346 THE WELFARE OF THE DEAF.

drawn from scattered sources has been assembled,systematised, and discussed in this book. Anothereducational effort of the Institute, a volume preparedby Dr. Fisk in the " American Viewpoint " series.will contain a simple story of health and hygiene, andinformation as to governmental health organisations,for the education of immigrants, school children,industrial workers, and that portion of the publicwhich welcomes information presented in a simple andpictorial form. A moving-picture series has beenplanned to present the material in this work and tomake available a film library of simple, fundamentalhealth instruction. An unpaid examination of 100Post Office employees revealed that 12 per cent. ofthese men were in need of some form of medicalattention. On the basis of this study the cooperationof the United States Public Health Service wassecured, and 1000 Post Office employees were

examined ; the report on this inquiry is not yet Ipublished. Plans are nearing completion for turning Iover as a free gift the common stock of the Institute to ’iseveral leading Universities, and the ultimate retire- ’

ment of the preferred stock, thus placing the finalcontrol of the Institute in the hands of the trustees ofthese Universities, who will be able to safeguard it inthe distant future for such work as it can best perform.At its New York office the Institute employs a staffof about 30 physicians, whole-time and part-time,and 120 technicians and lay employees. Consultingspecialists work with the regular staff. The Institutehas referred its examinees to their family physiciansfor medical treatment which, at an average rate ofmedical charge, would represent fees amounting tobetween five and ten millions of dollars. TheInstitute does not practise medicine. No dividendshave yet been paid : the President of the Institute,Mr. H. A. Ley, gives his time without salary. A noteis added to the report, to the effect that neither themedical director nor any member of the staff hold anystock of the Institute or derive any emoluments fromit other than moderate salaries.

THE ROLE OF THE PROSTATE IN URINO-

GENITAL TUBERCULOSIS.

NOT long ago tuberculosis of the prostate wascommonly regarded as a rare and comparativelyunimportant condition, of far less importance thantuberculosis of the epididymis. Thanks to the investi-gations of Simmonds of Hamburg and other patholo-gists, this mistake has been corrected, and it is nowgenerally admitted that the prostate plays a mostsinister part in conveying tuberculosis from the urinaryto the genital system. This teaching is confirmedin a recent paper by Dr. P. J. Schultz’ of the Patho-logical Institute of the Berlin-Moabit Hospital.Among 14,086 necropsies performed between April 1st,1908, and April 1st, 1920, he found 125 cases ofgenital and urino-genital tuberculosis in the male.In as many as 104 cases the prostate was involved,the vesiculae seminales taking second place with 78cases, and the epididymis third place with 66 cases.In 35 cases the prostate was the only gland in thegenital system to be involved, and in 23 of these casesboth the urinary system and the genital system werein other respects intact. The prostate, in other words,would seem to have been infected by the blood-streamin these 23 cases. All the 125 cases were associatedwith tuberculosis elsewhere, and with few exceptions,the lungs and pleurae were also the seat of tuberculouschanges. Isolated " genito-primary " tuberculosis ofthe epididymis proved to be exceedingly rare and onlyfour such cases were observed ; in a fifth case theepididymis was the only structure in the genitalsystem affected by tuberculosis, but in this case renaltuberculosis was also found. The question withwhich Dr. Schultz was largely concerned was thecomparative importance of

" testipetal " and" testi-

fugal " infection. He has come to the conclusionthat, in the overwhelming majority of cases, the

1 Zeitschr. f. Tuberkulose, 1922, Bd. xxxvi., Hft. 2.

genital system becomes infected by the prostate; that"testipetal" spread of infection is, in other words,the rule and not the exception. Without this gland,which forms a connecting link between the urinaryand the genital systems, men would suffer as seldomfrom tuberculosis of the epididymis in conjunctionwith renal tuberculosis as women suffer from tuber-culosis of the Fallopian tubes in conjunction withrenal tuberculosis. An important conclusion to bedrawn from this paper is that, in one respect at anyrate, tuberculosis of the kidneys is fraught withgreater danger to men than to women.

THE WELFARE OF THE DEAF.

A SPECIAL appeal has recently been issued by theNational Bureau for Promoting the General Welfareof the Deaf. Since its foundation in 1911, theBureau has helped to coordinate the numerous

organisations for the deaf. It has brought together forpurposes of discussion many persons interested in allaspects of their welfare, and has collected and classifiedinformation, maintained a valuable library, andanswered many inquiries relating to such variedmatters as lip-reading, employment, electrical aids,private and public schools for deaf children, highereducation for the deaf, and how to deal with quacks.It has provided information for Government Depart-ments and public authorities. The Bureau drewpublic attention to the causation and prevention ofdeafness by means of a series of lectures--delivered in1912 by Dr. J. Kerr Love, and later issued in bookform-which constitute an indispensable basis forfurther research, and has also published a useful andmuch-needed handbook of information relating to thedeaf, the only work of its kind available. Imme-diately before the war the Bureau brought together arepresentative gathering in order that a practicalscheme might be formulated for the foundation of aNational Training College of Teachers of the Deaf.The war prevented further work on this scheme, but itmay be said that the foundation of the present Chairof Deaf Education, at Manchester, by the late SirJames E. Jones, was largely due to this movement.The war left the Bureau in a condition described in theappeal as one of " partial functional paralysis."There is ample provision for the education of deafchildren in the 51 day and residential schools estab-lished throughout the country by private philanthropy,or by municipal and county education committees,but much remains to be done with regard to schoolattendance and to the evolution of the best teachingmethods. There is no general provision for suitableeducation or technical training of the adolescent deaf,whilst the work for the adult deaf everywherelanguishes for want of public support. An organi-sation such as the National Bureau is, therefore,required to coordinate isolated effort, to bring Z5

together agents and interested people for concertedaction, and to carry through a national policy.The appeal is signed by Mr. Macleod Yearsley (ActingChairman of the Bureau) and Messrs. G. SibleyHaycock, Arthur J. Story, and Albert Smith, whoexpress the opinion that the future functions of theBureau should be briefly as follows : (1) assistanceand education of the adolescent deaf by getting intotouch with the various schools and societies, and byconference and otherwise seeking to unify theirexperiences and results ; (2) continuance of the workof coordination and of general assistance to the deafin which it has been so successful in the past, with thecreation of an efficient publicity department; (3)institution of a medical department which should(a) stimulate prompt and efficient treatment ofchildren deaf or threatened with deafness, in thepre-school period as well as during the scholastic age,and (b) promote and assist by all means in its powerthe studies of causation and prevention ; (4) institu-tion of a political department to urge the earliereducation of deaf children and their higher educationafter the age of 16, and establishment of a college orcolleges for higher education or technical training

347BIOLOGY AND THE KINEMA.

in Great Britain, analogous to those already existingfor the deaf in the United States and for the blind inEngland ; (5) a legal department, controlled by asolicitor, to provide expert advice with regard tolegislation and other matters. A questionnaire is

appended to the appeal, asking for information underfive headings : (1) as to whether the reorganisationof the Bureau on the lines indicated would meetwith support ; (2) as .to the constitution of a councilto include representatives of teachers of the deaf,of missions and after-care organisations, of themedical profession, and of those whose work is thetraining of teachers, with the possible addition ofothers connected with public life and industry ;(3) as to the increase of the income of the Bureau fromunder i5400 per annum to a necessary minimum of;&bgr;lOOO; (4) as to the existence of any funds whichmight be devoted to the uses of the Bureau; and(5) as to the existence of persons, societies, or organi-sations interested in the deaf or likely to assist theBureau financially. It is hoped that replies will bereceived from the authorities who have been circu-larised before October 31st of this year, in order thatthe work of reorganisation may not be delayed.

THE EFFECTS OF SALINE PURGATIVES ON THEABSORPTION OF OTHER DRUGS.

IT is well known that saline purgatives act chieflyowing to the poor absorbability of certain ions-e.g.,those of magnesium sulphate and phosphate ; theosmotic action of the unabsorbed salt, which drawsfluid into the intestinal lumen, leads to the accumula-tion of fluid in the intestinal canal. D. I. Macht andE. M. Finesilver 1 have’investigated what effect theadministration of such purgatives may have upon theabsorption of other drugs given by the mouth simul-taneously or a little after the laxative. Experimentswere made with phenolsulphonphthalein, a drugrapidly absorbed and excreted by the kidneys.To dogs a solution of this drug was given by stomach-tube and the amount excreted in the urine hour byhour determined. Several days after the drug wascompletely excreted, the drug was again administered,but this time mixed with a 5 per cent. solution ofsodium sulphate and the amount and rate of excretionby the kidneys determined hourly. It was foundthat the excretion of the phenolsulphonphthalein wasmarkedly delayed by the simultaneous or previousadministration of sodium sulphate, and the same wastrue of magnesium sulphate and other saline purga-tives, but no such effect was produced by the adminis-tration of cathartics of a non-saline character, such ascastor oil or cascara sagrada. In the method employedto study the mechanism of absorption cats wereanasthetised, the abdomen opened, and two loops ofintestine of the same length tied off ; into one astandard solution of the coloured drug with a givenvolume of water was injected, and into the other loopthe same amount of the dye was placed mixed withsodium sulphate solution and the abdomen closed.At the end of an hour the animals were killed, the loopsexcised, and the contents measured. In the controlloops-i.e., those with dye and water, much of thefluid had disappeared, while sometimes 60 per cent. ofthe dye had been absorbed. In the saline-dye loopsthe volume of fluid was greatly increased, while over90 per cent. of the dye was unabsorbed. Representa-tives of other classes of drugs were tested-e.g.,digitalis, various antipyretics, such as salicylates,acetanilid, antipyrine, urotropin, iodides, opiates,various alkaloids, bichloride of mercury. It wasfound that almost every kind of drug examined wasdelayed more or less in its absorption by the previousand even by the simultaneous administration ofsaline laxatives. These results are of some interestin connexion with chronic constipation amenable tosaline purgatives. Careful spacing in the administra-tion of salines between meals is desirable in order notto interfere with the assimilation of other substances.

1 Soc. for Expt. Biol. and Medicine, vol. xix., April, 1922.

BIOLOGY AND THE KINEMA.

ON August 3rd, at the private theatre of Goldwyn,Ltd., 12, Great Newport-street, London, W.C., a

private view was given to officials of various Govern-ment departments and others of several reels froma series entitled " The Science of Life," which repre-sents the latest educational kinematographic work ofthe Bray Productions Corporation, New York.The " Science of Life " series is described as " athirteen reel motion picture course of instruction,produced under the direction of the Surgeon-Generc1tof the United States Public Health Service." Fivereels were shown, the first and second being illustra-tive of general biology, and dealing particularlywith the lowest forms of life. The movement,irritability, and processes of assimilation and repro-duction of Amaeba, Stentor, Paramcecium, and Hydra,together with the structure and sexual life of flowers,were made clear, partly by the actual combinationof microscope and kinema camera, and partly byexcellent simple " animated " diagrams. Reels 8and 9, showing the life-histories of the mosquito andhouse-fly, and their methods of spreading disease,should be valuable for purposes of public health.The diligence which went to the making of thesevery fine pictures is typified by the fact that thebiologists who took the mosquito reel watched for72 hours in order not to miss the moment when theanopheles larva broke out of its capsule. Reel 10,illustrative of the " Personal Hygiene " section ofthe series, was devoted to sex education for boys andmen; it suffered from lack of cohesion, or possiblyfrom large " cuts " in the original production. Theattention of the audience was whisked to and froamid such items as : an athlete hurling the javelin ;Theodore Roosevelt talking on his verandah, anda photograph of Abraham Lincoln-these last twosubjects being illustrative of virility ; a warning asto the power of the sex impulse ; a rider controllinga bucking horse-this scene being apparently intendedto typify the difficulty of mastering that impulse ;a brief reference to the ductless glands ; a diagramof the male genital organs ; a reassuring observationconcerning nocturnal emissions ; various staccatostatements relating to venereal diseases and theireffects, with " close-ups " of Treponema pallidumand gonococci (if the term employed for the well-known means of registering facial expression maybe applied to portions of film exposed throughthe microscope) ; cases of locomotor ataxia andcongenital blindness, and one glimpse of a mentallydeficient child. If this reel is for adults only itsexcellent purpose would bear a starker interpretation.If it is intended to be shown to children, it should beless confusing. There would be more propagandain two minutes’ projection on the screen of theSydney Bulletin cartoon to which we referred a

month agol than in the quarter of an hour or twentyminutes occupied by this portion of the " Scienceof Life." From the examples shown the wholeseries is so excellent that it is a pity the level shouldnot be maintained throughout.

A SIMPLIFIED SYSTEM OF ACCOUNTS FORSMALL HOSPITALS.

ECONOMY combined with efficiency is the touch-stone of all successful hospital management, whetherthe institution be large or small, and a uniform systemof keeping accounts such as that devised by KingEdward VII. Fund, known as the R.U.S.-RevisedUnit System of Hospital Accounts-affords a verypractical means of enabling hospital managements tocompare their maintenance expenses with those ofhospitals of similar size and range of cases, with a viewto seeing where economy can best be carried out. Butthis system is more particularly adapted to largehospitals, and as was pointed out by Lord Cave andemphasised by Lord Onslow, the chairman, and otherspeakers at the recent National Conference of Local

1 THE LANCET, July 8th. 1922, p. 75.