to drift into precarious ways of life. Very many of them should be particularly suited for a life on the land, but once more it must be asserted that employment on a large farm would give them far more scope and opportunity than could be found on any small holding. Unconsciously, perhaps, the Committee themselves seem to conceive this, for in the list of occupations for which partially disabled men should be suitable they give prominence to shepherding, management of live-stock, turnip-hoeing, hay-making, harvest work and threshing, and the use and repair of agricultural machinery, none of which suggest themselves very particularly in connexion with small holdings. The Committee seem to be of the opinion that a very active propaganda will be required to bring their small-holdings scheme to the notice of a sufficient number of men. They recommend that the Board of Agriculture should arrange with the Admiralty and War Office for a distribution of literature amongst the troops on active service, and that representatives of the Board should visit naval and military hospitals, convalescent camps, etc. Further, that the help of the various associations for the employment of soldiers, and of regimental societies, should be enlisted in the same work. The Committee instance the well-known methods employed by the Colonial Governments for securing colonists, and refer to the attractive pamphlets issued by them, which, they suggest, our Board should imitate. Most of us are familiar with the Arcadian pictures on these pamphlets, in which attractive young men and women stand about in cornfields or orchards, whilst in the distance somebody else appears to be doing the work of the holding; many of us have heard the comments made on these advertisements by the colonists whom they have deluded. It is most desirable that strenuous effort should be made to keep our best men at home, and that nothing should be left undone to this end. But work is work, and the idea of the attractive pamphlet ' is a very dangerous one, particularly in connexion with a scheme for the creation of small holdings. Apart from this it may occasion some surprise that the Committee should consider that there would be such a real need for this campaign to boom' their scheme. Under the most favourable conditions it is difficult to see how they can hope to settle more than two or three men from every battalion, and one would have thought that this limit would be reached without any advertising campaign. The danger is that the proposals of the advertising agents would prove attractive to too many men, and that the difficult and delicate situation which the provision of employment may occasion, after the war, would only be aggravated if many thousands of the returning soldiers were to get it into their heads that there was employment waiting for them on Government farms, with the prospect of fully-equipped holdings of their own a few years ahead of them. In considering the Report of the Committee the big question of whether State action is called for at all has not been treated. It is conceivable that the State might set itself to demonstrate to farmers in various parts of the country what is possible by means of better organisation, better finance, and better management. Such an object lesson would have the greatest educational value. But if the State is to embark upon any such educational work its plans must be based upon a very sure economic foundation. C. S. ORWIN. THE CONTROL OF VENEREAL DISEASES Report of the Royal Commission on Venereal Diseases. THE HE issue of the final Report of the Royal Commission on Venereal Diseases is an event of national importance, deserving the attention of all well-wishers of humanity, even in the stress and strain of a world-war. It may be doubted whether even this war at its finish will have shortened a larger number of lives, and decreased the physical and mental efficiency of a larger number of persons, than have venereal diseases during a single generation. Nor is there any more promising field of work for rapidly restoring our national efficiency and for healing the ravages of war than is to be found in adopting to the fullest extent the chief administrative measures proposed in the thirty-five recommendations in which the members of the Royal Commission have summarised the practical results of their deliberation. The Commission was formed in November 1913 under the able chairmanship of Lord Sydenham of Combe. Among its members were Sir Kenelm Digby, G.C.B., Sir Almeric Fitzroy, K.C.B., and Dr. Arthur Newsholme, C.B., representing various Government Departments; Mrs. Burgwin and Mrs. Creighton, with Mrs. Scharlieb, M.D., representing the supreme interest of women in the problem; Canon Horsley and Dr. Scott Lidgett, representing religious communities; Mr. Philip Snowden, M.P.; and Sir Malcolm Morris, K.C.V.O., Sir John Collie, Mr. Lane, and Dr. Mott, F.R.S., representing the medical profession and pathology. The Report of the Commission is in harmony with the growing feeling of the educated, and particularly of the medical, public, that further efforts are urgently needed to prevent the spread of venereal diseases. Already by preventive measures we have secured the abolition of typhus fever, the rapid decline and impending almost complete abolition of enteric fever, far-reaching control over smallpox, the reduction of tuberculosis and of child mortality. There is no reason why venereal diseases, and especially syphilis (great pox), should not become as rare in this country as is smallpox. There are two chief venereal diseases, gonorrhoea and syphilis. Until recently gonorrhoea has been regarded with some degree of complacency as a relatively mild disease. 'It 'has, in reality, serious and far-reaching consequences,' for an enumeration of which page 26 of the Royal Commission's Report should be studied. In women it is frequently followed by a condition of permanent semi-invalidity, and it is perhaps the commonest cause of sterility. It also has a cruel effect upon new-born infants. Gonorrhoea in the mother, commonly acquired by her innocently from the father, infects the infant's eyelids during the act of birth, and unless active and energetic steps are taken total loss of eyesight may result. Between a fourth and a third of all the cases of blindness in children are due to this one cause. The saving of the present expenditure by the community on the special education of these children and on their support through life would alone go far towards covering the cost involved in organising the control of venereal diseases. The effects of syphilis are more complex and numerous than those of gonorrhoea, and its remote results extend beyond the patient to the next generation. In this sense it is inherited, though the inheritance consists not in any given habit of body tissues, but in actual transmission of the germs of the disease from parent to child. Some idea of the subtlety of this insidious infection may be gathered from the fact that the innocent child may suffer up to adult life from disease which has been transmitted from husband to wife, and conveyed to the offspring by the latter, while she herself may never have displayed obvious signs of syphilitic disease. There is no tissue of the body which may not be invaded by the virus of syphilis, transmitted by the blood from the original site of infection. So much is this the case that the clinical medicine of any part of the body may be taught to a medical student in terms of syphilis and its consequential diseases. The primary sore or chancre occurring in syphilis is followed later by skin eruptions, by general anæmia, falling of the hair, and diffused or localised inflammation which may attack any part of the body, but commonly the heart and arteries, liver, lungs, bones, and the brain and spinal cord. Serious bone disease with nasal deformity often owes its origin to syphilis. A man is as old as his arteries,' and syphilis is thus commonly the cause of premature old age, by causing arterial disease between the ages of thirty and fifty. But perhaps the most startling effects of syphilis are produced on the nervous system. Fatal brain disease in middle life is often due to the syphilitic virus. Locomotor ataxy is a very frequent late result of syphilis, and general paralysis of the insane is always due to syphilis. The Royal Commission reports that in the case of males 14 to 15 per cent. of the admissions to the asylums of London and of other large cities are due to syphilis, and in the case of females 2 to 3 per cent. In most cases syphilis is acquired, as is also gonorrhoea, during sexual congress. This is not always so. It may be acquired by kissing or by intimate contact with infected materials. There is much more 'innocent syphilis' (syphilis insontium) in addition to inherited syphilis than is commonly supposed. Syphilis has been known to be communicated for instance to a number of workmen from using in glass works a blow-pipe which had previously been used by a workman having a syphilitic lesion in his mouth. Perhaps this consideration will lead the minority of subscribers to voluntary hospitals, who still appear to think that treatment of this disease in these hospitals implies a condonation of sin, to revise their judgment, lest their action should mean the neglect of treatment and the destruction of the health of innocent' and 'guilty' alike. This consideration is still further emphasised by the facts as to congenital syphilis. Were not these demonstrated by indubitable evidence, they might be regarded as too strange and too terrible to be true. Congenital syphilis is perhaps best studied in the history of selected syphilitic families, examples of which were supplied to the Commission by Dr. Mott. He found that in the case of 34 syphilitic mothers 175 pregnancies were followed by only 30' apparently healthy ' children, leaving 104 premature births, still births, or deaths in infancy, and 41 seriously diseased' offspring. It cannot |