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The first case was that of a man who had been suffering fora few days. The case was diagnosed as small-pox, and thepatient was removed to hospital on July 22nd. Two dayslater another case hailing from the same property was dis-covered. The patient, in this instance a woman, was onintimate terms with deceased’s family, and had assistedthem in their affliction. She was also removed to the small-

pox hospital at King’s Cross, and both families were removedto the reception house. A third case was discovered on the27th, that of a young woman who resided in the vicinitywhere the other cases occurred. The first case succumbedon the evening of his admission to hospital ; the other casesare doing well. The origin of the outbreak has not beentraced. The area in which the cases have occurred is in theopen country.

Turriff District -Hospital: Annual Meeting.The annual meeting of the committee of management of

the Turriff District Infectious Hospital was held on July 27th.Thirty-five patients have been treated in the hospital duringthe year ended May 15th last. Fourteen of these were casesof diphtheria and 21 scarlet fever. At the beginning of theyear there was a balance of £35 Os. 5d. and at the end of theyear a balance in hand of £29 lls. 9d. The clerk submitteda statement of the probable expenditure for the current year,which amounted to £494 lls. 9d., less balance, leaving £465to raise by assessment, 347 2s. 11d. falling to the Turrifl’district and £117 17s. 1d. to the burgh of Turriff. The meet-

ing agreed to intimate accordingly.August lst.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

Dublin Hospatals and the Insurance Bill.AT a meeting of representatives of the chief Dublin

hospitals held last Monday to consider the effect of theNational Insurance Bill on the hospitals of Ireland, thefollowing resolutions were carried :-

1. That this conference is of opinion that the National InsuranceBill as introduced into Parliament will, if unamended, have an injuriouseffect on the income of the hospitals of Dublin.

2. That hospitals and dispensaries by which services are rendered toassured persons should receive the actual cost of the expenditure theyhave incurred for such services under conditions that will preserve theindependence of the voluntary charitable institutions concerned.

3. That Clause 15 be amended so as to provide that hospitals anddispensaries should receive the same benefits as sanatoria.

4. That voluntary hospitals be excluded from contributing under theBill, or, in the alternative, that power be given to the Insurance Com-missioners to pay the contributions of employers in addition to theImperial contributions in the cases of voluntary hospitals out of thefunds at their disposal.

5. That in maternity cases treated in hospital wards the allowance bepaid directly to the assured person.

Vital Statistics of Ireland.The annual report of the Registrar-General for Ireland, just

presented to Parliament, states that the mortality-rate per1000 from phthisis in the years 1907, 1908, 1909, and 1910has shown a successive decrease-viz., 2-7, 2’6, 2-4, and2-3 respectively. The marriage-rate shows a decrease of0-12 per 1000 as compared with 1909, the birth-rate adecrease of 02, and the death-rate of 0 - 1. Of the 101, 963births, 52,103 were of boys and 49,850 of girls. 97-2 percent. of the children were legitimate, the highest rate of

illegitimacy being in Ulster, 3.7 percent., and the lowest inConnaught, 0- 7 per cent. The number of emigrants who leftIreland in the year was 32,457.

Lunaoy in Ireland.The annual report of the Inspectors of Lunatics in

Ireland was laid on the table of the House of Commons twoweeks ago. The summary of the number of insane undercare shows an increase during the year 1910 of 250 ; thecorresponding increase in 1909 was 213. The average annualincrease in ten years was 328. The number of insane inworkhouses has decreased by 84. The percentage of re-

coveries to admissions was 36-5, being 1. 9 lower than thatfor the previous year.

The Abbey Sanatorium.Mr. Robert Hall, medical officer to the Abbey Sanatorium,

Belfast, has presented his report for the half-year ending

March 31st, 1911. Of the males, 19, and of the females, 11(total, 30) were discharged as ’’ greatly improved " ; 142 (95males, 47 females) were discharged as ’’ improved "; 29 (16males, 13 females) left "not improved"; 23 (12 males, 11females) were " not long enough in sanatorium "; and 64 (43males, 21 females) died; in other words, a total of288 patients (185 males, 103 females) altogether were

treated during the half-year. Of these, 105 (67 men, 38women) were married, 35 (18 men, 17 women) were widowed,and the remaining 148 (100 men, 48 women) were single.Of the 185 males, the age-period varied from 5 to 73years. The age-period 25 to 30 years supplied 26 cases;25 were between 35 and 40; while between 30-35 yearsand 40-45 there were 24 each. Of the occupations, 89were labourers, 24 housekeepers, 15 spinners, and 11

weavers; the others belonged to almost every type ofworker. Mr. Hall recommends in his report the building ofa large self-contained pavilion to accommodate femalepatients, the appointment of a second resident medicalofficer, the erection of a verandah round the front of thehospital, and an inter-telephonic exchange. He draws atten-tion to the constantly arising difficulty that patients suitablefor sanatorium treatment show a strong dislike to entering

the infirmary lest they should be considered as paupers, yetthis course is necessary, because the institution is under thePoor-law system. There should certainly be a broader field ofadmission by which the consumptive poor could enter thisadmirable sanatorium without being branded as paupers.The best solution would be for the public health committeeof the city of Belfast to take over the charge of the placeas the central authority. The Abbey Sanatorium was

acquired by the Belfast guardians in the autumn of 1904,and was opened for 40 patients in January, 1905, whileat the beginning of 1908 there were 265 beds. It isinteresting to note that in 1905 (the year the Abbey wasopened) 1116 patients died from consumption in Belfast, in1906 the number was 1015, in 1907 it fell to 926, in 1908 itwas 880, and in 1909 it was 811. Mr. Hall thinks that awider field of admission to the Abbey would produce stillmore gratifying results. This sanatorium is an excellent

example of what can be done for the Irish consumptive byan intelligent body of Poor-law guardians, aided by anenthusiastic medical officer.

Conszcmptzves in Irish Workhouses.At a meeting of the Strabane (county Tyrone) board of

guardians held on July 25th a resolution was unanimouslypassed to the effect that separate accommodation for con-sumptive patients be provided, and that a committee be

appointed to prepare a scheme for the approval of the board.

The Royal S’anitary Institute.The twenty-sixth Congress of the Royal Sanitary Insti-

tute has been in every respect a great success. The dis-cussions in all the sections and conferences have beenadmirable, largely in consequence of the prior publicationin book form, obtainable by each member, of the various

papers to be read. On July 25th, in the Conference onthe Hygiene of Childhood, Sir John W. Byers (the President)delivered the inaugural address on the Hygiene of the Child,with Special Reference to Ireland, to which reference wasmade last week. Then followed two discussions, the first,introduced by Professor J. A. Lindsay, on the Hygiene ofSchool Life ; and the second, introduced by Dr. AlfredGreenwood, on Infantile Mortality in Large Towns. A most

interesting discussion, in which several speakers took part,followed on the Dental Hygiene of Childhood, introduced byMr. George Thomson, L.D.S. On the same day, in theSection of Sanitary Science and Preventive Medicine, theaddress of the President, Sir Lauder Brunton, Bart.,was read in his absence, as we noted last week. Adiscussion on Sewage Purification and on Purification ofRivers and Estuaries followed. In the same section, on

July 26th, Dr. J. King Kerr read a paper on TyphoidPrevention, Dr. W. J. Wilson and Dr. C. Dickson readone on the Viability of the B. Typhosus in Water andits Isolation Therefrom, and Dr. Thomas Houston madea communication on Epidemic Cerebro-spinal Meningitis.In the Conference of Municipal Representatives on July 25th,at which the Lord Mayor presided, Dr. P. Boobbyer reada paper on Municipal Hospitals. On the same eveningDr. Louis C. Parkes gave a popular lecture on the Pre-vention of Tuberculosis : a National Task. In the Section of

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Engineering and Architecture, on July 26th, a paper wasread on How a Town Succeeded without a Town PlanningAct; and on July 27th, in the Sanitary Inspectors’ Conference,one on the Smoke Nuisance and Dairies and Milk Supply.In the Conference of Women Dr. Eric Pritchard read a paperon the State Endowment of Motherhood, which gave rise toa very fine discussion. After this Dr. John McCaw read acommunication on the Reduction of Infant and ChildMortality from Measles. Papers were also read on Women inPublic Health and on Hygiene and Industrial Employ-ment by Miss H. Martindale, H. M. senior lady inspector offactories ; and one by Dr. Elizabeth G. Bell on Babies’Clubs, in which she described very fully these institutionsin Belfast, which were greatly commended by Dr. EricPritchard. A vote of thanks to the Lady Mayoress foracting as President was carried. In the Conference ofMedical Officers of Health Dr. Samuel Agnew read a

paper on the Medical Officers of Health in Ireland. On

July 29th Mr. P. C. Cowan gave an interesting presi-dential address at the Conference of Engineers and Sur-veyors, after which there were papers on the Dischargeof Sewage into Tidal Waters, and on the Dust Nuisance.In the Conference of the Port Sanitary Authorities Dr. R.Thomson gave the presidential address, after which Dr.Herbert Williams of London read a paper on Plague Pre-cautions in Reference to the Destruction of Rats, and Dr.W. Hanna of Liverpool read a communication on the

Importation of Unsound Food. In the Veterinary Inspectors’Conference Dr. H. O’Neill read a paper on Meat Infection,and described the new Belfast public abattoir. At thefinal meeting of the Congress on Friday votes of thanks werepassed to various local bodies and to the Earl and Countessof Aberdeen. Saturday was devoted to excursions.

Condition of Irislt Schools.In several papers read at the Sanitary Congress last week

in Belfast attention was called to the insanitary condition ofIrish primary schools. For years past the Board of NationalEducation has been urging on the Treasury the necessityof fulfilling the promise made by successive ChiefSecretaries to find funds to improve and maintain theschool buildings. In many cases the expenses of cleaningand heating had to be borne by the teacher himself out of astipend less than that of a policeman. At length theGovernment is to find funds to pay half the expense of clean-ing and heating the schools, the other half being paid out oflocal sources. There is, however, no provision for the costof installing heating and ventilating apparatus. The build-ings themselves, moreover, are in many districts utterlyunsuitable as school premises. "All types of school build-ings are to be found," says our inspector, "from the well-equipped modern school down to the wretched thatchedcabin by the roadside, or the equally objectionable erectionin a graveyard.

"

One can hardly expect a high standard ofhygiene from working classes who receive their education insuch surroundings.July 31st.

PARIS.(FROM OUR OWN CORRESPONDENT.)

The Damin2ction of -L7ydrovhobia.SINCE the first years when Pasteur’s discovery of the

antirabic vaccine was utilised for the treatment of personsbitten by mad dogs statistics have shown a constant declinein the number of deaths. In the year 1910 the numericalrecords of the Pasteur Institute, compiled by M. Jules Viala,préparateur in the antirabic department managed by Dr. Roux,show that 401 patients had antirabic treatment without anycase of death being reported. In the year 1886 the number ’,of persons who after being bitten were treated in the PasteurInstitute was 2671, and among them there were 25 deaths,but in 1896 there were 1308 patients with 4 deaths. Sincethat time the cases of hydrophobia have diminished from yearto year, and the number of bitten persons treated annually atthe Pasteur Institute has been under 1000 since 1902. Therewas 1 death in each of the years 1908 and 1909, the numberof patients being 524 in the former and 467 in the latter.Among the 401 caSts treated at the Pasteur Institute in 1910

there were 11 foreigners, including 3 of British and 8 ofSpanish nationality.

The Physiological Effects of Aeroplane Flying.The increasing number of aviators and the development of

aeroplane fl,ing have given opportunities for making someinteresting observations on the physiological conditionsincidental to this new method of progression. Severalfactors have to be taken into consideration. Rising to a greatheight in the air produces effects similar to those of mountainsickness-namely, giddiness, nausea, and headache; butowing to the rapid transition from a low level to a high one orconversely, the blood pressure if it is altered is not allowedsufficient time to become steady as it can do in mountainclimbing ; the conditions, in fact, have some resemblance tothose of a balloon ascent or of an abrupt descent, and evenmore resemblance to what is seen in the case of subaqueousworkers who are quickly brought to the surface from a divingbell, although in aviation the pressures are very much lesp.There are also great variations with differpnt individuals, forattacks of mountain hickness and other discomforts due tochange of pressure are experienced by some at a height of1500 metres, while others are not affected until they reach2000 metres. All the observations that have been made showthat the blood pressure is increased, but only to a slight extentbecause it is counterbalanced by the free access of airwhich, according to the researches of Langlois, tends toreduce the blood pressure. Other factors to be con-

sidered are the duration of the flight and the encounteringof difficulties. Nervous fatigue lowers the blood pressureand quickens the pulse. The nervous tension broughtabout by the necessity for being continually on thealert in presence of dangers has a special influence whichvaries according to the temperament of the individual.I had an opportunity of examining the aviator Beaumontwhen he came down from his machine after having won theprize for the European circuit. He was remarkably calmand his pulse-rate scarcely reached 85, but he told me thathis great natural composure and his long practice in makingascents did not prevent him from having sensations ofemotion and cardiac palpitation in moments of danger. Asa general result it may be said that aeroplane flying does notcause any special form of illness. Increase of the blood

pressure is the most constant phenomenon, but it is verydifficult to collect comparable data from different indi-viduals, because this hypertension is counteracted to a

variable extent by such influences as the altitude, the lengthof the flight, the sensation of danger, and the amount ofcomposure possessed by the aviator.

Dogs in the Medical Service of the Army.The manoeuvres in which the medical department of the

army has been engaged with a view to the training of theofficers both of the active forces and the reserve have oncemore shown that dogs may be taught to trace wounded menand guide relief parties to the place where they may belying. Conclusive experiments have already been made atNancy, at Rennes, and at Lyons, with the result that thesedogs-the so-called chiens sanitaires--will henceforth beregularly attached to the service of the French army,and a national society has been formed for the purposeof providing a supply of trained animals. At Vincennes,where the recent manoeuvres were held, it was remark-able how quickly a stretcher party accompanied bya trained dog could thoroughly examine every part ofan extensive area and carry off soldiers concealed inthickets and under branches in the most difficult conditions.A dog can also work by itself. When sent by its master in acertain direction it finds the wounded man, allows him totake the various articles attached to its collar, and carrieshis cap back to its master, who fastens a string to the dog’scollar and is immediately guided to the place where the manwas found. If a cap is not to be had the dog searches withits foot or its nose in the man’s pockets and takes a

handkerchief, a glove, or some other article which may servefor identification. The dog has a collar to which a bell canbe attached, and on its back a piece of cloth fastened toits neck with a strap and marked with the Geneva Cross ;it also carries a cloth pocket. Retrievers are preferred todogs which bark and may thereby give much trouble. The

qualities chiefly desired in a chien sanitaire and developedby training are a keen sense of smell, absolute obedience to