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artificially induced immunity to foot and mouthdisease. The Third Progress Report of the Foot andMouth Disease Research Committee will be publishedshortly.

VIENNA.

(FROM OUR OWN CORRESPONDENT.)

Conflicts in the Medical Profession. ’

THE increasingly difficult position of physicians inthis country has divided the profession into threedistinct groups: (1) doctors employed in full or inpart by the Krankenkassa, or sick-clubs, numberingabout 1200 ; (2) independent doctors with no fixedsalaries, of whom there are about the same number ;and (3) hospital staff doctors, university lecturers,and medical officers of health, some 2000 in all.The last group sometimes throws its lot in with thefirst and sometimes with the second, according topersonal interests. The clash of interests between thethree groups was recently manifest when the Govern-ment, or rather the political parties, attempted to winthe votes of certain sections of the community byorganising a new sick-club for bank employees andcertain business and factory clerks. The formation ofsuch a club would result in a large and by no meanspoverty-stricken section of the community beingtaken out of the hands of the private practitioner.The organisation of Vienna doctors refused to acceptthe proposal, and as its president, together with a fairproportion of representatives of the sick-club doctors,favoured the Government’s plan, he was forced toresign. After a very heated election campaign therepresentative of the independent doctors, Dr.Weinlander, was elected president by a small majority.Thereupon the other group threatened to separatefrom the organisation, and the danger of a split in theprofession seemed imminent. The conservativeelements in both groups were anxious to bring about areconciliation, and a few days ago we learned thatsome sort of an understanding had been reached whichwill enable all medical men to partake of the oppor-tunities afforded by the formation of a new big sick-club. Only a few appointments with fixed salarieswill be made for members living in outlying districts,all other members being allowed to choose theirphysician and specialist from a panel of doctors.Payment will be made at a fixed scale according towork done-i.e., for each consultation or call. Thismeans that the practitioner will have to work forlower fees than those paid by private patients, butthese are gradually disappearing. He does not losehis private patients entirely as they may come to himas panel patients. The sick-club doctors on their sidehave consented not to oppose the attempt which isbeing made to remove from membership of the sick-clubs those persons whose income is above ;1325 to ;1330a month. A certain section of wage-earners shouldthus be left to the private practitioner. The professionis also trying to bring this condition concerning incomeinto force in the other sick-clubs, especially amongstrailway, municipal, and state officials. Many of thesehave salaries of £50 to £80 a month. Yet they are allcompulsory members of the sick-clubs though thisincome is considered large in this country, beinggreater than that of most medical practitioners.

Voronoff’s Operataotz.At a recent meeting of the Vienna Society of

Physicians Dr. Schleyer showed two patients whosix months previously had undergone Voronoff’soperation, which consists of implantation of part ofthe testis of a monkey into the testis of a man. Thepatients were 70 and 56 years of age respectively, andtheir condition before operation was typical of senility,showing loss of mental and physical strength, withforgetfulness, fatigue, impotence, and loss of libido.No change was noticeable for five weeks after theoperation, but the older patient then stated that hewas beginning to feel much better, and after nine

weeks he again had erections ; the younger also feltstronger and was more active. Both men are satisfiedand look strong and healthy. In the discussion whichfollowed Dr. Schönbauer, from the Eiselsberg Clinic,reported on four Voronoff operations, two of whichhad had good results, and two of which had beenfailures. Experiments have been made in the clinicon the transplantation of testicles from one monkeyto another, and it was shown that the transplantedgland was always destroyed, microscopical examinationshowing that destruction took place within threemonths. Dr. Bachrach says that he has got the sameresults as Voronoff claims for his method by implantingtesticular tissue into the muscles of the abdominalwall. Prof. Bauer, who at first was sceptical about theresults of the operation, had to admit that evenexcluding auto-suggestion the improvement of somaticconditions is undeniable. He thinks that the implanta-tion of young glandular material into testes sufferingfrom regressive changes causes a distinct renewal oftheir function. Suggestion must be excluded, for the-favourable results do not appear till some weeks afterthe operation. Prof. E. Schwarz is not in favour ofthe word " rejuvenation," since he believes that thenormal physiological process of senility cannot beprevented by our interference. Transplantation-anoperation which can be repeated several times-simplyresults in a temporary renewal of the production oftesticular hormone, and this disappears with increas-ingly short intervals after each transplantation..Death cannot be averted. The effect, as Voronoffhimself has stated, lasts at most from two to fouryears, but even this added period of well-being isimportant to the aged, as Dr. Schleyer remarked insumming up the discussion.

Statistics of Practitioners in Vieitiza.As a result of the registration of medical men now

being carried out by the Vienna Board of Health,some interesting facts have come to light. Theyoungest practitioner (apart from hospital doctors) is23i years of age, and the oldest 87. The majorityenter the ranks of wage-earners at the age of 29y(40 per cent.), whilst only 12 per cent. settle downafter the age of 36. More than 70 per cent. of alLpractitioners are between 40 and 65 years, and 9 percent. of the total are women. There are 3-5 doctorsper 1000 inhabitants, and 3-8 women doctors per-10,000 female inhabitants. Whilst only 11 per cent.of the population of Vienna are Jews, they form over30 per cent. of the profession. Only Austrian subjectsare practising here, but over 20 per cent. are foreignborn-i.e., were born in places now situated outsidethe Austrian Republic. More than 22 per cent. ofthe total are specialists, and 10 per cent. are dentalsurgeons. About 2000 medical men (apart from thedental surgeons) have a telephone, and no doctor isallowed to practise in two separate places. Paneldoctors, however, can use their own consulting-roomfor private patients if the Krankenkassa provides themwith another one elsewhere for their panel patients.

PARIS.

(FROM OUR OWN CORRESPONDENTS.)

B.C.G. Vaccine.THE extent to which the daily press in Paris has

commented on the recent discussion at the Academyof Medicine on B.C.G. vaccine is a sign of the interesttaken in this matter by the man-in-the-street. Thefact that 81.600 infants have been inoculated withthe vaccine in France alone, between July 1st, 1924,and May 1st, 1928, shows how extensive has been itsemployment, and in as many as 75,000 cases it hasbeen given to infants in non-tuberculous surroundings.This is a point of the greatest importance ; no one,apparently, had any cogent objections to raise tothe use of B.C.G. in infants born into tuberculoussurroundings. The immediate and ultimate effectsof B.C.G. inoculation might be rather unpleasant.,