- Email: [email protected]
SCIATIC PAIN.
74 the
BESREDKA’s stimulating suggestions on immunity leucocytes and their ferments, and the humoral; begotten largely of the German school, emphasising are not his only contribution to current thought, the importance of the body fluids and the phenomenon for he appears also as the ardent advocate of an of bacteriolysis. The battles of long ago resulted in entirely new method of bacterial therapeusis. He an agreed peace, and the modern student has been maintains that the cessation of growth in bacterial brought up to believe that immunity is governed by cultures is not due to any exhaustion of the pabulum both of these influences. But it must be admitted that available-as is generally supposed-but rather to our knowledge is incomplete and our explanations the production of an antivirusinimical to the if he no in this a has worker continued field, unsatisfactory ; organisms’ growth. This view, which fits critical sense, can feel complacent about their in well with the experiments on which MARMOREK sufficiency. Part of the confusion may be due to the founded his belief in the unity of the streptococcal fact that immunological research has opened up so species, has suggested a possible means of treatment. many paths for investigation, and has produced so In superficial infections, such as those caused by the many useful by-products in the way of clinical tests, pyogenic cocci, he recommends the use of dressings that the main issue has been clouded in the complexities soaked in filtered cultures, and it is said that excellent introduced by elaborate- technique. It is the merit of results have been obtained. The opinions which more recent workers, and of BESREDKA in particular, we have here briefly summarised are expressed at that they have once again drawn attention to the length in a monograph on local immunisation, written main problem of the antagonism between the living by BESREDKA and recently translated into English.2. In it the bacteriologist and the student of medicine in body and the invading organism. The earlier and more important of BESREDKA’S its broad aspect will find an abundance of novel ideas. theses is now generally known. The body defends with a strong infusion of commonsense. He will also itself, he considers, not so much by a general reaction find much that is slipshod and uncritical, but this does common to many tissues, as by a local reaction in the not mean that the claims do not deserve careful tissue which is primarily the seat of disease and examination and independent repetition, by which through which the organism normally gains entrance. alone their worth can be decided. This tissue, different in different diseases, he regards as both susceptible to invasion and capable of acquiring an immune state, a theory which has been SCIATIC PAIN. mainly based on the phenomena of infection by I in which it it is is essential AMONGST painful diseases sciatica occupies a anthrax, held, disease, that the skin shall first be invaded if infection is to foremost place, by reason of its prevalence, of its occur. Experiments have been produced and multi- production by a great variety of conditions, of the plied which go to show that if anthrax bacilli be great disablement it may produce, and of its tendency introduced into the body without infection of the skin to relapse. These have led to its recognition as one the animal will survive their attack. Conversely no of the great scourges of humanity. It was in these immunity results from infection which avoids the words that Prof. VITTORIO PUTTI introduced his skin, whereas " solid " immunity can be given to new conceptions in the pathogenesis of sciatic pain animals-and even, apparently, to such susceptible when delivering the Lady Jones Lecture at Liverpool creatures as the guinea-pig-if the virus is applied to the skin in such a way as to produce a mild local a few weeks ago.3 This lecture appears at length in our lesion. Such ideas present a point of view somewhat present issue. Prof. PUTTI’S unparalleled experience fashionable in France at the moment, finding an echo at the Bologna Orthopaedic Institute, of which he in LEVADITI’s contentions about the "neurotropic has charge, and his great reputation as a technician dermatoses," and their logical extension suggests that will ensure a respectful hearing for unfamiliar views.4 immunity to superficial and septic infections can be Continental writers, it has been recently remarked,4 secured by dermal inoculation, whilst resistance to lay great stress on the association of spinal arthritis typhoidal and dysenteric disease is to be sought with sciatic neuritis ; the occurrence of bony union through local immunisation of the intestinal mucosa between the transverse processes of the fifth lumbar with vaccines given by the mouth. In connexion vertebra and the sacrum, known abroad as sacralisawith this subject attention may be drawn to some tion, has been credited with a great variety of extremely interesting observations made by D. B. painful affections of the lower limbs. Dr. HENRI "
BLACKLOCK and R. M. GORDON upon an allied phenomenon in metazoal infections, and recently described in our columns.1 They found that in animals experimentally infected with larvae of a fly, Cordy7obia anthropophaga, which can penetrate and exist in the skin, giving rise to boils, a definite degree of immunity follows upon a first infection. This appears from their experiments to be an example of tissue immunity localised in the skin and most pronounced in the area in which the initial infection was produced, although diffusing to the rest of the epidermis. Our knowledge of immunity in metazoal infection is so fragmentary that this contribution deserves grateful attention. At the same time, as the authors state, there is some indirect evidence that the immune state, even if conferred by the skin, may be dependent upon the general metabolic exchanges, since grafts of skin from a susceptible individual eventually become immune when implanted in the body of a resistant animal. 1
THE
LANCET, April 30th, p. 923.
some of last month before the Paris Medical Society of Hospitals ó ; in them there was not only fusion of the last lumbar vertebra with the sacrum,. but the twelfth rib was missing, an observation which Dr. he would like others to note and confirm. DuFoun is inclined to regard Sacralisation as by no means a rarity, although it will be seen that Prof. PUTTI does not regard it as a frequent or potent cause of sciatica. The last lumbar vertebra is on the Bologna showing very liable to congenital variation ;i the foramen between it and the sacrum is the smallest of the series of openings transmitting spinal nerves-, the vertebra itself is exposed more than any other to
DuFOUR, of the Hopital Broussais, brought these
2
cases
Local Immunization.
By Prof. A. Besredka, Pasteur Edited and translated by Dr. Harry Plotz, Pasteur Institute, Paris. London: Baillière, Tindall and Cox. 1927. Pp. 181. 16s. 3 THE LANCET, March 12th, p. 557. 4 J. H. Anderson, Ibid., April 16th, p. 837. 5 Bull. et Mém. de la Soc. Méd. des Hôpitaux, June 23rd, Institute, Paris.
1927, p. 922.
75 the sort of compression and strain which may set Herein, according to Prof. up arthritic processes. PUTTI, lies the explanation of the frequency of nervous involvement in this region. We are not aware Ne quid nimis." of any extensive X ray examination of such cases in this country which would throw light on the Bologna THE "CHEMIST AND DRUGGIST." findings, but marked changes have often been found on of WE the muscular and fibrous tissue offer our congratulation to the Chemist and attached palpation to the spine long before any bony change has become Druggist on the production of a special number (June 25th, 1927) which can be described as a triumph apparent on the X ray screen. In another region of of trade journalism. Not even in the United States the spinal column, Dr. HENRI FoRESTIER, of Aix-les- of America, where they do these things so well, do Bains, recalls attention to the nodules and thickenings, they produce anything better than this ; and when frequently found in the neighbourhood of the cervical we consider that this large volume-too large to be vertebrae in patients complaining of chronic headache sent through the post-was delivered to its suband neuralgic pains, described many years ago by scribers at almost the usual time on the ordinary of publication, and this without impairing the ,Prof. R. STOCKMAN, of Edinburgh. It should prove day of its market we think the ediup-to-dateness possible by some special method of screening to torial staff, the printers andnews, publishers have done demonstrate changes such as these on the radiogram. of which they can be justly proud. The Spondylitis, when clearly marked by bony change something Chemist and Drugg’ist was, we believe, one of the visible on the screen, is already a late stage in the if not the first, trade paper to be produced in condition. Whatever may be its earliest manifestation first, this country ; there were, of course, scientific and -and much more study of the subject is required journals in being a considerable time before a definite opinion can be given-the work at our Cannon-street contemporary issued its the Bologna Institute is instructive in explaining before as for instance (not to mention ourhow vertebral abnormality may cause pressure on first number, the Pharmaceutical Journal, which at that selves) But the nerves in the intervertebral foramina. if our recollection is right, was devoted almost question still remains, Is this pressure sufficient in time, to the scientific side of pharmacy. To the entirely itself to produce sciatica ? Prof. PUTTI seems to Chemist and Druggist, however, belongs the honour hold that the congenital abnormality produces of being a pioneer of trade journalism. We underarthritis which in turn leads to sciatic pain, but he does not make it quite clear whether the congenital stand that this special number synchronises with the retirement from the editorial chair of Mr. S. W. abnormality may be present without giving rise to Woolley, who has been editor of the Chemist and arthritis. Clinicians in this country are familiar for some ten years ; in this his final contrienough with cases of spinal arthritis in which the Druggist bution to the chemists’ library he has certainly left of evidence spondylitis is convincing but in which no behind him a monument. Mr. Woolley has, we pain is referred to the endings of the sciatic nerve. believe, for many years been a student of times past, It seems likely that in addition to the congenital and from time to time has given his readers the abnormality which Prof. PUTTI demonstrates so benefit of his searches in old book shops and libraries clearly there is a superadded factor of infection and museums both at home and in continental somewhere in the body, for there is evidence that countries. Evidence of the patience and diligence removal of a chronic source of infection may cure with which he has pursued his hobby is to be found sciatica even though the spinal arthritis persists. In in some of the articles in his last special number. For recalcitrant cases, however, the publication of Prof. there is an historical sketch running to PUTTI’S experience should certainly lead to a trial instance, some 12 pages, the illustrations, as well of course as of the treatment which he recommends-namely, the text, in which will no doubt be preserved by activehypersemia with mobilisation of the lumbar every chemist who receives a copy of the paper. spine. There are, for example, reproduced in colours four vellum leaves from the beautiful MS. prepared at FELLOWSHIP OF MEDICINE AND POST-GRADUATE Constantinople in 512 A.D. for Juliana Anicia, MEDICAL ASSOCIATION.-Dr. A. C. Roxburgh will give a daughter of the Emperor Flavius Anicius Olybrius. special demonstration at the In-Patient Department of Then, again, the Arabesque border on the first page St. John’s Hospital for Diseases of the Skin (262, Uxbridge- of the article is from a of the Galen MS. at road, London, W. 14), on July 12th, at 2.30 P.M. On July Dresden. Indeed, the page abounds with paper reproa 5 will on at Mr. G. Viner lecture 15th, P.M., give Epiphora at the Royal Westminster Ophthalmic Hospital; and on ductions of priceless frontispieces : volumes in the the same date Mr. Archer Ryland will demonstrate at the Vatican Library, the British Museum, the National Central London Throat, Nose and Ear Hospital at 10 A.M. Library at Turin, and so on have been utilised by the ’Those desirous of attending this latter demonstration are block maker in a most skilful way. This is only asked to notify the hospital-Museum 1539. All these to mention one section of the number; equally demonstrations are free to members of the medical proof perusal are the illustrated article on the fession. From July llth to 16th the St. Mark’s Hospital worthy used by the ancient druggists and the metal utensils staff will undertake a special course occupying six afternoons and three mornings, and including lectures, operations, entertaining, not to say amusing, anecdotes about X ray and pathological demonstrations. Also beginning quacks of old.
Annotations. "
professional
llth is a two weeks’ vacation course at the Prince of Wales’s General Hospital, Tottenham, which will include instruction in medicine, surgery, and the specialties. The formal lectures at 4.30 are open to members of the Fellowship of Medicine. A four weeks’ course in neurology at the West End Hospital started on July 4th, consisting of lecture-demonstrations at 5 P.M. daily. From July 13th to 30th a course in infectious fevers will be held at the Park Hospital, Hither Green, S.E. Instruction will be given on Wednesdays at 2.30 P.M., and on Saturdays at 11 A.lBI. Two special courses will take place in August-one on Diseases of Infants at the Infants Hospital, from August 8th to 20th, and one on Medicine, Surgery, and the Specialties, at the Queen Mary’s Hospital, from August 29th to Sept. 10th. A general course of work. for which a separate programme is issued, is also provided by the Fellowship at the associated hospitals. Copies of all syllabuses and of the Post-Graduate Medical Journal are obtainable from the Fellowship of .:Medicine, 1, Wimpole-street, London, W. on
July
the
____
INHERITANCE FACTOR IN TUBERCULOSIS. THE detailed schedules of over 4000 consecutive patients who first attended the tuberculosis institutions in the City of Belfast from 1914 to 1917 are the material from which Dr. Percy Stocks, inspired by Earl Pearson, has compiled a studyof the inheritance factor in tuberculosis. Dr. Stocks has deduced rates of active tuberculosis among brothers and sisters of those tuberculous patients by sex and age-groups ; the ages of non-tuberculous brothers THE
Prof.
1 Fresh Evidence
I
i I
on
the Inheritance Factor in Tuberculosis.
By Percy Stocks, M.D., Medical Officer, Galton Laboratory, University of London. From Annals of Eugenics, vol. ii., Parts 1 and 2, April, 1927. Cambridge University Press.
BESREDKA’s stimulating suggestions on immunity leucocytes and their ferments, and the humoral; begotten largely of the German school, emphasising are not his only contribution to current thought, the importance of the body fluids and the phenomenon for he appears also as the ardent advocate of an of bacteriolysis. The battles of long ago resulted in entirely new method of bacterial therapeusis. He an agreed peace, and the modern student has been maintains that the cessation of growth in bacterial brought up to believe that immunity is governed by cultures is not due to any exhaustion of the pabulum both of these influences. But it must be admitted that available-as is generally supposed-but rather to our knowledge is incomplete and our explanations the production of an antivirusinimical to the if he no in this a has worker continued field, unsatisfactory ; organisms’ growth. This view, which fits critical sense, can feel complacent about their in well with the experiments on which MARMOREK sufficiency. Part of the confusion may be due to the founded his belief in the unity of the streptococcal fact that immunological research has opened up so species, has suggested a possible means of treatment. many paths for investigation, and has produced so In superficial infections, such as those caused by the many useful by-products in the way of clinical tests, pyogenic cocci, he recommends the use of dressings that the main issue has been clouded in the complexities soaked in filtered cultures, and it is said that excellent introduced by elaborate- technique. It is the merit of results have been obtained. The opinions which more recent workers, and of BESREDKA in particular, we have here briefly summarised are expressed at that they have once again drawn attention to the length in a monograph on local immunisation, written main problem of the antagonism between the living by BESREDKA and recently translated into English.2. In it the bacteriologist and the student of medicine in body and the invading organism. The earlier and more important of BESREDKA’S its broad aspect will find an abundance of novel ideas. theses is now generally known. The body defends with a strong infusion of commonsense. He will also itself, he considers, not so much by a general reaction find much that is slipshod and uncritical, but this does common to many tissues, as by a local reaction in the not mean that the claims do not deserve careful tissue which is primarily the seat of disease and examination and independent repetition, by which through which the organism normally gains entrance. alone their worth can be decided. This tissue, different in different diseases, he regards as both susceptible to invasion and capable of acquiring an immune state, a theory which has been SCIATIC PAIN. mainly based on the phenomena of infection by I in which it it is is essential AMONGST painful diseases sciatica occupies a anthrax, held, disease, that the skin shall first be invaded if infection is to foremost place, by reason of its prevalence, of its occur. Experiments have been produced and multi- production by a great variety of conditions, of the plied which go to show that if anthrax bacilli be great disablement it may produce, and of its tendency introduced into the body without infection of the skin to relapse. These have led to its recognition as one the animal will survive their attack. Conversely no of the great scourges of humanity. It was in these immunity results from infection which avoids the words that Prof. VITTORIO PUTTI introduced his skin, whereas " solid " immunity can be given to new conceptions in the pathogenesis of sciatic pain animals-and even, apparently, to such susceptible when delivering the Lady Jones Lecture at Liverpool creatures as the guinea-pig-if the virus is applied to the skin in such a way as to produce a mild local a few weeks ago.3 This lecture appears at length in our lesion. Such ideas present a point of view somewhat present issue. Prof. PUTTI’S unparalleled experience fashionable in France at the moment, finding an echo at the Bologna Orthopaedic Institute, of which he in LEVADITI’s contentions about the "neurotropic has charge, and his great reputation as a technician dermatoses," and their logical extension suggests that will ensure a respectful hearing for unfamiliar views.4 immunity to superficial and septic infections can be Continental writers, it has been recently remarked,4 secured by dermal inoculation, whilst resistance to lay great stress on the association of spinal arthritis typhoidal and dysenteric disease is to be sought with sciatic neuritis ; the occurrence of bony union through local immunisation of the intestinal mucosa between the transverse processes of the fifth lumbar with vaccines given by the mouth. In connexion vertebra and the sacrum, known abroad as sacralisawith this subject attention may be drawn to some tion, has been credited with a great variety of extremely interesting observations made by D. B. painful affections of the lower limbs. Dr. HENRI "
BLACKLOCK and R. M. GORDON upon an allied phenomenon in metazoal infections, and recently described in our columns.1 They found that in animals experimentally infected with larvae of a fly, Cordy7obia anthropophaga, which can penetrate and exist in the skin, giving rise to boils, a definite degree of immunity follows upon a first infection. This appears from their experiments to be an example of tissue immunity localised in the skin and most pronounced in the area in which the initial infection was produced, although diffusing to the rest of the epidermis. Our knowledge of immunity in metazoal infection is so fragmentary that this contribution deserves grateful attention. At the same time, as the authors state, there is some indirect evidence that the immune state, even if conferred by the skin, may be dependent upon the general metabolic exchanges, since grafts of skin from a susceptible individual eventually become immune when implanted in the body of a resistant animal. 1
THE
LANCET, April 30th, p. 923.
some of last month before the Paris Medical Society of Hospitals ó ; in them there was not only fusion of the last lumbar vertebra with the sacrum,. but the twelfth rib was missing, an observation which Dr. he would like others to note and confirm. DuFoun is inclined to regard Sacralisation as by no means a rarity, although it will be seen that Prof. PUTTI does not regard it as a frequent or potent cause of sciatica. The last lumbar vertebra is on the Bologna showing very liable to congenital variation ;i the foramen between it and the sacrum is the smallest of the series of openings transmitting spinal nerves-, the vertebra itself is exposed more than any other to
DuFOUR, of the Hopital Broussais, brought these
2
cases
Local Immunization.
By Prof. A. Besredka, Pasteur Edited and translated by Dr. Harry Plotz, Pasteur Institute, Paris. London: Baillière, Tindall and Cox. 1927. Pp. 181. 16s. 3 THE LANCET, March 12th, p. 557. 4 J. H. Anderson, Ibid., April 16th, p. 837. 5 Bull. et Mém. de la Soc. Méd. des Hôpitaux, June 23rd, Institute, Paris.
1927, p. 922.
75 the sort of compression and strain which may set Herein, according to Prof. up arthritic processes. PUTTI, lies the explanation of the frequency of nervous involvement in this region. We are not aware Ne quid nimis." of any extensive X ray examination of such cases in this country which would throw light on the Bologna THE "CHEMIST AND DRUGGIST." findings, but marked changes have often been found on of WE the muscular and fibrous tissue offer our congratulation to the Chemist and attached palpation to the spine long before any bony change has become Druggist on the production of a special number (June 25th, 1927) which can be described as a triumph apparent on the X ray screen. In another region of of trade journalism. Not even in the United States the spinal column, Dr. HENRI FoRESTIER, of Aix-les- of America, where they do these things so well, do Bains, recalls attention to the nodules and thickenings, they produce anything better than this ; and when frequently found in the neighbourhood of the cervical we consider that this large volume-too large to be vertebrae in patients complaining of chronic headache sent through the post-was delivered to its suband neuralgic pains, described many years ago by scribers at almost the usual time on the ordinary of publication, and this without impairing the ,Prof. R. STOCKMAN, of Edinburgh. It should prove day of its market we think the ediup-to-dateness possible by some special method of screening to torial staff, the printers andnews, publishers have done demonstrate changes such as these on the radiogram. of which they can be justly proud. The Spondylitis, when clearly marked by bony change something Chemist and Drugg’ist was, we believe, one of the visible on the screen, is already a late stage in the if not the first, trade paper to be produced in condition. Whatever may be its earliest manifestation first, this country ; there were, of course, scientific and -and much more study of the subject is required journals in being a considerable time before a definite opinion can be given-the work at our Cannon-street contemporary issued its the Bologna Institute is instructive in explaining before as for instance (not to mention ourhow vertebral abnormality may cause pressure on first number, the Pharmaceutical Journal, which at that selves) But the nerves in the intervertebral foramina. if our recollection is right, was devoted almost question still remains, Is this pressure sufficient in time, to the scientific side of pharmacy. To the entirely itself to produce sciatica ? Prof. PUTTI seems to Chemist and Druggist, however, belongs the honour hold that the congenital abnormality produces of being a pioneer of trade journalism. We underarthritis which in turn leads to sciatic pain, but he does not make it quite clear whether the congenital stand that this special number synchronises with the retirement from the editorial chair of Mr. S. W. abnormality may be present without giving rise to Woolley, who has been editor of the Chemist and arthritis. Clinicians in this country are familiar for some ten years ; in this his final contrienough with cases of spinal arthritis in which the Druggist bution to the chemists’ library he has certainly left of evidence spondylitis is convincing but in which no behind him a monument. Mr. Woolley has, we pain is referred to the endings of the sciatic nerve. believe, for many years been a student of times past, It seems likely that in addition to the congenital and from time to time has given his readers the abnormality which Prof. PUTTI demonstrates so benefit of his searches in old book shops and libraries clearly there is a superadded factor of infection and museums both at home and in continental somewhere in the body, for there is evidence that countries. Evidence of the patience and diligence removal of a chronic source of infection may cure with which he has pursued his hobby is to be found sciatica even though the spinal arthritis persists. In in some of the articles in his last special number. For recalcitrant cases, however, the publication of Prof. there is an historical sketch running to PUTTI’S experience should certainly lead to a trial instance, some 12 pages, the illustrations, as well of course as of the treatment which he recommends-namely, the text, in which will no doubt be preserved by activehypersemia with mobilisation of the lumbar every chemist who receives a copy of the paper. spine. There are, for example, reproduced in colours four vellum leaves from the beautiful MS. prepared at FELLOWSHIP OF MEDICINE AND POST-GRADUATE Constantinople in 512 A.D. for Juliana Anicia, MEDICAL ASSOCIATION.-Dr. A. C. Roxburgh will give a daughter of the Emperor Flavius Anicius Olybrius. special demonstration at the In-Patient Department of Then, again, the Arabesque border on the first page St. John’s Hospital for Diseases of the Skin (262, Uxbridge- of the article is from a of the Galen MS. at road, London, W. 14), on July 12th, at 2.30 P.M. On July Dresden. Indeed, the page abounds with paper reproa 5 will on at Mr. G. Viner lecture 15th, P.M., give Epiphora at the Royal Westminster Ophthalmic Hospital; and on ductions of priceless frontispieces : volumes in the the same date Mr. Archer Ryland will demonstrate at the Vatican Library, the British Museum, the National Central London Throat, Nose and Ear Hospital at 10 A.M. Library at Turin, and so on have been utilised by the ’Those desirous of attending this latter demonstration are block maker in a most skilful way. This is only asked to notify the hospital-Museum 1539. All these to mention one section of the number; equally demonstrations are free to members of the medical proof perusal are the illustrated article on the fession. From July llth to 16th the St. Mark’s Hospital worthy used by the ancient druggists and the metal utensils staff will undertake a special course occupying six afternoons and three mornings, and including lectures, operations, entertaining, not to say amusing, anecdotes about X ray and pathological demonstrations. Also beginning quacks of old.
Annotations. "
professional
llth is a two weeks’ vacation course at the Prince of Wales’s General Hospital, Tottenham, which will include instruction in medicine, surgery, and the specialties. The formal lectures at 4.30 are open to members of the Fellowship of Medicine. A four weeks’ course in neurology at the West End Hospital started on July 4th, consisting of lecture-demonstrations at 5 P.M. daily. From July 13th to 30th a course in infectious fevers will be held at the Park Hospital, Hither Green, S.E. Instruction will be given on Wednesdays at 2.30 P.M., and on Saturdays at 11 A.lBI. Two special courses will take place in August-one on Diseases of Infants at the Infants Hospital, from August 8th to 20th, and one on Medicine, Surgery, and the Specialties, at the Queen Mary’s Hospital, from August 29th to Sept. 10th. A general course of work. for which a separate programme is issued, is also provided by the Fellowship at the associated hospitals. Copies of all syllabuses and of the Post-Graduate Medical Journal are obtainable from the Fellowship of .:Medicine, 1, Wimpole-street, London, W. on
July
the
____
INHERITANCE FACTOR IN TUBERCULOSIS. THE detailed schedules of over 4000 consecutive patients who first attended the tuberculosis institutions in the City of Belfast from 1914 to 1917 are the material from which Dr. Percy Stocks, inspired by Earl Pearson, has compiled a studyof the inheritance factor in tuberculosis. Dr. Stocks has deduced rates of active tuberculosis among brothers and sisters of those tuberculous patients by sex and age-groups ; the ages of non-tuberculous brothers THE
Prof.
1 Fresh Evidence
I
i I
on
the Inheritance Factor in Tuberculosis.
By Percy Stocks, M.D., Medical Officer, Galton Laboratory, University of London. From Annals of Eugenics, vol. ii., Parts 1 and 2, April, 1927. Cambridge University Press.