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to cases in which there are strong or clear grounds of suspicionthat the death has not been natural. The Medical Witnesses

Act, if properly carried out, would remove this scandal fromthe Coroner’s Court. The inquest, if it is to be of any value,should in all cases determine the actual cause of death; andwhen it fails to do so it is not only unsatisfactory, but a useless,and, it may be, a mischievous inquiry. The fact of so large anumber of deaths being " uncertified" points to the vastamount of illegal practice which is carried on in this country,not only by quacks and impostors, but by druggists, and callsloudly for a remedy.

A SANITARY handbill is in circulation, drawn up at the sug-gestion of Dr. Aldis, and with his assistance, by Mr. EdwardHall, for the Working Men’s Club. We noticed in THE

LANCET some little time back a movement by this Club ina sanitary direction, but were not aware that it originatedwith Dr. Aldis. He had, however, written a letter, which

appeared in two or three newspapers, recommending theestablishment of a Working Men’s Sanitary Club. The re-sult was that one of the council of the existing Club invitedhim to a conference with its agents, when he suggestedthat sanitary measures should form a prominent part of

their operations, that the working man might be informedas to what was detrimental to health, and that he mighthave some channel through which he could make complaints,if he feared the responsibility of doing so himself. Thehandbill is a very useful one, and affords a great deal ofinformation which it is always important that working menshould have, and even more so while the present epidemic isprevalent than at other times. It ought to be widely circu-lated amongst the poorer classes.

JUDGING from the number of letters which we receive onthe subject, the question of assurance against sickness engagesthe attention of many members of the profession. It is cer-

tainly remarkable, in a calling so precarious and beset with somany dangers to health as ours, that no society exists in whicha medical practitioner can assure against the time of sickness,of accident, or of incapacity for practice by advanced age orinfirmity. A large proportion of the members of the medicalprofession, however laborious their occupation and thriftytheir habits, die poor, from being unable to lay by for

any future calamity or necessity. The knowledge of this factembitters the life of many a worthy man, and its causes, ifpossible, should be removed. Few are so straitened that theycould not pay a moderate annual premium to be assuredagainst the day of sorrow. Why should we not in this respectfollow the example set us by the benefit clubs which are

everywhere established by the working classes ? Now that

the system of life assurance has become so extended, why isthe assurance against sickness-in our profession at least-all but impossible ? One life assurance office, if not more,

has, we know, entertained the question. It is high time thatsome definite step should be taken in the matter. *

MR. SniON is preparing to carry out for the Privy Councilan investigation concerning the present outbreak of cholera.The arrangements are still incomplete ; but the following ap-pointments have been made : - Treatment Committee: Dr.Wilks, Dr. Martin, Dr. Bristowe, and Dr. Hughlings Jackson.Pathological Committee: Dr. Thudichum (chemical pathology);Dr. Burdon Sanderson (contagion experiments); other mem-bers not yet appointed. Water-stand Conditions: Mr. Glaisher.

* Since writing the above, we have received the report of the BritishMedical Association, containing an account of the career of the MedicalProvident Society, which has, we regret to observe, proved a failure, and isabout to be wound up. Only thirty-two members had joined, although greatefforts have been made to extend its operations.

In addition, it is known that the medical inspectors of thePrivy Council-Dr. Seaton, Dr. Buchanan, and Dr. Hunter,together with Mr. Rawlinson-have been making investi-

gations concerning the outbreak in East London.

ReportOF

THE LANCET SANITARY COMMISSIONON THE

EPIDEMIC OF CHOLERA IN THEEAST END OF LONDON.

No. I.

THE outbreak of cholera in London has now become so ex-tensive as to furnish material for profitable investigation intosome of the circumstances which are influencing its progress.In the fortnight ending July 28th, 1820 deaths from choleraand diarrhoea have been recorded as having occurred in theregistration districts of London. Although there have beencases in most of these districts, the vast majority have occurredin those of East London. The inquiry therefore immediatelysuggests itself why cholera is prevailing so extensively in theseas compared with the other districts of London. That it shouldfirst appear about the ports of London was to be expected,though we know as yet of no proof of its direct importationby ships which have come in. The initial cases will requireinvestigation. In any case, however, the fact of its rapidspread through Poplar, Bow, and Whitechapel, and not overother localities, where at least one case has occurred whichmight have formed a centre, would not be thus explained.The general absence of sanitary conditions in these places isonly in part sufficient to account for it, for there are otherdistricts, such as those south of the Thames, in which this isat least equalled. The one great difference in the circum-stances which may influence the sanitary condition of EastLondon, as compared with other parts of the metropolis inmost respects similarly circumstanced, is its supply of drink-ing-water. The present purpose of this Commission is tomake inquiry how far there is ground for supposing that thewater-supply is a cause of the spread of the cholera in London.Before proceeding with this investigation, it is very necessaryto set forth in a general way the evidence we already havethat the spread of cholera among a population may be influ-enced by the nature of the drinking-water, though few readerswill be altogether unfamiliar with the facts we are going tomention.

" An experiment, at which mankind would have shudderedif its full meaning could have been prefigured to them, hasbeen conducted during two epidemics of cholera on 500,000human beings. One half of this multitude was doomed inboth epidemics [1848-49 and 1853-54] to drink the same fe-calized water, and on both occasions to illustrate its fatal re-

sults ; while another section, freed in the second epidemic fromthat influence which had so aggravated the first, was happilyenabled to evince by a double contrast the comparative im-munity which a cleanlier beverage could give."*The unfortunate people who were experimented upon were

the inhabitants of nine districts of London, south of theThames - namely, of St. Saviour’s, St. Olave’s, and St.

George’s, Southwark ; of Bermondsey, Newington, Lambeth,Wandsworth, Camberwell, and Rotherhithe. One part ofthis people were supplied by the Southwark and VauxhallCompany with water from the Thames at Battersea during

! Mr. Simon’s Report on the last two Cholera EpidEmics of London asaffected by the Consumption cf Impure Water. Addrcssed to the lightHon. the President of the Board of Health.

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both epidemics ; the other part of this people, intimately dis,tributed through the first part, were supplied by the LambethCompany with water from the Thames at Battersea during theepidemic of 1848-49, and with water from the Thames atThames Ditton during the epidemic of 1853-54. The follow-ing were the results of this experiment :—

First. " In the 24,854 houses supplied by the LambethCompany, comprising a population of about 166,906 persons,there occurred 611 cholera deaths, being at the rate of 37to every 10, 000 living. In the 39,726 houses supplied bythe Southwark and Vauxhall Company, comprising a popula-tion of about 268,171 persons, there occurred 3476 deaths,being at the rate of 130 to every 10,000 living. The popula-tion clrinl:ing cdi7ty water accordingly CtppeCl1’S to Iaccze szzferedthree and (t 7talf times as much mortality as the populationdri-rzking otltC1’ 2ccter."

Second. The tenantry of the Lambeth Company (a popula-tion of 166,906, comprised in 24,854 houses, as has been justmentioned) lost 611 persons by the epidemic of 1853-54; whileby the epidemic of 1848-49, in the same houses (or rather in asmany of them as then existed), it lost 1925 persons. Not only,then, did this population suffer not a third as much as itsneighbours in 1853-54, but it suffered also not a third as muchas at the time of its unreformed water-supply (1848-49).To this evidence of a positive kind, as most of our medical

readers are aware, much could be added, were it necessary.But we shall now proceed to a consideration of the water-supply of the East of London.The east of London north of the Thames is supplied with

water exclusively by one company-the East London-to aline running irregularly northward from the Thames at St.Catherine’s Docks. This line crossing the Basin, and passingbetween the West and East Dock, makes a detour round theMint at some distance east of it, and then proceeds westwarda short distance, south of the Blackwall Railway. It turnsnorthward again along Mansell-street, Somerset-street, acrossHigh-street, Whitechapel, and along Goalston-street. At this

point it passes with slight irregularity to the south end of NortonFolgate, it then proceeds along Norton Folgate, Shoreditch,and the beginning of the Kingsland-road. Just beyond wherethe North London Railway crosses the Kingsland-road it leavesthis road and proceeds in a straight line in a north north-westdirection for about a mile and three-quarters, to where theAmherst-road and Dalston-road cross. At this point it bendsin a north-westerly direction to follow some distance east ofthem-the Amhec&t- and Rectory-roads; but we have followedit far enough for our purpose. We should have mentionedthat in the course of this line along Shoreditch it leaves themain road for a time so as to include a semicircular mass ofhouses facing the terminus of the Great Eastern Railway.The southern portion of this line corresponds to a certain

extent with the boundary between the Central and Easternregistration districts. The central districts are supplied bythe New River Company. In the week ending July 21st morethan six-sevenths of the deaths by cholera occurred in theeastern districts, and in that ending July 28th more thaneight-ninths. In the former week, 309 out of the 346 deathsby cholera happened in the registration districts of London;in the latter week 815 out of 904 in the field of the East LondonWater Company’s mains.

If we take the boundary line we have indicated of the EastLondon Water Company’s mains we find that in Aldgate,which lies across the south of this line, of the six deathswhich occurred up to July 28, five were on the East LondonCompany’s side of the line. North of the Aldgate sub-districtis that of St. Botolph on the west side of the line, and ofGoodman’s-fields on the east side. In the former sub-district,which is supplied by the New River Company, and perhapsBishopsgate and Whitechapel pumps-the last of which sourcesis in a terrible condition-four deaths were registered. This

we shall see is the only marked instance of the spread of cholera aimmediately west of the boundary line. In Goodman’s-fields, sup-plied by the East London Water Company, seventeen deaths bycholera have occurred up to July 28th. In Whitechapel Churchsub-district, north of this, and, like it, east of St. Botolph’s,seventy-nine cholera deaths have been recorded. North ofthis district lies the White chapel North sub-district, in whichtwelve deaths have occurred up to July 28th. This districtextends a little west of the boundary line of the East LondonCompany’s mains, but all the deaths occurred east of the line.In Whitechapel, Artillery sub-district, three cholera deaths,up to July 28th, have been recorded on the east side of theline. North of the St. Botolph sub-district and west of the

* JJr. Simon’s Report.

East ’London Water Company’s mains occurs the Holywellsub-district, and north of this the St. Leonard’s sub-district,both in the East registration district, but west of the mainsof the East London Water Company. In the Holywell sub-district two deaths by cholera, and in the St. Leonard’s sub-district one, occurred up to July 28th. North of the White-

chapelArtillery sub-district comes the Bethnal-green, Hackney-road sub-district, east of the last mentioned sub-districts, andsupplied by the East London Water Company. Here elevendeaths have occurred up to July 28th. North of the preceding,and running across the limits of the East London Company’smains, is the Haggerston West sub-district ; in this one deathhas been recorded, occurring east of the limiting line.

These points in the distribution of the cholera deaths occur-ring near and on either side of the limits of the East LondonWater Company’s supply we have made out by comparing theRegistrar-General’s returns with a map, on which the engineerto the Company has kindly traced for us the limiting line.From a consideration of these points, it will be seen that thisline indicates with very general accuracy the boundary of thecholera field in London. Further, the cholera field extendsbeyond the London registration districts, to West Ham,Plaistow, and Stratford ; and so does this Company’s water-supply. However, on the other hand, their mains run fairlynorth of the present cholera field. The evidence so far seemsto bear strongly against the East London water. Still, it maybe only an accidental coincidence that the cholera and thewater supplied by the Company should be distributed overthe same area. With regard, however, to the lowness of thedistrict where the disease prevails, other regions in South andCentral London are as low. And while, as to drainage, theincompleteness of the low-level sewer leaves a large part of thecholera field undrained, this is not so, we believe, in the

Bethnal-green district, which is drained by the mid-levelsewer, and in which 137 deaths from cholera have occurred upto July 28th.We have gone over the waterworks at Old Ford, under the

guidance of Mr. Greaves, the engineer, who kindly placedhimself at our disposal for the time, and readily gave us suchinformation as we sought. There is at Old Ford a large coveredreservoir, which is in communication with the company’s filter-beds at Lea-bridge by means of a four-foot iron pipe, whichruns under ground on the east side of the Hackney-ert. Fromthis reservoir is sent the greater part of the supply of water tothe low-lying districts of the company’s mains (the presentcholera field). There are also at Old Ford two large open re-servoirs, communicating with the Lea-bridge works by an opencanal. These reservoirs and this canallie east of the Hackney-cut. This canal and the open reservoirs are not used, we weretold, at present for the water-supply, although they commu-nicate with the covered reservoir, and therefore can be usedon an emergency. This fact is much to be regretted, althoughit may be the case that this emergency never does occur. Thecovered reservoir lies west of the Lea, in what we cannot butfeel to be dangerous proximity to the river, under which theiron feed-pipe from the filter-beds has to pass. However wellthe reservoir may be made, it is very difficult to keep waterfrom oozing through brick and concrete. The water in thereservoir looked very clear, and exhaled nothing but a pure-smelling aqueous vapour. The latter statement would, how-ever, we hear, not always be true. The open reservoirs havenot long since been cleansed ; and we are informed by an eye-witness from the Great Eastern Railway, which passes alongtheir margin, that the matters removed were very offensive.From the filter-beds at Lea-bridge the water is supplied directto the mains of the high-lying district, the excess suppliedflowing down to assist in supplying the low-lying districts.This may serve to explain the non-extension of the cholera.field to the north and high part of the East London water field.Of course it can only do so on the condition that the waterreceived in the lower districts differs in quality from that inthe upper, either by the supply to the upper districts beingpurer, or by deposits having collected in the lower mains, andbeing swept on with the water when it is turned on to thehouses. At any rate the connexion of the difference of supplywith the difference in the prevalence of cholera is an importantfact to be noted.The East London Water Company take all their supply, we

understand, for their filter-beds at Lea-bridge from the riverLea at Ponder’s-end, more than two miles above the bridge,by a cutting running down to their works ; but their workshave also a communication with the river at Lea-bridge bymeans of wired lock-gates which rudely strain the water whichflows through them.

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The sewage of Edmonton, the refuse from a gasworks andfrom a crape manufactory, are received into a cutting madeby the company to intercept its course into the river until itgets to below Tottenham where, together with the sewage oithis place, it then enters the river-that is, at a point aboveLea-bridge, but below Ponder’s-end. At Ponder’s-end, outinformant tells us, the water seems clear and good ; near and.above Lea-bridge carcases of animals were observed in thewater. It is needless for us to mention the filthy state of theriver below Lea-bridge.Now with regard to the state of the water. We must foi

present information on this matter turn to the analysis madeunder the superintendence of Professor Frankland, and pub-lished by the Registrar-General. We shall convert the num-bers representing parts in 100,000 of water into the more fami-liar statement of grains per gallon.

These results can hardly be said to afford any very important indication. For while the organic and other volatihmatters were so largely above the average quantity on July Ist,the oxidizability of the water was at that time below thtaverage. On August 1st both the amount of the organic mat.ters and the oxidizability of the water were below the average,particularly the latter. The condition of the water as indicatedby these results is as good as that of the Thames Companiessupplies, but it is decidedly inferior to that of the New RiveiCompany, which derives its supply in part from the Lea.The presence of organic matter in water is no actual proof oi

its unfitness for human consumption; much less can the rela-tive quantity of organic matter be taken as an indication oithe degree of its unfitness. It is the nature of the organicmatter which is of importance. These matters, or the productof their change, may interfere with the healthy action of thebody without exciting any specific disease, or they may be themeans of conveying a contagious disease. In the latter casethey must of course be of animal origin, and usually of humanorigin. It is in this way that water is believed to excite cho-lera-namely, by conveying organic particles from a cholerapatient to another person. From this possibility of the organicmatter derived from human beings being capable of excitingin a person the disease of him they come from, they are to belooked upon with exceeding suspicion and dread. Besideswhich, they usually possess the putrefactive quality to a verymuch greater extent than organic matter derived from thevegetable kingdom, so as to be largely armed with all thedeleterious power of this decaying vegetable matter.The surest way of determining the human or other origin

of the organic matter found in a sample of water is to tracethe history of the water. But at times microscopic observa-tion serves to detect animal matter in water, if it be in thesolid state ; while the detection of nitrogen in the organicmatter, or of this substance, as ammonia or nitric acid inmaterial quantity in the water, renders the past or presentoccurrence of animal matter in the water probable. As a rule,the detection of nitrogenous organic matter in water may beconsidered to prove it to be a noxious beverage. The presenceof ammonia or nitric acid does not indicate that the water hasbaneful properties, but it shows that nitrogenous (probablyanimal) matters find their way into the source from which thesample was taken, and the danger therefore of using suchwater for fear that at any time the change of these mattersinto such harmless bodies as ammonia and nitric acid may nothave taken place.The atmosphere is the great purifier of water, partly by the

chemical action of its oxygen and ozone, and partly by its re-moving gases and vapours from the water by diffusion. Butthere is no certainty as to what degree of exposure is sufficientthus to purify a water. Many persons consider the atmosphericpurification of water to take place very rapidly, while SirBenjamin Brodie, Professor of Chemistry at Oxford, in his- evidence before the Royal Commission appointed to inquireinto the Pollution of Rivers, states his opinion to be that it is

simply impossible for the oxidizing power of the atmosphereover sewage running in mixture with water over a distance ofany length to be sufficient to remove its noxious quality, andthat the noxious quality imparted to the Thames water by the

l sewage of Oxford is not removed by the time this water, reaches Teddington Lock (above which the Thames companies; draw their supplies for London). This, it must be remembered,is the opinion of one of our most profound chemists, but we, cannot but feel that in it the powers of the atmosphere are de-cidedly underrated.L There is one property which all physiology serves to show, organic matter must possess to be active in developing vital, actions, and that is a tendency to undergo change-the pro-

perty of chemical instability. Now this property is possessed’ by organic matter-more especially animal matter-pretty, nearly in proportion to its power of undergoing oxidization.’ Hence, matter not easily oxidized can have but little action

on the body, so that its presence in water is of comparativelylittle importance, while the presence of readily oxidizablewater is of correspondingly great importance. Now readily

- oxidizable organic matter will often take oxygen from thingsl that it meets containing it—converting, for instance, sulphates

into sulphides, and nitrates into nitritcs. So that the presencein water of these salts and other allied bodies, as well as ofoxidizable matters, is a probable evidence of the powers of thewater to cause some effect on the human organism for good orfor evil, and much more likely for the latter. The oxidizabilityof the constituents of a drinking-water is therefore a materialpoint to determine, and forms an important part of the exami-nation of a drinking-water. It is since the outbreak of cholerain 1853-54 that an available means of doing this has been madeout. In respect of this point, the East London water con-trasts favourably with that of the Thames Companies.

Before closing our present remarks on this part of our sub-ject we are anxious not to pass over the methods we have offreeing our drinking-water from possibly dangerous impuri-ties. Thorough filtration is indispensable, because not onlydoes it remove some of the impurity, but probably some ofthe most active part of it, since different considerations serveto render it likely that solid particles of organic matterare more powerful for harm than organic matter in solution.But filtration alone is insufficient. Boiling the water is awell-known means of purifying it; but this, besides usuallyrendering the water vapid to the palate, cannot, in the opinionof many scientific men, be relied on.The Registrar-General’s report contains two recommenda-

tions from Professor Frankland-one, the admixture of per-manganate of potash with the water ; the other, the use ofanimal charcoal filters or purifiers at the waterworks. Hecalculates that 300 tons of bone black would be requiredbetween all the metropolitan water companies, which wouldserve for at least three months-perhaps for a year-to removethe whole of the organic matter. Its employment he considersto be neither formidable nor expensive. He calculates that ifthe permanganate be employed, 80 Ibs. ought to be mixed with1,000,000 gallons of water-a calculation that indicates therequisition of 80001bs. of this substance per diem to purify thewater supplied to Lcndon. This method would not only be ofenormous expense, but it would render the water turbid shouldany of the permanganate pass unchanged through the filter-beds.Our own recommendation is to employ Mr. Spencer’s " inag-

netic carbide"-a form of magnetic oxide of iron prepared byhim. This substance is stated by him to cause the oxidationof all the organic matter in water without losing its power byuse. It is equally applicable, we believe, to the filter-beds ofa waterworks and to the house-filterer. Of our own knowledgeof its power we can speak thus far : one of his domestic puri-fiers thoroughly oxidized the water supplied by one of theThames companies, and this after a month or two’s use aswell as at first. The test of oxidizability of the water beforeand after purification was the permanganate of potash solution.The colour of the water caused by the organic matter was alsoremoved by this purifier. In this material, then, lies a meansof purifying water at a trifling cost at the waterworks. And in

Spencer’s water purifiers for domestic use (obtainable at Euston-square), or in the filterers of the London Water-purifyingCompany (Strand), as mentioned by Professor Frankland, suchpersons who can afford the necessary outlay have what may belooked upon as a safeguard against drinking-water containingoxidizable organic matter.

During the week ending August 4th, 930 deaths by choleraoccurred in the field of the East London Waterworks mains,against 75 in the rest of London north of the Thames and 4isouth of the Thames. Of the 75 north of the Thames andwest of the East London Company’s mains, 12 occurred in the

sub-district of St. Botolph, East London district. Whateverthe cause, therefore, this sub-district is being severely visited,

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16 deaths from cholera having occurred in a fortnight. Theabove numbers for the week ending August 4th may be slightlymisstated, as we have not had time to examine the supplementto the Registrar-General’s report with any care.We have to acknowledge the kindness of the Registrar-

General for favouring us with some of the suggestions andinformation contained in his weekly report for this week

previous to its publication, and for affording us other facilitiesfor the prosecution of our inquiry.

0

THE BRITISH MEDICAL ASSOCIATION

THIRTY-FOURTH ANNUAL MEETING,HELD AT CHESTER, AUG. 7TH, 8TH, 9TH, AND 10TH, 1866.

ALTHOUGH at a great distance from the metropolis, no placecould have been selected for the annual meeting of the BritishMedical Association which possesses such varied attractions asthe ancient city of Chester. It is rich in memorable incidentsand associations, and has a history chronicled not only inbooks, but in its walls, towers, and venerable remains. Situateon the river Dee, its Roman name was undoubtedly " diva ;"and it formed the head-quarters of the 20th Legion, which isbelieved to have come into Britain before the year 61. Altars,Roman pavements, and other relics of former times, have beenfrom time to time discovered in various parts of the city andits environs, and it is not a little remarkable that these havebeen for the most part found four or five feet below the levelof the present day.The ancient walls of Chester are the only perfect examples

of the kind in England, and they are doubtless of Romanorigin. Even more remarkable, however, are the "Rows,"which constitute the great peculiarity of the city. These con-sist of covered ways or arcades, which form a gallery occupy-ing the first floor of each house, through which the public canwalk over the shops on a level with the streets, and by theside of a second series. They form a most convenient pro-menade, especially in wet weather.Our space will not allow us to do justice to the various

public buildings of Chester, and especially its ancient Cathedral;but we must not omit mention of the Chester Infirmary, ahandsome brick building, capable of containing 100 beds, andwhich is enabled by the services of its efficient staff to do avast amount of good among the poor of the city and neigh-bourhood.

The first general meeting of the Association took place inthe fine Music Hall of the city on Tuesday, August 7th, ateight when there was a good attendance of membersboth from London and the provinces.

Dr. JEAFFRESON, of Leamington, took the chair, and alludedin a few well-chosen and affecting sentences to the loss theAssociation had sustained in the death of its founder, SirCharles Hastings, whose funeral he had attended the daybefore, as the representative of the Association, at the requestof Sir Charles’s family. He proposed, as the first business ofthe meeting, a vote of condolence with the Hastings family,expressive of the appreciation by the Association of the loss ithad sustained.Mr. CARDEN, of Worcester, seconded the proposition, and

gave some interesting details of Sir Charles’s last illness, andof the interest which he took in the Association to the last.

Dr. RICHARDSON said he would venture to trespass byspeaking to the proposition, and, in an able speech, calledattention to three attributes of Sir Charles Hastings’ character :his wonderful power of bringing together for one object menwho might differ in many ways; his untiring industry; andhis quietness in his labours.The vote of condolence was carried in solemn silence.Dr. Jeaffreson then gave place to Dr. EDWARD WATERS, oj

Chester, the President of the year, who proceeded to read hiEaddress. Among other topics he alluded to the late prevalenceof typhus at Chester, and mentioned that in twelve monthshe had had to deplore the loss of one physician, two house,surgeons, and a pupil of the Chester Infirmary from thatdisease. Dr. Barker, of Bedford; had also died of typhus,

thus resembling Laennec and Reid in falling a victim to thedisease he had especially studied. It was remarkable that thefounder and the first recipient of the Hastings medal had bothdied within the year. Mr. Toynbee was to be regretted, notmerdy on account of his scientific attainments, but for hisopen-handed charity and for the labour of love he bestowedon the Medical Benevolent Fund. Dr. Conolly was alsoalluded to as one of the earliest members of the Association,and as the founder of asylums for idiots. The cattle plaguehad been most severely felt in Cheshire, more especially sothan in any other county. The true note of alarm was soundedby Dr. Budd, of Clifton, last year, when he predicted the result ofneglect of preventive measures. No adequate steps, however,had been taken by the Government, and hence the melancholyresults. The President had in vain, at the first onset of thedisease, urged upon the county members that " stamping out"was the only remedy, and that attempts to cure were useless.Owing to the loss of cattle large quantities of hay had beensent from Cheshire to other parts, and it was to be fearedthat these might convey a possible infection not yet developed.The water-supply of Chester was shown to be very defective,it being drawn from the Dee, which being a tidal river, thesewage was apt to be carried up to the point whence the sup-ply was taken.A vote of thanks to Dr. Jeaffreson, the retiring president,

and his election as a vice-president, was proposed by Dr.FAULKNER of Bath, and seconded by Mr. HARRISON ofChester.The Council’s Report was read by the Secretary, and was

very satisfactory, showing 2462 members against 2368 in 1865,and stating that there was a balance in favour of the Asso-ciation of .E318 14s. 8d. The Council had presented, throughMr. Paget, of Leicester, fifty petitions to the Council of theCollege of Surgeons in favour of proxy-voting by the Fellows ;and suggested a deputation to the Home Secretary to ask hisinterference in the matter. It was announced that the Hast-ings medal had been adjudged to Mr. Furneaux Jordan, ofBirmingham, for his essay " On Shock after Operations andInjuries." "

Mr. Watkin Williarns was unanimously re-elected GeneralSecretary of the Association.The Report of the " Medical Provident Society" was then

read, from which it appeared that the number of its memberswas only thirty-two; and that no application had hithertobeen made for participation in the benefits of the institutionby any of the members.

Mr. STEELE, of Liverpool, spoke against the Society, which,he said, had utterly failed, since, according to Mr. Tidd Pratt,it could not succeed with less than 200 members. He moved thatthe British Medical Association decline to be connected with theSociety. This was seconded by Mr. MORRIS, of Spalding, andgave rise to a very animated and somewhat personal discussion,in which Mr. Heckstall Smith, Dr. Davy, Dr. Husband, Dr.Camps, and Dr. Richardson took part, resulting in the with-drawal of the amendment, and the reappointment of theDirectors of the Society, on the understanding that they wouldtake immediate steps to call the members together, and explainthe position of the Society with a view to its dissolution.

The proceedings of the second day began with a publicbreakfast in the Corn Exchange, at which Dr. Waters presided,and upwards of a hundred members sat down.

I Dr. MACKESY, of Waterford, brought the question of parlia-mentary representation of the medical profession under thenotice of the Association, and urged the formation of threemedical constituencies, one for each division of the kingdom.He moved the following resolution :-

" That a favourable opportunity now presents for solicitingthe attention of the Government, the public, and the membersof our profession, to the question of granting parliamentaryrepresentation to the medical profession in its collectivecapacity; that with a view to the accomplishment of thisimportant object, the Council be empowered to take suchmeasures as they may consider judicious to promote its success,by presenting memorials to the Government, petitions to bothHouses of Parliament, and by communicating with the medi-cal Universities, Colleges, and Associations, to urge theirzealous co-operation."

Dr. PAGET, of Cambridge, seconded the proposition, thoughhe was not sanguine of the ultimate success of the movement.

Mr. HoLES opposed the motion as undignified and inju-dicious, and thought that the idea of representation as a classwas contrary to the genius of the medical profession. It wasnot the case that the Law was represented in the House of