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been relieved during the year from the ordinary income ofthe charity fund and 31 patients had been relieved by theBevan Trust fund.

In the absence of Dr. T. S. Clouston through indisposi-tion the report of the physician-superintendent was read by I’Dr. J. M. Rutherford, Dr. Clouston’s principal assistant.The total number of patients under treatment during the Iyear had been 1385. There had been 423 admissions, ofwhom 189 were men and 234 were women. The number of

patients discharged had been 297, of whom 130 were menand 167 were women. There had been 138 deaths, of whom73 were men and 65 were women. The number of rate-paidpatients admitted was 358, which was eight more than theaverage of the past five years. In consequence of the largenumber of pauper patients sent in, the wards of the WestHouse had been in a chronic condition of overcrowding suchas he (Dr. Clouston) had never before experienced. It wasa state of matters which was bad for the discipline andquiet of the wards, as well as for the health of the patients.As to the cause of insanity in the cases admitted no fewer

than 119 cases, or 28 per cent. of the admissions, were putdown as due to intemperance in the use of alcohol. This wasthe highest number that had ever been sent there from thatcause. Of the 423 admissions 56, or 13 per cent., were casesof general paralysis. This was, with the exception of lastyear, the largest number of cases of this disease that hadever been sent in and this confirmed his remarks in hislast year’s report as to the distinct increase of this disease inthis district. Their admission-rate in this disease was nowthe highest in Scotland. Of the 297 patients discharged 134were recovered. One-third of the admissions were incurablefrom the beginning, being cases of advanced senility andgross brain lesions. The number of deaths had been the

largest that had ever occurred in the institution and thedeath-rate was also somewhat larger than they had everexperienced. The causes of the high mortality were (1)the large number of cases of general paralysis, organic braindiseases, senility, and general weakness ; (2) the overcrowd-ing of the wards ; and (3) an outbreak of asylum dysenteryor colitis. This epidemic occurred among the female

patients. There were 27 cases in all with seven deaths.

Only three of the patients attacked were, however, in fairbodily health at the time, 18 of the cases having occurred inthe female hospital of the West House and six in No. 1female ward where the patients were of a class weak inbody.The drainage system of the West House had been

thoroughly renovated four years ago, but part of the oldsystem had at that time been left for the purpose of drainingsome deep cellars. After the epidemic of dysentery beganit was found that some of those old drains had not been

properly disconnected from the building and were un-

doubtedly dangerous. Two of the cats in the ward hadcontracted the disease and had possibly acted as carriers ofinfection. When this was discovered the cat life of theinstitution came to an abrupt termination. Dr. Clouston, inconcluding his report, referred to the treatment of incipientcases of insanity in the wards of a general hospital. Hebelieved that it would be a humane and perfectly practicalproceeding if such a step were taken by the Royal Infirmary.

f

THE PREVENTION OF CONSUMPTION ANDOTHER FORMS OF TUBERCULOSIS.

CORK. I

As already mentioned in detail by our Cork correspondentin THE LANCET of March 7th, p. 690, the preliminary stepshave been taken for the formation in that city of a branchof the National Association for the Prevention of Con-

sumption and other Forms of Tuberculosis. The meetingconvened for the purpose was attended by a number ofinfluential persons, the Church, the medical profession, thecounty families, and various public bodies being represented.

WINSLEY SANATORIUM.

Progress is being made with the scheme for the erectionof a sanatorium at Winsley, near Bath, for the counties ofWilts, Somerset, and Gloucester. The site, on high groundoverlooking the Avon valley, has been levelled and tendersare being invited for the erection of the buildings.Liberal contributions to the fund that is being raised

have been received from the men employed at thelocomotive works of the Great Western Railway Com-

pany at Swindon, as well as from the TrowbridgeCooperative Society. Up to the present time .f.9607 havebeen subscribed towards the fund. Of this sum E3649have been expended on the purchase of 50 acres of land,levelling the site for building, and other preliminaries. Themaintenance of 12 beds is already provided for-four by thecorporation of Bristol, two by Bath and Swindon respectively,and one each by Gloucester, by Mr. J. Clark, by Mr. andMrs. W. Clark, and by Messrs. Fry and Sons. The first part ofthe building to be erected includes the administrative blockfor the institution and 20 beds. The cost of this will be about£ 6500. The completed scheme will be for 60 beds at anestimated cost of .f.20,000, while .f.4000 will be required formaintenance.

A PROPOSED SANATORIUM FOR EMPLOYES OF THE GENERALPOST OFFICE.

At the conference of the Postal Telegraph Clerks’ Associa-tion held in Leeds on March 7th a motion was adoptedappointing a committee to investigate the means of providingsanatorium accommodation for postal employes. In thecourse of proposing the motion Mr. C. H. Garland (London)said that the Post Office established staff in 1899 was 82,172and there were 62 deaths and 83 retirements caused byconsumption, a total loss of 145 persons. The total staff at

present numbered over 179,000 and there was no reason tosuppose that the rate of loss was less among the unestab-lished staff than among the established, so that it might bereckoned that from 300 to 350 persons per year fell victimsto the disease. The indoor staff was almost certainly thestaff that suffered most, the loss being aL least 2 per 1000 perannum. Mr. Garland then quoted at some length medicalopinions as to the advantages of sanatorium treatment,making reference also to the "Report of the Association ofBritish Postal Medical Officers on the Prevalence of Tubercleamong the Employes of the Post Office during the yearending Dec. 31st, 1900." He then continued as follows :-The cases of superannuation and death from consumption show that

nearly two of every 1000 employes suffer seriously from this diseaseeach year. It is usual to reckon about ten times the number of deathsin order to arrive at the number of the sick, but I believe such anestimate would be much too high in the Post Office and it will besufficient for our purpose to suppose that among the indoor staff about4 per 1000 require treatment each year. The last Postmaster-General’s report showed that the number in class H. or " CounterClerks and Telegraphists, Sorters, Sorting Clerks and Telegraphists,and Telegraphists " was 30,330. Among this body we can assume thenthat some 120 persons require treatment each year. Each bed in asanatorium would supply treatment for three or perhaps four patientseach year. Let us suppose only three, and to treat 120 persons weshould require 40 beds. It is estimated that the cost of erection perbed is .8200, so we can reckon that we want roughly Q8000 for erection.The cost of maintenance would not exceed JE65 per bed per annum.This would provide medical attendance, nursing, food, and medicine atno expense to the patient. So that our financial requirements wouldbe an initial outlay of £ 8000 and a yearly income of t2600. How arewe to get this ? If 30,000 persons consented to have ld. a week stoppedfrom their salaries it would provide £ 125 weeklv or Q6505 per year. Sothat if we could get the indoor staff to subscribe ld. per week for 64weeks, or about 15 months, we should have our Q8000 for erection, and ifthey would then continue to subscribe a halfpenny per week it wouldyield about R3250 per year for maintenance.

In conclusion, Mr. Garland said that he felt certain that nomore than a very small percentage of the officials concernedwould refuse to subscribe to such an object and that noserious difficulties would be encountered in collecting thesubscriptions.

MEDICINE AND THE LAW.

Private Bills affecting the Medical Profession.AT this early period of the Parliamentary session there

are already several Bills printed and awaiting the opportunityfor their further introduction to the House of Commons

which directly or indirectly affect the medical profession orsome branch of it. Some of these appear for the first timeand some do not. Private members’ Bills, it is well known.do not form a large proportion of the legislative output ofthe year owing to various causes which need not be goneinto, but it is well that their provisions should be known tothose whom they concern. Assistance may thus be obtainedfor useful proposals, the introducers of which can hardly besorry to receive the support of expert opinion outside theHouse, and improvements or modifications may be suggestedin matters of detail by those best qualified to express

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opinions. On the other hand, attention may be called to sug-gested measures which are likely to prove futile or obnoxiousand their failure to become law may thus be rendered morecertain.

Medical Acts Amendment Bill.

The private members’ Bill before the House of Commonswhich is of most importance in that it concerns the medicalprofession more or less as a whole is introduced by SirJohn Batty Tuke, while it further bears the names of SirJohn Gorst, Mr. James Campbell, Sir Richard Jebb, Mr.Talbot, and Sir Michael Foster. Its principal objects areto give the General Medical Council power to erase

from the Medical Register for a limited period the nameof a registered practitioner who has been guilty of a crimeor who has been adjudged guilty of infamous conduct in aprofessional respect, and to enable the medical authorities-that is to say, the universities and other bodies entitled togrant medical diplomas-summarily to deprive a practitionerwhose name has been erased from the Medical Register ofthe medical diploma obtained from that authority. A third

provision orders that, notwithstanding the provisions of anyAct in force or hereafter to be passed, all fines and penaltiesrecovered under the Medical Acts or the Dentists Act, 1878,shall go to the General Medical Council to be applied in aidof the expenses incurred by the Council in putting into forcethe Medical Acts. The changes proposed to be made requirebut little comment or commendation. At present the GeneralMedical Council can inflict but one penalty, the erasure ofthe name of the person brought before it from theMedical Register. The power to modify and to regulatethe penalty to be imposed is a highly desirable one for anvpunitive body to possess, for many reasons. One of these isthat where the necessary penalty is not one of extreme

severity offences are more likely to be complained ’of andpunished than where the accusation, if successful, must

necessarily involve the professional ruin of the accused.The second proposed change enables the bodies which grantmedical diplomas to withdraw them subject to their possiblefuture restoration where the General Medical Council hasexercised its powers of removal from the Register ; this

power to withdraw diplomas is not now possessed by all thebodies which may grant them. The third proposed changeis due to the fact that in London the penalties referred to areclaimed by the Receiver of Police under the MetropolitanPolice Courts Act, 1839.

A Public Health Bill.

The full title proposed for this measure is "The PublicHealth (Officers’ Tenure of Office and Superannuation) Act of1903." It is introduced by Sir Francis Sharp Powell and issupported by Sir Walter Foster, Mr. Talbot, Dr. Farquharson,Mr. Henry Hobhouse. Mr. Cripps, Mr. Heywood Johnstone,Sir Michael Foster, and Sir John Batty Tuke. Its main

objects are to insure that none but those properly qualifiedshall be employed as officers of health (a definition inwhich are included medical officers of health, sanitaryinspectors, and inspectors of nuisances) ; to give to theseas far as is reasonable security of tenure in their offices; andto enable them by definite contributions proportionate totheir salaries, paid to a central fund, to provide for them- ’,selves superannuation allowances to assist them in the event z,of old age or disablement. The memorandum prefixed tothe Bill calls attention to the highly technical duties per-formed by sanitary inspectors and points out that as thelaw stands urban and rural sanitary authorities may appointofficers of health on such conditions as to qualifications,tenure of office, and other matters as they deem fit. The

body of the Bill would enact that no person should be

appointed an officer of health unless he either is the holderof a certificate of the Local Government Board or of somebody for the time being approved by that Board, gained byexamination, or unless he has for three years before the

passing of the Act served as an oflicer of health. This

portion of the Bill is, no doubt, to a large extent designedto obtain the appointment of competent sanitary inspectors,the qualifications of these for their posts being less easy toappreciate in existing circumstances than those of medicalmen who offer themselves for the posts of medical officersof health. It also proposes to do away with the term

"inspector of nuisances," substituting for it the more

euphonious one of " sanitary inspector." Conditions ofsuperannuation are proposed, followed by a scale of super-annuation allowances. These range from fifteen-sixtiethsof the average annual salary of the last five years of

service, payable after a service of ten years, to forty-sixtieths, a maximum only to be obtained after 35 years’service. The proposed deductions from salary a-! con-

tributions towards these allowances are graded from 2 to 3per cent. according to the time of service. Contribution

by those already holding office is to be according to choiceand various matters of detail, financial and otherwise, areconsidered in various sections devoted to them. Enough hasbeen said to show that the measure is one of considerable

importance to the two classes directly affected by it.

An Anti- Vaccination Bill.

A brief Bill, containing but one operative section, wouldorder that "a vaccination officer shall not take proceedingsagainst a parent or other person under section 29 or

section 31 of the Vaccination Act, 1867, except withthe express sanction and authority in each case of theguardians of the union or parish for which he acts."This attempt to repeal the Vaccination Acts locally atthe option of a more or less uneducated majority of theenfranchised population embodies the present ambitions ofthe anti-vaccinationist, as already shown in a succession ofdefences to prosecutions and subsequent appeals. It is,perhaps, not likely to receive the serious consideration ofthe House of Commons, and it is to be hoped that if it doesits rtjection will be decisive. It is introduced by Mr.Channing and is supported by Sir John Rolleston, Mr.Goddard, Mr. Cremer, Mr. Brigg, Mr. Broadhurst, Mr.Corrie Grant, and Mr. Bell.

An .7<- MMCOM Bill.

This Bill seeks to amend 39 & 40 Vict. c. 77, the statutewhich already regulates and controls the performance ofexperiments upon live animals. Its main object appears tobe the abolition of the existing provisions for the per-formance of certain experiments under certificates, whichwithout such certificates are not permissible. Those espe-cially aimed at are no doubt those in which it may bedesired to dispense with the administration of an anses-thetic. There is also in the Bill a section ordering that"there shall be present during and throughout the wholecourse of the experiment an inspector," "and no suchexperiment shall at any time be performed or continuedsave in the presence of such inspector as aforesaid."Power is given to the Secretary of State to appoint a suffi-cient number of inspectors for this purpose. Their dutieswould, however, obviously be such as only highly qualifiedmembers of the medical profession could adequately performand the questions to be decided by them are now safely leftin the hands of the highly qualified members of the medicalprofession whose experiments at times under the existingAct lawfully include those upon live animals. These experi-ments are already subject to conditions with regard to

inspection and other matteis, the stringency of which, it isproposed, should be increased in other directions besidesthose to which we have called attention. Members of Par-liament who have considered the existing Act and are

acquainted with the statistics relating to its subject matterwill for the most part be satisfied that the protection whichit affords to dumb animals is sufficient without the additionalrestrictions proposed in a Bill which is brought in by SirFrederick Banbury, Colonel Lockwood, and Mr. MacNeill.

MEETING OF PUBLIC VACCINATORS ATPLYMOUTH.

A MEETING was held in the room of the Plymouth Medical"Society on Feb. 28th to elect a district council from amongjhe public vaccinators of South Devon and North and EastCornwall (including members and non-members of theassociation of Public Vaccinators of England and Wales).Mr. G. Jackson of Plymouth presided. The following&ecirc;esolutions were adopted unanimously :&mdash;

1. This resolution referred to the constituting of a district council.2. That the Local Government Board should be the authority to

which the administration of vaccination should be intrusted.3. That failing the entire transference of administration from boards

)f guardians to the Local Government Board it is absolutely necessaryn the public interests that the public vaccinator should be as inde-oendent in position as the vaccination officer.

4. That the minimum fees cannot be fairly reduced, and in manyJountry districts they are inadequate on account of the distance to be