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all interested in medicine in this Presidency. It maybe observed that more than one local body in themofussil has already opened Ayurvedic dispensariesin place of those equipped according to Western ideas.

Madras, May 15th.

UNITED STATES OF AMERICA.

(FROM AN OCCASIONAL CORRESPONDENT.)

The Right to Prescribe.THE right to prescribe was stoutly maintained by a

decision in the Federal District Court of New York,given on May 8th. Judge John C. Knox ruled that Section 7, Title II. of the Volstead Act was unconstitu-tional in a suit brought by the Association for theProtection of Constitutional Rights. Section 7 limitsthe amount of alcohol in any form which a doctormay prescribe for any one patient to one pint in tendays. This limitation the judge regarded as arbitraryand without justification. Probably the intention ofcongress was not to restrict the prescription ofnecessary medicinal alcohol, but to prevent abuse oftheir privileges by dishonest physicians who might betempted to issue prescriptions without any goodprofessional reason. Medical men point out, however,that there is no limit placed on the amount of alcoholicliquor which a clergyman may order for sacramentalpurposes, and they consider that the profession ofmedicine is worthy of as much confidence as that of theChurch. The prohibition authorities announce thatregulations will not be relaxed until the decisionhas been reviewed in the Supreme Court. They areconfident that it will then be reversed.

Automobile Fatalities in 1922.

The National Automobile Chamber of Commercehas just issued a statistical record of the automobileaccidents which have occurred in 1922. The totalnumber of deaths from this cause is 14,000, as comparedwith 12,500 in the previous year. The death-rate fromthis cause is thus still rising ominously. In the lastthree completed years it has been 0.104,0.110, and 0’133respectively per thousand population. The numberof motor-cars registered per thousand populationhas in the same period increased from 87 to 115, sothat the number of deaths per carhas slightly decreased.It is interesting to note from the statistics on mortalityamong doctors collected by the American MedicalAssociation that medical men run a much greaterrisk than the general population. The number ofdeaths from automobile accidents in 1922 was

39, and 23 more deaths were due to collisionsbetween trains and motor-cars. The number ofqualified physicians in the United States is esti-mated at 146,000, hence it appears that theirmortality-rate from this cause is more than threetimes that of the general population.

Trudeau Sanatorium.

The thirty-eighth annual report of the TrudeauSanatorium, just issued, is a mine of information forthe statistician. The tables which it contains havebeen prepared according to suggestions made by theNational Tuberculosis Association. One of them givesthe present condition of all patients discharged in eachyear from the year 1885 onwards, the cases are dividedinto three classes (minimal, moderately advanced, andfar advanced) with three subclasses in each classaccording to the condition at the time of discharge(apparently arrested, quiescent, and active). Of thepatients discharged during the last year nearly one-fourth had no rates, about one-tenth lost their rales,in nearly one-tenth the rales remained unchanged.Fewer râles were heard at discharge than on admissionin nearly one-fifth, and more extensive rales in nearlyone-tenth. Rales developed in new areas in aboutone-third. The X ray results were encouraging,showing clearing in no less than 150 out of 226 cases. Fifty of these cases had. however, an increase or

development of râles. Dr. Heise, commenting on the-want of parallelism between clinical and X ray findings,suggests that " rales appear early in the stage of

activity when inflammation is not too severe andreappear when the inflammation subsides and allowsair to flow freely in the smaller bronchi and bronchioles.in sufficient volume to set the mucus in vibration,.or that increased secretion of mucus may take

place before any X ray evidence." The specialdiagnostic criteria adopted will be of interest to-sanatorium superintendents.

KING EDWARD’S FUND.SPECIAL GRANTS TO LONDON HOSPITALS.

WE published last week a brief report of the-annual meeting of King Edward’s Hospital Fundfor London, and we now print the list of grants-in connexion with the Combined Appeal. Thequestion of hospital accommodation has a veryimportant bearing on the position of the voluntaryhospitals, and it is interesting to note that an Ambu-lances Cases Disposal Committee has been given the-powers of the General Council two inquire andreport to the President and General Council on the-methods at present employed for ascertaining where-bed accommodation is available at hospitals in themetropolitan and neighbouring areas for accidentcases requiring admission ; and on the proposal thatdaily reports of vacant beds should be supplied tothe police and ambulance authorities ; and to make-such consequential recommendations as they mayconsider desirable."

Distribution of Proceeds of Combined Appeal.Approval was given to the special distribution by

the King’s Fund of the proceeds of the CombinedAppeal. The hospitals to which grants are made-are those which accepted the invitation to cooperate-in the appeal. Out of 127 invited to cooperate 120accepted.

Name of Hospital. grant.-Acton Hospital .. .. .. .. .. .. £585All Saints’ Hospital .. .. .. .. .. .. 875Antivivisection Hospital ......... 980Baby Clinic and Hospital (Kensington) ..... 360Beckenham Cottage Hospital ....... 630Belgrave Hospital for Children ....... 1,825.Blackheath and Charlton Hospital ..... 525Bolingbroke Hospital ......... 1,200Brentford Cottage Hospital ........ 85.British Hospital for Mothers and Babies (Woolwich) .. 760Cancer Hospital ............ 1,820Canning Town Women’s Settlement Hospital .... 855-Central London Ophthalmic Hospital ..... 925Central London Throat and Ear Hospital ... 1,000Chelsea Hospital for Women ....... 1,130Cheyne Hospital for Children ....... 1,325.City of London Hospital for Diseases of the Heart andLungs (Victoria Park) 4,275-

City of London Maternity Hospital ..... 1,540Clapham Maternity Hospital ........ 825.Dreadnought Hospital (Seamen’s) ...... 7,415East End Mothers’ Lying-in Home ...... 1,130East Ham Hospital ............ 260East London Hospital for Children 5,200Elizabeth Garrett Anderson Hospital ...... 2,830Eltham and Mottingham Cottage Hospital .... 180Lvelina Hospital ........... 1,910,Finchley Memorial Hospital ........

625Florence Nightingale Hospital for Gentlewomen .... 665,French Hospital .. .. .. .. .. .. 760General Lying-in Hospital.......... 1,000,German Hospital ............ 2,430Grosvenor Hospital for Women ........ 725Guy’s Hospital ............18,135Hampstead General and North-West London Hospital 4,865Hendon Cottage Hospital .......... 790Ilornsey Cottage Hospital . , , , 850Hospital for Consumption, Brompton (including Sana-

toritmi at Frimley) ....... 7,620Hospital for Epilepsy and Paralysis ...... 2,090Hospital for Sick Children ....... 8,700Hospital for Women (Soho-square) ...... 1,605Hospital of St. John and St. Elizabeth ... 2,200Hostel of God ............ 345,Hostel of St. Luke............ 200

Infants’ Hospital ............ 725Italian Hospital............ 490

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.Jewish Maternity Home .......... £195Kensington, Fulham and Chelsea General Hospital .. 615Kensington Dispensary and Children’s Hospital.... 195King Edward Memorial Hospital (Ealing) .. .. 795King’s College Hospital .......... 18,150London Fever Hospital .......... 2,160London Homoeopathic Hospital ........ 2,985London Hospital .......... 23,360London Jewish Hospital .......... 1,120London Lock Hospital 3,605London Temperance Hospital ........ 2,935Maternity Charity and District Nurses’ Home, Plaistow. 2,090Metropolitan Ear, Nose and Throat Hospital.... 370Metropolitan Hospital .......... 5,610Middlesex Hospital ............ 12,375-iliddlesex Hospital Cancer Charity ...... 1,545Mildmay Memorial Hospital ........ 525Mildmay Mission Hospital .......... 1,850Miller General Hospital for South-East London.... 4,635Mothers’ Hospital of the Salvation Army .... 1,645National Hospital for Diseases of the Heart .. 1,255National Hospital for the Paralysed and Epileptic.. 6,185Nelson Hospital (South Wimbledon) ...... 695Northeourt Hospital and Home for Sick Children (Hamp-

stead) .............. 1,185North Islington Infant Welfare Wards...... 305Paddington Green Children’s Hospital .. - ... 1,030Passmore Edwards Hospital for Wood Green, &c... 415Poplar Hospital for Accidents ....... - 2,145Prince of Wales’s General Hospital ...... 6,065Putney Hospital ............ 350Queen Charlotte’s Lying-in Hospital...... 3,040Queen Mary’s Hospital for the East End...... 5,120Queen’s Hospital for Children ........ 6,695Royal Dental Hospital of London ...... 1,545Royal Eye Hospital ............ 1,130Royal Free Hospital ............ 11,330Royal Hospital, Richmond .......... 1,230Royal London Ophthalmic Hospital ...... 4,140Royal National Orthopaedic Hospital ...... 5,665Royal Northern Hospital (with which is amalgamated theRoyal Chest Hospital, City-road) ...... 13,650

Royal Waterloo Hospital for Children and Women.. 2,120Royal Westminster Ophthalmic Hospital ...... 1,065St. Andrew’s Hospital (Dollis Hill) ...... 650St. Bartholomew’s Hospital ........ 16,610St. Columba’s Hospital .......... 825St. George’s Hospital .......... 9,000St. John’s Hospital, Lewisham .... 2,315St. John’s Hospital for Diseases of the Skin.... 1,030St Luke’s Hospital for Advanced Cases...... 595St. Mark’s Hospital ............ 910St Mary’s Hospital ............ 8,240St. Mary’s Hospital for Women and Children, Plaistow 2,010St. Monica’s Home Hospital........ 355St. Peter’s Hospital for Stone ... 1,020St. Saviour’s Hospital for Ladies of Limited Means (Osna-

burgh-street) ............ 280St. Thomas’s Hospital .......... 16,455Samaritan Free Hospital for Women ...... 1,300Santa Claus Home ... 465South-Eastern Hospital for Children (Sydenham) .. 1,485 ISouth London Hospital for Women ...... 2,525Stoke Newington Home Hospital for Women .... 345Streatham Babies’ Hospital ........ 205University College Hospital ........ 12,360Victoria Hospital for Children ........ 2,830Walthamstow, Wanstead, and Leyton Children’s and

General Hospital .......... 1,070Weir Hospital (Balham) .......... 410West End Hospital for Nervous Diseases...... 1,795Western Ophthalmic Hospital........ 715West London Hospital .......... 7,700Westminster Hospital 7,210Willesden Hospital ........... 1,635Wimbledon Hospital .......... 525Winifred House Invalid Children’s Convalescent HospitalHome .............. 300

Woolwich and PIumstead Cottage Hospital .... 145Woolwich and District War Memorial Hospital.... 3,300

Total.......... £365,000

Special distribution by King Ed- .8 s. d. ,&bgr; s. d.ward’s Hospital Fund, as above,viz. : :Payments on account, August,1922 ........ 150,000 0 0

Payments on account, October,1922 .... 100,000 0 0

Final payments, June, 1923 .. 115,000 0 0365,000 0 0

Other forms of distribution.. 48,214 8 9

Total distribution .... 413,214 8 9

DURHAM MEDICAL GRADUATES ASSOCIATION.—Theannual meeting will be held at the College of Medicine,Newcastle-upon-Tyne, on June 25th, at 5 P.M., and theannual dinner at 7.45 P.M. on the same day in theKing’s Hall, Armstrong College. Any Durham medicalgraduates who are not already members of the Associationand who desire to join, are requested to communicate withthe hon. secretary, (North), Royal Victoria Infirmary,Newcastle-upon-Tyne.

TUBERCULOSIS.

Tuberculosis in Bradford.THE Medical Research Council has issued as one of

its Special Report Series an investigation by Dr.Harold Vallow of tuberculosis in insured personsaccepted for treatment by the Bradford HealthCommittee. The period covered is July 15th, 1912, toApril 30th, 1921, and a special study was made ofthe 584 cases of pulmonary tuberculosis applying fortreatment in 1914-16. In addition, there were 20cases of non-pulmonary tuberculosis. It was foundthat of the 204 patients in the first stage, only seven,or 3-4 per cent., had died from pulmonary tuberculosis,whereas of the 158 second-stage patients, 87, and ofthe 222 third-stage patients, 220 had died frompulmonary tuberculosis. The treatment given wassanatorium, hospital, and domiciliary treatment, butlittle information is vouchsafed as to the duration andcharacter of the sanatorium and hospital treatment,and the character and extent of the domiciliary treat-ment given are not fully described. Apparently nodistinction has been made between sputum-positiveand sputum-negative cases, and owing to these andother important omissions, it is difficult to form anestimate of the value of the tuberculosis work inBradford. It would be well if, in the preparation ofreports of this kind, a uniform procedure were to befollowed, so that a fair comparison could be madebetween the tuberculosis organisations in the variousparts of the country.

The JY Ray Diagnosis of PulmonaryTuberculosis.

A small monograph has recently been published byDr. Max Cohn on this subject. A particularlyinteresting chapter is devoted to the X ray diagnosisof miliary tuberculosis, and of all the forms of pul-monary tuberculosis, the miliary is, according toDr. Cohn, the one which presents the most definiteX ray picture. The X ray diagnosis of miliarytubercle of the lungs is barely ten years old, but it hasbeen worked up to such a pitch of perfection that thiscondition may now be detected by the X rays earlierthan by any other method. Dr. Cohn supports thisclaim by an account of a soldier admitted to hishospital during the war for observation. Thereappeared to be little amiss with him apart fromoccasional attacks of lassitude ; the ordinary physicalchest signs were negative. But the X rays showed thecharacteristic fine mottling, and after six weeksthe patient died, and the necropsy confirmed theX ray diagnosis of miliary tubercle. Again andagain Dr. Cohn has diagnosed miliary tubercleof the lungs at a stage when the clinical diagnosishalted between influenza, empyema, and an inter-lobar effusion.

A Report on the Friedmann Vaccine.The Committee appointed by the Prussian Landtag

to inquire into the merits of the Friedmann vaccinehas now issued its report. 2 It is not very helpful.This was, perhaps, inevitable. For as many membersof the Committee had long ago ranged themselves onone or other side as inveterate enemies or enthusiasticadvocates of the remedy, a unanimous report couldhardly have been expected. The main report is alukewarm analysis of the results achieved, andthe nine members of the Committee not signingthis report have dissociated themselves from itin two groups, the one insisting that the reportis too favourable, the other too unfavourable.It would, therefore, seem that the result ofthe work of this Committee is to prove that theFriedmann remedy is useful, useless, neither, or

both.

1 Tuberkulose Bibliothek. Die Lungentuberkulose im Röntgen-bilde. Leipzig: Johann Ambrosius Barth. 1923.

2 Deut. med. Woch., April 13th, 1923.