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being only able to accommodate an insignificant pro-portion of the infant population in the immediate district inwhich they are situated, they have done, and are still accom-plishing, a valuable work. The advantages offered are

readily sought and evidence is not wanting to show thatthere would be a real demand for such provision if made inthe most congested and poorest quarters of the city whereoftener than elsewhere women are the bread-winners. The

subject was referred to by the medical officer of health in a

special report last year, but without his making any recom-mendation. It has also been brought before the healthcommittee, but no action has as yet been taken. In view ofthe infantile mortality and the decreasing birth-rate many inBirmingham think that some such provision should be made,but the general feeling is that it should emanate from aprivate rather than a public source. The question may, inthe near future, reach a more acute stage in Coventry thanin Birmingham, for the Coventry city council has con-

firmed the recommendation of the sanitary committee thatthe education committee, in view of the extensive prevalenceof infectious disease in infants’ schools during the last fewyears and on the grounds of the general health of children,should be urged to do its utmost to discourage the attendanceof children under the age of five years at its schools.

The Royal Commission on the Care and Control of theFeeble-niinded.

At the last meeting of the Stoke-on-Trent board ofguardians a letter was received from the Local GovernmentBoard stating that the Royal Commission on the Care andControl of the Feeble-minded had appointed two medical mento make an inquiry respecting the number of the mentallydefective in the union of Stoke and in several unions ofSomersetshire. Dr. W. A. Potts of Birmingham will makethe inquiry in the Stoke-on-Trent union. The inmates ofthe Poor-law institutions, workhouses, infirmaries, casualwards, and schools will be examined with a view of notingand classifying the mentally defective therein. Inquirieswill also be made from medical officers and relieving officersas to the same classes comprised among those receivingout-relief.

The Health of Worcester.The medical officer of health of Worcester in his report

upon the second quarter of the year records that the birth-rate of 24’ 22 per 1000 of the population was 3 3 per 1000below the average rate of the ten preceding second quarters,while the death-rate of 13’ 85 was 4’ 21 per 1000 less thanthe average of the ten preceding quarters. The deaths ofinfants under one year numbered 51, which had only beenonce exceeded during the ten preceding second quarters andwas ten in excess of the average number. The infantiledeath-rate per 1000 births was 4’ 5 above the average.

Sept. 5th. __________________

LIVERPOOL.(FROM OUR OWN CORRESPONDENT.)

-Report of the Medical OJficer of Health for the Year 1904 : :Health of Liverpool.

THE area of the city comprises 14,909 acres, or a littlemore than 23 square miles, with an estimated population of723,430. The birth-rate continues high-namely, 33’5 5 per1000 of the population. A diagram in the report shows howthe birth-rate of Liverpool has exceeded that of England andWales during the last 40 years. The death-rate of the cityfor the year was 21’ 9 per 1000 of the population, being 2’ 1per 1000 higher than that of the preceding year. Theincrease in the death-rate was entirely owing to the increasein deaths of infants and children below five years of

age, the deaths at other age-periods having been belowthe average. The year 1904 was characterised by an ex-cessive mortality from infantile diarrhoea during themonths of July, August, and September, the temperaturebeing very high in July and the rainfall lower than the

average during that and the preceding month. The deathsof over 1500 infants during July, August, and Septemberwere registered as being due to choleraic diarrhoea andallied causes. Great attention has been given to the milkdepots. The members of the medical staff of the Children’sInfirmary and other medical men of the city have madeuse of the depots as a means of lessening sickness amongstinfants requiring their attention. The more dangerous forms

of zymotic disease have shown a decrease. Representativesof the health committee were invited by the London CountyCouncil to attend a conference upon the subject of thespread of small-pox by vagrants and the preventive orremedial measures to be adopted. Alderman Roberts andthe medical officer of health (Dr. E. W. Hope) attended theconference on behalf of the committee on Nov. 10th, 1904.The conference, which was somewhat prolonged, resulted inresolutions being passed as to the detention, cleansing, andvaccination of tramps. Ultimately these matters were re-ferred to a subcommittee, upon which Alderman Roberts wasselected to represent the city of Liverpool. Typhus feverhas continued to appear from time to time, although to arelatively trifling extent as compared with its prevalence informer years. With regard to tuberculosis some interestingtables will be found in the report illustrating the remarkabledecline in pulmonary tuberculosis owing to the sanitarymeasures adopted during the last 20 years. The voluntarynotification of pulmonary tuberculosis by the medicalattendant originated in 1901 has been persevered with and thehelp of the sanitary authority has thus been available inthose forms of the disease in which it can be of use.

Instructions for the guidance of tuberculous persons areissued through proper channels. Owing to the prevalenceof infectious sickness of various kinds amongst the pupilsit was found necessary from time to time duringthe year to close a considerable number of schools.The greatest sufferers were those attending the infants’schools and the babies’ classes. It is not in the interestsof health for very young children to be sent to school. Onthe contrary, there is every reason to believe that injury

. results from the proceeding. A large number of schoolswere examined under the terms of the resolution of the

: education committee, which occupied a considerable amountof the time of the staff. Reference is also made to theworking of the Midwives Act. The health committeeapproved of an application being made to Parliament

: for additional powers in regard to certain important’ sanitary measures, notably to facilitate dealing withnuisances and conditions injurious to health arisingfrom noises made by animals in confinement ; to preventthe continued occupation of cellar dwellings; for checking

j the spread of ringworm and for the sanitation of hairdressing’ saloons ; for dealing more effectively with stables; for the) better lighting, ventilation, and cleanliness of restaurants and places where food is prepared for consumption; for1 improved sanitary conveniences in lock-up shops ; and forE checking nuisance arising from smoke from steamers on the1 river, hitherto not under control. From time to time con-1 siderable anxiety was occasioned by the difficulties in the way of dealing adequately in the interests of the public

health with certain parts of the area of the Rivingtonwatershed. The section of the watershed knownas the Lever Park threatens to be a source ofdanger to the community of Liverpool and will requirecareful consideration to insure the protection of the eom-munity from conditions which in almost innumerable in-stances have been proved to be the source of dangerousoutbreaks of typhoid fever. The President of the LocalGovernment Board received a deputation on May 13th, !1904. on the subject of a quinquennial census. Dr. R. l

Caton and Dr. Hope represented the health committee of .

E Liverpool upon the deputation. The deputation, which was ,r a very large one, represented generally the sanitary interests

I’r of the country and was unanimous in urging upon the1 President the necessity for a quinquennial census. Fromthe 111er report of the medical officer of health for the week endingl August 26th, 1905, it is gratifying to know that Liverpool is , steadily improving in its health conditions. During the I

week only 280 deaths were registered, showing a decrease of ff 130 on the corresponding week of last year, and representing.r a death-rate of 19’ 9 per 1000 of the population. The number- of births during the same period was 497, being equivalents to a rate of 35’3 per 1000. Only 233 cases of zymotic disease were reported and the deaths therefrom numbered 97, as compared with 209 from the same cause last year.;

r s

I New Department at the David Lewis Northern ]Hospital.1 A new department for orthopaedic gymnastics andr massage " has been created at the David Lewis Northern s Hospital, to which Dr. W. H. Broad (who is devoting him- 3 self specially to the practice of massage after a course oft instruction in Sweden) has been appointed surgeon in charge.s Through the generosity of Mr. Levy, one of the David Lewis

797

trustees, a room has been fitted up at the hospital containingseveral " exercise machines."

Conferenoe of Lccneasltire and ot7ter Unions.A conference of representatives of Lancashire, Westmor-

land, Cumberland, and Cheshire Poor-law unions was heldon Sept. 1st in the town hall, Lancaster, under the presi-dency of Sir John T. Hibbert who quoted statistics showingthe increase of vagrancy in the North-western Poor-lawdistrict. The meeting favoured the establishment of farmand labour colonies for the accommodation of tramps and acommittee to be appointed from the different boards of

guardians to further such a scheme was approved of.The Spread of Asiatic Cholera.

The customary strict precautions taken by the portsanitary authorities of Liverpool are never relaxed and areefficient for dealing with any situation which might arise.The flow of cases of cholera is from east to west and in theopinion of Dr. Hope, the medical officer of health, the firstpoint of difficulty in England will be Hull.

Beri-beri in Liverpool.The German steamer which arrived in the Mersey

on Sept. 2nd, had on board five Chinese sailors who were saidto be suffering from beri-beri. All were removed to thetropical diseases ward of the Royal Southern Hospital.

Sept. 5th. _________________

NORTHERN COUNTIES NOTES.

(FROM OUR OWN CORRESPONDENT.)

Nerccastle-?ipOn-Tyne: Opening of New Nurses’ Ho-rne.THE first stage in the opening of the new infirmary

at Newcastle took place when the new nurses’ home wasrecently started. It is now many years since the old

infirmary ceased to be able to house its nurses and the

majority of them have been sleeping out in the old nursinghome, but even this accommodation was insufficient andsome had to be lodged in the hostel of the Young Women’sChristian Association. The new home has accommodationfor 104 nurses, but at present it is only partially occupied, thesisters still retaining their rooms in the old building. In thenew home each nurse has a bedroom to herself and these arevery tastefully and substantially equipped. The sitting anddining rooms are on the ground floor ; they are large,light, airy, and properly furnished. The new infirmary isconnected to the home by a covered way, the entrance to thelatter being through a large conservatory which will form avery useful addition to the recreation room. Throughoutthe building the electric light is fitted and a lift connectsthe various floors in addition to the staircases. Already theplace has lost its dreary aspect, for apart from its

being inhabited the shrubs and planted borders roundabout are looking quite smart. The nurses themselves are

thoroughly satisfied with their new quarters thoughat present it means that they have a walk of about20 minutes night and morning through a not very salu-brious part of the town, for the home is about three-quarters of a mile from the old infirmary. They haveto make an early start, as breakfast is ready at 6.15 A.M.and they must be on duty by 7. In the evening theyreach the home about 9.30 and the lights have to beout by 10.30. Sir Riley Lord, the chairman of the buildingcommittee, presided at the opening and was supported,among others, by the Mayor of Newcastle (AldermanJ. Baxter Ellis), the Sherift of Newcastle, Lord Arm-

strong, Sir George Hare Philipson, Dr. D. Drummond, andDr. G. H. Hume. The chairman, on behalf of the buildingcommittee, officially handed over the home to LordArmstrong who, as chairman of the management com-mittee, represented that body. At the close of the pro-ceedings the Mayor gave a donation of £5 towards furnishingthe nurses’ library.Sunderland Infirnaccry Appointment of Honorary Phy-

sician; Annual Report.By the death of Dr. James Murphy two vacancies were

virtually caused in the staff of the infirmary, for Dr.William Robinson, who was appointed to the vacancy in thesurgical side, was himself one of the honorary physicians.There were four candidates for the vacancy on the medicalside-Dr. G. B. Morgan, jun., Mr. A. Ayre Smith, Dr.

H. K. Wallace, and Dr. J. Chalmers. The first votewas as follows : Dr. Morgan, 17; Dr. Chalmers, 12 ; Dr.Wallace, 3; and Mr. Smith, 2. Another vote resultedas follows: Dr. Morgan, 18; and Dr. Chalmos, 16. Dr.Morgan was therefore elected. The lllth report of theSunderland Infirmary shows that a total number of 11,333patients were treated at the hospital during 1904, an increaseof 606 over those treated in 1903. Of this number 3172were in-patients and 8161 out-patients. The averagestay in hospital was 21 days and the cost per headwas £ 18s., while the cost per bed occupied worksout at E49 14s. lld. The ordinary income, thoughincreased to .610,623, as compared with £ 10.2’19 for theprevious year, does not quite reach the total expenditure.Funds are not yet forthcoming for the provision of a

children’s hospital in connexion with the infirmary, thoughseveral substantial donations have been received. Itseems a great pity that a hospital in which so much workis done does not give more details of its labours, for there isnot one word in the report as to the nature of the medicalwork done nor is there any information that would beinteresting to the student of vital statistics.

Central Mid7vives Board Newcastle Centre.At the recent examination held in the Lying-in Hospital

at Newcastle-upon-Tyne there were nine candidates ofwhom two were unsuccessful. The training of the candi-dates is carried on at the Lying-in Hospital where thenurses attend personally 20 cases, mostly, of course, in theextern charity. Last year there were 800 cases attended andthis number is yearly increasing, for there is no other similarcharity in the neighbourhood.Sept.5th.

________________

SCOTLAND.(FROM OUR OWN CORRESPONDENT.)

Infants’ Milk -Dep6t in Glasgow.A DEPOT for the preparation of milk suitable for infants

was opened in Glasgow in June, 1904. It has been in opera-tion for a year and a report on the work done during thefirst six months is now published. The milk is getting intothe hands of that section of the people whom it is desiredto reach and now the dairymen in various localities in con-sequence of the demand are applying for the speciallyprepared milk in greater measure than the institution isable to supply it. These dairymen are all anxious to be-come distributors. The charges for a supply of this milkare payable in advance and the terms are for infants underthree months 2d. per day, under six months 21/2d per day(six-ounce bottles), and over six months 3d. per day (seven-ounce bottles). The central depot is open from 11 A.M. to6 P.M. on week days and a two days’ supply of milk is givenout on Saturdays. The milk is supplied in bottles in a basket,each bottle containing sufficient milk for one meal, theamount varying with the age of the child. Infants undertwo months of age receive nine bottles per day, whileolder children receive fewer bottles as they are fed less

frequently. Breakages are charged at the rate of ld. perbottle and damages to the baskets must be made good.Every person using the milk is supplied with a teat andmothers are warned that on no account must a bottle be

opened until the infant is ready to be fed. It is impressedupon the parents that the milk must never be used in

preference to that of a healthy mother, which is thebest of all foods for young infants. A leaflet isalso issued to the purchasers bearing instructions as tothe hours of feeding, the heating of the milk, and the

cleansing of the bottles after use. During the first sixmonths 314 cases were entered at the depot, and of these atthe end of that period 176 remained on the register. Ofthose who did not continue taking the milk 44 children leftwithin a week’s time, 11 within two weeks, 14 within fourweeks, 18 continued till the third month, 11 to the fourthmonth, and five over four months. It is satisfactory to notethat a large majority of the children are in the early months,84 of the total being under a month at entry, and 54 beingunder two months. As was to be expected, the largest pro-portion of the children is drawn from the districts in theimmediate neighbourhood of the depot, but with the in-crease in number of the distributing dairies those living at agreater distance should have no difficulty in obtaining a