993PUBLIC HEALTH SERVICES.

by Dr. Boswell who explained that the prescriptionwas a recognised method used in hospitals, but understrict medical supervision.Breach of its rules is a matter which can be left

to the Central Midwives Board to deal with. Themidwife whose conduct formed the subject of the’inquiry gave her evidence with frankness ; she had

eight years’ working experience ; more than one

practitioner testified to her ability, and the jury’s:

verdict absolves her. Two general observations

may perhaps be added. Midwives who observe atreatment successfully applied by a doctor to onepatient should not assume too readily that theythemselves can safely apply it to other patientswithout supervision ; secondly, prescriptions are notmeant to be circulated like library books, least of all’when a breach of the Central Midwives Board’s rulesis involved.

PUBLIC HEALTH SERVICES

PAYMENT FOR ACCIDENT CASES AT

HOSPITALS.

UNDER Section 36 (2) of the Road Traffic Act, 1930,where any payment is made in respect of the deathof or bodily injury to any person arising out of theuse of a motor vehicle on a road, a sum not exceeding925 shall be paid to cover reasonable expenses at thehospital where treatment has been given, providedthat no charge has been made. Mr. W. Taylor, chiefpublic assistance officer to the Surrey County Council, Ipoints out that the numerous accident cases admitted to Surrey municipal hospitals fall into two classes:(a) those belonging to the county, and (b) those who Ihave a fixed place of abode in some other county orcounty borough. He suggests that all assistance Igranted to class. (a) should be " on loan ’’’ under theprovisions of Section 49 of the Poor Law Act, 1930.Each case reported to him would be considered onits merits, and in cases of probable long duration it might be advisable to make a charge and ’inot a claim on the authorised insurer. Class

(b) cases he would deal with under Section 80 of the Poor Law Act, 1930, which provides thatthe county or county borough in which they have a fixed place of abode should reimburse the ’,council in full in respect of treatment. Credit would be given for moneys recovered from theauthorised insurer. Such an arrangement wouldbe a mutual one with other counties and county ! liboroughs. The Surrey Council has decided to adopt the

procedure suggested by Mr. Taylor for a period of six months.

UNSOUND FOOD GIVEN AWAY AS PRIZES. AT a meeting of the Metropolitan Boroughs Standing

Joint Committee it was reported that unsound choco-lates had been given away as a prize for a winningticket at a recent entertainment in Islington. As aresult of a visit paid to the stall by officials of the local authority, several hundred boxes of chocolates were ’,surrendered as unfit for food and subsequently removed for destruction. The Metropolitan BranchCouncil of the Society of M.O.H.’s believes that aconsiderable amount of food is distributed in this way ;complaints of unwholesomeness have from time totime arisen, but as the goods are not exposed or

deposited for sale, Section 47 of the Public Health(London) Act, 1891, does not apply. The healthcommittee of the Stoke Newington Borough Councilis asking the London County Council to promotelegislation, by means of a clause in a General PowersBill, requiring that food given away as prizes or bytradesmen as gifts should, if intended for human

consumption, be regarded as food exposed for saleunder the section of the Public Health Act abovementioned.

INFECTIOUS DISEASEIN ENGLAND AND WALES DURING THE WEEK ENDED

APRIL 18TH, 1931.

Notifications.-The following cases of infectiousdisease were notified during the week :-Small-pox,163 ; scarlet fever, 1376’; diphtheria, 880 ; entericfever, 36 ; pneumonia, 1313 ; puerperal fever, 45puerperal pyrexia, 122 ; cerebro-spinal fever, 83 ;acute poliomyelitis, 5 ; acute polio-encephalitis, 2 ;encephalitis lethargica, 21 ; dysentery, 6 ; ophthalmianeonatorum, 131. No case of cholera, plague, or

typhus fever was notified during the week.The number of cases in the Infectious Hospitals of the-

London County Council on April 21st-22nd was as follows :Small-pox, 208 under treatment, 8 under observation (lastweek 190 and 7 respectively) ; scarlet fever, 1234 ; diph-theria, 1568 ; enteric fever, 26 ; measles, 146 ; whooping-cough, 432 ; puerperal fever, 29 (plus 15 babies) ; encepha-litis lethargica, 129 ; poliomyelitis, 2 ; "other diseases,"182. At St. Margaret’s Hospital there were 19 babies.(plus 8 mothers) with ophthalmia neonatorum.

Deaths.—In the aggregate of great towns, including-London, there was no death from small-pox, 4 (1)from enteric fever, 55 (0) from measles, 4 (1) fromscarlet fever, 34 (4) from whooping-cough, 35 (10)from diphtheria, 36 (7) from diarrhoea and enteritisunder two years, and 110 (11) from influenza. Thefigures in parentheses are those for London itself.The deaths from enteric fever occurred in Exeter;

Nottingham, and Bradford. Eight deaths from meningo-coccal meningitis occurred in London, 4 under 1 year,1 each from 1-2 years, 5-15, 15-25, and 25-35 years. Twelvefatal cases of measles were reported from Birmingham,7 from Sunderland, 6 from Liverpool. Leeds reported 4deaths from whooping-cough. Diphtheria claimed 9 victimsat Liverpool, 4 at Birmingham. The 99 fatal cases ofinfluenza outside London are scattered over 54 great towns :9 were reported from Birmingham, 5 from Leeds, and 4tfrom Croydon.The number of stillbirths notified during the weekwas 305 (corresponding to a rate of 42 per. 1000births), including 44 in London.

LANCASTER JOINT HOSPITAL DISTRICT.—Lancastertown council is applying to the Ministry of Health for a.

Provisional Order forming the boroughs of Lancaster andMorecambe and Heysham, and the urban district of Carn-forth, into a united district to be called The Lancaster andand District Joint Hospital District for the provision,maintenance, and management, for the use of the inhabitants.of the joint district, of hospitals for the reception of cases ofinfectious disease, including small-pox.

MIDDLESEX HOSPITAL.-The report for 1930 wasadopted at a court of governors recently. The number of.

patients admitted during the year (471 beds) was 6751, andtheir average weekly cost 1:5 4s. Id. The average stay was 22-49days and the total cost of each patient was 916 14s. 4d. The’number of new out-patients was 52,118, and the attendances,which numbered 234,869, showed a marked increase. Withmore beds opened and a larger out-patient department to-maintain, the expenditure amounted to £129,967. Theincome, thanks chiefly to some large legacies, was .8141,602,leaving a credit balance of £11,635. Prince Arthur of,Connaught, who presided at the meeting, said that thereconstruction scheme is nearing completion, but that themoney in hand is sufficient only to cover the cost of theframework, leaving approximately £245,000 to be found to.finish the work.