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said : " I must ask you to be careful and remember that youcome here as an expert witness. If a man falls as a resultof slipping upon a piece of banana skin, do you, as a medicalman, say that indicates a dangerous condition of thebrain? " To this inquiry the witness replied : " Taken inconnexion with the sprained thumb I think it would." Afterevidence from Professor R. Saundby, who, whilst refusing togo so far as the last witness, was of opinion that theaccidents should have been disclosed, the Lord Chief Justicein summing up said that a policy of insurance dependedupon absolute good faith upon both sides. What the juryhad to decide was whether the questions had been answered- correctly by the deceased. In considering whether the two-occurrences in question were accidents they should not paymuch attention to the fact that the deceased describedthem as such to the accident insurance company, since he- could not well have described them as anything else. If

they thought that the information as to the injured knee.and the sprained thumb was the sort of information thatthe questions submitted on the paper of application wereintended to elicit, then they must come to the conclusionthat they were incorrectly answered. The jury found that.all the questions were correctly answered.

Health of the City.The epidemic of diarrhoea which visits the city at this time

of year has put in its appearance with the hot weather andan abundant fruit-supply. In the week ending July 23rdthere were 27 deaths from diarrhoea, in the following week’76, and in the third week 98. This increased the death-rateto 23’ 3 per 1000. The zymotic death-rate rose in the sametime from 8.5 to 10.8.

The Sewage of Hanley.Dr. George Reid, medical officer of health of Stafford-

shire, has presented to the sanitary committee of his countycouncil a report on certain experiments in connexion withsewage which have been going on at Hanley for the past twoyears. Works were constructed for treating one-sixth of thedry-weather flow of the sewage of Hanley on biological lines,the object being to determine by experiments on a largescale whether septic tank treatment followed by singlefiltration would yield satisfactory results with the sewagein question, and whether the process could be conducted onthe site of the present outfall works, which is at no greatdistance from a populous part of the borough. For manyyears past, and at the present time, the method of disposalhas been by chemical precipitation followed by land treat-ment. The land available, however, is very ill suited for thepurpose and the area is altogether inadequate. It has’become clear that the idea of continuing land treatmentmust be given up if the present outfall is to be retained.Mr. Scott-Moncrieff designed a piece of apparatus for theadistribution of the tank effluent upon a circular filter, andMr. Wilcox designed a mechanical distributor which wasfixed in connexion with a rectangular filter. Both of thesepieces of apparatus have been at work during the whole timethat the experiments have been in progress. The area ofthe experimental filters amounts to half an acre, one quarterof an acre being given to each shape of filter. In both casesa depth of 4 feet 6 inches of filtering material was used.This material was broken " saggers." a waste material whichis to be had in any quantity in North Staffordshire. The- filters were divided into sections in each of which the

particles were of different sizes and the effluent pipes were- so fixed as to ’allow of samples being separately collectedfrom each section. This was done with a view of ascertain-

ing which size of particle was the best adapted for the pur-,pose. The filters have now been in operation for some 18months. A constant and regular flow of 200 gallons persuperficial yard was obtained from the circular filter. The,flow from the rectangular filter was not so large nor so con-stant. It varied from 130 to 200 gallons, the mean havingbeen 162 gallons. After tabulating the results of the

analyses of the sewage and of the effluents in respect of thevarious filters Dr. Reid proceeds to state that the conclusion-to be drawn from the figures is that in every case the degreeof purification which has been effected is excellent. The

:good quality of the work done exceeds that of any plant ofwhich he has had any experience, neither (lid he know ofany published records from similar works which wouldapproach those of Hanley as regarded the degree of purifica-tion effected. Treatment in the " septic " tank effected apurification of 64 per cent. and 62 per cent. in the organic.ammonia and oxygen absorbed respectively, whilst as

regards the filter effluents these percentages varied from94 per cent. and 91 per cent. in the case of the large grainsection of the circular filter to 97 per cent. and 94 per cent.in the case of the finest grain section, the last-named figuresbeing practically the same in the corresponding section ofboth filters. As regarded the degree of purification effected,the results were practically the same in corresponding sectionsof both filters. With reference to the routine working of thefilters, with the exception of a temporary water-logging ofthe large grain section of the circular filter (1 inches to

inch fragments), an occurrence which was corrected bya short period of rest, no trouble was experienced. In con-

clusion, Dr. Reid states that the working of the preliminaryplant has exceeded his highest expectations, and he is of

opinion that the Hanley corporation might with confidenceproceed to lay down, on similar lines, a plant of suffi-cient capacity to deal with the whole of the sewage of theborough.August 23rd.

LIVERPOOL.

(FROM OUR OWN CORRESPONDENT.)

The Prevalence of Diarrhcca and its Causes; Disc2cssion at theHealth Committee; High Rate of Mortality.

AT the meeting of the health committee held on

August 18th attention was drawn to the prevalence ofdiarrhoea and the high death-rate of the city for the past twoweeks, which had reached 37 - 7 per 1000. Dr. E. W. Hopepointed out that, in regard to the causes of diarrhoea, itoccurred at a certain season-namely, the season of decay,when food became rapidly putrescent. In turn in everytown in the civilised world there was at that season

an enormous destruction of infant life, but it was almost

entirely confined to those whose mothers, from one cause oranother, did not suckle the infants. Dr. Hope said that thereturns from Birmingham, Aston, York, and other placesalso showed a high rate of mortality but the causes did notoperate in every town at the same time. Many circum-stances did not coincide to make the rate uniform everyweek. Unfortunately, for two weeks Liverpool had been atthe top but other places followed closely with 36. 35, 32,&c., per 1000. The high death-rate had happened only fortwo weeks in Liverpool and he thought it was an encouragingthing that such a rate was sc rare that it was seized uponnow and made the subject of a great deal of conjecture. Hewas sorry to see a somewhat wrong impression created.The rate last year and right up to July of this

year was about 19 per 1000, taking the whole period.They knew that they could not go on with such a lowrate. The birth-rate in Liverpool was much higher than inthe majority of places and thus they had a much largerinfant and susceptible population. The high death-ratewould probably continue for a week or two, possibly to theend of September. There was no royal or magic road tostop the disease. The proper course was to adopt Nature’smethods ; if her methods were set aside she would have her

revenge. The supplying of sterilised milk, which had beencopied from France, had given most promising results. Nextto mother’s milk it was the best food for infants, but thedifficulty was that as there were thousands of mothers whocould not suckle their children so there were thousands whowould not give them sterilised milk. As regards the preva-lence of scarlet fever and typhoid fever Liverpool occupieda relatively satisfactory position.

Beri-beri in Liverpool.A Norwegian barque, the Sunniva, arrived in the Mersey

on the morning of August 18th, from Cuba, with five cases ofberi-beri on board. The patients are Norwegians. Thesanitary authorities, taking the matter in hand, had fourof the men placed in the tropical diseases ward of the RoyalSouthern Hospital, which possesses an admirable equipmentfor observing and dealing with such cases. Two of the menare suffering severely from the disease. Leaving Algoa Bayas early as March the vessel, with the sufferers on board,reached Santa Cruz, Cuba, in May. Thence they set out forthe Mersey, which was reached, as stated, on August 18th.

Lancashire County Council; Registration of Midwives;University Grants.

The midwives committee of the Lancashire county councilreported that certificates had now been granted to 457

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midwives out of 524 who had applied. It was recommendedthat as the regulations were very stringent and so manyof the women were illiterate a trained obstetric nurse shouldbe appointed as inspector of midwives at a salary of £104a year. The council has increased its grant of f.500 to theUniversity of Liverpool to £1000.August 23rd. __________________

IRELAND.(FROM OUR OWN CORRESPONDENTS.)

National Yeterinary Association.THE members of the National Veterinary Association

opened their annual conference on August 15th in thelecture theatre of the Royal Dublin Society, where they werereceived by Mr. C. Uniacke Townshend, Vice-President, whowelcomed them on behalf of the Royal Dublin Society. ThePresident of the association, Mr. Clarke Allen, delivered aninteresting address in which he alluded to the fact that sincethey last met in Dublin four years ago Professor Koch hadstartled the world by stating that tuberculosis of thelower animals was not the same as tuberculosis in manand that the one could not be transmitted to the other.The interim report of the commission which was appointedto investigate the question and of which a very distinguishedVice-President of their association, Professor D. J. Cun-ningham, was a member, did not support the view of the great German scientist. The members of the veterinary ’,profession had good reason to doubt its truth and wereaware of the loss of valued colleagues from tuberculosiswith which they were accidentally inoculated while makingpost-mortem examinations.

Infantile Mortality in Dublin.At the meeting of the public health committee held on

August 16th the death-rate for the previous week wasreported to be 28 1 per 1000 and of this large mortality noless than five deaths in every thousand were due to diarrhoea.Sir Charles Cameron said that he was issuing a circularsetting out what precautions should be taken to reducethe mortality from this cause. Professor Antony Rocheaddressed a letter to the papers on August 18th inwhich he described the method adopted by the Liverpoolsanitary authorities in connexion with the matter.

Depots were established throughout that city where parentscould obtain pure milk for infants supplied in small separatebottles. As appeared in the last report of the Liverpoolmedical officer of health, this had the effect of diminishingthe infantile death-rate from diarrhoea. The council of theDublin Sanitary Association met on August 18th and calledattention to the fact that diarrhoeal diseases had causeddeaths in this city during the previous four weeks numberingsix, five, 15, and 33 respectively, and mentioned the well-established fact that when the subsoil temperature at adepth of four feet below the surface reaches 56° F. diarrhoeicaffections become prevalent each summer.

Small-pox in Dublin.No new cases of small-pox have been reported in Dublin

and the three patients in the isolatien hospital are conva-lescent. All the members of the Royal Irish Constabularystationed at the Dublin depot who have not been vaccinatedwithin the last two years are now having that operationperformed by order of the authorities.

The Belfast Board of Guardians.The proceedings at the last meeting of the Belfast board

of guardians tend to bring popular representative govern-ment into contempt, the lively discussion," "generalwrangling," "disorder," "interruptions," "uproarious sceneof excitement," "uproar," and "low personal remarks," as

reported in the daily papers of August 17th, being a disgraceto any body of individuals who are supposed to have charge ofthe poor. The whole farcical proceedings centred round thequestion of a proposed consumptive sanatorium, and it mustbe admitted that a letter from the Local Government Boardin Dublin had the effect of making matters ridiculous at theoutset of the meeting. As already reported in THE LANCET,two inspectors of the Local Government Board held a publicinquiry some considerable time ago (in December, 1903) inreference to the suitability of a place known as the Abbey,in the neighbourhood of Belfast, which the guardians wishedto acquire as a consumptive sanatorium. These in-

spectors have already reported and now the Local Govern-ment Board writes, after all the correspondence and the

inquiry, that if the guardians are prepared, after full con-sideration, to place a definite scheme before it and ifthey are satisfied that the Abbey is the most suitable sitefor their purposes, the Board will be ready to give itsdecision on learning fully the guardians’ views. Evidentlythe Local Government Board is unable to make up its mindon the question and wanted to know if the guardians werein the same state, and the discussion which ensued showedthat the guardians are so divided in their views. The-matter was finally referred to the infirmary committee.While an immense deal of public time was beingwasted in unseemly discussion matters requiring serious-attention were being neglected. As an example, a reportfrom the works committee revealed a serious state ofaffairs in the children’s infirmary, for Miss Ward, the

lady superintendent, reported that " the patients in thechildren’s infirmary are infested with vermin, and owing to.the walls and woodwork it is impossible to keep the beds freefrom these pests. The beds in use are old and so constructedthat insects get into crevices at the joints." The membersof the works committee not only confirm these statements-but say that during their inspection of this departmentthey observed a loose board on the ground floor and on,

lifting it there was some sewage matter lying beneath it.When it is considered that this is the state of an institution,over which the guardians who wrangle at length on personalmatters are the responsible authorities it is little wonder-that some people think that the Local Government Boardshould dissolve the Belfast board of guardians and appointtwo or three paid officials to manage the workhouse.

Small-pox in the North, of Ireland.It is to be regretted that small-pox continues to spread,

throughout Ulster. At Monaghan attention was drawn at ameeting of the guardians on August 22nd to the part played’by the professional tramp in spreading the disease, especiallythose coming from places like Armagh and Clones, where theepidemic is prevailing. If tramps were dealt with as the" work-shys " are treated in Switzerland the nuisance whichis present all over Ireland would gradually cease. In Switzer-land able-bodied vagrants are arrested and sent to a home ofcorrection where they are forced to labour or to a farm wherethey must keep pace with the voluntary worker. There are 21cases of small-pox in Armagh where there is not adequateaccommodation in the view of the Local Government Board,which recommends that instead of cases being treated in thefever hospital (which is close to the infirmary) an additionalshed should be erected to accommodate, say, 30 patients.The fever hospital should be cleared of the small-pox casesand thoroughly disinfected and reserved for other forms offever. At present the enteric fever cases are being treatedin the infirmary wards reserved for consumptives and thereis no accommodation for the " contacts." The Newryguardians on Sept. 3rd are to consider how they will

arrange to accommodate small-pox cases should the diseaseappear in their area. Enniskillen and Omagh are also.

making preparations.Increase of Dispensary Medical Officers’ Salaries.

The Banbridge board of guardians at its meeting onAugust 22nd decided to increase the salary of Dr. W. J.Cowden of Dromore from S80 to .6110 per annum and thatof Dr. J. Taylor of Tanderagee from £100 to £120 perannum. Dr. Cowden has had a service of five and Dr.

Taylor of 25 years.The Belfast Maternity Hospital.

The new Belfast Maternity Hospital, which will be of so.

much value to the medical school, is to be opened in.November by the Countess Grosvenor, wife of the ChiefSecretary for Ireland.

I August 23rd.

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PARIS.(FROM OUR OWN CORESPONDENT.)

The Nen Nursing School.THE first school for sick nurses, which is open to all

classes, has just been opened in Paris. The scheme wasinitiated by Madame Allegret, the head of the lycée for

girls at Versailles, and Madame Alphen-Salvador. Theschool includes a hospital of 30 beds and as many privaterooms. In consideration of a fee of 800 francs perannuor,payable quarterly in advance and guaranteed by the relatives