1864

causing injury to health, was widely circulated. A

very large number of practical experiments wasmade with results that may be judged from theconcluding paragraph of the report, which was asfollows : " We are confident that aluminium, as it isnow made by reputable manufacturers, is a suitablematerial for cooking vessels, and that any suspicionthat it may communicate poisonous qualities tofood in the process of cooking may safely be dis-missed in view of the results of the practicalexperiments which we have recorded, showing thatthe metal is not appreciably acted upon in cookingoperations." This finding was confirmed sub-

sequently in a report issued by Dr. JOHN GLAISTER,Regius professor of forensic medicine and publichealth, Glasgow University, and his senior assistant,Dr. ANDREW ALLISON, who summed up their workby saying : " We find ourselves in accord with theconclusions arrived at in that article" (referring toTHE LANCET report).In THE LANCET of May 3rd appeared an annota-

tion on " A Recent Analysis of Asparagus." The

presence of a sulphur oil was confirmed, a bodywhich is probably responsible for the well-known peculiar odour of the kidney excretionafter a diet of asparagus. A curious fact was

observed during the experiments-namely, thatwhen asparagus shoots are left in water for a few

days a decided odour of onions is developed. Itwas further shown that quite 80 per cent. of

asparagus is soluble in boiling water, and hencefrom a nutritive point of view asparagus soup issuperior to the boiled shoot. The nutritive valueof the entire asparagus is in any case low, the

sugars amounting to 3’6 per cent., the proteins to3’8 per cent., the fibre (in the tender portions of theshoot) to 1’00 per cent., and the mineral salts to0’80 per cent. The pleasant flavour of asparagus,however, is a factor of undoubted importance indietetics, as is also the presence of the basic bodyvitamine.In THE LANCET of June 14th were reported the

results of some experiments made in regard tothe measurement of the chemical energy of thesun’s rays. The experiments were made during abrilliant spell of weather at the latter end of Mayand early in June. The sun’s rays then were shownto display extraordinary chemical activity. Themaximum chemical intensity was shown to occurbetween 1 and 2 P.M., although the temperaturedid not appear to reach its highest point inthe same interval. It was observed that if thechemical energies of sunlight are concerned in thephysiological joyousness of the body, and are reallythe foundation of the cheerful effect of the brightsunny day, their measurement is clearly of interestand importance.The question having been raised in our corre-

spondence columns as to the accuracy of clinicalthermometers, an independent investigation uponthe subject was undertaken in the laboratory.About 150 observations were made under vary-ing conditions with 12 thermometers obtainedon the market at prices ranging from ls. 6d. to 2s. 6d. The results showed fairly accuratereadings, but the interesting observation was

made that at temperatures ranging between 100° I,and 105° F. the readings in many instanceswere closer to the actual truth as shown by astandard instrument when the duration of thetest was two minutes instead of half a minute.The conclusion that the 30-second thermometers give, generally speaking, more satisfactory results

when they are incubated for more than 30 seconds,a two minute incubation giving exact results, hasbeen confirmed by other observers. There are,however, some further interesting points in con-nexion with this subject which we propose toinvestigate.In THE LANCET of Nov. 29th appeared a

special article from the laboratory entitled " TheChemistry of a Cup of Coffee," in which it was

pointed out that hitherto such analyses of coffee ashave from time to time been made and publishedhave referred to an examination of the entirecoffee berry, and not to the infusion as it reachesthe consumer. The results in this report refer tothe composition of the infusion to be drunk, thechemistry of the " grounds " having been left out ofconsideration. In drawing a comparison betweencoffee and tea it was shown that while the alkaloidcaffeine in coffee is identical with that in tea, yetits associations in coffee are quite different.In tea infusions the alkaloid occurs chiefly asa tannate, which is a compound insoluble inthe acid juices of the stomach. In coffee itoccurs as an easily soluble compound. Herewould appear to be the explanation of the

prompt action of coffee as a restorative andstimulant, particularly when employed as an anti-dote to narcotic poisons. In the same way coffeeprobably serves to overcome to some extent thenarcotic effect of alcohol, and to render a personwakeful owing to its stimulating effects upon thecentral nervous system. One interesting pointbrought out in the inquiry was that cold waterextracts from the coffee berry as much material asdoes boiling water, including the whole of thecaffeine. On the other hand; cold water extractsfrom tea less than half of the substances whichhot water extracts, and the cold water infusion oftea contains only 17’5 per cent. of the total caffeinepresent. It was shown that there is practically norelation between chemical composition and quality,but the process of roasting effects unmistakablechemical changes which are seen chiefly in a reduc-tion in the amount of caffetannic acid and in a

development of aromatic bodies which give to coffeeits sesthetically attractive characters. In con-

clusion, it was remarked that coffee has no directfood value, but inasmuch as it diminishes nervous

fatigue it may serve in this way to increasemuscular power. ____

PHARMACY.

Scientific Work.The year just closing has been distinguished by

several interesting events, and may justly be

regarded as one of pharmacy’s red-letter years..Matters which at ordinary times would have beenregarded as of paramount importance have beeninevitably overshadowed to some extent by thenovel modifications produced by the NationalInsurance Act and the consequent rearrangementof a large part of the system of pharmaceuticalservice. But there has been no diminution in theoutput of the ordinary scientific work, thoughthis is not remarkable, since the workers in thescientific field are among those least affected by theadministrative changes which the Insurance Act hasbrought in its train. The papers communicatedat the evening meetings of the PharmaceuticalSociety, at the annual meeting of the BritishPharmaceutical Conference, and at the Inter-national Pharmaceutical Congress have not,

1865

perhaps, been striking, but they show that a c

good average amount of work has been accom-

plished. In a paper read before the Pharma- Iceutical Society Mr. E. F. HARRISON and Mr. P. A. W. bSELF showed that the method employed by the Ichemists at the United States Customs for the r

analysis of asafetida was imperfect, and that c

undoubted samples of genuine asafetida might con- c

ceivably be condemned by the process. In a paper on cStandardised Powdered Alcoholic Extracts Mr. E. H. i

FARR and Mr. R. WRIGHT explained a method for t

preparing powdered aconite extract, the standard tfor which they suggested should be 1 per cent. of i

aconitine. A communication of considerable value ato medical practitioners was contributed by Dr. H. A. D. JOWETT, in which he discussed the question of the advisability of replacing galenical prepara-tions with their active principles. He showed that while the sole use of active principles, either singly or in combination, is the ideal state ofadministration of remedies, it is at the present time in the majority of cases impracticable. Thereare nevertheless cases in which our knowledge issufficient to warrant the statement that thegalenical preparations can be replaced adequatelyand advantageously by the active principle or

combination of principles. On the other handthere are drugs from which the active principleshave been isolated and investigated, but aboutwhich there is a doubt as to whether theseprinciples represent the full activity of thegalenical preparation. Dr. JowETT’s communica-tion sufficed to show that much investigationremains to be carried out before galenical prepara-tions can be entirely replaced by active principles,and that the work should be carried on by pharma-cologists, pharmaceutical chemists, and cliniciansworking in unison. The results of much pains-taking research were contained in a paper on

Euphorbia Pilulifera by Dr. F. B. POWER and Mr.H. BROWNING, jun. This drug attracted considerableattention some time ago on account of its reputedvalue in the treatment of diseases of the

respiratory organs; but a thorough chemical exa-mination revealed no constituents to which anyspecific physiological action could be ascribed, andsuch therapeutic virtues as the plant has beenpresumed to possess do not appear to dependupon any single substance of a definite chemicalcharacrter

The British Pharmaceutical Conference.The jubilee of the British Pharmaceutical

Conference, an organisation which has played an important part in the progress of pharmacy,was celebrated in London at the end of

July, and some 600 members took part inthe celebrations. Taken as a whole, the paperswere of a high standard, and the majority con-tained good sound material which will form avaluable addition to the stock of pharmaceuticalresearch. Mr. JOHN C. UMNEY, the president,devoted his address to the subject of the revision ofthe Pharmacopoeia; he showed that in mostcountries medical practitioners and pharmacistsdivided the work of revision and shared the credit,and expressed the opinion that in Great Britainpharmacists are not accorded a fair share of thecredit. Mr. UMNEY, speaking on behalf of pharma-cists as a body, declared that until their work wasproperly recognised they would have nothing moreto do with the preparation of the Pharmacopoeiaafter the next edition is published. He proposedthat an Imperial Commission should be appointed,

omposed equally of physicians and pharmacists,ncluding representatives of both professions fromBritish colonies, and that the Pharmacopoeia shouldIe the authoritative work for the whole of theBritish Empire. Professor VAN DER WIELENead a communication on the standardisationtf opium, in which he suggested that a normal

)pium should be prepared by mixing opium of fourlifferent origins, and showed that in this way the’esultant opium would be more constant in strengththan one made by adding some inert substance tothe drug and standardising to 10 per cent. of

norphine, irrespective of the quantities of codeineand the other alkaloids. In a paper on the ChemicalExamination of Wheat Germ, Dr. F. B. POWER andDr. A. H. SALWAY showed that wheat germ containsa very small amount of sinapic acid-a fact of3Special interest, inasmuch as this acid has hithertoonly been known to occur in mustard seed, or atleast in the family of cruciferae. Two useful paperson Thyroid Pharmacy were contributed; in one ofthese Mr. R. G. GUYER gave the result of theexaminations of large quantities of thyroid glandsobtained in Scotland, and called attention to thedual standard in vogue in prescribing and dis-pensing the thyroid gland preparations. He ex-

pressedtheopinionthat as the British Pharmacopoeiadefinitely stated thyroideum siccum as the sub ;stance to be used pharmacists should always employthat standard in dispensing. In another paper onthis subject Mr. N. H. MARTIN suggested that if aniodine standard was set up for thyroid the standardof 0’25 per cent. would not be difficult to maintain.Mr. E. M. HoLMES, curator of the PharmaceuticalSociety’s museums, contributed an interestingcommunication on the Myrrh of Commerce,Ancient and Modern, in which he showed thatthe general belief that the myrrh of the Scripturewas medicinal myrrh is incorrect. Two paperson Extract of Male Fern were communicated,in which the authors, Mr. E. F. HARRISONand Mr. P. A. W. SELF, and Mr. C. A. HILL,suggested methods by which the adulteration ofthis product could be detected. Dr. F. H. CARRand Dr. H. H. DALE presented a communicationon Ergot and its Preparations ; the authorssuggested that since the chief active principles ofthe drug had been isolated in a state of chemicalpurity, it seemed opportune to submit to the testof this new knowledge the pharmacopoeial require-ments for the drug and its preparations. From thispoint of view they criticised the pharmacopoeialpreparations of ergot, and suggested, among otherthings, that suitable salts of ergotoxine and thefluid extract of ergot of the U.S.P. should be intro-duced into the British Pharmacopoeia and some ofthe other preparations discarded.

The Eleventh International Congress of Pharmacy.The Eleventh International Congress of Pharmacy

was held at The Hague during the third week inSeptember, and was attended by delegates fromabout 20 different nations. Reference should bemade to the lecture on the Synthesis of Glucosidesby Professor BOURQUELOT , of the School of Pharmacyof Paris, who has done so much valuable work inconnexion with the investigation of drugs. He

gave a most interesting account of his long seriesof experiments in regard to the action of emulsinon glucosides, and announced that he had discoveredthat the action of enzymes is twofold-decomposingand synthetic. A committee was appointed to framea scheme for the establishment of an International

1866

i-Pharmaeopeeial Bureau. Another matter of con-

siderable pharmaceutical interest discussed bythe Congress was the law affecting trademarksapplied to chemical products used in medicine, andit was resolved to recommend that every medicinalsubstance bearing a trademark name should alsobear an ordinary name from the use of which theowner of the trademark would suffer no loss of

rights. A proposal to introduce into pharma-copoeias a system of international nomenclaturewas brought forward by one of the French dele-gates, who suggested that in addition to the:national names of drugs, &c., international namesshould be used which should be either in- Latin or Esperanto. After discussion the matterwas referred to the International PharmaceuticalFederation.

Pharmacists and National Health Insurance.

Pharmacists began the year less hopefully thanthey now witness its close. Twelve months ago the

operation of medical benefit under the InsuranceAct was about to commence, and not unnaturallymany people were apprehensive for the future ofthe craft. Actual experience, however, has shownthat while the oonditions -regulating the pharma-ceutical service under the scheme are capable ofimprovement, pharmacists are on the whole some-what better off than they were before the Act cameinto force. The immediate effect of the operationGof medical benefit was to increase enormously the(professional work of the chemist, and in industrial,districts there are many chemists’ shops in whichhundreds of prescriptions are now dispensedweekly, whereas in pre-Insurance Act days the dis-pensing of medicines in these shops was quite asubsidiary part of the business carried on.

-Unfortunately, the sums available for the payment,of the drug bill do not allow the Insurance Com-mittee to pay for the drugs ’on a scale which

’permits of more than a very small profit, and, whatis more unfortunate still, it is probable that in someinsurance areas the amount allotted will beinsufficient to pay the chemists’ bills in full. In suchdistricts panel chemists are faced with the

possibility that their bills will have to be dis-counted, although it is hoped that the Committee,will find some means of making up the dencienciesJThe tariff which has been adopted throughout the-country was drawn up by the PharmaceuticalStanding Committee, a body which has done aninvaluable amount of work. Some modifications:were made in various districts to suit local require-’ments, but, generally speaking, the tariff is muchthe same in all parts of the country. The principleupon which it is based is that of making a chargefor each ingredient according to its quantity andvalue and an additional charge for the time andskill required in dispensing. The tariff has been

recently revised by the Standing Committee, andaccepted by most of the local Pharmaceutical Com-mittees and Insurance Committees; the new tariffforms the basis of the new contracts which are beingmade between the chemists and the committees.It will probably be found when the figures for thewhole year are available that the average cost perprescription, taking the country as a whole, will bebetween 7d. and 8d. In Scotland the chemists are

negotiating with the Insurance Commissioners fora. small increase in the dispensing fees, the claimfor special treatment being based upon the factthat much of the dispensing which is now done onInsurance Act terms was formerly paid for at

ordinary prices, a large proportion of private clientshaving been transformed into insured persons.Early in the year representations were made to

the Commissioners that the requirements of theAct as to the qualification of persons who wishedto go on the panels and to undertake the dispensingof medicines operated harshly in some quarters andwere to the disadvantage of the insured population

‘

generally. A Departmental Committee was accord-ingly appointed to investigate these complaints,and many witnesses were heard. Evidence was

given on behalf of drug-store proprietors tothe effect that in certain areas serious inconveni-ence had been experienced by insured personsin obtaining medicines ordered for them by theirdoctors, and that this was due to the fact that thepanel chemists were unable to cope with thedemand. On behalf of the doctors’ dispensers itwas represented that the provision whereby In-surance Committees were unable to make arrange-ments, except in special circumstances, for doctorsto dispense, part of the work which medical prac-titioners had employed dispensers to do had beentransferred to chemists, and the field of em-

ployment open to such persons had been restrictedin consequence. With regard to the case of thedrug-store proprietors, the Departmental Committeecame to the conclusion that such slight inconveni-ence and delay as was proved by the evidence tohave taken place was due to temporary causeswhich had been removed. Further, the committeeexpressed the opinion that it would be inadvisableto amend the Act in such a manner as to permit ofarrangements for the dispensing of medicines forinsured persons being made with persons otherthan those entitled to carry on the business of s,

chemist and druggist. If, however, it should for

any reason be deemed desirable that persons whoare not qualified under the Pharmacy Acts, but havebeen employed in business as drug-store proprietors,should be permitted to enter into arrangementswith Insurance Committees for the dispensing ofmedicines which do not contain scheduled poisons,the amendment of the Insurance Act necessary forthis purpose should, in the opinion of the Depart-mental Committee, be framed not so as to confer astatutory right, but so as to authorise an insurancecommittee to enter into arrangements, if it thinkfit, with persons who are known to the committeeto have been bonâ fide engaged in business as drugstore proprietors. With regard to the case of thedispensers the committee considered that experi-ence as a dispenser to a doctor or to a public insti-tution should not be regarded as in itself and alonequalifying for employment by a chemist and

druggist in that capacity. They expressed theopinion that some direct test of actual attainmentshould be imposed, the chief object of such a testbeing to ascertain the ability of the dispenser todispense any kind of prescription such as it mightafterwards be his duty to deal with. Short of thequalifying examination in pharmacy there is notest such as that which the committee appear tohave had in mind, but it is understood that theCouncil of the Pharmaceutical Society intends tointroduce a Bill to set up an assistants’ examina-tion-which would possibly be a half-way houseto the qualifying examination in pharmacy-whichwould be a suitable test for dispensers who intendto deal with insurance prescriptions under thesupervision of panel chemists.At the end of the last Parliamentary session an

Act was passed to amend the Tnsurance Act, one

1867

of the effects of which was to set up pharma-ceutical committees in each insurance area. Thesecommittees were duly elected towards the close ofthe year, and-it is anticipated that the Pharma-ceutical Committees will be able to assist InsuranceCommittees in such a way as to enable the latterto overcome many little administrative difficultieswhich were experienced during the first year of theoperation of medical benefit. The new Regulationsas to medical benefit, which were also issuedtowards the end of the year, contain provisionswhich were not in the first Regulations, the effectof which will no doubt be to facilitate the smooth

working of the machinery of the Act. Among theseprovisions is one which sets up in each district apharmaceutical subcommittee and another whichsets up a joint services subcommittee ; it will bethe duty of these committees to consider difficultiesarising out of the drug supply and to suggest meansof overcoming them. One of the matters on whichthe joint services subcommittee will be able to giveadvice is the question of the prescribing of pro-prietary medicines, and another that of the dis-

pensing of prescriptions during the hours in whichchemists’ shops are ordinarily closed. In isolatedcases complaints have been made that patientshave found it difficult to obtain medicines on theweekly half-holiday, but in order to remove anyinconvenience of this kind chemists in the areasaffected have very properly made arrangements bywhich medicines can be obtained at all hours.Should difficulties of this kind arise in futurethe pharmaceutical subcommittees and the jointservices subcommittees would no doubt be able to

suggest means of removing them.Pharmaceutical Organisation.

It has become evident that some change in thesystem of pharmaceutical organisation will berendered necessary as the result of the working ofthe National Insurance Act. Fortunately, the Phar-maceutical Society is in a very healthy condition,and is stronger in membership than it has ever beenbefore; it has been shown to be capable of linkingup the local pharmaceutical associations throughoutthe country, and of directing their energies in theproper channels. Mr. W. J. U. WOOLCOCK, whosucceeded Mr. RICHARD BREMRIDGE as the society’ssecretary, had proved himself a valuable organisingofficer before his appointment, and since then hisservices to pharmacy have been more valuable thanever. If it should be found desirable to federatethe Pharmaceutical Committees, there can be nodoubt that this could only be done effectively withthe Pharmaceutical Society as the central body. Mr.EDMUND WHITE, the president of the society, andother members of the Council, have shown bytheir untiring efforts that they are able and willingto overcome the problems which beset pharmacy.

Pharmaceutical Education.No further steps appear to have been taken with

regard to the introduction of a compulsory curri-culum in connexion with the qualfying examina-tion in pharmacy, and it is a question worth con-sidering whether, after all, the best curriculum forthe chemist is not a period of apprenticeship in achemist’s shop. There is hardly a pharmacy in thecountry where there is not now a sufficient amountof dispensing to allow of a pupil obtaining a goodinsight into the practical work of pharmacy, andunder these circumstances few future candidatesfor the qualifying examination should be unpre-pared for the test in practical pharmacy and dis-pensing. A tendency to encourage boys who intend

to adopt pharmacy as a career to pass the necessarypreliminary examination before beginning theirapprenticeship has become more pronounced, andit would perhaps be better for all concerned if thiswere made compulsory. The council of the Phar-maceutical Society no longer requires students topass a preliminary examination in Latin, and thisconcession will no doubt greatly facilitate the

passing of the preliminary examination before theapprenticeship is begun. In the earlier part of theyear a series of post-graduate lectures on Micro-biology and Pathological Chemistry in relation tothe pharmacist was delivered in the PharmaceuticalSociety’s lecture theatre by Professor R. T. HEWLETT,of King’s College, and it is not altogether improb-able that when the syllabus of the major examina-tion is overhauled the subject of pharmaceuticalbacteriology may be introduced.

The Proprietary Medicines Inquiry.The Select Committee on Proprietary Medicines

resumed its inquiry in January, and subsequentlyheld many sittings for the examination of witnesses.Representatives of proprietary medicine interests,analytical chemists, and others appeared before theCommittee and produced in the aggregate a massof evidence which will take a very considerable timeto examine. An interesting witness was the presi-dent of the Pharmaceutical Society, who addressedhimself mainly to questions arising out of the lawconcerning the sale of poisons. In some districtsit has been the experience of chemists that thedemand for proprietary medicines has decreased byreason of the fact that a large portion of the popu-lation is now supplied with medical advice andmedicines by panel doctors and chemists respec-tively, but until the revenue returns showing theamount paid in medicine stamp duty for a full yearduring which the Insurance Act has been in opera-tion are available, the extent to which the sale ofproprietary medicines has diminished cannot beproperly estimated.

The Sale of Poisons and Other Matters.In March the Privy Council signified its approval

of a resolution of the Pharmaceutical Societydeclaring certain hypnotic drugs, including veronal,to be poisons in the second part of the scheduleto the Poisons and Pharmacy Act of 1908. In Maya Privy Council Order came into force by whichall liquid preparations sold as carbolic, or carbolicacid, or carbolic substitutes, or carbolic dis-infectants containing not more than 3 per cent.of phenols were required to be sold by retail inbottles distinguishable by touch from ordinarybottles, the containers to be labelled

" Poisonous--not to be taken," and with the name and address ofthe seller. In connexion with the administrationof the penal clauses of the Pharmacy Acts thePharmaceutical Society instituted proceedings in alarge number of cases, but there appear to havebeen no cases before the courts presenting unusualfeatures. It should be mentioned, however, that theCouncil recently prosecuted a Birmingham firm forselling snuff containing cocaine and omitting toobserve the conditions concerning the sale of

poisons. An unqualified person was charged at theinstance of the Pharmaceutical Society with causinga false entry to be made in the register of chemistsand druggists, and was convicted and .fined £ 50 ;this appears to have been the first case of persona-tion of this kind in which it has been the duty ofthe Pharmaceutical Society to take legal proceed-ings. In May the Departmental Committee on Jury

1868

Service issued a report which contained the re- v

commendation that chemists and druggists should tbe exempted from jury service; at present only I

pharmaceutical chemists are exempt, and it is r

hoped that in due course the Committee’s re- a

commendation will be embodied in an Act of s

Parliament. In August a Bill was introduced in 1the House of Lords by Lord LAMINGTON, the objectof which was to prevent medical prescriptions whichcontained scheduled poisons from being used as ameans of obtaining an undue quantity of the medi-cine prescribed. It provided that where the medicineprescribed by a medical practitioner contained a ]

scheduled poison the prescription should not be dis- ]

pensed more than once unless the medical attendant ‘directed that it should be repeated. No progress wasmade with this measure, and it is doubtful whether ’it will receive enthusiastic support if it is reintro-duced. The principle underlying the measure isno doubt sound, but it is questionable whether the proposed manner of applying it is the most

expedient. ____

GENERAL MEDICAL COUNCIL.The summer session of the General Medical

Council lasted four days. An interesting reportwas received from the Education Committee onthe standard of preliminary education in generalknowledge. Recommendations from the com- ’mittee were adopted by the Council with regardto the scope and character to be maintainedin any preliminary examination in generaleducation for which recognition is sought as

qualifying for admission to the Students Register.The winter session also lasted four days and was pre-sided over by Mr. C. S. TOMES, one of the CrownRepresentatives, in the unavoidable absence of SirDONALD MACALISTER, who was, unfortunately, notwell enough to be present. We note the way inwhich the business is disposed of in the minimumof time-viz., four days, because short sessionsmean an enormous saving of expense. But wewould remind our readers that these do not meanless work ; they imply that the delegation of greatquantities of work to good and energetic sub-committees is regularly bearing fruit. Among themost important business of this session may bementioned certain cases of advertisement of medicalmen in the interests of Approved Societies, medicalaid associations, and other institutions. The evi-dence before the National Health Insurance Act’Committee that abuses of this sort were going onwas abundant. It was considered in camerâ, butletters from the Registrar to a practitioner and tothe secretary of a medical aid association pointingout the gravity of such irregularities were read inpublic. Mr. VERRALL pointed out that the trans-ference of panel patients in bulk from one list toanother conduced to the evil, and the Council

unanimously resolved to call the attention of theNational Insurance Commissioners to the necessityfor preventing this practice.The financial position of the Council is just now

satisfactory, a surplus being announced for thelast completed year (1912) of X1105 being largelyaccounted for by the reduction of over £ 900in expenditure. The zeal of Mr. NORMAN KING,Registrar of the Council, in bringing abouteconomies. has contributed to the satisfactoryposition in which the Council now finds itself. Itmust be remembered that the income of theCouncil depends upon the number of medical men

ivho pay for registration, and that the outgoings ofthe Council are to a great extent regulated by theength of the sessions. If in any year the Council,receiving a smaller sum than usual, is by unavoid-able circumstances driven to hold long or additionalsessions, the surplus would inevitably be replacedby a deficiency.

____

BRITISH MEDICAL ASSOCIATION.

The British Medical Association has had an

anxious year. The responsibilities and expenseshave been much aggravated by its great services inregard to the National Insurance Act, and at theannual meeting held this year at Brighton proposalswere ventilated to raise the annual subscriptionand to form a fighting and insurance fund of

voluntary members. The meeting was well attendedin face of the fact that the International MedicalCongress was due only a few days later, and theRepresentative Body of the Association dulyapproved the recommendation of the Council toraise the annual subscription of the Associationto .f:2 2s. and to form a great fund for organisationand defence purposes.A Special Representative meeting was held in

London at the beginning of December, when it wasagreed, by the necessary majority, to raise theannual subscription to JE2 2s. ; but considerationof the scheme to raise a fund from 10,000 membersat an annual subscription of £ 4 4s. for the develop-ment of the organisation of the profession waspostponed until next July.

MEDICAL PRACTICE UNDER THE NATIONALINSURANCE ACT.

Our readers have been kept informed of the

working of the National Insurance Act throughoutthe year, and have probably reached the conclusionwhich we have reached, that nothing like finality inthe arrangements for the administration of medicalbenefit can be expected for a long time. A generalmovement on the part of a large group of medicalmen to alter the legal basis upon which theadministration of medical benefits is now foundedcame into existence at the close of the year. Thebroad expectation of this group is that a strongcombination of practitioners, resolved in no circum-stances to serve on the panels, may result in therepeal of the contract system, and the distributionof the funds to the insured persons with discretionas to the way the money is spent. Of course, the

possibility that such a movement, if successful,would lead directly to a State medical service hasbeen fully recognised by the protagonists. Associa-tions have also been formed to protect the interestsof panel practitioners and to promote the forma-tion of a State medical service. The medicalprofession as a whole is not yet reconciledeither to the principles or to the working of themeasure. There is no unanimity of this kind torecord, even if active opposition to the Act hasmuch decreased. It is perfectly true that theincomes of many medical men have been improvedby position upon the panels, but at the same timethe Regulations under which medical benefit isadministered, despite various recent modifications,are not satisfactory, and the latest Regulations havecome in for a good deal of legitimate criticism inour columns and elsewhere. The attitude of theCommissioners towards those who have approachedthem with representations that the Regulations