity with gauze after the method introducedby Pryor. In the radical treatment of cases ofsalpingitis it is urged that no operative procedureshould be undertaken until all acute symptoms havesubsided. The case is tested by a blood count anda thorough bimanual pelvic examination. If afterthis the temperature and the leucocytes are notraised the operation may be performed with safety.Four very interesting cases are quoted in this chapter,in which the streptococcus lay latent in a parametrialexudate for periods varying from five to 15 years,and then gave birth to a general infection. Inremoving infected tubes Dr. Polak recommends theprocedure by which a wedge-shaped portion of thefundus of the uterus, including the pars interstitialis,is resected. Resection of the ovary on general prin-ciples, in his opinion, should be discouraged.Dr. Polak’s book is interesting and valuable, and

contains a great deal of information based on soundprinciples and on a wide experience.

Cœsarean Section. By FRANKLIN S. NEWELL, A.B.,M.D., Professor of Clinical Obstetrics, HarvardUniversity ; Obstetrician. Massachusetts GeneralHospital. London and New York : D. Appletonand Co. 1921. With 53 illustrations. Pp. 210.£1 Is.THE operation of Cæsarean section is occupying

so large a place in the treatment of many com-plications of labour at the present time that a

methodical review of the operation and its results,

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such as this monograph contains, is of great interestand value. Professor Newell is an obstetrician ofconsiderable experience, and it is refreshing to seethat he, at any rate, is not so enamoured of thefrequent performance of Caesarean sections as a

means of overcoming many of the accidents oflabour as are a number of the younger obstetriciansat the present day. As he points out, the operationis undoubtedly abused, and ’’ its true value can onlybe appreciated when it is applied to properly selectedpatients by competent operators." On the wholehe declares himself in favour of the classical operation,and does not think that the various modificationsintroduced have any real advantages. At thesame time he admits that the good results obtainedby Kustner in his extraperitoneal method, namely112 cases with only two deaths, are very striking,and show the method to have good features.Professor Newell’s teaching with regard to the

treatment of contracted pelves by abdominal sectionis that generally recognised by the majority ofteachers. In dealing with ovarian tumours hefavours Caesarean section followed by ovariotomy.He agrees in general with the dictum " Once a

Caesarean always a Caesarean." In cases of eclampsiahe believes the operation has a limited application,but on the whole he agrees with the conservative eschool, who prefer to treat the eclampsia rather thanto terminate the pregnancy. In placenta præviahe is in favour of version or the use of a hydrostaticbag, and does not see any likelihood of the maternalor the foetal mortality being lowered by the morefrequent performance of Caesarean section. In theworst cases of accidental haemorrhage he recommendsdelivery by the abdominal route. In performing theoperation he follows the usual technique, and seesno special advantages either in the subumbilicalincision or in opening the uterus through the loweruterine segment. As he points out, the performanceof an ordinary classical Caesarean section calls formuch less skill or knowledge than the delivery of apatient in a difficult case of labour by the vagina,and this is one of the main reasons why the operationat the present time is so often performed on occasionswhen it is not certainly the best or the safest methodof delivering the patient.The book is a very sound piece of work, and Dr.

Newell’s views are in harmony with those of themajority of experienced teachers of the subject.

COUNSELS AND IDEALS FROM THE WRITINGS OF

WILLIAM OSLER.

Second edition. Selected and edited by C. N. B.CAMAC. London : Humphrey Milford, OxfordUniversity Press. 1921. Pp. 355. 8s. 6d.

COLLECTIONS of extracts from any author are, asa rule, unsatisfactory, except in the case of poets,where whole short poems can be given. Thiscollection is to our minds no exception to the rule,despite Dr. Camac’s statement on p. xv. of hispreface to this second edition, though we agree thata few of the extracts lose nothing by being divorcedfrom their context. But for an anthology Dr.Camac’s selection is well made, and those who have eneither the leisure nor the opportunity to readOsler’s works in their entirety will find fragmentsof gold dust which may well set them seeking inthe matrix where lies the original metal.

Osler was widely read and steeped in seventeenth-century literature. Sir Thomas Browne one mayalmost say he knew by heart, while the languageof the Authorised Version and of the Prayer Bookappears again and again in his writings ; and thoughhe was eminently practical, and though there perhapsnever lived a clearer teacher, yet in his writings we feelthe vague detachment from the troubles of this worldwhich we feel in reading Browne, or Vaughan, orFeltham, who wrote that wise book of " Resolves"when only 18. In these troublous times it is well forus to read Osler and to remember one of his rules

of life-" to do the dav’s work well, and not to botherabout to-morrow." To no man more than to Oslerdoes the dictum of St. Bernard apply,

" Tu qui inCongregatione es, bene vive, ordinabiliter, socia-biliter, et humiliter : Ordinabiliter tibi, sociabiliterproximo, humiliter Deo." We must refer to anerror which occurs on p. 24, where we find " No-where in literature do we have such a charmingpicture... as that given in Plato’s Dialogues ofEryximachus, himself the son of a physician,Acumenus." Of course this should read, " as thatgiven in Plato’s Dialogues, of Eryximachus." Ina third edition this should be corrected.

INTERNAL SECRETIONS,Die Innere Sekretion. By Dr. ARTHUR W-Ell,,Privat Dozent der Physiologic an der Univer-sitat Halle. Berlin: Julius Springer. 1921.Pp. 140. M.28.

THE author has compressed into a volume of 140pages a mass of scientific fact and theory. Hegives a concise summary of our present knowledgeof the internal secretions in regard to their functions,their influence on the growth and development ofthe body generally, and discusses the minute histologyof the glands. He is no slave to the idea that theinternal secretions alone reveal to us the secretsof life ; they do not, he says, rule over all, but sharewith the brain and nervous system the regulationof the course of life. The composition of the bloodand the influence thereon of the secretions of thethyroid, thymus, and suprarenal are discussed fullyby Dr. Weil, while special reference is made to theferments of the plasma and the effect of the injectionsof gland extracts on coagulation-time. ITe explainsthat both factors in the circulation of the blood,the activity of the heart and the resistance of theperipheral circulation, are under the influence of theinternal secretions, the thyroid and suprarenalsincreasing the excitability of the nerve endings,whilst the pituitary acts directly on the heartmuscles.

In discussing metabolism, he shows how inthyroidism the negative nitrogen balance can belessened by full doses of fat and carbohydrate ;as to heat production, he maintains that the thyroidand pituitary increase heat by stimulating celloxidation, whilst the adrenals act physically bytheir action in contracting the peripheral vessels.Many authorities would disagree with Dr. Weil here,and would claim that the thyroid acts partly byincreasing the electrical conductivity of the tissues,and that the suprarenal is directly concerned withcell oxidation. Dr. Weil considers that the kidneyhas its own internal secretion, on the grounds thatexperimental injections of kidney extract reduce thesymptoms of uræmia after the removal of the kidneys.The relation of the pituitary to the kidney, and theaction of cholin on the intestinal contractions, arealso discussed by Dr. Weil, who points out that thereis more of this latter base in the adrenals and spleenthan in the intestinal mucous membrane. Indealing with the theory of the vitamins, he suggeststhe possibility of their being antecedents of theinternal secretions, and shows the similarity inthe chemical formulae of tyrosin, tyramine, hordenin,and adrenalin, and further directs attention tothe resemblance between pellagra and Addison’sdisease, and to the degenerative changes in theductless gland, especially the thymus, in beri-beri.The influence of the internal secretions, more

especially those of the thyroid, parathyroid,thymus, sexual organs, and pituitary, on the rateof growth, relative development of the differentparts of the body, and the variations in the twosexes form the subject-matter of another sectionof the book. Dr. Weil describes the development ofthe sexual organs and shows how the testicular andovarian secretions influence the development of thesexual characteristics of the male and female.

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Experimental change of sex is illustrated by a photo-graph of some guinea-pigs, in whom transplantationof the glands of the opposite sex was effected. Dr.Weil recognises three ovarian secretions, one relatedto the development of form, another concerned withthe function of menstruation, and the third, whichhe associates with the corpus luteum, connectedwith the development of the placenta. In hiberna-ting animals he has found atrophy of the sex organsin the autumn and asserts that the thyroid andpituitary are similarly atrophied. Recent work inAmerica by Rasmussen on the woodchuck does notsupport this as regards the hypophysis. Mentalconditions Dr. Weil regards as directly under theinfluence of the internal secretions. The nervoussystem regulates the ductless glands as well as otherorgans of the body ; on the other hand, these glandsin their turn influence the nervous system. Thechemistry of the internal secretions, as far as theyhave been investigated, is discussed, and formulae

’’

are given of adrenalin, cholin, thyroxin, and spermin ;the isolation by Hermann of a hormone from theovary, and by Fiihner of a crystalline substance ofchemical structure still undetermined from the hypo-physis, is mentioned.The illustrations in the book are excellent and the

various tables instructive. Altogether the volumecan be recommended to those who desire a concisereview of the present knowledge of the internalsecretions. The clinical aspect is not dealt with.

THE COMMUNITY HEALTH PROBLEM.

By ATHEL CAMPBELL BURNUAM, M.D., HealthService, Atlantic Division, American Red Cross,&c. London and New York : The MacmillanCompany. 1920. Pp. 160. 8s. 6d.

THE author’s preface tells us this book is intendedto give welfare workers, public health nurses, andpractising physicians an outline of the measures

which are being suggested for the solution of thehealth problem as it exists in the United States.The problem as it exists in Great Britain does notdiffer in essentials, and for that reason we feel surethat Dr. Burnham’s book will be read with interestby a wide circle of readers in this country. In ourissue of April 9th we commented at length on therecently issued Hospital and Health Survey in Cleve-land. Ohio, and it is justifiable to deduce that experi-ments have been carried further in this countrythan in the United States as a whole. No generalsystem of school clinics, tuberculosis dispensaries,maternity and child welfare centres, free venerealdisease clinics, and medical treatment on the insuranceprinciple has as yet been established in the States.In this respect the Americans will be able to benefitby our experience and our failures. We wellrecognise, however, that we are only in the experi-mental stage, and that our own medical service isin the melting-pot. We have a long way to go beforewe secure for each family a family doctor with apublic health point of view, who will be called uponwhen required (irrespective of the fear of a bill whichmay cripple the resources of the family perhaps foryears), and who will be linked up with consultingphysicians and surgeons, dentists, hospitals, con-

valescent homes, midwives, district nurses, andmothers’ helps in such a way that his patients mayhave the benefit of these services in time of need.This is, in fact, something like the problem whichDr. Burnham puts before his readers.

In Chapter 1. the author endeavours to give someidea of the extent of sickness disability. He esti-mates that about 6 per cent. of an average communityare always in need of medical treatment, and thatsickness leads on an average to a loss of nine dayswages per head per year. He lays stress upon thesmall amount of the public expenditure to preventsickness, and instances the work of the RockefellerFoundation as an example which should be followedby public bodies. The fact that the private physician

has neither the experience nor the time to practisepreventive medicine is emphasised. Chapter V. isdevoted to the important part that must be played bypublic health nurses in any satisfactory " programmefor the betterment of community health." In thenext chapter the question of the rehabilitation of thedisabled worker is discussed, and the methods arenoted of the Ford Company, which can boast that aman is never discharged from their employ becauseof physical disability. " If he is unfit for his former’occupation, he is trained for another." In a laterchapter we learn from Dr. Burnham that theFederal Board was overwhelmed with the problemof training the men disabled through the war. Thisis somewhat surprising when we consider the immensefinancial resources available and the comparative sizeof the problem to be faced in the United States andin the other belligerent countries.

Interesting experiments in industrial medicine, inthe establishment of health centres and in social .

unit organisations are recorded in other chapters,and the ..book ends with some account of endowedhealth demonstrations such as the Rockefeller andRussell Sage Foundations.

WAR DIARIES.The Diary of an Aicetrczlictn Soldier (CaptainK. J. Barrett). Melbourne and Sydney: TheLothian Book Publishing Co. 1921. Pp. 222.7s. 6d.Books about the war are many, but it is right and

natural that this should be so. The one before us isof particular interest as a simple record, kept for theinformation of, his family, by a young Australianofficer, who, like so many others, developed both incharacter and grasp of things under the strain ofmilitary necpssity.

Keith Barrett’s father, Lieut.-Col. Sir J. W. Barrett,A.A.M.C., who writes a, preface :0 the dia-ry, pointsout that his son was not distinguished as a boy byany scholastic ability, but that the training in theofficers’ instruction school developed him in a remark-able manner. Mor80ver. he has left behind himvarious essays on discipline, on making men com-fortable, and on other branches oi knowledge essentialfor an officer, which, if they are anything like thediary, would be well worth publishing. Barrettreceived his training in Egypt in 1915, when he wasgiven a commission in thp Imperial Army, havingon the outbreak of war volunteered as private inthe 2nd Field Ambulance (Queensland). He servedfirst in the Dardanelles and then in France, wastwice mentioned in despatches during his life, andagain after his death, which occurred on April 16th,1917, from wounds received at Guemappe threedays previously. For his work at the capture of" The Harp " on April 9th he was recommended forthe D.S.O. The diary is a phin unvarnished recordof the hard work, the failures, the successes, and thedaily routine of warfare, but is full of little toucheswhich show what manner of man was the youngofficer of the improvised armies, how earnestly liestrove to do his duty, and how his whcie thought wasfor his men.

The Diary of a Yeomanry M.O. By Captain O.TEICHMAN, D.S.O., M.C., Croix de Guerre, Crocedi Guerra, R.A.M.C. (T.F.). London: T. FisherUnwin. Pp. 283. 12s. 6d.THIS book is remarkable for the self-effa,cement

of the writer. We se 1--y the title-page thatCaptain Teichman gained most honourable distinc-tions, yet the reader would hardly gather from hispages that he was anything but an intelligent observerwho had accompanied the forces on various fronts ;who had a certain amount of military knowledge andwas rather interested in medical matters. He servedin Fgypt, the Gallipoli Peninsula, Palestine. and on thePiave, and on at least two occasions was wounded.The greater part of his service was in the Palestineea.mpaizW, and he gives a graphic account of the

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sufferings endured by both men and animals mainlyon account of lack of water, but his own share of thework is mentioned only impersonally.Here and there he tells good stories. On p. 21b

we hear of a private in an Egyptian Labour Corpswho was anxious to return to Egypt. He accordinglywrote the following moving appeal to his C.O.:11 Sir, my absence is impossible, some man has up-rooted my wife, my God I am annoyed ; yoursfaithfully." Captain Teicbman does not say whetherthe writer obtained his leave, but we think hedid. Another incident occurred during his servicein Italy when he was acting S.M.O. of Faenza,where there were two hospitals, British and Indian,fed by train from various Fastern fronts. On p. 255he relates how " on one occasion a train containingIndians suffering from mumps was held up for halfa day near the station, being shunted on to a siding ;when it had continued its journey the local sanitaryauthorities disinfected the permanent way, but laterit transpired that the engine which had drawn thetrain had been waiting on another siding, andaccordingly the rails on which it had stood were alsosolemnly disinfected." It is pleasing to think thatso meticulous a regard for prevention has survivedin Italy for some seven hundred years, for AmmianusMarcellinus, writing of the year 353 A.D., tells us

in his account of Rome, Bk. XIV., cap. 6, that thefashionable Roman society of the day was so afraidof infection that not only did they decline to see asick friend, but even when they sent a slave to inquireafter him the slave was not permitted to re-enter thehouse with the answer until he had had a bath.We take leave of Captain Teichman’s book, with

a recommendation that it should be read, and addonly that we wish he had told us a little more abouthimself.

CLINICAL EXAMINATION OF DISEASES OF THE LUNGS.

By E. M. BROCKBANK, M.D., F.R.C.P., andALBERT RAMSBOTTOM, M.D., F.R.C.P. London :H. K. Lewis and Co. 1921. Pp. 88. 4s. 6d.

THE title of this useful little book suggests thatthe authors examine diseases rather than the organsin which they occur, and this seems a topsy-turvynotion. In the covers of much standard information,the authors sandwich in many useful hints whichare far too rare in text-books. Thus, in the caseof a short, persistent, dry cough, they give thesensible but rather unusual advice that the physicianshould search for its cause in the external auditorymeatus. Again, with regard to paracentesis abdo-minis in a case complicated by bronchitis they advisecaution, pointing out that if the fluid be removed,the stretched abdominal muscles may no longer beable to help the diaphragm and thoracic musclesin their expulsive efforts in coughing. " The resultis that the patient cannot get rid of the bronchialsecretion, and -may easily be drowned in his ownsputum." The authors’ English is deplorablyinelegant, but this is a matter of secondary importancein a handbook of this description.

THE RHYTHMIC DANCE-BOOK.

By DIARGARET EINERT. London : Longmans,Green and Co. 1921. Pp. 96. 4s. 6d.

Miss Margaret Einert, in her small and readablebook, tells us that a sound mind in a sound body isnot enough, there must also be a sound emotionalnature. In order that this may be cultivated. sheadvocates that children should dance to expresstheir joy in life. They must dance with body andhead and arms as well as with feet. They must notmove to the music ; they must be moved by it."

Imagine," she says, "a fresh green lawn and afiddler roaming about, playing as he walks from sheerhappiness and love of his art. Imagine then a flockof loose-clad children dotted all about among theflowers and the sunshine." Rhythmic dancing,

according to the enthusiasts, makes for joyoushealth, for complete coordination and control, forimagination, for self-realisation.One delightful chapter in Miss Einert’s book deals

with stories in movement. For instance, children areasked to dance as though they were on the sea-shore.At once they picture sands, surf, waves, storms,thunder, and mermaids, and mark on the grass asection for sand, one for surf, and one for deep sea.They listen quietly to the music played once throughand then they dance. The storm and the waveshave their appropriate musical passages, and sixchildren dancing together are taught to representthe curling wave, the incoming tide, the break ofthe surf on the sand. The teacher unfolds the storya little. Calm sets in after the storm, the sun comesout, and to a gentle melody the children springforward to the shallow water and at once becomemermaids combing out their long hair in the sunshine.Another dance-story represents the spirit of Christ-mas-another " The Wind and the Rose." Furtherchapters deal with verse-dancing, with plastic posing,and with suitable clothing to -allow freedom ofmovement.A charming book with a strong eugenic side.

Reports and Analytical Records.ETHANESAL.

(SAVORY AND MOORE, LTD., 143, NEW BOXD-STREET,LONDON, BV.)

Tlms anaesthetic apparently has the physicalproperties of ether. It is anhydrous, free from sulphurcompounds, and has a neutral reaction. It containsa very small amount of a substance oxidised toacetaldehyde by chromic acid, which presumably isethylic alcohol. Ethanesal commences to boil at33.9°C. When fractionated :-

41 percent. distilled over between 33’90 and 35’000.13 ,. " 35’0° 36·1°16 36.1° 37.828 ,. ,. " " 37°8° 40·2°2 , above 40’2°

When ordinary B.P. ether is fractionally distilledsome 97-5 to 98-5 per cent. passes over at 34° to 36°C.,hence it is obvious that ethanesal is a mixture ofsubstances having a boiling-point not far removedfrom that of ether. According to the statements ofDr. R. L. Mackenzie Wallis and Dr. C. L. Hewer inTHE LANCET of June 4th (p. 1173) it appears that theanaesthetic properties of ether are due to the presenceof certain ketones. Ethanesal is a mixture of pureether and these ketones, and the introduction of thisanaesthetic may be regarded as a distinct advance inanaesthetic practice.

TUBERCLE VACCINE R.

(ALLEN AND HANBURTS, LTD., LOXDOX.)We have received two sample boxes of this prepara-

tion, introduced on personal trial by Dr. Nathan Raw,together with an explanatory pamphlet. Accordingto the latter, this vaccine, which is designed for useboth as a curative and prophylactic agent, is preparedfrom cultures of B. tuberculosis, subcultured withouta break for 14 years. The vaccine is to be adminis-tered on the principle advocated by Dr. Raw, thatthe two types of disease, human and bovine tuber-culosis, are antagonistic to one another, and thata mild infection of the one protects against the other.It is suggested that doses should begin at 0-001 mg.and be continued for at least 12 injections in increasingdoses at intervals of seven days up to 0-025 mg. The

pamphlet does not state whether the bacilli have beenkilled by heat, and if so, at what temperature, or bythe addition of antiseptics. The price of the vaccineis 5s. per dose.Each box contained three ampoules of 0-001,

0.002, and 0-003 mg. vaccine respectively, markedhuman strain. The contents of a 0-003 mg. ampoule