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low incidence of diphtheria, which he attributes tothe success of the immunisation campaign. Toxoidantitoxin floccules are being used so that reactions areavoided, and the preliminary Schick test has beenabandoned because experience has shown that, in thisagricultural area, 80 per cent. of the children are

Schick-positive. This may be all the more reason for

doing a late posterior Schick test, at least on a fairlylarge sample of the immunised, since it has been foundthat communities less exposed to natural, if latent,immunisation are rather more difficult to immunise

artificially. Acceptances are satisfactory. Sevenschools were dealt with during the year. In three ofthem over 90 per cent. of the parents consented,80 per cent. in another, between 70 and 80 per cent.in two, and 54 per cent. in the remaining one. Duringthe past two years 2000 persons have been immunised.In Holland immunisation appears to be regardedlegally as a function of the sanitary authority,Dr. Booth acting for them at their expense. The legalposition is a little obscure. Under Section 80 of theEducation Act, 1921, a local education authority-i.e., a county council, except in the case of the largerurban areas-may do anything for the health andphysical welfare of the school-children to which theMinister of Health consents. The position of maternityand child welfare authorities (which may be countycouncils or county district councils) is similar underSection 1 of the Maternity andChildWelfare Act, 1918,and the Minister has given a general consent toextensions of schemes such as immunisation at centreswould involve. Apart from these provisions, whichcover most of the population requiring this form ofattention, it would appear that the county districtcouncils (i.e., sanitary authorities) can only undertakeimmunisation in virtue of Section 133 of the PublicHealth Act, 1875, which requires an explicit sanctionfrom the Minister of Health.

INFECTIOUS DISEASE

IN ENGLAND AND WALES DURING THE WEEK ENDED

MAY 25TH, 1935

Notifications.-The following cases of infectiousdisease were notified during the week : Small-pox, 0 ;scarlet fever, 2142 ; diphtheria, 1018 ; enteric fever,23 ; acute pneumonia (primary or influenzal), 945 ;puerperal fever, 46 ; puerperal pyrexia, 108 ; cerebro-spinal fever, 20 ; acute poliomyelitis, 3 ; encephalitislethargica, 10 ; continued fever, 1 (Rhondda) ;dysentery, 22 ; ophthalmia neonatorum, 107. Nocase of cholera, plague, or typhus fever was notifiedduring the week.The number of cases in the Infectious Hospitals of the London

County Council on May 31st was 3061, which included :Scarlet fever, 943 ; diphtheria, 12U 9 ; measles, 31 ; whooping-cough, 389; puerperal fever, 27 mothers (plus 12 babies) ;encephalitis lethargica, 268 ; poliomyelitis, 3. At St.Margaret’s Hospital there were 17 babies (plus 8 mothers)with ophthalmia neonatorum.

Deaths.-In 121 great towns, including London, therewas no death from small-pox, 2 (1) from enteric fever,22 (0) from measles, 6 (0) from scarlet fever, 22 (1) fromwhooping-cough, 48 (9) from diphtheria, 49 (11) fromdiarrhcea and enteritis under two years, and 70 (8)from influenza. The figures in parentheses are thosefor London itself.The only death from enteric fever outside London occurred

at Edmonton. Five deaths from measles were reported fromBirmingham, 4 from Liverpool, and 3 from Walsall. No greattown reported more than 2 deaths from whooping-cough.Liverpool had 3 fatal cases of diphtheria, West Ham, Man-chester, Preston, Sheffield, Birmingham, and Burton-on-Trenteach 2. Of the deaths attributed to influenza 9 occurred atManchester, 5 at Bradford, and 4 at Leeds.

The number of stillbirths notified during the weekwas 274 (corresponding to a rate of 38 per 1000 totalbirths), including 43 in London.

THE SERVICES

ROYAL NAVAL MEDICAL SERVICE

Surg. Rear-Admiral H. R. H. Denny, C.B., has beenappointed Hon. Surgeon to the King, from May 8th, inthe vacancy caused by the retirement of Surg. Rear.Admiral W. W. Keir, C.M.G.

Surg. Comdr. J. H. B. Crosbie to Drake for R.N.B.Surg. Lt.-Comdr. C. Keating to Victory for R.N.B., and

to St. Angelo for R.N. Hospl., Malta.Surg. Lt.-Comdrs. G. Rorison to Faulknor, on commg.,

and J. M. Sloane to Victory for R.N.B.Surg. Lts. (Short Service) S. K. Foster, J. W. Oliver,

H. de B. Kempthorne, F. M. Duthie, and T. McCarthy,transferred to permanent list, with original seny.

Surg. Lt. F. M. Duthie to 7on/ for R.N.B.

ROYAL NAVAL VOLUNTEER RESERVE

Surg. Lt. J. E. L. Morris and Proby. Surg. Lt. J. L.Dunlop to T-ivertol1.

Proby. Surg. Lt. (D.) J. W. W. James, L.D.S.U., to beSurg. Lt.

ROYAL ARMY MEDICAL CORPS

Short 5eri. Commissions.-G. S. Musgrove to be Lt.(on prob.), Lt. (on. prob.) G. C. Dansey-Browning is seed,under the provisions of Art. 213, Royal Warrant for Payand Promotion, 1931.

Temp. Commissions.—Maj. F. C. Doble relinquishes hiscommn., and retains the rank of Maj.

REGULAR ARMY RESERVE OF OFFICERS

The undermentioned having attained the age limit ofliability to recall, cease to belong to the Res. of Off. :-Col. W. R. P. Goodwin, D.S.O. (late R.A.M.C.), Maj.G. H. Rees.

TERRITORIAL ARMY

Capt. G. T. Symons to be Maj.TERRITORIAL ARMY RESERVE OF OFFICERS

Lt.-Col. W. D. Sturrock, D.S.O., having attained theage limit retires and retains his rank, with permission towear the prescribed uniform.

ROYAL AIR FORCE

The undermentioned are granted short service com-

missions as Flying Officers on probation for three years onthe active list, with effect from May 7th, 1935 :-R. C. H.Tripp, P. A. Cooper, L. E. A. Dearberg, H. L. Willcox, andA. R. C. Young.

Flight Lt. P. D. Barling is promoted to the rank ofSquadron Leader.Wing Comdr. A. J. Brown, D.S.O., is placed on the

retired list.Dental Branch.-Flying Offr. R. H. Marthews, L.D.S.,

is promoted to the rank of Flight Lt.Flying Offr. A. W. Smith to R.A.F. General Hospital,

Hinaidi, Iraq.INDIAN MEDICAL SERVICE

Lt.-Col. W. J. Simpson retires.Capt. S. S. Ahluwalia resigns his temp. commn.Indian l6ledical Department.—The undermentioned

retire : Maj. (Sen. Asst. Surg.) F. W. Holmes and Maj.(Se.1. Asst. Surg.) R. H. G. Thompson.The list of earthquake casualties reported from Quetta

includes the names of Lt.-Col. B. C. Ashton, I.M.S., andMajor J. G. Bird, I.M.S., amongst the injured.

BRIGHTON AND HOVE DENTAL HOSPITAL.—Owingto continued lack of support the work at this hospitalhas had to be curtailed. The move to the presentbuilding in Buckingham-road, Brighton, from the inade-quate accommodation in Queen’s-road, has been fullyjustified ; but the mortgage remains an anxiety and aburden. Until it is paid off it will be impossible to buyan X ray apparatus. It was stated at the annual meetingof the governors that the income from subscriptions lastyear was only .E37. A special appeal is to be made in theautumn. The institution was established in 1887 and willobserve its jubilee in two years’ time.