- S-UPPLEI3MENT' TO TEB BRITISH MEDICAL JOURNAL

LONDON: SATURDAY, JULY 4Th1, 1914. CONTENTS. PAGE PAGN Eighty-second Annual Meeting of the British Medical Proceedings of Council (continzled)- Association-Programme: Committee Advertisements for Tuberculosis Officers- THE SECT1ONS.-PATHOLOGICAL MUSE.UM.-EXCURSIONS, ETC. 1-12 Deputation to Members of the Governml-ent on Security of Tenure and Superannuation for Medical Officers of Health. Proceedings of Council: Hospitals Committee: Workmen's Medical Aid Associa- Return of the Chairman.-Apologies.-Deaths.-The Tr?a- tions and Members of Staffs of Voluntary Hospitals. Naval surer.-Resignations.-Vote of Thanks to Deputy Chairman and Military Committee: Resignation of a Member from of Council.-Representative from Australian Branches.- the Committee-The Shortage of Medical Officers in tho Dr. J. A. Macdonald's Visit to Australasia.-Sir Thomas Royal Navy. Insurance Act Committee: Returned Medical Roddick.-University of Wales.-Postal Vote.-Annual Cards-Relation of British Medical Association to Proposed Meeting at Newcastle, 1917. Finance Committee: Accounts Federation of Local Medical and Panel Committees- -Appointment of Assistant Medical Secretary-Appoint- Appointment of and Reference to Insurance Act Committee. ment of Solicitor to the Association-Heard v. Pickthorne- Non-Panel Committee: Consultants Employed for Purposes Candidates for Election to the Association-Election of of Insurance Acts. Supplementary Report of Council 13-16 Vice-Presidents. Scottish Committee: House of Lords Midwives (Scotland) Bill (No. 81). Organization Committee: MEETINGS OF BRANCHES AND DIVISIONS ... .. 16 Stuidents' Union-Grants to Branches for 1914-Election of ASSOCIATION NOTICES ...... 21 Members of Council, 1914-15 and 1915-16, by Grouped Repre- LOCAL MEDICAL AND PANEL COMMITTES ...... 25 sentatives under BY-law 43 (C)-Grouping of Branches not in the United Kingdom for 1915-16-Grouping of Divisions INSURANCE COMMITTEES 26 for Representation in Representative Body, 1914-15. Science INSURANCE NOTES ...... 28 Committee:c Middlemore Prize. Central Ethical Corn- INSURANCE ACT IN PARLIAMEN'T' 28 snittee: Regulations relative to the Insertion in tho "British Medical Journal" of Notices regarding Appoint- NAVAL AND MILITARY APPOINTAIENT.S... 23 ments-Position of Medical Practitioners in Connexion wi Lli VITAL STATISTICS ...... 23 *Publications to the Public on Medical Subjects-Case under HOSPITALS AND ASYLUMS 30 Articles 10 and 11. Medico-Political Committee: Fees for VACANCIES AND APPOINTM1ENTS 31 Medical Examinations for Life Insurance-Payment of Ship 32 Surgeons for Attendance upon First and Second Class BIRTHS, MARRIAGES. AND DEATrH' . Passengers-Fees for Medical Certificates under the Mental DIARY FOR THE WEE1.K ... 32 Deficiency Acts-Telephone Service Rates. PuLblic Health DIARY OF THE ASSOCIATION 32

EIGHTY--SECOND ANNUAL MEETING of the Br'itish Medical Association. ABERDEEN, JULY, 1914.

PROGRAMME OF BUSINESS. THIE SECTIONS. President: WILLIAM AINSLIE HOLLIS, M.A., M.D., Tlle scientific business of the meeting will be conducted F.R.C'.P., Consulting Physician, Sussex CouLnty Hospital, in sixteen Sections, wlichl will meet on Wednesday, July Brighton. 29th, Thursday, July 30tlh, and Friday, July 31st. President-elect: Sir ALEXANDER OGSTON, K.C.V.0., M.D., The President, Vice-Presidents, and Honorary Secre- LL.D., Consulting Surgeon, Aberdeen Royal Infirmary; taries of each Section constitute a Committee of Reference in to H.M. the King in Scotland. for that Section, and exercise the- power of inviting, Surgeon Ordinary accepting, or declining any paper, and of arranging the (Chairman of Representative Meet-ings: THOMAS JENNER order in which accepted papers shall be read. Communi i- VERRALL, M.R.C.S., L.R.C.P., Consulting Surgeon, Sussex cations with respect to papers slhould be addressed to one County Hospital, Brighton. of tlle Honorary Secretaries. Chairman of Council: JAMES ALEXANDER MACDONALD, A paper read in the Section must not exceed fifteen M.D., M.Ch.R.U.I., LL.D., Honorary Physician, Taunton minutes, and no subsequent speech miust exceed ten and Somerset Hospital, Taunton. minutes. Treasurer: EDWIN RAYNER, B.A., M.D.Lond., F.R.C.S. Paper-s read are the property of the British Medical Consulting Surgeon, Stockport infirmary, Stockport. Association, and cannot be published elsewvhere than in the Eng., BRITISH MEDICAL JOURNAL without special permission. Tlle Eighty-second Annual Meeting of the Britislh The following sixteen Sections have been authorized b:- Medical Association will be held in Aberdeen in July, 1914. tlle Council: The President's Address will be delivered on Tuesday, July. 28th, and the Sections will meet oln the tllree ANATOMY AND PHYSIOLOGY. following days. The Annual Representative Meeting will at 10 a.m. President: Professor ROBERT WV. REID, M.D., F.R.C.S., beain on Friday, July 24th, Aberde'en. Vice-Presidents: DENIS P. FITZGrERALD, M.B., The Address in Medicine will be delivered by ARCHIBALD B.Cll., Cork; J. STRICKLAND GOODALL, M.B., F.R.C.S., EDWARD GARROD, M.D., F.R.C.P., F,.R.S., Physician, St. London, S.E.; Professor. J. KAY JAMIESON, M.B., C.M., Bartlholomew's Hospital, London. Leeds; Professor J. A. MACWILLIAM, M.D., C.M., Aberdeen. Honorary Secretaries: NORMAN J. CALDER, M.B., Ch.B., The -Address in Surgery will be delivered by Sir JOHN Anatomy Department, Marischal College, Aberdeen; BLAN-D- SUTTON, Surgeon to the Middlesex Hospital, EDWARD PROVAN CATHCART, M.D., D.Sc., Department of London, W. Physiology, University of Glasgow; R. J. GLADSTONE, The Popular Lecture will be delivered by Professor M.D., F.R.C.S., University of London, King's College, J. ARTIHUR TIOMsoN, M.A., LL.D., Natural History Strand, W.C.; HUGH MACLEAN, M.D., Chemical Pathology Vepaitnicnt, Marishlial College, Aberdeen. Department, St. Thomas's Hospital, Londonr S.E. [5 321 'BU"LEMENT TO TUX ' 2- PROGRAMME OF ANNUAL MEETIN'G. 2* BIMMSHBIIHMDILJUniPMEDICAL JOUBNAL O R M E O AN U L M E NG[JL [JULY 4,14, 19144 The following papers have been accepted: tions of neo-salvarsan should be given, and mercurial BOYD, Sidney. A Note on a Congenital Anomaly of the treatment for two years. In the recurrent stage tlhe Duodenum Encountered during Operation. patient should be treated as if in the eruptive stage, but CALDER, Norman J. Rare Anatomical Anomalies. a cure is far less likely to result. In -the gummatous CATHCART, E. Provan. The Influence of Carbohydrate on stage two injections of salvarsan should be given Metabolism. and CULLIS, Winifred. The Distribution of Nerves in the Heart. ono or two courses of intramuscular injections of mercury EDIE, E. S. Some Experimental Work on the Action of and iodides, since no more can be expected than to cure Enzymes. the svmptoms. In the latent stage, provided the patient GARDNER, A. D. The Sugar of Blood and Urine. is perfectly healthy and nothing abnormal can be found GLADSTONE, R. J. Description of some Australian and upon thorough examination, in spite Tasmanian Skulls. of the Wassermann GOODALL, J. Strickland, and RICHARDS, Hedley N. D. Some reaction being positive, no treatment is indicated, because Instrumental Variations in the Human Electro-Cardiogram. a positive Wassermann reaction is by no means necessarily LEVY, A. Goodman. Ventricular Fibrillation, the Cause of indicative of active syphilis; it is often rather a measure Death under Chloroform. of the host's protective capacity against the organism. M,cKENDRICK, Emeritus Professor J. G., F.R.S. Theories of Hearing with Analogies from the Gramaphone, with a Pure meningeal and pure arterial lesions of the central Demonstration of Improvements on the Gramaphone and the nervous system can be markedly benefited by intravenous Obliteration of Noise. injections of neo-salvarsan and mercury. Some cases of McKENZIE, Ivy. The Reptilian Heart and its Significance in tabes are slightly improved, some are made worse or the Interpretation of the Co-ordinating Muscular Systems in unaltered; most cases of general paralysis of the insane the Mammalian. MCKENZIE, Ivy, and ROBERTSON, Jane I. Some Further are made worse or unaltered. Intrathecal injections of Researches on the Anatomy of the Bird's Heart. salvarsanized serum exert a beneficial and rapid action MAcLEOD, Professor J. J. R. (Cleveland, U.S.A.). Some Recent upon pure meningeal lesions. They may improve cases Researches on Sugar Metabolism. of tabes or leave them unaltered. They may slighltly MACWILLIAM, Professor J. A. (1) The Regulationi of the Heart improve cases of general paralysis of the insane, but on Beat. (2) Some Points in the Action of Chloroform. MELVIN, G. S., and MURRAY, J. R. Some Observations on the whole they tend to make such cases worse. Every Blood Pressure. woman who has once given birth to a syphilitic child ORR, J. B. A Contribution to the Metabolism of Creatine and should be treated throughout tlle whole of each suic- Creatinine. ceeding pregnancy, first with five intravenous injections REID, Professor R. W., and TOCHER, J. F. Anthropometric of neo-salvarsan at weekly intervals, and for the rest of Characteristics of Students of Medicine in the University of Aberdeen. the nine months with mercury. Congenital syphilis is RIDDOCH, G. The Sympathetic System of a Full-time Fetus. best treated with mercury. Every case of syphilis should ROBERTSON, Jane I. (1) The Phylogenetic Development of the be treated individuallv, as no two are alike. The treat- Bulbar and Ventricular Septa of the Heart. (2) Cardiac ment should be guided by clinical observations, and little Malformations in which the Great Efferent Vessels arise or no reliance should be upon any existing bacterio- from the Right Ventricle. placed TRIBE, Mrs. The Existence of Vasomotor Nerves in the logical or serological test. A spontaneous cure in most Lungs. stages is possible, and all that treatment does is to stimulate the factors which are responsible, thereore DERMATOLOGY AND SYPHILOLOGY. no treatment will kill directly all the' plhases of the President: ALFRED EDDOWES, M.D., M.R.C.P., London. Leucocytozoon syphilidis. Vice-Presidents: R. CRANSTON Low, M.B., F.R.C.P.E., Contributions of drawings, photographs, microscope and Edinburgh; J. M. HENDRIE MACLEOD, M.D., M.R.C.P., other specimens relating to dermatology and syphilis aro London, W.; J. A. NIXON, M.B., F.R.C.P., Clifton, invited for the Pathological Museum, and should be sent Bristol; J. C. OGILVIE WILL, M.D., C.M., Aberdeen. as early as possible to Aberdeen. Honorary Secretaries: J. FARQUHAR CHRISTIE, M.B., C.M., 7, Alford Place, Aberdeen; J. D. PRYDE MCLATCHIIf, M.B., DISEASES OF CHILDREN, INCLUDING C.M., 34, Welbeck Street, London, W. ORTHOPAEDICS. The following programme has been arranged: President: JOHN 0THOuISON, M.D., F.R.C.P.E., Edinburglh July 29th.-Discussion on the Need for more Method in Vice-Presidents: ANDREW FULLERTON, M.Ch., F.R.C.S.I., thle Conflict with Lupus and Ringworm. To be opened by Belfast; H. M. W. GRAY, M.B., F.R.C.S.E.,. Aberdeen; Dr. NORMAN WALKER. E. MUIRHEAD LITTLE, F.R.C.S., London; J. HUGH July 30th.-Discussion on the Modern Treatment of THURSFIELD, M.D., F.R.C.P., London. Honorary Secre- Syphilis. To be opened by Mr. J. E. R. McDONAGH. taries: A. S. BLUNDELL BANKART, M.C., - F.R.C.S., 14, July 31st.-Independent papers. Harley Street, London, W.; D. WATSON GEDDIE, M.B., DAVIS, Haldin. Infantile Eczema. C.M., 13, Golden Square, Aberdeen; H. TYRRELL GRAY, McDONAGH, J. E. R. The Rationale of the Wassermann M.C., F.R.C.S., 60, Harley Street, London, W. Reaction. TOMKINSON, J. Goodwin. Three Cases of Lahore Sore. The following programme has been arranged: WALTER, J. C. M. On the Use of Antimony in Syphilis. July 29th-(1) Discussion on Congenital Dislocation of WILLIAMS, A. Winkelried. Keratodermia Blenorrhagica. the Hip. To be opened by Mr. T. H. OPENSHAW. The following syllabus of his opening paper has been July 30th.-(2) Discussion on the Thymus Gland in its stupplied by Dr. NORMAN WALKER: Clinical Aspects. To be opened by Dr. ARCHIBALD E. Lupus: Statistics of cases attending the Royal Infirmary GARROD. during the past twenty-two and a half years. Particulars July 31st.-(3) Joint discussion on the Diagnosis of of their attendances. Discussion of the various methods Chronic Pulmonary Tuberculosis in Infancy and Childlhoocd' of treatment employed. Outcome. The difficulties of (See Section of Medicine). treatment. Lupus carcinoma. Suggestions. Ringworm The following papers have been accepted: and Favus: Statistics of cases; evidence of epidemics; FINDLAY, Leonard, and ROBERTSON, Madge (Glasgow). The effect of school inspection; opening of special schools and Treatment of Congenital Syphilis. FRASER, William (Edinburgh). The Influence of the Thymus of more organized treatment. and Certain other Ductless Glands on the Epiphyses. Tlle following is an abstract of Mr. J. E. R. McDONAGH'S MACLENNAN, Alexander (Glasgow). The Technique of opening paper: Thymectomy. The chancre should be excised when possible; failing MCNEIL, Charles (Edinburgh). The Association of Abnormal Types of Pneumonia and of Tuberculosis in Children with tlhat, it should be cauterized; and, failing cauterization, Thymo-lymphatic Hyperplasia. iiiercurial ointment should be rubbed in until every trace MCWALTER, J. C. (Dublin). Lime Salts in Children's Diseases. of the induration has vanished. In the primary stage, ROTH, Paul B. (1) The Treatment of Torticollis; and (2) The roughly, five intravenous injections of neo-salvarsan should Practical Treatment of Lateral Curvature of the Spine. 1)e given, allowing about four or five days to intervene WILKIE, D. P. D. (Edinburgh). Appendicitis and the Status between each injection. Mercurial treatment should be Lymphaticus. continued for one year in the form of intramuscular inijections given in three courses of eight weekly injections ELECTRO-THERAPEUTICS AND RADIOLOGY. alId allowing two months to intervene between each course; President: SAMUEL SLOAN, M.D., F.R.F.P.S., Glasgow, for the first three weeks of each iodides should be given Vice-Presidents: W. J. S. BLYTHELL, M.D., Kersal, internally. In the eruptive stage, roughly, seven injec- Manchesterl DAVID LAWSON, M.D., Nordrach-on-Dee. SUPPIEMENT TOTax JULY 4, 19I41 PROGRAMME OF ANNUAL MEETING LBRITISH MEDICAL JOUxNAL 3 N.B.; J. R. LEVACK, M.B., C.M., Aberdeen. Honorary ho given in which to see if the patient can deliver lherself. Secretaries: M. R. J. HAYES, F.R.C,S.I., 35, Upper Fitz- Pubiotomy, on the other hand, is a smaller operationi in william Street, Dublin; W. L. LOCI(E, M.B., Ch.B., 31, a favourable case; in an unfavourable case it- is a bigger Queen Anne Street, London, W.; F. PHILIP, M.B., 183, operation. It tends to cause, and practically always does Great AVestern Road, Aberdeen. cause, a permanent enlargement in the pelvis, alnd this The following programme hlas been arranged: allows the patienit in most cases to deliver lherself spontaneously in subsequent pregnancies. On the otlher July 29th.-(1) An Introductory Address by Professor hand, it is prone to cause laceration and injury to the LEDUC on Cerebral Galvanization. (2) Discussion on the surrounding parts, labour is prolonged and painful, andc Therapeutic Value of High-Frequency Currents; to be the fetal prognosis is worse unless the condition of tlie opened by the PRESIDENT. fetus is carefully watched. Tlle great advantage of July 30th.---Discussion on (1) The Comparative Value of pubiotomy is its effect on future pregnancies. In 19 case.s X Rays and Radium in the Treatmernt or Malignant operated oln in the Rotunda Hospital by Dr. Tweedy or Growtlhs; to be opened by Dr. IIERNAMAN-JOHNSON and the authlor all the patients recovered, and in all the chil(d Dr. JOHN MACINTYRE. (2) Electro-Tlierapy in Neurasthenia; wvas born alive. These 19 patients had had 29 labours to be opened by Dr. AGNES SAVILL, followed by Dr. W. F. prior to the performance of pubiotomy, 7 of the children Somerville. (3) Demonstration by Dr. C. F. BAILEY on being born alive and 22 dead. Subsequent to pubiotomy Testing and Treating Muscles by the Condenser Method. they had 15 labours, in whiclh 12 children were born alivce July 31st.-(1) Joint discussion on the Diagnosis of and 3 children were born dead, anld 2 of these deatlhs were Chronic Pulmonarv Tuberculosis (see Section of Medicine). due to complications in no way associated with pelvic (2) Discussion on X-Ray Diagnosis in Gastro-intestinal contraction. Tlle author's genieral conclusioili is that Conditions, with Special Reference to Appendicitis; to be pubiotomy is preferable to Caesarean section in tlho opened by Dr. HERTZ. second degree of contracted pelvis,- unless there are special circumstances or complications present, aiid tliat GYNAECOLOGY AND OBSTETRICS. perforation is only permissible when the child is dead. President: F. W. NIOOL HAULTAIN, M.D., F.R.C.P.E., Edinburgh. Vice-Presidents: Professor J. ALEXANDER KYNOCH, F.R.C.P., F.R.C.S., Dundee; Professor R. G. LARYNGOLOGY, RHINOLOGY, AND OTOLOGY. MCKERRON, M.D., C.M., Aberdeen; T. G. STEVENS, M.D., President: H. LAMBERT LACK, M.D., F.R.C.S., Londoni. F.R.C.S., London; W. C. SWAYNE, M.D., Clifton, Bristol. Vice-Presidents: J. M. BOOTH, M.D., C.M., Aberdeen; Honorary Secretaries: H. S. DAVIDSON, M.B., F.R.C.S., J. S. FRASER, M.B., F.R.C.S.E., Edinburgh1; A. A. GRAY, 6, Atholl Plahe, Edinburgh; S. G. LUKER, M.D., F.R.C.S., M.D., F.F.P.S., Glasgow; 1'. H. LIvINGSTONE, M.D.. 1, Harley Street, London, W.; ALEXANDER MITCHELL, M.B., F.R.C.S.E., Newcastle-on-Tyne. Honorary Secretaries: 2A, Albyn Place, Aberdeen. 0. ST. J. GOGARTY, M.D., 15, Ely Place, Dublin; J.- F. The following programme has been arranged: O'MALLEY, F.R.C.S., 16, Weymouth Street, Liondon, W.;, July 29th.-Discussion on the Treatment of Fibromyo- H. PETERKIN, M.B., 17, Bon Accord Crescent, Aberdeen. mata. To be opened by Dr. ARCHIBALD DONALD) (Man- The following programme has been arranged pro- clhester), followed by Professor Gauss (Freiberg). visionally: Jtily 30th.-Discussion on the Management of Pregnancy July 29th.-Discussion on the Treatment of Iiioperable and Labour in Contracted Pelves. To be opened by Dr. Growths of the Nose and Throat. To be opened by Mr. HENRY JELLETT, followed by Professor Frank (Cologne). WV. D. H1ARMER (Diathermy), followed by Dr. WILLIAM HILL Pathological Demonstrations anll independent papers. (Radiurn) and Dr. JOHN MACINTYRE (X Rays). The following papers have been accepted: July 30th.--Discussion on Oto-sclerosis. To be opened by MIC VALTER, J. C. Drug Treatmeiit of Dysmenorrhoea. Dr. A. A. GRAY (Etiology and Pathology), followed by Mr. MIURRAY, H. Leith. Acidosis and the Nitrogen Particles in J. S. FRASER (Clinical Aspects), Mr. G. J. JENKINS (Various Pregnancy. Methods of Treatment), and Mr. F. F. MUECKE (Auditory SHANNON, David. The cases of Contracted Pelvis admitted to Re-education). Professor Kerr's Clinic in the Glasgow Maternity Hospital July 31st.-Mr. J. S. FRASER (Edinburghi): Demonstra- between the years 1909 and 1913. tion-TThe Pathology of Labyrinthitis. Mr. WATSON- The following is a synopsis of Dr. JELLETT'S paper: WILLIAMS (Bristol): Demonstration-Intranasal Opera- Fromn a clinical standpoint contracted pelvis may be tions for Frontal Sinus Disease. Dr. BROWN KELLY divided into two mnain classes-symmetrical contractions (Glasgow): Paper-The Difficulties and Dangers of and asymmetrical contractions. The paper deals with Exploratory Puncture of the Antrum of Highmore. the former contractions alone. They may be divided The following is an abstract of Dr. GRAY'S opening paper into four degrees, based on what exDerience shlows is the on Oto-sclerosis: necessary treatment of each. In the first degree one Etiology: There are m-any contributory factors, but may assume that the child will be delivered spontaneously individual predisposition appears to be the most important if of normal size. In the second degree it nmay be assumed factor. How this predisposition comes into existence isi that delivery of a living child per vaginam is only possible one of the chief problems of the future in the case of if the size of the child is diminished or the size of the oto-sclerosis. Pcathological Anatomy: The most obvious pelvis increased. In the third degree spontaneous delivery cliange is absorption of the dense bony tissuie of the capsule tlhrouLgh the pelvis of a viable child is impossible. In the of the labyrintlh, associated as a rule with simultaneous fourth dearee delivery through the pelvis is impossible, deposition of new-formed porous bone. Tlle diseased area even if the child be reduced by a destructive operation to is most commonly found immediately in front of the oval the maximum extent, and so Caesarean section is the only window. The sharp demarcation of the affected portion .treatment, whether the child is alive or dead. The author is one of the most characteristic features of the disease. confines Ilis remarks to tlle treatment of the second degree, In many cases the stapedio-vestibular svnostosis is and contrasts in connexion with it deliverv through the obliterated and the stapes becomes fixed to the walls of pelvis thle induction of premature labour or pubiotomy the ov4l window by bony union. In the early stages of or symphysiotomy-and Caesarean section. The objec- the disease changes are not demonstrable in the sound- tions to induction are the risk of septic infection during perceiving structures. In the later stages of the disease the operation, its general uncertainty, and the fact that changes are usually found in the nerve structures, a small child, iiaturally delicate, results. There are, oln Contributions for the division of the Museum set apart the other hand, very few argum-ents in favour of it, except for preparations, specimens, drawings, and instruments that for the general practitioner it is simpler to perform relating to the work of the Section should be sent to than eitlier of tlle other operations, and that it does not Dr. Henry Peterkin, 17, Bon Accord Crescent, Aberdeen. necessitate a "cutting " operation. Caesarean section has in its favour simplicity, certainty, absence of all laceration of tile genital tract, easy labour, quick recovery, and an MEDICAL SOCIOLOGY. improved fetal prognosis. On tlle other hand, once a President: JOHN GORDON, M.D., Aberdeen. Vice-Prcsi- Caesarean section is done, it will probably always have to dents: J. MUNRO MOIR, M.D., Inverness; DAVID NICoLSON. be done in subsequent labours, because to get best results it C.B., M.D.. Camberley, Surrey; GEORGE WILLIAMSON, must be done at the beginning of labour, and so no time can M.B., Aberdeen. Honorary Secretarics: DAVID IORIE, SUPL 4 BBITI8HME:DICAMEILTTOJOURENALTERNL PROGRAMME OF ANNUAL MEETING. [JULY 4, I9'14 M.D., 1, St. Devenick Terrace, Cults, Aberdeen; Dr. ANNE (Section of Diseases of Children), and Dr. IRONSIDE BRUCB WATSON, 22, Waverley Place, Aberdeen. (Section of Radiology). The followino programme has been arranged: Paper: July 29th.-Discussion on the Responsibility of the MCKENDRICK, J. S. (Glasgow). Splenectomy in relation to the State as regards Venereal Disease. To be opened by Dr. Treatment of Anaemia. GEORGE ROBERTSON (Edinburgh), followed by Professor E. Headache.-In opening the first discussion Dr. HARRY Pontoppidan (Copenhagen), and Drs. A. K. Chalmers, CAMPBELL will deal witlh the subject on the following lines: Louise Mcllroy, and Lachlan Grant. By headache is usually meant pain felt anywhere above July 30th.-Discussion on (1) a State Medical Service the base of the skull. It is a symptom of many different versus a Panel System; to be opened by Sir JOHN COLLIE, morbid conditions acting singly or in combination, and the followed bv Drs. H. H. Miles, R. C. Buist, Lauriston Shaw, only classification of whiell headaches admit is one based auid Milson Rhodes. (2) Medical Certification (otherwise upon causation. The various causes of headache may be than in regard to Insanity); to be opened by C. SANDEMAN, grouped under three main heads: (1) Organic disease of Esq., K.C., followed by Drs. A. C. Farquharson and J. C. the parts actually involved in the ache, such as meningitis McVail. and tumour; (2) irritation in other areas, as from eye- July 31st.-Discussion on the Duty of the State towards strain, diseases of the nasal passages, and accessory the Early Environment of the Clhild. To be opened by sinuses; (3) morbid states of the blood, as manifested Dr. LESLIE MACKENZIE (Edinburgh), followed by Drs. John by "plethora," anaemia, higlh blood pressure, abnormal Carswell and Tlhomas Dewar. urine, etc. These constitute much the most important causes of headache, and it is in the detection and removal The following is a syllabus of Sir JOHN COLLIE'S of them that the skill of the physician is most severely put opening paper: to the test. The National Insurance Act is a form of State medical Artificial Pneu7mothorax.-Dr. RIST, in opening the service. The principles of the construction of the Act. second discussion, will bring forward the following points: Quotation from the speech of the Chancellor of the (1) How should wve select su,itable cases for_pneumothorax Exchequer to the first meeting of the Advisory Committee. treatment? And are such cases often met with? One- The scheme of medical benefit. The panel system clhosen sided phtliisis of an upper lobe, with cavity, which offers by the British Medical Association. Free choice of doctor: the best chances of success to the pneumothorax therapy, its obviously necessary limitations. Payment by attend- is a very common form of tuberculosis of the lung. It ance or by the capitation system. Own arrangements and occurs seldom only to the physician-wbo does not submit contracting out. Advantages of panel or medic-al list- all his patients to an x-ray examination. But the pleuro- system; limitation of State control to the minimum; scope discovers more cavities than the stethoscope. (2) Is it preserving the best of the individualistic idea; preserving advisable to attempt pneunmothorax treatmlent in acutte or sitb a lhealtlhy amount of competition. The curse of "iinsti- acute cases of caMeouspneumonia ? In the author's opinion, tutionalism." Our national characteristics are against although the chances of complete recovery are small, one any mathematical "brigading " for any purpose. Irregular very often succeeds in improving such cases in a remarkablo practice certain to follow any whole-time salaried system. way. (3) No doubt pleural effusions are the most important The following is a syllabus of Dr. MACKENZIE'S paper: and the commonest complication of artificial pneumo- (1) Ante-natal Care: Enforcement of pre- and post- thorax. As a rule, they are of tuberculous nature. Somo confinement rest periods. Relation of inefficient infancy to are very small, and can only be detected with the help of daily work of expectant mother. (2) Birth: Registration the pleuroscope. If they do not disappear rapidly, their and training of midwives. Notification and registration of volume generally increases, and they may be of very long births and "dead" births. Refer to Dr. J. W. Ballantyne's duration. Although thley are by no means an obstacle to paper on stillbirths. General enforcement of Notification of the continuation of the treatment, they must be considered, Births Act. Infant mortality in relation to defective environ- in the author's opinion, as a rather unwelcome occurrence. mIent of child or- mother. (3) Health Visiting: Natural The thickenilng and hardening of the visceral-pleura, whicl sequence of notification of birtlhs. Illustrations from is the unavoidable consequence of a long-lasting effusion, Edinburgh svstem. Need for administrative nucleus of means thle complete and permanent loss of the respiratory statutory health authority witlh organization of voluntary function for the compressed lung, which will never be assistance. (4) Infant Clinics andMilk Dep6ts: Reference able to expand again after the cure is completed. If sucl to Dr. MeLeary's book. French system of consultation a lung was very extensively diseased when the treatment centres and milk clinics. Restaurants for mothers; Coullet began, the function would have been lost anyhow. But if system. German organization. Cr6ches. (5) Pre-School the greater part of the lung was in a sound condition, its Age Clinics: Duty of healtlh authority. Danger of environ- permanent exclusion is a serious matter. This considera- miiental influences in years between 1 and 5. Infections and tion weighs heavily against the pneumothorax treatment their sequelae. Tuberculosis. Open-air homes. This brings of so-called incipient cases. (4) Apart from its efficacy as infant forward to school age. (6) General Measures: Muni- a cure, artificial pneumothorax has put before us quite a cipal pure milk supply. Housing; clearance of town and number of highly interesting scientific problems, and at country slums; uncrowding of houses; improvement the same time provided us with the means of investigatina schemes; town planning. The statutory powers available some of them. The study of a series of cases of artificial for these objects. pneumothorax with the pleuroscope throws unsuspected light on several physio-pathological problems; it has enabled us to discover many curious phenomena, such MEDICINE. as Kienboeck's paradoxical movement of the diaphragm President: F. J. SMITH, M.D., F.R.C.P., London. or the inspiratory displacement of the mediastinum or the Vice-Presidents: J. R. CHARLES, M.D., F.R.C.P., Clifton, increased amplitude of heart beats, which are of great Bristol; G. MAITLAND EDMOND, M.D., C.M., Aberdeen; physiological or physio-pathological importance. HERBERT FRENCH, M.D., F.R.C.P., London; Professor B. A. W. MACKINTOSH, M.D., Aberdeen; Professor T. K. Tuberculosis in Infancy and Childhood.-Dr. D. MONRO, M.D., F.F.P.S., Glasgow; Professor A. M. STALKER, LEES has supplied the following abstracts of the remarlks M.D., C.M., Dundee. Honorary Secretaries: D. BARTY to be made by him in opening the third discussion: KING, M.D., M.R.C.P., 6, Devonshire Street, Portland The suisceptibity of young children to the infection of Place, London, W.; W. RATTRAY PIRIE, M.B., C.M., 20, tuberculosis has long been known to the workers in Aberdeen. children's hospitals. Of late the use of tuberculin as a Bon Accord Square, test has given prominence to this subject, and x-ray ex- The following programme lhas been arranged: aminations have contributed to our acquaintance with it. Ju-ly 29th.-Discussion on Headaclhe: Its Causts and The object of this opening paper is to attempt to showv Treatment. To be opened by Dr. HARRY CAMPBELL. that the diagnosis of chronic pulmonary tuberculosis in July 30tlh.-Discussion on Artificial Pneumothorax in infants and young children can be effected by the ordinary Pulmonary Tuberculosis. To be opened by Dr. RIST methods of physical examination of the chest. Carefu (Plhysician to the Laennec Hospital, Paris). percussion of a patient in the proper position easily detects July 31st.-Conjoint discussion on the Diagnosis of in cases of pulmonary tuberculosis a series of small dull Chronic PuLlmonary Tuberculosis in Infancy and Child- areas at the apices and elsewhere, wlicih recur regularly 1iood. To be opened by Dr. D. B. LEES, Dr. CLlVE RIVIERE in case after case of this infection, and witlh at localization SUPPLEMITT TO =I JULY 4, !9I41 PTO JKRAMME OF ANNUAL MEETING. rBRITISH MEDICAL JOURNI 5

wvhich is limited to this disease. Over these areas WALKER HEWITT, R.N. (2) Gangrene in' War; to be

'usually a marked defect of air entry, btut there may nio opened by Captain C. MAX PAGE, R.A.M.C.(S.R.).

morbid sound heard on auscultation even when July 30tlh.-Discussion on (1) the Treatment of Syphilis; areas are of large size. Six of these areas-two the to be opened by Lieutenant-Colonel T. W. GIBBARD,

upper part of each upper lobe and one in the upper R.A.M.C., and Major L. W. HARRISON, R.A.M.C. (2) On

each lower lobe-correspond to the sites indicated Comnmon Ailments in Camp: their Prevention and Treat-

patlhological observation (Fowler) as the earliest nient; to be opened by Captain C. JOHNSON, M.B.,

pulnmonary tuberculosis. In addition to these R.A.M.C.('T.F.).

monary areas a special area at the root of the July 31st.-A lecture, with limeliglit illustrations, on on the riglht side), due to enlarged bronclhial Experiences of the Nortlhern Party of Captain Scott's sometimes be detected in tuberculous aduLlts, Expedition, by Staff Surgeon G. MURRAY LEVICK, R.N. those who suffer from asthma." X-ray examination The following synopses of the papers introductory of firms the existence of tllese dull pulmonary discussions in this Section lhave been supplied by their areas. They are important for prognosis as -vell autlhors: diagnosis, and the six typical areas at the Fleet Surgeon WALKER HEWITT: oughit to be carefully miieasured and their size Treatment of Wounded in Naval Warfare.-Difficultics regular intervals by a simple form of welhave to contend with on board slhip in our treatment children the clinical picture of chronic pulmonary of the wounded; comparison between ourselves in this culosis is different from that in the adult, owing the respect and the Royal Army Medical Corps. Our medical greater freedom of the lymphatic circulation young' arrangements andfighting efficiency. The first aid party child and the consequent tendency of the tuberculous and its duties; necessity for tlhoroutgll training in carryinlg fectioni to spreadalong the peribronchial lymplhatics the the wounded. First, aid by the surgeons in the dressing bronchial glands at the root of the lung. In stations versus treatment on the sp)ot wlhere the wounded infections or in cases with feeble resistance fall by first aid party. The nature of tlhe wounds and results may follow from pressure on the vagus the question of lhaemorrhlage and sepsis. Methods of root of the lung, and the lung itself may conveying the wounded to the dressinig stations illustrated. affected. The tlhickened bronclhial tubes swollen Preliminaries before going into action. The selection of glands are easily seenby x-ray exalmiination, order the dressing stations in various classes of ships. Tlho to avoid false inferences we must renmember that necessity for a specially trained first aid party on ships be a sound conclusions can based on a screen not carrying medical officer. The question of apure air without a photograph; (2) that for a satisfactory supply to our dressing stations during action; suggestions graph the apparatus must be of the very the as to the best means of averting the dangers of suffocating exposure very short; (3) tllat even a first-rate fumes to our wounded down below. The actual surgical requiresthle utmost caution in its interpretation. treatment of the wounded on board the figlhting slhips andI " cause of distortion of tlhe clinical picture of clronic the question of slhock "; our duty to tlleminor as well monary tuberculosis in young children as the serious cases. Tlle question of speedy removal of liability to infectioni by itamiy different microbes, eachi the wounded after action and the necessity forthelhospital which may produce bronchopneumonia and ship. areas in the lungs. Yet it is probable that Captain C. MAX PAGE: the six dull apical areasclharacteristic of pulmonary Gangrene in WVar.--Consideration of types of gangreno culosis is sufficient evidence eithler of a mixed or whlicl may be met with inwar. General outline of treat- of thle previous existence of tuberculosis imient. Any distinction in type from the gangrene met attacked. witlh in average civil practice due to the youth and vigour Dr. CLIVE RIVIERE hias supplied the followving suimmary of tlle subjects. In the Ballkan war an apparently of his paper: idiopatlhic symmetrical gangrene was frequently observedl of a nature whicll had not been previously described. An Chronic pulmonary tuberculosis only a curiosity account of the clinical plhenonmena of this condition as infancy. In childhood tuberculosis of thoracic observed by the author and as reported by othiers. Its nearly always clinically the first stage of disease, etiology probably similar totllat of frostbite. Alternativo some secondary involvement of lung tissue the suggestions. Treatment as practised and observed. Pro- name Tuberculosis. This adeno-pulmonary Hilus phylactic considerations. runs a different course to phlitisis, with whiichi Lieutenant-Colonel T. GIBBARD: prognosis, W. be confused; it requires a different of m treatment, and hence separate consideration the T'reatmzent Syphilis: (1) Review of ore im--portant work relating to the treatment of syphilis during the year. head of diagnosis. Apical phithisis far less (2) Comparison of results obtained at the Military Hos- ''chiildhiood. Tuberculosis of Thoracic Glands: Hiluts pital, Roclhester Row, with different metlhods of adminis- tubercutlosis: Numerous special signs nearly un- tering salvarsan. (3) Comparison of results obtainedat reliable. Two signs of real value: one a characteristic on physical sign over the lung, never accurately Rtochester Row withlthe best results obtained tlle Continient. (4) Salvarsan-natoriutm. the past, and hence practically new; the other

modern-examination with x rays. Differential Captain CECIL JOHNSON: from phlitisis. Apical Phthisis in Children: Common Ailmnents in Campl.-This paper is intended to

no more difficult than in adults save for the uncertainty open a discussion on the best means of preventing minor obtaining sputum. The most reliable physical ailments in camp and at the same time to show hiow these tained by gentle percussicn, but the diagnosis ailmients affect the members of the Territorial Force by one on a careful weighing of evidence derived from causing the loss of or more days' training. The

signs and symptoms, none ofwhiichi are alone remarks will be treated under two headings'; (1) Modes of inonic. prevention before camp, (2) modes of prevention during camp. A plea willpube t forward for asiTicter medical examination of recruits and also that all rec-uits shiould be NAVAL AND MILITARY MEDIAINE AND SURGERY. examined before camp by a regimental miedical officer, and President : Surgeon-General Wm. MAXWELL CRAIG, only in very special circumstances by a geleral prac- M.B.Ed., C.B., R.N., Haslar. Vice-Presidents: Surgeon titioner not holding a commission thein e R.A.M.C. It will General P. H. BENSON, I.M.S., Upper Walmer; Brigade- be suggested that outside of the ordinary medical exami- Suirreon-Lieutenant-ColonelGG1AY,,R. I.I.S., Aberdeen; nation recruits should be refused on account of bad teeth Major G.R. LIvINGSTON, M.D., R.A.M.C.(T.F.); and also on gleneral and moral grounds. Duiring camp theo Colonel GEOPG GE SCOTT, R.A.M.C. (ret.), subject of clothes will be treated (especially socks and HIlionorary Secretaries: Captain CECIL JOHNSON, R.A.M.C. boots), food and drink, cleanliniess of person and tents, (T.F.), Cricklewood, East Sheen, London, S.W; removal of tents at least every seven days, means for tenant-Colonel FRANcis KELLY, M.D., R.A.M.C.(T.F.), Wcst drying clothes,e tc. A "foot" inspectien will be advocated Cr'aibstuone Street, Aberdeen. and also an inquiry into the state of bowels on the second The following programmee hias been arranged: day with subsequent treatmnet, and the friendly co- July 29ti.-Discussion on (1) the Treatment of Wounded operation of othier officers shall be asked for in all the In Naval Warfare; to be opened by Fleet duties undertaken by the regimental medical officer- 6 EUPPLEMENT TO THE BwTISH MEDICAL JOURNAL] P1-OWRAMME OF' ANNUAL MEETING. [JULY 4, igr4 7 - 7 - NEUROLOGY AND PSYCHOLOGICAL MEDICINE. facility in its performance,' or is it better to vary tle Pree4dent: F. W. MOTT, M.D., F.R.C.P., F.R.S., London. character of operations to suit the needs of individual Vice-Presidents: DONALD J. ARMOUR, F.R.C.S., London; patients? (2) In tlle latter case, what are the indications JAZIEs NEIL, M.D., Oxford; WILLIAM REID, M.D., Aber- which should guide us in selecting the appropriate opera- ]lcen; H. CAMPBELL THOMSON, M.D., F.R.C.P., London. tion for each patient? The chief desiderata in the Honorary Secretaries: H. DE MAINE ALEXANDER, M.D., selection of a cataract operation are (1) safety, (2) visual ALberdeen District Asylum, Kingseat, Newvmachar; M. D. result, (3) beauty of eye, (4) brevity of procedure, (5) EDER, M.R.C.S., L.R.C.P., 7, Welbeck Street, London, fewness of operative interferences. (1) Safety holds tlho W.; A. W. FALCONER, M.D., M.R.C.P., 18, Bon Accord premier place. The bearing upon it of a conjunctival Square, Aberdeen. flap, of a Desmarre's bridge (1851), and of suturing after simple extraction will be considered, also the dangers of The following programme lhas been arranged: lavage apparatus. A simple device will be shown. Tlle July 29th.-Discussion on the Diagnosis and Treatment habit of doing a preliminary iridectomy whenever simple of Parenchymatous Syphilis. To be opened by Dr. F. W. extraction is not contemplated makes for safety. A mode MOTT, followed by Dr. Plaut (Munich) and others. of doing it with the minimum of traunmatism will be July 30th.-Discussion on tlle Significance of the advocated, and a keratome for tlle purpose slhown. Unconscious in Psycho-pathology. To be opened by Dr. (2) Visual resutlt comprises (a) vision with test types under C. G. JUNG (Zurich1). optical correction, (b) vision without correction (c) post- July 31st.-Independent papers: operative astigmatism. Each of tllese factors deserves BRUCE, L. Campbell. Demonstration-The Pathology of attention. (3) It is important to preserve beauty of the Disseminated Sclerosis. eye in certain cases by securing a circular pupil, especially HYSLOP, J. B. Anger in its Medico-Psychological Aspects. if the iris be and well in a com- MACKENZIE, Dr. (Inverness). Some Considerations regarding light-coloured exposed Insanity in the Highlands. paratively youthful patient. In later life the drooping of MIILLER, Crichton. The Psychic Factor in Insomnia. the lid renders this consideration unnecessary. (4) Brevity TURNER, W. Aldren. Epilepsy and Brain TumouLrs. ofprocedu,re; the self-control of some patients is extremely WILSON, A. S. Kinnier. The Temporo-Sphenoidal Form of short. For these a limbal incision after a preliminary Epilepsy. iridectomy may be best, being the briefest, especially if Dr. MOTT'S opening paper on the Diagnosis and Treat- the capsule be opened by the knife during the incision, or ment of Parenchymatous Syplhilis will be accompanied bv else Horner Smith's procedure be done. (5) Fewvness of a lantern demonstration and cover the followina ground: operative interferences; here intracapsular operations lea(l (1) The importance of tlle study of the pathology of the way, since they entirely obviate the necessity of general paralysis and tabes (in the light of recent needling for after-cataract. Failing an intracapsular researcbes) in respect to their diagnosis and treatment. extraction, " simple " or "combined extraction" may be (2) Syphilis a disease of the lymphatic system. The chosen, witlh or without simultaneous or early division of lymphatic systems of the brain and spinal cord in relation the posterior capsule. Four conclusions: (1) A simple to the mode of entry of the spirochaetes or their toxins extraction, subeonjunctivally performed, with a small into tlle central nervous svstem. The cerebro-spinal fluid, mobile pupil and the capsule split opposite thereto, exhibits a secretion of the choroid plexus, in relation to the the greatest boon surgery can confer upon an eye. In pathology of parenchymatous syphilis. The importance addition to its beauty it enables the patient to walk in tlho of the condition of the fluid in relation to diagnosis and street without spectacles, if need be. Its consideration treatment. (3) The existence of spirocliaetes in the should not be omitted when a quiet amenable patient, central nervous system in relation to the pathology of not too old, presents. a mature, uncomplicated cataract. parenchymatous syphilis. The infection of the central Prolapse of the iris can be guarded against by suturing tlle nervous system, tlle evidence of its occurrence, the flap or by a Desmarre's bridge. (2) Failing simple extrac- time of its occurrence, latency. Personal observations tion, a preliminary iridectomy should be done whenever on a series of 100 cases of general paralysis, in which practicable. (3) Failing both (1) and (2), combined extrac- spirochaetes were found in the brains in 65 per cent. tion slhould next be considered, with either a limbal (4) The correlation of cortical spirochaetosis witlh the incision or a conjunctival flap. (4) Lastly, intracapsulait iiorbid histological changes and phenomena of neuronic operations sLould only be done under the best conditiolns ir-itation and destruction, with their attendant clinical of assistantship and (if among the white races) in a certain signs and synmptoms. (5) Experiments on animals in class of patients only. These operations present advantages telation to the therapeutic action of mercurv and arseno- and disadvantages. beizol compounds. (6) Theories regarding the causation of parenchymatous syphilis: (a) Modification of the spiro- chaete and evidence thereof; (b) the hypersensibility of PATHOLOGY AND BACTERIOLOGY. the neurones; (c) a lowered resistance of the neurones. President: W. S. LAZARUs-BARLOW, M.D., F.R.C.P., (7) Neurorecidive, or Herxheimer's reaction in relation to London. Vice-Presidents: C. H. BENHAM, M.D., M.R.C.P., treatment by salvarsan. (8) Recent developments in the Hove; CHARLES BOLTON, M.D., F.R.C.P., London; J. C. G. treatment of parenchymatous syphilis by intrathecal LEDINGHAIM, M.B., Ch.B., London; J. H. TEACHER, M.B., injection of salvarsanized serum and of hypertonic F.F.P.S., Glasgow. Honorary Secretaries: G. MELLIS solution of neo-salvarsan. The results in general DUNCAN, M.B., C.M., 12, Bayview Road, Aberdeen; J. F. paralysis. GASKELL, M.D., M.R.C.P., 23, Ladbroke Grove, London, W.; J. W. TREVAN, M.D., B.S., St. Bartholomew's Hospital, OPHTHALMOLOGY. London, E.C. President: C. H. USHER, M.B., F.R.C.S.Edin., Aberdeen. The Vice-Presidents: A. R. GALLOWAY, M.B., C.M., Aberdeen; following programme has been arranged: KARL A. GROSSMANN, M.D., F.R.C.S., Liverpool; N. BISHOP July 29tlh.-Discussions on (1) the Action of Radiations HIARMAN, M.B., F.R.C.S., London; A. H. H. SINCLAIR, M.D., on Cells and Fluids; to be opened by the PRESIDENT. F.R.C.S.Edin., Edinburgh. Honorary Secretaries: F. R. (2) The Biochemistry of Immunity Reactions; to be openied IHILL, M.B., C.M., 62, Warwick Road, Carlisle; Miss by Dr. CARL BROWNING, followed by Drs. J. H. Tlhiele, EUPHAN M. MAXWELL, M.B., 19, Lower Baggot Street, J. CruLickshank, and Mr. Mackenzie Wallis. Dublin; W. CLARK SOUTER, M.D., 2, Bon Accordc Square, July 3Oth.-Joint discussion on the Pathology of Heart Aberdeen. Function (see Section of Pharmacology). The been July 31st.-Discussion on the Importance of Variability following programme has arranged: among Bacteria and its Bearings on Diagnosis. To be 1. Discussion on the Choice of a Cataract Operation. To opened by Dr. W. J. PENFOLD. be opened by Mir. E. E. MADDOX. Papers: 2. Discussion on the Hvgiene of Reading and Near HORT, E. C. Recognition of Haemic Inifections of the Urine Vision. To be opened by Mr. J. HERBERT PARSONS. and its Diagnostic Value. 3. Discussion on the Teaching of Ophthalmology to MORGAN, J. M., and TEACHER, J. H. Aneeurysm of the Aort3 Medical Students. To be opened by Dr. MAITLAND due to Bacterial Infection. IRAMSAY. In his opening paper Dr. LAZARUS-BARLOW deals witlh In hiis opening paper Mr. MADDOX will submit two his subject on the following lines: iluestions for debate: (1) Is it better for each surgeon to The great potency of radium and its widespread distri- lce) to one miiode of operating so as to acquire the greatest bution suggest tllat the beneficial results in medicine OULY 4, 19I41 PROGRAMME OF ANNUAL MEETING. BRITIEH MEDICAL JOURNAL which lhave been ascribed to its action in minute quantities structural formulae alone. The action of complex sub- may be real. Nevertheless, definite scientific groucds for stances-for example, the alkaloids-can only be deter- such a view are almost completely wanting, and the obSect mined experimentally in each case, though a new bodv of the discussion is, on the one hand, to formulate som6 lhaving close structural analogy to one of known action idea of the facts in our possession; but even more, on tlle would probably act in a similar manner. The difficulties otlier lhand, to inidicate the wide field for fruitful research in correlating structure and action are great, and arise that is unexplored. It is known that with relatively large miiainly from the biological side. We are ignorant of the doses of (radium) radiations the nucleus is the part of the way in which molecules as a whole act on protoplasm, and cell in which the most obvious modifications are seen; have little knowledge of the underlying causes of selective that paraplastic cell substances (Altmann's granules) may action. As an introduction to this discussion we may be modified by exposure to alpha radiation; and that sunmmarize our knowledge of the way in which chemical starch may be converted into dextrin by x radiation. structure directly or indirectly influences pharmacological These facts indicate that cell metabolism may be pro- action in tlle following way. It must be understood tllat foundly altered by radiations, but the limits of such changes in structure considered in this way only include alteration are unknown. At first it was assumed upon suclh alteratiolns as lead to new bodies chemically com- physical grounds that alpha, beta, and gamma radiations parable with the first. Alterations in chemical structure would act similarly upon cells if due account were taken may affect the pharmnacological action of a substance, (a) of their different contents of energy and range; but there by altering, its bellaviour before absorption, that is, in tlle is some evidence that this is not the case, specific types of alimentary canal; (b) by altering its general or special rays being associated with special types of pathological reactivity as regards body cells and fluids after absorption. change. From the more definitely remedial side tllere is These two headings may be subdivided as follows: (a) The a small amount of evidence that radium radiations can act behaviour of a body in the alimentary canal may bo beneficially on cell life, and a greater reason for believing ehanged by alterations (i) in its physical properties, for tlhat certain quantities can stimulate cell multiplication. example, solubility, (ii) in its ehemical properties, for But whether under the conditions all the activities of the example, its reaction to acids and alkalis; (b) after cell are improved so that an intrinsically better type of absorption or after intravenous or hypodermic injectio:ii cell results, or Whether one function of the cell is exalted the physiological action of a substance may be alteJ:ed at the expense of others, is unknown. Hence there is (i) by alterations involving clhanges in its physical room for a very large amount of work upon the effect of properties, suchl as its solubility in body fluids or its radiations in all branches of biological science, and degree of dissociation in solution, (ii) by changes in in vegetable and animal physiology and structure leading to more or less easy synthesis, particu*rlyphysiological chemistrv. reduction, or oxidation, (iii) by changes in the outlying Dr. W. J. PENFOLD Will show that from recent studies it parts of the molecule wlichl affect its special reactivity emuerges that not only fermnentation power but also all with certain cells in the body-that is, by changes culture and serum reactions are subject to variation. This (a) in the composition, (3) in the position of the sido variation and selection have been shown to occur within clhains or reactive atomic groups, (iv) by profound the body in the course of infection, while in the laboratory changes in its essential molecular arrangeluent whiclh tlhe precise factors in the environment effecting the selec- miiay affect its special or general reactions with cells or tion lhave been individually examined. It will be slhown organs. Such changes fall into two groups, both relating that the facts so far established on the subject affect: to tlhe special relations of the atoms, namely (a) changes (a) bacterial classification; (b) the recognition of bacteria, in valency, (!3) stereo-isomeric clhanges. tle standards adopted by the hygienist, epidemiologist, and tlle clinical bacteriologist; (c) tlle vaccinist, whetlhcr STATE MEDICINE AND MEDICAL JURISPRUDENCE. lie be engaged in immunizing patients or in producing President : Professor MATTHEw HAY, M.D., LL.D., serums for passive imimunization. F.R.C.P.I., Aberdeen. Vice-Presidents: E. LEE COLLIS, M.B., B.Ch., London; Professor F. W. -EURICH, -M.D., PHARMACOLOGY, THERAPEUTICS, AND DIETETICS. Bradford; W. HABGOOD, M.D., Sutton; W. LESLIE President: Professor J. THEODORE CASH, M.D., LL.D., MACKENZIE, M.D., F.R.C.P., LL.D.,-Edinburglh. Honorary F.1%.S., Aberdeen. Vice-Presidents: F. J. CHARTERIS, Secretaries : R. BALFOUR GRAHAM, F.R.C.S.E., Leven, M.D., Glasgow; 0. F. F. GRUNBAUMI, M.D., F.R.C.P., Fife; W. ALEXANDER MACNAUGHTON, M.D., County Build- London; J. C. MCWALTER, M.D., Dubliin. Honorary Secie- ings, Stolnehaven, Kineardineshire; FRANK E. ROCK, M.D., taries: W. J. DILLING, M.B., Ch.B., Materia Medica Town Hall, Edmonton, N. Department, Marisclial College, Aberdeen; J. M. The following discussions lhave been arranged: FORTESCUE-BRICKDALE, M.D., 52, Pembroke Road, Clifton; 1. On Deatlh Certification. To be opened by Sir VICToR J. DAVENPORT WINDLE, M.D., Cippenham Lodge, Sotuthall. HORSLEY. The following programme has been arranged: 2. On Malingering. To be opened by Sir JOHN COLLIE. July 29th.-Discussion on Recent Advances in tlle 3. On the Period and Duration of Infectious Disease. Relationship between Chemical Constitution and Plharma- To be-opened by Dr. J. H. BUCHAN. cological Activity. To be openied by Dr. FORTESCUE- 4. On the Administrative Treatment of Tuberculosis. BRICKDALE. To be opened by Dr. J. T. WILSON (the county standpoint) July 30th.-Joint discussion on the Pathology of Heart anid Dr. A. S. M. MACGREGOR (the city standpoint). Function, including the Experimental Pharmacology and The following papers have been accepted: Therapeutics of Pathological Conditions of the Heart. BUSHNELL, F. G. The Administrative Control of Tuberculosis To be opened by Dr. THOMAS LEWIs, followed by Sir and the Public Health Minister, Department, and Service. James Barr and Dr. J. Mackenzie. CHALMERS, A. K. Certification of Births aind Deaths. CHILDE, C. P. The Advisability of suitable Steps being July 31st.-Discussion on the Pharnmacology and Thera- adopted by the State and by Municipal Authorities to secure peuLtics of the Animal Extracts, exclusive of Thyroid the Earlier Treatment of Persons suffering from Cancer. Extract. To be opened by Professor NOEL PATON COLLIE, Sir John. Thirty-one Thousand Consecutive Medical (Plhysiology) and Dr. 0. F. F. GR{;NBAUM (Thierapeutics). Examinations conducted chiefly for the Public Service. CROFTON, W. M. Preventive Inoculation of Tuberculosis, and Papers: the Possibility of this on a Large Scale. GUNN, J. A. The Pharmacolody of the Isolated Human Uterus ESSLEMONT, J. E. Garden Cities for Consumptives. and Fallopian Tubes. Guy, J. The Causes of the Fall in the Tuberculosis Death-rate. MCWALTER, J. C. Notes on Cerii Oxalas. JESSELL, G. The Organization and Management of a Tuber- MUTHU, J. Chowry. Clinical Observations on Diet in the culosis Dispensary. Treatment of Pulmonary Tuberculosis. LEDINGHAM, J. 0. G. The Experimental Aspect of the Carrier Problem, with special reference to Typhoid Fever. Tlle following is an abstract of Dr. FORTESCUE-BRICK- MACRAE, Farquhar. Anaphylaxis in the Antitoxin Treatment DALE'S opening paper: of Diphtheria. Althouglh the pharmacological action of any substance MCWALTER, J. W. Tlle Necessity of Reforming the Coroner's introduced inito the body muust ultimately depend upoin Inquest. its chemical str-ucture, and all implied in that term, yet MILNE, R. The Prevention of Infectiouis Disease. MUTHU, Chowry D. J. Tuberculosis in India. at present it is only with regard to the simplest chemical PREST, E. E. Sanatorium Benefit and the Position of Sana- bodies that any deductions as to pharmaco-dynamical toriums in their Relation to the Treatment of Chronic- Cases properties can be made from a consideration of their of Pulmonary Tuberculosis. - 8 KIPLEXENT TO THE BaITISH MEDICAL JOURNWALJ PROGRAMMF4- OF ANNUAL MEETING.-[ [JULY 44, -f914 Ross, E. H. Intracellular Parasites in Acute Measles and Museum Committee, Marisclial College1 will be glad to Scarlet Fever. hear as soon THOMSON, H. H. The Care and Control of the Tuberculosis as possible from intending exllibitors, and Patient as an Individual. will later forward information as to packing, insurance of WYNNE, F. E. Death Certification, with some Criticisms on exhibits, etc., the expense of which will be borne by the the International List of Causes of Deatlh. Association.

SURGERY. Honorary Local Treasurer- President: J. SCOTT RIDDELL, M.V.O., M.B., C.M., GEORGE WILLIAMSON, M.B., Aberdeen. Vice-Presidents: J. GRANT ANDREW, C.M., 256, Union Street, Abercteen. F.R.F.P.S., Glasgow; ARTHUR CONNELL, F.R.C.S.E., Honorary Local Secretaries- Sheffield; W. MCADAm ECCLES, M.S., F.R.C.S., London; THOMAS FRASER, M.B., T. EAGLESON GORDON, F.R.C.S.I., Dublin; Professor 16, Albyn Place, Aberdeen. JOHN MARNOCH, M.B., C.M., Aberdeen; ALEXANDER MILES, FRED. K. SMITH, M.B., F.R.C.S., Edinburgh. Honorary Secretaries: G. H. COLT., East Craibstone Aberdecn. F.R.C.S., 12, Bon Accord Square, Aberdeen; RUPERT 7, Street, FARRANT, F.R.C.S., 59, Queen Anne Street, London, W.; J. M. GRAHAM, F.R.C.S.E., 5, Castle Terrace, Edinburgh; S. THOMPSON IRWIN, M.Ch., F.R.C.S.Edin. 29, University PROVISIONAL PROGRAMME. Square, Belfast. The following is the provisional time-table for the The following programme has been arranged: Aberdeen Meeting: Wednesday, July 29th.-Discussion on the Etiology and Treatment of Carcinoma of the Tongue. To be opened bv FRIDAY, JULY 24TH. Mr. W. G. SPENCER, followed by P-ofessor H. Morestii 10 AM.-Annual Representative Meeting. of Paris, and a demonstration by Professor J. K. Jamieson and Mr. J. F. Dobson (see below). SATURDAY, JULY 25TH. Thursday, July 30th.--Discussion on the Surgical Treat- 9.30 A.M.-Representative Meeting. ment of Arthritic Deformities. To be opened by Mr. ROBERT JONES. MONDAY, JULY 27TH. 9.30 A.M.-Council Meeting. Friday, July 31st.--Discussion on Anoci-association, or 10 A.M.-Representative Meeting. the Evolution of the Shockless Operation. To be opened by Mr. H. M. W. GRAY. TUESDAY, JULY 28TH. Papers.-The following papers have been accepted: 9 A.m.-Exhibition of Surgical Instruments, Drugs, BOYD, Sidney A. The Newer Indications for Removal of the etc. The Exhibition will remain open Spleen. until 6 p.m. on this and the three DON, A. Pott's Disease in Cervical RegSion, with Methods of following days. Bony Splinting. 9.30 A.M.-Representative Meeting. EDINGTON, G. H. A Method of Opening the Abdomen for 2 P.M.-Annual General Meeting. Appendicectomy. *8.30 P.M.-Adjourned General Meeting, President's GORDON, T. E. Duodenal Haemorrhage. Address. GUNN, J. A. The Action of Certain Drugs on the Isolated EHuman Vermiform Appendix (with a demonstration). WEDNESDAY, JULY 29TH. HEY GROVES, E. W. A Simple Form of Bed-rest for Maintaining 9 A.M.-Religious Services. the Fowler Position (with a demonstration). 10 A.M. to 1 P.M.-Sectional Meetings. JAMIESON, Professor J. K., and DOBSON, J. F. The Lymphatics 12.30 P.M.-Address in Medicine. of the Tongue (with a demonstration of specimens prepared 2.30 P.M.-Secretaries' Conference, followed by Dinner. by Gerota's method). 3.30 P.m.-Garden Party by Town Council in Duthie MILLIGAN, William. Some Practical Considerationis in the Park. Diagnosis and Treatment of Abscess of the Cerebellum, with *8.30 P.M.-Reception by University in Marischal a record of cases subjected to operation. College. PAGE, C. Max. The Treatment of certain cases of Appendix Abscess. THURSDAY, JULY 30TH. ROWELL, H. S. Mechanical Considerations of the Human Foot, with special reference to Flat-foot. 9 A.M.-CoUncil Meeting. 1BUSSELL, R. Hamilton. The Treatment of Urethral Structure 10 A.M. to 1 P.M.-Sectional Meetings. by Excision. 12.30 P.M.-Address in Surgery. WHEELER, W. I. de C. A further report on Three Cases of 7.30 P.M.- -Annual Dinner. Abdominal Aneurysm treated by Operation. WILKIE, D. P. D. Acute Appendicitis and Acute Appendicular FRIDAY, JULY 31ST. Obstruction. 9 A.M.-Council Meeting. 10 A.M. to 1 P.M.-Sectional Meetings. TROPICAL MEDICINE. *12.30 P.M.-Graduation Ceremony in Marischal College. 6 P.M.-Annual Exhibition closes. President: Professor W. J. R. SIMPSON, C.M.G., M.D., 8 P.M.-Popular Lecture, Marischal College. London. Vice-Presidents: DANIEL E. ANDERSON, M.D. *8.30 P.M.-Reception by Branch (Music Hall). Lond. and Paris, B.Sc., F.R.S.E., London, W.; J. MITFORD ATKINSON, M.B., London; HENRY PRASER, M.D., Kuala SATURDAY, AUGUST 1ST. Lumpur, Federated Malay States. Honorary Secretary: Excursions. G. A. WILLIAMSON, M.D., 15, Forest Road, Aberdeen. *Academic dress or uniform should be worn on these occasions. The has been Members desiring to have robes provided for them at Aberdeen following programme arranged: should communicate with Messrs. Ede, Son and Ravenscroft, Wednesday, Julv 29th.-Discussion on Kala-azar and 93 and 94, Chancery Lane, London, W.C.; Mr. William Northam, Allied Conditions. To be opened by Fleet Surgeon 9, Henrietta Street, Strand, London, W.C.; or Messrs. L. Y. and J. P. W. BASSETT-SMITH. Nathan, 4, Hardman Street, Liverpool. Thursday, July 30th.-Discussion on the Education and Position of the Sanitarian in the Tropics. To be opened by Colonel KING, I.M.S., C.I.E. PATHOLOGICAL MUSEUM. Friday, July 31st.-Discussion on the Surgical Treatment THE Committee of the Pathological Museum', organized of Colitis and Post-Dysenteric Conditions. To be opened in connexion with the Annual Meeting, proposes to arrange by Mr. JAMES CANTLIE. the material under the following heads: Papers: 1. Exhibits bearing on discussions and papers in the various sections. BAHR, P. H. Recent Researches in Sprue. BIRT, Colonel C., A.M.S. Sand-Fly Fever. 2. Specimens and illustrations relating to any recent research FRASER, H., and STANTON, A. T. The Rice Theory and Recent work. Conclusions. 3. Instruments relating to clinical diagnosis and pathological MACCALLAN, A. F. The Ankylostomiasis Campaign in Egypt. investigation. MARETT, Captain P. J., R.A.M.C. The Bionomics of Maltese 4. Individual specimens of special interest or a series Phlebotomi. illustrating some special subject. A Special Subsection of the Museum is being reserved It is also proposed to make an effort to gather together for exhibits in Tropical Medicine, and the Pathological series of exhibits relating to the pathology of the circulatory SUPPLFDMR',%T TO THU J'LY 4, 1914] ANNUAL- MEETING: RAILWAY FACILITIES. [BRITISH MEDICAL JOURNA 9Y

system and the ductless glands; the effect of radium a mnmber travelling fromii England may find it more advan- on malignant growths; pyelo-radiography and xc-ray photo- tageoIs to take a tourist ticket than to make use of the graplhs of brain, skull, and gall stones, and of ancient and special voucher. hiistorical surgical instruments. London to Aberdeen by Sea.-Members travelling from While making tllese suggestions the Committee, of the soutth may like to be reminded that they can make whichl Dr. G. M. Duncan is chaieman, will welcome the jraney from London by sea. The boats of the specimens illustrating other subjects. The Museuim will Aberdeen Steam Navigation Comipany, which are lighted occupy a central position in the same building as that in by electricity and in every way well appointed, sail from wlich the sectiolnal work is to be carried on. Aberdeen Wharf, Limehouse, E., every Wednesday and Communications may be addressed to the lholnorary Saturday (see advertisement, page 14). The return fares, secretaries, Dr. A. W. Falconer and Mr. William Anderson, available for six months, are-first cabin 45s., second cabin F.R.C.S., Pathological Department, Marischal College, 25s.; private cabins can be obtained for an extra fee. A Aberdeen. boat will leave on Wednesday, July 22nd, at 11 a.m., and on Saturday, July 25th, at 1 p.m. Furtlier particulars will RECEPTION ROOM. be published or can be obtained on application to the com- pany at Aberdeen Wharf, Limehouse, or the City Passenger TIlE reception room will be open during the annual meet- ing in the Advocates' Hall, Broad Street, Aberdeen, and Agency, 25, Cannon Street, E.C. members are advised to call there as soon as possible after tlheir arrival in Aberdeen. They will there find full RAILWAY FACILITIES FOR MEMBERS STAYING information at their disposal and will be able to Thbtain a IN THE NEIGHBOURHOOD OF ABERDEEN. copy of the daily journal. DURING themeeting reduced fares, with a minimum ofls., will be granted to places within a radius of fifty miles fronm Aberdeen. Memnbers who propose travelling to and from ACCOMMODATION IN ABERDEEN. Aberdeen dailv should use the first half of the ticket on A LIST of hotels and lodgings available in Aberdeen the first journey and the return half on the last journey; during the Annual Meeting is published in the advertise- the reduced fares for the intermediate journeys will be melnt pages (10 and 11) of this issue. Members desiring granted on production, at the time of booking, of the card further information on tllis subject are asked to corn- of membership. imiunicate with Dr. F. Philip, Honorary Secretary of tlle Weekly Seasont Tickets. Hotels and Lodgings Committee, 29, King Street, Aberdeen. Members staying at Banchory or Cruden Bay can obtain At a recent meeting of the General Committee, con- season tickets enabling them to travel to and from Aber- sisting of influential citizens, the intention to give a deen daily during the week of the annual meeting at the hearty welcome to members of the Association was following rates: Cruden Bay,lOs.; Banchory, 8s. 8d. Tile imiade evident, and a very large amount of private season tickets will be issued from intermediate stations at lhospitality is likely to be offered. The Local Executive proportional rates. Coommllitteelhopes tllat miiembers will not be led by the Oni the Caledonian Railwav to Stonehaven alnd inter- alswers they miiay get from some of the hotels to suppose mediate stations, during tlle meeting, return tickets will that the accommodation available in Aberdeen is filled be issued at Aberdeen to places where members wish to up; any member whiolhas difficulty in finding accomii- reside. These tickets will be available for the day of issue modationshould notlhesitate to communicate either with or following day, or from Saturday to Monday, at a single Dr. F. Philip, as above, or with Dr. Thomas Fraser, one of fare and a third for ttle double journey,minimum Is. the honorary local secretaries, at the same address. Season tickets are also available for more than one journey, at acharge of not less thanthe-snmulated fares per day RELIGIOUS SERVICES. as above,theminimum being ls. a day. THE annual service fortlle Association will be held in the West Parish Church of St. Nicholas (Church of Scotland) GOLF COURSES AT ABERDEEN AND IN ITS at 9 a.m. on Wednesday, July 29th. At the same hour VICINITY. a Romnan Catholic service will be held in St. Mary's Balgownie.-Tlie course of the Royal Aberdeen Golf Cathedral, and a service of the Episcopal Church in Club. A seaside links course of over 6,000vards in lengtl, scotland in the Cathedral Church of St. Andrew's. and well known as one of "The Best Courses." Tlhe Ulster Cup competition -will be played on these links. Water is laid on to the putting greens. There is a large ANNUAL EXHIBITION. and commodious club-house. The course is ofthe out-and- THE annual exhibition of surgical instruments, drugs, lhome variety, and" bogey" varies from 78 on a calm day foods, etc., held during the annual meetings of the British to a more difficult 80 with a stiff north-easter. Tlle Medical Association, will be arranged this year in the amateur record is 76, the professional 73. Golfing members Marisehal College, where also the Sections will meet, of tlle Britisli Medical Association have beeni made wlhere the General and Representative Meetings oftile holnorary members of the club from July 24th to 31st. Association will take place, and where the Addresses, in The course can be reached by tramwav car to the Medicine and Surgery will be delivered. The exhibition Bridge of Don or by taxi. There is also an adjacent relief on this occasion will, therefore, occupy a central and con- course of nineholes, which is the course oftlle Aberdeen venienit position, and members will have an excellent Ladies'GolfClub. opportunity of inspecting the exhibits. Mtrcar.-Tbis course is ontlhe samestretclh of coast as Balgownie, which it adjoins. It can be reaclied bytlle club motor bus running on rails from the brickworks close THE JOURNEY TO ABERDEEN. to the entrance road leading to Balgownie. Car to Bridge Special Vouchers.-Railway facilities similar tothlose of Don as before. The course is of good quality, but offered in previous years will be available this year- shorterthlan Balgownie. Sunday golf'without caddies. Llhat is to say, ret'urn tickets, valid from July 22nd to (Visitors ls. 6d. a day; 2s. 6d. on Saturdays and Sundays.) August 3rd, will be issued at a single fare and a third Bieldside.-Thle inland course of the Deeside Golf Club onotte presenitation of a voucher, which will be supplied, can be reached by train to Bieldside station, which it to memberswblo intend to go to Aberdeen, by the Financial immediately adjoins, by tramway car or motor. This is a Secretary and Business Manager, British Medical Associa- very good inland course of eighteen holes; the lies through tion, 429, Strand, London, W.C., on receipt of the notifica- tlhe green are excellent, and the puttilng green's in good tion form. A separate voucher is required for each condition. The club-hlouse adjoins the first tee. (Visitors passenger. Is. 6d. per day,5s. a week.) Toucrist Tickets.-Th-e attention of those who intend to Balnagask.-This course is on thle sea coast immediately travel to Inverness or other places north of Aberdeen is south of Aberdeen harbour, and is easily reached by the drawn to the tourist ticket arrangemnents. The advantage Trrry traniwav or by motor. The soil and turf is not of of a tourist ticket is that it is available for sixmontll,s, thle regular seaside type, being more of the inland variety. and the hiolder hiastlhe privilege of breaking-the journey There arc eighteen holes of no great length; a club-house at many places en route. The tourist ticket from Londcn adjoins the links. (Visitors is. a round, is. 6d. per day, to Inverness costs £3 3s., third class. In manyinstans es 5s. per week.) burPLEM'EXT TO THE 'I 0 BRITISli MEDICAL J OURNALI ANNUAL MEIETING: EXCURSIONS. [JULY 4, I9.14

Public Links.-These can be reaclhed by car, and are should be afforded to visiting members to see the town nearest to the town. There are eighteen holes, but the and its immediate neighbourhood, and also to plan course is on the sliort side, and suffers from overcrowding. excursions to more distant places within easy reaclh. .Aboyne.-Tlhis inland 18-lhole course is 32 lmliles from Aberdeen and tlle North of Scotland will not be backward Aberdeen. It is reached by train to Aboyne or by motor. in following this example, and those who are making suclh The turf is splendid and the surrounding scenery arrangements have, indeed, probably suffered from an em- delightful. A club-house is attached. Tlle council of the barrassment of choice, inasmuch as witliin reach of Aberdeen Aboyne Golf Club has agreed to offer honorary member- tllere is muclh beautiful river, mountain, and loch scenery. ship to members attending the annual meeting on pro- We give below some particulars of the provisional arrange- duction of their memlbership card. ments so far made, but this information must be prefaced Cruden Bay.-One of " The Best Courses." Thlirty miles bv the general observation that the meeting falls at a from Aberdeen by train or road. A delightful course, -with season wlhen the beauty spots of Northern Scotland are fine sea views. There are nmany good sporting holes, and beainninig to be crowded, and that it is therefore essential the putting greens are always in good condition. A first- that members slhould as far as possible make np their class hiotel, under the management of the railway com- minds early in regard to the excursion or excursions they palny, immediately adjoins the links, and thle Kilmarnock wishl to take, and notify their intention to the Secretary, Arms Hotel in tlle village call be hiighly recommended. Mr. G. H. Colt, F.R.C.S., 12, Bon Accord Square, Aberdeen, Sunday golf without caddies. The links belong to the at once. railway company, and tlle cliarge is ls. 6d. a day (2s. on The Committee will lhave to make arrangements for Sunday), ls. a day to visitors staying at the railway travelling facilities, catering, etc., with the railway coni- company's hiotel. panies and hotels, and all these arrangements must be Banchory.-Inland course, sixteen miles from Aberdeeni, made in advance. In the case of certain excursions tlhe rail or motor. Free to members of the Association on number must be limited and places will be assigned in productioni of miiembership card. order of application. A special office will be open in the reception roonms in Aberdeen and will be provided with time-tables, programmes, and guide-boolks, containing full information as to the many places of interest wlhiclh mav ARRANGEMENTS FOR LADIES. be visited from Aberdeen. The railway companies will A COMMITTEE of ladies lhas been formed to look after the make special concessions, but members of the Association comfort and interests of ladies accomipanying nmembers should note that they must produce their tickets of to Aberdeen. The Aberdeen Medico-Chirurgical Society memberslhip wlhen booking in Aberdeen for any exculrsion. lhas granted the use of its rooms at 29, King Street, The following arrangements lhave been made: as reception rooms for ladies from July 24tlh to 31st. There will be a a provided rest-roonm, writing-room, FOR REPRESENTATIVES. a tea room, and a dressing room. There will also be an office in the building.where information regarding The Annual Representative Meeting beginis on Friday, ladies' entertainments and mlotor drives will be given and July 24th, and will no doubt be continued on Saturday, tickets A member of the Ladies' July 25tlh. Arrangements have been made by members supplied. Committee in Aberdeen for running a special train to Cruden Bay on lhas given the use of lher flat at 245, Union Street, where ladies out of the town Sunday, July 26th, leaving Aberdeen in tlle morninig and livina may dress for thle returning the same evening. Slain's Castle, Bullers o' evening entertainments. It is hoped that a corps of lady will be available the of Buclhan, and Whlinnifold, the scene of Brain Stoker's guides fore assistance visitors. Mystery of the Sea, and a fine golf links are all within walking distance. Lunclheon can be taken at the lhotel P'r-ovisional Programe of Eentertainmentsfor Ladies. at Cruden Bay, and Representatives whio wish to make (Ganies.-Sevcral tennis clubs have given the use of their this excursion are particularly requested to send their courts. All ladies who are members of recognized golf names to Mr. Colt as early as possible. clubs will be ma(le honorary members of the Aberdeen Ladies' Golf Club (Balgowniie). A golf matchl will. be arranged for Thursday afternoon, July 30th, between SHORT EXCURSIONS FROM ABERDEEN. lady visitors and the Aberdeen Ladies' Golf Club, also Deeside and Donside may botll be seen on any oile day by a putting and approaching competition on Friday, July a circular tour tlhrouglh Alford to Strathdon and Ballater, 31st, at Balgownie at 10 a.n. Those who wish to enter and so back to Aberdeen. The excursion will occupy the for these comvpetitions are requested to send their names whole day, starting at 8.5 or 9.30 a.m., and arriving back and(I handicaps (L.G.U. if possible) as soon as possible to in Aberdeen at or about 7 p.m. The journey from Alford Miss Westland, 22, Albyn Place. to Ballater will be made by motor car, and it is thlerefore Entertairnnents.-Tuesday m-orning, July 28th: A visit essential to tlhe Art Gallery-limited to 35. Wednesday morning, that adequate notice should be given. The fares July 29th: Concert, including bagpipe playing and High- for the round are: First class, 12s.; third class, 9s. lanid dancing, etc., in the Mulsic Hall Buildings. Thursday Tlle following half-day excursions may be taken on morning, July 30th: A descriptive tour througlh Old Aber- either Wednesday, July 29th, or Saturday, August lst: deen, with visits to St. Machar's Cathedral and King's To Speyside, returnzing from Garten.-The train will College-limited to 35.- leave at 1 p.m., and luncheon will be served on it for a V'isits to Institations.-Conducted parties can visit the limited number. The party will reaclh Aberdeen on the following educational, charitable, and philanthropic insti- return journey at 10.32 p.m. Fare 2s. 6d. tutions: The Day Nursery, the Church of Scotland Home To Ballater at 1.15 p.m., including coach drive to for Working Boys, the Home for Working Girls, the Balmoral. Aberdeen will be reached at 10 p.m. Fare Maternity Hospital, the Morningfield Hospital for In- 2s. 6d. Coach drive 2s. 6d. extra. curable Diseases, the Oakbank Industrial School for Boys, and the To Aboyne, to visit Fungle, Aboyne Castle, and Glentanar. Home for Widowers' Children. The party will leave at 1.15 p.m. and reaclh Aberdeen S7tort Motor Drives for Ladies.-On the miornings of and again at 10 p.m. Fare 2s. There will be opportunity for Wednesday, Tllursday, Friday (July 29th, 30th, and on 31st) private nmotor cars have been offered to take a party golf these two excursions. of ladies to the following places: Wednesday, Drum Castle; To Elgin, where the cathedral can be visited. The Tlhursday, Crathes Castle; Friday, Muchalls Castle. Per- train leaves Aberdeen at 12.30 p.m., and tlle party will mission has kindly been granted to visit these places of arrive there on the return journey at 9.35 p.m. Fare 3s. historical interest. Ladies desirous of availing them- To Banff, Cullen, and Buckie, leavina at 12.30 p.m., and selves of these drives are requested to inform Miss reaching Aberdeen again at 9.35 p.m. Fare 2s. 6d. Grainger Stewart, Glendee Cottage, West Cults, Aberdeen- To Alford and Oyne, to visit the prehistoric fort on shire, before July 24th if possible. Nethler Tap of Bennachie and Maiden Stone. The train leaves Aberdeen at 1.37 p.m., and reaches it again at 8.52 p.m. Fare Is. 6d. Cruden Bay.-The train leaves Aberdeen at 1.30 p.m., EXCURSIONS. and the return train is due at 8.38 p.m. Fare 2s. 6d., ITiSthe hiospitable customii of members residing in or near including use of golf course. the town in whlich the annual meeting of tlhe British Stonehaven a7id Muchalls.-Visits may also be made on Medical Association is hleld to arrange that opportunities Wednesday or Saturday to Stonelhaven to see Dunottar r SUPPLEMURMT TO TEEG i JULY 4, 19141 ANNUAL MEETING: EXCTURSIONS. LBRITISH MEDICAL JOURNAi Castle, Raedykes Camp, the Ogham Stone, the Druidical there at 6.15. Members wishing to travel to Edinburglh, Circles, old Fetteresso Church, Cowie Churchyard, and to Glasgow, etc., from Aberdeen by the trains at 5.30 and Muchalls for the coast scenery and rocks. Both at 5.35p.m. can return from Balmoral by the railwaycompany s Stonehaven and Muchalls golf may be played, and at motor via Crathie to Ballater, and proceed thence by tlie Stonelhaven tennis and golf also. train duie to arrive in Aberdeen at 5.15. It will be possible Glen of Drumtochty.-A party of 200 will be able for a few members to obtain private motors at Ballater by to mnake an excursion to the Glen of Drumtochty on previous arrangement, and to drive to Braemar and Linni July 29tb, and a similar party will be arraniged on of Dee, lunchlinog at Braemar and joining the partv at August 1st. This is a most ellarming rouncl trip, pass- Ballater on the return journey. The return fare to Ballater ing many places of historical and archaeological interest, is 2s. 6d., and from Ballater to Balmoral 2s. 6d., lunclcon among them being Edzell, with its golf course and castle, and tea extra. Auchiinblac, Drulitochty, Clatterin Brigs, and Fettercairnl. Aviemore (Further Speyside). Thlis is a lhalf-day excursion, leaving shortly after 1 p.m. This is an alternative to the last excursion, and wvill and getting back to Aberdeen on Wednesday a little before afford to those who may have been unable to avail themii- 9 p.n. and on Saturday soon after 7 p.m. If desired it selves of the Three Rivers tour an opportunity of seeing could be arranged for a half of each party to coach from the lovely country of Further Speyside. The party wvill Fordoun and the other half from Edzell. The fare for the leave Aberdeen on Saturday morning) August 1st, and will round is from 5s. to 6s. reach Aberdeen in the evening. Members who may wish to return soutlh via Perth on Saturday evening should LONGER EXCURSIONS. make their own arrangements with the stationmaster at [For these excitrsions names mznst be sent in early in Aviemore, where lunclheon will be taken. The return order that saitable arrangements may be made.] fares are: First class, 20s. 8d.; third, lls. ld. Three Rivers Tour. On Saturday, August 1st, a tour will be made by a party ARCHAEOLOGY. not exceeding forty to the valleys of the Dee, Spey, and It is proposed to arrange excursions for members Don. The special l y same tour interesteli can also in Scottislh be taken hist o r y, on Wednes- archaeo- day, July l'o g y, geo- 29th. The logy, a nd party will FORIEs mount a in and marinp Aberdeen scenery. Among tho by train as CUSCI/ AC141 far as Din- wv I15 .places to bo net, aud t w visited will wvill motor ALL5P4DALLOCH be druidical to Strath- AXVI circles o n don, wherete IRP Ki ngcausio lunchecon *fr4" and at e Aquhorties, will -b Cock- LE.c....._2 ^ taken. It f%lromf.0 r C6 NORH OF SC the prehis- will then iIIENCR toric fort on g(o by coach the Mitlier Cock- A Tap of Ben- fronl " C bridgeys to nachie and TomrlintOUl9 tlle Maideni the hiig hiest Way at its U-.k un- village in. \SN0R foot, the Scotland, OltAsgAMAR *1-1 derground where tea li o u s e s waill be at Kil- taken. The CT- NORTH OF SCOTI drummy, re-aturn wil AND CONNECTIONS the vitrified Bal- forts at be~by iVrf N OC MW Talp

Ilin dalloc h,MO of Noth andl S peyside, at Finavon, and Doni- near Forfar, side, to Aberdeen, The fare for the round will be-first tlle sculpturedl stones at Aberlemino, andI many otlher class, 20s.; third class, 15s. This 'tour will o'ccupy the places of particular interest to archaeologistts. vwhole day, from 8 a.m. to 10.30 p.m. STRATHPEFFER SPA. Grantown and Speysidle. The medical men of Strathpeffer Spa and Dingwall, This trip has also been arranged for a party of 200 on along with the hotel proprietors, have arranged to invite Wednesday, July 29th, and Saturday, August 1st. At forty members of the Association who may be interested Grantown, whiclh is one of tlle chief healtlh resorts of in health resorts and spas, for two days, from Saturday, Strathspey, the valley of the Spey opens out into a August 1st, to Monday, August 3rd. As the accorn- large wide plain-the Cairngorm mountains to the left modation in the lhotels at tllis time of year is taxed and the Monadh Liath range to the right. Tlle party to the utmost, it is absolutely necessary that those will start on eaclh day at 2 p.m., and reach Aberdeen intending to take advantage of this hospitable invitatiou on the return journey at 11.15 p.m. Cold luncheon can should send in their names at once to Dr. Duncan, Strath-. be arranged oln the train for a limited number. The peffer Spa. Although tlle number of invited guests is fare will be 2s. 6d., third class. limited to forty, those who may be in the neighbourhood of Inverness or Strathpeffer will be entertained to luncheon Ba 'la ter, Balmoral, andt Braerm r. on either of the days mentioned. Tlle baths will be open Arranaement3 have beeln made for a party of 500 to for the use of the guests, and tlle courtesy of the golf visit Royal Deeside on Saturday, August 1st. The party course will also be extended to them. will travel to Ballater by a train leaving Aberdeen at Special fares will be granted by both the Great North of B.45 a.m., and by coach from Ballater to Balmoral. Lunch Scotland and Highland Railway Companies, but the better will be taken in a marquee in Balmoral grounds. Froim plan wouLld be for those travelling from England to taka B3almoral after luncheon the party will proceed by coach tourist tickets direct to Strathpeffer via Aberdeen (third to Ballater, and retturne 'io Aberdeen by a train arriving class return fare 67s. 3d.). These tickets can be made TO 12 SUPPLFSME'T TIfIF 1 S. BRITISH MEDICAL JOURPNALI ANNUAL MEETING: EXCURSION [JULY 4, I914

available to return via Dunkeld and Pertlh, but it is BY LONDON AND NORTH-WESTERN RAILWAY. essential thlat should ask for tickets so routed 1Fort JVillia,u and Intverness Circutlar l'outr No. 2.-Fares: First passengers class, 170s. 8d.; third class, 78s. 9d. Out from Euston Station, at the time of booking. via Carlisle, Carstairs, and Aberdeen to Inverness by rail, returning from Inverness by MeBrayne's steamers througlh INVERNESS, ELGIN, NAIRN, AND THE HIGHLANDS. the Caledonian and Crinan Canals to Oban, thence by rail direct The members of the Nortllern Counties of Scotland to Londoni. Branch of the Association have a Fort JVilliam anid Inverniess Circutlar Touzr No. 4.-Fares: First organized series of class, 160s. 2d.; third class, 81s. Out from Euston Station, via excursions for those members who propose to visit Carlisle, Carstairs, and Aberdeen to Inverness by rail, return- Inverness and neighbourhood. It is anticipated tllat ing from Inverness by McBrayne's steamers through thie many who attend the annual meeting will complete Caledonian and Crinan Canals to Glasgow, thence by rail to London. their lholiday by visiting the North of Scotland. In London. order to facilitate arrangements, the medical men in By GREAT NORTHERN RAILWAY. I Inlverness Tour and are anxious Circiular No. 1.-Fares: First class, 160s. 2d.; Inverness, Elgin, Nairn, Strathpeffer Spa tilird class, 81s. Outward journev, from King's Cross Station, to get the names of those members who propose visiting via Edinburgh, Forth and Tay Briidges, and Aberdeen, to Inver- these places as sooni ness by rail, returning as possible so as to by the McBrayne's lhave some indication steamers through the as to num- ORKDaxU1O thence by rail, via (fare Edinburgh, to Lou. a tlhird), and after- don. wards decide to 0/ oP remain in Scotland °/ The excursions in the ikom beyond period Inverness district IN for which suchiTAH include a trip up thle ticket would be Al N g; valid \ Caledonian Canal, can do so upon pay- lfj <55motors runs to Cul- ment of the differ- / u'fTLY loden Moor, Cawdor ence between tlhe VKyL Castle, Speyside, an(d reduced fare special 3~~~ITDE t o Glenurquhart, and tlhe -ordinary tourist fare. Those Strathglass, Loclh 0424vssUS TUnMzsod^.J. Maree, Loch Duicli. who can with con- .8to Macdbvt- All these are de- make M4LLAI fidenlce tlleir BALtORAL . liglitful excursions arrangements in ad- of Highland vance find it ad- IBAAEMAt SALLATrEA typical muay scenery. witl 0 L A N ~ Nairn, vantageous to take F v L A N DJ its fine golf course, tourist tickets to aeir Athol will be an attrac- Inverness (first class, L-RN PIrLOC#R v tion to m-lany, wlhile £7 6s. tlhird lld.; )(IRIfL; IR Elgin, witlh Lossie- class, £3 3s., from .dr/ax BFzo s mouWzroLithi as a golfing London by rail L.TAYri// OWDN-I ) centre, will charm thiroughout). Tllese r L v k NDEL// DivL others. To men tickets, which are IBAN who are not golfers, available for six drives to Grantown montlhs, permit a Spey Craigel- of C L^*vo~ANosCALLAND(R ~~~~on anid break journey lachie lhave been northward at Aber- r.o5SAC _A: arranged. deen, and are avail- ~\ _/ >rTluoe names of able, to return via q intending visitors the Highland Rail- should be sent in to way by Inverniess, Railway mal); the systemii of the Highli laLnd Railway is shown by the darker line. one of the under- Avienlore, and Duni- mentioned not later keld, going on to Edinburglh or Glasgow. Tlle journey than July 10th: Dr. J. Munro Moir (Inverness), Dr. may be broken at anv of tllese places on the way soutlh. Stephen (Elgin), Dr. E. Wilson (Nairn), who will bo Tourist tickets may also be obtained fromn any of the pleased to give any information as to lhotel accominoda- larger towns in England and Wales. Full particulars can tion, private hospitalitv, etc. be gathered from the Guide to the Highlands, which In order that the arrangements should run smoothly it be may obtained from the Traffic Manager of the Highland is absolutely necessary that those in charge of them sshould Railway Co., Inverness. know hlow many members are likely to take advantage of It will be found that the tours can be extended in the special excursions planned, anid it is suggested that, various ways, and can be made to include a return by the although J'uly 10th is stated to be the last day for giving in West of Scotland. We are indebted to Messrs. Stockwell names, members should, as soon as their arrangements for and Co., Passenger Ticket Agents, 8, Beak Street, Regent lholidays Lre' complete, notify one or other of the gentle. Street, S.W., for the following sample tours from men wlhose names are given above. London:

[The following tourist tickets are available for six months, Nairn. but the steamer portion of the tour must in all cases be The arrangements for those visiting Nairn are a' completed on or before September 30th. follows: The party will arrive during the forenoon of SUPPLEMENT TO T JULY 4, I914] PROCEEDINGS OF COUNCIL. [BRITISH MEIDICAL JOURN 13 _~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Saturday, August 1st; there will be 4 reception bv the Provost, followed by luncheon. In the afternoon there will be a motor run by Culloden Moor, visiting the battle- sRtirtatitait_ ntetft#tlnc. field, and on the homeward run Kilravock and Cawdor Castles. On Sunday there will be a motor run to the PRO)CEEDINGS OF COUNCIL. tpper reaches of the Findhorn (Glenferness and Dulsie). On Monday the 'baths and the golf course will be open to A MEETING of tlle Council was held at 429, Strand, London. tlle visitors. W.C., on Wednesday, June 24tlh. The proceedings lasted The medical men of Nairn are prepared to offer private from 10 o'clock in the morning until 7.30 in the evening. lhospitality over the 'week-end to twenty members. Presenit Members intending to make' this excursion are 'requested Dr. J. A. MACDONALD, Chairman of Council, in the chair. to communicate at once, and in any case not later than Mr. T. JENNER VERRALL, Bath, Chairman of Representative July 10th, with Dr. Eric Wilson, Wyvis View, Nairn. Meetings. Dr. JOHN ADAMS, Glasgow Dr. MAJOR GREENWOOD, Lon- Dr. J. MITFORD ATKINSON, don Elgin, Lossiemouth, and Grantown. London (Hong Kong and Dr. J. R. HAMILTON, Hawich, The arrangements for those visiting Elgin and Lossie- China, etc., Branches) N.B. mouth are as follows: The party will arrive during tlle Dr. R. M. BEATON, London Dr. G. E. HASLIP, Tiondon forenoon of Saturday, August 1st. After luncheon (pro- Dr. M. G. BIGGS, London Mr. W. T. HAYWARD, Oxford bably at Elgin) golfers will proceed to Lossiemouth, where Dr. CHARLES BUTTAR, London (Victorian, South and West there is a fine course; for others motor drives will be Dr. H. J. CAMPBELL, Bradford Australian Branches) arranged to Gordon Castle, Fochabers, or the Roman Mr. W. F. CHOLMELEY, Wol- Mr. P. NAPIER JONES, Crow- Well, Burghead; the town of Elgin, with its cathedral, verhampton thorne museum, and hospital, may also be Dr. J. SINGLETON DARLING, Mr. F. CHARLES LARKIN, Liver- visited. Lurgan pool On Sunday afternoon a motor drive for the whole party Dr. E. J. DOMVILLE, Chel- Mr. ALBERT LUCAS, Birming- will be arranged to Grantown, proceeding there by the wood ham Speyside route and returning bv way of the banks of the Dr. DAVID EWART, Clichester Dr. C. H. MILBURN, Hull Findhorn and Forres. By this route some very picturesque (New Zealand Branch) Mr. E. C. MONTGOMERY-SMITH, Highland scenery will be traversed. On Monday the Dr. FRANK FOWLER, Bourne- London Lossiemouth Golf Course will be open to visitors. mouth Dr. GEORGE PARKER, Bristol It is particularly requested that the names of those who Dr. ADAM FULTON, Basford, Sir JAMES PORTER, K.C.B., wvish to visit Elgin and Lossiemouth be received by Nottingham LL.D., London (Royal Navy Dr. J. Stephen, Murrayfield, Elgin, by July 18tll at latest, Mr. T. W. H. GARSTANG, Medical Service) or as much earlier as possible. Altrincham Dr. F. J. Smith, London Surgeon-GeneralJ. P. GREANY, Mr. D. F. TODD, S,'.nderland I.M.S., Ealing (Indian Medi- Mr. E. B. TURNER, London Inverniess. cal Service) Mr. DENIS WALSHE, Graigue Several excursions have been arranged for those Dr. T. D. GREENLEES, Wey- Mr. E. H. WILLOCK, CroydoII members who go on to Inverness from Aberdeen: mouth (S ou th African Dr. 0. R. M. WOOD, Woolpit 1. Kyle of Lochalsh and Loch Duich.-This is a very Branches) fine bit of seenery, the railwvay journey from Inverness RETURN OF THE CHAIRMAN. along the Beauly Firth, thence from Dingwall past Garve The Chairman was warmly congratulated on his safo and Achnasheen, passing Loch Carron, along the shore of return from his Australasian tour. which the railway winds until withiin a mile or so of Kyle of Lochalsh. A trip will be made on one of MacBrayne's APOLOGIES. steamers up Loch Duich amnidst beautiful Highland The President, the Treasurer, Sir James Barr, Mr. W. F. scenery. Brook, Dr. John Gordon, Dr. Livingstone Loudon, Dr. J. 2. Loch IMaree will be visited by another party. Pas- Munro Moir, Dr. J. E. Moorhouse, and Professor A. HI. sengers will leave the train at Achnasheen and join a White sent letters of apology foir non-attendance. motor car which goes by LochI- Rosque, and after a drive of about six miles reaches the beautiful Loch Maree. No DEATHS. pen can describe the beauties of this part of Ross-shire, The CHAIRMAN reported the deaths of Dr. B. H. Mumby with tlle towering Ben Slioch and Ben Eay on either side. of Portsmouth, a member of the Council, and Dr. J. If. These are whole-day excursions. Keay of Lewisham, a former member of the Council, and For those who do not' care for a long, journey, motor was requested to convey to the respective families votes of runs will be arranged: on their bereavement. 3. Glen Urquhart.-By Loch Ness side to Drumnaq- condolence rochit, up Glen Urquhart, crossing tlhe hill to Cannicl, returning to Inverness by Strathglass and Beauly, a THE TREASURER. beautiful run through very fine mountain scenery. The Council expressed its sincere sympathy with tho 4. Stratherrick and Strathnairn. Another party Nvill go Treasurer in his illness and an earnest hope for his speedy up to Loch Ness on the opposite side from No. 1 party to recovery. the Pass of Inverfarigaig, up Stratherrick crossing to RESIGNATIONS. Strathnairn. The CHAIRMAN reported the resignations of Colonel 5. To Cutlloden Moor and Cawdor (Castle. H. J. Waller Barrow, the Representative of the Army 6. To Fort Augustus by the Caledonian Canal by Medical Service on account of ill health, and Mr. C. MacBrayne's steamers-possibly calling at the Fails of Courtenay Lord. Foyers on the way. On the return of 4, 5, and 6 parties. tlle Provost and VOTE OF THANKS To DEPUTY CHAIRMAN -OF COUNCIL. rnagistrates of Inverness will publicly receive the members The Council placed on record its appreciation of tlho of the Association, and entertain them to luncheon. The able way Sir James Barr acted as deputy during tlho afternoon will be given up to garden parties, etc. absence of the Chairman in Australasia. REPRESENTATIVE FROM AUSTRALIAN BRANCHES. A LIST of periodical publications, official reports, and Blue Mr. W. T. Hayward, of Adelaide, was welcomed upoi. Books in the Library of the British Medical Association his attending the Council for the first time as the repre- available for issue to members onloan has been printed, and sentative of the South Australian Branch. copies can be obtained free on application to the Librarian, at the hoase of the Association, 429, Strand, W.C. ThIe DR. J. A. MACDONALD'S 'VISIT TO AUSTRALASIA. regulations governing the loan of these publications are Communications were read from the New Zealand stated in the introduction to the list. The Library is open Branch, New South Wales Branch, and the Federal fr consultation from 10 a.m. till 5 p.m. (on Saturdays Committee of the Association in Australia expressing ti1l 2 p.m.). satisfaction at Dr. Macdonald's recent visit to Australasia. I WUPPLI.ENT TO TE 1 4 BRITISH MEDICAL JOUUWAL I PROCEEDINGS OF COUNCIL. [JUL.Y 4, 11914_ Dr. MACDONALD gave an account of his tour, vilnilar CANDIDATES FOR ELECTION TO THE ASSOCIATION. to but somewhat briefer than that contained in his The candidates whose. names appeared on the notice address to the WVest Somnerset Branch, published ia this convening the meeting were- elected members of the ,week's JOURNAL (page 1). Britissh Medical Association. Dr. GREENLEES, Chairman of thle Dominions Committee, moved a vote of thanks to Dr. Macdonald for his address. ELECTION OF' VICE-PRESIDENTS. He felt confident that the visit had done good, and only It was decided to recommend to 'tle Representative regretted that Dr. Macdonald had not been able to visit Body that Dr. W. Ainslie Hollis, President of the Asso- South Africa also; he assured him of a hearty welcome if ciation for 1913-14, be elected a Vice-President of the and when he found it possible to do so. Association. Also that Mr. W. T. Hayward, Chairman Dr. HAYWARD, in supporting, said that Dr. Macdonald of the Australian Federal Committee, be elected a Vice. had given a racy account of his journey to Australia, for- President. the accuracy of whiclh he could vouch. The visit had done a great deal to make stronger the bonds between the SCOTTISH COMMITTEE. Australian Branches of the Association and the mnother As from January 1st, 1915, there will be established a society. Personally lie was indebted to Dr. Macdonald, Scottish Office with a whole-time' Scottish Medical Secre- because, wlhen he might have been enjoying himself, he chose tary in addition to the present Clerk. The Scottislh to sit at the meeting of the Federal Coommittee, witlh the Medical Secretary will be appointed by the Council on tho temperature at about 100°, for two whole days, giving advice recommendation o'f the Scottish Committee, and the salary witli delicacy and tact on all matters whicll came within will be £600 per annum. his purview. Dr. Macdonald lhad made himself a prime favourite by hiis tact, his bonhomie, his energy and sound common sense. 'He made all the medical'men with HoUSE OF LoRDs MIDWIVES (SCOTLAND) BILL (No. 81). whom he came in contact in Australasia feel that they The Council approved in the present instance of tlhe were a part of a great professioni. Scottish Committee being named in the House of Lords The motion was unanimously adopted. Midwives (Scotland) Bill (No. 181) as the body to appoint The Council ordered that a vote of thanks be sent to the imedical representatives on the proposed Central Midwives Presidents and Secretaries of the various Branches and Board for Scotland. Divisions visited' by Dr. Macdonald, to the Federal Committee of 'Australia, to the Clhief Medical Officer of ORGANIZATION COMMITTEE. the Government of New Zearand, to Dr. Billinghurst and STUDENTS' UNION. Professor Macfarlane of Hong KIong for the courtesy and The Council decided to report to the Representativo lhospitality extended to the Chairman of Council. Body that in its opinion the formation of a Students' Union on tlle lines suggested in Minute 197 of tlho Annual SIR THOMAs RODDICK. Representative Meeting, 1909, is, for the present at least, It was decided to forward the congratulation's of the impraeticable. Council to Sir Tlhomas Roddick, of Montreal, Presidenit of the Association in 1897, upon the honour of k'nightlhood GRANTS TO BRANCHES FOR 1914. recentiy conferred upon hlim by His'Majesty the King. It was decided that grants for 1914 be m-nade to the following Branches: Aberdeen, Gloucesterslhire, Oxford *UNIVERSITY OF WALES. and Reading, Shropshire and Mid-Wales, Surrey, and Dr. E.- J. Maclean was nominated a Representative of Ulster. the Association upon tlle Medical Board of the University of Wales for a further term. ELECTION OF MEMBERS OF COUNCIL, 1914-15, AND 1915-16 BY GROUPED REPRESENTATIVES UNDER BY-LAw 43 (C). POSTAL VOTE. (a) 1914-15. The CHAIRMAN OF COUNCIL read a letter from the Slheffield Pursuant to the authority conferred on the Council by Division concerning the question of a postal vote on the Minute 260 of the Annual Repr'esentative' Meeting, 1913, matter of the proposed Special Funcd, when it was decided the Council decided to group the United Kingdom con- to inform the Sheffield Division that the Council is of stituencies for election of twelve members of Council for opinion that each Division should conduct the postal vote 1914-15 in the same manner as for 1913-14, the consti- as a Divisional matter in the way it thinks best. 4 tuencies of the new Kent, Surrey, and Sussex Branches taking the place of those of the late South-Eastern Branclh. ANNUAL MEETING AT NEWCASTLE, 1917. The CHAIRMAN reported receipt of a letter from tlhe (b) 1915-16. Honorary Secretary of the North of England Branclh It was resolved to recommend to the Representativo invitin'g the Council of the Association to hold the Annual Body that the grouping of constituencies for election of Meeting in 1917 in Neweastle-on-Tyne. The Council twelve members of Council, 1915-16, be similar to that for decided to thank the North of England Branch, and to 1914-15, discretion being, however, left to the Council to file the invitation for consideration in due course. make any modifications in the grouping rendered neces- sary or desirable owing to numerical changes or formation FINANCE COMMITTEE. of new Divisions or constituencies or modification of those In the absence of the Treasurer, the CHAIRMAN OF bodies as at present existing. COUNCIL presented the report of the Finance Committee. G ROUPING M~F BRANCHES NOT IN UNITED KINGDOM FOR ACCOUNTS. 1915-16. The accounts for the quarter ending June 6tlh, 1914. The Council will recommend to the Representative Bodyv am-rounting to £10,984 Os. 2d., were received and approved, thzlt the grouping of thle Branches outside the United and the Acting Treasurer was empowered to pay those Kingdom for the election of -seven members of Council for unpaid. 1915-16 be the same as for 1913-14-that is, that tho Ceylon Branch be grouped with the Indian Branches, anl APPOINTMENT OF ASSISTANT MEDICAL SECRETARY. that the Hong Kong and China, and Malaya Branches Mr. C. Courtenay Lord, Gillingham, was appointed together form a constituency for the election of one member Assistant Medical Secretary as from October lst, 1914. of Cou.ncil. APPOINTMENT OF SOLICITOR TO THE. ASSOCIATION. GROUPINGT OF DI'VISIONS FOR REPRESENTATION IN Mr. W. E. Hewpson was reappointed Solicitor to the REPRESENTATIVE BODY, 1914-15. Associationi. In view of the fact the Roclhdale Division, wlliclh lhad HEARD V. PICKTHORNE. temporarily dropped to below the necessary 50 members A sum of £10 was voted to Mr. P. C. Raiment, Honorary to entitle it to separate representation, would, before tle Secretary to the National Medical Guild, as compensation iRepresentative Meeting at Aberdeen, be above 50 members, for the loss lie sustained in giving financial assistance to ,it was acco'-dc separate representation in the 1914-15 the plaintiff in the case of Heard v. Pickthorne. Rep,-esentativc Body, SUPLEMENT TO TI JULY 4, 1914] PROCEEDINGS OF COUNCIL. LBaiSH MEDICAL JOURNAS 15 SCIENCE COMMITTEE. Municipal Councils, Insurance Committees, and other MIDDLEMORE PRIZE. bodies which it may concern with a view to obtaining In view of the adjudicators' report on the essays sub- their co-operation. mitted it was decided that the Middlemore Prize be not a-warded for the current year, and that the prize be open DEPUTATION TO MEMBERS OF THE GOVERNMENT ON SECURITI for competition in 1915. OF TENURE AND SUPERANNUATION FOR MEDICAL OFFICERS OF HEALTH. CENTRAL ETHICAL COMMITTEE. The best thanks of the Council were given to Sir Philip REGULATIONS RELATIVE TO THE INSERTION IN THE Magnus, M.P., and Dr. Addison, M.P., for their services in "BRITISH MEDICAL JOURNAL" OF NOTICES secuLring the reception of the recent deputation on the REGARDING APPOINTMENTS. security of tenure of medical officers of health by the The Representative Body will be recommended to rescind Chancellor of the Exchequer, the President of the Local all its previous decisions relating to the Warning Notice, Government Board, and the President of the Board of and to empower the Couincil to approve Regulations, which Education, and also to those members of Parliament who in the opinion of the Council are appropriate, relative to showed their sympathy by attending. the insertion in the BRITISH MEDICAL JOURNAL of notices regarding appointments, and that the control of these HOSPITALS COMMITTEE. notices be in future left entirely in the hands of the WORKMEN'S MEDICAL AID ASSOCIATIONS AND MEMBERS OF Council. STAFFS OF VOLUNTARY HOSPITALS. It was decided that the support of the Association be POSITION OF MEDICAL PRACTITIONERS IN CONNEXION WITH given to any action tending to prevent the spread of PUBLICATIONS TO THE PUBLIC ON MEDICAL SUBJECTS. medical aid institutes which may be taken by any Branchi The Representative Body will be recommended to or Division with the consent of the Council of the Asso- adopt the principle tllat every medical practitioner who ciation. contributes to or in any way assists in the preparation of any publication on medical subjects intended for the use NAVAL AND MILITARY COMMITTEE. of the public must hold himself responsible for any undue RESIGNATION OF A MEMBER FROM THE COMMITTEE. or improper advertising that may take place in connexion Owing to illness Colonel H. J. Waller Barrow has lhad to with such publication, and also for the scope and distribu- resign his seat on the Committee. In his stead it is tion of the work. recommended that Colonel R. I. D. Hackett, A.M.S. (ret.), be appointed. CASE UNDER ARTICLES 10 AND 11. Having received a special report from the Central THE SHORTAGE OF MEDICAL OFFICERS IN THE ROYAL NAVY, with regard to representations of a Ethlical Committee A report on the shortage of medical officers in the Royal Division with reference to a member of the Association, to be forwarded the Council resolved that the member in question should Navy was approved, and a copy ordered membership of the Association. to the Admiralty with an intimation that it was proposed be expelled from to publish the report in the BRITISH MEDICAL J'OURNAL. MEDICO-POLITICAL COMMITTEE. The report has also been printed in pamplhlet form for circulation to the deans of medical schools for distribution FEES FOR MEDICAL EXAMINATIONS FOR LIFE INSURANCE. for entry into the Royal Navy The Representative Body will be invited to decide the (i) to intending candidates for life insur- Medical Service and (ii) in the libraries and reading- question of principle as to (a) whether fees rooms of the various medical schools. ance examinations should be based on the amnount of evidence required in confirmation of the examiner's pro- fessional opinion of the life, or (b) whether there should be INSURANCE ACT COMMITTEE. a fixed minimum fee for that opinion irrespective of the RETURNED MEDICAL CARDS. number of questions to be answered. Tlle Representative Body is recommended: (i) That it is no part of the duty of a panel practitioner to correct PAYMENT OF SHIP SURGEONS FOR ATTENDANCE UPON FIRST and keep up to date thle list of addresses of insured AND SECOND CLASS PASSENGERS. persons. The Representative Body is recommended to adopt the (ii) That a medical practitioner should be entitled to following principles: charge private fees to those insured persons demanding attendance treatment of him but who fail to produce their medical 1. That fees for medical and surgical cards, in view of the instruction of the various Insurance should be payable by first and second class passengers Commissioners to Insurance Committees than when thc in all cases of illness and injury except those due to medical card system is in full operation a practitioner the natural conditions of the voyage. on treatment, to require insured cases where the ship surgeon is at would be entitled, giving 2. That in those on list to their medical cards, should a the minimum fee shall be 5s. persons his present liberty to charge fee such a course appear necessary. and 2s. 6d. per attendance in the case of first and second class passengers respectively. 3. That accounts for any such fees should not be RELATION OF BRITISH MEDICAL ASSOCIATION TO PROPOSED subject to any preliminary scrutiny by the com- FEDERATION OF LOCAL MEDICAL AND PANEL mander, but it is clearly understood that any passenger COMMITTEES. questioning the legitimacv of any charge -may make It is recommended to the Representative Body that in representations accorhingly to the commander. the event of the proposed Federation of Local Medical and Panel Committees being formed, it be granted FEES FOR MEDICAL CERTIFICATES UNDEr THE MENTAL adequate representation on the Insurance Act Comm-ittee DEFICIENCY ACTS. of the British Medical Association, and that the decision The Representative Body will be advised to approve as to the exact amount of such representation be deferred that the fee for medical certificates unde-r the Mental until the policy of the Federation has been confirmed by Acts signed by the "s usual medical attendant" the Local Medical and Panel Committees concerned. Deficiency be made in the slhould not be less than £1 is. Further, that the necessary amendments Regulations of the Association to allow of two direct TELEPHONE SERVICE RATES. representatives being nominated by the proposed Federa- A reply of the Postmaster-General as to the telephone tion of Local Medical and Panel Committees for election service rates will be reported to the Representative Body by the Representative Body on tlle Council of the British for its information. Medical Association, such representatives to be members of the Association. PUBLIC HEALTH COMMITTEE. Provided that other arrangements for co-operation are ADVERTISEMENTS FOR TUBERCULOSIS OFFICERS. satisfactory, the work of the proposed Federation and It is recommllended to the Representative Body that the Association will be carried out by the same staff on the when premises of the Association; and that, subject to' paymenit Model Scheme for the Treatment of Tuberculosis, will adopted by the Representative Body, be circulated to by the Federation on an agreed tariff, the Association TO 6 SUPPLEMENT TILE I l U BRITISH MEDICAL JOURNNALJ MEETIITGS OF BRANCHES AND DIVISIONS. [JULY 4, I9I4 place the followina facilities at the disposal of the proposed Midwvives Bill.-In accordance with the suggestions Federation: of tlhe, Scottish Committee of the Association, it was (i.) Office accommnodation. agreed to support tlle Midwives Bill introduced into the (ii.) Clerical assistance. House of Lords by Lord Balfour of Burleiglh, and that the (iii.) Printing, etc. memibers of Parliament representinig the area of the Divi- (iv.) Space in the SUPPLEMENT to BRITISH MEDICAL sion slhould be informed of this decision and JOURNAL for reportiing the proceedinlgs of the asked to give Federation and its Branches. it their active support in Parliament. Election of Officers.-Tlhe following office-bearers were Co-operation will be encouraged between the Scottish, elected for the ensuing year: irish, and Welslh Executive Committees of the proposed Chairmzan: Dr. John Lindsay. Federation and any separate Committees set up by tlle Vice-Chairm)zan : Dr. James Todd. Association in those countries. Honzorary Secr-etary and lTreasulrer: Dr. Edward J. Primrose. If the above proposals are accepted by both the Asso- R?epresentative to Representative Mleetingls: Dr. A. T. Campbell. ciation and the proposed Federation, tlle Federation shlall Represeutatives to Branchl Counticil Drs. Morton, Primrose, olOt take action of Association in and Inglis. independent the any Execmttive Co)mmittee: Drs. Baird, Snodgrass, Graham, A. G. negotiations with lay bodies. Hay, D. J. Mackintosh, M.V.O., Caskie, J. G. Gray, and W. A. The whole of the foregoing decisions are provisionial only, Stuart. dependent upon whetlher the Representative Body is Indlction of Chairmzan.-Thc CHAIRMAN tllen intro- satisfied witlh the constitution, powers, objects, etc., of duced his successor, Dr. Lindsay, and mutual expressions tlle proposed Federation. of appreciation and thanks were made andl received. Annual Relort of Central Cottcil.-The ainnual report of APPOINTMENT OF AND REFERENCE TO INSURANCE ACT the Council was then discussed. In regard to the questioa COMMITTEE. of a special fund, the recommendations A, B, C, D, and B It was decided that the Representative Body be recom- (p.320 of the SUPPLEMENT of May 2nd, 1914) were, after dis mended to appoint an Insurance Act Committee for the cipssion, adopted, on the motioln of Dr. CASKIE, Withl theG forthcolmiing session, 1914-15, and that the present Coin proviso that the liability of the guarantors to the mittee be empowered to report direct to the Representative Defence Fund ceasedl. It was also agreed that the FunC Body as to the constitution and reference of the Insurance should be in the form of a trust, andl, as moved by Mr. Act Committee for 1914-15, after consideration of the con- WHITEHOUSE, that the wlhole matter should be subject to stitution, powers, objects, etc., of the proposed Federation tlle suggestions in Sub-P.-ppendix III of Appendix X, and of Local Medical and Panel Committees, and havinig regard referred back to the Divisions for thorough discussion by to alny proposed co-operation between the Association and the profession. the Federation. Insutrance Acts.-Answvers to the questions in tllo scheduile of the Future Developments of the Insurance NON-PANEL COMMITTEE. Acts Committee wvere filled in. The Representative to the CONSULTANTS EMPLOYED FOR PURPOSES OF INSURANCE Representative Meeting was ilnstructed according to these ACTS. flndings, and was directed in voting upon other matters to The Representative Body is recommended to define that use his own discretion. the policy of the Association sihould be opposed (with some Presentation to Dr. Caskie.-A very interesting cere- possible special exceptions) to whole-tiune consultative mony took place before the official business part of tlhe appointments in connexion witlh the Insurance Acts, and meeting. Dr. JOHN LINDSAY, speaking on behalf of thle that it siould be in support of the performance of sucl profession, referred to the work Dr. Caskie had done as duties being open, under conditions of free choice and Honorary Secretary to the Division for the past four adequate remuneration, to all registered medical practi- years, especially during the time when the Insurance Act tioneis qualified to perform them. was under discussion in Parliament. Dr. Caskio had OF COU unigruidgingly accepted the extra burden, and lhad per- SUPPLEMENTARY REPORT NCIL. formed his task well and faitlhfully. Tlle profession was The Supplementary Report of the Council was approved, under a deep sense of its indebtedness to hiim, and lie and was publislhed in the SUPPLEMENT of June 27th, p. 474. called upon the Chairman to make tIme presentation whicl marked the recognition of this. Dr. CAMPBELL read the illuminated address inscribed on vellum, and presented it 5s. with a cheque to Dr. CASKIE, who, in a few clhosen words, fattingsjof randbes anb jibisio tlhanked the subscribers for tlleir kindness and apprecia- [Theproceedings of the Divisions and Branches of the tion of his services. Association relating to Scientific and Clinical Medicine, LANCASHIRE AND when reported by the Honorary Secretaries, are published CHESHIRE BRANCH: in the body of the JOURNAL.] BURNLEY DIVISION. THE annual meetina of the Division was held in the Bull BIRMINGHAM BRANCH. Hotel on June 26tlh, when Dr. SCoTT was in the chair. THE annual meeting of the Birmingham Branch was held Election of Officers.-The following officers were elected at the Medical Institute on June 18tlh, when Mr. HASLAM for the ensuina year: (tlhe retiring Chairman), Dr. PURSLOW (the Clhairman- Chairman: Dr. A. E. Bird. elect), and twenty-two other members were present. Vice-Chairman: Dr. T. M. Scott. Honzorary Secretary antd Treasntrer: Dr. W. J. Purves. Election of Officers.-The following officers were duly Representative for Representative Meetings: Dr. H. J. Robinson elected: (re-elected). President-elect: Dr. J. Orton (Coventry). Representative on Branwch Coulncil: Dr. Jas. M. Ferguson Honiorary Treasutrer: Mr. J. Furneaux Jordan. (re-elected). Hottonoary Secretaries: Dr. Snamllwood Savage and Mr. Seymour Executive CommiUse: Dris. Ohas. A. Anderson, S. T. Biggs, Barling. A. Callam, F. E. Crossley, W. Crabtree (Nelson), T. G. Grump, Annual Reports.-The following reports were approved: J. Gardner, A. C. Glashan, J. J. Harty (Colne), A. Heys, H. Holden, J. Hoyle, J. A. Mackenzie, F. W. Marsden, G. S. Report of the Council, with the balance sheet; report of Pullen, R. C. Rodgers. the representative (Mr. A. Lucas) on the Central Council; report of the Ethical Committee; and report of tlle Annual Report of Division.-The report of tlle com- Pathological and Clinical Section. mittee was adopted. It stated tllat there was a slight drop Presidential Address.-Dr. PURSLOW (President) delivered in the membership-from between 100 and 90 to between his inaugural address on " The Diagnosis and Treatment 80 and 90. This was. to be expected after the passing of of Miscarriage." the Insurance Act. Therelhad been five meetings of the Division, with good average attendances, 17 committee GLASGOW AND WEST OF SCOTLAND BRANCH: meetings, with excellent attendances (average about 14), as GLASGOW NORTH-WESTERN DIVISION. well as several subcommittee meetings and deputations; Annual Meeting.-Presenttation to Dr. Caskie. Several Association matters had been dealt with,- and THE annual meeting was held on June 25th, when Dr. much discussion took place with regard to such matters as A. T. CAMPBELL presided, and eleven othermembers were raising the subscription to the Association to £2 2s. per present. annum, and the raising -of a fund for the development JULY MEETINGS OF BRANCHES AND DIVISIONS. r SUPPLErNTTorTim 4, I9I4] IBXITISH MEDICAL JOJRa O / of the organization and protection of the medical pro- Gilbertson, proposed by Dr. MACFADYEN and seconded by fession. Muell work had also been done regarding the Dr. AWELLS. Insurance Act, over-certification, etc. The dispute with the Garden Party.-Members of the Division and ladies were Poor Law Guardians has occasioned a great amount of worlk. afterwards entertained by Dr. and Mrs. Gilbertson. The Division was still trying to bring about a settlelDent with the guardians; several letters lhad been sent to them and to tlle Local Government Board, and the committee GREENWICH AND DEPTFORD DIVIsIoN. lhad held three deputations witlh tlle guardians, two THE annual general meeting of this Division was held on under the chairmanship of the Local Government Board June 24th. inspector. The auardians made offers to each of the nine The late Dr. Keay.-Tlhe Clhairman, Dr. R. D. MUIR, Poor Law medical officers, but the latter most loyally before entering on tlle business of the meeting, proposed a replied that the nmatter rested with the Division of the vote of sympathy with Mrs. Keay, on the recent death of Britislh Medical Association, and each instructed tlhe D-. J. H. Keay, and suagested that an expression of the committee to refuse tlle offer for them. This was splendid appreciationi of the Division of the self-sacrificing labours loyalty to the Division and to themselves, and would go a of Dr. IKeay on belhalf of the profession slhould be enterecl long -way towards obtaining a satisfactory settlement, and, on the minutes. Dr. R. CORFE seconded the motion, as last year, the committee trust and rely on the written whiclh was carrieduinanimously. pledge of the, members of the profession to uphold the late Annual Representative Meeting.-The Rev. Dr. S. D. district mnedical officers and public vaccinators, and Blhabha was elected Representative for the Representativo support them and the profession as a whole against Meeting, and was instructed to vote against the motions of under-payment and sweating of tlleir services. tlle Plymouth, Altrinclharn, and St. Pancras and Islinatoi Votes ofThanks.-Hearty votes of thanks were accorded Divisions (as regards National Insurance Act), and in to the committee, to Dr. Scott forhis able and untiring favour of the motion of- the St. Pancras and Islinatou work as president; to the Representatives, Drs. Robinsoln Division as regards treatment of tuberculosis. and Ferguson, for their valuable and able work; and to Dr. Bird, late honorary secretarv and treasurer, for hiis efficient work rendered tothe Division. ST. PANCRAS AND ISLINGTON DIVISION. AMEETING of tlle St. Pancras and Islington Division was LEINSTER BRANCIH: lield in the Midland Grand Hotel, King's Cross, on EAST LEINSTER DIvIsIoN. June 19tlh. THiE annual general meeting of the East Leinster Division AnnualReport of Division.-The Honorary Secretary was held in the Royal College of Physicians, Dublin, on and Treasurer, Dr. J. WILSON, presented the annual report June 23rd. drawing special attention to the large number of resigna- Election of Oficers.-&-Tlie followingD were appointed tions of membership durina the past year, the number officers for the ensuing year: now being 152 as compared with 210 at the end of 1913. Chairmaan: Dr. R. L. Heard. December, Vice-Chairmant: Dr. W. F. Law. Election ofOficers.-The following officers were elected Honorary Secretary an-d Treasutrer: Dr. Peacocke (Blackrock). for the ensuing year: Representative: Colonel Johnston. Dr. R. Deputy Representative: Dr.Peacocke. Chairnan: A. Roche. lI0oniorar-y Secretary and Treasurer: Dr. Norman Glaister. Representatives on Branch"Counici: Drs. Dampier-Bennett, Iepresentativtes to Branch Couniicil: Dr. A. Alexander and Dr. Good, Johnston, Law, and Peaccke. 0. A Wickham. Executive-Comnmittee: The officers and Drs. Dampier-Bennett, E.rtxcitii'eCo,nrnittee: Drs. A. Brown, Crabb, Glinn, Good- Dawson, Furlong, Good, Hatch, Groves, Lynn, Usher, andi child, Maughan, Rattray, S. Rowntree, Turner, Wilson, Wylie. Professor White(ex qoffcio). Representation on Islinyton School Treatment Centre. -The meeting considered the question of procedure of METROPOLTAN COUNTIES BRANCH: election of Managing Committee for Islington School EASTHERTFORDSHIRE DIVISION. Treatment Centre, and ontilemotion of the Chairman TiiE annualmneeting of theEast Hertfordshiire Division (Dr. RATTRAY), seconded by Dr. J. WILSON, it was resolved was held at the NorthIlerts and South Beds Hospital, nesniine contradicente: Hitchin, on June 18tlh. Dr. J. H. GILBERTSON was inthe That the five local practitioners who constitute the committee chair, and eleven members were presenut. shall be elected by the members of the profession residing Eletion of Officers.-The following officerswere elected: and practising in the borough of Islington, London County Council electoral area, by nominating anid voting at a meet- Chairmzan: Dr. Clark (Cheshunt). ing called.for the purpose, andthat the said comm-nittee V'ice-Chairmant: Dr. Sturge (Hoddesdon). slhall elect its own chairman, honorary secretary, Seretary antd1Treasurer: Dr. Ledward (Letchworth). andl Assistant Secretary: Dr. de V'ine(Stevenage). honorary treasurer. Representative onBrancch Couincil: Dr.Charles(Hitchin). Insurance Act.-Withl reference to schedule of questions ExecutiveConmmittee: Drs. Addison, Boyd, Brittain, Dockray, re future developments of the Insurance Acts (SUPPLEMENT Fell,Wells, anid Windsor. of June 13th, p. 436) it was unanimously agreed thattho Representativefor Representative leeting: Dr.ItJ. . Gilbertson (Hitchin). time before the meeting was too short to adequately Depupty Representative: Dr. H. D. Ledward (Letchworti). consider a series of questions of such complexity and Honorary Annual report of the scope. Secretary's Report.-The V'ote of Thanks .-A vote oftlianks to the retiring Division for'tle year 1913-1914 stated that the member- and slhip now stood at 52, a decrease of 7 during the year. Chairman, Dr. Rattray, and the Honorary Secretary Dr. J. Wilson, was proposed by Dr. GLAISTER Fiveme etings had been held during the year, at two of Treasurer, 'which scientific papers were read, the average attendance and seconded by Dr. BEATON. Both Dr. BEATON and Dr. RATTRAY made very kindly reference to the work whichi being fifteen: The financial statement showed a balance in hand of £4 17s. the motion of Dr. had been undertaken and carried out by the Honorary ld. On. BOYD, and their term of seconded by Dr. BINNING, the report was adopted. SeSretary, Dr. Wilson, during hlis office, Insurance Acts: Reports front Future Developments at a time when the secretarial work of the Division was of in reference to future develop- the most arduous and onerous nature. Dr. RATTRAYhiiin Committee.-The report thanked the Division, the Executive of Insurance Acts was considered and answers given reply and Committeo mnent in particular, for their sympathy, and support to most of the questions asked. One or two questions kindness, were left unanswered owing to time not being available for during his term ofoffice.- The Honorary Secretary and adequate discussioni. Treasurer, Dr. WILSON, having made a suitable reply, thuo business of the meeting was brought to a close. Mediccll Representative on Insurance Committee.-It was resolved to nominate Dr. A. J. Boyd as the Represen- tative of the East Hertfordshiire area on the County Insurance Committee, and to discourage any other SOUTH-WESTESSEx DIvIsIoN. nomination. A MEETING of theSouth--West Essex Division was hield on Vote of Thanks.-The meetingo terminated wihl a very. June 25th in the Wesleyan Schoolroom, Leyton,whven healtty vote of thankhs to the retiring chairman, Dr. J. H. Dr.POTTINGER ELDRED presided. i8 8 BIIHMDALJUBzISTUISPHPLMEEMDEINCTALTOJOTUHRUNAL[JLALI MEETINGS OF BRANCHES AND DIVISIONS. (JULY 4, -I914-91

Insurance Act.--The schedule of questions on future OXFORD AND READING BRANCH:. developments of Insurance Acts were considered, and the READING DIVISION. following were the decisions reached: THE annual meeting of the Reading Division was held in 1. Provision of Institutional Treatment.-(a) No. (b) Yes, in the Royal Berkshire Hospital on June 25th, when Dr. favour of Government supplying fund. (c) No. (d) Yes. ABRAM was in the chair, and nineteen other members were 2. Excessive Claims for Sickness.-(a) Yes. (b) There are other causes, chief of which is easy access to doctor without present. paying a special fee. (c) Yes. (d) No check possible. Election of Officers.-The following officers were elected 3. Proposed New Services.-(a) Yes, most decidedly. (b) for the en,suing year: Division would like a new authority created. (2) Details as to Services.-(a) Division makes no fresh suggestions. (b) Yes, Chairmant: Dr. Napier Jones. certainly. Vice-Chairman: Dr. Guilding. Nursing.-(a) Yes. (b) Yes. Representative: Dr. Holden. Referee-Consultants.-The Division agrees with the sug- Deputy Representative: Dr. Napier Jones. gestions. Executive Committee: Two new town members of the Execu- Treatment Centres.-The Division agreed with tive Committee-Drs. Abram and Clowes-were then elected ill suggestions. place of Drs. Guilding and Holden. The remaining town andl One member suggested that at the county members of the Executive Committee were re-elected hospitals formed by en bloc. Government arrangements should be made for the treat- Ethical Commnittee: The Executive Committee. ment of middle-class patients at a small fee for attendance hIontorary Secretary: Dr. Lambert (re-elected). and operations. It was, however, thought that, although tlle middle classes are always neglected, still no Govern- Vote of Thanks to Dr. Napier Jones.-The meeting ment would consent to anything which recognized a had previously accepted the resignation of Dr. Napier difference between classes, and therefore, after some dis- Jones from the office of Representative with great regret, cussion, the matter was dropped. and on the motion of Dr. ABRAM, seconded by Dr. BOKENHAM, a hearty vote of thanks was accorded to him. Dr. Abram pointed out that he had been an ideal Repre- sentative, hard working and outspoken, and that many of MIDLAND BRANCH: the recent resolutions passed at the Representative Meet- HOLLAND DIvIsION. ings had originated in his brain. He had, in fact, over- A MEETING of the Holland Division was held at the White worked himself on behalf of the Division. Dr. NAPIEPR Hart Hotel, Boston, on June 26th, when Dr. PILCHER pre- JONES acknowledged the vote of thanks, referring to th3 sided, and six other members were present. genuine pleasure which he had derived from the Represen- Joint Meeting of Division&.-On the motion of Dr. tative Meetings and fromn the knowledge that he had been MASON, seconded by Dr. RENDALL, it was resolved that the so well supported by the Division. The Division hal joint meeting of the Holland and Kesteven Divisions for always sent him to the meetings with clear mrandates, the purpose of instructing the Representative be held at with whiclh he found- himself in entire sympathy. I the Carre Arms Hotel, Sleaford, on July 19th. seconding the election of Dr. Holden as Representative, Insurance Act.-The memorandum regarding future he pointed out that the Division would be electing a mem- developments of the Insurance Acts was considered and ber whose ability and presence would entitle his opinions the questions appended thereto answered. to respect and consideration. The profession was passing Financial Statement.-The financial statement showed through a critical time, and the Division needed an able a balance in hand of about £8. Representative. The election of Dr. Holden would supply the need. Futu,re Developmenzts of the Insurance Acts.-Tlie meeting then discussed the questions sent out by the MUNSTER BRANCH. British Medical Association with a view to enabling the THE annual general meeting of the Munster Branch was Future Developments of the Insurance Acts Committee to held on June 20th, when Dr. W. DONOVAN (Queenstown) lay before the Representative Meeting a report on tho was in the chair. Reports were read regarding develop- views of the members of the Association, as to the lines ments in the medical service of the Insurance Acts and on on which future changes in organization of medical service thle distribution of funds of Divisions and Branches. A under the Insurance Act should proceed. Answers to the list of constituencies for election of Representative Body questions were agreed to. During the discussion, tho was considered. following suggestions and opiDions were expressed: Election of Offlcers.-The following were elected; Hospital Accommodation.-Dr. BOKENHAM felt that tlhe President: Dr. M'Call (Crosshaven). accommodation for in-patients at the Royal Berkshire Vice-President: Dr. W. Donovan (Queenstown). Retiring President: Dr. J. Reid (Bandon). Hospital was very inadequate for the population in tllo Memnber of Central Coutncil: Professor H. Corby. area of the Division. Dr. ABRAM suggested that the lack Representative to Representative MIeeting : Dr. McFettridde. of accommodation affected surgical rather than medical Representative to Irish Committee: Dr. J. Giusani. cases. Dr. SUSMANN endorsed Dr. Bokenham's view. He Branch Council:- Drs. H. R. Townsend, Lucy Smith, 0. found that surgical cases were sometimes kept waiting MIcCarthy, P. T. O'Sullivan, D. J. O'Connor, E. Murphy, J. T. O'Connor, C. Yelverton Pearson, W. Ashley Cummins, weeks for admission, and that owing to the pressure on A. S. Nance (Bantrv), R. Foott (Monkstown), J. Devane beds certain surgical cases were discharged at too early a (Limerick). date after operation. ronorary Secretary: Dr. Philip G. Lee (10, St. Patrick's Hill, Loans from the Government to Hospitals for Building.- Cork). Dr. ABRAM pointed out the danger of increased control over Ethical Committee of the Branch: Dr. W. Donovan, Dr. D. J. lhospitals by the Government which such loans would O'Connor, Dr. Philip G. Lee. involve. Dr. HOPE thought the question was one to be settled not by the Divisions but by the Government and hospital authorities. Dr. ROALFE-COX suggested that the NORTH LANCASHIRE AND SOUTH WEST- proposal referred not solely to existing hospitals, but to MORLAND BRANCH. the building of new cottage and other hospitals. THE annual meeting of the Branch was held at Lancaster Dr. ROWLAND proposed and Dr. HOPE seconded: on June 24th. Dr. BARLING succeeded Dr. Daniel as That the reply to this question shall be to the effect that the president. matter is one for the Government and boards of manage- Election of Officers.-The officers of the Branch for the ment of hospitals to settle. year are: This motion was withdrawn in favour of the following, President: Dr. A. S. Barling. proposed by Dr. NAPIER JONES and seconded by Dr. Presidentt-elect: Dr. G. A. Johnston. COLEMAN: Vice-President: Dr. G. Parsons. That the matter needs most careful consideration before any Treasurer: Dr. W. D. Barrow. change in existing arrangements is made. Dr. J. Secretary: Livingston. This resolution was passed. after an amendment that Tlle members present were entertained at tea by the the reply be simply ;' Yes " had been put to the vote and President. lost. [ SUPPLEMENT TO TIM I9 JULY 4, 1914] MEETINGS OF BRANCHES AND DIVISIONS. [BRITISH MEDICALJOURNAL Payment of HonoraryAredical Staffs of Hospitals for acknowledgemenit, Dr. AlrAMI expressed tlle pleasure Treating Insured Persons.-Opinions on this question which lie had always derived from wvorking with his were divided. After some discussion it was, on the motion medical colleagues for their comluon welfare. of Dr. NAPIER JONES, seconded by Dr. HOLDEN, resolved: Ainor Operations at the Ho1s)ital.-Dr. BOKENHAM said That the reply to the question be in the affirmative. that a considerable number of miiinor operations, such as circumcision and removal of adenoids, were performed at The addition of the words " but that no payment be made the Royal Berkshire Hospital by the resident medical to members of lhonorary medical staffs" was not sanc- officers. These operations could be performed by general tioned by the meeting. The addition was proposed by Dr. practitioners in the patients' homes, and in many cases ABRAM and seconded by Dr. LAMBERT, their suggestion the patients were well able to afford to pay a smiiall feo being that any mnoneys received for treatment of insured for tlheml. In other cases the parislh autlhorities would persons should be taken by the lhospitals. be willinig to pay the parislh niedical officer's fees for tle Causes of Excessive Sickness and Mledical Benzefit Claims operations. by Insured Persons.-Several members spoke on thlis question. Some tllouglit that a good deal of illness had been untreated before the Insu-rance Act came into opera- SOUTH-WESTERN BRANCH. tion, notably cases of anaemia in factory girls. Others THE seventy-fifthl annual meeting of the South-Western thiouglht that thle appointment of referees would con- Branch was held on June 23rd at the Royal Hotel, siderably reduce tlle number of claims. One member Plymoutlh. The retiring Presidenty Mr. G. YOUNG EALES pointed out that the fact that no sick benefit was granted (Torquay), took the chair at the openina of the meeting, during the first three days induced insured persons to wlhen tllere were forty other members present. remain on the funds for at least ten days. Another ..Annual -Repo rt.-The annual report showed that the member stated that certain people were over-insured, memberslhip oni April 30th was 479, as comupared with 504 paying to clubs as well as to the State, and that they in tlle previous ye-ar. This was considered satisfactory in found it advantageous to be ill. view of the great increase in membership during tho Frequency wvith which Insuredl Persons consutlt Doctors. Insurance Act campaign and the recent increase in sub-. -The general opinion of the miieeting seemed to be that scription to two guineas. The report enumerated th3i doctors were not consulted uninecessarily; that no check muatters which had chiefly occupied the attention of th- slhould be suggested to consultations with doctors; that it Branch during the year. Witlh regard to the relation of was the best policy to encourage insured persons to seelk Divisions and Branches to Local Medical Committees, it advice early. Replies were returned in accordance witl was pointed out that this question lhad been complicated these views. by the formation of Panel Committees. The enlargement Provision of a Nursing Scrvice.-It was decided tllat of the powers of Branch Councils-a subject dealt with iu tlle provision of a nursing service was desirable, but that the anniual report of the Central Council, the recommeni- the State registration of nurses was most important. dations of wlhiclh would come before the Annual Repre- Clinical Laboratories.-i Dr. ABRAM thought that clinical sentative Meeting-was also dealt witlh. On the question laboratories should be connected with hospitals, when well of midwifery fees, it was stated that this matter had equipped patlhological departments were available in the now becolmie of comparatively small importance, since hospitals of any area. Dr. DONALDSON expressed the the amlendment of the Insurance Act placed the-mid- opinion that, even in the vicinity of -universities, hospitals wifery benefit at the disposal of the parturient woman,' should undertake the clinical work. In this way university and this hiad considerably reduced the difficulty of professors would be allowed time for research work. More- providing for the remuneration of medical men when over, hospital patlhologists lhad to depend for their incomes called in. Tlle question of the necessity of arranging not only on the salary received from the hospital, but also terms for tlle futui-e treatment of uninsured persons upon on fees received for pathological work in private practice. the expiratioll of contracts had also received attention. It Appointm)zent of Referees and Consultants.-Dr. SUSHIANN was stated that the Branclh Council lhad determined that believed that there was a distinct need for referees and it was advisable to bring about an amalgamation of Divi- consultants, but that in certain districts they should not sions for special purposes corresponding to the area of tlhe be whole-time officers, the amount of work being in- administrative county of Devon. Th'e matter would come sufficient. Other members held the view that whole-time before the Annual Representative Meeting at Aberdeen, officers were more likely to form unbiassed opinions tllan and probably it would be found best to establish joinit part-time officers. Dr. ]DICKSON (Hungerford) regretted committees rather than to seek amalgamation. Tlhe that tlle Division had passed the resolution fixing a guinea appointment of Dr. Frank Roper as Assistant Branclh as the minimum fee for a referee's opinion on an insured Secretary had greatly helped the secretarial work of tlhe person. Before that decision lie and his colleague at Branch. The financial statement for tlle year showed a Hungerford had examined cases for one anotlher at a fee balance in lhand of £16 12s. 8d. of 5s. wlien thle approved societies asked for a second Election of Ogicers.-The report was adopted on tlhe opinion. The approved societies declined to pay the motion of the PRESIDENT, seconded by Dr. NoY SCOTT. guinea fee, and no consuLltations now occLirred. The next alnnual meeting of the Branch will be lheld at Offer of an Approved Society to ap)point a R?eferee. - Exeter and Mr. John M. Ackland was appointed President- Dr. THOMPSON (Newbury) reported that the Domestic elect. The Honorary Secretary (Dr. Russell Coombe) Servants' Association had offered to appoint him tlleir and the Assistant Honorary Secretary (Dr. Roper) were referee, fixing the fee for each examination at 10s. 6d. re-electedl. He had declined the offer, and the approved society in Indutction of President.-Mr. EALES then gave way-to question had then written pointing out that the fee fixed Mr. Woollcombe, the President-elect, remarking that by the British Medical Association was 10s. 6d., and Mr. Woolleombe was known as one of the leading asking him to read the letter at a meeting of the Reading surgeons of tlle South-West, and one eminently fitted to Division. The letter stated that other approved societies conduct the meeting of the Branch. liad found mnedical men willing to act as referees for a Vote of Thanks.-Mr. ACKLAND proposed a vote of fee of 10s. 6d. Dr. NAPIER JONES dlrew attention to two thanks to the retiring President, and that Mr. Eales's facts:-(1) That the British Medical Association fixed tlle name be added to the list of Vice-Presidents. Mr. EALES, mninimutnm fee at 10s. 6d., and Divisions were entitled to in reply, said he lhad been keenly interested in the affairs agree upon a liglher fee. (2) That the appointment of of the Branch all his professional life. He had held the referees by approved societies at a fee of 10s. 6d., office of Secretary five years, and had been their repre- mentioned in the letter, had not been made by the Britisl sentative on the Central Council of the Association. Ho Medical Association. had had a quiet year of office as President, and lie believed Mr. Woollcombe would have a quiet year, but he antici- Votes of Thanks to retiring Chairnan.-In proposing a pated that after the next twelve months their trouble vote of thanks to Dr. Abram for his services as Chairman witlh the Government would begin again. of the Division during the past year, Dr. SUSMANN referred Early Recognition of Cancer.-The President, Mr. W. L, to the valuable work he had done and to the judgement WOOLLCOMBE, then delivered an address on tlle responsi- and discretion which he had shown in fulfilling his bility of the medical profession to the municipal authorities, duties. The motion lhaving been seconded by Dr. and through them to the public in regard to the earlier NAPIER JONES, was passed unanimously. Speaking in recognition of the more common forms of cancer. All SUPPLEMENT TO THE 1 20 BRITISH MEDICAL MEETINGS JOURNALl OF BRANCHES AND DIVISIONS. [JULY 4, I914

medical men did what they could by advice to individual health, to instruct their health committees to consider and( but was too often the the door report what steps should be taken to remedy this state of patients, that shutting after things; also to offer the services of the council of the the horse had been stolen. What was wanted was South-Western Branch of the British Medical Association organized, combined, and sustained effort. Every medical in drawing up a report should such services be required. man liad found himself times face to face with the many Medical Benevolent Association.--Before the commence- tragic and humiliating experience of being consulted by a ment of the meeting, the HONORARY SECRETARY called for what was to be a trifling complaint, patient thought attention to the Devon and Exeter Medical Benevolent to find a condition of Why was only helpless malignancy. Association, and urged all medical men practising in it that a disease which above all others was so marked Devonshire to join it. The association had that it was almost to mistake the £3,000 invested, impossible significance and a subscription list of £80 a year. It had money for of its manifestations in most of its common early forms, the purpose, but was unable to do anything for medical slhould be the one to which the paid no yet very public men or their widows unless they were members. attention? There were two reasons. it was a First, Excursion.-In the afternoon excursions were made to and dictum that cancer widespread firmly-held popular Bantham, where the company were entertained by Dr. was incurable; secondly, the picture which the average Fox; to the Batten golf links, and to Devonport Dockyard. person formed of a cancer case was that of a wretched, Presentation to Dr. Donbavand.-After the annual dinner emaciated,- eachectic creature, racked with pains, and pro- in the eveining the members gathered in the Palm Court of from an offensive discharge; consequently bably suffering the Royal Hotel, where the President Inade a presentation no was attached to short of these. significance any symptoms on their behalf to Dr. Edgar J. Donbavand in M\Iedicine had for years been in possession of positive know- recognition of his work as honorarv secretarv of tlle Branclh. Tlle lodge that cancer was local in origin. For an appreciable presentation took tlle form of a piece of plate, a time it was amenable to cure by removal, if it occurred in a cheque, and a roll of the subscribers, numbering more than ninety. position where removal could be carried out with sufficient Mr. R. JACQUES paid eloquent tribute to the services ficedom, and in the great majority of cases it did occur in of Dr. Donbavand, which been particularly arduous sach situations. Statistics showed tllat in women 80 per lhad and valuable dulring the last two or three years. Dr. cent. of all cancers occurred in the breast and organs-of DONBAVAND returned thanks. generation. In men a, similar percentage occurred in the lips, tongue and alimentary tract, and, withi a compara- tively unimportant exception, these were all within reach STAFFORDSHIRE BRANCH: of free removal, though not all so easy of early recognition. MID-STAFFORDSHIRE DIVISION. All-were-agreed that for early cases thielre was nothing at THE twelftlh annual general meeting of the Mid-Stafford- present to take the place of thiorough removal by the knife. shire Division was held on June 23rd at the Trent Valley Ini setting about the task of painting a new picture of tlle Hotel, Lichfield. Tlle chairman, Dr. F. M. ROWLAND, and early and curable cancer case, the medical profession must eighteen other miembers were present. at first confine itself to certain common types which lhad Election of O:ficers.-The following officers were elected well-marked symptoms and work out a series of dogmatic, for the ensuing, year: clearly-defined axioms, easy to understand, and free from Chairman: Dr. F'. M. Rowland. uncertainty. For instance, any lump, however small, Vice-Chairmzan: Dr. A. E. Hodder. in the breast of a woman over 40 Honorar-y Secretary: Dr. T. D. Stuart Shaw. occurring was serious, Executtive Committee: Drs. Rowlanid, Hodder, Lowe, Stack, and slhould be shown to a doctor at once. It was more G. Reid, Clendiinnen, C. J. Armson, J. N. Cookson, Dixon, than likely cancer; any uterine bleeding after the meno- Freer, Gettings, and Stuart Shaw. pause demanded instant skilled advice. It almost always Representative at Annual Representative Meeting: Dr. W. M. meant cancer. Any pimple or sore on the lip or tongue of Clendinnen. a man over 40 was probably cancer, but curable if shown Representatives on Branch Council: Drs. W. G. Lowe, G. Reid, at once, and rectal bleeding in a patient over 40, eveln and Stack. Special Fund.-Matters referred to Divisions were con- if quite slight, was serious, and should be reported to sidered at length. With regard to the question of a doctor. These examples could be multiplied witlh ease. tlle In the endeavour to put the public in possession of the Special Fund a postal vote had been taken, but the result it itself possessed, the medical profession must was so indecisive that the Representative was instructed hnowledge to use his own discretion as to voting, the work through the municipal councils, wlhose lhealth com- Division, however, expressing the definite opinion that a trade iniittees had the power to initiate the necessary measures. union would be to a in event All teaching on tlle subject must be simple, dogmatic, and preferable trust, but only the of the Special Fund being supported by a large majority of tlle concise. A start had been made in a few places. At profession. Portsmoutlh Mr. Childe had been very active in preaching tliese doctrines, witlh distinctly noticeable effect, but the Supersession.-Dr. ROWLAND then proposed, and it was unanimously resolved, that the following become a rule of only national effort so far was that of the Central Mid- tlle wives Board, which had issued a leaflet to all midwives Division: That in the opinion of this Division it is always desirable concerning uterine cancer. Members of the medical pro- that a doctor before accepting a patient during an illness should fession should get some miembers of the Municipal Council satisfy himself that tlme superseded practitioner has been to introduce the subject, and have it -referred to a com- notified. inittee, with instructions to report, perhaps, with the help of the Division of the British Medical Association. Other WEST SOMERSET BRANCH. imieasures suggested were: (1) The calling of meetings to THE seventy-second annual meeting of the West Somerset district wlhich nurses, midwives, district visitors, and other Branch was lield at Bridgwater on June 26th. In tho ladies interested in charitable work and visiting among unavoidable absence of Mr. Penrose Williams, the chair t'he poor-perhaps even the clergy themselves-should be was taken by Dr. BALFOUR STEWART, Past-President, itnvited. (2) The publication in the press, at intervals, say, and twenty-two other members were present. of a month, of a notice emphasizing a few simple and Annual Revort.-The annual report and balance sheet definite points to assist people in the early recognition of for 1913 were adopted. cancer. (3) The provision of facilities for the examination Election of Officers.-The following officers were of suspected material from cancer cases amongst the poor. elected: (4) The bringing of pressure to bear on the Local Govern- President-elect: Dr. A. E. Joscelyne (Taunton). ment Board to make cancer a notifiable disease. This T'o Fill the Vacancies ont the Council: Drs. Alcock aiid would probably do some good, but the scheme would work Murphy. well without it. After the Honorary Secretary and Treasurer: Mr. Chas. Farrant (re- quite thanks of the meeting elected). lhad been conveyed to the President, he proposed thle fol- Ethical Conmmittee of the Branch: The Council of the Branch. lowing resolution, which was seconded by Mr. RUSSELL COOMBE, and carried unanimously: Vote of Thanks.-A hearty vote of thanks was accorded to Mr. Farrant for the energetic way in which he had That this meeting of the South-Western Branch of the carried out the duties of Honorary Secretary and Treasurer British Medical Association wishes earnestly to call the to the Branch during the past year. attention of health authorities to the high death-rate public Future Developments of the ques- from cancer, and to the appalling state of ignorance that Insurance Acts.-Tlhe exists in the minds of the public with regard to its early tion as to the future developments of the Insurance Acts symptoms; and to urge them, as guardians of the public was referred to the Council to answer. NOTICES. [ SUPPLFMENT TO TH 2 JULY 4-, I914J ASSOCIATION LBRITISH MEDICAL JOURNAL 21I Dr. W. C. G. COLLINS (Cannington), the new President, Branch ree'eing at Sheffield on March 18tll it was then took the h1air. resolved: Acldress by Dr. J. A. Macdonald.--Dr. J. A. MACDONALD That in the opinion of this meeting£350, as offered by the then delivered tlhe address wlichl is publislhed in tlhis Education Committee of the West Riding County Council, for a whole-time eye specialist is totally inadequate to secure issue of the JOURNAL (p. 1). Dr. Macdonald was hleartily the services of an experienced surgeon, and that the lowest thlanked at tlle conclusion of hiis address. be£500. Lnncheon.-An adjournment wasmnade for lunclleon, at fee offered shlould which twenty-two sat down. MIodel Organization Rnles.-It was decided to consider Visit to Cannington.-After lunlcheon Dr. Collins in- the model organization rules at a meeting of th6 Executive thermiembers to Cannington, wlhere a very enjoyable Committee, and then put the question of their adoption on vit'edafternoon was spent. Somle played tennis, and otlhers the agenda for next meeting of the Division. wvatched a boxing and gymnastic display by the boys of Finance.-The Treasurer, Dr. STEVEN, reported that; tlhe Cannington Industrial School. It was late before the there was a balance at the bank of£22lOs. 6d. (exclusive of party broke up, everybody feeling tllat it had been a very interest for the past year) on account of the fund for pay- meeting. ment of the Representatives at the Representative Meet- successful ings. Upon the proposal of Dr, STANGER, seconded by YORKSHIRE BRANCII: Dr. JOHNSON, the Treasurer was authorized to pay the, BARNSLEY DIVISION. Representatives who attended tlle Representative Meetings in July and December, 1913, at the rate of£1 s. a day. A MEETING of the Barnsiey Division waslheld on June 27th. 31 Secretary was Future Developmnents of Insurance Acts.-Circulars D Vote of Condolence.-The Honorary and D 31 A regarding future developments of the Insurance coquested to write to Mrs. Tlhompson, the widow of Dr. was referred to the Committee for An(rew Tlhompson of Dodsworth, expressing the sympathy Acts Executive coii-tlle of the Division with her in lher sad bereavement. sideration, with a view to answers being returned to Election of Oficcrs.-The following officers were elected: questions contained tlherein. Chairman: Dr. Castle. Vice-Chtairmant: Dr. Townsley. HonLorary Secretary: Dr. H. F. Horne. l.epresentative: Dr. Castle. Representatives onL Branzcht Couoncil: Drs. Burman and F. J. Sad ler. Ex'recuttive Comnmnittee: Drs. Goodman, Wallis, White, Allott, Special Representatiwre Meeting, Ilarvey, and Johnson. Aberdeen. Fu'ltture Developmients of the Insuranzce Acts.-The memo- randum received from the Medical Secretary, Form D31 A, was carefully considered and answered. 0N thie requisition of the Council, notice is lhereby given under Article 31 and By-laws 36 and 73, tllat a Special' Representative Meeting of tlle Association will be held on IIUDPERSFIELD DIvISION. Monday, July 27th, 1914, at 12 noon, at tlhe Marischlal THHE annual mneetina of the Huddersfield Division was College, Aberdeen, for the purpose of considering tho lheld at the Huddersfield Royal Infirmary on June 19th. following Report and Recommendation of Council (par-a- Annual Report of Division.-The annual report stated graplhs 211 and 212 of Supplementary Report of Counicil, that three meetings lhad been held during the year, witl 1913-14), and,' if considered advisable, amending By-law 67 aln average attendance of 11, and that the memberslhip accordingly: was now 51, a decrease of 10, dtue to 8 resignations and SCOTTISH COMMITTEE. 2 deatlhs. 211. The work of the Scottish Committee is growinig, lElection of Oficers.-The following officers were elected and it is found increasingly difficult for'the Chairman to 1914-15: be able to attend all the Committee meetings in Scotland for and Council an(d Committees in London as well. Tho Chairmjian : Dr. G. W. Croslan(l. Committee consequently desires be able to elect a Vice-Chairmeen: Dr. J. Irving, Dr. Braitliwaite. to IHoniorary Secretary mud Treasur-er: Dr. A. L. MeCully. Deputy Chairman as well as Chairman. By-law 67 pro- Representative for Represenitative Meetinigs: Dr. D. L. Cairns. vides that eaclh Standing Committee shall appoint from Representtativfe on B'raucZh Council : Dr. D. Wilson, jun. its own number a member of Council as Chairman, in Execultive Coimmittee: Dr. Ian Campbell, Dr. W. H. Smailes, order that the' Council may be able to keep in touch withl Dr. Draper, Dr. Latimer Walker, Dr. F. Knaggs. Dr. P. each Committee. The Scottish Committee wishes to be Rattray, Dr. R. H. Rigby, Dr. Edward Walker,. Dr. William an exception to this By-law and to be able to have a Bell, Dr. H. Tansley. Chairman not necessarily a member of Couincil, but that effective co-ordination shall be muaintained by insisting WAKEFIELD, PONTEFRACT, AND CASTLEFORD DIVISION. that one of its three officers-Chairman, Deputy Chairman, THE annual meeting of thlis Division was lheld at the or Honorary Secretary-shall be on the Council. As tlho Clayton Hospital, Wakefield, on Julne 24tlh, wlhen the clhair Scottish members desire the change as early as possible, was occupied by Dr. HILLMAN, and nine otlher mnembers the Council has arranaed that a special session of the were present. Representative Body shall be held at Aberdeen OiU officers were elected: Monday, July 27th, 1914, at 12 noon, for the purpose (only Election of Officers. -The following one month's notice of such an alteration of By-laws being Chairman: Dr. G. B. Hillman (Castleford). in the case of a Special Representative Vice-Chairman: Dr. E. W. Selby (Doncaster). required Meeting). iHoniorary Secretary: Dr. W. Eardley (Goole). 212. The Council recommelnds: Representtative to Representatire Mleetings: Dr. Hillman. Deputty Representatiie: Dr. Eardley. RECOMMENDATION GG. - That the Special Repre- Treasurer: Dr. W. Steveni. sentative Meeting, Aberdleen, amend existing Representative to Branich CouIIncil: Dr. Steven. By-law 67 of the Association, whiclh reads as 1Exaecutive Commi7?ittee: The above officers, and the following: follows: Drs. J. J. W. Campbell (Castlerod), W. F. Chrispin (Castleford), J. LH. Battersby (Doncaster), A. Thomson (Wakefield), R. AMay 67. Each Standing Committee shall appoint from its (Wakefield), L. A. Johnison (Normanton), H. Scholefield (Nor- own number a Member of Council as Chairman, manton), J. Orford (Pontefract), E. B. Osmond (Pontefract), W. Stanger (Wakefield). to read as follows: Annual R¢epresentative lMeeting.-The annual report of 67. Each, Standing Committee except the Scottish it was agreed Committee shall appoint froin its o'wn. numuber a the Central Council having been considered, of as Chairman. The Com- to instruct tlle Representative to vote in favour of the Meinber Council Scottish and its pro- nittee shall appoint from its own number a Deputy establishment of tlie proposed Special Fundcl Chairman, as well as a Chairman, and either the tection by means of a trade union. Chairman or the Deputy Chairman or the Honorary Ee? Specialists.-Tie HONORARY SECRETARY reported Secretary of that Committee shall be appointed from thlat a meetinag of tlle Executive Committee of the Division amongst members of Council. had been held on February 26th to consider further tlle question of an advertisement of the West Riding County T. JENNER VERRALL, Council, which had been refused insertion in the BRITISH Chairman of Representative Meetings. MEDICAL JOURNAL. Dr. STEVEN reported that at thle June 24th, 1914. S5U]PPLZMENT TO TIt 2 EJUTISH MEDICAL JouswLJ SHIP SURGEONS SUBCOMMITTEE. [JULY 4, 1914 on Thursday, July 9th, at 1 o'clock. Agenda: Correspondence. ELECTION OF MEMBERS OF COUNCIL BY Election of officers for 1914-15 (scrutineerq' report). Annual Report of Council. Balance sheet. Council's recommendationi GROUPED REPRESENTATIVES. re travelling expenses of secretaries of Divisions. Adoption of NOTICE is hereby given that Nominations for Candidates new rules of organization. Alterations of rules of golf com- for election of Members of Council by grouped Representa- petition. General business. At the conclusion of the business the President for the coming year (Mr. G. H. Coweln) will talie tives for the year 1914-15 will be received by the Medical the chair and deliver an address. Mr. Cowen invites tihe Secretary up to the end of the first hour of the proceedings members to luncheon at the hotel, at 1.45, and to afterlnoon of the Annual Representative Meeting on Friday, July 24th, tea, to which ladies are invited, at 4 o'clock. The golf com- 1914. Each' Nomination must be on the prescribed form, petition'will be played off at the Stoneham Golf Club directly copies of which will be forwarded by Medical after luncheon. Excursions will also be arranged. Members the Secretary intending to accept the President's hospitality will oblige by on application. sending word to that effect to Dr. W. A. Sjmpson, 3, Waterloo Separate forms have been prepared: (I) For Nomination Road, Southampton, as early as possible, but not later thavi by a Division (through its Representative), and (IL) for July 6th. Nomination by a Representative of a Constituency included in the Group, and those applying are requested to state for which purpose the form is desired. SHIP SURGEONS SUBCOMMITTEE. The voting papers will be issued at the Representative Meeting to each Representative or Deputy Representative THE followina practitioners have consented to act as " of a Constituency in the United Kingdom in attendance at "Correspondents of the Ship Surgeons Subcommittee, the Meeting. and are prepared to discuss witlh any ship surgeon in their By order of the Council, area any matter of interest either to that surgeon or to slhip surgeons in general, and to forward representations ALFRED COX, to the Subcommittee in regard to any question in June 24th, 1914. Medical Secretary. connexion with whiclh central action seems desirable: CHANGE OF BOUNDARIES. Correspondent. Port. Dr. J. Godding, 56, Leadenhall Street, London, LEIGH AND WIGAN DIVISIONS. E.C. Lon(lon. THE following change has been made in accordance witlh Dr. A. G. Hinks, 40, St. Vincent Row, the Articles and By-laws of the Association, and takes Southend-on Sea Lolndon. effect as the date of pu-blication of Dr. H. T. Bates, Church Road, Wavertree, from this notice: Liverpool Liverpool. That the urban district of Golborne be transferred Dr. C. Carlyle, 13, Menlove Avenue, Mossley from the area of the Wigan to that of the Leigi Hill, Liverpool Liverpool. Dr. C. J. Cooke, 1, Sussex Terrace, Plylmiouth Plymouth. Division. Dr. J. C. H. Beaumont, Chinsura, Khartoum R?epresentation in Representative Body.-Unaffected. Hill Roal, Southampton Southampton. Dr. 0. V. Currie, Union Castle Buildings, 58, Adderley Street, Capetown Capetown. BRANCH AND DIVISION MEETINGS TO BE HELD. Slhip surgeons visiting these ports and desiring to discuss BIRMINGHAM BRANCH: COVENTRY DIVISION.-Drs. L. E. matters of interest to the service are invited to place tlhemii- Price and D. Davidson, Honorary Secretaries, give notice that selves in communication with the correspondent for tlle a constituency meeting of thte Nuineaton and Tamworth and port. Coventry Divisions will be held at the Coventry Hospital on The Medical Secretary, 429, Strand, London, will Friday, July 17th, at 4.15 p.m., to instruct the W.C., Representative. be glad to hear from practitioners in passenger ports niot DORSET AND WEST HANTS BRANCH.-Dr. Frank Fowler, mentioned above who are willing to act as corresponidenlts Honorary Secretary (29, Poole Road, Bournemoutlh), gives to the Subcommittee. notice that the summer meeting of the Dorset and West Hants Ship surgeons are also asked to forward for the guidanice Branch will be held at the Town Hall, Bridport, on Wednesday, of the Subcommittee, eitlher to'one of the above couIc- July 8th, at 3.30 p.m. Mr. C. Edwards, Vice-President, will spondents or to the Medical Secretary, Britislh Medical read a paper, " Dr. Roberts, a Bridport Worthy." Dr. H. C. Manning will open a discussion on " The Theory and Practice Association, 429, Strand, London, W.C., their views upon' of Tuberculin Treatment." The Bridport practitioners very the following questions: kindly invite members to luncheon at the Greyhound Hotel (1) Whether ship surgeons should receive full sea (1.30 to 2.30), and Mr. and Mrs. Edwards, Granville House, have kindly offered to give tea. By kind permission of the Mayor, pay while in port plus a subsistence allowance at the the Municipal Archives will be on view at the Town Hall from same rate granted to the chief officer, with a possible 2.30 to 3.30. The West Dorset Golf Club kiindly offer members liability to have to report every day at the office of the the free use of the club at West Bay. Plans of the proposed company, or whether they would prefer to receive full new Bridport Hospital will be on view. sea pay only in port without such liability; subsistence pay, however, to be paid upon those days in port when EAST YORK AND NORTH LINCOLN BRANCH.-Dr. H. L. Evans, any dutv connected with the ship is performed. Honorary Secretary, gives notice that the annual meeting of (2) Their views generally on the question of annual this Branch will be held in Hull on Friday, July 10th. leave being granted with full pay to permanent ship Accounts, election of officers, etc. surgeons.

LANCASHIRE AND CHESHIRE BRANCH: ST. HELENS DIvISION. -Dr. F. J. Knowles, Honorary Secretary (Victoria Square, St. Helens), gives notice that the annual meeting of this Division THE LIBRARY OF THE BRITISH MEDICAL wvill take place at St. Helens on Wednesday, July 8th. Business: ASSOCIATION. (it) Election of officers. (b) Financial. (c) To consider matters contained in the SUPPLEMENT of June 13th. (d) General. BooKs NEEDED TO COMPLETE SERIES. THE Librarian will be glad to receive any of the following METROPOLITAN COUNTIES BRANCH: CITY DIVISION.-Dr. volumes, which are needed to complete series in the A. G. Southcombe, Honorary Secretary (83, Sidney Road, Library: Homerton, N.E.), gives notice that a special general meeting of American Association of Genito-U.-inary Surgeons. the Division will be held in Balfour Hall, Kingsland Road, on Transactions. 1906. Tuesday, July 7th, at 9.30 p.m., to consider the adoption of the American Climatological Transactions. Vols. 1, 4, 5, 6. model rules of organization for the Divisioni.-Following the American Dermatological Association Transactions. Vols. special meeting an ordinary general meeting will be held for 5, 7, 8,11, and 29. the usual business, and especially to consider the Supple- American Journal of the Medical Sciences. New series, mentary Agenda for the Representative Meeting (SUPPLEMENT, vols. 4, 5, 1842-3; vols. 14, 15, 1847-8; vols. 18-30, 1850; June 27th). vol. 33, 1857; vol. 46, 1864-5; vol. 59; or any parts of these vols. X NORTH WALES BRANCH.-Dr. H. Jones Roberts, Honorary South African Medical Journal. February and April, 1895. Secretary (Llywenarth, Penygroes, S.O.), gives notice that the Titles, Vols. 3 and 4. annual meeting of the Branch will be held on TuLesday, July United States Department of Agriculture, Bureau of 14th, at Benllech, Red Wharf Bay, Anglesey. Animnal Industry. Reports 1-7, 10-14. United States Hygienic Laboratory Bulletins. Nos. 3, 8, SOUTHERN BRANCH.-Dr. James Green, Honorary Secretary 9, 10, 11, 12, 13, 15, 17, 18, 19, 24, 29, 43. (lBrandon House, Mile End, Landport, Portsmouth), gives Virchow's Archiv. Vols. 1-150. notice that the forty-first annual meeting of the Southern Watt. Bibliographia Britannica, 4 vols., 1824w Branch will beheld at the South-Western Hotel, Southamuton. Yearbook of Pharmacy, 1912. r SUPPr.ETENT TO THI JULY 4, I9I4] LOCAL MEDICAL AND PANEL COMMITTEES. rBRITISH MISDICAL JOURNAL 23

III.-Finally, if any practitionei after investigation by the Mledical LOCAL MEDICAL AND PANELi Service Subcommittee is found to be persistently granting continuia- tibrn certificates when not actually required, a recominendation may COMMITTEES. be miiade by the Insurance Committee to the Commissioners requiring them to exercise their powers under Regulation 45,12, and Regulatioins Part VI: EDINBURGH. Where the Insurance Comimittee are of opinion that the con- PANEL COMMITTEE. tinuance on the panel of a practitioner will be prejudicial to the efficiency of the service of insured persons, they may make repre- A MEETING of the Burgh of Edinburgh Panel Committee sentation to that'effect to the Commissioners. was held on June 24tlh. Dr. DEWAR occupied the chair, and thirteen members were present. EXCESSIVE DRUGGING. It is well known to the Committee that some Practitioners are sti.l Budget Proposals.-The Committee had under considera- in the habit of prescribing excessive quantities of drugs, expensivu tion the Budget proposals so far as they affect the national drugs, when their exact equivalents might be used, and are being used- by miianypractitioners in psrivate practice, and articles which are being insurance scheme. After discussion of the general ques- used for their food value and not exactly for their medicinal value. tion, Dr. ORR inoved, ancd Dr. MORRISON MCINTOSn This m-latter was pointed out to practitioners in a former circular, but in order to bring it home a few cases be cited. seconded, the following which was agreed to miiay miotion, 1. One panel doctor ordered five phylacogen tubes within a, fortnight unanimously: at a cost of £3, four india-rtubber banda'les at 2s. 6d. each for one one patient at one tilmie, and in the previous month seven of these To ask the Commissioners in how far the proposals under the bandages for three Patients. Budget are designed to affect non-insured as well as insured 2. One panel doctor gave five prescription orders, the five bottles as persons. prescribed containing snore than two quarts of pure alcohol.- Thia cost of these five forms was respectively 34s. 6d., 17s. 4d., 15s. 9d.. Discussion then took place as to whether the administra- 14s. 3d., 14s. 3d., a total of£4 16s. tion of the new scheme should be placed in thle hands of 3. Orders for seventeen tubes of phylaciogen were found in one chemist's parcel prescribed by one doctor. Cost £10. Phylacogens tlle local authority, tlie Local Insurance Comnmittee, or an are now disallowed. enkirely new committee. On the motion of-Dr. MARTIN, 4. One patient received within three weeks, twelve flannel bandage3 seconded by Dr. ROBERTSON, it was resolved: 15s., and ointmnent Uls. unanimoously 5. Onechemist, by orders from one doctor, supplied to eighty That in the opinion of the Panel Committee, it-is inadvisable patients 76 lb. of cod-liver oil em-iulsion, and 74 lb. of malt and cocl- that the administration of the New Developments in liver oil emulsion to forty patients in one month. Medical Treatmelnt, outlined in this year's Budget proposals Itmaty also be pointed out that during the year 1913 the average price per prescription form rose from 8id. in January to lld. in in connexion with theInisurance Act, be wholly in the hands December, and this year the average cost still remains as high as itiL of the Local Insurance Committee or Local Authority. J)ecember. The cost per head for 1913 was ls. 2d., a's compared witht 8d. and 9d. in many areas in Scotland, and the Commissioners, after On the question of tlle administration being placed in inves'tigation, have found that the insured personsin the 8d. and 9d. thelhands ofa, new committee. Dr. MORRISON MCINTOSH areas receive just as good treatment as those in this area. One'districtc and Dr. ORR seconded, following motion, in this area is as high as 2s. 2d. per head. These facts clearly showr ioved, tile whicl that at present there is excessive Prescribing as to quantities or was carried unanimously: exlensive drugs. The Commnittee w.uld earnestly appeal to practitioners to be That a Joint Committee, composed of representatives electedi by ex'tremely careful in their prescribing. Otherwise the penalty of the following bodies,shotuld be instituted: (a) The Insurance surcharging or deduictinig fromi P)ractitioner's rem-iuneration the cost Commissioners (b) tlle Insurance Committee; (c) the whetn it is Proved to be excessive and unnecessary will be put in forecs County or Boroulgh Council; (d) the LocalHospitals (Boar(d by the Instirance Colimmiiittee. of Mlanagem ent and Medical Staff); (e) the Local Medical JOHN CRAIG, or Panel Committee); (f) the University and Colleges Joine 24tlh, 1914. Honorary Secretary. (where practicable); (g) Local Public Nursing Associationi. The Treasurer, Dr. MIORRISON MCINTOsH, reported, in Circular to Practitioners.-Tlie followinig circular, dealing responise to tlle voluntary call, that out of 94 panel with certificationi and excessive drugging, was passed by practitioners, 75 had, upt o date, paid£1 ls. eaclh, while lha(t6 tie Committee for distribution to practitioners on tue refused to subscribeariytliing, and one or twolhad resigne(d Edinburghl panel: from the panel. With these exceptions, he stated thathio CERTIFICATION-. expected to be able to collect most of the balance still out- It is wibinthe knowledge of the Panel Comiimittee that somiie doctors are still lax in their miiethod of dealing with sick benefit standing. On the miiotion of the CHAIRMAN, a hearty voto certificates. This is probably due to an insufficient knowledge toas ofthanks was accorded to Dr. Morrison McIntosh fortho the procedure. For the information and guidance of insurance prac- Iitioners it may be well tosnake some definite statements as to the very successful way in wliiclhlhe had carried out tlhi granting of these certificates. collection of the levy. I.-Thereluustbe no ante-dating or post-dating. On the motion of Dr. CRAIG, tlhe Treasurer was em- Ante-dating refers to the initial or declaring-on certificate. Post-dating refers to the final or declaring-off certificate. powered to pay to the chairman IiisouLt-of pocket expenses, TheInitial Certificate.-Dr. A. sees Mr. X. on January 10th.He must incurred in connexioin with Iiis visit to London in Marcla fill up and sign the certificate with the date January10th, and not Janiuary7th, 8th, or 9th. The essential point is that each certificate last in connexion witlhthe Conference of Local Medical must be dated for the day on which the patient is seen, as it is a docu- and Panel Comnmittees. m ent stating an actual fact, and m-xust be a true statem ent of what has taken place for the guidance of societies. If, as it occasionally happens, a patient is confined to bed for two or PERTHSHIRE. three days, and is under the belief that he will be better after a little A MEETINGof the Local Medical and Panel Committees of rest and simple home treatment, and therefore does not care to trouble the doctor, the latter may onbis first visit when sent for, while grant- Perth and Perthshire waslheld at Perth on Juine 26tl, ing the initial certifieate with the date onwhich the patient is seen, when Dr. STIRLING was in tise chair and nine other add the words or such like that from the signs and symptomis m embers shown, and from the statemuentm ade by the patient that he has been were present. confined to bed for two or three days, he believes the statement tobe true." This procedure does not entail ahardship upon a well-meaning patient, and leaves it open to the society to pay or not, as it thinks fit. Report of Subcomm)zittee. At all events, it removes the stigma of a possible complaint being Over-prescribing by Panel Practitionerj.-Dr. TROTTER made against the doctor for acting harshly, it does not penalise an statedthlat he had been in with the honest and careful insured person, and does not unduly cast a burden comimunication Pisar- on the society's funds, as the patient is legally entitled to have these maceutical Committee and the doctors concerned. It was first days counted as waiting days in the case of a first illness. in tile meantime not to surcharge for 'over- The Medical Service Subcom-lmnittee has recommended that the proposed doctor should, if the patient is suffering from an ailment which would prescribing, as this had probably occurredIthlrough in- incapacitate him or her from working even for a few days, or which advertence on tile part of doctors, but that doctors and miight develop into a more serious condition, give Form Med.0I134 his first visit. In this connexion it is to be remembered that the chemists should all be circularized by the Insurance initial certificate doesnotcarry with it any obligation on the part of Committees, ewarning theem on the subject. This circ'ular the society to pay sick benefit, but is only an indication that the was submitted for approval. insured person is suffering from an ailment which may in due course entitle him or her to sick benefit. Over-charges in Chemists' Accounnts.-Dr. HIUME stated Sick benefit is only paid on the production of the second or con- that a large number of accounts had been gone over, and tinuation certificate at the end of a week or thereby according to the rules of the society. it was found that mixtures formed a very small proportion .Post-dating.-In granting the final or declaring-off certificate, the of the prescribing, so that the charges for water only doctor cannot be allowed to sign and date this certificate until or after a very the day when the patient's incapacity for work has ceased. amounted to small total, in comparison withtoli II.-The greatest care must be taken in signing the second or con- large sums received by chemists for dispenSing ready-made tinuation- certificates. These have to be signed at certain intervals, pills and other preparations which were specially favoured and before signing these certificates the doctor must satisfy himself by a personal examination that the patient continues to be unfit for by certain doctors in preference to combinations of work. These certificates must not be granted on any consideration British Pharmnacopoeia drugs. A number of expensivo to messengers, without the patient having been seen by the doctor. read to meeting. When in doubt as to fitness or unfitness to work, it would be well prescriptions were the for the doctor to seek the opinion of a colleague in justice to himself On the motion of Dr. TROTTER, seconded by Dr. 11IG, and Medical referees shortly be when it the society. will appointed, the report was adopted, and Dr. Trotter was will be open to every insurance practitioner to avail himself of their autaltcu-d to services in these douibtful cases. write to the Clerk of tlle Insurance Committeo thiat steps 242 BamrsiiBUPLEMXNTMZIDICALTOJOUXN"THZ L.OCAL MEDICAL AND PANEL COMMITTEES. [JULY 4,.-:1914 were being taken to remedy over-prescribing, but that in Election of Cornunittee.-The SECRETARY reported that the meantime no surcharginig of doctors would take place. he had received a letter from the Commissioners assenting to the scheme drawn up by the Committee for the election Budget Proposals. of the new Panel Committee, and thanking the Committee Thle meeting considered at length tlle various Budget for its expedition in completing the scheme; also proposals with regard to certain important extensions of announcing that Mr. Whitehead, Clerk to the Insurance medical service ulider tlle Insurance Acts. It was decided Committee, had agreed to act as returning officer without by a majority that grants for clinical-purposes and nursing fee for his personal services. should be administered by Insurance Committees, witlh an Expenses of Committee.-The Finance Committee sub- adequate representation from hospital managers and staffs, mitted its report, and, on the motion of tlle CHAIRMAN, instead of by public health authorities. seconded by Dr. C. K. LUNN, it was resolved: That the Secretary be paid £37 for his out-of-pocket expenses and services during the period January, 1913, to March, LIVERPOOL. 1914. LOCAL MEDICAL COMMITTEE. Paymiient of Members.-A discussion took place on the THE forty-first meeting of the Committee was held at the question of payment to members of the Committee. On Medical Institution on June 19tlh, when the chair was the motion of Dr. A. JOSEPH, seconded by Dr. C. K. LUNN, taken by Mr. LARKIN, and ten other members were present. in was agreed that members attending meetings of the Representatives on. Insurance Conunittee.-In view of Panel and Insurance Committees should be paid 5s. for tlhe forthcoming election by the medical profession of every meeting they attended, the motion to be Liverpool of two representatives on thle Liverpool Insur- retrospec- .nce Committee, the meeting unanimously supported the tive from the formation of the Panel Committee. nominations of Mr. F. Charles Larkin W. B. Honorarium to Secretary.-On the motion of Dr. and Dr. POWELL, seconded by the CHAIRMAN, it was agreed tllat 1Bennett. the Secretary an honorarium of £50 a of Profession.-It was that a meet- slhould be paid year Meeting the decided from the formation of the Panel Committee. inig of the Liverpool medical profession should be held at Reports of Medical Service SubDcommittee.-The SECRE- the Medical Institution on Tuesday, June 30tlh, at TARY reported the receipt of a letter from the British p.m., to the following agenda: 3.30 consider Medical Association on the necessity of treating the names 1. Report of proceedings of the Local Medical Committee of doctors mentioned in cases dealt with by Medical Ser- since the last general meeting. vice Subcommittees as strictly confidential. The Comu- 2. Financial statement by the Treasurer. mittee agreed with the suggestion. 3. Scheme for the constitutioni of future Local Medical Committees. Representatives on Insurance ComnLittee.--The Coiln- 4. Question as to how the Committee is to be financed in mittee nominated Drs. Latimer, Greene (Stratford-oni- future. Avon), and Relton (Rugby), on behalf of the panel doctors of the area, to represent tllem on the Insurance PANEL COMMITTEE. Committee. Meetings of the Liverpool Panel Committee were held Certificates.-The SECRETARY reported the results of tlle at tlle Medical Institution on June 2nd and June 19th, conference held in London by the Coommissioners on whienl tlle chair was taken by Mr. F. C. LARKIN. June 16tll, at whiclh tlhe Chairmnan and Secretary attended, Meeting of Panel Practitioners. The SECRETARY read witlh regard to the proposed alterations in dealing with; a report of the special meeting held under the chairman- certificates of inability to work. slhip of Mr. Larkin on May 21st, to which all the Liverpool panel practitioners had been invited to confer with th6 Panel Committee; the proceedings of the Panel Committee WEST RIDING OF YORIiSHIRE. were reported to the meeting, and a motion by Dr. Shaw, LOCAL MEDICAL AND PANEL COMMITTEES. seconded by Dr. Moyles, that the fund to cover the MEETINGS of the Local Medical and Panel Committees oxpenses -of the Panel Committee should be raised com- were lheld at Wakefield on April 24tlh, May 22nd, and pulsorily under the provisions of the National Insurance June 12tli. Act, 1913, was carried by a large majority, after an amend- New Member. -Dr. H. Steinbach (Kuaresborouglh) inent suggesting a voluntary fund had been defeated by attended as representative for Harrogate and Ripon, vice 25 votes to 15. It had further been resolved that a Local Dr. Pringle. resigned. Panel Association should- be formed, and at the meeting of Putblication of Lists of Panel Doctors.-It was decided tlhe Panel Committee on June 2nd, it was decided to appoint to call the attention of the Commissioners to the fact that, a Subcommittee to draw up a scheme. in spite of their recommendation to replace the name of Expenses of Committee.-It was resolved to request the "doctor" by a number or cypher, the Insurance Com- Liverpool Insurance Committee to allot a sum sufficient mittee had issued to its nembers a list of the doctors and for the administrative expenses of the Panel Committee; the number of each one's patients. a subcommittee appointed to consider the matter esti- Disputed Removals.-This matter was referred back to mated the annual expenditure of the Committee at £130. the Subcommittee, with instructions to interview tlle Model Schentes.-A letter was read from the Insurance clerk, and, if necessary, request an interview with the Commissioners witli reference to proposed modifications of Medical Benefit Subcommittee, and thus endeavour to get certain of the clauses and rules of Model Schemes A and B, some sort of working arrangement. lliclh were considered by the Committee to be decided Model Schemes Jor Election of Pantel Committee.-A iaiprovements. report from the Subcommittee having been considered, it was Treasutrer.-Dr. S. H. Shaw was appointed treasurer of was decided to inform the Commissioners -tlat it tlle Committee. proposed to adopt with certain modifications Model Distribttion of Panel F-tnds.-Tlhe Committee approved Sclheme B, wllich provided for election by meetings of the a tlhe proposals of the Special Subcommittee contained in a panel practitioners summoned for purpose by com-iimunication fro(m the administrative officer witlh regard returning officer, but objected to the unnecessary expense to tlle method of distribution of the balance of the available of a returning officer. The Commissioners in reply had suggested that on the ground of expense the number of palel fundcs. constituencies should be reduced to six, in place of the WARWICKSIIIRE. present thirty-six. In this way it would be necessary to PANEL COMMITTEE. lhold only six meetings. They had further stated that the A MEETING of the Panel Committee for was expense of the election would form part of the administra- Warwickshire the lield on June 23rd at Leamington, when Dr. J. ORTON tive expenses of the Committee, and refused request one (Coventry) presided, and twelve otlher members were of the Committee to extend the term of office from to )esent. three years. It was resolved: Medical Referees.-Tlle SECRETARY reported that he had That the Secretary be instructed to write again to the Com- lad correspondence witlh a doctor with regard to referee missioners pointing out that six meetings for election of are insufficient to the needs of the -work, and that the doctor lhad agreed to send a printed representatives mect vast area of the West Riding, and t at the electors would notice, to those doctors whose patients he was requested not be able to turn up in sufficient numbers to make the by a society to visit. election representative. L SUPPLEMENT TO THE JUJLY 4, 1914J LOCAL MEDIC-At AND PANEL''COMMITTEES. BBITISH MEDICAL JOURNAL 25

The Secretary was directed at the same time to press Excessive Prescribing.-On opening the discussion on again for permission to carry out the election on the excessive prescribing, it was stated that the Panel Corn' previous lines, the election of the present Committee mittee had come to the decision to write to each practi- having proved simple, inexpensive, and satisfactory to all tioner on the panel asking him to make every efforbt concerned. consistent with the adequate treatment of the patielt, Rang e of Medical Services.-A letter having been read to keep the average price per prescription as low ais from- the Clerk of the Insurance Committee regarding a possible. Mr. A*xsoN, speaking for the Pharmaceuticai panel doctor's request for payment for circumcision, it Committee, stated that in asking for that joint meeting, was agreed that the operation came within the ordinary the object had been, not to prevent the medical men fromli routine of general practice, and therefore was not outside prescribing good medicine, but to come to some mutual the scope of medical benefit under the Act. It was also arrangement wlhereby the cost of medicine for insurod lecided that attendance on an insured person for gangrene patients might be reduced. Dr. ROWLAND sai(d that tlhe (during the month following her confinement was part of question of excessive prescribing lhad two aspects the attendance on the confinement. namely, the quantities of the drugs orderecl and tlhe Co-ordination of Local Medical and Panel Committees. number of prescriptions written, both of whiclh had their -It was resolved to subscribe £25 to the proposed influence on the drug fund. It was resolved: Medical and organization to co-ordinate the work of Local That a suggestion should be-ma(le to the practitioners in the Panel Conmmittees, and to safeguard and promote the county that they should, as a geileral rule, prescribe 8-oz. interests of those represented by them. A letter from the mixtures with 2-oz. doses. Leicester Local Medical and Panel Committe urging that the new organization should be registered as a trade union Repeat Prescriptions.-Dr. ROWLAND said that it Was was ordered to lie on the table. quite usual for a patient to require the same medicine Excessive Ordering of Drugs.-A letter witlh regard to continuously for some weeks, and it simplified matters excessive ordering of drugs was approved for circulation greatlv for the doctor if he was allowed to order " repeats." to doctors on the panel. He quite recognized the difficulty in tracing tlle prescrip- Model Scheme for Election of Local -Medical Committee. tions, but he felt it was a matter for the individual chemist -In view of the gen-eral desire tllroughoLit the area that to deal witlh. The CHAIRMAN observed that the Commis- the personnel of Local Medical and Panel Committees sioners had definitely refused to sanction repeat prescrip- should be the same, it was decided to adopt Model tions. Speaking for the Pharmaceutical Commiiittee, M1\. Scheme A, which provides that the Local Medical Com- L. B. ROWLAND said that he felt it would be unwise for mittee shall consist of the members for the time being of chemists to adopt a rigid attitude in tllis matter, and Mr. the Panel Committee for the area. T. J. ROBERTS that, in their circular letter, the Commis- sioners stated that they regarded " repeats " as a matter Medical Referees. - The following resolution was adopted: for working arrangement between practitioners anid chemists. Mr. E. D. JONES, Clerk to the Insurance Comii- That the Secretary be instructed to circularize the practi- mittee, said it must insist upon having copies bf tlhe area the scheme tioners of the West Riding that temporary on of medical referees, which was adopted by the Local original prescription made forms orderilng "repeats." Medical Committee in September, 1913, will remain in force .On the motion of Mr. L. B. ROWLAND, seconded by Dr. till a system of Government referees is carried out, and MORRIS-JONES, it was resolved: that each practitioner is requested. to observe the said scheme loyally in the future as in the past. That " repeat " prescriptions may be written, subject to the following conditions: Financial Statement.-The financial statement, which (a) That no other item be prescribed on a form ordering was approved, showed a balance in hand of £6 2s. lid. any " repeat." (b) That the date of the origiinal prescription be giveii on the form. CROYDON. (c) No repeat to be ordered when the original prescription PANEL COMMITTEE. was ordered more than twenty-one days previously. THE following were duly elected on June 25th to serve on (d) That the practitioner shall supply a copy if requestecl the Panel Committee: Drs. E. M. Cowell, T. A. Dukes, by the chemist. G. G. Genge, F. Nicholls, G. WTale, P. Harris, J. H. Emergency Dispensing.-Dr. ROWLAND said that in hiis Thomson, J. L. Menzies, F. Murphy, A. P. Allan, F. Beard, view, since dispensing had been taken out of the hands of S. H. C. Air, S. S. Simmons, F. D. Atkins, A. Rose, J. C. S. doctors for tllose insured persons who lived within a mile Peatson, H. L. Solls, C. G. C. Scudamore, E. H. Willock. of a chemist's shop, it was the duty of the chemist to The above members of the Panel Committee, together dispense for these patients at all times. There was some with the following ten medical men, who were duly discussion, in the course of which Dr. MORRIS-JONES said elected on June 25th last to serve on the Local Medical that in Colwyn Bay if a prescription was marked " urgent" Committee, constitute that Committee: Drs. C. Wray, there was no difficulty in getting it dispensed. Tlhe J. S. Richards, E. L. Adams, J. Wayte, R. C. Brown, following motion, proposed by Dr. MEDWYN HUGHES, and G. Lewin, J. Davidson, C. 0. Fowler, R. L. Pinkerton, seconded by Dr. J. D. LLOYD, was carried: P. W. James. That this joint meeting of Panel and Pharmaceutical Com- The Committees take office after July 15th next. mittees recommends the Insurance Committee t6 alloNv extra dispensing fees for prescriptions dispensed by chemists outside their ordinary hours of business; such prescrip- NEWPORT (MON.). tions to be marked " PANEL COMMITTEE. urgent." IN accordance with the scheme circulated the Welsh Marking Prescriptions.-Dr. ROWLAND reported tllat by had received a circular letter as to markingf Insurance Commissioners, a new Panel Committee (of practitioners prescriptions for the appropriate funds, but there wavas was elected on June 26th. The eighteen) following as to the correct fund for- certain for practitioners were returned as duly elected after a some difficulty drugs ballot: tuberculosis patients. Dr. MIDDLETON held that drugs for tlle treatment of concomitant diseases in tuberculous W. J. Greer, F.R.C.S. (Chair- J. Lloyd Davies, M.R.C.S. should- be marked and man) C. B. Gratte, M.R.C.S. patients "ordinary," charged S.. Hamilton, M.D. (Honorary J, Hurley, L.R.C.S. accordinglv. Dr. LLEWELYN WILLIAMS (Medical Officer to Secretary) J. Lane, M.B. the Welsh held that all drugs prescribed for E. Rhys Harries, M.D. W. M. James, M.R.C.S. Commission) V. Crinks, M.R.C.S. J. McGinn, F.R.C.S.I. these patients should be marked " Sanatorium," and W. Basset, M.R.C.S. 0. Morgan, L.R.C.S. charged to the Memorial Fund. On the motion of Dr. J. Buckner, L.R.C.S. Rees Morgan, .R.C.S. Dr. it was T. G. Lewis, M.B. J. F. Neville, L.R.C.S. Moss (Chairman), seconded by MORRIS-JONES, J. Cook, M.R.C.S. C. S. Vines, M.R.C.S. resolved: That in future prescription forms be marked "Panel," DENBIGHSHIRE. "Sanatorium," "Temporary Resident," anid that this be a PANEL AND PHARMIACEUTICAL COMMITTEES. recommendation to the Insurance Committee. A JOINT meeting of the Panel and Pharmaceutical Com- Mr. E. D. JONES said that it would be a convenience to inittees was held at the Queen's Head Hotel, Chester, on the Insurance Committee if temporary residents' prescrip)- June 22nd. Dr. E. Moss was unanimously elected to the tions were marked with the area from which the patient chair. came. RUPPLXZ3NT TO TH 26 BRITISE,, MRDICAL JOURNASL INSURANCE COMMITTEES. [JULY 4, 1914 Stock Miixtures and Proprietary Preparations.-It was lhad taken on panel work clhiefly on the assumption and on proposed and seconded: specific promises that their lists would be augmented front That nlo stock mixtures should be prescribed except from the those who had not chosen a doctor. Tlle resolution would tariff and the B.P.C., unless the practitioner had private treat those doctors very badly, and by putting money in formulae, for which be might arrange with the local the pockets of those with large lists, would encourage a chemists. bad nmedical service. WN'hereupon the following amendment was proposed: Mr. 0. E. WARBURG seconded tile am-endment. That stock mixtures may be prescribed, but that no particular Dr. B. A. RICHMOND said tllat as long ago as October wholesaler's name may be written on the form. 13th, 1913, a report was submitted to tlhe General Purposes Tllere was considerable discussion, during wrhich Mr. L. B. Subcommittee which set out the exact position whlichi ROWLAND remarked that many concentrated mixtures were would arise. That report was not dealt witlh because tlhe practically infringements of the Food and Drugs Acts in Committee was waiting for a legal opinion. The amend- that certain preparations nominally contained in them ment would not solve the pressing problem now before tlho could not conform to tlle British Phlarmi acopoeia standards. Cormmittee of getting more doctors in industrial areas; It was referred to a subcommittee to consider the questions it would penalize those who had devoted their lives to worlk of stock mixtures and the tariff, and to report, as early as in those areas. It was assumed that tlle doctor with a big possible, to a joint meeting of Panel and Pharmaceutical list was necessarily doing bad work and wvas an inefficient Committees. The following gentlemen were appointed to member of the service, but it was remarkable that many serve on the subcommittee:-Panel Committee: Dr. Moss more complaints in proportion came before tlle Committee (Wrexham), Dr. J. D. Lloyd (Chirk),. Dr. David Lloyd in respect of doctors witlh small lists. (Denbigh). Pharmaceutical Committee: Mr. J. W. Adam- Mr. R. J. MILLS, an approved society representative, son (Colwyn Bay), Mr. L. B. Rowland (Wrexham), Mr. T. J. urged that the agreements with the doctors only providecl Roberts (Ruthin), and Mr. E. D. Jones, Clerk to the for a payment per bead on acceptances, and made no Insurance Committee. promise of a bonus. He and other members had a nmandate from thleir organizations not to agree to a method GLAMORGAN. of distributing the monev wllich they did not regard as PANEL COMMITTEE. riglt or advisable. A MEETING of the County of Glamorgani Panel Committee Dr. H. H. MILLS said that the covering letter issued was held in Cardiff on June 22nd. Dr. W. E. THOMAS was wVithl the agrleement promised that doctors on the panel in thle chair, and twelve other members were present. would be paid in respect of all insured persons. If ati Medical Referees.-A discussion took place on the sub- agreemiient as to distribution had been made before tlhe ject of miedical referees and the minimum fee of 10s. 6d., end of tlle m-nedical year it would have been accepted bv and a resolution was passed directing the Secretary to everybody, and medical practitioners regretted tllat all send a synopsis of important imlatters to every panel agreement was not reached. practitioner. Dr. LAURISTON SHAW remarkc-d that it was agreed that Travelling Expenses.-A letter was read from the In- the doctors on tlle panel collectively were entitled to tile surance Commissioners stating that the travelling expenses oloney; tlley had a right to expect reasonable expedition. of miembers attending nmeetings of the Panel Committee Any reasonable method of distribution would probably bce could not be met out of any sumis paid to that Committee accepted by the doctors. under the provisions of Section 33 (2) of the National Mr. P. ROCKLIFF stated tllat thle Commissioners lhad Insurance Act. approved in some areas, since the end of the 1913 medical Election of Returning Officer.-The election of the new year, alternative methods of distribution. Pan'el Committee to hold office after July 15th was con- On. being put to tlle meeting tlle amendment was carried sidered, and 'Dr. J. Shaw Lyttle was appointed the by 27 votes to 25, and then adopted as a substantive retdrning officer. resolution. Legal Rightts of Pacni el Practitioniers. Tlle Medical Benefit Subcommnittee reported that in the INSURANCE COMMITTEES. case of a practitioner who becamie an inmate of an asvlum, the insured persons on his list were notified that lle ha(i LONDON. ceased to practise in the area and were provided witl AMIEETING of the London Insurance Commnittee was held forms for the selection of otlher practitioners. Thle prac- on June 25tl. titioner, after his discharge, served a writ on the Corn - Distribution of the Unallotted Fulnds. mitteee claiming £94 for professional services betweeni As briefly noted in the last issue (SUPPLEMENT, p. 495), January 14th and Marchl 31st. The Committee's solicitors the Committee gave further consideration to the question advised that, inasmuclh as treatment had been provided of the distribution of the unallotted funds. The Medical by a locumtenent during the doctor's absence, the Corn- Benefit Subcommittee advised the Committee either to mittee should settle the claim by consent. The prac- proceed at once to distribution, or to express the opinion titioner lhad accepted £90 and £5 costs in full settlemnent that the Commissioners should distribute. of his claim. Mr. F. CoYsH, Chairman of the General Purposes Sub- In regard to the action brought by Dr. Salter for the committee, moved that the Committee adopt the first restoration of his name to the medical list (BRITISH alternative. He said the payment to the doctors was MEDICAL JOURNAL, June 27tli, p. 1437), a question was based on a system of credits, and the Committee could asked as to wlhy the Commlittee had never been asked to lhave varied tlle basis of credits if it had passed a resolu- confirm the action of the Subcommittee in removing the tion to that effect during the medical year. As it hiad name, and a full report was promised for a subsequent not, it followed that it admitted the basis of the doctors' melCeting. acceptances as that on which- payments were to be made Complaints against Practitioners. for services rendered. Thle Committee endorsed the action of the Medical Mr. KINGSLEY WOOD moved the following amendment: Service Subconmmittee in a number of cases of complaints That having regard to the decision of the Committee, " that against practitioners. it is undesirable that any medical man on the London panel In six cases, in which the circumstances do not call for should undertake to treat a larger number of insured persons special ruention, the Subcommittee found that complaints of than 2,000,"' the Committee is not prepared to distribute the neglect were unsubstantiated. surplus moneys in the panel fund on a pro rata basis unless An approved society made a complaint as to certification in a or until a legal decision has been obtained or a further case in which an insured person continued to work while parliamentary authority has been given. drawing sickness benefit, and was sentenced to imprisonment therefor. The Subcommittee, on the evidence, upheld the He did not accept the explanation given as to why the 'doctor's certificate as bona fide; the man had just been Committee was debarred from preparing a scheme for operated upon for an abscess, he had bronchitis, a troublesome distribution; he did not believe any regulation under the cough, cardiac irregularity, and was emaciated, but, unknown Act was dependent upon considerations of time. No one to the doctor, he went to work. A case in which failure to could say that the system of distribution under provide treatment was due to a doubt whether a person was on provided a doctor's list, the corrected list not having been received from Article 40 (3) was just. He had received many letters the Insurance Committee, was adjudged to be met by the pay- from doctors with small lists, who pointed out that they ment by the doctor of 2s. 6d. expended in obtaining treatxnent T TU JULY 4, I9141 INSURANCE COMMITTEES. (BRITISHSUIBEN&NME:DICAL JOUJRNAL 27/ elsewhere. An approved society complained that a practitioner not felt competent to decide between the report of the had suppressed- information because in giving a certificate of incapacity for varicose veins and rheumatism he did not also Pharmaceutical Committee, which named sixteen of the state that the patient was pregnant. The Subcommittee found panel practitioners as having exceeded the average in the that the certificate was a proper one, as it stated the actual amount of their prescriptions per insured person treated cause of incapacity. in the last year, and the report of the Panel Committee, A complaint of failure to attend was found to be substantiated, which recommended that none of these and the Subcommittee stated that about 4,000 persons were practitioners (livided between the practitioner and a partner. The Sub- should be surcliarged for over-prescribing. The Commis- committee had oiome to the conclusion that the practitioner sioners replied that they had-no power to hold an inquiry, wvas unable to give adequate treatnment to all the insured but would be prepared to arrange a conference at their persons for whom he was responsible, and had decided to offices if the Committee so desired, where representatives remnove from his list without further inquiry the name of any of the the and the insured person who made application. A second complaint Committee, doctors, chemists miglht was made against the practitioner that he sent a prescription discuss the points at issue. on receipt of a verbal message given to his secretary and Several members of the Committee thought there was without seeing the patient. The Subcommittee thought the some danger under the present system of going to tlle doctor's methods of conducting his practice were not satis- opposite extreme-that is, of under-prescribing-as eaclh factory. It was understood that he had only recently obtained for cost of his own hiis qualifications and joined the panel. He was cautioned that doctor was individually responsible the an improvement in his methods must be shown. prescriptions. In that case the insured persons would It was alleged that a practitioner declined to provide treat- suffer, and the medical members of the Committee were ment because the request to visit had not been received before asked to state their opinion as to whether the 2s. available 10 a.m., and that he made callous remarks on the matter. for drugs and appliances was adequate. Another practitioner diagnosed the case as serious, and had the Dr. BRADLEY the in as patient's relatives sent for from the country. Before the Sub- said amount required such places committee the practitioner admitted that he lost his temper, Salford must be larger than in rural or seaside places. and said that he would have provided treatment if it had been The reason for the big bill in Salford was not the cost of a private case. The Subcommittee found that the practitioner the individual prescriptions, which was only about 7d. on refused to provide treatment, although he was actually in the the that so insured house, and had been informed that the patient was seriously average,but many people required ill. It had concluded that the doctor did not properly appre- treatment. In April there were over 17,000 sick people ciate his responsibilities towards insured persons. This practi- out of an insured population of 85,000. His own private tioner had previously been censured. The Subcommittee had view was that the 2s. was not sufficie-nt in Salford. tilerefore (lecided to make representations to the Insurance Dr. TAYLOR said he did not think it was possible to say Commissioners with a view to the removal of the practitioner's whether 2s. was sufficient or not. The cost for last year name from the panel. was 2s. 73d. per insured person, and if all the doctors who were alleged to have over-prescribed were cut out, the 2s. MANCHESTER. was even then not sufficient for the remainder; it would Sanatorium Accommodation. have needed about 2s. 2d. to pay the chemists in full. But AT a meeting of the Manchester Insurance Committee the first year was exceptional in many ways, and should on June 23rd attention was drawn to statements as to the not be taken as a criterion. Looking at the first five sanatorium accommiodation wllich had been the subject of months of the present year, since the system came into a question in the House of Commons, and seemed to operation by whiclh the doctors were credited with the rieflect on the Manchester Insurance Committee. The whole 9s. but debited each with the cost of his own pre- Chlairman said he thought there had been some confusion scriptions, it seemed that the 2s. was more than sufficient, in the press between the Manchester Committee and and there was undoubtedly some danger of under-pre- otlher Committees, and it ought to be made clear that the scribing. Thus he did not think the Committee was in a statement did not refer to Manchester. Councillor position at present to make any representations to the Jackson, the chairman of the Sanatorium Benefit Sub- Commissioners with regard to the 2s. being too small an coimmittee, said he took it that the statements did not amount. refer to treatment, but only to accommodation; thouglh After further discussion, the feeling was expressed that, Manchester was not directly referred to, it was somewhat after all, the dispute between the Panel and Phar- short of hospital accommodation for advanced cases of maceutical Committees might be referred back to them to tuberculosis, and up to the present had been able to deal see if they could not arrive at some understanding or properly only with the early cases. According to the compromise which could be accepted by the Insurance recommendations of the Departmental Committee on and this was resolved. Tuberculosis, Manchester ought to have about 300 beds, Committee, accordingly but as a matter of fact it had something like 330-namely, EDINBURGH. 150 at Baguley, 62 at Delamere, 50 at Abergele, and 70 at Allocation of Funds. Clayton, while they had also about 20 cases in the Man- AT a meeting of insurance service practitioners on the chlester Infirmary. The accommodation at Baguley was Edinburgh panel, held on June 4th, when Dr. DEWAr being increased, and when completed he thought the was in the chair and thirty-seven practitioners were pressure might be met, though he still had some doubts. present, it was unanimously agreed, after full discussion It appears that the statement referred to really referred of the method of distribution of the balance remaining in to the Salfora Insurance Committee; it was to the effect the panel fund, that the money should be divided equally that of 88 people who applied for sanatorium benefit, it among the practitioners on the Edinburgh panel. could be given to three only. The fact is that on May 13th At a meeting of the Insurance Committee for the burgh tlhe Salford Sanatorium Benefit Subcommittee considered of Edinburgh, held on June 25th, a report was submitted 88 cases. Of these, 42 were old cases, all recommended by the Medical Benefit Subcommittee to the Insurance for a further period of treatment, ten of them in resi- Committee recommending the Committee to adhere to its dential institutions; and all have received the treatment former proposal that the funds available should be divided recommended except one, wllo went to Australia, and on the basis of the scheme approved for a personal alloca- aniother who on examination at the dispensary was founcd tion, and that the sum so paid should be accepted in fllll niot to be suiffering from tuberculosis. Of the new appli- settlement and final discharge of all claims against the cations, 45 were recommended for sanatorium benefit, and Insurance Committee for the year ended January 11th, 1914. all lhave received it, eight being in residential institutions. Dr. BOWIE said that while tllere was some justification It is unfortunate that the Drinkwater Park Hospital of for the proposal that the medical men who had the smallest the Salford Corporation, where many of the patients panel should get most of the unallocated persons, but the receive sanatorium treatment, still retains its old name of proposal of the Subcommittee was quite different. Under hlospital," as it is now in every sense of the word it a doctor who had six insured persons on his list would t sanatorium for early cases of tluberculosis. receive the sum of £24, whereas those who had 1,500 to 2,000 on their lists would get £12 each. which was SALFORD. ridiculous. Alleged Over-p)rescribing. Mr. EuNsoN contended that the money should be equally AT the monthly meeting of the Salford Insurance Com- divided as desired bythe doctors, who w#ere the only parties mittee on June 25th the Clerk read a letter from the Com- interested. missioners wi.th reference to the request of the Committee Eventually the Committee's recommendation was re- that the Commissioners should hold an inquiry in Salford jected by 22 votes to 15, and the motion fo equal as to the alleged over-prescribing. The Committee had distribution was adopted by 25 to 7, SUPPLEMENT TO THE | 131UTTSH28 MEDICAL JOURNAJLR INSURANCE ACT IN PARLIAMENT. [JULY 4, I9'4 - - - INSURANCE NOTES. "'4REP. MIST." WE hiave received from a pharmacist in London a memo- ELEECIONS. randum inhlwhich e makes the following objections to the Insurance Committees. use of "Rep. mlist." a THE Insurance Commissioners ave issued regulations It seems that the medical profession as a whole dlo not providing that the members of Insurance Commnittees who appreciate the very real objection which pharmacists have to come into office on July 15th, 1914, shall hold office until "repeat mixtures." July 15thi, 1917. The pharmacist receiving"rep. mist." has first to ascertaini that he holds the original prescription or his own copy thereof. Panzel Committees. It has not infrequently happened that a second prescription Under the regulations issued by the Joint Committee of has gone elsewhere, and the "rep. mist." has apparently insurance Commissioners for the election of Panel Com- referred to a mixture the patient has been taking for some mittees it was provided in Part II, 5 (2) that the Com- time, therefore the doctor's intention is frustrated by no fault missioners should a officer, and that of the pharmacist. Very few medical men write either initials appointreturning or addresses; we have heard of a case where three "Mrs. the election, whether contested or not, should be carried Browns" got each other's medicine, they being patients of the out by this officer. it appears that thle Commissioners same doctor who wrote" rep. mist." for them all. while retaining the Fighit to appoint the returning officer The time of the pharmacist is taken up by searching for proposed that his expenses shiould be defrayed by the originals among prescriptions which are not those of only one Panel Committee. hias been taken to doctor but many, and he has further to make the necessary Strong objection copies for the Insuranice Committee, a work for which hie this proposal; it was felt that the Commissioners if they receives no remuneration, and whichi he was given to under- desired to appoint an outside official to do any work in stand was to be done by the doctor. connexion withi the Panel Committee, shiould bear thle The point that "rep. mist." gives rise to conscious and un- expense. The Commissioners, we uinderstand, hiave conscious recommendation of a particular pharmacist might seen the of this and lhave in certain also be made, and that to take advantage of the fact hiisthat justice contention, refusal to dispense them leads to personal loss is, to say the districts arranged thjat the clerk to the Insurance Com- least, ungenerous. mittee shall act as returning officer withiout expensetheeto From the point of view of the patient, the objection, over and(I Panel Committee. above that which is both his and the pharmacist's, is theo bindrance to chaniging from one dispenser to anothier (thie "free choice " promised by the Act), the probable ruinning backwardl THH E MANCESTER WAREHOUSEMEN AND CLERKS' and forward for copies or further particulars of the prescrip- ASSOCIATION. tions, and the very real danger of obtaining the medicine belong- Tlio of the directors of thle Manchester Ware- ing to someone of the same name, or of getting a prescription difficulty that has beensuLperseded by onie m-ooreof recent liouiseei and Clerks' Association in dealingwitih the dispensed(late. benefit of its members who are doubly insured for medicalmedica treatment, that is, in the National lnlsurance and in the association, hias not yet been solved. Thle scheme of thec directors was rejected by a meeting of the members, and at an unofficial meeting of members hield last week INSURANCE ACT IN PARLIAMENT. a comlmittee was appointed to bring pressure to bear on CO-MMITTEE ON ExcESSIVE SICKNESS. the directors. Several suggestions were made, but eventually thle following resolution was MR. CHARLES BATHURST asked wlhen the Departmental passed: Committeeupon excessive sickness, in connection witl That the directors approach the doctors and ascerta;in at the National Insurance Act, ceased evidence; what price they will attenld our voluntary members per taking howv head per annuim, or as ani alternative per visit at home or any meetings itlhad sincelheld, and when its report surgery. Until the above figures are available, voluntary was likely to be issued.-In reply, Mr. W. Benn said that members desiring medical attention to pay 6d. per month the Committeehad finislhed taking evidence and hopedl in addition to the present contributions, and doctors' bills to at an early date. to be met by the 2s. 6d. per visit at home or surgery. report This resolution is to be brouglht before the directors, witlh the request that they will meet the committee at an TRANSFERS. early date to consider the whole matter. When tlle Mr. W. Benn lhas informed Mr. Wortliington Evans Insurance Act came into operation all the medical officers thatcachl case of disputed transfer is decided after con- of the association, whlo nunmbered sometlhing like a hundred,- sideration of the statemlents of the society and the insured resigned their positions, and it now remains witlh the pro- person. fession to decide wlhat- attitude it will take in case tlle directors approach the doctors in the way suggested. MEDICAL BENEFIT. ' Outstaniding Paymients. Mr. Stewart asked whetlher theInsurance Committee A BRIGHTON DRUG STORES AND THE CHEMISTS' LIST. for Clheshirehad paid all the balances due to tlle panel An Inquiry Committee under Part VII of the Medical doctors for the year ending January 15th, 1914; and, if Benefit Regulations, 1912, sat at tlle offices of the Conmmis- not, what was the amount of outstanding payments due sioners, Buckingham Gate, on July1st, to lhear represen- and when they would be liquidated.-Mr. Wedgwood Benn tations by the Brighton Insurance Committee that the said that the settlement of accounts for the 1913 medical restoration to the list of clhemists of the firm of Sharp's year had been delayed in the case of the area referred to. Drug Stores, Limited, trading- at 49, Edward Street,- pending consideration by the doctors concerned of certain Brighton, wotuld be prejudicial to the efficiency. of the outstanding questions as to themethod of distribution to medical service. During 1913 tlhe name of tile firm was be adopted. erased from the register of pharmacists because the Registrar of the Plharmaceuitical Society was satisfied SANATORIUM BENEFIT. that dispensing had ceased to be done by a registered Mr. Haluilton asked a question witlh reference to state. pharmacistor under his direct supervision. - The Insur- ments made at a recent meeting of tlle South Manchester ance Coommittee alleged admissions by the managing guardians that there was no provision at the Withingt6n director of the company that prescriptions were dispensed Hospital for dealing effectively with the 112 men and by a man who kept a tobacconist's slhop some distance 41 women suffering from consumption, and to a lady away and came to the drug stores in the evenings, and guardian's further statement at the samie meeting tihat, as that on occasion they were dispensed by an unqualified a member of a Local Insurance Committee, slhe was aware person acting on telephoned instructions by the tobacconist- that 88 people applied for sanatorium treatment and that ex-druggist. Recently the firm regained admission to the it could only be given to 3; anid inqui'red what provision register of pharmacists-having again appointel a super- has been made in this dlistrict to supply sanatorium treat- intending qualified dispenser-and it applied for restora- ment.-The Parliamentary Secretary to the Local Govern. tion to the insurance list of chemnists. The Insurance ment Board said that the Manclhester Corporation had Commiittee asked thle' Commissio'ners to say, having provided 323 sanatorium and hospital beds for the treat. regard to the incidents above outlined, that the firm was ment of consumption on March31st, 1914, and was pro- not a suitable one for inclusion in the list. The decision ceeding rapidly with the provision of furtlher beds. Special the Commissioners will be announced later. inquiry would be made into the matter. SUPPLEMENT TO T JULY 4, 1914] VITAL STATISTICS. [BRITISHM1EDICAL JOURNwL ?

TERRITORIAL FORCE. ROYAL ARMY MEDICAL CORPS. Second East Anglian Field Ambulance. -ERNEST B. HINDE, M.B.4 gabal anAb gIR'l'tar vvitntnutz F.R.C.S.Edin., to be Lieutenant, April 20th. Third Highlantd Field Ambulacee.- Lieutenant WILLIAM L. ROYAL NAVAL MEDICAL SERVICE. ROBERTSON, M.B., F.R.C.S.Edin., to be Captain, April 19th. THE following notifications are announced by the Admiralty: Fleet Thir-d South Midland Field Ambulante. - Captain CYRIL C. Surgeon ROBERT L. DICKINSON, to the Temeraire, July 14th. LAVINGTON resigns his commission, June 17th. Fleet Surgeon WALTER H. S. SEQUEIRA, to the Tvne, July 14th. First Wessex Field Ambulantce.-Lieutenant LANGFORD G. DAVIES, Fleet Surgeon FREDERICK FEDART, M.B., to the Impregtable, vice M.B., resigns his commission, June 17th. Shand, July 1st. Fleet Surgeon JOHN H. STENHOUsE,, M.B., to the Secontd East Lancashire Field Ambuclance.-CLEMENT A. WEBSTER Hibernia, July 1st. Fleet Surgeon JAMES MOWAT, M.B., has been to be Lieutenant, May 16th. placed on the retired list at his own request, April 1st. Staff Surgeon Third West Lantcashire Field Ambulance.-ROBERT D. B. FREW, EDWARD B. KENNY, M.B. (retired), has been reinstated on active list. M.D., to be Lieutenant, May 14th. Staff Surgeon REGINALD ST. G. S. BOND, M.B., F.R C.S., to the Comn. First Londont (City of Lontdont) General Hospital. -Major Sir rnonwealth, on recommissioning, June 23rd. Staff Surgeon JAMEs A. ANTHONY A. BOWLBY, C.M.G., F.R.C.S., and Major Sir W. P. THOMPSON, M.B., to the Glory, temporary, undated. Staff Surgeon HEERINGRAM, M.D., hhve been appointed Lieutenant-Colonels, June RICHARD S. OSBORNE, to the St. George, vice Mowat, June 20th. Staff 20th. Surgeon LLEWELLYN LINDOP, to the Birminghiam, vice Osborne, For Attachsnent to Units ot7her than Medical Untits. - BASIL June 20th. Staff Surgeon EDWARD B. KENNY, to the Pembroke, HUGHES, M.B., F.R.C.S., to be Lieutenant, March 1st. HUGH H. additional, for disposal, July 7th. Surgeon HENRY E. Y. WHITE, ROBINSON to be Lieutenant, April 25th. M.B., to the Commonwealth, on recommissioning, June 23rd. Surgeon Attachled to Untits other thzant Medical Units.-Captain ALLAN F. JOHN C. F. D. VAUGHAN has been promoted to the rank of Staff RUTHERFORD, M.B, to be Major, February 1st. ARCHIBALD C. HADDOW, Surgeon, with seniority of May 19th. M.B., to be Lieutenant, May 15th.

ROYAL NAVAL VOLUNTEER RESERVE. TERRITORIAL FORCE RESERVE. HENRY C. W. NUTTALL appointed Surgeon, and to be attached to the ROYAL ARMY MEDICAL CORPS. Mersey Division, June 6th. COLONEL WILLIAM COATES. C B, resigns his commission, and is granted permission to retain his rank, and to wear the prescribed uniform, June 13th. ARMY MEDICAL SERVICE. Lieutenant-Colonel CHARLES G. GRANT, fromii the list of officers SURGEON-GENERAL WILLIAM BABTIE, V.C., C.B., C.M.G., M.B., is attached to units other than medical units, to be Lieutenant-Colonel, alppointed an Honiorary Surgeon to the King. vice Surgeon-General May 22nd. Sir W. L. Gubbins, K.C.B., M.V.O., M.B., June 1st. Colonel T. P. WOODWARD, from half-pay, late R.A.M.C., has been ap)pointed Deputy Director of Medical Services, Aldershot. ROYAL ARMY MEDICAL CORPS. Lieutenant-Colonel F. W. C. JONES has been ordered to Tidworth to suieceed Colonel T. J. O'Donnell, D.S.O. Major S. H. FAIRRIE lias been noted for service in India with the HEALTH OF ENGLISH TOWNS. Soulthern Army. IN ninety-seven of the largest English towns 9,168 births and 4,497 Major J. C. B. STATHAm has left the London District for duty at deaths were registered during the weekended Saturday, June 20th. The Sierra Leone. annual rate of mortality in these towns, which had been 13.3, 13.2, and Captain R. F. O'T. DIcKINSON has been posted to Dublin District for 13.5 per 1,000 in the three preceding weeks, fell to 12.9 per 1,C00 in the dluty. week under notice. In London the death-rate did not exce3d 12.2, Captain ALBERT E. F. HASTINGS is removed from the service, against 11.8, 12.7, and 12.8 per 1,000 in the three preceding weeks. May 1st. Among the ninety-six other large towns the death-rate ranged from Lieutenant N. BEDDINGFIELD has been noted for service in the 2.2 in Ealing, 4.6 in Northampton, 4.9 in Acton, 6.6 in Edmonton and Mediterranean Command. in Eastbourne, 7.2 in Gloucester, and 7.4 in Ilford to 18.5 in Wolver- Lieutenant F.' C. COWTAN has been noted for a tour of service, hampton, 18.9 in Liverpool, 19.1 in Bradford, 20.1 in Blackpool, Northern Army, India. 20.3 in Barnsley, and 21.5 in South Shields, Measles caused a death-rate of 1.3 iu Manchester, 1.4 in Smethwick, 1.6 in St. Helens and in Sheffield, 1.8 in Darlington, and 2.1 in Bootle and in SPECIAL RESERVE OF OFFICERS. Warrington; and whooping-cough of 1.0 in Oldham, 1.4 -in Plymouth, ROYAL ARMY MEDICAL CORPS. in Cardiff and in Warrington, and 3.3 in South Shields. The mortality LIEUTENANT HENRY H. MULHOLLAND is confirmed in his rank. from the remaining infective diseases showed no marked excess in Lieutenant JOHN MCG. SCOTT, M.B., resigns his commission, any of the large towns, and no fatal case of small-pox was registered June 1st. during the week. The causes of 29, or 0.6 per cent., of the total deaths Lieutenant THOMAS WARRINGTON is confirmed in his rank. were not certified either by a registered medical practitioner or by a Cadet DOUGLAs H. MURRAY, from the St. Andrew's University Con- coroner after inquest: of this number 6 were recorded in Liverpool, tingent, Officers' Training Corps, to be Lieutenant on probation, 3 in Birmingham, 3 in Gateshead, and 2 each in Portsmouth, Camn- May 25th. bridge, Sheffield, and Sunderland. The number of scarlet fever Cadet FRANCIS R. H. MOLLAN, from the Royal College of Surgeons patients under treatment in the Metropolitan Asylums Hospitals and in Ireland Contingent, Officers' Training Corps, to be Lieutenant on the London Fever Hospital, which had been 2,910, 2,970, and 2,993 at probation, May 20th. the end of the three preceding weeks, had fupther risen to 3,038 on Cadet WILLIAM B. JEPSON, from the London University Contingent, Saturday, June 20th; 405 new cases were admitted during the week, Offlicers' Training Corps, has been appointed a Lieutenant on proba- against 377. 339, and 391 in the three preceding weeks. tion, May 16th. In ninety-seven of the largest English towns 9,192 births and 4,193 IDRIs D. EVANS, late Cadet-Quartermiiaster, Durham-- University Con- deaths were registered during the week ended Saturday, June 27th. tillgent, Officers' Training Corps, has been appointed a Lieutenant, The annual rate of mortality in these towns, which had been 13.2,13.5, May 21st. and 12.9 per 1,000 in the three preceding weeks, fell to 12.1 -per 1,000 in the week under notice. In London the death-rate was also equal to 12.1, against 12.7, 12.8, and 12.2 in the three preceding weeks. Aimlong INDIAN MEDICAL SERVICE. the ninety-six other large towns the death-rate ranged from 4.9 in LIEUTENANT-COLONEL V. G. DRAKE-BROCKMAN is granted privilege Swindon, 5.5 in Bournemouth, 5.6 in Southend-on-Sea, and 6.1 in' leave for two m-ionths and fifteen days comnbined with furlough for Hastings to 17.3 in Liverpool and in Middlesbrough, 18.3 in Oldham, five months and niine days, with effect from May 1st. 18.4 in Smethwick, 19.8 in Wakefield, and 21.1 in Stockton-on- Major J. R. J. TYRRELL is posted as Agency Surgeon, Bundelkhand, Tees. Measles caused a death-rate of 2.0 in Smethwick, 2.1 with effect from May 1st. in Warrington, 2.5 in York, and 2.8 in Oldham; and whooping- Captain C. I. BRIERLY is posted as Civil Surgeon, Peshawar, with cough of 2.1 in Warrington, and 2.4 in Barrow-in-Furness. Tha effect from May 1st. mortality from the remaining infective diseases showed noa Surgeon-General A. M. CROFTS, C.I.E., K.H.S., is permitted to retire marked excess in any of the large towns, and no fatal case of small- from the service, with effect from May 25tb. pox was registered during the week The causes of 29, or 0.7 per cenit., Lieutenant-Colonel H. E. DRARE-BROCKMAN, [.M.S., has been of the total deaths were not certified either by a registered medical granted six m-lonths' combined leave, with effect from April 18th, practitioner or by a coroner after inquest; of this number 6 wera The services of Captain R. G. G. CROLY, I.M.S., have been placed recorded in Liverpool, 4 in Stockton-on-Tees, 4 in Birminghani, and 3 at the disposal of the Madras Government for civil employment. in St. Helens. The number of scarlet fever patients under treatment Captain A. H. NAPIER, I.M.S., has been appointed to the Bacterio- in the Metropolitan Asylums Hospitals and the London Fever logical Department and posted to the Central Research Institute, Hospital, which had been 2,970, 2,993, and 3,038 in the three preceding Kasauli. weeks, further rose to 3,088 on Saturday, June 27th; 440 new cases Colonel A. 0. EVANS, Inspector-General of Civil Hospitals, Burma, were adniitted during the week, against 339, 3)1. and 405 in the three is granted with effect from May 25th, 1914, comlbined leave for eight preceding weeks. months-namely, privilege leave from May 25th, 1914, to August 24th, 1914, and leave on private affairs from August 25th, 1914, to January 24th, 1915. HEALTH OF SCOTTISH TOWNS. Lieutenant-Colonel G. J. H. BELL, M.B., Inspector-General of IN the sixteen largest Scottish towns 1,276 births and 641 deaths were Prisons, Burma, is appointed to officiate as Inspector-General of Civil registered during the week ended Saturday, June 20th. The annual Hospitals, Burma, during the absence on leave of Colonel A. 0. Evans, rate of mortality in these towns, which had been 15.6, 16.0, and 14.4 or until further orders. per 1,000 in the three preceding weeks, rose to 14.6 in the week under A good service pension of £100 per annum has been conferred on the notice, and was 1.7 per 1,000 above the rate in the ninety-seven large Honourable Surgeon-General R. W. S. LYONS, M.D. English towns. Among the several towns the death-rate ranged froil 8.8 in Kilmarnock, 10.1 in Motherwell, and 10.5 in Clydebank to 18.3 in INDIAN SUBORDINATE MEDICAL DEPARTMENT. Leith, 18 7 in Greenock, and 18.9 in Hamilton. The mortality frolmi Senior Assistant Surgeon with the honorary rank of Lieutenant to the principal infective diseases averaged 1.5 per 1,000, and was highest be Senior Assistant Surgeon with the honorary rank of Captain: in Clydebank and Hamilton. The 306 deaths from all causes in LEWIS M. CABRAL, January 1st. Glasgow included 16 from whooping-cough, 9 from infantile diarrhoea, To be Senior Assistant Surgeons with the honorary ranik of Lieu- 8 from measles, 3 from scarlet fever, and 1 from diphtheria. Threo tenant: First Class Assistant Surgeons HERBERT W. V. COX, IIERBERtT deaths fromn measles were recorded in Dundee, 3 in Hamilton, and 2 in JAMES GALLOWAY, WILLIAM C. M. CHARTERs, GEORGE C. F. HOLMES, Clydebank; from diphtheria, 2 deaths in Aberdeen and 2 in Mother- CHRISTOPHER C. A. WALE, . well; from whooping-cough, 2 deaths in Greenock; and from diarrhoea The King has approved of the retirement of Senior Assistant and enteritis, 4 dleaths in Dundee, 2 in Aberdeen, and 2 in Hanmilton. Surgeons and Honorary Captains DANIEL R. DAVIES (December 20th, * In the sixteen largest Scottish towns 1,301 births and 605 deaths 1913), CHARLES N. GCREGG (December 31st, 1913), WILLIAm FORRESTER were registered during the week ended Saturday, June 27th. The (Marcnh 3rd, 1914). annual rate of mortality in these towns, which bad been 16.0, 14.4, ., 1UPPLrISMINT TO THU 30 BRITISH MotDICAL JOUeNAL J HOSPITALS AND ASYLUMS. [JULY 4, 19r4

and 14.6 per 1,000 in the three preceding weeks, fell to 13.5 In the week and apoplexy, etc., in 12; otlher bodily disorders in 8; child- under inotice, and was 1.7 per 1,030 above the rate in the ninety-seven bearing in 5; physical exhatIstion in 18; critical periods in 50; large English towns. Among the several towns the death-rate'ranged bodily trauma in 1, and ri.ental stress in 23. -Hereditary iniflu- from-. 10.5 in Clydebank, 11.0 in Falkirk, and 11.3 in Motherwell to 18.0 iu Aberdeen, 19.0 in Kirkealdy, and 23.0 in Perth. The mortality from ences were ascertained in 68, and congenital defect existel the principal infective diseases averaged 1.2 per 1,000, and was in 6, whilst no cause could be assigned in 98. Previous attacks highest in Leith and Aberdeen. The 265 deaths from all causes in had occurred in 64. The proportion of cases of alcoholic Glasgow included 15 from whoopinig-cough, 5 from mieasles, 3 from inisanity (11.2 per cent.) was less than usual. scarlet fever, 3 from diphtheria, 2 from enteric fever, and 2 from infantile diarrhoeal diseases. Four deaths from diarrhoeal diseases Syphilis. were registered in Aberdeen and 2 in Leith, and 3 deeths from Dr. Robertson gives particular attention in hiis report to diphtheria in Aberdeeni. _ general paralysis. Of the 24 general paralytics a1mitted only 1 was a woman. As there were 107 male admissions, 21.5 leL HEALTH OF IRISH TOWNS. cent., or over 1 in 5, suffered from this disease. The average DURING the week ending Saturday, June 20th, 641 births and 410 deaths admission-rate of general paralytics at this institution has beets were registered in the twenty-seven principal urban districts of Ireland, over 19.5 per cent. Such statistics, Dr. Robertson says, reveal as against 636 births and 413 deaths in the preceding psriod. These a state of affairs urgently calling for public attention. "; Large deaths represent a mortality of 17.7 per 1,000 of the aggregate population in the districts in question, ,as against 17.9 per 1,000 in the previous period. numbers of soldiers," be says, " used in the past to fall victims The mortality in these Iri§h areas was therefore 4.8 per 1,000 higher to it, but medical treatment in the army has become so than the corresponding rate in the ninety-seven English towns during thorough and scientific that, after twelve or fifteen years, this the week ending on the san'e date. The birth-rate, on the other hand, profession will probably cease to supply its proportion of cases. was equal to 27.7 per 1,000 of population. As for mortality of indi- Cait something of the same kind not be done for men in thie vidual localities, that in the Dtublin registration area was 17.6 (as civil They would no doubt require to be educate(d against an average of 19.5 for the previous four weeks). in Dublin city population? 18.1 (as against 20.5), in Belfast 17.1 (as against 16.4), in Cork 19.0 (as to a sense of their dangers, and the value of earlv treatment, by against 18.4), in liondonderry 11.4 (as against 10.8), in Limerick 23.0 (as short addresses or printed warnings in their workshops. Tho against 20.3). and in Waterford 30.4 (as against 19.9). The zymotic insurance or some other public authority would re(uire to death-rate'was 2.2, as against 18 in the previous week. make provision for treatment, which woiuld not be difficult or During the week ending Saturday, June 27th, 665 births and 364 expensive owing to the short time now required, and the deaths were registered in the twenty-seven principa1 urban districts mredical profession- should- be given the power of exercising of Ireland, as against 641 births and 410 deaths in the preceding treatment till period. These deaths represernt a mortality of 15.7 per 1,000 of the more pressure than at present for insisting upon aggregate population in the districts in question, as against 17.7 per a cure be obtained. If these measures were successful, ins 1,000 in the previous period. Thenmortality in these Irish areas was fifteen years ssOt onlv general paralysis, but a host of serious therefore 3.6 per 1,000 higher than the corresponding rate in the maladies, would decrease enormously in' number. The onie ninety-seven English towns during the week ending on the same date. policy of merelv ignoring the existence of these' ills is Ilow The birth-rate, on the other hand, was equal to 28.8 per 1,000 of inexcusable and something must be done." population. As for mortality of individual localities, that in the Dublin registration area was 15.5 (as against an average of 17.9 for the previous four weeks), in Dublin' city 17.6 (as against 19.5). in Belfast Recoreries anid Deaths. 17.5 (as against 17.0), in Cork 12.9 (sS against 17.0), in Londonderry 10.1 During the year 58 were discharged as recovered, giving a (as against 11.4), in Limerick 12.2 (as against 18.9), and in Waterford recovery-rate on the admissions of 35.0 per cent.; also 50 as 13.3 (as against 19.0). The zymotic death-rate was 1.6, as against 2.2 in relieved and 21 as not improved. During the year 62 died, the previous week. giving a death-rate on the average number resident of 7.4 per cent. The deaths were due in 26 to diseases of the nervous system, including 16 from general paralvsis; in 10 to diseases of the respiratory system, including in this 6 from pulmonary M1l- Itals altb As Iumz# phithisis; in 14 to diseases of the heart and blood vessels, but excluding 5 from cerebral haemorrhage entered anmong the ROYAL EDINBURGH ASYLUM, MORNINGSIDE. deaths for nervouis diseases; 2 from kidney disease, and 10 from Thle WFork of a Centtry. general diseases, including 8 from senile decay. RATHER over otle hundred years ago the then managers of The low death-rate from consumption (under 10 per cent.), this asylum presented to the general meeting of contri- and the fact that 3 of the cases suffered on admission from the butors the first annual report for the year 1813. Although disease of which they died, show a satisfactorv state of affairs the asylum was incorporated by Roval Warran' in 1807, it was as regards this disease. ilOt till June 19th, 1813, that tlhe first patient was admitted. During that year 6 patients in all were admitted, 1 was dis- Research anzd Post-Gradiuate Teaching. charged as recovered, removed by her relatives, and 4 re- It need hardly be said that the best traditions of this asylum mained in the asylum at the end of the year. Since its as a centre of scientific research and teaching are fully main- opening 21,942 patients have been under treatment in this tained under Dr. Robertson's direction, but it should be men- institution, and, as tpe managers well say in their report, it is tioned that -since -the University of Edinburgh created its impossible to overestimate the debt of gratitude which the Diploma in Psychiatry, a post-graduate clinical lebture has community owes to the benevolent persons who conceived the been delivered weekly of a Isigher and more technical nature idea of the asylum and who undertook the tedious and trying than the ordinary classes for students.' The lectures are work of raising the funds necessary to give effect to their attended by the full staff of the asylum, to the benefit, Dr. views. Robertson says, of teachers and taught alike. The proposal for the establishment of the asylum was originally made by the President of the Royal College of Physicians of Edinburgh, and its object was to provide for the GENERAL HOSPITAL, BIRMINGHXM. care of insane persons who were still in a recoverable state by THE number of patients treated in 1913 was 64,815, and of members of the Royal Colleges of Physicians or Surgeons. these 5,908 were in-patients and 58,815 out-patients. There The Lord Provost of the City and others holding high official lhas been a great pressure on the beds, as there has- been a list pOsitioisS agreed to form themselves into a body of trustees to of from 180 to 200 cases awaiting admission during the greater carry the scheme into operation. part of the year. Many cases that needed treatment have The institution was thus launche(d under the most favourable been in consequence sent away, while at the same time there auspices, both medical and lay, but even the most sanguine of has been overcrowding 'in some of the wards. A ward which its originators could hardlv have foreseen the immense amount has been kept up to the present for emergencies was opened; of beneficent work to be accomplished and the world-wide but this addition of ten beds only gave very slight relief. A influence to be wielded by this great institution under the large number of insured patients have been treated in tihe direction of suiccessive distinguished physician-superinten- hospital, but the Insurance Commissioners have made no dents. arrangement for the treatment of these patients whei Report for 191?. seriously ill, and the hospital has only received £13 7s. 11(i. Turning to the statistics for the year 1912, the Physician- from approved societies,'and no single subscription from tlhe Superintendent, Dr. G. M. Robertson, shows that on January Insurance Committees. The ordinary income was £31,993 1st, 1912, there were 753 patietsts on the general register, and oln and the total income from all sources £38,360, while the the last day of the year 784. The total cases under treatment ordinary expenditure was £29,319, and the total expenditure (luring the year numbered 975, and the average number (laily £30,482. A number of important improvements in the build- resident was 756. During the year 222 were admitted, of whom ing have been approved, and will add considerably to thle 186 were first and 36 not-first admissions. In 72 thie attacks efficiency of the work of the hospital, and also to the comfort of were first attacks within three, and in 37 more within twelve, the resident, nursing, and domestic staffs. The most important m3nths of admission; in 36 not-first attacks within twelve of these alterations consists in a considerable enlargement of months; in 66 the attacks, whether first attacks or not, were of the pathological department, which will enable more clinical more than twelve months' duration, and 11 were congenital investigation work to be undertaken, and obviate the delay and cases. inconvenience existing under the present conditions. The per- The total admissions were classified according bo the forms sonnel of the massage department has been increased, and, in of mental disorder into: Simple mania, 23; delusional mania, 6; view of the necessity of this form of treatment, a large addition simple melancholia, 30; delusional melancholia, 24; and agi- to tlse accommodation of this department is proposed. The tated melancholia, 3; delirious insanity (including in this work of the x-ray department has increased greatly, and a acute delirium, subacute delirious insanity, and mild con- movable x-ray apparatus has been purchased to enable patients fusional states), 39; systematized delusional insanity, 16; to be radiographed without removal from the wards. Some (lementia praecox, 14; general paralysis, 24; dementia, 33; additions are also contemplated to the operating theatres. It congenital defect, 3; moral insanity, 6; and morphomania, 1. has been resolve3, to place in th? hospital a tablet in memory of As to probable causation, alcohol was assigned in 28, syphilis the late Mr. John Roderick. Mr. Albert Toft has been entrusted in 27, aud other toxins in 8 more; epilepsy, gross brain disease, with this work. SuPPLEMUNT TO THU JULY 4, 1914] VACANCIES AND APPOINTMENTS. IBRITISH MEDICAL JOURNAL 3' r- -~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ LIVERPOOL INFECTIOUS DISEASES HOSPITAL. -Assistant Resident Medical Officer. Salary, £150 per annum. ani LIVERPOOL SCHOOL OF TROPICAL MEDICINE.-Research Ja1canc'ts ppo'intntents. Assistant in the Runcorn Research Laboratory. Salary, £150 per annum. WAINING NOTICE.-Attention is callecl to a Notice (see Index to LIVERPOOL STANLEY HOSPITAL.-(1) Two House-Physicians. Adver-tisementts-Wa -nitig Notice) appearing i?l on1e- adver tisement 1(2) House-Surgeon. Salary, £75 per annum each. colutmnts, givinlg particuZars of vacancies as to twhicl inquiries MANCHESTER: HULME DISPENSARY.-House-Surgeon. Saiery, £180 per annum, increasing to £200. shoulid be made befor e a(pplication. MANCHESTER NORTHERN HOSPITAL FOR WOMEN AND VACANCIES. CHILDREN.-House-Surgeon. Salary, £120 per annum. MANCHESTER ROYAL EYE HOSPITAL.-Junior House-Surgeon. ABERGAVENNY: MONMOUTHSHIRE ASYLUM.-Locumtenent Salary, £80 per annum. Assistant Medical Officer (male). Terms, £6 6s. per week. MILDMAY MISSION HOSPITAL, Bethnal Green, E.-Two Recg4t BARROW-IN-FURNESS: NORTH LONSDALE HOSPITAL.-Malo Medical Officers. Salary, £83 per annum. House-Surgeon. Salary, £150 per annum. NORTHAMPTON GENERAL HOSPITAL.-Two House-Surgeons.- BEDFORD COUNTY HOSPITAL.-Assistant House-Surgeon. Salary, Salary, £120 per annum each. £100 per annum. NOTTINGHAM EDUCATION COMMITTEE.-School Dentist. BIRKENHEAD BOROUGH HOSPITAL.-Senior House-Surgeon Salary, £250 per annum, rising to £300. (male). Salary, £120 per annum. NOTTINGHAM GENERAL HOSPITAL.-Assistant House-Physician. BIRMINGHAM AND MIDLAND EAR AND THROAT HOSPITAL.- Salary at the rate of £100 per annum. House-Surgeon. Salary at the rate of £100 per annum. OGMORE AND GARW URBAN DISTRICT COUNCIL.-Medical BIRMINGHAM: CITY MENTAL HOSPITAL.-Assistant Medical Officer of Health. Salary, £325 per annum, rising to £400. Oflicer (male). Salary, £200 per annum. ORKNEY: PARISH OF SHAPANSEY.-Medical Offlicer and Publio BIRMINGHAM GENERAL DISPENSARY. -Resident Medical Vaccinator. Salary, £90 per annum. Officer. Salary, £240 per annum. PLAISTOW: ST. MARY'S HOSPITAL FOR WOMEN AND BIRMINGHAM: QUEEN'S3 HOSPITAL.-41) House-Physician; CHILDREN.-Male Assistant Resident Medieal Officer. Salary (2) Two Hous-Surgeons. Salary at the rate of £50 per annunm. at the rate of £100 per annum and £10 honorarium on comple.ion BOARD OF CONTROL (MENTAL. DEFICIENCY ACT).-Medical of six months. Superintendent of a State Institution for Defectives to be opened PLYMOUTH: SOUTH DEVON AND EAST CORNWALL near Liverpool. Salary, £800 per annum. HOSPITAL.-House-Physieian. Salary at the rate of £9) pir BOLINGBROKE HOSPITAL, Wandsworth Common. S.W.-House- annum. Surgeon (male). Salary at the rate of £75 per annum. PORTSMOUTH: ROYAL PORTSMOUTH HOSPITAL.-House- BOLTON INFIRMARY AND DISPENSARY.-Third House-Surgeon. Surgeon. Salary at the rate of £90 per annum, rising to £110 on Salary, £110 per annum. appointment to senior post. BRADFORD ROYAL INFIRMARY.-House-Surgeon (male). Salary, PRESTON: COUNTY ASYLUM, Whittingham.-(l) Junior Assistant £100 per annum. Medical Officer; (2) Assistant Medical Officer to act also as Patho- BRENTFORD UNION.-Second Assistant Medical Superintendent of logist. Salary, £250per annum, rising to £300. the Infirmary, etc. Salary, £175 per annum, rising to £200. PRESTON COUNTY BOROUGH.-School Medical Officer. Salary, BRIGHTON: ROYAL ALEXANDRA HOSPITAL FOR SICK £350 per annum. CHILDREN.-House-Surgeon. Salary, £100 per annum. PRINCE OF WALES'S GENERAL HOSPITAL, Tottenham, N.- BRISTOL ROYAL INFIRMARY.-Honorary Ophthalmic Surgeon. (1) Junior House-Physician; (2) Junior House-Surgeon. Salary, BRITISH MEDICAL ASSOCIATION.-Scottish Medical Secretary. £75 per annum each. Salary, £600 per annum. QUEEN'S'HOSPITAL FOR CHILDREN, Hackney Road, E.-House- BUXTON: DEVONSIHIRE HOSPITAL.-Assistant House-Physician. Surgeon. Salary, £80 per annum. Salary, £100 per annum. RETFORD: STATE CRIMINAL LUNATIC ASYLUM.-MI) Assistant CAMBERWELL TUBERCULOSIS DISPENSARY, Bruniswick Medical Officer (male); salary, £225, increasing to £350. (2) Loculmi- Square, S.E.-Assistant Medical Officer. Salary, £250per annumi. tenent (male); salary, £5 5s. per week. CARDIFF: KING EDWARD VII HOSPITAL.-Two House-Sur- ROCHDALE INFIRMARY AND DISPENSARY.-Senior and Junior geons. Salbry, £60 per annum. House-Surgeons (males). Salary, £120 and £110 per annum CHELSEA HOSPITAL FOR WOMEN, Fulham Road, S.W.- respectively. Surgeon. ROTHERHAM HOSPITAL.-Senior and Junior House-Surgeon3. INFIRMARY.-Second Assistant Medical Officer. Salary, £200 and £100 per annum respectively. CHELSEA PARISH ROYAL FREE HOSPITAL, Gray's Inn Road, W.C.-Assistant Anaes- Salary, £140 per annum. thetist. Salary, £75 per annum. CHEPSTOW UNION.-Medical Officer for the Tintern District. ROYAL WATERLOO HOSPITAL FOR CHILDREN AND WOMEN, Salary, £40 per annum. S.E.-) Surgeon to Out-patients; (2) Junior Resident Medical CHORLEY: RAWCLIFFE HOSPITAL.-House-Surgeon (male). Officer; salaryat therate of £50 perannum. Salary, £100 per annum. SALFORD FEVER HOSPITAL.-Junior Resident Medical Officer at COLONIAL OFFICE.-Two Assistant Medical Officers for Ankylo- Ladywell Sanatorium. Salary, £150 par annum. stomiasis Campaign in Trinidad and Grenada. Salary, £400 per annum or with free quarters. SALFORD ROYAL HOSPITAL.-(1) House Surgeon; (2)' Jtunior without quarters £350 House-Surgeon; (3) Casualt:y House-Surgeon. Salary at the rate DEVON EDUCATION COMMITTEE, Exeter.-Assistant School of £100 per annum each. Medical Officer and Oculist. Salary, £300 per annum. SALISBURY GENERAL INFIRMARY.-House-Surgeon. Salary, £100 DEVONPORT: ROYAL ALBERT HOSPITAL.-House-Surgeon. per annum. the rate of £150 annum. Salary at per SALOP INFIRMARY.-Hou3e-Physician. Salary at the rate of fll0 DURHAM COUNTY HOSPITAL.-House-Surgeon. Salary, £150 per per annum. annum. SAMARITAN FREE HOSPITAL FOR WOMEN, Marylebone Road, AST LONDON HOSPITAL FOR CHILDREN, Shadwell.-(1) Houise- House-Surgeon. Salary, £80 per annum. Physician: (2) Medical Officer to Casualty Department (males). N.W.-Resident Salary at the rate of £75 and £100 per annum respectively. SCARBOROUGH HOSPITAL AND DISPENSARY.-Senior House- EDUCATION COMMITTEE.-Medical Inspector. Salary, Surgeon. Salary, £100 per andum. ESSEIX SHEFFIELD: EAST END BRANCH OF THE CHILDREN'S £300 per annum, rising to £400. £120 per annum. EVELINA HOSPITAL FOR SICK CHILDREN, Southwark, S.E.- HOSPITAL.-House-Surgeon. Salary, House-Surgeon. Salary at the rate of £75 per annumii. SHREWSBURY: COUNTY ASYLUM.-Second Assistant Medical GLOUCESTERSHIRE EDUCATION COMMITTEE.-School Medical Officer (male). Salary, £230 per annum, rising to £250. Inspector. Salary, £250 per annum, rising to £300. SOMERSET COUNTY COUNCIL.-Assistant Tuberculosis Officer. INFIRMARY.-Second and Third Salary, £300 per annum. HALIFAX: ROYAL HALIFAX STAFFORD: STAFFORDSHIRE GENERAL INFIRMARY.-House- House-Surgeons. Salary, £120 and £100 per annum respectively. Physician. Salary, £100 per annum. HERTFORD COUNTY HOSPITAL.-Resident Medical Officer. Medical Salary, £100 per annum. SURREY COUNTY COUNCIL.-Assistant Officer of Health. HOSPITAL FOR CONSUMPTION AND DISEASES OF THE CHEST, Salary, £400 per annum. Brompton.-(M) Assistant Physician. (2) Assistant Resident SWANSEA GENERAL AND EYE HOSPITAL.-Two House- Medical Officer; salary, £100 per annum. (3) House-Physician; Surgeons. Salary, £125 per annum. honorarium, 30 guineas for six months. TRURO: ROYAL CORNWALL INFIRMARY. - House-Surgeon iiOVE: LADY CHICHESTER HOSPITAL.-Resident Medical (male). Salary, £100 per annum. Woman. Honorarium, X£30. UNIVERSITY COLLEGE. Gower Street, W.C.-Lecturer and HULL: ROYAL INFIRMARY.-1) Honorary Assistant Ophthalilic Demonstrator in Anatomy. Salary, £350 per annum. Surgeon; (2) Casualty House-Surgeon; (3) Assistant House-Surgeon. UNIVERSITY COLLEGE HOSPITAL, Gower Street, W.C.-Junior Salaryfor (2) and (3) £80 and £100 per annum respectively. Surgical Registrar. Salary, £80 to £100 per annum. INVERNESS DISTRICT ASYLUM.-Assistant Medical Officer. VICTORIA HOSPITAL FOR CHILDREN, Tite Street, S.W.- Salary, £200 per annum. (1) House-Physician; (2) House-Surgeon. Honorariun, £40 for KENT COUNTY ASYLUM, Maidstone.-Fourth Assistant Medical six months each. Officer (male). Salary, £250 per annum. WALSALL AND DISTRICT HOSPITAL.-Assistant House-Surgeon. KIDDERMINSTER INFIRMARY AND CHILDREN'S HOSPITAL.- Salary, £110 per annum. House-Surgeon. Salary, £100 per annum. WARWICKSHIRE AND COVENTRY JOINT COMMITTEE FOIR KING EDWARD VII SANATORIUM, Midhurst.-Second Assistant TUBERCULOSIS.-Tuberculosis Officer. Salary, £500 per annum. MIedical Officer. Salary, £150 per annum, rising to £200. WEST AFRICAN MEDICAL STAFF.-Appointments to the Service. KING'S LYNN: WEST NORFOLK AND KING'S LYNN HOSPITAL. Salary, £400 per annum, rising to £500, and thence to £600, with -House-Surgeon. Salary, £150 per annum. prospect of promotion to higher posts. LAMBETH PARISH INFIRMARY.-Fourth and Sixth Assistant WEST BROMWICH AND DISTRICT HOSPITAL.-Assistant Resi. Medical Officers. Salary for former, t160 per annum, rising to dent House-Surgeon and Anaesthetist. Salary, £100 per annum. £200; and for latter. £150 per annum. WEST HAM AND EASTERN GENERAL HOSPITAL, Stratford.- LEEDS PUBLIC DISPENSARY.-Junior Resident Medical Officer. (1) Junior House-Physician. (2) Junior House-Surgeos. Salary at Salary, £130 per annum. the rate of £75 per annum. LEEDS TUBERCUJLOSIS ASSOCIATION.-Resident Medical Officer WEST HARTLEPOOL: CAMERON HOSPITAL.-House-Surgeon. for the Eanatorium at Gateforth. Salary, £100 per annum. Salary, £150 per annum. SuprLEMEN'T TO TTE 1 3 B21RITISH1 MII DICAL JOUDIINALJ DIARY. [JULY 4, 19r4

WESTON-SUPER-MAIRE HOSPITAL. -House-Surgeon. Salary, ROBrERTS, C. Rupert, M.D., F.R.C.S., F.R.C.P., Examiiiner in MIidwifery £120 per annum. and Diseases of W'Wmen to the Conjoint Board, London. WESTMINSTER UNION INFIRMARY.-Third Assistant Medical SEERISETT, Frank B., M.B., B.Sc.Lond. and Vict., D.P.H., M.R.C.S.. Officer. Salary, £140 per annum, rising to £160. Assistant Medical Officer of Health and Chief Assistant School W'IL.U,ESDEN URBAN DISTRICT COUNCIL.-(1) Assistant Medical Medical Officer for the County Borough of West Ham. Officer of Health and Assistant School Medical Officer; salary. STEADMAN, F. St.J. S., M.R.C.S., L.R.C.P., L.D.S., D.P.H., Assistant £300 per annum. (2) Consulting Ophthalmic Surgeon; payment, Dental Surgeon to the Royal Dental Hospital. £1 is. per hour. STEVENT.S, T. G., M.D., F.R.C.S., Obstetric Surgeon to St. Mary's WOLVERHAMPTON AND MIDLAND COUNTIES EYE IN- Hospital, Paddington, W., vice Dr. William J. Gow, F.R.C.P., F'IRMABY.-House-Surgeon. Salary, £120 per annum resigned. WI2INCHESTER: ROYAL HAMPSHIRE COUNTY HOSPITAL.- WX YcwE, E. M., L.R.C.P., M.R.C.S., D.P.H.Lond., Senior Medical House-Physician (male). Salary, £80 per annum. Inspector to the Nottingham Education Commilllittee. CERTIFYING FACTORY SURGEONS.-The Chief Inspector of Factories announces the following vacant appointmen-ts: Harris (Inverness), Southwell (Nottingham).il BIRTHS, MARRIAGES, AND DEATHS. To e;lsur,e notice in tlis columniz1-wvlic1 is conpiled f om)z outr advertise- T'hle chargefor insertinos announcements of Births. Marriages, andz mJent colutmnts, where futll p-Erticulars will be found-it is Deathis is 5s., which sumt sh1outld be torwuarded int Post Ofice Orders jiecessarv that advertisemtents shtould. be received ntot later theat or' Stamips wvit/ tlhe nIotice sIot later than first post Wednesday lie first post ont Wecldnesday vornin. Persons intterested slholld l10?rning in order to ensure insertion in7 the curr)enet issute. icfer also to the Index to Advertisements wilich follows tlue Talble of Contentts in tite JOURNAL. GRE:ATOREx.-On thi21st June, at Manor Drive, Halifax, the wife of R. W. Greatorex, M.B., of a son. APPOINTMEINTS. RoIGGALL.-On June 26th, at th(A Queen Alexandra Saualoriusm, Davos BALiNEs, Stanley, M.D., F.R.C.P., Honorary Physician to the Bir- Pi-atz, Switzerland, the wife of Surgeon R. M. Riggall, R.N., minigham General Hospital, vice Sir Robert M. Simon, M.D., a son. resigned. MARRIAGE. CAI MAN, Mrs. Alice J., M.B., Ch.B.. Junior Assistant in the Oph- ODGEmits-HIGGINS.-On Tuesday, June 30th, at All Saints, Ennismore thalmic Department of the New Hospital for Women, Euston Gardens, by the Rev. W. E. Addis, M.A., Normaii Blake Odgers, Road. M.Ch., F.R.C.S., third son of the Rev. Dr. Odgers, of Oxford, to CAMERON, J. T., M.B., Assistant Medical Officer of the Leicester Mabel, youngest daughter of G. Randell Higgins, The Croft, Union Infirmary. liurcote-on-Tham-ies, Oxon. COuYN, Harold F., M.B., B.C.Cantab., M.R.C.S., L.R.C.P.Liond., DEATNS. Medical Registrar to the Royal Hospital for Diseases of tilc Chest, City Road, E.C. MUGLISTON.-On the 24th June, Dr. H. Boyes Muigliston, elder son of G. T. W. Mugliston, M.D., at his residensce, Coo-ce," Brenu DOOLEY, G. G., L.R.C.P.andS.Irel., District Medical Officer of the Howden Union. Knoll, Somerset. the 30th W. his HENDRY, J. A., M.B., Ch.B.Aberd., District Medical Officer of the MUGLISTON.-On inst., G. T. Mugliston, M.D., at Bakewell Union. residence, " Birsay," Hatch End, Pinner, aged 89 years. HE-nLEY, Randal, L.R.C.P.andS.Edin., L.F.P.S.Glasg., Ophthalmic Surgeon to the Dewsbury and District Infirmiary. DIARY FOR THIE WEEK. HOLMEs, Gordon M., M.D.Dubl., F.R.C.P., Physician to the Royal London Ophthalmic Hospital, Moorfields. JONESi., Howard, M.B., B.S.Lond., M.R.C.S., L.R.C.P., Honorary POST-GRADUATE COURSES AND LECTURES. Anaesthetist to St. Mark's Hospital for Diseases of the Rectumii. Post-Graduate Courses and Lectures are to be given next week at LUKE, G. F., L.R.C.P. and S.Edin., L.F.P.S.Glasg., Medical Officer of the following schools, colleges, and hospitals: the Tempo Dispensary District of the Enniskillen Union, vice CENTRAL LONDON THIROAT AND EAR HOsPITAL, Gray's Inn Road, Dr. Hackett, resigned. W.C. MACKAY, C. G., M.B.. Ch.B.Glasg., District Medical Officer of the DUBLIN: ROTUNDA HOSPITAL. Newport (Mon.) Union. I{OSPITAL FOR CONSUMPTION AND DISEASES OF THE CHEST, MfONOD, Gustave, M.D.Paris, M.R.C.P.Lond., Physician to the Vichy Brompton, S.W. Thermal Hospital. HOSPITAL FOR SICK CHILDREN, Great Ormond Stceet, W.C. MORTON, Hugh, M.D., Ch.B.Glasg., Professor of Physiology, Anderson College of Medicine, Glasgow. L,ONDON HOSPITAL MEDICAL COLLFEGE1, Turner Street, E. LONDON SCHOOL OF CLINICAL MEDICINE, Dreadnought Hospital, MYERSs,Bernard, M.D.Edin., M.R.C.P.Lond., Out-patient Plhysician Greenwich, S.E. to the Royal Waterloo Hospital for Children and Women, London, S.E. LONDON SCHOOL OF TROPICAL MEDICINE, Royal Albert Docl. OLIVER, M. W. B.. M.B.Camb., F.R.C.S.Eng., Assistant Surgeon to |MANCHESTER HoSPITALS: Post-Graduate.Clinics. the Central London Ophthalmic Hospital.| MEDICAL GRADUATES' COLLEGE AND POLYCLINIC, Chenies Street. PE13K, J. Harold, M.D., Ch.B.Edin.. D.P.H.Cantab., Assistant County London, W.C. Medical Officer of Health for Flintshire. NATIONAL HOSPITAL P5IR THE PARALYSED AND EPILEPTIC, Queen RANSFORD, W. R., L.D.S.Eng., Dental Surgeon to the Civil General Square, London, W.C. Hospital, Rangoon. NORTH-EAST LONDON POST-GRADUATE COLLE.GE, Prince of Wales's IIENNY. Eustace G., M.R.C.S.Eng., L.R.C.P.Lond., Honorary Assistant General Hospital, Tottenham, N. Surgeon and Anaesthetist to the Essex County Hospital, Col- ROYAL HOSPITAL FOR DISEASES OF TEI, CHEST, City Road, E.C. chester. WEST END HOSPITAL FOR DISEASES OF THE NERVOUS SYSTEM,: RICTIMOND, Arthur, M.B., Ch.B., Tuberculosis Officer for Berkshire, Welbeck Street, W. vice Dr. Norris, resigned. WEST LONDON POST-GRADUATE COLLEGE, Hammersnmith, W. RIrcnMoND, D. Stevenson, M.B., B.S.Glasg., Medical Officer of Health [Further particulars cass be obtained on application to thte Deans to Cwmamman Urban District Council, and also as Medical of tile several institutions. os- int sonic instanices from our advertise- Officer to Post Office, Garnant and Glanamman. inent colsonn]s DIARY OF THE ASSOCIATION.

Date. Meetings to be lIeld. Date. MIeetings to be Ileldl.

JULY. JULY (continwed). 7 Tues. City Division, Balfour Ilall, Kingsland Road, '14 Tues. London: Standing Ethical Subcommittee, 9.30 p.m. 2.30 p.n. London: Metropolitan Counties Branch Coun- 8 Wed.' Dorset and West Hants Branclh, Brilport, cil, 4p.m. 3.30 p.m.; Luncheon, 1.30 to 2.30 p.isi. St. Helens Division, Annual Meeting, St. North Wales Branch, Annual Meeting, Red Helens. Wharf Bay, Anglesey. London: Insurance Act Commlittee. 17 Fri. Coventry Division, Coventry Hospital, 4.15 p.m, 9 Thur. Southern Branclh, Annual 'Meeting, South- ampton, 1 p.m.; Luncheon, 1.45 p.mi. ANNUAL MEETING, ABERDEEN, 1914. 30 Fri. London: Therapeutic Subcommittee, 2.30 p.m. Annual Representative Mfeeting, Friday, July 24th, and following days. Lonidon: Medico-Political, Medical Inspection 27th. an(d Treatment of School Children Sub- Special Representative Mceeting, July Committee, 7 p.m. Presidential Address, Tuesday, July 28th. Sections--July 29th, July 30th, and July East York and North Lincoln Branch, A nual 31st. Meeting, Hull. Annual Exhibition, July. 28th-31st. 11 Sat. London: Science Conimittee, 10.30 a.m. Excursions, August 1st.

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