749

;after the removal of the departments of physics and

chemistry to Bournbrook, there will be room at Edmund-street for the further expansion and development of the

departments of arts, medicine, and commerce, but that ex-pansion and development must inevitably be hindered anddelayed unless money as well as room is available.

Worcestershire and Medical Inspection.The sanitary subcommittee having reconsidered the subject

.of the medical inspection of school children presented afurther report to the education committee on Feb. 23rd.The subcommittee recommended that the inspection shouldbe carried out by the inspector of midwives, a new inspector,and two assistants, with possibly the addition of a thirdassistant during the course of the ensuing year. After con-siderable discussion this proposal was adopted by the educa-tion committee. The subcommittee suggested that the

salary of the inspector of midwives should be raised to 500,that the new inspector should be paid a similar sum, and that,each assistant’s salary should be &pound;150. Ultimately theeducation committee decided to recommend that theinspector of midwives and the new inspector should be paid&pound;400 per year and each assistant <&175. The scheme has stillto receive the approval of the council, but it is extremelyinteresting to note the different ways and different meansby which county councils and other bodies are seeking tomeet the requirements of the new Act. All the schemeswhich are being adopted cannot be successful and very fewpeople seem to be particularly enthusiastic about the

possibility of securing results commensurate with theexpenditure which will be necessary.

Birmingham Sanatorium.The report of this institution for the past year is of a most

satisfactory character so far as the work done is concerned.During the year 1589 patients were received and the averagestay was 17.8 days, whilst the daily average number ofpatients was 78’1. In other words, the total number ofpatients, the daily average, and the average stay were allgreater than in the preceding year, which is sufficientlyclear evidence that the work of the institution is progressing.The financial part of the report was less gratifying. Thetotal expenditure for the year was &pound;2808 and themanagement account showed an adverse balance of <&44.The committee is justified, therefore, in its appeal forfurther support on the grounds of increasing work anddeficient means.

The Children’s Hospital.The committee of management of the Children’s Hospital

states in its report for 1907 that the total number of

patients was 14,849, or an increase of over 500 as comparedwith the previous year, but the average stay of each in-patient was almost half a day less than in 1906, and theweekly cost was 4s. 5d., as contrasted with 4s. 62d. in thepreceding year. Nevertheless, in spite of increasedeconomy, there was a deficiency of 277, as contrastedwith ;&68 in 1906, and the accumulated deficiency nowamounts to &pound;1216. The deficiency is due partly to adecrease of donations and partly to increased expenditure.It is naturally a matter of deep concern, more especiallywhen noted in association with the fact that a new hospitalhas been decided upon for which a considerable sum ofmoney will be necessary, not only for creation, but also formaintenance purposes.

Birmingkana and Midland Eye Hospital.At a special general meeting of the governors of the

Birmingham and Midland Eye Hospital held on Feb. 27thit was decided to purchase at a cost of 6500 some adjoin-ing leasehold property in Barwick-street for the purpose ofextending the accommodation of the hospital. Extensionhas become absolutely essential if the work of the hospital isto be continued in anything like an adequate manner and ifit is to meet the requirements of the district. At presentno less than 70 patients are awaiting their turn for admissionand the numbers requiring attention will naturally increaseas the population of the district grows, whilst it is not

improbable that the new Act for the inspection of schoolchildren will also be a means of increasing the work. Inthe circumstances, therefore, the authorities are lucky to beable to obtain such favourably situated premises for thepurpose of increasing the hospital’s capabilities.

The General Dispensary.The annual report of the committee of the Birmingham

General Dispensary is a record of increasing work, increasing

expenditure, and excess of expenditure over income. TheLord Mayor, who presided at the annual meeting, took theopportunity to draw attention to the increasing deficit and heexpressed the opinion that the state of trade might be takenas accounting for it in part, but he thought that very many ofthe professional men and traders of the city either did notsupport the charities at all or not sufficiently. Apparently itdid not occur to the Lord Mayor that many of the people towhom he referred have been educated or forced by circum-stances to live so nearly up to their incomes that when theyhave made some attempt to provide for their families in caseof death, and for themselves when overtaken by old age, theyhave little or nothing left to give as donations to charities. Asthe Lord Mayor admitted, the General Dispensary is not theonly charity which finds either that its income is falling offor is not increasing sufficiently and if one, at all events, ofthe new Bills recently introduced by the Governmentbecomes law many of the charities will probably feel theeffects of an increased diminution of donations and sub-scriptions.

Annual Report of the City Analyst.The yearly report of the city analyst shows that during the

past year our food has been considerably less adulteratedthan in some previous periods and the reduced adulterationincludes not only diminished adulteration by preservativesbut also diminished adulteration in other ways. The adultera-tion of milk has been considerably less than usual. This is

possibly due, in the analyst’s opinion, partly to the com-paratively cool summer of last year and partly to the number ofconvictions secured in the previous year. So far as thefarmers are concerned there has been no adulteration duringthe past eight years and in Birmingham it would appear thatpreservatives are usually added by the middleman. In onecase it was found that samples taken from a milkman’s cartwere pure but the milk which he supplied to shops wasadulterated.

The Annual Report of the Medical Officer of Health.Dr. J. Robertson’s annual report on the health of the city

during 1907 contains nothing startling but it is an eminentlysatisfactory record, for it shows steady progress towardsincreasingly better conditions except as regards the birth-rate. The mean death-rate was 16’ 3 per 1000, the birth-rate 28’ 3 per 1000, and the infantile death-rate 147 per1000. The general death-rate is satisfactory, but it willmost probably be considerably reduced during the next tenyears, as improvements are introduced in works and in houses.As regards the birth-rate it is nearly useless to say anythingfor we have no means of checking the decrease. The infant

mortality rate is still too high, though it is the lowest onrecord, but it certainly will be reduced if the new plans forthe visiting and instruction of mothers are successfully carriedout. A significant feature of the report is the statementthat the mortality from pulmonary tuberculosis amongstmen was as great again as that amongst women.March 4th.

MANCHESTER.

(FROM OUR OWN CORRESPONDENT.)

Overlying of Children.THE slaughter of the innocents, either by fire or suffoca-

tion, goes on apace. Yesterday three cases of overlyingwere inquired into by the deputy-coroner, Mr. W. Sellers,who said that cases of overlying of children " wereoccurring in Manchester almost every day, but therewere more during the week-ends." He went on to

say that it would have been thought that thesecases would occur when the mothers were in a heavysleep in the earlier parts of the morning, but inevery case the parents said that the children were all rightwhen they awoke in the early morning but were deadwhen they awoke again a few hours later. The ex-

planation may be that when in their heaviest sleep themothers are still and do not change their position but thatwhen sleeping more lightly they turn over and suffocate theirchildren. It is not improbable that if the parents did notget off as a matter of course with a verdict of accidentaldeath but might be exposed to a charge of manslaughterthis mode of reducing the population would receive acheck. There is another possible factor helping to bringabout the excess of these cases during "the week-end, as

750

that is the time in households where these cases commonlyoccur which is by preference devoted to extra drinking.

Lancashire Asylums.At the quarterly meeting of the Lancashire Asylums Board

on Feb. 27th it was decided to raise the rate of maintenancefor patients received at the asylums from unions within thecounty board’s district from 8s. 2d. to 8s. 9d. per week.This increase of charge is due to the balance having gonedown considerably from last year. Presumably it indicatesthe tendency which just now seems universal for prices, andtherefore expenses, to increase, the only exception being thetoo common lack of any corresponding increase of income.At the new asylum at Whalley the main building is to be 50yards south of the position originally intended. It was saidalso that between 300 and 400 patients were to be housed onthe villa system as a test of the cost and efficiency of thetreatment. It must be hoped that success will accompanythe experiment.

Mid- Cheshire Infirmaries.Dispensaries and hospitals cannot be traced back very far

in Mid-Cheshire. A provident dispensary was established atNorthwich in 1859 but it was not till 1887 that the VictoriaHospital with 25 beds was founded. In 1898 Winsford andMiddlewich followed the example of Northwich by providingthe Albert Infirmary with its 17 beds. These hospitals dosomething to relieve the pressure on those of the largetowns ; they are near the patients and are good for the localmembers of the profession, as they tend to keep theminterested and alert in regard to the progress of medicineand surgery. At the annual meeting of the supporters of thetwo institutions on Feb. 26th it was stated that there had beenan increase of 50 per cent. in the number of patients (323)and the accommodation had been severely taxed. The Albert

Infirmary had had 103 patients-the highest number recorded-and both institutions would welcome more donations andsubscriptions, though they are managed economically. One

pleasant feature is that the Working Men’s Hospital Satur-day Committee of Northwich had raised &pound;270, penny a monthcollections proving most helpful.

Crewe Ambulance Class.It seems quite appropriate for a railway town like Crewe

to have an ambulance class, and its success shows that themembers of the Crewe Cooperative Society, St. John Ambu-lance Class, 50 in all, have been earnest in the work, as theyhave all passed the examination with honours. Mr. J.Lawrence, M.R.C.S. Eng., L.R.C.P. Lond., has been pre-sented with a handsome cabinet.March 3rd.

WALES AND WESTERN COUNTIES NOTES.

(FROM OUR OWN CORRESPONDENTS.)

Cardiff Infirmary.THE whole of the &pound;30,000 required for the erection of a

new wing in connexion with the Cardiff Infirmary has nowbeen promised and Mr. John Cory, who promised provision-ally .65000, has sent this sum to the treasurer of the insti-tution. There are at present 184 beds in occupation-anumber quite insufficient for the needs of a district with apopulation approaching half a million. The annual reportof the governors states that the expenditure last yearamounted to .f.14,190 and that the income fell short ofthis amount by nearly &pound;3000. The additional wing willrequire, it is anticipated, another .f.4000 annually. At theannual meeting of the governors Mr. John Lynn Thomassuggested that the board of management should take intoconsideration the desirability of reorganising the constitu-tion of the institution in order to effect some economies inthe administration.

west wates Sanatorium.

In April, 1905, the Carmarthen county council decided tocontribute the sum of E500 towards the cost of the

Alltymynydd Sanatorium and to make an annual grant of.6130. In order to legalise these payments it was foundnecessary to take advantage of the provisions of the Isola-tion Hospitals Act, 1893, and an inquiry was recently held bythe council to decide whether an isolation hospital should beestablished in the county and whether, in accordance with

Section 26 of the Act, the council should declare pulmonarytuberculosis to be an infectious disease within the meaning ofthe Act so far as the county of Carmarthen was concerned.It was stated at the inquiry that the cost of the proposalwould entail a rate of only one-twentieth of a penny inthe &pound;. A majority of the county councillors who wereengaged in the inquiry decided to recommend the councilto take the necessary steps to enable the contributions namedto be given. It is to be regretted that this recommenda-tion did not meet with the approval of the whole councilwhen it came before it. Some members of the council

appear to have been influenced by a statement thatthe effect of making pulmonary tuberculosis an infectiousdisease in the county would be that the movementsof consumptive persons would be harassed. This viewis very distinctly traversed by Dr. H. Timbrell Bnlstrodein his recently issued report. He states that a

person suffering from pulmonary tuberculosis is not byvirtue of the action of a county council in making the-disease an " infectious disease " rendered amenable to any ofthe disabilities under the Public Health Act, 1875, or othermeasures relating to infectious diseases, nor is the disease byreason of such addition a notifiable disease. A consumptive.person is thereby subjected to no limitation of his movementsand to no disqualifications. "The application of the term’ infectious dsease ’ to pulmonary tuberculosis must, indeed,in this case be regarded rather as a legal technicality neces-sary to satisfy the terms of the statute than as a scientificdeclaration." 1

Anthrax in Ctlamorganshire.An outbreak of anthrax which up to the present has

affected seven men, one fatally, is reported from a smallvillage called Ynismudw situated in the rural district ofPontardawe, some ten miles to the north of Swansea. Duringthe early part of last month 15 cows had died on a farm inthe village. Upon a county veterinary inspector visiting thefarm he found that the carcasses after being cut up had beenburied only a few feet from the surface of the ground in a.field 250 yards from the farmhouse. He made arrangementsfor carrying out the regulations of the Board of Fisheriesand Agriculture and three of the men who assisted inthe work of exhumation and reburial were taken ill within aweek. They were admitted to the Swansea Hospital andfound to be suffering from anthrax ; and one, a butcher, whohad skinned one of the affected animals, had his forearmamputated on Feb. 27th. He died on the 29th, 14 days-after the date of the infection and eight days after he hadfirst complained of being ill. On March 2nd four other menwere reported to be ill from the same disease. They alllived in the vicinity of the infected farm but only one hadany direct connexion with it. At the last meeting of thesanitary committee of the Glamorgan county council it wasstated that some of the meat and the hide of one of theaffected animals had been disposed of in Swansea.

Medieal Inspection of School Children.At the quarterly meeting held on Feb. 13th the Cardigan-

shire county council agreed to arrange a conference betweenthe council, the education committee, and the severaldistrict councils in the county for the purpose of consideringthe question of medical inspection of school children in itsgeneral aspects and of deciding upon the feasibility of con-certed action on the part of the different authorities con-cerned. All the medical officers in the county will beinvited to attend. A motion was adopted in favour of thecost of the medical inspection being borne by the ImperialExchequer and not by local rates.

South Devon and East Cornwall Hospital, Plymouth.The annual meeting of the subscribers to this institution

was held on Feb. 28th under the presidency of Mr. F.Layland-Barratt, M.P. The medical report stated thatduring 1907 the in-patients admitted numbered 1413, com-pared with 1223 in 1906. The financial statement showedthat the receipts amounted to e7650 and the expenditurewas .E9807. The invested property of the hospital is nowover .6100,000. The chairman announced that the late SirMassey Lopes had bequeathed .B6000 to the institution,bringing his total donations to the sum of &pound;20,000.March 3rd.

1 Report on Sanatoria for Consumption, and Certain Other Aspectsof the Tuberculosis Question, by H. Timbrell Bulstrode, M.D., p. 143.