conferred on suffering humanity by the skill with which persons were treated before their removal to the hospital. The second paper was, perhaps of even greater importance, as it showed how infectious patients were being moved to hospitals without the fear of infecting others. In old days, removal to an hospital simply meant an ingenious and elaborate means of spreading infection to other people. Some instances had already been given, and perhaps many would recall one which was mentioned in the 'Times' some time ago, about a person passing a small-pox hospital, who saw a cab drive up and deposit a very bad case of confluent small-pox, and when it had driven about fifty yards off actually take up another fare, and drive off with it. Under these excellent arrangements nothing of this kind would be possible in the future.

Surgeon-Major HUTTON then read the following short paper :

IN the limited time allowed in these meetings for discussion, I can only select one subject for comment, among many relating to the removal of the sick and injured. This one, however, is very important, as it has close connection with the national health and the national wealth. I would refer you to the numerous accidents that are continually occurring among our large mining population, our colliers and ironworkers. By way of example, I would first refer to an individual case. A man, a skilled artizan, has his leg broken in one of our large ironworks in the Midland counties. Let me read to you an account of the accident, as given to me in a letter from the doctor in attendance. "The man was hurt in the beginning of February-his injury was a simple fracture of the leg, and carrying him home the fracture was complicated by a serious displacement of the foot, which has acted so seriously that a limb which would have been well in three months, will take at least seven months before it is quite sound." You see there the unfortunate result of

want of system, care and skill in the removal of an injured man-fully 16 weeks more, in this case, of enforced idleness, for lack of timely first aid and careful removal in the manner recommended by Mr. Furley and the St. John Ambulance Association. Now, the man was in receipt of 30s. a week, and, of course, during the whole period of his sickness, this has been lost, but that is not all, he has been receiving from the Employers' Liability Assurance IOS. a week, and another 5s. from the sick club, making a total loss of £2 5s. a week. The question arises, can we sum up this loss as dead loss, for, of course, the sick bequests replace the wages as the family's expenditure, but then the man's productive labour is lost to the amount of his own wages, and his employer's profits also; unless having taken on another man who was out of work, then we must cancel the 30s., as being dead loss to the sufferer only, and not to the productive labour of the community. If so, you must subtract the money he receives from his wages, and say he loses 15s. a week, and the clubs 15s. a week more. It seems to me an important calculation, and I should like, when opportunity affords me, to take the opinion of some expert on questions of social economy on this case. It must be evident, however, to everyone here, that the loss to this man and his family is very great. The money he receives per week for the support of himself and family is reduced from 30s. to 15s. a week, and that means less food, less clothing, less of the actual necessaries of life, and therefore less health for his family. Now, this is one of many thousands of cases that take place every year among our great mining and industrial classes. Let me instance a private engineering and manufacturing firm, employing, perhaps, the highest skilled labour in the country. I find that in one year (1883) their accident compensation fund had paid £1,306 8s. Id. for injuries received by the workmen, 214 claims had been admitted, and the sums awarded varied from 2s. 3d. to £200. This firm has, during the last winter, introduced proper ambulance matériel, and a large number of their men have been in

structed in using it, and in a letter I have recently received from the secretary of the accident fund, he states, "when preparing the report of the ambulance classes, I called the attention of the committee to the remarkable diminution in the number of cases coming forward for compensation." Carry this inquiry still further, to a district, the great iron-mining district of Cleveland and North Yorkshire. From returns that have been furnished me by the Secretary of the Miners' Association, for the year ending December 31st, 1883, the total number of accidents reported were 847 non-fatal, and 29 fatal. This report states, "if we make a very moderate calculation in relation to the accidents which have not been reported, we arrive at the startling fact that one person has been injured or killed during 1883 for every eight employed in and about the Cleveland mines." Some of the non-fatal accidents have been of a very serious character, laying off work the sufferers for weeks and months; and I am sure a perusal of these returns convey with terrible distinctness an idea of the dangerous nature of the miner's work. I cannot give a correct account of the time lost in all these cases, but, in another report of a small cottage hospital in this district,— the "Guisborough Miners' Accident Hospital "-75 injured men have been treated during the same year (1883). Many of these were serious fractures, and the combined time these cases were in hospital amounted to 750 days, or upwards of two years' employment. That did not mean all the loss, for many of these poor fellows, after they left the hospital, had not regained sufficient strength to resume work for some time, so serious had been the nature of their injuries.

If we extend our inquiries to the coal and iron-mining districts generally throughout the country, you will find that there are some 560,000 men and boys employed, and that one relief society alone in one year assisted 14,929 injured cases, and last year (1883), out of a total membership of 224,000 belonging to the various societies in our mining centres, no less than 44,579 cases of injuries were relieved. Lord Crawford and Balcarras, a high authority on

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these matters, stated at an ambulance meeting at Wigan some time ago, there could be no doubt that as many as 100,000 accidents, large and small, occurred throughout the mining districts of this country in one year. Surely, then, with facts such as these before us, so much pain and suffering to alleviate, there is abundance of good work to be done by proper means of carriage for the injured, as brought to our notice by Mr. Furley. It must be obvious to every one, from the facts and figures I have quoted, that this subject is one largely affecting the national health and the national wealth, and especially the health and well being of a class of men whose toil and whose labour contribute so much to the comfort and wealth of the nation. I believe it would afford much pleasure to His Royal Highness the Prince of Wales to know that this Exhibition had been the means of assisting in promoting work calculated to relieve pain and suffering among our mining population, by assisting in the introduction of well-regulated means for the carriage of the injured everywhere among our collieries and ironworks. I would ask, then, everyone here to examine for themselves the ambulance exhibits, and to exert their influence to foster and extend this good work. I would particularly urge upon the owners of royalties in mines that they should largely contribute, and unite with those who work the mines, to provide proper ambulance material for the mining districts. I hope the day is not far distant when this work of the St. John Ambulance Association, the safe carriage of the sick and injured-will take the same place in the hearts of the people of this country as that other noble work, which has done so much during the past sixty years to save life and relieve suffering on our stormy coasts-the work of the Royal National Lifeboat Institution. I ask you all to assist Mr. Furley and the St. John Ambulance Association in making more widely known this humane and christian work, for in reality it is, if only the public were made aware of it, A National Life Brigade upon the Land.

The CHAIRMAN said he might venture to hope that all who had heard the paper and address had been as much gratified as he had himself, for he must reckon himself as one of the audience, his office of President carrying with it no pretence whatever of being a leader in relation to this subject, or even to be well acquainted with it. He had to confess, like possibly some who had listened to the addresses, that he had no familiarity with ambulance work. His occupation in his profession had been of a totally different kind, and he had been so entirely engaged in it, that he had had no opportunity or time whatever to study the very useful facts which had now been placed before them. There was, in fact, only one direction in which he had studied them, namely, that as surgeon to a large hospital he had constantly seen the need there was for a better transfer of patients, whether sick or wounded, into the hospital wards; and he could, of course, from his own experience, tell numbers of instances similar to those which had been mentioned. In apology for himself and others who had to do with hospitals, he must remark that, when they looked at the difficulties which existed, they could not but observe that as the difficulties existed everywhere so must the remedies be everywhere. They might have arranged a system of ambulance close by, but the patients in large hospitals were brought from the narrowest streets and the most distant villages, and from every part of the country, and it needed the enterprise and co-operation which was shown in a society such as this, to be able to take in hand a work of which the design would be, as they had developed it, to spread the system of ambulances far and wide to every village in the kingdom, and to bring the knowledge of its utility and its application within the range of the whole community. The work was not onehalf, nor yet one-tenth, accomplished when an ambulance was established even in that great city, whilst they did not exist in places 10, 15, 100, or 200 miles off. The Association, however, had shown its intention to work this affair