THE HORSE IN WAR.

1168 my invitation to speak at Toronto. There I was welcomed by Prof. W. E. Gallie, and his band of keen assistants, and I had an opportunity of seeing his work in the General Hospital and in the large, magnificently equipped private block. End-results of cases of lumbar sympathectomy, and cases of repair by living fascial grafts were among many of uncommon interest. Dr. Gilbert Parker, the Secretary of the Academy of Medicine, had arranged an enthusiastic audience of some 250, to whom I spoke and showed my film. No less hearty was the hospitality extended to me the following day by Dr. Edward Archibald, professor of surgery in Montreal, and his associates, amongst whom were Dr. Scrimgeour, Dr. Miller, and Dr. William Moffatt. The main lecture hall of McGill University was placed at my disposal for a late afternoon meeting, and I was honoured by the presence of a large audience. As in the United States, so in Canada, everyone I met went out of his way to show me everything of interest and to extend every possible, often overwhelming, hospitality. The memory of these 14 hectic days in North America will amply repay the 10,000 miles of travel, and the inspiration received from the English-speaking giants of our profession beyond the seas will last a lifetime.

adoption.

DETECTION AND MEASUREMENT OF DEAFNESS IN SCHOOL-CHILDREN. SOME two years ago, when reviewing an important book on " Speech and Hearing," by Dr. Harvey Fletcher, director of acoustical research to the Bell Telephone Laboratories,l we remarked that the audiometer would probably be in general use by otologists in the near future, and commented on the value of the gramophone type of audiometer for testing large groups to discover those whose hearing is deficient for speech, mentioning that, at its trial in a school in New York City, 40 pupils could be tested at a time and about 100 in an hour. We are glad to note that this instrument has been adopted in this country, for Dr. G. P. Crowden and Dr. A. H. Gale have reported2 that it has been employed in the examination of some 1500 children in the borough of Hornsey. The type of apparatus employed was the 4-A type gramophone audiometer, supplied by the Western Electric Company, and the outcome of extended experiments and practical trials by the technical staff of the Bell Telephone Laboratories. It consists of a gramophone with a magnetic pick-up, by which the sound is transmitted to a number of single headphones. The unit of intensity adopted is the decibel, which is the smallest change perceptible to the normal ear; the normal, or zero, level was determined by preliminary experiments in America, and the intensity of the voice sounds is graded down in 12 steps of three decibels each from 30 above to three below the zero level. On the record employed, each step consists of four series of three figures spoken in the ordinary voice. The normal of hearing doubtless varies within physiological limits, but it is found that children with a loss of nine or more decibels usually have some abnormal condition. Each ear is tested separately, and children who show this degree of loss are tested again to eliminate nervousness. The audiometer is a far more delicate test than the watch or the whisper ; it examines the hearing for ordinary spoken words, which is the important function to be tested, and it eliminates the error due to lipreading. It is not intended for use by the medical officer at his routine examination, but may be undertaken by the school nurse or teacher, and the children showing defective hearing set aside for his examination. With a little care on the part of the examiner to avoid haste and to interest the children, it is a thoroughly reliable method of testing a large number 1

2

THE LANCET, 1929, ii., 615. Med. Officer, Sept. 13th, 1930, p. 113.

of children in a uniform manner. The authorities concerned should seriously consider its general HOUSE APPOINTMENTS AT L.C.C. HOSPITALS. THE question of the shortage of house physicians and house surgeons in London County Council general hospitals was raised at a recent meeting of the Council by Dr. C. W. Brook, who asked the chairman of the central public health committee: (1) whether any difficulty had been experienced in securing the services of suitable registered medical practitioners to act in both capacities ; (2) whether the monetary remuneration attached to these posts was only £80 per annum ; (3) whether, in view of the fact that many voluntary hospitals with established reputa. tions were paying salaries of at least £150 to £200 per annum to members of their junior medical staffs, an early increase in the salaries paid to house physicians and house surgeons at general hospitals would be considered ; and (4) what was the remuneration offered and paid to a locum tenens acting as house physician or house surgeon pending the filling of any vacancy that might arise ? Dr. Barrie Lambert (chairman of the committee) answered " Yes " to the first question. She said that the remuneration was £80 a year, plus full residential emoluments, and that a substantial amount of time is allowed weekly for post-graduate study. The scheme for the appointment of residents in the Council’s hospitals is, she said, experimental, and was devised in order to provide hospital experience for those who are newly qualified and had held no previous hospital appointment. It has not yet been in operation long enough to judge whether or not the appointments meet a need. Posts in voluntary hospitals, where the duties are analogous to those of house surgeon and house physician in the Council’s hospitals, usually carry only a small salary, often lower than £80 a year. The posts in the Council’s hospitals which correspond to those mentioned in question 3 are junior assistant medical officers with a salary of £250 a year, together with full residential emoluments. No special rate of pay, said Dr. Lambert, has been fixed for a locum tenens. In one case only has it been necessary to engage a locum tenens for a house physician or house surgeon, and in this case the salary was £6 6s. a week, plus full residential

emoluments. THE HORSE IN WAR. AT one period in France the British Expeditionary Force possessed roughly 475,000 horses and mules, and the total wastage from death, destruction, and missing amounted to approximately 250,000 up to the end of December, 1918. On the whole more than 750,000 animals took part in the war, and there is a case to be made out for the statement that the inability of Germany to acquire suitable horsesas exemplified by the retreat of her Grand Army with mixed teams of oxen and horses-was responsible for her failure. A pamphlet written by MajorGeneral Sir John Moore,1late Director of Veterinary Services to the British Expeditionary Force in France, tells the story of the war service of the horse. A chapter on sickness and wastage describes the diseases from which horses in France suffered, and another on veterinary services gives an account of the hospitals and ambulances and their work. The story is of great interest not only to those who like horses but also to students of war. It ends with an appeal that equine members of our fighting forces should have their own memorial in endowed chairs or wards in recognised veterinary teaching institutions-and particularly at the Royal Veterinary College in Camden Town, where a special fund has been opened for the purpose. The proceeds of the sale of the pamphlet are dedicated to this excellent

project. 1 Our Servant the Horse. H. and W. Brown, 20, Fulhamroad, S.W.3. 1931. Pp. 32.