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renewing my acquaintance with the County Lunatic Asylumof Milan at Monbello. There were 857 admissions duringlast year and the number of patients remaining on

Jan. lst, 1906, was 1883, the two sexes being almost

equally divided. The total number of pellagrous ad-missions during last year is entered in the report as 62,but that cannot in any way represent the number of lunatic3who are pellagrous, for in every courtyard I found at least adozen pellagrous lunatics. The deaths from pellagra duringthe year were 13 men and 22 women. At this spring time otthe year the erythema can be very well seen on the exposedparts of the body. This asylum is now under the directionof Dr. G. B. Verga, the nephew of a professor whose nameis well known in pellagra literature, and he is aided by tenassistants, one of whom, Dr. Rossi, is doing some excellentmicroscopic work.

BIRMINGHAM.(FROM OUR OWN CORRESPONDENT.)

The New Pathological Department of the University.ALTHOUGH a certain number of details have yet to be

dealt with the new pathological department is practicallycomplete and work has commenced in it. The new depart-ment may be entered either through the old pathologicaldepartment, which is still retained for histological classes,or by a special entrance in the new buildings. In the base-ment are the animal rooms, the operating room, the mor-tuary, a centrifuge room, and a projection room andassociated dark room. On the ground floor, to theleft of the main entrance, is the assistants’ room,and to the right is the private room of the specialdemonstrator for public health work. At the back on thisfloor is a beautifully lighted and splendidly fitted bacterio-logical class-room from which there is access to the histo-

logical laboratory. In addition there is a room which will bedevoted chiefly to kymographic work. On the second floorare the private rooms of the professor and the demonstrator,a large clinical room, and a balance room. On the thirdfloor are a laboratory reserved for the private use of themedical officer of health and a large research laboratory. Inaddition to the main rooms there are a number of smallerrooms for special research work, all admirably designed andfitted, well lighted, and well ventilated. The department isan important addition to the resources of the University andthe city and it provides unsurpassed facilities both forteaching and for research.

Playgrounds for City Children.It is well known that the healthiness of town districts

depends very much upon the plentifulness and freedom oftheir air-supply. Apparently the conditions in Birminghamas regards air-supply and open spaces are very unsatisfactory,for Dr. J. Robertson, our medical officer of health, who hasbeen making investigations upon the subject, points out thatwhen public parks and other open spaces are taken intoaccount Birmingham is in a worse position than other manu-facturing towns of this country. Taking eight of the largestmanufacturing towns-Newcastle, Bradford, Bristol, Man-chester, Nottingham, Liverpool, Sheffield, and Birmingham-the number of people per acre of park and open spaceincreases from 206 in the case of Newcastle to 1026 in

Birmingham. Birmingham is unfortunate also in the factthat the areas to the south, north, and north-west of thecity are built upon and densely populated, and the air

coming to us from them is therefore more or lessdeteriorated as contrasted with that which reaches some ofthe more favourably situated cities. Moreover, we have nolarge river passing through our midst to sweep in fresh airwith the flow of its stream. Dr. Robertson finds that inmany of our central districts the only places in which thechildren can play are inclosed and in some cases unwhole-some courtyards and it is not possible for the childrento get to satisfactory open spaces where there are treesand shrubs. It is, of course, impossible, on account of

expense, to provide parks in these central districts but itis occasionally possible to acquire small areas which can beopened up and transformed into wholesome playgroundswhich will serve also to increase the air-supply of the

surrounding buildings. Opportunities of this kind, however,are allowed to slip by because it is no one’s duty to takeadvantage of them and to obviate this it is proposed to form

a committee to promote the formation of an association themembers of which will unite in an attempt to provide thecentral districts with as many open playing spaces as

possible. Besides the medical officer of health, CouncillorNettlefold, Professor Muirhead, Professor Ashley, andMr. Kirkaldy are taking a prominent part in the move-ment. It is to be hoped in the interests of the city’s healththat a powerful association will be formed and that theobject desired will be attained.

The Health of the City.During the last three weeks the death-rate of the city has

fallen steadily from 21’ 4 per 1000 to 16 - 9 per 1000. Deathsfrom most of the zymotic diseases have decreased, but for abrief period there was a decided rise in the notificationsof scarlet fever. This, however, was merely a passingfluctuation from which there was a prompt recoil and therei3 obviously no reason to fear an epidemic.

Canal-boat Life.In THE LANCET of April 7th I drew attention to the

difficulty which Dr. J. D. McCrindle (assistant medical officerof health) had experienced in getting information regardingthe deaths of children born on canal boats. A lurid

side-light has been thrown on this matter during a recentinvestigation in the Wolverhampton coroner’s court intcthe cause of death of a child three weeks old. Themother stated that the child was prematurely born andthat she had had 15 children, nine of whom had diedin infancy. She added that she worked on the boat towithin a short period of each birth. It was assertedat the same inquiry that two cases were known in oneof which only one child out of 14 survived and in theother all the eight children born died in infancy. Thecoroner commented strongly on the matter and expressed thehope that some action would be taken to prevent womenworking at such critical periods of life.May 15th.

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LIVERPOOL.’ (FROM OUR OWN CORRESPONDENT.)

Liverpool School of Tropical Medicine.THE King of the Belgians has sent to Sir Alfred Jones,

the chairman of the School of Tropical Medicine, a letterintimating a contribution of R2600 to the funds of the school.This sum is in addition to the large amount which KingLeopold has already contributed to the school. Sir AlfredJones has also received a letter in the following termsfrom the Secretary-General of the Congo Free State inBrussels : "Referring to our recent conversation, I begto confirm to you that the Government of the CongoFree State has resolved to bear the expense whichwas occasioned by the visit of the members of the

Liverpool School of Tropical Medicine during their sojournin the Congo. These expenses, which include in a generalway the maintenance of the expedition, the salaries of theattendants, and transport expenses, amount to 1421.The Government desires by this decision to show its

sympathy with the philanthropic work undertaken by theSchool of Tropical Medicine and with the spirit in which itsmembers acquitted themselves in their mission to the

Congo." Dr. Jacques of Brussels has been deputed by theKing of the Belgians to attend the course of instruction underthe auspices of the Liverpool School of Tropical Medicine.Joint Matriculation Board of the Universities of Liverpool,

Manchester, Leeds, and Sheffield.The arrangement whereby the matriculation examination

can be held in July at a school as a form examination underthe ordinary regulations requiring candidates to offer five

subjects and not allowing them to offer more has beenextended to meet the case of schools in which the curriculumdemands six subjects. In such a case a form will be allowedto take six subjects provided that either Latin or Greek isincluded among them. In order to obtain a matriculationcertificate a candidate must satisfy the examiners in the twoobligatory subjects and in three of the optional subjects, oneof the three subjects being a language.

The High &bgr;eath-1’ate of L-iverrpool.At the weekly meeting of the health committee of the

city council held on May 10th the chairman referred to thehigh death-rate, which during the past week was 27 per 1000,

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and said he thought that it was only right that somethingshould be done to diminish it. The chief causes of theincreased rate were old age, the weather, the epidemic ofmeasles, and infantile mortality. He suggested that themedical officer of health (Dr. E. W. Hope) should prepare acomparative statement of the death-rates in the differentdistricts and submit it to the committee which could thenconsider the steps to be taken in those districts where thehighest death-rate occurred. Crewe appears to be in a muchmore fortunate condition than Liverpool, as in the formertown the death-rate during the month of April reached theremarkably low figure of 8 per 1000, establishing a record inits history. The medical officer of health (Dr. A. J. Laird)in his weekly report states that this happy result is due to thecomparative freedom from infectious disease among childrenand to the low infantile mortality.

Cheshire New Nursing Associatiún.A large and influential meeting, convened by the Duke of

Westminster, was held on May 5th in the council chamber ofChester town hall to consider the advisability of forming acounty nursing association for Cheshire. The Duke of West-minster presided and the attendance included the Earl ofCrewe, the Bishop of Chester, Lord and Lady Stanley ofAlderley, Sir John Brunner, Bart., M.P., and others. Theassociation maintains a nurse who visits the districts,reports to the local committees, and gives help and advicewhen required. It also keeps a reserve of two or three nursesavailable as substitutes. The Duke of Westminster explainedthat some time ago it was suggested to him that it would bedesirable to convene a meeting of those interested in thecounty for the purpose of starting a county nursing associa-tion. There were many local nurses employed in Cheshire,but the local committees acted independently and it was withthe idea of bringing those local committees together thatthey hoped to justify the existence of a county nursing asso-ciation. Influential support had already been promised buthe would like to lay stress upon the fact that that was not ascheme which should merely be supported by influential peoplebut that it should be maintained by the help of the wholecounty. Miss Hughes, general superintendent of the Queen’sInstitute, gave an interesting address on the work of thecounty associations, pointing out their great advantages.The Earl of Crewe moved :-That a county nursing association for the county of Chester be

formed, this meeting fully recognising the advantage of forming suchan association.

He said that scientific nursing had only really moved duringthe last 50 years and it had always been associated with thename of Miss Florence Nightingale. He alluded to theadmirable work done by the Queen’s Jubilee nurses. The

Bishop of Chester seconded the motion which was unani-

mously carried. The Duke of Westminster was electedpresident, and the list of vice-presidents included theDuchess of Westminster, Katherine, Duchess of Westminster,the Earl and Countess of Crewe, the Earl and Countess ofStamford, the Bishop of Chester, Lord and Lady Newton,Lady Stanley of Alderley, Mrs. Henry Gladstone, Sir JohnBrunner, and others.May 15th.

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WALES AND WESTERN COUNTIES NOTES.(FROM OUR OWN CORRESPONDENTS.)

Bristol Lunatic Asylum.THE visiting committee of the Bristol Lunatic Asylum at

Fishponds in its forty-ninth annual report, which hasjust been issued, states that on Dec. 31st, 1905, the numberof inmates in the institution was 944 (418 males and 526females). The highest number in residence at any periodduring the year was 957. Plans providing for furtheraccommodation for 59 male patients have obtained the

approval of the Commissioners in Lunacy and the work willshortly be commenced. The committee adds that it hasreduced the weekly charge of maintenance, from 11s. to10s. 6d., and in conclusion records its appreciation of theway in which the duties connected with the institution havebeen performed by the medical superintendent (Dr. J. V.Blachford) and staff.The Somerset Edt({Jation Committee and Medical Ce’l’tificates.At a meeting of the Somerset education committee held

at Bridgwater on May 8th the school attendance committee

reported that as the medical practitioners of the Tauntonrural district did not approve of the county committee’s scaleof fees they refused to grant medical certificates in cases ofabsence from school through alleged illness and the districtsub-committee had accordingly been instructed not to askfor medical certificates.

Vaccination at Stonehouse.At a meeting of the Stonehouse board of guardians held

on May 10th a discussion took place concerning the cost ofvaccination. It was stated that the vaccination fees for thepast quarter were <M8, compared with L24 for the corre-sponding quarter of 1905. The clerk said that the increaseof expenditure was due to the present small-pox scare.

District Nurses for the Poor at Plymottth.A scheme has been initiated by Countess Fortescue, wife

of the Lord-Lieutenant of Devon, and the Earl of MountEdgcumbe with a view to provide nurses for the poor ofthe Three Towns " and eventually to establish a traininghome similar to the institution at Plaistow. An influentialcommittee has been appointed and L250 have been alreadypromised. It is intended to affiliate the branch with theDevon County Nursing Association and with the QueenVictoria’s Jubilee Institute for Nurses. At an early datea public announcement will be made of the scheme with anappeal for financial help.May 14th.

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SCOTLAND.(FROM OUR OWN CORRESPONDENTS.)

Scottish Poor-law Medical Officers.LAST week a deputation waited upon the Secretary for

Scotland with reference to the position of the Poor-lawmedical officers in Scotland. Mr. W. L. Muir of Glasgow,the secretary of the Scottish Poor-law Medical Officers’Association, stated the case for the deputation and drewattention to several grievances which they wished to seeremedied by legislation. First, they desired to have an appli-cation to the Local Government Board in cases of unjust dis-missal by the parish council, there being, as they contended,many cases in which that power was harshly and unreasonablyexercised. They pointed out that in some remote districtsdismissal might mean absolute ruin to the medical officer.In the second place, they claimed to have a right to order aninvalid diet for paupers without an appeal to the inspector ofpoor who had at present the power to veto any specialdiet which they prescribed. Thirdly, they urged that

powers should be given to erect from parochial funds

dwelling-houses for medical officers, there being manyparishes in which they could not obtain proper accom-modation. In the fourth place, they contended that theyshould be granted a suitable annual holiday when the greaterpart of their income was derived from parish sources. (Atpresent they could not obtain a holiday without payingfour guineas a week for a locum tenens.) Fifthly, theyurged that a uniform fee of one guinea should be givenfor granting a lunacy certificate. At present there was agreat diversity in the fees that might be paid by the parishcouncil for those cases and in many instances the medicalman got nothing at all. They also urged that there shouldbe a special fee for special cases which they had to attend.In substance, they asked that they should be put in the sameposition as the Poor-law officers in England and Ireland.Their education and duties were the same and their statusought to be made at least as satisfactory. They furthersuggested that there should be a special Governmentsubvention for the outlying islands and poorer parts of theHighlands. The Secretary for Scotland promised to makefull inquiry into their complaints.

Lodging-houses on -Fire.A series of regulations has been drawn up by the special

committee appointed by the corporation of Glasgow toreport upon the disastrous fire which occurred some monthsago in a model lodging-house in the city and which resultedin the loss of so many lives. The regulations will commendthemselves to everyone who has realised the possibility offire in these crowded lodging-houses. The provision, in par-ticular, that every lodging-house or hotel with sleepingaccommodation for over 100 persons should have at leasttwo adequate means of exit to the street is a wise proposal,