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personally conducted by Dr. Strauss, the Inspector-Generalof the French military hospitals.

THE WAR IN THE FAR EAST.

There has been heavy rain following a dust storm in

Manchuria, rendering the roads bad and impeding transport.There are signs of extensive movements of Marshal Oyama’sforces and skirmishes are reported by both sides. In these thecasualties seem on the whole to preponderate on the side of theRussians and are gradually mounting up. The deaths fromdisease in their army since the war began must have reached aheavy total as compared with those in the Japanese armies.Notwithstanding that the next battle threatens to take

place between the hostile armies public interest and specula-tion have been transferred from the land forces to thefleets in consequence of its being universally recognised howmuch hinges upon the results of the impending operationsat sea. It will obviously be of the greatest interest andimportance to the naval powers generally to see whatarrangements are made for the disposal of the sick andthe wounded in the event of the occurrence of any navalengagement.According to the Novosti, Professor D. O. Ott has been

ordered to join the acting Russian army for four months.His special mission is to investigate the nature of medicalorganisation in the army.

Correspondence.

DIABETES AND THE THYROID GLAND.

II Audi alteram partem."

To the Editors of THE LANCET.

SIRS,-In his very instructive Goulstonian lecture on

Diabetes Mellitus, published in THE LANCET of April 22nd,p. 1053, Dr. W. C. Bosanquet says : "Lorand states thatit is chiefly in female diabetics that actual enlargement ofthe thyroid is present ; though why the other sex shouldnot also exhibit the same alteration is not clear." MayI be allowed to make a few remarks on the subject ? 7According to George Murray, the thyroid of women is

bigger than that of men. I do not think it improbablethat this may be in connexion with the fact that there exist

very intimate relations between the ovaries and the thyroid,demonstrated clearly by the frequency of the swelling ofthe thyroid in consequence of defloration, conception,during puberty, menstruation, pregnancy, lactation, and theclimacterium (menopause). Thus the female thyroid is moreexposed to hyperfunction than the male one, and this

might also be the cause of the greater frequency of goitre, ofGraves’s disease, and of myxcedema in women. I should alsolike to add that the median lobe of the thyroid is in the

great majority of cases more developed in women than inmen; its swelling can thus be easier seen and felt thanthat of the lateral lobes which are more covered bymusculature.

It is certainly not easy to judge the condition of a thyroidby its external appearance. Sometimes a thyroid may notbe seen or felt and still there might be at the necropsy avery big thyroid. As generally accepted Graves’s disease is acondition of hyperthyroidia (hyperactivity of the thyroid)and still there are not so rarely cases of Graves’s diseasewhere no big thyroid can be seen or felt. On the other hand,the big size of the cretin’s thyroid is no proof of its goodworking condition. Hence the only reliable proof of thefunctional activity of the thyroid as of other glands canbe gained merely by its histological examination. As Istated in my paper before the London Pathological Societyon Feb. 21st last I have found in the thyroid of fourdiabetic dogs alterations that resembled those found byChalmers Watson 1 in fowls fed for a certain time only onanimal food.May I also be allowed to say a word on the rarity of

diabetes in myxoedema ? 7 As Dr. Pavy has stated in his dis-cussion with me in the Pathological Society he has neve)seen a case of myxoedema with diabetes ; and in the descrip-tion of the three cases of the Philadelphia County MedicalSociety which he kindly lent me, the author himself admits

1 THE LANCET, Feb. 11th, 1905, p. 347.

that two cases were not pronounced "and the third casewas irregular." After having looked through the literatureon the subject I have only found two cases of myxcedemawith diabetes, those of Ewald 2 and Beclere.3 In both casesdiabetes had been the consequence of thyroid medication inbig doses. I am, Sirs, yours faithfully,

Carlsbad, May 15th, 1905. DR. ARNOLD LORAND.DR. ARNOLD LORAND.

TO MEDICAL FREEMASONS.To the Editors of THE LANCET.

SIRS,-May I, through the medium of your widely readjournal, thank the many medical Freemasons and others who

sent me their votes for the medical candidates at the recentelections of the different Masonic charitable institutions ? 1The success of these candidates is largely due to the heartyresponse to my appeal in THE LANCET of March 25th andmust be very gratifying to those who were interested in thecases. The results are as follows :-

Royal Masonic Institution for Girls.-Eileen Torrens, successful with5591 votes ; Mary Trevor Webster unsuccessful.Royal Masonic Institution for Boys.-Charles Hughes, successful with

5309 votes; Alfred Burns, successful with 3709 votes; Cyril Hockleyunsuccessful.Royal Mason Benevolent Instit1ttion.-Joseph Rickets, successful with

3602 votes ; Elinor Gartley, successful with 3855.

I am, Sirs, yours faithfully,HAROLD S. SINGTON,

Secretary, St. Luke’s Medical Lodge of Instruction.44, St. Mary’s Mansions, W., May 22nd, 1905.

THE FINANCIAL RELATIONS OF THELONDON HOSPITALS AND THEIR

MEDICAL SCHOOLS.

Zo the Editors of THE LANCET.

SIRS,-In a leading article in THE LANCET of May 20th,p. 1362, in which reference is made to the arrangement thathas been come to between the Westminster Hospital MedicalSchool and King’s College for the teaching of the preliminaryand intermediate subjects of the curriculum at the latterinstitution, it is stated that the arrangement has been madewith King’s College Medical School, and not as should havebeen said with the Science Department of King’s College,which has no necessary connexion with the Medical School.As this statement might possibly lead to some misunder-standing as to the relations between the two medical schoolsI should be much obliged if you can find room in your nextissue for this correction.

I am, Sirs, yours faithfully,E. PERCY PATON,

Dean of Westminster Medical SchoolPark-street, Grosvenor-square, W., May 22nd, 1905.

A PLEA FOR THE RECOGNITION OFTHE TREATMENT OF DISEASE BY

INTRAVENOUS INJECTIONS.To the Editors of THE LANCET.

SIRS,-In the report of the discussion on the above subjectat the meeting of the Edinburgh Medico-Chirurgical Societyheld on May 3rd-1. It was not a single but six injectionsof a 1 in 2000 solution of OH2O in physiological solutionwhich affected the temperature in the case of oral sepsis. It

brought it down from 104’ 5° to normal in nine days. Each

injection was 110 cubic centimetres. 2. While the tuber-culous abscess was quite cured as reported the patientsome months later broke down and died from a practicallygeneral tuberculosis. Had she remained well permanentlythe power of arresting recent acute tubercle with CH20intravenously would have been phenomenal. Still the imme-diate success in this case with I lVIaguire’s solution wasbrilliant. 3. I am also reported as having said that thepresence of apical scars or caseous nodules was not proof ofthe curability of pnl17wnary tnberculosis. The term I usedwas phthisis not pulmonary tuberculosis, and I furtherexplained my meaning by stating that I referred to the

2 Berliner Klinische Wochenschrift, 1895, No. 2, Jan. 14th.3 Société Médicale des Hôpitaux, Oct. 12th, 1894, and Gazette

Médicale de Paris, 1894, p. 41a.

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condition after the necrotic process has begun and phthisisis a clinical entity. These points are of some importance andI trust that you will be good enough to give space to them.

I am, Sirs, yours faithfully,

Xincaim, Dunblane, N.B., May 22nd, 1905.THOMAS W. DEWAR.

FIFTH ANNUAL SOUTH AFRICAN CIVILSURGEONS’ DINNER.

To the Editors of THE LANCET.

SIRS,—Through the medium of your journal we shouldlike to call attention to the above dinner, which will takeplace on Tuesday, July 4th, at 8 o’clock, at the ImperialRestaurant, Regent-street. Mr. W. Watson Cheyne, C.B.,has kindly consented to take the chair. Reply cards will besent to those whose addresses are available and we hopethat those who wish to attend will reply as soon as possible.The price of the dinner will be 10s. 6d. (exclusive of wine).

Tr - c;,.n .,;4Hr,.»,.

FRANCIS E. FREMANTLE, Honorary SecretariesC. GORDON WATSON, Honorary Secretaries.44, Welbeck-street, W., May 24th, 1905.

UNPAID AS USUAL!To the Editors of THE LANCET.

SIRS,-I received a few days ago a letter from the seniormedical officer of the volunteer infantry brigade to which Ibelong. I inclose a copy of it.A number of volunteer medical officers will be required for duty

in the station hospitals of the regular army during the training season(May to August) Those officers would not, of conr.<e [the italics aremine], receive pay nor would any expense to the public be admissible,hence their attendance must be entirely voluntary. Should you bewilting, &c.

Comment is, perhaps, superfluous, but one cannot helpobserving what an encouragement such a proposal must beto the volunteers to perfect themselves as a reserve to theregular forces. Do our colleagues in the Royal ArmyMedical Corps serve during the training season without payand with no expense to the public ?That such an offer can be seriously made to qualified

medical men with, presumably, some idea of a more or

less favourable response points to the urgent necessity ofsome strong professional combination, while the fact thatthe War Office considers it probable or even possible thatcommissioned officers of the auxiliary forces may be willingto perform public duties without any expense to the public,but at a considerable loss to themselves, and alongsideofficers of the regulars and militia who are drawing fullrates of pay and allowances for the performance of thesame duties, only indicates the utter futility of any hopeof any irnproved position for the volunteer or any practicalrecognition of him as a genuine factor in any scheme ofnational defence. It is to be devoutly hoped that volunteermedical officers with any respect for their profession or forthe force to which they belong will have nothing to do withthis proposal. I am, Sirs, yours faithfully,May 20th, 1905. A. M. R.

MANCHESTER.

(FROM OUR OWN CORRESPONDENT.)

Physique of Salford Children.Mr. C. H. Tattersall, the medical officer of health of

Salford, and the assistant medical officer, Dr. J. J. Butter-worth, give interesting reports on the medical work done bythem in 1904 for the Salford education committee. Thereare 4000 children in Salford attending school who are underfive years of age and Mr. Tattersall agrees with many otherswho have studied the question that the attendance of thesechildren should be discouraged, helieving that the sixth yearis early enough for a child to attend school." There is con-siderahle difference in the social condition of the neighbour-hoods in which the six schools selected for observation aresituated and the schools differ considerably also. 1. Boyschiefly from the class of clerks, warehousemen, and shopkeepers. The boys are clean, well nourished, and sufficientlyclothed. The school is surrounded by a large open space

and has a very l.irge playground. 2. Boys chiefly the sonsof unskilled labourers. Clothing is deficient both in qualityand quantity, not one boy wearing an under-vest. Verminare very prevalent. 3. Boys from the skilled artisan classand latterly a good many children of dock labourers. The

neighbourhood has of late become thickly populated. 4.Scholars chiefly from the skilled artisan and clerk class.They are well dressed and nourished, each boy wearingtwo garments, an under-vest and shirt. The school isclose to a large park. 5. Here the boys are chieflythe sons of mill-workers. They are well but roughlyclothed and well nourished. There is a large playing fieldattached to the school. 6. This school is situated in whatis still regarded, in spite of some improvement in late years,as the worst district in Salford. It is, as one would expect,densely populated. In these six schools, three of a betterand three of a poorer class, records were taken of the height,weight, and chest girth of all the boys between the ages ofseven years and nine months and eight years and threemonths, between nine years and nine months and ten yearsand three months, and between 12 years and nine monthsand 13 years and three months. This gave three age periodsapproximately of eight, ten, and 13 years. As would be

expected, in the three higher class schools-i.e., in thosewhere the social conditions and the surroundings are compara-tively more favourable for healthy existence-the physiqaeis better than in the three poor schools. At the age of eightyears all are fairly equal, but at 13 years there are markeddifferences. As showing that something more than meret-ocial condition affects the result there is a seeming excep-tion in the case of No. 5 school which stands at the top ofthe list as to physique, although the boys are roughly clothedchildren of mill-workers. They are, however, well fed and" attached to the school is a large playing-field" in an opensituation. This appears the chief factor likely to account forthe better growth and development of the No. 5 boys, who at13 years of agf are two and a third inches taller and 13 poundsheavier than those of No. 3 school, the latter being chieflythe sons of skilled artisans. Over those of No. 6 fcbool theyhave the advantage of being nearly four inches taller andabout 14 pounds heavier. As the,e boys will most of themearn their living by bodily work the advantage at the startshould always keep them in front of those less favoured.In accounting for the marked superiority of the boys in No. 5school it may be ment,ioned that the district is one wherethe social and moral tone is somewhat above the average."More than 90 per cent. of the children attend Sundayschool," the people keep early hours, and "the childrenare abed betimes." As Mr. Tattersall says, impr’per feed-ing and under-feeding have marked consequences ; where thepeople are poor and the children are badly fed the physiqueshows the natural result. On the other hand, he doe not blamethe mothers for want of care of their young children and hefinds that more than 90 per cent. of these have been breast-fed. These working class mothers set a good example tothose in more comfortable positions. There has been of lateconsiderable improvement in this respect, for three or fouryears ago only 70 per cent. of these Salford mothers fedtheir children from the breast. He advocates " breast-

feeding and teetotalism on the part of the mothers." Someof the schools are well provided with facilities for out-door play but others are not. No. 6 school, where thechildren are "dirty, badly clothed, and ill-nourished" "

and where "a large proportion showed distinct signs ofrickets," is situated in Greengate, the worst district inSalford and has none of these advantages close at hand, andthe children would rather play in a dirty crowded slum nearhome than in a park at a distance. Now that attention is somuch directed to this question it is to be hoped that sensiblemeasures will be taken to improve as much as possiblethe evil influences of our manufacturing towns on the

physique of their inhabitants. It is a matter of the

gravest import to the future of our race and it willbe a sorry result of our civilisation if "men decay."Although there are some encouraging fact" it is notcheering, to quote the words of a careful observer, that" the average of child physique is lower in Salfordthan in any town in Great Britain of which record has beentaken, with the possible exception of Rochdale." Oursanitarians have plenty of work before them in the irnprove-ment of hygienic conditions, while our moral sanitarianshave a harder and, perhaps, more important task still in

helping the people to understand and to live a higher lifephysically than the groveller in the slums ever dreams of.