1
1628 Dr. MACKAY accepted the amendment. Dr. MACKAY’s motion as extended by Sir Charles Ball’s amendment was asTfpd to. Sir HENRY MORRIS then formallp moved the motion, the terms of which he intimated at the conclusion of his speech. Dr. LANGLEY BROWN seconded. It was unanimously agreed to defer further consideration on the motion until the next session of the Council in May, 1911. Inst, cction in Scientifio S1Jbjeots. On the motion of Dr. MACKAY a report in the following terms was received from the Education Committee :- On May 28th, 1910, the Council received a memorial relating to the position of the purely scientific subjects of chemistry, physics, botany, and zoology in the medical curriculum, which, on the motion of Dr. Saundby, was referred to the Education Committee for its consideration. The subject to which the memorial refers having been dealt with specially in the report of the committee, further comment appears to be unnecessary at the present time. The committee would thank the memorialists for the expression of their views. Instruction in Ophthalmology and Otology. Dr. MACKAY presented a report from the Education Committee. It set out that- On May 28th, 1910, the following resolution by the Examination Committee was referred to the Education Committee for its con- sideration :— In the curriculum of all the licensing bodies, with three exceptions, special courses on ophthalmology form an essential part. The com- mittee are of opinion that every student of medicine should receive some special instruction in the subject. The committee do not think it necessary to insist that every student should be examined in ophthal- mology, but they are of opinion that all students should be liable to be examined in some branch of the subject. . While the committee would commend the practice of giving specialised instruction in otology and diseases of the throat they do not think it necessary to insist, in the present crowded condition of the curriculum, that special courses and examinations should be made obligatory, provided the subject be included under the general headings of Medicine and Surgery. The report was received. 6’OKCKMOM of Session. A vote of thanks having been awarded to the chairman for his services in the chair, the business before the Council for the winter session was concluded. The Council rose and will meet again in May, 1911. THE LONDON COUNTY COUNCIL AND MEDICAL AFFAIRS. Rearrangement of Coroners’ .DMtricts. THB Public Control Committee in a report to the London County Council on Nov. 22nd referred to the resolution passed by the Council on Oct. llth praying the King to order such alterations in the boundaries of the coroners’ districts, exclusive of the franchise districts, as to make them coincide with the boundaries of the metropolitan boroughs. One effect of such an adjustment would be that extensive altera- tions would be made in the areas comprised in the southern and south-western coroners’ districts, and since the Council’s decision the committee had been advised that serious difficulties in regard to compensation, &c.. might be encountered in taking steps to carry out the alteration of boundaries in the two districts mentioned. The committee was of opinion, therefore, that the alterations of boundaries should be confined at present to those cases in which the boundaries did not coincide because of alterations of parish areas. At the meeting on Nov. 22nd and again on Nov. 29th the consideration of the report was adjourned. Observance nf Health By-la1vs. Replying to a question as to the enforcement of the Council’s by-laws as to spitting on tramcars, Mr. White, chairman of the Highways Committee, said that seven con- victions for contravention had been obtained and a few hundred letters of caution had been sent. It was extremely difficult for the conductors to deal with the matter, and he wished passengers could be persuaded to help. It would then be possible to do a great deal to check this objection- able habit. Ad,iiiini,4tratqoit of the P.rli1’Ùilin lil Meals Act. The Education Committee of the Council on Nov. 23rd re- ceived from the Children’s Care Subcommittee an exhaustive report on the working of the Council’s scheme for providing meals for necessitous children. The subcommittee stated that existing arrangements by which children attended at either (a) buildings hired by or lent to the Council, (b) coffee houses, and (c) private dining centres were not completely satisfactory. It was difficult to ensure a proper supply of meals. As an alternative-notwithstanding the Board of Education’s objection-the subcommittee thought it would be better to make a wider use of school halls. Teachers and others had urged numerous objections to this course, but the subcommittee stated that the children could all leave by 1 o’clock, so that there would be ample time for ventilation; the spilling of food was a trivial matter-all that was necessary was that the helpers should pick up anything on the flour of a greasy nature and the halls should be washed fortnightly instead of once in three weeks. The provision of accommodation for washing up was a difficulty, but it could be met by building annexes. The whole number required would cost E20,000. The subcommittee had to admit that from the Council’s point of view the decision to enter into a four years’ contract with an outside body for the supply of meals was ill advised and added that the ideal method would be the establishment of a dining hall and kitchen for each group of schools. The discussion was adjourned. On Nov. 30th, after debate on points of detail, the proposals of the subcommittee were agreed to. Cleansing of Verminous Children. The subcommittee also reported as to the cleansing of children infested with vermin, recommending that as the number of such children would probably show a progressive diminution arrangements should be made to use borough council cleansing stations rather than go to the expense of establishing special stations at the schools. Thirteen borough councils-the City Corporation made a free offer- were willing to do the work at a charge of 2s. per head, and agreements for one year should be entered into. For the remaining districts the County Council would have to make its own arrangements, adapting existing buildings or putting up temporary ones. Any scheme for cleansing the bodies and clothing of children would be ineffective unless their homes were cleansed too, and the borough medical officers were willing to cooperate in this. It was estimated that about 20,000 children required cleansing, and the agreements with the borough councils would provide for 12,000 of them. Three visits to the cleansing station would be necessary in each case. The proposals were agreed to. Cost of Dental Treatment. The subcommittee submitted a fresh recommendation in regard to the recovery from parents of the cost of dental treatment,’ advising that instead of the definite charges then proposed each case should be considered on its merits, pro- vided that some charge was made in all cases and that in no instance should the amount paid by the parent exceed ls. As in the case of medical treatment, legal proceedings would not be taken where the local care committee was of opinion that the parents could not pay. The recommendation was approved. Medical 2’reatment at Hospitals. At the meeting of the County Council on Nov. 29th Mr E. A. H. Jay, who has just succeeded Mr. Cyril Jackson as chairman of the Education Committee, and who took a prominent part in the organisation of medical treatment in London through the agency of the hospitals, had charge of the Education Committee’s report. He stated, in reply to a question, that inquiry had been made into the allegation, voiced by several speakers during recent debates on the ques- tion of medical treatment, that children had been sent away from certain hospitals because they had not with them a card issued to each child attending under the Council’s scheme of medical treatment. The secretary of the St. George’s Hospital wrote that every patient who applied for medical relief was treated, no distinction being made between patients coming with or without letters, or between attending school and voluntary patients. The authorities of the Poplar Hospital and of the East London Hospital wrote in similar terms. 1 THE LANCET, Nov. 19th, p. 1507.

THE LONDON COUNTY COUNCIL AND MEDICAL AFFAIRS

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1628‘

Dr. MACKAY accepted the amendment.Dr. MACKAY’s motion as extended by Sir Charles Ball’s

amendment was asTfpd to.Sir HENRY MORRIS then formallp moved the motion, the

terms of which he intimated at the conclusion of his speech.Dr. LANGLEY BROWN seconded.It was unanimously agreed to defer further consideration

on the motion until the next session of the Council in May,1911.

Inst, cction in Scientifio S1Jbjeots.On the motion of Dr. MACKAY a report in the following

terms was received from the Education Committee :-

On May 28th, 1910, the Council received a memorial relating to theposition of the purely scientific subjects of chemistry, physics, botany,and zoology in the medical curriculum, which, on the motion ofDr. Saundby, was referred to the Education Committee for itsconsideration.The subject to which the memorial refers having been dealt with

specially in the report of the committee, further comment appears to beunnecessary at the present time. The committee would thank thememorialists for the expression of their views.

Instruction in Ophthalmology and Otology.Dr. MACKAY presented a report from the Education

Committee. It set out that-

On May 28th, 1910, the following resolution by the ExaminationCommittee was referred to the Education Committee for its con-sideration :—

In the curriculum of all the licensing bodies, with three exceptions,special courses on ophthalmology form an essential part. The com-mittee are of opinion that every student of medicine should receivesome special instruction in the subject. The committee do not think itnecessary to insist that every student should be examined in ophthal-mology, but they are of opinion that all students should be liable to beexamined in some branch of the subject.

. While the committee would commend the practice of givingspecialised instruction in otology and diseases of the throat they do notthink it necessary to insist, in the present crowded condition of thecurriculum, that special courses and examinations should be madeobligatory, provided the subject be included under the general headingsof Medicine and Surgery.The report was received.

6’OKCKMOM of Session.A vote of thanks having been awarded to the chairman for

his services in the chair, the business before the Council forthe winter session was concluded.The Council rose and will meet again in May, 1911.

THE LONDON COUNTY COUNCIL ANDMEDICAL AFFAIRS.

Rearrangement of Coroners’ .DMtricts.THB Public Control Committee in a report to the London

County Council on Nov. 22nd referred to the resolution

passed by the Council on Oct. llth praying the King to ordersuch alterations in the boundaries of the coroners’ districts,exclusive of the franchise districts, as to make them coincidewith the boundaries of the metropolitan boroughs. Oneeffect of such an adjustment would be that extensive altera-tions would be made in the areas comprised in the southernand south-western coroners’ districts, and since the Council’sdecision the committee had been advised that seriousdifficulties in regard to compensation, &c.. might beencountered in taking steps to carry out the alteration ofboundaries in the two districts mentioned. The committeewas of opinion, therefore, that the alterations of boundariesshould be confined at present to those cases in which theboundaries did not coincide because of alterations of parishareas. At the meeting on Nov. 22nd and again on Nov. 29ththe consideration of the report was adjourned.

Observance nf Health By-la1vs.Replying to a question as to the enforcement of the

Council’s by-laws as to spitting on tramcars, Mr. White,chairman of the Highways Committee, said that seven con-victions for contravention had been obtained and a few

hundred letters of caution had been sent. It was extremelydifficult for the conductors to deal with the matter, and hewished passengers could be persuaded to help. It wouldthen be possible to do a great deal to check this objection-able habit.

Ad,iiiini,4tratqoit of the P.rli1’Ùilin lil Meals Act.The Education Committee of the Council on Nov. 23rd re-

ceived from the Children’s Care Subcommittee an exhaustivereport on the working of the Council’s scheme for providingmeals for necessitous children. The subcommittee statedthat existing arrangements by which children attended ateither (a) buildings hired by or lent to the Council, (b) coffeehouses, and (c) private dining centres were not completelysatisfactory. It was difficult to ensure a proper supply ofmeals. As an alternative-notwithstanding the Board ofEducation’s objection-the subcommittee thought it wouldbe better to make a wider use of school halls. Teachers andothers had urged numerous objections to this course, but thesubcommittee stated that the children could all leave by1 o’clock, so that there would be ample time for ventilation;the spilling of food was a trivial matter-all that was

necessary was that the helpers should pick up anything onthe flour of a greasy nature and the halls should be washedfortnightly instead of once in three weeks. The provisionof accommodation for washing up was a difficulty, but itcould be met by building annexes. The whole numberrequired would cost E20,000. The subcommittee had toadmit that from the Council’s point of view the decisionto enter into a four years’ contract with an outside bodyfor the supply of meals was ill advised and added that theideal method would be the establishment of a dining halland kitchen for each group of schools. The discussion was

adjourned. On Nov. 30th, after debate on points of detail,the proposals of the subcommittee were agreed to.

Cleansing of Verminous Children.The subcommittee also reported as to the cleansing of

children infested with vermin, recommending that as thenumber of such children would probably show a progressivediminution arrangements should be made to use boroughcouncil cleansing stations rather than go to the expense ofestablishing special stations at the schools. Thirteen

borough councils-the City Corporation made a free offer-were willing to do the work at a charge of 2s. per head, andagreements for one year should be entered into. For theremaining districts the County Council would have to makeits own arrangements, adapting existing buildings or puttingup temporary ones. Any scheme for cleansing the bodies andclothing of children would be ineffective unless their homeswere cleansed too, and the borough medical officers were

willing to cooperate in this. It was estimated that about20,000 children required cleansing, and the agreements withthe borough councils would provide for 12,000 of them.Three visits to the cleansing station would be necessary ineach case. The proposals were agreed to.

Cost of Dental Treatment.The subcommittee submitted a fresh recommendation in

regard to the recovery from parents of the cost of dentaltreatment,’ advising that instead of the definite charges thenproposed each case should be considered on its merits, pro-vided that some charge was made in all cases and that in noinstance should the amount paid by the parent exceed ls.As in the case of medical treatment, legal proceedings wouldnot be taken where the local care committee was of opinionthat the parents could not pay. The recommendation wasapproved.

Medical 2’reatment at Hospitals.At the meeting of the County Council on Nov. 29th Mr

E. A. H. Jay, who has just succeeded Mr. Cyril Jackson aschairman of the Education Committee, and who took aprominent part in the organisation of medical treatment inLondon through the agency of the hospitals, had charge ofthe Education Committee’s report. He stated, in reply to aquestion, that inquiry had been made into the allegation,voiced by several speakers during recent debates on the ques-tion of medical treatment, that children had been sent awayfrom certain hospitals because they had not with them a cardissued to each child attending under the Council’s scheme ofmedical treatment. The secretary of the St. George’sHospital wrote that every patient who applied for medicalrelief was treated, no distinction being made between patientscoming with or without letters, or between attending schooland voluntary patients. The authorities of the PoplarHospital and of the East London Hospital wrote in similarterms.

1 THE LANCET, Nov. 19th, p. 1507.