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possibly dangerous duty. But the incident suggestsvarious questions. Are adequate official instructionsissued to the police for dealing with occasions of thiskind ? Is the possibility of veterinary examinationand of using a painless killer borne in mind ? Andwas any post-mortem or other investigation made toascertain if this was in fact a case of rabies ?

Dazzgerous Drugs Regulations : A Severe Sentence.The prosecution recently undertaken under the new

Dangerous Drugs Regulations, which specially prohibita drug addict from obtaining morphia preparationsthrough several practitioners without disclosing thefact, has ended in a severe sentence. Mr. Gill, theWestminster police-court magistrate, at a previoushearing, seemed willing to release the accused oncondition of his entering a home. At the final hearing,however, on Sept. 15th, a detective-inspector gaveevidence of the man’s criminal record which made aconsiderable difference to the magisterial disposal ofthe case. It appeared that the defendant had beenconvicted in different names of both fraud and house-breaking and that, though it was true that (as he hadstated) he was gassed during the war, he was sentencedto three years’ penal servitude in January, 1923.Mr. Gill passed a sentence of four months’ imprison-ment. It is hardly to b& supposed that a drug addictwho infringes the new Regulation will be so severelydealt with if his character is reasonably good.

NATIONAL HEALTH INSURANCE.

NEW ARRANGEMENTS FOR DENTAL BENEFIT.

SINCE July last a greatly increased number ofinsured persons have become entitled to dentalbenefit, the amount of money available for its provisionexceeds £2,000,000 per annum, and a large majorityof the approved societies and of the practising membersof the dental profession are now concerned. DuringJuly a Dental Benefit Joint Committee, consistingof 14 members representative of approved societiesand 14 of the dental profession, considered a newscale of fees and conditions of service, and early inAugust the report of this committee was approvedby the Consultative Councils in England and Scotland.

It is understood that private contracts betweenpatients and dentists for the payment of additionalfees are only permissible under this agreement inexceptional conditions or where some form of treat-ment or appliance is desired not provided for in thescale, and the insured person is prepared to meet theadditional charge. The committee recommended thatthe adoption of the new scale of dental chargesshould be conditional upon the institution of a serviceof regional dental officers charged with duties some-what similar in character to those of regional medicalofficers, and the Ministry of Health and Scottish Boardhave undertaken to frame a scheme for such a service,the expenses to be defrayed out of the funds availablefor dental benefit. Under the schemes of dentalbenefit now in operation it is a condition that thewhole of the cost of dental treatment shall be defrayedby the society, except that as regards provision ofartificial teeth and repairs and remodelling of denturesa society may decide to pay a proportion of the cost,not being less than one-half. This provision wasadopted on the advice of the Consultative Councilwith the object of encouraging conservative treatment.Apprehension having been expressed by certainsocieties that benefit under the new conditions mayexhaust the available funds, the central health depart-ments are considering the possibility of amendingthe scheme so as to permit a society in suitablecircumstances to pay a proportion only of the cost of-treatment, the principle of encouraging conservativetreatment being maintained. The Dental BenefitJoint Committee will also prepare a model dentalletter and formulate procedure for disciplinary.action.

,

Agreed Scale of Dental Charges.The following is the scale of dental charges for

members of approved societies, which has beenapproved by the Dental Benefit Joint Committee,and is to operate from Oct. 1st, 1926, to July 6th,1930 :-

£ s. d.1. Scaling and treatment of the gums-per individual 0 7 62. Fillings-per filling 0 7 63. Root treatment-

Six front teeth, upper or lower-per tooth.. 0 -5 0Remainder, upper or lower-per tooth.... 0 7 6

4. Crowns, gold or other-per crown .. .. .. 1 11 6Where root treatment is necessary, this may be

charged for at the rates shown in (3) above.5. (a) Extractions-

With or without local anæsthetic—per tooth.. 0 2 6Maximum fee for upper or lower 0 15 0Maximum fee for upper and lower .. .. 1 5 0

(b) General anaesthetics: (i) Administration fee-Upper or lower 0 7 6Upper and lower .. .. .. .. .. 0 10 0Where nitrous oxide or similar anaesthetic

(simple administration) is used, only one adminis-tration fee to be charged to each patient.Maximum fee for extractions, including simpleadministration of general anaesthetic—Upper or lower 1 2 6Upper and lower .. .. .. .. .. 1 15 0

(ii) Under prolonged anaesthesia. Where not less than ;.12 teeth are extracted at one operation under pro- -

-

longed anaesthesia, excluding the simple adn-iinis- -

tration of nitrous oxide or similar anaesthetic—* ’., , ’Dentist’s fee (including all extractions) .. .. 1 5 0Anaesthetist’s fee ..........’ *1 1 0 .

* Or such lower sum as the anaesthetist is ordinarily prepared toaccept.

6. Dentures-For first two teeth on a denture 1 0 0

For each additional tooth ... 0 5 6Fee for a full or nearly full (ten teeth or more)

upper or lower denture 3 0 0Fee for full or nearly full (ten teeth or more per

denture) upper and lower dentures.... 6 0 0Where the fee for full or nearly full denture applies

to the single denture, no charges under items(1), (2), or (3) above to arise in respect of thejaw concerned. Where the fee for full or nearlyfull dentures applies to the double dentures, nocharges under items (1), (2), or (3) above to arise.

7. Repairs, additions, and emergency treatment-Repairs and emergency treatment up to 10s.without previous submission of estimate-account to be rcndered to the society on thesociety’s recognised dental letter.

Minimum fee for repairs and/or additions.. 0 7 6Maximum fee for repairs and/or additions.. 1 10 0

8. Remakes-Fees to be calculated at two-thirds or, within

12 months, at one-half of the scale, withnecessary additional teeth at 5s. per tooth.

Maximum fee, including additional teeth, perdenture .. .. .. .. .. .. 2 10 0

9. Examination and report-Where patient does not return for treatment .. 0 2 6

Coitditions and Specification of Materials.j An appendix to the scale sets out the conditionsand specification of materials approved by thecommittee, and to come into force over the same period.The dentist shall apply to each case he undertakesthe degree of skill and attention necessary, irrespec-tively of whether the patient comes to him under theterms of this agreement or as a private patient.The agreed scale is based upon the understandingthat the dentist shall not be required to acceptinstalments or to incur the risk of bad debts, andmay decline to commence or proceed with the workuntil he has received the proportion of the cost payableby the member. Any society which does not under-take liability for the full cost of dentures shall makethis position clear to its members by an appropriatenotice upon its dental letter. Other conditionsbinding on the dentist are these :-

Bands, wires, and fastenings must be of gold withoutextra charge.

After multiple extractions impressions for a permanentdenture are not to be taken, except with the consent inwriting of the approved society, within a period of threemonths from the date of the final extraction, but when itis necessary to fit dentures before the mouth is ready forpermanent work, and the society approves this course,these must be of a permanent character and charged forat scale fees. These and all other new dentures are, ifnecessary, within ]2 months to be remodelled or remadeat one-half the original fee. It is understood that anynecessary adjustment of the dentures within a reasonable

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time after completion will be made by the dentist withoutadditional charge.The term " root treatment " is understood to mean either

of the following : (1) The devitalisation of the pulp of atootli and the subsequent removal of the pulp followed bythe necessary treatment and filling of each root of the tooth.(2) The treatment of septic root canals and subsequent fillingof each root. It does not include any dressing or treatmentof the pulp of a conservative nature.The anaesthetist’s fee includes the cost of the anaesthetic

as well as the cost of its administration. The choice of ananaesthetist will rest with the dentist performing the extrac-tions. The anaesthetist must in all cases of prolonged anges-thesia be either a medical practitioner or a dentist (otherthan the dentist performing the extractions) skilled in theadministration of a suitable general anaesthetic and includedin a list to be approved by the Dental Benefit JointCommittee.A dentist will be required to accept a dental letter only if it

is produced to him within 21 days of the date of its issue andwithin six weeks of the commencement of treatment. Hewill be entitled to be paid, for such treatment as is thencompleted, at the original rates agreed upon between himand the patient. For the remainder of the treatment he willbe entitled to the scale fees only. If a dental letter is pro-duced either more than 21 days after the date of its issue,or more than six weeks after the commencement of treatment,the dentist will be entitled, if he so desires, to be paid for thewhole of the treatment at the fees originally agreed upon.In order to avoid subsequent difficulties, the dentist beforearranging on the occasion of a patient’s first visit to chargeon the basis of his private fees, should endeavour to satisfyhimself as to whether the patient is or is not an insuredperson.

If a dentist is unable for any reason to complete thetreatment authorised in respect of any insured person, heshould notify the society concerned of the amount oftreatment completed, of any payment already made by theinsured person, and of the reasons for his inability to completethe remainder of the treatment.

If any doubt arises as to the correctness of interpreta-tion of the scale of dental charges, the matter shouldbe referred to the Secretary of the Dental Benefit JointCommittee, Ministry of Health, Whitehall, London,S.W. 1.

In the case of unforeseen conditions or unforeseen develop-ments arising during treatment after diagnosis and accept-ance of the estimate, the dentist may submit an additionalestimate.

When any estimate has been submitted to an approvedsociety and the society has questioned it, there shall beprovision for an appeal by either party to a professionalreferee or committee to be recognised by the Dental BenefitJoint Committee.

The specification of materials to be used in workfor members of approved societies provides thatfilling material is to be of first-grade quality manu-factured by the best-known manufacturers and suitablefor each individual cavity. In prosthetic work it islaid down :-

In vulcanite work, if pin teeth are used, all pins to be of(a) platinum, (b) nickel gold-cased, or cased with otherprecious metal, or (c) nickel alloy gold-cased, or cased withother precious metal, such as are made by the best-knownmanufacturers. Pins, gold or platinum, sheathed (i.e.,anchored) within the porcelain, are permissible. If diatoricsare used for anterior teeth, they are only to be used in caseswhere artificial gum is necessary and the upper anteriorteeth must be wired in. All vulcanite partial cases must besufficiently rigid. Metal strengtheners must be compatiblewith vulcanite and not liable to corrode in the mouth.Where gold has to be used for dentures by special estimate,it must not be less than 16 carat and must be of adequatestrength. Bands and wires to be of not less than 16-caratgold, and bands to be not less than 7 gauge.

CALEDONIAN MEDICAL SOCIETY.-The annual meet-ing of this society was held at Storrs Hall Hotel, Windermere,on Sept. 24th. Dr. W. E. Henderson, the President,M.O.H. for Vrestmorland, delivered an address on theHistorical and Literary Associations of Westmorland toa large audience. Sir Robert Jones, of Liverpool, andSir Samuel Scott, High Sheriff of Westmorland, were

elected honorary members, the annual dinner being held inthe evening. The 1927 meeting is to take place at Dundeeunder the presidency of Dr. Angus MacGillivray, while in1928 the society will celebrate its jubilee at Edinburghunder the joint presidency of its founders, Dr. S. RutherfordMacphail and Dr. W. A. Macnaughton.

SCOTLAND.

(FROM OUR OWN CORRESPONDENT.)

Courses for Health Visitors.LAST year the Scottish Board of Health arranged

some four courses of lectures, demonstrations, andspecial visits for the health visitors of Scotland. Acourse was conducted in each of the four large cities.The educational value of post-graduate training ismuch higher than that of primary courses, since, touse a term less common than it used to be in psychology,the post-graduate’s apperception masses are greaterand better organised when, through experience, theweak points in his or her knowledge have beendiscovered. The functions of the health visitor areso novel and have developed at such a pace withinthe last ten years that most of those appointed in theearlier stages of the child welfare movement welcomethe opportunity of seeing the great new developmentsat the city centres, and last year local authorities gavethe movement their cordial support. The attendancewas considerable, but it was felt that four such courseswere rather more than the circumstances justified,and the Board has now decided that requirements willbe met by courses held in the autumn and spring ateither Aberdeen, Dundee, Edinburgh, or Glasgow.Local authorities may pay to their health visitors thefee for the course, travelling expenses (third class), andsubsistence not exceeding 27 for the period. Thisexpenditure ranks against the maternity and childwelfare grant, or, in the case of whole-time tuberculosisnurses, against the tuberculosis maintenance grant.Since in Scotland the local education authority is anad hoc authority, these two grants cannot apply to theschool nurses, but the Board is

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prepared to approvethe attendance of school nurses at such refresher coursesas part of the Education Authority’s scheme for schoolhealth administration," and in this way the wholeground is covered.

It may be added that the Scottish NationalAssociation for Health Visitors, Women SanitaryInspectors, and School Nurses is a thriving body.At its annual meeting some special subject---forexample, ultra-violet light or venereal diseases-isdiscussed by a group of experts, and the Associationis entertained every year by some local authority.In this way both the health interest and the adminis-trative interest are kept in touch.

Nursing in Scottish Health Administration.To a booklet issued by the Alexandra Memorial

Fund Sir John Gilmour, Secretary of State forScotland, contributes an article on the Place of Nursingin Scottish Health Administration. He states that forhealth visiting in maternity service, child welfare,tuberculosis, school nursing, and combinations of these,the Scottish local authorities (town and county)employ about 430 whole-time trained health visitors.There are also about 400 part-time official healthvisitors, or part and whole-time school nurses. He

emphasises strongly the need for special socialtraining along the lines followed at the EdinburghUniversity School of Social Study and Training.Courses on similar lines are being organised inGlasgow. It is now fully recognised by medicalofficers and local authorities alike that a nurse’straining, indispensable as it is, is somewhat toorestricted for the full development of a health visitor’swork. In the cities, of course, there is always apreference for whole-time officers, but in the countiesthe large federations of county associations are

coming into greater favour.Women Citizens and Health Work.

The Edinburgh Women Citizens Association is oneof the most active educational bodies in Scotland.For the coming winter some 80 lectures have beenarranged, as well as visits to civic institutions andindustries. Some of the lectures are public, others aregiven at special study circles and are paid for by fee.Such subjects as mental deficiency and maternal