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approved in spending .640,400 on feeding the children, butthere is another subsidy of ,E40,400 which is divided amongthe maternal schools, the health colonies, various homes fororphans, and different institutions connected with primaryeducation. The teaching itself is, of course, obligatory andgratuitous and all the other services connected with theschools are likely to become equally gratuitous.Such a tendency in England would doubtless not fail to

excite much opposition. It was in 1884 that children attend-

ing the Paris elementary schools were first fed on a largescale at the public cost. Paris has therefore had 23 years of

practical experience of what has not yet been done anywherein England. But a law has now been passed. The Provisionof Meals Act of 1906 empowers the English school authoritiesto take some steps in this direction. All the arguments nowbrought forward in England against the free feeding ofchildren were heard in France a quarter of a century ago. Whathas become of such arguments in the face of practical experi-ence is shown by the facts and figures given above. Some willbe tempted to deplore the result; none can afford to ignore thisParis experience, for it constitutes the greatest object lessonthat has ever been given on the subject. The Paris experi-ment is not as radical as that attempted by the municipalityof Vercelli where, as already described,2 every child is com-pelled to take his midday lunch at school and no parent isallowed to pay, but then Vercelli is quite a small place.while Paris is the second largest town in Europe. In 1905there were in Paris 202 public schools for boys and 202public schools for girls. The number of pupils inscribedwere 79,698 boys and 74,124 girls. Of these 24,023 boys and14,157 girls attended school during the holidays, where theywere watched and fed but not taught. The allowing of childrento play in the school building instead of the streets during theholiday is an excellent measure to keep them out of mischiefand to insure their being properly fed. Altogether the townof Paris spends. on primary education about ,El,280,000 andthe feeding of the children does not amount to one-thirtiethof the entire outlay. The cost is therefore in no wise to becompared with the importance of the service. The benefitsto public health and to the growing intelligence of the pupilsare generally recognised to be out of all proportion comparedwith the expenditure; no outlay has ever given betterresults.

Of course, the feeding is but part-doubtless the mostimportant and expensive part-of a whole system of physicaleducation. One advantage of the meal at school is thatwhen the attending school physician prescribes a spacialdiet or certain medicaments with the meal the pupil getsthem. At home such medical instructions would not alwaysbe as punctually executed. Then the great harm done bycalisthenics when imposed on starving school children isavoided, because in the Paris schools the children cannotstarve. Finally, when consumption and other diseases may be avoided by sending the child to the country or seasidethis can often be done as there is a large municipal subven-tion for that purpose. If we compare the completeness of ,

all these measures, the care with which they have beencombined to supplement each other, with the comparativechaos that prevails in the English elementary schools, it isnot surprising to find that so much more is said about

physical degeneration on the British than on the Frenchside of the Channel.

MANCHESTER.(FROM OUR OWN CORRESPONDENT.)

ASl2ams.THE medical officer for the Northwich urban district in his

annual report makes some interesting remarks on the effectof " slums " on the health and morale of the population. Hebelieves that proper housing would lower the mortality bymore than one-half, would decrease infectious disease bythree-fourths, would sweep away nearly all the anasmic,undersized, scrofulous beings who now crowd our alleys,almost stamp out tuberculosis, and do much to elevate themoral and mental refinement of the bulk of the people andlessen the need for workhouses, prisons, asylums, sanatoriums,epileptic colonies, and hospitals. This is a long catalogue ofbenefits, and perhaps a somewhat optimistic view, but thereis no doubt that the evils named, with their accompanying

2 THE LANCET, Nov. 10th, 1906, p. 1308.

wretchedness, would be greatly alleviated if houseswere light, airy, and wholesome, and overcrowding wasabolished. It is to be feared, however, that no im-

provement would follow very rapidly. The "residuum" isnot yet educated up to a very high level, and his instinctsare not those of a high civilisation. Also it is a splendidnotion to " check the erection of slums by the jerry-builder,and provide houses of a proper character for those who needthem." But unfortunately that kind of work in Manchesterhas proved costly to the ratepayers, and municipal enter-

prises do not seemed to be managed with the care andeconomy necessarily exercised in private ventures.

Afraid of a Hanging Man.A strange incident came to light’ at the coroner’s court the

other week when the death of a man by hanging was beinginquired into. He was 75 years of age, and was found byhis niece suspended by a rope to a clothes’ rack. Shedid not cut him down, nor did her husband, as theysaid "they were too unnerved." The coroner suggestedthat they wanted to be quite sure the man was dead. "Helooked as if he was dead." They sent for a police-man who came in half an hour. " So you left himfor half an hour ? " "Yes, sir." Speaking to the jury, thecoroner said that some day a verdict of manslaughter wouldbe brought against people who left anybody hanging and didnothing. Such an occurrence as this shows a degree ofmental and physical unreadiness enough to make one almosthopeless as to the future of a large proportion of our urbanpopulation. In any emergency, instead of being alert and; ready to act promptly, they are timorous to imbecility. It isto be presumed that both the niece of the poor suicide andher husband have shared the blessings of the education thathas been so liberally imparted for the last 30 or 40 years,but what effect has it had in giving them character or

courage ? It would have been well if the man had gonethrough such an amount of military drill as to bring outsome of the readiness to act that the book knowledge whichhe must be supposed to have imbibed evidently failed togive. The verdict was one of " Felo de se," and the jurygravely agreed with the remarks of the coroner as to " thefolly of leaving anybody hanging."

Darty Milk.The farmers of Saddleworth are indignant at charges having

been made of uncleanliness in their dairies and carry the warinto their customer’s country by complaining that some ofthem are anything but cleanly. They say that jugs are usedfor days together without being washed, and if the farmerprotests he is told that they must be clean because theyhave had nothing else in them but milk. Sometimes, saythe purveyors, customer’s milk has to be poured into oldsalmon tins and jam pots. It is difficult to eradicate habitsof slovenliness and dirt which have become habitual to too

many of the working population, and there need be nowonder that the farmer sometimes hits back.April 9th.

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SCOTLAND.(FROM OUR OWN CORRESPONDENT.)

The St. Andrew’s Ambulance Association.A POINT of considerable importance, more especially to

those interested in ambulance work in Scotland/has beenraised by the action of the Order of St. John of Jerusalem inpetitioning the Privy Council for a supplementary charter toenable it to establish priories in Scotland. The St. AndrewsAmbulance Association has lodged a counter-petition sub-

mitting that the power to establish priories in Scotlandwould, if granted, be detrimental to the interests of thepublic and unjust to the Association. The St. Andrew’sAmbulance Association was established in 1882 with theobject of providing instruction in ambulance work inScotland and rendering first-aid to the injured and a RoyalCharter of incorporation was granted in 1899. The Asso-ciation has been very successful indeed in carrying outthe objects for which it was incorporated, and has nowcome to be recognised as an important charitableand philanthropic institution. An ambulance corps of2500 officers and men has been distributed in sectionsthroughout Scotland and the corps is rapidly increasing innumbers. Upwards of 400 classes are conducted by theAssociation every year and the area of instruction embraces

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the whole of Scotland, extending even to the outer Hebridesand the remote parts of Caithness, Sutherland, Invernessand Argyll. In connexion with these classes the association has issued more than 72,000 certificates of proficiency in first-aid to the injured, over 20,000 medallion:for advanced students in first-aid, and nearly 2000 certificates of proficiency in home nursing and hygieneThroughout Scotland 42 centres of the Association havEbeen established.’and a service of ambulance wagons habeen provided in every considerable town in which a policeambulance service does not exist. In Glasgow, for example,;,be whole ambulance work of the city and neighbouringburghs is done solely by the wagons of the Association, ancit is believed by us in Scotland that no finer ambulancEservice exists in any part of the United Kingdom. The call;attended to by the association’s motor and other ambulancewagons in Glasgow alone amount to 12’ 44 daily. Theassociation has further trained the constabulary throughoutScotland in giving first-aid, so that there are now few place.in Scotland where this cannot be obtained from the police.During the late South African war the Association equippedand sent out a base hospital of 520 beds, and it is now

recognised by the army and navy as an institution withwhich these authorities can enter into direct relations for thesupply of men and material in case of emergency. Inaddition the association has recently been intrusted by theBritish Red Cross Society with the organisation of its workin Scotland. As the Association has for so many years donesuch excellent work and appears to be capable of efficientlymeeting all requirements, it seems only reasonable to askthat the Order of St. John should not be allowed to initiate newcentres of ambulance work in Scotland, and thus engenderrivalry and competition which could not but be detrimentalto the interests of ambulance work in general. Those whocontrol the affairs of the Order of St. John are of opinionthat the St. Andrew’s Ambulance Association should becomemerged in the Order as a department charged with ambulancework in Scotland. This view the Association refuses to

accept as being in derogation of its charter, and likely tocripple seriously the work it has carried on so successfullyfor 24 years. But the Association has gone so far as to offerto act as the Order’s ambulance department in Scotland, itbeing understood that by so doing the charter of the Associa-tion would not be invalidated. It is earnestly to be hopedthat the Order of St. John will not persevere in any high-handed fashion with its claims. The St. Andrew’s Ambu-lance Association has done the spade work in Scotland for 24years, and now when, thanks to its efforts, the public inScotland are waking up to the value of ambulance work theOrder of St. John proposes to step in and reap the fruits.That, at any rate, is how the matter must appear to us.

There can be no doubt that the granting of the petition ofthe Order of St. John will be bitterly resented by thosewho have given their time and money to developing theSt. Andrews Ambulance Association.

Glasgow Royal Infcrrnary Post- Graduate Classes.The summer course will this year be a short but very

complete one, including, besides instruction in generalClinical Medicine by Dr. J. M. Cowan and in ClinicalSurgery by Mr. J. H. Pringle and Dr. H. Rutherfurd,the following special subjects: Symptomatology of theNervous System, by Dr. Walter K. Hunter ; SurgicalDiseases of the Urinary Organs, by Dr. David Newman ;Gynaecology (A), by Dr. J. K. Kelly; Gynaecology (B), byDr. G. Balfour Marshall; Diseases of the Eye, by Dr. H.Wright Thomson; Diseases of the Skin, by Dr. AlexanderMorton; Diseases of the Throat and Nose, by Dr. Robert

Fullarton ; Anaesthetics, by Dr. J. King Patrick; Gynæ-cological Pathology, by Dr. W. D. Macfarlane ; OperativeSurgery, by Dr. Peter Paterson ; and Bacteriology, byMr. David McCrorie. These courses will be thoroughlypractical, the amount of material at the disposal of theteachers being so large that they have every facility ofillustrating their lecture demonstrations by clinical cases.During last year the attendance on the various courses wasmost encouraging. The attendance at the classes (notincluding members of the staff) numbered 137 members. Itis therefore very desirable, in order to facilitate arrange-ments, that members of the profession who wish to join anyof the classes should communicate as early as convenientwith the superintendent, who will enrol members and supplyany information desired.April 9th.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

Association for Housing the Very Poor of Dublin.THE annual meeting of the Association for Housing the

Very Poor of Dublin was held at Trinity Chambers on

April 8th, Sir Lambert Ormsby, the chairman, presiding.This is a small company, but it has already donework that is much needed, for it is recognised that thewretched state of the tenement houses is one of the chiefcauses of the high mortality in the city. Sir CharlesCameron complimented the association on the way thetenements in its charge were kept and said that althoughthose in Derby-square were reconstructed houses, the roomswere model ones and sanitary in every detail. A dividend of3 per cent. was declared on the capital of the company.

The Pnblic Health of Belfast.At a meeting of the public health committee held on

March 28th, the medical officer of health reported on certaininsanitary areas, and it was decided to appoint a subcom-mittee to visit these localities. and to draw up a report andrecommendations for the consideration of the health com-mittee. On April 25th and following days it is proposed totake evidence before the Health Commission in reference tothe’ Belfast water. For the week ended March 23rd thedeath-rate was 23’ 5 per 1000. At a meeting of the city cor-poration held on April 2nd it was reported that betweenFeb. 17th and March 16th the large number of 302 cases ofinfectious disease had been notified-viz., 64 enteric fever,58 scarlet fever, 28 simple continued fever (evidentlytyphoid), 4 puerperal fever, 27 diphtheria, 1 croup, 19

erysipelas, and 104 cerebro-spinal meningitis. There were263 deaths registered from chest diseases. The averageannual death-rate was 23 7. These returns show a veryhigh number of infectious diseases notified and suggest that,as so often happens in Belfast, another epidemic of typhoidfever may be coming. A very decided opinion was expressedby many members of the corporation against the waste ofmoney in employing counsel at the Health Commission. Itwas finally settled to agree that the Lord Mayor should let thechairman of the public health committee know what were theideas of the members of the council in regard to their beinglegally represented at the Commission. A very curious pointwas referred to-that was a resolution appointing a deputa-tion of the public health committee to visit some towns inEngland and Scotland with a view to ascertain methodsof public health administration-in other words, a resolutionto send Belfast officials to other cities to learn their business.

The Belfast City -Fever Hospital.Dr. G. Orr, medical officer of Ballylesson Dispensary, has

reported to the Lisburn board of guardians at a recent meet-ing that since the establishment of the Purdysburn InfectiousHospital in his district he has had to register all the deathswhich took place in that institution. This entailed hardshipon the relatives of the deceased who had to travel anothermile after their journey of two or three miles from thenearest train to the hospital. The dispensary patients werenaturally alarmed at the presence of people from all parts ofBelfast who came to register deaths from infectious diseases,a feeling much intensified by the occurrence of two deathsfrom cerebro-spinal fever in the neighbourhood, one case

being that of the dispensary caretaker and the other of a boywho two days previously had been in the dispensary for somemedicine. It is clear that the Registrar- General will have toconstitute the hospital a special Belfast district, so that aresident official may be appointed registrar and thus avoidthe evils referred to.

Rainfall in Belfast in March.In March 4’ 89 inches of rain fell on 21 days, making the

amount for the year 1907, so far, 9’ 78, which is a littleabove the average amount.

The Health Corramission in Belfast.The Belfast Health Commission resumed sitting on

April 8th, when Sir John Byers was examined at bothsittings on that day and again on Tuesday. He dealt veryfully with the various problems confronting Belfast and madea number of suggestions for establishing a really efficientmodern public health department in Belfast.April 9th.