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incision-a point which the patient appreciates very highly. Allthat is necessary is to apply a compress of lint soaked in thesolution, and the pain will be relieved, the inflammation disappear,the pus give place to serum, the ' core ' separate and a healthy.granulating surface be left."My treatment differs from Mr. Morison's in two respects.

In the first place, whereas he applied first a paste andafterwards a solution of the salt, I apply a solution fromthe beginningj and secondly, while he used a solution con-taining 40 oz. of MgSO, in 30 oz. of water, I employ a20 to 40 per cent. solution, and less as healing proceeds.As the title of my paper indicates, I use this treatmenit

not for carbuncles only but for all surface inflammationsand suppurations (including tuberculous), and have done soconstantly for the last fifteen vears-that is, since 1909,when it first occurred to me to use magnesium sulphate inthis way. For those who do not kniow of this mode oftreatment, perhaps you will allow me to quote a sentenceor two from what I wrote on the subject in March, 1912.I then said:" It does not appear to have been hitherto recognized that

magnesium sulphate has a remarkable power over inflammatoryan suppurating lesions. If a solution of this salt be directlyapplied to any such lesion, the advance of the inflammation willbe at once checked, and under the continued application of thesolution the inflammation will be entirely eliminated. If pus hasformed and be discharging, the purulent discharge will give placeto one of serum, and the tissues will return to a healthycondition."The treatment of carbuncles is only a very small part of

its usefulness. More important is the fact that it wipesout erysipelas. But as I have indicated, it has completecontrol over all surface inflammations and suppurations,whether it be acute dermatitis, phlebitis, cellulitis, inflamedand suppurating wounds, puruleiit otitis media, or anyother such condition to which it can be directly appliedby bath or compress, or, as in the case of the ear, by drops.I have also come to look upon it as the ideal initestinaldisinfectant, having a similar beneficial effect on thebowel to that wliich it has oni the skin and underlyingtissues. I would like to warn those who have no ex-perience of it against too highly concentrated solutions,especially when applied to the fingers, toes, penis, scrotum,and external ear, where the blood supply and therefore theamount of serum is limited.-I am, etc.,Edinburgh, April 18th. JAMEs ALSTON.

SIR,-In your issue of April lgtli (1). 703) the late Mr.A. E. Morison discussed the treatment of carbuncle bymagnesium sulphate. I should like to call attenition to amiiethod I have carried out for several y-ears with iinvariablesucecess. As soon as a case is seeil to be definiitely olne ofcarbuncle I inject subcutaneously in the abdominial wall10 c.cm. of antistreptococcus serurn (p)olyvalent). In onecase of aggravated carbuncle of the nieck I used a seconddose. A pad moistened with glycerini is applied locally.In my experience the imiiprovement has been rapid anidcomplete, without destruction of tissue alnd scarring.-I ani, etc.,

R. PJICHARD, M.D., D.P.H.,April 20th. Medical Officer, Ely Isolation Hospital, Cardiff.

CLINICAL RESEARCH IN GENERAL PRACTICE.SIR,-The letter by Sir James Mackenzie in the

B1RITISH MEDICAL JOURNAL of March 29th (p. 598) will,I feel sure, have been read with interest by a large numberof practitioners who have leaniings towards the scientificside of clinical medicine. Sir James Mackenzie statesquite truly that all the meanis at present available, in-cludinig the most recent laboratory methods, onily detectend-results of morbid processes. He therefore advocatesthe study of the earliest symptoms in order that we maybe able to recognize a disease at its v-ery beginning, whenwe might hope in some cases to be in a position to arrestits progress. This is an aim wlichl e-eryione hopes willone day be realized, but I suiggest tlhat, how-e-er earlywe may succeed in recogniizinig the iniitial symptoms, wecannot in many cases claim to lhav-e caught tihe disease atthe beginning. Take, for example, a case like lhaemo-philia. We know it to be a Mendelian sex-linked recessivecharacter that occurs in a certain ntumber of male clhildrenof women who, being themselves niormal, are the offsprinig

-immediate or remote-of haemdiphilic males. What igwanted is not a means of recognizing a haemophilic inthe early stages, but a method that will detect the hetero.zygote female carrier of this disease. The same appliesto pseudo-hypertrophic muscular paralysis and a few otherconditions that are transmitted in a similar manner.Huntington's chorea is another interesting example.

The disease, which behaves like a Mendelian dominant, doesnot set in till about the age of 35 years, when the personis already married and the parent of children, 50 percent. of whom will develop the disease when they reach theage of 30-40 years. Until we can find some method ofdiscovering which of the children are the heterozygotesthat will certainly develop the disease and transmit it to50 per cent. of their children, it is impossible to know whichof them to allow anid which to forbid marriage. Glaucomaand diabetes (mellitus and insipidus) are examples ofsimilar nature, but the most cogent is the case of feeble-mindedness. We know that this condition behaves as aMendelian recessive, so that there must be a large numberof normal people who carry this trait as a recessive.Indeed, it has been shown that whilst the large number offeeble-minded form only 0.3 per cent. of the population,the number of normal carriers of feeble-mindedness con-stitute no less than 7 per cent. of the population. Inter-marriage between such normal heterozygotes will result inprogeny 25 per cent. of whom will be feeble-minded and50 per cent. will be again heterozygotes. What we want isa certain means of detecting these heterozygote carriers.Until this is achieved we cannot hope to reduce thenumber of feeble-minded, from whom a large number ofthe criminals, prostitutes, and insane are recruited.-I am, etc.,

W. M. FELDMAN, M.D.Lond., F.R.S.Edin.London, W., March 31st.

MRS. JEM'S ATTACK OF SWINE-POX.SIR,-In connexion with the article (April 12th, p. 671)

on Mrs. Jem's attack of swine-pox, I may say that I haverecently received an MS. diary kept by my great-grand-mother, Mrs. John Barclay Clibborn, of Anner House,Clonmel, from 1800 to 1817.On several occasions she mentions that lher children had

attacks of swine-pox, which I concluded were attacks ofchicken-pox, and not, as is suggested, modified small-pox.I am confirmed in this theory by the fact that my great,grandmother was an enthusiastic advocate of vaccination.She had a small clinic at her house, and she herself vacci-niated many of her employees and tenants, and she recordsthat all her children were vaccinated at an early age.-I am, etc.,Beaminster, Dorset, April 15th. ARTHUR A. PIM.

" BAYER 205."SIR,-The BRITISH MEDICAL JOURNAL for March 8th

contains an article on " Synthetic therapeutic agents "

by Sir William J. Pope, in which the author points toa publication of the Times (August 25th, 1922), that " at ameeting of the Association of Tropical Diseases held inHamburg the statement was made that ' Bayer 205 ' isthe key to tropical Africa, and consequently to all tllecolonies, and that the German Governnment miust ' berequired to safeguard this discovery for Germany; its valueis such that any privilege of a share in it granted to othernations must be made conditional upon the restoration toGermany of her cololnial empire.' "

May I beg to inform you that I already, in 1922 (Arch iv

fIir Schiffs- und Tropen-Hygiene, 1922, p. 332), have publiclystated that in the meeting of our association no suchstatement was made, and that the question of " Bayer 205 ",

has not at all been treated in the meeting? In fact, itmay be that a German politician has miiaintained a sentencelike that quoted above in a political gazette, but niot a wordof such or a similar idea has been uttered in any scientificmeeting or by any German medical man.

I would be very much obliged if you would publish thisletter in your JOURN-AL.-I am, etc.,

PIIOFESsoIc DR. NOCHT,President of the German Association of

Hlamburg, April 16tlh. Tropical Diseases.