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of signature, but only if the total quantity of either doesnot exceed half a grain of morphine or a quarter of a grain ofheroin. If the medicine is for subcutaneous use, then itsunhindered repetition is forbidden under any circumstances.Another interesting example. A prescription calling for

tinct. opii dr. iij., with the directions to take 20 drops t.i.d.,may be repeated without renewal of signature, but if thedirections merely read to be taken as directed " then therenewal of the signature must be obtained, for in the formercase the single dose is apparent and does not overstep thepermissible repetition maximum of 24 grains, but in thelatter instance this would not be the case. It becomes atonce evident that such a strict supervision with regard to thesale of potent drugs can only be to the patient’s benefit, forhe is thereby prevented to a very great extent from the harmlikely to result from an injudicious use of some poison, as heis so often bound to apply once more to a medical man. Onthe other hand, the ooncurrence of physician and chemist inachieving this object is worthy of our attention, especially asthe provinces of both professions are clearly defined to eachother’s satisfaction and to the public welfare.

T J1.m Rir vnnrc fJ1,it,nfllllv

G. P. FORRESTER.

ASCITES IN ENTERIC FEVER.10 the Editor of THE LANCET.

SIR,—It may be of interest in reference to the anno-tation in THE LANCET of Nov. 28th, 1908, p. 1617, onAscites in Typhoid Fever, to which Professor McPhedran ofToronto has called attention, to add this observation whichI have already brought forward at a clinical meeting of theMedical Society.l Some years ago I was called urgently toa child suffering from a severe abdominal illness. The

diagnosis lay between appendicitis and typhoid fever.Widal’s reaction had proved negative but the illness was inan early stage and probably of some nine days’ duration.The condition was so acute that I thought it safer to explorethe region of the appendix, and this Mr. H. Stansfield Collierundertook for me at my request. As events proved mydecision was wrong, although fortunately no seriousmishap resulted. On opening the abdomen we were

astonished to see a considerable quantity of almostclear fluid escape from the abdomen, and taking someup in a sterilised pipette I found it swarming withtyphoid bacilli and obtained a pure growth of thebacillus typhosus. The course after operation was that ofa severe typhoid attack, ending in recovery without anygrave complication, such as haemorrhage or severe peritonitis.The condition of ascites was easily explained in this case, Ithink, by the intense congestion of the peritoneum over allthe small intestines, although no lymph was observed. The

appendix was also intensely congested but this was only onefeature in a far more general condition. Naturally, an errorin diagnosis such as this one does not blazon forth, but as allended well and interesting clinical observations have sincebeen made on the point, I think this striking experimentalproof of their truth is valuable.

I am, Sir, yours faithfully,F. J. POYNTON.

THE PROMOTION OF SCIENTIFICRESEARCH.

10 the Editor of THE LANCET.SIR,—A copy of the second edition of my Scheme for the

Promotion of Scientific Research was sent to you some weeksago. My object in now writing to you is to obviate the riskof any misapprehension on your part of the nature of the

investigations by referees to be appointed by the Board ofTrade under the provisions of the Scheme. As I find theextent of such investigations may be exaggerated I desire todraw your attention to some of the conditions under whichthey would be made if the principles of the Scheme were inoperation. Permit me to assume that grants are allocated, subject tothe restrictions in Clause 22 of the Scheme, to new dis-coveries which elucidate the nature or causation or which areeffective in the treatment or prevention of diseases from

1 Transactions of the Medical Society, vol. xxxi., p. 370.

which the mortality is great enough to warrant the allocationof grants. A referee appointed to investigate the completespecifications of such discoveries, accepted during any pre-scribed period, would commence his investigations by aperusal and consideration of the statements and claims madein such of the complete specifications as conform tothe provisions of Clauses 6 and 7. Having upon suchpreliminary examination determined which of the completespecifications describe and claim discoveries that primâ facieare eligible subjects for grants he may then act upon thepower which it is proposed to confer upon him byprovision 1 of Clause 28, and he may require the applicantswho have lodged the complete specifications of these dis-coveries to furnish evidence in verification of the statementsand claims made in their complete specifications. In thecase of the allocation above mentioned such evidence may in-clude the statutory declarations of well-accredited physiciansor of experts to be appointed as provided by Clause 27,subject to such terms as may be determined by a referee inregard to the payment by the applicants respectively of theexpenses of the examination of their complete specificationsby the experts.Now, it will be apparent that the provision of such

evidence as a condition precedent to the completion of theinvestigations of a referee would enable him to confine themwithin practical limits, and he himself would be concernedbut little, if at all, with the investigation of merely plausibleclaims to the grants. Consequently his investigations,having regard also to the nature of the discoveries includedwithin the terms of the allocation to which his appointmentrelated, would be much less extended than might be assumedon a merely superficial consideration of the Scheme. Theseobservations apply also to other allocations of grants-such,for example, as those that have reference to new discoveries,not of a patentable nature, which advance our knowledge ofphysical or chemical phenomena.May I request you particularly to observe, in relation also

to the investigations of the referees, the facilities for the re-investigation of the subject matters of applications for grantswhich are specified in provisions 2, 4, and 6 of Clause 26 ?Allow me to add that it is not because the publicdo not desire to fulfil their obligations to successfulresearch workers in departments of science which are

intimately connected with material interests that so

little is done to promote scientific research in those

departments; but this is due to the radically defectivemeans which have hitherto been proposed to be adoptedfor the application of public moneys to this purpose. Thesemeans offer no guarantees for the effective employment ofsuch moneys. And I submit that it is only by methods thatmake their expenditure dependent upon the attainment ofresults of prescribed descriptions that it is possible to providesuch guarantees. With the recognition of the practicabilityof these methods the policy of expending public moneys inthe promotion of scientific research will assume an entirelydifferent aspect. It is the object of the Scheme to demon-strate their practicability. I may also mention that it hasbeen submitted in its revised form to eminent scientists andpoliticians without its practicability being impugned ; thereis, therefore, reason to conclude that if those who are

interested in the promotion of scientific research wouldcooperate in advocating the adoption of its principlesappeals might be successfully made for allocations of publicmoneys, in conformity with its provisions, to grants forscientific purposes.

I am, Sir, yours faithfully,WALTER B. PRIEST.

THE CAUSE AND PREVENTION OF DENTALCARIES.

10 the Editor of THE LANCET.

SIR,-Dr. J. S. Wallace complains in your issue of Dec. 12thof the opinion expressed in the Dental Surgeon’s review of oneof his works and which I quoted in support of Mr. F. Coleman’sremarks. He objects, so I understand, to being creditedtherein with the belief that the value of hard and resistantfood and general exercise of the jaw muscles as prophylacticsagainst dental caries is a new discovery." While I have nointention or desire to enter into a discussion with him in

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your columns, the hospitality of which you have so courteouslyextended to me and which I must therefore not abuse, Iwould ask leave to add a few words.

I desire to point out that the reviewer’s criticism inquestion seems to be amply justified by what appears onp. 67 of his book, "The Role of Modern Dietetics in theCausation of Disease." Here Dr. Wallace says-This year [i.e., 1905] we read in the "Dental Annual" that "interest

has been aroused by iconoclastic opinions ventilated in medicalperiodicals as to the efficacy of tooth-powders and the artificialoperation of brushing the teeth and gums. There has been a remarkableconsensus of opinion as to the superiority of early mastication, the useof hard and resisting food, and the general exercise of the jawmuscles ...... as compared with soft feeding and artificial cleansing."

Immediately after which he proceeds to add-I doubt if converts to a new truth are so speedily got unless both the

older beliefs are hopelessly insufficient and the new ones are obviouslyin accord with known facts.

The italics, I may say, are my own. Moreover, whileDr. Wallace in his letter quotes selected portions of pp. 103,104, of Mr. Alfred Coleman’s well-known manual he ignoresthe following passage to be found on p. 107, which page isone of those alluded to by Mr. F. Coleman- !,An animal’s tooth brush is its proper food, which, if changed for an

improper one, will often result in injury to the teeth.

I am, Sir, yours faithfully,THE EDITOR OF THE DENTAL SURGEON."

Dec. 17th, 1908. ________________

TREATMENT OF NEPHRITIS.To the Editor of THE LANCET.

SIR,—The following was communicated to me by a

gentleman returning from a malarious district in Africa,where the great dread was hæmoglobinuric fever. Heassured me that it had been exceptionally successful. Itseems to be allied to a form of therapy which is some-

what discredited, I think, at present. Yet, because this

gentleman assured me that under his personal observation ithad been so very successful, I think it worth while to com-municate it :-Un rein de pore absolument frais est decortique et hache menu. On

le lave rapidement a l’eau distillee pour enlever l’urine stagnante quepeut contenir le hachis. Le hachis de rein est ensuite broye, pulpe aupiloy dans un mortier avec 450 c.c. de serum artificiel a 7’50 pour mille(soit 3’25 pour 500 environ). Le pulpage effectue, on laisse exposer labouillie qui en résulte, toujours dans un endroit frais, en ete dans laglace entourant le mortier. Au bout de 4 heures on décante. Leliquide decante forme environ 400 gr. d’une sorte de lavure de chairque le malade doit absorber en 3 ou 4 doses le 24 heures. Ce medicamentpeut etrepris dans unetasse de bouillon ou de julienne tiède à la condi-tion expresse que la temperature du melange ne depasse pas 38° C.

Dr. Touin, the prescriber, adds as a note : " Le traitementne doit pas depasser dix jours consecutifs."

Translation.—An absolutely fresh pig’s kidney is decorticated andminced. It is next washed rapidly in distilled water to remove anystagnant urine. The minced kidney is next pounded in a mortar with450 c.c. of artificial serum at 7’50 per 1000. This being done the resultingbroth is left standing, always in a cool place, in summer surroundedby ice. At the end of 4 hours the supernatant liquid is decanted.It forms about 400 c.c. of a sort of "washing of flesh" which thepatient should take in 3 or 4 doses during the 24 hours. Thismedicament may be taken in a cup of beef-tea or soup, on theexpress condition that the temperature of the mixture is not morethan 38° C. This treatment should not be continued for more thanten days consecutively.

Opportunities for the treatment of nephritis of malarialorigin are infrequent in these latitudes, but possibly this freshinfusion of nephritic tissue may be of service in the ordinaryforms of acute nephritis.

I am, Sir, yours faithfully,S. G. MOORE, M.D. Vict.,

Medical Officer of Health of Huddersfield.

***It will be seen by the letter of our Paris Correspon-dent (p. 68 ) that a paper on this mode of preparing kidney ,,extract was read before the Paris Therapeutical Society onDec. 9th, 1908.-ED. L.

THE LATIN NOMENCLATURE OF BLOODPARASITES.

To the Editor of THE LANCET.SIR,—May I be allowed the hospitality of your columns

to plead with those responsible, for some uniformity in theLatin nomenclature of blood parasites ? I have recently beenreading the third edition of "The Practical Study ofMalaria and other Blood Parasites" (is malaria a blood

parasite ?), by Dr. J. W. W. Stephens and Dr. S. R.

Christophers. At the end of the preface to the third editionit is stated that the authors have included a new unclassified

parasite called Histoplasma capsulata. Why the feminineadjective ? A reference to the index under the word Piro--

plasma shows that plccsrncc is rightly considered neuter.Thus the terms P. bigeminum, P. quadrigeminum, andP. parvum appear. Let me take another parasite, Herpetc-monas. The word is feminine except when used of a,man. But in the index I see H. algeriense with a neuteradjective and H. subulata with a feminine adjective.

Again, take the genus hæmamœba. The authors evidentlyknow that the gender of this word is feminine, for on p. 247they make its plural hæmamœbæ, but on p. 249 appears the.term H. murinus, a masculine adjective, and H. melani-

pherus. The last-mentioned adjective may possibly be con.sidered as feminine from being a Greek compound adjective(cf. and such as a rule has no feminineform. But what can be said of H. monosoma ? Is monosoma,adjectival ? On p. 250 appears H. relicta, a correct title,Surely, Sir, if it is necessary to adopt Latin terms for

parasites, and undoubtedly it is necessary, some care shouldbe taken to adopt uniformity.

I am, Sir, yours faithfully,Dec. 29th, 1908. OXONIENSIS.

MALTA FEVER IN SOUTH AFRICA.10 the Editor of THE LANCET.

SIR,—It may serve a useful purpose to call the attention ofthe profession at home, and especially of those frequentlyconsulted by people recently home from South Africa, that"Malta fever" is quite a common disease throughout this.country. In apparently obscure cases the application ofthe Widal test for Malta fever would perhaps frequentlymaterially help towards a speedy diagnosis. What promptsone to write this letter is the announcements of the homecables of our daily newspapers during the past few days-about the illness of a distinguished visitor who has justreached home from this country and whose illness is. ’

evidently causing some difficulty in diagnosis.I am. Sir. yours faithfully.

KARROO PRACTITIONER,

SANITATION IN INDIA.THE PREVALENCE OF ENTERIC FEVER AMONGST

BRITISH TROOPS IN INDIA.

(FROM A SPECIAL CORRESPONDENT.)

I. —Historical Statistical Retrospect.BEFORE considering’ the general subject of enteric fever iia

India a brief retrospect of the disease with regard to itsoccurrence among the British garrison in that country willnot be without interest. Perhaps the earliest mention isthat of Dr. Moorhead in his Researches on the Diseases of

India," Vol. I., p. 307, published in 1856, where he states’’ that typhus and typhoid fevers are unknown in India" ;still he records in the same volume a few cases of feverwhich showed characteristic enteric ulceration. In the

Army Medical Department Report for 1861 a paper appearson Typhoid Fever in India from a Sanitary Point of View,by Surgeon W. Hanbury, 33rd Foot, in which he gives anaccount of two cases of fever (attended with ulceration ofPeyer’s glands) in the 2nd Queen’s Regiment underDr. Hunter at Deesa in 1841-42, and of six other cases inthe same station in 1859-a most accurate account, clinicaland pathological, of enteric fever. In his introductoryremarks to the paper Surgeon Hanbury writes :-As the interest of the disease rests mainly on the morbid changes

disclosed after death, and the clinical history and character of theaffection can be fully exhibited in the description of the fatal cases, Ishall refer to these only. The identity of the subject will thus be pre-served, and no doubt will arise as to the real matter under consideration;but it will be readily understood (though we do not affect to diagnosethem) that a large number of cases of fever, which at this time ter-minated in recovery, presented symptoms greatly resembling thosewhich characterised the cases selected for observation.

Describing the six fatal cases he adds :—

And taking the direct and corroborative proofs of the existence oftyphoid fever at what I conceive to be their legitimate value, I am notonly of opinion that its identity is fairly established in the history 0’