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being more nearly controlled than in the past; an 1this appears to be so, even when the pos /Ulity ofdisease cycles of varying virulence is kept in mind.Medical officers of health will regret the belated issueof the sickness notification statistics in this volumeinstead of in a separate volume, issued not later thanApril, as was formerly the case. The chief value ofthese sickness figures lies in the possibility of earlycomparison between different parts of the country,and the 11 months required to cB r’re accuracy andcompleteness in the death returns is a long time towait.

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SEX GLANDS AND ENDOCRINE FUNCTION.

Six lectures given at the Serotherapeutic Instituteof Milan have just been reprinted in book form.1The course was designed to elucidate the followingproblems : Whether there is in the sexual glands anendocrine as well as a generative function ; whetherit is possible, by transplanting the glands, to utilisetheir hormones ; and whether it is possible to isolatefrom these glands an active substance like adrenalinor insulin. The subject-matter of these lectures maybe briefly set out thus :-

1. The Sexual Characters, their Cause and Biolc:’;’:’.-Prof.C. Champy, of the Faculty of Medicine of Paris, describeshis experiments on salamanders (Triton alpestris), in whichby starvation (alimentary castration) a sexual inversion isproduced. In birds, if a functioning left ovary is excised,the right gland becomes transformed into a testicle andsecondary male characteristics appear. He further showsthat, while the testicle secretes an exciting hormone whichinfluences the development of the comb in the cock, thehorns in the ram, the beard in man, and the thumb glandin the frog, there is also an inhibitory substance in theovary, a

" kalone," which prevents the growth of a comb inthe hen. He emphasises the law of " all or nothing."Partial castration shows that there is no direct proportionbetween the mass of the genital gland and the action ofthe hormone. This law, as also the existence of an ovariankalone, shows the necessity of reserve in interpreting thenegative experiments of castration in invertebrates in whichit can never be certain that some small residuum of thegenital gland is left. Hence the hormone acts as a catalyser,the kalone as an inhibitor.

2. The Laws of Action of Inter7ial S’ecretions.-Prof. E. Gley,of the College of France, also describes experiments on cocksto ascertain the relation between the volume of the testicleand length of the comb. He found that the animal with largetesticles had a no more perfect comb than one in which amere nodule remained. He consequently disbelieves inhypo- or hyper-function of the endocrine glands. A givensecretion, however, may really be a complex of various pro-ducts. The substance which determines sexual charactersmay not be the same as that which presides over thedevelopment of the cock’s comb, and the thyroid substancewhich acts on the psyche, may not be identical with thesubstance which regulates the skeleton. If a given internalsecretion is composed not of a single but of several products,and if one of these should be wanting either temporarily orpermanently, a dissociation of morphological and functionalphenomena would ensue. Cases of partial myxoedema aresatisfactorily explained on this hypothesis. Another lawof great physiological interest is that of " functional con-stancy," as shown in the retrogression of sexual character-istics in castrated cocks, characters which can be preservedby the injection of testicular extract at regular intervals.

3. The Anatomical Basis of Ovarian Correlations.-Prof.A. C. Bruni, of the Veterinary Institute at Milan, works outthe thesis that the production of a morphogenetic hormonecapable of stimulating the development of certain character-istics and preventing that of others cannot be ascribed toone part of the ovary rather than to another, but to thewhole organ. The thecal and interstitial cells, besides beingdeposits of nutrient material, are an intermediary betweenthe germinal elements and the somatic. The ovary onthis hypothesis would act like other endocrine organspouring into the blood useful products and abstractingharmful ones.

4. Correlation 6e)!!eeeM. the Psychic System and the SexualGlands.-Prof. E. Lugaro, of the University of Turin, givesan interesting summary of the psycho-sexual developmentof the child, calling attention to pre-puberty misogynywhich, in his opinion, is not a "repression" " but a tem-porary redundance of sensuality through virile psychictendencies. The effect of early castration is a certain degree

1 La Funzione Endocrina delle Ghiandole Sessuali. Milan :Istituto Sieroterapico. 1925. Pp. 243. Lire 25.

of infantilism, but no deviation towards femininity. Geniusis not a pure sexual characteristic. Discussing dementiaprsecox, Prof. Lugaro thinks that Mott’s researches pointto a phase of exhaustion of glandular activity that happensin these patients when, after a period of extraordinaryexaltation, the sexual function ceases for ever, nor does heagree with Freud that the delirium, hallucinations, and sexualimages are due to a psychogenic mechanism. He attributesmental disturbances at the menopause to thyroid and notovarian influences, and hyperaesthesia sexualis to othercauses than the sexual glands. As to sexual perversion, hethinks the sexual glands only play a part through the genericfactor of precocious and exaggerated erotism.

5. Old Age, and Rejuvenation by Grafting.-S. Voronoff,of the Laboratory of Experimental Surgery in the College ofFrance, discusses the cause of old age. Unicellular animalsreproduce by fission, old age and death do not occur. Higherup in the scale the somatic cells have definitely lost theaptitude of reproducing the complete organism, but canonly reproduce parts as in hydra and lumbricus. In thevertebrates even the power of reproducing parts is lost andit remains for the sexual cells to reproduce the species.Old age is due to hardening of the tissues and organs byfibrous material by which the quantity of functioning cellsis diminished. The endocrine glands through their hormonesact on the nutritive metabolism, on the evolution of the cells,and on their morphology-if they cease to function lifebecomes impossible. Observations on castrated animalsshow that testicular hormone directly influences morpho-logical change in all parts of the body, as much of the braincells as of the epidermis, bones, and other tissues. Suchanimals when not slaughtered do not live as long as others.Eunuchs become old at 60 and do not live long. Opotherapyonly offers a slight palliative to insufficiency or suppressionof endocrine glands. Hence the importance of grafting.Prof. Voronoff describes his experiments with graftingtesticles on old rams and bulls which recovered not onlvsexual power, but all the other qualities of young animals.He shows photographic representations of several men,bulls, and rams before and after testicle grafting, claimingthat the internal secretion of a young testicle in an oldorganism activates the multiplication of cells and theirmetabolism from which results a true rejuvenescence of thebody. He claims that the beneficial results of these graftingsboth in animals and men lasted several years. The photo-graphs are without doubt very striking.

6. Reactivation of Physical and Meratal Force.-1IaxThorek, chief surgeon at the American Hospital in Chicago,deduces from his experiments that the seminiferous andSertoli cells play no part in the production of libido, sexualpower, or sexual characters in the male, but that only theinterstitial cells of Lcydig have this power. He arrives at thisconclusion from the grafting of testicles previously " inter-stitialised " by X rays. He describes his technique, thepeculiarity of which consists in " fenestrating " the tunicaalbuginea with the actual cautery. He gives a table of theresults of 143 cases-in 63 per cent. there was return to anormal condition, while 22 per cent. were unsuccessful.The cases included senility, dementia prsecox, neurasthenia,and hypogenitalism. He protests against the prominencegiven to restoration of sexual function : what is aimed atis the general reactivation of physical and mental force.

These six lectures, written by men who may beconsidered masters in their special subject, are

worthy of careful study. It is to be regretted thatthey have not as yet been translated into Englishso as to increase the number of their readers.

BACTERIAL CONTENT OF FÆCES.

IT has long been recognised that living streptococciare practically always present in the faeces of healthypersons. Considerable doubt, however, exists as tothe importance that should be attached to variationsin the number of colonies of these organisms obtainedon plate culture. There are those to whom theiroccurrence in numbers even remotely approachingthose of the coliforms justifies the attribution ofpathological activity and the exhibition of a vaccine.Variations in the bacillary forms occurring in thefseces have come in for a good deal of investigation,particularly in America. The influence of diet in thisrespect is now well recognised, the standard examplebeing the passage from the infantile to the adulttype of flora consequent upon the passage from a milkto a mixed diet. That the reverse change from a mixedto a milk diet may in the adult bring about a returnto the infantile type of flora has not been so widelyrecognised, and instances are not wanting in which