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treatment was with the galvano-cautery point; in thisway sometimes polypi which had been the reasonfor the discharge had been brought away.

Mr. DOUGLAS GUTHRIE (Edinburgh) said that inthe Army suppurative otitis media had been andremained one of the commonest causes of rejectionof recruits and of invaliding. He saw every recruitin Scotland, and he did not hesitate to reject anycandidate who suffered from chronic suppurativeotitis, even though by the time he was seen the earmight be dry. It was also the custom to pensionoff men who were actually serving, unless they werenear the time of retirement. It was of no use to

perform radical mastoid operations in the Army,because the operation did not render men fit. Itwas not uncommon to see intracranial complicationsfollowing acute otitis media in the acute stage, buthe had seen these only once in a chronic case. Con-servative treatment having been decided upon in agiven case, he insisted that this must be thorough; itshould not be left to the mother or a nurse to carryout, the otologist must himself do it. He had himself

recently taken up the ionisation treatment with success,but it needed great care and attention to detail.

Mr. L. GRAHAM BROWN agreed that in most casesthe simple Schwartze operation sufficed, though forlong-continued suppuration he had been doing trans-mastoid attico-tympanotomy, which was first sug-gested by Charles Heath 30 years ago and wasmodified by several otologists later. He had foundthis operation very satisfactory.

Mr. JAMES ADAM (Glasgow) expressed his generalagreement with Dr. Ritchie Rodger’s views. Formany years he had been carrying out occlusion ofthe Eustachian tube in the radical operation.Mr. W. S. THACKER-NEvILLE (Harrogate) con-

sidered that the wide dissemination of Dr. Ritchie

Rodger’s paper in the profession would be of realbenefit. Cases of chronic otorrhoea would get farbetter treatment in otologists’ consulting-rooms thanin crude clinics.

Dr. SOPHIA JEVONS said that to reduce the inci-dence and complications it was necessary to come outinto the open and explain the possibilities of cure.From close observation she entertained muchadmiration for Dr. Friel’s work with ionisation.

Dr. RITCHIE RODGER, in reply, said he had triedionisation, but did not secure such good results asdid Dr. Friel; he adhered to the old-fashioned treat-ment which he detailed in his paper. It was veryimportant to get the ear clean before putting in thewall of protective antiseptic powder; this should beleft in the ear until it began to break down of itself.If the suppuration had extended into the antrum noconservative treatment was likely to succeed. Hedid not think the chronicity of these cases dependedon secondary organisms, but on the site which thesuppuration had reached. Mastoid tenderness in the

early stage-i.e., before rupture-did not mean therewas necessarily infection of the mastoid process.

EUGENICS SOCIETY

AT a meeting of this society held on May 3rd,Dr. AUBREY LEWIS read a paper on the

Inheritance of Mental Disorders

He said that as the result of the very active inquiryinto the subject during the last two decades, thereis now a definite, though far from complete, bodyof knowledge about the inheritance of mental dis-

order. There had been much sifting of the evidenceand examination of the methods employed. Thedifficulties were partly psychiatric and partly bio-logical. The psychiatric problem depended mainlyon the provisional nature of the current groupings,which might not have biological validity. Hysteriaand schizophrenia were examples of this difficulty :if one contrasted them with some of the neurologicaldisorders, the difference was striking. The uncertainrelation of types of personality, not necessarilyabnormal, to pronounced mental disorder alsoresulted in much controversy. The biological

‘

problem concerned chiefly the choice of methods,.especially statistical methods, and the questionof constitution, blastophthoria, and multiple genedetermination. Most of the more strictly genetictroubles in this field had arisen from inadequateuse of the available methods and data. Importantobstacles to research had been the relatively longlife of the human subjects investigated and the

inaccessibility of their families to full investigation.For example, in involutional melancholia one coulddraw no conclusions about the patients’ childrenuntil they had reached their fifth or sixth decade oflife, and the patients’ parents were usually dead bythe time he or she was seen. A single investigatorwas hampered by this circumstance and by the

inadequacy of diagnoses made by others manyyears before. In spite of the difficulties enumerated,much useful information had been collected.Investigations in a rural area where the populationremains settled through several generations were

of special value. Definite knowledge had beenobtained on the inheritance of rare-conditions suchas Huntington’s chorea and myoclonus epilepsy,and the affective psychoses had been found, especiallyin their characteristically endogenous forms, to showa high transmissibility. In schizophrenia the formsin which physical or psychic trauma had been aprominent causative factor showed less strikinghereditary relationships than the far more numerousgroup, commonly known as dementia prsecox. In

paranoid states, paranoia, psychopathic forms,cerebral arterio-sclerosis, the relations were compli-cated. It was usually possible in any individualcase to predict the probable risks for the offspringif sufficient information was available about the

family history on both sides.Investigations were at present being conducted

at the Maudsley Hospital into special and generalproblems in the inheritance of mental disorder.These referred to the special inheritance of obsessionalstates, of schizophrenia in children, of involutionalmelancholia in men, and the psychoneuroses asso--

ciated with compensation claims and prolongedunemployment. More general studies were being-made of mental disorders in twins, in the childrenof parents who had both been insane, and in the generalpopulation. Special methods were needed for eachof these studies. The cooperation of one or morespecially trained psychiatric social workers was

essential. The assessment of the frequency of mentaldisorder and abnormal types of personality in theaverage population was of great importance forgenetic prognosis. Mendelian relations could not

always be determined satisfactorily for mentaldisorders, but empirical studies had yielded valuableinformation on the frequency of a given mental’disorder in the different relatives of a patient withthe disorder. It was necessary to ascertain whetherthe frequency discovered was any greater thanthat which would be found if one started withunselected members of the average population.-

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For the study now being carried on, patients in thesurgical ward of a general hospital had been thestarting point ; data were thus obtained for the

average population of a given district of London.Individual genetic prognosis was the chief concernof the doctor ; he was often asked by patients orby the children of patients whether they should

marry and have children. The question of marriagewas not, but procreation was, essentially a matterof genetic concern. It was, as a rule, unwise for atainted person to marry one in whose family a similarmorbid taint was present, if the couple proposedto have children. The particular risks could neverbe settled merely by making a diagnosis and applyinga simple rule ; careful inquiry into the family historyof both husband and wife’ was essential. Wherethis was possible, it was seldom difficult to reach aconclusion. In many cases the psychiatrist wouldrefrain from giving advice, but would merely statethe probabilities and relevant facts and leave thedecision to the people concerned. Positive qualitiesof personality and intellectual or other endowmentmust be taken into consideration as well as thenegative qualities of mental disorder. This was

also an important consideration in schemes of nationalimprovement by the elimination of mental disorder.It could not be said that the knowledge at presentavailable would be sufficient, if applied in the widestpossible way, to eradicate mental disorder. Itwas questionable whether in any case so drastic ameasure would be advisable, since many valuablequalities might also be eliminated. Until further

knowledge of the inheritance of normal personalityand special endowment was available, as well as

of the inheritance of mental disorder, schemes of thiskind were premature. One would hope for themaximum provision for the giving and implementingof eugenic advice to individuals. But carriers,not themselves manifesting the disorder, could notat present be recognised with certainty, and measuresto eliminate mental disorder must therefore fail toachieve more than a small or moderate diminutionin the total incidence. Both for individual andnational well-being, the collection of further knowledgeby painstaking and critical genetic research was

desirable. It was necessary to compile accuraterecords and to train competent and enthusiasticworkers for research of this kind.

REVIEWS AND NOTICES OF BOOKS

Great Men of Science

By PHILIPP LENARD, Nobel Laureate. Translated

by STAFFORD HATFIELD. With preface by Prof.E. N. DA C. ANDRADE. London : G. Bell and Sons,Ltd. 1933. Pp. 389. 12s. 6d.

Tms is a history of scientific progress described

through the medium of a series of biographicalportraits whose subjects range in date from Pythagorasand Archimedes to Clerk Maxwell, Crookes, andHeinrich Hertz, under the last of whom the authorhimself worked. Sixty-five men are selected toillustrate a great story of continuity in discovery,and the composition of the list is somewhat surprisinguntil the principles upon which it has been made aregrasped ; for while the list must appear brief, seeingthat the progress of over 2000 years is being con-sidered, it none the less includes names that will befamiliar to few who are not working in the worldof physics. Both the omissions and additions aremainly accounted for by the fact that Prof. Lenarddoes not take art or philosophy into account-

regarding medicine, it would seem, as a blend ofthese-but finds room for the biographies of specialworkers in physics whose contributions to knowledgehave been of fundamental importance. The list ofsuch men he finds to be brief, and he finds also, insome pessimistic reflections, that additions to it areneeded at the present day. ,

,

For a man to find a place in Prof. Lenard’s listit is not sufficient for that which he has begotten tobe new, it has also to be supplemental to previousknowledge at the time or to be found later, in lightof further experiences, confirming such knowledgeand assisting in its further potentialities. Discoverersof such new things are the founders of our presentprogress in knowledge and technical power. Forexample, in astronomy we have the separate contri-butions, set out with their general message, of

Copernicus, Tycho Brahe, Kepler, Galileo, Huygens,and Newton, who enabled man to see the visibleworld as one great unity. In electricity we are farless familiar with the roles of the protagonists, andhere the sequence of biographies forms an even

clearer picture of the interdependence of knowledge

and of the difference between the really new thingsand the development of the old things which do notadd to fundamental wisdom. The group may bestarted with Faraday, that prince of original investi-gators, though he was Humphry Davy’s pupil, andis continued by Wilhelm Weber, Julius Meyer, Joule,and Helmholtz. Their work, though separate, wasinterdependent ; reaching backwards it is foundedon the labour of Laplace, Ampere, Ohm, and Gauss,while reaching forwards it makes contact, intimateor otherwise, with the discoveries of Helmholtz,Kelvin, Clerk Maxwell, and Hertz. How each ofthese relied upon the results obtained by the others,and how their joint efforts brought about units ofstandardisation on which the world relies in the mostimportant fields of development, make the materialof a fascinating section of the book ; continuitycould not have been more aptly exemplified. Similar

sequences, as they appear in the book, could havebeen brought forward to show how associatedresearches along widely differing lines give resultswhich perpetually reinforce and interdigitate withresearches in other spheres of investigation. To thereaders of this book the veritable leaders of scientific

thought and action will appear as members of onegreat family.

Inherited Abnormalities of the Skin and itsAppendagesBy E. A. COCKAYNE, M.D., F.R.C.P., Physicianto the Middlesex Hospital, and to Out-patients,Hospital for Sick Children, Great Ormond-street,London. Oxford Medical Publications. London: s

Humphrey Milford, Oxford University Press.1933, Pp. 394. 32s.

Tnis book, as Dr. Cockayne says in his preface, isan attempt to deal with the genetics of the defectswhich cause some change in the skin, teeth, hair,or nails. It is an analysis from the genetic point ofview of all the hitherto recognised congenital-develop-mental abnormalities and " diseases " in any wayaffecting the skin and its appendages. The taskset himself by the author must have involved animmense amount of labour spread over years, and