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greatest injury had been done where strikes and labour dis- turtances prevailed. The carriage of sterilised milk suppliedby the corporation for the use of infants of the poorerclass had been seriously interfered with. The city presentedthe appearance of a besieged city with its barricaded shopwindows. This precaution was adopted as many shops,especially in the lower parts of the city, were looted by thehooliganism which disgraced the city. The strikers are

acquitted of taking part in this ruffianly conduct.

English Cholera in Mid- Cheshire.The Northwich urban and rural areas are suffering from an

epidemic of English cholera, or summer diarrhoea, themedical officer of health estimating the cases at fully 500,chiefly children under 18 months. The deaths have numbered50 The outbreak is attributed to the long spell of hotweather, with the attendant contamination of milk and otherfood-supplies and interference with drainage. The medicalofficer of health has advised the boiling of all milk consumedby children, and regards flies as a fruitful cause of spreadof infection.August 29th.

BRISTOL AND THE WESTERN COUNTIES.(FROM OUR OWN CORRESPONDENT.)

Serious Accident to a Bristol Surgeon. Dr. H. G. Kyle, one of the surgeons to the Bristol General

Hospital, met with a serious accident while travellingthrough Shropshire on a motor cycle. The exact reason forhis fall is not known, but the resulting injuries to the headand right shoulder are very severe, and his condition givescause for grave anxiety. Dr. Kyle has a wide circle offriends in Bristol, and they are receiving information dailyfrom his relatives who are staying with him at the house towhich he was taken after his fall.

A Plague of Crickets.During the hot weather the Bristol health committee was

confronted by an unusual problem. Robertson-road, East-ville, was for several weeks swarming with crickets. Thecentre of attraction appears to have been a heap of refusedeposited by the authorities at the neighbouring workhouse,but the houses in this and other streets were freely invadedby hosts of insects. Various insecticides were tried ; carbolicacid and lime were ineffective, and petrol, which was moreefficacious, was too costly for wholesale use. Fortnnately,the end of the trouble came when the hot weather passed ;but while it lasted the people of the district were put to veryserious inconvenience.

The Bristol Guardians and Hospital Accommodation.The Bristol board of guardians is at present much exercised

as to the means of providing adequate hospital accommodation.A scheme for demolition of existing premises on a large scalewith erection of a new building has been passed, but it is

being opposed by a strong minority, who plead for a smallerand more economical change in view of the present uncertainstate of Poor-law affairs. This difEerence of opinion has beenproductive of many debates, some of them more conspicuousfor heat than light. There is no doubt that it is a very seriousmatter, for the scheme which has received the sanction of themajority is a costly one. It is an interesting fact that onepart of the doomed premises at Fishponds was built in theeighteenth century as a prison, and was used for years for theincarceration of prisoners of war.

Medical Practitioners and Public Servants.At the last meeting of the Bristol board of guardians a

letter was read from the guardians of the Merthyr TydvilUnion enclosing a copy of a resolution adopted by them asfollows :-That this board, being of opinion that it is better to pay for the pre-

vention of disease rather than for the cure of same, believes that thetime has now arrived when the medical practitioners of this countryshould become public servants. That copies of this resolution be sentto the President of the Local Government Board, local Members ofParliament, and to all boards of guardians in the country.The Bristol guardians, after a slight discussion, dropped thematter.

Rural and Urban School Children.The school medical officer of Wilts (Dr. R. H. Bremridge),

in his annual report for 1910, which has been recently

issued, states that the rural children are superior to theurban children in every physical characteristic of which hehad taken notes, the rural standard of cleanliness is better,and the advantage of the rural over the urban area in thematter of height and weight was demonstrated.

The Royal Albert Hospitszl, Devonport.At a special meeting of the governors of the Royal Albert

Hospital it was decided to realise stock value £1083 and todevote the proceeds to the general maintenance fund. Itwas stated that, under the most careful management, theexpenditure had for many years exceeded the income byabout £800 per annum, and the present adverse balanceagainst the hospital was .f.2640.

The Water-supply of Ilsington (Devon).A Local Government Board inquiry was recently held at

Ilsington into an application of the Newton Abbot ruraldistrict council for sanction to borrow .f.4900 for the purposeof water-supply.

Spotted Fever in the West of England.At the last meeting of the Holsworthy (Devon) rural

district council the medical officer of health (Mr. W. G.Gray) reported eight additional cases of "spotted fever,"with three deaths. He asked the council to provideshelters and isolation accommodation, but this was not

granted, and the matter was adjourned for a fort-

night. There is a feeling of great dissatisfaction at theattitude of the Holsworthy rural district council in not sup-porting their medical officer of health, whose action hasbeen warmly commended by the Local Government Boardinspector (Dr. R. J. Reece), and also by the medical officerof health of Devon (Mr. G. Adkins). The local press basmade several strong comments upon the council, and theWestern Morning Ne7vs urges the interference of the LocalGovernment Board. The Tavistock (Devon) rural district.council, owing to two cases of spotted fever having occurredin its area, and acting upon the advice of its medicalofficer of health (Mr. C. C. Brodrick), decided to provideisolation accommodation for the district and to make thedisease notifiable.

Sanitary -Inspectors and the Local Government Board.At the last meeting of the Redruth (Cornwall) rural dis-

trict council it was reported that the Local GovernmentBoard had refused to sanction the appointment of a certainsanitary inspector for a portion of the district. The LocalGovernment Board stated that its inspector (Dr. S. W.Wheaton) had informed the Board of the unsatisfactory stateof the district, and it was not willing for such a state ofthings to continue. The Board therefore urged the councilto appoint a qualified sanitary inspector for the whole district,and to give him an adequate salary.

Death of William Steer Riding, B.A. Lond., M.D. Edin.,M.R.C.S Eng. L.S.A.

Dr. William Steer Riding died at his residence,"Stamlands," Buckerell, Devon, on August 19th, in his

seventy-sixth year. Dr. Riding, who graduated as M.D. atEdinburgh University in 1857, had at one time an extensivepractice in London, where he resided at Endsleigh-gardens,Easton. square. He retired from active work about 20 yearsago and took up his residence at Buckerell, near Honiton.He was very popular in the district, and the poor have lostin him a good friend. He leaves a son and two daughters tomourn their loss.

I August 29th. __________________

WALES.(FROM OUR OWN CORRESPONDENT.)

The Treatment of Consumption in Newport. FoiR several years past the Newport board of guardians

has had special accommodation for consumptive patients. A

large house, apart from the workhouse and in its own grounds,has been utilised for the special treatment of these caes,and by the erection of huts as many as 37 patients can beaccommodated at one time. The corporation has erected a.wooden pavilion in the grounds of the isolation hospital forthe accommodation of ten patients, and in his annual reportfor 1910 the medical officer of health, Dr. J. Howard-Jones,states that during the year there were treated in this pavilion

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102 patients. Unfortunately, as in previous years, the ,majority of the patients were in an advanced stage of the ’,disease. Some had not sought advice unuil their chances ofrecovery had become imperilled, while others, though undermedical treatment, had not been informed until a late periodof the nature of their ailment. Notwithstanding this draw-back, Dr. Howard-Jones considers that the results attainedby the segregation of cases in an infectious stage fullyjustify the cost entailed. As a rule, each patient stays in theinstitution for one month ; in exceptional cases for a longerperiod. On returning home they are encouraged to keep intouch with the medical officer of health. They are visited intheir homes and are urged to carry out the lessons inculcatedduring their stay in the sanatorium.

the Nursinq Arrangements in Dolgelly Wor7zhouse. ,

At a recent meeting of the Dolgelly board of guardiansMr. Hugh Williams, Poor-law inspector of the Local Govern-ment Board, urged very strongly the appointment of atrained nurse for the workhouse infirmary. At present, hesaid, only about 20 per cent. of the workhouses of the

country were unprovided with trained assistance. The rateof pauperism depended upon the way the Poor Laws wereadministered, and there was no doubt that if the amount ofsickness could be reduced by proper nursing a considerablesaving would be effected in the cost of relief. The medicalofficer, Mr. John Jones, endorsed the recommendation andstated that the patients then in the infirmary required carefuland skilled attention. The proposal was opposed by severalmembers of the board, apparently on financial grounds,though one guardian openly avowed that he had no faith indoctors or nurses, and stated, in all seriousness and as an un-answerable argument, that there were several cases in whichpatients had died after being nursed. In the end decisionon the question was postponed for two months.

West .Wales Joint Asl2cm.The dispute which has been going on for many years past

between the county authorities of Cardigan, Carmarthen,and Pembroke, with respect to certain charges connectedwith the asylum belonging to those bodies, has at last beenbrought to a satisfactory termination. Many improvements,including arrangements for proper classification, are nowrendered possible, and suitable additions to the asylumbuildings will lessen the existing overcrowded state of theinstitution, in which the number of inmates on March 31stlast was 687. In his recently issued annual report themedical superintendent, Dr. John Richards, refers to the

importance of keeping under surveillance patients dis-

charged as recovered. He suggests that they should bemedically supervised and, when necessary, monetarilyassisted for several months after leavi" the institution.One male patient died during 1910 at the age of 106. Hehad been an inmate of the asylum from the date of itsopening in 1865.

The Rhondda Health Report,The’ population of the Rhondda urban district at the last

census was 152,798, an increase of 39,063 upon that recordedin 1901. There are now only 18 county boroughs and oneurban district, that of Willesden, with populations exceedingthat in the Rhondda valleys. In his annual report for 1910the medical officer of health, Dr. J. D. Jenkins, refers atlength to the infantile mortality, which has always beenhigh in the district, averaging in the past ten years 178 per1000 births. In 1909 it was 129 per 1000 and 136 in 1910.During these two years two health visitors have been

employed in the district. It appears, however, that theirwork was restricted to one portion of the district in whichthe infantile mortality rate in 1910 was 142 per 1000,while in the remaining portion of about the same populationthe rate was only 130 per 1000. The death-rate from diarrhoea,which was 0- 29 per 1000 in England and Wales in 1910, was0- 83 per 1000 in the Rhondda, and of those who died fromthis cause over 80 per cent. were under one year old. As theRhondda is essentially a water-carriage locality, and as thereis no storing of household refuse in the immediate vicinity ofdwellings, it is necessary to seek for some cause of this pre-valence of diarrhoea other than that which is to be found inhe northern counties-namely, privies and dustbins. It

appears, however, that although there is a daily removal ofrefuse from the dwellings in the Rhondda, it is carted to

huge mounds at no great distance, and Dr. Jenkins states

that these " tips " afford a suitable breeding-ground for flies,an excessive number being noticeable in the houses nearestto the accumulated refuse. He asserts that the abolition ofthe I I tips " will be instrumental in reducing the death-ratein the locality concerned, and especially so amongst youngchildren. There are no less than 200 loads of refuseto be dealt with daily, , only about one-tenth ofwhich is disposed of in the destructor erected in1900. Power has been sought, however, to purchase landand to erect destructors in four different parts of the district,and also to use the existing tramways to convey the refuse tothe destructors. The erection of these destructors is withoutdoubt the most urgent matter claiming the attention of thecouncil. The staff of six sanitary inspectors, which has notbeen augmented for 12 years, and which has only beenincreased by one since the time when the population of thedistrict was half that of the present time, appears quite in-adequate for the proper carrying out of the duties imposedby the Local Government Board. Dr. Jenkins states thatamong the subjects which have to be neglected owing to theinsufficiency of his staff are the inspection of meat and foodsupplies, measures specially aimed at the prevention of

pulmonary tuberculosis, inspection of the gathering groundsof the many different areas of water-supply, and the sanitaryadministration of workshops and workplaces.August 29th.

SCOTLAND.

(FROM OUR OWN CORRESPONDENTS.)

II Proposed New NÚrsing Home for Edinbnrgh.THE executive committee of the proposed new nursing

home for Edinburgh has acquired a block of three housesin Chalmers-street, Edinburgh, as the site of the new home.Of the £ 10,000 required a sum of E8640 8. 1ld. has nowbeen subscribed. The home, it is expected, will be self-

supporting.Yol1mta’l’Y Health Visito’l’S of the City of Edinbcrgh.

The work of the voluntary health visitors in connexionwith the Public Health Department of the city of Edinburghcontinues to maintain the satisfactory level of efficiencywhich was reached in the first years after the initiationof the scheme. The medical officer of health, in his reportfor 1910, announces a reduction in the rate of infantile

mortality from 113 in 1909 to 103 in 1910, and states :’’ There can be little doubt that, in addition to the generalimproved sanitary condition of the city, much of thisresult has been obtaineu through the sustained effortson the part of the large body of voluntary lady healthvisitors who for some years past have dealt with this wholequestion in a manner which can only be characterised asthorough in every detail." The Notification of Births Act

gives to the ;public health department knowledge of thebirth of a ,child within 36 hours, and in the cases wherenotices come from homes where no paid medical man hasbeen in attendance visitation of the infants is under-taken. As soon as possible after receipt of the notifi-cation the official lady health visitor pays an

initial visit, and then passes on slips with the in-formation to the secretaries of the voluntary visitors.The secretaries receive the notices each week, distribute thecases to the captains of the various areas, and the captains inturn distribute them to the individual visitors. The visitorsare required to visit fortnightly-and much oftener in caseof illness-while after each fortnightly visit a report of thecondition of the child has to be made out on a printed formand given in to the public health department. In the endof 1910 there were 267 ladies engaged in the work and 149infants were under visitation. The total number visited

during the year was 2395. During the winter of 1909-1910three sets of five lectures were delivered to the visitors,the subjects being "Infant Life," by Dr. BeatriceRussell; "Infection," by Dr. John Thomson ; and "SomeMethods of Charity," by Mrs. George Kerr, honorarysecretary of the City of Edinburgh Charity Organisa-tion Society. The visitors attending the lectures were

charged 2s. 6d. for each set, and this charge more thancovered the expenses of the lectures, including the lecturers’fees. Voluntary health visiting, as carried on in Edinburgh,is a demonstration of how satisfactory and efficient such