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the precautions taken by them for the protection of the public, in addition to the favourable opinions we have already expressed respecting their establishment. -Ed.]

VENTILATION OPEN COMPETITION. At the Ventilation Open Competition just concluded at Birkenhead, Messrs. Robert Boyle & Son, of 64 Holbora Viaduct and Glasgow, have been awarded the Gold Medal, the highest and only prize offered for their system of ventilation, it being adjudged the best.



SOCIAL SCIENCE CONGRESS. The following special questions relating to Sanitary Science have been agreed upon between the local committees and the council of the Social Science Association for discussion in the Congress, to be held in Birmingham in September next.

Health.-1. What is the best method of dealing with (a) town sewage : (b) the products of house and street scavenging; and (c) the products of combustion? 2. What are the best means, legislative or other, of securing those improvements in the dwellings of the poor which are essential to the welfare of the community. 3. How far may the average death-rate of a population be considered an efficient test of its sanitary condition; and by what means can the high death. rate of children be reduced.

HAY AND HARVEST WORK WITHOUT BEER. Farmers in considerable numbers have either given up, or are now giving up, the practice of giving their men beer in hay and harvest work. Conferences of farmers have recently been held in various

of the country on this subject, and after full discussion it has been generally agreed that it was desirable to discontinue the practice of giving beer. At well-attended conferences of farmers in the Town Hall, Basingstoke, on June 11, and in the County Hall, Lewes, on June 17, the following resolution was unanimously passed :

'That in the opinion of this Conference it is desirable in the interests of both masters and men that the practice of supplying beer in the hay and harvest field be discontinued, and that all work be paid for entirely in cash.'

All experience goes to prove that this change will be of great ad. vantage to the men. They will soon fall into the way of providing themselves with good wholesome drinks at a small cost. Perhaps you will kindly

assist by allowing the following receipts, that have been found useful, to appear in an early issue of your paper.

Home-Made Drinks for the Harvest. Stokos is a most refreshing and strengthening drink. It is easily made, and costs only 3d. per gallon.

Put into a large pan { lb. of fine fresh oatmeal, 6 oz. of white sugar, half a lemon cut into small pieces. Mix with a little warm water, then pour a gallon of boiling water into it; stir all together thoroughly and use when cold. The lemon may be omitted, raspberry vinegar, citric acid, or any other flavouring may be used instead. More oatmeal may be used if preferred.

Cokos is a good nourishing drink made as follows:--8 oz. of sugar, 6 ozs. of good fine oatmeal, 4 ozs. of cocoa at rod. per lb., mixed gradually and smoothly into a gallon of boiling water ; take to the field in a stone jar. Cost 6d. per gallon.

A Good Harvest Drink.-Boil 1 oz. hops, \ 07. of ginger (bruised), in 11 gall. of water, for twenty-five minutes, add 1 lb. of brown sugar and boil ten minutes more, then strain and bottle while ho: ; it will be ready for drinking when cold. It should be kept in a cool place. Dried horehound may be used instead of hops. Cost zd. per gallon.

Ginger Beer.-Pour two gallons of boiling water over i lb. of lump sugar, 1 oz. of bruised ginger, two lemons sliced, let it stand till luke. warm, then add one tablespoonful of brewer's' barm, or one small teacupful of baker's barm ; let it stand twelve hours, then bottle it. It will be ready for use in twenty-four hours. Cost 4d. per gallon.

Boiling water poured on a few slices of lemon, with a little sugar, makes a very refreshing drink. Butter-milk should be more used as a drink.

One ounce of coffee and half an ounce of sugar in two quarts of water is a very thirst-quenching drink. So is cold tea, but neither of these is so supporting as the oatmeal drink.

It is quite a mistake to suppose that beer or spirits give strength. They do give a spurt to a man, but that quickly goes off : and spurts in hard heavy work, too often made, certainly lessen the working powers.

JOHN ABBEY, Secretary of the Agricultural Department, C.E.T.S. 44 St. Giles, Oxford, June 30, 1884.

[The drinks recommended are excellent, but we cannot help thinking that the names are unfortunate. Imagine the expression of a haymaker or harvest hand when asked if he would take a glass of Stokos' or 'Cokos !'-ED.)

VACCINATION OFFICERS' ASSOCIATION. The next meeting of members of this Association will be held on Saturday, July 19, at 2.30 P.M., at the Charing Cross Hospital Medi. cal School, 62 Chandos Street, Strand, W.C.

AGENDA. -1. To read minutes of last meeting. 2. Correspondence. 3. Election of members and honorary members. 4. To take into consideration a letter received from Dr. Henry Stevens, Inspector of the Local Government Board, asking for information from members of this Association, as follows. 'To show how promptly on the action of the Vaccination Officer the protection of vaccination can be secured to those in infected houses. Any instances in which such prompt action has illustrated its advantages.' 5. To consider the pamphlet issued by ‘The National Health Society' upon the benefits of vaccination, and to move a resolution. 6. And such other business as may arise.


Hon. Sec.
20 Clarendon Street, Pimlico,

London, S.W.

for one year.




Medical OfficeRS OF HEALTH. BRAUND, James Montaguc, M.R.C.S.Eng., L.S.A. Lond., has been

re-appointed Medical Officer of Health for the North Division

of the Stratton Rural Sanitary District, at 625 for one year. CLEGG, Walter, M.R.C.S. Eng., L.S.A. Lond., has been re-appointed

Medical Officer of Health for the Boston Port Sanitary District, Cogan, Lee Fyson, L.R.C.P. Edin. and L.M., M.R.C.S.Eng., has

been re-appointed Medical Officer of Health for the Northampton

Urban Sanitary District, at £150 per annum, for three years. FISHER, Thomas, M.R.C.S.Eng., L.S.A.Lond., has been re-appointed

Medical Officer of Health for the Garstang Rural Sanitary

District, at 650 for one year. GAYLOR, Edward, L.R.C.P.Edin., and L.M., L.F.P.S.Glasg., has

been re-appointed Medical Officer of Health for the Alfreton Urban Sanitary District, at 620 for one year, and for the Ripley

Urban Sanitary District at £20, for one year. Hollis, Elphinstone, M.D., M.B., C.M., Univ. Edin., has been

appointed Medical Officer of Health for the Woodbridge Rural Sanitary District, Suffolk, at '£50 for one year, vice Marshall,

deceased. JAMES, James Rowland, M.B.Univ. Edin., M.R.C.S.Eng., has been

re-appointed Medical Officer of Health for the Ystradyfodwg Urban Sanitary District, Glamorganshire at £150 per annum,

for one year. Livert, Henry William, L.R.C.P. Edin., M.R.C.S. Eng., L.S.A.

Lond., has been re-appointed Medical Officer of Health for the

Wells (Som.) Urban Sanitary District, at 630 per annum, for MARSHALL, William Norris, M.R.C.S. Eng., L.S.A. Lond., has been

re-appointed Medical Officer of Health' for the Newent Rural

Sanitary District, at £40 for the year ending April 30, 1885. Moxon, James Burdett, M.R.C.S. Eng., L.S.A. Lond., has been

re-appointed Medical Officer of Health for the Glanford Brigg

Rural Sanitary District, at £170 per annum until June 30, 1886. POLLARD, William' Robert, L.R.C.P. Edin., L.R.C.S. Irel., has been

re-appointed Medical Officer of Health for the Blackburn Rural

Sanitary District, at 650 for one year.
ROBINSON, William, M.D., M.R.C.S. Eng., L.S.A. Lond., has been

appointed Medical Officer of Health for the Gateshead Urban
Sanitary District, at £350 per annum, as Medical Officer of
Health, and £50 per annum for attending the hospital, from

year to year, vice Green, resigned. SEATON, Edward, M.D.Univ. Lond., M.R.CP.Lond., has been

appointed Medical Officer of Health, Public Analyst, and Examiner of Gas, for the Parish of St. Luke, Chelsea, at 6450 per annum, vice Barclay, deceased

THE INTERNATIONAL HEALTH EXHIBITION. The Minister of Commerce, M. Hérisson, has nominated the fol. lowing as members of the jury of the International Health Exhibi. tion, now held at London. M. Arnould, Professor of Hygiene at the Medical Faculty of Lille, M. Bérard, Secretary to the Comité Consultatif of Art and Manufacture ; M. Brouardel, Gueneau de Mussy and Proust: M. Buisson, Director of Elementary Education; M. Dethomas and Dr. Liouville. deputies; M. Dutert, Inspector of Schools of Design ; Dr. Gariel, Assistant Professor of Physics at the Paris Medical Faculty; M. Guillaume, Member of the Institut; M. Guy, President of the Syndical Chamber of Wholesale Distillers of Paris : M. Jacquemart, Inspector General of Technical Education and of the Art and Trade Schools ; M. Jartauld, President of the Paris Syndical Chamber of Wine and Spirits ; M. Jordan, Professor of Art and Manufacture at

the Ecole Centrale ; M. Lavezzari, Principal Architect of the Berck-on-Sea Hospital; Dr. Layel, Professor of Hygiene at the Bordeaux Medical Faculty : M. Leblanc, Member of the Academy of Medicine, formerly Chief Veterinary Surgeon of the Prefecture of the Seine ; M. Lesousaché, architect'; M. de Montmahon, Inspector-General of Elementary Education ; M. Emile Müller, Professor of Art and Manufacture at the Ecole Centrale ; Dr. Napias, General Secretary to the Society of Public Medicine and Professional Hygiene ; M. Nourrit, Printer and Publisher : M. Schrieber, President of the Syndical Chamber of India-rubber ; M. G. Trelat, Professor at the Ecole Special d'Archi. tecture; Dr. Vallin, Professor at the Military Medical School of the Val du Grace.

three years.

SPURGIN, William Henry, M.R.C.S. Eng., L.S.A. Lond., has been Hill, Mr. F. A. Brooks, Bank Manager, has been appointed

appointed Medical Officer of Health for the Maryport Urban Treasurer to the Pewsey Guardians and Rural Sanitary Authu. Sanitary District, Cumberland, at 63; for one year, vice Pearson, rity, vice Wood, resigned. resigned

HOLDROYD, Mr. Alfred, has been re-appointed Inspector of Nuisances STATHERS, George Nicholson, L.R.C.P.Edin., M.R.C.S.Eng., has for the Cleckheaton Urban Sanitary District, at E30 for the year

been appointed Medical Officer of Health for the No. 1 Division ending June 24 next. of the Wycombe Rural Sanitary District, at £40 for one year, HOOLEY, Mr. Cosmo C., has been appointed Surveyor to the Bartonrice Hayman, resigned.

upon-Irwell Rural Sanitary Authority, at £22; per annum, vice STELE, Henry Octavius, M R.C.S. Eng., L.S.A.Lond., has been Price, resigned.

Te-appointed Medical Officer of Health for the Cleckheaton HOULDERSHAW, Mr. William, has been appointed Inspector of Ur'an Sanitary District, at $40 for one year.

Nuisances for the Liversedge Urban Sinitary District, YorkSTART, William, M.B., C. M. Univ. Aberd., has been re appointed shire, at £26 per annum, vice Womersley, whose appointment

Medical Officer of Health for the South Division of the Stratton has expired.
Rural Sanitary District, at 615 for one yeur.

Hughes, Mr. Thomas, has been appointed Public Analyst for the TORNER, George, L.R.C.P.Lond., M.R.C.S. Eng., S.S.Cert Cantab, Borough of Newport, Mon., until Sept. 11.

has been re-appointed Medical Officer of Health for the Bishop. Jones, Mr. E. W. T., has been re-appointed Public Analyst for the Scortford, Buntingford. Hertford, and Ware Rural, and the Borough of Walsall for one year. Bi-hop-Storford, Hertford, and Ware Urban Sanitary Districts KNIGHTS, Mr. James West, has been re-appointed Public Analyst for combinedd, at £600 per annum, for five years.

the County of Huntingdon. WARREX, Thomas, M.R.C.S. Eng., LS.A. Lond., has been re- MANN, Mr. Robert, has been elected a Member of the Handsworth

appointed Medical Officer of Health for the No. 2 Division of the Local Board and Urban Sanitary Authority, vicc Bragge, deWycombe Rural Sanitary District, at £35 for one year.


McNeill, John Patrick, M.D.Univ.Dub.. has been re-appointed SURVEYORS, CLERKS TO GUARDIANS, INSPECTORS OF

Pub ic Analyst for the Borough of Tiverton.

Nixon, Mr. Thomas, has been re-appointed Inspector of Nuisances NUISANCES, &c.

for the Stafford Rural Sanitary District, at $ 50 per annum, in

addition to £15 and 635 per annum, as Inquiry and Attendance BASTIMAX, Mr. James, has been appointed Inspector of Nuisances Officer to the School Attendance Committee.

for the Scarborough Urban Sanitary District, at 610; per annum, PLATT, Mr. Samuel, has been appointed Inspector of Nuisances for Tie Finlay, resigned.

the Gainsborough Urban Sanitary District, at £30 per annum, BEKINGER, Mr. John Jacob, has been appointed Public Analyst for vice Greenhalgh, relieved of his duties (but continued as Surthe Borough of Penryn, rvice Parry:

veyor) Eest. Mr. Joseph, has been appointed Survevor to the Shildon and PONTING, Mr. Frederick William, Banker, has been appointed

East Thickley Local Board and Urban Sanitary Authority, co. Treasurer to the Preston Guardians and Rurai Sanitary Autho-
Durham, at £43 per annum, and Inspector of Nuisances at £oo rity, zrice Dalby, resigned.
per annum, vice Laycock, appointe i Surveyor to the Walker PRICE, Mr. John, C.E., Assoc. M. Inst.C.E., M.S.E., has been
Local Board and Urban Sanitary Authority.

appointed Surveyor and Inspector of Nuisances to the Toxteth BILAM, Mr. Frederick, has been appointed Inspector of Nuisances Park Local Board and Urban Sanitary Authority, at 6350

Lur the Wareham Urban Sanitary District, at £10 per annum, per annum, vice Hall, deceased. i Hobbs, resigned.

RIDLINGTON, Mr. Walter, has been appointed Surveyor, Inspector PRAELL, Mr. Thomas, Branch Manager of the London and Pro. of Nuisances, and Collector to the Holbeach Local Board and

vincial Banking Company, has been appointed Treasurer to the Urban Sanitary Authority, at £100 per nnum, vice Dyuse, re.
Tredegar Local Board and Urban Sanitary Authority, and to the signed, after nearly twenty-two years' service.
Bedwellty Guardians and Rural Sanitary Authority, Monmouth- RILEY, Mr. Thomas, has been elected a Member of the Board of
Shire, zice Green, resigned.

Fleetwood Commissioners and Urban Sanitary Authority, vice Bins, vir. John, has been appointed Surveyor and Inspector of Warbrick, deceased.

Nuisances to the Corporation and Urban Sanitary Authority of ROBINSON, Mr. Thomas, has been elected a Member of the Nelson Chepping Wycombe, Bucks, at £150 per annum, vice Wakelam, Local Board and Urban Sanitary Authority, vice Elliott, re. who declined the appointment.

signed. DEADLEY, Mr. Herbert Edward, Manager of the Chipping Sodbury Shaw, Mr. Joseph, has been appointed Surveyor to the Stainland

Branch of the National Provincial Bank of England, has been with-Old Lindley Local Board and Urban Sanitary Authority at appointed Treasurer to the Chipping Sodbury Guardians and

£is per annum and re-appointed Inspector of Nuisances at 230 Rural Sanitary Authority, vice Foxwell, resigned.

per annum for three years, froin April 11 last, and Collector at Bu 14, George 1. C., C.E., has been appointed Surveyor and £19 per annum (665 altogether).

Inspector of Nuisances to the Corporation and Urban Sanitary SMALLPIECE, Mr. Gilbert John, has been appointed Treasurer to the

Authority of St. Helens, at £400 per annum, vice Hart, resigned. Guildford Guardians and Rural Sanitary Authority, viie Hay. DS, Mr. Thomas, has been appointed Inspector of Nuisances don, re-igned.

for the Leighton Buzzard Rural Sanitary District, at £83 per STAINTHORPE, Mr. Thomas William, has been appointed Surveyor annum, tice Mr. W. Brown, deceased.

and Inspector of Nuisances to the newly formed Eston Local Core, Mr. S. B., has been elected Chairman of the Bilston Improve. Board and Urban Sanitary Authority, at 6150 per annum, for

cient Commissioners and Urban Sanitary Authority for the three years, from July 1. ensuing year.

STEPHENSON, Mr. John, has been re-appointed Inspector of C. LARD, Mr. Christopher Lethbridge, Solicitor, has been appointed Nuisances for the Boston Port Sanitary District for one year.

Clerk to the Launceston Local Board and Urban Sanitary STUART, Mr. Charles Madock, has been appointed Public Analyst Authority, at thirty guineas per annum, vice Mr. J. L. Cowlard, for the Borough of Newcastle-under-Lyme, vice Purdie, resigned. his father, resigned.

Thorpe, Mr. G. A., has been appointed Deputy Accountant to the CEWELL, Mr. F., has been appointed Collector to the Awre Local

Corporation and Urban Sanitary Authority of Bradford, York. Board and Urban Sanitary Authority, Gloucestershire, at £15 shire, at £200 per annum. per annum.

UNWIN, Mr. W. T., has been appointed Surveyor and Inspector of DrayTOS, Mr. John, has been re-appointed Inspector of Nuisances Nuisances to the March Local Board and Urban Sanitary

for the Glanford Brigg Rural Sanitary District, at £100 per Authority, at £80 per annum, vice Amos. annum, and Surveyor at 610 per annum, until June 30, 1886.

WAKELAM, Mr. Henry Titus, C.E., who was appointed Surveyor EASTWOOD, Mr. G. E., has been appointed Collector to the Corpo. and Inspector of Nuisances to the Corporation and Urban Saniration and Urban Sanitary Authority of Blackburn at £120 per tary Authority of Chepping Wycombe, Bucks, has declined the

appointment, and continues as Surveyor and Inspector of Nuis FLITHER, Mr. Thomas, has been appointed Accountant to the Cor. ances to the Corporation and Urban Sanitary Authority of

poration and Urban Sanitary Authority of Bradford, Yorkshire, Oswestry, at the increased salary of £150 per annum. at £300 per annum.

Whittaker, Mr. John, has been appointed Surveyor, Inspector of GIFATHEAD, Mr. Francis Joseph, Solicitor, has been appointed

Nuisances, and Collector to the Worsborough Local Board and Clerk to the Reeth Guardians and Rural Sanitary Authority, Urban Sanitary Authority, Yorkshire, at 6,140 per annum, with Yorkshire, at 640 per annum, as Clerk to the Guardians, and

house, gas, and water, vice Senior and Wilkinson, resigned. such salary as Clerk to the Rural Sanitary Authority, to the WILLIAMS, Mr. Frederick Edward, has been appointed Clerk to the School Attendance Committee, and to the Assessment Committee, Leigh Guardians and Rural Sanitary Authority, Lancashire, at as may be fixed from time to time, and fees as Returning Officer £120 per annum as Clerk to the Guardians, 660 per annum as and Superin:endent Registrar of Births, &c., vice Tomlin, Clerk to the Rural Sanitary Authority, 630 per annum as Clerk deceased.

to the Assessment Committee, k29 per annum as Clerk to the GREEXHALGH, Mr. Christopher, on being relieved of his duties as

School Attendance Committee, and fees as Returning Officer andi Inspecior of Nuisances, is to be continued as Surveyor to the

Superintendent Registrar of Births, &c., vice Heywood, resigned. Gainsborough Local Board and Urban Sanitary Authority, at £125 per annum, and £25 per annum

for the Water Works. HARMAS, Mr. Thomas, has been appointed Collector to the West

VACANCIES. Hartlepool Improvement Commissioners and Urban Sanitary Authority, at £125 per annum, vice Downey, appointed Medical Officer of Health for the Nottingham Urban Sanitary Accountant.

District. Harison, Mr. John, has been elected a Member of the Dronfield Medical Officer of Health for the Cork Urban Sanitary

Local Board and Urban Sanitary Authority, vice Rhodes, District. resigned.

Medical Officer of Health for the Whitby Urban Sanitary Howard, Mr. Samuel, bas been re-appointed Inspector of Nuisances District. for the Whit wick Urban Sanitary D strict at L o per annum, for

Medical OFFICER of Health for the No. 1 or Whitby Division of five yea's ending June 24, 1889.

the Whitby Rural Sanitary District.



MEDICAL Officer of Health for the Grange Urban Sanitary

District, Lancashire. Clerk to the Oundle Guardians and Rural Sanitary Authority. SURVEYOR to the Swinton and Pendlebury Local Board, Lancashire. SURVEYOR AND INSPECTOR OF NUISANCES to the Haverhill Local

Board and Urban Sanitary Authority: £100 per annum, from year to year, with the prospect of additional salary as Manager of the Gas Works. Application, 21st inst., to Charles F. Free

man, Clerk, Haverhill, Suffolk. SANITARY INSPECTOR for the Parish of St. Pancras, £90 rising to

k 100 per annum. Application, 17th instant, to Thomas Eccleston Gibb, Vestry Clerk, Pancras Road.

Vaccination Acts. the exchange of experience and advice, and the mutual benefits of its members. The members of the association will consider and answer all matters of correspondence submitted for their consideration, and will, to the best of their ability and experience, assist all brother officers in any matters of interest arising in the course of their duties. The association will further endeavour to obtain such alterations in matters of detail as from time to time may in their opinion prove beneficial to the cause they represent. Every vaccination officer, public vaccinator, and medical officer of healeń is cognisant of the many difficulties and hindrances that are frequently met with in the proper enforcement of vaccination, which, when efficiently and properly enforced, has repeatedly proved to be of such incalculable benefit to the community, and the association feel that, hy thorough combination and with the hearty support and assistance of the medical profession generally, and others interested in the promotion of efficient vaccination, the objects of the Vaccination Acts will be better served in the future, and the public health safe-guarded more thoroughly. The association do not confine themselves to London and districts only, therefore the support of all vaccination officers, public vaccinators, and medical officers of health throughout the country is earnestly desired, and the association appeal to all such gentlemen to become members and honorary members. The annual subscription for members (vaccination officers) is 55., and for honorary members ios. The association is under the management of the elected officers and committee, consisting of twelve, who are all subject to annual election at the general meeting in February, when an annual balance sheet and report will be published. Applications for membership, honorary membership, rules, and all other information can be obtained of the honorary secretary, Charles O. Elkerton, 20 Clarendon Street, Pimlico, S.W.

MANAGEMENT. Chairman.-Mr. Charles Shattock, St. Mary Abbotts, Kensington.

Vice-Chairmen.-Mr. William M. S. Sherman, Whitechapel; Mr. William H. Ward, Bethnal Green.

Treasurer.- Mr. John H. Richards, St. Pancras. Honorary Secretary.-Mr. Charles O. Elkerton, Si, George, Hanover Square.

Committee.-Mr. Charles Atkins, vaccination officer, Lewisham ; Mr. William Bence, vaccination officer, Edmonton ; Mr. Charles O. Elkerton, vaccination officer, St. George's Union, Middlesex : Mr. Charles Hearson, vaccination officer, Lamheth ; Mr. William Malins, vaccinatinn ofhcer, Islington ; Mr. Thomas W. Maslen, vaccination officer, Greenwich : Mr. J. R. Moloney, vaccination officer, Stepney; Mr. John H. Richards, vaccination ofhcer, St Pancras ; Mr. Charles Shattuck, vaccination officer, Kensington: Mr. William M. S. Sher. man, vaccination officer, Whitechapel : Mr. Willian John Upton, vaccination officer, Mile End Old Town ; Mr. William H. Ward, vaccination officer, Bethnal Green

Honorary Members.-Lieut.-General Batten, 14 Notting Hill Square. Kensington, W. : Dr. Charles Thomas Blackman 4 Highbury Grove. N.; Dr. W. Riddell Brunton, 43 Kirkdale, Sydenham, S.E.: Dr. Edwin Child. Kingston-on-Thames ; Dr. C. C. Claremont, Millbrooke House, Hampstead Road, N.W.; Dr. Robert Cory, St. Thomas's Hospital ; Dr. Richard Fegan, Westcombe Park, Blackheath, S.E. ; Dr. Charles Maynard Frost, 47 Ladbroke Square, Notting Hill, W.; Dr. William Hall, Tottenham, Middlesex ; Dr. Henry F. E. Harrison, 33 Shepherd's Bush Green, W.; Dr. Joseph Loane, 1 Dock Street, Whitechapel, E.; Mr. Shirley F. Murphy, St, Pancras ; Dr. Robert S. Nightingale, 658 Commercial Road, Limehouse, E.; Dr. John Reid, 12 Bridge Avenue, Hammersmith, W.; Dr. George A. Rogers, 164 High Street, Shadwell, E. : Dr. Thomas Scoresby. Jackson, ‘St. Hilda,' Hoe Street, Walthamstow, Essex ; Dr. James Smart, 256 Cambridge Road, E.; Dr. Meredith Townsend, 27 Upper Phillimore Place, Kensington, W.; Dr. Alfred G. Wells, Beaumont Terrace, West Kensington, w.

LOCAL INTELLIGENCE. The Stoke Damerel Rural Sanitary Authority and their officers have subscribed for a tablet in memory of their late chairman, Mr. F. C. Rickard, which has been placed in the Board room. It consists of a slab of coloured stone, on which is placed a white marble scroll, bearing the following inscription : -“This tablet is erected by the Commissioners of the Poor of Devonport and their officers in remembrance of the late Francis C. Rickard, Esq., who for twentysix years was a member of the Board, and for the last fourteen years faithfully carried out the duties of Chairman. April 1884.'

The Cambridge Improvement Commissioners and Urban Sanitary Authority have passed the following resolution by 17 votes to 10:

That it is expedient to apply in the next session of Parliament for legislative sanction to alter the constitution of the Board of Com. missioners, and to amend the provisions of the Local Acts and the Award Act with respect to the relations between the university and the town on the basis of the provisions of the Bill of 1874 ;' and empowered the Parliamentary Committee to take the necessary steps for carrying it into effect.

The Denton Local Government District is to be merged in the Haughton District, on Sept. 29, by Provisional Order of the Local Government Board.

The Barking-Town Local Board and Urban Sanitary Authority have increased the salary of the Survevor from 480 to £150 per annum, and that of the Inspector of Nuisances from £40 to £70 per


Having for some time back been in the receipt of Queries apper. raining strictly to sanitary work, and which it would be easy to answer, without having to refer our corre ipondent to competent professional advisers, we have opened a column in which to register such Queries and Replies thereto as can fairly be expected from us; and our subscribers and readers are invited to make such use of this column as will tend to benefit themselves and the community. Both Queries and Replies will, however, be subjected, if unnecessarily long, to a strict curtailment.

The Maryport Urban Sanitary Authority, upon a vacancy for a Medical Officer of Health having arisen by the resignation of Dr.

arson, have increased the salary from £25 to 650 per annum. At Llandysilio, a statutory meeting of owners and ratepayers was held some time since, ard a resolution pasied, that it was expedient that it should be constituted a Local Government District. An inquiry was then held in accordance with the Act of Parliament ; but as certain works of drainage, &c., had not been carried out, the Inspector declined to report in favour of the resolution. They have now, however, heen completed, and another inquiry held, at which the Inspector intimated that he would report in favour of the parish being constituted a Local Government District under the title of • The Menai Bridge Local Government District,' with a Board of nine members, Mr. H. Bulkely Pryce to be the returning officer. ! The parish of East Grinstead has been constituted a Local Govern. ment District by Provisional Order of the Local Government Board. There are to be twelve members, and, if there should be a contest, the voting papers are to be collected on August 20.

The St. Anne's on-the-Sea Medical Offcer of Health commences his report to the Local Board and Urban Sanitary Authority, dated July 1, with the following satisfactory sentence. During the past month not a single death has taken place in this district.'

The Stafford Rural Sanitary Authority, at their meeting on June 21, reconsidered the proposed reduction of the salary of Dr. George Reid, the Medical Officer of Health, from £75 to £50 per annum, in compliance with the request of the Local Government Board (see page 574); and, after a short discussion, a resolution that a reply be sent to the Local Government Board to the effect 'that the authority could not come to any other conclusion than that previously arrived at,' was proposed and carried by si votes to 3.

The Colchester Town Council and Urban Sanitary Authority, have voted Two hundred guineas to Mr. Charles Clegg, the Surveyor, in recognition of his extra services in connection with the erection of a water tower, &c., instead of increasing his salary £80 per annum, which he had asked for.

CREDITON IMPROVEMENT COMMISSIONERS AND URBAN SANI. TARY AUTHORITY. -At the annual election on the ist instant, the following were elected commissioners for the ensuing three years, viz. :-Messrs. James Templeton, John_Squire, William Pope, G, H. Chaplin, *W. H. Symes, William Dodridge, James Searle, *G. Bicknell, William Labbett, and *A. A. Gale. (* Retiring com. missioners re-elected).


VACCINATION OFFICERS' ASSOCIATION. This association was inaugurated on Feb. 16, 1884, and has already on its roll of members almost every vaccination officer of the metro. polis and surrounding districts, and as honorary members a large number of public vaccinators, medical officers of health, and other distinguished persons interested in the promotion of vaccination. The association has received the cordial support of Henry Stevens, Esq., M.D., one of Her Majesty's Inspectors under the Local Government Board, who, under date lan. 31, 1884, wrote to the promoters of the association as follows:-'I may state that I fully sympathise with you in your desire to unite together for mutual support and co-operation, and I believe that much advantage might accrue to the community by securing a more complete administration of the Vaccination Acts through such combination.' The objects of the association are to secure as far as possible uniformity of action in working of the

125. FLOWERS IN SICK ROOMS. Are cut flowers unhealthy in a sick room? Are flowers growing in

pots unhealthy in a bedroom either during the day or night! If so, why?

A. Z. (Healthy plants and cut flowers are not unwholesome in bed and other inhabited rooms, and in those cases where mischief has arisen from their presence, it is invariably caused by sungi generated in the stale, unventilated earth of the pois. or in the putrid water in which cut flowers are kept. To secure immunity from any injurious effects the water of cut flowers must be frequently changed, and the potted plants be effectually drained, and have the earth freely stirred up from time to time. Interesting papers on the subject may be consulted by reference to the Lancet, Vol. ii., 1878, p. 68: ; the Practitioner, Vol. ii., 1881. p. 387, and Vol. i., 1982, p. 238 ; and also to the British Medical Journal, Vol. i., 1884, p. 1137, -Ed.]


on the householder or guardian, though I fail to see that compulsion as such need be considered more

objectionable by a professional than by a non-proTHE NOTIFICATION OF INFECTIOUSfessional informant. It is, however, said to be

DISEASE: ITS IMPORTANCE AND derogatory to a medical man's dignity and selfITS DIFFICULTIES.*

respect to be so compelled. But wherever a duty

of great importance to the general welfare has to be By ALFRED HILL, M.D.,

performed, the only way to ensure its performance

is to make it compulsory; to make the Act simply Medical Officer of Health for Birmingham.

permissive would inevitably mean failure from nonWHETHER Lord Bacon did or did not say that compliance on the part of some, where it is essential 'knowledge is power' matters little compared with

that compliance should be made by all. It is rather the importance of the truth expressed in the dictum.

late in the day for medical men to display such Without a knowledge of the causes, symptoms, and

extreme sensitiveness on this point, and to treat it treatment of a disease, we should possess very little

as though it were a new principle and practice. power to alleviate or cure it ; but without a know. They are accustomed to notify under compulsion ledge of its existence, none at all.

the deaths of persons whom they have attended ; In order to prevent the spread of disease, and the

and although it is true that when this measure was possibility of one or two cases developing into a

originally proposed it met with similar opposition to widespread and fatal epidemic, a knowledge of the that now exhibited to the notification of disease, it existence of first cases is indispensable. The im

became law; and while it proves a great public portance of this knowledge, I presume, will be advantage, it is found to be in no way detrimental almost universally admitted. There is only one way

to the interests of the medical man, or hurtful to his of obtaining such knowledge, and that is by means

amour propre. Compulsion again is seen in the laws of notification, the imparting of it or making it

in respect of registration of medical men, and of known to the proper person or authority.

their services as scientific witnesses, in respect of the Leaving out the small section who deny the

sale of poisons, and more heavily still with regard to desirability of notification at all as too insignificant the provisions for the practice of vivisection. Under in number to demand attention, there are two classes these circumstances, it seems difficult to understand of those who agree that notification is desirable, why, when another service inseparably connected who stand in opposition to each other as to the

with professional duty, and inferior to none of the question, on whom should the duty of notifying de others in importance, is required in the interests of volve? This question is one not so much exercising public health, there should be such a violent opposithe mind of the general public as that of the mem

tion to its imposition. It seems to me that the bers of the medical profession, but it is one upon dignity of medical men, instead of being injured by which, on this account, it is very desirable there the performance of the duty required, would be should be as nearly as possible unanimity of greatly magnified and enhanced. All law is associopinion and action among medical men, as it is

ated with compulsion, which is as indispensable to with them and them alone that primarily the duty control the action of non-medical men as of medical. of notification of some kind must rest, and without

This is seen in the registration of births, vaccination, whose co-operation any notification of a thoroughly education, regulation of hours of labour in mills, efficient kind is impossible. There is a difficulty, manufactories, and other places, service on juries, however, in obtaining this unanimity, and while one

and numerous other matters, and it is only because section of the profession fully admits the import- it is impossible to accomplish the object in view by ance and necessity of notification, and is willing to voluntary action that penalties become necessary. carry it out, another, and, I believe, a smaller and It has been urged by one opponent of compulsory still diminishing one, strenuously resists all attempts notification that the voluntary principle is the true to impose the duty upon them, maintaining that it one, that it has been known to succeed, and he does should be imposed solely on the householder or

not see why it should not be adopted everywhere. guardian. At first sight there is a certain amount

There is a simplicity about this view which renders of reasonableness in this view of the case, but even

any serious consideration of it unnecessary. this disappears when its advocates proceed to argue

No one will deny, I presume, the value for various that where notification is in operation it has had the

purposes of the certification by the medical man of effect of doing harm rather than good. If this is

cases after death, but it is of little use as regards the their opinion, instead of declaring that they are in prevention of disease, because it comes too late ; favour of early notification as an abstract proposi- notification seeks to remedy this defect by giving to tion, they should, to be logical, declare themselves the sanitary authority the earliest information opposed to it, unless they are prepared to prove that possible of the case, by which not only may the best notification by the householder is beneficial, while

be done for it in the way of removing causes, and by medical men it is injurious.

rendering assistance in various ways, so as probably I propose here to consider the alleged objections to prevent a fatal termination, but also to prevent to compulsory notification by the medical attendant, the spread of the disease to other members of the as it is these which constitute the chief obstacles or

household and to neighbours. The causes of the difficulties with which notification has to contend.

disease are often not inquired into by the medical The first of these is the compulsory character of attendant, who is apt to regard his duties more as the duty, the compulsion pure and simple, no objec- curative than preventive ; it is seldom that he makes tion being made to the proposal to put compulsion discovering sanitary defects, whereas the duty of a

a searching examination of a house with the view of Paper read at the Conference organised at the International medical officer of health is not to meddle in any way Health Exhibition by the Society of Medical Officers of Health, the Sanitary Institute of Great Britain, and the Parkes Museum of

with a patient, but to seek for any existing defect in Hygiene, on June 13, 1884.

the sanitary arrangements of the dwelling. Let us



take a common case ; a me nber of a fainily may be The voluntary system answers very well in the suffering from diphtheria or typhoid fever, which the case of cholera, because so great is the alarm and medical attendant may skilfully diagnose and treat, even horror excited by the disease, that it is pracbut he may content himself with some general in-tically compulsory, in other words, that result is quiry as to the sanitary condition of the house and effected by fear which is denied by reason. But in its surroundings without making a rigorous investi- the case of a disease of which there is no fear, such gation ; the cause of the illness may be probably a as scarlet fever, although it is a thousand times more sink or cellar drain in direct communication with destructive to life, the voluntary system breaks down the sewer, or it may be a faulty water-closet, leaky altogether. Instead of the medical man reporting soil pipe, a polluted well, or some similar defect, every case of preventable disease, he reports only discoverable only by such an investigation as would such as he chooses; he will report for instance the be made by the medical officer of health. If this case of a domestic servant whose presence in a large exciting cause of the illness be allowed to remain and respectable family is considered objectionable, during the illness, there is little likelihood that the and whose removal is therefore desired, and she is patient will recover, but if speedily removed the removed to the hospital accordingly, but the next probabilities of recovery are iinmensely enhanced, case he may for special but insufficient reasons causâ sublatâ tollitur effectus. So that not only is decline to notify, although the danger to the public the recovery of the patient rendered more likely, but may be as great in the one case as in the other. the dangers of the spread of the disease are likewise There is generally no reticence in publishing to diminished. This illustration will serve to indicate the whole world the illnesses of Royal or disthe value of early notification, and one of the tinguished personages, and in much more detail directions in which it is calculated to be of ad- than is required for the protection of the public vantage.

health, while in notification of disease to the sanitary The objection to voluntary notification is that it authority there is no publication at all, there is is incomplete, and, as human nature is constituted, simply intimation accepted in confidence and acted probably ever must be. but unless complete it is upon with the sole view of benefiting the patient useless for the prevention of epidemics; it is and the community. Notification to be of real value only because of its incompleteness, and, therefore, must not be optional but imperative, it must not be uselessness under the voluntary system, that it is sub-ordinated to individual interests or caprice, benecessary to resort to compulsion. The value of cause it is then too uncertain, too impartial, and complete notification was well seen in Birmingham frequently too late. As a fact I frequently receive during the early days of the present visitation of from the medical man notification of cases of small-pox. This disease is one which from its rarity, zymotic disease after being attended by him for and from the dread of it in the minds of the public, several weeks, and sometimes after the death of the is more likely to be spontaneously notified than any patient. This is under the voluntary system which other ordinary zymotic ; the consequence was that obtains in Birmingham, although for such informafor many months the disease could get no footing in tion a fee of five shillings is paid. To expect effithe town, because under the influence of fear every cient, that is, complete notification by voluntary case was notified to me directly on its nature being means, is to ignore all past experience, and to dismade out ; over many months seventy-seven sporadic play a credulity which would discredit an intelligent cases were reported, with the result that the disease child. was prevented spreading by means of isolation, dis- Another alleged objection to notification by the infection, &c. ; but in time cases occurred which medical man is that it leads to the concealment of were not reported, and then the disease, liberated cases, and consequent spread of disease, but the from control, rapidly became epidemic ; as long as proof of this has never been forthcoming, and every case was reported the epidemic was pre- the objection rests mere assumption.

Let vented, but no longer. The voluntary system us hear on the contrary what is said by some who answered for a time, but soon broke down as it have had experience of the actual working of the always will do, and as it always has done from time compulsory clauses, for a little practice is worth immemorial to the present. The experiment has much hypothesis, however ingenious. Dr. Butterbeen made so long that it is unnecessary to continue field, when Medical Officer of Health of Bradford, it; it has indeed lasted too long, and to continue it wrote, “As to the allegation that people would constill is altogether unjustifiable. Of the three hundred ceal infectious disease, and not send for medical practitioners in Birmingham only one hundred and advice for fear of having the case reported, I can eighteen have ever voluntarily notified.*

safely say that such has not been the case in this town.' The Mayor of Macclesfield says, Our ex

perience is that compulsory notice does not tend to • In reference to this statement, Mr. Lawson Tait, F.R.C.S., wrote

The Mayor of to a daily contemporary : The experiment has been conducted by concealment, but rather the reverse.' the Health Committee, of which I am chairman, and I am not aware Oldham gives similar testimony, and the same with that they have expressed any opinion whatever to the effect that it is other towns ; while in Dundee it was found that a failure. Personally I regard it as a success, and the fact that nearly 2,400 cases were reported last year is sufficient evidence in there was less concealment of disease after notificasupport of my belief. In 1877, before the experiment began, we ad- tion was made by the medical attendant, than there mitted only 43 cases of scarlet fever to the hospital, while last year we admitted 638, a number much larger than we had satisfactory

had been previously when the duty rested with the accommodation for. The Town Council has just sanctioned an householder. It thus appears that there is no expenditure of 28,000l for a new hospital for scarlet fever, and last ground for the assumption of notification leading to year they distinctly refused to apply for powers to secure compulsory notification in the Consolidation Act. We believe, therefore, that

concealment, and if there were, it would constitute compulsion is wholly unnecessary. There are only 257 practitioners in the Medical Directory' returned as practising in Birmingham, householder or the medical man, and is therefore an

an argument against notification, whether by the and of these I believe there are only 140 practising in such a way as to be likely to be called upon to deal with infectious diseases within argument against notification altogether. the municipal area. As Dr. Hill tells us 118 have notified voluntarily, It is further asserted that compulsory powers prowe may take it that there are only some 22 whom we have yet to convert to our views.'

mote antagonism between the medical practitioners


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