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that out of 17 persons convicted (all on one day 1) 3 were Imentally deficient. One of these, who was charged Iwith driving at 32 miles per hour, was also deficient in i

hearing and sight, and could not differentiate between ’[’the " go " and " stop " signals used by the trafficcontroller. It is clear that only a stringent examinationfor the driving licence will protect the public from suchdangers as this.

A Psychiatric Clinic. iA mental hygiene survey in the town of Cincinnati

(Ohio) this year resulted in recommendations for acoordinated municipal effort centring in a psychiatricclinic and including the public school system, thesocial welfare agencies, the police courts, and thefaculties of the local universities. The scheme was wellsupported by prominent representatives of medicine,

Ilaw, and education, and as a result$30,000 a year of z,public money has been voted to carry it into effect.Cincinnati is the first town in this country to adopt so Icomprehensive a scheme. ’

A Health Journal for the General Public.An important new venture is being undertaken by

the American Medioal Association, which is to publisha new journal of " individual and community health."Hygeia, as it is to be called, will be written in non-technical language, so that all may benefit from itsteaching. It is understood that many prominentmedical men have undertaken to contribute. Thefirst number is promised for April, 1923.

Cancer Publicity.As a result of th e publicity organised by the American

Society for the Control of Cancer during the recent" Cancer Week " no less than 2864 personal requestsfor information have been received by the society.Your readers are, no doubt, aware that this societyseeks to combat cancer by spreading a knowledgeof the predisposing causes and early symptoms ofcancer, and of the importance of early diagnosis andtreatment.

Public Health Services.REPORTS OF MEDICAL OFFICERS OF HEALTH : I

SUGGESTIONS BY THE SCOTTISH BOARD.THE Scottish Board of Health has issued a circular,under date Dec. 28th, 1922, to medical officers of

health for Scottish burghs containing hints for Iincreasing the usefulness of their annual reports. Incases where these reports are printed, the Boardsuggests that arrangements should be made for a ijudicious local distribution of the reports as soon asthey are available, and that steps should be takenthrough the local press, and otherwise, to bring theircontents effectively to the knowledge of the people.One of the main purposes of the compilation of thereports is recognised to be that, by giving them thewidest possible publicity, they may engender a

popular interest in the subject, and an enlightenedpublic opinion to support the local authority inrealising its high responsibilities for the health of itsarea, and in remedying, at the earliest opportunity,the various defects which the survey may bring tolight. Such an increase of public knowledge andinterest in these matters may also, it is suggested,become an effective means of educating the citizensin the more important conditions of public health,of warning them against particular dangers, and ofsecuring that important cooperation and confidencebetween them and the health authority and its staffwhich is essential to successful health administration.The annual report, it is recommended, should be

concerned chiefly with the conditions affecting health. in the burgh and with the means for improving those

conditions. Its should contain an account, broughtup to the end of the year under review, of the sanitarycircumstances of the burgh and of any improvementor deterioration that may have occurred during theyear. Care should be taken to -report fully andexplicitly on injurious influences in any degreeaffecting or threatening to affect the public health inthe burgh, and on the action that has been taken orthat may still be required to combat these influences.It is of special importance that medical officersshould record what action has been taken to remedyunhealthy conditions that have been referred to bythem in previous reports, and that attention shouldbe called afresh year after year to such as remain iunremedied. !

Report is specifically asked for from the medicalofficer of health on the following points :- !

1. A general account of influences and conditions injurious Ior dangerous to the health of the burgh, and of the measures Ithat in his opinion should be adopted for its improvement.

2. A statement of the general inquiries he has madeduring the year, and of any special inquiries as to sanitarymatters.

3. A general statement of any matters as to which he hasgiven advice or granted certificates, including any action asto offensive trades.

4. A specific account of the administration of the Factoryand Workshop Act, 1901, in workshops and workplaces.

5. An account of any proceedings under the Housing(Scotland) Acts, 1890-1920, dealing specifically with (1) thesufficiency and habitability of working-class dwellings;(2) any schemes under consideration or contemplated forthe improvement of insanitary areas under Parts 1. and II.of the Housing of the Working Classes Act, 1890 ; and (3)the action taken where instances of overcrowding have beenascertained or suspected.

6. A statement showing whether any conditions havearisen, or are expected to arise, pointing to the expediencyof a town-planning scheme for the proper control of furtherdevelopment.

7. An account of the presence or absence of pollution ofrivers or streams in the district, the sources and nature ofanv such pollution, and any action taken to check it.

8. An account of any proceedings under the BurghPolice Act.

9. An account of the hospital accommodation availablefor persons suffering from infectious disease in general, andfrom small-pox in particular (including the means providedfor the conveyance of such persons), and of, the houses ofreception, with observations on the furnishing, maintenance,administration, and adequacy of such accommodation, &c.

10. An account of the premises with necessary apparatusand attendance available for the destruction or disinfectionof infected articles (including the means for the conveyanceand return of such articles), also of other processes of dis-infection in use, with observations on the adequacy of sucharrangements and processes.

11. An account of the action taken to prevent the out-break and spread of infectious disease.

12. A statement of any action taken (a) for the controlof acute primary pneumonia, acute influenzal pneumonia,malaria, dysentery and trench fever, under the PublicHealth (Pneumonia, Malaria, Dysentery, &c.) Regulations(Scotland), 1919 ; and (b) with regard to

" carriers " underthe Public Health (Infectious Disease Carriers) Regulations(Scotland), 1921.

13. A statement of the facilities available for the treat-ment of persons suffering from venereal diseases, withrecommendations as to any further measures that mightusefully be taken for dealing with these diseases.

14. A statement as to the causes, origin, and distributionof diseases within the burgh, and the extent to which thesame have depended on or have been influenced by condi-tions capable of removal or mitigation.

15. A statement of the measures adopted for the adminis-trative control of tuberculosis, with recommendations as toany further measures that might usefully be put in force.

16. A statement of the arrangements made under thescheme of maternitv service and child welfare.

17. A report on the working of the Notification of BirthsAct, 1907.

18. Observations on the wholesomeness of the milkproduced within or imported into the district and on thegeneral adequacy of the arrangements for the supply anddistribution of milk of pure and wholesome character ; alsoon the administration of the Dairies, Cowsheds, and Milk-shops Orders and the Milk (Scotland) Order, 1921 ; and anyaction taken as to tuberculous milk, whether under local Actsor under the Dairies, Cowsheds, and Milkshops Orders.

19. An account of the work done under the existingarrangements for the inspection of meat at slaughter-houses, shops, and elsewhere ; observations on unsoundfood, food inspection, and the sanitary condition of premiseswhere foods are manufactured, prepared, stored, or exposedfor sale, indicating any important respects in which existing

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powers have been found inadequate for dealing with insani-tary conditions in such places.

20. A report on the work done by the local authorityunder the Sale of Food and Drugs Acts, and under the Saleof Food Order, 1921, with observations on any specialquestions which have received or require attention.

21. A tabular statement, in such form as the Board maydirect, (1) of the cases of infectious disease notified in theburgh, and (2) of the infantile mortality in the burgh.

The medical officer of health is asked to transmita copy of his report to the Board and to the localauthority not later than April 30th, and he is remindedthat report must be made to the Board, with theleast possible delay, of every case of ophthalmianeonatorum in which, in his opinion, there occursappreciable loss of vision.

A SURVEY OF PUBLIC HEALTH IN SOUTH AFRICA.

UNDER the title of the Public Ill-Health, Dr. J. A.Mitchell, secretary for public health and chief healthofficer to the Union of South Africa, delivered a stimu-lating address to the recent South African MedicalCongress at Johannesburg. His frank review offailures is not merely of local interest and we sum-marise, as closely as possible in Dr. Mitchell’s ownwords, some of the features which he finds disquietingin the public health of the Union.

First, he mentions the overcrowding and insanitaryhousing of a considerable section of the population,both European and native. Many of the smaller townsand villages have polluted water-supplies, leading to aprevalence of worms and intestinal diseases. In manycentres tuberculosis is a serious scourge. Malaria isprevalent and is retarding the development of a largepart of the Transvaal, Zululand, and the northerncoastal belt of Natal, comprising the most fertiledistricts. The death-rate of the Union is descreditable.The infantile mortality among Europeans in the Unionis twice as high as it should be ; in some places it couldbe halved, in others it could be reduced to a thirdof the present rate. There is widespread ignoranceand carelessness as regards health matters, includingthe care of infants and children and the feedingboth of children and adults, while little is being doneto enlighten the rising generation in these matters.Very few are short of food, but a considerableproportion eat too much for the work they do, andstill more eat the wrong kind of food or do notcook it in tne ngnt way. scnooi mecticai inspectorsreport that malnutrition is common, even in thechildren of the well-to-do. Children are fed on

sloppy food, requiring no mastication, resultingin decayed teeth and ill-developed jaws. Attendingfootball matches, &c., is more popular than participa-tion in games. There is much use of patent nostrumsand " Dutch " medicines. There is a great dearthof competent maternity nurses, and an enormous

consequent loss of infant and maternal life. Thepeople as a whole are too extravagant and pleasureloving. The Union, with a white population of1,500.000 and an annual government expenditure ofz29,000,000, spent in 1920 900,000 on bioscopes andentertainments, and .811,000,000 on liquor. There isa growing disinclination in both sexes for the ties andresponsibilities of marriage. The average age atmarriage is increasing and so is the divorce rate. InJohannesburg the annual number of divorces is morethan one-third of the marriages. Large families are outof fashion and birth control is on the increase. A typeof female-more or less of the neuter gender-isincreasingly common ; she does not marry, or if shedoes, she proves sterile or takes care to have nochildren, or at most one or two, and these she bringsup on the bottle. Were tlus state of things to con-tinue and increase, says Dr. Mitchell, the prospect ofbuilding up a strong white nation in South Africawould be gloomy indeed.

Fortunately, however, there is another side to thepicture. In recent years, and especially since theinfluenza epidemic, all responsible authorities havebeen devoting more attention to health matters. The

public press is lending a hand. Religious organisationsare realising that they cannot hope to survive on dogma,ritual, and abstractions, and that mankind to-dayrequires a practical religion applied to the currentproblems of life. The boy-scout and girl-guide move-ments have beneficial and far-reaching effects. TheRed Cross is doing good peace work. The thinking andintelligent section of the public is waking up. Thecrying need of to-day is for more knowledge, for a returnto simpler habits of life, for a truer appreciation of thethings that really matter, and for better organisation.’ Dr. Mitchell passes on to ask what the medicalprofession is doing in connexion with these matters.In civilised countries to a large extent advancementin the public health depends upon the knowledge andeffort of the individual. " Is the medical professionin South Africa playing the part it could and shouldplay in diffusing that knowledge and awakening thatsense of responsibility ? " asks Dr. Mitchell, and hegoes on to say " that some means should be devisedof giving the private practitioner a live, real, andfinancial interest in prevention." He is not in favourof a State medical service free to all. He realises thatspecialist assistance must be brought within reach ofall and regards the Dawson report as an excellent basisfor discussion. He concludes by a reference to theprofit made by the Metropolitan Life AssuranceCompany of New York by the system, instituted in1914, of free periodical medical examination and. advicefor their policy-holders.

The Services.ROYAL NAVAL MEDICAL SERVICE.

Surg. Comdrs. to be Surg. Capts: R. J. MacKeown(Vernon), F. H. Nimmo (Victory), R. F. Clark (Vivid), andR. St. G. S. Bond (R.N. College, Greenwich).

Surg. Lt. K. A. 1. Mackenzie to be Surg. Lt.-Comdr.

ROYAL NAVAL VOLUNTEER RESERVE.

Surg. Lt.-Comdr. R. Wilbond to be Surg. Comdr.Hon. Surg. Lt.-Comdr. F. J. Hannan to be Hon. Surg.

Comdr. -

ROYAL ARMY MEDICAL CORPS.

Col. R. J. Blackham, late R.A.M.C., is placed on half pay.The undermentioned Lt.-Cols., from R.A.M.C., to be Cols. :

Bt. Col. R. S. Hannay, vice Col. A. H. Morris (ret. pay) ;(Temp. Col.) H. P. W. Barrow, vice Col. R. J. Blackham.

Lt.-Col. G. B. Riddick retires on ret. pay.Lt.-Col. G. M. Goldsmith relinquishes the temp. rank of

Col.Capt. and Bt. Maj. L. G. Bourdillon retires, receiving a

gratuity, and is granted the rank of Maj.Capt. A. E. Drynan resigns his commn.

ARMY RESERVE OF OFFICERS.

The undermentioned cease to belong to the Res. of Off.on account of physical unfitness : Lt.-Cols. J. P. Silver,C. S. Smith, W. F. H. Vaughan, F. S. Walker, M. C. Wetherell,and A. H. O. Young; Majs. W. M. Power, (Bt. Lt.-Col.)G. F. Sheehan, and F. T. Turner.

, Lt.-Col. W. Owen-Prichard, late E. Afr. Med. Serv., to beLt.-Col.

ARMY DENTAL CORPS.

Capt. U. J. G. Dancer, late Spec. List, to be Capt.TERRITORIAL ARMY.

Maj. L. D. Bailey to be Lt.-Col., and to commd. the Co.of Lond. Fd. Amb.

Capt. R. S. Taylor resigns his commn. and retains the rankof Capt.

General Hospitals : The undermentioned, having attainedthe age limit, are retired and retain their rank except whereotherwise stated : Lt.-Cols. G. E. Wherry, F. Deighton,E. Hobhouse, R. F. Jowers, E. F. Maynard, and F. J. Paley ;Majs. A. Cooke (granted the rank of Lt.-Col.), E. L. Jones,J. A. Wright, W. Broadbent, C. F. Bailey, T. H. Ionides,F. G. Bushnell, and W. A. Bowring; Capts. (Bt. Maj.)J. F. Fawcett and (Bt. Maj.) A W. Ormond ; Capts. J.Gutch, G. S. Haynes (granted the rank of Maj.), P. N. BOdgers, H. W. G. Mackenzie, H. G. Turney, W. S. Colman,R. P. Rowlands, R. J. Probyn-Williams, M. Horne, H. F.Lancaster, and F. D. S. Jackson (granted the rank of Maj.).