1670 DIPLOMA IN PSYCHOLOGICAL MEDICINE AT CAMBRIDGE UNIVERSITY.

from six months to three and a half years. The disease was

advanced and active, and the prognosis was very bad inevery case, yet the disease was either arrested or was under-going arrest in 13. Five patients were either dead or dying.Amongst other observers Molon, of Venice, subjected44 cases to the treatment. In 12 the operation could not befully carried out owing to pleural adhesions ; 6 cases becameworse, death occurring in 3 ; but in 26 cases goodresults were obtained. Zubiani recorded 25 cases, success

following in 14. These results indicate that in a goodproportion of cases successful results may be expected.The technique requires care, and a special apparatus,including a manometer and cylinders to hold gas and anantiseptic fluid. The method therefore is not likely to be

extensively used in general practice. Nitrogen gas is

preferable to sterilised air. The explanation of the goodresults obtained has been much debated, but, as Dr.

Lillingston maintains, immobilisation and drainage of thediseased lung are the chief causes which lead to arrest of thedisease. The rest to the lung thus obtained brings a cessationof auto-inoculation. In order that a condition of pneumo-thorax may be obtained the lung must not extensively bebound down by adhesions. The class of case therefore suit-

able for the treatment is one in which there is active disease

of one lung (the other lung being free of disease or onlyslightly affected), and in which ordinary therapeuticalmethods have not proved successful; but those cases mustbe excluded in which the pathological processes are in anadvanced degree-namely, in which much cavitation,fibrosis, and extensive pleural adhesions exist. We wouldfurther insist that the treatment should be controlled

throughout by means of the X rays, so that proof may beobtained as to whether pneumothorax has been produced andwhether it has been maintained. This method of treatment,although its limitations must be recognised, will probablyprove to be of value in some cases in which the prognosishas hitherto been considered very bad.

A DIPLOMA IN PSYCHOLOGICAL MEDICINE ATTHE UNIVERSITY OF CAMBRIDGE.

SINCE 1875 an examination and a Diploma in Public

Health, and since 1904 an examination and a Diplomain Tropical Medicine and Hygiene, have been establishedin the University of Cambridge, and opportunities have thusbeen created for training in research, which have improvedthe efficiency of those engaged in these special departmentsof medicine. But as regards the study of mental diseaseand the care of the insane-subjects which, together withpublic health and tropical medicine, may be regarded as form-ing the main branches of State medicine-no examinationor diploma exists at Cambridge. The report furnished tothe Senate of the University by the Special Board for

Medicine states the case thus: The inadequacy of the-

ordinary medical curriculum for the training of thosewho intend to devote themselves to psychological medicinecannot now be disputed. At the present time the newlyqualified physician enters upon asylum service with a veryinsufficient knowledge alike of psychology and the physio-logy of the nervous system on which psychiatry and

neurology depend, and of the modern methods of researchin mental and nervous disorders. Once having engagedin asylum work he rarely has opportunity of learning moreof these subjects." The Board, believing that an examina,tion in psychological medicine and its cognate subjects, ifestablished, could not fail to raise the present standard ofefficiency in applicants for asylum posts, has decided to insti-tute an examination and to grant a diploma in the subject.That a general desire for the establishment of a Diploma inPsychological Medicine exists among those best qualified toform an opinion on the subject is shown by the fact that

last year the Medico-Psychological Association of GreatBritain and Ireland-a body comprising about 700 membersof the medical profession, nearly all of whom are engagedin this special department of medicine-addressed a letterthrough its President to the universities and other examiningbodies of the United Kingdom, setting forth the advantageswhich a special examination and diploma would confer instimulating research and in advancing knowledge of th&

nature and treatment of mental and nervous disorders. The

first examinations for the diploma are fixed for June andJuly next, and all further information can be obtained fromDr. C. S. Myers, at the Psychological Laboratory, Cambridge.

THE REACTION OF URINE TO LITMUS PAPER.

IN a recent number of the Journal of the American- Pharmaceutical Association Mr. G. H. Meeker discusses

certain improvements in manipulation in determining thereaction of urine to litmus paper. Although the test appearsto be a simple one, fallacies arise from the use of dry litmuspaper and from the faintness of the change of tint. The

eye needs a control colour guide in order to render theresults certain. The plan suggested is as follows. Half fill

a small beaker with the urine and take two slips of red litmus.paper, Rl and R2. Wet one slip, Rl, with neutral waterand lay upon a white tile. Hang the other slip, R2, overthe edge of the beaker, so that it is immersed about two-

thirds of its length in the urine. After three minutes layR2 beside Rl. Proceed in the same way with two slips ofblue litmus paper, Bl and B2. The order on the tile should

be Rl, R2, B2, Bl. In this way the eye can readily detect.any change of colour that may have occurred. There are

three possible alterations in tint : (1) R2 may become

bluish, indicating alkalinity in the urine ; (2) B2 may become reddish, indicating acidity; (3) R2 may becomebluish and B2 reddish, indicating that the urine is

amphoteric. If an alkaline reaction is observed it is im-

portant to determine whether or not it is due to ammoniumcarbonate. This is done by heating the tile gently until thepaper slips are perfectly dry. If R2, after having becomebluish, regains its reddish tint the presence of ammonium

carbonate is indicated. In such case the bladder is probablyinfected. The colour changes indicate whether the urine is’faintly or strongly acid or alkaline. It is an advisable--

precaution to wash the hands carefully before handling the.-test papers.

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THE INFLUENCE OF THE CHEMICAL COMPOSI-TION OF THE AIR ON THE VITALITY

OF MICROBES.

THE current view that certain infectious diseases may be. -

contracted by exposure to the foul air of drains or cesspools.is difficult to reconcile with the fact that such air contains>

fewer microbes than ordinary air. At a meeting of the-

Academic, de Médecine of Paris on Oct. 15th M. Gueniot reada report on an important investigation made at the InstitutPasteur by M. A. Trillat which throws a new light on thedangers of foul air. The task was appropriately assigned toM. Gueniot, for he had in 1892 read a paper at the Academic-entitled "Du Mephitisme de I’Air comme Cause de Septi-cemie Puerperale." He related the cases of three womenwho lived and were confined in a foul atmosphere and-suffered from puerperal fever. The care which they badreceived during the lying-in period was quite proper, and no,source of contagion could be traced to any person by themost minute investigation. M. Gueniot therefore drew the-

conclusion that the fever was due to vitiated air which

emanated from a water-closet, cesspool, or sink freely com-municating with a drain found in these cases. But how-

could such contamination have a pathogenic effect on-

the puerperæ? On consulting Dr. Miquel (of the