5 31AN OLD HIGHLAND FARM.

directly or indirectly, of bodies of unknown nature,which combine with the malarial organism anddestroy it.

Of the numerous observations undertaken with the

object of determining the line of treatment most

likely to be successful in eradicating the parasitesfrom victims of relapsing malaria, Colonel LANE

singles out for special notice two sets of experiments,the Macedonian cases recorded by A. G. ANDERSON,and the Liverpool series by J. W. W. STEPHENS.In each series the conclusion has independently beenreached that the efficacy of quinine in the preventionof relapse varies according to the time of year, theperiod of greatest efficiency coinciding with thewarmer months. In assessing the relative value ofdifferent methods it is clearly of the greatest import-ance to recognise and make allowance for this under-lying seasonal influence, and the failure to do so

must be regarded as vitiating the results arrived atin much of the experimental work on the subject.No proof appears to be forthcoming of the widelyheld view that quinine is effective mainly or

exclusively against extracorpuscular organisms. Onthe contrary, there is evidence that plasmodia arevulnerable to the influence of quinine in all but theterminal phase of intracorpuscular growth. It isconcluded that the practice of timing the administra-tion of quinine so as to correspond with a specialphase of the life-cycle of the organism is not supported by scientific evidence. In discussing the muchdebated subject of intramuscular quinine stress is

rightly laid on the experimental work bearing on theunfortunate sequelae that may follow the injudicioususe of the intramuscular route. On the other hand,while oral administration suffices for all ordinarypurposes, it must be recognised that there are casesin which, for one reason or another, quinine require-ments cannot be fully met by the oral method, andin these cases we believe that the value of thealternative route, as a temporary means of supple-menting or replacing oral quinine, has been amplydemonstrated. The clinical experience of the war, inwhich the aggregate number of intramuscular injec-tions was very large, shows that, provided due careis taken to prevent sepsis and to avoid injury tonerve trunks, the risk of serious local complicationsinvolving permanent disability is very small indeed.Perhaps the only circumstance in which the intra-muscular method should be absolutely prohibited isthe concurrence of a debilitating condition, such aschronic dysentery, with malaria ; in such cases

intramuscular injections of quinine are likely tocause widespread necrosis of muscle and abscessformation, and therefore should not be prescribed.The review concludes with a short account of recentwork on the comparative values of quinine and otheralkaloids derived from cinchona, such as cinchonine, cinchonidine, and quinidine, in the course of which aconsiderable discrepancy of evidence is disclosed,and it is clear that the subject is one on which furtherresearch may profitably be undertaken.The problem of the treatment of malaria presents

peculiar intricacies. When it is remembered thatthere are three forms of malaria, differing not onlyin biological and clinical characters, but also in theirtherapeutic reactions ; that there are a number ofcinchonal alkaloids, mostly of proved value, but ofwhich the relative efficacy awaits exact determination ;and further, that there exists a seasonal factor whichdirectly influences the results obtained by treatment,the difficulties of a scientific investigation in which somany variables have to be taken into account arereadily realised.

AN OLD HIGHLAND FARM.1To have compiled a book which is not only interesting

but eminently readable out of an ill-kept, incomplete,and what would now be called illiterate account bookis a literary feat of which Miss Grant may well beproud. She has produced a lifelike picture of Highlandrural life at a date when what was practically mediaevalfeudalism as it existed in England, say, in the fourteenthcentury, was still in being. William Mackintosh,of Balnespick, whose account book between 1768and 1782 is the foundation of Miss Grant’s work,was born sometime before the year 1745, being infeft-i.e., enfeoffed-into Balnespick in 1743, whichestate he sold to Macpherson of Invereshie in 1748.At the date of his account book he held a tack-i.e.,lease-for " Three nineteen years

" from the Chiefof Mackintosh of the Davoch of Dunachton andKincraig in the parish of Alvie on the upper reachesof the Spey. The position of the tacksman was asfollows. Of the land which he held from his chiefhe kept a portion in his own hands ; the rest he leasedto subtenants who farmed it on a sort of cooperative esystem on the same principle as village communitiesin mediaeval England (v. Chap. VII.). As Dr. Scottpoints out in his preface,

" it appears that the rentsdue from his subtenants nominally covered thechief rent he paid. That left him the produce of theportion of land he reserved for himself for his ownmaintenance." But " he was not dependent on

the produce of the lands of Dunachton for his ownliving, since he had other sources of income." In acase where the tacksman had not the latter resources,continues Dr. Scott, there might have been somedanger that the subtenants would have suffered.Anyway, they did not suffer under Balnespick’s rule,for we find him acting as a beneficent landlord.He received and administered the pay of a man whowas with the army, and despite the fact that the manwas in debt to Balnespick the whole of the moneytransmitted in this way was spent on the man’s familyand the debt was not claimed until after his return.Balnespick also arranged marriage settlements,administered the affairs of widows and orphans,acted as a sort of bank, provided credit for thetenants, and formed an arbitrator in grazing disputesand the like. In fact, lie carried out the feudalsystem at its best, a system which only fell because

those who worked it would not remember thatalthough those below them had duties to carry out,yet they themselves also had responsibilities to theirinferiors. He was responsible for the distributionof such poor relief as there was, for the collecting ofthe minister’s stipend and the schoolmaster’s salary.What strikes a modern reader is the hardness of thefarming life and how both the people and theiranimals were generally very near to starvation.The plough was as primitive as that described in theGeorgics, and yet so small and weak were the cattlethat it took a 12 ox team to draw it. Yet withall this they were a hardy and happy race, and noone who has studied the history of the British Empirewill fail to remember what a debt that Empire owesto such men and their descendants.

THE University of Sydney is about to appoint itsfirst professor of obstetrics, a new chair having beenfounded with the aid of a grant made by the NewSouth Wales Government. This appointment willincrease to eight the number of professors in the medicalfaculty, which includes one-third of all the studentsat the University. Applications for the chair are nowbeing invited in this country as well as in Australasia,and should reach the Agent-General for New SouthWales at Australia House not later than Saturday,Jan. 24th. A committee sitting in London willinvestigate the claims of candidates for this chair.

1 Every Day Life on an Old Highland Farm. By L. F.Grant. With a Preface by W. R. Scott, M.A., Phil.D., AdamSmith Professor of Political Economy in Glasgow University.London: Longmans, Green and Co. 1924. Pp.276. 12s. 6d.