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Parliamentary Intelligence.HO,USE OF LORDS.

TUESDAY, MAY 3RD.PUBLIC HEALTH (TUBERCULOSIS) BILL.

THE Earl of ONSLOW (Parliamentary Secretary of theMinistry of Health), in moving the second reading of thePublic Health (Tuberculosis) Bill, said that the deaths fromtuberculosis during the past six years were as follows :-1915,54,295 ; 1916, 53,858 ; 1917, 55,734; 1918, 58,073 ; 1919, 46,312 ;1920, 42,545. The drop in the figures in the last two yearswas mainly due to the valuable services rendered by thecounty councils in combating disease, and afforded proofof the immense gain to the nation through their work.The number of beds provided for tuberculosis patients bythe local authorities and voluntary institutions had increasedsince 1912 from 4300 to 17,447.Lord STRACHIE said that, on the whole, the county

councils were fairly satisfied with the Bill, and were obligedto the Ministry of Health for the way in which they had I,considered many amendments they had suggested. Theyapproached the Bill in no hostile spirit. The feeling at themeeting of the County Councils Association was that as theBill made sanatorium treatment compulsory on the countycouncils the obligation to pay for the same should also becompulsory.The Earl of ONSLOW said that the Government had

promised to find £300,000 to reimburse the councils plusa further grant this year of £1,000,000. It was the fixed andfirm policy of the Government to continue this institutionaltreatment of tuberculosis.Lord SYDENHAM asked whether the figures mentioned by

the noble lord represented the maximum annual expendi-ture under this bill.The Earl of ONSLOW said that the block grant might be

regarded as final, but the £200,000 depended on the amountthat the councils spent on the approved schemes each year.Lord HARRIS protested against the enormous charge

which was being thrown on the rates for this purpose. Thetreatment of tuberculous people was a national object andtheir cure was a national advantage. Why, then, shouldsuch a very large proportion of the cost be thrown on therates ? Why should it not be 25 per cent. on the rates and75 per cent. on the Exchequer ?The Bill was read a second time.

HOUSE OF COMMONS.

THURSDAY, APRIL 28TH.

Grouping of Medical Appeal Boards.Mr. WATERSON asked the Minister of Pensions whether

there had been any joining together of medical appealboards ; if so, for what purpose ; and under what powerssuch had been done.-Mr. MACPHERSON replied: The answerto the first part of the question is in the negative. Perhapsmy honourable friend has in mind an administrative arrange-ment by which, in certain large areas, a number of boardsmay be grouped for supervision under one Deputy Commis-sioner of Medical Services, each board, however, retainingits own chairman.

University Students and Defence Force.Mr. RENDALL asked the Secretary for War what action he

intended taking on the letter received from Sir I. Owen,Vice-Chancellor of the University of Bristol, which pointedout the importance of university students being releasedfrom the Defence Force at the earliest possible moment.-Sir CHARLES OMAN asked the Secretary for War whether hewould take measures to secure the prompt demobilisation ofthose university students who were still retained by theircolonels in the battalions of the Defence Force, when thelarge majority of such persons had been granted leave toreturn to their studies and examinations, as cases of greathardship were being reported by university authorities.-Sir L. WORTHINGTON-EVANS replied: It is not possible togive leave to students from the Defence Force without atthe same time giving leave to others who may desire it onurgent grounds. It is hoped, however, that the presentnegotiations will lead to a speedy settlement, when stepswill be taken to demobilise the Defence Force.

Medical Equipnzeut of Auxiliary Division, R.LC.Lieutenant-Colonel WALTER GUINNESS asked the Chief

.Secretary to the Lord Lieutenant of Ireland whether theAuxiliary Division, Royal Irish Constabulary, were stillentirely without medical staff or ambulances; and whether,in view of the very dangerous work and heavy casualtieswhich their units were now sustaining, he would consultthe Director of Medical Services as to the advisability of

attaching to each company one motor ambulance, onemedical non-commissioned officer, and two medical orderlies.-Sir H. GREENWOOD replied: As stated by my right honour-able friend, the Attorney-General (Mr. Henry), in reply to aquestion on this subject on April 14th, the Auxiliary Divisionis not provided with its own special medical transport, butambulances and other necessaries of medical equipment areborrowed from the Regular Forces as and when required.I have inquired into the working of this arrangement, andam assured that it is found to answer satisfactorily, as thewhereabouts of neighbouring military stations are wellknown and can be communicated with easily in the event ofcasualties occurring.

Supervision of Private Vaccine harms.Mr. HAYDAY asked the Minister of Agriculture whether

his department exercised any supervision over the privatevaccine farms in this country in which vaccine lymph wasmanufactured, having regard to the fact that at least twooutbreaks of foot-and-mouth disease in the United States ofAmerica had been attributed by the authorities to the use ofcontaminated vaccine lymph on private vaccine farms.-Sir. A. BoscAWEN replied : The Ministry exercises no super-vision or control over private vaccine farms in this countryin which vaccine lymph is manufactured. I may add thatthe Ministry has inquired into hundreds of outbreaks offoot-and-mouth disease in this country since the report fromthe United States of America was published, but in no casehas any evidence been obtained that foot-and-mouth diseasehas ever been introduced into Great Britain through themedium of vaccine lymph.

Proposed Reduction of Government Medical Staff.Major Sir KEITH FRASER asked the Minister of Health

what necessity there was for having increased the numberof medical men on the public health staff in the directservice of the Government from 39, who performed thefunctions under the Local Government Board in 1914, to 100,,at present employed by the Ministry of Health, at an annualcost which was increased from f:26,871 15s. 9d. in 1914 to£130,630 3s. in 1920; and whether he proposed to take anysteps to reduce the numbers and cost.-Sir A. MoND replied:I am inquiring into the functions and numbers of themedical branch of the Ministry, and pending the result ofthe inquiries have given instructions that no vacanciesarising in the medical branch are to be filled.

Educational Food Leaflet.Colonel Sir ARTHUR HOLBROOK asked the Minister of

Health when it was proposed to issue the educational foodleaflet, the draft of which was submitted early in March,with a memorial on this subject from medical, scientific,health, and other associations ; and would he deal with thematter as one of urgent importance, having regard to thepresent general distress and the consequent necessity fordisseminating knowledge of healthy, nouiishing, andeconomical foods.-Sir A. MoND replied: The matter isreceiving attention and I will see whether any usefulpurpose can be served by issuing any such pamphlet.

Protection against Small-pox.Mr. FREDERICK GREEN asked the Minister of Health, in

view of the statement contained on page 219 of the annualreport of the chief medical officer of the Ministry for theyear 1919-20 that cases of small-pox did not occur afterrecent successful re-vaccination, how recent re-vaccinationshould be in order to be absolutely protective; and whatwere the characteristics represented by the word successful.-Sir A. MoND replied: I am advised that the protectionagainst small-pox infection by efficient vaccination is practi-cally absolute during the early years following the operationand that in the great majority of cases the protectionremains effective up to the tenth or eleventh year aftervaccination. The evidence of successful vaccination is theproduction at the seat of inoculation of the characteristiclesions followed by well-defined marks.

MONDAY, MAY 2ND.The Spahlinger Treatment.

Mr. HIGHAM asked the Prime Minister whether he wouldconsider the advisability of appointing a commission toinvestigate at once the merits of the Spahlinger treatmentfor consumption, particularly in view of the fact that 18persons were treated in England with this serum in 1913-14when they were in the third degree of consumption, andto-day these persons were well and able to carry on theirformer occupations; and whether, in view of this fact andalso that 40,000 people died of consumption annually in thiscountry, he would consider it desirable to exhaust everymeans in his power to ’secure the Spahlinger treatment forthis country so that it might be available to all peoplesuffering from consumption in any of its stages.-Sir A.MOND (Minister of Health) replied: I may remind myhonourable friend that the question of the merits of theSpahlinger treatment for consumption have been under

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consideration by the responsible medical authorities in thiscountry since 1914; and during the last few months the

Ministry of Health, following their usual practice of investi-gating the efficacy of all new methods of treatment fortuberculosis which are brought forward, have given furtherspecial attention to the matter at the particular request ofMr. Spahlinger. The difficulty in the case is, however, thatthe serum itself and reliable details of the clinical evidencein support of its use are not forthcoming. An undertakinghas, however, been given that when supplies of this serumbecome available for independent and scientific investigationin this country the Ministry of Health will facilitate anexhaustive examination of its efficacy. The appointment ofacommission as suggested by my honourable friend wouldnot therefore appear to be of any advantage at the presenttime. I think it desirable to emphasise that in the opinionof my medical advisers there is not yet available a sufficientbody of evidence to justify the claims made for thistreatment.

Cost of the Ministry of Health.Mr. MILLS asked the Minister of Health if he would submit

a return showing the total expenditure defrayed out ofnational funds in respect of each of the administrativesections under the control of his department during each ofthe last two completed financial years, andalso the estimatedsimilar expenditure in respect of the current financialyear.-Sir A. MOND replied: I am not quite clear what thehonourable Member has in mind. If, as I assume to be thecase, he refers to grants made by the department out ofvoted moneys towards the cost of housing, national health,insurance, and miscellaneous health services, the informa-tion is as follows :-

E ’. EstimatedExpenditure. expenditure.1919-20 1920-21 1921-22

.f: x xHousing ...... 24.109 3,145,888 ...... 11,000,000National Health Services ... 6,596,436 7,713,704 ...... 8,500,000Miscellaneous 11 .. 777,142 2,451,059 ...... 5,000,000

Indian Jledicat Serdce Appeals.Major GLYN asked the Secretary for India whether British

officers of the Indian Medical Service had any right ofappeal if the contention was upheld that such officers hadno right of appeal under Section 42 of the Army Act, andwith special reference to the notification in the LondonGazette of March 15th, p. 2099 ; and, if so, by what procedurethey could appeal.-Mr. MONTAGU replied : I am advised thatofficers of the Indian Medical Service have no right ofappeal under Section 42 of the Army Act, but have a rightof appeal to the Governor-General under Section 180 (2) (d)of that Act. If dissatisfied with his orders they may thenappeal to the Secretary of State for India, and through himto H.M. the King.

Snaccll-pox and Vaccination.Mr. ROBERT YOUNG asked the Minister of Health if his

attention had been called to the following figures relating tothe cases of small-pox notified in 1919-namely, 294-asshown on pages 34 and 39 of the First Annual Report of theMinister of Health, and pages 27 and 241 of the AnnualReport of the Chief Medical Officer for 1919-20; 288, as shownon pags 215 of the last-named Report; and 361, as shown onpage lxviii. of the Registrar-General’s Annual Report; if hewould state the reason for these differences and say whatwas the total number of cases notified or discovered in 1919,and how many of those cases occurred amongst each of thecivilian, military, and naval sections of the population,and how many in port sanitary districts ; and how manydeaths occurred in each of these sections.-Sir A. MONDreplied: The figure 288 shown on page 215 of the AnnualReport of the Chief Medical Officer of the Ministry for1919-20 is the total number of cases of small-pox notifiedunder the Infectious Diseases (Notification) Act during1919. Twenty-three of these cases were afterwards with-drawn on the ground of incorrect notification, and 29 caseswere discovered in the civilian population which had notbeen notified. The figure 294 shown on pages 34 and 39of the first Annual Report of the Minister of Health, andon pages 27 and 241 of the Annual Report of the ChiefMedical Officer, which is arrived at by adding 29 to the figure288 and deducting 23 therefrom, is the actual number ofcases of small-pox occurring in the civilian populationduring 1919. Of these cases 38 occurred in port sanitarydistricts. In addition, 13 military and 4 naval cases occurredin this country, and 50 service men arrived in this countryconvalescent from small-pox incurred abroad. The figure361 shown on page lxviii. of the Registrar-General’s AnnualReport is arrived at by adding these 50 cases to the totalnumber of civilian, naval, and military cases which occurredin this country. The number of deaths was 25 in thecivilian, 4 in the military, and none in the naval sectionsof the population.

Mr. LUNN asked the Minister of Health how many deathsfrom small-pox had occurred amongst children under 5years of age in each year since the passing of the Vaccina-tion Act, 1907 ; and how many deaths of children under 5years of age in each of those years had been certified by thedoctor in attendance as having been caused by, or associatedwith, the operation of vaccination.-Sir A. MOND replied:The particulars asked for, according to the Registrar-General’s Returns so far as England and Wales are concerned,are as shown in the following table :-

Deaths of Children Under 5 Years of Age.

certified by doctor to have been caused by,-or associated with,vaccination.

Mr. CHARLES WHITE asked the Secretary for Scotland howmany deaths from small-pox had occurred in Scotlandamongst children under 5 years of age in each year sincethe passing of the Vaccination Act, 1907 ; and how manydeaths of children under 5 years of age in each year had beencertified by the doctor in attendance as having been causedby, or associated with, the operation of vaccination.-Mr.MuNRo replied: The answer to the first part of the questionis 28, of whom 27 were unvaccinated and 1 vaccinated.The answer to the last part of the question is 6.

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Pelvic Inflammations in Women. By Prof. John OsbornPolak, M.D. Pp. 229. Five vols. will be issued in August;10 vols. complete, 10 10s.

BASTE, A., Leipzig.Handbuch der Arztlichen Erfahrungen iiii Weltkriege. 1914-1919.Band VIII. Pathologische Anatomie by Ludwig Aschoff,Pp. 590. M.170.

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Eye, Ear, Nose, and Throat Nursing. By Prof. A. E. Davis andProf. B. Douglass. 2nd ed. Pp. 346. 2.50.

Rational Treatment of Pulmonary Tuberculosis. By C. Sabourin,M.D. Authorised English translation from the 6th French ed.Pp. 440.$3.50.

HARRISON AND SONS, London. ,

Transactions of the Medical Society of London. Vol. XLIII.Edited by Donald Armour, F.R.C.S., and W. H. Willcox, M.D.Pp. 291. ’

HBiNEMANN, W., London.A Text-book of General Pathology for the Use of Students andPractitioners. By J. M. Beattie, M.D., and W. E. C. Dickson,M.D. 2nd ed. Pp. 496 + xlv. 31s. 6d.

JOHNS HOPKINS PRESS, Baltimore.Diagnosis of Protozoa and Worms Parasitic in Man. By AssociateProfessors R. W. Hegner and W. W. Cort. Pp. 72.

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LONGMANS, GREEN, AND Co., London.The Electronic Conception of Valence and the Constitution ofBenzene. By H. S. Fry, Ph.D. Pp. 300. 16s.

MASSON ET CIE, Paris. ,

Manuel de Coprologie Clinique. Par le Dr. J. Ch. Roux. Pp. 383.Fr.12

Chirurgie de Guerre et D’apres-Guerre. Par Prof. A. Broca.Pp. 479.

SCIENTIFIC PRESS, LTD., London.A Handbook for Nurses. By J. K. Watson, Capt., R.A.M.C.6th ed. Pp. 770. 10s. 6f!.

SPRINGER, JULIUS, Berlin.Das Sputum. Von Prof. Dr. H. von Hcesslin. Pp. 398. M.148.Konstellationspathologie und Erblichkeit. Von Dr. N. Ph.Tendeloo. Pp.32. M.8.60.

UNIVERSITY OF CHICAGO PRESS, Chicago.The Origin and Development of the Nervous System from aPhysiological Viewpoint. By Prof. C. M. Child. Pp. 296.