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part-time dentists who obviously could not be translatedfrom their practices. Some delay in the continuity ofconservative dentistry was therefore excusable, but asthe public was beginning to appreciate the value of schooldentistry it was vital to ensure that this growing interestwas not discouraged. This will not be achieved by theadvice ’in circular 1523 that the amount of work doneshould be dictated by the personnel available and not,as it should be, by the requirements of the children.There is no encouragement to local authorities to makean effort to secure the most efficient service possible inthe circumstances and some of the evacuating authorities,though fortunately not the majority, thinking more oftheir financial liability than of the health of their children,have added their curb to that of the board to limit theactivities of the reception authorities to the least thatthe country will tolerate. We can still hope that thepublic, now convinced of the benefits of the schoolmedical and dental services, will not submit to theircurtailment if it can possibly be avoided.

INFECTIOUS DISEASE IN ENGLAND AND WALESDURING THE WEEK ENDED AUG. 24, 1940

Notificatiokis.-The following cases of infectious diseasewere notified during the week : smallpox, 0 ; scarletfever, 1257 ; whooping-cough, 1046 ; diphtheria, 829 ;enteric fever, 137 ; measles (excluding rubella), 6688 ;pneumonia (primary or influenzal), 349 ; puerperalpyrexia, 148 ; cerebrospinal fever, 131 ; poliomyelitis,39 ; polio-encephalitis, 9 ; encephalitis lethargica, 1 ;dysentery, 40 ; ophthalmia neonatorum, 96. No caseof cholera, plague or typhus fever was notified duringthe week.The number of civilian and service sick in the Infectious Hospitals

of the London County Council on Aug. 23 was 742, made up of :scarlet fever, 134 ; diphtheria, 153 ; measles, 49 ; whooping-cough,28 ; enteritis, 59 ; chicken-pox, 27 ; erysipelas, 33 ; mumps, 9 ;poliomyelitis, 1 ; dysentery, 9 ; cerebrospinal fever, 26 ; puerperalsepsis, 29 ; enteric fevers, 50 ; german measles, 2 ; other diseases(non-infectious), 56 ; not yet diagnosed, 77. ,

Deaths.-In 126 great towns, including London, therewas no death from smallpox or from scarlet fever, 1 (0)from enteric fever, 5 (1) from whooping-cough, 5 (1)from measles, 12 (1) from diphtheria, 33 (4) fromdiarrhoea and enteritis under 2 years, and 6 (2) frominfluenza. The figures in parentheses are those forLondon itself.The number of stillbirths notified during the week was190 (corresponding to a rate of 35 per thousand totalbirths), including 20 in London.

In England NowA Running Commentary by Peripatetic CorrespondentsAdolf arrived, as current slang goes, in time for a meal

as usual—Sunday supper on this occasion. We listenedcrossly to the sound of wheelbarrow races being conductedacross the rather badly laid floor of heaven and went onputting away cold beef to the song of the sirens. " We’llget to bed early," my aunt said comfortably,

" and thenwe won’t notice it." But this time we had reckonedwithout the nuisance value of our lively Saxon cousins.They popped across in droves, apparently sticking to onehigh road-the milky way, perhaps-and as they camepast one landmark-skymark ?-a little gun went off ;half a minute later they reached some other chosen spotand a nearer gun joined in ; and of course the visitingteam were dropping things all the time so there was nosleep to be had. Somebody opened the back door andthe cat shot in looking black affronted ; with a nice senseof personal values he took up a position in a clothes-basket under the stairs. The dog, a Staffordshire bull-terrier who has the proud kennel name of Bocking Amosbut is more accurately known as Porkie, took a poorview of the whole thing, laying a mournful head in everylap in turn. I was invited to prescribe for him, and foundsome Sedobrol in the sample cupboard. He thought itlovely and was shortly reduced to a heavenly languor inwhich he would open one eye, smile dreamily and oozea little further over one’s knees under the impressionthat he was a lap-dog. About midnight my uncle, whoaffects a Melancholy Jacques delivery, muttered gloomilythat some people had no consideration and went to bed.The rest of the party also went to bed in relays through

the night and returned at intervals to the basement-dogged but defeated of sleep-for tea, biscuits andconversation. Even my uncle, enfolded in his entirebedclothes including an eiderdown which gave him thelook of an orange water-snail, came heavily down againremarking that it was time somebody told Hitler to callhis cattle home. The two air-raid wardens in the family,who were supposed to be having a night off, exchangedbitter condolences, and my aunt, an incorrigible adven-turer, kept slipping off like sister Anne to the watchtower, to look for excitement from the topmost window.My uncle, whenever he detected her absence, muttered indisgust " She’s peeping again," and went off and retrievedher. Towards five o’clock I remember lying on my backand being dogmatic and insulting about Ruskin whomsomebody had brought into the conversation in quite akindly spirit. We all went to bed for the last time afterthat, and had the pleasure of hearing the all-clear (whichgoes on too long and too loud) as we settled down to anhour’s sleep.At eight o’clock I opened the front door thinking to

find London hanging together by a thread. The streethad its usual drowsy aspect : the dew was on the grassand I heard the rattle of a milkman. Incredible that somuch noise could be rewarded with so little obvious result.

* * *

My partner is a member of a medical board for theexamination of recruits. Though apt to dwell at somelength on its arduous nature he obviously enjoys thework. His morale varies directly with the standardof physique encountered on any given day but he isconstantly impressed by the spirit of the men them-selves. On being confronted one day with a man,otherwise grade A, but with a pair of very flat feet, mypartner scratched his head. " I don’t like those feet ofyours, old man," he said. " That’s all right, sir,"replied the recruit, " I’ve ’ad ’em for years, and I likes’em all right." Another man, otherwise physicallyhefty, had a hammer toe. " Does the toe ever causeyou any trouble ? " he was asked. " Never, sir," was theinstant reply,

"

you can take it from me, sir, I’m O.K.I got four brothers all in the Navy and mother neverbred a jibber yet."

* * *

The Phantom Aerodrome o7 It’s an Ill Wind.-OneSaturday evening about 9 o’clock an Army lorry trundledup to our front door to the strains of " Roll Out TheBarrel " from its cargo of a score of war-like soldiers.We met in the hall an important looking officer whointroduced himself as a captain. though his tunic boreonly two pips. He said he had come to defend ouraerodrome. We told him that so far as we were awarewe had no aerodrome, but this he flatly refused tobelieve. One would not expect an aerodrome to beeasily mislaid but somehow ours appeared to have beenlost. The officer did not know exactly where it wassupposed to be but was sure it must be somewhere andthought we ought to know something about it. No, hehad no map showing its position, but he believed it wasa stone’s throw from the hospital. Anxious to do ourbit to facilitate the defence of the aerodrome we set outon a tour of likely places in the vicinity, scampering withthe officer over fences, up hills and down dales, ploughingthrough bunkers, until all of us were showing signs ofbellows to mend, especially the officer who was loadedwith all the impedimenta of war. But all to no purpose ;nothing like an aerodrome could we find, and it was atired and rather irritable officer that returned with us tothe hospital. We suggested that he might care toinquire the whereabouts of our aerodrome from theofficer commanding the area, or from the R.A.F. stationthirty miles away, but there again he drew blanks, fornobody had even heard of our aerodrome. In thecorridor we met a V.A.D. on whom his eye lightedhopefully as an old friend. " My God, Lorna," hegreeted her, this is a dreadful place ; is there nowhisky here ? " There was neither whisky nor aero-drome, and as he seemed to be set on another voyage ofexploration we offered to procure a meal for him and thetwenty noisy ones, who were still rolling out the barrelunder the bedroom window of a choleric member of ourstaff. Yes, they would need food, but he did not knowwhen they would be able to get it for they would haveto guard the aerodrome. To our untutored eye that

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appeared to be problematic, but we announced firmlythat food would be ready for them in one hour’s timeand with that we bade them adieu. In the morningwe learned that our visitors had tarried until 3 A.M.and had eaten fourteen pounds of roast beef and twenty-two loaves of bread. Except for a crestfallen officerthey departed in high spirits, still rolling out the barreland declaring that this had been their best night sincejoining the Army. We subsequently ascertained thatthe aerodrome, always a bit nebulous, had disappearedaltogether some years ago, and was now rearing anexcellent crop of potatoes.

* * *

When primitive man first of all with chalk made onthe cave wall a sign which conveyed to a chosen friendor two a meaning, he and they found they had createdfor themselves a new power, power to communicatewithout being present, to record, to taunt, to voiceopinions with impunity, the executive power of the pen,and this gave them a feeling of superiority which is stillapparent in many an office clerk. There was once aman who use to travel up to London every day on theold G.E.R. who laid down the law to his fellow-passengersabout cricket. He practically selected the test teamand was authoritative on every cricket subject. Hedidn’t appear on Saturdays, but during the week wouldcasually mention, " We did pretty well on Saturday-afirst wicket stand of 106 against the Old Bunhillians,"something of that sort. Apparently he belonged to awell-known club, and from the way he verbally tookbowlers off and selected the order of batting, everybodythought he was captain. Years later it turned out hewas the scorer. He felt, and I suppose with somejustice, that he controlled the whole game. I’ve knownclerks to insurance committees and hospital secretariesimbued with the same feeling of superiority, and evenhistorians have often mixed up the functions of recordingangel and omniscience. This office-clerk complex isparticularly noticeable in the mercantile marine andaccounts for much that is unsatisfactory in it. I knowa shipping company which not very long ago celebratedits centenary and published a book about itself. Duringthat time its ships, sojourning the seven seas, must havehad wonderful adventures, which would make goodreading. They were hardly mentioned ; it was all aboutthe office staff. "In 1871," we read, " iMr. Jonesbecame manager and it was owing to his wonderfulenergy and foresight ... the new office building waserected in 1904 and a new fleet ordered the next year,and this was entirely due to Mr. Brown ... duringthe depression of 1910 the company was saved by theheroism of Mr. Smith...." The sea and the gallantseamen were very secondary affairs. Here is an extractfrom a letter from another shipping company endeavour-ing to appoint me surgeon to a liner. " We are notagreeable for our Medical Officers to charge a fee topassengers for medical attendance but if passengerswillingly volunteer on their own account to acknowledgeyour services by offering you a fee, under these circum-stances we have no objection to your accepting same."Ink can be heady wine, but typescript, especially on astomach empty of grammar, is raw spirit.

* * .

Some of us medical officers in charge of mobile unitsin rural areas have, in our insubordinate way, beenwondering about them. My particular travelling circusconsists of 10 souls (if they all turn up), 2 cars and acrazy van full of complicated apparatus packed partlyin cupboards and partly in a sort of outsize and extremelyheavy coffin. We have a cruising speed of about 25miles per hour. I am told that we serve a twofoldfunction : first, to hasten to any adjacent village whichmay have been raided and suffered considerable casual-ties ; secondly, to proceed to divers large cities and towns(some of them 3 or 4 hours’ journey away) to reinforcethe medical services there in the event of massive andprolonged air-raids. Now I may be an optimist but itseems to me that anything in the nature of intensivebombing of small villages of no military importance is,to say the least of it, unlikely even in this war. What hashappened, and what will doubtless happen again, is thatodd bombs, jettisoned by justly nervous Nazis, havefallen on or near villages causing one or two casualtiesand the local doctor, by virtue of his proximity, has been

and will continue to be called, just as he is for roadaccidents or any other emergency. Clearly there is noplace for the mobile unit here. for by the time it hasassembled, loaded up and reached the site of the incident,all the work will have been done. Nor can I visualiseour being called upon to exercise the second part of ourfunct,ion-namely, the reinforcement of the medicalservices of large cities or towns perhaps 100 miles away.Professor Trueta tells us that speedy transport to ahospital where deliberate treatment of bomb woundscan be carried out is of first importance if lives are to besaved. Those casualties who are expected to lie aboutfor several hours until we can reach them with our splintsand bandages will either have died before we get there or,more probably, gone home in disgust. Once more I ask,where does the mobile unit come in ? I submit that onedoctor, in his own car and with his own accident bag anda few splints, makes an excellent mobile unit. What werequire in rural areas is a better ambulance service-and less first-aid.

* * *

Our air-raid wardens have been sitting for a first-aidexamination. Gathered in the local schoolroom, theywere quietly confident, for they had been well coached.They had been told that an epileptic fit can easily berecognised by the sterorterous breathing, and that whensplinting a fractured femur they must not forget theperennial band. This sharing of terms between medicineand horticulture is of course well established. Readersof " An Innkeeper’s Diary " will be reminded of a prankplayed by its versatile author, John Fothergill. He hadasked a famous scholar-poet, whom he was showinground his garden, how to pronounce (ejiothei-ci and wasnettled by the reply " evening primrose." So he " pro-ceeded to point out all the plants with vile names.

’ There’s Herniaria;... that’s lllonarda fist-ulosa ;that’s Lobelia syphilitica, got it to give it a good home ;and over there I have a Phallus amorphus, but it hasn’tcome up yet.’ " Nor must one forget the sharing ofzoological and medical terms, as witness Mr. BobbyHowes’s wild beast of the Amazon, the dreaded Stetho-scope. Nevertheless, certain questions puzzled some ofthe candidates. The oldest lady warden, for instance,could not decide how many splints she should put on thefrontal bone, which runs up the front of the leg. Ourinformant had to deal with an imaginary Pott’s fractureon the person of a boy scout. He was proceeding topush a narrow-fold bandage gingerly under the limb withthe aid of a splint when he was stopped by the victim." Don’t be silly," said that experienced young manscornfully, " the doctor isn’t looking." Thereafter, withthe patient keeping watch, the fracturedlimb was splintedwithout trouble. The wardens are now awaitingexperience, most mercifully withheld here. In the mean-time the lady wardens are fiercely making jam.

* * *

We have recently returned from the West Country,where we have been, rightlv or wrongly, for a shortholiday. Difficulties of localisation were paramount.The unaccustomed train journey was complicated bythe anonymity of the railway stations. It was like beingat a play without a programme, and the porters, who cryso merrily in screen and fiction, are now as silent as thesignboards are blank. Formidable also are the diffi-culties of a country walk in unfamiliar territory. Themost innocent inquiry as to one’s whereabouts maybring forth unblushing mendacity. Tea-cottage pro-prietors, standing by their mineral water signs, assureone that they are strangers in those parts. (This is notsolely a British habit. I remember once arriving inGermany at Trier, and on asking the way to the PortaNigra, being informed by an apparently typical burgherthat he was a stranger there.) Our holiday was spent ata place the beauty of which is more rugged than obvious.A friend of mine once said hopefully that the place grewon one.

" 7Ve11," said his hearer scornfully, " if it grewon me I’d have it amputated." War disturbance in thisplace is more potential than actual. Food rationinghas, however, been introduced there. We saw a notice," conceal your lights," posted in the window of a smallbutcher’s shop ; on reflection, however, we realised thatthis did not necessarily adumbrate a shortage ofunrationed meat.