mortality, Budin states that the death-rate is abnormally high among illegitimate children and those whose lives have been insured, and also among children of working women who are obliged to entrust them to the care of others, whether paid or unpaid. On the other hand, the mother who feeds her own child at the breast may almost always expect to rear it, in the absence of special risks, such as an alcoholic tendency on the part of the mother, which of course affects the milk. The reduction of an excessive infant mortality is a question of obvious importance in a country which, like France, has a stationary or declining population; and in suggesting remedies, most of which follow directly from the causes to which the excessive mortality is assigned, Budin demands state intervention as well as more intelligent individual effort. Every mother who can do so should be induced to suckle her own child. The importance is urged of mothers bringing the children each week to a doctor to be weighed and inspected.

These consultations are of the utmost benefit wherever doctors feel it their first duty to secure that all mothers shall, if possible, suckle their children. Where the mother's milk is insufficient, some sterilized milk may be supplied, but complete artificial feeding should be deferred as long as possible. Budin himself sees about 100 children weekly in this way, and during four years not one under his care has died from diarrhoea. Other suggestions are: (1) That women be not allowed to go to work for a month after delivery, compensation to be given during this time; (2) that a nursing mother be allowed to leave work twice a day to feed her child; (3) that municipalities ensure the good quality of milk sold; (4) that the manufacture and sale of long-tubed bottles be made illegal; (5) the inspection of all children not under the care of their parents; (6) the treatment in hospital of prematurely born children below a certain weight; (7) the prohibition of the insurance of infants.

UNIVERSITY AND EDUCATIONAL NEWS. THE Lord Mayor of Liverpool has proposed that a tax be levied to cover the expenses of

the University of Liverpool, and that tuition should be made free in all departments. Should this plan be carried into effect, Liverpool would be the only university in Great Britain without tuition fees.

THE Journal of the American Medical Association states that all the medical schools in the country now have a four years' course, this having been adopted by three schools in 1902 and this year by the last school with a three years' course.

It is said that plans have been perfected for combining the faculties of medicine of Toronto and Trinity Universities.

THE following were recently appointed as assistants in the department of histology and embryology at Cornell University: Wm. A. Hilton, Ph.D. (Cornell); S. G. Winter, A.M. (Ohio), and Geo. W. Partridge, A.B. (Rochester).

CHARLES H. SHAW has been appointed adjunct professor of botany in the department of pharmacy of the Medico-Chirurgical College, Philadelphia.

DR. ERNST STEINITZ has been elected professor in the Technical Institute at Charlottenburg, in the room of the late Professor Hamburger.

THE Royal Commissioners for the exhibition of 1851 have made appointments to science research scholarships for the year 1903, on the recommendation of the authorities of the several universities and colleges. The scholarships are of the value of £150 a year, and are ordinarily tenable for two years (subject to a satisfactory report at the end of the first year) in any university at home or abroad. The scholars are to devote themselves exclusively to study and research in some branch of science the extension of which is important to the industries of the country. Fifteen new scholars are appointed, fifteen scholars are reappointed for a second year and six for a third year. Two of the students who are reappointed will study in the United StatesMr. G. B. Waterhouse at Columbia University and Mr. T. C. Hebb at the University of Chicago.

Marine-Hospital Service, now bearing the title of the Public Health and MarineHospital Service of the United States, has become so developed and strengthened, and the state health organizations have been so perfected, that a sentiment of respect, one for the other, has been established, finding its expression in this law of 1902, and, in particular, section 7 above referred

to.

To my mind the outlook is bright. The great problems to be solved in sanitary affairs; the great work to be done in the suppression, and even elimination, of disease, and the cultivation of health and strength, so that physically, as well as in other respects, the United States may take a leading position among the nations, are propositions which should not be considered impossible of solution, and a proper development under the terms of this law will be an important step in this solution.

One of the most important features of this assemblage is its official character. All of us are familiar with conventions of similar purpose, productive of much useful information but entirely lacking in official significance. Here, however, are assembled the legalized health authorities of the states, representing the practical administrative experience as well as the theoretical and scientific knowledge required in the consideration of public health affairs.

Many of you have devoted the best years. of a long professional life to the consider ation of the subjects which will come before us, having acquired, in individual instances and on special subjects, unusual knowledge and wisdom.

Combined effort appears to be a distinguishing feature of this new twentieth century. This is seen in nearly all forms of civic and commercial life and even scientific and professional effort. It would

seem that when the history of the twentieth century is written there will be lacking those great and single characters looming far above the average, leading, directing or dictating; instead, there will be an elevation of the average, the best individual effort will, neither in purpose nor effect, aggrandize the individual, but will be exerted in connection with other effort of like nature for the establishment of a parity of well-being among all. This, I take it, will be the keynote of our action, bearing constantly in mind the actual results to be attained and being determined to attain them.

To refresh your memory I will now read section 7 referred to, and also section 8, which is somewhat analogous.

It will be seen that section 7 provides for three kinds of conferences. First, the surgeon-general may invite as many of the health and quarantine authorities as he deems necessary, not more than one from each state, territory or District of Columbia, to a conference, whenever in his opinion the interests of the public health would be promoted thereby. Second, a conference must be called at least once a year of all the states, territories and District of Columbia. Third, upon the application of not less than five state or territorial boards of health, quarantine authorities or state health officers, he must call a conference, but in this event only those states joining in the request are to be called.

While the present is the first annual conference, it is not the first conference called under the law. Last January, upon the request of twenty-two states, a so-called plague conference was called to consider the situation in San Francisco. The proceedings of that conference in detail have been transmitted to each of you. The effect of it was undoubtedly very great in

bringing about the present satisfactory status in San Francisco. The object of that conference was specific, but, as you will note, the law providing for the annual conference gives no details. We must assume, therefore, that the intent of the law is that we shall get together, and we are to decide ourselves as to the matters to be considered. It is evident that the conference is advisory in character, without changing in the least the present executive force of this bureau of the Treasury Department.

It seems advisable at the outset, and for a satisfactory understanding of one another, to give a review of the laws and of the organizations relating to the Public Health and Marine-Hospital Service, and to receive in return an account of the same nature from each state delegate.

The laws especially relating to the United States Public Health and Marine-Hospital Service can be found listed in the appendix to the regulations of the service of 1902, and the laws relating to quarantine can be found printed in full in the quarantine regulations of 1903.

Having thus referred to the laws, I propose now to describe the organization of the Bureau of the Public Health and Marine-Hospital Service. For executive administration, the bureau is divided into six divisions, each presided over by an assistant surgeon-general. There is, also, a miscellaneous division, presided over by an assistant surgeon, and the office of the chief clerk. The clerical force numbers about twenty. These divisions are named as follows:

Division of Marine-Hospitals and Relief. Division of Domestic Quarantine. Division of Foreign and Insular Quarantine and Immigration.

Division of Sanitary Reports and Statistics.

Division of Personnel and Accounts. Division of Scientific Research. Miscellaneous Division.

DIVISION OF MARINE-HOSPITALS AND RELIEF.

To this division are sent all matters relating to the marine-hospitals, 22 in number owned by the service, and to the patients, numbering 58,000, treated annually in these hospitals and in some 110 relief or contract stations. The Purveying Depot, a large building located in New York, is under the direction of this division, to which are also referred all matters relating to hospital supplies, including subsistence, drugs, hospital furniture, surgical instruments and appliances, plans and specifications for hospital construction, and the conduct of the sanatorium for consumptive patients at Fort Stanton, New Mexico, where the service has a sanatory ranch, 56 square miles in area, the buildings of the fort having been placed in perfect condition, the patients in the sanatorium numbering about 150. The scheme for this ranch embraces the removal of consumptives from our hospitals with a view to their improvement or recovery. Quite a large percentage have recovered, a number leave greatly improved, and all who desire can find employment after leaving in the same high, dry and healthy locality. The hospitals are thus relieved from this contagious disease, and the vessels from which they come are subject to inspection and disinfection as to their forecastles or other quarters that have been occupied by known consumptive patients.

DIVISION OF DOMESTIC QUARANTINE. To this division are referred all matters relating to the national maritime quarantine stations, embracing nineteen complete disinfecting stations and eighteen inspection stations. At the former are hospitals, barracks, disinfecting machinery, steamers

and small boats, all requiring constant care and attention. This division, also, must see to the expenditure of appropriations for new stations, involving purchase of lands, construction of piers and buildings, said construction being generally under the supervising architect of the treasury on plans approved by the bureau and the department; but occasionally the bureau attends to this construction itself. To this division are also referred all matters relating to the quarantine regulations and their interpretation. Matters relating to interstate quarantine and suppression of epidemic diseases are also handled in this division. Quarantine upon the Mexican and Canadian borders is also conducted through this division.

DIVISION OF FOREIGN AND INSULAR QUARANTINE AND IMMIGRATION.

To this division is assigned the management of the national quarantine stations in Hawaii, Porto Rico and the Philippine Islands, the supervision of officers detailed for duty in the offices of the United States consuls in foreign ports, who sign the bills of health with the consuls. At present there are three officers in Japan, Yokohama, Kobe and Nagaski; two in China, Shanghai and Hong Kong; one in Naples, Italy; ten in Cuba, three in Havana, one each at Cienfuegos, Santiago, Nuevitas and Matanzas, and several at sub-ports; four in Mexico, two in Vera Cruz, one at Progreso, and one at Tampico; six in the fruit ports of Central America, namely, Bocas del Toro, Colombia; Port Limon, Costa Rica; Bluefields, Nicaragua; Ceiba and Puerto Cortez, Honduras; Livingston, Guatemala; and Belize, British Honduras.

To this division are also referred all matters relating to the medical inspection of immigrants, a most important function of the service, requiring the detail of a large number of officers.

DIVISION OF SANITARY REPORTS AND

STATISTICS.

This division is charged with the preparation of the public health reports, published weekly by the bureau. All matters of a statistical nature are referred to it.

It may be of interest to state that some question has arisen as to whether the work of this division which is authorized both by the law of 1893 and the law of 1902, may not duplicate the work of the Census Bureau, but I am pleased to state that, after conference with the Chief Statistician of the Census Bureau and others connected therewith, it has been found that there need be no duplication or interference by one bureau with the other; on the contrary, each will be helpful to the other. The Census Bureau, in addition to the decennial census, will publish an annual census of mortality and births, but the weekly and monthly reports will be published as heretofore by this bureau, and morbidity reports, which are so much desired and which will require special organization to procure, will be undertaken by the Public Health and Marine-Hospital Service.

DIVISION OF PERSONNEL AND ACCOUNTS.

To this division are referred all matters relating to the personnel of the service, examinations for admission to the corps of commissioned officers; examinations for promotion, appointments and resignations, appointment of boards for the physical examination of officers of the Revenue-Cutter Service. This division has also charge of the bookkeeping of the service.

DIVISION OF SCIENTIFIC RESEARCH.

This division might be better called the Division of Scientific Research and Sanitation. To it are referred all matters relating to the hygienic laboratory. It should be understood that this laboratory, or the staff thereof, is not a part of the bureau proper, though at present located in