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523 PUBLIC HEALTH SERVICES. offered. Mr. Grandison thinks that this was due, not so much to antagonism or ignorance as to inconvenience-for example, the mother might find difficulty in accompanying the child at the time appointed. With such figures as 94-9 of sound temporary teeth after treatment, those responsible may be gratified by the success of the Cambridge dental scheme. Scarborough. Dr. S. Fox Linton introduces a detailed report by Dr. Anne Roxburgh. Scarborough is a town with rather a small child population, and there are some fortunate local circumstances and energetic social workers. The small numbers have perhaps been the reason for the absence of special schools; accommoda- tion has been found for several defective children in institutions belonging to other authorities. There is no open-air school, nor is it deemed so essential as in the large and industrial towns ; but for playing fields a piece of ground has been levelled on the Castle Hill and a large field has been rented by the Education Committee on the Northstead estate. The authority does not provide spectacles gratuitously; help is given to the poor children by the Amicable Society, often repaid by the parents in small weekly amounts. This Society also supplies cod-liver oil, milk, and free meals when needed. There are few cripples, so that an extensive orthopaedic scheme is not wanted ; but a clinic is held at the local hospital, attended by the orthopaedic surgeon, Dr.H.L.Crockatt, and a massage sister. Institutional treatment is obtained when required at the Kirbymoorside Orthopaedic Hospital. Cases of chronic deformities, such as those produced by old infantile paralysis under treatment by private practitioners or at the hospital, may need massage. This the poor can obtain by the help of the Council of Social Service, the parents paying what they can towards the cost. Some at least of the reduction in the number of infantile deformities may be due to the activity of the infant clinic, where the health visitor has the assistance of a strong body of voluntary workers; several cases of early rickets are at present under treatment there. Another factor for good is doubtless the nursery class, at which the infants are kept under close medical supervision. X ray treatment for ringworm will be provided by a private arrangement with a skin specialist in the town. Though there is no special M.D. school, there is a really adequate class for dull and backward, under a specially trained teacher, who has this year been given an assistant. A Council of Social Welfare, work- ing in conjunction with the Yorkshire Association of Mental Welfare, takes over the after-care of children leaving this class. While in many branches of the work the ordinary official methods have not been developed, keen unofficial agencies have creditably filled the gap. i MENTAL HOSPITAL REPORTS. THE 132nd report of The Retreat, York, records the gratifying fact that during the year 1928 over 69 per cent. of the patients admitted came as voluntary boarders, and the medical superintendent concludes that the era of the certified lunatic is’drawing to an end. On Dec. 31st there were 210 patients on the books, the number of admissions (126) being the highest on record. The recovery-rate was 25 per cent., which is a high figure for the standard in use. A patient is only put in the ’’ recovered " group when he is adjudged fit to resume his ordinary occupation without further supervision. The death-rate was 8-2 per cent. The general health was good, except for an outbreak of very mild paratyphoid fever which affected six patients and one nurse. A house was taken at Whitby for the summer months, and was much appreciated. The further development of occupa- tional therapy is being considered, and every effort is made to induce the patients to share in their own entertainment. Fifteen patients have parole outside and 34 inside the grounds. The main part of the building had to be re-roofed last summer; the slates taken away were the original ones put on in 1793. Fourteen male and 20 female nurses are certificated in mental nursing; a sister, who was appointed matron of the Gloucester County Mental Hospital last year, was the seventh Retreat official to be promoted to a matron’s post within six years. James Murray’s Royal Asylum, Perth, published its 102nd annual report for the year 1928-29. Ninety patients were admitted during the year-a record number—and the total on the books on March 31st was 192, an increase of 55 in four years. This increase has severely taxed the accommodation of the hospital, and a self-contained and detached reception block for 40 patients is to be built. The beds will be about equally divided between private rooms and dormitories, and the block will have its own nursing and domestic staff. There will be a surgery and dental room, clinical rooms, a laboratory, facilities for hydrotherapy and continuous baths, and an electrical treatment room with X ray apparatus and ultra-violet lamps. Acute cases will be sent to this block. The building has been so planned that another one like it can be erected near by in a few years if need arises. Many of the patients-over 62 per cent.-were admitted on a voluntary basis, and of these rather more than two-thirds were able to leave hospital restored or improved. Only about half the certified patients were discharged recovered. One general paralytic, treated by malaria followed by intensive antisyphilitic medication, has now been managing a successful business for 18 months. The death-rate was 9 per cent., and post-mortem examina- tions were made on half the fatal cases. The staff suffered a good deal from sickness during the year, but the hospital was remarkably free from epidemic disease despite the severe weather ; there was only one case of influenza and no tonsillitis. A long series of patients was treated by protein shock and another series by ovarian extracts, but the results were confused and uncertain, as were also the results of ultra-violet therapy. Septic foci have been sought and treated, and a number of urinary antiseptics were tried. The occupational therapy department was attended by a great many patients; rug-making, basket-work, leather-work, and wood-carving all attract much interest. Open-air treatment is extensively used. The dairy herd has been disposed of ; the fruit and vegetables did fairly well. A good deal of renovation has been carried out, and old- fashioned casements have been replaced by large panes or vita-glass. In January the carriages were replaced by a 24-h.p. seven-seater Austin limousine. Nine nurses sat for the R.M.P.A. certificate and were all successful, but there is a dearth of candidates for the State certificate. At the beginning of this year there were 668 patients in the City of Cardiff Menial Hospital, an increase of ten on the previous year. The death-rate was 9-26 per cent. and the recovery-rate 38-7 per cent. The general health was good ; there were three cases of tuberculosis, three of erysipelas, one of scarlet fever, and one of paratyphoid B. General paralysis was the cause of 34-84 per cent. of the deaths. Autopsies were held in all cases in which permission could be obtained. The dental surgeon has attended regularly throughout the year ; the gynaecologist has examined 32 patients and the aurist 53. A wireless set has been installed ; its cost was largely borne by members of the Japanese Community in London, in recognition of the care of certain Japanese patients in the hospital. The out-patient clinic in psychiatry is held weekly at the Cardiff Royal Infirmary, and the secretary attends there to follow up discharged cases. Various physiological tests are carried out on all suitable new patients, and investigations are being made into the condition of the vegetative nervous system, the blood cholesterol and hydrogen-ion- concentration, and the carbon dioxide combining-power of plasma.
