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accounts of the current year cannot be ready byJan. 1st, that only a formal application is to bemade before that date. This appears to be reason-able enough, and the rates proposed, if they do notcover the cost of treatment in an individualhospital, can presumably be refused by it withoutits incurring any blame or obloquy on that account.The charity accepting them will make a bargainwith the State under which it will be recouped upto a known figure but not beyond it. The maximumallowed for in-patients is to be 11s. per day paid upona sliding scale, varying according to the circum-stances of the hospital and its cost of maintenance.For out-patients the existing fiat rate of 2s. perattendance is continued, and in order to encourageevening clinics the Ministry guarantees a minimumtotal payment of £2 2s. per session per clinic, irre.spective of the number of attendances. Also, in thecase of aural or ophthalmic clinics, at which thenature of the disability requires active attention bythe medical man personally on each occasion of thepatient’s attendance, the rate of pay is to be 5s. perattendance as long as the number is below 12, andfor any number above 12 payment will be at therate of 3s. per attendance, while the Ministry willguarantee a minimum total payment of JE3 3s. persession per clinic.When we consider that a large proportion of

those permanently affected by wounds, or otherwisesuffering from disability due to the war, are under25 years of age, and that some of these may requireconstant or intermittent treatment during the restof their lives, we realise that the definite estab-lishment of a principle of national responsibilityfor their benefit has been just and necessary.These sufferers will keep alive tbe memory ofthe killing and maiming inseparable from war

in all our minds. They will form a classof patients who will recall to us what sciencedid to preserve life while the great strugglelasted, and may yet be called upon to do. Theletter of the British Hospitals Association informsus that the improved arrangement now enteredinto is the result of negotiations initiated

by it with the Ministry of Pensions, and it isto be congratulated upon what it has achieved.The sanction of the Treasury had not been obtainedwhen the Association’s letter was printed, but pre.sumably it will not be withheld in the circum-stances. It will remain for the Ministry of Pensionsto carry out its own conditions in a just and

generous spirit, asking only for such evidence ofcost as, to quote its own word, is "reasonable," andascertaining and fulfilling its obligations with" reasonable " promptitude.

SIMULATION AMONG PRISONERS OF WAR.

As the result of his observations in the prisonersof war camp at Celle (Hanover), which mainly con-sisted of officers, and in the adjacent hospital, inwhich Belgian, French, and Russian soldiers weretreated, Pellegrini 1 came to the following con-

clusions. Simulation among prisoners of war isvery uncommon. The rarity of its occurrence isnot due to fear of punishment or to a lofty moralstandard, but mainly to a peculiar state of anaphy-laxis or hypersensitiveness to pain and to the lackof physical and moral energy to which the prisonersoon becomes a victim. When simulation doesoccur it is only found in isolated cases, and hardlyever in epidemic form, as it is seen at the front.The methods employed are often extremely

1 Gazetta degli Ospedali e delle Cliniche, 1919, xl., 828-332.

common-place and indicate a puerile mentality,thus differing widely from the ingenuity of themalingerer attempting to escape from service.As a general rule there is a reluctance touse methods which require the endurance ofeven a slight degree of pain. Hunger strikes onlyoccur when the individual knows that it isalways in his power to make a recovery, owing tothe existence of a relative abundance of food.Cases of simulation are extremely rare unlessthere is a real illness prevalent in the camp.The principal diseases simulated by the prisonerswere tuberculosis, epilepsy, nocturnal enuresis, andankylosis of the limbs from immobilisation ; theproduction of bullous eruptions by hot fluids wasthe most obvious of the auto-mutilations.

EPSOM COLLEGE.

AT the same time as a wider culture is beinggenerally recognised to be desirable, the publicschool education which should ensure it is steadilyretreating from the grasp of those with moderatemeans. Our grandfathers, to whom we owe a debt ofnlial gratitude, foresaw this and founded, in the year1855, on the breezy Surrey Downs, and in pleasantproximity to a famous racecourse, a public schoolproviding, amongst other things, free education-together with clothing, maintenance, and pocket-money-for 50 necessitous sons of medical men.Sir Henry Morris, the present honorary treasurerof Epsom College and of its Royal Medical Founda-tion, in a letter this week exhorts the presentgeneration to emulate the generosity and foresightof their ancestors, and to give according to theirmeans to keep up and to extend the benefits of theFoundation. On p. 5 of our advertising columnsare set forth for all to see what uses will be made ofthe contributions sent to the treasurer. They willafford no mere gilt-edged security. The value ofthe training at Epsom College is sterling through =

and through. -

THE GENERAL NURSING COUNCIL.

ENACTMENTS for the State registration of nursesin all three constituent parts of the United KingdomhavebeenhurriedthroughbothHousesof Parliament.In each case the Act provides simply for the enrol-ment of names on a list, and leaves it to a GeneralNursing Council to define the standard of trainingand other important matters. The first EnglishCouncil to be appointed will held office for notless than two years and not more than threeyears, and will consist of 25 members, two to beappointed by the Privy Council, two by the Boardof Education, five by the Minister of Health afterconsultation with training authorities. The remain.ing sixteen members, also to be appointed by theMinister of Health, must be, or have been at sometime, actually engaged in nursing the sick, and theappointments will be made after consultation withthe Central Committee for the State Registrationof Nurses, the College of Nursing, the Royal BritishNurses Association, and other bodies desiring to beconsulted in the matter. After the first Council .has held office for three years the constitution willremain the same, except that the sixteen nursemembers will be elected by the nurses on the

register. The members of this second, and finallyconstituted, Council will remain in office for five

years. Since Parliament, when establishing anyState register, must safeguard the interests ofthose already in practice, there is a " loose "

clause in the Bill which covers the admission of