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inconceivable that anyone could approve of the Bill,which was based on a failure of ima,gination. Hethen spoke of the importance of experimentation ondogs and cats to cerebral pathology, and quoted from0. Henry : " I am a Kentuckian and I have seen agreat deal of both men and animals, and I never yetsaw a man who was over-fond of horses and dogs butwhat was cruel to women." The public entrustedtheir lives to the profession, and it did not seem toomuch to expect that they would not cause unnecessarysuffering to another of God’s creatures.

Mischievous Vlethods of Attack.Sir THOMAS LEWIS said that the science and practice

of medicine had been built upon the examination ofliving people, the dissection of dead bodies, andexperiments on living animals, and all our knowledgeof human disease was derived from these sources.Had any one of them been closed, medicine would havefailed to emerge from the Dark Ages. He suggestedthat any one of his hearers should sit down and write areasoned statement on the process and control of thecirculation, or of the nervous system, without usingany fact or inference derived from experiments onliving animals. Only then would he fully understandthe fundamental part these experiments had played.He illustrated this point from the cardiovasculargrstem. The supporters of the Bill displayed astonish-ingignorance of the conditions under which animal

experimentation was carried on. No-dog could bekept in serious pain without the fact becomingimmediately known, and there was no licensed buildingin the land in which such conduct would be tolerated.The recent petition of the National Canine DefenceLeague proved by its inaccurate statements that itssignatories were the victims of a mischievous campaignand unfitted to influence the decisions of Parliament.The leaders of the antivivisectionists in this countrywere unscrupulous or culpably negligent in presentinggrossly inaccurate evidence and in perverting themeaning of plain words. The campaign satisfied amorbid craving for the horrible and gruesome and the" tortures " of animals which brought to many right-minded people much needless suffering existed onlyin the imagination. Those engaged in attackinganimal experiment were engaged in an attack on theprogress of medicine ; those who lent their supportwere upholding a campaign against the cure andalleviation of human suffering.

Lieut.-Colonel J. W. BRITTLEBANK said that as aveterinarian he saw a good deal of the societiesresponsible for this emotional propaganda, and wereit merely emotional, and not unprincipled, would notobject to it, but actually there were no lengths towhich these propagandists would not go. He thoughtthere could be no other civilised land where men whodevoted themselves to the mitigation of suffering inman and animals were so pilloried as in this country.He was there to offer the utmost support of theveterinary surgeons. lIe emphasised the differencebetween the mental attitude of man and animals, andreferred to the research on distemper, asking whetherthat was to be stopped.

The General Pra^titioner.Dr. H. B. BRACKENBURY said that an accusation of

cruelty or callousness, or even of a lack of sympathy,was one which, if closely examined by any responsibleperson in the country, would be at once repudiated.General practitioners associated themselves with thosewho knew a great deal more than they did about theactual experiments and recognised their value in

everyday practice. He mentioned particularly thetesting of drugs and the treatment of cardiovascularand digestive disorders. He failed to see how anyonecould consistently support this Bill unless preparedto refuse the chief medical aids which his doctor couldgive him. Much was heard nowadays of the impor-tance of research work by general practitioners,but this research could not begin on human beings : -.it must receive its impetus from animal experiments.If the medical profession were going to create such apublic opinion as would prevent the annual recurrence

of such absurdities as this Bill, it was the generapractitioners who must play the greatest part. Thiswas no easy task, and it required a good deal of couragefor doctors to tackle their patients on the question.He was certain, however, that there was a very largebody of people sincerely anxious for and willing toaccept guidance, and he urged practitioners to throwthemselves into the campaign, and to make oppor-tunities where none were offered.

General Discussion.Lord LAMINGTON (Research Defence Society) spoke

of the persistence of certain highly-placed supportersof the Bill and the necessity for energetic counter-measures.

Mr. E. W. MOSS BLUNDELL (Field Distemper Fund) pointed out that the work on distemper was for dogs,but would probably lead to the relief of humandiseases. The work was progressing admirably andreceiving enthusiastic support from all over the world.Its stoppage by legislation would be a calamity and abitter disappointment to dog-lovers everywhere.

Lieut.-Colonel F. E. FREMANTIE said that the realdifficulty to be countered was the feelings of dog-loverswho were blinded by their love, and were imperviousto argument. A statement as to how much animalsin general and dogs in particular had benefited byexperiments would be very useful in dealing with thesepeople.

Prof. F. T. G. HOBDAY described his experimentson the use of chloroform for veterinary operationsand related the horrors of the pre-anaesthetic days.For these experiments he had had to obtain the most" brutal " licence and was now branded as a vivisector,but truth must prevail.

LIVERPOOL MEDICAL INSTITUTION.

A MEETING of this Institution was held on

March 17th, when Dr. R. W. MACKENNA read apaper on

Psoriasi,3.It was a reproach to the profession, he said, thatthough psoriasis was one of the most ancient ofrecognised diseases, there was as yet no certain meansof curing it. Its cause was still unknown, thoughundoubtedly a definite familial tendency was traceablein about 30 per cent. of cases. The determining causeof the first outbreak was usually some slight trauma,but once a person had had an attack he was likelyto suffer from recurrences all his life. The psoriasispapule, the initial lesion, was a characteristic patho-logical entity, and it should be possible to diagnosethe disease from a single papule. The appearancesproduced by systematic curetting (grattagej were verycharacteristic, and Dr. MacKenna demonstratedby photographs of sections the anatomical conditionson which they depended. He also gave an account ofexperimental observations, made with the help ofDr. Elizabeth Hunt, in his clinic at the Royal Infirmary.No new and certain method of curing the diseasehad, however, been discovered.

Dr. R. E. ROBERTS and Mr. ST. GEORGE WILSONcontributed a note dealing with

The Treatment of Menorrhagia by X Rays.Thirty-four cases had been treated, and it had beenfound that the technique adopted should varyaccording to the patient’s age. In older women theobject was to bring about an artificial menopause,whilst in younger ones-those under the age of 40-the aim was to avoid, if possible, any interference withfertility except as a last resort. A dose that wouldcause sterility in a patient over 40 years of age wouldnot have the same effect in a younger woman, whichmeant that there was a bigger margin for submaximal

, dosage in younger subjects. If, however, it was. finally decided to sterilise such patients it would take

longer to bring about the desired result. In olderwomen a permanent amenorrhcea had been in every’ case successfully produced by X rays. In the younger

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group an amelioration of symptoms was broughtabout in most of the cases by submaximal dosage,and it was rarely necessary to proceed to completesterilisation. Most of the cases had been treatedunsuccessfully by other means before X rays had beentried. Dr. lloberts and Mr. Wilson also referred toirradiation of the spleen as an adjunct to the treatmentof excessive bleeding and to irradiation of the ovariesby very sniall stimutating doses in the treatment ofprimary amenorrhœa. Too few cases of amenorrhœahad been treated in this way to allow of any conclusionsabout its value.

Reviews and Notices of Books.LISTER AS I KNEW HIM.

Bv JOHN Rum LEESON. M.D., C.M. London :

Baillière, Tindall and Cox. 1927. Fp. 212.8s 6d.

Tn E work of great minds endures long after thecarthly tenrples of the body have dissolved in dust :of that work later generations will have cognisance,but the persona) characteristics and mode of life ofthe worker will often be hidden, although of absorbinginterest to those who have not had the opportunity orthe privilege of personal relations with him alive.Lister’s labours, by which he converted operativesurgery from what was—before his teaching began totake effect—in many cases, and necessarily, a death-dealing art, to one which is in verity a life-giving one,are known to all men, to the public now as well asto onr profession, but the personality of the manhimself, as he appeared to his contemporaries and tothose who had the honour of working with him isstill largely concealed, despite Sir Rickrnan Godlee’sbiography and the published estimates of a group ofearly and devoted followers. flenc(- the appearanceof Dr. Leeson’s book in this centenary year of Lister’sbirth is timely. The book is very simply written by a faithful

disciple who had and bus. as any disciple of Listermust have, a whole-hearted reverence and love forhis teacher. Dr. Leeson commenced medical studyat St. Thomas’s Ilusloital, which was removed from theBorough to its present site near Westminster Rtridge inOctober, 1871. The site was new, as airy a one as couldbe found, and there was as much chance of sunlight asis possible in London, the building was new, thefittings were new, and the nurses were of the newschool of :B110rence Nightingale. Never did an institu-tion start less weighed down by evil heritage. Sir JohnSimon, who had been assistant surgeon at King’sCollege Hospital (where Lister was afterwards topreach to audiences mostly apathetic), was one of thesurgeons, and was also the first medical officer ofhealth for the City of London and medical utficerunder the lliiblie Health Act. Everything to allappearance that could make for the successfulhealing of wounds was present at St. Thomas’sHospital by Westminster Bridge. " And yet." Dr.Leeson says, a.-, far as surgery was concerned... pyæmia, septicæmia, and erysipelas were as

rife as ever.’’ And the student, of those days knewvery much about the working of the wards, though themedical curriculunt occupied only two and a half yearswhen Dr. Leeson joined his medical school, of which ’,,term the first year wa.s taken up also with dissectingand attending lectures. The spare time was devoted ! tcr walking the hospital. Leeson on arriving at thelatter portion of this time. which to-day, seems soterribly inadequate, asked one of the staff, the greatCharles Murchison, how he had best spend thiseighteen months and Murchison then gave thisremarkable answer: " It’ I were you, Mr. Leeson, Ishould not spend the whole of my time at St. Thomas’s.I should go to Edinburgh and follow the practice ofProfessor Lister ; I believe there is a great futurebefore his work and that it is well worth your whileto study it." And it may be noted that shortly beforethis advice was given a series of papers was running in

THE LANCET by Murchison, in juxtaposition t..Lister’s earliest reports of his results.

Accordingly, armed with letters of introductionfrom 1lurchisoll to Lister and Grainger Stewart, theyoung student arrived in Edinburgh in the summerof IS73 and was admitted tu Lister’s wards. Theywere dark. gloomy, and sunless. but t In- patients were-cheery and comfortable, there was little pn’-, no

pyfpmia and no putrid wounds, and there was—Mr.Lister. Consider what an impression the place, thework, the results of the work. and the personality ofhim to whom these results were due rltnst have made

upon a young and receptive tnind fresh from th.,horrors of the ordinary surgery of those days. Dr.Leeson manages to make us realise something of hisfeelings. lie became dresser. then surgical clerk.and lie describes with vivid touches Lister and hismethods, his passion for accuracy and attention t’t

detail, his never-ceasing personal interest in eachpatient, his kindliness, his courtesy, his modesty, aswhen he would say, " Never be afraid of confessingyour mistakes, it is cowardly not to do so, and it mayprevent others from falling into like error." In 1877.when Lister migrated to London as professor ofsurgery at King’s College in succession to Sir WilliamFerguson, he offered to take his old cterk with him. hutcircumstances forbade the acceptance a the offer.Hesides the personal recollections of Lister, Dr. Leesonsupplies all excellent résumé of the history of antl-

septics, the development of antiseptic dressings, anda description of an operation by Lister in the earlydays of the system when the spray was srill in use.The book is well done. Not only all medical menof the younger generation should read it but lay folkas well.

DIABETES MELLITUS.The Pathology and Treatment of Diabetes Mellitas.Second edition. By GEORME GRAHAM, M.D..F.R.C.P., Assistant Physician, St. Bartholomew’sHospital. London: Humphrey Milford : OxfordMedical Publications. 1926. Pp. 239. 8s. 6d.

THE appearance of the second edition of this workwill be w-elcomed by research workers and practitionersalike. It is not only a concise enunciat ion of thepresent state of knowledge of carbohydrate e meta-bolism, but this edition also contains practicalinformation, invaluable to those who watch over theprogress of diabetics in their daily lives. in a newlyadded chapter entitled Details of Treatment withInsulin. The first three chapters of the book, whichdeal with the distribution, storage and physiologicalregulation of sugar in the body, have been broughtup to date ; it is important to note that insulinis only one, though the most important, of the sub-stances produced in the body contributing to theregulation of the blood-sugar ; the part played byadrenalin, thyroxin, and pituitrin is probably con-siderable. A new chapter follows in which the historyof the discovery of insulin is summarised and itsproperties and mode of action are set out. as far aitthey are at present understood. So far as the musclesare concerned, insulin, it is suggested, converts glucoseinto anew kind of glucose (neo-glucose) but stores thedextrose as glycogen, while the glycogen in the liverbears no direct relation to insulin.With regard to treatment. Dr. Graham is strongly

in favour of the ladder diet as opposed to the main-tenance diet extensively used in the U.S.A. andCanada, which is, however, detailed in a specialappendix. His reasons for this preference are: (1) themore rapid relief of symptoms; () the possibility offorming, under conditions of temporary fasting, a mor&accurate estimate of the severity of an attack; and(3) the valuable psychological effect on the patientwlio learns early to understand the principles of thetreatment of his complaint. The sense of well-beingin patients treated with insulin is emphasised as

more than compensating for the minor inconvenienceof a daily injection. Most diabetic patients below

the age of 10 require insulin, and Dr. Graham tiudsthat