THE DUSSELDORF MEDICAL EXHIBITION.

1213 difference between the sugar content of the arterial and that of the venous blood, after ingestion of sugar the former runs for some time at On the a decidedly higher level than the latter. assumption that approximately half the right auricular blood has the same composition as that in the cubital vein from which samples for analysis are taken, it is found that almost the whole of the sugar ingested i? absorbed in the periphery. In order that this observation may be brought into line with the known function of the liver as being a storehouse for carbohydrate, the hypothesis is put forward that alimentary hyperglycaemia covers two processes-viz., (1) a hyperglycasmia caused by the sugar which is carried through the portal vein to the liver, passes this and is deposited in large amount in the peripheral tissues ; and (2) a hyperglycaemia caused by sugar carried to the peripheral tissue from the liver, but this transportation not come into action until the absorption from the intestine has ceased or almost ceased. Dr. G. Liljestrand and Dr. A. V. Sahlstedt contribute an important addition to the subject of gas diffusion through animal membranes. Using the frog’s lung they find that the rate of diffusion of gases is proportional to where V is the volume of the lung, a result which was to be expected from mathematical considerations. Temperature changes, however, affect the rates of diffusion of C02and of C2H2in a very different manner, a change of temperature from 08° to 37° hardly affecting the rate of diffusion of CO2, whilst causing a marked increase in the rate of diffusion of acetylene. These differences are so far unexplained on a physical basis, since in both gases a marked diminution in the rate of diffusion with rise in temperature was to be predicted. It is pointed out, therefore, that the solubility of each gas is probably very differently influenced by the components of the tissue forming the alveolar wall. Among other contributions of interest is one by Dr. Bj. Vimtrup on the structure of the Malpighian bodies in the human kidney. Though it has long been recognised that the glomerular tuft is divided up into several clusters of capillaries and that the visceral layer of Bowman’s capsule is reflected into the spaces between these clusters, evidence is now brought forward that each capillary loop is covered, independently of the remainder, by a reflection of this membrane. The surface at which filtration may occur thus becomes very much greater than that which the more common histological descriptions of glomerular structure would have us believe. The editors and publishers deserve congratulation on the collection in such attractive form of an interesting and stimulating series of papers

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THE DUSSELDORF MEDICAL EXHIBITION. THE great medical exhibition now being held in Dusseldorf may be fairly described as a medical Wembley. The word Gesolei, by which it is known for short, is compounded of Health (Gesundheitspflege), Social Welfare (Sociale Fursorge), and Physical Culture (Leibesiibungen), and here by every possible means these subjects are brought before the notice and imagination of the public. Prof. Arthur Schlossmann and his capable assistant, Dr. Liesegang, the moving spirits of the exhibition, are to be congratulated on the result of their efforts during the past twelve months. Here, illustrated by large-scale diagrams, maps, working models, and miniatures of hospitals, convalescent homes, health centres, and the like, are room after room and corridor after corridor filled with structures designed to illustrate every phase in the development of health insurance, public health, and preventive and curative medicine. The building and engineering trades have contributed their part and the result will interest public health officials, general practitioners, and social welfare workers. In Germany health insurance is compulsory for everyone with an income under 2250 per annum, and voluntary subscribers are accepted over this

level without income limit, with the result that privatepractice is said to have shrunk to 20 per cent. of its former extent. The great majority of German practitioners are, therefore, vitally interested in theproportion of insured funds which go to sick pay, maternity benefit, unemployment pay, maternity, hospital, and medical services. The visitor whosepatience and stamina will bear the strain can learn all these things in one day at the Dusseldorf Gesolei. Relaxation is afforded by bands, restaurants, miniaturerailway, and the whole exhibition is picturesquely situated on the banks of the Rhine. The official catalogue in German contains 420 pages of letterpress and numerous plans, while shorter explanatory pamphlets in English are available. The exhibition remains open until October. THE LATE EFFECTS OF POISON GAS. BEFORE the Disarmament Drafting Subcommitteeconcluded its labours it adopted Lord Cecil’s proposalthat the Military and Economic Subcommittees should study the effects of poisonous gases used in warfare and give an opinion as to the best means of preventing their employment in future. In such an investigation the remote effects of any gas are as important as the immediate. The nature and the degree of permanent disturbance of the respiratory and other systems that may be fairly attributed to gassing during the war is still uncertain, though a large amount of material should be available for study in all belligerent countries. In America the problem is now being attacked by an attempt to investigatethe present or recent condition of some 70,000 ex-Service men whose hospital records show that they have been gassed. The members of the Board appointed by the United States Veterans Bureau to organise the investigation include Dr. Philip, B. Matz, Chief of the Medical Research Subdivision of the Bureau; Dr. A. K. Krause, Associate Professorof Medicine, Johns Hopkins University Medical School; and Lieut.-Colonel H. L. Gilchrist, Chief of the Medical Research Division of the Chemical Warfare Service, U.S. Army. The Board is not concerned with the better-known and more immediate effect of war gases. It particularly desires information on several points :1. Does any

gassing received in action result in is relatively lasting and permanent ? 2. Does it cause lasting anatomic (pathological) changes, with or without disturbance of function (symptoms and war

disability which disability) ?

3. What organs or systems may thus be permanently affected or disturbed ? 4. What symptomatology may exist under these circumstances ? 5. If war gassing does produce relatively permanent effects, may a similar condition or conditions be produced by other agencies (diseases such as influenza, tuberculosis, effort syndrome, &c.) ? The term " lasting " or " permanent," as used above, means such late residual or remote changes that continue down to the present time and are appreciable.

Those who are in a position to cooperate in the projected study by offering impressions from their personal experience are asked to communicate with the United States Veterans Bureau, Washington, where reprints of relevant articles will also be received The most difficult point in the with appreciation. questionnaire to answer categorically will probably be No. 5. If it be found that war gassing may produce relatively permanent effects, are these of a peculiar nature or might they equally well have been produced by other agencies ? Symptoms or lesions produced by an individual chemical agent may easily be recognisable shortly after the time of injury, but after a term of years the body’s healing process, which is essentially that of absorption and fibrosis whatever the nature of the insult to the tissues, is more than likely to mask their characteristics. The existence of a late lesion pathognomonic of gassing would have to be confirmed by its demonstration