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orders, when given, will be fulfilled with expedition. There

are, as a rule, the strongest political reasons why theGovernment of the day should withhold its decision on

such a question as war as long as possible, and shouldonly let it be known when war has become inevitable.The consequence is that the political situation gets acutebefore the war preparations are complete, and for wantof timely warnings all is hurry at the last. It doesnot seem possible for this hurry to be avoided ; allthe more necessary is it that previous preparations insuch direct ons as they can be made should be made.If we turn to the past histoiies of military organisation,War Office reforms, and plans for re-organising the head-quarter staff, as recorded in the evidence of those most

intimately acquainted with the subject, the result is notmore satisfactory than is the contemplation of an inevitableunreadiness. The division of powers and responsibilitywhich, according to both the Hartington Commission andthe Dawkins Commission, was the main source of weaknessat Pall Mall, has been going on for a long time and stillexists, and has become a matter which, as Lord Rosebery hassaid, is not a question of party but of national safety. Thenation must therefore see that our military organisation issettled on some more secure base ; the shifting sands ofparty government offer no foundation upon which to rear astructure of permanent value.One of the first things to be determined in any given i

campaign is what is to be the percentage of medical strengthfor a force-a matter which must obviously depend upona variety of circumstances, such as can only be properlyconsidered at the time and in connexion with each war.In the caoe of South Africa the circumstances proved to bealtogether exceptional and, as everyone knows, the strain onthe medical service grew more intense as the war went onand the forces engaged in it were enormously increased. Atthe time when the first expedition went out it was never

expected that more than one army corps would be necessary,and to meet the need:, of this the medical strength requiredproved to be much in excess of what had previously beendeemed proportionate. Taking the war in South Africa as awhole it is estimated that counting the medical strength ofall kinds it was approximately from 3 to 4 per cent. ofthe total forces. The commissioners tried to elicit informa-tion from witnesses with the view of getting some ideaas to what would be the proper proportion, and the militarymedical witnesses, speaking generally, agreed with ProfessorA. Ogston’s estimate, based on statistics of other modernwars, that about 5 per cent. of the total strength of a forceought to be connected with the Army Medical DepartmentThere is one fundamental difficulty in the professional

training of our medical officers which has been largelyovercome by an essentially military power like that of

Germany. It is to make such training as far as pos-sible of a practical character. Actual experience in the

, application of medical and surgical methods, such as

falls to the lot of members of the medical and surgicalstaffs and to the resident surgeons and physicians of civilhospitals, has, it is needless to say, a value of its own com-hospitals, has, it is needless to say, a value of its own com-

pared with which other acquisitions of knowledge are of

relatively insignificant importance to the individual or tothe State. Medical officers should unquestionably be

encouraged in making themselves acquainted with themethods of army medical administration, hygiene, and

equipment of other countries, and we look forward tothe time when leave will be granted to them for this

purpose and for taking out special courses of instructionboth in this country and on the continent. It is beyondthe scope of any man to cope equally well with the artof modern surgery and with medicine, hygiene, medicalstatistics, and army hospital administration, but armymedical officers have perforce had to fulfil the multifariousdllties implied in such all-roand knowledge. There is a grow-ing tendency in the present day for young men to devotethemselves to different branches of scientific knowledge,and while it is unreasonable to expect that all army medicalofficers can become experts upon one side or the other oftheir calling, and not only unreasonable but undesirable, itseems to us to be certain that in the near future therewill be some specialisation of function in the service.The report of the latest Royal Commission considers that inthe interest of the army all officers in the Army MedicalService should have opportunities of refreshing their profes-sional knowledge and that anyone endowed with any specialability and aptitude in direction should have reasonable

facilities for cultivating them. The Director-Generalshould certainly have such a knowledge of his medicalofficers as would enable him on the outbreak of war toput his finger upon the right men to fill the right places.When all this has been done, however, and when we have aRoyal Army Medical Corps of sufficient strength and qualityfor times of peace (in which phrase we include the timesof our perpetual little wars) it will always be absolutelynecessary to supplement the service largely from the civilside of the profession in any big war. All the arrangementsfor adding to the regular medical and nursing services toany required extent should be made by the Governmentbeforehand in time of peace, and we should like to learn thatan immediate start has been made in this direction.

If there be one subject more than another that requires tobe put upon a satisfactory basis is is that of army sanitation.The Commissioners had their attention called to this subjectby several witnesses and among them by Lord Roberts, SirCharles Warren, Professor Ogston, Surgeon-General Jameson,and Surgeon-General Sir William Wilson, and on readingtheir evidence we are confirmed in a view that we have

previously expressed. What seems to us to be wanted isthe organisation of some special sanitary body or corps toform part of every future military expedition, to be composed’of a directing advisory portion armed with the requisitepower and authority and an executive portion to give effectto, and to carry out, the practical sanitary work requiredon field service. It is necessary if we are to avoid dis-

appointment that our ideas as to what can and cannotbe done should be of a sound and practical kind.Time is an essential element in any sanitary work intendedto be of a preventive nature. It has to be borne in mindthat in war nothing can be done for an advancing armyuntil the enemy has been defeated and driven out of anygiven position, when the mischief caused by a pollutedwater-supply and fouled camps and sites is soon effected.It is not possible to send sanitary engineers in front of anadvancing army to select healthy sites for camping, to digwells, and to construct latrines. Where time plays no partin the contract all this can be done in a leisurely and effec-tive manner, but what the sanitary corps must be drilled todo is to make the best of the circumstances of war. That

applied sanitary work so often fails to be carried out in- warfare is commonly not so much due to any want of know-ledge as to what should be done as to not having the means,appliances, and requisite time for doing it. We are strongly ofopinion, however, that every possible effort should be made,and that the skilled advice and cooperation of sanitaryexperts and of officers of the medical and engineer depart.ments of the army might be utilised for the purpose. Thesooner the requisite organisation is considered and settledthe better.

There are many other points in the Royal Commissioners"report connected with the Army Medical Service, but it is onturning to, and studying, the minutes of evidence that thereader will find his interest and attention most keenlyaroused. Some of these minutes are a mine of curious in-formaion and others strike us as containing able and valuablemilitary criticism. There is an amount of intellectual vigour,grasp, and earnestness about much of the evidence that isre-assuring. The reader can leave off with the feeling that,even though he has been perusing a melancholy record ofofficial inefficiency, there is abundant ability available andready to hand, if the nation will only devise a right methodfor giving it the requisite amount of freedom and fairplay.

MEDICINE AND THE LAW.

Begging-letter Impostors.A MAN named Shepherd, educated at Cambridge and

ordained a clergyman, was sentenced at the recent sessionsat the Old Bailey to 12 months’ hard labour for forging anduttering requests for the payment of money with intent todefraud. The attention of medical men has frequently been.called in THE LANDET to the ease with which the membersof the learned professions, particularly clergymen andmedical men, are victimised by impostors belonging, or pre-tending to belong, to their own calling and to the frequencywith which cases of this kind have occurred recently-Shepherd assumed for the purpose of getting money thename of a-brother clergyman and by representing him to be

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in poverty obtained remittances. He forged the necessaryindorsement to a cheque thus received and it was forthis that he received the salutary sentence mentioned.His detection was caused by his applying for aid toa clergyman who happened to be acquainted with the hand-writing of the gentleman personated and who accordinglymade inquiries. Apparently other victims had sent sums ofmoney without asking any question whatever. Impostors ofthis kind use a clergy list or a medical directory or similarbook of reference, to which they can usually have access ata free library, and a letter written to the name given in thebegging letter, but to the address found in the professionallist of addresses, will at any rate discover whether the personseeking assistance is the man whom he pretends to be. The

impostor has, of course, to have his letters addressed to himwhere he can. Inquiries can also be made of the authoritiesat schools, colleges, and hospitals where these are men-tioned. Appeals of this kind where not addressed tomembers of the alleged profession of the mendicant are oftenbased upon a supposed university acquaintanceship.

Black7nailing a Medical Man.At Johannesburg on August 14th a woman named

Higham pleaded guilty to the charge of attempting toextort money by threats from Mr. James Alexander Thwaits,a medical man in practice there, and was sentenced to threemonths’ imprisonment with such hard labour as she mightbe able to perform within the precincts of the prison. Thecrime was committed with a fatuity and absolute ground-lessness which almost necessarily insured its failure, butapart from this the sentence must be regarded as an

extremely mild one. The prisoner bore a good character,it is true, and had apparently been left by her husband tomaintain herself and five children, with whom she wasdesirous of leaving the country. Need of money, however,is not usually accepted as an excuse for the commission ofso cruel an act as that of Mrs. Higham. With no othermotive or reason than the impecuniosity referred tJ she com-municated with Mr. Thwaits, to whom she was a total

stranger, threatening to denounce him to the authorities ashaving performed an illegal operation at a well-known hotelat Johannesburg and as having received a large sum ofmoney for so doing, and she demanded the sum of .E200as the price of her silence. A few days later she reducedher terms to .S25, but her intended victim informed the

police and thus prevented any measures to defame himwhich she might possibly have taken in revenge had he beenmerely content with a refusal to listen to her. To face thesituation on such occasions and to invoke the assistance ofthe police is the best course to adopt, although contemptcoupled with the threat of criminal proceedings is some-times effectual in preventing further molestation and dis-

agreeable publicity is thereby avoided. Even innocentmen, however, sometimes, when faced with the possi-bility of a scandal affecting their good name, have beenknown to yield and by doing so once have delivered them-selves with their hands tied into the power of a merci-less robber for the rest of their lives. Towards criminals ofthis class in England, at all events, but scant mercy is shown,and where grounds exist for the allegation upon which theextortion is based the cruelty is regarded as all the greater,so that the penalty is rendered heavier rather than lighterthereby. Mr. Thwaits is to be congratulated upon havingeffectively defended himself against the dangerous attackmade upon him and it is to be hoped that the punishment inflicted will be sufficient to deter others from similarattempts in the future. , -, , , r .

Infant Mortality and Crime.In two cases dealt with at the recent sessions at the Old

Bailey Mr. Justice Ridley passed sentences of three months’hard labour upon young women in connexion with the birthof their illegitimate children. In the one instance a

laundress, aged 19 years, living with her mother, had

got out of bed and gone downstairs in the early morningto the backyard where she delivered herself of a childwhich she placed in the dustbin. She went to her workas usual and it was only the cries of the child heardmuch later from the dustbin which revealed its existence.In the other instance the prisoner was in domestic serviceand her mistress, who suspected what had occurred, made asearch and found the dead body of a newly born infantconcealed in a cupboard with a piece of tape tied tightlyround the neck. In the first case the offence charged wasone of wilfully exposing the child, and in the second case

the prisoner pleaded guilty to concealment of birth. Inpassing sentence upon the case of concealment Mr. JusticeRidley called attention to the frequency of crimes of thisclass and to the necessity for punishing them, in spiteof the pity which he might feel for the prisoner in thedistressing circumstances in which she appeared beforehim. Crimes of this kind are, indeed, extremely frequent,and there can be little doubt that a substantial pro-portion of the mortality among infants, as well as

of the cases of stillbirths, is due practically to childmurder. Murder, however, is but seldom charged, partlyon account of the lack of evidence necessary to convictand partly because conviction would leave the alternativeof punishing homicide lightly or of treating with severitypersons who often deserve, and who usually obtain, con-

siderable sympathy. The fact, however, remains the samethat if the children were desired to live by their parentsthey would, in the majority of cases, be safely born andreared. The remedy is yet to be found.

A Conviction under the Dentists Act.

At Bow-street police-court the British Dental Associationrecently obtained the conviction of a man named Flax whowas summoned for using descriptions falsely implying thathe was registered under the Dentists Act, 1878, and that hewas specially qualified to practise dentistry. The descrip-tions complained of were contained in advertisements pub-lished in a German newspaper circulating in London and werealso printed upon business cards. The statements made wereas follows : °° Ordinary extractions, ls. ; painless extractionsby a new process, 3s. American crown, bridge, and bar work.Stoppings in gold and enamel. Mr. Flax, gold medallist,attends personally. French and American diplomas. Practisedwith success with first-class English dentists." The magis-trate was informed that the gold medal referred to by thedefendant was obtained at the Paris exhibition for themanufacture of artificial teeth and that it was not, as theadvertisement was clearly calculated to suggest, the rewardof proficiency bestowed by any institution, whether reco-gnised or not, in respect of proficiency in dentistry. It was

urged in defence that the defendant was qualified to prac-tise in America or France, but the ease with which a

diploma might be obtained in America was mentioned inreply to this. Mr. Marsham, dealing with the adver-tisements and the question of fact submitted for hisdecision as to whether these contained descriptions falselyimplying qualification and registration, found that an offencehad been committed and fined the defendant 40s. on each ofthe two summonses against him, with 3 guineas costs. Noone could reasonably dissent from such a decision. Anadvertisement that a man is a " gold medallist" who has"practised with success with first-class English dentists"

"

would naturally convey an impression of British qualifica-tions to the ordinary patient of the class which it wasintended to attract, and the defendant might have found itdifficult to say for what other purpose the words in questionwere used.

Lookíng Back.FROM

THE LANCET, SATURDAY, SEPT. 24, 1825.

HOUSE SURGEONS OF THE LONDON HOSPITALS.

To the Editor of THE LANCET

SIR,-Permit me to address you upon a subject loudlycalling for the interference of the Governors of the LondonHospitals generally, namely, the appointment of the HOUSESURGEONS. It is notorious, that any man, however ignorantof his profession, or dull in his natural abilities, by becominga perpetual pupil, is considered fully competent to thearduous duties of the office in question, when it comes to histurn. Knowing the importance and responsibility of thesituation, and at the same time being aware of the

many instances of gross ignorance and neglect that areconstantly occurring in the Metropolitan Hospitals, (forI except none of them) ; are they not (the Surgeons)highly culpable in not endeavouring, by some means or other,bo put a stop to a system that must ultimately be productiveof disgrace, if not of ruin, to those institutions ? ? Now, Sir,