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enteric fever becoming carriers of the germs of these diseases ; -and what steps he proposed to take to secure that thesepreventive expedients did not lead to an increased spread ofthe diseases in question.-Mr. MACDONALD replied : I amadvised that when a majority of the child population have beenimmunised against diphtheria the danger will for all practicalpurposes disappear. There is no evidence that a communitya portion of which has been immunised against enteric fevercontains a greater proportion of carriers than one not soimmunised.

Mobile First-aid Units

Replying to a question Mr. MACDONALD said : The averagenumber of occasions on which a mobile first-aid unit has beensent to an incident in London during October and Novemberis 4-4. In addition, the doctor, usually accompanied by anurse, has been sent out without the rest of the unit on 5,3occasions on the average, making a total of approximately 10.Up to the present these units have been used rather less thanwas expected, but their use, which has proved of great value,must of course depend upon the nature of the incidents. Thenursing personnel are available to help in the work of thehospital or first-aid post on which the unit is based and toreinforce neighbouring first-aid posts when necessary.

Medical Officers in Air-raid SheltersMr. LiNDSAY asked how many boroughs within the London

region had now provided a medical officer in charge of shelters,a canteen or catering officer to supervise communal feeding,and a shelter welfare officer.-Mr. MAcDoNALD replied:-32 boroughs have made arrangements under which doctors

, are present in shelters all night, or pay regular visits, or are oncall if required, the exact nature of the arrangements depend-ing on the size of the shelter. 8 boroughs have appointeddoctors to the staff of the M.O.H. to assist him in the regularinspection of shelters. The second part of the question is amatter for the Minister of Food, the third part for the Ministerof Home Security ; but I understand that an officer to dealwith general shelter amenities, including food, has been

appointed in 24 boroughs. As regards shelter welfare officersI am informed that whilst boroughs have not been requiredto appoint such officers one or two boroughs have done so.

,

Surgery HoursCaptain PLUGGE asked the Minister whether he was aware

that panel doctors had, in many cases, made no attempt toadjust their consulting hours to black-out conditions and thatin consequence very few insured persons attended eveningsurgeries ; and what steps he proposed to take to remedythis.-Mr. MACDONALD replied : At the outbreak of war mydepartment recommended insurance committees to reviewthe arrangement of surgery hours, having regard to therestriction of lighting and other war conditions. I have noreason to think that there is, at the present time, any generaldissatisfaction as to surgery hours, but I shall be glad toinquire into any complaint.

Protection of Panel PracticesIn reply to a question Mr. MACDoNALD said he understood

that insurance medical practitioners who had suffered hard-ships by reason of air-raids were receiving every possibleassistance from the insurance committees and their profes-sional colleagues. Where his approval would be necessaryto an extension of the Protection of Practices Scheme inoperation in any area to cover practices which are in temporaryabeyance as the result of air-raids, he would be prepared toconsider the matter on application from the insurancecommittee.

Day NurseriesIn reply to Mr. THORNE, Mr. MAcDoNALD said the number

of day nurseries established under the normal M. & C.W.arrangements before the war was 103. The average cost wasestimated at 3s. per child per day, towards which the motherswere expected to contribute what they could afford. Mostof these nurseries had been evacuated from the towns and hadbecome residential homes. 23 day nurseries (with 995 places)for the young children of mothers who were munition workershad now been approved.

Protection against TyphoidMr. BROOxE asked the Minister whether he would make it

possible for all persons who so desired to get themselves in-oculated against typhoid fever free of charge or at a nominalcost.-Mr. MAcDoNALD replied : I have recently authorisedall local authorities to provide free facilities for inoculationagainst fevers of the typhoid group, and I have arranged for

supplies of the vaccine required for this purpose to be issued tothe authorities at the cost of the Exchequer.

Fortified Flour

Mr. DE LA BsBE asked the Parliamentary Secretary to theMinistry of Food whether he was now in a position to makesome further statement regarding the Government proposalsto introduce vitamin Bl into the bread supply to the publicthroughout the country.-Major LLOYD GEORGE replied :Yes, sir. An advisory committee, including scientists andrepresentatives of the various trade and other interests in-volved, has been appointed for consultation on administrativeand technical questions arising in connexion with the intro-duction of synthetic vitamin Bl and calcium into white flour.The committee have held two meetings and made recoi-ii-

mendations on numerous matters of principle and detail. Atthe same time negotiations have been proceeding with manu-facturers and potential manufacturers of aneurin, with theresult that I am able to confirm that it is expected that thedistribution of fortified flour on a national scale will com-mence next spring.

In reply to a further question Major Lloyd George saidthat at the moment one commercial firm and one only wasin a position to produce aneurin; other firms were gettingready.

Medical News

University of CambridgeAt recent examinations the following were successful :-

FINAL EXAMINATION FOR M.B., B. CHIR.

Part 1: surgery, midwifery and gn,ceeolog.-P. H. Abbott, P. S.Barclay, R. F. Bates, R. 1. S. Bayliss, S. L. Binderman, M. Q.Birkbeck, W. W. Brigden, W. R. Burkitt, A. E. Burns, D. Caddy,D. S. Cadman, W. E. Church, E. D. H. Cowen. D. Currie, R. Daley,J. 0. W. Dick, J. P. Donnell, W. M. M. Douglass, J. R. Ellis, A. G.Farr, J. Foley, G. C. Franklin, R. B. Franks, E. H. M. Gillieson,N. Gillman, S. C. Gold, E. C. E. Golden, J. 1. Hallinan, P. A. S.Hargrove, B. M. Heap, F. H. Howarth, A. D. Husband, G. T. James,M. D. King, A. Kinnier Wilson, E. F. Laidlaw, S. E. Large, A. G.Leishman, L. A. Little, J. F. Lucey, G. M. Lunn, F. N. Macnamara,0. D. Macnamara, W. D. Mail, A. E. de la Mallett, D. E. Marmion,R. Martlew, J. G. Mathewson, S. L. Melville, D. T. Milnes, J. N.Milnes, G. A. Mott, H. H. Nixon, J. F. North, M. S. M. Palmer,G. H.-Parkinson, J. Perrin, M. T. Pheils, G. F. Purves, E. S. Reed,W. J. B. Rogers, K. B. Rooke, C. S. Savage, F. E. T. Scott, R. D.Scott, W. M. Scott, C. G. R. Sell, J. W. Shrimpton, A. W. Simmins,J. A. Smith, J. M. Stansfeld, G. 0. Storey, W. H. Tattersall, J. G.Thurston, A. J. H. Tomlinson, A. B. Unwin, I. G. Wickes, A. H.Widdup, J. J. Wild, J. 0. D. Williams, and W. B. Young.

University of AberdeenOn Dec. 17 the following degrees were conferredf..D.—*A. R. R. Cumming.11LB., Ch.B.-J. C. Bowie, T. B. DaB"ídson, D. A. Grant, E. S.

Gray, E. G. Hendry, P. M. Jackson, M. 0. C. Jones, A. W. McBain,Norman Menzies, William Slater, William Stewart, Peter Tytler,M. G. Valentine. Commended.

At a meeting of the Royal College of Surgeons of Edinburghheld recently with Dr. H. M. Traquair, the president, in thechair, the following were admitted to the fellowship :-

L. H. Aitken, M.B. N.Z., A. S. Dill-Russell, M.B. Lond., C. J. H.Gibson, M.B. Sydney, Conrad Latto, M.B. St. And., C. T. Moller,M.B. Witwatersrand, Elizabeth McCallum, M.B. Edin., G. D.McDowall, M.B. Edin., I. A. M. MacLeod, M.B. Edin., M. S.Nirankari, M.B. Punjab and Henry Wapshaw, M.B. Glasg.

Lieutenant D. A. Draffin, M.B. Belf., R.A.M.C., who waspreviously reported missing, is now reported prisoner of war.The military cross has been awarded to Major W. D.

Jackson, M.B. Edin., R.A.M.C., and Lieutenant M. T. Read,M.R.C.S., R.A.M.C.The nursing recruitment centre, which was opened by the

Fund in April at 21, Cavendish Square, W.l, has dealt withsome 2000 inquiries on hospital training, and conditions and ,

prospects in the nursing profession. Talks on. nursing as acareer were arranged at 16 schools, information on pre-nursing courses throughout the country has been compiled,and advertisements and articles have been placed in news- .

papers and periodicals. The matrons of the 85 hospitals inthe Fund’s area which are approved as training schools havecooperated in the work of the centre and some of the largeteaching hospitals have referred to the centre candidates theywere unable to accept. Some 300 candidates have been

already placed by the centre.

Owing to war conditions the Industrial Health EducationSociety has resolved to wind up its work in arranging fortalks on the requirements for industrial health. The work

829

started in Scotland in 1927, a few years later it spread toEngland, and an average of 400 talks were arranged each yearall over the country. At a meeting held in Edinburgh, it wasresolved, that the remaining funds of the society should behanded over to the British’Medical Association to establisha Mackenzie lectureship on industrial hygiene, called afterMr. James Mackenzie, who began the work and continued asorganiser of the society.

-

The Margaret Ogilvie readership in ophthalmology in theUniversity of Oxford which is held in conjunction with thepost of senior surgeon at the Oxford Eye Hospital will bevacant on Sept. 30 next. The duties of the reader include

original research and teaching. With the expansion of theOxford medical school as a result of Lord Nuffield’s benefac-tion, it may be expected that the scope of the readershipboth on the research and on the teaching side will be enlarged.It is understood that the board of electors proposes to adver-tise the vacancy early in 1941 and that-full particulars willthen be given, especially of the facilities for research whichwill be provided.

Since the course of training for midwives has been dividedinto two parts it has become apparent that, though the entriesfor the first part are satisfactory, there are not sufficient pupilstaking the second part to maintain an adequate supply ofpractising midwives. Many nurses who wish to study mid-wifery but who do not intend to practise it take the first part,and in order to encourage more pupils to proceed to the secondpart of the course the Minister of Health is revising his systemof grants to recognised training schools. In future all candi-dates entering for the second period of training will beeligible for a grant for the first period, and candidates whocomplete the second period will receive a grant without beingasked to sign an undertaking to practise. As the grants aregiven to help the pupil midwives, the minister will not recog-nise a training school unless he is satisfied that the grants arebeing handed on to the pupils, either as salaries or as a reduc-tion in fees.

King Edward’s Hospital Fund has made a Christmasdistribution of :f:300,000 to the London voluntary hospitals.This brings the total amount distributed by the Fund sinceits foundation in 1897 to over 10,000,000. Twenty-twoadditional hospitals will benefit from this year’s distributionas the King’s Fund area has been extended to cover the wholeof the metropolitan police district.The Ross Institute of Tropical Hygiene has returned to

Keppel Street, Gower Street, London, W.C.I.CORRIGENDUM.—In the annotation on sulphathiazole

as a urinary antiseptic, on page 752 of THE LANCET of Dec. 14,the urinary concentrations found by Pool and Cook shouldhave been given as ranging from 16-8 to 222 mg. per 100’c.cm.

Births, Marriages and DeathsBIRTHS

BYNOE.—On Oct. 22, at Singapore, the wife of Dr. M. L. Bynoe,Malayan Medical Service-a son.

HADDEN.-On Dec. 18, at Bournemouth, the wife of Captain W. E.Hadden, M.B., the Nigeria Regt., seconded from ColonialMedical Service-a daughter.

HOLLINS.—On Dec. 18, at Lancaster, the wife of Dr. Charles Hollins,Colonial Medical Service-a son.

SCHUI.ENBERG.—On Dec. 16, at Farningham, the wife of Mr.C. A. R. Schulenburg, F.R.C.S.-a daughter.

MARRIAGESFRENCH—TAYLOR.—On Dec. 17, at Burgh Heath, Edward Brodie

French, lVLR.C.P., to Barbara Yvonne Taylor.TAYLOR-LAUDER THOMSON.—On Dec. 19, in Edinburgh, Arthur

W. Outram Taylor, M.B., Captain R.A.M.C., to Helena ScottLauder Thomson, M.B.

TEMPLETON—MORGAN.—On Dec. 16, at Fairlight, Sussex, WilliamTempleton, M.B., of Chichester, to Winifred Morgan.

DEATHSCOXWELL.—On Dec. 19, Charles Fillingham Coxwell, M.D. Camb.,

M.R.C.P., aged 83.DELBRUCK.—On Dec. 15, at Newquay, Cornwall, Raoul Ernest

Delbruck, M.B. Camb., of Cromwell Road, S.W.7.GREY.-On Dec. 17, at Hexham, Northumberland, Thomas

Campbell Grey, F.R.C.S., aged 73.HENDERSON.—On Dec. 17, at Parkstone, William Savile Henderson,

M.D.. Lpool.MARTINDELL.—In December, 1940, at Singapore, Ernest Walter

Martindell, M.D. Lond., D.T.M. & H., D.R.C.O.G.PROUDFOOT.—On Dec. 20, Frank Grégoire Proudfoot, M.A. St. And.

& Oxfd, M.D. Edin., Colonel A.M.S., T.A., consulting obstetric-

physician to the Radcliffe Infirmary, Oxford, aged 71.WALLACE.—On Dec. 16, William Wallace, M.D. Glasg., F.R.A.M.,

aged 80.

Notes, Comments and Abstracts

BOMBS OR HEALTH?

Mr. John Audric, headmaster of Brockham GreenSchool, Surrey, writes : Education in the vulnerable areassuch as the industrial north, certain south-coast townsand London, must be a serious business, and the imagina-tion of directors of education and teachers has beentested to the full. There are, however, towns which sofar have entirely escaped aerial attack. Others whichhave had bombs have not been singled out as a target,but have been damaged when an enemy pilot unloadedhis bombs in an attempt to escape. But this has alsohappened in villages remote from any military target.Indeed, many have suffered more than their neighbouringurban areas. The town schools have shelters and usethem ; the village schools without shelters carry onhoping for the best, and rely on the protection to befound in corridors, under desks, or behind wired windows.

This winter promises to be severe, and in less dangerousurban areas there are too many schools with an over-developed siren-complex. The wail of the siren is thecommand for a rapid exodus from the warm classroomsand a procession to the shelters. These shelters weremiserable enough in the summer ; they are already manytimes worse, and will become more so as winter wears on,when the children will be forced to shiver in the cold andgloom. Many children do not have too liberal a break-fast, and worse, this meal may have been hasty, especiallyif it has followed or preceded a paper round. Others arenot too strong, and were in pre-war days the regularhabitues of their council’s clinic.

Schools in the safer urban areas must choose betweenchance bombs or health. Today, very few shelters haveheating installed ; only a small number have efficientlighting and hurricane lamps must be used. Thoughsafer than the school building they are not safe from adirect hit. At night they are used by the public, andmany have been left in a disgusting condition. Infestedbedding has been brought in, and people suffering frominfectious diseases have been known to spend theirevenings there. The ventilation problem has not yetbeen solved. These are the havens some children haveto use whenever the siren wails.On the educational side it is useless to pretend that

much that is useful can be done. School magazines andjournals bravely print photographs of classes in art, butone is inclined to be sceptical when it is remembered thatthe equipment used by the children has to be removed atnight to allow the general public right of entry, and thatif the children do leave their classrooms immediately thewarning is sounded their progress to the shelter mustindeed be leisurely if all the apparatus in the photographsis gathered up and taken down. I know of scores ofschools where ever since war was declared whole sessionshave been spent in shelters and yet not a bomb has fallenanywhere near them. What, then, is the balance-sheetof their educational achievement ?In the village schools which have often no greater

immunity from attack than their neighbours in thetowns, education has proceeded normally, and the healthof the child has been unimpaired. The village boy orgirl has already distinct advantages, both physical andacademic, over his town neighbour.To the present school population will fall the task of

putting the world in order after this war, and they mustnot store up in their young bodies a legacy of ill health.Parents do not demand the elaborate security theteachers enforce. During holidays they allow their sonsand daughters to go walking and shopping, even to thepictures, regardless of all the sirens in the locality.While no-one would dare to suggest that grave risksshould be run by children in our established dangerzones, the children of our less dangerous areas are payingtoo great a price for their safety in their daily processionsto shelters.

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Messrs. BAYER have produced their admirable diariesagain this year, with a refill for each quarter and a fullpage for each day. In addition there is a section pro-vided for brief entries called " Two Years at a Glance "which encourages one to make plans as far ahead asJanuary 1943.