650

.f:l000 and JE2000; 11 between .f:800 and .f:1000 -;32 between .f:500 and JE800; and 47 between JE300and .f:500. Among those making incomes lessthan .f:300 per annum from panel practice, andparticularly among 88 practitioners who havemade less than £50, there are, no doubt, manywho only attend as patients under the InsuranceAct the servants and other dependents of their

private patients in the wealthier neighbourhoodsin which the bulk of their work is done. It will be

interesting to set the above figures beside thosethat will record the working of the Act at Man-chester during the current year. The figures givenfor panel practice at Leeds during ’1913 form auseful comparison. Out of about 190 medical menon the panels there, 5 have made incomes ofbetween £1000 and .f:1500, 7 between £800 and.E1000, 25 between jE500 and £800, and 27 betweenjE300 and JE500 ; 30 made less than £50. The above

figures, of course, take no account of partnerships.

LANCASHIRE INSURANCE COMMITTEE.At a recent meeting of the Lancashire Insurance

Committee a request was made by the MedicalBenefit Subcommittee for Chadderton, Crompton,and Royton that medical men on the panel shouldbe supplied with drugs and articles likely to berequired upon an emergency, and should draw fromsuch a stock in the event of insured personsapplying to them for treatment at a time when

druggists’ shops were closed. The practice of

making up prescriptions from their own stocks ofdrugs and keeping an account in accordance withthe requirements of the Insurance Committee inorder to obtain repayment was found to take up agreat deal of time. On the other hand, the clerkto the Insurance Committee pointed out that con-siderable clerical work -would be entailed upon thecommittee if the proposed change were adopted.Eventually the subcommittee’s recommendationwas approved subject to the County Medical Com-mittee and the County Pharmaceutical Committeebeing able to arrive at a working arrangement.

Medical News.UNIVERSITY OF OXFORD.-The Philip Walker

studentship in pathology, of the annual value of E200 andtenable for three years, has been awarded to Charles JosephSinger, D.M., Magdalen College.-The following medicaldegree has been conferred :-

D.M.—F. 0. Stohr, Trinity College. .

UNIVERSITY OF BRISTOL.-In the final examina-tion for the degrees of M.B., Ch.B., held recently, thefollowing candida.te was successful :-Maurice Charles Barber.

Lieutenant-Colonel Sir David Prain, directorof Kew Gardens, was nominated by the President of theBoard of Agriculture and Fisheries as one of the three repre-sentatives of that department at the International Conferenceon Phytopathology held at Rome this week.

THE CAMPAIGN AGAINST INFANT MORTALITY.-On Feb. 24th the Queen attended a matinee at the PalaceTheatre in aid of the Schools for Mothers in Fulham, Poplar,Shoreditch, and Stepney. These institutions are designedto give simple advice and instruction to working women,and are aimed directly against infant mortality. Originatingin Ghent, these schools, which have now spread over

Europe, were first tried in England at St. Pancras in 190’1.They have proved a great success in many districts ofLondon and in provincial towns, giving meals to women at anominal cost for six months before and a year after thebirth of a child, while medical men attend the schools twice

a week, when babies are weighed and the mothers advised asto their own health and’that of the children. Instruction inthe making and mending of clothes is also given, the wholeorganisation being put at the disposal of the women for ld. amonth. ’

ST. GEORGE’S HOSPITAL.-The annual dinnerof the Hunterian Society of this hospital will be held onFriday, March 13th, at the Waldorf Hotel, and will befollowed by a smoking concert. Tickets for the dinner willbe 6s., exclusive of wine, and those desirous of being presentshould communicate with the honorary secretaries of thesociety at the hospital.

’

THE TRAINED NURSES’ ANNUITY FUND.-TheCountess of Hardwicke, Lady Barlow, Lady Champneys,

: Mrs. Charles Balfour, and Miss Sidney Browne, members ofthe council of the Trained Nurses’ Annuity Fund, haveissued an appeal to nurses asking them to subscribe 1d. permonth with the object of forming a benevolent fund. Theaddress of the Trained Nurses’ Annuity Fund, of whichPrincess Christian of Schleswig-Holstein is the President, is73, Cheapside, London, E. C.

ASSOCIATION OF ASSISTANT MEDICAL OFFICERSOF ASYLUMS, ENGLAND AND WALES.—The executive ofthis association has issued a statement which is being, sentto all members and clerks of visiting committees of publicasylums in England and Wales. The statement summarisesthe various directions in which the association, desiresimprovement in the terms and conditions of service ofassistant asylum medical officers. These have been dealtwith on several recent occasions in THE LANCET, and thecase for reform was set out and discussed in- a leading articleon Jan. 10th last.

,

CONFERENCE ON THE TEACHING OF ANTHROPO-LOGY.-Members of the Royal Anthropological Institute,representatives of the universities, and others interestedin anthropology, met at the Drapers’ Hall, London, on

Feb. 19th, to discuss the practical application of the teach-ing of anthropology in the universities. Lord Selbornepresided, and Sir Henry Craik, M.F., moved a resolutionwhich approved the findings of the joint committee of theBritish Association and of the Institute, and declared thatin the highest interests of the Empire the extension andorganisation of the ’teaching of anthropology in the uni-versities of Great Britain was necessary. Professor A. Keith,the president of the Institute, pointed out the lost oppor-tunities for good which were the result of travellers toremote parts of the Empire not having sufficient knowledgeof anthropology. The Institute ’wished to systematise allthe information that it had gained and to place thatinformation at the disposal of every university graduate.The resolution having been adopted, Sir Hercules Readmoved that the chairman and members of the joint com-mittee represent to the Prime Minister the views of theconference and ask for the appointment of an inter-

departmental committee for advising as to the form inwhich the sympathy and support of the Government couldbe best expressed. Professor T. H. Warren seconded, andthe motion, which was supported by Dr. W. L. H.Duckworth, Professor J. G. Frazer, and Dr. W. P.

Herringham, was passed unanimously.

Parliamentary Intelligence.NOTES ON CURRENT TOPICS.

Elementary Education (Defective and Epileptic Children) Bill.

THE Elementary Education (Defective and EpilepticChildren) Bill, which has been introduced into the House otCommons by Mr. PEASE, the President of the Board ofEducation, has been printed. It lays down that it shall bethe duty of the local education authority for the purposes ofthe Elementary Education (Defective and Epileptic Children)Act, 1899, to make suitable provision for the education ofchildren belonging to their area whose age exceeds sevenyears, and who are ascertained to be mentally defectivewithin the meaning of the Act.

.

Inebriates Bill.A Bill "to consolidate and amend the law relating to

inebriates has been introduced into the House of Commons

651by Mr. ELLis GRIFFITH, the Under Secretary for the HomeDepartment. It has been read a first time.

Higher Animals Protection Bill.Mr. CATHCART WASON, with the support of Mr. Cowarr

and Mr. WEBB, has presented a Bill in the House ofCommons "to prohibit the vivisection of the higheranimals." It has been read a first time.

The Insurance Act.In the House of Commons on Wednesday, Feb. 25th, an

animated debate took place on a motion brought forwardby Mr. HAMILTON to the effect that an inquiry ought to beinstituted to report whether it was desirable to substitutea voluntary system for the compulsory system of insur-ance under the National Insurance Act. The discussionturned largely upon the financial stability of the existingsystem. The Chancellor of the Exchequer resisted themotion, admitting that in time it would be desirable toinquire fully into the working of the present Act. Mr.LLOYD GEORGE strongly combated the idea of a voluntarysystem. Mr. BONAR LAW, the leader of the Opposition,supported the motion, which was ultimately rejected by283 votes to 199.

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HOUSE OF COMMONS.

WEDNESDAY, FEB. 18TH.

Hospital Accommodation in Jamaica.Sir JOHN JARDINE asked the Secretary of State for the

Colonies whether anything had lately been done by theGovernment of Jamaica to increase the hospital accommoda-tion in that island, especially in districts remote from exist-ing hospitals; and whether anything had been done toutilise the services of ordinary independent medicalpractitioners, especially in districts reported upon as

containing an extraordinary number of cases of syphilis.- Mr. L. HARCOURT answered: In reply to the first part ofthe question, hospital accommodation in Jamaica hasbeen steadily augmented for a number of years past bothby extension of building and by provision of additionalbeds. Comparison of the Blue-book for 1912-13 withthat of three years before shows an addition of nearly250 beds to the provincial hospitals. A new cottagehospital was provided last year at Ulster Spring, a

district remote from existing hospitals. During 1911-12and the ensuing year out-patients’ departments havebeen established at all the hospitals, and in the latteryear the number of out-patients attended to in thedistricts, in addition to those treated at the out-patients’departments of the hospitals, amounted to over 45,000.The medical expenditure since 1907-8 has increased by nearly90 per cent., and in the current financial year nearly £11,000has been provided for new works, as against £522 at thebeginning of the period. The answer to the last part of thequestion is in the negative, but special provision has beenmade to utilise the Government medical service for dealingwith disease in such districts.

Medical Treatment of litsitrecl Persons.Mr. R. GWYNNE asked the Chancellor of the Exchequer

whether his attention had been called to cases in whichinsured persons, on moving their residence, had beenrefused medical treatment by panel doctors on the groundsthat they had recently had a touch of influenza and weretherefore in need of a bottle of medicine; whether doctors,in so acting, complied with the Regulations which governedthe administration of the sickness benefit under the NationalInsurance Act; and, if so, what steps insured persons wereto take to obtain advice and medicine if all the local doctorson the panel act similarly.-Mr. WEDGWOOD BENN (whoreplied) said : No cases of the kind referred to have come tothe notice of my right honourable friend. Medical men onthe panel have, of course, a right under the NationalInsurance Act, 1911, to refuse in the first instance to acceptan individual insured person, but arrangements have beenmade whereby a medical man may be obtained by anyinsured person so refused. If the honourable gentlemanknows of a case where the arrangement has been broken I’shall be very glad to know about it.

The Cost of Medical Treatment.Mr. F. HALL (Dulwich) in the course of a question

addressed to the Chancellor of the Duchy asked whether theTreasury estimates of the cost of treating insured personshad been exceeded; whether there were enough funds in thecase of the London Insurance Committee to give propermedical treatment to insured patients ; and whether it hadbeen suggested to the London County Council that halfof the deficiency should be met out of the rates.-Mr.WEDGWOOD BENN (who replied) said: Under the arrange-ments entered into between Insurance Committees--including the London Insurance Committee-and . thedoctors on their respective panels, no deficit can occur uponthe funds available for defraying their liabilities to thosedoctors, and the rest of the question does not therefore arise.

Sanatoria in Derbyshire. ’

Mr. THOMAS asked the Secretary to the Treasury whetherthe Insurance Commissioners had taken any steps to safe-guard patients whom they were sending to sanatoria in

Derbyshire against the infringement of the provisions ofSubsection 2 (e) of Section 14 of the National Insurance Actby the managers of those institutions ; and whether he wouldprohibit the payment of any money by the Insurance Com-mittees to any sanatoria in Derbyshire the managers ofwhich might refuse to respect conscience in the mannerprovided in the above-mentioned subsection.-Mr. WEDG-WOOD BENN answered : The duty of making arrangements toprovide treatment for tuberculous insured persons in insti-tutions or otherwise and of considering cases with a view torecommendation for such treatment is by the Act laid uponInsurance Committees, not upon the Insurance Commis-sioners. The arrangements made by the Insurance Com-mittees require the Commissioners’ approval, and in no casedo they impose any obligation upon insured persons to submitto vaccination as a condition of their being recommended fortreatment.

Sickness in Cradley.Mr. G. LOCKER-LAMPSON asked the Secretary to the

Treasury whether his attention had been called to a reportof a Worcestershire Insurance Subcommittee on thesickness in Cradley, in which statements of Mr. Appleton,secretary to the General Federation of Trade UnionsApproved Society, were admitted to the effect that thesickness-rate amongst female workers in the district wasenormous and was between 6 per cent. and 7 per cent., orthree times the normal; and whether, if this rate was con-tinued until the first valuation, it would entail a very heavylevy on, or a reduction of benefits to, the compulsorilyinsured members.-Mr. WEDGWOOD BENN said in reply : Myright honourable friend has- seen the report, but it does notappear that the figures have been tested. In any case sinceApproved Societies or branches of societies and notgeographical districts are the units for valuation purposes,the benefits of insured persons resident in Cradley districtwill be governed after the first valuation (subject to theprovisions of the Act for pooling surpluses and deficiencies)by the general experience of the different Approved Societiesor branches of which they have respectively becomemembers.

Sanatorium Benefit in Fife.The Marquis of TULLIBARDINE asked the Secretary to the

Treasury how many persons had -applied for sanatoriumbenefit in the county of Fife since Oct. 15th, 1913 ; and howmany of these had received it under the provisions of theNational Insurance Act, including any applicants whoseapplications were standing over at the date mentioned.-Mr. WEDGWOOD BENN (who replied) said: The answer tothe first part of the noble lord’s question is 48. Five applica-tions were outstanding at the date which he mentions and49 persons have received treatment since that date.

A Case of Antlarax Poisoning.Mr. C. BATHURST asked the Home Secretary whether his

attention had been directed to a recent inquest upon awaterside labourer who died in Guy’s Hospital on Dec. 21stlast from anthrax poisoning, at which the jury, in returninga verdict of accidental death from such poisoning, expressedthe opinion that the Home Office should extend the regula-tions of the Factories and Workshops Act, which appliedonly to anthrax in factories and workshops, to wharves andother places where horsehair, hides, skins, and pigs’ bristleswere dealt with ; whether he was aware that the Depart-mental Committee on Foot-end-Mouth Disease recentlycalled attention to the danger of such substances, unlesseffectively disinfected, becoming carriers of anthrax andother animal diseases; and whether he proposed as theresult of the above fatality to take any action in thedirection suggested by the coroner’s jury.-Mr. McKENNAsaid in reply: The answer to the honourable Member’s firsttwo questions is in the affirmative. The rules referredto cannot be extended in their present form to wharvesor to any place other than factories and workshopsbecause they were made under the old Factory Act of 1891,which applied only to factories and workshops, but I hopeto be able shortly, when certain inquiries now on hand havebeen completed, to replace those rules by fuller regulationsunder the Factory and Workshop Act of 1901, and the ques-tion of applying these regulations to wharves and ware-houses where the danger may arise will receive very careful

consideration.Mr. C. BATHURST: Does the right honourable gentleman

realise the importance of greater cooperation between theHome Office and the Board of Agriculture in respect to fataldiseases which are common both to animals and men ?-Mr.McEENNA: Yes, certainly.

THURSDAY, FEB. 19TH.Approved Societies and Benefits to Tl’oitteit.

Mr. G. LOCKER-LAMPSON asked the Secretary to theTreasury whether one of the consequences of a threatened

652

deficiency of Approved Societies under the National InsuranceAct was the refusal of benefits by some societies to womenwho were certified as incapable of work owing to pregnancy ;and, if so, what steps the Commissioners and the Govern-ment were taking in the matter.-Mr. WEDGWOODBENN (who replied) said: Societies are responsibilefor determining in the first instance whether an insuredperson claiming sickness benefit satisfies the condi-tions of Section 8 (i.) (o) of the Act of 1911 of beingrendered incapable of work by specific disease or disable-ment. The Commissioners have no reason to think thatsocieties are refusing benefit in cases where they considerthat this condition is satisfied.Mr. G. LOCKER-LAMPSON : Is the honourable gentleman

aware that one of the medical referees has reported to theLondon Insurance Committee that this is being done ?-Mr.WEDGWOOD BENN: No, sir. I shall be glad if the honour-able gentleman will give me the statement made by themedical referee.

County Councils and the Treatment of Tuberculosis.Replying to Mr. G. LOCKER-LAMPSON, Mr. HERBERT

SAMUEL (President of the Local Government Board) said:The great majority of county councils and councils of countyboroughs in England have submitted schemes for the pro-vision of institutional treatment of tuberculosis, whichtreatment will be available for all classes of the community.In some few instances the schemes are at present limited tothe provision of dispensary treatment. Six county councilsout of 50 and seven councils of county boroughs out of thetotal of 75 have not yet submitted proposals, and ’thedepartment is in communication with these authorities.I understand that proposals will shortly be submitted by theLondon County Council for providing additional sanatoriumaccommodation.Mr. LOCKER-LAMPSON further asked whether in some

districts no accommodation was available for advancedcases of tuberculosis among insured persons under theNational Insurance Act.-Mr. HERBERT SAMUEL answered:In Eome districts there is insufficient accommodation atpresent for advanced cases of tuberculosis, but it will begathered from the answer I have just given that county andcounty borough councils generally are taking steps toprovide additional accommodation for such cases as part oftheir schemes for the institutional treatment of the diseasein all classes of the community. The question is receivingmy immediate attention.Sir RANDOLF BAKER asked the right honourable

gentleman to state how many county councils had builtsanatoria since the coming into operation of the NationalInsurance Act and how many had taken no steps beyondthe provision of dispensary treatment.-Mr. HERBERTSAMUEL replied : County councils are providing the neces-sary sanatorium accommodation in various ways. Ninecounty councils have already acquired existing buildings orprovided new buildings, eight have acquired beds at existinginstitutions and are arranging for extensions to be providedfor the use of the council, and ten have purchased or proposeto purchase -sites for the erection of new buildings. Theother councils which propose to provide sanatorium accommo-dation as part of their schemes have not yet definitelydecided in what way the accommodation shall be provided.Only seven of the councils have limited their schemes for thepresent to dispensary treatment.

Progressive Decline of the Birth-rate.Sir WALTER ESSEX asked the Prime Minister whether he

had in contemplation an inquiry by a Commission or other-wise into the progressive decline in the birth-rate in theUnited Kingdom.-Mr. AsQUITH answered : I understandthat the matter is the subject of an inquiry on which theLocal Government Board and the General Register Officeare represented. It does not, therefore, seem that anyfurther inquiry is necessary at present.

’

Returns on Industrial Poisoning.Mr. NOEL BuxTON asked the Home Secretary whether the

’cases of industrial poisoning which appeared under thehead of diseases of occupation in the Board of Trade LabourGazette included only those furnished by the certifyingsurgeons ; whether there were a certain number of cases inwhich the medical referee overrode the decision of thecertifying surgeon ; whether a corrected list would show adifference in the number of cases of industrial poisoning ;whether the figures in the Board of Trade Labour Gazettewere invalidated by the absence of any reference to thedecisions of the medical referee ; and whether the figures as’modified by the medical referee’s decision appeared in anyother return.-Mr. McKENNA replied : The returns of indus-trial poisoning to which the question refers include all caseswhether reported by the certifying surgeon, by medicalpractitioners, or by occupiers. It occasionally happens thatthe certifying surgeon’s opinion is subsequently overruledby the medical referee. So far as practicable allowance hasbeen made for these cases in the annual return published in

the January number of the Gazette, but the cases are sofew as not to affect the substantial accuracy of the monthlyreturns.

T7accitiation in the Navy.Mr. WILLIAM THORNE asked the President of the Local

Government Board whether the calf vaccine lymph used forthe Navy was supplied by his department; whether he wasaware that according to the annual reports of the health ofthe Navy the cases of cow-pox placed on the sick list in con-sequence of vaccination, which were 233 in 1908, had in-creased to 482 in 1909, to 688 in 1910, to 845 in 1911, and to1255 in 1912 ; whether he could give any explanation of theseincreases of the ill effects of the operation ; and whether hewould consider the advisability of suspending the issuing of-vaccine lymph until such time as there was a considerable im-provement upon the present variety.-Mr. HERBERT SAMUEL.replied : The answer to the first two parts of the questionis in the affirmative. As regards the third part of thequestion, I understand that the increase in the number ofcases placed on the sick list is due chiefiy to the muchgreater care now exercised in preventing the possibility ofuntoward occurrences following on vaccination. With this.object in view men and boys are now in a greater number ofcases recorded as being on the sick list after vaccination, andare consequently excused from duty for a few days. The-character of the lymph supplied has no bearing on thequestion, and I see no reason for any alteration of thepresent procedure.

Hop Substitutes in Breiving.Mr. HERBERT LEWIS s (Parliamentary Secretary to the

Local Government Board) informed Mr. ROWLANDS that itwas not proposed to reintroduce this session the Bill to.prohibit the use of hop substitutes in brewing.

MONDAY, FEB. 23RD.

Sanatorium Benefit.Mr. WEDGWOOD BENN informed Mr. GODFREY LOCKER-

LAMPSON that a return on the subject of the administrationof sanatorium benefit was in course of preparation andwould shortly be laid before the House.

Insured Persons and the Selection of Medical Men,Replying to Mr. BuTCAER, Mr. WEDGWOOD BENN said r

Under the Regulations issued under the National InsuranceAct insured persons who had selected or had been assigned toa medical man in the course of last year are deemed to haveselected that doctor for the current year unless they gave thenotice required of their intention to make a fresh selection.

Insurance Drug Fund in Illanchester.Mr. GODFREY LOCKER-LAMPSON asked the Secretary to the

Treasury whether there was a deficiency in the insurancedrug fund in the Manchester district to the extent of about£16,000 ; and, if so, whether, in consequence, chemists on thepanel had only been paid 50 per cent. of their accounts.during the three latter months of 1913 and only about 27 percent. for December, although it was one of their heaviestmonths; and what the Government proposed to do in thematter.—Mr. WEDGWOOD BENN replied: My right honour-able friend is informed that the total sums already paid or inthe course of being paid by way of advances amount to-approximately 60 per cent. of the total amount of theaccounts presented for this year. It is not, however, possibleto estimate what further sums will be payable until thoseaccounts have been scrutinised in accordance with theRegulations and the total sums available to the InsuranceCommittee for the purpose have been finally ascertained.

Distribution of Insurance Funds.Colonel GREIG asked the Secretary to the Treasury

whether the accumulated funds in the hands of the Insur-ance Committees in Scotland, arising from payments formedical benefit for insured persons who had not yet claimedor did not desire to claim a panel doctor, were to be distri-buted among the existing panel doctors or to be otherwiseapplicable and, if so, how; whether any regulation had beenlaid down in London or elsewhere for the application of suchfunds ; and whether such regulation was applicable in Scot-land.-Mr. WEDGWOOD BENN wrote in reply: Both in Scot-land and elsewhere in Great Britain the whole of the sumsavailable to a committee in respect of the responsibility forthe treatment of those insured persons (including the personsreferred to in the question) who have not been allowed orrequired to make their own arrangements " and who havenot selected an approved system or institution are payable,under the regulations and the agreements entered intobetween committees and doctors, to the doctors on the panelupon whom that responsibility devolves.

TUESDAY, FEB. 24TH.Distribution of Insurance Funds.

Sir HENRY CRAIK asked the Secretary to the Treasury whythe amount accruing in respect of insured persons who hadnot chosen a doctor, and had not been assigned to any doctor

653

on the panel, had not been distributed by the London Insur-ance Committee.-Mr. WEDGWOOD BENN replied: My righthonourable friend understands that the matter of the distri-bution of funds is receiving the attention of the LondonInsurance Committee.

Excessive Sickness at Cradley.Mr. GODFREY LOCKER-LAMPSON asked the Chancellor of the

Exchequer whether he was aware that certain members ofthe county of Worcester Insurance Committee recentlv heldan inquiry into an alleged shortage of doctors in Cradley;that the inquiry disclosed excessive sickness; and that thedoctors alleged at the inquiry that some Approved Societies,to help themselves out of the difficulty of inevitable in-solvency, were refusing to give sickness benefit for certaindiseases, a list of which had been made out and included goutand bronchitis ; and seeing that the societies’ members werethereby necessarily suffering, whether the Governmentproposed to make a grant to the societies concerned, so thatthe members might obtain their rights, and the fears ofinsolvency with levies or decreased benefits might beremoved.-Mr. WEDGWOOD BENN (who replied) said : Theanswer to the first part of the question is in the affirmative.As regards the second and third parts, the subcommitteereferred to reported that they had no means of confirmingthe allegations and expressed no opinion upon them. Theremaining part of the question does not therefore arise.

Machine-Skimmed Condensed Milk,Mr. BARNSTON asked the President of the Local Govern-

ment Board whether he intended to issue an order, underthe Public Health (Regulations as to Food) Act, 1907, regula-ting the sale of machine-skimmed condensed milk, or whetherhe would take any other action to give effect to the recom-mendations contained in Dr. Coutts’s Report to the LocalGovernment Board on the use of condensed milks as infants’foods in August, 1911.-Mr. HERBERT SAMUEL answered :The question of making regulations on the subject referredto is now under consideration, but I am not yet in a positionto make a statement on the matter.

WEDNESDAY, FEB. 25TH. Allocation of Insured Persons.

Mr. BUTCHER asked the Secretary to the Treasury whetherhe was aware that the allocation of insured persons to adoctor who had not been selected by them had given and wasgiving rise to discontent and dissatisfaction ; whether sur-prise and dissatisfaction had been caused bv the interpreta-tion which had been placed by the National InsuranceCommissioners on Form 110/I.C. to the effect that a personwho had been allocated to a doctor whom he had not selectedwas deemed to have selected that doctor; and whether theCommissioners would issue, or cause to be issued, to insuredpersons a circular instructing them what steps they shouldtake if they wished to change the doctor whom they had notselected but to whom they had been allocated.-Mr. WEDG-WOOD BENN (who replied) said: Under the Regulationsnow in force no allocation is carried out, except upon theapplication of insured persons themselves. It was open toinsured persons who were allocated to doctors last year tochange their doctor at the end of the year by giving thenecessary notice, and every opportunity was taken of bring-ing to the knowledge of insured persons their rights in thisrespect. It is still open to insured persons who omittedto take the necessary steps last year and who now desireto change their doctor to do so by consent, and the medicalcard issued to insured persons already on the lists of doctorscontains full instructions on the subject.

BOOKS, ETC., RECEIVED.

ALBIN MICHEL, Paris.Le Passe Anecdotique. Hygiene de nos Aieux, with 66 illustra-

tions.BAILLIÈRE, TINDALL, AND Cox, London.

Aids to Medicine. By Bernard Hudson, M.D. Cantab., M.R.C.P.Lond. Second edition. Price 3s. 6d. net.

BALE (JOHN), SONS, AND DANIELSSON, LIMITED, London.Health Preservation in West Africa. By J. Charles Ryan,L.R.C.P.I., L.M., L.R.C.S.I., L.M., Diplomate in Tropical Medi-cine, University, Liverpool ; late M.O-. West African MedicalStaff. With Introduction by Sir Ronald Ross, K.C.B., F.R.S.,Nobel Laureate, M.D. Price 5s. net.

BROTHERHOOD PUBLISHING HousE, Holborn Hall, Clerkenwell-road,London.To Every Man in England. The Campaign Handbook of theNational Brotherhood Council. Price 6d.

GLAISHER, HENRY J., 55-57, Wigmore-street, London, W.Time and the Timeless. Songs of Shadow and of Hope. By APhysician. Price 2s. 6d. net.

KING, P. S., AND SON, London.The Problem of the Continuation School and its Successful Solu-tion in Germ2.ny. By R. H. Best and C. K. Ogden, B.A. PriceIs. net.

LIVINGSTONE, E. AND S., Edinburgh.Fellowship Examination Papers for the Diplomas of the RoyalCollege of Surgeons, Edinburgh, for several years. Price Is. net.

Dental Examination Papers for the Diplomas of the Royal Collegeof Surgeons and the Royal Faculty of Physicians and Surgeons,Glasgow, for several years. Price Is. net.

LEWIS, H. K., London.The Road to a Healthy Old Age. Essays Lay and Medical. ByThomas Bodley Scott. Price 2s. 6d. net.

MALOINE, A., Paris.Principes d’Anacousie (Reeducation Auditive). Par A. Ziind-Burguet, Preface du Professeur M. C. Gariel.

Appointments.Successful applicants for vacancies, Secretaries of Public Institutions,

and others possessing information suitable for this column, areinvited to forward to THE LANCET Office, directed to the Sub-Editor, not later than 9 o’clock on the Thursday morning of eachweek, such information for gratuitous publication.

BANISTER, J. BRIGHT, M.D. Cantab., M.R.C.P. Lond., F.R.C.S. Edin.,has been appointed Surgeon to Out-patients at the Chelsea Hos-pital for Women.

BELL, J. T., M.B., B.Ch. Durh., has been appointed CertifyingSurgeon under the Factory and Workshop Acts for the HighWycombe District of the county of Buckingham.

BENNETT, H., has been appointed Certifying Surgeon under theFactory and Workshop Acts for the Billingshurst District of thecounty of Sussex.

BHUTTACHARJI, J. C., L.R.C.P. & S. Edin., L.F.P S. Glasg., has beenappointed Certifying Surgeon under the Factory and WorkshopActs for the Arnesby District of the county of Leicester.

CARLILL, HILDRED B., M.D. Cantab.. Tvf.R.C.P. Lond., has beenappointed Physician to Out-patients at the City of London Hos-pital for Diseases of the Chest.

DAVIDSON, H., M.R.C.S., L.R.C.P. Lond., has been appointed Certify-ing Surgeon under the Factory and Workshop Acts for theTeddington District of the county of Middlesex.

GILL, D. M., M.B., C.M. Aberd., has been appointed Medical Officer tothe Fleetwood Council.

HAMILTON, Captain A. F., I.M.S., has been appointed Clinical Assistantat the Chelsea Hospital for Women.

McCowEN, Major W. T., LM.S., has been appointed Clinical Assistantat the Chelsea Hospital for Women.

MARTIN, THOMAS HARTLEY, M.B , Ch.B. Liverp., has been appointedResident Medical Officer at the Leasowe Sanatorium for theTreatment of Surgical Tuberculosis in Children, Leasowe, Cheshire.

O’SULLIVAN, J. E., L.R.C.P. & S. Edin., has been appointed Certify-ing Surgeon under the Factory and Workshop Acts for theCharlestown District of the county of Mayo.

SHERA, A. G., M.R.C.S., L.R.C.P. Lond., has been appointed JuniorAssistant Medical Officer at the Fulham Infirmary, Hammer-smith, W.

WALSH, J., has been appointed Medical Officer to the Midleton UnionHospital, Cork.

WHITE, HILL WILSON, M.B., B.Ch., B.A.O. Nat. Univ. Irel.. L.M.Rotunda, has been appointed Assistant Medical Superintendent ofthe Paddington Infirmarv, W. ’

WiLSON, IVAN S., M.D., Ch.B. New Zealand, F.R.C.S. Eng., has beenappointed House Surgeon at the Chelsea Hospital for Women.

Vacancies.For further information regarding each vacancy rejerence should be

} made to the advertisement (see Index).

BANBURY, HORTON INFIRMARY.-House Surgeon. Salary .e120 perannum, with board and residence.

BATH, ROYAL UNITED HosPITAL.-House Surgeon. Salary £100 perannum, with board, lodging, and washing.

BEDFORD COUNTY HOSPITAL.—Assistant House Surgeon. Salary £80per annum, with board, lodging, and laundry.

BIRMINGHAN AND MIDLAND HOSPITAL FOR NERVOUS DISEASES. Bath-row, Birmingham.-Physician to Out-patients.

- BIRMINGHAM GENERAL DISPENSARY.-Resident Medical Officer, un-

married. Salary jB220 per annum, with apartments, fire, light, andattendance.

BIRMINGHAM, YARDLEY-ROAD SANATORIUM AND ANTITUBERCULOSIS’

CENTRE. Broad-street.-Assistant Medical Officer, unmarried.Salary .e250 per annum, with board and residence.

BLACKBURN COUNTY BOROUGH EDUCATION COMMITTEE.— SchoolMedical Inspector and Assistant to Medical Officer of Health.Salary 2300 per annum.

CAMBRIDGE. ADDENBROOKE’S HOSPITAL.-Second House Surgeon.Salary £80 per annum, with board, residence, and laundry.

CANTERBURY, KENT COUNTY ASYLUM, Chartham.-Junior Assistant(Third) Medical Officer, unmarried. Salary 2220 per annum, withapartments, attendance, laundry, &c.

CARLISLE, CUMBERLAND INFIRMARY.-Resident Medical Officer as

House Physician for first six months and House Surgeon duringensuing six months. Salary at rate of £80 and .e100 per annumrespectively, with board, lodging, and washing.

CATERHAM ASYLUM, Caterham, Surrey.-Senior Assistant MedicalOfficer. Salary £300 per annum, with board, lodging, and washing.

CENTRAL LONDON OPHTHALMIC HOSPITAL, Judd-street, W.C.-Assistant Surgeon.

CHARING CROSS HOSPITAL.-Obstetric Registrar.CHELSEA HOSPITAL FOR WOMEN, Fulham-road, S.W.—Registrar.

Salary £40 per annum.