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THE BRITISH NURSES’ ASSOCIATION.

AT a meeting of this association in Hanover-square, underthe presidency of Mr. Pickering Pick, a paper on PrivateNursing was read to a large audience by Miss FogoThompson, in the course of which she thought the advanceof nursing as a profession had noc kept pace with theirprogress as individuals. The public and the nurses hadhitherto come together through the agency of institutions.She deprecated the action of those well-meaning peopleposing as philanthropists who devoted the proceeds ofthe nurses’ labour to the maintenance of charitable under-takings, and she thought that their remedy lay in havingsome central authority which might deal a deathblowto these nurse farms, and improve the status of properlyqualified nurses. An authority of this kind should havefor its head a woman of common sense, tact, and know-ledge, who had herself undergone a very complete trainingas a private nurse, and should also be in some way or otherconnected with a hospital. This might secure for thenurse some amelioration of the conditions under which shelaboured, and secure a fairer apportioning of the extra chargemade on the public for cases involving increased strain, risk,and worry for the nurses, which at present went to swell thereceipts of the institution, and was not in the least degreeshared by the nurse. She thought if nurses would unite ina strong and sustained effort to obtain a remedy for theanomalies which existed in their profession they would indue time reap the benefit of such combined action.Miss Wood, Miss Homersham, Dr. Heywood Smith, and

Miss R. Graham afterwards made some remarks on thepaper, and generally endorsed the suggestions of Miss

Thompson. A vote of thanks was awarded to her for herinteresting paper, and also to the chairman.

Public Health and Poor Law.LOCAL GOVERNMENT DEPARTMENT.

REPORTS OF INSPECTORS OF THE MEDICAL DEPARTMENTOF THE LOCAL GOVERNMENT BOARD.

On Fever in the Bedlingtonshire Urban District, byDr. PARSONS.—The condition of this colliery district in

Northumberland, with a population of some 16,000, evidentlyleaves much to be desired. It was inspected by Dr. Parsonsin 1880, and in now revisiting the place ten years later, hefinds himself obliged to report with regret that his formerstatements concerning it apply only too well at the presenttime. The improvements effected have related mainly tosewerage, but the sewers and drains are still imperfect.The ventilation of the former is defective, and the generalarrangement of open drain channels about houses is asso-ciated with much uncleanliness of surface. External filth isalso accompanied by a number of filthy interiors. The water-supply seems to be fairly good, but the midden-privyaccommodation is highly defective. The authority are suf-ficiently backward to advocate receptacles for excreta, inthe vicinity of dwellings, large enough for a man to get intoto do the work of scavenging; and though the latter processis carried out under contract, yet it is associated in someparts of the town with the dirty and altogether inexcusablepractice of first wheeling the filth into the street and theresoiling the surface with the deposit, and then pickingit up again in order to cart it away. During the tenyears 1879—88 the zymotic death-rate averaged 3’3 perthousand, as opposed to 2-3 for England and Wales as awhole; and when the zymotic deaths are consideredin detail it appears that scarlet fever and the continuedfevers are largely accountable for the excess ; " fever

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reaching a rate of 6 . ’0 per 1000, as opposed to 2 ’6 for Englandand Wales. The causes of the enteric fever prevalences inthe place are discussed, and it seems clear that the excessiveamount which has existed must in the main be put down tothe facilities for the diffusion of this essentially filthinfection which are afforded by the midden-privy system.There has also been some typhus in Bedlington, but the

disease did not widely spread. Obviously, one of the mainefforts of the sanitary authority should be a remodelling oftheir midden-privy system, which, unless water-carriageshould be decided on, ought to be so designed and managedas to secure the utmost procurable dryness of closet contents,and such systematic removal that there shall be no excusefor the retention of excreta about dwellings for a periodexceeding one week at the most.

REPORTS OF MEDICAL OFFICERS OF HEALTH.

Stapleton Urban District.-During the year 1889 thegeneral mortality-rate for this district was 13’3 per 1000 ..,and Dr. W. Brown is able to say that there was a markedabsence both of cases and mortality from the several in-fectious fevers. Where such cases did occur some very-obvious insanitary conditions were discovered, pointing tasthe desirability of a regular house-to-house inspectiontogether with the maintenance of a record of its results, so’that the faulty conditions discovered may be got rid ofbefore the occurrence of preventable disease. The privatestreets, so often a source of nuisance in small towns, sadlyneed attention; and it is to be hoped that the action nowcontemplated may be carried through wherever it is wanted.Inspection of cowsheds and dairies has revealed a numberof objectionable and unwholesome conditions, and it is to behoped these may be effectually abated before the occurrenceof mischief.

Hastings Urban District.-Mr. Knox Shaw has an ex-ceptionallysatisfactory report to offer as to the year 1889. Thegeneral death-rate and the so-called zymotic rate were only12-4 and 0.6 per 1000 respectively. From scarlet fever andsmall-pox there were no deaths, although 22 cases of theformer disease were received into the isolation hospital.Diphtheria caused six deaths, and atmospheric infectionfrom sewer gas is referred to as a probable cause. We areglad to see that the corporation are advised by theirmedical officer of health not to hinder the isolation of theinfectious sick by making a charge for admission into theordinary wards of an institution erected and maintained atthe cost of the ratepayers. A good deal of excellentsanitary work is in progress in the town, and improvementsof an important character have been made as to water-supply and drainage.

Clitheroe Urban District.-This being the first annualreport which has to be transmitted to the County Council,Mr. J. J. Fraser has reviewed the topographical and generalcircumstances of Clitheroe in some detail. He also describes-the conditions of water-supply, sewerage, and refuse dis-posal which are in operation there. The method of sewage-disposal is obviously wrong, and this matter may well comewithin the proceedings which the County Council shouldtake for preventing the pollution of water-courses. Openashpits have largely been done away with, and the directconnexions between drains and houses has been to a greatextent abolished. The general death-rate for 1889 was20’1 per 1000, which is distinctly in excess of that whichshould prevail. Enteric fever also contributed by someexcess to augment the general rate,, but whooping-cougband measles were largely prevalent and caused the most con-siderable fatality. In reference to the notification of infectious-diseases mention is made of the need for means of isolationand efficient disinfection if the adoption of the compulsoryclauses of the new Act is to operate properly in preventingthe spread of disease.

Wellingborough Rural District.-In discussing the in-fectious fevers which have prevailed during 1889, Mr. HowellThomas refers to a serious outbreak of measles at Rushdenand to certain occurrences of enteric fever which wereassociated with faulty sanitary conditions. In six of thelarger villages public scavenging is performed with excellent,results, but the need of an infectious hospital still remains un-supplied. Thesoil being chiefly of aclayeynature Mr. Thomas-points out the real advantages which would be arrived atas regards both phthisis and rheumatism if the sites of alldwelling-houses were covered with concrete so as to excludemoisture. The death-rate for the year was 15’6 per 1000living.

Bislcy Urban District.-llr. T. Partridge records a death-rate of 16 per 1000 in this district during 1889, and he draws-attention to the difficulty he experiences in dealing effec-tually with infectious diseases, since, in a number of cases,he only hears of them during convalescence. The need for