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will contain the surgical wards. The surgical amphitheatrewill be equipped with ten small operating rooms all withineasy access of the various wards and complete in everydetail. The hydropathic department, designed to surpassthat of any public or probably even private institution and tocontain bathrooms for both employes and patients, will beon the ground floor of the central pavilion. It will be

equipped with all modem apparatus for the treatment ofdisease by water and will be one of the most remarkable newfeatures of the hospital. There will also be an elaboratesystem of balconies on all sides of the hospital. Each ofthe 92 wards will have either an open or an inclosedbalcony of sufficient siza to accommodate all the patients ineach ward at one time. Two enormous covered arcadesfacing the river will accommodate all the patients in thehospital at one time if necessary. I

THE SERVICES

ROYAL NAVY MEDICAL SERVIOB.IN accordance with the provisions of Her late Majesty’s

Order in Council of April 1st, 1881, Fleet Surgeon JohnDowson has been placed on the Retired List (datedMay 14th, 1904) and Fleet Surgeon Henry Harries hasbeen placed on the Retired List at his own request (datedMay 21st, 1904).

ROYAL NAVAL VOLUNTEER RESERVE.The undermentioned appointments have been made :-

Robert Meredith Littler to be Surgeon. Honorary SurgeonCharles O’Brien Harding to be Honorary Staff &rgpon(dated May 17th, 1904).

ROYAL ARMY MEDICAL CORPS.Lieutenant N. E. Dankerton, from the Seconded List, to

be Lieutenant (dated May 2nd, 1904). Lieutenant-ColonelR. C. Gunning retires on retired pay (dated May 25fh,1904). Lieutenant-Colonel J. T. Carey retires on retired

pay (dated May 25th, 1904). Surgeon-Major W. C. Beevor,C.M.G., from the Scots Guards, to be Major, with senioritynext below R J. A. Durant (dated May 25th, 1904).

INDIAN MEDICAL SERVICE.The King has approved of the following promotions

among officers of the Indian Medical Service made by theGovernment of India : - Captains to be Majors (datedJan. 30th, 1904) : Bengal Establishment : Bruce GordonSeton. Madras Establishment : Robert Henry Elliot, RobertKing Mitter, and Wilfred Ernest Arbuthnot Armstrong.Lieutenants to be Captains (dated Jan. 29th, 1904) : CharlesWilliam Francis Melville, Robert McCarrison, James Masson,Norman Septimus Wells, William Morris Anderson, EdmundHamilton Blake Stanley, William Hugh Leonard, AndrewWatson Cook Young, James Graham Goodenough Swan,Robert McLauchlan Dalziel, James Jackson Robb, ShaikAbdur Rnzzak, and Robert Basil Boothby Foster.The King has also approved of the retirement from the

service of the undermentioned officers : Colonel ChristopherWilliam Carr Calthrop (dated April 2nd, 1904) and Lieu-tenant-Colonel Thomas Henry Pope (dated March lst, 1904).

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Major J. Adam to be Surgeon-Lieutenant-Colonel(dated May 3rd, 1904). Surgeon-Captain J. H. G. Whitefordto be Surgeon-Major (dated May 7th, 1904).

VOLUNTEER CORPS.

Rifle: : 2nd Volunteer Battalion the NorthumberlandFusiliers : Supernumerary Surgeon-Lieutenant (HonoraryLieutenant in the Army) J. Clay to be Surgeon-Captain(dated May 21st, 1904). lst Volunteer Battalion, the

Northamptonshire Regiment: William Peart Thomas to be

Surgeon-Lieutenant (dated May 21st, 1904).ROYAL ARMY MEDICAL CORPS (VOLUNTEERS).

The Manchester Companies : Lieutenant W. R. Matthewsto be Captain (dated May 21st, 1904), and Harry WashingtonPritchard to be Lieutenant (dated May 21st, 1904).

THE ROYAL MILITARY TOURNAMENT.

The Royal Military Tournament, now being held at theAgricultural Hall, Islington, N., has become one of theevents of the London season and this year promises toeclipse all previous exhibitions excellent though they have

been. The pageant represents the rise of the Royal Artilleryfrom the days of the Black Prince to the present time,and for novelty there is 11 push-ball " with mounted

players. A very satisfactory feature of the present tourna-ment is the wider scope which has been allowed to theNavy to exhibit its wonderful agility and smartness, qualitieswhich the public are never tired of witnessing. Surgeon-Lieutenant-Colonel W. R Crooke-Lawless of the ColdstreamGuards is the Principal Medical Officer.

THE WAR IN THE FAR EAST.Amid the various rumours and often conflicting statements

that are being published in the press of this and othercountries it is extremely difficult, if not altogether im-possible, to form any adequate idea of what is actuallytaking place in the Far East. We know little or nothing ofthe numerical strength of the Rassian forces (except that theyare big) or of what has become of the vast reinforcementsalleged to have been sent east along the Siberian RAilway ;and with regard to the strength and disposition of theJapanese forces in the field we can only form a very rough.approximate estimate, while wa know next to nothing oftheir strategical movements. The situation must always beread by the light of accomplished facts in the past and withthe aid of maps and the exercise of a good deal of the"scientific imagination." The educated classes in Russia.are said to have lost all faith in the official reports from thescene of war, but at the present time we are neverthelesslearning more of the whereabouts of the Japanese fromKouropatkin than from Japanese sources. Whatever mayhave been the losses which the belligerent armies ofboth sides have suffered up to the present time, itis scarcely conceivable that these should not mount

up to a grave total as the war goes on and theheat increases. We must remember possible outbreaks ofepidemic sickness, the privations incident to warfare, andthe neglect of hygienic precautions or, what amounts to thesame thing, the impossibility of carrying them out under theconditions of such a war as that now going on. General,Kuroki reports that the exact number of Japanese casualtiesin the battle of the Yalu was 318 killed, including fiveoffi0ers ; and 783 wounded, including 33 officers. The Russiandead buried by the Japanese numbered 1363, whilst thereare 613 prisoners. There does not seem to have been anyfighting on a big scale since that on the Yalu and to bedecisive in character in such a war as this big fighting mustoccur. Losses in affairs of outposts and reconnaissances areto be expected, but they only serve at best to indicate thepreliminary movements of the belligerents and the possiblesite of a coming battle.

Information is forthcoming from the chief military medicalcommittee that the organisation of measures to combat.

possible outbreaks of infectious diseases in the Russian armyin the Far East is completed. Disinfecting chambers arealready at the theatre of war and a laIge quantity of vaccinelymph has gone forward. Between the outbreak of war andMay lst there have been only three cases of small-pox atChita, 14 at Vercbneudinsk, and 15 at Ailanae. Orders havebeen issued that all spring waters used by the troops are to becarefully guarded, and if water must be taken from wellssuch water must first be tested by medical men.On May 14th a gathering of medical men in St. Petersburg

entertained and fê,ed Dr. M N. Chrabrostina and Dr. M. L.Banschikova of the ill-fated warships Variag and Koreetz.respectively that were destroyed by the Japanese at

Chemulpo. Accompanied with appropriate complimentsthey were presented with gold medals inscribed "To thehonoured guest."The Novoe Dnya of Kieff reports that of the 30 medical men

of the reserve forces just called up in the Kieff militarydistrict 26 were Jews.On May 14th, according to the Novosti, there were in the

Red Cross hospitals in the Far Eat 6200 beds, whilst 2070were on the way and 2700 were in preparation.Tne Novoe VreMya reports an outbreak of fire at the head-

quarters of the Russian Red Cross Society in St. Petersburgon May 16th. The fire, which broke out at 7 P.M., waschecked by the firemen on the third floor where it broke out.A Times telegram states that Dr. Hashimoto, the Emperor

of Japan’s physician, Dr. Sato, and Dr. Kikuchi have beenappointed superintendents respectively of the Tokio, Hiro-shima, and Matsuyama military hospitals.

THE TIBETAN MISSION.In the Times of May 24th a special correspondent resumes.

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his interesting description of the advance of the Tibetan lMission to Gyargtse and in doing so pays a tribute to the lework of the Indian Medical Service. After fibe recent fightat the Hot Spring General Macdonald remained for threedays at Thuna, says the writer, and then moved on

to Guru, "passing over the scene of the sudden climaxof the previous Thursday. There were, indeed, still some

ugly traces of the tragedy, but everything that was

possible had been done to restore the quiet shores ofthe Bam Tso to their usual quiet aspect, and it reflectsno small credit upon the management of the IndianMedical Service that the wounded of the enemy were

already -o well cared for that numbers of woundedTibetans had of their own motion applied for treatment

by ourselves at Guru and the Hot Spring. Only the nightbefore one or two had evidently been unable to drag them-selves fuither and had fallen and died within a few hundredyards of our outposts. Many of the prisoners declinedto accept their freedom and have remained at their own

urgent request as coolies or dhooly-bearerd in our service. "

Describing Kala Tso, which is the remnant of a vastly greaterlake, the Tinies correspondent says : "The most remarkablething was the evidence of a very large population in earlierdays which the almost continuous string of ruined walls andvillages supplied. For a space of nearly two miles the hill-side of the road-which clings still to the mountains inavoidance of the now vanished lake-is marked by a wilder-ness of great round building pebbles dropped from the wallsand houses of a lost civilisation, and still marked by lines ofcrumbling structure held together in the semblance of theirfirst shape by dry layers of mud mortar. As with mostthings in Tibet, there are many reasons suggested for thiswholesale desertion. Small-pox, the subsidence of the lake,the Mongol invasion, the ultimate inability of the inhabitantsto adjust themselves to so wretched and inhospitable anenvironment, perhaps also the closing of the trade routesover the Sikkim passes-all may have had their effect."

THE AMIR OF AFGHANISTAN’S LATE INJURY.The political value and importance attaching to the

professional services which medical officers in Indiahave from time to time rendered occupy a place in thepast history of that country. The latest instance to be addedto the record is that connected with the Amir of Afghanistan.His Highness wounded his left hand last month by the accidental explosion of a firearm and the injury was followedby the formation of an abscess, a process which wasnaturally attended with considerable pain. The Amir

applied for the services of a European surgeon, whereuponMajor R. Bird, the surgeon attached to the staff of the Viceroyof India, journeyed to Oabul and did all that was surgicallyspeaking necessary for the rapid relief of the patient, whohas expressed the greatest gratification for the servicesrendered.THE PRIVATE FEES OF GOVERNMENT MEDICAL OFFICERS

IN INDIA.On page 1538 of our present issue our Special Corre-

spondent in India gies the text of a notification of theGovernor General in Council regarding the remuneration ofmedical ofiicers for attendance on native chiefs, nobles, andnative gentlemen of high position in a native State. Thenotification is one having an important bearing.The latest report of the Sanitary Commissioner of India

states that 29 per cent. of the mortality of the Indian

European Army is due to enteric fever.

DEVON AND EXETER BENEVOLENT SOCIETY.-At the annual meeting of this society held at Plymouth onMay 12th under the presidency of Dr. E. B. Thomsongrants were made to four widows who applied for assistance.This society was founded in 1806 for the benefit of widowsand orphans of medical men who have practised in the cityof Devon and who have failed to leave adequate provisionfor their families upon their decease. The annual sub-scription is small and the benefits are great. Canvassingfor votes is not necessary. All urgent cases are immediatelyrelieved. At the next annual meeting such claims are

considered and a yearly grant is made which is regulatedaccording to the available funds of the society. There is aconsiderable funded property of over £3000, the interest ofwhich, together with the subscriptions, is divided amongst thebeneficiaries. The secretary is Mr. G. Fortescue Webb ofMoretonhampstead, Devon, who will give further informationrespecting the society upon request.

Correspondence.

THE TENURE OF OFFICE OF THEMEDICAL OFFICER OF HEALTH.

" Audi alteram partem."

To the Editors of THE LANCET.

SIRS,-The letters upon the above subject which havebeen appearing in recent issues of THE LANCET discloseconditions which ought not to be allowed to continue andI echo the sentiment of one correspondent in hoping thatyou will assist us in securing reform. As one of thehonorary secretaries of the Incorporated Society of MedicalOfficers of Health I have perhaps exceptional opportunitiesfor knowing how much the public generally suffer in somedistricts because the medical officer of health has to trimhis reports to suit the whims of members of the councilwhich elects him. The President of the Local Govern-ment Board is, I believe, in sympathy with us to a

certain extent, but I cannot think he is altogether aware howmuch public health administration in small towns and ruraldistricts is handicapped owing to the ease with which amedical cfficer of health who is not sufficiently complacentcan at present be got rid of. If Mr. Long would institute aconfidential inquiry among medical officers of health I amconvinced that he would realise that some alteration oughtto be made not solely in the interests of the medical officer ofhealth but so that the Public Health Acts may be ad-ministered in a less lax manner than is the case now in manyparts of England and Wales.

I am, Sirs, yours faithfully, T____-

HERBERT JONES.

To the Editors of THE LANOET.

SIRS,-My own experience on this subject may be ofinterest to your readers. In March, 1901, I was appointedmedical officer of health to a large combined district for aperiod of three years. The area comprises four urban andlive rural districts. The appointment was a whole-time onebut carried with it the post of medical superintendent to ajoint hospital board. My predecessors have been appointedor reappointed for periods of either three or five years.About three weeks before the expiration of my term of cfficedelegates from the various councils met to consider my re-appointment. The delegate from one of the councils atonce informed the committee that the council which herepresented would refuse to remain in the combinationshould the reappointment be made for more than one year.No reason was assigned for this action. The other delegatesthought it better to agree rather than run the risk of break-ing up the combination. The Local Government Board pro-fessed to be unable or unwilling to interfere but expressedthe hope that a longer term would be substituted at the nextreappointment. I am, Sirs, yours faithfully,May 18th, 1904. X. Y. Z.

MEDICAL DEFENCE: A PARALLEL.To the Editors of THE LANCET.

SIRS,-A parallel occurs to me :-"A good deal has been said to- See. TVatch: How if a’ will not

day about the man who is not a stand ? ’member of the British Medical Dogberry: Why, then, take noAssociation. I venture to say I note of him, but let him go; andhave no sympathy with him; he presently call the rest of the watchought to be : and if he does not together, and thank God youchoose to come into a scheme of rid of a knave,-Much Ado a bthis sort let him stay out."-Dr. Nothing, act iii., scene iii.G. A. Heron at the meeting of theSouth-West (Wandsworth) divisionof the British Medical Association.

I am, Sirs, yours faithfully, --nF. BACON.

A WORD OF THANKS.To the Editors of THE LANCET.

SIRS,-May I through the medium of THE LANCET thankall those who sent me votes for Mrs. Georgina Skinner forthe Royal Masonic Benevolent Institution for the Widows ofFreemasons and for their response to the appeal which was