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Observations " contain much which can be read withinterest by those who see a future in the study ofcomparative medicine to-day. The lecturer, in

conclusion, suggested the establishment of a branchof the Hunterian Society amongst the graduates andstudents of the Royal Veterinary College, statingthat the veterinary profession owed a great deal tothe memory of John Hunter " for the part he playedin the start of its oldest veterinary college ; and that,knowing the reputation he bore for thoroughnessin all he did for the science he loved so well, it wasa great calamity to our progress that he did not liveat least some ten years longer."

In the remarks which followed the lecture, Dr.Bullock, the registrar and librarian of the RoyalCollege of Veterinary Surgeons, gave interesting

. extracts from some unique books in the college librarywhich bore tribute to John Hunter and the part he hadplayed in the foundation of the veterinary profession.

AN EMPIRE DAY APPEAL

AT the Mansion House meeting held in support ofthe British Empire Cancer Campaign on May 1st,the Duke of York who presided said the purpose ofthe meeting was to inaugurate an appeal on EmpireDay, May 24th. He recalled the hope he had

expressed ten years previously that the shadow of thegreat fear of cancer was slowly but surely lifting,although much remained to be done. The policyof the campaign all along had been not to husbandits resources but to meet every reasonable call madeupon it in aid of cancer research. Lord Horder,who proposed a vote of thanks, said he was sure thatthe solution of the problem of cancer would yield tocareful observation and patient research. Sir HiltonYoung remarked that cancer now took the secondplace in the list of fatal diseases and justified thecampaign in its primary task of promoting andcoördinating research on the causation of cancer.

Prof. W. S. Lazarus-Barlow, vice-chairman of the

investigation committee and chairman of the appealcommittee, spoke of the change in the type of

investigation during the 30 years in which he had beenassociated with cancer research ; it must not be

thought, he said, that the paths pursued for 30 yearshad proved fruitless. The extension of the criterionof success-namely, freedom from the disease-from three to ten years showed a sense of growingmastery over the enemy. The associations andaffiliations of the campaign throughout the BritishEmpire and its friendly relations with cancer researchorganisations abroad entitled the campaign to nationaland imperial support. It was announced that the

King and Queen and other members of the RoyalFamily had sent donations to head the EmpireDay list. In response to the Duke of York’s wordsthe appeal committee of the B.E.C.C. has arrangedfor appeals at 1000 centres on May 24th.

GASTROSCOPY

THE flexible gastroscope which was recentlydescribed in these pages has made its debut inAmerica, and E. B. Benedict has made a preliminaryreport 2 on its use in the Massachusetts GeneralHospital, where 75 gastroscopies have been smoothlycarried out. The instrument is in routine employ-ment in many German clinics, but little has yet beenheard of it from other countries. The reason isprobably a certain hesitation about its value indiagnosis. It is clear from the German experience

1 THE LANCET, 1933, ii., 813, 389.2 New Eng. Jour. Med., March 29th, 1934, p. 670.

that, in general, gastroscopy offers no advantageover radiography in the recognition of gastric ulcerand gastric carcinoma, and it is never likely tobecome as necessary as cystoscopy. On the otherhand it enables inflammatory and atrophic changesin the gastric mucosa to be seen much more clearlythan by even the best radiological technique, andchronic gastritis can therefore be defined with greaterprecision than heretofore. Since the pathogenesis ofchronic gastritis may well be the key to the preventionof more serious conditions, a new method for its

investigation is to be welcomed. Benedict’s experi-ence so far bears out the German claim that gastro-scopy with the Wolf-Schindler flexible gastroscopeis an "easy, harmless, and profitable procedure."

CHILD GUIDANCE IN AMERICA

SINCE 1922 when the Commonwealth Fund ofNew York first turned its attention to mental hygieneseven major child guidance clinics have been foundeddirectly through its agency, and support has beengiven in this country (in the words of the fifteenthannual report) " to finance activities which are stilltoo novel to command full support from the Britishpublic." The London Child Guidance Clinic, nowin its fifth year, is still liberally supported by theFund, although as a measure of economy the parentInstitute for Child Guidance was closed last summer,after it had offered training during the six years of itsexistence to 32 psychiatrists, 15 psychologists, and289 psychiatric social workers. It should be ofinterest to discover what form the child guidancemovement is taking in the land of its origin, and inthis we have the help of Dr. D. N. Hardcastle, who hasreported after spending three years studying clinicsin America. The lines of approach and the goals oftreatment he finds still in a state of flux, and widevariations in philosophy are evident ; some clinicsare content with a simple evaluation of their problemsand are almost didactic in their therapy, othersattempt to analyse all their material, whether parentsor children. Asked " what is the potential positionof the general medical practitioner with regard tothe child guidance clinic, and can his services beutilised ? " 10 out of 12 clinics referred to the generallack of psychiatric education, and the practitioner’sinability to cooperate ; 3 clinics thought that whenadequately trained the practitioner should treat thebulk of the patients who now come to the clinic,and 2 considered that he could then cooperate inpsychiatric treatment. Five replies reported close

cooperation on the physical side only of the patient ;only one speaks of all-round cooperation. Three

clinics, however, enjoy the cooperation of children’sspecialists ; one regards itself as in opposition tomedical practice. To the question whether non-medical persons should be able to refer cases, 11 outof 12 clinics definitely said that they should ; 2 ofthem refrained from treating cases so referred untilthe practitioner had been informed and his permissiongiven. In another question Dr. Hardcastle embodiedthe criticism so often heard, that the child subjectedto a team of people loses all chance of a personalpsychiatric contact. Eight replies point out thatthe child has a much closer contact with the

psychiatrist than he would have in any other form ofmedical treatment ; the parents are not present,for they are seen by the psychiatric social worker.One detailed reply states that 55 per cent. of caseshave dual attention, the psychiatrist treating the

1 Brit. Jour. Med. Psych., 1933, xiii., 328.