THE INTERCOMMUNICATION OF NERVES.

767 of this diminished resistance is improper and insufficient food, precisely those exigencies to which, for the most part, the poor are subject. Take, for example, the case of corneal ulcers, so frequently met with among ophthalmic outpatients. In the great majority of instances this diseasebetter classes--i unquespractically never seen among the tionably the result of nutritional defect. The cornea receives probably a small accidental abrasion of its epithelium, the repair of which in a healthy person would be generally effected in a few hours. But in those in whom diminished resistance is present no repair occurs and a corneal ulcer results, as seen so frequently among the children of the poor applying for relief at a hospital. When centrally situated these ulcers after repair are the cause of much diminution of vision, and an eye so affected is permanently damaged for visual purposes. It follows, therefore, obviously, from this, that if the staple food of the poor-namely, bread -can be rendered more nutritious by the introduction of a standard quality, the diseases of malnutrition, of which corneal ulcer is one, would become presumably less frequent in their incidence. Underlying this question there is, however, a national aspect from which it may be viewed. Corneal opacities, incurred in childhood, owing to the diminution of vision to which they give rise, become the cause of rejection of many an otherwise eligible candidate for the combatant services. Anything, therefore, which tends to improve the nutritive qualities of the food upon which the poorer classes mainly subsist must indirectly prove advantageous to the I am, Sir, yours faithfully, State as a whole. PERCY DUNN. Wimpole-street, W., March llth, 1911.

EYE-STRAIN IN RELATION TO GENERAL HEALTH.

THE ETIOLOGY OF "LATE RICKETS." 10 the Editor

of THE LANCET.

SIR,-In an article which appeared in THE LANCET of Oct. 23rd, 1909, I described a case of the type to which the The child, a girl, ttrm I I late rickets"is usually applied. was perfectly healthy up to the age of 13, about which time there appeared deformities of the lower limbs and curvature of the spine. She was treated withoot avail for nine months, at the end of which time the family left the district. I have recently traced the case, and regret to say that the condition shows no improvement, though the child’s general development corresponds with her present age (15). She has had no medical treatment since I saw her in 1909. A case of this kind has recently been shown before the Royal Society of Medicine, when the suggestion was made that the changes in many instances of so-called late rickets In are in reality allied to those found in mollities ossium. this connexion I may perhaps be permitted to recall that I made a similar suggestion in the article above referred to, and that you were kind enough to endorse this opinion in an editorial note. I am, Sir, yours faithfully, Bishop Auckland, March 6th, 1911. F. HERNAMAN-JOHNSON.

THE INTERCOMMUNICATION OF

NERVES. To the Editor of THE LANCET. St. Thomas’s Hospital Reports of the year 1874 SIR,-In a paper entitled " Intercommunication of Nerves " is published under my name, laying before the reader evidence in proof of three propositions-namely : 1. That structures bearing a iunctional relationship to one another are generally supplied by the same nerve. 2. That in regard to parts thus related, though not supplied by the same nerve, communications are often established between their respective cerebrospinal nerves through ganglia. 3. That certain branches of the sympathetic have in their distribution a definite relation with cerebro-spinal nerves arising from the same region. In this paper appears the hypothesis of the protective reffex and the basis of the doctrine of referred pain. Having read somewhere lately that the new views on pain, now almost universally entertained, took their origin from ideas expressed by Ross first published in the year 1888 in an article in Brain I hope you will give me space to draw attention to a prior claim of originality for these views. I am, Sir, yours faithfully, H. WALTER VERDON. Streatham-hill, S.W., February, 1911.

To the Editor of THE LANCET. A. A. Bradburne, in his letter to this week’s SIR,-Mr. LANCET, avers that : " Brain-fag arises from congestion of the high visual centres owing to the difficulty of interpreting ’ slightly fogged’ pictures and unequal visual representations, and leads to ansemia of other centres and the various organs which demand a good blood-supply." Admitting the ingenuity of the argument, it is very doubtful, however, if the cerebral circulation is under the influence of the vasomotor system. Leonard Hill persistently failed to get any vaso-motor effects by stimulating the sympathetic nerves supplying the brain, and Bayliss holds that the cerebral vessels are devoid of vaso-motor control. But. assuming the local-anæmia-cum-congestion hypothesis of Mr. Bradburne to be correct, how can it explain "eye-strain"" in view of the fact that the brain itself is insensitive ! I am, Sir, yours faithfully, KENNETH CAMPBELL. London, March llth. 1911.

A CORRECTION. To the Editor of THE LANCET. SIR,-In your report in THE LANCET of March llth of the pathological specimens shown at the Medical Society of London on Feb. 27th, the account of my case of Cyst of the Upper Extremity of the Femur has been so curtailed as to omit the most important fact-viz., that the cystic portion of the femur was resected. It was only after this had been done that the bead of the femur appeared to be too small to serve any useful purpose and was resected, allowing the upper end of the shaft to be secured in the acetabulum. From your account it would appear as if the only treatment had been resection of the head of the femur. The portion of bone involved in the cyst was shown at the meeting. I am, Sir, yours faithfully, P. MAYNARD HEATH. Weymouth-street, W, March 13th, 1911.

LIVERPOOL. (FROM OUR OWN CORRESPONDENT.) Ne?v Maternity Hospital for Liverpool.THE committee of the Maternity Hospital and Ladies’ Charity has secured an admirable site for the proposed new hospital by the purchase of the old almshouses in Cambridgestreet. By means of the sale of the present maternity hospital in Brownlow-hill, the committee will be enabled to pay for the site of the almshouses and other incidental The surplns, if any, will be devoted to an expenses. endowment fund of £20,000, which Sir William Hartley made a condition antecedent to the erection, at his personal cost of not less than £15,000, of a new hospital capable of meeting the demands of the charity. Towards the .f.20, 000 endowment, over .E10.000 have already been raised, and as soon as £5000 more are forthcoming building operations will be commenced. The site has had the approval of Sir William Hartley, and if it had not been promptly secured the lands would have passed into other hands as a site for carriage works. Situated midway between the University of Liverpool and the Infirmary for Children, the old almshouses for widows will appropriately give place to a hospital for women and a training school for nurses and midwives. The almshouses were erected in 1789, while the Ladies’ Charity was founded in 1796, its first maternity hospital being erected in 1841. In 1869 the charity was amalgamated with a kindred institution, so that it has been continued for upwards of 40 years on the present basis, and for 115 years since the foundation. The need for a new maternity hospital is pressing. Within the boundaries of Liverpool 23,600 children were born in 1910. The maternity hospital, with its 23 beds, was the only provision outside the workhouses for all the cases from the poorer classes presentirg difficulties. Over 100 cases, after having been deemed suitable for admission, were refused for lack of room-a fact amply demonstrating the need for larger accommodation. -