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The report went on to state that a covering letter 1was sent by the chairman of the committee to each tof the dental schools, in which the further inquiry was ! amade whether the supply of students was or would be affected by the ultimate selection of one or other of the alternative methods of obtaining instruction in mechanical t

dentistry-viz., at the hands of a private practitioner i

or in a department of a dental school. The committee regretted that as it had up to the present received Ianswers from only about half the number of the licensing bodies and from a somewhat larger proportion of the 1

teaching bodies, it was not in a position to make a

complete report nor to make any recommendation. It was within their knowledge that some of the licensing bodies who had not yet answered had the matter undercareful consideration, but were not yet in a position tomake their report.’

Dr. SAUNDBY mentioned that the body which he repre-sented was considering the matter. ’

Sir HENRY MORRIS said that his College was also con-

sidering it. A joint committee was considering the matterto see whether any change could be made which might beadvantageous to the public and the profession.The report was adopted.

National Insurance Act Committee.On the motion of Dr. KIDD, Sir Arthur Chance was

appointed an additional member of the National InsuranceAct Committee.

End of the Session.At the close of the session of the Council on

Friday, June 4th. it was intimated that Major N. C.King, the Registrar, who was present in khaki, hadbeen instructed to report himself for duty with the3rd Battalion of the London Rifle Brigade atTadworth Camp. Major King received the goodwishes of the Council on his departure. It is under-stood that he will be called to an importantcommand in his regiment.On the motion of Dr. NORMAN MooRE, a vote of

thanks was passed to the President for his servicesin the chair.The session then came to a conclusion, and the

Council rose to meet again in November.

THE VALUE OF ANTITYPHOIDINOCULATION.

IN view of the opposition that continues to bemade in some quarters to the use of antityphoidvaccination, we are enabled, through the courtesyof Dr. L. S. Mackid, to publish the following reportmade by him as medical officer at Calgary, Alberta,Canada, to the Canadian Pacific Railway, on theresults of a systematic antityphoid vaccination ofthe company’s employees extending over the threeyears 1911-13 :-

With the large increase of the population in the western

country during the last few years it has been a hard matterto keep pace in a sanitary way with the growth. This istrue not only of this country, but of all new districts whichopen up, and as a result we suffer from those diseases whichfollow insanitary conditions. Our worst enemy in this fieldis typhoid fever. To a large company like the CanadianPacific Railway the presence of typhoid means a very greatloss, much more than one would imagine without going intoit thoroughly. We have already done our utmost to fight thecondition by sanitation, and have been greatly re warded forour efforts- We followed pretty closely the rules as laiddown by the military authorities covering the sanitationof the camps. With the introduction of typhoid vaccineinto the armies of the world and the marvellous resultsthat have been recorded we decided to introduce it intothe railway world.To give an idea what typhoid means to a big company a

few figures are given. When a man goes down with typhoid

he is incapacitated for a period of at least four months, or interms of days about 120 days. In the year 1911 there wereabout 320 cases of typhoid fever on the Alberta Division,which means a loss of time to the company of 38,400 days.Again, this disease comes just at the time of the year whenthese men are most needed, that is, in the fall of the year.,when the work is being finished before the oncoming winter,and when the company is getting the harvest away andplacing coal and other winter supplies all over the country.Now if it means all this to the company what does it meanto the man himself ? It means that he is incapacitated justat the time when there is plenty of work for him to do. Itmeans a heavy raid on his financial condition for medical,hospital, and convalescent expenses at the time of the yearwhen he can least afford it.

Initial Difficulties.-Technique and Reactions.Having all this in our minds we decided to approach the

company and get their cooperation, and were met more thanhalf-way in the scheme. This, however, was only thestarting point, as we still had to get the consent of the men,as it was upon them that the vaccine had to be used. Weinterviewed as many as possible and placed the propositionbefore them as clearly as we could and were more than satis-fied to find that a great number entered in the work, sufficient,at least, to warrant our going ahead with the vaccination.All the district surgeons were also eager to start ahead withthe work as soon as possible. We soon found out that ourtroubles were only commencing. The men all had verypainful recollections of having been vaccinated for small-poxand immediately put typhoid vaccination in the same

category. We were also dealing with a non-disciplined lotof men whom we could not force to be vaccinated, so ithad to be optional, and in several places it required a greatdeal of patience and some hard talking to convince themthat it was being done for their own good.

For the complete treatment we used three inoculations atintervals of 10 days. The first inoculation consisted of8 minims containing 500,000,000 killed bacteria. Ten dayslater a second inoculation of 15 minims containing1,000.000,000 bacteria, and again, 10 days later, 15 minimsof 1,000,000,000 bacteria. The site of the inoculation was

chiefly the upper arm, either at the insertion of the deltoidmuscle or the back of the arm into the triceps. Theseinjections were done as far as possible in the afternoon, sethat the reaction would be all over by morning. A fewhours after the injection the reaction commenced like anoncoming attack of "la grippe "-slight headache, generalsoreness, lassitude, slight elevation of temperature, and insome cases slight nausea. This lasted for about 10 hoursand was then completely gone. The local reactionwas redness, pain, swelling, and heat. This lasted longerthan the general symptoms, but was pretty well over

in 48 hours. We used the ordinary hypodermic syringewith several needles, which were sterilised by boiling, a

separate needle being used for each inoculation. The siteof inoculation was simply prepared by painting with iodine,and after the injection was done no dressing was applied.Some of those inoculated showed more severe symptoms thanthe rest, such as syncope, which lasted for a short while,and was recovered from without any treatment. Examina-tion of these men showed no reason why it should have

happened. We found no condition that we could classify asa contra-indication to vaccination. As to the time lost as theresult of the vaccination, about 95 per cent. of the men keptright on at their work. The other-5 per cent. were laid offfor not longer than 48 hours.

Results Showing the Value of Antityphoid Vaccination.In 1912 there were about 5500 inoculations done with

two cases of typhoid developing amongst them, and one ofthese two had only received one injection and came downwith the fever a few days later, so that it is possible that hewas coming down at the time of the inoculation. Amongthe other men living under exactly the same conditions asthe men who were vaccinated there were 220 cases of

typhoid.One of the most striking results of the vaccine was in a

gang of about 35 men, who were camped within the citylimits, and who absolutely refused to be vaccinated at first.In this camp 11 cases developed, and then the men beganto ask to be vaccinated, which was done, and following it wehad the only other case.

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Dr. Maclaren, Dr. King, and Dr. Green used the vaccinein the treatment of cases, using at each injectionsmall doses, the first of 1,000,000 bacteria and doublingit every fourth or fifth day. They found that in thosecases which were treated from the beginning of the diseasethe complications were almost nil, although it did notlessen the course of the disease at all. Those cases thatwere well advanced before they came in under treatmentshowed no effect at all, the vaccine here being moreharmful than beneficial.For 1913 we have not as yet received all the reports,

so can only give an incomplete report. So far the totalnumber vaccinated is 2771, with 1 case developing fever,and against this there are reported 70 cases amongst thenon-vaccinated. When all the reports are in, these figureswill probably be between 8000 and 10,000.The conclusions that we draw from this work are :—

1. We have a very valuable aid for the prevention oftyphoid fever in the use of vaccine.

2. The name of vaccination should be abolished andinoculation should be used in its place.

3. When cases of typhoid come under observation earlyenough most of the complications can be lessened.

4. The use of the method should be advocated in all

places where men are to be in camp and under doubtfulsanitary conditions for any period of time.

5. The period of immunity is apparently indefinite,probably equal to that produced by a single attack oftyphoid.

Since this report was made the various lists tocomplete the work for 1913 have been sent to us byDr. Mackid. The additional number vaccinated was8400 with only the one case developing, making a itotal vaccinated of 13,900, among whom 3 cases oftyphoid developed. The figures read as follows ;-

Total number men employed ......... 24,000" 19 vaccinated ......... 13,900

Number of cases among non-vaccinated ... 290

" 11 11 vaccinated ...... 3

New Inventions.A USEFUL SHOULDER-SPLINT.

AFTER excision of the shoulder-joint it is often difficult togive the necessary support to the arm, and a splint whichacts perfectly in the sitting position may be quite unsuitable’when the patient is lying down.

1ht:! 1

The one here described is very comfortable and easilymade, as well as cheap. It is S-shaped in side view,6.ttmg over the shoulder and under the forearm. It con-

sists of a kidrey-shaped shoulder-piece (Fig. 1) A, of

thin zinc or sheet steel, 7 X 3; inches, or wide enoughjust to clear the neck muscles and the acromion on eitherside. This is riveted to the upper end of a piece of

galvanised iron strap 1i inches wide and 1/16 inch thick,so that it (the latter) can be bent on its long axis to fitthe chest. The splint c for the forearm is approximately10 inches long and of the ordinary trough pattern, or

FiG. 2.

long enough to reach to the wrist. It will be found thatthe forearm varies very greatly even in persons of the sameheight. This part of the splint is riveted to the upturnedend of the upright strap-shaped bar at C. The whole splintis kept in place by a strap and buckle passed from a slit inthe shoulder-piece behind and under the opposite axilla.The splint must, of course, be moulded and bent to a

perfectly snug fit, and as a refinement a still more perfectresult can be obtained by inserting a piece of house flannelsoaked in plaster-of-Paris under the shoulder-piece, paddedwith wool, when the splint can be bent to fit this at leisure.The arm is bandaged to the side at night and the wound canbe dressed without removing the splint.The cost of the above is trifling and, what is more, the

materials can be got even in an out-of-way French town, andit can be put together by anyone of the slightest mechanicalability.

J. CROPPER, M.D. Cantab.Anglo-Ethiopian Hospital, France.

A Prussian WOMAN DOCTOR.-According to theNovoe V’1’ernya M. G. Stanishevskaya has been appointedp’1’ivat-doaent of the chair of pathology in the ImperialNovorossisk University. She is the first woman to receivethis appointment in a Russian university. She finished hermedical studies in Nancy in 1899, passed her examinationsin the Moscow University in 1900, and in 1913 presented anddefended a treatise for the degree of M.D.

BIRMINGHAM HOSPITAL FOR NERVOUS DISEASES.-The second annual report of the Birmingham and MidlandHospital for Nervous Diseases states that the new cases

treated were 1093 and the total attendances numbered13,215. Among the conditions most frequently dealtwith were epilepsy 122 cases, neurasthenia 176, acute

neuralgia 48, hysteria 34, neuritis 23, alcoholism 20,dementia and insomnia 18 each, and melancholia 16. Theexperience of the last two years has emphasised the need forbeds. There has been a great increase in the employmentof massage, and electrotherapy has been used with consider-able success, so that the expenditure of .6300 for theinstallation of more up-to-date electrical appliances has beensanctioned. The year’s income amounted to .E892, whichleft a favourable balance after payment of expenses of 143.

J. CROPPER, M.D. Cantab.