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the distributing centres in the town. These methods mayseem to imply such a strict attention to details as to be

beyond practical application but, as Dr. McCleary pointsout, they are in operation in the city of Rochester in NewYork State. Precise precautions are carried out at this

depot to sterilise not the milk but everything with which itcomes into contact. Another defect of the British milk

dep6ts pointed out by Dr. McCleary is that practically noprovision is made for the effective individual medical super-vision of the children. There is no doubt, he thinks, that thevalue of our dep6ts would be much increased if a regularmedical consultation formed part of the work and espe-cially if that consultation were opened to nursing mothers.Finally, Dr. McCleary concludes that (1) municipal milkshould not be sterilised milk but clean milk producedunder the strictest possible aseptic precautions. For thispurpose the cows must be owned by the municipal autho-rities. 2. Municipal milk should be supplied primarily tothree classes of consumers of milk-namely, nursing mothers,children over nine months old (who would not in the naturalcourse of events be breast-fed, or at all events not whollybreast-fed), and infants under nine months for whom breastfeeding is impracticable. Lastly, it should be the object ofthe municipality to increase the number of nursing mothersso as to diminish the number of infants placed in the lastcategory. -

A CASE OF TRAUMA OF THE POSTERIOR PART OFTHE SECOND FRONTAL CONVOLUTIONFOLLOWED BY ATAXIA, NYSTAGMUS,

AND EPILEPSY.

AN interesting case was reported to the American Neuro-logical Association and was subsequently published in theJournal of Nertozis and Mental Disease for February last byDr. F. X. Dercum, in which a man; aged 24 years, whosefamily history was good and who enjoyed good health,received a blow on the head from a baseball bat. He was

stunned and subsequently lay in bed for some weeks withdelirium passing into mental confusion. Examined twomonths after the injury the condition was as follows. There

were two extensive scars in the frontal region, one on eitherside of the median line, that on the right side being thelarger and more serious; there were also present ataxicgait, tremors and ataxic movements of the left handand arm, nystagmus on lateral movement of the eyesof an irregular and ataxic kind, difficulty in standing oneither foot, especially on the left, and intense headache.An exploratory operation in the right frontal region wasadvised but was refused. About a year after the accident anattack of an epileptic nature, succeeded by severe frontalheadache, occurred. The patient was re-examined. The graspof the left hand was found to be defective and he stood with

difficulty on the left foot ; there were persistence of tremorin the left hand, ataxia of the left limbs, diminished sensi-bility of the left arm, and diminution of the left knee-jerk.The condition of the eyes was as before. Rather more than a

year after the accident he was operated upon, an osteoplasticflap being removed in the right fronto-parietal region from theborder-line of the hair to just behind the Rolandic fissure.The dura mater was yellow and adherent to the pia-arach-noid over an area of from four to five centimetres. The

cortex on incision was found to be darker and redder thannormal and softened. The posterior portion of the secondfrontal gyrus was the region specially involved. The patientmade a good recovery from the operation and examinationfrom time to time showed improvement in the symptoms.At the final examination, a little over four years after the

accident, the condition was as follows: the ataxia was absent,the patient stood well on either leg, the knee-jerks werenormal, the tremor in the left hand was disappearing, therewas slight awkwardness in movements of this hand, nystagmuswas still present on lateral movement of the eyes, there was

no feeling of numbness, and headache was rare. No epilepticattack had occurred for over a year and only one was recordedafter the operation. The patient was unable to do hard work.The special interest of the case lies in the ataxia and the

nystagmus in Dr. Dercum’s view. He states that it is knownthat lesions of the frontal lobe may give rise to ataxia, some-times bilateral In connexion with the nystagmus it is

pointed out that the second frontal gyrus is a centre whichstands in direct relation to movements of the eye. But whilst

conjugate deviation has been noted in lesions of this regionnystagmus has not been previously observed, though refer-ence is made to a similar case of nystagmus reported byKlien at the time of appearance of the above paper.Attention is drawn to the general character of the convulsiveseizures although the lesion giving rise to them was limited.

PROPOSED CONFEDERATION OF THE LONDONMEDICAL SOCIETIES.

UNDER the above heading we publish in another column aletter from Sir William S. Church drawing attention to a

meeting to be held on April 10th at the Royal College ofPhysicians of London, at 5 P.M., when the question of thedesirability of uniting the central medical societies of Londonwill be discussed. At the annual meeting of the RoyalMedical and Chirurgical Society held on March lst the projectwas referred to in the President’s annual address and was wellreceived by those present and, as we reported last week, on theoccasion of the anniversary dinner of the Medical Society ofLondon held on March 15th, it was mentioned, by Sir WilliamChurch and sympathetically received by his audience.There can be but little doubt, in our opinion, that a con-federation of the medical societies of the metropolis wouldbe of great benefit in many ways. We hope that the forth-coming meeting will be largely attended and that a

conclusion favourable to confederation may be come to.

THE SUPPLY OF ELECTRICITY.

AN analysis of the accounts for the year ended March,1904, of the electricity supply undertakings established inthe County of London, together with miscellaneous statisticsrelating to the area of supply, capacity, output, and averageprice obtained, has been published by the London CountyCouncil. The most interesting part of this analysis to theconsumer is that which deals with the various prices chargedfor current per unit by different companies. The medical

man, too, who has uses for the current other than that of

lighting may well consider under what category he ought topay-viz whether that of lighting or of power and heat. Inmost cases the maximum price which is authorised to be

charged for each unit is 8d. but in a few instances it is 7d. or6d. and in the case of the Chelsea company it is as high as 10d.As a matter of fact, in no case in the County of London isthe maximum price charged. The methods of charging forcurrent are two. There is the flat rate system wherebycurrent is charged at a fixed rate per unit whether thedemand has been regular or intermittent. The maximumdemand system appears, however, to be generally the mostsatisfactory so far as the economical working of an under-taking is concerned, though it is difficult, we fancy, to

convince the consumer that this method is an advantageto him. The principle of the maximum demand systemis that the rate charged per unit depends on the regu-larity of the demand. The system involves, in additionto the usual meter, the use of a demand indicator, the

purpose of which is to register the maximum demand madefor current at any one time during the period (usually aquarter) of the account. It is thus possible to work out theequivalent number of hours per day during which the maxi-mum demand has been maintained and a sliding scaleof charges is applied accordingly. The public, however,in general prefer the fiat rate as being, perhaps, the more