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present. At that meeting it was proposed that the establish-ment of a public medical service was desirable. In the dis-cussion which followed there were three most prominentfeatures. First, the expression of great dissatisfactionwith the conduct of the dispensary and the out-patientdepartments of the local charities ; secondly, resentment

against some of the details of management of the Hos-pital Saturday Fund and the idea fostered in the mindsof the workmen who subscribed to the fund that by theirsubscriptions they were entitled to the services of thehospitals so converting them practically into penny clubs ;thirdly, the feeling of fear that a public medical serviceestablished on a basis of a weekly subscription of 2d. wouldnot attract the class of patient desired as they werealready well provided for and would probably only enrollthose who were at present private patients. When the votewas taken it was found that the feeling of the meeting wasoverwhelmingly against the proposal to establish a publicmedical service and the motion was lost by a majority ofabout 33 out of a total vote of about 87.

Children’s Teeth.The report presented at the annual meeting of the

governors of the Birmingham Dental Hospital contains, inaddition to the statement of the number of patients andnumber of operations, some interesting information con-

cerning the results of the examination of the teeth of thechildren attending some of the elementary schools which hasbeen carried out during the past year by the aid of moneyprovided by an anonymous donor. During the year 2733 ’,children were examined and the teeth of 96 per cent.

required treatment. If the proportion is the same through-out the city we are brought face to face with the fact thatonly 4 per cent. of the children attending the elementaryschools have normal healthy teeth. If this is so and if thestate of affairs is to be remedied it means a very large annualexpenditure, and if things are to remain as they are thenfaulty digestion will continue to be responsible for unhealthychildren and adults in spite of the improvement of otherconditions.

The Maternity Hospital.As I pointed out in a previous letter, the funds of the

Maternity Hospital are insufficient for the needs of theinstitution, and money must be obtained if the work is tobe carried on. In these circumstances it has been decidedthat a ball shall be held in the Grosvenor Rooms ofthe Grand Hotel on Jan. 2nd, the object being to obtainfunds sufficient to meet the working expenses for some

months. That the ball will be a success is practicallycertain, for it is to be held under the presidency of theLord-Lieutenant of Warwickshire and the Marchioness ofHertford who will have the support of a large number ofdistinguished patrons.Dec. 10th.

_________________

MANCHESTER.

(FROM OUR OWN CORRESPONDENT,)

7Ae J.nfr/l’m(l’J’Y Site.WHILE the new infirmary in Oxford-road is rapidly

approaching completion controversy still goes on as to thefuture of the Piccadilly site. The report of the architectis on the whole adverse to the conversion of the presentbuilding to the purpose of an art gallery and a free library.As regards the well-being of the city from the sanitary pointof view, the best thing would be to preserve it as an openspace. The days are now passed by, and almost forgotten,when the infirmary garden was a favourite resort for thedwellers in Mosley-street, at that time a 11 genteel street"

"

of good substantial houses and free from the invasion ofshops, offices, and warehouses. And in these later daysthe five acres of land judiciously planted and caredfor would be a restful oasis, the presence of which inthe busy, bustling life of such a city as Manchester would beof untold value. The idea is not Utopian, for with theincreased realisation of the baneful, wasteful extravaganceof the present mode of dealing with fuel we may confidentlylook forward to being freed from our dismal leaden pall andto a time when it will not be a novelty to see bright skiesand a sunny day. It is said to be too costly a site to be leftunoccupied, but it would cost a good deal leqs to keep it as alung for Manchester than to spend another .6400,000 or morein addition to the .6400,000 which the site cost.

St. John A7ttbitlanee Assooiation.Interest is still kept up in Manchester as a centre of the St.

John Ambulance Association and a meeting of the centre washeld the other day under the presidency of Surgeon-MajorG. H Darwin who has long been an earnest worker for itswelfare. The report showed that 27 classes had been heldduring the year, 11 of them being under the management ofthe technical and other schools of the district. Four of themwere composed of members of the Manchester city police,four were in connexion with the Manchester and Salfordcorporation employees, three were connected with clubs formutual improvement, one consisted of members of the Man-chester and Salford corps, and besides these were four notclassified. Moreover, during the year 358 certified memberswere re-examined, 179 passing for vouchers, 108 formedallions, and 55 for labels. Since the formation of thecentre in 1880 the total number of the certificates issued forfirst aid and nursing now exceeds 11,450. The goodinfluence of this movement must be far greater than themere figures would indicate. Numerous small accidentsoccur in which the knowledge and aptitude of the certificateholders come into play without any record, and all of themserve more or less as diffusers of knowledge which by thetraining they have received is at once put to practicaluses.

Protection of Infant Life.An interesting philanthropic experiment has been tried at

Blackburn by the Christian Social Union of that town. A

good wholesome dinner was given to 12 poor women withinfant children and it was found after eight months’ trialto have been followed by "extremely gratifying results,"the mothers being able to suckle their babies who have"thriven splendidly." Bishop Thornton suggested that thescheme should be continued on a larger scale and that themunicipality ought to subsidise it. It is easy to understandthe physical benefit to the children, but at what cost to thespirit of independence of the mothers ? The daily good,wholesome dinner to the wives must be a great relief to thehusbands and enable them to contribute more to the;E3,000,000 which, according to Mr. John Burns, is spentweekly in drink. All this illustrates the difficulty of com-bining charitable work with strengthening instead of under-mining the foundations of character.

The late Dr. Adolphe Wahlt1wh.By the death of Dr. Wahltuch Manchester loses the

familar presence of an amiable, active-minded member ofour profession. An obituary notice of the deceased was

published in THE LANCET of Dec. 7th, but I may men-tion that notwithstanding his devotion to his professionhe was an enthusiastic lover of the game of chess.As a notice in the chess column of the ManchesterGuardian puts it, ’’ he was one of the most popular andenthusiastic as well as the oldest member of the Manchesterchess community." He founded the South Manchester ChessSociety in 1882 and had been president and vice-presidentof the Ardwick and Manchester Chess Clubs, and was also avice-president of the Manchester Chess Association.

The Unpopularity of Sanatoriums.Some short time ago there was a scheme for establishing a

sanatorium for consumption at Romiley, near Stockport.Oakwood Hall, some distance from the village, which it wasproposed to convert to that purpose, was in many respectseligible, but the objection to the scheme by the residents inthe neighbourhood was so strong that it was not carried out.It is quite evident that unless care is taken convalescent homesor sanatoriums for consumption may do much to destroy thecomfort of the residents in the neighbourhood. It is said thatthe great institutions, telling as they do of the philanthropyof cities and individuals of Manchester and Liverpool, do notadd to the amenities of the Delamere district. With regardto Romiley there is a marked inconsistency in the attitude ofthe people. They were in arms against the sanatorium, butallow apparently this place, marked by much natural beauty,to be spoiled by the smoke from the mills which are toonumerous to serve as improvers of the landscape, It seemsthat some nuisances are to be preferred to others.

Irish Medical Schools’ and Graduates’ Association.Perhaps one of the most agreeable forms which nationality

and comradeship can assume is by schools’ or graduates’associations. Those, therefore, who cannot boast of theselinks with each other and with Ireland may cordiallywelcome the formation of a northern branch of the rish

1731

Medical Schools’ and Graduates’ Association, to includeManchester, Liverpool, Leeds, Sheffield, and other places intheir neighbourhood. The council of the association hasundertaken the task of working out the details.

Hospital Sunday.A meeting of the supporters of the Hospital Sunday Fund

was held on Dec. 2nd in the town hall, the Lord Mayorpresiding. The amount raised at the close of the year endingJune was £3,434, compared with £3,633 in 1906, a decreaseof .6199. Appreciation was expressed of the way in whichthe Saturday and Convalescent Homes Fund had actedtowards the medical charities at the last distribution.Although there was the responsibility of maintaining thetwo homes provided by means of the bazaar of November,1905, their contribution was not lessened. It is evidentthat there is a confident feeling that the work-people of thedistrict will raise sufficient to defray the cost of the con-valescent homes. But it was regretted, as well it might be,that the efforts made to collect subscriptions from those whoderive income from Manchester but live at a distance " hadnot been very satisfactory." The Lord Mayor, in commend-ing the cause, ‘ deplored the continuous decrease in thereceipts." Is it that rates, taxes, motor-cars, and otherthings are drying up the springs of charity, or that thesprings are fewer and less bountiful, and are diverted inthese days of luxury and extravagance in other directionsthan that of charity ?

Dec. 10th. ________________

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

The Sanitary Condition of Cardiganshire. ,

AT the last meeting of the county council of Cardiganreference was made to reports which had been made byinspectors of the Local Government Board upon the urbandistricts of Newquay and Aberayron and the rural districtsof Aberayron and Tregaron and one member of the councilsaid that if there had been any remissness in carrying out thePublic Health Acts it was on the part of the Local Govern-ment Board. His only reason for making this statement iappears to have been the alleged delay in issuing the reportsafter inspections had been made of the districts concerned. In the case of Tregaron there is certainly no groundfor this charge, for Dr. E. P. Manby first visitedthe district on July 15th last and his report was

dated Oct. 14th. The condition of the cottages inthe district was described by Dr. Manby as beingfar from satisfactory. The floors were of bare earth,the walls were damp, and the rooms were insufficientlylighted and ventilated. In many instances there was nothrough ventilation and numerous houses were built with"back to earth." A commentary upon this report is to befound in the account of the last meeting of the ruraldistrict council, when a case of diphtheria was reportedin a house in the parlour of which, measuring 440 cubicfeet, seven persons slept.

Cardiff Workhouse.Mr. A. B. Timms has been elected by the Cardiff board of

guardians as visiting medical officer to the Cardiff work-house. Mr. Timms was for several years resident medicalofficer and succeeds the late Dr. Alfred Sheen.

Hozcsing at Merthyr Tydfil.The newly formed corporation of Merthyr Tydfil is

actively continuing the policy of the urban district councilin preventing the occupation of uninhabitable houses andis at the same time providing habitable dwellings for ’’

those persons who are displaced. At a recent meetingof the health committee the medical officer of health(Dr. A. Duncan) reported upon nearly 50 cottages as beingunfit for human habitation. It was stated that for the last38 of the council’s houses which were to let there were noless than 200 applicants. Some difficulty is being found inpreventing the occupiers taking in more lodgers than isdesirable. The first 100 houses that were built by the councilhad only three bedrooms and it has now been decided thatthe number of persons in each house (including lodgers)shall be limited to six.

Spectacles for G’hildren in Elementary Schools.When the Pontypridd education committee appointed the

medical officer of health (Mr. Howard Davies) to be alsomedical officer to the committee he began to make system-

’

atic examinations of the children attending the publicelementary schools. After making a preliminary examina-tion of their eyes he sent those with defective vision to a-specialist who was paid by the committee. Upon therecommendation of the medical officer the committee pro-vided spectacles in those cases that required them. A sumof L25 thus expended was surcharged by the auditor butupon the committee appealing against the surcharge tothe Local Government Board the expenditure has beensanctioned. When communicating with the Board on thesubject the committee pointed out that it was unreasonableto compel children to attend school when they were unableto carry on their studies owing to defective eyesight.

The Salary of Poor-law Medical Officers.At the meeting of the Bridgend (Glamorganshire) board of

guardians held last week Mr. W. Randall, a district medicalofficer, who had recently been granted an increase of salary,sent the following letter to the guardians which was readwithout any comment :-

I presume I must thank the board for the totally inadequateincrease of salary allowed me. Your board’s absolute ignorance ofthe remuneration due to a professional man would be ludicrous if itwere not cruel. For several years the board paid the barber who cuthair and shaved once a week at the workhouse more per annum thanthe medical officer who visited three times weekly, not countingemergency calls and clerical duties.

Dec. 10th. _________________

SCOTLAND.

(FROM OUR OWN CORRESPONDENTS.)

Complimentary Dinner to Dr. Alexander James.ON Thursday evening, Dec. 5th, Dr. James was entertained

to dinner in the Caledonian Railway Hotel, Edinburgh, by anumber of his colleagues and friends. Dr. James completedhis term of office as a physician to the Royal Infirmary inAugust last and it was felt by his friends to be a suitabletime to express in this way their appreciation of his manyexcellent qualities and their personal esteem and affection forhim. The company, which numbered about 60, was presidedover by Dr. C. E. Underhill, the President of the RoyalCollege of Physicians of Edinburgh. The toast of the

evening was proposed by Dr. J. J. Graham Brown, who hadbeen associated with Dr. James as assistant physician inthe infirmary, so it could not have been in more suitablehands. Dr. James replied in his usual felicitous manner.Even those who could not be present at the dinner felt thatit was a most suitable expression of the sentiments enter-tained towards Dr. James by the profession in Edinburgh.

Mental Wards in the Edinburgh Royal Infirmary.The agitation for the addition of mental wards to the

Edinburgh Royal Infirmary has been lately revived by anappeal in the daily newspaper press. Everyone would beglad to see a hospital established for the reception of acuteand incipient mental disorder where it was not necessary tohave the patient certified, but that the infirmary should beenlarged for this purpose is not regarded with universalfavour. There are other urgent claims upon the infirmarywhich cannot be met for the want of funds, and it is also aquestion whether a great public charity like the infirmaryshould have this additional burden thrown upon it.

AeriaZ Sanitation.In the course of his annual report the chemist and analyst

of the city of Glasgow draws attention to the part whichdomestic fires play in the contamination of the atmosphereof the city. He maintains that either through faulty con-struction or careless firing these contribute substantially tothe pollution of the air and to the resulting blackenedappearance of the public buildings of the city. From aseries of experiments extending over several months it wasfound that every million cubic feet of chimney gases from anordinary domestic fire contained 5’ 4 pounds of heavy oilyhydrocarbons. These hydrocarbons were practically solid atordinary temperature, black in colour, and when liquefiedpossessed properties akin to a heavy oil tenaciouslyadhering to stonework. To impart a practical concfptiion asto the importance of these 5’4 pounds per 1.000000 cubicfeet he calculated that on the basis of there being 130,COGinhabited houses within the Parliamentary boundary of

Glasgow and that in each house one fire was kept burning