1920 THE METROPOLITAN HOSPITAL SUNDAY FUND.

investigate the matter and to report to the committee. In themeantime Dr. Reynolds discovered and published the factthat arsenic was the cause of the epidemic.

I have examined about 240 samples of beer within the lastfew weeks and found them to contain : two half a grain, oneabout one-third of a grain, five about one-fifth of a grain,three about one-seventh of a grain, two about one-tenthof a grain, and five from about one-tenth to aboutone-twentieth of a grain of arsenic trioxide per gallon. 174contained amounts varying from one-twentieth part to one-two-hundredth part of a grain of arsenic trioxde per gallonand 48 samples were free from arsenic. In samples of beerbrewed from the same quantities of sugar and malt, one con-taining, however, a greater quantity of hops than the other,the former .contained considerably less arsenic than thelatter. The hops, therefore, appear to precipitate some ofthe arsenic from the beer. I then found arsenic in beer tothe extent of one-thirtieth of a grain per gallon, which wassaid to be brewed from malt and hops alone and I thenobtained and analysed samples of malt.

I have found that a number of samples of malt containedquantities of arsenic which if dissolved in the beer in theproportion of two and a half pounds of malt to the gallon(assuming all the arsenic in the malt to go into the beer)that the contamination so produced would be as great, ifnot greater, than that of the average arsenic contaminatedglucose beer. It is difficult to see how under the presentusual methods of malt manufacture arsenic contaminationcan be avoided, as it is suggested by some that the fumesarising from the burning of anthracite or coke on beingallowed to impinge upon barley after it has sprouted duringthe drying operation gives rise to a peculiarity of taste in thebeer which is demanded by beer-drinkers.

In 17 samples of malt which I have examined five werefree from any trace of arsenic, one contained a one-

seventeenth, one a thirty-third part of a grain per pound,three contained one-fortieth, two one-fiftieth, one one-

sixtieth, three one-seventieth, and one one-hundred-and-fortieth of a grain per pound. I have examined five

samples of barley which were all free from any trace ofarsenic except one, which was a dried barley, and this con-tained not more than one-five-hundredth of a grain per pound.This arsenic is contained in the vapours from pyrites in theburning anthracite or coke, as is shown by the fact that maltculms,which are the separated sprouted portion of thebarley and which I understand are only used for cattle food,contain arsenic (in one sample which I examined) to theextent of one-seventh of a grain per pound. This materialexists in very small grains and the fumes from the anthraciteor coke would therefore affect a much larger proportionatesurface than would be given with ordinary malt, which is amuch larger grain.

If we take it, then, that all the arsenic contained in themalt would go into the beer manufactured and assume thattwo and a half pounds of malt be used for every gallon ofbeer, and if we take the average of a fiftieth of a grain ofarsenic per pund of malt, it is evident that the beer mightcontain one-twentieth of a grain of arsenic per gallon-i.e.,about a gallon and a quart of beer would contain a maximummedicinal dose of arsenic.

I have also found small quantities of arsenic in the hopsto the extent of one one-hundredth of a grain per pound, butfrom the quantity of hops used in making beer the amountin the finished beverage must be extremely minute.

I have also detected arsenic in other mineral substancessometimes added to beer, but these are used in such small ’,quantities that they could not materially affect the beer.Phosphate of soda, for instance, contained about three grainsper pound ; metabisulphite of potash contained a one-

sixty-sixth of a grain per pound. The yeast appears tosecrete arsenic from the wort, as I found it to be presentin certain samples to a greater extent than in the beerbrewed with it.From this estimation of arsenic in the samples of malt I

presumed that that metal must exist in considerable quantityin ordinary soot. I therefore obtained a few days ago somesoot from an ordinary kitchen chimney which I have analysedand find it to contain one and a half grains of arsenictrioxide per pound. I have also examined two samples of cokeand one of Welsh anthracite used in drying the malt andhave found the former to contain in one sample one-twentieth,the other one-seventeenth, of a grain of arsenic trioxideper pound, whilst the sample of Welsh anthracite containednot more than one four-hundredth of a grain of arsenicrioxide per pound. Presumably, therefore, if the present

process of malt drying is to be continued, anthracite] annot coke should be employed by the maltster.

It is questionable how much arsenic, if any, should beallowed in any article of food. The Scandinavian Govern-ment will not allow a carpet or piece of cloth to be broughtinto their country which contains one-hundredth of a grainper pound, whilst some medical men are inclined to pass abeer containing a one-hundredth of a grain per gallon.This involves a problem which demands serious con-

sideration."

THE METROPOLITAN HOSPITAL SUNDAYFUND.

AT the annual general meeting of the constituents ofthis Fund held at the Mansion House on Dec. 20thArchdeacon SINCLAIR presided in the absence of the LordMayor, and the following report, proposed by the Rev.

Prebendary RIDGEWAY, seconded by the Earl of STAMFORD,and supported by Canon Mc CORMICK, was unanimouslyadopted.The twenty-eighth year of collecting this Fund has

resulted, under the Presidency of the Right Honourable SirAlfred J. Newton, Bart., Lord Mayor, treasurer, in a total of.651,993 1. 6d.The constituents in annual general meeting, assembled

in the Mansion House on Dec. 13th, 1899, elected thecouncil for 1900. At the same meeting Hospital Sunday for1900 was fixed for June 24th, and the usual invitations tocooperate were ordered to be sent to the heads of all congrega-tions within the metropolitan area. Collections were madeaccordingly and have resulted in a total of £ 35,856 8s. lld.The Rev. Prebendary C. J. Ridgeway, M.A., of Christ

Church,’Lancaster Gate, heads the list of contributors withf.1519; the Rev. Canon Fleming, B.D., of St. Michael’s,Chester-square, collected .61158; and the Rev. PrebendaryEardley Wilmot, M.A., of St. Jude’s, South Kensington,.£ 655.There is a decrease this year of f.2313 from congregational’

collections, owing no doubt to the very large contributions.collected to meet the wants of our soldiers and sailors.

engaged in the war in South Africa. Seven more èongrega-tions have collected this year.

In addition to the collections from the contributing con-gregations Mr. George Herring sent a further munificent,donation of f.10,000 and expressed his high approval of the-manner in which the Fund was administered. Mr. Herring alsooffered to give an additional E10 000 if the collections could.be raised to .690,000. e1090 was received from the estate ofthe late Mr. Thomas King, of Tisbury, Wilts..61000 wa8received from "F. H." Sir Savile Crossley, Bart., againgenerously contributed f.500 (tenth donation); " A. G. P.,"&300; and "Delta" sent his twenty-second donation of.6200.The first meeting of the newly-elected council was held

on Jan. 19th, 1900, when the General Purposes Com.mittee, the Committee of Distribution, and the Special Com-mittee for the issue of Surgical-Appliance Orders andHospital Letters were appointed. Sir Edmund Hay Currieand Mr. Richard B. Martin, M,P., as honorary secretaries,and Mr. Henry N. Custance, as secretary, were re-elected.Dr. W. S. Church, President of the Royal College ofPhysicians of London, was elected to a vacancy on thecouncil caused by the death of Sir James Paget, Bart.,F.R,.C.S. Eng.The council gave its general assent to a memorial intended

to be presented to the President of the Local GovernmentBoard with a view of gaining the exemption of hospitalsfrom local rates.On the motion of Sir EDMUND HAY CURRIE, seconded by

Mr. SANDEMAN, and supported by the CHIEF RABBI the lawsof the constitution, which have been in force during thepast year, were re-affirmed.The Rev. A. A. DREW proposedThat the council for the year 1900 be re-elected (with the thanks 1

of this meeting for their labours in the past year), for the-year 1901, with the Rev. Ravenscroft Stewart, M.A, the Rev. R.Fotheringham, M.A., the Rev. E. H. Pearce, M.A., and Roger de (,,1Quincey, Esq., to fill vacancies.

The Rev. Sir B. SAVORY seconded the proposal, which wascarried.June 16th was fixed for Hospital Sunday for 1901, and a

1921THE SERVICES.-" ISOLATION HOSPITALS."

vote of thanks to the Chairman and to the Lord Mayorterminated the proceedings. I

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are notified :-Surgeons:

J. H. Fergusson to the Ramillies and R. B. Ainsworth to theHannibal.

ROYAL ARMY MEDICAL CORPS.

Lieutenant A. D. Jameson has been instructed to proceedto Woolwich on Jan. lst, 1901, for duty.

VOLUNTEER CORPS.

A,rtille,ry : 4th Lancashire : Surgeon-Captain J. C. M.Given resigns his commission. Rifle: The Queen’s RifleVolunteer Brigade the Royal Scots (Lothian Regiment) :Andrew Hutton Watt to be Surgeon-Lieutenant. 8th(Scottish) Volunteer Battalion the King’s (Liverpool Regi-ment) : William Saville Henderson to be Surgeon-Lieutenant. lst Volunteer Battalion the East LancashireRegiment: Arthur Foster to be Surgeon - Lieutenant.1st (Renfrewshire) Volunteer Battalion, Princess Louise’s(Argyll and Sutherland Highlanders): Claud WilliamMarshall to be Surgeon-Lieutenant.

VOLUNTEER MEDICAL STAFF CORPS.Aberdeen Company: Arthur Hugh Lister to be Surgeon-

Lieutenant (supernumerary).TRANSVAAL WAR NOTES.

Lieutenant-Colonel R. T. Beamish, R.A.M.C., is returninghome invalided on board the s s. Wakool. Colonel A. H.Anthonisz, R.A.M.C., and Civil Surgeons E. A. Chartres, T.Kay, G. B. Buchanan, A. C. Bird, and F. 0. Stoeher arereturning home in the same vessel. At the request of themilitary authorities the Imperial Yeomanry Hospitals Com-mittee have consented to prolong the duration in SouthAfrica of all the Imperial Yeomanry hospitals until April.

ARMY MEDICAL SERVICE REGULATIONS.The Army and Navy Gazette of last week states that the

latest (1900) regulations for the Army Medical Services havebeen published, and many useful additions appear in them.One alteration particularly demands attention-viz., thatnow it is ruled that the principal medical officer of a forcein the field (Part II. War, para. 626) will be attached tothe staff of the general officer commanding-in-chief. This

effectually deals with the stupid arrangement which rele-gated the P.M.O. to the base, at whose suggestion it isdifficult to know. Experience in South Africa has doubtlessmade it clear that a restoration of the principal medicalofficer to his proper position was urgently needed. The new

regulations, together with the Manual for the Royal ArmyMedical Corps," and the standing Orders" for the same(1899 edition) show work well done at the medical divisionof the War Office during a time of great pressure.

THE LATE OUTBREAK OF FEVER IN THE PUNJAB.There has, according to the Pioneer Mail, been a severe

outbreak of fever of a malarial character in the Punjabduring the autumn of this year. It is, however, subsiding.At Lahore and Mian-Mir European officers, civil and mili-tary, have been sufferers, while at Ferozepore the wholegarrison (with the exception of British troops from the hills)have practically been placed hors de combat. Orders havebeen issued for the 47ch Battery R.F.A. to be transferredtemporarily to another station for change of air, but atpresent the men are too feeble to be moved. The disease isof the Peshawar fever type and it has prevailed in the nativecity as well as in the cantonments. Delhi also has been amongthe towns that have suffered and the mortality in some ofthe districts is stated to have been heavy.

RECRUITING.In 1899 the Inspector-General of Recruiting was able to

point to a return of 42,700 men who had accepted service inthe regular army, as compared with 38,418 in 1898, 33,722in 1897, and 27,809 in 1896. The increase during the

present year will probably be still greater. Major-GeneralBorrett in his report on last year’s recruiting states : " Thewar in South Africa largely contributed to the material

improvement which set in during the early months of the

year ; thus the year has closed as the best since the intro-duction of the short service system. Not only did morerecruits present themselves for enlistment, but they were-of decidedly better physique. While recruiting was in anunsatisfactory condition the percentage of recruits takenunder standard had been very high, but in the last quarterof the year it fell materially."

THE EXPERIMENTAL TRIAL OF A NEW SYSTEM OFCOOKING IN INDIA.

It will be remembered that it had been determined, as anexperimental measure, to replace the native cooks employedin connexion with British regiments serving in India bycooks drawn from the regiments themselves. The new

system has not proved altogether satisfactory so far as theexperiment has been tried at present, but it is too early yetto pronounce any definite opinion in regard to it. The nativeservants of India are excellent cooks, as a rule, and it is

surprising how well they contrive to succeed in their art,often under very adverse conditions, but it is open to doubtwhether they are as careful in the matter of cleanliness andsanitary precautions as are Europeans; hence it was, we-

believe, that it was determined to give a trial to the latter.

Correspondence.

"ISOLATION HOSPITALS."

"Audi alteram partem."

To the Editors of THE LANCET. .

SIRS,-As I before pointed out 1 isolation hospitals arepreventive institutions or nothing. Keeping this fact in viewthe chart which Dr. A. J. Tonkin furnishes in your issue ofDec. 22nd (p. 1835) only adds force to my argument that thesepreventive institutions do not prevent. The story would havebeen told with added emphasis had Dr. Tonkin continuedthe upward curve for 1899 (Nottingham) to 2580 instead ofleaving it at 1500. Your correspondent does not attempt todeny the importance of the figures, but he seeks to

explain them on the hypothesis of 11 well-known and

recognised periodic waves." I do not wish to imitate the-tone of Dr. Tonkin’s letter, but I may be allowed to say thatsuch "periodic waves" " are neither well known nor

recognised. It is a small matter that I have failed todiscover such a law, but I find on page 124 (vol. ii.) ofAllbutt’s 11 system of Medicine" these words, 11 own carefullysurveying the records of scarlet fever epidemics in the past,it is manifest that nothing approaching periodicity hascharacterised its epidemic prevalence." But if it be grantedthat such epidemic prevalence is merely an operation of afixed law then our efforts at prevention are absurd andunscientific. Your correspondent’s line of argument onlyproves what was known before-that the real raison d’6tre-of isolation hospitals is being lost sight of, the futility ofefforts directed to prevention having been silently recognisedlong ago. Let your readers, Sirs, again examine Dr. Tonkin’schart by the light of the fact that he is not authoritativelysupported in his views about periodic prevalence and theymust conclude, with me, that that gentleman has renderedme considerable assistance. In his conduct of the defencehe has made the not altogether unknown mistake of callingone of the most powerful witnesses for the prosecution.

I am accused of having dealt only with a period "whenscarlet fever was epidemic in all the large towns." Inview of the impossibility of reproducing all the statistics-which bear on this question in one letter I did whatstemed to me quite fair : I gave the returns of severalof the largest towns, taking them in the order of theirimportance. The editorial comments which called forthmy reply had reference to a booklet dealing with the32 large towns of England and Wales, from the dates.when each of these came under some form of notification tothe present time. When that letter was written it neverdawned upon me that any man who had in view the objectsaimed at by the establishment of isolation hospitals wouldbuild up an argument founded on the admission that no effortcan stay the oncoming of the periodic wave. It is a kindof logic which I find extremely puzzling. That it is giving

1 THE LANCET, Dec. 15th, 1900, p. 1759.