1236 ROYAL COLLEGE OF SURGEONS OF ENGLAND.

Daughter, aged 64 years, of late:M.R.C.S., who practised in Hamp-shire. For many years has acted as companion to mental cases but is Inow unable to obtain such a post; hopes shortly to be elected to a

pension from a benevolent society. Relieved twice, 215. Recommendedby Mr. E. East. Voted £ in one sum.Widow, aged 67 years, of L.R.C.S., L.R.C.P., who practised in Herts.

Unprovided for at husband’s death; children only able to give slighthelp; indifferent health for last three years. Relieved 14 times, .B144.Recommended by Mr. J. Roche Lynch. Voted E12 in 12 instalments.Widow, aged 49 years, of L.R.C.P, L.R.C.S. Edin., who practised in

London. Quite unprovided for at husband’s death two years ago andunable to obtain employment on account of bad health. Relievedtwice, .B17. Recommended by Dr. J. Mitchell Bruce (vice-president).’Voted 25 in one sum.

Daughter, aged 59 years, of late M.R.C.S., L.S.A., who practised inSussex. Receives a pension from the Kent Medical Benevolent Society,but income is insufficient for maintenance on account of slight mentaldleficiency which necessitates applicant being placed in rooms where- she can be looked after. Relieved ten times, .E96. Recommended by.Mr. A. S. Bostock. Voted 12 in 12 instalments.

ROYAL COLLEGE OF SURGEONS OFENGLAND.

. ANNUAL REPORT.

THE Council of the Royal College of Surgeons of EnglandTias just issued its annual report, which is to be laid before-the yearly meeting of the Fellows and Members on

Nov. 15th. The meeting will be held in the College at:3 P.M. The report is an exposition of the year’s work and"contains items of considerable importance.

The length of the medical curriculum has been carefullyconsidered and a committee of the two Royal Colleges in:England was appointed to report upon the following pro-posals : (1) to treat chemistry, physics, and biology as sub-jects of preliminary education and to require that an examina-tion in them should be passed before the recognition of the’commencement of medical studies ; and (2) to adopt a firstyear’s curriculum of professional study from the date ofpassing the preliminary science examination. With regard tothese questions the committee was unanimously of opinion:(1) that it is undesirable to treat chemistry, physics, andbiology as subjects of preliminary education ; (2) that it is’undesirable to require an examination in chemistry, physics,:and biology to be passed before the recognition of the com-mencement of medical studies; and (3) that it is therefore,undesirable that the Royal Colleges should approach theuniversities and other examining bodies with a view to

adopting a five years’ curriculum of professional study from,the date of passing the preliminary science examination.’The report contains the reasons why the Council has

-adopted the opinions as set forth above.The regulations for the Fellowship have been under con-

sideration on account of a report received from the court ofexaminers recommending the alteration of the clause in theregulations requiring a candidate before admission to the’jirst examination for the Fellowship to produce a certificate" of having been engaged in the acquirement of professionalknowledge at a recognised medical school subsequent toTegistration as a medical student during a period of not lessthan three winter sessions."

The court pointed out that the 18 months’ dissectionsrequired for the Fellowship could be completed in two winterand two summer sessions, but that, while those candidateswho had studied the early subjects of the medicalcurriculum-viz., chemistry, physics, and biology amedical school could count such study as part of the courserequired for the Fellowship, those who had studied thesesubjects at a non-m’edical school could not do so but wereobliged to complete another winter session at the medicalschool.The Council having appointed a committee to consider the

,proposal of the court, it was pointed out that the suggestedalteration of the regulations did not reduce or alter in anyway the course of study then required for the Fellowship.The main object was to make the conditions of admission tothe first examination fair for all classes of candidates.Under the conditions then in force two candidates mighthave pursued the same course of study and yet one might be-admissible and the other not. Thus a candidate who hadstudied chemistry, physics, and biology at a medical schoolfor 18 months was admissible to the examination, but acandidate who had studied chemistry, physics, and biologyelsewhere than at a medical school for six months and haddissected at a medical school for 18 months was notadmissible to the examination, although the study of

chemistry, physics, and biology at non-medical schools wasrecognised and approved by the College. It was to removesuch inequality of treatment that the alteration of the

regulations was designed. The committee, having con-

sidered the question of altering the by-laws, arrived at thefollowing conclusion-viz., that it is inadvisable to alter

By-law Section 20, Clause 3, so as to make it necessary for acandidate for the first examination for the Fellowship todissect for three winter sessions.With regard to the suggested diplomas in tropical medicine

a report has been received from the visitors appointed by thetwo Colleges to inquire into, and to report on, the arrange-ments made by other institutions for the study of tropicalmedicine and examination therein. The committee of visitorsadmitted that the schools of tropical medicine haveopportunities of research in a ceitain number of diseaseswhich are much greater than those possessed by most generalhospitals in the British Isles ; and that a knowledge of thesediseases is eminently desirable in the case of medical menpractising in the tropics, but not by any means equallynecessary for medical men practising at home. It isimpossible for the Royal Colleges to ignore the existenceof this important branch of knowledge or the followingfacts : (1) that it is not at present adequately provided forat the ordinary medical schools ; and (2) that it is providedfor at Liverpool, the London School of Tropical Medicine,and the Navy and Army Medical Colleges. They may well,therefore, consider whether, in extension of the functionsthey already possess of giving diplomas in medicine, surgery,obstetric medicine, and State medicine, they should not alsogive diplomas or certificates which would implicitly or

expressly guarantee a knowledge of tropical medicine.The question of varicocele as an impediment to military

service has been considered owing to the Council having beenconsulted by the Director General of the Army Medical Serviceas to whether, and, if so, to what extent, varicocele shouldbe regarded as a disqualincation for military service. TheCouncil replied that in cases where candidates are otherwisephysically fit, varicocele, unless present in a severe degree,need not disqualify them from service in the army.Regarding College scholarships, Mrs. Macloghlin, whose

munificent proposal to bequeath to the College a sum of.f.l0,OOO for the endowment of scholarships in memory ofher husband, the late Mr. Edward Percy PlantagenetMacloghlin, M.R.C.S., was recently announced, intends toincrease the value of her bequest. She now proposes furtherto bequeath to the College the residue of her estate to formthe "Eliza Macloghlin Bequest," the income arising there-from to be applied for the purpose of increasing the valueof the Macloghlin scholarships.With regard to the financial state of the College, the gross

income for the past year amounts to 0825,361, being £ 394less than the gross income. for the previous year. Thebalance of income over expenditure amounts this year to082329.

___

THE CALENDAR—NEW FEATURES.’

THE present issue of the College Calendar contains manynew features. In addition to an historical summary there isa concise account of the foundations of the College lecturesand prizes. As not the least important among the improve-ments of the Calendar may be noted the revision of the list ofMembers. Much time and attention have been devoted tomake the list as complete and as accurate as possible.Only about one-half of the list has at present been revisedbut it is intended to complete the revision in time for thenext issue of the Calendar. There are now on the College roll1363 Fellows, of whom 1311 obtained the Fellowship byexamination; 27 were elected as "Members of 20 years’standing" ; one is a Fellow elected ad e2cndena; and of theoriginal Fellows by election only 24 now remain. There are17,414 Members, 2C46 Licentiates in Dental Surgery, and 578Diplomates in Public Health.

The College endo)v?7ient3.-For the first time there appearsin the Calendar a succinct account of the College endow-ments, beginning with the Hunterian Oration which datesback to the year 1813. In this year Dr. Matthew Baillieand Sir Everard Home, Bart., executors of John Hunter,"being desirous of showing a lasting mark of respect tothe memory of the late Mr. John Hunter," gave to theCollege the sum of 081684 4s. 4d. 3 per cent. consolidatedbank annuities for the endowment of an annual oration tobe called the Hunterian Olation and to be delivered in thetheatre of the College on Feb. 14th, the birthday of John

1237PUBLIC HEALTH AND POOR LAW.-VITAL STATISTICS.

Hunter, by the Master or one of the Governors for the timebeing, or such other member of the Court of Assistants asshould be appointed by the Master and Governors or anytwo of them, such oration to be expressive of the merits incomparative anatomy, physiology, and surgery, not only ofJohn Hunter, but also of such persons as should be fromtime to time deceased whose labours have contributed to the

improvement or extension of surgical science. In 1853,after consultation with the representatives of the founders ofthe trust, it was decided that the oration should in future bedelivered biennially instead of annually.

Reoeipts and expenditure.-With regard to the receiptsfor the past year the fees for the Fellowship examina-tions amounted to f,2464. The expenses in connexionwith the examination, including the examiners’ fees,subjects, patients, instruments, &o., amounted to .61970.The examination receipts of the Conjoint ExaminingBoard, of which the College is entitled to one half,amounted to .E13,051 and were derived as follows ; first

examination, .61256 ; second examination, .E1452; thirdexamination, 95066; diploma fees paid by university can-didates, .E3457 ; and incidental receipts amounted to .E1817.The expenditure in connexion with the Membership examina-tion amounted to 99627. Of this sum the largest item wasthe fees to examiners which amounted to 94412. The

receipts and expenditure of the Diploma in Public Healthwere respectively .6321 and .6204, and of the Licence inDental Surgery the receipts amounted to .E2269 and the ex-penditure to .EI052. The general working expenses, in-

cluding fees to the Council, salaries and wages of the secre-tarial department, rates, taxes, &c., amounted to .64541.The museum expenses were .E2858, while the library upkeepamounted to .61792. The receipts from house propertyamounted to .E700 and from investments to .61221. Thedividends in stocks and shares of the Erasmus Wilsonbequest yielded .64926.

Public Health and Poor Law.LOCAL GOVERNMENT BOARD.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

City of 11-’ottinghcrra.-Dr. Philip Boobbyer reports for1905 the lowest birth-rate ever recorded for this city-i.e., 26’4 4 per 1000, and in this connexion he refers to thegrowing use of lead as an abortive which his experiencein Nottingham has taught him is now much used for thispurpose in the shape of diachylon plaster. It is taken, hestates, in large quantities and for a considerable period,irreparable and even fatal injury being thus done to thematernal organism. Good work appears to have been carriedout at the Bagthorpe isolation hospital during 1905 and asregards the fatality rate of hospital and home treated casesof scarlet fever there was a difference of 1’ 3 per cent. infavour of the hospital, notwithstanding the fact that 46of the hospital cases were of a severe type and speciallyselected for the open-air treatment reserved for such cases.Dr. Boobbyer adds with reference to this treatment : " Inmy opinion the line of safety and success in dealing withcases of acute specific diseases, among many others, lies inthe direction of open-air treatment. With due precautionsagainst exposure of the person to extremes of temperatureand wet the results are excellent. There are no drawbacks,so far as I am aware, except those which arise from thenatural prejudices of the patients and their friends against anew thing not generally adopted." As regards diphtheria,the fatality rate in hospital was 7’ 45 per cent., as againsta fatality rate of just under 10 per cent. for the cases treatedat home. The health department supplies anti-diphtheriticserum gratuitously to medical men attending poor patients,and it is now, the medical officer of health states, somewhatfreely injected for protective purposes. He points out, how-ever, that the protection thus afforded frequently does notextend beyond 14 days. Dr. Boobbyer has for several yearskept records of the incidence of enteric fever in houseshaving different methods of excrement disposal and the

averages for the years 1887 to 1898 are as follows : Houseswith pail closets, one case of enteric fever in 120 houses ;houses with midden privies, one case in 37 houses ; andhouses with water-closets, one case in 558 houses. Some

recent investigations relative to the age and sex distributionof fatal tuberculosis among industrially occupied malesand females from the age of 15 years and upwards broughtout the interesting fact that the death-rate of the males wasequal to 2-408 per 1000, while that of the females onlyamounted to 0 881-i.e., the female death-rate was a littlemore than a third of the male rate. Nottingham possessesa lethal chamber for dogs, cats, and other animals andduring the year 1507 dogs and 548 cats, together with twomonkeys, were painlessly put to death.

Metropolitan Borough of Woolmiah.-The council of thisborough subsidises six beds at the Maitland Cottage Sana-torium for pulmonary tuberculosis and up to June 30th,1905, 20 patients had passed through these beds, three ofwhich are apparently used for two months’ treatment and theother three for four months’ additional treatment for suchcases as seem likely to benefit by it. At the date of writinghis annual report for 1905 Dr. Sidney Davies summarisedthe results as follows: Five apparently cured, seven muchimproved, and eight died. He then proceeds : "As it is

possible that some of the seven improved will presentlyrelapse it is a question whether the curative results can beconsidered quite satisfactory, but the educational results havebeen found altogether good. Those who have returned fromthe sanatorium have always been found to continue to carryout open-air treatment at home and to take the other pre-cautions, such as sleeping in a separate room, necessary to

prevent their infecting others. These precautions can onlybe very partially tiught by the distribution of printedinstructions and by visits to the home. It is a questionwhether it would not be better to further reduce the period ofstay at Peppard, for all but selected cases, to six weeks ora month in order to admit a larger number of consumptives."Dr. Davies will, we trust, tell us in his next annual reportthe after-history of the 12 surviving cases above referred to,as information of this nature from a source such as his is ofvery great value, and apparently the above comments relateto cases the majority of which had at the date of Dr. Davies’sobservations only left the sanatorium for a relatively shortspace of time. Obviously unprejudiced comments and factssuch as those furnished by Dr. Davies are much needed.During 1905 one of the wells supplying the borough withwater was found to be yielding in October and Novemberfrom 14 to 140 microbes per cubic centimetre and also tocontain an unusually large amount of chlorides. From thesefacts it is inferred that Thames water was being drawn fromthe bed of the river through into the chalk, a sufficientlyserious matter, more especially from the fact of the pre-sence of so many micro-organisms in a water generallycontaining so few. Although after a period of rest and aresumption of less exhaustive pumping the water returnedto its former purity the circumstance suggests the mostcareful watching.

Metropolitan Borough of 8t. Pancras.-Dr. John F. J.Sykes reports that during 1905 the council of this boroughdecided to adopt the voluntary notification of pulmonarytuberculosis, the usual fee being paid for such notifications.It has been determined that prior to notification the patient’sassent should be obtained and that in addition to the notifica-tion being regarded as confidential nothing will be done toprejudice the patient’s occupation or employment. On the

receipt of a notification there is forwarded to the patientnot only the usual leaflet relative to preventive measures butalso a list of institutions where accommodation of differentforms may be procured, as also a form requesting the sanitaryauthority to disinfect a room previously occupied by a con-sumptive patient. Beyond this no further action will betaken by the sanitary authority except by special request inwriting. No disinfection will be done save on the receipt ofthe form above referred to, nor will any sanitary inspectionensue as a result of the notification except on specialrequest. Gratuitous examination of suspected sputum isundertaken by the sanitary authority and the necessaryswabs and tubes are supplied when asked for.

VITAL STATISTICS.

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8665 births and 4422deaths were registered during the week ending Oct. 27th.The annual rate of mortality in these towns, which hadsteadily declined in the seven preceding weeks from 22 ’ 3 to14’ 6 per 1000, was again last week equal to 14’ 6. During