1383HIGH HEELS.—"DUPLEX THERAPY."

- tourth day as against eight to ten days in untreated- cases. Moreover buboes invariably resolve; when serum’its given on the second day, half the cases suppurate,and thereafter there is no difference in this regard.There are, however, certain drawbacks inseparable- from the use of serum So-called serum disease

_prolongs convalescence and has to be set off againstthe rapid neutralisation of the toxins. Vegetarians.almost entirely escape its manifestations. Parsees-and Mahommedans, who are non-vegetarians, sufferin a certain proportion, Europeans most of all.Acute anaphylaxis has been observed whilst the,serum is actually running into the vein ; coryza,Jacrymation, pyrosis, and urticarial wheals. In,other cases, severe rigors supervene a few hours.after intravenous injection of even 50 c.cm., followedby high temperature with cardiac distress and weak-ness. The temperature falls gradually in a few hours,.and all the graver symptoms disappear. Death butrarely occurs.

I am, Sir, yours faithfully.N. H. CHOKSY.

HIGH HEELS.

To the Editor of THE LANCET.SIR,-Mr. Roth says that high heels do not project

-the weight of the body to the fore part of the footto a greater extent than low heels. This is the crux.of the matter. I admit that, when standing still,the weight distribution is not disturbed, but, whenwalking, I say that high heels do project the weightto the fore part of the foot. Observation duringthe period of short skirts has repeatedly shown me-that when walking in high heels, women hold theirknee-joints flexed about 15 per cent. permanently.This means that the tibia is inclined in a more forward-direction than normal, and, on Mr. Roth’s own

.admission, it follows that the weight of the body willbe distributed to a greater extent to the fore part ofthe foot. Only if very minute mincing steps are

taken can the knees be fully extended. Incidently,it will also be found that if anybody tries to walkextra fast he will find himself keeping his knee-jointsslightly flexed and his body inclined forward. It isnot therefore surprising that a woman won a walkingrace in high heels. A mathematical calculation- could doubtless be made showing the exact differenceof weight distribution consequent on this flexion ofthe knee-joint. Statistical evidence could also be.obtained from any out-patient department. Take200 men and 200 women consecutively and enumeratethe numbers of cases of fallen metatarsal arches.I wager the greater number will occur among thewomen-that is, among the wearers of high heels.It may well be that women, who do a lot of standing,find that high heels relieve the strain on the instep,but, unless they change into low heels for walking,the relief is purchased at the cost of fallen metatarsalarches.

Mr. Trethowan taught me that the way to preventflat-foot was to throw the weight of the body tothe outer aspect of the feet by walking with the feetstraight or even slightly turned in, and, if necessary,by raising the inner border of the sole and heel.That this is the right method my experience in

,general practice and in an infantry regiment forthree years has proved to my satisfaction. Womenhave told me that they have found flat heels notless but more comfortable and that they can walkmiles in them, whereas before they could not do so.Nevertheless, I admit that the human body was not

constructed for long continued standing, and usefulwork could be done in driving this fact home to thepublic, and so preventing the prolonged standing,usually quite unnecessary, that some occupationsdemand from pure force of custom.

I am. Sir. vours faitlrfullv.P. D. H. CHAPMAN.

" DUPLEX THERAPY."

To the Editor of THE LANCET.SIR,-In your last issue (p. 1333) I noted with interest

the report on Mr. G. G. Blake’s lecture deliveredbefore the Royal Society of Arts on what he terms" duplex therapy." By this he means the simul-taneous applications of diathermy currents withsome other current employed in electrotherapy.Reading the resume of his address, one is given theimpression that Mr. Blake is unaware of the factthat the filtering device, which he makes use of andwhich he praises, has been used for some time bythe medical profession to superpose other currentson high-frequency currents. Not knowing exactlyat what moment Mr. Blake evolved his apparatus,I might do him an injustice by claiming that I appliedthe same circuit to medical electricity before him,but J wish to point out that at my suggestion a Britishfirm constructed a diathermy machine incorporatingthe necessary chokes and condensers well over a

year ago. This, after I had experimented and hadsatisfied myself of the value of combining diathermywith other currents. It is regrettable that Mr. Blakeshould not have acquainted himself with the literatureavailable on the subject or even perused an electro-medical apparatus manufacturer’s catalogue beforealluding to his apparatus as a new contribution tomedical science. The " contactometer " which hedemonstrated, and the importance of which was

grossly overrated by the lay audience, was certainlya most ingenious if elaborate piece of apparatus.It is, however, worthy of note that although thousandsof diathermy treatments on eyes have been carriedout by myself and my assistants, not once would theapparatus have had an opportunity of cutting offthe current, to exhibit the importance with which itwas invested by the lecturer. For, as your reporterjustly remarks,

"

damage would already be done whenthe contactometer gave evidence of it," and as

he further suggests, correct technique should precludeany possibility of accidents happening. I fear Icannot however agree with his conclusion as to" the need for the physicist interested in biology in theinvestigation of problems that confront the prac-titioner of physical medicine." The need is a sound

knowledge of physics in the practitioner of physicalmedicine. I am, Sir, yours faithfully,

Wimp ole-street, W., Dec. 15th, 1931. PH. BAUWENS.

DONATIONS AND BEQUESTS.-Among other bequeststhe late Mrs. Rose Ray Coyne Goldberg, of GrosvenorHouse, Park-lane, W., left jE2000 to the Hospitalfor Sick Children, Great Ormond-street, for cots to beknown as the " Arthur Hilton Greaves " and " TheRay Greaves" cots; 91000 each to the Royal Hospitalfor Incurables, Putney, the Hospital for Consumption,Brompton, Guy’s Hospital, St. Thomas’s Hospital, and theLondon Hospital ; and the ultimate residue of the propertyequally between the last-named five hospitals.-The lateLady Battersea left, in addition to many private andpersonal bequests, 610,000 between the Cromer Hospital,the Metropolitan Hospital, Kingsland-road, the JewishAssociation for the Protection of Girls and Women, andthe Jewish Board of Guardians, and oE1000 to the Metro-politan Hospital Convalescent Home.

PH. BAUWENS.