1290

while the total ordinary policies showed a mortality of70 per cent. During the second year, while the totalmortality remained the same, the mortality on thelives examined increased from 39 to 47 per cent.It appears, therefore, safe to conclude that " thebenefits of the life extension examinations are

pretty well limited to the years immediately followingthe examinations, and run out at the end of aboutfive years." Dr. Knight’s report goes on to showthat the company in paying for these examinationshas had its principal returned, and has made a

200 per cent. profit on the investment, during a periodof approximately five years. This is on the assump-tion that the subsequent experience on these livesdoes not exceed the experience expected accordingto the American Men Table.

Dr. Knight points out in conclusion the reservationsneeded in arriving at even tentative inferences.They are reservations common to nearly all attemptsto measure statistically the effect of social measures.The results do not, nor could they, allow for thefactor of self-selection. The group of policy-holdersreported on elected to be examined, sought out theopportunity to be examined, and returned periodicallyfor examination, even though many of them showedno serious impairment. These facts denote that theywere persons taking their health seriously, and who,apart from medical examination, would be likely toadopt measures to protect their health. In theserespects there may have been initial bias in thespecial group which colours the general results,and it is not possible to measure the effect of thisfact. But we may agree with Dr. Knight that itprobably does not negative the highly favourableresults shown. On the whole the experiment hasbeen of great value, and even if the extent to whichmoney has been saved by the examinations andaction taken on these cannot be fully demonstrated,the system itself is likely to appeal to the insuredperson as well as the company, and may be imitatedin other countries.

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MEDICINE IN ART.

ACCORDING to Sir Berkeley Moynihan, who dis-coursed on " Medicine in Art " to a social gatheringof Fellows of the Royal Society of Medicine and theirfriends on Dec. 7th, the proverbial hideousness ofgargoyles was merely an exaggerated portrayal ofabnormal conditions. The celebrated gargoyle ofthe church of Santa Maria Formosa, at Venice,erroneously described by Ruskin as " leering in bestialdegradation " typical of the evil spirit of Venice inthe time of her decadence, was immediately reco-gnised by Charcot as the facies of hystero-epilepsy.This was the condition so frequently described anddepicted in the Middle Ages as of one possessed ofevil spirits," the exorcism of which was the subjectof many pictures by the old masters. The attitudeof the victim, characteristic of hystero-epilepsy, wasmore or less accurately portrayed in many celebratedpictures-for example, Reuben’s " Transfiguration,"in which the boy " possessed of evil spirits " wasdrawn with spine arched backwards, forearms flexedand pronated, and hands firmly clenched. SirBerkeley Moynihan showed pictures in which theartist had exhibited great anatomical knowledge inthe portrayal of emotions. Sir Charles Bell, themedical artist, had drawn the face of the father inthe Laocoon when he wished to portray " anguishand the sense of impending death." Many diseasesonly recently recognised had long been recorded inart. The Egyptian god, Ptah, whose images dateback to 3000 B.C., was a typical achondroplasticdwarf, and so also was the god Bess, who presided atbirths. In the Bayeux tapestry Turold, the horse-holder, was an achondroplasiac, and many pictures,such as Velasquez’s Antonio the Englishman,"showed achondroplastic dwarfs in charge of animals.Deformities, such as talipes equinovarus and genurecurvatum, were represented in early Egyptian art,while the bust of _Tsop showed the angular curvature

of Pott’s disease. Early Roman bronzes even por-trayed the condition of hydrocephalus. One ofHolbein’s canvases was a faithful reproduction ofrhinophyma. The late Sir Spencer Wells had alwayssaid that the famous portrait of Mary Tudor depictedthe typical facies of a woman with an ovarian cyst.The craft of the surgeon was also represented in art-the operation most frequently portrayed being circum-cision. Sir Berkeley Moynihan showed a pictureof the removal of a sebaceous cyst by a surgeon whosediploma hung on the wall behind the patient, whilehe carried another in his hat. A picture in theSistine Chapel depicted the first woman surgeonperforming circumcision, while another, by Moroni,even showed an early appliance for dropped-foot, theresult of a wound of the external popliteal nerve.The address was learned, amusing, and suggestive,

and was very highly appreciated by the audience.

HYGIENE BY EXAMPLE.

A SOCIETY, entitled L’Hygiène par I’Example, hasbeen formed in France, with Mr. Leon Bourgeois,former President of the Republic, as its first president,Dr. Marchoux, professor at the Pasteur Institute, asgeneral secretary, and Mme. Leon Mazart as assistantsecretary. As its title implies, the object is not todeliver lectures or distribute pamphlets but to preachby example. Therefore, wherever its members canobtain admittance they endeavour to introduce somemodification that will tend to improve the health ofthose concerned. In rural districts especially, andin elementary schools, there is much need of sanitaryimprovement. Thus, for example, a boys’ school wasdiscovered with no water-supply and no washingaccommodation. Thereupon a hose and pump wasinstalled at the communal wells, and the boys weredrilled in pumping water to the school and in givingthemselves a thorough wash every day. Then, again,in Paris there is a school for weakly girls in the rue desEpinettes, a crowded neighbourhood. Thereupon thesociety arranged for a class-room to be built near,at the fortifications in the Boulevard Bessieres, wherethere is a large expanse of open air hard by. Theroom was well heated and well ventilated, care beingtaken to distribute the cold air as it entered andprevent any direct draught. In summer lessons aregiven in the open air and the pupils exposed as muchas possible to the direct rays of sunlight. They areall carefullv washed and abundantly fed. Statisticsare published setting forth the increased height andchest measurements resulting from all this care, andthis is truly termed a practical demonstration ofhygiene by example. There may be many occasionsin Paris and elsewhere when outside help or advicesupplies the final stimulus necessary to action, andthus a long meditated reform is realised.

THE INTERNATIONAL STANDARDISATION

OF SERA.

AT the conference which was started by permissionof the Government at the Ministry of Health on

Monday afternoon last, the President of the HealthCommittee of the League of Nations, Prof. Madsenof Denmark, presided. The various countries whoseleading workers in serological problems had beeninvited to attend were enumerated in our columns lastweek, and the following is a list of the correspondingdelegates.

Austria : Dr. R. Mueller, Professor of Serology at theUniversity of Vienna.

Belgium : Dr. Renaux, Deputy Director of the PasteurInstitute at Brussels.

France : Dr. Louis Martin, Sous-Directeur de l’InstitutPasteur, Paris ; Dr. Dopter, de l’Institut Pasteur, Paris;Dr. Cotoni, de 1’Institut Pasteur, Paris.

Germany : Prof. W. Kolle, Geheimrat, Director of theInstitute of Experimental Pathology, Frankfort; Prof. H.Sachs, Director of the Cancer Research Institute, Heidelberg.

Great Britain : Sir Frederick Andrewes, M.D., F.R.S.;Dr. II. H. Dale, F.R.S. ; Prof. W. Bulloch, M.D., F.R.S.