dried. Afterwards an antiseptic dusting powder should be freely used, and care should be taken not to dust healthy areas of skin with a powder-puff or cotton wool which has been applied to affected parts. The child should be swaddled in cotton wool and kept warm.

In grave cases, especially of the septicemic type, treatment must usually be symptomatic. Vaccines have been tried in several outbreaks, notably in the United States, but without apparent success. Having regard to the present uncertainty as to the bacteriology of the disease, it is doubtful if their use is justifiable.

Prevention.

The serious nature and high mortality of some types of the disease, its contagious character, and the knowledge that some persons who are sources of infection and agents of spread remain infective for a long period, make it very desirable to utilise every practicable means of prevention. The first requirement is early diagnosis of cases and an immediate report to the Local Supervising Authority, in order that prompt enquiry may be made to discover the person who is responsible, and the manner in which infection is being contracted. In some outbreaks enquired into by Medical Officers of the Ministry the information was obtained that none of the cases had been seen by a medical man in the early stages because the midwives who attended either had not called in a doctor at all or had not done so until the infants were practically in extremis. When a midwife or nurse is suspected of being the agent of spread, she should be suspended from practice at least until an examination has shown that she is free from any sign of infective illness which can be detected by thorough medical inspection, and until satisfactory evidence is forthcoming of disinfection of person, wearing apparel, equipment and other belongings. Until we know precisely the mode or modes in which the disease may be spread it is justifiable that disinfecting measures should cover a wider range than may hereafter be found to be sufficient; and this is an adequate reason for the sterilisation of rooms and furniture which is usually carried out in maternity hospitals where serious outbreaks of the disease have occurred.

For personal disinfection a daily bath of one in two thousand bichloride of mercury solution has been recommended. It is advisable that, on resuming practice after suspension, the midwife should be required to report immediately all births attended by her in order that they may be regularly visited with a view to detecting new cases in the earliest possible stage.

MINISTRY OF HEALTH,

WHITEHALL, S.W.1.

May, 1925.

I am directed by the Minister of Health to refer to the last paragraph of Circular 558, and to state that he has caused to be published in the London Gazette of the 22nd May, 1925, a Notice containing in the Schedules descriptions of the certificates, labels, marks and stamps which will be recognised as Official Certificates for the purposes of the Public Health (Imported Food) Regulations, 1925, from the date of commencement of the Regulations (i.e., the 1st June, 1925).

A copy of the Notice is appended to this Circular.

Further copies of this Circular may be obtained through any bookseller, or directly from H.M. Stationery Office, at the addresses shown below.

APPENDIX.

Notice inserted in the London Gazette of 22nd May, 1925.

NOTICE.

PUBLIC HEALTH (IMPORTED FOOD) REGULATIONS, 1925.

The Minister of Health hereby gives notice in pursuance of the above-named Regulations that he will recognise from the date of commencement of the Regulations each of the Official Certificates of which particulars are given in the Schedules hereto as evidence that the meat to which it relates has been derived from an animal which was free from disease at the time of slaughter and has been dressed or prepared and packed with all necessary precautions for the prevention of danger to public health.

The recognition is subject to the conditions set out in the headings to the schedules, and where the certificate is in the form of a label the recognition will apply only if the label is securely affixed to the meat or to the package containing the meat and if the label has not in any other circumstances or on any other occasion been used as an Official Certificate.

FIRST SCHEDULE.

Certificates recognised for the purposes of items (a) and (c) of the Second Schedule to the Regulations, i.e. :

(a) A severed part of the carcase of a pig (including the severed head and the whole carcase without the head) which has not been salted, cured, pickled, dried or smoked or otherwise prepared in the manner in which bacon or ham is ordinarily prepared, and from which no submaxillary, pre-scapular, pre-crural, or popliteal gland has been taken out;

(c) All edible parts of a pig other than (i) the head or other severed parts of the carcase and (ii) the intestines prepared in the form of sausage casings.

I.-Argentine Republic.

A mark or stamp with the subjoined representation or design with or without the addition of a number signifying the official number of the slaughter-house, and impressed in blue upon the package, or upon a label.

A label having on it a stamp or design and a certificate in the form set out below, except that for the words "New South Wales " may be substituted the name of any other State comprised within the Commonwealth of Australia, and that the signature of the Inspector is to be added.

III.-Belgium.

1. A label having on it a design and certificate in the form set out below, the certificate being completed by the insertion of the name of the Commune, the number of the slaughter-house, the date of certification and the signature of an authorised officer.

Meat inspected for export according to the Belgian Royal Decree of 23 March 1901.

Vleesch goed verklaard voor den uitvoer krachtens het Belgisch Koninklijk Besluit van den 23" Maart 1901