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delicate health. Relieved eight times, .B96. Granted B12 in 12 instal-ments.—Widow, aged 50, of M.B. Aberd., who practised in Warwick-shire and New South Wales. Receives a little help from her sister.and son, but is suffering from general illness and quite unableto work. Relieved six times, £66. Granted .B12 in 12 instalments.- Daughter, aged 67, of M.R.C.S. Eng., who practised at Cran-trook, Kent. Health bad and quite unable to look after herself.Bas an annuity of £16 9s. 8d. and a little help from the KentBenevolent Society. Relieved seven times, £84. Granted C12 in

12 instalments.-Daughter. aged 63, of L.S.A. Lond., who practised atKilburn and Regent’s Park. Health very bad and has to keep a;sister. Recently lost a friend who paid the rent and assisted otherwise.Relieved five times. E60. Granted .BI2 in 12 instalments.-Widow,aged 44, of M.B., C.M. Edin., who practised at Ballindalloch. Athusband’s death was left with four young children, the eldest of whomis now 15 years old. Has tried to earn a living by taking in boarders,but owing to the recent illness of self and children has been unableto properly attend to this. Receives £15 per year from the FlemmingTund. Relieved three times, £30. Granted £10 in two instalments.-Widow, aged 44, of L.S.A,. Lond., who practised in London. Has been

trying to makea living by letting rooms, but has not been successful, andowes rent. Three children, the youngest of whom is six years old.Relieved twice, £12. Voted .E3 as a special grant.-M.D., of Aberdeen,.aged 61, practised at Walsall and other places. Suffering from lateralsclerosis and paralysis since 1881. Income from various sources E70per anuum. Three children, the youngest 3 years and the oldest15 years. Relieved six times, £53. Granted £12 in 12 instalments.—Orphan, aged 68, of M.R.C.S. Eng., who practised in Harley-street, W.Too old to obtain employment. Receives pension from anothersociety of B25 and some help from the Guild. Relieved twice, E24.Granted R12 in 12 instalments.-Widow, aged 69, of M.R.C.S. Eng.,who practised in Stratford, E. Has pension of R30 from EpsomCollege, but health very bad. Relieved four times, £39. Granted ,EI0in two instalments.-Widow, aged 71, of L.R.C.P. Edin., who practisedat Sparkbrook, Birmingham. Only income ,E16 per annum and a littlehelp from children. Has tried to augment this by taking in boarders,but owing to age and bad health unable to make this pay. and the rentand taxes are in arrears. Relieved twice, ,E20. Granted 210.

Contributions may be sent to the honorary treasurer,Dr. Samuel West, 11, Chandos-street, Cavendish-square,London, W.

Parliamentary Intelligence.NOTES ON CURRENT TOPICS.

Asylum Officers (Superannuation) Bill.Lord WOLMER has introduced in the House of Commons a

Bill "to limit the hours of employment of officers andservants in asylums and to amend the Asylum OfficersSuperannuation Act, 1909." It was read a first time.

Naval Medical Compassionate Fund Bill.Mr. G. LAMBERT, the Civil Lord of the Admiralty, onTuesday, May 12th, introduced a Bill to make’ further andbetter provision with regard to the Naval Medical Compas-sionate Fund." It was read a first time.

HOUSE OF LORDS.

THURSDAY, MAY 7TH.

Midwives (Scotland) Bill.’THE (House went into Committee (for the second time) onthe Midwives (Scotland) Bill.Lord BALFOUR of BURLEIGH, in moving the adoption of a

series of amendments en bloc, explained that with one

exception they were of a drafting character. As theBill stood there was a provision that on the formation ofa Central Midwives Board in Scotland three members wereto be appointed by the President of the Council, andtwo of these when available should be certified midwivespractising in Scotland under the terms of the Bill. Of course,these midwives were not available now, and it was uncertainwhen they would be. Therefore, after conference with theScottish Office and the Privy Council, it had been suggestedthat he should make the Privy Council responsible for theformation of the Board for a period of years. That wouldget over the difficulty. He also proposed to insert specificprovisions that the new Board should elect a chairman fromamong its own members and that the sittings should takeplace in Edinburgh.

All the amendments were agreed to and the Bill wasreported to the House.

-

HOUSE OF COMMONS.

WEDNESDAY, MAY 6TH.Infants lVTilk Bill.

Mr. DOUGLAS HALL moved for leave to bring in a Bill"to ensure the supply of milk to certain persons." He saidthat the aim of the Bill was to ensure the sale of pure milkto certain mothers of infant children at a price which theycould afford to pay. The measure would increase the supply of ipure milk from dairy farmers, and it would cost the com-munitybut a trifling sum, if anything. It was proposed to make i

use of the local authorities and the medical officers of healthas agents for groups of mothers in districts to enable themto obtain milk at a price which they could afford to pay.In the event of any jobbery or corruption it was proposedthat the Local Government Board should fix the price of themilk to be thus sold. It was stipulated that it was to bepure. The best definition was that contained in the Sale ofMilk Regulations Act, 1901, and it was proposed that thisdefinition should be altered in future if there was a statutorydefinition better defining what pure milk was. Havingreferred to the insufficiency. or even the entire lack. ofnourishing milk in the budget of the very poor, the honour-able Member proceeded to say that his Bill laid down thatthe local authority, through their officer of health, shouldprovide milk to certain mothers in their district belongingto the poorer classes. The Bill defined these mothers asmothers who came under the maternity benefit of theNational Insurance Act. The time during which they couldobtain the milk was to be limited, say, to three months afterthe birth of the child. Even in the country districts it wasdifficult for mothers to obtain milk. In many districtsfarmers sent the whole to the large towns for sale, and it wasalmost impossible to get milk in those districts. If the Billpassed, the local medical officer could make arrangementswith some dairy farmer and make it worth his whileto keep back sufficient to be sold to these mothers.If there was a slight loss on the purchase-he did notbelieve that there would be-it would be borne by thelocal authority. He recommended the Bill to the House as ashort, simple, practical, and inexpensive contribution to thegreat question of public health and the physical fitness of thenation.Leave having been granted, the honourable Member

brought in the Bill. He has the support of Lord HENRYCAVENDISH-BENTINCK, Mr. CHARLES BATHURST, Mr. ASTOR,Mr. GRANT, and Mr. JoYNSON-HicKs.

THURSDAY, MAY 7TH.

Domiciliary Treatment in :Middlesex.Mr. WORTHINGTON EvANS asked the honourable Member

for St. George’s-in-the-East as representing the InsuranceCommissioners whether he was aware that the MiddlesexInsurance Committee was refusing to carry out its tubercu-losis officer’s recommendation that no insured person shouldreceive domiciliary treatment with extras unless the insuredperson had chosen a panel doctor; and whether, in a casewhere an insured person had provided and paid for his ownmedical man, who was willing to act in consultation withthe tuberculosis officer, it was the intention of the Govern-ment that the insured person was to forfeit the extras underthe sanatorium benefit which the tuberculosis officer recom-mended.-Mr. WEDGWOOD BENN said in reply: The recom-mendation of an Insurance Committee for sanatorium benefitand the nature of the treatment provided thereunder is, as thehonourable Member is aware, a matter for the discretion ofthe committee. My right honourable friend is informed,however, that no such advice as the honourable Membersuggests has been given by the tuberculosis officer referred to.

MONDAY, MAY 11TH.

Payment of Panel Practitioners.Mr. FELL asked the honourable Member for St. George’s-

in-the-East why some better arrangement was not made forthe payment of the panel doctors under the NationalInsurance Act; and would he say why money due was paidby driblets and was nearly always in arrear for periods ofweeks, which treatment of the doctors did not conduce toefficient and satisfactory work by them.-Mr. WEDGWOODBENN replied : As payments to doctors during the year areadvances on account of remuneration which could not bedetermined till the end of the year, a margin mustnecessarily be reserved for the final settlement. It will, how-ever, be possible for Insurance Committees in many casesto reduce the margin reserved when the accounts for lastyear are completed and more precise information is accord-ingly forthcoming as to the actual sums available.

TUESDAY, MAY 12TH.The Largest Panel List.

Replying to Sir J. D. REES and Mr. F. WHYTE, Mr.WEDGWOOD BENN said : The maximum number of insuredpersons on the list of any single medical man on the panel inGreat Britain is 5455.Mr. F. WHYTE : Does the honourable gentleman mean a

single medical man or one having an assistant?-Mr.WEDGWOOD BENN : He is the only medical man on the paneln respect of those persons, but as a matter of fact he hasiWO assistants.

Treatment by Herbalist Practitioners.Mr. BRASSEY asked the honourable Member for St. George’s-

n-the-East whether his attention had been called to the

action of the Southport and other Local Insurance Committeesn refusing to allow insured persons to make arrangements

1434

for medical treatment by herbalist practitioners notwith-standing that the Approved Societies to which the insuredpersons belonged were paying sickness benefit on thecertificates of such practitioners; and what action he pro-posed to take in the matter.-Mr. WEDGWOOD BENN said inreply : As I have previously stated, the question of grantingor refusing permission to insured persons to make their ownarrangements under Section 15 (3) of the National InsuranceAct, 1911, is a matter for the discretion of Insurance Com-mittees, and my right honourable friend cannot interfere inthe exercise of that discretion.

Milk and Dairies Bill.Mr. H. SAMUEL, in moving for leave to present a Bill " to

make better provision with respect to the sale of milk andthe regulation of dairies," said that the general law in thiscountry in relation to milk had regard chiefly to the pre-vention of fraud and to the checking of deliberate adultera-tion. It had so far had very little regard to the moreimportant matter of the health of the people. Expertsand authorities had reported that tuberculosis was un-

doubtedly spread, particularly amongst children, by theconsumption of tuberculous milk. The Royal Commissionon Tuberculosis and the Departmental Committee knownas the Astor Committee reported in this sense. There werein England and Wales about 53,000 cases of tuberculosisevery year, and no fewer than a fourth of them were non-pulmonary tuberculosis amongst children, and a not incon-siderable proportion of these was due to milk. Althoughinfinite care was taken in this country as to the water-supply, yet the safeguarding of the milk-supply, whichwas of equal importance, was little regarded by thelaw. About a hundred local authorities had now securedpowers to protect their population from contaminatedmilk, but the result was a multiplication of inspectionin rural districts, much to the disgust of the farmers.It had been recognised in all quarters of the Housethat this was a matter which demanded legislation. The

subject of milk, however, which ought to be a peaceful topic-the very name of it summoned up ideas of what was meekand mild—bad been a matter of hot and almost burningcontroversy. There were great interests concerned. Thepublic health authorities, especially of the towns, wereeager to safeguard the health of the populationunder their care, and they were unwilling to sur-

render the powers which had been conferred uponthem by local Acts, unless they could be sure that areally efficient system of protection and control would beestablished in the rural districts. The milk-selling industrywas a numerous and highly organised body which was con-ducting a trade of inestimable value to the community.They were anxious to see that the purity of the milk-supplywas secured, but at the same time they were, not unnaturally,anxious to secure that they should not in the conduct of theirbusiness be unnecessarily harassed by regulations and especi-ally they were anxious to secure that the members of the milk-selling trade should not be punished for faults which theyhad not themselves committed because they were the partiesmost easy to reach. Thirdly, there was the great agriculturalindustry which was equally eager to observe any practical Imeasures for safeguarding the health of the population andto maintain the reputation of the milk industry, but themembers of that industry did very strongly object to thepresent system of multiple inspection, and they were timidlest they should be exposed to harassing and impracticableregulations. They were especially timid lest their industryshould be put to great expense by the adoption of measurespressed forward by idealists. He had been in communicationwith the representatives of all those interested. He foundthat each of them was anxious to see legislation, and tohave the whole matter put upon a more satisfactoryfooting. He had endeavoured to frame a Bill which wouldmeet with the general assent of the various authoritiesconcerned. The Bill was of a detailed character, and it wasnot possible for him within the short time at his disposal todescribe the somewhat numerous and certainly very detailedclases. It would be enough to say now that it proposed tomake Regulations in order to prevent the supply of con-

taminated and dirty milk, and these Regulations should bemade by the Local Government Board with the concurrenceof the Board of Agriculture, who would be asked in this matterto act in couperation wi th the Local Government Board. TheseRegulations would be laid before Parliament and they wouldnot become operati ve if either House passed an address againstthem. He was thus taking every step to prevent unreasonableRegulations. The Bill proposed to provide means for tracingdiseased milk back to its source and for stopping the sourceof such mllk. Where there was adulteration the Billenabled improved procedure to be adopted to bring theoffence home to the guilty persons. It proposed alsoto get rid of multiple inspection and to apply similarregulations to foreign milk imported into our towns.He should make it clear that the Board of Agricultureproposed to compensate farmers for the cows that had to be

slaughtered for tuberculosis on a somewhat more generous.scale than hitherto. The Public Health grants which wereproposed this year would provide for paying not only halfthe salaries of medical officers, but those of veterinarysurgeons and millB inspectors. Therefore half of ,theseexpenses would be paid out of national funds. Heshould most carefully consider any amendments or sugges-tions which might be made by persons interested in themeasure with a view to meeting all the interests concerned.For five years Bills on this subject had been before Parlia-ment. He hoped that this session Parliament would be readyto deal with a subject which it was admitted on all handsdemanded the attention of Parliament.Leave having been granted, Mr. SAMUEL brought in the

Bill, which was read a first time.

BOOKS, ETC., RECEIVED.

CAMBRIDGE UNIVERSITY PRESS, London and Cambridge.The Bacteriological Examination of Water. (Cambridge PublicHealth Series.) By W. G. Savage, B.Sc., M.D.Lond., D.P.H.Price 7s. 6d. net.

Isolation Hospitals. (Cambridge Public Health Series.) ByH. Franklin Parsons, M.D. Lond., D.P.H. Camb., formerlyFirst Assistant Medical Officer of the Local Government,Board.Price 12s. 6d. net.

’

COLLINGRIDGE, W. H. AND L., Aldersgate-skeet, LondonThe City of London Year Book, 1914. Price 5s. net.

GEORGE ROBERTON AND COMPANY, Melbourne, Sydney, Adelaide,Brisbane, and London.

Australasian Fossils: A Student’s Manual of Palaeontology. ByFrederick Chapman, Paleontologist to the National Museum,Melbourne. With an Introduction by Professor E. W. Skeats,D.Sc., F.G.S.

HEINEMANN. WILLIAM, London.Appendicitis : Its History, Anatomy, Clinical Etiology, Pathology,Symptomatology, Diagnosis, Prognosis, Treatment. Technicof Operation, Complications, and Sequels. By John B. Deaver,M.D., Sc.D., LL.D.. Professor of the Practice of urgery, Uni-versity of Pennsylvania. Fourth edition, thoroughly revised.Price 17s. 6d. net.

KING, P. S., AND Sox, London.Building By-LAW in Rural Districts. By Sir William Chance,

Bart., M.A. Price Is. 6d. net.

LEWtS, H. K., London.Lectures on Dietetics. By Max Einhorn, Professor of Medicine atthe New York Post-Graduate Medical School and Hospital.Price 4s. net.

SAUNDERS (W. B.) COMPANY, London and Philadelphia.A Text-book of the Practice of Medicine. By Jas. M. Anders,M.D., Professor of the Theory and Practice ot Medicine and ofClinical Medicine, Medico-Chirurgical College, Philadelphia.Eleventh edition, tully illustrated. Price 24s. net.

Pathologic Histology. By Frank B. Mallory, M.D., Associate Pro-fessor of Pathology at Harvard Medical School. With 683 originalillustrations, 124 in colours. Price 24s. net.

Diagnostic Symptoms in Nervous Diseases. By Edward L. Hunt,M.D., Instructor in Neurology and Assistant chief of Clinic,College of Physicians and Surgeons, New York City. Illustrated.Price 6s. 6d. net.

Medical Gynecology. By S. Wyllis Bandler, M.D., Adjunct Pro-fessor of Diseases of Women, New York Post-Graduate MedicalSchool and Hospital. Third edition, with 150 original illus-trations. Price 21s net.

Biology, General and Medical. By Joseph B. McFarland, M.D.,Professor of Bacteriology and Patholugy, Medico-ChirurgicalCollege, Yhiladelphia. Second edition. Price 7s. 6d. net.

The Practice of Pediatrics. By Chas. Gilmore Kerley, M.D., Pro-fessor of Diseases of Children, New York Polyclinic MedicalSchool and Hospital. Illustrated. Price 25s. net.

Development and Anatomy of the Nasal Accessory Sinuses inMan. By Warren B. Davis, M.D., Corinna Borden Keen ResearchFellow of the Jefferson Medical College, Philadelphia. With57 original illnstiations. Price 15s. net.

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

and others possessing infor nation suitable for this column, areiruited to forward to THE LANCET Office, directed to the Sub-Editor, not letter than 9 o’clock; orz the Thursday morning ofeachweek, such iujornzcttimz for gratuitous pblication.

BAKER, A. DE WtNrr.2t, :iLlt.C.S., L.R.C.P. Land., has been appointedHonorary Anesthetist to the Putney Hospital (Chester Bequest).

BRANTHWAITE, lt. W., M.D. Brux., L.It.C.P. Lond., M.R.C S., has beenappointed an Inspector under the Board of Control (MentalDeficieiicy Act).

DOYLE, J. S. M.B., B.Ch. R.U.I., has been appointed CertifyingSurgeon under the Factory and Workshop Acts for the Ennis-corthy District of the county of Wexfor,i.

EVANS, A E., M.B., B S. Lond., has been appointed an Inspector underthe Board of Control (Mental Deiiciency Act).

FELDMAN, W. M., bLI3., B S Lond., has been appointed AssistantPhysician to the Infants Hospital, Vincent-square. Westminster.

GiLL, S. E., M.D.Lond., has been appointed an Inspector under theBoard of Control (Mental Denciency Act).

GREEVES, R. Arri,isoCK, M.B. Lond., B.S., F.R.C.S.Eng., has beenappointed Assistant Ophthalmic Surgeon to the Middlesex Hos-pital.