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exempting them from further deratisation for sixmonths; but, on the other hand, the sanitaryauthority is given authority to deratise a healthyship in exceptional circumstances and for well-founded reasons communicated in writing to the

captain. In this way the balance is maintainedbetween the desirability of keeping down the ratpopulation on ships and the hardship inflicted on

shipping interests by repeated and possibly unneces-sary deratisation. _

Regulations of Travel and Transit.Cholera.-The Convention recognises the impor-

tance of anticholera vaccination by exempting incertain cases persons vaccinated against cholera fromdetention under observation. The importance ofthe cholera carrier receives limited recognition only.The conference adopted the view that the examina-tion of healthy persons travelling on ships comingfrom an infected area demands such elaborateorganisation and technique and involves so muchinconvenience to passenger traffic that its enforce-ment is impracticable, and that reliance shouldrather be placed on anticholera vaccination. TheConvention, however, requires persons under observa-tion or surveillance to give facilities for bacterio-logical examinations if considered necessary ; thisenables healthy persons on an infected ship to beexamined for the cholera vibrio during the periodof observation or surveillance.

Yelloiv Fel’er.-The regulations dealing with thisdisease are remodelled so as to give full recognitionto the part played by Stegomyia calopus in itstransmission.Emigrants.-A new section is introduced dealing

with emigrants. This section enforces the medicalexamination of all pilgrims at the point of departure,so that rejections at the frontiers of countries oftransit and destination may be reduced to the fewestpossible, and recommends that certain medical andsanitary arrangements should be made at the portof departure and on the voyage.

Bills of Health.-Anew Article recommends (1) thatBills of Health should be issued free of charge ;(2) that charges for consular visas should be equiva-lent to the cost of service only; and (3) that specialagreements should be made with a view to the gradualabolition of consular visas and Bills of Health.When the Office International is working as an

intelligence ebureau and port authorities are in con-sequence kept fully and promptly informed of thesanitary conditions at other ports, the need for Billsof Health and consular visas will have ceased to exist.

Merchandise and Baggage.-The new Conventionlays down that merchandise and baggage arrivingby sea and land may not be forbidden either entryor transit. The only measures permitted are dis-insectisation, deratisation, and disinfection, andthese only in special circumstances. This is a greatadvance on the 1912 Convention which permits theprohibition of entry of merchandise in the case ofplague and cholera-a prohibition that cannot bejustified on epidemiological grounds.

t?’uMa.(/es.—The sanitary supervision of pilgrimstravelling by the Hedjaz railway, entrusted by the1912 Convention to the Constantinople SuperiorBoard of Health, which ceased to exist soon after theoutbreak of the world war, is now entrusted to theStates traversed by the railway. Similarly, thesanitary supervision of the Black Sea ports and theStraits, formerly under the charge of the sameBoard, is undertaken by the Turkish Governmentwhich is a signatory of the Convention.An important Article entrusts to the International

Quarantine Board of Egypt the duty of transmittingto the sanitary authorities of the countries concernedand to the Office International all sanitary informa-tion as to the pilgrimage and as to the sanitaryconditions of the countries through which the pilgrimspass. The International Quarantine Board, in addi-tion to its other functions, thus becomes an intelli-gence bureau for the pilgrimage area.

MEDICINE AND THE LAW.

Milk Prosecution: : sample 50 per eent. Defic’îentin Fat.

THE Sale of Food and Drugs Acts are intended toprotect the community from the disadvantages anddishonesties of adulteration. They penalise sales" to the prejudice of the purchaser " of articles offood or drugs which are "not of the nature, substance,and quality " demanded. Where the article of foodis milk, cream, butter, or cheese, the Minister ofAgriculture may make regulations determining whatdeficiency in the normal constituents of such foods,or what addition of extraneous matter or proportionof water, in any sample shall raise the presumption(until the contrary is proved) that the food is notgenuine or is injurious to health. In 1901 it wasprovided by the Sale of Milk Regulations that, if asample of milk (not being sold as skimmed, separated,or condensed milk) contained less than 3 per cent.of milk-fat, the milk should be presumed (until thecontrary was proved) not to be genuine by reason ofthe abstraction therefrom of milk-fat or the additionthereto of water. In discussing lately the unsuccessfulprosecution of a Norfolk farmer, it was shown thatthe standard of 3 per cent. of milk-fat can be easilyevaded. The farmer, it may be remembered, showedthat the deficiency of fat in a sample from his churns(a deficiency of 42 per cent. below the standard) wasnot due either to the abstraction of fat or to theaddition of water. He and other witnesses provedthat the milk had not been tampered with from thetime it left the cow to the time it reached the purchaser.He had a perfectly good explanation of the deficiency- namely, that he had been adopting a course ofpartial milking, the fore part of two cows’ milk beingplaced in churns for sale, the after part being leftfor the cows’ calves. The prosecution alleged it wascommon knowledge that in such a course of milkingthe fore part of the milk is less rich in fat. It iscommon sense that, if a farmer knows that he is givingthe calves the benefit as against the purchaser, hissale of the less rich milk (which thereby falls belowthe prescribed standard of purity) should be treatedas a sale to the prejudice of the purchaser. Thepurchaser should at least have a right to be told thathe is not getting what he expects. This, however,is not the law. Owing to the wording of the Acts andRegulations it was possible for the courts to decidein 1917 (in the Case of Grigg v. Smith) that, wherethere is a course of exceptional milking, the farmeris at liberty to prove his milk " genuine " if he provesthat it has not been tampered with. It is genuine,of course, in the sense that it is natural milk, takenfrom the cow, unadulterated and undiluted, but thepurchasers, who suppose that they are buying milkof the standard prescribed by the Regulations, arecertainly prejudiced. The farmer’s defence is easy.Unless there has been deliberate adulteration or

dilution, he can call witnesses to say the milk wasnever tampered with. He has only to explain to themagistrates that he had adopted a course of milkingwhich prejudices the quality of milk sold to thepurchaser, and he escapes any penalty for selling milkto the prejudice of the purchaser. In the recentNorfolk case the magistrates suggested to the farmerthat, if the after part of a cows’ milk was being leftfor her calf. the milk of that cow should not be placedon sale. In an earlier case it is believed that thebench suggested to another farmer who had employedthis defence that he should consider the use of oilcakeor other special food to improve the quality of thecow’s milk so that the purchaser did not suffer.But these magisterial suggestions carry no compulsion,and meanwhile the deficient milk is presumably soldat full price and the purchaser is, in fact if not in law,prejudiced.

This point has been emphasised by repetition sinceyet another milk prosecution has recently failed onthe same ground. The Ilfracombe Urban District

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Courcil, on Sept. 20th, prosecuted a farmer who hadsupplied milk of which a sample showed 50 per cent.deficiency in milk-fat. The bench dismissed the case,though holding the deficiency established, becauseit was not proved that the milk had been tamperedwith. The analyst reported that the sample did notcontain added water ; the prosecution suggested thatthere had been an addition of scalded milk. This thefarmer denied, though in cross-examination he admittedscalding his evening milk which he said he gave tohis calves and pigs. The statement made on behalfof the defence, as summarised in the North Devon iHerald, was that the farmer kept shorthorns and

I

crossbreds which were not rich milkers. One cowhad a calf running by her side ; another had justhad the calf taken from her. In such circumstances,it was frankly admitted, cows would hold their milkback and it was said to be well known that the fatwas contained in the last of the milk. If farmers willagree in this admission they will appreciate thepurchaser’s point of view. Calves are entitled totheir natural nourishment, but the law must somehow Imanage to prevent the nourishment of the calf z,interfering with that of invalids and children.

Chemist’s S1tpposed Error: Doctor’s InitialsIllegible.

’

A year or so ago in an action for damages in theHigh Court there was a question of the proper propor- ’i

tion of a drug prescribed by a doctor, and its decisionturned upon the correct deciphering of the figures inthe prescription. This case, in which the plaintiffdid not succeed, is indirectly recalled by a recentincident in which a Birmingham chemist is said tohave sold in error pills containing one-fourth insteadof one-fortieth of a grain of strychnine. The purchaserhad presented a prescription dated 1921, but thedoctor’s initials could not be deciphered, and thechemist, on discovering his error, was unable toidentify and warn the purchaser. The prescriptionbore the name of Mrs. Penn. In the hope of retrievingthe pills and avoiding any unfortunate consequencesof the error he believed himself to have committed,the chemist is understood to have sent telegrams to allpersons named Penn in the Birmingham directory andto have invoked the aid of the police and the publicityof the press and of the British Broadcasting Company.

It was a case apparently of absence of mind, notof misunderstanding the specified proportions of drugs.The lay public, however, will doubtless connect theincident with its habitual pessimism as to the legibilityand intelligibility of doctors’ prescriptions. Customhas sanctioned the use of the doctor’s initials just as,in the different field of marine insurance, custom hassanctioned the initialling of brokers’ slips. Initialsare accepted by the law courts as equivalent to fullsignature (if intended as such) in cases under theWills Act or in the authentication of agreementswithin the Statute of Frauds. In connexion with theDangerous Drugs Acts, where it may be importantto identify the writer of a prescription, regulationshave enacted that the prescription " must be inwriting, must be dated and signed by the medicalpractitioner, registered dentist, or registered veterinarysurgeon as the case may be, with his full name andaddress." Parliament has insisted upon clear hand-writing in dealing with another vocation. The Pawn-brokers Act of 1872 obliges pledge-books and pawn-tickets to be written " in a fair and legible manner."There is probably no other example of an expressstatutory obligation of legibility, though there areplentiful occasions when the law requires writtensignatures to certificates, records, and other documents.A deliberately illegible signature might conceivablybe held no signature at all.

THE LISTER CENTENARY.—The centenary of LordLister’s birth falls on April 5th next year, and the RoyalFaculty of Physicians and Surgeons of Glasgow, the Corpora-tion of the City, the University, and other local publicbodies are conferring as to the best method of celebratingthe occasion.

THE HUMAN FACTOR IN INDUSTRY.

REPORT OF THE INDUSTRIAL FATIGUERESEARCH BOARD.

REFERENCE was made in our issue of Sept. 18th tothe contents of the latest report 1 of the IndustrialFatigue Research Board ; some of the investiga-tions into human activity brought together in theadmirable analysis given of the Board’s work sinceits inception call for more extended notice.

Hours of Labour.The topical subject of hours of labour has

received much attention ; here is a matter of whichMr. W. L. Hichens rightly says2 it is " to-day asubject of political controversy rather than of scientificinquiry ; this is to be regretted...." Many studiesof output by the hour of each shift, by each shift ofthe day, and by each day of the week, have beenmade. Curves representing the results exhibit humanactivity as varying with the type of work performed ;for physical work the curve rises as the muscles warmup, but falls as fatigue comes on ; for monotonouswork the curve gradually declines, to rise as the spelldraws to an end. Maximum output, as exemplifiedby the curves for the best workers. is found associatedwith curves which rise steadily from hour to hour,from shift to shift, and from day to day. Outputbeing the objective of industry, study of curves sothat their shape may be improved by modifications inlength of spells, and in number of hours worked,and by organised rest pauses, becomes a subject forscientific research. Thus inquiries in steel smelting,tin-plate mills, and glass-making, when contrastedwith textile processes, show that increase in hourlyoutput follows reduction in hours of work in pro-portion to the extent to which the process is manualrather than automatic. The optimum periods forwork can clearly be determined by simpler and moreaccurate means than the hit-or-miss methods ofpresent-day disputes.

Other Factors : Ventilation, Illumination.Hours of work, however, can only refer to prevailing

conditions of labour ; if these latter are modified bvintroducing labour-saving devices, adequate ventila-tion or improved illumination, the problem alters.Here the subject of ventilation, including the tempera-ture and humidity of the air, has been the subjectof extended research following up the fundamentalprinciples laid down by J. S. Haldane and L. Hill.Thereby the whole outlook on ventilation has beenprofoundly changed ; the objective now is to producethe correct cooling power of the air, having regardto the work in progress, more for heavy work, lessfor sedentary work ; no longer are chemical impuritiesand emanations called in to explain the ill-effects ofstagnant air. Instances are quoted from a numberof industries of output varying from 10 to 15 per cent.with variations in the cooling power of the air.Ventilation is for the most part under direct control ; ;-but the different standards found in such diverseplaces as laundries, potters’ shops, shoe factories,and weaving sheds, indicate that this control is notwell exerted. Moreover, ventilation should be atleast as cooling for the head as for the feet ; thereverse more usually prevails, but when correctadjnstment is made comfort and output are increased.One’ of the most striking points throughout theinvestigations is that optimum conditions for output,whether by arrangement of hours or of environment,are found to coincide with a minimum of sicknessand of accidents-in other words, the greater is theattention paid to the human factor in industry the

’ Sixth Annual Report of the Industrial Fatigue ResearchBoard to Dec. 31st, 1925. H.M. Stationery Office. 1926.Pp. 126. 3s.

2 The Physical and Mental Effects of Fatigue in ModernIndustry. By W. L. Hichens, Brit. Med. Jour., Sept. llth,1926, p. 480.