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The War.THE BATTLE OF NEUVE CHAPELLE : SIR JOHN

FRENCH’S DISPATCH.Sir John French’s dispatch, dated April 5th,

which was brought to London by H.R.H. the Princeof Wales, contains a warm commendation of thework of the Royal Army Medical Corps and of theArmy Medical Service. The following extract fromthe dispatch will be read with gratification by allmembers of the medical profession :- .

.

Health of the Army.Since the date of my last report the general health of the

army has been excellent ; enteric has decreased, and therehas been no recurrence on any appreciable scale of the" foot " trouble which appeared so threatening in Decemberand January. These results are due to the skill and energywhich have characterised in a marked degree the work of theRoyal Army Medical Corps throughout the campaign, underthe able supervision of Surgeon-General T. J. O’Donnell,D.S.O., Deputy Director-General, Medical Services. Bftt.much credit is also due to divisional, brigade, regimental,and company commanders for the close supervision whichhas been kept over the health of their men by seeing that theprecautions laid down for the troops before entering and afterleaving the trenches are duly observed, and by the establish-ment and efficient maintenance of bathing-places and wash-houses, and by the ingenious means universally employedthroughout the forces to maintain the cleanliness of themen, having regard both to their bodies and their cloth-ing. I have inspected most of these houses and establish-ments and consider them models of careful organisationand supervision. I would particularly comment upon theenergy displayed by the Royal Army Medical Corps inthe scientific efforts they have made to discover and check-disease in its earliest stages by a system of experimentalresearch, which I think has never before been so fullydeveloped in the field. In this work they have been ablyassisted by those distinguished members of the medicalprofession who are now employed as military medicalofficers, and whose invaluable services I gratefully acknow-ledge. The actual strength of the force in the field has beenincreased, and the health of the troops improved by a systemof "convalescent" hospitals. In these establishmentsslight wounds and minor ailments are treated, and menrequiring attention and rest are received. By these meansefficient soldiers, whose services would otherwise be lost fora long time, are kept in the country, whilst a large numberof men are given immediate relief and rest when they requireit without removing them from the area of operations. Thisadds materially to the fighting efficiency of the Forces.

Arnty Medical Service and Hospitals.The principal convalescent hospital is at St. Omer. It was

started and organised by Colonel A. F. L. Bate, ArmyMedical Service, whose zeal, energy, and organising powerhave rendered it a model hospital of its kind, and thisexample has materially assisted in the efficient organisationof similar smaller establishments at every Divisional Head-quarters.

I have already commented upon the number and severityof the casualties in action which have occurred in the periodunder report. Here once again I have to draw attention tothe excellent work done by Surgeon-General O’Donnell andhis officers. No organisation could excel the efficiency of thearrangements-whether in regard to time, space, care andcomfort, or transport-which are made for the speedyevacuation of the wounded.

THE WAR AND MEDICAL RECIPROCITY WITH CANADA,Since the meeting of the Executive Committee of

the General Medical Council of Feb. 22nd, 1915, ithas been learnt unofficially that a Bill to Amendthe Ontario Medical Act and to provide for theregistration in Ontario of Medical Practitionersqualified in the United Kingdom has been intro-duced in the Provincial Legislature by the Attorney-

General. The ’ progress of the measure haslot yet been announced. Movements towardshe establishment of reciprocity have also beenbaken by other Provinces. On March 24th, 1915,3j cable was received from the College of PhysiciansMid Surgeons of the Province of British Columbiastating that their Medical Council had passed aresolution authorising reciprocal arrangementswith the United Kingdom. This was confirmed ina, letter written on the next day by their Registrar,in which the following phrases show how exactly thesituation is being understood in the Dominion :-

It has been felt for some time that in view of the presentconditions, brought on largely by the war, there oughtto be reciprocity between this country and Great Britain inorder that there may be no question as to the standing of ourmen serving in Britain or on the continent. It was felt,further, that- this was a very fitting time, when everypart of the empire is trying to do its best to assist,to bring this matter to a conclusion,, and our desirewas accordingly cabled to you. It will, of course,be necessary to pass an amendment to our Medical Act.I saw the Attorney General of . thisProvince last night, andhe gave me the assurance of his Government that thiswould be done."

Further, on April 4th, 1915, a cable was receivedby the General Medical Council from the Registrarof the College of Physicians and Surgeons of theProvince of Saskatchewan stating that their MedicalCouncil desired reciprocity, and requesting theGeneral Medical Council of Great Britain to outlineprocedure. This was at once done, and the much-desired medical reciprocity between Canada and theUnited Kingdom is now approaching accomplish-ment, owing to the activity of the General MedicalCouncil and the patriotic sense of Canada.

THE CASUALTY LIST.

Captain D. M. C. Church, I.M.S., is reported ashaving been wounded in the recent fighting withthe Turks in Mesopotamia.

THE COOPERATION OF CIVIL AND MILITARY AUTHO-RITIES IN SANITARY MATTERS.

A circular upon this important subject, issued bythe Local Government Board this week to countycouncils, sanitary authorities, port sanitary autho.rities, and medical officers of health, begins bypublishing the gratifying letter from the AssistantSecretary of the Army Council to the Local Govern-ment Board which will be found on p. 819 of thisissue of THE LANCET.The circular of the Board cordially endorses the

expression of appreciation of the Army Council,and hopes that the assistance which has beenrendered will be continued and extended, as

" changes in the number or personnel of troops inthe area will frequently call for immediate re.

consideration or modification of existing arrange-ments."The Board take the opportunity of this circular

to refer to matters which, in their opinion, it isdesirable that local authorities and their officersshould give special attention to. The circular runsas follows :-

District oounoils and district medical offioe’l’s of health.-Attention is particularly drawn to paragraph (1) on thesecond page of the Board’s Circular (No. 1) as to the dutyof district medical officers of health to inquire for and bringat once to the notice of the sanitary authority any conditionsin which sanitary services can be rendered by the authorityto the military population, and also to the importance ofprompt action by the authority on receipt of such reports.

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In respect of charges for such services the Board wouldagain insist on the necessity that no urgent sanitary workshould be postponed for consideration of the items which maybe the subject of charges to the military authorities. For the

guidance of sanitary authorities they have included amongthe appended documents a letter from the Army Councilof 31st October, 1914 (No. 3), as to the principles of pay-ment from army funds of charges by local authorities for in-creased expenditure on sanitary services rendered to troops.The question of payment for professional services of medicalofficers of health, inspectors of nuisances, &c., is referred toin paragraph 6 (b) of that letter. In this instance also theBoard consider that the Council should not, pending theadjustment of any application which they may make forreimbursement from army funds, delay the payment to theseofficers of such sums as may be necessary to recoup them foradditional time or special expenses of travelling incurred inthe inspections and inquiries, which are essential if thedesired cooperation is to be effectively established and con-tinued. The Board will be glad to advise the Council in anycase of difficulty arising in these matters.

The attention of district medical officers of healthis then directed to the following :-

County councils and county medical officers of health.-TheBoard and the Army Council attach much importance to thework which has already been done by county medical officersof health in assisting the military authorities in the provisionor "pooling" " of isolation hospital accommodation, or ofarrangements for disinfection within the county, the in-

vestigation of infectious disease, the protection of water-supplies, and like matters, and they are desirous thatthis work should be continued and amplified. Withthis object the county medical officer of health shouldobtain from the district medical officer of health eachweek information (a) of the occurrence of any militarycases of infectious disease which have come to his

knowledge in the district, and (b) of any new movementsof troops into or out of the district which are known to him.District medical officers of health should give to the countyofficer any information as to the camps or billeted troopswhich will assist the latter officer to determine where hisassistance may be most needed, and where visits of inspec-tion by him are desirable. It is important that the countymedical of health should visit (wherever practicable in con-junction with or after communication with the districtmedical officer of health) any large camps or importantbilleting centres. The Board would be glad to receive

copies, at the time they are made, of any representationswhich the county medical officer of health considers it

necessary to make, separately or jointly with the districtmedical officer of health, to the military authorities (No. 1,p. 10), or to sanitary authorities in the county.

Årrangements for bacteriological eaeamin’1tions of contactcases of cerebro-svinal meningitis.-In connexion "ith theprevalence of cerebro-spinal meningitis in the civil popula-tion, some councils, on the advice of their medical officer ofhealth, have already made arrangements for the visits of abacteriologist to any affected area, and for laboratory exa-mination of material obtained from the contacts of cases of

cerebro-spinal meningitis. The Board consider this actionof much utility at the present time, alike in the interests ofthe civil and of the military population, and they trustthat it will be actively pursued and extended wherevernecessary. Corresponding arrangements have been madeby the Army Council for military cases.The circular proper closes by intimating a similar

cooperation to that existing between the LocalGovernment Board and the Army Council, betweenthe Board and the Lords Commissioners of the

Admiralty.Appended to it, with the consent of the Army

Council and the Home Office, are extracts fromofficial documents which may be of use to localauthorities in the circumstances. This appendixcontains :-

(1) Reprint of Local Government Board Circular,Oct. 21st, 1914 (general system of cooperation) ; (2) letterfrom Army Council to General Officers Commanding,Oct. 10th, 1914 (general system of cooperation) ; (3) letter

from Army Council to General Officers Commanding,Oct. 31st, 1914 (payment of charges for sanitary services) ;(4) Local Government Board Memorandum to ArmyCouncil, Dec. lst, 1914 (as to some results of inspec-tion ; circulated by the Army Council) ; (5) extractsfrom "Rules as to Filleting (issued with Army Orders,Dec. 1st, 1914) ; (6) letter from Home Office toChief Constables, March 6th, 1915 (as to importance ofobserving Rule 21 as to billeting); (7) letter from ArmyCouncil to General Officers Commanding, Oct. 18th, 1914(payment for military cases in isolation hospitals) ; (8) letterfrom Army Council to General Officers Commanding,Dec. 2SId, 1914 (additions to isolation hospitals) ; (9) letterfrom Army Council to General Officers Commanding, Oct. lst,1914 (inspection of food); (10) letter from Army Councilto General Officers Commanding, March 3rd, 1915 (as tomeans for reducing overcrowding in huts and billets).The first of these reprints recapitulates a circular

letter issued by the Local Government Board onAugust 31st,1 which, in setting out the lines ofaction on which medical officers of health shouldcooperate with the military sanitary services,comprised the following points :-

(1) That each medical officer of health should place him-self in communication with the local military authoritiesoffering his services ; (2) that each medical officer of healthshould give information and assistance to military sanitaryofficers as to water-supplies, disposal of refuse, drainage andconservancy arrangements, control of infectious disease, &c. ;(3) that the assistance of the sanitary inspector should be.secured ; (4) a system of inter-notification of infectiousdiseases, both by military and civil sanitary officers, wasarranged ; (5) the value of antityphoid inoculation wali

indicated ; (6) the probable need for increased hospitalaccommodation for small-pox and enteric fever was

emphasised; (7) the services of the medical staff of theBoard were offered to medical officers of health for consulta-tion, and local visits by medical inspectors were announced.The circular letter adds that the officers con--

cerned acted promptly upon that letter, and afterrecapitulating the prescribed duties of the medicalofficers of health, proceeds to indicate that theduties of the district medical officer of health ofa sanitary district in which troops are quarteredshould included

1. Inquiring for and bringing to the notice of the sanitaryauthority any conditions in which sanitary services can be’rendered by them to the military population-e.g., by ex-tending water mains, opening or extending sewers, providinglatrines or baths, providing hospital accommodation forcases of infectious disease, disinfecting clothing and blankets,destruction of refuse, making special arrangements for

scavenging. Reports on these matters should be dealt with.as urgent, and special meetings of the local authority shouldbe called to consider them if necessary. Copies of all suchreports should be sent to the Board.

2. Inspecting systematically billets and also camps orother places solely in military occupation as to water-supply,methods of disposal or removal of all solid and liquid refuse,general cleanliness, and for the prevention of exposure toinfection.

3. Taking action by recommendations to the military’authorities, by reports to the sanitary authority, or other-wise, with a view to the removal of any dangerous orobjectionable conditions.

4. Giving information to the medical officer with thetroops as to local cases of infectious disease as soon as theycome to knowledge, and as to any localities, premises,’bathing places, &c., which on health grounds should not befrequented by soldiers. In some’districts troops will need’to be cautioned against the consumption of sewage-pollutedshell-fish. Two copies of the Board’s weekly report as toinfectious disease will be sent to each medical officer ofhealth. One of the copies should be handed to the medical,officer locally in charge of troops, in addition to theimmediate notifications indicated above.

5. Ascertaining in association with the county medicalofficer of health what hospital provision is available for cases

1 THE LANCET, Oct. 31st, 1914, p. 1053.

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of infectious disease among troops in the district, and

assisting in making arrangements for such provision.Existing civil resources should be made available to the

greatest practicable extent for infectious cases among troops,care being taken not to diminish the accommodation for thecivil population unduly.The rest of this valuable reprint deals with the

precautions to be taken by the sanitary executive inrespect of the establishment of billets; the valuewhich the services of the county medical officer willbe to the military authorities by virtue of his con-sulting relations with district medical officers; andthe machinery by which the recommendations ofmedical officers of health should be made to themilitary authorities.The second reprint is a letter from the War

Office enjoining upon general officers commandingin chief the necessity of cooperation in reference tothe quartering and encampment of troops with thecivil sanitary authority ; and the third is an expan-sion of the same subject, whence the following maybe quoted :-

1. As already pointed out in previous correspondence, itis necessary that there should be the closest cooperationbetween the civil and military sanitary officers in co-

ordinating sanitary measures necessitated by the suddeninftux of a large additional population.

2. In many cases it will not be possible to dissociate civilfrom military services, and, wherever it can be arranged, thesanitary services for the combined population should becarried out by the civil authorities. The adjustment ofadditional expenditure thus thrown on the local authoritieswill be carried out on the following lines.

3. The cost of additional scavenging in connexion withpremises occupied by troops, whether hired premises or

billets, may be refunded to local authorities, preferably atan arranged rate, based on the number of troops in occupa-tion, rather than in the form of an account of expenses ofactual collection, cost of appliances, disinfectants, &c. ;cases of difficulty may be referred to the War Office forinstructions.

4. The actual cost ot special services specifically performedfor the troops, such as the erection of latrines, extendingwater mains, &c., may also be refunded.

5. It is recognised that considerable additional expendi-ture of a recurrent nature may be incurred in connexionwith various sanitary services, which, although not connectedwith the premises occupied by the troops, arise definitely outof military requirements—e.g., it may be necessary, in theinterests of the health of the military as well as of the civilcommunity, when large numbers are in billets : (a) to

arrange more frequent clearances from all houses, whetheroccupied as billets or not; (b) to incur additional

expenditure in connexion with professional services ofmedical officers, inspectors of nuisances, &c. Whereverpracticable, such measures should be arranged beforehandbetween the military and civil authorities, and the additionalcost may be refunded, provided general officers commandingare satisfied as to the reasonableness of the measures takenand of the amount claimed.

6. In the case of expenditure under 5 and 6, regardshould be had to the fact of the continuous payments underparagraph 4. (Indeed, it may be possible in some cases toprovide for such expenditure by inclusion in the arrangedrate suggested in that paragraph.) In this connexion, how-ever, Army funds should not be called upon to meet

expenditure on special measures which are really necessitatedby the inadequacy of existing sanitary conditions, and whichmay be aggravated, but not specifically created, by theincrease in population ; any case of dispute in this respectshould be referred to the War Office.

7. For the present all claims on account of capitalexpenditure, other than those contemplated at paragraph 5,should be referred to the War Office with a full report of thecircumstances and the recommendations of general officerscommanding.

8. Arrangement should be made, as a rule, for localauthorities to submit monthly claims of recurrent expendi-ture. Claims for capital expenditure should be renderedseparately.

The letter closes by saying that only general linesare indicated, that economy must be preserved, andthat everything said refers equally to detentioncamps.The fourth reprint is a report from the Local

Government Board with respect to inquiries incamps and localities occupied by troops up toNov. 30th, the inquiries having been made by theinspectors of the Local Government Board. Theexamination of the various billets was obviouslyundertaken with considerable vigour.The fifth reprint consists of extracts from the,

rules of billeting, which were issued with armyorders last December.The last five reprints are very brief, and th

summary already given indicates their purport.A valuable addendum to the circular letter

consists of notes on the inspection of billets andcamps by medical officers of health. On these we-comment in a leading article upon the wholedocument.

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ROYAL COLLEGE OF SURGEONS IN IRELAND ANDTHE WAR.

An emergency meeting of the Royal College ofSurgeons in Ireland was held on March 31st to grantrlicences to students who had recently qualified..The licentiates having been admitted, the President,.Mr. Conway Dwyer, referred to the services rendered-by members of the College in the present war..

One of the objects of the College, as set out inthe original charter, was " to provide a sufficient,number of properly educated surgeons as well forthe service of the public in general as for that ofour navy and army." At the present time over 600Licentiates of the College held commissions in theRoyal Army Medical Corps. No less than 28 ofthese had been mentioned in despatches in th&present war; three had been made Companions ofthe Order of St. Michael and St. George; four hadreceived the Distinguished Service Order ; and one,Captain W. F. M. Loughnan, R.A.M.C., had been the-first medical man to receive the Military Cross,."for gallantry on many occasions in Flanders in-,assisting to rescue the wounded whilst exposed to.heavy fire." Captain Loughnan, who was present,.being at home wounded, was heartily congratulated.

NOTES FROM THE GERMAN MEDICAL PAPERS.

The following notes have been sent to us by acorrespondent in a neutral country who has beenable to secure copies of German and Austrianmedical journals :-

’

A sign of the times is the shifting of interest in the treat-ment of tetanus and other anaerobic infected wounds to theprophylaxis and treatment of typhus, including in the termboth T. abdominalis (our typhoid fever) and T. exanthe" .maticus (gaol and famine fever. ) The usual expectanttreatment of typhoid fever has sufficed to give excellentresults in the military hospital at Strassburg, under Professorvon Tabora, the death-rate being scarcely above 5 per cent.,and comparing favourably with peace statistics. Not a,

single case of infection of the staff had been observed, aresult attributed to the daily inspection of the 200 helpers,when all had to show their hands; this was before

prophylactic inoculation was practised. The diet was-

limited to 5-7 cups of milk daily (each of 180-200 c.c.),with 4-5 cups of fairly thick gruel. Bath treatment was.found impracticable with the available helpers, and hadbeen entirely replaced by pyramidon internally ; 7 table-spoons of a 1 per cent. solution in 24 hours (=1’05 grm.daily), gradually reduced but not omitted until the fifthto seventh day of defervescence. Heart failure was-avoided by giving digitalis early in all cases, six times.

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C’l grtn. of digipuratum, the tolerance being extra- I.ordinary, and the mortality from intoxication or., heart i

failure less than 1 per cent. ,.

"

’..’ -

Professor Goldscheider, a physician with the army, reportson the vaccine treatment of typhoid," .having been inducedto try it by the experience of a prophylactic dose whichhappened to fall in the prodromal period. The Marxvaccine was used in a -dose of 250-750 million bacilli.

Fifty-seven cases were so treated, and in 55 out of 70 injec-tions a remission of fever followed on the first to third day,lasting an average of two days, and sometimes coincidingwith the final defervescence. In the remaining cases therewas an increase of fever, but not of a serious character.Otherwise no special effect on symptoms was observed, thelocal reaction being less than in the healthy subject. Norwas any influence of a previous prophylactic inoculation to beobserved. Unfortunately in the more severe cases of diseaseonly the smaller doses of vaccine could be employed. Dr.,M. Rhein records a smaller series of cases at Strassburgusing, the Halle vaccine diluted 1 in 20, a dose of 0’6to 1’4 c.c. into the ulnar vein, In 94 per cent. ofpatients a rise of temperature with rigor followed infrom half an hour to 2½ hours with subsequent rapiddefervescence. Nine cases out of 33 were completelysuccessful with one injection, another case with two-in all ’a high eosinophilia (100200 cells per c.mm.)being noted along with an absolute leucopenia.From Professor Ziegler’s hospital at - Freiburg i.Br. comes

an encouraging account of an attempt at auto-serum-

therapy. 50 c.o. of blood were withdrawn, phenolised, and2’ 5 to 4 c.c. of the serum injected daily sub cutem on the outerside of the thigh. In 14 out of 18 cases improvement wasrapid; the temperature falling in 2-5 days, often withmarked sweating, coma especially clearing after three orfour injections, the patients expressing great relief. Thecases so treated were nearly all severe ones, but were all ableto be up within four weeks ; twice a sudden drop of 2.5° C.was noted with small but not frequent pulse, amenable tocamphor. This, as well as the therapeutic effect in general,is to be probably ascribed to bacteriolysis, an explanationgiven by Hammerschlag as early as 1893. Professor Matthes,of Marburg, is working with a trypsin solution of typhoidbacilli filtered clear as an immunising agent, which hasalready given encouraging results with guinea-pigs. Writersall assume that the merits of the prophylactic inocula-tion are still on trial, and that it will still be longbefore exact figures are available. Of immediate effects the

percentage of serious harm is very low. Under ProfessorPenzoldt at Erlangen, out of 4000 injections in 1780 personsonly 6’8 per cent. had fever above 380 C. and 0’2 per cent.above 390 C. In two cases, aged 28 and 33 years, thrombosisoccurred once in the forearm, and once’an embolic thrombusof the leg. In a third case, a few hourm after-the second

prophylactic injection, the.. temperature rose to 39.6° C.,followed by typical splenic enlargement, roseolar rash, andbronchitis and exitus 14 days later from intestinal hoemor-rhage. Menzer had already recorded a case with diarrhoeaand roseola, and Professor Penzoldt inclines to the assump-tion of an aggressin action of the dead bacilli on a con-current living infection. At Strassburg Professor Schlesinger,out of 1340 injections, never saw any serious local reaction ;after the three injections 5 per cent., 3 percent., and 2 percent. respectively were unfit for service on the following morning,the indisposition differing from influenza in that improvementwas almost always noted within 24 hours. Urticaria wasnot very uncommon, and in 5 to 8 per cent. the spleen wasenlarged. Professor Weichardt (Erlangen) finds that localreaction is slighter with the newer vaccines sterilised at alower temperature, there being no appreciable risk in theiremployment, as 0’5 per cent. phenol kills any living bacilliin the vaccine within 24 hours. Smaller doses at longerintervals will probably immunise as fully as larger ones atshorter interval.

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THE TEMPORARY EMPLOYMENT OF MEMBERS OFSCHOOL MEDICAL STAFFS IN MILITARY HOSPITALS.-TheBoard of Education has issued a circular to local educationauthorities alluding to the urgent need for more medicalmen in order fully to staff the additional hospitalsrequired by the large forces now being placed in the field.In response to a question whether the Board would beprepared to facilitate the volunteering of officers of the

School Medical Service for this hospital work the circularsays that in cases where a school medical officer is also anedical officer of health, the Local Government Board mustbe consulted. So far, however, as the Board of Education.s concerned, it assents freely. Should any school medical)fficer desire to volunteer the Board will raise no objectionto his doing so even though his temporary absence mayjause dislocation of the school medical service, assumingthat local educational authorities will regard the matter in thesame light and will give any medical officer, who desiresj0 volunteer, leave of absence on such terms as will notinvolve any loss in his salary, status, or tenure. Arrange-ments can be made by which officers of the School MedicalService who join the Royal Army Medical Corps will beemployed for home service only if they so desire, while theycan offer themselves for service in military hospitals as

civilians. In. view of the pressing need for further medicalassistance, facilities are being given to medical men who areserving as combatant officers in the Territorial Forces totransfer their services to the Royal Army Medical Corps ofthe Regular Army.

VACANCIES FOR MEDICAL OFFICERS.-We areasked to state that medical men are urgently wanted for theR.A.M.C. (T.) 2nd London Division for the Sanitary Service,in the Field Ambulances, and also as regimental medicalofficers. Candidates for the Sanitary Service should possessthe D. P. H. or have had some special training in preventivemedicine. Those joining the Sanitary Service especially arelikely to have an early opportunity of serving abroad. Appli.cations should be made in writing, or preferably in person, tothe Officer Commanding, Depôt Medical Units, 2nd LondonDivision, Duke of York’s Headquarters, Chelsea, S.W., whowill be pleased to see intending applicants any day between9.30 A.M. and 5 P.M.—Three medical men are urgentlyrequired to complete the establishment of the 2/lst High.land Mounted Brigade Field Ambulance, R.A.M.C. (T.).Full particulars as regards pay, duties, &c., will be given byCaptain A. Mowat, officer commanding, 2/lst H.M.B.F.A.,R.A.M.C., Houghton Hill House, Houghton, Huntingdon.

RELIEF WORK IN SERBIA.-Sir Ralph Paget,who has been Assistant Under Secretary for Foreign Affairssince 1913, and has had an extensive experience in thediplomatic service since 1888, has been appointed BritishCommissioner for Red Cross relief work in Serbia, and willwork under the joint committee of the Red Cross Society andthe Order of St. John of Jerusalem. His wife, Lady Paget,who contracted typhus fever during her hospital work inUskub, is happily now convalescent.-It has been announcedthat Dr. Ernest Magruder, of Washington, D.C., who, incompany with other American medical men, went to renderaid in Serbia, has succumbed to typhus fever there. Sister

Augusta Minshull, of the Scottish Women’s Hospital inSerbia, has also fallen a victim to the disease.

,

A meeting will be held in aid of the London Unit, ScottishWomen’s Hospitals for Serbia, on Monday,, April 26th, at8.30 P.M., at St. Marylebone Institute, 50, Paddington-street, W. Mr. Welby Fisher, of the Serbian Unit, BritishRed Cross, 1913, will give a lecture, illustrated by lanternslides, entitled "With the Serbians." Dr. Inglis willreport on the work of the hospitals, prior to leaving forthe front. Miss Cristitch, who has just returned fromSerbia, will take the chair. Tickets of admission may behad on application to Mrs. F. W. Mott, 25, Nottingham-place, W.

,

NON-ALCOHOLIC BUFFETS FOR WORKERS.-In aletter to the Times Mr. Howard Marsh suggests (in view ofthe proposed self-denying ordinance, with or without prohibi-tion) the establishment of non-alcoholic buffets for workers,such as have already justified themselves in numerous

centres where soldiers are quartered. The services of theY.M.C.A. have been of the highest value in this direction." In one of their institutions," he says, "or in some othersufficiently large room (in other cases tents have been used),a buffet has been provided, staffed, most willingly, byvolunteers attending in relays, in many instances from6 A.M. to 10 P.M. Three or four business workers haveordered in, and taken charge of, the supplies, and some-one, used to accounts, has collected the daily takings,paid them into the bank, kept the books, and pre.pared them for audit. A tariff sheet has been so

837

placed that It could be easily inspected. Sausage -rolls,beef pies, ham sandwiches (of a size amply sufficient for" a snack at the bar ") cost 2d., a large cup of coffee and hotmilk 1½d., all other items-cake, plain bread and butter,and many others-1d. or less. A buffet worked on theselines, and when numbers are considerable, is quite a payingconcern. As the items afford a good choice, are of goodquality, and of moderate price, and well served, the buffetobviously meets a want and has been everywhere verypopular: What has been done in a large number of casesfor soldiers would be equally sound and beneficial in thecase of men who are turning out war material and doingother heavy work." Mr. Howard Marsh further suggests thephysiological importance of working the men in shifts.THE EMPLOYMENT OF TRAINED NURSES IN

MILITARY HOSPITALS.-The War Office has notified thatnurses who have certificates of three years’ training and aredesirous of employment in military hospitals should apply,without delay, to the "Matron-in-Chief, Q.A.I.M.N.S.,"War Office, for information as to conditions of service.

,

RUMOUR v. REALITY.-A lecture recently delivered at Lochinver, N.B., by Mr. W. S. Mackenzie callsforcible attention to the need for common sense and restraintin giving credence to the wild rumours that inevitablybecome current during periods of excitement. Stories hadbeen put in circulation that the deaths at the military campat Bedford had reached the enormous total of 300 and moreduring the month of January, largely due to an epidemic ofmeasles. Mr. Mackenzie investigated the. matter, and wasable to state, from an official list in his possession, givingname, age, regiment, and cause of death, that from the firstweek of August up to March 6th there had been 78 deathsin all, of which measles, with all its complications, wasresponsible for 58. Mr. Mackenzie took a practical methodof allaying the fears of his highland audience by offering tohand over the list to any responsible man selected by hisauditors, and promising to pay E5 for the name of everymember of the Highland Division who had died and whosename did not appear on the list.

GLASGOW MEDICAL GRADUATES AND THE WAR.-At the conferring of degrees at Glasgow University on

April 1st Principal Sir Donald MacAlister said that he hadalready received the names of 384 graduates in medicine ofthe University who were on service with the forces of theCrown, and the list was by no means complete.INSTRUCTION IN NURSING FOR BELGIAN LADIES.

-It is announced that the Joint Anglo-Belgian Committeeof the King Albert’s Hospitals for Convalescent BelgianSoldiers have determined on the establishment in London,under the supervision of Professor Jacobs, of a trainingschool where Belgian ladies may receive a course of trainingfor nursing.A DISTINGUISHED RECRUIT TO THE ROYAL ARMY

MEDICAL CORPS.-The Earl of Crawford, who has done

vigorous service in recruiting since the outbreak of thewar, has now capped his patriotic service by himselfenlisting as a private in the Royal Army Medical Corps.Lord Crawford, who was formerly a captain in the firstvolunteer battalion of the Manchester Regiment, as LordBalcarres represented Chorley in the House of Commonsfrom 1895 to 1913, and was Whip to the Conservative party.He studied social problems as a resident of the OxfordSettlement in the East End of London when the presentBishop of London was head of the institution.MILITARY HOSPITAL AT ASCOT CLOSED.-As

several cases of scarlet fever have broken out at the MilitaryHospital at Ascot the medical authorities at Aldershot havedecided to close the hospital temporarily.BLENHEIM PALACE AS A HOSPITAL.- The library

of Blenheim Palace is being used, by the generosity of theDuke of Marlberough, as a hospital for wounded soldiers.

AT the annual meeting of the North Stafford-shire Field Club, held in the new Central School of Science,and Technology, Stoke, on March 23rd, Mr. W. DunnettSpanton, F.R.C.S. Eng. and Edin., was elected president.The meeting marked the jubilee of the club, of whichMr. Spanton is an original member.

Medical News.EXAMINING BOARD IN ENGLAND BY THE ROYAL

COLLEGES OF PHYSICIANS OF LONDON AND SURGEONS OFENGLAND.-At the quarterly examination in PracticalPharmacy held on April 9th, the following candidates wereapproved :—

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Herbert Claude Apperly -and Ralph William Codrington Ball,Middlesex Hospital; Mahmud Bayumi, Cairo and London Hos-pital ; John Prichard Bracken, University College Hospital!;Douglas Crellin, Cambridge University and St. Bartholomew’s sHospital; Patrick Arthur Dargan, St. George’s Hospital; FrederickOloff Fehrsen, London Hospital; John Eskdale Fishburn, Ports-mouth Municipal College; Arthur Alan Forty, Leeds Universityand Guy’s Hospital; Leslie Stewart Goss, Oxford University andMiddlesex Hospital; Bernard Heynes Greensill, BirminghamUniversity; Rupert Bannatyne Hick, St. Mary’s Hospital;George Gerald Jack and Vincent Coram James, MiddlesexHospital; David Joseph Heritage Jones, St. Mary’s Hospital;James Phillips Jones, Guy’s Hospital; Vladimir Kameneff,Moscow and University College Hospital; Nicholas EdwardKendall, Guy’s Hospital ; Maynard Lambert Loveless,Cambridge University and Middlesex Hospital; William BirdLoveless, Cambridge University and Middlesex Hospital; William

George, McKenzie, Bristol University; Thomas Walter Melhuish,Cambridge University and Middlesex Hospital; Sadek GirgisMoftah, Cairo and London Hospital; Edgar William Mottau,Ceylon,Medical College and University College Hospital; NavaRatnam Nalliah, Ceylon Medical College and London Hospital;Hallock Ratnarajah, Ceylon Medical College and St. Mary’sHospital; ArthurLowry Robinson, University College Hospital;Malcolm Catchick Sarkies, Middlesex Hospital; Adolphe GladstoneMillott Severn, Guy’s Hospital; Sydney Frank Simpson, King’sCollege Hospital; John Greet Stevens, Guy’s Hospital; ArthurSunderland, Charing Cross Hospital; Godfrey Trehane Symons,King’s College Hospital; Thomas Joseph Taunton, St. Bartholo-mew’s Hospital; Robert Ookleston Townend, London Hospital;Arthur Reginald Stuart Warden, Cambridge University andSt. Thomas’s Hospital; Edward Scott White, Bristol University;and Israel Hyman Zortman, London Hospital.

ROYAL COLLEGE OF PHYSICIANS OF EDIN-BURGH, ROYAL COLLEGE OF SURGEONS OF EDINBURGH, ANDROYAL FACULTY OF PHYSICIANS AND SURGEONS OF

GLASGOW.-The quarterly examinations of the above board,held in Edinburgh, were concluded on April 9th with thefollowing results :-

FIRST EXAMINATION.Janet Adeline Agnes Sang, William Bethune Stott, Rebecca Good-man, Muriel Keyes, Nathaniel Brownlee Watson, and AndrewFrancis Briglmen.

Physics.-Max Gottschalk, John Kohler Steel, and Trevor FrancisThomas. ’

Biology.-Jung Bahadur Singh and Thomas Ferguson Minford.Chemistry.-Gordon Spivey Woodhead, Alexander Forsyth Cuddell,John Lawson Gibson, Richmond Francis Kerr, and ThomasFerguson Minford. ’

SECOND EXAMINATION.Andrew Inglis Meek (with distinction), John Bruce Watson Telford,Mohammed Talaat, Patrick Joseph Murnane, Janie IsabelMcBirnie, Agnes Emilie Keen, and Alan Herbert Brooke Hudsom.

Anatomy.-Leslie MacDuff, Eduard Louis Adendorff, and ErnestEbenezer Bronstorph.

Physiology.-Daniel Cornelius Howard, Hassan Amin Madwar, andRichard Gordon Bell.

THIRD EXAMINATION.Zachariah Albert Green (with distinction), John Alexander Mnrray,John Alexander Tolmie, John Forbes Campbell, Frederick CharlesJoseph Mitchell, Iwan Davies, Ernest Andrew Hamilton, MarthaHunter Hoshing, Phoebe Tripp, Frank Jones, and Paul Vertannes.

Pathology.-Indranarayan Borrah, William McElroy, and StanleyWall Hoyland. ,

FINAL EXAMINATION.Arthur Craig, William Leckie Coullis, Victor James Wilson, Bak Hin

Ong, and Alamu Ojo Olaribigbe.Surgery.-Charles Evelyn Meryon, John Murray Hiddleston, andJoseph Sydney Dickson.

Midwifery.-Nathaniel Benjamin Morris, Charles Evelyn Meryori,and John Murray Hiddleston.

Medical Jurisprudence.-Matthew McLintock Bainbridge, John ParkMathie, William Ainsley, Alexander Cray McKee, Douglas CharlesMurray Page, Alexander William McGregor, William AlfredBackenstoe, Paul Lucien Manuel, Robert Christian Wilson Spence,William James Forsyth Craig, and Edward Spence.

UNIVERSITY OF GLASGOW.-The degrees ofM.B. and Ch.B. were conferred on April lst on the

following :-With commendation: Ronald Thomson Grant and SeymourCochrane Shanks. Ordinary degrees : Ismail Abdurahman,George Kirkwood Allan, James Mair Anderson, William ErnestBoyd, M.A., Samuel Bryson, John Buchanan. John MunroCampbell, Alfred Mackenzie Clark, George Gibson Cooper,Henry Paterson Crow, Alexander Hogg Donaldson, HarryTaylor Findlay, George Fleming, George John Fraser,Ian Maclean Frazer, David Gould Gardmer. WilliamGordon, Thomas Cameron Houston, William Hunter Howat,