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I may claim to have a somewhat intimate knowledge of local Isanitary conditions.

I

I am, Sirs, yours faithfully, - -

Gibraltar, March 7th, 1907.OLIVIER L. ROBINSON,

Major R.A.M.C.

THE ELECTIONS OF GUARDIANS.To the Editors of THE LANCET.

SIRS,-In a few days there will be an election of guardians.May I impress upon your readers the importance of securingthe nomination and election of candidates who are in favourof outdoor relief of deserving aged poor where prac-ticable, and of making such out-relief adequate ? TheLocal Government Board itself issued a circular to thiseffect in August, 1900 (which may be bought for 2.), anduntil old-age pensions can be obtained this is far betterthan offering to the veterans of industry a painful choicebetween the workhouse and starvation or at least greatdestitution. Also, it is most important to elect guardianswho will give outdoor medical relief (in the first instance)to all poor persons unable to pay a medical man, without

Iplacing obstacles in the way such as making the relief aloan, or requiring the patient (or in the case of a child, aparent) to appear before the guardians. Of course, when themedical man has seen the patient he can decide whether itis a case to be treated at home or in the Poor-law or someother infirmary or hospital. The great point (for the publichealth) is to take care that cases of illness come beforethe medical man at a very early stage. By this means wemay check infectious diseases such as measles, whooping--cough, fevers of various descriptions, and phthisis. Cuttingdown medical relief is dangerous to the public health.

I am, Sirs, yours faithfully,J. THEODORE DODD,

A Guardian and Councillor of the City of Oxford.March 12th, 1907.

MANCHESTER.(FROM OUR OWN CORRESPONDENT.)

Yictoria University,THE acceptance of the office of Chancellor of the Victoria

University by the Duke of Devonshire in succession to EarlSpencer, who retired on account of ill-health, has beenreceived with general satisfaction. It may not be remembered

by all that the present Duke’s father was Chancellor of theUniversity, so that the Devonshire family has taken anactive interest in its progress from very early days.

Medical Degrees at the Victoria University.At a meeting of Convocation on March 6th a communica-

tion was received from the registrar relating to the proposedconditions of award of degree of Doctor of Medicine, whichhad been approved of by the Senate and Council. They hadstill to be drafted as ordinances and regulations It was

provided, among other things, that-(1) No candidate will be admitted to the degree of Doctor of Medicine

unless he has previously received the degrees of Bachelor of Medicineand Bachelor of Surgery; (2) candidates shall produce evidence ofhaving, subsequently to having received the degrees of M.B. and Ch.B.,been engaged tor at least one year in attendance on the medical prac-tice of a general hospital or on the practice of special hospital or lunaticasylum, or in scientific work bearing directly on his profession such asis conducted in the medical departments of the University, or alter-nately of his having been engaged for at least two years in practiceother than practice restricted to surgery ; and (3) candidates may electeither (i.) to present an original dissertation or (ii.) to undergo anexamination.

This was accepted and approved.A Descendant of Hzcg3 Oldham.

Manchester has a strong feeling of regard for its GrammarSchool, founded in 1515 by Hugh Oldham, Bishop of Exeter,and is interested in the public bequests of the late Mr.Charles James Oldham, F.R.C.S., of Brighton, a descendantof the bishop, chiefly perhaps because he left z23000 to theGrammar School, together with half the residue of his estate,which may amount to from .67000 to <810,000. The legacyof Z3000 is I Ito be applied for the advancement of learningas the authorities may think fit." Another clause in thewill suggests that he may not have been altogether freefrom the prejudices which we sometimes call insular. He"peremptorily requested and desired that no person be

appointed as an additional trustee or executor of his will

who shall be either a solicitor, a Jew, or a German, althoughhe may be a British subject, but that he desired rather thata competent business man in a responsible position, suchas a bank manager, shall be appointed to such post."

Emergency Cases at Poor-laqz-, Hospitals.At a recent inquest by the city coroner it was stated that

a woman was kept waiting in a cab outside the Withingtonworkhouse hospital for 35 minutes when suffering fromsevere burns from which she died. The jury suggested thatprovision should be made for the speedy admission of suchcases. The clerk to the guardians said that no one couldregret more than they did that there should have beensuch delay, but that the workhouse hospital was underthe Poor-law and was purely a pauper establishment for theadmission of paupers and not an emergency hospital, such asthe Manchester Infirmary and the Ancoats Hospital. In this

particular case the medical officer was at the very farthestpossible point from the porter’s lodge attending to a seriouscase, and if found at once he would have been some time ingetting to the lodge. It must be remembered that the work-house is a very large establishment. The board has decidedto establish a special ward where emergency cases can beadmitted at once. It is, no doubt, against the Poor-lawtheory that non-pauper cases should be admitted but it caneasily be understood that the friends of a patient would seekthe nearest place where treatment could be obtained.

The New Asylum at Whalley.The block plan of the asylum at Whalley has received the

approval of the Home Secretary and of the Commissionersin Lunacy. The latter body says that the scheme generallycommends itself as having advantages in concentration andeconomy of working. The estimate of the funds requiredfrom April, 1907, to March, 1908, amounts to Z142 517, andthe finance committee of the Lancashire Asylums Board,having regard to the fact that the average weekly cost ofmaintenance was more than the present charge to the unions,does not think it at present advisable to make any reduction.March 12th.

LEEDS.(FROM OUR OWN CORRESPONDENT.)

Appointments at the General Infirmary.ACTING on the recommendation of the Faculty, the board

of the infirmary has appointed Mr. J. A. Coupland surgicalregistrar in succession to Mr. H. Collinson who was recentlyelected assistant surgeon in charge of the convalescent hos-pitals. Mr. Coupland has during the last two years held theposition of resident surgical officer at the infirmary and at ameeting of the Faculty held on March 8th Dr. L. R.Braithwaite was elected his successor. Dr. Braithwaite, likeMr. Collinson and Mr. Coupland, had a distinguished careerat the Leeds School of Medicine.

The University.The written examinations for the second M.B., Ch.B.

degrees will begin on Monday, March 18th, and that for thefirst part of the final examination on the same day. In ac-

cordance with recent regulations, which direct that Part II.of the final examination shall be held in July and December,there will be no examination in the subjects included in thispart of the examination at the end of this term. In futureit has been arranged that the examination in Part I. of thefinal shall also be held in July and December. The vivd-voceand practical examinations will follow immediately on thewritten examinations and the results will be announced onthe evening of March 22nd. The work of the term will notend until March 27th and the summer term will begin onApril 22nd.The Association for the Prevention and C1f,re of T1f, &ugrave;erculosisA perusal of the seventh annual report of the Association

for the Prevention and Care of Tuberculosis shows that theuseful work of this chatity is being carried on with con-tinued success and that it is increasing. The total numberof patients under treatment during the past year at thesanatorium at Gateforth and at the country hospitalamounted to 278, which is an increase of 112 as comparedwith the previous year. The results of the treatment havebeen encouraging in many ways. A very useful additionto the accommodation has been made by the provision atArmley Hospital of a Doerker barrack which provides

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for the treatment of eight patients. In appealing foran increase in the financial support of the institutionsthe committee calls attention to the present sources ofincome. This income amounted during 1906 to only<S4097, and this includes a sum of -&2000 received under anagreement with the city council whereby the society under-takes the treatment of a certain number of cases. Annual

subscriptions are represented by the sum of .61595. TheBradford guardians contribute .6122 in respect of the treat-ment of patients from their union, and the rent, ,6120, ofArmley House, which is used for the acute cases, is

generously contributed by Mr. Henry Barran, a memberof the committee. The association possesses no investedfunds, and being a charity which deals with a disease whichclaims in the city almost as large a mortality as all the acutefevers added together-namely, 570 as against 587 deathsrespectively for the year 1906-it deserves an amount ofsupport which as yet has not been extended to it.March 12th.

SCOTLAND.(FROM OUR OWN CORRESPONDENTS.)

Presentation to Sir Henry D. Littlejohn,ON March 8th Sir Henry D. Littlejohn, medical officer

of health of the city of Edinburgh, was presented withhis portrait, painted by Sir George Reid. The movementwas initiated when Sir Henry Littlejohn resigned thechair of forensic medicine in the University. The pre-sentation took place in the Royal College of Surgeons,the President of the College occupying the chair. Therewas a large gathering of representatives of the legaland medical professions, several of the lords of session

being present. The presentation was made by Lord

Stormonth-Darling who spoke both as an old friend and

pupil in appreciative terms of Sir Henry Littlejohn’s powersas a teacher and as a medical jurist. Dr. John Smith spokeas his oldest medical friend. Sir Henry Littlejohn in aracy and humorous speech acknowledged the honour whichhad been conferred upon him.

.4dniission of TT’o?nen Dentists.At the annual general meeting of the Odonto-Chirurgical

Society of Scotland it was stated that a new departure hadbeen made in connexion with the society by the admission oflady members. The rules of the society had been modifiedin order to enable it to welcome them.

Inspection of Imported Meat.The public health committee of the town council of

Glasgow has been considering this week the whole questionof the inspection of meat imported into the city from othercountries. The question has been raised by the corporationveterinary surgeon, who reported that in the course of hisduties on Feb. 18th and again on the 20th he seized as unfitfor human food a foreleg of chilled beef deposited in themeat market on the stance of the agent of one of the largestmeat exporters in the United States. Each foreleg wasmarked " U.S. Inspected and passed. 3

" On examinationeach foreleg was found to have the costal pleura strippedfrom the ribs but at places distinct tuberculous nodule,remained and on incision glandular invasion was manifest.These forelegs were parts of carcasses which in accordancewith the regulations issued by the Bureau of Animal Indu-tryto the Government meat inspectors detailed for duty inthe packing establishments of the United States ought tohave been rejected as unfit for human food and to havebeen used for the manufacture of tallow after the diseasedparts had been removed. These two cases seen to indicatethat meat inspection in the United States is not so trust-worthy as it ought to be. In the report of the Bureau ofAnimal Industry for 1905 it is stated in dealing with this

subject that during the year there were slaughtered in theUnited States 2 333,879 cattle, 3,346,451 sheep, 6,051,836swine, or a total of 11,732,165-making the average for eachworking day 37 482. The number of inspectors is given as40. It therefore follows that, to overtake the examinationof 37 482 animals, each inspector will require to examinethe carcasses and viscera of not less than 937 animals eachday. This calculation, however, does not allow for holidays orillness, otherwise the number of animals which would fall tobe inspected by each inspector would be materially increased.

Another aspect of this subject of meat inspection which hasfor some time engaged the attention of the Glasgowauthorities is the need for a uniform standard cf meat

inspection throughout the country. In Glasgow the PublicHealth Act of 1897 dealing with meat inspection is carriedout with considerable stringency, but unfortunately authoritiesoutside the city area do not exercise the same thoroughness.The result of this is that many doubtful animals, more

especially pigs, rather than be allowed to run the risk ofbeing condemned on reaching Glasgow, are consigned toareas outside the city where they are cured into hams andno doubt ultimately find their way by rail into the city.The only way for the Local Government Board to deal withsuch a state of matters is to demand a uniform standard of

inspection and no doubt the expediency of such a step willcome to be recognised in time.

The Gir(Jlnti Home for Inebriates.The corporation of Glasgow has decided to cease taking

into the Girgenti reformatory any new inmates ; to ask theSecretary for Scotland to arrange for the early removal ofall the present inmates to some other inebriate reformatoryor to the State reformatory at Perth ; and to di-continue atthe earliest possible date the use of Girgenti Home as aninebriate reformatory. The institution was started in 1900at the invitation of the Government to experiment with thenew Act dealing with inebriates. A sum of about .f:8000was spent in acquiring an estate under the assurance thatthe Government would practically give the corporation afree hand. No sooner had the property been acquiredthan the Government interfered and placed a considerablenumber of difficulties in its way before it was able to

open the institution, and after the institution was openedit was found that the Act which it was asked to ad-minister was sadly defective. The Secretary for Scot-land could give it no help, as he acknowledged thatin the meantime there was no prospect of legislation onthe subject. Also, in addition, notice had been received thatthe Government grant for patients would from April lst bereduced from 10s. 6d. to 7s. per head. The expdriment hascost the ratepayers of Glasgow about <81300 a year, and,although not entirely a failure as many women have beenreclaimed, yet it is not sufficiently a success to encourage theratepayers to carry it on without more support, financial andotherwise, from the Government.March 12th.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

&Eacute;v&Uuml;ltlllitJ Ccrebro-spinal Fever in Dublin.Up to March 12th no additional case of epidemic cerebro-

spinal fever has been reported to the public health authoritiesin Dublin.

Royal V’ational Ilospital for Co nS1l111pt ion.The annual meeting in connexion with the R03 al National

Hospital for Consumption for Ireland was held at the RoyalCollege of Physicians, Dublin, on March 8bh. The annualreport stated that there had been no further extension of thehospital at Newcastle during the past year. The number ofbeds is now 100, which was the number originally con-templated when the hospital was founded ; they have beenfully occupied during the year. The Registrar General said,in reference to the mortality from tuberculosis in Ireland,that the number of in 1905 was 11,882, representing arate of 2’ 71 per 1000 of the population, which means,taking the mortality from the disease in relation to thedeaths from all caues, that in every 100 deaths 16were victims of the malady. As regards tuberculousdisease in the Dublin registration area, for 1906 it caused1694 deaths, representing an annual rate of 4’47 per1000 of the population. In the registration area the deathsfrom the pulmonary form of the disease were 1152 innumber and represented an annual rate of 3’04 per 1000.Sir Charles Cameron, C.B., said that one of the most potentmeans of resisting the spread of tuberculosis was the im-provement in thn dwellings of the working classes. He

regretted that out of nine or ten sanitary authorities inDublin only three or four expressed agreement with theproposed establishment of a sanatorium. He stated, how-ever, that a sanatorium would be erected in Dublin by the