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or three years the number of new students has been so greatthat the Minister of Public Instruction is intending tolengthen the curriculum by one year in order to checkovercrowding, which is a great obstacle to the proper andpractical education of the students.

Newspaper Attacks on the Medical Profession.A tragic incident of recent occurrence has given rise to

much comment in the daily newspapers, some of the articlesthat have appeared being evidently intended to excite publicopinion against the medical faculty. The circumstanceswere that a very well-known n-terchant named Schöberl hadbeen killed by his son, who suffered from epilepsy andconsequent dementia. This son, who was 28 years of age,lived in his father’s house, and took a great interest incollecting and firing off pistols and rifles, with which he hadalready caused a panic at a summer villa in a village nearBudapest. A few days ago several members of the familywent to a theatre, Mr. Schöberl, who was 58 years of age,remaining at home with his imbecile son. The fatherseems to have found fault with his son for some reason,whereupon the latter with a pistol fired three bulletsinto his father’s head, and as the wounds were not

immediately fatal the murderer proceeded to strikehim on the head with a large stick until he died. The

newspapers are now mercilessly abusing the psychologistsand the faculty in general, because they allowed an imbecile,who was dangerous both to himself and to the community,to remain at large instead of being placed in an asylum.This argument is, no doubt, correct, but it is in evidencethat the young man had not previously shown symptomsof being dangerous. It is also true that intelligent parentsought not to allow their sons, even if they are quite sane, tocollect pistols. On the other hand, if a person of note isplaced in an asylum the medical men concerned are accusedby the newspapers of sending a sane person to an asylum atthe instigation of some interested individual.

Jan. 27th.

NOTES FROM SOUTH AFRICA.

(FROM OUR OWN CORRESPONDENT.)

Cape Hospitals and Charitable Institutions Ordinance. THE Ordinance dealing with the hospitals and charitable I,

institutions of the Province of the Cape of Good Hopetakes effect from March 1st, and applies to every State-aided hospital and charitable institution in the

province other than those controlled or maintained by theGovernment, by a local authority, or by any religious ’,organisation or body. Institutions, however, which are

reserved mainly for the aged or chronic sick are also

exempted from its operations. For all existing institutionshospital districts are created, corresponding with the fiscaldivisions within which they are situated ; but in the nativeterritories of the province, where there are no fiscal divisions,the areas of the hospital districts are left to be fixed by theAdministrator and his executive committee. In areas wherethere are no institutions the Provincial Government isenabled to establish new hospital districts by Proclamationon petition fiom not less than 25 Parliamentary voters, ifthe proposal has been duly advertised in the local papers,and no counter petition has been received thereafter from alike number of voters or from any local authority in theproposed district. In the event of a counter petition beingreceived by the Administrator, a new hospital district canbe established in the area only with the consent of theProvincial Council.Each hospital district will be under a board of from 6 to

36 members at the discretion of the Administrator after con-sultation with the old board. The local authorities will

appoint one-third on the basis of their rateable property inthe district. One-third will be elected by contributors tothe board funds, one-sixth by the honorary visiting medicalofficers, and one-sixth will be Government appointees. One-third of the board will retire annually in rotation, but.

subject to re-election or reappointment. A contributor isdefined as one who raises by any means not less than ,f,1 perannum or makes a donation of not less than £20 towardsthe board funds, and includes local subscribers-i. e. , thosewho do the same for a particular institution in the district,

also existing life governors and patrons. An annual meetingof contributors will elect members and receive reports on thedifferent institutions. Each institution will be governed,where there is only one in the district, by the board ; whenthere are more, by committees of management appointeddirectly by the board. For every ten members of the com-mittee the honorary visiting medical staff may elect twoadditional representatives. Stringent provisions forbidmembers of boards from trading with the institutions, a

serious abuse in the past. The boards will take over existingproperty from the old boards and control all such existingand future institutions. All necessary officers will beappointed by the boards or by committees of managementsubject to the board’s approval.During the Committee stage of the Bill it was alleged that

the existing system of staffing hospitals with Europeannurses was partly responsible for the " Black Peril," and animpracticable amendment was moved prohibiting Europeannurses from being employed in coloured or native wards.It was withdrawn and replaced by one requiring that withinsix months after the taking effect of the Ordinance everyboard must provide sufficient orderlies, ward-boys, native orcoloured ward-maids or nurses to perform all menial dutiesin wards where native or coloured male patients are treated,but enabling European nurses in these wards to supervisetheir work and to render necessary professional assistance.After discussion this was accepted by the Government. No

manager or matron of any institution can be appointed until12 days after the Administrator has been notified of theproposed appointment unless the Administrator has previouslyapproved thereof. The reason for this, apparently, is thatin the past unsatisfactory appointments have been made,owing to the boards not having taken the trouble to makeproper inquiries. Every matron, sister, staff nurse, headnurse or charge nurse, or midwire holding office under a

board is required to be registered as such by a ProvincialMedical Council, but the position of all existing officers isspecially safeguarded. This is a salutary provision, tendingto remedy a defect in the Cape Medical Act, which gives theMedical Council jurisdiction over the professional conduct ofregistered nurses but none whatever over unregisterednurses, thus making it an advantage for a nurse to remainunregistered.

Hitherto hospitals have been subsidised by grants from theState voted annually on no fixed principle, and varyinglargely in the past from political grounds. All this is nowdone away with, and a subsidy of 30s. for every £1 receivedin contributions or gifts of money other than bequestssubstituted. But in addition for every .61 received inbequests up to E500 the Provincial Government will pay 20s.,and a similar amount for every .61 received from payingpatients. The 30s. subsidy will extend to voluntary contri-butions by any local authority in a hospital district,provided that it is made before Sept. 30th in each year. Incase of a deficit in the funds of a board in any year, if theProvincial Government is satisfied that the board has

reasonably endeavoured to collect voluntary contributionsfrom the public and to recover fees from patients, andthat having regard to the circumstances of the districtand the class of patients furnished with relief a reason-

able amount has been received from all such sources

of revenue, it is empowered under the Ordinance to

authorise the payment of the deficit in whole or in

part in equal proportions out of the funds of thelocal authorities of the district and of the provincialrevenues. In any district where special circumstanceswould render it unfair that the whole of any amount tobe paid by the local authorities should be paid by them,the Provincial Government may reduce such amount bymaking a special grant not exceeding .f.150 in any calendaryear. Local authorities are encouraged to make voluntarycontributions, firstly by the Government subsidy of 30s. foreach P-1, and secondly by the fact that each local authority socontributing will get a special rebate of 20 per cent. of itscontribution at the expense of those that have not con-tributed. These financial proposals came in for much

criticism during the passage of the measure, but were

eventually approved of. If money is borrowed from theProvincial Government by the boards to erect new buildings,half of the sinking fund and interest charges will be bornedirectly by the Provincial Government, the other half beingtaken into the board’s accounts and again halved under

353

the subsidy plan. This is intended to encourage the

building of new hospitals, and especially of small cottagehospitals, which in outlying parts of the province are badlyrequired.

Boards will be empowered under Government sanction toestablish new hospitals, dispensaries, maternity homes,convalescent homes, sanatoriums, and institutions for anyother public charitable purpose within the meaning of theOrdinance, or for any two or more of the above-mentionedpurposes. The classification asked for by the South AfricanMedical Congress in 1910 has been adopted, and patientspaying 3s. 6d. per diem and over towards their maintenancemust, as far as practicable, in the absence of Governmentexemption, be provided with separate accommodation tothose receiving relief free or at a lower rate. They are alsoliable for medical fees to their medical attendant and,subject to regulations, are entitled to select such attendantwhether on the staff or not. Institutions may, however, beexempted from this temporarily. Relief may be refused tothose capable of paying the charges of an approved privatehospital or nursing home, save in exceptional cases. TheBill appears to aim at the establishment of three classesof hospital-namely, hospitals for paying patients notsubsidised by the State, hospitals for part-paying patients,and hospitals for the poor, the two latter classes beingsubsidised by the State.To prevent hospital abuse, except in cases of emergency,

every person seeking admission to an institution at less than7s. 6d. per day (which sum appears to be a trifle more thanthe daily average cost per diem) must supply certain

specified information and must produce a certificate fromhis medical attendant. An applicant knowingly furnishingfalse or misleading information to obtain from a boardtreatment free of. cost or at a lower rate will be guilty offraud and may be punished. The charges for the reliefgranted to any person will constitute a debt due by thatperson to the board, and the charge for relief to a

married woman or a minor will constitute a debtdue to the board by the husband of the married womanor the father, mother, or guardian, recoverable at law.

Lastly, provision is made for the appointment of a medicalinspector of hospitals and charitable institutions. He is

required to make an annual report on the working of theinstitutions for the Provincial Council. The measure asamended during its passage has not suffered materially froma medical standpoint, and, though a somewhat tentative andcomplicated piece of legislation, has been received with

approval by the profession and the general public. Itssuccess or otherwise must necessarily depend upon itsadministration, but with Sir Frederic de Waal as Adminis-trator of the Cape Province there is every reason to hopethat the Ordinance will be well and wisely administered.The latter, in bringing forward the Bill and in supportingthe views of the South African Medical Congress, when itwas before the House, has once again demonstrated hissympathy with the medical profession in a manner whichunfortunately is all too rare amongst South African statesmen.Jan. 10th.

ROYAL HOSPITAL FOR DISEASES OF THE CHEST.-A six months’ course on diseases of the chest (includingtuberculosis) was commenced at this hospital on Jan. 14th,when Dr. Barty King took for his subject Physical Examina-tion of the Chest. The lectures from Feb. 10th to 15th andfrom June 9th to 14th deal with tuberculin.

NATIONAL ASSOCIATION FOR THE PREVENTIONOF INFANT MORTALITY AND FOR THE WELFARE OF

INFANCY.-Under the auspices of this association the RightHon. John Burns will preside at an English-speaking con-ference on infant mortality, to which the King and Queenhave given their patronage. It will be held at Caxton Hall.Westminster, on August 4th and 5th, immediately before theInternational Medical Congress. The subjects for discus-sion include: The Responsibility of Central and LocalAuthorities in the Matter of Infant and Child Hygiene ; theAdministrative Control of the Milk-Supply ; the Necessityfor Special Education in Infant Hygiene ; Medical MilkProblems ; and Ante-Natal Hygiene. Sir Thomas Barlow,K.C.V.0., is the chairman of the executive committee.Further particulars may be obtained from the secretary,4, Tavistock-square, London, W.C.

Obituary.WILLIAM LIVESAY, M.D. EDIN.

THE death is announced in his sixty-eighth year, onJan. 24th, at the Pines, Bembridge, I.W., of Dr. WilliamLivesay, who practised for nearly 40 years at Sudbury, Derby.Born at Ventnor, he received his medical education at

Edinburgh, where he graduated M.B., C.M. in 1871, takinghis M.D. degree in 1875. He interrupted his medical studiesin 1869 in order to accompany Mr. (now Sir) James Lamonton a voyage of sport and discovery to Spitzbergen andNovaya Zemlya, acting as artist to the expedition. He after-wards edited the account of the voyage (I I Yachting in theArctic Seas." London : Chatto and Windus, 1876), the bookbeing profusely illustrated by woodcuts from his beautifuldrawings in black-and-white and water-colour. In those

days photography was not the convenient process fortravellers that it is now, and even water-colour drawing wasnot easy where, as he has recorded, his washes often frozeon the paper. In 1871-72 he was successively resident

surgeon to Mr. (afterwards Professor) Annandale, and resi-dent physician to Dr. Haldane, while he also received thedistinction of being one of the Presidents of the RoyalMedical Society. As a student he took great interestin botany, obtaining a prize for a herbarium, and onhis return from the Arctic he read a paper tothe Edinburgh Botanical Society on the plants he hadcollected on that voyage. His interest in botany had animportant influence on his life, for it was at the house ofProfessor John Hutton Balfour that he became engaged to adaughter of the late Dr. Thomas Shapter, of Exeter. Hemarried and settled at Sudbury, in Derbyshire, where heremained for the rest of his professional life. To his friendsit was somewhat of a disappointment that he aimed nohigher, but he was fond of the country and possessed privatemeans which made earning a large income no special object.He enjoyed his life., and generally managed to get a month inScotland every autumn, while he frequently travelled in thespring. He was an accomplished etcher, an associate of theSociety of English Etchers, but he published few plates ; hedesigned book plates for his friends, and for many years sentthem an etched Christmas card. About three years ago hisheart began to fail, possibly connected with an attack ofacute rheumatism he had in 1872. On the advice of hisfriends he retired from practice and went to live in the Isleof Wight, but last autumn his condition grew much worseand left no hope of his recovery. He possessed the giftof making friends, and will be missed by a wide circle whoappreciated his sterling goodness of heart, his love of fun,his ready wit, and his genial sympathy.He lost his wife many years ago, but two daughters

survive who have devoted themselves to the work of the

Wantage and East Grinstead Anglican Sisterhoods.

JOHN MILFORD BARNETT, M.D. EDIN., M. R. C. S. ENG.,MAJOR (RETIRED),I.M.S.

THE death occurred at Bexhill, Sussex, on Jan. 24th, ofSurgeon-Major John Milford Barnett, late of the IndianMedical Service. He was 82 years of age, and had residedat the Sussex health resort for some years. Born at Belfast,he was educated at Trinity College, Dublin, and EdinburghUniversity. Taking up the study of medicine, he becamea Licentiate in Midwifery at Coombe Hospital, Dublin, in1850, and two years later took his M.D. degree in Edinburgh,and became a member of the Royal College of Surgeons,England, in the same year. In 1853 he joined the BombayArtillery, and was off Bombay during the terrible cyclone inNovember, 1854, and in which he had a narrow escape fromdeath. In 1857 he served as surgeon of the 26th BombayRegiment, N.I., with the Persian Expedition, and waspresent during the forced march on Boorazjoon, the battleof Khooshab, in which he was wounded, and at thebombardment and capture of Mohumera and forts. In 1860he served as staff-surgeon of the Kattywar Field Force

against the Wagheers. Five years later he was promoted tothe rank of major, and he retired in 1869. He was twice

married, his second wife (a daughter of General Brooke

Boyd, of St. Leonards-on-Sea) surviving him, while foursons and three daughters also mourn their loss.