Negative results were obtained in all non-pulmonary cases. The tubercle bacilli present in the gastric contents were all of human type. The presence of tubercle bacilli in the gastric contents establishes a definite diagnosis. Segregation of such cases is advocated. Gastric lavage should be a routine diagnostic measure. It should be done on successive days, and frequently during treatment. We are greatly indebted to Dr. D. W. Fenwick Jones, medical superintendent of the Adelina Patti Hospital, for allowing us the use of the case records and for much valuable advice and assistance. Our thanks are also due to Dr. D. A. Powell, principal medical officer, Prof. Tytler and Dr. Ruth Milne of the Central Tuberculosis Laboratory, and to Sister Powell, who carried out so successfully the actual procedure of gastric lavage.

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In no other branch of medicine have doctors appeared so nihilistic or so defeatist as in the domain of psychiatry. It seems to me questionable whether this is due to the disparity in the therapeutic results between psychiatry on the one hand and general medicine on the other. In general medicine it is frequently forgotten that the really specific remedies at our disposal are so few that they can be counted on the fingers of one hand. If, on the other hand, we remember that as late as the time of the French Revolution mental patients were kept in chains, and that to-day in modern hospitals we see impressive results with such specific treatments as malarial therapy, then it must be admitted that the psychiatrist is not the only nihilist; but that this also applies to representatives of other branches of general medicine.

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