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gratuitously to necessitous sons of medical men. The reportfurther impressed upon those intending to leave money forthe Foundation of Epsom College the great importance ofmentioning in their wills the official title of the College-namely, I I Epsom College "-as a legacy of .6500 which theCouncil thought was certainly intended for the College,had recently been lost as a result of what was, if the Councilwere right, a clerical inaccuracy in the descriptive titleof the College. The work of the College, the general healthof the boys, and the school discipline had, as usual, beenquite satisfactory. The various school games-cricket, foot-ball, and hockey-had been played with success, the footballteam having won most of its matches ; the Officers’ TrainingCorps was in a flourishing condition; an aero section andworkshop had been instituted ; and the various schoolinstitutions had been very successfully carried on. Sincethe last annual general meeting G. W. Davis had obtainedan open scholarship in science at St. Mary’s Hospital ;L. V. Ardagh had secured an exhibition for classics atWadham College, Oxford; A. R. Wood had won an exhibitionfor science at Clare College, Cambridge ; and two old

Epsomians had gained open scholarships at St. Bartholomew’sHospital in October last-namely, G. K. Bowes in science,and J. W. S. Dick in arts.

In proposing that the report be adopted Sir HENRYMORRIS referred to the suggestion which had been made bysome persons that the Royal Medical Benevolent Fund andEpsom College ought to have compromised in regard to thebequest left by the late Miss Glenny. He baid that it wouldhave been most unjustifiable for the College to agree to sucha proposal, as the Council was convinced that the testatrixintended the bequest for Epsom College, and their opinionwas fortified by the statement in the proof of Mr. Crosse,the solicitor to the testatrix and one of the executors, thatthe executors were satisfied that Epsom College was entitledto the legacy, that being the institution the testatrix intendedto benefit. Furthermore, the executors would have beenfailing in their duty had they not done their very bestto enable the bequest to reach the destination intendedby the testatrix. The chairman emphasised the point thatan interval of four days had elapsed between the occasionon which Mr. Justice Joyce stated that if either side knew,either by inadmissible evidence or otherwise, that the legacywas intended for the other, the legacy ought not to be con-tested, and the day on which judgment was given in favourof the Royal Medical Benevolent Fund.

Mr. PARKER YOUNG explained the reasons which hadactuated the committee of the Royal Medical BenevolentFund in the course they adopted, and expressed the hopethat there would be no future difficulties between the twomedical charities.Formal business having been transacted, a vote of thanks

to the chairman, moved by Sir WILLIAM CHURCH andseconded by Sir THOMAS BOOR CROSBY, brought the pro-ceedings to a close.

ROYAL COMMISSION ON VENEREALDISEASES.

AT the forty-third meeting of the Royal Commission onVenereal Diseases evidence was given by Dr. J. J. Pringle,physician in charge of the skin department of Middlesex

Hospital and President of the Dermatological Section of theRoyal Society of Medicine.

Dr. Pringle stated that of 36,151 cases of skin diseasedealt with in the out-patients’ department of the MiddlesexHospital during the last 25 years, 1853, or rather over 5

per cent., presented indubitable evidence of syphilis. This

figure did not represent the number of patients who hadattended the hospital for syphilitic manifestations, but onlythose who had been referred to the special department assuffering from some affection of the skin. Of the 1853cases of syphilis 925 were males and 928 females. Dr.

Pringle thought that this apparent equality of incidence inthe two sexes was due to the fact that men do not willinglyattend hospitals during working hours, except for diseaseswhich in their opinion threaten life or cause grave dis-comfort or pain. On the other hand, anything causingdisfigurement impelled women to seek medical advice. Ofthe 1853 cases of syphilis already mentioned nearly 24 percent. were foreigners.

Dr. Pringle stated that he could not see his way to

supporting or advocating any measure of compulsory noti-fication of venereal diseases. The medical profession was,he thought, practically unanimously opposed to it, andeven if made confidential its effects upon the public wouldbe merely to drive them to seek treatment from unqualifiedpersons. His experience both in hospital and privatepractice convinced him that much of the syphilis existentin England was of foreign importation. He believed that aconsiderable number of prostitutes left their own countriesbecause they were unable to ply their trade there, andspread the disease in this country. It was important thatthis matter should be further investigated and that stepsshould be taken to deal with it.

Public Health.ANNUAL REPORTS OF MEDICAL OFFICERS OF HEALTH.

Metropolitan Borough of Stoke Newington.-In Londonsanitary and social progress is greatly affected by theincreasing " tenementation " (if the word may be allowed) ofhouses originally built and contrived for single families, andProfessor H. R. Kenwood’s report on Stoke Newington for 1913brings out very clearly the drawbacks to such a tenementhouse in working-class neighbourhoods. The proper washingand drying of body clothing, bedding, and household linen isalways difficult in these circumstances, and in many cases itis impossible. The one copper in the basement or on theground floor has to be approached through someone else’skitchen or scullery; there are few if any conveniences inthe shape of mangles, washing boards, and the like,and the drying has to be done in a small room whichmust often serve as a living room, and which is crowded attimes throughout the day. A tenement house lacks adequatespace for healthy reasonable comfort or for children to play,has no provision for storing food or proper facilities for washingup, and no place for storing coal or wood. Little advantagecan be expected from school education in "hygiene," orfrom visits of sanitary inspectors and health visitors, whilethe means of carrying out elementary requirements ofcleanliness are absent. The local authorities in London areable to enforce the provision of a water-supply on each floorof a tenement house, but this is often met merely by theprovision of a tap on the landing, and all dirty water has tobe carried down one or more flights of stairs. It ought, inProfessor Kenwood’s view, to be possible to demand that ascullery sink should be provided on each floor. Where thetotal number of lodgers in a tenement house exceeds 12 thelandlord is required to provide a second water-closet, butalmost invariably this is placed alongside the other water-closet in the backyard. It should be on the first floor, whereit could also serve if necessary as a slop sink. Provision shouldbe required for the proper storage of food in respect of eachtenement, against an external wall, and properly lighted andventilated. Professor Kenwood also lays stress on the defectiveprinciple on which the laws relating to these houses are based.The landlord should be required to maintain his propertyin a sanitary state under a penalty, whereas at present " hehas no obligation to do anything until insanitary conditionsare belatedly discovered by the sanitary inspector and a noticeis served upon him."

" Professor Kenwood is evidently ofopinion that Section 15 of the Housing and Town PlanningAct, 1909, of which much was expected, is inadequate forthis purpose. Realising that the insanitary tenant is oftenby no means free from blame on his own account, the reportadvocates additional powers in by-laws relating to tenementhouses by which the tenants themselves are made moreresponsible for cleanliness and the proper maintenance ofsanitary provisions. It is difficult to read this report, whichis confirmed by that of many other medical officers in recentyears, without surprise that these matters have not alreadybeen more seriously taken in hand in London. The matterof tenement houses is one on which the Local GovernmentBoard and the London County Council might be expected tohave a settled policy, in the active pursuit of which anynecessary additional legislation should be-strongly pressedfor. Possibly the solution lies in-the annual licensing of allsuch houses. Professor Kenwood reports what appearsto be an exemplary penalty for milk adulteration in StokeNewington. The defendant, who had several previous

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convictions against him, was proceeded against for sellingmilk containing 8 per cent. of added water, and was fined£ 100, with costs, with the alternative of three months’imprisonment.

Gwildford Rwral lJiatriot.-Dr. R. W. C. Pierce refers toan investigation made by Dr. E. P. Manby for the LocalGovernment Board, which showed that a shortage of

working-class dwellings existed throughout the district, andparticularly in five parishes. This confirmed the opinionwhich the medical officer of health had frequently ex-

pressed, but from which the district council dissented. Itseems to be argued that no action need be taken by thelocal authority, as many of the cottages are occupied bypersons working in other districts. This fact, however,hardly lessens the responsibility of the district council to usethe Housing Acts for the purpose of providing cottageswhere there is a clear demand for them by personsworking in their district, and it may be supposed that thecouncil would have full control over the tenancies of anyworking-class houses which they provided under the HousingActs. Dr. Pierce states that the four cheap cottages erectedat Merrow by Mr. St.Loe Strachey could have been let overand over again. He doubts, however, if the solution ofthe rural housing problem can be found in attempting tobuild a E100 cottage, which really means the reduction ofthe cost of materials and construction to the lowest limits of

habitability. The Merrow cottages are characterised in nearlyall details by cheapness of materials and omission of manyitems usually considered necessary from the points of view ofsanitation and convenience. A particular defect in suchcheap cottages is the lack of cubic space ; even old and other-wise insanitary country cottages frequently have a roominesswhich is absent from the modern cottage, in the constructionof which the low common lodging-house standard of 300cubic feet per person is too readily accepted. Goodand substantial cottages, even when built in numbers

by contract, cannot be erected in this part of Surreyunder from 175 to .6200 each. Dr. Pierce asks whythe rural worker should be required to put up witha cheap and unsatisfactory cottage, and remarks that thiscountry is not so impoverished that it is obliged to providefor its rural population by makeshift methods. In regard tothe treatment of tuberculosis in non-insured persons(excluding dependents of the insured) a scale of costs wasarranged last year between the district council and the

county council of Surrey. The latter are to pay one-quarterof the total cost and the Treasury one-quarter. The otherhalf is to be made up from the funds of the rural districtcouncil and from the Treasury grant in equal amounts, afterdeduction of any sums received from the patient. In 1913tuberculosis work by the county council appears to havebeen limited to domiciliary visiting of insured patients bythe county tuberculosis officer. A dispensary is now to beestablished in Guildford, and progress will be made with theinstitutional treatment of both insured and non-insuredpersons. The report refers to the working of the tuberculosisOrder of 1913 in regard to tuberculous cattle ; experienceso far has shown that the veterinary examination ofcows in the manner prescribed by the Order cannot take theplace of systematic veterinary inspection of all the milkingcows of the district, which is needed if the tuberculous cowsare to be identified. It is noteworthy that out of five cowssuspected to have tuberculous udders, on veterinary examina-tion under the Order, four did not yield milk in whichtubercle bacilli were found on centrifugalising.Auckland Rural District.-This report, like the two above

referred to, contains instructive information on housingquestions. The Durham colliery village, as is well known,often consists of large numbers of houses built in rows,which do not allow of through ventilation, and haveupper rooms the height and lighting of which are altogetherinadequate. The houses have no yards or spaces belongingto the dwelling, but abut on unpaved common yards’ orback streets the chief feature of which is the line of

capacious middens in between the rows of houses. It isevident from Dr. John F. Macdonald’s report that thecouncil of the Auckland rural district, are making consider-able progress under the Housing Acts in improving suchvillages, and that inspection is proceeding fairly rapidly.Plans are given in the report to illustrate clearanceswhich have been made, and photographs show the greatimprovement which has resulted either by requiring

closing, demolition, and rebuilding, or by getting the,roofs of the houses raised and substantial large bedroomwindows provided in place of the small apertures whichformerly served as window spaces in the upper rooms. Thework has been largely undertaken by different colliery ownersas a result of the representations of the local authority andits public health officers. Self-contained yards have beenadded in some cases, and insanitary privy middens havebeen removed. Over 100 new houses were erected andoccupied during 1913. Out of 397 cases of scarlet fevernotified during the year 233 were removed to hospital.Dr, Macdonald gives a table to show the occurrence of

secondary cases in households infected by scarlet fever (a)when the primary case was taken to hospital and

(b) when the primary case was treated at home. Whileas many as 14 households were affected by return cases afterthe primary case had been sent home from the hospital,about four times as many secondary cases occurred when nohospital treatment was given to the primary case. In

preparing this table Dr. Macdonald has in each instancereckoned the proportion of attacks on susceptible childrenunder the age of 14.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN the 97 English and Welsh towns with populationsexceeding 50,000 persons at the last Census and whoseaggregate population at the middle of this year is estimatedat 18,120,059 persons, 9192 births and 4193 deaths were

registered during the week ended Saturday, June 27th. Theannual rate of mortality in these towns, which had been13-2, 13-5, and 12’9 per 1000 in the three preceding weeks,.further fell to 12-1 per 1000 in the week under notice.During the first twelve weeks of the current quarter themean annual death-rate in these towns averaged 13’9, against13’1 per 1000 in London during the same period. Among theseveral towns the death-rate last week ranged from 4-9 inSwindon, 5’5 in Bournemouth, 5’6 in Southend-on-Sea, 6’1 in.Hastings, 6-3 in Croydon, and 6-6 in Walthamstow, to 17-3 inLiverpool and in Middlesbrough, 18’3 in Oldham, 18’4 inSmethwick, 19-8 in Wakefield, and 21-1 in Stockton-on-Tees.The 4193 deaths from all causes were 304 fewer than the.

number in the previous week, and included 394 which werereferred to the principal epidemic diseases, against 395 and390 in the two previous weeks. Of these 394 deaths, 144-resulted from measles, 93 from whooping-cough, 79 frominfantile diarrhoeal diseases, 35 from diphtheria, 30 fromscarlet fever, and 13 from enteric fever, but not one fromsmall-pox. The mean annual death-rate from thesediseases was equal to 1-1 per 1000 and coincided with the.rate in the previous week. The deaths attributed to.measles, which had been 131, 119, and 140 in the threepreceding weeks, rose to 144 last week, and caused thehighest annual death-rates of 1’8 per 1000 in Stockton-on-Tees, 1-9 in Dewsbury, 2-0 in Smethwick, 2-1 in Warring-ton, 2-5 in York, and 2-8 in Oldham. The deaths referredto whooping-cough, which had been 117, 111, and 99 inthe three preceding weeks, fell to 93 last week; the highestdeath-rates from this disease were 1-6 in Middlesbrough.1-9 in Gillingham, 2-1 in Warrington, and 2-4 in Barrow-in-Furness. The fatal cases of diarrhoea and enteritis (amonginfants under 2 years), which had been 80, 69, and 79 in thethree preceding weeks,were again 79 last week, and included15 in London, 8 in Liverpool, 7 in Birmingham, and 3 eachin Smethwick and Manchester. The deaths attributed todiphtheria, which had been 38, 56, and 40 in the three pre-ceding weeks, fell to 35 last week, of which 11 occurredin London, 4 in Birmingham, and 2 each in Edmonton,West Ham, and Bradford. The deaths referred to scarlet.fever, which had been 26, 24, and 24 in the three precedingweeks, rose to 30 last week, and included 6 in London and3 in Liverpool. The fatal cases of enteric fever, which hadbeen 9, 16, and 8 in the three preceding weeks, rose to 13 last.week, and included 2 in London and 2 in Liverpool.The number of scarlet fever patients under treatment in

the London Fever and the Metropolitan Asylums Hospitals,which had steadily increased from 2862 to 3038 in the sixpreceding weeks, further rose to 3088 on Saturday last ;440 new cases were admitted during the week, against339, 391, and 405 in the three preceding weeks. Thesehospitals also contained on Saturday last 1100 cases ofdiphtheria, 304 of whooping-cough, 72 of measles, and 35 ofenteric fever, but not one of small-pox. The 1045 deathsfrom all causes in London were 8 fewer than the numberin the previous week, and corresponded to an annualdeath-rate of 12-1 per 1000. The deaths referred to diseasesof the respiratory system, which had been 179, 143,