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steady is the sequence of ideas with a man of a trulycomprehensive grasp; and we wish to place on record our

opinion that this last volume forms a fitting conclusion to hisseries of essays on the sanitary progress of Europe’s greatest- city, progress which is without a rival in the history ofthis or any other country.

Hospitals and Hospital Funds.THE two great Hospital Funds for London, the King’s

Fund and the Metropolitan Hospital Sunday Fund, representin their capital a very large sum of money contributed by the

eleemosynary public, alive and gone, and by their annual

receipts prove that the spirit of charity still shines among uswith undiminished radiance. Any factor which influences

the just employment of such money is a subject of publicconcern as well as a matter of particular interest to the

,medical profession, so many of whose members are engagedin carrying out the work for which these Funds help to

provide. Our attention is thus inevitably arrested when wefind the King’s Hospital Fund for London and the

Metropolitan Hospital Sunday Fund, through their executiveofficials, arriving at strictly diverse conclusions upon the

same questions, and, we believe, with the same evidenceavailable for their assistance. We allude, of course, to theattitude of the two Funds towards St. George’s Hospital,the King’s Fund having decided to withhold its annual grantbecause of the manner in which the funds of the hospital are

employed, and the Hospital Sunday Fund, after inquiry intothat manner, having made the usual subsidy. We do not

propose at this moment to enter into all the minutiæ of

hospital accounts, but we believe that it is possible to givethe broad outlines of the situation so that our readers

can understand it, and either relieve our feelings of

misgiving or make clear the unnecessary nature of those

sensations.

At the meeting of the King’s Hospital Fund for Londonin December, 1910, the grant which had in previousyears been awarded to St. George’s Hospital was

withheld until the figures of the expenditure of the hos-

pital in respect of 1909 and 1910 could be regarded as

.. clear from any payments on account of medical educa-tion." The hospital, through its treasurer, Mr. A. WILLIAM

WEST, consequently presented a detailed account of

the expenditure of the money received, showing that,m the opinion of the hospital authorities, no pay-ments were being made from the general funds of the

hospital except for work done directly in the interests

of the patients of the hospital. The King’s Fund perhapsdid, and perhaps did not, agree with the representa-tions of the hospital, but at any rate the ground wasshifted and the refusal of the grant maintained for a

different reason-viz., that at St. George’s Hospital moremoney was spent in the bacteriological and pathologicaldepartments than the average returns from other hospitalswarranted. To this allegation the hospital replied, andstill replies, that if the officials of the King’s Fund

will go properly into detail in their examination of the

,figures of expenditure, it will be found that the moneyspent in the incriminated departments of St. George’s

Hospital is within the average of that spent by other

hospitals of similar size and educational standing. -

The contention has been raised by the hospital that fair

comparisons of cost per bed at different hospitals cannot

possibly be made unless a really thorough investigation is

held, one which takes into its purview all kinds of expendi-ture, such as the cost of laundry and certain items of theboard of patients, for the expenditure on these is differentlymanaged at different hospitals. Some institutions, of whichSt. George’s Hospital is one, supply the patients with

absolutely everything ; others require patients to bringwith them certain articles and to provide themselves withcertain accessories. Obvious and considerable differences

in the cost per bed arise in this manner. Further, in com-

paring the financial statements of different hospitals we haveto reckon with, or should reckon with, the existence of dis-

cretionary funds which exist alongside with general funds atsome hospitals dependent for their support on public charity.Money taken from discretionary funds is, so to speak,spared from the general funds, and the apparent cost perbed can thus be lowered. The authorities at St. George’sHospital contend that they have throughout acted strictlyin accord with the findings of the Fry Commission and withthe recommendations of the King’s Fund. Although the costper bed at St. George’s Hospital may be higher than that atother comparable institations, this excess is due to adminis-trative and other reasons, and not because the expenditure onthe pathological and bacteriological departments is in excessof the average. Where the same scrupulous care is not

taken to charge to the general funds every penny spent uponthe welfare of the patients, whether that penny is spent uponfood, dressings, and remedies, or upon pathological, bacterio-

logical, and electrical departments, a false comparison will beinstituted. In 1911 the hospital, seeing no straightforwardway of altering its attitude, forewent the grant.

Owing, perhaps, to the action of the King’s Fund, the

Metropolitan Hospital Sunday Fund last year took the

position of St. George’s Hospital into serious consideration,and as a result the question of a grant from the senior fundwas left open until the allegations against the institution offinancial profligacy had been made the subject of a reportby Sir THOMAS CROSBY, who is at once Lord Mayor of

London, a physician, and the President of the Metro-

politan Hospital Sunday Fund. The Lord Mayor reportedthat a careful investigation of the whole matter had con-

vinced him that, in the departments of bacteriology andpathology at the hospital, work recognised at all efficient in-stitutions as essential to the scientific diagnosis and treatmentof disease was being done, and that the amount expendedupon this work was in no way excessive. The MetropolitanHospital Sunday Fund accordingly allowed the grant. We

publish in another column this report, which, having hadthe figures upon which it is based produced to us, we are ableto endorse. The difference of attitude in those responsible forhe management of these two great agencies, the King’sFund and the Metropolitan Hospital Sunday Fund, towardsthe same important charity is so marked that we think

it right to draw attention to it; the public importancethat must attach to such discrepancies in judgmentmakes it necessary to discuss them, and we trust that

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it is possible to do so without appearing to challenge the

good faith of the administrators. The administrators of these

funds have, indeed, grave responsibilities, which in our view,and surely in theirs, are not fully discharged by the meredistribution of money upon some principle which they believeto imply a fair division of available sums amongst the

various claimants. This is in itself an obligation heavyenough, but trust funds are in question, and the reasonfor any action taken should be justified up to the hilt in apublic manner.

In the particular situation between the King’s HospitalFund and St. George’s hospital the medical profession, noless than the charitable public, have been left much in thedark. The principle upon which the actions of the

executive of the King’s Fund are based is not clear;though subscriptions are invited from all, it is not open to

all to understand the action of the Distribution Committee

of the Fund. This is dangerous. We feel sure that publicconfidence would be increased-or perhaps we should saythat the confidence, now great, would become entirely un-assailable-if the reasons for such drastic action as the

withholding of a grant from a hospital were made public as a

signed report. We have here the case of a large hospitalwhich prefers to forego a grant rather than comply withdemands which are not only contrary to the principlesapproved of by the charity, but which also seem to

traverse the rulings of the Fry Commission. Such a

state of affairs is not satisfactory. It may quite well be

impossible for the executive of the King’s Hospital Fund tohave clear-cut rules for the distribution of its trust money,but there should not be any chance of suspicion that thescheme, whatever it is, can be made to operate more hardlyin one direction than another, and this without full explana-tion to the public which provides the money. Everyhospital doing good work, which fails in its application tosecure a grant, is a criticism upon the distribution of the

Fund that is only justly destroyed when the Fund has

shown sound reasons why, in spite of the good work, the

grant is not earned. The King’s Fund, like the Metro-

politan Hospital Sunday Fund, stands for that element oforder in charity which all who know anything of a vast

subject feel is sadly needed. The value of its work .is

beyond doubt; the sincerity and self-sacrifice of its

voluntary executive are unquestionable, and here un-

questioned ; but the relations of the Fund to St. George’sHospital should certainly be made the subject of publicexplanation.

Arsenic and Murder by Poisoning.THE trial of FREDERICK HENRY SEDDON and MARGARET

ANN, his wife, for the murder of ELIZA MARY BARROW

ended in the conviction of the former prisoner and the

acquittal of the latter, after a trial lasting ten days at theOld Bailey, and following upon inquiries before the coronerand magistrate which extended over many weeks. An

appeal against the verdict has failed. The death of

Miss BARROW too place on Sept. 14th, 1911, and the

trial of the SEDDONS ended upon March 14th last, full par-ticulars of the evidence having been reported so constantly

in the newspapers that it is not necessary to recapitulate the

story here. Medical men who read the evidence of Dr.

WILLCOX and Dr. B. SPILSBURY will have observed

that it proved facts essential to the prosecution, failingwhich not even a p’l’imâ fczaie case could have been

made out against SEDDON ; but at the same time neither

their evidence, nor that of the other medical men called,connected him with the administration of arsenic to the

deceased, or showed more than the facts, essential as theywere, that the deceased died from arsenical poisoning, andthat if fly-papers of a certain kind are in a man’s possessionit is easy for him to extract from any one of them a

poisonous dose of arsenic. The process of steeping them inhot or cold water was not proved to have been undertaken

by the prisoner, nor was it shown that he possessedknowledge likely to suggest such a course, but the obviousnature of the operation was matter for the jury to

consider, the fact of its possible effect being before them.The links connecting the prisoner more directly with

his crime were supplied rather by his own provedconduct, his squalid greed, his indifference to the suffer-

ing of the dying woman, and his attitude towards her

relatives. It must have been. however, a matter of con-

siderable anxiety to the defence to feel compelled, while

denying the purchase of arsenical fly-papers by the prisoner’sdaughter for the purpose of murder, to admit their

presence in the house for the destruction of flies. Without

such evidence, however, there could have been no suggestionsuch as was made, that Miss BARROW might have accidentallydrunk the water in which fly-papers had been steeped, fourat a time, in a soup-plate-that is to say, there could havebeen no explanation of any means whereby arsenic couldhave entered her body during life in the quantities revealed

by post-mortem evidence. As to that evidence, and themanner in which it was treated by counsel for the defence,little need be said. Scientific tests for the detection of

poison and for estimating the amount absorbed by a par-ticular person, the time at which it was so absorbed, the

method of its administration, and other important particulars,become constantly more detailed and more conclusive. The

elaborate nature of the tests used, however, and even the

precision claimed for the deductions made from their results,not unnaturally supply material for the advocate which it ishis duty to make use of when criticising evidence vitallyaffecting his client. If a process is of so subtle a nature, he

reasons to the jury, may not a fundamental error as to the

deductions to be drawn from observed facts, or in the appli-cation of a test, affect the result when a minute quantity ofa poison is alleged to be present in a small portion of ahuman body, and may not that error vitiate the whole pro-

ceeding ? 7 It is right that every such possibility should be

raised by counsel addressing a jury on behalf of a prisoner,and Mr. MARSHALL HALL in his able defence of SEDDON

did this, paying a tribute at the same time to

the fairness and ability with which the scientific evidence

had been presented by the witnesses for the Crown.After all, however, the circumstances and-the result of the

SEDDON trial, so far as they affected the prisoners, are of less

importance to the public and of less interest to the medical

profession than the fact that in a case in which a person