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account of ill-health), Mr. Wellington Lake (the medical’officer of health of Guildford), Mr. Collins (Kingston), Mr.Howlin (Woking), and Dr. Reginald Dudfield (Paddington)were’called.

Dr. Gayton, after an experience of small-pox extending over nearly a’quarter of a century in the hospitals of the Metropolitan AsylumsBoard, did not agree that a very large area around a hospital was tieces- j isary. He thought aerial convection was a theory which was not worthy- of much practical consideration, and the facts on which it was basedwere capahle of other explanations.

Dr. Savill, from his inquiry at Warrington on behalf of the Vaccina-tion Commission, and elsewhere, believed that a sufficient belt of’space around a hospital was very desirable, but solely for thepurpose of efficient ventilation, not to avoid aerial convection, to whichlie could not subscribe. It was universally conceded that freefresh air was the best known natural germicide, and lie failed to under-stand how it could become the vehicle for carrying contagion to suchdistances as had been alleged. There were also other grounds for dis-believiug that it could take place. Cross-examined by Mr. Warrington,on the plans of Whitemoor Common, he thought the site a goodone. He admitted that infection could be taken within the limits of anordinary room or ward by a person who simply breathed the patients’respiratory impurities, but not beyond this limit in presence of freshnir.

Dr. Orme Dudfield’s evidence dwelt on the necessity of properudministration within the hospital in preference to a large area aroundit as the best means of preventing spread.The other medical witnesses for the defence gave similar

evidence.Mr. Justice Kekewich, in the course of a long and

- elaborate judgment, first excluded from his considerationsuch points as the alleged greater suitability of other sites,and the accessibility of this one. The question was, ’’ Isthere here a real apprehension of real danger to theinhabitants or damage to their property or their trade ? "

If the existing cottage, and arrangements as now made,were used for small-pox patients the evidence went to:-;how that there would be danger by reason of direct:nfection. In that sense, therefore, it constituted a- nuisance," and the plaintiffs were entitled to a verdictso far as the present arrangements were concerned. Butthe plaintiffs also sought to restrain the defendant Boardfrom erecting a suitable small-pox hospital on this site.lit had been shown in evidence that a properly built andadministered hospital could be erected here, and the onlyquestion which remained was concerning the area of unin- ihabited space around, and whether small-pox could be con- Iftracted by persons frequenting and dwelling on the adjacent ’Iiand. The real question, then, was, "Is aerial convectiona theory sufficiently established to enable the Court

judicially to say this constitutes a source of danger Iagainst which the defendants have to provide 1" But !iMs lordship had not been satisfied by the evidence before ’IMm that such a theory had been conclusively proved to Iexist, nor that the particulate matter " referred to by onemedical witness could be conveyed a mile, half a mile, or.even a quarter of a mile. Under such circumstances it would ’ibe entirely wrong to grant an injunction against the ’defendants erecting this hospital, which would be an ’advantage to the public, because some learned men, ’,whose opinions were entitled to great respect, came tothe conclusion, though they could not prove it, that

small-pox was the subject of aerial convection. Thecase came before him almost as a res i’nte.r;ra, for his

lordship had not found any reported case to assist him in

coming to a conclusion. 1 But on the evidence he was of

opinion that he should be going much too far in saying thatthere was any real apprehension of a real danger. Theverdict would therefore be for the defendant board upontheir undertaking (as they had consented to do) not to usethe existing cottage and site for small-pox patients until aproper hospital had been erected ; but, as each side hadfailed in part of the action, no order would be made as tocosts.

ROYAL COLLEGE OF PHYSICIANS OFLONDON.

A MEETING of the Comitia of the Royal College of

Physicians was held on Friday, the 22nd inst., the President,Sir J. Russell Reynolds, Bart., being in the chair.The President announced that he had nominated Dr. J. F.

Payne as Harveian Orator for 1896. He also reported to theCollege that at a meeting held on the previous day at the

1 The case of Hill v. Metropolitan Asylums Board was finally con-cluded by arbitration.

University of London, Sir James Paget presiding, delegatesof various bodies concerned in the question of the recon-struction of the University were selected to attend a deputa-tion to the Duke of Devonshire on Nov. 28th. The delegatesof the Royal College of Physicians were the President, theRegistrar, Dr. Norman Moore, and Dr. Allchin.The College seal was set to a deed declaring and accepting

on the part of the College the Weber-Parkes prize trust.A letter of thanks was received from the Cambridge

Antiquarian Society for permission to photograph certainobjects of interest possessed by the College.A letter was read from the secretary of the Royal College

of Surgeons reporting the proceedings of its Council.A letter was read from Sir Arthur Watson resigning the

office of standing counsel, which he had held since 1872.On the motion of the Registrar, seconded by the SeniorCensor, Sir A. Watson’s resignation was accepted, and acordial vote of thanks passed to him for his valuable services.On the motion of Dr. J. K. Fowler, seconded by Dr.

Poore, permission was renewed to the Fellows’ Club to dine inthe College.The report of the delegates of the two Royal Colleges on

the proposed third and fourth examinations under the fiveyears’ scheme was received. The Registrar reviewed thevarious steps taken in the framing of the original scheme,and stated that the present revised plan was almost exactlythe same as that which had been recommended in 1871 bythe delegates of the College on the Committee of Manage-ment. The scheme, which would come into force inJanuary, 1896, established the third examination (medicine,surgery, and midwifery) at the end of the fifth year,with certain extensions over the present examination; andpermitted the examination in midwifery to be passed at anytime after the completion of the fourth year of professionalstudy, provided one year has elapsed since passing theanatomical and physiological examination. It also establishedan examination in pharmacology to be passed at any timeafter the completion of the fourth year of professional study,provided that the anatomical and physiological examinationhas been passed. Amongst other matters it recommendedthat the subject of elementary anatomy be eliminated fromthe first examination. Considerable discussion arose uponthe desirability of instituting a separate examination in

pharmacology, in which Dr. Curnow, Dr. Payne, Dr. Church,Dr. Fowler, Dr. S. West, Dr. I. Owen, Dr. Ewart,Dr. Poore, Dr. Cayley, Dr. Coupland, and Dr. Taylor tookpart. Eventually it was moved by Dr. Church, secondedby Dr. Curnow, and carried, that the report of the

delegates be adopted, but that the Royal College of Surgeonsbe informed that this College would regard it as an improve-ment if the subject of pharmacology were included with theother subjects of the medicine examination, and not made adistinct examination by itself. Dr. Griffiths moved, andDr. Play fair seconded, that the subject of midwifery anddiseases of women be placed on the same footing as medicineand surgery-i.e., relegated to the end of the fifth year. Themotion was negatived by sixteen votes to nine.On the motion of Dr. Champneys, seconded by Dr.

Playfair, a committee was appointed to prescribe the properconduct of a practitioner when brought into relation with acase of acknowledged or suspected criminal abortion. Thecommittee consists of the four censors, the mover andseconder, and Dr. Black.

A TEACHING UNIVERSITY FOR LONDON.

AT a meeting held at the University of London, onThursday, the 21st inst., Sir James Paget, Bart., in the

chair, and attended by delegates from institutions named inthe report of the Royal Commission on the Gresham

University, by members of that Commission and of theearlier Commission on a Teaching University for London,and by others interested in the establishment of a Teach-ing University, the following resolution was unanimouslypassed :-"That the Government be requested to introduce, at an early date, a

Bill, similar to Lord Playfair’s London University Commission Bill,1895, appointing a Statutory Commission. to carry out the recommenda-tions of Lord Cowper’s Commission, but with an added clause giving [inaccordance with precedent Acts of a similar tenor] to all institutions orpersons directly affected by any Statute or Ordinance proposed by theStatutory Commission a right of appeal to the Privy Council for the

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disallowance or alteration thereof, previous to such Ordinance beinglaid before Paa’liament for confirmation."

A second resolution was passed to the effect that a deputa-tion in favour of this resolution should wait upon the Dukeef Devonshire at the Privy Council Office.This deputation, which waited upon the Duke of Devon-

shire on Thursday, Nov. 28th, was introduced by Lord Kelvin.The following representatives of institutions explain the

object of the deputation : Professor Riicker, for the Senateof the University of London ; Dr. Allchin, for the RoyalCollege of Physicians ; Mr. Heath, for the Royal College ofSurgeons; Sir George Young, for University College ; Dr.

Wace, for King’s College; Dr. Frederick Taylor, for theMedical Schools; the Rev. Principal Whitehouse, for the

Theological Colleges ; Sir Henry Roscoe, for the ProfessorialUniversity Association ; Professor Silvanus P. Thompson, forthe Annual Committee of Convocation; and Mr. JamesAnstie, for the Committee of Graduates.In replying, the Duke of Devonshire said he would not

commit either himself or the Government to any definitedecision, but would lay the whole matter before his col-leagues. At the same time he urged them by every possiblemeans to inform those who opposed the scheme from mis-understanding of its true nature, in order that there mightbe as little opposition as possible should a Bill come beforeParliament.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF INSPECTORS OF THE MEDICAL DEPARTMENTOF THE LOCAL GOVERNMENT BOARD.

-Enteric Fever at IVe7v Delaval, by Dr. &veeting1-NewDelaval lies in the Tynemouth rural district, about ten milesnorth-west of N ewcastle-upon-Tyne, and it has a populationof 1975 with 331 houses. The report refers to 129 cases ofenteric fever in the six months August, 1894, to January, 1895,in addition to certain cases that were not notified and to asynchronous prevalence of diarrhoea. Dr. Sweeting discussesthe outbreak at considerable length, and the reader is

materially assisted by a lithographic plan of the place, inwhich the houses affected with the fever are specially markedin their relation to the local drainage system. He alsodescribes the general sanitary circumstances of New Delaval.The place is provided with midden-privies having all the worstfaults of this offensive system, and the water-supply is derivedfrom a spring issuing from the sandstone at the foot of adeclivity. Thence it is piped by ordinary field pipes to acollecting well, called a tank," which further receives theoverflow from an open dipping well or trough. Previouslyto Dr. Sweeting’s visit the tank was open to contamination ;indeed, the ground around it was early this year found to bethe ordinary defecating place for tramps and others ; thelatter apparently preferring the open air to the stinkingmidden-privies. A drainage theory of causation had obtainedlocal support, but after a careful analysis of all the circum-stances involved Dr. Sweeting is unable to accept it as a

definite cause. On the other hand, the localisation of thedisease over other areas than New Delaval, but havingthe same water-supply, gave special force to the viewthat the water had served as a means of conveying theinfection. The actual source of the prevalence at its onsetwas not a matter that admitted of demonstration ; but, givenits importation, the local conditions of unwholesomeness,including the risks of the excremental pollution of the waterservice, amply sufficed to explain its subsequent diffusion.And even importation would not be far to seek in an areawhich has long had much enteric fever. This report is wellcompiled and deserves careful reading by those who areinterested in etiological investigations.

lJipJdheria at Potterne, by Dr. S. MONCKTON COPEMAN. 2-For some years antecedent to 1893 diphtheria had been

1 Eyre and Spottiswoode, East Harding-street, E.C. ; John Menziesand Co., Edinburgh and Glasgow ; Hodges, Figgis, and Co., Dublin.Price 6d. 1895.2 Eyre and Spottiswoode, East Harding-street, London, E.C.; John

Menzies and Co., Edinburgh and Glasgow ; Hodges, Figgis, and Co.,Dublin. Price ls.

practically unknown in the parish of Potterne, which lies inthe Devizes rural district and has a population of nearly 1200.By the third week of July, 1893, the disease had led to 18,attacks ; the schools seemed to be identified with its spreadand they were closed, but the disease was maintainedthrough August. It then abated, and had practically dis-appeared in December. Several attacks, however, occurredagain in the period January-March, 1894, but there beingcomparative freedom from the disease, the schools were

opened in April. Within ten days there were 3 fresh cases; and,some subsequent cases occurring, the school work was againsuspended on June. lst. The disease, however, soon spread,and other cases occurred right up to a time when thereopening of the schools was once more permissible, omAug. 20th. In fact, 143 cases of diphtheria were notifiedin Potterne in sixty-five households from July 18th,1893, to Oct. 6th, 1894, and yet not a single case

occurred among the large number of children of the better-class residents in the parish. The origin of the disease-remains undetermined ; indeed, Dr. Copeman found antrace of source lost amongst certain cases of so-called"sore-throat." As to its spread, a number of conditionscommonly regarded as having to do with its diffusion are*set aside; but it seems clear that at certain stages theaggregation in school of susceptible persons was concernedwith it, and that, apart from this, personal infection came-largely into play. The school was badly ventilated, one’

class-room was distinctly "fusty," and the flooring andfoundations were not so constructed as to avoid damp andground air getting into the building. These are conditionswhich, though they may not explain the onset of thedisease, are such as would certainly tend to its diffusion

amongst the school attendants, if not do more by producinga condition of unhealthiness in the fauces such as wouldrender the individual particularly susceptible to receivethe infection. Dr. Copeman reports that these conditions.have now been remedied in accordance with his advice,.and we may hope that no further prevalence of the same:sort may arise.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Lancashire County Sanito?’y District. - Mr. Edwarà1Sergeant estimates the population of the administrative’county of Lancashire for 1894 as 1,870,141. The generaldeath-rate of the county for the year in question was but,16-16 per 1000-i.e., 16’42 in the urban and 14-87 in the-rural districts. Mr. Sergeant reports that during 1894tmedical officers of health have been more careful to take.into account the deaths of persons belonging to their dis-tricts but occurring in outside institutions. It appears"however, that a not inconsiderable number of the deaths inthe county still remain unappropriated, and the writer ofthe report somewhat significantly remarks : " It may be-observed that the tendency to put the best complexion on the.statistics is more noticeable in residential districts and in-certain districts desirous of acquiring reputations as healthresorts." The infantile mortality for 1894 was a low one,being but 134 per 1000 registered births, as compared witha rate of 177 in 1893. In connexion with infantile mortalityseveral of the district medical officers of health refer to the-

necessity for limiting the use of the feeding-bottle in the’

manufacturing towns. In the matter of small-pox an interest--ing instance of the influence of tramps on the spread of disease-is given in the report before us, one tramp being instrumentalduring his wanderings in infecting directly or indirectly nc,less than twenty-six persons. During the year the Chad-derton, Royton, and Crumpton joint hospital district was:*

formed under the provisions of the Isolation Hospitals Act,1893 ; but in connexion with the subject of isolationaccommodation we regret to see that the Prescott urbar.-3sanitary district has requested its medical officer of healthtto refuse admission into the local fever hospital unlesf,the guarantee of the payment of a guinea a week ü>

forthcoming or the patient is provided with a magistrate’order. We shall not be surprised if the hospital in question’,goes down to posterity as one that did not fulfil its purpose.The supervision of dairies, cowsheds, and milkshops stillseems in a backward condition in the county, although ir-3,some districts these places are conscientiously inspected.The smoke nuisance has been specially inquired into during-1894, and as a result of a recommendation on the part of it"public health committee of the county council some attentionseems to have been paid to the matter. It is, nevertheless,true that Section 91 of the Public Health Act, 1875, is not