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Suppressioit of Venereal Disease: Police Suggestions.At the recent international meeting of the police,

which took place in this city, reports were made havinga bearing on medical subjects. A suggestion was madeby the head of the Vienna police to abolish the controlof prostitution. He advocates strongly compulsorytreatment of all persons, both male and female, foundsuffering from venereal disease. It is interesting tonote that this demand has been brought forward inseveral instances by medical men at meetings ofpreventive societies, and that in the Austrian NationalAssembly’s archives there are deposited several Billsdealing with this matter, but which had to be shelvedowing to adverse public opinion.

BERLIN.

(FROM OUR OWN CORRESPONDENT.)

Care of War Victiins.DURING the war and after the German Government,

no less than other belligerent Governments, had aheavy burden to bear in the caring for the woundedand providing for the families of the fallen. Accordingto a report recently published, the total casualties inthe army and navy amounted to 1,846,293 killed and4,247,864 wounded. The care of the disabled wasformerly entrusted to the local military authorities-the so-called Bezirkscommandos, who in additionhad many other duties to fulfil-e.g., the control ofthe conscripts and the reservists, under the supervisionof the War Office. When this military organisationwas abolished under the Peace Treaty, the care ofthe disabled was transferred to the Ministry of Labourand was dealt with by special district offices-Versorgungsamter. Up to the present these officeshave settled the claims of 1,537,000 injured and of1,945,000 dependents. Under the former systemthe disabled man received his pension and hadhimself to provide treatment, but the present lawprovides for the free treatment of disablement due

. to war service. This enables any one case to bestudied as a whole and ensures continuity of treat-ment. The treatment is, as a rule, carried out by abenefit society ; for those who are not members ofsuch societies the Government has appointed medicalofficers. There are still 70 military hospitals in usethroughout the country, and these are given over to thecare of the injured. In the German spas the Govern-ment have 16 sanatoriums at their disposal, nine ofwhich belong to the Treasury, the others havingbeen taken over temporarily. Private accommoda-tion for invalids is also available in numerous healthresorts and spas. In 1922 some 14,500 patients weresent to these institutions. In the tuberculosissanatoriums 2700 beds are reserved for war victims.In 63 towns and districts there are centres for ortho-paedic treatment, and necessary appliances, &c., are

supplied to patients. A great number of medicalofficers who formerly belonged to the Army MedicalCorps are now attached to the Versorgungsamter.

Accidents Due to Drunkenness.Dr. Miibsam, chief surgeon to the Moabit Hospital

in Berlin, states in the V ossische Zeitungthat the numberof accidents due to drunkenness has greatly increased.He points out that the spread of drunkenness whichhas grown of late in Germany might well be combatednot only by the Government but also by the benefit tsocieties and workmen’s insurance clubs, which arecalled on to pay the costs of treatment, already veryhigh, in such cases of accident.

Height and Weight in Children.The German Health Office published the results of

an inquiry into the height and weight of school-childrentaken during a period from 1913 to 1922 in the citiesof Stuttgart, Leipzic, Munich, Augsburg, Mannheim,Freiburg, Mulhouse (Thuringen), Königsberg, andSpandau. These cities differ much in size and are Isituated in different parts of Germany. The statistical I

tables show that boys are taller and heavier thangirls of the same age, except at the time of pubertyfrom the eleventh to the fifteenth year. The pupils ofthe secondary schools are much taller and heavier thanthe pupils of the elementary schools. The childrenlost greatly in weight and in size during the war. InStuttgart the average weight of boys of 10 years fellfrom 27-9 to 25-7 kg., but this loss had disappeared atthe last period of the inquiry which ended in thespring of 1922. It is, however, to be feared that asthe supply of food has become again scarce the weightof the children may soon be reduced once more tothe war-time level.

1’reatme,it of Tuberculosis.Prof. Duhrssen recently read a paper before the

Berlin Medical Society on a new treatment of tuber-culosis by inhalations discovered by Prof. Weniger, aGerman medical man residing in Rio de Janeiro, Brazil.The remedy consists of a mixture of uranium, thorium,manganese, and certain acids which form a new

compound, called nitoplasmin. By permeating thecapsule of t 11 e tu‘ercI-e aci idestroys the toxic andinfectious substances, and further it strengthens theimmunising substances within the body cells. Thedaily inhalation of Weniger’s compound has no

obnoxious or disagreeable effect, the patients, on thecontrary, state that they are able to breathe morefreely ; the sputum first increases, but the discharge iseasier and the general state improves, so that theyare able to work again. This change was especiallynotable in graver cases. The condition of the lungsshowed an improvement, even at the end of threeweeks. Every case was examined before and after thecure by radiographic and bacteriological methods.Dr. Duhrssen stated that during his stay in Rio deJaneiro he had seen hundreds of patients who hadbeen cured by Weniger’s method within a few months.His own experiences had also been very satisfactory,and he recommended the treatment to the profession.

Public Health Services.REPORTS OF MEDICAL OFFICERS OF HEALTH.THE following table gives some of the principal

health statistics of the city of Leeds and five countyboroughs. If it is justifiable to group the first threeas dirty-aired towns and the last three as compara-tively clean-aired towns, it is suggestive that theaverage death-rate of the first group from disease ofthe respiratory system with influenza is 2-3, whilethat of the second group is 3-8, and that the differenceis greater than the total tuberculosis mortality ratein any of the six towns.

C.=city. C.I3.=county borough.

Z?<?<S.Dr..T. Johnstone Jervis reports that owing to the

numerous conversions of premises into flats (55 houses

623

were converted into 260 flats in 1922), Regulationsfor underground sleeping rooms under Section 17 ofthe Housing Act of 1909 have been adopted andsubmitted to the Ministry. The control of commonlodging-houses has been transferred from the WatchCommittee to the Health Committee. Applicationwill shortly be made to the Ministry to extend thedefinition of offensive trades to include fried-fish shopsand rag and bone dealers. The local Fish Friers’Association approve the former proposal as they areanxious to have the unsuitable premises brought upto the high standard of the majority. Dr. Jervis, indealing with the smoke nuisance, says the railwaycompanies are among the worst offenders. Lecturesfor stokers were arranged at the Technical School inNovember and December, and were well attended.Out of about 7000 observations (one hour each) ofchimneys during 1921 and 1922, there were 556 caseswhere chimneys emitted dense smoke for three minutes.There were no prosecutions in either year.The Milk Order has met with a poor reception so

far in Leeds, licences having been issued to oneretailer for " certified " milk and to one for " pas-teurised." The two corporation farms have, however,recently been licensed for grade A (tuberculin tested)milk and supply two sanatoriums,the Infants’Hospital,the residential nursery, and the one remaining daynursery (the other three day nurseries having beenclosed as unnecessary). About 10 per cent. of themilk samples were returned as adulterated. Theinspection of cow-sheds shows that the country cowscompare very unfavourably with the city cows forcleanliness. Dr. Jervis comments on the culpablenegligence shown in protecting meat, bread, fish,fruit, &c., from contamination. Mussels from Lythamand Hoylake are excluded from the Leeds marketon account of sewage contamination. There is urgentneed for more hospital accommodation for acutebronchitis and pneumonia. Another need is an

increase in the ambulance service, for dealing withmaternity cases amongst others.The percentage of persons abandoning treatment

at the V.D. clinic before cure is complete reached thelow figure of 7-8 in 1922. Dr. Jervis is very dis-satisfied with the tuberculosis scheme and does notthink the reduction of the tuberculosis death-ratefrom 1-74 in 1913 to 1-40 in 1922 is a result commen-surate with an expenditure of 116,444 during thelast ten years. Other people might think theexpenditure well worth while if they could feelassured the reduction was due to it. Dr. Jervisgoes on to say that if half the money spent on tuber-culosis were spent on slum clearance and betterhousing the result would be much more satisfactory.Well, the Government is now offering Leeds 22500a year for 20 years (total z50,000) towards slum clear-ance, to which Leeds will presumably add a likeamount, making a sum in all not far short of halfthe Leeds tuberculosis expenditure. However, it isfutile to talk of scrapping tuberculosis expenditurealtogether, and Dr. Jervis recognises this when hesays " A proper sanatorium built on up-to-date linesis badly wanted," and welcomes the gift of " TheHollies," a mansion which will accommodate 50children and " be a valuable addition to the generalscheme for the treatment of tuberculosis in the city."At the same time everyone will sympathise with Dr.Jervis’s desire that more should be done to strengthenthe resistance of contacts and to secure the completeconvalescence of children after debilitating illnesses’ by the establishment of recuperative centres andpreventoria up and down the whole country."

Wigan.Dr. Henry Whitehead is able to report that the

scheme for conversion of privies and pail-closets tothe water-carriage system has been begun and thatgreat progress has been made in dealing with insani-tary houses. Proper receptacles are needed for houserefuse, up-to-date vehicles for its removal, and Dr.Whitehead emphasises the need for watering thesbreets before sweeping in dry weather. The construc-

tion of a public slaughter-house is under con-

sideration. An inspection of the gathering groundsof the Wigan water-supply has revealed sources ofpollution. Chlorination has been adopted for twoof the three supplies and steps to prevent the pollutionare being considered. Two additional maternity andchild welfare centres have been established. Advant-age is to be taken of the Government-assisted schemefor dealing with unhealthy areas, and two suchareas are at present being carefully considered. Dr.Whitehead’s school report shows that many thingsare lacking. There is no arrangement for the treat-ment of tonsils and adenoids. A residential open-airschool and an open-air day school are needed andeither a special school or more special classes inorder to carry out the statutory requirements forthe education of mentally and physically defectivechildren. An additional school clinic is wanted.There is ample work for a whole-time dental surgeon,but the school dentist at present only gives threehalf-days a week to inspection and treatment. Arecently completed inspection has shown that thesanitary condition of the schools leaves much to bedesired.

Bury.Dr. G. Granville Buckley shows that the phthisis

and infant mortality rates were the lowest ever

recorded. He issues a warning as to the neglect ofvaccination. At present only one child out of everyfive born is vaccinated. Bury is setting an exampleto the mill towns in smoke abatement. There weretwo prosecutions, one of which resulted in a jB5penalty, the other being dismissed. In over 4 percent. of the chimneys observed, black smoke wasemitted in excess of the limit of 2 minutes in 30laid down by the Bury Council. One observationshowed 28t minutes black smoke and 1 of moderatesmoke in 30 minutes !

East Ham.Dr. W. Benton reports that an up-to-date steam

disinfecting station is needed. An agreement hasbeen made with West Ham Corporation for dealingwith small-pox cases.Judging from Dr. Benton’s report as school medical

officer, the East Ham Education Committee do nottake their duties very seriously. Only children whoseacuteness of vision is -f6g or less are offered the chanceof treatment at the school ophthalmic clinic.The two rooms occupied by the dental clinic were

built as store-rooms and are totally unfit for the prac-tice of dentistry. The system of charging hasinterfered with the attendance and retarded the work.The appointment of at least one more dental surgeonis urged. -The dental needs of children over 10 yearscannot be systematically dealt with. The schooldentist, Mr. Cyril S. Neame, who also treats casessent by the mateinity and child welfare centres,comments on the wonderful improvement in thehealth of the mothers treated (although to his regrethe has not the facilities to provide dentures), andmentions that it is no uncommon thing for him totreat babies of 19 months who have septic mouthsand require three or four extractions. The resultsof past years’ work are becoming evident in thelessened amount of oral sepsis among the scholars.

Dr. Benton emphasises the need from the preventivepoint of view for proper provision being made for thelarge number of delicate and pre-tuberculous childrenin day and residential open-air schools and schools of

’

recovery. From the lack of a cleansing and disin-fecting centre for the treatment of uncleanliness,scabies, and other skin diseases the education of manychildren is interfered with. During 1922, 12,145school sessions were lost by children suffering fromsuch conditions, as compared with 10,113 in 1921.There are no special centres available for the

education of physically or mentally defective childrenunable to attend ordinary public elementary schools.A remedial clinic, with massage, &c., is needed forcases of infantile paralysis, spinal curvature, &c.Dr. Benton points out that the scheme in operation

624

for securing payment from parents for the cost oftreatment has resulted in a setback to the work offollowing up, and that the school nurses are likelyto become unwelcome officials rather than friendlyadvisers. The primary consideration, he urges,should be to secure treatment, and the financialquestion should form no part of the duties of membersof the school medical service.

Derby.Dr. Albert E. Brindley tells us that 1922 was a" measles " year. There were 2618 cases notified,with only 12 deaths, and this lower mortality ascompared with past measles years he claims as beingin no small measure due to the educational efforts ofthe health staff. The figures for 1922 show that thedeath-rate among hand-fed babies was nearly fourtimes that of those naturally fed. Dr. Marion Knowles,maternity and child welfare medical officer, says thework of the dental clinic grows slowly, but that the oldidea that nothing can be done for the teeth duringpregnancy dies hard. She is anxious that the clinicshould provide dentures for the mothers in necessitouscases. Dr. W. H. Wray, tuberculosis officer, statesthat an endeavour is being made to limit admissionsto the sanatorium to early cases and to increase thelength of stay. The average stay per patient wasincreased from 90 days in 1920 to 196 days in 1922.Nine shelters are on loan for continuing sanatoriumtreatment at home, and Dr. Wray thinks this methodmight be usefully extended. Two cases of anthraxof the localised type occurred during the year. Ineach case the patient worked at a tannery and wastreated successfully by operation at the DerbyshireRoyal Infirmary. The source of origin was said tobe imported goat skins.

Bournemouth.Dr. A. D. Edwards thinks the Registrar-General

has considerably under-estimated the population.He therefore gives some of the principal statisticsobtained on his own estimate of 93,770 and on theRegistrar-General’s of 81,500 side by side. For

purposes of comparison between the various townsthe only equitable method is, obviously, to acceptthe Registrar-General’s estimates. Perhaps, too, itis better for a health resort to be stimulated by anover-estimated death-rate than lulled to sleep by anunder-estimated one. The Corporation housing schem econsists of 164 houses, 162 built by contract and twopresented to the town by the Builders’ Guild. Eachhouse contains at least three bedrooms, a parlour,and bathroom. The weekly rents, inclusive, exceptfor water-rate, are as follows :-

The applicants were divided into Bournemouthex-Service men married with families, marriedwithout families, and single; and Bournemouthnon-ex-Service men and non-Bournemouth ex-Service-men similarly subdivided. Nearly all the tenancieswere allotted to Bournemouth ex-Service men withfamilies. Four of the four-bedroomed houses havebeen adapted, so that each may accommodate two ifamilies, each co-tenant being responsible to theCorporation for half of the rent. On written applica-tion the committee may grant permission to sub-let,provided the sub-tenancy includes a sitting-room,a bedroom with fireplace, and joint use of sculleryfittings, bathroom, and water-closet. The sub-tenantis liable for not more than half of the rent and water-rate, which he pays to the tenant. On Dec. 31st,1922, there were 37 sub-tenancies recorded in theregister. The committee may grant permission tokeep poultry. The number is limited to eight fowls,and the height of the hen-house to 5 ft. On Dec. 31st,1922, there were 75 poultry runs. The erection of18 sheds for cycles, &c., has been permitted up to thepresent. ’

. The public analyst, Mr. R. A. Oripps, reports that, four of 21 samples of cream illegally contained a. boron preservative, and that samples of sponge cakecontained boric acid up to 31 gr. per lb. The boricacid in the latter case is used to preserve the liquideggs used for making the sponge cake. Of 21 samplesof green peas 16 contained copper, in four instancesundeclared. It is customary in Bournemouth notto take proceedings if the presence of copper isdeclared on the label and the quantity does notexceed 2’0 gr. of sulphate of copper to the lb. of peas.Penalties of 22 and .81 1 lls. &bgr;d. costs were obtained inrespect of five samples, the highest amount of copper-sulphate present being 4-1 gr. to the lb. In a sampleof lime-juice cordial about half the acidity was dueto adulteration with phosphoric acid. Mr. Cripps.comments on a successful defence of this practice inLondon, when it was claimed to be an improvement.He is still of opinion that this practice is a grossfraud, and suggests that if it is permissible to replacethe natural constituents of a foodstuff by cheaper-substitutes under the specious plea of

"

improving,"the manufacturer might advertise the " improve-ment " on the label and there would then be no.

prejudice to the purchaser, especially if the pricecharged corresponded with the reduced cost to themaker.

____

SCHOOL MEDICAL SERVICE.

Derbyshire.DURING the year 26,744 children were medically

examined, 26,389 of these coming under the routineage-groups. Of the latter 6702 were referred for-treatment, and during the year 2505 children receivedtreatment for eye trouble, 3605 for ear disease.Operations for diseased tonsils and adenoids were-

performed upon 1155 children, and these are excludedfrom school for two weeks after operation ; 151 cases.of ringworm were treated by means of X rays.

Dr. Sidney Barwise demonstrates that the boys andgirls in Derbyshire are taller and heavier than theaverage of the same class in England and Wales, butin the later ages the advantage is not maintained.Examination of the secondary school-children reveals.the fact that postural defomnities, with the exceptionof flat-foot, are much less common in boys than in girls.Of 816 boys examined, 54 had more or less flat-foot ;.2 per cent. had colour blindness. Of 1803 girls.examined in the secondary schools 270 had enlargedor septic tonsils and adenoids. Goitre was present in194. In the more marked cases it was fairly easy topersuade the parents to have the condition treated, butin far too many of the milder cases it is still regardedas just Derbyshire neck-something that runs in the-family. Tables are given showing the personalequation of the doctor in discovering and recordingdefects, the percentage of children referred for allconditions varying in different doctors’ districts from33-6 to 11-5 per cent. During the year 861 childrenwere excluded from school : 105 because they wereverminous, 755 for medical reasons, 287 of these beingon account of tuberculosis. There were 17 permanentexclusions from school, 7 of them being on account ofmental condition, 2 for epilepsy, and 2 for defective-vision.

Dr. Mary Gallagher gives the results of 983 cases ofenlarged tonsils and adenoids upon which she hadoperated. In one-half of these cases the conditionhad caused secondary complications, such as suppurat-ing middle-ear disease or chronic catarrh of the middleear with deafness, chronic inflammation, and dischargefrom the nose. In a considerable number of casesoperation had to be deferred owing to treatment foransemia, septic teeth, &c., having to be carried out-In one case the child had to be treated for six months.before she was fit for operation ; considerable painshave been taken to follow up these cases. Of the.983 cases operated on, 890, or 90 per cent., weredischarged cured and 83 improved. In 10 cases therewas no improvement. In several cases operations wereperformed on children who had already been operatedon with the guillotine-that is, a piece of the tonsil

625

had been sliced off, and after a short time the symptoms Ihad unfortunately recurred. The cardiac conditionof 30 children was such that the operation wasperformed without an anaesthetic.The school dentist submits an interesting report.

He finds that out of the number of children inspected80 per cent. were referred for treatment and 20 per cent.actually treated. He insists that any propaganda forthe prevention of caries in children must depend onthe teachers. Dental extractions amounting to 19,936and 13,526 dental fillings were accomplished. This isa considerable increase on the figures for previousyears ; more than twice the number for 1920 andthree times that for 1918. The extra work was accom-plished at a comparatively small increase of expenditureby the use of dental dressers. It would be interestingto compare the cost per head for 1922 and 1918. Theemployment of dressers for the unskilled work isfound to reduce working costs considerably, with noloss of efficiency. Sanction has been granted by theBoard of Education for the continuance of thisexperimental scheme for a further two years, bywhich time, it is hoped, it will have thoroughlyvindicated itself.

Derbyshire Education Committee are certainly to becongratulated on the consistent way in which they havetackled the problem of treatment of defects foundamong the rising generation. As long ago as 1909 theystarted a scheme for dental treatment. They were alsopioneers in the introduction of X ray treatment forringworm, which has made such a difference in schoolattendance statistics all over the country. They haveestablished a specialist service conspicuous by itsconscientious work. The medical and nursing staffhere have had to be reduced in the interests of econcmy,but it is to be hoped that the economy campaign willnot deal too ruthlessly with a scheme of treatmentbuilt up with so much care and foresight.

STORY OF THE

SMALL-POX EPIDEMIC IN GLOUCESTER.

AT a special meeting of the Health Committeeof the City of Gloucester held on Sept. 7th, a

report on the circumstances of the recent small-poxepidemic in that city was read. This report wasapproved and adopted by the committee with only onedissentient. The following extracts from the reportoutline the main facts attendant on the outbreak ofthe disease and on the administration of the powers ofthe local authority in dealing with it. The extractsembody suggestions for the better working of thePublic Health Services, arising from conclusions arrivedat by the acting medical officers of health and approvedby the Health Committee. The report states :-

Prior to the month of June, in March and April, only sixcases of small-pox in the city had been notified, registered,and reported as such to the Ministry of Health. Thesecases were all sent to the small-pox hospital at Longford andwere in due course discharged ; and at a meeting of thecouncil on May 30th the chairman of the Health Committee(Councillor Wood), relying on the report of the medicalofficer of health, stated that the city was then quite free Ifrom small-pox.

Cases Diagnosed as Chicken-pox.On June 1st Dr. J. R. Hutchinson, a medical officer of the

Ministry of Health, came to Gloucester and late in the ievening had a conference with the Mayor (Councillor J. 0.Roberts), the chairman of the Health Committee, AldermanDr. Knight, and the medical officer of health (Dr. Bibby),and stated that he had been sent to Gloucester by theMinistry to inquire as to the existence of small-pox in thecity, having regard to the fact that although cases werenotified in surrounding districts, some of which were believedto have become infected from Gloucester, no cases were beingnotified from Gloucester, that he had visited a number ofcases which had been notified as chicken-pox and foundthem to be small-pox, and that he had found other cases ofsmall-pox which had not been notified in any way. As itappeared that the medical officer of health questioned Dr.Hutchinson’s diagnosis, it was agreed that Dr. Hutchinsonshould arrange for an expert to come to Gloucester andreport upon some of the cases. In the evening of the follow-

iing day (June 2nd) Dr. Hutchinson returned to Gloucesterwith Dr. A. F. Cameron (medical superintendent of therivers hospitals and ambulance services of the MetropolitanAsylums Board) and had a conference with the Mayor, thechairman of the Health Committee, and the town clerk,when Dr. Hutchinson reported that since their arrival theyhad seen the medical officer of health and examined about16 patients, Dr. Cameron agreeing with Dr. Hutchinson that,with the exception of one case of chicken-pox, all thepatients examined were suffering from small-pox. Dr.Hutchinson intimated that the course to be adopted wasfully explained in Memorandum 71a issued by the Ministryin November last (which was laid before the Health Com-mittee when issued, and again in March last), but he alsomade a number of suggestions for the guidance of thecommittee.On June 3rd Dr. Cameron and Dr. Hutchinson had a

further interview with the Mayor, when Dr. Cameronstated that he had examined 15 more patients, making 31 inall, and that, with one exception, they were all suffering fromsmall-pox.A special subcommittee was formed to consider any

question arising in connexion with the outbreak of small-pox with power to deal with any matters of urgency.

Appointment of Dr. W. H. Davison.At a meeting on June llth of the special subcommittee

formed to deal with the outbreak the chairman reported thathe had been to Birmingham and, through the kindness of thecorporation of Birmingham, had arranged for Dr. W. H.Davison (assistant medical officer of health) to come toGloucester for a month to assist the medical officer of health indealingwith the outbreak of small-pox. It was then resolved-

" That Dr. W. H. Davison be requested to deal with allnotifications of small-pox and chicken-pox, arrange as to thecourse to be adopted for investigating, dealing with and followingup such cases, and generally dealing with the epidemic ; andthat he be given plenary powers with regard to such matters,including authority to give directions to the staff of the healthdepartment and visit patients in hospital."At a meeting of the Health Committee on June 15th it

was temporarily arranged (subject to the sanction of theMinister of Health) for Dr. Davison to perform any of theduties of a medical officer of health, in connexion with theexisting outbreaks of small-pox and chicken-pox in the cityand measures for preventing the spread of such diseases ;.and he was accordingly appointed to perform all or any ofsuch duties with all the powers of a duly appointed medicalofficer of health. The committee also passed a resolutionrecommending the council to delegate to them and to thespecial subcommittee, during the present outbreaks ofsmall-pox and chicken-pox or until further order, authorityto exercise any of the powers of the local authority or cor-poration under the Public Health Acts, 1875 to 1907, theInfectious Disease (Prevention) Act, 1890, and the GloucesterCorporation Acts, 1894 and 1911, with respect to thosediseases and measures for preventing the spread thereof ; ;.and such recommendation was duly approved and adoptedby the council. The hospital at Brockworth was openedfor the reception of patients on June 15th.

Difficulties of Public Health Administration.At a special meeting of the council on June 20th Dr.

Davison read a report dealing with the epidemic in whichhe stated that as the outbreak had been allowed to gounchecked for such a long time, great difficulty was experi-enced in getting patients to agree to removal to hospital.There were certain influences at work endeavouring to fosterthis resistance and throw sand on the administrativemachinery designed to protect the community. An emer-

gency meeting of the Health Committee was held on

June 23rd. Dr. Davison stated that the present conditionsmade it impossible for him to continue to take administrativecharge of the epidemic, and referring to the fact that he hadpointed out that it was a ridiculous position to have incharge of small-pox cases a medical superintendent who didnot admit the cases to be small-pox.

Resignation of Dr. J. R. Bibby.At a special meeting of the Health Committee on June 25th

the chairman referred to the fact that at the last meetingit was explained that the subcommittee had suggested tothe medical officer of health that, having regard to hisviews about the epidemic, he should temporarily relinquishall duties in connexion therewith and that he had refused to<do so. After hearing the report of members of the committeewho had since seen the medical officer of health, it wasresolved-That it be recommended that, as far as practicable, and

until further order, the medical officer of health (Dr. Bibby)be relieved from all duties connected with the diagnosis of casesof small-pox and chicken-pox and the admission to hospitalof cases of small-pox and their subsequent treatment anddischarge ; and also from the superintendence, administration,and visiting of the hospitals at Longford and Brockworth.