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caught in a cicatrix or projection of callns, itsdeformity and a failure of the spread of the opaquesubstance can be demonstrated. After neurolysis,recovery of the nerve is shown by the graduallyincreasing length of the shadow in the X ray.Clinically, this change in the radiological picturesoccurs pari passu with the recovery of nerve

function. Disturbance of central spread has been themain feature of nerve lesions, as demonstrated in

radiograms taken before and after operations on theulnar, radial, and peroneal nerves. Perineuritis,according to Saito, produces a knotty defect in theshadow. Some interesting pictures were obtained inthe case of multiple neuromata, showing the varyingrelation of the tumours to the nerve trunks-arelation that was subsequently verified by operation.The only objection to the use of thorotrast seems tobe the extreme slowness of its absorption ; in fact,there seems no proof that it is finally absorbed fromthe substance of the nerve. It appears, however, tobe clinically inert, and its presence gives rise neitherto pain nor paresis along the area of nerve distribution

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or at the site of injection.MUSIC AND MEDICINE

THE time has come when the profession as a whole,we feel, might devote more study to music ; for itseffect upon our patients, for both good and evil, is

very potent. The use of music was encouraged byphysicians of classical times and in the Middle Ageson account of its beneficial action upon mind and

body ; this subject was studied in considerable detailsome years ago by Dr. Agnes Savill in an interestingbook, " Music, Health and Character." As a professionwe should endeavour, for the sake of the health ofthe people, to ensure that the original object of the"alternative programme " scheme of the B.B.C. isadhered to-namely, that on one of the programmesgood music should always be obtainable, so that ourpatients may be soothed towards the evening hours.An unpretentious little volume 1 of Dr. Keith Barryis written with the aim of being a guide to musicalunderstanding. It is addressed to those who " listenin " and switch off when good music is on the air,believing they cannot understand it. Simple explana-tions are given concerning the different instrumentsof the military band, chamber music, and the modernorchestra ; the meaning of the nomenclature used inmusical compositions is dealt with briefly : such as

adagio, andante, &c. ; the elements of the sonata,concerto, and symphony ; and the ignorant are toldhow to listen in order to obtain the most pleasure and’benefit. The book reads as if it were a series oflectures ; its matter could with advantage be drawntogether and presented more systematically ; but its

very simplicity and brevity may induce those whobelieve they dislike good music to listen .until theirprejudices are conquered.

SUPPLY OF INTERNATIONAL VITAMIN

STANDARDS

WE are asked to announce that the internationalstandards for vitamins A, Bl, C, and D, to whichreference was made in a leading article last week, arenow available for issue to laboratories, institutions,and research workers in Great Britain and NorthernIreland. These standards are kept at the NationalInstitute for Medical Research, London, which actsfor this purpose as central laboratory on behalfof the Health Organisation of the League of Nations.The required quantities of each of the vitamin

1 Music and the Listener. By Keith BarrY, M.B., Ch.M.Melbourne : Robertson and Mulling Ltd. 1934. Pp.126. 2s. 6d.

standards are now being scut to national centrallaboratories for subsequent local distribution incountries abroad. The National Institute for MedicalResearch will continue to supply the internationalvitamin standards for use in Great Britain andNorthern Ireland The standards for the vitaminsBI and D remain unchanged and their supply at

regular half-yearly intervals will be continued as

before. The standard for vitamin A has been changed,a pure specimen of (3-carotene having been adoptedin place of the impure preparation of carotene hithertoemployed. The unit of vitamin A remains unchanged,though it is now defined as the vitamin-A activitycontained in 0’6 microgramme of pure &bgr;-carotene.In accordance with the recommendations of theSecond International Conference on Vitamin Stan-dardisation the (3-carotene is issued in the form of a

solution in oil, of which 1 gramme contains 500International Units. The quantity of this standardsolution supplied to each applicant is approximately5 grammes, and, on account of the small quantityavailable, it can be supplied only at yearly intervals,and not half-yearly as formerly. It is suggested,therefore, that care and economv should be exercisedin its use and that subsidiary laboratory standards,exactly assayed in terms of the international standard,should be prepared for routine work. l-Ascorbicacid has been adopted as the international standardfor vitamin C, the unit of activity being defined asthe vitamin-C activity contained in 0’05 milligrammeof pure l-ascorbic acid. A quantity of approximately550 milligrammes will be supplied to all laboratories,institutions, and research workers in Great Britainand Northern Ireland who require it.

It is suggested that those laboratories, institutions,and research workers in Great Britain and NorthernIreland who do not receive the standards at present.and who desire to receive any or all of them, willapply to the Director of the Department of BiologicalStandards, The National Institute for MedicalResearch, Hampstead, London, N.W.3.

CENTENARY OF ST. MARK’S HOSPITAL

THE Lord Mayor of London, Sir Stephen Killik,presided on March 2l8t at the 99th annual meeting ofthe governors and supporters of St. :B1ark’s Hospital.City-road. His lordship gave a brief sketch of thedevelopment of the hospital from small beginningsuntil, at the dawn of its lOOth year, it had developedinto a centre for treatment of wide reputation. This,he said, justified the authorities of the hospital inappealing for 60,000 needed to meet the heavydemands now made upon its services. He recalled tothe audience that on St. Mark’s Day, April 25th, thecentenary banquet, in support of the funds of the

hospital, would be held at the Mansion House whenhe would have the pleasure of presiding-a well-deserved compliment to a great charity which had itsorigin in the City within a few yards of the centre.Contemporary with the centenary celebrations the

medical committee of St. Mark’s Hospital haveselected and produced in a sumptuous volume1 a seriesof papers written by surgeons to the hospital andcontributed to medical literature. These papers rangeover a period commensurate with the existence of theinstitution and form a running commentary on theoperative side of proctology for a century. The firstessay was contributed by Frederick Salmon, thefounder of the hospital, to THE LANCET in 1831, twoyears before the hospital existed; he was at that timesenior surgeon to the Aldersgate General Dispensary,and his paper was an excellent plea for intensive1 Collected Papers of St. Mark’s Hospital, London, 1835-1935.

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and special study of all rectal disease. The next

paper describes Salmon’s operation for internalhaemorrhoids and is written by that distinguishedproctologist William Allingham. In this paper, which

appeared in 1888 in Allingham’s well-known text-book on " Diseases of the Rectum," Salmon’s originaloperation, devised and practised at the opening ofthe hospital, is fully described. At the other chrono-

logical end we have a paper by Mr. E. T. C. Milliganand Mr. Naunton Morgan on the surgical anatomyof the anal canal, with special reference to anorectalfistuhe (vide THE LANCET, Nov. 24th, 1934, p. 1150,and Dec. 1st, p. 1213), and between the extremes wehave a number of contributions from past and presentmembers of the staff of the hospital, among whom areAlfred Cooper, David Goodsall, Swinford Edwards,who still fortunately is with us, and Herbert Allingham,a brilliant surgeon who died tragically young, when.already in the front rank of general surgeons, but whohad begun his career by following his father WilliamAllingham’s specialty. The papers are preceded by ahistorical sketch of the institution, illustrated by aportrait of Frederick Salmon and pictures of thehospital in its first home in Aldersgate-street, and its- second home on its present site, with views of thenewer buildings and of the wards and out-patientdepartment. One notes in this historical sketch theremarkable fidelity of members of the honorary staff-to the institution. Salmon, the founder, worked atthe hospital for 24 years, Alfred Cooper for 34, DavidGoodsall for 33, Peter Gowlland, the elder Allingham,Swinford Edwards, Gordon-Watson, and Lockhart-

Mummery all for more than twenty years. SirCharles’Gordon-Watson remains as consulting surgeon, whileMr. Lockhart-Mummery, though resigning his position,on the regular staff, will continue to serve for a period.as emeritus surgeon.

The volume was formally presented to the LordMayor at the close of the annual meeting.

EXPERIMENTAL ANÆMIA

Up to date it has proved extremely difficult to

produce a megalocytic anemia, in animals by anexperimental procedure. uch an anaemia has been

produced in dogs by causing stenosis of the small

intestine, and in young pigs by a diet of corn, fish-

meal, and draft Quite recently D. K. Miller andC. P. Rhoads,’ feeding swine a diet which will causeblack-tongue in dogs, have produced a characteristicsymptom-complex. The principal manifestations wereanaemia, which was often megalocytic, lesions of theoral mucous membrane, achlorliydria, and motorweakness of the extremities. When the disease was

present it was impossible to demonstrate hsemopoietic.activity of the gastric secretion or liver when tested oncases of pernicious anaemia in man, though both theliver and gastric juice of healthy pigs were haemopoieti-cally active. The disease syndrome of swine could beprevented and alleviated by the administration ofcertain substances, such as liver extracts which areprophylactic and curative of sprue, tropical megalocyticanaemia, pellagra, and pernicious an2emia in man. Theauthors found the similarity between this experi-mental disease of swine and a group of pathologicalstates of human beings to be striking, and to justifythe inference that in man the pathological changesare due, in part at least, to a common cause, and thatthe cause is basically a lack of intake or utilisation of.some as yet poorly dofined dietary constituent. It isnot yet clear exactly what essential factor is absentfrom the diet used in these experiments. As far a,s

1 Jour. Clin. Invest., 1935, xiv., 153.

rats were concerned, the vitamin-B complex appearedadequate ; it may be possible that the requirements ofpigs for this vitamin are different. A diet adequate inevery respect but vitamin B will not produce black-tongue however, so presumably it was not deficiencyof this complex that caused the symptoms. Noris there any evidence that a lack of any mineralconstituent was involved, since liver extract, which isexceedingly low in minerals, will cure or prevent thedisease syndrome. Even in those cases where theanaemia which developed was of the microcytic typeiron was without effect, while liver extract wascurative. The nature of the missing factor is not yetobvious, but it is a matter of considerable importancethat by an unknown dietary deficiency it is possibleto produce within a period of weeks not only megalo-cytic anaemia, but also profound changes in gastricsecretion.

THE CRICKET ON THE HEARTH AGAIN

WHATEVER the cause, whether it be Keats for callingthe " cricket’s song " to witness that the " poetry ofearth is never dead," or merely Milton and his" cricket on the hearth," there is no doubt that thecricket has held a position of respect in the Englishhousehold enjoyed by few other insects. But in an

age which finds little time for poetry, and which isbecoming less and less tolerant of " little inmates,"however " full of mirth" they may be, the cricketis finding itself in the same class as the universallydetested cockroach. Gilbert White, it is true, whilewriting of the cockroach, which was something of anovelty to him in 1790, in terms of kindly interest,refers to crickets as " noisome pests " which " oftengnaw holes in wet woollen stockings and aprons thatare hung to the fire." He notes that they delightin new-built houses, and that is so to-day : it is

chiefly the inmates of newly erected council houseswho complain that they are overrun with crickets.The reason for this is not certain, but in many casesit is less because the crickets are " pleased with themoisture of the walls ... and the softness of themortar" than because such houses are often builtclose to old refuse dumps where uncrushed tins in awarm environment provide perfect nurseries forcrickets. They are not, as a rule, difficult insects toeliminate. The Curate of Selborne explains that they" may be blasted and destroyed by gunpowderdischarged into their crevices and crannies " ; butin t less violent age they can be poisoned with a baitof equal parts of bran, treacle, and sodium fluoride,flavoured, perhaps, with a little beer.

SCIENCE AND SERVICE

IT must happen that details of scientific work, whengiven with the elaboration which is necessary, seem toobscure the very reason for their publication. Manya one will have asked, while glancing through columnsdescribing technical work that is outside his own

sphere, how is all this of practical service to me inmy daily work To the notice of any who havefelt like that, we commend the beautiful speech ofMile Eva Curie, whose words will be found as she

spoke them in a report of the dinner held on

Wednesday, March 20th, in support of the BritishMemorial to Marie Curie (see p. 760). The physicsand chemistry of radium, when under discussionfrom any aspect, entail the publication of detailsthat can only be comprehensible to workers uponcertain scientific fields. If such details are not

published those workers cannot obtain the inter-communication which is so valuable for progress.But as these labourers in the special field are able to