A "DRAW-OVER" ETHER INHALER.

436

REVIEWS AND NOTICES OF BOOKS.-NEW INVENTIONS.

One of his main lessons is the necessity of putting aside the utilitarian spirit, a view which is apparently in direct contradiction of a strenuous movement that is now taking place among scientific workers, but the contradiction is in appearance only. Science is not to be measured by practical service alone, that is the high teaching we must remember; but this does not mean that science is only noble, and only elevating to her followers, when the results of the quest cannot be applied to the work of the world. Mr. Gregory’s description of the scientific mind is well done, and his narration of the episodes that have attended the pursuit of knowledge throughout the ages is a pleasant feature of the book, which, indeed, is largely a collection of the more prominently romantic stories associated with scientific progress. The recognition of the fact that scientific investigations carried on with the motive of acquiring new knowledge has led to results of great practical value show Mr. Gregory to be no visionary ; it is necessary to point this out because the chapters entitled "Across the Border " and Towards Infinity"show also that he recognises no bounds to the field beyond which knowledge may be extended. There is a fairly comprehensive section on science interesting to medical men, entitled "Conquest of Disease," and it is here that some of the best examples will be found of the altruism displayed by so many scientific leaders. Pasteur, for example, could certainly have become a multi-millionaire if he-had treated his work from a commercial point of view. We hope this book will reach a large public. Applied science is playing the predominant part in the war : and when the war is over it is to applied science that the nations will turn in their enormous works of reconstruction, rehabilitation, and repair. This country needs some straight teaching, like that conveyed by Mr. Gregory’s book, upon the service that science does and upon the spirit in which that service is rendered. More general appreciation of the essential aims of science will dispel the confusion that seems to exist between practical and academic knowledge.

LIBRARY TABLE. The Mediecl Annual, 1916. Bristol : John Wright and Sons, Limited. Pp. 919. Price 10s. net.-In the thirtyfourth issue of this useful Annual the usual features have been retained, while special attention has been given to the needs of naval and military surgeons. In Part III., Deputy Surgeon-General A. G. Wildey contributes a general review of the points of most practical importance concerning the medical officer’s relation to the fighting man ; and this is followed by a valuable chapter on wound infections from the pen of Captain A. C. Inman, illustrated by excellent coloured plates. The admirable quality of the illustrations is indeed a feature of the whole volume. The practitioner, both civilian and military, will find the Annual an almost indispensable vade mecum and a source of enlightenment on many subjects too recent to have found their place in textbooks. The Story of a Red Cr088 Unit in Serbia. By J AMES BERRY, B.S.Lond., F.R.C.S.Eng.; F. MAY DICKINSON BERRY, M.D., B.S.Lond.; W. LYON BLBASB, LL. M., and other Members of the Unit. With 30 illustrations. London: J. and A. Churchill. 1916. Pp. 293. Price 6s. net.-In this volume Mr. and Mrs. Berry have collected the experiences of the Royal Free Hospital Unit at the request of many friends who wished to have some permanent record of the work done by the mission. As our readers will remember, little surgical work fell to the hands of the unit, but they were able to give an objectlesson in hygienic methods which can hardly fail to bear fruit. Three members of the mission were, or became, fluent Serbian scholars, and were rewarded by gaining more insight into the Serb character than many who have made a superficial study of the country. The Serb is described as "a very simple, egoistic, likeable people indeed: dirty enough, living on mud floors, disliking fresh air, and consequently suffering much from tuberculosis and diphtheria, careless about water-supply, and therefore horribly tormented with worms, but always lively and affectionate, delighting in bright colours and wild music, and making a most attractive combination of its characteristic virtues and failings." The book gives a pleasing picture of an experiment in international amity.

The book of 8M’row. By ANDREW MACPHAIL. Oxford: Press. 1916. Pp. 500. Price 6s. net.-This book of verse contains, Dr. Macphail assures us, all that has been said-all, indeed, that can be said-upon the theme of sorrow. Designed at the outset for private luxury, the compiler has completed his task in Flanders, where the scenes provide ample warrant for such a collection. For any imperfection in the book Dr. Macphail pleads as excuse the place of his present abode and the nature of his employment. In peace time professor of the history of medicine in McGill University and editor of the Canadian Medical Journal, he is now, we believe, a lieutenant-colonel in the Canadian Engineers. Our readers have already some experience of the author’s sympathetic style and breezy frankness as an essayist, and a perusal of this anthology will not bring disappointment. The poems are arranged under headings such as Serenity, Rest, Resignation, and Consolation. An index of authors and of first lines affords ease of reference. The publishers have adopted a similar style of type and binding to the familiar Oxford Books of Verse.

University

New Inventions. A "DRAW-OVER" ETHER INHALER. THE apparatus here illustrated is a modified form of A contains a large removable Vernon Harcourt’s inhaler. intake valve, and is fitted with a rubber ring to keep it at any level ; B is a three-necked bottle for ether ; c, a Clover’s mask; H, a three-way adapter connecting it with the efferent tube of V. H. bore, and carrying D, an expiry valve ; E is an enamelled hot-water basin, F its waste-pipe; G, a clip ; and K (mislettered H), a thistle-funnel, replaceable by a cork, for adding ether or giving 02. The apparatus is not n

1-4

used for inducing anoesthesia; before changing, say, from the Clover method the patient should be well" "under," or the end of A some inches above the ether, lest coughing or breath-holding ensue. When the patient breathes freely A is brought down close to the ether, and hot water may soon be needed, to increase the vapour strength. A V.H. mask may be used instead of c, D, and H. The ether vapour may be moistened and warmed by placing a steaming hotwater jug, or thermos, close under A. All adjustments can be made with one hand ; generally both hands are free for holding the jaw. This inhaler is efficient for abdominal cases of all kinds, and specially convenient for operations on the breast, neck, and head, as plenty of air and ether can be given without disturbing the sterile towels. The apparatus is made by Messrs. Barth. A. BERESFORD KINGSFORD, M.D. Durh., Assistant Anæsthetist, Anesthetist, University College Hospital Hospital. Upper George-street, W.

ECONOMY AND PUBLIC HEALTH.

THE

LANCET.

LONDON: SATURDAY, SEPTEMBER 2, 1916.

Economy

and Public Health.

437

The suggestion to economise in our use of water has primarily the same reason behind it as the suggestion to reduce the employment of the electric current. Practically speaking, water is brought to our doors by coal, hundreds of thousands of tons of coal being used annually to keep the pumping machinery effective. Clearly, if we elected to use less water the strain on the pumping engines would be relieved and the public coal bill accordingly reduced. There can be no doubt that we could, without much inconvenience, use less water than we do. But it must be remembered that the bulk of the public supply goes to keep efficient the sanitary machinery in the bath, the sink, and the watercloset. The proportion that is used for simple drinking purposes, compared with these demands, is quite small and may be left out of calculation. The suggestion to be sparing of water for sanitary service cannot be lightly entertained; but a material economy might be reasonably attempted in the matter of baths, for in recent years a very big demand on the water companies in regard to baths has been accompanied by gross waste. The amount of water used in domestic baths is usually out of all proportion to what is necessary. We should be sorry to see any interference with the standards of personal cleanliness, and undoubtedly the regular use of the bath has done much to maintain the health of the public ; but the benefits of cleanliness need not be lost by A complete economy of water in the bath. the be in a comof can secured sponging body little The of the bath water. luxury paratively amounts to a complete immersion, which involves a considerable quantity of water that is not actually necessary for a mere cleansing process. The recent exhortations to economy have in the course of the last day or two become more timeous than was intended, for such advice may be particularly needed when the tremendous pressure of the great war can be seen by everyone to be lifting. The entrance of Roumania into the conflict has this enormous significance-a significance which all can see-inevitably it must shorten the duration of the struggle. More soldiers are added to the forces of the Allies, the blockade of the Central Empires becomes stricter, and the sense of victory in itself forces the pace. This is just the condition of things which is likely to lead to failure in economy after a strain of long duration. When the obviously great things are going well it is difficult to pay due attention to what seem to be the small things; and when an end appears to be approaching to a rigid and compulsory parsimony, it is hard not to anticipate that end. But it is absolutely necessary that the strictest economy should prevail in our domestic expenditure and our domestic consumption until the end of the war, remembering, however, that no proceeding which leads to a failure in public health can ever be anything but disastrously expensive. All householders should take steps to limit their consumption of water and electric light; but no municipality should allow the sanitary service to go short in

THE air is full of exhortations to economy, and it is not the abandonment of luxuries that is enjoined upon us, but the practice of economy in regard to the necessaries of life. Luxuries have, we believe, been surrendered by the greater part of our population either from motives of patriotism or poverty, or out of a desire to conform to general conduct; but many who have been proud of giving up the superfluities of life have not dreamt of being sparing in their use of the necessaries. Now we are urged to reduce our consumption of electric light and gas, and our water requirements. Such suggestions obviously raise serious considerations of public health, and already our readers have been consulted as to the public duty in the matter. The fact that the exhortations appear sometimes to be inconsistent with the general position of affairs has laid them open to criticism. For example, we are asked to cut down our consumption of gas because coal should be saved. But the importance of getting a large quantity of gas residuals from which explosives are made is emphasised, while the larger the amount of gas made, the larger is the amount of coal distilled, and the larger the yield of residuals. It follows that to satisfy the demand for explosives implies a bigger output of gas; therefore our supply of gas should be abundant and cheap, which should be a reason for using it more extensively, particularly for cooking purposes, reserving coal for the making of munitions. But the gas companies are charging the public more for gas. Why gas should be dearer when gas residuals are in enormously increased demand and when something must be done with the gas-which, from a war point of view, has become the bye-product-passes the common understanding, while economy in the use of gas is a real drawback to domestic hygiene, either in the institution or the home. Exactly the same may be said of electric heating and illumination-their use makes directly for the improvement of public health. Yet the case is different for the electricity companies, for they burn coal and do not distil it, and therefore get no residuals. The current costs more to produce owing to the great demand for coal. In other words, steam-making is a very expensive matter, and steam is essential for driving the dynamo. There appears, therefore, to be a good reason for reducing our electric consumption, but, on the contrary, an equally good reason for making all the use we can of gas both for lighting and heating purposes. any

particular.