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838 MEDICAL STUDENTS ABROAD answer even in the most unlikely conditions, where the price of the foodstuff was already comparatively cheap so that the total reduction in expenditure would only be small. It was also desired to make the experiment where purchasing power was very small. A mining village in the county of Durham was therefore selected as being one where the per- centage of those unemployed for continuous long periods was very high. There were 2437 unemployed (insured) male workers, with 3799 dependants, in a population of 5000 insured workers and 19,000 total inhabitants. The experiment was confined to the families of the unemployed and was carried out in February and March. Families containing up to three persons could purchase 1-1 stone of potatoes weekly, and larger families proportionately more. Instead of paying 10., the ruling price for this amount, the 11 stone could be bought for 6d., thus saving 4. a week. It was also particularly desired to test how .the trade of retailers of potatoes in the area would be affected and the cooperation of the shopkeepers was secured. The full number of vouchers for cheap potatoes was issued and only 7-3 per cent. of these were not used. The normal sales of potatoes in the retail shops fell by 40 per cent., but the total consumption in the whole area rose by 96 per cent. When this figure is corrected for any possible source of error, an increased con- sumption of 69 per cent. is still shown. The main thesis-that increased consumption will result from lowering the price of an already cheap staple food- stuff, when purchasing power is very small-appears therefore to be proved, as it was scarecely possible to doubt that it would be. But to implement this conclusion is another matter. MEDICAL STUDENTS ABROAD ACCORDING to a report by the Council on Medical Education and Hospital it appears that 710 Americans enrolled as medical students in schools outside the United States in the academic year 1930-31. If still studying abroad these students will probably finish their course during this year or next, and it may be expected that most of them plan to return to the United States to practise. It was a considera- tion of the problem created by this migration that led the Federation of State Medical Boards to harden their hearts against American students matriculating abroad and not to admit them to any licensing examination without producing satisfactory evidence of pre-medical education. The numbers in question are still by no means negligible, for during the last academic year 1934-35 there were known to be 1471 American students training in 97 institutions abroad, and 199 who graduated or completed their medical training during that time. The report contains a caustic remark that of 502 students whose names were supplied to the Association of American Medical Colleges this year 106 had made application to medical schools in the United States without success since 1931, and it is hinted that some of these students have signified their inability to obtain a medical education in the U.S.A. by rejection at 25 different medical schools. Various European countries have, it seems, sent representatives to the U.S.A. to discuss measures for dealing with the students who come over, and it may be interesting to note which European schools at the present time especially are offering hospitality to American students. For the academic year 1934-35 the highest numbers of students were enrolled, in descending 1 Jour. Amer. Med. Assoc., August 31st, 1935, p. 688. order, at Edinburgh Royal Colleges 190, University of Rome 161, University of Bern 114, University of Basle 83, University of Zurich 72, University of St. Andrews 69, University of Paris 63, Friedrich- Wilhelm University, Berlin, 62. A footnote to the table of figures suggests that the totals of 1471 enrolled and 199 who completed course should be larger, inasmuch as the following schools, viz., Vienna, Bologna, Naples, St. Mungo’s, Glasgow, and Geneva, which previously reported- large numbers of American students, do not now figure in the list. SKIN DISINFECTION USERS of Harrington’s solution may be interested to know that its virtues have been rediscovered in the United States. J. A. Vaichulis and Lloyd Arnold, who make no reference to Harrington’s solution, have presumably repeated the steps in argument or experiment which led to its formulation, for the skin disinfectant evolved by them contains almost identical amounts of mercuric chloride, hydrochloric acid, and alcohol; it differs in containing also 10 per cent. of acetone and 0-2 per cent. of chrysoidin Y, the former serving to dissolve fat and thus assist penetration, the latter giving characteristic colour and some added disinfectant power. The phenol coefficient of this solution, using Staphylococcus aureus as the test organism, was found to be 357. It is cheaper than tincture of iodine and much cheaper than solutions of other mercurial compounds such as mercurochrome or metaphen, and it is said to have been used successfully not only for preparing the skin in 185 cases of operation on the neck or abdomen, but in 300 cases of gunshot wounds and automobile accidents, another matter altogether, since the sterilisation of intact skin and the disinfec- tion of a wound are quite different problems. These claims involve two questions which are in a highly unsatisfactory position. One is the true disinfecting capacity of mercury salts under clinical conditions. Although Geppert exposed the fallacy in Koch’s original experiments with mercuric chloride no less than forty-five years ago, numberless papers have continued to appear up to the present day reporting experiments in which inhibitory as distinct from bactericidal action is ignored. The conditions of a test of mercuric chloride can be so arranged as to give almost any result, but the nearer those condi- tions approach to those obtaining in the body, which is tantamount to saying the richer the medium employed, the less does its disinfecting power appear to be. It is very desirable that a test suitable to the peculiar action of the heavy metals should come into general use. The second question does not arise directly from this paper, since no observations of the kind were made by Vaichulis and Arnold; it concerns the proper method of determining whether or no skin has been disinfected. Various authors have scraped or swabbed treated areas ; Tinker and Sutton 2 excised strips of skin from the edges of operation wounds, and others have cut portions of skin from animals, to furnish material for cultivation. Colebrook’s method 3 differs from all of these in securing adequate dilution of the inoculum and in furnishing quantitative results. This is admittedly a proceeding not lending itself to exact definition, but a nearer approach to uniformity of method would make it possible (which at present it is not) to compare the results obtained by different experimenters. 1 Surg., Gyn., and Obst., 1935, lxi., 333. 2 Jour. Amer. Med. Assoc., 1926, lxxxvii., 1347. 3 Jour. Obstet. and Gyn. of Brit. Empire, 1933, xl., 966.
