1323THE SERVICES.

the middle of July. The three fatal cases of"fever" corresponded with the number in the pre-vious week, while the three of whooping-cough exceededthe number in any recent week. The 121 deaths from allcauses during the week included 22 of infants under one

year of age and 27 of persons aged upwards of 60 years ;both these numbers showed a considerable decline fromthe numbers in recent weeks. Seven inquest cases andfive deaths from violence were registered, and 41, or 33. 9per cent., of the deaths occurred in public institutions.The causes of five, or 4’1 1 per cent., of the deaths regis-tered during the week in Dublin were not certified ; inLondon the causes of all but three of the 1212 deaths were

duly certified, while in Edinburgh the proportion of uncer-tified causes of death was 3 - 8 per cent.

THE SERVICES.

ROYAL NAVY MEDICAL SERVICE.THE following appointments are notified :-Staff-Surgeons:

G. E. Macleod to the Calypso; P. H. Bannister to the

Skirmisher; and H. H. Pearse to the Tharnes. Surgeons : R.Willan to the Barkant; A. B. Marsh to the Speedy, lent tem-porarily ; and W. J. Stitt to the Charybdis, on recommis-sioning.

ARMY MEDICAL SERVICE.Lieutenant-Colonel Walter G. A. Bedford, C.M.G., from

the Royal Army Medical Corps, to be Colonel (datedSept. 19th, 1908).

ROYAL ARMY MEDICAL CORPS.

The undermentioned Captains to be Majors (dated Oct. 28th,1908): Leonard Addams-Williams and Malcolm MacG.Rattray. Captain Dudley S. Skelton is seconded for serviceunder the Colonial Office (dated Oct. 14th, 1908). CaptainJohn F. C. MacKenzie resigns his commission (datedOct. 28th, 1908).

TERRITORIAL FORCE.

Yeomanry.Denbighshire (Hussars): The undermentioned officer, from

the Denbighshire (Hussars) Imperial Yeomanry, is appointedto the regiment, with rank and precedence as in the ImperialYeomanry (dated April lst, 1908) : Surgeon-LieutenantRichard Geoffrey Williams. Royal East Kent (The Duke ofConnaught’s Own) : Surgeon-Lieutenant Campbell TilburyFox, from the Royal East Kent (The Duke of Connaught’sOwn) Imperial Yeomanry, to be Surgeon-Lieutenant, withprecedence as in the Imperial Yeomanry (dated April lst,1908). Shropshire : Surgeon-Lieutenant-Colonel John DanielLloyd, from the Shropshire Imperial Yeomanry, to be

Surgeon-Lieutenant-Colonel, with precedence as in the

Imperial Yeomanry (dated April lst, 1908). Sussex :

Surgeon-Lieutenant John Robert Steinhaeuser, from theSussex Imperial Yeomanry, to be Surgeon-Lieutenant, withprecedence as in the Imperial Yeomanry (dated April lst,1908).

Royal Horse Artillery.lst City of London (Honourable Artillery Company) : The

undermentioned officer, from the Honourable Artillery Com-pany of London, is appointed to the battery, with rank andprecedence as in the Honourable Artillery Company ofLondon (dated April lst, 1908) : Surgeon-Lieutenant-Coloneland Honorary Surgeon-Colonel Richard James Reece. 2ndCity of London (Honourable Artillery Company) : Theundermentioned officer, from the Honourable Artillery Com-pany of London, is appointed to the battery, with rank andprecedence as in the Honourable Artillery Company ojLondon (dated April lst, 1908) : Surgeon-Captain JohrFrancis Taylor.

Infantry.5th Battalion, Suffolk Regiment: Surgeon-Captain Sidney

Hillier, from the 2nd Volunteer Battalion, The Suffolk Regiment, to be Surgeon-Captain, with precedence as in the Volunteer Force (dated April lst, 1908). The Hertfordshire Battalion, The Bedfordshire Regiment: Surgeon-LieutenanArthur Herbert Foster, from the lst (Hertfordshire) VolunteeBattalion, The Bedfordshire Regiment, to be Surgeon-Lieutenant, with precedence as in the Volunteer Force (datelApril lst, 1908). 7th Battalion, Cheshire Regiment

The undermentioned officer, from the 5th Battalion,The Cheshire Regiment, is appointed to the bat-talion, with rank and precedence as in the Volun-teer Force (dated April lst, 1908) : : Surgeon-Majorand Honorary Lieutenant-Colonel John Herbert Hacking.5th (Cumberland) Battalion, Border Regiment : Surgeon-Lieutenant William Marley-Cass, from the 3td (Cumberland)Volunteer Battalion, The Border Regiment, to be Surgeon-

’

Lieutenant, with precedence as in the Volunteer Force (datedApril lst, 1908). 4th Battalion, Essex Regiment: Surgeon-Captain James Aitken, from the 1st Volunteer Battalion,The Essex Regiment, to be Surgeon-Captain, with precedenceas in the Volunteer Force (dated April lst, 1908). 9thBattalion, Durham Light Infantry : Surgeon-Captain JohnArthur Kendall, from the 5th Volunteer Battalion, TheDurham Light Infantry, to be Surgeon-Captain, with pre-cedence as in the Volunteer Force (dated April lst, 1908).

Royal Army Medical Corps.Sir Frederick Treves, Bart., G.C.V.O., C.B., late Honorary

Colonel, Royal Army Medical Corps (Militia), is appointedto the Honorary Colonelcy of the Royal Army Medical Corpsin the Wessex Division (dated Sept. 21st, 1908)

lst Home Counties Field Ambulance: Lieutenant JamesS. Warrack to be Captain (dated May 19th, 1908). 2ndScottish General Hospital: Honorary Lieutenant in the

Army Auckland Campbell Geddes (formerly Captain, TheQueen’s Rifle Volunteer Brigade, The Royal Scots (LothianRegiment) ), to be Major (dated June lst, 1908).

Sanitary Service : Major Arthur Newsholme to be Lieu-tenant-Colonel (dated August 22nd, 1908). Arthur CyrilBird to be Lieutenant (dated August 12th, 1908). Surgeon-Lieutenant Charles Kessick Bowes, from the lst VolunteerBattalion, The Buffs (East Kent Regiment), to be Captain(dated April lst, 1908). Surgeon - Captain FrederickBurroughs Jefferiss, from the 4th Volunteer Battalion,The Queen’s Own (Royal West Kent Regiment), to be

Captain, with precedence as in the Volunteer Force (datedApril lst, 1908).

SURGEON-GENERAL J. P. GREANY, I.M.S.The Times of India of Sept. 26th devotes a valedictory

article to the retirement of Surgeon-General J. P. Greany ofthe Indian Medical Service. "When Surgeon-GeneralGreany went on leave early in the year," says our con-

temporary, "he was in very indifferent health, and it wasdoubtful if he could return. Consequently his retirement isnot unexpected, but it is sincerely to be deplored. The officeof Surgeon-General is one of the most difficult in the

presidency, and Surgeon-General Greany’s task was not madeeasier by the fact that his immediate predecessors wereappointed in the autumn of their lives and could not there-fore be expected to push forward a backward depart-ment with any great energy. But undaunted by thesedifficulties Surgeon-General Greany devoted himself heartand soul to his work. He was assisted by the larger funds atthe disposal of the Bombay Government, and although he hadto fight hard for his larger grants he would be the first to

recognise that he received liberal support from Government.In this way he was able to effect a very great improvementin the presidency hospitals and dispensaries, and materiallyto improve the condition of the Service. We say withouthesitation that Surgeon-General Greany was the best head ofthe Medical Department in Bombay we have experienced formany years, and that his régime was marked by an all-roundimprovement in the standard, whilst at the same time he waseverywhere not only respected but greatly liked. Everyoneconnected with hospital management and with the nursingservice feels that in the retirement of the Surgeon-General hehas lost a personal friend and a splendid controller of hiswork. We can only regard his severance from his work inIndia as a severe loss to the Government and as a source ofdeep personal regret." We have reproduced our con-

temporary’s remarks almost in extenso. Surgeon-GeneralGreany must feel highly gratified at such a testimonial,

, emanating, as it does, from a fully-informed source.THE TERRITORIAL FORCE: WATER SECTION DUTIES.

, Lectures are to be given to the men of the Territorial Forcerin water section duties. The lectures embrace a simple- account of the nature and properties of water, followed byi an explanation of the necessity of a sufficient water-supply: and the evils which result from a deficiency. A simple recital

1324 THE CONTAMINATION OF MILK.

is to be given of the diseases attributable to impure water,followed by an account of I I germs " and the part they playin the causation of disease. Filters are to be dealt with,also sterilisation and the utilisation of chemicals for theroutine purification of water. Arrangements are being madein the Southern Command by officers of the Royal ArmyMedical Corps to lecture at the more important centres ofthe Territorial Force.

THE SLEEPING SICKNESS COMMISSION.

Captain F. Percival Mackie, LM.S., has been selected bythe Government of India to join the Sleeping Sickness Com-mission which has recently left England for Uganda underthe auspices of the Royal Society and under the directionof Colonel Sir David Bruce, R.A.M.C. Captain Mackiehands over his duties as assistant to the Director, BombayBacteriological Laboratory, and joins Sir David Bruce andhis party at Mombasa.

ROYAL ARMY MEDICAL CORPS EXAMINATION.

An examination of candidates for not fewer than 30 com-missions in the Royal Army Medical Corps will be held onJan. 27th and following days. Application should be madeto the Secretary, War Office, London, S.W., not later than,Jan. 18th next, on which date the list will be closed. The

presence of candidates will be required in London fromJan. 25th.

______________

Correspondence.

THE CONTAMINATION OF MILK.

"Audi alteram partem." "

. To the Editor of THE LANCET.

SIR,-The question of the contamination of milk is one of,immense public importance and is now beginning to receivethe amount of attention which it deserves. As evidence ofthis I need only refer to the recent exhaustive report on thesubject issued on behalf of the East and West Ridings ofYorkshire, to another important report by the medical officerof health of Chester to which you have devoted a leadingarticle in THE LANCET of Oct. 24th, p. 1226, and also to anotice in the Times of Oct. 26th in reference to the action ofthe public health committee of the London County Council.In the very elaborate work on

" The Bacteriology of Milk "

by Swithinbank and Newman (1903) they say "that thereare two rises and two falls in the number of bacteria,[in milk], the first being due to extraneous organisms, and thesecond to lactic acid organisms, "and they believe this " to bethe almost universal rule in untreated natural’ milk " (p. 135).At the first decline "the common extraneous bacteria dieout, and that for the very simple reason that they cannot livein the presence of the new tide of acid-forming bacteria."This is said to occur after about 12 hours at temperaturesbetween 60° and 98° F., whilst the second decline beginsafter six days at 60° and after 72 hours at 98°. As thedecline progresses moulds (OiddumL lactis, &c.) increase, so

that ultimately these latter completely replace the bacteria.A similar statement is made by these authorities in referenceto the ripening of cream," concerning which they say(pp. 187-189), ’’ In three or four days the number of organisms[bacteria] found in cream has abated, and eventually nothingremains but Oidium lactis, as in milk."

Seeing that these are the natural changes that occur inmilk and cream one would expect to find very distinctreferences in reports on ’’ the contamination of milk " to thepresence and abundance therein of spores and conidia ofmoulds, these being bodies enormously larger than bacteria.iHitherto, however, I have been unable to find any specificstatements on this subject, either in the Yorkshire report or.even in the important work from which I have quoted, inwhich the inevitable appearance of moulds is so explicitlystated. This is to me all the more surprising because ofcertain observations of my own many times repeated duringthe last eight years. The first and simplest observations were.of this nature. Fresh milk from one of the very bestLondon companies was poured into a small one ounce i- sterilised beaker over which another was inverted. If left.at a temperature of about 70° F. a thick layer of cream soon rises to the surface,, and when minute portions of this are i

r, examined by the microscope after about 33 hours thoughty myriads of bacteria are to be seen no spores of mould can, be detected; but in from 40 to 45 hours I have invariablyle found conidia of mould together with more or less myceliumle infiltrating the layer of cream.y After studying the work of Swithinbank and Newman a)f few months since and reading the Yorkshire report I have

repeated these observations, and carried them much furtherwith the purest milk that I could obtain both from Londonand the country. The new observations have been of this

y nature. A shallow Petri dish containing some layers of-

blotting paper on which a microscope slip was placedr

was thoroughly sterilised (so that the blotting paper became0. scorched) ; and as soon as this had cooled a little some

e recently boiled distilled water was poured over the blottingpaper, and a single drop of fresh milk was placed by meansof a sterilised pipette on the centre of the microscope slip.The cover of the Petri dish, which had been thus brieflyremoved, was then replaced, arrangements having been made

- that in this damp chamber the cover should come into contactwith the drop of milk, which was thus fixed between it and

the microscope slip. This arrangement was made because ithad been found that conidia of mould always tended to

subside to the level of the slip. Therefore, when the coverof the Petri dish was removed for examination of the dropafter some days the less important portion of the milk wascarried away with it. The application of the cover glassto the slip could then be made and the result of theexperiment studied.What I have invariably found has been this : that in four

or five days with a temperature of 70° to 650 F. thousands oftorula-like bodies or conidia were to be found among themilk globules and swarms of bacteria. It seems perfectlyclear that the milk has to be rendered acid by the swarms oflactic bacteria before the moulds can make their appearance.But we may well ask, Whence come they ? Can we believethat the air is so full of the spores or conidia of Oidiumlactis or other common moulds that in every single drop of thepurest and most carefully preserved milks supplied to thepublic these moulds can be made to make their appearance?My observations are thoroughly in accord with the state-

ments of Swithinbank and Newman as to the natural changesoccurring in milk and cream. Yet the bacteriologists tellus nothing about the prevalence of the conidia of moulds inmilk, and although they are so much larger than bacteria theyseem almost to elude their observation. I searched carefullyfor information on this subject in the Yorkshire report and theonly definite statement I could find is that made on p. 56, inwhich Dr. Thomas Orr says in reference to the examinationof sediments obtained by the centrifuge from various speci-mens of milk: ’’ Bacteria were always present and some-times yeast cells." Surely bacteriologists ought to tell us

something more about the invariable appearance of mouldsin milk. I am, Sir, yours faithfully,

H. CHARLTON BASTIAN.The Athenaeum, Pall Mall, S.W., Oct. 26th, 1908.

ON CHRONIC MORPHINISM AND ITSTREATMENT.

To the Editor of THE LANCET.SiR, -In THE LANCET of August 15th, p. 439, there appeared

what may be termed a " causerie " on the Opium Habit by SirDyce Duckworth, characterised, as Professor A. Gamgee inhis subsequent paper in THE LANCET of Sept. 12th, p. 794,remarks, by much grace of style, but which, taken as anexposition of the question by a medical teacher, shows con-clusively how little the subject is understood in England.

"Sir Dyce Duckworth, "says Professor Gamgee, "attemptsno analysis of the essential causes, leaves absolutely un-touched the nature and the clinical characters of the multiplecravings...... which are rendered evident by the circulatory,respiratory, digestive, metabolic, and nervous phenomena....... He ignores the methods by which these distressingsymptoms may be combated ...... and he throws the wholeweight of his authority " in favour of what Professor Gamgeecalls the ’’ extremely vicious

" English system, a systemwhich to recommend at the present day, when the morphiahabit can be cured without the infliction of suffering, is, asMr. J. Q. Donald remarks, "almost criminal," and showseither the most unpardonable ignorance or the most surprisinginhumanity.