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to suppose that a continuance of slight irritation may create Ia predisposition to cutaneous cancer, as was pointed out longago in the case of chimney-sweeps and more recently in thecase of workers in paraffin factories ; while the connexion

between betel chewing and oral cancer, to which we refer

in another place, has the same probable explanation. From

the frequency of malignant disease in the mouth and perioralregion dental surgeons often see it in the early stage, a

circumstance which provides opportunities for the exercise ofskill in diagnosis and for the practical advancement of ourknowledge of the disease. The "gumboil from which theman who formed the subject of the inquest was said to havesuffered may have been epulis, a chronic manifestation ofalveolar sarcoma very different in its nature from an ordinaryacute abscess connected with a carious tooth.

"MILK-BLENDED" BUTTER.

THERE can be no doubt that the Board of Agricultureintends to give the question of "milk-blended" "butter veryserious consideration with a view to check the unfair com-

petition which its sale has introduced. A strong deputa-tion representing the colonies as well as the mother countrywaited upon Mr. Hanbury at the House of Commons onMay 27th and urged upon him to clear the law from the con-fused state in which it was at present in order that the saleof watered butter could be placed under more effectualcontrol. Mr. Hanbury gave a very reassuring answer. Henot only agreed that legislation was required but that it wasrequired without delay. He expressed the desire of the

Board of Agriculture to keep up the standard of agriculturalproducts and to protect the public by making certain thatthe buyer of butter should be quite sure of getting what heasked for.

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THE NAVAL MEDICAL SERVICE IN GERMANY.

IN a recent leading article 1 we called attention to the

regulations which prevail in Germany for maintaining a highstandard of professional knowledge in the naval medical

service. Our remarks having excited some comment we

think that a more detailed account of the regulations to

which we alluded may be interesting to our readers. In the

German naval medical service every medical officer without

exception has to attend a course of four weeks’ duration atthe universities of Kiel, Rosto, Greifswald, and Berlin

respectively. The course includes every branch of practicalmedicine and is given during the university holidays by theprofessors of the universities. The medical officers of the

navy (and those of the army likewise) are ordered to attendthese courses at least twice, once when in the rank of Ober- IAssistenzarzt and another time when in the rank of Stabsarzt.

A great many of the medical officers, though not all,have to attend the course a third time when in the rank of

Ober-Stabsarzt. The courses are held at the expense of theGovernment. The medical officers receive their regular payand also their travelling expenses. Medical officers of the

navy who have received specially good training are allowed,or rather deputed, to hold civil appointments for one year ortwo years whilst continuing to belong to the service. Theyreceive the pay of their rank during that time and at theexpiration of their appointments they return to the navy. The

following civil appointments are among those open to navalmedical officers : assistantships at the Hamburg General

Hospital, at the clinics of the Kiel University, and atthe Berlin Institution for Infectious Diseases, while thereare also posts at the Imperial Health Office which

they may be invited to fill. Until two years agoassistantships at the Charit6 Hospital of Berlin were opento naval medical officers but since the complete separation

1 THE LANCET, April 26th, 1902, p. 1193.

of the naval medical service from the army medical

service these appointments are now given to members ofthe army medical service exclusively. At the great navalhospitals of Kiel, Wilhelmshafen, and Cuxhafen ample oppor-tunity is afforded to naval surgeons for professional study.From all of this it will be seen that the officers of the

German naval medical service are encouraged to look upontheir profession in the proper way. They are enabled at noexpense to themselves, and at different points in their career,to get into touch with modern university teaching, while theirprofessional attainments and records are taken into accountin allotting to them civil appointments. The opportunitieswhich they have of holding clinical posts in great generalhospitals should be simply invaluable in keeping them up-to-date in practical therapeutics.

THE DISTRIBUTION OF PLAGUE.

THE report of the medical officer of health on the state ofplague in Cape Colony during the week ending May 3rdsays that at the end of the previous week six personsremained under treatment-namely, five Europeans and onenative. There have been no fresh cases during the weekending May 3rd. Mr. D. C. Rees, the senior Governmentplague medical officer of Cape Colony, has, we understand,been appointed medical inspector on the staff of the medicalofficer of health of Cape Colony. A Times telegram datedParis, May 27th, states that a note published by the ColonialOffice announces the existence of eight cases of plague atMojanga. There have been four deaths since May 19th.Mojanga has been declared infected and all the neighbouringports have been informed of the outbreak of the disease in

Madagascar. 33 cases of bubonic plague were reported atHong-Kong for the week ending May 24th.

REPORT ON DIETING OF PAUPER LUNATICS INSCOTLAND.

THE Commissioners in Lunacy for Scotland have presenteda supplement to their forty-third annual report which dealswith the dieting of pauper lunatics in the asylums andpoor-houses of Scotland and which has been drawn up byDr. J. C. Dunlop of Edinburgh in compliance with in-

structions issued by the General Board of Commis-sioners in Lunacy in March, 1900. A very full and ex-haustive examination was made of the returns of the regula-tion dietaries in the various asylums and poor-housesand in many instances by visits to the institutions the

returns were verified as correct. A careful study of thecomposition of the foodstuffs used in asylum dietaries,according to the proportions of proteid, fat, and carbo-

hydrate present in them and estimates of their "energyvalues " according to established physiological principleswere made. For dietary purposes the male working lunaticwas considered as an able-bodied man doing a moderateday’s work, as it appeared from the scheduled returns that inmost asylums the working male patient was employed aboutsix or seven hours a day at agricultural or other manual

labour. The standard of energy value necessary for sucha patient was taken at 3500 calories, while for the

working female patient the amount estimated as requiredwas 2800 calories, or four-fifths of that of a male.It was also calculated that the average male asylumdietary should have an energy value of 3300 calories

per male patient and 2650 calories per female patientwhen both working and idle patients were considered.On the basis of these requirements the various dietaries werecritically examined. Attention was also paid ro the factsthat variety in food and a proper supply of fresh vege-tables and of condiments were a sine quá non for all

dietaries, as it was only when these conditions were

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satisfied that any dietary could be regarded as adequate.Calculations were then made of all the dietaries as regardstheir food value and the results were classified into three

groups-viz., dietaries which were excessive, dietaries ap-proximating to the standard, and dietaries which were

defective. Thus among the dietaries for male patients in 39specified institutions 11 were found to be excessive, 13 wereapproximately standard, and 15 were deficient; and amongthe corresponding dietaries for female patients 25 were

excessive, eight were approximately standard, and sixwere deficient. Excessive feeding was thus found to bemore prevalent in female than in male departments, and itwas clearly evident, says the report, that some of the dietariesmight safely be reduced and others with much advantage mightbe increased. Excess of carbohydrate food was noted in thedietaries of three institutions. The report concludes withvaluable suggestions regarding the proper feeding of asylumpatients. Bread is recommended to be given ad libituna withall meals, "an improvement which is called for in nearlyall the asylum dietaries, "and little fear is entertained ofundue waste arising from this source. The minimum weeklyamount of meat uncooked without bone should be 24 ounces

per patient distributed into four meals, of potatoes threepounds, and of other fresh vegetables one and half pounds.A fish dinner, or a fifth meat dinner, should be given weekly.The weekly allowance of butter should be not less than fiveounces and tea, coffee, or cocoa should be given twice ineach week. The report forms an important document on thedietetics of the insane in pauper asylums.

THE DUST PROBLEM ON THE RIVIERA.

THE motor-car has produced one great evil-it has

caused a most serious increase in the quantity of dust onthe roads. On the Riviera, where the motor-cars are

numerous, the nuisance is so great that it has been de-

scribed as "the dust plague." Even the strong and

healthy feel the discomfort, and invalids, especiallythose with affections of the chest for whom the Rivierahas been a favourite resort, are beginning to find the

place intolerable. With considerable ingenuity and assi-duity Dr. Guglielminetti of Monte Carlo has endeavoured tofind a remedy for the evil. In the Gazette Médicale de Parisof May 17th he advocates as the result of his labours

the tarring of the roads. Thorough watering would bevery expensive. The use of sea water is open to the objec-tion that after evaporation salt would remain which would

injuriously affect the eyes of pedestrians and the dressesof ladies. Moreover, the heat is so great that the roadsrapidly dry after being watered. Dr. Guglielminetti there-fore turned his attention to the processes which have been

substituted for watering roads. In California and otherAmerican districts water has given place to petroleum as adust-layer. In Algiers olive oil and naphtha oil have beenused since 1896. The American method is to cover the roads

with a layer of heavy unrefined petroleum heated to 80° C.An asphalte-like deposit, which is solid and durable andforms but little dust in summer and no mud in winter, isformed. This roadway is greatly appreciated by cyclistsand drivers and a saving of 45 per cent. of watering expensesis effected. Two applications of petroleum a year are

sufficient ; 5000 litres of petroleum, which cost 400 francs,are required per kilometre. But in France the cost would befive times as much. Dr. Guglielminetti therefore turned hisattention to coal-tar which has been applied to roads in theHaute Garonne and in Ravenna in 1901. In the latter town 246metres of roadway were treated with excellent results. The

authorities at Monte Carlo have been induced to try thetar method on the road leading to the slaughter-house. In

spite of the prolonged period of drying the results surpassedall expectations. The surface became so hard and compact

that it was difficult to break up. There was no dust andrain did not penetrate the layer formed by the tar. After 40

days’ traffic the surface was not damaged and had resistedthe wear and tear of wheeled traffic. The cost was from six

to seven centimes per square metre. The prefect of AlpesMaritimes and the engineer-in-chief of roads and bridgeshave favourably received the idea and are willing to allowexperiments on public roads provided that they are madeat private expense. The municipal authorities and hotel-

keepers of Monte Carlo are moving in the matter. We trustthat Dr. Guglielminetti’s efforts to combat the dust

plague " will be crowned with the success which theydeserve.

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VOLUNTARY AID FOR THE SICK AND WOUNDEDIN SOUTH AFRICA.

AN account of the voluntary organisations in aid of thesick and wounded during the war in South Africa has justbeen issued in the form of an interesting and instructiveBlue-book,l illustrated by a number of well-executed repro-ductions of photographs and diagrams. In the book will befound articles dealing with the work of the National AidSociety, the Red Cross Commissioners in South Africa, theSt. John Ambulance Association and St. John Brigade, andthe Army Nursing Service Reserve, together with a descrip-tion of the hospital ships and trains. The work of the

foreign Red Cross societies is described and there is an

account of the voluntary aid received from British coloniesand other British possessions. Private hospitals and minorschemes also receive notice and there is a chapter on theorganisation of convalescent homes in the United Kingdom.The object of the report is not so much to give an

account of the actual work done as to indicate the mannerin which the several schemes were initiated and carried

out ; and as showing generally the resources that are likelyto be made available in future wars the information

contained in the pages of the report is of great value. It

is interesting to note that "the total value of the voluntaryaid resources placed at the disposal of the sick and woundedof the army must have amounted to close on £1,000,000.’’Among the conclusions arrived at in the final chapter of thereport are that the voluntary aid organisations such as existin connexion with continental armies are not applicable tothe genius and spirit of the British nation and that the bestorganisation for this country would be the formation of localcommittees in time of peace.

THE PHARMACEUTICAL SOCIETY OF GREATBRITAIN.

Ox the occasion of the annual dinner of the members of

the Pharmaceutical Society of Great Britain at the WhitehallRooms, Hotel Metropole, on May 27th, presided over by Alr.G. T. W. Newsholme. the speeches turned chiefly upon thedesirability of pharmacy having a representative in the

House of Commons. There are certainly points connectedwith the administration of the Pharmacy Act and the saleof poisons which can only be properly understood by apharmacist. Sir William Church, in reply to the toast of

"The Medical Profession," agreed that it was desirable thathis own profession should have a better knowledge of

pharmacy and should pay greater attention to pharmacologythan they had done before. He instances the extraordiraryignorance shown by some candidates at medical exa-

minations of the composition of simple and familiar prepara-tions of the British Pharmacopoeia. It was only quite recently.he said, that it had been discovered that ferrum redactum

invariably contained arsenic, which obviously must seriously

1 Report by the Central British Red Cross Committee on VoluntaryOrganisations in Aid of the Sick and Wounded during the SouthAfrican War. London : His Majesty’s Stationery Office.