CARBON MONOXIDE FROM MOTOR EXHAUSTS.

1081

captured and the distance of the shelter from breeding-grounds. Unfortunately the influence of

males

other factors is so much greater than that of distance that this percentage, whether for A. maculipennis or A. quadrimaculatus, cannot, with the relatively small collections usually possible, be used as a signpost to lead the hygienist in the field to the breeding-places of these mosquitoes. Whether this negative conclusion is of more general application only wider investigation can show. ____

ANTISCARLATINAL SERUM AND RELAPSE. analysis of relapses occurring at Ilford Hospital after an attack of scarlet fever (see p. 1060), Dr. A. H. G. Burton and Dr. A. R. Balmain come to the conclusion that these are more frequent in cases treated by antiscarlatinal serum. In 432 such cases they have found the relapse rate to be 4-16 per cent., which is high compared with the generally accepted rate of from 1 to 2 per cent. It is not easy to arrive at an accurate relapse rate of this disease since occasional errors in the original diagnosis arise, and many relapses are mild and sometimes difficult of recognition. However, the 4-16 per cent. of relapses in this series of cases can hardly be in doubt since rise of temperature, a punctate erythema, congested fauces, and a peeling tongue were all present. It would be interesting to know whether the relapses were, as is usual, milder than the primary attack, and what relation the severity of the initial attack had to the relapse. They say that antiscarlatinal serum appears to have the definite effect of increasing the number of Dickpositive reactors during convalescence, and evidence of this is given. This is not surprising since the antitoxin, being supplied artificially, the need for the human mechanism to set up its defence is less. They conclude that cases of scarlet fever admitted to isolation hospitals should be Dick-tested at the end of the third week, and that it is unjustifiable to retain cases of scarlet fever in a general ward who give a marked Dick-positive reaction during convalescence, but that such cases should be isolated or immunised. That these conclusions are reasonable can hardly be doubted, especially when antiscarlatinal serum has been administered and so increased the chance of relapses, as shown by the authors. At the present time scarlet fever, being the mild disease that it generally is, the question arises whether it is desirable to administer antiscarlatinal serum to all cases. There is, however, a tendency towards increased severity to be noticed in certain areas and Doubtless Drs. a few toxic cases have been reported. Burton and Balmain had their special investigation in view when they gave serum to every case on admission ; the opinion held by most observers is that serum treatment may be reserved for the more severe attacks. IN ari Isolation

____

CARBON MONOXIDE FROM MOTOR EXHAUSTS. THE rapid increase of motor traffic in all civilised countries has led to so many mishaps that world-wide attention has been given to the question of the presence of carbon monoxide in the air, not only of garages-where the likelihood of its occurrence is by no means as well recognised as it should bebut of the streets themselves. A correspondent in the United States of America recently citedI some data collected in 14 large cities by officers of the public health service. Very small, but still determinable, amounts of carbon monoxide havebeen found in the air of Paris, and the same order of impurity has, we are informed, been found in the air of London streets by the research chemists of one of the London gas companies. The day is probably far distant when the air of our streets is likely to become dangerous fron this cause, even if no measures are taken to reduce the risk, but a recent occurrence in one of the tunnels under the Thames has given prominence to the very different atmospheric condi1 THE

LANCET, April 28th, p. 881.

tions existing in these sub-aqueous highways nowand at the time when they were constructed. Theresponsible authority appears to be fully alive to the necessity for coping with the problem, not an easy one, of ventilating these tunnels. Everyone will:. agree that their ventilation should be adapted to modern conditions, but there seems no reason why an attempt should not be made to reduce the amount of carbon monoxide entering the air. This couldbe done without any public regulation if motorists would make a rule of stopping their engines whenever their cars are brought to a standstill in a confinedspace. This would seldom mean any real delay as an engine which must of necessity have been. running for some time would hardly cool so rapidlyas to give difficulty in starting. Motorists as a class are inclined to take risks in this respect which no. chemist or medical man would lightly incur. As. regards the general question of carbon monoxide’ in the air of streets, it is consoling to note that MM. Cambier and Marcy discovered no sensible increase in the carbon monoxide content of the air of Paris. over the amounts found by A. Gautier in 1877, except when samples were taken at the level of and near.; the exhaust of a car, or during a traffic block in a one-way street.. At the junction of the Place de 1’Opera and rue Auber, as much as 13 parts of CO. per 100,000 were found when the number of vehicles passing was 2600 per hour ; in rue Mogador, a narrow one-way street, five parts were present during a traffic block. But these amounts represent con--

ditions which

are

quite transitory.

ANATOMICAL NOMENCLATURE. AFTER an interval of some years Dr. Cuthbert Morton has renewed his campaign on the present condition of terminology in anatomy. His letter appeared in THE LANCET of May 12th. Concerning the general questions involved in this matter, we see no reason to alter the opinions which we published in 1920, when Dr. Morton had contributed a paper on the subject to our pages. We may say, however, with reference to the item in the agenda of the Anatomical Society to which he refers in his last letter, that we are informed that it was merely a private motion brought by a member at an ordinary meeting, in which he sought for some expression of’ opinion from his colleagues, and that even then its discussion was, after argument, postponed to a future occasion. Under these circumstances we cannot, of course, say more about it, but it is evident that the facts do not in any way warrant the direful assump-tions and forebodings which darken the greater part of Dr. Morton’s letter. No one can help feeling sympathy with Dr. Morton in his sorrowful contempla-tion of the scene of chaos, but, on the other hand, we have a suspicion that the confusion is not so confounding as is often alleged, and that the cry of urgency is perhaps a little overdone. In any case the terminology fated to survive must evolve itself from the materials at hand, and the introduction of another system or set of " principles," although it may add to the material, will certainly not lessen the confusion. Anatomists are as much concerned as anyone with this question, but they seem to be aware of the fact that an international nomenclature is really an impossible ideal. Moreover, as we have pointed out already, their views embrace a wider field than that in which medicine is interested or concerned, and for this reason we would not anticipate much useful result from a conference between them and their clinical brethren. We are in cordial agreement with Dr. Morton’s plea for wider use of the English tongue, and we fancy that the competent teachers of anatomy employ their nativelanguage much more than might be imagined from a study of many text-books. We must also, like everybody else, admit that the adoption of sound principles of nomenclature would afford a solid foundation for building upon; but as each individual would have his own views on what might be a sound principle, and what could not be so,