298 THE INTERNATIONAL MEDICAL CONGRESS.

great country may, we trust, be taken as already secured.One guarantee of this hopeful view being realised is to befound in the nomination of Dr. FLINT as President of the

Conference. Dr. FLINT is so well known amongst us, not

only by his works but by his genial and dignified presence,that the English profession will need no other proof of theoneness of the profession in both countries, both in its

spirit and its practice, than the selection by the AmericanMedical Association of this distinguished physician for thechair of the Congress. It will be the same in other

European countries. Dr. FLINT has not hesitated to takelong voyages in promotion of the international co-operationof the profession. He was as active at Copenhagen as inLondon, and we doubt not that the European response tothe American invitation will be wide and hearty. The little

differences which have arisen in America are such as the

near approach of the Conference will dispel or resolve.

Some of them are differences which will keep, and whichcan be postponed till after the Congress. The Congressitself will swallow many of them up, and give an over-

whelming exhibition of the unity of the profession, such aswill best at once answer and convert those who would break

it up into sections and cliques, or liberate any of its membersfrom those great traditions which have been the distinctionof the profession from the time of HIPPOCRATES downwards.There are, indeed, powerful attractions to draw members of

the profession over to Washington in 1887. The road is not

an untrodden one. Many of our brethren have already crossedthe water, and they bring back but one report of the greatnessof the land, and the hospitality and kindness of its people, andespecially of our medical brethren. Besides this, we need notremind our readers of the fact that medical art and science

are in a most active state across the Atlantic. The Americans

set us an excellent example year after year of disregardingthe sea and its sickness in search of knowledge, and to acquirethe last hints of Europe in art or science. They come so

freely that we are apt to think they are only learners, andnot teachers; but no mistake could be greater. They areprofoundly influencing both surgery and medicine, and ourown foremost leaders would be the first to admit their in-

debtedness to American physicians and surgeons in respectof details, and of boldness, in the improvement of instru-ments, in the great operations of surgery, in the additionof new medicines, and of enterprise in the whole field

of pathology and therapeutics.

Annotations.

PUBLIC HEALTH (METROPOLIS) BILL.

"Ne quid nimis."

FEW circumstances tended more to increase efficient

sanitary administration throughout the country generallythan the consolidation under the Public Health Act 1875 ofall the sanitary laws then in existence. But the metropolishas always had exceptional legislation, and this legislationis spread over a number of Acts, and is even contained inisolated clauses in general Acts, the result being that thereare but few persons who have a detailed and accurate know-

ledge of the sanitary law as applicable to London. TheGovernment have therefore done well to introduce thePublic Health (Metropolis) Bill, which is really an Act to

consolidate, with certain amendments, the Acts relating tonuisances, infectious diseases, and other allied matters in so

far as the metropolis is concerned. The principal mattersdealt with relate to public and private nuisances, offensivetrades, inspection and condemnation of unsound foods, water.supplies, isolation of the infectious sick, disinfection, &c,.and as regards some of these matters the sanitary authoritiesare invested with new powers. Concerning isolation arrange.ments in the metropolis, it is probable that the plan, whichwas adopted in 1883 and renewed in 188t, of vesting thumatter essentially in the hands of the Metropolitan AsylumsBoard, and this quite irrespective of the question of pauper-ism, will become permanent, for it is re-enacted in theproposed Bill, and it becomes increasingly evident that thesystem of multiple authorities dealing with precisely thesame question is not likely to ensure success. The duties ofthe vestries in this matter, however, are not done away with;but, as things now stand, it is to be expected that they will,apart from any great emergency, look to the Asylums Boardto do the work. In the face of any great epidemic, the pro-posed Bill will re-enact the various powers which now vsfin the Local Government Board as to issuing orders relatingto the speedy burial of the dead, house-to-house visitations,disinfection, &c., and the provision of medical aid for thesick. The Bill is not intended to become law this session.It will, however, now be printed and circulated, so thatit it

may be studied by those concerned in the health of the

metropolis, with a view to such suggestions as may tend tomake the consolidation effective.

INFECTIOUS HOSPITALS FOR SMALL TOWNSAND VILLAGES.

THE Local Government Board have recently issued twodiagrams relating to the provision of infectious hospitalaccommodation, and these, taken together with the re-issueof the official report on the same subject, go to showthaincreasing interest which is now given to the importactmeans of sanitary defence which adequate isolatiobaccommodation affords to a community. The official reportlaid it down as a principle that the permanent accommo.dation at each hospital centre should include provision forthe immediate isolation of two diseases in both sexes; and,since this has always been carried out by providing aseparate pavilion for each disease, the arrangement IIquestion necessarily involved the erection of two wardblocks in addition to the requisite administrative buildingsIn the case of small towns and sparsely populated districtwhere some four to ten beds alone were needed as a per-manent provision, this plan seemed altogether prohibitory,and hence we are glad to see that the difficulty has beculargely overcome in one of the diagrams in question, whichindicates the best form for a hospital building in the case ofsmall towns, villages. or public institutions. One wardbuilding alone is provided, and it consists of four rooms, arranged in two groups. Each set of rooms consistsofiward for two beds and of a nurse’s room; and whereas thltwo doors of the one set open into a covered verandah at

the front of the building, those of the other set opensimilarly at the back, and thus no commimicatinbetween the inmates of the one set with those ofthe other is possible, unless they make the tour ofthe building, a thing that can easily be prevented by mean;of proper administrative control. One diagram shows asmall administrative cottage for a care-taker, and it is sug-gested that the nurses should sleep in an upper floor of

this building ; but in case no such arrangement should be

practicable, a second storey containing a nurse’s sleeping-room is shown in the centre of the ward-block, and in ont’rto secure that infected ward air should not have access to