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Commission will be as follows: a President, appointed by theTsar; a certain number of members, appointed by the Senate;six members named for three years by the St. Petersburgtown council ; two members chosen for the same period bythe zemstzo of the St. Petersburg government ; and not morethan four members named by the Tsar. The example ofEngland is quoted where the cholera outbreaks that occurredbetween 1846 and 1860 led to the inauguration of those greatpublic health measures and legislation which have producedsuch brilliant results in the last few decades of the nine-teenth century.The execution of the new scheme of water-supply in the

Russian capital will require some 15 years for its completion.In the meantime, in order to deal with the existing outbreakof cholera, "first aid" stations have been opened in 17different parts of the city ; 42 disinfecting stations have alsobeen established, of which 30 are situated in the central partof the town and 12 on the river. At each of these stationsthere is a medical officer, a disinfector, and a number ofsubordinate employes. In order to ensure an effective resultnot more than six separate operations of disinfection are

permitted at each station in the course of 12 hours.Chole’l’a Cases in Germany and A1l-8t’l’ia-H1tnfja’l’Y’

A single case of cholera occurred in Konigsberg on

July 20th. The patient had arrived from Russia. Deathoccurred on the following day. The diagnosis of cholerawas confirmed by bacteriological examination. News hasalso been received of a suspicious case of the disease at

Lemberg, in Galicia, but details are wanting.

Plag2ce in Adalia.The first case here occurred (as stated in my last letter) on

July 2nd. On the 12th another case was reported; the patientwas a little girl, aged eight years, living in the Djami Atikquarter of the town ; she apparently recovered. On

July 19th, in the Yaniklik quarter, a third case was seen ;the patient was a shoemaker, aged 16 years ; he had been illfor four days ; he died on the 23rd. Then on the 29th newswas received of the following incident. An inhabitant of

Adalia, a man, aged 35 years, left the town on the 27th, in-tending to drive to a place called Stanos, 60 kilometres fromAdalia. He had been ill for some days before he started.After driving some 50 kilometres he died on the road. The

municipal doctor, who happened to be in the neighbourhood,examined the body and pronounced that death was due tobubonic plague. On. July 28th yet another case had beenseen in Adalia itself ; the patient was a boy, aged 14 years ; the died on the 30th. There have thus been up to the presentfive cases of plague, with three deaths, in or near Adalia.

Ce’l’eb’l’o.apinal Meningitis in Arabia.Within the last year or two epidemic cerebro-spinal

meningitis has been showing unusual activity in many partsof the world. News has recently been received here of itsappearance, in apparently a very fatal form, in a quiteunexpected and little known country. Owing to the presenceof plague in endemic form in the Assyr province of Arabia(situated between the Hedjaz on the north and the Yemenon the south) a sanitary officer in the service of the

Constaninople Board of Health is permanently stationed atEp-ha in that provincs. In June this official was requestedby the Vali of Assyr to visit certain villages in the neighbour-hood of Mihail, in the interior of the province, and reportupon a very fatal outbreak of disease which had appearedthere. In the first villages visited (those of Ma’ash,El-Daris, Mansab, Al-Fahma, and Ennus’b) no cases wereseen, but in each there had been a heavy mortality from adisease which had in most instances caused death in 24

hours, or at most in a few days. The cemeteries showed,by the number of new graves, how high the mortality hadbeen. In the next district visited, that of Al-Mohsin,nothing was seen but two cases of typhoid fever. Furthertravel in these regions was not withont danger, but with theaid of Sheikh Faiz-bin-Nouh, a sheikh much venerated inthose regions, it became possible to visit several villages inthe districts of El-Hadjif and Tayal-Marwa. Here, in eachvillage "and almost in every hut," patients were found,suffering from an acute disease which is said to haveresembled in every way the epidemic form of cerebro-spinalmeningitis. There were in each case high fever, accom-panied with vomiting, excruciating headache and backache,contracture of the limbs, delirium, torpor, coma, and then

death after a day’s illness. The strongest and healthiest.individuals did not escape; they were suddenly struckdown (writes the author of this excellent report), crying," Oh ! my head I " or Oh I my back I I have been shotin the back." The disease had apparently spreadslowly in each village, and from one village toanother. The district first affected had been that ofAl-Fahma, then that of Al-Mohsin, and then that of Al-Hadjif. Although the population is extremely sparse-lessthan one person per square kilometre-the epidemic is 6aidto have been " 1Me des pl1lS tC’l’’l’ibles et ravageantes," as

shown by the new graves in all the cemeteries. While stillin these regions news was received of the appearance of thedisease in the Al-Machwal district, and on visiting the

villages in this district several of the first cases were seen ;the symptoms were identical with those already described.It is noteworthy that both here and in the earlier villagesvisited an epidemic of enteric fever was prevalent at the sametime as that of cerebro-spinal meningitis. Nothing was seenor heard of the prevalence of plague in any of the villagesvisited ; but the tour did not extend to the country of theBeni Sheir, where the centres of endemic plague exist (orused to exist). That tribe or group of tribes was in activerebellion against the governing authorities, and it was

impossible, without great risk, to penetrate to theirjsettle-ments.

Constantinople, August 6th.

BRISTOL AND THE WESTERN COUNTIES.(FROM OUR OWN CORRESPONDENTS.)

The University of Bristol.THE appointment of Dr. J. Michell Clarke to be the first

Pro-Vice-Chancellor of the University of Bristol, which wasbriefly announced in my last letter, demands fuller notice thanwas possible at that time. The Faculty of Medicine is justlyproud of the honour done to one of their number, and it is

generally agreed that the office could not be better filled. Dr.Michell Clarke has given an immense amount of time andpains during the past 25 years to the establishment and

expansion of medical teaching in Bristol. He has taughtmedicine in the wards of the General Hospital for manyyears, and lately as professor of medicine at UniversityCollege; and until it was found possible to appoint a whole-time professor of pathology, he held this office and taughtpathology with conspicuous success. Prior to this he waslecturer on practical physiology, so that he has a verycomplete personal experience of the medical curriculum.

Beyond this, he has taken a leading part in the heavy workof administration which has been necessary during theevolution of the University.-Lord Rosebery, as Chancellorof the University of London, has appointed Sir Arthur W.Rucker, M.A., D.Sc., LL.D., F.R.S., to be his representativeon the Court of the University of Bristol for a period ofseven years.-The education committee of the Bristol citycouncil has had a surprise in the shape of an applicationfrom the authorities of the University for the payment of thesum voted by the council several months ago. This sum i3:about f.7000, the proceeds of a penny rate, 3000 of whichare earmarked for a scheme of scholarships, Z4000 remainingfor the general maintenance fund. The application was notexpected yet, but the University development was rapid inits final stages, and the first session will begin on Oct. 1st.It is not likely that all the regulations will have taken shapesufficiently for use by that date, but such as are completewill presumably come into force then. Under the circum-stances the education committee agrees to provide 92000(half the general fund) in December, the special 9300awaiting till the scholarship scheme is ready.

Bristol Royal Iitfirmapy.At the half-yearly meeting of the governors of the,,

infirmary held on July 27th, Sir George White, the President,gave a brief account of the financial position during the firsthalf of 1909. Comparing the figures with the same half of1908, the total receipts were .68142. as against 8420 the.preceding year ; the ordinary expenditure was .c8578, com-pared with f.8457. Extraordinary expenditure to the extentof E943 was incurred in the starting of the nurses’ trainingschool and other items, leaving a balance due to the.

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treasurer of .61384. This makes an adverse balance of

nearly f.5000 accumulated during the last three years. Mr.Francis Tagart and Mr. Samuel White have each promised.1000 towards the extinction of this debt, and other

promises amounting to f.457 have also been received. Themost hopeful feature of the financial outlook is the increaseby E217 of the sum total of regular subscriptions. Legacieswere productive of 1173, as against £ 92. Sir George Whiteconcluded with an appeal to the public for more adequatesupport, a statement of the work of the institution during thepast half-year (1781 in-patients and 20,587 out-patients, as.,compared with 1747 and 20,227 in the corresponding half of1908), and a brief reference to the building scheme. Thishas progressed as far as the demolition of the houses whichoccupied the site to be devoted to the projected newpremises, the detailed specifications for which are beingprepared. Building tenders will be asked for in a fewmonths. After the general meeting a special meeting washeld to elect Mr. G. Munro Smith consulting surgeon onhis resignation of the post of surgeon. The President, Dr.R. Shingleton Smith, and Mr. J. Paul Bush all expressed the-general regret felt by the committee and staff at the retirementof such a popular and devoted officer, and Mr. Munro Smithreplied. Mr. H. F. Mole, who has for some years beenassistant surgeon, was elected to the full staff, and Mr. C. F.Walters, surgical registrar to the infirmary, was electedassistant surgeon.Death of Mr. Ed7vard Benjamin Steele-Perkins, L. B.A. Lond.Mr. E. B. Steele-Perkins, who died at his residence,Wilton-place, Exeter, on July 30th, in his sixty-eighth year,was a member of an old Exeter family. He received hismedical education at Charing Cross Hospital, and afterqualifying in 1876 joined his father in practice at Exeter.For nearly 40 years he was a familiar figure in that city, andhis geniality won him many friends. He was keenlyinterested in the Volunteer movement and for many yearsheld a captaincy in the lst Devon Artillery Volunteers,retiring about ten years ago with the honorary rank of major.His father, the late Dr. John Steele-Perkins, was one of theearliest Volunteers in the country. Mr. Steele-Perkins had a

large practice in Exeter, he was honorary surgeon to theDevon and Exeter Home of Refuge, and also medicalexaminer for the Royal Navy and Royal Marines. He was aI I freeman " of the city of Exeter, for many years representedSt. Sidwell’s ward in the city council, and was held in highrespect. He leaves a widow and two daughters.

P-ublie Health in Honiton District.At a recent meeting of the Honiton (Devon) rural district

council a letter was read from Mr. F. R. S. Cosens, the secre-tary of the Honiton and Axminster Unions Medical Associa-tion, stating that at a meeting of the medical men of theHoniton and Axminster unions a resolution was passedurging the provision of an isolation hospital for the Honitonurban and rural, Sidmouth urban, Ottery St. Mary urban, andAxminster rural district councils, and favouring the appoint-ment of a medical officer of health for the district, who shouldalso be superintendent of the hospital and devote all histime to public health work.

The Pearn Convalescent Home, near Plymouth.The annual meeting of the subscribers of this institution

was held recently under the Presidency of Vice-AdmiralJ. E. Maitland Wilson. The medical report stated that

during 1908 the patients admitted numbered 496, comparedwith 491 in 1907. 307 patients were admitted from theSouth Devon and East Cornwall Hospital, 172 from the RoyalAlbert Hospital, Devonport, and 17 from the Plymouth EyeInfirmary. 61 nurses from these hospitals were also receivedduring the year. The expenditure for the year was .S1123,the average cost of each patient being 2s. 6d. per day.

The Totnes Cottage Hospital.At the annual meeting of the subscribers of the Totnes

(Devon) Cottage Hospital the following members of thehonorary medical staff, whose term of office had expired,were re-elected : Dr. K. R. Smith, Dr. G. J. Gibson, Dr.W. R. Edmond, Dr. W. Chapman, and Mr. H. S. Johnson.

l’he ?bM ". 7 L" "

The party of foreign medical men who have been touringEngland under the auspices of the "Enseignement Medico-Mutuel Internationale arrived at Bristol on August 15th

under the guidance of Dr. Etienne Bazot of Paris. Theyvisited the Royal Infirmary and were conducted through thatinstitution by members of the honorary staff. They thendrove on to the General Hospital where they were receivedby the president, Mr. J. Storrs Fry, the matron, and severalmembers of the visiting staff. They went all over theinstitution and expressed their admiration of the wards, theoperating theatres, and the nurses’ home. After lunch at theRoyal Hotel, to which representatives of the two staffs wereinvited, they made a tour of Clifton which included theZoological Gardens, and were finally entertained at thehouses of several medical men who had conducted them overthe institutions in the morning.August 17th.

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SCOTLAND.

(FROM OUR OWN CORRESPONDENTS.)

- Z/<M Visitation in Glasgow.UNDER the scheme of visitation of the Public Health

Department in Glasgow an inspector calls at every housewhere a birth has occurred. Under this arrangement 12,954inquiry cards were issued to the female inspectors during theyear. Of these, however, 273 proved to be duplicates ofprevious notifications, and 1247 were not visited for variousreasons. Of the others, 200 were not found at the addressesgiven, while 737 more had medical men in attendance.There thus remained 10,497 children not medically attendedat birth who received at least one official visit after notifica-tion. It is worthy of note that of the children found aliveon the occasion of the first visit no less than 96 per cent. hadthe advantage of breast-feeding in the early weeks of life.In this respect much help has been given by the GlasgowInfant Health Visitors’ Association. Of this associationthere are now 15 different branches supplying voluntaryvisitors to the number of 300, who undertake visitationin 19 wards or districts of wards. While the visitors areuntrained in public health work, and no standard of trainingcan be insisted on beyond a familiarity with the requirementsof district visitation, there is every reason to believe that theinfluence of an educated and sympathetic visitor cannot failto operate for good in the homes of the poor. Informationregarding the cases to be visited is sent by the health officeto the secretaries of the various branches of the association,and they in turn are responsible for returning reports to thehealth office at the end of each month. The cards forwardedfrom the health office at present consist of a yellow cardwhich is sent for information, and a small white cardwhich is for the visitor’s monthly report. The yellow cardsmay be retained by the secretary or distributed amongst thevisitors as she thinks best, but in any case they are

only for information, and are returned to the healthoffice when the babies pass from under observation. The

complete record of each baby thus consists of the yellowcard and 12 white ones, and these are all returned to thehealth office immediately the baby has completed his twelfthmonth.

{heenock and Phthisis Cases.In a report to the Greenock corporation the medical officer

of health for the burgh states that even 12 beds in theCombination Hospital would enable the health authorities toinstitute a definite campaign against phthisis. The cost isestimated at .6620. It is proposed to establish a dispen-sary, the upkeep of which would probably not exceed .E100per annum.

Large Donation to D1tndee Royal lnflrmary.At a meeting of the directors of the Dundee Royal

Infirmary held on August 12th Mr. George Duncan, one ofthe directors, read a letter from Miss Duncan of Drumforte,intimating a donation of &pound; 4200 to the funds of the infirmaryfor the purpose of endowing two beds in memory of, and tobe named after, Miss Duncan’s late brothers, Mr. JamesDuncan of Drumforte and Indanstone, and Mr. GeorgeDuncan, banker, Alyth ; and two cots in the children’s ward,one to be named after her late sister, Miss Marjory Duncan,and the other to be named after herself, preference to begiven to patients from Alyth and Blackwater districts. Onthe motion of the chairman, the directors resolved to recordtheir cordial thanks for the generous gift, coming as it did ata time when claims and heavy calls were being made upon the