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treatment of tuberculosis under the National Insurance Act.The report suggests that in regard to domiciliary and dis-pensary treatment in rural districts the services of the districtnurse, if there is one, should, so far as her time allowed, bemade available for the visitation of tuberculous cases-

especially advanced cases-in their own homes, in order toassist the doctor in securing the maintenance of proper pre-cautions. The medical officer of health of the city ofAberdeen has already one nurse exclusively employed in suchwork, and he expects that two nurses will soon be required,especially if they are also to give assistance at the proposeddispensary. As regards the establishment of tuberculosis

dispensaries or clinics and the appointment of tuberculosismedical officers for the three areas to which the report refers,the medical officers are of opinion that it would be difficultto have a joint arrangement that would embrace all threeareas, although some degree of cooperation is both desirableand practicable. The medical officer of the city had sug-gested that a suitable detached building at the city hospitalmight be utilised for a tuberculosis dispensary, and thata tuberculosis officer should act both as officer of the

dispensary and as ordinary physician to the tuberculosiswards at the hospital. The county of Kincardine had

already had under consideration a proposal to request thecounty medical officer and his assistant to undertake theduties of tuberculosis medical officers. The population ofthe county is scarcely 30,000, so that the appointment ofa whole-time medical officer would not be warranted.Aberdeenshire has a population not far short of that of the

city, and its medical officers think that a whole-time medicalofficer should be appointed, to reside in the city of Aberdeen,and perhaps to be associated with the tuberculosis wards atthe city hospital, so that he might keep in touch with hos-pital diagnosis and treatment. It might also be advisable toestablish small dispensaries in several of the more populouscentres, such as Peterhead, Fraserburgh, and others, but abeginning should be made with only two or three dis-

pensaries in order to ascertain from actual experience theirvalue and convenience. The use of a couple of rooms

where available, in an existing hospital or convenientlysituated building would be amply sufficient. As tosanatorium treatment, the city had already made provisionfor 60 to 70 cases of tuberculosis at the city hospital, andcould not be expected to take part in the erection of a jointhospital. The medical officers think that each county shouldmake separate provision for its own advanced cases byutilising wards in existing hospitals, or erecting suitable addi-tions to the present isolation hospitals. They think one largesanatorium for the three areas would be as efficient as andmore economical than separate smaller ones. They considerthe estimate of the Astor Committee with regard to necessaryaccommodation as too low, at least, for urban populations,especially since the Act forbids Local Insurance Committeesarranging with parish councils for the treatment of tuber-culous persons. On the whole they think that, should a jointsanatorium be erected, there should be accommodation fornot fewer than 100, preferably for 120, beds with provisionfor extension if necessary to 150 beds. At least 20 bedsshould be for tuberculous children, and they regard it as

worthy of consideration whether 20 beds should not bereserved for so-called pre-tuberculous children. If the

larger sanatorium was decided on the sum to be raised from local sources would be .66400. The annual cost of a jointsanatorium was estimated at £8500, and the interest on thesinking fund £383. Of the total expenditure the city wouldaccount for .E4465, the county of Aberdeen for £3412, andthe county of Kincardine for E623.Feb.25th.

DONATIONS AND BEQUESTS.-By the will of thelate Sir William, Arrol, of Seafield, Ayr, the Royal Infirmaryand the Western Infirmary, Glasgow, will receive £2500each.

ASSOCIATION FOR PROMOTING THE TRAINING ANDSUPPLY OF MIDWIVES.—The ninth annual meeting of thisassociation will be held at the Central Buildings, West-minster (entrance Tothill-street), on - Friday, March 14th,at 12 noon. The chair will be taken by H.R.H. PrincessChristian of Sohleswig-Holstein, and a. short address on

Midwifery and the Maternity Benefit will be delivered byDr. Christopher Addison, M.P.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

The National University.LAST week a statute was issued by the Senate of the

National University of Ireland. It intimates that diplomasmay be issued in various subjects, including, among others,public health, tropical diseases, mental diseases, and

veterinary hygiene, to students who, although they may nothave matriculated at the University, shall have completedthe courses of study prescribed, and shall have compliedwith the regulations prescribed by the University and passedthe examinations prescribed, provided that the diplomas inpublic health, in tropical diseases, and in mental diseasesshall not be granted except to a registered medical

practitioner.Infantile Mortality in Dublin.

At a meeting of the Committee for the Prevention ofInfantile Mortality, held in the Mansion House, Dublin, onFeb. 21st, it was stated that the infantile mortality in Dublinwas 142 per 1000, which is the second highest rate in theUnited Kingdom. Mr. A. J. Horne, Master of the NationalLying-in Hospital, attributed this awful mortality to the

following chief causes : (1) bad housing, (2) drink traffic,and (3) influx from the country, with consequent overcrowdingand improper food.

The Commission on Medical Benefit.The Commission on Medical Benefit at its first sittings, to

be held next week in Belfast, will devote itself solely toinquiry as to whether the medical benefit should be extendedto Ireland or not. No conditions or matters of detail willbe considered. As a consequence only three medical wit-nesses are likely to be examined at this stage. Shouldthe committee decide this main question in the affirma-

tive, it will sit again at a later date to consider theterms on which the benefit should be extended. Re-sentment is felt by the medical profession in Belfastthat the Commission has refused at present to hear anyevidence from the medical witnesses appointed to putforward the views of the medical profession in that cityand also has declined to admit witnesses on behalf of theRoyal Victoria Hospital, Belfast. Further, only one medicalwitness is to be called to represent the whole of the north ofIreland. The situation will need very careful handling.

Payment for Medical Certificates under the NationalInsurance Act.

The Irish Insurance Commissioners held a conferencelast week with representatives of the leading ApprovedSocieties, at which, among other matters, the disposal ofthe .650,000 recently voted by Parliament to assist in

obtaining medical certificates came under discussion. Thesocieties naturally were anxious to have the spending of thismoney, but their demand was met by a definite refusal.The Commissioners laid it down as a principle that the ,

fund is to be administered by the Insurance Committees.This decision will meet with warm approval from themedical profession. The societies, however, are receivingin return a concession which seems to have beentacitly, rather than overtly, granted. They are to berelieved of the duty of finding any money to pay forevidence of sickness. Under the terms of the Act the

duty of paying for evidence of sickness was put on thesocieties, the expenses to be drawn from their administrationfunds. This sop to the societies need not concern themedical profession, were there any assurance that the.650,000 would be sufficient for the purpose. On this pointthere is reason for doubt. The Commissioners would bewiser to insist that if in any area the share of the .B50,OOOallotted to such area were found to be insufficient to pay formedical certificates, the deficiency should be borne in dueproportion by the societies concerned. In whatever schemethe Commissioners may adopt the demand of the professionthat the certificate must be signed by the medical man inattendance should be borne in mind.

The Proble?7is of Maternity Benefit in Ireland.

Maternity benefit in Ireland is leading to endless discussions

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in our lay press. Owing to the deliverance of the LocalGovernment Board, many boards of guardians are earning acheap popularity by suggesting that the dispensary doctorsmust, by the issue of a "red line," attend women at theirconfinements in order that all the maternity benefit be madeavailable to the mothers, forgetful of the fact that the firstcharge on the 30s. is the nurse or doctor. " Women of the

working classes in critical cases are neglected sadly,"said Mr. Lloyd George in the House of Commons, I some-times through carelessness, but oftener through poverty,and that is an injury, not only to the woman herself,but to the children born. We therefore propose thatthere should be a 30s. benefit in those cases, which wouldcover doctoring and the nursing, but only conditional uponthose who are women workers not returning to their workfor four weeks." The certificates required by some societiesbefore maternity benefit is paid are simply to show that themoney is being expended-as it was intended-in providingeither a nurse or doctor. If a certificate means simply toprove that a son or daughter has been born to a woman

qualified to receive maternity benefit, such a document canbe obtained when the child is being registered at a cost of3d. As is pointed out in an able letter to the lay Irish pressof Feb. 22nd by Dr. Samuel Agnew, medical officer ofhealth of Lurgan, the attempt in many parts of Ireland toprovide cheap charity at the expense -of the wretchedly paiddispensary doctors, which has been so manifest recently atthe meetings of boards of guardians, comes badly fromthose bodies which exact 4s. from all old-age pensioners inthe workhouse. If they are so anxious that the 30s.maternity benefit should be preserved intact to be spent onthe rest of the family, they should invite insured womenduring:the time of their confinements to come to the maternitywards in the workhouses, a line of policy which, however,would quickly bring down on them the wrath of the Insur-ance Commissioners and of the Local Government Board.Another question that is sure to give rise to keen discussion isthe relationship of maternity hospitals to the maternity benefit.It would appear that lying-in hospitals are to be paid by theApproved Societies a grant of 5s. for each patient confinedin the intern or out-patient departments who is entitled tomaternity benefit, a sum which is also to cover the necessarycertificate. Now this raises two difficulties : (1) Are outsidepanel doctors and midwives to be undercut in this way bythe maternity hospitals’! and (2) Will the voluntary sub-scribers to such charities not object that the receiving ofGovernment money in this way clearly indicates that theinstitutions are no longer charities ?

The Belfast Lister Memorial.A local committee was formed in Belfast on Feb. 19th,

with the Lord Mayor as treasurer, to collect moneyin aid of the national memorial to the late LordLister.Feb. 26th.

QUEEN CHARLOTTE’s HOSPITAL.—The annualmeeting of governors and subscribers of Queen Charlotte’sHospital was held on Tuesday last week. The chair wastaken by Mr. F. W. Hunt, Vice-president. The reportstated that during the past year 1880 patients had beenadmitted to the wards of the hospital. being the largestnumber ever received in one year. In addition 2367 patientshad been attended and nursed in their own homes. Thecommittee regretted that the income had been insufficient tomeet the expenditure by £1257, and as there had also been adeficiency of £1970 in the year 1911 there was now a totaldeficiency of £3227, to meet which arrangements for an over-draft at the bank had had to be made. A preliminary trainingschool had been opened in connexion with the midwiferytraining school. In moving the adoption of the report thechairman appealed for increased support to meet the out-standing liabilities and to provide a much needed new out-patient department. The annual meeting of the ladies’association of the hospital was subsequently held. Con-siderable progress had been made by the association, ofwhich there were now over 200 members. Valuable gifts oflinen had been made to the hospital. A bed (the Ladies’Association bed) was being supported by annual subscription,and a donation of .&200 had been made towards the proposednew out-patient department.

Obituary.SIR THOMAS FREDERICK CHAVASSE, KT.,J.P.,

M.D. EDIN., F. R. C. S. ENG. & EDIN.,CONSULTING SURGEON TO THE BIRMINGHAM GENERAL HOSPITAL.

Sir Thomas Frederick Chavasse died suddenly from pul-monary embolism on Feb. 17th at his residence, theLinthurst Hill, Barnt Green, Birmingham, at the age of 58.On Dec. 13th, 1912, he met with an accident in the

hunting field, breaking his thigh in four places, and

suffering considerably from the exposure before he could beconveyed home. Since then he had been confined to his

room, but was making good, if slow, progress. On the dayof his death he had been walking about his bedroom, andthere was every prospect of his ultimate recovery, when asudden change took place in the evening and he died in afew hours.Thomas Frederick Chavasse came of an old family and

one that has produced several worthy representatives ofthe medical profession. He was born in 1854, and was thesixth son of the late Mr. Thomas Chavasse, F.R.C.S., ofWylde Green House, Sutton Coldfield, Warwickshire. Hereceived his early education at the Queen’s College,Birmingham, and the General Hospital, proceeding thenceto Edinburgh University, where he graduated as M.B. andC.M. in 1876. In the same year he took the M.R.C.S.Eng.and the L.S.A.

After graduating at Edinburgh Chavasse went to Viennain September, 1876. There he worked hard at surgery,attending especially Billroth’s clinic, and doing much

operative work on the cadaver. At that time material wasabundant, and Chavasse took full advantage of it. He and afriend arranged to have a body delivered once a week at theanatomical rooms, and the two men practised syste-matically all the operations that were possible. Thenumber of British graduates in Vienna at that time wasconsiderable, and there was an English table in the Piedhof,at which the men used to meet twice a day. Amongstthose who were present during Chavasse’s stay were Dr.George A. Berry (of Edinburgh), Dr. Samuel West, Dr. (nowSir James) Reid, the late Dr. Andrew Duncan, Surgeon-MajorShepherd (soon afterwards killed at Isandula), and towards thelatter part Mr. C. H. Mansell Moullin and Dr. Story (of Dublin).After spending six profitable months in Vienna Chavassewent to Berlin, where he worked chiefly with Langenbeck,returning home at the end of the summer to become housesurgeon to Professor Spence in the old Edinburgh Infirmary.He had a great affection for his chief, admiring his greatclinical acumen and operative dexterity, but he was none theless a convinced disciple of Lister and a most regularattendant during his student days at the latter’s Sundayafternoon clinics. Amongst his fellow residents were Dr.George Gibson (who died only a few weeks ago), Dr. JamesMurray (of Inverness), and Dr. David Grant (of Melbourne).With all three his friendship was life-long.

In 1877 Chavasse qualified for the F.R.C.S. Edin., but hadto wait a year for the diploma, as he had not yet attained thestatutory age of 25. In the same year he was appointedassistant surgeon to the old General Hospital in Summer-lane, Birmingham. In 1878 he took his M.D. degree. The

F. R. C. S. Eng. , honoris causâ, was conferred on him in 1899.He was appointed full surgeon to the General Hospital in1881, and his active connexion with the hospital continuedfor 31 years, until he resigned in March, 1912, as senio,’

surgeon. He was then appointed to the consulting staff,and received from the board of management a cordialexpression of appreciation of his conspicuous services to thehospital. These services were not confined to the pro-fessional side, for he was a generous contributor to its funds,and endowed a bed at a cost of .61250 in memory of hisfather. His influence, moreover, was continually at work inall directions on behalf of the hospital, and among otherfruitful results had a great share in securing for it the

splendid donation of £25,000 from Miss Ryland, a relative ofhis wife, which rendered possible the construction of thepresent admirable institution. So recently as Jan. 30th of thisyear, as stated in THE LANCET of Feb. 8th, p. 416, a presenta-tion was made of a three-quarter length portrait by Mr. A. T.Nowell of Sir Thomas Chavasse, to be hung in the board