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be postponed for a second examination aftersuitable treatment; mercurials, salines, and a re-stricted diet generally reduce the tension. Aconsiderable range of blood pressure is con-

sistent with good health. With some the systolicpressure is naturally high, and such persons maylose their sense of well-being if it falls below140. There is, again, the subject with habituallylow pressure, who is fain to get up and walkabout his room to help him to think. In viewof the natural rise with age, especially at the

climacteric, a periodical testing after the age of40 years would be a good practice. No decisiveindication as to the effect of tobacco on bloodpressure has been reached. In an extreme instancequoted by Dr. H. W. Collier, a man of 34 had smokedvery largely since childhood: his systolic readingwas only 98. The relative importance of systolicand diastolic pressures was raised by some

speakers at the discussion before the AssuranceMedical Society; records were submitted, and itwas urged that the diastolic readings, indicatingthe minimal constant pressure in the artery, gavea truer indication of the strain upon thevessel, and were much less under the influence ofposture, exercise, and emotion. Others objectedthat reliable diastolic readings were difficult toobtain. We may point out, however, that, thanks tothe late George Oliver and to Professor MacWilliam,of Aberdeen, the auscultatory method has now beendeveloped in a form easy to practise. Furtherobservations are needed, and the influence of peri-pheral resistance, and the modern view of thestimulation of a weak ventricle by automatically in-duced increase of pressure must, among other fac-tors, be taken into account. But it seems likely thatdiastolic pressure records will in the future attainincreased importance for purposes of prognosis.

THE FOOD ALLOWANCE FOR BOYS AND GIRLS.THE medical officer of health of Bristol City,

Dr. D. S. Davies, has recorded a recent experience ofrevising the dietary of an institution for growingboys which has warned him that considerable life-long injury might be caused to boys and girls byinsisting upon a too strict regime in their cases.Of course, the needs of the growing and developingindividual are more important than those of theadult, and this point has already received officialattention, for in one of the pamphlets pub-lished by the Ministry of Food it is rightlystated that children need plentiful food for threereasons: first, their surface is large comparedwith their weight; secondly, they are growing;and thirdly, they are almost always very activecompared with many adults. It is generallyconceded that a child of 8 needs half as muchas a grown-up and a child of 12 three-fifths asmuch, while a girl of 16 needs as much as

her mother and a boy of 16 may eat as much ashis father. In these cases the foundations of freshtissue for development are being laid down, andthis goes on until the phase is reached of completemanhood and womanhood. Upon the conditions ofnutrition of growing boys and girls depends thefuture physique and mentality of the race. Parentsand guardians will do well to bear this in mindwhen the question of rationing juveniles is beingconsidered. Food should not be dealt out to thesein proportion to age, the children getting but afraction of the dose for an adult. The parent mustspare for the child.

THE MEDICINAL USE OF GLYCERINE.

THERE is now no glycerine being allotted formedicinal purposes, and pharmacists who haveexhausted their supply can only obtain more byborrowing from those who have some left. As wenoted four months ago the Ministry of Munitionsconsidered that the stocks then in the hands ofpharmacists should be sufficient to meet the

legitimate demands of prescribers. An analysis ofprescriptions undertaken by the Chemist and

Druggist 30 years ago showed that glycerine cameout ninth on the list of favourite drugs, and its useboth in mixtures and as a toilet preparation hasprobably much increased since then. But neitheras a solvent, a demulcent, or a flavouring agent isglycerine at all indispensable, and medical menwould do well to assist the pharmacist in restrict-ing its use to the few remaining purposes-perhapsin the case of calf lymph or in organo-therapeuticextracts-in which hardship would result from itswithdrawal. It should hardly be necessary to pointout that to prescribe glycerine freely in a lotionmight place the conscientious pharmacist in adifficult position. He is prohibited by law fromsupplying it direct to one customer for toiletpurposes, and it would be invidious for him tosupply it to another customer for the same purposeon a medical man’s order.

ANÆSTHETICS IN MILITARY PRACTICE.

THE adminstration of anaesthetics at or near

the front was described recently in an admirablepaper by Captain Geoffrey Marshall before theSection of Anaesthetics of the Royal Society ofMedicine.1 The author, in spite of the stress andhurry of a busy casualty clearing station, madescientific clinical observations on a number ofcases, and his conclusions form a valuable additionto our knowledge of the factors that should indi.cate the choice of anoasthetics and the methodsof administration in the exceptional conditions ofshock, heamorrhage, and septic tog2emia. Perhapsthe most striking lesson which Captain Marshalldraws from his observations is the danger ofchloroform and of spinal analgesia in the presenceof the combination of shock and recently pro.duced anaemia. In civil practice we are familiarwith the baneful effect which anæmia has in

influencing the behaviour of the anaesthetisedsubject; when that anaemia is grave and recentlyproduced the effect is so pronounced that theproper selection and administration of the anæs-

thetic may make the difference between life anddeath. The use of

"

gas and oxygen " or of warmedether vapour should result in saving lives in thesecritical cases.

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PREPAREDNESS.

THE April number of the Military Surgeon openswith a paper entitled "An Apostle of Preparedness,"discussing the teaching of Lauder Brunton, andwritten, of course, before the United States hadcome into the war. The writer, Dr. Fielding H.Garrison, lieutenant in the Officers’ Reserve Corpsof the U.S. Army, addresses himself particularlyto the volume of essays on physical and mili-tary training written by his old teacher in thelast 17 years of his life. Brunton securedless popular support for his views than theydeserved because he tried too openly to introduce

1 THE LANCET, 1917, i., 615.