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time when the cervix was two to three fingers’ dilated,was 17 hours in primiparae and six hours in multipart.Ether was eliminated from the child’s lungs. Therewas in no case any need for resuscitation, and delayin the second stage was not abnormal. As regardsalleviation of pain, 21 patients had no recollectionof any pain after the beginning of treatment, 13had marked relief, 6 had moderate relief, and only-1 woman was quite conscious of her labour.

CENTRAL BUREAU OF HOSPITAL

INFORMATION.

AN event of importance to all those interestedin hospitals is the merging into a Central Bureau,of the corresponding organisations of the IncorporatedAssociation of Hospital Officers, the British HospitalsAssociation, and the Joint Council of the Order ofSaint John of Jerusalem and the British Red CrossSociety. In the new Bureau all the informationpreviously collected and issued by these bodies is nowpooled. The chief activity of the past year has beenthe preparation of the first edition of the HospitalsYear Book, which retains everything of generalinterest that previously appeared in " Burdett’sHospitals and Charities." The work has been heavy,but the result will prove to be worth the effort.’The Year Book is appearing in two main sections:a report giving particulars of the work done and offinances and kindred matters; and a directory of

institutions, with addresses, names of chief officials,and other particulars. In addition to hospitals,dispensaries, and convalescent homes, the Year Bookenumerates nursing institutions, homes for the

mentally and physically defective, medical univer-sities, and administrative and collecting societies.The publication price has been fixed at 15s.,but hospitals and kindred institutions may obtaincopies for 10s. if they order them direct from thepublishers.

In addition to the Year Book, the Bureau publishesmemoranda on topics which concern hospitals.During 1930 these publications covered such subjectsas outside laundry work for larger hospitals, rubberflooring, working arrangements of X ray depart-ments in hospitals of 50-100 beds, and the cost ofbuilding of hospitals recently constructed. Manyother memoranda apply to particular districts or

groups of hospitals. The advice and assistance whichmay be obtained from the Bureau is being soughtmore frequently by boards of management of voluntaryhospitals, particularly in connexion with the selectionof sites and the preparation of plans for new buildings,or with investigation into the costs of administration.In the course of this work the director has visitedhospitals in various parts of the country and theBureau has prepared reports. He has also visitedseveral towns to discuss local problems with thecommittees of hospitals, or to address public meetingson behalf of local institutions. The Bureau has alsoassisted, as in previous years, in the distribution ofmoney raised for a group of hospitals. The list of theBureau’s activities is published in the eleventh reportof the Joint Council 1 ; it covers more than a fullpage and embraces topics of amazing variety. Itsaims (summarised), in addition to publishing theYear Book, are to collect data concerning all mattersof administrative interest ; to make inquiries forthose responsible for guiding hospital policy; toestablish a library of hospital literature, and to act as

1 12, Grosvenor-crescent, London, S.W.1.

a clearing house of information. Its services are

available without further fee to all hospitals whichare members of the British Hospitals Association.An organisation of this kind grows in usefulness inproportion to the use that is made of it, and hospitalscan best serve themselves and each other by taking theBureau into their fullest confidence.

MINERS’ NYSTAGMUS.

THERE are two schools of thought on miners’nystagmus, one looking on it as a local affection ofthe eyes due to long hours of work in darkness, whilethe other regards it as a manifestation of psycho-neurosis. 1 In a paper2 by Mr. W. J. Roche, of New-port, Mon., both these points of view are recognised.As is clear from Prof. Collis’s lectures, reported onp. 1220 of our present issue, the condition is of greateconomic importance. Mr. Roche says that between1910 and 1929, with a diminution of the total numberof men employed underground, the incidence of thedisease increased threefold, despite many of the

improvements as to lighting recommended by a

committee of the Medical Research Council in 1922.The percentage of the underground workers receivingcompensation in 1929 was 1,2, at a cost of 1440,000.Yet this only represents a small proportion of thecases of coal-miners with oscillations of the eyes. Inthe underground workers examined by Mr. Rochethey were present (though not necessarily constant)in 23 per cent. The great majority of these men arenot incapacitated, and they only have to cease workif such symptoms as vertigo or photophobia super-vene. The school which looks upon the oscillationsof the eyes as the main feature of the disease is con-fronted by two puzzling facts-first, that whereasonly a small percentage of underground workers areincapacitated, more than 20 per cent. of them shownystagmic oscillations, the great majority withoutany disabling symptoms ; and secondly, that sincethe general substitution of the one-candle powerelectric lamp for the old hand lamp the number ofmen disabled by the disease has not only notdiminished but actually increased. In spite of thisMr. Roche believes that the main cause of the condi-tion is defective lighting, and he explains the last-mentioned anomaly by saying that the electric lightwith clear glass is dazzling, and causes disturbingafter-images. The ideal light for mines is the caplamp worn on the miners’ head, but it is heavy andthe men do not like it. As a compromise he advocatesa four candle-power electric light with frosted glass.He himself, on taking on hewer’s work as an experi-ment, found this much more effective and less

irritating than the one candle-power clear glasslamp.

MEMORIALS TO CLEMENS VON PIRQUET.ON May 12th two impressive ceremonies took place

in Vienna at the unveiling of memorials to the lateProf. Clemens von Pirquet, director of the UniversityKinderklinik, who died in 1929. In the Central-friedhof, where his grave is among those granted bythe city of Vienna to her most distinguished citizens,the memorial takes the form of a sculptured reliefsymbolic of his work for children, with a portraitin profile by Prof. Mullner. This was unveiled byDr. Schober, the present Foreign Minister and late

1 See annotation in THE LANCET, May 2nd, p. 984.2 Brit. Jour. Ophthalmology, April, 1931, p. 211.