NOTES 389 



the discovery by Kent and by His of the specialised conducting bundle gener- 

 ally associated with the name of the latter observer. In recent years the 

 "pacemaker" of the heart, or the point of origin of the cardiac rhythm, has 

 been definitely localised as a result of the work of Keith, Flack, and Lewis. 

 The pioneer work of Mackenzie on disorders of cardiac rhythm has been 

 greatly extended by the use of Einthoven's storing galvanometer, which, in the 

 hands of Lewis and other workers, has yielded results of great scientific interest 

 and clinical value. The exact nature of disorders of cardiac rhythm has been 

 determined, and complete irregularity of the pulse has been shown to be due to 

 fibrillary contraction of the auricles. Clinically, these results are of great 

 importance, inasmuch as they help to differentiate serious from trivial conditions, 

 previously often confused, and furnish a rational basis for the administration 

 of cardiac remedies. 



In contrast to the advances made in the study of the disorders of rhythm and 

 conduction is the unsatisfactory state of present knowledge in regard to the 

 functional competence of the heart. Prognosis in cardiac failure is a matter of 

 extreme difficulty, for as yet there is no method of ascertaining the reserve power 

 of the heart muscle. If a method could be devised which could be applied 

 clinically, it would be possible to substitute facts for conjecture, and thus enable 

 prognosis to be placed upon a more reliable basis. 



Radiology. — Radium is now being widely used in the treatment of malignant 

 growths. It is, however, not yet possible definitely to appraise its value in 

 this respect ; it cannot yet be said to what extent radium treatment is likely 

 to supplant operative interference, although it is generally accepted that radium 

 treatment is useful as an aid to eradicating traces of growth left behind after 

 operation. There appears, however, to be general agreement on the following 

 points : (1) Unfiltered rays have a high power of tissue destruction ; (2) certain 

 rays, notably the (3-rays, have the power of stimulating growth, and they may 

 therefore act harmfully by inducing increased multiplication of cancer cells ; 

 (3) the 7-rays are the most useful therapeutically, since young actively growing 

 cells are most susceptible to their influence ; (4) malignant growths of mesoblastic 

 origin (sarcomata) are more amenable to treatment than carcinomata ; 

 (5) filters of aluminium or lead or even air are useful in removing the undesirable 

 radiations. 



At present, although radium is of value in treating superficial growths, its 

 penetrating power is limited, so that for deep-seated growths, such as cancer 

 of the breast, it is unjustifiable to rely on this treatment to the exclusion of 

 operative measures. There is evidence to show that the application of X-rays and 

 radium to the field of operation tends to lower the liability to recurrence. All 

 cancerous growths are not equally amenable to treatment ; those of the mouth and 

 tongue are less favourably affected than those of the breast, whilst carcinoma 

 of the uterus affords a hopeful field for radiotherapy. 



Successes which have attended other applications of science to the practice 

 of medicine, such, for instance, as inoculation against typhoid fever, were 

 reported to the Congress, but space does not permit of their mention here. It 

 should be noted that the advances in scientific medicine which have been 

 communicated to the Congress could not have been made without experiments 

 on animals. This was fully recognised by the Congress, which was unanimously 

 of opinion that no restrictions which might in any way impede the progress 

 of medicine should be placed upon such experiments. 



The future is full of hope ; increasing interest is being taken by the people in 



