A NEW EVACUATOR FOR LITHOLAPAXY.

373 Press of Aberdeen has recently published a subject catalogue containing the titles of the books in the Phillips Library of Pharmacology and Therapeutics, Marischal College, which was founded in memory of the late Dr. C. D. F. Phillips by his widow. Dr. Phillips contributed several works on Materia Medica and Therapeutics, and his library shows what a vast source of reference on this and cognate subjects he kept by him.-Dr. J. Ewing Mears is to be commended for his effort to spread broadcast a knowledge of what is probably the greatest object lesson the world has had of the power of intelligent and scientific sanitation to abolish deadly diseases that have for centuries held certain tropical countries in their grasp. Of countries so oppressed, perhaps the Isthmus of Panama was the very worst; yet so important was it

New Inventions. A

NEW

STOMACH

CLAMP.

THE accompanying figure illustrates a stomach clamp recently made for me by the Holborn Surgical Instrument

Holborn-circus, London, E.C. The blades

Company,

may be had either straight or curved. It has been a well-recognised difficulty to obtain a clamp possessing

length and rigidity with world progress that thousands of lives have been strength sufficient to effecto utilise it for the lost there in futile attempts retain a grasp on the tually of commerce. In the Zri2cmph of Amer-acan purposes stomach without unduly Medioine in the Construotion of the Panama Canal (Philacrushing it. This instrument has the desired spring, delphia : W. J. Dornan. 1911. Pp. 26) Dr. Mears traces .and with the end locking the transformation of the "canal zone "-a belt of territory -arrangement there is no containing 322 square miles, extending 5 miles wide on each possibility for the blades to side of the Panama Canal, extending from the Atlantic to side-slip. The fenestras the Pacific-from a pestilence-ridden area, reducing the permit, if desired, the death-rate of all white folk who went there from 70 per cent. insertion of sutures to prevent haemorrhage, while at to under 1 per cent. He details the measures and prethe same time they assist cautions taken in the achievement of this result, which in retaining the grip upon certainly fulfil the definition of genius as "an infinite the stomach wall after capacity for taking pains." It is not so much superior knowIf the slot be division. not desired, rubber tubes ledge as superior powers of organisation that has rendered may be placed over the possible this remarkable achievement of Colonel W. C. but this is not blades, the Medical of the United States of Gorgas, Corps Army.recommended as the forceps In a Manual of Heraldry (London: T. Werner Laurie. possess the necessary rigidity Pp. 291. Price 6s. net) Mr. Gale Pedrick traces the rise, and safe grasping power when used naked. If covered progress, and decay of this ancient science, without some by rubber the blades must knowledge of which, he truly says, it is absolutely impossible be locked much too tightly for anyone to understand and appreciate the associations and to retain a hold without even the beauty of much poetry, art, architecture, or literature. risk to the tissues grasped. The beauties of symbolism are being too much lost sight of in ALEX. MacLENNAN, this realistic age. In this book the precursors of heraldry M.B., C.M. Glasg. are described, the authorities of British arms explored, the various charges and armorial instances are historically and symbolically discussed, the influence of heraldry upon art and architecture, archaeology and genealogy, as well as A NEW EVACUATOR FOR LITHOLAPAXY. upon literature and poetry (particularly that of Scott), is IN THE LANCET of Jan. 20th Mr. John Pardoe expounded, and finally the author proposes a reform of draws attention under this title to the fact that heraldry-whose spirit from an archaeological and artistic of the older forms of evacuators for litholapaxymany are standpoint is always fresh, though its ancient exercise is made with ttieir metai dead and incapable of resuscitation-by measures designed collars permanently attached to them, and he to accommodate it honourably to modern conditions. The describes an evacuator of illustrations of coronets, ordinaries, tinctures, differences, the Bigelow type in which and so forth, are facsimiles of those contained in a 11 Pocket the glass bulb is removeable Herald" and Gentleman’s Companion,published by Richard from the bottle. Messrs. Down Barry, of Bristol, " as the Act directs," on August 1st, 1810. Bros., -The fourth (revised) edition of Hassam’s Arabic Self Taught Limited, point out that Mr. Milton’s evacuators (Syrian) (London : E. Marlborough and Co. 1911. Pp. 128. have been made with both Price, paper, 2s. ; cloth, 2s. 6d.) has been practically the mounts removeable for rewritten by the Rev. N. Odeh, and much entirely new i many years past, and were matter, including an outline of the grammar, has been added. first described in their cataThe transliteration used has been carefully devised to give logue in the year 1900, and the illustration appended the phonetic pronunciation of Arabic in accordance with has appeared in their catathe scheme adopted by the Congress of Orientalists, and has !, logue since the year 1906. been simplified to the last degree. That being the case, it has na.tnra.llv nr
to

)

,..

improved

’-&..LGII"".I...L

couucuuavu

uv

have

THE NATIONAL INSURANCE ACT.

374

during this past week a remarkable unanimity in certain political papers in misrepresenting the point of view of those medical men who are opposed to the Act, while we are sure that our readers are as willing to hear both sides of any question as we are desirous of presenting those sides. The method employed by politicians has been to suggest that our opposition to the measure is purely the outcome of Tory bias or greedy terror, and it is endeavoured to prove this suggestion by demonstrating that as within the covers of the Act everything that is wanted by any fair-

been

THE LANCET. LONDON: SATURDAY, FEBRUARY 10, 1912.

minded

The National Insurance Act. As

we

which to

foreshadowed in

the

National

last issue the conference

our

Insurance

hold with

Commissioners

of

medical

man

can

be

obtained,

no

medical

man our con--

It is on the principle of audi alteram pa’l’tem that this Examination of the Medical Provisions of the National Insurance Act." It will be obvious to all who have followed the previous leading articles in THE LANCET that

proposed

interests

medical

We invite oppose the Act and be fair-minded. readers to study Dr. BREND’s articles and form their own can

clusions. we

print

representatives to nothing. Finding their invitation such declined by important bodies as the General Dr. BREND is not in agreement with ourselves as to the main Medical Council, the Royal College of Physicians of but it is always well to clarify our ideas by a issues, London, the Royal College of Surgeons of Edinburgh, the critical study of the strongest case that can be made out for Society of Apothecaries, and the Council of the British the other side by one who can speak as an expert; and Dr. Medical Association, and being threatened with refusal BREND has clearly studied the Act very closely as a barrister, from other bodies whose answers they awaited, the Com- while as a medical man he can appreciate the force of missioners decided at the last moment to postpone the medical Oar arguments. lay critics have not these The reasons given for not accepting the advantages. conference.

Feb.

2nd

invitation

came

of

the

quarters, but clearly much

the

feeling

the

same

and

the

on

most

Commissioners

general

varied

behind

in

the

different

replies

The result of the breakdown of the conference with the Commissioners is surely to show that, at any rate, delay

was

must be

granted before the working of the Act commences;9 the most favourable view of the medical provisions in the

The

everywhere. strongest objection to attending the

that it had been sprung upon the bodies Act that can be taken by any partisan seems to us to point Daring the week an exposition of the concerned without giving them time either to consult their the same way. National Insurance Act has appeared which will surely constituencies or to confer together. In support of this with studied the be greatest possible attention by many suddenness we presume that the Commissioners would quote Section 58 of the Act, which instructs them, "As soon as of our readers, and they will note in the preface, contributed by Mr. LLOYD GEORCE, that the Chancellor may be after the passing of the Act" to appoint an Advisory Committee for the purpose of making and altering regulations anticipates difficulties in the working of the Act, although under the Act. If the object of the conference had been con- he does not go so far as to admit, as Sir JOHN SIMON, the fined to obtaining the help of the medical profession in form- Solicitor-General, has already done, the certainty that will be required. The description in this ing this Advisory Committee (which must contain "duly amendments 1 of the which the medical profession willvolume in position qualified medical practitioners who have personal experience the Act has been very careof general practice " ), and if the invitations had been given be placed by the working of with proper notice and due discrimination, the various bodies fully done, but the thing that stands most clearly therefrom is summed up in the words of the might have replied with less unanimity. For the formation authors : 11It is impossible to forecast what the ultimate of the Advisory Committee is the necessary prelude to the " issue of the Regulations. But even if the Commissioners effect of the Act will be on the medical practitioners ...... had displayed both tact and knowledge of the medical pro- That incomplete sentence of an excellent work, carefully written and admirably edited, forms a powerful argument fession, it is very likely that the attempt to secure a conferfor insistence upon delay in the working of the Act. The ence with representative medical bodies would have failed, medical profession was not consulted before the original so strong is the feeling that no regulations whatever can Bill appeared. During its transformation into the very shape the medical provisions in the existing Act into an different Act that it is, the representations of the medical acceptable form. were rewarded by little tangible improveWe know that this view is not held universally, and profession The medical profession has come to a fairly ment. we publish this week the first of a short series of articles unanimous opinion that under the existing medical provisions by Dr. W. A. DREND upon the position of the medical prowill not obtain fair treatment-a statement which is fully fession under the Act, which are designed to persuade the they out by the pledges given by many thousands of medical borne profession that a scrutiny of the parts of the Act affecting and which will receive endorsement at the forthcoming the medical profession will show the practitioners to be in a men, 1 National Insurance. By A. S. Comyns Carr, W. H. Stuart Garnett, stronger position than is usually supposed. Wechoose this and J. H. Taylor, M.A., M.B. With a Preface by the Right lion. time for publishing Dr. BREND’s articles because there has D. Lloyd George, M.P. Macmillan and Co. Price 6s. net.

conference

was

I

out