A LARGE WASTE OF ACCESSORY FOOD MATERIAL.

474 Deliberate malingering was, during the period definite programme of education. A scheme of dealt with, very rare indeed. On the other hand, affiliating children’s hospitals with particular Major Ormond records 39 cases of what he terms general hospitals is the policy of the College, and " concussion blindness," but which might more has already been adopted in one or two instances. appropriately be called psychical blindness, since The time spent by the nurse at the children’s they are neither cases following the passage of hospital is then counted as part of her general To those who are outside the actual missiles in the vicinity of the globe and producing training. a compromise on these lines would arena of conflict cases nor results, ophthalmoscopically recognisable in which a concussion of the cerebral cortex may seem not difficult of arrangement. Given a working fairly be assumed as the cause. These cases are scheme of State registration as a basis the rest usually the result of an explosion in the immediate should soon follow. vicinity of the patient rendering him unconscious. On regaining consciousness the patient is unable A LARGE WASTE OF ACCESSORY FOOD MATERIAL. to open his eyes, and believes himself to be blind. Now that it has been shown that the antiHe is not a malingerer. At the same time, if the scorbutic properties of lemon juice are in no way true nature of the condition is not recognised in the connected with the citric or other acids present, early stage by the surgeon the prognosis of the case and that the accessory factor can readily be Other points in the separated from these acids, attention may well be is enormously prejudiced. analysis which may be noted are the rarity of directed to the manufacture of citric acid from lemon sympathetic ophthalmia in this war, the dis- juice on a large scale in such a way as to save the appointing ultimate results of the extraction of vitamine for special dietetic purpose. The world’s foreign bodies from the vitreous by the electro- yearly output of citric acid so prepared runs into magnet, and the too great proportion of cases many hundreds of tons. The acid itself is separated invalided on account of such conditions as high and recovered by a very simple process. Chalk myopia and nystagmus, which, if the medical is added to the juice, when insoluble calcium inspection of these cases on enlistment had been citrate is formed. The precipitate is removed and anything more than a farce, should have prevented treated with an equivalent amount of dilute them from ever entering the army. The rather high sulphuric acid, which liberates the citric acid, proportion of injuries due to accidents not attribut- leaving behind insoluble calcium sulphate, part able to enemy action is also commented upon. of which is deposited and the rest removed by filtration. Concentration and crystallisation of the clear fluid complete the process. It is obvious THE REGISTER. that the liquor strained off from the calcium CONTROVERSY centres at present around the pro- citrate must be rich in the antiscorbutic factor, posal to grant supplemental registration to nurses but as far as we know it has not been utilised. trained exclusively in children’s hospitals, and there Here is a valuable source of accessory substance We suggest to manuis considerable opposition to including the nurses which should be saved. with special hospital training only in any scheme facturers of citric acid from lemon juice that they for State registration. The Central Committee for devise some simple means of recovering the State Registration will not consider the proposal, vitamine in a convenient form for transport and but the Bill drafted by the College of Nursing administration. In so doing a supply of contains a clause empowering the General Nursing useful nutritive material would be rendered Council, when set up, to institute supplementary able without interference with the. citric acid registers to include nurses trained in other than manufacture. Should the process, however, involve general hospitals, the assent of the Privy Council prolonged heating, the vitamine would possibly not being obtained to the conditions of training. survive, but steps might conceivably be taken to Although this clause does not definitely establish avoid such an occurrence. a register for children’s nurses, it grants power to the General Nursing Council to do so, and in this A DIMINISHING POPULATION. respect goes one stage further than any other WITH the cessation of slaughter on the Western association working for State registration of nurses. Although the nursing of children is not Front pestilence took up the task of keeping down identical in every respect with the nursing the surplus population, and in the last quarter of required by adults, because the range of disease 1918 the number of civilian deaths in England and is different, a three-years’ course of training in a Wales, as stated in the Registrar-General’s returns, children’s hospital has the whole framework of a exceeded the number of births by 79,443. An liberal nursing education, and we think that it actual diminution in the population in any quarter would only be fair to nurses so trained to grant of the year was previously unknown during the them the status conferred by entry upon a whole period for which exact figures are available. supplementary register. The other nursing It was, of course, principally the result of the specialties might then be pigeon-holed by the influenza pandemic, which is officially credited with State, and in this way justice would be done to a casualty list of 98,998, or 41 per cent. of the total the special nurse and protection granted to the deaths registered. And this figure is more likely general-hospital-trained nurse, and the one would to be under-estimated than exaggerated. In the be less likely to encroach on the province of the face of such a violent quake to the whole apparatus other. It seems likely that a Parliamentary Com- of vital statistics it seems hardly worth the mittee will be appointed to consider the two regis- trouble to attempt to estimate the effect of the tration Bills which are now being promoted, andcustomary small oscillations in birth and death Suffice it to note the encouraging fact that one of which has just been read a first time in therate. House of Commons. A compromise may then be laid8000 more births were recorded than in the correbefore Parliament. The position of the College ofsponding quarter of 1917. But here, too, the Nursing is strengthened by the fact that beyond ;aftermath of war is seen in the unusually high the promotion of State registration it has a proportion of illegitimates. ] ____

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