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neonatorum cases notified was 29. Four of the mostsevere cases were treated in the sanatorium. " Ulcera-tion of the cornea occurred in one case only, thiscleared up completely under treatment." Thefollowing scheme of precautions has been drawn upfor the use of the midwives :-

1. Directly the head of the infant is born wipe each eyewith clean cotton-wool. Use a fresh piece for each eye ;burn it after use.

2. As soon as the child is separated, wash the child’seyelids with a warm boracic lotion.

3. When first bathing the child use fresh water and aclean towel for the face and allow no bath water to enterthe eyes. After the bath open each eye and thoroughlywash out with a warm boracic lotion-a thorough irrigation.This is most important.

4. Then open the eyes again and drop into each eye onedrop of argyrol (10 per cent. strength). Drops of argyrolmust on no account be continued after the first day exceptthey are ordered by a doctor.

5. Continue ablution as stated in (3) daily during attend-ance.

6. At no time during the lying-in period use the mother’ssponges, napkins, towels, &c., for the child.

A ward at the sanatorium is set aside for infantssuffering from malnutrition, mostly for those attendingthe infant welfare centres who fail to improve.Dr. Forbes’s report gives full particulars of the workof the school medical department. He draws atten-tion to the increasing interest of the parents in thiswork, and expresses his warm appreciation of thehelpful and enthusiastic assistance given by the teachers.

Huddersfield.The annual report, for 1919 of the medical officer’

of health for Huddersfield consists of the usualtables and a short introductory letter, in which Dr.S. G. Moore tells us that " in accordance with instruc-tions it (the report) contains essential facts only."The Hegistrar-General’s estimate of the population is,for birth-rate 118,036 and for death-rate 105,346.Dr. Moore is of opinion that the establishment of" British Dyes " has caused exceptional immigrationand that the population was over 120,000. Even ifhe is correct, the error in the rates would not be avery great one. The death-rate for 1919 was 15’81and the infant mortality rate 95. The birth-ratewas only 12’66 and for the second year in successionthere have been more deaths than births in Hudders-field. In 1918 the births were 1575 and the deaths1737, and in 1919 the births numbered 1519 and thedeaths 1701. No wonder Dr. Moore writes: " Theleast satisfactory feature of the vital statistics of theborough is presented by the birth-rate." Duringthe influenza year (1918) half the 45 largest townshad death-rates higher than their birth-rates, butduring 1919 the only towns which kept Huddersfieldcompany in this respect were textile mill towns-namely, Blackburn, Bradford, Halifax, and Oldham.At the end of 1919 came the revival of the birth-rate, and in 1920 none of the 45 towns had a death-rate higher than the birth-rate, in Huddersfield thedeath-rate being about 13’0 in comparison with abirth-rate of about 18’0. Dr. Moore records that thesystem of voluntary notification of pregnancy, begunin 1916, " continues to confer benefits upon paido-poietics, both substantial in character and to a con-siderable extent..... The work proceeds smoothlyand agreeably to all concerned." During 1919.34 per cent. of the pregnancies were notified. Wemust enter a gentle protest against the introductionof the dreadful word "paido-poietics" to denotethe expectant mother. It may be a little illogical tocall a woman pregnant for the first time a

" mother,"even when qualified by the epithet " expectant,",but the Greeks used Dr. Moore’s term equally of.begetting and conception.

Barnstaple.In the health report for 1920 of the borough of

Barnstaple the estimated population is given as

14,270. There were 361 births in 1920 and 238 in1919. The death-rate in 1920 was 13-7 and the infantmortality rate 43’9. Dr. H. C. Jonas submits a verycomplete report of the work of the health and schoolmedical departments. The main industries of thetown. are lace manufacture, cabinet-making. gloving,agriculture, and (recently) shipbuilding. The tuber-culosis death-rate appears high, 2’3 for 1920 and 1.6for 1919. Among the matters reported as needingattention are the substitution of " proper coveredashbins for the filthv boxes which are still far toocommon," and the provision of public baths andschool baths. Satisfactory arrangements have beenmade for the treatment of the school children. Aschool dentist began work in April and is " pleasedwith the results so far obtained," but reports somereluctance to accept treatment both in the schoolwork and at the maternity clinic. The school nursealso acts as health visitor and thus overlapping isavoided. Of three schools reported in 1919 as

unsatisfactory, two have been renovated and theworst has been closed, army huts having been putup to provide the necessary accommodation. Dr.Jonas reports that the converted army huts makegood and airy class-rooms. Progress with the coun-cil’s housing scheme has been slow. The sites for200 houses have been bought and laid out. In themeantime an unhealthy area including 4 0 housescannot he dealt with. There is also great difficultyin getting repairs done so as to keep existing housesfit for habitation. The owners say they cannot dothe repairs, and owing to the shortage the councildoes not want any houses closed. This would seemto be a case where the local authority should do therepairs and recover the cost from the owners.

SCHOOL MEDICAL SERVICE.

Rutland County Council.-In his annual report for1920 Dr. C. Rolleston complains of the want ofcooperation between the public health and educationauthorities, and that " within no distant period therewill be two sets of officials visiting each home in thecounty, one on account of infant welfare, the otherfor the well-being of the school child." Nursingassistance is needed both for the ophthalmic surgeona.nd the dentist. The total number of entrants,interi2ie(iiates, and leavers examined during the yearwas 731. Parents attended 8t per cent. of theexaminations. There is a good deal of parentalopposition to the treatment of teeth and of tonsilsand adenoids. The percentage of clean children was84’9, of normally nourished children was 91, and 100of the 731 examined were found to be in urgentneed of dental treatment. During 14 months theschool dentist inspected 1515 children, of whom1303 (85 per cent.) were referred for treatment and912 (69’9 per cent.) actually treated. Dr. Rollestondoes not think the amount of dental caries is worsein Rutland than elsewhere, and instances Hull childrenwith 85 per cent. and Sunderland with 94’5 per cent. ofcaries. He also compares the 70 per cent. acceptingtreatment with the 48 per cent. of Leeds and the 49 percent. of Stoke-on-Trent. The parent of a child with 11carious teeth wrote to the school dentist, " He caneat and drink more than enough, and that’s all Iwant him to do." And another parent,

" I am notgoing to have him messed about just to please you."The arrangements for treating tonsils and adenoidsare not satisfactory, and Dr. Rolleston recommendshis committee to come to an agreement with Oakham Cottage Hospital and Stamford Infirmary. Dr.Rolleston records the gradual extinction of ring-worm in Ruitand " which has been brought aboutby the application of X rays to all cases irrespectiveof the extent of the disease." Under the heading" Sanitary Conditions," Dr. Rolleston comments ondirty towels and lavatories, the unsatisfactory water-supply of the majority of the schools and the con-tinued existence of " privy vaults," and puts in aplea for more playground classes.