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persons aged 60 years and upwards ; the deaths of infantsslightly exceeded the number in the preceding week, whilethose of elderly persons showed a decline. One inquestcase and two deaths from violence were registered, and 91,or more than 42 per cent,, of the deaths occurred in publicinstitutions. The causes of nine, or over 4 per cent., of thedeaths registered in Dublin last week were not certified.

THE SERVICES.

ROYAL NAVY MEDICAL Service6THE following appointments are notified :-Deputy In-

spectors-General : T. D. Gimlette to Hong-Kong Hospital andL. H. Kellett to Plymouth Hospital. Fleet Surgeons : J. L.Barrington to Haulbowline Hospital H. R. Osborne to theGood Hope; W. Bett to the Russell E. B. Townsend to theBritannia, for Dartmouth sick quarters ; and J. H. Sten-house to the Spartan. Staff Surgeon W. H. S. Stalkarttto the 2MbM?KOM<A. j surgeon J. Fullarton to the <7<K%MMS.

ROYAL ARMY MEDICAL CORPS.Lieutenant J. Waddell is placed on temporary half-pay on

account of ill-health (dated March llth, 1904).ARMY MEDICAL RESERVE OF OFFICERS.

r-

Surgeon-Captain G. A. Lang, having resigned his com-mission in theVolunteerF, ceases to belong to the ArmyMedical Reserve of Officers.

VOLUNTEER CORPS.

-Royal arrison Artillery (Volunteers) 7th LancashireThe appointment of Joseph Grant-Johnston to a Surgeon-Lieutenancy is cancelled.

Rifle: 2nd Volunteer Battalion the King’s (LiverpoolRegiment) : Captain D. Smart, from the Liverpool Volun-teer Infantry Brigade Bearer Company, to be Surgeon-Captain and to be borne as Supernumerary whilst doingduty with the above Bearer Company (dated April 2nd,1904) ; Lieutenant J. G. Martin, from the Liverpool Volun-teer Infantry Brigade Bearer Company, to be Surgeon-Lieutenant and to be borne as Supernumerary whilst doingduty with the above Bearer Company (dated April 2nd,1904). 2ad Volunteer Battalion the Durham Light Infantry:Surgeon-Lieutenant T. H. Livingstone resigns his commission(dated April 2nd, 1904). 9th Lanarkshire: Surgeon-Lieu-tenant W. J. Mackinnon to be Surgeon-Captain (datedApril 2nd, 1904).

DEATHS IN THE SERVICES.

Inspector-General Timotheus J. Haran, R N. (re’ired), athis residence in London, in his seventy-fifth year. He enteredthe Royal Navy as assistant surgeon in 1850, became staffsurgeon in 1858, fleet surgeon in 1871, and reached the rankof inspector-general in 1886. He retired two years later.In 1851 he was assistant surgeon of and employed in chargeof the Harlequin’s boats in the attack on Lagos (mentionedin despatches), and he was also present in several sub-

sequent expeditions to the rivers and lagoons adjoiningagainst the expelled chief Kosoko. He was also employedrepeatedly in boat cruising in the Harlequin’s boats forthe purpose of suppressing the slave trade on the WestCoast of Africa. During the Crimean war he was assistantsurgeon of the Viper in the Black Sea and was repeatedlyin action. He took part in the battle of Eupatoria, theoperations on the coast of Circassia, including the captureof Kertch, and the expedition in the Sea of Azov, the nightattacks on the sea defences of Sevastopol, the capture ofKinburn, and the subsequent operations in the Gulf ofDneiper (Crimean and Turkish medals, the Azoff andSevastopol clasp). He was assistant and additional surgeonof the Bosca7ven, flagship of the Hon. Sir F. W. Grey on the z,

Cape of Good Hope and West Coast of Africa station,between 1857 and 1860 and landed at Ascension to attendyellow fever cases of the Tridtnt in 1859, He was surgeon ofthe Brisk from 1860 to 1863, being employed at the Cape ofGood Hope and East and West Coasts of Africa, and accom-panying Commodore Wilmot in December, 1862, on a missionto the King of Dahomey-an enterprise then consideredperilous and which entailed an absence from ship of sixweeks. He was selected for service with the Royal Marinebattalion which proceeded to South Africa in 1879. In 1881he was employed at Haslar and was afterwards in charge ofthe Malta hospitals up to the year 1886, when he was pro-moted to inspector-general and appointed to Plymouth

Hospital. Inspector- General Haran was a justice of thepeace of Queensland and was honorary surgeon to the King.

Staff Surgeon William Rogers, R.N. (retired), on April 7th,at his residence at Saltash, Cornwall. The deceased enteredthe Royal Navy as surgeon in 1839 and was promoted tostaff surgeon on Oct. 20th, 1845. He had seen no warservice. Since his retirement he had lived at Saltash wherehe was much respected.

Colonel Robert de la Cour Corbett, D.S.O., R.A,M.O.,principal medical officer of the Ondh and Rohilkhunddistricts, at Lucknow, on March 24th, aged 59 years. Heentered the service in 1867 as assistant surgeon, becamesurgeon in 1873, surgeon-major in 1879, brigade-surgeon in1893, and surgeon-colonel in 1898. He served with theBurmese expedition in 1886-87, during the later part of thecampaign acting as principal medical officer of the UpperBurmah Field Force (mentioned in despatches, D.b.O.,medal and clasp).

Lieutenant Colonel Nathaniel Alcock, A.M.S. (retired),at Bellevue, Ballybrack, co. Dublin recently. He joined thearmy in 1860, became surgeon in 1873, surgeon-major in1875, and retired in 1889. He served in the Kaffir war of1878 (medal). He had been employed for some time asmedical officer in charge of the military prison, Dublin.The deceased was a much esteemed and deservedly popularmedical officer who possessed considerable literary andscientific attainments. The loss of health mainly broughtabout by field service and exposure in the Kaffir war,unfortunately led to his comparatively early retirement, bywhich the Army Medical Service lost an able and promisingmember.

DENTISTRY IN THE ARMY.It is only of late years that the importance of dentistry has

been recognised by military authorities. A soldier to gothrough an arduous campaign with efficiency must keep ingood health, but unless his teeth are in good order he cannotmasticate his food properly and his digestion will thereforebe defective. Military rations in the field are not alwaysreadily assimilable ; on the contrary, they are often suppliedin a highly indigestible form, so the soldier more than thecivilian should have every part of his assimilating apparatusin good working order. In the Deutsche Milit&auml;r&auml;rztlicheZeitschrift for January Dr. Richter discusses the subjectof military dentistry at considerable length. It was

in Saxony that steps first were taken to instruct soldiershow to take care of their teeth. On April 3rd, 1902,a Ministerial circular containing instructions regardingthe hygiene of the mouth was issued and in the follow-ing March a similar procedure was generalised for thewhole of the German army. Lectures on the subject byqualified medical officers have also been instituted and non-commissioned officers are required to see that the inculcatedtheories are carried out. A few dental dispensaries are nowin operation in some of the chief garrisons of Saxony andBavaria, including Dresden and Leipsic, the charges beingextremely moderate. Tooth-stopping, for example, costs 6d.only and a denture of eight teeth can be fitted for 7s. The

personnel of these dispensaries is furnished by the dentists(qualified and probationary) who are fulfilling their term ofcompulsory military service. The reason that these establish-ments are as yet comparatively few in number is not dueto budgetary restrictions, for the expenditure involved istrifling, but to the fact that dentists in Germany are ex.tremely scarce. Whereas close on 30,000 medical men areengaged in the active exercise of their profession throughoutthe empire the total number of dental surgeons does notexceed 1800. And yet, according to Dr. Richter, the scopefor skilled dentistry is considerable. Out of 1000 personsexamined by him he found that on an average each individualhad 5’9 9 teeth in his mouth that were more or less decayed.A perfectly sound set of teeth was extremely rare. In an

infantry regiment there would be need, he says, of 2300 toothextractions every year, 2100 teeth would require stopping,and 50 men would be candidates for dentures, partial or com-plete. Every recruit, continues Dr. Richter, should be taughtthat with care the usefulness of his teeth can be greatly in-creased and their duration prolonged. Caries in his opinionis not hereditary. Every night before going to bed the mouthshould be thoroughly rinsed and the teeth well scrubbed witha wet brush. Unless this is done fermentation will take place,acids will be generated, and decay facilitated. During thedaytime the mouth is seldom as quiescent as it is duringsleep. Talking serves to keep the teeth clean and toothpicksafter meals are very useful. Dentifrices and washes, in Dr.

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’Richter’s opinion, are worse than useless. Nothing can bebetter than mechanical cleansing with a wet brush.

A BRITISH OFFICER’S REPORT ON THE FIGHT ATCHEMULPO.

A long extract from a letter by Captain Lewis Bayly ofH.M.S. Talbot, dated Feb. 20th, has been published, fromwhich we reproduce (from the Standard of April 12th) thefollowing very interesting medical details connected with anaval engagement in modern war :-In connexion with the engagement between the Russian ships

Varyag and Korietz and the Japanese fleet I beg to inclose the follow-ing remarks -Chaplain Roudneff states that the carrying away of thewounded on stretchers became impossible; several men were carryingthem when shot down and only five men altogether were brought downto the doctor below the water-line, while of these five the doctor of theVaryag says two were practically dead when they arrived. Theyhave held classes on board the Varyag to instruct men in " first aid ";bags of bandages had been served out and the doctor says that somelives were thus saved by being thus treated. The Russian sailors beartheir operations wonderfully well. There were 150 men employed on theVaryag’s upper deck during the action and nearly all the killed andwounded were out of this 150, which is 28 per cent. killed, 45 per cent.wounded. It must not be forgotten that having no gun shields hergun crews were practically unprotected and that shrapnel shell werelargely used, to judge by the holes in the boats, funnels, &c. All was.quiet in the engine room, as though they had been at target practice.In one stokehold (they have five with no fore and aft bulkhead) thewater came up to the floor of the furnaces but did not get into the Iother stokeholds.

Further on and at the end of his communication CaptainBtyly goes on to add that-A vprv orpat deal of Rhrannpl mn.t, have hPan firprl fit. tha Vr/.t"/7

judging by the round holes, and not much lyddite, for there seemsto have been no inconvenience from poisonous gases. Much troublehas been caused to the wounded on account of the pieces of cloththat are constantly being extracted. Many men are wounded withpunctures, holes about as large as the top of the little finger, andfrom a quarter of an inch to half an inch or one inch deep, but with noforeign substance such as iron, &c.. being present in the wound, andno sign of scorching round the mouth of the wound.

THE WAR IN THE FAR FAST.

1h3 Japanese Red Cross Society has a roll of between.800,000 and 900,000 members and its organisation leaveslittle if anything to be desired. Nearly 300 medical menare employed in its service and some 1600 qualified nursesare ready for immediate work in connexion with the war.The two permanent hospital ships of the society haveaccommodation for 400 patients.The Times states that " 200 Canadians who served in South

Africa with medical and bearer corps have been engaged bythe Japanese Government to serve in the present war in asimilar capacity. The Japanese authorities have shown acomplete knowledge of Canadian participation in the SouthAfrican war in the selection they have made."The executive committee of the Russian Red Cross Society,

says the Novosti, has received advice from Athens that in theRussian Embassy there many Greek medical men have en-rolled their names with the request that they may be sent tothe theatre of war to serve in the hospitals.’THE LATE FREDERICK CHARLES STEARN, SURGEON, R.N.

The funeral of Surgeon F. C. Stearn, one of the medicalofficers of Portsmouth Dockyard, took place on April 6thwith full naval honours. The service in the Dockyardchurch was held by the Rev. Dr. Shone and was attendedby Rear-Admiral Henderson and all the Dockyard officers,Flag-Captain Sir R. K. Arbuthnot representing the Com-mander-in Chief. Afterwards a procession was formed,headed by a firing party. Then came the band of the RoyalNaval Barracks, preceded by a field gun carriage on whichwas the coffin covered with a Union Jack and bearing thedeceased officer’s hat and sword. Six surgeons were pallbearers. Carriages with private mourners followed andafter them walked a large number of naval and Dockyard- officer. The interment was at the Highland-road Cemeteryand at the close of the service the usual three volleys werenred over the grave.

NAVAL MEDICAL SUPPLEMENTAL FUND.At the quarterly meeting of the directors of the Naval

Medical Supplemental Fund, held on April 12th, Sir J. N.Dick, K.C.B., being in the chair, the sum of .650 was dis-tributed among the several applicants.The Army and Navy Gazette of April 9th states that

Surgeon-General G. J. Evatt, C.B., retired list, A.M.S., hasbeen invited to contest the Fareham Division of Hampshireat the general election in opposition to the sitting member,Mr. A. H. Lee, Civil Lord of the Admiralty.

Correspondence.

SYPHONAGE IN THE GREAT INTESTINE."Audi alteram partem."

To the Edito’r8 of THE LANCET.SIRS,-A reference to Dr. R. W. Leftwich’s latest work on

syphonage and Hydraulic Pressure in the Large Intestine" "has served to confirm the opinion I formed from the evidenceproduced in his earlier papers-viz., that he is in error inwpposing the great intestine to act as a syphon in manduring life. The chief observations on which he bases histheory of syphonage are (putting them in brief) thefollowing :-

1. That a piece of garden hose, bent so as to represent thevarious curves and segments of the colon, acts as a syphonwith substances which are only partially fluid in nature,such as glycerine. The criticism I offer to this observationis that the normal contents of the great intestine are of sucha consistency that they cannot be made to flow in a tubeeven with rigid walls, much less in one with flexible andunequal walls. Further, the curves given by Dr. Leftwichto his artificially constructed colon have no resemblance tothe actual flexures of the colon as seen in the human body,either living or dead.

2. That the theory of syphonage offers the only full andsatisfactory explanation of the arrangement and fixation ofthe human great intestine. Unfortunately Dr. Leftwich hadno time, as he himself explains, to examine the arrangementin animals allied to man .or to consult the literature on thissubject, otherwise he would have found that the dispositionof the great intestine cf man does not differ in principlefrom that found in other mammals, in which, he is careful toexplain, there can be no colic syphonage. It is certainlytrue amongst genera of primates that the more they arehabituated to the upright posture the more firmly is theirgreat intestine fixed to the posterior abdominal wall, butthis feature finds a full and satisfactory explanation in thealterations in the respiratory movements of the abdominalviscera and need for greater fixation of the abdominalcontents, caused by the change of posture.

3. That the theory of syphonage explains the arrangementof the fibres of the muscular coats of the human colon.The muscular arrangement of the human colon is not

peculiar, it is similar to that of all mammals which live ona mixed or vegetable diet and in which the contents of thegreat intestine are more or less of a solid consistency. The

disposition of the longitudinal muscular coat of the colon intaenia is an adaptation for the production of the peculiarperistaltic movements which help in the digestion, absorp-tion, and propulsion of the semi-solid contents of the colon.

4. That the tonicity or contraction of the tsenia of thecolon can render the walls of that viscus rigid and thus fitit to act as a syphon. No one, so far as I know, has everdenied tonicity to either the longitudinal or circular coatof the colon, but I am unable to conceive that the action ofthe longitudinal coat can have any effect on the bowel otherthan to shorten it. The only manner in which the walls ofthe bowel could be rendered rigid enough to serve as asyphon would be to suppose that the circular fibres of thecolon, which alone can alter the lumen, possessed an activepower of elongation. Dr. Leftwich, however, in harmonywith modern physiological teaching, regards such an actionas impossible, but, on the other hand, he refuses to acceptphysiological evidence of the importance of the peristalticmovements of the great intestine, yet the muscular coat ofsix inches of the human colon is nearly three times theweight of an equal segment from the small intestine.The only manner in which the cascal or colic wall could

be rendered rigid enough to serve for syphonage would be tocreate a negative pressure within the cavity of the abdomen.This effect could be obtained by placing the patients, not inthe upright posture, as Dr. Leftwich places them to obtaincolic syphonage, but in a head-down posture, for we knowthat in such a posture the negative pressure within theabdomen is sufficient to cause ballooning of the bladder,vagina, or rectum if the orifices of these viscera be opened.In the upright posture, on the other hand, the intestinalcontents are subjected to a pressure of from 10 to 20 milli-metres of mercury, the pressure rising three or five milli-metres with each expiration, from 20 to 30 millimetres with