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the earlier studies from the clinical work, and the presentdanger of medical education throughout the kingdom liesin the amount of time demanded for the earlier studies at

the expense of that devoted to clinical observation. It is

upon this subject that Professor CLIFFORD ALLBUTT’S

address is at the present moment peculiarly valuable. He

enumerates the complex divisions of clinical work which fallto this period of a student’s career, and it at once becomesevident that the last two academic years are wholly in-adequate to afford opportunity for obtaining more than amere smattering of them. Some of these subjects maybelong to what is now regarded as the earlier scientific

training but several of them can only be attended during theclinical period of study, to the manifest overcrowding of that

period. In practice it has been found that the whole of thefirst three years has been annexed by the teachers of theearlier scientific subjects and with the uncertainty of theresults of examinations students are fortunate, indeed, if atthe end of this period they are free to commence their

clinical work. And when they do so they find themselvesconfronted with more work than it is possible to get through,without great ability and considerable luck, in the statutoryperiod of their two remaining years. Professor CLIFFORD

ALLBUTT regards as possible an extension of the curriculumto six years, as in Germany, France, Italy, and other

continental countries, but pending such an alteration he

urges a revision of the curriculum to allow at least two and

a half years to be spent in clinical work. He also, perhapssomewhat to the astonishment of his audience, warmlyadvocated the one-portal system of qualification, though thiswas natural, as under such a system a certain amount oftime would certainly be saved.

It is at first sight curious, at a time when some of theLondon schools are resigning the giving of instruction in

the earlier scientific subjects and devoting themselves

purely to clinical work, to find Professor CLIFFORD

ALLBUTT raising his voice in favour of instruction in

country hospitals. He would seem to be in one voice

advocating consolidation and recommending the oppositecourse. But this is not so. The union of the London

hospitals will surely lead to arrangements for free inter-

change of students and in many cases it will tend to theinculcation of broader views and to weaken the spirit ofdogmatism which so often results from the present systemof separate centres. There would appear to be many diffi-

culties under any general scheme of amalgamation, amongstwhich it is only necessary to mention that of "signing up "

for attendance at lectures, and there would be some

loss of the personal relation between the teacher and

the student which has long been recognised to be

the chief advantage of the smaller schools. But

economy and efficiency seem to us to call for this

reform. With regard to the wards of a country hospital,we see no reason why they should not furnish valuable

material for clinical observation if the medical staffs can

make any arrangements for the reception of students, and ifit is understood that no new centres of education are beingstarted, but merely wayside stations provided along an

arduous track, whereat the traveller can obtain occasionalrefreshment. The limited time of the student is too preciousfor any part of it to be unproductive, and in the hospital

of a great city the constant variety in the medical and

surgical wards, as well as in the special departments, mustof necessity be greater. Throughout Professor CLIFFORD

ALLBUTT’S thoughtful address this was the only suggestionthe force of which we had some difficulty in appreciating andit only remains to conclude with a word of gratitude to

him for the valuable help which his words have rendered

in the solution of some of the problems which surround the

complex question of medical education in London.

Public Control and Public Healthin the County of London.

WE have received from the Clerk to the London CountyCouncil a report by Mr. ALFRED SPENCER, chief officer ofPublic Control, which gives particulars of the work of hisdepartment for the year ended March, 1905. This reportmay be regarded as supplementary to that of the medical

officer of health, inasmuch as it deals with several matters

affecting either directly or indirectly the health and well-

being of the dwellers in the metropolis. It opens with an

interesting section on coroners, giving particulars as to

the number of inquiries held in the several metropolitandistricts and as to the remuneration of coroners and

the costs of inquests. Useful and well-arranged tables

are given, showing, as regards the several cases in whichinquiry has taken place, the causes of death of the

deceased, their ages at death, and the ‘ findings " of thecoroners’ juries. The powers of the London County Councilwith reference to coroners differ considerably from thosepossessed by other local authorities. They consist chiefly inthe appointment of these officers and the payment of theirsalaries, the apportionment of their districts and the regula-tions and disbursement of costs connected with the holding of

inquests and last, but not least, in the provision of suitablecoroners’ courts, with convenient mortuary and post-mortemarrangements in connexion therewith. But in the judgmentof the County Council even the exceptional powers which it

possesses are inadequate for the administrative needs of the

metropolis. Accordingly, on several recent occasions the

Council has memorialised, hitherto unsuccessfully, the

Lord Chancellor and the Home Secretary, urging uponthem the desirability of amending the Coroners Acts.

The following are among the more important alterations

advocated by the County Council, the adoption of which,the Council believes, would lead to greater efficiency aswell as to economy in the discharge of the work of

the coroner’s court: (1) that no death should be regis-tered without attestation as to cause on a prescribedform, signed either by a medical practitioner after identi-fication of the body or by the coroner after inquiry,the certificate being sent to the local registrar and not

to the relatives of the deceased, as at present; (2) that

medical investigators should be appointed to inquire into

the causes of all uncertified deaths, to make post-mortemexaminations when necessary, and to act as medicalassessors to the coroner; and (3) that the number of

jurymen should be reduced to half their present statutoryminimum and that the " viewing of the body" by thejury should no longer be obligatory. The County Council

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in its endeavours to obtain a revision of the present h

law is giving expression to general opinion to a great o

extent and if we are unable wholly to endorse the o

views expressed by the Council we can see that they t

are dictated by zeal for the public safety. The point 1;

upon which all are agreed is that the best available C

medical evidence should be obtained. With regard to t

medical investigators to assist coroners as assessors, a s

medical coroner requires no such assessors, while a lay s

coroner will only benefit by their aid if he is able to use c

them in the best manner and if the best sort of official is

provided. These are large "ifs," for public bodies must t

safeguard public funds, while genuine professional experts (

will rightly demand special fees. A medical coroner can 1

appreciate at its just value the medical evidence given t

before him by the proper person and can interpret it to

the jury. If such a coroner views the body of the deceased (

the jury certainly need not be asked to do so. It is for

these reasons that we have always upheld the appointment of medical coroners as leading both to efficiency and to i

economy-i.e., to the declared objects of the London CountyCouncil. We believe that if the Council made an invariable

practice of appointing medical men to these posts the

public would benefit thereby.The action of the County Council under the Infant Life

Protection Act of 1897 is particularly important at the

present time in view of the recent revelations before the

committee on physical deterioration as regards excessive

infantile mortality in relation to the continued decline of thebirth-rate. The Act, as a whole, has proved useful in safe-

guarding the lives of infants. "put out to nurse" for a

pecuniary consideration. It requires, under penalty, that

persons who, for hire or reward, undertake the care of

(1) more than one infant under the age of five years for alonger period than 48 hours, or (2) a single infant under twoyears old, in consideration of a lump sum payment not

exceeding .620, shall notify the fact to the local authority.The giving of notice is also required on the removal of anyinfant and the coroner must be informed in the event of an

infant’s death. And, further, where an infant is known to be

kept in conditions detrimental to health, power is given tothe local authority to remove the infant to a workhouse.At the present time two male and three female inspectorsare employed by the County Council for the purposes of

the Infant Life Protection Act and during the year underreview between 3000 and 4000 domiciliary visits have beenpaid by the inspectors with the object of securing compliancewith its provisions. We are gratified to learn from the

report that the keepers of " notified houses " are generallyfound to be respectable, hard-working women, anxious to

do their best for the infants under their charge althoughthe remuneration appears frequently to be insufficient for

the services demanded. It is a matter of frequent experi-ence for the inspectors to find adults in notified houses

going short of food but in no case have they found the

nurslings deprived of necessary nourishment. Statistics

are given in the report as to the mortality occurring amongthese children but as the numbers dealt with are insignificantit is futile to draw comparisons between this and the

mortality of infants nursed by their parents at home.In regard to the action of the Poor-law authorities who

have procured the introduction of a Bill into the House

of Commons having for its object the further strengtheningof the Infant Life Protection Act, the report assures us thatthe amendments of the present law advocated by the Poor-law authorities and fully approved by the London CountyCouncil would secure (1) the more adequate safeguarding ofthe lives of adopted infants ; (2) the effective inspectorialsupervision of lying-in homes and of persons who

systematically advertise or answer advertisements for the

care or adoption of nurse infants ; and (3) the granting of

powers to the local authorities to enforce the provisions ofthe Prevention of Cruelty to Children Act in respect of actsof cruelty to infants coming under the Infant Life ProtectionAct. Amendment of existing law on the foregoing lines hasbeen on several occasions urged on the Government and in

June, 1904, the Home Secretary was asked to receive a

deputation from the London County Council on the subject.Mr. AKERS-DoUGLAS, however, declined to comply with this

request on the ground that the Government was unable tointroduce legislation of this nature during the session.

Accordingly, both the Poor-law authorities and the London

County Council found themselves once more foiled in their

praiseworthy efforts for the adequate protection of infant

life. These efforts, however, will assuredly be renewed onthe first available opportunity and in the present state of

public opinion we cannot doubt their eventual success. In

the interest of the rising generation it is satisfactory tonote that the protective action of the London CountyCouncil is by no means limited to the stage of infancy.The Employment of Children Act of 1903 gives power tothe Council to regulate by by-law child labour under the

age of 14 years and street trading under the age of 16

years. Section 3 of that Act prohibits the employmentof children under 11 years of age in any sort of street

trading and also forbids the employment of children

under 14 years of age between the hours of nine in

the evening and six in the morning without the formalconsent of the local authority. No child may be requiredto lift or to carry heavy articles or to follow any

occupation likely to injure health or to cause danger to lifeor limb, regard being had to his or her physical condition.The employment in various industries of ‘‘ half-timers "

under the Factory Act of 1901 is expressly prohibited bythis Act and under the by-laws submitted by the Councilto the Home Secretary, and now under consideration, the

employment in any handicraft of school children, whetherin whole or partial attendance, is carefully regulated. It

is hoped that after the promised statutory inquiry these

by-laws will be settled and put in force, for until this hasbeen done there will be no effective means of checkingthe over-employment of school children which unfortunatelynow exists to a serious extent.

Under the same Act the Council has submitted for

the Home Secretary’s approval a series of by-laws as

to street trading by persons under 16 years of age.These by-laws, which are fully set forth in the report,are designed to regulate the employment in this industryof both boys and girls of tender age. Many of the

proposed by-laws are of a salutary character but as.

some of them will certainly provoke trade oppositionwe doubt whether the Council will obtain them without.

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modification after the statutory inquiry. Under the ShopHours Acts, 1892-95, the employment in places of businessof young persons of both sexes under the age of 18 yearsis limited to 74 hours a week, including meal-times. In

order to secure compliance with the terms of that Act thereare employed six male and three female inspectors, who last

year made 120,000 inspections and discovered 7000 irre-

gularities as regards the employment of 36,000 young personsengaged in London shops. The report states that there isa. steady and satisfactory decrease in the cases of serious

over-employment detected by the inspectors year after year.The Seats for Shop Assistants Act of 1899 is also reported tobe working satisfactorily. The essential section of this Act isthis: that in all rooms of a retail shop where femaleassistants are employed the employer must provide seats

behind the counter, or in other suitable position, such seats

being in the proportion of at least one seat to every threeassistants employed. During the past year no legal proceed-ings have been taken under this Act ; shopkeepers as a rule

recognise the usefulness of its provisions and loyallyendeavour to carry them into effect.

Annotations."Ne quid nimis."

SOME LESSONS OF THE ELECTRICALEXHIBITION.

THE exhibition of electrical appliances which was heldrecently at Olympia lends decided force to the view

that before long we shall see electricity employed in

a good many fresh directions. Indeed, this mysteriousform of energy as soon as it can be supplied abundantlyand at a moderate cost, which we may expect to be

the case at no very distant date, bids fair to become

part and parcel of our daily needs and comforts. Weare familiar with its application to lighting, to locomotion,to telegraphy, but less familiar, perhaps, with its use fordomestic heating and cooking, for rocking the cradle, forkeeping water and air pure and clean, for indicating time,for cleaning our boots and linen, and for other innumer.able purposes. The meaning of it all is that electricityis, after all, an easily produced, easily transmitted, and aneasily translated force. Energy must, of course, be spentto obtain it and we have only to await the time when itsproduction will be reduced to an economical minimum andits uses will be universal and its applications well-nighillimitable. As these applications increase so it may

safely be predicted shall we probably find a new factor

concerned in impioving the public health in manydirections. We have already evidence of this when we

consider the hygienic improvement effected by the intro-

duction of electric traction and of electric lighting. The

universal adoption of electric heating should be produc-tive of a similar hygienic gain. In this connexion, however,the events at the centre of production must be taken intoaccount. Where no direct natural power is available, as thatsupplied by the fall of water, coal is still our great source ofenergy and consequently of electricity, and it is desirable,therefore, to insure that in the methods used in the combus-tion of coal no offence against hygienic law is committed bythe engines used to drive the dynamo. There are other direc-tions also in which the universal application of electricityshould be watched by those jealous for the public health. In

spite of the great advances made in electrical engineering

the systems of lighting in vogue have undergone but

little development. The arc light and the incandescentfilament were devised several years ago and there are few

striking improvements to record in regard to their

construction. Certain modifications in detail, it is true,have been made as, for example, in the use of a vacuum

with the arc light and in the adoption of terminals whichgive a more brilliant light, while filaments with the sameobject in view and composed of materials other than carbon,such as osmium or rare metallic oxides, have been intro-duced into the electric incandescent lamp. The principleof the systems in the respective cases remains, however,the same. One mistake, we venture to think, is

being made in devoting so much attention to increasingthe brilliancy of the light rather than to new means

of diffusing it. When the source of light is con-

centrated at a given point the eye invariably shirksthe dazzling rays, whereas if the same intensity of lightcould be distributed the result would be pleasingand comfortable. Startlingly brilliant light as a source

of advertising in our streets is open to considerable

objection and the blazing arc lights with their intense

yellow glare which have recently been adopted in manyplaces in London may be a triumph as regards intensity oflight but they are very trying to the eye. The sun, it is true,is the ideal source of light but we are not compelled tostare at it, or to be bombarded continuously by its rays.The recent display of so much intense lighting at

Olympia was a source of considerable fatigue to the

eye and the headache which some visitors complained ofwas undoubtedly due to the tiring effects of brilliant light.Other directions in which development is to be hoped for isin the means of storing electric force. As the exhibition

amply evidenced, we have not advanced very much onthe old Faure accumulator made of heavy lead plates.We have heard of the wonderful accumulator of Edisonwith its great portability and capacity but its applica-tion to practical use appears to be moving very slowly.Something like an advance will indeed be made when

it becomes possible to drive a brougham 100 miles or

so with a box of energy which is comparatively light andnot bulky. The complications of the oil motor will thus

be dispensed with as well as the nuisance arising fromimperfectly consumed oil. The future is bound to see

further devdopments and applications of electrical scienceof equal, if not of greater, wonder than before.

THE CONDITIONS OF MEDICAL PROGRESS.

THE interdependence of the different branches of know-ledge renders it inevitable that any one of them whichceases to recognise, and to adapt itself to, the progress madein other directions must present a one-sided growth or evencease to develop at all. If this is so with abstract sciences,it is so still more with an art such as that of medicine which

represents the practical side of knowledge. In days gone byscientific discoveries were chiefly made by workers in thefield of medicine who pursued the path of research with thedirect object of improving the existing means of combatingdisease. More recently the conditions have been reversedand advance in medicine has been mainly owing to the

progress made in abstract science which has led to

new therapeutic and diagnostic methods. In bothcases the relation between medicine and science in

general has been sufficiently close and any breach in thealliance would have been fatal to the growth of knowledge.Such is the burden of a most interesting address given byDr. J. Michell Clarke to the Bath and Bristol Branchof the British Medical Association, an address which

may be studied profitably by all members of the profession.Unfortunately, the conclusion which the speaker finally