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DEAFNESS IN SCHOOL-CHILDREN
91 can quite reasonably be supposed to lower the physique, and make the infant more liable to piles later on in life. The ideal should be a normal action of the bowels without any medicine whatever, when if an aperient should be necessary for illness at any time its efficiency is so much greater. As an extreme
and
a mother informed me last winter that she unable to afford any woollen garments for her children, but stated, with evident pride, that she was able to afford a 3s. 6d. bottle a week of some lung tonic to prevent them catching colds. It is suggested that some competent body should issue a small cheap book stating exactly what is the ideal life time-table of a healthy infant, breast-fed and bottle-fed, with practical and economical advice from birth up to 2 years. I believe re clothing, &c., this would fill a much desired want on the part of mothers and welfare staffs and might obviate some of the defects of infant life which still permit a mortality of 69 per 1000 births.-I am, Sir, yours faithfully, A. G. G. THOMPSON. Southampton, July 6th, 1924.
instance, was
I i I
THE PROBABLE DUAL CONSTITUTION OF
INSULIN.
I
Similar results were obtained with white rats. The average respiratory quotient of three of these animals worked out at 0-77 in the fasting state. A hypodermic injection of two units of insulin produced a characteristic fall in the blood-sugar and a rise in the respiratory quotient to 0-82, while a hypodermic injection of 0-25 c.cm. of adrenalin was followed by an increase in the sugar-content of the blood and an average respiratory quotient of 0-82. Two units of insulin given by the mouth for three hours produced no alteration in either the percentage of sugar in the blood or in the respiratory quotient, and when 0-25 c.cm. of adrenalin was injected a quarter of an hour later there was still no change, an average respiratory quotient of 0’77 being obtained, demonstrating that in these animals, as in guinea-pigs, insulin administeredby the mouth was capable of
influencing carbohydrate metabolism, although only so far as its anti-glycogenolytic properties were concerned.
If, as these experiments indicate, the antiglycogenolytic fraction of insulin taken by the mouth enters the circulation, while the sugar-utilising fraction is destroyed, or at any rate is not absorbed, it is possible to account for the beneficial effects
To the Editor of THE LANCET. claimed to have resulted in some cases of diabetes SiR,-It has been assumed that since insulin from the oral use of crude extracts of insulin, such administered by the mouth does not induce a fall as that of Mackenzie Wallis, and from the administrain the sugar-content of the blood similar to that tion of raw pancreas, or preparations of the gland, which results when it is given intravenously or by the mouth, for the anti-glycogenolytic portion hypodermically, it has no influence upon metabolism, being effective such treatment would be likely to and is either not absorbed by the mucous membrane be helpful where the hyperglycaemia was dependent of the alimentary tract or is destroyed by the digestive upon defective storage of glycogen and there was no secretions. The metabolic experiments on animals interference with sugar utilisation. It would, however, upon which I have been engaged for some time in be of little or no value in cases in which there was association with Mr. H. A. H. Howard, B.Sc., suggest defective utilisation as well as over-production of that this conclusion is not entirely correct, for from sugar, thus explaining the failure of oral treatment observations on the respiratory quotient in a series with pancreatic preparations where actual disease of guinea-pigs and rats to which insulin had been of the pancreas existed. I am, Sir, yours faithfully, given by the mouth it was found that, although P. J. CAMMIDGE. there was no diminution in the blood-sugar, the effects 1924. July 4th, of a subsequent injection of adrenalin were counter- I acted in much the same way as in animals to which DEAFNESS IN SCHOOL-CHILDREN insulin had been administered hypodermically. It To the Editor of THE LANCET. would therefore seem that insulin may be absorbed through the walls of the alimentary tract, but that SIR,-May I, as one who has had some experience its properties are modified in the process, or, what of the needs of the deaf child in elementary schools, is more probable, a fraction which promotes the be permitted to comment upon the report of Miss utilisation of sugar by the tissues is destroyed, while E. Lowry’s paper in THE LANCET of July 5th (p. 20) ? another fraction which is able to neutralise the What I have to say may be best summed up under glycogenolytic effect of adrenalin passes into the five heads. circulation unchanged. 1. There should be more adequate provision for Six guinea-pigs, with an average fasting respiratory removal of tonsils and adenoids, both at hospitals quotient of 0-73, gave an average respiratory quotient and in school treatment centres throughout the of 081, with the usual drop in the blood-sugar, after country, and the cases operated upon should be two units of insulin had been injected subcutaneously, followed up. and 081, with increases in the blood-sugar ranging j 2. These operations should be done by experts. between 0-14 and 0-18 per cent., after a hypodermic In my experience many such operations are inadeinjection of 0’25 c.cm. of adrenalin. When insulin quately performed, and it is quite common for mothers and adrenalin were injected in succession there to state that their children’s deafness was " made was little or no change in the sugar-content of the worse " by the treatment. Moreover, it is by no blood or in the respiratory quotient if the doses means uncommon to find children who have been were correctly adjusted, showing that the hypo- operated upon not twice, but three times. In many glycaemic effect of the adrenalin had been neutralised cases, also, the operation appears to have been the by the insulin and that less carbohydrate was being be-all and end-all, the deafness being left to get well utilised than when either was given separately. by itself. In the same series of animals the administration of , 3. In school treatment centres, ear conditions should two units of insulin by the mouth at hourly intervals be treated by specialists. Harm has been done by for three hours was found to have no influence classing ear troubles as " minor ailments," which they upon the sugar-content of the blood or upon the most distinctly are not. There is no dearth of comrespiratory quotient, but when a hypodermic injection petent young specialists to take charge of these of 0’25 c.cm. of adrenalin was given 15 minutes centres. 4. Efforts should be made to deal with the child subsequently the increase in the respiratory quotient, which should have developed if the adrenalin were of pre-school age, with the definite view to preventing acting unchecked, failed to appear, the average for the conditions which lead to deafness. the six animals working out at 0-735, or practically 5. More effort should be made to discover cases of the normal fasting value. It was therefore evident early deafness in the schools. This, as I have pointed that, although insulin given by the mouth had no out repeatedly, -could be done by introducing a effect upon the sugar-content of the blood, it was whisper test during the vision-card test ; or, as in capable of preventing the glycogenolysis consequent France and Chicago, by means of games. I pointed Plea for the Deaf Child " two and a upon theintroduction of a potent dose of adrenalin this out in my into the circulation. half years ago (THE LANCET, 1922, i., 1027). These "
92 tests are best done by the teacher, whom the children know and trust, rather than by the doctor, with whom they are apt to be Hhy. Children found wanting can be handed to the medical authority for more detailed examination. Deaf children could thus be discovered CHARLES HUNTER STEWART, D.Sc., when treatment is of use and a large number of cases M.B., C.M. EDIN. of deafness could thus be prevented. At present, I these children go unrecognised, often until too late. BY the death of Dr. Charles Hunter Stewart, I may add that it is a matter of great gratification professor of public health and sanitary science and to me to find that the attention of otologists is becoming director of the John Usher Institute of Public Health, aroused to the necessity of prevention. I have been the University of Edinburgh has suffered another preaching it for the past 15 years, as has my friend loss. Although he had been in poor health for some Dr. Kerr Love in Scotland. time, his death on June 30th at his residence in I am, Sir, yours faithfully, Melville-street, Edinburgh, came quite unexpectedly. MACLEOD YEARSLEY, F.R.C.S. Prof. Stewart was born in Edinburgh in 1854, and Wimpole-street, W., July 7th, 1924. at the University of his native city, while later he studied extensively on the continent. He first underwent training as a pharmaceutist, but, RESEARCHES ON LEPROSY AND THEIR forsaking materia medica and chemical pharmacy, he BEARING ON THE TREATMENT applied himself with marked success to the study OF TUBERCULOSIS. of experimental science and medicine, graduating Bachelor of Science in 1882, Bachelor of Medicine in To the Editor of THE LANCET. a in 1884, and Doctor of Science in 1894. In 1880 he won to I attention statement draw Sin,—May Sir Leonard Rogers’s lectures (THE LANCET, June 28th, the Hope Prize Scholarship in organic chemistry, and p. 1297) in which he credits me with the statement four years later the Mackay-Smith scholarship in that " the addition of 3 per cent. solutions of sodium chemistry. His early scientific training made him a gynocardate, morrhuate, or oleate to a pancreatic keen observer and a most painstaking investigator. extract doubled the fat-splitting effect of the pan- When in 1894 the University of Edinburgh decided to creatic lipase on an emulsion of olive oil." The institute a public health laboratory in connexion with accelerating action of sodium oleate on lipase varies the chair of forensic medicine he was chosen by considerably according to the percentage strength of Sir Douglas Maclagan, then professor of medical the solutions used, and so far from using 3 per cent. jurisprudence, to organise and conduct the instruction strength solutions, 0-9 per cent. strength solutions in it. In 1898 he was appointed to the newly founded were used in my experiments. My statement in the Bruce and John Usher Chair of Public Health, and he " paper1 referred to by Sir Leonard Rogers is Syste- occupied that chair till his death. In 1902 he became matic investigation of sodium oleate had previously also director of the Usher Institute of Public Health, shown that the accelerating action on extract of to the planning and arranging of which he devoted pancreas varies considerably according to the per- a large amount of time and thought, the result being centage strength of the solutions used ; graduated the provision of laboratories, which at that time were amounts added to the extract show also a regarded as perhaps the finest in the country. His colleague, Dr. J. Buchanan Young, writes: rise in values up to a maximum, falling ultimately to nothing. I chose, therefore, a 0-9 per cent. solution " In experiment Prof. Stewart was resourceful, and of sodium oleate which had given good results above all accurate, and he demanded the same formerly, and the same percentage solutions of accuracy in working from those whom he trained. sodium morrhuate and sodium gynocardate, using As a young man he had worked hard, and he never 1 and 2 c.cm. amounts of these solutions." Obviously failed to impress on his students the necessity for hard the matter is of importance also in therapeutic work if success was to be attained, and he took a keen dosage. He says further that these experiments interest in following the careers of those whom he in vitro led me to suggest a stimulating action of had taught. His prolonged study in continental tissue lipolysis in part explanation of the therapeutic laboratories and his vast experience in laboratory effect of sodium morrhuate and sodium gynocardate work made him quick to appreciate improvements in on acicl-fast- bacilli, and led him to investigate -the processes and methods, but before any new methods possibility of these substances also stimulating the were introduced into his courses of instruction they production of fat-splitting lipase in the blood of had to be thoroughly tested by himself as to accuracy leprosy and tubercle cases, whereas, as a matter of of the results given. For many years he was well fact, in my paper, after giving the actual results in my known and much sought after as an expert witness experiments in vitro, I went on to say that in view of2 before the Scottish courts in river pollution cases, and the ascertained action of sodium oleate in vivo, in reference cases involving special knowledge of " To the investigations connected it would seem reasonable to infer a direct stimulating water-supply, &c. action of tissue lipolysis in, at any rate, partial with these he devoted a large amount of time and explanation of the therapeutic effect of sodium inor- energy. The number of experiments he conducted, rhuate and of sodium gynocardate, in addition to a and the amount of labour and time he expended in direct destructive action claimed for both (Rogers) satisfying himself as to the soundness of the views he or for the chaulmoogrates alone (Walker and Sweeney) expressed in evidence, were only known of by those who were associated with him in such work. His on acid-fast bacilli." I am glad to see the confirmation of the lipase favourite reply when asked if it was absolutely theory by Sir Leonard Rogers in the particular case necessary to make a certain experiment, which to the of leprosy, which I have so long pointed out and inquirer seemed somewhat troublesome, wasProve maintained in cancer, tuberculosis, and other infec- all things’ ! In later years he devoted himself largely the epidemiological and statistical departments of I may, perhaps, be permitted to tious diseases. add that in 1912 I showed that in recovered public health. His grasp of figures was marvellous, tuberculosis the lipolytic activity of the serum is and his memory for figures ratheruncanny.’ As a Somewhat later it was found to be lecturer he was emphatic in style, interesting, and increased. decreased in the acute stages, as well as (1914) in insistent on salient points. He had a quiet, somewhat T.B. infected guinea-pigs and rabbits examined in 9pawky ’ humour, and those who met him in private the bacteriological laboratory, King’s College. In my life found in him a most interesting conversationalist, culture experiments also lipase killed tubercle bacilli. willing to discuss practically any subject. During 40 years as a teacher in the University (26 of these as I am, Sir, yours faithfully, J. A. SHAW-MACKENZIE, M.D. Lond. professor of public health) he had seen many changes in the Edinburgh Medical School, and had taught a London, July 4th, 1924. I very large number of students. We who remain are 1 Med. Press and Circ., August 18th, 1920. all the poorer by his passing." 2 Proc. Physiol. Soc., Jour. Physiol., xlii., p. 11.
Obituary.
I educated
’
gradual
to
.
-
--
and
a mother informed me last winter that she unable to afford any woollen garments for her children, but stated, with evident pride, that she was able to afford a 3s. 6d. bottle a week of some lung tonic to prevent them catching colds. It is suggested that some competent body should issue a small cheap book stating exactly what is the ideal life time-table of a healthy infant, breast-fed and bottle-fed, with practical and economical advice from birth up to 2 years. I believe re clothing, &c., this would fill a much desired want on the part of mothers and welfare staffs and might obviate some of the defects of infant life which still permit a mortality of 69 per 1000 births.-I am, Sir, yours faithfully, A. G. G. THOMPSON. Southampton, July 6th, 1924.
instance, was
I i I
THE PROBABLE DUAL CONSTITUTION OF
INSULIN.
I
Similar results were obtained with white rats. The average respiratory quotient of three of these animals worked out at 0-77 in the fasting state. A hypodermic injection of two units of insulin produced a characteristic fall in the blood-sugar and a rise in the respiratory quotient to 0-82, while a hypodermic injection of 0-25 c.cm. of adrenalin was followed by an increase in the sugar-content of the blood and an average respiratory quotient of 0-82. Two units of insulin given by the mouth for three hours produced no alteration in either the percentage of sugar in the blood or in the respiratory quotient, and when 0-25 c.cm. of adrenalin was injected a quarter of an hour later there was still no change, an average respiratory quotient of 0’77 being obtained, demonstrating that in these animals, as in guinea-pigs, insulin administeredby the mouth was capable of
influencing carbohydrate metabolism, although only so far as its anti-glycogenolytic properties were concerned.
If, as these experiments indicate, the antiglycogenolytic fraction of insulin taken by the mouth enters the circulation, while the sugar-utilising fraction is destroyed, or at any rate is not absorbed, it is possible to account for the beneficial effects
To the Editor of THE LANCET. claimed to have resulted in some cases of diabetes SiR,-It has been assumed that since insulin from the oral use of crude extracts of insulin, such administered by the mouth does not induce a fall as that of Mackenzie Wallis, and from the administrain the sugar-content of the blood similar to that tion of raw pancreas, or preparations of the gland, which results when it is given intravenously or by the mouth, for the anti-glycogenolytic portion hypodermically, it has no influence upon metabolism, being effective such treatment would be likely to and is either not absorbed by the mucous membrane be helpful where the hyperglycaemia was dependent of the alimentary tract or is destroyed by the digestive upon defective storage of glycogen and there was no secretions. The metabolic experiments on animals interference with sugar utilisation. It would, however, upon which I have been engaged for some time in be of little or no value in cases in which there was association with Mr. H. A. H. Howard, B.Sc., suggest defective utilisation as well as over-production of that this conclusion is not entirely correct, for from sugar, thus explaining the failure of oral treatment observations on the respiratory quotient in a series with pancreatic preparations where actual disease of guinea-pigs and rats to which insulin had been of the pancreas existed. I am, Sir, yours faithfully, given by the mouth it was found that, although P. J. CAMMIDGE. there was no diminution in the blood-sugar, the effects 1924. July 4th, of a subsequent injection of adrenalin were counter- I acted in much the same way as in animals to which DEAFNESS IN SCHOOL-CHILDREN insulin had been administered hypodermically. It To the Editor of THE LANCET. would therefore seem that insulin may be absorbed through the walls of the alimentary tract, but that SIR,-May I, as one who has had some experience its properties are modified in the process, or, what of the needs of the deaf child in elementary schools, is more probable, a fraction which promotes the be permitted to comment upon the report of Miss utilisation of sugar by the tissues is destroyed, while E. Lowry’s paper in THE LANCET of July 5th (p. 20) ? another fraction which is able to neutralise the What I have to say may be best summed up under glycogenolytic effect of adrenalin passes into the five heads. circulation unchanged. 1. There should be more adequate provision for Six guinea-pigs, with an average fasting respiratory removal of tonsils and adenoids, both at hospitals quotient of 0-73, gave an average respiratory quotient and in school treatment centres throughout the of 081, with the usual drop in the blood-sugar, after country, and the cases operated upon should be two units of insulin had been injected subcutaneously, followed up. and 081, with increases in the blood-sugar ranging j 2. These operations should be done by experts. between 0-14 and 0-18 per cent., after a hypodermic In my experience many such operations are inadeinjection of 0’25 c.cm. of adrenalin. When insulin quately performed, and it is quite common for mothers and adrenalin were injected in succession there to state that their children’s deafness was " made was little or no change in the sugar-content of the worse " by the treatment. Moreover, it is by no blood or in the respiratory quotient if the doses means uncommon to find children who have been were correctly adjusted, showing that the hypo- operated upon not twice, but three times. In many glycaemic effect of the adrenalin had been neutralised cases, also, the operation appears to have been the by the insulin and that less carbohydrate was being be-all and end-all, the deafness being left to get well utilised than when either was given separately. by itself. In the same series of animals the administration of , 3. In school treatment centres, ear conditions should two units of insulin by the mouth at hourly intervals be treated by specialists. Harm has been done by for three hours was found to have no influence classing ear troubles as " minor ailments," which they upon the sugar-content of the blood or upon the most distinctly are not. There is no dearth of comrespiratory quotient, but when a hypodermic injection petent young specialists to take charge of these of 0’25 c.cm. of adrenalin was given 15 minutes centres. 4. Efforts should be made to deal with the child subsequently the increase in the respiratory quotient, which should have developed if the adrenalin were of pre-school age, with the definite view to preventing acting unchecked, failed to appear, the average for the conditions which lead to deafness. the six animals working out at 0-735, or practically 5. More effort should be made to discover cases of the normal fasting value. It was therefore evident early deafness in the schools. This, as I have pointed that, although insulin given by the mouth had no out repeatedly, -could be done by introducing a effect upon the sugar-content of the blood, it was whisper test during the vision-card test ; or, as in capable of preventing the glycogenolysis consequent France and Chicago, by means of games. I pointed Plea for the Deaf Child " two and a upon theintroduction of a potent dose of adrenalin this out in my into the circulation. half years ago (THE LANCET, 1922, i., 1027). These "
92 tests are best done by the teacher, whom the children know and trust, rather than by the doctor, with whom they are apt to be Hhy. Children found wanting can be handed to the medical authority for more detailed examination. Deaf children could thus be discovered CHARLES HUNTER STEWART, D.Sc., when treatment is of use and a large number of cases M.B., C.M. EDIN. of deafness could thus be prevented. At present, I these children go unrecognised, often until too late. BY the death of Dr. Charles Hunter Stewart, I may add that it is a matter of great gratification professor of public health and sanitary science and to me to find that the attention of otologists is becoming director of the John Usher Institute of Public Health, aroused to the necessity of prevention. I have been the University of Edinburgh has suffered another preaching it for the past 15 years, as has my friend loss. Although he had been in poor health for some Dr. Kerr Love in Scotland. time, his death on June 30th at his residence in I am, Sir, yours faithfully, Melville-street, Edinburgh, came quite unexpectedly. MACLEOD YEARSLEY, F.R.C.S. Prof. Stewart was born in Edinburgh in 1854, and Wimpole-street, W., July 7th, 1924. at the University of his native city, while later he studied extensively on the continent. He first underwent training as a pharmaceutist, but, RESEARCHES ON LEPROSY AND THEIR forsaking materia medica and chemical pharmacy, he BEARING ON THE TREATMENT applied himself with marked success to the study OF TUBERCULOSIS. of experimental science and medicine, graduating Bachelor of Science in 1882, Bachelor of Medicine in To the Editor of THE LANCET. a in 1884, and Doctor of Science in 1894. In 1880 he won to I attention statement draw Sin,—May Sir Leonard Rogers’s lectures (THE LANCET, June 28th, the Hope Prize Scholarship in organic chemistry, and p. 1297) in which he credits me with the statement four years later the Mackay-Smith scholarship in that " the addition of 3 per cent. solutions of sodium chemistry. His early scientific training made him a gynocardate, morrhuate, or oleate to a pancreatic keen observer and a most painstaking investigator. extract doubled the fat-splitting effect of the pan- When in 1894 the University of Edinburgh decided to creatic lipase on an emulsion of olive oil." The institute a public health laboratory in connexion with accelerating action of sodium oleate on lipase varies the chair of forensic medicine he was chosen by considerably according to the percentage strength of Sir Douglas Maclagan, then professor of medical the solutions used, and so far from using 3 per cent. jurisprudence, to organise and conduct the instruction strength solutions, 0-9 per cent. strength solutions in it. In 1898 he was appointed to the newly founded were used in my experiments. My statement in the Bruce and John Usher Chair of Public Health, and he " paper1 referred to by Sir Leonard Rogers is Syste- occupied that chair till his death. In 1902 he became matic investigation of sodium oleate had previously also director of the Usher Institute of Public Health, shown that the accelerating action on extract of to the planning and arranging of which he devoted pancreas varies considerably according to the per- a large amount of time and thought, the result being centage strength of the solutions used ; graduated the provision of laboratories, which at that time were amounts added to the extract show also a regarded as perhaps the finest in the country. His colleague, Dr. J. Buchanan Young, writes: rise in values up to a maximum, falling ultimately to nothing. I chose, therefore, a 0-9 per cent. solution " In experiment Prof. Stewart was resourceful, and of sodium oleate which had given good results above all accurate, and he demanded the same formerly, and the same percentage solutions of accuracy in working from those whom he trained. sodium morrhuate and sodium gynocardate, using As a young man he had worked hard, and he never 1 and 2 c.cm. amounts of these solutions." Obviously failed to impress on his students the necessity for hard the matter is of importance also in therapeutic work if success was to be attained, and he took a keen dosage. He says further that these experiments interest in following the careers of those whom he in vitro led me to suggest a stimulating action of had taught. His prolonged study in continental tissue lipolysis in part explanation of the therapeutic laboratories and his vast experience in laboratory effect of sodium morrhuate and sodium gynocardate work made him quick to appreciate improvements in on acicl-fast- bacilli, and led him to investigate -the processes and methods, but before any new methods possibility of these substances also stimulating the were introduced into his courses of instruction they production of fat-splitting lipase in the blood of had to be thoroughly tested by himself as to accuracy leprosy and tubercle cases, whereas, as a matter of of the results given. For many years he was well fact, in my paper, after giving the actual results in my known and much sought after as an expert witness experiments in vitro, I went on to say that in view of2 before the Scottish courts in river pollution cases, and the ascertained action of sodium oleate in vivo, in reference cases involving special knowledge of " To the investigations connected it would seem reasonable to infer a direct stimulating water-supply, &c. action of tissue lipolysis in, at any rate, partial with these he devoted a large amount of time and explanation of the therapeutic effect of sodium inor- energy. The number of experiments he conducted, rhuate and of sodium gynocardate, in addition to a and the amount of labour and time he expended in direct destructive action claimed for both (Rogers) satisfying himself as to the soundness of the views he or for the chaulmoogrates alone (Walker and Sweeney) expressed in evidence, were only known of by those who were associated with him in such work. His on acid-fast bacilli." I am glad to see the confirmation of the lipase favourite reply when asked if it was absolutely theory by Sir Leonard Rogers in the particular case necessary to make a certain experiment, which to the of leprosy, which I have so long pointed out and inquirer seemed somewhat troublesome, wasProve maintained in cancer, tuberculosis, and other infec- all things’ ! In later years he devoted himself largely the epidemiological and statistical departments of I may, perhaps, be permitted to tious diseases. add that in 1912 I showed that in recovered public health. His grasp of figures was marvellous, tuberculosis the lipolytic activity of the serum is and his memory for figures ratheruncanny.’ As a Somewhat later it was found to be lecturer he was emphatic in style, interesting, and increased. decreased in the acute stages, as well as (1914) in insistent on salient points. He had a quiet, somewhat T.B. infected guinea-pigs and rabbits examined in 9pawky ’ humour, and those who met him in private the bacteriological laboratory, King’s College. In my life found in him a most interesting conversationalist, culture experiments also lipase killed tubercle bacilli. willing to discuss practically any subject. During 40 years as a teacher in the University (26 of these as I am, Sir, yours faithfully, J. A. SHAW-MACKENZIE, M.D. Lond. professor of public health) he had seen many changes in the Edinburgh Medical School, and had taught a London, July 4th, 1924. I very large number of students. We who remain are 1 Med. Press and Circ., August 18th, 1920. all the poorer by his passing." 2 Proc. Physiol. Soc., Jour. Physiol., xlii., p. 11.
Obituary.
I educated
’
gradual
to
.
-
--