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was masculine, and there was a pronounced hirsuties ofthe face. The chin was prognathous. No pathologicalchanges could be detected in any of the internal organs.The thyroid was not enlarged. The basal metabolic ratewas normal. The blood pressure was low (115/80). The

blood-sugar was low; a sugar-tolerance test gave aninitial hyperglyosemia followed by a rapid return to theprevious low level.

Radiography showed that there was a general increasein thickness and density of the bones of the cranialvault, and that the inner table in the frontal regionwas rough and irregular in outline. The sella turcicaappeared normal. Antero-posterior radiogramsrevealed a zone of irregularly calcified bone (areasboth of increased density and of rarefaction) surround-ing each frontal boss. The prognathism observedclinically was very evident.

ERADICATION OF DOMESTIC PESTS

DESPITE the civilised conditions under which welive in this country, our houses are infested by animmense variety of pests-insect, arachnid, mam-malian, and fungal-which are a constant source

of annoyance and a common cause of great materialdamage. Although, in England at the present day,few of these creatures are concerned directly withthe causation of disease, the public health authoritiesand even the general practitioner are continuallyrequired to give advice on how best to eradicate themThe pests are so numerous and so diverse in theirhabits that it is not always easy to find and providethe information required. An excellent little boobon the subject by Mrs. L. Hunter is therefore welcome.The author has experience as zoologist, as teacher ofpeople of all classes, and as housewife. This hasenabled her to produce a book which has a wideappeal. It is simple, very practical, and not tootechnical in style to suit the housewife and welfareworker ; at the same time it is scientific, in thesense that it explains the principles upon which thecontrol of domestic pests must be based, and is thusadapted to the requirements of the medical adviser.

HICCUP

Hiccup is one of those complaints which, like ,

mumps and sea-sickness, is apt to be considereda joke by everyone except the sufferer himself.Actually, except in its most transitory forms, it is

always distressing, and, in its post-operative andepidemic types in old people, may prove fatal. Thegreat majority of cases owe their origin to acute orchronic dilatation of the stomach, with or withoutintestinal meteorism, but the less common causesare legion. Dr. A. H. Douthwaite (Guy’s Hosp.Gaz. Nov. 5th, p. 447) divides them into three classes.Of the first, the central causes, the most importantare uremia specially after prostate operations,when reflex irritation from the operation site or frommeteorism is a contributory cause-and hysteria,also usually post-operative. This group also includesthe intractable hiccup met with in epidemics of

encephalitis lethargica, and the toxic forms seen

in pneumonia and typhoid. In the second class thecondition is secondary to irritation of the phrenicnerve, very rarely from lesions in the neck, some-times from mediastinal pleurisy, tumour or peri-carditis, or from a diaphragmatic hernia, sub-

diaphragmatic abscess or secondary deposits in theliver. The third class, the reflex, is the most common.This may arise in the stomach, as in children who bolttheir food and in sufferers from gastritis and theindigestion of over-smoking ; in the intestines, fromdistension or the irritation of thread-worms ; andpossibly in the prostate and liver.Many of the forms of treatment are empirical and

have been devised by sufferers themselves-forexample, the induction of sneezing (as Bacon observes)or vomiting, drinking from the wrong side of a

1 Domestic Pests. By L. Hunter, M.Sc., Lecturer in Biologyand Hygiene, Domestic Science College, Leicester. London:John Bale, Sons and Curnow. 1938. Pp. 235. 7s. 6d.

tumbler, holding the breath, or applying a tightbinder to the epigastrium. " The hickot," writesa sixteenth-century doctor, "is cured with suddenfeare or strange news" ; another maintains that "itis good to caste colde water in the face of him thathathe the hicket." Turning to more drastic remedies,the phrenic nerve may be attacked directly by firmpressure above the clavicles or by the injection ofprocaine at the same site. One of the most effectivemethods is the inhalation of 5-7 per cent. of carbondioxide in oxygen, or, more simply, breathing in andout of a paper bag. Morphia is justifiable for

persistent cases, and may be life-saving in the epidemicvariety. Where there is dilatation of the stomachlavage usually gives relief. Meteorism may berelieved by passing a flatus tube or giving 1-5 c.cm.of prostigmin or O’5-l c.cm. of pituitary extract. Inpost-operative cases it is important to reduce thefluid intake which has often been pushed to excess.In the milder forms associated with vague indigestionand flatulence carminatives such as sal volatile mayhelp. Drugs are on the whole disappointing, thoughmany are recommended. Finally, in hystericalhiccup, careful explanation combined with some

impressive procedure, or the mere suggestion ofstomach lavage, may work wonders, but hypnosismay be necessary in a few obstinate cases. Fortunatelymost patients will recover spontaneously beforemany of the formidable list of therapeutic measureshave been tried.

A HOME FOR RETIRED NURSES

Dr. W. S. RICHARDSON writes : Will you allow meto call the attention of my medical brethren to theElderly Nurses’ National Home Fund ? Lord Nuffieldgave, a few days ago, a generous donation of z10,000to enable the committee of the fund to complete thehome in Bournemouth by adding two double wings,and this will provide for an additional 24 nurses,with accommodation in small self-contained flats.The central block, which is now finished and in theprocess of being furnished, will provide for 12 nursesand contains, besides the usual administrative offices,common sitting, dining, and writing rooms. Thesewill be available for the nurses in the flats.

The scheme provides for nurses under the threefollowing headings : (1) nurses who are able to bearthe full cost of their upkeep from their own resourcesif provided with a home ; ; (2) nurses only partiallyable to bear the cost of their maintenance ; and

’ (3) nurses whose resources are so limited as to be ableto contribute little or nothing. A bazaar is to be heldin the town hall, Bournemouth, on May 10th and llthnext year when it is hoped to raise a sufficient sumof money to equip the home free of debt and to giveit a good start.

Our profession need not be reminded of the invalu-able services rendered to the community by thedevoted attention of skilled and trained nurses andit is felt that many will be only too ready to helpmake the declining years of these unselfish womenas happy and comfortable as circumstances willpermit ; this can be done by sending contributionsto me or to the hon. treasurer, Mr. F. Cobley,35, Verona-avenue, Southbourne, Bournemouth.

RADIOGRAPHY OF MOVING ORGANS

Dr. Pollitzer of Buenos Aires has devised a methodof radiography of moving organs to which in its earlydays he gave the name digraphy.l He continues touse the name, although with improvements in hisapparatus it has ceased to be accurately descriptive.Briefly, it enables the radiologist to obtain twoimages (or more) of the organ in successive phasesof movement, superimposed on a single plate, andaffords a permanent record of the direction andamplitude of the movement. The plates with whichthe work is illustrated suggest that digraphy mayprove a useful adjunct to the study of pulmonaryand cardiac disease.

1 Digrafîa. By Guido Pollitzer, of the Hospital F. J. Muñiz.Buenos Aires: Imprenta Amorrortu.