29

when put upon a harder grade. Dr. PATERSON’S

suggestions and his explanations of his results are

of great interest and are worthy of careful con-

sideration. The system of graduated labour as applied tothe treatment of pulmonary tuberculosis has many obvious

advantages : it tends to improve the physical condition ofthe patient, and to render him ready for work directly he is

discharged with his disease arrested ; moreover, it brings amore definite interest into the treatment than where the

only exercises prescribed are graduated walks. The theoryof auto-inoculation must, of course, be regarded only as a

working hypothesis, but Dr. PATERSON’S interesting observa-tions, although not a direct outcome of this theory, lend con- I

siderable support to it, and should serve to encourage the

application of similar methods to other infections. We

congratulate him upon his work.

Annotations."Ne quid nimis."

IMPROVEMENTS IN THE NAVAL MEDICAL

SERVICE.

WE understand that the recommendations of the Committeeon the Naval Medical Service, which has been presided overby Vice-Admiral Sir John Durnford, have been accepted bythe authorities practically in their entirety. Under the newconditions of service the inducements to young medical mento join will be distinctly greater. There are increases of

pay in certain directions, provision is made for accelerationof promotion in response to good and scientific work, and thefacilities for post-graduate study are multiplied. The pro-jected reforms affect also Queen Alexandra’s Royal NavalNursing Service, where the age of entry has been raised andthe rates of pay increased, and the Sick Berth Staff, wherealterations for the better have been made in training, andwhere special allowances will be granted for the dischargeof exceptional duties. We desire to bring this informationprominently before those of our readers who are connectedwith medical schools, for they will find in the report when itis issued many reasons for suggesting to young qualifiedmen that the career of the naval medical officer contains

excellent opportunities. -

HOSPITAL SATURDAY FUND: A CORONATIONAPPEAL.

" IN view of the Coronation, and having regard to the factthat His Majesty has recently become Patron of the HospitalSaturday Fund, the time is felt to be opportune for a

special appeal on behalf of the work which that Fund

is doing amongst the hospitals of London." These open-ing words of a circular letter signed by Sir Savile

Crossley and Mr. A. W. Davis, respectively chairmanand secretary of the Fund, will probably meet with a

good response. The great interest which His Majesty hasalways evinced in the hospitals is well known, and Corona-tion year could not be more fittingly commemorated by thecharitable than by increased provision being made for theever-growing needs of hospital work. The suggestion in thecircular was that those who now contribute regularly to theHospital Saturday Fund should double their weekly contri-butions in Coronation week as a special offering. We joinSir Savile Crossley and Mr. Davis in cordially commendingthe idea to contributors, and remind them that though

Coronation week has passed the opportunity for generosityremains.

____

SCIENTIFIC RESEARCH FOR THE LOCALGOVERNMENT BOARD.

THE President of the Local Government Board hasauthorised the following special researches to be paid for outof the annual grant voted by Parliament in aid of scientificinvestigations concerning the causes and processes ofdisease :-

.

If 1. A research into the causes of premature arterial

degeneration in man, by Dr. F. W. Andrewes, pathologist toSt. Bartholomew’s Hospital.

2. An inquiry by Dr. J. H. Thursfield, of St. Bartho-lomew’s Hospital, into the causes of death in measles.

3. A comparison by Professor Nuttall, F.R.S., Quick Pro-fessor of Biology at the University of Cambridge, of thenumber and kind of fleas found on rats.

4. A continuation by Dr. C. J. Lewis, of Birmingham Uni-versity, of his investigation into the degree of prevalence andthe characteristics of micro-organisms known as non-lactosefermenters in the alimentary canal of infants.

5. An investigation into the same subject by Dr. D. M.Alexander, of Liverpool University.

6. An inquiry by Dr. Graham Smith, of Cambridge Uni-versity, into the incidence of non-lactose fermenters in fliesin normal surroundings and in surroundings associated withepidemic diarrhoea.

7. A study by Dr. F. A. Bainbridge, of the Lister Insti-tute, of the anaerobic bacteria in the alimentary canal ofinfants.

8. An investigation by Dr. Graham Smith into the possi-bility of pathogenic micro-organisms being taken up by thelarva and subsequently distributed by the fly.

TUBERCULOUS BURSITIS.

TUBERCULOUS bursitis has not received much attentionIn the Johns Hopkins Hospital B1Ûletin for May Dr. SydneyM. Cone has described two interesting cases. A man, aged22 years, was admitted into hospital complaining of pain in,and loss of function of, the right shoulder. He had alwaysbeen strong and healthy, and there was no family history oftuberculosis. For about three years the right shoulder had beenstiff on getting up in the morning, but this wore off after hehad worked. For the past three months the shoulder hadbeen constantly painful. The pain was increased on move-ment and prevented him from working. Examination

showed fulness of the shoulder, especially over the coracoidprocess, and crepitus was felt in front of the joint. Therewas localised tenderness at the acromion process. He couldnot raise the arm or place it behind him because of the pain.Radiography showed rarefaction over the tuberosity of thehumerus and slight roughening there as well as at the upperpart of the glenoid fossa. Two milligrammes of tuberculinwere injected subcutaneously and produced a reaction locally,focally, and generally. At the site of the injection therewere swelling, tenderness, and redness. On the followingday there was pain in the shoulder and the temperaturerose to 100° F. On August 2nd, 1909, an incision was madefrom the acromion process outwards and downwards towardsthe deltoid insertion. The deltoid muscle was dividedand a thick grey sac was exposed by blunt dissec-tion. As there was difficulty in removing the sac in

consequence of adhesions it was incised and about 400facetted bodies shot out with a thin serous fluid. The sacwas then removed without difficulty. An incision was madeinto the joint at the point of greatest adhesion near the

tuberosity. The joint was found to be normal. The musclewas sutured, the wound was closed, and union took place byfirst intention. On Sept. 8th he was readmitted with a sinus

. in the line of incision. This closed under treatment, butothers formed. On Jan. 24th, 1910, the apices of both lungs