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RHEUMATISM

Dr. F. J. POYNTON, president of the section dealingwith Rheumatism and Allied Diseases, opened a dis-cussion on the Treatment of Chronic Rheumatism.In the same section Dr. C. W. BUCKLEY (Buxton)read a paper on the Spa, and Dr. W. S. C. COPEMANand Mr. T. J. O’REILLY (London) spoke on the workof the British Red Cross Clinic for Rheumatism.-In a paper on Rheumatic Heart Disease in Childhood,Dr. H. L. WALLACE (Edinburgh) laid stress on thehigh incidence of rheumatic disease in childhood.He considered that the child suffering from rheumaticheart disease was the victim of wanton neglect onthe part of the community. He had found that25 per cent. of all rheumatic children died from heartdisease before they left school, while a further 30 percent. were crippled by heart disease for the remainingpart of their lives. The ideals to be aimed at weretwo-the easing of the burden which had to beborne by the cardiac cripple, and the prevention ofrheumatic heart disease occurring at all.

MEDICINE AND THE LAW

The Burden of Proving InsanityIN Sodeman v. the King (on May 28th) the Judicial

Committee of the Privy Council declined a somewhatoptimistic invitation from Australia to vary the

legal rules of the criminal responsibility of the insane.The prisoner was convicted of murdering a girlaged 6l years in circumstances of brutality. Hetook her for a ride on a bicycle, strangled her, tiedup her body in a curious way, stuffed some of herclothing into her mouth, and left her for dead. Hehad committed three similar murders, all characterisedby identical method. His appeal from the deathsentence was rejected by the full court of the Stateof Victoria, and the High Court of Australia refusedhim leave to appeal to the Privy Council. Hisapplication to the Privy Council last week for specialleave to appeal was one of a kind which the JudicialCommittee in Downing-street does not welcome.The judges of that supreme tribunal do not regardthemselves as a Court of Criminal Appeal; theyrefuse to re-hear cases without the advantage of

having seen the witnesses ; the grounds on which theyinterfere in criminal proceedings are severely limited.The appellant’s complaint was that the trial

judge had misdirected the jury as to the burden ofproof ; he had also directed them on delusions,whereas the accused had no delusions but merely amind which could not resist doing these meaninglessacts. His counsel pressed for the enlargement of the"rules in McNaghten’s case " ; he desired to engraftthe further rule that, where a man knew that he wasdoing what was wrong, he might none the less beinsane if he was caused to do the act by an irresistibleimpulse produced by disease. Counsel had to admitthat English decisions do not go so far; but he

urged that, since some earlier dicta suggested thatsuch an additional rule might exist; this was a goodopportunity for settling the point uniformly for thewhole Empire. The Lord Chancellor, in dismissingthe petition, answered that such a course would resultin different standards being set up in England andthe Dominions ; the decisions of the Court of CriminalAppeal in England (e.g., Rex v. Flavell and Rex v.Kopsch) would remain unaltered. Lord Hailshamadded a few words on the alleged misdirection at thetrial with regard to onus of proof. The trial judgehad apparently told the jury that the Crown hadto prove its case beyond reasonable doubt, but that

the burden of proof in the case of insanity rested onthe accused. Sodeman’s counsel argued that the

jury might have wrongly understood that the burdenon the accused was as heavy as the burden on theCrown. Lord Hailsham observed that the burden ofproving insanity on the part of the defence was not soonerous as the burden of proof resting on the Crown.It was no higher than the burden which rested onplaintiff or defendant in civil proceedings. Thecourts below were agreed that the language of thetrial judge was not such as to be misunderstood by thejury or as to be capable of misleading them. TheJudicial Committee would therefore not exercise the

" very exceptional jurisdiction " reserved to it incriminal cases.

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IRELAND(FROM OUR OWN CORRESPONDENT)

A HOSPITALS ASSOCIATION FOR IRELAND

ON the occasion of the recent sweepstakes drawon behalf of the hospitals of the Irish Free State ameeting was held of representatives of nearly allthe hospitals in the Irish Free State and some inNorthern Ireland for the purpose of founding anIrish Hospitals Association. In the report of theHospitals Commission attention was drawn to theneed for such an organisation in order to encouragecooperation between the several hospitals. Dr. G. J.Moorhead presided at the meeting which was heldat the Royal College of Surgeons on May 25th, andhe consented to accept the presidency of the newassociation. The choice is a fortunate one, for tomany years’ experience as a hospital physician heis able to add a considerable experience as a hospitalgovernor. Dr. J. P. Brennan was appointed honorarysecretary, and a small provisional committee wasappointed to frame a draft constitution and reportto a second meeting of hospital representatives tobe held in the autumn. It is intended that the

membership of the association should be open bothto institutions and to individual governors or mem-bers of medical staffs, and to rate-supported institu-tions as well as to voluntary hospitals. The pro-visional committee contains several public repre-sentatives as well as governors of voluntary hospitalsand members of honorary staffs.

THE CAMBRIDGE DIPLOMA IN RADIOLOGY

THE diploma in medical radiology and electrologyis the only one granted in Cambridge that can beobtained by persons who have not resided or takencourses in the University. It was established in1919 for a period of five years, and it has been pro-longed from time to time on the ground that therewas no other satisfactory alternative. It appearsthat 397 candidates have obtained the Cambridgediploma since its inception, while the total for allthe other diplomas in medical radiology is less than80, and the general board of the University are ofthe opinion that as long as this diploma is grantedunder the present conditions there is little likelihoodof any other diploma in the subject becoming success-fully established. In order that facilities for the

lectures, practical instruction, and examinationsmay be provided elsewhere, they have decided notto continue the present arrangements indefinitely.Allowing enough time for plans to be made thatwill carry on the traditions and standards of the

Cambridge diploma, the board have recommendedthat this shall no longer be given after October, 1941.