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substance present which is essential to the assimi-lability of food. If we accepted the position laiddown we should have to conclude that there issomething radically wrong with our methods of

preparing food which seemingly ought to havefavoured a general distribution of " deficiencydiseases." A letter in another column has promptedthese remarks.

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THE COMPLIMENTARY DINNER TO SURGEON-

GENERAL GORGAS.

AT this dinner, which will be held on Mondaynext, March 23rd, at 7.45 P.M., at the Savoy Hotel, weunderstand that the Archbishop of Canterbury andthe Lord Chancellor, Lord Haldane, will be present,as well as the Colonial Secretary, Mr. LewisHarcourt, and Viscount Bryce. The dinner issupported by Sir Rickman Godlee, President of theRoyal College of Surgeons of England ; Sir FrancisH. Champneys, President of the Royal Society ofMedicine; Sir David Ferrier, President of the

Medical Society; Dr. W. A. Hollis, President of theBritish Medical Association ; Sir Havelock Charles,President of the Society of Tropical Medicine andHygiene; Sir William Osler, Regius Professor ofMedicine, Oxford; Sir Clifford Allbutt, RegiusProfessor of Medicine, Cambridge ; Surgeon-GeneralArthur W. May, Director-General of the NavalMedical Service; Sir W. Launcelot Gubbins,Director-General of the Army Medical Service;Professor W. J. R. Simpson and Dr. F. M. Sandwith,of the London School of Tropical Medicine; SirRonald Ross, Sir James Reid, and Sir FrederickTreves. The chair will be taken by Sir ThomasBarlow, President of the Royal College of Physiciansof London, and the organisers of the dinner areparticularly anxious that representative medicalmen should be present to do honour to their

distinguished American guest. All communica-tions should be addressed to Mr. J. Y. W. MacAlisterat the house of the Royal Society of Medicine,1, Wimpole-street, London, W. The dinner ticketsare 25s., and cheques should accompany applica-tions.

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"DICHOTOMY" IN THE UNITED STATES AND

IN CANADA.

THE dodge of dividing fees secretly between thegeneral practitioner and the operating surgeon wasstated publicly not long ago to be rife in the UnitedStates and Canada. The question was discussed atthe time with an acrimony that, despite some weakevidence, went far to prove the custom to be invogue ; and now the matter is again on the tapis.At the twenty-third annual meeting of theWestern Surgical Association held in St. Louis onDec. 19th and 20th, 1913, Dr. Jabez N. Jackson, ofKansas City, Mo., the President, in his presidentialaddress, took " dichotomy," as the reprehensiblepractice is called, for his main subject. His

objections to the practice were the obvious ones,and were formulated in the obvious manner.

He said that dichotomy induced family practitionersto betray the confidence of their patients who werereferred to surgeons, not necessarily the most com-petent, not those who offered the greatest possi-bility of the saving of life or the preservation ofhealth, but to men who paid coin to get hold of theirvictims. By this practice the patients were robbed,while it penalised honesty in those who sat idly byrather than make shameful bargains, allowingless competent competitors to buy their practices.

Finally, and perhaps worst of all, it led to manyunnecessary operations with their attendant riskand expense. "In all it was a betrayal of trust,encouraged dishonesty, bred incompetency, and

should, in short, be regarded as a crime." Theindictment is not too severe for the offence-in

fact, the professional degradation of "dichotomy" canhardly have required pointing out. What is neededis a remedy-viz., the public exposure of known

offenders, and this is the course that is now

being widely discussed and forcibly advocated.In Canada the practice of secret division offees was stigmatised no less harshly some twoyears ago at the annual meeting of the OntarioMedical Association by Dr. Herbert A. Bruce, ofToronto. Dr. Bruce appeared to admit that thecustom existed by the terms of reprobation whichhe considered it his duty to use. Enough wordshave been wasted in describing the professionalenormity of the offence ; we should now like to seesome of the offenders named and shamed. Surelyif the sin is so common many of the sinners mustbe known.

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MEDICAL PROTECTION.

THE annual report of the London and CountiesProtection Society, which will be presented to theannual meeting of the members on March 25th,discloses once more a record of steady growth andof increasing usefulness. Since the last annual

meeting the society has lost its President, SirJonathan Hutchinson, who had filled that officeduring the whole 22 years of the society’s existence.In his place Dr. G. A. Heron has been elected, andhas resigned the treasurership in consequence, towhich Mr. C. M. Fegen has been elected in hisstead. The report contains cases illustrative ofthe defence work done on behalf of the members.Interesting as many of these cases are, there is a

strong similarity between the events of one year andanother ; and they point very strongly once morethe moral which impresses itself instantaneouslyon all who read them-namely, the imperativenecessity of an organised and cooperative system oflegal defence for the medical profession. With

increasing experience of the new system in-

augurated in 1911 the financial position ofthis society is growing rapidly stronger andmore assured. It will be remembered that inthat year the constitution of the society was

altered in such a way as to give the councilpower to insure members up to an amountof .:B2000 in any one case and up to an aggregateof .:B22,000 for the whole society against costsand damages given against them. Previously thesociety had insured members only against theactual costs of their defence. It is evident fromthe financial statement that the increase of thesubscription from 10s. to 11 per annum has so

far been more than adequate to cover the extrarisk insured; and the consequence is that thereserve funds of the society are accumulatingrapidly. This is, of course, a source of greatstrength, and if the favourable experience of thesociety in respect of this part of its work con-tinues it will be possible either to reduce the

subscription which the members pay or to terminatethe arrangement whereby the society reinsureswith Lloyd’s the whole of its annual risk of adverseverdicts beyond the first .:B2000, thus saving theannual premiums paid to cover this contingency.As previously, the society was able to recover a sub-stantial proportion (nearly JB900 out of £2300) of its