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asphyxiated, over half the children in the presentseries cried immediately after delivery, and only7 per cent. were deeply asphyxiated. Dr. Williamsconcludes by saying that though Caesarean section isfrequently the easiest manner of delivering thepatient, in the presence of various abnormalities itis not always the safest, and that ideal results areobtained in only a few clinics. ,

JUBILEE OF PROFESSOR LEON FREDERICQ.AT the end of the present academic year Léon

Fredericq, Professor of Physiology in the Universityof Liege, will become Emeritus Professor on resigninga chair which he has held with high distinction for42 years, for he was the immediate successor of Th.Schwann. The occasion will also mark the fiftiethyear of his academic activities as well as the fiftiethanniversary of his promotion to the degree of " Docteuren Sciences Naturelles." Prof. Fredericq’s scientificactivities have ranged over a wide field of physiologicalinvestigation and discovery, and his name and theresults of his life-long work find a place in everytext-book of physiology and every physiologicallaboratory. His wide knowledge of zoology and onoccasion its practical pursuit enabled him to take acomprehensive view of physiology. His work rangesover such diverse fields as coagulation of blood andfibrinogen, haemoglobin and hsemocyanin ; physiologyof the squid, echinus, and crustacea, autotomy, cardio-graphy, venous pulses, the physiology of the heart andrespiration and the cardiac nerves, tension of bloodgases, apnoea, variations of the volume of the brain,&c. ; while he has added considerably to physiologicaltechnique, as in the description of the cesophagealsound, crossed circulation, atriotome, oxygenograph.Moreover, he has trained and helped a large numberof pupils to carry out original work in his laboratory,the later results being published from 1888 in theArchives Internationales de Physiologie, edited byFredericq and Heger (of Brussels). His " Elementsdes Physiologic Humaine," edited jointly with M. Nuel,is in its seventh edition. It is proposed to publish a" Volume Jubilaire," to consist of contributions by hisBelgian colleagues, and those of allied and neutralcountries. The volume will be dedicated to Prof.Fredericq and will be published in the ArchivesInternationales de Physiologie.

STEREOSCOPIC VIEWS OF THE MIDDLE EAR.

IN the course of an investigation extending overmany years Mr. Arthur H. Cheatle assembled themost complete collection of specimens ever made toillustrate the surgical anatomy of the middle ear andof its accessory air sinuses. Every specimen wasobtained from a subject of known age and sex, andhence the collection is of the utmost value for thestudy of the age changes undergone by the middleear, and of the prevalence in adults of variationaltypes. Ten years ago Mr. Cheatle presented hisentire collection to the Royal College of Surgeons ofEngland, where it has been placed in the upper galleryof Room 11 of the Museum, side by side with thefamous Toynbee collection. A descriptive catalogue,prepared by Mr. Cheatle, has been published by theCollege for the use of visitors, who come to study fromall parts of the world. There are, however, manyaural surgeons and others who cannot afford the timeor means to visit London and share in the fruits ofMr. Cheatle’s toil, and hence have suggested thatstereoscopic views of the more typical and importantspecimens should be made and placed on the market.This has now been done under Mr. Cheatle’s super-vision.! About 200 specimens have been photo-graphed and a series of lantern slides prepared tomeet the needs of those who have to teach the surgical

1 Catalogue and Guide to Collection of Lantern Slides of theAnatomy of the Temporal Bone. Set of 200 slides in five boxes,with Album of Photographs and Catalogue. H. K. Lewis & Co.,Ltd. 1921. Price £30.

anatomy of the temporal bone. The photographs-and slides are of excellent workmanship, and shouldprove of the utmost utility for teachers of anatomyand aural surgery.

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A TRIBUTE TO DR. ADDISON.

Lord Carson presided at the recent complimentarydinner to Dr. Christopher Addison, the lateMinister of Health. The gathering was al1.’

eminently appropriate one, for political circum-stances appear to have dictated Dr. Addison’s with-drawal from office at the very time when the valueof his pioneer work was becoming evident to all’except impassioned critics. It had no politicalcomplexion, and was a spontaneous expression offriendship towards Dr. Addison, arising out of hisstrenuous work in high official capacities throughoutthe war. Lord Carson said, ’’ Dr. Addison is one ofthe few who has lasted from the beginning of the waruntil to-day," adding that he, Lord Carson, had triedto do so, but had failed. Tributes of appreciation to-Dr. Addison were paid by Sir Henry Birchenough,Sir Thomas Neil, chairman of the ConsultativeCouncil on Health Insurance Societies, ProfessorR. A. Bolam, chairman of the Council of the BritishMedical Association, and Sir Ernest Moir, latelyController of the Inventions Department of theMinistry of Munitions. The dinner was attended bymembers of both Houses of Parliament and by thestaffs of the Ministry of Munitions and of other Depart-ments over which Dr. Addison had presided, and theguest of the evening had a right to be deeply gratiuedwith such multifarious recognition of his patriotism,industry, and zeal. --

THE FÆCES IN ALIMENTARY DISORDERS.

THE examination of the faeces has not yet becomeestablished as an essential part of the clinical investi-gation of a patient suffering from disease or disturb-ance of function in the digestive system, in the routineway that the urine is observed in morbid conditionsof the kidney and in diseases of metabolism. Thisis the more surprising when it is recognised whatvaluable indications, both in regard to diagnosis andtreatment, examination of the faeces can afford,and, further, how comparatively simple the essentialprocesses in this investigation are. The subject isdealt with in a practical, interesting. and suggestivepaper, published in THE LANCET of July 2nd, by Dr.Robert Coope. He commences his paper with thestatement that it is important to bear in mind thatnormally on a digestible diet the only food residuesfound in the faeces are remnants of muscle fibre and-the tough debris of vegetables. This fact is often

forgotten or not appreciated. It should, moreover,be recognised that test diets may be given, especially

where it is desired to examine for occult blood orsoluble albumin. Dr. Coope suggests that a simpletechnique should involve the macroseopical, micro-scopical, and chemical examination of the faeces, eachof which may give valuable information. Suchinvestigation may afford indications of crucial im-portance, as Dr. Coope’s records show. He pointsout that the abnormal findings can be divided intotwo catagories : the absence of normal constituents,and the presence of abnormal ones. In the firststercobilin is the chief constituent studied. If it is.absent, it may be inferred that no bile is reaching theintestine. In the second category he mentions thepresence of various food residues, especially un-

digested muscle fibre, connective tissue, starch grains,.and fat, and the addition of blood, soluble albumin,and mucus. Dr. Coope maintains that if connectivetissue reaches the faeces in any marked amount, theconclusion that there is a failure of gastric digestionmay be drawn with complete confidence-a practicalpoint. The whole paper is a valuable contributionto the study of diseases of the digestive system. Untilrecently there was a tendency to treat these diseasesin this countrv in a less scientific fashion than is thecustom on the Continent and in America, but the-

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routine application of test-xneals, X ray examinations,and faecal investigations seems likely to becomeestablished. The alimentary system admits of moredirect investigation than some other of the importantsystems of the organism. and accurate diagnosis, witheffective treatment, should be possible in a largemajority of cases. _____

THE POSITION OF INTESTINAL COILS.

Dr. A. C. Gruillaume in La Presse Jleclicule ofJune 15th has tried to answer the old query as towhether there is or is not any definite arrangementof the coils of small intestine within the abdomen.1 obody would deny that great importance might beattached to a definite answer in the affirmative, butno anatomist will be tempted to give this. Dr.Guillaume’s views are in strong support of thoseusually taught in this country, that the first portionof the mesenteric gut generally lies to the left of themiddle line, the succeeding coils being in front andin the pelvis. He points out that the arbitrary junc-tion of jejunum with ileum is fairly constantly placed- at the left pelvic brim. English anatomists will agreewith these findings and will correlate them not onlywith the line of mesenteric attachment, but with thegreater depth of the mesentery in the region of theileum ; but they will hardly feel inclined to agreewith the suggestion that it might be possible to go,with any practical advantage, into more particulardetails of topography. It may be admitted at oncethat the material on which the anatomist works isnot typical of young and healthy bodies, but in spiteof that, and perhaps even on account of that, itrepresents a class likely to come under clinical observa-tion and to call for clinical diagnosis. Yet even the-anatomist who is accustomed to open these bodieshesitates to predict what he will find in the abdomens.Treves, Henke, Sernoff, Weinberg, and other investi-gators have reached divergent conclusions regardingthe arrangement of the coils of the small intestine.Mall’s primary loops are of developmental interest,and are recognisable to a great extent in the adult,but hardly bear on the present question. The situa-tion of coils en masse, and also their disposition anddirection, would seem to be related in some way tothe arrangement of the large gut, but no definite lawson this matter have yet been laid down ; the point isnot dealt with by Dr. Guillaume. His work is of someinterest to the clinician, but more observations willbe necessary to establish the proportionate occurrenceof the varieties he gives and to indicate the con-ditions concomitant with these varieties, so that thechance of an error in topographical intestinal diagnosismay be reduced to an absolute mininrum—and this,- we fear, will remain an ideal for many years to come.

THE SIROCCO FAN.

Sir Samuel C. Davidson who received the K.B.E.on the occasion of the visit of the King and Queen toBelfast is not indeed a medical man, but he has donea great deal for hygiene, particularly at sea. He isthe inventor and manufacturer of the " Sirocco "fan which, first invented to dry tea, is now used soextensively, particularly in the ventilation of ships.There are at least 68 in the Aquitanza and 74 in the.olympic, more likely 100 in each, but we may say,without fear of serious inaccuracy, that every largesteamer uses them for forcing draught in the stoke-holds ; they are employed in the Royal Navy,while one of the tube railways and one well-known

theatre are ventilated with their help. The Siroccofan, which is made in Belfast, has not beenmaterially improved by any foreigner though oftenpirated. It is of quite original design. The ordinaryfiat propeller fan has blades which, at different pointsalong their length, move at very different velocities :they therefore drive the air along the air trunk atdifferent velocities at different distances from thecentre, and so much energy is lost by friction and- eddies. Sir Samuel Davidson had an jmspira- j I

tion, and devised a fan which uses a ring, an

annulus, of blades only 1/20th of the distal endof the radii, all parts of which ring are sensiblymoving at the same velocity. The moving partof the fan is shaped like a tall hat, but instead of theimpermeable side, there is a sort of venetian blindarrangement of slats running the length of the hatfrom the brim to the crown, some 48 of them, and eachwith a slight uniform twist. The runner rotates ina trunk. Air enters in the centre and the appro-priately curved slats, as they rotate, shave off the airnear them, slip it through between them at greatspeed and take more continuously. They pass itthrough and send it on at a pressure three or fourtimes what any other fan can get, and that is achievedwith great economy of energy. Hence it is they areused in men-of-war where the deck openings must bekept as small as possible and yet stokehold pressuresmust be as high as possible. The Royal VictoriaHospital at Belfast is ventilated with the Sirocco fan,this prophet having some honour in his own country.With reference to Sir Samuel Davidson’s honour, aregular correspondent writes to us : " I have twopersonal recollections of the Davidson fan. Whenthe Royal Sanitary Institute met at Belfast Davidsontold me that he had persuaded a man’ there whomanaged a tea-shop to have his shop properly venti-lated, and that the man afterwards declared that hewas very well satisfied, for since he had installed goodventilation his customers ate more cakes. But whatis more important, I remember a ward of 40 beds ina ship with bad ventilation, stuffy and hot, and themen could not sleep at night. Two Sirocco fans, threefeet each in diameter, were turned loose on it, venti-lated and cooled it, and thereafter the men slept. Itis a fine hygienic instrument, and has done greatgood at sea, and it was fitting that the Sailor Kingshould have honoured one who has brought greatbenefit to seamen."

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A STOMACH TUBE FOR INDUCTION OF LABOUR.

-N OE of the various methods of inducing prematurelabour are free from disadvantages of one or anotherkind. The use of bougies is safe and certain, butmay be very tedious, and the introduction of a

hydrostatic bag, such as that of Champetier de Ribes,has the great objection that it displaces the presentingpart and often produces a malpresentation, a seriouscomplication when the child is premature. In someclinics rupture of the membranes is practised, andthis has the merit of being simple and certain, butrenders the labour a dry one, with its attendant risksto the child.

In the June number of the Dublin Journal ofJIedical Science Dr. Gibbon Fitzgibbon describes amethod of inducing labour which is perhaps moresimple and at the same time more free fromdanger than any hitherto suggested. On one occa-sion he found the bougies selected for an inductionwere spoiled in preparation, and in the emergencyhe made use of a 30-inch No. 22 stomach tube.He has since used this method in all private cases,and more recently in several hospital cases, andhas never found it to fail. The tube must beof soft rubber (No. 20 to 24). The lips of the cervixhaving been exposed with a speculum and forceps,the end of the tube is passed into the cervix. If afterabout four inches are introduced the tube sticks, aslight twist on its long axis or a change in the directionof pressure enables it to be pushed right inside theuterus. It coils itself in front of the presentingpart in rings about 3 inches in diameter, and whenthe os is half dilated can easily be removed. Dr.Fitzgibbon states that the tube has the followingadvantages over bougies : (1) greater ease andcertainty of sterilisation ; (2) practically completeabsence of risk of rupturing the membranes ; (3) in theuterus it is confined to the lower uterine segment andso avoids the possibility of disturbing the placentaand also of carrying infection up to the region of theplacenta ; (4) it is as stimulating as the bougies-in all probability it is more so, as it is all in the lower