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Public Health Services.RECORD CARDS AS AN INDEX OF EFFICIENCY.

A PSEUDONYMOUS correspondent to the J’z7nesrecently described the examination of the recordcards kept by insurance practitioners as a " medicalinquisition." He thinks that " insurance doctorsmay be unjustly fined " as the result of an estimationof the number of entries on a sample of cards takenhaphazard. The method he describes is what is knownas a dipping audit which enables the Ministry ofHealth to classify practitioners as to whether they areor are not keeping records. We understand thatwhere there is reason to doubt that the practitioneris neglecting this part of his contract a further stringentexamination is made of at least 25 per cent. of hiscards and in the estimation of the value of the recordsvarious tests are applied, such as the character ofthe clinical notes, the number of attendances givenin certain cases of acute illness, and the average numberof attendances and visits given to his patientsgenerally. Disciplinary action is not likely to be takenuntil a very full investigation has been made. Itcan hardly be denied that the record cards constitutesome index of a practitioner’s efficiency.

REPORTS OF MEDICAL OFFICERS OFHEALTH.

THE following are some of the 1925 statistics oftwo county boroughs, two large urban districts, andtwo cities :-

Croydon.Dr. H. P. Newsholme describes an outbreak of

food-borne paratyphoid B fever, which caused theillness of about 80 persons in Croydon and district.The first case was notified on Sept. 5th, and as thepatient had been for a fortnight’s holiday to theseaside it was at first assumed that she had contracted Ithe infection elsewhere. She was the head assistantof a confectioner’s shop, and inquiries showed thatnine out of a total staff of 15 had had similar attacksbeginning between August 31st and Sept. 2nd. Noneof the Croydon cases ended fatally, although some hadsevere complications, including sharp haemorrhagefrom the bowels. Exhaustive inquiries were madeinto the exact source of infection, and ultimately theoutbreak was traced definitely to veal and ham piesand fancy cakes infected at a late stage of theirpreparation by a pastrycook, who had suffered froman unrecognised attack of the illness. The origin ofthe pastrycook’s illness could not be traced, but it

was within the bakery, either from infected materialsor an infecting person, and it may have accountedfor some earlier cases occurring in the district duringJuly and August. No case was traced to the pastryof this firm subsequent to the withdrawal of theinfecting pastrycook from work. Some of the lessonsfrom the outbreak are : The need for better washingarrangements on such premises ; the need forscrupulous care in the cleansing of utensils ; and theneed for means whereby every process involvingpersonal handling is followed by heating of the food-stuff sufficient to prevent infection. This particularfirm used bacterial virus for the extermination of ratsand mice, and although it was possible to exclude thisas a cause of the present outbreak, Dr. Newsholmeemphasises the necessity of protecting food from thissource of contamination. He further suggests thatthe trade might with advantage consider the adoptionof some form of industrial insurance for the mainten-ance of employees who are obliged to leave workbecause they are carriers of infectious disease. Themain conclusions arising out of the epidemic havebeen referred to the Bakery and Confectionery Sectionof the London Chamber of Commerce, the NationalAssociation of Master Bakers and the Croydon MasterBakers Association.The only case of diphtheria among the staff of the

hospital was that of a ward maid who had not beenSchick-tested and immunised as is the custom fornewly engaged members of the staff. Arrangementshave been made with the Croydon General Hospitalfor the use of their light clinic. Thirty-eight cases ofmalnutrition, rickets, and other diseases were undertreatment during the year, and the results wereencouraging. Cooperation with the same hospitalhas led to the establishment of an orthopaedic scheme,which includes clinics for massage, remedial exercisesand electric treatment, and in-patient treatment,when necessary, at the St. Nicholas and St. MartinOrthopaedic Hospital, Surrey. During 1925 there were3406 births, and 609 expectant mothers attended theantenatal clinic. A course of six lectures to midwiveswas delivered by Dr. J. A. Willett, of the City of LondonMaternity Hospital. Of the eight cases of puerperalsepsis notified six proved fatal. There were 22 casesof ophthalmia neonatorum, in three of which visionwas impaired.

In spite of increasing activity in private and publicenterprise, there is much leeway to be made up inhousing. Over 5 per cent. of 3492 working-classhouses inspected were found to be overcrowded. Thestandard adopted was that of the local by-laws forhouses let in lodgings-viz., 360 cubic feet in bedroomsfor each person over ten and 400 cubic feet where aroom is used both as living and sleeping room, with250 cubic feet for persons under ten. The municipallodging-house has 101 cubicles for lodgers. The chargeper night is 9d. and the nightly average of lodgerswas 99. The receipts for the year were .S1346 and theexpenditure jB1485. Of 94 samples of milk examinedfor tubercle one was found to be infected, and as aresult one aged cow was found in a borough cowshedwith a tuberculous udder. It was subsequentlyslaughtered and compensation at one quarter of thevalue (27) was paid under the new Act. Of 99 samplesof ordinary milk examined for bacteria, 87 conformedto the Grade A standard, but a large proportion hadbeen subjected to commercial pasteurisation.A five years’ survey of the school work shows great

progress. Thus the percentage of verminous children,13-2 in 1921, has come steadily down to 8-0 in 1925,and the children treated for dental trouble numbered1210 in 1921 and 3357 in 1925. The work will begreatly facilitated by the opening of

" admirable clinicpremises " in 1926. Dr. Newsholme points out thatit is difticult to gauge the changes in physical fitnessresulting from school medical work owing to differencesin standard due to changes in the medical staff.He is able, however, for two schools, to give a com-parison of average heights and weights in 1905 (whenDr. Meredith Richards was school medical officer

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and in 1925. The comparison shows a clear general 1

increase both in height and weight among boys andgirls at all age-periods in these schools.

Hastings.Dr. G. R. Bruce reports that the most important

recent event has been the opening of the new venerealdisease clinic in January, 1924. This building hasbeen designed on model lines, is entirely adequate forits purpose, and has been visited by many officers ofother authorities. The water-supply is insufficientfor the increasing needs of the community and theCouncil is looking to the chalk area in the Cradlevalley to the east of Eastbourne to provide a satis-factory supply sufficient for many generations. Dr.Bruce points out that many elderly or retired persons.and invalids come to live in Hastings and help toswell the death-rate from cancer and circulatory andrespiratory diseases. When the correction factor(0-718) is used the death-rate of 14-5 becomes 10-4.Antenatal work is as yet only carried out on a smallscale. There were 783 births, and 72 expectant mothersattended the two antenatal clinics. The municipalcases admitted to Fern Bank maternity home num-bered 35, attendance at one of the antenatal clinicsbeing a condition of admission. An orthopaedic schemein connexion with the Royal East Sussex Hospitalwas under consideration during the year.

Willesden.

Dr. George F. Buchan reports that there were37 notifications of ophthalmia neonatorum-a caserate of 13-4 per 1000 births. Private doctors attendedin 16 cases, midwives in 17, whilst the remaining fourwere born in hospital. In one patient one eye waspermanently injured and two cases were under treat-ment at the end of the year. Proceedings were takenagainst a doctor and a midwife for failure to notify.The case against the doctor was dismissed, but themidwife was fined B30 and subsequently struck off-the roll. At two of the three schools for mothers thework is hampered by the unsuitability of the premises,but a large number of health talks and demonstrationswere given throughout the year. No general ortho-paedic scheme has yet been adopted, but instruments,are provided in necessitous cases and crippled childrenare sent to outside institutions. The school premisesfor the physically defective at Furness-road are

unsatisfactory as there is no playground available for.open-air classes for the crippled children. The classesfor stammering children are being extended. Themedical staff of the department are taking part in-the inquiries into defective vision and anthropometryinstituted by the Board of Education. Dr. Buchancomplains of the cumbersome procedure, in theexisting state of the law, which is necessary in order-to secure a reasonable standard of repair of dwelling-houses.

Many interesting matters are dealt with in appen-dices to the report. Appendix H. deals with mentallydefective children and dull and backward children.Dr. Buchan draws attention to the fact that thedefinition of the mentally defective child in theEducation Act of 1921 differs from that given in theMental Deficiency Act of 1913. He thinks that" mental defect " in the Education Act may meanan educational disability only and that there is,therefore, no power to send a child to a special schoolunless it can be certified under the Mental DeficiencyAct of 1913. Correspondence with the Board ofEducation is given, which shows that the Board,differs from this view, but as yet there has been nodecision on the matter by the courts. The questionarose owing to the refusal of a parent to allow hischild to be sent to the Leinster-road mentally defec-tives’ school. Dr. Buchan also points out that40 per cent. of the children at this school are education-ally retarded and that 60 per cent. are mentallydefective within the meaning of the Mental DeficiencyAct. The 40 per cent. could be transferred to classes

for dull and backward children if such were available,and it is suggested that such classes should servegroups of schools and should be established at suitablecentres throughout Willesden. In another appendixit is shown that the Pound Lane site, on which thereis a proposal to establish an open-air school, is notlarge enough to provide for the needs of Willesden.The proposed site of two acres would be large enoughto accommodate the 100 children at present attendingthe physically defective schools, but it is shown thatthere are about fi00 children in Willesden who needthis provision.Another appendix deals with the school dental

scheme of October, 1924, under which a fee of 2s. 6d.was to be charged to the parents for the re-treatment ofroutine cases. A table is given which shows that duringa year’s operation there were 13,482 routine inspec-tions, and the number of children found to requiretreatment was 9431. Of these only 898 receivedtreatment at the clinics ; about 100 were treatedelsewhere. Dental treatment at the Willesden schoolsis chiefly given to the most neglected and difficulttype of case, and is largely of a palliative natureinstead of being preventive and constructive inaccordance with the principles laid down by theMinistry of Health. A revised scheme was adoptedby the Education Committee in February, 1926.Dr. Buchan points out that an addition of one dentistto the staff should be made during 1927 and otherin creases in succeeding years as required. An appendixby Dr. H. Ilaldin-Davis, dermatologist to the

council, deals with light treatment, which was

established in November, 1925. Some improvementwas noted even in the six and a half weeks before theend of the year and striking results were obtained insevere cases of asthma and alopecia areata. The typeof lamp used is a flaming carbon arc of Siebe andGorman working at 30 amperes. Dr. Bessie R.Mackenzie gives a history of health visiting in Willesden.During 1902, the year preceding the appointmentof the first health visitor, the infant mortality-ratewas 130. There are now 20 health visitors and theinfant mortality-rates for the last four years were:59, 53, 73, and 62. During the last six years thenumber of infants breast-fed for nine months has goneup from 15 per cent. to 19 per cent., while the numbersolely bottle-fed from birth has gone down from6 per cent. to 4 per cent. In a further appendixDr. W. D. Champneys reviews the present positionof work against cancer, and expresses the opinion thatby far the most important measure for securing theearly diagnosis and treatment of cancer-and one thathas not been so far tried in this country-is the cancerclinic for free diagnosis. Such a clinic, he considers,should be established by the council.

Totteithani.

Dr. David C. Kirkhope says that many housescontain two or more families, and occasionally a familyin a single room, notwithstanding that they are bothable and willing to pay for more commodious dwellings.There are 2800 families upon the register of thosewho seek houses upon the council’s estate. Tottenhamhas no land available unless the houses are of the largetenement type, which system Dr. Kirkhope does notrecommend. Adequate means of transit from Totten-ham to the metropolis are not available. The solutionof the housing difficulty appears to lie in the extensionand enlargement of the underground system. Thepollution of the River Lea below Tottenham lock hasreceived the consideration of the council on severaloccasions, and it is now hoped that the authoritiesconcerned with the river will take action. Dr.

Kirkhope goes on to complain of the nuisance causedby the tipping of refuse, both by his own and neigh-bouring authorities.

There were 17 notifications of encephalitis lethargicawith eight deaths. The home treatment of scarletfever is encouraged in Tottenham and the use of scarletfever antitoxin for the inoculation of susceptiblecontacts has been tried with partial success. The

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immunity conferred by the intramuscular injectionof 5 c.cm. of concentrated serum only seems to lastfor about a fortnight. In two cases mothers whodeclined inoculation contracted the disease, andrendered the attempt at immunisation useless. Abetter result was obtained in the case of a school inwhich there were recurring cases of scarlet feverwhich ceased after the immunisation of half ofthe scholars with the consent of their parents.Grade A (tuberculin tested) milk is now suppliedto mothers and children through the centres andto the creche. There were 338 new cases atthe antenatal clinic, the total births numbering2756. The scheme for dealing with school-childrenwho need operative treatment for tonsils andadenoids has given entire satisfaction. A contracthas been made with the North Middlesex Hospital.The tonsils are enucleated under an anaesthetic in theforenoon. Later in the day the children are takenhome in an ambulance in the custody of a nurse.If there is any apprehension of after trouble they areretained in hospital for a longer period. Good resultsare also being obtained by ionisation at the clinic forotorrhoea, which was started two years ago and isunder the charge of Dr. A. R. Friel. There is stilla large percentage of refusals by parents of dentaltreatment for the children.

York.

Dr. P. R. McNaught reports that the corporationduring the last five years have built 367 houses attheir Tang Hall estate, and that 312 houses were incourse of erection at the end of 1925. Nevertheless,there are 1400 applicants on the waiting-list for housesand developments in the confectionery trade and theerection of a sugar-beet factory just outside the citywill increase the demand. Many distressing cases ofovercrowding are cited. An antenatal clinic is con-ducted by the Infants’ Welfare Association and wasattended by 113 women during the year. There werealso 129 attendances at the antenatal clinic of thematernity hospital, at which 271 mothers were con-fined during the year. The neonatal mortality washigh (43) and just half the total infant mortality.Forty-six samples of milk were submitted to bacterialexamination and 19 were reported to be dirty andunfit for consumption. Six of the 19 were samplesof the milk produced at the municipal sanatorium.Two of the 36 samples contained tubercle bacilli.

Carlisle.

Dr. Joseph Beard reports that three out of 26

samples of milk were found to contain tuberclebacilli. As a result four milch cows were eliminatedfrom the herds. It is difficult to estimate the realshortage of houses. Dr. Beard puts it at 1000. Aninspection of the Currock estate of the corporationduring the year showed that 50 out of 222 tenantswere subletting. Seven of the houses were foundto be seriously overcrowded and a number of otherswere dirty. The shortage of houses has been aggra-vated by the falling off of building by private enterprisesince 1907 and the demolition of many tenements incarrying out reconstruction schemes. The onlyinstitutional provision for tuberculosis is 20 beds atBlencathra Sanatorium. These are intended for earlycases, but advanced cases are also admitted for shortcourses of instructional treatment, and some cases ofsurgical tuberculosis are transferred to Blencathrafrom the Cumberland Infirmary. There were 166 newcases at the antenatal clinic, the total births in thecity being 1045 ; the neonatal mortality-rate was 37,nearly half that for infant mortality. The city councilhave employed a veterinary surgeon to inspect cowsfor the last 27 years, whose practice it is to examineall the new cows in the city within three days of theirpurchase. During 1925, 146 cows were so examinedand 14 were returned to the would-be vendors forvarious reasons. The city is exceptional in having asatisfactory public abattoir.

SCHOOL MEDICAL SERVICE.

i i i I i

* Excluding uncleanliness and dental defects,t Not given.

Edmonton.

In Edmonton there is close coordination betweenthe child welfare work and the school medical service,.for the dental clinic serves both infants and school-children as does the orthopaedic clinic for massageand muscle re-education, and Dr. H. W. Harding, theschool medical officer, is on the committee for the-local creche. There is, however, no definite link withthe Juvenile Employment Committee nor with thefactory surgeon, and the local work of the guardians,the County Council, the Home Office, and the generalhospitals is unrelated to that of the local educationauthority. The large variation from previous years inthe numbers of defects found during 1925 is accountedfcr by the different standards adopted by the newmedical inspector, Dr. Marjorie Dalby; thus, therewere 280 cases of functional heart conditions andanaemia noted as against 39 for 1924, and enlargedtonsils were noted in 610 cases compared with 173 in1924. There is no open-air school. Dinners to thenumber of 52,466 were given to school-children duringthe year and 1375 16 oz. bottles of cod-liver oil wereprovided in addition to milk meals, but it is doubtfulif the end results of wholesale extra dieting comparefavourably with the benefits and educational alueof an open-air regime. No organiser of physical trainingis employed. Special classes are held for the partiallyblind and the partially deaf while mental defectives.are educated at a special school in Enfield, but Dr.Harding believes the atmosphere of the elementaryschool is preferable for cripples.

Cambridge.The apparent smallness in the incidence of defects

in Cambridge is largely accounted for by the fact thatall dental conditions are excluded from Dr. A. L.Laird’s report to be dealt with separately by Mr. W. B.Grandison, the public dental officer. Statistical tablespresented by Dr. Laird and figures supplied by Dr.A. Mabel Gurney show evidence of improved physiquein both boys and girls and the percentage of childrenin whom no defect was found was higher in 1925 thanever before, while the proportion of children foundto be clean was the highest yet recorded. There hasbeen a marked and steady decrease in otorrhoea from3-7 per cent. in 1911 to 0-7 per cent. in 1925, and indeafness from 5-6 per cent. in 1911 to 1-9 per cent.in 1925. Dr. Laird regrets that although the plansfor the new open-air school have been approved, asite purchased, and bricks deposited ready for use,no further action is being taken for reasons of economy.Meanwhile, the temporary open-air school establishedin 1916 continues to do excellent work, which is furtherextended by the helpful activities of the InvalidChildren’s Aid Association which sent 46 children tothe seaside during 1925. An orthopaedic scheme isnow working in conjunction with Addenbrooke’sHospital, which also carries out much of the generaltreatment required by the local authority. Muchuseful information is given by Mr. Grandison, whoseboast it is that " there e are 5000 school-childrenin Cambridge who now show no evidence of dentalcaries .... due principally to active dental treat-ment."

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Colchester.Dr. W. F. Corfield surveys the changes that have

taken place in the school medical service during thepast five years. Cleanliness has markedly improvedas have also the conditions of clothing and boots.Malnutrition, anaemia, rickets, and spinal curvaturesall show lessened incidence, but enlarged tonsilsand adenoids were more prevalent in 1925. Thisincrease, perhaps, may be more apparent than real,since special attention was focused on the resultsof operation in a special inquiry by Dr. R. W.Cushing. At the same time, Colchester is not alonein reporting bigger incidence of morbid throat con-ditions during this year. Blepharitis and conjunc-tivitis are less frequent owing to increased cleanlinessand relief of eye-strain by glasses, but the numbersof scalp ringworm cases still keep high, thoughthe increased facilities for X ray treatment atthe Essex County Hospital should materially reducethem. Routine medical inspections were attendedby 77 per cent. of parents. Special classes are

held for stammerers and for cases of spinal curva-ture, and under the orthopaedic scheme Mr. W.Howell, of Brookfield Orthopaedic Hospital, Waltham-stow, visits the clinic periodically. Special classesare also open for mentally defective children and forthe partially blind, while open-air classes are heldduring the summer at most of the elementary schools.

INFECTIOUS DISEASE IN ENGLAND AND WALESDURING THE WEEK ENDED OCr. 30TH, 1926.

Notificatioiis.-The following cases of infectious diseasewere notified during the week :-Small-pox, 131 (last week126) ; scarlet fever, 1924 ; diphtheria, 1157 ; enteric fever.48 ; pneumonia, 828 ; puerperal fever, 45 ; puerperalpyrexia, 114 ; cerebro-spinal fever, 10 ; acute poliomyelitis,78 ; acute polio-encephalitis, 9 ; encephalitis lethargica, 33 ;continued fever, 1 ; dysentery, 4 ; ophthalmia neonatorum,114. There were no cases of cholera, plague, or typhusfever notified during the week. No cases of small-pox werenotified from London or the southern counties. The casesof poliomyelitis and polio-encephalitis taken together areless numerous than last week, the counties reporting morethan 3 being London 15 (Deptford 2, Islington 4, Kensington1, Lewisham 1, Paddington 1, Marylebone 1, Southwark 1,Wandsworth 4); Kent 5 (Broadstairs 4, Faversham 1);Leicester 8 (Leicester C.B. 2, the remainder scattered overfive urban and rural districts) ; Warwick 5 (Birmingham 1,Leamington 2, rural districts 2). ).Deaths.-In the aggregate of great towns including

London, there was no death from small-pox, 1 (0) fromenteric fever, 7 (1) from’measles, 3 (0) from scarlet fever,14 (4) from whooping-cough, 43 (8) from diphtheria, 124 (30)from diarrhoea and enteritis under 2 years, and 71 (15) frominfluenza. The figures in parentheses are those for Londonitself.

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The Services.ROYAL ARMY MEDICAL CORPS.

Maj. A. G. Biggam is seed. for serv. under the ForeignOffice.

Maj. J. J. Magner is restd. to the estabt.Capts. A. Jackson and J. W. C. Stubbs to be Majs.The undermentioned Capts to be Majs. : G. D. Jameson,

J. G. Ronaldson, W. D. Arthur, K. P. MacKenzie, R. R. G.Atkins, R. H. Leigh, J. H. G. Hunter, W. G. Shakespeare,0. C. Link, E. E. Holden, R. G. Martyn, R. H. Hodges,and H. W. Browne.

Capts. Sarat Chandra Basu and Pearey Lall Whigrelinquish their temp. commns.The King has approved the retirement of Col. J. H.

McDonald and Lt.-Col. D. McCay.TERRITORIAL ARMY.

Maj. C. D. Mathias, having attained the age limit, isretd. and retains his rank, with permission to wear theprescribed uniform.

Capts. E. L. Sandiland and H. T. Bates to be Majs.Maj. George Young, late R.A.M.C., T.F., to be Capt., and

relinquishes the rank of Maj.Lt. H. V. Forster to be Capt.J. W. Eames to be Lt.The King has conferred the Territorial Decoration upon

Majs. W. C. Gunn, R. Henry, and F. E. H. Keogh.

ROYAL AIR FORCE.

Temp. Lt. V. G. Pedley, General List (Army), DentalSurgeon, is granted a temporary commission as a FlyingOfftcer on attachment to the R.A.F.

Flying Officer G. J. Hanly is promoted to the rank ofFlight Lt. -

DEATHS IN THE SERVICE-!.

Major Charles Louis Williams, I.M.S. (retd.), who diedsuddenly at Banstead, Surrey, on Oct. 31st, was a Liverpoolman, and studied at Liverpool and the University ofEdinburgh, where he graduated M.B., C.M. in 1886 andM.D. in 1889. He also took the diploma of M.R.C.S. Eng.in 1888, and the D.P.H. Camb. in 1896. He was HoltScholar at University College, Liverpool, and lecturer inthe Liverpool Tropical School, and served for a period ashouse surgeon in the Royal Infirmary, Liverpool, sometimeafterwards becoming medical superintendent to the BoothShipping Line. Entering the Indian Medical Service, heserved for 17 years in India and became surgeon to theGeneral Hospital, Madras. On the outbreak of the late warhe was appointed to the Hospital for Indian Troops atthe Pavilion, Brighton, and after the departure of theIndians held several important surgical posts, eventuallyacting as a surgeon specialist. After service in connexionwith the Ministry of Pensions, Major Williams retired twoyears ago. He leaves a widow and three daughters.

MEDICINE AND THE LAW.

C’orztamiuatiori of Meat by Flies : Butcher’s SuccessfulAppeal.

A PARAGRAPH in the Times records a successfulappeal to the Middlesex Sessions by an Acton butcher,who had been fined £2 and ordered to pay £5 5s.costs on a conviction, for neglecting to guard meatagainst contamination by flies. The brief reportstates that at the hearing of the appeal butchersgave evidence that glass fronts to shop windowsencouraged flies, and that open windows were better,as a through current of air kept the flies on the wing.Then follows the information that the Court foundthat the defendant did not take all the precautionshe should have done, but that his neglect was notwilful, whereupon the Chairman (Sir Montagu Sharpe,K.C.) said that on this finding the appeal would beallowed, but without costs. This somewhat puzzlingresult is possibly due to a compromise between themembers of the Bench. If a valid enactment requiresa butcher to take certain precautions, and if he iseither actually or constructively aware of his obliga-tion and fails to discharge it; the wilfulness or inno-cence of his motives would seem to be immaterial,unless the by-law or other enactment is so expressedas to give a defendant the benefit of good intentions.

Wilfulness as an element in the commission ofan offence presents well-known difficulties. BaronBramwell, on a prosecution under a Local Act of1774, governing the maintenance of the Aire andCalder navigation system, once held that " wilfully

"

throwing soil into a river meant wantonly or cause-lessly, and did not apply to a person acting in thecourse of his business and in the supposed assertionof a legal right. On the other hand, a surveyor wasonce held to have committed the offence of " wilfullyobstructing " the highway by leaving large stoneson a road under repair inadequately lighted at night.The stones were placed there purposely; it wasculpable negligence not to warn the public of thedanger; therefore the obstruction was wilful. Inthe case of the Acton butcher, the decision of theCourt perhaps means that, though he did not protecthis meat as he ought to have done, he honestlythought his own method of non-protection was thebest method of preventing contamination by flies.If this is to be a good defence, it is a waste of timeto undertake further prosecutions of this kind. Muchdepends, of course, upon the exact wording of therequirement which the butcher was charged withhaving failed to satisfy ; but in the sphere of publichealth it is the facts, not the motives, which matter.