ties all over Canada, as well as to medical health officers in the large cities and to professors in the universities having to do with public health matters. As the question is to come up for discussion in the House of Commons again this session, especially as there are several members interested in it other than those belonging to the medical profession, medical societies and the medical press and all others should early press the matter on the attention of members of the House. Recent events at Ottawa suggest the possibility of the reorganization of more than one department of the government in the immediate future; and the opportunity thus presented to the medical profession of Canada should be seized eagerly and prosecuted with vigor and "sticktoitiveness." It may be considered wise on the part of the Special Committee on Public Health to again press the matter upon the Prime Minister and his colleagues, and especially so now that the Canadian Association for the Prevention of Tuberculosis will join hands with the Canadian Medical Association in urging the Government to consolidate the various branches of the medical service, when the former meets in Ottawa next June. If so, we can only urge upon the attention of the profession, and particularly upon those directly engaged in public health matters, the desirability of their presence and support at that meeting.

The Report of the Ontario Commission on Insanity is before us. It shows that the Commission went carefully and very fully into the methods employed in caring for and treating the insane. in different university centres in Great Britain and Europe. Particular attention was given to the investigation of the organization and methods and equipment of psychiatric hospitals and psychiatric clinics, and the most important of the Commission's recommendations is set forth in these words: The psychiatric hospital being the ideal institution for the treatment of all acute forms of insanity, we would recommend the establishment, as necessity arises, of such hospitals at university centres. The other recommendations are: The enlargement of the present staffs of physicians and nurses; the isolation of the tuberculous; the proper care and treatment of insane criminals. Regarding the first of these, we would express the hope that the appointments of physicians be made purely on merit and fitness and not on any political pull, and that the advice of the heads of the institutions be followed rather than that of the ward patronage committee. The

recommendations as to the tuberculous and also the criminal insane are abreast of the times and should be rapidly adopted by the provincial authorities. Reference is made to those who have a "horror of the name asylum."" If we mistake not, hospitals for the insane perpetuate this "horror" largely by continuing themselves to carry it on their letter paper, make mention of it in official communications, as well as in the writings of those engaged in this branch of medicine. If the word were quietly dropped and never mentioned in the medical press, in scientific publications and official documents, it would rapidly become obsolete in this connection.

What Word Do You Use when you find yourself chewing a bread label the cook has failed to remove? Some people when putting a stamp on a letter lick the stamp instead of the envelope. It would be interesting to know which the bread-labeller applies the tongue to. Who started this silly system anyhow? Who should put an end to it at once? There has been a great deal in the public press lately about light-weight bread and standard loaves. It shows that the people are alive to the question of the production and handling of the staff of life. Some dealers put wrappers on some loaves. Why not have them properly and fully dressed? Many years ago we advocated the putting of all loaves into paper bags. We are coming to it by degrees. Why not adopt it at once and be done with it?

Speaking of Bread leads us to say a word about "Gluten" breads and crackers. The elimination of the overcharged starchy cereals from the diabetic's diet paves the way for the gluten article. A writer in Scientific American says to take ten minutes and find out what gluten is. Obtain a tablespoonful of white flour, add water in a saucer and make your dough into a compact ball. Take it to the tap and let the water run on it through your hands. In ten minutes' time you have a nodule of yellow, firm, vegetable gum. Take and chew this gum for a couple of hours. It is smaller. The tap water washed away the large starch cells; the saliva, the infinitesimally fine starch cells. Take the small ball of gluten left to an analytic chemist. The report will be: Starch 15 or 18, gluten 85 or 82. The writer then argues that "where a case is a desperate one, and starch or no starch will turn the balance of life, it is very easy to procure and analyse a sample of

He says

the flour or cracker of "gluten " the patient is to use. such a course would save a physician many a perplexing hour, and maybe an esteemed patient now and then.

The Use of the Cinematograph in Medicine for recording and illustrating movements of patients, victims of various nervous diseases, has been successfully employed, says Dr. H. Campbell Thomson in a recent issue of The Lancet. Photographs taken at the rate of sixteen in a second of time clearly show these movements and have been utilized for imparting instruction to students. The cinematograph has been used by some eminent surgeons, particularly one in Paris, showing mostly the actions of the operator, and it may be that there will open up a field in this direction which, while interesting and delightful, may prove of useful help to the student of medicine, particularly in class teaching. It may in time supersede to some extent the lantern.

Editorial Notes.

Phimosis and Circumcision in Infants.-Phimosis is nearly always present at birth, and is due to a small preputial orifice as well as to adhesions between the glans and prepuce. The glans, in growing and during the erections which occur with difficult defecation in infants, gradually dilates the preputial orifice, and breaks up the adhesions between glans and prepuce, a process which is usually not complete until the eighth year. In other words, a certain degree of phimosis is physiological in early childhood. Many reflex phenomena, including most of the functional diseases of childhood, have been attributed to it, and circumcision has been recommended for their cure. That the symptoms are really not caused, at least not always caused, by the phimosis, is proved by the fact that in at least one-half the cases they are not relieved. In a plea for fewer uncalled-for circumcisions, appearing in the Correspondenz-Blatt fur Schweizer Aerzte of Dec. 1, 1907, G. Rheiner mentions a few of the indications and contraindications for the operation in early childhood. He considers a phimosis pathological only when it acts as a mechanical obstacle in urination. The urine is passed in a thin stream, or only a drop at a time, the space between glans and prepuce balloons out, the urine decomposes in this space, and is thus liable to cause balanitis. The straining at urination is liable to be followed by hernia or prolapsus

ani, the balanitis incites to masturbation. These patients of course require circumcision if the prepuce cannot be retracted after any adhesion between it and the glans have been broken up. On the other hand, there are patients who have difficulty in urinating which is attributed to a phimosis though it is really due to other causes. Thus in cystitis and balanitis the infected urine or purulent discharge will cause an inflammation of the prepuce which renders urination painful, and this may lead to voluntary retention while there is no mechanical hindrance to the flow of urine. In such a condition circumcision, which is often advised, is really strongly contraindicated, as the wound readily becomes infected, thus aggravating the symptoms and possibly causing sepsis. In patients in whom small ulcers follow herpes preputialis similar urinary symptoms may set in, but here, too, a circumcision is contraindicated. Rheiner also draws attention to conditions which are often attributed to phimosis and in which a circumcision will do no good, though it may not cause any harm. Thus it is quite natural to attribute urinary symptoms due to a stricture (congenital or after an early urethritis) to phimosis. A more frequent source of error is the condition in which urine is passed in small quantities, its voidance being accompanied by bearing down pains. This condition exists in children troubled with constipation due to faulty diet or to fissures about the anus, and the liability to error in diagnosis is increased by the erection reflexly caused by the constipation, for during erection the small preputial orifice is more noticeable. It can readily be understood that a circumcision will not cure these patients.

In many children the physiological phimosis seldom causes any trouble, and if it does circumcision is not always necessary as one can frequently relieve the condition by retracting the prepuce after breaking up the adhesions between it and the glans. The best treatment lies in prophylaxis. We can avoid all future trouble by retracting the prepuce over the glans immediately after birth. This usually requires slight stretching of the preputial orifice, most easily accomplished by inserting a closed scissor artery forceps into the orifice and then separating the blades. Thus sufficient dilation is brought about without causing any bleeding, after which the adhesions between glans and prepuce are broken up and the latter is easily retracted. After the removal of any smegma present, a drop of oil is placed on the glans and the skin is drawn forwards. The skin should then be drawn over the glans daily until there is no longer a disposition to a recurrence of the adhesions. This little manœuvre is probably not practised by many obstetricians, but it cannot be too strongly recommended, as it does no harm and may prevent much trouble.-Med. Rec.

News Items.

DR. JOHN PARKE, of Arcola, Sask., is dead at Feversham, of heart failure.

DR. FRED GUEST, St. Thomas, has been appointed coroner for Elgin County.

CANCER caused 50 deaths in Hamilton last year, and 10 to date this year.

DR. HOPKINS, of Marshville, formerly of Dunnville, has been appointed a coroner.

DR. SPOHN has resumed practice at Penetanguishene, with his son, Dr. Howard Spohn.

DR. W. J. GRAHAM, formerly of Ashgrove, has moved from Tonawanda to Brooklyn, N.Y.

DR. STANLEY BURNS, of Caledonia, has accepted a position as assistant to Dr. Jacques, Jarvis.

DR. D. A. SHIRRES, Montreal, has gone to Jamaica.

DR. J. H. O. LAMBERT, Winnipeg, will go to Europe in May.

ONTARIO hospitals are to receive an increased grant from the

Government.

DR. CHAS. C. GURD, Montreal, will spend the next five months

in Germany.

VANCOUVER is considering the adoption of the medical inspec tion of its schools.

DR. WM. B. HOPKINS, of Hamilton, has been appointed associate coroner for Wentworth County.

BANFF objects to the establishment of a sanatorium for consumptives in the National Park bounds.