973

which such material dries up in the tropical sun. The

maggots produced seemed to find their way into the groundbeneath the fsecal deposit and to emerge thence as flies afterabout a fortnight’s interval. Little care seems to be

exercised in India as to the disposal of faecal matter onaccount of the prevalent view that the sun’s heat rapidly tenders it innocaous. Major Smith’s observations supplyat least one reason for greater scrupulosity in this respect..while there can be little doubt that germs of disease maybe present in fseces even when no illness is suspectedand that the flies which resort to the excrement for

breeding purposes will also be capable of carrying theinfection to food or other materials on which they maysubsequently settle. It may be added that, as a con-

sequence of the leading article to which we have referredabove, we have received a singular letter from a memberof the medical profession who quite seriously asks us whyin that article certain names were mentioned and not his

own, seeing that ten years ago he had in a book " clearlyand positively asserted that flies do carry infection byorganisms, especially to milk and therefore to all food."We did not pretend to give a list in our article of all themedical men who had ever printed the idea that flies mightact as carriers of disease. Nor do we understand any ofthe three medical men, whose names we gave, as setting upa patent in the notion. The value of the observations of Dr.H. H. Tooth, Dr. A. B. Dunne, and Dr. R. M. Buchanan liesin the fact that they have not " clearly and positivelyasserted" any universally recognised generalities but havestudied the matter with the view of proving experimentallyin particular directions what was so far only a matter ofcommon surmise. Claims of priority ought to be very care-fully made, and in particular we view with distrust the

attempt to cover future developments in medicine by pre-liminary announcements of some far-reaching kind. In

1897 our correspondent stated that flies carried infection ;we throw no doubt on the statement, but the fact does not

give him any title to share the credit with Dr. Buchananof elaborate researches proving how certain bacilli in certain

circumstances are actually conveyed by flies to certain

artificial media and with what result. Dr. Buchanan’s

paper was a detailed account of a difficult piece of scientificinvestigation, and our correspondent’s general statement

ought not to have seemed to him to compare in any waywith it.

___

THE SCHOOL INCIDENCE OF TUBERCULOSIS IN

THE UNITED STATES.

AT the meeting of the Sociological Section of the AmericanNational Association for the Study and Prevention of Tuber-culosis, held this summer in Washington, among other

phases of the tuberculosis problem discussed was that oftuberculosis in schools. The influence of school life uponthe incidence of tuberculosis is a matter which has not

seriously occupied the attention of the medical profession onthe west of the Atlantic until a comparatively recent date,but from the account of the proceedings at Washington,published in a recent issue of the Medical l2ecord, it is clearthat the Americans intend for the future to take the problemspresented by school hygiene in connexion with tuberculosisvery seriously. Dr. John Lowman (Cleveland) read a

valuable paper at the meeting in which he said that

he was of the opinion that in order to control tuberculosisduring the school age it was necessary : (1) to discover

through the records of the municipality and public institu-tions the children who were infected and those who lived ininfected houses; (2) to examine and to classify the individualsthus found and place the contagious cases in sanatoriumsand the others in separate schools; (3) to develop the

hygienic surroundings of these separate schools to the

highest plane of excellence; (4) to discriminate betweenthese children and their healthy comrades, even during thevacations, by referring them to the special consideration of"outing societies"; (5) to obtain medical men who wouldat stated intervals examine the children and report to thesupervisors the conditions found; (6) to use the utmost pre-cautions for the protection of the teachers ; (7) to introducesystematic courses on hygiene and tuberculosis into thecurriculum of the schools ; and (8) to provide sanatoriumsfor the children. This, of course, is a most comprehensive pro-gramme and no one expects that it will all be carried out atonce. Dr. S. A. Knopp made the suggestion that the teachershould be instructed in the signs of early tuberculosis. The

average school teacher, he said, was intelligent and couldbe taught the objective symptomi of tuberculosis, especiallythose of early tuberculosis or of the pretuberculous stage.With teachers so trained and with periodical examinationsby skilled diagnosticians, he firmly believes that we wouldstrike at the root of this evil. The assumption that earlytuberculosis is easy to diagnose will hardly pass un-

challenged. At the Congress on School Hygiene held inLondon at the beginning of August Dr. T. J. Macnamara 1dwelt upon the incidence of pulmonary tuberculosis on schoolteachers in a significant manner, and it is now commonlyaccepted that instruction of the teachers in the elementarylaws of hygiene would be of benefit both to teacher and topupil. In England, not without persistent effort on the partof enlightened people, medical inspection of the pupils atelementary schools has become the law, and it seems prob-able that like effort will succeed in making compulsory theteaching of the elements of hygiene in schools. We are, of

course, a long way from Dr. Lowman’s very inclusive

proposals for dealing with one disease only, but we fearthat it may be some time before the tuberculous childrenin America receive the intelligent attention which he

advocates. ___

THE CRICHTON ROYAL INSTITUTION, DUMFRIES:RESIGNATION OF DR. J. RUTHERFORD.

THE public estimation of an asylum for the insane dependsin a great measure on the professional and administrativecapacity of the medical man who presides over it, andthis feeling will no doubt contribute to the regret felt for theresignation of Dr. James Rutherford of the Crichton RoyalInstitution at Dumfries. Dr. Rutherford was born at Falkirkin 1840 and received his medical training at the Universityof Edinburgh, where he graduated as M.D. in 1863. Hethen spent a year on the Continent, studying medicine inBerlin and Vienna. On his return to this country he andDr. Lockhart Robertson jointly made a translation of

Griesinger’s "Manual of Mental Diseases," which was

published by the new Sydenham Society in 1867.In 1866 he became a Fellow of the Royal Collegeof Physicians of Edinburgh with a view to practising in thatcity, but in 1867, as a result of his translation of Griesinger’swork, he was offered, and accepted, the post of assistant toMr. Green of the Birmingham Asylum. In 1870 he was

appointed medical superintendent of the Argyle and ButeAsylum. Four years afterwards he obtained the super-intendentship of Woodilee Asylum at Lenzie in Lanark-shire. Here he made a high reputation as an asylum physi-cian and a good administrator. He carried out many reformsin the treatment of the insane in the direction of more full

employment and greater freedom of his patients. With aview to this the asylum grounds were extended to over

500 acres. There were no airing courts and no locked doors.These reforms attracted much attention, both in this countryand on the Continent. He received many honours from

foreign countries, having been elected an honorary1 THE LANCET, August 17th, 1907, p. 462.