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SURGICAL REGISTRAR, LIVERPOOL ROYAL INFIRMARYCONGENITAL dermoid cysts and sinuses associated with the limbs appear to be very rare and to have escaped description in the English surgical literature. Dieterich, however, records a dermoid cyst of the shoulder, and PhClip has described a congenital dermoid cyst occurring on the index finger of an infant aged 13 months.Epiphanov has also described a cystic dermoid femoral hernia. Apart from these cases, Paterson, Cisneros, and others have described dermoid cysts occurring in the inguinal canal, and Bland-Sutton has recorded the removal of a very large dermoid cyst of the right labium majus ; these latter cases, however, did not occur on the limbs, although they probably had the same etiology.Etiology.-The limbs arise as buds from the ventro-lateral aspect of the trunk and they are composed of a number of body segments. Owing to the fact that the more peripheral part of the limbs is derived from the middle segments of the limb bud, there is formed a dorsal and ventral axial line in the proximal portions of the limbs, between the upper and lower segmental portions. These

78 JAN. 15, 1944 EFFECT OF VITAMIN SUPPLEMENTS ON HEALTH, ETC. M3RITISH aged 9 to 14. Of the London children 123 were boys aged 9 to 14 living in a camp school.The tests began in Nov./Dec., 1941, and ended in July/Aug.,1942. The school-children were examined before, during, and after the period of feeding. They were divided at random into two equal groups according to school, age, and sex; one group received a vitamin capsule every school day, and the other a capsule containing a similar quantity of arachis oil, which is practically devoid of vitamins. Records were kept of all illnesses, of their nature and duration. The medical examination included examination of the teeth and gums by dentists-in London by T. S. Rodgers.The factory tests were conducted at the zinc-smelting works at A and L, where the labour is extremely strenuous and exhausting. The men work in gangs of five or six, and the average output of zinc for each gang is weighed daily. In factory A 12, and in factory L 24, gangs of workers were divided at random into a vitamin and a control group. Each man received an appropriate capsule six days a week. The naked weight was taken monthly before the men began work. Haemoglobin and blood pressure were also measured at regular intervals, and the output of zinc and all absences due to illness were recorded.The findings for the children were similar in all four places. During the period of observation the vitamins had no statistically significant effect on the rate of growth, nutritional status, muscular strength, condition of the teeth and gums, or absence from school on account of illness. Muscular strength was measured in London and Glossop by a dynamometer like that described by Hill, Magee, and Major (Lancet, 1937, 2, 441); it was not done in Ipswich. In Glossop alone a special test of endurance by hanging on a bar was done. Both the controls and the vitamin children improved in endurance, and the improvement shown by the vitamin children was greater than that shown by the controls. In view of the relatively small number of Glossop children tested, we feel that this particular finding should be strictly limited in its application to that group of children. Similar findings would have to be obtained in other areas before any wider application of the Glossop results could be regarded as justifiable. Feeding tests with this object were started on several thousand children three months after the conclusion of the above tests, and are still in progress.In the factory tests on 214 adult men, the results showed that the vitamin capsules had no significant effects on weight, haemoglobin, blood pressure, absence from illness, or output of material. The conditions of the test in the factories, however, were such that only relatively large differences in output would have been revealed.Many people assisted us in conducting these feeding tests and analysing the results, but lack of space forbids individual acknowledgment of their help. A mass expression of thanks to all who co-operated is all we can make in...