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The interpretation of photosynthesis experiments using 18O as a tracer becomes very difficult on account of the exchange rate between oxygen atoms of carbon dioxide and water. The mathematical analysis of the kinetics of isotope exchange between CO2 highly enriched with 18O and the water of an aerial leaf kept in darkness allows the determination of two velocity coefficients, ke and k. ke, related to the gaseous CO2 diffusion, makes it possible to evaluate the CO2 flow between the gaseous phase and the leaf, as well as the diffusion resistance of the boundary layer and the leaf stomata. k, related to the CO2 hydration, gives the in situ enzymic activity of carbonic anhydrase. Measurements carried out on a great number of leaves show that ke and k vary in the same direction.

In 1927 we were appointed a committee by the American Society for the Control of Cancer to report on the best methods of improving the service to the cancer patient. The present report is based on an individual study of the problem by us and on information secured from many sources. Discussions have been held with other members of the society and with many physicians, surgeons, and public health officers. The reports of the cancer conference at Lake Mohonk in 1926, and of the London congress of 1928, have been consulted. We and other members of the society have visited several European countries and have observed the trend of thought and progress in those countries and discussed the question of cancer service with authorities in each of these countries. In Europe we found uniform agreement that improvement in cancer service must precede any substantial progress in cancer control.The character

In most fractures of the lower extremity, the well established methods of immobilization by plaster cast or of continuous traction by Buck's extension or Hodgen's suspension will prevent shortening. Open operation is rarely indicated—in less than 5 per cent.— according to Darrach, with whom I fully agree.There is a definite group of exceptional cases in which none of the aforementioned procedures are applicable; here, nail extension has proved of value. According to this method, continuous traction is applied to the ends of a steel nail transfixing the lower fragment at a point well away from the site of fracture (Figs. 1, 2, 3 and 4). The nail is removed at the end of from twenty-eight to thirty-five days. As a rule, by this time there is enough callus to prevent shortening Needless to say, introduction and extraction of the nail are performed under anesthesia and with the strictest aseptic

Nothing may be more difficult than the exposure and control of the vessels in the pedicle of an enlarged or adherent spleen; the application of clamps or ligatures is often very uncertain; if hemorrhage does occur, it may be impossible to check it completely until after the spleen has been removed.I believe that ligation (either temporary or permanent) of the arterial supply of the spleen at certain points which are more accessible than the deeply situated splenic pedicle will greatly facilitate matters in difficult splenectomies. These points are (1) the splenic artery close to the celiac axis, and (2) the gastroepiploica sinistra where it reaches the stomach wall from the splenic artery.The celiac axis is readily exposed through an opening in the lesser omentum just above the lesser curvature of the stomach; (it may be made to come within an inch or so of the anterior abdominal wall

To the Editor:—My article, describing a turnbuckle and clamp method for reducing fragments of fractures of long bones in the open operation, was considered by you worthy of an abstract in the Current Medical Literature Department (The Journal, Nov. 30, 1912, p. 2002). It may therefore interest your readers for me to serve notice for their protection that an instrument put on the market and called by some "Haslam's or Haslam's modification of Gerster's" (traction bar) and called by others "Gerster's traction bar," does not fulfil the requirements outlined in my article.

In 1912, Schmilinsky1 reported a case in which a biliary fistula developed after resection of the stomach for ulcer followed by gastro-enterostomy. From 800 to 1,000 c.c. of bile were discharged per day. The stools were acholic. The patient was losing strength so rapidly that it became apparent he could live but a few days longer. Schmilinsky met this crisis by collecting all the bile escaping from the fistula and introducing it into the stomach through a stomach tube twice a day (about 400 c.c. each time). The treatment was kept up for two months. The patient bore it excellently. As the fistula showed no tendency toward closing, an anastomosis was made between it and a loop of jejunum. A cure is reported to have followed.This eminently simple means of improving the condition of such patients was carried out by me in the following case:Nov. 25, 1914,