926 BIRMINGHAM.

in their statutes a clause establishing a system of conciliation andarbitration for the settlement of differences or litigation that may arise Tbetween members of the profession or with private individuals but thatinterest the medical profession. This Congress further urges theimportance of keeping young medical practitioners well informed oftheir duties towards their feUow members of the profesion:-1. Bylessons and lectures on deontology given at the universities. 2. By thedistribution of codes of deontology, drawn up by the examining juriesand medical committees.

When this motion was carried, Mr. ADOLPHE SMITHwas invited by the President to give an account of theorganisation of medical unions in England. As Liege isa great mining centre, Mr. Smith insisted especially onthe success of the Northumberland and Durham medicalunions in raising the payment made to the colliery surgeonsfrom 6d. to 9d. per fortnight. The PRESIDENT expressed thegratification with which the Congress heard of the goodprogress achieved by its medical brothers of Great Britainand a very cordial vote of thanks was given to Mr. AldolpheSmith for his encouraging communication.On the second day a report was read, and a discussion

followed, on the purely local difficulty which exists on theBelgian frontier. It sometimes happens that the nearestpractitioner lives on the other side of the frontier and thusFrench and Belgian medical men are constantly crossing thefrontier and interfering with each other’s practice. This hasled to many diplomatic communications, conventions, andcomplications, and yet none of the parties concerned seemsatisfied. Now a new factor is coming on the scene.

The Congress resolved that the Belgian medical unionsshould appeal directly to the French medical unions ardthat they should jointly endeavour to find a solution ofthe difficulty and invite their respective Governments to actaccordingly.The question of the inspection of schools was next intro-

duced but not without protest, for it was considered a specialmatter, not directly concerning professional medical interests.Nevertheless, on the proposal of the PRESIDENT the followingmotion was adopted :-That the medical inspection of schools and school children being a

public service interesting the community at large, the Congressexpresses the desire that this service shall be organised throughout allthe schools of the country and confided exclusivelv to medical men paidfrom subsidies given by the State, the provincial, or the communalauthorities.

This resolution is important, for its application wouldmean that in all matters relating to the health of thechildren the secular sanitary authorities would control theclerical schools.The next important matter discussed was what in England

would be described as the medical treatment of paupers.There are in Belgium no workhouses and no Poor-law

system but each commune is supposed to appoint and pay apoor man’s medical attendant, who must attend those whocannot afford to pay a private practitioner. How this isdone was shown by figures given by Dr. Deneffe con-cerning 264 communes of Eastern Flanders. Of these, 21only paid their medical officer for the poor .62 perannum, 22 communes paid .63, and 33 paid from .f’.3 to£4. Then 66 communes paid from E4 to .f’.8. More thanhalf the communes paid from .62 to £8. There were 47communes giving from .68 to .610. 35 from £12 to £16, 25from .616 to .620, six from .620 to £24, and 10 from .624 to.628. One commune paid .630, one .f’.34, and one .636. Where,however, the larger sums are given the work is sometimedivided between two practitioners. For such inadequateremuneration the poor man’s medical attendant mustattend lying-in cases, provide bandages, antiseptics, and,indeed, if he does his work fully it will cost himas much as, or more than, he receives. Inl"ufficient as isthis payment a public inquiry made in 1895 revealed’the fact that in the surrounding districts of Brussels,Charleroi, Huy, and Liege out of 345 communes only85 had appointed a medical officer for the poor. Asfor payment in proportion to the population, there isno rule. Thus at Anglcur it was E4 per annum per 1000inhabitants ; at Awir.-, E2 per 1000 ; at Flémel1e-Grande, .&4per 5000 inhabitants ; at Vevegins, E3 for 1700; and atTheux E4 are divided between two medical practitioner-,and the population is set down at 5000 souls. After hearingthese and many other details the Congress adopted a propo-i-tion stating that the organisation of the service for givingmedical assistance free of charge to the indigent was amatter of urgent necessity. The poor should, the propositionwent on to say, be free to select the medical attendant theypreferred. The latter would be paid by the local authoritiesaccording to a tariff to be prepared and drawn up by the

Academy of Medicine, the Superior Council of Hygiene, themedical commissions of the various provinces, and the-Federation of the Medical Unions of Belgium.A few other matters of minor importance were discussed

and the labours of the Congress concluded.

MEETING OF THE BELGIAN MEDICAL PRESS ASSOCIATION.

Those members of the Congress who were medical journal--ists remained and a meeting of the Belgian Medical PressAssociation was held. The Executive Committee or Bureauwas re-elected and consists of Dr. Dejace, president ; Dr.de Bussher, vice-president ; and Dr. Pechere, secretary.The latter gentleman, it will be remembered, is treasurerof the International Medical Press Association. Thenthere was some discussion concerning the forthcomingInternational Congress of Medicine at Lisbon and the

organisation of a service of information for the medicalpress. Finally a resolution was passed blaming thepromoters of some of the scientific congresses recentlyheld at Liege, who, while very pleased to have notices in-serted in the press, had given themselves but little troubleon behalf of the representatives of the medical journals.The resolution goes on to state that the members of theBelgian Medical Press Association will no longer publishnotices concerning congresses unless the organisers of thosecongresses send, with such announcement, a press card andundertake to give the representatives of the medical journals !all the facilities necessary for the accomplishment of their work. Finally a banquet united together those who are enaged ’

in the useful work of organising the medical profession and themedical press. It is anticipated that such meetings willtake place every year and thus the medical unions of Belgiummay continue to gather strength.

BIRMINGHAM.(FROM OUR OWN CORRESPONDENT.)

Ihe Warlpy Woods: : a Lung for Birmingham.IN previous letters I have referred to the strong agitation.

which is being carried on by a number of Birminghamgentlemen, notably by Mr. A. M. Chance, to procure WarleyWoods as a public park for Birmingham and district. The-agitation began some months ago when it was learned thatthe woods were to be sold for building sites and that thefelling of the timber had already commenced. Mr. Chanceat once interested himself in the question and on his-initiative a subscription list was opened with the view of

raising the necessary sum for the purchase of the woods and

if possible for an extension of the adjoining Lightwoods

Park, in all an area of 27 acres. For these two objects thesum required was .613,000 ; this has now been obtained. But

having gone so far and having been encouraged by the readyresponse to the appeal, the committee which has hadthe business in hand is of opinion that it should go stillfarther and acquire the whole of the Warley Abbey estatewhich would give to Birmingham a beautiful woodland parkof 100 acres. For this a further £33,000 are asked and

’

already donations of £3000 and E500 have been promised. Asubscription list has been opened by the Birmingham Daily

’ ltTail and more than £200 are already announced. So farthe Birmingham, Smethwick, and Oldbm y councils have madeno contributions, although many, including the Right Hon.

’ Mr. J. Chamberlain, M.P., advocate their doing so. The, feeling which the councils seem to sl are is that the pro- vision of such a park is a luxury rather than a necessity and

that they n consequence cannot call upon the ratepayers to’ contribute collectively.

Local Serverage Schemes.s For some time past the methods of dealing with the sewageDat Oldbury have been considered very unsatisfactory and4finally the Staffordshire county council has taken proceed-,t ings againat the authorities. Prior to this. however, the local, council sought the advice of Professor Frankland and Mr.g H. Silvester, who have conducted a series of experimentsi- extending over a period of two years and who recommendg reconstruction of the works. They are of opinion that thea best means of dealing with the sewage its the contact-bedn system, requiring ten acres of contact beds, and the sewage:y to be treated three times. It is, however, pointed out that’s if they had not to deal with the refuse from certain neigh-ie bouring alkali works five acres of beds would suffice and

927BIRMINGHAM.-MANCHESTER.

there would be no necessity to pump the sewage ; a saving 1would in that case be effected of £600 per annum. A good Ideal of the plant at present in use at the sewage farm,including filter materials and beds, will have to be sacri-ficed under the scheme, the whole cost of which is esti-mated at .819,000. The council will be recommended at (

its next meeting to adopt the scheme and the fact, tthat for some months pat an effluent has been obtainedby the method suggested capable of sustaining fish will no doubt have its proper weight.-Difficulty has arisenat Worcester in connexion with the payment for the outfallsewers and the tunnel beneath the river, owing to the originalestimate having been exceeded by more than £4000, despitethe fact that the tunnel and the two sets of iron pipes hadbeen reduced, the former from 8 feet 6 inches to 6 feet6 inches and the iron pipes from 2 feet 6 inches to 1 foot8 inches, a change which, it was thought, would effect a

saving of at least &1200. The amount in dispute has beenreferred to arbitration.

The Small-pox E .pidemic at Nuneaton.The cases of f mall-pox at Nuneaton now number over 60.

It was hoped that the epidemic would be confined to onepart of the town but unfortunately cases of the disease havemade their appearance in several directions. A large pro-portion of the patients are unvaccinated children.

Local Guardians and the Tramp Question. i

At the last meeting of the Birmingham board of guardians a letter was read from the e clerk to the King’s Norton board (of guardians suggesting that a conference should be held by the Birmingham, King’s Norton, and Aston boards to con- isider the tramp question and discuss the advisability of the tcontinuance ef three separate tramp wards for the city andits immediate surroundings. It has been pointed out thatit is not the feeding of the tramps which is the importantexpense, for the cost of bread and cheese is 2½d. per head,and if gruel is also given it only cots another ld.each. The chief cost is in providing sleeping accom-

modation and in keeping the casral wards clean. It is

expected that five representatives will be appointed byeach of the three boards to confer as to the advantages (ifany) which have resulted by combined action on the partof neighbouring unions in other large centres of population.From the financial statement of the Birmingham board ofguardians for the year ended Lady-day last I learn that thedaily average of workhouse inmates during the year was1651, the highest number that has been maintained since thecompletion of the infirmary. The average number of inmatesin the infirmary was 1040, as against 1088 in 19C4. The

expenditure on vaccination during the year was £19C3, being£ 205 less than the previous year. The lunatics chargeableto the parish cost B25,160. In the discussion on the state-ment it was stated that the workhouse numbers had in-creased 36 per cent. and the expenditure less than 35 percent. during the last seven years. The Aston board of

guardians has practically decided to purchase WhittonHall as a home for " ins and outs " children. The buildingwill cot Z2650 and it is expected to provide accommodationfor 80 children. The Birmingham board of guardiars havedecided to seek an expert opinion as to the marketable valueof the proposed site at Summer Hill for a home for "ins andouts. ULUja.

A Milk Problem at Wolver7ia,,)77_vton.A case of considerable interest to farmers and dairymen

was brought before the stipendiary magistrate of Wolver-

hampton a short time ago. A dairyfarmer was chargedwith selling milk from which 20 per cent of the originalfat had been abstracted. It appeared, however, from theevidence that samples of milk taken directly from the cowand examined at once showed the same deficiency of fat, sothat there was no question of improper treatment of the milk.It was further shown that the afternoon and evening milkwas considerably richer in fat than was the morning milk, thecows being milked three times a day. The case was, ofcourse, dismissed.

Handsworth Health Report.The medical officer of health of Handsworth has just

presented his annual report. The births registered duringthe year were 1436 ; of these, 755 were males ar d 681 werefemales. The birth-rate was 23 - 4 per 1000. The death-ratewas 12’ 2 per 1000. The infantile death-rate was 133 per1030. The epidemic death-rate was 1 3 per 1000. Interestingfigures are included in the report showing the rapidity withwhich the district has grown. In 1871 the population was

14,947 ; in 1904 it was 61,500 ; and it is now numbered by theRegistrar-General as one of the 76 great towns.

Scarlet Fever in Birmingham.Mr. Alderman Cook, presiding at a lecture lately delivered

on the subject of scarlet fever, gave some interesting informa-

tion concerning the disease in Birmingham. During thelast15 years the number of cases and deaths has been as

follows :-

The total number of cases was 35,053 and the total numberof deaths was 1720, the percentage of deaths to cases being4 - 9. As shown by the figures quoted, there had been a greatincrease of cases every sixth year-viz., in 1890, 1896, and1902. Although scarlet fever caused so large a number ofcases the deaths were not Nearly so numerous as frommost of the other zymotic diseases. During the pastten years the average number of deaths from thosediseases had been as follows : small-pox, 3 ; measles,226; scarlet fever, 121 ; whoo], ing-cough, 256 ; diphtheria,149 ; typhoid fever, 100; and diarrhoea, 698. The poorestwards in the city were not the districts where scarletfever was most prevalent. The children in the slum seemedto enjoy an immunity from the disease which the better-keptchildren in the other districts did not, but while the slumchildren appeared to be less susceptible they were at thesame time liable to take it in a more virulent form thanwere the others. 87 per cent. of the cases occurring inBirmingham have been treated in the isolation hospital.

Sept.19th.

MANCHESTER.(FROM OUR OWN CORRESPONDENT.)

" Beautiful Oldham."IN what may be called prehistoric times, before Oldham

existed (speaking Hibernically), it may have been, andprobably was, beautiful, but since man built tall chimneys,used steam engines, and burnt smoky coal lavishly the

phrase "beautiful Oldham" has been supposed to be ironicalor contemptuously satirical. But even in Oldham there isa craving after beauty and a society has been in existencefor the last three years and was mentioned in thesecolumns a year or two ago the object of whichis to make the ugliness of a manufacturing town less

ugly. Those who have ever been at an Oldham rail-

way station will remember the black unloveliness aroundthem, but at one of them they may now see " thewalls and pillars brightened by little wicker baskets filledwith vivid green." This has been done by the voluntaryefforts of the porters. One "court" in a slum of which thechief feature was an old midden, decorated with derelict potsand pans, is now a small green garden. Shrubs have

Telossomed in it and are tended by the boys and girls of thecourt who have by the influence of the society becomeso far civilised as to work with a will and to watchwith delight the growth of the young plants fromseeds of their own sowing and to fight for their

protection. This invasion of beautiful things into therealms of ugliness roused the envy and the anger of

neighbouring courts, and it was only after "fierce battles" "that the lovers of beauty were left to enjoy their handiworkin peace. These are illut-trations of the good that is graduallybeing done. Among the objects of the society are thepreservation of exstirg features which add to the attractive-ness of the town ; the utilisation of waste places for tree-planting, &c. ; the cultivation of shrubs and flowers in the

spaces adjoining public buildings, schools, and mills ; thecultivation of the love of nature and gardening in school