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1220 Mr. P. H. WHITAKER said that comparison of rickets or were suggestive of rickets, but not sufficiently post-mortem findings with radiograms was of extreme definite to class with the other cases ; 9-2 per cent. moment to the radiologist, and helped him to assess the of the children of the inner ring showed marked signs relative importance of various shadows and mottlings. of rickets ; 4-6 per cent. of the children of the outer A radiogram was apt to exaggerate the lesion found ring showed marked signs of rickets. The monthly incidence of rickets in both years post mortem probably because the cedema round the lesion was mistaken for consolidation. That probably showed its peak in May, and after the severe winter accounted for the different interpretation of the 1928-29 the percentage of children in the inner ring acute pneumonic type of tuberculosis by the patho- showing marked signs of definite rickets reached logist and the clinician. " Ring shadows " were 30 per cent. On examining the social conditions, almost certainly due to the suction action of the two the effects of poverty and overcrowding, though these layers of the pleura on a thin fibrin exudate between were evident in a higher incidence, were not so marked them. In a number of cases where these shadows had as when the type of the home in regard to houseappeared in the radiogram, they could not be found wifely care and mothercraft was considered. Here post mortem, and had they been cavities, could not in the good homes 4-7 per cent. had rickets ; in the have closed in the time intervening. It was surprising fair homes 6-4 per cent. had rickets ; whereas in the how accurate a picture of the pathological process neglected homes 20 per cent. had rickets. With was given by X rays, but when tuberculous disease was actual poverty the variance was between 6-3 per cent. associated with other pulmonary lesions, such as and 11-9 per cent., and with overcrowding, between pneumoconiosis and malignant disease, diagnosis 6’7per cent. and 9-6 per cent. It was noted that only 16 per cent. of the rachitic became difficult. children were never breast-fed and that 15 per cent. were breast-fed for 12 months and over. Dr. MANCHESTER MEDICAL SOCIETY Chisholm pointed out that lactation, though the best method of rearing the young child,was influenced AT a meeting of this society on Nov. 2nd Dr. the health of the mother and her exposure to CATHERINE CuiSHOLM gave an account of an inquiry by and was not sufficient in itself to protect sunshine, into the varying incidence of active rickets in from if it is prolonged. She rickets, Manchester made by the maternity and child welfare believed that forespecially the prevention of rickets in the more department of the public health authorities in con- neglected homes, from which the mother did not junction with the Manchester Babies’ Hospital. of her own volition attend maternity centres, the Rickets in Manchester well-informed, tactful, and enthusiastic health visitor It is known, she said, that the centre of Manchester was the agent most likely to banish rickets. In and the industrial area has fewer hours of sunshine season and out of season she could supervise the than the outer suburbs with the exception of a short progress of the child. Private practitioners, she said, time when north or north-west winds prevail. During should make it their business to study the physiology two and a quarter years infants from 10 to 30 in of the lactating mother and child, and particularly the number were taken to the hospital, their histories advantages and limitations of breast-milk feeding. and general condition were noted, and later radiograms were taken of wrists, knees, and occasionally CORRIGENDUM.-In the debate on Faith in Mediankles. In all, 1600 children were examined. It before the Hunterian Society recently, Dr. cine, was found that 7-3 per cent. of these showed marked Robert Hutchison was reported to have alluded to signs of definite active, healing or lately healed rickets. faith in " Purkinje’s Tract but he said " Perkins’s A further 21 per cent. showed signs of very slight Tractors." .

NEW INVENTIONS COMBINED RADIUM NEEDLE INSERTER AND PROBE AT present radium needle inserting holders and radium needle probes are made as two separate instruments. This entails extra work, waste of time, and unnecessary exposure to the radiation during

AN IMPROVED GAG

HAVING experienced some difficulty in keeping the Boyle Davis gag in position in edentulous patients, it occurred to me that some form of plate in place

I have designed combined radium needle inserter and probe as of the usual dental attachment would be more shown in the accompanying figure. Both angled satisfactory. This, which is shown in the accompanyand straight types of instrument are now being ing illustration, we have used for some time at the Northern Hospital and it has proved very successfully used at the Manchester and District The gag has been made for me by Messrs. Radium Institute. Charles F. Thackray, Park-street, A. King, Devonshire-street, London, W. Leeds, are the makers. ; R. WADE, M.R.C.S. Eng. DAVID A. HERD, L.R.C.P., L.R.C.S. Edin.

operation. To obviate this defect

a

Royal

iuseful.