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under 5; the former was the more active and fatal.Two things which needed remedy were tuberculosis incattle and the segregation of the advanced adult case,in both of which the "massive dose" was the chiefadverse factor.Dr. L. J. SHORT pointed out the advantages of close

cooperation between the tuberculosis officer and theschool medical officer. In Somerset this was obtained

by means of a history card which was sent with thefindings of the school doctor to the dispensary. Thiswas, after the tuberculosis officer had added his

diagnosis, returned to the school, and in this way acomplete record was kept. He had found that simpleexclusion for a period from school was sufficient to

bring about the cure.Dr. CLIVE RIVIERE said that there was no separation

of infection and incidence; the latter was so universal.Most children had bronchial gland with slight hilusdisease, but of these few developed signs or symptomswhich demanded treatment. The X ray showed manyshadows, which meant very little. All children whoshowed physical signs had at some time suffered fromthe disease, and possibly this would light up in adultlife. He recognised a class of

" subtuberculous " childrenwho should be under supervision at school, be weighedregularly, and sent to convalescent homes for shortperiods to improve the general health. He thoughtthe acute and chronic catarrhs were responsible for thedevelopment of tubercle.

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Dr. HALLIDAY SUTHERLAND considered that the main

symptoms were failure to gain weight and an irritabilitycoupled with dyspepsia. Care should be taken not tooverlook worms, which caused the same symptoms. Hedid not agree with the pre- or sub-tuberculous class;either a child had or had not got the disease. Theschool medical officers and the tuberculosis officers hadmuch in common, and he hoped that the meetingwould lead to a closer union of the two societies.

Dr. F. S. LANGMEAD said that tuberculosis inchildren was a lymphatic disease. 55 per cent. gavea positive von Pirquet reaction, but intracutaneousinjection gave a positive reaction in 95 per cent. Heuttered a note of warning against sending the rheu-matic child to the open-air school, which would be verydetrimental for it.Dr. J. SORLEY spoke of the impossibility of obtaining

sputum from children and of the method adopted byDr. L. E. Holt. It was difficult to know how to avoidnumbers of children at the dispensaries, as if theywere turned away there was no method at present forthem to obtain treatment or supervision.

Dr. F. C. SHRUBSALL said that it was simplest andprobably most correct to consider that everybody hadtuberculosis, but it was not everyone who suffered fromit. He thought that all schools should be made veryairy and bright, and that prevention should beginthere. School teachers should be encouraged to bringforward ailing children, a procedure which had beenput in the background by routine inspection.- Dr. HORACE WILSON was of opinion that the infec-tion of childhood produced an immunity to disease inlater life, and that few of the cases when once healedcome back as adult cases.

THE MEDICO-LEGAL SOCIETY.

A MEETING of this society was held on Nov. 28th at11, Chandos-street, London, W. In the unavoidableabsence of Mr. R. HENSLOWE WELLINGTON, the Pre-sident, Dr. MORGAN FINUCANE took the chair, and readMr. Wellington’s inaugural address on the rise offorensic medicine as a subject of first-class importancein practice and in education.

Dr. A. P. GIBBONS read a paper entitled

Suggested Reforms in the TJorkmen’s Compensation Act.The author, whilst paying tribute to the courtesy andpainstaking endeavours of many county court judges,referred to some of the unhappy incidents thathave occurred and do occur in courts where

doctors, especially when appearing on behalf of

defendants, are in compensation cases treated

with something less than the courtesy due to themas professional men desirous of assisting justice. Dr.Gibbons criticised the manner in which medicalassessors and referees are appointed by the Home Office,since it results not infrequently that consulting phy-sicians, innocent of surgical experience, are called uponto act as experts in cases of surgical importance, andbacteriologists in cases of industrial disease, such aslead-poisoning and the like. The suggestion was putforward that boards of medical assessors or refereesshould be appointed for areas, and that to these boardsall medical questions and disputes in respect of compen-sation cases should be referred. A further suggestionwas made to the effect that workmen should be assessedfor incapacity after accident, not merely in respect ofthe skilled work performed up till the time of theaccident, but in percentages of earning capacity in thebroad sense of the phrase, without reference to trade-union restrictions.

Discussion.In the discussion which followed Dr. F. S. TOOGOOD

agreed that there exist at present good grounds for dis-content, but was not convinced of the applicability ofDr. Gibbons’s proposal that boards should be appointedfor the decision of the medical problems involved.Mr. A. S. MORLEY insisted on the need for amendment

of the Act, whereby it should provide that a case shouldbe heard before a medical referee if either party to thesuit so desire, and not only when, as at present, bothwish reference. He questioned the wisdom of thepresent state of affairs, whereby sickness secures lesspay during disability than does accident; and. asked ifit would not be possible to amalgamate the Insuranceand the Compensation Acts ?Mr. G. C. GARDINER favoured Mr. Morley’s suggestion

of reference on the desire of either party, and thought itdesirable that county court judges should be bound torefer cases to medical assessors when asked to do so.Mr. A. HAIR, disapproving of Dr. Gibbons’s notion,

drew attention to the inextricability of the medical

questions from those of fact involved in compensationcases, and declared that the assessment of earningcapacity was not a purely medical affair.His Honour Judge BURROWS agreed with Mr. Hair

that the medical part of a case could not be conductedseparately from the legal, and insisted on the advantageof medical witnesses being present for examinationduring inquiry into the facts.Dr. F. G. CROOKSHANK, recognising the difficulties

commented on by Dr. Gibbons, supported the nomina-tion in each area of a panel of referees or assessors, sothat appropriate specialist experience could be utilised ;but, after a not inconsiderable experience in the courtsbefore the war, and of medical boards at home andabroad during the war, expressed himself strongly infavour of the present system, whereby conflicting evi-dence given by medical men in open court was candidlyand acutely balanced by a trained legal intellect. He

pointed out that great part of medical evidence in courtdeals with the attributability or otherwise of presentconditions to antecedent events, and that medical men,too often obsessed by the notion of the " single cause "of " special diseases " (which they persist in regardingas things having objective reality), fail to appreciatethe true question as it appears to the more logical andphilosophic lawyer: " Would this man be as he nowis if the accident that happened to him had notoccurred? "I The CHAIRMAN briefly summed up the discussion,observing that at present county court judges are notbound to accept the award of medical referees.The next meeting of the society will be held in

January, 1920. Applications for membership should beaddressed to either of the honorary secretaries, Mr. E.Goddard, 3, South-square, Gray’s Inn, W.C. 1, or Dr.B. H. Spilsbury, 31, Marlborough-hill, N.W. 8.

WELSH PRIORY OF ST. JOHN.-It has been decidedto build, at a cost of £70,000, headquarters for the WelshPriory of the Order of St. John of Jerusalem at Cardiff, on a.site near the ruins of the ancient Greyfriars Priory inCathays Park. The land belongs to Lord Bute, who hasoffered to contribute £5000 towards the building fund.