A letter was read from Mr. F. R. Humphreys, honorary THE ROYAL COLLEGE OF SURGEONS OF secretary of the Midwives Bill Committee, enclosing a copy ENGLAND. A QUARTERLY meeting of the Council was held on Jan. 12th, the President, Sir WILLIAM MAC CORMAC, Bart., K.C.V.O., being in the chair. The Council adopted the recommendation of the Museum Committee that the first volume of the Physiological Catalogue of the Museum with coloured illustrations should be published. It was decided to postpone sine die the further consideration of the question of permitting the Members of the College to wear a special gown. The following report from the Laboratories Committee was approved and adopted : 1. The work on diphtheria for the Metropolitan Asylums Board. Preparation of antitoxin.-Since Oct. 7th 1825 doses of antitoxin, each containing 2000 units, and 3547 doses, each containing 4000 units, for the treatment of diphtheria in the hospitals of the Metropolitan Asylums Board, have been supplied and all the demands fully met. During this period 17,838,000 units, or 278,718 units per diem, have been supplied, as against 11,229,000 units, or 175,453 units per diem, for the corresponding period of last year, an increase of 6,609,000 units, or 103,265 units per diem. Since Nov. 24th 30 doses of 4000 units each have been supplied to medical officers of health according to instructions 'received from the Metropolitan Asylums Board. 2. The grant from the Goldsmiths' Company.-Under this grant 492 doses of antitoxin, containing 1,106,000 units, have been supplied to the General and Children's Hospitals in London. 3. The committee have agreed to undertake the bacteriological examination of material from suspected cases of infectious disease in the St. Giles' District Hospital for a period of six months, and if the arrangement proves satisfactory, it is proposed, at the termination of this period when the amount of work and its cost is ascertained, to enter into an agreement with the Vestry of St. Giles' District for the continuance of the work. A report from the Discipline Committee was received and adopted. The committee had considered the letter from the President of the General Medical Council and the clauses which had been prepared for amending the Medical Acts so as to prevent persons whose names have been erased from the Medical Register for a criminal offence or professional misconduct, from using any title, diploma, or degree so long as the erasure remains in force. The committee recommended that counsel's opinion should be taken upon these clauses and their bearing upon the disciplinary powers of the Council of this College before any reply is sent to the letter mentioned. The Council on the recommendation of the Discipline Committee decided to reply as follows to the first resolution carried at the annual meeting of Fellows and Members in November last : While appreciating the congratulations of the meeting respecting the action of the Council in the matter of the Army Medical Service, the Council would point out that they do continually give their attention to remedying those abuses connected with civil medical practice which are brought to their notice and which fall within their jurisdiction; 1 It was decided that the following reply should be given to the third resolution passed at the same meeting : While not prepared to express a general opinion on the questions ruised by the resolution the Council would repeat that they are willing to consider any evidence which may be submitted to them respecting the conduct of any Fellow or Member of the College in connexion with the practices therein referred to.2 The wording of the resolution carried at the meeting was as follows :---“That this meeting congratulates the Council on the successful results of its representations in the matter of the reform the Army Medical Service, and trusts that it will now turn its attention towards remedying the notorious abuses which exist in connexion with civil medical practice." a The wording of this resolution was as follows:-"That this meeting notes with satisfaction that the Council has at last definitely expressed its disapproval of canvassing for patients and of the employment of professional advertisements addressed directly to the lay public, and this meeting further trusts that the Council will extend its disapproval to the acting by Fellows and Members of the College as paid officials of any association which adopts these unprofessional practices." 8 THE LANOKT, Jan. 14th, 1899, p. 106. of a draft bill which it is proposed to introduce next session into Parliament, stating that certain alterations from previous bills have been made in view of the requirements of the General Medical Council and asking for the active support of the College in pressing the bill upon the con sideration of the Government. The subject was referred to a committee to consider and report. A letter was read from the honorary secretaries of the Medical Students' Association of Queen's College, Cork, asking for the consideration of the following resolution passed at a recent meeting of the Association, viz. :— That we respectfully ask the Royal College of Surgeons of England to recognise as an equivalent to their Second Professional Examination the Third Professional Examination of the Royal University of Ireland, so that students having passed the latter may be enabled to proceed to the Final Examination of that body. The matter was referred to the Committee of Management. The PRESIDENT reported that H.R.H. the Prince of Wales had signified his intention of being present on the occasion of the Hunterian Oration and Dinner on Tuesday, Feb. 14th. The Council adopted the following report of the Committee of Management : The Committee of Management have considered the communication from the medical school of St. Bartholomew's Hospital taking exception to the recent alteration in the regulations relating to the commencement of dissection after the student has received his instruction in chemistry, physics, practical chemistry, and biology, which was referred to them by the two Royal Colleges for consideration and report together with communications to the same effect which have been received from the Deans of Charing-cross Hospital and St. Thomas's Hospital medical schools and have adopted the following resolution, viz.:-That after receiving the written opinion of the several medical schools the Committee of Management recommend to the Royal Colleges that in Clause 3 on page 4 of the regulations the words between the brackets be omitted. The clause will then be the same as before the alteration. The committee also recommend that Mr. Thomas Cooke's course of operative surgery be recognised for the ensuing year. "PUBLIC VACCINATORS AND THE NEW VACCINATION ACT." PUBLIC VACCINATORS IN THE WEST OF ENGLAND. FROM reports in the daily press it seems that the recent discussion and an endless variety in the scales of fees proOrder of the Local Government Board has given rise to much discussion and an endless variety in the scales of fees proposed and adopted by the various boards of guardians throughout the country. Neighbouring unions have come to the most opposite decisions, so that in some cases where the same man is public vaccinator for districts under two boards of guardians he will have quite different scales of fees for Some boards. exactly similar work in adjoining districts. have adopted payment by mileage while others will not allow mileage under any consideration and insist upon an inclusive contract price of so much per case. Perhaps the greatest diversity exists with regard to the fee under greatest diversity exists with Article III. (a), the minimum 1s. being considered in many cases to be too small for the amount of work entailed. That this is evident, we think, is proved by the number of boards of guardians who have given 2s. 6d. instead of 1s. At South Molton on Dec. 15th it was unanimously resolved to adopt the committee's recommendation that the minimum fee for public vaccinators should apply to all cases within two miles of the residence of the officer and for cases beyond the two-mile radius a fee of 10s. for each case of successful vaccination. At Bodmin on Dec. 24th it was resolved that the fees for successful vaccination should range from 78. 6d. to 9s. for each case beyond the one-mile limit. It was further proposed that another fee of 2s. 6d. should be paid where on going to a house the practitioner, owing to the insanitary condition of the house or unhealthy state of the child, had to postpone vaccination, but this was defeated by 19 to 12 votes. The Camelford Guardians have now come to a satisfactory arrangement whereby Mr. Jerome will receive 5s. for each successful case, except in the parishes of St. Breward, St. Cleather, and Davidstow, in each of which the fee is 7s. Mr. Wade will receive 6s. for cases in Tintagel and Otteram and 5s. for all others. As reported in THE LANCET of Dec. 24th, 1898, the minimum scale had been carried by 14 votes to 12, the acceptance of which the medical officers had refused. At Helston Board of Guardians it has been reported that four of the six public vaccinators had accepted the fees offered by the board and it was expected that the remaining two would also accept. This is for twelve months. In THE LANCET of Dec. 24th, 1898, we mentioned that this board served the vaccinators with twenty-eight days' notice to terminate their contracts so as to have a free hand. Are we to assume that the fees have been accepted under compulsion? had been submitted to them and they had therefore found it necessary to call in an expert to assist them in making the inquiry. The inquiry was not a new one and the assistant Commissioner was appointed for the purpose of sifting the conflicting and very embarrassing figures which had been laid before the Commissioners. Mr. BALFOUR BROWNE on behalf of the London County Council said that he did not think that they would wish to submit their witnesses to examination by Colonel Rathborne. The CHAIRMAN pointed out that it was open to the County Council to take whatever course they might think fit. Mr. POPE, Q.C., on behalf of the metropolitan water comcourse which the Commissioners had proposed. At Tavistock on Dec. 30th the following scale of fees was adopted :-Tavistock, 6s. 4d.; Milton Abbott, 8s. 6d. ; Buck-panies, said that they had not the slightest objection to the land Monachorum, 78.; Bere Ferrers, 6s. 4d.; Calstock, 68. 3d.; Lewdown, 7s.; Whitchurch and South Lidford, 88. 6d. The medical men met the committee but did not agree to accept these sums. It was resolved to inform the public vaccinators that the board were prepared to pay the above-named sums and that they would be glad of a reply from the medical men to the effect that they would accept the payment for twelve months, the chairman remarking that at the end of that period they would all be in a better position to estimate the value of the services rendered. THE ROYAL COMMISSION ON THE METRO- THE forty-third sitting of the Royal Commissioners was held at the Guildhall, Westminster, on Jan. 16th. The Commissioners present were the Chairman (Lord Llandaff), the Right Hon. John William Mellor, Sir John Dorington, Sir George Barclay Bruce, Mr. de Bock Porter, Mr. Robert Lewis, and Major General Scott. At the commencement of the proceedings Mr. BALFOUR BROWNE, Q.C., on behalf of the London County Council, said that his clients had received an intimation from the secretary of the Commission that Colonel Rathborne, R.E., had been appointed as an assistant Commissioner for the purpose of aiding the Commissioners in their inquiry with reference to the relative cost of the Welsh and the Thames schemes for providing an increased supply of water for London. Mr. Balfour Browne asked on behalf of the London County Council whether it was intended that Colonel Rathborne should hold a separate inquiry or whether he would deal with the evidence which had been already given to the Commissioners. The CHAIRMAN replied that the evidence which had been given was conflicting. Colonel Rathborne was appointed in order that he might criticise and compare the figures which had been presented to the Commissioners. This task was one of infinite detail and considerable labour and the Commissioners intended to refer the examination of the estimates to Colonel Rathborne who would be ready to hear any explanations which the witnesses of the County Council or the metropolitan water companies might wish to lay before him for the elucidation of the estimates which they had put in. Mr. BALFOUR BROWNE suggested that it seemed to him that it would practically amount to beginning the inquiry over again in so far as it concerned the comparative merits of the Welsh and the Thames storage schemes. The CHAIRMAN pointed out that the Commissioners had decided that Colonel Rathborne should take into consideration the evidence which had been already given and that should he require any explanations on particular points he would question the persons who had given the evidence for their elucidation, but it was not proposed that Colonel Rathborne should take fresh evidence. Mr. BALFOUR BROWNE said that he objected to the course which was proposed and pointed out that the scheme of the County Council for bringing water from Wales to London was now submitted to Parliament and that it would be for Parliament to determine as to the merits of the scheme. Under these circumstances he would deprecate any anticipation of the action of Parliament by a report on the Welsh scheme by Colonel Rathborne. The CHAIRMAN said that the inquiry before Parliament would not be in any way prejudiced by the action which the Commissioners had taken. It was necessary for them to make up their minds on the merits of the estimates which The witnesses examined at this sitting were Mr. CHARLES | HAWKSLEY and Mr. E. W. EATON. In the course of his examination the CHAIRMAN pointed out to the former witness the great advantages of the use of the words "yes" and " "yes" and "no" in giving affirmative and negative replies respectively to questions that were asked him and that if the witness were unable to answer a question it would save time if he would at once say that he did not know. The witness did not act in accordance with these suggestions. Mr. HAWKSLEY contended that the charges for high service made by the metropolitan water companies compared favourably with those made by local authorities throughout the country and submitted a table which he had made giving the water rents charged in the case of certain selected provincial towns and a table showing the water rents charged by the metropolitan water companies. With regard to the question of the introduction of constant supply the witness contended that it had a tendency at first service was completely established the companies would be to increase the consumption of water, but that when constant able to devote their energies to the prevention of waste, and he gave it as his opinion that they would be able to reduce the amount of waste to such an extent that the supply per head would not amount to more than an average of 25 gallons per day. In fifteen of the largest towns in England where the corporations had reduced the amount of water wasted to a minimum the average supply per head was 28 gallons, and of this amount 10 gallons were supplied by meter and 18 gallons only were used for domestic supply per head. The witness contended that the London water companies were at the present time under more stringent control than the water companies in other places and in his opinion the only alteration which he could suggest as a reasonable additional measure of control was that the water examiner appointed by the Local Government Board should have the right to enter the companies' 'works when he pleased and that his visits should not be as at present subject to the permission of the water companies. The witness said that he believed that private companies managed water undertakings better than public authorities and he thought that no advantage would obtain to the ratepayers and water consumers if the undertakings of the companies were transferred to a public body. He thought that they would suffer a loss by such a transfer because they would have to provide a sinking fund. The witness said that as a rule he did not advise local authorities to take over water undertakings, but he admitted that he had generally been employed by water companies in cases in which it was proposed that their ventures should be taken over by some public authority. Mr. E. W. EATON said that in his opinion it was a waste of the resources of the Thames to allow 200,000,000 gallons a day to pass over Teddington Weir. He contended that if only 100,000,000 gallons daily were allowed to pass over the weir there would be quite enough water to provide for the navigation of the river. He suggested that tidal water could if necessary be ponded at Richmond Lock at high tide and be used for flushing the course of the river at low water. He suggested that it would be well to gauge the amount of water at Teddington. The CHAIRMAN said that the Commissioners wished that the evidence tendered by the companies should be kept within reasonable limits. The Commissioners would be glad to hear the scientific witnesses' evidence to show how filtration could be so improved as to exclude bacteria. The views of scientific witnesses on other points were already before them in their published reports. He hoped that the Commissioners would be able to take all the necessary evidence in the course of four more sittings. The forty-fourth sitting of the Royal Commissioners was WE have been requested by the Secretary of King's College to publish the following letter from the Secretary of State for the Colonies to the Principal of King's College :[COPY.] Downing-street, Jan. 7th, 1899. SIR,-I am directed by Mr. Secretary Chamberlain to inform you, with reference to the letter from this office of Dec. 23rd last, that he has carefully considered your letters of Nov. 22nd and Dec. 5th and their enclosures and that he has come to the conclusion that in selecting candidates for the Colonial Medical Service preference should be given (other things being equal) to those doctors who have received such bacteriological or similar special training as King's College provides, but that when candidates have been definitely selected they should be required to attend at the School of Tropical Medicine which is being established at the Albert Docks Branch of the Seamen's Hospital and to go through the complete course of instruction which is now being settled by a special committee of experts appointed for the purpose. 2. Mr. Chamberlain considers this arrangement to be the one best suited to the requirements of the Colonial Medical Service, and he trusts that the medical authorities at King's College will coöperate as far as possible in giving effect to it. 3. Mr. Chamberlain desires me to express his thanks to you and to Professor Crookshank for the great interest which you have shown in this scheme for extending the study of tropical medicine and also for the suggestions which you have been good enough to put forward. I am, Sir, your obedient servant, The Principal, King's College. H. BERTRAM COX. THE (EAST) SUBURBAN MEDICAL PROTECTION SOCIETY: ACTION CONCERN ING MEDICAL AID SOCIETIES. THE annual meeting of this society was held at the West Ham Hospital on Jan. 12th. Representatives were present from all the districts, including Wood Green, Walthamstow, Forest Gate, Canning Town, Plaistow, and Wanstead. The annual report, a copy of which had been sent to every practitioner, was taken as read. The appointment of a collector to look personally after the debt collecting department was announced, but the amount of commission to be paid to him could not be determined until it was ascertained how far members intended to avail them selves of his services. With reference to medical aid societies the secretary explained that as the first result of their deliberations the medical aid sub-committee, and on their preliminary report the council also, had come to the firm conviction that the best and first step to take in the matter was for the society to establish a public medical service in connexion with the society to be managed on similar lines to those already existing at Eastbourne, Bexhill, Cork, Brussels, and further mentioned that the sub-committee had already considered a preliminary set of rules. But these it was found on further consideration would need a vast amount more consideration which neither they nor the officers of the society were prepared to give unless they knew that the principal was approved and permission obtained from the general meeting to start. It was proposed by the honorary secretary of the council and seconded by the honorary secretary of the subcommittee: That the Executive Council be empowered to draw up a scheme for a public medical service according to the memorandum of association and to allow the same to be started and carried on by the members and branches after approval by the council. The proposition was carried, one vote being recorded against it. The proceedings then terminated with a vote of thanks to the President. VITAL STATISTICS. HEALTH OF ENGLISH TOWNS. IN thirty-three of the largest English towns 6580 births and 3995 deaths were registered during the week ending Jan. 14th. The annual rate of mortality in these towns, which had been 19.1 per 1000 in each of the two preceding weeks, declined again last week to 18.3. In London the rate was 18.0 per 1000, while it averaged 18.5 in the thirty-two provincial towns. The lowest death-rates in these towns were 11.0 in Brighton, 11.8 in Derby, 12.6 in Cardiff, and 12.9 in Leicester and in Hull; the highest rates were 22-4 in Manchester, 22.5 in Gateshead, 23.2 in Oldham, and 24.0 in Sunderland. The 3995 deaths in these towns included 352 which were referred to the principal zymotic diseases, against 404 and 367 in the two preceding weeks; of these 94 resulted from whoopingcough, 85 from diphtheria, 68 from measles, 43 from "fever" (principally enteric), 34 from scarlet fever, and 28 "from diarrhoea. The lowest deathrates from these diseases were recorded in Newcastleupon-Tyne, Cardiff, Croydon, and Bradford, and the highest rates in Leeds, Norwich, Nottingham, and Birkenhead. The greatest mortality from measles occurred in Bolton, Salford, Gateshead, and Nottingham; from scarlet-fever in Swansea ; from whooping-cough in Huddersfield, Swansea, and Bristol; and from fever" in Bolton. The 85 deaths from diphtheria included 34 in London, 8 in Leeds, 5 in Liverpool, 4 in West Ham, 4 in Sheffield, 3 in Portsmouth, 3 in Norwich, and 3 in Nottingham. No fatal case of small-pox was registered last week in any of the thirty-three large towns, and only 1 case of small-pox was under treatment in the Metropolitan Asylums Hospitals on Saturday last, Jan. 14th. The number of scarlet fever patients in these hospitals and in the London Fever Hospital on the same date was 2777, against 2939 and 2912 at the end of the two preceding weeks; 220 new cases were admitted during the week, against 221, 225, and 291 in the three preceding weeks. deaths referred to diseases of the respiratory organs in London, which had been 306 and 365 in the two preceding weeks, were 363 last week, and were less than half of the deaths in the thirty-three towns were not certified, the corrected average. The causes of 50, or 1.3 per cent., either by a registered medical practitioner or by a coroner. All the causes of death were duly certified in Bristol, Bradford, Leeds, Hull, and in seventeen other smaller towns; the largest proportions of uncertified deaths were registered in West Ham, Liverpool, Preston, and Sheffield. HEALTH OF SCOTCH TOWNS. The The annual rate of mortality in the eight Scotch towns, which had been 18.2 and 21.3 per 1000 in the two preceding weeks, further rose to 21-7 during the week ending Jan. 14th, and was 3.4 per 1000 above the mean rate during the same period in the thirty-three large English towns. The rates in the eight Scotch towns ranged from 13.7 in Greenock and 14.9 in Paisley to 26 3 in Edinburgh and 32.1 in Perth. The 663 deaths in these towns included 35 which were referred to. whooping-cough, 13 to diarrhea, 12 to scarlet fever, 11 to measles, 11 to diphtheria, and 6 to "fever" (principally enteric). In all, 88 deaths resulted from these principal zymotic diseases, against 58 and 78 in the two preceding weeks. These 88 deaths were equal to an annual rate of 2.9 per 1000, which was 1.3 above the mean rate last week from the same diseases in the thirty-three large English towns. The fatal cases of whooping-cough, which had been 14 and 20 in the two preceding weeks, further rose to 35 last week, of which 19 occurred in Glasgow and 10 in Edinburgh. The 12 deaths referred to scarlet fever were within one of the number in the preceding week, and included 5 in Glasgow, 4 in Edinburgh, and 2 in Greenock. The fatal cases of diphtheria, which had been 3 and 9 in the two preceding weeks, further rose to 11 last week, of which 4 occurred in Glasgow, 2 in Edinburgh, 2 in Aberdeen, and 2 in Leith. The 11 deaths from measles exceeded by 2 the number in the preceding week, and included 4 in Aberdeen and 3 in Glasgow and of the 6 deaths referred to different forms of "fever 2 were recorded in Aberdeen and 2 in Glasgow. The deaths from diseases of the respiratory organs in these towns, which had been 110 and 123 in the two preceding weeks, further rose to 156 last week, and almost corresponded with the number in the same period of last year. The causes of 26, or nearly 4 per cent., of the deaths in these eight towns last week were not certified.. HEALTH OF DUBLIN, The death-rate in Dublin, which had been 27.7 and 26.7 per 1000 in the two preceding weeks, rose again to 27.1 during the week ending Jan. 14th. During the past four weeks the rate of mortality in the city has averaged 26.7 per 1000, the rate during the same period being 18.1 in London and 22.2 in Edinburgh. The 182 deaths registered in Dublin during the week under notice showed an increase of 3 upon the number in the preceding week, and included 10 which were referred to the principal zymotic diseases, against 9 and 13 in the two preceding weeks; of these, 3 resulted from whooping-cough, 3 from diarrhoea, 2 from diphtheria, 1 from scarlet fever, and 1 from "fever," but not one either from small-pox or measles. These 10 deaths were equal to an annual rate of 1.5 per 1000, the zymotic death-rate during the same period being 1.5 in London and 37 in Edinburgh. The fatal cases of whooping-cough, which had been 4 and 6 in the two preceding weeks, declined again to 3 last week. The 2 deaths referred to diphtheria exceeded the number in any recent week, while the mortality from whooping-cough showed a marked decline from that recorded in the preceding week. The 182 deaths in Dublin last week included 30 of infants under one year of age and 48 of persons aged upwards of sixty years; the deaths both of infants and of elderly persons exceeded those recorded in the preceding week. Six inquest cases and 7 deaths from violence were registered; and 60, or nearly a third, of the deaths occurred in public institutions. The causes of 16, or nearly 9 per The causes of 16, or nearly 9 per cent., of the deaths in the city last week were not certified. THE SERVICES. ROYAL NAVY MEDICAL SERVICE. THE following appointments are announced : Fleet Surgeons: S. F. Hamilton to the Jupiter; J. L. Sweetnam to the Unicorn; and J. Dudley to the Vivid, additional for Devonport and Keyham Dockyard. Staff Surgeons: H. R. Osborne to the Pembroke, temporarily; P. E. Maitland to to the Raleigh; C. Strickland to the Volage; J. W. O. Underhill to the Medea; and Daniel J. P. McNabb to the Northampton. Surgeons: Harold Huskinson to the Pembroke, additional for disposal; John A Keogh to the Calliope; Eric D. Macnamara to the Jupiter; Arthur A. J. McNabb to the Sans Pareil; Norman L. Richards to the Northampton, additional for the Curaçoa; and Samuel H. Facey to the Diadem. Surgeon and Agent: C. A. Lapthorne at Littlehampton. ROYAL ARMY MEDICAL CORPS. Captain R. J. Copeland joins at Woolwich for duty. Captain Austin is transferred from the Sind to the Poona District, and Captain W. J. Taylor from the Bombay to the Mhow District. Captain G. T. Rawnsley has embarked for India. Captain J. Thomson is posted to Western Heights, Dover, for duty. Major George W. Brazier-Creagh is seconded for special extra-regimental employment. INDIA AND THE INDIAN MEDICAL SERVICES. Lieutenant-Colonel W. J. Charlton, R.A.M.C., is appointed to officiate on the Administrative Medical Staff of the Army with the temporary rank of Colonel. Captain J. G. Hubert is appointed to be Personal Assistant to the Principal Medical Officer, Bengal Command, vice Captain R. H. Maddox, whose services have been transferred to the Civil Department for civil employment. Captain W. G. Beyts, R.A.M.C., is appointed Surgeon on the Staff of His Excellency the Commander-in-Chief in India. Major R. W. Wright., R.A.M.C., on his arrival in India will be posted to the Bengal Command for a tour of service. ARMY MEDICAL RESERVE OF OFFICERS. Surgeon-Lieutenant Arthur Peel Nuttall, 1st Volunteer Battalion the Lancashire Fusiliers, to be Surgeon-Captain. VOLUNTEER CORPS. Artillery : 4th Durham (Western Division, Royal Artillery): Surgeon - Lieutenant H. H. Gourley to be Surgeon-Captain. 2nd Middlesex: Surgeon-Major A. H. Robinson resigns his commission; also is permitted to retain his rank and to continue to wear the uniform of the corps on his retirement. 1st Newcastle-on-Tyne (Western SURGEON-GENERAL WOOLFRYES, C.B., O.M.G., He was men Surgeon-General J. A. Woolfryes is to be appointed Honorary Physician to the Queen, in succession to the late SurgeonGeneral A. Smith, M.D. Edin., C.B. Surgeon-General Woolfryes entered the Army Medical Service nearly fifty-two years ago and has been on active service on the West Coast and in South Africa. In 1873-74 he took part in the Ashantee War, as Principal Medical Officer during a portion of the period, and was present at the battles of Amoaful and Ordahsu and capture of Coomassie. tioned in despatches, received the medal and clasp, and was promoted Deputy-Surgeon-General. In 1877-78 he was Principal Medical Officer in the Kaffir Campaign against the Galekas and Gaikas, was mentioned in despatches, and received the Companionship of the Bath. In 1879 he took part in the Zulu War, was again mentioned in despatches, received the medal with clasp and the Companionship of the Order of St. Michael and St. George. INDIA. The Anglo-Indian papers dated up to the end of December, 1898, contain relatively little of medical interest beyond information about the progress of epidemic plague and the proceedings of the Commission thereon; but this news has been in a great measure anticipated by telegraphic intelligence already received from India and published in this country. The Times of India of the 31st ultimo has, as might be expected, very full descriptions of the arrival of the new Viceroy and of the ceremonial receptions consequent thereon together with Lord Curzon's speeches and a summary analysis of what he has written on the subject of India and Indian policy generally. DEATHS IN THE SERVICES. Surgeon-General James Macbeth, in Rome, in his eightysecond year. He joined the Army in 1841 and served with second year. He joined the Army in 1841 and served with the 10th Foot in the Sutlej campaign of 1845-46, including the battle of Sobraon (medal with clasp). He was present at the Punjab campaign of 1848-49 and was also at the siege operations before Multan. Surgeon-General William Pearl, I.M.S. (retired pay), on Jan. 10th, aged sixty-six years. He served in the Indian Army, retiring in 1885 as a Surgeon-General of the Madras Army. Brigade-Surgeon - Lieutenant-Colonel Robert Pringle, I.M.S. (retired), at his residence, Blackheath, on Jan. 19th. ARMY RECRUITS. Speaking generally it is understood that the recruiting returns for the past year contrast favourably with those of 1897, the number of recruits that have enlisted into Her Majesty's army in 1898 having been in excess of those enlisted in the preceding year. Surgeon-Gencral W. Taylor (whose appointment we announced last week to Deputy Director-General), on his acceptance of the post of Principal Medical Officer in India, is succeeded by Surgeon-General H. S. Muir, and SurgeonGeneral W. S. M. Price takes the place of Surgeon-General Muir who is to act as Principal Medical Officer with the British Forces in Egypt. It has been decided that the medical officers of the Household Troops are to retain the titles they held before the issue of the Royal Warrant constituting the Royal Army Medical Corps. Surgeon-General Harvey, Director-General of the Indian Medical Service, proceeds to Burma during the present month on his tour of medical inspection. Correspondence. "Audi alteram partem." "POISONING BY BROMOFORM." To the Editors of THE LANCET. SIRS,-Such untoward effects as are reported by Mr. Harold W. Evans in THE LANCET of Jan. 14th and by your Manchester correspondent in THE LANCET of Dec. 31st, 1898, will cause practitioners to hesitate before they prescribe bromoform for cases of whooping-cough. I believe, however, that such accidents can be easily prevented and that they almost always depend on the imperfect suspension of the drug in an emulsion and its concentration in the last dose of the bottle. In the Practitioner of February, 1893, I recorded some observations on 30 cases of whooping-cough treated with bromoform and a continued use of the drug has confirmed the belief that it controls the symptoms and course of the disease more distinctly than any other remedy. In 3 cases I have met with symptoms of bromoform poisoning. In the first there were loss of consciousness, stertorous breathing, small pupils, and a weak irregular pulse, as described by Mr. Evans, and as in his case recovery followed the use of the stomach pump. In my other 2 patients the symptoms were less pronounced and resembled intoxication; the children were drowsy, incoherent in their speech, and uncertain in their gait. In all 3 cases it was the last dose in the bottle that had affected the children unfavourably, which again coincides with Mr. Evans's experience. For the last four years, therefore, whenever I have prescribed bromoform in mucilage and water the simple expedient has been adopted of always directing the mother to throw away the last dose in the bottle and during this time no further mishap has occurred. Though in out-patient practice the drug has been dispensed in this way, for private patients I prefer to let the nurse have the pure drug, instructing her to measure each dose separately from a drop-bottle and administer it in half a teaspoonful of glycerine. Children take bromoform in either of the above forms better than when it is dissolved in spirit. If allowance is made for the difficulty of properly suspending this heavy liquid it can, I believe, be given with perfect safety and will be found to distinctly lessen the number and severity of the paroxysms of coughing, to stop the vomiting and other manifestations of the attacks, and to minimise the dangers of the disease. I am, Sirs, yours faithfully, Norwich, Jan. 17th, 1899. F. W. BURTON-FANNING. To the Editors of THE LANCET. SIRS,The case of bromoform poisoning reported in THE LANCET of Jan. 14th, seems to be an instance of misadventure in the use of the drug both as to dose and administration. The peculiarities of the drug should be well borne in mind both by the dispenser and the patient. In this case the drug was well guarded by its mixture with mucilage, with the evident intention of suspending the bromoform, but it should be remembered that the drug has a high specific gravity and is far heavier than either water or mucilage. Bromoform can only be temporarily suspended after agitation of its mixture which if allowed to rest permits of the drug falling to the bottom of the containing vessel. Thus unless free agitation takes place at each exhibition of a dose a dangerous mixture For the same reason is left on the emptying of the bottle. unless agitation be frequent and efficient the earlier doses would be proportionally weak as little bromoform would be suspended. In this case the effects were not observed until the last dose in the bottle had been exhibited and after a decided quantity of bromoform had been proved to be present in the stomach, as was evidenced by the syphon pump. Under these circumstances it is well to bear in mind the physical characteristics of bromoform and for every prescriber and dispenser to warn all concerned with the administration of the drug of the necessity of well and efficiently shaking the bottle before each dose is exhibited to the patient. If attention be drawn to these facts the administration of bromoform may in the future be free from any such alarming symptoms as occurred in the case narrated which unfortunately is not the first published. Bromoform may be safely given and repeated to adults and children in the form of the small capsules (each containing a -minim dose) as prepared by Messrs. Martindale. I am, Sirs, yours faithfully, London, Jan. 18th, 1899. M. BAINES, M.D. Lond. PUBLIC VACCINATORS AND THE To the Editors of THE LANCET. THE LANCET of Jan. 14th on the action of the Chesterfield SIRS, -I was greatly interested in your remarks in THE LANCET of Jan. 14th on the action of the Chesterfield guardians as I am in about the same position as the public vaccinators of Chesterfield. In November the Edmonton guardians sent a circular to all public vaccinators stating that they had decided to pay the minimum fees; afterwards all public vaccinators were asked to meet the clerk. I was unable to attend but the clerk wrote four and myself. Having nearly completed forty years to me stating that all had agreed to take minimum fees except (three in Thanet and thirty-five here) under Poor-law the matter was of so little importance to me that I had no intention of troubling about fees, but on request I joined the four public vaccinators in a letter to the guardians asking for higher fees as we had rural districts and cases over three miles away. The answer to this was to ask us to act for six months on minimum fees; this would deprive us of the right of appeal to the Local Government Board and was not accepted. Afterwards two of the four did accept; three of us remained. At the meeting of guardians on Jan. 4th they decided to give my two friends higher fees and to myself notice to quit. On Jan. 7th I received formal notice; the post is advertised and no doubt a successor will be elected. Before Christmas I wrote to the board stating that I should attend to the duties but should ask the Local Government Board to determine the amount of fees (Art. 5, |