973

cooperating with and supporting all public healthmovements, and in certain cases possibly forming acentrai clearing house for voluntary activities of thiskind.The national Red Cross Society contemplated

by Dr. Winslow is one that should include in its

permanent membership from 10 to 20 per cent. of thepopulation of the country, but he points out theimpossibility of attaining such a standard unless themembers receive something for their membership,and--an even more important point-are given some-thing practical to do for the organisation of whichthey form a part. We agree with Dr. Winslow thatthe secret of the strength of the Red Cross movementundoubtedly lies in the fact that it constitutes achallenge to the spirit of human service.

TRYPANOCIDE.

IN a critical review of recent work on the treatmentof sleeping sickness. Prof. Warrington Yorke discusses ’!the fundamental assumptions on wluch C. H. Marshall ’,and S. Vassallo base their optimism as to the efficacyof serum treatment. These assumptions are, broadlyspeaking, (1) that although the administration of onedose of salvarsan or a substitute is sufficient to sterilisethe blood-stream, symptoms reappear within a variableperiod, averaging about four months, and the diseaseprogresses to a fatal termination ; (2) that quiteearly in the disease the trypanosomes appear to gainan impregnable position in the central nervous

system, where they are protected from the action ofdrugs and whence they can re-infect the blood. Werecently pointed out’ that the presence of trypano-somes in the cerebro-spinal fluid may be fortuitous,and it is by no means proven that they are invariablypresent at any stage in the course of the disease.Before the 53 successful cases published byDr. Marshall are accepted as cures Prof. Yorke con-siders that we ought to know what proportion ofcases (1) die, (2) are alive after more or less prolongedperiods when untreated, when treated with one orseveral doses of arsenic or antimony compounds, and ’,when subjected to prolonged treatment. In the !iabsence of sufficient controls to answer these questionsProf. Yorke contends that Marshall and Vassallohave produced no satisfactory evidence that intra-thecal injections of salvarsanised. serum steriliseinfected cerebro-spinal fluids. The doubt expressedby such an authority in tropical medicine as Prof.Yorke on the efficacy of the method which the missionrecently organised by the Tropical Diseases PreventionAssociation was primarily designed to test, addsstrength to our plea to the medical officers in chargethereof not to confine their investigations to a singlemethod but to explore trypanocide in general.

CENTRAL COUNCIL FOR LONDON BLIND.

IN pursuance of the scheme for the welfare ofblind persons in the County of London, which wasapproved by the London County Council in Julylast, the Council has now decided upon the constitu-tion and order of reference to the Central AdvisoryCouncil which will be appointed under the scheme.The Council will consist of : (a) One representativeappointed by each of 19 associations and institutionslocated in the London area. (b) Not more than sixpersons, selected by the London County Council,with special knowledge of the needs of the blind.(c) The chairman and vice-chairman of the SpecialCommittee of the London County Council dealingwith the welfare of the blind. (d) One representa-tive appointed by the Minister of Health. (e) Onerepresentative appointed by the Board of Education.(f) One representative appointed by the RoyalCollege of Surgeons of England. The County Council

1 Tropical Diseases Bulletin, Oct. 15th, 1921.2 THE LANCET, Sept. 10th, p. 573.

will review annually its appointments, and willappoint the chairman. The vice-chairman will beelected by the Advisory Council. The clerk to theLondon County Council will act as clerk. The orderof reference to the Council will be as follows :-To assist the London County Council (1) by advising on

matters specifically referred to it by that authority and onany other matters to which the Central Council may deemit expedient to direct attention ; and (2) in such other waysas that authority may suggest in connexion with theadministration of the scheme for the welfare of the blind inLondon, especially with the object of securing the essentialcooperation between the several societies and associationsand between such societies and associations and the LondonCounty Council.

All meetings of the Central Council and its com-mittees will be held in private, and all expenditureincurred will, after prior sanction, be defrayed bythe London County Council. The Special Committeeis taking immediate steps to obtain nominations tothe Council from the various associations concerned.

OVARIAN GRAFTS.

Prof. Th. Tuffier contributes a valuable surgicalstudy of 230 ovarian grafts to a recent issue of theBulletin of the French Academy of Medicine.l Theseoperations were performed with the twofold object ofpreserving the menstrual flow after removal of theovaries, when the uterus is left, and of obviating thegeneral disturbance following excision of the ovariesand uterus. Two varieties of grafts were investigated,the homograft derived from another woman, and theautograft, which involved the use of a portion of thepatient’s ovary. The former was found to be withouteffect. The autograft, which must be fresh, wasplaced in the subperitoneal tissue, the subcutaneoustissue, or in the mammary gland. If the graft doesnot " take " it disappears in from six months to twoyears. In successful cases no changes were observedfor four to five months, the graft then commenced toenlarge and might be painful for a few days before aperiod was due. When menstruation was re-estab-lished, it occurred about five to seven months after theoperation, and was often irregular in quantity,duration, and time of recurrence. Dr. Tuffier foundthe most favourable subjects for grafts to be youngadults ; in patients over 40 years the grafts were notsuccessful. The average persistence of menstruationin all cases was, however, only one to two years, asthe transplanted ovaries appeared to undergo a

precocious senescence.

THE TESTING OF CLINICAL THERMOMETERS.

IN reply to a recent question in the House ofCommons concerning the inaccuracy of a large per-centage of clinical thermometers in use in this country,Mr. Stanley Baldwin, President of the Board of Trade,stated that he hoped next session to reintroduce theBill dealing with the testing of thermometers, whichwas introduced bv the Government earlier in thesession and abandoned owing to lack of time. Mr.Baldwin also stated that most British manufacturersof clinical thermometers are voluntarily having theirproducts tested at the National Physical Laboratory,where the fee charged for large quantities is 3d. perinstrument, but where any single clinical thermometercan also be tested on payment of a fee of Is. 6d. Ina circular issued a few days ago by the British Lamp-blown Scientific Glassware Manufacturers’ Association,Ltd., it is pointed out that, whilst makers of goodclinical thermometers would naturally depend uponthe ordinary course of business to obtain orderssolely on quality or make, only rarely do instrumentsbear the makers’ name or trade-mark. The bulk arelabelled with ‘’ Best British Make," or some similarphrase, and it is very difficult to trace the maker of afaulty instrument. This association of manufacturers

1 Bulletin de l’Académie de Médecine, 1921, No. 30.