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Down, there were higher levels that would be of greater ’

advantage. An inquiry into the question is beingheld, and the Castlereagh rural council instructedtheir solicitor, with a deputation from that body, toappear at the inquiry and to oppose the proposal of theDown County Council. In one of the Belfast papersMrs. Green, the widow of Mr. Forster Green, whoestablished the " Forster Green Hospital for Con-sumption," states that many years ago, when herhusband considered the suitability of several places fora tuberculosis sanatorium-even as far back as 30years ago-Fortbreda, high and sheltered, was felt tobe infinitely better than any site near the shores ofBelfast Lough. She entirely agrees with those who saythat either side of Belfast Lough is unsuitable for atuberculosis sanatorium.

A City Bacteriologist.The City of Belfast Municipal Council have decided

that, pending the erection of a municipal laboratory,arrangements shall be made for carrying on thegeneral bacteriological work of the corporation in theCentral Tuberculosis Institute, and that a qualifiedbacteriologist, to devote his whole time to the duties ofthe office, shall be appointed. The proposed salary isJ6700 a year, rising by f:50 increments to .E900, and awhole-time laboratory attendant is to receive X250 ayear. It was also recommended that Professor St. Clair

Symmers, whose appointment as bacteriologist expiredon March 31st, should be retained in that position for afurther term of one year at a salary of J63SO.April 12th.

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PARIS.(FROM OUR OWN CORRESPONDENT.) .

The Fi’J’st Reeoa°ded Case of Aleppo Boil in F1’ance.M. Ravaut has reported to the Academy of Medicine

a case of Aleppo boil contracted in France. It occurredin the Pyrenean district in a young girl who had neverbeen out of France. She had been subject to bites bymosquitoes every summer, and two of the bites werefollowed by nodules, one on the nose and one under theright eye. The lesions had been present for a year andhad resisted all treatment. Clinical diagnosis wasalmost impossible, as neither the induration nor theclassical furunculosis was present. Microscopic exami-nation, however, showed by the presence of innumerableLeishman’s bodies that the nodule was an orientalsore. Treatment by novarsenobenzol was immediatelyfollowed by shrinkage of the lesions. The case is

interesting since it is the first reported proof of thepropagation of this infection in France ; the germ musthave been introduced by the Kabyles or by colonialsworking in the vineyards of the district. Other cases willalmost certainly be discovered if a systematic search isundertaken; examinations should be made on smallportions of tissue crushed between two slides and noton the serous secretion.

The Eight-71oit)- Day and Hospital Staffs.Physicians and surgeons are complaining that the

institution of the eight-hour day among hospital staffshas totally upset the nursing, and on behalf of theircolleagues MM. Cuneo and Sergent have made a proteston this subject to M. Mesurier, director of the AssistancePublique in Paris and of the supervisory council of thisadministration. The rounds of the honorary staff areusually made from 9 A.M. The change of shift followingshortly after their visit results in the treatment beinggiven by nurses who, not having been in attendance onthe round, cannot carry it out as efficiently as if theyhad themselves heard the precise details ordered by thechief. To quote the protest of MM. Cuneo and Sergent" the change of personnel produced by the law of aneight-hour day is very prejudicial to the patients; itwould seem as though the law should never havebeen applied to hospital staffs." Questioned on

this subject, M. Mesurier said that it was impossibleto discuss the eight-hour day, which is applicableto all municipal employees and consequently to thehospital staffs, who could not be treated differently. The

way to avoid the danger emphasised in the memo-randum of MM.Cuneo and Sergent is to change the methodof application of the law and to make it accord with theinterests of the patients. M. Mesurier promised togive the reform his immediate consideration and hasno doubt that a new adjustment of the rules will givesatisfaction to all parties. This controversy havingbeen published in the press, the union of hospitalattendants has issued a protest, in which it accuses thedoctors of not having made efforts to adapt themselvesto the consequences of the law and of beginning theirrounds too late. It is alleged that some of them do notarrive at hospital till 11 o’clock, after having disposedof their private patients. When these clinicians haveseen some 100 patients between 11 and 12, the shiftwhich has been on duty since 6 A.M. has no time tocomplete the treatment and dressings ordered beforegoing off duty, and these are left to the next shift,which has, perforce, to receive its instructions at second-hand. This statement on the part of the hospitalstaffs seems much exaggerated, and it is onlythe exceptional cases which have been quoted by them.In practice, when the visiting doctor arrives late,his assistants have already examined the patients andhave prescribed for most of them so as to have to referto their chief for a decision only on new or seriouscases. Besides, all the dressings are done in thehospitals by the assistants themselves, not byattendants or nurses.

The Campaign against Ca’neel’.

M. Le Troquer has made a proposal to the MunicipalCouncil of Paris, designed to develop the fight againstcancer, which is still on the increase. While in 19103073 cases were* notified by doctors, last year therewere 3619. Nevertheless, M. Le Troquer estimatesthat, according to results already obtained by numerousscientists, the certain cure of cancer will be realised inthe near future by means of radium. Unfortunatelyradiotherapy has hitherto been confined to the

private practice of a few specialists, mainly resident inParis. Apart from these, there are other medical men-certainly becoming more numerous-who possess of thisprecious substance a fragment so small as to havelittle therapeutic value. Obviously, at 800,000 francsa gramme radium is not available for many purses. TheAssistance Publique is not in a position to affordthis special treatment to the poor. Dr. Regaud and oneof his colleagues in the Pasteur laboratories are theonly ones who have begun to treat cancer patients inParis hospitals by radium. In other countries, on thecontrary, radiotherapy has developed considerably. Forthis reason M. Le Troquer asks for the institution of anautonomous hospital dispensary, in connexion with theRadium Institute of the University of Paris, whichshall have the possession of 2 grammes of radium,bought by means of a loan of 2 million francs, forwhich M. Le Troquer also appeals. The hospital wouldbe constructed near Paris on a site now available owingto the demolition of fortifications.

April 10th.

BUDAPEST.

(FROM OUR OWN CORRESPONDENT.)

Effect of Altitnde on the Blood.Dr. Voicu, a Roumanian pilot, formerly a medical

practitioner, has been studying the effects of a highaltitude on the blood, and for this purpose has analysedthe amount of iron contained in the organs of soldiersand animals in the highest parts of the Carpathianmountains, as compared with control men and animals.Even after a short stay in the mountains a decidedreaction is noticed, since liver and blood and spleenbecome rich in iron. The explanation is probably thatreserve depots are opened and more haemoglobin is

passed into the blood; since this is used up more rapidlymore iron is deposited in the liver. After the second orthird week the haemopoietic apparatus ceases its over-production and the liver gives up its iron to theblood. As a result the iron content of the blood

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gradually increases, while that of the liver firstrises and then falls. This observation is in perfectaccord with the result of blood counts made on pilotpupils, who during instruction time are spending, so tosay, several months in the air at heights equal to highaltitudes. The chief stimulant is probably the rarefiedair, but it is likely that radio-activity, which is

present to a marked degree in the mountains, plays aprominent part.

The Toxicity of Cresols.In the absence of modern and up-to-date disinfectants

recourse is had to cresols; which are widely used hereinstead of the modern lysoform preparations. Dr.

Vamossy examined the effects on a number of animals(cats, rabbits, mice, frogs) of the three isomeric cresols,and found that all the three behaved differently.Paracresol is decidedly more poisonous than carbolicacid for both carnivorous and herbivorous - warm-blooded animals ; orthocresol is equal in toxicity tocarbolic acid, as described by Dr. Tollens in 1901,but metacresol is less toxic. A number of crudeand saponified samples of cresol on the marketwere also examined. Contrary to the usual statements,they gave rise to the same symptoms in about the samedosage as carbolic acid and some of the crude samplesproved even more toxic. The presence of soap does notseem to diminish the intensity of action, and the sameis true for carbolic acid, since the latter, plus soap,introduced into the stomach of an animal, kills just asrapidly as carbolic acid alone.

The Practice of yZedicine in Albania.Dr. Vulcan practised during the last four years of the

war in the Mohammedan part of Albania and recentlystated before the Medical Society of Nagy-Szeben thatpractice in Albania is attended with great difficulties inconsequence of social and religious customs. These,with the dense ignorance and extreme poverty of themass of the people, are responsible for the widespreadepidemics which prevail and which have baffled Iall the efforts of the Austro-Hungarian Govern- ’,ment for their suppression. There is no scientificsystem of native medicine. Herb doctors, known as" hodzsas," combine with their medical practice theuse of charms and incantations, with offerings to thegods. Superstitions and astrology are credited andmuch practised. Surgery is in the hands of unskilledbarbers. The condition of women is particularlydeplorable. Even the daughters and wives of theso-called cultured classes can never see a male

physician, but must be treated through the mediumof ignorant midwives. The intermarriage of near

relatives and child marriages are an unfailing sourceof evil. Girls of 12 to 13 years are known to becomemothers. Of course, an increasing population underthese physical conditions cannot be a healthy andvigorous one. The mortality is great in consequenceof the grinding poverty and bad housing. The nutritionis very poor ; pork fat is not used, herbaceous oils alonebeing allowed. The hospitals established of late yearsmay perhaps improve the high mortality rate.

PotSOMM ’J7 C07:0.Owing to the high price of pure refined alcohol

unscrupulous brandy-dealers have recently sold methylalcohol, with the result that several of the consumershave died, or have suffered from severe nervous dis-orders, particularly optic neuritis. In this connexionDr. Pollak recently gave an address on the comparativetoxicity of alcohols. He said that all the alcohols ofthe methyl series are toxic, but in an ascending scalefrom methyl alcohol to amyl. Methyl alcohol, or wood-alcohol, as it is called here, is cumulative in its effect;the others are not. This seems to be due to the factthat one of the most important effects of methyl alcoholis a great retardation of oxidisation. Methyl alcoholremains more or less unchanged when in contactwith the. tissues, and as a consequence continuesto exert its influence. According to some authoritiesmethyl alcohol partly metabolises into formaldehydeand formic acid, which would account for its toxiceffects. In recent years, owing to the making ofodourless wood-alcohol, there has been much more

abuse than has come to light. Some cases haveeven been reported in which pharmacists have usedit in tinctures. It is surprising, said Dr. Pollak,that more peripheral neuritis has not been reportedfrom its use. It seems probable, however, that deathcomes so soon that peripheral neuritis has not time todevelop. It acts specially on the ganglion cells of theretina, but also on other important cells of the centralnervous system.Nagyvai’ad. March 24th.

TUBERCULOSIS.

1’tcbencclosis as a F(wtor in Deou,lcction.A RECENT number of the Paris 3edicab gives an

interesting abstract by Dr. Perrin, professor in the

Faculty of Medicine at Nancy, of an investigation madeby him years ago into the influence of a tuberculousstock on the upward or downward trend of population.Dr. Perrin, in the course of his duties at the hospital atNancy, made inquiry into the histories of 1000 families,all of the working classes. Of these families, 500 hadone or other parent tuberculous, while in each of theother 500 families bcth parents were free from tuber-culosis, the visit to the hospital being ,on account ofno7a-tuberculous disease. The families were in no otherway selected, and were a consecutive series in theirattendance at the hospital. Dr. Perrin further statesthat in their environment, habitations, overcrowding,exposure to infectious disease, alcoholism, venereal-disease, and gastro-enteritis, and also in their years ofmarried life, the two groups were exactly comparable.At the same time it must be pointed out that theireconomic circumstances would require very careful

investigation before their similarity can be unreservedlyaccepted; on this Dr. Perrin’s summary in the journalin question does not throw sumcient light.The first point deduced from Dr. Perrin’s data is that,

whatever the reason may be, the non-tuberculous groupis markedly more prolific than the tuberculous group.Then, not only are the children of the non-tuberculousmore abundant, they are also less vulnerable to diseasein general, and less affected by tuberculosis in par-ticular. The proportion of healthy children among thenon-tuberculous families was double that among thetuberculous. The difference was, in fact, such that apopulation consisting of households infected with tuber-culosis would tend steadily to diminish, while a popula-tion composed entirely of healthy non-tuberculousfamilies would tend to double itself from one generationto the next. In all this there is, of course, no validargument for the policy of leaving the extirpation of thedisease to natural laws. Assuming the accuracy of Dr.Perrin’s standards for the comparison between the twosets of families, there is nothing but encouragement tothe social worker in the view that his human efforttowards the elimination of tuberculosis is in the samedirection as, and not opposed to, the natural historyof the disease itself. These data are an indication ofthe need for caution in associating a downward curvein the mortality from tuberculosis with particularpreventive or curative measures.

The Effect of T1.Lberculosis on the Length of Life.In the Statistical Bulletin of the Metropolitan Life

Insurance Company for February a report is publishedof the effect of tuberculosis on the length of life ofindustrial’ policy-holders. The disease reduces the

expectation of life of white males by nearly threeand a half, and of coloured males by approximatelyfive years. Under the prevailing rates of tuberculosismortality, the expectation of life of the industrial whitemale at birth is 46 years, and of the coloured male only37 years. It is calculated that the eradication of tuber-culosis would add as much to the life-span as hasresulted from all the sanitary improvements of the last25 years. The tuberculosis mortality among wage-earners in 1919 shows a favourable decline, equivalentto a drop of 33 per cent. below the figure for 1911. This’achievement is attributed to public health and educa-tional work during the past 30 years and to the intensive