AUG. 6, 1932] CHRONIC HYDROCELE OF THE TUNICA VAGINALIS THE 3BRITISH'- 241

the block in the glands. Is it not possible the B. colimay not cause the same obstruction by direct infection ofthe glands from the bowel? Constipation is generallymarked in these cases. If the hydrocele were tapped once,the bowel irrigated by the suda bath method, and thealkaline reserve of the blood maintained, it is possiblethat, if the glands had not become too fibrosed by inflam-mation, medical treatment might suffice for a cure.

RATIONALE OF INJECTION TREATMENTSmall quantities of iodized phenol are injected into the

cavity of the tunica vaginalis, with the object of cauteriz-ing the endothelial surface, closing the stoma, and causingthe two surfaces of the sac to adhere together-thus closingthe cavity completely. If an inflammatory reaction is pro-duced in this way, during the process of healing, proto-plasmic buds are sent out from the surfaces, which adhereto form a fibrosed mass. Unless the fluid injected isequally distributed over the surface of the endothelium,loculi will form, and recurrence will occur more easily.Also unless the fibrosed mass-in fact before it has time tobecome too fibrosed-is massaged regularly inflammatoryreaction will be set up in the testis, and may cause im-potence.

TECHNIQUE OF METHODThe amount to inject in each case must be decided by

the general condition of the patient and the size of thehydrocele. Not more than 5 c.cm. should be injected atany one sitting or serious inflammatory reaction will occur.It is better to commence with 2 c.cm.The patient is placed in the lithotomy position on a

genito-urinary table and the entire perineum and scrotumcleansed with ether soap ; surgical methylated spirit isapplied, which partly anaesthetizes the area.- The surgeonstands in front of the patient and with his left hand appliespressure from above downwards from the upper part of thescrotum, so that his fingers lie behind and can palpate thetestis. A 20 c.cm. Record syringe, fitted with a full-sizeneedle, is used. The needle is thrust through the' scrotaltissues in an upward direction, carefully'avoiding the'super-ficial vessels. On piercing the sac all resistance disappears,demonstrating that the sac has been entered. All thefluid is withdrawn with the syringe. Then, with theneedle still in situ, iodized phenol (4 parts iodine to 2parts phenol, 3 minims for every ounce of fluid withdrawnis safe) is injected into the sac through the same needle.This is removed as soon as the injection has been com-pleted, and the scrotum is massaged for about five minutes.A collodion dressing is applied to the needle puncture.The patient usually experiences a burning sensation fora few minutes. Sal volatile should always be at hand,as the patient sometimes feels faint.

After treatment the patient should rest in bed fortwenty-four hours with the scrotum supported upon apillow, and should there be any pain, a lotion such aslotio plumbi c opio should be applied frequently on lint.

CASE RECORDCase IX, a wood-joiner, aged 63, from Suffolk,, complained

of bilateral hydrocele of four years' duration, which had beenperiodically tapped by his own doctor. There were no urinarysymptoms, no history of tuberculosis, and he denied anyvenereal disease. Constipation was constant without strongpurgatives. Examination revealed no obvious focus of infec-tion or evidence of tuberculosis or venereal disease. Hesuffered from myocarditis of rheumatic origin,. and had attacksof dyspnoea. His general condition would not have warrantedan open operation. Locally there was a bilateral hydroceledistending the scrotum to the size of a Rugby football. Thesize and weight were so great that it was necessary to havea special suspensory Xbandage made for him..

In1 view of the patient's poor .general health I deemed itwise to refrain from attempting to cure the condition in onesitting. The follow^ing treatment was therefore adopted.

September 10th, 1931. Left hydrocele tapped-13 pints ofclear, straw-coloured fluid removed and 2 c.cm. iodized phenolinjected. Right tapped-2 pints withdrawn; no injection.November 23rd, 1931. Left hydrocele-slight recurrence:

6 oz. fluid withdrawn, 3 c.cm. iodized phenol injected. Right-20 oz. fluid withdrawn, 3 c.cm. iodized phenol injected.

February 3rd, 1932. Left hydrocele-no recurrence. Right-5 oz. fluid withdrawn, 3 c.cm. iodized phenol injected.June 2nd, 1932. Left and right hydrocele-no recurrence.

Small fibrosed lump felt in front of each testicle. Testicularsensation no-mal.

OBSERVATIONSHydrocele of the tunica vaginalis is a common condition,

usually occurring in middle life.Injection treatment is simple, effective, and curative,

and is not followed by untoward complications.There is no recurrence or complications such as are

sometimes met with after open operation.No anaesthetic is necessary for injection treatment,

and there is the minimum absence from work.rlany cases are associated with constipation, which

suggests -that the cause may be auto-intoxication fromthe bowel through the lymphatics, acting as an obstruc-tion to their normal circulation.

MemorandaMEDICAL, SURGICAL, OBSTETRICAL

SYMPTOMLESS CORONARY THROMBOSIS

On January 12th, 1932, a retired schoolmaster, 70 yearsof age, was sitting at the table in a public library,writing, when he collapsed on to the floor and died almostinstantly.

HISTORY OF THE CASEOne of'"us knew the man slightly, and was his family

doctor, although he had never attended him professionally ashe was never ill. Careful inquiry from his relations andfriends has failed to suggest that he had had any symptomswhatever before the fatal seizure. He spent most of his timereading novels in front of the fire, smoking innumerablecigarettes-in fact he was never without a cigarette in hismouth. (Levine mentions smoking as one of the possiblecauses of coronary thrombosis.) He had spent Christmas withhis family in London, and enjoyed it with the youngest. Onthe afternoon of his death he had had tea as usual, and wentout about an hour afterwards. He does not seem to havehad any -difficulty over the two flights of stairs leading to thelibrary nor to have been short of breath. He had been sittingdown for about half an hour before he collapsed. He nevercomplained of pain, and any shortness of breath he may havehad lie -attributed to his age. His appetite was good, and hiswife never thought he was ill, nor indeed that he was a bitoff colour; but one of his friends has since said that hethought the patient looked older and greyer after his returnfrom London early in 1932.

Post-Mortemz FindingsAt post-mortem he was a well-nourished man, rather muscular

for his age. The pericardium contained about an ounce ofblood clot. The heart was normal in size, but there was ananeurysmal dilatation half an inch across on the posterioraspect of the left ventricle, over which there was some patchythickening of the pericardium. Rupture of this area of thinnedmuscle was the immediate cause of death.The coronary arteries showed gross senile degenerative

changes ; the left was the more extensively damaged, itsanterior descending branch being converted into a rigid calcifiedtube, with its lumen irregularly diminished in size but no-where completely occluded. The circumflex branch, passingdown the posterior aspect of the left ventricle, was almostoccluded at a point one inch from the auriculo-ventriculargroove; thrombosis had taken place just below this narrowing,resulting in infarcation of the myocardium. In the process

242 AUG. 6, 1932] MEMORANDA

of healing, the infarcted mass of muscle had become thinnedand fibrotic, allowing the formation of an aneurysm, belowwhich the myocardium was grossly fibrotic as far as the apexof the left ventricle. The endocardium over the affectedarea was somewhat thickened and roughened, but no thrombuswas attached to it. The right coronary artery displayedpatches of atheroma, and terminated as a very small posteriordescending branch. The aortic and mitral valves were

slightly thickened, but the valves of the right side were

normal.Microscopical examination confirmed the naked-eye appear-

ances, showing the atheromatous nature of the arterialdegeneration and the absence of any features of syphiliticdisease. The ischaemic necrosis of the myocardium had beenfollowed by fibrous tissue replacement of the destroyed muscle.All evidence of the immediate reaction to infarction had dis-appeared, and it is probable that some months at least musthave elapsed between the initial thrombosis and the fataltermination. The lungs, liver, spleen, kidneys, and brainwere normal. There was no oedema.

It is well known that coronary thrombosis may occurwithout pain, but when one considers the profound generalillness usually associated with the condition it is surpris-ing that a man and his friends should be entirely ignorantthat anything serious was amiss.

FREWEN MOOR, M.C., M.D.,Physician, Margate and District General Hospital.

HERBERT ROGERS, M.B., Ch.B.Assistant Pathologist, Bristol General Hospital.

PHOSPHORUS AND ALLERGYThe following case of allergy presents a point of interestwhich may have some bearing on the nature of allergicconditions in general.

The subject is a man, aged 30. His father suffered fromhay fever. His grandmother (maternal side) was a victimto asthma and bronchitis. The patient himself sufferedperiodically from hay fever until he went to live in the countryfour years ago (a district 300 ft. above sea-level, having an

ironstone subsoil). On one occasion recently he was workingin his garden with phosphate of lime-spreading the substanceas a dry powder. After working thus for about an hour henoticed symptoms similar to those produced whenever hehas eaten fish, to which he has been sensitive since earlychildhood. The symptom was that of swelling in thethroat, and forced him to abandon using the phosphate oflime. There was not the accompanying vomiting such as

occurs on his eating fish. The symptoms lasted for fivehours-until bedtime-and had disappeared next morning. Hehas not been in contact with phosphate of lime since thattime.

DIscUSSIONIt occurred to me that phosphorus might play a part

ini allergic conditions, being a constituent of protein-theusual excitant of allergy. A search through the literaturerevealed the following facts in this connexion-:

1. Those substances known to be common causes ofallergy are, as a rule, comparatively rich in phosphorus.Rackermann gives eggs, wheat, cow's milk, and, to a

lesser extent, fish, as by far the commonest foods givingrise to allergic symptoms. The following tables show thehigh phosphorus 'content of these foods compared withother articles of diet:

E7~gMAPul

Percentage of phosphoric acid (P,O,) in some fresh foods(Ilutchison).

Per cent Per cIgs 0.337 Cabbage ... ... ... 0.Ik ... ... ... 0.220 Turnip ... ... 0.,tato ... 0.140 Carrot

... ... OX

cent.)89058036

Amount of P in 100 grams of fresh substance (ash content of theedible portion of some common foods (Sherman).

Wheat, entire graiI ...n 469 mg. Potato ..... ... 61 mg.

Oatmeal 30... ... . m-0Ing. Cabbage ... 27 mg.

Beans, lima, dried 336 miig. Beefsteak, lean ... 22 mg.

Rice, polished 9 mug. A.pples ..... ... 13 mg.

WTheat flour ... ... 86 ing.

The second part of the table brings out the very highproportion of phosphorus in wheat-one of the commonestcauses of allergy-as compared with other foodstuffs.Different meats vary considerably in their phosphoruscontent. According to Sherman fish has a slightly higherphosphorus content than meat. An analysis of eggs andof milk reveals phosphorus to be the largest constituentof the ash in each case, with the exception of potassium.

2. Individuals manifesting allergic symptoms frequentlyhave a low blood phosphorus. Sterling says: " We havefound a marked deficiency in phosphorus in allergicpeople." Bray found a tendency to a low bloodphosphorus in allergic children-thirteen out of thirty casesshowed a blood phosphorus of less than 4 mg. per100 c.cm.

3. An important method of treating allergy tends toincrease the absorption of phosphorus from the intestineby the administration of hydrochloric acid by the mouth.Bray found in 200 analyses of the gastric secretion ofasthmatic children that 80 per cent. showed a responseof acid gastric secretion below the normal. Other investi-gators (Hurst, Duke, Brown, Rowe, Criep, and McElroy)have found varying proportions-sometimes strikinglylarge-of allergic subjects with hypochlorhydria or achlor-hydria. As a result, Bray, Lockard, Beckman, andothers have used the empirical remedy of hydrochloricacid in cases of allergy with deficient acid gastric secre-tion. Beckman in 1930 " collected together the resultsobtained in 237 cases treated by thirty-four physicians,each using the remedy for the first time. Of this number160, or 67 per cent., obtained complete or marked reliefof syniptoms."Now alkali interferes with the absorption of phosphorus

from the intestine, whereas "acid promotes absorptionof phosphorus " (Peters and Van Slyke). This fact doesnot appear to have been related to allergy in theliterature of the subject, but is mentioned by the aboveauthors, as follows: " Acidity of the intestinal contentsalso affects Ca and P04 absorption. Other factors beingequal, an acid diet causes diversion of more Ca and PO,from faeces to urine than an alkaline diet."

'Is it possible that the administration of hydrochloricacid in cases of allergy acts by promoting the absorptionof phosphorus from the intestine, increasing the phosphoruscontent of the blood, and thus removing an " innerfactor of- the allergy-an abnormally low bloodphosphorus?

4. The effects of phosphorus poisoning in some respectsclosely resemble allergic conditions. In phosphoruspoisoning the throat and tongue may become swollen,and vomiting may occur. Swelling of the throat andtongue, with vomiting, may also be seen in certain casesof allergy-for example, from eating fish. Urticaria, one

of the allergies, sometimes results from phosphoruspoisoning. Workers in match factories, using phosphorussesquisulphide, are liable to bodily effects similar to thoseof hay fever: " The sesquisulphide acts, in some instances,as an irritant, causing conjunctivitis and oedema of theeyelids" (Rosenau). These match workers are also liableto eczema of the skin.

5. A low blood phosphorus might be caused by aninability to make full use of the phosphorus in the diet(for example, in achlorhydria), or it might be due to adeficiency of phosphorus in the diet. In the UnitedStates this deficiency does seem to exist. According toSherman 0.88 gram of phosphorus is required daily fora body weight of 70 kilos. He states that " only eightout of 224 American families received this amount in theirdaily diet."

Vhile' no definite conclusion can be drawn from theabove facts, they seem to suggest that some allergic con-

ditions may be due to the ingestion of substances richin phosphorus by individuals with a low blood phosphorus.

I wish to thank Dr. G. Wv. Bray for corrections in thepreparation of the above memorandum.

London, W.9. R. L. WORRALL, M.B., CH.M.

r THE BRITrsFMIEDICAL JOIJRNAL

276 AUG. 6, 19321 OBITUARY [ THE BRITIS2OMEDICAL JOURNAL

sports in three successive years and played Rugger forthe hospital and for the United Hospitals, acquiring thecommon badge of Rugby footballers, a thick ear. Al-though of a retiring disposition his warm-heartedness andsincerity quickly became apparent to those who gainedhis friendship-; and as the writer of this notice is wellaware he was a trusty and loyal colleague. He leaves awidow and children to mourn the loss of- a devotedhusband and father; to his many friends he leaves amemory which is altogether pleasant.

SIR CHARLES BURTCHAELL, K.C.B.Lieut.-General A.M.S.

Lieut.-General Sir Charles Henry Burtchaell, Colonel Com-mandant R.A.M.C., K.C.B., C.M.G., K.H.S., died onJuly 28th after an operation in Queen Alexandra's MilitaryHospital, Millbank, aged 65. He was born at Kilkennyon August 30th, 1866, the son of Mr. Peter Burtchaell ofBrandondale, County Kilkenny, and was educated -atTrinity College, Dublin, where he graduated B.A.,M.B., B.Ch., and B.A.O. in 1889, subsequently takingthe D.P.H. at Trinity College, Dublin, in 1906.He entered the R.A.M.C. as surgeon captain on July

28th, 1891, and on May 20th, 1898, was promoted tosurgeon major, a special promotion for his services in theTirah campaign, which gave him five years' seniority overhis contemporaries. He was the last officer of theR.A.M.C. promoted to surgeon major before the grantof military titles. He became lieutenant-colonel eightyears later, and was promoted to colonel in the long warpromotion list of March 1st, 1915, to major-general onDecember 26th, -1917, and to lieutenant-general on June3rd, 1919, on appointment as Director of Medical Servicesin India, retiring on September 6th, 1923. He served inthe campaign on the North-West Frontier of India in1897-8, taking part in the actions of Chagri Kotal andDargai, in the capture of the Sampagha and ArhangaPasses, the reconnaissance of the Saran Sar, and theoperations in the Waran Valley and the Bara Valley, wasmentioned in dispatches in the London Gazette of April5th, 1898, was specially promoted to surgeon major, andreceived the frontier medal with two clasps. He nextserved in the South African war in 1899-1902, when hetook part in the advance on Kimberley, including theactions at Belmont, Enslin, Modder River, and Magers-fontein, and in other operations in the Orange Free Stateand the Transvaal, including the actions at Venterskroomand Lindley, was mentioned in dispatches in the LondonGazette of July 29th, 1902,- and received the Queen'smedal with four clasps and the King's medal with twoclasps. After the war he was appointed principal medicalofficer of the South African Constabulary, and held thatpost for three years, 1902-5.

Before the great war he was serving as AssistantDirector-General in the War Office, and in that capacitywas responsible for the allotment and mobilization of themedical units of the Expeditionary Force until he wassent abroad himself in October, 1914. There he servedas A.D.M.S. at headquarters, and when Lieut.-General SirArthur Sloggett retired in May, 1918, succeeded him asDirector-General of the Medical Services of the BritishArmies in France. He was mentioned in dispatches eighttimes, in the London Gazette of February 17th and June28th, 1915, January 1st, 1916, January 4th, May 29th, andDecember 24th, 1917, and May 25th and December 30th,1918. He received the C.M.G. in 1915, the C.B. in 1917,and the K.C.B. on January 1st, 1919; also the Legion ofHonour. On June 1st, 1918, he was appointed an HonorarySurgeon to the King. After the war his University gavehim an LL.D., and the Irish College of Surgeons anhonorary Fellowship ; and in 1925 he was appointed a

Colonel Commandant of the R.A.M.C. He married BerthaMarcella, daughter of Mr. J. G. Auret of Johannesburg,and had +1untw niiorht-erQ

The following well-known foreign medical men haverecently died: Professor MORITZ KATZENSTEIN of Berlin,an authority on plastic surgery and operative ortho-paedics, aged 59; Dr. JAMES BIRNEY GUTHRIE, professorof medicine, Louisiana State University Medical Centre,aged 56; Dr. JOHN FARQUAHAR FULTON, emeritus pro-fessor of ophthalmology and oto-rhino-laryngology, Minne-'sota Medical School, aged 73 ; Dr. WILLY MEYER.:emeritus professor of surgery, New York Post-GraduateMedical School and Hospital, aged 73; Dr. JACQUESSILHOL, professor of clinical surgery at the Marseillesfaculty of medicine, aged 58 ; Dr. PIERRE TEISSIER, pro-fessor of infectious diseases in the Paris faculty, memberof the Academie de Medecine, and commander of theLegion of Honour; and Dr. GLEBOWSKY, medical officerof health of -Moscow, aged 55.

Medico-Legal

RENT-FREE ROOMS: AN INCOME TAXPROBLEM

The position of- individuals having the rent-free use ofa house or rooms is somewhat confusing, because thequestion of liability to taxation of the benefit so accruingdepends in part not so much on the nature of the benefitas on the status of the person or body of persons employ-ing the individual using the rooms. The question in eachcase will, of course, be governed either by statute lawor case law, and it may be convenient to deal with thematter under those heads.

Statute Law(a) Rule II of No. VII, Schedule A, of the Income Tax

Act of, 1918 provides that houses or rooms belonging tothe Crown and occupied by an officer of the Crown arechargeable to tax on their annual value upon the indi-vidual officer. This provision was apparently designed tocover such cases as rent-free rooms in prisons, naval andmilitary barracks, or hospitals, etc. It merely brings theofficer concemed into the position of paying tax on in-visible income to the same extent as he would if he hadlarger emoluments and, like the great majority of tax-payers, paid his rent out of his taxable income.

(b) Under Rule I of No. VI, Schedule A, the publicbuildings, offices, and preniises belonging to a hospital areexempt so long as they are not occupied by an officerwhose total income amounts to £150 or more. Whererooms, etc., are occupied by an officer having such anincome the hospital authority is chargeable on the valueof such rooms (Governors of Sutton's Hospital in Charter-house v. Elliott), but whether the individual officer wouldbe liable to recoup the hospital for the tax paid on thevalue of his rooms is a question that has not been testedin the courts, and, we imagine, would be very unlikely tobe the subject of- litigation.

(c) With regard to ordinary property-that is, that notoccupied by either of the special classes mentioned above-the statutory rule is that income tax on the rental valueis chargeable on the " occupier." If he pays rent thetax is deductible pro rata from the rent when paid;if he is the owner the burden of the tax remains on hisshoulders, and represents the taxation of the benefitderived from his ownership of the property.

Case LawIt will be realized that, in applying the general rule

above, questions arise as to who precisely is the" occupier " who should pay, and bear the burden of,the tax. The leading case on this point is that of Tennantv. Smith, which was decided by the House of Lords in-1892. The point in issue was whether a bank managerresiding in rooms over a bank was liable to pay tax onthe value of the rooms which he occupied rent free. The

AUTG. 6, 1932] UNIVERSITIES AND COLLEGES rMrnirAL TnuR?AL 277

case was decided against the Crown on the ground thatthere were certain restric6ti6ns as to the use andn ighfsof tenancy of the rooms, and that the advantages of theoccupation were not received in money or in a formcapable of being converted into money-for example, therooms could not be let by the occupier. With certainmodifications, which are not relevant to the presentpurpose, that decision remains sound;.-law to-day. Con-sequently where an assistant is provided with furnishedor unfurnished rooms, which he has merely the right touse and not to let, his principal is entitled to treat thecost of supplying that accommodation as part of his pro-fessional expenses, but the assistant- is not liable toaccount for tax on the value of the benefit which hereceives in that way. AIn exception to this would ariseif the assistant had complete use and full control of thewhole premises so that he became the legal occupierof the house.There is, however, one special type of case which it may

be advisable to distinguish. Cases have occurred wherean employer has provided free quarters, and sometimesfree board, on the terms -that a specified deduction forsuch benefits shall be made from the nominal salarystated in the agreement for service. In such cases liabilityattaches to the nominal amount, although part of it doesnot reach the employee in cash (Cordy v. Gordin, 1925).

UNREGISTERED PRACTITIONER SENTENCEDAt the Central Criminal Court 6n July 21st, Richard W7illiamStarkie, aged 56, an unregistered medical practitioner, ofOaklev Square, St. Pancras, was founid guilty of using aninstrumeInt with intent to procure the miscarriage of awoman named Edna May Meredith, a -shop assistant, andwas sentenced to eighteen months' imprisonment. In hisevidenice the defendant, who denied the charge, stated thathe-i was struck off the Medical Register ten 'years ago. * Hehad previously been for eleven years a police surgeon, andhe had made a special study of gynaecology, and had heldan important post in a gynaccological hospital. He main-ta ined that he was entitled to carry on his practice as adoctor, although unregistered. The only requirement wasthat he should not pretend to be a registered medical prac-titioner.

After the defeindant had been found guilty, it was statedby the police that in September, 1921, Starkie was sentenceda.t the Central Criminal Court to nine months' imprisonmentfor administering a noxious thing with intent to procure mis-carriage, and in 1929 he was convicted of procuring drugs.Mr. Justice Roche said that in view of the fact that thedefendant had not been before the court during the last tenyears on this kind of charge he would refrain from passinga sentence of penal servitude.

Universities and Colleges

UNIVERSITY OF OXFORDAt a congregation held on July 30th the following medicaldegrees were conferred:

B.AM.-F. Hawking, IH. G. H. NNVaters, G. B. Malone-Lee, J. L.Ryce, WV. H. Greany, A. J. E. Edelsten, R. H. Bolton, R. L. H.Townsend, MIrs. Caroline E. 'Nicholson.

UNIVERSITY OF LONDONAt the June matriculation examination 205 candidates passedin the first division and 1,100 in the second division, 45 tookthe supplementary certificate in Latin.The following candidates have been approved at the exam-

ination indicated:AI.D.-Branich I (Medicinie): H. G. Close, AM. MI. Cowasjee,

Marjorie M. Dobson, C. N. Evans, I. Gordon, MI. Kremner, FlorenceLouis, *I. McPherson, Anna P. Montgomery, R. K. Price, T. N.Rudd, J. G. Scadding (Uniiversity Aledal). Branzch II (Pathology):Ruby 0. Stern. Branch III (Psychological Medicine): MI. Mlac-kenzie, Muriel L. MI. Northcote, D. N. Parfitt, Mary E. Tyars(H. and S.S.), Hilda MI. Weber. Branich IV (Midwifery and Diseasesof Women): F. S. Cooksey, Greta, I-lartley, F. Heber, MlarionRavell, F. R. Stansfield (University Medal), Dorothea C. Wigfield.

Branclh V (Stale M1feldicinie): E. J. de V'erteuil, R. D. (Gross,W. H. S. Wallace: Broach VI' (Tropical Medicine): R. C. Amies.

*Awvarded a mark of distiniction.The degree of M.Sc. (Physiology) has been awarded to

XV. R. Spurrell (Guy's Hospital Medical School).

ROYAL COLLEGE OF SURGEONS OF ENGLANDAn ordinary meeting of the Council was held on July .28th,when the President, Sir H. J. WVaring, was in the chair.

Sir Arthur- Keith was appointed Master of the BuckstonBrowne Research Farm. Mr. NV. Sampson Handley -wasre-elected a member of the Executive Committee of theInperial Cancer Research Fund.Diplomas of Membership were granted to the following

candidates who had passed the examinations in mediciiie,surgery; and midwifery of the Examining Board in Enlgand:Towhida Abdel-Rablman, H1. Ackers, R. XV. F. Alles, F. C.

Angicr, *if. Barcroft, V. IH. Barnett, -XV.- N. W. Barns, C. -1.Bateman, C. G. Batty-Smith, *F. H1. Bentley, R. II. Berry,F. R. BettleNv, G. A. Betts, R. IN'. Bhatia, J. D. If. Bird,S. E. Birdsall, R. N. Biswas, J. R. Blackburne; Marjorie Bolton,C. P. F. Boullen, T. Bromberg, Ethel D. M. Brook, 1) G. NV.Brown, L. I. S. Campbell, B. Cates, B. Chandra, J. W. Cheethaim,AX. H. Chenard de la Giraudais, S. J. Cliesser, T.. A. Connold,Gwendolen N. Cook, P. T. Cooper, A. C. Cox, C. F. Cuming;s,J. Cunard, Annia V. K. Cyriax, Phyllis E. Dain, D. T. Davies,W.V. H. D. Davies-, S. Chandra De, A. K. Deb, L. XV. B. Dobbin,N. M. lDurrani, R. AM. Ebeid, F. R. Edwvards, M. H. Evans,WV. J. M\. Evans, T. B. Field, R. .. K. Fleming, F. E. Fletcher,D. H. Fulton, A. H. Galley, D. XV. C. Gawne, P. A. I. Gorer,C. H. Gray, N. Green, Phyllis N. Greene, A. K. Guiha, MA. A. F. A.Hadi, M. Hafezi, J. Jialperin, R. J. C. Hamilton; J. C. Hardy,K. W. Hardy, E. R. Hargreaves, J. B. Harinani, L. P. Hodgson,J. S. Horsley, TI. G. HSovenden, J. Howkins, A. G. H. liuglhes,XV. Hunt, A. D1. Iliff, ITrsula Y. iun Thurn, E. James, J. R. E.James, XV. L. James, C. G. Jones, J. E. Jones, Katherine AI.Jones, XV. W. Jones, AM. Katz, B. S. Kaushal, Agnes V. Kelynack,G. WV. Kendrick, Ml. Klass, L. O'.N. Knox, C. P. Lanyon, AnnieLawson, Z. Lefkovitz, A. R. R. Le Flemnjng, Gladys A. Rf.Lenanton, Peggy Levi, P. Lewis, R. S. Lewis, L. IT-. B. Light,S. Livni, T. E. S. Lloyd, J. L. Lovibond, Ml. J. F. AlcArdle,J. C. MIcGregor, Mlary A. McKean, J. D. M\acLeod, 1-1. A: Alagnus,R. A. MIanclark, J. I. AMaran, Lois MI. MIarris, Gwendolen E.Mlatthews, F. S. A. Mlaw, P. V. F. Mercer, G. A. M\iller, M. A. N.MIoezuddin, NV. HL. WV. Morris, Edith A. AMuirhead, J. dIe C. Mluller,R. B. Munro, W. T. iNorth, HI. E'. Offord, T. G. Osler, G. H. C.Ovens; J. NV. Ml. Owen, J. S. Parkinson, R. E. -J. Pembrey,S. H. B. Platts, G. A. Powell-Tuck, *A. Rashid, G. R. C. Rayner,-H. G. Rees, T. G. Richards, A. E. G. Ridgw\ay, D. F. Robb,A. Rothwell, *E. Rudkin, T. J. Ryan, H. B. C. Sandiford,A. J. Sanghani, B. H. Sayed, J. WXI. V. Sheldon, I. Singh, F. J.Sladen, S. B. Smith, E. J. Somiierset, Charlotte Al. H. Sparrow,J. E. Stephens, F. Summers, Annie C. Taylor, N. S. Taylor,Enid A. Taylour, D. H. H. Thomas, H. R. Thomnpson, A. S.'Thorley, Greta Traub, H1. A. Treble, E. Troensegaard-Hansen,A. R. Walters, E. A. XVebb, C. U. XWickhamn, R. F. WX'inckworth,Albertine L. XV'inner.

Diplomas in Ophthalmic Medicine and Surgery weregranted, jointly with the Royal College of Physicians, to thefollowing:

WV. F. T. Adams, R. H. B. Barrow, A. S. Baxi, M. L. Bhagat,S. C. BiswA-as, R. Bolton, AM. MI. D. Chughtai, R. A. Condon,Margaret C. Falconar, S. H. Faulkner, P. Fleming, R. E. Henrv,R. Lal, A. imd Din AMinhas, I. A. Aloliamed, N. K. Munsi, XV. J.Robertson, C. B. V. Tait, R. WValkingshaw.

* M.R.C.S. previously granted.

ROYAI, COLLEGE OF PHYSICIANS OF LONDONAt a quarterly comitia of the Royal College of Physicians ofLondon, the President, Lord Dawson of Penn, in the chair,the following were elected officers for the ensuing collegiateyear: Censors, Robert Arthur Young, C.B.E., M.D., ArthurJohn Hall, M.D., George Frederic Still, M.D., Sir Thomas J.Horder, Bt.,' K.C.V.O., M.D.; Treasurer, Sidney PhilipPhillips, M.D.; Registrar, Raymond Crawfurd, M.D.Harveian Librariat, T. H. Arnold Chaplin, 'M.D.; AssistantRegistrar, Robert Oswald Moon, M.D.

AwardsThe Bisset Hawkins Gold Medal was awarded, on the

recommendation of the Council, to Dr. T. H. C. Stevenson,C.B.E., for his valuable work when Superintendent ofStatistics in the Office of the Registrar-General.The Presidlent announced that on the recommendation of

the Science Committee the Leverhulme Scholarships hadbeen awarded to Stanley J. Hartfall, M.D., M.R.C.P., andJ}hn Fleming Brock, M.B., MI.R.C.P.The Murchison Scholarship w^as awarded to G. HI. Newns;

M.'B., of Kinlg's College Hospital Medical Schlool.

278 AUG. 6, 1932] UNIVERSITIES AND COLLEGES

Harveian OrationSir George NNewman will deliver the forthcoming Harveian

Oration on October 18th at 4 p.m.

AppointmentsThe following appointments were announced: Sir Thomas

Lewis as Harveian Orator, 1933 Sir Humphry Rolleston asFitzPatrick Lecturer, 1933 ; Dr. C. S. Myers as BradshawLecturer, 1933; Dr. C. R.- Box as Lumleian Lecturer, 1933;-Dr. C. E. Newman as Goulstonian Lecturer, 1933; Dr. E. A.Carmichael as Oliver-Sharpey Lecturer, 1933 Dr. W. G.

Savage as Mitchell Lecturer, 1933 and Professor 0. L. V. S.de XVesselowv as Croonian Lecturer, 1934.

Dr. James Collier was appointed the College representativeon the National Florence Nightingale Memorial Committee.

Men bershipThe following candidates, haviing satisfied the Censors'

Board, were admitted Members of the College:Ghulamahmad Niazmohammad Ahmadi, M.B.Bombay, Simon

Behrman, L.R.C.P., Harold Walter Benharn, M.B.Lond., L.R.C.P.,Albert Harold Godwin Burton, MI.D.Lond., John Egerton Caughey,M.B.New Zealand, Judson TIvndale Chesternian, L.R.C.P., JackDinham Cottrell, M.B.Sydney, Gerald Henry Davy, O.B.E.,M.D.Camb., L.R.C.P., Geoffrey Duckworth, L.R.C.P., TheodoraClemetns EIasterfield, M.B.New Zealanid, Savid Abdel Kader Effat,Al.D.Cairo, Richard Huxley Fish, L.R.C.P., MAichael Scott MontagueFordham, M.B.Camb., Frank Forman, M.13.Aberd., Philip RutlandGravres, L.1R.C.P., Gilbert Steward Hall, i\I.B.Birm., L.R.C.P.,E-ric Oates Ilalliwell, L.R.C.P., Thomas Frederick Hewer, M.D.Bristol, Leonard Haydn Howells, M.B.Lond., L.R.C.P., AlfredThomas Lock Kingdon, M.B.Lond.,, L.R.C.P., Julius Libman,M.D.Liverp., L.R.C.P., George Roderick Marcano, M.D.Lond.,L.R.C.P., John Henry George MIason, MI.B.Lond., L.R.C.P.,\Valter Lindesay Neustatter, M\.B.Lond., L.R.C.P., George HenryNewvns, AI.B.Lond., WN'illiam Drev Nicol, M.B.Lond., L.R.C.P.,Christopher Robert L'Estrange Orme, L.R.C.P., Gerald EustacePeacock, L.R.C.P., Norman Swvift Plummer, l1.B.Lond., L.R.C.P.,Edwvard Tobias Renbom, i.B.Lond., L.R.C.P., David BrahamnRosenthal, M.B.Melb., Harley Edward SteVenes, M.B.Sydney,AldNvyn Brockwvay Stokes, L.R.C.P., George-_ Mellor Tickler,L.R.C.P., Henry Ashbourne. Treadgold, MI.D.Lond., L.R.C.P.Dagmar Florence -Curjel WNNilson, MAIl.D.Glas.,- Ian Jeffreys XVood,l\LD.Melb.

Licences and DiplomasLicences to practise physic wve-re granted to 159 successful

candidates, and Diplomas in Ophthalmic Medicine andSurgery to nineteen successful candidates, jointly with theRoyal College of Surgeons. (The list of successful candidatesis published in the report of the meeting of the Royal Collegeof Surgeons in this issue.)The following diplomas w ere also coinferred, jointly 'with the

Royal College of Surgeons:DIPLOMA IN PUBJ.IC HEALTIT.-E. R. Bennion, A. D. Cust, Idris

Davies, J. F. Galloway, C. Ive, J. D. Kershaw, S. Kin, AL. R.

Lakhwarah, Kathleen McC. McKeown, J. 1\1addison, N. F. Pearsoin,K. N. Sen, G.' McK. Thomas, C. HI. Williams.DIPLOMA IN TROPICAL MIEDICINE AND HYGIENE.-S. S. Alam, A. S.

Arora, E. F. Duck, P. B. Fernando, WV. A. Gomes, Florence R.liart, Esther C. Johnson, WV. A. N. MKarrow, N. AM. MI\ian, F. J.OM3Ieara, C. W. Richardson, Mary McD. Richardson, A. J.Sanghani, W. J. Silva, J. Singh, E. P. Veatch.DIPLOAMA IN PSYCHOLOGICAL AIEDICINE.-H. L. Burton, C. C.

Davis, S.. W.- Hardwick, W. V. Harke, W. Hinds, Effie L. Hutton,J. H. 0. Roberts, Mlarjorie E. F. Sanders, R. H. Stanbridge,E. S. Stern, C. A. Sundara Raj, L. S. Torrance.DIPLOMIA IN LARYNGOLOGY AND OTOTIOGY.-C. N. L. Cantor,

AT. A. Carneiro, S. K. Chatterji, W. A. D. Drummond, J.- C.MLcFarland, J. Parry-Evans, E. FE. Scharfe, R. R. S. Strang.

BRITISH COLLEGE OF.OBSTETRICS ANDGYNAECOLOGY

The quarterly meeting of the Council was held in London onJuly 25th, with the president, Professor WV. Blair-Bell, in thechair. 4

The President reported the deaths of two FoundationFellows-Professor H. Leith Murray (Liverpool) and Dr.WV. D. Macfarlane (Glasgow)-and of one Foundation Member-Dr. A. Remington Hobbs (London)-and resolutions ofsympathy were passed. Professor J. Windeyer (Sydney) wasadmitted to the Foundation Fellowship in absentia and Dr.

Ivan Young Patrick (Montreal) was admitted to the Founda-tion Membership in absentia.The President announced that the following candidates had

passed the examination for the Membership of the College:George Herbcrt Alabaster, William John Hunt Montgomery

Beattie, Charles Botterill Baxter, Gladys Helen Dodds, Eric ArthurGerrard, Alistair Gunn, Thomas Arthur Nornman Jeffcoate, HectorRoss MacLennon, ID)oUglas- Hamilton MIcLeod, Chassar Moir, Robert\Newton, Charlcs Ross Stansfield, Norman L. White.The President reported that a deputation of the Council had

discussed with the Standing Committee of- the Royal College

of Physicians and the Royal College of Surgeons the questionof a Diploma in Obstetrics and Gynaecology.The President informed the Council that it was hoped to

open the College House, 58, Queen Anne Street, at the endof October or the first week in November, but full details ofthe ceremony had not yet been arranged.The Council decided that the Honorary Fellowship of the

College should be conferred upon Sir Robert Jones, Bt.,K.B.E., C.B., F.R.C.S., and Professor W. P. Graves, Pro-fessor of Obstetrics and Gynaecology in 1-farvard University..Dr. John Shields Fairb-airn -was elected to be the next

President of the College, and to take office at the Autumnmeeting of the Council. Mr. Eardley Holland was re-electedhonorary treasurer and Professor Fletcher Shaxw honorarysecretary. Mr. A. Leyland Robinson (Liverpool) was electedto fill the casual vacancy on the Council created by the deathof Professor Leith Murray.

SOCIETY OF APOTHECARIES OF LONDONThe following candidates have passed in the subjects indicated:SURGERY.-N. P. Bruce, E. F. David, I. S. Lloyd, T. S. Nicol,

L. R. C. Rose.MIEDICINE.-R. N. O'D. Burns, AM. Davies, C. II. Fagge, A. E.

Glanvill, G. F. C. Harvey, D. Kyle, I-I. Owen, R. H. Wheeler.FORENSIC MEDICINE.-F. WV. Baskervill, N. P. Bruce, RZ. N. OD.

Burns, X. Cook, C. H. Fagge, A. E. Hassan, R. H. Wheeler.AMIDWIFERY.-R. N. OD. Burns, AM. B. Chlandulal, T. S. Nicol,

B. Shapiro, L. Wailer.The Diploma of the Society has been granted to Messrs.

M. l)avies, I. S. Lloyd, T. S. Nicol, and L. R. C. Rose.

Medical NewsThe Medical Research Council has appointed Mr. Ernest

Bevin; Dr. C. G. Douglas, F.R.S., and Mr. W. S.Morrison, M.P., to be members -of its Industrial HealthResearch Board in succession to Mr. Arthur Pugh, Pro-fessor E. P. Cathcart, F.R.S., and Major A. G. Church,who retire by rota on September 30th.The fourth international medical post-graduate course

of the Tomarkin Foundation will be held- at Milan fromSeptember 12th to October 2nd. The subjects to bedealt with comprise cardiac diseases, cancer, the hormones,anti-diphtherial vaccination, neurosyphilis, disseminatedsclerosis, and poliomyelitin. The speakers include manyof the leading authorities on the Continent. Furtherdetails may be obtained from the secretary of thisFoundation, Casella Postale 128, Locarno,7Switzerland.The forty-fifth international post-graduate course of

the medical faculty'of Vienna will extend from September26th-to October 8th, and will be largely devoted to thera-peutics, including such topics as collapse procedures of thelungs, radium and x-ray therapy, and the treatment ofdiseases of the heart, stomach, liver, gynaecological andobstetrical abnormalities, syphilis, and gonorrhoea. Theprogramme can be obtained from the Dean of the MedicalFaculty, The University, Ring des 12 November,Vienna, 1.The eighth Congress of the International Union against

Tuberculosis will be held at The Hague from September6th to 9th under the presidency of Professor Nolen,when the following subjects will be discussed: '(1) Rela-tions between allergy' and immunity, introduced by J.

Bordet of Brussels, followed by H. Aldershoff of Utrecht,S. Lyle Cummins of Cardiff, J. de Daranyi of Budapest,Debre of Paris, K. A. Jensen of Copenhagen, R. Kimlaof Prague, Bruno Lange of Berlin, D. Ottolenghi ofBologna, A. Wallgren of Gothenburg, and W. C. Whiteof New York (2) Chrysotherapy, introduced by L. Say6of Barcelona, followed by Burns Amberson of New York,Ameuille of Paris, F. Bocchetti of Rome, L. S. T. Burrellof London, Knud Faber of Copenhagen, Jaquerod ofLeysin, W. Neumann of Vienna, R. Renchi of Lwow, G.Schroder of Schomberg, and J. Valtis of Athens; (3)Post-sanatorial. assistance, introduced by B. H. Vos(Holland), followed by J. Bl:anco (Spain), E. Bresky(Prague), Buerger (Breslau), R. Courtois and E. Olbrechts(Brussels), Guimard (Bligny), N. Heitmann (Oslo), E.Morelli (Rome), H. A. Pattison (New York), D. A. Stewart(Canada), and Harley Williams (London).

r THF BRITTS7MEDICAL JOURNAL

AUG. 6, 19321 MEDICAL NEWS F THE BRITISHD ' 279- NEDICAL JOURNAL

The fourteenth International Congress of Physiologywill be held in Rome from August 29th to September30th. The inaugural' address will'be delivered by ProfessorA. V. Hill, on energy exchanges in muscle and nerve. The.subscription is 100 lire.The American Congress of Physical Therapy will meet at

the Hotel New Yorker, in New York City, on September6th, 7th, 8th, and 9th. The meeting will be lheld inconjunction with New York medical societies, and theBritish representative will be -Dr. F. fHoward Humphrisof London.The second International Congress of Tropical Medicine,

which was to have been held at Amsterdam next Sep-tember, has been indefinitely postponed owing to thepresent financial conditions.The annual dinner of the Chartered Society. of Massage

and Medical Gymnastics will be held at the ConnaughtRooms, Great Queen Street, on Thursday, September22nd, at 7.30 p.m.The address on tuberculosis schemes from the points

of view of the administrator and the clinician, which wasoriginally delivered by Dr. A. S. M. Macgregor, medicalofficer of health for Glasgow, at a meeting of the Tuber-culosis Society of Scotland last year, and published in theEdinburgh Medical Journal (vol. xxxix, No. 3, 1932), hasbeen reprinted in pamphlet form. Reference is made init to the authoritative article entitled " The outlook ontuberculosis," which appeared in the British MedicalJournial of January 10th, 1931.At the July meeting of the Central Midwives Board for

England and Wales a letter was received from the UnderSecretary of State for the Colonies, enclosing a copy ofan Act passed by the Legislature of Barbados for theregistration and better training of midwives in the island,and stating that he would be glad to receive any observa-tions which the Board might wish to offer. It was decidedto reply that the Board had no observations to make onthe Act, but that if the - General Nursing(Council ofBarbados wished to enter- into arrangements with theBoard for the purpose of reciprocal registration of mid-wives in England and in Barbados the Council shouldtransmit to the Board a draft copy of the rules to beframed by it, under the Act, in order that it can be seenwhether the standard of training- and examinatio'n inBarbados is equivalent to that in England. The applica-tion of the London County Council that twenty-two hos-pitals should be approved under Rule E.26 was granted.Approval as lecturer was granted to Dr. Francis JohnHector, Bristol General Hospital. The Board recordedits deep sympathy with the relatives of the late' Dr.Herbert Leith Murray and its appreciation of the valuableservices rendered by him as an examiner at the Manchesterand Liverpool Centre.The London County Council has affixed a glazed-ware

tablet on No. 3, Manchester Square, W., to commemoratethe residence there of the eminent neurologist John.Hughlings Jackson.

The annual report for- 1931 of the West End Hospitalfor Nervous Diseases states that 522 patients wereadm'itted during the. year to the in-patient department inRegent's Park,- and 41,256 out-patielnt attendances weremade at the department in Welbeck Street. The pro-vision of facilities for patients-in the men's and women'swards to engage. in handicrafts under trained instructionhas proved so satisfactorv that it has been extended alsoto the children's ward. The hospital's post-graduatecourses have been continued during the year, and facili-ties for attendance at the general practice of the hospitalare being developed. The annual subscriptions receivedwere in excess of those for the year 1930, and, by theexercise of the most stringent-teconomy, expenditure wasreduced under practically every heading.' The executors and trustees of the late Mr. BernhardBaron are making a gift of £5,000 to the Lohddn Jewish-Hospital, to be received over a period of fi~vwe'Fyea. Thisgift will form the nucleus of a fund of £1'20,000,.'which'has been openled for the purpose, of carrying out'ani ex-tension of the hospital, includiiig a separate nurses' home.

Letters, Notes, and AnswersAll commuLnications in regard to editoriail btusiness should be addressed

to The EDITOR, British Medical Journal, British MedicalAssociation House, Tavistock Square, W.C.1.

ORIGINAL ARTICLES and LETTERS forwar(lcd for publicationare understood to be offere(d to the Blritish Medical Joutrnal aloneunless the contrary be stated. Correspondents wlho wish notice tobe taken of their comtmuiinications should authienticate them withtheir namiies, not necessarily for publication.

Autihors desiringtr REPRIN'TS of their articles published in the BritishMedical Journal must comm unicate wvithi the Financial Secretaryand BuLsiness A\lanager, British iMeedical Association House, Tavis-tock s'quiare, xV.C.1, on receip)t of proofs.

All comnmuiiinications with referenice to, AD)VERTISEMENTS, as wellas orders for copies of the Jouruii', slhould. be addressed to theFinancial Secretary and Business M\anager.

The TELEPHONE NUMBERS of the lBritish Mledical Associationand the British Mledicacl Journal are MUSEUilM 9861, 9862, 9863,and 9864 (internal exchange, four lines).

The TELEGRAPHIC ADDRESSES are:EDITlOR OF THE BRITISIl AIEDICAL JOURNAL, Aitio.ogy

Westcenzt, Lonzdon.FINANCIAL SECRETARY AND BUSINESS MANAGER

(Advertisenments, etc.), Articulate WVestcen tt Lonzdon.MIEDICAL SE1CRETARY, Mle(lisecra IVcstceu;t, Lonzdon.

The address of the Irish Office of the British MIedical Association is18, Kildare Street, Dublin (telegranms: Bacilltis, Dutblinl, tele-phone: 62550 D)ublin), and of the Scottish Office, 7, DrumsheughGardens, Edinburgh (telegrams: Associate, Ediinbuirgh; telephone:

Edinburgh)._

QUERIES AND ANSWERS

Injection of HydroceleMr. SYDNEY RuMBOLL (Leeds) writes: " H. C." wishes toknow of an effective yet safe substance for the injection othydrocele. When I was a student in Edinburgh in theearly 'eighties I saw MIr. Joseph Bell often inject a hydrocelewith iodine. The following is the description in his Maniualof Surgical Operations. " The surgeon enters a trocar andcannula about an eighth of an inch in diameter into the dis-tended cavity of the tunica vaginalis near the fundus of theswelling. When it is evident the instrument is fairlyentered, and not till then, the trocar is withdrawn and thefluid allowed completely to drain off. When it ceases toflow the surgeon places hlis forefinger over the end of thecannula to prevent the exchange of air till he fits into itsorifice a suitable syringe containing t"Vo drachms of tinctureof iodine, made according to the Edinburgh Pharmiiacopoeia-the tincture of the British Pharmacopoeia is not suffi-ciently strong. Having injected this cautiously into thecavity the cannula is withdrawn, and the surgeon, seizingthe now flaccid scrotum in his right hand, gives it athorough shake, so as to spread the iodine over as much aspossible. of the inside wall." I may say I have personallyused this method of injection for over forty years withl greatbenefit and satisfaction to my patients.

Dr. ANDREW T. Ross (Cornwall) writes': See De Lisle Gray'sarticle (British Medical Jouiirnal, April 5th, 1930, p. 649).Take equal parts of alcohol, carbolic acid, and glycerin,and inject about 4 c.cm. of mixture after emptying sac. 1have not found it fail.

*** In his article on non-operative treatment of chronichydrocele, printed this week at page 240, Mr. MortonWVhitby recommends injection of iodized pheniol.

Income TaxBenlefit of Occupation of Prcmises

Resident " is medical officer of a local (lispensarv at asalary of £100 a year, " and house free of renit and rates."The local inspector claims that he is chargeable on theamount of the rates on the ground that he is the occupierof the premises, and quotes the case of Lady Miller.

*** If " Resident " is correctly regarded as the statutoryoccupier of the premises, then he is personally liable forthe rates, and the payment thereof by the dispensary on hisbehalf would constitute income liable to tax. But 'se arevery doubtful whether the circumstances justify the aulhori-ties in regarding him as the "dcupier." In the leadingcase of Tennant v. Smith, MIr. Tennannt was a bank managerresiding on premises used for the purposes of the bank, andhe resided there as an employee of the bank and for thepurpose of carrying out his duties there. Lady Miller wvasa widow entitled to rent-free occupation of lands under herhusband's will, and any rights the trustees had with regard