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Dezani’s organic non-colloidal preparation of leadwas administered. The following conclusions were

reached : 1. Lead, when introduced intravenouslyinto the pregnant rabbit in small repeated doses,shows a selective poisonous action on the chorionicepithelium. 2. The following changes in the chorionicepithelium, and further in the placenta are progressive,and depend on the dosage : (a) Swelling of the syncytiallayer of the chorionic villi, with alterations of theprotoplasm and consequent ischemia in regard to thematernal blood-spaces of the placenta. (b) Necrosisof the syncytium with congestion of the placentalblood-spaces. (c) Complete disappearance of thesyncytium, breaking down of the supporting septa,and the production of haemorrhagic areas with necrosisof the foetal placenta. 3. The pregnant rabbitreacts to lead with toxic symptoms with smaller dosesthan when not pregnant. (Dallera did not attempt todefine the abortion dose as was done by Blair Bell andhis fellow-workers.) 4. There are no essential differ-ences between the changes of the placenta in relationto the different periods of pregnancy. 5. The action oflead may not always be confined to the foetal ectoderm,but some derivatives of lead may also affect thematernal organs to a degree that varies with differentpreparations. 6. The colloidal lead prepared at theInstitute of Biochemistry of Italy acts chiefly on theplacenta, and in order to produce slight temporarylesions in the liver it is necessary to inject doses four tofive times greater than those which markedly damagethe chorionic epithelium. (This preparation appears,therefore, to have a higher chemotherapeutic indexthan the preparations used in Liverpool.) 7. Themetallic colloidal lead is that which best realisesthe essential postulate of chemotherapy-that is, thegreatest divergence between the active dose and thetoxic dose. 8. The distribution of the lead conveyedin different preparations varies. The colloidal leadlocalises itself specially in the placenta, and only invery heavy doses also in the liver (which, however,does not present any alteration). The lead sulphiteand Dezani’s soluble salt are found only in smallquantities in the placenta, and in large amounts inthe liver and kidneys with evident lesions in theseorgans. From these data it appears that the colloidalstate of the lead is of great importance.

THE MORALE OF THE BLUEJACKET.1

A LITTLE book, described on its appropriatelyblue " jacket " as a social study of the lower deck,is worth the serious attention which its modest con-tents hardly claim for it. In a recent issue of THELANCET we reviewed a study of the mental reactionsof the sailors of the fleet in war by Dr. Thomas Beaton,himself then a Temporary Surgeon-Lieutenant, R.N.,and thus possessing full opportunity for his investi-gations ; and this skilled alienist concluded that " thetraining of the sailor has for its first aim the renderingof the individual, not into a precise automaton, butinto a intelligent and cooperating personality, andin the achievement of its purpose it cannot be toohighly praised "-in other words, the object oftraining was to turn out a good ship-mate, since incor-rect conduct makes a man a bad ship-mate. How theeducation which has earned so high an encomiumeffects its purpose, what are its reactions in daily lifeon the lower decks of ships, we learn from Mr.Trystan Edwards’s account of his three years’ servicewearing " the three rows of tape " on his blue collar as aseaman " for the duration " (1915-18). Judged evenin comparison with the life of the public school anduniversity man, he did not find the training wanting.It is disciplinary training, he says, which while itsaves the seaman from carelessness and from panic intimes of stress, gives him health, a sense of cleanliness,and steadiness of nerve, and makes him energetic andalert, as well as good-mannered. On the lower deck

1 Three Rows of Tape. By A. Trystan Edwards (ex-AbleSeaman, R.N.). London : William Heinemann, Ltd. 1929.Pp. 167. 6s.

there is no word for good manners-they are a sinequa non ; the few and new without them are called" ignorant," but it is charitably expected that theywill soon acquire them. The author found the menhabitually cheerful, often singing, working very hard,and always wanting sleep. And there is a significantcomment that the men of exceptionally fine physiqueand character were nearly always from large familieswhose parents had both married young. He covetsthe bluejacket training for more of the youth ofEngland, and concludes his important study thus :" Complete liberty and equality there can never be.....fraternity finds nowhere a greater measure offulfilment than in the humane company of those whoserve under the White Ensign." But it will surpriseeveryone, and especially parsons, to learn why it isthe seamen like church on board (p. 123).

THE STUDY OF TROPICAL MEDICINE.

THE transactions of the seventh congress of theFar Eastern Association of Tropical Medicine appearin a volume containing 97 communications whichoccupy some 871 pages. The chief subjects discussedare plague, cholera, dysentery, sprue and intestinalinfections, bacteriophage, leprosy, tuberculosis, typhus-like diseases, leptospirse, and malaria in all its aspects.To the section on plague such well-known authoritiesas F. P. Mackie, Wu Lien-Teh, Fabian Hirst, andN. H. Choksy appear. The Joint Meeting of theExpert Plague Committee of the League of NationsHealth Organisation and of this Association stressedthe importance of further inquiries into the methodsof destruction of rats and fleas, the comparativeepidemiological role of various species of fleas inplague transmission in selected areas in India, thesurvey of plague in wild rodents in Northern Asia, andthe part played by grain and cotton in the dissemina-tion of plague. As regards prophylaxis and thera-peutics, the speedy preparation of antiplague vaccine,the possibility of producing a plague antitoxin serum,further studies on anti-plague bacteriophage and itspractical application were considered. Pneumonicplague is dealt with separately in these Transactions; ;the incidence of bubonic plague, and its relation topneumonic plague, is considered important, as well asthe possible existence of a special ultra-virus or filter-passing form of B. pestis. The subject of cholerastimulated a number of communications. Lieut.-Colonel A. J. H. Russell is responsible for statisticalstudies in its epidemiology. C. L. Dunn and S. Khanshow that cholera is not endemic in Hardwar, but isan accompaniment of pilgrimages. J. W. Tomb andG. C. Maitra, from experiences gained in AsansolMining Settlement, believe that the non-agglutinatingintestinal vibrios take on the agglutinating charac-teristic under certain still unrecognised conditionsin the human intestine.The dysenteries of Bengal have been studied by

A. C. Ukil, who finds mild forms of bacillary dysenteryto be the form most prevalent. F. P. Mackie,N. H. Fairley, and the staff of the Haffkine Institute,Parel, Bombay, contribute a report of progress on thesprue inquiry. P. Manson-Bahr, L. M. Maybury, andP. H. Martin testify to the therapeutic value of bloodtransfusion in sprue anaemia. S. S. Sokhey writesupon the pancreatic and liver functions in sprue.Special interest centres on the accounts of bacterio-phagy and bacteriophage by F. d’Herelle. He setsout clearly his reasons for regarding the bacteriophageas a living being, an ultra-virus parasitic on bacteriaand which provokes in them an extremely contagiousdisease. With Major R. H. Malone and M. N. Lahirihe believes that in the treatment of cholera withbacteriophage the cultures of this substance shouldbe endowed with maximum virulence and maximum

1 Transactions of the Seventh Congress, British India, 1927.Edited by Lieut.-Colonel J. Cunningham, C.I.E., B.M., M.D.,I.M.S., Director, Pasteur Institute of India, Kasauli, BritishIndia ; Chief Organising Secretary for the Seventh Congress.Calcutta : Thacker’s Press and Directories, Ltd. Vol. II.1929. Pp. 871.

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activity. Lieut.-Colonel Morrison and Major C. de C.Martin state that bacteriophage alone has been provedas effective in the treatment of bacillary dysenteryas is orthodox treatment given in control cases.The leprosy section is particularly full. E. Muir

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propounds his latest views on the treatment withspecial reference to the employment of potassiumiodide ; R. Row amplifies his well-known work on thecurative value of tubercle bacillary autolysate inleprosy ; it must be remembered that it is still doubtfulwhether this action is specific or whether it is due tonon-specific protein. E. V. Pineda contributes animportant paper on the presence of the leprosybacillus in 53 per cent. of the placenta and umbilicalcord of advanced sufferers of the disease. R. Inadacontributes a short comparative study of leptospirse.R. McGuire writes on colour variations in the fungusof Dhobie’s itch, and D. G. Panja believes he has culti-vated the organism responsible for dandruff, which hehas termed Malassezia ovalis. Typhus and typhus-likediseases also attracted much attention, notably fromJ. W. D. Megaw and C. Strickland. Under the sectionof Protozoology, R. Knowles and B. M. das Guptahave studied the influence of the thyroid gland on thecourse of a protozoological infection.No less than 30 papers are devoted to the question

of malaria, divided under three headings-control,general considerations, and treatment. Sir MalcolmWatson writes informatively on the future ofmalaria control in the Federated Malay States.Colonel S. P. James, Drs. W. D. Nicol and P. G. Shutehave studied the habits of anopheles in relation totheir r6le in the spread of malaria from observa-tions made in England, and they have also madeexperiments on the treatment of malaria, from whichit appears that thorough and prolonged quininetreatment of the primary attack has no more effect inpreventing a true relapse than has intensive treat-ment by quinine during the acute phase.

A MEMORIAL TO JOHN THOMSON.ON Saturday, Dec. 14th, a memorial to the late Dr.

John Thomson was unveiled by Sir Thomas Barlow inthe Royal Hospital for Sick Children at Edinburgh.The memorial takes the form of an inscribed marblepanel with a bronze portrait medallion by Mr. Pil-kington Jackson, placed opposite the entrance ofDundas Ward, where Thomson did such a large partof his work. In addition, a medal is to be awardedby the University of Edinburgh for a thesis or

original investigation of special merit and dealingwith children. Recalling Thomson’s appointment in1884 to one of the resident medical posts at theHospital for Sick Children in London, Sir Thomasconfessed that at the outset of their acquaintancehe was not impressed by Thomson’s personality,while some of his contemporary residents esteemedhim but lightly. They little knew then what areserve of quiet power, sound method, and goodjudgment lay beneath that modest, half-deprecatingdemeanour. A slight hesitancy of speech was theoutcome of a resolute determination to cultivate accu-racy of statement. Good botanist that he was, hehad been trained in sound observation. When histwo years at Great Ormond-street were completedand he returned to Edinburgh, Thomson was almostimmediately appointed physician to the New TownDispensary, where he soon developed a successfulchildren’s clinic, and shortly afterwards he waselected assistant physician to the Children’s Hospital.His most important contribution to medical know-ledge was, in Sir Thomas’s opinion, his account ofpyloric stenosis in infants ; an exhaustive report of 100cases under his own care during a series of years openedthe eyes of medical men to the serious importanceof its early recognition, and the vital indications foiits treatment. In this as in all his work he was keento share his knowledge in the give and take of realfellow workers. He was generous in acknowledgingthe help of his colleagues, whether older or younger :jealousy and self-advertisement were both unknown

to him. Later in his career Thomson set himself toengage the interest of the mothers of mentally deficientchildren in simple methods of wakening intelligenceand cultivating self-control. He was determined inhis instructions to use no word or phrase which mightdiscourage or humiliate the mothers, holding by themaxim, " By hope are ye saved." To those thatknew him best, Sir Thomas concluded, the memoryof John Thomson would always be that of a modestgentle true-hearted soul, with a passion for verifica-tion and a deep desire to widen the boundaries ofbeneficent knowledge. The same sentiments wereexpressed in other ways by Prof. G. F. Still, Dr.Logan Turner, and Dr. Robert Hutchison, whowere also present to do honour to a great poediatri-cian. In accepting the commemorative medal onbehalf of Edinburgh University the Principal, SirThomas Holland, pointed out its economic as well asits humanitarian value. There was, he said, as yetno organised research into the psychology of thechild under the age of five years, with the resultthat much harm was done in our schools throughignorance.

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TREATMENT OF CATARACT AND GLAUCOMA

IN MADRAS.

Lieut.-Colonel R. E. Wright’s professional reportlof the Government Ophthalmic Hospital, Madras,for the year 1928 will be of interest to ophthalmicsurgeons everywhere. The average number of opera-tions for senile cataract alone is over 1500 a year.Precautions to prevent squeezing on the part of thepatient while on the table and to secure quiet after-wards include novocain injections to block theseventh nerve and into the orbit, and the druggingof the patient to such an extent as sometimes toamount to a kind of twilight sleep. Various forms ofconjunctival bridge flaps have been tried during theyear in order to maintain the lips of the section incontact, but the natives, it seems, are more liable toconjunctival bleeding than Westerners, and bloodclot under the bridge sometimes interferes withhealing. In Colonel Wright’s opinion no form ofbridge is so efficient as suturing the lips of the section.Various types of operation are performed, but inthe great majority of cases the capsulotomy operationis chosen, usually with a peripheral iridectomy. Ina proportion of cases Barraquer’s intracapsularextraction is performed, a procedure not now popularin this country ; but no mention is made of ColonelHenry Smith’s intracapsular method.

In the Madras Hospital they classify all theirprimary cases of glaucoma, whether acute or chronic,into posterior segment types and anterior segmenttypes. In the former the important factor is theincrease in the volume of the vitreous ; the anteriorchamber early becomes shallow, but the cupping ofthe disc does not appear till late. In the anteriorsegment type, on the other hand, the anterior chamberis not shallow and cupping of the disc is an earlysymptom, and in these cases it is suggested the block-ing of the angle of the anterior chamber takes a moreimportant part in causation. A systematic investi-gation of 100 cases was undertaken along these lines,which may help towards resolving the perennial con-troversies. As to non-operative treatment or treat-ment preliminary to operation, eserine drops are thegreat stand-by, but in certain cases their effect wasgreatly enhanced by simultaneous employment ofadrenalin. Glaucosan and amino-glaucosan are notso highly spoken of. In well-marked cases a decom-pression operation, preferably trephining, was alwaysnecessary eventually.

Elsewhere in the report there is reference to anepidemic of superficial punctate keratitis whichoccurred in 1928. Over 800 cases were seen beforethe end of that year. Like herpes febrilis it appearsto be due to a non-filtrable virus, and is probablyidentical with the keratitis described by Herbert in

1 Madras Government Press, 1929. Rs. 2.