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to abide by their decision. Now they are threatened with theestablishment of a medical aid association in the town andthe societies interested have issued a report in which theyconclude" that should a medical association be instituted itwill confer a lasting benefit on the friendly societies in thedistrict." Added to this are extracts from balance-sheetsof similar societies and these are interesting and certainlydemand the careful consideration of the profession if not ofthe General Medical Council itself. It is deplorable after thecost and the time spent in a medical education that men canbe found to take such appointments. The balance-sheet of theWarrington Association for the year 1897 showed twenty-fivesocieties with a total membership of 3265. The incomewas from all sources Z547 15s. lld. The expenditurefor the same period was f:551 13s. 7., thus showinga deficiency of Z3 17s. 8. This was accounted for

by extraordinary expenditure, such as paving the street,<E24 9s. ; replacing surgery chairs, Z5 5 7.s. 3d. The previousyear there was a profit of .f:23 7s. 4d. Now for the interest-ing portion. The medical officer who has seen ten years’service received with allowances ;&231 6s. and for this hepaid 4694 visits and gave 15,988 prescriptions, the averagenumber per day being 44, including Sunday. Now, the

money value works out at lls. 8y- per day and 3. perprescription, with the visits thrown in. Can this be termedanything else than sweating" ? The Preston Associationfor the year ending Dec. 21st, 1896, gives a balance on theyear’s working of f:28 10s. 107. The medical salarieswere Z385 12s. 4d. ; probably this includes the dispenser.During the year 11,878 prescriptions were dispensed, 13,064attendances were made at the surgery, 5136 visits were paid,and 32 confinements were attended and 18 vaccinations. ThePreston Medical Aid Association is worth Z1296 14s. TheManchester Association employs three surgeons and pays them.S459 7s. 6d., equal to <E153 2s. 6d. each, and has a balanceto the good of .f:119 10s. 9. on the year’s working. Now ifa new medical aid association is to be formed on lines similarto these surely the profession will be found to contain menwho are honourable enough to uphold its dignity as well astheir own and who will refuse to be sweated by a combinationof societies which refuses fair terms to their medical officers.The " sixpenny dispensary man is looked down uponand practically ostracised by his professional neighbours, butwhat can a medical man who is the servant of a lay com-mittee expect when he is selling his services at a less sumthan the man with an independent dispensary ?

PUBLIC VACCINATORS OF THE STAINESUNION.

MR. C. DWIGHT MORRIS, the medical officer of health ofthe Staines Union, recently called a meeting of all the publicvaccinators in his union to discuss the provisions of the newVaccination Act. At this meeting, which all the publicvaccinators in the district attended, it was unanimouslyresolved that they would be prepared to accept the follow.ing scale of fees which they trusted their board wouldagree to :-

Article 3, General Orders.-Sub-section (a), 2s. 6d. ; sub-section (b), 6s. ; and sub-section (e), 2s. 6d. That the

postage as before be paid by the board-i.e., the variousforms be stamped as before. The arrears cases to be subjectto special arrangement as there appears to be no definite

provision made for these (the Act dealing with cases

registered after August 31st, 1898).The public vaccinators arrived at the above conclusions

after mature deliberation on the great difference in thecharacter of the work as performed by them under the oldcontract and that required to be performed under the newregulations, which is roughly shown in the following scheme.The above scale is only slightly over the minimum as fixedby the Local Government Board ; thus, taking into considera-tion that it is fully expected that a large number of personswill avail themselves of the conscience clause the actualcost will probably be very much less than under the oldcompulsory Act.SCHEME SHOWING DIFFERENCE IN CHARACTER OF WORK TO BE DONE

UNDER THE OLD ACT AND THE NEW.The old regulations.-Stations appointments. Appointments four

times a year. To vaccinate. Keep register. Forward accounts to ivaccination officer. Only three forms required. The new regulations.-Receive list from vaccination officer every

week (Form H). Issnc notices to parents (Furm 1). Visit and offer tovaccinate between the hours of 9 and 4 any part, of the district or atparent’s request (Form G). This might, necessitate extra visits in anagricultural district like Staines. return Form H to vaccination officerevery month filled in. To keep register. To perform the act of vacci-nation strictly according to antiseptic conditions and protect withspecial antiseptic pads. To subsequently attend the child if upset hyvaccination free of charge. No less than ten forms are now required tocarry out the Act&mdash;viz., Forms B, C, D, E. F, H, I, 0, 1’, and G. Thepossibility of being called to attend court to prove visits.On Dec. 20th, 1898, Mr. Morris appeared before the board of

guardians when the fees were unanimously accepted subjectto the approval of the Local Government Hoard. In manydistricts boards are allowing mileage above the minimumscale, but this, it was considered, would be complex anddifficult to adjust.

ASTOUNDING BRITISH ACTION AS TOPLAGUE.

THE news which comes to this country from Calcutta as tothe action taken on the East Coast of Africa which is underBritish jurisdiction, as regards a plague-infected ship, willcause great astonishment, and that feeling will be stronglyemphasised by the statement that the action in question hasbeen upheld by the Foreign Office in London. The BritishIndia Steam Navigation Company’s steamer Bhandara wasengaged in carrying 1000 coolies from India for thepurposes of the Uganda railway and, if report be correct,the authorities at Karachi, the port of departure, tookthe precaution to examine all the coolies prior to their

departure. It is not, however, stated whether the same

precautions were taken as regards the crew, concerning whomthere is in some ports too much laxity. Twelve days afterleaving Karachi the Bhandara arrived, on Dec. 27th last, atKilindini, near Mombasa, and reported seven deaths fromplague during the voyage. Here again nothing is as yetstated as to whether the first appearance of the disease was

amongst coolies or amongst members of the crew. But peremp-tory orders were at once issued by the British GovernorSir Arthur H. Hardinge, to the effect that no com-

munication would be allowed with the shore and that thevessel was to return to sea ; in brief, an infected vessel wasrepulsed from British territory and an effort was made toprevent the vessel from getting water at Zanzibar which alsocomes under British control.We believe that this action stands unique in modern British

sanitary administration. It is in entire violation of every-thing that England has so long contended for, and, as

the Indian Government points out, Great Britain is thefirst Power to make the Venice Convention a dead letter andhence to lay British shipping open to the same treatment inforeign ports by reason of the precedent she herself hasestablished. The repulsion of an infected vessel has for thelast fifty years been condemned in this country as involvingdistinct cruelty, and in the past it is known to have led tosome of the most tragic disasters at sea by reason of therapid spread of disease amongst those who must remainexposed to infection and because of the lack offood and water on board vessels which had only beenprovisioned for the purposes of a limited voyage. The storyas it is told is too circumstantial for us to doubt the essentialfacts and we are obliged to admit that we have read itwith shame. Our only hope is that in the closing days ofthe year and during a festive season someone at Whitehallhas during a temporary absence of his chiefs blundered bycommending that which should have been condemned.

It may, of course, be argued that our East Africandominions have not formally accepted the Venice Convention.This is, we expect, true. But if the Home Governmentcommend the greatest possible breaches of that Convention inthe case of territories under their direct control what becomesof the pressure which they bring to bear on some of ourcolonies to become parties to the same Convention? Even ifthe sick had been left on board the Bhandara whilstthe healthy had been encamped for nine days on shore thematter would have been better. As the story stands it impliesgross neglect and unpreparedness at a British port which isknown to have long been in constant relations and com-munication with plague-infected ports of India; and as

regards the actual action taken in the case of the unfortunatevessel with her 1000 coolies and crew it seems to be withouta solitary redeeming feature.