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in touching upon the matter again in the light of the ex-tended information so recently provided, more especially asthe conclusions which our leading daily paper draws from theinvestigations of its contributor are open to some doubt.Taking five of our principal hospitals, the General, theQueen’s, the Women’s, the Children’s, and the EyeHospital, it appears that 20 years ago (1886) thetotal income of the five was 34,069 and last year(1906) it amounted to 54,825. In 1886 the moietyderived from subscriptions was £12,963, and in 1906this moiety had increased to 17,416—that is, in the formeryear the subscriptions formed a little more than 35. 1 percent. of the total income and in the latter year the percentagehad fallen to about 30’ 7. In other words, there has beenduring the past 20 years a relative diminution of the sub-scriptions as contrasted with the total income. During thesame period the number of in-patients received into the fivehospitals has increased from 7134 to 10,297, and the numberof out-patients from 10,297 to 159,032. One of the inferencesdrawn from these facts by the writer of the leading articlein the Daily Post is that as the number of subscribers andthe amount of subscriptions are falling off some of the com-mittees should " concentrate their attention upon the acquire-ment of new subscribers," and he urges that nothing but apersonal canvass will produce the desired effect. It is

frequently stated that " the number of persons capableof giving a regular subscription to one or more institu-tions is far larger than is accounted for by a perusalof the subscription lists," but the evidence upon which thisstatement is made is not quite clear, and it by no meansfollows that because a given person has a certain amountof income or lives in a certain style he has any moneywhich he can devote to hospital support, for frequently hehas to spend the whole of the income he makes in maintain-ing those conditions of life which enable him to gain theincome. Moreover, in considering this question of therelative diminution of hospital support by persons who havegood average incomes, it must not be forgotten that thenumber of hospitals, dispensaries, and other charities is

continually increasing, and taking the case of Birminghamthe actual increase in the amount of subscriptions duringthe past 20 years as shown by the returns of the fivehospitals referred to does not give a complete ideaof the total increase of subscriptions during the wholeof that period, for numerous other charities on variousscales have been established or enlarged and theirnecessities have caused an expansion of the area

over which subscriptions are distributed. It may still lappear when statistics are available that taking allthe newer institutions into consideration the amount of

subscriptions is still showing reduction as contrasted withthe number of patients treated and the total amount ofincome. If this should prove to be so the fact would not besurprising, for it must be remembered that the portion of thecommunity from which subscriptions are drawn finds that theexpense of living continually increases. We are in a period ofextravagance, not only in public but also in private life, andat present there is no sign of a movement which shall tend tothe reduction of those so-called " necessary " expenses whichabsorb money that otherwise might be devoted to charities.Further, the classes from whom hospital subscriptions areexpected are feeling more and more the burden oftaxation. Their incomes are taxed in unreasonableproportion for national purposes, they are taxed forthe education of other people’s children, and for the moreor less complete maintenance of many of them. In thesecircumstances it is scarcely surprising that voluntary sub-scriptions for charitable purposes do not greatly increase, forit may be taken as certain that the more people are forced todo the less they will do in a voluntary manner. Looked atfrom this point of view it does not appear probable that apersonal canvass will be very effectual in raising the amountof the subscriptions for any length of time, for it is notlikely that the causes which militate against increasewill diminish. In these circumstances, then, it becomesinteresting to inquire into the amount given to the hos-

pitals by the more popular Hospital Saturday Fund, whichmay be looked upon as the subscriptions of those whomake most use of the hospitals. This Fund, under theadmirable management of the committee, has consider-ably increased during the past 20 years, and it is there-fore the more surprising to find from the statistics pro-vided that the portion devoted to the five hospitals hasdiminished as contrasted with their total income. In 1886 j

the amount given from the Hospital Saturday Fund to thefive hospitals under consideration was .E4583, and in 1906 ithad increased to E6975, or, in other words, in the earlier

year it formed a little less than 13’ 5 per cent. of the totalincome and in 1906 a little more than 12’ 7 per cent. Thereis no doubt that the remainder of the Hospital Saturday Fundis well utilised, but in the circumstances it may be urgedfairly that more of it might with advantage be devoted to themaintenance of the hospitals.

The Health of Birmingham.For a considerable period we have rejoiced in a low death-

rate and some of the more sanguine of us were hopeful thatthe time had come when the low rate would be practicallypermanent. We are inclined to feel disappointed, therefore,to find from the medical officer’s report that whilst it isstill low, 19’ 9 per 1000, it is higher than it has been duringthe first quarter of the year since 1904, but there is consola-tion in the knowledge that it is still below the average forthe first quarter of the past ten years, which is 20’ 3 per1000. Part of the increase appears to have been due to thevery varying and inclement weather, for the number ofdeaths from pulmonary and pleuritic inflammations has beenlarge. Measles also has been more than usually fatal, andthe scarlet fever from which we have been suffering appearsto have become more virulent, for its death-rate has risen to4’ 7 per cent. Diphtheria and typhoid fever are also moreprevalent than is desirable. The birth-rate for the quarterwas only 29 per 1000.

The Noti fcecction of Consumption at Coventry.’ Coventry has decided to follow Birmingham’s lead and itssanitary committee has made arrangements for the voluntarynotification of pulmonary tuberculosis. It was also de-cided at a recent meeting of the Coventry city councilthat Birmingham should be approached as to the termson which Coventry might be allowed to utilise the proposedsanatorium which is to be established near Cheltenham,where it is suggested that 40 chalets should be erected assoon as possible.April 30th.

LIVERPOOL.(FROM OUR OWN CORRESPONDENT.)

Tlte Health of Liverpool.THE birth-rate in Liverpool for the week ended April 20th

was 35 per 1000. The death-rate was 20’1 1 per 1000, com-pared with a mortality of 23’ 5 per 1000 a year ago. The

zymotic cases in hospital were : small-pox, 4 ; scarlet fever,372 ; typhus fever, 7 ; typhoid fever, 42 ; diphtheria,37 ; and in isolation, 63. This time last year the epidemicof measles was accountable for the higher death-rate.

St. Helen’s Hospital: Workmen’s Contributions.The thirty-fourth annual report of the St. Helen’s Hospital

showed that, in spite of the large growth of expenditure con-sequent on the enlargement of the hospital, the income for theyear had grown correspondingly owing entirely to the highlysatisfactory increase in the penny-a-week contributions of theworking men, which amounted to .63198, against £2478 inthe previous year. During the year 829 patients had beentreated, against 707 in the previous year. The hospital hassustained a great loss by the death of Sir David Gamble,Bart., who was one of its warmest supporters.

Epidemic of Measles at St. Helen’s.The medical officer of health (Dr. J. J. Buchan) has sub-

mitted a lengthy report on the epidemic of measles amongschool children to the St. Helen’s health committee. Hestated that the history of measles during the last 30 yearsin St. Helen’s showed that the disease had been almostconstantly present, breaking out in epidemics of greateror less severity every two or three years. The epidemicsexhibited themselves in two forms, a major and a minorvariety. In the major epidemics the disease had appearedin the earlier part of the year and assumed a more virulenttype than in the minor ones, which contributed less to thedeath-rate. The disease was spread by personal contact withthe sufferer, particularly in the early stage of the illness, the in-fection then being apparently given off by the discharges fromthe throat, nose, and lungs. The actual cause of the disease hadnot so far been discovered. Measles appeared to be spread to a,

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very great extent by school influence, acting by the attend-ance at school of actual sufferers from the disease. Evidenceis still wanting in St. Helen’s that healthy " contacts " hadintroduced the disease to the schools. Measles was presentat the end of the year and became epidemic in January.The number of families apparently affected had been about930 and the number of cases among these was 1800. With

regard to the exclusion of scholars living in infected housesin St. Helen’s, there has never been any rule laid down bythe health committee on the matter ; the same general rulewhich applies to the exclusion of scholars from any cause isheld to apply in St. Helen’s. He recommended to the com-mittee that it should be remitted to the secretary for

elementary education and himself to draw up draft regula-tions for the exclusion of .. contacts with infectiousdiseases, similar to those adopted now by several authoritiesin the large towns.April 30th.

WALES AND WESTERN COUNTIES NOTES.

(FROM OUR OWN CORRESPONDENTS.)

, Cardiff Infirmary.DURING the past few years it has been customary for the

board of management of the Cardiff Infirmary to issue, inconnexion with its annual report, a supplementary reportpointing out what are the needs of the institution as regardsextensions and improvements. As a result many importantadditions have been made, including an operating theatre,casualty wards, and a new out-patient department. The lastsupplementary report suggested additional accommodation for64 patients and other extensions to cost altogether E30,000.This would increase the accommodation to 250 beds. Thatthis would not be too great is shown by the fact that thereare constantly between 500 and 600 patients awaiting admis-sion to the wards. For it must not be forgotten that theinstitution serves not only Cardiff but the large collierydistricts of the Rhondda Valleys, Aberdare, and Merthyr,where there is a population approaching half a millionpersons. The appeal of the board has already met with afavourable response, Mr. John Cory, J.P., having promisedto give £5000, provided the remaining E25,000 are subscribedwithin six months.

Meat Inspection by the Police.It has been pointed out more than once that the difficulties

of meat inspection in Cardiff arise almost entirely in con-nexion with meat which is slaughtered outside the borough.There are no private slaughter-houses in the town and

inspection at the public abattoirs is a comparatively easymatter. Dr. R. Prichard, medical officer of health of theLlandaff and Dinas Powis rural district, which adjoinsCardiff, has recently made a suggestion for increasing the effi-ciency of the inspection in rural districts. He points out thatthe county police already take samples for analysis under theSale of Food and Drugs Acts and administer the ContagiousDiseases (Animals) Acts, and he proposes that they shouldvisit the slaughter-houses on their beats and inspect anycarcass that may be there. Dr. Prichard admits that theordinary policeman is not a trained meat inspector, but hethinks " that a lesson or two from the county medical officerof health would be enough to enable him to distinguishdiseased meat from what is not."

Isolation Wards of the Bristol General .Hospital.Special wards for the observation and isolation of sus-

pected cases of infectious disease are now recognised as anecessary part of the equipment of general hospitals. Theirabsence must not only increase very considerably theanxieties of the resident staff but must also add to thedifficulties and cost of administration. It is gratifying,therefore, to be able to record the completion of the isolationblock which has recently been erected in connexion with theBristol General Hospital. The building is of two storeys,each with a distinct entrance. On the ground floor are twowards for two beds and one for one bed. Between twoof the wards is a nurses’ duty room. Leading out ofeach of the larger wards is a circular sanitary annexe,containing water-closet and slop sink, with cross-ventilatedpassage. There is a portable bath for the use of all thewards. The remaining rooms include bedrooms for twonurses, bath-room, water-closet, and store room. The

arrangement of the first floor is nearly the same as that of

the ground floor, the difference being in the provision of anurses’ sitting room and the exclusion of a bath-room.The characteristics of modern fever hospitals, including therounding of corners and the absence of ledges, have beenapplied to the wards, and the Gilmour hardwood doorshave been used. These are made of small pieces of woodlaid grain against grain and finished with an absolutelyflash surface on both sides. There are fireplaces in thewards and other rooms, and the building is also heated withlow pressure hot water pipes and radiators. The lighting isby electricity and the air can be extracted by an electricallydriven fan. The cost of this building, which is quiteseparate from the main hospital buildings, was £5500, by nomeans an extravagant sum considering the accommodationwhich has heen

April 30th.

SCOTLAND.(FROM OUR OWN CORRESPONDENTS.)

Cerebro-spinal Fever in Edinburgh and Leith.THIS fever is increasing in Edinburgh. According to the

report submitted to the public health committee, 35 caseshave occurred since the beginning of the month. The firstcase reported in the city was in January and in the monthof March 31 supposed cases were reported and 18 deathsoccurred. Of the 35 cases reported in April up tothe date of the meeting (April 23rd) twice as manyoccurred in the old town as in the new town. Duringthe month there were 24 deaths. The disease is also

present in Leith, where the medical officer of healthhas been examining bacteriologically the throats and nosesof persons who have been in contact with cases. Thefamilies of patients have been isolated and "contacts " whoare not isolated have their noses and throats disinfected.The houses where cases have occurred are being thoroughlydisinfected as well as the belongings of the inmates. Therehas been a reduction in the number of cases notified in Leith.Dr. W. Robertson’s report will be waited for with unusualinterest. There is no aspect of the disease so unsatisfactoryand even alarming to the public mind as the knowledge thatthe channel by which infection enters the body is not knownand that it is consequently impossible to know what specialprecautions to take.

Edinburgh Public Health Estimates.It is always interesting to note the cost of administering

the public health arrangements in a large city and the esti-mates for the incoming year, which begins on May 1st, havejust been before the public health committee. The esti-mated expenditure amounts to £ 30,795. Some of the itemsgoing to the making up of this amount are: medicalofficers, £1765 ; sanitary inspectors, .&3985; burgh engineer’sdepartment, £1005 ; reporting infectious diseases, ,8350;Colinton Mains Hospital, £19,350 ; Portobello Hospital,£410 ; and Campsie Convalescent Home, £955.

Royal Visit to GlasgowThe visit to Glasgow of their Royal Highnesses the Prince

and Princess of Wales was accomplished last week under themost favourable auspices. The city was profusely decoratedin their honour, the weather was propitious, and notwith-standing the multitudes that kept holiday and crowded thestreets there was almost an entire absence of seriousaccidents. Their Royal Highnesses during their visit, whichextended from Tuesday to- Friday, were the guests of LordBlythswood at Renfrew. On the first day there was areception in the St. Andrew’s Halls ; in the afternoon the newlaboratories at the University were inspected and formallyopened by the Prince. The next day was occupied in layingthe foundation stone of the new Royal Infirmary, followed bya luncheon at the Municipal Buildings ; while on the last dayof their visit their Royal Highnesses visited Clydebank andinaugurated the new Rothesay Dock which has just beencompleted there. The scene at the University was excep-tionally brilliant. A crowded and distinguished gatheringrepresentative of the academic, civic, and other interestsassembled in the Bute Hall, where the ceremony of con-ferring the honorary degrees took place. Among thosewho received the degree of LL.D. were the Princeand Princess of Wales, the Lord Provost of Glasgow,Mr. Wyndham (late Lord Rector), Mr. Asquith (present LordRector of the University), and Professor J. G. McKendrick.rhe degrees were conferred by Lord Kelvin, Chancellor of