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while stroke cultures were made on potato gelatine. He

afterwards adopted the method of direct inoculation fromthe stock bouillon tube into tubes of gelatine peptonebouillon which were then poured out into Petri plates.Some inoculations were also made on spleen gelatine pre-pared with fresh bullock’s spleen. The result was that with

the 20 specimens of fasces he found typical typhoid bacilli inonly 2 cases. In 8 others he found a bacillus which gavesome of the reactions both of the typhoid bacillus and of thebacillus coli and which he accordingly called the ’’ inter-mediate" bacillus. In the 16 samples of urine he foundonly 1 colony of typhoid bacillus, and even this one wasdoubtful. On the other hand he found a coliform bacillusin 8 cases out of the 16. It was somewhat larger than theone usually found in the stools, but after some growths onagar they were indistinguishable and their reactions weresimilar.

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THE NEW VACCINATION ACT.

A CIRCULAR has been issued from the Local GovernmentBoard to the clerks of the various boards of guardianspointing out that although the Act in its entirety does notcome into force until Jan. 1st, 1899, the provisions ofSection 2 became law on the passing of the Bill. Thissection contains the much-discussed conscience clause.

THE WORKMEN’S COMPENSATION ACT: ACIRCULAR LETTER TO THE MEDICAL

REFEREES.

A CIRCULAR letter has been sent by the Home Office tothe medical referees enclosing copies of the various officialforms which will have to be filled up in the working of theAct and calling their attention to the dual nature of theirduties. The first and most important function of a medicalreferee is to act as adviser to arbitrators or judges ; buthe has a second responsibility bringing him into relationwith the injured workman rather than with any court orcommittee of arbitrators which it will require considerabletact and judgment properly to discharge. Schedule 1 (11)of the Workmen’s Compensation Act runs as follows:-

, Any workman receiving weekly payments under this Actshall, if so required by the employer, or by any personby whom the employer is entitled under this Act to beindemnified, from time to time submit himself for examina-tion by a duly qualified medical practitioner provided andpaid by the employer, or such other person ; but if the work-man objects to an examination by that medical practitioner,or is dissatisfied by the certificate of such practitioner uponhis condition when communicated to him, he may submithimself for examination to one of the medical practitionersappointed for the purposes of this Act, as mentioned in theSecond Schedule to this Act, and the certificate of thatmedical practitioner as to the condition of the workman atthe time of the examination shall be given to the employerand workman, and shall be conclusive evidence of that con-dition. If the workman refuses to submit himself to suchexamination, or in any way obstructs the same, his right tosuch weekly payments shall be suspended until such examina-tion has taken place."The Home Secretary in his letter reminds medical refereesthat he is not empowered by the Act to make any regulationas to the mode of carrying out this duty, but that care mustbe taken by the medical referee not to give the certificatesin any circumstances other than those specified in the Act.The fee for the examination and subsequent certificate is

payable not by the Treasury but by the workman himself,who, says the Home Secretary, ’’ may be required to pay areasonable fee before the examination is made " ; but thereferee is asked to remember in determining the amount ofhis fee that it is the workman who has to pay it and that

only in some cases will he be able to recover it from his

employer later. This second duty of the medical referee,

if not so important as his main duty of acting as a judicialassessor, is certainly a very delicate one. He will be sitting-in judgment, perhaps, upon the diagnosis of a professionalbrother.

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MILK AND INFANTILE MORTALITY.

A PAPER by Dr. Lemiere which is quoted in the -journal!de Clinique et de Th6ralpeiitiqite Infantiles discusses the

relation long since recognised as existing between milk-supply and infant mortality. The statistics given are chieflythose of the city of Lille. Among other points of interest.noted by the writer is the fact that the death-rate undertwo years of age in that city is 398’6, and in one parish.it has risen to 520, for every 1000 deaths recorded. A-

large proportion of these is attributed to gastro-enteritis,which is most prevalent in districts inhabited by the-

working classes, the comparative mortality between a richand a poor district selected for illustration being as 1 to 7.Gastro-enteritis is, as a rule, a preventable disease and this:fact is fully admitted in the article to which we have referred-It is satisfactory to find that its explanation is sought for-where it is most likely to be found-namely, in the dietadministered. With regard to this Dr. Lemiere makes two-practical observations-one in which he accuses the employ-ment of watered milk as a cause of malnutrition and the other

in which he advocates efficient sterilisation and general carein feeding. Too much importance can hardly be attachedto these remarks, especially during the present sultryweather. It is true that they teach nothing new, but theyremind us of precautions which should never be but

constantly are forgotten. We do not dispute the influ-ence of subsoil water as a factor in the production of’infantile diarrhoea, but we recognise as of equal!and even greater importance the quality of the infants’ milk-supply. The former consideration is in a great measure-ultra vires, the latter is at all times within our control. If"

this control is applied with judgment and vigour the climatic’and subterranean evils may often be entirely counteracted..Nothing, therefore, in domestic management is more.

important than care in the selection of the milk used;and in its after-treatment. The health of the cattle pro-

ducing it, of the people who sell it and the cleanliness of

persons and vessels connected with its sale are as mucb.the concern of a nurse or mother as is its actual preparationfor the infant. As a rule mothers in this country understand3the importance of cleanliness in all the manipulations of’artificial feeding. Nevertheless they are frequently im

error. They are very apt to under-estimate the value offresh air, especially at night, and many an infant is.

poisoned with milk which has fermented in a close bedroom..We need hardly impress upon medical practitioners the:

necessity of instructing their patients in this matter and

also with regard to the means adapted for the ready sterilisa-tion not only of milk but also of the vessels in which it iscontained and administered.

THE SILENT STRAND.

THE Strand without bustle and activity is no longer the.’Strand. By a ukase issued last week the Strand has been,closed for traffic and sure and certain signs of the pavior-coming along were evident to everybody by the accu-

mulation of black wooden’ blocks upon the pavements,of this thoroughfare. At the time of writing the Strand,is "up" and those whose business is conducted within.its precincts begin to enjoy a respite from vehicular-clatter and also from sundry other street noises. The,,relief is perhaps most marked to those who, like our-

selves, are engaged upon literary work. The appearancesof the great historic street, however, in spite of its usual

distracting condition, is somewhat depressing. One thing is

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clear and that is that the biggest factor in the vehiculartraffic is the omnibus, and this is essentially the vehicle whichcarries people to and fro through London’s great artery.Despite the drawbacks which result from the congested con-dition of a street by the enormous traffic passing along inboth directions there can be little doubt that this fact, afterall, possesses a hygienic importance. The air of the Strand is

now quite stagnant, an observation which has been madeby a good many who use the thoroughfare. The lumberingomnibus is a big vehicle and in proceeding down a streetpushes a volume of air in front of it, thus establishing animportant degree of circulation. Hence the much-abusedomnibus serves, so to speak, like a plunger in a cylinderchasing air in front of it and inducing fresh air to take itsplace. This process going on in both directions must havean important influence on the air of London’s streets,for so narrow are some of our thoroughfares that the

air is hemmed in, but the voluminous omnibus in its

onward course tends to stir this up and to obviate stagna-tion. So we have an important compensation, perhaps, forthe evils arising from the employment of animal power inour streets. Oddly enough, the hundred-and-one other streetnoises seem to have disappeared with the diverted traffic,except, however, that perennial curse the newspaper boy,whose irritating cries are more in evidence than ever, beinguntempered by vehicular noise. But we are no longerworried beneath our windows with a most exasperatingtoy which is regarded as imitating the utterance ofchanticleer. People in the country know well that whenthis is produced by the bird itself it is sufficiently dis-turbing, but when the cry of the early bird is imitated ona toy it is almost beyond human endurance.

LAWLESSNESS IN THE STREETS.

ON August 8th Mr. Massey Mainwaring asked the HomeSecretary a question concerning lawlessness in the streets andreceived the following typical ministerial answer :-

’’ I have received representations from the vestry on thissubject, but after making inquiries I was not satisfied thatthere was any such insecurity as was alleged or such a con-dition of lawlessness that the existing force of police in thedistrict were unable to cope with it. In certain districtsthere is doubtless more street rowdyism than in others, dueto the general character of the population, but as far as thepolice are concerned active steps are taken by them tosuppress any disturbances and to arrest offenders. Thematter is, of course, of some importance, and I shall notlose sight of it."It used to be said that nothing would be done to preventrailway accidents until a director or two had been killed.Are we to wait until a Home Secretary has been garrottedor knocked down and severely kicked before the policeare given some more valuable weapon than a truncheonand are authorised to use it or until magistrates can ordersome more suitable punishment than a paltry fine whichis always paid by a whip round of the prisoner’s friends ? 7The one and only remedy is the "cat"; it is cheap andefficacious. It did away with garrotting in the "sixties"

"

and everyone will remember how Mr. Justice Day brokeup the " High Rip Gang" " in Liverpool by the use ofthe same means. Fines are useless, and prison is far toocomfortable for Hooligans. Gymnasia and I education " mayaffect the budding Hooligan but not the full-grown plant.Since the Home Secretary’s Epicurean answer hardly a dayhas passed without a case of violent assault being reportedin the daily press.

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THE ADULTERATION OF COFFEE.

ON reflection we should not think that the method ofadulteration about to- be described is " new," for it seems tou.s that it offers some explanation of the wooden character I

of the coffee infusions which are commonly offered to thepublic in this country. Coffee affords a most excellent

beverage, but nobody seems to be able to get it good,and this is probably the reason why the consumptionof coffee is rapidly declining. But the material must,of course, be good and fresh, with all the aromatic

oils preserved intact. We have heard that by coat-

ing the roasted berries with a thin film of gelatin thedelicious aroma of freshly roasted coffee may be indefinitelypreserved. But this step would be quite futile in view of the"new" adulteration. This consists in washing, colouringand drying the berries in centrifugal machines with sawdust,with the result that the crevices of the berries become filledwith powdered wood which is said to make them of a fine

white colour, and thus to enhance the market value of theproduct. This ingenious but immoral process is said to be

carried on in Hamburg, Bremen, Antwerp, and Rotterdam,and we respectfully request our Customs authorities to keepa sharp look out on the consignments of coffee coming fromthese places in spite of the market value, as it is said, being-thus enhanced.

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THE DENTAL HOSPITAL OF LONDON.

WE are pleased to learn that the difficulties which have-for some time hampered the action of the Committee of

Management of the Dental Hospital of London have beenovercome and that the contract with the builder for thenew hospital is now signed. The building is to be finishedin twenty months, and the fact that definite arrangements.have at last been made must be very satisfactory to LordKinnaird and Mr. F. A. Bevan, the trustees, and Dr.

Joseph Walker, the honorary treasurer, who have worked

very hard to attain this end. We hope that the

public will help forward the work by donations and

subscriptions. So far the dental profession has con-

tributed 7000 and the public about the same amount,while some .E30,OOO are still required to discharge theliabilities incurred. The Dental Hospital has a distinct

claim on public generosity over and above the value of itswork. Mortgage had to be incurred when the buildings onthe new site were demolished two years ago by the order ofthe London County Council, while the hospital lost a revenueof .E1200 a year, which sum the Committee of Management.intended should accrue to help to pay for the new building.

NEW MEDICAL INSPECTORS OF THE LOCALGOVERNMENT BOARD.

WE are informed that the two temporary medical

inspectors to the Local Government Board who were sanc-tioned under the report of the Treasury Committee of

August, 1897, have at last been appointed. The difficultieswhich have caused such long delay have been owing firstlyto the fact that a permanent increase of work called forpermanent and not temporary appointments, and secondly tÛ"

the circumstance that when the appointments were at lastoffered it was naturally found that some of those nominatedcould not abandon permanent posts which they then held forthe sake of temporary ones. At last, however, all difficultyhas, for the moment at least, been removed. Dr. L. W.Darra Mair, the well-known medical officer of health of the

Croydon Rural District, has obtained one year’s leave ofabsence from his duties in order to accept one of the postsin question. The other post has been conferred by Mr.Chaplin on Dr. Ralph W. Johnstone. Both of the new

inspectors hold the Diploma in Public Health.

A TELEGRAM from Hong-Kong was received on Mondaymorning last by the Colonial Office reporting that only one:case of plague occurred last week.