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ALLEGED OFFICIAL NEGLECT OFSMALL-POX.

To the Editor of THE LANCET.

SIR,—That some notable reform in the sanitary arrange-ments of the metropolis may evolve out of my troubles

is most devoutly to be wished. That those arrange-ments are inexplicably confusing to the uninitiated is, withthe story of my recent experiences, a pretty patent fact.

Why, may I ask, should a vaccination officer be an officerwho does not vaccinate? Why should the Local Govern-ment Board itself be unable to enlighten inquirers as towhether certain " rural sanitary authorities "-the WestHam Union to wit-are provided with means for isolatingsmall-pox patients? Why should it be at all doubtfulwhether the Home of this institution, situate in the WestHam Union, is within the area covered by the MetropolitanAsylums Board? Why should four public officers refer aninquirer from one to the other-living no mean distancesapart-and the fourth flee from him, as it were, to takerefuge in the authority of a board of guardians? The girlscertainly were not paupers in the sense of being in receipt ofparochial relief, but they were in almost every case main-tained in the Home by charitable contributions, which barelysufficed for their maintenance. From the relieving officer’spoint of view, the hand of that beneficent Providence whichhad aided them hitherto (so helpful at the same time inmitigating poor-rates) now slammed the doors of the Metro-politan Asylums Board hospitals in their poor ravaged faces.It was no such thing. Poor-law and Local Governmentofficials must be held responsible for this; for in 1877, on asimilar outbreak occurring, the then relieving officer at onceremoved the patients-three in number-and there was nospread of the disease. Why should he not have done so onthis occasion, and with a like result ? In the present instanceevery possible effort was ineffectually made to obtain theremoval of the first three cases ; and as a result thirteen poorgirls had to be sent to the Pay Hospital, Highgate. Neitherwas the delay attributable to any lack of power, as surmised,on the part of the sanitary authorities ; for, ultimately, themedical officer of health handed to the sanitary inspector anorder for their removal (so the latter official himself informedme some days after), but could not recall what he had donewith the order. Referring to the memorandum of the LocalGovernment Board, I should have said, in my letters tothe press, it was handed to me with a message that " theyeould do nothing to assist" (not that the memorandum itselfconveyed this intimation) ; but that I would find in thememorandum suggestions as to what steps I should take,and that an official reply should be sent me in the morning.The memorandum was as follows :-

" -Local Government Board, Whitehall."Mem. of steps advisable. - Immediate vaccination of

every inmate. (Best apply to public vaccinator of district.)Small-pox Hospital at Highgate-hill receives patients onpayment. Official letter to-morrow."May 8th, 1884." (Signed) H. P. THOMAS.

On the 10th I received the official letter referred to, ofexactly the same purport as the memorandum, with thisadditional suggestion, and this only-that such of theinmates as were attacked with small’pox should be isolated.This amplification of the memorandum was spread over twosides of a sheet of paper having a superficial area of 450 in.The letter and memorandum are enclosed. You refer to theoutbreak at this Home as being extra-metropolitan. Is notthis a mistake ? or how is it an order is given for removalof the cases to one of the metropolitan hospitals ? " We aretold," you say, that the authorities at Highgate possessedno ambulance." Neither, Sir, did the authorities at theHomerton Hospital, though I am informed it has since beenmade an ambulance station. When in search of this hos-pital, I observed, as I approached the locality to which I hadbeen directed, a very spacious public-looking institution,and I inquired of a milkman going his rounds whether thiswas the Small-pox Hospital. "No, sir," he said; " thereit stands on the other side of the road, where the hearse is.""What, then, is this ? " I inquired. " This, he replied, " isa college, where from three to four hundred young peoplereceive their training ; that college, sir, has been there forover one hundred years, and I think it a great shame theSmall-pox Hospital should have been placed where you seeit. With regard to the later cases showing themselves at

H. P. THOMAS.

the Home, I may say there was great difficulty in obtainingthe requisite supply of lymph for so large a number. Re-vaccination was proceeded with day after day as lymph wasobtained. The officers of the institution were the first tosubmit themselves to it as an encouragement to the girls,and the writer submitted himself to it a second time, thefirst not having taken, to satisfy himself the failure was notin any way attributable to the character of the lymph used.This, however, had the same negative effect as the first. Icannot speak in too high terms of the behaviour of the girlsthroughout this trying ordeal; there was not one faint heartamong them. The patients attacked with small-pox wereat once isolated in the infirmary of the institution, com-munications between it and the residential part of theHome being maintained by speaking-tubes, and disinfectantswere used freely throughout the house. Indeed the veryperfect sanitary arrangements of the Home constituted thegreat stumbling-block in the way of the officer of healthgiving an order for the removal of the patients. Imme-diately on the outbreak occurring, Dr. Harvey J. Philpot,L.R.C.P., a member of the committee, visited the Home,and saw the patients, and the medical officer of the Home.He made a minute inspection of the premises from garret tocellar, and satisfied himself as to the satisfactory sanitarycondition of the Home, and as to the precautions taken toprevent further spread of infection.

I am, Sir, very faithfully yours,ALFRED M. GILLHAM, secretary.

Princess Louise Home, National Society for theProtection of Young Girls, 32, Sackville-street.

To the Editor of THE LANCET.SIR,—I am pleased to state that the Princess Louise Home,

Wanstead, is now free from disease, the small-pox having sofar passed away. There is not one case of illness throughoutthe Home. All children, immediately on the outbreak, wererevaccinated, and in some few cases it was found necessaryto repeat the operation, the first having proved unsuccessful.

I am, Sir, yours faithfully,Stratford, E., Jane 5th, 1884. THOS. G. WHITEHOUSE.

LIVERPOOL.(From our own Correspondent.) )

, HOSPITAL SATURDAY.

THE sum realised by the Hospital Saturday boxesamounts already to ;62700, and is expected to reach 92800.It is not generally known that Liverpool was one of thefirst places, if not the first, where Hospital Saturday becamean institution. It was begun in 1871, on the Saturday afterthe first Hospital Sunday. The arrangements being hurriedand very incomplete, the amount realised was but a littleover 2100. It is a proof of the growth of good works whenhonestly persevered in that the proceeds of Hospital Satur-day here have for some years exceeded .E2000, and are nowclosely approaching £3000. It is however, urged, and withmuch reason, that a completely organised movement amongthe working men extending throughout the year and cul-minating in Hospital Saturday would produce a greatlyincreased amount. And seeing that sums of £5000 havebeen raised among the working men of Birmingham andGlasgow for the local hospitals, surely an equal, if notincreased, amount might be expected in Liverpool.

THE SCHOOL OF MEDICINE.

A great advance in recent years has been made in theestablishment of an anatomical class with regular dissectionsduring the summer session. Twenty years ago there wasnone except for such students as had been so unfortunate asto be rejected during the spring examinations at the College,and who purposed going up in the following July. Nowthere are fifty students attending in the dissecting-room anddissecting diligently ; the supply of subjects is very good, andthe atmosphere wonderful considering the time of the yearand the recent hot weather. The advantages of studentsbeing able to keep up their anatomical studies throughoutthe academical year are too obvious to need discussion.

CASES OF TRIPLETS.

Mrs. Evans, a midwife of the Ladies’ Charity, has had twocases of triplets within twenty-seven da) s of each other. In

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the first case all three children presented by the head, thefirst in a separate bag of membranes, the second and thirdin a single one; there was a single placenta. All threelived till the twelfth dav, when the second and third died ;the first is still living. In the second case, the first and thirdchildren presented normally, the second by the breech. Thefirst child had its own placenta, the second and third a singleone ; there were three bags of membranes. All died withinfour days after birth.

INCREASE OF SMALL POX.

There have been so many cases of small-pox reported ashaving broken out in different parts of the city, that it wasproposed by a medical member of the Health Committee toask the Government for a ship to be used as a hospital. Itwas urged, however, that hospital accommodation on shorewas more desirable, and, if really needed, there will be nodifficulty in establishing temporary wooden or iron hospitalswithin a reasonable distance of the city.Liverpool, June 5th.

NEWCASTLE-ON-TYNE.(From our own Correspondent.)

THE CONVALESCENT SOCIETY.

THE annual meeting of the Convalescent Society has beenheld here lately, and the report stated that the number ofpatients was now nearly fourfold what it was when thenoble building at Whitley was opened. Dr. Philipson, inpresenting the medical report, stated that during the year1227 cases had been admitted, the greater proportion ofwhich had been cured, relieved, or greatly benefited. The

Mayor (Mr. Newton, Surgeon) made some remarks at themeeting, setting forth the advantage it would be to have aninland home in connexion with the Society, as during a con-siderable portion of the year the seaside was not desirablefor some patients. Dr. Philipson, while admitting thatsuch might be desirable, thought that the governors of theConvalescent Society would hardly undertake the task, butpointed out that there was some feeling that it might beundertaken by the Newcastle Dispensary, which is aninstitution having ample funds for the purpose.

SUNDERLAND AND DURHAM EYE INFIRMARY.

This institution has lately held a very successful bazaarat Sunderland, with the view of removing the debts andplacing the hospital on a firmer basis, the proceeds of thetwo days being over ;13600. This useful institution has beenestablished since the year 1836, the late Mr. Maling andMr. Dodds being its pioneers.

HOSPITAL FOR INFECTIOUS DISEASES, NEWCASTLE.The Corporation has resolved to proceed at once with the

erection of this hospital on a site at Heaton-not that origi-nally proposed, but near to it, and comprising ten acres.The design for the hospital has been accepted, showing abuilding providing eighty-four beds on the pavilion system,the entire cost of the building, fittings, and furnishings tobe from jE20,000 to £30,000, so that our authorities undertakethe object in no peddling spirit.

PENNY DINNERS FOR POOR SCHOOL CHILDREN.

The Rev. W. Moore Ede, rector of Gateshead, feeling inthe same spirit as THE LANCET as to the connexion of mentalwork and food, which he quotes when you say " that theposition in which education places the brains of underfedchildren is that of a highly exercised organ requiring foodand finding none-or very little," set himself to work out theproblem of cheap dinners for school children with very suc-cessful results, which he details in our local papers, and whichare full of interest as well for humanity as for education. Mr.Ede says that some weeks ago he received a pamphlet headedwith the question, " Can a sufficient mid-day meal be givento poor school children at a cost for material of less than onepenny?" and that he felt disposed to answer, Most certainlynot. He found, however, that Sir Henry Peek, M. P., claimedto have accomplished the feat at a country school on hisestate at Rousden, in Devonshire, where mid-day mealshave been provided since October, 1876, at a cost of 107,406pence for 110,222 dinners, with an average allowance ofsolid food of eight ounces per child. Mr. Ede visited theRousden School, and returning home, converted to the

scheme, commenced similar operations in the St. Mary’sNational School, Gateshead, feeling that what could bedone in Devonshire could be done on Tyneside. It wouldoccupy too much of the space allowed for this letter todetail the week’s course of five dinners, but I may giveyou the bill of fare for Thursday in providing 117 dinners:Thursday, soup : One ox head and a half (11½lb. meat andbone), 3s. 9d. ; ham bones, Is.; pea-flour, 7Ib., Is. ; rice, 6lb.,8d. ; onions, 4½lb., 4½ d.; potatoes, 7 lb., 3zcl bread, 14 lb.,2s.; total, 9s. ld. Dinner for 117 childred, and a surplus offorty-four quarts of strong soup, which was sold to parentsat ½d. per quart, Is. 10d.; showing a net cost of 7s. 3d. Theother days’ dinners consisted of soup and bread, rhubarbpudding, rice with treacle, or jam pudding. Mr. Ede ex-plains that during the week’s experiments 479 dinners wereprovided at a cost of 369 pence, thus leaving a balanceof 6s. 10½d. as profit ; and that the financial result has notbeen obtained by placing the children on short commons, forthey each had daily as much as they liked, and, unlike poor" Oliver Twist," they had been allowed to ask for "more"as often as they chose. One boy was heard to boast that hehad sent in his plate "eight times," and five helps werecommon.

PRESENTATION TO MR. TAYLERSON, WHITBY.Mr. John Taylerson of Whitby, who has filled the office

of surgeon to the workhouse, and various other medicalappointments, for nearly fifty years, and who is held inhigh respect as a practitioner and a citizen by all classes)has been lately the recipient of an address from his fellowtownsmen accompanied with a purse of gold. Mr. Taylerson’shealth, I regret to say, has been in a declining state forsome time, yet he was able to receive his friends on thisoccasion, express his gratitude to them, and refer to hispast labours, pointing out with some pride the improvedcondition of the charitable institutions of the town, and itsrising importance as a health resort &c.Newcastle-on-Tyne, June 5th, 1884.

IRELAND.

(From our own Correspondent.)

ROYAL COLLEGE OF SURGEONS IN IRELAND.

THE annual elections for president, vice-president, secre-tary, and council took place on last Monday, the 2nd inst,,and created a considerable amount of interest, as it was

tolerably well known that a determined attempt would bemade to remove two or three of the outgoing council. Mr.E. H. Bennett, Professor of Surgery in the University ofDublin, was promoted to the presidency, and the vice.

presidency which he vacated was filled by the selection ofMr. A. H. Corley, who, as I expected, was unopposed. Forthe council two vacancies had arisen by the resignation ofMr. Butcher and Dr. Denham, and for the nineteen placesthere were twenty-six candidates. As I prognosticated someweeks since, Prof. Stokes and Mr. Elliott were successful inobtaining seats, and also Messrs. Fitzgibbon and Carte.Two of the outgoing members were not re-elected-viz.,Messrs. Rawdon Macnamara and Thornley Stoker. Mr. W.Colles, as usual, was re-elected secretary without opposition.As regards the vice-presidency of the College for 1885, thinkI am correct in stating that either Professor Stokes or Pro-fessor Cameron will be a candidate. By the sudden deathof Dr. J. Stannus Hughes, vacancies have arisen for a jointlecturer on surgery in the Medical School of the College, andthe secretaryship to the council ; for the latter appointmentDr. C. H. Robinson will be a candidate.

ROYAL MEDICAL BENEVOLENT FUND SOCIETY OF IRELAND.

The forty-second annual meeting of this Fund was held onthe 2nd inst., presided over by Dr. William Moore. Thereport of the Central Committee showed that the financialcondition of the Society continued fairly satisfactory. Thesum of £1230 had been distributed, and £1104 added to thefunded property. Of the amount distributed £205 was tomedical men, f930 to widows, and £95 to orphans. Some ofthe speakers complained of the apathy shown by the profes-sion towards the claims of this Society, which will be readilyacknowledged when it is stated that of the 2500 medicalpractitioners in Ireland only 500 are subscribers. If a rulewere enforced to the effect that no grant would be made to