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exceeds 0’02 per acre, 2s.per insured person; and (3)in county areas where the density of the insuredpopulation is less than 0’02 per acre, 2s. ,6d. perinsured person. About one-half of the rural areaof Ireland falls into the second group and half intothe third group. In accepting this offer themedical profession has sacrificed some of its

original demand, which was for a sum equal to2s. 6d. per insured person in the whole country,and it has recognised the special conditions whichlimit the resources of the Treasury at the presenttime. The Commissioners have not yet communi-cated their views as to the method by which thesums available for each area are to be distributed,but it is thought that the scheme most in favour isthat of a "pool" from which payments would bemade in proportion to the work done by the severalpractitioners in tli’e area. The Irish. Medical,Committee has appointed a special committee toconfer with the Commissioners and representativesof the societies in working out the details of thescheme, and it is hoped"11hat no further differencesmay arise.

Trinity College and War Service.

Special Commencements were held in TrinityCollege on Sept. 24th for the purpose of conferringdegrees on the candidates who, having passed therecent final medical examinations, wished to jointhe Royal Navy or the Royal Army Medical Corps.Mr. Justice Madden, Vice-Chancellor of the Univer-sity, presided and made a statement as to theservices already rendered by graduates of DublinUniversity in the army and navy. Of theMedical School, 650 past, or present membersare or have been on servi’ee; of these, 24 havelaid down their lives for their country, 26 are

among the wounded, 3 are missing, and 10 havebeen made prisoners of war. The number of dis-tinctions gained by Trinity College men is high.Their work has been mentioned in despatches on 28occasions. To five the Military Cross has beenawarded, tp one the Legion of Honour, to three theDistinguished Service Order, to two the Order ofSt. Michael and St. George, and to three the Com-panionship of the Bath. Ninety-five students of theMedical School, in their eagerness to serve theircountry, had accepted combatant commissions. Of

these, 10 had fallen, 12 were wounded, and 3 weremissing. Judge Madden gave particulars also ofthe part taken in the struggle by other than medicalgraduates. The women students and graduates,through their Voluntary Aid Detachment, hadorganised a hospital in Dublin, in which manywounded soldiers had been treated. Its work hadearned the marked approval of the War Officeauthorities.

Tyrone Doctors’ Salaries.The dispute between the Tyrone doctors and the

Omagh guardians is rapidly reaching a climax. On z,Sept. 18th Mr. P. McCartan applied for four weeks’

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holiday, the length of vacation decided upon bythe Tyrone Medical Association, and nominatedMr. George Evans to do duty for him at theremuneration of 4 guineas per week. The boardof guardians decided unanimously to allow onlytwo weeks’ holiday and to pay their usualremuneration. A notice signed by all the doctorsof the union was handed in withdrawing from thearrangement made some time ago as regardsconsultation fees and fees for temporary services.Sept.28th.

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ASYLUM REPORTS.

The Retreat, York (Anwm4i Report fM’ the 1ear 1914,).-The total number of cases under treatment during the yearwas 261, the average daily number resident being 186’5 apatients and 6 boarders, making 192 in all. There wereadmitted 43 certified patients, of whom 38 came direct tothe Retreat, and b were transferred from other institutions.Of the direct admissions- 26 were cases suffering from)a first ’attack, and 12 had had previous attacks. As usual, melan-cholia was the most frequent form of mental disorder, beingpresent in 14 cases. Dr. Bedford, Pierce, the medical superim--tendent, comments on the fact that very little progress hasbeen made in regard to the treatment of melancholia and thatthe recovery-rate is high, though convalescence may be longdelayed. Dr. Pierce also notes the complete recovery of aease of acute delirium, and with regard to it considers thatthe procedure of certification of recent temporary cases of

mental breakdown should be quite different from thatneeded for prolonged detention. There were in all 15-recoveries, and of these 4 were over 65 years of age. The-

percentage of total recoveries on the direct admissions was-394?. The deaths numbered 7, making a death-rate of3 75 per cent. on the average daily number resident.Twenty-seven voluntary boarders were admitted during theyear. Six of these were still under treatment at the tnd or-the year ; of the remaining 21, 6 recovered and left, 5 leftmuch improved, 5 left not improved, and 5 were placed under,, rcertificates.

Royal Eastern Counties Institution for Idiot3, rr8erzles,and the llaeirle-hlinded, Colefiester (Annucal Report fo’l’ the year z

1914).-The total Lumber of cases under care during the yearwas 443. The average daily number resident was 394, being .the largest in the history of the institution. The admissions- Yreached the figure of 55, and of these the average agewas 15 years. Fifteen of these might be described mentallyas of quite high grade, with a fair promise that in each easethey would not only learn a trade, but become quite useful attheir work. Eighteen were cases which would need constant nursing care and would never be able to learn anything, mostof them being partly or wholly paralysed and only six havingany power of intelligible speech. Of the remaining 22cases who came between these extremes, all attendedregularly in the schools or the shops, and all were able tolearn to some extent, The discharged patients numbered 13Six of these were removed to go to other institutions, fourwere taken back to their own homes, two whose term had-expired were allowed to go home pending re-election, and.’the thirteenth was only technically discharged, being re-admitted under a fresh order. It is evident that the -institution continues to provide, by its system of re-election, .almost complete permanent care for all those cases ’once

admitted by election, and this to a greater extent than anyother charitable institution for defectives in England. The -number of deaths was 15, five lower than in the previous-year.The death-rate on the average daily number resident was3-8 per cent. Since the opening of the institution in 1859 the average rate has been 6-76 per cent. The number ofdeaths from all forms of tuberculosis was 4, or 26 per cent.of all the deaths that occurred. The work in the various-shops continued satisfactorily. In the handicraft exhibition,held by the Essex Handicrafts Association, the patients in-competition with normal individuals took five prizes, two formats, two for chip wood-carving, and one for baskets.

Glasgow Royal Asylum (Annual Repopt for the Year 1914).-The total number of cases under treatment during the - -

year was 558, the average daily number resident being 443. -There were 116 admissions, and of these 39 sought treat- -ment voluntarily. In 14: of the cases no definite cause’for -the insanity could be assigned, and in 45 there was a

hereditary predisposition to mental or nervous disorders.In no case could the outbreak of the European War be con- -sidered as- the cause of the breakdown, though in several’the,symptoms were coloured by its occurrence. Dr. L. R.Oswald, the physician-superintendent, states that it ’has .

iappeared to him that the national need has raised the -mental tone of the nation and that, to hi& observation,.there has not at present been any increase of insanity.The discharges numbered 87, of whom 4t had recovered,

making a percentage of 36 on the total ’number ’admitted..-

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The nature of the admissions was not favourable from acurative point of view, and a large percentage was senileor paralysed, or had been so long ill that no hopes ofimprovement could be entertained. There were 30 deaths.General paralysis accounted for 6, pneumonia for 7, and oldage for 3. Phthisis pulmonalis was the cause of death in- only 1 case, a striking testimony to the hygienic conditions.obtaining in the hospital. The cause of death was con-- firmed in 22 cases by post-mortem examination. Dr.- Oswald refers to the centenary of the asylum, which wasopened in December, 1814, and comments on the deplorable- condition of the insane 100 years ago. There is now no countrywhich excels Scotland in the provision made for their treat-ment, and the beginning of the second century of the

history of the hospital sees a great and increasing attentionbeing given to the scientific study of mental disorders bythe establishment of laboratories where skilled workers aregrappling with one of the most obscure problems of medical- science. The Glasgow Royal Asylum is fortunate in havingnear it one of those laboratories-the Western AsylumsResearch Institute-to the maintenance of which thedirectors contribute and which has proved of great benefitto the hospital.

Londonderry Lunatic Asylum (Annual -Report for the Year1914).—From the annual report of this asylum just issuedit appears that the total number of cases under treatmentfor the year was 651. The expenditure during the 12 monthswas for maintenance .E15,908 8s. 5d., and for repayment ofloans JE2501 7s. 3d., sums which show an increased ex-

penditure on the previous year of .6197 17s. 2d. in respectof maintenance and a decrease of ,c42 13s. 6d. in respect ofloans. The receipts for the year amounted to .618,920 13s. ld.The average cost for each patient was during the year£23 14s. 4d.

MEDICINE AND THE LAW.

A Coroner and a Medical Witness.AT a recent inquest at Derby held upon the body of a man,

60 years of age, it was proved that the deceased fell downwhen in his garden and was taken into the house unconscious.His usual medical adviser was away, and another medicalman was summoned, according to whose evidence the.deceased was paralysed down his left side when he sawhim, and that he died about five minutes later with all the

symptoms of cerebral haemorrhage. To this the doctor ascribeddeath in a certificate which he gave without hesitation, and,the jury at the inquest which was afterwards held accepted,his evidence and gave a verdict in accordance with it.The coroner, however, expressed great displeasure at acertificate of the cause of death having been given in thecircumstances described. In our view the medical man’s

replies to questions on the subject completely justified hisaction. "I I thought the symptoms were so typical that itwould be absurd to have an inquest." " Nothing else couldhave caused his death but cerebral haemorrhage." The

coroner, from other observations which he made, appears toha.ve thought that a medical man called to an unconsciouspatient five minutes before death would be liable to a penalty-for giving a certificate, and so he informed the witness.In any ease he held an inquest, believing, no doubt, that itwas his duty to do so. The law on the subject is plain. The coroner is obliged by the Coroners Act, 1887, to hold an Iinquest when there is "reasonable cause " to suspect that aperson " has died either a violent or an unnatural death, orhas died a sudden death of which the cause is unknown." There was, of course, nothing in the facts known to thecoroner to suggest a violent death, and with regard to it

being an unnatural death, or a sudden death of which thecause was unknown, there was the certificate of a medicalpractitioner who had attended the deceased while he wasstill alive. If the coroner had "reasonable cause" to

suspect that the certificate stated the cause of death

wrongly he would be obliged to hold an inquest, butin that event it would equally be his duty to clearup all doubt by ordering a post-mortem examina-tion. This, apparently, he did not do, while he is

reported as having commented adversely upon the medicalevidence to the effect that nothing could have caused death&nt cerebral hasmorrhage by saying, " I do not question that

at all, but does it alter the fact that you had no right to givethe certificate ? " If the coroner did not question thecorrectness of the statement in the certificate he can hardlyhave had "reasonable cause" to suspect that the death waseither unnatural or from an unknown cause. With regard togiving the certificate, a practitioner attending a deceasedperson in his last illness is bound to give a certifi-cate, and though in the circumstances in which thedoctor in question attended he might have declined todo so, it is difficult to see what legal justification hewould have had in taking such a course. Whether he did soor not, it would have been open to the coroner, if informedof the death, to make suitable inquiry, and in the exercise ofhis discretion to hold an inquest or to abstain from doing so.There would appear to be more ground for suggesting thatan unnecessary inquest was held than for saying that themedical man who gave the certificate acted in any wayincorrectly.

THE ANNUAL REPORT OF THE CHIEFVETERINARY OFFICER FOR 1914.1

THE issue of the annual report for the year 1914 of SirStewart Stockman, Chief Veterinary Officer and Director ofVeterinary Research to. the Board of Agriculture andFisheries, has been delayed by the fact that Sir StewartStockman has been busily occupied in research into thetreatment of swine fever by serum and vaccination. The

report is a very interesting one. It opens with the con-sideration of foot-and-mouth disease, and accounts are

given of nine outbreaks, an increase of seven over thoseoccurring in 1913. In several cases the origins of infectioncould not be traced, but in other instances the sources of theepizootic were ascribed to imported chilled meat being fedto pigs, to butchers concerned with animals in a previousoutbreak visiting a dairy, and to a cow sent for service to abull on infected premises. All the outbreaks were promptlydealt with by the stamping-out method.

Outbreaks of swine fever to the number of 4356 wereconfirmed, which represents a considerable increase since1913. 39,277 pigs were slaughtered by the Board, whichis a proportionately smaller number than were sacrificed inprevious years. Swine fever will probably in future be dealtwith by a protective serum in infected herds and the

production of immune herds. The Chief Veterinary Officerhas prepared a report on the treatment of the disease byserum, and there is reason to believe that the control anderadication of the scourge will be governed by his sugges-tions. Other countries have adopted this method satisfac-torily for some time.

Glanders shows a gratifying decrease in number of out-breaks, and the satisfactory position is undoubtedly due toa wide recognition of the use of mallein in the exterminationof the disease. Attention is called in the report to therather slack view taken as regards "in-contacts," where horsesbelonging to one and the same owner are being constantlyshifted from one stable to another. A word of advice isalso given as to the use of the certificates of veterinarysurgeons in connexion with testing newly purchasedponies under the Mines Act. The certificate shown maynot apply to the pony to be sold, or may be of tooancient date to be valuable. Eleven out of the 18 out-

I breaks discovered under the Mines Act were in Russianponies. More than half the reports of suspected cases ofanthrax proved on investigation to be fallacious, and out ofthe 1150 lots of pathological material sent to and examinedat the laboratory, 722 outbreaks were declared to exist. A

dog and two cats died from feeding on anthraxed carcasses,and as these animals carry portions of flesh over largedistances the necessity of guarding such carcasses fromflesh-eating animals is indicated. Some animals bedded on

shoddy from woollen mills contracted anthrax, and twohorses died from anthrax that were respectively carting hidesand dragging a cow dead from anthrax.There were nine less outbreaks of scab in sheep than in

previous years, and Scotch sheep were mostly concernedin spreading the disease. Ineffectual dipping is the chief

1 Annual Report of the Chief Veterinary Officer of the Board ofAgriculture and Fisheries for the Year 1914. Wyman and Sons,Limited, Bream’s-buildings, Fetter-lane, London, E.C. Price 3d.