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overtures he repulses. During a temporary absence on

account of ill-health he is cheated out of his appointment.His closest friend is estranged through HELLMANN’S failureto satisfy wholly unreasonable demands upon his skill andthe death of his own child from diphtheria is regarded byhis neighbours as evidence of his incompetence. We are

introduced to cranks of all kinds except, curiously enough,the antivaccinationist who does not appear to flourish in

all parts of Germany. Against the various evil influenceswhich oppress him HELLMANN makes little headway andit is not surprising to find him describing himself "as aslave of that many-headed monster " the public or re-

garding the establishment of a species of trade union asthe only hope for the future of the medical profession.How many medical men in this country, with provocationshardly less real though not so sensationally accumulated asare the imaginary troubles of Dr. HELLMANN, have come tothe same conclusion. We cannot support the view wholly,because the trade union implies in its aims and workingsmethods which are not consonant with the position of a

learned profession; but we welcome the signs, which haverecently become more evident, that medical men in this

country are awaking to the need of organisation againstabuses. A perusal of " Aerzte" cannot fail to confirm the

reader in the opinion that this need is a real one.

The Fees of Public Vaccinators.AT a recent meeting of the Surbiton board of guardians

a letter was read, which had been received from the LocalGovernment Board, approving certain surcharges made bythe district auditor relating to fees paid to public vaccina-tors. The fees which have been improperly paid fall undertwo heads. A sum of more than £400 has been overpaidto public vaccinators for the revaccination of persons at

places other than their own homes and a small amount hasbeen paid for the revaccination of children less than ten

years of age. The letter of the Local Government Board, towhich body the question has been referred upon the refusalof the district auditor to pass the items under discussion in

auditing the accounts of the Surbiton board of guardians,is as follows: It appears that of the sums in question£453 18. represents so much of the fees paid to public vac-cinators for the revaccination of persons at places otherthan their own homes as exceeded the amounts payableunder the vaccination contracts. The remaining sum of&2 10s. represents fees paid for the revaccination of

children under ten years of age notwithstanding the

express provision in the Vaccination Order, 1898, that

no fee shall be paid for such vaccinations." With

regard to the first item the Vaccination Order referred

to in the letter of the Local Government Board laysdown that vaccinations and revaccinations performedat the patient’s home are to be paid for at not

less than 5s. apiece, while vaccinations performed at thevaccinator’s surgery or elsewhere are to be paid for at

not less than 28. 6d. apiece. That is to say, the rules fix

the minimum sum which is to be paid in each instance, andsuggest that a smaller amount should be paid when thepatient comes to the vaccinator than when the medical

man has to go to the patient’s home. A form of con-

tract to be used by boards of guardians and publicvaccinators is appended to the rules and calls atten-

tion to the distinction between the two classes of fees bydealing with them separately. This form is presumablyfollowed in all cases and the amounts to be paid are thusfixed beforehand by a contract which binds both parties.With regard to the revaccination of children under ten

years of age, it may reasonably be contended that all

successful vaccinations should be recognised as being forthe public protection and should be paid for accordingly, butapart from such an argument the rule says clearly that"no payment shall be made in respect of the revaccinationof any person who shall be less than ten years old or who

shall have been previously revaccinated within a period of tenyears." Moreover, the contracts of public vaccinators,if they follow the prescribed form, call attention to the point.The matter is one of considerable importance to medical

men who are public vaccinators and who during an outbreakof small-pox may have a large amount of work thrust uponthem with little time in which to discriminate and to con -

sider the conditions under which they work. In the case at

Surbiton sums ranging from a few shillings to over B100

will now have to be refunded by those who have receivedthem in good faith, believing themselves to be entitled

to them and trusting to the knowledge of the officials

paying them. The latter should no doubt be sufficientlyaware of the rules governing the work of the publicvaccinators not to make payments which will be disallowedbut this will be no consolation to those who have to endure

the worry and irritation inseparable from such proceedingsand who will be expected to repay money possibly at an

inconvenient time. Others in their position can, however,take warning and protect themselves by carefully observingthe regulations that govern the appointments which theyhold and their contracts with the boards that employ them.

Annotations.

IS THE DELAY IN INTRODUCING MEASURESFOR THE BETTER CONTROL OF OUR

FOOD-SUPPLIES JUSTIFIABLE ?

" Ne quid nimis."

To this question we may as well reply at once and

emphatically in the negative. It is now more than three

years since the Departmental Committee on Preservativesand Colouring Matters issued its report. The report waspublished early in 1901 and one of the most importantrecommendations in it was the formation of a court ofreference to which all food questions should be referred,and it was further recommended that no preservativesshould be allowed in milk and only small specifiedquantities of boron preservatives in cream, butter, andmargarine. Up to the present time no legislation has

been made on these recommendations. Why is thereso much time wasted in making statutory these recom-

mendations, which were everywhere regarded as a sourceof protection to the consumer and as fair and reasonable ?Again, the Royal Commission on Arsenical Poisoning issuedits report on Nov. 6th, 1903, and recommended that theLocal Government Board should appoint a special officer

who would make inquiries for the Board into the processes

1068 T

of manufacture of foods in this country and who wouldalso obtain information as far as possible concerning foodsimported from abroad. Has this been done or was this

recommendation of the Royal Commission on Arsenical

Poisoning looked upon as frivolous ? On Feb. 5th Mr.Walter Long, in the House of Commons, replying to a

question upon the subject, said that he was considering thematter and in his opinion a conference of representativesof the Government departments concerned should be heldbefore a decision was arrived at. Where is this conferenceof representatives? Has Mr. Long given to it any furtherconsideration ? The necessity of a food authority has beenadmitted and its formation recommended by both the RoyalCommission and by the Departmental Committee, and byourselves again and again, but no further steps have, so faras the public know, been taken in this most important matter.The necessity for such an authority is emphasised when wetake into consideration the increasing numbers of newmanufactured foods which are constantly being placed onthe market day by day. It is open to anyone to make anyfoodstuff and to place it on the market without any further

protection to the public than that provided by the Sale ofFood and Drugs Act. As the report of the Royal Commissionon Arsenical Poisoning points out, knowledge is required asto the question whether thee new food preparations do ordo not contain substances deleterious to health or in the

process of their manufacture may be liable to contamina-tion by any deleterious substance. "These foods are soldunder fancy names without any indication of the ingredientswhich they contain or of the substances used in their

manufacture, and in present circumstances hardly anyofficial control is exercised over the purity of these pre.parations." When samples are taken under the Sale ofFood and Drugs Act, which as a matter of fact is seldomthe case, the analyst has no means of knowing whetherany particular deleterious matter should be looked for.That the present administration of the Sale of Food and

Drugs Act is not all it might be was shown by theoutbreak of arsenical poisoning owing to the contamina-

tion of beer in the neighbourhood of Manchester. The

arsenic in the beer was not discovered by the revenue

officials or by the public analysts but by a medicalofficer of one of the large hospitals. Since this epidemicthe Board of Inland Revenue has caused, under an

order from the Treasury, numerous samples of brewingingredients to be taken at breweries and examined in

order to see if they are free from deleterious substances.It is of the utmost importance to the community that thisprocess of inspection should not be confined to beer and beeringredients only. Under the Factory Acts men are protectedas far as possible from accidents by well-guarded machinery ;boys are not allowed to work until they have passed amedical examination by the factory surgeon. Surely in asimilar manner their food should be open to inspection, asrecommended by the Royal Commission on Arsenical Poison-ing, to see not only that the finished product is free fromdeleterious substances but that in process of manufacture

proper precautions are taken to safeguard the ingredientsused in its manufacture from contamination. It is wellknown that the arsenic in the beer in the Manchester epi-demic had its origin in the use of arsenical glucose madewith arsenical sulphuric acid, but we have since learnt, espe-cially with regard to the arsenical poisoning cases at Halifaxin 1902, that arsenic can also get into beer through themalt. Now at the present time sulphuric acid is used in thepreparation of many other food ingredients besides glucoseand malt enters largely into the preparation of many patentfoods now on the market, so taking only these two foodingredients it shows very clearly the necessity for some formof supervision or inspection of foods beyond that of theSale of Food and Drugs Act. The United States of

America are fully alive to the necessity of having a’

Pure Food Law and a Bill has just passed through Con-gress the provisions in which are said to be, first, the fixirgof standards of foods and drugs as to their purity, strength,and character and the defining of what .hall be con-

sidered adulteration or misbranding of foods and drugs ;and secondly, the prohibition of inter-state commerce in

such misbranded’or adulterated articles. It is scandalousthat this matter should be so lightly considered by theGovernment and made the subject of mere pourparlersbetween the various Government Offices. The question ofthe health and the well-being of the community is concernedand the reform indicated should be commenced without

delay. -

THE SUNSHINE OF SPRING.

THE brilliant sunny weather of the present week wouldseem to have come to assure us that we have at lengthemerged from the long, dark, cheerless days of winter.The effect upon the well-being and the physical aspect ofthe individual is quite noticeable. The winter pallor is

gradually yielding to a healthier-looking colour, faces evenlook sunburnt, and the general personal appearance is thatof renewed vigour and health. Improved tone and nutritionare moreover disclosed in the temperament as well as in thephysical appearance. All this is the beneficial work of a

bright spring which brings especial joy after the dark,devitalising influences of an unpropitious winter. About thistime of the year the sun in England exerts its maximumactinic strength ; the solar rays are more active in the monthof May than in any other month. They effect profoundchanges in plant lite and a priori they must have an im-portant influence upon the physiological processes of theanimal body. Both analytic and synthetic processes aregoing on in the full flood of chemically active light in

which the spring sun’s rays are peculiarly rich. It would be

difficult to estimate the good which a bright, sunny springbrings in its train, what epidemics and disease it mayavert. It is fatal to the materies morbi which may havesurvived through the dark days of winter; it purifiesthe streams, it vitalises the air, and it revives and

healthily stimulates the great circulatory processes ofboth vegetable and animal life. In short, light is life,yet of the exact nature of the action of light we

know very little. Modern discoveries are teaching us thatthe whole interest of nature lies in the perpetual degrada.tion and change that are going on not only in the animal andvegetable kingdom but in the mineral kingdom also. The

very enjoyment and agreeable stimulation which we experi.ence from the spring sunshine are gained at a cost whichmeans the sun’s degradation. When that degradation is com-plete, life, as we now understand it, must cease. For aughtwe know the sun may be a vast mass of radium which inthe process of breaking down gives out heat and light, newelements appearing which possess no radio-activity at all.How immense and almost inexhaustible this energy mustbe is well illustrated in the apparent permanence as regardsthermo- and photo-activity of even a thousandth of a grainof radium.

___

"TESTING THE EYESIGHT OF A NATION."

THE reception given by the Times to the circular underthe above heading, which was sent by the Optician andPhotographio Trades Revierv to the press generally, has

in no -,mall degree fluttered the Volscians of the opticalCorioli. The Times, in very plain language, condemned theproposed "I diploma of the Spectacle Makers’ Company asa document which would be used to mislead the public andpointed out that the relations between errors of refractionand troubles arising from, or connected with, disease were so