756 IHI. Jirn 1A-ENEED FOR RESEARCI

SATURDAY, -NOVEM1BER 20TH, 1915.

NEED FOR RESEARCH IN TIMIEOF WAR.

Two propositions witli regard to the growing impor-taince of pathology in p 'actical affairs have beenm-iiaintainied in this JOURNAL during the last tensears or so. The first is that a laboratory forclinical pathology is an essential part of a modernlhospital, and the second that the hospital laboratorymust dlo research work. The battle for the first waseasily woni. Tlhe demand from the clinical staffs oflhospitals rapidly grew too insistent for the governing,b)odies to resist oven had tlley wished to do so; to dothiem justice, however, they showed no disposition toobstruct, for the more enlightened members -werequick to perceive that to complete the armamentof a hospital by adding a department which madediagnosis speedier and more certaini, whiclh preventedcomplications in tlhe individual and checked thiespread of clisease to otllers, was a scheme worthy ofencouragement, since it would diminish alike theslLm of suffering and the expenditure of money. Then-ew position wvas appreciated as quickly by manydoctors engaged in private practice, and not a fewgeneral practitioners fitted up small laboratories forthemselves. The modern stuldent witnessing duringhis hospital training the constant assistance given bythe clinical laboratory, will not willinjgly be deprivedof it afterwards, and asks for it in a imiilitary lhospital.But the ather proposition was lnot so readily

established. To the layman, to some persons engagedin public health work, and even to some members oftheo clinical staffs of hospitals, it seemed that thepathologist's sphlere should. be strictly limited, thathe should occulpy a very subordinate position, and becontent to go onl from month to month and from yearto year doing routine work on the lines laid down inthe textboolks. This is one of those curious mistakeswlicll even able men can make when they forgethunman nature and the foodl on which the mind ofmian thrives. Under such colnditions even routinework cannot continue to be well done. If a man iscontent to sink to it, the very drudgery of it makeshim lose interest, so that his daily task is done in aperfunctorv way. No miian worth his salt could sinkto it, because in pathology as in every department ofbiology, and particularly when a new science is inan early stage, as bacteriology is to-day, the livingtlhings dealt witlh so frequiently escape from thetextlbook, whlichi, as every man who practisesmedicine or surger-y knows, can serve onily asa general guide by giving a conspectus ofthe knowledge of yesterday. The coming of theMedical Research Comrnmittee was a turning of theways. The researchl p)enny provided by the Insur-ance Act miglht easily have done more harm thangood had not the point wvo are trying to make hierebeen understood. Fortunately the direction of theen-terprise was committed to good hands. TheoExecutive Committee consisted for the most part ofmen of science; it 'Was perhaps too much to expectthat in the present stage of political educatioll its

H IN TIME OF WAR. [Nov. 20, 1915

Chairman slhouldl be oine of tlhem, but in. LordMIoultonwas found a Chairman who, though nothimself a man of science, had durilng his distinguishedcareer at the bar been brought more closelv intocontact Nith the actualities of science than is commonamoing members of hiis profession, or among poli-*ticians. The Committee was fortunate also in ob-taining the services of Dr. W. M. Fletcher, F.R.S., asits Secretary. He is a miian of science; lhe Nwas at onetimne Demonstrator in Physiology in the University ofCambridge, and hlas m-ade important contributions toknowledge hiimself. In his new post lhe has shownhimself able not only to understand the good that tlhejudicious expenditure of an annual income for medicalresearchl miiiglht accomplish, but also the risks offailure were it inijudiciously adnminlistered on a "cashon delivery " system.The Committee hacl barely beeni got into working

order when the war broke out; hence the researellscheme it put out about a year ago lhas necessarilyundergone great miiodifications, because nlot onily'were the staffs of the patlhological laboratoriesdepleted by the call upon them for military medicalservice, but the Cominittee rightly felt that its mosturgent dluty was to co-operate with the War Officefor the benefit directly of the very large proportion-of the active miiale population in the prime of lifewhio enlisted, and directly and indirectly for tha&tiof the civilian population to whlich, sooner orlater. they would return. It was certain that theexistence of a national medical research fund, ifwisely administered, would mnark. ani epoch in Britishmedicine, but it was niot altogether a misfortune thLtit slhouldt onlly just have come in-to existelnce at tholoutset of a world-war, because the immuediate practicalvalue of its work quickly became manifest. Theexecutive of the Medical Research Ftund lhas, in fact,formed anl intelligence department for the militarymnedical services, and has been able to providedirect and rapid service in organizing inquiries,in obtaining expert advice, and in stupplying per-sonal service. That we have "1 to beat the Germansis the dominating fact of our national life to-clay,but only a fool would use the fact as an argumelntagainst the earnest intensive prosecution of researchwhile the war continues. If wo are to beat theGermans it must be, as the military authorities anidmilitary critics din daily into our ears, by providingbig battalions, and it is no use enlisting men, or worsethan no use, unless we take every means whichscience can provide for keeping them in healtlh.Routine work will not do; thiat has been abundantlyproved already. All medical work, from the. study ofa single case to the investigation of an epidemic,partakes of the nature of research work; within thiefirst few nmonths of war maniy details of formerpractice were chalnged for the better, and imanyopinions on epidemic disorders were reviewed in thenew light thrown on them by study- and experiencewon in tlhe field. The conditioils of warfare are suchthat the study must be intensive and experiencequickly pooled, if knowledge essential to success isto be gained quickly and diffused quickly. Neglectto organize inquiry means that action has to be takenin the dark. The results of the inquiries into tlhecauses and treatment of sepsis, of gas gangrene, ofthe treatment of head iniuric- and fractures of thelower limbs, of typhoid and paratvphoid and dysentery,are exam-iples at once to hand.When the genefral territorial hospitals w-ere being

organized the offer made to the War Office by thieComnmit-tee to lhelp it by makinig additional provisionfor pathological wvorlk was accepted. It was found

Nov. 2Of Tt)I5J flUGHLINGS-JACKSON, (TC BA 757NO.29TNWLPCL:UX%77

that the nieedis of various lhospita-ls varied widely indifferent places, both in character and amount; atsome complete arrangements had beeln made forpathological and ba]teriological work, at others none.Owing, perhaps, to the fact- that the territorial hos-pital scheme was worked out some years ago, beforeit hiad been fully recognized that clinical pathologicallaboratories had becolmie a niecessary part of everygeneral hospital, the instructiotns on this head werenot precise and muclh depended upon local circum-stances. The lesson that good opportunities andfacilities for pathological work of the best and highesthitid is a vital lnecessity has now beeni learnt probablyin every cenitre, but there seems still to be hesitationin giving proper recognition to the men who are doingit. The head of the pathological department of a bighospital ought to be placed in respect of status andrank on an equality with the heads of the surgicaland medical departments. Indeed, if we were logical,which heaven forfend, we should put the general'sbadge on his slhoulder, for is he not the medicalstrategist concerned witlh the institutes of medicineand the principles uponi whichi effectivo treatment,must be based ?An article publislhedl in another column indicates

somie of the dlirections ill which the Committeehas been able to assist the work of the clinicalpathological laboratories of military general hos-pitals. Its efforts in instituting or encouragingcombined researches inito particular questions havealready yielied results of the greatest value not onlyto the inidividual for the alleviation of suffering, butto the cotuntry by safeguiarding lives and economizingresources both in imlen and moniey. Sonme of theresuilts have been published in detail in originalarticles in our pages, such as, for instance, theresearches of Sir Almroth Wright into the physio-logical prilnciples underlyinig the effective treatmentof wounds, the experimeental inquiries as to the valueof hypochIorites as antiseptics, and the researchesillustratirng thle value of systematic bacterioscopicexaminations in infectious disorders. War makesexperim-lenits on man on a huge scale, horrible to con-temiiplate, but the horror is mitigated when the oppor-tunity is taken to institute inquiries into meanis ofpreventioni or alleviation; such inquiries serve notonly the imiimediate practical needs of the army bvsaving the life and health of the troops now engaged,but also the civil population of to-morrow, wlhilehastening the progress of medicine throughout theworld.The schem.es of wvork undertaken under the direc-

tion or at the ihstigation of the Committee for theWar Office and other Governmenit departments inconnexion with the war are many, and wili probablybecomLe even more nlumerous and more important,but the results of what has been donie are already sostriking that, as has happened before, people who callthemselves " practical men " are becoming impressedwith.the fact that there is nothinig so cheap as know-ledge, if only you go the' right way about gaining it.A research wlhich costs a few hundred pounds mayyield results wlhich in their application at once savethe country as many millionls in mioney. From thefinancial side resea-rch is truly econonoical, the savingof life and the saving in long illness and chronicdisablement have a value wlich can be expresse(d inpounds, shillings, and penee; but we will not withthe anti-thises and the anti-thats pretend to pat outof mind the saving in suffering to the brave mnen whoof thleir own free will have comne out to fight for theirCOUntry in its dire need. We xNish Mr. Tennianlt, whoseemis too ready to suffer fools gladly, or some other

miinister wlho is heckled by these folk in the House ofCommons, would some day speak out, dealing boldlywith well ascertained facts and principles, and tell thecountry what experimental medicine and bacterio--logical researelh have already donie for it in this greatcrisis.

HTGHLINGS-JACKS' )N.IT wNa a hlappy tlhought of the editors of BTaiimto bring otut a double number' devoted to anexposition of the views on aohasia of that verygreat genius Hlughlings.Jackson. A considerablenumher of hiis scattered papers on aphasia arohere collected and reprinted; and are prefaced by:an admlirable summary of his views from the pen ofDr. Heacd. Hughlinigs-Jacksoin's methods of publi--cation were curious. He fully recognized that his-doctrines were caviare to the general, and lhe diilnot seek for tlhenm a wNide puolicity. As soon as he-had thothght out a section of any subject, he wasanxious to publish it, or rather to get it into print.He had great difficulty in expressing h-iimself clearlv,not because his ideas were lacking in clearniess, butbecause of their abstruseness and complexity, andhe wouldl likeni his literary efforts to tlhoso of acoachman drivinig six horses abreast and havilngto keep all the traces tight. He was punctili-ously accurate, and this led hiim, as Dr. Headreminds us, to pepper every page with explaniatoryphrases or footnotes, so that tho generalization canscarcelv be distinguished from its qualifications. Sodifficult did lhe find tle task of literary comlpositionithat lhe wrote lhis papers over and over again, andlcould never get themii into a fornm satisfiactory to him-self. It was probably his despair of reaching his idealthat led him to publish them as he did.. He sent themilto be printed in order to get thenm into permianelntform, and to put a stop to the othe-xrwise endless taskof revision and rewriting. As long as they were gotinto print lhe did nlot much care wlhere-they appeared,and many of his most valuable articles are storedaway in i;he columns of jourinals that niever had 4nyconsiderable circulation, and that have long beenextinct. The task of unearthing them-1 and collect-ing theim1 must therefore be one of considerable diffi-culty, and thie present generation owes a debt ofgratitude to Dr. Head for this collectioni of thosepapers that refer to the difficult subject of aphasia.

Hughlings-Jackson's work has of late years beenmnuch neglected. It is now knowvn to comparativelyfew, except in as far as it has permeated and modifiedmethods of thinking about the constitution of thenervotus system and the effects of nlervous lesions.But a revival of interest in it is inevitable; this inustcome sooner or later, for he laid down for all timecertain fundamental principles which govern theconstitution of the nervous system ancd the workingo,of its processes. His fundamental principle was thatthe nervous system is the piodilet of evolution; thatit has gradually grown up to be what it is through aprocess of budding, and branching, and growth, ancdelaboration, in this direction and in that, to meet therequiremenlts of the living acting organism ; that itis therefore divisible, more or less arbitrarily, into"-evolutionary levels," of which the lowest are theoldest, and most completely and compactly organized;they represent functions that are crude, simple, gross,general, fUndamentally necessary to life, and impli-cate massive movements of visceral and trunk museles,ILondon: MIacilUlan aiA Co.: New York: The Macmillan' Co.

Price 8s., or 2 dols. It contains a chronological list -of Hughlinga.Jackson's papers bearing on affections of speech.

75811mL]OB1, PRIZES.

such as the functions of circulation and respiration.On the other hand, however, the newest and mostloosely and incompletely organized represent func-tions that are elaborate, complex, fine, precise,accessory, and imiplicate delicate movements ofperipheral i-hiuscles, succh as those that move theeyes, the tongue and lips, and the fingers. Diseaseis, according to Hughlings-Jackson, a process ofdissolution, a pulling down of t-hat which evolutionhas buiilt up,, and proceeds in the reverse direction,attacking first and most severely thie higlhest evolu-tionary level, wlhichl is also the last to recover whenrecovery takes place, and proceedinig downwards fromlevel to 1evel until tihe lowest level of all is the lastto be damaged, the least affected, and the first toresume its futictionsA corollary of this doctrine is that quoted by Dr.

Head, that destructive lesions never cause positiveeffects. They can only destroy and abolish. Anypositive manifestation, such as convulsion, or mania,or mistakes in wvords, is not produced, but permittedby the lesion. It is due to the uncontrolled and dis-orderly action of those lower levels that are permittedto overact by the removal of tlle control formerlyexercised by the higher level that has been destroyed.This is now become a commonplace, but it was a verystartling heresy whlen Hughlings-Jackson first formu-lated it, and it was long before it made its wvay anidwas received and accepted. It hias now the appear-ance of a truismn; and his other doctrines, when oncethe tangtled phraseoloay in which they are expressedis penetrated and their meaning is grasped, captivatethe jLudgemiient, and appear as much as this in thelight of truisnms.Hughlings-Jackson's rank as a pioneer and dis-

coverer in miiedicine is niot inferior to tllat of Harveyand Lister, and in due time he will take his placeamong the very briglhtest of medical luminaries.

THE NOBEL PRIZES.THE awards of the Nobel Prizes for Chemistry andPhysics 1914 and 1915 are now made known. The 1914Award for MIedicine, as we have already stated, has beenm-ade to iBArany, of Vienna, who hias observed and formu-lated certain seemiiingly colnstant relations between yes-tibular vertigo aud ataxia and vestibular nystagmus. In1IVi1 Dr. B'arany was a guest of tlho British MedicalAssociation whien tlle annual meeting was held in London.In the Sectioni of Otology he opened a discussion on the" Diagnosis and treatiment of infective labyrintlhitis," andin the Section of Psychology and Neurology he read apaper on the "Vestibular apparatus and the cerebellumn."Illis work on the peripheral nervous system lhas also beenof great value. He was on dcuty in a field hlospital inIPrzemysl during the siege by the Russians. From therehle sent his last work, dealing with the treatment of skulllesions, by a6rial post. He is now a prisoner of theRussians. The award in Medicine for 1915 is reserved.The awards for Chenmistry go respectively to ProfessorTlleodore William Richlards, of Harvard, and ProfessorA. P. Willstatter, of Berlin. The forluer lhas devotedhimself to experiments on atomic weights, the com-pressibilities of elements, and electrothermal dynamics.A great deal of his work has been publislhed bv theCarnegie Institution. Professor Willstiitter holds acliair of cliemistry in the University of Berlin and hasspecialized on alkaloids. Thle awards for Physics are ofspecial interest, in the first place because one of themcomues to this country (for tile third tinie), and in thesecond, because the workhonoured by the one award is indirect sequenco with tlle work lonoured by tlie other.

1tBInTISn MEDICAL JOURNAL,1910. vol. ii. p. 1245.

The prize for 1914 goes to Professor M. von Laue, unitilrecently of Zurichi, and now, apparently, of thie newuniversity of Frankfort-on-Main. The prize for 1915is divided between Professor W. H. Bragg, of LondonUniversity, and his son, Mr. W. L. Bragg, of Canm-bridge, wh1o is now serving in France as an officer of tllcLeicestershire Royal Horse Artillery (Territorials). Tloeinvestigations both of Laue and of the Braggs relateto thie analysis of a rays by means of crystals; takentogetiler tlleir results mark tile greatest advance on tilisside of plhysics since Roentgen's discovery. Thiree yearsago it occurred to Laue, who believed x rays to be rays ofliglit having wave lengths of an atomic order of magnii-tude, tllat the regular groupings of atoms in a crystalslhould be capable of producing interference effects when abeam of x rays was passed through tile crystal structure.His tlleory was tllat tile repetition of the atoms at certaindefinite initervals in tlle crystal migllt act as a kiiid ofdiffraction grating for tilese rays of short wave lengtll.Tfhe tlheory was put to tue test, a parallel beam of x raysbeing made to traverse a crystal, and some beautifullysymmetrical interference patterns were recorded on apliotograpliic plate. This investigation, whicli demon-strated conclusively tlhat' x rays underwent diffraction,was tlle starting point for freslh researches. In thiscountry the Braggs, fathier and son, were able to slhow alittle later that x rays were regularly reflected by thecleavage planes of crystals. Laue on the one lhand andthe l3rVaggs on the othler differed, lhowever, in their ideasas to tlle constitution of the r-ray beamii, the former tlhinkingit to be made up of a limiited naumber of independentt lhomo-geneous constituents, representing only certain wavelengths, wilie W. L. Bragg sutpposed it to be like light, con-taining every possible wave lengthl over a wide range andcapable of formincg a continuLous spectrtum. Experimentalinvestigation lhas gone to prove the trutth of tihe lattertheory, and the Braags lhave obtained x-ray spectra witldifferent anticatlhodes, and by means of a special spectro-meter tiley have been able to measure wave-lengthls witlhan accuracy compar-able witlh the spectroscopic analysis ofordinary light. 'T'lle result has been to detmonstrate thena.ture of x rays. Until recently there was some doubtas to whetler the rays miglht not be tile fliglht ofmaterial particles, but with the discovery that th-ey can bediffracted and reflected by crystals, it becomes clear thatthey are clectro-magnetic disturbances of the same niatureas liglht, heat, and electricity, and tllat tlheil novel pro.perties are due to tlle shlortness of tlwir wave-lengtlh. The¢Procecdings of the Royal Society for 1913 and 1914 con-tain full accounts of the investigation. Bcafore occupyingthe Quain Chlair of Plhysics at London University, Pro-fessor Bragg was professor at Leeds for seven years, andpreviously at Adelaide for twenty-tw;o years. Psracticallyall his scientific writincgs have been concerned wvith theproblemns of radlioactivity. Hlis Sttudies in i'a4ioactivity.puLblished three years ago, reeites the theoretical reasoninawhichl led him: to predict the nature uf tlhe absorptioni ofalpha rays by. matter-another piece of researelh witlwhliclh his name will alwa'ys be coupled.

MILITARY SERVICE AND LIFE ASSURANCE.THE qtuestion of life as;suiuance inmst .still be a atter ofanxious thougaht to wlhose 'vho "may teinporarily leave civilpractice to undertakec military service. We have pre-viously mentioned that the majority of life offices areeither declining to entertain proposals witlh such a con-tingency or are clharging, a-s -awar extra, to those -.vllomay be ordered for service otutside the United IKingdomrates which can only be called prohibitivc. Realizing thenecessity of assisting medical men wlho may join HisMajesty's forces the Medical Insurance Agency lhasentered into an agreement with a substantial officewhereby life policies are issued at ordinary tabular ratesso long as the military service is confined.to the Ulnited

ftr TITtiTion 1758 ME,IDICAL JOrRNTAL j rNOV. 209 $91I;

NOV. 20, i9ilJ THE NEW HOUSE OF THE GENERAL MEDICAL COUNCIL. TM 759

Kingdomi. Shlould the assured be ordered abroad, the full middle one has Aeseilapius as a judge, and the thirdvalue of the policy is maintained, but an additional pre- is an attempt to represent symbolically the work ofm-liumn of nine guineas per cent. per annum is required to registration, one of tlle figures bearing a scroll. Thecover the increased risk. If the assured finds his work work of these panels is of lhigh artistic merit, and in tllaabroad does not take him within the actual firing zone, or selection of the motives the intimnate kliowledge of Greekto within a radius of ten mniles of the firing zone, and oni art possessed by Dr. Caton has been freely drawn uponl.Ihis return to civil life is able to show a cleall bill of health, The bay windows of the new Council roomn run throughthe office in question Ludertakes to refund a sum amlount- two stories, and the monotony of the long upright mullionsing to at least one-half of the war extra premium. So has been relieved .by forming their upper parts intofar as we know, no such favourable conditions are offered symbolic figures. It is a difficult mlatter to treat agenerally, and the colntract appears to offer equitable figure wlhich is of necessity narrow and elongated, a}ndterms to the assured. Anothier poinlworthy of considera- wlichl has to carry weiglht, but tllis difficulty has beention is tllat in whicll, as lhas often happened one partner very satisfactorily overcome and these figures look verylas undertaken military service, leaving a partnier at well. The otlher ornament, sparsely usedl but sufficient,home; ini sucll cases tlle life of the latter is of great is excellent both in desiagn and execution. fin tlhe interiorfiinanjcial importance to the other on military duty. As an office, muclh larger than the present office, whlich hasan act of prudence the life of the partner at home proved too smliall for conivenience, is provided. Veryslhould be assured, anid for hitn the ordinary rates muchl better accommiilodation is beinlg giveni for witnesses,prevail. A man on active service unfortunate enouiglh solicitors, and counsel wlho have to attend during tlheto lose hiis partner by deatlh would run thel risk of serious transaction of penal business. A staircase separatefinailcial loss. In such a case the protection wvoiuld be from that used by the members of thle Council,provided by takiing a slhort-period policy on tlhe life of tlhe has been provided for tlhem, as well as lavatory andpartiner remainiug at lhomiie, or by a whole-life policy witlh waiting roomns, in all of wlhich respects tie old premisesat strrender valtue after thie second year, or a guaraniteed were very inconvenient, maniy people having lhad to waitreturnI at the end of five years, in the event of it being no about in tlle hall. Thle Council chamrlber itself is a finelonger necessary to continue the policy. As an examiiple, roomn, btut its decoration -to be ma Dly in the forn of oakhwe limay take the case of a man witlh a partner aged panelling--has been postponed in order to,allow the walls55 years. A five years policy for £1,000 on his life would to dry. The domestic offices are, as is now niot uncommon,cost £24 2s. 6d. per annum', or £120 12s. 6d. for the five placed at the top of thle building instead of in the base.years. If, hlowever, an ordinary whole-life policy was pre- ment. Hallamn Street in the past h-as not been vellter-ed, the anntual cost wouild be £45 Os. 10d. In five years known, and at first those whio lhave business with thoa sumn of £225 4s. 2d. woeild have been paid in premiunms, Council may not know whiere to finid it. It may not bobut at the end of thlis period the expediency of milaintaining amniss, thlerefore, to mention that it is parallel to Portlandthle policy might no longer exist, when the office guiaran- Place and to Great Portland Street, lying between thiem.tees the return of a sum of approximately £93, or would As the leases are all falling in almost at once, the ratherissue a fully paid up policy of £166. This contract affords stiabby houses of whlichi it partly consists will be whollythle greater elasticity, anid on the whole appears to offer replaced withlin two or tlhree years by otlhers of quite athje best protection for the absent partner unfortunate different grade, and the clharacter of tlje strett will boenlougli to lose by deatlm hiis colleague at lhomne. Full par- entirely changed.ticulais can be obtained by those interested if tlley willa,)ply, stating age inext birtJ4day of thie life it is proposed THE HISTORY OF IPECACUANHA IN DYSENTERY.to insure, to the Medical Insurance AgeIncy, c.o. British WiTH reference to a note on thI lSMtoILy of ipecacuaL3Medical Associatioa, 429, Strand, London. which appeared in the sM ICAL JOURNAL o

THE NEW HOUSE OF THE GENERAL MEDICALCOUNCIL.

For. the last time the Genieral Medical Cotincil lhas met inthe place so long its h-omne, and before Christmas the officeand the work of registrAtion will be transferred to HallamStreet. Very soon, too, the familiar front, built originallyfor the Royal College of Clletmiistry, will have disappeared,anid will be replaced by a miiore imposing building. Butthe miiemory of the Royal College of Clhemiiistry wvill bepreserved by a foundation stone, upon wheill it is recordedthat it was laid by Prince Albert. This Mr. Delissa Joseph,the architect who is going to erect the new buildings on the3ite, has most kindly presented to thic General MedicalCotuincil, who will doubtless find a fitting place for itspreservation. The completion of the new premisesof thlle Council in Hallam Street hias been somewlhatdelayeod by ihe difficulty of obtaining certain materia'sfor tlle sanitary and lhot water worl, but this has

been surmounted, and it is now possible to judge ofthe general effect of tIme front. It is of stone andhas been treated by Mr. Frere, the architect, witha dignified simplicity, tlle spirit of Greek arclhi-tecture being kept so far as this is compatible withthe amoutnt of window required for the darker Lonidonclimuate. It is to be hoped tllat wlhatever is to be erectednipon the vacant site next to it imay lharmonize with it, or

at least be no detriment to its appearance. On a plinthover the door are tllree sculptured panels executed byMIr. Lessore; the one represents Aesculapius as a lealer,with Telesphorus bringing a cock for sacrifice; the

iNovemnber 15L31, Simr lyce Duckwortl has called ourattention to -articles in vols. v and vii (1869 and 1871) oftlle Saint Bartholomnew's Hospital Reports, in whichi horecorded the restults of a series of experiments made bylhirn ", on the action of ipecacuanlha anld its alkaloidemetia." In it lhe gives some informiation as to the historyof the introduction of ipecacuanlha into Europe which mayusefully supplement our own brief note. He quotes aprivate letter from Sir lRobert Christison in wlhiclh it isstated that both Maregraf and Piso, wlho first made tlhevirtues of the drug knowni in Europe, recomntmended 1 or2 drachm doses in dysentery. Clhristison further says-:"How European physicians came to stbstitute 1,2, or3 gurainsfor Maregraf's 1 or 2 drachms I do not know, but theiniquiry would be curious could we follow it out well." SirDyce Duckworth cites Baglivi, who, in tlle seventh editioiof his treatise on medical practice, publislhed at Lyons in1714, wrote: "Radix hlipecacuanhlae est specificum acferme infallibile remedium in fluxibus dysentericis."Baglivi adds that he learnt its virtues from a Dfr.William Sherard at Rome. Sir Dyce DLuckwortlh coni-jectures that Sherard was the famouLs botanist, Fellow ofSt. John's College, Oxford, who was Eniglislh Consul atSmnyrna, bequeatnied his herbarium to hiis university andfounded the chair of botany there in 1731. In h is treatiseDeDysenter-ia Commentar'i us, published in 1761, Mark Aken-side, tlle poet, who was physician to St. Tijiomas's Hospital,wrote warmly in praise of thlle drug. In 1831 tle MadrasMedical Board published a number of reports by differentinedical officers, showing tlle efficacy of 5 grain doses give-neveiy hour in acuLte dysenterytill frequently hundreds ofgrains were given in a short period. Sir Dyce Duckworth

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760o U.L JVs-A I MIEDICAL NOTES IN PARLIAMENT.- (Nov. 20, TgI5

adlds the testinion-Y of MI. Alexander' IHiunter, colonialsurgeon at B3clize, British Honduras, who informiedl hiimthat in cases of actute dysentery lie began the uise ofipecacoi'anha by giving l scrtple of the lpo-wder. A secondlose of 25 grains given after the first had the effect ofallaying all tlhe symptorns and altering the clharacter oftlhe dischlarges; it was seldom necessary to adnministermore than two or tlhree doses. Sir Dyce Duckworth also(juotes Mr. Hullke anid' otlhers hllo saw the effects ofipecac'uanhalla in dysentery in tlle Crimea as bearing w-itniessto its great valuie. We think it riglit to state hlere that anaccouLnt of the initr-oductioni of the drugy illto France, which(liffers in certain particulars from that giveni in ouLrnlote, isto be found in Flickiger anid Hlaibtury's Phiarmnacogrjrphtia(second(l cdition, Lotn(doln, 1879). Tlhcy say that a travellernamed Legi as brotughlt a quantiLy of the root fromiSouth America to Paris in 1672; sonicG of thjis wasobtainied by Jean Adrien Helvetius, tlhenl livini inthle Frenichl cap)ital. The first trials of it were unsuic-cessful becauise too large dloses were uise(l. In 1680a mierclant of Plaris named Gar-iier becanic posscsse9.dof 150 lb. of ipecacuanlha, the valuable propertics ofwhich inl dysentery lie vaunted to hiis miiedical attel-dant Afforty, and( to Lielvetitus. Gamiiier, oii his conivales-cence, made an present of somue of tlle newv drug to Afforty.

hllo attached litLle importance to it. Helvetitus, on theother hand, again used the root, thlis timi1e with greatsuccess. Hle wvas so elated by this thjat lie is said to haveCaRused placards to be athixed to the corners of the streets(about the year 1636) annlotun-cilng hiis triumplhs wvitltlhe3 new dru,g, sriup)lies of whiichellli obtaine(d througllGarimier froni Spaini, anid sold as a secret miielicinie.The famle of tlle cures effected l)y Helvetin1sreached the French C'otit, alind cauised some triatls ofipecacuanlia to be mitadte at tlih 1H16tcl-Dieu. Theseltainvig been sucec!ssful, Louis XL- accorded to Helvetilisthe sole righlt of vendinghiis reincdlv. Subsequentlyseveral gi-eat personages, including the Dauphlin of1'rance, liaviug experienced its beniefit, thje Kinga Collsulted hiis phliysiciani, Anitoine d'Aquini, anid the wehl-known Jesutit, P'Cre Fran:.-ois de Lacliaise, whio hiadbecome the King's confessor in 1675. Through tlicniwas chiiefly negotiatCd theo-ppurchase fromi Hielvetius ofhlis secret for 1,000 louis (['or; it was nmade public in 1688.The righit of H,elvetius to this paymiient was disputed inlaw by (Gralm1ier, buit miaint?ained by a decision of theCliAtelet of Paris. FIfiekiger and Itlanbury give referencesin. support of these stateelnIts WhIliCh Will help any oneinterested in the lhistory of ipceacuanhia to putsue the in-vcstigatioin. Tlherc is evidlently a sufficielnt ambunt of clis-crepancy aimng authorities to temipt tllc critical stuident.And even vhlen the exact part pllayed by Helvetius iscleared -up there will rcmaain the followving out of SirRobert Christisonis ';e"urious inquiry " as to tle abandon-ment of the larg,er doses of Mareg-af and Piso.

ROYAL MEDICAL BENEVOLENT FUND GUILD.A DRAWING-P001ooM sale in aid of the fuLnds of the RoyalMedical Benevolent Fund Guild will, by kind p1rmission ofthe Marqtuis and Mifarchioness of Crewe, be lheld at CreweHouse, Curzon Street, W., on Wednesday, Novem-ber 24tlh,ff-om 12 to 7 p.mi. We take tilis opportunity of once mnorecalling attention to the excellent work done bv the Guildin hielping the famililies of doctors whlo, owing to theill-healtlh or the untimiely deatlh of the breadwinner, lhavebeen left without ade(quate mueans of livelillood. Theprofession hias answered the country's call with a self-sacrificing devotion of whliell it may juistly be proud. Tothe heavv tributte whiiel dleatlh and disablement bysicklness or w7oundclsh,ave already levied must be added theloss of incomne causedl by absence onl active service.It is too likely that inl a large nulmber of eases thisloss will never b)e niad1e up, as with1 thle most loyalassistance fromn thlose who take thle place of the men

who gro, it mu,st becoimo inereasinigly difficuhll to keeppractices that lhave been laboriouisly buiilt tip froml fallingto pieces. O'n nio miemiibers of the colmmnllity d1o tllobtrldens of thlc wvar fall more lheavily thau on tlh -ivesand mothers of muedical mlen wlho hlave given tlleir lhtusbandsanld sons to the service of our defenders, and by none arethey more uncomplainingly borne. The delependants of themen wvlio are doing so miuchl for thle relief of suffering onthle battlefield, in the trenclhes, anid in hmospitals, lhave aspecial claimn on the gvatitude of the whlole people of thiscounlltry. To the medical professioni they will niot look invain, but cloctors tc a class are not richl. C'alls o'n tlhcresources of the Royal Medical Benevolent FuLiid (Gtildare constantly increasing, and mnuList, it is to be fearcd,continue to increase. We lhope, tllerefore, that tlhe saleiow being arranged for thc beniefit of the GuLild will bringa substantial addition to its funds. AmlIong the stall-hiolders are Lady Barlow. Lady Pearce Goutld, LadyFerrie-r, Lady Fripp, Mrs. 11Fred Smith, and Mr. Donal

CHOLERA IN AUSTRIA--HUNGARY.C_-HOLERA lhas prevailed in Austria and(IHuinlgary for thelast year or lmiore, but seemlis to hiave attained seriousepidemic pl)roportions in Galicia oly. From Decenib, r27tlh, 1914, to Septeml)er 18tth, 1915. the official statisticsin tlle mionitlilv Baliclin, of tllc Itntenliationial office slhow27,591 cases and 15,270 deaths. Of these, 699 cases witlh180 deaths occurred among prisoniers of wvar, aind only 172eases witlh 34 deaths am-lonig soldiers. Jutidging froimi thestatistics for Austria for the period from-- Atug,ust 15t1h toSeptem-lber 18tlh it woulld appear that tlhe epideimic hlasbeaen severe aimlontg the civil poptulation, as there -were nofewer than 15.175 reported cases aud 9,113 deatlis. ofwhich only 327 cases withi 32 deaths occulrred amiong tlic'troops-,, anid 39 cases with 12 dceatlhs amoung prisoners ofwar. The coipiarative immunity of the armly mnay b) (dtuoto the use of an-lticlholera vaccine, for it is reporLted tlhatthe Autstrian cavalry genieval v. Ziegler, wlho died oniA-ugust 1st of Asiatic clholera, the dliagnlosis beiniig COel-firmed bJy a l)acteriological e.nlamination, was tlle only casoof cholera either am-ion)gIuis staff or amuong thle civil popti-lation of theptlace where hie wvas stationed. Tre general,it is stated, wias the only officer on thie staff whlo, in spiteof repeated mnedical advice, hiadl efuIseCd to be vaccinatedaagainst (holera.

The Medical Service of the Army.-Oni Novem-lber 11tMr. Joynson-Ilicks asl;ed the Under Secretary of State forWar to give tlle nutimber of doctors in the R.oyal ArmnyMedical Corps on the active and Special Reserve lists atthe present timue. andl tlle number in the TerritorialMedical Corps; and to indicate tlle increase in tLcfigtures since May 18th last, wlleni Mr. Joynson-Hickhs, itmay be rememlbered, asked a similar question. Mr.Tenniant said that tlhe total number of medical officers(regulars, retired officers re-employed, temoorary commis-sioned, Special Reserve, and Territorial Force) was now9,626. Thlere had been an increase of 2,599 over thecfigures he gave on May 19th last. The present number ofTerritorial Force medical officers was 2,474. In tljeanswer given on May 19tlh (BRITISH MEDICAL JOURNAL,May 29th, p. 941) tlhe number of medical officers R.A.M.C.Territorial wa-s given as 2,122.

Red Cross Medical Officers and the R.A.M.C.--On November9tll Sir Plhilip Magnus asked whetlher, lhaving regard tothe freshi call for doctors for the armuy, tlle services witlhthe Red Cross Society of those wlho had returned homieafter spending some months in the dischlarge of medicalduties at the seat of war could be recognized; andwlhether, as an induceluent to offering a fturtiher term- ofservice, tlle War Office would take into consideration tljotime already served toward the reduction of the six