June 8, 1907. THE HOSPITAL. 247
Annotations.
Mobility of the Kidneys.
Dr. Hector Mackenzie's communication on this
subject to the Medical Society of London is one to
be carefully noted. He recognises an " abnor-
mally movable kidney " as one in which it is possible
to get the hand completely above the upper end of
the organ, and to palpate it in its whole extent.
In addition, he defines the " palpable kidney " as one
in which, though a considerable part of the kidney
can be felt, it is impossible to displace it so as to get
the hand above the upper end. Among 2,801
females of all ages who were examined, there were
found 449 cases in which the kidneys were palpable
and 515 in which they were movable, while of 1,607
males only 25 cases showed palpable and 11 cases
movable kidneys. In only a single instance was a
movable kidney present on the left side alone, while
in 49 cases both kidneys were movable. There
seems great reason to doubt the commonly
accepted statement that repeated child-bearing
is an influential factor in the production of
abnormal mobility of the kidneys. An im-
portant practical point is the degree of disturb-
ance which such abnormal mobility produces, and
here Dr. Mackenzie's figures show that out of 526
patients with definitely movable kidneys 411 were
wholly unaware of the existence of the condition.
This view was confirmed by other speakers, who
agreed generally with Dr. Mackenzie's conclusions
and with the advice that surgical measures are seldom
advisable. In face of all this it is startling to hear
from Dr. Suckling, of Birmingham, that " the daily
interference with the elimination of urine and reten-
tion in the prolapsed kidney and ureter causes auto-
intoxication leading to insanity and other disorders
of the nervous system," and that " the frequency of
suicide when dropped kidney exists is remarkable."
The Practical Applications of Scientific Medicine
In the Times of May 23rd may be found a leading
article dealing in an appreciative spirit with the
advances which have distinguished the course of
scientific medicine during the last half-century, and
with the obstacles to the full application of the new
knowledge. The writer, naturally, considers more
Particularly the effects of bacteriology on surgical
operations and on the treatment and prevention of
in ectious diseases. In connection with the latter he
finds that the public generally, instead of seeking to
secure the application of scientific conclusions which
rest upon as firm a basis of assured knowledge as
the phenomena of gravitation," remain passive, or
even active, opponents of measures by which many
lives might be preserved and much permanent in-
jury to the health of individuals be prevented. Not
merely "v estrymen and such-like people," but even
some members of Parliament, are included in this
condemnation. And this attitude of apathy and re-
sistance is attributed to a want of imaginative capa-
city to realise either the truths of science or the
results which could be secured by their application,
and to the absence of the introduction of " physical
matters" even into what is supposed to be the
highest type of education. It is highly satisfactory
that all this should be set forth in the columns of
the lay Press, and its exact correspondence with
facts is beyond question. Unless public opinion is
educated to appreciate the function which science^
and science alone, can discharge in practical life, the
attainment of the full results of observation and in-
vestigation is impossible. Perhaps no illustration
of the large scope of this function can be more for-
cible than the recent work in connection with Malta
fever. The discovery that this disease is due to a
microbe inhabiting healthy Malta goats and com-
municated to human beings through their milk, has
been followed by certain steps which have led to
most impressive results. Hitherto there has been
in Haslar Hospital an average of some two hundred
patients suffering from this disease, but last month
it was reported that not a single case was included
among the patients. Here the necessary measures
were independent of public support, and if the same
thing were true of certain other diseases, paralleL
action would be followed by equally good effects.
The General Medical Council and the B.M.A.
The address delivered by the President of the
General Medical Council at the opening of the
recent session of that body contained an announce-
ment of great interest to the members of the British
Medical Association. It appears that the Associa-
tion has formally decided not only to investigate
cases which might require to be brought officially
before the Council, but also to act in support of
any charges which may seem to be justified. The
Association, in short, has determined, as opjior-
tunity offers or demands, to act as prosecutor in
certain charges which will require the judicial
action of the General Medical Council. In these
circumstances it is obvious that the position of those
members of the Council who are at the same time
members of the Association becomes a very delicate
one. Acting in the former capacity, they might
appear as judges of causes in which, as members
of the British Medical Association, they were
more or less interested as complainants. The
President of the Council has very properly taken
legal advice on the matter, and, acting on this
advice, has himself resigned his connection with the
Association. Further, he has announced that what
he has done is, in the opinion of the legal advisers
of the Council, imperative on all other members of
the Council who happen to be members of the Asso-
ciation, and this, it will be generally allowed, is in
accordance with the fitness of things. The judicial
actions of the Council must obviously be entirely
beyond suspicion of unfairness and partiality, and
members of the Council cannot therefore be also
members of a prosecuting association. It is a pretty
pass to which the present ruling influences have
brought the Association. Defeated in their attempt
to elect delegates from the Association to be
members of the Council, they have broken out in a
new place, with the result that no member of the
Association can now be considered eligible for a seat
on the General Council. In these circumstances it
may be questioned whether the Association is for^
tunate in its " pastors and masters."


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