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appointed a military member of the County Association, buthas now retired with the rank of Lieutenant-Colonel of theRoyal Army Medical Corps, T.F. He has also received theV.D. He has been a member of the town council for 20

years and has done good work on the sanitary committee, ofwhich he is chairman, and also in connexion with the isola-tion hospital. Eleven years ago he was unanimously calledto the office of mayor, which he filled with success. Besidesbeing chairman of the free library committee and the museumcommittee, Mr. Appleby is connected prominently with severaleducational undertakings in the borough over which he

presides.Oswestry.—Mr. R de la Poer Beresford, M.D. Glasg.,

L.R.C.P., L R.C.S. Edin., L.R.C.P. Lond., V.D. (re-elected)has served his borough in the capacity of medical officer ofhealth for 43 years, which makes him possibly the seniormedical officer of health in England. He is the senior

surgeon to the Oswestry Hospital and Dispensary and to theEllesmere Cottage Hospital, and surgeon to the Cambrian

Railway Company. He now holds the rank of Colonel,R.A.M.C., T.F., having received his first commission in theVolunteers in 1887.

Ruthin.—Mr. T. Owen Jones, L RC.P., L.R.C.S. Edin.,L.F.P.S.G. (re-elected), received his medical education atAnderson’s College, Glasgow, and qualified in 1894. Heobtained the appointment of medical officer of health of theRuthin rural district in 1898, when he went to residein that district. He is deputy medical officer to H. M.Prison, inspector of school children, and lecturer andexaminer to the St. John Ambulance Association. For sixyears he was a member of the Ruthin town council. In1908, although not then a member of the council, he wasunanimously elected mayor, which honour he again receivedin 1909, and this year for the third time has beenunanimously chosen to occupy the mayoral chair.

Saffron Walden.-Mr. J. P. Atkinson, M.D. Glasg.,L.R.C.P. Lond., L R.C.S. Edin., was born in 1838. Afterserving a term of pupilage with Mr. Little, Mr. Young, and Mr.Adams of Boston, he proceeded to Glasgow University, wherehe received his medical education, and graduated as M.D. withhonours in 1863, having previously passed the examinationfor the diploma of the Royal College of Surgeons of Edin-burgh. In the same year he took the L.R.C.P. Lond.

Subsequently he settled at Bampton, Oxon., but removed in1881 to Saffron Walden, and finally retired from practice in1908. He entered the town council of the borough of SaffronWalden in 1888 and in 1891 was elected mayor, being re-elected in the following year. He was again appointed in1900 and re-elected in 1901, and was mayor at the time ofthe Coronation of the late King Edward VII. and received

, the Coronation medal. This year he has been elected

mayor for the fifth time. Dr. Atkinson joined the medicalstaff of the 3rd V.B. the Suffolk Regiment, received the V.D.in 1904, and retired with the rank of surgeon-colonel in 1905.He has represented the town council on the joint isolationhospital board, of which he has been chairman since its

incorporation in 1903, is a member of the Essex CountyTerritorial Force Association, and has represented the

borough on the Essex county council, and also on the

county association recently formed for combating con-

sumption.Warrington.—Mr. G. W. Joseph, M.D. Darh., L.R.C.P.I.,

M.R.C.S. Eng., L.S.A., is an ex-president of the WarringtonMedico-Ethical Society and was lately medical officer ofhealth and public analyst for the borough of Warrington.

Wrecham.—Mr. S. Edwards Jones, L.R.C.P., L.R. C.S.Edin., L.F.P.S.G., who received his medical education atAnderson’s and St. Mungo’s Colleges, Glasgow, qualified in1892. He was a prizeman in medicine and operativesurgery. After holding the appointment of senior housesurgeon at Glasgow Royal Infirmary in 1893-94 he com-menced private practice. He has been a member of theWrexham board of guardians and rural district council since1905 and takes a keen interest in all public health matters.At one time he was medical officer of health for the combinedborough and rural districts of Wrexham. In 1906 he waselected a member of the Wrexham town council and hasbeen chairman of the health committee for three and a halfyears. In 1909 he was returned to the council withoutopposition and successfully advocated several importantimprovement schemes with regard to the health of theborough.

MEDICINE AND THE LAW.

Macrae v. Harness : The Care of an Infant Mentally Defective.Mr. Justice Swinfen Eady was occupied for six days in

hearing and deciding in the Chancery Division the claim ofDouglas Gordon Macrae, a young man suing through thecommittee of his estate his step-mother, Mrs. Harness. Theaction was brought to obtain a declaration that money paidby the lad’s trustees to the defendant during the plaintiff’sminority for his maintenance and education had not beenproperly expended upon these objects and for an account ofthe money thus paid to her. Young Macrae was the sonof a wealthy man who died in 1901, leaving the plaintiff,a boy 15 years of age, and a daughter. From the estateof the deceased an income of about Z4000 a yearwas paid to his widow, whom he had married in 1897,and who was expected to keep up the principal residence ofthe deceased, a country house at Collingbourne. Oat of theother half of her husband’s estate the trustees allowed thislady £3000 a year in respect of the maintenance and educa.tion of her two step-children. The boy, according to herevidence, showed signs of mental weakness during his father’slifetime, giving trouble at home and at two schools which hehad had to leave. In 1901, when the father had died, the con.clusion was arrived at that the plaintiff’s mental conditionrequired special care, and the following provision was provedin the course of the case to have been made for it. At firsta house was rented on his account at Eastbourne, where heresided under the care of Mr. H. N. Harness, a medical manwho had been called in to attend him in London. Mr. Harnessremained in charge until March, 1902, and then left. The

patient remained at Eastbourne until December, 1902, thecost of his maintenance there being at the rate of B1200 ayear, £50 per month having been paid to Mr. Harness duringhis care of the case. In December, 1902, Mr. Harnessbecame engaged to Mrs. Macrae, whom he married in thefollowing February. In January, 1903, Mr. Harness hadarranged with Dr. Harry Corner that the boy should be takencharge of by him in a private home at New Southgate,the payment to be 4 guineas a week, to include board,lodging, laundry, and medical attendance, and an additional2 guineas a week for a private attendant to sleep in thepatient’s room. According to Dr. Corner’s evidence, thequestion of expense was to be considered, and, as a matterof fact, the inclusive charge was eventually reduced to5 guineas per week, when it was considered that the patientwould require less exclusive attention. At one time when£20 extra per month was charged in respect of the necessaryemployment of extra nurses, Dr. Corner was informed by Mr.Harness that this was more than could be afforded. The ladimproved under Dr. Corner’s care and was reported to theCommissioners in Lunacy as having no symptoms of insanity.In July, 1904, young Macrae, who had been removed fromDr. Corner’s establishment, was placed under the care of amedical man at Farnborough, an arrangement being made forthe payment of 6 guineas per week, to include an attendant,not necessarily trained, and not more than £1 for amusement.Evidence was given by this medical man’s wife that Mrs.Harness in an interview with her said that she would alsopay for anything very necessary or urgent. The limit of£1 a week for amusements was denied by the defence. The

expense of a special attendant during a trip to Ireland wasrefused. The plaintiff remained at Farnborough for 18 monthsand then went back to his relations, living with them at ahouse where Mr. Harness did not himself reside, but wherehe spent his week ends. At a later date the plaintiffwas placed in the care of Mr. A. Moore at Pailton Hall,near Rugby, where the provision for him, if proportionateto the payment made for it, was in the opinion of Dr.F. Bryan, who visited him in January, 1908, at the instanceof the lunacy authorities, wholly inadequate and unsatis-factory, and where the treatment included the use ofmechanical restraint and of drugs, stated to be chloral andhyoscine, in quantities sufficient to be injurious to the patient.One of the attendants employed was a groom or stable helper.The attention of the lunacy authorities had by this timebeen called to the case, and as a result of the inquiry held bya Master in Lunacy the plaintiff was placed under the careof Dr. Bryan, and since then had improved markedly inhealth. In the opinion of Dr. Bryan the treatment with drugs

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to which the plaintiff had been subjected would have beenlikely to endanger his life if persevered in. It was stated

by Mr. Harness that the treatment given by Mr. Moore,including the drugs used, was according to the recommenda-tion of Dr. Krumbholz, whose instructions Mr. Moorefollowed. Mr. Moore was not called as a witness, andan application was made to the judge at the close of the

evidence that he might be allowed to make a statement inview of what had been said with reference to him. Un-

fortunately his lordship was not able to permit this, but hereferred in his judgment to the hardship of the circumstancesin which Mr. Moore was thus placed. It may be observedthat with regard to the gentlemen in whose care the plaintiffhad been, and who gave evidence, it was not alleged thattheir treatment was other than proper and in accordance withthe amount of the sum paid for the accommodation, board,and attendance arranged for on the plaintiff’s behalf. In

giving judgment Mr. Justice Swinfen Eady reviewed theevidence, laying stress upon that of Dr. Bryan as tothe improvement in the lad’s condition under hischarge, and it should be stated that the arrangementsanctioned by the court with regard to this allowed thespending of an annual sum of .E1700 for the plaintiff’smaintenance. In reviewing the negotiations and arrange-ments entered into by Mr. Harness, his lordship heldthat it was not a question with him of what shouldbe done in the boy’s interest, but of economy. Itwas clear, he added, from the cross-examination of Mr.Harness, that the relatives of the boy had not been consultedwith regard to his removal from Dr. Corner’s home, and thata statement made by Mr. Harness in a letter to Dr. Cornerto the effect that the relatives were agreed that he must beso removed, because the extra payments of £ 20 a monthcould not be afforded, was untrue. " It is quite impossible,"his lordship said, "to read Mr. Harness’s letters without see-ing that the boy’s welfare was the last consideration andeconomy the first." Mrs. Harness’s statement that the boywas removed from Dr. Corner’s care because Mr. and Mrs.Harness wanted him at home was, in his lordship’sopinion, absolutely untrue. He expressed himself as satis-fied with the evidence of the medical men with whom theplaintiff had resided, and where their evidence came intoconflict with that of Mr. and Mrs. Harness he believed theformer and not the latter. After referring in detailto the period spent at the house of Mr. Moore and tothe fact that when it was telegraphed to the defendant toNorway that the lad was worse she did not return but onlytelegraphed back that he should be removed to an asylum,his lordship save ludsrment in the plaintiff’s favour. Theissue to be determined was whether during the time involvedhe had been maintained in a reasonable and proper manner

having regard to his position and means. His lordship wasof the opinion that he had not been so maintained, and thatMrs. Harness had failed to discharge her duty as his

guardian. He said a declaration would be granted to thateffect, and also a declaration that the defendant was liableto account for 18,847 paid to her by the trustees betweenApril, 1901, and August, 1907, when the plaintiff came ofage, proper deductions to be made in respect of expenditureupon the education and maintenance of the plaintiff and hissister. The costs of the action he ordered to be paid by thedefendant.

LITERARY INTELLIGENCE.-Mr. H. K. Lewis willpublish almost immediately a new work dealing with the neworganic arsenic compound 11 Diamino-dioxy-arseno-benzol,"the famous " 606," which is intended to provide in a handyand condensed form information not readily accessible else-where. Recent English and foreign literature on the subjectis given. The writers are Mr. W. H. Martindale and Dr. W.W. Wynn Westcott, the well-known authors of the" ExtraPharmacopoeia." " The same firm has also just ready a mono-graph on "Meningitis, Sinus Thrombosis and Abscess ofthe Brain," by Dr. John Wyllie, author of " Tumours of theCerebellum." The work contains appendices on LumbarPuncture and Diseases of the Nasal Accessory Sinuses.-Messrs. Bailliere, Tindall, and Cox inform us that theyhope to publish early next year an English edition ofBrunings’s "Direkte Laryngoskopie," with some additionalmatter, bringing it right up to date, supplied by theauthor.

Public Health.ANNUAL REPORTS OF MEDICAL OFFICERS OF HEALTH.

The City of Nottingham.-Dr. Philip Boobbyer deals inhis current annual report with the sanitary circumstancesof a population of 263,441, the general death-rate ofwhich for 1909 was 16-20 per 1000, while the birth-rate was 25’ 6 per 1000; the infantile mortality figureamounted to 150 per 1000 births. There has been a

marked fall in the percentage of children successfullyvaccinated within recent years, and in the first half of1909 there were no fewer than 1728 certificates of exemptionobtained as compared with 829 in the previous half year. Asto any administrative methods Dr. Boobbyer observes that"conscientious objection as interpreted by the averageobjector is not only broadly farcical in itself but is rapidlyreducing compulsory vaccination to something of the sameorder," and he adds that the gratuitous statutory provisionfor escaping vaccination is so simple that it is regarded bymany persons as an authoritative encouragement to evadevaccination, a statement which is, in our opinion, quite a.moderate one. Commenting upon the employment of diph-theria antitoxin Dr. Boobbyer refers to the large number ofcases of diphtheria in which the use of this absolutely essentialtreatment has been neglected, and he states that cases arefrequently sent into hospital which have received no serum,although the disease has been diagnosed for several days, andthis notwithstanding the fact that the antitoxin is distributedgratuitously for the use of poor patients. The death-ratefrom enteric fever was 7 per 100,000, as compared with a rateof 3 for London and 6 in England and Wales generally. As

is well known, Dr. Boobbyer attributes the excessive entericfever death-rate of Nottingham largely to the persistence ofthe conservancy system of excrement disposal, and his annualreports for several years past contain some very instructivedata upon this subject, as well as with reference to a highdiarrhoea mortality, which is also attributed largely to the re-tention of the pail system. Writing upon the subject of tuber-culosis, attention is directed to the provision in the groundsof the isolation hospital at Bagthorpe which is intendedpartly as an educational establishment and partly as a

hospital. During 1909 the average stay of the patientswas a little under three months, the weekly chargebeing 10s. ed. One of the most interesting featuresin connexion with the Bagthorpe Hospital is the prac-tice which has now obtained for some years of nursingcases of acute specific disease as far as practicable in theopen air. Experience shows, Dr. Boobbyer is confident, thatcases thus dealt with do better than in the ordinary wardsand no untoward results have accrued. As regards what isknown as the barrier" system of treating cases of in-fectious disease-that is to say, the isolation or insulation ofeach patient’s bed in a space by itself by means of a screen,cord, or tape-Dr. Boobbyer thinks that it is an excellentprecaution against contact, which he regards as the principalmeans of infection, and as a method of impressing upon nursesand others the full meaning of physical isolation. He thinks,however, that the system is very difficult to carry out in its

entirety with young patients of the poorer classes and with alimited nursing staff. In his opinion the open-air treatmentabove referred to is preferable, so much so that he is advo-

cating the alteration of all the ward blocks so as toafford facilities for such treatment- i. e., the provision ofan open verandah extending along the entire side of eachward block and communicating with the wards by Frenchcasement windows extending to the floor. The advantage ofhospital accommodation for patients suffering from entericfever is emphasised by Dr. Boobbyer, and we quite agreewith him that it is rarely possible to properly nurse athome patients suffering from this disease. The Notificationof Births Act, 1907, has been in force in Nottingham sinceMay, 1908, and during 1909 there were 4900, or 73 per cent.of all the births registered, notified. It is, of course,provided by the Act that all births shall be notified,but the number above given includes all thosein whichuseful action can be taken by the sanitary authority.The number of certified midwives amounted in 1909to 86, and of these 50 per cent. were engaged in active.

practice. ,