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bleeding from her mouth and the stools were blood-stained. IAt the end of January her scalp suddenly became swollen, asdid also her eyelids. In this condition she was taken tothe surgical section of a hospital, where she was kept underobservation until Feb. 12th. The diagnosis was hsematoma.capitis. The swelling diminished visibly after the applica-tion of wet compresses, so that at the time of her dischargefrom th3 hospital no tumour could be felt. On Feb. 2&thshe was again taken to the hospital. She then lookeddelicate and was very ill developed, but there were nocharacteristic signs of rachitis. The shafts of the left

thigh-bone and the left tibia were enlarged and on palpa-tion hard, irregular swellings could be felt. Over both

parietal regions of the skull there was a swelling, throughwhich, on deep pressure, the sparsely covered bone could befelt. Both the upper and the lower eyelids were generallyof a bluish-red colour. From these symptoms the diagnosisof Barlow’s disease was established. The following sym-ptoms were especially characteristic : rapid development,pains in the limbs, subperiosteal hemorrhages over the longbones and the bones of the skull, and haemorrhages from themouth and the bowel.

The Ears of School C7til(Zren.At a recent meeting of the medical society of a consider-

able country town in Hungary a school medical officerpresented an interesting report on the examination of theears of 1000 school children. The investigation was under-taken with the objects of ascertaining the amount of eardisease in children of the poorest class, and if necessary ofdrawing attention to the subject. For the purpose of thisinspection ears were considered to be normal when themembranes presented the usual appearance and the whispered.voice could be heard at a distance of from eight to 12 metres.Inability to pass this test with one or both ears was presentin 634 out of 1000 children. Foreign bodes were found inthe ears of 16 children, of whom 13 were girls. Of 107cases of deafness there were adenoids in 91 ; 270 of thetotal number of children had a discharge from one or bothears and in 74 cases the discharge was suppurative. Thenumber who had previously suffered from middle ear dis-charge was 219 and of these 183 had adenoids, and perfora-tion existed in 49, while adenoids occurred in 416 children,of whom 387 presented some aural troubles.

A New VTet7od of Percussion.It is well known that among men similarly trained some

are more expert than others in the use of percussion as Ia means of diagnosis. This shows that even in such asimple matter there is room for the exercise of skill.A common error in employing percussion is for the band tobe laid flat upon the surface to be examined ; this has theeffect of diminishing the resonance, and the proper methodis to place only the extremity of the " anvil finger " on thesurface to be examined. An improvement has been suggestedby Dr. Janos Plesch, a Budapest practitioner. Instead of

placing the hand on the surface in the manner just describedhe flexes the middle finger of the right hand at a right angleat the joint between the first and second phalanges, only thepulp of the finger being brought into contact with thesurface, by forcibly extending the joint between the secondand third phalanges. Percussion is then practised on thelower epiphysis of the first phalanx. This it is claimed givesa clearer resonance and has the advantage of enabling theobserver to limit his investigation to a smaller area of thesurface. In abdominal percussion this method is less dis-turbing to the patient than when the flat of the hand isapplied to the surface.May 13th.

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NOTES FROM INDIA.(FROM OUR SPECIAL CORRESPONDENT.)

The Appallir/g Nortality from Plagtte.BESIDES the appalling mortality from plague there is

little of medical interest to record. For the week endingApril 13th 87,561 cases with 75,472 deaths were reported.This is an increase of some 14,000 cases and 12,000 deathsover the previous week. The Punjab heads the list with45,296 cases and 39,084 deaths ; then following are : United.Provinces, 27,236 cases and 23,948 deaths ; Bengal, 7915<cases and 7092 deaths ; Bombay, 4092 cases and 2981-deaths.; Central Provinces, 1218 deaths; and Rajputana,

348 deaths. , Besides these weekly returns it is of interestto calculate the recorded mortality from the present epidemic’of plague since its commencement. From October, 1896, toDec. 31st, 1906, the total deaths reported have been 4,411,242,and during the first three months of the present year noless than 495,000 deaths have been known to occur. The

mortality has fluctuated greatly :-In 1901 there were reported 274,0C0 deaths.1902 " 57,000 "

1903 " 851,000 "

1904 ., 1,022,000 "

,; 1905 " " 951,000 "

" 1906" " 332,000 "

With the intensely severe recrudescence which has occurredduring the present year, especially in the north-westportion of India, even the highest of these figuresmay be exceeded. It will be noticed that the BombayPresidency now takes a much better place than formerlyand it would almost seem as if - the disease were

dying out gradually in that province. On the otherband, it must not be supposed that the official figuresare accurate. The returns of plague in many places donot account for the whole of the increased mortality, andif that can be clearly shown for places where the registra-tion of deaths is fairly correct it is reasonable to assume thatplague carries off many more victims than the above figuresshow. In addition to plague there has been an increasedmortality from all other causes. The death-rate for the wholeof India has increased steadily during the past five years-viz., from 29 per 1000 in 1901 to 36 per 1000 in 1905. Whenit is found, however, that Madras recorded the low rate of21’ 4 during 1905 one looks with suspicion upon the returns,notwithstanding that this province is practically free fromplague. Amidst these unsatisfactory returns Calcutta takesa comparatively enviable position. The plague returns fromthis city, which has now been infected for over nine years,are very small compared with other places. It is urue thatover 50,000 people have died in the city, but this is a smallnumber in all the circumstances. Last year there were

only 2600 deaths and the recrudescence this year, thoughsomewhat more severe than that of 1906, is less than halfthe severity of that of 1905. It has been noticed during thepresent outbreak that the average duration of each fatal caseis about five days.

Tile Plag1w Department in Cczleutta.The question of the amalgamation of the plague depart-

ment in Calcutta with that of the health department ofthe corporation is again up for discussion. Up to the

present the plague department has been under the

Bengal Government and has been worked smoothlyand satisfactorily. Motives of economy occasionallysway the corporation and it is supposed that by takingover the subordinate staff of the plague department allthe previous work of the two departments can be accom-plished by the health department. The opportunity is beingtaken also of improving the status of the district healthofficers and of introducing new men. In the long run verylittle expense will be saved but if the new health officersand the new district officers are suitable men the transferenceof the plague department may be successful. It is the

general opinion that the change if made with the existingstaff would be disastrous.April 26th.

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Obituary.SAMUEL LODGE, L.R.C.P. EDIN., M.R.C.S. EJm.

Mr. Samuel Lodge of Bradford, Yorkshire, died at hisresidence in that city on May 9th at the age of 83 years,during 25 of which he had held the position of policesurgeon. He had been for a much longer time one of thepoor-law medical officers and had been in receipt of a retiringallowance in that capacity for several years before his death.Mr. Lodge was the oldest medical practitioner in the cityand with his departure the chief representative of whatmay be called the old school medical practitioner hasdisappeared. Sprung from substantial yeomen parents inWitney, Oxfordshire, and the eldest of a family of 11,all of whom predeceased him, he obtained the beginningof his medical education under the old system of apprentice-ship as an articled pupil of Dr. W. Field. Before thattime Mr. Lodge had been a schoolmaster, but the teaching

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profession did not prevent him from pursuing medicalstudies. During his apprenticeship days he entered as a

student at the Leeds School of Medicine, at that time andfor long afterwards the most important provincial school inthe country. He was dresser to the late Mr. Pridgin Teale,father of the present Mr. T. Pridgin Teale. Before therailway was opened he used to make the double journey fromDudley Hill to Leeds and back on foot. Five shillings aweek indoors was the extent of his remuneration at thecommencement of his apprenticeship and many of the dutiesabout the surgery which are now considered menial formedpart of his daily work. The amount of work which fellto the lot of the apprentice at that day was very great.To dispense for perhaps 100 patients a day, including themaking of pills and powders by hand, keeping made up alarge number of stock medicines ready for all eventualities,responding to urgent calls in the absence of the principal,and attending to the lion’s share of some 300 midwiferycases a year, besides keeping the books, formed the dailyand nightly routine of medical students. The only wonderis, how any time could be set apart for medical study. Pro-fessional examinations in those days, however, were directedto the discovery of whether candidates for qualificationhad practical knowledge of how things were donerather than into their knowledge of the more abstrusetheories which might underlie practice. Even beforehe became qualified Mr. Lodge assisted his principal,then an old man, in a post-mortem examination whichbecame classic, as it formed the starting-point of thoseinvestigations which, through the labours of the late Dr.J. H. Bell and others, have placed anthrax, or what was thencalled wool-sorters’ disease, on the scientific basis where itnow rests. Mr. Lodge wrote the account of the post-mortemexamination of that case in the year 1854. In 1859 he tookthe diplomas of L.R.C.P. Edin. and M.R.C.S. Eng. Hewas a prompt, energetic, and self-reliant practitionerwho was at all times ready to act as circumstancesmight require. The writer of this little memoir has himselfentered a cottage home in company with Mr. Lodge andhas seen him there and then cut down on a strangulatedumbilical hernia, relieving the stricture by means of a

pocket scalpel opening on the principle of a penknife. The

patient made an excellent recovery without suppuration,although no special antiseptic precautions were taken.This was about the time when a distinguished student ofa Scottish university was " sent back " by the Royal Collegeof Surgeons of England, it was generally believed, because hebad advocated in his examination more care for asepticismthan was then considered necessary by the Collegeauthorities. So wide has been the change in medical

opinion and in surgical practice. Some distinguished prac-titioners of medicine, if unknown to general fame-notablythe late Mathew Lee, a very prompt, resourceful, andbrilliant surgeon-were trained by Mr. Lodge. Although insome respects the present generation of medical practitionersis better educated than those who are rapidly passing awaythe older men in their time set a good example of courage,resource, probity, honour, and humanity. Rel2ciesca2t in

pace.

THE ROYAL SANITARY INSTITUTE:ANNUAL DINNER.

THE annual dinner of the Royal Sanitary Institute washeld in the Langham Hotel, Portland-place, on Wednesday,May 15th, the Duke of Northumberland, the President ofthe Institute, occupying the chair. On the chairman’s rightwere Major-General Right Hon. Lord Cheylesmore, Major-General Sir Thomas Fraser, Sir Lauder Brunton, Surgeon-General Sir Alfred H. Keogh, Sir John McFadyean, Surgeon-General A. M. Branfoot, Mr. S. Pollitzer, and Sir AlexanderBinnie. To the left of the chair were Mr. H. D. Searles-Wood, Chairman of Council; Sir Francis Powell, ColonelSir Charles M. Watson, Sir Aston Webb, Canon Barker,Sir James Crichton-Browne, Sir Thomas Brooke-Hitching,Sir Shirley F. Murphy, Dr. H. Gervis, Mayor of Brighton,and Dr. E. B. Forman.

After the usual loyal toasts had been proposed andhonoured, Sir JOHN McFADYEAN proposed the toast of’’The Navy, the Army, and the Auxiliary Forces." Heconfessed to some amount of ignorance in regard to navaland military affairs, but expressed an admiration for both

services. He thought that the Royal Army Medical Corps-was in a high state of efficiency and it was a source of great>satisfaction that it included a great many supporters of theinstitute. In reply to this toast Major-General Sir THOMASFRASER referred to the importance of maintaining thestrength of our forces on land and on sea.The toast, "The Houses of Parliament," was proposed by

Sir THOMAS BROOKE-HiTCHiNG, who said that they owedmuch to Parliament in regard to sanitation. Major- Generalthe Right Hon. Lord CHEYLESMORE replied for the Houseof Lords and Sir FRANCIS POWELL for the House ofCommons. The latter paid great tribute to the zeal ofMr. John Burns in his efforts to secure sanitary conditionsfor the people. He was, he said, devoted heart and soul tothe physical well-being and health of the people. Hereferred also to the attempts of the Government to insure apurer food supply. He thought that something had beengained when the public showed, though it might be incom--plete, yet some knowledge of the laws of health. Inconclusion he congratulated the Sanitary Institute on theexcellent work which it was doing.

In proposing the toast of " The Royal Sanitary Institute "

the Duke of NORTHUMBERLAND said that the progress of,the institute was most satisfactory. The Secretary of Statefor War had recently complimented them on the standard oftheir examinations. The institute was in a sound financialposition and he thought it a very excellent fact that theywere spending their money in doing just that work for whichthe institute was established. Mr. SEARLES-WOOD, replyingto this toast, gave some statistics as to the annual numberof candidates examined on whom they looked as sanitarymissionaries.

Sir ASTON WEBB, in proposing the toast of " The Visitors,"said he should like to see legislative measures introducedproviding for the regulation of the development of towns.and cities, for open spaces, and for broad streets andavenues which would admit plenty of sunshine and air.Overcrowding was a terrible evil, engendering squalor andmisery and a menace to the health of the bread-winner.Colonel Sir CHARLES WATSON replied and referred to theexcellent work of the War Office in advancing sanitation.The dinner was excellent and well served, and the

organising committee and its secretary may be congratu-lated on the distinct success which attended the occasion.

Medical News.ROYAL COLLEGES OF PHYSICIANS OF LONDON

AND SURGEONS OF ENGLAND.-The Conncil of the RoyalCollege of Surgeons of England on May 9th conferred

diplomas of M.R.C.S. upon the undermentioned gentlemenwho have completed the Final Examination in Medicine,Surgery, and Midwifery of the Examining Board in England,the Royal College of Physicians of London having conferredits licence upon the same candidates on April 25th last :-George Henry Adam, King’s College and St. Bartholomew’s Hos-

pital ; Frederick Octavius Arnold. B-A. Cantab., Cambridge and’Manchester Universities and St. Thomas’s Hospital; Hugh TukeAshby, B.A. Cantab., Cambridge and Manchester Universities;Philip Heinrich Bahr, B.A. Cantab., Cambridge University and,London Hospital; Harold Josiah Beddow, B A. Cantab., CambridgeUniversity and St. Bartholomew’s Hospital ; Richard CharlesPalmer Berryman, St. Bartholomew’s Hospital ; John Birch,Manchester University; Robert Edward Brayne, Guy’s Hospital;Josiah Browne, King’s College Hospital; Charles Walter GordonBryan, St Mary’s Hospital; Martin Binns Studer Button, L.S.A.,London Hospital; Harry Vivian Byatt Byatt, B.A. Cantab., Cam-bridge University and London Hospital; William James Chapman,M.D., O.M., Toronto University and Middlesex Hospital; PercyJohn Chissell, Middlesex Hospital ; Spencer Churchill. B.A.Cantab.. Cambridge University and St Thomas’s Hospital; EdwardBellis Clayton, B.A.Cantab., Cambridge University and King’sCollege Hospital; Horace Charles Colyer, L.D.S., Charing Cross andUniversity College Hospitals ; Percival Sandys Connellan, Uni-versity College, Bristol; Paul Alfred Creux, Lausanne University andLondon Hospital; Timothy Howell Davies, Middlesex Hospital;Arthur Hubert Treby Davis, St. George’s Hospital; HerbertEdwin Tonge Dawes, B.A. Cantab., Cambridge University and St.Thomas’s Hospital ; George Denholm, M.B., B.S. Durh., DurhamUniversity ; Arnold Thomas Densham, Cambridge University andGuy’s Hospital; Horace Dimock, B.A. Cantab., Cambridge Uni-versity and St. Thomas’s Hospital; Maurice Mason Earle, Guy’sHospital; Howard Robinson Elliott. Sheffield University ; CarltonAtkinson Ellis, London Hospital; William Aiken Fairelough, M.B.,Ch.B. New Zealand, New Zealand University; John HenryFarbstein, University College Hospital; Marmadake Fawkes, St..