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His Majesty the Emperor "the great success in eliminatingberi-beri from the navy which ensued from the change in theration, and that hereafter there would be no reason whyJapan should longer dread the ravages of this silent foe."" In view of that unquestioned success in eradicating thisdisease from the navy, the reluctance of the army authoritiesto adopt a ration that had been tried with so much successwas all the more surprising. In February last (1904), how-ever, the number of cases in the army had becomeso alarming that General Terauchi, the Minister of War,ordered a change in the army ration, by which a

mixture of rice and barley, seven parts of rice tothree of barley, was issued to the troops insteadof pure rice." "An immediate change for the bettertook place." " So sure is Baron Takaki that his theory isright that he does not hesitate to say that he could produceberi-beri by diet alone and that he could cure a case andprevent a relapse by diet alone." ’’ Almost one-half of thesickness in her army was from that disease. The estimateof the number of cases ...... shows that they amounted tothe enormous total of 84,545." It therefore comes to this,that beri-beri is a food disease.With all these facts before him even Dr. Seaman goes out

of his way to find a specific cause in the form of an organismwhich is introduced into the body, probably by the mouth,and its propagation generates a toxin which causes de-

generative changes in the peripheral nerves." This is themicrobic theory "run mad." Yet he says : "That it has adirect relation to food is admitted by all authorities and asit only occurs among those races which make rice theirchief staple the question among experts is whether the ricealone or some fungus or toxin of rice is the exciting cause."The observations of Dr. Fraser and Dr. Stanton go to

negative the latter idea and furnish "evidence that thedisease is not a directly communicable one but is due to adeficiency in some of the elements which are necessary forproper nutrition. Nor should I omit to draw attention to thegreat contrast between the Russian and Japanese forces inthe matter of disease. While the former were decimated bytyphoid fever among the latter this disease was almost anegligible quantity. Thus, in Kuroki’s army, in the periodcomprising the months from March to August, the cases oftyphoid fever only amounted to 27, as against 1248 of beri-beri. Lest I should encroach too much on your space I will

only add that I believe it will yet be shown that typhoidfever is also a food disease.

I am, Sir, yours faithfully,GEORGE GRANVILLE BANTOCK.

** We are glad to recall these facts to our readers bypublishing Dr. Granville Bantock’s letter. We publishedthree lectures by Baron Takaki on the Preservation of Healthamongst the Personnel of the Japanese Navy and Army inTHE LANCET of May 19th, May 26th, and June 2nd, 1906.These contained the facts mentioned by our correspondent,and in the issue for June 16th we reviewed Surgeon-MajorSeaman’s work in a leading article on Japanese Medicine.-ED. L.

PURULENT CONJUNCTIVITIS OF INFANCY.To the Editor of THE LANCET.

SIR,-Mr. Sydney Stephenson again suggests that the term" ophthalmia neonatorum " should be retained because it is" time honoured." This argument is too hoary to admit offurther serious discussion. He next claims that there is

nothing to choose between the time-honoured term and"purulent conjunctivitis of infancy," because both termsare inexact. But as between the accuracy of each, theweight of numbers is largely in favour of the latter, and inthis regard Mr. Stephenson himself may be quoted. He haswritten : ’’ About two-thirds of all cases of ophthalmia [con-junctivitis] in newly-born babies brought to hospital are

associated with, and due to, the micrococcus of gonorrhaea.The importance of this generalisation lies in the fact ......that in ophthalmia [conjunctivitis] the cornea suffers com-paratively seldom unless gonococci be the cause of the con-junctival inflammation." That is to say, except for the puru-lent conjunctivitis in infancy caused by the gonococcus therewould be no necessity for any inquiry into the subject. There-

fore, seeing that the sole aim and purpose of the sub-committee

of the British Medical Association is to consider that formof purulent conjunctivitis in infancy which is due to thegonococcus, it is impossible to understand the reason of theretention of the misleading time honoured " ignorantterm " ophthalmia neonatorum," which in no way indicatesthe specific disease into which the committee has been

appointed to inquire. If the term purulent conjunctivitis assuch is objected to, then it is impossible to deny the accuracyof the description gonococcal conjunctivitis of infancy."

I am, Sir, yours faithfully,PERCY DUNN.

CONGENITAL DISLOCATION OF THE HIP-JOINT.

To the Editor of THE LANCET.

SIR,-I read in the report of the last meeting of theMedical Society of London on p. 466 of your issue ofFeb. 13th that one case of the above-named deformity inwhich the surgeon had unsuccessfully attempted Lorenz’s

manipulative method of reduction was made the basis of astatement that this method is of little value. Sometimeswhen important professional topics are to be brought beforea medical society those who have most practical experienceof the matter are invited to express their opinions. I thinkthis course is a good one, because in this way alone can

timely correction of the errors of inexperience be obtained.I hope at an early date to collect together as many as can

be traced of the patients on whom I operated in 1905-06 andto arrange to show them before the Royal Society ofMedicine, previous to publishing a full statement of theresults I have obtained in some 50 cases. At present I willonly repeat what I stated in my article in THE LANCET ofMarch 9th, 1907, p. 650, that when the operation is done byone experienced in the method at a suitable age it is notfollowed by any severe pain or other serious effect and thatin about 80 per cent. of the cases a permanent cure—i.e., atrue anatomical reduction as shown clinically and by x rays,with a perfect physiological function, is obtained.

I am, Sir, yours faithfully,J. JACKSON CLARKE.

THE OBJECTS OF EXAMINATIONS.To the Editor of THE LANCET.

SIR,-Letters appearing in THE LANCET of Jan. 5th and12th on "The Objects of Examinations" are particularlyinteresting to unfortunates like myself who were never luckyat these ordeals. I wonder whether my experiences are

unique ? I believe I was of average intelligence at schooland left obtaining an "exhibition or "scholarship" at amedical school, intending to work hard and hoping in timeto obtain the F. R. C. S. Eng. and an M. B. of a British

university. I passed the second " Conjoint " and the inter-mediate M.B. in the shortest time allowed by the regulationsand was ’’ ploughed" " for both finals in due course. Inthe subject, surgery, in which I failed I happened to beexamined by the same gentlemen in both examinations. I

presented myself again for both and met the same gentlemenwith the same result.

Three months after the second defeat I obtained the onlyqualification I possess. After a few years’ practice at homeI again presented myself for the College examination and,curiously enough, met one of the same examiners whoreferred me for three months. I could not complain at anyexamination, either at papers or at questions asked byvivd voce examiners, and I honestly believe that the examina-tion I passed was the most searching of any I tried. Myone complaint was one of manner. The searching gaze, theforbidding manner of the questioner, and the almost insolentreception of my answers caused in me such a helpless stateof hopeless nervousness that after a few minutes of therack my answers must have been as wide of the mark asAuntie Martha’s to Joseph Vance.My last experience was too painful. I was in practice ;

my medical friends knew I had tried and failed. I sold outand " got " to the " colonies " and have never since grumbledat my lot. I have a practice considerably over the £1000 perannum which is regarded as ’’ decent." I hold moderatelyhigh rank in a "colonial" A.M.C., am an M.O.H., a J.P.,

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and medical officer to two hospitals as large as many non-teaching hospitals at home, so though by no means

brilliant may claim, I think, average intelligence. Butbecause of lack of surgical knowledge or an equable nervoussystem, or horresco referens-after reading your leader on theobjects of examinations-lack of an examiner who could

examine, I still am only an L. S. A.PS.-And am rather proud of it.

BIRMINGHAM.(FROM OUR OWN CORRESPONDENT.)

The University. s

AT the recent annual meeting of the court of governors, the tVice-Chancellor (Alderman Beale), in moving the adoption of the report, drew the attention of the governors to the fact tthat a pension fund had been established for the members of Ithe staff of the University. He admitted that the usual ‘obligation to do something for those who had given the best Iof their lives to the service of an educational establishmentwas obvious, and he stated that by utilising the earmarked portion of the Government grant the council had seen its way to adopt a definite scheme which would, at first, entail isome increased expense but which would eventually become self-supporting. He gave no details of the scheme but it is ]understood to be a contributory scheme, those who are tobenefit devoting a certain percentage of their income to thefund whilst the council contributes the necessary additionalamount from the Government grant and from its other re-sources. Having dismissed this subject the Vice-Chancellorpassed on to the opening of the new buildings at Bournbrook,which is to take place in July, but he was unable at themoment to give any information as to the date or otherdetails. In dealing with the financial part of the report hereferred to the deficiency in the annual accounts of R4924.This deficiency is quite apart from capital expenditure andis due largely to interest on borrowed money and to the

expense entailed in establishing Queen’s College as a hall ofresidence ; eliminating those two items, then, it was found thatthe income had increased by £1741 and the expenditure by alittle under R200. He did not expect that the two items whichhad disturbed the accounts in such an unsatisfactory mannerwould recur, but, on the other hand, he desired his audienceto recognise that the expenditure at Bournbrook wouldbe greatly increased when the departments of chemistryand physics were opened. Turning next to the appealfor money which has just been launched, he was able to

report that during the short time which it had been beforethe members of the court of governors an additional £10,000had been received and the total at the date of the meetingwas £67,000. The increase had come, however, from a

comparatively limited number of subscribers, and he ex-

pressed the hope that people would not hang back becausethe amounts already contributed were chiefly large amounts,for small as well as large amounts were required. He wassure that if they had cooperation and the public could beroused anything could be done, and he appealed to the

present generation to do for their successors what their

predecessors had done for them.2’/;e Birmingham and Midland Eye Hospital.

Last year the committee of the Birmingham and MidlandEye Hospital secured the adjoining premises which hadpreviously belonged to the Girls’ Friendly Society. It hasbeen decided that that building shall be devoted to the use ofthe nurses and servants and their removal from the hospitalbuilding will give accommodation for 16 additional beds.The enlargement will necessarily increase the expenses of thehospital, and the committee hopes that the public will,therefore, give it increased support. It has also beendecided that some of the additional accommodation shall beutilised for paying patients ; by this means some of theincreased expense may be recouped and at the same timehelp will be given to comparatively poor people. To preventany abuse of the system a small committee will satisfy itselfas to the suitability of the patients admitted to the payingwards from a general point of view, the medical officers

deciding as to their fitness.A Case of Rupture of the Heart.

At an inquest held on a case of sudden death which

occurred recently in Aston, Dr. G. P. Adamson, who made thepost-mortem examination, stated that the right auricle ofthe heart had burst to such an extent that he could put threefingers through the rupture. The subject was a youth, aged19 years, who was 6 feet 2 inches high. All his internal

organs were healthy except the heart, which was generallyaffected with fibrous degeneration. In the evening of hisdeath he complained of pain in the throat and chest and hevomited. He consulted a medical man and afterwards

walked, with assistance, to his lodgings. There he was

given an emetic and directly afterwards he became worseand died very suddenly.

Increase of Lunacy at Aston.At a recent meeting of the Aston board of guardians it was

shown that the number of lunatics maintained in asylums bythe board was that week 68 more than in the correspondingweek of the previous year, and the suggestion was made thatthe medical officers should consider the advisability of

remanding some of the cases to the workhouse for a fewweeks so that they could be under observa,tion. The chair-man pointed out that the guardians were only administratorsand had nothing to do with deciding who should be sent tolunatic asylums. He stated, further, that the increase ofthe number of lunatics during the past year meant an addi.tion of Z1800 to the expenses of the union and he noted thatsome years ago they were paying £10,000 annually forlunatics, whilst now they had to pay almost .620,000 a year.

The Children’s Hospital.The annual report of the Children’s Hospital, presented at

the meeting held on Monday last, is a record of increasedwork done at a reduced cost and resulting in a financialdeficit of .6294, which brings the total adverse balance to£1233. This deficit, though a small matter in itself, isominous as regards the increased support which will be

necessary when a larger hospital is erected, and it is to theprojected new hospital that the committee particularly wishesto direct public attention at the present moment. Not onlyis the lease of the present building rapidly nearing itstermination but the building itself is so badly adaptedfor its purpose that the chairman (Mr. A. F. Bird)did not hesitate to state that if an outbreak of in-fectious disease occurred and the new hospital was not avail-able the in-patient department might have to be closed.The estimated cost of the new hospital is £90,000, towardswhich .619,904 have been given or promised and to which maybe added a balance of uninvested legacies amounting to£3644. After the committee has paid for the site of thenew hospital from the combined amount it will only have.f.6500 in hand for rebuilding purposes. The committee is ofthe opinion that such a relatively small sum does not justifyit in commencing building operations and the scheme mustremain in abeyance until the public subscribes about £30,000.This is not a very large amount to a.sk for, and in spite ofthe bad times and various other appeals it ought easily to beobtained for so excellent a purpose.Feb. 23rd.

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MANCHESTER.

(FROM OUR OWN CORRESPONDENT.)

Fire at a Lodging-house.THE recent fire at a lodging-house in Manchester, where

nine people lost their lives, may perhaps serve to call atten-tion to the very anomalous conditions under which theseinstitutions, if they may be so called, are allowed to becarried on. This lodging-house was made up of three adjoin-ing houses, in a street which has fallen considerably inpopular esteem. That they had been houses of some import-ance is shown by their being registered for 339 lodgers,but there were only 308 beds, and on the morning of thefire 225 men slept there. At the inquest, held on Feb. 18tb,the proprietor said he opened them as a lodging-housein 1905, that they required no alterations except a woodenpartition or two, "or something of that sort." There werethree front doors, a strong latch on one, four bolts and achain on another, and the door in the centre on the chainonly. At the back there were three doors, and each house hadone staircase. The precautions against fire were that bucketshung in the passages, exit notices were posted up and down,