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1338 approval upon its aims and objects, had now conferred a i still greater honour upon the Fund by consenting to become s its Patron. The news of this honour, which Prince Arthur had hoped to convey in person, was very warmly received. The message continued : ! 1 am not sure that we all realise what a debt we owe to the medical profession. Surely the fact that its members are spending their lives in alleviating suffering and are engaged lighting with disease must appeal to the imagination. Yet, do many of us, whose ordinary business hours are from 10 to 4, ever think of the overworked doctor, who is liable to be called out at any hour of the day or night to pass several hours at some bedside, while others, who have probably not spent nearly such a hard day in pursuit of their profession or business, are earning what they consider a well-deserved rest ? Great prizes, in the way of fame and fortune, are no doubt attained by a few of its members, but these must always be in a minority ; and when we con- sider the long and patient training needed for such a profession as medicine and surgery has become in these days of exact science, it is inevitable that amongst the rank and file some must go to the wall. Even those whose talent and industry give promise of a brilliant career may be struck down by illness, and it is to provide for the fatherless children of such that I had hoped to be present to plead this cause to-night. As you are all aware, the Royal Family and myself have very special reasons of gratitude to the medical profession, by whose skill and care my beloved mother the Duchess of Connaught, though passing through a very great crisis, is being slowly restored to her normal health and strength. Consequently it is a very great pleasure to me to subscribe to this fund to-night and also to send you a cheque from my father as his contribution as a thankoffering and tribute of respect and admiration for the noble profession so largely represented to-night. Dr. SAMUEL WEST, in acknowledgment of the toast, expressed the regret of all present at the absence of His Royal Highness, and their warm appreciation of the terms in which he had spoken of the Fund and its work. Dr. West said that the new honour bestowed by His Majesty had come as a surprise to most of them. This unexpected compliment, carefully prepared by the kindly thought and consideration of Prince Arthur, would render the gathering that evening memorable in the history of the Fund. Dr. West suggested that an invitation should be conveyed to Prince Arthur to become Vice-Patron, and on the proposal of the CHAIRMAN, seconded by Mr. PARKER YOUNG (chairman of committee), it was resolved to send him a telegram of thanks and sympathy. Mr. GEORGE BETHELL then announced subscriptions and donations amounting to more than £2848, including E25 each from the Duke of Connaught and Prince Arthur of Connaught. ________________ Public Health. ANNUAL REPORTS OF MEDICAL OFFICERS OF HEALTH. Borough of Southend-on-Sea.-Dr. C. G. Pugh’s report on this district for 1912 contains an exceptional amount of interesting material. It relates to a town which is rapidly growing, having now some 67,000 inhabitants, and from being merely a place of resort by trippers has become a residential borough which is the home of large numbers of people engaged in occupations in London and men who have retired from business. Day trippers still come in the summer, however, and on some days the total of temporary visitors has been estimated at 70,000. Only 263 houses were vacant in the middle of the year, though more than 700 had been erected during the previous 12 months. Dr. Pugh emphasises the responsibility imposed on the council by this rapid growth, and urges that every endeavour should be made to avoid a repetition on new building sites of the errors in town planning which are so painfully obvious in the greater part of the area of the borough which has been built over in recent years. The custom of builders of putting up long rows of houses in terraces has given rise to special inconvenience through the difficulty of obtaining access to the backs of houses for removal of refuse and the dirty condition of such back passages as are available. If the corporation properly supervises the develop- ment of building estates in future these conditions should easily be avoided. On the whole, the report gives a favour- able impression of the sanitary government and progress of the town. The authorities are completing the enormous scheme of sewerage and sewage disposal which is designed to stop the pollution of the foreshore in this part of the Thames estuary ; they are providing a dust destructor, a large swimming bath, and new offices of the health department, and have made a beginning with a number of necessary improvements. The better control over the collection of shellfish from the foreshore has had good results which are directly shown in the returns of typhoid fever cases, and Dr. Pugh urges that this control should be still further extended to secure a removal of the mussel banks, which are not only a source of danger but also contribute to a marked extent to the unsightly appearance which the foreshore presents. We are glad to note also the observation that " public conveniences " should be provided not as a source of revenue to the council but for the con- venience of the public. It is unreasonable to expect the working-class woman who takes a family of children to Southend to spend a perceptible part of her holiday money on micturition. Another matter in which strict control is needed in a town of this kind is the condition of the smaller milk shops, many of which in Southend seem quite unsuited for the business. In discussing measures against tuber- culosis the report lays stress on the zeal shown by medical men in the town in dealing with preventable causes of infec- tion among their patients. There is no reason to believe that the advice given to these patients would have been more efficacious if it had come from the medical officer of health, and Dr. Pugh regrets that the Tuberculosis Regulations do not allow some discretion to the medical officer of health as to the cases he should visit. We cannot imagine, however, that the Local Government Board would object to the exercise of discretion in such a matter. The Essex county council has appointed a joint committee for Southend and its neighbourhood, which consists of repre- sentatives of the local district councils, to exercise its powers of providing and working dispensaries. The report lays stress on the importance of thus securing local control over the dispensary system. We read with some surprise that " no fewer than 6’ 3 per cent. of the deaths in the borough in 1912 were registered as being uncertified, thus placing Southend-on-Sea in the position of being, among the great towns, the area in which the greatest number of persons are buried without any medical certificate or skilled inquiry as to the cause of death." It would be interesting to know the causes to which this high figure is to be attributed. Urban District of Weston-super-Mare.-Dr. John Wallace reports an exceptionally thorough system of dealing with diphtheria contacts in Weston-super-Mare, which has been adopted since the county council of Somerset established a bacteriological laboratory in that town. Every suspicious nose and throat has been "swabbed," while every person known to have been in contact with a case or with a bacteriologically positive contact case has been similarly swabbed. It is further stated that no case (unless it had left the town) has been allowed to join the healthy community until two successive negative swabs have been got from the nose and throat, and the patient and the premises with its contents disinfected. This procedure must certainly have entailed a large amount of work on the public health staff, and it is a testimony to the way in which it has been done that Dr. Wallace does not report any substantial opposi- tion from the healthy people with whose business the rigid application of such a system must necessarily at times cause serious interference. The total number of swabs examined was 898, of which 176, relating to 79 different individuals, were positive as regards the Klebs-Loeffier bacillus. All this work was undertaken in connexion with a total of 44 notified cases of clinical diphtheria. It may be questioned whether the system described could be fully maintained during any considerable outbreak of the disease, but we may reasonably suppose that the greatest value can be obtained from it in inter-epidemic periods or at times of relatively low diphtheria prevalence. Borough of Chesterfield.-The importance of giving atten- tion to suspicious cases of lead poisoning in districts which have a soft water-supply derived from moorlands is well illustrated in Dr. F. A. Sharpe’s annual report. A medical practitioner having drawn attention to a case of lead poisoning in which water was suspected, investiga- tion was made of the plumbo-solvency of the public water-supply in its several sections. It was found that samples of water drawn off in the early morning from the low-level supply showed little or no lead, but that on the high-level supply amounts of lead such as 0-07 grain per gallon were present in houses served by old lead pipes and as much as 0’1 and 0’3 in certain houses with new pipes. Water from the Upper and Lower Linacre reservoirs,
