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Sundays, all practically without exception, are urgent andrequire replies. Even although handed in at eight sharpI seldom get them before nine, and frequently myreplies do not reach the original senders until the Monday.I should imagine that Sunday telegrams are few in numberbut great in importance, and that their necessity is like the

necessity for carrying a revolver, as described by the Yankee,"You don’t want it often, but when you do, you want itd-d badly." I have always had to work myself onSundays, and am consequently far from being an advocate ofany increase of Sunday labour, and I am consistent in this,as you will see by the fact that, though obliged to work onSundays myself, I have only twice in my life had out onSunday a trap or my car for purposes other than professionalones, and I have never played golf on Sunday either on apublic course or our own private one.

I am, Sir, yours faithfully,Sept. 7th, 1909. ASYLUM SUPERINTENDENT.

WALES.

(FROM OUR OWN CORRESPONDENT.)

Porthcawl Rest.THE additions to the Rest at Porthcawl, to which reference

has already been made in THE LANCET,1 were formallyopened by Lord Tredegar on Sept. 7th. The two new wingsgive accommodation for 40 men and 12 women, so that therecan now be received into the institution at one time 110 menand 52 women and children. The extensions also include a

receiving-room, an office for the matron, a board-room andsecretary’s office, and a large assembly hall. The entirebuilding has been lighted with gas, and gas and steam

cooking appliances have been installed. In addition, thelinen store-rooms are now heated with hot-water radiatorsand hot or cold sea-water can be supplied to the baths. TheRest has grown from very modest beginnings, having beenfounded in 1862 by the late Dr. James Lewis of Maesteg,who at first rented three small cottages. 12 years laterland was given by the late Mr. C. R. M. Talbot upon whichthe existing buildings were erected, and extensions have beenfound necessary every 10 or 11 years. Some five years agoarrangements were made for the reception in the Rest of con-valescent patients from the Cardiff Infirmary during thewinter months, with the result that not only have the patientsthemselves been benefited but the beds they have vacated atCardiff have become available for other cases. The Rest has

always been well and economically managed, and there is nodoubt that it plays an important part in lessening the sick-ness and death-rates of the county of Glamorgan. Thehealthiness of the district may be estimated from the factthat the death-rate of the Porthcawl urban district in 1908from all causes was only 8 per 1000 and the infantile

mortality-rate only equal to 65 per 1000 births, while thezymotic death-rate was 0 - 29 per 1000.

Housing in Tredegar.At a recently held special meeting of the Tredegar urban

district council it was decided to require the owners of 21cellar dwellings to make such alterations to them as wouldsecure for the occupants more sanitary conditions. Theowners of other houses were urged by the council to carryout alterations without compulsion. This action of thecouncil was no doubt prompted by the report which wasrecently made to the Local Government Board by Dr. J.

Spencer Low as the result of an inspection which he madeof the district. If no more vigorous action than thisis taken by the sanitary authority very little improve-ment will result, and that there is room for a greatdeal of improvement is abundantly evident from thefacts disclosed by Dr. Low. The manner in which slumareas and slum landlords have been created in Tredegar is notvery creditable to those concerned. It appears that localcolliery companies have sold old houses to the tenants andalso to speculators, and the latter have taken advantage ofthe absence of workmen’s houses in the district and haveraised the rents of the older houses they have thus acquired.Reference was particularly made by Dr. Low to 82 cellardwellings, 41 of which were actually erected for habitation

THE LANCET, April 24th, 1909, p. 1221.

as separate dwellings. They contained a living room andtwo bedrooms, the back room being in total darkness andthrough ventilation entirely absent. Other dwellings to thenumber of 36 were originally used as underground kitchensin connexion with houses above them, but they had been con-verted into separate habitations. These were also described asdamp, dark, and insufficiently ventilated. Another class ofdwelling which should receive the attention of the districtcouncil is the back-to-back house which has been transformedfrom a through or single four-roomed cottage by merely stoppingup the doorway between the front and back rooms. Onetenement is then served by the original staircase, while theother has provided for it a staircase little better than a ladderleading from the ground floor to the bedroom above. AsDr. Low points out, the result is that there is no efficient

through ventilation, the smallness of the tenement leads togross overcrowding, and as the occupiers of the fronttenement are completely cut off from convenient access tothe closets and slop drains, waste water, &c., is thrown intothe gutter. Such dwellings as these are let at a rental of 4s.or 5s. weekly. About 100 new houses are being built in

Tredegar yearly, and although they are usually let at a

weekly rental of 7s. 6d. they are said to be much sought afterand are occupied as soon as completed.

Sept. 14th. _________________

SCOTLAND.

(FROM OUR OWN CORRESPONDENTS.)

Glasgow Cancer Free Hospital.TO-DAY the first portion of the new extension to this

hospital was opened. The hospital when first institutedconsisted of an old manse and two adjoining villas, whichwere altered and reconstructed as far as the money availableat the time would allow. These buildings up to the presenthave served the purpose fairly well, but owing to lack ofsufficient accommodation for nurses and patients it was

decided to erect a new hospital which would embodyall the latest improvements in hospital construction.As the site of the old hospital, both as regardscentral position and elevation, was excellent, the new

hospital when complete will occupy the same site. Thefirst portion of the hospital now completed comprises anew block of wards and nurses’ home. The block of wardscontains four large wards, each of eight beds, and thearrangement of these is such that each ward obtains lightfrom three sides, but principally from the south. At thesouth end of each ward there is a large balcony, and attachedto each pair of wards there is a duty room with ward kitchenand linen cupboards close at hand. In addition, a largeconvalescent ward has been provided and nine single wardsfor patients requiring quiet and isolation. The floors of thewards are fireproof and of pitch pine. The dados are tiled tothe height of six feet, while the upper walls and ceilings are inKeene’s cement, enamelled, and with all angles rounded. Thebeds are of the balcony pattern, so that the patient canbe wheeled to the theatre or douche room with the minimumamount of disturbance. The sanitary annexes are in towerscut off from the wards, and all the fittings are of the mostapproved pattern. An interesting feature is the presence oneach floor of a douche room, fitted with sterilisers, &c., towhich it will be possible to take, if necessary, any patient inher bed to get dressings or douche applied-a great advantagein some foul-smelling cases of cancer. The corridors are

wide, with floors of terrazzo. An electric lift is provided forpatients, while electric service lifts are placed at convenientparts of the building. In the basement is a large and well-fitted kitchen, one of the features of which is an electric fanto prevent the odour of cooking from travelling throughthe building. The roof of the block is flat and divided intotwo parts. On one portion which is open to the air patientswill have the advantage of sitting out when convalescent.The other part is roofed with glass, and is so arranged andfitted as to make a most excellent research laboratory. Thisdescription applies entirely to the new east wing. In thecentre the old building still stands, but is now to be takendown to provide room for more wards. The west wing,which is now complete, is a block of three storeysforming the nurses’ home. Here each nurse will havea separate bedroom, and a dining-room is provided, and also

894

a suite for the matron. Behind the nurses’ home, iia separate building, is the laundry, which is suppliefwith a destructor, steam steriliser, and all the latest electri(fittings. In another separate building are a small mortuar3and chapel. It may be mentioned that the heating throughout is by the I I Reek " system, by means of radiators easilycontrolled. Now that patients can be moved into the newwing work is to be started at once on the remaining centra:portion of the building, which will contain the new operatingtheatres and should be completed in six months. The wholf

hospital then will be one of the most complete and up-to-dateof its kind, thanks largely to the efforts of Sir George T.Beatson, chairman of the building committee, and Dr.Donald J. Mackintosh, whose services as consulting expertwere secured by the committee from the outset.

Ner/) Infirmary for Perth.A meeting of the subscribers to the City and County of

Perth Royal Infirmary was held in the council chambers onSept. 6th, when it was unanimously agreed to approve of thesite in Western-avenue, Tullyhuish, for the erection of a newinfirmary, and the directors were authorised to acquire it onthe terms mentioned in the draft agreement submitted. Asum of over .615,000 had been subscribed for the re-

construction of the present building, but it was ultimatelydeemed advisable to go on with the erection of a new

infirmary altogether on a different site. The directors havereceived a sketch plan from Mr. James Miller, A.R.S.A.,architect of the Glasgow Royal Infirmary (at present beingre-erected) and the designer of the Glasgow exhibition build-ings. Mr. Miller estimates that a modern, up-to-dateinfirmary, with 120 beds, administrative block, and offices,can be erected on the site for E36,800. To meet that thereis at present in hand or available a sum of £ 32,000. Anendeavour is to be made to induce contributors of L6532to the reconstruction scheme to allow their contributionsto go to the new building, and if that is done there will besufficient to meet the cost of the new infirmary.

A Medical Practitioner’s Bequests.The late Dr. Ferguson, Loftus House, Broughty Ferry, and

formerly of Port Maria, Jamaica, has left a fortune of about.655,000. A very large part of his estate falls to be dividedas public and private bequests. Ministers and churches bulk

largely among the beneficiaries.Sept. 14th.

________ _______

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

The Home Treatment of Tuberculosis in Dublin.THE quarterly meeting of the Hospitals’ Tuberculosis

Committee was held on Sept. 9th, Sir Arthur Chance beinin the chair and Lady Aberdeen being also present. Th<

report of Mr. J. T. Daniel, who had been placed b3the Women’s National Health Association at the disposalof the committee to attend cases that were receiving ncmedical aid, was considered most satisfactory. It was

felt that in this way a great want was being met. A

report was made on the work done during the last six monthsby the tuberculosis jubilee nurses working in Dublin. 247

patients have been attended ; of these 125 were old casesand 122 were new cases. In all 3504 visits were paid to thepatients’ homes. Almost two-thirds of the patients themselvessought the nurses’ aid, and patients’ friends frequently askfor the disinfection of their homes. This is not to be wonderedat when it is realised what is done for the patients throughthe Samaritan Committee in addition to the actual nursing-help and advice being given which enable patients to carryout medical orders in their own homes. 63 families receivednourishment; 39 families received clothes, shoes, bedding,&c. ; ten families’ rent was paid while the bread-winner wasunder special treatment. 87 children of parents suffering fromtuberculosis were sent to the country through the fresh airfund; three families of children were boarded out while themothers were in hospital; 60 rooms were disinfected; fivefamilies were removed to more healthy homes ; for seven

patients work had been obtained ; and 16 patients had beenadmitted to Newcastle. There were 66 families occupyingone room, and in 35 families more than one member wasaffected. The total earnings of the families attended when

the bread-winner is ill is estimated not to exceed 5s. a weekL on an average. Mrs. A. M. Sullivan presented a report on: the work of the Samaritan Committee, and the nurse

7employed by the Terenure branch of the Women’s National-Health Association also made a report showing that the

7people amongst whom the nurses work are commencing to7understand something about the nature of the disease, andare themselves assisting in trying to stamp it out.

Cork Council and the Notifiecction oj Tuberculosis., At a meeting of the Cork corporation on Sept. 3rd the

report of the medical officer of health recommending theadoption of Part I. of the Tuberculosis Prevention (Ireland)Act, 1909, was considered. This part provides for the com-pulsory notification of pulmonary tuberculosis. On themotion of Sir Edward Fitzgerald, and after a long discussion,the council decided not to adopt Part I. of the Act in spiteof strong expert advice to the contrary.

Mullingar Asylum Committee: Claim of Surcharges.At the monthly meeting of the joint committee of the

Mullingar District Lunatic Asylum, which took place lastweek, a letter from the auditor of the Local GovernmentBoard was read asking why a surcharge of &pound; 415s. made byhim at last audit on some members of the committee had notyet been paid, and intimating that legal proceedings wouldbe taken if the amount were not promptly lodged to thecredit of the accounts by the members who had been sur-charged. A letter was then read from one of the latterstating his refusal to pay. The Chairman (in reply to theMost Rev. Dr. Hoare) explained that a contractor, whosetender for the supply of drapery goods had been acceptedby the committee, subsequently refused to fulfil his con-

tract and was released from his obligation by the com-mittee. The goods were then ordered from anothercontractor, who charged the trade price, which was

somewhat higher than that in the tender originally ac-

cepted. When the question of payment was brought underthe notice of the official auditor he surcharged the difference.The chairman expressed the opinion that it was a monstrous

proceeding on the part of the Local Government Board notto remit the charge. He did not mind the amount, whichwould be about .61 each, claimed from the members sur-

charged ; it was against the principle that they shouldprotest. After expressions of similar opinions from variousmembers, and after it was pointed out that the first contractorhad not signed a bond, the chairman moved:-That this committee is of opinion that the surcharge in this case is

unjust, and we recommend the three members surcharged to refuse topay; and, furthermore, this committee refuses to accept responsi-bility where there are bona fides and an intelligent, honest effort to dowhat is right between the ratepayers and contractors.

This motion was unanimously adopted.The Local Government Board and the Salary of the Medical

Officer of the Trim District School.The committee of management of the Trim District School

has received a letter from the Local Government Board ask-ing for information on the reasons which influenced theboard of management in again increasing the salary of themedical officer, Mr. G. McManus, and pointing out that " norecoupment can be made in respect of any additional salaryowing to the operation of Section 6 (1) of the Local Govern-ment (Ireland) Act, 1902." The committee has unanimouslyrequested the Board to sanction the increase. The factswhich formed the basis of the request were that Mr. McManushas been medical officer of the school from the time of itsinception 19 years ago, during which time he treated over2250 children for various illnesses, including cases of oph-thalmia, measles, scarlet fever, whooping-cough, bronchitis,&c., and that only five children died during that time,the deaths being mostly due to tuberculosis; and thatthe medical officer has by his attention to the welfareof the children prevented any serious developments ofdisease occurring amongst them, thus saving the board ofmanagement a considerable amount yearly in connexion withnursing. It was further pointed out that it is now seven

ears since the medical officer got his increase of salary andhat the earlier age at which children were sent to theschool necessitated more frequent attendance than formerly,with the added consideration that as the medical officerleems not to be entitled to a pension on account of his

:ervices, we consider it only fair that he should be given a