PYORRHŒA ALVEOLARIS

ticular skin. (He finds it necessaryat times to contrive to save it in anotherway later!) He forgets the speetal liability of the lying-in woman to infection. The results of it are nearly always most serious,whereasit is more commonly a passing circumstance in general sllrgery. That is why the obstetricianis at a greaterdisadvantage than his self-satisfledconiere. Then is applied the flattering B オ ョ 」 エ ゥ ッ ョ セ ィ ゥ ウ environment militates against good results, But herestatisticsare againsthim. Environment, if we would only admit it, has no such baleful influence. The excusegoes down. Hehas savedhis skin again and we find it a little thicker than it was before. The obstericianmay exclaim againstconclusionsdrawn from statistics. That they are not very reliable is shown in returns published by R. Dudfield in The Lancet, 1923, who easily exposes the figures to ridicule. It" is most disturbing to discover in print what we all individually must acknowledge,that if the deaths from sepsis work out at 52.9% of the casesreported, there must be many casesnot so reportedas due tosepsisand a morbidity in addition reaching a much highet,'proportion than published figures show. Remembe'ring"that notification is comparatively"a recent institution, figures prior to it are more likely to be a true reflex becausethe temptation to spoil one's averages by talking about them was accompanied by less compromising results. As things go then, we may expect the ridiculous mortality quoted by Dudfield to increasein the future. Such admissionsas we have that might reasonablybe taken as a reflection on modern methods are qualified in a manner characteristicof all who make them as is shown in the following extracts: "Someonehas said that the dirt in the home of the very poor is dirt, while the dirt in the hospital is germs, and that is about as scientific a dismissal of the facts as can be made." But why dismiss them so, are they not very significant and worth more than a passingsneer? Then again: "But even discounting all of that, there is the same factor of immunity if it can be 80 called, among the patients in slum districts which we mentioned above." (Eno, Surgery, Gynecology ana Obstetrics, 1923) Why avoid the issueby a qualification which ill-disguises the truth? . I will not weary your readersby quoting other examples, but I trust I have given a line for the future honest teacher fearlessly to follow. Yours, etc.• A. C. F. HALFORD, M.D. (Melb.). WIckham terrace, Brisbane, July 19, 1924.